HomeMy WebLinkAboutT15N R1W SEC 2 SW4
NAME
MUNICIPALITY OF ANCHORAGE .--, (~'~'-/~ ~:~ ~
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION /___.~'TgGT'/M ~'.~- /
ENVIRONMENTAL ENGINEERING DIVISION ~_~?_~'~.~--w.._ ~
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE I. []NEW
LEGAL DESCRIPTION
/ ~:z WaR
~--~ DISTANCE TO: ] ~ !
Liq, capacity in gallons
Absorption
~rea
! /
NO. OF BESOMS
PERM NO,
WellF HOMEMADE: IDn~iel ii iingth
~ //~"'-~ No, of co,.~artments
Liquid depth
PERMIT NO.
DISTANCE TO:
Well
DISTANCE TO:
Length
No. of lines ! li~e
Top of tile to finish grade
Width
Crib diameter
Foundation ,~_~j ,,
Total lan h of I'nes
Material beneath tile
Depth
Crib depth
Type of crib
Dwelling
Material~-~--~--~l~___
W dth
Material[~/~
Nearest lot line /t
I Trench width
· ~'~ inches
inches
Well Building foundation
DISTANCE TO:
Class Depth Driller
Bul]ding foundation Sewer llne
DISTANCE TO:
OTHER
Liqui~ capacity in gallons
PERM T NO,
Distance between lines
Total effective absorption area
PERMIT NO.
Total effective absorption area
Nearest lot line
Septic tank Absorption area(s)
Distance to lot llne PERMIT NO,
PIPE MATERIALS
SOl L T EST RATING
INSTALLER
REMARKS
""J~ ~J I J-- '"'7--d)
APPROVED
DATE LEGAL
PERMIT NO.
DEPRRTHENT OF HERLTH RND ENVIRONMENTRL PROTECTION
825 'L' STREET,. RNCHORRGE, RK. ~501
RPPLICRNT
LOCRTION
LEGRL
HERBERT L FRSSLER
PETERS CREEK
SM i74 SEC 2 Ti5N ~LL~.
CFILI~IRK
LOT ,.,I,=E
210000 SQLIRRE FEET
TVPE OF SOIL RB$ORBTION SVSTEM IS: TRENCH
MRXIMUH NUMBER OF BEDROOMS = 4
SOIL RRTING
THE REQUIRED SIZE: OF THE _Oil. RBSORF'TION _,V_TErl IS:
THE LENGTH DIMENSION I~ THE LENGTH (IN FEEl') OF THE TRENCH OR DRRINF'IELD,
THE DEPTH OF 8 TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION KIN FEET).
THERE IS NO SET WIDTH FOR TRENCEIES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETMEEN THE OUTFRLL PIPE
8ND THE BOTTOM OF ~WE EXCRVRTION (IN FEET),
PERMIT RPPLICRNT FIRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING
IN~TRLLRTIDN INSPECTIONS OF 8N¥ WELLS RDJRCENT TO THIS PROPERT~' RND THE
NUMBER OF' RESIDENCES THRT THE WELL WILL SERVE.
THE
8RCKFILLINO Of RNY SYSTEM WITHOUT FINRL IN~,FEC~I~N RND RPPROVRL BV THIS
DEPRRTHENT HILL BE ~LIBJECT TO PROSECLITIEIN.
MINIMUM DtSTRNCE BETWEEN R NELL RND RMV ON-SITE
i00 FEET FOR R PRI'./RTE NEL,L.~ OR
;tSO TO 200 FEET FROM R PUBLIC WELL. DEPENDING UPON THE TVPE OF PUBLIC NELL.
OTHER REQUIREMENTS NRV RPPL. Y. 5PECIFICRTIONS RND CONSTRUCTION DIRGRRNS RRE
8VRILRBLE TO iNSURE PROPER INSTRLLRTION. -
I CERTIFY THRT
~: I RH FRMILIR~ WITH THE REQUIREMENT~ FOR OH-SITE SEWERS RND WELLS RS ~ET
FORTM BY THE MUNICIPRLITV OF RNCHOEFIGE,
2: I MILL INSTRLL THE S¥~TEH IN RCCORDRNCE WITH THE CODES.
~: I IJNDEESTRND THRT THE ON-.,S~TE SEHER SVSTEM HR~/ REQUIRE ENL. REGEMENT IF THE
RESIDENCE I~ REMODELED TO INCLUDE MORE THRN 4 BEDROOMS.
O & E ENG.,qEERING & DEVELO, MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster Earl Ellis
694-2774 SOIL LOG 688-2280
Mailing Address: ~)' ~'~7: /~)~ j
Performed for: Tel. NO
Legal Description:
0
4
5
6__
8__
9__
10__
PLOT PLAN
11__
12__
13
14__
15__
16__
PERC. TEST
Ground Water Encountered: Yes__No J If yes, what depth
PropoSed Installation: Seepage Pit Drain Field
Comments:
Performed by:.~~ ~ ~-/~4~ Date: