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HomeMy WebLinkAboutT12N R3W SEC 33 LT 111 S99't --------------------------------------- L MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES /Jr,//.''~,'~4 ~/1'/~'~,~~)f''C '~y T~ SEPTIC ABSOflPTION ~ad,.s~ TANK FIELD WELL LEGAL DESCRIPTION I Township, Range, Secnon AS-BUILT DIAGBAM (Show Iocabon el wen. septm symem, prope~y lines, Ioundat~on, Manuiacturer Capamly tn ganons ~ ~ ~ Material , NO of Compadments TYPE OF SYSTEM .... ~TRENCH CBED ~ W. DRAIN ¢ OTHER /~'¢( ~epth to pipe bo[tom t~om ~o[al depth from original grade ~ ~ ~ ~ , ;01 added above ong~ai grade Gravel dep[h beneath pLpe ~ ~ Gravel w~dlh t ~~ Grave, length ~f FT ~/ ~T Date Inst lied WELLS ~ PRIVATE ~ OTHER f~ ~¢ ~' Total Depth ~ased to P~. ' / Classinoahon (A,B,C) Total Dep~ I cedily that Ibis inspection was pedormed according Io all Heallh Depa~ment Approval: ~~~ ~ate::~0 72-013 13/851 ALASKA er/uiRorlmenTAL COI~TROI. S(!RUICE!S, lilt. ~n~ineerinq 6 ~nuironmenlol Studies MUNICIPALI~ OF ANCHORAGD DEPT. OF HEALTH & ENVIRONMENTAL PROH~CTION 0'1990 RECEIVED ( 907 ) P. O. BOX 240668 Anchopa2-e , AK 99524 0668 279 5553 ;2** FAX (90'7) 276. 8706 Sel) tembep 10, ] 990 Municipu} [ty af Anchopage I)epaptment of Ilea]Eh & Ilulnan ScPvJl:es 825 [, Stpeet, Fifth Floo~' Anchorage, AK 99510 ATTN: Robbie Robinson RE: A po~'t ion of I, ot: 1 ] ] T12N R3I¢, Sec, "'~ Deap RobbJe: C, Reid, ,]r P E , D E E i. ()i i t::i 'ii]!iii [ I'::' il:Cf' i.,., :il:,N[: F:' ~iYEiil:i::Fl,, ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 Z O. Z .J ~L Z 0 0 F- D 0 Z .J 0 O. D H 0 H 0 ~- H Z ~ 0 0 Z ~J / 0 PERFORMED FOR: LEGAL DESCRIPTION:. ,~//? 8 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES SOILS LOG -- PERCOLATION 'rEST 10- 11 12 13 14 15 16- 17- 18 19 20 Township, Range, Section: 7-/~/*J .,~ .?'/..-a -¢1~..~ SLOPE WAS GROUND WATER ENCOUNTERED? .. iF YES, AT WHAT DEPTH? /~) 'Y'/ Deplh te Waler After SITE PLAN Reading Time Net Time Depth to Water PERCOLATION RATE .4~ {minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~' ~-~- FT AND __¢'-J FT cz" Net Drop p ,// PERFORMED BY; __ ~//' /~/ r~/ I CERTIFY THAT THiS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE~ _ 72-0D8 (Rev. 4/85) 0 ~ ~, go.oN