HomeMy WebLinkAboutMCKINLEY HEIGHTS BLK 1 LT 22.17_.-
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
MAILING ADDRESS
LOCATION
DISTANDE TO:
Manufacturer ~7~L~¢~ ~.~ /-
Liq,
IF HOMEMADE:
DISTANCE TO:
Manufacturer
DISTANCE TO: ~
NO. of lines / Length of e~c.~/l,~ne ,~--
gra
Width
Inside length
Dwelling
Depth
NO. OF BEDROOMSc_~
Material
Trench ~/~d ~t;;~ -f
~'~//. ~ inches
- '( inches
P E R¢I T~)¢ (.~,~
No, of compartments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
Length
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
PERMIT NO.
Class Depth Driller Distance to lot line PERMIT NO.
Building foundation Sewer line Septic tank Absorption area(s)
DISTANCE TO:
OTHER
PIPE MATERIALS
sol L TEST
/ao W
INSTALLER
REMARKS
PEF.'I"'. IT
[:,EPFIRTME:NT ,¢~, HEFlLTH RND ENVZRONMEN]"FiL/~?OTEC:TI TiN
S25 '"' STREE]"., RNCNORFIGE., FIK. 9S
2(54-4720
,$ 820,4]:J.. ::,
RPPLtC:RNT FLORENCE] K 1.4tL, LIFIMS PO BON 42 CNUGIFtK
L. OCFIT I ON
L. EGF!L L2Eh,{ MCKINLE'¢ HTS L. OT SI~E
T"r'RE OF SOIL. FiBSORPTION SYSTEM IS: DRRtNF:'IELD
MFt;,.,: :E MUM NLIMBER OF 8EE:,ROOMS = ]: SOIL RFITING ('56! FT,."BR)'= :t. 00
'THE REQUIRED SIZE OF 'T'FIE SOIL. FIBSORPTION S"?E;TEM
THE LENGTH [:,IMENSION IS THE LENGT'H '::IN FEET:) OF' THE TRENCH OR [:,RRINFIE:L.[:,.
'THE DEPTH OF R TRENCH OR PIT' IS THE t.')ISTBNCE BETNEEN THE SURFRCE OF' THE
GROUt.,![:, RI",I[:, ]"PIE BOT"rOr,'l OF THE EX(].':RVRTION (IN FEET).
THE GRRVEL DEPTH tS 'THE MINIHUH DEPTH OF GRRVEL 8ETNEEN THE OUTF'RI.J... PIPE
Rt'.,l[:, TF.IE BOTTOH OF." THE EXCFI'v'FITiON (IN FEET).
IR.'.:: E]: ,Z::.,. LIt X F..: ILE::![::, ¢5-;E2:F"T' :.E C:
PERMIT FtPPL. ICFtNT HFIS THE RESPONSISIL. ZT'¢ TO INFORM THIS; DEPFIRTMENT DURING THE
INSTFIL. L. FITION INSPEE:TZONS OF FINS' NELLE; RD.II::fCENT TO THIS F'ROPERT'¢ FIND THE
NLtMBE.:.'R OF' RESIDENCES THRT THE t4ELL NIL. L SERVE.
44000 ': ..... :':
..,I.:.!UM F..E FEET
BRCKFIL. L. ING OF RN"?.:,"~' ,,'-r'~'~,.~ :,. ~:.~ t,tTTH']I~ .. T FINBL IN.:,FEU I'IUN~'- '--'" ~ RN[:, FIPF:'F.:OVFtL B'.'r' T.I'4i"""
[:,EPFIRTHENT NIi..L BE '- '* ...... .. _
.... :,JE,..~EL.] TO PROSE" TI"'FI.
MINIML!H DISTF:tNCE BETWEEN R NELL. R.ND RN'¢ ON-SI'TE SENF:fGE DIE;POSRL S'¢STEM IS;,
±00 F.'EET FOR Ft PRIVFtTE 1.4ELL OR :;L50 TO 200 FE:ET FROM FI PUBLIC NELL DEPENDING
UPON THE T"r'F'E OF' PUBLIC FIELL..
MINIHUM [:'tSTFiNCE FROH R F'RIVFiTE t.,!ELL TO R PRIVRTE SENER LI!",!E I:-2; ;2.'5 FEET RND
TO Fl COHMUNIT~r' SENER LINE IS 75 FEET.
NELL. LOG'_:-."; I::IRE REC!UIRE[:, RND MUST BE RETURNED 'f'O 'THEE DEPRRTHENT f.4ITHZN :~:0 DH"r'S
OF THE 1.4EELL COMF'LEETION.
EfT'HER RE(.:.!UtREHENTE; MFI"? RPPL."r'. SPECIFICRTION$ FII'4D C:ONSTRUC'TION D!RGRRHS FIRE
R',,,'RIL. FiE~LE TO INSURE F'F..'OF'ER tNSTFtLL. RTZON.
I CEF..'TIF'¢ THRT
ii..: I FlM FF':IMILIFtR NI'T'H THE RE~RJ]:REMENTS FOR ON-E;ITE SENE;RE; FIND I.,.IELL. S RE; SET'
FORTH B'¢ THE MUNIE:IPRL!T'¢ OF RNCHORRGE.
2: I !.,.tIL. L. INSTRLL. THE S'T'STEf'! IN RCCORDFINCE NITH THE CODES.
]:: I UNDERSTRN[:, "r'HRT THE ON-SiTE SEWER S'¢STEM HR¥ RE6~UIRE ENL. F~RGEMENT IF' 'THE
RESI[:,ENCE tS REMODELED TO INCLUDE HORS TNRN ~: BEDROOMS.
E; I GNED:
FIF'PLICRNT FLORENCE K NZL. LiFIME;
' I
SOILS LOG
PERFORMED FOR:
LEGAL DESCRIPTION:
1
3-
4
7
10
12
14
20
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
U ~ ~/~ J~ DATE PERFORM
SLOPE
ENCOUNTERED? ' / O
P
IF YES, AT WHAT ? E
DEPTH?
[] PERCOLATION
TEST
PERCOLATION RATE W /~-'~ minutes/inch
;ITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
COMMENTS
PERFORMED BY:
[~ RIVER, ALASKA
72-008 (6/79) ~ ~, ~94-2979
TEST RUN BETWEEN FT AND
-- FT