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Home My WebLink AboutZODIAK MANOR ALASKA BLK 2 LT 16Zoo iA K ,ER ANCHORAGE AREA BOI Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 UGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TAN K: (~), FROM WELL J MANUFACTURER ~___ MATERIAL . COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPAC TY / ~¢¢~"~ _ . _ 'GALLONS, TILE DRAIN FIELD: DISTANCE FROM WELL ~_~07 FOUNDATION ~/'(L~ ! ~-__~. TOTAL LENGTH,/ .NEAREST LOT LINE ~/~ /~¢U__OF LINES t / NUMBER OF LINES / DIS]~/&NCE BETWEEN LINES TRENCH WIDTHS_ IN. TOTAL EFFECTIVE ABSORPTION AREA --~(~d¢ ~1 SQ. FT, LENGTH OF EACH LINE ~?. · ' J___'d- / DEPTH OF F,LTER ~'~¢/ DEPTH: TOP OF TILE TO FINISH GRADE__ MATERIAL BENEATI4 TILE IN, ABOVE TILE IN. WELL: TYPE el/If' CONSTRUCTION BUILDING NEAREST NEAREST SEPTIC CESSPOOL _ OTNER SOURCES APPROVED DISAPPROVED REMARKS __DEPTH _DISTANCE FROM: SEEPAGE: · SYSTEM _ __, DISTANCES: INSTALLED BY: ~ ~2--~ -I uV SEWER LINE DEPTH: LOT SLOPE:~~-~' Form LQ-032 DJ ,AG.P;i~J~tV1 OF SYSTEM DATE ~ GRE 'ER ANCHORAGE ARF"A BC UGH/ DEPARTMENT OF ENV IRONM ENTAL QUALITY L,/ ~ ~ /~;er'M"r~/'~'' SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME Of AppLICANT ~ L~/~.~'/~-~ iNSTALLATION LOCATION LEGAL DESCRIPT,ON X(> Y- NOTE: THI~ PER~IT lei NOT VALID WITHOUT ~OIL TEGT FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS,;/ FOUNDATION TO SEEPAGE pIT / -~' DRAIN FIELD SEPTIC TANK I~'~ SEEPAGE P~T ~{~/~ WATER MAIN TO SEPTIC TANK DRAIN FIELD ~ . SEEPAGE PIt SEPTIC TANK, , SEEPAGE PIT TO RIVER, LAKE. STREAM. , DRAIN F]ELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP O~ EXCAVATION 5 FEETINTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT PITTED WITH AIRTIGHT REMOVABLE CAPS, CONFORM TO BOROUGH JREGULAT[ONS REGARDING INSTALLATION. SEEPAGE AREA [ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANC ORAGE AREA BOROUGH ORDIN~ANCE NO 28-6~ AND THAT THE ABOVE DESCRI B ED SYSTEM IS:~N ACC,O~ANCE WITH SAIl} CODE' ~) ~ T.H. No. 1 4-21-75 0o0I Sandy Silt w/ Some Organics (FLL) 1o5~ Gravelly Sand w/ Some silt (SM) 8.07 Sandy Gravel w/ Tr.ace Silt (GM) -10.5' Graveily Sand w/ Some Silt (SM) Note= No Water Table Loq Represents Lot I6 Block 2 7~0d].ak Manor Subdiw[sion Engm~ering 8~ Geological Consultants inc. 16.0' T.D. [~ppe Excavating Log of Test Hole Anchorage, Alaska oa're 4-21-75 S~AL~ 1,,=2, OWN BY BH CHKD mY pj P~Oa. NO. 562016 OWe NO. A-0i LABORATORY TEST REPORT TEST ON PROJECT NO, , PROdECT NAME Rappe. Excavating T.H. 1 SAMPLED FROM LSUBMITTED BY SOURCE ~ot 16 Block 2 BZodiak H~nor Subdivision Jackson LOCATION Anchorage, Alaska OEPTH_. 10'-11' DATE SAMPLED, 4~21-75 CLASSIFICATION RaM PROJECT NO. 5..__62.__0..16 _LAB NO. 75A-503 __FIELD NO. 1_____~ ........ DATE REPORTED,.4-22-75 DATE RECEIVED 4-21-75 COMPACTION OPTIMUM MOISTURE_, MAX. WET DENSITY MAX. DI~' DENSITY CORR. MAX. DRY DENSITY % FRACTURE METHOD NATURAL DENSITY NATURAL MOIGTURE WEIGHT LOOSE WEIGHT RODOED DELETERIOUS MATERIAL STATIC IMMERSION BRAND__ ~% ~ ~/2% 2%-- GRADE ORGAN.IQ COLOR ~ ~mglnaering ~ (3eologlcol Con8ultan?8 MOISTURE - PERCENT MUNICIPALITY OF ANCHORAGE DEPT. O,' , Al.tH DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTii~VlRONh",LNTAL 82§ L Street - Anchorage, Alaska 99501 MAR 1 9 i979 ENVlRONMEN'rAL ENGINEERING DIVISION Te,ep,o.e ,,,.,,,o R E C E I V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES J DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER ~, .,._ PROPERTY RESIDENT (If different from above) BUYER PHONE PHONE PHONE MAILING ADDRESS 3. LENDING INSTITUTION MA~L~N~ ADDRESS PHONE MAILING ADDRESS S. LEGAL DESCRIPTION STREET LOCATION ~/~/// 6. TYPE OF RESIDENCE ~IUMBER OF BEDROOMS [] One E) Four ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three ~ Six [] O[ner 7. WATER SUPPLY ~ INDIVIDUAL' ' ATTACH WELL LOG. A well Icg Is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that Bate, give well [] PUBLIC UTI LITY depth lattach Io§ if available.} / ~, ' 8. SEWAGE DISPOSAL SYSTEM '*If individual/on-site, g~ve installation date ~(~r ~-~. INDIVIDUAL/ON-SITE*' If system is over two (2) veers old an adequacy tes~'is require(~ [] PUBLIC UTI LITY 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 : INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP ECTO R DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVI DUAL/ON -SITE DATE INSTALLED I~ PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: ~ ~) O~ If Tank is hqmemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Sept,c/Hold,ng q~ank I~Ablsorp~tion~Are~ ~'~ '"'~/"~'~'Nearest Lot · ' ' Sewer Line L[nu 4, DISTANCES WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS I~_.-~APPROVED FOR ~""~ . BEDROOMS [] CONDITIONAL APPROVAL (letter must accompan~ertificate) []DISAPPROVED // DATE , BY (Title),/'p 72-010 (Rev, 3/78) C?I;MIOAL 8 gEOLOGICAL LABORATORIF.8 OF AI.ASY, A, ll~C. P.O..OX 4.12,o A.C.O,AOE,,,LAS, Drinking Water Analysis Report for Total Coliform Bacteria TELEPHONE (007) 2794014 TO BE COMPLETED BY WATER SUPPLIER Public ~ATater Syste~ Name ~ ~ Moiling Ad?reaa /) City Stale Zip Code Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose FJ Treated Water E} Untreated Water SAMPLE NO. LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY LABORATORY: NAME ADDRESS CITY Date Received Time Received / Analytical Method: [] Fermentation Tube ~embrane Filter Lab Ref. No. Result* Analyst I ~ I I~ I.F~ READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18-310 (3-78) 06.1220 (b) Rev. 1978 BAC~TER OLOG CAL WATER ANALYSIS RECORD GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received // Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. Property Owner: ~.~,~ Mailing Address: 4. Location: 5. Type of facility to be inspected 6. Well Data: A. Type No. of bedrooms C. Construction B. Depth D. Bacterial Analysis System: ]~' all Sewage Disposal ~X~_~- A. Installed ~ ~:;~( (] . B. Inst er ! u m C. Septic Tank: 1. Size /~-~) 2. Manufacturer D. Seepage Pit: I. Absorption Area ~/~i 2. Material E. Disposal Field: Total length of lines ~//~/ ... Distances: A. Well to: Septic tank , Absorption area , Sewer Lines ._, Nearest lot line Other contamination B. Foundation to septic tank ., Absorption area C. Absorption area to nearest lot line __ EQ-034 (1/74) Page 1 of two pages 06-1220(a) Rev, 1973 DATE ALA',DEPARTMENT OF HEALTH AND SOCIAL SE ~ES DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL WATER ANALYSIS INDIVIDUAL [~ SEMI-PUBLIC [] CHLORINE RESIDUAL PPM REPORT RESULTS TO NAME ~' ' ADDRESS CITY ~ ' ' ZIP CODE ADDRESS / OF SOURCE ' ~ ' /" Lab No qFFICE Analysis shows this Waler SAMPLE to be: [] SoUsfaclory [] Unsatisfactory [] QuesUonable [~ Sample too long in lronsit; sample should not be over 48 hours old al examination to indkote relbble results. Please send new sample, [] Botlle broken in transit, please send new sample. SANITARIAN~S REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAl. SUPPLY SAMPLE COLLECTED BY ' ' DATE COLLECTED "' ' ' TIME COLLECTED [] Other (List) LOCATION: Septic Tank .Feet, Feet. Privy Fe~t, [] Yes [] No PURPOSE OF EXAMINATION: Illness Suspected? [] Yes [] No READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE od.~o (b) BACTERIOLOGICAL WATER ANALYSIS RECORD ~ev. 1973 Lactos~ Broth 10cc 10cc 10cc 10cc 10cc 1.0cc l.Occ 24 Hours 48 Hours EMB AGAR Lactose Broth, 24 hfs, - 48 hfs, Gram's slain Coliform Density (Most probable No. per 100c¢) Reporled by Date p,m, Thls analysis indicates Coliform Organisms 1o be: Absent