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Home My WebLink AboutTROLL KNOLL BLK 1 LT 1TIZoLL KAoLL SID 057..05211-0 3 - LOT S USN Tint, Municipality of Anchorage APR 0 311p On-Site Water and Wastewater Program • (907) 343-7904 Pageo•I'' of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 161237 PID Number: 05152113 Dwelling: ❑■ Single Family (SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: ❑ New ❑■ Upgrade Name: JAMES ROBERTSON ABSORPTION FIELD Address ❑ Deep Trench ❑ Shallow Trench ❑ Bed EI Mound 20433 LEPRECHAN ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 -- GPD/SF -- Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot -- Ft._— Ft. TROLL KNOLL 1 1 Fill added above original grade Gravel length Township Range Section __ Ft. -- Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES -- Ft. -- -- Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line __ Ft2 -- -- Ft. Well +100 -- -- -- -- TANK ❑p Septic 0 S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water +100 -- -- -- ANCHORAGE 1000 Gal. Material Number of compartments Lot Line +5 -- -- -- STEEL 2 NA Foundation +5 __ -- __ LIFT STATION Manufacturer Capacity Curtain Drain +50 -- -- -- -- -- Gal. Remarks OLD CONC TANK ABANDONED IN Pump on level at Pump off level at High water alarm at PLACE PER CODE -- in. -- in. -- in. TANK REPLACEMENT ONLY Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034Tank to 3034 Installer drainfield �j3`' GUARANTEED SERVICES Drainfield UNK cO/MTE3i'di4q Inspector CHARLES BALZARINI BENCH MARK (Assumed elevation) ADO ft Inspection 1m8/23/16 Location and description dates: 2nd 3'd 4"' BOTTOM OF SIDING NEAR FCO COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL +. �tee Conditional Approval: Date ^ • 4 -•.` # rte.. •�. ...4 . • ... . aro .. 44 am E . l 3854 G�•et. Approved aCeej? Id" Date /d y /e ,,�\-�FEST.1$.��• Inspection Report_9-1-12.doc LEGEND lif oCLEANOUT �G OF A�,�� • MONITOR TUBE ��? � ' .4 TEST HOLE APPROX / �*'� �� •*/// WATERLINE ,, , • • / N LOCATION7: �/ i' / f'�" 7 ( / - ` •RLES G BALZARIN1 P S OA 1s'. J�!E-13 •4 .•`-,�/ PJB (`�e•4 P ill�NP•' , 7. ROFESSI +- �F'e��' DRIVEWAY `�\\\```� Cp. 7 TROLL KP �� BLOCK 1 l • (COMMUNITY `� SEPTIC TROLL KNOLL 7 BLOCK 1 LOT 1 7 (COMMUNITY WATER ) 7' EXIST 7 LEACHFIELD HOUSE TO REMAIN A / NEW 1000 GALLON NEW AFTER \ SEPTIC TANK • TANK CLEANOUTS BM .4s- "Fr TY WELL \ OLD CONCRETE OM \ TANK ABANDONED INPLACE 10' UTIL EASEMENT SWING TIES A_ B_ C 27.2 29 PLAN – SCALE: 1" = 30' —+100. BTA SIDING +91.1 2" INSULATION +/- 3.2' COVER INLET OUTLET 1000 GAL TANK 87. 87.1 SCHEMATIC ELEVATION – SCALE: NTS LEGAL DESCRIPTION: TROLL KNOLL B1 L1 C&M ENGINEERING SERVICES OWNER: ROBERTSON DATE:10/20/17 REV: DRAWN: CB REF:OSP161237 907-854-5558 SEPTIC RECORD DRAWING On -Site Water and/or Wastewater 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: OSP161237 Tax Code Number: 05152113000 Work Type: SepticTank Upgrade Permit Effective Dates: August 22, 2016 to August 22, 2017 Design Engineer: C & M Engineering Subdivision: TROLL KNOLL Site Legal Address: TROLL KNOLL BLK 1 LT 1 G:1360 Owner/Address: ROBERTSON JAMES E & GLORIA A P O BOX 670575 CHUGIAK AK 995670575 Site Mailing Address: 20433 LEPRECHAN DR, Chugiak This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 29396 Total Bedrooms: 3 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. Received Issued By: Date: g Z l� MUNICIIMF ANCHORAGE VCS Community Development DepartmentPhone: 907-343-7904 Development Services Division 1W Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D.y S i 6:0 3 I_ Property owner(s) T a /hCS 9064304 Day phone t?5�—?gS0 Mailing address a oq?3 fa 4 a.Un µ Site address u Legal description (Sub'd., Block & Lot) f roll K, no 11 b la & K 1, lat 1 Legal description (Township, Range & Section) Lot Size 3 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field El Initial ElSingle Family (SF) Tank 5 Upgrade V Septic 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: certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ciL' ' re of property owner or authorized agent) Permit/Rush Fees: Date of Payment: _ Receipt Number: _ Permit No. QSP Permit App_:- : 121 16'00 Waiver Fees: 9/zsho6 pac( o prd3870 Date of Payment: Receipt Number: Waiver No. Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Alk 99507 RE: Proposed Septic System Repairs for Troll Knoll Block 1 Lot 1. Dear Reviewer, The above referenced property is currently served by a 3 bedroom septic system. The existing tank has collapsed and is in need of emergency replacement. We are requesting immediate approval to replace the existing tank with a new moa approved 1000 gallon steel septic tank, as soon as possible. All work shall be completed in accordance with MOA standards and the following Specifications: The existing tank will be pumped and disposed of properly, in accordance with moa requirements. The new 1000 gallon tank shall be of MOA approved construction with two 4" cleanouts. The tank shall be installed level, and within the excavation created by removing the old tank. The bottom of the excavation shall be leveled and compacted sufficiently to prevent settling of the tank. The new tank shall be insulated with no less than 4' of cover, and the manufacturer's maximum burial depth shall not be exceeded. The ground surface shall be sloped to prevent ponding. Dual after tank cleanouts shall be installed within 5' of the new tank, between the tank and leachfield The new tank shall be installed in accordance with the separation distances required by 15.65.050A. The tank will be installed: Greater than 5' from the property line, building foundation, and drain field. Greater than 10' from any water main or service line. Greater than 100' from any surface water. Greater than 100' from any private well, and greater than 200' from any public or community well. The Class A well serving Troll Knoll subdivision is well over 200' from the property. The well radii for Greatland Estates #2 Block 1 Lots 7 and 8 shall be surveyed in prior to construction to ensure the new septic tank does not encroach. A record drawing will be submitted after the installation of the new tank. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarinita")gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE TROLL KNOLL �` • • • • _`ry� l[ BLOCK 2 LOT 2 (COMMUNITY WATER) / *. 49 RL APPROX •* I WATERLINE LOCATION/ I ....-. ... ......... / CHARLES G BALZARINf TROLL 2K NLL O CE -1385 //��,, •��`��% (COMMUNITY WA 1 ) F -G / DRIVEWAY �IIF"P$�" "`` TROLL KNOLL BLOCK 1 LOT 2 (COMMUNITY WATER TROLL KNOLL SEPTIC) / BLOCK 1 LOT 1 / (COMMUNITY WATER ) EXIST / LEACHFIELO HOUSE TO REMAIN / NEW 1000 / GALLON NEW AFTER SEPTIC TANK TANK CLEANOUTS / NOTE: COMMUNITY WELL FROM ABANDON OLD CONCRETE THIS L - THIS LOT - - - - - - TANK PER MOA REQUIREMENTS - - - - 10' UTIL EASEMENT GREATLAND ESTATES#2 BLOCK 1 LOT 7 100' WELL RADIUS _� SEPTIC LEGEND O CLEANOUT • MONITOR TUBE ® TEST HOLE 0.5%\ SLOPE INDICATOR 100' WELL RADIUS C&M ENGINEERING SERVICES 907-854-5558 LEGAL DESCRIPTION: TROLL KNOLL BLOCK 1 LOT i OWNER: JAMES ROBERTSON I DATE: 8/20/16 1 REV.0 1 DRAWN: CBJ REF: SITE PLAN @G11171 ANCHORAGE AREA BOR"`IGH Department of Environment Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM /'! NAME V7� R,A/�"'q// MAILING ADDRESS -�JO� � �r�j��/%I��" "// PHONE Z7/p -724S LOCATION //COQ/ XA011 c5/49-' LEGAL DESCRIPTION A1A140 T / )":z oe -r! Moll AA1,011 S/,0 - SEPTIC TANK: DISTANCE (bNri I '� //A NUMBER OF FROM WELL WRI MANUFACTURER 1%/%//•/T�MATERIAL ell& �f'��'�- COMPARTMENTS / INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY -42r-0 GALLONS. TILE DRAIN FIELD: QOn� NM R TOTAL LENGTH DISTANCE FROM WELL Co htFOUNDATION ?'� 7 NEAREST LOT LINE 9010/KS OF LINES 1 9 NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTHZ IN. TOTAL EFFECTIVE ABSORPTION AREA �Z? SQ. FT. LENGTH OF EACH LINE 4Z --DEPTH OF FILTER tl�/ DEPTH: TOP OF TILE TO FINJSH GRADE MATERIAL BENEATH TILEIN. ABOVE TILE / IN. WELL: 06 AtAtawl Try W A Tcd- - TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM • CESSPOOL APPROVED DISTANCES: INSTALLED BY: SEWER LINE DEPTH: OTHER SOURCES DISAPPROVED PIPE MATERIAL: (//5 / lof7-// p(-,e^F )"/F4- LOT /v4 LOT SLOPE: REMARKS: fJ6//_ 7eS% d�.` Form PW -027 REMARKS DIAGRAM OF SYSTEM 0 09pi sAP 01 Sof �� •ti �}PP�° t3��"�E t"� cAwf ylplj�(ik�`s (i 1 1 1 lit I I I Ili 11 DATF/0//3/1;5 APPROVED ipApdy"j G.A.A.B. NAME OF APPLICANT GREf``_R ANCHORAGE AREA BOF -UGH DEPARTMENT OF ENVIRONMENTAL QUALITY' PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274.4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT MAILING ADDRESS " - ` PHONE INSTALLATION LOCATION �J/[) LEGAL DESCRIPTION L • 1 -"' Tre-/l ' ` /'/�/ D /l -5/e/ L� INSTALLATION OF: SEPTIC TANK SEEPAGE `PIT TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS .dl SOIL COMPLETION DATE ANTICIPATED TO BE INSTALLED BY OTHER 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. /%T� E��L'� TYPE//J�~�f� SEEPAGE AREA 512��/ r" /1•^I�,fTYPE �� SEPTIC TANK SIZ � ///J/J�� `` MINIMUM DISTANCES. REQUIREMENTS ` ��AGROF SYSTEM F� , FOUNDATION TO SEPTIC TANK IL —r. g FOUNDATION TO SEEPAGE PIT GRAIN hebO tD SEPTIC TANK TO SEEPAGE PIT WALL � IDLY/� �• SEPTIC TANK SEEPAGE PIT DRAIN FICLD TO NEAREST LOT 'INE. WELCTOSEPTIC TAfTC� SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK/ r• SEEPAGE PIT �� ' DRAIN FIELD TO RIVER. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION B FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDINGvr TALLATION. G.A.A.B. OR LICENSED DESIGNER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26.66 AND THAT THE ABOVE DESCRIBED SYSTEM////IS IN ACCORDANCE WITH SAID CODE. //^AJI DAT S 21?