HomeMy WebLinkAboutPIERSONS PALACE LT 1Onsite File
r
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MUNICIPALITY OF
Community Development Department
Development Services Division 6
On -Site Water & Wastewater Program
101;4'�6 f (.0
. g :'30 G.,ti..
T •
1U,
Ei OCT 2 0 2016
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-051-93
Property owner(s) LYUDMILA ANDERSON
Mailing address 9321 NICKELL CIR, ANCHORAGE AK 99507
Site address 9321 NICKELL CIR, ANCHORAGE AK 99507
Day phone
Legal description (Sub'd., Block & Lot) HANSHEW HTS L4C & 4D
Legal description (Township, Range & Section)
Lot Size 21,972 Sq. Ft. Number of BedroomSA-9—
APPLICATION
9
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑x
Initial
❑
Single Family (SF)
❑X
(w/wo ADU)
Septic Tank
ElUpgrade
❑x
Duplex (D)
❑
Holding Tank
F-1Renewal
F]
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
property owner or authorized agent)
Permit/Rush Fees: 9 .?C 7.66
Date of Payment: D
Receipt Number: 0
Permit No. 6 % 1
Permit App__- :
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
Pannone Engineering Services «c
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve(cDpanengak.com
09 November 2016
Subject: HANSHEW HEIGHTS L4C & 4D
Septic Upgrade Permit Request
Design Narrative
This is a design narrative for a permit to install an upgrade absorption field to be issued for this property. The
existing drain field is in failure and will be abandoned per MOA Code. This lot and the surrounding lots are
served by a non -transient, non -community well (PWSID #211643). The non -transient, non -community well is
156.3' from the proposed upgrade system. A separation distance waiver has been submitted to ADEC and is
pending review and approval. Due to features on the lot and the location of the existing absorption field no
other options are available.
1. Soils. One test hole was performed by PES in September of 2016, and groundwater was monitored for at
least seven days. Ground water was not observed to a depth of 15.5' below the surface in the test hole
monitor tubes in September of 2016. Bedrock was not encountered in the test hole. Based on the results of
the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet was used
for a conventional wastewater system in the area of the test hole.
Due to the existent soil morphology no pre-soak of the test hole is required. Paragraph 3 of Table 3-8 of the
EPA Design Manual (Onsite Wastewater Treatment and Disposal Systems) provides two conditions in which a
presoak of the soils for a percolation test are not required. First is if the soil is sandy with little or no clay.
Second is if 12" of water that is introduced into the test hole seeps completely away in less than ten minutes
twice. These are either-or conditions not both -ands due to the construction of the sentences.
Further in Paragraph 4 the conditions required for completion of the percolation test in sandy soils are met
when two successive water level drops do not vary by more than 1/16`h of an inch and the test has been
conducted for one hour with readings in 10 minute intervals. When these conditions are met the soil is
assumed to be in a saturated state which is the intent of pre-soaking the soil (to ensure the water is in a
saturated state) and a percolation rate for the existent soil can be determined.
2. Surface Water: There is no surface water within 100 feet of the proposed upgrade system. The upgrade
will maintain at least 100 feet from all surface water and drainage ditches.
3. Topography: The existing topography in the area of the system is generally level in the area surrounding
the proposed field. The lot in general slopes from East to West at 10%-15% along the eastern portion of the
lot then levels out towards the middle of the lot. There are no steep slopes within 50' of the proposed field.
The proposed installation will not affect the future development of the surrounding or existing lots
If you have any questions or concerns, please contact me at 272-8218.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501 .
Telephone: (907) 272-8218 FAX: (907) 272-8211
THE STX1"E
GO-YGERN6R BILL WALKER
November 7, 2016
Mr. Steve Pannone, RE
Pannone Engineering Services, LLC.
P.O. Box 100217
Anchorage, AK 99510
Department of Environmental
Conservation
DIVISION OF ENVIRONMENTAL HEALTH
Drinking Water Program
555 Cordova Street
Anchorage, Alaska 99501
Main: 907.269.3076
Fax: 907,269.7650
thomos.brannan@aloska.gov
File: Hanshew Heights SD
PWSID: 211643
Class: Non-TransientNon-Community
Re: Hanshew Heights SD PWS — Hanshew Heights SD Lot 4C & 4D
Source -Proposed Septic Separation Distance Waiver
Dear Mr. Steve Pannone:
Source: Groundwater
On October 5, 2016, this office received your submittal requesting a reduction of the State's
minimum separation distance requirements between a non -transient non -community drinking water
source and potential sources of contami_nation..This letter approves. the requested reduction in
the State's minimum separation distance requirements from.200' to 150' be6Wcri the
drinking water well serving the-Hanshew'Hetglifs..Subdivision-(HHSD) Public Water ,
System (PWS) and -proposed septic system improvemenis forHHSD Lot 4C & 4D; this
encroachment int 16des an existing -1,250 gallon concrete septic tarik*at 150', an existing
_ (proposed.for decommissioning) drainfield-at-175', and the subject proposed drainfield at
C:,155'. —
Waiver Determination
As indicated in your submittal, the septic system serving HHSD Lot 4C & 4D consists of a 1,250
gallon septic tank and drainfield; the drainfield is in a state of failure and its replacement is now
proposed. As with the original septic dramficld, the location of proposed septic drainfield system
fails to meet the State's 200' minimum separation distance requirement between a non -transient
non -community water system source and a wastewater disposal system. At its nearest, the septic
system and its associated appurtenances are 150' from the well serving the HHSD PWS. This well
was deepened in August of 1977, the well log for the original (un -deepened) well could not be
located; the well's 6" casing extends to 235' below ground surface (BGS) (originally 199' BGS) and,
as indicated'fiotn a prokirr al well log, from 0' BGS to 199' BGS penetrates lenses of sands, gravels,
silts, and mixes thereof primarily being sandy gravel, and from 199' BGS to 235' BGS penetrates
mixes of silts, sands, clays, and gravel primarily being silt or sandy clay.
The following additional items were taken into consideration as part of this waiver approval:
1. From November 2000 to December. 2015, source water sampling results for nitrate
concentration rose from 0.38 mg/l to 0.73 mg/1. This suggests that the well is minimally
influenced by septic system exfiltration, decomposition of organic matter in soils, and/or
erosion of natural deposits, despite this nitrate -nitrite concentrations remain well below the
10 mg/L Maximum Contaminant Level (MCL)/MCL Goal;
2. From February 2000 to September 2016, Total Coliform Rule sampling for total coliform
and e. coli found resulted no coliform or e, coli positive results;
Mr. Steve Pannone, P.E.
November 7, 2016
3. Surface topography is generally flat with shallow drainage ditches and a gravel roadway
between the well and the encroachments;
4. The groundwater gradient slopes from east to west, generally towards the well;
5. Site constraints such as grade, layout, and existing utilities limit the location of the proposed
septic system components, it's proposed location maximizes horizontal separation to nearly
the greatest extent practical; and
6. The well accesses a presumed confined/semi-confined aquifer.
Based on an evaluation of the available information and in accordance with the State's
Drinking Water Regulations, 18 AAC 80, a Separation Distance Waiver for the
encroachments detailed herein is issued.
Limitations and Appeal Process
Any changes, constructed or natural, that affect the conditions to which this approval was granted
will void this approval. This approval does not imply, the granting of additional authorizations, nor
obligate any federal, state, or local regulatory body to grant required authorizations. This is not an
approval of omissions or oversights by this office or noncompliance with any applicable regulation.
The Department's approval does not guarantee correctness of the functional design or waiver the
owner's responsibility for continued compliance with State regulations.
Any person who disagrees with this decision may request by mail, e-mail, or facsimile an informal
review in accordance with 18 At1C 15.185 or an adjudicatory hearing in accordance with 18 AAC
15.195-15.340. Informal review requests must be delivered to Division Director within 15 days of
receipt of this decision. Adjudicatory hearing requests must be delivered to the Commissioner within
30 days of this decision, otherwise, the right to appeal is waived. For more information, visit
wNvw.dec.state.ak.us/commish/ReviewGuidance.htm.
If you have any questions regarding this plan review please do not hesitate to contact me.
Sincerely,
T.W. nnan, F.I.T.
Engineering Associate I
Cc.: Hanshew Heights Homeowners Association
9340 Nickel Cir.
Anchorage, AK 99507
161 W7 Hanshew Iieigha S13 — Hanshew Heights SU L4C & 41) Source-Sepdc_211643W,Vdocx
I
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WELL E uLOTS 4A & 48 UNDIVELOPED J
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4BR
157.0 DRIVEWAY SFD
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150.0
—1 r � T I
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IU LAIOIIIN�
DCO, VALIDATE INTEGRI
a7_ 0% OF LINE BETWEEN DCO
T . I AND CONNECTION FOR
NEW SYSTEM
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ABANDON UNDOCUMENTI
(--SEPTIC
�AREA
3B
NOTES: PANNONE ENG SVC, LLC
FOR coNSTRucTION P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (9071 272-8218 FAX (907) 272-8211
HANSHEW HEIGHTS L4C & 4D
DRAWN JRL LYUDVILA ANDERSON
9321 NICKELL CIR
SITE PLAN ANCHORAGE, AN 99507
SCALE 1- 50'
2
3
ABSORPTION FIELD (E)
PER MOA CODE
SAREA
EP A—
'It—'I
4
I
I
I I
I I
I
I
I I
5
Date
L 17/09/2016
�`P��••••}1%� Scale
lu
... .... . ... 'W• P.I.D, N050
.. n. ram rvnc PERMIT N0.
