HomeMy WebLinkAboutSUMMIT ESTATES BLK 4 LT 6O?l
GRB..i'ER ANCHORAGE AREA B01.._.J'UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
II~SPECTION REPORT ON-SITE ~.~EWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE
/
FROM WELL
INSIDE LENGTH
MANUFACTURERc~'~-/~
INSIDE WIDTH
/~-j'~ NUMBER OF
MATERIAL , COMPARTMENTS
LIQUID DEPTH LIQUID CAPACITY/~:~G)ALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL //'2/,~/' FOUNDATION
NUMBER OF LINES / DISTANCE BETWEEN LINES
ABSORPTION AREA ,~"~('~ SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRAOE ¢ / DEPTH OF FILTER
MATERIAL BENEATH TILE__~::) / ~ABOVE TILE
NEAREST LOT LINE 2,/) / TOTAL LENGTH..~.~.~../
OF LINES
/~///~ TRENCH W IDT H(-~ IN. TOTAL EFFECTIVE
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE__
DEPTH
SEPTIC SEEPAGE
TANK SYSTEM
DISTANCE FROM:
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL-
LOT SLOPE:
rP s�,r���► ',`ra r'rI'r�`,r '`e�'rs
V V,rw ..n i.r. 4arwV rr 'ea aa..d vlrt, ago- .rwe w �
+ne ��r
• ��✓Y )3 `s'�.0 i3i'1 `ri 5y :°'i"3',1Ilt �:.'d ii' ., ,i .�'ti i'1T9�:!.,°e 7�i'',.
.11',.1 `.i7\s''a a-�•i :� �il
SIX INCH WATER WELL DRILLED AND '_A, : C1 _7 T �;i_ [±I:p`H nr
[DRILLED AT THE RATE OF
_ pROpgRTy. OWNER d :3.$• e,., .:;....^,:7
F- {„1�373..----.._.—
t
LOCATION OF WELL SITE_____Lt, 63•%,-_" «.�
+
i
' DRILLER Pemle Claus cf 2anp—_tt
s — -- ---- -
-- �. _
I
WELL LOG.
q '!
Ow 190 Gracel and Bobbles.
r
4" 'i s&ndy 0l
' t
s
i.in'`
47-76 Sandy gravil with Oti 014Y !"r.
I
78...80 1Vbearing gravel producit t t, n G'?', with a 4j fort head
of aster etandr 4
r
pump shIo t be lnatalled ten feet Off tottr-.Ij
I i ,
5
y
: 1 r
Y ,
!1{ t
4 OST INCLUDES ALL LAVOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
wF�
,t
t
WRI'WCHECK PAYABLE TO RAMPART DRILLINNf- WORKS FOR THE SU.M
OF
THANK YOU VERY MUCH.
}
BERtJH_ CLn!_ ;� cP' RnvOAH7
DRIt.-Llai , V.ORKS
I
4
1 DATE_ 24tli,77- –
-
S I RV ICE CHARC, L 1 1 VF 1- 'ID'; 'l A
F'b'O P~ITTY OWNER
L,OCATIOH C,F X, UELL SITE
VVELL LOG;
'U-IANK YOU VL ,'~ ML Gl- .
i'iFi::':; 7[ !¥!1 tj"i i'-~Ii tbii!!:l~il:;i: [' [:::' ii:l~:f)F;:f)Oi'i::~; ..... :i.
-ii-J[:!: I .I !:b!f?i 'I'H
]r'l'iF: !')i:::F"t!...i OF:' F:I
f!iF:1:Cltliq!:) f:fi",lE:, '!FIF::
i'HE!:N:ii: :f:~; NO ?:Wi'
']'H!:~: f3i.i~:faVii!i:t., i::*i:::f:'-iI.-I :i:S "i'H[!:
FIN[:) i'idF:: [i:ICI'!TCIi'! f3F' Th!l:
"On~ t~sl is ~,o~h a ~h~sd~d
· 2204 Cleveland Anchorage, Alaska 99503'
Performed For ~C~,~ C~6~Date Performed
Leaal ~escri~tion. L~t ~ Block ~ Subdivision
This ~orm Reports Soils Lo~ //~ Percolation Test
10--
14--.
16
18--
20--
Depth
Feet ,,,~ .~_ So~, ~har, a~teri_s%i~c_s
1
,
Was Ground Water Encountered?
IF Yes, At what Depth?
I Readinq Date Gross Time Net Time Depth to H20 Net Drop
Percolation Rate !Ii nute
Prnnosed Installation: SeeDaae Pit
Den. th of Inlet Depth To
/' I
Data
Test Performed By . _~ ~
Drain Field
Bottom Of Pit Or Trench
Certified BY: ~.
Date: ~/~-~/~ ~ _
MUNICIPALITY OF ANCHORAGE _ _ ' '
DEPARTMENT
OF
HEALTH
&
ENVIRONMENTAL
825 L Street - Anchorage, Alaska g9501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests wig not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER
IAI LING ADDRESS
PROPERTY RESIDENT (If different from above)
2. BUYER
MAILING ADDRESS
3. LENDING INSTITUTION
MAILING ADDRESS
PHONE
PHONE
PHONE
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE NUMBER OF SEDROOMS
,~ [] One [] Four
SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
[] Other
7. WATER SUPPLY
~ INDIVIDUAL* ~TTACH WELL LOG. A well log is required for all wells ddlled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.) /~,~¢~. ~.~ ~5~-/~7'-z~¢,~,~:)~.
8' S EWA~O~ iA~ iSDYL~_/Mo N. S i T E * * **If individual/on-site, give installation date 7-',~-77.
If system is over two (2) years old an adequacy test is required
E] PUBLIC UTI LITY by this Department.
NOTE: THE INSPECTION FEE MUSTACCOMpANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.