HomeMy WebLinkAboutPARADISE VALLEY BLK 9 LT 5
';.~/ MUNICIPALITY OF ANCHORAGE %'-'/
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONIV]ENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
IPHONE ~NEW
~¢/-4~' ' ~.~'-~'/~ [] UPGRADE
DISTANCE TO:
Manufacturer
Liq. ~ '.ity in gallons
Absorption area~
IF HOMEMADE:
Inside le[~,qth
IDwelling
Well
Dwelling
Matej:ial
Width
NO. OF BEDROOMS.~
PERM]~ NO. I
No, of compartments
Liquid depth
PERMIT NO.
DISTANCE TO:
Manufacturer Liquid capacity in gallons
Foundation PERMIT NO.
DISTANCE TO:
No. of lines
Top of tile to finish grade
Well
Length of each line~//
lA
Length
Type of crib
Material
Nearest lot line
Trench w dth
Total length of lines Distance between lines
inches
Material beneath tile Total effective absorption area
inches
Depot h/
Crib depth
Building foundation
Driller
Sewer line
Width
DISTANCE TO:
Crib diameter
Well
D~t h
Building foundation
DISTANCE TO:
PERMJT NO.,
Total effective a~sorptionj~a
Nearest ~ne/~z¢
Distance to lot line
Septic tank
PERMIT NO.
Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
NSTALLER
-REMARKS
DATE / L E G A/L ~
CON'T'AC'I" P I-'I C,' lq ii!i: ~,~
LEGAL DESCR :[P ::
~sVSiS'{L(bf[l ,, C~hc)£:)~i[H!i.? 'k.l"i(i. TJ '" .....c)'? :i. C-,ri -"" 1 ~::.'" '"~ i:1)~?:,55'[~. ( 5. ".,S \/'"~ ~r~ ~!. :[. '1:
)::)L:i]:::']"H TO ' F:' :[ F:'E~: BO'TTC!N (FT.)
,'2RAVEL. DIi!]:::'TH- 'c"~"
qi::~.,'>,t sl:::'I v.J ]. L) i ,"~ (F:']" ,, )
(:':'}RAV'I!EL twit "'I1:::' (CU YDS
TP.,NK S'r.,. ,:..';" ~:::', .... u..~,' :'z'.......:='5.
SOZL RAT:!:NG (.":.i~g!,, F:'T.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
[] SOILS LOG
PERCOLATION
TEST
, I
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5-
6-
7
8
9-
&H
DATE PERFORMED:
SLOPE SITE PLAN
10-
11
WAS GROUND WATER ~ I~
ENCOUNTERED? - O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
12
13-
14-
15-
16-
17-
18-
19-
20-
COMMENTS
PERFORMED BY:.
72-008 (6/79)
~l~r~ A, '
PERCOLATION RATE
TEST RUN BETWEEN '~ FT AND ~ FT
CERTIFIED
(minutes/inch)
SUBJECT:
CO'~9iPUTATION SHEET "-'
SHEET / OF ~/
BY
CKD ~
/k/OF*
FAT
SUBJECT:
Cr~TATION SHEET
SHEET ~OF -.2-~
BY
CKD ~
1201 P~zaent; $*.. A~(~tO~E~ AL~ 99515
SIX iNCH WATER WELL DRILLED ~ OUT TO THE DEPTH OF
DRILLED AT THE RATE OF ~,~.OeO0 PER FOOT.
PROPERTY OWNER ~ ~ C~J~O ~--~0 8517 ~/JJ~O
LOCATION
OF
WELL
SITF
/
DRILLER
VCELL LOG:
105 ¢,t.~ ~2100o00
THANK YOU VERY MUCH.
BERNIE CLAUS OF RAMPART DRILLING WORKS
kEF[VICE CHARGEOF 1~/~% PER MONTH WILL E~E ASSESSED ON PAST DUE ACCOUNTS.