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HomeMy WebLinkAboutT15N R1W SEC 3 NW4NW4SW4SE4 PTNr 7.0 13 ev. 31721 r _ MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SY TEM AND/OR WELL INSPECTION REPORT NAME PHONE UPGRADE G MAILING ADDRESS / LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS byell Absorption area Dwelling PERMIT NO. Uy DISTANCE TO: ' i Manufacturer ! ,� A /I Material No. of compartments Q N Liq. capacity in gallons Inside length Width Liquid depth IF HOMEMADE: Well Dwelling PERMIT NO. JO'Z DISTANCE TO: _ F Manufacturer Material Liquid capacity in gallons Well Foundation Nearest lot line PERMIT NO. w= DISTANCE TO: _J u z No. of lines Length of each line Total length of lines Trench width Distance between lines F Z w inches Ic H Top of tile to finish grade Material beneath the Total effective absorption area CI inches Length Width Depth PERMIT NO. w C7 a F Type of crib Crib diameter Crib depth Total effective absorption area LJ y Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J J W Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST ATIN INSTALLER REMARKS r � V r APPROVE DATE LEGAL L�v l ZGe, 7.0 13 ev. 31721 P"°"P 1-.A IoA 1: A-.' 1 F=" A -A I_ I Y- kT ° TO F- L--314 CD fA C3 E^--'. FA C3 EE: DEPARTMENT C-4.HEALTH AND ENVIRONMENTAL OWECTI��Nd '_'u5 'L !STREET, ANCHORAGE, AK:. S 2� L?Aj Lo 264•-4720 G1ac� ISj�ZJ`( p A SPA--°Tl-rE E=P-".PEyFs° L-A Fo C3 FQFAEQEE &- ° PERMIT NO. i 81O330 ) PQ_I,LU 7 L9L I�,bS EV V C h7 j 1- APPLICANT EDWARD NEOTNICH BOX 1140 CHUGIAK: 688-2713 LOCATION MILE 22 GLENN HWY LEGAL LOT 1 STOP K:HAU'SEN LOT SIZE 43560 `'QUARE FEET TYPE OF SOIL ABSORPTION SYSTEM I S : TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 :OIL RATING (SQ FTIBR)= 320 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: s fl -10e (0F?F A EE _ E>E=F lFVA== THE LENGTH DIMENdSION IB THE LENGTH (IN FEET) OF THE TRENCH OR DRAINdFIELD. THE DEPTH OF H 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 IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INdSPEC:TIONS OF ANY G+TELLS, ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. -7- t j A=A c_: ;:2 I PA F=° E= A_: _r' 3: CAP -4"=--. FI F T E= FT E= C ! A_A T FTE E> _ BACKFILLING OF ANY SYSTEM WITHOUT FINAL IN=PECTIi_N AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSEC:UTIONd. MIN IMUN9 DISTANCE BETWEEN A 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 H PRIVATE WELL TO A PRIVATE 'SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONdSTRUC:TION+i DIAGRAM= ARE AVAILABLE TO INd-,URE PROPER INSTALLATION. T FREM5 P >P=C? EEP lE3F.=F=. Ani _ L: M Y A to 10-- 1 F=�, F4 L_ I -r V 1_e F F4"C . t•-•i ID F;;� F=l (3 F_= --- — -- - DEPARTMENT 4' `HEALTH AND ENS.+IRONMENTAL !`-QTECTION 825 'L. STR,EET� ANCHORAGEr AY. 99- _1 264-4723 rA--� I `A'•E A_AI 13F;:F=A0E F'E-FRr+t I -IF PERMIT NO. C 810330 ) APPL.IGANT EDWARD NEUTWICH BOX 1140 CHUGIAK 688-2713 LOCATION MILE 22 GLENN HWYS LEGAL .'LOT 1-iSTOCKHAUSEN LOT SIZE 43560 SQUARE FEET l IL0 TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH V` '2 MA�IMUM NUMB—EP-10F BEDROOMS = 3 SOIL. TING CSQ FT/BR)= 320 � 0' syS l.Hq-.F+EC!LIIRED SIZE OF THE SOIL A :::SO.." Oh SYST 9 I_K: H>FEF=+7 H LEt 1�ai H= F?�i°v'll�� GtiIE F'TH THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR. DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NCI SET WIDTH FOR. TRENCHES. THE'GR.AVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). PEPMIj APPLIr_ANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE LNST8L'LATION`INSPECTIONS OF ANY,WELLS ADJACENT TO THIS PROPERTY AND THE. "NUMBER-OF RESIDENCES THAT'THE WELL WILL SERVE. Tt Bib < L-2::� .I C-d:-.P'El�, TX iLbr� FA6-`E FSE e_a�RJ I !� ECS _ BACKFILLIP-413 OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT'WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BET14EEN Ft 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 A 'PRIVATE WELL. TO A PP NATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LIME IS 75 FEET. OTHER REQUIREMENTS MAY APPL4'f SPECIFICATIONS FMD._C.ONSTRUCTILIN DrIfGKAMS ARE AVAILABLE TO :INSURE PROPER INSTALLATION. j F^ EI G:M I -r aXf=" I FRf-=f5 I CERTIFY THAT i 1: I AM FAMILJAR WITH THE REQUIREMENTS FOR 'ON SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN AC!CORGAhdCE WITH THE-CODES. I UNDERSTAND THAT THE CSN-SITE S1=WER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS'REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED '= --•-----------_- APP� ICAt T DWARD~hdEUTWIC:H �. �, ISSUED BY _ c `'�6 -__DATE__ _ V4. 0 d I t/ `y /�� ❑ -SOILS LOG MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR:t��6%7 /d LC �I !` _ DATE PERFORMED: ov LZ"� LEGAL DESCRIPTION: DEPT 7 SLOPE SITE PLAN 1 CL fy/S-/lam 77 2 JUP 41 1'n 5- 6- 6 � 9 10 11 12 13 14 4'-( * 000555 A/ WAS GROUND WATER L jl J ��°'� ENCOUNTERED? ��a .#�—,0'--3D#/�^ IF YES, AT WHAT �:• �(!//v El? =' / (j/moo �Q DEPTH? COMMENTS Reading Date Gross Time Net Time Depth to Watery Net Drop 16- 617 17- i0 AaA, 18- it i Robert A. S.aier _ 19 a3 No. i4l -E 20 COMMENTS Reading Date Gross Time Net Time Depth to Watery Net Drop .30MI A) i0 AaA, Lam¢/ rXl/ r PERCOLATION RATE L CJ (minutes/inch) -AA TEST RUN BETWEEN FT AND FT PERFORMED BY: Ls..&5 EAQ1DPexji,,_CERTIFIED 72-008 (6/79) iAAB HD-1 GPc ATER ANCHORAGE AREA BORO"H HEALTH DEPARTMENT a - 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME 4d ins d MAILING Q /X�/V/ ' .+ 5� ADDRESS ,BOX 115/© PHONE LOCATION ////x 3 jr�P/Yi( d✓ LEGAL DESCRIPTION Lu1 I .S/06,eiDU.SPM SEPTIC TANK: — r NUMBER OF STe DISTANCE FROM WELL /�S MATERIAL cj-% COMPARTMENTS / LIQUID /�� / INSIDE WIDTH DEPTH +3 LIQUID CAPACITY GALLONS. INSIDE LENGTH SEEPAGE SYSTEM: SEEPAGE PIT: / 'L / - A, DEPTH NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH LENGTH LINING MATERIAL S . DISTANCE FROM WELL V ,, BUILDING FOUNDATION , i 33 SQ. FT. NEAREST LOT LINE �D TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL FOUNDATION-, NEAREST LOT LINE-, OF.LINES , NUMBER OF LINES -DISTANCE BETWEEN. LINES TRENCH WIDTH - IN. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE _ DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTERMATERIALBENEATH TILE,- - IN. ABOVE TILE WELL: n TYPE uiaz;Ve_J_ / DISTANCE FROM - i WATER DEPTH ,.BUILDING FOUNDATION. SAMPLE , NEAREST LOT LINE NEAREST SEPTICSEEPAGE`. / OTHER , SEWER LINE ,TANK A9 S_ SYSTEM %�O,-CESSPOOL , SOURCES_ DIAGRAM OF SYSTEM - DISTANCES: DATE /�+ ���� APPROVED Zo;" GAAS-HD-2 GRE'AM ANCHORAGE AREA .TROUGH Case No. HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT/JNP/U_7-1, SMAILING ADDRESS )3JK &7U PHONE NO. RESIDENCE ADDRESS LOCATION OF INSTALLATION S%') L�a LEGAL DESCRIPTIO APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY SEEPAGE PIT ti , DRAIN FIELD , OTHER FINANCED THROUGH TO BE INSTALLED BY U/G/� 101IZJ/N/�9 PERCOLATION TEST RESULTS PL p f ANTICIPATED DATE OF COMPLETION ���� 9 BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT �z11512 THIS IS TO SERVE AS DISTANCES: ,PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE 0 , ITT BE SERVED SEPTIC TANK SIZE TYPE 'GAP SEEPAGE AREATYPE DIAGRAM OF SYSTEM 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. DATE / .��—�� APPLICANTS SIGNATURE,/%J/- .GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT CASE fi 327 EAGLE STREET ANCHORAGE, ALASKA 99501 3v?c 0 J Performed For e f , ); C-I,�_. c,r -- _Date Performed SC�� l" �,� �1 to �( Legal Description: Lot Blbck Su division �pckQKSu This Form Reports a: Soils Log �/ Percolat on Test Depth roer Soil Characteristics Location Sketch _ 3' 4' Was Ground Water Encountered? an If Yes, At lI at Depth_�� � Reading j11� "),xu� �bt P GO ca b�i-pQ"t� —"—t r 13oC'�T..+ Jl aJ c-,—tI +( Was Ground Water Encountered? an If Yes, At lI at Depth_�� � Reading Date Gross Time Net Time Depth To H2O Net Drop erco aeon a e Proposed Instal Depth Of Inlet COMMENTS: A-'-, -, �?q eepage Pit 2% Drain Field Depth To Bottom Of Pit Or Trenc Test Performed By p u o n Data Certified By:� Date: --1 IG fa c� PGU-eX .t-, (KC +.a Time APPLIC IVT FILLS OUT UPPER HAL liONLY Property p v Owner � f� yia�.�C� 1� �n,J - .0 "7 Phone Date n Z % C Zip Code Mailing Address (^� U Inspector Beyer / Address All Zip Code G� e. Lending Institution ` 1 /� //1 i i /r�, /7� A ✓G,-..._.. J� r Phone Address - Zip Code Realty Co. & Agent Phone Address Zip Code DISAPPROVED✓ Legal Description f DATE " % Street Location Type of Residence Single Family Bedrooms ❑ Multiple Family No. of ❑ Other Water Supply Individual Soils Rating WELL LOG. A well log is required for all wells drilled since June 1975. FFo�r /A-9--In Community Well Log Received drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Well to Tank Sewer Disposal i❑ndividual Year Individual Installed: Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. - Time Time Time Time Date Date Date Date Inspector - Inspector Inspector Inspector ORAGE Field Notes: DEPT. OF H.`I%LTII I PROTECTION ENVIR0N.,11rtTAL { :. RECEIVED (,�3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ND DISAPPROVED✓ r -�- C/�✓/�/�G ���� �_�� ( ) ( ) CONDITI NAL PPROVAL* 6)11c 6Y1676zeA) DATE " % Aba yev "/-I j C rjw/ 6724= (l�i!> /hT CyGlC Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72023 (3192)