HomeMy WebLinkAboutELMORE BLK 2 LT 6?AP-,,C..t~L ~t Olt6_ I"/I- II-
GI~'TER ANCHORAGE AREA BOROI"~
Dtr..rARTMENT OF ENVIRONMENTAL QUALI, ·
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
MAILING
ADDRESS ~~'sl'~/~'~ --z~,.-~'~ ~"~ PHONE
LEGAL DESCRIPIION ~ ~. ~~t~-
DISTANCE PROM WELl
LIQUID CAPACITY
NUMBER OF
MATERIAL ,,~r,,~ -/ COMPARTMENTS
LIQUID
GALLONS. INSIDE LENGTH / INSIDE WIDTH ~ DEPTH.__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS ~ ~DTH
LINING MA~.,.~''~'''- DISTANCE FROM WELl
NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
· LENGTH DEPTH
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
· - . TOTAL LENGTH ,
FOUNDATION , NEAREST LOT LINE e/~) ~'2"*'a'"* ,~OF LINES /"~'~
DISTANCE J~ETWEEN lINES ~ ~' TRENCH WIDTH e~,, -~ / IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE ~ ~ '~"~ !, / ~ ~ ~'
DEPTH OF FILLER MATERIAL BENEATH TILE ~ IN. ABOVE TILE ~ ~'
WELL: (,.,,e~,,~.,~?..J ~
TYPE ~".-~J:,~'--'~"' DEPTH
NEAREST SEPTIC
LOT LINE ~ '~'~ , SEWER LINE. ~,a~ ,~- ., TANK
DISTANCE FROM
BU,LD,NG FOUNDAT,ON
~/,~, SEEPAGE
. SYSTEM
WATER
SAMPLE ~ j NEAREST
o,.ER
cesspool {I//~'~t- , SOUUCE~'
DISTANCES:
DIAGRAM OF SYSTEM
DATE
G.A.A.B.
GreAIEr ANCHORAGE AREA BOROUGH
¥
INSTALLATION OF: SEPTIC TANK ~'
TYPE AND SIZE OF FACILITY TO BE SERVED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY ~=YBT~M WITHOUT FINAL INSPECTION BY THE!
HEALTH DEPARTMENT AUTHORITY V/ILL BE SUBJECT TO PROSEQUTION.
MINIMUM DISTANCES. REQUIREMEN~ DIAGRAM OF ~YST~M
FOUNDATION TO SEEPAGE PIT ~ DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
EEPY,C TANK ~ I ,,~0 t
SEEPAGE PIT DRAIN FIELD
!
5E~ZC TANK. ~ 5EEPAG~ PIT /00 DRAIN FIELD
GRAVEL BACKFI~
DESCRI B~~~~OANCEI CERTIFY TH T I FAMILIAR WITH THEwITHREQUIREMENTSsAiD CODE. OF GREATER/~ANCHORAGE AREA BOROUGH~ORDINANCE~NO. 28-68 AND THAT THE ABOVE
1,
30
4.
$o
7.
8o
9,
XO.
X! 7~, at ~at ~pth
...,MUNICIPALITY OF ANCHORAGE_~
DEPARTMEI 'OF HEALTH AND ENVIRONMENT~ ~, PROTECTION
825-L street, Anchorage, Alaska' 99501/~~;°~
279-2511, ext. 224 or 225
Date Received: June 2~, 1977
~1: Time 11:00 a.m. ~2: Time ~3: Time
Date 6-28-77 Tues Date Date
Insp JKennedy Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request: First Federal Savings and Loan Assoc.
Mailing Address:
2. Property Owner:
Mailing Address:
3. Legal Description:
Post Office Box 4-2200 99509 Phone:
Garner Buchanan Phone:
Star Route A Box 329 99507
274-6561
349-1810
Lot 6 Block 2 Elmore Subdivision
4: Single Family Residence: ~) Number of Bedrooms: three
Multiple Family Residence: ( ) Number of Bedrooms:
Well System:
Permit #
Construction
Individual Well ~) Community/Public System ( )
Depth of Well 101' Well Log on File
Bacterial Analysis
( )
e
Sewage Disposal System: On-site System ~ . Public Utility ( )
*See note on paperwork, have asked to wazve the adequacy test.
Permit # Installed 1972 Installer
This is a refinance.
Septic Tank Size Manufacturer
Absorption Area
Soils Rate
Material
7. Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO
2. Property Owner: Garner Buchanan
RECEIVED
VA FHA CONV ××
Mailing Addrem: SRABox 329, Anchorage. Alaska
3. Name of Buyer: Same as above
Day Phone 349-[810
Mailing Address: N/A Day Phone N/A
4. Name of Lending Institution: First Federal Savin~s and Loan Association of Anchorage
Mailing Address: 1'. O. Box 4-2200, Anchorage, Ak 99509phone 274-6561
5. Name of Realtor or Agent: N/A
Mailing Address: R/A Phone R/A
6. Legal Description: Lot 6. Block 2, Elmore Subdivision
Location: 132 Avenue. Anchorage, Alaska
7. Type of Facility to be inspected:
8. Water Supply Well
Type of Supply:
Single Family No. Bdrms. 3
Public Utility Individual XXX
If Individual, number of dwellings presently sen/ed one
If Individual, depth of well 101'
9. Sewage Disposal System
Type of System: Septic Public Utility Individual (on-site) XXX
If Individual, date of installation 1964 New system installed 1972
You are hereby instructed to waive the adequacy t~st. .ltowever, please note
there is any evidence'of surface seepazg~'~s~,~ck for proper distance
requirements.' ~-~~' ,, ..~
Assistant Secretary
EQ-037 (1/74)
Department of IIeatth and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 6 Block 2 Elmore Subdivision
Comments:
Affadavit Attached: ( )
Letter Attached: ( )
Approved: Date: ~ --
Disapproved: Date:
Department Worksheet: