HomeMy WebLinkAboutTURNAGAIN #2 BLK 5 LT 7/4 o
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'"':"~6.TER ANCHORAGE AREA BORO,~'
,._~,../ HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
N? 509
SEPTIC TANK:
ADDRESS
LEGAL DESCR PT,ON
DISTANCE FROM WELL '~O
LIQUID CAPACITY .//~?~) GALLONS.
MATERIAL ~'?f°'x~ /
INSIDE LENGTH
NUMBER OF J
COMPARTMENTS
~'~' ~¢'/~/ ~ ~:~' ~ LIQUID
INSIDE WIDTH__DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
NEAREST LOT LINE
OUTSIOE DIAMETER OR WIDTH
. DISTANCE FROM WELL
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH , DEPTH
, BUILDING FOUNDATION
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
TOTAL LENGTH
,~c'O'~AIION . NEAREST LC~E ~'~ ,
OF
LINES
SQ. FT. LENGIH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: TYPE DEPTH
NEAREST
LOT LINE ., SEWER LINE
SEPTIC
, TANK
DISTANCE FROM WATER
, BUILDING FOUNDATION. SAMPLE . NEAREST
~ SEEPAGE ,'~) f OTHER
, SYSTEM76/ , CESSPOOl , SOURCES
DISTANCES:
vo
Ac=gO
DIAGRAM OF SYSTEM
GRE~,.~'~ER ANCHORAGE AI~E~A BOr~'~UGH
DEPARTMENT OF' ENVIRONMENTAL, QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
PHONE
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY~SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
h ? :1~/~.,. ~¢^ ,.:,~y-¢o':->~ we//
SEPTIC TANK
TO NEAREST LOT LINE,
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOU.DATIONTO'EEPACE P'T
F[ELD
SEPT{C TANK TO seepage Pit WALL / .~
-, SEEPAGE PI ~ DRAIN FIELD
DIAGRAM OF SYSTEM
SEPTIC TANK, , SEEPAGE PIT , DRAIN FIELD
TO RIVER, LAKE, STREAM.
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.
LICENSED DESIGNER
I CERTIFY THAT [ AM FAMILIAR WiTH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE / ?/qTI APPL'CA T'SSIGNATURE :
GREATER ANCHORAGE AREA BOROUGH
D~oartment of Environmental O.~lity
3500 Tu4or 2oa4, Anchorage, Alaska 99507 279-8686
Date Received
Time of Ins~ectio~
Dat~ of Inspection
REQ!.;~!ZT FO; APoRO',/AL QF
INDIVIDUAL ¢~i~1~
..... ~A~ER FACILITIES
3,
5. Type of Facflitv to be !nspected:~~
Number of Bedrooms: ..... ~
Sa
Well Data:
C. Construction ~ __. D.
Sewage Disposal System:
Bacteria] Analysis
C. Septic Tank: 1. $ize~.~.2, Manufacturer
D. Seepage Pit: ]. Size 2. Material. ~2~-~
· .o~a] Length of Lines
Disposal F~e]d- T ~
Distencos:
A. ?;ell To: Seotic Tank___~_O_ .... , Absorntion ,Area
, Sewer Lines
, Mearest Lot Line
· Ofher Contamtnstion
Foundation to So.tie T.3nk
',~ Ab.~ormtion Ar~e
C. Absorption Area to Nearest lot Line
Request for Approval of ~ividua]
Page Two
9. Comments:
Sewer & Water Facilttte~g~
Approval Valid for One Year From Date Signed
Greater Anchorage Area Borough, DeFartment of Environmental Quality
DIAGRAM OF SYSTEM
I certifv that the information contained in this request for approval to be a true
and accurate representatfon of the subject sewer and water facilities located at:
S~gned ~ Datff,
£
"', ~ , ~ /~ GREATER ANCHORAG~ AREA BOROUGH
. ,~r,'~ DEPARTMENT OF ENVIRONMENTAL QUALITY
I ~ , 3500 TUDOR ROAD '
] \l\lv ANCHORAGE, ALASKA 99507
· ~ [~v 279-8686
[ l/ INSPECT'
~ t TIME- '
~ ' REQUEST FOR APPROVAL OF'
INDIVI'DUAL SEWER AND WATER FAC:ILITIES
FOR
.
1. APPROVAL REQUESTED BY:
PHONE:
PROPERTY OWNER:
LEGAL DESCRIPTION:
TYPE FACILITY TO BE INSPECTED:
NUMBER OF BEDROOMS:
5. ,ri WELL DATA :
A. TYPE
B. DEPTH
C. SIZE
A. SEPTIC TANK
1. SIZE
2. AGE
3.
4. INSTALLER
D. CONSTRUCTION -
SEWAGE DISPOSAL SYSTEM: '"
(IF HOMEMADE, !SHOW
MANUFACTURER
DIAGRAM ON BACK)
APPROVAL REQUEST FOR SEWER
PAGE TWO
& WATER FACILITIES
SEEPAGE PIT
1. SIZE
2. LINING
DISPOSAL FIELD iNES~E~E~..~
1. NUMBER OF L
2. TOTAL LENGTH
REQUIRED MEASUREMENTs
A. WELL TO SEPTIC TANK
B. WELL TO SEEPAGE PIT
C o
D.
E.
F.
G.
H.
WELL TO SEWER LINE
WELL TO PROPERTY LINE
WELL TO OTHER POSSIBLE CONTAMINATION
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEEPAGE PIT TO PROPERTY LINE
8. COMMENTS:
DATE: ~ ~/2&/~/"~:'~ / DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL
QUALITY
klEATER ,~NCHOR~GE AREA BOROL~'H
['~L~I DEPgR~.~NT
327 EAGLE ST~ET
~CHO~GE, AEASKA 99501
279-2511
· ,~ ~, ,(~/L ' '. U~' DATE RECEIVEDff-~~ ~.
INDIVIDUAL SE~qAGE mWD WATER FACILITIES
D. Construction
E. Bacterial Analysis
6. Sewage Disposal System:
A. Septic Tank (If homemade, show diagram on back)
1, Size ~'~:~:~
2. Age
3 ,~4anufacturer
4, Installer
ApproVal Request for Se~,~_~: ~ ~a~i~acilities
Page Two
B. Seepage Pit
2. Lining ~,
C DispOsal Field
1. Number of Lines
2. Total Length
7. Required Measurements
A. Well to Septic Tank
:~-~ell to Seepage Pit
C. Well to Sewer Line
D. Well to Property Line
E. Well to Other Possible Contamination
P. Foundation to Septic Tank
G. Foundation to Seepage Pit
H. Seepage Pit to Property Line
8. COUNTS:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
EDll70
May ,]4, 1971
Spokane Mortgage Company
523 West 8th Avenue
Anchorage, Aladka
Subiect~ Sewer System on Lot 7, 0lock 5 Turnsqatn Subdivision
Number 2. O~ner: Joseph Bard.
Dear Sir:
An insoectton was ma~e on the subiect let and It ~e$ discovered
that a cesspool is serving ae the sewer system. The wail is
86 to 90 feet from the cesspool.
Approval cannot be ,,liven for th~.s system. Temporary approval cmn
be ,given if funds ara escrowed to upgrade the system. An
system normal~y cons&ets of 8 sept&c tank ~nd seepaqe o~t,
?roper dlstances from the ~e]l. Before aDy work is started on
system 8 permit must be obtm~n~d from our offlce.
If ~ou have any questions regarding the above ~aase do not
hesitate to contact this office at 279-8696, extension 336.
Sincerel~,
Lynn S. Coed
CC~ Mr. Joseph Bard
Veteran's Admtnstratton
ky