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Home My WebLink AboutKENAI VIEW LT 3OG ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE I [] NEW H D Cc>mi'ns 1:5q'5'-1305'I IU.~.ADE MAILING ADDRESS PO ~ox I]OO~ q~ll LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS ~ Well Absorption area Dwelling PERMIT NO, DISTANCE TO: Manufacturer Material No. of compartments Liq. capacity in gallons IF HOME~E: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons N.... ,ct .o. NO. o~nes Le ngt~o~a~¢e Total length of lines T ~ ~ ~ Top of tile to finish grade Material beneath tile Total effectiveabs~ption area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to Jot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER , PIPE MATERIALS 125 ~¢ / ~eJ~oom I INSTAELER ~ _ REMARKS ~ D. ~~ ~>ts+~ ~ ........ !..._ / CDEPT. OF HEALTH & EF~V~ROFi~.4ENTAI PROTECi C APPROVED ''-~A~ '~ LEGAL 72-013 (Rev. 3/78} PERMIT NO. i~LI~llCI[ ~tLIT~u C,F, DEPARTMENT L~HEALTH AND ENVIRONMENTAL ~.:OTECTION 8~5 "L' STREET, ANCHORAGE, AK. ~50t 264-4728 C~f-~--SITE SE~E~: F'E~=r4 IT ( 8~0657 ) APPLICANT LOCATION LEGAL HD COMINS KENBI VIEW L~ PO BOX ±10075 LOT SIZE 345-i~05 999999 SQURRE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRAINFIELD MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RRTING (SQ FT?BR)= 125 THE REQUIRED SIZE OF THE SOIL ~BSORPTION SYSTEM IS: C-,EPTH= 5 LE~-~GTH= :E:E: ~S~:R"..-'E [. DEF'Tt i= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFtELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCRVRTION (IN FEET). THE T~E~4CH ~4IDTH IS 5_ E~E~O FEE'I. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REQLi I RED SEPT ]~ Ii: Ti-II'-,IK: S I ZE""= :1_ ;-";'5~__-'~ GRLL~]i'4S 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. T~JI] (~') I ~4SF'FC:TIC~4S R~E REL--41_II ~:E[:* BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND 8NY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE PROM R PRIVATE WELL TO 8 PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INST8LLRTION. I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES, ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCL~I1}E MORE THAN 4 BEDROOMS. SIGNED: _ APPLICANT HD COMINS /~ ~ ~-- iSSUED _ _ ___" , MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST PERFORMED FOR: /~/~',-~, LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ~{'~O--<~ S ENCOUNTERED7 ~ P E IF YES, AT WHAT ~,~ DEPTH? ~7~"-g--.~ DATE PERFORMED: &-.~7"~B SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE COMMENTS '~iSus~ ~. ~ PERFORMED BY: ~,~t%~,~{"! ~J~¢¥~'~ CERTIFIED BY: 72-008 (6/79) (minutes/inch) TEST RUN BETWEEN FT AND -- FT ~ HEALTH DEPARTMENT ~ 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION SEPTIC TANK: DISTANCE FROM WE" LIQUID CAPACITY GALLONS. MAILING ADDRESS LEGAL ESCR MATERIAL ~C.~'~/~f_ j NUMBER OF / COMPARTMENTS INSIDE LENGTH ~'/ INSIDE WIDTH '~ r DEPTHLIQUID //~ r/~ ,, SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL ~EAREST LOT . NF SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH , LENGTH , DEPTH 9:5.-/ DISTANCE FROM WELl BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA [WALL AREA] SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA FOUNDATIO.N · NEAREST LOT LINE TOTAL LENGTH , OF LINES DISTANCE BETWEEN ._INE$ TRENCH WIDTH IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE; IN. ABOVE TILE WELL: TYPE f/~,~ , DEPTH NEAREST LOT LINE . SEWER JNE SEPTIC · TANK DISTANCE FROM ,~! , BU LDING FOUNDATION _ SEEPAGE SYSTEM WATER SAMPLE · CESSPOOL. NEAREST OTHER SOURCES DISTANCES: DATE DIAGRAM OF SYSTEM APl: ROVED HEALTH AUTHORITY 327 ~"G~LE ST. HEALTH DEPARTMENT h~.,.~ ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ~.~.X NAME .~]~"J~ U' .S ~'C~ ~ ~ ADDRESS LOCATION ~ S~)~ ~ LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY jO~)O MATERIAl GALLONS. INSIDE LENGTH NUMBER OF j COMPARTMENTS INSIDE WIDTH DEPTH SEEPAGE SYSTEM: NUMBER OE PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH DISTANCE FROM WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH DEPTH ~ BUILDING FOUNDATION SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELl NUMBER OF LINES FOUNDATION , NEAREST LOT LINE DISTANCE BETWEEN LINES TRENCH WIDTH ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE i DEPTH: TOP OF TiLE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE; DISTANCE FROM WELL: TYPE DEPTH BU LDING FOUNDATION. NEAREST SEPTIC SEEPAGE. LOT LiNE SEWER LINE , TANK SYSTEM TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WATER · SAMPLE NEAREST OTHER , CESSPOOL , SOURCES DISTANCES: D -,6,= DIAGRAM OF SYSTEM GREATEI~NCHORAGE AREA k.~)ROUGH HEALTH DEPARTMENT ' 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAl. SYSTEM - APPLICATION & PERMIT Case No. / I~ NAME OF APPLICANT ~'///Y///.5' RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH -~PERCOLAT, ON TEST .ESULTS ,~:/t" MAILING ADDRESS .,~'~..¢;.z- /?~/-Tff PHONE LOCATION OF INSTALLATION ],/'/. SEEPAGE PIT ~,~ ^,/~. TO BE INSTALLED BY ANTICIPATED DATE OF COMPLETION ,DRAIN FIELD ~ ,OTHER BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT 'r..s .~'ro s~,v, ^~ '~-~ ,,,~,,v,,-r TO .,S'rA,,,, '~~.~ ~~/~,~, AS DESC"IBEB BELOW. SIZE OF UNIT TO BE SERVED ,SEPTIC TANK SIZE /'~0 TYPE SEEPAGE AREA ~ TYPE DIAGRAM OF SYSTEM DISTANCES: 'E~' F'~/~ .../; APPLI~_j~IT,FILLS OUT UPPER HA~ONLY o~ert? Owners "COR~LnS Phone ~, D~via and ~ry Jo Mailing Ad.r~ NHN Ti~mn ~ Zip Cod~9511 ~45--1305 Address : Zip Code Lending Institution Phone %~ Address Zip Code Phone Rea~y Co. a Amn~ CarOl J. Douthit 263-2404 Address C-91 R~eaq~ R~m~ z~pCod~ 99503 Legal Oescriptio%~:3, ~ ,~ ~i~' Street Locati~ N~ ~{ ~ Type of Resl~nce Single Family Multiple Family No. of Bedroomq ~ ~ Other Water Supply ~ Individual A~ACH WELL LOG. A wall log is required for all wells drilled.since June 1975. ~ community ' ~' Fo~ wells drilled prior to that date, give well depth (attach log if available). ~ Pu61t6 U{~llty Sewer Disposal ~ Individual Year Individual Installed: 1970 ~ Public ~ility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Ti76~ Time Y ~/93/~b Date ,.._]~ . r ~_~/~,__,,6/ Date Date Dat~)'~:'~ ~:'~ -,,~3 ~"~l~'~ Insp~tor ~ Inspirer Inspirer Inspirer RECEIVED ( ) DISAPPROVED ( ) CONDITIONAL ~PPROVAL* Soils Rating Date ~wer Installed Well To Absorption Area /~7 Well Log Received 72-023 (318Z 327 E^C~ STREET kNCHORAGE, ALASKA ~9501 DATE RECEIVED INSPECT: ~QUEST FOR APPROVAL'OF INDIVIDUAL SEWAGE ~D WATER FACILITIES FOR STREET: I£,homemade, show diagram on'back) Approval Request £or S~..~e ~ Water Facilities Pa~e T~o Seepage Pit ~ 1. Size 2. Lining C .... Disposal Field 1. Number o£ Lines 2. Total Length 7. Required Measurements A. Well to Septic Tank B.. Well to Seepage Pit Well to Sewer Line D.Well to Property Line E.Well to Other Possible Conta~nation F.Foundation to Septic Tank /~ G. Foundation to Seepage Pit ~ Seepage Pit to Property Line 8. CO~ENTS: GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT EDll70