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Home My WebLink AboutBEEDE BLK 1 LT 9b MUNICIPALITY OF ANCHORAGE ~ DE ,TME.T OF HEALTH A.D.UM^. SER~ -=S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~ame DISTANCES Address '-~ E ~ ~ OO R E ~ SEPTIC ABSORPTION WELL ~ TANK FIELD Pho..~,) Ip.~m,, No. INo. o, B:rooms WELL L~A~ O~SCR,PT,O. LOT LINE Lot 1 Block I Subdiv,si~ ~ / ~ P ~ FOUNDATION ~' Township, R~nge, Section AS-BUILT DIAGRAM (Show location of well, septic system, property Ime~ TANKS .,;~~e,. N Manufacturer Capacity in gallons ~01~ ~"f, )lA Material No. of Compadments TYPE OF SYSTEM ~ TRENCH ~ BED ~ W. DRAIN U OTHER Depth to p~pe bottom from Total depth from original grade or,gma~ grade ~' ~ FT I, ~ FT Fill added above original grade Gravel depth beneath p~pe ~ FT ~. ~ FT . "' Total ab~rphon area Distance between lines Numberothnes Soilratlng Pipemateria, ~_~/~ ~,~ Installer ~"" Date Installed WELLS a~,~-' / ' ~ PRIVATE {~STt.~) ~ OTHER (Identify) ~¢S / Classllication (A,B,C) ~ota, Depth I Cased to / Installe~ Date Installed:/ , Hi ~, ~ P~J~N~ ...... ' ~.: ...... SEAL I¢ I ~/8 7 Municipal and State guide ines in effect 0n this date: . Health Depadmenl Approval: -~ F Date: 72-013 (3/85) A N C H 0 R A G E, A K '9 ci.~1:5 :l. 6 Lc)'L [.... (.:¢.: (.;i a ] I~ Su.l::,d:Lv:L~iJ. oi"~: BEEDE L.c:)'t:.." 9 B].(:aci-::: ~ii~ (<.:.:, ,:::: t :i. c:)r; ',', :::...: :}. "r c.)t...or'; sh :i. r:). :', :l.;?.J',l ,:",..~":'t I%. ci... (~c, :1 '-',::: J...,c)t S:i.:~.:e 5,,,':::i4 A (sq,, ft. c:,r a,':::r~es) }'"}a::.~ )::?,ecl r'. (::) c) n'r!!!~ :: 'fh :}. s J:::: ;.:.:.:, r' m :}. '!:: ...'.1. 'T'c:,'L a ]. Cap ac: :L-I:..y. :: -'.'-'1. ,MUNI~IPA. LITY OF ANCHORAGE ENVI'P. ONMENTAL SERVICES DIVISION C MUNICIPALITY OF ANCHORAGE O ]987DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 E IV E D so,.s .o~ - .~.co~,o~ ~s~ [] SOl LS LOG PERCOLATION TEST PERFORMED FOR: ~ ~. /~lv~r~ re~,'~¢~c e DATE PERFORMED: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 lo SLOPE L/'T././. SITE PLAN 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER S ENCOUNTERED? N L O IF YES, AT WHAT flZ. O b~et',$~I~('- DEPTH? ~/~?1~7 ee THEODORE F. MOORE ". CE- 3589 ."' Gross Net Depth to Net Reading Date Time Time (~ ¢'t~n) Water Drop PERCOLATION RATE '~, ~' ;1(::¢'l TEST RUN BETWEEN ~, O COMMENTS /~ ~ ~ ~'~, o ,m (4.0 ~ ~1/ ~~ ~ See o~c~-~ ~ ~o' x ~' ~fie~r PER~O~UE~ B~: ~/O~ ~ ~ CE~T~ED~: 72-0O8 (6/79) SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS ~P DATE PERFORMED: ~'/3 /~'~' SLOPE SITE PLAN i THEODORE F, MOORE '. CE- 3589 eeeeeeee WAS GROUND WATER S ENCOUNTERED? ~ L 0 P IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: ~"(/~_...4'~II]~ '~C~/I;t¢~. J' ,.~,~"/,/t'¢~' CERTIFIED BY: ~r'~.,~ ~ DATE: ~/$/'~"7 72-008 (6/79) [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 3 4 ? 8 SLOPE DATE PERFORMED: ~/ I,,~ /8~ SITE PLAN lO 12 13 14 15 16 17 18 19 20 COMMENTS e® e®eelee®~el®elee~e THEODORE F. MOORE CE - 3589 WAS GROUND WATER S ENCOUNTERED? ~ L 0 E IF YES, AT WHAT DEPTH? ~'a.~ ~'"'er, f*'~f Gross Net Depth to Net Reading Date Time Time (~ ¢'t;~_.) Water Drop preCc~elr BI&flaT ~.'2~ ~7 ~ PERCOLATION RATE ~ (minutes/inch) TEST RUN BETWEEN I.,,~ FT AND ~'~) FT PERFORMED BY: F~::~A/~ ~'~r_.X ~"t~C,/ DATE: 72-008 (6/79) [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 Co~ I~/,~ s~odX ~r~el /00 o ~ l~clrm SLOPE (/7-. ~e #~') SITE PLAN 10 11 12 13 14 15 16 17 18 19 2o WAS GROUND WATER S ENCOUNTERED? )~ L O IF YES, AT WHAT E DEPTH? THEODORE F, MOORE CE-3589 COMMENTS Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: DATE: 72-008 (6/79) Lo~ 6 / / / LOT ? I l I ' ~ TA T~ PAR I< Aff6~ APPRoXtr'tAT'~ ! S IT~ PI-AN -CcAA~..' F}..s htoT'~ D 09-'08-87 2570 60,,nh ~.S O. OOST O. OOCD 00 '.~ 6 09-33 GREI, ANCHORAGE AREA B0F Department of Environment Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION /'~,~ ./~_~_~/~ ~D~ MAI LING ADDRESS LEGAL DESCR,PT,ON SEPTIC TANK: DISTANCE ./ FROM WELL~/~F~///¢~//¢~ MANUFACTURER ~-~'~ / INSIDE LENGTH ~'-'~---' INSIDE WIDTH MATERIAL. __.~ ~:;~ NUMBER OF' / COY PA RTM ENTS _ LIQUID DEPTH ----- LIQUID CAPACITY JZ/~l GALLONS. TiLE bRAiN F;r'LD: DISTANCE FROM WELL NDATION/~/.,¢.~¢¢'~-¢'~''~ NUMBER OF LINES ~/~ ... DISTANCE BETWEEN LINES ABSORPTION AREA_ d'(/u SQ. FT. DEPTH: TOP OF TILE TO FINISH GRADE · NEAREST LOT LINE' //~-/~ /'/'' TOTAL LENGTH _ OF LINES ..... /E~ .TRENCH WIDTH -- IN. TOTAL EFFECTIVE LENGTH OF EACH LINE DEPTH OF FILTER / MATERIAL BENEATH TILE ~_ IN. ABOVE TILE ~ IN. WELL: TYPe //'~_ ¢~/~z~"~/ .CONSTRUCTION DEPTH B U~ll L~G .... ---~EA REST NEAREST ~ SEPTIC S~AGE. ..... - __, SEWER/L.I~__, TANK__, SYSTEM FOUNDATION CESSPOOL , OTHER SOU~ DISTANCE FROM: APPROVED DISAPPROVED REMA R KS DISTANCES: DIAGRAM Of SYSTEM SEWER LINE DEPTH: ~ // LOT SLOPE: Form PW-027 GreATEr AnchOrAgE Area BOrOUgh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C"STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. NAME OF APPliCaNT ~'~Q INSTALLATION OF: SEPTIC TANK ~-=--~/~- '"~' TYPE AND SiZE Of FACiLiTY TO BE SERVED ~ DRAIN FIELD OTHER FINANCED THROUGH COMPLETION DATE ANTICIPATED TO BE INSTALLED BY ~/~'~T'* L~..J-U~ __ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLIng_ OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BI, SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ~ ~ TYPE SEEPAGE SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK fOUNDAtIOn TO seePAGE Pit SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ~v( . SEEPAGe Pit TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD /~)/~ F DRAIN FIELD ., DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD SEEPAGE PIT SEPTIC TANK, ~ ., SEEPAGE PIT TO RIVER, LAKE, STREAM. ., 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 INSTALL~N. G.A.A .B · OR LICENSED DESIGNER 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. FORM NO. E(~-01 6 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For T~. ~o~¢~___ Dated Performed ?/~/))~ , Legal Description: Lot ~ Block / Subdivision ~/~ This Form Reports Soils Log ~ Percolation Test__ - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics 3m 4 5m / 11~ 12-- 13~ 14~ Was Ground Water Encountered? If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit or Trench' C 0 M M E N T S: c/~o/~, ~I ~/~ ~; ~ ~ ro ~ / Test Performed BY Date Certified BY: Date: I; / 'fi: 2:. r~ -~-~C,- ~ cHo -- -~ .... E , ECHO STREET '-'4 O~ <C ITl C) m C. g c