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Home My WebLink AboutBRUIN PARK BLK 1 S142' OF E2 [~ 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 NA ' IPHONE I~ I F-~EW ff/~ __. AbsorPtionS/~ ' PER~~ ~Z Manufacturer ~ -- Material ~~ ~ ~o. of~o~rtmonts ~ ~ ~ Liq. capacity in gall - E: inside length Width Liquid depth ~ ~ ~~ DISTANCE TO: Well Dwelling PERMIT NO. ~ -- ~ Manufacturer Material Liquid capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO, ~ = DISTANCE TO: ~ ~ ~ No, of lines Length of each line Total length of lines Trench width 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 m 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 SOIL TEST RATING INSTALLER 72-013 (Rev. 3/78I PERMIT NO. RPPLICRNT LOCRTION LEGRL. GONZRLES ESTRTE/BOB GON BOX 4-'±~57 99508 LRKE OTIS/O~MRLL. EV ROAD SIL42~ E2 B iL BRUIN PRRK S?D LOT SIZE 244-:~080 40000 SQURRE FEET TYPE OF SOIL RBSORPTION SYSTEM IS: DRRINFIELD MRNIMUM NUMBER OF BEDROOMS = 4 SOIL RRTING (SQ FT/BR)= ~76 THE REQUIRED SIZE OF THE SOIL RBSORPTION S'¢STEM IS: -'-- -- -"- --~ i ~- -- --- -- THE LENGTH DZMENSZON ~S THE LENGTH (~N FEET) OF THE TRENCH OR DRR~NF'ZEL[:,. THE DEPTH OF R TRENCH OR P~T ~S THE DZSTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRT~ON (ZN FEET). T H E T ~: E r-J ,2: H 14 I [) T H I 5 LZ~. ~3 (:~ CZl ~-- E E THE GRRVE[. DEPTH IS THE MINIMUM DEPTH OF GRRVEL. BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE ENCRVRTION (IN FEET). F..:E,;!LI I F..:ED SEP'T I C: 'TR~-~F::: .-'E,_, I ZE== 50E~ F'ERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTALL. RTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS F'ROPERTY RND 'T'HE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. BFICKFILLING OF RN"r' SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS :1.00 FEET FOR R PRIVRTE WELL OR iL50 TO 200 FEET FROM R PUBL. IC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE WELL 'TO R PRIVRTE SEWER LINE IS 25 FEET RND 'TO R COMMUNITb' SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY 8PPLY. SPECIFICRTIONS AND CONSTRUCTION DIRGRAMS ARE RVRILRBLE TO INSURE PROPER INSTRLLFITION. I CERTIF"r' THRT iL: I RM FRMIL. IRR WITH THE REt.]UIREMENTS FOR ON-SITE SEWERS RND WELL% RS SET FOF.'.TH B'¢ THE MUNICIPRLITY OF RNCHORRGE. ;'2: I WILL INSTRLL. THE S"r'STEM IN RCCOR[:'RNCE WITH THE CODES. 3:: I UN[:.,ERSTRND THRT THE ON-SITE SEI.4ER S"r'STEM M8°¥' REQUIRE-. ENLRRGEMENT IF THE RES I[:,ENCE IS REMODELED TO I NCLLIDE MORE THRN 4 BEDROOMS. RPP/.ICRNT GONZRLES ESTRTE,.'"BOB GONZRLES MUNICIPALITY OF ANCHORAGE Department Health and Environmental rotection 825 L Street, Anchorage, AK. 99501 ~~ 264-4720 * * * HANDWRITTEN PERMIT * * * ~?~5/ W~ AND/OR ON-SITE SEWER PERMIT Applicant: ~r~ / _~ ~Z~P~-Mailing Address: Location: ~- ~ ~ ~3 7~ 'S ~ Phone Number: Legal Description: 5. J~'~ ~y~ ./~/ ~f~¢'~ ~ Lot Size: ~/ Type of Soil Absorption Sy~em Is: Trench: Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms; ~ Soil Rating(sq.ft/br) /7~ The Required Size of the Soil Absorption System Is: DEPTH ~ LENGTH GRAVEL DEPTH WIDTH The length dimension is the length(in 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(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). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = ~OO GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection ~and approval by this department will be subject to prosecution. Minimum 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 a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER ~1~ 1 9 ~ 1 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that~ bedrooms. ~p~llc~n~ - ' SWP/024 (1/81) by DOC Co. dba SULLIVAN WATER WELLS P. O. BOX 272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759 OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE - Started PERMIT NUMBER Ended DEPTH OF WELL STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KlND OF CASING KIND OF FORMATION: From From From.__ From__ From__ From __ From___ From__ From__ From From ~ From . From From__ From From From Ft. to~Ft Ft. to~.Ft. .Ft. to Ft. Ft. to Ft. Ft. to__Ft. Ft. to , Ft. Ft. to Ft. Ft. to.__Ft. Ft. to Ft. Ft. to Ft. Ft. to Ft. Ft. to Ft. Ft. to Ft. Ft. to.~.Ft. Ft. to Ft. Ft. to Ft. Ft. to__Ft. From__Ft. to__Ft. From.__ Ft. to ... Ft. From__Ft. to Ft. From__Ft. to Ft From__Ft. to__Ft. From___Ft. to__Ft. From__Ft. to Ft From__Ft. to Ft. From__Ft. to Ft. From__Ft. to Ft From Ft. to__Ft From__Ft. to Ft From Ft. toMUNICIP/~[TY OF ANCHORAGE DEPT. OF I',~ALTH & From Ft. to ENVIRON~NTAL P;]OTECTION From Ft. to ~q ~ o ~non -- ~ IOUU From Ft. to Ft. From Ft. tok .El VED MISCL. INFORMATION: DRILLER'S NAME " PERMIT NO. r. li_iF4 1 c: I ~ FtLIT~' OF R~4CH ,,~RRGE DEPRRTMENT OF HERLTH RND ENVIRONMENTRL PROTECTION 825 "L~ STREET, RNCHORRGE, RK. 99501 2~4-4720 I~IELL PERr-1 IT ( 800~20 ) LOT SIZE ~44'-~962 45560 SQURRE FEET MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVRTE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS WRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRRLE TO INSURE PROPER INSTRLLRTION. PER~I I T EXP I RES [:.ECE~IBER I CERTIFY THRT l: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. SIGNED: RPPLICRNT I_oLiED b ESTRTE OF JOE GONZRLES V4, 0 , GRE/-ER ANCHORAGE AREA BOP"IGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~*~ ~-~ff LOCATION SEPTIC TANK: MAILING ADDRESS '~"~, /~2~ ~)//)~ ~-~ LEGAL DESCRIPTION DISTANCE t FROM WELL ~ ~' MANUFACTURER NUMBER OF MATERIAL ~-~O~7~Z~ COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY //g~&-~ GALLONS. SEEPAGE Pit: NUMBER OF PITS / DIAMETER ~ LINING MATERIALCT~ ~t~ CRIB SIZE: ! BUILDING FOUNDATION /tO . OR WIDTH DIAMETER NEAREST LOT LINE ADDITIONAL ABSORPTION LENGTH , DEPt, DEPTh ~ ~DISTANCE fROM: WEll TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. WELL: TYPE ~Z~/~/d. CONSTRUCTION BUILDING ~ NEAREST /0 t 4- NEAREST FOUNDATION /~O , LOT LINE , SEWER LINE CESSPOOL , OTHER SOURCES APPROVED / DISAPPROVED. REMARKS DEPTH SEPTIC , TANK / DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: INSTALLED BY: ,J'-"/:~/ O~u)~y PIPE MATERIAL: LOT SLOPE: REMARKS: Form No, EQ-031 DATE DIAGRAM Of SYSTEM GREATER ANCHORAGE AREA Borough DEPARTMENT OF ENVIRONMENTAL OUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT / INSTALLATION LOCATION LEGAL DESCRIPTION -~ /~/~ / / INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACilitY TO BE SERVED --'"" SEEPAGE PIT ~DRAIN FIELD / TO BE INSTALLED BY COMPLETION DATE ANT,C,PAtED OTHER NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REOUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL (~UALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. i _ / ,'I~_ . ,4//&- _..._... ,--.,- - SEPTIC TANK SIZE _ _ TYPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK _~/~ FOUNDATION TO SEEPAGE PIT - _ . DRAIN FIELD SEPTIC TANK TO SEEPAGE Pit WALL SEPTIC TANK . SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD TO RIVER, LAKE, STREAM. DIAGRAM OF SYSTEM ~J~f~'~ / DRAIN FIELD ~ ALSO CONSIDER AREA WELLS. , SEEPAGE PiT /~,' ~ · DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND BEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER A~/~RAGE A~~OUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ~__~/~__~ . , / FORM NO. EGI-016 ~ Performed for ~ Legal Description: This GREATER ANCHORAGE AREA BOROUO" Jepartment of Environmental Qu, 3330 "C" Street Anchorage, Alaska 99503 cy form reports: SOILS LOG - PEROLATION TEST <_o_~~ Date Performed ~/~/? '~/ '. / -/ Soils log~ ......... Percolation test 1 1' 1: 1: 1, Depth Feet -- ~00 Was ground water encountered? If yes, at what depth? Reading Percolation rate .Proposed i.)ep th of COI',II'ilE[~TS: Date Gross l'ime Net Time minute. Depth to Water Net Drop installat~-~n?---~'ebpa-'-.qe Pit Drain Field .............................. Inlet . Dept}i-¥o--b~-t-t-o-~--O~--pit or trench ............................... EQ-040 (6/74) = * MUNICIPALITY J~FANCHORAGE . ~--,,,~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO'~d~II~LITY OF ANCHORAGE ' ~/,_,~ ~__~ ' ' : 825LStreet-Anehoraga, Aleska99501 DEPT. OF HE~,LTH & ' //I,?l~J ~J~,/// ~ ~VIRON~ENTAL PROTECTION ~ Telephone 2644720 UAR ~1981 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND ~ ~T~S DIRECTIONS: Complete all parts on page 1. In=ompleta reqUes~ will not be pro=e~ed, Please allow ten (10) da~s for processing. 1. PROPERTY oWNER · ~' - ' ...... / "I PHONE ~s~ o~ 3~ ~nz~te-s~ ~~= ~ ~n=~es I 333-2268 ~.~. g...~x. 1357 ~. ~. 99509 ,, . , PROPER~Y RESIDENT ( f d fferent from above) ~ . , ' ~ PHONE. ~1~ ~ ~ ~~ 276-9324 MAI LING'ADDRESS ' ~ ' ' 852' ~t 36~ A~. ~. ~. 99503 · . ~ ~ - 263-3240 .,~p~es, S~ (~ey ~) MAILING ADDRESS" - ' ,64~ W- 8~.Av. ~. ~. 99501 4. REALTOR/AGENT ~ HONE MAILING ADDRESS ~ .r . ~577 C. S~e~, S~03 .~.~, 9~50~ . . , . STREET LOCATI ON · t~ I=~ke (:Yc~s :Road 6, TYPE OF RESIDENCE ' ~ ~ ,L- NUMBER dF BEDRO6MS ' ' ' ~ SINGLE FAMILY ~ One ~ Four ~ Other ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7. WATER'SUPPLY '" ~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ~ COMMUNITY _ Since June 1975. For wells drilled prior.to that date, give Well ~ PUBLIC UTILITY depth (attach log if available.) ~ ,NDIVI DUAL/ON-SITE** *'If individual/on-site, give installation date ~ PUBLIC UTI LtTY If system is over two (2) years old an adequacy test is ~eq'uired by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCES~IN~ CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS TIME TIME DATE DATE INSPECTOR DIRECTIONS: INSPECTOR DATE RECEIVED r' TIME DATE INSPECTOR NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SlX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] I NDIVI DUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: ./~{DC) If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING MANUFACTURER ~ Septic/Holding Tank IAbsorption Are4 ISewer Line ! Nearest Lot Line I~,'~ONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE ~--~5~ -~ LEGAL DESCRIPTION I' BY {Titl~ ~ 72-010 (Rev. 3/78) ALASKA e[1UIROIlme[1TAL CO[1TROL SeRUICe$, II1C. ~ngin¢¢rJn~ 8 I~nuironmcntal Studi~s MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 2 ? 1981 RECEIVED MARCH 24 1981 F'EOF'LES BANI.( AND TRUST POUCH 7007 ANCHORAGE Al.', 99510 SELLER - GONZALES SUBDIV][S][ON-BRUIN PARK BLOCK-1 LOT-S lq2' OF' E 1/2 THE TYPE OF ABSORPTION SYSTEM IS A PTT WITH AN AREA OF THE SYSTEM IS CAF'ABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY, THE SO][I_S RATING OF' THE SYSTEM AT CONSTRUCTION WAS 150 AN[) NON IS 176 SQFT/ BEDROOM, BASED UPON I'HE: TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME[. THE SEI::'TIC TANl.( NAS PUMPED ON 3-24'--81 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 2 ? 1981 RECEIVED 1220 U Jest 25th Auenue * Anchorage, Alaska 99503 · (907) 275-1361 825 "L" SI REET A LA;., k.A 9950 ! ANCHORAGE, ~-' '" (907) 264.41 t I GEORGF! M. f::UL. LtVAN, MA'YOR [')EPARTMHN'F OF IJEAL'f'!4 AND ENVJFtOI',IMr~',f,'FAL PROT~'(tTION March 26, 1981 Estate of Joe Gonzales Executor Bob Gonzaies Post Office Box 4-1357 Anchorage, Alaska 99509 Subject: SI. a2' of *z E-~ Block 1 Bruin Park Subd.i. vision Approval for the individual sewer and water facilitie, s cannot be granted until the following i. tems have been completed: . .].v .:.red to The water: analysis repo.rt, needs -to be de]..'-¢', --: this office from-hhe C.h.e~n Lab~ 5633 B Street., for our revie{q; The septic tank pumped with a receipt, submitted to this office. An adequacy %est needs to be performed on the exis'l:.ing leaching area, This test will determine if the .L.. t. ing is addquate according to Natloi al Standards. A of private, firms performing the %est is enclosed, This report needs..%o be s~lbmitted to this department for our review, "" (4) Tho appii.c!ation shows the number of bedrooms exceeds 'the number the sewer system was originall, y designed for. An upgrade will be required, addition of a 50() gallon septic tank. Prior %0 any upgrade, a permit wi]..! need to be isstxod by this department. Robert C, Pratt, R.S. Associate £pecialist If there are any furtzher questions, pi. ease ca],l this office at 264,~4720. Sincerely~ ~0~~ ~%~ RCP/Ijw 1. Approval requested by: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received C Time of Inspection Date of Inspection ~.' REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Mailing Address: 2. Property Owner:X~/~ ~Mailing Address: ~/~/~- 3. Legal Description: ~?f~'~-//~,~ / ! 4. Location: 5. Type of facility to be inspected ~(~ --~-~-~ 6. Well Data: e Phone: No. of bedrooms A. Type ..~,///~, B. Depth /~"0 C. Construction D. Bacterial Analysis Sewage Disposal System: .~ ~~ J~ -'~ ''/~ /~~ ~ ~ ~/~ ~x ~~' A. Installed %?At~...~. /~'~ B. Installer C. Septic Tank: 1. Size/-~-~C)/o--o~o 2. Manufacturer ~ ~ D.~~I. Absorption Area ~o~ 2. Material E. D~Total length of lines e Distances: A. Well to: Septic tank ~ ~ , Absorption area ~ ~ /, Sewer Lines· Nearest lot line , Other contamination B Foundation to septic tank ~o r-/' Absorption area C. Absorption area to nearest lot line . ~ / EQ-034 (1/74) Page I of two pages Page 2 of two pages - Request for Approval of Individual ~:wer & Water Facilities Legal Description ~ 5 / ~z~ o~ ~ ~/~_ ~ ~ ~/zL ! ~xe~/ ~_ Comments ~ ~~-~L~_~K[ 7_ ~?~ Approved ~ ~ ~isapproved Date Z-xo-?.~., Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I 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)