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HomeMy WebLinkAboutP & S LT 3 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL-INSPECTION REPORT NAME MAILIN(} ADDtlESS LEGAL DESCRIPTION ~ ~ I ~anu~acturer ~ Liq, capaciw in gallons i Ia'r¢ . HOMEMADE: 6,.g J D STANCE TO' [Well I J~ ~~ ' t  Manufacturer Absorption area Dwelling I ......~Y~ ............ Material~' S' .,~, t Inside length I Width Dwellin9 DISTANCE TO' JWell ~)/ FoundatTon I NearestlotDine · - ~ -L-- t ~f Total length of lines I Tlenc_h width .... 7~ ............ L ~¢ 'i ~p~f~J~'d h~sh'~tJ'h~ ................. Malelial belmath die ~, .¢~/ 5~ -~',, niches inches ,P,H ON E -,: NO. OF BEDROOMS $ PERMIT NO. (~'~03~'3 - No. of c.~partments Liquid depth PERMIT NC). Liquid ~apacity in gallons PERMIT NO, Distance between lines Total effective absorpuon area Length Width · : DISTANCE TO: Cla~s . ' DiSTANcE TO: Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorouon area Well Building foundation Ne~ rest lot line Depth Driller Distance to lot line Buildiug foundation Sewer line Septic tank PERMIT NO, Absorntion area s [~NEW [~UPGRADE OTHER 30~?' S~I~Z 0~7Zt? Per/' SOIL 1 EST RATING DA-rE I_ E(:;A I_ · ~--' , .-..Sf'.. ----Ca t(.~OY~ '"'~ ~)' ~j, :if, uE,.A--~ '"" -- ........ -.- - /' ' .... ,-i ...... i-~-i: --., ................' ---~,---~A ~'--, l-- -- I~ ..... , -'~- --( .-.-q-J - : q.¢ 't~ ........ l .~.. ~ .............. ~ ....... m..,...-1----.4---i ..... i-- E- l I I t~ ..... , .... .... ;~ 72-013(Rev. 3/78), ' ~ TItEODORE F. MOORE, P.E. PH: (907) 345-1355 C~. & EN~O~NT~ ENG~EER~G · ENERGY CONSERVA~ON & December 1; 1992 14530 ECHO ST. ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 RE: Lot 3, P & S S/D Septic system inspection report Dear Sirs: In researching DHHS files for an adjoining lot I discovered that there is no as-built inspection report on file for the septic system which was installed in 1985 for the subject lot. I checked back in my ~ecords. and came across the enclosed inspection report, which I had prepared at the time on installation. Since it appears that our submittal must have gotten mis-filed, I am enclosing another copy of our original inspection report to bring your records up to date. Please give me a call if you have any questions. Sincerely, Ted Moore, P.E. ,~Ix~CHORAGE ALASKA 99502-0650 {007) 264-411i DEPARTMENT OF HEALTH & HUMAN SERVICES January 10, 1986 TO: Permit Applicant Subject: Permit # 850363 Lot 3 P & S Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit PERMIT NO: DATE ISSUED: DEPARTMEN'T' OF HEALTH AND ENVIRONMENTAL PROTEC'TION. j~._~ ~'-'~ , 825 L S'I'REEI'~, AIqCHORAGE, AK 99501 850363 06/2.6/8~ AF'F'L I CANT: DONALD DEVL I N ADDRESG: 5040 F-'. 112TH ANCHHORAGE, AK 99516 LEGAL DESCRIP: SUBDIVISION: P&.S SECTION: 22 TOWNSHIP: LOT SIZE:' 1.02A (SQ.FT. OR ACRES) MAX BEDROOMS: ..:,-'~' F:'EF~.["~ql Z T ,LOT~ ~ BLOCK: NA RANGE: 3W Listed beIow are the options avaiIable to you in designing your septic system. ~hoose t. he Option tlnat best ~its your site. DEPTH TO PIPE BOTTOM (FT.) .:.'~, 5 ~ 4.=.~ 4.0 GRAVEl._ DEPTH (FT.) 4.5 0.5 3.0 TOTAL DEPTH .(Fl". ) 8.0 5.0 7, 0 GRAVEL WIDTH (F'T.) 2.5 21.0 .~=.0 'GRAVEL. [~ENGTH (FT.) 65.0 42.0 68.0 GRAVEL VOLUME (CU. YDS. ) 30. 1 ~;~). 7 44'. 1 TANK SIZE (GAl_S) 1,000.0 *~ 1,()00..0 ** 1,000.0 ~ SOIl_ RA)'ING (SQ.FT. /El.) 194 :1.93 194 DEPTH TO PIPE BOTTOM < 4.0 PT. MAY REQUIRE A t..IFT. STATION ** TANK MUST HAVE A'I" LEAST TWO COMPARTMENTS I cert. i~/k that: 1. I am ¢amiliar with the requirements [or on-site sewers and wells as set ~'orth by the. Municipality o~' Anchorage (MOA) and the State o~' Alaska,. 2.' I will install the system in accordance with all MOA codes and regu].ati(]ns~ and in compliance ~ith the design criteria oF this permit. 3. I will. adhere to all MOA and State or Alaska ~Fequirements .lop the set back distances ~Pom any existing well, wastewater disposal system or public sewerage system on this oP any adjacent oP nearby lot. 4. I understand that this permit is valid..~or a maximum oF 3 bedrooms and any enlargement wi-ll require an additi, ona! permit. IF A LIPT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~ THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUS"F BE OBTAINED; (2) AS.-BUIL.:]"S WILL. NOT BE APPROVED WI'THOUT AN EL. ECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. APPL ICAN'~O~D' DEVLIN . MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: ~"~/~y i,~¢ 4 F~"8 g5 6 SLOPE k SITE PLAN 10- 13 TI4EODORE F. MOORE CE- 3589 .'° ~: l~l~ 18 0~ 12" 19 20 WAS GROUND WATER S ENCOUNTERED? NO 0L P E IF YES, AT WHAT .~ DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~,tl 0i: ~-( ~Y '//~ _ PERCOLATION RATE TEST RUN BETWEEN . COMMENTS l~e~,~' ,'/' //~;/'-¢~ ~m'~ ¢'',W~.C'e PERFORMED BY: ~ ~0~ CERTIFIED BY: ~~¢ ~ (minutes/inch) FT AND ~*~ FT Permit ~ ~%-~ Applicant: ~ Location: \\ ~k MUNICIPALITY OF ANCHORAGE Department, f Health and Environmenta? '~rotection 825 ~/' Street, Anchorage, AK. ~=~:~:501 264-4720 ~~_~ * * * HANDWRITTEN PERMIT * * * ~ON-SITE SEWER PERMIT ~ Mailing Address: S.~, ~, Phone Number: Legal Description: 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 Z~. 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 ~w~en 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 by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet fora 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 8 3 * * * t 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 understand that the on-site sewer system may require enlargement if t~residence is remodeled to include more that 3 be~ooms. Signe~: ' C c:7.,F..~ ~/~ ,~~'~' Issued by: ~~"/ Appli~nt SWP/024 (1/81) GP-'::ATER ANCHORAGE AREA BOROI' ~',H '~ ..... · HEALTH DEPARTMENT ...~. 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: ADDRESS /.~)~Z) X /'~7~.~ ~ PHONE LEGAL DESCRIPTION/-7~ ,.~.~:)~./..~,~, ,~;~ .~' ~/~ ~;,7 DISTANCE FROM WELL LIQUID CAPACITY /~2 t~ GALLONS. MATERIAL ~[~/j; ~,/~/Z~~ NUMBER OF COMPARTMENTS ,~,, C?,/)/',~'~Z~.//')~'~ /~;~l~ LIQUID INSIDE LENGTH. INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PiTS J OUTSIDE DIAMETER ,r. OR WIDTH /~ LINING MATERIAl ~:'ed~l/~"t'tt'~d~'-Z= ~'~JA/~'-~ DISTANCE FROM WELL. ~ / NEAREST LO! LINE /~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH /~ , DEPTH BUILDING FOUNDATION SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES~ ABSORPTION AREA FOUNDATION DISTANCE BETWEEN LINES SQ. FT. LENGTH GE EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE · NEAREST LOT LINE TRENCH WIDTH TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILT IN. ABOVE TILE WELL: TYPE ~';)/,~/Z,.ZUZ,~ , DEPTH ~/~ LOT LINE ~'~ ! NEAREST ~ i SEPTIC , SEWER LINE. , TANK DISTANCE FROM ~/~ J WATER , BUILDING FOUNDATION. SAMPLE J~ NEAREST ~;, .4~ / SEEPAGE ~/;~d.~ / OTHER , SYSTEM , CESSPOOL '~ , SOURCES DISTANCES: DATE GAAB-HD-2 Case No. __ GREATEL~NCHORAGE AREA ~.DROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION 8, PERMIT RESIDENCE ADDR DESCR,PTIDN ~ ,~SEEPAGE PIT MAILING ADDRESS '~/~' ~'f~' '~ ~ _ z: ..~.~.,,c/7~ PHONE NO. ~.,.-~r~OA~INSTAELATION ~ ~ / , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH -~"z~'~ ' TO BE INSTALLED BY ~N TEST RESULTS /¢~-~///~ ANTICIPATED DATE OF COMPLETION ~-/~ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ,/¢ff~ ~/'//7//) J~//~/-.,)7'~, PERMIT TO INSTALL A AS BESCRIBED BELOW. SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE /~)~-')0 TYPE ~SEEPAGE AREA DISTANCES: alth Authority ,/~-~ I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68/and th~he above described s.vstem is in accordance with said code. ,..._,/ ~t //j ~' .,~,~/ ~ '.REATER ANCHORAGE AREA HEALTH DEPAF:THENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 CAS~ # . t~l Desceip{i°n: Lot ~_ Biock.~ _Subdivision Depth Feet -- ' Sdil Chamacteristics Location Sketch Was Gmound Watem Encountered? /~/0. [f Yes, At.Wha~ Depth _ Reading Date Gmos.s Time Net Time Depth To H20 Net Drop ~_bco£a~.i.o, ...... ,,,, . ........ ii Late 1"! '~. Minut ' ' ' Pmot59sed Installa{J ~n: Seepage Pit / Dz'aln Field Depth'Of Inlet Depth To Bottom Of P~t .Or Trench COMMENT~. , ....... . ..........