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Home My WebLink AboutTIMBERLINE LT 3LoT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM ,~ INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION Liq PHONE [] NEW DISTANCE TO: TO: JAbsorption area Dwelling Material NO. OFBEDROOMS3 PERMIT NO. IF HOMEMADE: Inside length Well Dwelling IWidth Liquid depth Material DISTANCE TO: No. of lines DISTANCE TO: Well Foundation rib diameter Crib depth Nell Building foundation Nearest lot lin PERMIT PERMIT NO ~lass Depth Driller DISTANCE TO: Building foundation Sewer llne Total effective absorption area Nearest lot llne Septic tank Absorption area(s) Distance to lot line PERMIT NO. OTHER PIPE MATERIALS / ' APPROVED DATE 72-013 (Rev. 3/78) LEGAL PERMIT NO. ,:: 8109S1 ) DFITE OF I,:,,;:,JE :+:s::+: HRRNING - DUE TO CNRNGI~TS THt'5 F'RINTOUT MFI'¢ NOT BE FIN EXRF:T :+::~':~+: COP"? OF THE ORIGtONF4L, F'ERMIT F'ff:'PLICFINT BEF:NF!RE:, MCR~E C;R ~90',.",' 2049 M g4La-iSOS LOCRTi ON L3 TIMBERLINE LEGRL L.]: TIMBERLINE LO-I- SIZE 49665 SQUFIRE FEET 'f'¥PE OF SOIL RBSORBTION S"¢STEM IS: TRENCH ..... ~;dqTIllld ,'S:) FT/BR)= h'IF!:'~:IMUM NUi"1BER OF TNE REg!LIIRED 2';IZE OF THE SOIL FIBSORP]"ION SYSTEM IS: TF!E LENGTH DIMENSION tS THE LENGTH (IN FEET) OF THE TRENCN OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT tS THE DISTRNCE 8ETHEEN THE SLIRFBE:E OF' THE GROUND RNB' THE BOTTOM OF THE E..XCRVRTION '::IN FEET). THERE IS NO SET 1.4IDTH FOR TRENCHES. THE GRB. VEL DEPTH IS THE MINIMUH DEPTN OF GF.:FtVEL BETHEEN THE OUTFFILL PIPE BND ]'HE BOTTOM OF TNE EXCRVR'f'ION '-'.'iN FEE]'). BRCKFtLLING OF' RNY S'¢STEM HITHOUT FINial._ I.NSF'ECTION RN[:, RPPROVFIL B'¢ THIS DEF'RP. TMENT kilL. L BE SUBJECT TO PROSECUTION. HINtHUH [:,ISTFINCE BETNEEN R NELL FIN[) FIN'¢ ON-SITE SEP.IRGE DISPOSFIL. S"r'STEM !S t00 FEET FOR R F'RIVRTE 14ELL* OR ±50 TO 200 FEET FOR R PUBLIC NELL DEPENDING UPON THE T'~"PE OF PUBLIC NELL MINIMUM DIS, TFINCE FROH R F'RIVRTE NELL TO R PR:[VRTE SENER LINE IS 2.5 FEET RN[:' T'O R COHHUNIT'.,:' SEHER LINE t'E, 75 FEET. OTHER REQUtREHENTL=, HR'~" RPF'L'¢ - SPEC!FICFITiONS RN[:' CONSTRUCTION D!RGRRHS RRE Wv'RILRBLE TO INStJP. E F'F-.'OF'ER INSTRLLRTION I CER:TIF'¢ THFtT i: I Ri'4 FRHILIRR 14tTH THE REL-':!UIREi',tENTS FOR ON--SITE SEI-4ERS RI'iD 14ELLS RS SET FORTH B'¢ THE MUNICIPRLIT'¢ OF RNE:HORRGE. 2: I HILL INSTFILL THE S'¢STEM IN RCCOF!DRNCE HITH THE CO[:,ES. 2: I UNDERSTRND THFIT TNE ON-SITE SEHER S'.¢STEM HR'?' REQUIRE ENt...RRGEHENT IF THE RESIDENCE IS REHOE:,ELED 'f'O INCLUDE HOP. E THRN 2: BEDROOHS. SIGNED: .................................................................. F~PPL I CFINT BEP. NRRD MCRRE ISSUED BY ............................................ DRTE .......................... INSF'ECTION HISTOR'¢ - SEI.qER i 0 SE:HER 2 0 HELL INSP 0 HELL LOG DRTE 0 DRILLER = PERHII" NO. FIF'PLIC:RNT BERNBRE:, hlE:RFIE LOCFITION L2: TIHEEEL. t, ir: [ ,E ':iF,_ L7: T I MBERL I hie TYPE (jIF' fSt]JIL HE,_,.I-~.,~ I..i',t .... T_,l Ei'l ..... SR BOX 2E~49 M LOT =,I&E II:lS- 2:4~-i3E~8 ~ I"'IFtF:iIMUM ,*.il HEER ElF [,h.[RClt..I.~L = . ~ c;O I L RFIT I NG ,:' :S6, FT/E:R) = 2'.-::F~ THE REQUIRED ._,!¢..E rlF THE ';;OTL HE, mLIh. P FIOI,! _.,z_,-fE. ft THE LENG]`'FI DIMENSION IS THE LENGTH (IN FEET) OF' THE TRENCH OR DRFIiNF'IELD. THE DEPTH OF F! TRENCH OR PIT IS; -/'HE DtSTFINE:E BETWEEh! THE SUF.'.FRCE OF' THE GROUND RND ]''HE BOT].'OM OF TlqE E;=:CRVFITION (IN FEET), THERE IS NO SET FIIDTH FOR TRENCHES, '['FIE GRR',,,'EL [.',E:PTH IS THE HINIHUM DEPTH OF' GRRVEL BE'T.WEEN ]''HE OUTFFILL PIPE FIND THE E~O]`"FOH OF THE E,%'CFt',,,'F~TIO!'..t (IN FEE]`'). F'ERf'tIT RPP_IC:RNT FIR_, THE RE=FLir'~.uIE~LIT~- TO INFO,C:H ]'H.[..., [:,EF'RRTMENT E, I,,!=,FFLLHTION Il'L[ b. ETI_.l',!,_ CF' RN'¢ NEL. LS RDJFICENT TO ].'HIS FR_. EF.].. RN[:, THE NUI',IBER OF RE_-,I[;ENL. E=, THFIT -['PIE HEL. L P.I!LL _,ER THE E, HL.k. FILL1Nim:'--" "OF~',[~1':~ P' = T: / ~'.. -, ,,-,,~-r'-.,, P.tITHZUT FINFIL It'~_FEL.I'= ...... it. Il" HNL- -' RI::IF'RO',,~FIL E:'¢ 'FHI_,'':' DEPRF'.THENT I.',!IL.L. BE =,UE, JEuT TO FF.U_:,EL. LITI_N. btINIMUM DISTRNCE BET.t,!EEN FI NELL RND RN"/ ON-L=,ITE SEI4RGE DISPO:.=;.,RL S"/2;'TEM IS :LEIE~ FEET FOR FI PRIVFITE -WELL OR 15C~ TO 2E,:ZI FEET FROM R PUBLIC I.,.IELL. DE_'PENDING UF'ON THE TYF'E OF' PUBLIC WELL MINIMUH DItS',TFtNCE FROM Fl PRIVRTE WELL 'l'O F! PRIVFFFE SE.[..!ER LIh!E iS; 25 FEET F:~ND 'TO R COMMUNITY SEWER LINE IS 75 FEE].'. OTHER REE:!UIF.'.EMEN]"S F1B"r' FtPPL.'T'. SPECZFICFITIONS RNC.., CONSTRUCTION DIFIGRF!i-"I~ FIRE FWRILRBLE TO INSURE PROPER tNS]`'[:ILi.,RTION. t CERTiF',r' THRT t: I BM P'FtMILIFtR WITH ]'PIE REQUIREMENTS FOR ON-.E;ITE SEWERS FIND ~-'.~ELrLE; FlS SET FORTH B'¢ THE MUNIC:IPRLIT'¢ OF FINCHORRCiE. 2: I klILL INL';;TFtLL THE S'¢S, TEM IN FICCORD~NCE !.,.tITH THE CODES. '2:: I UNDERS'TFiND THi::I'F THE ON-SITE SEWER S'T'STEM i',lR? REO!UIRE Ei'.,!LRROEHENT IF THE RES;IDENCE IS REHODELEO TO INCLUDE MORE THRN 2: BEDROOMS. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, AlasEa 99501 264-4720 SOILS LOG - PERCOLATION TEST [~SOI LS LOG ~PERCO LATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10- 11 14- 15- 16- 17- 18- 19- 20- COMMENTS PERFORMED BY: ~'~_ (c2,~(-"~ SLOPE SITE PLAN WASGROUNDWATER ENCOUNTERED? IF YES, AT WHAT Reading D6te Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE C~F (minutes/inch) TEST RUN BETWEEN ,~' e FT AND *,-~-.~FT 72-008 (6/79} GRE :ER ANCHORAGE AREA BOP JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION SEPTIC TA~K:~----- , ~ DiSTANCE~~ /x, , -- FROM WELL MANUFACTURER (-~-~g//~/~/ INSIDE LENGTH INSIDE WIDTH O~L MATERIAL ~'C2~Y/~_/~/~COMPARTMENTsNUMBER OF LIQUID DEPTH .LIQUID CAPACITY}-~-~ GALLONS. SEEPAGE Pit: NUMBER OF PITS . LINING MATERIALdEZ~% I'~; CRIB SIZE: DIAMETER BUILDING FOUNDATION -~", NEAREST LOT LINE ADDITIONAL ABSORPTION ~ / ~2~/~[~/'~' DIAMETER OR WIDTH /f, LENGTH~-'~;~' DEPTH // DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. WELL: TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: b/~( 1'/~/'[2~/ LOT SLOPE: Form NO. EQ-031 DIAGRAM OF SYSTEM GrEaTer ANChOrAGe Area Borough PERMIT NO. SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK ~/ SEEPAGE PIT ~ -, DRAIN FI LD TYPE AND SIZE OF FACILITY TO BE SERVED . ~/ FINANCED THROUGH TO BE INSTALLED BY SOil TEST RESULTS ~'~/~/02/~ ., OTHER cOmPLeTION DATE ANTICIPATED ~'~'/ 7 L/~ 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 SEEPAGE PIT WALL /'~ ) SEPTIC TANK ~/ , SEEPAGE PIt ~ / ., DRAIN FIELD TO NEAREST LOT LINE, WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK 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. 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 T. H 2 ~: .*~:~? wE'LL CONSTRUCT I ON LOG ?" /'~"".G co._ A DA, O~'i Well location: (address & legal description) Geptb of ,e~ /7,'? ' ft. CasinG: depth US~S no.__ Dote we~ co.,et,, .2 //?/7,f;' ! / Location sketch or remarks ft. diem ~=.-_~in. stot,e .a,,r ,e,e, .~ ~ ,,. ''"'~,ond ,u,,ac,. oot,_~,/~ Finish of well: (open-end, screen, perforated,~other)- Well yield tested by ~bailing, air) at ~ Gal/min. for ~ hours with. /~)(~ ft. ef drawdown from static level, DRILLER'S MATERIAL LOG Depth below land ~urface in feet Give description of strata penetrated (size of material, color, hardness of drilling, and water content) IF" to_ to to to- -- to ALASKA nUlROnm nTAL CONTROL $ RUIC $, Inc. ~ncjineefin§ 8 ~nuironmental Studies MUNICIPALITY OF ANCHORAGE DEPT. OF HEAt.lil & FNVIRONMENI'AL AUG 2 ? lg8t RECEIVED 8/24/81 J.C. HOBSON SR BOX 2049-M ~/~CHORAGE AK 99507 SF~,T.RR -- BERNARD MCRAE SUBDIVISION-TIMBERLINE SUBDIVISION BLOCK-0 LOT-3 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 564 SpT. THE SYSTEM IS CAPABLE OF ACCK~TING 200 GALLONS OF WA'I'~ PER DAY. B~ED UPON THE TEST DATA THE SYST~4 IS NOT ACCEPTABLE FOR A HOME OF 3 Rk~ROOMS. THE SEPTIC TANK WAS PUMPED ON 8/24/81 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3 BEDROOM HOUSE. 1350 IS ADEQUATE FOR 1220 [Uesl 251h Auenue "AncJlora§¢, Alaska 99503 · (907) 276-1361 · 274-3364 5633 B z,-- ......... ~ Drinki ater Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D. NO. Water System Name Phone No Malting Address city SAMPLE DATE: Mo. Day SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose State Zip Code Year [] Treated Water [] Untreated Water SAMPLE NO. LOCATION 1 4 Time Collected Collected By ' TO BE COMPLETED BY LABORATORY Aha ysm snows this Water SAMPLE [o De: [] Satisfactory [] Unsatisfactory [] Sample too long n transit, samom should not be over 48 hours old a[ examination [o indicate reliable results Please send new samDle. Date Received Time Received Analytical Method: [] Fermentation Tube ,,' [] Membrane Filter Lab Ref. No. Result* Analyst I I I READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Lab, NO. PresumPtive 1Omi 1Omi 30mi 1Omi 1Omi 1.0rnl O.lml 24 Hours MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTS. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 ENVIEONMENTAL P~OTECTION ENVIRONMENTAL ENGINEERING DIVISION NOV ~ 0 1978 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. MAILING ADDRESS PROPER~FY RESIDENT'(If different from above) PHONE PHONE MAILING A~D R ESS ~o~ ~,~:::2~ ;3. LENDING INSTITUTION M,~I LING ADDRESS PHONE 4, REALTOR/AGENT MAILING ADDRESS PHONE 5, LEG L DESCRIPTION ,- 6. 'TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ SINGLE FAMILY [] ' MULTIPLE FAMILY 7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY [] One [] Four [] Other [] Two [] Five ~ Three [] Six Dmllwd' ~-X./~/.- J~'7~/ ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that,date, ~ve well depth (attach Icg if available.) ~a'~'~.~ ~7 8. SEWAGE DISPOSAL SYSTEM I NDIVI DUAL/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, =~010(3/78) P.O. BOX 4-1276 464g RU$1NESS PARK BLVD. ANCHORAGE, ALASKA 99509 Drinking Water Analysis Report for Total Coliform Bacteria TELEPHONE (907) 279-4014 TO BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM: Public Welsr System N~me ~ I.D. NO. Zip Code City State Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose SAMPLE NO. LOCATION 1 I? [] Treated Water [] Untreated Water 3 I 4 Time Collected Collected By TO BE COMPLETED BY LABORATORY LABORATORY: NAME ADDRESS CITY Date Received Time Received / Analytical Method: [] Fermentation Tube ~ Me~brane Filter Lab Ref. No. I J Result* Analyst 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18-310 (3-78) Date Collectect Source Date Received Time Received Lab, No. Presumptive lOml ).Omi 1Omi lOml 1Omi l.Oml O,lml 24 HOURS 48 Hours Confirmatory 24 HOURS 48 HOUrs Broth 48 hours: [Omi Tubes Positive/Total IOml Portions Collform/Z 00mi D,,~, ~ RECEIVED , ,~ -~ INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ~NVIRONMENTAL p~O'fECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~~ 825 LStreet-Anchorage, Alaska 99501 ~U~ 2 0 198~ ) ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R E C E 1 V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS~ Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing, PROPERTY RESIOENT (If different from above) PHONE t PHONE 3. LENDING INSTITUTION ~ ~ t ~ PHONE MAILING ADDRESS · MAILING ADDRESS 5. LEGAL DESCRIPTION iTR EET LOCATION TYPE OF RE IDENCE NUMBER OF BEDROOMS 6. [] One [] Pour [] Other__ INGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY E~'~Th re e [] Six WATERRSUP~SUP -LY [~/~INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE3E DISP~I~DISP SAL SYSTEM [~"INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS E~/~SI NG L E FAMILY ~ ONE E~"~TH R EE [] FIVE [] OTHER [] MULTIPLE FAMILY E] 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 I'NDIVIDUAL/ON -SITE DATE INSTALLED ft~ ~- t/ ~ ~'~ ~ PUBLIC UTILITY Connection Verified INSTALLER ~-'r~ptic Tank or [] Holding Tank Size: /~'~"~ _ lf Tank is homemade 8OILSRATING ~,~. / give dimensions: 4' (. TYPE OF TANK 5. COMMENTS ~]~'P R O V E D FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED