HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 7 LT 29mc>la '14
GAffER ANCHORAGE AREA BOROU,,C~H
HEALTH DEPARTMENT
1327 EAGLE ST. ANCHORAGE. AlaSKA 99501 279-2511
N°. 477
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELLC"7,~,.~:'.-'~t-*'-"<//T',',',',',',',~'
uou,o J O LO.S.
MAILING
ADDRESS '~.'~./'./
LEOAL DESCRIPTION ,,.~'?.7'-....~ ?.
NUMBER OF
MAIERIAI. ~ z'~--'*.~,~_.-~-'-'~'-;')'~ COMPARTME. NTS /
INSIDE LENGTH INSIDE WIDTH DEPIH
SEEPAGE SYSTEM: SEEPAGE PIT: ~
NUMBER OF PITS f"~OUTSIDE DIAM~ · OR WIDTH ~ , DEPTH
LINING MATERIAl / DISTAN~ / , BUILDING FOUNDATION
/
NEAREST LOT LINE . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. Fi.
TILE DRAIN FIELD:
DISTANCE FROM WELl ('~'~-~..~../~///-'~'/~-"'/' , FOUNDATION.
NUMBER OF LINES ~ J DISTANCE BETWEEN LINES
ABSORPlION AREA -~ ~:~ J SC). FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE ~
, NEAREST LOT LINE
IRENCH WIDTH
3 / -' .~"..r?TM LENGT~ . __ /
(...~/.~,;~ r.~ OF LINES /~' ~_
IN. TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
' DISTANCE FROM WATER
WELL: TYPE {tC'-~':/'~"-'~':'~"r'~, DEPTH , BUILDING FOUNDATION. SAMPLE~, NEAREST
~ NEAI{EST SEPTIC ~ SEEPAGE OTHER
LOT LINE SEWER LINE '' TANK , SYSTEM ~ CESSPOOL ~ , SOURCES
DISTANCES:
J
DIAGRAM OF SYSTEM
GReATeR ANCHORAGE AReA BOROUG~
DEPARTMENT OF ENVIRONMENTAL QUALITY
$350 "D" STREET ANCHORAGE. ALASKA 99503
SEWAGE DISPOSAL SYSTEM M APPLICATION Al,ID PERMIT
COMPLETION
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLI
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL
OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
SUBJECT TO PROSECUTION.
TYPE
ALSO CONSIDER AREA
DRAIN
DIAGRAM OF SYSTEM
"On~ te~ is wort~z a Iho~a.,; o~inions"
..Performed For Mr! O. Ekberg
Leaal ~escrtntlon: ILot 29 Block 7
This rorm Renorts Soils' Loq yes
~eoth t
Feet Soil Characteristics
1 --- Overburden
Coarse Sandy Gravel ( silty near
top and becomming.cleanGr with
depth )
5~Level of Trench line
6 ~ Coarse Sandy Oruvel -(8~)
7
~4~m~Ground water ~levation
.Was Ground Water
I¢ Ves,
ncountored? yes d'/oj~
At what D nth? -8 i%
I
Oate Performed 7-20-73
Subdivision ~KX Campbell Heights
Percolation Test
Readinq Date; Gross Time Net Time Depth .................... to H20 tlet'Dron.
Percolation Rate
Uinute
Prooosed Instal: Seenaae Pit Drain Field yes .',-=~;
Doeth of Inlet! Death To Bottom Of Pit O~ Trench ,,.
: 8~ sq. ft. drainage erea re,aired.per bedroom.
water table 3 I't. below s~-p~ drain l'ield · · *,: ....
i ~: J':~,
Performed ByJim Mack Data Cert'f'fted By: Consb~ction
' '~ Lab Manager Date: Y-20-Y3
O~,e test :s ~,,ort;: ~ tho~s~,cl opines
Sheet of
Date~
Depth
SIEVE.
"-~' !'"t ':'
".7: I.
~'-~' '---~-:.L:-.
:':t--::""' :
'::I:~I..' . . '
.,)
OP~I;-R?ER ANCHORAGE AREA BORO?~H
HEALTH DEPARTMENT
!327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION ~ ~/~~AL DESCRIP110~~ ~7~,~
SEPTIC TANK: ~
DISTANCE FROM WELl · MATERIAL ~~/~ COMP~TMENTS /
LIQUID CAPACITY ~ : GALLONS. INSIDE LENGTH INSIDE WIDTH DEP~H~
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS ~DE DIAM~ER OR WIDTH
NEAREST LOT LINF . TOTAL EFFECTIVE ABSORPTION AREA (WALt AREA)
, LENGTH ,DEPTH
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL ; i
NUMBER OF LINES
' DISTANCE BETWEEN LINE~--- ~' ---- TRENCH WIDTH ~ IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF F,LTER , TER ^L BENEATH T=LE ABOVE T,LE
/~ DISTANCE FROM WATER
WELL: TYPE/"?~'~/'~,.z'~_ ~ DEPTH '~' , BUILDING FOUNDATION.__SAMPLE
NEAREST SEPTIC SEEPAGE
LOT LINE ~ , SEWER LINE , TANK ., SYSTEM , CESSPOOL
DISTANCES:
· NEAREST
OTHER
. SOURCES'"-"-'
GREATEI""ANCHORAGE AREA r'OROUGH
IIEALTil DEPARTMENT
.- 327 Eagl St. Anchorage, A{aska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RES,nENCE ADG~ES."~ __'OCAT'ON DF,NSTAL~T,ON ~--
LEGAL
APPLICATI0~ T0 INSTALL: SE~I~ TANK ~,SEEPA~E PiT , DflA N F ELD ~ ,0THEft
TO SERVE THE FOLLOWING FACILITY --.-"'-) '"~D~"~'")
BELOW TO~E FILLED OUT BY HEALTH DEPARTMENT
AS D~SCR,"EO,ELOW. S,ZE DF ~'N,TTO BE SERVE'" '~ ~ .~,~r~
· DIA 'RAM OF SYSTEM
II
II
II
II
I'~"V] I
II
II
DISTANCES:
ater Anchorage Area Borough Ordinance No. 28-68 and that thc
I am familiar with the req
I
above described system is in a~;ordance with said code.
DATE APPLICANTS SIGNATU RE
SUB3ECT: On-Site 9c~:al:e Disposal
on Lot 28~ Block ?~ Caen?bell Bcif, hts
~ubdivtston
la:ur ;$~r. i~torson:
Proposed for the s~jcct lot.
· ~ts ~oll t,st slu~.d ~at the surface uater t~le ts ;o mar ~ae
gr~nd suffa~ m~d the sell so saturated ui~ ~ater that m~ ca-:Itc
~s!;os~ sTste~ ['tll net
: sati;facto~l).,
~'er ;syste;ns to the ['e;t of your proi~rty have failed ~'itn the
~ter :t~le teln~ co~i~rably lin'er than m your lot,
~c ~g~t to infom you that b~ed on ~e Soil ta;t fro: this lot~
eh-site scunge disi;~al (septic tank
proved, - drain field) };ili not [e
cc: Ple~tn~; Ucrart~*cnt
$tnccrcl¥~
CLI! FORD p. 3LgOKINS~
3c2nizdstrativu l)ircctor
BY:
E~viroz~::cntal I~ealth Director
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE
DATE
~ NSPECTOR i INSPECTOR INSPECTOR
i MUNICIPALITY OF ANCHORAGE ~tCIPALI~ OF A~O~
~ ~ L S~-A~, A~I
! ENVIRONMENTAL SANITATION DIVISION AUG ? 1981
~EQU~T FQ~ ~PROVAL OF INDIVIDUAL ~ATEa ~D sE~ I
DI~E~TIOffi: co~le~ ~1 ~ll~ o~1 ~ 1. Iffi ~ ~11 ffi ~ ~. film all~ fen (10] ~vi for pr~i~.
1. ~O~IRTY ~NER , I PHONE
MATLI ~ ADORE~
2. BUYER PHONE
MAILING ADORE~
~ LEND~G INSTIT~ION ~ -- ~ PHONE
~ R~O~AGENT~ ~ j ] PHONE
MAILING AO~E~ ;
$. ' LEGAL DESCRII~'ION
B. TYPE OF RESIDENCE
.~ SINGLE FAMILY
i'-] MULTIPLE FAMILY
7. WATER BUI~LY
[] INDIVIDUAL*
COMMUNITY
PUBLIC UTILITY
L SEWAGE DI~SFOSAL BYSTBM
NUMBER OF BEDROOMS
~ One [] Four
Two [] Five
~ Three [] Six
I'-I Other
* ATTACH WELL LOG. A w~tl Io~ is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available,)
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72010 (Rev.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
r'-I MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
I'"l INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
•PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or [] Holding Tank
Size: If Tank is homemade $O~LS RATING
give dimemions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
8. COMMENTS
APPROVED FOR '~ BEDROOMS
[~ONDITIONAL APPROVAL (letter mu~t accompany c~rtificete)
[] DISAPPROVED
DATE BY ~
72.010 (Rev. 8/79)