The URL can be used to link to this page

Home My WebLink AboutEAGLE RIVER HEIGHTS NORTH BLK 4 LT 44 G' -'~'ER ANCHORAGE AREA BORO,.. '~ LI~-I, AFITMENT OF ENVII~0NMENTAL 0.UALI1 ~ 3500 TUDOFI t~OAD ANCHOF~AGE, ALASKA ggs07 27g-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME/JZ?.~"~('("//~! LOCATION ('~/1'~1 SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY /(~ C GALLONS. ADDRESS .j NUMBER OF MATERIAL ('C~I,~'( 'A:"~'=~= COMPARTMENTS INSIDE LENGTH INSIDE WIDTH__DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER LINING MATERIAL ~(: ~1:' NEAREST LOT LINE ~'~' '-- OR WIDTH /~ ' LENGTH /~ / · , DEPTH DISTANCE FROM WELL (~IWI'~I BUILDING FOUNDATION -~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: ABSORPTION / DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH · OF LINES I N~'~ EFFECTIVE IN. ABOVE TILE__ g DISTANCE FROM WATER WELL: TYPE I/I~;tU//V/~.:/~' ~ DEPTH. ~ BUILDING FOUNDATION. -- SAMPLE /Z ,~t~,c= NEAREST ._ NEAREST ~-_ SEPTIC SEEPAGE ~ - OTHER LOT LINE , SEWER LINE , TANK. , SYSTEM__. , CESSPOOL , SOURCES__ DISTANCES: t~~ DIAGRAM OF SYSTEM DATE GREaTEr ANCHORAGE Area BOrough DEPARTMENT OF ENVIRONMENTAL QUALIT~ 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE. ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PER.,TNO. I'-t?0 INSTALLATION LOCATION ',~T..L~L~-- ~ _ _~] ~_.~_~J ' ~ · ~ INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT ~ , DRAIN FIELD . , OTHER TYPe AND SIZE OF FACILITY TO BE SERVED ~ ~"~/~' FINANCED THROUGH / TO BE INSTALLED BY !,~allace Construction Co, NOTE: THIS PERMIT IS NOT VALID WITHOUT ~OIL TEST 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. MINIMUM DISTANCES, REQUIREMENTS / FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE Pit ~'~ SEPTIC TANK TO SEEPAGE PIT WALL /~ SEPTIC TANK ,~' ,SEEPAGE PiT TO NEAREST LOT LINE. WELL TO SEPTIC TANK J~'~ DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, · DRAIN FIELD ~ , DRAIN FIELD / , SEEPAGE Pit ALSO CONSIDER AREA WELLS, , SEEPAGE PIT 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 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. LICENSED DESIGNER DIAGRAM OF SYSTEM 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 SAID CODE. DATE APPLICANT'S SIGNATURE · - "' DEI~T, OF HEALTH & ' ' MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PRO~ECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street-Anchorage, Alaska 99501 SEP 2 0 1978 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will oot be processed. Please allow ten (10) davs for processing. 1. PROPERTY OWN. ER . /__7/~/ [ PHONE PROPERT~ RESIDENT (If different from above) ~ PHONE / .oY I 4. REALTOR/A~ENT PHONE ~AI LI N~ AO B~ ESS STREET LOCATION J 6. TYSCR4(S i D E, C E~ ~-~,o~-~ ~, ~"~ ~'~ ~UMB ER OF B~E OO/MM~S SINGLE FAMILY ~ One ~ Four Two ~ Five ~ MULTIPLE FAMILY Three ~ Six [] Other 7. WATER SUPPLY [] INDIVIDUAL' '~ COMMUNITY PUBLIC UTI LITY *ATTACH WELL LOG. Awell log is required for all 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 UTILITY **If individual/on-site, give installation date /~ 7/ If system is 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-O10(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED . - I NSPECTI ON APPOI NTM ENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF REsIDENcE NUMBER OF BEDROOMS [] SINGLE FAMILY E~ ONE I-q THREE [] 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 E~INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~ ~ ) Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: /~)~:3 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER ~.j _ ,,~ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area ISewer Line I Nearest Lot Line WELL TO: I I Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR 3 BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE ~'*-- ~ ~'"")~' BY (Tit~ LEGAL DESCRIPTION 72-010 (Rev. 3/78) GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: ::/' ,?' INSPECT: TIME: APPROVAL REQUESTED BY: ADDRESS: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR ; . , ,;./-, ..; ' ' . r ~ ,'~ ~ PHONE: / ' ~' ,'': "'" PHONE: PROPERTY OWNER:~:_ ~ ,, , , TYPE FACILITY TO BE INSPECTED: ":~ :'/]'- i~.,, , STREET: NUMBER OF BEDROOMS: ':~'" I ~', WELL DATA: A. TYPE B. DEPTH C. SIZE D. CONSTRUCTION E. BACTERIAL ANALYSIS SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 1. SIZE /~.'' 2. AGE / · /~,' 3. MANUFACTURER 4. INSTALLER ,-'" · APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO B. SEEPAGE PIT ~ ~ "~ ~, /1 ~ l 1. SIZE i .... 2. LINING L~'~z<,~' ;~'~ j/ C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL ~GTH REQUIRED MEASUREMENTS A. WELL TO ~EPTIC TANK B. WELL TO S~PAGE PIT C. WELL TO SEW~ LINE_ D. WELL TO PROPERTY LINE E. WELL TO OTHER FOSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK G. FOUNDATION TO SEEPAGE PIT H. SEEPAGE PIT TO PROPERTY LINE 8. COMMENTS: ~x', - / DISAPPROVED: APPROVED: ' · ,r., ~,: DATE: .- ,,.,' DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEtA Anchorage, Alaska ~.~G~GO4 02, S~N$O~ Associate Builders Bank and Trust L Yes No ' , ,, P~biic *.y,;tcm Community system [t is the ci~mion of d;e ~ State [] Counw ~ Local l)epartment of Health that this mdividual water-supply system []~ is F2 is not g:tisfactory as a domestic water supply for the subject property. PUD] i c t,Satev it is thc opicdon of the L~ State ~ County L~ t,,cal Dq, at{,u,~nt of ]Jeahh that this indivMual sewage-disposM s~s- tenl wid~ propez maintenance: [2~ Can be exFected to function satisfactorily, and ~ ~mnot be expected to function satisfactorily is no~ likely to c:e:~e an insanitaw condition /'-~/ ..... · :: i" ( i.,:":7;7../:.[~ t Environmental Speci al i s t / [ ha~e review, cd ti~e foregoing and the F~rtinent FItA Coml, li~lce lns~ion Repo~, and recommend that the Individual v,z=er-supply system be considered ~-] Acceptable ~ No~ Accep~ble ~'zge dis~sal ~ considered ~ Acceptable [L] Not Acceptable. umm~rd '~ seTzm1D .~ ~ pum q~'L~'all to tlI~H *~ II~aU~ '31~ ~q pi 13aI~O~d ol o~uoail~a ul I$ ~ollul :uepznu~ .~ ,zue~ ~0~66 ~ '~zoqm~f A ?dg~ ~?d [] A~l'l¥1qi~ 'I¥/NgWNO~IAN] :10 'idea Honotloll V~l~l¥ iO~60H~,NY · ~otnE e~ ~ey eseeyd s~oy~senb o~ ~e~TnSe~ eq yy~ ~eT~ yy~ ST ~Oy~e~Oy~$ ~e~nyotzT aq~ adopt I ~Y~ ~ OT%e~o~s YeOT~e~oe~ e ~o aaT~OO Te~@Aas e~e ~eqoe~V @UTT~a~e~ T~6T · o~y SaT~TYT~Q ~q~TeK ~@AT~ e~seI~? 099-9 qono~ q~no:o~ ee~F e~e~oqouv ~e%ee~0 £~I~nb Ie%~@m~o:TA~Z $o Ol