HomeMy WebLinkAboutZODIAK MANOR ALASKA BLK 2 LT 19ZoD iA K
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GRE ANCHORAGE AREA BOR JGH
Department of EnvironmeRtal Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~ ~O,;IA ~)~ ~.,.2 ~- ~-~"'/}/'['5 ¢'.~ MAILING ADDRESS '~[ '~ ~' ,'~-~ ~ . PHONE
LOCATION LEGAL DESCRIPTION '~;) ~, ~ (,( lC ~_~J2 I'- ~'~.lNq Z
SEPTIC TANK'.
DISTANCE
FROM WELL -- MANUFACTURER ~ig0 ~¢%MATERIAL
NUMBER OF
COMPARTMENTS I _
INSIDE LENGTI4
INSIDE WIDTH
;rMJ=E,-IECRC~N-F i EL=E~.'
DISTANCE FROM WELL FOUNDATION
LIQUID DEPTH
LIQUID CAPACITY[.~'~O GALLONS.
~ t TOTAL LENGTH
NEAREST LOT LINE OF LINES '~7~' ~'--
NUMBER OF LINES 2~ .DISTANCE BETWEEN LINES ~ TRENCH WIDTII__'~)~N.
ABSORPTION AREA ~ ~" ~/ SQ. FT. LENGTH OF EACH LINE I ~' (~, ~-/ /~
DEPTII: TOP OF TILE TO FINISH GRADE ~-~/f~ DEPTII OF FILTER ~¢
MATERIAL BENEATH TILE _~. ABOVE TILE
TOTAL EFFECTIVE
IN.
WELL:
~''~ ~ CONSTRUCTION ~¢'O OC'~)~ J DEPTH DISTANCE FROM:
TYPEItA,~k~ ~i(~ ( ' e
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE ___ TANK SYSTEM.
CESSPOOL ........ O'FNE R SOURCES
APPROVED DISAPPROVED
--REMARKS
DISTANCES:
INSTALLED BY: __
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
GPIE: E:I'~ ANCHORAGE AREA got JGH
~' S~WAG~ ~)IS~OSAL SYSTEM -~ APPLICATION AND PERMIT
NAME OF APPLICANT
INSTALLATION OF: SEPTIC TANK ~ ~EEPAGE PIT
COMP[ ET[ON DATE ANTICIPATED
..... , ~RAIN FIELD
SEPTIC; TANK TO SEEPAGE piT WALL
, DRAIN FILLD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAp OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIl_
GRAVEL F~ACKI~'I LL
Test Hole No.
Depth in Feet
From TO
0.0' 2.0'
2.0' 10~0'
LOT 19,
1
10.0' 11.0'
11.0' 15.0'
Bottom of Test Hole:
Frost Line:
Free Water Level:
TABLE A
BLOCK 2, ZODIAK MANOR
W,Oo
#17491
Soil Descrip.tion
F-4, brown, ~nd~ silt, ML, damp,
stiff, NP
F-l, brown, silty very sandy gravel,
GM, silt content 15% to 25%, damp,
medium density, maximum particle
size 6"
NFS, brown, sand, SP, damp, medium
density
F-2, brown, silt~ ~ravelly. sand,
SP/S~~ to SM, silt content 10% to
20%, damp, medium density, maximum
particle size 2"
15.0'
None Observed
None Observed
Re dif~orm
5H 33
KEEP THIS SLIP FOR F~EFE~EN~
APPLIC
Phone
'T FILLS OUT UPPER HAl )NLY
z,p Code
Realty Co, & Agent ~:
Type of Residence
. Single Family
~ Multiple Family
[] Other
Zip Code
Phone
; Supply
Community
Public Utility
Sew r Disposal
[] Holding 'rank
ATTACH WELL LOG. A well log is required lot all wells drilled since June 1975.
For wells drilled prior to that date, give well depth (attach log if available).
Year Individual Installed: ...... ,~ <:i ~ '~
When Connected to Public UtiJity:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Date
Time
( ) COND~ONAL APPROVAL*
DATE
Time
Time
Soils. Rating
Date Sewer Installed
jWell to Tank / O~d / Septic Tank Size
· CHEMICAL & G~. ~OGICAL LABORATORIES L ALASKA, INC.
,/~ TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER ~
//~ 5633 B Street ~
..... "'""~ Drinking Water Analysis Report for Total Coliform Bacteria -~
TO BE COMPLE'rED BY WATER SUPPLIER
WATER SYSTEM:
Water System Name
I.D, NO.
Phone No,
City State Zip Code
Mo. Day Year
SAMPLE TYPE:
)
[]~Routlne
[] Check Sample (for routine sample
with lab ref. no. )
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION
/
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[~ Satisfactory
,[~ Unsatisfactory
[] Sample tgo Io~hg in transit; sample should
not be over z~8 hours old at examination
tS ndicate'r~iibble results. Please send
new sample. ,
Date Received
Time Received / ~ "'
Analytical Method:
[] Fermentation Tube
,-~i Membrane Filter
Lab Ref. No, Result* Analyst
2:i r-Tn "'
? ! ; ..., .,,
//
READ INSTRUCTIONS
BEFORE
COLLECTING SAM PLE
06.1220 {b)
Rev, 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
3reluolPtlve 1Omi 1Omi 1Omi 1Omi 1Omi 1,0mi 0.1mi
24 Hours
48 Hours ~
BGB
Approval requested by:
Mailing Address:
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
"C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
2. Property Owner: ~x,~,~]
Mailing Address: ~
3. Legal Description:
4. Location:. ~'~--~.o~
5. Type of facility to be inspected j~,~o~,~, No. of bedrooms
6. Well Data:
C. Construction
Sewage Disposal System:
A. Installed ~(~.~.
C. Septic Tank: 1.
D. Seepage Pit: 1.
E. Disposal Field: Total
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
C. Absorption area to nearest lot line __
Phone:
Phone: ~/~- /~lq~
B. Depth
D. Bacterial Analysis
B. Installer
Size 2. Manufacturer
Absorption Area 2. Material
length of lines
, Absorption area
, Other contamination
, Absorption area
, Sewer Lines
EQ-034 (1/74) Page 1 of two pages
Parle 2 of two pages - R~ .,st for Approval of Individual ~er & Water Facilities
Legal Description
Comments
Approved~. '~__~/~,~.~~-2 Disapproved Date ~-//~__
Approvg~Valid for one year from date signed
Greater Anchorage /Trea Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1, Type of Inspection: CMRO
2. Property Owner: ~¢2,'~4~,,'J~_/
Mailing Address:
VA z~"// FHA CONY ____
Mailing Address: Day Phone
Nameof Lending Institution: /'5r~'~.~2~,/ ~,~-~, ~
Mailing Address:
Name of Realtor or Agent:
Mailing Address:/'2~ ~2
Phone
6, Legal Description:
7. Type of Facility to be inspected:
8. Water Supply
Type of Supply:
Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well
Individual
/
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation ,/~
Individual (on-site)
E0-037 (1/74)
]6-1220¢al ~ev. 1973
DATE
INDIVIDUAL []
ALA DEPAR'rMENT OF HEALTH AND SOCIAL SL. ,CES
DIVISION OF PUBLIC HEALTIt Lob No._
INDIVIDUAL AND SEMI'PUBLIC
BACTERIOLOGICAL ~VATER ANALYSIS _
NAME
SEMI-PUBLIC [] CHLORINE RESIDUAL PPM
REPORT RESULTS TO
ADDRESS
CITY ZIP CODE
ADDRESS
Analysis sh0w~ thls Water SAMPLE to be:
[] Satisfactory
[] C~uestJonable
send new sample.
SANITAR AN'S REMARKS
COMPLETE THIS SECTION
ONLY IF WATER IS AN INDIVIDUAL SUPPLY
SAMPLE COLLECTED BY ~ '
DATE COLLECTED . ' : :. .'.;r ~ TIME COLLECTED --, :
Well -- [] Dug [] Driven [] Drilled [] Bored
SOURCE: [] Spring [] Cistern [] Olher
Dug Well or Cistern ConstruclJom
Walls-[] Wood [] Concrete [] Melal
GENERAL: Does Water Become Muddy or Discolored? C] Yes [] NO
When?
[] Of Well [] Giber
PURPOSE OF EXAMINATION: Illness Suspected? [] Yes [] No
READ INSTRUCTIONS
ON
REVERSE SIDE
BEFORE
COLLECTING SAMPLE
06.1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 1973
Lactose Broth '10cc 10cc 10cc 10cc 10cc 1.0cc 1.0cc
24 Hours
48 Hours
ALASKA IILIII OFIFll FITAL COFITi OL S [tUIC S, IFIL
FEBRUARY 2 1984
M/M BURBANK
4331 MARS
ANCHORAGE AK 99507
SELLER - M/M BURBANK BUYER - GRIMES
SUBDIVISION - ZODIAK MANOR BLOCK - 2 LOT - 19
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 888 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 4 BEDROOM HOUSE.
1200 [~Jcsl 33rJ Au¢~u¢, 5ui1¢ ~ · Anchor~q¢, Alas~e 99503 · {907) 276 1361
433j. :qars Drive
o~J]!'~.C'.o llrom i;i~e Cheln Li:lk}~ 5633 [~ S~ye,2t;, i!OL- OUr
Specialist
13
14
/8
BO
(Neptune
Drive)
lO0 90 [ 90
ZODIAC Drive
MARS
:
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