/�/�PPLICANT'S SIGNATURE' 7)fJ7// 1 FORM NO. EQ -014 r- ' 0 & E GEOICCHN1 CAL & DEVELC)MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688.2290 Russell Oyster Earl OGS 6942774 SOIL LOG BM -2280 Soils Er Foundations Land Development Performed for: Now: Tel. No. 27q -7a l,�5 Mailing Address: Legal Description: \^t Depth (feet) Soil Characteristics 0 2- 3- 4 3U 5- 6— CE) 6S r7*y Co+7s a7,1 k -y —tb J,., - M tZ1 y 9�J�arw� p . L„l,r V, M,J*4rA6 AAl e>l. IJt 1C G.t—c u + Ca4.ai LA%- L 12 < <^t HCO►�f✓Nt?uV 13 So.a Occa��ea��Y , a r ..J tA< 1U 1 r 1 d V LL-- - Cil {tib Vr- to L. 15 C. 16 Ground Water Encountered: Yes No If yess whit depth � rro,4,*- Proposed Installation: Seepage Pit Drain Field Comments: u�s4� N, J Performed by: �~, . ,� 'i Date: 'Z? ��r•t '7� GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 % Date Received June 23, 1976 Time of Inspection 10:00 a.m. Date of Inspection 7-1-76 Neale REQUEST FOR APPROVAL OF Thursday INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: First National Bank of Anchorage % Jackie Mailing Address: Po$t Office Box 4-2090, 99509 Phone: 274-1521 2. Property Owner: Jigynie U. Marshall Phone: 279-7263 Mailing Address: 3003s East Manor 3. Legal Description: Lot 1 Block 1 Troll Knoll 4. Location: 5. Type of facility to be inspected Single Family No. of bedrooms 2 6. Well Data: Public Utility A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On—site system A. Inv*led 1975 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines B. Distances: A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages i a ... ..... ,. .. �.-.._�......._. _.... .. ..-_ __-. _.. __. _.-..._.-..__..-_.i:r+�. � �-.a c -T0."'"....-.--- .............. ........ _.. . . Page 2 of'two pages - Req"�t for Approval of Individual S 1,r & Water Facilities ,Legal Description Lot 1 Block 1 Troll Knoll Comments Approved disapproved Date 71 / %6 Approval;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 EQ -034 (1/74) Date CJ IAUNXIPALITY CF ANCHCP.AG: DES'T. OF HZALTh1 i. ` fN'✓12CIJhSCNi?.L F,:CiCCTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ] J I i 2510 East Tudor Road, Anchorage, Alaska 89504 276.2221 a�'� �� REQUEST FOR APPROVAL OF RECEIVED to P INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONY X 2. Property Owner: Jimmie E. Marshall Mailing Address: 300',1 East Manor Day Phone: 279-7263 3. Name of Buyer: Sgt. James and Gloria Robertson Mailing Address: 21-570 ^Gr' Lemon St. Day Phone: 753-9393 1 Elmendorf AFB, AK 99506 4. Name of Lending Institution: First National Bank of Anchorage - South Center Br. Mailing Address: 201 W. 36th, Anchorage 99503 phone: 274-1521 80r".oU Gti (\Am 5. Name of Realtor or Agent: STAR Realty - Max Bevins/ Yukon Realty-- Kenny Broom Mailing Addressb40 W. 36th, Anchorage 99503 Phone: 279=2491 6. Legal Description: Lot 1 Block 1 Troll Knoll Subdivision Location: Peters Creek, Alaska 7. Type of Facility to be Inspected: Residence No. Bdrms. 2 8. Water Supply Type of Supply: Public Utility X Individual If Individual, number of dwellings presently served % If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) Septic If Individual, date of installation S -e N 2` t ?� 72 003W76) 06122010) .Rev. j471 h ALAS, DEPARTMENT OF HEALTH AND SOCIAL SEF DIVISION OF PUBLIC HEALTH Lob No. '7 j o INDIVIDUAL AND SEMIPUBLIC DATE BACTERIOLOGICAL`WATER ANALYSIS OFFICE Analysis shows this Water SAMPLE to be: INDIVIDUAL ❑ SEMI-PUBLIC ❑ CHLORINE RESIDUAL PPM tI+ Q Soti.fectory - REPORT RESULTS TO _ Unsatisfactory ..0 Questionable NAME ❑ Sample too long in transit; temple should not be over 48 � hours old at e.an ination to indicate reliable results. Plea" ADDRESS send new temple. i I CITY ZIP CODE . 