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, .GRE -`R ANCHORAGE AREA BO'e "GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME JON/r 134111V13 / MAILING ADDRESS L� EtR L•i �E' D(' PHONE
LOCATION
SEPTIC TANK:
LEGAL DESCRIPTION
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DISTANCE C _NUMBER OF
FROM WELL I 'o't MANUFACTURER J"ICPEe MATERIAL .r+�^F�� COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 6"S4'GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL 1_�FOUNDATION /0'1L O NEAREST LOT LINE Iff- TOTAL LENGTH—OF
ENGTH _
OF LINES -50 '
NUMBER OF LINES If DISTANCE BETWEEN LINES 1-4 TRENCH WIDTH -.MIN. TOTAL EFFECTIVE
ABSORPTION AREASSQ. FT. LENGTH OF EACH LINE �,
�
1 DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE 2tMATERIAL_ BENEATH TILE �� / &&ABOVE TILE ` IN.
WELL::
TYPE P&lllca CONSTRUCTION�z'v��. DEPTH_
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION , LOT LINET_, SEWER LINE , TANK , SYSTEM_
CESSPOOL
OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES: v
INSTALLED BY: �r FKc
SEWER LINE DEPTH: y
PIPE MATERIAL:. - 9 !�'1r•
LOT SLOPE: L'f�
REMARKS:
Form EQ -032
REMARKS
DIAGRAM OF SYSTEM
APPROVED
G.A.A.B.
DISTANCE FROM:
1p,
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTA'sATlI?N�O[.F:: SEPI
TYPE L7. SIZE OF F�C� I
FINANCED THROUGH
SOIL TEST RESULTS
;-
GRA. R HORAGE EA L. JGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C•• STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274.4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
MAILING ADDRESS ✓
PERM
wfflpp
M1T'N.
v
COMPLETION DATE ANTICIPATED
NOTEI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPI
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PRQSECUTION. .. —/
SIZE
TYPE
MINIMUM DISTANCES. REQUIREMENTS /
FOUNDATION TO SEPTIC TANK S
BY THE
SEEPAGE AREA 512E TYPE
irrul T// ;4 T
V) DIAGRAM OF SYSTEM IJ:L
FOUNDATION TO SEEPAGE PIT DRAIN FIELD �" /
SEPTIC TANK TO SEEPAGE PIT WALL
SEEPAGE PIT DRAIN FIELD
SEPTIC TANK
TO NEAREST LOT LINE
WELL TO SEPTIC TANK /1 v "' / SEEPAGE PIT
DRAIN FIELD (! L.L0 ' ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK= SEEPAGE PIT DRAIN FIELD
TO RIVER. LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
It p
GRAVEL BACKFILL/ �
CONFORM TO BOROUGH REGULATIONS REGARDING I TALLA'h1O
1 J � _.//IJ�'1
G.A.A.B.
OR
L ENSED DESIGNER
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1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.58 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. �/,/,4/j'�,}C\'�
DATE � '^ —7� APPLICANT'S SIGNATURE _ '%' I
FORM NO. EO -01 4
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1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.58 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. �/,/,4/j'�,}C\'�
DATE � '^ —7� APPLICANT'S SIGNATURE _ '%' I
FORM NO. EO -01 4
1
1
1
1
1
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVTROUMFNTAL QUALITY Case N
3330 "C" Street
ANCHORAGE, ALASKA 99503
Performed For 3 OH N BRANDY Dated Performed 4 -14 -TJ
Legal Description: Lot 3 Block Subdivision-rIMBEPL ux _ -4 3
This Form Reports Soils Log �4 Percolation Test
- Soil Test I•lust Be Logged To 4' Below Proposed Seepage System -
Depth N
Feet Soil Characteristics
Was
I Date
Gross Time
Net Time
Depth to H2O flet Drop
2
7
26 %
3`
41
z/i-S sil�./ C�TQJe GM:22S
a s�•'
�Zov :
3 s
5
I
b
"
7
Bf
v'
S�_ Iz� Si ItI 5M:25'0
-
9
0
'r.
1
it
2
•%
3--
-
4—
4—
Was Ground Water Encountered? AID
If Yes, At What Depth?
Reading
I Date
Gross Time
Net Time
Depth to H2O flet Drop
7
26 %
a s�•'
�Zov :
3 s
I
79
V7, f,:a
Percolation Pate Minute
Proposed Installation: Seepage Pit Drain Field
Depth of Inlet Depth
//�� o Bottom o Pit or Trench—
COMMENTS: Si14., "ravel ���.ea;ra i., v,svo-V' I, QIY:u.�,i)v�n cl 5,,__si;" z,
Test Performed BY
�S-I
ate Certified BY:
Date:
M -W DRILLING, Inc.
P. O. Box 4.1224 • 1310C International Airport Road
• (907) 2744611
ANCHORAGE. ALASKA 99509
L/4s /333
DRILLING LOG
Well Owner John Brandt Use of Well Dom
Location (address of: Township, Range, Section, if )mown; or distance main road
(300 Egavik Drive) L39 Blk Jg Timberlux Sub,,4dd No. 3
Size of casing–_6 Depth of Hole 75 feet Cased to 69 feet
Static water level 40 ft. (ab" (below) land surface. Finish of well (check one) open end ( x ) ;
Screen ( ); Perforated ( ).
Describe screen or perforation None
Well pumping test at 9 gallons per *7 (minute) for---l---hours with_ loo; xt,
of drawdown from static Ipvel_
Date of completion 24 April 1975
ncL ,q t3
WELL LOG J-rS–
�� 3y) 7-1,21ij )(3O) S�]
U fo / 05/ 0. `f
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
O TO 2 Surface Organics
2 TO 4 Silty Small Gravel
DEPT. OF HEALTH &
4 TO 6 Boulder EIiVIApNUAFbaAt PRCITErnoN
--L—To 40 Silty/Sandy Small Gravdl APR 'zt•
40 TO 51
65 TO 75
—TO-
O
-TO-
TO
-TO-
TO
-TO-
-TO-
-TO—
TO
TOTOTOTO
—TO—
Gravel
O
Gravel
Medium Gravel
._..– –
Medium Gravel: waterbearing
1–CUSTOMER
FROM: DEPARTMENT:
INITIATED BY:
off
INTEROFFICE MEMORANDUM
GREATER ANCHORAGE AREA BOROUGH
,{cr[
-J )��---- -- . DATE OF MEMO: - - ----------------- --
TO: DEPARTMENT: __L: L) P_1_60,-5
RECEIVER:
REQUESTED ACTION SCHEDULE
DATE ANSWER -Il-,1;7-
I-/7- 75
REQUESTED:
FOR INFORMATION ONLY PREPARE BACK-UP INFORMATION
FOR IMMEDIATE ACTION CALL ME BEFORE YOU ANSWER
FOR YOUR CONSIDERATION Tf' NEED YOUR RECOMMENDATION
E� OTHER
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