HomeMy WebLinkAboutPREUSS #4 BLK 9 LT 8 ;, MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
'( · ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON~-SlTE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
'"T~HONE la NEW
MAILING AI;NDRESS ~ - ~ ~ ~
LEGA _ ~. A ~ ~ '~ ~, '
NO. OF BE~OMS
Well Absorption a~a l Dwelling
~ ~ Materi~ No. of comp~ments
~ ~ Manufacturer
~k Li.. tap.city in gallons inside~ntt~ ~,dth Liquid depth
PERMIT NO.
Well Dwelling
DISTANCE TO: ~ ~ Material Liquid capacity in gallons
~ ~ Manufacturer
Nearest lot line I PERMIT
N~ Top of tile to finish grade ~ Material beneath tile ~ches Total effective abso~tio~a ~
PERMIT NO.
, Length p(~ ~idth Depth
~ Total effective absorption area
Type of crib Crib diameter Crib depth
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Cia Depth Driller Distance to lot line PERMIT NO.
~ ~uilding foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE
OTHER '
PIPE MATERIALS
SOl L TEST RATING ~D"
REMARKS ~ I '~.
A~OVE~ ~ . DATE LEGAL
72-013 (Rev. 3/7~ ~
FiI::'!:::'L. 1i: C:I::]i",! T
L ':: :: ]:!"t" ]' O
L. E C:J I::1L.
THE !..IiE?',IGTH [::, 1[ ME:lq':::: i O?',! 1t: :ii!; 'THE: L.E.M(:!i-i'H ':11i: N FEET > Cfi::' 'T'HE 'T'i::~:Ef'I 1': I'". OFf: E:,t:~i:F:i 1[ I",!F:' :[ ELD.
'THE [)EF'TH C!F:' I:::i '!'T~:EJqC:H I:)l:~:: I::']:"i" :[S~:: "l'H!ii!: !:::'Z:~TTf::IfqC::E: .E~[~:'['!.,.I[i~:[~:N 'i".HE~: !~i.!]:~'1::'1:::II"[~:: CIF '!"Ht!~:
I~[[~:OLJf',![> I:::i!",![::' THE EuDTTCff"I CI!::' 'T'H[~: !.:::::':D:::f:!VFI'I"]:CIF~! ~:: Z f'~!
TI"IE:['~.:[.~: Z :El NO :E:ET 1.'.I :[ DTH F:'OI:~: 'T'l:;?l::.:h[ ":
THE (:iil:~:!::['v'E[.. DEF:'TF'! :!:'J:~: THE ["! ]: M :[ I"!UM DI~:F::"['H OF' '::.PF:IVE:.:..~ E~I'~:'T'!.,.IE~:[~.:N THE C. ILTI:::'F:iL.L
!::ff',l[> THE: I~i[l:::!"l"'l"i::ll'"l OF:' TH.C E::'~C:f':'!"/I:::ffF ]: Olq ':: ]: N F!!ii:E"f' >.
I C:EI:~:'I" 1[ I::"T' TI'"If:IT
::L: ]: I::11'! I:::F:Ii"I C[ L :[ !::iI:;?. I.'.!:[TH TFIE F?.Ei:C!t...I:[I:;?.!i!!:I'"IEI",I'T'S I::'Cl[;i: OI",!-':~]:TEi: S;E[,.II!~::I:;i::::; F:IM[::' ['.iEL.[...S I:::l:~i SL:~T
.I::'C~I~:TH i:T::"r' THI!~': I'"!LI!qIC:.'iiI:::'F:I[...]:T"~" 13F:'
:~?.: :[ I.'-! ]: L.L. ]: 1",I':'STI::ILL THE: :i!;'T".?T"~M :!: I",1 ::::::::::::::::::::::::::::::::::::::: 1.'.1Z TH THE
Z:: ]: L.ti",IDEI:;i::~;TI:::If',II:> THI::IT 'T'HI'Z ON"~".:~;Z'['!!!!: ~;[!:.'I.,.tEI:;i: 'Ji!;"F:E;TEZI'"t I-"iF:t"? F[:EC-:!LIZI;i:[~: !~!:I",IL..FII:;?.C~iI::iCt"'I[~:J",I"t" :[1::: TH['!i:
!"~'.ES 1' I~)EMC:E :[ :i~; I::~:E!"tCC:'EL..li~:D 'T'C~ :.1: NC:LJ.JE:'E MOIRE "t"F'tFIIq 2~: I~i:EDF-'.OC~M'.::;.
~:~ ]: ~3!",fE[::' :~~"~...~....__. ........... I:::11::' F:'L.. ]: C:FI f',l'l' [:~', ]: L.L..
! ~; Fjt...I[.~: [::, I~,T _ ............ 1... k'l 1 ~::..
