HomeMy WebLinkAboutCOTTONWOOD HEIGHTS BLK 1 LT 190 t:.1:0 n OOCl
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GRE'"'ER ANCHORAGE AREA BOF'~'IGH
Department of Environmental Qualit~
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING ADDRESS f,O, ~)0'~ 3- /"~l'Z't~
LEGAL DESCRIPTION ~1' IQ
PHONE.
SEPTIC TANK:
DISTANCE
FROM WELL
MANUFACTURER
MATERIAL~¢I~
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH
NUMBER OF
COMPARTM ENTSZ
.LIQUID CAPACITY.
GALLONS.
SEEPAGE PIT:
NUMBER OF PITS ] . DIAMETER ~'
LINING MATERIAL ~ CRIB SIZE:
!
DIAMETER__DEPTH DISTANCE FROM:
TOTAL EFFECTIVE
WELL
BUILDING FOUNDATION qg', NEAREST LOT LINE ABSORPTION AREA (WALL AREA) '''~'~
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE CONSTRUCTION
BU I LDI NG N EA REST NEA REST
FOUNDATION __, LOT LINE , SEWER LINE
C'ESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DEPTH
SEPTIC
, TANK __
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY:
PIPE MATERIAl ·
LOT SLOPE:
REMARKS:
Form No. EQ-O31
DATE '/'j~¢/~'¢
/ 7"
_/
APPRO ~4J ~'/~ ~
.A.A,B.
GREATer ANChORagE AREa BoROUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
LEGALDESCRiPt,ON /9
INSTALLATION OF: SEPTIC: TANK ~
TYPE AND SIZE OF FACILITY TO BE SERVED~
FINANCED THROUGH
PERMIT NO,
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PHONE
SEEPAGE PIT DRAIN FIELD OTHER
TO BE INSTALLED BY
SOIL TEST RESULTS
NOTE~ THIS PERMIT IS NOT VALI,D WITHOUT SOIl.
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.
SEPTIC TANK SIze /~_/~//)
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL ,
!
SEPTIC TANK ~ . SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TAnk /~}~
· _ . SEEPAGE PIT
DRAIN FIELD
TYPE ~j~EEPAGE AREA SIZE
DRAIN FIELD
., DRAIN FIELD
!
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
, DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, /6~ , SEEPAGE PIT TO RIVER, LAKE, STREAM.
,......~.CAST IRON INTO AND OUT OF CRIB CROSSING
EXCAVATION 5 FEET INTO UNDISTURBED SOle.
4 INCH DIAMETI:'~ C:.A~T IRON SIPHON PIPES ON SEPTIC TANK ~ND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOR/~H REGULATIONS REGARDING INSTALLATION.
G .A .A .B ·
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
Russell Oyster
694-2774
Civil Engineering
Soils b Foundations
Performed for:
0 8. E EIvdlNEERING 8. DEVELOi,',,'/IENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 333-5240
SOIL LOG
Mailing Address:
Legal Description:
Depth (f,eet)
Earl Ellis
333-5240
Surveying
Land Development
Tel. No.
Soil Characteristics
lO
ll
Ground Water Encountered: Yes~ No ~/ If yes, what depth i
Proposed Installation: Seepage Pit ~///Drain Field~
Comments: ~.< k'~,r~,~'¢-'> ~ ~~ ~ ~ ~
Performed by:
APPLIC" ~iT FILLS OUT UPPER HALF ONLY
Address Zip Code
Realty Co, & A~nt Phone
Address Zip Code
Type of Resl~nce
Single Family
Multiple Family No. of Bedroo~
~ Other
Water Supply
'~lndivldual A~ACH WELL LOG. A wall log is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach log If available).
~ Public Utility
Sewer Disposal
Year Indiv~ual Installed:
~ Public Utility ~:; ~ ~,' When/Connected to Public Utility:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date D at,~ .
Inspector Inspector Inspector Inspector
( j)~ ^PP~OVED B~DROOMS ~ 'COmTIONS O~ APPRO~imqrmmmntal 140tecU0n"
(/~ ) DISAPPROVED
I ) COND,T,ONAL APPROVAL'
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
Well to Tank Septic Tank Size
72.023 (3182)
CIIEMICAL & GEv,,OGICAL LABORATORIES ~. ALASKA, INC.~
TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER
274-3364 , 5633 B Street
· .-,. /7 /
"Drinking Waier A~al~ysis' fl'aport for Total ColifOrm Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
.. .' I.D. NO, /
Water System Name f, i Phone No,
M~iling
City State Zip Code
Mo, Day
SAMPLE TYPE:
[] Routine
[3 Check Sample (for routine sample
with lab ref. no. , I
D Special Purpose
[] Treated Water
~ntreated- Water
SAMPLE
NO,
1
2
3
LocATION Time
I :.,vf' :':~ /
' ' ~/'7:"
,. --/' , : 7~/,,'~
I ",,, . ,,.',~'. "~)~", ,'"'
I ,
, I
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[] Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample.
Date Received
Time Received - ," ::' -. ·
Analytical Method:
[] Fermentation Tube
~Membrane Filter
Lab Ref. No. Result* Analyst
I
I
*NO: of colonies/lO0 mi or NO, ot Positive portions
06-1220 (P)
Rev. 1978
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLe'
Date Coll~ct~l Source ,
Data Recal¥~:l Time Recalvegt p.m. Lib. No.
I~.,umpt lye 1Omi 10mi 10mi 10mi 10mi 1.Omi 0.1mi
-- 24 H.ourI
48 Hours
Confirn~tory
~4 Houri
48 Houri
EMB
Multiple Tuba Report;
Membrane Filter; DIr~t Count
Verification: LTB
Final Membrane Filter R#ultt
Reported BY '
Broth 24 houri= Broth 48 houri=
10mi Tubes Po$1tlv~/l'otsl lOml Portlonl
Collfoml/100ml
BGB
,,--, , Collform/100ml
Date
iomo
TIME .... "
DATE
THIS SIDE FOR OFFICIAL USE ONLY
I NSPECTI ON APPOI NTM ENTS
TIME
DATE
DATE RECEI~ED ' '
T ME
DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3, SEWAGE-DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
F'-IPUBLIC UTI LITY
Connection Verified
[]Septic Tank or [] Holding Tank
Size' lO00 If an i a e
'TYPE OF TANK
'TO'I'AL ABSORPTION AREA
4. DISTANCES'"
WELL TO:
Absorption Area to near~st Lot Line
[] ONE [] THREE []
[] TWO [] FOUR []
FIVE``` .... [] OTHER
SIX
PERMIT NUMBER
~)I~PTH OF W~LL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
~ILS RATING
MANUFACTURER
MATERIAL
Septic/Holding~Tank IAbsorption Area [Sewer Line
'] Nearest L~)t Line
5. COMMENTS
[] APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany
[Z~DISAPPROVED
DATE
LEGAL D ESCR I'TPTION
72-010 (Rev. 3/~8)
certificate)
S%even A. Johnson ,~?~ A~
Test Performed for
Legal Description
Number of Bedrooms
Day I
(1) Test Volume (TV) =
STil = 92 in.
(2) 1209 gal (eRi) + 45o
STfl = 92 in. Tfl =
Day I I
,iates P.O. !,ox 76, Chuc_ .k, AK 99567 6,58-30¥5
DATA SHEET - DRAINFIELD
Jim McGoldrick Date Started 10,/2~/_78~
Lot 19 Block 2 Cottonwood Ht~umper Rent-A-Can (85_0 gal)
3 Tank pumped XX yes no
3 bdrms x 150 gal/day = 450 gal/bdrm/day
Til = 1445 _
.gal (TV) = 1659 .gal (CRf)
1.5o5 _
STi2 = 92 in. Ti2 = 1_345__
(3) Surge volume (SV) = 0.4 TV = 0.4 450 gal = 180 .gal.
(4) 2609__gaI (CRi) + _I_SIL gal (SV) = 2789 gal (CRsv)
(5) 2609__gal (CRi) + 450 gal (TV) = 3059 _gal (CRtv)
(6) (a) 1545 .... To2 - 1355 _Tcrsv = 0.17 hr (Tsv)
(b) 134~___Tp2 - 1420 Tcrtv = 0.58 hr (Ttv)
(?) Surge capacity (XC) = SV = 118g ,g.al = 18 gal/min.
mln
Tsv
(8) Percolation rate (PR) = TV = 450 gal = 12.9 .gal/min. Ttv 35 min
gal/min x 1440 min/day = 4.50 . gal/day = 150 gal/day/bdrm(min)
3 no. bdrm
Day III (if required)
STi3= in
Ti3 =
Tf =
~i3 + 4 hr =__
Summary
Surge capacity (XC) = 18.0
Percolation rate (PR) = 12.9
gal/pin
ga!/day/bdrm
ned /~'~' /- ~ '[~.~
Si
g .........
¢, IEMIGAL & eEOLOelGdld. LABOI TORE8 OF ALA8KA, IN(3,
P.O. BOX 4-1276 ANcHOR~AGE, ALASKA 99509 4649 BUSINESS PARK BLVD.
Ddnking Water Analysis Report for Total Coliform Bacteria
TELEPHONE
(807) 279-4014
TO BE COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM:
I.D. NO.
Public W,.ater System Name
Mailing Address ,.
City State
Mo. Day Year
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
Z:L-Special Purpose L-0,,.<~/i/
Zip Code
[] Treated Water
~-; Untreated Water
SAMPLE
NO. LOCATION
1 /~ /9
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
LABORATORY:
NAME
ADI~,RESS
CITY
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
~'Membrane Filter
Lab Ref. No. Result* Anal~t
No. ol colonies 1100 mi. or No: of Poeltlve porflone.
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form No. 18-310 (3-78)
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collected Source.
a.m.
Date Received Time Received p.m. Lab. No.
Presumptive 10mt 10mi 10mi 10mi 10mi 1.0mi 0.1mi
24 Hours
48 Hours
Confirmatory
24 Hours
48 Hours
EMB Broth 24 hours:
Multiple Tube Report:
Membrane Filter: Direct Count
Verification: LTB
Final Membrane F~e~t's~ ~
Reported By //-/'/' ~ ~
Broth 48 hours:_
10mi Tubes Positive/Total 10mi Portions
Collform/100ml
BGB
__ Collform/100ml