HomeMy WebLinkAboutMCCABE LT 7 o18
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
· ENVIRONMENI'AL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
MAILING A DDR ESSp/,
Liq~a~n gallons IF HOMEMADE: Inside length Width Liquid depth
~ v DISTANCE TO: Well Dwelling PERMIT NO.
O ~ <~ Manufacturer Material Liquid capacity in gallons
~ DISTANCE TO: iWy~J~pO-~ lO0 Foundatioc~ ~.~ ~ Nearest lot line PERMIT
Distance t lin(~s
_~ u.I No. of ,iney L~n'gth~:h~ine Tota~L_~t~,of lines I Trench~d~ inches
~-~ Top of tile to finish grade Material beneath tile ~ ....~ Total ef tion area
Length Width/ Depth PERMIT NO.
<~ I- Type of crib Crib diameter Crib depth Total effective absorption area
~u Well Building foundation Nearest lot line
u~ DISTANCE TO:
.~ Class Depth Driller Distance to lot line PERMIT NO.
Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATER~t(2
SO,LTEST RAT,
REMARKS
APPR~ DATE LEGAL
72-013~ . 3/78)
PERMIT NO.
RPF'LI_.~NT
LOCRTION
LEGRL
GENE JRNIGO
r!L,~O.E,E. L. I F,L.,LE ERST
PO E,u,.,, 4-'13.05
LCIT SIZE 51000 SQURRE FEET
TYPE OF SOIL RB_URFTIUN =,%.:,TEM IS: TRENCH
f"IRXIMUM NUMBER OF BEDROOMS
SOIL RRTING
THE RE~.JIRED _,I~E OF THE SOIL RBSORPTION St_,TEM IS:
[)EF'TH= 12 LE~-~GTH== --~-:-~ 0 ~3RRVEL DEPTH---- 5
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF' GRRVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCRVRTION <IN FEET).
F-:E~:~.Li IRE[:, SEF'T I C TR[4F¢; $ I ~.~F ......... -1 ~--;'~00 mSF~LLO~-~S
PEF.:MIT RF'PLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RN'¢ WELLS RDJRCENT TO THIS PROPERTY RND THE
N_ME. EF. OF RE=IDENME=, THRT THE NELL WILL SERVE.
TI.-J~D ,:; 2 ;) I ~-~_qPEC:T I C,F~S .,-;RI=' REC'4!L~ I RED, ----
E:ACKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION AND APPRO',/RL BY THIS
DEPRRTMENT I.,JILL BE SI IBJEr:T TO PRO_,EL. LITION.
MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS
i00 FEET FOR R PRIVRTE WELL OR 150 TO ~00 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND
TO R COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS RRE REQUIRED 8ND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS WRY RPPLY. SPECIFICRTIONS 8ND CONSTRUCTION DIBGRRMS RRE
8VBILBBLE TO INSURE PROPER INSTRLLRTION.
PEF-:I'"I I T E,'=<:F' I RES DECEI~IBER ~:1.. " ~ "=~ ~''
I CERTIFY THRT
t: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON--SITE SEWERS RND HELLS RS SET
FORTH B'T' THE MUNICIF'RLIT¥ OF RNCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
Z,':: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE I$ REMODELED TO INCLUDE MORE THRN 3. BEDROOMS.
· -, I Ur,lED:
RPF'LI CRNT GEF~ ..TRN ~0
I .... UE[. BY_ ...... [.,RTE___ V4.. 0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
~'"'"SOI LS LOG
[] PERCOLATION
TEST
LEGAL DESCRIPTION:
1
2
3
4
5
6
8
10
11
13
0-/
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SITE PLAN
14
15
16
17
18
19
20
COMMENTS
PERFORMED BY:
'": ':':" .....~ ~/'~/J~' ~,~'~~ .__~i~l~ ~II Depth to Net
Reading ::: Da~e ~1~ . j~lte Water Drop
PERCOLATION RATE
(minutes/inch)
72-008 (6/79)