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Home My WebLink AboutSUETAWN ESTATE #1 LT 10.511 / ~' MUNICIPALITYOFANCHORAGE 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 BEDROOMS~ ,, DISTANCE TO: IWe~.~ ~ I Abs°rpti°n )eh / Dwelling N~ PERMIT N~7~ Manufacturer Material No. of compartments ~ ~ ~o. of lines ~nish ~rade~ ii2222~ Total eff~ct,ve~o~¢ar~ ~ T°p°ftilet° Length ' Width 3epth PERMIT NO. ~ ~ Type of crib Crib diameter rib depth Total effective absorption area ~ Well Building foundation Nearest lot line m DISTANCE TO: ~ Class Depth Distance to lot line PERMIT NO. ~ ~ / ~ f fl~di~g fo~d~[o~ ~ lSewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS INSTALLER -- er. 3178) MUNICIPALITY OF ANCHORAGE Department( ~ Health and Environmenta~ ~rotection 825 ~ Street, Anchorage, AK. ~501 ~ I~C~'~ * * * HANDWRITTEN PERMIT * * * P~rmit ~ ' WC-k~AN~ON-SITE SEWER PERMIT ~ocation: Phone Number: ~egal Description: ~ ~ /O C~~q~- ~ Lot Size: -- Type of Soil Absorption System Is: Trench: ~ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ','~ . Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH /% LENGTH ~? ~/ ---- GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The d'epth 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(FIO~,,,~,- 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 rlesidences that the well will serve. · * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by 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 51, 1 9 8 3 * * * Z certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I u~rstand that the on-site sewer system may r~equire enlargement if tt/~s~nce is~emodeled to include more thy~room?/~ ' ~Applicant Date: L~./~ ~ ~ SWP/024(1/81) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION B2§ L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ~-- SOl LS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3- 4- 5- 6- 7- 9- SLOPE SITE PLAN 10- 11 12 --13 14 15 16 17 18 19 20- COMMENTS PERFORMED BY: 72-008 (6/79) ~' ~'{~ ~ WAS GROUND WATER ~'C~ ~7~]~ ,.~*}L~-'~ IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop [ ~'~ '~; Sh~' ,~I:,";~-E R CO LATIO N RATE f ~ (m,nutes/,nch) ~ NO. ~457- ,~ ~:TEST RUN BETWEEN FT ~N~ ~ ~H, G~ ~:.2979 GR~'~TER ANCHORAGE AREA BOROP k .... HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279L2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: MAILING A D DRESS ~,,'~'~/¥ LEGAL DESCRIPTION,~/-~)"~/,,~,, ~'~?~";~ ~ NUMBER OF DISTANCE FROM WELL~C)/ ,~:'-~)/,~--~.-') MATER AL '~ ~'--~'-- COMPARTMENTS / LIQUID LIQUID CAPACITY ."~'~' GALLONS. INSIDE LENGTH ~"'~'-INSIDE WIDTH ~ DEPTH SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAl NEAREST LOT LINE SEEPAGE PIT: .~",m/.,~. ~'~/~':.,,,~/,~--~ .~z//Z( ~ ~ OUTSIDE DIAMETER '~ OR WIDTH. /~ / , LENGTH /~ / , DEPTH /'~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) .- ~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM [~ DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF EILTER MATERIAL BENEATH TILE IN. ABOVE TILE W ELL.iAi/),A/~J "~, T~'PE ~/~/.~S/~ DEPTH NEAREST LOT LINE /.,~ ",~'-'~'~') SEWER LINE ~ DISTANCES: ~ DISTANCE FROM ' ~i~ '" )WATER , BUILDING FOUNDATIO .~'"~)' · SAMPLE SEPTIC. · SYSTEM//~'~,,~'~, ) CESSPOOL .TA~K~, ) . SEEPAG~ . , /. DIAGRAM OF SYSTEM ., NEAREST .~ OTHER · SOURCES DATE HEALTH AUTHORITY GAAB-H D-2 · GREATEL~>tNCHORAGE AREA ,., 2ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case No. ~/~ SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT~ ~; O/"~*](..,/,KI MAtLIN0 ADDRESS~X'~/7 /~_,' ,Tg.~ PHONE NO~'~ . . g&~ P~>~/~ ~ - . ~ESIBENCE ABBBESS~ ~,~ I~r~'l LOCATION OF INSTALLATION APPLICATION TO INSTALL: SEPTIC TANK ~ , SEEPAGE PIT ~ , DRAIN FIELD ,OTHER FINANCED THROUGH TO BE INSTALLEB PERCOEATION TEST 8ESULTS ~ ~.~ ./~, ANTICIPATED DATE OF COMPEETION BELOW TO BE FILLED OBT BY HEALTH DEPARTMENT THIS IS TO SERVE AS/~//)/7 . .J~/~'.Y'J~/~ "~ , PERMIT TO INSTALL A A8 OESCRIBEO BELOW. 81ZE OF UNIT TO BE 8ERVEO ..SEPT,C TANK S, E '7SEEPAOE AREA TYPE DIAGRAM OF SYSTEM DISTANCES: Health Authority I certify that I 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. 0ATE 7'"" ~, ,~-- ~ APPLICANTSSIGNATURE HEALTH ,;-,~ Ar ARCHORAt:E, A Depth ' ~h~ ..... e Feet So~ o ...... ~t rls%ics Depth To Net Drop o.: UNITD STATES DEPAR~T OF AGRiCUL~URE FARMERS HOME AD~-N-ISTRATi0N HEALTH AUTHORITY APPROVAL I~DD1-V/DUAL WATER SUPPLY AND/OR S~.,'[AGE DISPOSAL SYST~,[ · Total Nut,bet Area Bedrooms Baths Property Address: Water Supply by: ~ublic System Sew~_~e Edsposal by: /__/ Public System Seller or Contractor: Bs seine nt Zes Community System New Installation ~ rudividual Retnrn to: Farmers Horns Administration IBlk. No. I Lot Can kttic ~r other a:~e--"~- be made into additional bedroom? If yes~ how ms, rj~? ~.stem Designed for ~ Cormuuuity System ~ Individual This space and ba~'k 'for Health Authority Inspector's use FOLLU,'FiNG TO BE COMPLETED BY HEALTH AU~:~IORITY Zt is the opinion of the /--~ State /~ County ~ Local IMpartment of Health that this indiviah~al water supply sys--tem ~ i~- ~ is no~--satisfactory as a domestic water supply for subject property. Et is the opinion of the /=-/ State /~ County F,~'~ Local Departmsnt of Health that this indivia~al sewage system ~th proper~intenance,i- can be expected to function satisfactorily and /~-.is not likely to create an insanitary condition cannot be expected to ~/~ function satisfactorily INSPECTION REPORT - INDIVIDUAL SE~qAGE-DISPOSAL SYSTE~I PP~TM~J~H TREATM~ consists of ~/~ Septic Tsnk ~/~ Cesspool' Septic Tsmk: Dist,.ce from well/~ ft. M~terial To~ 1 liquid c~oacity '/6~, ga!. Capacity i~et continent / g~ Znside ~e~h '-~~.~ Inside ~dth ~'~ ft. Liq~d depth ~ ft. Cesspool: Distance from: ~-~ell/~'~, ft. F~ndation -%- ft. Ne~st lot ~ne ~ <~ ft. ~/~ S~epage Pits ~/~ Other .... SECO~'.~-D~,~ YREA%~'~i~ co~_sists of /~ Tile Disposal Field ~le Disposal Field: Dzov~ce from: Well f%~ Foundation ft. Ne~ lo% ~ne ft. Tots2 length of ~nes ft. ~er of lines Distance betvmen lines Trench ~,rld%h in~ Total effective absorption a~a in t~nch bottom sq~f%. mDgoh of each' line ft. ~pth of top soil to fi~sh ~rade in. ~e of f~ter material: ~ Gravel ~'~oken ~one ~__ ~her ~pth of filter material under tile in. ~pth of ~lter mterial on tile__ Seepsge ~-t: No, Pits ~tside ~.~ter ft. Depth ~ni~ ~_sv~ce !rom. %~ell ft. ~%ion ~e~st lot line ~ Inspection Made By: ~/~ State ~ Coomty ~/~ Local Health Authority Date Inspected b~ INSPECTION REPORT ~ ~fDMDUAL ?lATER-SUPPLY SYST~ Distance to the nearest public water main__ft. Size of main__in. - - L~e individual ~.~lls customa~g- in this ~ighborhood? ~ Give most recent record of failure of wells in vicinity to furnish adequate supply of'~-~..ater .ire properties in neighborhood being developed on both individusf[ water & sewer? , Lo% size ~,mlling. ft from front property line.. Distance of well from: Building foundation__ft. Nearest lot line__ft. Cast iron sewer ft. TLle se~mr ft. Septic tank ft. Disposal field ft. Seepage pit fro Cesspool fro Other sources of possible p611ution ft. ~all construction: ~lam~er in. Total depth ft. Type of casing and depth ft. Approxo dept----h to pumping level__ft. Approx. yield gals. per mirmbe Sealed ~,~atertight. to depth of ft. Well cover material ~%erzor casing~soace fill material Are opeuings watertight? The ~,~ll is: / / Drilled /-~Driven / / Dug / / Bored Pump: /'~ Shall~-~ well /-~ ~ep well. --~op pi~--length ft. Pump capacity glmm. Locate-~ in: /-~Garsge --/~Basement /--/Pumrphouse /--/--Pumoreo-m in or off house ~Dmmp mountir~ w---atertight.~- Storsge--t _ype: ~/--/G~a~ty __/~Pressume. Capacity if bacteriological e~srmination of water has beeu made~ Rive date: Quality of water ~ is ~ is not satisfactory for human comsumption. .~nspection made by: ~State ~Couuty ~/~ Local Health Authority. Date Inspected by DATE ALA..~.. ARTMENT OF HEALTH AND SOCIAl: S,ER'~.~,; -. iobNo · DIVISION OF pUBLIC HEALTH'.--:'. .- INDIVIDUAL AND SEMI-PUBLIC,-; ;'"' · ~? ' B A C T E RI 0 L 0 G I C A E W A T E R:'~:?A~N!;A.L-'¥ SI:'S'~;':~:'~ OFFIC~ NDIVIDUAL [] ADDRRS~ OF SOURCE REPORT RESU TSTO ~ ~ ~ ,~ ~"~7 ZIP CODE SAMPLE 1o be COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY [] Other(List) ' READ INSTRUCTIONS )o~R~.,wd ON REVERSE SIDE BEFQ?E COLLECTING~A/~ ~LE B,~,C[ERIoLO--~GIcAL WATER ANALYSIS RECORD '-~ , '~ T~me Rece,ved No C~~ ~,' - Lactose Brolh --t' I Occ I acc I acc I Occ 1 acc I .acc 1 .acc RMB AGAR Lactose Broth 24 hrs This anal zsis indicates Colffor re'Oeo ~is'm; lo be. 48 hrs Most orobable No. ~er 100ccl ./ OCT 1 ~ 1§73