HomeMy WebLinkAboutEAGLE RIVER HEIGHTS NORTH BLK 5 LT 8GREA,.R ANCHORAGE AREA BOR~.~,GH
Department of Environmental O. ualiW
3330 C S~reet
Anchorage, Alaska gg§03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE ,~ ,] /
INSIDE LENGTH INSIDE WIDTH
//::;I NUMBER OF
MATERIAL . .~"~'-I'~ COMPARTMENTS ~
__ LIQUID DEPTH LIQUID CAPACI GALLONS.
NUMBER OF LINES / DISTANCE BETWEEN LINES
ABSORPTION AREA r~ (~F~/
DEPTH :
F TOTAL LENGTHen. E~ /
NEAREST LOT LINE ~ OF LINES
/~/,~ TRENCH WIDTH ~'~{~IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE ~ ~ /
TOP OF TILE TO FINISH GRADE 3 MATERIAL BENEATH TILE {~~.,~__~l~ IN. ABOVE TILE '~'1g' //
_ IN.
WELL: , .
BUILDING
FOUNDATION ,
CESSPOOL
APPROVED
NEAREST
LOT L,NE ,
OTHER SOURCES
DISAPPROVED
-~/~/~ DEPTH ~'~///JF' DISTANCE FROM:
NEAREST ~/~? SEPTIC SEEPAGE
SEWER LINE ., TANK~/~, SYSTEM
REMARKS
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
LOT SLOPE:
DIAGRAM OF SYSTEM
DATE//~
G.A.A.B. ~'~J
Form LQ-032
FIF:'F'L.. ]: CI::ti",i'T' IF..: :[ Cf'::: I'"JI:'I'T' (:4E:J"4 [:'EL.. E.R.
I_E F:t:IT t Ot'.4 Fl~.4',,,' l I-::: C I R[::LE 'E'I';' HGT:E; i'.,I(]R'T'H L. OT :E; :l:
L EGFI... I....',~', 85 EF:IGLE: R:[,, ...
· j..,4. E~l?iO S'::d...IFtRE FEE:T
t',II~::.,:!MUI'I NIJHE:ER OF BEI::,REK]MS = ii: :E"]'IL Rla"f'ING ,:::E;6! F"T,.."E:R:: ..... ::5
.... '" '""-'"'-I I
THE LEN(3TH [):I:HENSION IS THE I_ENGTH ,:: IN FEET::' OF ']"HE "."RENE:H (IR I::,F:IaINF IEL[:'.
THE [:,EF'TH OF FI TRENCH OR F'IT ]:"2; THE [:,:[ST'FIhlCE E~E"rP]EEN 'fHIE '2E .iRFFtCE OF THE
THERE: I :E; NO '_'~i;E't" b.I I [:,TH F[)R 'TRENCHE'-:~;. OUTF'FiL. L P ]: F'E
T.4E 3F-t,E.L. [:,EPTI-4 IS TI-IE MIN:I:HUH [:,EF'TH (:)F ~h:I-4,,,Et_ 8E:TI-,.IEEN THE
I::11'.,1[:, THE E "'T'T'OM I::IF' THE ......... v_.. ..
i::,EF'FIRTHEN]' 14 ]: M_ E',E 'F;I IE:..!ECT TO F'RO:'~;E(:: - T t 3N
:i.~E~ FEE"[ FOR R PRI',,,'FI]"E HELL. OR ;;'::~E~ F'EET FOR R F'_EI.. IE: 14EL. L.
HE:M_ LOG:E; RRE F4, E}JIF-4'E::, FINI:::, HLIST BE RE"IUI:~'.NE[:, TO THE [':,EF'FtR"r',IENT H]:TH]:N ]i:(i~ ..I"T:,
OF -f'HE 14EI_L. :' F MF't. ET ]: O '-,
:1: NSTFILI_taT I ON.
I CE:RT I F"T' 'I"HR"f'
:L: :t: l::~t'"l F'F~MII_:I:F~R t.,.ItTH "I-HE F~:EI]:!I_IIREHENT:E; F'I3R ON-'SiTE :E, EP.tER~; taN[::' !.,.IELL:.::; RS :SE"t"
F(:)RTH B"r' THE HIjN:I:CIPI::II..ZT'T' OF' I::tNCHE~RFIGE:.
2' I H:[M- IN:E;"I"RM- THE S'T'::_';]"EI1 :I:N RCCOR[:'taNE:E t.,.IITH THE ::[~DE:::5.
::ii:: ]: LtNI:::'EF-::STFIt"4[:' THRT THE (]N-'}'_;ITE SEI4ER .:,T.:, I E,'I MR'T' RE(;:!UIRE E:NLRRGEHENT :[1:: THE
RES :[ I:::'ENCE :1: S REMO[:'EI-E:[:' T '] INCL. LI[:'E MORE "fHFH"4 :~: E~E:C, ROOH:5.
[] SOILS LOG
PERFORMED FOR:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99502 276-222~'
I--I PERCOLATION
TEST
SOILS LOG- PERCOLATION TEST
~ ~ ~ ~ DATE PERFORMED:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13-
14-
15-
16
17
18-
19-
20-
SITE PLAN
WAS GROUND WATER /~ SL ~ .,.--" ~ ~ ~
ENCOUNTERED? O ~
P
IF YES, AT WHAT E !~
DEPTH? ....... ~
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
TEST RUN BETINEEN
COMMENTS /~/'/~r/?/q.') ~')~
PERFORMED BY:
FT AND FT
CERTI FI ED BY: /4/'~CL-~/")/~-.~ - ~,~-..~U o~'
72-008 (7/76)
Pratt
~-'-* ~ Rc:c,2i.ved: December 6, 1977
~<i~..¢L'~:,;,l ~'l.~ L ()? ~N',):V] )(iill SEWi:N. AN!~ WATER
~ill hand carry
LePxtinc{ Ittst:;,_tdtioP, Re. quest: Peoples Bank and Trust
:'Iai] lng~ .... ,~ct,-'~'..~.~,,>' Pouch 7-007 99510
PropeYty C,w_qer: Rick May Phnnc: 694-9495
General Delivery, 99577
3. .i.,cc,~il F)c:scri~:~t:~on: Lot 8 Block 5 Eagle River Heights North Subdivision
Three
Y,k,! · Log on Fi!e ( )
Construction E .c~_e~.lat And
Sewage F;J sposctl ~-¥,~ [ -m: ON-.q it:c cz.,~.~ .
-~.,bl .c' Ut:LLLL:7 ( )
Instal J_ei
Septic ~a, ,. Size
MaDuf ac:tllrer
Soils Rate
:da Let ia 1
to Sew:Ir i,J}~(, N~,~rost Lot lin :
t.o Nearest Lot
· :. S,.)~ i~t-lC):, Auca
Page ~Pwo
Depar,. ~ ..... o.~ I!e ~] til and Environmenta
~{ ..... ~ Lot 8 Block 5 E~_~io River Heights North Subdivision
Affadavit Attached: ( )~ ) Letter Attached: ( )
Disapproved: ..................... Da~.(;:
JNICIPALITY OF ANCHORAGE
Department of Health and Environmental Protection
825 L Street, Anchorage, Alaska 99501..
264-4720
Property Owner:
Mailing Address:
Name of Buyer:
Mailing Address:
_=quest for Approval of Individual Sewer and Water Facilities
Lending Institution:
Mailing Address:
Realtor/Agent:
Mailing Address:
Legal Description:
Street Location:
Phone:
Single Family Residence: (~) Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well ( ) Public/Co.__~uQ.~ty System ~,)
If Individual Well, well depth
If Community System, name of system
8. Sewage Disposal System: *~n-site System ~ Public System ( )
If On-site System, date of installation: ~0~A_~ ~ ~
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77