HomeMy WebLinkAboutKENO HILLS #4 BLK 6 LT 1171 A6
MUNICIPALITY OF ANCHORAGE
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
NAME
MAILING ADDRESS
[] UPGRADE
LEGAL DESCRIPTION
LQCATION
DISTANCE TO:
Manufacturer
Liq. caf
DISTANCE
Well
IF HOMEMADE:
Well
Absorption areg ..~ , Dwelling.~C_ "~ (~
Inside length Width
NO. OF BEDROOMS
PERMIT NO,
ppartments
Liquid depth
PERMIT NO.
DISTANCE TO:
No. of lines
Top of tile to finish grade
Length
Foundation ~. Nearest lot line ~
Trench width ~
[ength°flin~e~ i ;6 inches
Material beneath tile
PERMIT NO. f¢O C~, ,-~ O,
Total effective'~..~p area
PERMIT NO.
DISTANCt
Depth Driller
Building foundation Sewer line
DISTANCE TO:
OTHER
PIPE MATERIALS
SOIL TEST RATING
Distance to lot line
Septic tank
PERMIT NO. 80 0 '-~O ()
Absorption area{s)
APPROVED
72-013 (Rev. ~/781
DATE LEGAL
PERMIT NO.
DEPRRTMENT ¢~r~-"HERLTH RND EN~, IR_NMENTRL F~<OTECTION
8-"'.- STREET, RN~HORRGE, RI<. 9950±
( 800200 ) .,
1649 ALDER DR 99504
LOT =,I,-E
APPLICANT EDWARD-.,c FoPEF,
LOCRT I ON RCISEMONT
LEGRL LiB6 KENO HILLS
TYPE OF SOIL ABSORPTION SYSTEM' IS: TRENCH
II,
I1R,~-,,II'I.M NUMBER OF BEDROOMS = 4
~' v,,,:..,??_4_~84
100000 SQUA~T
SOIL RAT,lNG <SQ FT.."BR)= t00
THE REQUIRE[) SIZE OF THE SOIL ABSORPTION SYSTEM IS:
[:.EF"TH= :i;? L Ei'-.tGTH~ .:::' ~ 6AR"".-' EL DFF'TH= 8
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTRNCE 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).
REt=-:ILi I F-:E[> SEPT I C TRNI-'-:: _'5 1- ZF-.-~ :_1._P5~] GI~Li, ,,,~]I'-~S
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS [:,EPRRTMENT DURING THE
'. INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AN[).THE
I NSTRLL8T I UN
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TL..IO .:: 2 ) 1- I'-,ISPIFCT ! Or-IS RRE REIL-41_I 1- RE[:'
BRCKFILLING OF RNY _-,Y_~EM WITHOOT FINAL INSPECTION RND RPPROVRL BY THIS
DEPRRTMENT WILL BE SUBSECT TO PROSECU.T-ION.
MINIMUF1 DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWRGE DISPOSAL _.T_TEM IS
±00 FEET FOR A PRIVATE WELL OR t50 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF F'UBLIC WELL -
MINIMUM DISTANCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS--._,"~ FEET RND
TO R COMMUNITY SEWER LINE IS ?,5 FEET.
WELL LOGS ARE REQUIRE[:, AND MUST BE RETURNED TO THE DEPARTMENT WITHIN -~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MFIY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRRMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
I CERTIFY THAT
±: I RM 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 INCLUDE MORE THAN 4 BEDROOMS.
S I GNED: _
APPLICANT EDWARD=,. "- POPEK
V4; 0
LOT
'~- CONSTRUCTION TEST LAB
"One Test is worth a Thousand Opinions"
2204 Cleveland ~Anchorage, ~laska~9~503. ~277-0231
Perfor~ned for
Legal Description:
This Fomn reports:
ED POPEK-
Lot 1 Block. 6
SOILS TEST XXXXXXX
Date Performed JUNE 9, 1980
Subdivision~ KENO HILLS
PERCOLATION TEST ·
Depth
Feet
5.5
Soil Characteristics
GROUND SU~RFACE- '
BROV~ ORGANIC SILT
BRO~fN SANDY GRAVEL WITH
NUMEROUS COBBLES ......
::BROWN SANDY GRAVEL
'16.0
BOTTOM 'OF TRENCH'~
Was Ground~ ~'~ater En,countered
If~ YES~ .Wha~ depth?
Reading I qate
Gross T~ne ~ -: < Net~ ~TJL~e~i.' .Depth ~to H20
Pe~rcolation Rate Minute . -- ·
Proposed Insta:L!ation~%:''-'S~EPAG~'RTT~'[' ~'~ .~- D~AIN/-VIELR
D-epth~o,f inlet~-- Depth ~o_~Bottom o~ Pit-or Trench-
CO2~4ENTS: RATING: .100 square feet~bedroom in material below 2 feet.
Ne~ D~ainage
Test Performed by B~rnard Nidowicz
Data~Certified Bv: James E. Ringstad, P.E.
Date : '9 June 1980
Mark Begich
Mayor
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.orq/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number SW
Parcel Identification Number:
Date of Issue:
Legal Description
Keno //,7/5 1 61k C Li- 160 -"Port
Property Own e & Address:
l 7 Soo go SCrrwro-r- DR
99624
Pump Installation Date:
27— IS
Pump Intake Depth Below Top of Well Casing: 2'lL feet
Pump Manufacturer's Name:
Pump Model:
Pump Size
esal
hp
ge9.�o4ca
Pitless Adapter Burial Depth: /0 feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
0#4
Well Disinfected Upon Completion?KYes _ No
Method of Disinfection: £iikyrt ri ctocittects
Comments:
Pump Installer Name: Allc.A c yse Ltze2.'/ Azz4.- 70
Attention: The pump installer shall provide a pump installati&n log to the DSD within 30 days of pump installation.