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Home My WebLink AboutELMORE #2 BLK 9 LT 3 '~ MUNICIPALITY OF ANCHORAGE , ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ~NEW LEGAL DESCRIPTION LOCATION / ~ DISTANCE TO: I~~ I Abs°rPt'°n "/~ D'~~ ~ ~ Well DISTA~ ~ Dwelling PERMIT NO. :--~ ~turer ~ ~' M~ Liqu,~llons 4 ~ Ty~¢ 6rlb d% ~ Crib depth ~ absorption area ~ ~ ~ ~ ~ation DISTANCE TO: PERMIT NO. ~ DISTANCE TO: Building foundation $~r line Septic tank Absorption area(sD OTHER PIPE ERIA~ SOl L TE~T RATING [oo REMARKS I, tO P ED ~ DATE LEGAL PERMIT NO. MUt4I~I~LITY OF · Rt4CH~"~RRGE DEPARTMENT Or HEALTH AND 'ENVIRONMENTAL PROTECTIOH 825 ~L~ ~TR~ET, ANCHORRGE~ AK. ~501 264-472~ [4ELL Ar4D 0r4--5 I TE SEIqER < sleo67 > P.O. BOX I0-2157 APPLICANT JOHN NENSLEY LOCATION 145TH AVE LEGAL LOT ~ BLK 9 ELMORE SUB #2 LOT SIZE 39520 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SO FT?BR>= THE REQUIRED ~IZE OF THE SOIL ABSORPTION SYSTEM I~: DEPTH= 4. 5 LEt4GTH= 60 GRR%'EL DEPTH= 2. 5 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 ~URFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET>. THERE IS WO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. RE(~.U I P. ED SEPT ! ¢ TRt4~,-. S ! ZE= :L000 t--'iALLOI%IS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ------ T~qO ( 2 > ! NSPECT I 0t45 ARE RE~.U I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT i. IILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND.ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM R PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY ~EWER LINE I5 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT l; I AM FAMILIAR WITH THE REQUIREMENT~ FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SY-~TEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. V4, 0 Contracting Engineers & Associates 212 East International Airport Rd. Suite 204 ANCHORAGE, ALASKA 99502 (go7) 278.3773 SOILS LOG -- PERCOLA'~ION TEST ~ SOILS LOG I-I PERCOLATION TEST LEGAL DESCRIPTION: ~3T ::~ . ~::)Lo(.~l~. ~ EL]V[0{~.-~c.. ~u~/~ ~c[''~ ~ 1 2 3 4 5 6- 7 8 9- 10- 11 · 13- 14- 15- 16- 17- SLOPE SITE PLAN 19- 20- COMMENTS WAS GROU.O WATER IF YES, AT WHAT ], E DEPTH?. Reading Date Gross Net Depth to Net · Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND I~T PERFORMEDOY:~ __CERTIFIED BY: ' -- DATE:~ !~:i~i: '.i ~.~!~'~:.:Pump ,Sales & Service '~'~:::;~ :':"'} i MI~E 20'MALLEY RD. W'"'-:Wells PHONJ- J,~4-3792 WELL DRILLIHG P.o. aox ~ /~' -/~7~ ANCHORAGE, Al( I~j~l, ~ ~-'/,,/ DRILLING LOG *-' WELL DEPTH.: .~Z~,'/ ,,'~,~"' CUING SIZE: ~ STATIC WATER LEVEL: -~'~ ~ WELL PRODUCTION: CASIi'IG ~PTtt:/'c~-//~*"/'' /rx.~ GALLO,~S PER ~m~'~ FORMATIONS ENCOUNTERED / TO ~ TO · z/Z... TO · z~f TO _ . ~ft.~ TO ., /~ TO. TO '* TO TO · -. L,,~,~*E RECEIVED ~ INSPECTION APPOINTMENTS TIME TIME TIME DATE ~)ATE DATE MUNICIPALITY OF ANCHORAGE DEPT. OF H[~LTH & ~ DEPAR~E~ OF H~LTH & ENVlRONME~AL PROTECTIO~~t~O~M[HTAL i ;,OTE~ION ~ ENVIRON~NTAL ~ITATION DIVISION RECEIVED REOU~T FOR ~PROVAL OF INDIVIDUAL WATER ~D ~E~ FACILITIES PR~ERTY RESIDENT (If different from ~o~1 PHONE 2. BUYER ' PHON~ 3. LENDING I~TIT~ION I PHONE I ~ R~ETO~AGENT I PHONE I MAILING ADDRE~ LEGAL DE~CRI FTION TREET LOCATION TYPE OF RESIDENCE ~//SINGLE FAMILY i--t MULTIPLE FAMILY 7. WATER SU~LY .[~ INDIVIDUAL* r~ COMMUNITY [~] PUBLIC UTI LITY SEWAGE DI~I~)~AIL SYSTEM ~ INDIVIDUAL/ON-SITE*· I'-I PUBLIC UTILITY NUMBER OF BEDROOMS [] One r-'l Four [] ~TXwo [] Five ~'~ Three [] Six [] Other · A'VrACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72.010 (Rev, 6/7~) I / THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE I-'1 THREE r-1 FIVE [] OTHER [] MULTIPLE FAMILY [] TWO (-I FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [] Septic Tank or [] Holding Tank Size: /~::~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER .~, .e,.- TOTA A SORPT,ON AREA MATER,^L Absorption Area to nearest Lot Line 5. COMMENTS ;; "ROVEDFOR ,EOROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79)