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HomeMy WebLinkAboutCONTOUR ACRES BLK 1 LT 3On L. 6-1 GAAB-HD-, G-' ~TER ANCHORAGE AREA ~,,.,_,,ARTMENT OF ENVIRONMENTAL QUAL,,, 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS LEGAL DESCRIPTION .,~Z~..T'"~., SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY ~---~,~'"~' .GALLONS. NUMBER OF _~ MATERIAL -~ ,~'-~,~---~'~---- COMPARTMENTS P~,-~// "~'~)'"'~ /-~'~'~'~'"'~"'"'~-'~/~/'~ LIQUID INSIDE LENGTH. ~ INSIDE WIDTH ~ DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE ETER OR WIDTH ~ / L DISTAN~ / BUILDING FOUNDATION.~ TOTAL~ ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL ./~'~ ~) NUMBER OF LINES_ / ABSORPTION AREA ---~ ~*¢=' ~ DEPTH: TOP OF TILE TO FINISH GRADE --~-- TYPE,~,.~2~'~ , DEP'J'H .-~'~--.,-~' ! NEAREST / SEPTIC LOT LINE /'~'~ ~ SEWER LINE//-'~ ~ , TANK / /-~. / TOTAL LENGTH ?~ , FOUNDATION ~,~ ~T~ , NEAREST LOT LINE ~-~ OF LINES .., .DISTANCE BETWEEN LINES TRENCH WIDTH '~' " IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE / ~ ?~ ~ DEPTH OF FILTER MATERIAL BENEATH TILE ~' . IN. ABOVE TILE DISTANCE FROM WATER BUILDING FOUNDATION. ,,"/-'~ '~ , SAMPLE /~,~D~/~'/~-''''', NEAREST .~._5""" j SEEPAGE ~' OTHER SYSTEM ,/~ Z'2 , C ES S p O OL,,~/,/~,~ , DISTANCES: DIAGRAM OF SYSTEM DATE GrE;ai'Er ANCHORAGe AREA BON, JUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH PERMIT NO. DRAIN FIEL~D ~ OTHER :> NOTE~ THIS PERMIT IS NOT VAUD WITHOUT ~1~ ~ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREM,,M~,?i~TS DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC: TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGe PST WALL SEPTIC TANK '~' . SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRA,N FIELD f~ WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK,. 2 ~ ., SEEPAGE PIT TO RIVER, LAKe, STREAM. , DRAIN FIELD SEEPAGE PIT SEEPAGE PIT , DRAIN FIELD 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. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER I CERTIFY THAT i AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BO~ORDINANCE NO. 28-68 aND THAT THE ABOVE DESCRIBED SYSTE~IN ACCORDANCE WITH SAID CODE. ~~/4~~ Augue~ S, 1~71 ZIOl Ottlr Dear Hr Sttgau~ Sincerely, [nvtrmmae#tel Specialist CREATER ANCHORACE ARiStA I% 32? ~AgLE A~'JCHORAC, E~ ALASKA 99501 CASE Performed ?or_.]g_o~ q ~"P-"~' ' Date Performee Depth ~,~ ~e~t c~ Chap:-~eT,~s.ics Locatio~ S~etch Was Ground Water Encountered?._~. ~ Yes, At Wk~,+ ~- ~ Depth Date Depth Tc? H20 Net Drop ' P ~ ~ Drain Piel.d COMMEETS: Test Performed By Data Certified Date~~ GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received  ~~~~~..~ ~]-/-~""~~ Time of Inspection J'©O Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Approval'requested by: ~v~_ /y_~-~/~ , t x /' ' Mailing Address: Phone: 2. Property Owner: /~ y~ Phone: Mailing Address: ~/~--/~'~ ~ -- /~~ 3. Legal Description: ~~ ~ /~ ~ 5. Type of facility to be inspected~No, of bedrooms 6. e Well Data: A. Type ~ C. Construction Sewage Disposal System: B. Depth ~.~ .9~ ,, . , >-'-Z ~-2f D. Bacterial Analysis ,.-.~d~(?