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Home My WebLink AboutALDER PARK LT 6 ! ~~~ 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 ],%'SPECT~C,%' P, EFORT PHONE I [] NEW NAME L~.~i'~ --~ ~ ~PGRADE MAI LI ~g ADDR E~S LEGAL DESCRIPTION LOCATION ~ - - ' -~Q Well ~ Abs°rpti P ~ DISTANCE TO: /~ ~ ~) ~a~ea Dwelling' ~Z Manufacturer ~~ ~ M~rial~~ No. of compar~ents . Liq. capacity in gallons IF HOME,DE: Inside length / ~ ~/[~ Width ~/A Liquid depth ~, DiSTANCE TO: Well __, / ~:elling ' PERMITNO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~ Well ~ Foundation/ Nearest lot I~ne PERMIT NO. ~ DISTANCE TO: ~ ~ ~. ~O ~ ~ No. of lines Length of each line Total length of lines Trench width Distance nes J ~ 0 ~0 ~ inches h ~ ~ Top of tiJe finish grade Material beneath tile tl TotaJ effective absorption area ~ ~ / to ~ ~ ~ inches Length Width ~ Depth PERMIT NO. ~ Type of crib Crib dia~r / pth Total effective absorption area ¢~ DISTANCE TO: Well ~ ~ / / Build~gfoundat, on., t Nearestlotline ~ Class ~ Depth · I / /~ Driller Distance to lot line PERMIT NO. ~ ~ DISTANCE TO: Building ~n ~wer line Septic tank Absorption area(s) OTHER PiPE MATERIALS ~ ~ ~ ~ ~ ~ ~ ~ '~' ...... - SOIL TEST RATING INSTALLER/~~---~----:, REMARKS hi APPROVED DATE LEGAL 72-013 (Rev. 3/78) F'ERMIT NO. DEPARTHENT C HEALTH AND ENVIRONMENTAL : 3TEC:TION 825 gL' STREET, ANCHORAGE, AK. 995~3 264-4720 ~3r4--_c;.ITE '_-%EL4ER F"E~:F4 I T' 788420 > rdo AF'F'LICANT ROY ,~. CHARLENE HUNDORF 8~21 EN[:,IC:OT '-' '~' '~'- .... LOCAT I ON END I COTT .-.-:t ,. ,=_._ SAURRE FEET LEGAL L6 88 ALDER PARK S/E:, LOT SIZE --, -'"",.M _ TYPE OF SO I L ABSORBT I ON SYSTEM I S: TRENCH /. y ~,-.... -= t ~ '" ,-_,.~ MAXIMUM NUMBER OF BEDROOMS :~."' SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS' ~ m]RA~/EL [~EF'I'H= ~: [)EPTH= 12 LENGTH: '~'~ THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION <IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIF'E AND THE BOTTOM OF THE EXCAVATION (IN FEET>. ~:E'Y~U I RED SEF"T I C: TR~-~-':-: S I ZE= ±~-:3£1~.Ut mgRLI_mZ~[-4Ss F'ERMIT RPF'LICRNT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE: INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T'~J~3 <2) I NSPE~STIO[4S F-I~:E RE6~I] I REE> BH..KFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL E:Y THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR A PRIVATE WELL~ OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE T~PE OF PUBLIC WELL. OTHER REQUIREMENTS MA~ APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRRMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'ERI'"I I T E×P I RES DE£:Er-IBER ~ ..~-~- ::L .. =.'L ."_'~- 7 :~ I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENL. RRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. APPLICANT ROY & CHARLENE HUNDORF ISSUED _UAl - ~,. SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-2221J SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST LEGAL DESCRIPTION: 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O DATE PERFORMED: ;LOPE SITE PLAN ' WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ~ FT COMMENTS '~,~.~_ ':-i.,,~r~.~.~.,-,< Mo~ ,~ ,~.,~~-~ [ ~ ,~ L~ 72-008(7176) ~ ,.x . DATE RECEIVED INSPECTION APPOINTMENTS TIME i TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP ECTO R MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF AHCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIROI'qME,~ii',.~L , ~ ~CTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION JUL Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proces~d. Please allow ten (10) days for processing. 1. P~RTY OWNER l, PHONE PROPERTY RESIDENT (If different from above) PHONE 2. BUYER ~ . PHONE MAILING ADDRESS 3. LENDING INSTITUTION I PHONE MAILING ADDRESS 4. REA,~OR/AGENT ~ PHONE 5. LEGAL DESCRIPTION STRUT LOCATION 6. TYPE OF RESIDENCE [~--'"~SI NG LE FAMI LY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five ~ Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* ~1~ COMMUNITY [] PUBLIC UTI LITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE~* [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY , 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVI DUAL/ON -SITE F-IPUBLIC UTI LITY Connection Verified []Septic Tank or [] Holding Tank Size: ! ~:~C_~ If Tank is homemade [] ONE [] TWO PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED NUMBER OFBEDROOMS PERMIT NUMBER [] THREE [] FIVE [] FOUR [] SIX DATE INSTALLED INSTALLER SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line [] OTHER Septic/Holding Tank IAbsorption Area ISewer Line JNearest Lot Line 5. COMMENTS ~-/'APPROVED FOR ::'i. BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79) CHEMICAL & GI~ LOGICAL LABORATORIES ~ 'ALASKA, INC. · TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I I I I.D. NO, Water System Name Phone No. Mailing Address City State Zip Code SAMPLE DATE: MO. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose ) [] Treated Water [] Untreated Water SAMPLE NO. 1 4 LOCATION Time Collected Collected By 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 II I-]-} II I-I-] I I *No of colonies/lO0 mi or NO. of Positive portions READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collacte(t Source Date Received Time Received -- p.m. Lab. No. Presumptive Z0ml Z0ml 10mi /0mi Z0ml 1,0mi 0.Xml 24 Hours 48 Hours Confirmatory 24 Hours 48 Hours EMB. Broth 24 hours: MultlDla Tube Reoort: Membrane Filter: Olr~ct Count Verification: LTB Final Membrane Filter Results Reported By Broth 48 hours: 10mi Tubes Positive/Total Z0rnl Pcwtloni Collform/lO0ml BGB Collform/100ml Date Tlme~ I.m. p.m. TNis ~eate~ a~':a VS s ¢:%.;,~is ~vhh "~ ,,':~teria~s h'm:sea ser¥ mmv, te quantities. Carelessness in coBecti~g Nave ';se reach the ~ahora er/a~, qt cMy as possfb~e vv~thN-~ a8 hours a'f{er ~e s~g~F ca~ce et ?Ne bacCeraeSeg;ca~ a~a~s~s ~s ~'~pa~red and resa~'~p~eg ~ be nec~ ANCHORAGE CESSPOOL PUMPING Star Route A, Box 144 ANCHORAGE, ALASKA 99502 Phone 344-2632 or 344-2453 I RECEIVED BY All claims and returned goods MUST be 3 7 9 8 accom~an,ed,, th,s b,,,. ~7~r~~ SERIES 609