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HomeMy WebLinkAboutT13N R3W SEC 13 E2NE4NW4SE4NE4GR~"~ER ANCHORAGE AREA BOROL,r~'~ DEPARTMENT OF ENVIRONMENTAL 0.UALIT~,'" 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /~' ,/~',~:~-'~ ~-~'~ ~,,~'.,/~~ LOCATION ~ ~'~'/~'!/~_~t~'~4'.'~-~m SEPTIC TANK: DISTANCE FROM WELL /~"O / LIQUID CAPACITY ~ GALLONS. MATERIAL INSIDE LENGTH *'"'~.INSIDE WIDTH MAILING ADDRESS ,~':~"~'~ ~/,,~_~"T,J,,,~, PHONE. LEGAL DESCRIPTION ~Z, ~~ ~~ ~--~, ~~ NUMBER OF / COMPARTMENTS LIQUID DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: ,,~o,.~.~,,:~" NUMBER OF PITS / OUTSIDE DIAMETER / OR WIDTH //~ / · LENGTH /',~ /. DEPTH ' LINING MATERIAL ~ ~ ~/~-~~. DISTANCE FROM WELL "~ ~ BUILDING FOUNDATION. NEAREST LOT LINE _~ _~ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~~ SQ. FT. TILE DRAINi FIELD: DISTANCE FROM WELl NUMBER OF LINES / ABS~ DEPTH: TOP OF IILE TO FINISH GRADE FOUNDATION. , NEAREST LOT LINE DISTANCE BETWEEN LI~I'I~::~ TRENCH WIDTH SQ. FT. LENGTH OF EACH LINE-'"'-~ DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: ,~'~-~ ,j-- ,,~'/.~4x~-- , DISTANCE FROM TYPE/,/2/'~-,~.~'~,~ ~ DEPTH ~--~ , BUILDING FOUNDATION. LOT LINE //'~9 "~' NEAREST SEPTIC SEEPAGE · SEWER LINE ~/f'/'~-., TANK ~/~:;~ ~'~Z- ., SYSTEM WATER SAMPLE /J'/O , NEAREST /'J/,~/~'-- 0 T H E R, , CESSPOO~J/L,~',/'~'~z~, SOURCES/c~J'~:~ DISTANCES: Great'Er ANcHoragE Area BoruUgh DEPARTMENT OF ENVIRONMENTAL QUALITY :3500 TUDOR ROAD POUCH 6-650 ANCHORAge, ALASKA 99502 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. NAME OF APPLICANT .~* INSTALLATION LOCATION ~"-- LEGAL DESCRIPTION INSTALLATION OF.' SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED PHONE SEEPAGE PIT DRAIN FIELD OTHER NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION= 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY TH= HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO pROSECUTION. SEEPAGE AREA SiZE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ~ SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD DRAIN FIELD DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE WATER MAIN TO SEPTIC TANK DRAIN FIELD / SEP+IC TANK, ~/'-- , SEEPAGE PIT /~t~ , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION ~ FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. Mr. David B. Harkness Health D~pt. 327 Eagle St. Anchorage, Ak. 99501 }~. Lee Goodman Box 202 Soldatna, ~k. 99669 k~A~ ? 1969 D~ar Mr. Harkness: ................................. Enclosed are 'the receipts for the materals used in the con- struction of our septic tank. The floor was poured 4 in..deep, c~cept 6 to 8 inches .~round the edge where pipe and ether reinforcing was used. 3/8 rebar stuck in every 16 in. as .dowels,To stop earth from moving the base of the x~all, three courses were l~yed. Then one course of bond be~m block lzyed. Concrete was poured in the bond beam that has ~- in. rebar ~nd also in cells that were dowled. Corners and middle wore reinforced all the way up. Blocks ~:ere used to separate the two compartments.' The first was zpp- roxim,~tely 2/3 of the tank.'~ ~nen thc top was poured 6 in. thick~ the concrete was allowed to run do:~n the cells of the blocks, The top was reinforced with 4 x 4 mesh and pipe. ~¢o man holes were left in by using plastic dish pans and bent iron for handles. A clean out was set in up from the inverted tee which , is 2 in. or more above the outlet and extends into the liquid 14 or 16 inches. A block was left out 24 in. high in the partition. A cement plaster was put on the inside w,~ll to seal the blocks. The outlet was run back to the original cessp~51 which we be- lieve to be 12 x 12. It was on the property when purchased and is approxim~tely 4 years old. We've never had trouble ~th the sanitary facilities at the apt. Thc soil is course s~nd and gravel. The cesspool is over 250 feet from the well. Thank you, Mr. Lee Goodman .o~ .,:.D-,~ ?.. GRE-A--TE[ ANCHORAGE AREA ~. ~ROUGH c,s, N0. C~/n ~/~ ~? ,~.~ ~ HEALTH DEPARTMENT ~ ~ ~ ~x ~ ~327 Eade S~) Anchorage,~a 99501 279-2511 to~,O~EWAOE DISPOSAL.SYSTEg ' APPLICATION & PER~IT . i '-2 ' ~'~ ~PHONE NO 0~,N4%72 NAME OF APPLI g,d_ (~D~5/~ MAILING ADDRESS /OOZL3D ' · RESIDENCEADDRESS~ R~' ~'~ ~ LOCATION 0F.!NSTALLATI0~ ~b ~' ~Mb,',~ ~, APPLICATION TO INSTALL: SEPTIC TANK J ,SEEPAGE giT /~ , DRAIN FIELD TO SERVE THE FOLLOWING FACILITY · ': FINANCED THROUGH C TO' BE INSTALLED BY (_ PERCOLATION TEST RESULTS '~ ANTIC P:ATEo DATE OF COMPLETION ~ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS[iS TO SERVE AS fi']~, '~O0ct~F'~/v~ , PERMI~ TO ~A AS DESCRIBED BELOW. SIZE OF UNITTO BE SERVED .,SEPTIC TANK SIZE O,STANCES: TYPE - - ,- ~ SEEPAGE ,TYPE :';LO:'?~' DI'AGRAM 0F SYsfEM I certify that i am familiar with the requirements of Greater Anchorage Area Borough Ordinanco No. 28-68 and that the above described system is in accordance with said code. ~ ,': . DATE DATE RECEIVED ?. ~ INSPECTION APPOINTMENTS ~ )~? TIMId' TIME TIME DATE DATE DATE ~UNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~EPT' OF HEALTH &  825 L Street - Anchorage, Alaska 99501 [NMIRONMENTAL p;;O~ECTION ENVIRONMENTAL SANITATION DIVISION SEP 5 I981 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. I.~omplete reques~ will not be proce~ed. Please allow ten (10) days for processing. ,1. PROPERTY OWNER PHONE PROPERTY RESIDENT (If different from above) .: PHONE 2, BUY R PHONE MAI LING ADDR ESS 4. REALTOR/AGENT I PHONE MAILIN~ ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION ' 6, TYPE OF RESIDENCE NUMBER OF~I~EDROOMS [] One [] Four ~ Other [] SINGLE FAMILY [] Two [] Five [~ MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY ~ INDIVIDUAL* * ATTACH WELL LOG, A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ~] PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY ~, INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLEO [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~] INDIVIDUAL/ON -SITE ,~,/,u ~ DATE INSTALLED ~] PUB LIC UTI LITY ~/ Connection Verified INSTALLER [~]Septic Tank or [] Holding Tank Size:~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Ho]ding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 'XPP OVED FOR '/gED OOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE B 72-010 (Rev. 6/79)