HomeMy WebLinkAboutFAIRMOUNT ADDITION A LT 28
GRE ,,:R ANCHORAGE AREA BOk,,,.,GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPE TIO
~--.~y~.YSpE(j;TION~ REPOR1' ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION ,~ O~ LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE
FROM WELL~J~'( 0
MANUFACTURER
INSIDE LENGTH
INSIDE WIDTH__ __
MATERIAL
LIQUID DEPTH
NUMBER OF
__COMPARTMENTS
LIQUID C A PAC I TY. ~,~,~N S.
TILE DRAIN FIELD:
WELL~'/~ O O
DISTANCE FROM
NUMBER OF LINES
ABSORPTION AREA ,.~.~---~,-~
FOUNDATION NEAREST LOT LINE
TOTAL LENGTH
___OF LINES
DISTANCE BETWEEN LINES
TRENCH WIDTH-~L~ IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
SQ. FT.
LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE
IN. ABOVE TILE ~ "/
IN.
WELL:
TYPE . _
BUILDING
FOUNDATION _,
CESSPOOL
APPROVED . _ DISAPPROVED
DISTANCES: .
SEWER LINE DEPTH:
PIPE MATERIAL' ~&''')''''~ ~3~
LOT SLOPE:
REMARKS:
CONSTRUCTION
NEAREST NEAREST SEPTIC
LOT LINE SEWER LINE , TANK
OTIRER SOURCES
REMARKS
DEPTH
SEEPAGE
SYSTEM
DISTANCE FROM:
.... D,.!~.A.M OF SYSTEM
DATE ~,.~..-r'~ APPROVED
Form EQ-032
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GARY PLAYER VENTURES
CONSUl_TING GIfOLOGIS1
13OX 476-M, STAR RouTE A · ANCHOI~AGE, ALASKA 99507 · PHONE 344-7071
SOILS LOG
Performed for.
Location ~
16
Soil Type
Water Level
18
20
Total Depth of Excavation
Groundwater
( ) Not Reached
Depth, ~.f Reached [ ~ '
Classification Method
:( ) Visual
( ) Sieve Analys~,~;
()
Remarks
j ;
Material at Total Depth
Bedrock
( ) Not Reached
Depth, if Reached
Gary F. Player, Cons~-~ ting Geologist
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M-W DRILLING, INC.
DRILLING LOG
Well Owner Use of Well
Location (address of: Township, Range, Section, if known; or distance main road
Size of casing_ Depth of Hole_
Static water level ft. (abOVe)
Screen ( ); Perforated ( ·
feet Cased to. feet
(below) land surface. Finish of well (check one) open end (
).
Describe screen or perforation -" ;"- '~
Well pumping test at gallons per ('hoUr)
of drawdown from static level.
Date of completion
(minute) for hours with
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
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2 -- STATE
MUNICIPALITY OF ANCHOI~AGE~UNICIPAUTY OF ANCIjFOR*,~
DEPT, OF HEALTH & .
DEPARTMENT OF HEALTH & ENVIRONMENTAL Pli]~)'~I~TAL
825 L Street - Anchorago, Alaska 99501 ~'~' . ~ l~
ENVIRONMENTAL ENGINEERING DIVISION NOV 2 1 197
Telept~ono 264-4720
DE~EI~/~
~DIRECTIONS: Complete aH parts on pag~ 1, Incomplete roqu~sts will not be processed, Pleas~ allow ten (10) days for processing.
!1. PROPERTY OWNER J PHONE
MAILING A~R ES~
"~RoPER~Y RESIDENt (I} different from~bove) PHONE ........
2. BUYER PHONE
MAI LING ADDRESS
3, LENDING INSTITUTION ~ PHONE - '
MAILING ADDREss
4. REAL~OR/AGENT ~ PHONE
I
MAILING ADDRESS
5.' I' EGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE
E~"SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF BEDROOMS
E'_~ One [] Four
[] Two [] Five
[~ Three [] Six
[] Other
7. WATER SUPPLY
[~INDIVIDUAL~
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For weIIs drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
[~. INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
by this Department,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
THIS SIDE FOR OFFICIAL USE ONLY
-~ATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
E_-J SINGLE FAMILY [] ONE [O THREE [-_~ FIVE [~] OTHER
E:~] MULTIPLE FAMILY [] TWO [] FOUR [-_~ SIX
PERMIT NUMBER
2. WATER SUPPLY
[-_~ INDIVIDUAL DEPTH OF WELL
L":I COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
~] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY ~)-~
Connection Verified INSTALLER
[~-] Septic Tank or L~_l Holding Tank b (~) ~ ~'¢--
Size:~"(~ If Tank is homemade SOILS RATING
flive dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
5. COMMENTS
~- APPROVED FOR ~ BEDROOMS
iZ] CONDITIONAL APPROVAL (letter must accompany certificate)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
'qUNICIPALITY OF ANCHORAGE
,. DE.Pj~r. MEI .,F HEALTH AND ENVIRONMENI PROTECTION.-'..
. ~ ~25 L Street, Anchorage, Alaska 99501 .
'¢/ ~ ~_~,,1;~,~ ~~ceived: F~y 25. 1977
~1:
Time
Date
Insp
1.
Date ~'A/~--/'~ ~Z. Date
FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request:
Alaska Bank of Commerce
Mailing Address: Pouch 7-012 99510
~2// Property Owner: Joseph/Betsy Mitchell
Mailing Address: Box 470 Star Route A
Phone: 279-'5641/350
3. Legal Description: Lot 28 Fairmont Subdivision
4t Single Family Residence: (x)
Multiple Family Residence: ( )
Number of Bedrooms:
Se
Well System: Individual well (x) Con, unity/Public System ( )
Permit # ~ Depth of Well Well Log on File ( )
Construction ~¢ Bacterial Analysis
6. Sewage Disposal System: On-site System (x) Public Utility ( )
Permit # Installed ~ ~
Installer
Septic Tank Size.~~./~ Manufacturer~L
Absorption Area ~--~'~ Soils Ra~ ~ Material~
7. Distances: Well to Septic Tank .~ to Absorption Area /~;
to Sewer Line /~ I~_ Nearest Lot line /~ ~ Absorption Area
to Nearest Lot Line
'GREATER ANCHORAGE ARk/, BOROUGH.,~.~,.,~.,
,, Department,, of Environmental' Quall
3330 C St., Anchorage, Alaska 99503
REQUEST FOR ·APPROVAL OF
· INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection:
2. Property Owner:
Mailing AddreSs:
CMRO VA FHA CONV ~
Joseph Mitchell and Betsy Mitchell
Box 4.70 SRA Day Phone 279-8560
Name of Buyer: Same
Mailing Address:
Day Phone
Alaska Bank of Commerce
Name of Lending Institution:
Mailing Address: Pouch 7012
Name of Realtor or Agent:
Phone 279-5641
Mailing Address:
Phone
Legal Description:· Lot 28~ Fairmont
Location: NHN Ricky Road, Anchorag~ ~laska 99507
?. Type of Facility to be inspected: SFD . ~
8. Water Supply
Type of Supply: Public Utility .......... Individual
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal' System
Type .of S~stem: Public Utility
If Individual, date of installation
No. Bdrms. 5
Individual (on-.site) X
p~ge TW, o'' ,' ·
'Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 28 Fairmont Subdivision
Comments:
Affadavit Attached: ( )
Department Worksheet:
Letter Attached: ( )
Date: ~0 '-/7-- 77
Date: ~"2 ~ ~ 7%
DATE
4S 469
SEND PARTS ! AND $ WITH CARBON INTACT - ~_~x/
PART 3 WILL BE RETURNED WITH REPLY
DETACH AND FILE FOR FOLLOW-UP
August 9, 1977
Joseph Mitchell
Star Route A BOX 470
Anchorage, &laska 99507
Subject: Lot 28 Fairmont Sub~lvision
Dear Mr. Mitohe11:
The well log from the subject property is inadmquate as
%he total daily capacity is not stated. A 100% draw-
down in sixty(60) minutes at 2 gpm is not passing for
Municipal code.
If there are any further questions, please contact this
office at 279-2511, extension 224 or 225.
Sincerely,
$~u~ ~ou~ A ~x 470
Anchor&ge, ~ka 9~307
~ot 28 Fa~rmong 8ul~l~Kv~s~o~
~ o~m~tXo~ s~son o~ 1977.
~X~ ~S~ aua~ ~ s~Lt~ ~o t~s O~X~ SO ~at a
sXn~ereXy,
I'tie No.: 6-20
4-2-4
~ P.
470 Star
Am~m'e~e, AIUka
(Fairmont Subdivision - Rabbit Creek area)
STATEMENT
ISAACS PUMPING SERVICE
(Norm Tibbetts - Owner)
1601 Tudor Road
ANCHORAGE, ALASKA 99507
Phone 272.3731
DATE
TERM~;
DATE
BALANCE FORWARD
ISAACS PUMPING SERVICE
IN THIS COLUMN
Nov. t ,1976
Municipality of Anchorage
2516 E. Tudor Road
Anc. Ak. 99504
Att. Mr. John Lynn,
I hereby stipulate that to comply with the municipal enviremental
requirements in regards to sewage disposal I will do the following,
1. Provide an on site holding tank of 1200 gallons or more to
service the proposed single family residence to be located at
lot 28, Fairmont Subdivision( Rabbitt Creek a~ea)
2. Contract with Isaacs cess pool.service for a periodic maint.
of the holding tank to insure no overflow or leakage.
3. To finish soils test data and develope on site disposal
during next construction season.
Sincerely
Joseph P. Mitchell