HomeMy WebLinkAboutT15N R1W SEC 4 LT 51
~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT / .
LEGAL DESCRIPTION
LOCATION NO, OF ~EDROO~
Material No. of compartments
~ Liq. capacity in gallons Inside ~ength Widt Liquid depth
, ~ Weg Dwelling PERMIT NO.
O z ~ Manufacturer Material Liquid catty in gallons
~ Well Foundation Nearest lot I,7 ~O ' PERMIT NO.~ qO 3 q q
No. of lines Length of each ae., Total length of I,n~ ,, Trench widte,. ,nches Distance between let ~
~ ~ ~ Top of tge to finish grade ~ Material beneath tile Total effective absorp~on area
OTHfiB
MATERIALS ~ J~L'~
72-013 (Rev.
I-~iELL I:::1 l'-.I [:,
PERMIT NO. < ?'~0-'-;49 >
APPLICANT
LOCATION
LEGAL
LORANE SPRAGUE
OBERG ROAD
LSl S4 TISN
BOX 20i CHUGIRK 8K
DEPARTMENT OF HEALTH AN[:, ENVIRONi',IENTBL PROTECTInNL~__
LOT SIZE i~800 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT/BR)= 85
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM
[-"EF'TH= ? L E I'-,! G T H= --~-:-- 2 GRFtVEL DEPTH: 4
TNE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF ~ TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND RND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
~;~.:EI24U ~. RE[) SEF'T I E: TRI'-~K S I ZE= :1_ ~3~3~, GRLLn]~I'~S
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
T~I] (;~_:) ! ~SPECTIm]~-IS I~RE RE.!Id IRE[)
BACKFILLING OF 8NY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL RND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
· 00 FEET FOR A PRIVATE WELL; OR
150 TO ~00 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST 8E RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS M8Y APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PEF.:I"i ]IT EXF' I RES ~.,ECE~qBER
I CER'FIFY THAT
it: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 8ND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2~ I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3:~ I UNDERST8ND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
IbWED ................
~PPLIC. ANT LURAN~P~GUE
ISSUED E ..... DATE _ _ ',,,'~. 2
~UNI~IPALITY OF ANCHORAGE ~,
Departmen~'~ Health and Environments~-.protection ~ __
· 825 ~ ~ Street, Anchorage, AK. ~9501 ' ~/~d
264-4720
· * * HANDWRITTEN PERMIT * * *
Permit ~ ~ ON-SITE SEWER PERMIT ~/P~~b~:-
Location: Phone Number: ~(~--}~,
Type of Soil Absorption ~ystem rs:
Trench: ~-~--~ainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: ~,,. Soil Rating(sq.ft/br) ~ ~
The Required Size of the Soil Absorption System Is:'
DEPTH ~7 LENGTH 3.~ . GRAVEL DEPTH ~ WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
· * REQUIRED SEPTIC(HOLDING)-TANK SIZE = /~ GALLONS
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property, and the number
of residences that the well will serve.
· * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval b~ this department
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 a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
· * * PERMIT EXPIRES DECEMBER 31, 1 9 * *
I certify that:
(1) I am familiar with the requirements for on-site sewers ~nd wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I u~derstand that the on-site sewer system may r~uire enlargement if
/~e/residence is remodeled to include more tha~' 3~be~rooms~/~>~~
Signe~ . d
s$~/024(i/8i)
E
GEOTI~-':,HNICAL 8' DEVELO:~/IENT
Box 90, Davis St., Eagle Rivor, Alaska 99577
694-2774 or 688-2280
CO.
Russell Oyster Earl Ellis
694-2774 SO[L LOG 688-2280
soils ~ Foundations ~ Land Development
Perfomed for:
Mailing Address:
Depth (feet) ~c~e~istlc)
o
6
7
8 ~ .-5'/N
9
13
15
16
Ground Water Encountered: Yes No ~f yes, what depth~
Proposed Installation: Seepage Pit..~Drain Fte)d~
Comments:
(gerf:fieh riliing' og
by
DOC Co. dba
SULLIVAN WATER WELLS
P. O. BOX 272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759
OWNER OF LAND
ADDRESS
Ended
LEGAL DESCRIPTION
DATE - Started
PERMIT NUMBER
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING
K1ND OF FORMATION:
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MISCL. INFORMATION:
Ft,
· - ,Ft.
Ft.
Ft._
Ft
Ft.
.Ft.
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.Ft.
Ft.
Ft
From Ft. to--Ft
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From Ft. to Ft.
From Ft. to Ft.
From Ft. to FL
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft._
From Ft. to Ft.
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ENVIRONMENTAL ?~ OTECTION
AUg 9 1979
RECEIVED
DRILLER'S NAME
¢2
474 ~ 47B
GERTIFIC~,TE OFOWNERSHIP · DEDICATION
NOTARY'$ ACKNOWLEDGMENT
77 - 2 7&
DT1002429
PLAT OF
LOTS 47A 8~ 47B
SEC. 4,TI5N, RIW, S.M., ALASKA
A SUBDIVISION OF SECTION LOT 47
FRED WALATKA It ASSOCIATES
S424~