HomeMy WebLinkAboutWERRE LT 1 WERRELoT
(~,,,/ MUNICIPALITY OF ANCHORAGE L.~/
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 204-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE E~E~
NAME
.~,~.,g~ ~ ~ ~ UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
NO. OF BEDROOMS
PERMIT NO,
No. of compartments
LOCAT,ON
DISTANCE TO: I / '~ sorption area
Manufacturer ~--t,~-~
~Liq. capacity in gallons ~ ~ Dwelling
/~0 IF HOMEMADe: Inside length
DISTANCE TO: Well
Dwelling
Mat~---j
W dth
Well
DISTANCE TO: ~ ~'; ~/'),' /.~
Length of each line~
tile to finish grade
Material
Total length of lines
Material beneath tile
Liquid depth
PERMIT NO.
Manufacturer
Foundation Nearest lot line PERMIT NO.
Depth
inches
Crib depth
Crib diameter
Liquid capacity in gallons
Distance between lin/es
Total effective absorption area
PERMIT NO.
Total effective absorption area
Well Building foundation Nearest lot line
I~,~__'/ Depth Driller Distance to lot line PERMIT NO.
DISTANCE TO: Building foundation Sewer line Septic tank ~_ ¢- ---~ , Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
APPROV D LL"~ DATE LEGAL
72-B13 (Re~. 3/78J ~
PERMIT NO.
,:' ~005~o )
FIPF'L I CBNT
LOCFIT 1 ON
LEGFIL
HERE: NERRE
LT. t NERRE
DEF'BRTMENT" HEFILTH FIN[> EN IRLNMENTHL 'OTECTION
R'::.'~ "E~-/ :,TF. EEI., MNC. HORRL~E., RK. '.~'~.'~ii
264-4?20
~; E blEr~ PERf4 il: T
LSR E:~",=~ j r~.O~[I ~)
........ CHUG IAI< ,.-S
LOT ~- --
_-.IZE
~--20000 SQIJFIRE FEET
I--,. DRBINFIELD
TYPE OF q-I '- " '-' "- ""
_LIL RB~ORFTION --,T:,TEM ~
MR,'.<IMUM NUMBER OF BEDR~nnM'g = 4 :,OIL RHTINJ (SQ FT/'BR)=
THE REQUIRED _I,=E OF THE :,uIL RBz, CRFTI_N :,'r_-,TEM I':::
C, EF'T~-t= ~-': ~._ E ~".-I ~3 T H = 1~. L-' ,3 ~"~': R %~' E L DEF'TH= 5
F' ': I S G < 0 F
'THE LEN.~TH DIMEN_ION THE LENmTH IN FEET) THE TRENCH CIR. DRRINFIELD.
THE DEPTH OF R TRENE:H OR PIT IS THE DISTFtNCE BETNEEN THE SURFFICE OF THE
GROUND FIND THE BOTTOM OF.,,.T~E.~:E~a-$VA.~'~I'~F'I~"(':~['N"~FEE~TCq'~ ........ ......................... ,
THE TRE~'-4Ol~ (..$--~ I [.,TI-! ]: ~ ........ -_,. ~-~00 FEET:..~...?
THE GRR',/EL DEPTH IS THE M-~II~f'¢~~ GRR~,,~"~"~,'ETI;~I",I~'"'PN~'~'OIJTFR~E' PIPE
RN[:, THE BOTTOM OF THE EY, CRSRTION (IN FEET).
F'ERMIT RPFLI_.HNT HRS THE RE_-,FUN-~IE. ILIT~ TO INFORM THIS DEPRRTMENT DURING ]'HE
IN:,THLLRTILN INSPECTIONS OF FIN'T' NELL:-] FI[:,JFtCENT TO THIS PR_FERIT' FIND THE
NUMBER OF RE_,I.r.,ENCE_, THFIT THE NELL WILL SERVE,
TbJC, ( ~ TM I ~SPEC]- I C,[-~S R~.'E REC--!~J I F~:E[:,
_~m:TEM WITHOUT FINRL IN:,PEL. TION RND RPF'ROVRL B'T' THIS
BRCKFILLING OF RN¥ '-"¢" '- "
[:,EPRRTMENT NILL BE _,UE, JEI_.T .TO PROSECUTION.
MINIMUM DISTRNCE BETNEEN FI NELL AND RNY ON-SITE SENRGE DISPOSRL SYSTEM IS
· 00 FEET FOR R PRIVRTE WELL OR ±50 TO 200 FEET FROM R PUBLIC NELL DEPENDING
UPON THE TYPE OF PUBLIC NELL.
MINIMUM DISTRNCE FROM R PRIVRTE NELL TO R PRIVBTE SEWER LINE IS 25 FEE]' RND
TO R COMMUNITY SENER LINE IS 75 FEET.
OTHER REQUIREMENTS MRY RPPL% SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION,
F'EF-'Pl I T E::-(F' I RE'---]
I CERTIFY THRT
t: IRM FFIMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS BND WELLS RS SET
FORTH 8¥ THE MUNICIPRLIT9 OF FINCHORFIGE.
2: I WILL INSTFILL THE SYSTEM IN FICCORDFINCE WITH THE CODES.
~: I UNDERSTRND THBT THE ON-SITE SEWER SYSTEM MR9 REQUIRE ENLBRGEMENT tF THE
RE~IDENnE IS REMO~ELED TO INCI_UDE MORE THRN 4 BEDROOMS.
'--, I GNED: - - F PLI L. HNT HERB H EF. F~jE
.._ ..................... _
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-550, Anchorage, Alaska 99502 276"222~
SOILS LOG -- PERCOLATION TEST
[~'~SOI LS LOG
[] PERCOLATION
TEST
PERFORMED FOR:
LE~]AL DESCRIPTION:
1
2
3
4-
5-
6-
7-
8-
9-
10-
11
13
14
15
16
17
18
19
20
DATE PERFORMED:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
/-
IF YES, AT WHAT
DEPTH?
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time / Water Drop
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND , FT ~
PERFORMED BY: ~'~'¢ ~¢~ ~O CERTIFIED BY: ~'¢~ DATE:
72-008 (7/76)
EAGLE
'£HUGA~t
P~IERS
~ DR