HomeMy WebLinkAboutT14N R2W SEC 11 LT 61
GREA.
ER ANCHORAGE AREA BOR JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska ggS03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION /JJ'(4/'~ $ (',/2, /~/C~lffg../_: LEGAL DESCRIPTION /( ~, / ~,_~,. // /7~/1/ ,{o,.~ ~
SEPTIC TANK:
DISTANCE v.~- /9,~ NUMBER OF
FROM WELL /00 / MANUFACTURER MATERIAL COMPARTMENTS
INSIDE WIDTH
INSIDE LENGTH
LIQUID DEPTH
LIQUID CAPACITY /O//~OGALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL/~)D/ FOUNDATION
NUMBER OF LINES '~ DISTANCE BETWEEN LINES
ABSORPTION AREA ',~ '~ ,~
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
NEAREST LOT LINE
"~//~- TRENCH WIDTH~]~'' IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
~¢ DEPTH OF FILTER
-~ MATERIAL BENEATH TILE ~/ ,~J~$ ABOVE TILE ~' IN.
WELL:
TYPE ~ '
BUILDING
FOUNDATION
CESSPOOl
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST SEPTIC
SEWER LINE TANK__
REMARKS
DEPTH
SEEPAGE
SYSTEM
DISTANCE FROM:
DISTANCES:
INSTALLED BY: ~ ~('~.
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DI.,~RAM OF SYSTEM
G.A.A.B.
Form LQ-032
F'ERI"IlT NCL ,:.' 7E:!'_-]20 )
F:IP F'I- I C FIN -I-
LOCFCI.' I ON
[JEEiF~L
I}EF:'I::IR1-MENT '~'~ HERLTH FIND E]q',,,'IROI"4MEI"EI"I::~L/"~'~i'.OTECTION
;~'.5~J.6 IS']. FIJDOR RI:'.., I::~I",ICHCdRFIGE., FIK.
E} ~'-a --' S; ]E '-it-' E-Z
M FI U '.'S E ',:.:: C
MI :I.S": OL[:, £ii[_.El'ql'q l.il4V
!_6:1. SEC :1_i "l,'::t. 4N RZI4
SRB E:O,'.'.,', E;::L5
LOT E;I ZE
745-~0~4
20000 SQI.JI~I~IE FEET
T'.r'PE OF SOIL. FIE~S;ORBTIOI'.,I S'T'STE]"I lei;: TREI'.,!C'H
f"IF:I::';;IP'IUM NLII'IE[EI:N: OF' BEC, Fd]I])M'.'i; = ~:
SOIL RR'TII"4G ,::SQ FI-,.-"BR)= ;:1..25
THE REQUIRE[:, SIZE OF 'THE SOIL RBSOIE:F'"I"):OI",I S'T'STEI'd IS:
THE LENGTH [)IMENSION IS TPIE L. EI'4GI"H (I1".1 FLEET) OF THE TREIqCt4 OR DRRII'.~FIELE:,.
THE C, EPTH OF I::I 'T'REi'.,ICI'4 OR PIT IS.: THE DISTRI'-,ICE BETklEEN THE SURFRC:E OF THE
GF?.OLIIq[) F:II",I[:, THE BOTTOM OF THE EXCR',,,'RT I ON ,:: I N FEET'>.
]"HERE IS NO SE]" WIDTH F'OF?. TI::,:ENCHES;.
'I'HIE I]iF$:I::I',,,'EL DEPTIfl IS; THE MII'.,tIMUM [)EP]"H OF GIi:I::t',,,'EL. E:E"I.'I4EEI'.,I 'I"HE OUTFfflLL F'IPE
RI'-,!D 'FHE BOT'TOM OF 'THE E,'.".%F:I',,,'FFi" 101".1 ( I N FEET ).
.... F' ILdt E:} ,:: 2E: ::, .~: IP-41 ES; F" E: C:: T ][ C~ tP-,II :'-~'; IFil IF~:: E: F~i: E E~:.~ IL.It _~:: ~-4~.:: E] 117_:,
BFICKFILI_.ZNC. i OF FIN'-? S'-r'SIEf'I !.,.IZ]"I4OUT FINFIL INSPECTION FIND RPF'RO",,'FIL. B'9 THIS
[)E;:PI::IRT'MEi",FI,' I.,.tZLL BE; SUBJECT TO PROSEC'UTION.
