HomeMy WebLinkAboutTHUNDERBRUSH LT 3
i"~ 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
NAME PHONE J~ NEW
5~t 5 Engir, eer;rLe ~4¢-6J~1 []"EGRADE
MAILING ADDRESS
7/2: o/d ;e waM. ~,,'~or~ /N 79~02
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS ~
~, DISTANCE TO: Iwell ~' I Absor~tion area F' Dwelling //, PERMIT NOeZO~
Manufacturer . MateriaT/~/ No. of compartments2
Liq, capaci}~:~allons [F HOME.DE: Inside length.~ Width Liquid depth
q ~ DISTANCE TO: Well Dwelling PERMIT NO.
O ~ Manufacturer Material Liquid capacity in gallons
~} DISTANCE TO: Wel'/OO/ F°undati°nw~' Nearestlotline 7~2
_ ,o. o,,,n.,f Length of each line~sz Total length of ,inosTn, Trench wldth2~inches Distance between
~ M Total effective absorgtion area
~ Top of die to finish grade 40 Material beneath 'tile 72,.c...
Length Width Depth PERMIT NO.
~ ~ 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.
Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
INSTALLER ~
REMARKS / ---~%/~0~/.~'8 ~ //.ri' /
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IL:fl 5'i
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
DEPP, RTHENT FIERLTH FIN[:, EN'¢:[F'.ONHENTRL. ~-f;.'.EiTECTION
:325 '"L"' ~;TREE]"., FINCHOF?.FIGE., FII.(. 99581
LEGRL
':'~": E:htL3'rhlFEt~": iHE:
L3: " '=,, c~
't, ,LlhlE:EL.E d_ ff
-,:~, ........ .. _,I¥ HL!HE]ER uF ......... F:EE,Pr'lr'd','l,--,_ = :'~:
'THE f<Ed!I_I~:Et:, :5.T_ZE 3F 'THE' E:O_TL RE~tF;~U3F~:F'T]:Cd',I
THE LENGTH DZHEN:~;ZOh,I 1':5 THE LENGTH (Zi'.,l FEET::, OF T'HE TRENCH OR DF:FtZNFZELD.
THE DEPTH OF F! TRENCH OR P:[T :[~; THE D:[_%TRNCE BE"FP.IEEN THE 5URFRCE OF THE
,EiREIUND FINE:, THE BOTTOH OF' THE E::-:',(::FI',,,'Fi"f'_TON ,::ZN FEET).
THERE )7~ NO SET I.,.IZDTH FOR TRENCHES.
TFLE GRR',,?_EL. DEPTH Z5 'THE HZNZP!UM. DEPTH OF' GRR',,,'EL BETHEEN THE OUTFFILL F'ZF'E
FIND ]"PIE E:cFr"FOH OF THE E::.:',CFt',,,'FIT_TON (IN FEET).
F,,m; - . !HI..., DEF'RR-FMENT B, URIIqC. i THE
~:. J'!1' FiPPL;£CRNT HR:5 'THE F~:E:SF'OF,irSIE:iLT_.T'¢ TO ZNF::F.'M "' ':
ZN:STF!L.t..RT]:L3F~ ]:N:~,FEL., !'UN._ OF FIN'¢ [,]ELL.~ FID..TFIC:ENT 'Tr' "rHl'5 F'ROPEF'.T'?' FIN[::, THE
NUHE:ER OF FtE£:;.f. DEF,fC:ES "['HFtT THE HELL !,.IILL 9ERVE.
Eq:IC:k:FZL.L:[i"J.G {ELF' F:ff',{'¢..,':"""::'F~':'~", ...,. ,..,, .............. bITTNf:tUT F~i",!RL TN'~F'E'-TIOFJ RN[:' nr-.-m_ ~ r'~.. b r TIdZ:~
C, EF'FiRTHEI",F[' !4 Z LL~:,,.:."'~' .......... ':-; [: .TFT':T "FO F'F;:CESECI_IT Z ON.
HZN_THUh! E>IE;TRNCE BETIqEEN FI HELL FIND FIN".," ON-SITE 5EI,.IF:iGE g, ISF'O%FtL L:;"r'E, TEM l'-:;
:1..OO FEET FOR FI PRIVF:ITE HELL OR 158 TO 200 FEET FROi"i R PUBLIC HELL [:,EPEN[>ING
UF'ON THE T'¢PE OF F'UE:LIC HELL.
H:[i",!ZHUI'I D;[STFtI",!CE FF:Ohl Ft PI-:;:i',/F~TE HELL TO F~ F'F:.,T. VRTE SEHER LZI",IE ZE; 25 FEET FIND
TO F:! COHHUN:[T"/ SE.t,.IER LINE :[E; 75 FEET.
