HomeMy WebLinkAboutRANDOM HEIGHTS LT 4
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP221439 PID Number: 017-411-08
Dwelling: nE Single Family (SF) n with ADU n Duplex (D) n Two Single Family Project: F-1 New nN Upgrade
Name
EDITH LYNCH ABSORPTION FIELD EAST/WEST
Site Address n Deep Trench X Wide Trench n Bed F-1 Mound
12725 GINAMI STREET 'ANCHORAGE, AK D Other
Number depth Numt
Phone 47 er of Bedrooms Soil Rating Total d th from original grade
907-345-5225 1.2 GPD/SF 6.98/7 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot SEE DWG. Ft. 2/2 Ft.
RANDOM HEIGHTS; LOT 4 Fill added above original grade Gravel length
Township Range Section SEE DWG. Ft. 35/35 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES Ir,
1-11 1J Ft. Ft.
To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches
From Tank Field Tank Line 500 Ft2 2 6+
Ft.
Well 100,+ 100,+ 25'+ TANK 9 Septic El S.T.E.P. [I Holding n Other
Manufacturer Capacity
Surface Water 100,+ 100,+ GREER TANK 1500 Gal.
Material Number of compartments
Lot Line 5' 10'+ NA PLASTIC 2
Foundation 10,+ 10,+ LIFT STATION
Manufacturer Capacity
Remarks PER CONTRACTOR OLD TANK WAS DECOMMISSIONED PER UPC Gal.
Alarm location Electrical installed by
PIPE MATERIAL House to tank D3034 tank to D3034
Installer drainfield
ARM SEPTIC SERVICES Drainfield D3034 CO/MT D3034
Inspector GEG BENCH MARK (Assumed elevation) 98.22 ft
Inspection 1 st 5/5/2023 5/8/2023 Location and description
dates: 2M 3rd _5/10/202 4" 5/11/23 TOP OF MANHOLE
ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp
Conditional Approval: Date
4
Septic System y A. hess.-
CE-195J
Approved
Date 2.
Note: this approval does not include well permit requirem ECC ofess'101
(Rev 05/02/18)
M=11
PERMIT NUMBER: RECORD DRAWING
` „ I N G PARCEL INUMBER:
OSP221439 \v/\vJ 017-411-08
A . PRIOR TO CONSTRUCTION IT WAS CONFIRMED BY A
FCO 8.1 42.8 PLS THAT THE 100' WELL RADIUS ON LOT TO THE
MH1 14.0 48.6 NORTH DOES NOT ENCROACH ON SUBJECT LOT
ST1 18.7 52.3 FL
NEW
10' UTILITY EASEMENT
C04
53.3 1 74.9 1v
d
MT4
53.5 1 74.5
SWING TIES
WERE DERIVED
FROM .DWG
FILE PROVIDED BY
WALATKA AND
ASSOCIATED, LLC.
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l I RANDOM HEIGHTS; LOT 3'
PER ARM SEPTIC SERVICES, THE OLD FIELD DID NOT HAVE PROPER DISTRIBUTION PIPING.
PER GEG CONVERSATIONS WITH THE OWNER, SHE DID NOT WANT THE EXPENSE OF
REPARING/INSTALLING NEW DISTRIBUTION PIPING THROUGHOUT THE OLD FIELD. BASED
UPON THIS FACT, THE FIELD WAS ABANDONED IN PLACE. IT SEEMS PLAUSIBLE THAT IN THE
FUTURE A CONTRACTOR COULD REPAIR AND CONNECT TO THE ABANDONED TRENCH.
iu:mnammz,a'v:< ENGINEERING SALES -CONSULTING
3701 E. TUDOR ROAD, SUITE 101' ANCHORAGE, ALASKA • PHONE (907) 337-6179' WEBSITE: wew.gamessengineering.com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
EDIE LYNCH 907-345-5225 2 OF 3
PROJECT/LEGAL DESCRIPTION: DRAWN BY:
RANDOM HEIGHTS; LOT 4 D.J.G.