~._ '~ - / A. Installed Z~ ~a'/,~/~7//B. Installer ~//4/ ~o~0 C. Septic Tank: 1. Size /~) 2. Manufacturer ;¢~',o~ D. Seepage Pit: 1. Absorption Area - · 2. Material . E. Disposal Field: Total length of lines ~ / e Distances: A. Well to: Septic tank Nearest lot line /~/~ / , Absorption area /~d/, Sewer Lines /JF~, Other contamination ~ · B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line ~w EQ-034 (1/74) Page 1 of two pages page 2 of two pages - Re~.Jst for Approval of Individual J ..,er & Water Facilities Legal Description Comments Approvedj~~-~ Disapproved Date ~'x.Y!,~Y~.~/J' Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner: ~~..~/ Mailing Address: x/~/Y /x~(~~- D y Phone 3. Name of Buyer: ~?~/--(J~~ Mailing Address: . ~/~~~~~. Day Phone~~/~/~~ 4. Name of Lending Institution: Mailing Address: ~_~-~ y~y~<~x Phone 5. Name of Realtor or Agent: Mailing Address: ~.~ ~ __~~~ P,,.. ~.~n _ Type of Facility to be inspected: Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well ~~' Sewage Disposal System Type of System: Public Utility If Individual, date of installation No. Bdrms. Individual (on-site) ,~,~ EQ-037 (1/74) GREATER ANCHORAGE AREA BOROUGH APPROVAL ADDRESS: PHONE:. PROPERTY DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 DATE RECEIVED: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR OWNER: LEGAL DESCRIPTION: ~ 6 ~J~ / / TYPE FACILITY TO BE INSPECTED:~C~ q~ WELL DATA B. DEPTH C. SIZE CONSTRUCTION BACTERIAL ANALYSIS ~Y~/~/(''''' 22 SEWAGE DISPOSAL SYSTEM: SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 1. SIZE /~ ~ 2. AGE /'q % 1 3. MANUFACTURER ~'~'~ ~ APPROVAL REQUESl .OR SEWER & WATER FACILITIL PAGE TWO B. SEEPAGE PIT /'V/~ ]. SIZE 2. LINING ///~ C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS A B C D E F G H WELL TO SEPTIC TANK WELL TO~ WELL TO ~EWER LINE WELL TO PROPERTY LINE /00 ' WELL TO OTHER POSSIBLE CONTAMINATION FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEEPAGE PIT TO PROPERTY LINE COMMENTS:, . APPROVED: ~.-~.-,-/~,ut~,..~ f~.~ DISAPPROVED: ^,~,ov^, v^~, ~o, o,~ ~. ~,o. ~ GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY DEPARTMENT OF II(}IJ'ING AND UR[~AN O[VELOPM[NT Form A ppr c,~*e:J Budget Bureau No, 63-R0296 I'IEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY ,AND SEWAGE DISPOSAL SYSTEM PART I.----TO BE COMPLETED BY FHA - I A~ORTGAGEE .?'. First National Bank Country Club O New installation Lane 111 -01 341 3-203 Anchorage, Alaska Richard D. & Norma D. Hilstrom Contour Acres Subdivision ~SEMENT . . 3/4 ~l~l SUP~Y IY: DEPARTMENT INSPECTOR'S SKETCH ! ~.ocK No [ t0¥ ~o. I 1 3 additional bedf~ome? (If Yam. ~ SYSTEM DESIGNED 1'~1 Yes O No D Community .w~tem 1~ Community system [~] ind,viduai i PART II.---TO BE COMPLETED BY HEALTH DEPARTMENT :it is the opinion of the D state F'-] Count,. [~ Local DePartment of Health that this individual water-supply system ITl is O is 'not sat,s£actory as a domestic water supply for the subject property.. It is the opinion of the ~ state ~ County ~1 Local Department of Health that this individual sewage-disposal sys; tern with proper maintenance: [~ Can be expected to function satisfactorily, and is not likely to create an.insanitary condition '4/'18/72 Cannot be expected to function satisfactorily