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HomeMy WebLinkAboutT13N R4W SEC 32 SE4 NW4 Clithroe Detox Center Subdivision STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPLICATION FOR ON-SITE WATER AND SEWER SYSTEM APPROVAL I. GENERAL INFORMATION Legal Description of the Location Applicant Name Address (Street or P. O. ~ox) City, State and Zip Code Ap licant is: (Check one) ~l~ank [--]Certified Installer No,~//~/ L~~ Owner/Builder Type of Residence~,5~,. Tot~/~t~of Bedrooms []Single Family ~J ~ulti-Family Telephone Send pproval to: ~A~plicant [] Other: (Give Name & Address) I[. WATER SUPPLY SYSTEM Source of Water and Containment (Check all that Apply) Type of Water Supply System Treatment of Water (Check all that Apply) []Well (Drilled or Driven) [] Surface (Identify) ~]Private [~None r~Chlorinat[on [] Roof Catchment [] Other (Identify) [] Public (Serves more than one [] FiltratiOn []Mineral Removal [] Holding Tank family) []Other: Well Data Is the Height of the Well Casing more than 12" above the Ground? [] Yes [] NO is a sanitary seal installed on the well casing? [] Yes [] NO Is drainage directed away from or around the casing within a radius of 10 feet of the well casing? [] Yes [] NO Gate Drilled Depth of Well (Feet) Static Water Level (Feet) Yield (If Available)Gal/Min Pump Rate (If Available) Separation Distances from the Well Casing to each of the Foilowlng Sources of Contamination: Septic/Holding Tank on Lot ewer Lines on Lot Absorption Area on Lot Closest Septic/Holding Tank on Adjacent Lot ~losest Sewer Lines on Adjacent LOt Closest Edge of an AbsorptiomArea on Adjacent Lot If toxic materials are stored on the property, including fuel tanks, paints, lubricants and other petroleum On Lot on Adjacent Lot based materials, pesticides, fungicides or herbicides; indicate distance from contaminants to well casing: Water Sample Taken by: Name Sampler Is: I certify that the above information is correct: S gnature Tvped/Printed Name Title Date NOTE: Must be signed by aCertifled Installer, Professional Engineer, Department of Environmental Con~rvarion or the Owner/Builder 111. ~IASTEWATER DISPOSAL ' / [] Septic Tank/Absorption SYstem- k Holding Tank - Capacity of Tan [] Specify: [~New System [] {Specify Brand Name or Process) Package Treatme~) Where Waste is Disposed Other {Specify): [] {Outhouse, incinerator, etc.) Frequency of Pumping Date Insta[led Name of Installer ~///~~/~//A/il/~- /W~ ~*/--~//~ [] Owner/Builder [] Certified installer [] Other: Type/Manufacturer No. I Septic Tank Size (Gallons) Number of Compartments Soil Type or Rating ~ ' Dimensions/Size Soil Absorption System lIT /Ouantitv Backfill Material used for Soil ~ ~'~/'~ ~ Feet[ ~es ~ NO r ~ Yes ~ NO Dist .... to: P~/g ~eet ~/~ Feet ~ ~ ~ ~et certify that the above information is correct: Sigt3atu re Typed/Printed Name I ~'[tle, R, ag, NOTE: Must be signed b~ a certified instal/er, professional engineer or DEC Staff. [] Existing System Name of installer ~ [] Owner/Builder E]Cer~ed installer [] Other: Type/Menu Type Soil Absorption System Dimensions/Size Soil Absorption System Sackfill Material used for Soil %ion System Adequacy[] Pass Test[] Results:Fail equecymest Performed By:(Attach. ' ~ Copy of Report) Date Septic Tank Pumped (Attach Copy of Receipt) Minimum Ground Cover over Absorp- Minimum Ground Cov~over ,cover Septic Cleanout Pipes/Caps installed on Cleanout Pipes/Caps installed on Feet ~ Feet [] Yes [] NO [] Yes [] NO Typed/Printed Name Title, Reg./Cart, N~t. NO. Date I certify that the above information is correct: Signature NOTE: Must be signed by a professional engineer. SEAL Registered Professional Engineer ALASKA ENVIR~O-~IMENTAL CONTROL SERVICES, INC. 1200 west 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 '% / :i .( /bO ~: .T X' g'~ x /4~ ,¥ lq. OD Id- P ~x / :'DO ,oo OSI © 4O 120 60 4O 20 ....... ; ............................... S NGLE PHASE, 60 HZ p . · "~...j._'"~'"?"?"-'". ':'"i"'~'"?" '"r"!'"!'"i'"T"F'".'"F':" '"~"7'"~i ~ i -! ~ ! ..i...[...,~i...L..L ..~....L..:....i...L..i...~....~...!.....~...:-...:....:...-!..-!...~--.~ ........... !.., -.-i.--b.!..-i.--~:--i.+.-'.!''' -";:'"?--?'"i'-i'"*'"?-r" "1 --!'-="r' ~ i ! ! i ~ i..._!....~...L..L..i...i....L..L..L.; .J...;...~....~...!.--i-.-i-;..~-.-,-.-~.-.i--. ~..4.. '...i-..!--+- .q.-.? ~.--i--.i...~---~---?--?-.--.f-.i--~---'~--""T"="=' r-'-=- L.+..~....;...~ ....... 5--!---+- ---i-"f"! ........ ~--.~..h=--.-h-=-'?'!'":'"='?'"c"."'"~'"t"i'"'"'~-?.'"-.~" ~'-r'-%"F:'""'~ : ~ : : ..... '....i...; ......... ~...'...i......i....:...~ ......... :-..~ ......... ~ .-~------.~..-.--.:.-.; ......... ;..-.-..?+-~"--'-":-"~ ~'""."-'x'~ ........ ?-7'"':"'c'r'"'"'" 40 60 80 100 120 NET DISCHARGE, GPM 2826 Colonial Road Roseburg,OR 97470 503/673-0165 PRESURE HEAD HEAD PSI 0.125 0.1875 0.25 0.3125 1 0.43 0.20 0.45 0.79 1.24 2 0.87 0.28 0.63 1.12 1.75 3 1.30 0.34 0.77 1.37 2.15 4 1.73 0.40 0.89 1.59 2.48 5 2.17 0.44 1.00 1o77 2.77 6 2.60 0.49 1.09 1.94 3.04 7 3.03 0.53 1.18 2.10 3.28 8 3.47 0.56 1.26 2.25 3.51 9 3.90 0.60 1.34 2.38 3.72 i0 4.33 0.63 1.41 2.51 3.92 11 4.77 0.66 1.48 2.63 4.11 12 5.20 0.69 1.55 2.75 4.30 13 5.63 0.72 1.61. 2.86 4.47 14 6.07 O. 74 1 o 67 2.97 4.64 15 6.50 O. 77 1.73 3 . 07 4.80 ENTER PRESURE HEAD (ft) @ S19 5 ENTER LATERAL HOLE FLOW @ S20 1.77 0.375 1 · 79 2.53 3.09 3.57 3.99 4.37 4.73 5.05 5.36 5.65 5.92 6.19 6.44 6.68 6.92