TYPE OF WORK: DATE:
RECORD DRAWING OF TANK AND DRAINFiELD 6/13/2023
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PERMIT NUMBER: PARCEL ID NUMBER:
OSP221439 RECORD DRAWING 017-411-08
TOP OF MH = 98.22
FINAL GRADE = 97.49-97.93
MH ST1
TOP OF TANK AT INTLET = 94.20 I + I I r /—TOP OFTANKCONTRACTORN PER ANK AT OUTLET =94.18
INVERT OF BUNG AT INLET =
NEW 1500 GALLON H.D.P.E. GREER SEPTIC
TANK RATED FOR 10' BURIAL - NO
GROUNDWATER ENCOUNTERED IN TANK HOLE
EAST
ORIGINAL GRADE AT MT CO FINAL GRADE = 93.18.93.83
HIGHEST POINT = 93.05 f
2022 T.H. /
2 - FEET
ORIGINAL GRADE AT
HIGHEST POINT = 89.30
FILTER FABRIC
-INVERT OF PIPE = 88.07
BOTTOM OF TRENCH = 86.07
TIVE ELEVATION OF BOTTOM OF T.H. = 80.05
(T.H. DRY ON 5/4/2023)
INVERT OF BUNG AT OUTLET = 93.33
WEST
FINAL GRADE = 89.30-89.67
FILTER FABRIC
-INVERT OF PIPE = 84.30
2022 T.H.
2-FEET
f '-- 5'—�
BOTTOM OF TRENCH = 82.30
RELATIVE ELEVATION OF BOTTOM OF
T.H. = 76.30 (T.H. DRY ON 5/4/2023)—
ENGINEERING H SALES �, CONSULTING
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3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 'PHONE (907) 337-6179 - FA%(907) 338-3246 - WESSITE: m
g=essengincering.cnm
PREPARED FOR:
PHONE NUMBER:
PAGE NUMBER:
EDITH LYNCH
907-345-5225
3 OF 3
LEGAL DESCRIPTION:
DRAWN BY:
RANDOM HEIGHTS; LOT 4
D.J.G.
TYPE OF WORK:
DATE:
ASEPTIC TANK AND DRAINFIELD PROFILE
5/22/2023
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Municipality of Anchorage
On -Site Water and Wastewater Program
P.O. Box 196550 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
Review Comments
Engineer: GARNESS ENGINEERING GROUP LTD
Legal Description: RANDOM HEIGHTS LT 4
Parcel ID: 01741108000
Permit: OSP221439 Septic
Report Type: As Built Review
1 /9/2024
Completed By: C.Townsend
The application has been reviewed and the following comments have been generated. These are to be satisfactorily
addressed prior to MOA approval:
1. what separation was maintained between the new trenches and the existing trench?
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP221439
Work Type: Septic Upgrade
Tax Code Number: 01741108000
Site Legal Address: RANDOM HEIGHTS LT 4 G:2841
Site Mailing Address: 12725 GINAMI ST, Anchorage
Owner: LYNCH EDITH V
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft
Total Bedrooms:
1'R__ �ZNcnr
U•
ll�parrmcnr
11/23/2022
11/23/2023
46747
Q Disposal Field Cl Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
.Z55tAl—J f0 (rEG Date:
Issued By: �{% Date: 2
4
Municipality of Anchorage
\� Ue p;;rtment N
P.O. Box 196650 ® 4700 Elmore Road
Anchorage, Alaska 99519-6650 e (907) 343-7904 • Fax (907) 343-7997
http://www.rnuni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV221077 COSA#: Permit#:OSP221439
PID#: 017-411-08
Legal Description: RANDOM HEIGHTS LT 4
Engineer: Garness Engineering Group
Your request for a waiver of the required 6 foot horizontal separation from the absorption field to
the existing absorption field has been approved. The approved separation distance is 8.0 feet. In
addition, the field is approved to be on a slope less than 45%.
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.
............................................... ■ ............................. ■ 1
Waiver is Granted: X Waiver is not Granted:
Date: Z3 Z Approved by:
Name of Reviewe
............................................................ ................�
**** VARIAN C E/WAIVER REVIEW ****
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/VVELL PERMIT APPLICATION
Parcel I.D. 017-411-08
Property owner(s) EDIE LYNCH Day phone 907-345-5225
Mailing address 12725 GINAMI STREET *ANCHORAGE, AK
Site address 12725 GINAMI STREET *ANCHORAG,E AK
Legal description (Sub'd., Block & Lot) RANDOM HEIGHTS; LOT 4
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 4
APPLICATION 1S FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field 0 Initial ❑
Single Family (SF) Q
(w/wo ADU)
Septic Tank El Upgrade
(D) ❑
Holding Tank ElRenewal ElDuplex
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
DRAINFIELD TO SLOPES GREATER THAN 25%
Distance: 0 FEET
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 agent)
Permit/Rush Fees: d'd 0 Waiver Fees:
Date of Payment: /' ;';z Date of Payment:
Receipt Number: 0 / 1 Receipt Number:
Permit No. G S 10 a012 1 Waiver No. 0,5 V 22.107 7
GADevelopment Services\Building Safety\On Site water and wastewater\Forms\Client ForinsTermit Application.doc �l,/I
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221439, Deb Wockenfuss, 11/23/22
r-c,-�tu r► ►- 9-�, L L¢
Page 2 of 2
unknown required separation distance down to 8 feet. Justifications for granting this wavier are as follows:
• Only one of the systems/trenches will be in use at a time.
• The testhole adjacent to the existing surcharged trench is dry to a depth of 13 feet; therefore, it is
reasonable to believe that lateral migration of the effluent will be minimal between the new and
existing trenches.
6. WELL: Per MOA records, there were two wells drilled on the property. Per conversations with the
owner (on 10/12/2022) it is unknown if the abandoned well was decommissioned or abandoned. The 'old
well' could not be located by GEG. It is assumed that it was cut below grade.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineering.com
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221439, Deb Wockenfuss, 11/23/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221439, Deb Wockenfuss, 11/23/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221439, Deb Wockenfuss, 11/23/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221439, Deb Wockenfuss, 11/23/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221439, Deb Wockenfuss, 11/23/22
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GREA,FR ANCHORAGE AREA BORudGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska gg503
NAME
LOCATION
INSPECTION
REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE
,!
FROM WELL -/C~
INSIDE LENGTH
MANUFACTURER~
INSIDE WIDTH
MATERIAL ,:~g0
LIQUID DEPTH
NUMBER OF
____COMPARTMENTS
LIQUID CAPACITY/<~'~'~ GALLONS.
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH:
FOUNDATION
DISTANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
DEPTH
OF
FILTER
TOP OF TILE TO FINISH GRADE ~1
TOTAL LENGTH
NEAREST LOT LINE OF LINES
TRENCH WIDTH~(~ IN. TOTAL EFFECTIVE
MATERIAL BENEATH TILE
IN. ABOVE TILE ~'J/' IN.
WELL:
TYPE
BUILDING
FOUNDATION__
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST NEAREST SEPTIC
LOT LINE__, SEWER LINE TANK__
, OTHER SOURCES
DISAPPROVED REMARKS
DEPTH
SEEPAGE
, SYSTEM
DISTANCE FROM:
DISTANCES
INSTALLED BY: ~
SEWER LINE DEPTH:
PIPE MATERIAL:~'~
LOT SLOPE: ~-/~ ~
REMARKS:
DIAGRAM OF SYSTEM
GEe/ zr ANCHORAGE Area BoL Ugh
DEPARTMENT OF'ENVIRONMENTAL QUALITY ' ~ PERMIT NO.;
SEWAGE DISPOSAL SYS'i:EM -- APPLICATION AND PERMIT ~~
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT . DRAIN FIELD OTHER
sO[~ ~EST RESULm~ --1~-- 7~~ NOT=, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST m'
/
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL (~UALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE 1~:~'~) TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK . SEEPAGE PIT .
TO NEAREST LOT L'NE.
WELL TO SEPTIC TANK
DRAIN FIELD
.. DRAIN FIELD
· SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
WATER MAiN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK. /~0 , SEEPAGE PiT
TO RIVER. LAKE, STREAM.
SEEPAGE PIT
/~O ! DRAIN FIELD
CAST lEON 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.
DIAGRAM OF SYSTEM
==========================================
[ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREAJ~OROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. /~~ /,/~
q-irt-
DATE APPLICANT'S SIGNATURE/
FORM NO. EQ-016
4040 "B" STREET,'
ANCHORAGE, ALASKA 99503
PHONE: 907.279.2581
September 18, 1975
W.O. #17517
Mr. Steve Ellis
SECO Construction
Star Route A - Box 36E
Anchorage, Alaska 99507
RE: Subsurface Investigation for On-site Sewer
Lot 4, Random Heights Subdivision
Dear Mr. Ellis:
As requested, we conducted a subsurface exploration on the above
lot to determine the soils' suitability, as required by the Greater
Anchorage Area Borough, for placement of an on-site sewage system.
The exploration was conducted on Tuesday, September 9, 1975, utili-
zing a track mounted, Mobile Drill B-50 drill rig, owned and oper-
ated by Denali Drilling, Inc. The drilling was supervised and the
testhole logged by Mr. Pete Herstek, staff technician with Alaska
Testlab.
The testhole was located approximately 40 feet south and 80 feet
east of the northwest corner of the lot. Its log is included on
Table A. To help interpret the information contained on the log,
we have included three sheets of "Standard Explanatory Information"
in the back of this report.
The hole was filled with water and left to saturate. On Tuesday,
September 16, 1975, water was again placed in the hole, to within
3.0 feet of the surface. For 60 minutes the rate at which the
water level fell in the hole was recorded at 10 minute intervals.
At the end of an hour the water level in the hole was at a depth
of 6.4 feet, which is a total drop of 40", in 60. minutes, for a per-
colation rate of 1.5 minutes per inch. Utilizing the data published
in Table A "Absorption Area Requirement for Individual Residences",
on page 8, of the "Manual of Septic Tank Practice" published by the
U.S. Department of Health, Education ~ Welfare, the required absorp-
tion area per bedroom for such a percolation ra~e is 80 square feet
per bedroom.
No water table was detected at the time of exploration. It should
be noted, though, that seasonal and climatic changes can cause
fluctuations in the water table.
We hope this is sufficient for your present needs. If we can be
of further service, please do not hesitate to contact'us.
Very sincerely yours,
ALASKA TEST_LAB ·
-Me~vin R. Nichols, C.E.
Lot 4
Depth in Feet
.From To
0.0' 1.5'
1.5' 4.0'
4.0' 16~0'
Bottom of Test Hole:
Frost Line:
Free Water Level:
TABLE A
W.Oo #17517
Soil Description
F--4, brown, organic overburden
F-2, brown, silty gravelly sand, SM,
~wet, medium density
F-2, brown, silty ~rave~l¥ sand, SM,
..dry to damp, medium density
16.0'
None Observed
None Observed
WELL LOG
Material Type
Bottom
dlom. __ ff. DeDth
9 FINISH OF WELL:
Above or
Well NO
CONTRACTOR'S CERTtFICATI)N:
~ ~ MUNICIPALITY OF ANCHORAGE
· . , DEPT. OF I-ff:ALTH &
~ ENVIRONMENTAL PROTECTION
Well Log .~ ?
~o~ .......... ,~:~ ...... ~.....~...,..~ ...... ~.__,....~ ........................ R.~.C.EI.V.~D
]Date completed ...... .~..~~....~..../../..~...../~...~ .............................................
Size of casing.~: ........ .,W~z~..~..~.... ................................................................
Distance to water while pumping .:.-,~4'......~/':~.~...~~J~-- r~te
of....~....~.~.~.~.~.....~.=..gallons per hour.
Driller
DELTA DRILLING COMPANY
SRA BOX 394 B
ANCHORAGE, ALASKA 99507
Depar. tmer~t. (::~' Health & Human Services
825 L. S'L r'.ee'L ~, Ar'H:::hcsr age, A ].~aska 9950 !
0 N ..... S 2[ T' E W E L,. t .... P E R M I T'
Da'Lc issued: L~:],/].5/89
Own ep Name .'-.' T i1'. M LYN[.;H
Owner'. r..,~.,. ,.'Ir ~.,.ss. PO B[]X 11()496
~.~I,,,H ,,tl ~,. [, h:, ~ AK
Day
:". 4 5 -
Lo'i:, l....ega t ': Sub d :i. v i s :i. on: RANDOM HIE I GH"FS L..o'L ~ 4 B '.t. oc k: ....
Lot ~;;i,:;~e 46747 (sq,, {'t,, or' acr'es)
Max Bedr'.ooms~ Th:i.s Per'mit: () To'Lal Capac:i.t.y~ 4.
WE]..,,I....: ' ' .
~,..,..,,g must be subm :i, tted 'L o Mun :i, (::: [ ~,'~'~ I i 'L y o { Anchor ac e D~,:.;p ar 'L men'L (::~ f Plea 1 'L h
....... ~ ~ ices with:i.n ::!!;() days of wel :t. comp let ion,,
INSTALL. PIER DR:[I...,LERS SI'TIE F'LAN,, GROU'f'IN['!} t"I;.~Y BE: NIECIES!~;~ARY IF
BIE;[)F:;:OCK IS ENCOUNTERED AT L..ESS THAN
NOTE: N:["fRA'T'ES ARE F'RESENT tN 'H'"tIS At:RtEA, A WATER SAMF::'L,E SHOULD
BE (:]BTAIIxlED 'T'O VARIF::'Y 'f'HE (];OI\I[]ENTRA"IH}.'OI\I F:'OR T'I.,.IIS tAIEL, t
CIERt"IF'Y 'T'HA]:
I a¢~] ,zalfl:J.].:i. ai" wi'Lb 1:.he requiremen'Ls ~oi" orr,,.site sewer's and wells a~i~ set
for'1'J-~ by the Idur~:i. cipal:i, ty o¢ Ancl"u:)rage (MOA) ar'id the State oF Alaska,,
I w:i,].l install the system :i,n a(:::cor'dar'ice w~,t,h all MOA codes arid r'egu:[at
and :Ln comp],iance w~.t.h the dcs:i, gn c:r'it',,et":i,a of th:i.s pel'mit.
I w:i, tl a(::ll"tel"e ~,(::~ all MOA arid State of Alaska r'equ:i, refi~er'rLs {'of the set back
s~,.;,~wsrag6~ syst, sfli ol"i 'Lh:J.!!~i Qr' ar]y acl.jaE;er'rt or' r'H.:earl:)y lc)t,,
also ur'icier'stand 'Lha'L the capac:i, ty (::)~ the 'Lot. al :~;y!~'l:,em :is 4 bedr'ocm'Hs and
(J:]Wf'iE'P) T'IM I,.,,YNCH
12401,
/,
2/
12,4.35
SUB.
12500 12515
12720
LOFT)'
lA 2A
SUB.
TOILSOME
12601
/
HILL
SUB,
12570
HEI~, TS
2 /
SUB.
:801
8601
8701
SPENDLOVE
8600
8?0O / 8 ?4O
8800
/
8801
DR.
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received November 8, 1976
Time of Inspection ~'~
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Cony.
l. Approval requested by: Alaska Mutual Savings Bank
Mailing Address: Post Office Box 1120
2. Property 0wner: Timothy Lynch
Mailing Address: NHN Ginami Street
Phone: 274-3561
Phone: 276-3222
3. Legal Description: Lot 4 Random Heights Subdivision
4. Location:
5. Type of facility to be inspected Single Family
6. Well Data:
A. Type Individual
C. Construction
7. Sewage Disposal System:
A. Installed
C. Septic Tank: 1. Size
D. Seepage Pit: 1. Absorption Area
E. Disposal Field: Total length of lines
8. Distances:
No. of bedrooms
B. Depth 130'
D. Bacterial Analysis
On-site system
B. Installer
2. Manufacturer
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
C. Absorption area to nearest lot line
, Absorption area
, Other contamination
2. Material
, Sewer Lines .,
, Absorption area
EQ-034 (1/74) PaQe 1 of two DaQes
Page 2 of two pages - Re¢-'st for Approval of Individual .~'~r & Water Facilities
L'egal Description ]Sot 4 Random He±qhts
Comments
Approved~/F~~~) Disapproved Date//-~
App~val Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
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)
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
NOV 0 8 1976
RECEIVED
GREATER ANCHORAGE ARL,h BOROUGH
Department of EnvirorJmental Quality
3330 "C" St.~ Anchorage, Alaska 99503 274~4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
Type of Inspection: CMRO VA FHA CONV ~
Property
Owner:
Mai 1 lng Address: ~__F~/~__~_Z~~/-- ..... _Da_y_P_~one _~6 ],~ ~,'
Mailing Address: __~_~ZZZ]L~ _.D_a=% Phone
Mailing Address: ~=~.J ~ ~_ _
5. Name of R, ealtor or Agent: ~_~/~
Mailing Address: Phone
Phone ~.L~2~.~_(~ / _
7. Type of Facility to be inspected:
8. Nater Supply
Type of Supply: Public Utility
o
No. Bdrms.__
Individual
If Individual, number of dwellings presently served
If Individual~ depth of well ~ ~
Sewage Disposal' System
Type,of S~stem: Public Utility Individual
(on-site))~