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~ 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
Materia~¢~ No. of continents
~anufacturer Material Uquid capacity in gallons
No, of line,/ Length o~c~n~ Total ~of~es TrenCh ,nches ' Distance ~e ~, e~n lines
Top of tile finish grade ~ z Material beneath tile ~ Total elf ion area
OTHER
A' ~
72-013 3/78)
PERMIT NO. ,'
DEPRRTMENT OF HERLTH ~ND ENVtRONMENTRL PROTECTION
825 '"L" STREET., RNCHORRGE, 8F'.'.'. 99501
264-4720
8i0742 )
RPPL I CaNT
LOE~RT InN
LEGRL
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]R~'IBOU INVESTMENTS INC ~,1= E1 5TH
,uLll HF HRK ~
LS B4 SOBTHF'RRK ~ LOT SIZE
~...'.. $~k SQURRE FEET
PE.:,uRF] I_N _,~.:TEM : TREN_.H
TVPE L]F SilL ""--''' n c ,,- IS "'
MRXIMLIM NUMBER OF E:EE:,RL]OMS = ";.: SOIL F.:RTING ,::SQ
THE REQOIRED =,I~E OF THE EOIL RBSORPTION _,~._TEM I=,.
THE LENGTH DIMENSION IS THE LENGTH ,::IN FEET) OF THE TRENCH OR [:,RRINFIEL[:,.
TFIE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF TFIE
GROUND FIND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IB THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF' THE EXCRVRTION (IN FEET).
PERMIT RF'PLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES THRT THE WELL WILL SERVE.
BRCKFtLLING OF RNY SYSTEN WITHOUT FINR[.. INSPECTION FIN[:, RPPROVRL 8'T' THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R WELL RN[." RNY ON-.SITE SEI.4RGE DISPOSRL SYSTEM IS
±00 FEET FOR R PRIVRTE WELL OR 150 TO 200 FEET FRON R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTRNE:E FROM R PRIVRTE klELL TO R PRIVRTE SEWER LINE IS 25 FEET RNB,
'FO R COMMUNITY SEWER LINE IS '?5 FEET.
OTHER REQUIREMENTS MRY RPPL"r'. SPECIFICRTIONS RND CONSTRUCTION DIRGRBMS RRE
RVRILBBLE TO INSURE PROPER INSTBLLRTION.
I C:ERTIFY THRT
ii.: IRM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS RS SET
FORTH BY THE MUNICIPRLITY OF FINCHORRGE.
2: t WILL INSTFtLL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
3:: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MR"r' REQLIIRE ENLRRGEMENT tF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN _2 BEDROOMS.
RPPLICRNT CRRIBOU INVESTMENTS INC.
ISSUED BY _ ..... DRTE. V4. 0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAl- PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
,~ SOILS LOG
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
/.?
2-
SLOPE SfTE PLAN
10-
11
13-
WAS GROUND WATER S
ENCOUNTERED? (~
P
E
IF YES, AT WHAT
DEPTH?
14-
15-
16 ,
17-
18-
19-
20-
COMMENTS
PERFORMED B
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN FT AND
72-008 (6/79)