HomeMy WebLinkAboutCREEKSIDE PARK #1 LT 53
GREA cR ANCHORAGE AREA BOR _ dH
Department of Environmental Qualitv
3330 C Street
Anchorage, Alaska gg§03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LEGAL DESCRIPTION ,/ ~ I
SEPTIC TANk(,: , , ---.~-
D, STANC E~' ~__~...~;~''~';
FROM WELL /~lrl~l' MANUFACTURER
INSIDE LENGTH
INSIDE WIDTH
%,¢ NUMBER OF
~"~ COMPARTMENTS
LIQUID DEPTH LIQUID CAPACITY GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL
FOUNDATION
NEAREST LOT LINE
TOTAL LENGTH
OF LINES
NUMBER OF LINES
DISTANCE BETWEEN LINES
TRENCH WIDTH.__ IN. TOTAL EFFECTIVE
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE__
IN. ABOVE TILE IN.
WELL:
TYPE _
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE_
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE__
REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK __ SYSTEM ,
DISTANCES: --
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL: Cd/' .'~
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
Form LQ-D32
GReaTeR ANChORAGe AREa BOROUGh
DEPARTMENT OF' ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
INSTALLATION ~o~lo. ~ ~'~ ~' ~ '~ ~
INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT
TYPE AND SIZE OF FACILITY TO BE SERVED ~ . /
FINANCED THROUGH
PERMIT NO.
DRAIN FIELD OTHER
TO BE INSTALLED BY ~'L~//~
SOIL TEST RESULTS
NOTE:: THIS PERMIT IS NOT VALID WITHOUT BOIL TEST
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 TO SEEPAGE PIT WALL
SEPTIC TANK ., SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAin FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, , SEEPAGE PIT
TO RIVER, LAKE. STREAM.
SEEPAGE AREA SIZE
, DRAIN FIELD
., DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
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.
TYPE
DIAGRAM OF SYBTEM
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.
~ /' ~f /~J~PPLICANT'S SIGNATURE
~oe~ NO. =e-o~ e
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received June 30, 1976
Time of Inspection 2: 30
Date of Inspection 6-30-?6
REQUEST FOR APPROVAL OF Wednesday
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
~.L. King
7600 Dover
Phone:
Phone:
333-8538
Legal Description: Lot 53 Creekside Park Subdivision
Location:
7600 Dover
e
e
Type of facility to be inspected Single Family
Well Data:
A. Type
Public Utility
C. Construction
Sewage Disposal System:
A. Installed
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
Distances:
1. Size
1. Absorption Area
Total length of lines
No. of bedrooms
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
B. Depth
D. Bacterial Analysis
On-site system.
B. Installer
2. Manufacturer
2. Material
, Absorption area
, Other contamination
, Absorption area
, Sewer Lines
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION L?:: · ,-:: :~ ,'~
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO
2. Property Owner: /'7/
Mailing Address:.~ ~
VA FHA
i ECEI
CONV
Day Phone:
3. Name of Buyer:
Mailing Address:
Day Phone:
4. Name of Lending Institution:
Mailing Address: Phone:
5. Nameof Realtoror Agent: ~-~/~ ~--- ~-~ ~/~- z~_~./~Oc~,.~ ~ ~~/~J~' ~~-~
MailingAddre~:~2~ ~ W~ '
6. Legal Description: ~ ~ ~ _5~_~ ~ ~ ~'~ ~/~ ~ ~-~ ~ ~/~Y~-~
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
No. Bdrms. ~Z
Public Utility. J 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
Individual (on-site)
J
72-003(3/76)
Page 2 of two pages - R~ ~t for Approval of Individual Jr & Water Facilities
Legal Description Lot 53 Creekside Park Subdivision
Comments
Approved ~C~'D[/ ~,oJ~/,O~x_. Disapproved Date 6-30-?6
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" Street, Anchorage, Alaska 99503 274-4561
Perc Test
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Date Received June 10, 1976
10~/a .m.
6-1~7_ 6 Friday
Kennedy
1. Approval requested by:
e
4.
5.
6.
Mailing Address:
Property Owner:
Mailing Address:
H.L. King
7600 Dover
Phone:
Phone:
Legal Description:
Location:
7600 Dover, off of Muldoon Road, ~ is on the house
Type of facility to be inspected
Well Data:
A. Type
C. Construction
Sewage Disposal System:
A. Installed
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
Distances:
1. Size
1. Absorption Area
Total length of lines
No. of bedrooms
B. Depth
D. Bacterial Analysis
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
B. Installer
2. Manufacturer
2. Material
, Absorption area
, Other contamination
, Absorption area
, Sewer Lines
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page ~o~%wo'.pages Re,'
t for Appro~al"of IndividUal~ · r & Water Facilities
Le. gal D~scription Address: 7600 Dover
C omme n ts .
Approved
Disapproved Date
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)