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Home My WebLink AboutLOMARU LT 4Lomaru Lot 4 #051-101-26 MUNICIPALITY OF ANCHORAGE \) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-0720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME/ PHONE ]NEW C/J I� JJ_ -�SJS UPGRADE MAILING ADDRESS �� O LEGAL DESCRIPTIOff �8 111QrCA, LOCATION /-1 / v� Cl �G Lt n2 NO. OF BEDROOMS [/— r DISTANCE TO: Well Absorption area Dwelling PERMIT NO. O .Y 1-2 Manufacturerv� t ?/ N /l J / �y ,, erial No. of compartments W< l' �,� 7411 Liu. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth be d DISTANCE TO: Well Dwelling PERMIT NO. t7 Manufacturer Material Liquid capacity pacify in gallons DISTANCE TO: I11p1la, i Foundation!� Nearest lot hn7 Av P HMI NO J W Z Z W t— - R No. of lines Length al acfyh Total a pf Ijnes T Tren width/ Q IrICheS Distance t n Inez o f Top of taep 4sh grade -h ate=i� ne�h file / ,PI..Cfi(OLX %Z inches Total effec ive absorption rea, 'u Length Width Depth PERMIT NO. / U Wn Type of crib Cr b tlitp.r�/ Crib depth Total effective absorption area a DISTANCE TO: Well Building foundation Nearest lot line W Cla vis Depth V Driller Distance to lot linePERMIT NO. W /? /✓a 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) OTHER PIPE MATERIALS L� SOIL TEST RATING INSTALLC/ REMAR S --w -f vf A L All, r yam. :� Il C • ... r No. 1437-E APPH ED DATE LEGAL S & S Engineerinn r cv, q/, nev. 41 10) MUtJ I CC I F'FFL I TY OF nrJCHOFZFiGE DEPARTMENT P� HEALTH AND ENVIRONMENTALfuATECTION 825 STREET, ANCHORAGE, AK. 9_ J1 264-4720 OtJ—SITE SEWEFZ UP(3FSFiE}E F=>EFRM I T PERMIT NO. < 800637 ) APPLICANT GERALD LIZER PO BOX 7 99577 694-9535 LOCATION GINA.CIRCLE LEGAL SLOT 4 LOMARU SID LOT SIZE 27000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRAINFIELD MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SO FT/BR)= 100 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DQEF"lFF4= 13 L.EFJGTH= 53 C3FcfA%0EFL C KF}TH= 1 THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THE TF;ZEFJCH tJ I E>TH I S S. 10CA0 FEET. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). FSEG!U I FSEE> SEF'T I CT I-FlV4K S I ZE= 1000 C3FILFLOt4S PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATIONINSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER. OF RESIDENCES THAT THE WELL WILL SERVE. --- TWO C 2 ] I tJSF"ECT I OMS FAF2E FZEGLU I FZEE> --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER. LINE IS 25 FEET AND TO A COMMUNITY SEWER. LINE IS 75 FEET. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. F>lZFRM I T EXP I FRES D>ECEMBEF2 31� I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I !JILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED APPLICANT GERALD LIZER ISSUED BY ------------------------------ DATE-iIQ_a11=01--- 1'4 S 0 AND WELLS AS SET ENLARGEMENT IF THE V4. 0 i mur•a I jC I F= FiL I T'T ID F=' Ar-dCH0F=:t=lGEF- DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIONNGj 825 'f�STPEET, ANCHORAGE, AK. 99'x. �0 IVB 264-3720 41EL_L Ffr•JCN rJtJ—CITE CEI.IEF? FyEF2M I T _ PERMIT 140. ( I ) p APPLICANT CIFeratcl 1,rg-4 LOCATION �slNa- Gircre, LEGAL [. J4 Loma r" TYPE OF SOIL ABSORPTION SYSTEM IS: Pb l3ax —7 C r•e e,_ LOT SIZEcZ-/aO SQUARE FEET MAXIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING (SQ FT/BR>= /CSO THE REQUIRED SIZE OF THE SOIL FBSOP.PTIOPI SYSTEM IS: /— r C>EFlTH= (o L_EFJGTH= (3 F=, t=, EL_ GEF= --r THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DP.AINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET. F?EGtU I REGI CEF•T I C TArJK C1 =- E_ f 0 Do GFiL_LO�rJC PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TWOS C 2> I r-JCF=•ECT I Or4S ARE F?EGeU I FREC-N BAr_KFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE I -JELL TO A PRIVATE SEWER. LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER. F.EQUIP.EMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS APE AVAILABLE TO INSURE PROPER INSTALLATION. F`EF�,M I T EXP I F:EC C�MCMMOeFZ ==1r 1c.g0 I CERTIFY THAT 1: I AM FAMILIAR.. WITH THE REQUIREMENTS FOR OP! -SITE SEI4ERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL - THE SYSTEM IPJ ACCOP.DANCE 141TH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE P.ESIDENC I5 REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. L SIGNED: AR LICANT ISSUED BY-- - '%ill - --DATE--- 0_1%5Y 24J ENLARGEMENT IF THE V4. 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION \ ' 825 L. StrNt, Amhon(p, Alaska 99501 2641720 — SOILS LOG - PERCOLATION TEST PERFORMEDFOR: LEGAL DESCRIPTION: /7/ DEPTH Tj•.� Sa L' 1 . 2- 3- 4- 7- 8. - 3-4• 8. . 9 10• 11 12 13 14 15 16 17 18 19 20 PERFORMED 72-008 (6/79) r (fo 66le-c- 12 't /D o p/r�,e WASGROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ASOILS LOG ❑ PERCOLATION TEST DATE PERFORMED✓✓ S L 0 P l� ( E PERCOLATION RATE— TEST RUN BETWEEN DATEI-C/� cR�a GRE/'�R ANCHORAGE AREA BOF'wlGH - Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME Q MAILING ADDRESS R4�i(et _(2i fl PHONE E78-22RI LOCATION (�21 CM P -V6 LEGAL DESCRIPTION LOT Li Locmu. 4 •U SEPTIC TANK: DISTANCENUMBER OF '1I C.oNUfFTE 1 FROM WELL 1�WA •+ MANUFACTURER u-A(� MATERIAL COMPARTMENTS MENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY 1000 GALLONS. SEEPAGE PIT: ��Q NUMBER OF PITS -. DIAMETER _4W OR WIDTH It LENGTH -W, DEPTH LINING MATERIAL aMr-1QCTV CRIB SIZE: DIAMETER _4�DEPTH k, DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) Zgg SQ. FT. ADDITIONAL ABSORPTION WELL: L0+-tR2u "Uj), 4 Uje" TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE , TANK SYSTEM CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM �11/K r s INSTALLED BY: 11'' r 4 JMJ,Rcz o -a PIPE MATERIAL: F-5(� -p� _� f i- CAST 1RpN fry S lL LOT SLOPE: Leve I. S�+ REMARKS: Sysremk, lam Vnue� � 41U^ URGL� AUS l bm1Jet2s S i DATE APPROVED Form No. EO -071 r^l GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99303 TELEPHONE 274.4S6I SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT '�"'�IIpS' �'MAILING ADDRESS[ �! / �'` •" PHON /0' `I�4f/ INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK L", SEEPAGE PIT I� DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED"'a FINANCED THROUGH TO BE INSTALLED BY—_I[Ld.Vi1 0 SOIL TEST RESULTS _rt -I"- NOTEI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED 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 ( cry"o TYPE SEEPAGE AREA SIZE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK J^, 'F^^I FOUNDATION TO SEEPAGE PIT (N DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL IC ' SEPTIC TANK SEEPAGE PIT ?'0 i . DRAIN FIELD TO NEAREST LOT LINE. IImm , 'VV WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD 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 S 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.S. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 36.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. c�Ate'-cl�DATE 3 ly APPLICANT'S SIGNATURE _ FORM NO. EG -016 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH 8 HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # �� — t)t- RLL 1. GENERAL INFORMATION Complete legal description Lot 4; Lcmaru Subdivision Location (site address or directions) 9741 a cina circle, rhugiak Alaska Property owner Norm SU ter Day phone 688-3654 Mailing address HC 80 Box 1310, Chugiak, Alaska 99567 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. nmslR«.INTI F, of MOA121 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone Address 17034 Eagle River Loop Road No. 20¢ Engineer's signature 6. DHHS SIGNATURE Approved for 2 Z3 bedrooms. Disapproved. Conditional approval for Additional Comments a Date 2 - S -92 Ile; .�� 6. S!J$�.•a e: 240 c; ROG HAFER No. 6 15 l - r- - bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and thei r lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. nms m.•. us,) exk MOA#21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:,zof OrNAfZJ �AD Parcel I.D. ga5�/— A. WELL DATA Well type A If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG Wires properly protected (Y/N) AT INSPECTION SEPARATION DISTANCES FROM WELL TO: _ o 200 %* On adjacent lots ?5m Septic/holding tank on lot 1 Z Absorption field on lot 'moo ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: B. SEPTIC/HOLDIN11 �/ �/4ATA Date Installed // Tank size 1002 GnArL— Compartments Cleanouts (�) Foundation cleanout (Y& a Depression (YO High water alarm (Y&3� a Alarm tested (Y/N) �fe Date of pumping q 9 Pumper 549- Ltlxi'-i Poo L� Collected by: Other bacteria SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: �.k Well(s)onlot Zvo t}' On adjacent lots alp Foundation Topropertyline 1,0 �J Absorption field S t+ Water main/service line 1p%+ Surface water/drainage \oo t 72026 (Rev. 751) Fml (` \` . .CONTINUED ON BACK PAGE jC7 ^' M CO g.p.m. g.P.nfl o P: :� t -n m O SEPARATION DISTANCES FROM WELL TO: _ o 200 %* On adjacent lots ?5m Septic/holding tank on lot 1 Z Absorption field on lot 'moo ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: B. SEPTIC/HOLDIN11 �/ �/4ATA Date Installed // Tank size 1002 GnArL— Compartments Cleanouts (�) Foundation cleanout (Y& a Depression (YO High water alarm (Y&3� a Alarm tested (Y/N) �fe Date of pumping q 9 Pumper 549- Ltlxi'-i Poo L� Collected by: Other bacteria SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: �.k Well(s)onlot Zvo t}' On adjacent lots alp Foundation Topropertyline 1,0 �J Absorption field S t+ Water main/service line 1p%+ Surface water/drainage \oo t 72026 (Rev. 751) Fml (` \` . .CONTINUED ON BACK PAGE C. LIFT STATION Date Installed _ I Size In gallons Vent(Y/N) High water alarm level Meets MOA electrical on lot "Pump on" level at Manufacturer Manhole/Access (Y/N) Cycles tested _ E FROM LIFT STATION TO: D. ABSORPTION FIELD DATA On adjacent lots off" level at Surface water — Date Installed 1f1 F20 Soil rating loth 12vtz- System type P.1,JFI9-t o th Len `5 1 t 9 Width S Gravel thickness --A2--Total depth Ld Total absorption area Cleanouts presentON) `� Depression over field (YA116[) t -A Date of adequacy test Resultsfail) PkcS for 'rr�tZF.�-�3� `� bedrooms Peroxide treatment (past 12 months) (Ya tiD.IE If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 'Zoo 1+- On adjacent lots Property line— 1 a 1 To building foundation Is } To existing or abandoned system on lot 42-c> On adjacent lots `; ) Cutbank #- 6Water main/service tine 101 Surface water - 1 on 1' Driveway, parking/vehicle storage area So 1 Curtain drain- psItr E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. r S 8 S ENGINEERING r , Signature 17024 Eagle River Loop Rad No 2014 Eagle River, Alaska 99577 Engineer's Name Date 2 HAA Fee $ 70 / Waiver Fee: $ Date of Payment --' Date of Payment Receipt Number Z Z C 6 z9 Receipt Number 72-026 (A". 3/91) B.G MOA 21 ICG R SHr.FER- DEPT. OF ENVIRONMENTAL, CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99503 FOR: S & S Engineering February 4, 1992 PWSID # 213467 WALTER J. H/CKEL, GOVERNOR (907)349-7755 My review of the records on file in this office reveals that the Lomaru Subdivision Class `A" Public Water System, is in compliance with the routine coliform bacteria sampling requirements listed in Table C, and with the inorganic sampling requirements listed in Table B of 18 AAC 80.200. Sincerely, Byron Roys Environmental Engineer BR/cf 9 :3� OF ANCHORAGE MUNICIPALITY OF ANCHORAGE MUNICIPALITY _ - DEPARTMENT OF HEALTH 6 ENVIRONMENTAL PROTECTION DEPT. OF H-ALTH & ENVIRONMENTAL PCOTECTION 626 L Street. Androraw, Alaska 99507 ENVIRONMENTAL ENGINEERING DIVISION OCT 17 1930 Telephone 264-4720 NUMBER OF BEDROOMS RR FF (('' FF II1/ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FRtltrTfE$ E D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proceresd. live allow ten (101 drys for procuring, 1. PROPERTYGWNER ❑ Two ❑ Five V PHONE Gerald and Donna Lizer 7. WATER SUPPLY 688-2469 MAILING ADDRESS 'ATTACH WELL LOG. A well log is required for all wells drilled P.O. Box 709 Eagle River, Ak. 99577 since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT (If different from above) depth (attach log if available.) HONE 2. BUYER 9 INDIVIDUAL/ON-SITE" "If individual/on-site, give installation date Norman Sutter If system is over two (2) years old an adequacy test is required PHONE Work 752-5568 MAILING ADDRESS NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATED. 3. LENDING INSTITUTION PHONE 5100 MAILING ADDRESS — 4. REALTOR/AGENT PHONE MAILING ADDRESS S. LEGAL DESCRIPTION Lot 4 Lomaru Sub. STREET LOCATION Gina Circle Chugiak, Ak B. TYPE OF RESIDENCE NUMBER OF BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ MULTIPLE FAMILY ❑ Two ❑ Five V Three ❑ Six 7. WATER SUPPLY ft ❑ INDIVIDUAL' 'ATTACH WELL LOG. A well log is required for all wells drilled 14 COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM 9 INDIVIDUAL/ON-SITE" "If individual/on-site, give installation date ❑ PUBLIC UTILITY If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATED. nntnl�nset t�� / lJ a rn THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED ' TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY 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 C3 Septic Tank or ❑ Holding Tank Size: 1000 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL t 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area bem,Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [] � APPROVED FOR �_ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 3 BY Title LEGAL DESCRIPTION 72010 (Rev. 3/78) DAVID A.SLENKAMP ROBERT A.SHAFER �Y MECHANICAL ENGINEER CIVIL ENGINEER A �" � � 694.9055 6947979 October 29, 3.980 Greatland Realty ATTEITTInN:.Toyce _ _. _ P.O. Roz 633 Eaelo River, Alaska 99577 Doar Joyce., Reference: Dr. Gerald Lyzer property; Lot 4; Lomnru Subdivision A'sever.system adequacy test was performed on the referenced property per your request. The septic tnnk was pumped and verified to have a capncity of 1000 grllons. The scopnge f' pit was charged with water until the water bognn to run back into the septic tank. The water level was menrured at the end of 'a 24 hour period and it was determined that approximately 214 gallons of water had percolated from the crib. It can be concluded from this test that the septic tank is adequate, however, I regret to inform you that the seepage pit will require upgrading to provide for three E` bedrooms. A permit for the npgr ding work can ba o'.*a ined from�the Phtniclpality of Anchorage, Department of Health and Enviornmental Protection, 825 L. Street, Anchorage. If we may be of further assistance, please do not hesitate to call. E. cc: yunicipality of Anchorage Department of He31th and Enviornmontal Protection Alaska U.S.A. Federal Credit Union ATTENTION: Diane Gibson SRO 196X EAGLE RIVER, ALASKA _. .. ..... _. ....v... - n. 1 ' • .— ., , GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 2. 3. 4. 5. 6. I ' ,[ /G� ,/ Date Received June 11, 1976 Time of Inspection 9;An,om Date of Inspection /.-AJ06rnUv REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES ' FOR V.A. Approval requested by: Alaska Statebanx XAJ kTI Mailing Address: 310 East Northern Lights Blvd. Phone: 279-7637 / 3� Property Owner: Dorian Heiser Phone: 688-3151 Mailing Address: Post Office Box 431, Chugiak Alaska 99567 Legal Description: Lot 4 Lomaru Subdivision Location: Gina Circle, off Glen Highway Type of facility to be inspected Single Family No. of bedrooms 4 Well Data: A. Type C. Construction 7. Sewage Disposal System A. Installed C. Septic Tank: 1. Size B. Depth D. Bacterial Analysis On-site system B. Installer D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: 2. Manufacturer 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 EQ -034 (1/74) Page 1 of two pages 1. Type of Inspection: r�) n MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274.4561 MUNICIPALITY CF ANCHCRAGE DEPT. OF HTALTH a ENVJn31 ;;,;ENTAL rnCTECTICN ". "I 1 1 1976 REQUEST FOR APPROVAL OF RKEJ VEO INDIVIDUAL SEWER and WATER FACILITIES CMRO VA XK= XX FHA CONV _ 2. Property Owner: Dorian Keise Mailing Address: P.O. Box 431 Chuciak.-A/laska /Day Phone 688-1151 3. Name of BuyeygA Gerald W1 Lizer l.t�tNbnr L Mailing AddressP ^ Box 709 Earle River Day Phone 6fl-eJ20 4. Name of Lending Institution: Mailing Address: 11n F_ Northern Lights Blvd. dhT1iT 979- &'V__ 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: + t, A rjr4rcl. * <0 Location: Chugiak off old Seward Hwy Phone 7. Type of Facility to be inspected: R-1 House No. Bdrms. 4 8. Water Supply Comm. Water Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation EQ -e37 (1/74) Individual Individual (on-site) xXXXXCX Page 2 of two pages - Re '1-,t for Approval of Individual �r & Water Facilities Legal Description Lot 4 Lomaru Subdivision Comments Approved isapproved Date Approval;Yalid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 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 r n GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received `- 10/21/74 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR M 10/21/74 1. Approval requested by: Tom Mc Cormack Mailing Address: Box 661 Eagle River Phone: 688-2281 2. Property Owner: Same Phone: Mailing Address: 3. Legal Description: Lot 4, Lomaru Subdivision 4. Location: Peters Creek 5. Type of facility to be inspected Single No. of bedrooms o2 6. Well Data: A. Type Community B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: A. Installed 1974 B. Installer Wallace C. Septic Tank: 1. Size /S^-0 QaL 2. Manufacturer Wallace D. Seepage Pit: 1. Absorption Area 121xl2'x6' 2. Material Concrete 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 9' Absorption area C. Absorption area to nearest lot line 50' EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Re'�t for Approval of Individual & Water Facilities i:egal Description Comments Lot 4, Lomaru subdivision f S. Disapproved Date 10/21/74 Approval.,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM r-- - ....moi to ka a trt1P an I certify that the lntormaLion cunudiimu ut w1va--- accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. Date SIGNED EQ -034 (1/74)