HomeMy WebLinkAboutMCMAHON #2 BLK 9 LT 16
GRE,,,ER ANCHORAGE AREA BOk= JGH
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Department of Environmental Ouality
3330 ¢ Street
Anchorage, Alaska 9@503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING ADDRESS
LEGAL DESCRIPTION
PHONE
SEPTIC TANK:
DISTANCE
FROM WELL ~'-~"
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
MATERIAL
LIQUID DEPTH
NUMBER OF
COMPARTMENTS '~..-
LIQUID CAPACITY/')~'/~ GALLONS.
TILE DRAIN FIELD,
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA Y~
FOUNDATION
DISTANCE BETWEEN LINES
NEAREST LOT LINE
TOTAL LENGTH
OF LINES ,..~c.~
TRENCH WIDTH,~ IN. TOTAL EFFECTIVE
SQ. FT.
LENGTH OF EACH LINE
DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE
£
~ ,1~. ABOVE TILE (r'/' IN.
WELL:
TYPE J~"' ~' '"-~'
BUILDING
FOUNDATION__
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST NEAREST SEPTIC
LOT LINE__ SEWER LINE , TANK
OTHER SOURCES
DISAPPROVED REMARKS
DEPTH
SEEPAGE
SYSTEM
DISTANCE FROM:
DISTANCES:
INSTALLED BY: '.~,! ~'J'(~'/~ BIP~¢'~'
SEWER LINE DEPTH:
PIPE MATERIAL' ~'' J4S'~
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
APPROVED ('2~ C, _
G.A.A.B.
Form LQ-032
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'FEi ~E: !"1ORE T!...IF!N ::~: E;ii!::l:::,!:;i:ClOi"i'.!~;.
CONSULTING GEOLOGIST
BOX 476-M, STAR ROUTE A · ANCHORAGE, ALASKA 99507 - PHONE:
~-~ -s/'~/'~n
Per£ormed
Legal ~escription
D~?pth
-12-
-14-
-is- 14- Ih
-48-
SOILS LOG
Soil Descriptiqn_~
-20-
Was groundwater encountered ~J ? What depth
Depth to bedrock '~-O o How determined k~J ~
Respectfully submitted,
Gary ~. Player
Consulting Geologist
?
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WATER WELL LOG
FOSS DRILLING
1336 Ingra Street
Anchorage, A/aska 99501
WELL OWNER ~_/~ )~.~ 0~.~6)r~ USE OF WELL
FT.
7
FEET OF DRAWDOWN.
REMARKS
PUMP TO BE SET AT
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MUNICIPALITF CF ,,\NCHOIb%GE
DEPT, OF I:L:,LT; i ,%
to ,
#1: Time
Date
Insp
DEPARTMEN:i JF HEALTH A.ND EN~VIRONMENTA~_PROTECTION
825 L Street, Anchorac~.. Alaska 99501
264-4720
Date Received: October 6, 1977
10:00 a.m. #2: Time #3: Time
10-7-77 Friday Date
Date
Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request: Amfac Mortgage Corporation
Mailing Address: 705 West 6th Avenue 99501 Phone: 277-8588
2. Property Owner: Charles E. Jackson
Mailing Address: Star Route A Box 1582N 99507
Phone: 344-0491
3. Legal Description: Lot 16 block 9 Mc Mahons Subdivision
4:
Single Family Residence: (x)
Multiple'Family Residence: ( )
Number of Bedrooms:
Number of Bedrooms:
Four
Individual well (x)
Well System:
Permit # ~)'~? ~,3 Depth of Well
Construction ..:~'/L~.~?-~'~ '~ ~
Community/Public System ( )
~ ~7~ Well Log on File (!D
Bacterial Analysis
Sewage Disposal System: On-site System (x) Public Utility ( )
/ 1
Permit # ' i['!OI?"-t Installed
_ ~... ~(~ ..... ~
Septic Tank Size I
Distances: Well to Septic Tank jqo'
to Sewer Line /~ F Nearest Lot line
to NeareSt Lot Line ~6~ /
to Absorption Area /~(~
~ .$~ ' Absorption Area
.~Pag .Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 16 Block 9 Mc Mahon Subdivision
Comments:
Affadavit Attached: ( ) Letter Attached: ( )
Disapproved:
Date:
Department Worksheet:
/IUNICIPALIT,Y OF ,ANCHORAGE
· ~ Department of Health and Environmental Pro~o~'~:,
[[~~.~ 825 L Street, Anchorage, Alaska 99501'
~"~~quest~ for Approval of Individual Sewer and WaterL?a~,.!gt~[s~,
Mailing Address: K~fi~.- ~fi .~.ff/,+ff'~ ff Phone:
e
Name of Buyer:
Mailing Address:
3. Lending Institution:
Mailing Address:
Realtor/Agent:
Mailing Address:
Legal Description:
Street Location:
Se
o
Phone:
Phone:
Single Family Residence: ( )
Multiple Family Residence: ( )
Water Supply: *Individual Well
If Individual Well, well depth
If Community System, name of system
Sewage Disposal System: On-site System
If On-site System, date of installation:
Phone:t.> ~- ~-/7~
Number of Bedrooms: ~
Number of Bedrooms:
(~ublic/Community System
( )
(~blic System )
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77