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Home My WebLink AboutDAV-DOR LT 5FHONE~ DATE_.~__~~ SEPTIC TANK CESSPOOL HOURLY RATE ~,~GRF~TER ANCHORAGE AREA BO'-')~UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~'~/"v-f'~',"',~/' (~AJST*~'.. MAILING ADDRESS /'~/ ~,~ PHONE LOCATION //~P~S~ ~,~'~¢ /~:<'r~t~ LEGAL DESCRIPTION /e~ ~V-- ~C~ SEPTIC TANK: DISTANCE P~'("I'O 5~= ~ FROM WELL IC'~ INSIDE LENGTH NUMBER OF MANUFACTURER ("~LC~"~--"--'¥'~''j'' MATERIAL'~(/~ /~'~/ COMPARTMENTS / INSIDE WIDTH ~ LIQUID DEPTH ~ LIQUID CAPACITY ~c''~'/) GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER ~-' OR WIDTH /'~ , LENGTH/~ , DEFrTH ('~ ! LINING MATERIAL /~"~)) CRIB SIZE: DiAMETER~,J,DEPTH ~ I DISTANCE FROM: f TOTAL EFFECTIVE BUILDING FOUNDATIO"~'-~(~ , ADDITIONAL ABSORPTION NEAREST LOT LINE WELL P'~'. '~ ABSORPT,ON AREA (WALL AREA) .~ 3t. SQ... TYPE II~I')tV~ CONSTRUCTION__DEPTH BUILDING NEAREST NEAREST FOUNDATION- LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM . DISTANCES: INSTALLED PIPE MATERIAL: LOT SLOPE: REMARKS: Form NO. ED-D31 DIAGRAM OF SYSTEM GrEATEr ANCHORAGE Area BoROugH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PHONE DRAIN FIELD ~ o OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY HOT VALID ITHOUT ~OIL 'r~ST COMPL~,O. D^TS ^.TICIP^TEO / q 7~/ FINAL INSPECTION: 24 HOUR ~OTICE REQUIRED. ~ACKFILLING OF ANY SYSTE~ WITHOUT FINA~ INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILE BE SUBJECT TO PROSECUTION. WELL TO SEPTIC TANK DRAIN FIELD //~ ~ / DRAIN FIELD SEEPAGS PIT / ~ TYPE DIAGRAM OF SYSTEM SEEPAGE PiT /,~d/ · DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2EI.68 AND THAT THE ABOVE DESCRIBED SYSTEM I$ IN ACCORDANCE WITH SAID CODE. DATE q--/(/' 7~ APPLICANT'S 'IGNATURE , '1' ' : l]I : : . ' : l' -:.'-lOT -q' ". .... l · :i:!. ~; , -~~~.2._. :-"-.~_ ... ~ q .... ... ~ r~ :' ::'::~:'+,:~ ....-.-- .;,.. ~..,._,.,.., ..... ...... ,..,..,. ~' . 9.::' '.; .... ~" .... '~: .I.'~ '.~'.. · . ','. , .. '" ' ....'.-.".' ,..,:..,.' .,.-'/t., ~..~ · .. ~.:.-'......' .-.'....'... '... ....~ 0~' __ .,..,. ~~-, Well Owner DEPT. OF H~.ALTH & P. O. Box 4-].224 · ].310C International Airpi~IVJ~ENTAL PROlI'C~C~ (907) 274-461 ! ANCHORAGE, ALASKA 99509 APR 8 986 RFCEIVED Use of We~ Location (address of: Township, Range, Section, if known; or distance main road S~ze of casing Depth of Hole Static water level ~ ~ ft. '(above) Screen ( ); Perforated ( Describe screen or perforation Well pumping test at "' gallons per of drawdown from static level. Date of completion ~.~ ~"" - feet Cased to -"0 feet (below) land surface. Finish of well (check one) open end ( ;~. ); ). 2-.'c nc (minute) for " houm with "~'~"~ fL WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness .'TO. - -~ .TO. 28 2= x'O. 40 40 .TO 41 .TO. TO TO TO TO TO TO .TO ~TO .TO TO. ¢¢ 1 .~-? C! .-.." :L s- - 5-0 C, 3--CONTRACTOR ,.~ ' ~ DAT~ RECEIVED -; INSPECTION APPOINTMENTS ~-IME TIME TIME MUNICIPALITY OF ANCHORAGE...,,.~u'~'DEpT--'~'~ 'OF- I ~AL~IF,~T~jON & ' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~O~A[;~T'~& ~25LStr.-An~o,~,AI~,~' APR 3 1980 ENVIRONMENTAL SANITATION DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES Gary B./Yvette ]{amiltonJ 349-1179 ~AILING ADDRESS Star Route A Blox 1789-H 99507 PROPERTY RESIDENT Jif different Irom ahoy) PHONE 2. BUYER PHONE Craig W./Sylvia I Berndit 349-4096 ~AILING ADDRESS 2601 Solomon Avenue ~35C 99507 National Bank of AlaskaI 276-1132 Pouch 7-025 99510 4. ~EALTO~/AG~NT J PHONE Mary ~n Dodge % C21 Sleeper Inc.I 344-2501 ~050 Old Seward Hi~hwa7 5. LEGAL DESCRIPTION Lot 5 Da~'-Dor Subdivision TREET LOCATION Hendrickson Circle 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS r-I One [] Four I-1 Other ~: SINGLE FAMILY :~ Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY gg<: INDIVIDUAL· [] COMMUNITY [] PUBLIC UTILITY · ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SL=WAGE DISPOSAL SYSTEM Z~[~X INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. · . THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS -~ SINGLE FAMILY ~ ONE [] THREE [] FIVE f--I OTHER [] MULTIPLE FAMILY I-'] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER ~ INDIVIDUAL DEPTH OF WELL I-'1 COMMUNITY DATE DRILLED I--'1 PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER 1~] INDIVIDUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER ~E[]Septic Tank or I--'lHolding Tank ~- (~ t~, ~ ~ ~' Size: ~(~)(~ If Tank is homemade SOILS RATING ' give dimensions: t [~ ~ TOTAL ABSORPTION AREA MATERI,~ 4. DISTANCES ~; Septic Hold~ng Tank r Absorplion Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompve~y certificate) [] DISAPPROVED 72.010(Rev. 6/?9) April 23, 1980 R&MNo. 051001-23 iSAACS PUI~IPING SERVICE (Norm Tibbetts, Owner) 6218 Quinhagak Street ANCHORAGE. ALASKA 99507 S T A T ,E~I~,E N T Phone 344-0114 ~bdivi- in the ;er the lropped :e rate Dn the ISAACS PUMPING SERVICE ,- . ' DATleI 'iNVl~lCte NUMBER/DESCRIPTION IcHA~G[S I c,~,.. I .~,c; o. ~h~ '' ~ it was ~NCE FORWARD quid unicipalitYof Anchor ¢ 825 "L' STREET ANCHORAGE, ALASKA 99501 GEORGE M. SULLIVAN, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION April 14, 1980 Gary B./Yvette Hamilton Star Route A Box 1789-H Anchorage, Alaska 99507 Subject: Lot 5 Day-Dot Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: (1) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. (2) Expose the standpipe to the seepage pit for our inspection. This is %o insure the minimum distance requirements are met between your well and sewer system. (3) The septic tank pumped with a receipt submitted to this office. (4) An adequacy test be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: National Bank of Alaska MUNICiPALItY O~ /~NCHORAGE Depart ,m~t of tlealth and Environme~al Protection · 82. L Street, Anchorage, Al' ka 99501 2 6 4 - 4 7 2 0 ~UNICIPALITY OF ANCHORAGE DEPT. OF I!~ALT?i & ]uest for Approval of Individual Sewer a~w~AFaCl~.[ecNies APR S~ Box 1789-ll ; Mailing Address= 000 liendr~ckson C~rale~ n~hora~e~ - '2. Name of Buyer: Cra~ W. & Sylvia I. Berndt Mailing Address: 2601 Solomon Avenue ~35C, Anchora~,e, AK Phone: 349-&096 Lending Institution: National Bank of Alaska Mailing Address: Pouch 7-025t AnchoraKe, AK 99510 Phone: 276-1132 Se Realtor/Agent: ¢21 Sleeper Inc. - Mary Ann DodBe Mailing Address: 8050 Old Seward ~{~, Anehora~e~ AK 995 Phone: 3&6-2501 O2 Legal Description: Lot 5 Da~-Dor Subdtv~s~on Street Location: llendr~ekson C~rcle, Anchorage, Alaska Single Family Residence: (x~ Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: e Water Supply: *Individual ~,lell ~ If Individual Well, well depth If Community System, name of system Public/Community System ( ) Sewage Disposal System: *~)n-site System ~ Public System If On-site System, date of installation~//~g d;~/~,w ***PLEASE CALLMARY ANN DODGE AT 344-2501 or 349-4057 (home) ~IEN IT'S READY TO GO TO ~M LAB, ~udq~s *** *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 April 23, 1980 ~'~ ~'~ Century. 21 Page ~2- system can be expected to be 300 gallons per day. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 2 bedroom residence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions regarding this letter or if we can be of additional service to you. Very truly yours, Rtd'tCONSULTANTS, INC. Ernest R. Rahaim Staff Geologist JC:ERR/dj/AT&SI-F Janice Cecere Project Hanager