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