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HomeMy WebLinkAboutEKLUTNA HEIGHTS #1 BLK 3 LT 10AOnsite File Eklutna Heights #1 Block 3 Lot 10A PID# 051-061-91 Formerly Lots 10 and 11 S 10 8 § ~ oEc o ~ 2ool ASBUILT S~1,TA~D & I HEREBY CERTIFY .THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY, INDICA~. IT IS THE RES~SIBILI~ OF THE WHI~ ~ NOT ~E~ ~ THE RE~ ~I- VISION P~T. UND~ NO CIRCUMST~CES S~ F~ ~ FEtE LIN~ OR ~R E~LISHING ~ND- ARY LINES. Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ' ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~".~¢3c'~'~- PID Number: ~J- ..... Na~e:~ ~~ Wastewater System: ,,,,,,~ New, , ~ Upgrade *~;~ ~,~/~ ~,~ ~ ~ ABSORPTION FIELD Phone: ~_~/~ No,~ed'r;;ms: ~ OeepTrench D Shallow Trench ~Bed,,,,,,,~ Mound., , ~Other . To~al Depth from ordinal grade: LEGAL DESCRIPTION so,,,,~,.~:'~.~ ~D~.~t. /q.. Lot: // Block: ~ ~7~;u di ,ion: ~ Depthto pipe bottom from original grade:. ~ ~ ........ Ft= Gravel~;p~be~eath pipe Ft. Tow~hip: Range: I Section; Fil~ added above original grade: Gravel length:~ ~, Ft. , , Ft. WELL: ~ New B Upgrade erave~width: ~.~ Ft. / C'.8,ifl~.tJO~ (Private, A,.,C); T~,a~ Depth: Cased To; Total absorp~a; Ft. Ft. SQ. Ft. , .. Drille~: Date Drilled: Static Water Level:Ft. Installer: ~I~ D~te installed: Yield: '~mp Set at: I Casing Height Above Ground: TAN K SEPARATION DISTANCES ~Septic ~ Holding U S.T.E,P. From TO SeptiCTank AbsorptlonField Statio~Lift HoldingTank 3ubli~Privatesewer Lines Manufacturer: ~ Capacity~in gallons: WelF W~ ~ ~ ~ ~ Mateda': ~ Number of Compa~ments' / Su~ace ,,, Lot Fo.ndation ~ ~ ~ ~ .~ "Pump on" level at: ~ "Pu~ff" level at: j H,gh water al,tm at: .r.,. ...... I'""m ,, , ' ~_ ~performed by: ,, ~. Theodore , ~e ~'~ Department of Heal~ andHuman Services approval '~-"~,~ ~:,..' ...' Reviewed and approved by: Date: ,~2 -~, -~ 72q313 (Rev, 9/91) MOA 25 P.O, BOX 111790 ANCHORAGE AK 99511-1790 TEL 907 349-1003 800 478-I003 lIN ALASKA) Designed by "'~. 'q Checked by Sheet / of / Number Date Date W 4' PVC FROM TANK MEA ELEC POLE = ~ 101,8 100,5 ~ ~ ] FILTER FABRIC ~ 96,9 4" PERF PIPE 96,7 ~ ~ s~,o 89,8 FILTER FABRIC 96,9 4" PERF PIPE I 39,0 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG w PERCOLATION TEST DESCRIPTION,~///, //~"~.'~'-~'~{ /-~ ~"---~ "Cf / 2 wnship, Range, Section: LEGAL ' SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? $ IF YES, AT WHAT ,/~/> (~ DEPTH? P E Depth to Water Alter Monitoring? . Date: 2 3 4 5 6 7 8 9 10 11 12 13- 14 15 16 17 18 19 20 Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TE,$T RUN B[TWE,~.,I',I PERFORMED IN 72-008 (Rev, 4/85) unicSpa ty Anchorage P.O. L X 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOIR DEPARTMENT OF HEALTH & HUMAN SERVICES January 9, 1987 Everette Caulkins Box 10309 VFW Road Eagle River, Alaska 99577 Subject: Lot 11 BLock 3 Eklutna Heights Subdivision On-site Sewer Permit Upgrade ~860387 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1986. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. In addition to the expiration of the permit, the fees for the subject permit were not paid nor the permit signed by the applicant. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as-built inspection report(three part form) must be sent to this office for review and approval, and for documentation. The fees for the permit will need to be paid and the permit signed by the applicant if any or part of the installation have been installed. If there are any further questions, please call this office at 264-4744. R.W. Robinson Program Manager On-site Services RWR/ljw enc: copy of permit !::. v' c:.r~.l . ~ !~:. '"' '" ......... v ," ,.4 .::~'D , 4 ,, () .'.'I. ,, () 4. () :!. 2 ,, :!;2 ,, 0 ::~;zl. ,, 0 41 ,, 0 :i.?. :5 2 ;I.. D :50.4- ~~., :[25 ;!. ::;: 5 :[25 . :. ,..h::~l.. ~::.t., ! h: 1.1{..Jc:) , ~:. ~::: ............. .... L..Ir: ' I'"i .l I ', C:. I... ii ( :':"~ } ('~'::' '"'-;' '" J' Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: G~8~-~z57 LEGAL DESCRIPTION: ~'U~y~..~. C~Z I ~l'lC~S DATE PERFORMED:__ L Il I~ ~k~.~L~ ~'~L~ownship, Range, Section: SG~4. %3-1' fC, r'J 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth to aVa~ter'rterAIter '-"~:~-':~ ..... ~ Moniloring~,,,~, ~¢~1~--,~ Date: ~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE J~Jo~"~O~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN __ FT AND FT PERFORMED BY: ~-----~'~'~ ~ ~aJ ~'~ ~ci ~/~Ci ' ~ ~YS, I*~. I C ~,~ ]~r.~~ O~I~, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: [O- ~o- ~o 72-008 (Rev. 4/85) 9000 Sto!e 0 q) 53 coNs'~,¢.~ f~ P T A R M A G A I N NO0° 04' 00" W ST Ri' ~x%-~ 8~ 90 6 O0 _. GORSUCH MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I,D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING -,)-- ('- 000 - ?(~ 'x/ NAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) c;,~. [ ?~.~ .-~_--TT'E~.~' Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: --~ TYPE OF WATER SUPPLY: Individual well Community well [~//'--- Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION By ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the dat(~ of this inspection. Name of Fi rm ~/"~/(...~ J/~ ~_,.4~/~/¢c ,.~ p h o n e ,~ ~'~ -/E:Y-2..-2 Address /~ /~ ~//~ / ~¢~ ~ ~,~/ Engineer's signature /~~ Date.~ / /~ DHHS SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: /_./Y~4 ~ /~------~ "/:1,'11[']i The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91 ) ~ack MOA ~Y21 Well ~¥Log present Total depth Sanitary seal (Y/N)  Municipality of Anchorage ~/V~/~ON/~/~/L~,~Y OF ANCH~k · DATA I~B, or C, attach ADEC letter. ADEC water system number ¢.~ t../J [[ [ Date completed __ Cased to Casing height round) Wires protected (Y/N) FROM Date of test Static water level Well production WATER SAMPLE RES~L~."' Coliform D~~of sample: B. SEPTIC/HOLDING TANK DATA Date installed Foundation cleanout ~N) Date of Pumping C. ABSORPTION FIELD DATA Date installed ' Length ~' Width ~,~, Effective absorption area ~:>~(~ .~' 2ate of adequacy test Nitrate g.p.m, g.p.m. Cleanouts ~___~N~ Collected by: Fluid depth ~/' (ins) Minutes later:. ~(~ Absorption rate = Peroxide treatment (past 12 months) (Y/~_.)~ ~..~'r ~--' If yes, give date 72-026 (Rev. 3/96)* Soilrating ~orffqbdrm) 0,8 Systemtype '~E./~CIJ~, ' TotaldepthI I, f 6ravel thickness below pipe '~ ¢ Monitoring Tube present C/N) ~E~ Depression over field (Y/~.") ~ Results (Pass/Fail) ~ For ~ .bedrooms Fluid depth in absorption field before test (in.); ~ ~ Immediately after ~ gal. water added (in.): ~J// Tank size. /(..JOG Number of Compartments ,~.x~oA-'/,.-Depression (Y/~ ~ High water alarm (Y~ Size in gallons Manhole/Access (Y/N) ,~~ ._~ "Pump off" level at* High water alarm level at* ~ *Datum ~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot ~J/A- Public sewer main ~//~- Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~> r Property line ~. t Absorption field Water main/service line / 0 '-F Surface water/drainage [ O~ ¥ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /~0 Building foundation ~ ~ Water main/service line Surface water /'dJ/~ Driveway. parking/vehicle storage area Curtain drain //~J///]' Wells on adjacent lots ~J/,~r F. ENGINEER'S CERTIFICATION /0/Y- I certify that I have det/erl~ed thru field inspections and review of Municipal records tha~ in conforrnance yt~O/~ H~rdel~.~es in effect on this date. Engineer's Nam ~ ~ ~'~. HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Location (site address or directions) ~J~O~' ~.~m.~ ~)~-/'~ ~'~/_-,/~,?~./'c_ Property~)wner ~?':,~.,~//crwch' / ~-~""//~ "~',,>''~d)lc-'{'~ Mailing address L en ng agency Agent.? '*~ "' Address ........... Day phone Day phone Day phone -:'' '; Unless otherwise requested, HAA will be held for pickup. "-~,~';:,",~. '.'~ ......... ~,-'.,~:~ .... · , .~,,. '~- 3." -' TYPE OF WATER SUPPLY: ........... '?:":~:"?' ': .... Individual ~ell .......................... communi~ well ........... ~'~" ' ~ ,.. ....... Public water . NOTE: lng to the legality and status.of system~ ...... 4. - TYPE OF WASTEWATER DISPOSAL: ... -~. ~ Individual on-site ~ Holding tank ;: - -~: ' ' Community on-site - : ~ Public sewer ; NOTE: If community well system, provide written confirmation from State ADEC attest- ,,' - ~'..,~{~, . .'. '.','./)~ ~,. ~'~ . ,... '...~ ..¥. ~ ;, ~,;'~; ,~'.~,,, .:: '~.~ . . %.'.,Z/,~ ~y,,.',' ~ ' If community wastewater system, 'provide written confirmation from State ADEC attesting to the legality and s, tatus of system. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verity that based on the information obtained from the Municipality of ~n.c..h,orage files .a~d from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. 6. DHHS SIGNATURE :~cc} ~. Condltlon~ ~ppr~a for ' Additional Comments ....... '., ':~The Municipality ,o.*~Artchorage Department of Health and Human Services (DHHS) Issues Health Authority ',. Approval Certif. iC~,e, s,,based only.upon the representations given in paragraph 5 above by an independent r Prdfes~ional ~'ng~e'~ registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and !heir lending institutior~s !q old. er to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev. 1/91) Beck MOA i~21 Legal Description: Municipality of Anchorage E IV E D DEPARTMENT OF HEALTH & HUMAN SERVI~:::~L, Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) $,~'~'4zl ~ 1995 A. WELL DATA Well type Log present (Y/N) Total depth 4//~ Sanitary seal (Y/N) Date of test Municipality o'l Anchorage Dept. Health & Human Services Health Authority Approval Checklist IfA, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION O~er bacteha Collected by: Static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate Tank size [0069 Number of Compartments // Cleanouts (Y/N) High water alarm (Y/N) Date installed /'q 9f ~ Foundation cleanout (Y/N) F~i~,'d~ ~,~o~') . I~- tJepressmn (YfNr) DateofPumping }]- ~--~.5-'- PmnPer 5~/F~ ~ ABSORPTION FIELD DATA Date installed , t/~:>~ Soilrating (g.p.d./ft2orft2/bdrm) <552/~:) Systemtype Length ~,~a;~ Width ~ ~ Gravel thickness below pipe '-~ ,~) Total depth Effective absorption area ,~-4~& (p Monitoring Tube present(Y/N) ~;2 Depression over field (Y/N) Date of adequacy test /'/,,~/O) oz'"- Results (Pass/Fail) P~,~, ~; For ~ bedrooms Fluid depth in absorption field before test (in.); ~ ~_, hnmediately after~/Qgal, water added (in.): Fluiddepth '(-'c~ Minutes later: ~r_) (in.) Absorption rate = /! ~2.7_.- g.p.d. Peroxide treatment (past 12 months) (Y/N) //x/" If yes, give date LIFT STATION Date installed /~~~4 Manhole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons "Pnmp on" level at* *Datum A//~ E. SEPARATION DISTANCES "Pnmp off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line ; On adjacent lots : On adjacent lots Public sewer manhole/cleanout A/t/J- Lift statiou At/A- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Water main/service line Surface water/drainage /¥f/ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundatiou Surface water Curtain drain F. ENGINEER'S CERTIFICATION Water mai~ffservice line Driveway, parking/vehicle storage area Wells on adjacent lots 1 I certify that 1 hage.determirt~d thrufield inspections and review ofMunicip~ ,~_~e, above aystems are in conformat~wi~ MOd~t/LA~zuidelines in effbct on this date. Eug~neer s Name I ~~/~- ~ / / __ .......................................................... ................................ ............... HAA Fee $ ~, ~ Waiver Fee $ Date of Payment Rev. 8/95 OSS: haa.wk.doc Date of Payment Receipt Number Tim~ Time ~e Inspector Inspector Inspector Comments ~°ndltlonal ,, ,,,, D~te Sewer Ins~lled Permi~ No. Septic T~nk Gize Holding T~nk Glze Goils R~ing Well To Absorption Are~ Well Log ~ecelved Well ~o T~nk APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~V~.~ ~O~q ~[~ Phone Lending Institution ~/4j/4 Realty Co. & Agent ~HV/0 (b, ~'/~ D ,, Phone LegalDescription Z D ~ )// Street Location ~ X/~ Typeof Residence ~ Single Family ~ Multiple Family No. of Bedrooms ~ Other Water Supply ~lndividual A~ACH WELL LOG. A well log is required for all wells drilled since June ~Community 1975. For wells drilled prior to that date, give well depth (attach log if ~ Public Utility available.) Sew~ Disposal ~ndividual Year Individual Installed: ~ Public Utility When Connected to Public Utility:. ~ Holding Tank NOTE: THE INSPECTION FEE MUST AccoMpANY EACH ~EQUEST BEFORE PROCESSING CAN BE INITIATED. EXCAVATION ROBERTA. SHAFER WORK CIVIL ENGINEER 694-2979 May 23, 1982MUNiCiPALITY OF ANCHORAGE ENVF . ' :1,/,.: ,u r , ~ Coleman Reynolds P.O. Box 461 Eagle River, Alaska 99577 RECEIVI D Dear Mr. Reynolds, Reference: Lot llt Block 3: Eklutna Heights Subdivision As you requested, the septic tank and seepage pit serving the two bedroom trailer located on this property was excavated to-determine why the system was backing up and to install a stand pipe in the crib so an adequacy test could be performed as a condition of your purchase of this property. Through excavation it was determined that the pipe between the septic tank and the crib had been frozen. The pipe was cleaned, repaired and a clean out was installed, in the seepage pit. An adequacy test was then performed. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to the crib had percolated out. It can be concluded from this test that the waste water disposal system serving the two bedroom trailer located on this property is currently functioning adequately. If we may be of further assistance, please do not hesitate to call. /J~?/~laska B(nk of Commerce Everett, Thomas, and Reynolds Escrow Account Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA EXCAVATION ROBERT A, SHAFER WORK CIVIL ENGINEER 694-2979 February 4, 1982 MUNICIPALITY OF ANCHORAGE ENVIIi ,h, .I;;A. ! ,0 F ;'; I Dall Realty ATTENTION: David Aquino 700 West 41st Avenue Anchorage, Alaska 99503 RECEI '! D Dear Mr. Aquino, Reference: Lot 11: Block 3: Eklutna Heights Subdivision A sewer system adequacy test could not be performed on the system located on the referenced property since we were unable to locate the absorption area. However, the septic tank was pumped and verified to have a capacity of 1000 gallons. After breakup this spring (1982) we will arrange to have an excavator locate the absorption area and will perform the adequacy test as requested. If we may be of further service, please do not hesitate to call. Sin~el~y, ~cc?/S;las.ka ~'/a/nk of Commerce ATTENTION. Carol Sherod Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA QGREATER ANCHORAGE AREA BOR dGH Department ~3E0n~irs~ntal Quality Anchorage, Alaska 90503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME D/~'/D /O~,,~/~S~)~'¢'] MAIUNGADDRESS/~'~C'~F~ //~7 /~'"~/~/~ PHONE~0 /240~' SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER .~'~¢'¢ ,]/-" 5 ¢' T" MATERIAL INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS .LIQUID CAPACITY /.7g) ¢'2~ GALLONS, SEEPAGE NUMBER OF PITS__ DIAMETER OR WIDTH __, LINING MATERIAL CRIB SIZE: DIAMETER BUILDING FOUNDATION , NEAREST LOT LINE ADDITIONAL ABSORPTION , DEPTH // ~ DEPTH~ DIST~N?E FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ SQ. FT. WELL: ~//~ ~ ~ ~r ~'~' ~ ~ 4 TYPE CONSTRUCTION BU I LDI NG N EA REST N EAR EST FOUNDATION_ LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK __ SYSTEM DISTANCES: INSTALLED BY:_ PIPE MATE RIAL: -z~// LOT SLOPE: RE MA R KS: ~'~/T,~_ ~..,~' ~'~'~ DIAGRAM OF SYSTEM APPROVED G.A.A,B. Gte, .r ANCHORAGE AREA Bor' )gh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT 'EGALDESCRIPT,ON C /0 PIT D~At OTHER INSTALLATION OF: SEPTIC TANK , SEEPAGE FINANCED THROUGH TO Be INSTALLED BY COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES., REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK ~ , SEEPAGE PIT , DRAIN P+ELD DRAIN FIELD ALSO CONSIDER AREA WELLS, WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD SEPTIC TANK, / SEEPAGE PIT , DRAIN FILL , 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. // .~K_~ /A_~E~/~ G.^,,E- , CONFORM TO BOROUGH REGULATIONS REGARDINC.~INSTA[,.L)ATION. RAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THe ABOVE DESCRIBE SYSTEM IS IN ACCORDANCE WITH SAID CODE. FORM M. EO-OI6 ~ ~ Gl]EATER ANCHORt\G[:: AP, LJ\ ~OIZOumi Department of Env~ronnlen[a] Qua]'ity 3330 "C" Street Anchorage, A1 aska 99b03 SOII,S 1,0(i PEI{OI,ATION TEST Dep th Feet 5- 6- 7~ 8- ]3- 14- Was ground water encountered? ~] _~l ..... If yes, at whaL depth? EQ-040 (6174) Reading Date Gross Time Net Time _~e_p_t.!L.._t__o Wftt(.;P Net Orop Percolation ~;-a t--e .Proposed linstallat~on: ,eepage Pit Drain Field Depth of hllet . Deptl~-¥o'-}~¥t-o~n-;~:f-'pit or trench ................ ~ .............