HomeMy WebLinkAboutT15N R1W SEC 18 LT 186
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
'~-~ ~..~-~-~p H L~fZ-~. FROM~ SEPTIC ABSORPTION WELL
^~dre~s "~ TANK FIELD
Ph~l~e(s) Permit No. No. ol B~rooms WELL
Township, Range, Section AS-BUILT DIAGRAM (Show location oi well, septic system, p~ope~y )ines, (ounda~ion,
~ ~ ~ ~[~ ~ ~, ~ dr,veway, water bodies etc,
TANKS
SEPT C ,OLm.6.
TYPE OF SYSTEM "
~ TRENCH ~ED ~ W. DRAIN ~ OTHER
Depth tO pipe bottom from Totm depth from original grade
:,,, added above origi.a, grade Grave, depth beneath pipe
~ FT ~' ~F1
Gravel length Gravel width
Total absorption area ~ ~Sg F1 ~ist"nce between lines ~ FT /
Number of linesSoil rating Pipe material
WELLS
~RIVATE ~ OTHER (Identify}
_1 1111
REMARKS:
11 4 Ea le River Loop Road No. 204
72-013 (3/85)
M U N I C I P A L I T Y O F A N C I"~1 /ii R A G E~
825 L ',:iH:.r, ee't.., Anchr:)l~age, Alaska 9950',1. 343-.4720
IX'er, mit Numl::ler'~ 89()101
Dat. e J. ssued: ()61,'..~%:~189 lii!:ng inee~~
S E W E R P Ei. R M
De!~igned
Owr'~er' Name:
Own e r, Ad d r' ess:
R I CI"~AI::~D MOORE
P,O. BOX 2()()42
AN[',H[IRAGIE: ~ Al<
Day Phclr~e:
694-2979
L,.o'L L. eg a 1: Sub d :i. v i s i on: I_o'~:. ~: 1E:~6 B 1 oc k = ....
Sect.:i. on~ :1.8 'l"owr~ship~ 15N Rar~ge~ 1W
Lot. S:i. ze 54450 (sq. f"L.. cm acmes)
Max Becl p CJC:)[IMil; II Th :i. s Perm i t: 3 "l"o'[a 1 Capac: i ty: :3
SEI:::'T'IC T'ANK: Minimum t. otal sel;)t:i.c rani.:: capac:ity: 1~,000 gallons. Each sept.:m.c
tank must have at ].east, 2 c:ompar"~..ment,~. Dept. h '[(::) top c){ sept. ic: t. anl.::(s) < 4.0
Ilql::rCIl::;'.M l}.l"t,,H.~!,i., I:::'RIOI::;: T'O 1ST 8< 21qD INSPIE:[;'I"IOI',!!!i$ BY ENI3INIE:I!i!:F'i~ IF:'
AFTEI:~ OFFICk]: H(Z)LIRS, CAI,...I., 34,:3-'4.68 :1. AND L. IEAVE ¢4 MESSAI;'~)E,,
CON~I]"RUC',T' PI>ER IEN&:}IIqEIERSi A"I'TACHED AF:'F'RCIVED DE~}[~Ii31q.
'THIS I:::'IERMIT EXP]:RES :1.2./3:1,/89 AND VhI.,..ID F'OR A SINGI_E F:'AMZI_Y HOME.
I CERI":I:FY FI'IA'I
1. I am familiar wit. h tl"~;~ r, equir, emer'rLs ~'l::m on.,.,s:i.t.e sewer's and wells as set
f'or't.h by t.l'~e Mun:kc:i.f,:)alit. y o~' Anchc~r, age (MOA) and 't'.,he S'l',,at, eo~' A:l. aska~
2. ~[ I~i',[~[ ;if'l~iiF(.a],l 'U"I~G) !~;y!i[il:,elfl :J,t"l acc:oPdal"lC:e with a].]. MOA c:odes and r, egulat, ions,
and :i.n comp:l, Jance with the design cr'&t, er':i,a o¢ this per, mit.
3,, ]: t4i].], adher'e t.o all MOA anti State (::)t Ala~ll,::a r, equir, emerrt'.s ~'(:)f, the set. back
d:~star']c:es fPom any existirlg well~ ~as'Lewat. eP disposal, syst. em of i::H..tblic:
4. ]J] LU"ld~DPst. ar'~d t. hat, this per'm:i,t, is valid
also undcr's't'.and t. hat. the c:apac::i,t,y o¢ the t. otal syst. em is :3 bedf'c)cHlu~; al'id
any e:,r'llar'gemer'~t ~:i. ll r'equiPe an addit, ional pePin:i.t,.
(Owne~r'.)~ I~RD MOORrZ
SCALE
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Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE
Township, Range, Section: ,..~OCf/(~. T/5/~ ,,~/~
SLOPE SITE CLAN
I-
N
.,
10
11
12
13
14-
15-
16-
17
18
19-
20-
//~L)/~. WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT SL
DEPTH? pO
E
Depth to Watar ADer~/~- ~¢y
Mo~ltorinll? (.,"~ ~Z' Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE __
(m~nutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN FT AND FT
,*=r~ o,, S & S ENGINEEKI~G
ACCORDANCEWI~iI~DL~¥*I~EJI~t~U~N~I"~IPALGUIDEL~FECTON THISDATE. DATE: ~,/~ ~/~/~:~ ~
Eagle F, iver, 32aska
,&
SAiUI COTTE!'.~' DRi'LLhNG CO.
Box 298
Eagle River, Alaska
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