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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 AND/OR WELL INSPECTION REPORT
NAME
PHONE
[J NEW
s�IUPGRADE
MAILING ADDRESS
P)OX
c3/ u e. vcc f� IaC ct
LEGAL DESCRIPTION
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1 01 .l_
\\
tti�(1y,Z `S U,U CSI\ V I- I ci t/\
LOCATION
--
--
_
NO. OF BEDROOMS
®Well®
fl sol area
Dwelling
PERMIT NO.
o
DISTANCE T0:
��--
b Z
Manufacturert
- ,;',,`'
Material
No. of compartments
LU
N
Liq. opacity in gallons - Inside -'i*'
/��pq® IF HOfvNiAD�_ I'
Width
Liquid depth
F
0
DISTANCE TO:
well ° w
PERMIT NO.
0 Z
Manufacturer-—
VJiiia;n lio:cruon ° rirsl
'drtid$}ion.,�'''�
Material
Liquid capacity in gallons
O
Well�Ji °z f�lil
No. �
Nearest lot line
PERMIT NO.
w [L
DISTANCE TO:
J. . .��'
J LL i
No, of lines
Length of eac �q"
pr
°Total'I'ej (71b p.%7ines
��'�
french width
Distance between lines
Z iu
6�
rE
inches
f-
Top of tile to finish
grade NWQjpjfl9Ff5eneath
the
Total effective absorption area
p
inches
Length
Width
Depth
PERMIT NO.
w
(7
Q F
Type of crib
Crib diameter
Crib depth
Total effective absorption area
a—
w(L
_
LU
ell
Building foundation
Nearest lot line
_1STANCETO:
a s
Depth
192
Drille
Distance to lot line
,
PERMIT NO.
r�\�;a��
��
6
DISTANCE TO:
Buildin foundation
Sewer line)
Norv�•
Septic tank
Absor �ti i areas)
OTHER
PIPE MATERIALS
SOIL TEST RATING
—
INSTALLER
-
REMARKS
4
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LEGAL
APPROVED DATE
���
no
GREA? ANCHORAGE AREA BOROF.AJd Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME G�r[c'i�e( �GL,� (f1 MAILING ADDRESS PHONE(
LOCATION LEGAL DESCRIPTION_��'%
17
SEPTIC TANK:
DISTANCE // r NUMBER OF
FROM WELL /� MANUFACTURER � aC'Glc /�'�/ MATERIAL 5 ���' i- —COMPARTMENTS _
INSIDE LENGTH INSIDE WIDTH - LIQUID DEPTH LIQUID CAPACITY lerV GALLONS.
SEEPAGE PIT:
NUMBER OF PITS L-. DIAMETER OR WIDTH LENGTH Op DEPTH
LINING MATERIAL (�6'11WUW CRIB SIZE: DIAMjE�TER__DEPTH DISTANCE FROM: WELL
TOTAL
TIVE
BUILDING FOUNDATION j�/ , NEAREST LOT LINE . ABSORPTION CA EA (WALL AREA) �� SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE �7/bhb� CONSTRUCTION ��<Gl[C l!!l DEPTH_ _DISTANCE FROM:
BUILDING / NEAREST NEAREST SEPTIC/ SEEPAGE /
FOUNDATION LOT LINE— SEWER LINE___, TANK—y% SYSTEM
CESSPOOL OTHER SOURCES _
APPROVED DISAPPROVED_ REMARKS_
DISTANCES:
INSTALLED BY: _
L4[��f� s[J4
PIPE MATERIAL:.
LOT SLOPE:
REMARKS:
Form No. EQ•031
DIAGRAM OF SYSTEM
G` 1 ij
t>
-1
C� f
J
11,
DAT
rAI.L
G.A.A.B.
GREATER ANCHORAGE ARCA BOROUGH
/ DEPARTMENT OF ENVIRONMENTAL. QUALITY PERMIT NO. _---
350o TUDOP ROAD POUCH R. 650
ANCHORAGE_ ALASKA 99502
Fc;jpHONE 279.0665
SEWAGE [DISPOSAL SYSTEM — APPLICATION AND PERMIT
NAME OF APPLICANT __C l2 t � �[�- .--- MAILING ADDRESS �I--�^�'-- PH/O/NE f • —
INSTALLATION LOCATION
LEGAL DESCRIPTION
F
INSTALLATION OF: SEPTIC TANK k__� SEEPAGE PIT_- —. DRAIN FIELD . OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED l
_ TO BE INSTALLED BY ('
A�1li/y�/1�
SOIL TEST RESULTS _ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL. TEST
/C/
'7/
COMPLETION DATE ANTICIPATED � /'�
�RMiT VAI 1� [INF VPA'l
FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE /"'� TYPESJPe-L--OX---f(=n Ci-a4GSEEPAGE AREA SIZE /'JXI -JX [�1 __ TYPE /f IF 6_66? '
MINIMUM DISTANCES, REQUIREMENTS
5 ft.
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT 20 ft. 0I9AIN FIELD 10 ft.
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK —5 t. SEEPAGE PIT 2/ ft,—. DRAIN FIELD 10 ft
TO NEAREST LOT LINE.
1 m 1
S i V�r _, SEEPAGE PCE � C)
WELL TO SEPTIC TANK '
DRAIN FIELD Z —. ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK f �--• SEEPAGE PIT 10 ft•
DRAIN FIELD 10 —ft'
SEPTIC TANK. _ 25 ft*, SEEPAGE PIT 10O fte , DRAIN FIELD 50 ft.
TO RIVER LAKE STREAM.
DIAGRAM OF SYSTEM
4" CAST IRON SIPHON
SEPi I PIPE WITH AIRTIGHT CRIB
)ACh CAPS
IN
CAST 11OL_.
f.----^
level .S I\ //I
CAST IRON
INTO
UIIDISTERBED SOIL
SII IIIkU:� IIINIHUH "
,vx
C I required whenever line crosses (CRIBS
under Jrive4q. TABLE)
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF "-------�"
EXCAVATION 4 FEET INTO UNDISTURBED SOIL.
I0 PIT- 100'
to SiCLR UGE- 10'
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
•..-PIIBL IC
FITTED WITH AIRTIGHT REMOVABLE CAPS.
10 TAS-- 110
in I'i T- 170'
110 y.E::Ee I.P11- An
0
GRAVEL BACKFILL 4'.ec' OIL['
CAS: lana SE;IfH
uE
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I_Ilnl IC
Tn ,A':e. 200'
�n
IT . 200'
-tan' OIAV
'1•'T Ilu st'.:EN
r. r.
In::. Al:�LITII nP
HEALTH AUTHORITY
OR
LICENSED DESIGNER
r, 111(11 s!. 8i 11 .I HL.
L0I;1INR dk V: WELLS.
SLEPACE Pit EXCAVATIOII BASED ON
SOIL TEST.
HOUSE
CAST If 011, l SEPTIC
I'I TO —` ,•:TAI!,I I.:
II
STUPCED
SOIL
a
0
%VEL RAGKf11.L ter•
nin CRIB.
' NININU11 ABOVE WATER'
•«DLL
Grade:V.per ICO'
or 1/4' p r fun'
except 10' Precw,ding
tank 8 tha. should I
not exceed2c.
6' per 100 on flat
terrains.
4 INCH
CAST IRON SIPHON PIPE
>5 -SEEPAGE PIT
CRIB
GRAVEL VACKFILL
10' HINIHUN
iCEAPEST LOT LINF
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I. j% h 1) ,/ ,v
1w_,. ,.� 01&/ iT 71 11 • � APPI Ir'ANT'S QMNATHRR X
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF "-------�"
EXCAVATION 4 FEET INTO UNDISTURBED SOIL.
I0 PIT- 100'
to SiCLR UGE- 10'
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
•..-PIIBL IC
FITTED WITH AIRTIGHT REMOVABLE CAPS.
10 TAS-- 110
in I'i T- 170'
110 y.E::Ee I.P11- An
0
GRAVEL BACKFILL 4'.ec' OIL['
CAS: lana SE;IfH
uE
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I_Ilnl IC
Tn ,A':e. 200'
�n
IT . 200'
-tan' OIAV
'1•'T Ilu st'.:EN
r. r.
In::. Al:�LITII nP
HEALTH AUTHORITY
OR
LICENSED DESIGNER
r, 111(11 s!. 8i 11 .I HL.
L0I;1INR dk V: WELLS.
SLEPACE Pit EXCAVATIOII BASED ON
SOIL TEST.
HOUSE
CAST If 011, l SEPTIC
I'I TO —` ,•:TAI!,I I.:
II
STUPCED
SOIL
a
0
%VEL RAGKf11.L ter•
nin CRIB.
' NININU11 ABOVE WATER'
•«DLL
Grade:V.per ICO'
or 1/4' p r fun'
except 10' Precw,ding
tank 8 tha. should I
not exceed2c.
6' per 100 on flat
terrains.
4 INCH
CAST IRON SIPHON PIPE
>5 -SEEPAGE PIT
CRIB
GRAVEL VACKFILL
10' HINIHUN
iCEAPEST LOT LINF
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I. j% h 1) ,/ ,v
1w_,. ,.� 01&/ iT 71 11 • � APPI Ir'ANT'S QMNATHRR X
r, 111(11 s!. 8i 11 .I HL.
L0I;1INR dk V: WELLS.
SLEPACE Pit EXCAVATIOII BASED ON
SOIL TEST.
HOUSE
CAST If 011, l SEPTIC
I'I TO —` ,•:TAI!,I I.:
II
STUPCED
SOIL
a
0
%VEL RAGKf11.L ter•
nin CRIB.
' NININU11 ABOVE WATER'
•«DLL
Grade:V.per ICO'
or 1/4' p r fun'
except 10' Precw,ding
tank 8 tha. should I
not exceed2c.
6' per 100 on flat
terrains.
4 INCH
CAST IRON SIPHON PIPE
>5 -SEEPAGE PIT
CRIB
GRAVEL VACKFILL
10' HINIHUN
iCEAPEST LOT LINF
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I. j% h 1) ,/ ,v
1w_,. ,.� 01&/ iT 71 11 • � APPI Ir'ANT'S QMNATHRR X
71
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street • Anchorage, Alaska 99501
/
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
SINGLE FAMILY
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.
1. PROPERTYOWNER —
PHONE
AIA;EA��
MGAD R S ¢q -zlAf,
/J / /11 !�
PROPER RESI ENT (If different from above) -�
PHONE
2. BUYE �—
PHONE
/�
MAN�ADDR �S N—aQ —
❑ PUBLIC UTILITY
3. LEM PING INSTITUTION
`+."14�.f��
S. SEWAGE DISPOSAL SYSTEM
PHONE
AILING ADDRESS
**If individual/on-site, give installation date
Tiy�,� ,o
�13i G9 C, A4 g,,a7�:�tf d / e0 A 0 ,!F K� A karaiLAY�5i_
4. REALTOR/AGENT Y PHONE
MAIL C ADORES/
Aa i1.o� er�fl,.9r�.rl e
DESCCRIPTION
5. LEGAL DESCRIPTION
STREE LOCATION
T
d&4-0
6. TYPE OF CE NUMBER OF BEDROOM
❑ One 2 Four ❑ Other
SINGLE FAMILY
Two ❑ Five
MULT LE FAMIL
❑ Three ❑- Six
7. WATER SUPPLY
*.ATTACH
�' DIVIDUAL*
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 UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
f�1 INDIVIDUAL/ON-SITE**
**If individual/on-site, give installation date
If system is over two (2) years old an adequacy est is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
r— �—
72-010 (Rev. 3/78)
THIS SIDE FOR OFFICIAL USE ONL
INSPECTION APPOINTMENTS
DATE RECEIVED - - -
_
TIME --
TIMF ---
TIME --
17ATE _
DATE :
DATE -
INSPECTOR — -
-
NSPECTOR
INSPECTOR _
- -
DIRECTIONS: -- — -
1. TYPE OF RESIDENCE
NUMBER OF BEDROOMS s -
[�IXSINGLE
❑ ONE
FAMILY
THREE ❑ FIVE` ❑ OTHER
❑ MULTIPLE FAMILY
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
PERMIT NUMBER
EV
—
--
DEPTH OF WELL
INDIVIDUAL
❑ COMMUNITY
—
❑ PUBLIC UTILITY
DATE DRILLED- -
Connection Verified
LOG RECEIVED - - —
3. SF�WAGE DISPOSAL. SYSTEM
PERMIT NUMBER "��----
C INDIVIDUAL/ON -SITE
DATE INSTALLED -- --
❑PUBLIC UTILITY
/ r
Connection Verified
INSTALLER ,( � J ^—
❑ El
Septic Tank or Holding Tank
Size:.11M If Tank is,1wm made
SOILS RATIN —
give—
l0
TYPE OF
TA K --
MANUFACT RER
TOTAL ABSORPTION AREA
MATERIAL_ �� —�—
4. DISTANCES - - Septic/Holding Tank Absorption Area Sewer Line arest Lot Line
Ne
WELL TO:
Absorption Area to nearest Lot Line-
s. COMMENTS
L'7 APPROVED FOR�BE�OM
EJ CONDITIONAL APPFTOVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE -- BY Iif ltle) - - `--- ---
L E�17
R I P ION —
,l
72-010 (Rev. 3/78)
INC- ;0;0 co H"0 Ill I 1IOX Eno] en, ill, nr e. nt I 1111 ,rq 51, Pt n11 2 7 1 r. ,in i n II x unn /s 16e
�_iv n�nic r -ns
oc usTs
i n.a romans
July 12, 1978 R&M No. 851550
Mr. Charles Schulz
Box 931
Eagle River, Alaska 99577
Re: Well Inspection, Water Sampling and Adequacy Test on Existing Sanitary
Sewer System, Lot 1, Schulz Subdivision, Eagle River, Alaska. For
Professional Services Rendered July 10, and 11, 1978.
Dear Mr. Schulz:
The following is our invoice for professional services rendered on the above
referenced project.
Professional Services
Fixed Fee
Invoice No.851550-1
Total Invoice No. 851550-1
$185.00
$185.00
Please note our invoice number on your remittance. Should you have any
questions concerning this invoice, please contact me or the Project Manager,
Mr. Gary Smith.
Thank you,
R&M CONSULTANTS, INC.
k. ( a
M. A. Matlock
Anchorage Office Manager
MAM/kah
I I,,_H 0H n13L II1110 1 N:cs J''I'ILiIU .. ;.1uL-i .,n_.II
Sys
iiI,N1 ,--[id-tII-i'l-.. f,i,.� II'.J c. >>z,- co�r_.,.. ,aL, ,. ,Millis a�n I c rli. ,-,l, an. 7a,
,, July 11, 1978 R&M No. 851550
Charles Schulz
P. 0. Box 931
Eagle River, Alaska 99577
Re: Adequacy Test on Existing Sanitary Sewer System; Lot 1, Schulz
Subdivision, Eagle River, Alaska.
Dear Mr. Schulz:
Per your request of July 7, 1978 we conducted a test of the sanitary
sewer system on the above described property.
The septic tank was pumped prior to the performance of the test on the
crib. During the test the liquid level in the crib was measured, before
and after the addition of 950 gallons of water. All liquid levels were
measured below the top of the standpipe and are summarized in the
following table.
Liquid Level Liquid Level Total Rise in
Before Water Added After Water Added Liquid Level
11.9' 10.0' 1.1'
The water rose 13.2 inches (1.1') with the addition of 950 gallons of
water indicating an acceptance rate of 72 gallons per inch in the crib.
Twenty-four hours later the liquid level was again measured and found to
be 12.4'. It had dropped below the original water level indicating that
all of the water had been accepted by the surrounding soils. The average
effluent acceptance rate for this lot is in excess of 950 gallons per
day. If the 4 -bedroom residence is to house 8 people the average load
on the system can be expected to be 600 gallons per day. We can there-
fore conclude that the system is disposing of effluent at an adequate
rate for a 4 -bedroom residence.
We appreciate this opportunity.
Very truly yours,
R&M CONSULTANTS, INC.
Lynne Kosikowski
Staff Geologist
LK/GS/kky
. �l,(-
Gary Smith
Project Manager
4t TntNOfA(` A
ES
1 I
°"irto unow" �.
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received Ei/24174 _
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Veteran's Administration
1. Approval requested by: >ud Schultz
Mailing Address: 930 Dowling Rd.
2. Property Owner: Bud Schultz
Mailing Address:
3. Legal Description: _ Lot i Schultz Subdivision
4. Location:
5. Type of facility to be inspected ! — No. of bedrooms
6. Well Data:
A. Type 1.)r111ed B. Depth _192'`
C. Construction Standard D. Bacterial Analysis
7. Sewage Disposal System:
A. Installed 1973 B Installer Charles Schultz
Greer t,1nk
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 12{2'0X',' _ 2. Material Co tic rFate______
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank 91' Absorption area 114 Sewer Lines ,
Nearest lot line Other contamination
B. Foundation to septic tank �, Absorption area _ 16
C. Absorption area to nearest lot line
Phone: 144-9712
Phone:
EQ -034 (1/74) Page 1 of two pages
Page 2 of two pages - Rc.,t ,, for Approval of Individual --v,,. & Water Facilities
Legal Description _ Lc�t 1 SCHl1LTS 1l f3flI1(LSIOPL-- ---
Comments
Approv
Disapproved
Date 44-117V
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
Fn -0n4 (Ina)
Date
,ncxagact t
4wM Pfd
hy' �
1 0
s
• GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 °C" Street, Anchorage, Alaska 99503 274-4561
Pn/PLO lAnully •
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by:
Mailing Address: Phone:�,�
2. Property Owner:i� Phone:
Mailing Address:
3. Legal Description:
4. Location:
5. Type of facility to be inspected No. of bedrooms
6. Well Data:
A. Types c�[�P--i B. Depth i iz
C. Construction D. Bacterial Analysis
7. Sewage Disposal System:
A. Installed �% j B. Installer1�/ a?G
C. Septic Tank: 1. Size 4 2. Manufacturer �1
D. Seepage Pit: 1. Absorption Area izx),y,_ 2. Material-yt�_r�✓
E. Disposal Field: Total length of lines
8. Distances:
i
A. Well to: Septic tank Absorption area _Zlx , Sewer Lines
Nearest lot line Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
Page 2 of two pages - Requ.._„ for Approval of Individual Sc . & Water Facilities
Legal Description
Comments
Lar E
Disapproved
Date i7/
/ 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
EO -034 (1/74)
Date