HomeMy WebLinkAboutROBIN HILL #2 BLK 4 LT 4Robin Hill #2
Block 4
Lot 4
017-393-02
Not eligible for Certificate of On -
Site Systems Approval because
final Inspection Paperwork is
needed!
Municipality of
P.O. Ikxx 11XHM • .lnc6nnige, Alaslui $Y9519-&;50 • Telephone (!X)71343-SU)l • Fax (!X)7) 343-KNX)
4700 M gaw sthel • :tnchorogc, Alaska 4X65(17
mm.muni.org
Mayor Mark Begich
Iluilclitlg Safety Division
22 Jun 05
Ken Peterson
13101 Floral Lane
Anchorage, AK 99516-3142
Subject: Expired On -Site Water and/or Wastewater Permit
Permit Number: SW030399
Legal Description: Robin Hill #2 Block 4 Lot 4
Dear Mr. Peterson:
This letter is to inform you that your permit SW030399 expired on 25 Sep 04.
Our records indicate that a house was built on this property. To date we have not received a final
Inspection Report for the installation of the on-site wastewater disposal and/or the water supply
system.
Please be aware that you will not be able to receive a Certificate of On -Site Systems Approval at the
time of any transfer of title.
If you have any questions, please call this office at 343-7904.
Sincerely,
Kathleen Maricle
Permit Clerk
On -Site Water and Wastewater Program
Enc: Copy of permit
Coiilinuitity, Security, Prosperity
Municipality, of.Anehorage
o
4( \ - , ..
P.(). N)x 19;67A) • Anchoragc, Alaska JD.919-WZ0 • Tcicphonc (907) W -M01 • Fax (007) 313.82 MI
47(X) Bragmv Strcc( • Anchomgq Alaska 91M07
Mayor Mark Begich
August 16, 2004
Ken Peterson
13101 Floral Lane
Anchorage, AK 99516
u1%
1v.m1ml.0
r9
Buildhifir Safety Division
Subject: On -Site Water and/or Wastewater Permit.
Permit Number: SW030399
Legal Description: Robin Hill 92 Block 4 Lot 4
Dear Mr. Peterson:
An On -Site Water/Wastewater Permit, number SW030399, issued by this office for a single-family
system, %gill expire on September 25, 2004. This permit was valid for 365 calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this office for
documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to
this office for review, approval and documentation. This as -built inspection report must be signed by
the licensed Professional Engineer who inspected the installation of the system. As -built inspection
reports are required to be submitted within 30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or wastewater
disposal system, a new permit must be obtained from this office. A new permit for a second year may
be issued for a fee of $115.00 if the renewal application is received on or before the expiration date of
the original permit.
When applying for a new permit, the fees are: $460.00 for a wastewater permit and $175.00 for a well
permit.
If you have any questions, please call this office at 343-7904.
Sincerely, �� /
!_/
`��/7
��" c1
Daniel J. Roth
Program Manager
On -Site Water and Wastewater Program
Enc: Copy of permit
Community, Security, Prosperity
MUNICIPALITY OFANCHORAGE 2"'r h/alc
Development Services Department
On -Site Water d Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Sep 26, 2003
Expiration Date: Sep 25, 2004
Permit Number: SW030399 Parcel ID: 017-393-02
Legal Description: JROBIN HILT: #2 BLK —4 LT -4F
Design Engineer: 0088 Anderson Construction & Eng'g Site Address: 013101 FLORAL LN
Owner Name: Ken Peterson Lot Size: 56989 SO. FT.
Owner Address: 13101 FLORAL LN Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99516-3142
This permit is for the construction of:
❑,/ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, seated, and heated to prevent freezing.
Received By.
Issued By
Date: 29
Date:LZ 6 03
Municipality of Anchorage 41—,
-. Development Services Department
Building Safety Division 3z• 1 '�'
!; On -Site Water and Wastewater Program .. ...
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343 7904
ON-SITE SEWER/WELL-REERMIT APPLICATION - -
FOR A SINGLE FAMILY DWELLING
Parcel I.D. ('21'1 Permit Number SW 030399
Property owners) I Lr ✓� Y �T r S u ✓1 Day phone
Mailing address (1) 121 r%I nYr� � (LIQ nC. s -,AC
Mailing address
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
Ngsq
Lot Size Acres q.Ft.
Zip Code
L� afIf— 4 K'dnrn Ft'I(s i/ -Z
13101P-adl 0 -'no -
Number of Bedrooms �_ 3
THIS APPLICATION IS FOR:
SOnly
K
Well Only
Elewer
Sewer and Well
Cl
Water Storage
❑
Sewer Upgrade
❑
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jacuzzi
❑
Swimming Pool
❑
Water Softening Unit
❑
Therapy Pool
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: %{ 01CD Waiver Fees:
17
Date of Payment: 'l 7(Cr-2 — Date of Payment:
Receipt Number: 2 OReceipt Number:
(Rev. 12/00)
Michael N. Anderson, P.E.
Civil/Structural Engineering and Excavation
4640 Shoshoni Avenue
Anchorage, Alaska 99516
Phone 345-3377
Fax 345-1391
September 18, 2003
Municipality of Anchorage
Department of Health and Iluman Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Re: Lot 4 Block 4 Robin Hills #2 S/D
To Whom It May Concern:
This is a request for a new septic permit due to the existing system failing. The ground over the existing tank has
started to collapse, thus the system needs to be replaced. A new test hole has been completed on the east side of
the old trench, the soils consist of silty sands with some gravel SM. The depth of the test hole was 18 feet with no
water observed during the excavation or during the seven day monitoring period. The perc was 24 minutes per inch,
the new system is deep trench with #'feet of effective depth for total length of 63 feet.
9-
The lot slopes gently to the south east at about I to 3 percent. The lot will not encroach any neighboring lots for
future development due to the large lot size and existing systems. The existing tank will be demolished and the new
tank installed in its place, sec the plan.
If you have any question please call me at 345-3377
SincercLv
Michael N. Anderson, P.E.
DESIGN CRITERIA:
3 BDRM X 150 = 450 GPD
APPLICATION RATE: 0.6 GPD/SQ. FT.
2.0' WIDE TRENCH
450/0.6 = 750 SO. FT. REQURIED
750/14 = 54' REQUIRED TRENCH
TRENCH:
10.0' DEEP
7.0' EFFECTIVE
2.0' WIDE
(1) 54' LONG
EXISTING WELL
100' RADIUS
MOUND OVE
(THI1) o GRADE
FILTER FABRIC
SM -2.0
2' INSULATION
IF REQUIRED
4'0 PIPE
SEWER ROCK
-18.0 -9.0
2.0'
R
EXISTING HOUSE,--
1 w I
TANK AND / v w
CLEANOUTSI a I J
OPOSEh
TIC SYSZEM n.
EXISTING ERTIC Z
a
J —
~ o:
o~ -- EXISTING SEPTIC =
EXISTING SEPTIC o J
I I I i
� PO
� � O
O�
P
R�
Septic Design Prepared For '
BOB BURGESS &KEN PETERSON OF Al1
LOT 4, BLOCK 4 ,-1P,.•• �:QSIt
ROBIN HILLS #2 SUBDIVISION
Prepared By 00* • 49T�Hsy�'. •••� y� �,
MICHAEL N. ANDERSON, P.E.i�!/J .. .....
4640 SHOSHON1 DRIVE •�„ MICHAEL N. ANDERSON
(907) 345-3377 / FAX (907) 345-1391 �,•. �C,Ej9 69 ;��
SCALE: 1"=200' SEPTEMBER 15, 2003 11, p ..... y��
Q
WELL
2-37.
DRop`(
--------------
NEW 1000 GALLON TANK
2-37/
DOUBLE GO
VALVE
�C�
r—
.0 1 6.0 1
1 1
1
1 1
EXISTING DRNI
Septic Design Prepared For
BOB BURGESS & KEN PETERSON
LOT 4, BLOCK 4
ROBIN HILLS #2 SUBDIVISION
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SHOSHONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=30'
1
1
1
1
1
1
I
1
I
1
1
i
i
i
-100' EXISTING WELL RADIUS
54.0 10.0
i
SEPTEMBER 15, 2003
I
I
E
z-,S7�1
i
OF
Al • X91
ry' • rl
*:*49T"* .* 0
M40.00.0
.MAI
.
MA...
fs • MICHAEL N. ANDERSCN :4k -
CE
4'CE 94 9 j
e Municipality of Anchorage .
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: I-r-r*r �4rr'g D n DATE PER
2 /� 11 --0 Ti
LEGAL DESCRIPTION: Lrf t4 61/c y Po6 n Al), Township, Range, Section:
DEPTH . SLOPE
(FEET) p+a/or(r i F-7—T—T-1 r_T-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18•
19
20
COMMENTS
(rgrvf O t' pian
A�o1
lqd�'
u4c- 'A','n t
WAS GROUND WATER .._L!y
ENCOUNTERED?
IF YES. AT WHAT
DEPTH?
Depth to Water Mer
Monitoring? M u. c Date: _-4m)
)
11
•.r+ vv. .�.r..........
P MICHAEL N. ANDERSON *
L4
Reading Date Gross Net
Time rime
Depth Wu
Water
Net
Drop
`i e3 rt ser , n �S�r
*:49TH.�'
*+I
•,!A,r.•7:...�I.JJJ.4•..a..�
•.r+ vv. .�.r..........
P MICHAEL N. ANDERSON *
L4
Reading Date Gross Net
Time rime
Depth Wu
Water
Net
Drop
`i e3 rt ser , n �S�r
3nm,
.r
✓/• o Of
N. 7 5"
z f
PERCOLATION RATE 711_ (minutes/inch) PERC HOLE DIAMETER
TESTRUNBETWEEN 610 FTAND A3"5- FT
I 1
PERFORMED BY: Ms Ae e'/A I An i KA in I CERTIFY THA THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE. '�7,0 3
72-008 (Rev. 4/85)
GREr!R ANCHORAGE AREA BOF"IGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON -SITES SEWAGE DISPOSAL SYSTEM
NAME '-5 ' 6 ,J�..//LLI_� MAILING ADDRESS ": 0V 1✓'Vk''' `- 3Z- - PHO/N/E - �Gr
LOCATION 0/ III" � LEGAL DESCRIPTION/// 2��, /J' ��f v
SEPTIC TANK:/ f,h/ /hJ 4olol ,%
DISTANCE WGrah �� �k �jATER1ALNUMBER OF
—COMPARTMENTS—
FROM WELL MANUFACTURER/
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/ -4LGALLONS.
TILE DRAIN FIELD:
�pp L f � �, i�. TOTAL LENG�Tn /
DISTANCE FROM WELL FOUNDATION . 1 NEAREST LOT LINE 210 LINES
NUMBER OF LINES / DISTANCE BETWEEN LINES TRENCH WIDTIiTI'k IN. TOTAL EFFECTIVE
ABSORPTION AREA 46" It SQ. FT. LENGTH OF EACH LINE
/ DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE/,o-2-12-IN. ABOVE TILE IN.
WELL:
TYPE CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCE'S:
DIAGRAM OF SYSTEM
• le
INSTALLED BY: Ctr LJ04
d
SEWER LINE DEPTH: / lR� po v /
f
PIPE MATERIAL//:C.3�VN
LOT SLOPE: ';;:40/'PL✓ roll"
REMARKS: - 'o r'
DATLO � � APPROVED
At
2033-1
• GREj"^:R ANCHORAGE AREA BO' ,JGH
,4 DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3370 "C" STREET ANCHORAGE, ALASKA 99303
TELEPHONE 274.4791
Vj�YYYY ONONONON� lY,. SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
NAME OF A PPLICANT• />-, /•/�P MAILING ADDRESS �./17--PHONE 3'06
/ f
INSTALLATION LOCATION ` �s �u �"'-' L• J
LEGAL DESCRIPTION
INSTALLATION OF, SEPTIC TANK SEEPAGE PIT DRAIN FIELD OTHER ri11�`
TYPE AND SIZE OF FACILITY TO BE SERVED ,(�'
FINANCED THROUGH ten/ _ TO BE INSTALLED BY M / • ` Y- ' r e -,e Q /Sy 1-2:"-,:✓�
SOIL TEST RESULTS `�� r U NOTE, THIS rERMIT 15 NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OP ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE I &-C�e TYPE
MINIMUM DISTANCES, REQUIREMENTS/
Sr
I NK
$REPACK AREA SIZE
FOUNDATION TO SEPT C TA
FOUNDATION TO SEEPAGE PIT � G DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL /J /14 AX
�/[� / /I �� / s /
SEPTIC TANK `� 0 8[fPAGC PIT 1La�. DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK /�`� 1.. SEEPAGE PIT � 0
DRAIN FIELD / `' /� , ALSO CONSIDER ARCA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, � SICPAOC IIT �/ DRAIN FIELD /Q � .`
TO RIVER. LAKE. STREAM. \.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING OAP OP
EXCAVATION B FEET INTO UNOISTURGED SOIL. \
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT`
FITTED WITH AIRTIGHT REMOVABLE CAPS.
eJ•//%eeA e df //'.,Aq NY v� T/71r/fir �\
GRAVEL BACKFILL a ya I 141
CONFORM TO BOROUGH REGULATIONS REGARDING
ARDING INSTALLATION. \
G.AA.S.
OR
LIC CNSRO D$f,GN$R
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATCR AyIC
DESCRIBED SYSTEM I IN ACCORDANCE WITH SAID CODE.
.f"�J'
DATE APPLICANT'S SIGNATURE �
FORM NO. CO -416
TYPE
DIAGRAM OF SYSTEM
BOROUGH ORDINANCE NO. 28.88 AND THAT THE ABOVE
C6
lilmMI
CNMI
1111111
BOROUGH ORDINANCE NO. 28.88 AND THAT THE ABOVE
INC.Fa
.n:Nlcw
244 EAST SIST AVENUE P.O. BOX 6017 • ANCHORAGE. 'ALASKA 09303 • TELEPHONE 907-279.0453 • TELEX 090.33619
May 15, 1975 Rat No. 562031
• Sebring Builders
Box. 1540 C Star Rt. A •.
Anchorage, Alaska ..
RE: Test Hole and Soil Log Report for Sanitary..System
Lot 4 Block 4-Robin Mils.Subdivision;
Dear Mr. Sebring: .
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at-the subject site. - This
investigation was'performed in accordance with your request'of ttay 12,
1975, and those procedures outlined in a letter dated December 19, 19741:
by Mr. Rolf Strickland of.the Greater Anchorage Area Borough Department
of Environmental Quality.
A single.test hole was put down within.the Lot 4 area for the-purpose '
Of defining general subsurface soil conditions for 'the proposed sanitary
system. Excavation was accomplished with an auger type drilling 'rig
and the test hole was extended to a total depth of 20.0 feet below
ground surface. One sample was recovered•from the test hole and
retained for grain size analysis. The results of this sample are'
enclosed. The final log prepared for the test.hole has been'included
in Drawing A-01:
Ground water was not encountered in-the test hole:
We appreciate being given this opportunity to be of service to you.
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yours, .
R &-M CQNSULTANTS,_IM,
James W. Rooney -
Vice -President
Encl_ .
s
NOTE: Tast hole extended with auger
type drilling unit.
Log Represents
..Lot 4 Block 4
Robin Hills Subdivision Sebring Builders
Xoy'of.Tcst hole ., ••
Anc;orage,. Alaska
R Engineering eA Geological Consultants Inc.
y ANCIMRACE IAIH9AN%S ALASKA JUNEAU
t
LABORATORY TEST .REPORT
TEST ON Tnsitu Material
RAM PROJECT NO.
562031
PROJECT NO PROJECT NAME
Sebring Builders
LAB NO.
75A-753
SAMPLED FROM Test Hole No. 1
SUBMITTED BY
"Jackson FIELD NO.
1
SOURCE
Lot- 4 Dlock 4. Robin Hills
Subdivision
DATE REPORTED
5-15-75
LOCATION Anchorage, Alaska DEPTH
7-81 DATE SAMPLED
5=13-75 DATE RECEIVED
5-13-75
GRAIN
SIZE DISTRIBUTION
CLASSIFICATION
95
LL
aro'
.BS
PL
04
' .COMPACTION
'
' PASSING
SINE
As SPEC
RECEIVED
UNVI[D AA3H0 FAA
SN
410
•58
REMARR3
,uta
Classification
S'
9•' i 10 '
,FRO
OPTIMUM MOISTURE
.. �"
%+3
3`
% GRAVEL
% SAND
I.IFt�
% SILT
1"
100'
.7. CLAY
3/4.
99
Fsv
V2"
95
LL
aro'
.BS
PL
04
71
PI
'
,ya
CLASS
SN
410
•58
REMARR3
,uta
Classification
,FED
Based on/
,FRO
Gradation
040
47
41so
.•
#so
0100
40200
36
STATIC IMMERSION
BRAND 0%—I/2%—
'
y-
006
.Oz MM
.00SMM
DELETERIOUS MATERIAL
MINUS 10 200' ME$"
SOFT FRAGMENTS
COAL 0 LIG. OR LT. WT. PART.
CLAY LUMPS
3TICX3 0 ROOTS
FRIABLE PARTICLES
SPECIFIC GRAVITY
ABSORPTION
FINENESS NODULUS
SULFATE SOUNON99S
FREEZE -THAW RATIO
L.A. 'ADRASION LOSS—
DEGRAOATION VALUE_
THIN -ELONGATED __
OR'.ANIC COLOR
GRADE
i �nglnnUring aGaologlcol Conaulloni-t
MAX. WET DENSITY
MAX. DRY DENSITY
CORK MAX. DRY DENSITY
% FRACTURE
METHOD
NATURAL DENSITY
NATURAL MOISTURE
WEIGHT LOOSE
WEIGHT RODDED
MOISTURE - PERCENT
No. 1 '
5-13-75 0.0'
ORGANIC MATERIAL (Peat),
N 1.51 .
' 471.T _ Tra ro CanA (MT.1 '
LABORATORY
TEST REPORT
TEST ON
Insitu Material
%+10
RBM PROJECT NO.
562031
PROJECT
N0. PROJECT NAME
,
-LAB NO.
Y
% GRAVEL
Bole No. 1
2"
Jackson .FIE LD
% SAND
LABORATORY
TEST REPORT
TEST ON
Insitu Material
%+10
RBM PROJECT NO.
562031
PROJECT
N0. PROJECT NAME
Sabring Builders
-LAB NO.
75A-753 .
% GRAVEL
Bole No. 1
2"
Jackson .FIE LD
% SAND
SOURCE
Lot 4 Block 4 Robin hills
Subdivision
DATE REPORTED
5-15-75
LOCATION
Anchorage, Alaska DEPTH
7 -BI DATE SAMPLED 5-13-75 DATE RECEIVED
5-13-75
GRAIN SIZE DISTRIBUTION
CLASSIFICATION
FSY
• COMPACTION.'
.
'
SPEC. '
UNIFIED AASHO FAA
y
%+10
1"
%+S
% GRAVEL
.
2"
% SAND
11/2".
% SILT
.
I"
100
% CLAY
3H"
99
FSY
'
1/2"
95
LL
3/5"
BB
PL
..#4
71
PI '
* a
CLASS
SM
*10
4015
58
REMARKS
Classification
020
Based on
0 30
Gradation
/40 •
47
050
0410
*100
41200
.02 N M
003MMIL
36
STATIC IMMERSION
BRAND—. O^/°_I/2°/.—
ly,_1v2%_2%_
u
o_
DELETERIOUS MATERIAL
MINUS 4# 200 ME3N
SOFT FRAGMENTS
COAL B LIG. OR LT. WT. PART.
CLAY LUMPS
STICKS a ROOTS
FRIABLE PARTICLES
SPECIFIC GRAVITY
ABSORPTION
FINENESS MODULUS
SULFATE SOUNONE33
FREEZE -THAW RATIO
L.A. ABRASION LOSS .GRADE
DEGRADATION VALUE
THIN -ELONGATED
ORGANIC COLOR'
EnginooTing rat Oaological. Consultants
ANCrow AAs PAIANANR\ ALASKA'+u NAwu
OPTIMU/A MOISTURE
MAX. WET DENSITY
MAX. DRY DENSITY
CORR. MAX. DAY DENSITY
FRACTURE
METHOD
NATURAL DENSITY
NATURAL MOISTURE
WEIGHT LOOSE
WEIGHT RODDED
.MOISTURE - PERCENT
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MUNICIPALITY OF ANCHORAGE • -7
DEPARTMENT OF HEALTH E HUMAN SERVICES (V ��
DIVISION OF ENVIRONMENTAL SERVICES n
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264.4744
Application Date 91S / e 7
1. 'GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot block, subdivision, section, township, range)
I rt4-4 'l kck.q 'Pnb,-n Hills SJbdlvtsr4n�fla
Location (address or directions)
I X101 PIofa1L Lo,n.
(b) Property Owner
Home 34S-650) Business 426i430A
Mailing Address "51 L11 r•' "".Q.—
(c) Lending Institution AlaQlu- USA � CRS �� Ii elephone ?86 --.'' sly �Z>o : $r enenk
Mailing Address Po.lox 1966 (3iUU
in i9&ata-• 'FIMY-66/3
(d) Real Estate Company and Agent B,
Address
Telephone /Aodyr p4E✓4
O'G—O�a roc.
(e) LMail ist contact person anld day phone number below ere �, if hold for pick up. d /o
lo*, $tcnno,.nr, i A•io.oka-�, USA ±� PhMC
2. TYPEOFRESIDENCE
Single -Family 10
Number of Bedrooms
3. WATER SUPPLY
Individual Well JO Community D 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
Onsite PublicE3 Community O Holding Tank O
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72.073 IRw SMI nmI
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pawelgo uorlewlolui eqt uo paseq legl AluaA lagllnl l u!alaq poleo!put amlonils to adAl pue swoolpeq to lagwnu eql lol
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NOIlVWUOdNI CNV VIVO'HOHV3S 31ld'S1S31'SN01103dSNI ONI01AOU WHId ONIH33NION3 'S
CIAI'L
MUtytCtpgllTY Of An010mm MUNICIPALITY OF ANCHORAGE (MOA).
EtyytROw tENTAL5E6v;CE3 DIVISION HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
ScP ] o 1987 264.4720
Legal Description:
P� C �v �� Atwb H,//, .S2bdrvur� k1•,2
A. WELL DATA
Well Classification Pr va ife If A, B, C, D.E.C. Approved (Y/N) ti, A.
Well Log Present (Y/N) 1^ Date Completed _0/9 / 7S Yield 36p- 0eer
Total Depth le Y2 Cased to le 'It Depth of Grouting N•A•
Static Water Level _P 2 i Pump Set At '--M P23
Casing Height Above Ground 3 f Sanitary Seal on Casing (Y/N) Y
Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) N
Separation Distances from Well:
To Septic/Holding Tank on Lot Ito, -- ;On Adjoining Lots > 100'
To Nearest Edge of Absorption Field on Lot 1-311 : On Adjoining Lots r CAO'
To Nearest Public Sewer Line N.A. To Nearest Public Sewer
Cleanout/Manhole M A. To Nearest Sewer Service Line on Lot N•A
Water Sample Collected by T 1`n ; Date %/ t/ 6 7
Water Sampie Test Resulis c:_t• Ac 0 ce1(4 15'cp � 1 1 V 0'e: nLle- Kf' bWk -N
B. SEPTIC/HOLDING TANK DATA
Date Installed/ZC 7f Sizef 0 00 Ufa, No. of Compartments /
Standpipes (Y/N) r Air -tight Caps (Y/N) r Foundation Cleanout (Y/N) Y
Depression over Tank (Y/N)
Date Last Pumped 8 / zd' / a7 yt Mpr•AL�sd
Pumping/Maintenance Contract on File (Y/N) R.A. ; for tit
Holding Tank High -Water Alarm (Y/N) 1v,A - -- Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Well lieu S-ftM c. o, To Building Foundation 111F,
P. �a ' To Disposal Field 20
To Properly Line P
To Water MaiNService Line A'A' To Stream, Pond, Lake, or Major Drainage
Course
Comments
Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating In Absorption Strata '25V r7' /R dr,.. Type of System Design —2CrP 7-rrirC6
Date Installed 0'r Zo / Length of Field MO
Width of Field ?d. Depth of Field 167
r
Gravel Bed Thickness yZA',.it - Yn o,
Square Feet of Absorption Area Xco `- Standpipes Present (Y/N) r
Depression over Field (Y/N) N Date of Last Adequacy Test 9 / Z 67 "
Results of Last Adequacy Test Aof'•4aater' r 3 b.o[rvow�
Separation Distance from Absorption Field:
To Water -Supply Well 1 fir' S+o� �• •• To Property Line d 0
To Building Foundation H7ROM C. o To Existing or Abandoned System on
Lot -N•A . ; On Adjoining Lots
To Water Main/Service Line 1'1. O. To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course root
To Driveway, Parking Area, or Vehiyle Storage Area f62
Comments 'v`• Ar?.
D. LIFT STATION 1.(A
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N) _
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
.. Check Permitted Bedroom Rating Against HAA Request .6
Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
certi fy that I have checked, verified, or conformed to all MOA and HAA guidelines In effect on the date of this inspection.
Signed ! -5 Date Srpf9. 160 Z
Company/�P T cA _ C oer MOA No. 87-QCF-
ReceiptNo. 01q_001 _01W
/ ��
Date of Payment Y 7 OF A/
0 o w •( 0
Amount:$ ��`� g,`Q`,.•'
Engineer's Seat
Page 2 of 2
?2.020 111/8I)
CO...
49TN� •"r� d
..........................d
�Tf1EODORC F. MOORS �� 17
CE"3589
• .
Df...; RECEIVED
r INSPECTION APPOINTMENTS
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
LN PEL`TOI�
❑ Two ❑ Five
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONENVIRONMENTAL fl%OTECTION
825 L Street -Anchorage, Alaska 88501
*ATTACH WELL LOG. Awell log is required for all welts drilled
•
SEP 17 1981
ENVIRONMENTAL SANITATION DIVISION
Telephone 2644720
R 4
L � E D
S
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FAC L I
DIRECTIONS: Complete all parts at page 1. incomplete toques" will not be processed. Please allow ton (10) days for processing.
1. PROPERTY OWNER
❑ PUBLICUTILITY
PHONE
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEDL
MAILINGADDRESS
73 2 / .ncho/QGE . filQS
1
PHONE
PROPERTY R SI DENIM differentfrom�abov V
2. SIAER
`�"��
9144 x 3D
MAI ING OR SS
� .
3.ENDING INSTITUTION
PHONE
AleuskQ_, OSA Aid l
MAILING ADDRESS
r
4. REALTOR! GENT
PHONE
MAILING ADDRESS
e ea^
5. LEOA/LDESCRIPT ON
F
STREET LOCATION if
N N Al F-
6. TYPE OF RESIDENCE
NU41BER OF BEDROOMS
FAMILY
❑ One ❑ Four ED Other
SINGLE
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
% INDIVIDUAL'
*ATTACH WELL LOG. Awell log is required for all welts 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
INDIVIDUAIJON-SITE**
'p �/
ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLICUTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEDL
72.010 (RW. 6179)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE. ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLICUTILITY
Connection Verified
PERMITNUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON•SITE
❑PUBLICUTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
r _j
INSTALLER
❑Septi a or ❑FloldingTank
Size: If Tank is homemade
give dimensions:
SOILSRATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
SeptiolHoldinq Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
U - APPROVED FORBEDROOMS
❑ CONDITIONAL APPROVAL (letter mus ccompany certificate)
❑ DISAPPROVED
DATE rr
i`
B
Ralall,
r1
NEMICAL & GEOLOGICAL LABORATORIES OFALASKA, INC.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343
FEDERAL TAX ID N 920040440
rft!.15c' REPORT N S611PLE
"::eot YOl : VU(BAL ken 9:
:iie:It Dqui 10: L4, 04 BOBIR HILLS rig
5'Aplt^ kec•a : SBP o f!'
Orcerec 07 : TED WiRle
1£c IMM'. 5Ek9icz
145 a ECIC) 5T
AIi0 01?AOa, fit. 94b!6
SilP:lat
i i:J'fur t:
bort Urcer No. : 2&1
client Acco3nt : FLA:M
Vat: Leport Printed: SEP 9 67 a 0:1s
^:leaned EY = �«
Reports Acdrens 92
4(Kms ' Pec V: '55�j Lar 6:111:1 IN I Ratrix: hater
Al lu',4nir(
;,ae
aralxr r ssteu kesu!t:Units Ne:rod Lren::
_._..._...__.--------------------- ----------------- .------- --I-
NI RMP -ii 0.60 Ira i)
CG!1V'ai): YA-0'
I t? •� � :oa7 S'cfP1iC!1 c. Elly l' r-
LAiil �1v..YY.,.. )S:1{: �j��:•'!." I�,LC.-��
1 Yest6 Vortorsed ► Sea ;3peclal lastractlnns hwvo
?ti - !.c:x 9Y2n;e0 *4 Sec 6m:ple Pcoacks Ar,•o.",
V11- Nut e6aIY:e0 1.14,e33 lh,n, 61 O'ioter Titan
\ ; I
. I•� n i
} C.J
�I
1 q.,
CHEMICAL & GEOLOGICAL LAhO.�RATORIES OFALASKA, INC.
5033 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 582.2343
FEDERAL TAX ID k 92.0040440
Olin t IT;} : VEdi'L
!J. 84 BILL.) 4it
b'at?Ic Frc . �Et t tl% .
ilydered 8v : TEo NOARE
JG 1:1
Heont is 'ix 1:A1 aUP "!°Cn;Il1: �L S%!RVICY.
145-')'o ECMO S r
rUlCBvt:AGF', AC. 49b1tr
Speclai
irsuast:
mw;:;Alao Nci a: 7):d Ub S`rol lD: 2
rareceier Tcsten
'N AL CUL!lti4:!
r�1;rtiJ I e
PeKZrl.y:
1 NiALYSIS RRIP" BY 5 w`!?EC
•.
'sx�c ir, oer1Co;. • • : z62!
theht hccaLel : tiP, dU't
Date Report ?r!ntcn: SiT 14? u9:r!
Release(! E<l'
P.enorts Adoress a2
llatrlx: Vater
AI Irvab le
Re 4tNrllta tethad Llur!t.
V colilUC>ul
Y`I lcsts Pedorend + Ste Special instruction:+ Anaee
&U, None letected +.e See Saeple Remarks Above
ai;= Not Anaiysed LY -Less Yvan, Of-trnter _man
Tobben Spurkland P.E.
8155 Cranberry St.
Anchorage, Alaska 99502
Phone (907) 243-5302
Mrs. W. Troyer
SRA Box 373-Z
Anchorage, Alaska 99507
MUNICIPALITY OF ANCHORAGE
DEPT. OF HG'dril 4
FNVIRONMENTAL PLOTLcnON
Oct.
OCT 12 1981
RECEIVED
S E VIER$ KDE(4UJLC Y TES T
Legal Lot 49 Block4j Robin Hills s/D
Location On Floral Lane, Two blocks off DeArmon
Owner Will Troyer
Residence Two Storeyq Three Bedrooms
Water On site well
Sewer System From Municipal Records:
12* 1981
Tank 1000 gal Sunset Plastic One Compartment
Absorption System 40 feet long trench with 10 feet of gravel
Absorption Area 800 sqj, ft.
Soil Rating 250
Installation Date June 1976
Date of Test Oct. 10g 1981
Test Procedure System was inspected on Sept. 29. On that day the clean out for
the trench was found to be 6 feet below ground and containing
no water. The sump was found to have a total depth of 18 feet
with 15 inches of pipe sticking up above ground. Liquid level
was found 71-71' below top of pipe. TAnk was 10 feet deep with
a liquid depth of 44 inches.
Tank was pumped ozi Oct. 8.
On Oct. 10 water was added to the sump. A total of 150 gal was
added at which time water was heard entering the tank and the
filling stopped.
Prior to filling the liquid levels in the tank and sump were
checked and fount to be 24 inches and 71-8" respoctivety.
Test Result The absorption system had not absorbed any measurable amount
of water 1n the 48 hours between pumping of the tank and test
The actual depth of liquid in the sump was found to be more
than 10 feet prior to toot• indicating that the trench was
OF Aja\%j full of water. The test substantiated this indication. Only
p�;e.••"'••q.C,F1( 150 gal was needed to surcharge the trench and cause backflow
into the tank. ''his system does not meet the criteria of the
r *: q9Ui FAk * to Municipal Codet which requires an absorption rate of 150 gal
• •••••• •• •••� per bedroom per 24 hour period.
,•.
o. 222571 '�/ �- w / (�
JUNE 25. 1971 ; ��,�� C I fti-c-�wl�. l
,MUNICIPALITY OF ANCHORAGE
Department( '� Health and Environmenta�-)rotection
825 '1;" Street, Anchorage, AK. y9501
20
4A.q►►►b� * * * HANDWRITTEN PERMIT * * *
WELL AND/OR ON-SITE SEWER PERMIT
.pplicant: Mailing Address: S. A- bob_ -L32--
vocation: -1 &a C ' /J _ Phone} Number: 3 SIJ = /
4-f 5�
aegal Description: L ; / Z/pww0 Lot ��G •c
'ype of Soil Absorption System Is: S {a
Trench: r/" Drainfield: _ _ Seepage Bed: Holding Tank:
laximum Number of Bedrooms: Soil Rating (sq. f t/br)
The Required Size of the Soil Absorption System Is:
DEPTH 1�T _ LENGTH GRAVEL DEPTH S WIDTH
The len4f-i dimension is t o 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). 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).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE _ GALLONS
.rmit applicant has the responsibility to inform his department during the
:stallation inspections of any wells adjacent to this property and the number
residences that the well will serve.
* *.* TWO M INSPECTIONS ARE REQUIRED
:ckfilling of any system without final inspection and approval by this departme
.11 be subject to prosecution.
.nimum distance between a well and any on-site sewage disposal system is 100 fe
>r a private well or 150 to 200 feet from a public well depending upon the type
public well. Minimum distance from a private well to a private sewer line
25 feet and to a community sewer line is 75 feet. Well logs are required
id must be returned to this department within 30 days of the well completion.
:her requirements may apply. Specifications and construction diagrams are
railable to insure proper installation.
* * * PERMIT EXPIRES'DECEMBER 31, 1 9 3 1
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the res dente is remodeled to include more that 3 bedrooms.
Signed: kIssu6d by: -� tip✓
App'li ant
Date: 14 --•r 3-- 8r
SWP/024(1/81)
�1
Municipality
.1l1 !1' t i !,& a .0 ,1 y ..
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264.4111
GI:OHGV M. SULLIVAN.
MAYOn
DEPARTMENT of IIEALTII AND ENV IHONMEN7 AL P170TECTION
October 13, 1981
Will/LuRue Troyer
Star Route A Box 373-Z
Anchorage, Alaska 99507
Subject: Lot 4 Block 4 Robin Hills Subdivision $2
The adequacy test performed on the on-site sewer system
indicated the system is not functioning properly according
to National Standards for a three(3) bedroom single family
dwelling.
Therefore, before approval may be granted to the lending
agency, an upgrade will be necessary. Prior to the upgrade,
a permit will need to be issued by this department.
