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PERFORMED FOR:
LEGAL DESCRIPTION'._L~ \
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICE
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION 'rEST
6
8
9
10
I1
12
13
14
15
16
17
18
19
2O
Township, Range, Section: '~
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED? X
IF YES, AT WHAT I IS-
DEPTH?
E
Depth Io Water After ~ )
Monitorieg? '~ Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RAIE .~'~ ~ __ tminuto$/incht PEnO HOLE DIAMETE~ __
TEST RUN SETWEEN _ _ FT AND __ FT
COMMENTS
PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85~
P.Q b~.X 6650
ANCHORAGE, ALASKA 99502-0650
~'0/) 26,4-4111
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 10, 1986
TO: Permit Applicant
Subject: Permit # 850252
Tract C-1 Teri Subdivision #2
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 31, 1985.
Permits are issued on a calendar year basis by authority of Municipal
Ordinance. A new permit must be obtained from this Department for any
well and/or on-site sewer system not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to this
Department for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system
the original as-built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/ljw
enc: Copy of Permit
...... L., ', i {::U" . ~Y7!50 :L
~.~ SOILS LOG
PERFORMED FOR:_
2
MUNICIPALITY OF ANCHORAGE
[] PERCOLATION
DEPARTMENT OF: HEALTH AND ENVIRONMENTAL PROTECTION
TEST
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SLOPE
SITE PLAN
10-
11
13-
14-
15-
16-
18-
19-
20-
COMMENTS
WAS GROUND WATER /~"~.,) ~
ENCOUNTERED?
O
P
IF YES, AT WHAT E
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
,- /
PERCOLATION RATE (minutes/inch)
TEST RUN SETWEEN i/F AND FT
/
CERTIFIED BY: DATE: