HomeMy WebLinkAboutCREEKSIDE PARK #3 LT 33P rk $'D'
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~ MUNICIPALITY OF ANCHORAGE --~.
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage. Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
'NAME
IPHONE I [] NEW
MAI LING ADDRESS
LEGAL DESCRIPTION
J W.~/t~ J AbsorP,,o. area Dwelling PERMIT NO.
D~STANCE TO: ~,
~Z< Manufacturer 6~ ~) 6 ~ Mater~
~ ~ Liq. capacity in, aliens Inside length Width' Liquid depth
~. IF HOME,DE:
~ ~ Well Dwelling PERMIT NO.
~Z DISTANCE TO:
O ~ ~ Manufacturer Material Liquid capacity in gallons
Q Well Foundation Nearest Io~in~ PER~ NO.
~ D~STANCE TO: ~ ~
~Z No. of lines Length p~ e~ch line Total length o~ lines Trench width Distance between lines
~ ~ /~ ~ ~ inches
~ ~ ~ Top of tile to finish grade ~ Material beneath tile Total effective absorption area
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ 'Well Building foundation Nearest lot line
m DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
PIPE MATERIALS ~J
SOl L TEST RATING
INSTALLER
REMARKS
.., /
/
APPROVE DATE LEGAL
72-013 (Rev. 3/78)
DEPARTMENT ' HEBLTH AN[;, ENVIRONMENTRL '~?JTECTION
ON--S I TE '--~EI-qER LIpI_~D:HCJE F'ER~-I
PERMIT NCL ( 8tC~842 ',__ ·
RPF'LICRNT V.R. CHRON ?202 OLD HARBOR RD. __ ~,~0
LOCnTI,_-,N ?2e~' OLD HnRBOR RD.
LEGRL L33 D3 0REEKSIDE PARK S/D LOT SIZE 3::E:000
TYPE OF SOIL ABSORPTION S~rSTEM IS: TRENCH
Mm.':IM'_,M NUMBER OF E, Er, ROOMS = ~ SOIL R~TING <SQ FT/BR)= ~-~
THE REQUIRED SIZE OF THE SOIL ~BSORPTION SYSTEM
DEF"TH= 1:1_ L E I'-,! LilT H = ,42 Ci F-' Fl'-,," E L C, EF"TH= ~-_-;
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRBINFIELD.
THE DEPTH OF ~ TRENCH OR PIT IS THE DISTRNCE 8ETHEEN THE SURF8CE OF THE
GROUND 8ND THE BOTTOM OF THE E~CBVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRR9EL DEPTH IS THE MINIMUM DEPTH OF GRBVEL BETHEEN THE OUTFBLL PIPE
HND THE BOTTOM OF THE EXC89RTION (IN FEET).
~:Em;!IJ IRED, SEPTIC TR~-I~=C S I.-"~'-E=.~. ~L25~Z~ m3RLLC,~J-~_
PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RNY HELLS RDJRCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES THRT THE WELL HILL SERVE~
T~..Im] ~-'. 2 ) I ~SPECT I Cm~-~S ARE REL-J. lJ IRE[>
BRCKFILLING OF RN9 SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS
DEPBRTMENT WILL BE SUBJECT TO PROSECUTION
MINIMUM DIST8NCE BETWEEN R WELL RND RNY ON-SITE SEHRGE DISPOS8L SYSTEM IS
1OO FEET FOR R PRIVRTE HELL OR t50 TO 200 FEET FROM R PUBLIC HELL DEPENDING
UPON THE TYPE OF PUBLIC HELL.
MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND
TO ~ COMMUNITY SEWER LINE IS ?5 FEET.
OTHER REQUIREMENTS MBY 8PPLY. SPECIFICBTIONS 8ND CONSTRUCTION DI8GRBMS 8RE
8VRIL88LE TO INSURE PROPER INST8LLBTION.
F'EF.:rl I T E:~F" I RES [~.,Em]Er,IBER
I CERTIFY THRT
±: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEHERS RND HELLS RS SET
FORTH BY THE MUNICIPRLITY OF RNCHORRGE.
2: I HILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
~: I UNDERST8ND THRT THE ON-SITE SEHER SYSTEM MR¥ REQUIRE ENLRRGEMENT IF THE
RESIDEI',tCE,IS REMODELED TO I[/~U..IDE MORE THRN
_,
SIGNED: .......... ~,. ~_~__~:~__ ~'-"-~., I~o
RPPLICRNT ',,,. E. C:HF.'.ON
DRTE__?.' / 7- ~"/
Io1
e~'k~-e ~,I .
