HomeMy WebLinkAboutELMORE #1 BLK 3 LT 5Onsite File
Elmore #1
Block 3
Lot 5
#018-171-31
Municipality of Anchorage
On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201432 PID Number: 018-171-31
Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade
Name
JOHN STURGEON
ABSORPTION FIELD
❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
❑ Other
Site Address
4450 SHOSHONI AVENUE 'ANCHORAGE, AK 99516
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
907-230-0072
3
1.2 GPD/SF
0.5 & 0.5 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
SEE DWG. FL
Gravel depth beneath pipe
0.5 & 0.5 Ft.
Subdivision Block Lot
ELMORE #1; BLOCK 3, LOT 5
Fill added above original grade
SEE DWG. Ft.
Gravel length
40 & 40 (80) Ft.
Township Range Section
Gravel width
5 & 5 Ft.
Beds: Number of Lines
-
Distance between lines
- Ft.
SEPARATION
DISTANCES
To
From
Septic
Tank
Absorption
Field
Lift Station
Holding
Tank
Sewer
Line
Total absorption area
400+ Ftz
Number of trenches
2
Dist. between trenches
6+ Ft.
Well
100'+
100'+
-
-
25'+
TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer Capacity
ANCHORAGE TANK 1500 Gal.
Surface Water
100,+
1 00'-I-
_
_
Material
Number of compartments
Lot Line
5'+
10'+
-
-
NA
HDPE
2
Foundation-
10'+
_
-
LIFT STATION
Manufacturer
Capacity
Remarks PER THE CONTRACTOR OLD TANK WAS DECOMMISSIONED PER UPC
Gal.
Alarm location
Electrical installed by
Installer
WILCO EXCAVATION
PIPE MATERIAL House to tank D3034 drainfield Tank to
D3034
Drainfield D3034 CO/MT D3034
Inspector GEG AND TIM ECKLUND
BENCH MARK (Assumed elevation) 99.95 ft
Inspdecct sn 1st 6/11/21 2"d 6/11/21
3rd 6/11/21 4'h 6/11/21
Location and description
TOP OF MH 1
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
yS�t Engineer's P
Conditional Approval: Date
Do �(%• "' 5���
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9�Q
Septic System
Approved Date j to a02
Note: this approval does not include well permit requirements.uAEcceao�000��'0
tKev uaiu[iiu)
PERMIT -NUMBER: RECORD DRAWING PARCEL NUMBER:
OSP201432 018-177 1-31
2"
GEG T.H.#1
2" INSULATION
TOP OF TANK AT INTLET = 97.43
INVERT OF BUNG AT INLET = 96.72
TOP OF MH = 99.95
/-- FINAL GRADE = 99.2-99.6
NEW 1500 GALLON
H.D.P.E. GREER
SEPTIC TANK RATED
FOR 10' BURIAL
LOWER
FINAL GRADE = 98.6-99.3
MT CO
FILTER FABRIC
�HORIGINAL ILL
OP OF SAND GRADE 94.81
TOP OF TANK AT OUTLET = 97.40
INVERT OF BUNG AT OUTLET = 96.54
NO GROUNDWATER IN TANK HOLE
DURING INSTALLATION
FINAL GRADE = 98.4-98.9
2" INSULATION UPPER FILTER FABRIC
MT CO ORIGINAL GRADE AT
HIGHEST POINT = 95.81 GEG T.H.#1
i ,TOP OF SAND = 95.31
'- 5'�� "' �""'` �- INVERT OF PIPE = 95.31
�^
BOTTOM OF EXCAVATION = 93.81
6'+
INVERT OF PIPE = 95.81
• BOTTOM OF EXCAVATION = 94.31
RELATIVE ELEVATION OF BOTTOM OF T.H. = 79.81
GW AT 6.2' BELOW GRADE ON 6/10/21 —�
ON 6/1/2021 GROUNDWATER WAS FOUND AT
RELATIVE ELEVATION OF BOTTOM OF T.H. = 79.31 5.6 FEET BELOW GRADE AND A CHANGE
GW AT 6.2' BELOW GRADE ON 6/10/21 ORDER WAS ISSUED BY THE MOA.
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ENGINEERING -SALES CONSULTING .��.
