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GREA-r rR ANCHORAGE AREA BM_�,'GH
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�6 Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
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INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME i� i P �Q sic /L MAILING ADDRESS
011 .h� PHONE
LOCATION V LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE NUMBER OF
FROM WELL MANUFACTURER MATERIAL {ems, COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY -Qy GALLONS.
TILE DRAIN FIELD 'A"t_v� -
TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE p OF LINES
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH o IN. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER r
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE IN. ABOVE TILE
WELL:
TYPE_ CONSTRUCTION DEPTH
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE , SEWER LINE , TANK , SYSTEM
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY: -t1✓
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE: tr.X
REMARKS:
Form EQ -032
DIAGRAM OF SYSTEM
DATE Z3.'APPROVED._ :
G.A.A.B.
10
DISTANCE FROM:
r_41
r-.
:ave � � II'II14A\//\`]\•s
Y�
e f
• �4aro ,awe ap �
NAME OF APPLICANTO
INSTALLATION LOCATION
GREATER ANCHORAGE �ffEE BOROUGHop
7
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT No. /693/
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
v 4 , 7)
MAILING ADDRESS
LEGAL DESCRIPTION%-
INSTALLATION OF: -SEPTIC` TANK
SEEPAGE PIT_
TYPE AND SIZE OF FACILITY TO BE SERVED
PHONE
DRAIN FIELD OTHER ✓/c'Z %yC
FINANCED THROUGH { TO BE INSTALLED BY
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED NOTE., THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
_�, '�
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 SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL —_
DRAIN FIELD
SEEPAGE AREA SIZE
SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANKL�1 I
SEEPAGE PIT — /erL'
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
SEPTIC TANK, SEEPAGE PIT
DRAIN FIELD
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.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A .B.
OR
LICENSED DESIGNER
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE
APPLICANT'S SIGNATURE��f
FORM NO. EQ -016
TYPE
DIAGRAM OF SYSTEM
GREAT�--K'ANCHORAGE AREA BOROu-vil
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME MAILING ADDRESS �J �P�HJONEC% 6 & a lcO
LOCATION LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE NUMBER -OF
FROM WELL MANUFACTURER MATERIAL �, COMPARTMENTS�
i
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY �a / GALLONS.
SEEPAGE PIT: iiQQ ll
NUMBER OF PITS �. DIAMETER OR WIDTH L, O, C
LENGTH DEPTH
_ -
L
LINING MATERIALCRIB SIZE: DIAMETER.. 6 DEPTH DISTANCE FROM: WELL,
BUILDING FOUNDATION ' NEAREST LOT LINE �V' 'S- / TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) t,� � SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPECONSTRUCTION
BUILDING NEAREST
FOUNDATION -.LOT LINE
CESSPOOL OTHERSOURCES
APPROVED DISAPPROVED
DISTANCES:
DEPTH
NEAREST SEPTIC
SEWER LINE TANK _
REMAR
INSTALLED BY:
" I
by
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. EQ -031
DIAGRAM OF SYSTEM
DISTANCE FROM:
SEEPAGE
SYSTEM _
DATE t�S ). r A. Tra
G.A.A.B.
p 1 V
1
,PREATER ANCHORAGE AREA BOROUGH
\bl I Gil DEPARTMENT OF ENVIRONMENTAL QUALITY
? I IIIf �J I 3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
�Oj*uro uw°•
SEWAGE DISPOSAL SYSTEM - APPLICATION AND
NAME OF APPLICANT 1�4 kI
INSTALLATION LOCATION Vjf
_c%.
LEGAL DESCRIPTION . Lei -e '
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
MAILING ADDRESS
SEEPAGE PIT
i0 BE INSTALLED
PERMIT NO.
3:
RMITR
"
PHONE
DRAIN FIELD OTHER
{r` BY
SOIL TEST RESULTS _�L'�_�`� li�.lc
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTIClIPATED I
FINAL INSPECTION. 24 HOUR NOTICE REQU RI ED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE L. fJ TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK S /
FOUNDATION TO SEEPAGE PIT 1_6
DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
I
SEEPAGE AREA SIZE
/1r
SEPTIC TANK SEEPAGE PIT N DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK �!� / SEEPAGE PIT 1-2-c; /
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
SEPTIC TANK, SEEPAGE PIT
DRAIN FIELD
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.
GRAVEL BACKFILL
CONFORM TO BOROUGH,_REGULATIONS REGARDING INSTALLATION.
G.A.A,B.
OR
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM '
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA 130ROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBE SYSTEM IS IN �ACCORDANCE WITH SAID CODE. z /2 01�7S_
DATE ' APPLICANT'S SIGNATURE
FORM N07EQ-016
LOG OF TEST BORING
C' Hole No.
uumpleted R&M CONSULTANTS, INC. sheet of
Rig TotoI Depth
ANCHORAGE —FAIRBANKS—JUNEAU -
Project No, ALASKA
Project Name
i Location Ground Water Table
Method Used Depth in Ft.
Field Party Geologist Time
Weather Date
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Sampling
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DESCRIPTION
Soi I type, color, texture,
estimated particle size,
„ sampler driving notes,
depths circulation iost,
v notes on drilling ease
bits used, etc.
Location Notes 8 Diagram! a®�
Traffic.
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°<°nm
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2E 0 OF
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2
3
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5
6--
7--
8
9
2
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4 --
5 --
456
6 --
8
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FF7
441
—
441
441
;
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4
or
—
Unless otherwise noted all samples are taken w/14'ID Standard Penetration Sampler driven w/1401b. hammer. 30"drop.
04272
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 E. TUDOR RD., ANCHORAGE, AK 99507
276-2221
L4 IE L_ L_ F=' 1= F;," rl I -F
PERMIT NO. ( 76:156 )
APPLICANT BOB FITZPATRICK 7111 CHAPEL DR 688-9125
LOCATION CHAPEL DRIVE
LEGAL f.LIS SMITH TERRACE SUED; LOT SIZE 8800 SQUARE FEET
MINIMUM DISTANCE BETWEEN 8 WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
lQa-.FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED�O THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION.
Fes'F= � M I 7r %-w F4 L_ I E> 1= C3 FZ 01"E V E" Fz,: F= F� r_') M I f; !E; U I=—
I CERTIFY THAT
1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED: ----- ----
APPLICANT -Z PATRICK
ISSUED 81
2
111t4f) exlt^_61
121
MINIMUM DISTANCE BETWEEN H WELL HND HNY ON—SITE SEWIHGE DISPOSAL SYSTE11 IS
100 FEE'[' FOR H PRIYHTE NELL OR 200 FEET FOR H PUBLIC WELL
WELL LOGS IR
REQUIRED AND MUST BE RETURNED TO THE DEPHRT�E�JT WlTHIN �0 DHYS
OF THE WELL C8MPLETION.
��
SPECIFICAT ION- HND Of. NSTRUCTION DI8GRHMS ARE HVH
INSTHLLHTION. ILHBLE TO INSURE PROPER
�� 'r-0���� ������ ������
I CERTIFY THAT
1: I HM FHMILIHR WITH THE REQ8IRE1,1ENTS FOR ON ---SITE 5ENERS FIJI) WELLS HS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2� I WILL INSTALL THE -1 Fil -:CIf 'IFINCE WITH THE CODES.It
SI8NED� 4,
ISSUED BY~
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ENYIRONMEMT[1L ). TECTIQN
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2510 E.
lUDQR RD. HNCHORHGE/
HK.
276�2221
�z�������~�
PERMIT
NO. r,.' 76�7� )
HPPLICANT
P. 0.
BOX 1091 -^ HNCHORA@E 9951 688�9125
LOCHTI8N
p
LEEG HL
L17 SMITH TERRHCE
SUBDIVISION
LOT SIZE 17000 SQUARE FEET
MINIMUM DISTANCE BETWEEN H WELL HND HNY ON—SITE SEWIHGE DISPOSAL SYSTE11 IS
100 FEE'[' FOR H PRIYHTE NELL OR 200 FEET FOR H PUBLIC WELL
WELL LOGS IR
REQUIRED AND MUST BE RETURNED TO THE DEPHRT�E�JT WlTHIN �0 DHYS
OF THE WELL C8MPLETION.
��
SPECIFICAT ION- HND Of. NSTRUCTION DI8GRHMS ARE HVH
INSTHLLHTION. ILHBLE TO INSURE PROPER
�� 'r-0���� ������ ������
I CERTIFY THAT
1: I HM FHMILIHR WITH THE REQ8IRE1,1ENTS FOR ON ---SITE 5ENERS FIJI) WELLS HS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2� I WILL INSTALL THE -1 Fil -:CIf 'IFINCE WITH THE CODES.It
SI8NED� 4,
ISSUED BY~
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DEPT. OF ENVIRONMENTAL CONSERVATION
SOUTHCENTRAL REGIONAL OFf/CE
JAYS HAMMOND, GOVERNOR
338 BENALI STREET
Mad(AY BU/LO/NG, ROOM 1108
ANCHORAGE9950I
April 27, 1976
MUNICIPALITYDEPT. OF OF ANCHORAGE
ENWRoHBALN R
i TAL PROTECTION
APR 30
Department of Health & Environmental Protection
Anchorage Municipality
2510 E. Tudor Road
Anchorage, AK 99507
Subject: Lot 17, Smith Terrace S/D, Peter Creek
(Bob Fitzpatrick)
Gentlemen:
This office has no objection to the distances given
in the "Sewage Disposal System - Application and
Permit" date May 12, 1975 and signed by John Lee.
sv
CC: Bob Fitzpatrick
Sincerely,
RECEIVED
--;;� W ca"--�Ae
Kyl J. Cherry, P.E.
Regional Environmental Supervisor
y
b y`
Ourm 290
4&
3
post Office San 1001
ftcharagag. ffaas
sulbJeats Well da x-
molal 11cri-;x e Lot 17 ismfthTO-traca- 4 vo
Olur moorda aw'sltwat Vnis dopartatat Uas not raaoived
a voll off:a ktJeo - ° -party,
w. b-UAr ( s�) datya afar ft-ril"'ling,sk co ,plet4ou,
The �''�i.€+A. aaiwwt _3da on`a2rd Ysi�.+.r 0,�=ralv3n by t21.4b "'pgr�° ...
mut wAtil the, groll 104- la raCOrved.
woule. v$ plea la ioznd off:=vi carry a cop of tha wl 1
' tO the a t. aalt of fmalth aud Protaotion,
Sower • Water flactitmg, i ,.: , d, ayour file$
arcs Close Out vo,-,=
if y0a havo arW K UawU , �r YW4 have not as yep.,1110
you wall ploaso Call us at, 2U-22210 . ens" res 243 or
9a�apncxo¢eot p�g _.
10
Eagle River Area
t y.
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
1.tTUr4Y �� /� �f
3330 "C" Street, Anchorage, Alaska 99503 274-4561
v �v `fqy��/�/
i
Date Received November 10, 1976
Time of Inspection ll: syn
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.�
1. Approval requested by: Peoples Bank & Trust % Lvnn Manley
Mailing Address: Pouch 7-007 99510 Phone: 279-7511
2. Property Owner: _ Robert Fitzpatrick Phone:
Mailing Address: % Jo Davis, Executive Realty, 276-7777
3. Legal Description: Lot 17 and 18 Smith Terrace
4 Location: Triplex behind Peter's Creek Chapel, Mile 21.5
5.1 Type of facility to be inspected Triplex No. of bedrooms 5
6. Well Data: TvT '1
A. Type B. Depth / I
C. Construction D. Bacterial Analysis Q{ -
7. Sewage Disposal System: On—site system
A. Installed
B. Installer
C. Septic Tank: 1. Size /,, 3 e 2. Manufacturer
D. Seepage Pit: 1. Absorption Area/ /ogw sem, !
r 2. Material
E. Disposal Field: Total length of lines -
8. Distances:
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
EQ -034 (1/74) Page 1 of two pages
.Page '2 of two pages - Retest for Approval of Individual mer & Water Facilities
_.legcQ Description Lot 17 and 18 Smith Terrace
•y ,
Comments
Appro
ApprovW.,,Valid for one yVar from date signed v
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
A)txqj
=- i
I 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
EQ -034 (1/74)
Date
d
Gcl
11
A)txqj
=- i
I 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
EQ -034 (1/74)
Date
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO VA FHA CONV
2. Property Owner:
Mailing Address: Day Phone:
3. Name of Buyer:
Mailing Address: Day Phone
4. Name of Lending I
Mailing Addre
Name of Realtor or
Mailing Address: /6 �' �� �L v Phone:, -2- 7(-)' - 27
6. Legal Descripti
Location:
Uuy_6_x
7
E
�
Type of Facility to be Inspected: i
No. Bdrms. —
Water Supply
Type of Supply: Public Utility Individual
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility Individual (on-site)
If Individual, date of installation _/ 26
72-003(3/76)
SS