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Home My WebLink AboutPRATOR BLK 14 Municipality of Anchorage Page 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: ,_~t.3 cJ'~[~)'R PID Number: (~ t7 * ~c//-~.~ Name: ~[~)t~ ~P~E~ Wastewater System: ~ew ~ Upgrade Add~ ~O~ 5~ ~, ~ ?~6J~ ABSORPTION FIELD Total Depth from o~ginal grade: LEGAL DESCRIPTION Soil Rating: /'~ GPD/Sq. Ft. Lot: Block~ ~bdiv~ion: Depth to pipe bosom from original grade: Gravel depth b;~ath pipe Township: ~ Range: Section: Fill added above original grade: Gravel length: d~ Number of lines: Distance baleen Pines: WELL: E~ New D Upgra Gravel width: ~,5 ' Ft. ~ - Ft. Classifica~on~T~(Private, A,B,C):~ ~Ft. Cased To: Ft. Total absorption area:~ ~SQ. Ft. Pipe~material:~o/~T~ p~ Driller: ~ Date Drilled: StaticWater Levek InstaUer: Date installed: Y~ GPM PumpSet~t: Ft. Casing Height Above Grou;;: TANK SEPARATION DISTANCES ~ septic ~ Holding ~S.T.E.P. To Septic Absorption Lift Holding ~ublic/Pr[vate Manufacturer: Capacity in gallons: From Tank Fie,d Station Tank SewerLines ~~ ~ Material: Number of Compa~ments: Su,a~ ~ ~ LIFT STATION Lot ~ ~ + Sizein gallons: Manufacturer: Line ~ * ~ ~ ~ ~ ~O~ "Pump on" level at: I "Pump off" level at: High water alarm at: Foundation ~ ' ~ I0 ~+ ~ ~ Ou~ain ~ -- ~ ~ ~ ~ ~ Pump Make & Model Electrical Inspections pedormed by: ~,- Remarks: BENCH MARK Location and Description: ~ Assumed Elevation: 11034 EaoI. Eiver L~op Roa~, ~e~ 2nd /o -a -% Department of Health and l~u ~ap~ i;e~ices aoproval _ 'e~-~>, Reviewed and approved by:- ~ Date: 0~11~ ~ .... .~' .... 72-013 (Rev. 9/91) MOA 25 Permit No, SW9601 08 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report BLOCK 14, PRATOR SUBDIVISION 017-091-23 )tion: PID No.: MT1 = ~04.2' MT2Mit/=,1[[03'5'~ · F] :P.k~ 10' UTIL, ESMT. I I 1 __ I / ALT. SITE 33' SECTION LINE ESMT. I / , ~ '~, '~/ ST' 76.5' 68.5 - / ~ ] %~ ixx ST: 69.5' 61.5 - I / ~ / ~xm'~x MH 69.0' 59:5 - 88T' B.O.H. X~u~2 O NEW TRENC~ ,- N~W 1500 GAL ~ I ~ RIV~ '~'~,.~. ~;~ ~~c .;,, ~.~,~:... ,. ~,.~,,~ ...... ~:.,?~.., ~o~~''' ':'.:':~;"~:'~°w~'~'~°'-"~"~""""....'"'::~'"~':/~ ,- ~--~ 72-013 A (Rev. g/91) MOA 25 A'IU UDY bU{~blE .~AA I~U. 901 OUOO ~. I ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. CIVIL ENGINEERS HEALTH AUTHORITY APPROVALS SEWER&WATER f,/CJ N EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITEPLANS ROAD DESIGN PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTE'WATER O~SPOSALSYSTEM DESIGN Date: Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: ~ ro c~ i? P R4 70r~ (907) 694-2979 FAX (907) 694-1211 The septic inEp~ctions for the referenced property were performed on io/,/q ~ and ;0/A/g& . Prior to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the ~"~te'~ ~c,o¢,-rw~ to be completed. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP" SUITE 204 · EAGLE RIVER, ALASKA 99577 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 PERMIT PERMIT NUMBER:SW960108 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DUPREE RANDY G &KARI R OWNER ADDRESS:14000 PRATOR ST ANCHORAGE, ALASKA 99518 PARCEL ID:01709123 PAGE 1 OF 1 DATE ISSUED: 6/10/96 EXPIRATION DATE: 6/10/97 LEGAL DESCRIPTION: PRATOR BLK 14 LOT SIZE: 174240 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: {FOR ATTACHED DESIGN, ~SE HOLE SPACING SHOWN ON RECEIVED BY: ISSUED BY: DATE: DATE: ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. May 24, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL iNSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Block 14, Prator Subdivision Request you issue a permit to install a septic system to serve the proposed four bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate loc~ion of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole. The monitoring tube within the test hole has been checked and found to be dry. This property has enough area for a future septic upgrade which can be seen on .the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Cowanr P.E. RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP . SUITE 204 · EAGLE RIVER, ALASKA 99577 'IHS3 ']llr] ,OL Z w 100' WELL RADIUS NOlS30 NV'I& 311S :~gVO~ ,09 = ,,[ L,J Z OW oF-I- >- Z 5D · 39130Hd OLd L~O~ )- 22} · 91V13(3 :ll¥Og Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4- 5- 6- 7 8 9 SLOPE SITE PLAN I S~ 10- 11 12 13- 14 15- 16- 17- 18- 19- 20- WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT ~ O DEPTH? P E Depth to Water After Monitoring;' 2)g~/ Date: Gross Net Depth to Net Reading Date Time Time Water Drop q: ~- ]~ 7 ~/~" '1 v" PERCOLATION RATE Z]/ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND--~3 FT COMMENTS PERFORMED BY: $ & S ENGINEERING I~ -' _ - ) CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WiTH~/~Ta~¢:S~aNL~°~IiI~bi,L~iN EFFECT ON THIS DATE. DATE: ~ '/'~ //~, 72-008 (Rev. 4/85) ROBERT C. COWAN, RE. ROBERT A. SHAFER, P.E. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERINGSTUOIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN REFERENCE: Block 14, Prator Subdivision May 24, 1996 GENERAL: 1. e e Se The scope of this project includes the installation of a 1500 gallon septic tank effluent pumping (S.T.E.P.) and pressurized leachfield trench to serve the proposed four bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wast°water disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer° Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3° Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 ° EAGLE RIVER, ALASKA 99577 Page Two Block 14, Prator Subdivsion May 24, 1996 e Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the holes faced downward. The distribution piping is to be of PVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. Se A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. e Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Block 14, Prator Subdivision May 24, 1996 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. e The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. e Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). e Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. e Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the ~200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Block 14, Prator Subdivision May 24, 1996 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: e 0 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Block 14, Prator Subdivision May 24, 1996 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER HEALTH DEPARTMENT 327 EA~["E ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME //~'7/''/~-/~-~ ..:~ ~4;~ >~'~ ~ LO CATi 0 N ,~ ~'~-~ ~ ~ ~ SEPTIC TANK: DISTANCE FROM WELL ~ / LIQUID CAPACITY /~: ~' GALLONS. MAILING ~ . . -- .~ ~, ADDRESS,/~'~.)f ~ ~/· :~ ~ ~-~"c",~"./PHONE. LEOAL DESCRIPTION~ /~ ,//~-~ ~.. , ~ ~ NUMBER OF MATERIAL ~~ COMPARTMENTS NSIDE LENGTH. WOTH SEEPAGE SYSTEM: NUMBER OF PITS. / LINING MATERIAL ~ NEAREST LOT LINE ~.~.~,C~ SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH ,/--.~ / / ~ / ...... , LENGTH ~-~-/ , DEPTH DISTANCE FROM WELL '/'~? '~' ? ~2Z": '~''~ BUILDING FOUNDATION"'~ - , TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,?' ./' 6 SQ. FT. TILE DRAIN FIELD: ~ ' --~'"~ TOTAL LENGTH DISTANCE FROM WELL / , FOUNDATION \ NEAREST LOT LINE ~ , OF LINES , NUMBER O DISTANCE BETWEEN .\ ABSORPTI~ AREA . . 'H OF EACH bl~lE~ ~~/ / DEPTH- ~'OP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPE .~.~..×~z~/~ DEPTH /-"~"'~ : DISTANCE FROM WATER · BUILDING FOUNDATION. "~'~ SAMPLE //'-z/~? , NEAREST LOT LINE ,./~_D '"-//~ NEAREST / SEPTIC _~.~: / SEEPAGE /,/__.}/. " ~ OTHER , SEWER LINE , TANK , SYSTEM J '~: , CESSPOOl , SOURCES DISTANCEs: DIAGRAM OF SYSTEM _ DATE /:"~'// APPROVED ~ -/ H L GAAB-HE ' '~ HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK MAILING ADDRESS ~' L//-,/7.~ PHONE NO. SEEPAGE PIT ,~ DRAIN FIELD OTHER TO SER,,E T.E F0'LOW,NG FAC. L,TY FINANCED THROUGH -//~'~ ~/~?.,/T0 BE INSTALLED BY ~ . .' , ,~..~ i~ , - BELOW T0 BE FILLED OUT BY HEALTH DEPARTMENT AS DESCRIBED BELOW.' Siz~ OF UNIT TO BE SERVED-; ~ ¢~::~ '~ TY~E ~ SEEPAGE AR~A ~ U~ TY~ ~'r~ . SEPTIC TANK SIZE /~ .S~ DIAGRAM OF SYSTEM - ~:J DISTANCES: HEALTH AUTHORITY OR LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage A.re%Boro, ugh Ordinance No, .,28-.~8 and that the above de~e/s~'bed system is in accordance with said code. .~.?y ~/z'./~, ......... &'///'~U~('~ty_¢'~ ,¢ff~'~ ~' ~--~-'~-, ~ _, qREATER ANCMORt~G~ &K~a ~U~UU~M HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA'99501 CASE Legal Description: Lot.~____B!ock_~_~_Subdlvasl°nP__~%~%____ · ~= pn~m Ra~opts a: S6£is Log /~/ Percolation Test Depth Feet Soil Cha~.~r't episl~ics ........ -3 ..... -- '~i,l~,,~ ,,.~. ~:~,~ ~,~,,~,,~ . Was Ground Water Encountered?/?_~~ If Yes, At What Depth Date Reading .~C~la~ion Gross Time Net Time Location Sketch Depth To H20 Net Drop Pmoposed Instal~Seepage Pit / Drain Field Depth Of Inlet COMMENTS: Q ' ~/~ z~ ~,~ Test Performed BS,:~~ Date, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING -O¢11 -~-3 HAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) ,P~;oPerty owner '"';Mailing address ::, Lpnding agency ),Mailing address Day phone A'gent Address Day phone '4. Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: z/ TYPE OF WATER SUPPLY: Individual well ~' Community well Public water NOTE: RECEIVED APR 0 1997 Municipality of Anc, ho~-~gr~ Dept. Health & Human Servioe8 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 'TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: X If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for 'the number of bedrooms and type of structure indicated herein· I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. $ & $ ENGINEERING Phone dj' ~ ~/- ~ ~j '7 ~ Name of Firm lyO~,; Eagle River Loop Road No. 204 Address Eagle River, Alaska 99577 DHHS SIGNATURE __ £ ~ .~ Approved for /z-~fj~_ Disapproved. Conditional approval for bedrooms. CF.. 8801 "~,,'. .'.. ,.;~ .",' bedrooms, with the following stipulations: Additional Comments By: If~ ~'J/[~ ,. The Municipality of Anchorage Department of Health arid Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~25 (Rev. 1/91 ) B~ck MOA #21 Legal Description: glo c~.. A. WELL DATA Well type ~o R / ¥,~ -~- ¢_ /~UN~Cm^[m, OF ^~cHo~ei Municipality of Anchorage ~, DEPARTMENT OF HEALTH & HUMAN SERVICES AP~ ~ 0 Environmental Se~ices Division 825 L Street, Room 502, Anchorage, Alaska 99501 - (907) 34~_~CE !~ Health Authority Approval Checklist ParcelI.D.: 0/7 - off/ _ D~ Log present (y/~, ~u 0 Total depth _ / ~ o Sanitary seal ~/N) ¥ ~: 5 Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform o _ if A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to ~/o v- FROM WELL LOG ut~ / ~ g.p.m. Casing height (above ground) _ Wires properly protected (~/N) AT INSPECTION j /-/- _ g.p.m. ___ Nitrate dT. / Other bacteria o Date of sample: __ '-//~ ;~ / ~? 7 Collected by: S & S ENGINEERING B'~-LL'-¢~, HOLDING TANK DATA -- '~~q~L-oo~ __ '~ag/e River, Alaska 99577 Date installed _Z o/__~ /o/__.~ Tank size i &--o O. _ Number of Compartments ~ Cleanouts ~/N) Foundation cleanout~')~N) ~'~/~ Depression (y/~_)) /,v o High water alarm ~,YN) _ Date of PumPing ~t/4 - ~.~ Pumper '-- -- c. A SO.PT ON FIELD DATA Date inSta,ed ¢ , _ Soil rating ~/or ft~/bdrm)/ , ~ Length : ~/"/ / / ~ -- _ System type '~,,, __. Width ~.~ - Gravel thickness below pipe (a / ..... Total depth _ /~o Effective abSorPtion area ~ 6 V___.~ ~ ~_ Monitoring Tube present (~/N)?__~ Depression over field (Y~) ,'v__.__~O Date of adequacy test ~/~ - N¢_,.,~ Res .... ~, ~ .... UltS (Pass/Fail) ~ ~"~_ For z_/ bedrooms I-laid depth in absorption field before test (in.); ~er._ ~ gal water adde---d Peroxide trea past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* Manhole/Access ((~N) "' *Datum High water alarm level at* Cycles tested E, SEPARATION DISTANCES SEPARATION D~STANCES FROM WELL ON LOT TO: Date installed. ! a / ''~ / °1G Size in gallons / ~'~ o O "Pump on" level at* ~ "Pump off" level at* ___-------- / oO 4- Sewer/septic service line SEPARATION DISTANCES FROMI~'~OLDING TANK ON LOT TO: ,+ ? o o '.~- Absorption field_ s~ ~ Property line On adjacent ~ots _ /oO On adjacent lots _ Public sewer manhole/cleanout Lift station ~holding tank on lot _ Absorption field on lot _ Public sewer main _ I00 Foundation _ water main/service line 9 o '-~ Sudace water/drainage /?__o ~ Wells on adjacent lots _ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ,.¢._ , / o o / -~ Water main/service line I ~" o 3 ~' '/- Building foundation _ ,. Prope~y line ) o "+- ) o ~ ' +- Driveway, parking/vehicle storage area Surface water _ .i o o Cu~ain drain _ P 0 ~.~ ~ ~ o ~ w Wells on adjacent lots F, ENGINEER'S CERTIFICATION · e determined thru field inspections and review of Mu P ~ ~ .... ";..;,~t~ I ce~/fy that I hay ...... ~ ~ ~Uidelines in effect on this date. ~/' ~/"..~ in conformance w'~'~? ~~' ' =-7 ,~,~.. Engineer s Name ~ ~ HAAFee $ ~0~>/ Date of Payment ~ Receipt Number ~/~ ~~~' 72-026 (Rev. 3/96~* Waiver Fee $ Date of Payment_ Receipt Number Buyer Address· Zip Code Lendinglnstitution ~~ ~ ~.~'1"~ ~//~/~ ~/~'~ Phone Address Zip Code Realty Co. & A~nt /~ tv~ ~OC ~U &//, '" Phone . c~. Address Zip Code Legal ~escriptio. Type of Resi~nce Single Family Multiple Family No. of Bedrooms g Other Water Supply ~ Individual A~ACH WELL LOG. A w~l log is required for all welts drilled since June lg75. ~ Community For wells drilled prior to that date, give well depth (attach log if available). - ~ Public Utility Sewer Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time . .~.~-~--(~ - '~--~ MUNICIPALI~ OF ANCHO~GE ~ C~ ~ ~ ~~ DEPT. OF HEALTH & ~NVIRONMENTAL PROTECTION ( ~ISAPPROVED Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ~-"~ 0 Well to Tank ~1~ Septic T~k Size 72-023 June 2, !9~}3 Thomas J. ~?ianger~ SP, A }Jox 443 Ancl~orage, AK 99507 Subject~ ~ioc]~ !4~ Prater ~ubdivision Al~{)roval for the individual sev;er ~lnd ~ater fac~.iities cannot be granted until the following items have been o The depression or pit around ti~e %~eli casin~ needs to be filled ~ith impervious type soil so that it slopes from the ~-~eil casin~3- %3he septic tank pumped %~ith a receipt submitted to this department. o A four (~) inch cleanout needs to be installed to the sep- tic tank. o A four (~t) inch cleanout needs to be installed to the leaching area. o ~:%n adequacy test needs to be performed on the existing . [eachin<] area. TI]is test ¥~ill determine if the system ade{luate according to National ,~t<~u~. A listing of private firms }?rfor~ing the test is enclosed. This report needs to be subnli'tted to this office for our reviews. Please notiJ[y this Depart~ent for a reinspection v;hen the . · · .-~,~ ~ if there are any noted discrepancies have been cor~=~e~. further questions, please call this of]lice at 26~-~720~ ~3incerely, ]3nclosure t:ioDort C. Pratt Associate Environ]nental ~3pecialist