HomeMy WebLinkAboutT12N R3W SEC 33 LT 111 S99't
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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
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PERFORMED FOR:
LEGAL DESCRIPTION:. ,~//?
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Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
SOILS LOG -- PERCOLATION 'rEST
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13
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16-
17-
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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)
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