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Home My WebLink AboutT13N R3W SEC 26 LT 5A OF 28 & 29 OAAB,HD-I ~TER ANCHORAGE AREA BOROI~ nt:rARTMElYT OF ElYVIR01YI~IEBITAL 3500 TUDOR ROAD ANCHOI~AGE, ALASKA gus07 27g-8(~81] INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ' ~' - PHONE NAME ,,'/J'/,'~.~?~'~=:'~' ~"~CZ '~/;'~/~'/~'~'~=~-~/~' ADDRESS:~'~'~ ~Z' ~ ~ / ~ .,~ LOCATION ~ ~~-/~ LEGAL DESCRIPTION ~//~ ~ '~ ~ - ~ SEPTIC TANK: DISTANCE FROM WELL ~-~ /~' NUMBER OF MATERIA[ _~-=~ ~c)~--_L~ C~.~/../'~:.:.:.:.:.:.:.:.:~::~- COMPARTMENTS LIQUID LIQUID CAPACITY ---- GALLONS. INSIDE LENGTH INSIDE WIDTH -'-- DEPTH -- SEEPAGE SYSTEM: SEEPAGE PIT: /p/L~,-~..~ ~/~./~./jZ~-,~L~_~ NUMBER OF PITS ~:~ OUTSIDE DIAMETER OR WIDTH , LENGTH DEPTH ~ ~j~_~Z~/~ ~ / BUILDING FOUNDATION LINING MATERIA~ ~/~/~ ~Z~ DISTANCE FROM WELL ~ ~~ ~~ NEAREST LOT LINE ~ ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ SQ. FT. TILE DRAIN FIELD: A BSOR DEPTH: TOP OF TILE TO FINISH GRADE ~r-~cJ FTD~'TI O N /~~ -~ ~.NEAREST.~T I~1(- N WII~iTLOT LINE DISTANCE BETWEEN LINES ,~.~,, -.~,H SQ. FT. LENGTH OF EACH LINE WELL: T y p E,...~/..~,~..V..)~ ~- LOT LINE /'~ /"/--- TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE-- DISTANCE FROM 2 / WATER .j-~'~.~-~'L~-'~ NEAREST DEPTH. /~"/~'-'~' -, BUILDING FOUNDATION.-/~ ~'"-- SAMPLE NEAREST SEPTIC / SEEPAGE ~' OTHER ~.~--,~y -~"-- ~'~.S' , CESSPOOL,..-'g~")/~'~-'~, SOURC~'",,'f:-'~/~v' · SEWER LINE /~) /:/~ TANK SYSTEM DISTANCES: DIAGRAM OF SYSTEM DATE GREATER ANCHORAGe AREA BoROuGH DEPARTMENT DP ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT COMPLETION DATE ANTICIPATED PINAL INSPECTION: 24 HOUR NOT~CE REQUIRED, BACKFILLING DP ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT DP ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZ TYPE SEEPAGE AREA SIZE . TYPE MINIMUM DISTANGE$, REQUIREMENTS SEPTIC TANK TO SEEPAGE PIT WALL WATER MAIN TO SEPTIC TANK SEPTIC TANK, , SEEPAGE Pit TO RIVER, LAKE, STREAM. CAST iRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL SAC:KIFILL TO BOROUGH REGUL ,TIONS REGARDING INSTALLATION. I CERTIFY THAT I Am FAmiLiar WITH THE REQUIREMENTS OF G~EaTER ANCHORAGE AREA BOROUGH ORDINANCE O, 28-68AND THAT THE ABOVE ESCR,,ESYSTE ' i ACCO DANCE 'T",AIDCODE.(, '~e-rformed~ For Duane Go~de~ Date Performed_ teaal This ~escrt~tion: Lot 5 Block form Renorts Soils LoQ~ Subdivision 3809 Campbell Field Road~ Percolation Test Peoth Feet Soil Characteristics Silty Gravel 2 -- 3-- Si~ty Sandy Gravel- 22~ Sandy Gravel - 8~ Silty Sandy Gray, el - ~60 Was Ground Water Encountered? I¢ Yes, At what Denth? N CI ].Read i n q Date Gress ~rCglatton Rate PruPosed Insta-1l~-~on: of Inlet 160 ft dre om water Time Net Time Minute Seena~e Pit yes Depth To Depth to H20 Net Dron Drain Field Bottom Of Pit Or table ft. below see Te~.t Lab Data Certified By: Date: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Approval requested by: ~¢~,L~L~ ~)~,~C~ ('T'~r~O~ Mailing Address: &~q ~ ~ ~~ Phone: Property Owner: ,z. '~~, Phone: Mailing Address: ~ eO~o~[ ~,~4~ ~ Location: Type of facility to be inspected Well Data: No. of bedrooms A. Type C. Construction B. Depth D. Bacterial Analysis 7. Sewage Disposal System: A. Installed B. Installer C. Septic Tank: D. Seepage Pit: 1. Size iJ~'--~) 2. Manufacturer 1. Absorption Area /O~J'- 2. Material E. Disposal Field: Total length of lines 8. Di'stances: A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages 3330 GREATER ANCHORAGE AREA BOROUGH DePartment of Environmental Quality "C" St., Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA x FHA CONV 2. Property Owner: GRAVELY, Thomas E. Mailing Address: 3809 Campbell Airstrip Road DaS Phone ? 3. Name of Buyer: DOAK, Barney Ro Mailing Address: Box 1253 Anchorage, Alaska Day Phone279-6661 99510 4. Name of Lending Institution: SECURITY PACIFIC MORTGAGE CORPORATION Mailing Address: 319 west 5th Ave. Phone 272-9501 5. Name of Realtor or Agent: Bob Diggins Realty Mailing Address: 444 7th Avenue Phone 279-3922 o Legal Description: Location: Lot 5, of the subdivision of Lots 28 & 29, of Sec° 26, T13W, R3W Seward Meridian Anchorage ~ Alaska Type of Facility Water Supply Type of Supply: If Individual, If Individual, to be inspected: Home ~O,.Bdrms. 4 Public Utility number of dwellings depth of well unknown Sewage Disposal System Type of system: Public Utility If Individual, date of installation Individual x presently served 1 Individual (on-site) X 8/15/73 ? EQ-037 (1/74) Pa~ge 2 of two pages Pr~Jst for Approval of Individual~' - er & Water Facilities Legal Description o~zJ/.r5 ~J).P~ ~5]~] r~) ~F~_t ~ & ~q ~_ ~/~-~1~(,~. Comments (~ ~~ ~ ~~(~ ./~ Approved g[~ Disapproved Date ~'*~/~ j~ Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM i certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ~034 (1/74) ~EATER ANCHORAGE AREA BOROUGH !~ALTH DEPgRT~MNT 527 EAGLE STREET ANCHORAGE, ALASKA 99S01 279-2Sll / ,~/,,a/~tt~. b ~ 1'7- DATE .ECEIVEO INSPECT: ,~ TIME: ~//',-~t::~ ~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES FOR / 2. Property Owner ~Z.~b(~ Phone 4. ~e of Facility to bo Ins'p~ct~~~T: '[~,~dl~d~ '; ff~f/.~ B. Depth C. Size d D. Construction E. Bacterial Analysis 6. Sewage Disposal System: Septic Tank (If homemade~ show diagram on back) 1. Size 3. Manufacturer 4. Installer A~provdl Request for S ) ~ Water Facilities Page Two B. Seepage Pit 1. Size 2. Lining C .... Disposa] Field 1, Number of Lines 2. Total Length Required Measurements A. Well to Septic Tank B. Well to Seepage Pit C. D. E. F. G. H. Well to Sewer Line /~ ~-, Well to Property Line ·ell to Other Possible Contamination/(/~_~/~---f/t/~z~ Foundation to Septic Tank Foundation to Seepage Pit ~ Seepage Pit. to Property Line 8. COY/~ENTS: APPROVAL VALID FOR ONE YEAR FROH DATE SIGNED. GREATER ANCHORAGE ARBA BOROUC~ HBALTH DEPARTMENT EDllT0 REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES (Fill out in Triplicate) k. ~a~ .of parson requesting approval 2.' ,~a.~,,~ o£ property~owner 4. NumLex"of b~dz~ooms in house 5. Watex~.Analy$is: OP~.~ p~ t~ a. Bactemla] b. Detergent Well data: c. Casing Size__ ~1t d. Distance from well to closest existing or proposed: 1. Sewer llne ~z~2 7. Sewage disposal system, 2. Septic tank__~_~. 3, Seepage Area Cesspool' Q7 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. ~R, a. Age of system . '3 b. Septic tank capacity in gallons c. Name of septic tank manufacturer 1. If "home made" show diagram on reverse side of this form. d.' Disposal field or seepage pit size and type, Distance to property line to house foundation -e, Pereolat ion~,Test '%¢e sul-t s f. Percolation Test performed by ~ ., Use the reverse .side of this form to show diagram. Diagram should include [~he fo]~].owlng information: p~operty lines~ .well location, house location, ~c tank location ~ disposal area location, location of percolation test ~ a~d direction of ground slope. The ln~f~.~ion on this form is true and corrq~t to the best of my knowledge. k ~gnat~0 Applicant D~te Si~ned T__O, BE FILLED OUT BY HEALTH DEPARTMENT PERSONNEL ~-~'T~e above described sanitary facilities are hereby approved~ subject to the Conditions: The above described sanitary aczlztles are disapproved for the following reasons: Signature of ~f~i'¢i;Rla ~ ...... ~ ; , Approval is valid fop one yeam following the date of approval. CPJ:cw