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HomeMy WebLinkAboutELMORE BLK 1 LT 1 REMsip LI ~UNICIPALITY OF ANCHORAGE tlea!' h and Envzronmental Protec: ,n Fourth Floor West · 825 L Street 3mchorage, Alaska 99501 264-4720 SEPTIC T A l~Jl'(: . DISTANCE ~ FROM y,'r' LL,~~''- MANUFACTURER INSIDE LENGTN ~ INSIDE WlDTtt NUMBER OF g M%~__.~_ f'F._ M A T E R i AL __~"¥~E 0---~. COMPARTMENTS ~ LIQUID DEPTH LIQUID CAPACITY ALLON.~ iOF L,NE DISTANCE FROM WELL (..~___~ { ,FOUNDATION ~ ~ NEAREST LOT LINE~ r TOTAL LENGm '~ of Lines / . OISTANCE BETWEEN UNES ~[~' ,R~NCH WIDTH Y~. TOTAL EFFECTIVE ABSORPTION AREA ~ ~ SQ. FT. LEITH OF EACti LINE ~t~ / b t/ DEPTII Or FILTER ~ OEPTIh TOP OF TILE TO FINISII GRADE ( ~ -MATERIAL BENEATH ~ILE IN. ABOVE IILE IN. SEEPAGE PIT: DIAMETER , OR WIDTH ,.. lENGTH ., DEPTH Log Crib. Rings Crib si e:, DIAMETER~DEPTH . DISTANCE FROM: WELL .. -- TOTAL EFFECTIVE BUILDING FOUNDATION .., NEAREST LOT LINE ABSORPTION AREA (WALL AREA). SQ, FT. Well Clas S: ~ i~;~D~pt h: Well Distance TO. Lot Line Bldg: Sewer Line: Pipe Materials: # of Bedrooms: Installer: Remarks: O^TE/ 'W'77. ^.PROVED NAME OF APPLICANT fl(~'/~ ,~ INSTALLATION LOCATION ~-"~ INSTAL~TION OF: legit TANK TELEP.O.E ".,-.S, / SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT / / FINANCED THROUGH DRAIN FIELD ~ OTHER COMPLETION DATE ANTICIPATED FINAL INSPECTION: Z4 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL DE SUBJECT TO PROSECUTION. SEPTIC TANK SEEPAGE PIT DRAIN FIELD /~ DRAIN FIELD WELL TO SEPTIC TANK ~'~)~'"' ~'~ OJ'~U;A"~'$EEPAGE PIT DRAIN FIELD /OOe SEEPAGE AREA SIZE ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK. (O,;'~ I SEEPAGE PIT DRAIN FIELD 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEl. BACKFILL. CONFORM TO I~OROUGN REGULATIONS REGARDING It~tJ-LATION* TYPE DIAGRAM OF SYSTrM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENT DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. 28-68 AND THAT THE ABOVE GAF Y' PLAYER' VENTURES CONSULTING GEOLOGIST sox 476-M, STAR ROUTE A · ANCHORAGE, ALASKA 99507 · PHONE~ 344-7071 SOILS LOG Soil Type Water Level ~emarks 0 2 4 6 8 12 14 16 18 20 Total Depth of Excavation }[aterial at Total Depth Groundwater Bedrock ( ) Not Reached Depth, if Reached. ~Not Reached Depth, if Reached Classification tie thod ~Visual ( )' Sieve Analysis () Gary F. Player, Consulting Geologist MUNICIPALITY OF ANCHORAGE DMSION OF 55'v/~ HEALTH (a) [~Gg_l.Pescripticn (include. lot, bl~ock, sub~ivisicn, secticn, tcwnship, range) ~_~C~O~_ Subd;o,${o~/Lo+ I /Slock [ Te:epnone BqS- 5& 83- Te le phone Address (e) P~al Estate Co. & AGent Add=ess Te le phone 2. Type. of ~siden~ Single-Family ~ Number of Bedro~s Multi-Family ~'~ Other (describe) 3. t~hter Supply .: Individual W~ 11 .~. Community ~-~ Public ~-~ Note: If ~,,~nity ~11 ~tem, ~st ~ ~it~n ~ti~ ~ ~ State ~nt ~ ~vi~ntal ~r~tton attestirg to ~ ~gality ~d s~tu~. Is ~ ~11 ~a~ f~ ~ ~r of ~ ~cified in ~ts ~ ~) 4. ~ Dis~al " ~i~ ~ ~blic ~ ~ntty ~ ~ldi~ Ta~k ~ [Pa~ 1 of 2] 2-15-84 Engineering Firm Providirg Inspecticns~ Tests, Data and Inf~uaticn I ~tify that I have checked, ~rified, c~ confc~,,ed to all M~A HAA Guidelines in effect on the date of this ie.