HomeMy WebLinkAboutBROADWATER HEIGHTS TR D BLK 1 LT 12 / MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMIENTAL PROTECTION
ENVlRONIVlENI'AL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
M'~A, L, NG ADDRESS h --
LEGAL DESCRIPTION
LOCATION
NO. OF BEDROOMS
I We]l Absorption area Dwelling PERMIT NO.
_~ DISTANCE TO:
I-2 Manufacturer ~j~ j ,_ j Material No. of compartments
i Liq. capacity in gallons Inside length Width Liquid depth
~ GOO IF HOMEMADE:
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
T--I--O Z ~: Manufacturer Material Liquid capacity in gallons
~ Well Foundation Nearest lot tine PERMIT NO.
E DISTANCE TO:
~ U. 2 No. of lines Length of each lirae TotaJ length of lines Trench width Distance between lines
~ Top of tile to finish grade Material beneath tile -- Total effective absorption area
Length Width Depth PERMIT NO.
~ I- -Type of crib Crib diameter Crib depth Total effective absorption area
'" Well Building foundation Nearest lot line
u~ DISTANCE TO:
j !Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
SOIL TEST RATING
INSTALLER
REMARKS
{ ~'C 0'
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
DEPARTME~.~ OF HEALTH AND ENVIRONMEN~,qL ~PROTECT!ON
' 825~ 'L' STREET, ANCHORAGE., AFC 9950~. ,
'
b4ELL Rt-4D or-.I----~, I TE '-";EI~JER , F'ERt-1 I T
PERMIT N0. < ' ,
LOCRT ION
LOT "-";IZE ~,~Od,~ SQ.URRE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS'
MAXIMUM NUMBER OF BEDROOMS = ,.~. SOIL RATING (SQ. FT/BR:,= ~,.~-
THE REQ.UIRED SIZE OF THE, SOIL ABSORPTION SYSTEM IS'_- "-<- / '-~Y
LE[4~'~TH= '
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIEED.
THE DEPTH OF A TRENCH~ OR PIT IS THE DISTRNC:E 8ETNEEN THE SLIRFAiZ:E OF THE
AROUND AND THE BOTTOM,. OF THE EXCAVATION < IN FEET).
THERE IS NO SET WIDTH, FOR TRENCHES. '
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRA',/EL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE, EXCAVATION (IN FEET).
PERMIT APPLICANT HAS THE RESF'ONSIBILIT',r' TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJFICENT TO THIS PROPERTY FIND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
BACKFILLING OF ANY S'¢STEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILF BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWRGE DISPOSAL SYSTEM I'-';
I~30 FEET FOR A PRIVATE WELL.: OR
:L514 TO 2~30 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
HELL LOGS FIRE REQ.UIRED AND MUST BE RETURNED TO THE DEPARTHENT WITHIN _~E~ DAYS
OF THE WELL COMPLETION.
OTHER REQ.UIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F"ERr-1 I T EXP I F-'ES E, ECEr-IE:EF.: -----:-1 .. -1 -5 ,---'- .-,
I CERTIFY THAT
±: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS 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~JDE MORE THAN 8 BEDROOMS.
Applicant
I$SL,ED B¥~ ~
MUNICI 'ALIT¥ OF Ar~r_-F
DEPSRTMENT of HESLTH FIND ENVIRONMENTSL r-ROTECTION
825 'L ' STREET.. ANCHORSG6 MK. _g9.501
~:EI~IE!~
ON--S I TE
PERMIT NO. ( 8000~2 >
8PPLICSNT
LOCSTION
LEGRL
RODNEY C. WILLIS POST OffICE
ESGLE RIVER
LOT SIZE 64000 SQUSR~
TYPE OF SOIL RBSORPTION SYSTEM IS: DRRINFIELD
MRXIMUM NUMBER Of BEDROOMS
SOIL RRTING (SQ FT/BR>= 85
THE REQUIRED SIZE OF THE SOIL 8BSORPTION SYSTEM IS:
E. EPTH= 3 LENGTH= 45 GRR~EL DEPTH=
THE LENGTH DIMENSION IS THE LENGTH <IN FEET> OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF 8 TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND 8ND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THE TRENCH WIDTH IS 5. 000 FEET.
THE GRSVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFSLL PIPE
8ND THE BOTTOM OF THE EXCRVRTION (IN FEET).
REQI_I I RED SEPT I C TArqK S I ZE= -1000 GALLONS
PERMIT RPPLICRNT HMS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES THRT THE WELL WILL SERVE.
------ TWO < 2 ) INSPECT IONS RRE REkgU I RED
BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R WELL RND 8NY ON-SITE SEWSGE DISPOSRL SYSTEM IS
100 FEET FOR ~ PRIVRTE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
OTHER REQUIREMENTS MRY 8PPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS 8RE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
PERM I T E.XP I RES DEi_-:EMBER 3l.. 1~80
I CERTIFY THRT
l: I 8M FSMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPRLITY OF 8NCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN 8CCORDRNCE WITH THE CODES.
~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
SIGNED:
8PPLIC~NT RODNEY C. WILLIS
ISSUED BY_
V4. 0
SOILS LOG
PERCOLk~ZO:.; ~EST
77-31
Perfo~e~ for Alfred Romanszewski
Date Performed 9/3/77
Legal Description
Lot 12, Block 1, Tract D, Broadwater Heights Subdivi'sion
Red, sandy silt w/organics (ML) ' 275 'ft.'2/bdrm.
Dense, brown, well-graded, sandy g~avel w/boulders
t~ 2 feet (GW) '
85 ft.2/bdrm.
Bedrock at -9 feet
Total Depth = 9 feet
No water table encountered
Date Net Time Depth Net Drop
t'ercolat ion Rate l.~inu te
ertifiei rilling
b~
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
OWNER OF LAND Ii~ Ot,0'~g' ~ /,~d'./~.
ADDRESS g~X Id ~ ~, ~,
LEGAL DESCRIPTION Z j~ ~ i ~
DATE-Started 7~5/7 t _ Ended
PEamT NUM~Ea ~ ~ ~¢ ~g~
DEPTH OF WELL
STATIC LEVEL OF WATER F'F.
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING
KIND OF FORMATION:
From ~ Ft. toC~
From
From [ 0 Ft.
From
From ~q',l Ft.
From 36~ Ft.
From. 3 ! 6'" Ft.
Ft. O O-~'~ ZJ~J,~ ~/ From. Ft. to Ft.
Ft. to [0 Ft. (~_.~4~ ~" ~ ~ ~ O~ From~Ft. to .... Ft.
to ~,~Ft. ~0~/~__ From~Ft. to~Ft.
to ~[ Ft. ~o~ ~ F~o~OFro,~~~ Ft. to _ Ft
to ~ 0 ~ Ft. ~0~ ~l~ From ..... Ft. to Ft
to ~C Ft. ~~ ~rO~ j O~
__ from ~ Ft. to Ft.
to--Ft. ~[~ ~ ~& ~O From~Ft. to__Ft.
From~Ft.
From .7_t'~ Ft.
From Or3~Ft.
From Ft.
From /'~ ~'Ft.
From Ft.
From__ Ft. to
From Ft. to
From Ft. to
From Ft. to__
__Ft. to__Ft.
From__Ft. to__Ft.
From__Ft. to Ft.
From Ft. to Ft
From Ft. to__Ft.
From Ft. to Ft.
From_ Ft. to Ft.
From__Ft. to__Ft.
From__Ft. to Ft.
From Ft. to Ft
to Ft
Ft.
Ft.
Ft.
Ft.
MISCL. INFORMATION:
# T o7,'9c.
DRILLER'S NAME ~~'-~a- '_. ~
F:'IEF.:P1 ].' 'T' I'.,IO.
t"1I I'.,I :!: I"IL.II'"t C, I Z'TI:INCE DET!.,.I[:..:EN R HELL. I::-II'.,ID I::.'11'.,1'¢ Ol'.,l--.S; I "I"IE ::~!:EI.,.If::IGE:". [:, I ZF:'O:~i;I:::IL.. S;'-r':!!i;'T'tEl"l :1: :!~;
::[.ii~E~ F'Ei:L:.~:T I:::' O1:;.: FI F'I:?~I'¢t::ITE I.'.IELI....~
::t..!:.~i~) "f'O ;?.6~EI FE:ET F'l:;d::)l'q F:I F'UBL:[C t.'.IEL. L. [::,[:ZPEND:[NG IJF'OIq 'THE 'T"¢F:'E OF F'LIBL. IC: I.,.IIELI .....
1.4EL. L.. LOEff~; I":II:~:E F;:~E(~:!UIFi:E;[::~ F:II'-,ID I"IL.I:~!;"I" E:E F;.:E'T'IJF.:I",IE[::, "1"O THE: [::,[ii:F'F:tt:~¥f'I'"IEI",IT' I,.I]:'T'H:[N
[,'.':iF:' THE 1.4ELL E:OI"1F'I_ETI ON.
C:~"t"I'-I[EI;i: I:;?.E6'RJ :[ REI"tEI"4T':'E; 'i"1f:l"r' I:;IF'I:'L"r'. SPEC :[ F :[ CRT ~. Ed"iS F:tND C:ONST't~:UE:"I" :1: C. fl",t [;:' :[. l:::l(~il:;;:l:::ll"l:i!i; t:::ll:;;:E
RVI::I ]: L.,FIBL. E: TO :[ t",I'.:~.;URE PROF'Ef;':.' :[ NSTI::ILL..FI'f' ]: ON.
:1: CER'T':[ F""r' 'T'HFIT
::L: :[ I::tt'"t I:'FIPI:[L.]:f::It:;.: F.I]:"t'H THE ['?.E(;:!U:[I:;i:E:i"IENT~i; f:'"O[;.: Cff',I"-.'.::i:[TE:~ :!!i;E':HE!:I:~::~!; I::llq[::, !qEL. L:i:!;
F:'OI:~'.TH li.:.';"r' THE tql...ll'.,l :[ C: :[ I::'I::IL :[ T"r' O1::'
2: :[ t.'.1 ]: LL. ].' NSTf"':IL.L. THE: '.".:.;"r'STE:t"I ]: N F~tCCOF;?.E:'FII",IC:E 1.4 Z "FH THE
FfF:'PL. T CF:tI',IT L. :[ I",IDR 1.4 :[ LL ].'
PERMIT NO.
MLINI~D I PRLITk' ~3F R~C:HC~RtaE
DEPARTMENT Or HEALTH AND ENVIRONMENTAL P~')TECTION
825 'L STREET, ANCHORAGE, AK. ~L z
224-4720
L.~ELL PER,'1 IT
( 780517 )
APPLICANT ,LINDA WILL~ BO~< 1242 EAGLE RIVER
LOCATION BROhP6;MIER DR
LEGAL Li2 Bi BROADWATER HTS S/D LOT SIZE
694
0 SQUARE FEET
MINIMUM DISTANCE BETWEEN 8 WELL AND ANY ON-SITE SEWAGE DISPOSAL. SYSTEM IS
100 FEET FOR A PRIVATE WELL; OR
150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST 8E RETURNED TO THE DEPARTMENT WITHIN )0 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS RND CONSTRUCTION DIAGRAMS ARE
RVRILABLE TO INSURE PROPER INSTALLATION.
PERM I T E×P I RES [)Em~ErdBER
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED:
APPLICANT LINDA WILLIS
ISSUED BY .... DATE
NAME OF APPLICANT.
INSTALLATION LOCATION
LEGAL DESCRIPTION
GREATEr ANCHORAGE ArEa BOrOUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456!
-- APPLICATION AND PERMIT
PERMIT NO.
PHONE
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
TO SE INSTALLED BY
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.
SEPTIC TANK SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK . SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, ., SEEPAGE PIT
TO RIVER, LAKE, STREAM.
SEEPAGE AREA SIZE
DRAIN FIELD
, DRAIN FI'ELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
TYPE
DIAGRAM OF SYSTEM
OR
F""~"i~'l'{~wiTr~ 'i"IE'RE~UIREMENTS'OF GREATER ANCHORAGE'AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
I
CERTIFY
THAT
]
AM
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE,
FORM NO. EQ-01 6