HomeMy WebLinkAboutHUNTER HEIGHTS LT 3Onsite File
Hunter Heights
Lot 3
PID# 020-151-25
Formerly Hunter Heights Tr 1
09/24/2012 04:52 9072430742
i
Vg?
Mark 6egicn
Mayo
AWPS, INC.
r y.tildr1 7 f'r'iC2� .^.4pur'firtier:
Ors' 5C;'rsty bit:;Sior
":water . 'G9ra f^.
°Gaut Street
.79q.
Pump Installation Log
Well Drilling Permit Number: SIV__
Parcel Identification Number:
Date of Issue:
PAGE N1/01
gal Deseription
H /14,±2 r F eAg415
'to f 3
Pump Installation Date: /z N
Property Owner Name &
/721/+ f.<, int r• Wei
IA J.% e
Pump Intake Depth Below Top of Well Casing: ';91/ feet
Pump Manufacturer's Name: 1'1 , ,v1 Ot? i d
Pump Mode): 2 3 0 5 ()V S L M
Pamp Size l/z hp
Pitless Adapter Burial Depth: ties feet II
PitiessAdapter Manufacturer's Name: AAt'L u.es7"
Pit4es5 Ade:nese lamssle� :
E'ell Disinffec:ed Upon Completion.'
lethodofDisinfection: CGy r,t4tc4.t
Comments:
Pump installer Name:
W PS
Attention: The pump installer shall provide a pimp
allation log to the 08D within 30 days o4pl_ n,p installstio
Municipality of Anchorage Page 1 DI 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 4 Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW 01S 6 3 l0 1 PID Number: _ O •z O ^ 151 —I (,p
Name:
D fav E D'Am
Wastewater System: o New 1g,Upgrade
Address: 1, 4), AG
lI to
ABSORPTION FIELD
Phone:
No. o18ed s
%`J Deep Trench O Shallow Trench O Bed O Mound O Other
LEGAL DESCRIPTION
Soil Rating
• GPD/Sq FI.
Total Depth from original 91a: FT
NI
L� SubdivS :
9�
Depth to pipe bottom from originkf grsdr
�f
Gravel depth beneath pipe
` U $ D
Ft.
`r FI.
Township:
Range: $action:
Fill added above original grade:
Gravel length:
'*";L Ft.
o
38 Ft
WEL ❑ New O Upgrade
Gravel width:
3
Number 1pI lines: Distance benne Ines
Classification (Presale.• 1 total Depth: Cased TO:
S
Ft.
Total absorption ares'
1 FI
Pipe material:
Ft.
Dr111aI: ale Dnoed: Stake Water Levet:
SG Ft
installer.
1)37 _ o
Date Installed: ^
OV -1 N
t °' "� Q
Yield:
Pump Set at:
irq He ghl Above Ground
TANK
GPM
FI.
Ft.
SEPARATION
DISTANCES
VgSeptic 0Holding OS.T.E.P.
To
From
Septic
Abwarloo
Lin
HOldi69
NbilerPrivals
Manufacturer:
Capacity In gallons -
Tank
FBW
Station
Tank
SatyrLiMs
t tij
Well
Well'
OQ'..t
I
�"
2S `
47 T
Material -
ISTEeL
Number of Compartments
Watere
1i
loo �
1101d -fl
1:`,
\
?;:t:
LIFT STATION
LotLine
1
IOD i
t ��
Size In gallons.
Manure r
„
Foundation
8/
�0
1c.,,
'Pump on" level at:
.
-Pumpotr lal:
High water alarm at•
at -
`
i,
CD
�A
h
N
•,
..
pump Make S Model
:
Electrical Inspections perlormed.�•\
NGW
elm
i(t ,.
Remarks: co
BENCH MARK
COHeaVf T4 SGP%rc TANK ttiT
Location and Description: ` !