-~pection. ? ! 6. Di{EP .Apprcval Appro%~d fo~ (ENGINEER SEAL) The Municipality of Anchorage Department of Health a~d Envirorm~ntal Protection dce$ not Guarantee the continued sstisfact__~ry ~erfc~manoe cf t]~ water supply and/(r the. wastswate= dis~sal system. .'his app~oval ir~icate$ that, as of the validati¢~, date shcwn abo%~, based on the data arJ~ ir~c~nation furnished by an engineer registered in the State ~f Alaska, the ~te= supply and wastewater disposal system is safe and func- ticeml fc~ the rnmber of b~drc~ms and type of structure indicated. (u P SZAL) 7. Mail the }{~% to the following address: KS2/d5/ [Page 2 of 2] ; / / / 2-15-84 To ,l)ui!ding Foun~ation ~,~.~' TO Disposal Field o--J:5-' ~' To Stz~,'% Po~, Lake, ~r Major ~ainaGs Separation Distances fz~n'S~tic/Tk)ldin~ Tank= '~ ~~ly ~11 ~9,// ~ ~ ~rty ~ '~3~' ~ ~r ~i~i~ ~ ~/~ [Pag~'l of 2] ~ ". . . . 2-15-84' .- ,C. AI~OP~I'/ON I~ELD ~TA " Type Of S~tem ~esigu D. L~FT STATION .Date Installed" Sl~e' in Gallons ' ' "Pump On" Level at High Water. Alarm Level at Testmd fo= Electrical Codes(Y/N) · Manhole/Access "Pump Off" 'Level at Vent (Y/N)-- Date Installed /O/K'/77' Length cf Field ~/ Width of Field ~. Depth of Field '.:-' ~ .... · . . Gravel Bed Thick~ess squ~ Mt of ~=.ti~'~ea' ~O--~~ · D~p=essio~ over Field Date of Last Adequacy Test $/~-/~/ Separation Distanc~ f~cn A~sc~ticn Field: ' ' .' '~o Water-Supply Well . /.)~/ ..... T~ Pr°~erty Line To Building Foundatio~ ~,// "To EXisting ~ Abandoned System cn -. ' ~;~ ', On Adjoining Lo~s To Water Main/Service Line 'A'~,4- To Cutbari(if present) TO Stream/Pond/Lake/ct Ma]ct Ikaina~e Coars~ A31,~, .. ...' :~,.~ -. . , . , . · )j ALASKA b lUIROIllllfllTAL COI1TROL S RUIC $, [.qin~rJnq ~, J~nuironmen)o) Sm~Jies IllC. I~d~CH 9 1984 ELLEN & JOE PITTMAN SPA BOX 305 ANCHOPAGE AK 99507 SELLER - ELLEN & JOE PITTMAN BUYER - SUBDIVISION - ELMORE BLOCK - 1 LOT - 1 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 255 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM ROME. THE SEPTIC TANK WAS PUMPE T 1 . FLOW TEST ON WELL THE WELL FLOW RATE WA~ FOR 5 ROURZ~"xX'~S. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250~ ADEQUATE FOR THIS 4 BEDROOM ROUSE. [;,..f,.i :.,~'..,, ........ ~....~. -~- %'. ~m.. 1200 L~¢$t 33rc) Aucnu¢. $ui1¢ ~ o Anchoraqe. Abb 99503,(907) 561-5040 3ATE RECEIVED 71ME TIME TI DATE OA~E DATE MUNICIPALITY OF ANCHORAGE ~.,.~., r~,.~. ;, CT~ION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC~  825 L Strut · Anchora~. Al~a ~1 FEB 1 9 1981 ~ ENVIRONmENTaL SANI?~TION DIVISION RECEIVED ~EOgEST FO~ APPROVAL OF INDIVIDUAL. WATE~ AND SEWE~ FAOILITIES 1. PROPERTY OWNER ' PHONE MAILING 2. BUYE~ ~ PHONE MAILING ADDRESS 3. LENDING INSTITUTION ~ PHONE MAILING ADDRESS 4. REALTORIAGEN~ PHONE MAILING 5. LEGAL DESCRIPTION X. G ,El, £1,,.