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HomeMy WebLinkAboutTHOMAS L BOYLE BLK 1 LT 5AThomas L. Boyle Block 1 Lot 5A #015-282-27 On -Site Wastewater Disposal System Permit Crlr MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 1 (1 4700 Elmore Road, PO Box 196650 I)cparuueni Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161265 Tax Code Number: 01528227000 Work Type: Septic Upgrade Permit Effective Dates: October 19, 2016 to October 19, 2017 Design Engineer: PANNONE ENGINEERING SERVICES Subdivision: THOMAS L BOYLE Site Legal Address: THOMAS L BOYLE BLK 1 LT 5A G:2734 Owner/Address: DOSIER JERRY LEE & MELODY ANN 11801 WAGNER STREET ANCHORAGE AK 995162022 Site Mailing Address: 11801 WAGNER ST, Anchorage This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank Lot Size in Sq Ft: 49500 Total Bedrooms: 2 N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Bed cover shall not be mounded against sides of existing shed. This will require moving shed, at least temporarily. Received By: Issued By: Date: fb 19 ?OJ( Municipality of Anchorage ' ,n P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http:/Iwww.m u n i.org/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV161120 COSA#: Permit#:OSP161265 PID#:015-282-27 Legal Description: Thomas L Boyle Block 1 Lot 5A Engineer: Pannone Engineering Services Applicant: Jerry & Melody Dosier Your request for a waiver of the maximum 15 feet bed width has been approved. The approved width is 25.0 feet. In addition, your request for a waiver of the required 5 feet horizontal separation from the test hole to the absorption field has been approved. The approved separation distance is 0 feet; see engineer's waiver request. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. .............................................................. M................ Waiver is Granted: X Waiver is not Granted: Date: lG 19 ?C J (o Approved by: fi&,7l! &Z/ Name of Reviewer ............................................................................... **** VARIANCEMAIVER REVIEW **** MUNICIPALITY OF la - Community Development Department Development Services Division On -Site Water & Wastewater Program 61' 3ar.w ANCHORAGE('_ Phone: 907-34_8=(14 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-282-27 Property owner(s) JERRY & MELODY DOSIER Mailing address 11801 WAGNER ST, ANCHORAGE AK 99516 Site address 11801 WAGNER ST, ANCHORAGE AK 99516 Day phone Legal description (Sub'd., Block & Lot) THOMAS L BOYLE B1 L5A Legal description (Township, Range & Section) Lot Size 49,500 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑ Upgrade ❑X Duplex (D) F-1Holding Tank ❑ Renewal F1Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: BED WIDTH DIMENSION f `res+ oh Distance: 25'W I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. property owner or authorized agent) Permit/Rush Fees: ; 0 _ Waiver Fees: a 15� Date of Payment: C, P �a 1 00 Date of Payment: 1 D Receipt Number: (A NI(1 Receipt Number: D � Permit No. 05 e I �P i� 4 S Waiver No. O S V l (oi 12c) Permit App_-'-: Pannone Engineering Services UC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com 12 October 2016 Subject: THOMAS L BOYLE B1 L5A Septic System Upgrade Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic system to be issued for this property. The proposed system will serve an existing two-bedroom (2BR) house. Currently the lot is developed. This lot and the surrounding lots are served by private wells. There are no wells within 100' of this system. The existing drain field is in failure and this permit will be to install an upgrade system to serve the subject property. 1. Soils. One test hole was performed by PES in August of 2016, and groundwater was monitored for at least seven days. Ground water was not observed to 3.0' below the surface in the test hole monitor tubes in September and in October of 2016. Bedrock was not encountered in the test hole. Based on the results of the percolation tests and overall soils appearance; an application rate of 0.3 gallons/day/square feet was used for a conventional wastewater system in the area of the test hole. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The proposed system will be placed in front of the existing house. The area slopes from the east to the west at approximately 0%-1% in the area of the test hole and proposed drain field. 5. Waivers: a. Bed Dimensions: We are requesting a waiver to adjust the dimensions of the proposed bed from 15' in width to 25' in width. The homeowner wishes to minimize the amount of loss of the vegetated privacy separation from the road which a 15' wide bed would cause. We request the 15' bed width requirement be adjusted to 25'. b. Test Hole Location: We are requesting a waiver as to the location of the test hole in relation to the proposed field. The test hole depth was minimal in depth and when completed native soils were returned to the excavated hole and compacted. Further the proposed system is a pressurized system which will evenly distribute the effluent evenly throughout the field further minimizing any chance of concentration of effluent into one spot in the absorption field. We request the 5' separation from the test hole to the absorption field be waived. The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 I I/ I M EXTENT �ryO"F BED OT TH L U) CY 7J w Z � c I� \ I W / I 10 J� SEPTIC AREA \ 4B v I^ INSTALL DRAIN FIELD CP) ✓V MOUNDED BED W/ 1:3 SIDE SLOPE 25.0'Wx40.0'Lx0.5'E.D.,+2.0'T.D. & 3.0' SAND FILTER & MTs. 1.25' PVC, W/ 0.125" HOLES DRILLED 18" O.C. ER UiPK1ENT SHALL N6T pq�V£ oIA sot TU' of 6£NTPCs, SP -orr- _�/5A �HE^ I SFD -174.1 DRIVEWAY - _ 1250G SEPTIC ;;. � 250G AUX PUMP CRIB E ABANDON P h UNDOCUMENTED FIELD E ABANDON PER MOA CODE WELL E �sEPTIc� \ A�REA NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 A%; PHONE (907) 272-8218 FAX (907) 272-8211 TRUE NOR Ii SOALE�0" Y T THOMAS L. BOYLE B1 L5A DRAWN JRL JERRY & MELODY DOSIER 8149 11801 WAGNER STREET SITE PLAN ANCHORAGE, AK 99516Rv�ceriYl Date 10/12/2016 Scale 1" = 50' P.I.D. NO 015-282-27 'ERMIT N0. OSP16126t 1 OF 4 DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO_ BEDROOM: 2(300 gpd) TANK SIZE: 1250g PERC RATE: 39.3 MPI SOIL RATING: 0.3 GPD/SF AREA ROD: 1000 SF SYS. TYPE: BED 0.5'ED MIN LENGTH: 15.0'Wx66.7 LF USE: 25.0'Wx40.C'LxO.5' E.D., +2.0' TD TOTAL AREA: 1 000 SF w w — WATER LINE / WELL RADIUS — NEW SEPTIC ABBREVIATIONS TH TEST HOLE (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. MT MONITOR TUBE NO. TYR TYPICAL NOTES: FOR CONSTRUCTION DRAWN I JRL SECTION/PROFILE CLEAN OUT MONITOR TUBE PANNONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THOMAS L. BOYLE 31 L5A JERRY & MELODY DOSIER 11801 WAGNER STREET ANCHORAGE, AN 99516 v MONITOR TUBE rpTl z G CLEAN CUT 0 n a W CLEAN OUT o DOUBLE CLEAN OUT(E) ➢ N DIVERTER VALVE(E) p AUX PUMP MONITOR TUBE VAULT(E) n i O —3 011 O 05, 1—' 30- -�o m ;un O �` MONITOR TUBE O F Z PE MONITOR TUBE PANNONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THOMAS L. BOYLE 31 L5A JERRY & MELODY DOSIER 11801 WAGNER STREET ANCHORAGE, AN 99516 v MONITOR TUBE rpTl z G Dote 10/12/2016 Scale :* 1 = 10' ••' P.I.D. NO 015-282-27 8749is* osP161z6s Sheet zoFa M ➢ N p MONITOR TUBE n i O —3 011 O 05, 1—' 30- -�o Dote 10/12/2016 Scale :* 1 = 10' ••' P.I.D. NO 015-282-27 8749is* osP161z6s Sheet zoFa TEST HOLE 1 OR TOPSOIL 1 2 SM Brown Silty SAND '173 _ 14SEP16 10OCT16 4 SM/SC Tight Packed Silty/Clayey 5 Mix _ 29AUG16 6j: SM Silty SAND 7 BOH DATE PERFORMED: 29AUG16 GROUND WATER @ 5.5 SOILS LOG - PERCOLATION TEST sITE PLAN SLOPE TEST HOLE WAS GROUND WATER ENCOUNTERED? Y IF YES, AT WHAT DEPTH? DEPTH TO WATER AFTER MONITORING? — 3.0' DATE: 14SEP2016 10OCT2016 SHED •J � GT1�EK hl WATER LEVEL READING NET DROP RATE (MPI) U) 1225 LLJW l 0 = 5 n� < DRIVEWAY 7.150" 0.875" READING DATE GT1�EK NET TIME WATER LEVEL READING NET DROP RATE (MPI) 1 29AUC16 1225 6.275" 2 1305 30 MIN 7.150" 0.875" 34.3" 3 1306 6.275' 4 1336 30 MIN 7.040" 0.765" 39.2" 5 1337 6.275" 6 1407 30 MIN 7.038" 0.763" 39.3" SLOPE TH 1 SOIL TEST RESULTS/ANALYSIS • PERCOLATION RATE 39 (miNinch) (Hydrologic Soils Group: HSG A) • PERC HOLE DIAMETER 6" • TEST ,RUN BETWEEN 1.5 FT AND 2.5 FT. • TEST RUN FOR OVER AN HOUR, LAST THREE READINGS PROVIDED. COMMENTS: Test hole excavated by A+ HOME SERVICES. Test Hole was NOT required to be presoaked before Perc test due to existent sandy material (Table 3-8, Para.3, EPA Design Manual), PERFORMED BY: Joseph Lawendowski. I CERTIFY THATTHIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: FOR DRAWN I JRL SOILS LOG PANNONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THOMAS L. BOYLE E31 L5A JERRY & MELODY DOSIER 11801 WAGNER STREET ANCHORAGE. AN 99516 10/12/2016 * NTS j P.I.D. NO C15-282-27 9 PERMIT N0OSP161255 Sheet 30F4 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55, 2. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 3.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 3.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 7. THE CONTRACTOR -SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED -LINE AS -BUILT DRAWINGS TO THE ENGINEER. THE RED -LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS, 10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION -TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN -OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 12. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS -BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY: NOTES: FOR CONSTRUCTION 1 DRAWN I JRL DESIGN NOTES Em TITLE: PANNONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THOMAS L. BOYLE 31 L5A JERRY & MELODY DOSIER 11801 WAGNER STREET ANCHORAGE, AK 99516 VCII CE 8149 10/12/2016 Scale NTS P.I.D. NO — 015-282-2 'ERMIT NO. OSP161265 Sheet 4 OF Municipality of Anchorage Page —hof -2— DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -SW 9 R D47-3 PID Number: Name: GYL2'laoS/L12 Wastewater System: ❑ New Y WJpgrade Address: 11601 ABSORPTION FIELD Phone: No. ofd rooms: z ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating Total Depth from net grade: GPD/SoFt. Lot: Block: Subdivision: SA ` Depth to pipe bottom from original grade: Gn epth beneath pipe O L[g•' F Ft. Township: Range: Section: Fill added above original grade' Gravel length: Ft. Ft. WELL: ❑ New ❑ Upgrade Gravel widen. umDutancebetweenknes: Classification (Private. A,B,C): Total D Cased To: Ft. Total orption area: Ft. Pipe material: Ft. Ft. SO. Ft. Driller. Date Drilled: Static Water Level: Installer. Date Instal)ed: Ft. OWN6t, /O( 1148 Y I Pump Set at: casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES 74LSeptic ❑Holding ❑S.T.E.P. To saptic Absorption Lm Holding bft/Private Manufacturer. Capacity In gallons: From Tank Field Station Tank Sewerunn 6;1LMeet_ WeltI Q q Material: Number of Compartments: WaSurfter /ce t loo' LIFT STATION Lot/ Line qcr a Size in gallons: Manufacturer.rformed Foundation Q V �'�.` .'Pump on" level at: u evel at: High water alarm at: Curtain Drain Pump Mak I Electrical Inspections peby: Remarks: 1 ao BENCH MARK Location and Description: Assumed Elevation: :..•fOO EN L to OF* Inspections performed by: Dates: 1st In/m/w 2nd "CIMITE Steven R. rernone ,� Department of Health and Human Services approval E-8149 • rf��c 8lslilpl Reviewed and approved by: Date: _[L -g. [V13 (mn. ami) MpA n P.I.D.Nt 1. 015-282-27 AS -BUILT PERMIT NO. SW 04 3 WASTE ATER ABS❑RPTI❑N SYSTEM Z LOT 5A, B CK 1 B❑YLE S/D CO A B DC1 30.0 16.9 TI 31.4 20.0 T2 39.5 24.5 DC2 42.3 26.5 EI 44.9 39.8 c) 0 in %D 49LN NEW SEPTIC r� 2 BR EXIST'G WELL EXIST'G 7508 SEPTIC ABANDON IN PLACE EXIST'G CRIB j 13'x17'x6' EFF. I EXIST'G WELL N61 -06.B4 W149-49.17 NOTEi B 8 1) EXIST'G TANK IS A 750 g SEPTIC TANK @ 8 AND WAS ABANDONED IN PLACE. 2) INSTALLED NEW SEPTIC TANK OUTSIDE THE 100' WELL RADIUS. INSTALLED DOUBLE CLEAN- 9s9 OUTS BEFORE 6 AFTER THE NEW TANK. 3) CONNECTED TO EXIST'G CRIB. R. Pannone',, Jerry Dosler CF Bt4s ���t 11801 Wagner Drlve .I.o3 •'f Anchorage, AK 99516 FEEW 1 (907) 345-6225 NEW 911 1250 Gal 90.9 SEPTIC TANK TANK ELEVATION PANNONE ENG. SVC P. O. BOX 142025 ANCHORAGE, ALASKA 99514 272-8218 Phone & Fax NTE, 11-3-98 AS -BUILT CALEi 1'=50' MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW980423 Legal Description: THOMAS L BOYLE BLK 1 LT 5A Design Engineer. 0062 Steven R. Pannone, P.E. Owner Name: Jerry Dosier Owner Address: 11801 WAGNER STREET ANCHORAGE, AK 99516-2022 C, 1-Y. Date Issued: Oct 30, 1998 Expiration Date: Oct 30, 1999 Parcel ID: 015-282-27 Site Address: 011801 CANGE ST Lot Size: 49500 SO. FT. Total Bedrooms: 2 Permit Bedrooms: 2 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (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 Issued By: Date: /n/,?C)( '1 Date: P.I.D. NO. 015-282-27 L 4911! s jt,.itavin , R.•�er_• !� :_ No. CE 8149 .••'� i "DESIGN PERMIT I WASTEWATER ABSORPTION SYSTEM ❑T15A BLOCK 1 BOYLE S/D;, I A t BR EXIST' -t" i NEW000 WELL i EPTICNK � i E 751N IN �i TANK EXIST'G CRIB r i' 3'x17'x6' EFF. g cil 8 EXIST' dl ::).CS WELL L) 1 i - i i i NOTE# 1) EXIST'G TANK IS A 750 6 SEPTIC TANK AND IS 8 B $ B LOCATED APPROXIMATELY 99 FEET FROM WELL. 2) INSTALL NEW SEPTIC TANK OUTSIDE THE 100' WELL RADIUS. INSTALL DOUBLE CLEAN - OUTS AFTER THE NEW TANK. 3) CONNECT TO EXIST'G CRIB. NEV 1000 Cal SEPTIC TAW \Vork\5A-1BOYL.DWG TANK ELEVATION 'REPARED FOR, PANNONE ENG. SVC Jerry Dosler P. O. BOX 142025 11801 Wagner Drive ANCHORAGE, ALASKA 99514 Anchorage, AK 99516 272-8218 Phone & Fax (907) 345-6225 DATE, 10-27-9e SCALEi 1•=100' DESIGN °•'8MP1 GRO ITER ANCHORAGE AREA BOR0I0"4 OErARTMENT OF ENVIRONMENTAL QUALII L•• 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME- �/MAILING PHONE �7 SEPTIC TANK: DISTANCE FROM NUMBER OF / COMPARTMFNTS K _ LIQUID LIQUID CAPACITY %� U GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH / LENGTHS, DEPTH C" / LINING MATERIAL �� ` v x�'Y��� //o, r % .DISTANCE FROM WELL BUILDING FOUNDATION. NEAREST LOT LINE "'�• �I TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) .?6 O SO. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF ABSORPTION AR TOTAL LENGTH FOUNDATION , NEAREST LOT LINE , OF LINES ES FT. LENGTH OF TRENCH WIDTH �TN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE A DEPTH OF FILTER MZERTAbBENEI�I ATLE IN. ABOVE TILE WELL. TYPE `/KULCy`DEPTH �,j� , DISTANCE FROM WATER ,BUILDING FOUNDATION. SAMPLE 10CA r NEAREST SC/� ` NEAREST _ SEPTIC (/ SEEPAGE / _ OTHER LOT LINE , SEWER LINE-, TANK , SYSTEM Z� , CESSPOOL ,SOURCES_ DIAGRAM OF SYSTEM DISTANCES: DATE ��/ APPROVfD�--I //��l ••�-Y�-�/ G.A.A.B. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY ' 9500 TUDOR ROAD POUCH 6.650 ANCHORAGE. ALASKA 69502 TELEIRONE 279.8666 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT w r I 1 I SII INSTALLATION LOCATION LEGAL DESCRIPTION - L.O7 INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED. FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED S. MAILINGS �A �✓- PERMIT NO. +Sus 2795 �zG z7z-/S/D HONE TO BE INSTALLED BY - 11 ' — r -- -I f 14C- NOTEz THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK 61TYPE �'—]�E. " SEEPAGE I MINIMUM DISTANCES, R UIREMEN7 FOUNDATION TO SEPTIC TANK S FOUNDATION TO SEEPAGE PIT C� DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL / l SEPTIC TANK SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. r WELL TO SEPTIC TANK O SEEPAGE PIT DRAIN FIELD 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 5 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 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26.66 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. /—i /% I APPLICANT'S SIGNATUREE�d��`IL [A7