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HomeMy WebLinkAboutROBINDALE LT 9OS'~ 0'4 0~0 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 NAME PHONE . ! [~EW MAILING ADDRESS LEGAL DESCRIPTION LOCATION ~'~ NO, OF BEDROOMS ~ DISTANCE TO: Well /~/ / Absorption area~ ~ Dwelling /~/ PERMIT ~ z Manufacturer Material ~-- ~ N°' of compartments  Liq. capacity in gallons Inside length Width Liquid depth /~ IF HOMEMADE: ~ ~ Well Dwelling PERMIT NO. DISTANCE TO: ~ ~ ~ Manufacturer Material Liquid capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO~ ~ ~ DISTANCE TO: /~ / /~. ~ / ~ ~ ~ Length of each I,,e Total length of lines Trench width Distance between lines ~ No. oflines~ ¢ ~ ff ¢ ~ ¢ ~O inches ~ -- Top of tile to finish grade Material beneath tile Total effective absorption area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: Driller Distance to lot line PERMIT NO.~ ~ DISTANCE TO: Building foundation~ z Sewer line /~ / Septic tank /~ / Absorption area(s) OTHER PIPE MATERIALS i~,~'~ ~/ SOIL TEST RATING~ ~-- REMARKS ~ G ,. .,~ ,.d ~,~' APPROVED D~T~ ~ --'-~AE ' [:,E:F'F~RTHEi'.,tT OF HEFtLTH FIN[:, EN',,,'IREtt'.,tMENTFIL F'FF'ZTEITI:i'.t E~25 "'1...'" E;TREET., RNZH.EF.'RGE, RK £.~'Z.~501 ;:_:'64-4.720 ' RNE:H_iF.'RGE 59,~$--2±Z:"::fL ' ERGLE RIVER PERMIT NO. E:~:0996 FIF'PL I E:RNT: R I OHFIFF:E:',~::,L. ILL. Ii' FiN F'ER:-.;ON FiDDRESS: PO BO;,.:; 77';247Z.': EFIGLE Ri',,,'ER., ~1.,:: 99577 LEGFIL DESCRIPTION - SUBE:,I',,,'I':_r, ION: ROBINDFIL. E LOT S:IZ".E iLn.'Ol?,4. :Eh]EL F'T. 'f'OP.!NSHiP: ±5N F'HF~NE: c,,:,,:,-~_,4i E:L¢,Z:K: 0 LWT: '~ RFtNI_iE :tW _-,E _.T I ON : .!.: i"IFI;:.:iIMUM NUMBEF.: OF E:E[:,FF.:L-,id'"IS = iE: SOiL RRTING = ,4:~L'_'4, 3:&:---: 4t. 9 ,::SL::h F:'T.. ~.F.... L..ZSTEC, EEL. OW FIFF.:E THE E*Fq"iONS FI',,,'RILFIE:LE TO 'T"OU IN Ii:,E:_--;IE~t'-~ING '¢EIUFF: SEF'TIC E%"STEH. CHE, OSE THE [.iF'TION THFIT E:EST FI'I"_-=, 'T'-~...tR SITE. ti'- ~l-: E.--... it-4! C:: ~i ' El:~ EE :~_--.,; :iE Ei-~ I.,.IIE:,'TH = ,='--' 5. FF. LENGTH. = ~'q, .... .... 0 F'T. ~ NOTE ~ - -'-='fl. ... FT. FF:EQUIF.'.ES TWO TRENCHES TOTFtL B, EF'TH = ~[.tr-:. 0 FT. 3F.'R',,,'EL DEPTH = b.-' ~;~_ FT. GFFtFi',,,'EL ',,,'ILUME = E:9_' :L CU. TRNK :.El I ZE = ::t_., 000. 0 ':4RLI. ONS ,' TWO COMF'FIFF:TMENT TFINk:::, lb:. E.. [... El.::, El ::5; 3!: WI!],TH = ;27. 