(,.4_5 A UI
IAi SLA aC
Assumed Elevation-
0o Ft
EN _41644r11
yr •
v � "•�'95���tl�,
L'
r o S
Inspections perfornyj ne2c`� Dates: is
17034 Eaplb Rlvw loop Road, No. 20 2nd 1101910,1)
v'
r 110:E27 G COWANc� It
like S
iv�r las77
bepartmehtZffirank�eal�1 an�Human Services approval
f. r.;."% C'c-SEQI
Reviewed and approved by: Dale:777
.7
-013 in". (nes. 9191) MOA 25
PERMIT NO. SW050361
PAGE 2 of 3
Municialit of Anchora e
DEVELOPMENTp SERVICES DEPARTMENT
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On—Site Wastewater Disposal System and/or Well Inspection Report
LEGAL TRACT 1. HUNTER HEIGHTS S/D P.I.D. No. 020-151-16
I 1
I 1
1
I 1 F.fj
Ii1 s�
W 1 yC
1 E I
W 1 L) F�
� 1�1
I FLOW SPUTTER (FS)
z i I EXISTING CRIB
0 1 1 NEW 500 \ CT1 NSW
GALLON SEPTIC LEACHFIELD
oWi 1� i TANK (INSULATED) \ y
Y\ 01
TH
CONCRETESEPTIC
'J 1 1 \\`o SJ�4'EXISTIN 1000C TANK Di�O�
1 I (VERIFIED 10/01/05 'a ` \v ei� 1\
v
5
1
ENCIN&Ut
1 \ 9m \ N ;j t: M ........ f'n A�tQ�
ROBERT C. COWAN
1 SCALE 1' 40' \1
PERMIT NO. SW050361
PACE a OF 3
Municipality of Anchora e
DEVELOPMENT' SERVICES DEPARTMENT
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On—Site Wastewater Disposal System and/or Well Inspection Report
LEGAL TRACT 1, HUNTER HEIGHTS S/D P.I.D. NO. 020-151-16
FINAL GRADE
103.3' ST3
INSULATION
NEW
99.8' 500 GALLON
SEPTIC 99.6'
TANK
F 6 '
T 69.0'
DBLI 35.0' 70.0'
DBL2 36.0' 70,5'
FS 64,0' 49.0'
COI 52.0' 3.0'
COI MT1 86.0' 45.5'
CO2 MTI COl = 103.8' 602 86.0 46.0
CO2 = 102.5' OLD MT 63.0 63.0
FINAL GRADE DBL3
2" INSULATION DBL4
ST3 1 55.5 57.5
COI = 99.0'
SR CO2 = 99.0'
MTl = 93.9'
•
NO WATER
FOUND .i
87.9' B.O.H.
F S• ROBERT C. COWAN W�
+ c • c� ea9 � ~ r
Sf+4L . M.f.i It',i11.11��,�A`+~w
MUNICIPALITY OF ANCHORAGE �\�,k66
Development Services Department \ V"
On -Site Water & Wastewater Program
4700 South Bragaw Street 101'
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Sep 21, 2005
Expiration Date: Sep 21, 2006
Permit Number: SWO50361 Parcel ID: 020-151-16
Legal Description: HUNTER HEIGHTS TR 1
Design Engineer: 0003 S & S Engineering Site Address:
Owner Name: DAVE D'AMATO Lot Size: 189921 SQ. FT.
Owner Address: 17211 KING'S WAY DR Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99516-6930
This permit is for the construction of:
Q Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by catling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Date:
Issued B(_I Date: z 0
Municipality of Anchorage
Development Services Department
Building Safety Division
' On -Site Water and Wastewater Program
4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
L f�
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O ZO — 1 57 1— I t o _Permit Number SW
�1JGCJQ a W\ 'D Day phone 5 3 z
Property owner(s) n n
Mailing address -1 Z t ,1—Aa�'S (.)aW n OYchMq? . �Qip Code "1 q 5 � lv
Site address _1 1 7-t IGt Aa c � 1 A) a v Q _Zip Code 9 6) 37( L9
V" _� O / U
Legal description (Lot, Block & Sub'd.) I ►rot Z-1 � ' I t04,-
Legal description (Section, Township & Range)
Lot Size 18q, V] Act Sq.Ft.
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
1 certify that the above i
Single Family Dwelling
Number of Bedrooms q
❑ Well Only ❑
❑ Water Storage ❑
to
❑ Jacuzzi ❑
❑ Water Softening Unit ❑
❑
do )s co ect. I further certify that this application is being made for a
in accord ce with applicable Municipal Codes.
1�-
(Signature of propert��or au horized agent)
Permit/Rush Fees:
Date of Payment:
Date of Payment:
Receipt Number: 7g0101 Ei— Receipt Number:
(Rev. 09104)
To: Municipality of Anchorage
On -Site Services
From: David D'Amato
17211 Kingsway
Anchorage, AK 99516
Re: 17211 Kingsway Anchorage
To whom it may concern,
I have experience in installation and construction of septic systems and septic fields; I am
also a qualified and competent heavy equipment operator.
I intend to install the septic system upgrade according to S+S engineering's design and
build criteria, on this particular lot.
Sincerely,
David D'Amato — M t n I �C
12v- I(,Z) tf
(LI t.( (i�w.0 it Pie
DSD—ls�-16
�.� v9e,adL-c
S L�
IE&TNNITHMTY
September 19, 2005
ROBERT C. COWAN, P.E.
ROBERT A. SHAFER, P.E.
CML ENGINEERS
(907)694-2979
FAX (907) 694-1211
mow+
MUNICIPALITY OF ANCHORAGE
Development Services Department
P.O. Box 196650
Anchorage, AK 99519
SEWER6WATER
WVNE(TENSIONS
REFERENCE: Tract 1, Hunter Heights Subdivision
SEWERA WATER
INSPECTION
It is requested that you issue a permit to install a septic system to upgrade the existing
two bedroom dwelling on the referenced property to four bedrooms.
ENGI EERINGSTIAES
A test hole was excavated and a percolation test performed. The approximate location of
ANOREPOWS
the test hole is located on the attached site plan. At the time of excavation 5/31/05, water
was not found. After monitoring, ground water was not found.
WELLTNSPECTM
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
MOWTEST
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
SITE PLIM
If you require additional information, please contact us.
Sincerely,
Tq/�DOESN;H
SOILTEST
.1 0 . Cowan. P.E.
r
Enclosure
PERCOlAnCH
TEST
STMXTLOV .I
►ECl4NION-
INSPECTIONS
DN SITE
WASTEWATER
DISPOS&SYSTEU
OF910N
1 MU NORTH EAGLE RIVER LOOP • SURE 204 - EAGLE RIVER ALASKA 99577
TRACT 1, IiUNTER IIEIGHTS S D
Ms'��. •yam `, •Y '.
JMvm R*: :.LGKEO R.: DATE: S LEE: s Y j,• .. \_• -:
B.J.J. R.C.C. 9-19-05 2 OF 2
ngtnrering DESIGN CRITERIA:
..,K< ..
�4 BDRM = 600 GPD
SOILS = 0.8 GPD/SO.FT. �?. A. li .
600/0.8 = 750 SQ.FT. REO'D..
17034 EAGLE RIVER LOOP ROAD
EAGLE RIVER, ALASKA 99377
PHONE! (907)691-2979 7/ W '
FAY/ (907)694-1111
2 BEDROOM ADDITION'
DRAINFIELD CRITERIA:, WW
Z 9.0' DEEP 1 'Q/L p
a 5.0 EFFECTIVE t�� wW
(L 3.0' WIDE I 9
38' LONG 1 PROPOSED TRENCH
ALT. I SITE CRITERIA: EXISTING CRIB Ed
9.0' DEEP I FLOW \
9.0' EFFECTIVE SPLITTER CO
3.0' WIDEI DOUBLE T MT
42r LONG \I O� CLEANOUT 10' MIN
PROPOSED \ STH / /,4v10' MIN. \-\
SEPTIC500 ATANK \ MT
H I \ �O� JfiFF EXISTING 1000 GALLON P �O� N
V) \`' CONCRETE SEPTIC TANK \ 10' MIN.
� O � v JQ
�� 0F.
I
Pring
ALL PORTIONS OF SYSTEM
WITH LMS THAN 35' OP
COVER REQUIRE INSULATION.
TRACT 1, HUNTER HEIGHTS S D
Lv: .;aLCKLD 6•: A,E:
B.J.J. R.C.C. I
9-19-05
DESIGN CRITERIA:
4 6DRM = 600 GPD
SOILS = 0.8 GPD/SO.FT.
600/0.8 = 750 SOFT. REO'D.
i'
l
II
II
I I
ADDITION
I
I
I
I
I
I
oti
o�
�h
PROPOSED
EXISTING
CONCRETE
J0tVroa
zo�
1 OF 2
CONTRACTOR IS REQUIRED TO
OBTAIN UTILITY LOCATES
PRIOR TO ANY EXCAVATION
WORK.
;i G.j.
T.
`r r
ti � a,•54t,iL. r
0i7Fp`A•,,.5 yam;
4
AT
sur. o+.somas ..o trscN
Wa CFS
ssw. ro WtC, YR
CO.VIM
17004 EAGLE RIVER LOOP ROAD
EAGLE RIVER, ALASKA 99577
PHONE/ (907)694-2979
FAX/ (907)694-1211
2 BEDR00
DRAINFIEL
DEEP
g9.0'
5.0' EFFECTIVE
n
3.0' WIDE
w
38' LONG
V)
ALT. SITE
9.0' DEEP
9.0' EFFECTIVE
3.0' WIDE
42' LONG
Z
0
VI
W
ALL PORTIONS OF SYSTEM
WITH LMS THAN 35' OP
COVER REQUIRE INSULATION.
TRACT 1, HUNTER HEIGHTS S D
Lv: .;aLCKLD 6•: A,E:
B.J.J. R.C.C. I
9-19-05
DESIGN CRITERIA:
4 6DRM = 600 GPD
SOILS = 0.8 GPD/SO.FT.
600/0.8 = 750 SOFT. REO'D.
i'
l
II
II
I I
ADDITION
I
I
I
I
I
I
oti
o�
�h
PROPOSED
EXISTING
CONCRETE
J0tVroa
zo�
1 OF 2
CONTRACTOR IS REQUIRED TO
OBTAIN UTILITY LOCATES
PRIOR TO ANY EXCAVATION
WORK.
;i G.j.
T.
`r r
ti � a,•54t,iL. r
0i7Fp`A•,,.5 yam;
4
AT
sur. o+.somas ..o trscN
Wa CFS
ssw. ro WtC, YR
CO.VIM
Municipality of Anchorage
Development Services Department
Building Safety Division ""•
yam, On-SReWater and Wastewater Program
4700 South Bragaw St. 9 ROBERT C. COWAN ••i
P.O. Boz 196650 Anchorage, AK 99519-6650 CE - 8801
www cl. anchorage .sk.us �J••`„• �;'
(907) 343-7904 it �0'ir••••..... ..........•`a.N
.....:.
Soils Log -Percolation Test
Performed For: 1%fjV C 0 "q voAT O Date Performed: sj /3 / zO S
Legal Description: TR A C -T ) HO /4 T [ R #7--S Township, Range, Section:
Slope Site Plan
13-
1
COMMENTS
O RGA,.+) r— S
�m SIL% j SANd
& GRAvt L
WAS GROUND WATER
ENCOUNTERED?
Date
Gross Time
S
s1LT#Sj) IF YES, AT WHAT DEPTH?
to Depth to Water After
a-a'rA"f— MonItoring7
G
P
NONQ E
Date:
6 1710S -
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
pR�JgAK
��7IDS'
O
—
-7 s�gu
3 0
30 rr,v
j ,y8 ,.
3 K; .
30
_
'7 yl '
60
30
1o'y,.,
3 „
60
—
7'4"
'10
30
o 'i "
3
PERCOLATION RATE / V (rmWe~t PERC HOLE DIAMETER (�
TEST RUN BETWEEN ;A Y,;- FT AND 3'11 FT
PERFORMED BYS S S ENGINEERING ) 1,�'f (� Z—je r� CERTIFY THAT THIS TEST,WAS
PERFORMED IN / ICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6 / 7 /0�
Eagle River, Alaska 995
Municipality of Anchorage
Department of Health and Human Services
825 U' Street
Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
343-4744
November 15, 1994
Mr. Jerry Hunter w— � 16 6
17211 Kingsway Drive
Anchorage, AK 99516
Subject: Tract 1, Hunter Heights
Permit#SW930287, Parcel ID #020-151-16
Dear Mr. Hunter:
The subject pertnit, issued August 11, 1993 by this office for a single family well and/or on-site
wastewater system, has expired as of August 11, 1994.
A new permit must be obtained from this office for a well and/or on-site wastewater system NOT
installed by the expiration date.
If you have drilled the well, a well log must be sent to this office for documentation of the
installation and to close the pert -nit.
If the on-site wastewater system has been completed and a licensed Professional Engineer has
inspected the installation of the on-site wastewater system, the original as -built inspection report
must be sent to this office for review, approval and documentation. All inspection reports must
be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00
for a well permit and $440.00 for a combined on-site wastewater and well pernit.
If you have any questions, please call this office at 343-4744.
Sincerely,
�/� otud
James Cross, P.E.
Program Manager
On -Site Services
JC/kb
Date Drilled:
6-2-94
WELL LOG
Static Water Level 18 feet
Draw Down N/A feet
Type Material Drilled:
0
feet
_
65ft. Clay
10
ft.
to
70 ft, Rock w/ little wade. --
15
ft.
to
83 ft. Clay & Rock
42
ft.
to 10 ft Clay & Rock
to 15 ft. Wet rock -&
to 42 ft. Clay & Rock
JOrry Hunter
Bear Valley
Gallons Per Minute 5
Total Feet of Casing 120
to 45 ft. Clay & Rock w/little water
45
ft.
to
65ft. Clay
65f t.
to
70 ft, Rock w/ little wade. --
70
ft.
-
to
83 ft. Clay & Rock
�83
ft.
to
9_0_ ft. Rock w/ water_��--
90
ft.
to
120 ft. Clay w/little rock & H2O
HEFTY DRILLING
3540 AKULA DRIVE
ANCHORAGE, AK 99516
(907) 345-0593
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930287
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:HUNTER JERRY E &
OWNER ADDRESS:17211 KINGSWAY DR.
ANCHORAGE, AIC 99516
PARCEL ID:02015116
LEGAL DESCRIPTION: HUNTER HEIGHTS TR 1
I
LOT SIZE: 189921 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
DATE ISSUED: 8/11/93
EXPIRATION DATE: 8/11/94
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED B
ISSUED BY:
Y: 4&Ao��DATE' " r�✓
DATE: A /
N
rl
30
tJ
O
R oA D r()
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i OAL DE SCIt IPTION:
ABUILT OF,
TKACT
i Uhl `1"C R 1-I C I BHT S S V 6.D.
Lr
111NE(-IK-r' r, 3/27_ X87 tNDD
llrII/i57 P 7 1 L r5M7'S
--
SUnVEY CEnTIPICATION: I harohy certify filet I havo surveyed the Property drown and do
thereon Oro within the property lines end nu
scrlbod 1'0100- and that the Improvomonts shuatod
`
encroachrnantr exist other then noted.
i
�
0.
L
PLEASE NOTE: It Ir the contract
LEGEND:
SFT
ER[i
' f3URV6YC)REi
-or'oof responsibilitychuck
illtintoreletlon t
FOUNO
IIED
p4
WIN. By!
1\ICilf\I l3RFJ • RI.AfVN
usponsi
to
[IUD &TACK
p
G'�
fl3
10 WEST BENSON BLVD,6291
finish grads and building rot•
backs In. rolodon to lot Ilne$
MONUMENT
AL -CAP
tuneKID.
99503
692
end aasemenu,
PK NAIL
X
NCI1011AGE, ALASKA
mvN rlr•�:
i OAL DE SCIt IPTION:
ABUILT OF,
TKACT
i Uhl `1"C R 1-I C I BHT S S V 6.D.
C'P'"4TER ANCHORAGE AREA BOROI'M
HEALTH DEPARTMENT NO 809
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
/, �l/ r MAILING1 -, c Y
NAMEyy
ADDRESS 'G-/� ' ' P
TI (/ GZ �" i f j�—_� a // H,ONE—
LEGAL �1
42
LOCATION___ DESCRIPTION
SEPTIC TANK: �� (�t'_L ifYc_� �_rl"�l.✓
/l�( l——/l_.0 =/L -i_ NUMBER OF
DISTANCE FROM WELL � �_ � ,�� MATERIAL "�' —COMPARTMENTS
—
C/ l 7 ! if �� LIQUID
LIQUID CAPACITY �< [ (/ GALLONS. INSIDE LENGTH r' / �� / INSIDE WIDTH DEPTH_
SEEPAGE SYSTEM: SEEPAGE PIT
TILE DRAIN FIELD:
� TOTAL LENGTH
DISTANCE FROM WEtL,, FOUNDATION �A NEAREST LOT LINE _- - -"-; QLE INES
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOT-ALE-FFECTIVE
ABSORPTION AREA
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: rx/ DISTANCE FROM WATER
TYPE` •t'SEPTH BUILDING FOUNDATION. SAMPLE NEAREST
NEAREST SEPTIC ,..•I SEEPAGEOTHER
```
LOT LINE SEWER LINE TANK SYSTEM � CESSPOOL , SOURCES—
DIAGRAM OF SYSTEM
DISTANCES:
l
NUMBER OF PITS
/
OUTSIDE DIAMETER OR WIDTH
, LENGTH , DEPTH,
LINING MATERIAL
I' _. DISTANCE FROM WEILe>ij<- � � C
,BUILDING FOUNDATION__,
'
NEAREST LOT LINE
TOTAL TOTAL EFFECTIVE ABSORPTION AREA (WAIL AREA)
`' / SQ. FT.
TILE DRAIN FIELD:
� TOTAL LENGTH
DISTANCE FROM WEtL,, FOUNDATION �A NEAREST LOT LINE _- - -"-; QLE INES
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOT-ALE-FFECTIVE
ABSORPTION AREA
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: rx/ DISTANCE FROM WATER
TYPE` •t'SEPTH BUILDING FOUNDATION. SAMPLE NEAREST
NEAREST SEPTIC ,..•I SEEPAGEOTHER
```
LOT LINE SEWER LINE TANK SYSTEM � CESSPOOL , SOURCES—
DIAGRAM OF SYSTEM
DISTANCES:
l
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
TYPE
MINIMUM DISTANCES, REQUIREMENTS
!
FOUNDATION TO SEPTIC TANK 5
FOUNDATION TO SEEPAGE PIT ���) DRAIN FIELD
a- /
SEEPAGE AREA SIZE
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK 5- SEEPAGE PIT t
)o DRAIN FIELD
TO NEAREST LOT LINE. q
WELL TO SEPTIC TANKLl SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
SEPTIC TANK, , SEEPAGE PIT o� DRAIN FIELD
TO RIVER, LAKE, STREAM.
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 SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
TYPE
,
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBE SYSTEM IS IN ACCORDANCE WITH SAID CODE,
DATE �f Y47 �` APPLICANT'S SIGNATURE �i �X/, �I �yLT
"t4✓.1-. a!Y�/d
i'i,b+-�,
All ��;.�I,! 4'✓L"u£•�j ! L�S 1�
NAME OF APPLICANT-��liYl,✓LY4`7vt�
MAILING ADDRESS
- / PHONE
�4"•
INSTALLATION LOCATION /51/o"o/ I''�`�
T "�/�
""'�L'`G +`
60
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
SEEPAGE PIT __
DRAIN FIELD OTHER ,
/
TYPE AND SIZE OF FACILITY TO BE SERVED
J
f:
v/
FINANCED THROUGH _�_r
TO BE INSTALLED BY
(
SOIL TEST RESULTS'L Gbt
NOTE: THIS
PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
TYPE
MINIMUM DISTANCES, REQUIREMENTS
!
FOUNDATION TO SEPTIC TANK 5
FOUNDATION TO SEEPAGE PIT ���) DRAIN FIELD
a- /
SEEPAGE AREA SIZE
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK 5- SEEPAGE PIT t
)o DRAIN FIELD
TO NEAREST LOT LINE. q
WELL TO SEPTIC TANKLl SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
SEPTIC TANK, , SEEPAGE PIT o� DRAIN FIELD
TO RIVER, LAKE, STREAM.
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 SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
TYPE
,
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBE SYSTEM IS IN ACCORDANCE WITH SAID CODE,
DATE �f Y47 �` APPLICANT'S SIGNATURE �i �X/, �I �yLT
,REATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
CASE N
1f ave.;
Performed For u, '�cveQc+ :m w{.G,, Date Performed
Legal Description: Lot } Blo-cw Sub ivasionc. \V
This Form Reports a: =oils anon rest
1 Depth
Feet Soil Characteristics Location Sketch
O/, Sa�A� j�l C:r aver 6%P1
1' •do
F�RA k si �c w/ y nn _.
4 �% �:.-�.+�,ell,� S;li 10�,., Sc,,,,,1�. G•weA1.
I
Was Ground Water Encountered? ,J
If Yes, At.What Depth
,P
I
Reading ! DateGross Time Net Time
Depth To H2O Net Drop
Proposed Instal lat'4 o'n¢ eepage Pit
Depth Of Inlet ,N—= � Drain Field
Test Performed BS,,
Dates
Data Certified By:
�LC.F
l
• I
1 i
o7e,.u: 7 tiraut%
/ow///a.► 7�o sub
/Q'
Cif LIlGN a a r6 Ve
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•,
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1
�O
blame% Ca/ort..oyr, 5ti.«6�
J '• , ,
d-lH0 Ur! � p� lud.,fpJz .G.PP_�oCt-t�f_
OA
�w-CP
Was Ground Water Encountered? ,J
If Yes, At.What Depth
,P
I
Reading ! DateGross Time Net Time
Depth To H2O Net Drop
Proposed Instal lat'4 o'n¢ eepage Pit
Depth Of Inlet ,N—= � Drain Field
Test Performed BS,,
Dates
Data Certified By:
�LC.F
l
• I
1 i
Time
Time ie —
Date
Date
Date
J
Inspector
Inspector
Inspector
Comments
Conditional Approval
Date Sewer Installed
Permit No.
Septic Tank Size
Holding Tank Size
Soils Rating
Well To Absorption Area
Well Log Received
Well to Tank
AQP—P'LICANT FILLS OUT LOWER HALF ONLY
-r
Property Owner - r
//J%�' r -._ __ Phone
//�� /
Mailing Address t�/7//`� /�
�Y /C6' C �-
_
Buyer d
1 c - .
Address
----
Lending Institution Phone
Address 0�
�{� ✓1_U P 7v
l t
Realty Co. & Agent
Phone
Address
Legal Description rJ� r�7-[7I
Street Location
� /
Typeyfaf Residence
/[Single Family
❑ Multiple Family
No. of Bedrooms
_❑ Other
_
Watee{{,,Supply
1CTlndlvidual r1 �� ATTACH WELL LOG. A well log is required for all wells drilled since June
❑ Community e c�-c-�C:A 75. For wells drilled prior to that date, give well depth (attach log if
❑ Public Utiles
a lable.
Se Disposal Disposal c.Y
/C]�Individual
VV - �-
YeYr Individual Installed: _
Cl Public Utility
0Holding Tank
tility: _❑
When Connected to Public Utility:--
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.