HomeMy WebLinkAboutTract C
MUNICIPALITY OF ANCHORAGE
.~ D[..~:ITMENT OF HEALTH AND HUMAN SER,,.~.~ ES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
~,~ ."7~ ~oofA DISTANCES
~ SEPTIC ABSORPTION
~ere~ WELL
~EO /V~-~ Po,~=~ ~. ~o,-~ ~' ~j-~ ~ TANK FIELD
Phone(s)~ ~ Permit NO. ~ ~ NO. Of Be~oms. o WELL //~ ~ +
LEGAL DESCRIPTION LOT LINE ~ 1 ~ ~ ~ ~O
r~ c S ~j.,...~ I/o.~4 ~5 FOUNDATION q 500 .-k
Township, Range, Section
TANKS
g SEPTIC ~ HOLDING c~. .~h~..,f
TYPE OF SYSTEM
~TRENCH ~ BED ~ W. DRAIN ~ OTHER
original grade ~ FT / ~ F1
~ FT ~ ET
~ FT
~ ~ S~ ET ~ FT
WELLS
~ PRIVATE ~ OTHER (Identify)
FT~ ~
RE~ARKS:
Health Depa.ment Approval: /~ ~' '~7~Date: .... 'g--~C--~
72-0t3 (3/85)
DEF'ARTHE]',I'T C)F:' HEAL]'H AND ENVIRONME]',ITAL PRO'FE:C'I'ION L STREI!.:.Tr, Pfl'-~C,I-h._,R~...d:~E;., ,/..',il.::) 9950
F'ERM I ]' NO .~ 8o ....: ,J8
· DATE ISSUED: ()9/1'7/86
AF:'F'L I CANT:
ADDRESS:
CON'I-AI]"f' F:'HOhlE ~
GREG BOOTH.
9940 NEARFq]INT DR~
ANCHORAGIE, Al< 9950'7
3:37-46:59
LE']GAL DIESCR I I:::':
LOT SIZE:
NAX BIEDROOMS:
SUBDIVISION,", S]UCKAGAIN NTS. LOT: TRACT C
SEC]'IOIq~ 6 'TOWNSNIF:': i~N RAN('3E~ 2W
:il;?,. ()2A (SQ,, FT,, C}R ACRES)
3
,.. L.OL, F,.: NA
l_.i, steE below ape 't..ht~! optior]~i available 't.o you in dEO)Eiigj!"liFl(J your' septic
system,, Choose tl-i,~:~ c,p'Limn ':']a't !:.~as~'. F:i.'Ls your' site~
DEF:'TH 'l-C) I:::'IPli_{ BO'I-TOH (F:"F.) 4= 0 ~' 5.0 5.0
GRAVEl_.. DEPTN (F-'T~) 6,, 0 ~ 0,. 5 3.0
!'O-I'AL DEF'TH CF'F=) !().0 / 5,,5 8. '
GRAVE]_ WIDTH (F'T.) 2.5~ :17,," 5.0
E~RAVEL, I,..E:NGTH (F-['.,) 33.0 E:4.= 0 44., 0
GRAVE]..,. VOLUME (CLI,, YDS ~ ) 19.9 ~2 :[. 5 ;~8,, 6
"I'ANK SIZE (GAI_.S) 1,000.0 '~'~:- 1,000,,0 -~.e 1,000.0
SOIl;_ RATIN[~ (SQ.FT,, /BR) 130 125
'TANK MUS"F I-CAVE AT I_EAS'T I'WO Chi Ih,.,~r..
I cer't, ify 'Lhai:.:
I,, I am familiar
~ci,'Lh t.l"ie requirements for on-si't.e sewers and ~e:.l, ls as set
foPtLh by 'LhE~ IqLuqi~ip~].J.'Ly Of And'~cmage (NOA) and Lhe State oF Alask~,
i t,~i].l ins'La].]. 'l:,he system in a(ECOPdO. FiCC~ t4i{:.h all MOA c:ode)~ and
and in coifipJ.:J, aFHze !,~iith '~,h~:, d~sJ. gl'l cr, itePia of this per'mit.
I t~d.].], adher'e i:.o ali PIOA and State of Alaska i,equ:ipemer'lt.s fop the si.~'L bac:k
distarlces fpc)m any t~xi~9'Cil']g t~E9].].~ ~sastewater disposal, sys{em or public
sewerage tsystem on Chis op any acJ.jaceFrL or' nearby
I LtF/dEeps~tarqd t, lqa'L this per'mi{ :is valid for' a max:J, mLtm of' 3 bE:dPE]OFllS and
any enlargement will pequire an additional permi'L.
IF: A LIF'T STA'I'IC)N IS !F.ISTALLED ):lq AN AREA COVEF~ED BY MOA BLIIL. DING CC]DES,
'THIEI~ (1) AN ELECTFU[CAL. F:'ERMIT AND ]:IqSPECTION MUST BE OBTAINED; (2) AS-BU):L,,TS
W!L.L NOT BE: APF:'ROVED WITHOUT AN ELECTRICAL, INSF'ECTION REPOF~T; AND (3) THE
ELECTRIC)AL WORK MUST BE DONE BY A LIE)LENSED ELECTRIC:CAN.
Municipality of Anchorage
DEPARTMENT OF HEALTH A HUMAN SERVICES
825 "L" Street. Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
.J
DATE PERFORMED~
LEGAL DESCRIPTION: '/"~'~' (~j S'I[~¢~"C..~.r,.,' ~Township, Range, Section: ~/~ ~ ~c. ~ ~/~-~
SLOPE SITE PLaN
5
6
8
9
10
11
12
13
14
15
16
17
18
19
20-
WAS GROUND WATER
ENCOUNTERED?
s
IF YES, AT WHAT ~)
DEPTH? p
Deplh Io Waler After/'
Monitoring? ~ Date: ?-/1-~
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
[m~nutes/mch) PERC HOLE DIAMETER
CERTIFY THAT THiS TEST WAS PERFORMED IN
72-008 IRev. 4/85)
· ALASKA ENVIRO N AL
· . 'CONTROL SERVICES, INC.
1200 West 33rd Avenue. Suite B
ANCHORAGE. ALASKA 99503 CALCULATEO BY
(907) 561-5040
CHECKED
SC^LE
OF
DATE
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