GREATER ANCHORAGE ArEA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456i
DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INStalLaTiON Of: SEPtiC taNK I (~) O C-) ~c~ SEEPAGE Pit
tYPE aND SIZE OF FAC,L,t¥ SE SERVEO '2
DRAIN FIELD , OTHER
PERMIT NO.
FINANCED THROUGH
CO M pL ET~ ON DATE ANT ' C ' PATED ~l ~~ ~
TO BE INSTALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY W1LL BE SUBJECT TO PROSECUTION,
SEPTIC TANK SIZE '/ ~) ~-~ ~ TYPE ~-E~E AREA SIZE TYPe
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK ~
FOUNDATION TO SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK SEEPAGE PIT ., DRA~N FIELD
TO NEAREST LOT LINE.
i /
WELL TO SEPTIC TANK / C~ SEEPAGE PIT / ("-'~ ~
DRAIN FIELD - { O~ / ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
SEPTIC TANK, ., SEEPAGE PIT
TO RIVER, LAKE STREAM.
, DRAIN FIELD
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.
LICENSEE) DESIGNEE
DIAGRAM OF SYSTEM
I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDl~CE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. //~~~/~
by
A & L DRILLING COMPANY .......... u
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTION
DATE - Started.
PERMIT NUMBER
Ended
/-'/
DEPTH OF WELL '~/,~
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING
KIND OF FORMATION:
From /") Ft. to c:~ Ft.
From '- } Ft. to / .3"' Ft.
From [ .'~" Ft. to ] ~'~t Ft.
From / / Ft. to -'} q'- Ft.
~, ..';! 't
From ' Ft. to Ft.
From "~ Ft. to .)~ .... Ft.
From i~' ~; Ft. to '~"~ .Ft.
From_ t% Ft. to ~ / Ft.
From~~ / Ft. to ~7-i~ Ft.
From_ Ft. to.__Ft.
From _.Ft. to Ft.
From Ft. to_--Ft.
From. Ft. to Ft.
From Ft. to Ft.
From Ft. to. Ft.
From Ft. to_ Ft.
From Ft. to _Ft
From.__
From__
From
From
From
From
From Ft. to-- Ft.
.Ft. to.__Ft.
.Ft. to Ft..
Ft. to Ft.
Ft. to Ft
Ft. to Ft.
Ft. to Ft..
Ft. to Ft.
Ft. to Ft.
Ft. to Ft.
From Ft. to. Ft
From Ft. to Ft
From_ Ft. to Ft.
From--Ft. to Ft
From · Ffito ' Ft.:
From Ft. to : Ft.
From Ft. to___Ft.
MISCL. INFORMATION:
' DRILLER'S NAME '" : :;, ,i
I::II:::'I::t_ICFINT8ILJ... F:'L]II::f::[EMFIN GEN DEL. E.R. 995}:"2~
L. OGFJ T' ]. OJq Ptq:l l:i:E'.:~;'.~i; L.F:IJ'.,Jl:~i
LEGF1L L.8 1!i:9 F'F?.LIi~'.Lr,?, '.::~;,.'"I}" L.O"[
91215,!;;
FEET
T"r'I'::'E Ol::' SOIl._ FIE',SORBTiOt',I '.'~;?S-i'EM iS: 'TREi",tCt~I
t"1F-I;:-::IHUi'i NUMBER O1':' I:i!:Et}ROOH'.ii; =
SOIL f.i~FI'T' I i'-.tt'3
THE RE(;!U :[ REl:) '-:.!; I 2E OF THE SO I L.. F1BSOF::PT i (IN S'¥'ST'EH l':-];:
J :]:~ E-:.: ~-:::" '"'!I- tl:-Ii == :_-L.. ;;~Et: L. IEE Ih.,~. ~:/:~}i "' ~'"' F-Ii == ;Z:~ ~i~ ~::~F~-:It ~,~:: tt ...... tE:~ E'.C ii::::~ "F If--Il =.'~-
THE Miii:NG"rH [)]:t"iEi'.dSI(::~N tS 't'i.'it'X L..EN('.:i'T'H (]:N FI~:~i....~It...IE TRiEN(:.~ OR
· r~-,~: ~::,,~:~::."-I'H ,:::,~: l:.:, a:~:~:N,:::l:-.I ,:::,:: ~:'~"~' :l::~ '~',~: ~:,~s-,'~:~"f~:~:~.~. 'rt-~...:.:.,...,~.:~:l:<:~ ,>:' ~',...,~::
