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HomeMy WebLinkAboutT12N R3W SEC 22 LT 22 S2S2 ~'~MUNICIPALITY OF ANCHORAGE~ Hea % and Environmental Prote Fourth Floor West 825 L Street Anchorage, Alaska 9950] 279-2511, x 224, 225 INSPECTION REPORi' ON-Sil'E SEWAGE DISPOSAL SYSTEM b~R OF DISTANCE ~f _ ~ _MAFFRIAL _~ FROM WELL__~¢_'~ -- MANUFACIDRER INSIDE LENGTH ........... INSIDE WlDllt LIQUH) DEPfH .... LIQUID CAPACITY~ALLONS. ................. - ........ TILE DRAIN FIELD: / TOTAL LENGTH [)EPIH OF FILTER / DEPTI : TOP OF TILE TO FINISH GRADE ~.. MA'[~ RM~L L~ENEA1H TILE SEEPAGE PIT: DIAMETER --.-- OR WIDTH ~_, LENG fill ..... OEPTN Log Crib Rings BUILDING FOUNDATION .... Crib Size: DIAMEIE:~ .... DEPTH_ __DIS-fiANCE FROM: WELL ]OIAt_ EFFECTIVE NEARESq LOT LINE ..... ABS©RPTION AREA (WALL AREA) _____SQ. F'I. Nell /("~ . Class:~.~/~ Depth. Well ~istance To: Lot Bldg:~2~. Sewer Line:/~'--J Pipe M~te~ls: ~,~~,1 # of Bedroom¢:,~__~__ FENMI I NO. flPF'L I CFIN'I' t_OF:AT I ON L_EGF:;I_ LOCKE E~<C:RVA"FING E:OX ±2:L SRA 'rH AVE. I_OT :~;-z 'F±2N R~:W qEC zz _,t, ,_ ~- -4.4 ~.b ...... L.O'f' --,I,sE 44000 SQOARE FEET TYPE FIF ..-:.,_.ti... HB:,LE.E, I iEN SYSTEM tS: ]REN-.H NAXiMUM NUHE, ER OF E~E[:,ROOM':~ = q: SOIL RATING (Sbl FT,--BR. = '125 THE REQUIRED q' ':-; ..... '-"-F '" ~' ' - '-' "= .... _1ZE OF THE ~JIL HB~,JRETIuN -~'r_TEN IS: :'FIE I_ENGTH DIMENSION IS; 'THE LENGTH (IN FEE]") OF THE TRENCH OR DRAINFIEL. D. THE DEPTH OF' R 'TRENCH OR PIT iS THE: DISTANCE BETWEEN ]'HE SURFACE OF THE GROLIND AND THE BOTTOM OF' THE E',.'::CAVATION (IN FEE7'). THERE tS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS; THE MINIMUM DEPTH OF' GRAVE:[.. BETWEEN THE OLITFRL.L PIPE AN[) THE BOTTOM OF THE EXCAVATION (IN FEET). It-~1 D.J C;!! Lit ]; F-.'. E] E-':, .¢----; EJ F' "lf' X C: ']- R I'-41 k:] $ I.=-_ E----' "-- -j_ £.-1 [;-ii ,:Zi L'~ H L.. LJJ li'-41_.. F"AI:::i-<] Fll.~iE F'L. RN'T' ~])F"'I" .t: Eli-4 R PACKAGE PL. RNT MAY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJEC:T 'f'O THE FOLLOWING CONDITIONS: i. EI]"HER a CLASS; I OR Il NSF APPROVE[) PLRN'I' MA'T' BE INSTRLLE[:,. 2. A CONTINUOUS MAINTENANCE AGREEMENT tS REQUIR. ED. iF A HAINTENRNCE AGREEMENT i~ NOT KEPT CURRENT MOLl MAY BE REQUIRED TO ENL. RRGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE StJBJEC'f TO PROSECUTION. "F L--lIE, ,:J 2 :;, X i'-.t'..]~-';F'EIL'.:'IF' ]: C,~-,t$ IFtF-: E F.."E_'i:?L.Ii X c; ,~,,-' '"' ,. BACKFILLING OF ANY _~r_ IE. fi WITHOUT F'tNR/. INSPECTION AND, APPRO'¢F~L E:'T' THIS [:,EPRRTMEN'I' WIL. L 8b .=,UE, JEL.] TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL. AND ANY ON-SITE SEWAGE DISPOSFIL SYSTEM IS :t00 FEET FOR FI PRIVA'f'E WELL OR 200 FEET FOR a PUBLIC WELl... OTHER REQUIREMENTS MaY APPLY. SPECIF'ICRTIONS AND CONSTRLICTION DIAGRAMS ARE AVAILABLE TO INSORE PROPER INSTALLATION. i CERIlFY I"HR'I ±: I AM FAMIt_IAR WITH ]'FIE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AE; SE1' FORTH B'¢ THE MUNICIPALITY OF ANCHORAGE. 2:: I 14ILL iNS'TALL THE SYSTEM IN ACCOR[:,RNCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER S'¢STEM MAY REQUIRE ENL. RRGEMENT IF THE RESIDENCE IS REMODELED TO INCLODE MORE THAN 2; BEDROOMS. Vi:. 