3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507' PHONE (907)337-6179 ' FAX (907)338-3246 WEBSITE: www.gamessengmeam�g.com ......... .........
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: o •' .J rey A. ••eS8 45 w
JOHN STURGEON 907-230-0072 3 OF 3 0j�i' E-795 '�_�
aAV
LEGAL DESCRIPTION: DRAWN BY:
ELMORE #1; BLOCK 3, LOT 5 D.J.G. �j�FO........., ��
TYPE OF WORK: DATE: LICENSE 44, 9` i;`S� •
SEPTIC SYSTEM PROFILE 7/15/2021 #AECC884 i
PERMIT NUMBER: PARCEL ID NUMBER:
OSP201432 RECORD DRAWING 018-171-31
SWING TIE MEASUREMENTS
DERIVED FROM AS -BUILT SURVEY
I
If
_j NEW
SHOSHONI AVENUE
NEW 1500 GALLON HDPE GREER TANK
03 --------
S 3
Gp EXE
Om vious k
5EDF,o
DBL16 e Hi ------0 0 -
T2 7,
(1
•
4.
OLD TRENCH
ABANDONED IN PLACE
700
00,4�
7-
- - - - - - - - - - - - - 1- - - - - - - - -/,�T
I ELMORE #1; BLOCK 3, LOT 141
ENGINEERING - SALES - CONSULTING
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3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507 - PHONE (907) 3378179 - FAX (907) 33&3246' WEBSIE: —g—wengneedng,com
PREPARED FOR:
PH ONENUM BER:
PAGE NUMBER:
JOHN STURGEON 7
907-230-0072
2 OF 3
LEGAL DESCRIPTION:
DRAWN BY:
ELMORE #1; BLOCK 3, LOT 5
D.J.G.
TYPE OF WORK:
DATE:
k, SEPTIC TANK AND DRIANFIELD RECORD DRAWINGS
10/26/2021
SCALE:
1"=40'
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SHANE A. HOLT A �O AS -BUILT SURVEY V, =30,
V a LS -8914 y` 4
�4�4prDrBdSiOrtg� �o� NO CORNERS SET THIS DATE
❑®���CjQQ� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
10 5, &OCK3, ELM0RFSUR A00N 1
THE INFORNAIION HfRLON i5 FOk lHE LISE OF LENDING 1NSTIIUIIDNS SPECIFI[ALLY TO SHOW ANT ANCkHPRAGE RECORDINC DISTRICT, ALASKA, AND THAT THE
CONFLICTS 9ETWEEN EXISTING SiROCTURES AH➢ PLATTE❑ LD1 L1NES AHDIOR EASEMENTS; AND I5 VISTECE IMPROVEMENTS SITUATE THEREON ARE WITHIN
ROT TO 8E U5ED FOR PDS ITIOxING ADDITIONAL STRULTORES, IMPROVEMENTS, DH FEN+: ELI RE S. THE PRO PERTY CINES AND ND VISIBLE ENCROACHMENTS
EASEHEXTS DF RECORD, OR ANY LEGAL ERT ITT, ❑THER THAN THOSE APPEARING ON THE RECORD PLAT EXIST OTHER THAN NOTED.
ARE ND7 SHOYN Hf REDNI UNLE55 IXOF[AT EU] DATED AT ANCHORAGE,ALASKA THIS 25 r DAY OF
NOTE: FERC ELINES THAI KAT APPEAR ON THIS DRAWING ARE ROT rO BE USED IO DEtERMHE OCTOBER , 2025
PROPERTY Li NES OR PDSIrI0a ADDITIONAL IMPROVEMENTS.
ANT PAVING SHOWN HEREON MAY BE APPHOX IMATE DUE TO EXCESSIVE SN6W ANDIOR ICE.
