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HomeMy WebLinkAboutROLLING HILLS ESTATES BLK C LT 2Rolling Hills Estates Block C Lot 2 011-07240 EXPIRED PERMIT � 11 MUNICIPALITY OF ANCHORAGE 514' 1415D Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ) WATER SUPPLY PERMIT Renewal Permit Number: SW040491 Legal Description: ROLLING HILLS ESTATES BLK C LT 2 Design Engineer: 0024 Eagle River Engineering Services Owner Name: PETER RAYNOR Owner Address: 5132 W 72ND AVENUE ANCHORAGE. AK 99502-1901 Date Issued: Jan 28, 2005 Expiration Date: Jan 28, 2006 Parcel ID: 011-072-10 Site Address: 005132 72ND AVE W Lot Size: 22150 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Q Disposal Field Q Septic Tank Holding Tank El Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE EXISTING WATER WELL SHALL BE PERMANENTLY DECOMMISSIONED PURSUANT TO AMC 15.55 PRIOR TO CONSTRUCTION BEGINNING ON THE PROPOSED WASTEWATER DISPOSAL SYSTEM AND PROOF FURNISHED TO THIS OFFICE OF THIS CONDITION. i/3/os - CfWK Vv000S Cnr.cto Fon IZc'DesV : TRF.rcN QE "144yPD 40 3-1 5,4 [ Ev fir.+h W Jf=+ .+ 4' 'rFFe 41 ✓E DEPTq � THE r DCPA HULL. ItEMAyJ Cl'. Received By- l/IZI���o,� Date: _ /2 /c' 7 /0 Ay Issued By. �Y�{/� Date: by MAY-04-2005(WED) 13:10 EAGLE RIVER ENGINEERING (FAX)907 694 3297 P.001/001 05/04/2005 13:40 FAX 907 347 7997 � ON SITE / J NO WELL OROSEPi1C �GIr & lz ,W L=15.25' R=20.00' Nth • wr3l, 72ND AVENUE WELL Nt t Sx 6)' 351 I SFPTIC 5T`P[S (TVP) G IV e V, Z ,u Ni'M� P PIPIt1G's REWIRLI OD10 • — DIVERTER VALVE M — TEST HOLE a— MONITOR TUBE ° — SEWER CLEAN OUT -0• — WELL -- — EASEMENT PROPOSED LEACH FIELD ��— EIOSTING LEACH FIELD ©— DRIVEWAY 1. INSTALL BULL RUN DIVERTER VALVE WELL/SEPTIC SITE P N ,B#03-067WSI DATE: 1/21/04 1 SCALE 1" = 40' EAGLE RIVER ENGINEERING SERVICES P.O. Boz 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3291 N 89'59'000 SD�� � etl'1° 9 ',CMN R 4' 1?% �� sA •• • CE -1035 7 � Municipality of Anchorage Development Services Department Building Safety Division -''S. On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us Q 41EK� (907) 343-7904 (n ON-SITE SEWERIWELL PERMIT APPLICATIO FOR A SINGLE FAMILY DWELLING J�^� oyoyq � Parcel I.D. OI - U / Z - Permit Number SW4Y4416 Property Mailing Site address _5732- Legal /3Z Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size ZZ -/.5-0 Acres/ THIS APPLICATION IS FOR: phone' 2 Y3 - 376 C. Code 99Sd Z ye_ Zip Code Number of Bedrooms -3 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Eamily Dwelling and is in accordance with applicable Municipal Codes. owner or authorized agent) � I Ir Waiver Fees: Date of Payment: //-2=q --D Date of Payment: Receipt Number: Receipt Number: (Rev. 09104) ,,e Municipality of Anchorage .r Department of Health and Human Services 825 *V Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Rick Mystrom httpJtwww.cl.anchorage.ak.us Mayor Permit Number: #SW40 0010 Date of Issue: 1-28-04 Parcel Identification Number: 011-072-10 Date Started: 7-15.04 Date Completed: 7-15-04 Is well located at approved permit location? ® Yes ❑ No Legal Description: Rolling Hills Estates Blk C Lot 2 Property Owner Name & Address: Peter Raynor 5132 W 72cnd Ave. Anchorace. Alaska 995502-1901 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type:is eel Stick up 0 2 Wall Thickness: ,250 inches organics & slit 2 3 Diameter: ¢ inches Depth: 107 feet gravelly silt silty gravel 3 67 67 85 Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet sandy silt silty gravel 85 96 96 103 Static water level (from ground level): ¢3 feet Pumping level: f 0 feet after water sand & gravel 103 107 g hours pumping 2-0 gpm Recovery Rate: 20 gpm Method of Testing: peLr—lift Well Intake Opening Type: ® Open End ❑ Open Hole ❑ Screened Startfeet Stopped feet ❑ Perforations Startfeet Stopped feet Grout Type: bentonite # 8 Volume: j Depth: Start!2 feet Stopped 2 feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No RECEIVED Method of Disinfection: chlorine tablets Comments: AUG 0 3 2004 Well Driller. Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 61UNICIPALITY Or Pj`CNORAGE ENVIRONMENTAL SERVICES DIVISION Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property �..... .. A. —11 JJH.. C. of .. .._: J. . —911.. ...t. T... .011.-1.& 0 rc.__... 1 .—.:._. /R J.... .P.....J ..!... Permit Number: SWO40010 MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jan 28, 2004 Expiration Date: Jan 27, 2005 Parcel ID: 011-072-10 Legal Description: fROLUNG HILLS ESTATES BLK 7:C LT::2 _I Design Engineer: 0848 Eagle River Engineering Services Site Address: 005132 72ND AVE W Owner Name: Peter Raynor Owner Address: 5132 W 72ND AVENUE ANCHORAGE. AK 99502-1901 Lot Size: 22150 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑v Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy [✓j Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE EXISTING WATER WELL SHALL BE PERMANENTLY DECOMMISSIONED PURSUANT TO AMC 15.55 PRIOR TO CONSTRUCTION BEGINNING ON THE PROPOSED WASTEWATER DISPOSAL SYSTEM AND PROOF FURNISHED TO THIS OFFICE OF THIS CONDITION. Received By. Issued By. Date: 117-41041 Date: Z .9Al- Oct -.14-03 12:57P Permit Counter 907 343 8250 P.01 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw, St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWERIWEi l PFRMIT APPLICATION! FOR A SINGLE FAMILY DWELLING Parcel I.D. 01 0 7oC jO Permit Number SWQ4 010 - Property Mailing address (1 Mailing address (2) A Legal description (Lot, Block & Su 'd.) _KOI I I Al NI I k ��}( Legal description (Section, Township & Range) Lot Size q a 150 Acres q.Ft THIS APPLICATION IS FOR: DayphoneAgl. '3 06 Sewer Only ❑ Well Only ❑ Sewer and Well G 64JWater Storage El Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information is correcL I further certify that this application Is being made for a Single FIIy Dwelling aid Is in accorfiance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: �t'c Date of Payment: I/$'oy Receipt Number: 3z (Rev. 17!00) Qi Fees:'? 173 - Date of Payment: ,f/ 2,2 lo (- Receipt Number: 7 7Q /0 ACV Eagle River Engineering ,Services Christopher R. Wood, P.1~. 10421 VFW Rd. Suite 201 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 Fax January 28, 2004 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Rolling Hills Estates, Lot 2, Block C Narrative & Permit Application Dear Mr. Cross: This letter is to request approval for a leachfield upgrade at the above referenced property. The on-site leach pit and concrete tank have failed and require replacement. As part of the upgrade, the well will have to be moved due to more stringent separation distance requirements required today than in 1971 when the original septic system and well were installed. This lot and the other neighboring small lots face constraints from private wells and a pond that borders the properties. The proposed leachfield upgrade will have very limited impact on adjacent properties for the following reasons: 1. The property to the north of the lot in question, across 72nd Avenue, is undeveloped. 2. Immediate neighboring septic systems are all +20' distance from the proposed system, and no private wells within 100' of the proposed leachfield replacement, with the exception of the referenced property's existing on-site well. 3. This permit is for replacement of the septic tank and leachfield, and new well. 4. Drainage will not be affected and is not a major consideration in our design. Most adjacent properties have separation distance waivers to either their on-site wells, or to the pond that all adjacent properties butt up against. However, since the separation distance from existing well to existing septic tank, and proposed leachfield is only 50', it is evident that the well needs to be abandoned, and a new well installed that will meet the current separation distance requirement of 100'. \2003\03-067SrmcNARRATi VED.uoc The existing leachpit will be kept online with the use of a bull -run type diversion valve. This work will not affect the reserve septic areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerely, EAGLE E G -RING � C istopher R. Wood, P.E. Principal \2003\03.067SErncNnnnnrnvED.noc Eagle River Engineering ,Services Christopher R. Wood, P.1~. 10421 VFW Rd. Suite 201 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax January 8, 2004 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Rolling Hills Estates, Lot 2, Block C Well to Septic System Separation Distance 1 Dear Mr. Cross: `�Jh) h yo` Request. This letter is to request a separation distagee waiver from the referenced property's on-site well to septic tank and leachfield. The lots ' the immediate area all butt up against a pond, with the lot sizes being around .5 acres. Ne y all of the adjacent properties have separation distance waivers to on-site wells or to the p d. We are requesting a waiver allow a separation distance of 50' from the on-site well to septic tank, and 54' to the leach Id. Static water level in the well is at 138' below top of casing, and the bottom of the well i 65' below top of casing. Based on the static water levels from adjacent lots (Lot 1 and Lot 4 tt can be seen that the static water level is much lower, perhaps indicating that the referenced roperty is tapped into a confined aquifer that is deeper than on adjacent lots. Lot 1 has a stati water level of 65 feet, and Lot 4 has a static water level of 72 feet. However, we assumed t (e worst case scenario for the points system and calculated a gradient of -20 degrees for tyc water table based on static water levels. We bell a that granting of this waiver will not have a negative impact on the water quality of the on ite well for the following reasons: 1) No water table was encountering during excavation of the test pit 2) There is no history of well contamination on record on the adjacent lots where waivers have been issued. 3) The existing septic tank and leachpit are located 50 feet and 90 feet respectively, from the on-site well, and have been for the last 33 years. 4) The attached calculation based on the points system shows a low likelihood of contamination of the on-site well. 5) Well drilling logs indicate the presence of clay layers and hard -pan silt layers between the bottom of the leachfield and the static water level in the well. X2003%03-067WA vFRReQUEST.00c Thank you for your consideration of this matter. Please call if you have any questions regarding this waiver request. I can be reached at 694-5195 Siricer,� AGLE RIVER ENGINEERING SERVICES Christopher R. Wood, P.E. Principal \2003\03-067 W,ovERREQuE.sT.00c WELL SEPTIC SITE PLAN•OF�4 ROLLING HILLS ESTATES, LOT 2, SLK. C �E •. ..A� t t� OWNER: PETER RAYNOR ��P•'' s ���% CONTRACTOR: N A * .4 JOB 03-067WS DATE: 1/21/04 SCALE 1 to = 40' EAGLE RIVER ENGINEERING SERVICES �� '"'R CCE-HE e7 AV P.O. Box 773294 1�? ' • . AEAGLE RIVER, AK. 99577 �1�0 (907) 694-5195 FAX.• (907) 694-3297 ��k��� +�� UNDEVELOPED NO WELL OR SEPTIC 72ND AVENUE 1 L=15.25' R=20.00' N 89'59'00" W 171.80' PROPOSED WELL . _ J / •• . •.. ti • • / DRIVE GRAVEL41 �od \ �v%• •.. / A4. �A •.I q� �0° ABANDON EXISTING r \ REQUIREMENR INSTALL ODO GALW \�' 0 SEPTIC STANDPIPES (TW) INSTALL NEW SEPTIC TANK �• ox 7' TOUNDA ION �. ° � \ CIEAN-WT L9 8 TN I \ 'r o xs. \ HOUSE/ KIBUI ST RU L / / D1 vALYi / `Ddu• K� / / p- 7 INSTALL NEW PIPING AS REQUIRED p WELL TOO. %AGN NELI R,1t ° SEPTIC STANDPIPES (TTP) '� ° p6'p0• W 0— DIVERTER VALVE ® — TEST HOLE • — MONITOR TUBE D — SEWER CLEAN OUT ptl�D 4- — WELL — — — EASEMENT — PROPOSED LEACH FIELD ° — EXISTING LEACH FIELD Dom— DRIVEWAY 1. INSTALL BULL RUN DIVERTER VALVE WELL SEPTIC SITE PLAN•OF�4 ROLLING HILLS ESTATES, LOT 2, SLK. C �E •. ..A� t t� OWNER: PETER RAYNOR ��P•'' s ���% CONTRACTOR: N A * .4 JOB 03-067WS DATE: 1/21/04 SCALE 1 to = 40' EAGLE RIVER ENGINEERING SERVICES �� '"'R CCE-HE e7 AV P.O. Box 773294 1�? ' • . AEAGLE RIVER, AK. 99577 �1�0 (907) 694-5195 FAX.• (907) 694-3297 ��k��� +�� Eagle River Engineering Services Christopher R. WooJ, P.E. 10421 VFW RD SUITE 201 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM — MOA CERTIFIED INSTALLER LEGAL: Rolling Ilills Est. L 2 B C December 18, 2003 A. GENERAL 1. The replacement septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK 1. New sewer piping from the house to the tank shall be utilized. A foundation cleanout shall be installed. 2. New Septic Tank shall be a minimum of 1,000 gallon tank of MOA approved construction, insulated, or place with 4' of soil cover, min. or provide 2" per each foot shallower than 4', 2' soil minimum. C. TRENCH 1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. 2. The bottom of the trench shall be level, plus or minus 1.5", and shall be located no deeper than 9.5' below top of original ground surface. 3. The existing leach pit shall be connected to the new system with a Bull -Run type diversion valve. 4. The trench gravel shall be covered with typar fabric material. 5. Natural soil shall be placed over the trench to a minimum depth of 3; or 2" of insulation and 2' of soil. 6. The area over the trench is to be mounded, or finish graded to prevent ponding of surface water runoff. Care shall be taken to ensure that the required fill depth is maintained over the entire trench. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well, and is the Contractor's responsibility to verify. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = (NTE) 9.5' GRAVEL DEPTH = 6' under pipe, 2" over pipe TRENCH LENGTH = 47' TRENCII WIDTII = 3' SOIL RATING= 0.8 GPD/ft' BEDROOM CAPACITY= 3 SEPTIC TANK - 1000 Gal. Twenty-four (24) hours notice required for all inspections. \2003%03-067Trench- spcc.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 6945195 ERES Project No.: 03-067 Calculated By: CW Date: 12/18/2003 Legal: Rolling Hills Estates Lot 2 Blk C Single Family 3 Bedroom Dwelling Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = Percolation rate = Wastewater application rate = Required absorption area = Trench width (W) = Gravel depth (D) = TEST HOLE 1 C 450 gallons ,806 minutes per inch 0.8 gallons per day per square foot 563 square feet 3 feet 6 feet Required length = Required absorption area / 2 / D Required length = Required length = Total Excavation Depth = 583 / 2 / 6 47 feet 9.5 feet 03-067 Cal.xis 9:50 AM12118/2003 .. V: .�L •_ .._.....:'ITV �.. 03-067 Cal.xis 9:50 AM12118/2003 r • �, Municipality of Anchorage DEPARTMENT OF HEALTH d HUMAN SERVICES 825'L' Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: PULL RA•/AJV✓Z DATE PER LEGAL DESCRIPTION: D (.J F grU�5 p S7. L Z 3 G Township, Range, Section: T I IFEET) I FILE- 2- 3- 4- 5- 6- 7 - 8 l LL 1 234 6678 ht 9 10 , 16 16- 17- 18- 19- 20 817181920 COMMENTS • � JL toPSo! L SM - 510-7 SAA)b B Rotr.NJ PLAN WAS GROUND WATER ENCOUNTERED? AID S IF YES. AT WHAT L DEPTH? O P E Depth to Water Mer --H4:F Monituing? Alm"t' Date r2 5 Reading Date Gross Time Not Time Depth to Water Net. Drop Z '20 3 0 rr 11 0 = ',,'z Z •7o/ 7 •Vcr 'Ip (��• ��• $ 12)O '1F'al rn S'. 1, •", ,r X SoRtLb 4" .. PERCOLATION RATE Iminutee/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 4 FT yj ti' < T) T -y SAAlb , R 2otJA1, So PERFORMED BY: LNKIS L.Jnnt> �r CERTIFY/TJ1AT THIS TEST WAS PERFORMED ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE /A 72-008 IRar. 495) . EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER. AK 99577 (907) 694.5195 --4R.0 LIL-X;0�-1.14.ra:.c e - �WFSIMLWJ, SHEET NO. OF CALCULATED BY c DATE CHECKED DATE 4 ........ ... .. j. 12 7 Lo Lj' 12. . ....... .... .... -A t 07, It. -L I ii U17 :73 T tz, i I C'Q f L3 . . . .. .. ........ .... ... t4 . .........j I i i . . .... ...... . ... ............ ... ... ..... . ...... . ........ ... . ..... . — ...... ....... --,w�dy-1�/fir -s s AAROW PUMP & WER SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 • Fax (907) 333-8976 Palmer: (907) 745-9077 • Eagle River: (907) 622-9335 F— PSTOMER Y�e a N r 5 o3 t'). n gq:vd, JOB SITE X5-13 ) b it -21-" d J L MOUCIEE 6751. J I ICE TE WELL DEPTH SWL CHLORINATED PUMP DEPTH SAL 5 °RSON pter 14- .—,QUANT! - - ..:,....,.:.DESCRIPTION:: _. _.-_,-..-:—, ... :..:.-:. ...PRICE ... .. .: ANIOUNT ...... a a7 2nL wo -5- Or) e S - � sd ,P // ,r�"� rr 4JYIL u Y u• o11volo t!x U 51 X r Ala a a n I,r o i LABOR HOURS RATE AMOUNT TOTAL MATERIAL )qj-) O TOTAL LABOR asO WORK ORDERED BY DATE COMP. TOTAL LABOR ASO PAY THIS AMOUNT I /77 Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. GAAB-HD-1 GCTER ANCHORAGE AREA BOROI-ilii Ohl'ARTMENT OF ENVIRONMENTAL QUALM y _ 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM .4 'f NAME y�C ArE'E' < ✓ClZ' — -- ADDRESS MAILING „j/(rt (k'. "lC;/h //i/c e PHONE LOCATION /f y. SEPTIC TANK: DISTANCE FROM WELL �� MATERIAL LIQUID CAPACITY f4 ._GALLONS. INSIDE LENGTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF �(IMPAPTMFNTC _INSIDE WIDTH—DEPTH- NUMBER IDTH DEPTH NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH /O > LENGTHS, DEPTH , C lif��R'tE LINING MATERIAL ��eir'�''f .DISTANCE FROM WELL �©Q Z BUILDING FOUNDATIONew"a. NEAREST LOT LINE 26)'I;0 Gy TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 60144r SQ. FT. TILE DRAIN FIELD: DISTANCE FROM W NUMBER OF LINES ABSORPTION ISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE NEAREST LOT LIN TRENCH WIDTH TOTAL LENGTH OF LINES_, TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: DISTANCE FROM WATER TYPE/Jr�f C V DEPTH BUILDING FOUNDATION. SAMPLE NEAREST NEAREST SEPTIC` SEEPAGE i OTHER LOT LINE _ SEWER LINE ,TANK 2 SYSTEM CESSPOOL , SOURCES_ DISTANCES: DIAGRAM OF SYSTEM GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT �/ �'"�w � ' � � MAILING ADDRESS � �� �" ' �-PHONE -' INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK y SEEPAGE PIT ��- DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED ALZLS ` 'ffj &; /� FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS'�?7�/NC= NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST C COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. dG✓>/.cam A/� SEPTIC TANK SIZE TYPE �r� - SEEPAGE AREA SIZE�'�- TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK, SEEPAGE PIT'p / DRAIN FIELD --r TO NEAREST LOT LINE. WELL TO SEPTIC TANK �® ✓ SEEPAGE PIT �L%L/% / DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD ALSO CONSIDER AREA WELLS. 10 / Q / ,SEEPAGE PIT SEPTIC TANK, _✓� SEEPAGE PIT, DRAIN FIELD 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 IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, DATE APPLICANT'S SIGNATURE 0 CREATER AVCHnYAPY ARQ K HEALTA alVAITMENT CASE 327 EAKE STREET ANCHORAGn ALARKA 9001 Excavator - David Brown ArfoPmed For John E. Raynor Logo! Des CA titer,, .... . ... -._,.Date Performed 8/26/71 3 C O';"RRolling Tri g, Yarm Reporzs az s7T77-t10c, X SU!"vsn , Depth rpnr K Brown clayey silt (NQ 4 Gray fine to medium sand (SW) 6 8 Gray and brown silt sand mix (M) 10 12 Location skotrh lP was Ground Water Encountered? no If Yest AT N'Nrat DePTh rroposou X Drain Field Depth of jnje-�� COMMENTS; J'Iept& 3 0 Bottom Of Pit Or TroncT--- �3s _uaarilre�e . of (1r7a`nije`-'�-relii�is i t ofring-isuseYaAset at k!, 'e�—CL room Test Performed By: R. E. Carlisle Data Certified BY: NationalTesting Services, Inc. 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