HomeMy WebLinkAboutT15N R1W SEC 18 LT 151StctS
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t 51
Mark Beglch
Mayor
Well Drilling Permit Number:
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.m ni.aro/onsitt
(907) 343-7904
Pump Installation Log
Parcel Identification Nnmbert5/ -3(- a24'
Date of Issue:
Legal Description
Sec, l9, 7 /5N, R/ W 5,M,
Block
Pim
p6
Lot
/5/
Property Qwner Name & Address:
David ' ensen
/8653 7a&, ChbYak, 6k.
Pump Installation Date: 06 - 04 -2.007
Pump Intake Depth Below Top of Wel Casing: 70 feet
Pump Manufacturer's Name FLIn7 4//421-120.5
Pump Model: 4F/OSQs-3Qr
Pump Size hp
Pitless Adapter Burial Depth: /0 feet
Pities Adapter Manufacturer's Name: /V//f
Pitiless Adapter Installer. NA
Well Disinfected Upon Comp! on? X Y 0 No
Gl La
Method of Disinfection: j4 6-7,' PaM
Comments:
Pump Installer /Name: We S .1 pay P ekittnen
Company: Li Eh S let -prises
MallingAddress: RD, Bo% 77/236
city:Pa1Lt state: 4k zap: 99572
Attention: The pump installer shall provide a pump installation log to DSD within 30 days of pump installation.
GREE 'ER ANCHORAGE AREA BOF 1GH
Department of Environment Quality
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME '-Dann -0,a 2---0-04 0 MAILING ADDRESSCV (OA Q1/L4411/0" /r PHONE
LOCATION S
. 1 ref\i..+r+OGI L On P LEGAL DESCRIPTION r� b S.0
SEPTIC TANK:
DI STANCE :4R 2. LL NUMBER OF
FROM WELL /Ov it MANUFACTURER AfIliIn' a MATERIAL C[-eCOMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH — LIQUID DEPTH. LIQUID CAPACITYI/OObGALLONS.
TILE DRAIN FIELD:
47ie'-,1 TOTAL LENGTH /
DISTANCE FROM WELL /00 r FOUNDATION 51Z0 NEAREST LOT LINE - OF LINES /5
NUMBER OF LINES .3 DISTANCE BETWEEN LINES .t.20 / TRENCH WIDTH-'- IN TOTAL EFFECTIVE
ABSORPTION AREA 51S-0
SQ FT LENGTH OF EACH LINE /0 Vt/eji-V7 , /4 s /
DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE _ MATERIAL BENEATH TILE
IN ABOVE TILE IN.
WELL: !70 &c)C'!/ /S 77;// c e/1 •-‘)/'
/^ .
TYPE CONSTRUCTION
DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE—_, SEWER LINE TANK SYSTEM
CESSPOOL , OTHER SOURCES
APPROVED
DISAPPROVED
REMARKS
DISTANCES•
INSTALLED BY•
DIA%RAM OF SYSTEM
SEWER LINE DEPTH•
PIPE MATERIAL•
LOT SLOPE:
REMARKS:
Form PW.027
DATE& APPROV
tvr //
A.A.B.
GREk„ ER ANCHORAGE AREA BOR' JGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TD DOR ROAD VOUCH 0.050
ANCHORAGE. ALASK A 99502
'frLl00000 279.0505
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT
. P71 5 lima/E'_
par -'1 ZC�
INSTALLATION LOCATION al /`
LEGAL DESCRIPTION
<e t /r/
INSTALLATION OF: SEPTIC TANK
MAILING ADDRESS
Tj LYC%LIPOd &CPns,
j&x 6'3(p
PERMIT NO
Soc7S i 4'i
PHONE
SEEPAGE PIT C� . DRAIN FIELD . OTHER
3$vnn s �P �..: ,n��. , 4ci)re,--F,J
Of
TO BE INSTALLED BY
TYPE AND SIZE OF FACILITY TO BE SERVED
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
Z /7)
NOTE* THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
PFRMTS VALID ONF YFAR
FINAL INSPECTION* 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE /a' ery/C "' TYPEO`teel or caner P.tPS EEPAGE AREA
MINIMUM DISTANCES, REQUIREMENTS
5 ft.
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT 20 ft.
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK 5 ft.
TO NEAREST LOT LINE
WELL TO SEPTIC TANK
SEEPAGE PIT
5 o
DRAIN FIELD
15 ft.
10 ft.
20 ft.
DRAIN FIELD 10
SEEPAGE PII
roc,%,
ft.
DRAIN FIELD ALSO CONSIDER AREA WELLS,
WATER MAIN TO SEPTIC TANK
DRAIN FIELD 10 ft.
10 ft.
SEEPAGE PIT 10 ft.
SEPTIC TANK, 25 f t • SEEPAGE PIT 100 ft. DRAIN FIELD 50 ft, ,
TO RIVER, LAKE, STREAM. 1:11.1'ml1 1!111.
01 ti 0:1 f'
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF 21 110,1)
EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 10 1"'I:- 50'
10 011- 100'
1,0 Si: 01:1 LIRE- 10
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT ,14:1-PIIDLit
SIZE TYPE
/40 .y-
IAGRAM OF SYSTEM 074:471 bier
CJ7 ; H ; rn G PN'
4" CAST 1004 SIPHON
SONIC PIPE 11111 AIRTIGHT
\\ 1410:CAPS
CAST "111. ...0P.
1'
Leret—k
CAS1 IRON
INTO
UNDISTURBED SOIL
15'
11111111011
C I required 1+lenevcr Zinc crosses
4111 r drive' v.
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKPILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
-�- -L
' HEALTH AUTHORITY
OR
LICENSED DESIGNER
10 TANK- BO -
TO PI 1- 120'
11 5511100 I. IDE- 40
A0'-00' 001.11
00:1 10011 501101
t 11:0
1'110110
10 7211E- 200'
le PIT - 200'
100'-200' 01:111
00'? 111011 50400
111:E
1110.'1') 5011000 OF
011:101111411011
CRIB
GR0401 RAW I.LTh
0560110 CR18.
CRIB A' MINIMUM 0000E 14A0
ABLE)
A MD SEDER :1111.
CON51010 ,ARCA WELLS.
SUBBED PI1 ER000,Tl011 BASED ON
5011 1E51.
0051' 1000,
PIPE 5'
11120 0N.
1105108010 —)
5011
:J
HOUSE
*pit -֥
Grade: 1' per 'GO'
or I/O' p r foot
except ID' proceedln
tank & the. should
not exceed 00.
6' per 100 on flat
terrains.
SEPTIC
Y1nm:
)) / 4 INC
CAST IRON SIPHON PIPE
�S[C PACE PIT
RD' HINIMUN
1
CRIB
GRAVE UACKFILL
BEAPEST LOT LIME
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA
BB000UGGHH ORDIINANCE NO. 20.58 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DAT
Z t imp
PLICANT'S SIGNATURE
Gf/i x/c/�eII
C,9- c loaf
t� 4,.�
ee ig ,4/ti-e(
"few /nf
at tfe ,tt7)9/ coven
0267
Ate;,460 to,
59sE
is or 4-
Nzr we %/ It T
7.q Tinec-
/ o --cc 119 / wil14'C-c
e..._re sePr%c -7-MV/C;