HomeMy WebLinkAboutUS SURVEY 3201 LT 18 T10N R1W SEC 9Onsite File
~ 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
__ ~ ~ UPGRADE
LEGAL DESCRIPTION ~ --
I are?o' Dwelling
Z Manufacturer
¢ ~ Mater~[ No, of compartm~ts
Liq. cad. ions IF HOME.DE: ! Inside length Width ~ Liquid depth _
O ~ ~ Manufacturer Material Liquid capacity in gallons
~ DISTANCE TO: //6 7¢, Nearostlotline/~ ,__ PER THO,
~~<~ T°tallength°flin~' Trenchwidt~ches~_ Distancebetween~s
~ N°'°flines / Lengthofeachline- /
D Top of tile to finish grade~/ Material beneath tile~ches Total effe~r~ ~a~
Length Width Depth PERMIT NO7
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line ,~ PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank ~ ~ ~.~, p,; .......
SOl L TEST RATING
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
Permit # ~)/~
MUNICIPALITY OF ANCHORAGE
Department/-'f Health and EnvironmentaT~?rotection
825 ._ Street, Anchorage, AK. ~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
WE-~_~ ON-SITE SEWER PERMIT
~)L>?~ '~, ~ Mailing Address:
Location: ~%~L}~L~,.~ ~
¢?,~ Phone Number:
Legal Description: '~'~'~} ~ ~3 A..~ ~t~,~ ~ ~ ! ~ i~ ~ ~/~'~ ~.~/~ ,~ Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: ~ _ Seepage Bed: __ Holding
Maximum Number of Bedrooms:~'~< Soil Rating(sq.ft/br)
Tank:
DEPTH
The Required Size of the Soil Absorption System Is:
~t ~ ~ ~' WIDTH
LENGTH ~ ~i GRAVEL DEPTH ,Q ,
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by ~is department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days Of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 3L 1 9 8 3 * * *
I certify that:
(!) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to
Signe~: ~9~¢ ~c)~
Applicant
inc'lude more that 3 bedrooms.
Issued by: ~ i', d-- .~L4 ~,,¢ ~ ~
Date: { .... ~, ~
SWP/024(1/81)
F'ERfq:[T NO. ,::
~::,EPi:IF.:'i"I',IENT U. Ifl[CFILTH FIN[:, Ei'l ....... If IIIIENII. L" ' ...... , -"I"E-:-I']'-I'.,t
E:F2.5 "'L' E;"I"RIEET., I::II'.~CFIORFfGE., FII'::L
RPF'L.. ]; CF:INT
LOC:F:IT Z ON
I..EGRL.
[~ONF!L[) F'ORTER
L:~.fE: "Fie[Iq R::LI,.I ~;9 U';:;.¥~;
S;l'4:86~7 E:IRD CRK 9954E~
NONE
SQI. JlqRE I::EE T
I"IZN]:i'¢ILII"I [>Z:Ei-f'F:INCE E~ETP.IEEN F! I.,.IELL. 8ND Fll",l"r' ON-SITE 5EI.,.II::IGE [:,ZSPO51::II.. '?.i"r'::~;]"EP1 IS~
iEtE] FEE'T I':O[?. I::I PRI',,,'FITIE HELL.; OR
:l..SEI TO ;i~:C~:~ FEET FF.'.OM 1::1 PUE~I.tC I.,.ff£LL [:,EPEN[:,ZNG UPON "I"HFZ 'f"¢PE OF: F'UE:LZC I,.IEL. L..
I4EL.L.L. OGL:.; FIRE F..'EL--~LIIRE[:,
OF TNE FIE[..[_ COP'IPL. ETION.
OTHEP:'. RE6!UZREf'IEN]":'~; I'fif:l'~' I::IPPL'¢. '..=;.,PEC:[FICI::I'T]:OiqS FIt",I[:' CON:i?I"RLIC]"101",I DIFIGRFIM:r:; F':lf*~:l:'::
f:I",,'FI.-(LFIBLE "FO :[I",I~URE PROPEF?.
]: C:ERT]:F"r' THFIT
:.1.: I I::'IP1 t::[::IhllLIFIR 1.4ZTIfl THE REQLIiREMENT~; FOR ON-"~2;ITE ~SEI.4ER5 FIN[:, I.'.IEL.L5
F'ORTN E','¢ THE [dlJNZCIPFILIT'¢ OF' IRNCHORFIGE.
2: I 1.4ILL ZN~;TFILL. THE 5~r'%TEI'd IN I::IC:C:OR[:,F4NC:[~; 1.4ZTH THE
FIPPL. I ~INT I::~3~R L D PORTER
WELL OW~R
LOCATION
WATER WELL LOG
MUNICIPALITY OF ANCHORAOE
/'"',pEPT, OF HEALTH &
j~,)r, ONMENTAL PROTECTION
FOSS DRILLING
1336 Ingra Street 00T 4 1978
Anchorage, Alaska 99501
SIZE OF CASING /'DEPTH OF HOL ·
STATIC WATER LEVEL ~ FT. YIELD /~ GAL.PER.MIN.
PEET OF DRAWDOWN.
REMARKS
DATE COMPLETED 9- ~: ? R
WITH
PUMP TO BE SET
~ to
/_..~t o~..~
9'9' t o.~_2'
_....to
tO__
tO__
to~
tO__
___to
to__
.__to
to____
___~o
~do. roi
LEGAL DESCRIPTION:
2
?
8
10
12
14
~e -
17 ~ ~
20-
[] SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
,~ATE PERFORMED: ?'- 2 ¢ - ~3
71o ~/~ ) ~
SITE PLAN
WAS GROUND WATER /~/~ S
ENCOUNTERED? /~/(~ L
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
FT AND .--
(minutes/inch)
FT
COMMENTS
PERFORMED BY: ~. /~0 f'J'J CERTIFIED BY: DATE:
72-008 (6/79)