HomeMy WebLinkAboutKIMBERLY MANOR BLK 1 LT 15 !~l~~) .... " 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 ~._/ iPHONE
MA~LING ADDRESS
LEGAL DESCRIPTION I '
LOCATION/ ~NO. OF BEOROOM$
I Well ~ Absorption area DweIHng PERMIT NO,
~ ~ Manufacturer ~ I~. ._ Material~,~ No. of compartments
Liq. capacity in gallons Inside length Width Liquid depth
N ~ IF HOMEMADE:
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O ~ ~ Manufacturer / ~ Materiel Liquid capacity in gallons
~ Well Fou~ation Nearest lot line PERMIT NO,
~ ~,~A,C. ~o:
~ m ~ No. of lines Length of each line " ~ngth of lines Trench width Distance between lines
~ ~ N/~ inches
~ Top of tile to finish grade ~aterial beneath tile Total effective absorption area
~ inches
Length Width Depth ~ PER~.
~ Type of crib Crib diameter Crib ~ Total effective absorpd~ area
Well ~ Building foundation Nearest lot line
DISTANCE TO: ~ ~b ~ I ~
~ Class Depth Driller Distance to lot line PERMIT NO.
~ ~ISTA~Cfi TO: ~uildi ~ foundation Se~er line Septic tank ~bsorption area(s)
OTHER
PIPE MATERIALS%,
SOIL TEST RATING
INSTALLER
REMARKS
· r, ~ -: ~ ~ , -Tm,~ ~ ~.~ ~'
PERMIT NO:
DATE ISSLJED~
AF:'PL I CANT:
ADDRESS:
C[)NTACT PHONE:
L. EGAL DESCRIP:
LOT SIZE:
DEPARTMENT ii. HEALTN AND EI',IVtR[.)NMEI',-ITAL ,~')TECTION
tr_x::.~F1''~'~' xI.Z"S'I"IREET~. AI,JL, FIORA(.:~E.' '-' '" '" ::'-, AK 995("~ 1
-264,.-.47:.20
85 } :L'~ :'.:'.;'6 ENG I NIEEI::;,'ED DES I GI',I ·
0612.9/85
BARBARA WINKLEY
8120 RABBI]" CREEK ROAD
ANCHORAGE, AK 99516
345- 1954.
F::" FZ F;i,i Ihdl ]t: '"11'~
SUBDIVISIEIN: KIMBERLY MANOR
SEC'I"IOI',I: 25 TOWNSHIF': 12N
GSO0 (SQ.FT. OR ACRES)
LOT: 15
RANGE: 3W
BL.GCK: 1
I certi£y that:
1. I am' familiar, wi'E.l"~ the requirements CoP on-site sewers and wells as set
¢orth by the Municipali'Ey o~' Anchorage (MGA) and the State o¢ Alaska.
2. I will install the system in accordance with all MOA c:odes and regulations,
and in compliance with the design criteria o~' this permit.
3. I will adhere to all MOA and State of Alaska requipemerits eom the set bac:k
distanc:es from any existing well, wastewater disposal system of public
se~,erage system on th:i.s or any adjacent cm nearby lot.
IF A LIFT STATION IS INS'f'ALLED IN AN AREA COVERED BY MOA BUILDING CODES,
.THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUS]" BE OBTAINED; (2) AS-BUILTS
WILL NOT BE AF'F"ROVED W, ITHOUT AN ELECTRICAL INSPECTIOI'4 REPORT; AND .(3) THE .
ELECTRICAL WORK MUST BE DONE BY A LICENSED EL.ECTRIC~[AN.
SIGNED'
,~ ......... : ........................................... , ..............
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
7
8
12
~4
20 -
DATE PERFORMED:
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
O
P
I E
IF YES, AT WHAT
DEPTH?
I?-" J,'~ pt,,
Reading Date Gross Net Depth to Net
Time Time Water Drop
Io%.B ~o .6o , oc
PERCOLATION RATE
TEST RUN BETWEEN , "F.T,*,~ND /
COMMENTS ~.'~ ,~ ,-:,.,~ ~. ~ ~,+~ ~+,', ~.,~ ~ '..,,;.
. . ?~, ~: ,:. ~..~,,..'J'",'
. ,.,,~ /~_ :
72-008 (6/79) ~:'~'
~MuNICIPALITY OF ANCHORAGE
DEPARTMENT OF I-JEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3 :.'~
4
' 5
6
7
8
9
SLOPE
I
SITE PLAN
10
11
12
13
14
15
16
17
18
19
20
COMMENTS ':v ~, i .'
PERFORMED BY:
72-008 (6/79)
WAS GROUND WATER S
ENCOUNTERED? I"', ~' L
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
.
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
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
5
6
7
8
9
10-
DATE PERFORMED:
SLOPE
SITE PLAN
11
12
13
14
15
16
17
18
19
20
COMMENTS
' PERFORMED BY: "~,r~'-I t~[oA, ['~
72-008
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
SOILS LOG
MUNICIPALITY OF ANCHORAGE
PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
TEST
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
4
7
8
10
12
14
1§
17-
:20-
DA TEPERFORMED: OC"l~"~b' Y~ /
SLOPE SITE PLAN
WAS GROUND WATER ~, r .- S
ENCOUNTERED? L
O
IF YES, AT WHAT LI
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
lminutes/inch)
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
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19-
20
DATE PERFORMED:
SLOPE
ToAd
SITE PLAN
%1,,,'~ ,4.
',
.J--
~= .... -~ d~ n-1
/
COMMENTS ~
PERFORMED ~¥:
WASGROUND WATER
ENCOUNTERED? ' ~alL~_~
O
P
E
IF YES, AT WHAT ~V~
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
{minutes/inch)
DATE:,
72-008 (6/79)
.~,,.E R~vsa ALASKa, 'g~5~ C~MPUTATION SHEET
PH. 6~4-2~79
SUBJECT:
~//~ ~ /
//
G..~ 71PUTATION SHEET
Certified Well
For ........... I~%mb.a.r.a....~inkl.e~ ....................................................................
Location .......... ..B.~.9..O.~....~ , ~..9.~...~..~.,....~..[!~b.~.~.~...
.... · ~,.~-, Novembsr 5, 1984 DEPT, OF HEALTH &
Date ~,,~u ............. ......................................................
Depth of well .................'] ~.2....Eee2 ......... ........ ~., ............
..............................
Size of easing ...... ~...~.~ch ...............
Distance to water while p~p~g ....... l.~,~.'..~e/c.,[ ......
....... 6:0.0 ....................... ~....gallons per hour.
Deseripti0n of' ~rm~tioia ~ ' · ~ ' from
m~y ,....:,.... ..i' ot~ .-'~:
Sand ':'-:(~';' '::'. [,'[ .I -172 -178
2~nwn dj'ay.. ,. ,...' 5?2: .:' '.[. ,,~. 1 ?_a 1
~a~er, sand~ a"'~;:~]: ,-~".(::.'.;:.~-.- ,19o
:.~--0'::'?-" : '-" ~1 -'
I_
,,
I-certify ~hS' above ~nd~e~t - '. ""
"';' ' ' '. f..t: )-
PERM IT NO:
.DJ::Fr'E;
RPPL. I CF:ff.,Fr':
F:!E:,E:,R!E'Z; ::/:, :
CON'TF:~C'T F'i.IOf.~E:
LC T: 25
RFINEiE~:: ]:,b.i
E:L..OCK: 2.
C:EF;:'T' I I::".r' 'THFi'T':
::L. I F:!i'i F:'F:iHi'L:i:F:iI:;;: kilT'H 'T'HE!: i:~:E:,'.';!L!IF~tEi-fiENTS FOR ON-.:i;ITE :.~;EI.,.iEF;'.:~5 F:INC, i.,.!ELL.S RE; SET
F'ORT!-! .E;"r' 'T'HE: i'iLli-,ilCiF:'F!L:[TY' 0i::: RNCHORI::IGE ,:: MC~FI ::, f:ii'-,iD ]'HE ~'];TI:I"t"E OF F¢_FtS!<R.
;2. ): [,.!ZL.L. ZN:i?FF:tL.L. "['i'IE S"/:STE!M, IN !:::!CCOR!}FINC::E: F.!:i:]"H FILJ.... MOF:! CO[::'E~; I::!h,iD, F-:EGLtLFIT'tON"Z,.,
F:t!',iE:, ]: N COi'ff::'L. :[ FiNC!E !.,.i I 'T'H THE: [)E:!]; l EiN CR i 'T'Ei:':': l I::! OF 'TH .'i: :E; F:'ERH l T.
]:. ! NIL. L.. FIE:'HEF;:E: TO I::tL.L MOI::J f::tND :ii;"FFITE OF' ?!LF:I:~!;~:::I:::i I:;~:EQUtREMENT'.'7., F:OF:: ]"HE SET BFtCK
I:.', .i. STFINCE:S F:RCd"i FIN"? E;X i S"l":!: NG i4EL. I ...... I.,.IFI:!!!~TEHI:::FFEF:: E:, Z ~-:;,r'::'~:):F~;F~L. :5"¢STEH OF.': PIjE:L t C
'Z;,E:t.,.IE:!:;;:F:P,.':iEi: :E;"r'~;TEi'i i:)['.,j "I"HZ:!!i; CiF?. I::ff',i"r' i::I[:,.~i'FiCEi:NT O1;.: NEI::iR!D'¢ L. OT.
E~It.' .. ~ !.,.! :i: Ni<LE"?
.... ........................................ ...........
GNED'
F!F'F'L i E:FINT
IFF:, F" '