HomeMy WebLinkAboutLEVAR LT 5
oGRE"
'ER ANCHORAGE AREA BOP' UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME'/C/'~/h' z''2'I'K /~..~-"/~'/' MAILING ADDRESS~)X
LEGAL DESCRIPTION(-)-~I-)¢I /*'t ,/~ '~'./~ :!2~d_, I~, "i'/~/L) tC-):,~Z() '~'m.
SEPTIC TANK:
FROM WELL
INSIDE LENGTH
__ INSIDE WIDTH LIQUID DEPTH
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY /¢"~,'f--~i') ~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS I DIAMETER_-' .OR WIDTHI~,~", LENGTH/~)', DEPTH ('t
f . ' '"~ ' (-t ~ ~
LINING MATERIAL(CH'L){[~[:'(~: kC~IiJ~ZSIZ,: DIAMETER 4 DEPTH DISTANCE FROM: WELL(':()[¥'/'/I, --.
/ .- TOTAL EFFECTIVE
BUILDING FOUNDATION ~() l, NEAREST LOT LINE~')~'/u '~ ABSORPTION AREA (WALL AREA) ~l~ .SQ. FT.
ADDITIONAL ABSORPTION
TYPE CONSTRUCTION DEPTH
BUILDING NEAREST NEAREST SEPTIC
FOUNDATION __ LOT LINE SEWER LINE TANK __
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS.
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
INSTALLED BY::"~V)I''1~ [~'~Jf~ '
PIPE MATERIAl'
LOT SLOPE:
DATE
DIAGRAM OF SYSTEM
GREATER ANCHORAGE AREA t3OROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION ANJD PF. RMIT
PERMIT NO.
INSTALLATION OF: SEPTIC TANK . t ~-~ SEEPAGE Pit , DRAIN FIELD , OTHER --
SOil TEST RESULTS ~ NOTE~ THIS PERMIT iS NOT VALID WITHOUT SOil TES~
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 2.4 FLOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITNOUT FINAl.. INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
TYPE SEEPAGE AREA SIZE TYPE
SEPTIC TANK TO SEEPAGE P,t WALL /~
SEPTIC TANK ~'l SEEPAGE Pit ~ t
TO NEAREST LO~ LINE,
DRAIN PIELD ALSO CONSIDER AREA WELLS.
. SEEPAGE PIT
SEPTIC TANR, , SEEPAGE pit
TO RIVER, LAKE, STREAM.
, DRAIN FIELD
CAST iRON INTO AND OUT OF SEPTIC TANK AND INTO CRIBCROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC 'rANK AND SEEPAGe PI'I"
FITTED WITH AIRTIGHT REMOVABLE CAPS.
DIAGRAI'~ Gl~ SYSTEM
GRAVEL BACKFILL
CONFORM TO ~OROUGH REGULATIONS REGARDING/FL~STALLATION.
OR
LICENSED DESIGNER
I CERTIFY THAT IAM FAMILIAR WI-FH THE REQLJIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE
DATE APPLICANT'S SIGNATURE
FORM NO. EQ-016
3500 TUDOR ROAD RECEX~A?D-'~
ANCHORAGE, ALASKA 99502
JUN 2 5 ~'''
Performed For Bitt.Levar Date
Legal Description: Lot 5 Block SubdivJs~on %13N, R3W, ~bc. 13,
This Form .Reports SoJls Lbg. ~
Depth
Feet
18__
Soil Characteristics
/ Brown sandy clayey silt (ML)
Dray sand (SW)
and gray sandy gravel
W~s Ground Water Encountered?
If Yes,'At What Depth?
No
%
o
'; i
nute .
Proposed Insta]"la~'ion: Seepage Pit xx Drain Field
Depth Of Inlet Depth To Bottom Of Pit ~r
'COMMENTS:-140sq,ft, ofdrai~age, areaisrequire~ per bedroom below 6'depth.
Reading Date Gross Time i Net Time
j . Depth to H20 I Net Dro~
' i
Trench__
]~t Performed By R'.'E, Carlisle
ALASKA MINERAL & MATERIALS LAB,' INC~
Date :_~l_une 21; ,1'973 :
DAT(F~RECEIV ED
INSPECTION APPOINTMENTS
TIME TIME TIME
INSPECTOR INSPECTOR INSPECTOR
MUNICl PALITY OF ANCHORAGE DEPT.
DEPARTMENT OF HEALTH & ENVl RONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION
· R E C E 1 V E D
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplet. requesU will not be processed. Please allow ten (10) days for processing.
~ PROPERTY OWNER PHONE
W. L. Leva~
MAILING ADDRESS
~ives DUe of eown,
~ROPERTY RESIDENT {If different from above) PHONE
~enanes occuw ~he duplex
~2. BUYER PHON~
Oohn & Ge~a]dine 0elle~
MAILING ADDRESS
3. LENDING INSTITUTION ~ PHONE
Lawyers Tiele, ATTN: Wendy] 276-1151
MAILING ADDRESS
P.0. Box 2260, AnchoPa~e, Ak. 99510
4. REALTOR/AGENT [ PHONE
Sidsel Be~gmann, RE/MAX PROPERT~ES iNC.] 276-2761
MAI LIN6 ADDRESS O~ 344-9150
2702 Gambell St., Anchorage, Ak. 99503
5. LEGAL DESCRIPTION
I~t 5 of Levar Subd,
STREET LOCATION
260-261 Melody Place, Anchorage
6, TYPE OF RESIDENCE
[] SINGLE FAMILY
MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[-] One -~' Four
[] Two []~ Five
E] Three [] Six
[] Other
7. WATER SUPPLY
[] INDIVIDUAL"
[] COMMUNITY
~ PUBLIC UTILITY
* 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.)
8, SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** /? ~,~:~
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE pRocEsSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified iNSTALLER
[]Septic Tank or []Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
WELL TO: -
Absorption Area to nearest Lot Line
5, COMMENTS
[~APP ROV ED FOR (/'.t~- BEDROOMS
[] CONDITIONAL APPROVAL (letter must acco~y certificate)
[] DISAPPROVED
DATE BY.~
72-010 (Rev. 6/79)
29/!g Kimbe~:iie Court
ANCIIORA(;F, AI.ASKA 99b04
Phone 277-0478
JOB INVOICE
FDER TAKEN BY dATE PROMISED
PHONE
AMOUBT
HOURS LABOR
/ r~ECHA~ICS ~?
· -~5HELPERS
I hereby acknowledge the s
completion of the above described work:
SIGNATURE
TOTAL LABOR
AMOUNT
ALASKA erlUlI Onmi FITAL CO[1TrqOL $ rqUlC $, I C.
I~n§Jneering G ~nuironmental Studies
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
FEB 2,~.~'"' i§81
t::' o ,'.) o ili~ (i) X ":'";' ' fi
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...... ~ ~",,::.:.~ (:~::' ~'~'.'" :~C.:~F:'"'~.
'THZ ~Y~"t"~[~:H :Z~[~ [:~'~::'~E:L.i~: [)F:' f~[::i:)~:}::~'~':~:N(~ 600 (~q:.2...Cq~]~- (:)i::' Fh':CFtZFZ i::'Z:~ DF~Y.~
THE: ~J~(:):[]...~ FfFV'F:)::NG ~:)f:' "i'l"J~: ~Y~)"i'J~:~'~
E:F~[:D I. jF:~C}N TI..UZ 'i'E:E,T i:)F~Trq THE:
1220 LU¢sl 25lh Aucnu¢ · Anchoro§e, Alosb 999o3 · (907) 276-1361
[);!FPd~L,I!: ' i I,!F ll[:.t']r]'l! AI'][./. ~'~/ If} ~'~ :N["tl PNQJ'ECJ'H)!I
February 1.9r .iL981.
% Sidsel Bergmann
Re/,~a.x Properhies, Inc,
2702 Gambel] S'Lree[
Ancherage, 2',,]. a ska 99503
( :1.. ) E:Kpose h he ,:.'. cpi: ic ' '~ ', ~ '
~ O~r:t~ (2~]']te sept.:LC' '~ Lank,, pumped wit:.h a receipt submi'ht:ed ho this
~)~ t~ / ~0 del;~arhmenc' Ihe ho-haJ, number oE 9allons N~mped needs 'ho
~ .~.~t be on Lhe ce(zeJ, pk aJtd ver'J ':'i ed t y a ~eg'[sh-F~:~d :.nc i
~n ~ ~ c~t,s ~:o /:he /.tc{:uaL nurabex' o'ff ga].lons pumped. This :i.s Lo
~%i~ '1~)' ve:lTJ.:fi'v hhe size of t:he s~pl.:.ic tank.
O ~ ,%~ ~ · '·
(3)
An adequacy hesh needs ko be ipe:c:[ormed on -hbe ex:.i, sting
i[eac]']il~g ~t)fo,l. })his tnes, t will de'te:cllli.ne J.:~ the system
is adequahe accerding i:o NaLiona]. S~andards. A
Of pr:['va.l:_o .~J_rms perJformJ.ng 'llhe hes-h J_s enc].osed, This
:uepo.i:"l:: needs t.o be sub'mi~tted ho l::his deparhmenl- for our
review.
,
.}..il S l-
nc:p/] j w
. . . .l. iLl~. °'
l.,awyer s ri.' _' .., 'o ~' ¢! ]~[ (:_] ~'
Post OiTfice box 2260 99510