0 Settle broken In transit, plea" send new sample. - � . - i ADDRESS �. OF SOURCE , ; SANITARIAN'S REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BY - DATE COLLECTED - TIME COLLECTED .. Ij Sample Collected From , 0 Kitchen Top ❑ Bathroom Tap ❑ Bo..ment Top L ❑ Otho (It") {FE Well — ❑ Duo ❑ Driven ❑ Drilled ❑ Bored SOURCE: ❑ Spring ❑ Cistern ❑ Other Day Well or Cistern C...,.,ion: Walls—Wood Cen.'m Metal Tile Brick or Top — B Wood B Concrete B Metol B Open Top O Concrete •t LOCATION: ❑ In Basement 0 Basement Offset ❑ Undo Hoa. I]In Yard ❑ Other Wilding Sew., Septic DISTANCE TO: or Other Drol:.ge Pipe Feet. Tank Feet. rl. S.epog. Coss. . { Field Feet. Pit Feel. Pool Feet. Privy Feet. Otho Possible I S..,u. of Contamination MATERIAL: Building Sewer • ❑ Cast Iron ❑ Wood 0 We ❑ Fibre ❑ Asbestos o Plasfic loin, Material • Typ. Covent GENERAL: Does Water Became Muddy or Discolored? ❑ Yes 0 No When? �I. Diameter of Well Depth -Met. Well Casing Material Diameter Depth "coot" of Water Depth Drop Pipe Fre. Bottom Feet. Offset in In Utility PUMP LOCATION: ❑ In Well ❑ Basement 0 In Basemen, Room On Top ❑ Of Well ❑ Otho PURPOSE OF EXAMINATION: Illness Suspected? O Yes, ❑ No jNew Source of Supply? ❑ Yes O No Repairs to System? ❑ Yes ❑ No Signature 061220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1973 READ INSTRUCTIONS Dat. P..ised Time Received / �pmiab. No. I Lactose Broth loos lose loss loss 10cc I.0,c 1.0.c ON 24 Hours 48 Hour. Brilliant Green REVERSE SIDE 48 Hours EMB AGAR BEFORE Lactose Broth, 24 Firs. 48 Ms. Oro. s stain Coliform Density I~ probable No. per 100cc) MFR.,.Its COLLECTING SAMPLE j Reported by � / �"'=--'-==fie. �� Y , i t� ..' a.'s•� r This arwlYsis Indicates Coliform Organisms to be: C Absent --- Present k. i; GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality .t3330 "C" Street, Anchorage, Alaska 99503 274-4561 FAt& Da Received Time of Inspection \[1'.Q,() - � ( � q S Date of Inspection (v-„> ad- 7. Sewage Disposal System: A. Installed 1Q//317C B. Installer C. Septic Tank: 1. Size 14407) 2. Manufacturer �,7�/fJOW1LToa.� D. Seepage Pit: 1. Absorption Area G,64 2. Material 6 /P//dei/ E. Disposal Field: Total length of lines / ere rf -" 8. Distances: *; 1-Y A. Well to: Septic tank t!6�`1?�v, Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank 9 e Absorption area 3 d C. Absorption area to nearest lot line 30 -74- EQ-034 (1/74) Page 1 of two pages tpj� .G U O� r ,1,- REQUEST FOR APPROVAL OF INDIVIDUAL SEWER FORWATER FACILITIES Soo !�'p�ON v PP l�R (10)1-T> 1. r�1 Approval requested by: C�r4 nn /,A Mailing Address: (),C) a,), LI- ongn Phone: a `l,Ll- 2. Property Owner: 11�n rn o n F , C1 art rN ->r. 0 C Phone: Mailing Address: 3. Legal Description: ?Qn% 1 aonv ti 4. Location:F 5. Type of facility to be inspected �,LVJC Q-"rnLQ, No. of bedroomso, v, no 6. Well Data: 2'bLr- 1 _ttj A. Type , ri , , „ A ,�� J B. Depth C. Construction D. Bacterial Analysis IS 7. Sewage Disposal System: A. Installed 1Q//317C B. Installer C. Septic Tank: 1. Size 14407) 2. Manufacturer �,7�/fJOW1LToa.� D. Seepage Pit: 1. Absorption Area G,64 2. Material 6 /P//dei/ E. Disposal Field: Total length of lines / ere rf -" 8. Distances: *; 1-Y A. Well to: Septic tank t!6�`1?�v, Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank 9 e Absorption area 3 d C. Absorption area to nearest lot line 30 -74- EQ-034 (1/74) Page 1 of two pages Page'2 of two pages - Re'�st for Approval of Individual mer & Water Facilities Legal Description A 1 ('_,I M1 1 : (Parr,( l u 1 v,l M , k>l 01 Em_ i Comments I Approved �� 2 - �� /<proved Date Approval,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) .-._�.-.i__ CA ..__-�tL_y i•..�_ flJr.�r!!- .... iLlci r i i i r � i i I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 2744561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection:—�--- CMRO A� �-VA...11 FHA CONY X 2. Property Owner: ZZ'4q'C`S E. /v`nm ul l Mailing Address: 800)/2- 9 AA4Y101Z t -ArY-1 Day Phone .X19 72-h3 3. Name of Buyer: -J D. 61W1pbe l l Mailing Address: 130 e_� i+Zl 61(11 E tC J; Ve*_ Day Phone &q4 q7.') -r-; 4. Name of Lending Institution: Fir6i- nofibnol BaAk, ofme--h01'UC3f i Mailing Address: Ro. Box-%-20gb Phone .2� 5. Name of Realtor or Agent: N/A Mailing Address: — Phone 6. Legal Description: Lot II 811 I 1 Tmf l 1<4"w V S/p Location: L efrdeksQY1 Dr. EQg le. @uP�le.1 >�K. 7. Type of Facility to be inspected: Sin 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 If Individual, date of installation EQ -037 W74) Individual I No. Bdrms. -3 Individual (on-site) X Y, I 06-.12MLO) Rer 1973 DATE ALA' JDEPARTMENT OF HEALTH AND SOCUIL�S(�CES DIVISION OF PUBLIC HEALTH lab No. INDIVIDUAL AND SEMIPUBLIC BACTERIOLOGICAL. -WATER ANALYSIS ' INDIVIDUAL ❑ SEMI-PUBLIC ❑ CHLORINE RESIDUAL PPM REPORT RESULTS TO NAME ADDRESS " CITY ` j�%� ZIP CODE - ADDRESS OF SOURCE " OFFICE I ysis shows this Woter SAMPLE to be: Satialactory 0 Unsatisfactory 0 Questionable %0 Sample too long In transit, somple should not be over MO hours old at examination to Indicate reliable results. Please send new sample. ❑ Battle broken in transit, phrase send new sample. _ SANITARIAN'S REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BY , DATE COLLECTED TIME COLLECTED - - Sample Collected From 0 Kitchen Tap 0 Bathroom Tap _ 0 Baumtnl Tap 0 Olher (List) - - Well — 6 Dug 8 Driven B Drilled ❑ Bored. SOURCE: Spring Cistern Olho , pup Wdl or Cistern Construction, Walls—❑ Wood ConoeN Metal Tile Brick at Top — ❑ Wood B Canaeb B Metol 8 Open Top ❑ Convele LOCATION: ' 0 In Baumtnt 0 Bawmtnt Ofhtt 0 Undo House _ Dln Yard Cloth., Wilding Sewer ,_ SepGe - DISTANCE TO: er Other Drainage Pipe Tett. Tons Feet. Tilt Seepage Ceso- Field Feet. NI Feet. Pool Feet. Privy Fret. Other ymsibb Sources of Contamination MATERIAL: Building Sewer- 0 Cost Iran 0 Wood 0 Tile; 0 fibre 0 Asbestos 0 Plastic Joint Material • Type Cement GENERAL: Does Water Become Muddy or Discolored? ❑ Yes ❑ No When? i Diameter of Well Depth Feel. Well Casing -^ Material DiameterDepth Length of Water Depth Drop Pipe From Bottom het. Offset in In until, PUMP LOCATION; 0 In Well ❑ Baument ❑ In Ba»Ment 0 Room e On Top 0 Of Well 0 Olher - - PURPOSE OF EXAMINATION: Illness Suspected? ❑ Yet ❑ No 000 10 Signature New Source of Supply? 0 Yo 0 No Repair 1. System? 0 yo. Flo _ 06"1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1973 READ INSTRUCTIONS Date Received )1 + ). +i ^ i' Time Received ��Jab. No. Loos. Broth INC 'INC loss INC INC ON 2e Hours _ 4 Hours SMU.nf Green REVERSE SIDE "Haar' MR Hours EMS BEFORE Lactose Brolh, 24 hrs. MB hrs. Coliform Density MF Results COLLECTING SAMPLE Reported by" --� - t This analysis indicates Coliform Organlxns to be: AGAR J .4, i IBcc I.0,C O'ar's slain (Mod probable No. per lODcq o.m. pots Am. Absent i I �Petsitnt