HomeMy WebLinkAboutWYNTER PARK #1 BLK 3 LT 5AOnsite File
Wynter Park
#1
Block 3
Lot 5A
#051-492-59
Formerly Lots 5 and 6
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NAME
EGAL DESCRIPTION
LOCATION
DISTANCE TO:
MUNICIPALITY OF ANCHORAGE
DEPARI'MENT OF HEALTH & ENVIRONMENTAl- PROTECTION
ENVIRONMENTAl- ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITF SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
P ~-N E 'Z'NEW
~'~{.~ ~_~L..~I '~PGRADE
DISTANCE TO:
Absorption are~ ~welling ~,C~' I
DISTANCE TO: Fi~g
No. DE lin0$ th of
fJ
] of tile [o finish grade
Foundation
:he of crib
lANCE TO:
rib diameter
Well
:rib d e. pt h.~
DISTANCE TO:
Building foundation
IMaterial
NO.
Liquid capacity in gallons
PERMIT NO.
Distance between lines
PERM NO
Building foun ation Near0stlotline
Driller race to lot line PERMIT ND.
Sewer line Septic tank ForptiOr~ararea(s)
OTHER
PiPE MA FERIALS
L TEST RA~~ /
DATE LEGAL
GR[
ANCHORAGE AREA BO'
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
MAILING ADDRESS PHONE
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
NUMBER OF
~"T~iS~ MATERIAL ~T~L,.- COMPARTMENTS 2.--
LIQUID DEPTH
LIQUID CAPACITY. /ODD GALLONS.
SEEPAGE PIT:
NUMBER OF PITS r
LINING MATERIAL L~
BUILDING FOUNDATION__
NEAREST LOT LINE' '~--'~-- ' ABSORPTION AREA (WALL AREA)
BIAMETER (~l./' OR WIDTH ~/', LENGTH /~1, DEPTH __~!
CRIB SIZE: DIAMETER DEPTH DISTANCE FROM:
TOTAL EFFECTIVE
WELL
SQ. FT.
ADDITIONAL ABSORPTION
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, LQ~031
DIAGRAM OF SYSTEM
!37.','5 !,. l]?l"Fi'.li]lZ'l ~, A!~,tCiId!IRAI']iil ~ Al'( ?.?'410 J.
?./~ ~! '-' '1720
MUNICIPALITY OF ANCHORAGE
DEPARTMF-NT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99S01 264-4720
SOILS LOG - PERCOLATION TEST
[] SOILS LOG
PERCOLATION
TEST
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
GATE PERFORMED:
SLtDPE SITE PLAN
~~~WAS GROUND WATER , ~/-- SL
COUNTERED? ~ O
P
IF YES, AT WHAT i E
DEPTH?
Reading Date Gross Net Depth to Net
Time 'rime Water Drop
~ -¢gs" 11,'IS-A'~- ' -
,I- ,o '/¢"
PERCOLATION RATE ~/~ 0
.T~EST RUN BETWEEN ~" FT AND
(minutes/inch)
PERFORMED BY:
CERTIFIED BY:
DATE:
72-008 (6/79)
QGRE,
ANCHORAGE AREA BO,
Department of Environmental (~uality
3330 C Street
Anchorage, Alaska 99503
JGH
LOCATION
INSPECTION REPORT ON-SITE SEWAGE DISPO,S, AL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
INSIDE WIDTH LIQUID DEPTH
COMPARTMENTS
_LIQUID CAPACITY/0<~)~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
BUILDING FOUNDATION__
ADDITIONAL ABSORPTION
DIAMETER _-- OR WIDTH
CRIB SIZE: DIAMETER
NEAREST LOT LINE ~,.O'~
LENGTH/~, DEPTFI
DEPTH ~:/ DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) 4::t'~ ¢~ . SQ. FT,
WELL:
TYPE C ~ 2¢//,¢1 ~ ~,') ,'~ "~CC~N~S~T~R UC T i ON
BU I LDI NG NEAREST
FOUNDATION -- LOT LINE
CESSPOOL.
OTHER SOURCES
APPROVED
DISAPPROVED
NEAREST
SEWER LINE_
DEPTH__ DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM
REMARKS
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
DIAGRAM OF SYSTEM
LOT SLOPE:
REMARKS:
Form NO, EQ.031
GRE
ANCHORAGE AREA BOr
Department of Environmental Quatity
3330 C Street
Anchorage, Alaska 99503
JGH
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION_
MAILING ADDRESS PHONE_
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH.
_MANUFACTURER ~1~ ~ ,f,,l( ~""r F--.6 I,.. MATERIAL
INSIDE WIDTH LIQUID DEPTH__
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY I0~0 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
LINING MA'rERIAL
BUILDING FOUNDATION
ADDITIONAL ABSORPTION
DIAMETER ~"~'? OR WIDTH /"~', LENGTH /~', DEPTH
CRIB SIZE; DIAMETER DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
NEAREST LOT LINE ABSORPTION AREA (WALL AREA) ~ i'~
SQ. FT.
WELL: ~J>AI~.. '¢~, '~
TYPE.
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION. DEPTH DISTANCE FROM:
NEAREST NEAREST SEPTIC SEEPAGE
LOT LINE SEWER LINE TANK SYSTEM
OTHER SOURCES
DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY:
PIPE MATERIAL'
LOT SLOPE:
REMARKS:
Form No. EQ-031
DIAGRAM OF SYSTEM
APPROVE~'/B ~''-
GREATER ANCHORAGE AREA BOROUGH
SEWAGE DISPOSAL SYS'rEM -- APPLICATION AND PERMI"r
PERMIT NO.
INSTALLATION OF: SEPTIC TANK - ~/ SEEPAGE PIT- /
TYPE AND SIZE OF FACILITY TO BE SERVED ~ ~:~ ~
FINANCED THROUGH ~ TO be INSTALLED bY
SOIL TEG'r RESULTS
NOTEt THIS PI"I~MIT IS NOT VALID WI'rHOUT SOIL 'res?
MINIMUM DISTANC:E$, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PI~ ~/ -, DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT \~/ALL
SEEPAGE AREA SIZE
ALSO CONSIDER AREA WELLS.
TYPE
DIAGRAM OF SYSTEM
WATER MAIN TO SEPTIC TANK , SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, ~- ~) -* SEEPAGE PIT ~/~-~ , DRAIN FIELD
TO RIVER* LAKE. STREAM.
~ INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC: TANR AND SEEPAGE PIT
FITTED WiTH AIRtIGHT REMOVABLE CAPS.
GRAVEL
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORA(~E AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE'~27///~/' ,~, ~/~//~ _~__ j.~" ~
DATE APPLICANT'S SIGNATURE ~
FORM NO, E~l'01 ~