~,,~-~ S~b . STREET LOCATION ' 6. TYPE OF RESIDENCE NUMBER OF~BEOROOMS r"l One [] Four [] Other~ [~1 SINGLE FAMILY [] Two I--1 Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER SUPPLY t [~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ' r-I COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) ~ ~E:^GB DIS"OSAL SYSTEM . ' ~ INDIVIDUAL/ON-SITE*' /~"~.~7 YEAR ON-SITE SYSTEM WAS INSTALLED. I--I PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. (e, / 7 THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [--I SINGLE FAMILY ~] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or []Holding Tank Size: I~ ~ If Tank ishomemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELLTO: Absorption Area to nearest Lot Line PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING MANUFACTURER MATERIAL ~eptic/Holding Tank IAbsorption Area Sever Line JNearest Lo! Line 5. COMMENTS DATE {~'~APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] ' DISAPPROVED ' ~ 72-010 (Rev. 6/79) Date Tuesday ~--~MUNICIPALITY OF ANCHORAG~--% ' DEFARTME. ~OF HEALTH AND ENV[RONMEN ...] PROTECTION 825 L Street, Anchorage, Alaska 99501' 279-2511, ext. 224 or 225 Date Receivdd: August 22, 1977 #3: Time Date Insp~L[~ Time Date FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES National Bank of Alaska,i Att'n: MYrta 279~506 344-7217 1. Len~ing Institution Request: ~ M~ilin~ Ad. ess: P.0. BOX 3-3859 ~ Norman Schmtdt ~,' P~operty Owner: :', '- ' 824 "C" Street · Nailing A~ress: 99509 Lot 1 Block 1 Elmore Subdivision Legal Description: Phone: Phone: 41 Single Family Residence: (X) Number of Dedrooms: 3 Multiple. Family Residence: ( ) Number of Dedrooms: 5. Well,Syste~: Permit # Constructi'ox~ 6,;' Sewage Dis~sal System: On-site System (X) Permit $ Installed %~ Septic Tank Size Absorption Area Individual well (X) Co~munity/P,ublic System ( ) Depth of Well -. ~':ell Log on File Bacterial ?knalysis () Public utility Installer Manufacturer Soils Rate Material Distances: Well to Septic Tank tO Absorption Area to,Sewer Line Nearest Lot line Absorption Area to,Nearest Lot Line .,A.. ~ Department of Health and Envzronmental Protectzon.f'.~,, '~ ~ -53 77 .:~; ?/~%% : . 825 L Street, ~chorage, Alaska'~'~9~.:,; .,~ . 'D ~ , ~; '~~~~q 279-2511, ext. 224, 225 I~.h~:~,,,ri~-,,,. ,~P' ..... .rC~ 'ue;t for Approval of Individual Sewer and Wat~~zes ,'.. ,,, ~ , · )Pr~per~y -"Owner: Address : :) 6 '47. Phone: Maxllng Address. 'Len~ding Institution: Mailing Address: Realtor/Agent '. ~--~ 'Mailihg Address: egal eso iption.' Street Location: Phone: ~Single Family Residence: ,~ Number of Bedrooms: I, 'Multiple Family Residence: ( ) Number 6f,Bedrooms: IWater Supply: *I~dividual Nell I.If Individual Well, well depth Public/Community System ( ) ' Public System Jif Co'unity System, name of system ,Sewage' Disposal System: On-site ~ystem ~If On-site System, date of installation: *NOTE: A Well log is required on ALL wells drilled since 6/75. · Pa~gq· ,~'°~-,~· Department of I[ealth and Environmental Protection ,Request for Approval of Individual Sewer and Water Facilities Legal Description: Comments: Affadavit Attached:..~) Disapproved: Letter Attached: Date: Date: Department Worksheet Municipality O CH,-,50 ANCHORAGE, ALASKA 99502 O~ (907) 279-2511 Anchorage DEPARTM£NTOFH[ALTHAND~:NVIRONMENTAL~ROT CT ~ '[ 2',';,.'" August 31, 1977 Norman-Schmidt 824 C Street Anchorage, Alaska 99503 Subject Lot i Block 1 Eimore Dear Mr. Schmidt: The perc test run on .the seepage pit failed to pass the adequacy test. An upgrade of your sewer.system will be needed before approval can be sent to the lending agency. Before any construction begins a permit must be obtained from this office. A soils test must be submitted before the permit can be issued. If there are any further questions, please contact this office at 264-4720. Sincerely,~ Sanitarian ~cP/ljn August 24, 1977 ~orman $cb~!dt 024 C Street Anchorage, Alaska 99503 SubJectz Lot i Block I ~m~-ee Subdivision Dear }Er. Schmidt= Before this department can send an approval to the lending agency, several items will need to be accomplished: {1) A percolati~n test must be run to doternine the adequacy of the existing system, see enclosed handout. {2) If there is a tank it must be uncovered to varify its existance and pumped to verify its size. A standpipe must be installed to the tank. The well construction is approved. If there are any further questions, please contact this office at 279-2511, extension 214 or 225. Sincerely, P~bert C. Pratt, R.$. Sanitarian CCl .}lational Bank of Alaska Post Office B~x 3-3859 99509 5. Water Analysis: e REQUEST FOR APPROVAL Or INDIVIDUAL SEWAGE AND WATER FACILI~'IES (Pill out in Triplicate) description ~t. l I/9 DP, ~,~V~' ~, a. Bacterial ~'~-~7,__ · b. Detergent' ~'// . Well data: 6/ a. ype ~__.~_2~~' c. Casing Size d. Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank 3. Seepage Area 5. P~operty Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainaffe ditch, etc. . Sewage disposal system. a. Age of system o9 9~3 ._. b. Septic tank capacity in gallons, c. ~ame of septic ta~k manufacturer 1. If "home made" show diagram on reverse aide of this fox... Di.posal field or seepage pit size and type. ~ O' k~[~ ~ C~'//~ ~ 1. Distance to property line ~0' to house foundat~ ~1 · e. ?ercolatlon Test r~sults f. Percolation Test performed by Use the reverse side of this form to show dia£ram. Diagram should include the followtnZ ln£ormation: ~rop~rty lines;.well location, house locatlon, septic tank locatlon, disposal area location, location of percolation test, and'direction of Fround alope. The information on this form is true and correct to the best of my knowledge. $iEna~t~f Applicant ~ ed TO BE FILLED OUT BY HEALTH DEPART~ENT PERSONNEL T%e above described sanitary facilities are hereby approved, sub~eot to the .... ~611owtn? conditions: Conditions: ~The above described sanitary [actlities are dlsepprovod for the following reasons: /g.~.~z-~-~ / .th../~' -/~/,,'-. '~'~".,'.~*- ~.~.',7~.~ Approval is valid for one year followlnt the date of approval. CPJ:cw