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Home My WebLink AboutLOMARU LT 5Lomaru Lot 5 #051-101-25 GRE.(��ER ANCHORAGE AREA BorUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME,+ado.-MAILING ADDRESS PHONE / LOCATION LEGAL DESCRIPTIONZe/n L O kv ' SEPTIC TANK: DISTANCE ClA�.�iuyr� FROM WELL /0.4re� MANUFACTURER NUMBER OF MATERIAL �'��'- COMPARTMENTS INSIDE LENGTH INSIDE WIDTH — LIQUID DEPTH — I [QUID CAPACITY Z91L GALLONS. SEEPAGE PIT: NUMBER OF PITS /. DIAMETER OR WIDTH!�. LENGTHsi:, DEPTH �2 ''�� LINING MATER AL 41cc"'ys�c.c_ CRIB SIZE: DIAMETER ✓�� DEPTHd" DISTANCE FROM: ' ..e� TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION WELL: e !a>w n7 Gl G✓c..T—i TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LINE , OTHER SOURCES APPROVED DISAPPROVED DISTANCES:R�"ed':e93 :.Q Ta c =�? , , DEPTH NEAREST SEPTIC SEWER LINE , TANK _ REMARKS INSTALLED BY: / PIPE MATERIAL: u N LOT SLOPE: REMARKS: Form No. EO -031 DIAGRAM OF SYSTEM Qom.�.�s��..��c,}f WELL1�. FT. DISTANCE FROM: SEEPAGE DATE APPROVED 6 WAL t A(, C= UPT s"" �arU Russell Oyster 694.2774 Civil Engineering 0 & E E/'I NEERI NG & DEVELO^'4ENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694.2774 or 3335240 Earl Ellis 333-5240 Surveying Soils & Foundations Land Development Ferformed For 0 NU6\o\4 P K �q'�•�� \� tF r��'�S \��CLOKK��K Legal Description; Lot Block Groundwater incountor�d; Yes ✓ No _ Depth Soil Classification feet 0---- Cn� 1---' C\-4P%a G2gVf\� 2---- 3---- Scn 4---- 7---- 8----ti-- 10--- - 11 12--- 13--- Subdivision Depth %('� •h,t Area Calculations -Z-X��v 14--- Comments:St :4C --T ♦ t Sr �4c7�L�m ca-�S000K.oa Q.—'fc� �tou,Rrmf•�'s Test Performed By: Date - Conittuction geaE -fag � "One test is worth a thousand opinions" 9919 TUDOR ROAD. ANCHORAGE. ALASKA 99007 • TEIE•"owe 311.8471 Performed For. Bowles -McCormack Date Performed 4-13-73 Lenal Description: Lot 5 clock. Subdivision Lomaru - Chugiak This Form Renorts Soils Lon Y09 Percolation Test Tenth Feet Soil Characteristics Gravely Silty Overburden 2 �.,1 - A b1 Redish Brown Sandy Gravel -GW ` I i -;-I I E ' 7�e Brown Sandy Gravel with cobbles & boulders mixed thruout- moist n (GW -85 r Bottom of test Pit @ 12 ft. Wis Eround Water Encountered? NO If Yes, At what Denth? T i— Readinq Date Grnss Time Net Time Depth to H2O Net Dron' Percolation Ratp Hinutt+ Proposed Insta ation: Seenaae Pit Ye9 Drain Field Deoth of Inlet Dent T�ottom Of Pit Or rent @AMNENTS: 85 sq. 17t. cLrainage area required per bedroom No bedrock or water table 4 ft. below intended seepage pit " t Performed By James D. Mack Data Certified By: Construction.Teals Lab manager Date: 4-13-73 I • I i T i— Readinq Date Grnss Time Net Time Depth to H2O Net Dron' Percolation Ratp Hinutt+ Proposed Insta ation: Seenaae Pit Ye9 Drain Field Deoth of Inlet Dent T�ottom Of Pit Or rent @AMNENTS: 85 sq. 17t. cLrainage area required per bedroom No bedrock or water table 4 ft. below intended seepage pit " t Performed By James D. Mack Data Certified By: Construction.Teals Lab manager Date: 4-13-73 MUNICIPALITY OF ANCHORAGE Alk • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section go P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 051-101-25 1. GENERAL INFORMATION HAA # RA950426 Complete legal description Lot 5 Lomaru Subdivision Location (site address or directions) NHN Gina Circle Property owner Marie Ericson Day phone 688-2231 Mailing address PO Box 670027, Chugiak, Alaska 99567 Lending agency National Bank of Alaska Day phone 276-1132 % Ruth La Bar Mailing address PO Box 195127, Anchorage, Alaska 99519 6127 Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: three (3) 3. TYPE OF WATER SUPPLY: Individual well Community well Public water XXXXX NOTE: If community well system, provide written confirmation frorr_State AD_ECtattest v Ing to the legality and status of system. 1-j 4. TYPE OF WASTEWATER DISPOSAL Individual on-site xxxxx E( t',��C Holding tank Community on-site Public sewer NOTE: It community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (R«. 1/91) rmnl MOA /21 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 furtherverifythat 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 Eagle River Engineering Services phone 694-5195 Address PO Box 773294 Eagle River, Alaska 99577 - Engineer's signature This is a replacement to correct an error on any questions, please Date of the original Health Authority Approval the water system type. If there are call our office at 343-4744. 6. DHHS SIGNATURE xxx Approved for three(3) bedrooms. Disapproved. Conditional approval for Additional Comments , 1 By: bedrooms, with the following stipulations: Date November 28, 1995 CAUTION 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 their 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 engineers work. aaa (a... +Ao SKk rwA m MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & 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. # 051-101-25 HAA q F��i S DSI Gdt n GENERAL INFORMATION Complete legal description Lcmaru Lot 5 Location (site address or directions) Property owner MIN Gina Circle, Chugiak Marie Ericson Day phone 688-2231 Mailing address P.O. Box 670027, Chugiak, AK 99567 Lending agency N13AIR11th Le au Day phone 276-1132 Mailing address R n BO 19rIT7.-hnchnra9n "x 99519-6177 Agent 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 Day phone a� '-4 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 X 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. r2-02511".1199 from MOAR21 (L.YOW 4�8 (lNl'"U)SMU VOM s Jaaul6ua leuolssalad eyl ul suoisslwo jo siona jo; alglsuodsai lou sl e6eioyouV;o Atlledlolunlry e41 •panssl slaleopllJao a aioleq etep az(leue jo suol;oadsul )onpuoo lou op SHHo to saa(oldw3 •sluawailnbai alels pue lejapal ulepao Nslles of iaplo ul suolin3Nsul 6ulpual rayl pue sawoy to siaseyoind of Asolinoo ase sly; saop SHHo ey1 •u%selV to ele1S eyl ul paialsl6ei jaaul6ua leuolssaloid luapuadapul ue Aq anoge S ydei6eied ul uanl6 suolleluosaidai eyl uodn (luo paseq saleo!Nliao IenaddV A1!io41nV ylleaH sanss! (SHHo) saolniaS uewnH pue ylleaH to luawlieda(3 G6e1043uV to Al!ledlolunVq syl f/� P oleo :) �� , :Ag :suollelndlls 6ulmollo; eyl y)Im 'swoojpaq 0 31Oyj �� T -s--e - r --y Oleo sluawwoo Ieuo!1!PPV 10; lenadde Iellolllpuo•C) •panaddeslo •swoapaq £ Jo; panaddV 3HfLLVNJIS SHHo ain)eu6ls s Jaaulbu3 d ssalppV 96TS-669 euoyd saatnzaS 6uTaaauc6u3 .TanTH aT6e3 wJIj;o eweN •uolloadsul S14) 10 elep eyl uo loal;a uI suol)eln6ai pue'saoueulpio 'sapoo e)elg pue ledlolunlry He yllm eouelldwoo uI sI walsAs lesodslp jalemalsem jo/pue Rlddns Salem a)Is-uo ey) 'uoI)oadsul pue uolle6ijsanul ,tw wa; pus sail; e6ejoyouy;o A)Iledlolunytl ay) woal paule)go uollswjo;ul eyl uo paseq )eyl Aj!JanjayUn; l •ulajay paleolpul einlonils;o edit; pue swoojpaq to jagwnu ayl jo; elenbape pue leuolloun;'a;es sI wa)sAs lesodslp ja)emalsem jo/pue AIddns Salem ells-uo ey; lsy) smogs uoI)eolldde lenaddV Al!joylnV ylleaH sM )o uolle61)sanul Aw leyl ApJan I 'molaq umoys e)ep uo!lep!lsn GLI) 10 se pue o)alay paxllle leas Aw Aq pallpiao sy '9 H33NION3 A8 N01103dSNl d0 1N3W31V1S 'S Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division i 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 3434744 Health Authority Approval Checklist Legal Description: 1:01y17r ty GOT 1j Parcel I.D.: OS/—/D/ —ZS A. WELL DATA Well type is If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y!N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMP'. of sample: Date completed Cased to FROM WELL LOG Casing hc�(above ground) / 9— p.m-TS: Nitrate Collected by: B. SEPTICftHH; iP1G TANK DATA mwi Po 9 rly protected (Y/N) 1*7 C' AT INSPECTION = N � a g.p.m.. Other bacteria Date installed 19- Tank size /715 t9 Number of Compartments _L Cleanouts (Y/N) i/ES Foundation cleanout (Y/N) yC5 Depression (Y/N) IVO 11igh water alarm (YIN)IV A 6;atcofPumping.091/ 9S Pumper V-P— C. ABSORPTION FIELD DATA Date installed 19,73 Soil rating (g.p.d./ft2 or ft'/bdrm) 8 Ole2 System type P/T Length 13' Width ' /3 / Gravel thickness below pipe 6' 7YP Total depth 17-" Effective absorption area Monitoring Tube prcsent(Y"—k5 Depression over field (YRS /5 Date of adequacy test 9 Z / 95'- Results (Pass/Fail) oA55 For .3 bedrooms Fluid depth in absorption field before test (in.): nImmediately after5?" gal. water added (in.): 64. S fluid depth Eo Minutes later: 57 (in.) Absorption rate - t z/so ¢.p.d. Peroxide treatment (past 12 months) (Y/N) NIS If yes, give date 141A D. LIFT STATION / V�✓a Date installed Sizc m Manholc/Acccss (YIN) on" Icvcl at+ Pump oft" level at* High water alarm level at* *Datum C�EPARATION E. DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: N14 Scpticlholding tank on lot NSR ; On adjacent lots N/A Absorption field on lot A114 ; On adjacent lots Nlh Public sewer main Public sewer manhole/cleanout IV14 Seeder /septic service line /V//7 Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HCtMG TANK ON LOT TO: Foundation /61 Property line >-/0 / Absorption field Z3 ,Z, /w ,i Water maintservice line Y A9 Surface water/drainage >'/00 ' Wells on adjacent lots 'Q, 0 "��"' 0 ^ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation /S Water main/scrvicc line 00 74-/D Surface water t'/00 Driveway, parking/vchicle storage arca f /0 I f ZOD '5 Curtain drain Nip Wells on adjacent lots �" rfn� F. ENGINEER'S CERTIFICATION Oc A %d I certify that l have determined thru field inspections and review ofAfunicipal ry+t lboer<fe.67- ems are In conformance with AfOA HAA guidelines in effect on this date. W � �T ow • g9 Signature—',, �� / *:•' Engineer's Name t-OUIS RtrfErz 14 PE ' ... Lou:f A. Euiem W / CE -6776 Date 9– z3 –5r I av r HAA Fee S X06 • t%17 Waiver Fee S 16, Date of Payment % a 5-- 7L�— Date of Payment Receipt Numbcr / 33 JZ Receipt Number Rev. 8/95 OSS: haa.wk.doc ' r MUNICIPALITY OF ANCHORAGE n DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 + Application Date �'L- :Zis< 1. GENERAL INFORMATION (a) Legal Description (include lot. block, subdivision, section, tow ship. range) n Location (address or directions) (b) Applicant Name j-� [*u( Telephone: Home X31 Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution iftl Mt110 = ' �" %L Telephone Address (e) Real Estate Company and Agent Address Telephone (f) (f) M1A*iI the HAA to the following address: S Z t Em Irwaring SRB 196x ae o Raver, Alaska 99577 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well ❑ Community ❑ Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsitew, Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72.025 (11/BI) Page 1 of 2 I 5. ENGINEERING FIRM PROVIDI VV INSPECTIONS, TESTS, FILE SEARCH, DA rA AND INFORMATION ° 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 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. 1. Name of Firm 5Telephone nQ nae.r._ Addre Date 6. DHEP APPROVVA�3) �, Approved fb edrooms Approved \j Disappr Terms of Conditional Approval Conditional CAUTION OFA. A40, iQ It.b.A A. sh.fer Ho. iu7-E The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending Institutions In order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72.025 (11/84) MUNICIPALITY OF ANCHORAGE (MOAT HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1994 MUNICIPALITY OF ANCHORAOa DEPT. OF HEALTH a ENVIRONMENTAL PROTECTION 264-4720 RECEIVED Legal Description: S L,,or t/s Ltk A. WELL DATA Well Classification & If A. B, C, D.E.C. Approved4lVN) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to DepT of Grouting Static Water Level Pump Set At Casing Height Above Ground nitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic ding Tank on Lot.. �-- On Adjoining Lots To Nearest Edge of Absorption Field on Lot � ; On Adjoining Lots — To Nearest Public Sewer Line Cleanout/Manhole — Water Sample Collected by Water Sample Test Results Comments B. SEPTICa4etV= TANK DATA _ To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Date Installed Size l VS� No. of Compartments I' Standpipes) Air -tight Capsr!''N) Foundation CleanouteiN) Depression over Tank (Y& Date Last PVmped 2— i /k Pumping/Maintenance Contract on File (Y/N)�--I- —N ; for Holding Tank High -Water Alarm (Y/N) 1Temporary Holding Tank Permit (Y/N) N Separation Distances from Septic/Mdo" Tank To Water -Supply Well ( SD *- To Building Foundation 6 1 To Property Line ( a A To Disposal Field 2 5 To Water Main/Service Lin Course 1�4 Comments Page 1 of 2 72-026(11184) To Stream, Pond, Lake, or Major Drainage I. C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata�Type of System DesignPIT Date Installed "L. J PIT; Length o1 Field %-5, Width of Field (� I Depth of Field 140 Gravel Bed Thickness le Square Feet of Absorption Area '3 J 2 Standpipes Present&) Depression over Field (Y6 Date o1 Last Adequacy Test d5 -Za 9 Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well '� Sh 4- To Property Line 23 To Building Foundation Lot To Existing or Abandoned System on On Adjoining Lots 14— 00 To Water Main/Service Line 591EZ-4- To Cutbank (if present) n To Stream/Pond/Lake/or Major Drainage Course N A To Driveway, Parking Area, or Vehicle Storage Area rn Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments Check Permitted Bedroom Rating Against HAA Request •' Pumping Cycles during Adequacy Test. Meets MOA IcertifythatIhave checked. verified. orconformedtoall M Aan'd HAA guidelines ineffect onthe date oithis inspection. Signed !!.S 960n"rhV Date 112 444V46" Companyrk_ MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 tI1,84) • t 0 �( � J j, � � � � BILL SHEFFIELD, GOVERNOR ' DEPT. OF ENVIRONMENTAL CONSERVATION Te1#00M: 19071 Add . : ANCHORAGE/WESTERN DISTRICT OFFICE 274-2533 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE: 73'� a'� PWS I.D.w .21 3 41c i To Whom it May Concern: According to records on file in this office the i Water System is in compliance with the State Drinking Water Regulations Sincerely, r�' MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date �/� �1`' (a) Legal Description (include lot, block,�supdivision, section, tawrship, range) Location (adss or directic s) l Al e -t- t (b) Applicants Applicants. it J✓i c PO 27 C11109t4, 1-v jVJ67 -2z3/ (c) Applicant is (check one) Lending Institution Owner/builder ; Buyer C -::j ; Other � (explain); (d) Lending Institution Telephone Address (e) Real Estate Co. s Agent Address Telephone 2. Type of Residence Single -Family, Number of Bedroars 3. dater Supply Individual Well Multi -Family Other (describe) J C Ass C Comninity� Public Note: If ccumnity well system, must have written ecnfirmaticn from the State Department of Environmental Ccrservaticn attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this E14A4)) 4. Sewa�Dis�al Onsite P�l Public f=1 Ccr=nity Holding Tark Is the wastewater disposal system adequate for the nunber of bedrooms Al) (Page 1 of 21 2-15-84 5. Eraineering Firn I certify tha� effect on t1113 d Signed Name f irm _ t Signed bytll `'O Date (ENGINEER SEAL) 6,DHEP AOOrOval Approved for bedrooms Appr_____ Disapproved M Termsof Conditional Approval _ 1 Data and , or conformed to all MOA HAA Guidelines in Date 2 L Act By�XOiT./� Date S a7 conditional The Municipality of Anchorage Department of Health and Envirormental Protection does not guarantee the continued satisfactory performance cf the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation 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 func- tional urstional for the number of bedroans and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 21 2-15-84 /1 MUNICIPALITY OF ANCHORAGE t DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MDA) M AY(�2Y84 HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 R/ E� C E I V E D Legal Description: Z EI V E D A. WELL RATA Well Classification If A, B, or C, D.E.C. Approve (Y Well Log Present (YM) Date Ccupleted Yield Total Depth Z ZO r Cased to Depth of Grouting Static Water level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (YIN) Electrical Wiring in Conduit (YIN) Depression Around Wellhead (YIN) Separation Distances from Well: To septic/Holding Tank on Lot T ; On Adjoining Lots / To Nearest Edge of Absorption Field on Lo ; On Adjoining Lots To Nearest Public Sewer_ Li To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected By . -5-- mit J Date /x/2'0 Water Sample_ Test Results �' �/ �/�c T0s `7 B. SEPfIC/HOLDING TANK RATA Date installed Mau I !`73 Size _/Z.Sa Standpipe (YM Air -tight Caps Depression over Tank W Date Las Pumping/Maintenance Contract on File (Y Holding Tank High -tater Alarm (Y No. of Caq)aFoundation Cleats .-Y Foundation Cleanout ( ) s/t V/KAre; OL; for Jv i2 Temporary Holding Tank Permit Separation Distances from Septic/Holding Tank: _ To Water -Supply M ll To Building Foundation �S To Property Line /O To Disposal Field 23 t To Water ilait!•/Service Line _!o TO Stream, Pond, lake, or Major Drainage r Course [Page 1 of 21 2-15-84 r.t C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �-� Type of System Design 41 a it Date Installed length of Field 'J Width of Field /.3 Depth of Field �O Gravel Bed Thickness 1# f 3 Square Feet of Absorptic Area �j 2_O Standpipes Presen ( ) Depression over Field Date of Last Adequacy lost ^S Results of Last Adequacy Hest Separation Distance from Absorption Field: 23c To water -Supply Wall' /.SZ' 7L To Property Line To Building Foundation 2 9 To Existing or Abandoned System on Lot Al ; On Adjoining Lots 3 a /- To Water Mai rvioe Line 3 a 4- To Citbank(if present) To Stream/Pond/Lake/or Major Drainage Course �v /h To Driveway, Parking Area, cr Vehicle Storage Area /o CcRments X ,--/ 4 9S D. LIFT STATION - Date Installed J Dimensions Sia? in Gallons ole/Access (Y/N) "Ramp Gnu Level at f" Level at High Water Alarm Level atb�7 Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets Mat Electrical Codes(Y/N) Ccamnts *' CheAP9 Bedroom Rating Against HAA Request I certiI ified, or conforned to all MDA HAA Guidelines in effect on the ,i b,SignedE i t3 Date Z �rT;��:•• •^•.: :" .v Carpany pNEB '"7J MOA No. �' e KB1/d5/s a.t.rt A. [Page 2 of 21 Zi.��r .,.5��t.