HomeMy WebLinkAboutSOUTHPARK #3 BLK 1 LT 33 *-%, MUNICIPALITY OF ANCHORAGE
DEr jTMENT 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
Name
~ddress
Phone(s)
LEGAL DESCRIpTIoN
DISTANCES
SEPTIC
TANK
ABSORPTION
FIELD
4-$00.,
WELL
~IKS
[~*/~E PTIC [] HOLDING
c'ct o a I ' o0
Materia,~ jeji~ I' NO. o, Compart%
TYPE OF SYSTEM
[] TRENCH [~""BED [] W. DRAIN [] OTHER
Deplh to pipe bottom from
Gravel length
qT.o
Total depth from original 9rade
Gravel depth beneath pipe
ravel width
zq.o
istance between lines
Pipe material
'PVC
Inslaller Date Installed
WELLS
FT
FT
FT
[] PRIVATE
[~¢"OTH ER fldentifv)
Total Depth F~ Cased to
Date Installed:
REMARKS:
FT
LOT LINE
FOUNDATION
7-1¢' Z3' %5OOr
Municipal and State §ti?lines in ellect on Ibis darn:
Health Depadment Approval:
AS-BUILT DIAGRAI~I tShow Iocahon of well, septic system, p~operty hnes, foundation,
water bodtes, etc.)
.[;eMily tl~l Ihis inspecgon was pcdormed according to all
Scale: trio MC----
Inspections Perlormed by: : '" '
Dale:
DEPARTMF_']MT [)F HEAL. I'H AND ENV]~RONMIENI"AL. PRO'TECTION
H25 L. STRE;E7 ~ ANEff-IORAGE, AK 99501
264-4720
F:'ERM I "F NO: c') :~ ........ :~:
.LA]~:. i.~lclJ~:D,, c-)~ · '_ /?-}6
APPL..ICANT: :~!JUTHPARK DEV. CO.
ADDF:~ESS: 1.6420 ST. 3'AMES
qNCHORAGE~, Al<. 9951~
C(DN'TAC] PHOI',IE: 345-2 122
LEGAL. J2ESCRIP: SUBDIVISION: SOLFFHPARK ~3 L..OT."
SECT:[ON.~ 3 TOWNSHIP: :t:[N RANGE: ::;W
LOF SI ZE: ;,:L5756 (S~;~. F']'~ OR ACRES)
MAX BEDF400MS:
BLC]CK:
DEPTH 1'13 IPE };d]'I-t"OM (I::'T.
GRAVEL. DE:PTH (FT
FOTAL PEP H
GRAVEL W ]: I)"l'l
GF~AVEL L..ENBTI' I
GRAVEr VJ:)LLff'IE (CU. Vi)S.
TANK S'[ZE (GALS)
SOIl._ RAt ING (SQ.F'I". /BR)
L. is'~ed be.l. cm., are 'Lhe option~i avai].abl(~: t.o yOLt in design:Lng your' septic
;= ¢::~ ..8f ¢]ho('~f4~ ~.h~ op'LioFi tha'L b~t ~ its yC)L~P
· . 0 .3
..~ ,, 5 · 3.5
188
~:~'~ DEPTH 'IL] I":'IF:'E BOf'TOfd '::: ..:,~...,¢=' F:T. REQUIRES IN=UL.~TIOll
~-e' DIEF:'TH 'r[] P ZF'E BOTTOM < /~, (') FT. MAY RI=.B,L. I FE. A LIFT ,.~IAf ION
~<-'~-,.kU~xE:.L_ I E'NGT'H .::' 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 F7". lEACH)
~":~' f~-~Nl'-.. I"II.JS'I HAVE AT LEAST TWO [.,[~I-]FAf'~HENI~_
cent:i fy tha'L:
fc)r'Lh i:Yy 1Line IvJt..uq:i. cipaJ.:L'Ly c:~f Ai"lchopage (MOA) and the S'L~te of Alaska.
,Z,. i ~u:i.].l ir'is'La].], the csv~'L.(-~Jll :LB accor'danc:e ~J. th all IdOA codes and PBgl. J],att;J. Of]B~
and ].J complzance with 'the des:Lgn (:PitE. P:[a oJ 'Lhis pspmit.
3,, ]] ~l:j.].l adher'.e 'Lo ail. HOA arid State of Alaska r, acjt.t~.pef~erl'Ls f'op 'Lh(~ ~¢et
d:L!~FLarH;:es f'rom any existirtg well, was'Le~,~a'Ler d:i. sposal system op pub].ic
4,, I L&rider"s'JLand tha'L this pepiJiit :Ls valid For' a ma:,limufl~ of' 4. bedr, ooms and
'any er'tlargernerrL wi].], p(:g)cjt.t~,pE~ an ac:Jd:Lti;]ria], per'mit~
!F A L21:F:'T S'T'ATION IS ~NS'~'AL. LED IN AN AREA C-OVE:RED BY MOA BUII.-DiI',IG CODES,,
'1"HEN (J.) AN EL..EC:;TF~ICAL F'ERMI'T AND INSPE:C]'ION, HUST BE oBTAINED; (2) AS-BUIL..TS
WILL NOT BE AF:>F:'ROVED WITHOUT AN ELE[TIRICAL. INSPECTION REPORT; AND (3) THE
EI_.IEC'IT::IICAL WORK HL.IST BIE DONIE BY A LICIEIx. ISED EL. EC"FRICIAN.
AF:'PL. ICANT ~ SOUTI"ff:;ARK DEV,, CO.
DATE=
........... ~ ................. ;._..= ..............................................................
SEWER SYSTEM
nc.
Itlng Englneer~
Alagka
LOCATION PLAN
Lot: -~ Block: t
Prepared for: .~'~-,4~/~-
Date:
PERFORMED FOR:~' ~,~ · · ,,
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DEPTH
I t1
15
19
20-
COMMENTS
Township, Range, Section:
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water After
Monitoring? Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
,5-0
/O ltq t'V ~ o u "
PERFORMED BY:
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE~IN EFFECT~/R THIS DATE. DATE:
72-008 (Rev. 4/85)
PERCOLATION RATE ~LT(minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~.. FT AND .~/~-~T ,
, //)//¢' // ' CERTIFY THATTHISTESTWASPERFORMEDIN
I