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Home My WebLink AboutSHIMAKONIS LT 74AOnsite File Shimakonis Lot 74A #051-093-34 Municipality of Ailchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page , Of 7? www.ci.anchorage.ak.us (907) 343-7904 ON-SITE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT 1WASTEWATER Permit Number:PID Number:y� Name: zW�/ ,� // � Wastewater System: El New Upgrade ddress: ' � . _.. V I /e - _ 11 N 5_ `7 --ABSORPTION FIELD Phone: -7P70 Number of Bedrooms: ❑ Deep Trench 9 Shallow Trench ❑ Bed ❑ Mound ❑ Other: LEGAL DESCRIPTION Soil Rating: I Total Depth from original grade: yam. O c GPD/Ft? .� Ft. Block: Lot: '�/ / /f Subdivision:% j �.; 1-/yrJ Depth to pipe bottom from origi��gra Gravel depth beneath pipe: � � y � Ft •. Ft. Township: Range: Section: Fill added above original grade: ^J f�► Ft. Gravel Length: 6-7 Ft. Well: ❑ New ❑ Upgrade Gravel width: Number of lines: Distance between lines: —�a Ft. Ft. CI ification SPrivate, B C): f Total Depth: Cased to: Ft. Ft. Total absorption area: `�/ / Ft= ,fP_ Ma erial: _ _ 57-M SDN y F610 Driller. Date Drilled: tatic Water Level: Installer. , Date Installed: / ,0 Yield:tP-�et at: Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES 'septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Private Manufacture -e_ Capacity: Capacity. From Tank Field Station Tank Sewer Line vel erGal. Well ( / 7 ` �— Material: ' / D ^ ,r) N r of Compartments: it /{�.,j- Surface Water �q{I/� / /) W/J�) LIFT STATION Lot Line /' -T7 i V J1`' �/ ' Size: ��)"D �Ce Gal. Manufacturer. �" S -^ 7> A% P V( Foundation ^1 DS f 4 //� "Pump on" level at:. in.�in. "Pump off" level at: High water alarm at: _ in. Curtain Drain // Pump Make & Model EleJcal Inspections performed by: Remarks: BENCH MARK Location and Description: ` Z.& ,qLaodoig2 w e i� MA 51"'G if iAssu d Elevation: Di 07� ] Ft. r, EI ginee.,Jnq __//�� y En 'nee 's Stamp Inspections performed by: 15861 S. Birchwooc :.p. i y-1. Dates: 1s' 1—OV/ Chuglck Alaska 99567 L�/1 lJ- g`Q ...�Q rte.. 2nd Ie�F - [ w -`9 •d''o� �$ '� , Development Services Department Approval � � o ti �` �s e• o v' v •accayo :co c Conditional Approval Date: A. 1404 ' moi dL'G1j 4,0_? � Reviewed and approved by:,4 Date: cQl6 ��'�},R1s'Qf.�;� (Rev. 04/06) PERMIT NO. SW060273 PAGE 2 OF 3 Municipalit of Anchora e DEPARTMENT OF HEALTH AND HURAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Tele hone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 74A, SHIMAKONIS S/D P.I.-D. NO. 051-093-34 PERMIT NO. SW060273 PAGE 3 OF 3 Municipaht of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 • Anchorage, Alaska 99519-6650 • Tele hone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 74A, SHIMAKONIS S/D P.I.D. NO. 051-093-34 1 ST2 -96.1' FINAL GRADE- / 2"92.1INSULATION 91 .5' NEW 1250 91.3' GALLON HDPE SEPTIC TANK CO1 MT2 CO2 MTl CO1 = 99.1' CO2 = 99.0' FINAL GRADE CO1 = 95.5' SR CO2 = 95.6' MT2 = 92.0' MT1 = 92.0' WATER FOUND ® 87.0' 86.0' B.O.H. N. T. & 01/04/2008 12:31 DAUIS CONSTRUCTORS 6941211 gv& ❑ ..... __ _ _.. . _. mss. r � E-•cs-.=.r, ep s-7? NO. 191 902 :w � �ASBUILTSEWARD & I HEREBY CEF271FY THAT SURVEYED THE SCALE yFOLLOWING DESCRIBED RTY: THAT NO ENCROACHM�XIST �i'.9 EXCEPT ASINDICATED. DATEAND IT IS.THE REMILITY OF THE�OWNER rENF TO DETERMIit THEENCE OF ANY GRID' EASEMENTS,COVENANTS,ESTRICTIONSWHICH DO N0T APPEAR ONCORDED VISION PLAT. UNDER NO CSTANCES SUBDI- SHOULDFFANY DATA HEREON BE USEDCONSTRUCTIONOF FENCE LINES, OR FORLISHING BOUND- & '_'NES.�s s-7? NO. 191 902 :w ROBERT C. COWAN, P.E. ROBERT A. SHAFER, P.E. CIVIL ENGINEERS (907)694.2979 FAX(907)694-1211 Date: HEALTH AUTHORITY APPROVALS MunicEpaPLty o6 Ancho+cage Land Use 064iee MINNEXTENSIONS SEWER&WAAttn: Dan Bot" 3500 E. Tudor StWeet Anchahage, AK 99507 SEWER& WATER INSPECTION I � , I REFERENCE: S Ulm Flit S ", 1,-7 Y A ENGINEERINGSTUDIES The septic ins e tion6 601L the %e6enenced pnopeh..ty we&e pek6olmed on ANDREPORTS(a o and a P4ioq. to submitting the On-site Wa6tewatek D.is a Syst nd ah. WW Inspection Repant we ahe waiting box the Q� )QLL ,\k- duny�P.�-t to be eompteted. WELL & FLOW INSPECTION 16 we may be 06 6uxtheA aeAv.ice pt.ease contact us. OWTESTE3T Sineeuty,, SITEPLANS 0 //r,40- ROAD DESIGN Robert C. Cowan, P.E. SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 December 12, 2006 Re: Shandy Home Shimakonis 74A To Whom It May Concern: 1 here by certify that 1 have installed the electrical system for the above refe family home in compliance with the National Electrical Code and local ami electrician certification number is : 00106009 Sincerely, Dewe. MJL David Whidden Tsunami Electric Inc. 70� LTE'ON TTEIP69 F sdoiondiSNOO SIAUG My EV:ET GOOEIL1110 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO60273 Legal Description: SHIMAKONIS LT 74A Design Engineer: 0003 S & S Engineering Owner Name: JED SHANDY Owner Address: 20240 WEEPING BIRCH AVENUE CHUGIAK . AK 99567 - Date Issued: Aug 21, 2006 Expiration Date: Aug 21, 2007 Parcel ID: 051-093-34 Site Address: 020240 WEEPING BIRCH AVE Lot Size: 46744 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. ❑✓ Disposal Field Q Septic Tank ❑ Holding Tank ❑ PrivyPrivate Well ❑ ❑Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 5/2 2..1 C Date: -q t c AZunicipa i y of An'c rage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTICMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. n5I-013.5 Property owner(s) S0D SiYMA 4 Day phone Mailing address oCDaLjQ IJL)e-ePk na Site address ` Legal description (Sub'd, Block & Lot) S%uf Legal description (Township, Section & Range) Lot Size ` ut LL it Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field IT Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ PVQE Zip Code Code Number of Bedrooms 4 THIS APPLICATION IS AN: Initial Upgrade Renewal certify that the above Information is correct. I further certify that this application is being Single Family Dwelling ar>,fi )s in ac�ordagce with applicable Municipal Codes. (Signature of property owner or authoged agent) Permit/Rush Fees: 115 — Date of Payment: $11S/0lo Waiver Fees: Date of Payment: Receipt Number: N153 Receipt Number: (Rev. 11/05) for a MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SWO50289 Legal Description: SHIMAKONIS LT 74A Date Issued: Aug 15, 2005 Expiration Date: Aug 15, 2006 Parcel ID: 051-093-34 Design Engineer: 0003 S & S Engineering Site Address: 020240 WEEPING BIRCH AVE Owner Name: JED SHANDY Lot Size: 46744 SO. FT. Owner Address: 20240 WEEPING BIRCH AVENUE Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of: ❑✓ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: � CJ Date: Issued By. Date: — 1�7titiI 11jitlily utAndicti-.ige S • -- beveloptiiellt Setvlces bepattment 04 L Building Safely Division !t On -Site Water and Wastewater Program - 4700 South bragaw St. P.O. Box 196650 Anchorage, Ak 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION I.OR A SINGLE FAMILY DWELLING Parcel I.D. _ D51-093- a4 Permit Number SW Property owner(s) Jed. Mailing address 20 Z4 Site address 202A13 W1 Legal description (Lot, Block & Legal description (Section, Township & Range) Lot Size� M 4_Acres/ q: . THIS APPLICATION IS PDR: ( phone AA -L --iz88 Code ggSl�� Code 995bl Number of Bedrooms Sewer Only 9 Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 1 certify that the above information is correct. I further certify that this application is being made for a Single ramily Dwelling and is in accordance with applicable Municipal Codes. S L S ENGINEERING (Signature of property owner or authorized agent) 17°44 W" RINE `O°P ~4 Fob River, Alaska 99577. Permil/Rush Pees Date of Payment: _5/00 Fl/ Ilor Waiver Pees: Date of Payment: Receipt Number: 7Zz9(,il9t Receipt Number: (Rev. 09104) August 10, 2005 ROBERT C. COWAN PE CMLENGINEERS (907)694.2979 FAX(907)694.1211 ALS V MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK. 99519 SEWERd WATER LWNEMENSKM REFERENCE: Lot 74A, Shimakonis S/D SEPECTION ER It is requested that you issue a permit to install a septic system to serve the proposed four bedroom dwelling on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location ENGINEERINGSTUMS AWREPMS of the test hole is located on the attached site plan. At the time of excavation on 7/7/05 ground water was found at ten feet. After seven days of ground water monitoring the test hole was still found to be dry. WELLNSPECTION d FLONTEST We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent 61TE PLATS properties. If you require additional information, please contact us. fgAD DESIGN Sincerely,, SOIL TEST i %2 /m,,, Robert C. Cowan, P.E. RCC/jhm PERCOLATION TEST Enclosure STRUCTU M A MECHAMAL NSPECTI" ONSITE WASTEWATER OSPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER. ALASKA 99577 1" = 40' DESIGN SITE -PLAN I O tnn -P. > O C0 -+ / Lo F (!i(li W to d *0 c-CK'LTO•i�' \�// zo— iri `lig Qna� � m O z O ::E mO onna >Z �Omm 7 ex' N.0 8' ROWEASEMENT ---- �� =�u� SQA Am A 0'v N,o mom ;O I I •m C" OI N I C7• rA Pf9 CJ I I O tnn -P. O C0 -+ / -�S I\vio mm O DSOm C17 \�// zo— iri `lig no Xw � m O y I I NNrn I0 -i0 y 0 0 I cnIPOO I f 1 ~ 113M .00 I rn m I O 5t110da � N I 0 �O I n 1-�1 I Z z ♦� Yr O C0 -+ / -�S 0100 J%S/ ZN0 (/ / mm O DSOm \�// zo— iri `lig no Xw r u _ o A m O Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchoraae. sk.us (907) 343-7904 T Solis Log - Percolation Test Performed For:�J,te7 Jt} D Date Perk Legal Description: I-Vl T`I 91I l M1 lS Si& Township, Range, Section: Depth 2- b- 3- 4' n ' 5- 6- 7- 8- -67-8- o •a 10- 11- 12- 13- 14- 15- I 0-11-12- 13- 14- 15- 1 40/SW WAS GROUND WATER ENCOUNTERED? s IF YES. AT WHAT DEPTH? I C)' L Depth to Water AfterT,4 0 Monlloring7 Yr E Date: L*7 -oll t ROSERT C. COWAN r410, CrE n9li 5 rian 7 ERCOLATION RATE TEST RUN BETWEEN COMMENTS r, 11 LL 'PASS • d SIEUF' PERFORMED BY: 5 & S ENGINEERING PERFORMED IN A i Eagle River, Alaska 99577 (mm Mnch) tr• PERC HOLE DIAMETER (.11 FT AND 7 FT I -A{(W L, tl1 - — CERTIFY THAT THIS TEST W IPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Y/ f0 10,E S& tnGlneeRilIG ROBERT C. COWAN PE CMLENGINEERS (907) 694-2979 !W-&THAL FAX(907)694.1211 ON-SITE WASTEWATER DISPOSAL SYSTEM ffHMAPPROVALS n CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWERSWATER 1MMEXTENSIOTS REFERENCE: Lot 74A, Shimakonis S/D August 10, 2005 SEWERS WATER ►SPECWN GENERAL: 1. The scope of this project includes the installation of a 1300 HDPE gallon septic tank and a new trench to serve the proposed four bedroom residence ENONEERMCSTUM ANDAVVITS located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all WELLMSPECTION SiLOWTEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITE PLANS 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESrN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their SMTEST own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: PEROOIARON TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. STRUCTNRALS AEC/WrCAL MSPECTKN6 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WASTEWATER OMPOSALSYSTEN DESNM 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 Page 2 Lot 74A, Shimakonis S!D August 10, 2003 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCII/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. 6. A subsurface disposal field may not be located on a slope greater than 25 percent unless there is an approved exception documented. Page S Lot 74A, Shimakonls SID August 10, 2005 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 74A, Shimakonts SID August 10, 2004 1. The first inspection must be conducted atter the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER 'LOG OF DRILLING by A & L DRILLING KIND or FORMATION. FT. TQ.S / DEPTH OF WELL.. OWNER OF LAND ... ......... ...... ........ .......... ADDRESS.................... ................ ......................... ............... . ... ... ...... - STATIC LEVEL OF WELL SITE ...... E ....... ... .... ................................ DRAW DOWN FT. FROM ... : ........... T -r ...... FT. . . ........................ GALS. PER MR. DATE—STARTED ............ FROM ............... I ........ FT. .. FROM,?.1............. TOJ�' ................. '9 > KIND OF CASING FROMj� .............FT. TOLQ.1 ............. .................. FROM................... KIND or FORMATION. MISCL. INFORMATION: &"/e '9 'L. 4, F06 LTE'ON DRXLLEWS TTnveq <- sdoionNiSNOO SInUG ANY FT. .94�- .................... L Zt?:ZT Gooz/LT/To FT. TQ.S rn-( ................ FT FROM.......Q ............ ... .......... ........... FT, FROM ....:.................FT. ... ...._..._FT. TO.121-4 ............. FROM ... : ........... T -r ...... FT. D, FROM)� ............ -.kT. TOk/-.-_- ...... FROM ............... I ........ FT. .. FROM,?.1............. TOJ�' ................. FROM...................... -FT. FROMj� .............FT. TOLQ.1 ............. ... FROM................... FT. FROM./ ............. FT. TOIA-2N . ......... FTIZAU-4 FROM .. . ................FT. ♦..... FROM/ .......... -FT. TOI.47.1 F �U64. FROM ........................ FT. MISCL. INFORMATION: &"/e '9 'L. 4, F06 LTE'ON DRXLLEWS TTnveq <- sdoionNiSNOO SInUG ANY FT. .94�- .................... L Zt?:ZT Gooz/LT/To GAAB-HD-I GR.'ER ANCHORAGE AREA BOROU~I DL~I~RTMENT OF ENVIRONMENTAL OUALrM~' 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION MAILING ADDRESS ~' ~'~_, ~-"~'~/~/'~ PHONE LEGAL DESCRIPTION ~' SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY '~ MATERIAL GALLONS. IN,SIDE LENGTH NUMBER OF / COMPARTMENTS LIQUID INSIDE WIDTH DEPTH____ SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH ~'~/~ DISTANCE FROM WELL /~O [OTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH /~, JY, DEPTH BUILDING FOUNDATION SQ. FT, ABSORPTION AREA ~"EqD~A I N FIELD: DISTANCE FR~ ~ NEAREST LOT LINE NUMBER OF LINES DISTANCE BET EE NES ~'-'~-._ TRENCH WIDTH. SQ, FT. LENGTH OF EACH LINE ~ DEPTH: TOP OF TILE TO FINISH GRADE WELL: TYPE,~''~-- ~'//''~)-~'' , DEPTH NEAREST LOT LINE -- /~/' , SEWER LINE TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE DISTANCE FROM ~ / WATER //~ / , BUILDING FOUNDATION. SAMPLE SEPTIC ~' SEEPAGE TANK ~-~ ~'- SYSTEM /~ ~ , CESSPOOl NEAREST OTHER SOURCES DIAGRAM OF SYSTEM GREAeR ANCHORAGE AREA BOR~GH PERMIT NO SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK TYPE AND EIZE OF FACILITY TO BE SERVE[:) / PFRMTT VAI TD ~NF YFAR PINAL INSPECTIONI 24 HOUR NOTI~ REQUIRED. BACKFILLING OF ANY SY~EM WITHOUT PINAL IN~ECTION BY THE H~ALTH DEPAR~ENT AUTHORI~ WILL BE ~UBJ~CT TO PROSECUTION. NOTE~ THIS PERMIT IS NOT VALID WITHOUT ~IL ~$T SEPTIC TANK SIZE TYPE MINIMUM DI~'rANGE~, REQUIREMENT~ 5 ft. FOUNDATION TO SEL~r'rlC TANK FOUNDATION TO SEEPAGE PIT 20 ~:~e DRAIN FIELD WATER MAiN TO SEPTIC TANK 10 DRAIN FIELD ]-0 10 lC) ft. SEEPAGE PiT ALSO CONSIDER AREA WELLS. SEEPAGE PIT 10 ft. 25 ft. SEEPAGE P,T 100 ft. DRA~N ~IELO 50 ft.. ~GRAVEL eAGKIhlC'a , EXCAVATION S FEET INTO UNDISTURBED SOIL. ' I RI'I~!Et,iT OF EN\i~(RO,N,~!Eh~tAL QUALI'i~' 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE # Performed For ~,! ~i~_jeOrm~S Leoal Description: Lot~Block__ This ~orm Reports Soils Loq ~ Date Performed 11 ~-~1~ ._ Subdivision~r_~ I Percolation Test Depth Feet Soil Characteristics 5 6 7 8-- 9 Was Cround Water Encountered?_~/~_ IF Yes, At what Depth? Reading Date Gross Time Net Time Depth to H20 Net Dr'on Percolation Rate Proposed Installation: Seenaqe Pit ~ Prain Field Den, th of Inlet.~ ....................... Depth To Bottom c)f Pit Or Trench)~.. C n M ~ E N T S: Test Performed BV /3e~,oe~'~ ................... Data Certifier!