HomeMy WebLinkAboutSUN VALLEY HEIGHTS BLK 1 LT 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Envlronmenlal Health Division
825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
TANKS
SEPTIC I-) HOLDING
Capacdy in gallons
No. ol Compadmenls
TYPE OF SYSTEM
[] TRENCH [] BED [] W. DRAIN [~ OTHER
Depth Io pipe bottom Item Total depth Item original grade
original grade
FT
Fia added above original grade
FT
Gravelleng[h
SQ FT FT
Soil raling Pipe rnaJeria~
Sg FT
WELLS
[] PRIVATE '~ OTHER (Identifv)
Total Depgl
C~assibcation (A,B,C)
[ns Jailer
Date Installed:
FT Casedto
DIS'rANCES
SEPTIC ABSORPTION
TANK FIELD WELL
WELL
driveway, water bodies, etc.)
RI-'MARKS:
codily that Ibis inspeollon was parlormod according lo all
Muololpal and State guidelines In ellecl on this dal: -
ENGINEER'5 SEAL
72-013 (3/85)
I,. F:~F~Ei
:2; :L ':[ I I"IDFH!: Z ON
Fqg C;I"ICII :~: hl!.}lJii: ~
99','51 '7
5Rb 1 '"'O491.
'1 Id I ,~i3 F~[:~]::/l'"l i I I S
DNI .,Y (~hlD
REID, JR.
CE - 22§1
II
IV[UNICIPALITY OF ANCHORAGE
MEMORANDUM
Signed
91-o15 (Rev, 1/81)
GRE;..,ER ANCHORAGE AREA BOR
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
IGH
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION_
LEGAL DESCRIPTION
SEPTIC TANK: ~
DISTANCE ¢..¢t~V','v'iv~v [ ~C_~ .~e ~. NUMBER OF
FROM WELL MANUFACTURER ~.9~ MATERIAl_ ___y_ ..... COMPARTMENTS
INSIDE LENGTH_ INSIDE WIDTH ...... LIQUID DEPTH LIQUID CAPACITY ~AL. LONS.
T-'~'L-~ D RA I N FIELD: '
I
"""'--- ..... OF LINES '~ ~
DISTANCE F'ROM WELL ~-~' FOtJNDATION __NEAREST LOT LINE ,~ (-}l~ TOTAL LENGTH C
NUMBER OF LINES I DISTANCE BETWEEN LINES ~,J/_~'~__TRENCH W,DT,-I~ ~P IN. TOTAL EFFECTIVE
ABSORPTION AREA__ '~ ]"]__ SQ. FT. LENGTH OF EACH LINE ___ ~]~- ~ ~
DEPTH: TOP OF TILE TO FINISH GRADE ~ I DEPTII OF FILTER 7~¢ ~
MATERIAL. BENEATH TILE IN. ABOVE TILE~ IN,
WELL:
',
TYPE _~,]. 0 ~ ~'~A~ 1"~ ~""tl C O N S T R UCTI ON OEP rH
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOI LINE SEWER LINE TANK__ SYSTEM_..
CESSPOOL .
OTIIER SOURCES
APPROVED __ DISAPPROVED .... REMARKS
DISTANCE FROM:
DISTANCES:
INSTALLED BY; -- ~--~.
~.~,~
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form E C,~-0 3 2
DIAGRAM OF SYSTEM
t::l:::lt:i:;!::'!t t It",tFi It1:: I:;:!l",l"? ';;;;"i';;ill;;'l'l i,.t[11.1tlt1II I::ii1",11:;11 itil:',?!i;l:::'ti:;]t'i:T'lliilt~',! t::li",l!) J:;l?l;;~l;i]i )"~i;iii I:i'?'~'~
I)l:::il:::'l:::ll:;:' I' t'l!::i",t i ,.till I i::I1:;' ';;;i. ii:;,]ll;:l~; I Ill t:'!il ]'! ii]';I I1 ] "lt',,I
H Ii I",t I I'1i Ii't Ii:, 'il i:;'1'(:1t',111:i: i:i~:i I t,.!i:!il::il",i (;:! i,.1!!]1 i. I:::INt) (:1i",!¥ ('l !",l' -"i i; ] 'i!'[ :ii:]i,.il:::lilil:!] i:, 't ~i:;l::'l?!;(::ll i}i;?i::;'! (Iff
'il;-:11:::t i'1:(11'! I;;'lil;' ~I Pl:,?ii',?l::!ll:( !,!1:]!.! Iiit;ii;?t:!itlil l::;'t'!]l:i-i' Fill;? i:;! i::'ili!;I 't(;
I~1' ili:;i:,' I:,:'i::'iiiill:;;'l::l'li::'l.,li'i:i i'!i::1¥ i;:!¥'~;'1 ~' ';?l:i(i:][t::']'(i]:l:Xlt']ili',i:::; i;lt",l!) t]:t]lt'.,l%ll,'l!(];I ]Iii]Ii'.,! i)ili!::!i:ii;;?!::'.Pl:;
!::1',,'1:! i I:ii!it I! II]1 ]1 I.,1':;;I I1~'1:: I:::'l:;?llt':'!:i]:,~ ] t",l':';ltl! I !::!'1 i
I';I i:;il I il I::'~,' lil!:l I
;i iii (:'li'I F:'I::i!"!it]! Ii!::11;' I,,!(i'H Ii'ii:( I;?l:]il;!l.l'!'l;?l:(l'li:!it~',ll:i:; FI]It;?. I;ti",1' i:i;]]'iE ';!;I H~:ii;ii:: iff',it) I,ii];t.i ::;
!;;(].1!:;i~!1-1 l!i?'~'' tl-li!i Hili~',!ii i!:-'l:'li ]'i'?
;;;;' I I,.i ;I] I ! I i',i':::, i ~i I FI. II:'
i)!; i I ll:.,lt)i::?'::i i i;il.il) !!ll:;!l Il'Il( l]lt',!-"i';;i; 'i !:: ':i;!i(i.,.ll(I;i: '~?'l"r;:;I !:l:! i'll:'i~' !;?!')¥!1.1][ !;iii :i i~i",tl (:l(;i:(]!i!ii!"!i]ii',!"l ] !:::' i iii:]
I:'?1:i!::; i !'! i"~;l: I '::;i i;i'!::il'tlill)l I I:'l) 1'll I
l~:i;~:::;l li:::i) i.~ff i)I:i~'I:] 'v'?:; I;:I
QGRE!
ER ANCHORAGE AREA BOI SH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME fg-~'a/~/ t/~2#~'7~ ~MA'LING ADDRESS~~7 E' ~']'"~¢'~" PHONE ~¢¢"~ ¢7 ? -
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
INSIDE WIDTH LIQUID DEPTH __ _LIQUID CAPACITY/~,,~-<~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER ____ OR WIDT"/~,, LENGTH /~-, DEPTH ~-";/~ ~i~f~ /~.! .
t ~r'¢ ~ _~DEPTH~__ DISTANCE FROM: WELL,
LINING MA'TERIAL~r'*~'? _ CRI~'S~IZE: DIAMETER __.
BUILDING FOUNDATION NEAREST LOT LINE Z(2'"~. TOTAL EFFECTIVE ~'~'~0 .SQ. FT.
ABSORPTION AREA (WALL AREA)
ADDITIONAL ABSORPTION
TYPE CONSTRUCTION
BUILDING NEAREST NEAREST
FOUNDATION_ LOT LINE SEWER LINE
CESSPOOL . , OTHER SOURCES
APPROVED _ DISAPPROVED__ __ REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY: ~T~CCl~ //i//
PIPE MATERIAL:~// CCL,,~L' }/*/-]'>?
LOT SLOPE:
REMARKS:
Form NO, EQ-031
GREATER ANCHORAGE AREA BOROUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND P£RMIT
PERMIT NO.
SEPTIC TANK
TO NEAREST LOT LINE,
WELL. TO SEPTIC TANK --~>~J
water MAIN TO SEPTIC TANK ~J~ DRAIN FIELD--.--j O )
SEPTIC TANK, ~'~D ) ., SEEPAGE PIT ~//JO }
, SEEPAGE PIT .~'~'1 ~')
ALSO CONSIDEI~ AFJEA WELLS,
, SEEPAGE PiT -~-~J
, DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 ~EET iNTO UNDISTUF~BED SOIL.
Performed For
GREATER ANCttORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAl_ QUALITY
3330 "C" Street
ANCHORAGE, ALASKA 99503
Legal Description: Lot___~ Block
This Form Reports Soils
Soil Test Must Be Logged To 4.'
Depth
Feet Soil Characteristics
10--
11--
12--
Was Ground Water Encountered?_~
If Yes, At What Depth?
Case #
Dated Performed ~-~')]~
Subdivision
Percolatioh Test
Below Proposed Seepage System -
Reading
Date
Gross Time Net Time Bepth to Ii20 Net Dro
Percolation Rate Minute
Proposed Installation: Seepage Pit Drain Field
Depth of Inlet Depth to Bottom of Pit or Trench
MMENTS: ~.~ ~ - n ~ ~ ~
Tes~ Performed BY__~~~~ Date Certlf,ed BY:
Da te:
-~ MUNICIPALITY (DF ANCHORAG'= /.'~
® DEPARTP. OF ~EALTlt AND ENVIRONMEK L PROTECI'ION /¢_~.9~
279-251], ext~ 224 or 225
Date Received. June 21, 1977
~imc~ ~2: Thne ~,_~tQm ~% t3: Pime
Date __.6-2j 77 _W_ejn_esday Date J~S. Date
REQUEST FOR APPROVAL OF INDIVIIyAL SEWER AND WATER IACII,_t~IES
Lending £nstJtution Request: N~~l~~
Mailing Address: Post Office Box 3-3859 99509 Phone: 279-2506
2. P=operuy Owner: Wayne $cqmidt Phone:
Ma.iling Address:
3. Legal Descri[mion: _L_0_t_l__Bl_o,_ckj__.Su_a_V~all_¢y_H_e_i htgJ!~j_S~ubdivision
Family Re~d~ncu. (X) Number of Bedrooms: Three
Mull:ip].e Family Residence: ( ; Number of Bedrooms:
Wcl-[ Sysnem: Individual We]_[ ( } Community/Public System ~/X)
Depth of Wel.l We]]..Log on File ( )
Bacterial Analy szs
6. 5ewage D~sposal System: On--srke Syst. om (X~ Public Utility ( )
. Distances: Well. to Sc.,..[~t_._ic Tank _ rption Area
Line Nearest .[,ok line AbsorptN/n Area
LO Nearest Lot Line
j!jb! o 1
?- 7 6: ,~., ,c t
REQ. LII]{;]' I:Ol~ At:i~IqOVAL OF Ii I:,, ~,
IND IVI [;UA [. SEWER and ~/.,'l'l-l~l:t FAG LI I-I ES
1. 1-¥t~e of Inspectior~: CM[iO ........... VA ............. FHA ................... CONV
2.
Mailing Ad,lresg: ................................................. Day Pho~le .... ~_ ........................
4. Name al Lendiug Institution: ......... ~__~_ .........................................................
(3.
Loclttion:
7. 'l'yl)o el Facility to be irlspectod:
8, Water Supply ~~.~
Ty!)e r)~ Supply: Pubfk: LJlilb/ ..................... Indi,/idu~l ............................
If Individu~l, number d dv~,e!linqs plosenliy sel'v(~d
If I qdMcu;~l, del)th of well
9. Sewage I)isposat Systnm
Type of :;ystr. m: Public Utility ..................... Ir~dividu:d (on-sih:) ~"
If Ir~cliviclu[~l, date el instaltalion
Iiealth and Envirolmlc'nt:al Protection
of individual Sewer and ~ater Fac±lit±es
Department
Request [!or Approval.
~,ac, a'L Desc:r.~ p~ion: _ L_0_.t._!_~l_0__c_k_]_Jiu_oV~l lex I]9_i_g_ht_s~._S_q~d~i_vi__s]~l_ ..........................
Affadavil: Attached: ( ) L~ter Attached;