HomeMy WebLinkAboutSCHROEDER LT 12ScNroecler s tD
oq 6), 0 5 1 -12
Lai Brock
is
MUNICIPALITY OF ANCHORAGE
\�\11 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
\— ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE❑�,�N�El�1L
UPGRADE
MAILING ADDRESS ' (� s
LEGAL DESCRIPTION
LOCATfON r NO. OF BEDROOMS
®
U
DISTANCE TO:
Well
Absorption area
Dwelling
PERMIT NO.
YT
wQ
N
T
z
Z Q
2 F
—
Manufacturer Material
Liy. capacity in gallons IF HOMEMADE: Inside length lUidth
Well Dwelling
DISTANCE TO:
Manufacturer Material
No. of compartments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
O
DISTANCE TO:
Well /
1�—
Foundation
Nearest lof li��
PERMIT NO„
u z
Z w
Pe
No. of lines
Length of eacl lined
g ,��
—
Total le th 99f lines
'2g`•�(P _
- --.
Trench width -J-
!j inches/
— -
Distance between line
r
—
a
ccF-
a
-- _- _
Top of tile to finish grade ,� /
-.7 :'S-
Material beneath tile
Total effective absorption area
w
Length
Width
Depth
PERMIT NO.
C7
w ~a
w
rn
Type of crib
DISTANCE TO:
Crib diamet
Well
Crt/ ` `�---
Builndation
a
Total effective absorption area —
Nearest lot Zine
_j
Class
Depth
Driller .�
Distance to lot line
PERMIT NO.
w
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption areas)
a
OTHER
LEGAL
-
PIPE MATER IALS
r—
SOILT ST RATING
¢
INSTALLER �/
REMARKS
Rz
lv�o
S
APPR VED L DATE
is-
IF
_ ����1 f ����1 �� �� ��� �����
DEPHRTMENT HEHLTH HND ENVIRONMENTHL |UTECTION "'
9`�
STREET/ HNCHORHGE, FW.. 99501 o.uuo
-.7
C-11 P1.4_���.��� ������� ��������� �����.T~
PERMIT NO ( 8101]2 )
HPPLICANT JRCK HNDERSON BOX 125 MH�CUS ST]49^^4057
LOCHTION 11HRCU5 ST.
LEGHL L 12 SCHROEDER S/D LOT SIZE 20000 SOUHRE F�ET
TYPE OF SOIL HBSORPTION SYSTEM IS TRENCH
[-'!A::-:: 1111 NUMBER OF BEDROOMS 1-:; 1::SOIL RHTING (SQ FT/BR)= 150
THE I��T:- Sl. -,-"E OF THE S011., HB S,(-IRPTION SYSTEM IS�
�FEE F""���� �`� �������� �� �F����� E- IF" A 9 A
-_
THE LENGTHDIMENSION IS THE LENGTH (IN FEET) OF THE TRENCHOR DRHINFIELD
THE DEPTH OF H TRENC1-1 OR PIT IS THE f': - I'S THNC� BETWEEN THE SIJRFFIC E OF THE
GROUND FIND THE BOTTOM OF:
EXCHVHTION 4'IN FEET)
THERE TS NO SET WIDTH FOR TRENCHES.
THE G�HVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFHLL PIPE.,
HNDTHEE BOTTOMOF THE EXCHVHTION (IN FEET >.
HPPLICHNT HHS THE RESPONSI�ILITY TO INFORM THIS DEPHRTMENT DURING THE
�N�T��LHTION IN�PECTI��S OF ANY WELLS ADJHCENT TO THIS PROPERTY HND THE
NUI'll ��� OF THHT THE WELL WILL SERVE.
T�A����������� ����� ��j If.,e��� ~~�
BHCKFILLING OF HNY SYSTEM klITHIDUT FINfiL HPPROVHL BY THI�
DEPHRTM�NT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTHNCE BETWEEN H WELL FINE., HNY SEWHGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVHTE WELL OR A50 TO 200 FEET FR�M H PJB11 WELL DEPENDING
UPON THE T�PE OF �UBLIC WELL
MINIMU� DIST�NCE FR.OM H PRIVATE WELL TO H PRIVHTE SEWER LINE 1-c.6;25 FEET HND
TO H C���UNITY SEWE� LIAE, IS 75 FEET.
OTHER ��QUIR�MENT� �HY �PP�Y. SPECIFICHTI�NS HN� CONST�UCTIO� DIHGRHMS HRE
HILHBL E- TO PRCIPER IN�T�LLHTI�N
�����*T F"'
IF. EE"','E5,
It'l E:'�- F-,?
I CERTIFY THHT
1� I HM FAMILIHR WITH
THE REQUIREMENTS
�OR ON�S�TE S�WERS
HND WELLS HS SET
FORTH BY THE MUNICIPRLITY
OF HNCPIORHGE.
�� I WILL INSTALL THE
SYSTEM P-4HCCCRDHNCE
WITH THE CODES
]� I UNDE�ST�ND THAT TI
IE ON ....SITE: '_,,;EWER
SYSTEM MHY REQUIRE
�HLHRGE'MENT IF THE
R�SIDENC� IS R�MO�EL�D
R
TO INCLUDE M�E
N T��] B�DR�O MS.
\
SIGNEl" /\-.��������I
HPPLICHNT JACK FINE ERSOI
ISSUED BY__ ......
A SOILS LOG
-\ MUNICIPALITY OF ANCHORAGE
:
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
• �'�. TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: `"'"�/`DATE PERFORMED:X/11-
LEGAL
/ (J `
LEGAL DESCRIPTION: •"" / --/ /'��� ���/� (�i -
SLOPE SITE PLAN
f DEPTHiJ,
1-
2
3
e_..4 .
5
6
8
9
10
4 11
12
13
14
15
16
17
18
19
20
COMM
PERFORMED
72-008 (6/79)
I
f
1/4�
--5'14-- 7-/
j J /1��� {q� WAS GROUND WATER
/ ..JJJ l/ ENCOUNTERED?
ped i`ew, C
/,4r0 M0, 0, D4l
IF YES, AT WHAT
`ADJEPTH?
v�
P p1 I i i -vW' 4)
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
t-
Pj
rr
s
Rig
P p1 I i i -vW' 4)
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
t-
Pj
rr
s
PERCOLATION RATE
GAAB-HD I Gf `TER ANCHORAGE AREA BOROI H
D, ARTMENT OF ENVIRONMENTAL (IUALI,
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
NAMEC' ADDRE S_Fi >C;A Ll<" PHONE
r_
L0CATIONY �L, 1'l_ - (_0 r" 6L� . LEGAL DESCRIPTION 101 l`"._ I),: 'c'
SEPTIC TANK:
rNUMBER OF
DISTANCE FROM WELL_10(_ r —MATERIAL If '_,L[=7F 1-OO–LOC'-LLZ,4 Y(LITc/COMPARTMENTS
LIQUID CAPACITY l7i�%(1 _–_GALLONS. INSIDE LENG
SEEPAGE SYSTEM: SEEPAGE PIT:
INSIDE WIDTH
LIQUID
DEPTH.
r
NUMBER OF PITS L OUTSIDE DIAMETER OR WIDTH--/ LENGTH_" DEPTH
LINING MATERIAL tLje_(`-LI7Z CllliT�S % . DISTANCE FROM WELL—AEG-�_f___ —, BUILDING FOUNDATIONsj�7 ,
ll �
NEAREST LOT LINE !&LL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT,
TILE DRAIN FIELD
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO-51NISH GRADE
FOUNDA
STANCE BETW
FT. LENGTH OF EACH LINE
__.------- TOTAL LENGTH
LINE: . OF LINES_.
TRENCII WIDTH
IN, TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: DISTANCE FROM WATER
TYPE SAA)/V bWllleD , DEPTH—, BUILDING FOUNDATION. -_-_--SAMPLE—_ NEAREST
NEAREST SEPTIC SEEPAGE ` i OTHER CC'"("
LOT LINE ✓, _, SEWER LINE_. , TANK_ ! `' SYSTEM-- CESSPOOL /Il err , SOURCES -'clrz.'.v
DIAGRAM OF SYSTEM
DISTANCES:
T•k=r icirec�r,�-
(LLi.. (rCeS ," lI-iii,
KCv' p l I-" r'rYil
+/z.
NASTrc S �l', fMu� C, _
11LExi V-4rt-10l
F'Ir
irrly -II I"r - LTtWla
il' kriJjace 1 �z
FL IL 5 � ('cTSr u'Ow
L'� PP- i'1?Ev1'[uP� K•
,�=p�t la
04gaS(Ic ___
OIj)e
�0
�7
iO 1).5
c
�21
,
hr�(lrtrun
I�T�iL �P
DATE Az /"� �f. APPROVED 1'0141
CRE,.fER ANCH0R,7(;E-%AREA I of OUGH
DEPARTMENT OF ENVIRONMENTAL. QUALITY
lNl 3500 TUDOR ROAD POUCH 6650
ANCHORAGE. ALASKA 99502
TELEPHONE 279.8686
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
PERMIT NO,
NAME OF APPLICANT �����>�r/.�T_ MAILING ADDRESS/fJd��1`���L�G PHONE
INSTALLATION LOCATION' �G '
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT-__, DRAIN FIELD --OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED/-f)�%yI_
FINANCED THROUGH TO BE INSTALLED BY ���L'✓%
SOIL TEST RESULTS�// �L�t=lam /3'G- �,S U NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL THUT
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: a4 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION DY THIN
HEALTH DEPARTMENT AUTHORITY WILL/ BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE_ TYPE L/r�.�r SEEPAGE AREA SIZE _ TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT __=� U DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALT_
SEPTIC TANK SEEPAGE PIT DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC 'TANK _ _�V / SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK _�� SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, .�SEEPAGE PIT �GTU� DRAIN FIELD
TO RIVER, LAKE, STREAM,
CAST IRON INTO AND OUT Or 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,
GRAVEL EIAC:'ICFILL,
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
� � c
HEALTH AUTHORITY
OR
LICENSED DESIGNER
DIAGRAM OFSYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 20-60 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE ___L�L-/__� ____ APPLICANT'S SIGNATURE
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL H1;,AL:I`H
DEPARTMENT OF HEALTH AND LNVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUT'HORIT'Y APPROVAL, CERTIFICATE
1, General Information Application Date
(a) Legal Desccipti (include�ot, block -.s section, township, range)
Location (addres-` orddire cti ns)
(b) Applicants Name,.(-���� ,':" Tb lephone
Applicants Address0q����_
(c) Applicant is (check o_, n�eA Lending InstitVV for �� a4mer/builder
3uy Other + �(explain);
ye ; !�- aP�,!
(d) Lending Institution—/ 4A/ AJA XP!"� ,Telephone
Address
(e) Eb-al Estate Co. & Agent L t-jl�1
Address
Te le phos
2. 'ry2of Residence
Single-•Family� Multi --Family Other (describe
Number of Bedrooms -
3. Water Supp_
Individual V ll Community 1j Public
Note: If cr.,amunity well system, must have written c_rnfirmation from the State
Department of Environmental Conservation attesting to the legality and status.
Is the well. adequate for the number of bedrooms specified in this HAA 6Y
j^
4. Sewaqe Disposal
Onsit; Public Community Holding Tank
Is the wastewater disposal system adequate fcr the n=nber of bedronms (Y
"Page 1 of 2
2-15-84
s�-
i
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL H1;,AL:I`H
DEPARTMENT OF HEALTH AND LNVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUT'HORIT'Y APPROVAL, CERTIFICATE
1, General Information Application Date
(a) Legal Desccipti (include�ot, block -.s section, township, range)
Location (addres-` orddire cti ns)
(b) Applicants Name,.(-���� ,':" Tb lephone
Applicants Address0q����_
(c) Applicant is (check o_, n�eA Lending InstitVV for �� a4mer/builder
3uy Other + �(explain);
ye ; !�- aP�,!
(d) Lending Institution—/ 4A/ AJA XP!"� ,Telephone
Address
(e) Eb-al Estate Co. & Agent L t-jl�1
Address
Te le phos
2. 'ry2of Residence
Single-•Family� Multi --Family Other (describe
Number of Bedrooms -
3. Water Supp_
Individual V ll Community 1j Public
Note: If cr.,amunity well system, must have written c_rnfirmation from the State
Department of Environmental Conservation attesting to the legality and status.
Is the well. adequate for the number of bedrooms specified in this HAA 6Y
j^
4. Sewaqe Disposal
Onsit; Public Community Holding Tank
Is the wastewater disposal system adequate fcr the n=nber of bedronms (Y
"Page 1 of 2
2-15-84
s
5. Encineering Firm Providinq Inspections, Thsts, Data and Information
I certify that -Th. - checked, verified, or conformed to all. MOA 9kA Guidalires in
effect on the dat: inspection.
Signe . � � _ Datee.
Name irm Te lephone
F
Address C9s'
Signed by
Date
(ENGINEER SEAL)
6.DHEP Approval
Approved for----)-- bedrooms
Approved Disapproved
Terms of Conditional. Approval
5
AY V �/ _ . t. i� i •'� Date
onditional e �-
The Municipality of Anchorage Department of Health and Environmental Protection does
not guarantee the continued satisfactory performance of the water supply and/or the
wastewater disposal system. 'ih.s approval indicates that, as of the val.idation date
sham above, based on the data and information furnished by an engineer registered in
the State of Alaska, the water supply and wastewater disposal system is safe and furc--
tional for the number of bedrooms and type of structure indicated.
D
(DHEP SEAL)
7. Mail t e to t. following address:
� ®' err
Kn2/d5/s
(Page 2 of 21
2-].5-64
/2 `� cLi/® e c✓el S' o
MUNICIPALITY OF ANCHORAGE (MOA) �'
HEALTH AUTHORITY APPROVAL (HAA) MUNICI ITY (��_ NCIiQRAG�
DEP . OF HEALTH &
CHECKLIST - FEBRUARY 1984 ENVIRONMENTAL PROTECTION
MAR 2 1�
A. WELL DATA
Well Classification __ If Ar B, or C, D.E.C. Approved(Y� �" I
Well Log Present (1 a Date leted _ Yie1c1�%/Jl��
Total Depth )fo, L `ase �o L�pth of Grouting L.3
�f
static Water Level Pump Set At�� �
Casing Height Above Ground Sanitary Seal on Casing (Y
Electrical Wiring in Conduit lybe—repression Around Wellhead (�
Separation Distances from Well:
To Septic/i �g Tank on Lot ,SOD On Adjoining Lots
To Nearest Edge of Absorption Field on Lot . �; On Adjoining Lot 3t _1AK1��,
To Nearest Public Sewer Line 0 q To Nearest Public Sewer
Cleanout/Manhole To Nearest Sewer Service Line on Lot
Water Sample Collected By -5.,.5 E441&, e/ �333 — /62..p
Water Sample Test Results
Convents
B. SEPTIC/HOLDING TANK DATA
Date Installed JG/L I size ��»No. of Compartments
Standpipes Y Air -tight Caps(Y Foundation Cleanout
Depression over Tank (# Date Last Pumped
Pumping/MaintenancanContract on File (Y/e� ; for
Holding Tank High --Water Alarm (Y/N)./l/- AL Temporary Holding Tank Permit (YM)PIA
A
Separation Distances from Septic/Holdng Tank:
To Water -Supply will /ice �0- `1'o Building Foundation
To Property Line To Disposal Field
To Water Main/Service Line To Stream, Pond, Lake, cr Major Drainage
Course 1 ®�
Comments
[Page 1 of 21 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Type of Systemsigne?+c_
Date Installed � P2 / , Length of Field , ��� -
Width of Field j�0 _ Depth of Field
Gravel Bed Thickness
-
Square Feet of Absorption Area j/Phc `i Standpipes Present
Depression over Field eto Date of Last/ Aquacy Test