0 CONSULTING GEOI_OGIS¥ Performed for Location ~c~- ~ ~g_ SOILS LOG Soil Type Water Level Remarks 4 16 18 2O Total Depth of Excavation Groundwater ~. Not Reached Depth, if Reached Classification Method Visual Sieve Analysis () Material at Total Depth Bedrock ~ Not Reached Depth, if ReacheR Gary F. Player, Consulting Geologist ~ ,, APPLIC ~IT FILLS OUT UPPER HAt/J'~ONLY Address ~.) (Y', A L- [-~ ./ ~.~. (~ , Zip Code Lending Institution Address Zip Code Realty Co. & Agent ~O p~,5~ / ~-~ ,){~ %~X ~zx ~ ~ t-~ ~ Phone Legal Description ~ Wate~ Supply 'lndividual A~ACH WELL LOG. A w~l Jog is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach Icg if available). ~ Public Utility Sewer Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public UBJity: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Insp~ctor Inspector Field Note~,;. ~1,~. MUNICIPALITY OF ANCHOr( /.~~- DEPT. OF H~ALTII ff~ ~~ ENVIRONM:NTAL P~OTECrlO ,)j)~ DEC '1 o . CEIVED (~ APPROVEO BEDROOMS /~ ~ --~ ( ) mSA~PROVEO 8oils Rating Dale ~wer Installed Well TO Absorption Area Well Log Received ;~ ~ ? Well to Tank 8eplic T~k Size / ~ ~ ~ 72-023(3182) ALASKA [1UII OrlmI rITAL COrITI OL InC. DECEMBER 14 1983 MR. SUTHERLIN 8301 BRAIRWOOD SUITE 101 ANCHORAGE AK 99502 SELLER - SCOTT LAMKIN BUYER - SUBDIVISION - T12N R3W SECTION 22 S 1/2 S 1/2 ADEQUACY TEST FOR SEWER SYSTEM BLOCK - 0 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 375 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 500 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 500 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 2 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 12/16/83 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1001 IS ADEQUATE FOR THIS 2 BEDROOM HOUSE. 1200 IJJesl 33r~1/~uenue, Suil¢ [~ · Anchordqe, AI.skQ 99503 · (907) 276-1361 DATE RECEIVED INSPECTION APPOINTMENTS T_{,MI~ TIME TIME DATE DATE DATE I NS p E CT~,~ ~,~_xX. INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH  825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION ENVIRONMENTAL SANITATION DIVISION DEC 1 0 1979 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~~ DIRECTIONS: Complete all parts on pa~e 1. Incomplete requests will not be processed. Please allow ten (q O) days for processing. MAILING ADDRESS PROPERTY RESIDENT (If different from above) / PHONE MAILING ADDRESS ~3, LENDING INSTITUTION /~- 5. LEGAL DESCRIPTION [ R-%o I STR EE~' LOCATION 6. TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Other__  Two [] Five Three [] Six 7. WATER S~PPLY ~ I NDIVI DUAL* * ATTACH WELL LOG. A well Icg is~d--~r~l wells drilled [] COMMUNITY since June 1975. For wells dri¥'~prio.r_t__oo that_~, give well [] PUBLIC UTI LITY depth (attach Icg if available.) 8. SEWAGEAGE/DISPOSAL SYSTEM ~ '"~ INDIVIDUAL/ON-SITE** f YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY , . 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDiVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER •SepticTankor •HoldingTank L~,'~ I t~ -~ -] Size: ~/~) O If Tank is homemade SOILS RATING give dimensions: TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS ~ CONDITIONAL APPROVAL (letter must accompany certificate) ~ DISAPPROVED 72-010 (Rev. 6/79) ~ MUNICIPALITY~F ANCHORAGE DEPT. OF'I;~ALT~I :& DEPARTMENT OF HEALTH & ENVIRONMENTAL PRC~I~(~N,4ENTAL j::KO~ECT  825 L Street - Anchorage, Alaska 99501 E.VIRON~ENTALENGINEERI"GDIVISIO" APR 9 D79 Telephone 264-4720 RECEIVED ~E~UEST FO~ APP~OVAE OF I~DIVIDUAL ~ATE~ A~D 8EWE~ FAOlLITIE8 MAILING ADDRESS PROPERTY RESIDENT (If different from above PHONE 2. BUYER PHONE NAILING ADDRESS 3. LENDIN~INSTITUTION ~ [ PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four ~ SINGLE FAMILY ~ Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for ail wells drilled [] COMMUNITY since June 1975.' For welts drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ,~ INDIVI DUAL/ON-SITE** [] PUBLIC UTI LITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE eNL. CATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE iNSPECTOR INSPECTOR INSPECTOR DIRECTIONS; 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMSER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLEO [] PUBLIC UTI LITY ConoectiOll Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE ~NSTALLED E~]PU BLIC UTI LITY Connection Verified INSTALLER E~]Septic, Tank or [] Holding Tank Size: IIO0 IfTankishomemade SOILS RATING give dimensions: TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line [] APPROVED FOR . . BEDROOMS [] CONDITIONAL APPROVAL (lette~r must accompany certificate) [~ DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev, 3/78) . ~.~NVIRONMEN'I _~ PROTECTION I!~[~ · 11 ' ' ?~chorage, Alaska 9950]. ~;11, ext. 224 or 225 Date Received: #1: Time ~ .... [~2: Time ~~_ Date ~r_~5 Date ~-~m~.~% Jul.y 19, 1977 #3: Time _~ ]~_D Pn% Date Insp __~. ?.~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Coast Mortg~_g.e Mailing Address: 4797 Business Park Boulevard Phone: 279-0665 ~' ~ George/Marjorie Blake__ 2.P.:_oper~y Owner: Phone: 344-4702 Mailing Address: Star Route A Box 1729 ~95_q~ Legal Description: T12N R3W Section 22 S½ S½.~ .,,xeo3_dence. (x) Single Family TM Number of Bedrooms: Three Multiple Family Residence: ( ) Number Of Bedrooms: 5. Well System: Individual We]-]. (x) Permit # __./~J~l Depth of Well Construction Sewage Disposal System: On-site Permit # ~,~'~- Installed Septic Tank Size~_f~_--_ Community/Public System ( ) 140' Well Log on File Bacterial Ant lye is ~_~ System ~ Public Utility ( ) ~/7~ ' Installer~ ~¢ Manufacturer ~ Absorption Area Distances: Well to Septic Tank ! to Sewer Line /~ Nearest Lot line to Nearest Lot Line Soils Rate ,/~.'~ Material ~ to Absorption Area /~ ? ,~/~.~_ Absorption Area P~ge ~o Request for Approval of Individual Legal Department of Health and Environmental Protection Sewer and Water Facilities Description: T12N R3W Section 2.2__S~ S~~ Comments: Affadavit Attached: ( ) Letter Attached Department Worksheet: 7~/Jl'~l ' , .- /'~u~p~,~v ~c ~eUORAGE ~ ' ~,, '~%1 'Departmen, oz Health.an, Env~ronmen.tal ~ro,eccZon .' .. ~~/'' '825 L Street, ~chorage, Alaska 99501 ' ._ ~[k~7~]/ 279-2511, ext. 224, 225 "3' ~equest for Approval of Individual Sewer and Wa~er Mailing Address: Phone: o Name of Buyer: Mailing Address: Lending Institution: ai ing Address: Phone: Mailing Address: ~0) ~(), '(~clcfAo~.,rd_~ &~ Phofe: ~?O-?G,/ Legal Description: Tla ;~ ~3a} _ .~ <m ~ ~ ~&. Street Location: Single Family Residence: ~ Number of Bedrooms: ~ ~-~'~' Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply: * Individual Well ~Q Public/Conununity System ( ) If Individual Well, well depth ~ If Community System, name of system 8. 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 sznce 6/75. 3/77