HomeMy WebLinkAboutT12N R3W SEC 22 LT 23 E2L?
I
~ MUNICIPALITY OF ANCHORAGE
DE[ TMENT OF HEALTH AND HUMAN SERV~ ~S
Environmental Health Division
825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720
.. ' ~)N-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
IN,me DISTANCES
C,,-~,~ /A t R~??,~ / ~o'~,,*~l ~ SEPTIC ABSORPTION
~d~ .... TANK FIELD WELL
po go~ t~'~O~ A~ 1~ c~qsI[
t~o~sc.m.~moN LOT LINE 40~ + 401 ~ ~
~ownsh~p, BanOe, Section
~S-B~ILI D~G~ ~Show Iocabon of well. septic system, property hnes,
TANKS
SEPTIC
HOLDING
T
TYPE OF SYSTEM
~TRENCH ~ BED ~ W. DRAIN ~ OTHER
80 FT ~ FT
I L6~ 8QFT ~O~q c I F~JO / ~
WELLS
~ PRIVATE ~ OTHER (Identify)
REMARKS:
~CcS
Municipal and Slate ¢idelines in elfecl on I~}S ~ale: 7- ~ J~ ( ~ /Z8~
Health Depa~ment Approval' Mg ,a: ~, , ~ () , , Date:'- / i ~/
72 013 (3/85}
DEPARTMENT OF HEAI_'I"H AND ENVIRONMEN'TAL PROTECTION
El;?.5 L STREET, ANCHCJRABE, AK 99501
264-4720
FtERM ! T NO:
DATE ISSUED:
: '7/18/86
~-iF F L ]...fin [ .
CONTAEYT PHONE
CRAIG/AL RA]::'F'E/DOOLEY
P,,O,, BOX 1:1.2062
ANCHOIRAGE, AK 9951!
344.- 1086
LEGAL. Dl=cC~..[r.
LOT SI
I.,. X
SUBD I V I S I ()lq:
SECT I ON ~ .~n.~. TOWNSH I F'
4A SQ.F:T~ OR ACRES
LO]':,=°'~'.,.. ELOCI'... NA
12N RANGE: ..:,W
I...ist. r.~d belo~,~ ar'e the options available t.o you in designing ycmu' sep'Lic:
system,, C:hc)Qse 'Lhe opt. ion Cha'L best Fits your' site.
DEPTH -['0 F'IPE BOTTOM (F'I'~) 4,,0. 4..0 4.0
GRAVEl_ DEF:"FH (F'T~) 11,,0~ 0.,5 3.5
'I"O]'AL DEF'TH (F'T'~) 15~, (~ 4,, 5 7,, 5
GRAVEL W ]: DTH (F'['.) 2., 5 :1.9~ 0 5.0
GRAVEL L. ENGTH (FTc) 25,,0 38,,0 58.0
GRAVEL. VOLUME (CU. YDS. ) 26,, 7 . 26.8 4,3.0
TANK SIZE (GAL.S) 1,()0Ch, 0 '~'~' 1,000~0 -~'~' 1,C)00,,0
SOIL RA']'IiqG (SQ.F:T. /BR) 268 239 268
~.;;- 'I'ANK MUST HAVE AT L[:~..C~T TWO [L, IIh~-..~IMEPlT,
ceP'L:i, fy t. hat.:
1. I am Camilian wi'Lb t. he pequiPement, s fop on-sirra sewer's anc[ wells as set
[c¢-t.h by t. he Munic:ipality of Anchor-age (MOA) and the Sta'~e oF Alaska~
2~. I w:i. ll Jns'Lall 'Lhe system in accol-dance wit. h all MOA codes and [.egulat. ions,
and J.n compliance with the design c:pit, er'ia of this pel~mit..
3. ]: ~J.]l adhE, pe to all MOA and Stat. e (:)~' Alaska nequir~ements fc~r' the set back
dist. ances {?om ai'ly exist, irlg well, wastewat, eP disposal system or pub].ic
sewer'age s~yst, eat on this op any acljacent or neapby lot.
q. i under'stand that. t. his peru'nit is va].id fop a maximum Df' 2 bedpooms and
any enla?gemer~t will Pequipe an adclitional perunit,.
I !::: A
'THEN
I....IILL NOT' BE: APPROVED WI THOUT AFl EL. ECTRICAI.. INSPECI"ION REPOR'F;
IEI_ECTRIC~L. WORK MI.IST BE DONE BY A i21:(]ENSED EI_EC'TRICIAN.
L. iF'T STA'F!C.'N IS IN,":FTALL. E]} IN AN AREA COVERE.D BY MOA BUIL. DING CODES,
(1) AN EI..IECTRIE:AI- PEF:;.'MIT' AND :INSPECTION MUST BE OBTAINED; (2) AS-BLIIL.TS
AND (:5) ]'HE
AI::'PL. I CAN l":
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
/.-%
PERFORMED FOR: ~..'t-~ ' ~,~
LEGAL DESCRIPTION:
3-
4-
5-
6-
7-
8-
9-
10-
11
13-
14-
15-
16-
17
18
19
20
serf',1 .r , ,,ff y
DATE PERFORMED: 7 J~,/c~f ~'8o/
Township, Range, Section: --?~ 7-~ T- f2-CJ~-~k/- Sf~='--C.- ,2:;~
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Ooplh to Water Aiter 5'h'l( al~/ J,,t?' /'-/
Monitoring? Oale:
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
a- J.t7 / ~-~ ~ ,~ $~'
,zo,¢ to ,5-$~ ,
~ 3 ~ /o .fro
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER --
TEST RUN BETWEEN /'~ FT AND ~//g-~ FT
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT/~N THIS DATE, DATE:
72-008 (Rev. 4/85)
ALASKA ENVIRONMENTAL
· , CONTROL SERVICE~}NC.
1200 West 33rd Avenue Suite B
ANCHORAGE, ALASKA 99503
, . Phone 561-5040
CHECKED BY DATE
SCALE