HomeMy WebLinkAboutT15N R1W SEC 8 LT 86
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 WE!LL INSPECTION REPORT
-~./[J~_ I I~i} AD~DR ESS
LEGAL DESCRIPTION
~OCATION NO. QF BEDROOMS
PE MI NO.
~" Manufacturer~'S~*'O~ I / I z~ I Ab'°rpjib"P" - MaterlaIDWelling ~' ~'~r~ ~r:)' No~ '[~)' ~ of [omp~ments
-- Liqc~j~)paci Y in gall°ns IF HOMEMADE: Inside length ~ 7~h Liquld ~p)~
~ ~ DISTANCE TO: Well k { ~ A Dwelling PERMITNO.
~ ~ ~ Manufacturer~ Material Liquid capacity in gallons
Well Foundation Near~R,~ PER IT
~2 DISTANCE TO, J ~Oj ¢%/ '~ ~L-o
~ ~ Nc. of lines / ~_~ _ k, ches -
~ L'ength ~h/line Trench~l DisF~en lines
~ Top of tile to finish grade j Materia bene~t~e i~/*~,'~/' J(¢(l~
~ ¢ .;[ ~.~ inches Total effec ire r on area
m DISTANCE TO:
; Class Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundat Sewer line Septic tank Absorption area(s)
OTHER
~IPE MATERIALS
72-013 (Rev. 3/78)
DEi:F:'AR'T'MENT OF HEAL. TH AND I!~NVIRONHI!ENTAL F'ROTECTIC]Iq
825 L STRIE;ET, ~-~IxlCIdORAGE, Al< 9950:1.
264-Zl, 7~?0
FLRilZ1 lxlO:
I}ATIE I ,.I,.IUL. D,
Il_ ]~ I~ ~.fl ..... ~ ]E 'T BEE
e~4o'739 Pt/~,~-<M3-
0813 1184 off-
Al' F L .[ ..AN I .
COl 1 [ AC. I I HOI',IE...
L. EI!')AL. DI!,:.:Si]IRIF:': SL)BDIV]:SION:: I\IA LOT: 86
8ECTI[)I~: 8 TC3WNSHIP: :L51\1 RANGEE: 1W
I...OT SIZE: 2.C3A (BQ,,FT. C)R A{]RES)
MAX BEDI~0OI~$: 4.
BL..L)[.,{ ..... NA
L :i. ?i; t e d I:)e I o w a r' e t h e c~ p t i c)n s a v a :L 3, a b :L e 'L o y c:)u ~. n d e ~ i g n iJn ~1 Y {::)u r' s e p t i c
system. ChDose the c~p'Lion that bes'L 'fi'Ls y~JL~P
'IF IF;~ EEl I1',~ C]: H"-H :lEa lEE] 1[;I, II;,,.~ ~ IF .,. ~- ~ ][: IPql
DEP"I'H TO PiF'E BOTTOM (F'T.) 4., 0 4,, 0 4.0
GRAVIE:I.. DE:F:'TI'1 <F'T ,, > 6 ,, 0 () ,, 5 3 ,, 5
"r'OTAL DIEF'TH (FT.) 10.0 4,, ',:S '7,, 5
BFiAyI~I.., WIDTH (FT,, > ~,, 5 i~:1.,, 0 5,, ()
GF/A~EL. I.,,IEIqGTH (FT.) 46.0 40,, 0 60,, 0~
GRAVEl... VOI.,.UHI~( (CU,, VI)S,, > 2'7'. '7 3 :L ,, 2 4~4.5
'I"ANK S ]: ZE ([:JAL, S) 1, :;:tSO ,, 0 a..~. 1 ~ 250 ,, 0 .~,~' 1,2t50 ,, () '~'~'
SOIl.., RA'I"ING (SD,, FT,, /BR) :L38 :L3B ;L:58
.~-.,',~ TANI< MLJS"F I..IAVEE A'T' LEAE:i'I" TWO C[IMPAF~TI~IE]',IT.C.3
:l,. :[ a/Il t'atlli].iaP ~i'Lh t. hi;=, I"eqLlil"F-~lll~.f]'~.~ I'DP (]ri'~''~-:iitl';~ slf;~N~]l'~ al'id i~;~:L].~i~ a~il sE~t
{'clp'Lh by 'LI'J~ Muni, cil~a],ity o~ AnchcH'age (MOA) arid the E~tate o[ Alaska.
~;~,, ]~ will :i, ns'La],]. 'Lhe ~iyslt, em iii acc:cH',darlc:c-~ w:Lth all i~I(::)A c::(]des ar'id
and J.n cc)~lp].ial']ce ~i'Lh the des:i, gr'l cp:i. tem":ia c~t' this,pc~r'm:i.'L.
:~;,, I will adhepe,t.c:~ a].l M[IA and State (]t' Alasl::a pequipem~,m"lt.s t'cm 'Lhe set back
distanc::es t'~'om any existirlg v~e].]., wastewat, er' d:Lsposal sys'Lem c)p public:
sow~:,mage system c)r'l 'U']:i.s tip any ad,jacen'L {ir' ne}ar'by lc)t,,
4. 3: L~ncl~P~talqd 'LhaL 'Lhis p(er'mi'L is va],id t'c:){' a maximLun ar 4 bedr, c)oms arid
ally, [:~Fi1L;~PgE~iit6)r'I'[L ~i],]. p~ClL{iPe ar3 addJ.'LJ.(:3l"ia].
IF A L]:F:'T ,.~1A1 .ION IS II'4.)IAI..LE:D IN AN AREA I][]VERED BY MEIA t..LIII.J].[IIG CODIES,
TI-lIEN (1) AN I:.M_.btl .I.t.AL ILRM1T AND INSF'E[i]'I[IN MUST BE OBTA3:NED; (2) al~i-BUII2YS
WILl,.. NOT ~;E AF'F'ROVED WI]"HOLJT AN LL.L[,,FI~I[.,AI.. INSF'IECTION I~LI Obi, AND (..:,) THE
AF'PLIDANT~ C~[i S ~/S IZNGINEERS AL ;IgF~30N ~
ENGINEERS, INC.
712.~ OlD SEWARD HIGHWAY
ANCliORAGE, ALASKA 99502
(907) 349-6561
SOIL. LOG
SOIL LOG
PEERCOLATION TEST
DATE PERFORMED
DEPTH
(FEET)
15
16
17-
18-
SLOPE
ROUND WATEH
rERED?
IF YES. AT WHAT
DEPTH?
h
W E
o ~ I I ~ ~ , i
CERTIFIED BY:
DATE