V4. 0
CONSTFtUCTION
TEST LAB
180C~NV. 48TH AVE. STE. 'C'
ANCHORAGE, ALASKA 99505
248-1535
PERFORMED FOR, =Vergil Chron
LEGAL DESCRIPTION: Lot 33 Block
THIS FORM REPORTS: n Visuol Soils Examination
DATE PERFORMED:
Subdivision
(~ Percolation Test
5/7/8!
DEPTH SOIL
FEET DESCRIPTION NOTES
¢
¢ Overburden
'3,
/
IQ / Gravelly Silt [D~p5
/ (Br~)
/~/
,-8' /
'/~
~.~ Gravel with Silt Dry
13'
'~ / Gravelly $£1t Damp
15' , ~/ (~r~ ,.,.~.~ ur
BOTTOM OF HOLE
WAS GROUND WATER ENCOUNTERED
IF YES, WHAT DEPTH
LEGEND
~) -- Perc zone
® S - Sample token
· -- Frozen zone
Np '
! II ' : I .I. LI ; ~: ,
iii ~ i '~!!i 3-;ii ~
-ii ~-' ! i I i i ~ : : ~ ....
' .! I '
' ...
~J .
I I I '
GENERAL SITE SLOPE
Water table
READING DATE GROSS TIME NET TIME DEPTH TO H20 NET DRAINAGE
PERCOLATION RATE: 5 min/inch DRAINAGE REQUIREMENTS: 125 sf/br
PROPOSED INSTALLATION: ~ SEEPAGE PIT ~3DRAIN FIELD ~ OTHER
COMMENTS: Percolation test was tried due to apparent silt in the soil. The water level
could not be maintained to saturate the hole and a test was therefore not
taken.
TEST PERFORMED BY:
K. Braun
DATA CERTIFIED BY: Kinney R R~ter
DATEMay 8~ 1981
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Time of Inspection/ '.~/)
of Inspection [~ '7 ~ '
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIFS
FOR
,.
1. Approval Requested By:
e
Address ~ Phone:
Prooert~ Owner: ~NJ~Lr~',~. ~ ,Phone,
Type of Facility to be Inspected: k_ ~,~
A. Type B. Depth .
C. Construction D. Bacterial Analysis·
7. Sewage Disoosal System:
e
A. Installed
C. Septic Tank:
D. Seepage Pit:
\ ~ 0 ,~ Installer .......
1. Size I 0O° . Manufacturer
1. Size ~%X 9 2 Material_
E. Disposal Field: Total Length of Lines
Distances:
A. Well To:
Septic Tank , Absorption Area
, Sewer Lines
, Nearest Lot Line
, Other Contamination
B. Foundation to Septic Tank
"~ Ab'sorption Area
C. Absorption Area to Nearest Lot Line
'Aequest for Approval ¢ ndtvidua] Sewer & Water Facilt' s
.Page T~o -- _
~ppproval Valid for On'e Year From Date Signed
G-.eeater Anchorage Area Borough, De~rtment of Environmental Qua lSt7
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true
and accurate representation of the subjec~ sewer and water facilities located at:
Signed Date
1. Agproval Requested By:
e
3.
4.
5.
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road· Anchorage· Alaska 99507 279-8686
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Address:
Prooertv Owner:
Legal Description:
Location
Type of Facility to be Inspected:
Number of Bedrooms: ~ ~ ~,,~
Well Date: r~ /' '":" *
A. Type
B. Depth
Phone
/
C. Construction
D. Bacterial Analysis
7. Sewage Disposal System:
A. Installed
B. Installer
C. Septic Tank: 1. Size
D, Seepage Pit: 1. Size
2. Manufacturer
2. ~N~erial
E. Disposal Field: Total Length of Lines
Distances:
A. Well To: Septic Tank
, Absorption Area
, Sewer Lines
, Nearest Lot Line
· Other Contamination
B. Foundation to Septic,Tank "; Ab'~orption Area
C. Absorption Area to Nearest Lot Line
· _ Re~luBs, t fo~ A~proval of In, idual Sewer & Water Facilities
Page Two ~
Comments:
A~rova] Valid for One Year 'From Date Signed
Greater Anchorage Area Borough, Department of Environmental Quality
D~AGRAM 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 facilit~es located at:
//
Signed