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Home My WebLink AboutBRUIN PARK BLK 5 LT 1A 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 IPHONE / []NEW MAILINGADDRE~S ~0~__/ ~ ~;:) ~ ~~~~,,~ LEGAL DESCRIPTION LOOATIO~~ ~~ ~ /)' ~~ NO, OFBED~MS DISTANCE TO: ' ]Well / 0 ~U ~lAbso~ionarea~, Dwelling/ ~ ¢ P ERMITNO. q ~ Manuf"cturer~ Ma~ 'o. ofco~m~ts~ ~ Liq.;a;~i~n~lons IF HOMEMADE: Inside length Width Liquid depth ' ~ Well ~ ~ ~ M~urer ~ ~ ~ ~ Material ~iqulO capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO. ~ ~ DISTANCE TO: ~ / ¢ O f ~Z~ No. ofli~ ,Len2~ac~ Total lengthoflines~ Trench width¢ ~& Distancebetween.lines ~ ~ ~ Top of ~ to finish grade Material beneath til~ ' - Total effective absorpt Een~th ~idth Depth ~[~MIT ~0. ~ ~ Type ' ' Cr' Total area / ~t lot line ~ ¢ DISTANCE TO: ~~Depth ~ .. ,~~ncet°l°tline., PERMITNO. ~ DISTANCE TO: Building foundation ~' ~pti~?~ .~ Absorption are?)~ OTHER , PIPE M~TERIALS C~ ~ ~ ~ _ SOIL TEST RATING ~ U REMARKS ~ Ia' D ¢ /? DATE LEGAL L 72-01 (Rev. 3/78) PERMIT NO. APPLICANT RONALD D. BELL LOCATION OR CALL ~44-8482 LEGAL L1 &2 B5 8RUIN PARK TYPE OF SOIL ABSORPTION SYSTEM DEF'RRFblENT L.. HEALTH AND ENVIRONMENTAL . ,.~]TEC:TION '-'-'"'.~ "L '~ o.-".. STREET., ANCHOR. ROE, AK. · -.,=,4 4, ~-~ C,[-I--S I TE 5EL-~EF: F'EF.:t.11 T ( 82LEt12L~. ) ' BO,':.-:, 'r::eE;Z S,:,LDRTNR ~.j - ,~1 -~ I ~ 2.~r7",'.':'~,.' ,4- t/~- , . (~-",/'¢ 5 ¥--'0" LOI SI=E 4.:.,eoe =,QLIR~E FEET IS: DRRINFIELD ~-'~-' d '~.$-44G¢ ~ //~'. MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT./BR)= $5R THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEF'Tt4= 5 LEr-16TH= ¢=--; --:~: C_~ ~: FI"..." E L [:,EF"TH= 2 THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THE T~:ENI]:H 14IDTH I51 5. ~3~3 FEET. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). RE,;.!I_i I F-:EB, SEF'T I C: TRr-~F::: S I ZE= :1_E401-3 I3RLLC, t~.S-; PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT 'TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TI.40 (2> I ~-ISiPECTIC, NS R~:E RE,S!~J I E~E[:, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS ~00 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PEF.:M I T EXP I RES [:,EL-:EI'IBEF~: '::-: :t.. iD:B1 I CERTIFY THAT &: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH 8Y THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]:: I IJ~.~Eq~ND THAT THE ON-SITE SEWER SYSTEM MAY REQUIR. E ENLARGEMENT IF RES I[:,F J 7~f;~TO.,~.,ICE ' " I'.,ICLUDE MORE THRN .~=: BEDROOMS. ~F~,T ,,~,NRL[:, D. BELL .... I SSLIE[:, E,'.r ..... [.'RTE ....... THE V4. Et J~ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST P...OR~EO.O.: 'RoN ~Et- L LE~A~ DESC.,PT,O.: Lo'ir I& P_ . 1 2 lO 11 12 13 14 15 16 17 18 19 2o SLOPE SITE PLAN O P IF YES, AT WHAT ff ~ E DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) 72-008 (6/79) < DATE ECEIVED TIME ~ I DATE DATE ' D~TE INSPECT MUNICIPALITY OF ANCHORAGE ~UNICtPALI~ OF ANCHO~GE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & 825 L Street - Anchora~, Ala~a 99501 ENVIRONMENTAL PF~OTECTION ENVIRONMENTAL SANiTATiON D V S,ON MAR ffi 6 1981 Telephone 2~-4720 DIRECTIONS= Complete all parts on page 1. Incomplete requ~ will not be proceed. Please allow ten (10) days for processing. ~BOP~T~ ~fiSID~T {If differ,hr from abovo) '2. BUYER - PHONE MAILING ADDRESS 5.' LEGAL DE~I~R~I~N ' STREET LOCATION 6. TYPE OF RESIDENCE ' [~' SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY NUMBER OF'~BE'DROOMS ' ' [] One [] Four [] Two [] Five [~ Three [] Six [] Other * 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.) YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72t010 ~Rev. 6/79) ~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE I--I PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: If Tank is homemade give dimensions: [] ONE [] TWO PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOl LS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line NUMBER OFBEDROOMS [] THREE [] FIVE [] FOUR [] SiX [] OTHER Septic/Holding Tank IAbsorption Area ]Sewer Line Nearest Lot Line 5. COMMENTS DATE [~APPROVED FOR ~-~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev. 6/79) CHEMICAL & GE~..OGICAL LABORATORIES L. ALASKA, INC.~ TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name Mailing Address I.D. NO. Phone No. City SAMPLE DATE: J J.:!~ I ~ Mo. Day SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose State Year Zip Code [] Treated Water [] Untreated Water SAMPLE NO. 3 . LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results Please send new sample. Date Received Time Received Analytical Method: [] Fermentation Tube [~/Membrane Filter Lab Ref. No. Result* I cr~ i FT-I i r-I-] I r-Fl I FT3 *No, of colonies/100 mr. or No. of Positive port OhS Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collect~l Source a.m. Date Received Time Recelvea p.m. I_ab. No. Presumptive 10mi 10mi Z0ml Z0ml /0mi 1.0mi 0.1mi 24 Hours 48 Hours Confirmatory 24 Hours ,48 Houri , EMB Broth 24 hours: Broth 48 houri: Multiple Tube Report: 10mi Tubes Positive/Total 10mi Portions Membrane Filter: Direct Count Collform/100ml Verification: LTB , BGB Final Membrane Filter Results Collform/100ml Repot ta<l By , : Dete Timer I,m. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection ~'.:~ Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 2. Property Owner: ..~~)'-' c.~ Mailing Address: . . / 3. Legal Description: ~ ~ /~ ~ / ~. lype ~ B. ~epth 7. Se~a~e ~sposal System: Installed ~/~ ~o B. Installer A. C. Septic Tank: D. Seepage Pit: E. Disposal Field: 1. Size ./~.5-o$0~ 2. Manufacturer ~°~t-o. cJ~. 1. Absorption Area ~-/~-& ~' 2. Material Total length of lines e Distances: A. Well to: septic tank Nearest lot line Absorption area /0~ , Sewer Lines /~., , Other contamination B. Foundation to septic tank ~ C. Absorption area to nearest lot line , Absorption area I ~o EQ-034 (1/74) Page 1 of two pages ANC,! I()i"~A(2E, Al_,.-,okA ,:~.)[. l (!)07) 2(~4 411 J IAI_ April 2, 1981 Mary Bell Star Route A ibo:{ 1769 Anchorage, Alaska 99507 Subject: Lot 1 and 2 Block 5 Bruin Park Subdivision Approval 'for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) ].v(!.r ed to The water analysis report needs to be de].' ~ ~ this office from the Chem Lab, 5633 B St'feet, for our review. (2) Expose t:.hc septic tank manhole to verify its existance. (3) The septic tank pumped with a receipt submitted to this department. 2'he total number of gallons pumped needs Lo be on the receipt and verified by a registered engineer as to the actual number of gallons pumped. This is to verify the size of the septic tank. (4) An ad('quacy test needs 'to be performed on the existing leaching area. This test will determine if the system is adequate according 'to National Standards. A list. lng of private firms performing' 'the test is enclosed. This report needs to be submitted to this department for our review. If the sewer system is not adequate, an upgrade will be necessary. Prior 'to the upgrade, a soils test will need to be obtained so that specifications can be determined. Mary Bell April 2, 19811_ Page Two If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt~ R.S. Assoc,.ate Specialist RCP/ljw cc: Itoward Swerland 605 West Benson 99503 / / il ROAD 3Hl.~O zA l~V~ ~Hi pafia~hsun u, 101 6uo~ u6 uo~ - .~puo~ 6mpllAq oI anp ~2 u? V. 9 ~o1'1o UOlflppV (G)