HomeMy WebLinkAboutNETTLETON ACRES #2 LT 6
~--~,~.-- ~ MtJNICIPALITY OF ANCttORAGF.
DEPARTMENT OF HEAl:TH & ~NVi[~ONM~NTAI. PR()TEGTION
ENVIRONMENTAl. ENGINEERING DIVISION
825 I. Street- Anchorage, Alaska ,-,ia0, Telephone 264-47~0
ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OI-Z Wl~I.I. I~,SPE{CTIOP,~ REPORT
MAILING A D DS~
LOCATION
~ ~ / ~anufacturer ,
/Liq, capacity In gallons ~ ..
6.-~1 ~s,a~c[,o. I
~ ~ ~~ Building foundation;
NO. OF BEO..B~OOMS
Absorption area ,~'~ /
[Dwellin.~.~ ~ /
IWidtl~
P EF~MIT.NO.
~o. of compartments
Inside length Liquid depth
Dwelling P[--R M I T NO,
Liquid capacity in gallons
t Material
Foundation Nearest lot line
Total length of Ii nos ~-~//' Trencl;w~-.f~
Matelial beneath tile~.~ //
Depth
Crib depth
Building foundation
PERMIT NO.
Distance between lines
inches ~; /
Driller
Totat effective absorption area
Totat effective absorption area
Nearest lot Ible
Distance to tot line
Septic tank
%ERMIT NO.
Sewer line
OTHER
PIPE MATERIALS
~f tt-~ ~, -/,~,~ - ,cA ,-/~ ~
SOIL TEST RATING
INSTALLEB -- -
REMARKS
APPROVED
DATE
LEGAL
72-013 (Rev. 3/78)
0 0 0 0 0 0 0 0 0 0 0 0
F'E:F..'.M I T i'.,t0.
[:,EP!:IF.:TMI~]'.,t]' HE:FIL. TH FINE:, EN',/I IE:ONHEN'I"I::IL~ ?.OTECT t ON
825 '"L.."' S'FF. tE:ET., FII'.,fCHOI~:F:IGIE:., FIK. '.~E-)SEEL
2 E, 4-, 4 ? 2 C~
,:.' 8:!..055;2 ;:,
RPPL. I C:RNT
LOC:FITION
LE:GRL
L 0 T E; I Z E:
4]:SE;El SLT.!LIFIRE F:'EE:'F
T'T'F'E I]IF L:;.'OIL. I::IEISf]F.'.p'TI]~[.'II'.,! :5'.?:E';TEM IS: TREI'-,ICH
h'lF:l,':.::l'l"ll.J[:'l i",IIJI"IE:EI::,'. OF E:EDROOML:: = ]:
S, OIL RFI'TING ,::$C..: FT,."E:R)= 85
'TFtE REg!IJIRE[:, SIZE ClF THE :50IL F:IE:'.'50RP'FION 9'-rl'.E;,'t"EI"I IE;:
TFIE I..Ei",II:ZI"H DIMENS]ION IE; THE L.E:NC-iTFI <IN FEET) CII:::' "['FIE: TRENCH OR DF::FIII"4FIEL.[:,.
THE r2EF'TH OF FI TF.'.!:EI",IC:H OF.: PI]" ZS': THE DTE;TFINC:E BETHEE:N THE S;LIF:FFICE OF THE
EiROUND FIND THE: DOTTOH OF' THE E,':'::C:FI',,,'Ft]"II-~N ,:'. I I',l F'E'E:"I"::,.
THERE ]::5 I'.,ICI SET 14IDTH FOR 'f'RENCHEL:.;.
THE 1.3RFI',,,'EL DEF'TI-I I?]; THE: MII",IIMUH [:,EF'TH OF GRFa',,,'EL BF..]"I.,.IEEN THE" OU]"FFtLL PIPE:
Fli",l[:' THE BCITTI]['t ClI::;' THE EXCFI'I,"RTION (IN F'EE:T).
F:'E R['I I T R F:'F' L. I C: F:~N"[' H FI L'-'~; T H E R E f..:; F'O N S I E: I L I T ¥ T O I N F O R M T H I S [:,E F'F~R T H E N"F D Uf;'. I N G 'l" H E
I N:E;TRLLI::ITI 01",t I f-,ISF'ECT i ONE; OF RN'T' I.,.IELL'Z'; R[:'JRCE:N]' TO TEl I S PF.':OPERT'T' FIN[:, THE
NtJME~ER OF RE:E;I[:,ENCES THFI]" THE [,.IEI....[.. 14ILL L:;E:R',,,'E.
....................... ']F t..-..I ~'.:::]~ ":: ;;Z ::~ :E ~",~ '-".'!5; F' E C 'T' ]: (Z~ IP,! :.:T.4 IF:~ ER E i:R lED] E;:.~ EJ ][ FE.". EE] E]: ........................
E',F1CKF t LL. I NG OF' Rf',l"r' :E;"r'S;TEM I,.I I THOUT F'I NFIL I N'.:~;F'EC'I"I 0N Rf',ID IBF'I:::'RO',/FIL E','T' 'T'I'41 E;
DEPFIRTMENT HILL E:E SUBJECT TO PROSECUTION.
HINIMLIM DIL:.;TFtNCE E:ETHEEI",t R [,JELl_ RN[:' RN"r' ON-SITE .SEI,.IFtGE DI'.SF'Cr.E]FtL
:'LEI.~ F:EET FOR Fi PRII,,,'I::ITE I.,.tELL. OR ::t..Sl~il TO 21Z1Ei FEE"[' FF..'OM F:I F'IJEd.~tC: 1,.IEll...L [I.:,EPENt.)II'.,II]i
UF'ON ]"HIE ]"'T'F'E OF' PUBL. IC I.,.IEL[..
MINIMLIM t}IE;TFINCE FROH R F'RI',,,'FITE I.,.tELI._ TI] FI PRI',,,'IaTE E; E f4 E" I:;?. LIIqE I'.i.:; ;25 FEET F:IN[:,
'I"O FI E:CIMHUNIT'¢ SEI,.IEF:: LIt'.,IE IS 75 I:::EET.
I,.IELL. I...I[)L]iE; I::iE'.E F.'.EC,!LIIRE[:, i':IN[:, l'"!lJE;T [.~:E RETURNED TO THE [)EPFIR'TMENT
OF THE I,.IELL COMF'LE]"ION.
CFI"HEIT.'.' F.:IEQUIRE]"IENTS I','lFi'¢ FIF'PL'T'. SF'ECIFICF:ITIC~NS FIND C:OI'.,IfSTF.:UCTIC~N DIFICqRFIHE; F:IRE
FP,,'FIILFIE:LE TO II'.,ISLIRE: F'ROPER IN2;]"F:ILL. FITION.
I CERTI F'T' THFIT
±: I ElM I:::'F:IMILIFIR klITH THE REC!LIIRE]'"IEI'.4TE; FCIR I31",I-SITE SEI,.IE:F'.:!~; FIN[:, b. IEI....LE; Iq:5 :SET
F:ORTH EPT' ']'PIE: MIJI'.,I I C I [:'FI[... I T'T' OF FINCHORFIGE.
2: I klILL INS]'FILL TFIE Z;'¢STEM IN I':ICCOF..'DFINCE I.,.IITH THE: C:O[:,E::S.
3:: I LINDERSTF:tH[:, THFIT THE ON-SITE E;E!4ER S"r'~;TE]"I i"11::1'¢ REC!LIIRE EI",ILI:::IRGEMEI'-,IT Il:""' THE
RE:E; I [:,E},ICE I E; REHO[:'ELE[:, ]"O I I",IC:LU[:,E MORE THFIIq }?. BF:[:,F.'.OOM'.5.
HFFLI ]:,~1 E, ILL .::,NU[.I
I~SOI LS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
PERFORMED FOR: ?~'~'I II kU~(.(,~'Cl
LEGAL DESCRIPTION: Lo"~- .~L~
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15-
16-
17
18
19
2O
COMMENTS
PERFORMED BY:
72-008 (6/79)
DATE PERFORMED: (.r~- I'~'--- ~ I
SLOPE
SITE PLAN
WASGROUNDENcOUNTERED?WATER
IF YES, AT WHAT
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN FT AND FT
CERTIFIED B~
DATE RECEIVED
:; INSPECTION APPOINTMENTS
TIME i TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR I NSPECTOJ:N
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
D~PARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH &
825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION
ENVIRONMENTAL SANITATIONDIVISION OfiT 1 ~ 1981
Teleph°ne 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER ANDU
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing,
1, PROPERTY OWNER ~ PHONE
~LiNG A~RESS" ~ ~
P~OPE~TY'~81DENT (If differ~n[ from above) ' ' PHONE
2, BUYER ~ PHONE
MAILING ADDRESS
~,'~.ENDINGINSTITUTION I PHONE
MAILING AD'DRESS - '
MAILING ADD~ES~
B. I. EGAL DESCRIPTI~O[~
STREET LOCATION
6. TYPE OF RESIDENCE ~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF~BEDRODMS
[] 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 wells drilled prior t° that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev, 6~79) /' .~ ~, _ /
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
~r~S~NGLEFAM~LY [] ONE ~THREE [] F~VE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[]*'~INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
Connection Verified. INSTALLER /
E2~eptic..Tanl~ or.__~ [] Holding Tank
Size: ~ If Tank is homemade SOILS RATING
give dimensions: I¢~ ~ .
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4, DISTANCES Septic/Holding Tank Absorption Area ISewer Line I Nearest Lot Line
I
I
WELL TO:
Absorption Area to nearest Lot Line
[] APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY
72-010 (Rev, 6/79)
U25 "1." S'[ RE!E'I
ANCltORAGL, AL. ASIqA 99501
(907) 264 4] ~/
October 15, 1981
James J. Hansford
Rural Route Box 61P
Anchorage, Alaska 99507
Subject: Lot 6 Block 2 Nettleton Acres Subdivision
Approval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1)
The water analysis report needs to be submitted
to this office from the Chem Lab, 5633 B Street,
for our review.
(2)
A well log needs to be submitted to thJ s office
for our files and review.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Les N. Buchholz, R.S.
Senior Environmental Specialist
LNB/ljw
cc: First National Bank of Anchorage
Post Office Box 720 99510