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Home My WebLink AboutT13N R1E SEC 15 N2 N2 NW4 SE4 NW4 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHO~ ~NEW ~ I~__~O ~ [~] UPGRADE NAME LEGAL DESCRIPT]ON LOCATION NO. OF BEDROOMS Well AbsorPtion area Dwelling PERMIT NO. DISTANCE TO: ~ ~'~0 ~.~ ~'~0 ~ ~)~ ~ 0(~1~ Manufacturer ~ No. of compartments Liquid depth Liq. capacltyinga,lons IF HOMEMADE: ,nsidelength~ ~ [n .¢ IA Well Dwelling PERMIT NO. DISTANCE TO: Manufacturer Liquid capacity in gallons Well DISTANCE TO: Length of No. of lines each~ Total length of~) Top of tile to finish grade Material beneath tile Length Width Depth Type of crib DISTANCE TO: Nearest ]ct li~ ~-~ ~0 inches inches PERMIT NO.~_ ~ ~ ~)Oq Total effective ab~.ol~area PERMIT NO. Crib depth Total effective absorption area Nearest lot lin ~ Septic tank Absorption area(s) Distance to lot line PERMIT NO, Building foundation Nearest lot line DISTANCE TO: Depth Driller Building foundation OTHER SOl L TEST RATING INSTALLER REMARKS 72-013 (Rev, 3/78) LEGAL PERMIT NO. RPPLICRNT KENNETH BRRCL~' SR BOX 2t4 E~GLE RIVER LOCRTION ERGLE RIVER RORD LEGRL T±3N R±E St5 SM LOT SIZE T~PE OF SOIL ~BSORBTION S~'STEM IS: TRENCH :tO000B .=,L-..IJHI~.E FEET MAXIMUM NLIMBER OF E, EE:,ROuM_~ =_'.'~ :,_ilL EHTIN.~ ~';I.., FT, E,F.' ..... l.~F1 ' - ' ' c'~' :,~TEM ~-' THE F~.EL,!LIIF..ED _,I~.E OF THE SCIIL RBSORPTION '-'~ I:,. [:"EF'TH: :tr_-I LENG~"I~= gE.' ~3 RFI",/E L. I:)EP'TPI: (~ THE LENGTH DIMENSION IS TNE LENGTH (~N FEET) OF THE TRENCH OR DRR~NF~ELD. THE DEPTH OF R TRENCH OR P~T ~S THE D~TRNCE BETWEEN THE SURFRC:E OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE I~ NO SET WIDTH FOR TRENCHES. THE GRB',/EL DEPTH IS TNE MINIMUM DEPTH OF GRBVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCR',,,'RTION (IN FEET). F-. E,=-."U I F.:E [:. SEF'T I C: -f'R r~t:-'.'"_='. I ZE= 1~-], O,-S'i ~3~-IL_.L L ~-~.:- F'ERMIT HFPLI_.RNT HR=IS THE RE.=,FON_,IBILIT'¢ TO INFORM THIS DEPRRTMENT DIIF.'ING THE IN-,TRLLH'fIuN INSPECTIONS OF RN'¢ !.4ELL. S RDJRC:ENT TO THIS PRLFERI'r RND THE "g " "~ :,ER NUHBER OF RE_IE:ENL:E_ THRT THE WELL P,IILL '- ",' -~'t-JCI ' '=:'- ~ " -' -"::"- ........ ":..-: ::, I ~4._ F EL-T Z ON:. RF.'E F-:EC-:!L~ Z F-:EE:" ' BRCKF!LLING OF RN"r' SYSTEM WITHOUT FINFIL INSPECTION RN[:, RF:'F'RO',/RL B"r' THIS ; [EPHRTMENT WILL BE ..,UBJECT TO PROSECUTION. 'MINIMUM DISTRNCE BETWEEN A WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS ±00 FEET FOR R PRIVRTE WELB OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE T9PE OF PUBLIC WEL. L OTHER REQUIREMENTS MR~¢ RPPL¥. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RMRILRBL. E TO INSURE PROPER INSTRLLRTION. F'ERF'I :~ 'T E.~-~:F' I RES [:,EC:E~.IE:E:R 2:1.. 1L~ .- -P-. I · CERTIF'¢ THRT 1: I RM FRMIL. IRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SE:T FORTH B'¢ THE MUNICIPRLIT~' OF RNCHORRGE. 2: I WILL INSTRLL THE S'¢STEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTFIND THRT THE ON-SITE SEWER SYSTEM MB"," REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN Z.' BEDROOMS. SIGNED: INT KENNETH BRRCLR'¢ /' · ~;~,~e~£m A. Johnson P.O. Box 76 fihLgiak, AK 99567 Phcne: 907-688-3085 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST Kenneth 2arclab,' (FEET) SLOPE 0'- 2' gray-brown sa,n~]y [ ] and cobbles (G;,)., F~]l.!) ] w/ some silt and large organics upper 2 _ct. (~-., !50 ft 2/bm 1!4' brown sandy g::'ave! w/ some silt an3 very an~ular cobble%~: to elFht h:. 1Iq f't2/bm SITE PLAN i WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? /" L ~ r 'i ~ ' : Time PERCOLATION RATE TEST RUN BETWEEN FT AND (minutes/inch) FT PEP, FORMED BY: DEP~RTMENT OF HEALTH AND ENVIRONHENTHL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 9D501 264-4728 HELL PERrl IT PERMIT NO. APPLICANT KENNETH BARCLAY SR BOX 214 694 ~602 LOCATION EAGLE RIVER RD LEGAL '~/S~ ~F LOT SIZE 100900 SQUARE FEET MINIMUM DISTANCE BETWEEN R HELL RND ANY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVATE WELL~ OR ii~O TO 200 FEET F~OM ~ PUBLIC WELL DEPENDIN~ UPON THE TYPE OF PUBLIC WELL. ~WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS ;OF THE WELL COMPLETION. OTHER REQUIREMENTS ~AV APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE 'AVAILABLE TO INSURE PROPER INSTALLATION. PER~I I T EXP I RES DECE~'IBER -~l, 197@ I CERTIFV THAT l: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BV THE MUNICIPALITY OF RNCHORRQE. ~: I WILL INSTALL THE S~'STEM IN ACCORDANCE WITH THE CODES. APPLICANT KENNETH BARCLAY by A & L DRILLING COMPANY JAn BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONESf14-2588 OWNER OF LAND /< ~'/-~ LEGAL DESCRIPTION DATE-Started PERMIT NUMBER DEPTH OF WELL C~ ~. 0 STATIC LEVEL OF WATER FT. '-720 RECEIVED KIND OF CASING KIND OF FORMATION: From From From From From From From From From From From From From From From From · Ft. to /r? Ft. ~Z.~'ff ~'~7,a~5'~_ ~/O~°~:~'r~'~f~ Et. to Et. to /O~Ft. ~ ~ ~om Et. to Ft. to Ft. ~ ~ OC~O~ From.~Ft. to Et. to ~/o Ft._ ~t~~d~C From Et. to Et. to~) Ft. ,~O ~ff~ ~/ From~ Ft. to~ Ft. to Ft ~ ~~ From ~ Ft. to Ft. to Ft. From ~ Ft. to~ Ft. to Ft. From Ft, to Ft. to__.Ft. From ~ Ft. to Ft. to__.Ft. From Ft. to~ Ft. to Ft. From ~ Ft. to~ Ft. to~.Ft From ~ Ft. to~ Ft. to~.Ft Frmn_~.Ft. to Ft. to~.Ft From Ft. to ~ Ft. to Ft. From Ft. to~ Ft. to Ft. From ~ Ft. to Ft. to Ft. From Ft. to Ft. Ft Ft Ft Ft. Ft. .Ft._ Ft. Ft. .Ft Ft Ft, FL Ft. Ft. Ft. FL MISCL INFORMATION: DRILLER'S NAME APPLId'NT FILLS OUT UPPER HAl~m'ONLY Phone Water~/Su ly ~d~aI L~_~ ~ ~ ~ A~ACH WELL LOG. A w~l log is required for all wells since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Ulility Sewer D' osal ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date ~ Inspector Inspector Inspector Inspector Field Notes: 4f/~.~ ~.4:.~.~ MUNICIPALITY OF ANCHORAGE -~//~ DFP? Cc :':'~.'r ~ ~. ENV ~, .~, A . ,~ SCTION ' ,,'~; 3 1982 R[CEIV[D ( ~APPROVED BEDROOMS ~ *CONDITIONS OF APPROVAL ( )DISAPPROVEO ( ) CONDIT[ONAL APPR~AL' DATE/ ~~ ~ Soils Rating Date ~wer Installed Well To AbsorpBon Area Well Log Received ~ ~ ~ --q ~ Well to Tank Septio T~k Size / ~O 72.023 ENTA PROT J3FPT, OF I EALTH & DEPARTMENT OF HEALTH & ENV RONM L E~I~NMENTAL PROTECT(ON 825 L Street - Anchorage, Alaska 99501 ENWRO.MENTAL ENC NEER DW S ON JAN 5 197g Telephone 264-4720 nr~- r/tlrh d RECTIONS: Complete all parts on page 1. Incomplete requ~ts will not be proc~sed. Please allow ten (10) days for processing. 1. PROPERTY OWNER ~AH-~ N~ ADDRESS PROPE~-I:Y RESIDENT (If differe t ) ' ' 4, REALTOR/AGENT PHONE MAI LING ADD R ESS PHONE PHONE PHONE 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four ~. SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL* * 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 .1~ INDIVI DUAL/ON-SITE~ [] PUBLIC UTI LITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME I 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 ~ INDIVI DUAL DEPTH OF WELL [] COMMUNITY ~'~ ' DATE DRILLED [] PUBLIC UTILITY O~_ ~ ~_-~ Comrection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER '~ INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified \ INSTALLER l~]Septic Tank or [] HoJding Tank Size:~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MA UFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holdingl.~). Tank Absorptionl ~L~Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~PPROVED FOR '~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title).~ 72-010 (Rev. 3/78)