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Home My WebLink AboutDENAM LT 1 MUNICIPAUTY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 8;25 L Street - Anchorage, Alaska 99501 Telephone ;264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~-AILING ADDRESS L~GAL D~SCRIPTION ~CATION .~ NO. OFBEDROOMS NEW UPGRADE Absorption area Width.~ /Z-.~ Z~' D'STANCETO:IWe"// ' I D.,,,ing Manufacturer ~ ~ ~ Material. £>~'pjkz / No, of compartments~)~_ in gallons I F HOMEMADE: Inside length Liquid depth DISTANC~ TO: Well Dwelling PERMIT NO, Manufacturer Material Liquid capacity in gallons DISTANCE TO: w~l,/I~ r Foundation/ {~) ! No, of lines/ Length of~each~li e of tile to finish grade Nearest lot liner~ ! Trench wi~) inches Material beneath tile Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: ,31ass Depth Driller Distanc0 to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer Ibm Septic tank Absorption area(sD OTHER PIPE MATERIALS P V' ~. pc,q5 pla, SOl L TEST RATING /cOO D'O, FT', /~ ,'~. INSTALLER REMARKS APPROVED 72-013 (Rev. 3/78) LEGAL PERMIT NO. 8PPLICBNT ROGER MBRCUM STBR ROUTE BOX 90}0 9956?' G88-2057 LOCBTION BIRCHWOOD LOOP ROBD LEGBL ~lSN RiW SE~[IONi8 LOT 100 ~ LOT SIZE 150000 SQU~RE FEET TYPE OF SOIl_ BBSORPTION SYSTEM IS~ TRENCH MB~<IMUM NUMBER OF BEDROOMS = ~ SOIL RRTING (SQ FT?BR)= 100 ]'HE REr..~UIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DR~INF:IELD. THE DEPTH OF R TRENCH OR PIT IS '[HE DISTRNCE BETWEEN THE SURFBCE OF THE GROUND 8ND THE BOTTOM OF THE E;~CRV8TION (IN FEET). THERE IS NO SI=T WIDTH FOR TRENCHES. THE GRR',/EL DEPTH IS THE MINIMUM DEPTH OF GRBVEL BETWEEN THE OUTFBLL PIPE 8ND THE BOTTOM OF THE EXCRV~TION (IN FEET). PERMIT 8PPLIC8NT HR.~; THE RESPONSIBII.ITY TO INFORM THIS DEPBRTMENT DLJRING THE INST8LLRTION INSPECTIONS OF 8NY WELLS 8DJBCENT TO THIS PROPERTY BND THE] NUME:ER OF RESIDENCES THBT THE WELL WILL SERYE~ TP.I() ( ~: ) I N-."~F'IEC:T I 0~'4-~. FIRE REC~U I ~:E[) BFICKF'ILLING OF RNY SYSTEM WITHOU'r FINRL INSPECTION RND RPPROV~L BY THIS DEPF~RTMENT HILL BE SUBJECT TO PROSECUTION. MINIMUM DISTBNCE BETWEEN B WELL RND 8NY ON-SITE SEWAGE DISPOSI~L SYSTEM IS iL00 FEET FOR I~ PRIV8TE WELL OR iL'iD TO 200 FEET FROM ~ PUBLIC WELL DEPENDING UF'ON THE TYPE OF PUBLIC WELL. MINIMUM DISTBNCE FROM B PRIVBTE WELL TO B PRIVBTE SEWER LINE IS ~:5 FEET TO B COMMUNITY SEWER LINE IS 75 F:EET. [)'[HEIR REQUIREMENTS MBY 8PPLY. SF'ECIFICBTIONS BND CONSTRUCTION DIBGRRMS BRE FY,/F~ILBBLE TO INSURE PROPER IN.ST~LLBTION. I CERTIFY THaT l: I BM F~MILI~R WITH THE REQUIREMENTS FOR ON-SITE SEWERS I~ND WELLS ~S SET FORTH BY THE MUNICIPALITY OF 8NCNOR~GE. 2: I WILL INST~LL. THE SYSTEM IN ACCORDBNCE WITH THE CODES. 