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HomeMy WebLinkAboutT12N R3W SEC 22 LT 17Dx-..Ot, GREA R ANCHORAGE AREA BORuuGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION / SEPTIC TANK: DISTANCE ~' ~L NUMBER OF FROM WELL MANUFACTURER [/--~-~-~ MATERIAL ~' ~_~:L,/ COMPARTMENTS INSIDE WIDTH INSIDE LENGTH LIQUID DEPTH LIQUID CAPACITY /~'~/--)GALLON$. , DISTANCE FROM WELL~'-,,~'5',",$~-[',(/~OUNDATION NUMBER OF LINES DISTANCE BETWEEN LINES NEAREST LOT LINE_ TRENCH WIDTH TOTAL LENGTH OF LINES 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 NEAREST SEPTIC LOT LINE SEWER LINE__ TANK OTHER SOURCES DISAPPROVED REMARKS DEPTH SEEPAGE SYSTEM DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: Form LQ-032 DIAGRAM OF SYSTEM SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTA'.LATIO, LOO^T,O,, O INSTALLATION OF SEPTIC TANK JJ SEEPAGE P T ~/ . DRA N f ELD OTHER GrEATEr ANCHORAGE AREA Borough /~~ ~ DEPARTMENT OF ENVIRONMENTAL QUALITY O..~/ 2 - SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED ¢'~(2 ,~ ,'~ ¢' ~-*~ ~, ~ ¢ ~ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL C~UALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE SEEPAGE AREA SIZE TYPE DIAGRAM OF' SYSTEM MINIMUM DISTANCES, REOUIREMENT~i FOUNDATION TO SEPTIC TANK ~ ~r/~~- [ o ( FOUNDATION TO SEEPAGE4a~T DRAIN FIELD SEPTIC TANK TO SEEPAGE ~L SEEPAGE ,PJ~ DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK /OO DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEEPAGE PIT / (~ d < ALSO CONSIDER AREA WELLS. SEEPAGE PiT SEPTIC TANK, SEEPAGE PIT TO RIVER, LAKE, STREAM. DRAIN FIELD CAST lEON 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 i~/~~ CONFORM TO BOROU GULATIONS REG INSTALLATION. CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ~)RDINANCE NO. 28-68 AND THAT THE ABOVE / GREA,, kANCHORAGE AREA BORL,,,,t ~[1H~/j]/ Department of Environmen;~al Quality ~ 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~' '-t/'~6~9'//[~d6Ot'~ MAILING ADDRESS ~/~/~ ~]~g~( ~7~ '~ Z~ d~5~'7 PHONE SEPTIC TANK: DISTANCE FROM WELL' ~fi~J~ MANUFACTURER INSIDE LENGTH ,, t INSIDE WIDTH NUMBER OE MATERIAL O(~'~OJ'J~ COMPARTMENTS [ LIQUID DEPTH ~ ~F_IQUlD CAPACITY /806 GALLONS. NUMBER OF PitS / DIAMETER _--OR WIDTH ~'.) /~. LENGTH z'~, DEPTH LINING MATERIAL fi~6tt~ 4-?~/,~<~RiB SIZE: DIAMETER__DEPTH(~ DISTANCE FROM: WELL /~d9 / . TOTAL EFFECTIVE BUILDING FOUNDATION NEAREST LOT LINE ~ ~- -- . ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: · . ~ ~.L ~/, /gLc.~ [~ ~- CONSTRUCTION O..O(~:~h-. ~, TYPE'~Ui g/ , BUILDING . J NEAREST / NEAREST FOUNDATION: /~5 ~ LOT LINE //) -j~ , SEWER LINE DEPTH /0~ DISTANCE FROM: CESSPOOL ~' OTHER SOURCES /~d ~;~u~ APPROVED //~ DISAPPROVED REMARKS SEPTIC ~c~ O _f, SEEPAGE //~0 / TANK SYSTEM DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: (~CLL 4 ~' DIAGRAM OF SYSTEM DATE APPROVED G.A.A.B. Form PW-026 GAAB-HD I GR~.a,jTER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT · '~: ~ 327 EAGLE ST. ANCHORAGE/ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE EROM WELL ~'~ / ~ LIQUID CAPACITY ~q~'~ GALLONS. NUMBER OF MATERIAL ~"~ ~ -~'-~'~"'¢~" COMPARTMENTS INSIDE LENGTH INSIDE WIDTH_ LIQUID DEPTH __ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS /' OUTSIDE DIAMETER LINING MATERIAl NEAREST LOT LINE '----~ OR WIDTH . DISTANCE FROM WELl /~2~' ~:~'~) / ~ [OTAL EFFECTIVE ABSORPTION AREA .WALL AREA , LENGTH /~;~ , DEPTH BUILDING FOUNDATIOF~ SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL ..~ ,~UNDATION ., NEAREST LOT LINE. . OF LINES / WELL: TYPE ,,~tr/~//-~''- ~.~'-,¢~ DEPTH ~'~ / ~EAREST ~ SEPTIC LOT LINE /~' ! ~ , SEWER LINE , TANK DISTANCE FROM /~, WATER · BUILDING FOUNDATION. /~ SAMPLE NEARES1 ~ ~ SEEPAGE · SYSTEM J~ ~¢. CESSPOOl , SOURCES DISTANCES: DIAGRAM OF SYSTEM HEALTH AU]HORi1Y DATE GAAB-HD-2 GREATEI iINCHORAGE AREA' ROUGH HEALTH DEPA~RTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT ,:~-;,,.'-¢~'~'~,-'~'/~ ,:::2 NAME OF APPLICANT ~./:'/57~. ,/~/~-/~" ~' MAILING ADDRESS~~ ~ PHONE NO..~ RESIDENCE ABBRESS ~ ~~,~"~ON OF INSTALLATION ~/~ LEGAL DESCRIPTION~ ~- ~ ~ /~ ~. ;z ~ ~/~"/~ APPLICATION TO INSTALL: SEPTIC TANK ~EEPAGE PIT ~", DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY ~ ~~'~ PERCOLAT ON TEST RESUL / '/ ,/-_ . BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ? THIS IS TO SERVE AS .,/2~,/~s¢'/ ~-' :/-~'c';~--:2':=',PERMIT TO INSTALL A. ~-~ ~~~ , AS DESCRIBED BELOW. SIZE OF p~l~ BE SERVED ~ -~~:~ ~ ' . SEPTIC TANK SIZE ~ ~/~ TYPE d~-~EPAGE AREA~~/TYPE.~ ~ DISTANCES: 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. ~,~_.~ /"~'~,REATER ANCHORAGE AREA BOROUGH ~ HEALTH DEPARTMENT ~ CASE 327 EACJ, E' STREET ~ ANCHORAGE, ALASKA 99501 Performed For ,~mL*~*c'~ ©m~-o4; ......... pate Performed Legal Description: not~lock~S~division Depth Feet I[--~ Soil Characteristics ref~re~er,'t5 Was Ground Water EncounteredO~. /~_~_..~. ,~e/,~ ~Z. l If: Yes, At What Depth ..... Reading Date ate .L"/ Gross Time Net Time ' ' '~i~%%' ~ Location Sketch Depth To H20 Net Drop Proposed Instal~Seepage pit.____AzZ~ Drain Field Depth Of Inlet , Depth To Befit Or Tx;enc~ ~"' d[~!I ~ ~& ...... Test Performed B · Data Certified By:~~ . Date ~ I Anchorage Drilling Co. 2850 E~st 68fh Ave. Anchorage, Alaska 99502 OF ANCHORAGP ' & PROTECTION IVED Septe.d)er 12, 1972 Lee Thompson SRA Box 1737-E Anchorage, Alaska 99507 Dear Hr. Thompson; This is to verify the decision made by this Depart)~ent concerning the on*site sewage disposal system on your lot described as the )torth 523' ~f Lot 17, Section 22 T12N, R3W. The decisinn as explained to you by John Lee was that the sewer system which you installed in January of 1972 without a per~dt from this Department and inspected in August 1972, ~as not approved. The reasor) for disapproval was due Lo the self-made septic tank you installed, whtcii did not ~.~eet the specificatio,s for approved septic tanks; lacking the sanitary :ees at both the ii, let and outlot lines. The inspection ~lade o~ this system has been put on file for our information. Any change m~de by you as to the number of bedrooJ~ls in your house ~t~ust be reported to us, or should you decide to sell the house you will be required to upgrade ~his system by installing an approved septic tank. Should you have any questions, please do not hesitate to contact thi~ office. Sincerely, Deutse Bashaw Environmental Control mb cc: John R. Lee Environmental Ser~ RECEIPT FOR CERTIFIED MAIL--30( (plus posta~ SENT TO STREE¥ AND NO. OPTI0NAL SERVICES FOR A~DITTONAL FEES RETURN ~a~ 1, SUows to whom and date delivered ............ 15¢ With delivery to addressee only ............ 65¢ RECEIPTp 2. Shows to whom, date and where delivered .. 35¢ POSTMARK PS Form Apr. 1971 3800 NO INSURANCE COVERAGE PROVIDEO-- (See NOT FOR INTERNATIONAL MAIL ~o,x.,~ /7-~ /7- C DTI002348 LOTS 17-A, 17-B, I?-C end I?-D, A REPLAT OF BLM LOT IT, SEC.22, TI2N, R:SW, S.M., ALASKA DTI002349 2 CERTIFICATE OF OWNERSHIP ~ DEDICATION We hereby ~rfify that we are the owners of the properly ~hown and DTI002350 ~, ~