HOLT LAND SURVEYING
THE SLIRVEYDA TA UN V ft'ORA 8ff IVA[I 114R4.FARE'PfWri hilff *r(p NEH L.YHxlkAOCl1TXVZ MY 9399 GROVER DRIVE
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RNCHDRAGE,AK 99567
14774 FBI06-Ibi218• 6 345-5513
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SHANE A. HOLT A �O AS -BUILT SURVEY V, =30,
V a LS -8914 y` 4
�4�4prDrBdSiOrtg� �o� NO CORNERS SET THIS DATE
❑®���CjQQ� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
10 5, &OCK3, ELM0RFSUR A00N 1
THE INFORNAIION HfRLON i5 FOk lHE LISE OF LENDING 1NSTIIUIIDNS SPECIFI[ALLY TO SHOW ANT ANCkHPRAGE RECORDINC DISTRICT, ALASKA, AND THAT THE
CONFLICTS 9ETWEEN EXISTING SiROCTURES AH➢ PLATTE❑ LD1 L1NES AHDIOR EASEMENTS; AND I5 VISTECE IMPROVEMENTS SITUATE THEREON ARE WITHIN
ROT TO 8E U5ED FOR PDS ITIOxING ADDITIONAL STRULTORES, IMPROVEMENTS, DH FEN+: ELI RE S. THE PRO PERTY CINES AND ND VISIBLE ENCROACHMENTS
EASEHEXTS DF RECORD, OR ANY LEGAL ERT ITT, ❑THER THAN THOSE APPEARING ON THE RECORD PLAT EXIST OTHER THAN NOTED.
ARE ND7 SHOYN Hf REDNI UNLE55 IXOF[AT EU] DATED AT ANCHORAGE,ALASKA THIS 25 r DAY OF
NOTE: FERC ELINES THAI KAT APPEAR ON THIS DRAWING ARE ROT rO BE USED IO DEtERMHE OCTOBER , 2025
PROPERTY Li NES OR PDSIrI0a ADDITIONAL IMPROVEMENTS.
ANT PAVING SHOWN HEREON MAY BE APPHOX IMATE DUE TO EXCESSIVE SN6W ANDIOR ICE.
HOLT LAND SURVEYING
THE SLIRVEYDA TA UN V ft'ORA 8ff IVA[I 114R4.FARE'PfWri hilff *r(p NEH L.YHxlkAOCl1TXVZ MY 9399 GROVER DRIVE
ANY CLWYIN[z e�4 i+7q (ZW(. 111E Lid IA lIEA'EC"EV❑-i'AY?FIdN1CC>!yy(yH {;CN+Y.4R;fIT LAIN
RNCHDRAGE,AK 99567
14774 FBI06-Ibi218• 6 345-5513
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
POBox 198OoO 47noElmore Road
Anchorage, Alaska gSs19-G85o Phone: cw Fax: (907) 343-7997
xxp:xmw=.mun|.nrgmnoxe
On -Site Wastewater Disposal SystemPermit
Permit Number: OSP201432
Work Type: Septic Upgrade
Tax Code Number: 01817131000
Site Legal Address: ELK4DRE#1BLK 3 L 5 E):3038
She Mailing Address: 445OSHOSHDN|AVE, Anchorage
Owner: STURGEON JOHN L&CINDY B
Design Engineer: GARNESSENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
102OC2O2O
102D/2O21
0Disposal Field 0Septic Tank [] Holding Tank. [] Privy [] Private Well [] Water Storage
All construction shall bainaccordance with:
1 The attached approved design.
2. All requirements specified inAnchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (1GAAC72)and Drinking Water Regulations (18AAC8O)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 1S.8G,Provide nohficationbycalling (QU7)343-7SD4(24/7).
4. From October 15 to April 15, a subsurface soil absorption uyahom under construction during freezing weather
shall beeither:
a. Opened and Closed onthe same day, or
b. Covered, sealed, and heated boprevent freezing
�
Y-9-A,�^`q�"
'�
Received
Issued By: Lf 10"o
4,17-j -,� 021
Date: 6 / —)— ),.)— /
Date: 0 b C) cl'� 0
3
F
Municipality of Anchorage
P.O. Box 196650 ® 4700 Elmore Road
Anchorage, Alaska 99519-6650 a (907) 343-7904 m Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Section
�)C�181'Cllll•Il!