2~: I UNDERSTBND THRT THE ON-SITE SEWER SVS'T'EM HRY REQUIRE ENLBRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 5( BEDROOMS. S I GNED: .................................................. FIPPL I CFINT ROGER MFIRCLIf~I I SSLIED BY ~ ................................... D R T F _ _L_~. Z./~_~_~3_ ...... v4. 0 825 ~[_ ,,TREE-T, RNCiiOF,'ROE, RI<. 264-472~ N E g. L_ ~ I'..,I [:) Lq ~-4 -- :5 ~ l' E~ S g [-.I g F:: I=' E R I"1 I "r PERMIT NO. ( LEGRL T'r.PE OF SOIL RBSOkBTZO~ ~STEM ~S: MRXIHUH NLIHBER 0F BEDROOM ..... c~ SOIL RRTINL~ THE REQ.IRED SIZE OF THE _OIL RBS:RP"FION SYSTEH THE LENGTH [ IblENS.[ON IS THE LENGTH (IN FEET) OF THE TREHCH OR DRRINFIELD. THE DEF'TH OF R TRENCH OR PIT IS THE DISTRNCE BETNEEN THE SURFRCE OF TFmE GROUND FIHD THE BOTTOM OF' THE E,~_.RCRTIOH (IN FEET). THERE I2; NO SET HIDTH FOR 'TRENCHES. TNE [)RRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETHEEN THE OUTFRLt_ P~PE RND THE BOTTOM EmF THE EXCRVRTION (IN FEET). PERMI'F FIPPL. IE:FINT I-IRS THE RESPONSIBILITY TO INFORf'I THIS DEPF:IRTMENT DURIMG THE INSTfqLLFITION INSPECTIONS OF RN¥ WELLS BD, HuENI TO THIS PROPERTY 8ND THE HUMBER OF RE:,IDEN[.E_ TI-I~T ]'HE [4ELL NILL SERVE. BRCKFILLING OF RNY ..%ST,--r1 WITFIOLIT FINFIL INSPECTION RND RF'Pf~.OVRL BY THIS DEPFtRTMENT WILL BE SUBJECT TO FRO..EuUTION. MINZMt.IH DISTRNCE BETHEEN FI HELL RND RNY ON-SII'E SEWRGE DISPOSRL. SYSTEM IS ~.00 FEET FOR R PRIVRTE WELL~ OR ::t50 TO 280 FEET FROM R PUBLIC WELL DEPENDING LIPON THE TYPE OF PUBLIC 14ELL WELL LOG~ RRE REQUIRED RND HUST BE RETURNED TO THE DEPRRTMENT NITHIN ~0 DRYS OF THE 14ELL COMPLETION. OTHER RI-'QUIREMENTS MRY RPPL¥. .SPECIFICRTIONS RN[> CONSTRUCTION DIRGRRr'IS RRE RVRILRBLE TO INSURE PROPER INSI'RLL. RTION. PEF-~PI :I '1" E×P I RT..tS; [)EtT-EI'-IBE:R ~--:[--. :L.%TM 80 CERTIFY 'rHRT IRM FRHILIRR WITH THE REC.&JIREHENTS FOR ON-SITE SENERS RND WELLS RS SET I FORTH BV TNE hlUNICIF'RLI'F¥ OF RNCHORRGE. 2: !NILL IHSTRL. L THE .SYSTEM IN ¢ICCORDRNCE NITH THE CODES. _~: ! UNDERSTRND THRT Tt4E ON-SITE _~ENER SYSTEM HRY REQUIRE ENLRRGEHEHT ~F THE RPPL I CRNT Russell Oyster 694-2774 O & E ENG,,,EERING & DEVELOI Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Performed for: Name: ..,ENT CO. SOIL LOG ~ '~ A//// /~:~;,* Tel. No 4' / ~ '/¥ ,, , ~ -/ / ,' /'I~'/~t~ /Z /(.~, ~ Earl Ellis 688-2280 Mailing Address: Legal Description: -~:~ ' ' '/''~¢ / Depth (feet) Soil Characteristics PLOT PLAN 11__ 12__ 13___ 14___ 15___ 16__ ./... /?y/? :_,:/.',. Ground Water Encountered: Yes _ No Proposed Installation: Seepage Pit Comments: PERC, TES'r /'" If yes, what depth_ r -- Drsin Field Performed by'. ,~ ' ' Date: '