HomeMy WebLinkAboutHUNDRED HILLS BLK 3 LT 4
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
Dwelling
[] UPGRADE
LOCATION ~
DISTANCE TO: Well
Inside length
IF HOMEMADE: ~
Well Dwelling
NO. O3EDROOMS
PERMITNO. (~C)O ~/~.~ ~7
No. o~partments
Width depth
PERMIT NO.
Material capacity in gallons
Well
DISTANCE TO:
No. of lines Length of each
Top of tile to finish grade ~
V
Length Width
Foundation PERMIT NO.
go o 13 7
Total length of lin~.~ ! Trench wid~ ~ inches ~ lines
Material beneath tile fi' ~' .~t~s area
Depth
, diameter
foundation
Sewerline
PERMIT NO.
effective ab area
DISTANCE TO:
DISTANCE TO:
Nearest lot line
Distance to lot line
Septic tank
PERMIT NO. (~0
Absorption area(s)
.wr07
OTHER
PIPE MATERIALS
INSTALLER
DATE LEGAL
· .o DEPARTMENT L,/ HEALTH AND ENYIRONMENTAL r'KOTECTION
.,, ' 825 'L" STREET., ANCHORAGE., AK. 99501
APPLICANT JOHN b. LEARY SR bO;~ D-'-40 E. R.
LO~ATION HILflND RD. c -,
MHXIMUM NUMBER OF BEDROOMS = ~ SOIL RHTING (SQ FT/BR)=
The REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTH= ,~,. 5 LEI"4GTH= 5--~~ GRAVEl DEPTH= 4. 5
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF R TRENCH OR Pit IS THE DISTHNCE BETWEEN THE SURFACE OF THE
GROUND 8ND THE BOTTOM OF THE E×CBVBTION (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).
R:EC'41_I I i:;:ED SEPT I L--:
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS 8DJBCENT TO THIS PROPERTY 8ND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
THO ( 2 ) INSPECT I O~lS 8RE REL~LI I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A HELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVHTE SEWER LINE IS 25 FEET AND
TO 8 COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS 8RE REQUIRED HND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS
OF THE HELL COMPLETION.
OTHER REQUIREMENTS MHY 8PPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PER~I I T EXP I RES DFC:FMBER ~i.- -.1_~88
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS RS SET
FORTH BY THE MUNICIPALITY OF 8NCHORAGE~
2~ I WILL~, INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
_~: I UNDERSTAND THAT THE ON-SITE~EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDE~~D~T~f'IORE THAN ~ BEDROOMS.
S I GNED ~-~~-~-~ ........
~ ~ V4.0
xo:io~ ~ O & E ENG.NEERING & DEVELOr',vIENT CO.
~/~;t,~. ~/,~',~---,~ Box 90, Davis St., Eagle River, Alaska 99577
Russell Oyster
694-2774
Performed for: Name:
694-2774 or 688-2280
SOIL LOG
~-~//l~/ ~_ ~/q~ Y' Tel. No
Earl Ellis
688-2280
Mailing Address:
Legal Description: / ~ T
Depth (feet)
0
Soil Characteristics
2
3
4__
5__
6__
7__
8__
9__
11__
PLOT PLAN
12__
13__
14__
15__
16__
Ground Water Encountered: Yes
No ~
If yes, what depth
PERC. TEST
Proposed Installation: Seepage Pit
Drain Field
Comments:
Performed by:
by ENVIRONMENL, XL _CTION
DOC Co, dba
SULLIVAN WATER WELLS
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTION
DATE - Started
PERMIT NUMBER
Ended
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING
KIND OF FORMATION:
From Ft.[o Ft.
From Ft. to Ft.
From Ft. to Ft.
From__Ft. to - Ft.
From Ft. to Ft.
From__Ft. to .Ft.
From __Ft. to Ft.
From__Ft. to ~ Ft.
From__~Ft. to Ft.
From Ft. to~__Ft.
From ' Ft. to_ FI
From__Ft. to_--.Ft.-
From. Ft. to Ft.
From Ft. to : ' Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to _Ft.
From Ft. to Ft
From Ft. to_ _Ft..
From Ft. to. Ft.
From Ft. to_ _Ft.
From Ft. to Ft
From Ft. ro Ft..
From___Ft. to Ft.
From Ft. to_ Ft.
From__Ft. to Ft.
From__Ft. to Ft.
From__Ft. to Ft.
From__Ft. to Ft
From Ft. to__ Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Fl
From Ft. to Ft~
MISCL. INFORMATION: