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Home My WebLink AboutEAGLE RIVER HEIGHTS NORTH BLK 5 LT 2I?1 i% 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 LOCATION ~e~~ C~ ~ NO. OF BEDROOMS~ ] Well Absorption area Dwelling PERMIT NO. DISTANCE TO:~ ~Z Manufact.rer ~Jt ,S'~ Material No. of~ompartments ~ ~ Liq. capacity in g Inside length Width Liquid depth IF HOMEMADE: ~Z~ ~ DISTANCE TO; Well ~ ] /~ Dwelling ~ERMITNO. ~--~ ~ ~ Manufacturer/~ ~ ~ Material Liquid capacity in gallons ~ DISTANCE TO: W~ ~/~ F°undati°n ~/ No. of lines / Lengtt~a~ ,~ Total ,~gth ' T~bwidth ' Distance ~7~s of M~rial beneath~ ~1 ~ ~y ,~ ~b~ inches Total ef~b~pt~n area ~ ~ Type of crib Crib diameter Crib de~t~ Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: Class Cepthz / ~ Driller Distance to lot line PERMIT NO. ~ ~ DISTANCE TO: Building ~u~tion Sewer line Septic tank Absorption area(s) PIPE MATERI~S INSTALLER REMA~S r-lLIl'J I C I PAL I T%-' OF RNCHCIRRISE DEPARTMENT ~ HEALTH AND ENVIRONMENTAL ~.OTECTION 825 ' STREET, ANCHORAGE, AK. 9. 264-472~ ~ELL ~r'JD Or~--5 I TE SED~ER PERM I PERMIT NO. ( LOC~TION ~~ ~ LEGAL &~ ~ E ~ ~~ ~, ' LOT SIZE /~d~O 5QLIARE FEET TYPE OF SOIL ABSORBTION SYSTE~ I5' T/~C~ ~AXIMUM NUMBER OF BEDROOMS = J 50IL RATING (Se FT/eR>= THE REC~UIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS' EPT = R VEU & EPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE 8RAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REQUIRED SEPTIC TANK SIZE= ~0 0 aALLODIS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE ~UMBER OF RESIDENCES THAT THE WELL WILL SERVE. TIWC, (2) INSPECTIONS ARE REQLIIREC. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL~ OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY 8PPLV. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT EXPIRES DECFMBER ~l. I 9 80 I CERTIFY THAT ±: I AM FAMILIAR WITH THE REQIJIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. V_?.. 2 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 so,,s,o MUNICIPALITY OF ANCHORAGE [] PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAl- PROTECTION TEST SOILS LOG - PERCOLATION TEST / SLOPE SITE PLAN 10 11 12 13- 14 15 16 17 18 19 20 WAS GROUND WATER ~//'~ ENCOUNTERED? / \1 ~-~ O E IF YES, AT WHAT DEPTH? /~"/_..~,j "~' , · Gross Net Depth to Net Reading Date Time Time Water Drop / PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ~_/ COMMENTS . ,,/7,/.. 72 008 (7/76) GAAB-HD-I ~ ~¶R ANCHORAGE AREA BORC''''''''~1 /~RTMENT OF ENVIRONMENTAL QUAL,.. 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM C~ - MAILING ~__') NAME_ t..~ ._]__l~-('t F* ~L'C! -.L~3 ~,~_~.1 Lk. ~, ADDRESS LOCATION ~C~[-~_ ~C_ I~--)L~ · , 'J bJ~L_ ~ (-.-~L~.LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM NUMBER OF COMPARTMENTS LIQUID CAPACITY GALLONS. INSIDE LENGTH INSIDE WIDTH / LIQUID DEPTH SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH / ~'- / , LENGTH / ~' / , DEPTH ~; / DISTANCE FROM WELl (~', ,~)~u~ ~i_ L,;./, j ..... ~; BUILDING FOUNDATION ~J"-;/, TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) :~7'~'~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION . NEAREST LOT LINE D~W NUMBER OF/ILI~I[~" EEN LINES TRENCH WIDTH ABSORP~ON AREA SQ. FT. 4.`= DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH , OF LINES / ,-- ' IN. TOTAL EFFECTIVE _IN. ABOVE TILE DISTANCE FROM WATER WELL: TYPE[~"~,, ,~ ...... ~ .L,f' J~P'TH ,BUILDING FOUNDATION SAMPLE / NEAREST SEPTIC SEEPAGE LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL , NEAREST OTHER , SOURCES DISTANCES: DIAGRAM OF SYSTEM DATE G.-A.A.B. ..PER ANCHORAGE AREA DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3500 TUDOR ROAD POUCH 8-850 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INITALLATION OF: SEPTIC TANK FINANCED THROUGH SOIL TEST. RESULTS NO'r[i THIS PERMIT IS NOT VALID WITHOUT ~OIL '1'[~1' COMPLETION DATE ANTICIPATED FINAL IN~"ECllON, 14 HOUR NOTICE REQUIRED. BACKFILLING OF ANY EY~I'~M WITHOUT FINAL INSPECTION BY THE H~LTH DEPARTMENT AUTHORITY Will. BE IUBJECT TO SEPTIC TANK SIZE //t ~'~:~ (~ TYPE~PAGE AREA SIZE TYPE MINIMUM DISTANCE& REQUIREMENTI FOUNDATION TO SEPTIC TANK ~'~ FOUNDATION TO SEEPAGE PIT SF-P~IC TANK TO SEEPAGE PIT WALL REPTIC TANK DRAIN FI EI.D . EIrEPAGE PiT ~'~ / DRAIN FIELD TO NEARIr~T LOT lINE. DRAIN FIELD /_/~) /' WATER MAIN TO BEPTIC TANK ,//~ ! DRAIN FIELD SEEPAGE PiT , ALEO CONSIDER AREA SEEPAGE PIT ~ SEEPAGE PIT ~ RIVER. ~AKE. CABT IRON INTO AND OUT OF IEPTIC TANK AND INTo CRIB CROSSING GAP OF ~CAVATION 5 FE~ INTO UNDIBTURBED ~OIL, 4 INCH DIAMETER CAIT IRON II.ON ~I~E~ ON I~PTIC TANK AND ~E~PAGE PIT DIAGRAM OF IYWrl;M GRAVEl. BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. ..~,'ER ANCHORAGE AREA ~.~. _~UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-5~O ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO.: SOIL TEST. RESULTS PHONE , OTHER NOTE~ THIS PERMIT Il NOT VALID WITHOUT lOlL TI[B,T COMPLETION DATE ANTICIPATED FINAL INSPECTION, i4 HOUR NOTICE REQUIRED. BACKFILLING OF ANY EYITEM WITHOUT FINAL INIPECTION BY 'THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROIECUTION. .~.r,c TAN,< S,ZE ~,,~ TYPE MINIMUM DII'I'ANCEBv REQUIREMENTI FOUNDATION TO SEPTIC TANK ~ FOUNDATION TO SEEPAGE PIT ~'--~-( ~ / , DRAIN FIELD, SEPTIC TANK TO SEEPAGE PIT WALL ~ / SIrI~TIC TANK ,~- / , SEE'AGE pIT ~'~/~ DRAIN 'IELD TO N~.E~r -o~ LINE. / DRAIN FIELD DRAIN FIELD TO NIVIN, ~K[. ITNbM. sEEpAGE P,T ALEO COHE'DER AREA · ,E,PAOE P,T CABT IRON INTO AND OUT OF IEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED lOlL, G NAVl;I,. BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF IYITEM CErtIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. ~8-68 AND THAT THE ABOVE DESCRIBED IYSTEM IS IN ACCORDANCE WITH SAID CODE. . DATE APPLICANT'S ~IGNATURE