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HomeMy WebLinkAboutLEOS LT 2Leo s S/I) 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 ,,~"N EW [] UPGRADE ] Well Absorption are~ DISTANCE TO: J Man u facet ]Liq,~caj)acity ~D gallons I ............ I Inside length / DISTANCE TO' IWell .f ~/Dwelling [Manufacturer / Welt., -- Found,.a:t~ou. / D STANCE TO: Ira, >, No. of lines7 Length o~_c~'n~ Total len,.~th li~es / Length Width Dept~ [ Type of crib Crib diameter Crib depth ) Well Building foundation DISTANCE TO: m DISTANCE TO: Building foundation Sewer line / OTHER PIPE MATERIALS Dwellir~.g.g~__ Widt~ Material Neares~/J~)lin e/ No. of coml~artments ~ Liquid depth PERMIT NO, Liquid capacity in gallons Total ef~e~..~r!" 'p~ar,~.~ PERMIT NO. / inches Total effective absorption area Nearest lot line Distance to lot line pERMIT NO. Sept c tank Absorption area(s) DATE 72-013' (Rev, 3/78} 0 0 0 o 0 0 0 0 0 0 0 0 0 cd O O~ © rd 0 0 rd O o MUNICIPALITY OF ANCHORAGE HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST / 2'8' 10 11 12 13 SLOPE DATE PERFORMED: WAS GROUND WATER ENCOUNTE. D? /',,/O ~ O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop 14 15 16 17 18 19- 2O COMMENTS PERCOLATION RATE TEST RUN BETWEEN '~"~- FT AND (minutes/inch) ---- FT 72-008 16/79) WAIVER OF LIEN In exchange for $ 50.00 , receipt of which is hereby acknowledged, the undersigned hereby waives and releases any and all claims, rights to lien, liens or stop- payment notice rights created under AS 34.35.050-120 attrib- utable to labor, materials, services or equipment furnished on or before April 5~ 1979 upon the following described premises: Lots 5 and 6, Leo S/D located in the Anchorage Recording District, ~lird District, State of Alaska. DATED this __ day of , 19__. Judicial ]~p~rtmel~t ~,nvjLo_r~e_n_tal Quality __ STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this day of , 19__, before me appeared and , to me known and known to me to be the persons who executed the foregoing instrument and acknowledged volun- tarily signing and sealing the same. NOTARY PUBLIC FOR ALASKA My commission expires: L-74 (8-78)