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HomeMy WebLinkAboutSUNNY VALLEY LT 12 REMLoT GREi .,'ER, ANCHORAGE AREA BO UGH ~.~rj~/ Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION LEGAL DESCRIPTION ~/ ~ ,~//' ~ ~~ SEPTIC TANK: DISTANCE NUMBER OF FROM WELL /~O~.) / MANUFACTUREFL~__~.~./~ MATERtAL~g~'/Z~'~/ /~<~</'~/COMPARTMENTS / INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH -- LIQUID CAPACITY ~/(--)~)_~g'/,GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER__OR WIDTH ~' ', LENGTH/~,/ DEPTH LINING MATERIALg?~g/~Zg/~/~ CRIB SIZE: DIAMETER ,~ DEPTH ~-~ DISTANCE FROM: TOTAL EFFECTIVE BUILDING FOUNDATION ~'~ / NEAREST LOT LINE~) / WELL //~'/~:> / ABSORPTION AREA (WALL AREA) ~-~.~ SQ, FT. ADDITIONAL ABSORPTION WELL: //) TYPE ~'(L.~_ -/_~/~/2// CONSTRUCTION BUILDING NEAREST ~ FOUNDATION ~ LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEWER LINE REMARKS SEPTIC / SEEPAGE TANK /~) , SYSTEM LOT SLOPE: REMARKS: Form No, EO-031 DIAGRAM OF SYSTEM · ~ J GReATE~/~C'HOrAge Area BOROUGH ~ '~-SEW~'"~DISPOSAL SYSTEM -- APPLICATION AND PERMIT PHONE INSTALLATION Of: SEPTIC TANK ~ SEEPAGE PIT ., DRAIN FIELD OTHER TO BE INSTALLED BY /~///~//? f~ ~ FINANCED THROUGH ~ SOIL TEST RESULTS ~/~ '~ ~/ HOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLET]ON DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK ~/ TO NEAREST LOT LINE. WELL TO SEPTIC TANK FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE Pit C~~ / SEPTIC TANK TO SEEPAGE PIT WALL SEEPAGE PIT DRAIN FIELD // ~]~/ / WATER MAiN TO SEPTIC TANK K/~) / DRAIN FIELD -~/ ., seePAGE PIT _ i ALSO CONSIDER AREA WELLS. SEEPAGE PIT CAST lEON INTO AND OUT Of SEPT]C TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEETINTO UNDISTURBED SOIL. 4 INCH D~AMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAge PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL DIAGRAM OP' SYBTEM ] CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS Of GREATER ANCHORAGE AREA BOROUGH ORDINANCe NO, 28-68 AND THAT THE A~3OVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ~ / ~ DATE~ ~? /L/~-- ¢ aPPliCaNt', ,,ONATURE GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For ~.~e ~T-~ Legal Description: Lot io~. This Form Reports Soils Log ,~ - Soil Test Must Be Logged To 4' Depth Feet Soil Characteristics 2m ll-- 12-- 141 Block~l ~Subdivision ~ Percolation Test Below Proposed Seepage System Was Ground Water Encountered? If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H2D Net Drop I Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit Or Trench COMMENTS: ~/L¢~o~ ~o~b~'~lL ~-~t~ ~ ~,~' m~F~l / Test Performed BY_~ ~m~_~ Date Certified BY: Date: ~',~--~ tv1-W DRILLING, Inc. P. O. Box 4-1728 · 2811. Dawson A C 907-279-1741 ANCHORAGE, ALASKA 99509 Well Owner. Location Size of casing- DRILLING LOG Mr. & Mrs. John Jones ~ ' ell Dom Use ol W Static water level Screen ( Describe screen or perforatior~ Well pumping test at~2---ga1lone per (~r) of drawdown from static level (address of: Township, Range, Section, if known; or distance main road- b12, Sunny Va~l~ley Subdivision, Plat 651 Eagle .~River, Ak. Depth of Hole_ 149 feet Cased to. 1140 _feet 119 ft. (~e) (below) land surface. Finish of well (check one) open end ( X ) ); Perforated ( J~' ). Mille Knife Slots (~"xl/8"), 4/£t.: 1~ to 140 ft. depth level (minute) for 1 hours with Date of completion ~ May 7~ , WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness Silty Gravel 0 TO_ 4 ~ .TO '9 19 TO. 18 18 TO_ 20 20 _TO 99 TO_ ll~_TO 1~6 ___1~6 TO_ l~O ~O- .TO- _TO. ____TO. ~O- TO- Boulder Silty Gravel Boulder Silty Gravel Boulder Gravel: Coarse Gravel: silty/sandy, undifferentiated wet,.__ (1G~, 1OO'~Static Level) Small Gravel: silt2~ Medium Gravel: sliKbtly sandy, waterbearing r 94;4 1- CUSTOMER GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 2330 "C" Street, Anchorage,~ Alaska 99503 274-4561 .~/iI~i~O~2}A)? ~l~Z~J'f' Date of Inspection /~/Z/~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Date Received ~-o~ Time of Inspection C. ONV 2. Property Owner: 9 ~7~ ~ ~ ~ obou~ Phone: Mai l ing Address: 5. Type of facility to be inspected No, of bedrooms VaJI~ 6. Well Data: A. Type B. Depth. C. Construction D. Bacterial Analysis 7. Sewage Disposal System: A. Installed B. Installer ¢. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , Absorption area , Other contamination , Absorption area C..Absorption area to nearest lot line , Sewer Lines . , EQ-034 (]/74) Page 1 of two pages Page,2 of °two pages - Legal Description for Approval of Individual .~._~/& Water Facilities Comments Approved '-~J ~ Disapproved Date / Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 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) GR£ATER ANCHORAGE AREA BOROUGH...~ Department of Environmental Quality 3330 "C" st., Anchorage, Alaska 99503 - 274-4§61 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO 2. Property Own e r '~ ~/~//d]~ 3. Name of Buyer: ~5~l~. Mailing Address: ~/~'/6 ~; ~m~-. Day Phone 4. Name of Lending Institution: Mailing Address: Phone 5. Name of Realtor or Agent: Mailing Address: Phone Legal Description: ~.~)-~1~: Location: ~ ~ ~ '~ ~¢~. /~. ~l~/~Y~ RII~ ~1~, Type of Facility to be inspected: ~l~'~{~/ No. Bdrms.~ Water Supply Type of Supply: Public Utility Individual / If Individual, number of dwellings presently served ~ If Individual, depth of well I~~/~0 ! 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) Individual, date of installation ~F~y ~1 ~-~ If Eq-037 blAIl: UI~: ALASKA 'MENT OF HEALTH AND WE~ "':~"'~'DIVISION OF PUBLIC HEALTH ~'~'~" BACTERIOLOGICAL WATER ANALYSIS Lab. No OFFICE REPORT RESULTS TO' ?0 /30 /0 / Z CItY .~ ~/~ ~ ~ - Records in Ibis office indicate this WATER SUPPLY to be of: [] Satisfactory ~ Ouesllonable [] Unsatisfactory Sanitary Status. ~C$ ~ f i~f:l:~;y S h: s(~hl;: tiWoYa~ ~l~ A/~{~ L~ nfs: t ihs;:ac t o r y' 1. Notify consumers water is polluted. 8oii or'chemically freal Ibis waler as oulllned in the enclosed leaflet "Drink If Pure." 2. Increase chlorination sufficiently Io meet recommended residual standards. ar~ Determine source of conlamlnation and toJ~e action necessary to maintain pm a safe waler supply at 911 times [] Basement Taj~ 3. Check chlorinaBnr and other mechanical equipmenl. Make certain il is . functioning prop~r['~. -4 II ~fler checking equ*pment a disinfecting resldual is not obtained, please wire lhis,ofBce for emergency assistance or advisory.servic~s. Well- El Dug [] Driven [] DrillecJ SOURCE: ~ Spring [] Cistern [~ Other Dug Well or Cistern Construclion: Brick or Walls - [] Wood [~ Concrete -~ Melal [] Tile [] Concrele When? [~ Of Well [~ Othm PURPOSE OF EXAMINATION: Illness Suspected9 [] Yes [~ No This is a surface wafer source and subject to Dollution by man and animals. An approved water supply source should be developed. 6. Improve your [] spring [~ dug well [] driven w~ll [] drilled well [] ~clstern. 7 Relocate your well TO a sale location ir relationship Io your sewage disposal syslem. [] see enclosure B. Sama[e fao long in transil: sample should not be over 4B hours old al examinaflon fo indlcote reliable resulls. ~lease send new sample. [] Baffle Broken in transit, please send new samale 9. Confacl your nearest [] focal Health Deparlmem or [] Alaska Division of Public Heallh sanitation office for bulletins, consultation and SANITARIAN'S ~EMA RKS Signature ~-~ READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE BACT£'I~IOLOGICAL WATER ANALYSIS RECORD Date Beeeived /J ~ '~' Time Received LabNo Brilliant Green , ~ . 24 hours 48 hours EMB AGAR LClclOSe Broth. 24 hfs 48 Ers Gram's sfaln Coldorm Dens/ly [Mosl probable No. per 100cc.,