HomeMy WebLinkAboutELMORE #1 BLK 3 LT 17D
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MUNICIPALITY OF ANCHORAGE
He~/'~.h and Envzronmental¥
ProteCtion
Fourth Floor West
825 L Street
Anchorage, Alaska 99501
264-4720
INSPECTION REPORT ON-51TE SEWAGE DISPOSAL SYSTEM
· LEO^- ESCR, ,ON
SEPTIC TANK:
DIS1 ANCE
INSIL)[ LENGTH
MAiNUrACTURE R
INSIDE WIDTH
NUMBER OF ~
.COMPARTMENTS . ,~
LIQUID CAPACITY~._ GALLONi
TILE DRAIN FIELD:
DISTANCE i"ROM V, ELI{Z~j~'~T~t FOUNDATION~ NEAREST LOT LiNE_~O/ .oFTOTALLINELENGTH ~ I
~ of Lines ./ DISTANCE BETWEEN LINES ~ TRENCH WIDT~ IN. TOTAL EFFECTIVE
AJ~SORPTION AREA ~_ SO, FT. LEITH OF EACH LINE ~1
MATERIAL BENEATH TILE ~ I~, ABOVE TILE ~ IN.
SEEPAGE PIT:
Log Crib Rings
BUILDING FOLINDATIO?I
DIAMETER OR WIDTH
Crib Size: DIAMETER
NEAREST LOT LINE
[ENGTtl DEPTH
..DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA ONALL AREA)
;ell _
~ell Distance To: Lot Line
Ildg: Sewer Line:
,ipe Materials:
: of Bedrooms: ..
:nstaller: ..5 ,L~.29~.
,'emar ks:
DA~E//'7'77
APPROVED
PER['I I T NO.
APPLICANT
LOCFITION
LEGAL
JAMES BUP1GFIRDNER
TRONR DR
Lt? B3 ELMORE
LOT SIZE 37024 SQUARE FEET
TYPE OF SOIL RBSORBTION SYSTEbl IS: TRENCH
MFIXIMUM MUr'IBER OF BEDROOMS = 4
SOIL RFITING (SQ FT?BR)= 85
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEF'TH= 'F LEI'~IGTH= .S5 GRR~',-'EL DEPTH= 5
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRBINFIELD.
THE DEPTH OF Fi TRENCH OR PIT ~S THE DISTANCE BETWEEN THE SURFFICE OF THE
GROUND AND THE BOTTOM OF THE E×CRYRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRFIVEL BETWEEN THE OUTFFILL PIPE
AND THE BOTTOr'I OF THE EXCRYFITION (Ir.~ FEET).
RED, SEPT I C TANK S I ZE= :L250 G/::ILLOI'-,IS
pI~iS_,I<F.~ISE PLIANT (]PT I 01',i
R PRCKFIGE PLFINT MF~Y BE I~ISTFILLED FIT THE PERMITTEE/S OPTION SUBJECT TO THE
FOLLOI.IING CONDITIONS:
1. EITHER R CLFISS I OR II NSF APPROVED PLANT MAY BE INSTFILLED.
2. Fi CONTINUOUS MBINTENFI~.ICE AGREEMENT IS REQUIRED. IF Fi MFIINTENANCE
AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLFIRGE THE SOIL
RBSORPTION SYSTEM AND?OR YOU MFIY BE SUBJECT TO PROSECUTION.
TI, IQ ( 2 ) I I'-,ISPECT I 0 I'-.IS I~I:;:E RE["~ U I RE[::,
BACKFILLING OF ANY SYSTEM WITHOUT FINFIL IMSPECTION AND RPPROVFIL BY THIS
DEPFIRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTFINCE BETWEEN Fi WELL AND ANY ON-SITE SEWFIGE DISPOSAL SYSTEM IS
100 FEET FOR 8 PRIVATE WELL OR 200 FEET FOR 8 PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DFIYS
OF THE WELL COMPLETION.
OTHER REQUIREblENTS MAY 8PPL~. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS 8RE
B'./BILBBLE TO I~ISURE PROPER INSTALLATION.
PERI"11 T EXP I RES DECEI"IBER g:l... ::!_977-'
I CERTIFY THAT
l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPALITY OF RrICHORAGE.
2: I WILL INSTALL THE SYSTEM IN 8CCORD8NCE WITH THE CODES.
~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
RPPLICRNT ]RMES BLIM*~RRDNER ~
......
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Al~ka 99602 276-2221
SOILS LOG -- PERCOLATION TEST
[] SOILS LOG
I-I PERCOLATION
TEST.
DATE PERFORMED: ~)C~" ~- ~7
LEGAL DESCRIPTION:
1
2
3-
4-
5-
6-
7-
8-
10-
SLOPE
-- /
11
13-
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
14-
15-
16-
17-
18-
19-
20-
SITE PLAN
S
L
O
P
E
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE Jminutesllnch
TEST RUN BETWEEN FT AND FT
CERTIFIED BY: MO~I)~U/-- &P~Y DATE:~
72-008 (?176)
· MAR 1 6 1979
RECEIVED
F~EOtJESi' FOR APPIIOVAL OF INDIVIDUAt. WATER AND ,SEWE~ FACILITIES
SINGLE FAMILY E.-1 T;,,o Fi~
MUI.TI~L F FAMtl Y ~ 'lhr~e [] ~;ix
INDIVIDUAL' * ATI A:.?,l't W~ LL LO(L A we:l ic.9 is requ:r~'d for c,[ w s drll!ed.
COM;,1U~,qTY since J:mc !~7~. Fi;; wall: dr',ir(I i)rior to t; 31 date, pi',,,- vv';
~/ INDIVtOIJ.AL/ON-SITE" "If indF~i:iual/on-site, give i:~tallaHoa da[e.~ ....
II system is ~ve: two (2) Veals o~d an ad'Xl,~ac~,
¢-'~ PLJ!I g lC UTILITY by',,,l~' [,,,'* ,;riFfle,
NO'rEt 'r;-lE IJ'Jsp,"c rlO;.~ FE- MU..T A~CO,'V. A,~Y EA~.II I'{EOUEST L~E, ... L Ph ........ ,JG CA.,I B,. I,.IT,AT[:D.
TI' ~
1, TYPE OF RESIDENCE
~ i' .,-E FAMILY
['.3 ' "- .... ~" ·
L-'] OhJ~ ['.'.1 THREE L-] FIVE L~ OTHER
L.~ TWO ~ FC, Uti [..] ~;i./, - -
2. ~ATEP, SUPPLY
'"~g INDIVIDUAL
[] COMMUNITY
[] ~UBLIC IU~ILITY
Con;~cctlon Verificd
P,.J'I,, IT NUt. ,.ER
DATE DRILLED
LOG RECEIVED
3. SEWAGE'DISi~O3AL SYSTEhl
'~-glNDIVIDOAL/ON -SITE '
DPU3LIC LITI L lTV
Connect]on Verified
'f~JSeptic Tank or [] Roldin9 Tai~k
Size: J~ I[ Tank is homemade
TYPE OF TANK
4. DISTAN'~E$
WELl. TO:
5. CO?,,",M c.i'J TS
[] COh;DITIONAL APFROVAL (ietter II~t!E~ ~.ccc:l~p~.qy certif,cate)
[_-1 DISAPPROVED
1. PROPERTY OWNER
MAI LING ADDRESS
MUNICIPALITY OF ANCHORAGE ,,
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION .,
825 L Street* Anchorage, Alaska 99501 Telephone 264-4720."'
'. CERTIFICATE OF INSPECTION
SEWER AND WATER FACILITIES
2. LEGAL DESCRIPTION
Lo t '? ?
3. TYPE DWELLING
SINGLE FAMILY RESIDENCE
MULTIPLE FAMILY RESIDENCE
r-i OTHER (Describe)
I 4.WATER SUPPLY
~ INDIVIDUAL
· r-I COMMUNITY/PUBLIC
5. SEWAGE DISPOSAL
INDIVIDUAl/ON-SITE
r'-I PUBLIC UTILITY
r-i HOLDING TANK (Maintenance Required)
72-014 13/78)
SEAL.
j~ APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (See Attached)
r-I DISAPPROVED
