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Home My WebLink AboutEAGLE CREST #1 TR B LT 15S II ~ 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 I--I UPGRADE LEGAL DESCRIPTION ~ ~ Material~ ~ No. of compa~ments Liq. ca~c~Y ¢ g~ons IF HOMEmaDE: InsiOe length W,dth Liquid ~O Welt Dwelling PERMIT NO. DISTANCE TO: O z ~ Manufacturer Material Liquid capacity in ~llons ==~ D,STANCETO: We,, / ~t Foundation ~ ~ Neare, tlothnT~ ~ PE.MITNO. ~ ~ ~ No. of lin~ / Length of ee~e, Total leng~e, ,rench~h inches Distance ~,.en lines ~ ~ Type of crib Crib diameter Crib depth Total efi~ti~ absorption area ~ DISTANCE TO: Class ~. Depth Driller D~stance to lot hne PERMIT ~ DISTANCE TO: OTHER PIPE MATERIA~ ~ " ~OIL TEST RATING /~g ~ REMARKS 72 )13 (Rev. 3178) ~ MUr-I I C~PRL I TY OF Ar~ORAGE · AND ENYIRONMENTRL . ,~0TECTION - '~ DEP~RTMENT.~ HEALTH ANCHORAGE, AK. ~501A , , ~'~-~/ ~Z~ . '~~- ,_ '' S25 L STREET, 264-472e /~,~d5 -Ot~--5 I TE 5E~qER PERM I T APPLICANT ROBERT ~05S ~ C.S. BRRR PO BOX 54~ EAGLE RVJER 6~4-~e LOCATION, 3RD., EAGLECREST RD. LEGAL LOT 15 TRACt B E. CREST SUB LOT SIZE 1782e SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SO FT?BR>= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: D~PTH= ~ LEi'.iGTH= _'~-4 GRAVEL DEPTH= 2 THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R 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 I5 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. REQU I RED SEPT I C TRt~t( 5 I ZE= ieee GALLONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY HELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE HELL WILL SERVE. T~40 (2) I t~SPEOT I Otis ARE REQU I RED ----- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THI~ DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETHEEN R HELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS leo FEET FOR R PRIVATE WELL OR 15~ TO ~ee FEET FROM 8 PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC HELL MINIMUM DISTANCE FROM R PRIVATE HELL TO R PRIVATE SEWER LINE IS ~5 FEET AMD TO R COMMUNITY SEWER LINE I5 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT /' 1: I RM FAMILIAR I,lIlH THE REQUIREMENT5 FOR ON-SITE SEHERS AND HELL5 RS 5ET FORTH BY THE MUNICIPALITY Of RNCNORRGE. 2: I WILL IN~TRIL THE SYSTEM IN RCCORDRMCE WITH THE CODES. 3: I UNDERSTRMD THAT THE ON-SITE 5EWER SYSTEM MAY REOUIRE ENLRR~E~ENT If THE RESIDENCE I5 REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. .,~ ~ ISSUED PERFORMED FOR: LEGAL DESCRIPTION:' I 2 6 w 7 8 9 /~ $~]IL~ LO.~ PERCOLATION TEST MUNICIPALITy OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street. Anchor,ge. Aliske 99501 264-4720 SOILS LOG -- PERCOLATION TEST SLOPE SITE PLAN 10 11 12 13- 14- 15- 16- 17- 18 19 20 COMMENTS PERFORMED BY: 72.008 (6/79) Ito~e'~ A. :$ & S ~:ngineer~~''' WASGROUNDWATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN FT AND . FT , // / C E RT, F, E O El~/~.~//~,~//~~'/ (minutes/inch) BOX i072 ERGLE RIVER LOT SIZE 634-2466 22000 SQURRE FEET HINiHUI'I DISTRNCE BETWEEN A HELL AND RNY ON-SITE SENRGE DISPOSAL SYSTEH IS 400 FEET FOR R PRIVRTE HELL OR i50 TO 200 FEET FROH R PUBLIC NELL DEPENDING UPOhl THE TYPE OF PUBLIC HELL. HINIHUH DISTRNCE FROH FI PRIVFlTE HELL TO FI PRIVFlTE SENER LINE IS 25 FEET FiND TO Fl COHHUNITY SEHER LINE IS 7[5 FEET. HELL LOGS RRE REI~UIRED FIND HUE, T BE RETURNED TO THE DEPFlRTHENT HITHIN 30 DRYS OF THE WELL COHPLETION. OTHER REOUIREHENTS HRY RPPLY. SPECIFICRTIONS AND CONSTRUCTION DIRGRFlbIS FIRE · RVRILRBLE TO INSURE PROPER INSTRLLRTION. PERI'I I T EXP I RES DECEIIBER ~_L.. =LDSO I CERTIFY THFlT '.L: I FlH FFII'IILiRR HITH THE RE¢~UIREI'IENTS FOR ON-SITE SENERS FIND WELLS RS SET FORTH BY.THE NUNICIPRLITY OF RNCHORRGE. 2_: I HILL INSTRLL THE SYE. TEI,~ IN FICCORDRNCE WITH THE CODES, s i G N E D: _ _!"f.~.2...~!_-~_ _C2~_-'~.~.~._n.~. ......... V4.0 TIME TIME TIME DATE :)ATE DATE NSPEDTOR ,NSPECTO" NSPE:TORpra ~ MUNICIPALITY OF ANCHORAGE J~UNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~IONDEPT. ~ ) 825 LStr~t-Anchor~,Ala~a~1 ~I~ONMENTAL ~20T~CTION ENVIRONMENTAL SANITATION DIVISION MAY g 8 1981 TMe~one ~7~ .~o.~s. ~o. ~...ow~ o~ ,.~,v,~ .~. ~.~ s~A~-- ~1~ DIRECTIONS: Complete all pa~s o~t page 1. Incomplete r~u~ will not ~ p~. Please allow ten (10) days for pr~slng, 1. PROPERTY OWNER PHONE MAILING ADDRESS PROPERTY RESIDE~ (If ~lfferent from abd~l PHONE Z. ~UYER ~ PHONE MAILING ADDRESS ~ LENDING INSTITUTION PHONE 5, LEGAL DESCRIPTION TREET LOCATION ~ ~ · 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS ~ One ~ Four ~ ~ Two ~ Five SINGLE FAMILY ~ MULTIPLE FAMILY ~ Three ~ Six [] Other 7. WATER SUPPLY INDIVIDUAL' COMMUNITY [--I PUBLIC UTILITY ATTACH 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,) 8. SEWAGE DISIK)SAL SYSTEM e I~ INDIVIDUAL/ON'SITE" [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 1. TYPE OF RESIDENCE ; .. 1"3 SINGLE FAMILY [] MULTIPLE FAMILY _ . . THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] OTHER [] TWO [] FOUR [] SlX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER ' 2. WATER SUPPLY [-I INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified' 3. SEWAGE DISPOSAL SYSTEM [] IN DIVI D~JAI~/0'N '-SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: I(.~C~3 I f Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELLTO: Absorption Area lo nearest Lot Line 5. COMMENTS DATE INSTALLED INSTALLER SOILS RATING MATERIAL DATE [~///APPROVED FOR ~ BEDROOMS I--] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ,~~~ 72.010 (Rev. 6/79)