HomeMy WebLinkAboutBYERS LT 17BLT'
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
PHONE E~]NEW
~]UPGRADB
I0. O~F~_~ E DR~OMS
-~
Wel Absor aI/~,~
O,STANCETO: I I~ IDwelling/~tw
Liq. Inside length Wid
I F HOMEMADE: Dwelling
DISTANCE TO: Well
Total~gJ ngt f lines
Material beneath tile
DISTANCE TO: /O~I
No, of Len ,,~ of,~ea~vh line
Top of tile to finish grade ~
Length Width Depth
Type of crib Crib diameter Crib depth
Well Building foundation
DISTANCE TO:
~lass Depth Driller
Sewer line
Building foundation
DISTANCE TO:
Material
t~'~ inches
Liquid depth
PERMIT NO.
Liquid capacity in gallons
Dist a~e~ lines
Tota~..e~e~sor ptio n area
PERMIT NO.
Total effective absorption area
Nearest lot line
Septic tank Absorption area(s)
Distance to lot llne PERMIT NO.
OTHER
PIPE MAT :HALS
SOl L TEST RATING
REMARKS
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
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2O
[~SOI LS LOG
COMMENTS
[] PERCOLATION
TEST
DATE PERFORMED:~
S,TE PLAN
WAS GROUND WATER I~
ENCOUNTERED? 7~'~ pO
E
IF YES, AT WHAT
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
FT AND
(minutes/inch)
, FT
72-008 (6/79)
APPLIr'NT FILLS OUT UPPER HA' 'ONLY
ProlSertyOwner ~/-~.<~/ /. ~. /~z~v,'~ _~ ~,~ ~ Phone
Add~e~ Zip Code
Ma?)ng
Address Zip Code
Lending Institution /~/ ~ ~x~,~ ~ ~ ~ ~ ~ ~ ~ Phone
Address ~ -., ~,~, ~" /~ /,~,. Zip Code
Phone
Realty Co. & A~nt
Address Zip Code
Legal
Descript~n
Type of Resi~nce
~ Single Family
: Multiple Family No. of Bedroo~
: Other
Water Supply
lndividual A~ACH ~LL LOG. A w~l log is required for all wells drilled since June 1975.
Community For wells drilled prior to that date, give well depth (attach log if available).
: Public Utility
Sewer Disposal
~lndivid~l Year Indiv~ual Installed: f
~Public ~ility When Connected to Public Utility:
: Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED.
Time Time Time Time
Date Date Date Date /
Inspector Inspector Inspector Inspector
( ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( /~DITIONAL APPROVAL'
Soils Rating Date ~wer Installed Well To Absorption Area / ~ [ ~ Well Log Received
~ 0 ~ ~ ~ ~ ~ WelltoTank f~ t ~ Septic T~k Size
72-023 (3182) '
January 14, 19~3
Fred L. and Edith E. Byers
2711 W. 67th Ave.
Anchorage, AK 995U2
Subject~ Lot 2 Byers Sub.
Approval for the individual sewer and %~ater facilities cannot
be granted until the following items have been completed:
The water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B Street, for our review.
The depression over the sewer system will need to be filled
so that surface water drains away from the sewer system.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
~..,~im Roberts
Associate Environmental Specialist
JR25/p/EH