HomeMy WebLinkAboutTIMBERLUX #3 BLK F LT 6LoT
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MUNICIPALITY OF ANCHOP~AGm
He .k~/ and E~vironmental Prote¢k on
- Fourth Floor West ' '~J
825 L Street
Anchorage, Alaska 99501
279-2511, x 224~ 225
~ ........ IN--~CllON REPORT ON-SiTE SEWAGE DISPOSAL SYSTEM
LO~AIlON
SEPTIC 'rANK:
D, TANCE . ( NUMBEROF
F. RO~ WL:I~LL¢d MANUF^CTU~E~ _-~_ _C~--~-.-MATFRIAL ~'/ COMPARTMENTS_~
INSIDE LENGTP ..... ~___~ INSIDE WIDTH_ _ ~_IQLH[) DEPTH _~__.__ LIQUID CAPACITY~ALLONS.
~~/ / c ' LINE ~ / TOTA~ LENGTN
/
DISTANCE FROM WELL ~._FOUNDATION__~-- ___NEAR[LoT Lei' _ .... --- OF LiNE ___ .~--
/
~ of Lines -- DISTANCE BETWEEN LINES .... TREN H WIDT .~ IN. TOTAL EFFECTIVE
ABSORPTION AREA ~S~ SQ. FI. LENGrPI OF EACH LINE ~7 /
PEP]ii OF FILTER
DEPTH: EDP OF TILE TO FINISH GRADE ._~___MATERIAL BENEATH TILE ~ IN. ABOVE TILE IN.
SEEPAGE PIT:
DIAMETER .... OR WIDTIt ~.., ILENGTH__, DEPTH
L0,g Crib Rings Crib Size: DIAMETER ..... DEPTH .... DISTANCE FROM: WELL
....... TOTAL EFFECTIVE
BUILDING FOLINDAI'ION_ NEAREST LOT LINE ABSORPTION AREA (WALL AREA) ,SQ. FT.
Well
Well'Distance .To: Lot Line
Bldg: Sewer Line½ ~_~
Pipe ~Materials:'~ ~/~_
9:of Bedrooms: ~' ' ' ~
Install~r~ _~_~~
Remarks. i /~ _~/
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CONSULTING GEOLOGIST
I]oX 476-M, STAR ROUTE: A · ANCHORAGE, ALASKA 99507
SOILS LOG
Per£ormed flor ~A~i~ ~ ,
Description LO+
Soil Description' ..
-20-
Total Depth, (~
Was groundwater encountered
Depth to bedrock--~-~r~O'
? What depth ~ ?
How determined ~, ~,,,_ ?
Respectfully submitted~
Gary P. Player
Consulting Geologist
#1: Time
Date
Insp.
· MUNICIPALITY OF ANCHO~A~
DEPARTME~N.c, OF HEALTH AND ENVIRONMENT$,~PRO1ECTION
825 L Street, Anchoraa~, Alaska 9950].
264-4720
Date Received: March 28, 1978
jO;~q ~2: Time #3: Time
~ %~_Q~ ~ Date Date
~/~ Insp Insp
3e
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: First National Bank of Anchorage
Mailing Address: Post Office Box 720 99510 Phone: 276-6300/483
Property Owner: William/Mary Alexander
Mailing Address: NHN Longbow Avenue
Phone: 344-0456
272-3541/her
Legal Description: Lot 6 Block F Timberlux Subdivision
Single Family Residence: (x) Number of Bedrooms: Three
Multiple Family Residence: ( ) Number of Bedrooms:
Well System:
Permit #
Construction
Individual well (x) Community/Public System (
Depth of Well Well Log on File
Bacterial Analysis
()~
Sewage Disposal
Permit #
Septic Tank Size
Absorption Area
System: On-site System (x) Public Utility
Installed ~-~/--77 Installer c9~-~
/6)6)¢ Manufacturer J~
g/~--O Soils Rate Material
( )
Distances: Well to Septic Tank /~!
to Sewer Line Nearest Lot
to Nearest Lot Line
to Absorption Area
line Absorption Area
Pa~ge Two
'Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 6 Block F Timberlux Subdivision
Comments:
Affadavit Attached:~ ( )
Disapproved:
Letter Attached:
Date:
~epartment Worksheet:
UNICIPALITY OF ANCHORAGEL"]
Department of Health and Environmental Protection
825 L Street, Anchorage, Alaska 99501
264-4720
~~equest for Approval of Individual Sewer and Water Facilities
Property Owner:
Mailing Address:
Name of Buyer:
Mailing Address:
W~lllsm & Mary Alexander
NHN Lonqbow Avenue Phone: 34A-~q6
(You may contact Mrs. Alexander at work;
phOne: 272-3541)
none
n/a
Phone:
Lending Institution: First National B~nk
Mailing Address: Box 720 Anchoraqe, ~l~ka 99510 Phone: 276-~ 483
o
Realtor/Agent: n/a
Mailing Address:
Phone:
Legal Description:
Street Location:
Lot 6, Block F, TimberluxS/D
NHNL~ngbowAvenue
Single Family Residence: (x) Number of Bedrooms: 3
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well ~)
If Individual Well, well depth
If Community System, name of system
Public/Community System (
Sewage Disposal System: On-site System (x) Public System
If On-site System, date of ~nstallat~o ·
*NOTE: A well log is required on ALL wells drilled since 6/75.
We have approval cn ~he septic system by John Kennedy, '~ut not ~N~tl~e~.AN~Suld
DE , HEALTH &
appreciate it if you .could put a rush on th~ well approval for
assistance.
t','IAR 8 '1978
Marie Iiams 3/24/78
3/77
RECEIVED
06-1220[a) Rev. 1973 ~; ~;
Lab No. i:
DATE
DEPARTMENT OF HEALTH AND SOCIAL
DIVISION OF PUBLIC HEALTH
INDIVIDUAL AND SEMI.PUBLIC
BACTERIOLOGICAL WATER ANALYSIS
OFFICE
INDIVIDUAL I~.~. SEMI-PUBLIC I-- CHLORINE RESIDUAL PPM
. REPORT RESULTS TO
lAME ' '~'~ '~ j'" '~"-~":~"~'-- ~ '~-'L:-~"'~'~'4e~ '"~/"~ '-~"
ADDRESS
CITY
ADDRESS
OF SOURCE
Analysis shows t~is Water SAMPLE to be:
[] ~atisfact~ry
SANITARIAN'S REMARKS
COMPLETE THIS SECTION
ONLY IF WATER IS AN IpDIVIDUAL SUPPLY
SAMPLE COLLECTED I~Y
DATE COLLECTED TIME COLLECTED
Sample Collected Prom ~]'J(ilchen Tap [] Bathroom Tap [] Basemen ~ap
~ Other (List)
Well- ~ Dug [] Driven [] Drilled
SOURCE: [] Spring ~ Cistern [] Olher
Dug Well or Cistern Construct/om
WaBs--[~ Wood [] Concrele [] Metal
Top -- [] Wood [] Concrete [] ~etal
LOCATION:
[] In Basemem [] Basement Offset
[]In Yard [] Other
Building Sewer
DISTANCE TO: or Other Drainage Pipe
Tile Seepage Cess-
Field Feet. Pit- Feet. Pool-
Other Possible
Sources of Contamination .
MATERIAL: Building Sewer- [] Cast Iron [] Wood [] Tile
~ Plastic Joint Material - Type
GENERAL: Does Water Become Muddy or Discolored?
When?
[] Under ~ouse
Septic
Feet. Tank Feet.
Feet. Privy Feet.
[] Fibre J~ Asbestos
[] Yes [] No
Diameter of WeU
Well Casing
Material Diameter
Length of
Drop Pipe _ Offsel in
PUMP LOCATION: [] ~ Wel I- Basemenl
On Top
[] Of Well E Other
PURPOSE OF EXAMINATION: Illness Suspected?
New Source oF Supply? [] Yes [] No
READ NSTRUCTIONS
ON
REVERSE SIDE
BEFORE
COLLECTING SAMPLE
~ Yes [] No
0~-]~B0 ~ BACTERIOLOGICAL WATER ANALYSIS RECORD
~ev. 1973
Lactose Broth lOcc 1Otc 1Otc 1Otc 1Oct 1.0cc LOcc
~4 Hours
Brilliant Green ~::~
24 Hours
48 Hours