HomeMy WebLinkAboutEARL RAY BLK 3 LT 17 REM
GRE:,.~R ANCHORAGE AREA BOk~JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL,SYSTEM
SEPTIC TANK:
DISTANCE I
FROM WELL'--/fO MANUFACTURER
NUMBER OF
MATERIAL COMPARTMENTS_ Z~..-----
//'LIQUID DEPTH ~QUID CAPACITY/~ALLONS.
TILE ........ -F;,-LD:
D,STANCE FROM WELL
NUMBER OF LINES
I / ¢O ! TOTAL LENGTH
FOUNDATION ~'~U~ _NEAREST LOT LINE_ OF LINES
DISTANCE BETWEEN LINES /~'///~ TRENCH WlDT~H~'IN. TOTAL EFFECTIVE
ABSORPTION AREA ~
DEPTH: TOP OF TILE TO FINISH GRADE
TWyEpLEL~c O N ST R U CT, O N .~ ~.~-- ~ -~'"-~- ~'~
BUILDING NEAREST NEAREST SEPTIC
FOUNDATION LOT LINE__ SEWER LINE__. TANK--
IN.
DEPTH
SEEPAGE
SYSTEM
DISTANCE FROM:
CESSPOOL
OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY:-
SEWER LINE DEPTH:
REMARKS:
DIAGRAM OF SYSTEM
"-'
DATE . . APPROVED
Form EQ-032
' .~ ,~d~j~J~.~,~l~ ANCHORAGE: Area BO,.v.UGH t
'~'~EpARTMENT O~ ENV,RONMENTAL Q'AL'TY
~~ ~E~--AGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK ~ ~ SEEPAGE PIT
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
DRAIN F~La~D , OTHER
TO BE INSTALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING O~ ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE /~ (~ 0 TYPE SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM
TO SEPTIC TA K
FOUNDATION
FOUNDATION TO ~=~AC~Z ~-:T ~ ~/~ / ,, DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
., SEEPAGE PET
~ DRAIN FIELD
SEPTIC TANK, , SEEPAGE PZT
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.
CONFORM TO BOROUGH REGULATIONS RE/~RDIN(~ INSTALLATION.
//
OR
LICENSED DESIGNER
I CERTIFY THAT [ AM PAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA~BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
/
DESCRIBED SY TEM IS IN ACCORDANCE WITH SAID CODE. ,./ -.~ .
'.,,-,TE_ APPL'OANT'SS'GNAT,RE~ 3 ~ )? ':,,, . ..
.~ 613-75)
~ MUNICIPALITY OF ANCHORAGE ~
Departme~LL of Health and Environmental ~ ~ection
SOILS LOG
PERCOLAT IC}: TEST
Performed for Tim Swan Date Performed 3-22-77
Legal Description Block 3, Lot 17, Earl Ray Subdivision
10
12
14
16
18
GW- GP
0 - .5' - Soil, silt and orKanics
0.5'-13.0' - Moderately well graded gravel and
sand - few fines - GW-GP
Square feet per bedroom = 110
Total Depth - 13 feet
No groundwater encountered
AVERAGE SQUARE FEET PER BEDROOM = 110 visual
Date Net Time Depth Net Drop
Performed By 0~ ~, ~ CHAMPION DRILLING COMPANY, INC.
H iN:[HL.IH D)i:i~;TFfNC':E E~E]'].,.IEEN F:i MEL.L.. RND 1:::ti",i'¢ CIN--~E;:[TE:: :i,~;EWf::IGE [> ]: !iE;i';:'Ot!E;I:)L., :i~;',r'::,:,';TEH :[:5
Z~;ii~E~ FEE'f FEiF:'. FI F'F,::[V~TE 1.4E:LL., OR 2(i~61~ FEET FOR F~, PUl-iL:lC WELL,
WEL, L. L.Odi:!5 t~fi'.E F,:Ef;:!U :[ RE[:, F!Ni} I"IL!~;T BE I:;i:ETLJt:~:'.NE[:' TO THE i}EF'F!RTHENT F.itTH]:Ft
OF' ]'FIE .t4ELL CC'tHF'LET]: OF,t.
SPEC :[ F' ]: CFFi" ]: Ot"t~!; FIND CONSTRUCT ]: ON P :[ F!GRF4MtE: RRE !::iV!q Z I...F~E~i,,.E 'T'O ]i: NE~;UF~ffC F'~:OF-IEF?
Z i"~S"[ FIi...L.!:~T ]:
:[ C:ERT ! F'~'!'' 'THI::~;'['
::L: .'[ P,I'! FFIH:[Li[F!R WITH THE R[:.:'.(..':!UiREHENTS FOR
F:Ot:':':TH B"r' THE hjI.j,N l C Z F:'FtL l "f"¢ OF
21:: ]: lq.i'LL. ]:N:ii:';TF:IL.L THE '.:~;'~,':,~i;'TEM IN F::iC(.'.':OF,:DFtNCE i.,,t ): "['H THE C:ODE:{.::;.
RJ:::'P[.. :!: (_':F:II",iT T iii J"i SI.,.IRN
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTION L / 7
DATE-Started 3////7 ?
PERMIT NUMBER
(.gertifieh rtlltug
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
Ended
77 o7~-
I
DEPTH OF WELL / ~c~
STATIC LEVEL OF WATER FT.
~I~. /~q T' .~'aCD DRAW DOWN FT. ~0 '
?~/7 7' GALS. PER HR
KIND OF CASING
KIND OF FORMATION:
From C) Ft. to I Ft. Oa~,~ ~or~,~a From F~ to__Et
From I Ft. to 4 Ft. ~ ~ ~AU~'~ From~ Ft. to Ft.
From ~ Ft. to~Ft. ~Z~ ~O~O~m Ft. to Ft
From 7~ Ft. to ~2~Ft.~ ~~ ~L~V From Ft. to Ft
From Ft. to Ft. ~/ /'¢~ from r, ,o ~t.
From ~'~-Ft. to/Oq Ft. ~Z~ ~C< ~S~Off~om Et. to Ft.
From ]~ Et. to [[g Ft. ~ ~ C<~ From~ Et. to Ft.
From Ft. to Ft. ~ ,~&~ ~ ~. From Ft. to Ft
From 1~ [~ Ft. to [~ Ft. .{~ ~a~ ~~om~ Ft. to Ft.
From Ft. to. Ft From Ft. to Ft.
From Ft. to Ft. From--Ft. to Ft.
From Ft. to Ft. From Ft. ~o Ft
From Ft. to Ft. From Ft. to Ft
From Ft. to Ft From Ft. to Ft
From__ Ft. to Ft. From Ft. to___Ft.
From~ Ft. to. Ft. From___Ft. to Ft.
From Ft. to Ft From Ft. to Ft.
MISCL. INFORMATION:
DRILLER'S NAME
?--'~MUNICIPALITY OF ANCHORAGr~"~
L-~EPARTMENT .... - HEALTH AND ENVIRONMENTAL /ROTECTION
825 L Street, Anchorage, Alaska 99501
279-2511, ext. 224, 225
Date Received: April 7, 1977
let Inspection: Time
Date
Inspector
Pratt
2nd Inspection: Time
Date
Inspector
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request:
Mailing Address:
Property Owner:
Mailing Address;
Tim Swan
Box 82 Wasilla
Phone:
Phone:745-4094
3. Legal Description: Lot 17 Block 3 Earl Ray Subdivision
4. Single Family Residence: ~)
Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
5. Well Data: Type Individual Depth 120' Well Log Filed
Construction ~J Bacterial Analysis ~. ~
6. Sewage Disposal System: On-site system ~) Public ~k!i~[ )
Permit ~ Installed 1977 Installer _~~
e
Septic Tank Size /0~0 ~ Manufacturer
Absorption Area ~O ~ /Soils Rate /~0
!
/
Distances: Well to Septic Tank //~ to Absorption Area /~
to Sewer Lines ~( ~ Nearest Lot Line ~) ' ~
Absorption Area to Nearest Lot Line ~ !
qUNICIPALITY OF ANCHORAGL MUNICIPAUrF OF ANCHORAGE
~epartment of Health and Environmental Prot~.%bg~;~-,:..fi..
825 L Street, Anchorage, Alaska ~&INMFNYA~
279-2511, ext. 224, 225
APR ?.
_=quest for Approval of Individual Sewer and Water Facili~mes
RECEIVED
Property Owner: .--~
Mailing Address: ~ ~_ [~/~',//~ ~ Phone:
Phone
o
Lending Institution:
Mailing Address:
Realtor/Agent:
Mailing Address:
Legal Description:
Street Location:
Phone:
Phone:
Single Family Residence: ~) Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well (29
If Individual Well, well depth ~ ..
If Community System, name of sysnem
Public/Community System
( )
Sewage Disposal System: On-site System
If On-site System, date of installation:
(~) Public System ( )
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77
P&~e ~ ~wo
' Department of Health and Environmental Protection
~ ~ Request for Approval of Individual Sewer and Water Facilities
Legal Description:
Lot 17 Block 3 Earl Ray Subdivision
Comments:
Affadavit Attached
Approved:
Disapproved:
Letter Attached: ( )
Date:
Department Worksheet: