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~29.36 FND
R,O.W. Oedicatic
o_ ~ Street
MUNICIPALITY OF/A~CHORAG E
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
826 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCO/.ATION TEST
~ SOILS LOG
[] PERCOLATION
-rEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
SLOPE SITE PLAN
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
PERFORMED BY: ,'
72-008 [6/79)
IF YES, AT WFIAT
DEPTH?
F~eading Date
Gross
Time
Not
Time
PERCOLATION RATE / 177¢¢_ __ (minutes/inch)
fl'
TEST RUN BETWEEN FT AND FT
Depth to Net
Water Drop
CER~I FI E~~-
il
0
o
0
QGREA
'R ANCHORAGE AREA BOR 'GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
_ MAILING ADDRESS__ PHONE
LEGAL DESCRIPTION ~'T
SEPTIC TANK:
DISTANCE
FROM WELL_
INSIDE LENGTH
~L.'e-
NUMBER OF
MANUFACTURER S4.C,~..~4¢e~..- MATERiAL~.~4'd'~'L _COMPARTMENTS
__ INSIDE WIDTH__ __LIQUID DEPTH__ _LIQUID CAPACITY lO00 ,GALLONS.
SEEPAGE PIT:
NUMBER OF PITS J__ DIAMETER ~C/ OR WIDTH IS-I, LENGTH~i. DEPTH ~l
LINING MATERIAL ~ CRIB SIZE: DIAMETER
___ DEPTH (a . DISTANCE FROM:
(..~ ~/[ TOTAL EFFECTIVE
BUILDING FOUNDATION , NEAREST LOT LINE ~)~0~ ABSORPTION AREA (WALL AREA)
WELL
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE .1~"~~. CONSTRUCTION .DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATIDN__., LOT LINE SEWER LINE TANK __, SYSTEM
CESSPOOL OTHER SOURCES
APPROVED _ DISAPPROVE[) REMARKS
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY:
PIPE MATERIAl ·
LOT SLOPE:
REMARKS:
Form No. EQ-031
DATE
APPROVED
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTA!. QUALITY
3330 "C" Street
ANCHORAGE, ALASKA 99503
Performed For__ RI~W~
Legal Description: Lot 6~ Block
This Form Reports Soils Log
Soil Test Must Be Logged To
Depth
Feet
]4~
Case #
Dated Performed
Percolation Test
4' Below Proposed Seepage System
Soil Characteris='c~
.-~-J_LJ_J
.
Was Ground Water Encountered?_.~_
If Yes, At What Depth? 0/~
k_! L_._J__I__I__L_I J
Reading
Percolation Rate
Proposed Installation:.Sep, age. ~ Pit Drain Field
Depth of Inlet O,',~3th ~'6~F~Ji~i-~-{-~P'it or l'renc~--
COM~ENTS:
Date Gross Time ! Net Time I Depth to H2O Net Dro
/
Da l;e:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
Environmental Health Division
CASE REVIEW WORKSHEET
CASE NUMBER: DATE RECEIVED: COMMENTS DUE BY:
S-7485 February 14, 1984 March 2, 1984
SUBDIVISION OR PROJECT TITLE:
Lots 64A, 64B Koehler Subdivision
( 'f ~-)'PUBLIC WATER AVAILABLE
) COMMUNITY WATER AVAILABLE
(//}/ ~) PUBLIC SEWER AVAILABLE
COMMENTS:
!
PERFORMED FOR:
MUNICIP^LITY :< ANCHORAGE
IVlJJNICIPAI..ITY OF A ..... '~t":~,~,,CNIAL Pr~OTECTION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264~.
SOILS LOG-- PERCOLATION T~' C
SOILS LOG
PERCOLATION
TEST
[)ATE PER FORM ED:__('~
LEGAL DESCRIPTION:
1
2
3
4
6
7
8
SLOPE
SITE PLAN
10
11
12
13~
14-
15-
17-
18-
19-
20-
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
O
P
E
(]ross Net Depth to Net
Reading Date Time Time Water Drop
?
PERCOLATION RATE I /~_ (minutes/inch)
BETWEEN
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, StreeL Anchorage, Alaska 99501 264-4720
SOILS LOG -. PERCOLATION TEST
1
SLOPE
SOt LS I..OG
PERCOLATION
]-EST
DATE PERF : ~2~
SITE PLAN
3
4
d
7
10 -
11
12
I (; ,
1/
18
19
20
/t/l
PERCOLATION RATE
COMMENTS
//'
/"~¢
'" ~ ' '
/2-008 (~/79)
50' 50'