,-~.:~,,::,,_,~..~::, ,::,~.~::, ~l:..,,~ ~:~:,::,"r",i,:,r.~ ,,~:' '~+l:~ l:~:.::,::::,~,,'-,:,~"]:,:::,N ~ '~::~'.,/':.. /
THE Gi:~:8,,, Et.. i)IEI.::'TH ]::.(:; ']'l:.-iE I"1I i',l:l: HLIH E:, E: F" t" t~ OF: GR~E,~_.. BETt~EN ]'HE OLtTFFIL..I:.. P I:i:::'E
FII'.,I[) THE IgO'l:"rOM Ol::: 'TT.IE E:qCFtVFt'T'ION ,:: :IN ~Ei]E"F ::,. x~. /
/
.................................... ~ /
FI PF:ICI:(I.:!GL< 1-:' ..t::-ii'-, '[' '" :: .... E',E ! NS]'F:tt.].I_I.~} i::ft' 't"1-.11:~ F'ERM t "i-'1"~.: '" '.E; OF'TI ON E;i_iELJ'ECT' TO ]'HE
i:::Ol_.i...ObJ I lq(ii CL')t'-LF.:, I "1'i ONS: \ ~ ../
::i... E]:'t'HER l::l CI...FI:~;-S I L]l:',i [I N:i~f~F"F:'t';.:(~'~,'EI} F'L.tFI:NT I'"ll::f'r' k3E
?.. l::-I CON"I :[ Nt...ll:31J~i~; HFI I N'i'I:EI',tF-IN~'. ....... E~?:]"I~..]"4'F l Li/1],:-:E:).:]!i...I I Fi:I-_T:,. 1 F' f:::1 MFI t
I::IGi:;;flEIEt'II/i",FI:' I':_:': t'.,!( .:;f' ~~'(]i..i f'il::l),' E:E t:;?.1::3]:9_1tl~:[!:[)]"O Ei'-,ILf::IF..'.(::iIE '['l:"lEi:
F:I[:': "F.'F'T] "N '::;"r":;: E:I"i '" ';." "r'". HF:I'¥' EE' /~;I..J[:.' .TE:::T TO F:':;iI)SECI I"
E':F:ICI<I:': :!: M_. :t: NG Ol::: I::ll",l"r' S"Ri
L:'EF'I:::II';YT'i"IENT 1411....L
r Vi i N t MIJM [:, I S'I:'RNCE tE~EI'NE:
:.t.C'iCt FEE'I' t::Ol:;.". Fi I::'RI',,,'I::ITE
WELL LOG'.:~i I:::tt~:".E
Oi':' THE 14E]....L C:OMPL.E T .1: ON.
t'[ii:CT 'T'O
F:I !4E'LL.
L'I.._ L OR
il" F':[I'-,tF:iI.y ~, IOt',I FIN[:, PFI: [';:.. , L [':':'¥' ]"H .......
i]1'. E I..~(.]N.
'"Ii,ID FII",tU '~t',LSI"I'E LE;EWFI(:~iE [,T':',I::'rt':iI:::IL E;'-r'S'T't!3'I :iS
8!:3 FEET i::'l::ll~: t::t PUBL. iC; 14ELL.
BE RETUF. fiqE[:' TO "IH[~.: DE::I:::'FiRTI"!EIqT 14iTHii'.~ ]:.~3 Dt::l"?:~i;
U f'HER RE[;~U I RtEi"IEI'.,H-S I"1FI¥ I::tI:::'F'L.'./. SPEC )i t::" I CFtT IONS FIN[) CONSTRUCT i O1'.,i D
Fi',/I::1:1. L..FiEi:LE "1'O I NSUI:';~'.E F'K:'.OPiER ~- NST'f::ILL. FIT i Ot'.4.
THE
"
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774 SO~L LOG
Soils ~t Foundations
Performed for:
Earl Ellis
688-2280
Land Development
Name: /Z~/Z~ ~,(~.~7-~//~/~/ Tel. No. ~qz/
Mailing Address: ~-//~.' .D~,..'z~V/ ~>l~;Z~' X'~_/~'/z~.
Legal Description: ~z' ~ ~o~/~ .¢~d~'~ __O~,~-
~ Soll Characteri sttc~
6
7 .
8
10__
11 .
13
Z5
16
Ground Water Encountered: Yes~__No._~ Xf yes, what
Proposed Installation: Seepage Pit._~___Dr~in
Comments:
Performed bY~J~'
-- .~. (O°
-~.- DATE RECEIVED
INSPECTION APPOINTMENTS
,(,,,.j( DATE
DATE DATE
~s.~cmo~ ms.~cmo~ ~NS~cmoR
MUNICIPALITY OF ANCHO~GE
~UNIOIPALITY OF ANOHORAGE DEPT. OF H;:Z:'~ &
DEPARTMENT OF HEALTH · ENVIRONMENTAL PROTE~O~NM-;-: % :. ,'5 ~L-CTION
82D L Street - Anahornge, Al~sk~ ~1
ENVIRONMENTAL SANITATION DIVISION
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1, PROPERTY OWNER PHONE
MAI LING ADD~ESS
P~OPE~TY ~ESIDENT (If different from above) J ' PHONE
PHONE
2, BUYER
~AILING ADDRE8~
3. LENDING INSTITUTION J ~ ' ' J PHONE
/¢ c, tic ~/_~. ~rl,. ~ A~.
4. ~EALTO~/AGENT J PHONE
MAI LING ADDRESS
5. LEGAL DESCRIPTION
Lo-i- $,, g' l £ ? Pr c u r.r
STREET LOCATfON
6. TYPE OF RESIDENCE
[[~'~'~Si NG'L E FAM I LY
[] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One [] Four
[] Two [] Five
[] Three [] Six
[] Other
7. WATER SUPP~"' ~ INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. Awell Icg is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach Icg if available.)
~. SEWAGE D,sPosA, SYSTE~,
[Z~"~IVI DUAL/ON-SITE** ~ //9 -'~ ~ YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
F-I SINGLE FAMILY [] ONE BI THREE F-I FIVE [~ OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON-SITE DATE INSTALLED~--
[~]PUBLIC UTI LITY
Connection Verified
INSTALLER
[]Septic Tank or []Holding Tank
Size: //--0(-jO . If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL T,,,.~.~
4, DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5, COMMENTS
[~"~APPROV ED FOR _"~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
E~ DISAPPROVED
DATE BY
72-010 (Rev, 6/79)
825 "L" STREET
(90?) 2644!i i
M,4 YOR
! ?~,i; i ~!!/N t OF liSai_ FF{ Ah!D F:FP~IRONM, ENTAL PROi 6CTIOI',
,'ip:'il :1_6, ] 98/_
Ccaig/I, inda Parke,-
5714 Preuss Lane
Eagle River, AAaska 99577
Subject: Lot 8 [3lock 9 Preuss Subdivision
Appro'~'al for the ind]vidual sewer and water fac].lit. Jes
cannot be granted until the following items have been
comple ted:
(]_) The water analysis report needs to be deli.vered
ho -tb~s offfftce ff~om the Chem Lab, 5633 }~ StreeL,
Eot our :review.
(2) The septLc 'tank pumped with a receipt submitted
to t. his oiffJce.
If there are any further c~ues'tions, please call this
office at 264-4720.
SSncerely,
RECEIPT , Date ~'~ ~"~3~ 19 am/ 3867
Recoil, ed From _~?~
--- /~/- >'?...A~ /2._, ~7/~ ~.~ ~.
I ~daress ~ '~ ~ - ~ - ,
J ~ ~,~ ~.- .... ~Dollars $~o. ~
' _
CCOUNT / ·
8K806 Re di~prm
' ~C1pALITY OF ANCHOI~G~
MUNICIPALITY OF ANCHORAGEP ~ _DF,,I~. OW HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL RuI~i~(~MENTAL pROTECTION
) 825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION SE? 2 6 1078
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND S
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPER3;Y OWNER PHONE
MA,L,NGAODRE? . ,7/ .
PROPERTY RESIDENT (If different from above) PHONE
2, BUYER -- , PHONE
MAILING ADDRESS
3, LENDING INSTITUTION / J PHONE
MAILING ADDRESS
4. REALTOR/AGENT I PHONE
MAILING ADDRESS
5, LEGAL DESCRIPTION
STREET LOCATION /
6. TYPE OF RESIDENCE
SINGLE FAMILY
[] MULTIPLE FAMILY
7, WATEI~ S.~UPPLY
J~ ND V DUAL*
' ~[] COMMUNITY
[] PUBLIC UTILITY
NUMBER OF BEDROOMS
[] One [] Four [] Other
[] Two [] Five
~. Three [] Six
*ATTACH WELL LOG. A well log is required for ail wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
iNDiViDUAL/ON.SiTE~.
[] PUBLIC UTI LITY
If individual/on-site, give installation date
If system (s over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
72~10(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE r~I~OEIVED
iNSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR I NSP ECTOR I NSP ECTQR
DIRECTIONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
SINGLE FAMILY [] ONE THREE [] FIVE [] OTHER
MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2. WATER SUPPLY ERM,TNUM.ER '?
INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
Connection Verified LOG RECEIVED
3. .SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
'/~INDIVI DUAL/ON -SITE DATE INSTALLED
'EZPUBUC UT UTY
Connection Verified
, . INSTALLER
~Septic. ~ ..,~,/Tank or E~ Holding Tank //~/
Size:, ¢~ If Tank ~s homemade SOILS RATING
give dimensidns:
TYPE OF TANK MANUFACTURER
TOTAL ABSOBPTIO?'AREA MATERIAL
4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line [ Nearest Lot Line
I
I
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
\~_ APPROVED FOR B~DROOMS
[] CONDITIONAL APPROVAL {letter must, accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
k .
72-010 (Rev. 3/78)
