HomeMy WebLinkAboutZODIAK MANOR ALASKA BLK 4 LT 10 MUNICIPALITY OF ANCHORAGE h and Environmental Prote Fourth Floor West 825 L Street Anchorage, Alaska 99501 279-2511, x 224, 225 on Die] ANCE ] NUMBER OF , TILE DRAIN FIELD: TOTAL LENGTH £)I$-IAF~CL [ I?©M V/ELt . _FOU;,~DATIOIq ........ NEARESI' LOI LINE .......... OF LiNE tt of T,in~s _. _ DISIANCE BE]WEEN LINE-% ...... TRENCH Wl©~bl~~- IN, TOTAL EFFECTIVE SEEPAGE PI'Y: LO~ Crib I~J_ii~s C%ib side: Db~METt!R .... DI;PI IL __ DISTANCE FROM: WELl Well Class: Depth: Well D~stance To: Lot Line Bldg: Sewe/i L~ne: Pipe Materials: tt of Bedroon~7 Installer: Remarks: DA r E_J'~C ..... APPROVED 1] avtment of llealth and Environing. 2 Protection Anehovaffe, Alaska 99507 N/lll~S I,()(; - Iq,;III)I,ATI()N TEST Performed For ~/~/~ ~r/~/?~ ;)a~n Perlorl.r.J Jul/ '/Z )7 Dep th Feet 10 - 11 - 12- 13- 14 - -l~as groLincl waLcr eh,countered? If yes, at Wilat cle;~th? JoL location: Description: Materials: Lo, ~f' materJa]s Blk 4 lob i0 £eeb south of house YJeld:sbatic water level of 64.' Drilled by Thomas Drillers ~.o Box I0..516 Anchorage ~Alaska 995II 0 5' bopsoil 6 i[2' ~ravel I~ 2e~' sand 29 ~52' bou]~e? 76 85' f~ravel,sand(water bearing) at 6 ~/p/m Time Date Insp MUNICIPALITY OF ANCHORA~=~- DEPART~ ,T OF HEALTH AND ENVIRONME ~,L PROTFCT]ON 825 L Street, Anchorage. Alaska 99501 264-4720 Date Reeemved: January 31, 1978 10:30 a.m. ~2: Time ~3: Time 2-1-78 Wednesday Date Date Pratt Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES o Lending Insnmtution Request: Alaska State Bank Mailing Address: 310 East Northern Lights Blvd. Phone: 279-7637 Property Owner: Dick Wright Mailing Address: Star Route A Box 1585A 99507 Phone: 344-4214 ~ ' n' Lot 10 Block 4 Zodiak Manor Subdiv],smon Legal Descriptlo . Single Family Residence: Number of Bedrooms: Four Multiple Family Residence: ( ) Number of Bedroems: Well Sysuem: Permit ~ Construction Individual well (~ Communmty/Pu~lic System ( ) Depth of Well 89' Well Log on File~) Bacterial Ana]_ysis CkL~9~t e Sewage Permit Septic Disposal System: On-site System (x) Public Utility Installed 1977 Installe~ ~ Tank Size /~'0 __ Manufacturer _~ Absorption Area '~-% Soils Rate Material 7 o Distances: Well to Septic Tank to Sewer Line Nearest Lot line to Absorpsion Area Absorption Area to Nearest Lot L~ne Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 10 Block 4 Zodiak Manor Subdivision - Comments: Affadavit Attached: ( ) Disapproved: Letter Attached: ( ) Date: Deparnment Worksheet: ~-o~-o z~: oa'~ ~ llWi 1VtlOI/VNB3!N[ UOJ ION (o~]~{sod Shill) ,)OI~--31V{A{ OHI.JI£HHq,3 HOJ £dFJgHH ~_~ ; Department of Health and Enw[ronmental Protection //6~--~i// 825 L Street, Anchorage, Alaska 99501 ~quest for Approval of Individual Sewer and Water F~b, ili~ies Mailing Address: ~. ~Z /,~o~-w~ Mailing Address Phone: ~ ~ 6fF¢/~ . Lending Institution: ~z ~.~.=Z Mailing Address: ~/0 ~.. ~';~"J~'/~'~--~ ~ g,~ ~.~.= Phone Single Family Residence: Multiple Family Residence: Number of Bedrooms: ( ) Number of Bedrooms: Water Supply: If Individual Well, well depth ~/ If Con, unity System, name of system * Individual Well ~ Public/Community System ( ) Sewage Disposal System: *~n-site System If On-site System, date of installation: Public System ( ) *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 ADHW-LAB-2W r'-~ARTMENT OF HEALTH AND WD ~RE DIVISION OF PUBLIC HEALTH BACTERIOLOGICAl: WATER ANALYSIS Lab. No.__ OFFICE 2. Increase chlorination sulficienlly fo meel recommended residual stondards. - 6. Improve your D spring ~ dug well [] driven well ~ drilled well [~ cistern, 9. Con,ad your nearest [] Local Healfl~ Dep~rlmenlor [] Alaska Division el Public Heollh, sanil~tion o[fice for bulletins, consullatlon and SANITARtAN'S REMARKS READ .NSTRUCT ONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE I BACTERIOLOGICAL WATER ANALYSIS RECO,RD (j MF ~es.l~s ..:-~ ..-, ~ /