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Home My WebLink AboutT12N R3W SEC 27 (BLM LTS) LT 28ATI RSW c. 27 (BLM Lot 28A #018-092-61 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page ( of SUE)MIT _n,n t a nn... Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page ( of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 05P til 2Lt PID Number: OtS{-OY'Z–�{ Dwelling: [,Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New [Vpgrade Name: W,, t GM r v ABSORPTION FIELD [Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address El Other Phone Number of Bedrooms Soil Rating Total depth from original grade GPD/SF 11 (�o Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1 r Ft. Gravel depth beneath pipe Ft. Subdivision nn Block Lots) A L LT$ Z'6 origin I grade 0 Ft. Gravel length (( IJ 1A /''i�,L Township Range 'Section W Z C r Ft. ]addedabove th O ads: Number of Lines Distance between lines SEPARATION DISTANCES 2r Ft. Ft. ToSeptic Absorption Lift Station Holding Sewer rption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 �— Ft. Well too' r lvv9 ('14 (�( / Svl, TANK .Septic ❑ S.T.E.P. ❑ Holding [-]Other J� Manufa/yturer r J�" Capacity I Surface Water �QQI l00r.� I�vlCV ( 2aha Gal. Material f S S—t Number of compartments Lot Line 2t) f / t +„ NA Foundation 770 44of� LIFT STATION Manufacturer Capacity Gal. Curtain Drain (� ,[ (/' Remarks Pump on level at Pump off level at in. High water alarm at n. Pump make odel Electrical Inspections performed by Installer Y!t 4 T 414 i PIPEMATERIAL Housetotank Tank to 2 drainfield 3V 7 eJrso rf Drainfieldv3 303 CO/MT so3 Inspector wtrh< aYrq BENCHMARK (Assumed elevation) (v0 ft Inspections, b dates: t b'-9 r3 2"" / Y- /� Location and descri tlon p t� �v[VYo 31. 4f" SON VIAbCJ WTyi �.r COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Ftn:L�4:L��LP g�.OF Acget° • • • • • • Conditional Approval: Date i lP•• S ° 49TH ...:.......� s 'i0 - MICHAEL N. ANDERSON ; r' °ti�`fEssIti3> Approvedi! Date \\�o� IncneMinn Rannn Q_1_ GSL Per"mit No. OSP131245 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: T12N, R3W, SEC 27 BLM LOT 28A PID No.: 018-092-61 I I q I BENCH, TOP OF SONO TUBE I � I I CQ5--'rl� I IIMT II \\ II ! 1 I I II � II I I I I I B 1 ! \ MAR A B TC01 62 52 CO \� CO2 o 68 57 TC62 Col 79 86 i —� _ _ U C01 MT 107 80 � J � i I � / / v I / A \ A UILT \ __ :> 1.,_30' / co, ., W02 c 98 MT g 97 RICINAL ..•� OF•LATON FlLiER GABPoC �ISOftG . NV•l \� . N I�' Y. 49 TH 1.250 GALLCN • •• •• • ••• ••• ••••••• •••••� a STEEL TANK 90.4 °M � .MICHAEL N. AND ERSON;= a9 H2O MAY 2013. 93 No. E 9 469 _17. 90R. ELEV. $0 •.,%`��J••.•A �j .•• ' `(/.: SEPTIC SE00 c01 sa 512 CO2 � 70 59 I CO3 71 60 C04 C05 ' 120 85 On-Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131245 Tax Code Number: 01809261000 Work Type: Septic Permit Effective Dates: September 04, 2013 to September 04, 2014 Design Engineer: ANDERSON CONSTRUCTION & ENG'G Subdivision: T12N R3W SEC 27 (BLM LTS) Site Legal Address: T12N R3W SEC 27 (SLM LTS) LT 28A G:2936 Owner/Address: HARVEY WILLIAM R JR 13720 DAVIS ROAD ANCHORAGE AK 995163614 mrtment Site Mailing Address: 13720 DAVIS ST, Anchorage Lot Size in Sq Ft: 40402 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division OmSite Water & Wastewater Program Phone: 907-343~7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. Ct. Property owner(s) Mailing address Site address Day phone Legaldescription(Sub'd.,BIock&Lot) '['-/'?~/k.(~tllt2.'~uOi, ¢~.~__ ~::~.- Legal description (Township, Range & Section) LotSize H~)f~/c,"J,, Sq. Ft. Number of Bedrooms ~ APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: ([~ all that apply) Absorption Field [~ Initial [] Single Family (SF) (w/we ADU) Septic Tank [~ Upgrade [~ Duplex (D) Holding Tank [] Renewal [] Multiple Dwellings Privy [] (SF and/or D) Private Well [] Water Storage [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: z:~"~ O Date of Payment: '7/'~'//~'~ C_~ Receipt Number: oq~'q~ "~ Permit No. 0 ,~ ~\~"~' Waiver Fees: Date of Payment: Receipt Number: Waiver No. Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 July 31, 2013 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: T12N, R3W, Section 27, BLM Lot 28A To Whom it may concern: This is a request for a septic permit on the above referenced lot. A test hole was excavated to 17 feet revealing silty gravel for the entire test hole depth. The perc rate was 13 minutes per inch with no water observed during excavation but after the 7 day waiting period it was measured at 14 feet. A simple deep trench has been designed for the primary and secondary trenches. The owner has requested a 4 bedroom system therefore a new 63 foot secondary trench bas been shown. All of the old system will be abandoned in-place due to the bedroom increase. The lot slopes very gently to the west at about zero 0 to 1 percent. The contours on the site plan are two foot typical. This new system will not impact any of the neighboring properties due to the large lot sizes and good soils. Please call me if you have any questions. Sincerely .,~ Michael N. Anderson, P.E. ~MOUND OVER DESIGN CRITERIA: (TH#l) ~- ~7--",,,,~'~ /'-¢RADE 4 BDRM X 150 = 600 GPD OE~ SOILS = 600/0.8 = 750 GPD 1.o I ~ ~---F,I.L~TE;,R FABRIC 750 GA/12 = 63' -3.0- -~ ~-----4 ¢ PIPE ~SEWER ROCK (1 ), TRENCH OM 9.0 DEEP 6.0' EFFECTIVE H20014', MAY 2013 -9.0- 2.0' WIDE I 2.0' I 6,3' LONG 17 __ SEPTIC FIELD SECTION I PROPER~Y LINE- x/ i \ DP, AINFIELD~ ~,J n ~, [XlSTIN(~ SEPTIC TANK // ',, = i P TO BE ABANDONE, D~ ' L ~ i ) ~ -EAST 13E1~ AVE- . - \ XIST]NG WELL -DE RMOUN ROAD- T12N, R3W, SECTION 27 (BLM LOTS) LOT 28A Anchorage, Alaska ~.. :',.,.. .~./t...'.....;.. ;~......~ · ...,..% ~..~...T.,. ,,~ ....................... Michael N.Anderson,P.E. DATE: 7/23/2013 661 0R,VE ANCHORAGE, ALASKA 99516 -545-5377 / FAX: 545-1591 SCALE: 1"=200' CONTOURS TYP. ~ / / / \\~ T12N, R3W, SECTION LOT 1,~_~ P,OPE 10' T & E EASEMENT / T12N, R3W, SE~ION 27 (BLM EOm) LOT 2~ 'PROPOSED ~ ~,~ / T12N, R3W, SECTION 27 LOT 27 I . VA-- H I 1,250 ii \ [ GALLON SEPTIC TANK / \ ~ EXISllNG SEPTIC TANK xx '~ TO BE ABANDOI~ED PROPERLY ~"~'"'"~-- ....... '\t ~'~?/'X~//\ \\ \. ,,~ - '--= ------'----- ~"~T12N, ............ RSW,'"'~LOT SEC110N45 /'//2 z~'-~- EAST~=-138TH AVE- Septic Design Prepared for WELL® RICK HARVEY T12N, R3W, SECTION 27 (BLM LOTS) LOT 28A Anchorage, Alaska Michael N. Anderson, 466i NATRONA DRIVE ANCHORAGE, ALASKA 99516 345-3377 / FAX: 34-5-1391 P.E. DATE: DRAWN: SCALE: HOUSE 7/23/2013 D JR 1"=50' T12N, R3W, SECTION 27 LOT 29 v^C~ Municipality of Anchorage ~ Development Services Department ///~"~'~ On , ~ilding Safe~ Division [/ ~ ~ ~ -S'te ater and Wastewater Program ~, ~ ~,~ 4700 Ermore Road ~,L~~// .O. OX 196650 Anchorage, AK 99507 ~~// ~.ci.anchora~e.ak.us Sods Log - Percolabon Test Legal Description: ~/~ ~ 5~ 6~ ~ ~ ~ Township, Range, Section: GC~ L. ~ ~. s~ope 5- 8- 9- 10- 11- 12- 13- 14- 15- 16- 18- 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? L O Depth ~ Water After ,! p Monitoring? Reading Date Gross Time Net Time Depth to Water Net Drop -,,,,,,,:,, 2%, PERCOLATION RATE / ~'~ (mJnuleS,~nch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT PERFORMED BY: /~'ti ~--. "~,..,~.~ ~/. ~'*~ ~4 I t~, ,.,. ,,~.~ ~), CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: '~'~r t/C/~ ,~-~ GREA :R ANCHORAGE AREA MORt JGH ~,,~¥. ¢ Department of Environmental Quality ~ 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH '7 ~,.2~ / ' NUMBER OF MANUFACTURER ///0 2 ~ MATERIAL ~/1~/("~:~ COMPARTMENTS INSIDE WIDTN LIQUID DEPTH LIQUID CAPACITY/~ ~GALLONS. TILE DRAIN FIELD: DISTANCE [:ROM WELL /~¢ NUMBER OF LINES // __ ABSORPTION AREA /L//¢~.f) DEPTH: TOP OF TILE TO FINISH GRADE ? TOTAL LENGTH FOUNDATION /~') '.~ff .NEAREST LOT LINE 1~,2 ~ _OF LINES DISTANCE BETWEE. LINES A///~ TRENCN WIOTHZ¢;IN. TOTAL EFFECTIVE Sq. FT. LENGTH OF EACH LINE ~.-~ t DEPTH OF FILTER I MATERIAL BENEATH TILE ~ ~ ABOVE TILE ~ IN. TYPE ',~"<-;""t,~-~'(~L-,z~'5" BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED CONSTRUCTION NEAREST SEPTIC SEWER LINE TANK REMARKS DEPTH. SEEPAGE SYSTEM_ DISTANCE FROM: DISTANCES: INSTALLED BY: ff'~ ~/l~/'~,- SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: ~--¢¢'&~-?-1~/,/ REMARKS: DIAGRAM OF SYSTEM DATE 7'50 70^PPROVE O.A.^.B. CD ' Form EQ-032 F,'ERH I I' I'*,lO. [IFFLI _.t II,I I LOE;RT I ON LEGIBL LEE E4-t I E.:, [ I-I IE_, ROFIE:, Tt2N F,'.]:L,J_,:.,'::'":":' L28 F'. O. E:Q::-( 8370 LOT SIZE 'Zo:~ d.- 5 Z 70 ........... - Sg!UFfl;::E FEET T'T'PE OF SOIL FIE:c;F3F,:E:TIEqq S'-,-'?['IEI'I I:.,: TF,:Ei'-,ICH I"II::I;:':;II'II.JH I'.JI_IHBER DF E:E[:,F.:EII3HS =: .3 SCfII_ I::q::l,]"II",lG ,:.~:,L.! F:'T,.'"E:R)= THE F,:E(;¢JIF,:EE:, SIZE OF -FHE SOIL RE:SORF'TI,}3N.~¥.) :: r: FEI1 I:5: ~.-¢'/ / E:' E F" 'T i-It == .:~, L- EE_ fl .11 n_ut q It ~ .... . .......... ..:, F. ~ ~ "." E. L_ C:, HE F° -F HI TI.ii I_ENGI-lq L':,IMENSII31q IS THE LEI"JG-I-H ,::IN FEET) CIF THEE TRIENCH i--iF,: [:,RI:4II",IFZEL. D. TFIE [::,EFqH OF R TRENCH OF,: F'ZT Z% THE E:,ZS'Fi::Ii"4E:E: E:E:TNEEN THE SURFRCE OF THE (3ROLIN[:, FIND THE BEFfTOI'I OF THE E::'::E:R',,¢FITZEfl"4 ,::]:1"~ FEET). 'I"HERE ZS NO LE;ET NIDTH FOR TRENCHES. THE GRFI',,,'EI_ DEF'TH ZS THE HINIHLIH E:,EPTH OF GRFI',,,'EL BE-Iq.,4EEN THE EtlJ'IFFtLL PIPE RND THE " ....... :~ EuI ] UI1 OF THE E::':;C:R',,,h:ITIE*I"~ ,: E:FIC:~-(FILLII",IG ElF Fli"J"r' _,'r_,TEI1 PJI,]"HOI._IT F'II,h::IL IN_-,FE_.[I_i',I FINE:, HEFF dL E,r "1-HI2; E:,EPFIF.:TI'*/Ei"JT N ILL E E SLIF4JEC:T "1"0 F'F::OSEE:LIT I Ol"J. FIIIqIHUI'~ [:,ISTF,INCE E;E"I'I.,IEEI'-,I Ft HELL FIN[) FIt'-,I",-' ON-SITIE SEI.qFIGE DISF'OSFIL. S"r'S"FEI"I IS 1~;3171 I::'L{ET FOff.' F,~ PF.~:I'v'F,]I-E 1.4ELL. ELF.: 2EIEI I::'EF£'F FCIR'. FI PI..IE:L_IE: HELL. '-";PEC I F I CRT I OI*',IS RI',IE) CONSTF,'.UCT I CIN [:, I FIGF,:F-IH'_:_; FIRE Ff,,,'R I LFIBL.E TO I I'-,ISUI::::E PROPEl;.: I I'JS'T FII_L FIT I CIN. I C:ER:-I"IF¥ 1-HFIT t: I FII'"I FFII"IILIFIR: HZ[TH THE 17EC.:¢JIF,:EI'IEi'.JT2.q FOF,: id'q--SITE SEHERS I-':ltqD NELL'5 FIS SET FORTH B"r' THE HU;qlE:IPFILIT"r' OF Fti'qCHO,r;:FIGE. 2: I HILL IhlSTFiLL THE S'*r'S,]'Er'l Ii',J FIC:C:CIF,:[:,RI..ICE klITH THE CODES. 3: I LIN[:,E,q'.STFIN[:, THFIT ']-FIE QN-SITE S;ENEF,'. S'9'STEH F'lFf.r' RE(;!IJIIEE EIqI_RRGEI',IENT IF THE F.'.ESI[:,ENCE IS; REr,IODELED TO II*..ICLUE:,E P1ORE TI.,'RIq .7 E:E[:,FEOL-ff,'IS. 10- 11 - 12- 13 -,-. 14 - ~l~aS (jr(lUll(.{ water encount~.'red? .__//._~ If yes, at wh~t depth? :i, ._~I/ILSON WELL DRIL~NG I(.'/-" 2 '' Static water lc. vel ~3 ~ ~t. (above) ~land surface. Fin[sho~well (check one) open end ( Screen ( ); Perfarated ( ). ,.. De4crlbe screen or perforation V/ell pumping' test at.~'- (- gallons per (hour) of drawdown frorfl static level. Date of completion ! 'B fCt (~-~/, l ? '~ 3 lt. Depth in feet from ground surface _v TO. ~D .TO .~-' ! TO /~'( / ~f/TO__/~r-' ~ ! LLa' ~'o IZ(._' _TO .TO .TO¸ Give details of formations penetrated, size of material, color and hardness ' d ~ ~, -r ~ , n U,,.~ SIX INCH WATIER WELL DRILLED AND CASIF. D OUT TO THI~ DI=PTH OF ~.,~8 £e®te DRILLED AT THE RATE OF PiER FOOT. Re Leo Bates P.O~, Box PROPERTY OWNER LOCATION OF WELL SITE ~ ~ DRILLBR 8370 995O8 WELL LOG: you very mue~h Be~nio Claus MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & ENVIRONMENTAL PROTECTION JUN 2 ~ 19~, RECEIVED MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING ~.'.~\~.,~ (-'~o~ _ \"~ HAA# %~L-'~°t ~ 1, GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 28 Section 27 T12N R3W S.M. Location (address or directions) 13720 Davis Road Anchorage, Alaska 99516 (b) Property owner Same~, ~J~., ¢, r3q /~ ~'~r,.,'),%~'_~lephone: (home) MailingAddress Same I ~('~ ~,,'~ ~,~ U ~ ~,~I~-~.C~(~,IL/ Business 786-8123 (c) Lending Institution National Bank of Alaska Telephone 276-1132 Mailing Address 630 E. 5th Avenue99501 (d) Real Estate Company and Agent Address N/A Telephone (e) Mail the HAA to the following address: (or check here rq, if hold for pick up.) ~ontact person and day phone number below: Will ~ mm R- F]~rv~y: ,Tr. 7RR-R] 2'~ 2. TYPE OF RESIDENCE Number of bedrooms 3 % Single-Family [] 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 th legality and status. 4, SEWAGE DISPOSAL On-site ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. Page 1 of 2 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 JF~--~J/~-/I~,. ~Z~,~//(//,~?2..-~-/~'.~.-~/./~Telephone ~,./'//~/~/ Address ,.~'-Y~ ./ .~.. ,,~/~ ,7~/,/' j~/ .~.~?/~/~ .~' ¢~/~ Engineer's Seal 6. DHHS APPROVAL Approved for ,--~- bedrooms by ate ~ Approved Terms of Conditional Approval Disapproved Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 res 2onsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88)Back Page 2 of 2 A. WELL DATA Well Classification __~ndividua~ Well Log Present (Y/N) N Date Completed MUNICIPALITY OF ANCHORAGE (MOA) ~ Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: Lot 28 Section 27 T]2N R3W S.M. Before 6/75 If A, B, C, D.E.C. Approved (Y/N) ~/A Yield 190 GPH For 4 Itrs. ; On Adjoining Lots lOO' 105 ' 89 ' ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Total Depth 158' Casedto ].58' Depth of Grouting 0 Static Water Level ]oo ' Pump Set At 154 ' Casing Height Above Ground 1.5' Sanitary Seal on Casing (Y/N) Yes "z No Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 71' To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line 1000 ' + 1000'+ 4-8-91 To Nearest Sewer Service Line on Lot ]00o'+ Water Sample Collected by William R. Harvey,Jr. ; Date Water Sample Test Results Satisfactory ( SEE ATTACHED ) Comments B. SEPTIC/HOLDING TANK DATA Date Installed 9-30-76 Size Standpipes (Y/N) Yes ___ Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well 7] ' To Property Line 66' To Water Main/Service Line N/A TO Stream, Pond, Lake or Major Drainage Course .N/A Comments .__ 1000 No. of Compartments Air-tight Caps (Y/N) Yes Foundation Cleanout (Y/N) No Date Last Pumped 4-8-91 ~/A ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field 10' Garage HO 72-026 (Rev 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 9-30-76 Width of Field 3' 125 Type of System Design Length of Field 50' Depth of Field 9' Gravel Bed Thickness Square Feet of Absortion Area ,~00 Depression over Field (Y/N) ~o Results of Last Adequacy Test Satisfactory SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well 105' To Building Foundation 2].I Garage Lot ~T/A TO Water Main/Service Line N/A To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area 20' Gomments Statndpipes Present (Y/N) Date of Last Adequacy Test 3-9-9] To Property Line 25' To Existing or Abandoned System on ; On Adjoining Lots tq/A TO Cutback (if present) ~/A N/A D. LIFT STATION N/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, veri~or conformed to all MOA and HAA guidelines in effect on the date of this inspecti, on//~, Sign ed ~_~ .~- ~¢(.~,~ Company_ Date /74` -2~ f F/ :-ngineer's Seal MOA No. Receipt No. Date of Payment Amount: $ Receipt No. Waiver Fee: $ 72 026 (Rev 7~88) Back Date of Payment Page 2 of 2 NORTHERN TESTING LABORATORIES, INC, 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (g07) 277-8378 · FAX 274-9645 3330 INDUSTRIAL WAY FAIRBANKS, ALASKA 99701 (907) 456-3~ 16 · FAX 456-3~25 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT [~I~RIVATE WATER SYSTEM ciw State 8AMPLE DATa: ~ Phone Mo. Day Year Purchas( SAMPLE TYPE: [~outine [] Special Purpose [] Check Sample (for original contaminaf sample with lab reference no. __ Sample Time No. Location Collected 3 4 5 TO BE COMPLETED BY LABORATORY Received at: ~ Anch. [] Fbks. Date Received INVOICE ~'~ ¢¢ '7,~ SEWER AND DRAIN ~ ~ , CLEANING SERVICE RD. BOX 112688 PHONE 345-2513 ANCHORAGE, ALASKA 99511-2689 DATE ROTC'ROOTER SERVICE CALL__~__H RS. STEAM -/'HAWING HRS. TRIPCHARGE HRS. OVERTIMECHARGE HRS. ADDITIONAL LABOR CHARGE FIRS. 6 7 8 9 Signature of Representative FOR LABOI HYDRo'JET SERVICE MATERIALS HRS. PLEASE PAY FROM THIS INVOICE TOTAL FOOTAGE CLEANED OR THAWED PROBABLE CAU .... ~ ~ BLADES USED LINE CLEANED ~ JOB NOTGUARANTE ,,OR RE^so 3330 ]NDUSTRfAL WAY FAIRBANKS, ALASKA 99701 (907) 458-3116 · FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, Ab&SKA 99503 (907) 277 8378 · FAX 274-9645 William Harvey 13720 Davis Road Anchorage Ak 99516 Attn: - Report Date: 04/09/91 Date Arrived: 04/08/91 Date Sampled: 04/08/91 Time Sampled: 0700 Collected By: WRH Our Lab #: Location/Project: Your Sample ID: Sample Matrix: Comments: A109294 Kitchen Sink Water Flag Definitions U = Below Detection Limit DL Stated in Result B = Below Regulatory Min. H = Above Regulatory Max. E = Below Detection Limit Estimated Value Date Method Parameter Units Result Flag Analyzed EPA 300.0 Nitrate-N mg/1 0.8 04/08/91 Reported By: William E. Buchan Anchorage Operations Manager LOGARITHMIC 2 X 3 C¥CLE,~ 47 7320 7320 g 18 BEYER ENGINEERING May 21, 1991 Municipality of Anchorage Department of Health & Environmental P.O. Box 196650 Anchorage, AK 99519-6650 Protection Attn: Robbie Robinson RE: Lot 28, B~. 