The upgrade would include; 55 feet of trench with 5 feet
of gravel backfill. The existing trench must be utilized.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: Alaska USA Federal Credit Union
2600 De Barr Road 99504
Municipality
®2
825 "L" S7 R E ['r
ANCHORAGE, ALASKA 99501
(907) 2134 4111
M 01t/:F M. HILI IVA Y,
MAY011
DEPAHTMEN'r OF HEALTII AND ENVIHONhWNT A I. PROTECTION
September 23, 1981
Will/Lu Rue Troyer
Star Route A Box 373-Z
Anchorage, Alaska 99507
Subject: Lot 4 Block 4 Robin IIills Subdivision 42
Approval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
1) The water analysis report needs to be submitted to
this office from the Chem Lab, 5633 B Street, for
our review.
(2) The septic tank pumped with a receipt submitted to
this office for our review.
(3) An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system
is adequate according to tlational Standards. A listing
'of private firms performing the test is enclosed. This
report needs to be submitted to this office for our
review.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Robert C. Pratt, R:S.
Associate Specialist
RCP/ljw
cc: Alaska USA Federal Credit Union
2600 De Barr Road 99504
Tobben Spurk(and P.E.
8155 Cranberry St.
Anchorage, Alaska 99502
Phone (907) 243-5302
Mrs. W. Troyer Oct. 289 1981
SRA BOX 373-Z MUNICIPALITY OF AN'C'HORAGE
Anchorage, Alaska 99507 czar. c!". -U" G
ENV1201vd:NLu r:.�TLCTION
01"T 2 a Sa81
S E V E R Il
RECEIVED
Legal Lot 49 Block 4, Robin Hills 8/D
Amendment to sewer adequacy test conducted Oct, 10, 1981
On October 109 1981 I conducted a test on subject system. The test indicated that
the system was failing and had to be upgraded.
I retested the system on Oct. 27, 1981 on the assumption that the sump could have
been installed with only a weephole instead of beeing fully perforated, as is the
practice to day. Also in 1976 is was fairly common to install the drain with the
holes up.
I added 466 gal of water to the septic tank at a steady rate of 6.66 gal per min.
beery ten minuits I checked the liquid depth in the tank. The water level did
not rise. It reained stationary at 4834 in throughout the test.
Since there is no way of actually measuring the water depth in the treneht one
can only conclude that the system is acceptable if it can receive 450 gal within
a 24 hour period with out any signs of disteess. This system reseived 466 gal
in less than 90 min. and no signs of disstress or surcharging was observed*
This system therefore meets the Municipal requirements.
n r,
Municipality of Anchorage
MEMORANDUM
DATE: October 29, 1981
TO: Laura Crow
FROM: Senior Office Assistant
Sewer and water Program
SUBJECT; Request for Refund - Account #2460
Please make arrangements for the following refund. The
upgrading of the on-site sewer system was not needed at
this time and the permit has been voided.
Permit # 811130
Receipt 0161468
Amount: $20.00
LuRue Troyer
9009 Honeysuckle
Anchorage, Alaska 99502
Note: this is a new address, do not send to address on the
receipt.
Thank you.
LAura J. ward
Senior Office Assistant
attachments
e MR
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 ffi4-4561
Date Received I(,) -An -()5
Time of Inspection q•.(D0Qrr -9MAA
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by:
Mailing Address: • Phone:
2. Property Owner: egn c i)dP,-ir n CA_�V-_ _ —Phone: ,. tAtt-' Z�Ao9
Mailing Address: Rte, IF u' �O-A
3. Legal Description: 9A )-► . (n��� �? 14 2m%. ,. k�i � 0s X1,0
4. Location: _nP ('T%rrM, M tan n,v+i []S QICS06 a &U -m-
5. Type of facility to be inspected Ln_c). No. of bedrooms nhs a�
6. Well Data:
A. Type B. Depth
C. Construction D. Bacterial Analysis
7. Sewage Disposal System:
A. InstalledB. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 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
F0434 fl/741 pano 1 of +u,,, nanae
Page 2 of two pages - RE. ist for Approval of Individual pier & Water Facilities
Legal Description
Comments:.
Approved Disapproved Date �/ r
ApprovalkValid 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 Tor approval to De a true ana
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Date
MSV Un
��CGREATER ANCHORAGE AREA BOROUG11_.. V
Department of Environmental QualityA •v3330 "C" St., Anchorage, Alaska 99503 - 274-4561
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REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO VA FHA
2. Property Owner: Z fllll�& /0. Py. ie n Y t 8
Mailing Address: '7 e_ S Day done/41d&
3. Name of Buyer:
Mailing Address: Day Phon/e,���lf03�^
4. Name of Lending Institution:
Mailing Address: Phone
5. Name of Realtor or.Agent:
Mailing Address: Phone
6. Legal Description: • _&O.J7 a
Location: 4.;Cr jo r_ jjjfj�ff4i
or Flo rd 1 / L 4,v
7. Type of Facility to be.inspected:
8. Water Supply
Type of Supply: Public Utility
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t,VG�z No.. Bdrms. 13
Individual K
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
EQ -037 !?/74)
