HomeMy WebLinkAboutELMORE #2 BLK 10 LT 1mote.
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G.'~'~TER ANCHORAGE AREA
BORO~S~H
· HEALTH DEPARTMENT ,,,,: :~i~T .° 339
327 EAGLE ST. ANCHORAGE, A~S~ ~501 27~-2511
INSPECTION REPORT ON-SITE SEWAG~ DISPOSAL SYSTEM
SEPTIC TANK:
NUMBER OF
DISTANCE FROM WELL '.~-"~P ",,~,~-"~'~_~//~'..c.~.'7 MATERIAl. ,,,~,.,~.~.~. ~7-" ~'",,~.,,'"~"~,~'.,~T;:""~,,~- COMPARTMENTS, /
LIQUID
LIQUID CAPACITY /~'~"~'-'~ GALLONS. INSIDE LENGTH '~"~INSlDE WIDTH ~ DEPTH
SEEPAGE SYSTEM:
NUMBER OF FITS
LINING MAIERIAI
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
~ OR W~DTH /--~ ' , LENGTH /.-.'~ ', DEFTH ~"
DISTANCE FROM WELL ,,'/~'~/~'~"-~-"~:"'~ , BUILDING FOUNDATION ~ ~,
1OTAL EFFECTIVE ABSORPTION AREA ~ALL AREA) ~ ~ SQ. FT.
TILE DRAIN FIELD:
TOIAL
LEN(~TH
DISTANCE FROM WELL .~'-"~~,~ON. , NEAREST LOT LINF ~
NUMBER OF LINt. o' DISTANCE BETWEEN ~.~c~ TRENCH WIDTH IN. TOTAL EFFECTIVE
A A SQ. FT. LENGTH OF
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE .IN. ABOVE TILE
,/"/Z ,.~.,,,~...r.~"~
WELL: TYPE' -~'~~'~m~'~ DEPTH /
/NEAREST SEPTIC
LOT LINE , SEWER LINE / ,TANK
DISTANCE FROM / WATER /
· BUILDING FOUNDATION.~SAMPLE , NEAREST
SEEPAGE / OTHER
, SYSTEM , CESSPOOl ~ SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
GAAB-HD-2
GREATEi'"~NCHORAGE AREA ~ROUGH
IIEALTil DEPARTMENT
327 Eagle St. Anchorage, Alad~a 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RES,OENCE AO
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH ~ ~/
PERCOLATION TEST RESULTS I~'/F'c'/'~;4/
Case
10%
.AILINO AD D RESS~',,~~;/~'/~/T/~ PHONE NO. - -,
,SEEPAGE PIT ~ ,DRAIN FIELD , OTHER
/r TO Be '~TA ELED ~Y //'~ ~
BELOWTO BE FILLED OUT BY HEALTH DEPARTMENT
DISTANCES:
with the requirements of Grcate~ Anchorage Area Borough Ordnance No. :28-68 and that the
aboYedcscdbedsystemisinaccordanccwithsai~cod¢.
APPLICANT FILLS.OUT UPPER HALr-~0NLY
B~er
Address Zip ~e
Sewer Disposal
~ Holding Tank
NOTE: THE INSPE~ION ~E MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Insp~:tor
Field Notes<=j' ,~ ~ w., ~. ,MUNICIPALITY OF ANCHOP. AGE
-- DEPT. OF H~ALTH ~,
I fie ~.v~o,~,~:.r,~ PROTECTION
O,L.
H~o ,~
,:.'. RECEIVED
(~APPROVEg BEgROO~S 'CONDITIONS OF APPROVA~
( J OISAP~OVED
( ) CONDIT~NAL APPROVAL'
Soils Rating Date ~wer Install~ Well TO ~so*ptlon Area Well Log Receiv~ ~ .
~'~-~/- ~O ' w~.tot,.~ ~o~
September 16, 1983
Julte Ann Lamb and Michael J. Uilson
SRA 470-L
Anchorage, AK 99507
Subject: Lot l, Block 10, 2nd Addition to El~aore Subdivision
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
" The top of tile well casing should be sealed so that it is
water tight.
The septic tank pumped with a receipt submitted to this
department.
An adequacy test needs to be imrformed on ~e existing
leaching area. This test will determine if the system
adequate according to ~lational Standards. A listing of
private firms performing
needs to be submitted to
is
the test is enclosed. Thfs report
this office for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
C~;33/ej/E2
Cory willis, l{.S.
SERVICES
P.O.Box 104053
563-1944
Anchorage, AK 99510
September20.1983 Adequacy Test for Existing Septic System
Legal Description: /, /
Components of Septic System:
Number of Bedrooms:
How long vacant: ~//
Test Performed by: ~ ~J.
Initial Static Levels:
Septic Tank
Occupied prior to Test: Yes: / No:
__ Last Pumped:
Water meter/S.N.: -- / ....
~'/-- ; Seepage Pit: ~ ~z.
TEST DATA
Time
Liquid De[
~;o,nt i r
5%..
q~opage
~7
Water
Added. eal.
Weter
Readinq, qal.
Remarks
~1~
GREATER ANCHOP~ ~ BOROUGH
Department of E~li~e~)~l)~d~tal Qualtty
3330 "C" Street, Anchorage~ ~:~a 9gS03 274-4561
Date Received September 15, 1976
Time of Inspection 10:30 a.m.
Date of Inspection 9-16-76 Thurs.
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by:
e
Marston Realty, % Jerry Woodworth
Mailing Address: 2804 Northern Lights Blvd.
Property 0wner: John Vaught
Mailing Address: Star Route A Box 478P 99507
Phone: 277-3511
· ~ Phone: 344-0729
3. Legal Description:
4. Location: See map on back
5. Type of facility to be inspected Single Family
6. Well Data:
A. Type Individual
C. Construction ~
7. Sewage Disposal System: On-site
A. Installed
C. Septic Tank:
D. Seepage Pit:
Lot 1 Block 10 Elmore subdivision Addition
No. of bedrooms 2
1. Size I~0
1. Absorption Area
E. Disposal Field: Total length of lines
Distances:
A. Well to: Septic tank , Absorption area
Nearest lot line , Other contamination
B. Foundation to septic tank , Absorption area
C. Absorption area to nearest lot line
B. Depth
· D. Bacterial Analysis
system
B. Installer
2. Manufacturer
2. Material
100/feet
, Sewer Lines ,
EQ-034 (1/74) Page 1 of two pages
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
t,'~,';:~ ~ln E~t'T,;dor Road, Anchorage. Al~ka 99504 276-2221
REQUEST FOR APPROVAL OF '
~. - clINDIVlDUAL SEWER and WATER FACILITIES
1. Typeof lnspectionC E CMRO
2. Property Owner:
Mailing Address:
3. Name of B~yer:
Mailing Address:
4. Nameof Lending Institution:
o
VA FHA CONV
Day Phone:
Day Phone:
Mailing Address: , Phone:
Name of Realtor or Agent:
- Mailing Address: ~4¢~'
Legal Description: ~~
Location: ~'/
t
Type of Facility to be Inspected:
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
Individual
Individual {on-site)
If Individual, depth of well
Sewage Disposal System
Type of System:
If Individual, date of installation
Public Utility
72-003(3/76)
Page.'2 of two pages - ReqL;t for Approval Of ]ndivtdual S~ :r & Water Facilities
Legal Description I. ot 1 I)lock 10 ff~t=~3~-e S~b~l£vis£on A~lcl£t~on #2
Co~lnents
Approved
lOisapproved Date
id for one year from date signed
Greater Anchorage~Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
