HomeMy WebLinkAboutTRI LAKES BLK 1 LT 3A;7
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GR. )'rER ANCHORAGE AREA BOROI. '¥1
DEPAFITMEBIT OF EBIVIfl0BIMEBITAL QUALITY
3500 TUDOR ROAD AI~,IC:HORAGE, ALASKA ggs07 27g-8§SG
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING -. .
LOCATION ~4' O'~ .~,,~i-2~ ~' (~ LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY
NUMBER OF ~
MATERIAl . ~';~' -~'/--.~ COMPARTMENTS
GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS /' OUTSIDE DIAMETER
LINING MATERIAL -. ~-~
NEAREST LOT LINE ~'~/ "~ ~-(~¢~ ~/~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
-- OR WIDTH/~//~i /
DISTANCE FROM WELL ~//~ ~,
LENGTH /'~'~ , DEPTH
· BUILDING FOUNDATION
BQ, FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL _F.~DUND ON ,NEAREST LOT LINF
NUMBER OF LINES CE BEIW TRENCH WIDTH
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
, OF LINES
I~O~IAL EFFECTIVE
IN. ABOVE TILE__
WELL:
DISTANCE FROM
TYPE (~' /'7~.~(~.. . DEPTH. '-- -, BUILDING FOUNDATION
-~- NEAREST ~ SEPTIC ~ SEEPAGE
LOT LINE _ SEWER LINE. _,TANK. ., SYSTEM
WATER
SAMPLE
, CESSPOOL
NEAREST
OTHER
SOURCES
DISTANCES:
5~,, /'7~
~//~Z
DIAGRAM OF SYSTEM
GRE:AiER ANCHORAGE: AREA BOROUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACiLiTY TO BE SERVED
SEEPAGE PiT ~ DRAIN FIELD i OTHER
NOTE ERMIT 15 NOT VALID WITHOUT 80IL T~,
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL IFIBPEGTiON BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE BUDJECT TO PROSECUTION.
d~__~ ~'~ SEEPAGE ArEA SIZE TYPE
/,.COO
DIAGRAM OF ~Y~TEM
MINIMUM DISTANCES, REQUIREMENTS
~/~0/ DRAIN FIELD
ALSO CONS]DER AREA WELLS.
~/ATER MAiN TO SEPTIC TANK . SEEPAGE PIT
DRAIN ]FIELD
SEPTIC TANK, SEEPAGE PiT DRAIN FIELD ~
TO R]VER_~LAKE. S~TREAM.
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INC_.~H._H DIAMETER CAST IRON SIPHON PIPES ON SEPTIC: TANK AND SEEPAGE PiT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I CERTIFY THAT I AM FAMiLiAR WiTH THE REQUH~EMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WiTH SAiD CODE.I
(:REATF, R ANCSC, RASE ,M'2?A BO.
HEALTH DE BP,} i'~Eif T CASE
327 EAGLE ~,TREET
ANCHORAGE~ ALASKA 99501
.................. o:a~l ~ Sketch
Was Ground ~:ater Encountered?~
~: %es~ At ~hat f',epth
Reading Date (gross
,e,. ~:me Depth To H20 Net Drop
.... ~.~, , a...h ~ 1. e].o
Dsta Certified
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
Date of Inspection
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
3. Legal Description:
4.
'5.
6.
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
~ ~.~~~ Phone: ...~5-~'-~-~---~'-~..~,
Location:
Type of facility to be inspected ~~ No. of bedrooms
Well Data: ~~ ~
Z '
A. Type ~ ---'J ..~_z~~ B. Depth
C. Construction D. Bacterial Analysis
Sewage Disposal Syqtem: .~.~~ ~~~
A. Installed~ B. Installer
Septic Tank: 1. Size /~¢o ~ 2. Manufacturer.~~
C.
D. Seepage Pit: 1. Absorption Area ~ 2. Material~/~
E. Disposal Field: Total length of lines
Distances:
u
A. Well to: Septic tank , Absorption area , Sewer Lines ,
, Other contamination
,~/ , Absorption area
Nearest lot line
B. Foundation to septic tank
C. Absorption area to nearest lot line~'O /
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages - R(~ st for Approval of Individual ~er & Water Facilities
Legal D~scription
Comments
Approved ~/~ ~m/'TJX- Disapproved Date ~/~
! / /
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
'GREATER ANCHORAGE ARE,', BOROUGH
Department of Environmental Quality
3330 "C" St., .Anchorage, Alaska 99503 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Iuspection: CMRO VA × FHA
2. Property Owner: ____Ruth Sehwi11±ng
, ~ Da.y
Mai 1 ing A~dr..ss: 3052 Strawberry , Anch
3. Name nf Buyer; Melvin Pederson
CONV
Phonew 344-5628
Mailing Address: 3831 West 79th
4. Name of Lending Institution:
Mailing AddresS: P.o.
5. Name of Realtor or Agent:
Mailing Address: N/A
Day Phone
COAST MORTGAGE COMPANY (BILL LONG)
Anch. 99510 Phone 279-0666
Phone N/a
Legal Description: Lot 3A, Block 1', Tri-Lakes S bdivision
Location: 3052 Strawbe__rry~ Anchorage
Type of Facility to
Water Supply
Type of Supply:
If Individual,
If Individual,
be inspected:
Public Utility
number of dwellings
depth of well
Sewage Disposal' System
Type .of S~stem: Public Utility
If Individual, date of installation
No, Bdrms. 5
!nd1 vidual
presently served
Individual (on-site),, x
Unknown to us
GREATER ANCHORAGE ARE2 BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561.
Date Received
Time of Inspection
Date of Inspection
3.
4.
5.
Aoprova]
Requested By:
Address~
Prooerty Owner:
INDIVIDUAL SD~ER & WATER FACILITISS
FOR // / ·
Phone- -
Phone:
Legal Description: /~
Type of Facility to be Inspected: .
Number of Bedrooms: ~ ~
A. Type
C. Construction D.
Sewage Disoosal System: ~.
A. Installed ~/ 8.
C. Septic Tank: 1. Size 2.
D. Seepage Pit: 1. Size 2.
Depth
Bacterial Analysis
Installer
Manufacturer
~aterial
f. Disposal Field: Total Length bf Lines
Distances:
A. Well To~
Septic Tank
· Nearest Lot Line
, Absorption Area , Sewe~ Lines
· Other Contamination
Foundation to Septic Tank
"~ Ab~orption Area
Absorption Area to Nearest Lot Line
Request for Approval m Individual Sewer ~ Wate~ Faoilities
-Page Two
Comments:
Appr Valid for One Year From Date Signed
Greater Anchorage Area Borough, Department of Environmente] Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this reguest for approval to be a true
and accurate representation of the subject sewer and water facilities located at:
Signed Dale