HomeMy WebLinkAboutTURNAGAIN BLK 4 LT 1212-
Anchorage, Alaska 99~503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTE/¢,
LOCATION
SEPTIC TAN K:.~ l~..~
O STANCE
FROM WELL~ ~' MANUFACTURER
INSIDE LENGTH-- INSIDE WIDTH
PHONE_
NUMBER OF
__COMPARTMENTS.---
GALLONS,
LIQUID DEPTH .... LIQUID ~APACITYZ-(~¢~ O
NUMBER OF PITS ..... DIAMETER ' OR WIDTH--, LENGTH--, DEPTH --
LINING MATERIAL CRIB SIZE: DIAMETER__~DEPTH--- DISTANCE FROM: WELL__
TOTAL EFFECTIVE
BUILDING FOUNDATION---- , NEAREST LOT LINE ..... ABSORPTION AREA (WALL AREA) SQ. FT.
ADDITIONAL ABSORPTION
WELb
TYPE~'
BUILDING
FOUNDATION
CESSPOOL .....
APPROVED
r ___ DEPTH
CONSTRUCTION
NEAREST NEAREST SEPTIC
LOT LINE SEWER LINE .... TANK _--
DISTANCE FROM:
SEEPAGE
SYSTEM --
OTHER SOURCES--
--DISAPPROVED-
REMARKS_
DIAGRAM OF SYSTEM
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.......... ........................... ......................... : ..................... 'i ...................
GREA-~,ER ANCHORAGE AREA BOL, dGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE II~ ' ' (/~9~
FROM WEL~ MANUFACTURER ~_~ ~b~,~, MATERIAL ~2~L-
INSIDE LENGTH
INSIDE WIDTH
SEEPAGE ~r'~. :'~/~;~-~(~,-,~L,
NUMBER OF PITS -- DIAMETER --
NUMBER OF
COMPARTMENTS
LIQUID DEPTH LIQUID CAPACITY /600
OR WIDTH LENGTH DEPTH
GALLONS.
LINING MATERIAL
BUILDING FOUNDATION__
CRIB SIZE: DIAMETER
NEAREST LOT LINE
.DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
.SQ. FT.
ADDITIONAL ABSORPTION
WELI~ ..
BUILDING
FOUNDATION --
CESSPOOL
APPROVED
NEAREST NEAREST
LOT LINE SEWER LINE
OTHER SOURCES
DISAPPROVED _ REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM
DISTANCES:
INSTALLED BY: ~'~-(~
LOT SLOPE:
Form No. EQ-031
DIAGRAM OF SYSTEM
CO/E.
APPROVED
G.A.A.B.
GREATER ANCHORAGE AReA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C' STREET ANCHORAGE~ ALASKA 99503
TELEPHONE 274-4561
PERMIT NO. ~
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION LODATION ~¢~ /C~'~' ~:Z
MAILING ADDRESS
INSTALLATION OF: SEPTI~ TANK ~ 'SEEPAGE PIT , ~ . DRAIN FIELD , OTHER
FINANCED THROUGH TO BE INSTALLED BY
COMPLET[ON DATE ANTICIPATED ~///f/~ <?/~
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTB
/
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE 'pIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE P~--WALL
WELL TO SEPTIC TANK
SEEPAGE AREA SIZE
/ (~ "" DRAIN FIELD
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.
] CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. E8-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE
GREATER ANCHORAGE AREA DORO0~,,,!
Department of Environlnen~a] Qua]i~y
3330 "C" Street
Anchorage, Alaska 99503
: SOII,S LO(i - t EROI,AI'ION
-- ~ ~oc~_ Date Perforn:ed
Performed for_~___.~__~ ~. ~~e~ ....................
Legal D e s c r i pZ i~ n]--.----]~-~ f~ _l~[m_~ _~ 'c~,~
This form reports: Soils log~""'~ verco~rlon
Depth
Feet
9-
lO-
ll -
12-
13-
14-
Was ground water encountered?
^to
If yes, at whaC depth?
Reading Date Gross Time
Net Time Depth to Water Net Drop
Percolation FarCe .............
~Proposed installa~'n-:---~'~'ge Pit Drain Field
Oept~'~m~5~--pit or trench
Depth of Inlet
COMMENTS: ....................................................
EQ-040 ((i/74)
Date:
WATER WELL DB_r~.~.~.RS LOG
Drilling co.rVe.rn'~ Drilling & ~nterprises
DO NOT FTT,L IN
USGS No.
%~rnon Nowell
Driller
Well owner Steve Fo~d , . ,,. ,Use of well house
LocatiO-~ (address of, Township, Range~'& section, if ']~nown~ or dis~t~nce
6-12-75
main road .....
Lot 12~ Block 4 Turnigan Sub~
Size o ,, Depth of hole 123' .... feet C~sed to~feet
/~nd surface. Finish of well
Static ~ter level ~6' 6" ~fet (~$~)(~etoW)
(check one) 0p~x)~ Screen~ )~ Perforated ( ).
Describe screen or perforations . - ........
Well pumping test at 7 ~gallons 'Der (he~)(minute) for--l~ .3/.4hOurs with
40' 6". ..feet of drawdown from static level
Remarks
Well Log ...... ~ _.~.~
Depth in feet from Give details of formations penetrated, size of materlel~
round surface color and hardness.
~O' to 3! ,, brown till , , ,. ,
3' to 11' sandy & gravely, gray brown till
11~ to 17' hard pan
17' to 46' brown sandy silt & gravel
46' to 97' gray silt & little gravel,..
1~10' gray clay & gravel
97' to .......
110' to114' 6" hard clay silty clay with gravel
114' 6"to 122' gray sloppy silt-heaving
122~ to 123' silty sand & gravel H20
to
silty dirty Ha0 71'-'.<,2'
to
to
to
to
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~UNIC~PALITY OF ANCHORAGE
DEPT, G:: /,%T'.l &
825 L Street * Anchorage, Alaska ggE01 E ~ o , ~ = ~
E,VIRON~ENTAL ENGINEERING DIVISION NAY 2 5
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATERAND SEWE~I~I[~ ~
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1, PRO ~Y OWNER PHONE
PROPERTYRESIDENT(Ifdiffeze~tfromabove) ~ . m- - . I ~7~ '-~/~
2. BU~ R ~ ~' PHONE
,. LBGALD,SCR,P ".
STREET ~O CAT/~J) N
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four [] Other
[] SINGLE FAMILY [] Two ~ Five
[~- MULTIPLE FAMILY [] Three [] Six
7. WATER SUPPLY
~ INDIVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTILITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** **1 f individual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
[] PUBLIC UTILITY by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72~10(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DA'rE RECEIVED
INSPECTION APPOINTMENTS
TiME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
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
[~)INDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or [~ Holding Tank ~'~
Size: ,}c'~O~) If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
(~AP;ROV ED FOR ~" BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72-010 (Rev. 3/78)
-?
June 11, 1979
MOENING-GREY & ASSOCIATES, INC.
GEOLOGISTS AND ENGINEERS
MUN%CIPAg'T? OF ANcHORAG5
E qVJRONM~NTAL '
RECEIVED
James O. Starr
Environmental Engineer
State of Alaska
Department of Environemental Conservation
Southcentral Regional Office
338 Denali Street
McKay Building, Room 1206
Anchorage, Alaska 99501
Subject:
Approval of Waiver for Well-Sanitary
Sewer Seperation, Lot 12, Block 4
Turnagain Subdivision
Owner-Steve Ford
Dear Jim:
The well located on Lot 12, Block 4, Turnagain Subdivision, was
grouted in accordance with the earlier recommendations. Grouting
was accomplished on June llth.
The grouting was performed by Vern's Drilling of Anchorage. Three
grout pipes were emplaced around the periphery of the well casing
to a depth of 15 to 15~ feet, using a combination of drilling and
jetting techniques. Grout was pumped as the pipes were withdrawn,
providing a continuous grout curtain around the well. Grouting
pressures varied from 150 to 300 psi.
The grout contained a mixture of water, Type I and II Portland
Cement and Bentonite. The purpose of the Bentonite is to reduce
shrinkage from curing.
~ag~ 2
James O. Starr
· Approval of Waiver
Lot 12, Block 4, Turnagain Subdivision
,June 11, 1979
$
If you concur in the above stated procedure and agree this will
meet your department's requirements for waiver of the seperation
distance between the well and nearest septic systems, please sign
in the space provided. An additional copy is included for our files.
Thank you for your cooperation.
Sincerely,
TES,
Howard
INC.
I CONCUR IN THE ABOVE STATED GROUTING OPERATION.
James O. Starr,
Environmental Engineer
DATE
C'_I~"M_ ~__~,__ & 8EOLOalCAL LABORATORIF-8 OF'~I.ASKA, iNC.
P.O. BOX 4-1276 ANCHORAGE, ALASKA 99509 4649 BUSINES~ PARK BLVD.
Drinkin§ Water Analysis Report.for Total Coliform Bacteria
TELEPHONE
(907) 279,4014
TO BE COMPLETED BY WATER SUPPLIER
p~'~l~~ I.D. NO.
City
State Zip Code
Mo. Day
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE Time Collected
NO. LOCATION Collected By
06-1220 (b)
Rev. 1918
TO BE COMPLETED BY LABORATORY
LABORATORY:
NAME
CITY ,
Date Received
Time Received
Analytical Vlethod:
[] Fermentation Tube
.~ Membrane Filter
Lab Ref. No. Result*
Analyst
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAM PLE
Form No. 18-310 (3-78)
Date Collected Source
presumptive 10ml ]0nll 10mi 10mi 1Omi 1.Omi O.lml
Final Membrane Filter~ee½u)~ ~ · __ Collform/100m{
Reported By_ ~~~ ~ Date ~;~ ~