I'"I]Zi",I;i~I"'ILII"I I-)ISTRI",ICE 8ET!.,.tEEI9 R !.,.IEI._i... RND RN'9 ON-SITE SEF.IRGE [:,ISPOSRL.. SYSTEM
:i. 00 FEET FOR FI F'RZ',,,'I::I"I"E klEL. L OR 200 FEET FOR FI F'UBL..IC 1.4EL_L.
klEL.[.. LOGS RRE REQUIRED FIND MUST BE I::?.E'f'IJI~NE[:, TO THE; I}EPRRTI"IEI'.,I'I' I.,.IIT'HII",I 3':0 [:,F:I'.r'S
Ii.iF THE I.,.IE]_L. COMPLIE]"IOI'4.
SPECIF:ICRT'ICJI',IS laN[) CONSTRUCTION I}IRGI';.'.FIMS FIRE fflg'RIL.FIBLE TO INSURE PROPER
I N'.:i;TFIL. LRT I ON.
i CEIq:TIF"r' TH[IT
::L: I FIM FFIMILIF:IR I.,.IITH THE: REQIJIF~:EMENTS [::OR ON-SITE SEWERS; RI'.,IL':, I.,.IEI_Lg; I::IS .'E;ET
I:::'OI~:TH B"r' THE MUNICIF'RLIT"r' OF FINCHORFICiE.
;;::: I 14I[...L IN'_;.i;"I"I::I[_L 'T'HE S"r'STEM :[i",1 FICCORDFIIqCE 1.4ITH THE CODES.
::~:: ]: UNDERSTFIN[:, TFIFIT THE ON-SITE SEWER S"r'STEM i"lFl"r' REQUIRE ENLRI:;:'.EiEMENT IF THE
RES ZE)ENCE IE; ~EMODEL_E[:' TO I I",hZ:LJJ[:'E MORE TH[IN ~: E~E[:,RCIOi"IS.
s :t: .,_ .: ._. .......
FIF'PL I C:I::II',tT f'lFil. J~.,
//_
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: ~V[ F~b /~.F:II/F~7-1/,/,/'~ (.~,~T'h5 ~01~"~ HOIVT~-,~ DATE PERFORMED:
7-
8-
9-
10-
11
13-
14
15-
16-
17-
18-
19-
20-
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED? NO
IF YES, AT WHAT
DEPTR?
S
L
O
P
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN . FT AND -- FT
COMMENTS I-~U~P.
PERFORMED BY: H~W~
72-008 (7/76)
DEPT, O~ blEA~.TH, &
RECEIVED
,rtifi ,i rilling
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE604-2§88
~c ri
_ Ended
OWNER OF LAND (J/~Ct~
ADDRESS
LEGAL DESCRIPTION GO O
DATE- Started IJ~,-f 0/"7
PERMIT NUMBER
!
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR
KI~D OF c,sm~ ~ CJo o
l1
KIND OF FORMATION:
From O Ft. to c~ Ft
From c'.~ Ft. to z~.~' Ft.
From ~'~ Ft. to (~O Ft.
From ~O Ft. to · c~z~Ft.
From f~¢[ Ft. to 77 Ft.
From ~7'~ Ft. to q~ Ft.
From ~] ~'~ Ft. to__ Ft.
From __Ft. to__ Ft.
From __Ft. to Ft.
From Ft. to__ Ft.
From Ft. to__ Ft
From Ft. to Ft
From Ft. to Ft.
From Ft. to Ft.
From Ft. to__ Ft.
From__Ft to Ft.
From Ft. to Ft
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
Ft.
to
Ft
From~ Ft. to Ft.
From .Ft to~ Ft.
From ~Ft. to_~Ft.
From ~Ft. to Ft
From_ Ft. to Ft.
From Ft. to Ft
From Ft. to Ft.
From Ft. to Ft.
From_ Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
Fromm_Ft. to Ft
MISCL. INFO~ATION:
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPEC~
MUNICIPALITY OF ANCHORAGE DEPT. OF i'H/.LTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~VJRONMEN],V-
MAR 2 0 1980
ENVIRONMENTAL SANITATION DIVISION
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
15. L~L ~iRIP.~TIO~ ~ (~' ' J / & ~ ~j '~ / L~ ~
~R ~T LOCATION '
6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
~ One ~ Four
SINGLE FAMILY ~ Two ~ Five
MULTIPLE FAMILY ~ Three ~ Six
[] O~ther__
7. WATER SUPPLY
,,~¢~ INDIVIDUAL* * ATTACH WELL LOG. A well Icg is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
E] PUBLIC UTI LITY depth (attach Icg if available.)
S. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** \O~'-~i[o. YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC'UTI LITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)~'""~.-~ ~ '""~'[ 3. ~'~ ~ .~
~ THIS SIDE FOR OFFICIAL USE ONLY ,'J
1. TYPE OF RESIDENCE NUNIBER 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
[]Septic Tank or []Holding Tank
Size: J~)<:~) [f 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
~'"'APPROVED FOR , .~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
72-010 {Rev, 6/79)