Results of Last Adequacy 'lost /� /4A5,0 Gl�%_ l��C�yc�. 3 1_8
Separation Distance from Absorption Fidld•
To Water -Supply 9\bll 20 (fir _ To Property Line
To Building �Fogndation C� ` To Existing or Abandoned System on
Lot /"/ l//0 ; On Ad//' ' ning Lots /IZ J4/
To Water Main/Service Line = To Cutbank(if resent) A116-
To Stream/Pond/Lake/or Major Drainage Course Lt%
To Driveway, Parking Areal, or Vehicle Storage Area
Convents c' i' x/C2i.-(.BSc-
D. LIFT STATION
Date Installed Dimensions —
Size in Gallons Manhole/Access (Y/N) --�
"Pump On" Level at_ "Pump Off" Level at
High Water Alarm Leve at Vent (Y/N) --_
Tested for PurkAg Cycles during Adequacy Test.. Meets MOA
Electrical Codes(Y/N) — —�
Comments ----, _—��
** Check Permitted Bedztoon Rating Against HAA Request **
I certify t0at I av_ checked, verified, or conforned to all MOA HAA Guidelines in effect
on the day,6 of io —
S i e %' �(� Date,_
Comp•:,,5 F3fllrt MOA No.
,s
xa4 /xB1/a5/s� ] UP
(Page 2 of 21 "
2-7.5-84
A
ADEQUACY TEST
WATER AND SEWER INSPECTION
WELL INSPECTIONS AND
FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
ON SITE WASTE WATER
DISPOSAL SYSTEM DESIGN
EXCAVATION WORK
March 21, 1.984
The Municipality of Anchorage
Department of Health and Environmental Protection
825 L Street
Anchorage, Alaska 99501
REFERENCE: Lot 12; Schoreder Subdivision
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
MUNICIPALITY 01= ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL- PROTECTION
MAR
RECEIVED
Request a Health Authority Approval Certificate be provided for the residence located
on the referenced property. Provided for your information are the following
documents:
A. Application for Health Authority Approval Certificate
B. Health Authority Approval Checklist dated February 1984
C. Chemical analysis of the water for coliform bacteria
An adequacy test was performed on the system located on the referenced property and
reflects that the system is currently functioning adequately. However, it cannot
be guaranteed against subsequent failures. r, well yield test was also preformed
and it was determined that the well does provide the minimum yield of .104 gallons
per minute per bedroom per day. It was noted that thi.A well provides a minimum
flow and a, large (approximately 240 gallons) Storage tank is available to sustain
the residence during peak flows. The well cannot be guaranteed against subsequent
yield loss or failure.
The well casing is adequately equipped with a sanitary seal and the wires have
been placed in conduit. The ground around the well casing adequately slopes away
from the well.
If we my)be of further service, please do not hesitate to contact us.
Wey, P.E.
SRB 196X EAGLE RIVER, ALASKA 99577
I—
DATE RECEIVED
INSPE=CTION APPOINTMENTS
w
TIME
TIME - -
TIME
El one T Fd r ❑ Other
1 —
❑ QTwo Five
❑ MULTIPLE FAMILY
C�IJLA Q4
DATE
DATE
DATE
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
�
�.-
INSPECTOR
INSPECTOR
INSPECTO���
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT, OF 1! d.l I «
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTEI19MRONiJ,CNTAI. ._ -CCTION
825 L Street - Anchorage, Alaska 99501
•
ENVIRONMENTAL SANITATION DIVISION ;'13 2 1081
Telephone 264.4720
REQUEST APPROVAL UUNITf P
FOR OF INDIVIDUAL WATER AND SE
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PBO ,:RTY OWNER PHONE.
SS
MAILING/ ✓ IaEIL 0.C��i
PROPERTY RESIDENT (If different from above)
PHONE
2. BUY,, �-
PHONE
MAILING ADDRESS
3. LENDI G I JSTITUTION PHONE
J/4_ yl
-
MAI LING ADDRESS `
4. REALTOR/AGENT PHON
MAILINGAD RESS � /r n �// .
/r� /C 5��/C r7 9' -SZ Ll --
5. LEGAL DESCRIPTION 7 /
/
(�
STREET LOCATION
w
6. TYPE OF RESIDENCE
NUMBER OF,BEDROMS1 `
SINGLE FAMILY
El one T Fd r ❑ Other
1 —
❑ QTwo 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 hat date, give well
❑ PUBLIC UTILITY
depth (attach lag if available.)
8. SEWAGE DISPOSAL SYSTEM
-` INDIVIDUAL/ON-SITE**
_YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79) !L¢e.e: •---_. I_I_ C��JLP_eq�c6-�l �'�-�`'`��-'
THIS SIDE FOR OFFICIAL USE ONLY-�
1. TYPE OF RESIDENCE— NUMBER OF BEDROOMS_
❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX
---
2. WATER SUPPLY
PERMIT NUMBER �
❑ INDIVIDUAL
DEPTH OF WELL
❑ COMMUNITY
e
DATE DRILLED
❑ PUBLIC UTILITY
LOG RECEIVED
—
Connection Verified_—_
3. SEWAGE DISPOSAL SYSTEM
PERMIT NUMBER
❑INDIVIDUAL/ON -SITE
DATE INSTALLED
❑PUBLIC UTILITY
I
Connection Verified —
INSTALLER
❑Sept'{cbTaibor ❑Holding Tank
SOILS RATING
Size: l If Tank is homemade
give dimensions:
TYPE OF TANK -
MANUFACTURER �7 _
-TOTAL ABSORPTION AREA
MATERIAL
Septic(Holding Tank`Absorption Area Sewer Line Nearest Lot Line
4. DISTANCES
WELL T0:
Absorption Area to nearest Lot Line
5. COMMENTS
old
APPROVED FOR BEDROOMS
.�R, CONDITIONAL APPROVAL (letter mus a company certificate)
❑ DISAPPROVED
DATE —`�\ T—
BY !
_„ ...,. 111, 1
1AVfit\
Century 21, Sleeper
ATTENTION: Mary Ann Dodge
8050 0ld Seward Highway
Anchorage, Alaska 99502
Dear Ms. Dodge,
DAVID A. SLENKAMP
ROBERT A,SHAFER
MECHANICAL ENGINEER CIVIL ENGINEER
694-9055 --�.t� 694-2979
MUNIC Ai_lo
February 15, 1981 DEPT or
IV
C
.Reference: Jack Anderson property; Lot 12; Schroeder Subdivision
At your request, a sewage system adequacy test was performed on the
system located on the referenced property. 'Phe septic tank was
pumped and the tank was verified to have a capacity of at least
1000 gallons. The seepage pit was charged with 1000 gallons of
fresh water and after a period of 24 hours, 281 gallons had percolated
out of the crib.
It can be concluded from this test that the septic tank is adequate
for a three bedroom residence, however, I regret to inform you
that the seepage pit showed a percolation adequate for approximately
1.9 bedrooms. This means the absorption area 1 -rill require upgrading
for it to be adequate for a three bedroom residence. A permit may
be obtained :from the Municipality for this upgrading work.
If we may be of further service to you in arranging for the completion
of the work necessary on your system please do not hesitate to contact
use
Sincerely, I,
B T A. SHA R, P,E.
,RAS/ss
/ cc: Jack And rson
Alaska U.S.A. Federal Credit Union
Municipality of Anchorage
Department of Health and Enviornmental Protection
SRS 196X EAGLE RIVER, ALASKA