HomeMy WebLinkAboutDEBORA #2 BLK E LT 14f��C ,t<= -
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" GRE/v`ANCHORAGE AREA BOP"" '
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME! 11PY49% MAILING ADD
LOCATION_ee"te l LEGAL DESCRIPTION lot
PHONEY qlb�
-J_
SEPTIC TANK: 01'*-/75'yOr /y'��
i Ly /S ail./(P Oa. /5
DISTANCE [A'e fkyp _ NUMBER OF
FROM WELL 1Z' MANUFACTURER_ —MATERIAL Vee L- COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY_ SV GALLONS.
SEEPAGE PIT: //////
NUMBER OF PITS DIAMETER AOR WIDTH �, LENGTH _14/ DEPTH -to"
� �
LINING MATERIAL ' CRIB SIZE: DIAMETER! - DEPTH DISTANCE FROM: WELL /27/ ,
TOTAL EFFECTIVE
BUILDING FOUNDATION_, NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) 7-76 SQ, FT.
ADDITIONAL ABSORPTION
WELL:
TYPE 12 CONSTRUCTION 4i"� DEPTH bZ, DISTANCE FROM:
fit f,
BUILDING NEAREST
FOUNDATION LOT LINES SEWERSLINE TANKC //2, , SYSTEME I
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED REMARKS
3y'
DISTANCES: DIAGRAM F SYSTEM
�t R
INSTALLED BY:
Mf
r
PIPE MATERIAL:
1/Lt-ti+
LOT SLOPE: swa
REMARKS:
i
!� IIS•/. � / .
DATE APPROVED
G.A.A.B.
Form No. E"31
GREATER ANCHORAGE AREA BOROUGH
i• i DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT No.
5570 "C" STREET ANCHORAGE, ALASKA 99503 `
TELEPHONE 274.4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
TAME OF APPLICANT '"-R..,�} LM_A_ILIN-G ADDRESS ��4 �' x 5 ESP PHONEv • ;?i
INSTALLATION LOCATION lot
I�/�/�/�"�• /�
LEGAL DESCRIPTION l • N / Jl el ^'l"I.
INSTALLATION OF: SEPTIC TANK V S1EEEEEPfA}`GGEfE PIT� D.iRJAIN FIE D � OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH ISD TO BE INSTALLED BY
SOIL TEST RESULTS NOTE. 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 61 -75-0 TYPE Sfc�.Qo� SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
(
FOUNDATION TO SEPTIC TANK `� '
n f
FOUNDATION TO SEEPAGE PIT LO DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL IS'f
SEPTIC TANK SEEPAGE PIT DRAIN FIELD
TO NEAREST LOT LINE.
(�
WELL TO SEPTIC TANK Sa SEEPAGE PIT /m ,
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, —Y� SEEPAGE PIT -14V , DRAIN FIELD
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION B FEET INTO UNDISTURBED SOIL.
A 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.
44 te &
G.A.A.B.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESC D S TEM IS IN ACCORDANCE WITH SAID CODE.
DAT APPLICANT'S SIGNATURE
POR NO. EG-() 6
0 & E ENWNEER/NG & DEVELOrML NT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 333.5240
Russell Oyster
694-2774 Earl Ellis
Civil Engineering - 333-5240
Surveying
Soils Fr Foundations - Land Development
SOIL LOG -
Performed for: Name: ��`—C��t��p�� ��� �. Tel. No. 911-gz/"
Mailing Address: \ \Vtg- �� gq•a]7
Legal Description: %--oma \4.r'6co, No S��so�r�stol
Depth (feet)
0
1
ft, - 77-7Aa- So v r
2
Soil Characteristics
t✓i - '�ov- �, w .t
�ct`s�s �• a2cga.aS
3
SC' - \�5(%--) Zze�zC% v-> - C.4aa Ua��oetb,
4
5 Mme.,- -Z7•a Sb VT - `a %,,.
0
7 VN
8
9
10
5naal G2gvE,\,r
- Wk,�. GQoo� aur
11 �i7ti"CTAM rs� 7�
12
Ground Water Encountered: Yes No ✓If yes,'what depth
Proposed Installation: Seepage Pit ✓Drain Field
Comments:
v.otQe-,4
&� -T
4r'
N.J '�t
hR J
u�z1a�
\�1zIA
Performed by:�I_,,r�-��
,�,�C��,
Date:
GAAB•IID•,^„i • GREATEL .ANCHORAGE AREA .ROUGH
IIEALTII DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501
279.2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
Case No. 301 t
NAME OF APPLICANT "e«lf ZOLP MAILING ADDRESS PHONE NO.
