HomeMy WebLinkAboutNORTH SLOPE #1 BLK 4 LT 7Ell
~. , 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
MAILING ADDRESS
D,STANCE
~ Manu facturer~~
Light. gallons IF HOMEMADE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well
~O~ / ~ ~ Dwelling PERMIT NO.
~_~OZ~ Manufacturer ~ ~ / ¢ Material ~ Liquid capacityin gallons
~ ~ ~ o~ I~ lines Trench ~th /,
~ ~ ~o. of linesc ~ E t of .lin Total Distanca ~een~ines
N To. dO-tile to finish grade ' / _ / ~ ~ inches
Ma~rial ben~t~tile
~ Z /~Z~/ / ~Z~ ' ~ ~inches/~/ Total effectiveabsorptionarea
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
m Well Building foundation Nearest lot line
~ DISTANCE TO:
~ . Class
m Septic tank
~ DISTA~Cff TO: Buildinfl foundation Sewer line Absorption area{s)
PIPE MATERIALS
SOIL TESTRATIN~ ~
72-013 (I lev. 3~78)
"rut:,,,_ [)iEP'TH EU:::' hl'" 'T'RENE:H .r' p. .i:' ..i' T, .'r'= ..... "r.'-.iF' ...... '"'L., .I. ....... i=, ! r4i'.;rL-!::.""' '-'- E:EETI.,.iEfEN THE .':-; .... P,'-s',q. ...... '"'. .... :' C!F: ..... ~ ~::.' '"-
l'~':i?i'"lJi'.,ll'J:, I:~?.,{[:, THE BO'T"T'O!"~ l~iF-{"?{l.:; !;:'::.:;?:F~',.,'R'I:'~t-II'.,{ ('j'.'.l FE'F:"i",
"?' '.¢-~ (F:: .... .... i{'"' ~.:~' {i:::" ~"~"; K'"':: ~...-ii ~., .ii; ....... % ~:::'* 'T" ~"-'~*! -~',, ...... "::='., .._..~::::;; .. F'=...::*~ ,r::~ ..... !I ;~ ~':=' .~:::' ~:::;" "T'
T'HE GF;;F:i'v'EL DEP'T'H Z:E; 'Tl'qf':r l','l'[i'.J" "I hl D[EF:"T'H ""~:' '~::'~:"':'~ E:ETi,JF:F'FJ 'T~4i::: OLtTF:'FiLL. F:, 'r F,~::'
Fd'.~r:,_ T!- F' [3Cq-!"Ci!'"t OF THE: EXC:RVFi'T' ! -'"',',, ';: '~' f'J PT:'FrT"
:L~Z~C'i FEET i:::i'-~;;' l={ P,~;'i'VF:i'i"E ,iE' OR u,=;,.:: TO ~l.?.ll:::i I:::' [:' .',: T ,'..['-m, lq '{ .....
r,":.. I'i ?iJF;:I i IF'
i...iF'i]:I~',~ '?L.~, l~...c:' --] ~'"'"' I= ..... FtF'. ..... pi_I[3L. 'r,. ,..-"~' HELL..
.".iHJi"iL.M DISTFII",IE:E i:'F~:Cff'i H ~ {..~ ,, L. "}"I:t l:~ ............ t '~i .......
TO R CO{"ihlL!!'.~ Z T'./ :F;[EHER L. :i: NE I :E; ';:"::J:~ FEE T.
,'- '~"~ F'-~' ?.E:{:!}...l Z RE?'IEi'.JTS '"'*:' ' '""-
d - - -- I . '2 ?~i" ]' ~= 'J'{'"~7~ ....... ,..{<% -, ii~.
F¢,,,'FITi ~:iFt :::' TI:I "~ -t ~'" ""'"""'["'c-'"~ " '
..................... ,. ,,.: ......... ~ f ... ,' ,.:.[~. T I'.J':,'FFn i FIT T
Z C:EWT]:~'::"~' "rHnT
.L: Z Fill F:'i::ff~iZ!_:i:Fff,~: H:[TH TF.iE RE(;:!U!REMENTS FOR OH-SZTE SEi4E:;F~:S F!ND I,~EL.L..S F!S SET
F'OF:TH E??' THE ?!UF,ilC!F'F!L!T'T' OF F:iNCHORF!GE.
2: i H I L.L.. ! HSTF!L.L. THE S'?'ST'Ei"'I I ~',I F~C:C:OF;:DFii".iC:E F.! I TH 'THE CE!DES.
]:: i UHDER?T'F:iHD 'THF:iT THE Oi",!-'SiTE SEI.,.IEF~; S?E;TE!"I PiFI"/ !;:E6¢J~RE EHL. i::~;:GEi"IENT IF T'HiE
RES ! E:'ENC;E
PERFORMED FOR:
LEGAL DESCRIPTION: L"'7
1
2
3
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
[] SOILS LOG
PERCOLATION
TEST
SLOPE
-/
/
/
/
WAS GRODND WATER
ENCOUNTERED? / O
,FYES. ATWHAT /~ ~
DEPTH?
Gross Net Depth to Net
Reading Date
Time Time Water Drop
PERCOLATION RATE d ~ (minutes/inch)
TESTRUN BETWEEN ~ FTAND ~ FT
72-008
POIjCH 6-650
ANQHORAGE, ALAokA 99502 0650
(907) 264 4111
[)~ PARTMENT ()~ iii &i /!'. A :) ENVIRONMEIX~TAL PROTECTION
~Permit ~: 820159
· January 31, 1983
TO: Permit Applicant
Subject: Lot 7 Block 4 North Slope Subdivision #1
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.
Sincerel~
Robert C. Pratt, R.S.
Acting Program ~Manager
Sewer and Water Program
RCP/Ljw
enc: Copy of Permit
SWP/057
i"i l N ! l',!!_i.r,'! D 1 5.';TFI~-4C:E BE'I"!.,.!i_:E[..5:N fi b.!EL..L FIN[) F::ii',iY' ON-5.'; ~ 'T'E Sk'.'!4F!GE I} i' E.r, POE;FU.... SS-'S'T'EFI
LiF:'O?-~ THE 'T"r'F'Ii~ OF F'L![?,L.!C !.,.!ilE!....L..
i"!.T. Ni[I"iUi"! DI'E;TFINCE F'~:Oi"I F:~ PR ]: ',?R'T'E !4EL. L "FO R F':ff';.:ZVFIT~5: SE~.,.iE(R L..:..r.i'-,!E l.":5;
TO FI C:O!"!?ILI.i",!:[T'r' '.(i;E:!.'.![}:~: k.i[l",lg ]:S '?.55 I::'E~57!".
i,.!ELL L. OGS I::I!:~:!!.5: I;i:E(;!U:[F.:ED Ri",I.()i"iUST E.,'E';: N:E"TL!~?.h~ED TO THE DEF'R~:Ti"iEi",iT .i,.!'i_'TH]:N
OF" THE !.,.IEL. L C:ONPLETI
OTHEi;.: ?.Et';.:!i...! I' [;i:E!'"!ENTS h'lffr' i::lPl:::t"rL SF'EC :[ F .~ C:FIT l Ot",!S R!'qD C:OI".}STi:~'.L!CT'I Oi",! D
.FIVFi i LRE:i..E "FO :ii NS.!.;UF~:E( F'F,:OPE~: i i'-.ISTFILL_,C:FI'' ]; O.N.
! CER'[' ]; I:%.' 'T'HFI, T
:i.: I .F.,'M F'R.r-'I.i;LtFI,r.;.: l.,.li['.,q-! THE Fi'rEi;(;H...!IF. tEMENTS FOR ON--SZTE SE!4ERS
!:--Of~tTH E?~.' 7'H,E i"!LINICIF:'F!L.).;TS.' OF'
2: ! b-!ILL ti'.,!,S'f'RLL 'T'H~T. S"r"E;TEi'"I IN i:':I~Z:(i:OI:~;~DF:I.,!",iC.,SE i,.!!TH THE CO£:;ES;.
Permit '~
Applicant:
~ ]UNICIPALITY OF ANCHORAGE ~ i
Department~f Health and Environmental ~£otection
825 L Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL ~S£q~IL~R- PERMIT
Legal Description: ~__~ /L~/ ~],~,~i/,/~t cj'~,/~,_~,~;, ~/ Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank
Maximum Number of Bedrooms: ~ Soil Rating(sq. ft/br)
The Required Size of the Soil Absorption System Is:'
DEPTH --"~ LENGTH GRAVEL DEPTH WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
,the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well Or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, i 9 8
I certify that:
(!) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more that 3 bedroo, ms.
Signe~: Issued by:
Applicant ('~ U
Date:
SWP/024(1/81)
s- ,. h~,~UIRaD saP~IC(ttOtDi~) lANK S~a GALLONS
.... -* ~ua* ~n~peot~o~l ann approval by tn:~
~c~: ~ott'o by t}~a ~:4un~,J~s'alltz -
APPLI(, NT FILLS OUT UPPER HAk: ONLY
Mailing Address
Address Zip Code
Lendinglnstitution ~ ~)V")"~. '~"~) "''-' ~' [ U~i,~r~5 -- Phone
Realty Co. & A~nt ~ ,, .- Phone
Address Zip Code
Street Locati~
Type pf Resi~nce
Single Family
MultipW Famil~
~ Othor
Water Supply
~lndividual ~ ~ ~ ~ ~ , - A~ACH WELL LOG. A wall log is required for all wells drilled since Jane 1975.
~ 'Community ~ ~ ~. For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal .~
~ Individual ~ ~ ~ ~_~ .~ ~ Year Individual Installed: ...
~' Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Ti me .C.T~'x~
Time Time
Insp~tor Insp~tor Insp~tor Insp~t~
Field Notes: ~ , DFeT C:
(:) APPROVEB BEDROOMS : ~ ~ONDITIONS OF APPROVAL
( ) CONDITIONAL~%,'26 --~APPROVAL' ~
Soils Rating Date ~wer Installed Well To Absorption Area /O ~ Well Log Received
G~ e~ Well to Tank
72-023 (3182)