HomeMy WebLinkAboutT14N R2W SEC 11 LT 39 REMSf..C II
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(~ 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
PHONE [~'N EW
MAILING ADDR~S
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS
Absorption area ~ , PERMIT NO,~ 03(/°
~ DISTANCE TO: / /~0' [ ~' Dwelbn9
~ ~ Manufacturer Material No. of compartments
/~ 0 16 HOMEMADE:
a I Well Foundatio~ / Nearest lot line/o [ PERMIT.~O.
~ DISTANCE TO: Length of ea~ [~e/ i Total length o lines Trench width Distance between lines
__~ N°' °f lines / ~ ~¢ inches
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
Building fou ation Sewer line / Septic tank Absorption area(si_
OTHER
PIPE MATERIALS
INSTALLER
(Rev, 3/78)
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVlRONIVlENTAL PROTECTION
825 L, Street, Anchorage, AIaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR:
· EGAL OESCR,PTIO.
1
5-
8-
13
14
15
16
17
18
19
20
COMMENTS
SOILS LOG
72-008 (6/79)
[] PERCOLATION
TEST
DATE PERFORMED:
SITE PLAN
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE / ¥i/¢'~ (minutes/inch)
TEST RUN BETWEEN FT AND FT