HomeMy WebLinkAboutILIAMNA ACRES LT 1
MUNICIPALITY OF ANCHORAGE
. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
~ ENVIRONIVIENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
· ' ' IPH~ON~ I ,L~,NEW
M~LING ADDRESS
LOCATION NO. OF BEDROOMS
Wel~ _ / Absorption e~ Dwelling / PERMI~NO.
~ ~ Manu facture/]~ ~ Ma~ria ~ ~ ~ No. of~partments
q/~ gallo ns I FH O ME MADE:
Inside length
Width
Liquid depth
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
0 Z ~ ~anu~acturer
~ -- ~ ~at~ial Liquid capacity in gallons
~ ~h95c¢:' FOU,~O~ Nearestlotline, ,t,~ PER~O.
D STANC TO:
, Trench~d~ Distance between lines
~ ~ ~ Top of tile to finish grad, ~,/ Material "oeneath tile
--.O[ ~2~ inches Total ef~tive
absorption
area
~ Length ~ Width Depth PERMIT NO.
~-~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ DISTANCE TO: Well Building foundation Nearest lot line
~ Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
MATERILS TEST RAT/~ ' _ /~
REMARKS
AP~ /~P, I ~~ DATE LEGAL
/. 3~78)
/
D~te Drilled~
11-18-83
W~L LOG
Static Water Level
Draw Down N/A
46
feet
feet
Gallons Per Minute
Total Feet of uasing
20
66
?y~e Material Drilled~
0 feet to 30 Silty Sand
30 feet
55 feet
to 55 Sandy Clay
to 66 Gravel w/water
to
tO
%O
Hefty Drilling
S.R.A. Box 1553 H
Anchorage,Alaska
99507
Permit ~
Applicant:
Location:
Legal Description:
MUNICIPALITY OF ANCHORAGE
~ Health and Environmenta?
Department
825 ~ Street, Anchorage, AK. ~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND/~R ON-SITE SEWER PERMIT
Mailing Address:
Phone Number:
d(l~,~ ~creS, ,
~rotection
Lot Size
Type of Soil Absorption System Is:
Trench: ~ Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: ~ _ Soil Rating(sq.ft/br) ~-~-/
The Required Size of the Soil Absorption System Is:
DEPTH C~,, LENGTH ~ GRAVEL DEPTH ~-~ WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a 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 gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HfrL-'-Dt-NG) TANK SIZE = l~('~z_ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31~ 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence i-s remodeled to include more that ~bedrooms.
Signe~: Issued by: ~-~ ~~
Applicant
Date: (~-
SWP/024 (1/81)
Depar~_:t o~ R~alth and ~nvironme. ~a~ ~rote~tion
264-4720
D~PTH _.. ...... LENGTH ~ GRAVEL D~PTH <-~ WtI)TH '
· he leuqth d~e~a~.o~ i~ ~h~ long~h(tn ~eet.) o~ the ~rench or dra~field, -?
.-dep~li of a ~rt~noh or pit i~ the d~an~ between tire 0urface og ~ho qro~
the bo~om of ~he ~xcava~ion(in feet). Th,~r~ is no sa~ width for
,The grave~ depth %~ ~O m~ d~kh of 9~'ave~ betwee~ ~ha ou~:fal~ ~ipe '~
the ~ttom of the egcavat~on(in f~t).
~ * REQUIRED 8EPTIC(~I~) TANK $IZ~ = ~~ GALLONS ~" '-'::
Po~mit appJ. icant ha~ th~ r~po~ib~l~ty to i~fo~ ~his depart~on~ dur~g
.... ' * * ~0(2) INSPECTIONS
~ck~il~g of ~y ayat~ withOUt
public Wel~. ~in~_m,~ diet.ce f~ a ..]
I c~rkify ~ha~:
(1) :~ ~ f_am, iliar, with
met forth by ~he
(2) ~ wAlL ~n~ta%~ the
MUNICIPALITY OF ANC'HORAGE
DFpAITTMENT OF HI=A/TH AND FNVIF;ONMFNTAL PROT£CTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
~ S~)I LS LOG
PERCOLATION
TEST
PERFORMED FOR:
DATE PERFORMED:
LEGAL DESCRIPTION: TI~.,.,,,,,,,. Ac.,-¢s T,--~
2
3
4
5
6
7
8
9
10
11
12
19
2O
Reid, Jr..t
2251-E
COMMENTS ~9;\ :~ co.'~-¢¢~
PERFORMED BY: ~q~r~ ~
~ -- -1-HI
SLOPE
WAS GROUND WATER S
ENCOUNTERED? "~o L
O
P
E
IF YES, AT WHAT
DEPTH?
r~w~z~ l~oh _ST ~3 o~
SITE PLAN
Gross Net Depth to Nel
Reading Date Time Time Water Drop
fl~% -- . ~o -
~sI i,~ .~H
Io I~ -- .~ 3 --
PERCOLATION RATE "~"~ '1~'- (minutes/inch)
TEST RUN BETWEEN ~ FT AND ,.~ '/2. FT
CERTIFIED BY: DATE:
72-OOB (6/79)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:__
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
DATE PERFORMED: ~// [~ /C~'~
SLOPE SITE PLAN
WAS GROUND WATER S
ENCOUNTERED? L
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
q~5o I I ,50 ,1~
PERCOLATION RATE 1 ~ (minutes/inch)
TEST RUN BETWEEN ~ FT AND ~ '/Z. FT
PERFORMED BY: ~ff q~,% CERTIFIED BY: DATE:
72-008 (6/79J
APPLI(' NT FILLS OUT UPPER HAl ONLY
Buyer
Address Zip Code
Realty 0o. & Agenl Phone
Address Zip Oode
8treel Looali~l
~Single Family
Wa~er Supply
~lndividual ATTAOH WELL LOG. A well log is ~equired for all well8 drilled ~inoe dune 197~.
~ Oomm~ni~y For wells drilled prior ~o thai d~te, give well deplh (~ttaoh log if available).
~ Publio Ulili~y
8ewer Disposal
~ Publio UHlity When Oonneoled to Publio Ulility:
~ Holding Tank
NOTE: THE IN~PEOTION FEE MUST AOOOMPANY EAOH RE~E~T BEFORE ~OOES~ING OAN BE iNiTIATED.
Time Time Time Time
Inspector Inspector inspector Inspector
Field Notes:
(/) APPROVED BEDROOMS 'CONOITIONS OF APPROVAL
I i D~SAPPROVED
I I CONDmONALARPROVAL/
Soils Rating Date ~wer Installed Well To Absorption Area ~ / Well Log Received
72.023 (3/82)