HomeMy WebLinkAboutPETERS GATE BLK 1 LT 7
GREA,ER ANCHORAGE AREA BOE,.,dGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTIOI~I REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER ~ /c,,.~ c'"'7- MATERIAL COMPARTMENTS
INSIDE WIDTH LIQUID DEPTH __.LIQUID CAPACITy /,l~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / . DIAMETER__OR WIDTH-~,
LINING MATERIAI/~H~"'~ / CRIB SIZE: DIAMETER__
BUILDING FOUNDATIO NEAREST LOT LINE
ADDITIONAL ABSORPTION
· //
/
.DEPTH__ DISTANCE FROM: WELL / ~ ~
TOTAL EFFECTIVE ,,~.
.ABSORPTION AREA (WALL AREA) ~) .SQ. FT.
WELL: /
BUILDING
FOUNDATION __ ,
CONSTRUCTION
NEAREST
LOT LINE
C'ESSPOO L
APPROVED
OTHER SOURCES
/;DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST SEPTIC ,," SEEPAGE
SEWER LINE 3~ /' J0g}
_,T^N,~__, S','STEM
REMARKS
DISTANCES:
INSTALLED BY:
PIPE MATERIAl ·
LOT SLOPE:
REMARKS: __
Form No. EQ-O31
DIAGRAM Of SYSTEM
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Russell Oyster
694-2774
Soils E~ Foundations
Performed for:
GEO !CHNICAL 8- DEVEL PMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
SOIL LOG
Name: :,,~""",',~, .~r_..~ ¥- ~-,~ Tel. No.
Mailing Address: ~.~---~'~<~,~ (~-~ ~-.~,~,c~<, ~v.
Legal Description:
Depth (feet)
Earl Ellis
688-2280
Land Development
Soil Characteristic)
3
4
5~
7~
8
llw
No ~/ f yes, what depth
Drain Field
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit__
Comments: ~ .~c,A~/~
Performed by: I Date:
/',?~ I i 1§77 by
i A & L DRILLING COMPANY
RECEIVED. TE L£PHOIqE $fl4-2§88
OWNER OF LAND
ADDRESS
DEPTH OF WELL
LEGAL DESCRIPTION
DATE - Started; _}
PERMIT NUMBER
Ended
STATIC LEVEL OF WATER FT.
DRAW DOWN FT. / 5-0 '
GALS. PER HR (~? 6~
KIND OF CASING (~. '~' r> ~j
KIND OF FORMATION:
From ;.) Ft. to I Ft.
From [ Ft. to tO Ft.
From ~,,~' Ft. to ~ Ft.
From (.~ ;'K'Ft. to [ ,i¢ ~ Ft.
From J~ 5~'- Ft. to Jq~Ft.
From
From
From
From /¥/~ Ft. to ~,-9~Ft.
From_ :i<)~> Ft. to ~ %o Ft. [o_~/,)~c.,ct:.
From 5~0 Ft. to Ft. ~¢~6~/<
From Ft. to Ft
From Ft. to~Ft
From Ft. to Ft.
From Ft. to__Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From
From
From
From__
From
From
From
From
From
From
Ft. to Ft.
Ft. to_ Ft.
Ft. to Ft
Ft. to Ft
Ft. to Ft.
Ft. to Ft.
Ft. to Ft.
Ft. to Ft
Ft. to Ft.
Ft. to Ft.
.Ft. to Ft.
Ft. to Ft,
Ft. to.__Ft,
Ft. to Ft
Ft. to Ft.
Ft. to Ft.
Ft. to Ft,
MISCL. INFORMATION:
DRILLER'S NAME
PERMIT NO.
DEPARTMENT
2510 E.
Cm F ~R 1'-4 C: I-I r) E.'. i~ t]].~ El
HEALTH AND ENVIRONMENTAL ~OTECTION
TUDOR RD., ANCHORAGE.. AK. 99.5Ef7
I..-IEL_i_ F' E I~.', I"'1 I T'
':] ??~'3~[. ) DATE OF ISSLIE ]]:22??
I~.~..: Cm F'
RPPL. ICRNT
LOCATION
LEGRL
JACK FLOOD
PETERS CREEK
L? Bi PETERS GATE SLIBD
4048 LAUREL ST
LOT SIZE
274.-i58:L
540±4 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
t00 FEET FOR R PRIVATE WELL. OR 200 FEET FOR A PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS
OF 'THE WELt_ COMPLETION.
SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION.
F'E"~-':i'-I I T "-,¢RLI E:. F'm.'ZmFJ m:zm~-~E %r'EFIF-: FF-.'.CNf-i I :E3.'E;t_IE:
I CERTIFY THAT
±: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AN[) WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED:
RPPLICRNf JACK FLOOD
ISSUED BY
INSPECTION HISTORY - SEWER
WELL INSP 0 WELL LOG
DATE
0 SEWER 2
DATE 0 DRILLER
E-' '-DEPT' ~lF' 'I::'AL,T~` & MUNICIPALITY OF ANCHORAGE
~INVIRONMEN'b""'D~'Fi~'i~L~ OF HEALTH & ENVIRONMENTAL PROTECTION
//_~ ~ 825 L Street- Anehora~, Alaska 99501
uAR ?
. aU St APP.OVA
, DIRECTIONS: .Complete all parts on ~age 1. Incomplete reque=~ will not be proce, ed. Please allow ten ~10) days for pr~c~
1. PROPERTY OWNER
John J-. Flood
MAILING ADDRESS
Box 7155 Great Land Circle, Chugiak,
AK
99567
PROPERTY I~ESIDENT (If different from above) '
jPHONE
6g-~-- 9555
PHONE
PHONE
277-5551
PHONE
276-~,800
99501
r j ~bhE '
694-9555
21 BUYER ' ' '
Charles Harrington
MAILING ADDRESS
P. O. Box 789~ Eagle River~ AK 99577
3.'LENDiNGINSTITUTION ' "
Security National Bank
MAI LING ADDRESS ":~" '
· 2525 C Street Suite 502, Anchorage, AK
4. REALTOR/AGENT ' '
AREA, Inc. Realtors A1Romaszewski
99577
MAI LING ADDRESS
P. O. Box 249, ~.agle River, AK
5. LI~GAI' DESCRIPTION '
Lot 7 Blk 1 Peters Gate Estates
STREET LOCATION
NHN Sierra Mesa Drive
· 6, TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
7, WATER SUPPLY
[] INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
S. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
NUMBER OF BEbROOMS
[] One [] Four [] Other
~ Two [] Five
[] Three [] Six
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
**If individual/on-site, give installation date June 7 ?
If system is over two (2) years old an adequacy test is required
by, this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78) '
TIME
INSPECTOR
DIRECTIONS:
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS TIME
DATE
INSPECTOR'
DATE RECEIVED
DATE
INSPECT~)R
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
[] ONE [] THREE
[] TWO [] FOUR
NUMBER OF BEDROOMS
[] FIVE
[] SIX
[] OTHER
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] INDIVI DUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
r-qSeptic Tank or [] Holding Tank
Size: ~/(~O O If Tank is homemade
give dimensions,:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
MANU.ACTU.ER
MATERIAL
JNearest Lot Line
[]~APPROVED FOR ~ BEDROOMS
[~'~CONDITIONAL AI~P'ROVAL (letter must accom~/v certificate)
[] DISAPPROVED
DAT E~{~.~ '~C~ [BY(Title) '
LEGAL DESCRIPTION
72-010 (Rev. 3/78) "
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
CERTIFICATE OF INSPECTION
SEWER AND WATER FACILITIES
1. PROPERTY OWNER
MAILING ADDRESS
3. TYPE DWELLING
SINGLE FAMILY RESIDENCE
MULTIPLE FAMILY RESIDENCE
OTHER (Describe)
4. WATER SUPPLY
INDIVIDUAL
COMMUNITY/PUBLIC
5. SEWAGE DISPOSAL
~k~ INDIVIDUAL/ON-SITE
[-:~ PUBLIC UTILITY
L_L_L:3 HOLDING TANK (Maintenance Required)
~Z~ APPROVED FOR
BEDROOMS
F_'.] CONDITIONAL APPROVAL (See Attached)
DISAPPROVED
SEAL
DATE
72-014 (3/78)