HomeMy WebLinkAboutEAGLE CREST #1 TR A LT 28 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 WELL INSPECTION REPORT
NAME
PHONE
[] UPGRADE
MAILING ADDRESS
LEGAL O£SCR~PTION
LOCATION
DISTANCE TO:
IAb'°'Pt'2
IF HOMEMADE: DwellinglnSide le~ngth
NO. OF BEDROOMS
PERMIT NO.
N o,~.~ f compartments
Liquid depth
Well PERMIT NO.
Manufacturer Liquid capacity in gallons
No. of llnes~ Length ~)f each
~2; /.3'
· of tile to finish grade
Foundatio~ /
Total length of lines
Material beneath tile ~ /
Depth
Crib depth
Building foundation
Driller
Sewerline
DISTAN(
Nearest lot hne
Trench widt~ inches
Wpdth
Well
Building foundation
PERMIT NO.
Total effective absorption 8rea
Nearest lot line
Septic tank
OTHER
PIPE MATERIALS
SOl L TEST RATING
REMARKS
APPROVE[}
DATE LEGAL
PERMIT NO.
MUN I ¢ I~4L I TV OF ~r~C~9_ R~GE
DEPARTMENT! HEALTH AND ENVIRONMENTAL ~OTECTION
RPPL I CANT
LOCAT I ON
LEGAL
825 'L' STREET, ANCHORAGE, AK. 99501
264-4720
&dELL AND Ot~--S I TE SEWER
CHRIS SORENSEN
iL2S TAR ERGLE I~./L~ L~)
PERI'I I T ~
LOT SIZE ~99999 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT?BR)= 150
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTH= ii LENGTH----- ~ GRAVEL DEPTH= 7
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIEL~.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND' AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
REQUIRED ~EPTIC TRr~K SIZE= 1000 GRLLOr4~
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
------ TWO ( 2 > I t~SPE~T I Otis ARE REQU I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 50 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERI~"I I T EXP I RES DECEI"IBER :3:'1, :1.~'~S2
I CERTIFY THAT
i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
5: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS,
S I GNED: .-~---~ .....
APPLICANT CHRIS SORENSEN
V4. 0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage· Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[~$01LS LOG
[] PERCOLATION
TEST
DATEPERFORMED=
LEGAL DESCRIPTION:
1
2
5
6
7
8
9
10
~I 1
12
13
14.
15.
16.
17-
18-
19-
20-
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
W^SGROUNDWATER /Jo [
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN FT AND FT
COMMENTS
72-008 (6/79)
CERTIFIED
M-W DRILLING, Inc.
P.O. Box 10-378 * 10300 Old Seward Highway
(907) 349-8535
ANCHORAGE, ALASKA 99511
DRILLING LOG
Well Owner Chris $orcrl£en UseofWell
Location (address of: Township, Range, Section, if known; or distance main road Lot 2S Tract "A" Eat, le Crest
Size of casing 6' Depth of Hole ~ 35 feet
Static water level 205 ft. (61:;6;;6);- (below) land surface.
Screen ( ); Perforated ( ).
Describe screen or perforation None
Well pumping test at A gallons per (]i6iif)' (minute) for ]
of drawdown from static level.
Date of completion Octo%er l!. 1~[;2
Casedto -93;.'~ feet
Finish of well (check one)
open end ( :::: );
hours with ] ~,l" ?If-':
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
n .TO 2 Ca~ in,-
2 TO 3 Organic
2 .TO 25 .etltv ~rave]
c2 .TO. G3 Silty travel, war
. · .
~ '
137 .TO. 19E FilL': ~andv 1;ard
o~ 221 Silt'.' hard ~an
1.~ .TO · ~Z~.~
221 TO. 225 Fcndv ?ravel
225 TO 230 Sand,., Frave!,
230 TO 235 Sandy Fravel. waterbenrtn-
TO.
3--CONTRACTOR
' APPLIC~-"JT FILLS OUT UPPER HAL~'"'ONLY
P,opertyOwnor C_tIR~$T'/^~J 'T:. 5,0t~cHS~r,J Pho,s
Address Zip ~e
Type of Resi~nce
~lngte Family
~ Other
Water Supply
~ ~mm~lty For wells ~[11~ prior to th~ date. give well depth (attach I~ if available).
Sewer Disposal
NOTE: THE INSPE~ION ~E MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time ~.~.
Inspector Inspector InspeClOr Inspeclor
':-' ' ~ JUN 06 1983 J
(~PPROVED ~DROOM~ 'CONDITIONSOF APPR~apl' Ot He'th &
nmen~al Pro~eot~0n"
( ) DISAP~OVED
( ) CONDIT~N~L A~VAL'