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HomeMy WebLinkAboutSAND LAKE #2 BLK 4 LT 30() 1 1 13 5 23 000 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 E W /n T)o c) `7 - W�AMr `j%p 1-1 its UPGRADE MAILING ADDRESS 2, e) < LL to C,14 Ate So e LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS SCA\ C -LI I -F 2>1 Well Absorption area DISTANCE TO: 'o 'j" Dwelling �J- PERMIT NO. � O0 U y 3-7 F Z til Manufacturer C -1-I TAN i% Material 'tee 1E4 ` No. of com artmerits p T Liq. capacity in gallons- 19V-0 Inside length Width Liquid depth OJ Z DISTANCE TO: Well Dwelling PERMIT NO. C7 2 Z F Manufacturer Material Liquid capacity in gallons ❑ w= DISTANCE TO: Well �' Foundation�/ •a' (2 Nearest lot line PERMIT NO. �, © 5 -� J LL Z No. of lines / Length of each � line Total length of lines Trench width Distance between lines 1= Z Lu ! r1 r d� 2- 7�0 inches ¢ f.Top of tile to finish grade Material beneath tile Total -effective ab/sorp ion area ❑ inches a2 Length Width Depth PERMIT NO. w C7 Q I- ay Lu Type of crib Crib diameter Crib depth Total effective absorption area Lu DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J Lu ;z DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS �— z %P ✓ c- SOILTESTRATING INSTALLER z /1hlI:_- REMARKS rTb � ¢ Us� U d : 491—H L4 I .. y JUNE 25, 1971 •:t�� NAL APPROVED DATE LEGAL DEPARTMENT r HEALTH AND ENVIRONMENTAL ,OTECTION "^ 825 STREET, ANCHORAGE, 8K� ^ 264-4720 ^���� � ��� ������ ��W E= P--" ���M I � PERMIT NQ� ( 8]0]37 > � " ~ APPLICANT DOUG GALLANT BOX 4 -LL 99509 561~1165 LOCATION LEGAL L30 B4 SAND LAKE #2 LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS Z SOIL RATING �SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �FE-F7'r"� �-4 0 P7"v7j-T" :�-;2 ����-EEA [:-a F-- F:�`F " = �T THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H 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). ��C! 09 T I__z F= E--. ����_F T N::-� ��n P-1 F=-- _'. 1 2! EE: I DE C3 E3 113 n I I_Cv��� 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. | --- �r ��� < �> I ��_��1= ��1_ Cl��� ��� �����U I ��F= �� | BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS �DEPARTMENT I -JILL BE SUBJECT TO PROSECUTION. � MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS � 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. �I= FR M I -F ���I FR a _�-- ����E: 1 -1 E? 9= F2 ��� :JL ��� I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL. THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDfi^M|RE THAN 3 BEDROOMS. HPPLI GALLANT SOILS LOG MUNICIPALITY OF ANCHORAGE • +ve DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ��17Q G dLI GIN. L DATE PERFORMED: %C3 LEGAL DESCRIPTION: ko 1 UI rM14S nib In.AR,a WA S e G,OJIAN, QT u/ ` SLOPE SITE PLAN S' � 1 ■■■■■■■■■■ Gross Time r„i 2 Net Drop 14- U I,V laravA-C 0 0 0o 3 ■■■■■■■■■■ _ 16 4- :* 17 r. . ......... • 5 �° 18 M■■e-E■EE■ 6 0 o SAND g r� Q.Atk/ja L 7-0 8 a - p 0 ■ 9 O 00 10 O U0 11 O ENCOUNAS ER WATER N o ENCOUNTERED? V o 12. E IF YES, AT WHAT d Bt3TTn/••l V F DEPTH? '13 ■■■■■■■■■■ Gross Time Net Time Depth to Water Net Drop 14- 15- ■■■■■■■■■■ _ 16 ■■■■■■■■■■ :* 17 r. . ......... • �° 18 M■■e-E■EE■ N 2225-E �4® JU E 25„ .1971 : i�,4' 19' ■ ■.■■■■■■EMEMMEMENIM. M ■.■■■■.■IMMEMEMMEME ■ momommoomm 1011��IMMMMINMEMMII 11 O ENCOUNAS ER WATER N o ENCOUNTERED? V o 12. E IF YES, AT WHAT d Bt3TTn/••l V F DEPTH? '13 Date Gross Time Net Time Depth to Water Net Drop 14- 15- _ 16 n�*..491-H :* 17 r. . ......... • �° 18 -f V� N 2225-E �4® JU E 25„ .1971 : i�,4' 19' Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE (minutes/inch) _ p�/� /� TEST RUN BETWEEN FT AND FT COMMENTS ������ e-YLCAV,/•t` IK PERFORMED BY: 72-008 (6/79) CERTIFIED BY: m7S DATE: Time APPLIC, AT�,FILLS OUT UPPER HAL. ,®IDLY Property Owner Time Phone Mailing Address / <';� -=� - L x/ Zip Code Date Buyer Inspector Inspector Inspector Inspector Address - Zip Code MUNICIPALITY OF ANCHORAGE Lending Institution i' i Phone Address _ L _ Zip Code ENVIRO\tJ�'INTAL PPOTECIION Realty Co. & Agent Phone ECI'� Address Zip Code 'CONDITIONS OF APPROVAL Legal Description Street Location ( ) CONDITIONAL APPROVAL' Type of Residence DATE / / — I " e '!-> ❑ Single Family Multiple Family No. of Bedrooms EU Other BY: Water Supply Soils Rating Date Sewer Installed Well To Absorption Area - ❑ Individual Septic Tank Size ATTACH WELL LOG. A well log is required for all wells drilled since .June 1975. f�J Community For wells drilled prior to that date, give well depth (attach log if available). /❑ Public Utility Sewer Disposal I Individual Year Individual Installed: -�-='3 -- ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: MUNICIPALITY OF ANCHORAGE CEPT. OF ii`;_"t "_ ENVIRO\tJ�'INTAL PPOTECIION 13 ECI'� (3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE / / — I " e '!-> n r I�'"� BY: Soils Rating Date Sewer Installed Well To Absorption Area - Well Log Received Septic Tank Size Well to Tank 72"023 (3I82) ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction of� I r C � f S z.J 3 Ct C L..-'?-Spublic water system located in ±Ply C t O r�s �� Alaska, submitted in accordance with 18 AAC 80.100 by_� I�G� L( �� 6, f4 zt LL have been reviewed and are A approved. ❑ conditionally approved (see attached conditions). TITLE - DATE If construction has not. started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) Approved by Date Of s lce ttc-e 79)rO 114 / r0 Q-+ -6b loC, Cc- The c The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE The construction of the ;4&P ICE 4 'L to tS q j publliy water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. TITLE DATE As -built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted fin approval to operate. s y - TITLE -- DATE A.q