HomeMy WebLinkAboutT15N R1E SEC 1 E2NE4SE4
~ MUNICIPALITY OF ANCHORAGE
) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
~ ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage. Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF BEUROOMS
Well · ~ ~ t -~OO /AbsorPtion area Dwelling ' PERMIT NO.
2 ~ DISTANCE TO: ~~ ~ t 3 ~
Liq. capacity in gallons Inside length Width Liquid depth
/~ ~ O IF HOME.DE:
, ~ Well Dwelling PERMIT NO,
~ Well~°undat[°n ~ ~ ~ PERMIT NO.
~ DISTANCE TO: ~'~ ' Nearest lot line '~
~ ~ ~ ~o. of lin,s / Len,th o, oach~ , Total Ion,th of I~nes~ Trench mi~ Distanco bet~,,n lin,s
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
m Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to Jot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
SO~ L TEST RATING
INSTALLER
APPROVED~ DATE LEGAL RZ~ ~¢ y* 5~-7¢ K~.
72-013 (Rev. 3/78)
t-iL~FI -r C '[ F;FIL I T'¢ L]F RIqE:HF~RFI~SE
DEF'RI::;:Ti"ENT ):'~' HEFILTH FIND ElS/I F; 0N "IENTFIL ,~:ROTEr:T 1' 0N
825 STREET.. RNE:HGRRGE. fl[:' 9. ;31
'" Zt, 4-472M
C,l'4--S ::E TE __--.E[,4EF. F'ERI'"I Z T ~i
PFLI ~HNT tltL-. CHEEL.¥
L ClC:R T I ON
LEGRL T:L5N F.:±E .=-,EL..
GENERRL DELIYER'¢ E~,.LLTNII RE
2L ~£'/~1 ~'/o/ LOT SIZE '999'9'99 SQURRE FEET
_ -"--' '" q "-'"- " IS:
T"r'PE rIF SnIL HE, z, uF.F] I_N :,T~TEI1 TF. EN_.H
MR;";IMUM fJUtlEEF.. OF BEDROL1MS = 4
~, _-, ..~ FT,."BR .:' = ':'~
:,uIL RRTING '-- , ....
THE REQUIRED _.I~..E OF THE '--]1IL 8BSORF'TION :,-r_TEft IS:
[:" E F' T F~ = ":' '" " --- --
._. LEi'-~t3'TH= 3:4 ,_3F:R"¢EL IH EF TH-- '=;
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF Fl TRENCH OR PIT IS THE DISTFlNCE BETWEEN THE SURFRE:E OF THE
GROUND FIND THE BOTTOM OF THE ENCFlVFlTION (IN FEET).
THERE iS NO SET WIDTH FOR TRENCHES.
THE GRFIVEL DEPTH IS THE MINIMUM DEPTH OF GRFlVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCR~FlTION (IN FEET).
F-:Eg.,LIt ! F-:E[:, KEPT ][ C: TRf~]F] q I ZE= 125C~ .... - ':
- ,, ~ .... ,:' F~FM THIS [:,EPRRTMENT DURING THE
PERMIT HFFLI_.HNT HH..-, THE RESPriNSIBILIT'¢ TO IN --.:
INSTRLLRTION INSPEr:TtONS ~Z~F RN¥ [ELL-=, RD,TRL:ENT TO THIS PF.:OPERTY RND THE
~LIt,IBER OF RESIDENCES THRT THE NELL NILL
T 1t.4 ~3,-. .... ¢_-:" .') :[ [¢4 S F" E C: T I C, 1'-I S RF:E F' E ¢-, It. _. _11 :[ RE[:"
E, Md...FILLIN~ OF FINY :~z, TE~I NITHEIUT FINFlt_ INSPECTION BND ItFFR~vML B'¢ THIS
DEPFIRTI"IEI-,]T WILL E:E :UB.J'EL.T TO PF.u_,EL. UTIuN.
MINIMUN DISTFINCE BETWEEN FI NELL FIN[:, FIN'¢ ON-SITE SEWFlGE DISPOSFIL SYSTEM tS
J. 00 FEET FOR Fl PRI'¢FlTE WELL OR J. 50 TO 200 FEET FROM Fl PUBLIC WELL DEPENDING
UPON THE T'fPE OF PUBLIC WELL
I"IINIMI.JM DISTFlNCE FROM Fl PRI',,,'FITE WELL TO Fl PRIVFlTE SEWER LINE IS ;25 FEET FIND
TO Fl COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS I'"lFl'¢ FIPPL'L SPECIFICFlTIONS FIND CONSTRUCTION DIFlGRFlMS FIRE
FI'¢FIILFIBLE TO INSURE PROPER INSTFlLLFlTION.
F'EF-:FI :[ T E. -.F I F::ES E:,EC:EI"IE:ER __--<-1. - '--
I CERTIF~ THFlT
t: I FIFI FFIMILIFIR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH B'¢ THE MUNICIPFILIT'¢ OF FINCHORFIGE.
2.: I WILL. INSTFlLL THE S','STEM IN FICCOR[:,FINCE WITH THE CO[)ES.
Z-:: I UN[.,ER. STRN[:' THRT THE ON-SITE SEWER SYSTEM MR¥ REQUIRE ENLFlRGEMENT IF THE
RESIDENCE tS REMO[:,ELED TO INCLUDE MORE THFlN 4 BEDROOMS.
PERCOLATION
TEST
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: -/f~ ~ ~ cfqC.~f~Ly DATE PERFORMED: /t'I~V' / ~:*/~ /
LEGAL DESCRIPTION: ~'/~f~r~'~/~' /~-,~/~'~' ,,,~,~_~/I ~/5~ /~/~ .~C/~ (/~'~/.2~-~//~
1
2
5-
6-
7
10-
11
13-
14-
15-
16-
17-
18-
COMMENTS
PERFORMED BY:
SLOPE
WASGROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
'.~O
~ 3-~G 'Z lo p~ S ~/~."
PERCOLATION RATE ON' ~- (minutes/inch)
TEST RUN BETWEEN ~ , FT AND 7 FT
CERTIFIED BY: ~ DATE:
72-O08 (6/79)