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV201072 COSA#: Permit#:OSP201432
PID#: 018-171-31
Legal Description: Elmore #1 Block 3 Lot 5
Engineer: Garness Engineering Group
Applicant: John & CindV Sturgeon
Your request for a waiver of the required 16.0 feet horizontal separation from the proposed
absorption field to the existing absorption field has been approved. The approved separation
distance is 10.0 feet. See engineer's waiver request for justifications.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
............................................... ■ ...... 0 N t ... t t ...... 0 N a N M M ... ■ C
Waiver is Granted: X Waiver is not Granted:
Date: 1 0 .24 a 02 U Approved by:
Name of Reviewer
J C EMAIVE R REVIEW ****
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Ethan Berkowitz
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 018-171-31
Property owner(s) JOHN STURGEON
Mailing address 4450 SHOSHONI AVENUE *ANCHORAGE, AK 99516
Site address 4450 SHOSHONI AVENUE 'ANCHORAGE, AK 99516
Legal description (Sub'd, Block & Lot ) ELMORE #1; BLOCK 3, LOT 5
Legal description (Township, Section & Range)
Lot Size
APPLICATION IS FOR:
(® all that apply)
Absorption Field
Septic Tank
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Day phone 907-230-0072
Sq. Ft. Number of Bedrooms 3
APPLICATION IS AN:
Initial ❑
Upgrade
Renewal ❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
DRAINFIELD TO DRAINFIELD
TYPE OF DEWELLING:
Single Family (SF)
(w/wo ADU)
Duplex (D) ❑
Multiple Dwellings ❑
(SF and/or D)
Distance:
10 FEET
I certify that the above information is correct. l further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
PermiYRush Fees: gg6.j 011
Date of Payment: D DA
Receipt Number: 00 y 3 ? G
Permit No. —0_-5 P 2171 y :; 2
Waiver Fees: 1� I bM 5 (COV lb -101
Date of Payment: 1 D j �(
aZ
Receipt Number:
Waiver No. SV 1201 0 1 a
(Rev. 01/11)
GARNESS ENGINEERING GROUP, Ltd
ENGINEERING SALES CONSULTING
June 1, 2021
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System Upgrade for Elmore #1; Block 3, Lot 5
To whom it may concern:
During the layout on 6/1/2021 it was noted that the groundwater was at 5.6 feet below existing grade.
Seven (7) day groundwater monitoring was noted at 7.5 feet on October 6'h, 2020. In short, due to the
increased groundwater elevation, the design was changed to two (2) shallow five wide with a 1 -foot sand
filter. We are proposing to have the bottom of the effective at 0.5 feet below grade. While this is allowed
under municipal code (5.1 -foot separation to groundwater in June, required is 5 feet), we feel it is valuable
to note that had groundwater been taken one day earlier, the required separation distance to groundwater
would be 4 feet. In short, while we are theoretically "close" to the required separation distance of 5 feet, it
is reasonable to believe that groundwater has not changed significantly (if any) since the seasonal high of
May. We are also proposing to increase the tank size to 1500 gallons in the event that a lift station and/or
an AWWTS would be necessary.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
rel
, M.S.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201432, Rebecca Carroll, 10/20/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201432, Rebecca Carroll, 10/20/20
DESIGN CRITERIA:
GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER
ENGINEERING SALES CONSULTING
3701 E. TUDORROAD, SUITE 101 • ANCHORAGE, AK 99507' PHONE (907) 337-6179 • FAX (907) 33&3246 L4c.8S1 i c: waw gameaerg.n_r,1rg.com
THAT PERTAINS TO THIS DESIGN. BY PROCEEDING
NUMBER OF BEDROOMS: 3
FORWARD WITH THIS INSTALLATION, THE
GALLONS PER DAY (GPD): 450
ENGINEER, WELL DRILLER, CONTRACTOR AND
PERCOLATION RATE/S: 2.1 MIN/INCH
PROPERTY OWNER AGREE THAT THEY HAVE
PROPOSED APPLICATION RATE: 1.2
READ THESE SPECIFICATIONS AND AGREE TO
MINIMUM DRAINFIELD SQ.FT.: 375 FTI
ACCEPT THE TERMS AND CONDITIONS OUTLINED.
DRAINFIELD DESIGN:
MAXIMUM DEPTH: 1.5 FEET
WIDTH: 5FEET SHO�HONI AVENUE
LENGTH: 40 AND 40 (80 FEET TOTAL) /
EFFECTIVE: 0.5 FEET
MOA APPROVED SAND FILTER: 1 FOOT /
ACTUAL SQ.FT.: 400 FTI
PROPOSED 1500 GALLON HDPE
GREER TANK; INSTALL DOUBLE
PROPOSED DRAINFIELD CLEANOUTS AFTER TANK
/.
GEG TESTHOLE #1 �5% EXISTING 3
', BEDROOM NOUS
..T� MH
vii ST1 (D I
/ O/o /
<25olo
C
T /
C
APPROXIMATE LOCATION OF
EXISTING SEPTIC TANK, TO BE
DECOMMISSIONED PER UPC
SHED / \
J
APPROXIMATE LOCATION OF 100' OFFSET
FROM CREEK; PROFESSIONALLY
SURVEYED IN BY SHANE HOLT, PLS
G
I• 9
1 C� Q d•I
•a a
• d • o d
• a'
:d d
DRIVEWAY
EXISTING DRAINFIELD TO BE \ `
ABANDONED IN PLACE
PROPOSED 10' VARIANCE FROM �F<
DRAINFIELD TO ABANDONED DRAINFIELD
— — — — — — — — — — — — L — — — — — —
10' UTILITY EASEMENT i
CONTRACTOR TO HAVE WEST AND NORTH
LOT LINES, AS WELL AS THE 100 WELL RADIUS
FLAGGED BY A PLS PRIOR TO CONSTRUCTION
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LICENSE ®�A®®S®®d ®®®�
#AECC884 /
ILI Ltd
ENGINEERING SALES CONSULTING
3701 E. TUDORROAD, SUITE 101 • ANCHORAGE, AK 99507' PHONE (907) 337-6179 • FAX (907) 33&3246 L4c.8S1 i c: waw gameaerg.n_r,1rg.com
PREPARED FOR
JOHN STURGEON
PHONE NUMBER:
907-230-0072
PAGE NUMBER:
2 OF 2
PROJECT/LEGAL DESCRIPTION:
ELMORE #1; BLOCK 3, LOT 5
DRAWN BY:
D.J.G.
TYPE OF WORK:
DESIGN OF SEPTIC TANK UPGRADE
DATE:
0/112021
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LICENSE ®�A®®S®®d ®®®�
#AECC884 /
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201432, Rebecca Carroll, 10/20/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201432, Rebecca Carroll, 10/20/20
SHOSHON1 A VENUE
---------------- ...... ------------------ --- ----------
. OF
.............. !��Q
FA S/
SHANE A. HOLT i0-�' AS-BUILTSURVEY I" =301
LS -6914
............
to G7 NO CORNERS SET THIS DATE
lofessionax o"
I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWINiG DESCRIBED PROPERTY
LOT 5, BLOCK 3, EMORESUB ADD I
THE !NFORMAT;ON,HERE FORRTHE UUSE OF.LENDIUG TO SHOW AUY ANCHORAGE RECORDING DISTRICT., ALASKA, AND THAT THE
on IS y VISIBLE IMPROVEMENTS SITUATED THEREON ARE IWITHIN
STRUCTURES PLAT LOT LINES A D/O� EISEMEN
CONFLICTS WE EXIST ANTS; AND I S
BE N INADDITIONALRES
Ro
TO 8 E USED F R POSIT ON �l STRUCTURES, IMP OVEMENTS, R FEN ELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
; Y, THER 0 - ON THE EXIST OTHER THAN NOTED.
T 0 1 1 ' R - 0
EASEMENTS OF RECOR Oq ANY LEGAL ENTITY,. THAN TH SE APPEARING RECORD PLAT
aR P NOT SHOWN HEREON(
UNLESS INDICA -E DATED AT ANCHORAGE,ALASKA THIS 151 DAY OF
NOTE.
I p RE 5, ,A 'p
PRTE. FENCEL HES THAT MAY APPEAR On THIS DR,*,WIUG ARE NOT TO BE USED TO DETERMNE 'p7L'f8L
, OPE R ' TY LINES OR POSITION ADDITIONAL - I R RD OV E,`4 ENT S.
, 2020
ANY PAYING
G SlAO W N B EREON MAY
BE APPROX 1 MATE DUE TO EXCESS -VE SNOW AND/OR ICE.
iHOLT LAND SURVEYING
E
Sl—? VZ �' P 4 7A 01V TEAS z�TA N'4 %6 /S PRz,-A ED ?7� q I, 4� 0; 1, 1,VPR 0' R Z) CVC' 9309 GRAVER DRIVE
ANCHORAGE,
AK 99507
14778, FB 206-78 34S-5513
..-., GREA.ER ANCHORAGE AREA BOR, JGH
) Department of Environmental Quality
~ rr 3330 C Street
Anchorage, Alaska 99503
msP~cno, ~PO~Z ON-SlZ~ S~WAO~ mSPOS~C SYS;~
NAME~ ~. MA,,,NG ADDRESS ~O~, ~'-
LOCATION ~ t
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE ~'~
INSIDE LENGTH
MANUFACTURER ~
INSIDE WIDTH
MATERIAL _~'~
NUMBER OF
COMPARTMENT5 ~
LIQUID DEPTH
LIQUID CAPACITY /O00GALLONS.
TILE DRAIN
D,STANCE EROM WELL
NUMBER OF LINES
ABSORPTION AREA
FOUNDATION
NEAREST LOT LINE
DISTANCE BETWEEN LINES
TOTAL LE NGT H,,~..j
OF LINES
TRENCH WIDTH IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE
ABOVE TILE ~ ~* IN.
WELL~)
TYPE ~.-~-~ ~-~.---~ CONST RUCTION
BUILDING NEAREST
FOUNDATION__ LOT LINE_
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
NEAREST SEPTIC
SEWER LINE __ TANK
REMARKS
DEPTH
SEEPAGE
SYSTEM
DISTANCE FROM:
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY: (~t~.l
SEWER LINE DEPTH;
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form EQ-032 ;
PERMIT NO.
APPLICANT ~
LOCATION SHOSHONI
LEGAL L5 B3 ELMORE #1
MUr.i I C I Pt:IL I TV OF RNCH~)RRGE/ '--l'''
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
~LL ~N~ ON~ · T~ ~4~ P~
BOX 4-i6~
LOT SIZE 36846 SOUARE FEET
TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS
SOIL RRTING (SQ FT?BR)= 85
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTH= 8 LENGTH= 32 GRR~.~EL DEPTH= 4
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES,
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCRVATION (IN FEET).
REQU I RED SEPT I C TRNK S I ZE= ieee GFILLONS
BACKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
I'IINIMUM DISTANCE BETWEEN R WELL AND RNV ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPRRTMENT WITHIN 30 DRYS
OF THE WELL COMPLETION.
SPECIFICATIONS AND CONSTRUCTION DIRGRRMS ARE RVRILRBLE TO INSURE PROPER
INSTRLLRTION.
PERM I T VRL I D FOR ONE VERR FROF~ ISSUE
I CERTIFY THAT
l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPRLITY OF RNCHORROE,
2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
~: I UNDERSTAND THRT THE ON-SITE SEWER SYSTE~ MR~ REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN 3 BEDROOMS.
..........
SIGNED
RPPLICRN~ ,,BILL CHRI~
_
/
GREA._R ANCHORAGE AREA BOF~JGH
SEWAGE DISPOSAL SYSTEM/-- APPLICATION AND PERMIT
TYPE AND SIZE OF FACILITY TO BE SERVED .~
FINANCED THROUGH TO BE INSTALLED BY _
.a~ /,... d~__~/.~--~+,~.,~ ~..,:,.~.~__~t~--- NO~ THIS PERMIT IS NOT VALID WITHOUT ~IL
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE ~TYPE
WELL TO S[~lC TANK ~ . SEEPAGE PIT
WATER MAIN TO SEPTIC TANK /~ SEEPAGE PIT
SE~IC TANK. /~ ~ SEEPAGE PIT.
SEEPAGE AREA SIZE J~''~"J'~ /~/~ TYPE
DIAGRAM OF SYSTEM
:::.. ,,
Well Log
For ............. ./..~: ..... ~.~ ........... ~-? ./:.~ ..........
~ --~--~"~ ............ .~:~....~.. z.~...ZZ~ .............................................
S~e of c~g..~.~...z~ ..........................................
D~t~ce to water w~e p~p~g.........~ ........................ at rate
of ..... ~..~...[ .......................... ~o~ p~ ~o~.
Formation I i rom I to._
...-,:../ I
DELTA DRILLING COMPANY
· ' SRA BOX 394 ~1
10
soil
Gw
The sediments were very
with a high boulder and co~
LOCATION
-{
I: y$.~, Al: I~r, at PepLh?_.__~_~_t. , -
.!
' iNSPECTION APPOINTMENTS
TIME TIME TIME
)ATE DATE DATE
INSPECTOR INSPECTOR INSPEC;~R
825 L Street · Anchor~ll0 Alaska 99501 ENVIRONMENTAL FZOTZ-CTION
~"\\ ENVIRONMENTAL SANITATION DIVISlON JUN ! 6 1[}80
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE~I~A~III~I~
DIRECTIONS: Complete all parts on page I. Incomplete ~eque~ts will not be processed. Please allow ten (10) days for process?g.
I. PR PERTYOWNE · P NE
PROPERTY RESIDENT (If different from abow) PHONE
2. BUYER ~ PHONE
MAILING ADDRESS
MAILING ADDRESS
4. I~JtTO R/AG E,N T PHONE
5. LEGAL DESCRIPTION
,TREET LOCATION
6. TYPE OF ESIDENCE
~ SINGLE FAMILY
r-] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
7. WATE SUPPLY
-~'~ INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
[] One r-I Four
[] Two [] Five
[~ Three [] Six
[] Other
° 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. SEWAGE DISiN3~AL SYSTEM
INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONL~ . .
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL'
[] COMMUNITY
[] PUBLIC UTI LITY
Connection Verified,
3. SEWAGE DISPOSAL SYSTEM
r--IINDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SlX
OTHER
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECE)VED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
[]Septic Tank or [] Holding Tank
Size: J~) O(5 If Tank is homemade,
give dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELLTO:
Absorption Area to nearest Lot Line
MANUFACTURER
MATERIAL
Sewer .Line
INearest Lot Line
5. COMMENTS
DATE
~'/APPROVED FOR _~ BEDROOMS
r--II--] CONDITIONALDIsAPPROVED APPROVAL (letter must accompan/~ficate}
72-010 {Rev. 6/79)
MUNICIPALITY OF ANCHORAGE D~I** C.' ~ ~,lA':~ & u
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT~NM~*NT/... ;*.;,~; '~CTION
ENVIRONMENTAL ENGINEERING DIVISION ~EC 8 197~
T, , ho.p 264-47 0 R .....
DIRECT~CINS: Con~leu~ MI pa.s on page 1. Im:ompim re(luil~l Mil not I~ pro(ENd. Pt*me MIOw ~ (10I d~ys for processing.
4,MAIL~L~ A~DD~R LTOR/AGENT ] PHONE
6. TYPBOF RGelDENCE NUMBER OF BEDROOMS
One [] Four [] Other__
SINGLE FAMILY Two [] Five
MULTIPLE FAMILY j~ Three [] Six
7. WATER BUPPLY
INDIVIDUAL*
COMMUNITY
[] PUBLIC UTILITY
EL:WAGE OtBpO~AL BY~I'EM
[~ INDIVIDUAL/ON-SITE'*
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all walls drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.) ~
*'If individual/on-site, give im~lllltion date I~"31~. ~,~. '3.'q.
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 PROCESSING CAN BE INITIATED
72.010(3178)
.... ~ THIS SIDE FOR OFFICIAL USE ONLY · ~. ·
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TiME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
'1. TYPE OF RESIDENCE NUMaER Ol= BEDROOMS
I--I SINGLE FAMILY [~ 'ONE ' [] THREE~ [] FIVE [] O~HER
[] MULTIPLE FAMILY [] . TWO [] FOUR [] SIX
2. WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED , * ,
[] PUBLIC UTILITY
Con~ection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE ~NSTALLED
Connection Verified
INSTALLER
[]Septic Tank or [] Holding Tank (~ ~)^ . .'~1
Size: /O(~O If Tank is homemede SOILERATING .~'--'"~4.4].X3'%
give dimensions: ~ ' ~
TYPE OF TANK MANUFACTURER ""
TOTAL AB~ORFTION AREA MATERIAL
[] APPROVED FOR -.~ BEDROOMS
CONDITIONAL
APPROVAL
(I.etter must accompany certificate)
[] DISAPPROVED
DATE BY (Title) //'/
LEGAL DESCRIPTION
72~010 IR~. 3178i
