HomeMy WebLinkAboutPETERS CREEK BLK 3 LT 7
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 lPH°NE
Well ~// Absorption,cea/ PE~~
~ Z Manufacturer
Material No. of compartments
Liq. ~a~galJons IF HOMEMADE: Inside le.~ .... Width ........... Liquid d~
~ DISTANCE TO: Well ~g PERMIT NO.
~ Manufacturer/ ' Material Liquidcapacityingallons
~Q DISTANCE TO: Well ~ ~ndation Nearest lot line PERMIT NO.
~ ~ ~ No. of lines Length of each line '~ length of lines Trench width Distance between lines
~ ~ ~ Top of tile to finish grade fM~te~ial beneath tile inches Total effective absorption area
Q / inches
Length ,' t ¢., ~ PERMIT N~.
~ .~ t Width /~ Depth/ '
~ Type~ Crib di~,-. Crib ~_..~ Total effective absorption area
~ ~ ,-Dep ~ ~ ~/~ tiller Distance to lot line PERMITNO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
.~.E MATERIALS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L TREET, RNGHORAGE~ AK 995'
2~4-4720
m]~l--$ I TE SE&dER & NELL F'ERH I T
PERMIT NO:
DATE ISSUED:
057~9784
APPLICANT:.
ADDRESS:
CONTACT PHONE:
LEGAL DESCRIP:
LOT SIZE:
MAX BEDROOMS'
C?O S & S ENG~G.
EAGLE RIVER, AK
CCC CONSTR
995?7
SUBDIVISION: PETERS CREEK
SECTION: i0 TOWNSHIP: 15N
i0500 (SQ. FT. OR ACRES>
LOT: ? BLOCK:
RANGE: 1W
LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC
SYSTEM. CHOOSE THE OPTION ~HRT BEST FITS YOUR SITE.
DEPTH TO PIPE BOTTOM (FT.>
GRAVEL DEPTH (FT. >
TOTAL DEPTH
GRAVEL WIDTH <FT. >
GRAVEL LENGTH (FT. >
GRAVEL VOLUME
TANK SIZE (GALS>
SOIL RATING <SQ. FT./BR>
4.0
0.5
4.5
i4o
28.
i4.
000.
85
· ~ TANK MUST HAVE AT LEAST TNO COMPARTMENTS
I CERTIFY THAT:
i. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA> AND THE STATE OF ALASKA~
I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODES 8ND REGULATIONS~
8ND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT.
~. I WILL ADHERE TO ALL MO8 8ND STATE OF ALASKA REQUIREMENTS FOR THE SET'BACK
DISTANCES FROM ANY EXISTING WELL~ WASTEW~TER DISPOSAL SYSTEM OR PUBLIC
SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT.
4. I UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUM OF ~ BEDROOMS 8ND
ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT.
IF A LIFT STATION IS INSTALLED IN RN ARE8 COVERED BY MOA BUILDING CODES~
THEN (t> AN'ELECTRICAL PERMIT AND INSPECTION MUST BE OBTRINED~ (2) AS-BUILTS
APPLICANT: ~'4G~'G. CCC CON~TR
ISSUED BY ~_~~-
INSPECTION REPORT~ 8ND (~) THE
ELECTRICIAN.
DATE'
/
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOl LS LOG
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
SLOPE SIT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
~, T467-B
WAS GROUND WATER
ENCOUNTERED? ~' ~ SL
O
P
[ E
IF YES, AT WHAT
DEPTH?
COMMENTS ~"~rl 0I~( L -~5 .~- (~,
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERFORMED BY:
PERCOLATION RATE (minutes/inch)
D
TL)~_ZEST RUN BETWEEN FT
C ERTIFIED~~XX/ DATE:
72-008 (6/79)
