HomeMy WebLinkAboutT12N R3W SEC 27 LT 7
GREA..,:R ANCHORAGE AREA BOR, JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE
FROM WELL MANUFACTURER
INSIDE LENGTH
INSIDE WIDTH_
MATERIAL
LIQUID DEPTH
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY___ GALLONS.
'~DRAIN FIELD: ~,..¢_~/~gJ¢o ~,'Jt~ ~ ~'
~O ~' TOTAL LENGTH (
DISTANCE FROM WELL (O~ '~FOUNDATION J~J~ NEAREST LOT LINE OF LINES
NUMBER OF LINES I DISTANC~ BET EN LINES ~/~ TRENCH WIDTH~ ''. TOTAL EFFECTIVE
ABSORPTION AREA ~ ~ SQ, FT. LENGTH OF EACH LINE ~ ~
DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE ~ MATERIAL BENEATH TILE~ IN. ABOVE TILE ~ IN.
WELL:
TYPE ____
BUILDING
FOUNDATION__
CESSPOOL
APPROVED
DEPTH
NEAREST NEAREST SEPTIC SEEPAGE
LOT LINE__ SEWER LINE__, TANK SYSTEM
CONSTRUCTION
, OTHER SOURCES
__ DISAPPROVED
REMARKS
DISTANCE FROM:
DISTANCES:
SEWER LINE DEPTH:
Form EQ-032
DIAGRAM OF SYSTEM
DATE~i~TAPPROVED
ANCHORAGE AREA BO[. 'GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~'/t/ '~'-'1~+c~N%~- ~ MAILING ADDRESS
SEPTIC TANK,:
DISTANCE
FROM WELL ~'
INSIDE LENGTH
MAN U FACTU RERL~Jf t~
MATERIAL~
NUMBER OF
COMPARTMENTS
INSIDE WIDTH LIQUID DEPTH
-- I_IQUID CAPACITY
GALLONS.
SEEPAGE PIT:
NUMBER OF PiTS ~ DIAMETER OR WIDTH j~l
~'- . LENGTH ~ , DEPTH
LINING MATERIAL~ON.V't~ CRIB SIZE: DIAMETER .Z/ DEPTH ~ /DISTANCE FROM: WELL
· I N'~-.O ! TOTAL EFFECTIVE
BUILDING FOUNDATION ~B,~ , NEAREST LOT LI . ABSORPTION AREA (WALL AREA)
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE .O Y~ M P',~' ~
BUILDING
FOUNDATION LOT LINE
CESSPOOL OTHER SOURCES
NEAREST
SEWER LINE
DEPTH DISTANCE FROM:
SEPTIC ~1 SEEPAGE ~05/
TANK , SYSTEM
APPROVED
. DISAPPROVED _
DISTANCES:-~0 N$~ 0
REMARKS
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE.~N~ ~ ¥"~
Form NO. EQ-031
DATE ~'.o- "X~,qo,- "J '3
App R OV E D ~.~'.i'~, - G.A.A.B.
. ' ~ ~ ........ ~ .... GREATER ANCHORAGE AREA' BOROUGH ,'~t~)~ ~. ...........
:.~-:~:.,. :~_ .:..~ :~ S~AGE DISPOSAL SYSTEM ~ APPLICATION 'AND PERMIT ........
-~. ~ ~/ ....
TYPE AND SIZE O~ FACILITY TO BE 6ERVED '~:~ "~ ~/~ ~ :~/~ '"
,.-F]N~ INSPECIION: ~4 HOUR NO?ICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL IN$PECIION BY THE
~IEPTIC TANK SIZE //~/~//~ TYPE
~,. FOUNDATION TOSEEPAGE PiT ~ DRAIN FIE~D
SEPTIC T~NK ~ ' ' :'~ ~AGE PiT ~ / DRAIN FIELD
WELL TO SEPTIC TANK ~ ~ ' SEEPAGE PiT ,
SEPTIC TANK. -/~/~ :~.SEEPAGE PIT r/~ ORA N F ELD
4 I~CH DIAMETER CAST IRON 81PHON P PEg ON ~EPTIC TANK AND gEEPAGE'P T
:'.?.~ . . ~ . .'.:'.: .,, : ,
..~DESCR BED SY~TEM,I~I IN ACCORDANCE W TH SA a CODE
:,,..- ~'. -..~. .... .-... ,..; :: ..... . .
DEPART[,'I£NT -0 F ENV IRON MFNTAL. QUAL I TY
....-. ~3330 "C"' Street :.. ::'".. -
-- 'ANCHORAG£, ALASKA 9950'3
)treed 'F0r~:'::' ~;' Rou Summerville ~., ' P~ed April 2, 1974 '
~g.a~ D~Sc.iptt:o~= :'Lo~: ~ ~oc~ " S'ub-div~sion.(~E.'22~12N,'R3W, S~
~'?"- Sott Test:.Must Be' Logged To 4'.. Below;Proposed seepage s~lstem "'.::'::
Depth
Feet
Sot1 characteristics
Orsantcs (Pt) .
Gravelly sand (GW "SW), light brqwn.to
buff, gravel to. 1.5",- well roQndedl trace
of eilt,' low moisture - - :
--'"~:'?' Gradatio~al change to coarse stindy gravel-
-- .... (GW - SW) with trace to minor amount Of
· :: - · 'silt; Iow mol~/tu~e .
,~.,.: ,. ql · - .....:,: .
F3:::,':~' Sll* grave[ (OM), light gray; low moisture
low mo[8~o conten~ -. -
:Reading ~ Date ,, -'Gross Time Net'~Ttme -Depth to. H20 Net Oro
mrcolatton Rate Minute
~}::'F: Proposed'Installation: Seepage Pit xx Drain Field
~!~;"."Depth of Inlet Depth to Bottom of Pit O~ Trench
~[4HENTS 1,. Based upon GAAB requirements, we recommend 155 sq. ft. per bedroom.
mst Peeformed BY Howard$. Grey/JohnJameso. n
L~$KA ,~INIgP. A~r'. "&. ,MATERIAI...$. I.:,AB
"Date Certified BY:_ Date.: .......
.: -- ;'..,, 3..- ': :, '~'"
GREATER ANCHORAGE AREA BOROUGH
SOIL T[ST ~ESULTS ~ ~ ~ //~~ __ NOTE, THIS PER~IT I$ NOT VALID WITHOUT
5 ft.
SEPT,D T^~K 5 ~, SEEPAGE P,T 20 ft. O.^]N F,EL~ ~
WATER MAIN TO SEPTIC TANK DRAIN FIELD 10 ft.
ALSO CONSIDER AREA WELLS·
sE~^~E P,~ _10
SEPTIC TANK, 25 ft. SEEPAGE PIT 100 £t,. DRAm F,E~D ~50 ft, I
TO RIVER, LAKE, STREAM,
CAST lEON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION ~ FEET INTO UNDISTURBED SOIL.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
HOUSE
ANCHORAGE, ALASKA 99501
CASS
Performed ro~.,~Z, /~¢(~ ~/¢_¢'6~¢~ . Date Pevfovmed,,,C.3,?,~,
Legal Descrip(ib}: Borg, lock S~d~vzsaon~~.~ L~~
Th~s r Reports a: So~ls 'Log ~ - . .I~dola~idn Tes~
. -- FO ~ .... --- . ..........
Depth
Feet Soll ' ' '
Cha~ac ~eP~s~cs
~ ~,~:::'t ~'~· ' LqJ~4
~ Mc., i /I Vili
--/.~ I., . ... r' ,i
I.f Yes, At What [:gpth~ · '
Location Sketch
I
I
Depth To H20
Net Drop
Pit ~" Drain Field
n ' ' ' ......
:~~De, taro Bottom Of Pzt O~ lrenoh
MUNICIPALITY OF ANCHORA6E_
· DEPARTMEx-~ OF HEALTq AND ENVIRONMEN~_ PROTECTION
825 L Street, Anchorage, AlasKa 99501
279-2511, ext. 224 or 225
Date Received: June 28, 1977
#1: Time 10:00 a.m. #2:
Date 6-29-77 Wednesday
Insp Willis
Time
#3:
Time
Date
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: First National BAnk of Anchorage
Mailing Address: Post Office Box 720 99510 Phone:
2. Property Owner: Gerald D. Fletcher Phone:
Mailing Address: Star Route A Box 342A 99507
344-3246
Legal Description: T12N R3W Section 27 Lot ~
4: Single Family Residence: ( ~ Number of Bedrooms: three
Multiple Family Residence: ( ) Number of Bedrooms:
5. Well System: Individual Well (~ Colrmlunity/Public System ( )
Permit # Depth of Well 168' Well Log on File ( )
Construction (~-(3~ Bacterial Analysis
Sewage Disposal. System: On-site System
Permit ~ Installed 1973
Septic Tank Size.
Absorption Area ___~..q~
Distances: Well to Septic Tank
to Sewer Line ~ Nearest
to Nearest Lot Line
(~$ Public Utility ( )
Installer S~ ~ ~_C~/~C'~
~ Manufacturer ~ ~S'~z~C(C ,~--~
Soils Rate {~(~/~ Material
~ 0 ! to Absorption Area
Lot line ~0 + Absorption Area
.,Pa~ Two''
Department of Health and Environmental Protection
" Request for Approval of Individual Sewer and Water Facilities
Legal Description:
Comments:
T12N R3W Section 27 Lot7
Affadavit Attached: ( ) Letter Attached: ( )
Approved: O~
Disapproved:
Date:
bepartment Worksheet~-~ ^ ~
~MUNICIPALITY OF ANCHORAGE~-~
Department of Health and Environmental Protection
' 825 L Street, Anchorage, Alaska 99501
~7~~equest for Approval of Individual Sewer and Water Facilities
Property Owner:
e
Name of Buyer:
Mailing Address:
Phone:
Lending Institution:
Mailing Address:
Phone:
Realtor/Agent:
Mailing Address
Phone:
Legal Description:
Street Lo c a t i on: q~--/__~/~/~/~f-/~
Single Family Residence: ~) Number of Bedrooms: ~_~.
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well ~ Public/Community System ( )
If Individual Well, well depth /~
If Community System, name of system
Sewage Disposal System: On-site System ~ Public System ( )
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77