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HomeMy WebLinkAboutSUMMIT ESTATES BLK 1 LT 1pmcm 1-5 yrs Municipality of Anchorage Community Development Department Page 1 of 2 On -Site Water and Wastewater Program 4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite - (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161208 PID Number: 015-072-19 New Upgrade VIRGIL HOOE ABSORPTION FIELD Deep Trench R Shallow Trench R Bed Mound Address 9650 BIRCH ROAD Z Other Phone Number of Bedrooms Soil Rating Total depth from original grade LEGAL DESCRIPTION Depth to pipe invert from original grade 8.0 Ft. Gravel depth beneath pipe 4-0FL Subdivision Block Lot SUMMIT ESTATES I I Fill added above original grade 0.0 Ft, Gravel length 2@37.5 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Fielc Tank Line 750 Ft2 2 10.0 Ft. Well N/A 91.4* N/A N/A TANK El Septic S.T.E.P. 171 Holding 171 Other Manufacturer Capacity I Surface Water N/A 100+ N/A N/A Gal. Material Number of compartments Lot Line N/A 10.0 N/A NA Foundation N/A 18.0 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain N/A 50+ N/A N/A Gal. Remarks *WAIVER FOR 90'OSV1 61084 Pump on level at Pump off level at High water alarm at Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank Tankto drainfield 3034 ISAAC'S Drainfield 3034 COIMT 3034 Inspector PANNONE ENGINEERING SERVICES BENCH MARK (Assumed elevation) 100.0 ft Inspection Location and description 3"' 11/7/18 4 NE BOTTOM HOUSE TRIM COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date CE 814 Approved IV aw , IM, DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM \ \ NO, BEDROOM: 6(900gpd) \ TANK SIZE: 225Dg (E) \ � PERCRATE: 1.8 MPI / ... —.~. 1.2 GPD /SF � ' AREA RQD: 750 SF 00 SYS. TYPE: WIDE TRENCH 4.0'ED MIN LENGTH. 75 LF INSTALLED DRAIN FIELD U S -E- Q- W/ CLEAN OUT AND MONITOR TOTAL AREA: 750 SF I I INSI[ALLED FLQW SPUTTER 107.0 RE—USE AS RESERVE C3 INSTALLED DIVERTER VALVE EXISTING \ \ ` 6 BR En - DRIVEWAY WELL (E) a DATE PERFORVED: 0613012016 NOTES: PANNONE ENG SVC, LLC Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 12/7/18 Scale PHONE (907) 272-8218 FAX (907) 272-8211 DRAWN BY: CE 8149 9650 BIRCH ROAD 0'. or PLAN ANCHORAGE, AK 99507 Sheet DV 49.2 24.3 FS 159 61.0 C1 19.6 60.8 mi 23.1 63,5 C2 52.4 77.5 M2 51.9 78.6 C3 32.1 75.9 M3 35.2 C4 575 89.3 M4 57.2 89,B \ \ ` 6 BR En - DRIVEWAY WELL (E) a DATE PERFORVED: 0613012016 NOTES: PANNONE ENG SVC, LLC Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 12/7/18 Scale PHONE (907) 272-8218 FAX (907) 272-8211 DRAWN BY: CE 8149 9650 BIRCH ROAD 0'. or PLAN ANCHORAGE, AK 99507 Sheet On -Site Wastewater Disposal System Permit Permit Number: OSP161208 Tax Code Number: 01507219000 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 lleparttriint Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Work Type: Septic Upgrade Permit Effective Dates: September 06, 2016 to September 06, 2017 Design Engineer: Pannone Subdivision: SUMMIT ESTATES Site Legal Address: SUMMIT ESTATES BLK 1 LT 1 G:2437 Owner/Address: HOOE VIRGIL D LIVING TRUST 9650 BIRCH RD ANCHORAGE AK 995076631 Site Mailing Address: 9650 BIRCH RD, Anchorage Lot Size in Sq Ft: 16200 Total Bedrooms: 6 This permit is for the construction of: Y Disposal Field N 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. Issued By: OV�i�-- Date: Municipality of Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 a Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV161084 COSA#: Permit#:OSP161208 PID#: 015-072-19 Legal Description: Summit Estates Blk 1 Lt 1 Engineer: Pannone Engineering Services Applicant: Virgil Hooe Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the private well has been approved. The approved separation distance is 90.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: 1a f� Approved by: Name of Reviewe .......................................................... .................. **** VARIANCEMAIVER REVIEW **** Summit Estates Block1 Lot 1 Parcel ID: 015-072-19 Waiver from proposed field to well on Lot 1 8/26/2016 General See the engineers waiver request for mitigating factors. ADEC Criteria Water Table Depth to water bearing layer Depth of tank Soil Sorption Soil descriptions Points 46 feet 12 feet 34 feet 4.4 2.9 Permeability Soil descriptions DEC PTS Depth From Depth To Thickness Calc. Pts Sand, Clay & gravel 3.5 12 40 28 1.92 clay 6 40 43 3 0.35 hardpan 3.5 43 46 3 0.21 sand 1.5 46 58 12 0.35 sand and gravel 0.8 58 63 5 0.08 0 0.00 0 0.00 51 2.91 2.9 Permeability Soil descriptions 1.0 Water Table Gradient - Not calculated XX Horizontal Separation 90 2.6 Total Points 10.9 As per ADEC waiver guidelines, with a minimum point value of 10.9, contamination is unlikely from bacteria but could be possible from chemicals or virus. If the well was redrilled to meet the 100' separation, the points calculation would be withing the same points interval, therefore waiver approved. DEC PTS Depth From Depth To Thickness Calc. Pts Sand, Clay & gravel 0.8 12 40 28 0.44 clay 0 40 43 3 0.00 hardpan 2 43 46 3 0.12 sand 1.5 46 58 12 0.35 sand and gravel 1 58 63 5 0.10 0 0.00 0 0.00 51 1.01 1.0 Water Table Gradient - Not calculated XX Horizontal Separation 90 2.6 Total Points 10.9 As per ADEC waiver guidelines, with a minimum point value of 10.9, contamination is unlikely from bacteria but could be possible from chemicals or virus. If the well was redrilled to meet the 100' separation, the points calculation would be withing the same points interval, therefore waiver approved. MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE o 9 C JUI_ ? 2�)IS IK" Phone: 907 -343 - Fax: 907 -343 - ON -SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-072-19 Property owner(s) Virgil Hooe Mailing address 9650 Birch Road, Site address 9650 Birch Road AK 99507 Day phone Legal description (Sub'd., Block & Lot) Summit Estates, Block 1, Lot 1 Legal description (Township, Range & Section) Lot Size 16,200 Sq. Ft. Number of Bedrooms 6 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑ ADU) Septic Tank 11Upgrade FX(w/wo (D) ❑X Holding Tank ❑ Renewal F-1Duplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Drain field to well Distance: 90' 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 Permit/Rush Fees: da Date of Payment:rZ��G 1b Receipt Number: u4Lt s%, Permit No. 0,861 ZD F Permit App_::-: t:.._c Waiver FeesV/ Zr Date of Payment: 26�� Receipt Number: its, Waiver No. OS fi/6 /D �y Pannone Engineering ServiceS LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panenRak.com 1 September 2016 Subject: Summit Estates, Block 1, Lot 1 Septic Upgrade Permit Request Design Narrative This is a design narrative for a permit to install an upgrade absorption field to be issued for this property. The existing drain field is in failure and will be re -used as a reserve. This lot and the surrounding lots are served by private wells. The private well for this property is within 100' of the proposed absorption field. Due to the size of the lot and the location of the existing well no other options are available. There are no other wells within 100' of the system. 1. Upgrade Tank Design. a. See Sheet 1 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed upgrade system. The upgrade will maintain at least 100 feetfrom all surface water and drainage ditches. 3. Topography: The existing topography in the area of the system is generally level in the area surrounding the proposed field. The field is located at the crest of a low hill and the greater area slopes away. There are no steep slopes within 50' of the proposed field. 4. Waiver: We would like to request a waiver for separation distance for the existing septic system to the well located on the lot. a. Drain Field (P) to Well (E): A separation distance waiver between existing well on Lot 1 to the proposed drain field also on the same lot. The distance between the proposed drain field and the well is 94'±. We are requesting a waiver for the drain field to the existing well for a distance of 90' on Lot 1. i. DEC Criteria: The well on Lot 1 is a private well with a depth of 63 feet and a static water level of 28.5 feet The well data for this lot and Lot 2 to the west is summarized as follows: LOT # WELL STATIC YIELD Well Data H2O Test Soil Well Nitrate DEPTH WATER Date Date Characteristics Log Level LEVEL Data Summit Est 81 Ll 63' 28.5' 15 gpm 05/25/1976 NA Y y unk Summit Est Bl L2 80' 30 8 gpm 08/29/1990 06/17/1991 Y y 2.1 The ground water in this area typically flows from the east to the west as seen by the depths of the above listed wells and others in the area. The soil cross-sections are similar across the area and a homogenous cross-section was used to calculate the DEC criteria for all components. As outlined under 18 AAC 80.020 and 18 AAC 72.021(a), I have calculated the following points: Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 SummitEstdtes'81, L1SeoticSvstern to Well Distance from sewer system bottom to groundwater 3.0 Soil sorption below sewage system 4.5 Soil permeability below the system 3.0 Water table gradient 0.7 Horizontal separation 2_4 Total Points 13.6 "The sum of the above values could equate to the following conditions: 12-16 No bacteriological pollution possible butchemical pollution possible but unlikely from household chemicals." In my opinion, this waiver request meets the above criteria for approval and does not constitute risk to health. I hope the above information will assist you in determining that the waiver should be granted. The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 N' .w \ DESIGN PARAMETERS AB PRIMARY SEPTIC SYSTEM NO. BEDROOM: 6 (900 gee)TH TANK SIZE: 2250g (E) v EA PERC RATE: 1.8 MPI A \ FCO SOIL RATING: 1.2 GPD/SF T# AREA ROD: 750 SF ! C# I, - SYS. TYPE: WIDE TRENCH 4.0'ED M# RR 0.50 / ! R I MIN LENGTH. 75 LF WELL (E) ....USE: iDCO - - DV `` FS (2EA) 37.5LFx5'Wx4.0' E.D., 12.0' TD _ (E) TOTAL AREA: 750 SF —°"'' \� UPGRADE DRAIN FIELD (P) (P) \ \ .(SEA) 37.5LF x 5'W x 4.0'ED-x 12.0'TD I TYP WITH MONITOR TUBE AND - CLEAN OUT AT EACH END \ S; EXISTING I SEPTIC AREA. 107.0 I_ ' ( DRAIN FIELD (E) IN FAILURE FLOW SPLITTER �( 1 RE–USE AS RESERVE (P) — DIVERTED VALVE (P) lol uTlurl EASEN4; I EXISTING -- �� \ -qA __' SEPTIC AREA I _ _41 SS o o, c I DUPLEX LOT 1'_° I s _Z7E> WELL (E) � DRIVEWAY WELL (E) > E 97TH AVENUE 11 j W j TEST HOLE EACH FOUNDATION CLEAN OUT TANK CLEAN OUT NO. CLEAN OUT N0. MONITOR TUBE N0. RIGID INSULATION DOUBLE CLEAN OUT DIVEPTER VALVE FLOW SPLITTER EXISTING PROPOSED' TVi i I I/ �I I i li i 3 T A LEGEND ✓ WATER LINE/ WELL RADIUS SS NEIN SEPTIC NOTES: PANNONE ENG SVC LLC kki Date , FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 (� Cq tk � 9/1/2016 PHONE (907) 272-8218 FAX (907) 272-8211 %g�P �y�' Scale DP,AWN BY: *; Q �•�I"=5C' DRM ""' P.I.D. NO SUMMIT ESTATES, BLOCK 1. LOT 1 ....... .... .. .... 015-072-19 VIRGIL HOOE Steven R. onnone / PERMIT NO. 9650 BIRCH ROAD ���PF' CE 8149 .Yve- OSP161208 c. PLAN ANCHORAGE, AK 99507 �kI X,, ... ...'..�*`�� Sheet __ %���� - 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1 . ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 2, SCOPE OF WORK. INSTALL NEW SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 18 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 4, THE CONTRACTOR. SHALL NOTIFY THE ENGINEER ON HOW TO PROCEED SHOULD ANY OF THE EXISTING ABANDONED DRAINFIELDS ON THE PROPERTY ARE ENCOUNTERED DURING EXCAVATION. 5. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) HAD THE WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 6, THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIP.ED PERMITS, OTHER THAN THE ATTACHED. 7. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 8. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES WERE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 9, THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/Ll DILATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 10- AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 11. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 12. THE CONTRACTOR SHALL PROVIDE DATA (UPON WHICH THE RECORD DRAWING WILL BE BASED) THAT REPRESENTS THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 13, THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR. BY: . TITLE: DA NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 DRAWN BY: DEM SUMMIT ESTATES, BLOCK 1, LOT 1 VIRGIL HOOE 9650 BIRCH ROAD DESIGN DETAILS ANCHORAGE, AK 99507 8149 Date 9/1/2016 NTS P.I.D. NO -015-072-19 'ERMIT N0. OSP161208 Sheet 3 OF 3 SOILS LOG - PERCOLATION TEST SLOPE ` I I til ) X TH WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? ------ DEPTH TO WATER AFTER MONITORING? -DRY- DATE: 07/15/2016 / SITE PLAN �M M TH-1 6 BR DUPLEX LOT (E; DRI`JEWAY SLOPE TH X READING DATE TEST HOLE 1 NETTIME WATER LEVEL READING OR/ ORGANICS 1 --- FILL AND FILL 2 1:55 10 MIN 10.65 5.59 3 3 --- GM SILTY GRAVEL 4 4 10 MIN 10.69 5.63 — 2:05 5 1 5.06 --- 6 — 6 I 10.67 5.61 — 7 8 WELL GRADED GW/ SANDAND 9 SW GRAVEL 10 11 12 13 14 15 16 17 18 BOH DATE PERFORMED: 06/30/2016 SOILS LOG - PERCOLATION TEST SLOPE ` I I til ) X TH WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? ------ DEPTH TO WATER AFTER MONITORING? -DRY- DATE: 07/15/2016 / SITE PLAN �M M TH-1 6 BR DUPLEX LOT (E; DRI`JEWAY SLOPE TH X READING DATE CLOCK TIME NETTIME WATER LEVEL READING NET DROP 1 6/30/2016 1:45 --- 5.06 --- 2 1:55 10 MIN 10.65 5.59 3 1:55 --- 5.06 --- 4 2:05 10 MIN 10.69 5.63 s 2:05 --- 1 5.06 --- 6 2:15 10 MIN I 10.67 5.61 SOIL TEST RESULTS/ANALYSIS • PERCOLATION RATE 1.8 (min/inch) • PERC HOLE DIAMETER 6" • TEST RUN BETWEEN 4.5 FT AND 5.5 FT. • TEST RUN FOR OVER AN HOUR, LAST THREE READINGS PROVIDED. COMMENTS: Test hole excavated by ISAACS EXCAVATING SERVICE. Test Hole was presoaked before Perc test. PERFORMED BY: DAN MORAN. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLI NES IN EFFECT ON THE DATE OF THIS TEST. NOTES: FOR CONSTRUCTION DRAWN BY. DRM SOILS LOG PANNONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SUMMIT ESTATES, BLOCK 1, LOT VIRGIL HOOK 96.50 BIRCH ROAD ANCHORAGE, AK 99507 1112�\ Date OF, qC., kt 9/1/2C1 6 =Scale TH * �� N TS P.I.D. NO 015-072-19 n onnone PERMIT N0. CE 11149 �� OSP161208 Sh2eOF 3 W W LLL "MLLtI\V ? 1305 W. 45TH STREET --'C ANCHORAGE. ALASKA 99503 h1 PHONE 272-9343 �• U 'P> 12 ��.,m� 3`f `I-2 `1�3 /� 3 2- i 3 - 3 - 3 z �''J , /98G Ou�a:j f%rcr DRILLING LOG Well Owner L o[ Use of Well Location (address of: Township, Range, Section, if known; or distance main road Sy�ii» >L ESrta �Ls L/ .0/ (c f { Size of casing �V Depth of -Hole -,-10 Cased to feet Static water level _ft. (above) (below land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforatio* Well pumping test at 15 per (hour) inute for--2L--hours with ft. of drawdown from static level. Date of completion :IS u42w W-1 G WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO —4 d TOLL TO 3 _ ��trF! TO�g_ TO TO s TO TO TO TO TO� TO ze 6r 0 <` O I I •• I W Q CJ M O a \ o I o l0 O O x M \ o U M dl O N O O Q W W.. .. .. Q I W W E-A I 0 9 W Q a I M I � Q \ \ O W k -o 0 C7 0 0 \ \ o CD x o 0 U O I I I I � I I I O O o I I I I I I I 00 CD 0-) x I I I I I I I N m m E� W I I � oo a �> a I W E a a I M � I I d{ Ei W I I Q I I 1 �I O O I I I I rz o O a I .. E N H U) -- E+ I W flA U) L` 00 00 E-A O W rI W I E� I I ��Q4j DL, N C7 �n w E -i x H fes' I fZ w O I PQ E-A o r Ln O Q Q0 (1] I 6l O w FTI I E+ �I H o � I U) � I •• W I � I M U I � k I I Q0 0-) I I I x Ln O I [ 0-1 O w of O �q I I � I N rl I H I I � N W L` I O ILn P �i I H x CD I C7 O W W I Ox o Ln � N i O 1-0U a M I x rn 0 <` O I I •• I W Q CJ M O a \ o I o l0 O O x M \ o U M dl O N O O Q W W.. .. .. Q I W W E-A I 0 9 W Q a I M I � Q \ \ O W k -o 0 C7 0 0 \ \ o CD x o 0 U O O I I I � I I I O O o O I 00 N 0-) H W N m m E� a � oo a �> I rl W E a M x d{ Ei W I I N N 1 �I O O O I rz o O a I .. E N N �n E� Ln N N flA U) L` 00 00 O W rI Q W E� I I ��Q4j DL, N C7 �n I O I I I � I I I O �J o O I m 0-) 0-) H W m m m E� a Q oo a �> W E x I W I I W I I I I I 1 O O O O I o O O I co N N a E� Ln N N flA E� L` 00 00 O r1 rI i E� I I I O O O O �J o O o m 0-) 0-) rn rn m m m rn Q oo Ln Ln u-) Ln W I I I O O o O I O O O W E� Ln N N flA a I I N M M m 0 0 N 00 M Ln Ln Ln Ln 0-11 m m m 0-) 0-) rn rn m m m rn W E� a W E� flA DL, wWw �n w MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On -Site Sewer/Well Permit Application (-)j2_) NOTE: Application must be tilled out completely. SINGLE FAMILY DWELLING Parcel Identification Number Property Owner Name 'A" 7e - n U7771_6 Day Phone Mailing Address ���5�/��'H iSDO�✓4 /7i(�C,7 /7K Zip Code 9 /OS16 Legal Description I I unnn t+ E5di•air- , Lot Block bub /5 1Z Al 3W Section Township Range Lot Size %6� 200 Acres/sq Ft. Inspections will be conducted by: ENV i RL NMEN(,;L Number of Bedrooms: Approved Fingineering Firm Municipality (permit fee included) JUN 1 71991 Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, Jacuzzi, or Water Softener Unit? NIO If yes, which one? RECEIVED This application is for: Sewer Only Sewer and Well Sewer Upgrade )— Well Only I certify that the above information is correct. I further certify that this application is being made fora Single Family Dwelling and in accordance with applicable Municipal codes. Property Owner/Well Fees: �'o• Receipt # ?J? Permit # 72-012 (Rev_ 10/961 x,'15 L� ct • r !JLkj� S�D PIL{ a 'ljztc'4� Com"'" c �r O 1-1 `-i ,,� S % ��� /y F� s � �� ��Z �Y'`� t ���,- Municipality of Anchorage Page of 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 Permit Number: 31-0/74 PID Number: Name: Wastewater System: X New ❑ Upgrade ER.94D I-kivcy Address: ABSORPTION FIELD 5n 8112cm Phone: 347 -j3 No. of Bedrooms: ❑Deep Trench ❑Shallow Trench Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: 2 Total Depth from original grade: r - GPD/Sq. . Ft. G./ Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe _Sammi Ft. 6.5 Ft. Township: Range: Section: Fill added above original grade: Gravel length: /� 3W /5 Q./ FL �+ JrO Ft. WELL: El New ❑ Upgrade Gravel depth: /2r. Number lines: Distance bbeeen linees` Ft Classification (Private, A,B,C): Total D Cased To: Total absorption area: Pipe material: ® Ft. Ft. 50 SG. Ft. 7 I I/G Driller: Date Drilled: Static Water Level: Installer: OW,VER Date installed: Ft. Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES oseptic ❑Holding ❑S.T.E.P. To Septic Absorption Lift .Holding Public/Private Manufacturer: L/ Capacity in gallons: 1 /Z50 From Tank Field Station Tank 5ewerLines KNOWN Well /03.5 /d g " N9 MR 8¢' NM.co Material: CONc/?Sre Number of Compartments: Surface Water NONE NONE NONE 111/001,09 NONE LIFT STATION <u LotSize in gallons: Manufacturer: Line 15 13' NA NA /g r FG AJO. "Pump on" level at: "Pu "level at: High water alarm at: Foundation �' /o` AW NA C. 0.12 r' Curtain Pump Make el Electrical Inspections performed by: Drain NA NA NR NA 1,.4 *_5 BENCH MARK Remarks: Location and Description: y -441 s c MAI& IVSAP15 dF 'Tec L —C, MAAMIQ ` QAJ fir, - Assumed Elevation: v o o Nor r GN ft Et21PI fS`SEQ Zo -" o°> 00 0 omma�✓aoa�vawacnoa3 roa.�� Inspections performed by: E. Dates: lot /4 2nd a a, bo121 CE-7 4 V a��o Department of Health and Human Services approval of®®��'© Reviewed and approved by: Date: 72-013 (1/91) MOA 25 Permtt No. Page I of .3 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: 51/7t IWIT_ r�7-AV= /OT r 3/Or'/<'Z PID No.: SW/ IC TIE NE COJEP- r0 'K' = 35.0' NW CkNR To 'K, = /7,5, /7A"YOLE 'o 1 30"C141 - W 7 rN STc EL L /D. IJ 1 /�PP20x, Lc /" = 20' of s aAui SEEPAGE ; NEN/ /-5 x50 SEEPAG€- 8ED COZ2 0 a\ CID CF�O °. coNc,�� AJk --- 72-013 A (2/91) MOA 25 Mi ZIA SUl30/ vIoEo 00 q<fRE5) /OAJ O EX /sT. FE�/CE PERFPERF �, OT / 5Z 0C1< i !Z!'Lf�G9�r=D -_'a;.SriN6-/000-6A)L .STELL_-TANK, - A. /✓EWS-WEEPCL69n/OUrW/45'ELBOW 5,, NEW.54/EEI' CLGf7N0117- A,14W ,30-I J M9!/H01 E r0 EX/.`r, / 1250 -6'9L CONC..5EPT/G TAN/t, ECO/vO ,30 - /N MANHOLE. /JEW15WEEP CL.Ei/.voUT la F, NEw 5wcrP cLEF/ o&r �j G. ✓EW CL£i9NOUr TO Ex/ST..5rcEL rAr/K H, /✓EW.