27, T1ZN, R3W, Dear Robbie: SM--13720 Davis Rd., Anchorage The following additional information is transmitted for the septic system on the referenced property: 1. The septic tank is concrete. 2. The leaching trench was pumped when the septic tank was pumped with~about 300 gallons being pumped from the bottom of the trenches. After you called we made elevation measurements of the leach field as follows: Bottom of trench-observation pipe: 4.9 ~ Liquid level in pipe: 6.8 !,v Bottom of Perforated pipe: 9.8 ~i.~ The leach field appears to be working properly since the' bottom of the trench is about 5' below the pottom of the perforated pipe and the full depth is available for percolation into the soil. 3. Enclosed is a copy of the water level measurements taken in the field showing the time vs. depth to water in the observation pipe. A totalizing meter was connected to the well and used to determine the capacity of the leaching trench. Please feel free to contact me if you have additional questions. Very Truly Yours: 3:12 3/9/91 SEPTIC TEST, I T12N 319191 ?LuSt-~ 'TO? I 5/919! SEPTIC OAL/FT A B ' ...C D :3 SEPTIC TANK' FOOT/GAL DETERMINATION FOR SEPTIC SYSTEM 4 ' AT'1;~720 DAVIS ROAD ' ~ 5 OWNER: WH R. HARVEY, dR. 6 7 TIME DELTA TIHE I~IETER OISTANCE WATER 8 ' '~EADIN~ LEVEL RO~E 9 ,~,,~( ~ -,. ~0 ~ , 18 23 ~ , 24 ! 26 ~ ' ' 27 ~ 29 30 36 37 40 Page 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 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) _I,(~t' 2R ~O0h~on 27 q']2N R3!~ S.M. 6/18/86 Location (address or directions) ] ~720~Da'v~ s Road ADc, ho~c~._g~t,42'~],_aska 995]_6 (b) ApplicantName~Li_~ f,~ ~4'a'r'v¢.~L~:&~phone:Home q45-TR?R Applicant Address ~.Cj~me (c) Applicant is (check one): Lending Institution [~; Owner/builder:~]; Buyer []; Other [] (explain); Business 7R6-8323 (d) Lending Institution Centrust Mort_qaqe Corp. Address ~,Z~ OD ._Q]~]. _S~aJ2~L~ ~ y (e) R~I Estate Company end Agent Address Telephone 561-4930 02t Anchorge, Alaska 99503 Telephone (f) Mail the HAA to the following address: William R. HarveyCJr. 13720 Davis Road Anchorage.Alaska 99516 TYPE OF RESIDENCE Single-Family~ Multi-Family [] Other Number of Bedrooms 3 WATER SUPPLY Individual Well [~ Community [.-q Public E] 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 L~ Public [] Community ~ Holding Tank O Note: If corn munity well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025(11i84) ENGINEERING FIRM PROVIDI,. ~, INSPECTIONS, TESTS, FILE SEARCH, DA £A AND INFORMATION ~' As certified by my seal affixed bereto and as of the validation date shown below, I verify that my investigation,or 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 .~_/?'7/~ Date (;//~'J r/ Engineer's Seal DHEP APPROVAL Approved for Approved bedrooms by Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Flealth and Environmental Protection (DHEP) issues Health Authority ApprovaJ 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 DNEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsibJe for errors or omissions in the professional engineer's world. Page 2 of 2 72-025 (11/841 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 MUNICIPALITY OF ANCFIORAG2 DEPT. OF HEALTH & ENVIRONMENTAL PROTECT[ON 1986 264-4720 tegal Description: ;Lot- D R3~ S.H. Individual ~ .... ~B~te Completed r . Yield Depth of Grouting 0 Pump Set At 154 ' Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) If A, B, C, D.E.C. Approved (Y/N) N/A 300GPH Well Classification Well Log Present (Y/N) lq Total Depth 158 ' Cased to 158 Static Water Level _].00 ' Casing Height Above Ground ~, 5 ' Electrical Wiring in Conduit (Y/N) Yes Separation Distances from Well: To Septic/Holding 'rank on Lot '71 ' 100' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line 1000 ' + Cleanout/Manhole 1000~+ Water Sample Collected by B±ll Wilcox Water Sample Test Results Sat±sfaotory lO'gl ; On Adjoining Lots 89 ' To Nearest Public Sewer To Nearest Sewer Service Line on Lot 1000 ; Date 6-9-86 ( see attached ) Comments Location of adjoining lot's absorption field ambiguous ( no cleanout, depression only ) B. SEPTIC/HOLDING TANK DATA Date Installed ~~ Size T'00O Standpipes (Y/N) Yes Air-tight Caps (Y/N) Depression over Tank (Y/N) No Pumping/Maintenance Contract on File (Y/N) lq/.A_ N/A' Holding Tank High-Water Alarm (Y/N} Separation Distances from Septic/Holding Tank: To Water-Supply Well ? 1 ' To Property Line 66 ' To Water Main/Service Line N/A Course N/A Comments No. of Compartments ] Yes Foundation Cleanout (Y/N) No Date Last Pumped 5-3-86 ; for N/A Temporary Holding Tank Permit (Y/N) To Building Foundation _10 ' Garage To Disposal Field 5 ' To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(1 U84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 9-30-76 Width of Field 3 ~ 125 Square Feet of Absorption Area 400 Depression over Field (Y/N) ]No Results of Last Adequacy Test Satisfactory Separation Distance from Absorption Field: To Water-Supply Well ~'6'~ /~"~ ~ To Building Foundation 2] ~ C~a-ca~¢_ Lot N/A To Water Main/Service Line N/A To Stream/Pond/Lake/or Major Drainage Course Type of System Design Trench Length of Field 50 ' Depth of Field 9 ' Gravel Bed Thickness 4 ~ Standpipes Present (Y/N) Yes Date of Last Adequacy Test 6-6-86 To Property Line 25 ' To Existing or Abandoned System on ; On Adjoining Lots N/A To Cutbank (if present) N/A N/A To Driveway, Parking Area, or Vehicle Storage Area 20 ~ Comments Information on septic system from DHEC files D, LIFT STATION N/A Date Installed Size ia Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify thst I hav~¢ecked, verified, ~confo~ed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~/'d"~---"~/~' Company %//L(//~ ~_,~/LC~ MOA No. Receipt No. ~C~ Date of Payment Amount: $L-'z;*'~r: ' ~ ;;: Engineer's Seal Page 2 of 2 ,. P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 DEPARTMENT OF HEALTH & HUMAN SERVICES August 25, 1986 William L. Wilcox, P.E. Consulting Engineer 12221 Shenandoah Anchorage, Alaska 99516 Subject: T12N R3W Section 27 Lot 28 Waiver Request, WR86-084 Dear Mr. Wilcox: Your request for a waiver of the 100 foot well-to-septic system separation requirment has been granted. The separation distance between the septic tank and well on the subject lot has been waived to 71 feet. The separation distance between the well on the subject lot and the septic system on Lot 45 to the south has been waived to 89 feet. It should be noted that this separation distance was estimated from surface features on Lot 45 (namely an apparent depression over the drainfield) because there is no records of this system in this department's files. Information obtained about this septic system and its location was obtained from discussions with present and prior owners of Lot 45. Given the depth of the well and the nature of the soils indicated on the well log, a waiver of the 100 foot separation requirement is justified in this case. This waiver is valid for the existing situation only. Upgrades on any portion of the septic systems on Lot 28 or Lot 45 will require that they be brought into conformance with State and Municipal codes. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/lj William L. Wilcox, P.E. Consulting Engineer 12221 Shenandoah Anchorage, Alaska 99516 (907)345-7522 Dept. of Environmental Health Division of Environmental Health P.O. Box 6-650 Anchorage, Alaska 99502-0650 RE: Lot 28, Sec. 27, T12N, R3W, Well and Septic Inspection, waiver request August 8, 1986 MUNICIPALITY OF ANCHO~A(~ DEPT OF HEALTH & cNVIROF,M~N [AL PROI~CTION 'AUG 81986 Dear Sir: I appologize for the time lag from my last letter concerning this case. The owner of Lot 45 (to the south of the subject lot) was commercial fishing and I was unable to contact him until recently. He has confirmed that there is a septic tank installed for the septic system on his lot. I also spoke with the prior owner of Lot 28 in regard to the septic system on Lot 45, he also stated that he remembered a tank being installed with the septic system. I found a large metal object with a metal detector about 10' West of the standpipe shown on the site plan I previously transmitted to your office. In light of the aforementioned, I request a waiver be granted for the well/septic system distance. If you have any questions please feel free to contact me at 786-8415. Sincere-lY~, / ~ ' William L. WilcoX, P.E. William L. Wilcox, P.E. Consulting Engineer P.O. Box 111674 Anchorage, Alaska 99511 (907)786-8415 Dept. of Health and Environmental Protection Division of Environmental Health P.O. Box 6-650 Anchorage, Alaska 99502-0650 RE: Lot 28, Sec. 27, T12N, R3W, S.M. Well and Septic Inspection I?ECEIVED I am requesting a waiver on the required separation distance from the onsite well and septic system and the onsite well and the apparent septic system on Lot 45 (lot to the south of the subject lot). The distance from 71 feet and the distance Lot 45 is 89 feet. I am requesting the following reasons: the subject well to the septic system is from the subject well to the septic~on 100 foot separation to be waived for the 1. The subject well is 158 feet deep which exceeds the required separation. 2. The soils surrounding the septic system are of a silty nature which severly limits the bacteria spread as evidenced by the attached water analysis and the soil percolation test done in 1976 by GAAB. 3. The subject system has been utilized for 10 years with no apparant bacterial contamination. In the subject lot's file at DEH is a letter from Leroy C. Reid dated November 11, 1983 stating the system failed an adequacy test. The home has been occupied by a single person for the past 3 years. Mr. Reid and myself feel the system has rejuvenated itself enough to meet current standards as evidenced by the adequacy test performed by myself. If you have any questions feel free to contact me at 786-8415. Sincerely, William L. Wilcox, P.E. William L. Wilcox, P.E. Consulting Engineer P.O. Box 111674 Anchorage, Alaska 99511 786-8415 June 27, 1986 Dept of Environmental Health Division of Environmental Health P.O. Box 6-650 Anchorage, Alaska 99502-0650 RE: Lot 28, Sec 27, T12N, R3W, Well and Septic Inspection MUNICIPALITY OF ANCHOrC&G[~ DEPL OF HEALTH & ENVIRONMENTAL PROTECTION JUN 2 ? 198o RECEIVED Dear Sir: Attached to this letter is a site plan showing the locations of the subject well and the septic systems relative to each other and. near by structures. Things to note on'thls's~e' plan is the general surface slopes to the west at about a 2% slope. The location of the property line is approximate because no lot corners were found at this time. The owner found an undated well log which is also attached to this letter. The well log correlates with the measured depth of the well and tested well flows. Rampart Drilling Company, in a phone conversation verified the well was drilled in September of 1971. Front the well log there appears to be an impervious layer from 85' to 144' which would eliminate bacterial contamination from the septic systems to the well. When the septic system on the subject lot was upgraded in September, 1976, the required distance from the well to the septic system was 100 feet. This distance was measured by the GAAB inspector and found to be 100 feet. The well/septic seperation distances were approve in 1976 by GAAB. This request for a waiver should have been taken care of during the inspection of the 1976 upgrade. In light of the aforementioned site conditions I request a waiver be granted for the well/septic system distances. If you have any further questions please call me at 786-8415. william L. Wilcox,~P.E. / / \ \ ? / 0 ~o~ ~ 0 APPLI( NT FILLS OUT UPPER HA' ONLY Property Owner ,, .~) Legal Description LDO" ,~'d OF ~ ~cL ~-)~ T la N ~6~ LO ,5 i~ Dale Dale Date Dat MUNICIPALITY DY A~ ' ( ) APPROVED'BEgROOMS U -- 'CONDITIONS OF APPROVAL ( ~ DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE ~ ~ ~'% Soils Rating DAte ~wer Installed Well TO Absorption Area ~ Well Log Received October 20~ 19~2 c/o Cindy Lindman (l~21 /follYl DiRone & d791 I~usJnens Park Blvd. Anchorage, AR 9050~ Subject: Lot 28 off Doc 2'7, T].2N R3U, SU Approval for the individual sewer and water facilities cannel; he granted until t. ho {eli. owing items have! been 0 The water analysis report needs to be .qubmitted to th:).:; offics from the Chen't Lab, 5633 )3 fJtreet, for ¢)ur review. %,'{pose the we].], for our inspection to determine proper construction, also 'to inf~nre minimum distance requirelnen%s are met betwecell the we].l alld sewer system. The ~'$eI-~tJ.¢." tank pumped with a receipt submitted to this department, A four (4) inc}% cast iron eleanout needs to be J.~):~ta].led to the septic tank and/or leaching area. All adequacy test n~;ed~,~ [to bo. performed on the ex:i.s%inq leaching area. 'Phin test wi].l dx~t. er'mine if tho system is adequate accordinq ilo ]qatJona]. Stalldards, A l,i~;ting of private :~irltls performing 'hhe test is enclosed, This report. needs ire be sul)~aittod to this office flor our review, Pi_ease notifv this ]3F;part:.r<lent for a I?einspechion when the noted discrepancies have been corrected. )if there are any further questions, please call this offi. c(~ at 264-4720. Sincerely, Rol')eFt C. Pratt Associate ]~nvirontaenta]. Specia].i..qt ALASKA i dlBOI3Fll F1TAL COi3TROL SERulCSS, lilt. ~nqin~rinq $ ~nuironmcnl~l SIudics NOVEMBER 11 1983 LAND TITLE COMPANY/ATTN 101 EAST 9TH SUITE 3A ANCHORAGE AK 99501 PHYLLIS SELLER - WILLIAM HARVEY BUYER - SUBDIVISION - T12N R3W SECTION 27 BLOCK - 0 LOT - 28 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 1 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 102 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 3 BEDROOMS. 8EPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME IS UNKNOWN. 1200 [Uesl 33r~ Aucnu~, Suile B · Ancbro~¢, Al<~sko 99503 · (907) 276-1361 ~, f~ A~i~,_]REAT~/~NCHORAGE AREA BOROUGH ~.'~l II I~/~ L~/'wd~ Depart~e~q$/of Environmental Quality ~ ~3~0~'C" St~-~nchorage, Alaska 99503 274-4561 ,~ ~= ~ Date Received ~ugu~ 26t ~976 ~~~ ~1~ Time of Inspection ZO:O0~ ~ i ~-'~~ ~ '~' Da~e of Inspection ~3~ ~ FOR Buehho ~ z ], Approval ~equested by: ~,A. ReaZty Monday Tuesday Mailing Address: 3400 Mountain View Drive Phone: 279-2589 2. Property Owner: Lee Bates Phone: 344-5370 Mailing Address: Post Office Box 8370 3. Legal Description: T12N R3W Section 27 Lot 28 4. Location: Davis Street 5. Type of facility to be inspected Single Family No. of bedrooms 3 Well Data: ]individual A. Type _~ C. Construction ~ 7. Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: E. Disposal 8. Distances: A. EQ-034 _ B. Depth 127' D. Bacterial Analysis On-site system ~ ~ ~~/ 1. Size /~ _ 2. Manufacturer' ' ~'~/~"~ 1. Absorption Area 2. Material Field: Total length of lines ~ Well to: Septic tank ,.~Ot,~' , Absorption area /~9' , Sewer Lines Nearest lot line /'O~Z , Other contamination Foundation to septic tank~'~/6~ , Absorption area Absorptio/n area to nearest lot line Page 1 of two pages Page 2 of two pages - Re( st for Approval of Individual ~ Jr & Water Facilities Legal Description T12N R3W Section 27 Lot 28 Comments _ ~/~ ~-~.~ ~ - ~ Approve~ ~ ~-~9 .-~approved ~~ .~ Date Appr'~'ova] Valid for one year from date s~ed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM , po ~> ~'ue certify that the information contained in this request for approval~-4~a~-b~e~'~a t and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ;,, :: 2510 East Tudor Road, Anchora§a, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA 2. Property Owner: ~ ~:~: ~7/~- ~ Mailing Address: ~, El. /,'-~d'~ ~ '70 Day Phone: CONV 3. Name of Buyer: Mailing Address: 4. Name of Lending Institution'. Mailing Address: 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: Z-,/ Location: Day Phone:. Phone: 7. Type of Facility to be Inspected: No. Bdrms. ~ 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility ,Individual Individual (on-site) If Individual, date of installation /~)'~¢- 7 72-003(3/76)