HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 6 LT 28
MUNICIPALITY OF ANCFIORAGE
DEPARTMENT OF HEALTH & ENViRONMENTAl.. PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISFOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT
J~UPGRADE
MAILING ADDRESS
5'R A Zo ×'
LEGAL DESCRIPTION
LOCATION NO, OF BEDROOMS
Liq. capacity in gallons
Well
Manufacturer
WellF HOMEMADE:
DISTANCE TO:
No. of line/ I Length of each line
Top of tile to finish grade ¢~' ~ ~
Length Width
Type of crib Crib diameter
DISTANCE TO: Well
IAbsorption area Dwelling PERMIT NO,
Material
Width
No. of compartments
Liquid depth
PERMIT NO.
Class
DISTANCE TO:
Inside length
Dwelling
Foundation
Total length of lines
Material beneath tile
Depth
Crib depth
Building foundation
Depth Driller
Building foundation Sewer line
~__Material
Nearest lot line
inches
Liquid capacity in gallons
PERMIT NO,
Dist8 nc(~.t ween lines
Totat~.f~e a.~.ion area
PERMIT NO.
Total effective absorption area
Nearest lot line
Distance to lot line PERMIT NO,
Septic tank . Absorption area(s)
OTHER
PIPE MATERIALS
SOl L TEST RATING
/oo
INSTALLER
/d /3
REMARKS
APPROVED
72-013 (Rev. 3/78)
DATE LEGAL
,7- zJ-$' Z V 4,
GRE }R ANCHORAGE AREA BOr "'IGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~-4/ /~/~*~']~ MAILING ADDRESS //~, /~'-- .~B.C~ PHONE
LOCATION ~/~-~-~Z~ ~' ~-~EGAL DESCRIPTION ZO'7-- ~Zgl, z ~Z/~' /~
SEPTIC TANK:
DISTANCEFRoM WELL ~2~/' MANUFACTURER
MATER~AL
NUMBER OF
COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH __
_LIQUID CAPACITY /~ GALLONS.
SEEPAGE PIT:
NUMBER OF PItS /. DIAMETER
LINING MATERIAL ~/A/c~' ~ CRIB SIZE:
BUILDING FOUNDATION 2~
ADDITIONAL ABSORPTION
OR WIDTH LENGTH DEPTH g /
!
DIAMETER DEPTH /~ DISTANCE FROM: WELL
NEAREST LOT LINE ~ /f TOTAL EFFECTIVE $
ABSORPTION AREA (WALL AREA}
FT.
WELL:
~ ~//~/ .
TYPE
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form NO. EQ-031
DIAGRAM OF SYSTEM 0//~ f~/Z_ ~'4e~rt-r~-~-
DATE ,~./~/7 ~- APPROVED ~ *.
G.A.A,B.
F~F'F'L I
L.OC:Ffi" :[ ON
LEGFtL
HFt_r)L:: f-t,. ~. [.,
C:ROOI.(EC, "!"F%E C:ZF:C:LE
L.T.~.":":',.., E:Li{. ,S '¢RL.Z 'v'UE.,cL. ....
I-ri-t::. OF S';ETL FiEiSOF.:F'TiCd'-,! E;'.?'E;TEM IS: TRENCH
i"'!RX:!:MUM .!t_l!lbr:.l';. OF EE[:,r~'or']M"_:: = :3
'.EOII.. RFITIN3 '::SQ 1: T. E,t~,. -
'[I-'IE F;'F.~ 'i'~'p'r'' ~,¢l.~:$ ]ZiF' "J"l-~'~ ~ll.j~TL RESLqR"F'T'.[_qI'.,I .=, ::1F~.!1 IS:
THE L. ENGTH [:,iMEN'S;IOI'..! iS THE LENGTH (iN FEE'f) OF 'THE TRENCH OF..' DRRINFIELD.
THE DEPTH OF F:i TF:ENC:H OF'. PiT IS THE: [:,:[STRNCE E:ETP.!EEN THE SUi:RFF:ICE OF THE
GROLIi'.,!D RND THE BOTTOM (:iF THE E,'.'<CR',..,'R]"ION (Il",! FEE]">.
THERE .T.S NO SET HIDTH F'OR TRENCHES.
THE GRWv'EL DEPTH iS THE MINIMUM DEPTH OF GRff,,,'EL BETHEEN TIdE OUTFRLL PIPE
FINE:, THE ['30'TTOM OF THE EXCFIVRTION (IN FEET).
PERMIT RPPLIE:F. Ii'4T I-4FIS THE I.;;:ESPONStFJIL:(T'-¢' TO INFORM TH:!:S [:'EPF:IRTMENT [:,UF.:ING THE
INSTFIL. LFYFIC~N INSPECTIONS Oi.:' Fiiq"r' 14ELLS RDJRE:ENT TO THIS PF,:OF'ERT'¢ RIqD ]'PIE
!"g..IHBER OF RESIDENCES THFIT THE HEL.L. i,4tL. L SER",,'E.
MZIqIi"!LIi"I L.,]..:,I~'Ii",P...E ~:~:'"~' Ir:"[:'~ Fl !,.!ELL Ri"~[:, [~,i'.~'¢ Oi'.-~-L:ITE SEI4Fll3E [.-I ....... IL :,T-", Ell ....
...........'i F[:i FEET FUR ~::l , ~ ..... t IE HELL F ::t.[~ilZl TO :-"~.'~!."l F-~.ET FF. tCd"I F:I F'LE__T: HEI..I... [:,EF'EI'.,IL":,!'i'.g3
F"3N THE T'¢F'E OF' P !Bi'Z: HELL..
':-:' '"F F[;:OI'i R -';'"--':
i"I-ft".!!MU!"! £ .... ILl ........ FI'..1 ,¢'1 c HELL TO FI F'F.:i',2FITE SEI.,.IER LINE -":
.... FEET FIND
']"O i,'-:! COMMLII'.,!IT':.' SEHEI:.i: LINE !E; ,'='Y; FEET.
"'T'FIE[;' p,c:'-' i' "-;'" ~' ",r ...............
....... L_F.L!IE,,I"t_, i"iF1'¢ FIF:'F'L?. SF'E'.":iFIr_":F!T]:Fd'.,IS F:II'-,![:, uut',I:,%~.LI_. I:l",!, DIF!GI.;~:F!I"iE; FIRE
R' 'I::IT FIP' F TO 'i:;,' ..... F~ .
........... t. .... ZN':.~_IF;:E F,.=F E.... Ii",ISTFILLRTIC¢",L
! C:ERTIF'¢ 'I'HF!T
i: I FiM FRM!L. iFiR HiTH THE REQL!t,~REMEI",!TS F'OR Ohi-E;ITE SE!.qERS FIND HELL. S FIE; SET
FORTH E¢¢ THE MUI'.~IC:;I;PF:ILZT'-,.' OF Ri'..ICHORFiEiE.
:;~: '-( HiLL INSTFILL 'f"HE S'¢'_=;TEM iN FICCORDRNCE P.IITPI THE CODES.
3:: I Ui'.,!DEF4'.STFd'-,I[) THFtT 'THE ON-SITE SEI4E[~'. S'¢E;TEM i"!R'¢ REL.qUIRE ENL. RF~:GEPIEi'..IT IF THE
F::ES I [:,EI",iCE ! S F,:EMf3DEL. E[:, TO _T tqCL..!.IE:,E h'!O[;~:E THFIN 3: E:EDF;~f]i)MS. .,~
.............. :--'?- .......................................
GreaTEr ANCHORAGE AReA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "E" STREET ANEHORAGEi ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
NAME OF APPLICANT
INSTALLATION LOCATION
INSTALLATION OF: SEPTIC TANK ~ SEEPAGE ~I~r I ~ , DRAIN FIELD
~,,.,/ .
OTHER
FINAL INSPECTION: 24 HOUR NOT~CE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF' ENVIRONMENTAL QUALITY AUTHORITY WILL E~E SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENT~
FOUNDATION TO SEPTIC TANK '. ~1
SEPTIC TANK TO SEEPAGE PIT WAL£
SEPTIC TANK ., SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, , SEEPAC;E PIT
TO RIVER, LAKE, STREAM.
ALSO CONSIDER AREA WELLS.
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.
DIAGRAM OF SYSTEM
GRAVEL BACKFILL
CONFORMTO BOROUGH REGULATIONS REGARDING INSTALLATION.
OR
~ LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA E~OROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SA}D CODE.
DATE APPLICANT'S SIGNATURE
-. GREATER ANCttORAGE AREA BOROUGH
DEPARTMENT OF ENVTRONMENTAL QUALITY
3330 "C" Street
.ANCHORAGE, ALASKA 99503
er~ormed For /~:~1~/< /~--~z?~-Qb~d~' ] Dated Performed j~-//' ~
Legal Description: Lot ~ Bloc~ ~ Subdivision_ j~/~"~z~
This Form Reports Soils Log Percolation Test
Soil Test Must Be Logged To 4' Below Proposed Seepage System --
Depth
Feet
2--
3m
4--
7--
9--
lO-
llI
12--
13--
14--.
Soil Characteristics
Case #
Was Ground Water Encountered?
If Yes, At What Depth?
Reading
Pef'colation
Date ] Gross Time I Net
Rate
Mi n u l;e
Installation:
Proposed
Depth of Inlet ..................... Depth
COMMENTS:
Time
Depth to H20
Seepage Pit Drain Field
to Bottom o-i~-Pit or Trench-
Test Performed BY ,-c $ ~F~c~~
Net Dro
Date Certified BY:
Date:
/ViUN~CIPAU~Y
MUNICIPALITY OF ANCHORAGE DEP?, OF
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~viRONMEN1.A/ 825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION OCT 2 9 1981
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10} days for processing.
1. PROPERTY OWNER
Wade Bi Auld and Martha M. Auld
PHONE
344'0679
MAILING ADDRESS
6810 Crooked Tree Circle
PROPERTY RESIDENT (If different from above)
Anchora~e~ Alaska 99507
2. BUYER
Refinance Loan
(SAME)
PHONE
Same
PHONE
MAILING ADDRESS
3, LENDING INSTITUTION 1 PHONE
Alaska Statebank I 265-2257
MAILING ADDRESS
310 E. Northern Lights Blvd, Anchorage~ Ak 99503
4. REALTOR/AGENT
N/A
PHONE
MAILING ADDRESS
N/A
5. LEGAL DESCRIPTION
Lot 28, Block 6, VALLI VUE ESTATE NO. 2
STREET LOCATION
6810 Crooked Tree~ Circle
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
,,~__k~.~ *.~1~e$3~ ~' ? One * Four
[] SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ,~ ~' ~,P ~ 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 UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date 1974
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.
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
I NSPECTI ON APPOI NTM ENTS ',,
TiME TIME TIME
DATE~(~ ~'~/'f 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
~--J COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
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: ~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
~APPROVED FOR ~ BEDROOMS
~ONDITIONAL APPROVAL (letter must accompanv cert]ficnte}
DISAPPROVED
DAT~ BY
72-010 (Rev, 3/78)