HomeMy WebLinkAboutPRATOR BLK 8 LT 1
,,~/ 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
P~ONE
__~EW
[] OPGRADE
MAILING ~[[[~R ESS
OC.T,O.
NO. OF BEDROOMS
PERMIT ' ¢
No. of co~m'~nt~
Liquid depth
I nsJde length
IF HOMEMADE:
Well Dwelling PERMIT NO.
DISTANCE TO:
Manufacturer Liquid capacity in gallons
DISTANCE TO: ~ I ~/~f-,
of lines/ Length o~J~lin/e
~ of tile to finish grade ~/
Width~
Type of crib
Crib diameter
Well
Depth
Building foundation
F°undati°n~l~
Total I e~,~¢ li~ s
Material beneath tile
Depth
Crib depth
Building foundation
Driller
Sewerline
DISTANCE TO:
Class
Material
Nearest lot line~,~ #
Trencl~id~th
~(..~ riches
inches
DISTANCE TO:
PERMIT
Total effec~ a~r~n area
PERMIT NO.
ITotal effective absorption area
Nearest lot line
Distance to lot line
Septic tank
PERMIT NO.
Absorpt on area(s)
OTHER
NSTALLER ~
R EMAR KS
APPR~
",, 72-013 ~ 3/78]
DATE
LEGAL
THE I...E!:I'.,I~:3TH !:, :1: ME:I",I:E; :!: ON :!: Z '1"HE: I...E:i'.,IC~iTH ,::
TH[i!: I)E!:F:'"f'H OF::' Ft TI:~'.Ei:f',IC:H O1:,~: F' :[ T
~:SF~:OLINI:::, F:II",I[)THE: [ii',OTTOi"l OF:' THE:
"I"HE:t:~'.E~ ~[:S lqO ':SE:T F!Zl::,"f'l-'l F:'OF?.
"f'HE~ C. iI:~iFI',,,'E:L. [::,E:F'TH ]::i5 THE":: M:[i'-,!]:,UI...IM E:,[.!r.F:'TH
I:::It'.,tD THE: [3C[T'T'OM CIF' "['H[~: E::~.::C:.',::I',?FtT]:C~?',I ,:: ZN I::' E: E: T ::, .
MUNICIPALITY OF ANCHORAGE
Pouch ~650, An~orage, Al~ka 99502 276-222~
SOILS LOG - PERCOLATION TEST
LEGAL
3
4-
5-
6
7
8
9
10
11
12
13
14
15
16-
17-
18
19
2O
COMMENTS
SLOPE SITE PLAN ·
WAS GROUND WATER
ENCOUNTERED?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERFORMED BY:~¢,~' ERTIFIED BY: DATE:
72-008 (7~76)
PERCOLATION RATE ~ (minutes/inch)
' :': "' TEST RUN BETWEEN 7 . FT AND I~ FT
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch C--650, Anchorage, Al~ka 99502 276-222'~
SOILS LOG- PERCOLATION TEST
SOILS LOG.
PERCOLATION
TEST
TEST RUN BETWEEN Z FT AND
1
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
'~ Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
{minutes/inch)}
SLOPE,
......
WAS GROUND WATER
ENCOUNTERED:
,~nq~l~r' _q/'~'¢/
~.,~/~:~b~/~ ~'i~ /~: IF YES, AT WHAT
DEPTH?
SITE PLAN-
.... [ [ .... .... 1_! _i I_
.... ~---~---~-~'--~"~- ~-~-- I
i o l,tJ i / !
, LEGAL DESCRIPTION:
i~"--Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
3. Legal Description:
4. Location:
GREATER ANCHORAGE B ,,~W~4/~<9 g~,~---(-:~. ,~
Department of Environmental Quality .
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received April 12, 1976
of Ins aCtion ~/---~'~/~0-~.~¢"---¢¢~-~' /~/Z:
Date p ~~./~
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES ~,~' ~0'~
Co~. ~ ~ ~
Alaska Bank of Commerce % Carolyn Barrea
712 West 4th Avenue, 99501
Ron D. Mc Nay
Phone: 279-5641
Phone: 344-8133
Star Route A Box 448
Lot 1 Block 8 Prator Subdivision
2.7 miles up Rabbit Creek Road
5. Type of facility to be inspected Single Family
6. Well Data: Individual - serving one
A. Type B. Depth 120'
C. Construction D. Bacterial Analysis
7. Sewage Disposal System: On-site system
A. Installed 1957-60 ? B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
C. Absorption area to nearest lot line
, Absorption area
, Other contamination
, Absorption area
No. of bedrooms 2
, Sewer Lines
EQ-034 (1/74) Page 1 of two pages
Pag,.e 2 of two pages - Re,,. /.st for Approval of Individual .~,,er & Water Facilities
!
'k~gai~Descripti0n Lot 1 BloCk 8 Prator Subdivision
ApProved--~~ Disapproved Date ~/~/~
Approval~Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIO
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
FHA
1. Type of Inspection: CMRO__VA
2. Property Owner: .~.
Mailing Address: ,'~Lo~ ~t~ ~- ~y~ ~S/ DayPhone:
Name of Buyer: '~ C)~'~LV ~
Mailing Address:
Name of Lending Institution:
Mailing Address: ~¢'~,
5. Name of Realtor or Agent:
CONY
Mailing Address:
6. Legal Description:
Location: ~,-]
7. Type of Facility to be Inspected:
No. Bdrms. P .
Water Supply
Type of Supply: Public Utility ' .Individual
If Individual, number of dwellings presently served 1
If Individual, depth of well J ~)',0 ~
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation I C~
Individual (on-site)
72-003(3/76)
Anchorag~ ~ Alaska
712 We~t 4~h Av~u~
Ap~ll 16, I97t{
to be o~ am~f~to~y q~ity.
~t~t a new ~¢~ with a ~ompl~on da~~, 1~ ~ait ~{1
have ~ ~ ~t~ f~ t~ ~c~ ~~e st~rtc~.