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Home My WebLink AboutJOHNNA'S WOODS LT 2 NAME ~=~ MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMEN1AL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264 4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ,7/_../° N E ,_ '~l~l EW PGRADE MAI LING AD DR ESS LEGAL DESCRIPTION LOCATION ~ )¢~'~ V~e · I DISTANCE TO ~Z Manufacturer ~ ~ L]q ~t~,n.~,,o~.I ,. HOMEMADE ,ns,delength ~ ~ ~ I DISTANCE TO Well Dwelhng J Z I I I }Z ~ I Manufacturer ~= I ~S~A.CETO I ~ ~ ~o~ o.t,,..o,,n,....a.e d ~te~, ~.ea.. t,,e m ~ Length Width Depth ~ ~ ~ Type of crib Crib diameter Crib depth ~ ~ ~ Well Building foundation m ~ DISTANCE TO ~ lClass Depth Driller ~ ~ Building foundation Sewer hne DISTANCE TO I Dwelling M at er 'al/..~ ~_..~_~C~ W~dth Mater~al NO OF B~OOMS PERMIT NO No of com~,~ments L~qu~d depth PERMIT NO L,quid capacity in gallons PERMIT NO Nearest Io~..~, ~, Trenc~dth inches glsta~rn'h nes Total effective a~orptlon area 7~/~ ,riches I PERM,T NO Septic tank Absorption area(s) OTHER SOl L TEST R/L~ REMARKS ~ APPR(~w,~ DATE LEGAL STREET, RNCHORRGE, RK 264-4?20 014--S I Ti SIPPER F'ERr,11 T LOT SIZE ~6/~¢ SQURRE FEET MRXlMUM NUMBER OF BEDROOMS SOIL RRTING (SQ FT.-'BR)= /j-O THE REQUI~"ED SIZE OF THE SOIL RBSORPTION SYSTEM IS DEPTH= IlI LENGTH= ~ GRR%-'EL [:,EP TH= 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFBCE OF THE GROUND RND THE BOTTOM OF THE E×CRVRTION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES THE GRRYEL DEPTH IS THE MINIMUM DEPTH OF ORRVEL BET;qEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET) ¢ REQ. UIRE[';-' SEPT IC TRNK SI ZF: ~dO0 PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE IN_qTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE TWO (2) I[4SPECTIO[4S PRE REQL;I RED BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RF'PROVRL BY THIS DEP8RTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVRTE WELb OR t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOGS PRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION OTHER REQUIREMENTS MRY RPPLY SPECIFICBTIONS RND CONSTRUCTION DIRGRRMS 8RE RVRILRBLE TO INSURE PROPER INSTRLLRTION PE~P~ IT EXPIRES DECEMBER __?-1.. :2979 I CERTIFY THAT i I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE 2 I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES ~ I UNDERSTRND TH8T THE ON-SITE SEWER SYSTEM WRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS ISSUED B~~-?-~J~--~----. DRTE__!S--~_ .... V~ 2 W E LOT SURVEY CERTIFICATION LEGEND: ' ' / ' ' ' ~ Brass Cap Monument /J'///~' O Iron Pipe Lot ~, Block __ Arecl ' Sq. Ft. · steel Pm _=~?.~_ ~.'-, /7/~.." >"-iZX~.: ~ (~' e Surve~ Hub ~ Tack Plat F~le No. . , ~Zomng D~stmt. I, An~orage Recording District, Alaska J. . ..... . . ~ ~vl50NS ........ . , ' , ~ _. ~ ....... [~ ~ I~-'~ 4040 '~ STn~ET I ~m~ ........ .~...% .~ DATE RECEIVED · ' " INSPECTION APPOINTMENTS TIME TIME TIME )ATE DATE DATE INSP~. ~ ~NSPECTOR NSPECTOR /~UNIClPAI. ITf OF ANCHORAGE MUNICIPALITY OF ANCHORAGE D£PT. OF HEAl. TH & ~,~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIJ~IRONMENTAL PROTECTION [~Jl __R S2B l Street- A~hore~e, Alaska t ENVIRONMENTALSANITATION DIVISION NOV 8 1979. REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FAClLITI ' DIRECTIONS: Complete all parts o. page 1. Incomplete ~ue~t~ will not be pro~e~. Please ellow ten (10) days for processing. MAILING ADDRESS " PROPERTY RESIDENT Ill different trom above) PHONE 2. BUYER PHONE MAILING AODRESS ). LENDING INBTITIJTION J PHONE 5. LEGAL DESCRIPTION ;TREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four /~ SINGLE FAMILY [~ Two [] Five [] MULTIPLE FAMILY [] Three ~--I Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8* SEWAGE DISPOSAL SYSTEM /~] INDIVIDUAL/ON-SITE*· [] PUBLIC UTILITY · ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ~ ~ ~;~ / ~ ~'~ /~'~7 ~O /f;;~cY? ? YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIA.TED. THIS SIDE FOR OFFICIAL USE ONLY - NUM8ER OF BEDROO~ .. 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM I-'lIN DIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or []Holding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL TOTAL ABSORPTION AREA 4. DISTANCES WELLTO: DATE DRILLED LOG RECEIVED PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER MATERIAL · ~epticlHoicling Tank Absorption Area to nearest Lot Line IAbsorption Area ISewer Line INearest Lot Line 5. COMMENTS DATE [~'"~'APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev. 6/79) ( GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality "C" Street, Anchorage, Alaska 99503 274-4561 Date Received September 29, 1976 Time of Inspection 9: 30 a.m. Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 9-30-76 Thurs. Buchholz 1. Approval requested by:~ 4. 5. 6. Mailing Address: Property Owner- Clement & Evelyn Zzdzck Phone' Phone: 344-1184-h/344-4441w Mailing Address: 4938 West 86th Avenue Legal Description' (N~ Lot 29 Section 10 T12N R4W~ ~C)~ Location: 4938 West 86th Avenue, 9 on the mailbox Type of facility to be ~nspected Well Data: Indzvzdual A. Type C. Construction ~).~ Sewage Disposal System: A. Installed C. Septic Tank D. Seepage P~t. l. Size l. Absorption Area E. Disposal F~eld: Total length of lines Distances. A. Well to Septic tank Nearest lot l~ne B. Foundation to septic tank C. Absorption area to nearest lot line Szngle Famzly No. of bedrooms B. Depth 278' D. Bacterial Analysis B. Installer 2. Manufacturer , Sewer Lines , Absorption area , Other contamination , Absorption area 2. Mater~al EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - R[...'st for Approval of Individual ~.=jer & Water Facilities L~al Description N½ Lot 29 Section 10 T12N R4W Approved Disapproved~~[-~e Date Approval ,Valid for oneyear from date s~! d Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the ~nformat~on contained in this request for approval to be a true and accurate representation of the sub3ect sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1 Type of Inspection 2 Property Owner Malhng AddressY~--~ 3 Name of Buyer Mailing Address 4. Name of Lending Institution Mailing Address 5 Name of Realtor or Agent Mailing Address 6 Lo§al Descr,ptlon N "///~ L~ ~ Location CMRO VA FHA CONV . . Day Phone. ~Z//'/7{-////~:~/'//-/4.//d ~,~,~ Day Phone Phone Phone 7 Type of Facility to be Inspected 8 Water Supply Type of Supply' Pubhc Ut, hty If Ind~v,dual, number of dwelhngs presently served If Individual, depth of well Sewage D;sposal System Type of System Pubhc Ut,hty If Individual, date of installatson No Bdrms ~ Jnd~wdual ~ / Ind,v,dual (on-s;te) 72 003(3/76)