HomeMy WebLinkAboutKNIKWOOD LT 67B
MUNICIPALITY OF ANCFtORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
I ENVIRONMENTAL ENGINEERING DIVISION
! 825 L Street - Anchorage, Alaska 9950'1 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECI'ION REPORT
~.N EW
NAME
[~]UPGRADE
~AI LING ADDRESS it
LEGAL DESC~IPT~d ~ ' '
I_OCATION
~ [ Well ~ AbsoH)tion area
I DISTANCE T0: I lm~ i ~
~ ] Manufacturer
~' [Liq. cal~5~g'a ~s nsdalength
-- i /~ ' I IF HOMEMADE:
9~ I ~S~NC~ m: I ~ /
'~~~ I Well . ~ Foundation
J =IDISTANCE TO: I / f_ '~
o, ' Tot , ,.nC, o,,,n..
~ ~ ~ ~ H~{~sl~Fade /I / Material beneath tile
'~ '~ Width '~ De~ tT--
< ~ I Type of crib Crib diameter /~ Crib depth
~ ~ .......... Well Building foundation
" I DISTANCE '~O:
Bui d ng foundat oF ~ Sewer I ne
D STANCE
/
iOTI-IER
PIPE MATERIALS TO
~OI L :TEST RA~ING Ii~
INSTALLER
REMARKS
APPRO~CEy
iM a t e r i a;~TL_~.?L'
Width
NO, OF BEDROOMS
Dwelling / P~RMIT NO,
No. of compartments
[Material
Nearest lot line.~..~.~ /
Trench width
~) inches
~14~" inches
Liquid depth
PERMIT NO,
Liquid capacity in gallons
PERM,T
Distanca between line~
Total effecttve absorpbon area
PERMIT NO.
Total effective absorpldon area
/Distance to lot line
DATE LEGAL
PERMIT NO.
Absorpt on area(s)
by
DOC Co, dba
SULLIVAN WATER WELLS
P.O. BOX 272, CHUGIAK, ALASKA 99567 * TELEPHONE 688-2759
OWNER OF LAND
LEGAL DESCRIPTION
DATE- Started /
Ended /
PERMIT NUMBER
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT,
GALS. PER HR ' -"'-
KIND OF CASING (i ~;': '
From Ft. to -~ ~Ft.
From
From__
From
From
From"
From ____
From ,
From Ft. to _Ft.
From____Ft. to i? Ft.
From_--Ft. to '~Ft.
From__Ft. to til Fi,
From__Ft. to ~Ft.
From ____ Ft. to ~Ft.
From Ft. to i? Ft.
From Ft. to.__~Ft.
From Ft. to ~Ft
From
From
From ____
From---
From __
From
From
From____
From_
From-
From-
From___
From_
From
From
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.
Ft. to.~__Ft
MISCL. INFORMATION:
f
DRILLER'S NAME
[:,EI~f~F::THEN'F IZF~' FIEFILTH RI"~I::, EI~, I~ .hl~lEhlll'tl_ I::'F~'ETEF:TIFJN :.,~: .... "' L :E;TREET., I~1'.! 7 H ~ ~'FI 3E., F:II'::L
F'EF~:H ]: T I'.,IO. < E~;2::i.:YE~6 ::,
;
IW
I OI:::FtT I IDI'.,I
L.E:I3FIL L67B I':::N~t::: NOOE:':~; LOT SIZE :9:~'~9'~r~ SC!I...IRRE FEET
T'¢F'E OF SOIL. FES:{<F'Tt:N S"r'STEI'"I IS' E)RFIII",IFIELE:'
I"IR;:'::IHLIH t"YUt'"ttE:ER OF E:EE:'t~rOOf"l~; = 3: SOIL RATING
TIdE RE;~ ':RE::' SIZE :iDF THE SOIL RE',SORF"FION S'¢S'F'EH ItS'
"FHE I....ENI:3TH E)~f"II~EF.~SIEIN IS THE LENGTH ,'IN FEET', OF THE TRENCH 3~i' I::,F:RINFIELI]:,.
THE C, EF'TH OF FI TRENCFt OR F'IT IS TIdE DISTFINCE E, E IHEEI4 TFIE SURFRE:E IDF TFIIE
IZiRI3LINB, RI'ID THE iBO-TO"I OF THE E .... PI,H~ ION ,'IN FEET>.
THE GRR',,,'EL E:,EF'"~H IS THE HINIHIJH E)E:F'TH OF GRR',,,'EL E~EEI-I.,.IEEI'..i THE Ed_FFFFILL F'IF'IE
FIND TFIE BOTTIZIM !DF THE-EXCFIVRTION ,~IN FEET:.".
F:'ERI"I:[T FIF'F'LICFINT ~RS TIdE F:ESF'ZI'.ISZE~II._IT'¢ TO INFZIFY'H TIdI$ [:,EF'RRTHENT [:,U~:ING THE
- "~E'"'.
INSTRI_LRTION ~NbF'I=_.I 'IONS OF RN'¢ klEI._L~; R[::,..TRCENT TO TFlt% F'R.F'ER:I ~ FIND THIE
1'.YUHBEER OF RE:SIE:,ENCES THRT TFIE NELL :,dILL =EF. E.
;i
........... T' k-.~ EZu .......... ,:=: L? ':, :E ~-~ ~; F" ~E u%: 'T Z H%~ ~..~ =_,"'":' F~ ~: E F~:: E n%~ LI Z H:~: lEE E:: ..............
BFICKFILL. II",IG OF FIN'T~.; .= r=,TEI1 NITHOUT FINRL INSPECTION FiND FIFFR_ ,HI. THIS
E)EF'FIRTI"IENT NILL BE $UB.]ECT TO FFL=,EI..UFION.
'c .... ~ETI.,.IEEN FI NELL. FINE:' RN'?' ON-SITE SEI.,.IRGE E:'ISF'IDSFIL S'¢S'FEH
I"III",IIHUH [:'[-, FhN_.E-
2¢EI FEET FI:IR ¢1 F'R~',,,'FITE klELL OR &SEd TO 2(~6~ FEET FROH FI F'UE~LIC kIEL:_ E:'EF'ENE:'ING
_ . PJE, LIC NEL. L.
IF'I-IN "I'HE T'¢F'E OF 'l '
I'"III",IIHIJH E:'ISTRNCE CRZf"I R F'RI',,,'RTE NELL TO R F'R:IVRTE SE::ER LINE IS 25 FEET FIND
TO R "'ZI'"II"IUI',IIT'¢ SEL,IER I_INE IS "'5 FEET.
NELL. L. OI:~S FIRE REg!0IREI::' F~NE:' f,11_1%7' BE RETLIRNE[:' TO THE E)EPRRTMENT NITHIN ]aZ~ [:'Ff"r'$
OF THE NELL. IZ:OMF'L~TION.
OTFIER FY.E:~.U].R. EHEN~=, I"1F1'¢ RF'F'L.'¢. =,FEI_.IFIL. HTILN=, RND ZCIN'~;TFY'I.IC'FION DIPImFIdlI=, FIRE
Ft',,,'I~ILFIBLE TO IN'liRE FR.FER INSTRL..LFITION.
I CEIrY:TIF",'' THFFr
F'FIF.'.TH E"¢ THE HLNI:~!IF'RLIT'¢ L-iF FtFICHOF.'.FtGE.
2: I I.YILI.. INSTRLL THIE =,.,=,rErl z~.4 RCL~:OI;.:E:,FINCE NITH TFIE CIDDES.
:~:: I UNE:,EF.:STF4NE:, TFIRT THE ON-SITE SE:ER '.~'¢'.STEH HFI"r' F.:E.T.'_IRE ENLRRGEHENT IF TIdE
7125 OLD SEWARD H'WY.
ANCHORAGE, ALASKA 99503
349 - 6561
SOILS LOG PERCOLATION T'EST
SLOPE
SITE PLAN
WAS GROUND WATER /V~/'~ S
ENCOUNTEREO? L
O
P
E
IF YES, AT WHAT
DEPTH) ...... ~
2
3
4
5
. 6
7
8
9
10
12
16
18
2O
COMMENTS
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~.//-¢U/-?~ /s]~:~_' h'aim, es/inch)
TEST RUN BETWEEN ~.-~ .FT AND ~ . FT
,~~ ~ - ~:
?ERFORMEO BY: /.;/-, Y'/{;.
~2.oo8
: APPLI ",NT FILLS OUT UPPER H/t ; ONLY
Properly Owner ~} ~. ~ 1¢4' ~ L~ ./¥/~ J; 'r~'/ ~ //, Phone
Lending Institution /;¢11 ~ ~ Phone
Type ~f Resi~nce
/~ Single Family
B ~uUiCe Family ~o. of ~edrooms
B Olher
..~ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
~ Community ~ For wells drilled prior to thai date, give well depth (attach log if available).
~ Public Utility ]i~
Sewer Disposal
¢~ Individual Year Individual Installed:
~ Public Utility When Connected lo Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Ti me Time Time
Time i
Date u Date Date [)at
Inspector ~"-~.-q Inspector Inspeotor Inspector
( ) CONDITIONAL APPROVAL'
S~ils Rating o4B ~wer Installed Well To Absorplion Area Well Log Fleceived
,
Well to Tank __ Septic T~k Size
?2-023 (3182)
O¢~obe~ l~ lgTS
~id ~'i~h to install your sy~teci.
i
,'",;i(,dOR/\~rj AREA BOROUGH
DEPARTMENT OF ENVTRONMFNTAL QUALITY
3330 "C" Street
ANCHORAGE, ALASKA 99503
Case ¥t
Performed For !)_on L, Calihan
Dated Performed September 5, 1973
Legal Oescrip't"io6: Lot 67 Block Subdivision T15N, R1W, Sec, 7
This Form Report~ Soils Log__ __Percolation Test
Soil Testi!Must Be Logged To 4' Below Proposed Seepage Systenl -
Depth
Feet Soil Characteristics
Brown Gravelly Silt (ML)
Gray Silty o~avel (GM)
with silty s~hd ,seams 6' to 7,5'
with sand pockets and lenses by 8'
Was Ground Water Encountered?
If Yes, At Wh~t Depth?
· , Da!ie Gr
oss Time
~o
*%,
10 .....
Net Drop
Net Time
Depth to H20
Drain Field
Depth to Bottom of--Pit or Trench ............
235_~.~t, of drainage area is required per bedroom below 3 ft, depth,
Reading
e co,at]on Rate i~ ~Minute
Proposed Ins~ation: Seepage Pit
Depth of Inleilt
COMMENTS:
Test Performed BY l~, E, Carlisle
ALASKA ~INERAL & MATERIALS LAB
Date Certified BY: Da l:e:
0
0
BIRCHNOOD LOOP ROAD (dedicot ed 33~
N O' 08"~
O:
g