•� 2-15-84 r, n nus K8 BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: 19071 Address: SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 274-2533 ANCHORAGE, ALASKA 99501 DATE: ' Ste' ''l - 8 9 PWS I.D..B--a LLY-67 To Whom It May Concern: According to records on file in this office the Water System is in compliance with the Stat46 Drinking Water Regulations. Sincerely, ) � '44-4— �'fo A A ADEOUACYTEST WATER AND SEWER INSPECTION WELL INSPECTIONS AND FLOW TEST SITE PLANS ROAD DESIGN SOILTEST ONSITE WASTE WATER DISPOSAL SYSTEM DESIGN EXCAVATION WORN State of Alaska Department of Conservation 437 E Street Anchorage, Alaska 99501 n May 27, 1984 REFERENCE: Lomaru Subdivision mater System ROBERT A. SHAFER CIVIL ENGINEER 6942979 An on-site inspection was made to locate the daylight drain from the well house on May 27, 1984. The drain was located and was visible with an adequate screen over the end of the pipe. In addition to locating the daylight drain a water sample was taken and submitted to Chemical and Geological Laboratories of Alaska for coliform bacterial analysis. The results of this test were satisfactory. A copy is attached. We are in the process of obtaining a Health Authority Approval from the Municipality for Lot 5 of this subdivision. Request you provide a letter indicating the water system is currently in go standing. Sincer y, / Ze 6$ER1~1t: SH'AFER, P.E. AS/ss CC.* Municipality of Anchorage Department of Healht and Enviornmental Protection SRS 196X EAGLE RIVER, ALASKA 99577 n GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 5/9/74 Time of Inspection Date of Inspection x/9/74 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Kassler and Company ' Mailing Address: 319 5th Ave Anchorage 99501 Phone: 272-9501 2. Property Owner: Max Bevins Phone: Mailing Address: % Star Realty 640 36th Ave Anchorage 3. Legal Description: Lot 5 Lomaru Subdivision 4. Location: Gina Circle 5. Type of facility to be inspected Single Family No. of bedrooms 2 6. Well Data: A. Type rnmmunity B. Depth C. Construction 7. Sewage Disposal System: D. Bacterial Analysis A. Installed 1g74 B. Installer Walla e C. Septic Tank: 1. Size l?-qn 2. Manufacturer WallarP D. Seepage Pit: 1. Absorption Area 2. Material Rinac 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 pagc• c two pages - Rer st for Approval of Individual rt"er & Water Facilities Legal Description Comments Lot 5, Lomaru Subdivision Disapproved Date 5/9/74 Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 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. Date SIGNED EQ -034 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-9696 Date Received ul)e In_ 19� 71 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEDER b WATER. FACILITIES FOR Conrentlonaj„ 1. Anproval Requested 9y: Bowles - McCormick Address. Box 661 Eagle River 99577 Phone: 2. Property Owner: Bowles-McCorwick Phone: 3. Legal Description: Lot 5, Lomaru Subdivision a. Location: Peters Creek 5. Tvne of Facility to be Inspected: Single Family Dwelling Dumber of 3edrocros: 2 5. Nell Data: A. Type C9mmunity B. Depth 220' 'C. Construction Satisfactory D. Bacterial Analysis 7. Sewarle Dis,)osal Systems A. Installed 1973 9. Installer Vallate C. Septic Tank: I. Size 1,250 2. Manufacturer Wallace D. Seepage Pit: 1. Size 2. Material E. Disposal Field: Total Length of Lines 9. Distances: A. well To: Septic Tank^_ , Absorption Area Sewer Linea Nearest Lot Line Other Contamination a. Foundation to Septic Tank '> Absorption Area C. Absorption Area to Nearest Lot Line Request for Approval of 1pmW taunt newer a werer rscat ute �._ .-. • ..... Page Two 9. Comments: Aonrovtd Disapproved Date August 1, 1973 Approval Valid for One Year From Date Signed Greater Anchorage Area Rorough. Department of Environs:ental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the suhiert sewer and water facilities located at: Signed Date ) 00.0ee 3,50.v s • .�9i ' - 00.591 r o -r 00'091 Z N zW 1-� 3 LL W 0 O Y COW P m W I� F O N e0 P N �N . P Z N b N b I 'Z W J �tU . z •3,50.0'5 j w pU ILL: Q h 0 a W V) IM a ° 3 NSP °° ^� h^ P ��•\ a N (V \ • N� W C06> V 0 I �o I j .d 0 91 3;50 S y \LL Jp \ v P \ O J\J \08-3 ��Ho3j �'� 3� o• .4 o ri N / r 1 V h St co N coP ►I