HomeMy WebLinkAboutT15N R2W SEC 25 LT 57as-'
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C~'~--~ 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
NAME PHONE
~UPGRADE
LEGAL DESCRIPTION
LOC~N NO. OF B ROOMS
~' DISTANCE TO: IWell /~ O Absorplonarea / [ Dwelling ~ ~ , PERMITNO. g/
Mate'~l
Liq. c?~itrcn~llons IF HOME,DE: Inside I~ngtL Width Liquid depth
50 ~ DISTAN~O:~ I Well ..-~ _Dwelllng~ .~E~IT .~0'
~%~ DISTANCE TO: Well ~ Foundation~ /~ , Nearestlotlin~ /0 ' PERMITNO,
-- Trench wid h Distance between Ji
~ ~ ~ No. of lines Length of each line/ Total length of lines
a ~ ~ Top of tile to finish gradem ~ Material beneath tile ~ inches
¢ DISTANCE TO:
OTHER
PIPE MATERIALS
SOl L T EST RATING
INSTALLER ~5~ ~ ~
R~ARKS . , ~ /
72 013, ev. 3/78)
PERMIT NO.
RPPL I C R]-,IT
', '.OCAT I ON
,EGAL
DR','ID HCCFILL
_1 N
Ti..,N R2W _,EL ....
LOT 57 ' I=' c .'~
E:O::~; 7:461 E.R.
LOT _,I-E
4~:,._,e, SLqURRE FEET
"T'PE OF '= ..... '-' ' -'
.:,-IL RBSORF'TION :,~=,FEM I:,. TFEN_.FI
IRXIMIjM NUME:ER OF E:E[:,RCIOMS =
SOIL RATING ,'"-;~ FT. ER,-
THE RF=f)IJ'FF'ED .:,I~E. OF THE =,uIL HB_,uRFIIuI~ _,~r_TEfl IS:
THE [_ENGTH DIMENSION IS TNE LENGTH (IN FEET.'." OF' THE TRENCH OR DRRINFIEL. D.
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION <IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRR'v'EL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN ']'HE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCAVATION ,.';IN FEET).
THI_, DEPARTMENT DURING THE
PER. MIT RFFL_..HN'f THE RE..,FuNbIEILIT~ TO INFORM "=
IN_,fHLLH ION IN=,PEL. TIuN_, OF RN"r' HELL_, MB.fML. ENT TO THIo, FFEFEF. T'r RND THE
NIJHBER GF REc, ICENLE_ THFtT THE WELL WILL SERVE.
~FI-.-~O .:: ::' ::, .'~ I"-~.::.F'EE _- r X b,~'.i__ RF."E RE,;."LJ :E. F-:E[:,
BA::KFILLING OF RN'¢ _,Y_,TEH WITHOUT FINAl_ IN:,FE_.TIEN RND RPPRO'v'RL E:'¢ THIS
DEPARTMENT WILL E,E =,UBJE_.T TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL RND RN'¢ ON-SITE SEWRGE DISPOSRL S'¢STEM IS
t00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC 1.4ELL DEPENDING
UPON THE T'¢PE OF PUBLIC WELL
MINIMUM DISTANCE FROM FI PRIVFITE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNIT'¢ SEWER LINE Iff., 75 FEET.
OTHER REQUIREMENTS MRb' APPL~'. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS RRE
AVAILABLE TO INSURE PROPER INSTALLATION.
F"EF-:~--1Z T' E...-..F ][ I-.E--. [:.EE:E~'-IE:EF-: 2-::_1_.. 19.=1.
I CERTIFY THRT
i: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTN B'¢ THE MUNICIPALIT'¢ OF RNCHORRGE.
2: I WILL INSTALL ]'HE S'¢S]'EM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER S~'STEM MR'¢ REQUIRE ENLARGEMENT IF ,THE
RESI[:,ENE:E IS REt,IOD~LED TO INCLUDE MORE THRN. 2: BEDROOMS.
APF L I C:R~DRVID MC:CALL
O & E ENG,NEERING & DEVELOI~ MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
R,ssell Oyster Earl Ellis
694-2774 SOIL LOG 688-2280
Performed for: Name: /YL~, <~,~3d/-~3 '~J. //~ ~,~cc.- Tel. No
· Mailing Address: ~~-~/ ~"~g_,~U..~'~-~d~-'~ b/z.,
Legal Description: ~_~r" ~'-7/, ~'"~ '~'''~ '"'"~-~tlL ~ ~
Depth (feet)
Soil Characteristics
2__
3__
4__
5__
6__
7__
9__
PLOT PLAN
PERC. TEST
16__
Ground Water Encountered: Yes No
~ If yes, what depth
Proposed Installation: Seepage Pit__ Drain Field
Comments: