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HomeMy WebLinkAboutFISCHER BLK 3 LT 1C F.~,'UNICIPALITY OF ANClIORAGE,.--% lief ~ and Environmental Prote' /on Fburth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 It,,I__~.~2T_~.I_O._N._ REPORT ON-SITE, SEWAGE DISPOSAL SYSTEM LOCA]IO~i /~ ~t LEGALU[.SCRIPTION___~~ /-~ %--3 'F, sak~ ~/~ MAJ%'U F AC'I' U R E R _%..O ~-.~.- ~- . INSIgr V,,'IOTIt LIQUID DEPTH NUMDER OF COMPARTMENTS LIQUID CAPACITY/(9(~) GALLONS. TILE DFtAIN FIELD: DISTANCE f'I.JOM WELL # of Lines TO~', AL LENGTH FOUNDATION ___NEAREST LOT LINE OF LINE /'/~! DISTANCE BETWEEN LlrlES TRENCH W DTtI~~, IN. TOTAL EFFECTIVE SQ. rT. LEITH OF [ACtl LINE DEPTII or rlLTER MATErnAL 8[NEATH TILE_~ I . ~. ABOVE TILE ~ IN. SEEPAGE PIT: Log Crib Rings BUILDIrJG f'OL$:~DAT IO."~ DIAMETER __ OR WIDTtt LENGTH DEPTH Crib Size: DIAMETER___IJEPI'It DISTANCE FROM: WELL TOTAL ErFEcTIVE NEAREST LOT LINE A[~SORPTION AREA (WALL AREA) .SQ. FT. ell lass: Depth: ell Distance To: Lot Line ldg: Sewer Line: ipe Materials: ~f Bedr?o~:_ n~taller. ~t~J.~ emarks: API'IIOV[' D "' '~ DEPHRTM?',IT OF""--k~HLTH HND.ENVI~ONMENTHL · 8Z5 'L' :=,IREEI, HNL:HORHLiE, HK. £.JEI_L FiND Or~--S I 1-E _'--~.E£-~I--2R PERM I/l; '. ~.- -- HHPL1UHNI E~LDEN.,P.EDERSON_ SRfl BOX I?iBX ~5E17 //~44-B638 L OCla~,1 ION 1u4 I Ii~ I { LEGHL LIC Bg FISCHER SUBD LOT SIZE 50000 SQUBRE FEET ]'Y,~E OF SOIL BBSORBTION S¥S]EM IS: 1RENCH MRXID1UP1 NUD1BER OF BEDROOMS SOIL RHTING (SO FT/BR)= 125 IHE REQUIRED SIZE OF 1HE SOIL BBSORPTION SYSIEM IS: DEP-rH= ~ LENBI-H= Z<E: ~RRVP----L DEP]-H---- ~ IHE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. 1HE DEP1H OF R TRENCH OR PIT IS THE DISTBNCE BETWEEN THE SURFRCE OF THE GROUND BND 1HE BOTTOM OF THE EXCHVRTION (IN FEET). 'IHERE IS NO SET WIDI'H FOR TRENCHES. IHE GRBVEL DEPTH IS ]HE MINIMUM DEPTH OF GRBVEL BETWEEN THE OUTFflLL PIPE BND THE BOTIOM OF THE EXCHVRTION (IN FEET). . I~FjL~.I_I I R~--~ SEPI- I C 1-RNK $ I ZE= :l.;ia£aO m.~ FILLI3 r-~_.-Z. PI:ICF(FImT~Z PLRr-II' m_-mpl- I mTN H PHCKHGE PLHNT MHY BE INSTRLLED Rl' 1HE PERMIT1EE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER B CLHSS I OR II NSF HPPROYED PLRNT MRY BE INSTRLLED. 2. H CONTINUOUS MBINIENRNCE HGREEMENT IS REQUIRED. IF H MRINTENRNCE HL~REEMENT IS NOT KEPT CURRENT YOU MRY BE REQUIRED TO ENLBRGE THE SOIL HBSORPIION SYSIEM BND?OR YOU D1FIY BE SUBJECT lO PROSECUTION, -ri-JO ( 2 > I N--'3PI='CI' I ON--~ ~:IRE R~----QU I RED BHCKFILLING OF BNY SYSTEM WITHOUT FINRL INSPECTION 8ND RPPROVRL BY THIS DEPHRID1EN1 HILL BE SUBJECT TO PROSECUTION MINIMUM DISTHNCE BETWEEN R WELL AND ANY ON-SITE SEWRGE DISPOSRL SYSTEM IS tklCl FEET FOR B PRIVRTE WELL OR 2U0 FEET FOR FI PUBLIC WELL. WELL LOGS HRE REQUIRED BND MUST BE RETURNED TO THE DEPBRTMENT HI~HIN 30 DHYS OF IBE WELL COMPLETION. O'IHER REQUIREMENTS ~I~Y BPPL¥. SPECIFICBTIONS BND CONSTRUCTION DIBGRBMS 8RE HVHILMBLE '10 INSURE PROPER INSTHLLRTION. PERM1 T F--XPI RP--$ DEL~ErqBER ~_. '~ --q--?7 I CER11F¥ THHT 1: I HO1 FHMILIHR WI]H THE REQUIREMENTS FOR OH-BIlE SEWERS RND WELLS RS SET FORIH BY THE MUNICIPHLITY OF 8NCHORRGE. 