0 FT. L. ENGTH = 5,~. 0 FT. TOTFIL E:,EF'TH = 5. 0 FT. :iF.!FI',,,'E_ DEPTH = 0. 5 FT. GRR'v'EL ',,,':L ..ME = 54. ¢ CLI. 'TRNK S I ZE = :1.., 000. 0 'liRI. L ]'d~',l:-i; ,: "FI4E~ L-:LIMF'FIRTMENT TFIi'.4~:::::, WZB, TH = 5. 0 FT. L..ENGTH = i,4.7. 0 FT. .... ~ NEFf'E ~ - ".'~'R.. . ......... FT. F.'E~:~ IFF'ES TI40 TF:ENCHES TOTF!L DEF'TH = 7. 0 FT. GFF.'F!',,,'E!._ C, EF'TH := .l.:. 0 FT. GRFI',,,'EL ',,,'L-LLIr'IE= = 95..2 F. '¢E:,S. 'FFIN~:: '.SIZE = ::L, 000. 0 GFtLLONS ,'Ti40 COf',IF'RRTMENT TFtNK::, i ZEF.:TiF'¢ THFiT: % i FIr'1 FR!'I:i:L. iFiFF: WiTH THE F.:E.-..!_.iF:EHENTS FOFF: ON-SiTE SEWEFF:S RN[:, WELLS FIS SET FOFF:TH B'¢ THE MUI'.,!!E:IF'RLIT'¢ OF FiNZHZF:FIr'_'-;E FINE:, 'THE: :~,'TFITE OF FILRSKFI.. ;2. I WILL !NSTFII_L. TFIE S'¢STEH t1'.,1 RCCOF.:E:,FII'.4CE WITH THE F"[,E': FINC, HFI',,,'E F.:ECEI _[ Fl ]'-'F"¢ OF 'f'HE L-:i.-.~[i..,E': Siji'"ii'iFIR'¢ FINE:, [:,IRGRFtM FITTFICHHENTS WHICH iS F'FiF.:T OF THIS PERM l T. ]:. i. UNE:,EF.:STFtNE:, THRT THE ON-:ElITE :_=;E'k!EF: SYSTEM I"iR'Y REQUIFF:E ENLFIF-:GEMENT 'IF THE FF:E'_--.,]:E:,ENCE IS F.:E'ME[':,E'LE[:, TO II:NCLU[:,E I'"IORE THFtN Z:: E:E[:,FF:OOMS. PERMIT FIPF'LIE:FINT HFIS THE F:ESF'ONS IBIL I T'T' TO INFOF:M F'EF:SONNEL [,LtFF'.ING THE INSTFiL. L. FFFi--H INSPECTIONS OF' FIN'¢ i.,.!ELLS FIC,...TRCENT TI_-t THIS F'F.:OF'EFF:T'¢ FIND THE NUt'IE:EFF:: OF FF:ESi[.,ENCE:F.; THFiT THE i.,.iEL, t~. t.,.iiLL SEFF-:',,,'E. .iF IR t_iFT STFiT:[ON ]:S iNSTRLLED., FIN ELECTFF:ICI%L PER?lIT RN[:, INSF'E:CTION MUST BE OEFf'RiNE[:,. FIS-BLIL. TS CFiNNOT BE FIF'F"FF:O',,,'E[:' WITHOUT FIN ELECTFF:ICFIL INSF'ECTION FF:EF'OFF:T. THE ELECTRiZFIL [,.iERK MUST BE E:,ONE .E','Y Fi LiCEN'-=;E[:' E=E_.TF. ICiFtN. :51GNED: ~ .., FIF'FF'L I CFINT: F-': ii: ,_-:HRF.:E:,,~'.:L Z L.L t FiN I SSt...IEE:, E,U · E:'RTE: 09,-"'1:0,-'"E:--": :'~/ [~' 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 DATE PERFORMED: LEGAL DESCRIPTION: 5 9 SLOPE SITE PLAN 10 11 12 13 14- 15- 16 17 18 19- 20- COMMENTS WAS GROUND WATER S ENCOUNTERED? ,~/'O ~ P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop /'..~ ~,.,,,,,, ..~ ~" / ~" z.'~o ~ 3~" /~. PERCOLATION RATE ~5~' (minutes/inch) TEST RUN BETWEEN o "~ FT AND ~ FT PERFORMED BY: ~.~ ~-~ 0 © 0 0 © 0 0 © 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 C; 0 ,"4 0