HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 3A
' .IUNICIPALITY OF ANCHORAGE ~
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION /-.~--~='7~
ENVIRONMENTAL ENGINEERING DIVISION
· 825 L Street- Anchorage, Alaska 99501 Telephone 2~720 ~
ON~ITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE ~ ~NEW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION ~ ~ ~ I NO. OF BEDROOMS
Wail PERMIT NO.
Liq. ca.city in gallons Inside length Width Liquid depth
~ IF HOME,DE:
~O ~ Well Dwelling PERMIT
DISTANCE
TO:
O z ~ Manufacturer Material Liquid ca.city in ~llons
~ DISTANCE TO: WeT~,, Foundatlon~ Z/ NearestZ~n, PE ITNO.
.o. ofline, t Lan,th o~1~ ,oral lenggog~, Trench ~¢
~ T~ of tile to finish grede ~ ~ 1, Material beneath tile ~y inches Totaieff~ti. absorption area
~ Ty~ of cri~ Cri~ diameter Crib depth To~al eff~fi~ absorption area
~ DISTANCE TO:
~ DISTANCE TO: Building foundation S~r line Septic tank Absorption area(s)
PIPE
724)13 (Rev. 3~78)
PERMIT
iduN [ m_-:-i~"v"~ L [ T'T'
DEPARTMENT C. t,-RLTH FIND ENVIRONMEHTRL t..O.ECTION
825 'L' STREET, RNCHORRGE, FtK.
264-4720
OI"4--S 2[ Ti SEI-IEF: LIPGRAIC, E BiRr.1 'r T
( 780281 )
RPPL I CRNT
LOCRT I ON
LEGRL
H.F. VI~.! k¢c~f VTH_~U~iGFI i78 MAN 0 MAR RD
L3A ERGLE RIVER VRLLEY RRHCHET LOT SIZE
694 2674
18000 S¢!URRE FEET
TYPE OF SOIL RE:SORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4
SOIL RRTING (S6! FT?BR)= 250
THE REOUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS:
DEPTH= :l ~--I LEI'4GTH= 4El GRR'.¢'EL DEPTH= 6
THE LENGTH DIMENSIOH IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETI4EEH THE SURFRCE OF THE
GROUND END THE BOTTOM OF THE EXCRVRTIOH (IN FEET).
THERE IS IlO SET HIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETHEEN THE OUTFRLL PIPE
RND THE BOTTObl OF THE EXCRVFITION (IN FEET).
F-:EQL$ I RED SEPT I C TRI'4K S I ZE= 588 GRLLOI'-IS
PERMIT RF'PLICRNT HAS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
IHSTFtLLRTION INSPECTIONS OF FINY 14ELLS RDJFtCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDEHCES THAT THE ~IELL NILL SERVE.
Ti.lO ( 2 ) I 1'4SPECT I Of-IS RRE REQU I RED
BACKFILLING OF RNY SYSTEM NITHOLIT FINRL INSPECTION RHD RPPROVFIL BY THIS
DEPRRT£,IENT WILL BE SUBJECT TO PROSECUTIOH.
MINIMUM DISTANCE BETNEEN A HELL AND ANY ON-SITE SEHRGE DISPOSAL SYSTEM IS
i00 FEET FOR R PRIVRTE 14ELL~ OR
158 TO 200 FEET FROM Fi PUBLIC NELL DEPENDING UPON THE TYPE OF PUBLIC NELL
OTHER REOUIREr,IENTS MAY RPF'LY. SPECIFICATIONS Ft~4D CONSTRUCTION DIFIGRAMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
PERt.1 'r T EXP I RE`x, DECEr. IBER _-~-- :1..
I CERTIFY THAT
l: I RM FRMILIFIR HITH THE REE~UIREMENTS FOR ON-SITE SEHERS AND IdELLS RS SET
FORTH BY THE MUNICIPALITY OF RNCHORRGE.
2: I I, IILL INSTRLL THE SYSTEM IN RCCORD8NCE 14ITH THE CODES.
~: I UNDERSTAND THRT THE ON-SITE SENER SYSTEM MAY REQUIRE ENLRRGEHENT IF THE
RESIDENCE IS REMODELE[> TO INCLUDE blOR~THRN 4 BEDROOMS.
AF'PLIC~NT 1,1. F. VRN VRLKIN~F:GH
GP"'~TER ANCHORAGE AREA BORO~'~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, AI. ASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEh~
SEPIIC TANK:
DISTANCE FROM WELt ./~"~)'"J / MATERIAl
LIQU,D CAPACITY
(
MAILING
ADDRESS ,· ~ /4~ PHONE
LEGAL DESCR,P,,ON
COMPARTMENTS
INSIDE WIDTH~DEPrH
GALLONS. INSIDE LENGIH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:
t OUTSIDE DIAMETER
_ORW.DT. / F .LE.G.. '~¥ ,DEPT.
/~Oe3 ~, ; ,'
. DISTANCE FROM WELL . BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA ~ALL AREA) ~ .SQ. Fl.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
. FOUNDATION.
DISTANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
DEPTH; TOP OF TILE TO FINISH GRADE
. NEAREST LOT LINE
TRENCH WIDTH
TOTAL LENGTH
.. OF LINES
IN. TOTAL EFFECTIVE
.DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: 1.yp~/_~ ~' ~,//--~,~/~'~,~ DISTANCE FROM WALE.
, BUILDING FOUNDATION. S~PLE
NEAREST SEPTIC SEEPAGE
LOT LINE . SEWER LINE . IANK , SYSIEM . CESSPOOL
DIAGRAM OF SYSTEM
DISTANCES:
. NEAREST
OTHER
,SOURCES__
DATE
GREATEL ANCHORAGE AREA ~, '9ROUGH c=~No. ~
o° tlEALTII DEPARTMENT
~/ 327 Eagle St. Anchorage, Alaska 99501 279-2511
NAME OF APPLICANT.'7';'
RESIDENCE ADDRESS
LEGAl DESCRIPTION
APPLICATION TO INSTALL; SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PERCOLATION TEST RESULTS
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
( )
.~/I) MAILING ADDRESS , PHONE NO.
LOCATION OF INSTALLATION
SEEPAGE PIT .~ ,DRAIN FIELD
TO RE INSTALLED BY.
ANTICIPATED DATE OF COMPLETION
BELOWTO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ,PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
· SEPTIC TANK SIZE TYPE . SEEPAGE AREA
DIAGRAM OF SYSTEM
TYPE
DISTANCES:
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
· · ,.' .' ~ ' .-.', - HEALTI[ D~PA~T}DIT , · . · ; .., ~SE ~ - · ~' ;' "~
............ 327 EAG~ - , · , ~-. - ~ ..... ~ ,
............. ..*... ~CHO~G~,.~S~ 99501- ~ . -,,.. ~ . , ... ~ ........... ~ .......... ..
This Fom Eepo~ts a. So~ls Log ,,~ ~ -~ '-Perbolation Te~ - - ..... ' ~:
'Fee~ Sotl ~a~ac~e~ts~tcs "" ' ~cation Sketch " ': ' '
....... r~,~..' :..-; :,; ;.
"-.' :~; · . Was Gvoun~ water ~ncofinte~a?' '~0 '":; ~ 4
:..' ,... :' .'..I~ Yes~ At.},ha~ Depth. . L, . ,.. -;.
/
/
Eeadlng Date .:' g~*oss' TiMe: ' Nit 'Tlm~" Depth To H20 ', Net Dvo~"
! '
1
.' '- - -' Frop.)sed Instal~Seepage 'P~ ~ D~'aln Field
...... . Depth Of Inlet ~t .~,. Depth To Bottom Of Pit 0~- T~nch
- · COM~EItTS ~ ·
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
1. PROPERTY OWNER . *.
MAI LING ADDRESS
3. TYPE DWELLING
~ SINGLE FAMILY RESIDENCE
[] MULTIPLE FAMILY RESIDENCE
OTHER (Describe)
4. WATER SUPPLY
INDIVIDUAL
COMMUNITY/PUBLIC
SEWAGE DISPOSAL
INDIVIDU. AL/ON-SITE
[] PUBLIC UTILITY
[] HOLDING TANK (Maintenance Required)
~ APPROVED FOR H BEDROOMS
[] CONDITIONAL APPROVAL (See Attached)
[] DISAPPROVED
81: Time
Date
Insp
~'""~IClPALITY OF ANCHORAGE'-''"~
DEPARTMEH,-'Ur HEALTH AND ENVIRONMENT~'rROTECTION
825 L Street,.Anchorao~. Alaska 99501
264-4720
Date Received:
9:.30 ~.M. 82: Time ~ 83: Time
\ /
4- 7~78 Thrusday Date 3o I-~ /7~ Date
...Pr~t~A Insp ~( Insp
April 21, 1978
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request:
Mailing Address:
2. Property Owner: WF/Anna M.
Mailing Address:
Van Valkinburgh
170 Man'o War Road 99577
Phone:
Phone:
694-2674
3. Legal Description: Lot 3A Eagle River VAlley Ranchettes subdivision
4: Single Family Residence: (x) Number of Bedrooms: Four
Multiple Family Residgnce: ( ) Number of Bedrooms:
Se
Well System:
Permit #
Construction
Individual Well ( ) Community/Public System (x)
Depth of Well Well Log on File
Bacterial Analysis
( )
e
Sewage Disposal System:
Permit #
Septic Tank Size
Absorption Area
On-site System
Installed
/Do o
(xk Public Utility
1969 ' Installer
Manufacturer ~.~. ~-
Rate
Soils
Distances: Well to Septic Tank
to Sewer Line Nearest Lot line
to Nearest Lot Line
( )
Material ~
to Absorption Area
Absorption Area
*7'
MUNICIPALITY OF ANCHORAGE
!)Department of Health and Environmental Protection
/ 825 L Street, Anchorage, Alaska 99501'
264-4720
~equest, for Approval of Individual Sewer and Water Faczlzfies
1. Property Owner. W.F, ~A~n6,~,
Mal-zng Address: ~qJ/i ~'v¢~t~. 33A-77 Phone:
2:
Name of Buyer:
Mailing Address:
Phone:
e
®
Lending Institution:
Mailing Address:
Phone:
:Realtor/Agent:
Mailing Address:
Phone:~D~-a]]~
Legal Desc.r. iption:
Street Location:
Single Family Residence: (~ Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
7. Water Supply:_ * Individual Well ( ) Public/Community System
If Individual Well, well depth
If Community System, name of system
8. Sewage Disposal System: *~n-site System (~ Public System ( )
If On-site System, date of installation: ' ~'-~IV ~ ~D ' '
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77
t~age Two
Request for Approval of
Department of Health'and Environmental Protection
Individual Sewer and Water Facilities
Legal Description: Lot 3A Eagle River Valley Ranchettes Subdivision
Comments:
Affadavit Attached: ( )
Approved:
Disapproved:
Letter Attached:
Date:
Date:
( )
~partment Worksheet:
May 3, 1978
I?.F. Van Valkenburgh
170
~agle River, Alaska 99577
SubJect~ Lot 3A Eagle River Valley Ranchettes Subdivision
The percolation test performed on the subject property
failed to pass the ddequacy test. Therefore, before we
may approve thu request an upgrade of the syst~n will be
necessary.
The upgrade would include:
(1) Addition of a 500 gallon septic tank to the ~xisting
1,000 gallons.
(2) Installing e forty~40) foot trench with si.x(6} foot
of gravel belowthe drain pipe. The tsench should
be installed in conjunction with the seepage pit,
A pemit is required before any construction begins.
If there are any further questions, please contact this
office at 264-4720.
Sincerely,
Robert C. Pratt,
Sanitarian