2: I WILL INSIHLL THE SYSTEM IN BCCORDHNCE W1TH THE CODES. ~: ! UNDERSIHND THRF ]HE ON-SITE SEWER SYSTEM ~IHY REQUIRE ENLBRGE~IENT IF THE RES I DENCE :SIGNED:__, ~SLIED B7 V~:. 0 2204 Cleveland ~chorage, Alaska 99503 Lena1 qescrt~tton: Lot~Bloc~ ~ ,Subdivision ~l~c~ ,,. T~is form Renorts Soils Lon ~ Percolation Test_ .neath Feet, . . Sotl Characteristics 8-- ~as Ground ~ater Encountered? l~ Yes, At what Depth? I Readtna Da.%e:. Grnss Time Net Time Depth to H20 Net Dro~ Percolation Rate Ulnute Prnrosed lnsta'11atton: Seenaee Pit Dratn Field , Dee? o(lnlet ~. _ ~. ~¥~Got¥om Of Ptt Or Trench Test Performed By~%/~//~'~/'~ ~-- ~ata Certified 8~0~o~(~ MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~/ 825 L $~. AnchMNe. Atlska egG01 'ML~, ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES IRECTIONS: Compete MI pert; o~ page 1. laeemltle~ e~lUee~ wilt net be prac~eed. P~eIM allow ten (10) days for proce~ing, MAILING AOORE~ PROPERTY RESIDENT (If differem fro~t above) MAILING ADDRESS 4. REALTOR~AGENT MAILING ADDRESS /v // 3. LENDiNO INSTITUTION ,AOORES$ I PHONE PHONE PHONE PHONE PHONE LEOAI. OES , k)N ~REET L~ATION SINGLE FAMILY ~ MULTIPLE FAMILY WATER IU~LY ~ INDIVIDUAL* g PUBLIC UTI LITY S~AGE DIS~L S~EM ~ INDIVIDUA~ON-SITE** ~ PUBLIC UTILITY ,,vltE u EDROOMS  One [~] Four [] Other__ Two I-'1 Five .,.,.,.,.,.,.,.,.,.~ Three [] Six · A'I-I'ACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attac~ log if available.) *'If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCE$SING CAN BE INITIATED. 724)10(3/78) THIS SIDE FOR OFFICIAL USE ONL ..... DATE RECE,VED INSPECTION APPOINTMENTS (~Px, ~ ~L~ tq~:~ TIME TIME TIME DATE DATE DATE ]NSPECTOR I NSPE CTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE r--I OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVIOUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED [] PUBLIC UTI LITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL A~ORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/H°lding Tank IAb~°rPfl°n Are~ IS~r Li~ I Na~t Lot Line Al~orption Are~ to m~re~t Lot Line 5. COMMENTS [] APPROVED FOR BEDROOMS r--I CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78) On-Site Sewer Study by Robert Neale 10/21/74 Owner: Location: Legal: Soil Sample: Pederson Construction, 1801 East 53rd, Anchorage. Spruce Circle and Klinger Lot 3, Block 4, Fisbher Subdivision Varied from 140 to 250 2' 1' to 3' is sand, gravel 4' Conditions: . 6' _- _ _ ,.__, ~) r6 lqo~'Water Table Probl em 1,000 ,gallon septic tank, concrete rings. Appr.6.ved 10/17/74 cm ¢ '?";i '"'/.'I ' ';':"' Well Distance 100' Good Gravel Backfill