HomeMy WebLinkAboutT12N R3W SEC 15 LT 43
-~- ---.~ MUNICIPALITY OF ANCHORAGE
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
~ ]PHONE ~ NEW
MAILING ADDRESS
~ ~ ~"s o $o/c,~ ~- -Dr-
LEGAL DESCRIPTION
~ ZISTANOETO;~I-~ lkiq.____,ufacturerca ac'ty in-(ale ser~m IWel' .~- , s-~ ~Absorpti°naroalnsidelen~t,~--~ PWidthD~ellinglanal' ~+~ ~--
Well Foundation / Nearest Io~ line
DISTANCE TO:
Tota~ ~ Trench wid
NO. OF ~¢ROOMS
PERMIT NO.
Liquid
PERMIT NO,
PERMIT NO.
--
Total ef fe4tive
PERMIT NO.
DISTANCE TO:
DISTANCE TO:
Crib diameter
Well
Depth
foundation
OTHER
PIPE MATERIALS
INSTALL~
REMARKS
Crib depth Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line PERMIT NO.
Sewer line Septic tank Absorption area(s)
AP RO ED ' DATE LEGAL
72-0-"~( Rev. 3~78) ~'
PERHIT NO,
DEPFIR].'MEN'F i_'iF HEFIL'FH FIND ENVIRONNENTFIL PROTECTION
825 "L-" STREET, FINCHORFIGE~ FIK. ~)~5~
264.--472~
,:: 888104 )
FIPF'LICFIN]' RONFtLD W. BCIESE
LOCFI11'ION 9]SS:~ CRRLSON RE.',
LEGFIL. LOT 4~ ~:L~ Ti2N :R~I,~
TYPE OF SOIL. RBSORP'FION SYSTEM
IS:
NUMBER OF BEDROOMS
882:0 SOLFIfQ E)R
LOT SIZE
TRENC:H
SOIL RRTING ,:]Sr..'! F'T,,'BR ]:, ,=
THE LENG11'H DIMENSION IS THE LENGTH '::'~) OF THE
4]~E:00 S;QL.IFIRE FEET
TRENCH OR DRRINFIELD.
T'HE ()Er'TH OF FI 'FRENCH CIR PI]' IS THE DISTFINCE I.:~E'THEEN THE SURFFIC:E OF THE
GROUND RND THE BO'r'roM OF THE EXCRVFITION (IN FEET).
'THERE IS NO SI-Z]" HI[:,TH FOR TRENCHES.
THE GRRVEL DEF'TH IS THE f,IINIMLIM [:,EPTH OF GRFIVEL BETWEEN lq'HE OUTFFtLL PIPE
FIND THE BOTTOM OF' THE E,.'qCFIVFITION (IN FEET).
F~:E']L]L~Li I F--:tEE[:, SEF'T :i: C TF-~I'-oIK "--=; Z ZE-'=~ :Z,-~i~E'~ ,3FIL..L
I='ERI',IIT FIPPLICFINT HR.?, 'f'HE RESPOhlSIBILIT~r' TO INFORM THIS DEPFIRTMEN'T [:,URING THE
INSTFILLFITION INSPECTIONS OF RN¥ WELLS FID.IRCENT TO THIS PROF'ERT~? FIND THE
IqUM[?,ER OF RESIDENCES THFIT TPIE 14ELL HILL SERVE.
........... -F Ib.I (], ,:: 2:_' :) :Ii 1'-4 '_-'.:; F' E:- C: T I C! I~,! 2-:; FI F:I IF_-:._' F.: IFC (;i. I.J ::ii F.: E [:
IBI=IC:KFILLING OF FIN¥ S"r'DTEM WITHOUT FINFIL INSPECTION FIND 8PPRO'.,,'FIL IB'¢ THIS
I}FPRRTMENT HILL BE SUBJECT 'TO PROSECUTION.
MINIMLIM DISTFINCE BETWEEN R WELl_ I=IND FINY ON-SITE SEWFIGE DISPOSRL S'.PSTEM IS
::L00 FEET FOR FI PRI',,,'FITE HELL OR :I.!50 TO 200 FEET FROM FI PUBLIC HELL DEPENDING
ur'ON THE TYPE OF PUBLIC WELL
MINIMUN DISTFINCE FROM R PRIYFITE 14ELL TO A PRIVATE SEHER LINE If'-; 25 FEET RN[:,
'fEI FI COMMUNIT"? SE. PiER LINE ]:S 75 FEET.
OTHER REI]].UIREMEN'TS I'IR'T' FIPPL'.r'. SPEC:CFICFII'IONS FIND CONSTRtJCTION DIFIGRFIMS FIRE
FI',,,'FIILFIBLE TO INSURE PRCIPER INSTFILLFITION.
F:' [~: Fi: l-dl I "T' E :.~-::: F" I] R E]S [) EE IFS' L:] Ii-'1B EE I~: --.]:~ :l..- :]._ ::--'¢ F£c ~3
I CERTIF'T' THR'F
±: I Flfd FRMILIFIR HITH THE REf;!LIIREMENTS FOR ON-SITE !.:;EHEERS FIND HELLS FIE; SET
FOR'FH B~r' ]''FIE MUNICIPRL. IT"¢ OF FINCHORFIGE.
2: I 14ILL INSTFILL 11'HE S"r'STEM IN RCCORDF:INCE HITH 'rile CODES.
]~: I IJNDEF.:STFIND THFIT THE ON-SITE SEWER S'T'STEM fdFl'.r' RFQLIIRE ENLFIRGEMEN11' IF THE
RESIDENCE IS REMO[:,EI..ED TO INC:I_I..I['.,E MORE ]"I.-IFIN ~: BEDROOMS.
V4. 0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AN[) ENVl RONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99B02 ?.76-222~
SOILS LOG- PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13-
14-
15-
16-
17-
18-
19-
20-
COMMENTS
DATE PEREORMED: .,~,~/'. 2?:/?80
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Readin§ Date Gross Net Depth to Net
Time Time Water Drop
~ 4/gS~ 6 ~ ZO ~M $,(o3" ,,.
_ ~; 4o ,, B .SB"
',~,:;~ ~ ~ ~: co ,, 4,0 ~"
,~ 1100" 4.Z~"
PERCOLATION RATE ~'~ (minutes/inch)
TE -r RUN BETWEEN __ ~ . FT AND ~ FT
PERFORMED BY: ~, L. ~__ L ~t~_-~t7 ~na/~t~s;/"%/r%. P~" CERTIFIED BY:
72 008 (7/76)
DATE: