HomeMy WebLinkAboutROLLING HILLS VIEW ESTATES BLK 4 LT 7 i 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
IPHONE
J
[] UPGRADE
NAME
MAI LING ADDRESS
LEGAL DESCRIPTION
LOCATION
Well Absorption area . Dwelling
~ Z Manufacturer
~ Liq capacity in ga OhS ~ Inside length
' i ' /~.~ I. HOMEUAD.:
Manufacturer
Q I I Well / ~Foundation
~ I DISTANCE TO: I
~Z INo.oflines ILength°feach]ineN/ T°t~llength°flines
--~ I ~
~ ~ Top of tile to finish gralde ~ ~aterial beneath tile
~ Length · I Width ~ Depth
~ ~ Woll Bui din~ foundatiofi
DISTANCE TO: ~, --~/~
~ C~ass Depth Driller
~ Building found~io~ z Sewer line
DISTANCE
TO
Material
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
Nearest lot line
Trench width
inches
inches
Width
Material
Total effective absorption area
NO. OF BEDROOMS
PERM'T 7
No. of compartments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO.
Distance between lines
Total effective absorption area
PERM,T NO. ¢
Nearest lot line
Distance to lot line
PERMIT NO.
Absorption area(s)
A~81~ 9957~
~' ' \'¢ 8 2 5 "' :iii; T R E E T
E HF(iiL. E:E M I _J. i:J'F~' ;-;~S "3L 'I"H F '] P .:' COI'-,!ST ER
TYF'E OF' S 3 '[ L i:'.:IE',SORP'T' ! ON SYSTEM
L I::'
'.:~9'qPi.~F~9 S(;!LtFIRE F'EET
i"iF~X!i'iUM NUME~ER OF:' 8EDI:;;:OOMS = ]; SOIL RFt"!"!NG
THE LENGTH DZMENSZOi",! ZS THE L. ENGTH (ZN F'EET> OF THE TRENCH (:)R DRFIIt',II:::'ZELD.
THE [:,EPTH OF FI TRENCH OR PIT iS THE D ZSTt~NCE BE'T~,iEEh! THE SURFFICE OF THE
GROUND RI',E:, THE BOTTOM OF THE E;4CFI',,,'RTZON (ZN FEET>.
THE GRFtVEL. DEPTH Z:E; THE I"!ZNIMUM DEPTH OF GRF!',/EL. BEt"!,.IEE!q THEE OUTFRLL P ZF:'E
RN[:, THE BO]"TOM OF' THE' EXCt::I',/RTZON (ZN FEET).
i::'ERM :[ "[I I::iF'PL :!; CF!NT HI:::iS THE [.IESF' :::,~.t:~' I [:iii i L t '1"'¢ TO t NFORM 'T'H ! S DEF'fiR]"MEt',!T [;,t.jF: t ~.,I13 THE
_ * ,, c' ,,-i:::!D,)'I:::ICENT "t"(] "t"I...i:I::~E; PI:;'-::'FF'T'T' I:~',![::' THE
ZNS'T'FIL.!._FY!"!F:t',! iNSPECT'il]NC: OF H!,! b,,....Lr ......
i",iUMBER F'iF RES 'i' l'~'~l['t '" [;;'c; "i'" ..F . .....
................ fhh: THE ,.:E't ~ k!t!....L SERVE.
!"!:[Ni'MUt'i .C,!STfTNCE BETI-,!EE:I'.,i FI 14ELL. F!t'.,!C, f::tNY ON-:i::;ITE SE!.,tt::~,CiiE [,'> ],' E~POi!ii;[::iL S'.r'STEM
:B3E~ F:'EET F:'OI:;;'. !::i PRik.-'F:F.f'E HELL ('.'IR J..5!;i~ TO 20Et FEE'T FROM F:! PUBLIC i.,.!EI,...L..
L!PON THE 'YCPE (:iF:' F'UE;L.!C I,.!E]_L..
i"!INIML!M [:,]:STRi',!CE F'ROM FI F;R!',/RTE MEL. L, TO F! PR;F. VBTE SE!.,!ER L.t!'-,IE IS ;;;]:5 FEE'T Rl",i[)
TO I:::! COPiML!N I T"r' :i~:;Eb. IER L. :f NE ! S ?"5 FEET.
O"FHER RiE(;!U ]; REMEN'FS MFI'¢ RPF'L'T'. SPEC i F :[ C!::f'F I O!',!S Rt"~[:' CONSTF-:U(.'.': 'I[I ;[ 01',1 [:' I FI(:.;;RRMS RRE
Fi'v'R l' LFI!!;L.E TO :[ !".iSURE F'i:;i:OPER I i",t:!~:iT!::ILLF:iT ]:
i' CERT ]; F"¢ T["if:i",i''
:i.: :~ F. ii"! FF:iMIL_IFIR l.,.iITi-.! '!"HE REX;~UtREi'iE]',iTS F'OR ON-:~i;Z]"E SEHERS FIN[:, b.!ELL,S I::~S SET
FORTH Eft./ Til4E MLI!'..!ICIPF!LIT'¢ OF t:::!NCHORF!G!E.
2: t HILL tNS]"F!L.L THE SYSTEM IN FE::CORDF!NCE I.,.!ITH THE CODE:E;.
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
~. 4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19-
20-
COMMENTS
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
SLOPE
DATE PERFORMED: ~7
SITE PLAN
IF YES, ATWHAT II / E
DEPTH?
Gross Net Depth to Net
Reading Date Time / Time Water Drop
/
PERCOLATION RATE
TEST RUN BETWEEN
/FTAND
(minutes/inch)
__ FT
CERTIFIED BY:
DATE: