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Home My WebLink AboutEKLUTNA WEST LT 5A MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONIVIENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT [] NEW J~PGRADE NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION t ,Well I Absorption area DISTANCE TO: Liq. capacity ~n gallons IF HOMEMADE: DISTANCE TO: Manufacturer / 7 //~ DISTANCE TO: No. of lines ! We,, / ~o Length of eac~ Top of tile to finish grade Length Width Type of crib Well DISTANCE TO: Class DISTANCE TO: Crib diameter / Depth Buildi ng ,o u n~-~J Inside length Dwelling Foundatio~{~) ./,~, Total length of I~n~ -_~7 + Material beneath tile //epth foundation Driller Dwelling Material Width NO. OF BEDROOMS PERMIT NO. No. of compartments Liquid depth PERMIT NO. Material Liquid capacity in gallons Nearestl°t~,S/~, ' Trench widt~ inches 'd~ ~)inches PERM,T NO.~ ~7~ ~- Distance bet wej¢~//~ es Total effective~rea PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line [PERMIT NO. '~l~t i~ 't ~n'k' ....... ~,bsorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING / iNSTALLER C~ S dO'77- REMARKS 72-013 - m3~ ~,~ S I TF PERMIT NO. ( 820792 ) RPPLICRNT MRRVIN GRBEL LOCRTION LEGRL LSR EKLUTNR WEST MIJI~4 I C I PRI I T"r' OF Al'dC: :ORAGE DEPRRTMENT ~[~ HERLTH RND ENV I RONMENTRL '~3TECT I ON 825 ~L -TREET., ANCHORAGE., AK. 99, i 2~4-4720 SE~ER PERM I T SRZ BOX ~5~0 TIN8 CHUGIRK LOT SIZE 999999 SQURRE FEET TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH MRXIMUM NUMBER OF BEDROOMS SOIL RRTING THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: DEPTH= 7 LENGTH= 57 GRRVEL DEPTH= 4 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION <IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION <IN FEET). REQLI I RED SEPT I C TRNK S I ZE= ieee GRLLONS PERMIT RPPLICRNT HMS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RNY WELLS 8DJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. TWO ( 2 ) INSPECT IONS RRE REQU I RED BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND 8PPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN 8 WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM 8 PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE WELL TO A PRIVRTE SEWER LINE IS 25 FEET 8ND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRAMS RRE ~ RVRILRBLE TO INSURE PROPER INSTRLLRTION. ' F"ERIq ! T EXP I RES DECEMBER 3::1... ::1.~m$2 I CERTIFY THAT l: I RM FRMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPALITY OF RNCHORRGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDRNCE WITH THE CODES. 5: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REM~ELED TO INCLUDE MORE THRN ~ BEDROOMS. APPLICR.T GRBELqJ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST SOILS LOG' PERCOLATION TEST PERFORMED FOR: SLOPE SITE PLAN 2 5 6 ~ 7 8 9 ¸10 13 14- 15- 16- 17- 18- 19.- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop 20 - PERCOLA~rlON RATE /~ (minutes/in~h) TEST RUN BETWEEN , FT~ ;~D ~ FT COMMENTS 72-008 (6/79) ' :~" ~% ' ' "8 SES,r.t-Anchorage, Ala a99501" .¢,,la ,-.P,1978 DIRECTIONS: Cbmplete all parts on page 1. Ineompl~ reques~ will not be proceed; Please allow ten (10) days fo~ processing. 'R~P~T~ RESIDENT (If ~lffereat fro~ aboveF ' PHON~ ' PHONE MAILING ADD~E~ ' 4. REA[TO'R/AGENT ' ; ,. ; MAILIN~ ADDRESS ; ..~, . ~ STREET LOCATION ~:. TYPI~ OF RESIDENCE ~ SINGLE FAMILY ' ';~ -.FI- MULTIPLE FAMILY 7. WATER SUPPLY " [] INDIVIDUAL* [] COMMUNITY -, ,' ' .'~j~- '-POBLIC UTI LiT¥ 8,. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** : ' ' [] PUBLIC UTI'LITY 72-0~ 0(3/78) THE 'INSPECTION FEE MUST A~CCOMPAfilY"EACH REdUE~'r BEFORE i~RO~Si;~iG CA NUMBER OF BEDROOMS [] One [] Four [] Two [] Five * ATTACH WELL LOG. A well Icg is required for all well s drilled .. - **If individual/on-site, give installation date. k~/]~ . If system is over two (2) years old an adequac~test is required ~-~ ' - -:~ by this Department. " ? ' , ' -THISilDE FOR OFFICIAL USE,ONLY ; . ~. · ' : · - ' DATE RECE VED ~'. ' INSPECTION APPOI.NTMENTS -~': ?-;L - - _~,. ~ ... ~ , - _ _ - ~ - . ~ T ME ~- ' ~. Tt~E ' -' r · TIME .... .[. .. '. :. ~-,. · ~ - . DATE ~.- ' DATE DATE. .~-,... . - I NSPECTO R:~;~.~ ' · INSPECTOR INSPECTOR DIRECTIONS:=' ' r ' ' 1. o" 'R s o=NCE: ~ SINGLE FAMILy ~ ONE ~ THREE ' ~ FIVE ~ ¢~LT E ~ TWO .., ~ FOUR ~ SIX ' : PERMIT NUMBER 2. WATER ~0PPLY ~ IN~.I'VI DUAL DEPTH OF WELL ~ 'comMUNITY ~ · DATE DRILLED : ' '~ p~'LIC UTILITY . Coh~ection. .: Verified. ~, LOG RECEIVED . 3. SEWAG~.~DISPOSAL SYSTEM ! PERMIT NUMBER - ' ~ INDIV DUAL/ON -SITE DATE INSTALLED '~ PUBLIC ,UTI LITY ..: Co'nnectibn Verified, INSTALLER .~Se~tic:~nk er ~ Holding Tank ::Size: fi f Tank is homemade SOILS RATING ~give dimensions: · TYPE OF ~A'NK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES. WELL' TO: - S.pt,./.o,d,~. ~..k .iA~,o..,,o. A,. ISewer Line ' Absorption Area to nearest Lot Line 5, COMMENTS ~ CONDITIONAL APPROVAL (letter must accompany certificate) . ~ ~ DISAPPROVED ' ~ ' - LE~L DESoRIPTIO ;--~ 72-01 - Date ALASY/'"OEPARTMENT OF HEALTH AND SOCIAL ,~ ¥ICES DIVISION OF PUBLIC HEALTH Lab. No. BACTERIOLOGICAL WATER ANALYSIS Office PLEASE MAIL RESULTS TO: NAME ADDRESS ~ITY ZIP CODE Sample collected by Phone No. Date Collected Sampling Address Time Specific place of collection REASON FOR SAMPLE SUBMISSION: [] mness suspected [] Health Regulated Establishment ~q Other WATER SAMPLE SOURCE [] Well Type of casing. [] Improved (Enclosed, Covered) Spring [] Surface (Reservoir, stream, lake) [] Holding Tank [] Other Sanitarian's Signature: Analysis shows this WATER SAMPLE to be: [~Batisfactory [] Unsatisfactory [] Questionable [] submit other sample [] Sample too long in transit t~ indicate reliable results. Sample should no~ be over 48 hours old at time of examination. [] Bottle broken or leaked in transit. [] Other SANITARIAN'S REMARKS ~,EAD NSTRUCTIONS BEFORE COLLECTING SAMPLE 06-]220 (b) B/~CTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1978 Date Collected C?'{'': "' 0 "/',' Source Date Received -2 ~? ., Time ReceiveO --, , p.m. Lab. No. Presumptive ~' ' 10mi 1Omi 10mi 10mi lOml 1.0mi 0..1mi 24 Hours 24 Hours EMB Broth 24 hours: Multiple Tube RePort; Membrane Filter: Direct Count Verification: L_TB Final Membr~ane Filter Results Reported By ~~' Broth 48 hours: 10r~ Tubes Positive/Total 10r~ Portions Collform/100rnl BGB Collf orm/100ml Time: / ,a.m. //~~, ' DEPARTMEN1. ?F HEALTH AND ~NVIRONMEIx ' PROTECTION [/~,~) ? 825 'L Street, Anchora'o~. Alaska-99501 ~ ~ F ~. Date Received: Septeger 19, 1977 #1: Time Date Insp #2: Time q:~,~('"J,6~m ~#3: Time Date Ii(~-II-~ta&5 Date Insp &~ Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska Mutual Savings Bank % Sheryl Smith Mailing Address: Post Office Box 1120 99510 Phone: 274-3561 2. Property Owner: Lloyd W. Chaves Mai~ing Address: Box 199 Chugiak 99567 Phone: 688-2048 279-3537/w 3. Legal Description: Lot 5 Eklutna West Subdivision 4: Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Three Number of Bedrooms: e e Well System: Permit # Construction Individual WO&i (') Community/Public System (x) Depth of Well Well Log on File ( ) Bacterial Analysis Sewage Disposal System: Permit # Septic Tank Size Absorption Area On-site System (x~ Public Utility ( ) Installed Installer Manufacturer Soils Rate Material Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Sh~ ~1~'~ G. Smith -- Alaska Mutual S~'%ngs Bank P.O. Box 1120 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~., 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO , VA 2. Property Owner: l',lnyrl W. _~__~_>_tf~ ~ Mailing Address: Box 199 ChuMiak AK. (NHN Tina Lane 3. Name of Buyer: , -0- FHA__ ,CONY ×, Day Phone: 688-2048 W~. # 279-3537 Mailing Address:. 4. Name of. Lending Institution: Mailing Address: P, 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: A]..~a Mutual Savings Bank Box 1120 Phone: Day Phone: 27493561~ Phone: Location: 7. Type of Facility to be Inspected: Single Family Home 8. Water Supply Type of Supply: Public Utility X If Individual, number of dwellings presently served If Individual, depth of well. 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation No. Bdrms. 3 rlndividual Individual (on-site) X 72-003(3/76) Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Faciliti~ Legal Description: Lot 5 Eklutna WeSt Subdivision Comments: Affadavit Attached Disapprov~: g Letter Attached: ( ) Date: S-4557 ~' EKLUTNA WEST, LOTS'SA & 6A - The Municipality of Anchorage has receival~~-, ' petition from Lloyd Chaves to resubdivide 1.271 acres from two lots into two differed' Approved subject to: 1. Resolving utility easements. AUG 2 91977' 06~'~1~2(~[a)- Re"~1"~73 ~ .ALASK. 2EPARTMENT'OF HEaLTH.ND SOCIAL?S~'~S L~' ' ~ DIVISION OF ~'BEIC-HEALTH ': ~' ~" "~'· , ,. -, ~_.. ~/~ :...: . iNDiViDUAL~:N~:SGMi. PuBLic: ~ .- ~ -'~,, ' R A CT E R I O_L O-GI~C AL~W~AT.~: E R-. :A N A L YSIS ~ '~ ~ ~)ysis shows thlS Water S~pLE-to [[NAME ~ ~-~ ~ x / ~ '- ~ ? COMPLETE THIS SECTION ONLY IF WATEI~... , . IS AN. INDIVIDUAL SUPPLY :'-SAMPLE COLLECTED BY -DATE'COLLECTED ] ..... ~'~"~7'~'' T.~E COLLEC ~ ", Sample Collected From ~' Kltche~ 'Tap ~ ~ BatNrob~ ~ ~ Basemen~ Tap ~. ~ Other (List) - "~ ~. ~ ~ ~ . Well -- ~ Dug ~ Driven ~ Dtilled':~~ Bored SOURCE~ ~ S~tlng ~ Cistern ~ ~ -Wdlls--~ Wood ~ Concrete : ~ Metal Top -- ~ Wo~ ~ Concrete ~ Open Top ~ Con~r~t~ LOCATION: ~ In Basement ~ Basem~ ~fset ~ Under Hous~ ~ln Yard ~ Other Tile Seepage C .... Oth~( P~s~e :: MATERIAL: Building Sewer- ~ Cast Iron ~ Wood ~ Tile ~ Fibre' GENERA{: Does Water Become Muddy or Discolored? ~ Yes ~)No Diameter of Well aepth ~ .~et. [] Questionable ' '- I~1 Sample too long in transit; sample should .not be over _4 hour¢-old at examination to lndlcate.relldble re~ults.-PJease [] Battle broken ip. transit, please send new sample,:' ~_% Well Cas,ng ~ .~ Diameter De th Mater a ~ , ~ -'~ -- -- P .' PUMP LOCATI~)N: [] In Well :~.~Basem~t~.. ~ [] In Basement [] Room On Top ~ o~ w.. O ot~,,. ~_ PURPOSE OF EXAM~ATICN: Illness Suspected? B Yes Ne~ ~our~e of ~upply~.. B Yes ~ N~'.~epairs to System? B-Y~s ~N~'- Signature READ INSTRUCTIONS ON REVERSE' SIDE BEFORE COLLECTING Lactose'Broth 24" H~urs ~ ' , -' · - Brilliant24 I~our sOr~een -,.~, 48 Hours EMB ~, '--.~ . AGAR '' ' - ' , Lactose Broth, 24 hrs, . ~18 hfs t'.. Greta's stain' Coliform Density. ' "~' (M~st prol~able. No ~per MF Results . - (¢ "