.ice eias ,;�} OSP161313
Sheet
1 OF 3
—27.8
-- ------
f/
30.2
4D
INSTALL
ABSORPTION FIELD
CONNECT TO
EXISTING DCO (P)—
(2EA)22LFx2.5'Wx6.0'E.D.,
9.0'%—rIll
l /,i7/l
W/ COs & MTs
AT ENDS OF FIELD �/�/U,y
& QUANTICS
TRU—FLO SPLITTER
-
BEFORE TRENCHES
(RESERVE BASED UPON REMOVE
AND REPLACE OF
EXISTING SYSTEM)
4E
(--SEPTIC
�AREA
3B
NOTES: PANNONE ENG SVC, LLC
FOR coNSTRucTION P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (9071 272-8218 FAX (907) 272-8211
HANSHEW HEIGHTS L4C & 4D
DRAWN JRL LYUDVILA ANDERSON
9321 NICKELL CIR
SITE PLAN ANCHORAGE, AN 99507
SCALE 1- 50'
2
3
ABSORPTION FIELD (E)
PER MOA CODE
SAREA
EP A—
'It—'I
4
I
I
I I
I I
I
I
I I
5
Date
L 17/09/2016
�`P��••••}1%� Scale
lu
... .... . ... 'W• P.I.D, N050
.. n. ram rvnc PERMIT N0.
.ice eias ,;�} OSP161313
Sheet
1 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55.
2. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 15.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE
SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15.5 FEET
BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC
LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED
SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK.
5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
6. THE CONTRACTOR SHALL CALL FOR LOCATINGOFALL BURIED UTILITIES.
7, THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING
AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE
CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE
ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND
TANK ELEVATIONS.
10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION,
TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING.
11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER
(OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE
CONTRACTOR.
12. THE CONTRACTOR SHALL SIGN THE FOLLOWING:
I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE
ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS
CONSTRUCTED.
CONTRACTOR:
BY: TITLE:
DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
NO. BEDROOM: 4(600 gpd)
TANK SIZE: 1350g (E)
PERC RATE: 4.7 MPI
SOIL RATING: 1.2 GPD/SF
AREA ROD: 500 OF
SYS. TYPE: DEEP TRENCH 6.O'ED
MIN LENGTH: 41.7 LF
USE:
(2EA)22.OLFx2.5'Wx6.0
TOTAL AREA: 528 SF
NOTES:
FOR CONSTRUCTION
DRAWN I JRL
DESIGN NOTES
E.D., 9.0' TO
w w WATER LINE /
WELL RADIUS
55 SS NEW SEPTIC -
PL 11`ILVOl`IL' EN LLC
P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
HANSHEW HEIGHTS L4C & 4D
LYUDMILA ANDERSON
9321 NICKELL CIR
ANCHORAGE, AN 99507
ABBREVIATIONS
TH
TEST HOLE
(P)
PROPOSED
(E)
EXISTING
CO
CLEAN OUT NO,
MT
MONITOR TUBE NO
TYR
TYPICAL
CE 8149
Date
11/09/2016
Scale
NTS
P.I.D. NO
015-051-93
PERMIT NO.
OSP161313
Sheet
3 O 3
1
2
3
4
5
6
7
8
9
10
12
13
14
15
15.5
TEST HOLE 1
OR TOPSOIL
SM Brown sury SANS &
GRAVEL
SM orange Alty SAND Ar
RAVEL
GM/SM Silty SAND &
Gravel
BOH
DATE PERFORMED: 23SEP16
SOILS LOG — PERCOLATION TEST
SLOPE
TEST
HOLE
WAS GROUND WA
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
DEPTH TO WATEF
MONITORING?
DATE: 29SEPcu,a
READING DATE
CLOCK
TIME
NET
TIME
WATER
LEVEL
READING
NET DROP
RATE
(MPI)
I 235EP16
1105
HANSHEW HEIGHTS L4C & 4D
LYUDMILA ANDERSON
9321 NICKELL CIR
ANCHORAGE, AK 99507
6 265"-
PERMIT PERMIT NO.
osP161313
2
1115
10
MIN
8.528"
2.263'
4.4
3
1116
6 265"
4
1126
10
MIN
8.365"
2.100'
4.8
5
1127
6.265"
6
1137
10
MIN
8.350"
2.095"
4.8
SOIL TEST RESULTS/ANALYSIS
• PERCOLATION RATE 4.8 (min/inch)
(Hydrologic Soils Group: HSG A)
• PERC HOLE DIAMETER 6"
• TEST RUN BETWEEN 5 FT AND 6 FT.
• TEST RUN FOR OVER AN HOUR, LAST
THREE READINGS PROVIDED.
COMMENTS: Test hole excavated by A+ HOME SERVICES. Test Hole was NOT required to be presoaked before Perc test
due to sandy material (Table 3-8, Para.3, EPA Design Manual).
PERFORMED BY: Joseph Lawendowski. I CERTIFY THATTHIS TEST WAS PERFORMED -IN ACCORDANCE WITH ALL STATE
AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES
Ptll`Il`ONE ENG SVC, LLC
P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
pF
Q ' ' •.
�.
Yf:•'.7a
••
-
CE 8149
Date
1t/09/20t6
FOR CONSTRUCTION
Scale
NTS
HANSHEW HEIGHTS L4C & 4D
LYUDMILA ANDERSON
9321 NICKELL CIR
ANCHORAGE, AK 99507
P.I.D. NO
015-051-93
PERMIT PERMIT NO.
osP161313
DRAWN JRL
SIL LOG
Sheet
2 OF 3
GRE . c.R ANCHORAGE AREA UUK. _f)b.
Department of Environmental Quality
:33;30 C Street
Anchorage, Alaska 9950:3
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~r'z- ~/o~E- ~--~d ~ T~lg'27mx/'~VIA I L I N G A D D R ESS
LOCATION X/~¢/~CL~ C~,~Z~ LEGAL DESCRiPTiON
SEPTIC TANK:
DISTANCE ~/~
FROM WELL MANUFACTURER LC-'~//~/¢2~ MATERIAL
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH
NUMBER OF
COMPARTMENTS /
LIQUID CAPACITY / ~J""~ GALLONS.
SEEPAGE PIT: /¢ ~ /~
NUMBER OF PITS / DIAMETER OR WIDTH
LINING MATERIAL~?,~/~-4 /~CRiB SIZE: DIAMETER
BUILDING FOUNDATION 2242 /m" NEAREST LOT LINE
ADDITIONAL ABSORPTION
LENGTH DEPTH /'~' /"- I~
DEPTH q / DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
SQ. FT.
WELL:
TYPE
BUILDING
FOUNDATION --
CESSPOOL
APPROVED_
CONSTRUCTION ~' ~Z~ t z_ ~-~
NEAREST NEAREST
LOT LINE SEWER LINE
DEPTH DISTANCE FROM:
SEPTIC o~a/~- SEEPAGE /y-
TANK SYSTEM /~-g
OTHER SOURCES
DISAPPROVED "
DISTANCES:
INSTALLED BY:
PIPE MATERIAL: ~4~7~
LOT SLOPE:
REMARKS: ~.~-o
"7'"".,,~-.,~/~._ "'2TM
Form No. LQ.031
DIAGRAM OF SYSTEM
DATE ¢ _ ,:':':':3 - '74/
SEWAGE
G. reaTer ANCHORAGe Area BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456I
DISPOSAL sYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
SEEPAGE PiT , DRAin FielD
J OTHER
TO SE iNSTALLED BY
NOTE.' 'rH~s FERMIT IS NOT VALI~ ~/ITHOUT SOIL
COMPLETION DATE ANTICIPATED ,
FINAL INSPECTI~)N~. 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTICTAN"S'ZE ''000£ Z. TypES/ 4__ C* cw
SEEPAgL/ Area SIZE ~U~_~ TYPE
DIAGRAM OF SYSTEM
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK ~r~
FOUNDAT!~N TO SEEPAGE P~T , DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SePtIC TANK '~ " SEEPAGE PIT~
-, , DRAIN FIELD
T EAR T LOT LINE.
WELL TO SEPTIC TaNK
DRAIN FIELD
ALSO CONSIDER AREA WELLS.
WATEr MAiN TO SEPTIC TANK
DRA~N FIELD
SEPTIC TANK, /~ SEEPAGE PIT
, SEEPAGE PIT
/~ ! . DRAIN FIELD
TO RIVER. LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK aND intO CRIB CROSSING GAP OF
EXC~A~l~M ~ ~FFT INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDing INSTALLATION,
LICENSED DESIGNER
I CERTIFY THat I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM 1S IN ACCORDANCE WITH SAID CODE.
G~/,r'ER ANCHORAGE AREA BOROUGH L /'
Depar'ment of Environmental Quality]fZz~,~-~O
3330 "C" Street
Anchorage~ Alaska 99503
Performed for ~<~-%. ~-'~_m~-~ __~ Date performed
.L. egal Description:
'[his form reports: Soils log_/ _ ~i~ercolation test
Depth
Feet
2-
3-
4-
5-
6-
7-
8-
I1 -
12-
13-
14-
/6~ - -
Was ground water encountered?
If yes, at what depth? I ' I
"~eading
Date
Gross Time
Net Time
Depth to H20
Net Drop
Percolation rate minute, -
Proposed ins~alla, tion; S~..,oag= P '] t ..... I Drain Field
D~,,, of Inlet · L~4, cn co ,~o~tom of pit or trench
Date: