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PROSPECT HEIGHTS #1 BLK 6 LT 12
~" MUNICIPALITY OF ANCHORAGE :'~" DE. ,RTMENT OF HEALTH AND HUMAN SER~,~ES Environmenlal Health Division (///') r ~ 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ~ ~/~ ~ Tn SEPTIC ABSORPTION AddressFROM~ TANK FIELD WELL Phone{si P~rm,l No No. o1 Bed ..... WELL ~ ~/~' '/~;~ LEGAL DESCRIPTION~O ~(: ~/ LOT LINE ~, ~' Lot I BlOCk Subdiws~on AS-BUILT DIAGRAM {Show Iocabon ot well, septic system, property hnes, Ioundehon, TANKS U ~ SEPTIC ~ HOLDING ~ C i TYPE OF SYSTEM ~TRENCH ~ BED ~ W. DRAiN ~ OTHER ~ ~, %~' FT ~ FT ~ ~S~ FT -- FT ~~ ~' . , ~ WELLS ~PRIVATE ~ OTHER fldentifv) o, ' ~ ~ ~ ET FT ,,~ i ~ municipal and State Duidelines in effect on Ibis dale: ~/~1~ Health Depadment Approval' Date: ?--/7-~ 0 Iq .... [i~ :I: T Ii!: ,r..~ E: ~'~ E R F' E: [~ t9 Z T Enginm~?r Day I::'hOll~ ,, "-', ..... - . ~,~ LoC ~....e..(. ~:~ ~ S~:'Lior,:: 1:3 "l'm~r~sh ~p ~ 12N IRang~ EUEI::q"IC TANK:: Ivlil-)j. llil..li]) 'LoCal s~pt.J.c t. anl< capacity: 1,~Z5C) gal].(::)n~. Each 'Lau"~k mLu~FL hawe a't. lea[sC ~2 ~]QlEaP'Eal~)rlts. Dep'Lh 'Lc~ 'L~p o{' ~e~(~..~p't. ic 't. anl<(~) .::: {'6.)~:e'L pecli..~ii"(.:.~s iF~l..l].a~]ioFI Over 'Lanl.::(~). ]:NFORI9 D,F-I.H,,S. F:'RIOR TEl :[ST ~ 2ND INSF'ECCTIONS [~Y ENBINE[E:R~, ~d::'T!~R CH::'FICE F.ICH.JRS CPd....L. :$4iT,-...4~E~]. AND L.E~VE ~.~ CONSTF~UCT PER'. E:NGINEE:R~ CFFTACHED f-~F'PROVED DE[~IGN 'T'FIIS F'EFdg ]: "I" E~:XF:'IF~ES "FHI~ I:::'tERPIIT VALID FOR ~ SIN(%..E: F[kM:[LY R[ESIDENCE ONLY s~u~r~a.g~) ~y~;'L6)m c)n 'Lhis (:)r any ad.iac~n'L (m"' n~:aaPby ].(:)~' .... any (Ou~n,.:.:.)r) IRE)'E(E:F l:::'¢ff:~l'.'::S PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST , ~ '; Michael E. Anderson ,'* ,.~ - ~ ~UFESS~~ DATE PERFORMED: ~-- ~ LEGAL DESCRIPTION: ~- I ~- grS>~z~ /~/~o~g~-..~'~ //,.~,gTownship, Range, Section: /,.~, 7'-/,~A,~j SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9- 10 11 12 13 14 16 17 18 19 2O WAS GROUND WATER ENCOUNTERED? $ IF YES, AT WHAT ~) DEPTH? P E Depth to Wa~r ~ Monitoring? ,>/.5-' Date: d - / f- .-%g Gross Net Depth to Net Reading Date Time Time Water Drop i ,, 2_ 2- 7'~ , ~$ 5:,97 PERCOLATION RATE ~, ~ (minutes/inch) PERC HOLE DIAMETER ~" TEST RUN BETWEEN .~' FT AND ~ FT COMMENTS /~/~4/ ~)~? ~/£,-~-~t,',~W'-CL'~ /~/~--~I'E"J~ -- ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TH S DA E. 72-008 (Rev. 4/85) ' / ~,.) HEALTH AUTHORITY DA~E APPROVED G^^B-~D-2 GREATEi. .,NCHORAGE AREA i HEALTH DEPARTMENT ~" ~/::/ 327 Eagle St. Anchorage, Alaska 99501 279-2511 _ .)ROUGH c,s, No. /?? NAME OF APPLICAN'L' RESIDENCE ADDRESS 'LOCATION OF INSTALLATION SEEPAGE PIT / DRAIN FIELD. ,OTHER TO BE INSTALLED BY ,,~"/ ANTICIPATED DATE OF COMPLETI~OO~N LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACI£1TY_ FINANCED THROUGH ': PERCOLATION TEST RESULTS BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS _~,2~r~, ~~Z_~) , PERMIT TO INSTALL A AS DESCRIBE[) BELOW. SIZE OF UNIT TO BE SERVED . SEPTIC TANK SIZE/~ TYPE ~ SEEPAGE AREA~TYPE DIAGRAM OF SYSTEM DISTANCES: 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 accordance with said code. nATF ~:~/~//~ q APPLICANTS SIGNATURE ~" -'~J ~-~)~-'~'~ ~ ..... ' On-S~te Sew ces Section ..... P.O. Box 19~0 Anchorage, Alaska APPROVAL FOR A SINGLE FAMILY DWELL NG ' ' ' ' " I te I ' scri ion - . Lot 12;, ~ock~:~ P~o~p6~ H~¢~S Sub~v~4o~ ¢ " .............. Comp e .egal..de pt. , _ . _ · ; ~'.*,¢.;,~ ..... *--, '/'..-;~ ..... ' ' * --. ' Anchora,~6, AK '. '. ~(~[/-7 p~pe~oW&~*:AVIX OF:A~ERICA C/O 'Kondo '-' Day phone . ~ ' ....- ,?:? -.,, ?,~ ,:: .. -~ --~,;..- - . · . -: .. ~- ~:, ,.;.,'- 'Mailing'~ddre~s'~9900 B~ddY'~n~ Rd. Anchoraq6; :"AK 99516 %~.% Lendin!l:agen~,' % .... , · - Day phone %,-.,.,-~¢... . · ¢.-. :4. ,, .. · . . .~ '. . ', .' ,' ,'2't~ ' ' .... - · :: %- Ma ~ng address ' · .... ~bo,,~.bon (s~te e s r ~ s ~ ncr , ....NOTE: If community well system, provide written confj :~ ~..' . :": : ' : ,,: ~ng to the legality and status of system. - '.' .... ' ~ · .......... ............... ::~ ~' ~ 4. TYPE OF WASTEWATER DISPOSAL: .~ Ci,.., ::: ';':,::::;::' Individua on'site;, ., XXX ;;,,,:,:,,:;,.:;, ' &,.;~- Holding tank . Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 5., STATEMENT OF INSPECTION BY ENGINEER '- '' ' . '-~ '~'~ '" ~' As certified b;"my seal ~ffi~edhem{° 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 invest.~ation and inspection, the on-site water supply and/or w'astewater disposal system is in compliance with al! M.unicipal and State codes, regdiation~,in,~ff~{· ...... ~r ~=~ . ' 0n-t~e date of t~his inspection. · and ord,nances,' :._ ~ .., _~--, ,- -' .- :.. : .> ~*~ S & s ENGINEERING ..... Phone ............ Nameof Firm ~iG~4 ~_~_g;e ~ver L~op koad ~io. zu~ AddreSs ~ Date_ 4; /'~ /~£ Engir~er's"signature ,, ........ ' . .. . ., :.: ..... · .... · ..... ~-~ ~~:~ ...................... - ....... '~:%_'-,,. · _ ~. .. ...... ~ ~>'~ ...~ ,~ _~-' ........................ . .... ~t, <~;.~... .....:~.. . ..................... .......... : ................ ,~ ~..... ~,~.~-~ .-., -, ~ ....HHS SIGNATURE .~ . ~., ,.~ ,~.~' "~.-~-~ "-~,, . ... :-.~ ':.,?~-Approved for`> ....... ~ . :"'.'bedr°°m~'":.~'"':'-':'~':~ .....: "r~i:'!:' ..... '----:..- ,.. ---- sti Ui Uo.s: __ _i ....... ~-~.-:~,~DisapProved.:~:?:."¥.?!~:~-~:~'':'''': :-:':~ ':'-'i "' -, :.i ~onditio~a approval' for 6, "~> =' F.-, r~ ,'i ~:~ ::. bedrooms, with. the m : :'-. :' ,i--'-- ::: ~':- ~ .~ .-:.,-~ . -,., ~ :..'r: ...~'~,?~ ?':~ '.~' ' , .""._., ¢~-::~, !~., ./!~i,' ... · . ,> ' : --..' ' · :..,::~ ~,- , '~.'-.: :.. . , . . /,,,,f/~ : ?" ~ ,~ ~ ~' , , -: ~ .... ~ · -~ ! Date The Municipali~ of Anchorage Department of Health and 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, " Legal Description: A. WELL DATA ~AUNICI?ALt'~Y ©~ Municipality of Anchorage F~/~P. ONMENTAL SERVICES DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division jUN 4- ~996 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744.. _ REC iV U Health Authority Approval Checklist Well type Log present (Y,~ ~J ~ Total depth 2L, ~ Cased to If A, B, or C, attach ADEC letter. ADEC water system number Date completed %)/I~ Sanitary seal ~"'~N) ~ ~ FROM WELL LOG Date of test Static water level Well production Casing height (above ground) I Wires properly protected (~N) ~)~-% AT INSPECTION g.p.m. q .L{ g.p.m. WATER SAMPLE RESULTS: Coliform ~ Date of sample: ~ r t Nitrate c~. (~5'~ Other bacteria Collected by: ~ ~J '5 ~L~.~J e~t~J~ B. SEPTIC/HOLDING TANK DATA Date installed G ¢ ~ % Tanksize Foundation cleanout L~N) Date of Pumping C. ABSORPTION FIELD DATA' Date installed G Number of Compartments 2 Cleanouts (~N) Depression (Y/~I~ bio High water alarm (Y/N). Soil rating (g.p.d./fF or fF/bdrm) iqe ~/~5~w~System type ~T'r~c~ /c,~, Length Ll~-' /m Width ;.~-~ /~? /Gravel thickness below pipe c{'/~ Totaldepth Effective absorption area (~c[ ~ ~/33(~ '~ r Monitoring Tube present Y~)"/~ Depression over field (Y/~ Date of adequacy test q; - [~ -~,1,~ Results ~ail) "-~A~ 5 For ~'1 bedrooms ~,.~_ r~.,~-,s~.~z~,.~.~$ ~,, ¢,~ ._ <:.,?.,~, r~,~r~.,,,¢ 7t, 4£ R~/~'~-'~ ~-//,//r~ ~, . Fluid depth in absorption rield before test (in.); -5 ~ Immediately after ~5-gal. water added (in.): ,. Fluid depth l'~ (ins) MinUtes later: ~%" Absorption rate = GOO '~ _g.p.d. Peroxide treatment (past 12 months) (Y/N) ~) ~ [~_~o~ rJ If yes, give date. 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on"~cCat'-~ "Pump off" level at* High water alarm level at* .~~ *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ~holding tank on lot ~ qO ~ ~- ^~A~H~o t~AtV~n adjacent lots Absorption field on lot Iow ~ + On adjacent lots Public sewer main -~ 4- Public sewer manhole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM~S'~P-~iC~HOLDING TANK ON LOTTO: Foundation I ~' Property line to ~ ~- Absorption field tq Water main/service line ~ 'P Surface water/drainage ~oo'4- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line lo ' + Building foundation ~lo~ Water main/service line Surface water Driveway, parking/vehicle storage area Curtain drain Wells on adjacent lots ioo % F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records th.~~~tems are in' conformance with MOA.~AA ~tuide!~nes in effect on this date. Engine r' Na 'e '0af, r C, [ ....... Date ~ / ~ /~ G Date of Payment ~~ Date of Payment R eceiptNumber ~ ~~~ ~ ~ecoipt~umDor 72-026 (Rev. 3/96)* CT&E Environmental Services inc. Laboratory Division ~-~c' ~'-~: ;,~-- . Laboratory Analysis Report CT&E Ref.# Client Sample ID Matrix PW$~ 0 961784.96] 7~4001 PROSPECT HOTS gi 101 N~trit~-N ~itrate-N tOtat ¢otifgrm Collected Date 05/i5/96 Technical Director: ~epheJ~ C. Resutts ge PeL Units Meth,d Qua[ 0.100 U 0.100 mg/L ~PA 353.2 0.692 0.100 ~/t CPA 3S3.2 - 200 W_ Potter Drive, Anchorage, AK 99518-1 $05 -- Tel: (907) 562-2343 Fax: (907) 561-5301 3180 Peger Rood, Fairbanks. AK 99709-5471 -- Tel: (907) 474-8656 Fax: (907) 474-9885 ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA. FLORIDA, ILLINOIg MANY1 ~.n ~.cum~. ................ Rick Mystrom, Mayor Mtmicipali , of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage. Alaska 99519-6650 June 21, 1996 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 12 Block 6 Prospect Heights Subdivision #1 Waiver Request #WR960022, PID #015-092-19, HA960215 Dear Mr. Cowan: Your request for the waiver of the required 100 foot horizontal separation of an on-site septic tank to a private well on the reference property has been approved. The approved separation distance is 90 feet. This waiver approval applies to the existing on-site septic tank and private well separation only. Any furore upgrade to either will require all separation distances be met or another approval from this department. If there are any questions or concerns regarding this waiver please call our office at 343- 4744. Sincerely, Robert W. Robinson Civil Engineer On-site Services RWR/lj m: waiver/Avix of America MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ WR960022 PID~ 015-092-19 HA9 HA960215 Permit Date Received: June 4, 1996 Legal Description: Lot 12 Block 6 Prospect Heights #1 Engineer: Robert C. Cowan, P.E., S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska 99577 Applicant: Avix of America % Konda · Waiver Requested: Private well to private septic tank on lot of 90 feet Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: Points: I 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: /~ ~t~ Date: ~/~//~/ By: ,~~/~/~ ~/~ .Name of ~Reviewer Rec ~: 01904/9291 Amount: $ 625.00 Date Paid: 6-4-96 96-06-19 11:27 RCVD ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. CIVIL ENGINEERS HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN June 3, 1996 (907) 694-2979 FAX (907) 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED dUN 4 1996 Municipality of Anchorage Dept. Health & Human Services REFERENCE: Lot 12 Block 6 Prospect Heights Subdivision~ \ Request you issue a Health Authority Approval on the referenced property and grant a waiver for the horizontal separation distance between the well and the septic tank serving this property at 90 feet. The mitigating factors involved which support the issuance of the waivers are as follows: 1. Reference the site plan/topo, surface effluent would not flow toward the well. Generally speaking, septic tanks should not be considered a "continuous" source of contamination as would a leachfield. 3. Nitrate sample taken from the well located on the referenced property indicated .100 mg/1. 4. The house is located between the well and the septic tank. In our opinion, the separation distance requirement prescribed by 18AAC.021 is not necessary in this case. 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 100' SCALE SITE PLAN 96-06-19 11:27 RCVD iI SGALE SITE PLAN DESIGN 96-06-19 ~?:27 RCVD DATE RECEIVED !~ ,.~/) ' INSPECTION APPOINTMENTS C-0~L~-',~Z,~-~? ~ DATE / L'~l i DATE DATE INSPECTO~ [ ~ '~ INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE DEPT, OF i!F/',LTH & DEPARTMENT OF HEALTH ~ ENVIRONMENTAL PROTECTIO~NVIRONMENTAL ~:;~:'I'ECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed. Please allow ten (10) days for processing. PHONE 1. PROPERTY OWNER ~(.- S~& ~ i,~2~, ",~,~ .-;' ~ MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS ~'~:~ ~. ~7:c~'z~-- t2~:/;. 3. LENDING INSTITUTION ~ ] PHONE MAILING ADDRESS 4. REAL~OR/AGENT ~ PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE [~] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS E~ One -j~ Four [] Two [] Five [] Three [] Six [] Other 7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN DiE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED PERMIT NUMBER 3, SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~j~ ~ (~ C~ Connection Verified INSTALLER []Septic Tank or []Holdin§ Tank Size: !~.)d~)F--) If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER ' TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/H°ldingTank IAbs°rpti°nArea ISewer Line' INearest L°t Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS ~ APPROVED FOR ~ BEDROOMS ~ ~ONOITIONAL APPROVAL (letter must~Dcompany certificate) 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION September 3, 1980 Mick Stilley United Bank Alaska Post Office Box 7059 Anchorage, Alaska 99510 Subject: Lot 12 Block 6 Prospect Heights Subdivision Robert L./Winifred Stewart Property I am returning your application request and check to you. The Stewart's came into the office on August 25, 1980 and made application for the health authority. We have done the inspections and the enclosed copy of the letter is what needs to be completed before this department can give an approval. If there are any questions you may have, please give me at call at 264-4720. Sincerely, Laura J. Ward Sewer and Water Program LJW 825 ",L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION August 29, 1980 Robert L./Winifred Stewart 2908 Commercial Drive Anchorage, Alaska 99501 Subject: Lot 12 Block 6 Prospect Heights Subdivision #1 Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (i) The water analysis report be delivered to this department from Chem Lab, 5633 B Street, for our review. (2) The septic tank pumped with a receipt submitted to this department. (3) An adequacy test be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: United Bank Alaska 645 G Street 99501 Bob Rink % Marston Real Estate 2804 East Northern Lights Boulevard 99503 .TECTONICS, INC. P.O. BOX 4-2265 ANCHORAGE, AK. (907) 278-2115 CHECKEDBY: SHT/' OF PROJECT MUNICIPAEITY OF ANCHORAGE J~UNICIPALITY OF ^NCHOEAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL P,~OTECTION Telephone 264-4720 BIREOTIO~S: Complete all parts on page ~, Incomplete requests will net be processed. Please allow ten (10) days for processing, 1. PROPERTY OWNER PHONE MAILING ADDRESS PROPERTY RESlDENT (If different from above) ¢,~'~V/¢~ ~'~'~1~'~-2" /¢/J¢ ~/~ ~ .... PHONE MAILING ADDRESS 3. LENDING INSTITUTION ~ '".~'ZCZ~/ ~ , PHONE MAILING ADDRESS 4. REALTOR/AGENT ) IPHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATI ON &o/~,v/~ ~ .-~'/-/z-~<-<S' 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four ~ SINGLE FAMILY [] Two ~ Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well (attach log if available.) f'(~'~" depth **If individual/on-site, give installation date ~ ~.~'~ If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY · DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [~] SINGLE FAMILY [] ONE [] THREE [] FIVE [~ OTHER [] MULTIPLE FAMILY [~ TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~ INDIVIDUAL/ON -SITE DATE INSTALLED [~ PUBLIC UTI LITY~..~J¢) ,, ~ -- Connection Verified INSTALLER []Septic Tank or ~Holding Tank Size: ~--'- '~ ~ ' IfTank ishomemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line I I WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL {letter must accompany certificate) [2~'~DISAPPROVE D DATE BY (Title) ,/ "' LEGAL DESCRIPTION 72-010 (Rev. 3/78) October 2, 1978 Tony Smith c/o Lawyers Title 400 Tudor Road Anchorage, Alaska 99510 Attention: Sally Green MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOI'~r,'I No. 851597 OCT 4 1978 RECEIVED Re: Adequacy Test on Existing Sanitary, Sewer System; Prospect Heights Subdivision, Anchorage, Alaska Dear Mr. Smith: Lot 12, Block 6, Per the request of John Bashaw, Polar Realty, we conducted a test of the sanitary sewer system on the above described property. Twelve hundred gallons were pumped from the septic tank prior to the perform- ance of the test on the seepage pit. During the test the liquid level in the seepage pit was monitored as 750 gallons were removed and 725 gallons were pumped back into the seepage pit to the inlet level. Ail liquid levels were measured below the top of the standpipe and are shown in the following table: Initial Liquid Second Water Third 24-Hour Total Reading Removed Reading Added Reading Reading Drop (gallons) (gallons) 6.27' 750 8.60' 725 6.63' 6.80' 0.17' The average specific capacity is 28.8 gallons per inch based on two sets of readings showing 26.8 and 30.7 gallons per inch. After twenty four hours the liquid level was measured again at 6.80 feet. It had dropped 0.17 feet or 2.0 inches. This indicates an average effluent acceptance rate of 58 gallons per day for the surrounding soils. If the 5 bedroom residence on the prop- erty is to house 10 people, the average load on the system can be expected to be 750 gallons per day. We can therefore conclude that the system is not disposing of effluent at an adequate rate for a 5 bedroom residence. October 2, 1978 Tony Smith Page -2- We appreciate this opportunity to be of service to you. Please contact us if you have any questions regarding this letter or if we can be of additional service to you. Very truly yours, R&M CONSULTANT%, INC. Pro.ct Manager GAS/djb/12-P , ~~'~330 "C" Street, A~cho.age, Alaska 99503 Y274-456] ,:"; .,.~/ ~ ~ Date Received ~- ~ ~~No v~ .../ Date of Inspection ' ~, ,~ },~b ~NDIVIDUAL SEWER & WATER FACILITIES 1. Approval requested by: . ~b,~ ~~3e~ ~'~'2 o 2. Property Owner: ~c~l,,~e~ol Ix~ _o_~c~. ~, Phone: Mailing Address: ~l~ ~i 3. Legal Description: ~ I~ ~ ~ ~.qp~mi, 4. Location: ~%~,L~E( c~ ~8.~0_~ ~L~ ~o (~]~n~_..~,_L~t 6. WeJ;~':'Data: ;' A. Type _ B. Depth Sewage Disposal System: ~~.~D A. ~nstalled ~g~ B. Installer C. Septic Tank: 1. Size D. Seepage Pit: E. Disposal Field: Distances: A. Well to:' Septic tank Nearest lot line 2. Manufacturer 1. Absorption Area 2. Material Total length of lines , Absorption area . Other contamination B. Foundation to septic tank C. Absorption area to nearest lot line , Sewer Lines , Absorption area EQ-034 (1/74) Page 1 of two paqes P'age 2 Of two 'Rages - ReqL for Approval of Individual Ss "& Water Facilities "Legal~Des~ripti~n ~-~ I~ ~/c~ /~ ~c]~O<~C~ ~J~[~nq~.. Comments Approv~lJ:Valid for one year from date signed Greater Anchorage~i~ea 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) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561~mH, .~?~ Type of Inspection: CMRO VA FHA CONV × Property Owner: Edward W. Eckhoff~ Jr. Mailing Address: SRA Box 95E Name of Buyer: Edward W. Eckhoff~ Jr. Mailing Address: SRA Box 95E Day Phone 4. Name of Lending Institution: The First National Bank of Anchorage Mailing Address: ?. o. Box 720, Anchorage, Ak Phone 279-4481 99510 5. Name of Realtor or Agent: Mailing Address: Phone 6. Legal Description: Lot 12, Block 6, Prospect Heights S/D, Addn. #1 Locati on: corner Zermatt Avenue & Werner Drive 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual If Individual, date of installation private home NO. Bdrms..~ (on-site) ×