`WEEPCIE�1,10&7- TO STEEL TANK B Z 0 SWEET CLFi7,000T TD /JEW '.J, CCE.'1NOUr //✓ GEO NEA/DER P/PE U 1 ' L. CLE<7MOUT'/✓BEO PERF, P/PE PL �7/V 1� Herwles 7604 PROFESSIO�P� Permit No. 1419/-OIZ4 Page �_ of -9 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 rT J[ A el niW, b Ji :. -- - d r O'o on �W Iq J g a r sA v .0 W u� U 4 % . c , CX 10 Ij � 0000a Q y N >� J tj 0 4 Q M �;• �W Q J ENGINEERv4,kgALOF _ a W,�; V) d����� �vf LLJ ZZll o h _rte nl O �1�j O &even Hendee Q diJ �Q Q O e'A� a�$ ;C -7604 FU•',��'R�FCW�N�©oma 72-013 A (2/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910174 DATE ISSUED: 6/27/91 DESIGN ENGINEER:SKLH CONSULTANTS EXPIRATION DATE: 6/27/92 OWNER NAME:HELVEY GERALD A & OWNER ADDRESS:9650 BIRCH RD ANCHORAGE, ALASKA 99516 PARCEL ID:01507219 LEGAL DESCRIPTION: SUMMIT ESTATES BLK 1 LT 1 LOT SIZE: 16200 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL RECEIVED ISSUED B DATE* , DATE: �-2 7-qZ y,/. PROJECT NAME 1-11n IT [`S�JI�S LC77 / L�LOC'.�� 'SKLH Consultants NUMBER 003-9 / 7 Box 110261 SHEET NO. OF -3 /99g51y1 1345- 947) CALCULATED BY Sfi� DATE la -45 CHECKED BY DATE SKLH Consultants BOX 11026 I 99511 PROJECT NAME NUMBER < A ). s. .:;/ SHEET NO. 3 OF .3 CALCULATED BY S/-/ DATE 6S CHECKED BY DATE y SEPT/G R(1CK AB5 OA PVC. P&o.r P/PE FA/3Zlc 5TR<I74._ PA7lDInAPP1>'ox. _- i -IP/PE ���'; i •-_. �Q-fA//n/ln//TL).P SKLH Consultants R.O. BOX 110261 ANCHORAGE, AK 99511 (345-6947) 16 June 1991 TO: Dept. of Health & Human Services MOA/File BY: S. Henslee, F.E. SUBJ: Summit Estates Lot 1, Block 1 Municipal Code 15.65.030(4) There are no anticipated impacts to adjacent properties with the proposed on-site wastewater disposal system upgrade. Due to the very limited amount of useable area available for the proposed absorption bed, the replacement system will be installed in the same general area as the original system(s). The proposed location of the replacement absorption bed provides no less than 100 -foot separation distance between the existing on-site potable water wells for all contiguous properties. There will be little to no impact or, the existing drainage patterns of the lot and surrounding area. The area of the proposed replacement bed is generally level and will be returned to the same general grade. There is positive drainage over the full area of the lot. Drainage is generally towards the south and east where run-off is collected in the drainage ditches adjacent to Birch Road and 24th Avenue. 97' C/( SuN ����, CE 7604 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 49kh :. Henslae gC�2 7604 PERFORMED FOR: TE/�RY /7CL VCy—ow-mcg DATE PERFORMED: (o IO -5 LEGAL DESCRIPTION: _5//MM/7-CJ7.- LO-r/&t Z Township, Range, Section: T/Z/1/ /PAW, �5E-C /.5 �M T SLOPE SITE PLAN 1 '.r 2 �, 96UMD TO 51V19ROUAJD /�/NE 5<7ND, LDQSE 3 DA/77A, 09RK ORO�LU, 7-R/1CC CJF' CCgY .64,90S 5 � - ,' "' � } pERCOCR7ioN TEST 6 7 FOG/q�0 .SA.V/�Y r 8 CLAY T9N,,50F7 6 PAir1P. 6stimArE7 20 -30 % sANOD 9 o 14 15 16 17 18 19 WAS GROUND WATERMDN/roR 7Z/6E mpa/TORFOI Q//1CHrPl� ENCOUNTERED? R 7+ /D,q'�S DITGN G CNE*4L p L E /E 20 r /, n / IF YES, AT WHAT DEPTH? S L IVA2 P E Depth to Water After Monitoring? — (0 Date: 10 L �J � FRO PERCOLATION RATE T� (minutes/inch) PERC HOLE DIAMETER /N.%3Ln7 / /SloS.O(�U(C4 TEST RUN BETWEEN r FT AND 25,5 FT COMMENTS SnPKE/D N/)LF oye)? C- //CUR'S Bt6a" rear 5//JN//�16 J PERFORMED BY: 5, Z-ba/2 ,/ce I �Zji�1'-+/-v CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 91 72-00B (Rev. 4/85) Roc/n/o TD sUO— �:`°: � ROunllD, OR arv.tlJ 11 pA/>7P 6kF1uEc ro 3„ mrDxs/ZC G -S" 12 TD 5' 9. -/2' 13- 14 15 16 17 18 19 WAS GROUND WATERMDN/roR 7Z/6E mpa/TORFOI Q//1CHrPl� ENCOUNTERED? R 7+ /D,q'�S DITGN G CNE*4L p L E /E 20 r /, n / IF YES, AT WHAT DEPTH? S L IVA2 P E Depth to Water After Monitoring? — (0 Date: 10 L �J � FRO PERCOLATION RATE T� (minutes/inch) PERC HOLE DIAMETER /N.%3Ln7 / /SloS.O(�U(C4 TEST RUN BETWEEN r FT AND 25,5 FT COMMENTS SnPKE/D N/)LF oye)? C- //CUR'S Bt6a" rear 5//JN//�16 J PERFORMED BY: 5, Z-ba/2 ,/ce I �Zji�1'-+/-v CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 91 72-00B (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION l 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE �p UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION 1 r IfeY 1QC/r .8 NO. OF BEDROOMS Uy E TO: Well Absorption area Dwelling PERMIT NO. wr FLqin / Material No. of compartments v' gallons IF HOMEMADE: Inside length Width Liquid depth O 1'DISTANCE J0 TO: Well Dwelling PERMIT NO. = z F Manufacturer Material Liquid capacity in gallons O w= DISTANCE TO775 t Well IZO Foundation t Nearest lot lid PERMIT NO. u- Z Z w H — No. of linesI Length of each line Total length of lines Trench width inches Distance between lines r F p Tap of rile to finish grade � Material beneath rile f iercltEs• Total effective abt�n are w Length Width Depth PERMIT NO. QF- wa Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line b Septic tank Absorption at (s) OTHER t r L PIPE MATERIALS SOIL TEST RATING ryA� Z INSTALLER G p�.wt REMARKS - ", s' APPRO D DATE LEGAL 72-073 (Rev. 3/78 �ti `C?EPAR:TMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 8025 JL" STREET, ANCHORAGE, AK 99501 264-4720 PERMIT NO. < 81.0545 APPLICANT .iCiHN STEVENSON SRA BOX 75C LOCATION 9650 BIRCH RD LEGAL Ll Bi SUMMIT ESTATES TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH 9;/Po 01 Lf �r // Dhola 3:.x.1-9 9 LOT SIZE 23000 SQUARE f=ET �/a t9FC>;It'!i!t9 P•dIIt9BER: OF EEC?F::(1!it'IS = E. SOIL R:A-EIP+Iii (50 FT';'BR:?== 120 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIE.LD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE: EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH I_ THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F :w= C;fT-Y I KE0E e BEEF" -f- I C._:-F-i=ltAb2 ' I v — w"I nED PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTItaNS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER: OF RESIDENCES THAT THE WELL WIL.L.. SERVE. --------- -'t- F" -I CA a:_ 22 > I PA F" 1-= C. -F I CA VA A° FA FT Es F°� En C_'® U I Fm' E -Z t._ A ------- BACKFILLING "_--..BACKFILLING OF ANY SYSTEM WITHOUT F I NAVI NSPECT I ON AND APPROVAL. BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DIS'T'ANCE 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 T'A'PE OF PUBLIC: WELL. MINIMUM DISTANCE FROM A PRIVATE WELL. TO A PRIVATE :.EWER: LINE I:_: 25 FEET AND TO A COMMUNITY _;EWER: LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER It+I'=TAL.LATION. F=` E= ° r-1 I 1 KI -If" I FREE"m r;> K'_ E a l E e E= F= =: AL a A_ _ E 0. I CERTIFY THAT 1: I AM FAMILIAR: WITH THE REQUIREMENTS FOR: ON—SITE SEWERS AND WELLS AS SET' FORTH BY THE MUNICIPALITY OF ANCHORAGE. 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. _: I UNDERSTAND THAT THE ON—SITE SEWER: SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 6 BEDROOMS. SIGNED>wl G4LSGL /`fit � amt ---__.