HomeMy WebLinkAboutWALTER G PIPPEL #2 BLK 12 LT 18
· ~, ~y MUNICIPALITY OF ANCHORAGE ~,.
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
.NV,.O.MENTA' ENG,NEERIN. D,V.S,ON I'"1
825 L Street- Anchorage, Amaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE 'NEW
LEGAL DESCRIPTION
~ Z Manufacturer Material No. of compartments
Liq. c a ity in gallons Inside length Width Liquid depth
, ~ ~emm Dwdling PERMmT NO.
~Oz DISTANCE TO:
O ~ ~ Manufacturer Material Liquid capacity in galJons
Trench wi h
Lengt f each lin
No. of linesj Total length of ines
-- ' ~q '~ ~ ~ , ~ g C [.ches Wotam effect~.~Z~ion area
~ ~ Top of time to finish grade <~ Material beneath tho
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot Hne
~ DISTANCE TO:
j Olass Depth Driller Distance to lot line PERMIT NO.
Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
LEGAL
72-013 (Rev. 3/78)
PERMIT NO.
FIPPLICRNT
LOCFITION
LEGRL
DEPRRTMENT ',~ HERLTH RND EN,IRLNMENTHLx ,'RTE-TIZN
,=,~._ L _, rF. EET., RNCHORRGE., BK.
264-4728
( 8~8242 )
STEVE FRBNKLIN S.R.
HORSE SHOE DR.
L t8 BK 12 WRLTER PIPF'LE S/'D
BOX 244 E.R.
m z '-r- fl :£D.
LOT SIZE t2000 SQURRE FEET
TYPE OF' SOIL RBSORPTION SYSTEM IS: TRENCH
MBNIMUM NUMBER OF BEDROOMS = 4.
SOIL RFITING (SQ FT,/BR)= 85
THE REQUIRED SIZE OF THE SOIL RBSORF'TION S'?'STEM IS:
[:, E F' -F i-~, = ":~.~ L E ~'.',~ ,.3 T I-~ = 42: IS R Ft'.Z E L. [-" E F' T H == ,'¢,-
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TREN. CH OR DRFIINFIEL. D.
THE DEPTH OF Ft TRENCH OR PIT IS; THE DISTFINCE BETWEEN THE SURFBCE OF THE
GROUND RND THE BOTTOM OF THE E2,'CFIVRTION (IN FEET).
]"HERE IS NO SET WI[:'TH FOR TRENCHES.
THE GRB~,,'EL DEPTH IS THE MINIMUM DEPTH OF GRFI',,,'EL BETWEEN THE OUTFRLL PIPE
FIND THE BOTTOM OF THE ENCFP/BTION (IN FEET).
PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTFILLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES THFIT THE WELL WILL SERVE.
'IF'II..] C: ..'.: 2 .':.. ][ ~'-,~E;F"EC:]' ][ C, [:--]'_.~ R~:E F-.'E _¢-~k~ I:
BRCKFILLING OF RNY SYSTEM WITHOUT FINFIL INSPECTION RND RPPROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R WELL AND FtNY ON-SITE SEWRGE DISPOSRL SYSTEM IS
~.00 FEET FOR FI PRIVRTE WELL OR ~.50 TO 200 FEET FROM FI PUBLIC WELL DEPENDING
UPON THE T'¢PE OF PUBLIC WELL.
MINIMUM DISTFINCE FROM R PRI',/RTE WELL TO Ft PRIVFITE SEWER LINE IS 25 FEET FIND
TO FI COMMUNITY SEWER LINE IS 75 FEET.
OTHER REC..!UIREMENTS f'IFIY FIPPLY. SPECIFICBTIONS RND CONSTRUCTION DIRGRRMS FiRE
FP,,'RILFIBt_E TO INSURE PROPER INSTRLLRTION.
I C:ERTIF'¢ THRT
±: IRM FFtMILIFIR WITH THE RE6'UIREMENTS FOR ON-SITE SEWERS RND WELLS RE; SET
FORTH BY THE MUNICIPRLIT'¢ OF RNCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
~: I UNDERSTRND THRT THE ON-.SITE SEWER SYSTEM MBY RE6¢_IIRE ENLRRGEMENT IF THE
~~ ~NKZ I N
' APPLI ~C 'NT, FILLS OUT UPPER H~.~,~.:, ONLY
Property Owner ~'T~b ,~"/&/ ~]' /~/V~'//~ Phone
Buyer
Address Zip Code
Lending Institution Phone
Address Zip Code
Address Zip Code
Type of Resi~nce
~ Single Family
~ Multiple Family No. of Bedroo~ ~-
~ Other
Water Supply
~ Individual A~ACH WELL LOG. A w¢l log is required for all wells drilled since June 1975.
Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal /~/
~' Individual Year IndividuAl Installed: . , ~
~ Public Utility When Connected to Public Utility:
~ 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:
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONM2NTAL PROTECflON
AU8 ~ 6 i983
RECEIVED
( ) APPROVED BEDROOMS *GONDITIONS OF APPROVAL
( ) DISAPPROVED
{ ~)) ~O N~t!-~IO N A)Z A P P R O VA L *
Soils Ratio9 Date S~er ~nst~Hed Well T~ Absorption Ar~ Well ~og Received
Well to ~nk Septic T~k
72.023(3182)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
,;~ SOILS LOG
[] PERCOLATION
TEST
SLOPE SITE PLAN
WAS GROUND WATER ~
ENCOUNTERED? ~/~ ~
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE .(minutes/inch)
TEST RUN BETWEEN FT AND -- FT
,5---.//£P
DATE:
72-008 (6/79)
c�
ANCY~ ~RAGE WATER & SEWER L, 71LITIES
Point Woronzof Laboratory
Owned by Ihe M~nmipahty
ol Anchora~je
DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORMS
Water System: Stephen. A. Fran._k~l~in ......
Date Collected: 8/25/83
Collected By: s. Franklin
Time Received: o900
Date Analyzed: 8/25/83
Analyst: M. Spano
[] Routine Samole
Check Sample
Special Purpose
[] ~N Method
[] MF Method
Total
Sample Time Sample Location Coliform
# Collected fl/100 mL
33-34-47 0600 Walter G. Pippel Sub. ~J2, Block 12, Lot 16 < 1
Reported by: .. _ _ ~
~1: Time
Date
Insp Blair
~UNICIPALITY OF ANCHORAGE
DEPARTMEN~F HEALTH AND ENVIRONMENT~PROTECTION
825 L Street, Anchoraa~. Alaska 99501
264-4720
Date Received: October 14, 1977
Time ~3: Time
Date Date
Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request:
Mailing Address:
Phone:
o
Property Owner: KennethL/Shirley I. Ketchum
Mailing Address: Star Route 2 BOx 234 99577
Phone: 694-2254
Legal Description:
Lot 18 Block 12 Pipple Subdivision ~2
Single Family Residence: (~ Number of Bedrooms:
Multiple Family Residence: ( )
Well System: Individual well
Permit ~
Construction
One
Number of Bedrooms:
Community/Public System ( )
Depth of Well 100' Well Log on File
Bacterial Analysis
Sewage
Permit #
Septic Tank Size
Absorption Area
Disposal System: On-site System (x) Public Utility (
Installed 1975 Installer
Manufacturer
Soils Rate Material
7. Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
Page ~fwo
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 18 Block 12 Pipple Subdivision ~2
Comments:
Affadavit Attached
Approved~
DisapproVe;:
Letter Attached: )
Date:
Department Worksheet:
~' ~, ANCHORAGE'M_~/
~UNICIPALITY OF ~',~<:!:A'h','~, ~.
Department of Health and Environmental· Protections'; ~
825 L Street, Anchorage, Alaska 99301 .,,,.' ~ ~;,':,i
~'<-~quest for Approval of Individual Sewer and Water Facilities
Property Owner:
Mailing Address:
2. Name of Buyer:
Mailing Address:
Phone:
Lending Institution:
Mailing Address:
Phone:
Realtor/Agen ·
Mailing Address:
Legal Description: ~k,-;
Street Location: ~D~
Single Family Residence:
Multiple Family Residence:
Phone:
Number of Bedrooms: /
) Number of Bedrooms:
7. Water Supply: * Individual Well (~) Public/Community System (
If Individual Well, well depth /~ ?
If Community System, name of system
Sewage Disposal System: On-site System (~-~ Public System
If On-site System, date of installation: / ~ ~
( )
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77
DATE
TIME
PURCHASE ORDER NO.
SOLD TO
ALL ACCOL ~ITS DUE ! 0th OF FOLLOWING MONTH
INVOICE
UNITED BUILDING SUPPLY, I~C.
P. O. BOX 6085 * ANCHORAGE, ALASKA 99502 PHONE 277-3571
~,,-~'~ ' DATE
,':" ? ~',;" 7'~
CUSTOMER COPY
DELIVER TO
LOT BLOCK SUB DIV. JOB NO.