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Home My WebLink AboutDEBORA #2 BLK E LT 29A0 4psa 0q.l 53 0ob MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 41 DIM t cENVIRONMENTAL ENGINEERING DIVISION ..__. 13 (Rev. 3/78) ��-r-•ii-----••��•-•••••r•�raye,.uaslca 99507 7elephone264.4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION NAME REPORT A`,1 4, 3�Gnn Potts PHONE ❑NEW MAILING ADDRESS .7 •z UPGRADE r• n �%v Ca L LEGAL DESCRIPTION . LOCATION ('� r lt? 0- s . 1 NO. OF BEDROOMS Well DISTANCE TO: 7 00ir UY Absorption area p 1 Dwelling PERMIT N0. I-2 Manufacturer wF Material No. of compartments Lou. capacity in gallons IF HOMEMADE: Inside length y Width Liquid depth d D Z DISTANCE TO: Well Dwelling PERMIT NO. =?F Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well / Foundation Nearest lot line PERMITNO. ZW No. of lines Length of each line Total length of lines I Trench width Z� Distance between lines F Top of the to finish grade a Material beneath ti le inches �[ Tatal effective absorption area W Length Width Depth inches r f7 PERMIT NO. Q H W a Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Dtller Distance to lot line PERMIT NO. W 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS VC SOIL TEST RATING fl E—R INSTALLER JONO REMARKS e Y e LEGAL 6� APPROVED DATE 7z-0 13 (Rev. 3/78) TYPE OF SOIL ABSOPPTION SYSTEM IS: TRENCH MAXIMUM NUME'EF: OF BEDROOMS = ___l SOIL EATING CSO FT/F.R)= 85 THE FEOUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C-EF'TH=+ LEt4r TH= rF:H: EL CHEF TH= THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE E:OTTOM OF THE EXCAVATION CIN 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 CIN FEET). EE=Gs_ _T F:EC� TFft4F c I 2:E= 1:3nLLfDr-j � PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTION'= OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMPER OF RESIDENCES THAT THE WELL WILL SERVE. > I t-4EF•E0—r I Co F1RE F`EnIJ I IEC• --- EACKFILLING OF ANY c'YSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEIJAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE (JELL OP.. 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATION'= AND CONSTRUCTIOFJ DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'EF_f-f I T E:XF• I REQ C•ECEt•yEE:EF: = 1s 1_-+F:2 I CERTIFY THAT 1: I RM FAMILIAR. WITH THE REQUIREMENTS FOP ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENi?S\IS REMODELEryO INCLUDE MORE THAN 2 BEDP.00M'=. SIGNED ART £: JOANN POTTS ISSUED 'k,6 p-c� V4. 0 ► 1t_�? ! I r I F'1 i L I TY r,F Fl t+lC Hr_r F., Fi 13E - DEPP.P,TMENT� HEALTH AND EN%JIF:OF411EIITAL,�. c; OTECTIOFJ it. i1 ,- 820 STF:EET, AI;. 01 - 6.4 -4 2E4-�J 7 20 Crtd—= ITE =•EL•dEF: F•EF7C-7 I T PERMIT NO. C 820533 ) APFLICANT ART S. JOANN POTTS EO:; 50FJ MERCY DR E. R. 99577 279-2491 LOCATION MERCY DR LEGAL L29A BLOCK E DEEORA LOT SI3E 999999 SQUARE FEET TYPE OF SOIL ABSOPPTION SYSTEM IS: TRENCH MAXIMUM NUME'EF: OF BEDROOMS = ___l SOIL EATING CSO FT/F.R)= 85 THE FEOUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C-EF'TH=+ LEt4r TH= rF:H: EL CHEF TH= THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE E:OTTOM OF THE EXCAVATION CIN 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 CIN FEET). EE=Gs_ _T F:EC� TFft4F c I 2:E= 1:3nLLfDr-j � PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTION'= OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMPER OF RESIDENCES THAT THE WELL WILL SERVE. > I t-4EF•E0—r I Co F1RE F`EnIJ I IEC• --- EACKFILLING OF ANY c'YSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEIJAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE (JELL OP.. 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATION'= AND CONSTRUCTIOFJ DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'EF_f-f I T E:XF• I REQ C•ECEt•yEE:EF: = 1s 1_-+F:2 I CERTIFY THAT 1: I RM FAMILIAR. WITH THE REQUIREMENTS FOP ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENi?S\IS REMODELEryO INCLUDE MORE THAN 2 BEDP.00M'=. SIGNED ART £: JOANN POTTS ISSUED 'k,6 p-c� V4. 