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Home My WebLink AboutSANDI HEIGHTS LT 13ASo�.ndI {�eiyhis 5►� 01l 2 22 6&L GAAB-HD- I GRE ':R. E ' ,ANCHURAUR: AKLA OVICUUk 0 EPwATMENT OF ENVIRONMENTAL OMALITl 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILINGPHONE NAME ADDRESS LOCATION _'Z-/ v LEGAL DESCRIPTION SEPTIC TANK: DISTANCES; NUMBER OF DISTANCE FROM WELL —MATERIAL —COMPARTMENTS VI LIQUID LIQUID CAPACITY Z- .--GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: OR WIDTH_ LENGTH DEPTH NUMBER OF PITS -OUTSIDE DIAMETER �_ / 4 1 - 'I"k '1, .11 , BUILDING FOUNDATION DISTANCE FROM WELL LINING MATERIAL Z' ./- TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. NEAREST LOT UNE-- TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL wNDATroN- EST LOT LINE—, OF LINES NUMBER OF LINES _TREN H W IDTH DISTANCE BETWEEN LINES TREN H WIDTH N. TOTAL EFFECTIVE ABSORPTION EA SQ. FT. LENGTH OF EACH LINE SQ. T DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: DISTANCE FROM WATER BUILDING FOUNDATION.— SAMPLE NEAREST TYPE X, DEPTH— NEAREST SEPTIC SEEPAGE LINE TANK SYSTEM_ CESSPOOL—, OTHER SOURCES— LOT LINE SEWER DIAGRAM OF SYSTEM DISTANCES; DATE X�APPROVED G.A.A.B. VI DATE X�APPROVED G.A.A.B. F MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION 6. TYPE OF RESIDENCE Telephone 264-4720 ❑ One Four ❑ Other REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ❑ Two ❑ Five DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. ❑ Three ❑ Six 1. PROPERTYOWNER PHONE MAILIfV/G ADDRESS .240 !/C/. 9y �� * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY PROOP/ERTY RESIDENT (I ifferent-from above PHONE depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM 2. BUYER PHONE MAILING DDRESS If system is over two (2) years old an adequacy test is required 3. LENDI INSTITUTIO I PHONE NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MAI LI DDRESS 4. REAL7'O AGENT PHONE MAILINGADD EES�S� U 5. LEGAL ESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One Four ❑ Other ❑ SINGLE FAMILY ❑ Two ❑ Five MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ 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 >ia PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, installation date INDIVIDUAL/ON-SITE** give If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. A72-010(3/78) oil PCossf %l-t-� 0-00ja Lb L. (- Sc C� L7 Ll Ian" G`a ,�et�i� a U ��if'�' Y�leedlr'�.tu� �b I ki-t LAC- C�oLest o�ILu 3`i��• ( •�� .fear'"..""' G'rC� .. L4- THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED — TIME TIME TIME DATE DATE DA"fE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS — ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL O: T��__ Septic/Holding Tank Absorption AYe£I Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS LIDS APPROVED FOR BEDROOMS L1?CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE Ib �I� IY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78) John M. Lambe, P.E. 4303 North Star Street Anchorage, Alaska, 99503 907-279.8056 NEW PHONE NUMBER 276-4113 SOIL ABSORPTION SYSTEM TEST PERFORMED FOR: (� reVEL k --L &-5" [T 9 Z.ZS^ 'LIE a n i e—c T TELEPHONE: 243-3413 DATE OF TESTS: 2S Z7 LEGAL DESCRIPTION: AZA 15n 141_1d, i-1T� S 215D NO. OF BEDROOMS RECORDS ON FILE: W b"r,- CRIB -' DRAINFIELD -------- OTHER TEST PERFORMED IN ACCORDANCE WITH JML STANDARD PROCEDURE ACCEPTED BY MUNICIPALITY OF ANCHORAGE, DEPT. OF ENVIRONMENTAL QUALITY ON Z4ZAL7f, `fIITH THE FOLLOWING MODIFICATIONS: SURGE CAPACITY: SOIL ABSORPTION SYSTEM (SAS) h'lost SEPTIC TANK PLUS .SAS �--- ABSORPTION RATE i AVERAGE 24 hrs D AZ!gE rn STEADY STATE i RISE OBSERVATIONS: NOTES: PERFORMED BY- SUPERVISED Y: SUPERVISED BY: TEST DATA ATT .1 -7 ---PORT BY: P/ 2 Y � / SHEET i OF John M. Lambe, P.E. 4303 North Star Street Anchorage, Alaska, 99503 907-279-8056 T=ST.Llqu MMIN --�'$+y�*Drnr n mTnt�r n�r�IIAC REFERENCE: st sde C:'-1-4 _WY.�� rz-- DATEZYs/% jML `EET 2— OF Z John M. Lambe, P.E. 4303 North Star Street Anchorage, Alaska, 99503 907-279-8056 REFERENCE: o,� DATE -2 /Z C, /PERFORMED BY: LEGAL DESCRIPTION: Z' 5v -mc- Gm(�, DEPTH BELOW'L'I METER READING D�'TDrwry `� ( r-AT.Tf)TT4 ) I GALLONS PUMPED TIME ( VVT ) �B -44 sit z 7 U t a •S"J S4 3 zU ,5'0 /o. S� -Z /4 S-4 zo 3 Itt4 6-4470 93-4(' 2so >i 'lee 6-4S7Q 7--s�14 s4 -f 1 zZ -7 -2�d 7 ze-) 64 0 7 z gzo 1 5-4-6,70 4a It !4S 7' P a-4 e� G 44 1 1 S3 j 11 7 -3 /4 t Z 13 -7 4 ¢ t Z, 24 Z? - 1978 ,� I GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER_ & WATER FACILITIESllwi .. e 1. Approval requested by: / Mailing Address: Phone: 2. Property Owner: jr-oma cs%� _��•��} Phone: Nailing Address: _ 3. Legal Description: 4. Location: 5. Type of facility to be inspected No. of bedrooms 6. Well Data: A. Type C. Construction B. Depth D. Bacterial Analysis 7. Sewage Disposal System:� 1 A. Installed ///5/7/ B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: 2. Material A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line _ _ wage 2 of two pages - Request for Approval of Individual Serer a Water Facilities Legal Description Comments Approved Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM II 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