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Home My WebLink AboutELMORE #1 BLK 4 LT 2Ill 3'7 6RE, .ER ANCHORA6E AREA BOI 'IJ6H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ,'~'C"~,J~'''~ ,,<:~.~,~.,//,r/ MAILING ADDRESS.,~'~'J~'~P"~'-~'"~-~-~"F'~"/~"~ LOCATION /~~ ~ LEGAL DESCRIPTION ~/ SEPTIC TANK: DISTANCE /~g',,~",~--,,~'~'" NUMBER OF FROM WELE''''~'~ MANUFACTURER"~-'""r"~"/.~:~'-/''''~ MATERIAI.~'~'-<'~'~"-'"""'--~"~'~'~:~"~"~'~'COMPARTMENTS / INSIDE LENGTH ~ INSIDE WIDTH ~ LIQUID DEPTH ! IQUID CAPACITY,,'/'.-~''/'''~'j GALLONS. SEEPAGE PIT: NUMBER OF PITS /' DIAMETER ~'"" OR WIDTH/'"~, LENGTH,/"~ DEPTH C~'~.c~;'"~"" -(.~ .,) DEPTH...~_~ DISTANCE FROM: LINING MATERIAL .,'~./A/.,<"~' CRIB SIZE: DIAMETER ~" ' BUILDING FOUNDATION .~-/~ ~, TOTAL EFFECTIVE ADDITIONAL ABSORPTION NEAREST LOT LINE~'~''*~''', ABSORPTION AREA (WALL AREA) '~-=.~ '-) -SQ. FT. WELL: TYPE K BUILDING __~ FOUNDATION CONSTRUCTION DEPTH DISTANCE FROM: I NEAREST ~ NEAREST , SEPTIC ~ SEEPAGE ~ LOT LINE SEWER LINE TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED ,DISAPPROVED ---'- REMARKS ~-~-'--' DISTANCES:, INSTALLED BY: PIPE MATERIAL' LOT SLOPE: REMARKS: ~ ~',~.~ ~.~ ~,/~' APPROVED G.A.A.B. Form No. EQ-O31 GREATER ANCHOrAgE AReA Borough PERM IT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT FINAL INSPECTION: 24 HOUR NOTICe REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF eNVIRONMENTAL QUALITY AUTHORITY WILL ESe SUBJECT TO PROSECUTION* SEP'rlC TANK SIZE DRAIN FIELD /0C~I WILL TO SEPTIC TANK 100' SEI='TIC TANK, (O~ SEEPAGE PIT (Oef CONFORM TO BOROUGHi~~ ~~~R EGUt. ATION$ REGARDING.. STALLATION ._ OR* $,"AG'~A.EA$'" /.~/Z,X.(," T""': ~ DIAGRAM OF ~YSTEM DA,,~"" ?- ? ?~ A.P,.,DA.T'.S,G.AT,,.. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case Performed For ~'~ovJ Legal Description:~Lot ~ Block This Form Reports Soils Log Soil Test Must Be Logged To 4' Depth Feet Soil Characteristics 2-- 3-- 4-- 5-- 6-- 7-- 8-- 9-- Dated Performed ?-~--~ Subdivision~)~o~e ~/-/ Percolation Test Below Proposed Seepage System Was Ground Water Encountered? &~c~ ~m~ If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Depth of Inlet .Depth to COMMENTS: Drain Field Bottom of Pit or Trench Test Performed BY ?~6~ ~/~. Date Certified BY: Date: ~ .,~ MUNICIPALITY OF ANCHORAGE MUNICIPALITY O;=ANCHOI~GE ~ DEPAR~E~ OF H~LTH& ENVIRONME~AL PROTECTION DE~. ~ H~ALTil & L~~~ ENVlRONMENTAL ENOINEERINO DIVI'ION JUL · ? 1981 FOR ~PROVAL OF INDIVIDUAL WATER ~D '~& E~EiY& D DIRECTIONS: Conl~lm all per~ o~ p~e 1. Inemltpl4~ m41ues~ will not b~ prm:esmd. P~a~ allow ten (10) days for i, PROPERTY OWNER 3&CK. D.S]:i~[OIqDS & ,]*A~I]:S ¥. HcSB~,I~-¥ PHONE MAILING ADDRESS ER& ~ox 324A NI~ Shoshoni Drive PROPERTY RESIDENT (If diff~'eqt from above) i ADDRESS 310 E. Northern Lights Blvd. REALTORJAGENT PHONE PHONE LEGALOESCRiRTION Lot 2, Block t, ~Zmore Subdivision Add. #1 STREET LOCATION ~ Shoshoni Drive 6. TYPEOF RF.~IDENCE [~ SINGLE FAMILY I-'1 MULTIPLE FAMILY 7. WATER SUPPLY NUMBER OF EEDROOI~E i---I One ~T~ Four i'--] Two [] FiN [] Thr~ r-1 Six I~] - INDIVIDUAL* [] COMMUNITY I--1 PUBLIC UTI LITY EEWAOE DISPOSAL SYSTEM I~ INDIVIDUAL/ON-SITE** I--1 PUBLIC UTILITY [] Other - * ATTACH WELL LOG. A w~ll log is required for all v.~lls drilled s~nce June 1975. For wells drilled prior to that date, give well depth (attach log if available.) **If individual/on-site, give installation date 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. ~'T' '-'~HIs SIDE FOR OFFICIAL USE ONLY ~ DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME I DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECT)ONS: 1. TYPE OF RESIDENCE NUMBER OF 8EOROOIV~ I'-1 SINGLE FAMILY [] ONE i-'l THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO f-I FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER I'--I INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED ~. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAl/ON -SITE DATE INSTALLED I--IPUBLIC UTILITY INSTALLER []Septic; Tar~ or []HoldingTank Size: I-~C~) If Tank is homemede SOILS RATING give dimemiom: TYPE OF TANK MANUFACTURER TDTALA ORPT)ONAREA MATERIAL 4. DISTANCES S~otic/Holding Tank IAb~orl)tl~ Areal I;~ Line Neerlst LOt Line WELL TO:I I S. COMMENTS [~/APPROVED FOR ~- BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 8Y (Title) DATE LEGAL DESCRIPTION 72-010 (Rev. 3/78) :.?04 Clevelond Ava. ~'O. Bo~ 10-1126 ~.nc~moge ~ AK. 995.11 ~-77-OZ~I i.,J,T[RIALS'I'ESTIN'~ · (~UALITY COhrl'ROL DOLLS 710 Third Ave.' P.O. Bo~ Z~40 Foilbonk~, AK. 99707 452-1Z67' 456-5155 ,~D-~, PT I C SYS.]' E M ADEOUACY REPORT JOB NO. 81-1607 DATE OF REPORT 7/31/81 DATE OF TEST 7/29/81 LEGAL DESCRIPTION Lo:r - 2 , BLOCK 4 , ELHORE SUBDIVISION OR SECTION ., T N, R W, S.M. , ALASKA pERFORMED FOR: Jack Simmons PHONE NO REOUEST£D BY: Ne__a~_/~ausnm PHONE NO.__ TYPE OF SYSTEM CRIB 'LEACH ~,vEs 1,250 SEPTIC TANK - Sl~E GALLONS· OR SEEPAGE PiT FIELD NUMBER OF BEDROOMS -- SEPTIC TANK WAS PUMPED ~ NO 625 ABSORPTION RATE: AVERAGE 24 HOURS GALLONS. SURGE RATE: 600 GALLONS IN 5.5 .MINUTES. NOTES ~ OBSERVATIONS'. 7/29/~1 TNITr3,t, ..READING AT' END OF I.,E~CH PIELD. 136" FROI?I.~OP... _ ....... " 19-'13 a;m. - ..... r--104" ]0~gR " 11:14 a.m. ...... ___g .... L102" 7/30/§1 7:45 a.m. - ........ 130~ 43 min./inch TEST PERFORMED BY: _--lViE~ REPORT PREPARED BY: -- MEA--- APPROVED ex.' K~nney~ ~R~--Ba-~ter / rmnicipalit Anchorage 8.5 L STREET ANCHORAGE, ALASKA 99501 (907) 2G4-4111 GEORGE M. SULLIVAN, July 10, 1981 Jack D. Simmonds/Janis Y. Star Route A Box 324A Anchorage, Alaska 99507 Mc Sherry Subject: Lot 2 Block 4 Elmore Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. (2) The septic tank pumped with a receipt submitted to this office. (3) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: Donna Christal Alaska Statebank 310 East Northern Lights Boulevard 99503 [{%.-~:'+i~m~?-~.i) / 825 L Street, Anchorage, Alaska '9'~~ ~/. 3 ~ 279-2511, ext. 224 or 225 ~ '-~ Date Received: August 31, 1977" _~ ~1: Time V,~f'3gn'~. ~2: Time ~ .~3: Time Date (~.~~. Date ~ - ~q.nn ~% Date Insp Q,,~{ , ~. Insp ~~~' Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Mailing Address: Phone: 2. Property Owner: Floyd L. Braun Phone: Mailing Address: 10181 Klatt Station 99502 344-9824 3. Legal Description: Lot 2 Block 4 Elmore Subdivision 4: Single Family Residence: ~) Number of Bedrooms: Three Multiple Family Residence: ( ) Number of Bedrooms: Se Well System: Permit ~ Construction Individual Well ( ~ Community/Public System ( ) Depth of Well 128' Well Log on File Bacterial Analysis ( ) Sewage Disposal System: O~-site System.( ~x Public Utility ( ) IO1 175 Permit ~ Installed .--{~-~- Installer /~p/,'~;U~ Septic Tank Size ~ ~ Area ~,~. Soils Rate A~sorption '~istances: Well to Septic Tank 'i to,Sewer Line Nearest Lot line to Nearest Lot Line Manufacturer Material to Absorption Area Absorption Area MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION.~..,..,~,.._ip,., '.-' ......."* ' * ',' '.~ 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 ;': i'. ~; I' ' REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES /',.. ~ ',.,' '~' i! [~ 1. Typeof Inspection: CMRO VA_ 2. Property Owner: ,~O yd ,~, *~a/~ I.~/~ 3. Name of Buyer: ~ ~ , FHA "',~,CONV*, r. Day Phone: ,,~,c/c/- c~,,~c,.~ ~ Mailing Address: .4. Name of Lending Institution: Day Phone: Mailing Address: Phone: 5. Name of Realtor or Agent: '"-~ M ~ 0 ~ ~; L. L. Mailing Address: '~D/ ~=. '-'~/ 7~-6 Phone: ~7 ~" ~) ~/ c~'J 6. LegelDescription: J. o7- , I L/4"-f) Location: -~'z~Z~'' ~ ~J~ J/')f/~ 7. Type of Facility to be Inslsected: ,.~IM'~. I~..~ 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility. If Individual, date of installation No. Bdrms ~' Individual ~'~ ,Individual (on-site) 72.003(3/76) P~ge Two Department of ltealth and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 2 Block 4 Elmore Subdivision Comments: Affadavit Attached: (') Letter Attached: ( ) Date, Disapproved: Date Department Worksheet: