HomeMy WebLinkAboutGREENLAND BLK 7 LT 9 MUNICIPALITY OF ANCHORAGE Health and Environmental Protectmo,~ Fourth Floor West 825 L street Anchorage, Alaska 99501 264-4720 ................. ,. .~ RN~ORT ON-SITE SEWAGE DISPOSA% IN~PECI~ON LOCATION ~D~--~:~--~'m ~ ~ O'(~L ~-- LEGAL DESCRIPTION SEPTIC TANK: ~X~%~ ~ ~ oISTANCE FP, OM W~t_U~O-k-- MANUFACTURER ........... % Cb'~ :;P ::; ~'alf %:ri:Ell'fi']'5. M.~,-1-E R I AL LI QU ID DEPT }~ ........ LI QU ia'~ C P~¥'~\'c~is~W'~ GALLOIqS. INSIDE WIDI'i; ..... _ iNqlOE MENGTit ..... _il i l TILE DRAIN FIELD: TOiI,A'L LE'NGI'HI ~:~ DISTANCE f ROM WELL ~O_~----FOUNDATION'-h~ .... NEAREST LOF - --- - ~ O~ ~i~es _~ ...... DisfANCE BEIWEEN LILIES ~9~lj~-&~E~TRENCt' wiDTHS- tBZ TOTAL [iF:NE,,ClIVE ABSORPTION AREA -~'~ ..... SQ, F-l, LENG[H OF EACI~ ~ ¢ DEPltl ()F FILTER t)EP~II: lOP OF NLE IO FtNISit ORADE~--MA]ERIAL BENEATH TILE ~ ~ IN. 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CONSUL riNg GEOLOGIST BOX 47(;-M, STAR ROUTE A o ANCHOF:~AGE, ALASIRA 99507 ~' PHONN 344-7071 SOILS LOG Performed for Date Soil Type 0 2 6 .r~ ~ 12 16 18 20 Water Level Remarks Total Depth of Excavation Groundwater Not Reached Depth, if Reached Classification Method ~ Visual ( ) Sieve Analysis () Material at Total Depth R Bedrock ~>~ Not Reached Depth, if Reached Gary F. Player, Consulting Geologist - ~"~ ' /~9A ,, . ,- GR iER ANCHORAGE AREA BOROU H , ,./~f ..r ' ~' ~.¢,~ 327 EAGLE ST ANCHORAGE, ALASKA 99501 279 2511 /'~?~ ,, ,NSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME SEPTIC TANK: _ADDRESS. __ . PHONE DISTANCE FROM WELL L,QU,D CAP^ClTY ( ' GALLO.S. MATERIAL INSIDE LENGTH NUMBER OF INSIDE WIDTH ~'~ /'DEpTHLIC)UID SEEPAGE SYSTEM: SEEPAGE PIT: NEAREST LOT LINE OR WIDTH / DISTANCE FROM WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH_ , DEPTH BUILDING EOUNDATION SC). FT. TILE DRAIN FIELD: DISTANCE FROM WELl NUMBER OF LINES ABSORPTION AREA FOUNDATION _DISTANCE BETWEEN LINES SQ. FT. LENGTH GE EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE , NEAREST LOT LINE TOTAL LENGTH OF LINES TRENCH WIDTH IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROM WATER WELL: TYPE , DEPTH , BUILDING FOUNDATION SAMPLE NEAREST SEPTIC SEEPAGE LOT LINE ., SEWER LINE_ , TANK , SYSTEM , CESSPOOt DIAGRAM OF SYSTEM DISTANCES: e ~LI. , NEAREST OTEIER , SOURCES DATE APPROVED HEALTH AUTHORITY MUNICIPALITY OF ANCHORAGE L),'<PAI1TMEI',FF OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CEFt FIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GEI'qERAt. II'q FOR MAI'IO N (a) Legal L)escription (include lot, block, subdivision, seotion, township, range) Location (address or direotions)  ..... Telephone: Home '~ I'1/~ ' -,~'(¢ ~ Business ~ ~"~/¢ Applicant Address /!/~ I?//__ E//'.'~'T/?/ (c) Applicant is (check one): Lending Institution []; Owner,~ulNlef~; Buyer []; Other [] (explain); (d) Lending Institution __/~1~ ~,,1/.,,l:y~la4,,~ B~l~kelephone Addless (e) Real Estate Company and Agent Addr e.ss /xl 0 I, LE Telephone (f) Mail the 14AA to the following address: TYPE OF RESIDENCE Single-Farnily~?~, Multi-Family NL.m~ber of Bedrooms ~ Other W A '~, ".z. I:! SUPPLY Individual Well~/~ Community [] Public [] Note: Il community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL OnsiteX' Public [-"'] Community E] Holding -['ank [] Not/Il community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 z2-025 {~;,K..',I~[£~?IH.C-- FUt~.I PROVlFJ!NG 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 App~ oval 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 fudher verify that based on the information obtained hem 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 Ibis inspection. Name el [-irm ~_~_~ ~~' ~ Telephone ~'~ ¢- ~ ff/~ Engineer's Seal A p p, o v e O f o r'-~ .~//-~_~'¢~\/' bedrooms by ,~ AI)prox ed ___~__ ..... 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 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 8nalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's wo~k. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR g i 19,86 WELL DATA Well Classification '"~ '~---- -'~ Well Log Present (Y/N) _ Total Depth _~il~""~.>'~t · Cased to Static Water Level -~ ~ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ~:~ ~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line I~_ Cleanout/Manhole /~ O N L~, Water Sample Collected by Water Sample Test Results Comments If A, B, C, D.E.C. Approved (Y/N) 1~/~ Date Completed = "~".'"'~...- i'~1~¢~I' Yield ' 7 ~ ~7 Depth of Grouting I~[ ~ 'M ~ Pump Set At _ ~O-t"'~¢~ J ~:~ Sanitary Seal on Casing (Y/N) ~' Depression Around Wellhead (Y/N) ; On Adjoining Lots _ On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ;Date B. SEPTIC/HOLDING TANK DATA To Water-Supply Well To Property Line To Water Main/Service Line Course Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) _ Separation Distances from Septic/Holding Tank: Size I ~ No. of Compartments L.) Air-tight Caps (Y/N) _ ~" Foundation Cleanout (Y/N) Date Last Pumped "~//.%t Iv'/'~ ; f0 r ~/A _ Temporary Holding Tank Permit (Y/N) To Building Foundation'"~ To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date installed O 6,"¢' Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well J ~ To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) l-4 o NL . D. LIFT STATION Date Installed Size in 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 that I have checked, yerifieCCor conformed to allJvlOA and HAA guidelines in effect on the date of this inspection. Signed '"~ ~.~t~ Date Company ~ MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal 203 W. 15tl~ AVE "C" SUITE 203 ANCI4ORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOT 9, BLOCK 7 GREENLAND LOCATION: 4641 E ll3TH OWNER: JIM KI RKINDALL RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WATER SYSTEM: ON SITE WELL SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: 1000GAL+ UNKNOWN TYPE ABSORPTION SYSTEM: 'FRENCH ABSORPTION AREA: 490 SQ. FT SOIL RATING: 85 INSTALLATION DATE: TANK: PRE 1969 ABSORPTION 1977 DATE OF PUMPING: MARCH 21, 1986 DATE OF TEST: MARCH 19, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK HAS ONE STANDPIPE. TANK IS BURIED 4 . 5 FEET. LIQUID DEPTH IS 56 INCHES. TRENCH HAS 6.5FEET OF COVER. CLEAN OUT WAS DRY. SUMP IS 11 FEET DEEP. LIQUID DEPTH 20 INCHES. WATER WAS ADDED TO THE TRENCH AT A CONSTANT RATE OF 4 GALLONS PER MINUTE. THE LIQUID LEVELS IN TANK AND SUMP WERE MONITORED. AFTER ADDING 250 GALLONS THE WATER LEVEL IN THE SUMP HAD INCREASED5 INCHES. THE LEVEL IN THE TANK HAD NOT CHANGED FROM 56 INCHES. THE INFILTRATION RATE WAS MONITORED FOR 45 MINUTES. THE INFII, TRATION RATE WAS MEASURE[) TO BE 66 GALLONS PER HOUR. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. 203W 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279 3916 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: LOT 9, BLOCK 7, GREENLAND 4641 E ll3TH AVENUE JIM KIRKINDALL TYPE OF WELL: WELL LOG AVAILABLE: SINGLE FAMILY NO INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELl, LOG: PUMP YIELD: 4 GPM WITH 2 FEET DRAWDOWN DATE OF INSPECTION: MARCH 20, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 4 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED° STATIC WATER LEVEL WAS FOUND 54 FEET BELOW TOP OF CASING. AFTER ONE HOUR OF PUMPING THE WATER LEVEL HAD STABILIZED AT 56 FEET. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA MARCH ].0, 19860 TEST WAS N'' ~EGAPIVE. TEST RESULT: ON THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 1150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land ~se and other factors that may impact the conditions of the aquifer feeding the well. MUNICIPALITY OF ANCHORAGE !:O:':.;...,'. ,.:.~, , , . :, --  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION t825 L Street-Anchorage, Alaska 99501 ~ ; /, . , -i' ,-~ ENVIRONMENTAL ENGINEERING DIVISION i ...... -- r L -- Telephone204-4720 i'-'-! : ! } ~, . REQUEST FOR APPROVAL OF INDIVIDUAl.. WATER AND SEWER FACILITIFS DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (101 days for processing. -' PHONE "P"OPS"TYOWNE" 'b AI$.0 P C/iH Y' MAILING ADDRESS " ,2X_ trom/TZ /-- S E-A. AHC ,oN 9¢e7. PROPER'FY RESIDENT (If'-clifj~rent above) ' ' ' ~;c17~ ~ ~LOC/C '~' ("2~£.~l!!N~_.~.Nb 2. BUYER · PHONE MAILING ADDRESS - 3, LENDING INSTITUTION I PHONE MAILING ADDRESS 4, REALTOR/AGENT ~_ PHONE MAI LING ADDR ESS LEGAL DESCRIPTION STREET LOCATI ON 6, 'rYPE OF: RESIDENCE NUMBER OF BEDROOMS ;~ SINGLE FAMILY [] One [] Four E] Two [] Five [] MULTIPLE FAMILY ,~ Three [] Six 7', WATER SUPPLY [] Other INDIVIDUAL* 7'0 FT. [] COMMUNITY [] PUBLIC UTIL TY B, SEWAGE DISPOSAL SYSTEM ATTACH WELL LOG, A well Icg is required for all wells drilled s~nce June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) ~ INDIVIDUAL/ON-SITI:-** [] PUBLIC UTILITY **If individual/on-site, give installation date. ~"~O~,~"~. 1¢77 If system is over two (2) years old an adequacy test is required by this Department. NOTE; THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING (;AN BE INITIATED. 72-0t0{3/78) THIS SIDE FOR OFFICIAL USE ONL, ----- DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE -- DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED .... PERMIT NUMBER 3. SEWAGE DISPOSAL SYSTEM [] I NDIVI DUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: _~ ~-O If Tank is homemade SOl LS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL-- ~-"'~ ~1~/1....O~q,..~ .~' 4, DISTANCESwELL TO: Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS E~--~APPROVED FOR ~.~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) / / LEGAL DESCRIPTION 72-010 (Rev. 3/78) Time ime Ti, Date ~ __ Ins'pector Comments Date Inspector D;~te inspector Conditional ADproval Date Sewer Installed Permit No. Septic Tank Size Soils Rating Well To Absorotion Ares Wall Log Received Well to Tank Property Owner Mailing Address Buyer APPLICANT FILLS OUT LOWER HALF ONLY J~hone Address Lending Institution Phone Address Realty Co. & Agent Phone Address Legal Description Street Location Type~;(f Residence ETSingle Family E~ Multiple Family [] Other Water,Supply £~' Individual El Community L-] Public Utility_ Sewa~ Disposal ,r_~' Individual L-] Public Utility El Holding_Tank ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drillea prior to tl~at date. g~ve well depth (attach Icg if available.) Year IndlvMual Installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. )},')¼;',?'i'. (i. 'F))";~ :'1-. CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 May 26, 1982 LarryHardesty Century 21, Heritage Homes 207 E. Northern Lights Blvd. Anchorage, A/~ 99503 SEWER ADEQUACY TEST t ~T C": .... HOMAGE [' ECEIVfi'D LE~: LOCATION: RESIDENCE: WATER: SEWER SYSTS~4: DATE OF TEST: TEST PROCEDURE: Lot 9, BK 7, Greenland Subdivision. On E. ll6th off Libscomb, off O'Malley. Three bedroom single family. On-site well. From Municipal records Tank-steel-1250 gal. One compartment ? Absorption System: 70 f-h. trench, 3 ft. of rock. Total absorption area: 420 sq. ft. Soil rating: 85 System Upgrade: Oct. 1977 May 24, 1982. System was inspected ~y 24, 1981. Tank is 9 feet below ground, liquid depth 56-inches. Liquid very black. C.O. was dry. Sump is 12 feet deep, with 10-1/2-inch of liquid. Water was added to the cleanout at a rate of 6 gal. per minute. The following readings were taken of the liquid depth in ~he sump and tank: Tobben Spurkland P.E. larry Hardesty May 26, 1982 Page 2 Tinm Water Volume Depth Sump_ Depth Tank 0 0 10-1/2 10 60 11 20 120 11-1/4 30 180 13-1/2 40 240 17 50 300 21 60 360 22 70 420 22-3/4 80 480 22-3/4 TEST RESULT: 56 56 56 Check 24 hours later after tank had been pumped 11 inches. 9~is system consists of a rockfilled trench 3.5 feet deep. (42 inches) 1/4 of this depth (10.5 h]ches) has developed a biomat and partially plugged the soil. The present absorption rate is 450 gal. per 24 hours, which is the n~nimum rate for a three bedroom house. Assuming a linear decrease in the operation of the system, this system should give satisfactory service for another 10-15 years. ~is system meets the municipal requir~nents. IIi: Time Date Insp DEPARTME, 825 MUNICIPALITY OF ANCHORAGE qf~'Y'~[ ~L~ -- OF HEALTH AND ENVIRONMEN', PROTECTION L Street~ Anchorage, A].aska 9950] ..... 279-2511, ext. 22~ or 225 Date Received: April 15, 1977 9:30 a.m. #2: Time Ii3: Time 4-18-77 Monday Date Date Pratt Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILI[__ES' ' ' ' 1'[ I 1. Lending Institution Request: First Federal Savings/Loan Association Mailing Address: Box 4-2200 99509 % Freida Padget~bone: 274-6561/218 2. Property Owner: Edward Mulcahy Mailing Address: Star Route A Box 1721-D 99507 Phone: 344-3411 h 3. Legal Description: Lot 9 Block 7 Greenland Subdivision 4: Single Family Residence: (x) Number of Bedrooms: 3 Multiple amz.l.y Residence: ) N~ber of Bedrooms: Well System: Public/Conununit5 ffl~tem: ( ) Individual Well: (x) Permi~ Permit In sta 1 led Installer Septic Tank Size Manufacturez Absorption Area Soils Rate Material Distances: Well to Septic Tank to Sewer LJ. ne Nearest Lot line to Nearest Lot Line to Absorption Area Absorption Area MUNICIPALITY OF ANCHORAGE ~AUNI( 'ALII DEPARYMENTOF HEALTH AND ENVIRONMENTAL PROTECTION. i V' ~Nt,~ ;~ SE.root, Ancho]:age, Alaska 995011 279-2511, ext, 224 225 · ')' REQUEST FO~ APPROVAL OF 1. 'Type of Inspection: V * X A ............ FHA .............. (.ONV. ~ Edward P and Rena S Hulcahy 2. Property uwner: ........... '_ .......... ~ ........................................... Mailing Address:___SPA Box 1721-]} Day Phone:_ 344-3411 3. Name of Buyer: NA Mailing Address: Day Phone:__ Name of [.ending nst tut o ~:_ .F~.._~_S__T_?:~:?AL SAVlN~G.S~L_LO_A~_~A__S_S_OC_I_ATI~O_N ............... P.O. BOX 4-2200 99509 274=6561 Mailing Address: ................................. P ~one: r · 110110 5.Name of Realtor or Ajent Mailing Address: Phone: ..................... 6. Legal Description: ..... I_f~_t._.9 ,~Bl.ock~7 L._G_r_e_e!~_la~_n.d- S~/?_ ........................................ Location:.. 7. Type of Facility to be Inspected: ...... S~i_n_g. le fam, i].~ ............. No, Bdrrns. 3 8. Water Supply Type of Supply: Public Utility ............... Individual If Individual, number of dwellings presently served If Individual, depth of well 72' 9. Sewage Disposal System Type of System: Public Utility. 72-003(3/76) Individual (on-site) X If Individual, date of installation 1964 This request is fo}" a water pu'ri£ication test. Co]talent if absorption does not appear adequate on sewer system because of surface moisture. Also, a dete~dnation of p~oper distance ~equi~ements. An adequacy certification is not ~equested. IqUNICIPAI. ITY OF ANCHOttAGE DEPARTMENT OF HEAI_.TH AND ENVIRONMENTAL PROTECTION 825 !, ~;Lr-t2et , Anchoraq(~, Al~ska 99501. 279-.2513., ext. 224, 225 REOUEST FOR APPflOVAL OF INDfVIDUALSEWEHandWATER FACILITIES 1. 'Type of Inspection: VA ....... FHA .............. CONV X 2. Property Owner: .......................................... - ,, SRA Box 1721-D Mailin9A(mress: ....... 2 ...................... Day Phone: 544-5411 3. Narne of Buyer: NA ................................... M3il[ng Address: ...................................... Day Phone: ...................... 4. Na~ne of [_ending Institution: FIRST FIBDE]~I, SAVINGS ~ LOAN ASSOCIATION Mailing Address: P_jO. BOX 4-2200 99509 Phone: 274=6561 5. Nsfllr) of Realtor or Agent: llOIlC Mailing Address: ............................. Phone: 6. [_(~qa! [Description:.. I.ot 9, B]ock 7~ (;roonlal/d S/I} Location: 7. 'lype el F~milit¥ Io I)e In peeled .... Singl(2._l'alni_l_)- ............. No. Bdrms.._3 8. Water Suppl// Type of Supply: Public UtiliW. ..................... Individual ........ X If Indivichml, rlurnber of dwellings presently served (lie_ If Individual, clepth of ,,veil ....... 72r .......... Sewage Disposal System Type of System: t tml~c Utility ................. Individual (on-sito) X If Ind v dLal, date of installation 1964 This ]'('quest is FoP (1 l,r~]~O]' p[ll'i [:lear ion test. Comment :i:f absorption, does not apl)ear mi:.'ciu;~te on sewer s)'$!em because of surface mo istttre. Also, a determination of proper dislance requirements. An adequacy certJt'Jcation 2s not requested. Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 9 Block 7 Greenland Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Appro~. k D~ .~ Deparkmon~ ~orkshee~: April 22, 1977 .... ~r. Edward Mu'l.cahy Star Route A Box 1721-D Anchorage, Alaska 99507 Subject: Lot 9 Block 7 Greenland The water analysis for the subject property is sat'|.sfactoryo The distance requirement between well and sewor system is o.ko There ~as no overflowing sewage presont o This is not a full comprehensive approw%l of tile subject property, ~F If there are~any questions, Dleaee contact this or.:ice at 279~25.l.].,-exte~'~ion 224 o~ 225. Sincerely RoLezt C. Pratt~ R.S. oanitar lall RCO/ljh