RESIDENCE ADDRESS LOCATION OF INSTALLATION
LEGAL DESCRIPTI
APPLICATION TO INSTALL: SEPTIC TANK SEEPAGE PIT DRAIN FIELD , OTHER
TO SERVE THE FOLLOWING FACILITY 7' �sC L���J Ls� ��•
FINANCED THROUGH � TO BE INSTALLED BY I11Q1O�eP-
PERCOLATION TEST RESULTS—X40 p'r'o ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ��� ���'( , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
. SEPTIC TANK SIZE A7257) TYPESEEPAGE AREA TYPEG—
DIAGRAM OF SYSTEM
DISTANCES: Nf/N
/Vo pon�iNu
2) OvIxA^ C",L d2L1
9a��g0�
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described syst7mr, in accordance with said code.
DATE APPLICANTS SIGNATURE ���
Geer; rfirb OrWougo irug
by
DOC Co. dba
SULLIVAN WATER WELLS
P.O. BOX 272, CHUG IAK, ALASKA 99667 • TELEPHONE 6882759
OWNER OF LAND'c,,J DEPTH OF WELL
ADDRESS ' ` " STATIC LEVEL OF WATER FT.
LEGAL DESCRIPTION' = r. `� DRAW DOWN FT.
DATE • Started Ended GALS. PER HR
PERMIT NUMBER
KIND OF FORMATION:
KIND OF CASING
From Ft. to Ft. From Ft.
From
Ft. to '
Ft.
From
Ft. to
Ft.
From
' Ft. to
Ft.
= L, From
Ft. to
Ft.
From
Ft. to
Ft.
- From
Ft. to
Ft
From
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Ft.
From
Fl. to
Ft
From
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- From
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From
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r - From
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From Ft. to Ft.
From Ft. to—Ft.—
From—Ft.
o Ft.From Ft. to Ft.
From Ft. to Ft. CCF,
From Ft. to Ft
From Ft. to Ft.
From Ft.
�1N3W d3G
From Ft. to Ft.—.=aq* dl>lpl(V4om Ft. to Ft.
From Ft. to Ft. _..+QL:4 Ip From Ft. to Ft
MISCL. INFORMATION:
DRILLERS NAME
"UNIX C:--If-•nL-I TY CSS-
.r
DEPARTMENT ,A-,�; HEALTH AND EhJVIRO"JMEhJTAL�"t07ECTI0N '
y 82t , STREET, ANCHORAGE, Of. 9':...�,'1 ,
-4720
FJ P"! — S I T 1= LTJ 1='L S.- f�- ¢= F2 M I T
PERMIT NO: 850091
DATE ISSUED: 04/0S/85
APPLICANT: DWIGHT EDMONDSON
ADDRESS: '/.TS&S ENGINEERING
EAGLE RIVER, AK 99577
CONTACT PHONE: 694-2979
LEGAL DESCRIP: SUBDIVISION: DEBORA LOT: 14 BLOCK: E
SECTION: 14N TOWNSHIP: 2W RANGE: I
LOT SIZE: 12000 (SG..FT. OR ACRES)
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alas);a.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
I will adhere to all MOA and State of Alaska requirements for the set bac;.:
distances from
thom existing well, wastewater disposal. system or public
9.
sewers e Sy
m s or any ad .cent or nearby lot.
j �/J
SIGNED
APPLICANT: Itj:GL EDMONDSON
ISSUED BY
DATE:
_--- DATE:
h
/�
Wel l Log
For................ 92. J .... '. 190...1 l?...........................................................................
Location ......... 1-o... ...... �%ck..,s ........ / ..... . .....'�`�
Datecompleted .......... %.- cid'.-..U...................................................................
Depthof well ............. ...3....................................................................................
Sizeof casing................6.......................................................................................
Distanceto water........ a.'..............................................................................
Distance to water while pumping ........... a,.3..................................at rate
of ............... ...................gallons per hour.
Driller
DELTA DRILLING COMPANY
SRA BOX 394 8
ANCHORAGE. ALASKA 99507
to
m u r•.F i c i F• t=i L I -r I1 F' F=t rJ C H _, F: R l=i E
DEPARTMENT OF HEALTH AND'ENVIP.ONMENTAL PROTECTION
825 'L"STPEET, .ANCHORAGE. AK.
264-4720 _ -
L•JEL_L 1-►tC=T�- �'�` PERM I T
PERMIT 140. ( )
APPLICANT Robef.T -,goerh
LOCATION
LEGAL Lor 11313 Loc K V-@30�>� LOT SIZE SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS:
MAXIMUM NUMBER. OF BEDROOMS = SOIL RATING (SQ FT/eR)=
THE REQUIRED SIZE OF THE SOIL FBSOP..PTION SYSTEM IS:
C•EE: F•TH= LEFJOTH=
00-1 Fl 'EL C•EPTH=
THE LENGTH DIMENSION IS THE LENGTH <IFJ 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).
REGIU I F<EGP 'EF=•T I C TA FJ FC S I cE=
GFiLI-orJ=
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.
--- TWO < 2 ] I FJ`F•ECT 10 r-J'_S FARE REQL_F I REC• ---
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.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERMIT E:XFa I REQ L-ECEMEEFR :3:1-, 1 5:;leID
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: 1 WILL INSTALL -THE SYSTEM IN ACCORDANCE 14ITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
PESIDENgE__LiEMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGNED: ___ -At!1`i�` _ �`-"Ru
---------------
APPLICANTPp`
ISSUED BY_ "_� --DATE-V4. 0
P,u� �-�'
(-d--o
r
lily
V1 LJr4I C I r"ilL- 3117 •e CD r= fnrJCF-i NF;znGC (7t1�
DEPARTMENT G. HEALTH AND ENVIRONMENTAL a-OTECTION�n
' • �• .• 325 'L' STREET, ANCHORAGE, AK. 99501 0sc -4
264-4720
WCL -L- rwEZFTP1I T
PERMIT NO. C 500325 )
APPLICANT ROBERT T. BOOTH 1709 BRAGAW STREET 99504 276-2766
LOCATION ELENORA STREET
LEGAL ',LOT 13 & 14 BLOCK E DEDORA #2'i LOT SIZE 10000 SQUARE FEET
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.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVnILnCLL TO INSURE PROPER INSTALLATION.
1=`F=rZU; I T asm I uzu"5 [7F=CT=MF3F=FZ X11 13^EO
I CERTIFY THAT
n 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 THE CODES.
SIGNED
APPLICANT ROBERT T. BOOTH
ISSUED BY ------------------------------ DATE-1_Whf1-- V4.0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-0720
Application Date
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
4/4z B/%i 'E +DEBoG/O . 4eZ
Location (address or directions)
(b) Applicant Name J/--'/95g1'4gE + Telephone: Home - 69L2P79 Business
E11O1NEc'R;N:,
Applicant AddressRn SSL:"
- c.R. ALASKA "S?
(c) Applicant is (check one): Len1hHq fii!& ki6h Ci; Owner/builder Cl ; Buyer O ; Other O (explain);
(d) Lending Institution /fig Telephone
Address C ;t /f/O2TH�RnJ L� (ru?J
(e) Real Estate Company and Agent
Address
Telgphone
i/r) G,O
(f) the HAA to the following address:
2. TYPE OF RESIDENCE
Single-Family,16'Multi-Family C) Other
Number of Bedrooms 13
3. WATER SUPPLY
IndividualWelx Community ❑ Public[3
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
OnsiteX Public 11 Community 0 Holding Tank 11
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 72-025(11,4)
n
n
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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.
Name of Firm
Address
Date
Telephone
Wo z � .e�'q�f:t .2E'a cc.v oce,C
G bivOrT10n14 e. •lpoolv.euL/a. t_
d4A &I it—.r $S f�iza x ,Xee,
co
6. DHEP APPROVAL
Approved for bedrooms by
Approved Disappr ed Condition2
Terms of Conditional Approval
CAUTION
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
7
W
MUNICIPALITY OF ANCHORAGE
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 3 -ay -s r-
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range) 1
1 l y A'ce-1c:.. E D P_ ficl^c i -54 �02 `I %Lir% a Zu-1
Location (address or directions)
t=r_ Nor w S -re r_�Fz-t
(b) Applicant Name .7->,& • ^ A�r A5)A"•!Lq'c_-Yelephone: Home 434V-3 +(79 Business
Applicant Address
(c) Applicant is (check one): Lending Institution; Owner/builder ❑ ; Buyer ❑ ; Other D (explain);
(d) Lending Institution Al /9 A Telephone
Address C 9 r �O / �i1 ti i /F
(e) Real Estate Company and Agent
Address Aev �✓ /'
Telephone
[r U
(1) he HAA to the following address:
2. TYPE OF RES)DENCE
Single -Family Multi -Family ❑ Other
Number of Bedrooms 3
3. WATER SUPPLY L
Individual Well � Community ❑ Public ❑
Note: It community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite -36 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.
Page 1 of 2 72-025 (11,84)
Ara
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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.
Name of Firm
Address
Date
6. DHEP APPROVA'
Approved for edrooms by
Approved
Disapproved
Telephone
Conditional
Terms of Conditional Appr vat � n .vi w i 0' C.J � v • !l J/
,�,a1s A 46, 4e rc lee ctj e I-eo cj vee
aCCv4I/jglif AZ cf ^14 T /J -',A/ 0.,j /�F6.�
qP4
CAUTION
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 engineers work.
Paae 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH S
ENVIRONMENTAL PROTECTION
Legal Description: 1-14. 09C E ] V E D
FpSoe,Q 5 0
A. WELL DATA
Well Classification
,,FF�� S. P • If A, B, C, D.E.C. Approved (Y/N) /n
W
Well Log Presentt`xrN) Date Completed 4 ( ' B S Yield -- CAX --Gt�S 0-S4o/`f
Total Depth Cased to4j's--1 Depth of Grouting
Static Water Level 7$ Pump Set At (i/i
Casing Height Above Ground �— a Sanitary Seal on Casing)
Electrical Wiring in Conduit a)
Separation Distances from Well:
Depression Around Wellhead (Y4Q
To Septic/Hekhmg-Tank on Lot s ; On Adjoining Lots X00 f
To Nearest Edge -of Absorption Field on Lot - 1OD ; On Adjoining Lots 1'1:7e
To Nearest Public Sewer Line N//?, To Nearest Public Sewer
Cleanout/Manhole 10L//t To Nearest Sewer Service Line on Lot
Water Sample Collected by Sts FNr_ 1 u E rti l Pot- ; Date
Water Sample Test Results , .GAC TD ee
Comments eJf.
la�1? Z'6e 4 i Ajor Ati 00 C 4,.X le drCfs Peo. - L-C!W Nd/f o 7a
1" -4 -XZ -r0_ zo BA� 8ui.pao jIP`749�< G/le"Alt4cto
B. SEPTIC/HOLDING TANK DATA
Date Installed Size Id X'0 No. of Compartments
Standpipes®hq Air -tight Caps ®44 Foundation Cleanout pQ
Depression over Tankp/o Date Last Pumped 3--o9-.R5
Pumping/Maintenance Contract on File (Y/N� ; for D✓l�
Holding Tank High -Water Alarm (Y/N) N Temporary Holding Tank Permit (Y/N) N
Separation Distances from Septic/Holding Tank:
To Water -Supply Well 16 S To Building Foundation /b
To Property Line 1p r + To Disposal Field �O r
To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage
Course /n Ny ~46
Comments to .✓ E
Pagel of 2
72-026(11,64)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata T �� Type of System Design
Date Installed Length of Field
r
Width of Field r7 Depth of Field l0
gyp/ Gravel Bed Thickness r y/*
Q
Square Feet of Absorption Area �!� O " Standpipes Present N)
Depression over Field We Date of Last Adequacy Test
Results of Last Adequacy Test �'i4T �S J=wlano C y
Separation Distance from Absorption Field:
To Water -Supply Well led ; To Property Line y0
i
To Building Foundation To Existing or Abandoned System on
Lot A ��' ; On Adjoining Lots AOG& /yamr+
To Water Main/Service Line ✓d 14To Cutbank (if present) nt/
To Stream/Pond/Lake/or Major Drainage Course Nle /yb fir'
r
To Driveway, Parking Area, or Vehicle Storage Area
Comments —
D. LIFT STATION
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 "
Vent(Y/N)
Jr
j raping Cycles during Adequacy Test. Meets MOA
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
SignedE)IGIWE$rTj;,a Date
Company""E a1Y ALAS MOA No. f 5 •yO 3
Receipt No. 3 BLI S 14
Date of Payment 9-15-35 ••tifl }!�
po - ry
Amount: $ `) � ^. ••• �•• • Y
O'b• t & 1hef"r
No. 1457-E
Page 2 of 2
72-026(11,84)
ANCHORAGE/WESTERN DISTRICT OFFICE
437 'E' STREET, SUITE 303
ANCHORAGE, ALASKA 99501
March 26, 1985
Mr. Robert Shafer
S b S Engineering
SR8 196X
Eagle River, Alaska 99577
SUBJECT: Horizontal Separation Waiver Between Well and Septic
Tank, Lots 13 E 14, Block E, Debora Subdivision
Eagle River
Dear Mr. Shafer:
The department has reviewed the subject waiver request
prove the waiver. The report did not show that the
quired by 18 AAC 72.021 was clearly not necessary in
We recur mend installing private wells in this case.
Sincerely,
Leve Eno. P.1
District Engineer
SE/dd
274-2533
and cannot ap-
separation re -
this situation.
Nlw we L O 5L - -BS"
G Z, 1" EVG1WEEhii:3
SR13 19c),
r,, -?LE RIVER. ALASKA V=7
PH. 694-2979
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ;1' ��' `00
TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER �, +'
�.d-.o... 5633 8 Street
a W,,'%
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM: (-) See h on back
I.D. NO.
AS
Water System Name P11o" No.
9',< 4:5, /tip Y
Maemg Addreu
,-,a-.a x
Cry — — � State Zip Code
SAMPLE DATE: Lu J
Mo. bay Year
SAMPLE TYPE:
outine
Ctieck Sample (for routine sample
with lab ret. no. t O Treated Water
O Special Purpose P13111treated Water
SAMPLE Time Collected
NO. LOCATION Collected
'4tt r /r/ Af//c /!E-
g
4
5
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
PSatisfactory
❑ Unsatisfactory
❑ Sample too long In transit; sample should
not be over 30 hours old at examination to
Indicate reliable results. Please send new
sample via special delivery mail.
Date Received
Time Received
Analytical Method:
❑ Fermentation Tube
.i3 -Membrane Filter
Lab Ref. No. Result' Analyst
NEI
I ME
1�Elllllllllll,
.No 010,.11100. a no M 1bw•w oo�1gM
oe-tap (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
a... 1910
READ INSTRUCTIONS Membrane Filter. Direct Count Coilform/100ml
Verification: LTB BGB
Final Membrane Filter Results Colllorml100ml
BEFORE Reported By +C��;r �,! �� Date .41
Time: �Y1� a.m.
P.M.
COLLECTING SAMPLE TNTC= Too Numerous To Count
a
--•
r
.
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME-
TIME
TIME
DATE
DATE
DATE
ar SINGLE FAMILY
❑ I ❑ Five
n
INSPECTOR
INSPECTOR
INSPEC R
MUNICIPALITY OF ANCHORAGE DEPT. NT L F,', FI S
F,',OTECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
625 L Street - Anchorage, Alaska 99501
• JUL 15 1980
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNE
PHONE
❑ PUBLICUTILITY
(o 7 (o (P
MAI LING ADDRESS
I -I061 -04
PROPERTY RESIDENT (If different fromabove)
(�
1-t�.�+-�
PHONE
t n C— 1,
2. BUYER (` t
PHONE
�Jt.J1 v�'i—
MAI LINGADDR S
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTQ�IAG T
e
PHONE
MAILING ADDRESS n`^�
L7
01
v
5. LEGALDESCRIPTION
L 0 t -s 14 3
�bo�a S�(� �* -�-
STREET LOCATION
F_ l ILNI`, ^,r_e___
-
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
❑ One ❑ Four ❑ Other
ar SINGLE FAMILY
❑ I ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SY
'ATTACH
L1Y�DIVIDUAL'
WELL LOG. A well log is required for all wells drilled
®/COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
S. SEWAGE DI ALSYSTEM
INDIVIDUAL/ON-SITE"
YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLICUTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE . INITIATED
- w�Q9Um.
72010 (Ray. W79)
Acre.
lav t i9 Cloax ."R.�`Q`l
72010 (Rev. 6/79)
un
THIS SIDE FOR OFFICIAL USE ONLY _
<.`
1. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
❑ SINGLE FAMILY=. 1
❑ ONE
❑ THREE ❑ FIVE
❑ OTHER
❑ MULTIPLE FAMILY
❑ TWO
❑ FOUR ❑ SIX
2. WATER SUPPLY
PERMIT NUMBER
❑ INDIVIDUAL
DEPTH OF WELL
❑ COMMUNITY
DATE DRILLED
❑ PUBLIC UTILITY
Connection Verified
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
PERMIT NUMBER
❑INDIVIDUAL/ON -SITE
DATE INSTALLED
❑PUBLIC UTILITY
Connection Verified
INSTALLER
ilk
❑Septic Tank or 13 Holding Tank
Size: ' AIf Tank is homemade
SOILS RATING
give dimensions:
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
-
4. DISTANCES
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
WELL TO:
Absorption Area t ear t of line
5. COMMENTS
Q�
�n
=ice
eq.
Qr�
LY APPROVED FOR BEDROOMS
✓CONDITIONAL APPROVAL
(letter mu acco pany certificate)
❑ DISAPPROVED
DATE � �ID1r^�(]�y
BY
72010 (Rev. 6/79)
un
Cnllery of Homes
ATMITION: Robert Booth
1709 Bragaw Street
Anchorage, Alaska 99504
Dear Mr. Booth,
DAVID A. SLENKAMP
MECHANICAL ENGINEER
694.9055
JulY 21, 1980
Reference: Lot 14; Debra 1{2 Subdivision
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
MUNICIPALITY OF ANCHORAGE
DEPT. OF H-ALTH &
ENVIRONMENTAL PROTECTION
J U L 2 5 1980
RECEIVED
At your request a sewer system adequacy test was performed on the
system located on the referenced lot. The septic tank was pumped
and verified to have a capacity of 1500 gallons. The seepage pit
was dry when initially checked. The system was then charged with
approximately 900 gallons of water and at the end of a 24 hour
period checks indicated that the pit was again dry.
It can be concluded from this test that the septic system is adequate
to serve a 5 bedroom, single family dwelling.
If we may be of further assistance, please do not hesitate to call.
ra Ce
Department of He^lth and viornmental Protection
National Rank of Alaska
ATTUITIOA: Edith
SRO 196X EAGLE RIVER, ALASKA
n
1 "
. i ufticlpaw
of
Anchorage
July 230 1980
n
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN.
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Robert T. Booth
1709 Bragaw Street
Anchorage, Alaska 99504
Subject: Lots 14 and 13 Block E Debora Subdivision A2
Approval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1) Abandon the old well because it is to close to the
neighboring sewer system.
Obtain a permit from this department to drill a new
\v` well. The distance requirement is 120 feet from
i" any leaching area and 80 feet from any septic tank.
(3) Have the well inspected and a water sample drawn
by this department.
(4) The septic tank pumped with a receipt submitted to
o this department. The total number of gallons pumped
need to be on the receipt to verify the size of the
tank. This will need to be verified by a registered
engineer.
(5) An adequacy test be performed on the existing leaching
area. This test will determine if the system is
adequate according to National Standards. A listing
of private firms performing the test is enclosed. This
report needs to be submitted to this department for
our review.
n
Mt. Booth
July 23, 1980
Page Two
"Al
(6) The sewer system is located on Lot 14. There will be .
a trailer located on Lot 13 in the near future. As far
as this department is concerned, the persons residing
on Lot 14 will be responsible for the sewer system,
which will serve Lots 13 and 14.
Please notify this department for a reinspection when the
noted descrepancies have been corrected. Also, be advised,
we are unable to approve the sewer and water facilities until
all the reports have been submitted to this department for
review. If there are any further questions, please call this
department at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: National Bank of Alaska
Mortgage Loan Department
Pouch 7-025 99510