--__----_._. APPLICANT JOHN7PTEVEPd:=ON ,f ISSUED ! L' nit to t�-ck { - t' 4 V4. 0 i� t : T --•---- �-------- -�� --= -L: H'TE ---- 4 00 _/,_t T`k-S,tfl_ CFDTIf 7ANIV. /1 DISTANCE FROM WELL L� � LIQUID CAPACITY / Z_ � tr ( SEEPAGE SYSTEM: SEEPAGE PIT: �r/ NUMBER OF TERIAL C � ( COMPARTMENTS S. INSIDE L LIQUID IDE WIDTH -DEPTH - C, I IDTHDEPTH- J/ NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH , LENGTH , DEPTH- -3 LINING MATERIAL " "�� . DISTANCE FROM WELL / 7 _BUILDING FOUNDATION, -NEAREST LOT LINE z ZP7 TOTAL EFFECTIVE ABSORPTION AREA (WALL -AREA) ct�� t� SQ. FT. TILE DRAIN FIELD: F NUMBER OF LINES FOUNDA BETWEEN LINES NEAREST LOT TRENCH WIDTH TOTAL LENGTH OF LINES TOTAL EFFECTIVE ABSORPTION AREA SQ. FT``—LENGTH OF EACH LINE _ DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROMWATE WELL: TYPE 9 �v /' Com, DEPTH / �- / , BUILDING FOUNDATION. `� / SAMPLE , NEAREST NEAREST SEPTIC f SEEPAGE/ OTHER LOT LINE , SEWER LINE—, TANKl�� - SYSTEM -,� , CESSPOOL , SOURCES_ DIAGRAM OF SYSTEM DISTANCES: �i % P,L^C I / l[C bHildao ( �,p LP5 J. DATE // �� CUYI f�i"p C�ld 1.1%;SCATfPROVEDi �;' ATER ANCHORAGE AREA BORO 'H , HEALTH DEPARTMENT N? 503 I 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM �/ �m �/ MAILING �7`/� 7 I /n7AI i{�{ S / -i /� NAME �� -i`� S ADDRESS / PHONE o�C� <<"t l �//< I S1r �,)/n /' �l� LOCATION LEGAL DESCRIPTION CFDTIf 7ANIV. /1 DISTANCE FROM WELL L� � LIQUID CAPACITY / Z_ � tr ( SEEPAGE SYSTEM: SEEPAGE PIT: �r/ NUMBER OF TERIAL C � ( COMPARTMENTS S. INSIDE L LIQUID IDE WIDTH -DEPTH - C, I IDTHDEPTH- J/ NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH , LENGTH , DEPTH- -3 LINING MATERIAL " "�� . DISTANCE FROM WELL / 7 _BUILDING FOUNDATION, -NEAREST LOT LINE z ZP7 TOTAL EFFECTIVE ABSORPTION AREA (WALL -AREA) ct�� t� SQ. FT. TILE DRAIN FIELD: F NUMBER OF LINES FOUNDA BETWEEN LINES NEAREST LOT TRENCH WIDTH TOTAL LENGTH OF LINES TOTAL EFFECTIVE ABSORPTION AREA SQ. FT``—LENGTH OF EACH LINE _ DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROMWATE WELL: TYPE 9 �v /' Com, DEPTH / �- / , BUILDING FOUNDATION. `� / SAMPLE , NEAREST NEAREST SEPTIC f SEEPAGE/ OTHER LOT LINE , SEWER LINE—, TANKl�� - SYSTEM -,� , CESSPOOL , SOURCES_ DIAGRAM OF SYSTEM DISTANCES: �i % P,L^C I / l[C bHildao ( �,p LP5 J. DATE // �� CUYI f�i"p C�ld 1.1%;SCATfPROVEDi 02 GREATER ANCHORAGE AREA BOROUGH OJa✓ DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT No. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 \\\\VV�IIIl4v.e ur.Illllln%%//// SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT MAILING ADDRESS '76'J -o ;l -0j PHONE j 9 INSTALLATION LOCATION // - ,(/ LEGAL DESCRIPTION /^, / / "'& `�-lor / �� �6�z :r INSTALLATION OF: SEPTIC TANK SEEPAGE IP IIT TYPE AND SIZE OF FACILITY TO BE SERVED /2.6,y FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS COMPLETION DATE ANTICIPATED FIELD 6-B NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST 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 SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD -r' DRAIN FIELD DRAIN FIELD SEEPAGE AREA SIZE SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT 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. 4 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. Mi G.A.A.B. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE FORM NO. EQ -016 Consttuetlon gest -faw "One test Is worth a thousand npinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For Date Performed Lenal Descrintion: Lot Block Subdivision,Svltidr{f This Form Renorts Soils Loa er Oa-- Percolation Test_ nenth Soil Charac 2 — 4 6 s 10 _ �_ ----- 12- 14- 16- 17--- 18- 20— Was 2-14-16- 1s- 20— Was Ground Water Encountered? & If Yes, At what Denth? NOM0 P.M=�� Prnnosed Installation: Seenaae Pit Drain Field _ Depth of Inlet Depth To Bottom Of Pit Or Trench rnWAENTS: Test Performed Byz4v�. Data Certified By:L— Date: G" PATER ANCHORAGE AREA BORA ;H HEALTH DEPARTMENT- N? 503 Y 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 ' INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM f,�/,/,' �1h (SX 7Sc s ,�i�} .NE ca "'� /qY/1 DDD�`P S ADDRESS PHONE NAME �, LOCATION �rcGiDCPC! LEGAL DESCRIPTION el LEGAL ` �q j_' --'r SEPTIC TANK: DISTANCE FROM WELL / MATERIAL ��"%�'l�C-%LP/LP NUMBER OF COMPARTMENTS— 7- LIQUID LIQUID CAPACITY / GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH-, LENGTH,DEPTH2 , , LINING MATERIAL '_' '' ""'reh - .DISTANCE FROM WELL /- BUILDING FOUNDATION; � 1 NEAREST LOT LINE 2 TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) CLd e_ SQ. FT. TILE DRAIN FIELD: NUMBER OF ABSORPTION AREA FOUNDATION , NEAREST LOT BETWEEN LIN OF EACH LINE TRENCH WIDTH DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE ABOVE TILE I W ELLCom'_1 �t TYPE DEPTH , DISTANCE FROM �� WATER BUILDING FOUNDATION._ SAMPLE , NEAREST LOT LINE NEAREST SEPTIC , SEWER LINE—,TANK—, SEEPAGE / SYSTEM - �/ CESSPOOL OTHER , SOURCES_ DISTANCES: Ads-i/z' ,q, L= 1.37 GAABHD-i GP -ITER ANCHORAGE AREA BOROI-'H J HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM !r./� MAILING PHONE NAME ADDRESS DESC SEPTIC TANK: MBER OF DISTANCE FROM WELL I �..�.I MATERIAL � �~K G Y`�- - COMPARTMMENTS l ID LIQUID CAPACITS �o GALLONS. INSIDE LENGTH C_61'I INSID WIDTH DEPT YH SEEPAGE SYSTEM: SEEPAGE PIT r NUMBER OF PITS OUTSIDE DIAMETER -OR WIDTH / - LENGTH 2__ DEPTH , LINING MATERIAL DISTANCE FROMWELL DING FOUNDATION�f�" . /L _j BUILDING NEAREST LOT LINE -�L 1 TOTAL EFFECTIVE ABSORPTION. AREA (WALL AREA) ,C' SO. FT. TILE DRAIN FIELD: TOTAL' LENGTH DISTANCE FROM WELL, - - FOUNDATION-, NEAREST LOT LILINE OF LINES , NUMBER OFAINES DISTANCE BETWEEN LINES TRENCH W TH IN TOTAL EFFECTIVE AnvSORPTION AREA SOFT. LENGTH OF EACH -LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE; -IN. ABOVE TILE DISTANCE FROM - - WATER WELL: TYPE ILL/ f&Z DEPTH ,BUILDING FOUNDATION. SAMPLE , NEAREST NEAREST SEPTIC SEEPAGE`. OTHER LOT LINE , SEWER UNE-, TANK , SYSTEM-, CESSPOOL , SOURCES_ DISTANCES: DIAGRAM OF SYSTEM D SAAB -HD -z , .- GREATE�LJNCH®RAGE AREA L. )ROUGH Case__"01 � d ° , HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 1""40 37ve/14' YENr.S JE/ZV,CY SEWAGE DISPOSAL SYSTEM a APPLICATION ili PERMIT 4/6(. NAME OF APPLICANT, ret ��GlJ16 MAILING ADDRESS �l%DC/lQA-, d) P ONE NO -2 RESIDENCE ADDRESS f)�- LOCATION OF INSTALLATION S°« � c �� ���• o�� LEGAL DESCRIPTIO APPLICATION TO INSTALL: SEPTIC TANK - , SEEPAGE PIT 1✓ , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH 10 h)ajin1Ja L. TO BE INSTALLED BY N •X PERCOLATION TEST RESULTS THIS IS TO SERVE AS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ,PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED 5 _t.e eP SEPTIC TANK SIZE /SDn TYPESEEPAGE AREA— °^,.^° �--�------ ---------- 015 IAN Gtb: 04 ib — )�e�,=� ��� Z a TYPE dL-� 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 system is in accords cc with said code. A DATE APPLICANTS SIGNATURE :0 0 8 5 6 3 TELEPHONE: 2724114 ALASKA GEOLOGICAL CONSULTANTS ENGINEERING GEOLOGY * MINING d GEOPHYSICS it GROUNDWATER * PETROLEUM 2227 SPENARD ROAD ANCHORAGE. ALASKA 99303 May 15, 1969 Mr. Jim Vickers 4300 Wright Street Anchorage, Alaska Re: Percolation Test, Lot 1, Block 1, Summit Estates Subdivision Dear Mr. Vickers: This letter is to certify that a percolation test has been conducted on the above-mentioned property. The test was performed in a twelve -inch diameter, twelve -inch deep test pit in the bottom of the proposed absorption field. Location of the test pit, the log of the test pit and percolation data are shown on the -attached sheet. This test was made in accordance with the Greater Anchorage Area Borough Health Department specifications as prescribed in Appendix B of the National Plumbing Code, 1962 Revision. Very truly yours, ALASKA GEOLOGICAL CONSULTANTS BGP:js Bruce G. Purcell Attach. CHKO. BY.....__.... OATE ......... MBY................ ... bATF............. su JFCT- ------------ E r 0. .-W ' ...................... ..... . ........................................... S U AktA f.r 454P! ............... ....... .................. ...................... OF 0 Tess p ir o C, :SANDY ..6 (Ourw)OS14� o 0 ' XPMICOLA Iv-TrbKq" rj4TF- oiz MAY 14r, BIRCA More: PEWCOLAMON WPP MAKIAM 4LWAMR, MN our IN i-�z "tl4Arj 16 3eC41<)-S q AWW4A 4001,061CM- CM'SVL'rANi-,3 LAWRENCE A. SCHACHLE TELEPHONE 344.2612. {ii:G0a56� Penn ,➢eney CD00000a "Good Water Our Specialty" 2633 EAST 72ND AVENUE . ANCHORAGE. ALASKA 99502 May 13, 1969 i.'r. p_ P:rs. 1 alter Lewis 1000 !'Iri.ght Street Anchorage, U:. To whom it may concern: L agree to drill a i.ell on the property of Mr. & Mrs. halter Lewis, Lot 1, Block 1, Summit Estates„ 1-rhich will meet all specifications of FHA and the Borough specifications. Very truly yours, Penn Jersey Th-illing Co. Lawrence A. Schaehle - DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME NUMBER OF,BEDROOMS A Jo ❑/SINGLE FAMILY Q Two ❑ Five c�,I 0 DATE DATE DATE VJ� INSPECTOR INSPECTOR INSPECTOR' JIG Y� MUNICIPALITY OF A, O AGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEA i DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECWINON ENTAL ECTION 825 L Street - Anchorage, Alaska 99501 • 1n ENVIRONMENTAL SANITATION DIVISION L Telephone 264-4720 VLD F�fL1TIES REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER DIRECTIONS: Complete all parts on page 1. Incomplete requests will not he processed. Please allow ten (10) days for processing. 7. PROPERTY OW PHONE �L ❑ PUBLIC UTILITY MAILING ADDR % �5/`%— 670/ ?44so l 70 z PROPERTY RESIDENT (If different from ove) HONE o 2. BUYER PHONE ..// i MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAI LING ADDRESS:60 4. REALTOR/AGENT PHONE a 0 0 AV4iso MAILINGADDRESS , (} ( ri 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other ❑/SINGLE FAMILY Q Two ❑ Five 0 MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPP LY LPr 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.) r)"� 8. SEWAGE DI POSAL SYSTEM YEAR SYSTEMWAS INS INDIVIDUAL/ON-SITE** r-SITE (' d �% ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) '! 1 THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLEFAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Neares[ Lot Line Absorption Area to nearest Lot Line 5. COMMENTS Vw b� ❑ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) Ir-r DISAPPROVED DATE BY n Ai 72-010 (Rev. 6/79) GREATER AN RAGE AREA BOROUGH Department o Environmental Quality Street, An rage, Alaska 99503 274-4561 / Date Received Time of Inspection Date of Inspection 7 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1 . Approval requested by: ld). J. tZ�Oc�eS Mailing Address. ]b X 75--C. S 2 A Phone: 2. Property Owner: pr v -^-t„ Phone: Mailing Address: 3. Legal Description: Lot' I QkcJCL k Sv en.vy���-� lS7iIC4" 4. Location: q(c sm 2c k_ - _20o.A . en '6 5. Type of facility to be inspected 4&rp P� No. of bedrooms �? 6. Well Data: A. Type -ba%. l k f- C� B. Depth C. Construction SyAft da e A D. Bacterial Analysis 7. Sewage Disposal System:,'L' iG1 '#V'0�00, 6/ &A, A. Installed /170 B. Installer -sCi7�Ge C-11`-WAeI56' s C. Septic Tank: D. Seepage Pit: E. Disposal Field 8. Distances: 1. Size S D �? Manufacturer 1. Absorption Area Total length of lines 2. Material 6044—e'e,"� i A. Well to: Septic tank 112, Absorption area / 3 7 Sewer Lines Nearest lot line /D , Other contamination B. Foundation to septic tank 9 01 , Absorption area 2 C. Absorption area to nearest lot line 2.0 � l` �S5 4% 41 1/ 4104e iA) � EQ -034 (1/74) - agP" e 1 of two p ges Page 2 of two pages - ReI ,,.st for Approval of Individual S` 2r & Water Facilities Legal Description Comments Approve Disapproved Date Ap val,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74) De 1�2t%alll Bey 1973 • AL('A DEPARTMENT OF HEALTH AND SOCIAL S[�,,,,JIS - .' .a.� DIVISION OEPUBLIC HEALTH a6N - INDIVIDUAL AND SEMI-PUBLIC DATE BACTERIOLOG I CAIN WATER ANALYSIS OFFICE Analys s shows this Water SAMPLE to be INDIVIDUAL_ SEMI PUBLIC ❑ CHLORINE RESIDUAL PPM— PISorisfacrory - - - REPORT RESULTS TO - [] Unsoiisfacrory - NAME // A i/ E] Questionable ❑ Sample too long in transit,sample should not be over 48 _ -hours old at examination toindicatereliable results. 'Please ADDRESS R19C c\ send new sample. l //r -"' - ❑ Bottle broken in transit, please send new sample. CITY/i4, ZIP CODE ADDRESS --' - OFsouecE �. -, SANITARIAN'SREMARKS _ COMPLETE THIS SECTION Depth ,Feiet. ONLY IF MATER IS AN INDIVIDUAL SUPPLY Well Casing n - Material Diometer SAMPLE COLLECTED By % /D Water Depth- DATE COLLECTED TIME COLLECTED '0Y I - - Drop Pipe -Sample Colletled From Itchen Tap ❑ Bathroom Tap ❑ BasemeMTap - ❑ Other (Lisp - 71 In easement CI Room om - - .Well — F) Dug EI Driven El Drilled ❑ Bored On SOURCE: ❑ Spring ❑ Cistern ❑ Other _ _.. - - - - - Dug Well or Cistern Construction: ❑ Of Well 0 Other - - -- `Walls— ❑Wood - EJ Concrete C3 Metal ❑Tile- - Br ckor'.. ❑ - -. - Top — ❑ Wood - ❑ Concrete ElMetal ❑ Open Top Concrete - - - LOCATION:- In Basement ❑Basement Offset (] Under House>--- New Source of Supply?. ❑ Nes ❑In Yard- E) Other Repairs to System? - ❑ Yes ❑ No 5 gnature P r ' _ Building Sewer - Septic -'Feet. DISTANCE;TO: or Other Drainage Pipe - Feet.. Tank - - Tile - - Seepage Cess- Re 197Im Field—Feet PitFeet. Pool -Feet. Privy 'Feet. J - - Other Possible - - '- - Sources of Contamination READ INSTRUCTIONS - - - MATERIAL: Building Sewer - ❑ Cast Iron ❑ Wood ' ❑ Tile ❑ Fibre ❑ Asbestos .o. - - Cement - Lactose Broth .. - , IOcc `'•-: _1 Occ ❑ plastic Joint Material - Type IOcc I Occ 1.0cc 1.0cc - .GENERAL_Daes'Wa`ter Become Muddy or Discolored? - D Yes 0 N - When? Diameter of Well Depth ,Feiet. _. Well Casing - Material Diometer Depth Length of Water Depth- - - Drop Pipe Offset in From Bottom Feet - In - PUMP LOCATION: ❑ In Well ❑Basement 71 In easement CI Room om - On _ _.. ❑ Of Well 0 Other PURPOSE OF EXAMINATION: Illness Suspected'+ - ❑ Yes - ❑ No New Source of Supply?. ❑ Nes ❑ No Repairs to System? - ❑ Yes ❑ No 5 gnature P -"• BACTERIOLOGICAL WATER ANALYSIS RECORD Re 197Im READ INSTRUCTIONS De Received/�l Time Rceived - .o. - - . - Lactose Broth .. - , IOcc `'•-: _1 Occ . 10cc IOcc I Occ 1.0cc 1.0cc 24 Hours - - ON - - 48 Hours •. f- Brilliant Green --'-' - 24 Hours REVERSE SIDE - -:48 Hours - - - ' EMB - - AGAR BEFORE - - Lactose Broth, 24 hrs. - 48 hrs. Grams slain - - Coliform Density [Most probable No. per 100ccl - MF Rescl s COLLECTING SAMPLE J y / ' - This analysis indicates Coliform Organisms to -be: bsent - - Present t a GREATER ANCHORAGE AREA BOROUGH__ i Department of Environmental Quality 3330 C St., Anchorage, Alaska 99503 274-4561 C�k\(3qv-788�� REQUEST FOR APPROVAL OF 1/n f2 5« P'� INDIVIDUAL SEWER & WATER FACILITIES fz`�/�� 1. ,Type of Inspection: CMRO VA FHA CONV 2. Property Owner: N, \ 7 ad•C�S Mailing Address: T36K 7.S -c S K Day Phone, 3. Name of Buyer:- VV\C)�.IS zv,- {4zz Mailing Address: S'FgT�r S Day Phone 34--`it"i3 4. Name of Lending Institution: Mailing Address: Phone 5. Name of Realtor or Agent: &cr-yv-'�- Mailing Address: Phone 6. Legal Description: Location: so I-3iyck k0acl. - �J�v �Uoc�k I GT 7. Type of Facility to be inspected: 1�"PL`1 No. Bdrms. 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served (I�DI�� cwt -fix If Individual, depth of well ILS, 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation EQ -037 (1/74) Individual (on-site) I7L.7V REPORT OF INSPECTION -INDIVIDUAL SEWAGE -DISPOSAL SYSTEM PRIMARY TREATMENT consists of ❑ Septic tank. ❑ Cesspool. Septic Tank: Distance from well, feet. Material, Number of compartments Total liquid capacity, gallons. Capacity inlet compartment, gallons. Inside length, feet. Inside width, feet. Liquid depth, feet. Cesspool: Distance from: Well, Feet; foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet. Ins"Ic diam.ter, feel. Depiil, feet. Liquid capacity, gallons. Lining material SECONDARY TREATMENT consists of ❑ Tile disposal field. ❑ Seepage pits. Other Tile Disposal Field: Distance from: Well, feet; foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet. Total length of tile lines, feet. Number of lines, . Distance between lines, feet. 'French width, inches. Total effective absorption area in bottom of trenches, square feet. Length of each line, feet. Depth, top of tile to finish grade, inches. Type of filter material ❑ Gravel. ❑ Broken stone. Other Depth of filter material beneath tile, inches. Depth of filter material over tile, inches, Seepage Pits: Number of pits . Outside diameter, feet. Depth, feet. Lining material Distance from: Well, feet; building foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet. Inspection made by: ❑ State. ❑ County. ❑ Local Health Authority. Inspected by Date of inspection - , 19 REPORT OF INSPECTION -INDIVIDUAL WATER -SUPPLY SYSTEM Distance to nearest public water main, --feet. Size of main, inches. Individual wells ❑ are ❑ are not customary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood ❑ are ❑ are not being developed with both individual water -supply and sewage -disposal systems. Lot size: feet wide, Feet deep. Dwelling set back from ftont property line, feet. Individual water supply from: ❑ Drilled well. ❑ Driven well. ❑ Dug well. ❑ Bored well. Distance of well from: Building foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, cast iron sewer, feet; tile sewer,feet; septic tank, feet; disposal field,— seepage pit, feet; cesspool, feet; other sources of possible pollution, feet. Well construction: Diameter, inches. Total depth, Feet. Type of casing, Depth of casing, feet. Approximate depth to pumping level of water in well, feet. Approximate yield, gallons per minute. Sealed watertight to depth o! feet. Exterior space around casing sealed with: ❑ Cement grout. ❑ Puddled clay. ❑ Ordinary backfill. Well cover: ❑ Concrete. ❑ Wood. ❑ Metal. Openings in well cover watertight: ❑ Yes. ❑ No. Pump: ❑ Shallow well. ❑ Deep well. Length of drop pipe,_ feet. Pump capacity, gallons per minute. Located in: ❑ Basement. ❑ Pumproom off basement. ❑ Pumphouse above ground. ❑ Pump pit. Pumproom properly drained: ❑ Yes. ❑ No. Pump mounting watertight: ❑ Yes. ❑ No. Type of storage: ❑ Pressure. ❑ Gravity. Capacity, gallons. Has bacteriological examination of water been made? ❑ Yes. ❑ No. If answer is "yes," give date 19_ Quality of water ❑ is ❑ is not satisfactory for human consumption. Installation I–] does ❑ does not comply with approved exhibits, if any. Inspection made by: ❑ State. ❑ County. ❑ Local Health Authority. Inspected by Date of inspection , 19— IT S, 9 Y.S. GOVERNMENT PR I NT ING OFFICE: 19590-F-42)0]8 A I "' ',.�ATER ANMRAGE AREA BOROLYM HEALTH I)PPARDIIENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 279-2511 DATE RECEIVED 57-- 6 -`?/ INSPECT: j // - r%l TIME: UU 0- REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES FOR 1. Approval Requested By Address Phone - 1V - 2. Property Owner 1 3. Legal Description 4. Type of Facility to be Inspected STREET: 7�s� �lCsL �c� �✓ Number of Bedrooms— -7 edrooms'�- r 5. Well Data: A. Type �/�(C �GGC�' B. Depth _-lf s C. Size D. Construction L E. Bacterial Analysis 1 , 6. Sewage Disposal System: A. ,`Septic Tank (If homemade, show diagram on back j 1. Size / Z, psi 2. Ago / 70 Q�+ P�Op�n7� / q�p 3. Manufacturer y j 4. Instal ler SC G1 ` Approval R$quest�for Sem: & Water Facilities Page Two B. Seepage Pit 1. Size 2. Lining C.—Disposal Field 1. Number of Lines 2. Total Length 7. Required Measurements i A. Well to Septic Tank, B. Well to Seepage Pit 3 C. Well to Sewer Line D. Well to Property Line® + E. Well to Other Possible Contamination F. Foundation to Septic Tank G. Foundation.to Seepage Pit 2 H. Seepage Pit to Property Line 8. COMMENTS: APPRC DATE: DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. ED1170 GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT ADHW - LAB -2W DF""RTMENT OF HEALTH AND WELF4 E \_-,,�DIVISION OF PUBLIC HEALTH , BACTERIOLOGICAL WATER ANALYSIS .. DATE - - - PUBLIC SEMI-PUBLIC El INDIVIDUAL E] OTHER '• _ REPORT RESULTS TO Determine source of contaminationand take arfion necessary to maintain _ C NAME Sample Collected From C Kitchen Top C Balhroam Top C Basement Tap. _3.. Check chlorinalinn and other mechanical equipment. Make certain it is C Other (Us,) - - - - functioning properly. _ -4 If offer checking equipment a disinfecting. residual is. not obtained, please COMPLETE -wire this office for emergency assistance or advisory Well - C Dug C Driven C Drilled C Bored ._ C ADDRESS Dug Well or Cistern Construction: Bock or -b; Improve your ❑spring - C3 dug well ❑-driven well - C- Wood C Concrete - C Metal - C Tile Walls - ❑ Concrete Top - C Wood C Concrete C Metal C -Open Top _ LOCATION:. C In Basement ❑ Bosemem Offset - C Under House CITY - C In Yard' C Other disposal system; C see enclosure Building Sewer septic DISTANCE TO. or Other Drainage. Pipe�Feef. Tonk Feet . 8.'Sample -too long in transit; sample should not be over 48 hours old at Tile Seepage Cess .examination to indicate reliable results, please send new sample. Field Feet. pilFeet. Pool Foe. Privy - Feet. Other Possible - - ADDRESS Sources of Contamination Asbestos Von MATERIAL: Building Sewer - ❑ Cast ❑. Wood: - ❑:Tile- -, Fib,. -❑ Cement - - OF SOURCE �) Plastic loins Material -- Type assistance. GENERAL: Does Water Become Muddy or Discolored? C Yesr C No Lab. OFFICE Records in this office indicate this WATER SUPPLY to be of: Satisfactory. C Questionable C Unsatisfactory Sanitary Status. Analysis shows this Water SAMPLE to be: Satisfactory C Questionable C. Unsatisfactory.-. - If an "Unsatisfactory" or "Questionable" status is indicated above you should fake immediate action as recommended below.. -1. Notify consumers water is polluted. Boil or chemically treatthis water as outlinedin the enclosed leollel "Drink It Pure. - - - - - - SAMPLE COLLECTED BY _2. Increase chlorination sufficiently to meet recommended residual standards:' - - Determine source of contaminationand take arfion necessary to maintain _ DATE COLLECTED - TIME COLLECTED prn a sale wafer. supply al all times. - - Sample Collected From C Kitchen Top C Balhroam Top C Basement Tap. _3.. Check chlorinalinn and other mechanical equipment. Make certain it is C Other (Us,) - - - - functioning properly. SECTION OTHERWISE INSTRUCTED -4 If offer checking equipment a disinfecting. residual is. not obtained, please COMPLETE -wire this office for emergency assistance or advisory Well - C Dug C Driven C Drilled C Bored -5. This is a surface water source and subject topollution by man and animals. SOURCE: C Spring C Cistern C Other An approved wafer supply source should be developed.. Dug Well or Cistern Construction: Bock or -b; Improve your ❑spring - C3 dug well ❑-driven well - C- Wood C Concrete - C Metal - C Tile Walls - ❑ Concrete Top - C Wood C Concrete C Metal C -Open Top - - C drilled well C cistern. - - LOCATION:. C In Basement ❑ Bosemem Offset - C Under House - 7.. Relocate your well to a sale location in relationshipto your sewage - C In Yard' C Other disposal system; C see enclosure Building Sewer septic DISTANCE TO. or Other Drainage. Pipe�Feef. Tonk Feet . 8.'Sample -too long in transit; sample should not be over 48 hours old at Tile Seepage Cess .examination to indicate reliable results, please send new sample. Field Feet. pilFeet. Pool Foe. Privy - Feet. Other Possible - - - - - -' C Bottle Broken in transit, please send new sample. Sources of Contamination Asbestos Von MATERIAL: Building Sewer - ❑ Cast ❑. Wood: - ❑:Tile- -, Fib,. -❑ Cement - 9. Contact your nearest C Local Health Department or C Alaska Division of Public Health, sanitation office for bulletins, consultation and �) Plastic loins Material -- Type assistance. GENERAL: Does Water Become Muddy or Discolored? C Yesr C No SANITARIAN'S REMARKS' When? ,. Diameter of Well Depth Feet. Well Casing Material Diameter Depth - - th Drop Pipe FratmrBoU.nn Feet. Deep Pipe - PUMP LOCATION: C In Well C gmement In C In Basement C RooIn mlity - - - - - - On ToP - C Of Well C. Other -- PURPOSE OF EXAMINATION: Illness Suspected? - C Yes ElNo- New Source of Supply? C yes C No Repairs to System? C Yes C No - Signature BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS -. Pm I4876 'p^' - Lab.'No. - Date Received Time Received ON REVERSE SIDE BEFORE Laclose Broth loco locc IDcc 10,c `. IOcc- 1.0cc 0.1cc 24 hours. 48 hours Brilliant Green 24 hours - 48 hours - EMB AGAR Lactose B.alh,•z4 hrs 46 hrs. Gram s stain COLLECTING SAMPLE :Coliform Density (Most probable No. per 100ca.) .. MF results ]. Reported by - Date pm This analysis indicates Coliform Organisms to be: Absent Present 1. Apprc Addre Phone 'EATER ANCHORAGE AREA BOROUGH [?EALTH DF.PARThT'NT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 279-2511 DATE RECEIVED INSPECT: TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND {PATER FACILITIES FOR ' 2. Property Owner Phone 3. Legal Description 4. Type of Facility to be Inspected STREE' Number of Bedrooms 5. Well Data: A. Type B. Depth C. Size D. Construction E. Bacterial Analysis_ 6. Sewage Disposal System: A. Septic Tank (If homem 1. Size 2. Age � 3. Manufacturer 4. Installer show diagram on back) r6rA �' is ,3 vv- - 6rA v- Approval Request for Sewt,.,$ Water Facilities Page Two B. Seepage Pit 2. Lining ' fa C.,_ Disposal Field 1. Number of Lines 2. Total Length l✓�o� 7. Required !Measurements A. Well to Septic Tank 1,2,() B. Well to Seepage Pit--1-2,/ 7-1— C. Well to Sewer Line Lyre 7z- D. D. Well to Property Line /lj / 7/— E. Well to Other Possible Contamination /✓D/1/G� F. Foundation to Septic Tank Z G. Foundation to Seepage Pit .2 w i H. Seepage Pit to Property Line--3'42 8. COUNTS: APPROVED: DISAPPROVED: DATE: DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT ED1170 I Main Office THE FIRST NATIONAL BANK OF ANCHORAGE P. O. BOX 720, ANCHORAGE, ALASKA 99501 Health Department 327 Eagle Street Anchorage, Alaska 99501 March 3, 1971 S T° MAR � TS7I Attention: Sewer & Water Department Gentlemen: >�r<.ouct—ar�za�r o�A�nx�r i� According to our telephone conversation of March 2, 1971, I am enclosing the forms you requested. Your cooperation in completing these forms and returning them to me at your earliest convenience will be greatly appreciated. Very truly yours, Stephen W. Noey Mortgage Loan Department SWN/eta Enclosures LAWRENCE A. SCHArHLE _ TELEPHONE 34�-2612. {ii:06816� Lvmn kney Du°0005ne Qr%10® "Good Water Our Specialty" 2833 EAST 72ND AVENUE ANCHORAGE. ALASKA 99502 May 13, 1969 I°r. & Mrs. '-falter Leirls k300 Wright Street Anchorage, Ak. To whom it may concern: I agree to drill a well on the property of Mr. & Irs. lialter Lo i.s, Lot 1, Block 1, Summit Estatesy, which zai.11 meet all specifications of FHA and the Borough specifications. Very truly yours, Penn Jersey Drilling Co. Laurence A. Schachle