OTHER REQUIREHEN'T~ h'lFFr' FIF'F'L."/. ~;PECZFiE:R]"ION~; RND CONSTRUCTION [3, IROFtFIP'tS RF:E
FIVFi:[LF!BLE TO ZNSURE F'ROF'EF~ !NSTFILLRT!ON.
:[ CE:RTZF"¢ THFIT
:L: :[ F~t'! F'RHIL;[FIR F.!ITH THE F:EQUZREHENTS FOR ON-'S;ITE SEHERS ~ND I.,!ELL~ RS E;ET
FO~:TH I?'/ THE HUN;[CZP~LZT'¢ OF FINC!dORFIGE.
2: I HILL INE;TF!LL. ]"FIE S'¢:STEH IH RCCORDBNCE kI:[TH THE CO[:,Eg.
2: i UNDER:STRN[:, 'THFFr' THE OH-:SI-FE ~E;EHER S'~.'STEH ?'IR? REQUIRE ENLRF:GEHENT iF' TIdE
RESZDENCE ]:~5 REHODEL. ED TO :[NC:LUDE i'qOF:E 'THRN 3: BEDROOHS.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
DATE PERFORMED:
7
9-
10-
11
13-
14-
15-
16-
17
18
20-
COMMENTS__ .
PERFORMED BY:
SLOPE
WAS GROUND WATER
ENCOUNTERED? ~C~ SE
O
P
E
JF YES, AT WHAT
SITE PLAN
lES '-'
, jl ,.c~ r
_ ,(Z~ ~.
(4,
..
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATJON RATE
TEST RUN BETWEEN 7
CERTIFIED BY:
(minutes/inch}
FT AND c~ FT
DATE:
72-008 (6/79)
f~-~ _~WELL LOG
Gallons Per Minu%e ,
Draw Down £eet
~y~.~te~rlal Drilled:
0 feet to
Hefty Drilling
S.R.A. Box 1553 H
Anchorage,Alaska
9950?
F!F'F'L :il CFiNT
LE!CFIT I ON
LEGF!t_
L3: TNUhlE,E~'LZ I-:~'_ SN
L_']T SIZE '999'_a. 99
FEET
MINIMUM C'ISTRNCE BEi-kIEEh! FI NELL RNC, RHg' ON-SITE SENRGE DISPOSRL SYSTEM IS
&eS FEEl' FOR R PRiVRTE HELL OR &Set TO 2C~9 FEET FROM F! PUBL. IC HELL DEPENDING
UPON TNE T'?'PE OF PUBLIC HELL.
idININLiM [:'!STRNCE FROM ~a PRtVRTE HELL. TO R F'RIVRTE SEHER LINE I5; 25 FEET FIND
TO R C:OMMUiWIT'¢ SEHER LINE !S 75 FEET.
HEL..t.. L. OGS RRE RE(;!UiRED RND MUST ¢E RETURNED TO THE DEF'F!RTMENT Hri"HIN 1:¢¢ DRYS
OF THE kiELL COMPLETION.
OTHER RE6:!(_IIREMENTS HR'¢ RF'PL'¢. SF'EC!FICRTIONS FIND CONSTRL!CTION D,!BGRF!IdS FIRE
FiVRILRBLE 'TO INSURE PROPER ZN%TF~Lt..RTION.
i C:ER]"iF'¢ THRT
i: I R!',i FF!F'1!LIFdR Hi'TFI -F,'-.tE RE6!UiREMENTS F'OR ON-SiTE SEHERS RND HELLS RS SE-F
FORTH BY' THE ~'!UNIC!F'Rt...ZT'T' OF RNCHORRGE.
2; I HILL INL:;]"RLL TI-IE SYSTEM iF,! FiC:COR[:,RNCE H!TH THE CODES.
FIF'F'L I C:FtNT CF!RL
f
APPLIi -NT FILLS OUT uPpER HA:'%,ONLY
Mailing Addre~ ~ ~ ~ ~-~ ~
Buyer ~. .. {~
Address .~- ~ .~ / ~. //~ , ': Zip Code
Legal Description /~ ~ ~ [ ~ /!~ ) ~ ~ ~c/~r~.~5~ ~ ~
~ Single Family/~'-
Time I"~' (~ ~'~ ' Time~ ~.~ ~
Inspector Inspector Inspector
Field Notes:
~APPROVEO BEDR6OMS .¢ 'cONDITIONS OF APPROVAL~
CONDiTiONAL APPROVAL'
Soils Rating Date ~wer Installed Well To Absorption Area ~ ~ Well Log Received