HomeMy WebLinkAboutTURNAGAIN BLK 4 LT 2
!>.~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchora§e, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAl- D SCRIPTION,
'kc , NO. OESEDROOMS
~ DISTANCE TO: IWell/~ ( IAbs°r~a~' Dwelling ~
~ ~ Manufscturer
~ < ~~ Materi~y~ No. of comments
~ Liq. c~ga[Ions IF HOMEMADE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O Z ( Manufacturer Material Liquid c~pacity in gallons
~=Q DISTANCE TO: Well /~/ Fou n dation[~ ( .~ Nearest lot line,[~ [ P E R MIT N O.~z
~ ~ ~ ~o. of line~ kon~ o' each I~ ~ Total ,e~ ?, I,n.s Trench 'd h Distance ~,l,nes
~ Top of tile tb finish grade ~ inches
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well ~uildlng foundation Nearest lot llne
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area{s)
~ DISTANCE TO:
OTHER
REMARKS / ~'
" '
I
72-0 ev. 3/78)
~ ~ O~--SITE
PERMIT N0~ ( 800198 )
APPLIORNT RCJ ENTERPRISES
LOCRTION ±28t E, KLATT
LEGAL L2 84 TURNIGBIN
BOX 4-25?? ANCHORAGE 9950?
LOT SIZE 14400 SGURRE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MRXIMUM NUMBER OF BEDROOMS = 5
SOIL RATING',"-
THE REQUIRED SIZE OF THE SOIL ABSORPTION~EM IS:
DEF"TH: 2LO LENGTH: ~ GRFtVEL DEPTH: ¢_~.~z~
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL~.
THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND 8ND THE BOTTOM OF THE E~CRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE E~CRVBTION (IN FEET).
RE~..U I REC-' SEPT I Ii_: TFli'41'--'. S I ZE= :-t500 6F'~LLCINS
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF 8NY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TW~::) .:: 2 ) I i'-,ISPECT I OI'-,tS F-II:~:E REQIJ 1
BACKFILLING OF f~NY S~t-TEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A HELL AND ANY ON-SITE SEHHGE DISPOSAL SYSTEM IS
100 FEET FOR 8 PRIVATE HELL OR i50 TO 280 FEET FROM 8 PUBLIC HELL DEPENDING
UPON THE TYPE OF PUBLIC HELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO 8 PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
BVAILBBLE TO INSURE PROPER INSTALLATION.
PERM I T EXP :I: RES [:,ECEtqSER
I CERTIFY THAT
,
±: I RM FAMILIAR WITH THE REQLIREMENTS FOR ON-SITE SEWERS AND WELLS 8S SET
FORTH B~ THE MUNICIPALITY OF MN~HORBGE.
2: I WILL INSTR~THE SYSTEM IN 8CCORDRNC:E HITH THE CODES,
~: Z UNDED~TRNDCT~BT" THE ON-~TE
IF THE
V4. 0
~J'CONSTRUCTION TEST L~B ~ ~~
"One Test is worth a Thousand Opinions"
2204 Cleveland Anchorage, Alaska 99503 277-0231
Perfo~ned for RCJ ENTERPRISES
Legal Description: Lot 2 -Block
This Fomn reports: SOILS TEST Yes
4
Date Performed 6/3/80
Subdivision TURNAGAIN
PERCOLATION TEST
Depth Soil Characteristics
Feet
2.0
BrOwn Organic Silt
Brown Silty Fine Sand
~7.0 ,~,ray Sandy Gravel (GW)
'8.5 Brown Silt
Gray Sandy Gravel (GW)
Bottom of. Trench 14.0 feet
~ ?RlIN 2H
H )U ;E
Was Ground Water Encountered NO
If YES, What depth?
Reading Date
Gross Time
Percolation Rate
Proposed Installation:
Depth of Inlet
CO~iENTS: Five Bedroom
Net TLme
Depth to
H20
Net Drainage
Minute
SEEPAGE PIT
DRAIN ~IELD
Ratinq: 100 square feet/bedroom,
Depth to Bottom of Pit or Trench
GW mater~ia_l
Da ts Certified By: James R. Rin~s~a~,~,~
Date : 6/3/80
iTest Performed by. Bernard Nidowicz
GAAB-HO-I
GR~ER ANCHORAGE AREA BORO.U_~ J
DEFAF~TMENT OF ENVIF~0NMEI~TAL 0.UALIT-~'i
3500 TUDOR F~OAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACI~Y~ J
GALLONS.
NUMBER OF
MATERIAL (~i31~20 ~ i7I/~t; COMPAR[MENTS
iNSIDE LENGTH INSIDE WIDTH
LIQUID
DEPTH__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS ~ OUTSIDE DIAMETER
NEAREST LOT LINE
'- OR WIDTH
. DISTANCE FROM WELL I 0
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
., LENGTH I~ , DEPTH
BUILDING FOUNDATION ~'~'/ ,
TILE DRAIN FIELD:
DISTANCE FROM WELl , FOUNDATION_ . NEAREST LOT LINE
NUMBER OF LINES // DISTANCE ~ES~ TRENCH
WIDTH
OE
ABSORPIION AREA SQ. FL [ENGIH
DEPlH: lOP OF FlEE 10 FINISH GRADE DEPIH OF EI[IER MAIERIA[ BENEAIH TIlE
TOTAL LENGTH
OF LINES__
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: TYPE ~,-)~ ~ J J~Jb , DEPTH__ J J 0 , BUILDING FOUNDATION -~ SAMPLE
NEAREST SEPTIC ~7--z SEEPAGE
LOT LINE -~'~" /0'6~ ~ , SEWER LINE_ -~ .,TANK /7 , SYSTEM //g)C~ , CESSPOOL
· NEAREST
OTHER
, SOURCES
DISTANCES:
DIAG RAM OF SYSTEM
DATE
G~A.B.
GREATER,_,.~NCHORAGE AREA [,_)ROUGH C.ssNo.
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
DISTANCES:
APPLICATION TO INSTALL: SEPTIC TANK ~, SEEPAGE PIT. ~,, DRAIN FIELD. , OTHER
TO SERVE THE FOLLOWIN EAC,L,TY
FINANCED THROUGH TO BE INSTALLED BY
THIS IS TO
AS DESCRIBED BELOW. SIZE OF~NIT~O RESERVED
. SEPT'C TA"K S'ZE/~ ~/T TYPE
YPE ~ ~SEEPAGE A~EA
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
with saki code.
above described system is in accordance ~;~./~/~/j~
DATE /~ ~ APPLICANTS SlfiNATUR
, '~REATER ANCHORAGE~ ~REA BOROUGH
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
This Form Reports a: Soxls Log ..~ · . .~ercoza~.on ~es,_ ......
Yec~ Soil Characteristics Location Sk~ch
Reading } Date Gross Time Net Time Depth To Net Drop
Percozazzon R~re l"l
r.~o~sea. ' Zns~ai~Seepage Piz Dmain Field
DepZh' Of Inle~ Depth To Boz,~om Of Pz~ Om T~ench
Performed Bi "~ ......
~' INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
825 L Street- Anchorage, Alaska 99501 00T 8 ' 1980
ENVIRONMENTAL SANITATION DIVISION
Temo.. m,, 0 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts cfi page 1. Incomplete requests will not ~e proce~ed. Please allow ten (10) days for processing.
MAILING ADD~ESS
MAILING ADDRESS
5. LEGAL DESCRIPTION~
6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
~ One ~ Four ~ Other
~ SINGLE FAMILY ~ Two ~ Five
~ MULTIPLE FAMILY ~ Three ~ Six
7. WATER SUPPLY ~:)~?.5"T~///~, ~/~ ~ /z~
~ INDIVIDUAL* * ATTACH WELL LOG. A well Io§ is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach Icg if available.)
8. SEWAGE DISPOSAL SYSTEM
~ iNDIVIDUAL/ON-SITE** x/'~'~l~O YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY ~-
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [~] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Conoection Verified INSTALLER
[~Septic Tank or [] Holding Tank ~_~ ~ ~-(~
Size: / .~7'0 b If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
~"~AP~ ROY E D FOR .~Y BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED ~~_
DATE BY
72-010 (Rev. 6/79)
PROTECTION
~/e.,~,~:~/,-.~/ \ DEPARTME, OF HEALTH AND ENVIRONMEN[ ~-
E~---~-~'z / ' 279-2511, ext. 224 or 225
~:Z/"~-I~'lj)~.~ Date Received: May 'ii, 1977
REQUEST FOR APPROVAl, OF INDIVIDUAL sEWER AND WATER FACILITIES
1. Lending Institution Request: Spokane ~0rtgage Company
Time _ Il.00 #3: Time
Date ~-~g/-~q Date ~=~-~
Insp
Mailing Address: 3201 C Street, Suite 250
Phone: 277-0543
2. Property Owner: John C/Carol Mc Culloch
Mailing Address: Star Route A Box 1396 99~07
Phone
3. Legal Description: Lot 2 Block 4
4: Single Family Residence: (x)
Multiple Family Residence: ( )
Turnagain Subdivision
Number of Bedrooms:
Number of Bedrooms:
Well System:
Permit #
Construction
Individual Well (x) Con. unity/Public System ( )
Depth of Well Well Log on File
Bacterial Analysis
Sewage Disposal System: On-site System (x) Public Utility
Permit ~ Installed 1971 Installer
Septic Tank Size ~ Manufacturer ~ f~C2~'~(~
Absorption Area _,~7~ ~i~oi$~ls Rate ._ F~ Material ~_
Distances: Well to Septic Tank ? ~ /
to Sewer Lille Nearest Lot line
to Nearest Lot Line ~ /
to Absorption Area /~ /
~-- ~ Absorption Area
~ ~ Department of Health and Environmental Protection
· Request for Approval of Individual Sewer and Water Facilities
Legal Description:
Comments:
Lot 2 Block 4 Turnagain Subdivision
Affadavit Attached: i (i)
Approv ed: ~~,
Disapprov :
Letter Attached: ( )
Date:
Department worksheet:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
Sewer and Water Section, Fourth Floor, 825 L Street, Anchorage, Alaska
Attention: Laura Harrison
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
99501
I. Type of Inspection: CMRO VA.
2. Property Owner: John C. & Carol McCulloch
Mailing Address: S~A Box 1396, Anch., Ak.
3. Name of Buyer: Robert W. & Gloria K. Inman
XX FHA CONV
Day Phone
n/a
Mailing Address:
4. Name of Lending Institution: SPOF--~qE MORTGAGE CO.
Mailing Address: 3201 "C" Street, Suite 250, A~ch., Ak.Phone
5. Name of Realtor or Agent: COLONIA~ I~ALTY, Jim Kudrna
Mailing Address: Phone
Day Phone
277-0543
277-3551
6. Legal Description: Lot 2, Block 4, Turnagain Subdivision
Location: NHN Klatt Road, Anchorage, Alaska
7. Type of Facility to be inspected:
8. Water Supply
Type of Supply:
EQ-O37 (1/74)
Single Family
No. Bdrms. three (3)
Public Utility
Individual
if Individual, number of dwellings presently served
If Individual, depth of well unknown
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installatior;L971
Individual (on-site)
one (1)
