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Home My WebLink AboutBRUIN PARK FIRST ADDITION BLK 8 LT 3 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 DESCRIPTION DISTANCE TO: ~'r ~~ I b P~;are' ~ Dwelling ~ ,, PERMIT~O. ' ~ Manufacturer ~¢~ ~ i Liq~~~H°ns IF HOMEMADE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well ~w~ing ~ PERMIT NO. 0 ~ ~ Manufacturer~ Material kiquid capacitg in ~allons ~ DISTANCE TO: ~ Z ~ Foundation ~ ~ _ ~ ~ N°' of lines / Length ~f~ lengt~es Trenc~i3h inches Distan~tTn~es ~ ~ Top of ti~e to ~nish gra. ~ ~ ~ ~rial be~ath tile ~¢ Total effective absorption area 7,=z7 s 72 inches Length Width DePth PERMIT NO. ~ ~ Type of crib Crib diamet Crib depth qota~ effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: .' ClassW. ~ D?t~ Dr, ller Distancetolotline PERMITNO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS DJ c , SO~L TEST RAT~N~ APP~E¢// '~;:~(:~ ~:~ ..";' ~:~:",~' DATE LEGAL 72-013 (Rev. 3/78) PERMIT NO. RPF'L t C:RNT LOCRT I ON LEGRL JOHN FIOLSMRN KLETT F.:ORD L ]: B 8 BRUIN PRRK SMD #l X SR BOY, 99577 LOT SIZE 694-:2979 t9200 SQURRE FEE]' TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH MRXIMUM NUMBER OF' BEDROOMS SOIL RRTING (SQ FT/BR)= ±~0 ']"HE REQUIRED SIZE OF THE SOIL RBSORPTION S"r'STEM IS: [::, EE F' T H == -1_ C'" L_ E f-~ ,3 T H == _---.~: 2: ,3 F~: R "..-' E L [:. E F' -f' H = *.:~; THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL.[:'. THE DEPTH OF' R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF 'THE; GROUND RND 'THE BOTTOM OF THE EXCR',/RTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GF.:RVEL DEPTH IS THE MINIMUM DEPTH OF GRR',,,'EL BETWEEN THE OUTFRL. L F'IPE RND THE BOTTOM OF THE EXCR'¢RTION (IN FEET). PERMIT RPPLICRNT HRS 'THE RESPONSIBILIT'¢ TO INFORM THIS DEPRRTMENT [:,URING THE INSTFILLRTION INSPECTIONS OF RN'¢ WELLS RDJRCENT TO ]'HIS PROPERT'¢ RND THE NUMBER OF RESIDENCES THRT THE WELL WIL. L SERVE. BRCKFILLING OF RNY SYSTEM HITHOUT FINRL INSPECTION RND RPPROVRL BY THIS [)EPRRTMEN]' HILL BE SUBJEC:T TO PROSErZ:UTION. MtNIMLIM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEI.qRGE DISPOSRL SYSTEM IS t00 FEEl" FOR'. R PRIVRTE WELL OR t50 TO 200 FEET FROM R PUBLIC NELL DEPENDING UPON THE TYPE OF' PUBLIC WELL MINIMUM DISTRNCE FROM ~ F'RIVRTE WELL TO 8 PRIVRTE '_-]EWER LINE IS 25 FEET 8ND TO R COMMUNITY SEWER LINE IS '75 FEET. WELL LOGS BRE REQUIRED RND MUST BE RETURNED TO THE [)EPRRTMENT WITHIN ]7:0 DRYS OF THE NELL COMPLETION. OTHER REQUIREMENTS MR'¢ 8PPL'¢. SPECIFIC8TIONS 8N[:, CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. I CERTIF'¢ THRT ::L: I RM FRMILIRR WITFI THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SE'l" FORTH 8'~' 'THE MUNICIPRLIT'¢ OF RNCHORRGE. 2: I WILL INSTRLL. THE S'¢':_:;TEM IN RCC'ORDRNCE WITH THE CODES. .~:: I UN~:,ERSTRND THRT THE ON-SITE SEWER S'¢STEM MR'¢ REQUIRE ENLRRGEMEN]" IF 7'FIE RES I[:,ENC:E IS REMODEL. E[) TO INCLUDE MORE THRN 3 BEDROOMS. S I GNED: I=IPPLICRNT ,:rOFIN FIOLSMRN V4. 0 Legal Description MUNICIPALITY OF ANCHORAGE Department ~ Health and Environmenta. ~rotection 825 ~ Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND/~I~ ON-SITE SEWER PERMIT Mailing Address Phone um er: Type of Soil Absorption System Is: Trench: ~ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: _~__ Soil Rating(sq.ft/br) )~%~ ~_ 0 ~ The Required Size of the Soil Absorption System Is: The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(i .......... ) TANK SIZE = i~QQQ GALLONS * * 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. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 8 1 * * * I certify that: (1) 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signe~: App~i~n~t~~ Issued by: ~,~. ~~ Date: ~9 ~z~?. ~ /g~l SWP/024 (1/81) [] SOl LS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ~' 3 SLOPE 1 2 3 4 5 6 7 8 9 PERCOLATION TEST SITE PLAN 10 11 12 13 14 15 16 17 18 19- 20 COMMENTS WAS GROUND WATER ,~ O SL ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop / --- /lY " __ PERCOLATION RATE _~ ,.~ (minutes/inch) /, 2~ /' TEST RUN BETWEEN FTAND ~ FT "~'~ ~ ~'~'?~'~/,~, PERFORMED BY: 72-008 (6/79) CERTIFIED B DATE: PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 ~4 5 6 7 8 9 11 12 13 14 i5 16 17 18 19 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG DATE PERFORMED: PERCOLATIQN TEST SLOPE SITE PLAN WAS GROUND WATER S ENCOUNTERED? .~___~ ~ , ~ P E IF YES, AT WHAT DEPTH? :Afl/ Gross Net Depth to Net Reading Date Time Time Water Drop ~ ~%z? ,2 32 .6>' t, %2 .tm PERCOLATION RATE .~_.~ (minutes/inch) TEST RUN BETWEEN 2 . _ FTAND ~ - FT 72-4D08 (6/79) PERFORMED FOR: ~EGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 J6 17 18 19 20 COMMENTS PERFORMED BY: 72-008 (6/79) SOILS L(~G MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 sOILS LOG - PERCOLATION TEST PERCO LA'f'ION TEST SI_OPE SITE' PI.AN S WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date ¥ PERCOLATION RATE Gross Net Depth to Net Time Time Water Drop ,2. YZ t~ /,Y~' Z 't~ ~ /, ~2 ,,z.. FY ~ '~"' .... DATE RECE VED ' '- ' PECTION APPO NTM ;;" I NS I E NTS DATE DATE. / DATE ,INSPECTOR / I NSPECTOR~fo~ MUNICIPALITY OF ANCHORAGE ~UNIClPALI~ OP ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~IRONMENTAL PROTECTION 825 L Strut - Anchorage, Alaska 99501 ' ENVIRONMENTAL SANITATION DIVISION NOV g 1981 RmUEST FOR ..ROV L OF ,.D,V,DU L W TER SEWER OI RECTIONS: Complete all parts on page 1. Incomplete requ~ ~11 not be pt~d. Please allow ten (10) days for processing, 1' ~ROPERTY OWNER -- ~ -- r' j PHONE~ PROPERTY RESIDENT ( f d fferent from above) ] PHONE 2. BUYER ' PHONE MAILING ADDRESS 3. LENDING INSTITUTION ' ' I PHONE ' MAILING ADDRESS .~ ~ , ~ . 4.~Ti ~_¢~ ~ O I PHONE ~-~ 1~7~'' ¢7? MAILING ADDRES8~ I .~ GAL~DEE~.~IIPTION I 6. TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER~PPLY ~ INDIVIDUAL* [] COMMUNITY i--I PUBLIC UTI LITY 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY NUMBER OF~BEDROOMS ' ' [] One [] Four [] Other [] Two [] Five '~ Three [] Six ATTACH WELL LOG. A well I~)g is required for all wells drilled since,June t975. For wells drilled prior to that date, give well depth (attach log if available.) J ¢~,;¢// 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 [] SINGLE FAMILY [] MULTIPLE FAMILY [] ONE [] TWO NUMBER OF BEDROOMS [] THREE [] FIVE [] FOUR [] SlX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED ~,/~_~ ~ PERMIT NUMBER DATE INSTALLED INSTALLER []Septic Tank or []Holding Tank Size: /(~)c.~ If Tank is homemade SOILS F{ATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AR EA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line MATERIAL __~. ~ Septic/Holding Tank [A~bsorption Area Sewer Line Nearest Lot Line 5. COMMENTS DATE APPROVED BEDROOMS [~,~-CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev. 6/79) CHEMICAL & Gl LOGICAL LABOR.4TORIES .~£ ALASKA, INC. ~~ TELEPHONE (907)-279.4014 ANCHORAGE INDUSTRIAL CENTER . ~ Drinking water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY WATER SYSTEM: Water System Name Phone Nb. Mailing Address Aoalysis 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, City State Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. I-I Special Purpose Zip Code [] Treated Water [] Untreated Water Date Received Time Receivecl Analytical Method: [] Fermentation Tube ~(Membrane Filter SAMPLE NO. , I I 3 I LOCATION . I Time Collected Collected By Lab Ref. No. Result* Analyst I m I ~ I r-J"-I I ~-~ *No. of colonies/100 mi. or No of Positive port~ons READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collected Source_ , Date Received , Time Recelv~l p.m. Lib. No. Presumptive 10mi 10mi 10mi 10mi 10mi 1.Omi 0,1mi 24 Hours 48 Hours Confirmatory 24 Hours 48 Hours EMB Broth 24 hours: Multiple Tube Report: Membrane Filter: Direct Count Verification: L. TB Final Membrane Filter Results Broth 49 hours: 10mi Tubes Posltlve/'rotal 10mi Portions Collform/100ml BGB Collform/100ml Date Tlme~ '- ' a,m. pomp November 18, 1981 John D./Patsy K. Holsman 8607 Corbin Drive #4 Anchorage, Alaska 99507 0 Subject: Lot 3 Block 8 Bruin Park Subdivision Approval fQr the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. (2) The depression around the well casing needs to be filled in with impervious type soil. This will need to be reinspected by this office. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: First National Bank of Anchorage % Joel Fuller Post Office Box 8-9066 99508 Penny & Jenson 600 East Benson Boulevard 99503 <: Fold at (>) to fit (. d 0 0 PRODUCT 771 DU-O-VUE~' Envelope, PRtNTED iN USA I- Z 0 ¢~ ~ Z O ~(..~ < '; (- <' ( Q <' II~.L -- 0glxL0 '~selFi 'uoloJ9.''oul ~ moji elq~l!'~,~V ~ C'0lx06 .LONC]O[-Id