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HomeMy WebLinkAboutT12N R3W SEC 33 LT 188 E2 ~ P.O. BOX 4-1276 ANCHORAGE, ALASKA ~ ~9 BUSINE~ PARK BLV ...... ..... ~ :: '~' -~Ddnking Water ~alysis Repo~ for Total Coliform Ba~e~a TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLIED BY ~BO~TORY ~u~,c~sYs~= IIIIII ~ L~O~o~Y= PubllmW~er System ~_ · Mallln~ CITY City State Zip Code ' ' Date Received MO, Day Year Time Received SAMPLE TYPE: Analytical Method: ~ Routine ~ Fermentation Tube ~ Check Sample (for routine sample with lab ref. no. ) Q Treated Water Membrane Filter ~ Special Purpose ~ Untreated Water SAMPLE Time Collected Lab Ref. No, Result* Analyst NO. LOCATION '., Collected By READ:INSTRUCTIONS BEFORE:i COLLECTING SAMPLE Form No. 18-310 (3-78) Multiple Tube Report: Membrane Filter: Direct Count ~,enr 'afll~v~te~ ~)=r a nL eTFBii ,e r~Re~a ,~s` .F.',EPRRTMENT O, hIERLTH RNI> ENVIRONMENTAL F..JTEC:TION 825 "L' s-rF,:EET., RNCHORRGE, 264..~4.720 LOT SIZE FEET P1]:Nif'IUf'I DISTRNCE EERIEE. N R FiE:EL FIND RN"r' ON-SITE: SEPlRGE FEET FC~' R F'RI',,,'RTE ~4ELL.~ 'J.~iiIF~ TO 2R]:'~ F'E[T FROM FI F'.tE:I IZ [,.IELL E:,EPENE:'ZNG _F'FN THE T'T'F'E OF F'..ELIC: I.,.IEL. L. klELL L:C~'~; FIRE REQI. JZRED FINE:, fill: F E,[. R[E'f'LIF~NED TO THE DEF'FII4:Tf'IENT I.,.I];THIN <~.d - THE P.IELL E Zf'IF'[ ETLON. OTHEJR RECCJIRE:P'IENT:5 P1R"r' F:IF'F'L"r'. SF'EC:IFICFITIONS RN[:' '23f'I':TE'_ :'TI-'N [>IFIEiRFIFI2; fiRE I CERTIF'T' 'TFIFIT t.: I FIM FFIM:[L. tFtR NITH THE REQLIIREF1EN'f".':; FOR ON-SITE SEI.,.IER:'~; aND, FORTH B'¢ THE hlUi'.,I:[CIF'RLIT'T' OF RNCHORFtGE. 2: Z 1.4iLL. IN%TFtLL THE 2;?$TE1',1 ]:N RCCORDRNCE !4ZTH THE CODES. DEPI'. Oi ~ ' ii] & MUNICIPALITY OF ANCHORAGE ~i,j'/J2,ONMENTAL i:';iO'iECTION ENVIRONMENTAL ENGINEERING DIVISION Selepho.e 264-4720 RECEIVED ._ REGUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ;)IRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER MAI LING AD DR ES..S_~ PROPERTY RESIDENT (If different from above) 2. BUYER MAI LING A DDR ESS 3. LENDING INSTITUTION ' ggo ,e C-e_Ae MAILING ADDRESS 4. REALTOR/AGENT MAILING ADDRESS PRONE PHONE 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four ~ [] Other [~iNG LE FAMILY ~ [] Five [] MULTIPLE FAMILY [] Three [] Six WATER~SUPP [~NDIVI DUAL~ * ATTACH WELL LOG. A well Icg is required for all wells drilled [] COMMUNITY since June 1975. For wails drilled prior to that date, give well [] PUBLIC UTI LITY depth {attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM ~NDIvIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date 10 If system is over two (2) years old an adequacy test is required By this Department. NOTE: THE INSPECT!ON FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SING LL: FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] I ~IDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER E~] INDIVI DUAL/ON -SITE DATE INSTALLED [~]PUBLIC UTILITY lO _"/ ~/' Connection Verified INSTALLER []Septic Tank or []Holding Tank Size:_~)(~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL AESORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS L~ APPROVED FOR ._.~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Ti LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE ~ - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION [lr,~ J))" ENVIRONMENTAL ENGINEERING DIVISION ~1~// 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Liq. capacity in gallons Inside length ~ IF HOME.DE: ~ Width Liquid depth DISTANCE TO: W~ ~ ~ Dwelling PERMITNO. Type of crib ~b ~ia~ter Crib depth Total effective absorption area OTHER RATING ~ ~'] ~ INSTAELER ~ ~ ~ 72-013 (Rev. 3/78) fllJN I O I PRLI TY OF HN~HORHGE -DEP~IRTMENT OF HEALTH lIND EHVIRONMENTRL PROTECTION 825 ~L~ STREET., ANCHORAGE, AK. 99501 2¢4-4720 .-: ~,.IELL AND, OI'-.I--S I Ti SEWER PIMP1 I T .- PERMIT N0. ( 780905 > ROBERT BENTON 2615 W 3~ RABBIT CK RD LOCLOMRND TI2N R2W SEC 22 L lBS SM E4 APPLICANT LOCATION LEGAL 274 LOT SIZE 54440 SOURRE FEET TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = --< SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= i2 LENGTH= 22 GRR"~EL DEPTH= 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 PEET). THERE IS NO SET WIDTH FOR TRENCHES. ~THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. F,'E~LI I RED SEPT ! C TRNkC ~ I ZE= i000 GRLLOr~S PERMIT APPLICANT HMS THE RESPONSIBILITY TO INPORM THI~ DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ------ THO ( 2 ) I N'-.~PECT ION$ PRE RE C~.lJ I RED ------ BACKFILLING OF RN~SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION .... MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL~ OR 150 TO 200 FEET FROM 8 PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS PRE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 20 DRYS OF THE WELL COMPLETION, OTHER REOUIREMENTS MRY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT E~.PIR~.,,,,~ DECEMBER ~i~ i978 I CERTIFY THAT i: IRM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 2: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REOUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. SIGNED :'~__~_. RPPL ISSUED BY-~~, ,~CRNT ROBERT BENTON Il. No. ] 173 ' E ]./2, Gov't Lot 188, Sec 33, T!2N, R3W, Anchorage, Alaska. 1.25 Acres 165.00' Rabbit Creek F, oad N [:3 S 89© 52' 50" XOT 7'0 SCALE to location of test hole. _ Anchorage, Alaska 99502 (907)314-~9!50 T .!!. Xo. ] n-c -' · S5 - , sl noJ s t_,__};e_d~d.i sh brn . ~[p~L) 1.5' Silt: w/some sand a gravel, occ cobb}es & boulders, dry te sl m©ist~ med dense !..5' to i0.0' , dense 10.0' to . 15.5', gray brown. (Mt-GM) Note: Silt-gravel-sand percen- tages vary from Silty Gravel with some sand to a Silt with a trc to sone sand & gravel. NO defini, te stratafication noticed. NO WATER TABLE~,:~m',r"q~UN~=Ri,D !8.5'TD 'Pest Hole Boring Log represents soils encountered on ,;; ]./2, Gov't Lot 188, Sec 33, T[2N, R3W, SM, Ancherage, A] uska. Nobert W. BeP~ton Property F,'pte?l}~!'!- 21 , ] }78 Lot )% , Set 33, 'h'\F. ULP~TION OF PENCOLAi'Z('!: lES1' I 550 8 5" start shJrh stlart 1,09 1~.5" 6.0" !{ 1.7 1{,] 0 ]7.75" 3.25" ]{~ 3.1 !020 !S. 5" O. 75'* ]0 13.O ~ ~,30 23.0" 4.5" 10 2.2 i~.'~0 25.0~' 2.O" I0 ~.O ){,5} 27.O" 2.0" ~0 ~.k i'~!5 l,?. 33~.'d qve. ;'}:i': 5nvest[gation, which was dccop~p!Jsh .1 e~', Sol.cot:bet 2], 1978, ce~lsisted of the insNcction ef so[is removed durihg drilling o~' a 6 JncN dinne{e~ , 18.5 feet deep !{s:: ho!(, usJ~lg sol i~ fl ijht augers, po'.vorod Ny a h!c'k '.{ ln~od Hohi. le B-50 soils consisted of a ].5 fooL tNick layer of Or:anic S51¢, everl}'ing a Silt with ~rasses to 3 !feet raj}, with seine mosses. -,', auest-R~ns re{p.~;dJng this soils 5nv?suioatio:-. (907)3}4-9150 LEGEND 0 5/8" ~ DRAINAGE ARROW x SPOT ELEVATION TOP OF FOUNDATION WALL ELEVATION ELEVATIONS 8ASEO ON PREPAREO FOR'~¢¢/ C1~££k¢ /~OAD. OATUM PLOT )ES. ¢/~ CHK. E8'A. 3oI SCALE I"= 5d