HomeMy WebLinkAboutP & M TR C
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
NAME
LOCATION
_O v DISTANCE TO: Well .+ ~)--I~C~
~-'~1- Z Manufacturer
~;" Lq. caf IF HOMEMADE:
LEGAL DESCRIPTION
Absorption ar~
Materia]~[
Well
DISTANCE TO:
DISTANCE TO:
Inside le ngt..__h
IDwelling
PHONE , ~NEW
6 ~ d-~/~'% [] UPGRADE
Foundation
NO. OF BEDROOMs}
PERMIT NO.
No. of compa<~ents
Width Liquid depth~
PERMIT NO.
Material ~ Liquid capacity in~ja~ons
Nearestlotline.t~ IO PERMITNO. g.~[ OC~
Trench width Distance be~.~e/e~..nes
. '~) ~)inches Total effective{ ab~t,o~/~ ea
Top of tile to finish grade
Material beneath tile
Length ¥]dth Depth
DISTANCE TO:
Class~_~.~ Depth Driller
Building foundation Sewer line
DISTANCE TO:
Total effective absorption area
lot line
+P-o o
OTHER
PIPE MATERIALS
SOIL TEST RATING
I NSTALLERj~ ~
REMARKS
PERMIT NO,
Absorption area(s~[_ ,~ (~ ~:'")
APPROVED ,Q~
72-013 (F~v. 3/781
DATE LEGAL
PERMIT NO.
RF'PL I Cf:!N T
LOCRT I ON
L. EGRL
P&M GRRDEf".! E;EF.:VIC:ES
M!L.E 3. 5, ERGL. E RIVER R[:,.
LOT C: P & I"1 S,,."D
[:,EPFIRTMENT OF HEFtLTH 8ND ENV!RON!'dENTRL PROTECTION
825 "L'" '.'STREET., I::I1,-,IE:HORRGE,, FIK. 995E~!
264-47;28
BOX 349., ERGL.E RIVER
LOT SIZE
6;94--9293
3729(~ S~7~UR.RE FEET'
T'¢PE OF :;_';;OIL HE:SORPT'tON S'¢STEM IS;: TRENCH
MRXIMUM NUME~ER OF' BEDROOMS
SOIL RR'F!NG (SQ FT,.."BR)= ±45
THE REQUIRED SIZE; OF THE SOIL F!BSORPTION S'?'STEM IS:
THE LENGTH DiME1,.,ISION IS THE LENGTI.4 (IN FEET."., OF 'THE TRENCH OR DRRINF!ELD.
THE [:,EP-I,'H OF:' R T'F..:ENCH OR PIT IS THE' DIS'T'FINE:E BETWEEN T'HE SLIRFF~CE OF THE
GROUN[:, RND THE BOTTOM OF 'THE EXCff,,,'RTIEdq. (I1,.,t FEET). THEF..'E IS NO SE'T' !.,.tIDTH FOR TRENCHE"5.
THE GRFIVEL DEPTH IS 'T'HE J','fINIMUM DEPTH OF GRRVEL BET.WEEN THE OUTFF-!!....I_ PIPE
FIND THE BOTTOM OF THE. EXCFI',,,'RTION <I1,-,! F'EET).
PERMIT RPPLICRNT HRS THE RESPONSIB!L!T'¢ "['0 INFORM TFtIS DEPRRTMEI'.,iT DURING THE
INSTRLLRT!ON INSPECTIONS OF' R!'.,iY 14EL,/.S RDJRCEI'-,!]" TO 'THIS PROPERT'¢ RND THE
NU1,,1BER OF RESIDENCES T!-JF:IT THE 14ELL !.,.!ILL. SERVE
......... T'.*-.~]'~ ',::: 2 ::~ ;[ ,I'-,Ii'_-];F'EC:'T :E C~ f-,~.S; RE:E] F;.': E.; ~'_-] L~ % F:..:EE)
BRC.k.'FILLING OF RN'..r' SYSTEM klITHOUT' FtNRL INSPECTION R.ND RPPRO',,,'RL. B'¢ THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM [:,ISTFINCE EETWEEN R 14ELI_ FIN[:, RN'¢ ON-SITE SEI.,.!RGE DiSPOSRL S?STE'M IS
::LRe~ FEET F':~' Fi F'RIVRT'E WELL. CR ,':!._.SE'~ TO ;2_'C',~ FEET FR]M Fl PUB/..IC P4ELL DEF'E1,.,![:,ING
UPON ]'HE T'-r'PE OF PUBLIC WELl...
