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Home My WebLink AboutDALZELL-SCHNEITER BLK 2 LT 4PARc { ' 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 ~ UPGRADE LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS liq. capacity in gallons I IF HOMEMADE: I Inside length DISTANCE TO:{ Well I Dwelling Manufacturer Material Width IMaterial Nearest lot hne Trench width No. of compartments Liquid depth ' PERMIT NO. Liquid capacity in gallons Well Foundation PERMIT NO. DISTANCE TO: Length of each No. of lines line Total length of lines Distance between lines inches Top of tile to finish grade Material beneath tile Total effective absorption area inches Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s} OTHER PIPE MATERIALS SOl L TEST RATING ~(/--,~/ INSTALLER REMARKS APPROVED DATE 724)13 (Rev. 3178) LEGAL tdUNIC!i LITV _OF_,_Bt-iCH~ RAGE DEPBRTHENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L' ~TREET~ RNCHOR~GE~ RK ' ~501 - 264-472~ ON--S ITE SEWER PERI'~ I T PERMIT NO: ,~840504 UPGRADE DATE ISSUED: .~.~725/84 - APPLICANT: ROBERT G. DRLZELL ADDRESS: ---- BOX' 300 L. -E · ANCHOraGE, RK 99501 CONTACT PHONE: 346-1679 LEGAL DESCRIP~ i~UBDiYISION: DRLZELL-=SC~EITER _ . SECTION: LOT SIZE: i. 5R (S~. FT. OR ACRES> LOT,: '~; RANGE: 3W BLOCK: 2 i · CERTIFY -THAT: 'i. I RM FAMILIAR WITH THE REQUIREHENTS FOR ON-SITE SEWERS.AND WELLS RS SET · FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF R~'RSKR. -- _2. I WILL ~NSTRLL THE SYSTEH IN ACCORDANCE WITH ALL MOA CODES AND REGULATIONS., AND IN COMPLIANCE.WITH THE DESIGN CRITERIA OF THIS PERMIT. I WILL ADHERE TO ALL MOA AND ~TRTEJOF RLRSKR REQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY-EXISTING WELL., WRSTEWATER DISPOSAL SYSTEM OR PUBLIC SEWERRGE~SYSTEM ON THIS OR ANY ADJACENT OR HERRBY LOT. IF R LIFT STATION IS INSTALLED IN AN AREA covE'"R'i~ BY MOA BUILDING CODES.. THEN (d.> RN ELECTRICAL PERMIT AND IHSPECTION MUST BE OBTRINED.~'(2) RS-BUILTS iWILL NOT-BE APPROVED'WITHOUT RN ELECTRICAL INSPECTION-REPORT.~ AND (~) THE ! ELECTRICAL WORK ~U~T BE DONE[~Y' R LICENSE{> ELECTRICIRN~SIGNED ~ .~ ~___...__ DR~E: ~'~_~/. APPLICANT: ROBERT~T G_ DRLZELL - · / - ' G"~ATER ANCHORAGE AREA BORC'"~H 't ~ HEALTH DEPARTMENT ~ I 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N°. 183 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION ~'~ ~/~/~/~'~ ~ LEGAL DESCRIPTION~--~,,~~~.- SEPTIC TANK: n~', ~ ~ LI ~ ~ ~~~' NUMBER OF / DISTANCE FROM WELL ~ / ~ MATERIAL ~ ~~ COMPARTMENTS LIQUID CAPACITY /~ GALLONS. INSIDE LENGTH ~NSIDE WIDTH LIQUID ~DEPTH. ~ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL / ou,S.DE D, E,ER O,,W.DT. ~--~-~z~/~-~-~"-~~'~ ,~'~/~J/~' . DISTANCE FROM WELl /'-~ ' ~ L E NGTH ...,,-~ ~,.a'' , DEPTH BUILDING FOUNDATION ~:>',',','~ '~ NEAREST LOT LINE /~')~:? / ~ . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: DISTANCE FROM WELL /'"'"'/~J F OUN DATION~ , NEAREST LOT LINE .~, NUMBEROF L S[I S~'/'/ DISTANCE BETWEEN LINES ~ TRENCH WIDTH / IN. TOTAL EFFECTIVE ~PTH: T~F TEE ~O FINISH GRADE DEPTH OF FILl A[H IILE IN. ABOVE TILE WELL: LOT LINE TYPE ,~'.,~_/,~zm-?~'~ DEPTH ,~'"* · DISTANCE FROM ~/~ WATER ~ BUILDING FOUNDATION ~ ' ~ S~PLE ~, ~ NEAREST ~ SEPTIC ~ ~ SEEPAGE .. SEWER LINE , TANK ,, SYST~ /~/~ , CESSPOOl , NEAREST SOURCES DISTANCES: DIAGRAM OF SYSTEM GREATEE ANCHORAGE AREA : DROUGH II£ALTH DEPARTMENT 327 F~gle St. Anchorage, Ala~kn 9q501 279-2511 Case No. /~,~ , SEWAGE DISPOSAL SYSTEM = APPLICATION & PERMIT NAME OF APPLICANT-~e'~:f" 6' '~.'7_.~,~1 MAILING ADDRESS?'-'~ RESIDENCE ADDRESS ~l ~C~ ~ LOCATION OF INSTAL~TION ~I~H ~D APPLICATION Tp INSTALL: SE~IC TANK X , SEEPAGE PIT~, DRAIN FIELD , OTHER PE~CO~TION TEST.EESULTS(~O [/~ ANTICIPATED DATE OF COMPLETION . r- -~BELOWTO BE FILLED OUT BY HEALTH DEPARTMENT T,,S,STOSER':'EAS P-- .PERM,TTO,,STALL^ feXt' "" AS DESCRIBED BELOW. SIZE OF.UNIT-TO BE SERVED ~-- '""" ~ ~' TYPE .SEPTIC~T,A, NK SIZE" [000 TYPE SEEPAGE AREA q-S"O a ' '" ---:-z-' '"t-'-\'~' "' DIAGRAM OF SYSTEM certHealth A~thority ify 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. &~ P~ i~j~,O~a~~pf .~W~yRoB e ,r t Dalzell Legal Deseriptzon: Lot Block . This Fcrm RepoPts a: F"~REATER ANCHORAGE AREA BOROUGH~-~ HEALTH DEPARTMENT CASE 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Date Performed Subdivision120315 p ~E Ouart...~ec. ·.~ercolation Tes~' Depth Feet Soil CharacteriStics brown sandy silt (ML) gray sandy silt (ML) 8~ gray sand (SP) .0-- gray sand (SW) ---~gray silty sand (ML) /-- Was Ground ;,'at~_~ rtcountered? If %'es, ;.' ,?at Dc~th no Location Sketch I I ! eao~._~,_ .:.'.e [ Grc,s~. ?iae Ne~ Time Depth To H20 Net Drop .n..~l.,,._~,.a, Seepage Pit xx Drain Field FroF~sed ' ..... '- · .Depth Of Inlet Depth To Boltom Of Pit ~r Trench 12' COMMENTS: 170 square feet of drainage area is required per bedroom Test Performed By: R. E. Carlisle These recoranendattons are computed from visual observation and based on the uni- fied classification system. Data Csr~tfied By:,National Test~n~..~ervtce Inc. Date: