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)