HomeMy WebLinkAboutT15N R1W SEC 9 LT 66 S PTN GRE ER ANCHORAGE AREA BO?'UGH
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE , ~
FROM WE EL ~2/
INSIDE LENGTH
MANUFACTURER C' l'(' -~:~,~
INSIDE WIDTH
MATERIAL
NUMBER OF
COMPARTMENTS
LIQUID DEPTH __
LIQUID CAPACITY /z~,/~Z'~ GALLONS.
SEEPAGE PIT: /
NUMBER OF PITS /. DIAMETER __OR WIDTH/~ , LENGTHff-~,~'& ' DEPTH ~
LINING MATERIAL/I~f/~ CRIB SIZE: DIAMETER ~//DEPTH ~ ;~DISTANCE FROM: WELL/~)~'//~
BUILDING FOUNDATION~z~ ,~ NEAREST LOT LINE ~--~'~ ~ TOTAL EFFECTIVE
· ABSORPTION AREA (WALL AREA) /~/,~ SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK , SYSTEM
DISTANCES:
INSTALLED
PIPE MATERIAL: ~,$1
LOTSLOPE:
REMARKS:
Form No, EQ-031
NAME Of APPLICANT
INSTALLATION LO CAT~/q~
GREATER ANCHORAGE AREA BOROUGH
DICPARTMIE;NT OF ENVIRONMENTAL C~UALITY
P£RM]T NO,
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
~ SEEPAGE PiT ~', , DRAIN FIELD OTHER
TO BE INSTALLED BY
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
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEEPAGE P]T
SEPTIC TANK TO SEEPAGE Pit WALL / ~- [
SEEPAGE PiT
SEPTIC TANK
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SePTiC TANK
DRAIN Field
DRAIN FIELD
· DRAIN FIELD
SEEPAGE PiT///~l-/
ALSO CONSIDER AREA WELLS.
, 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 SOil.
4 INCH DIAMETER CAST RON SIPHON ~l~F-S--0~ SEPTIC TANK AND SEEPAGE PiT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DATE ~ ~/ :~7: APPLICANT·. SIGNATURE'S' ~'~:* / '
' 0SE
Russell Oyster
694-2774
Soils 8 Foundations
GEOTECHNICAL 8 DEVELOPMENT
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
CO.
Earl Ellis
6~-2280
Land Development
SOIL LOG
Performed for: Name: ~"'%~ ~ x"-,:. ~'x~%/-vS'~-~-Tel. No.
Mailtng Address: ~
'Legal Description: ~ ~' ~
Depth (feet) Sol1 Characteristics
5
'
Ground Water Encountered: Yes No ~ If ~e~, wh~t ~epth
Proposed Installation: Seepage Pit ¢ Drain Field
GP"e, TER ANCHORAGE AREA BOROI'~-H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE EROM WEL 5 /
LIQUID CAPACITY / ~_.~-,..~l GALLONS.
MAILING
ADDRESS ~'~ '/"///~'~'~/',~' PHONE
LEGAL DESCRIPTION
MATERIAL ~-~)/t~J C ~ ~'~' ~'~''' NUMBER OF
COMPARTMENTS /~
L,QU D
INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS
NEAREST LOT LINE
OUTSIDE DIAMETER ~ OR WIDTH ~'~! , LENGTH /"~ ! DEPTH
/~/J~/Cw;r,~ .DISTANCE FROM WELl //V~(~ f ,BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) /~ ~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELl
NUMBER OF LINES
ABSORPTION AREA
FOUNDATION .~.~...~,,-:"'~AREST LOT LINE
DISTANCE BETW[EN'CT~[S TRENCH WIDTH
.,~' SQ. FT. LENGTH OF EACH LiNE
TOTAL LENGTH
., OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
.DEPTH OF FILTER MATERIAL BENEATH TILE
iN, ABOVE TILE
WELL: TYPE ~/~.[~..~.et~ . DEPTH ~,.~l'J~
> NEAREST SEPTIC
LOT LINE SEWER LINE ~
, , TANK
DISTANCE FROM ~ / WATER j~/~
,BUILDING FOUNDATION, SAMPLE ., NEAREST
~,~ / SEEPAGE //~,~ ~' OTHER
, SYSTEM , CESSPOOL ~ , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
DATE
APPROVED
~*"~'~'~ GREATEI ANCHORAGE AREA' )ROUGH Case No.
HEALTH DEPARTMENT
327 EaSe St. Anchorage, Alaska 99501
279-2511
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH ~c~.~
PERCOLATION TEST RESULTS ~/',/4
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT ,/~-~-/.,~.,~ il. z~,../~.,~,.~j. MAILING ADDRESS .,, PHONE NO.
RESIDENCE ADDRESS LOCATION OF INSTALLATION
LEGAL DESCRIPTION////'/~' '' ' ×?
~/ ,SEEPABEPIT. ~ ,B~AINFIELB ,OTHE~
TO BE INSTALLED BY ~/~'~- . )
ANTICIPATED DATE OF COMPLETION ;}~ ~/~2 ,-,.4.~,~/~ 2
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
____ AS DESCRIBED BELOW. SIZE O~NIT TO ~SERVED ~ ~A',,'~-/ '
. SEPnC TANK S~Z, /O'~g~ .TY,E /~/~ ~',EPA~E AREA /~ ~/F TY,E '~ %?'"J
DISTANCES:
Mth Authority
/
/
DIAGRAM OF SYSTEM
I certify that I am familiar with the requixements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE .
Sapto 2#~ 1969
¢lebu~fle ~sa 75051
.~UBJECTI '1~o Bad,oma Rental tiouse
On Sl~h~Ond Loop Road
Wee
The ~reate~ .~age A.-em Bo~ot~h Health llepa~t~ent has bee. contacted
b~ ~he tenon~ yo~ s~e~ prope~ o~e~An~ ~he se~e~ ~7~em, T~e
Lueplot~on lbo. ~d the ~olt~An~t
The sewe~ system consists of a cesspool located 65t from the well.
2. The sewer system uo~ overflowing at the tine of the l~spactiou.
We wish to lnfoL-,m you that both conditions mentioned above a~e in
v~olation of Borough Ordinance #20-68 in that the mininu~ degree of
sewage treatment shall be by a p~ope~ly last&lied septic tank and
seepage pit and that overflo~in~ sewaBe le exposed to ehlldren, dogs,
flies, ver~ttn~ et~,, and aah spread serious diseases.
You Are he~,eby n~fioAmlly notified that this system is to be corrected
within 21 d~ys after ~his letter has been sent, Correction shall be
oc~plete on or before Ootobe~ 15, 1~69~
immediate legal action to have the pre.iaea vacated and remain vacated
until the sewe~ system has bees repaired.
This Department will issue a ~et~sit ~o install a ~ew system ~s soon as
~ritten notice is received from you that this ia satisfactory, ^rrenge-
manta for payment of the aewe~ system eau be made mt this time also.
The tenant contacted Wmllace Cons~uctinn to have ~he system installed
and was quoted m price of approxl~ateAy $1,000,00. Please advise us if
another company o~'y~u~ choice ls~sired.
Slnaerely,
DAVID R. Lo DUMCAN, H. O.
Medical Director
Sanitarian
cog Borough Attorney
the eub~eot p~operty,
wad sorrowed,
eot ~o~oufih At~t:ormmy
REQUEST P' APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITlt,~
(Fill out in Triplicate)
:'' '~ame of person requesting approv~~ ) '~~cr
b. DetemKent U
h.
c. Casin~ Siz9
d. Distance from well to closest existing or proposed:
1. ~ewer ].~ne ~
3. Seepa~e Area~.
4, Cesspoo]~___ ,,.
5. Property Line_~_~.
6. Other sources of possible contamination, i.e.: creeks, lakes,
houses~ ba~n~ drainage d~tch, etc.
Sew~t.e d~spooal system,
a. A~e of system ....
b. Septic tank capacity in ga].~ons... ,//~/.~
1. If "home made" show diagram on reverse side of this form.
d.' Disposal field or seepage pit size and type
_.
~-~. . ....... , ....
? ~''
- l, Di~tance tol~rope~y L~ne~.. to house f~mdation. _
Pefco] atJ on. Te'~.;t
Percolation Test performed by
Use the reverse .side of this form to show diagram. Diagram should include
.'the fo]lowing h~formation: p~operty lines~.well location, house location,
~>o-l,~c tank locatioa, disposal area location~ location of percolation test,
a~d direction of ground slope.
9. The ~n~-~,,,~¢m on this form is true and correct to the best of my knowledge.
'S'i~ature of Applicant
Date Signed
~.p. ~ FILLED OUT BY HEALTH DEPART~ENT PERSONNEL
The above described sanitary facilities are hereby approved, subje.c.t to the.
Condit iona :~~~
The above described sanitary facilities are disapproved for the followin~
Appz'oval is valid for one year following the date of approval.
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