Loading...
HomeMy WebLinkAboutSCHROEDER LT 5S MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 I_ Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME / -_- PHONE NEW �G /� _ __ ____ � _ �Q9� ❑UPGRADE MAI LIw'DDRESS • I, LEGAL `DESCRIPTION LOCA ION NO, OF BEDROOMS AU/ l Well D Absorption DISTANCE TO: area Dwelling P y C-R_NO. UL — wQ Manufacturer �P in M er al No, of comgart ents h- -- N Go. rapacity in gallons IF HOMEMADE: Inside length Width Liquid depth ❑ �• DISTANCE TO: Well - Dwelling � PERMIT NO. OQ 2 F• Manufacturer Material Liquid capacity in gallons WT =. DISTANCE TO: Well ��1 Foundation •' Nearest lot line` PERN] :, O. x;1K� J LL 1 No. of lines Length of ea h line Total length of I'pe Trench widt t _� Distance Iten lines H Z ui / aches /t— ¢F: ❑wz, Top of the to finish gra Material beneath tile AW inches Total effective absorptionarea Length Width Depth PERMIT w Q a F Type of crib Crib diameter Crib depth — Total effective absorption area Wo W Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO.�� J W DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER e PIPE MAT RIALS �\ C� -- SOIL TESTRATING !v 6) INSTALLER L S,, . /� / JA1 0J_W� REMARKS I L LEGAL APPR D DATE THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� DVT\u/o ` in co � THE LENGTH DIMENSION IS THE LENGTH (f FEA) OF THE URENCH OR DRHINFIF"|D THE DEPTH OF H TRENCH OR PIT IS THE DISTHHCF BETWEEN THE SURFRCE OF THF GROUND RND THE BOTTOM OF THE EXCRV0TION (lN FEET) THERE IS NO SET WIDTH FOR TRENCHES THE GRHVEL DEP[H IS TH[ MINIMUM DEPTH OF GRRVEL 8EINE: EN THE UUTFHLL PIPE HND THE BOTTOM OF THE EXCHVHTION (IN FEETI ~�FT 141 W, S 1. :-A ITT ��P . I 1 w " q� tl-�C-1) PERMlT RPPLIRAN T HHS THE RESPONSI8ILITY TO lNFORM T|1IS DEPqRTMENT DURIHG THE INSTHLLHTION INSPECTlONS OF ANY WELLS HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THHT THE NELL HILL SEWYE. BHCKFILLING OF HNY SYSTFM WITHOUT FINRL INSPECTION HND HPPROVHL BY THIS 1.:EP8RTMENT WILL UE SUBJECT TO PROSECUTIONC M(NIMUM DISTHNCE BETWEEN R MY A. AND HNY OH -SITE SEWHGE DISP0SHL SYSTEM lS 100 FEET FOR H PRIVHTE WFLLj OR 150 TO 200 FEET FROM H PUBLIC WELL DEPEND/NG UPON THE TYPE OF PU8LIC WELL OTHER REQUIREMENTS MHY OPPLY' SPECIFICHTI0NS HND CONSTRUCTION DIHGRHMS HRE HVHILHBLE TO INSURE PROPER INST8LLHT/CHI. Po� RZ � FV 1-1 :T F E: 5A 1w :K171 U S, UP Pit El 0 Q �TAH.^ IL SA ? , k Bi I CERTIFY THHT 1� I RM FHMILlHR WITH THE REQUIREMENTS FOR LIPS ITE SEWERS HND NB - LS HS SET FORTH BY THE MUNICIPHLITY OF RNCHORHGF. 2� I WILL INSTRLL THE SYSTEM IN HCCORDHNCE W{TH THE CODES � l UNDERSTHND THHT THE ON~SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMENT TF THE RESIDENCE IK MALAWI. ED TO INCLUDE MORE THHN ] BEDROOMS HP T ROGER FTEI, DER SOILS LOG MUNICIPALITY OF ANCHORAGE ❑ PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST iti0 ) Pouch 6-650, Anchorage, Alaska 99502 276-2221 l SOILS LOG – PERCOLATION TEST F 01 .9 /e Ro ver AK PERFORMED FOR: R_Ro Qc -;e d( 7' PL? 3—ihp,n c, crck DATE PERFOnRMED:_l a 19VgV-0' 07p LEGAL DESCRIPTION: 5-c 6✓—SChrDPile !' Svh°��V�Sto �a,'��2 /C'Ver��f ;e'577 SLOPE SITE PLAN ' I I-� LTY C 5/4) /V yt..-/�N� � T -E- S N/ 2AVF Z.,0 v,` 3 U ••G 4 o. 5- O0 GRAv1��c Y Si9N4 rsP� 6 /`1 01. QenJ e 7 APf'rox X09' CoWep 8 '•' ac�Qs;ora / i3o liters rl . 9 0. 10: WAS GROUND WATERS 11 S ___-•----_----__-- _.__-.. i _.. 2 11 ENCOUNTERED? //V C7 L 12 0. 13- 14- 15 314 15 16 17 18 19 20 COMMENTS KI PERFORMED BY: 72-008 (7/76) /L/. 0 P IF YES, AT WHAT E DEPTH? L Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN ,��mir�uLef�iTiuhl l Well M -W DRILLING;, INC. DRILLING LOG �li_II i XI"" t Location (address of: Township, Range, Section, if known; or distance main road of Well Size of casing Depth of Hole feet Cased to - _feet Static water level ft. (above) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforation Well pumping test at _gallons per (hour) (minute) for hours with ft. of drawdown from static level. Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness IIL� TO- TO- TO OTO TO TO TO 2 -STATE T-1 d APPLIC IT FILLS OUT UPPER HAI ONLY Time Property Ov.ner-,-. "- �- Phone Mailing Address�'t `` ' -11� �� �'-��- (.:,_ Zip Code Date Buyer Inspector Inspector Addressa `� I i %� C_ (' �.� y� i( �� �,.. Zip Code ` "� a t t ,a" r-N�IVIRO�;MENI'AL PROTECTION I -ending Institution ).. ,\, y �, ;,-\ \' ; K - Phone r ,-l.-, Address ',f i.,. ,.:� -� 'S� L.. l- Zip Code �lw� LU✓v�# (�.QJ Ilv^_ BY: 0 A_% l.�Ql\.. :J .+- �} .r �.xQ,,,: -- , ^ QA '"F Sl �/--may- lw , Realty Co. &Agent Phone Soils Rating Date Se r Installed Well To Absorption Area Well Log Received Address - _ Zip Code,.'��L l - Legal Description Street Location Type of Residence Single Family r ❑ Multiple Family No. of Bedrooms_ ❑ Other Water Supply 10 Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal 1d Individual Year Individual Installed: L ( -- - ❑ 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 Dale Date Date Date Inspector Inspector Inspector Inspector Field Notes: I q (J�C� w % O�JV4-.) `� � T/ U� MUNICIPALITY OF ANCHORAGE 1 I- ((,'DEPT. OF H`ALTH (; ` "� a t t ,a" r-N�IVIRO�;MENI'AL PROTECTION X IJ I r (� ) APPROVED BEDROOMS .7 'C(O�ND11 IONS OF APPROVAL ( ) DISAPPROVED l,U'nl�-C-O^'vn Q"-Q_QS�`J'ti,Q1 W�? ( F. ON DI.TIONAE_APPROVAL' ^ Ql�.�cT Qy9lC Jv/�.f'c_C_)A �` ok -� DATET'Q? e �ln13---D'�RC) �lw� LU✓v�# (�.QJ Ilv^_ BY: 0 A_% l.�Ql\.. :J .+- �} .r �.xQ,,,: -- , ^ QA '"F Sl �/--may- lw C cwu f�nA A ¢- �.c cls `�Q 4'", �.�l._Vki 1l3 aOAJ..Te/� GZCiO 0 �� l, �J D .ma c ii�sY�1l Pi Soils Rating Date Se r Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size ' 72023 oW) EXCAVATION WORK S LTD Investments 1107 West 71st Anchorage, Alaska 99502 ATTENTION: Mark Tigner August 11, 1983 Reference: Lot. 51, Schroeder Subdivision ROBERT A. SHAFER CIVIL ENGINEER 694-2979 A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of water without any adverse effect on the system. It can be concluded from this test that the waste water disposal system is currently functioning adequately for a •three bedroom residence. However, the system cannot be guaranteed against subsequent failure. If we may be of further service, please do not hesitate to call. E. cc: municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA INSPECTION APPOINTMENTS DA e RECEIVED L iot_�_t-11) TIME — TIME TIME DATE DATE DATE T �— INSPECTOR INSPECTOR INSPECTOR MUNICI CHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OP 1171-717F&—' ENVIRONMENTAL pliOFECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 2 /1 ^;f� 825 L Street - Anchorage, Alaska 99501 r, PR ENVIRONMENTAL SANITATION DIVISION 264.4720 RECEIVED Telephone depth (attach log if available.) REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. — 1. PROPE YOWNER nV - , r'� i� ��✓ [9- DIVIDUAL/ON-SITE** PHONE y MAILS( kv(K-� i U� PHONE PROPERTY RESIDENT (If different from above) Yc- >_— -V k it .-o 0 0v PHONE 2. BUYER MAILING ADDRESS 3. LEND�PF� INPHONE L/�/ a MAILING ADDR IS ? PHONE 4. REALTOR/AGENT e 4 f—� C/2 Y� v v Vi r ev 19— — MAILING ADORES( J') k e– /, h /, ?? j 0 — 5. LEGAL DESCRIPTIONJ <� CJ STREET LOCATION S�, / gvC.IAS 6. TYPE OF RESIDENCE NUMBER OF;BEDROOMS� ;;��Z__ ❑ g--- ` C�i® Four ❑ Other SINGLE FAMILY 1=1Five ❑ MULT - FAMILY Three ❑ Six 7. WATER EL INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled -SU ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM �/ YEAR ON-SITE SYSTEM WAS INSTALLED. [9- DIVIDUAL/ON-SITE** ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) O V� I, THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY RECEIVED Connection Verified__LOG 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑ INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY DATE INSTALLED c� Connection Verified _ — INSTALLER ❑Septic Tank or ❑ Holding Tank Size: ID -5-0 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line WELL T0: Absorption Area to nearest Lot Line - 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 71_ntn (Rav 6/79) RECEIPT Received From_ Address For.J`-- V - AMT• PAID ANCFInfzA� " _�— ,a) y HOW PAID T HECK '51 4- O BK006 Subject: Lot 5 Schroeder Subdivisi-on Approval for the individual sewer and water facilities cannot. be granted until the followinq items have been completed: I The water analvsi.s report needs to be delivered to this office from the Chem Lab, 5633 B Street, 1'� L for our review. (2) The septic tank pumped with a receipt submitted to this office. If there are any Eurther questions, please call this office at 264--4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/1jw cc: Peoples Bank and Trust Pouch 7•-007 995].0