HomeMy WebLinkAboutHEISLER LT 2
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
LEGAL DESCRIPTION
Well orption area
DISTANCE TO:
Manufacturer ~/ j_~.// /,~ ~
Li~ y in gallons IF HOMEMADE: Inside length
DISTANCE TO: IWell ~1 1.~ Dwelling
Manufacturer [ ~ // /
/ ~
Well, / ~
Length
Type of crib
LOCATION
DISTANCE TO:
Width
Building foundation
l. ONE [] NEW
y,UPCRA,E
Dwelling
No. of compartments
Liquid depth
PERMIT NO.
Material Liquid capacity in gallons
Foundation/~_~" ~ Nearestlotline~F ~
Total ,e~gt, of¢in.e~ Treno~'wiCh /-
al beneat~il~ ~ ~
Distance bet~ .~
I1~' Total ef~c.~krp~ ,r~
inches PERM T NO. ~
OTHER
Crib ?pth Total effective absorption area
Bui~ng foundation Nearest lot line
Driller Distance to lot line PERMIT NO.
Sewer line Septic tank Absorpt on area(s)
2.
DATE LEGAL
Robert A,
PERMIT NO.
[:'EPFIRTMENT OF HERL'TH RND ENVIRONMENTRL F, ROTEC'rlON
825 '"L'" :-];TREET., FtNCFIORFIGE., RK. S~S)50Z
264"-4728
C~"~ .... :5; Z ]-E ~;EB--IEF: F'EF:f'I Z T
RF'PLICRNT
LOCRTION
LEGRL
ERICKSONS BRCKHOE
BIRCHWOOD LOOP
L2 HEiSLER
SR BOX D030 CHUGIFIK
LOT SIZE
'TYPE OF SOIL RBSORPTtON SYSTEM IS: TRENCH.
MRXIMUM NUMBER OF BE[:,ROOMS = 4
688-~280
40000 SQURRE FEET
SOIL. RRTING (SQ F.f'/BR)= 85
TFIE REQUIRE[.', SIZE OF THE SOIL RBSORPTION SYSTEM IS:
THE LENGTH DIME:NS, ION tS THE LENGTH ,'IN FEET) OF THE TRENCH OF.: [:,RFIINFIEL[:,.
THE [:,EF'TH OF R TRENCH OR. Pt.f' I':; THE DISTRNCE BETWEEN ]"HE SUF.'FFICE OF' THE
GROUND RN[:, THE BOTTOM OF THE EXCRVFITION (IN FEET).
THERE IS NO SET I.,.lI[:,,f'Ft FOF.' TRENCHES.
THE GRR',,,'EL [:,EF'TH IS THE MINIMUM DEPTH OF GRFI',,,'EL BETWEEN THE OUTFRLL PIPE
FIND THE 8OT.f'OM OF THE E',,.,',C:R',,,'RTION (IN FEET).
PERMIT FIPPLICRNT HFIS ]"HE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTFILLRTION INSPEC.f'IONS OF FIN¥ WELLS RDJFICENT TO THIO-; PROF'ER'f'Y RND THE
NUMBER OF RE'_=;!DENCES THFIT THE WELL WILL SERVE.
........ T ~--,..~ ~.]-~ ,:: 2 ::, :[ ~'-0 :.-]. F" E C: T ][ ~],:n, I%1. ~.E-; .~-3 F:: E E~: I.-] ~Z'.:~ L..~ ~.. t'4: E
BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS
DEPRR'TMENT WILL BE SUBJECT TO PROSECUTION.
MINIMIJM DISTk~NCE BETWEEN R WELL RND FINY ON-SITE SEWRGE B, ISPOSRL S'¢STEM IS
:[.00 FEE.f' FOR R PRI',/RTE WELL. OR. ±50~ TO 200 FEET FROM R PUBLIC 14ELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTRNCE FROM FI PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RN[:,
TO R COMMLINITY SEWER LINE IS 75 FEET.
OTHEF.: REQUIREMENTS MR"r' FIF'PLY. SPECIFiCFITtONS RND CONSTRUCTION DIFIGRRMS FIRE
FIVRILFIBLE TO INSURE PROPER INSTRLLFITION.
F"EEE:F"I ][ 'T E.'-:-::F" · F:E:5 [:~EE:EI"IE:EP-.. ::]::1 .... ±.%=-.~:~:t.
I CERTIF'¥ THRT
:2: I RM FFIMILIRR WITH THE REQUIREMENTS FOR ON-SITE :SEWERS FIND WELLS FIS SET
FORTH 8'-,.' THE MIJNICIPRLIT'-/ OF RNCHORRGE.
2: I WILL INSTFILL THE S"¢STEM IN RCCOR[:,RNCE 14I.f'H TFIE CODES.
Ti:: ! IJN.[:,ERSTRN[:, THFIT THE ON-L~ITE SEWER S'.r'STEM .HF4Y REQUIRE ENI_FIRGEMENT
.'FIPP! T F:FtN.f',-~ER. I C:K':-]ONS BRCKHOE
...... ......
IF THE
V4. 0
/~'",, ~ ~1~" SOILS LOG
MUNICIPALITY OF ANCHORAGE
[] PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
TEST
525 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SI'OPE
10
11
12
13
14
15
16
17'
18
19
20
COMMENTS
Robed A.
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
//-~
PERCOLATION RATE
(minutes/inch)
/
· TEST RUN BETWEEN FT AND -- FT
PERFORMED BY:
GRE?- ER ANCHORAGE AREA BOP UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
pH ON E ~'o~- ~L~)~ 7
LOCATION t ~, ~'~' /~ ~.) ~/, ~P~t~'~- LEGAL DESCRIPTION ~
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
NUMBER OF
MANUFACTURER ~-'~ ~d& MA TERIAL~I~e~'.t~<~ COMPARTMENTS ~
INSIDE WIDTH LIQUID DEPTH __.LIQUID CAPACITY I~'~'~) GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL .~.I~¢~ CRIB SIZE:
BUILDING FOUNDATION
,
OR WIDTH !~, , LENGTH I~ , DEPTH
DIAMETER ~) DEPTH ~ DISTANCE FROM: WELL
TOTAL EFFECTIVE
NEAREST LOT LINE__ ABSORPTION AREA (WALL AREA) ~)~
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
BUILDING
FOUNDATION __
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK__ , SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
REMARKS:
DATE "~/h/7 ~
//'
DIAGRAM OF SYSTEM
GreaTer ANChOrAgE AReA Borough
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C"STREET ANCHORAGE~ ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
INSTaLLaTiON Of: SEPTIC TANk
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SEEPAGE PIT , DRAIN FIELD
TO BE INSTALLED BY c
OTHEr
SOIL TEST RESULTS
NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFiLLiNG OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY Will BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM
FOUNDATION TO SEPTIC TANK
TO RIVER, LAKE, STREAM.
FOUNDATION TO SEEPAGE PIT , DRA[N FIELD
· , DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK ,SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT , DRAIN FielD
CA~T IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION B FEET INTO UNDISTURBED SOIL.
4 ~NCN DIAMETER CAST IRON SIPHON PIPES. ON SEPTIC TANK AND SEEPAGE PiT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BAC:KFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION,
' LiCENsEDODRESiONER
[ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
.... MUNICIPALITY OF ANCttORAG~-t-='
DEPARYMENT ur HEALTH AND ENVIRONMENTAL FROTECTION
825 L Street, ~mchorage, Alaska 99501
279-2511~ ext. 224, 225
Inypector
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Date Received: April 5, 1977
2nd Inspection: Time
Inspector
Lending Institution Request:
Mailing Address:
Property Owner:
Aa~ress;
Mailing "~
3. Legal Description:
~ ~ Heisler
Lot 1 ~and ~ Heisler .Subdivision
Single Family Residence: ( )
Multiple Family Residence: (x)
Well Data: Type ~F~i~ln~l
Construction
Number of Bedrooms:
Number of Bedrooms:
Depth 220'
Bacterial Analysis
Well Log Filed ( )
Sewage Disposal System:
Permit ~
Septic Tank Size
Absorption Area
On-site system (x)
Installed 1969 Installer
Manufacturer
Public Utility ( )
Soils Rate
Ma'Lerial
D
Distances: Well to Septic Tank
to Sewer Lines Nearest Lot Line
Absorption Area to Nearest Lot Line
to Absorption Area
~ Dep~rtment of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
'\
Legal Description: Lot 1 and 2 Heisler Subdivision
Affadavit Attached: ( )
I Lehter Attached: ( )
Approved:
Disapproved:
Date:
Date:
Department Worksheet:
' ,' ' ' J , ", .,1UNICIPALITY OF ANCHORAGL . DEPT. 0~:
~ q~', J Departmen~ oz Health and Envlrommenual Pro[F~ ' '
~~/ ' ''825 L. Street, Anchorage, AlaSka 99501 ,__
Property Owner:
Mailing Address:
e
Name of Buyer:
Mailing Address:
)
3o
Lending Institution:
Mailing Address:
Phone:
o
o
Realtor/Agent:
Mailing Address:
Legal Description:
Street Location:
Phone:
Single Family Residence: ( ) Number of Bedrooms:
Multiple Family Residence: (~ Number of Bedrooms:
Water Supply: *Individual Well (~)
If Individual Well, well depth A~
If Community System, name of system
Public/Community System ( )
Sewage Disposal System: On--site System
If On-site System, date of installation:
(~) Public System
( )
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77 '
September 2, 1977
7211 JewellLake Road
Anchorage, Alaska 99502
Subject: Lot 1 Block 2 Heisler Subdivision
The percolation test run on yoHr sewer system failed to pass
the adequacy test.
Therefore, before we can ~end an approval to the lending
agency an upgrade of the sewer system will be needed.
Pr~r to construction a permits must be obaained from this
office.
If there are any further questions~ please contact this
office at 264-4720.
Sincerely,
Robert C. Pratt,
Sanitarian
RCP/ljh
April 13, 1977
Mro William Heisler
7211 Jewel Lake Road
Anchorage~ Alaska 99502
Subject: Lot 1 and 2 Heisler Subdivision
Dear Mr. Heisler~
Before this department will give approval on the lending
institution request for sewer and water approval~ several
~ems will need to be completed.
(1)
The eight (8) inch casing must be sealed to the six (6)
inch casing serving the well. The well seal must be
sealed sotthat it is air tight. The ground snuface
must be sloped away from the well casing.
(2) Standpipes for both tank and seepage pit must be
available so that pumping can be done if necessary.
(3)
After the standpipes are made availalbe~ a percolation
test must be perfommed on both systems. Enclosed
is a set of instructions that you will need to follow.
If there are any further questions, please contact this
office at 279-2511, extension 225, 224°
Sincerely,
Robert Co Pratt, RoSo
Snnitarian
RCP/ljh
ene:
INDIVIDUAL SEWA, GE AND WATER FACILITIES
(Fill out in Triplicate)
, ~ (~ . /~A, ,.~_~'~ ~1., '~. ~ t ~..~,:~ ,~
~ ] ~ ~ . %~ame of prope~y:owner /'~~~ ~.g~'~-. u.: .. /
· ., ~ . :,>~ .~,~ ,~ ~.,
d. Distance from well to closest exls~ing o~ proposed~
1. $ewe~ llne ,
2, Septic tank_ ~/20 /
3, Seepage Area
Cesspool'
7e
5. Property Line
houses, barn, drainage ditch, etc.
Other sources of Possible contamination, i.e., creeks, lakes~
Sewage disposal system.
a. Age of system l/~ , ~
b. Septic tank capacity in gallons
c. Name of septic tank man~factu~'r
1. If "home made" show diagram on reverse side of this form.
d,' Disposal field or seepage pit size and type
1. Distance to property line to house foundation
· e, Percmlation..Te~t'~esults
f. Percolation Test performed by . . , _ ___,
Use the reverse.side of this form to show diagram. Diagram should include
'~['.~he foi].~,dng information: ~operty lines]-well location, house location~
~n:~c tank location, disposal area location, location of percolation test~
a~d di~ectlon of ground slope~
9. The l-n-~o~.~t~o~ on this form is true and correct to the best of my knowledge.
~ S~gnature 'of Applicant Da~e Signed
T_~O BE FILLED OUT BY HEALTH DEPART~.~ENT PERSONNEL
~e above described sanitary facilities are hereby approved, subject to the
~6'l~owing conditions: '
Con di t i ohs: ~4 / ~;~9
The above described sanitary facilities are disspproved for the following
reasons:
Date' ?'.
Approval is valid for one year following the date of approval.
CPJ: cw