0 MUNICIPALITY OF ANCHORAGE • \, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Strsat, Anchorage, Alaska 89501 2641720 SOILS LOG - PERCOLATION TEST KSOILS LOG ❑ PERCOLATION TEST PERFORMED FOR: /D4c/, /' 1/' /rc, -/ DATE PERFORMED: -v/ 2' Z -7Z LEGAL DESCRIPTION: P Lira 4 s -*/1 t7 /1 Z 7L0`7 /p 1v vtx) de ts, . �� JA) C P )?,-kc PERFORMED BY: 72-008 (6/79) SLOPE WAS GROUND WATER /V D L ENCOUNTERED? O P IF YES, AT WHAT E DEPTH? SITE Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIED DATE:67— 17-41. cAA°"°',a. GRI. ITER ANCHORAGE AREA BOROU°0`4 DEPARTMENT OF ENVIRONMENTAL QUALM . < 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM U !G NAME nPL;i)le MAILING Y ADDRESS !'0. $nX �%� �� • PHONE SEPTIC TANK: DISTANCE FROM U NUMBER OF Stack 6 kel- UL d1 179024 LIOUID CAPACITY_ ZCQ-C GALLONS. INSIDE LENGTH INSIDE WIDTH LIOUID DEPTH DEPTH_ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETEROR WIDTH �� , LENGTH �& / , DEPTH (13/ LINING MATERIALCIYA'Ire>- hI4�mlryb &PM. DISTANCE FROM WELL �O3 / , BUILDING FOUNDATION, NEAREST LOT LINE a S . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 4/G SO. FT. TILE DRAIN FIELD: 4111f DISTANCE FROM WELL , FOUNDATIONTOTAL LENGTH , NEAR 1 LINE , OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA SO. FT. LENGT F EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPEjdQ-1cd--Tf j.0l� DEPTHDISTANCE / UVt,4.AWN FROM WATER FNDATIONCC} iK02. SMPLE /0%P NEAREST LOT LINE NEAREST n / SEPTIC 0 SEEPAGE-2OP dACAf �'I' SEWER LINE �� 'f ,TANK ,, SYSTEM IC%31 , CESSPOOL OTHER -.�_. SOURCES E-i4<'n DIAGRAM OF SYSTEM DISTANCES: 4csi jST ai; avrgnoTce: kry Nn4cLVy dba Ab wme W. CAS? Tee u r VN10, I( . i Ib' Tah � �� 1 l a F�f-► 315 3eel`agr PLt arfn OcM2tTr.block5 - _ _. ___ _ � ►ter/-- -- . ; ._. . . DATE 1'97Z APPROVED 'mac rCiC- I /_w/iaecr— G.A.A.B. NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION n � GREATER ANCHORAGE AREA BORvUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6.630 ANCHORAGE. ALASKA 99502 TELEPHONE 279.8686 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT MAILING ADDRESS INSTALLATION OF: SEPTIC TANKSEEPAGE K / PIT'\ �� TYPE AND SIZE OF FACILITY TO BE SERVED _ +y ✓( jy FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS NOTE, THIS PERMIT IS COMPLETION DATE ANTICIPATED PERMIT NO.V OTHER VALID WITHOUT SOIL TEST FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE �OJL TYPE Sqt MINIMUM DISTANCES. REQUIREMENTS 11 FOUNDATION TO SEPTIC TANK �0 FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL /!3-- / S 6' SEPTIC TANK SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. T / WELL TO SEPTIC TANK — Sd SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. ^ WATER MAIN TO SEPTIC TANK SEEPAGE PIT / DRAIN FIELD "R SEPTIC TANK. SEEPAGE PIT DRAIN FIELD TO RIVER. LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. ------------------- A INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUT TY OR LICENSED DeUt 4ER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE �_" `� APPLICANT'S SIGNATURE' AREA SIZE DIAGRAM OF SYSTEM AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE GhcATEP. ANCHORAGE AREA BOROU� ' DEPARTMENT OF ENVIRONMENTAL QUALITY CASE N 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed ForP Date Performed Aird Legal Description: Lot 34-B ock-�,r�,�, Subdivision -DP6„•`(T,? /-f This Form Reoorts Soils Lo �( Percolation Test' Denth Feet Soil Characteristics 1 — 3— 4 — 5' — 6- 7— B — 9 — 10 — Was Ground Water Encountered? r_ If Yes, At what Depth? Reading I Date I Gross Time Percolation Rate Proposed Insta Depth of Inlet COMMENTS: �i.r D� Minute on: Seepage Pit Dep Net Time I Depth to H2O Net Drop Drain Field 5 --Bottom Of Pit Or Trenc Test Performed By axe -f Data Certified By: i Date: T G r, 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 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L.>s -7 A ;/ ,V LF) Dr n xi p � Location (address or directions) -- ro X 15-0 " i � IJ.e (b) Applicant Name V �AIA6 /& Telephone: Home Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; ;Buyer 13; Other ❑ (explain); (d) Lending Institution / 'A� Telephone 4414 — SS3 / Address DEE (e) Real Estate Company and Agent T 1' / 1A 1Al rfn Address FdG /[/E / Telephone - j�, 94t — q4 9 tA (f) 164@1 the HAA to the following address: 2. TYPE OF RESIDENCE Single-FamilyA3 Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Welt 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 Onsite 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 72-025111,84) \ 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 S 1. £ E`!G!NEZR14%3 Telephone Address c.,:Lr: FIVEFL ALASM $.SIT Hi. 6N "fa Date ' ---' OF .A4L P, * 49 yY fd»n A. anal No. 1437-F l 6. DHEPAPPROVAL C Approved for bedrooms by - Date G J u Approved Disapproved Conditional 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 Stale 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 ( MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST264-4 FEBRUARY 1984 0uw 0 3 '1985 Legal Description: Gc"r Z9 � N � -fin /L/J A> A. WELL DATA Well Classification r If A. B. C. D.E.C. Approved (Y/N) Well Log Present (Y, ly Date Completed VA109 -Tb 1074 Yield • 4 41W Total Depth Q, r'. Cased to 4olt Depth of Grouting -- Static Water Level 135 Pump Set At L) K. u Casing Height Above Ground Sanitary Seal on Casing_eL'�N) Electrical Wiring in Conduit a) Depression Around Wellhead (Y/0) Separation Distances from Well: To Septic/HGdwr}Tank on Lot 1 r 1 ; On Adjoining Lots 1 r.- /� To Nearest Edge of Absorption Field on Lot 1 0 �� ; On Adjoining Lots I cin To Nearest Public Sewer Line N� To Nearest Public Sewer Cleanout/Manhole NT To Nearest Sewer Service Line on Lot Water Sample Collected by -54-5 ; Date Acoif'gs Water Sample Test Results Sit T/ S P Comments A Wei c ?�t 0 1£57- S aOVJ C4 T11Lc (/✓Eu To P//v0ucE e i FXcE5s eTF 4 a%til B. SEPTIC/HCCCUM TANK DATA Date Installed f'K Ioe. 1 `i 61 Size ( c -v No. of Compartments L Standpipes N) Air -tight Caps45)N) Foundation Cleanout (YdQ Depression over Tank (Yo Date Last Pumped Pumping/Maintenance Contract on File (Y/N) for Holding Tank High -Water Alarm (Y/N) N71+ Temporary Holding Tank Permit (Y/N) ~/^ Separation Distances from Septic/IFleiding Tank: To Water -Supply Well I Eno 1i To Building Foundation t 0, /t To Property Line I L,> I J_ To Disposal Field e^ r To Water Main/Service Line 8D 1 To Stream. Pond. Lake. or Major Drainage Course A Comments 6X141A..1•LL IASPCc.77^-J r-e/L -1-74e SFjL Tlc_ Ts►sV4 /5 /t/C7 CSC./ Pagel of 2 72-026(11,84) C. ABSORPTION FIELD DATA IF3 Soils Rating in Absorption Strata Type of System Design Date Installed 7 -el -oz- / Length of Field e, y Width of Field 3 U / Depth of Field I Gravel Bed Thickness 3G" a Square Feet of Absorption Area Standpipes Present MN) Depression over Field (Y9V Date of Last Adequacy Test Results of Last Adequacy Test -17J Separation Distance from Absorption Field: To Water -Supply Well ICU To Property Line /C To Building Foundation ? y / To Existing or Abandoned System on Lot =PY-4'? / ; On Adjoining Lots S4111-- gyp1fTo ToWater Main/Service Line �� t Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course /To N/16 'Sy 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 •4 Check Permitted Bedroom Rating Against HAA Request •• Vent(Y/N) Pumping 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. Signed S E?1f31NEERin i Date bKU "MA Compariy-� .F ( 57T _ MOA No. �(� GJ3 Receipt No. 5 6560 Date of Payment - q - F5 Amount: $ y� Page 2 of 2 72-026 (11,841 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. -- TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER ••^—�• �-5633 B Street - • ! _ l . _r . .: 1 , 1. "~. J�' �� Drinking Water, Analysis Report for Total Coliform Bacteria t TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY WATER SYSTEM: I (') See h on back Analysis shows this Water SAMPLE to be: I.D. NO.- \ r i. ^ . i : . . c -y _ � ZY 5 F'�If J� IN�f�I Illi- rpQ�-Z5 %9 V"lSatistactory - • Water System Name Phone No. ❑ UnsatisfactoryI'; S "" Ia ✓ - ci.. °� :,t ❑ Sample too long in transit; sample should Mailing Add ass J� I not be over 30 hours old at examination to `� n A A� �� indicate reliable results. Please send new �j K�( {''rte. ( sample via special delivery mail. city .,...1i:!•2 ..., -sate' i_-ZipCode 9 S Date Received a J • SAMPLE DATE: ® m Mo. Day Tesr . r_.? .f :. I: c . •Time Received SAMPLE TYPE: , Routine Check Sample (for routine sample with lab ret, no. t ❑ Treated Water ❑ Special Purpose >UMntreated Water . SAMPLE NO. , ,. I LOCATION .. .. Time . collected. -. Collected _ By .. . �G29A 1366- D63,510A 4�2-I 2 . _ 3 _ 4 I. 5 I READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Analytical Method: ❑ Fermentation Tube Membrane Filter Lab Ret. No. Result' Analyst L EM ED l I m •Mo. a Wew1,/100 w+. er Mo a re.n.. DemeD, 0&1220 Ili) BACTERIOLOGICAL WATER ANALYSIS RECORD a... leu .. . G . . • ' Membrane Filter. Direct Count Coliform/100ml Verification: LTB BGB Final Membrane Fllte ea lts - - r• ' pC�oillorm/100m1 Reported By Datey " d' .rte \ Time: ..:.:iJ/_p O a.m. P.M. TNTC = Too Numerous To Count ` >' 1 —DATE RECEIVED cam. INSPECTION APPOINTMENTS Ti TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR IMUNli-iVAL11Y OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEOMWONMENTAL P; O=TION 1 825 L Street - Anchorage, Alaska 99501 • MAY -5 1981 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. '_' 1.1 ROPERTYDWNEQ_ MAILINGA ESS_ So -Ar PROPERTY R SID NT (If different from above) PHONE S 2. BUYER -PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE \� MAILING ADDRESS 0. REALTOR/AGEN PHONE MAI LING ADDRESS C 5. LEGAL DESCRIPTION, r* d1:3�' STREET LOCATION It 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six t 7. WATER SUPPLY ❑ INDIVIDUAL' *ATTACH 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 DISPOSAL SYSTEM - Cij INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. 6/79) V —DATE RECEIVED cam. INSPECTION APPOINTMENTS Ti TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR IMUNli-iVAL11Y OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEOMWONMENTAL P; O=TION 1 825 L Street - Anchorage, Alaska 99501 • MAY -5 1981 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. '_' 1.1 ROPERTYDWNEQ_ MAILINGA ESS_ So -Ar PROPERTY R SID NT (If different from above) PHONE S 2. BUYER -PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE \� MAILING ADDRESS 0. REALTOR/AGEN PHONE MAI LING ADDRESS C 5. LEGAL DESCRIPTION, r* d1:3�' STREET LOCATION It 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six t 7. WATER SUPPLY ❑ INDIVIDUAL' *ATTACH 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 DISPOSAL SYSTEM - Cij INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. 6/79) V 5. LEGAL DESCRIPTION, r* d1:3�' STREET LOCATION It 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six t 7. WATER SUPPLY ❑ INDIVIDUAL' *ATTACH 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 DISPOSAL SYSTEM - Cij INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. 6/79) V 72010 (Rev. 6/79) V 72010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONL'. r, ` 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS - ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED _� Z INSTALLER ❑SeptiFTankor ❑Holding Tank Size: 100 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS �7 tJE✓ r �(^ J �.. n-C�A v�K�.J^ QA 1/.✓. /'CJ M/��1/��/11 •Y..'.O.^.• 7 h` ~ ..It..a.6%� i Q:t� .1t..— / ❑ /APPROVED FOR y� BEDROOMS WL CONDITIONAL APPROVAL (letter must accompany certificate) ISAPPROVED j57,� ;r • 1.1 DATE BY n 72010 (Rev. 6/79) 0, • y G'3 Lv'ilUfllt'iiplL��( \ 825 "L" STREET Municipality {Il��' ANCHORAGE, ALASKA 99501 of ° ,,^f 1. 1 (907) 204. 4111 Anchorage � ��"/� (;conGF N1. SUL L.IVAN, \_ y MAYOR DCPAHTWNL OF 11FALM AND ENVIRONh9F NTAL Pn OUCTION November 4, 1981 TO: Whom It May Concern Subject: Lots 29 and 30 Block fEDebora Subdivision Joining of the above lots By joining two(2) 10,000 square foot lots in an area of small lots and no public sewer, the additional square footage will increase the potential of the area to support an on-site septic system and enhance the value of the subject lot. If there are any further questions, please call this office at 264-4720. Sincerely, John W. Lynn Environmental Specialist JAIL/l jw n ' Municipalityg of Anchorage 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 2644111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION June 18, 1981 Arthur/Joanne Potts Box 50-11 Mercy Drive Eagle River, Alaska 99577 Subject: Lot 29A Block E Debora Subdivision #2 The adequacy test performed on your sewer system has failed. Therefore, an upgrade of the leaching area is required, Prior to the upgrade, a soils test needs to be performed by a private engineer. A listing of private firms is enclosed. A permit for the upgrade is then issued from this office. If there are any further questions, please call this office at 264-4720. Sincerely, James S. Roberts Environmental Specialist JSR/ljw cc: National Bank of Alaska Pouch 7-025 99510 JoAnne Potts Mercy Drive Box 50-N Eagle River, Alaska 99577 n. DAVID A. SLENKAMP ROBERT A.SHAFER MECHANICAL ENGINEER CIVIL ENGINEER 694.9055 694-2979 June 15, 1981 MUNICIPALITY OF ANCHORAGE DEPT. OFFLTyT CTION ENVIRONMENTAL JuPl 17 1g81 RECEIVED Dear Mrs. Potts, Reference: Lot 29AT Debra Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of approximately 1000 gallons. The seepage pit was full of water and had to be pumped. Approximately 500 gallons of water was removed. The crib was then recharged with 500 gallons of water and after a period of 24 hours approximately 22 gallons had percolated out of the crib. It can be concluded from this test that the septic tank is adequate for your three bedroom residence, however, the seepage pit has failed. The entire system will require upgrading before it can be considered adequate for the three bedroom residence located on this property. If we may be of further assistance, please do not hesitate to call. Sincerely, E. ATTENTION: Helen Parker Century 21, Metropolitan ATTENTION: Marion Pipple First National Bank of Anchorage Municipality of Anchorage Department of Health and Environmental Protection SRO 196% EAGLE RIVER, ALASKA p MUNICIPALITY OF ANCHORAGE ►• DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL HEALTH CASE REVIEW WORK SHEET a PLATTING BOARD O PLANNING & ZONING CASE NUMBER S-5588 NAME Lot 29A Block E Debora Subdivision N2 DATE RECEIVED February 25, 1981 COMMENT TO PLANNING BY March 10, 1981 FOR MEETING OF CASE OF CeopoUBLIC WATER NOT AVAILABLE TO PETITION AREA R--;'PUBLIC SEWER NOT AVAILABLE TO PETITION AREA REVIEWER'S COMMENTS: /�[• >\. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ~•..,� . 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received3/17/75 Time of Inspection Date of Inspection 3/18/75 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & 14ATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. 3. 4. Conventional Al Augstad Realty Property Owner: DIortgage Investors Mailing Address: Legal Description: Lot 29, Block 3 Debora N 2 Subdivision Location: Mercy Drive, Eagle River Phone: Phone: 5. Type of facility to be inspected 6. Well Data: 7. A. Type Filled C. Construction Standard Single No. of bedrooms 3 B. Depth 87' D. Bacterial Analysis Satisfactory 3/20/75 Sewage Disposal System: A. Installed 1972 B. Installer C. Septic Tank: 1. Size 1000 gals 2. Manufacturer Stack Steel D. Seepage Pit: 1. Absorption Area 416 sq/ft. 2. Material Concrete Blocks E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank 50' Absorption area 103' Sewer Lines Nearest lot line 8' Other contamination B. Foundation to septic tank ill Absorption area 20' C. Absorption area to nearest lot line 19' S" EQ -034 (1/74) Page 1 of two panes 0 Legal Description Lot 29, Block E Debora H 2 Subdivision Comments Pending escrow of funds to increase soil absorption portion of sewer systen by 470 square feet Disapproved Date 3/18/75 Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM i -•v u— ouivi-aulun cunwinea in Lms request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED m Date EQ -034 (1/74)