HomeMy WebLinkAboutSOUTHPARK #3 BLK 1 LT 8
/..~.-., MUNICIPALITY OF ANCHORAGE ~,-,-~
> D[ :TMENT OF HEALTH AND HUMAN SER !S
% · Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Na.~e DISTANCES
~O.~TH ~r~¢_,Y_ ~, ~. ~ TO SEPTIC ABSORPTION
[ ~0 ~ ~m~s ~N~ , ~ TANK FIELD WELL
township, Range. Section ~-~ ~S-B UI[~IAGRA~ (Show Iocat,on o[ wail. septic system, property hnes, founder, on,
TANKS U
~ SEPTIC ~ HOLDING
Material No. of Compartments
TYPE OF SYSTEM
~TRENCH ~ BED ~ W. DRAIN ~OTHER
Total absorpt,on area j Distance between I,nes ~ ~
Number o1~ .... Sod ral,ng~, CJ Pipe matebal .~ ~ - · ~ -
~ PRIVATE ~ OTHER fldentifv)
Classlbcat~on (A,B,CJ Total Depth Cased to
I
Scale:
I s~ections Pedormed by:
Health Depa~menl Approval' Date ~
72 013 (3/85)
OE:F:(.~R'FI"IEN'I- [IF' HE(:~LTH ~;~hlD E:NV I R!3NPIE:N-I"¢IL. PF,'O'T'E:C"F I
2~:,4.-4720
:O~TE 1,, ,..flJE.b,, "'1 /:~- /E¢&
I...E:GAL L)EL:;CR:I:F': I-3UBI):[VISION: SOUTHPARI< ~,~:5 LOT:
SECT:iON: ;: -['DWNSH1F': :[ 1N RANGE
LE)']' SIZIE: 20000 (Sg),FT. UR (~CRES)
I'~h:1X B E:DF;'.EIC)I¥tS: 4
BLOCk.. 1
IF '-:~ _.IFI'
I'I"II:EN ( 1 )
N]:l..d.. NDT l.~,~-: (:'~F'F'F,tEI'v%D N:['I"I"I£)LJ'I- (-"~1',1 E:I..['3Z:TF~IC(~L INSPIEECTION RtL"E.F'£)RT~ A/ND
~lr.~[IOII J:li:~ 'rI',ISI'ALL,.E9 IN AN ARE(:'~ CC)',.,'E:F.:ED L ~- MOA 81.JI[_i}:[l\l(:~; CC)DES~
qh.I E[...l::.L, fi-.,.[L,l.~l.. F:'E[I:-:~i"II"f al, Il) I. II,,.FIE.,.., 1OI4 FIUST ~::iE: EiBq(.:~]:NIE:i).~ (2'.) ,..... I..,U.,.I..,.I~
THE
.-.,I I ,...1,_,,.,..,i ..... )UI,I. ,-,.,.[,. DIEV
SEWER SYSTEM
561-6151
LOCATION PLAN
Lot: ~
I BIock: /
Subd= 5 ~/t ~-,~, ~
Prepared for: ~-
Date:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: Loll
DATE PERFORMED:
2
3
4
5
6
7
8
9
10
11
12-
13-
14-
15-
16-
17-
18-
19-
20-
,sm
WAS GROUND WATER
ENCOUNTERED7
IF YES, AT WHAT O
DEPTH? p
E
geCh ID Water Alter
Monitoring? Date;
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
{minutes/inch) PERC HOLE DIAMETER
~ TEST RUN BETWEEN F-T AN~ FT · ¢
PERFORMED BY: /~/~'/~-- ' , , ~ J,d~ CER,IFYTHATTHISTESTWASPERFORMEDIN
I1'' [// I IN FFECT ON THIS DATE DATE I ~ ¢~
(Rev. 4/'85)
VED
PERCOLATION TEST DATA SHEET
ADDRESS
ZIP CODE
LEGAL DESCRIPTION
TOTAL DEPTH OF HOLE W/~ -FT.
ZONE TESTED ._~ FT. TO ~,~ FT.
DATE ~'l~'~
I
READING CLOCK NET TIME DEPTH NET DROP
TIME TO
DATUM
~fhO 3: 4~ 0,4%
~'.~ ~0 m:~ 014.~ 0,05"
FINAL PERCOLATION RATE
PERFORMED BY
(min./in.)