HomeMy WebLinkAboutHENKINS BLK 1 LT 8
~. ~ ~ 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 PHONE J ~NEW
MAILING ADDR~S
LEGAL DESCRIPTION -- I
m~'°' ~r ~,~,'rek~ a~ 0l~ ~en~ ~°'°~°°m3
Well Rbsorption area Dwelling ' PERMIT NO.tl / ,
~ ~Z Manufacturer,,~ ~~'~ a Material/o.T~L ~ ~' No. of compartments
Liq. capacity in gallons Inside length Width Liquid depth
iO¢~ IF HOMEMADE: --
~ ~ DISTANCE TO: Well~ Dwelling ~ ~ ~ PERMIT NO,
~Oz~ ' ~ I
O z ~ Manufacturer Material Liquid capacity in gallons
;, DISTANCE TO: Well X~['~ Foundation Z?' Nearestl°tline 3Zl
~ ~ ' Distance between lines
~=~ ~ ~op'°' o,,,~.o, ,i,~ to ,,.,s~l ~m~m~ o. ~. ,,~ ~?1 T°tal lenflth °f I'nes ~TMatorial Benaath the Trench w'd'h~0inches Total effective absor~t~ZI
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
m DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATINg ~Z*~
INSTAELER ~X~
REMARKS ~
, ~ -- J ~ I'. ..... ~ , , ~.
........ ; ,~
APPROVED DATE LEGAL Y ~-~
P~rmit %
Applicant:
L'~cation:
L~gal Description: ~t~'~ O~
T~pe of Soil Absorption System Is:
Trench: Drainfield:
Max'imum Number of Bedrooms:
MUNICIPALITY OF ANCHORAGE
Department~f Health and Environmenta?~?rotection
825 _ Street, Anchorage, AK. _,9501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND/~ ON-SITE SEWER PERMIT
Phone Number: ~'~//~ ' '
Lot Size:
Seepage Bed: ~ Holding Tank:
Soil Rating(sq.ft/br) ~
The Required Size of the Soil Absorption System Is:'
DEPTH 2 , LENGTH J;~'~" GRAVEL DEPTH ~ WIDTH /~'
The length dimension is the length(in feet) of the trench or drainfield. The
d~pth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall ~ipe and
th'e bottom of the excavation(in feet).
* * REQUIRED SEPTIC(.P~C-5-I-NG) TANK SIZE = ~ ~ ~ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of~residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection.and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of'public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet, Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * *
I~certify that:
(1) I am-familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargem/ent if
that~ bedrooms.
the residence is remodeled to include more .~~
Signe~:Applicant DateISSued by:: ~/~ ,~~-~
SWP/024(1/81)
,, MUNICIPALITY OF ANCHORAGE
~ Department?~f Health and Environmenta~"~rotection ~:~
825 ' ~ Street, Anchorage, AK. ~501 ~
~ 264-4720
* * * HANDWRITTEN PERMIT * * *
Permit ~ ~3d~/~WELL AND/OR ON-SITE SEWER PERMIT
Applicant: &~y~_;~Q~ ~u~_~ Mailing Address: ~0.~-3~ ~/~?~ ~.
Location: 7-~ ~{oo g~B~ Phone Number:
Legal Description:
Type of Soil ~2osorption System Is:
Trench: Drainfield: ~/ Seepage Bed:
Lot Size:
Holding Tank:
Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:'
DEPTH LENGTH ~/~' GRAVEL DEPTH ~(~' WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimttm depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /dO c_) GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of ~esidences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection.and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system ma~ require enlargement if
the residence is remodeled to include~more that 3 bedrooms.
/ Applicant
SWP/024 (1/81)
Issued by: ~~//~/~
Date: ~//~/~ ~.
,~M. UNICIPAIITY Of ANCHORAGE
Department ' ~ealth and Environmenta]~',rotection
825 ~ Street, Anchorage, AK. >9501
264-4720
* * * HANDWRITTEN PERMIT * * *
Permit # ~D~ WELL AND/OR 0N~SITE 'SEWER'PERMIT
Applicant:. /~.~ ~N~ K~/~/~ Mailing Address: /~ ~/~ ~7- ~..~0~
Type of Soil Absorption System Is:
Trench: '~"- Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms:_~_~ Soil Rating(.sq.ft/br) ~
The Required .Size of the Soil Absorption System Is:
DEPTH ~ LENGTH (~/ GRAVEL DEPTH ~ WIDTH
The length dimension is the length(in feet) of the trench or ~rainfield. The
'depth of a trench or pit is the distance between~the surface o'f the ground and
'the bottom of the excavation(in feet). There is no set width 'for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE': /00o GALLONS * *
Permit applicant..has the respon'sibility to inform this dep'artment, during the
installation inspections of any wells adjacent to' this property and the number
of residences that the well will serve. ·
* * * TWO(2) INSPECTIONS-ARE REQUIRED * * *
Backfilling of any'system without final inspection.and approval by this department
will be subject to prosecution.
Minimum distance between, a well and any on-site sewage disposal system is 100 feet
f~r a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more t~ ~d;~
'SWP/024 (1/81) ~.
I~". .:-'~ [] SOl LS LOG
PERFORMED FOR:
LEGAL DESCRIPTION:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
PERCOLATION
TEST
DATE PERFORMED:
SLOPE SITE PLAN
lO
11
12
13
14
15
16-
17-
18
19
2o
COMMENTS
PERFORMED BY:
WAS GROUND WATER
ENCOUNTERED?
-- ~["~-~O{~. O~l~ ~-~b'~IFYES, ATWHAT · DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
I e~z~-8~ 7! ~o P ~-'~
/ ~ ~ N too P ~o r~,~ 7-~ ~'
Ho. ~457-E ~' 'ION RATE Z- '? (.~nutes/inch)
i~:~ TEST RUN BETWEEN 4 FTAND '~"~' ~'-'~'~ T
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4-
5
6
7
-8
9-
MUNICIPALITY OF ANCHORAGE ~..
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~. PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
SLOPE SIT
10
WAS GROUND WATER S
'i 1 ENCOUNTERED? ~L
P
E
12 IF YES, AT WHAT
DEPTH?
13
Gross Net Depth to Net
Reading Date Time Time Water Drop
~ ,, x)c ,o ,, ,~ ~,
,~ . ~ ~', .
20
PERCOLATION RATE 4 (~inutes/inch)
RUN BETWEEN ~ FT AND ~ FT .
COMMENTS ?~/~//~,~
TEST