MINIMLfM DISTR1,.,!CE FROM F-I PRI'¢RTE !.,.IELL TO R PRIVRTE SEklER LiNE IS 25 FEET RND
]"0 R COMMUNIT'-r' SEt.,.!ER LINE IS 'FEi FEET.
OTHER RE6!UIREMENTS .t,'IR? RF'F'L'.r'. SF'ECIFIC:RTIONS RND CC:NSTRUCT'ION DIF1GRRMS FIRE
ff~,'RILFtBLE TO INSURE PROPER INS'TRL. LRT!ON.
I CERTIF"¢ THRT
'£' i RM FRMII....IPIR I,.t!TH THE RE_::!UIREMENTS FOF.: OI'.,I-SiTE SEI.,.IER:S 81'.4[) I.,.!EI_L.S RS SE]"
FORTH B'¢ THE MLINICIF'RLIT'¢ OF RNCJ-I, ORRGE.
2: t .L,.!ILL iNSTF'!I,d_ ;"PIE S'¢STEM IN FtCC:ORDRNCE !-4ITH 'THE CODES.
3: I UNDERSTFIf",I[:, THRT THE ON-SITE SE.WER S'-r'STEM MR'¢ REC-.!UIRE ENLRRGEMENT IF THE
RES.T.[:,ENCE IS F.:Ei'4OI'.':,ELET.)'~'~ MOF,.':E THRN ;':5: E',EDF.:OE]MS.
S I GNED: ~~ ' RPPLICRNT P&M GRR[:,EN SEF~,YiCES
O & E ENG'~NEERING & DEVELO~"MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774
Performed for:
Legal Description:~''~ ~-~-I
Earl Ellis
SOIL LOG 688-2280
Mailing Address'~'z~ , ~,c~- '~*/~ Z_~"-./J4;~z~--- ~ ~J~-~_ ,~?~. c~2~'~77
Depth (feet)
Soil Characteristics
9__
10__
11__
12__
13__
14__
15__
Ground Water Encountered: Yes
No f If yes, what depth
Proposed Installation: Seepage Pit Drain Field
Performed by: ~'---~, ~// ,~'F-d:~~,
PLOT PLAN
PERC. TEST
A & L DRILLING COMPANY
BOXJg?, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTION
DATE - Started Ended
PERMIT NUMBER
DEPTH OF WELL c~[~[ /
STATIC LEVEL OF WATER FT. __1_
DRAW DOWN ~. /? /
GA~. PER HR 7~O
KIND OF FORMATION:
Fr"om 13 F,.io~g'
Erom °rl Ft.,o_frO
From--
From____
From
From
From_~"~O _Ft.
From F2 F,.
From lO! Ft.
From_./O3__Ft-
Erom !/2 FI
From I~ ,,Ft. to.-L~~;~--Ft-- H./c~ From
From..~[--Ft. to_./75-..Ft.~.~d~'~7~Z - From.~
From i ~ Et to~ O~Ft.__[ ]~~.V~ From__~
From~Ft. to~]~-Ft- ~/- ~_~-~O~C From-
_ ~r~ I From
F~om~aO Ft. to_ _ ' Ft. ~ t~.~ * ~//M&-- From
From Ft. to ._Ft.__' From
Ft. to Ft
Ft. to__ . ,Ft
Ft. to .... Ft
___Ft. to_. Ft
Ft, to Ft
Ft, to __Ft.
Ft. to ..... Ft.
Ft. to. __Ft.
.Ft. to__ Ft.
Ft. to ......Ft.__,
,._Ft. to_ . __Ft.
Ft. to_ Ft.
Ft. to Ft..
Ft. to .Ft,
Ft, to Ft.
Ft. to__Ft.
EL to___.Et.
MISCL. INFORMATION: