HomeMy WebLinkAboutT12N R3W SEC 33 LT 8 REM
MUNICIPALITY OF ANCHORAGE
D£ :ITMEN'r OF HEALTH AND EtUMAN SER ES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl. INSPECTION REPORT
Address
LEGAL DESCRIPTION
TANKS
SEPTIC
DISTANCES
SEPTIC ABSORPTION WELL
TANK FIELD
LOT LINE ,~5~'" ,~ ~ '~
/wt,,/ 'r, x
HOLDING
TYPE OF SYSTEM
TRENCH ~ BED L] W. DRAIN [] OTHER
~ . ~0/ 8QFT ~/~
WELLS
PRIVATE
J~ OTHER fldentifv)
REMARKS:
FT
Dale
[~unJcipg 3fid Slate guidelines in effect oll Elate: _
Health Department Approval: _/ -- -- ' --
ENGIN REAR'S SEAL
PERFORMED FOR:_
LEGAL DESCRIPTION:
Municipality of Anchorage
DE'PARTMENT OF HEALTH & HUMAN
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
Township, Range1 Section:
REID, JR. ~.
1
2
3
4
5-
6
7
8
9
10
11
12
13-
14
15
16
17
18
19-
20-
COMMENTS
SLOPE
SITE PLAN
fleplh lo Walnr Aller~
Monitoring? ~'' 7
WAS GROUND WATER 4~...~
ENCOUNTERED?
IF YES, AT WHAT / SL
DEPT,? /0
E
Gross Net Depth to Net
Readin9 Date Time Time Water Drop
tl/~,~ i. 9~I1.~'/ /oz.,l~/o$~~__ /~ ,g/// ,~2 -.~ , 7.~
~, / ,o~,/.- /¢9',1 I ,07- ,5'~ . o°
J.( Iod'/- I~Y'/ ( ,0'~ - · &O ,07
PERCOLATION RATE /~'~ {m,nutes/inch) PERC HOLE DIAMETER --
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: ~-.Z--/- ~'~
72-008 (Rev. 4/85}
/ / / I / /
MUNI(~
Depth of well ............ ~:8~ Feet .............
Distance to water while pumpzng ......... ~0..Ze~ ......................... at rate
of ......... ~.~.200. .......... .......... _ gallo~ per hour.
Description of format~Q~;~; ,..' from to
C,'~ -,.,,- ,._E~avel ,..~,~.,-~,V'~,M..'" O'~ 9'
~' ~ '" "~'~?~'""' ' 9' 1~'
Har~ pan
Quick sand
--Hard pan ' :] :'..:..~:}¢.~r:.::.. litt' 170'
Yellow cLq7 & ~raveI :. ";.' :~f.Z'}? J:'j ~0[. 187
_H~d p~ .
certify the above true and correct.
Driller
Drillers Co-Op
Spenard, A. laska
We advise you to record this certificate ~vith your warrantv deed