HomeMy WebLinkAboutJAMES HOLT LT 1dames Hoft
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* o9-7 141 0(0000
Department of Environmental Quality
33;30 C Street
Anchorage, Alaska 9950;3
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME i~oW P~-/£RS£P/~X?$~'.~"~,/zd~ILI~,~DRESS ~/~g~ ~ ~.~ /~/Fg/$~ PHONE
LOCATION LEGAL DESCRIPTION ,,'g'.~' /
SEPTIC TANK:
DISTANCE O~~
FROM WELL
INSIDE LENGTH
MANUFACTURER ~-~'*/¢~ ~/'~ MATERIAL ~-~// NUMBER OF
COMPARTMENTS /
INSIDE WIDTH -- LIQUID DEPTH. ~ .LIQUID CAPACITY//--~)~ GALLONS.
SEEPAGE Pit:
NUMBER OF PITS __
LINING MATERIAL
BUILDING FOUNDATION~L~
ADDITIONAL ABSORPTION
DIAMETER -- OR WIDTH__
CRIB SIZE: DIAMETER
/
NEAREST LOT LINE
pd~/1i~c,
DEPTH ~ DISTANCE FROM: WELL//O
TOTAL EFFECTIVE ./~R~d~
ABSORPTION AREA (WALL AREA) ~'",2~ . FT,
WELL:
TYPE D ,. Z TRUCT,ON
BUILDING NEAREST
FOUNDATION __ LOT LINE
CESSPOOt OTHER SOURCES
~¢ ~'f DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK__ SYSTEM
APPROVED DISAPPROVED REMARKS
DISTANCES: . L' F- ~/4/£
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DATE
DIAGRAM OF SYSTE~/
}io '-'""
.~ .~.~ _y~, .'/'7' ~ .~o'
/iii III1~'~\~.\ ,~ ~b' :3330 "C" STREET .ANCHORAGE, ALASKA 99503_~____~ ~, '
' ' -
~ SEWAGE DISPOSAL SYSTEM w APPUCATIOH-~D PERMIT
NAME OF aPPliCANT ~
INSTALLATION LOCATION
iNSTALLATION OF: SEPTIC TANK SEEPAGE PIT---- DRAIN FIELD
TYPE AND SIZE O~ FACILITY TO ~E SERVED . ~ -
be INSTALLED BY ---
f~NANCED ThROUgh ~ I ~/
/
PHONE
_, OTHER--
__ NOTE: THIS p~RMIT I~$ I~lOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION bY THE
DEPARTMENT OF ENVIRON~4ENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
TYPE
MINIMUM BISTANCEB, REQUIREMENTS;
FOUNDATION tO SEPTIC TaNK
FOUNDATION TO seEPage PIT ~I
~ DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TA~K SEEPAGE PIT . DRAIN FIELD
TO NEAREST LOT LINE.
DRAIN FIELD (~}i~?
WATER MAIN TO SEP+IC TANK DRAIN FIELD-//~ !
TO RIVER, LAKE, STREAM.
ALSO CONSIDEF- AREA WELLS.
DRAIN FIELD
SEEPAge AREA · ~// . w /
J/ r)IAGRAM OF ~;Y~¥E~
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 AIR'right REMOVABLE CAPS.
CONPORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
LICENSED OESIGNE
I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAge AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRISED SYSTEM iS IN ACCORDANCE WiTH SAID CODE. ~,~ ~.~ ~~~J~~/r '
Performed For ~7~rc~..
Legal Description:
%his Form Renorts
"Ome tesf is worth a ~housand opiniomg'
Soils Loq ~ e~ Percolation Test
2
3
Qeoth
Feet
8
91
Was Ground
I¢ Yes, At
Soil Characteristics
Water Encountered?__~
what Depth?
Reading . Date ' Gross Time Net Time Depth to H20 Net Drop
Percolation Rate tlinute
Proposed Installation: Seepage Pit ~CS Drain Field
Depth of Inlet Depth To Bottom Of Pit OF~Tr~nch
test Performed By ~',w~. //14.c~ Data Certified By:~
· ~m ~~ Date:
Mr. Les Buchholz
Greater Anchorage Area Borough
Dept. of Environmental Quality
3330 C Street
Anchorage, Alaska
J~EPT. OF ENVIRONMENTAL
SUBJECT: Lot I, James Holt Subdivision
Dear Mr, Buchholz:
We have no objection to the subject semi-public we I being
upgraded to meet the requirements which were in effect pr~or to
the promulgation of the Alaska Department of Environmental Waste-
water Regulations. It is understood that it may be necessary to
allow the septic tank to be approximately 8 feet closer than was
allowable under those regulations. Based on the fact that this
water system serves one house and 3 other small units and also
due to the fact that it has evidently performed without contamina-
tion in the past with waste disposal systems a much closer distance
from it, we have no objection to allowing this 8 to I0 foot en-
croachment. The well should be put on your list for sampling with
frequency considered in light of the above.
Yours truly,
~he~rr~
Regional EnviYr~nmP~nEta~Engineer
~__~_.,, HEALTH DEPARTMENT ~r
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N? 683
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
ADDRESS
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE FROM WELl
LIQUID CAPACITY
MATERIAt ~'~'~/~'~"~'~ ~/~ NUMBER OF //
COMPARTMENTS
GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH_
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIAL /~(tS'
/
NEAREST LOT LINE
OR WIDTH
DISTANCE FROM WELL //-~
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
LENGTH /' '''~ /
, , DEPTH
BUILDING FOUNDATION '~ /,
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL ,.FOUNDATION
NUMBER OF LINES ~~ STANCE BETW~
ABSORPTIO SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
, NEAREST LOT LINE
TRENCH WIDTH
DEPTH OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
, OF LINES
EFFECTIVE
IN. ABOVE TILE
WELL: TYPFp~.~///Z=/}) DEPTH //-~'~ / DISTANCE FROM / WATER
, , BUILDING FOUNDATION .~ SAMPLE -,J/?~.~/~"~ , NEAREST
~/~ ',~ NEAREST SEPTIC //~' SEEPAGE / OTHER
LOT LINE ~/~-) , SEWER LINE ~ , TANK , SYSTEM /-~ , CESSPOOL -- , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
DATE
H~j~d~T H AUTHORITY
~i'li GRE,~i"~R ANCHORAGE AREA BO~'O-'~GH
.,C;~ "\~\i~ DEPARTMENT OF ENVIRONM~NTA~ OUALl~ PERMIT NO. ~~/~
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE. ALASKA 99502
TELEPHONE 27~-8686
SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT
NAME OF APPLICANT ' MAILING ADDRESS ~:~' ~'~/~2 [ ~'~'~/. PHONE '"~J-~' G~J7
SOIL TEST RESULTS NOTE~ _1~ PERMIT IS NOT VALID WITHOUT ~OIL TES~
COMPLETION DATE ANTICIPATED
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 SIZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEEPAGE Pit
.
SEPTIC TaNK TO SEEPAGE PIT WALL
SEPTIC TANK
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK~l
DRAIN FIELD
WAter MAiN TO SEPTIC TANK
DRAIN FIELD
TYPE ~iI ~/~ SEEPAGE AREA SIZE TYPE
, DRAIN FIELD
, DRAIN FIELD
. SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT .
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~ IN__CH DIAMETEr CAST irON SIPHON PiPeS ON SEPTIC TANK AND SEEPAGE PIT
FITTED With AIRTight ReMovABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING iNSTALLATiON,
I CERTIFY THAT I AM FAMiliar WITH THE REQUIREMENTS OF GReater ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DEscrIBED SYSTEM IS~IN ACCORDANCE WiTH CODE.
DAte . APPLICANT'S SIGNATUR ,- ~
'. ......... " CASL ~?
- s&~d ~1 hen]. I-lUc~
' ~o ~i~L ma,'~re conTen~,
il----
~- ~ .... ] ..... ~ ~n H.)O ,~et Drop
Reading Date "~
~xon ~ ~ / ...t., Drain Field
. ~r:
Depth ~o ~o, to .........
G~-E~TER ANCHORAGE AREA BOROUGH-
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
279-8686
DATE RECEIVED:
INSPECT:
TIME:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
1. APPROVAL REQUESTED BY:
ADDRESS:
PHONE'
2. PROPERTY OWNER:
3. LEGAL DESCRZPTZON:
WELL DATA:
A. TYPE
B. DEPTH
C. SIZE
D. CONSTRUCTION
E, BACTERIAL ANALYSISC.~'~
6. SEWAGE DISPOSAL SYSTEM:
Ae
SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK)
2. AGE
4. INSTALLER
APPROVAL REQUEST~ffbK SEWER & WATER FACILITIE~'-~'~
PAGE TWO
B. SEEPAGE PIT
1. SIZE
2. LINING
C, DISPOSAL FIELD
1. NUMBER OF LINES
2. TOTAL LENGTH
REQUIRED MEASUREMENTS
A. WELL TO SEPTIC TANK__
B. WELL TO SEEPAGE PIT
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEEPAGE PIT TO PROPERTY LINE
C. WELL TO SEWER LINE
D, WELL TO PROPERT'< LINE_
E. WELL TO OTHER POSSIBLE CONTAMINATION
F.
G,
COMMENTS:
APPROVE~ /~'~¥~-~::~ DISAPPROVED:
DATE: ~ ~ _ / ~, DAT
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY