HomeMy WebLinkAboutEAGLE RIVER HEIGHTS NORTH BLK 4 LT 1ooo
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
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS
o ~: DISTANCE TO: I I ~
~< I Z..-' ~ I_~ "~//c/&-- I
[Liq. capacity in gallons IF HOMEMADE: Inside length Width L~qmd depth
~ ~ N ET ]Well [ Dwelling PERMIT NO.
~ Manufacturer /t///* ¢~ ~pacity in gallons
O [ IWell __1 i .~ [Foundation ~/~ t ~ INearestlot~e /~ PER~// ~
~ ~ ~to finish grade/ Mater]al~eneath tile -- ~/ "~ ~ t Total effe~or~,o~ area
~ Length Width Depth PERMIT NO,
~ [Typeofcrib ~r~r I / ' Cribdepth [Totaleffectlveabsorptlonarea
~ Well Building foundation [ Nearest lot line
/ TO: I
OTHER
PIPE MATERIALS
SOIL TEST RATI GI~
'NSTALLER
REMARKS
/-od,_
APPROVED~;./.z) / ~ /7/ / DATE LEGAL
72 013 (REV. 3/'781 / ./
QGRE'
· "r ANCHORAGE AREA BOr'l' 'H
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
INSIDE LENGTH
DISTANCE ~,~
FROMWELL MANUFACTURER -~',~¢¢2/( '~'"~ MATERIAL <~/~"~'~'
INSIDE WIDTH
LIQUID DEPTH
NUMBER OF
COMPARTMENTS
.LIQUID CAPACITY /[]~g¢' ] GALLONS.
SEEPAGE Pit:
NUMBER OF PITS / DIAMETER
LINING MATERIAL ~'~"~) CRIB SIZE:
BUILDING FOUNDATION
' ~1 , NEAREST LOT LINE
OR WIDTH /Z/ LENGTH , DEPTH
DIAMETER ,~ DEPTH DISTANCE FROM: WELL ,~"?/~
~? ~ TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) :~/~-'"~
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
BUILDING
FOUNDATION __
CESSPOOL
APPROMED' /gL
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPT lC SEEPAGE
TANK __ SYSTEM
DISTANCES:
, BY:
IN~iALLED '
PIPE MATERIAL
LOT SLOPE:
REMARKS:
Form NO. EQ-031
DIAGRAM OF SYSTEM
DATEL'¢~ CJ-'~' /~/'~-{ APPROVED'-7; ~/~,[ L- C--
,:~/ f ', ,///G.A.A.B.
GREATiTR~ t~NCHQR~qE ,,'~R~:A ~OF~C'~UGH
SEWAGE DISPOSAL SYSTEM APPLICATION AND PERMIT
FINAL IH~PECTION~ ~4 HOUH NOTI~ ~EQUI~ED. ~6KFII_LIN6 OF ~Nf ¢~'¢TE~.1 WITHOUT FINal IN~PE6TION Bf THE
HEALTH DEPARTMENT AUTHORI~ WILL BE ~UB,JECT TO pROSECUTIOH.
MINIMUM DIBTANCES, REOUIRIrMENTS
5 ft.
FOUNDATION TO SEEPAGE pit 20 f~. DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL __ 15 .
ft
$~rT,C TANX ___5__f~__~___. S~.E*^GE ~,T _20_
O.A,. F,ELO 10 ft.
SEPTIC: TANK. -- 25 ft., S.~^oE .IT 100 ft. ORAIN rtELO
EXCAVATION ~ FEET INTO UN[,)ISTURBE° SOIL,
IrtJ I vi!,l _~' \.- / l,.m:
1
H~~
GR' ~ t'ANCHORAGE AREA B( · ;H
UEPARTMENT OP ENVIRONMENTAL QUALITY PERMIT NO.
3500 TUDOR ROAD POUCH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NA,. OF APP-,CANT ~--'-.~'~ ~ ~-~-"-~ "~.~. ~ ~ ~:d~,'~,L,NO ADD.. ~'~C__;. [~;~' If (~ I C' ~-- PHONE
INSTALLATION OF: SEPTIC TANK SEEPAGE PITi DRAIN FIELD
FINANCED THROUGH TO BE INITALLEO BY
. OTHER
NOTE, THIB PERMIT !1 NOT VALID WITHOUT ~OIL. TEE1'
COHPLETIOH DATE ANTICIPATED
FINAL INIPECTION, g,4 HOUR NOTICE REQUIRI:D. BACKFILLING OP ANY EY~TEM WITHOUT FINAL INSPECTION BY THE
Hf. ALTH DEPARTMENT AUTHORITY WILE. BE SUBJECT TO PRORECUTION.
TYPE
MINIMUM DISTANCEI, REQUIR"'MENTI
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT ~'~-~/ . DRAIN FIELD
SEI~TIC TANK TO SEEPAGE PIT WALL /~-- /
SEPTIC TANK ~ SEEPAGE PIT '[~('~ / DRAIN FIELD
DRAIN FIEI. D / G~ /
DIAGRAM OF
GRAVEl. BACKFILl.
CONFORM TO BORO~RE('aUIATIONS REGARDING INSTALLATION.
I CERTIFY THaT I AM FAMILIAR WITH THE REQUIREMENTS OF GREAT'ER AN~RAGE ARE B/O~R~UGH ORDINANCE
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 '¢" Street, Anchorage, Alaska 99503 274-4561
Date Received ST~/JX~
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by: ~27/~Z~)
Mailing Address: ~/~//~ b~o~ ?~
2. Property Owner: ~r=~ <
Mailing Address: ~J' ~
3. Legal Description: ~z~/ ~/~
~ ~. /
4. Location: ~~ ~2/'
5. Type of facility to be inspected
6. Well Data:~ .,~ $ ,
A. Type B. Depth
C. Construction
Phone:
Phone:
No. of bedrooms
7. Sewage Disposal System:~
D. Bacterial Analysis
A. Installed
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
B. Installer
2. Manufacturer
1. Absorption n~:~..~ 2. Material
Total length of lines
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
· , Absorption area
, Other contamination
"~'~ : , Absorption area
, Sewer Lines
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages - Rec ~t for ,oproval of Individual F ~r & W ~r Facilities
Legal Description
Comments
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)
)'~'~ [~ REATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO VA ×
2. Property Owner: Howard Foley
Mailing Address: 610 Meadow Creek Dr.
3. Name of Buyer: James A. GlaspeZ1
Mailing Address: 1736 DoZ±na Cir¢Ze DaS Phone
4. Name of Lending Institution: The Lomas & Nettleton Co.
Mailing Address: 4449 Bus±ness Park BZvd Phone
5. Name of Realtor or Agent: AbZe ReaZt¥
Mailing Address:2002 w. Benson Phone
FHA CONV
Day Phone 694-2126
33?-63?2
274-7661
274-7676
Legal Description: Lot 1 Blk 4
Location: Eagle River Heights North Subd.
7. Type of Facility to be inspected: well & sewer No. Bdrms.
8. Water Supply
Type of Supply: Public Utility Individual oomm. well
If Individual, number of dwellings presently served ??
If Individual, depth of well ???
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
Individual (on-site) ×
EQ-037 (1/74)
DO
