HomeMy WebLinkAboutNORTH SLOPE #1 BLK 4 LT 3North Slope
#1
Block 4
Lot 3
#050-511-03
%._/ MUNICIPALITY OF ANCHORAGE ` /
/ ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264.4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
NEW
�qj — �j
❑ UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
O�
LOCATION
NO. OF BEDROOMS
4
L�
Well
Absorption area
Dwelling
PERMIT NO.
Uy
DISTANCE T0:
a Q
Manufacturer
Material
No. of compartmen s
w
U
Liq. capacity in gallons
Inside length
Width
Liquid depth
Z �
IF HOMEMADE:
.
y
DISTANCE TO:
Well _
Dwelling
PERMIT NO.
z
= z FQ-
ManufacturerMaterial
Liquid capacity in gallons
O
J
DISTANCE TO:
Well
x% �
Foundation /
•f
Nearest lot line /
'1'
PERMIT NO. / _
` -�
w
19,
_j z
No. of lines
Length of epich li g /
Total length of lines
Trench width
between lines /
0Distance
inches
[j
Q
Top of tiletofinish grade
Material beneath tile
Total effective absorpti� area
U
G. TN5UL-A'1 ED
cinches
50b 'F;
Length
Width
Dep h
PERMIT NO.
W
C7
Q F-
Type of crib
Crib diameter
r epth
Total effective absorption area
a. a
LU
wWell
u?fding foundation
Nearest lot line
DISTANCE TO:
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
Building foundat o
Ser ine
ew
eptic tank
Absorption area(s)
DISTANCE TO:
OTHER
PIPE MATERIALS
��vv
to VC
SOIL TEST RATING_ ?,
/ Z� 44 „
INSTALLER
LJAI Et3
REMARKS
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ek�P1$OFEc: ;' y��"
APP VE DATE LEGAL
M•fr
E'w<
72'011 (Rev. 3/78)
`����� �o� ������
^ DEPHRTMENT�� HEHLTH HND ENVIRONME�THL`��OTECTIOM �
~^ 825 /L' STREET, HNCHORHG�'
��G-y ~�
PERMIT NO ( 8 ...
018] )
HPPLICHNT CHRL EDWHRDS SR BOX 196X ER 694~]257
LOCHTION ERVHLLEY
LEGHL L] B4 NORTH SLOPE #1 LOT SIZK7. 40�GS SQUHRE FEET
TYPE OF SOIL HBS1 TEM IS� DRHINFIELD
MHXIMUM NJMBER OF BEDRO4 SOIL "HTING (SQ FT/BR)= 125
c --
THE REQUIREI SIZE OF THE SOIL HYSTEM IS�
���if� a= �H�
THE
LENGTH
DIMENSION
IS
THE LENGTH (IN
FEET)
OF THE ENCH
OR DRHINFIELD.
THE
DEPTH
OF H TRENCH
OR
PIT IS THE
DISTHN�E
BETWEEN THE
SURFHCE QF THE
GRQUND
HND
THE BOTTOM
OF
THE EXCHVHTION
(IM
FEET>
If
r
J���
THE
8RHVE1.
-EPTH IS THE
!lfl DEPTH
OF GRHVEL
BETWEEN
THE OUTFHLL PIPE
HND
THE BOTTOM OF THE
EXCHVHTI�N
(IN
FEET)
�������� ��������� ������� ����� ������� ����1����
PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE
INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PROPERTY HND THE
NUMBER OF RESIDENCES THHT THE WELL WILL SERYE
��� .... �11 ������� ��� ������ ~~_
BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTION HND HPPROVHL BY THIS
DEPHRTMENT WILL BE SUBJ�CT TO 3-
0 M.
MINIMUM DISTHNCE BETWEEN H WELL HND HNY QN�SITE :7r" DISPOSHL SYSTEM IS
100 FEET FOR H PRIVHTE WELL OR �5� TO 200 FEET FROM H PUBLI� WELL DEPENDI�G
UPON THE TYPE OF PUBLIC WELL
MINIMUM DIST�NCE FROM H PRIVHTE WELL TO H PRIy�TE SEWE� LINE IS 25 FEET HND
TO H COMMUNITY SEWER LINE IS 75 FEET
OTHER REQUIREMENTS MHY HPPLYSPECIFICHTIGNS HND CONSTRUCTION DIHGRHMS HRE
HVILHBLE i., PROPER INSTHLLHTION
[ CERTlFY THHl
1� T HM FHMILIHR WITH THE REQUIREMENTS FOR ON—SITE SEWERS HND WELLS HS SET
FORTH BY THE MUNICIPHLITY OF HNCHORHGE
2� I WILL INSTHLL THE SYSTEM IN HCCORDHNCE NITH THE CODES
]� I UNDERSTHND THHT THE OH^SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMENT IF THE
RESI�ENCE IS RB,1ODELED NCLUD
TO IE MORE THHN 4 BED0O�MS
SIGNED��~
HPPLICHNT CHRL
�
— �'�| �
MUNICIPALITY OF ANCHORAGE
�.e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: Callfolatzvls _ DATE PERFORMED:
LEGAL DESCRIPTION:
1
C S1
2 <
O
3
4 U `�
v � /
5 c n
6-
sq -
7
su_7 L A
5
rr
v V
9
10
WAS GROUND WATERS
11 ENCOUNTERED? L
O
P
12 E
IF YES, AT WHAT
DEPTH?
13
1 JUILJ LUU
❑ PERCOLATION
TEST
14
Date
Gross
Time
Net
Time
15
Net
Drop
�`°a,°�°aei►`��c�
16
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..• a fi
to
viV
17
f
k"
a e ;
18
at �!
Ao�ert �•
4,
.E
19
•. 5
^v
,�
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
20 N PR0FESS0Np1 r�
PERCOLATION RATE (minutes/inch)
T RUN BETWEEN FT AND FT
COMMENTS � �����
r {f=
>, � rb dh 16t=[� � �• �
`sil� 13�: J• �
S•n fF'i.i'iiif�n
PERFORMED BY: f �,,...( CERTIFIED BY: DA
72-008 (6/79)
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tt ��
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PUU1.4H 6 6511
ANCHc.
(907) 26
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, ()n
D EPAR_F%I c IVT OP HEALTH AND EN V I H O"l irl EATAL PROT i -C' '_`!
<Permit #: 820465
January 31, 1983
TO: Permit Applicant
Subject: Lot 3 Block 4 North Slope Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely a�
Q C /lam
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
9
x 0.
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O -^f -i Sa" Mision
On -Sits Water A Wosta nhr PI 09
4700 Bragow Strect
P.O. Box 196650
Andw age. AK 99519-6650
a�Iaamla[o(seliis
Mn 343-7W4
Pump Installation Log
WeH Dry Pesmft N=0xr: Dais of h=W ---
Pared Identi8eatfon Nambw.Q50--5LL--il -000
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IM"k IatlrxwalyowerN.AM=3 Mr. Car'L. El
31017 kv�a rvk ,�vc .,gLe lPi, �k
Pmnp Imftfttloa Data // - 09-- - UM
Pump lattice Depth Ddow Top of Wes CwhW %3 ✓
P=VM=O&ctwWsNswA1 Me,LO
Pomp Musa: a3asokS�t
PWV Size .ybp
Pftkn AdapterBwrW Depth:- --!Z fed
Pftka Adapts Mai ffiwft es Name: N!/4
Pftks Adapts Im im. N/h
PumpUsWkrNamC f&$P aS e2n_
e.s
MxMngA&IMM PO, &Y 771236
Attedlos; The pomp iostaUer shaU pevvide a pimp imtaiatian fog to DSD within 30 drys ofpomp iosfsifation