HomeMy WebLinkAboutT13N R1W SEC 15 Lot 7
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
LOCATION
DISTANCE TO:
Lie y in gallons
Well
DISTANCE TO:
IF HOMEMADE:
Inside length
Dwelling
Material
Foundation Nearest lot Pine
DISTANCE TO:
NO. of lines Length ~]e~c~, Total len,~_~th * Trench width,.~(:~ inches
Top of tile to finish grade Z~ I Material beneath tile
inches
Length Width
Type of crib Crib diameter
Well
DISTANCE TO:
, Crib depth
Building foundation
Depth Driller
Class
DISTANCE TO:
PERMIT NO.
No. of compartments2
Liquid depth~
PERMIT NO.
Material Liquid capacity in gallons
Distance between
Total effective~_~,~ ~,~abs°r~n area
PERMIT NO,
Total effective absorption area
Nearest lot llne
Septic tank Absorption area(s)
Distance to lot llne PERMIT NO,
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER ~,,~,,~_~
REMARKS
!~'i'F::CE[i]'J' :: F.~NC)'[C)F~:F.iE;Ei "-~""
?. E!EX.':Z ~
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
~ SOILS LOG
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
4
5
6
7
DATE PERFORMED:
SITE PLAN
10
11
13-
~14-
15-
16-
17-
18-
19-
20-
No.
~z~oq%oo-A oi¢ Ro~
COMMENTS
WAS GROUND WATER ~ ~ S
ENCOUNTERED7 I~,O ~
P
E
IF YES, AT WHAT
~EPTH?
Gross Net Depth to Net
~Reading Time Time Water
Date
Drop
PERCOLATION RATE
TEST RUN BETWEEN. FT AND
C ERTI IED
(minutes/inch)
__ FT
DATE: