HomeMy WebLinkAboutT13N R3W SEC 28 LT 19 N2 E100'Onsite File
3 N&G R 'd ban b a Law CAN a
!'Ot INZ E100
Lot mistakenly ed Clarbert B 19
,~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVl RONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME IPHONE I [] NEW
MAILING ADDRESS
LEGAL DESCRIPTION
DISTANCE TO: ]Well I AbsorPtion area Dwelling PERMIT NO.
~ Z Manufacturer Material No. of compartments
~ ~ Liq. capacity in gallons Inside length Width Liquid depth
IF HOME. DE:
9 ~ ~ DISTANC5 TO: ~ell D~ellin9 PS,MIT NO.
~- ~ Manufacturer Material Uquid capacitg in ~allons
~ell / Foundation G~" Nearest lot line~ / P5~MITNO.
-- ~ No. of lines ~ ken~th of each/ne Total length of lines Trench ~idth Distance between lines
~0'/~~ '~ ~ ~ inches
~ ~ ~ Top of tile to finish grade ~ Material beneath tile Total effective absorption area
~ ~' ~ ~ inches
Length 'Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
m Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
SOIL TEST RATING g
~EMABKS
i ..J { ' '
% I '
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
GR!
,'ER ANCHORAGE AREA BO 'UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE ~&
FROM WELL
MANUFACTURER
INSIDE LENGTH
INSIDE WIDTH
LEGAL DESCRIPTION ~:¢ ~ 0/~/ ~O~
NUMBER Of ~
MATERIAL ~~ COMPARTMENTS ~
.LIQUID DEPTH ~.LIQUID CAPACITY /~O~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS __
LINING MATERIAL
BUILDING FOUNDATION ~
ADDITIONAL ABSORPTION
DIAMETER
OR WIDTH__
CRIB SIZE: DIAMETER__
NEAREST LOT LINE
LENGTH , DEPTH
_DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
, SQ. Ft.
WELL:
TYPE ~UCTION~ DEPTH
BUILDING ///~N EAR EST N EAR EST~"~ SEPTIC
FOUNDATION _/ , LOT LINE____ , SEWER LINE '~ TANK__
CESSPOO , OTHER SOURCES
APPROVED. DISAPPROVED REMARKS
DISTANCE FROM:
SEEPAGE
, SYSTEM
J
DISTANCES:
DIAGRAM OF SYSTEM
iNStallED BY:
PIPE MATERIAL:
LOT SLOPE:
Form No. EQ-031
~¢il
MUNICIPALITY OF ANCHORAGE
Department~f Health and EnvironmentaL~Protection
825 Street, Anchorage, AK. 9501
Permit ~~.~_
Applicant:
Location:
264-4720
* * * HANDWRITTEN PERMIT * * *
ON-SITE SEWER PERMIT
W~LL ......... .
0 ~ Mailing Address:
Phone Number:
Legal Description: k t ~ ~ ~//~D~t S~ Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: ~ Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br)
DEPTH
The Required Size of the Soil Absorption System Is:
LENGTH J7' GRAVEL DEPTH WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /JO~ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feel
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31,. 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
S i gne~: the~residenc~ ~is remodeled to includeIssuedm~rey: /~-that 3 ~edToms.~~~~"
Appl'icant r7 / / ~
SWP/~024 (1/81 ) ~~ ~ ~" 'In. the. event, that a lift station le Installed an
e~ec[ricm permit and inspection must be
~ 'Dap~- -- ¥' ' ~-: S~ ~ ~ obtained. As-builts cannot be approved un-
~--~)~-r ~ til the electrical inspection is received in this
~/~AxJc._t ~9~'t~=-%' ~,2,4od 0~,~.=~ office. The electrical work must be per-
~o ~.~._ __~ ~u ;~L.r,_C' _~..q-r formed by a licensed electrician."
GReaTeR AnChORaGe ArEa BOROUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C"STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
PERMIT NO,
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK / SEEPAGE PIT-- DRAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TAN k S~ZE ./~~ TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
SEEPAGE AREA SIZE
TYPE
DIAGRAM OF SYSTEM
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK ,SEEPAGE PIT .DRAIN FIELD
TO NEAREST LOT Line.
WELL TO SEPTIC TANK .~ SEEPAGE Pit
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK J~ / . SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, , SEEPAGE PIT
TO RIVER, LAKE. STREAM.
· DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING iNSTAlLATION.
OR
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
FORM NO. EQ-016 /
SOl LS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
DATE PERFORMED:
[] PERCOLATION
TEST
2
3
4
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
O
P
E
Gross Net Depth to Net
Reading Date ~Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
COMMENTS
PERFORMED BY:
TEST RUN BETWEEN FT AND FT
72-008 (6/79)
LOT SURVt~Y CERTIFICATION--_ I
LEGEND:
e Iro~ Pipe
· St#l Pin
pt S~v~ Ht~ &Tock
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a)
Legal Description (include lot, block, subdivision, section, township, range).
Location {address or directions)
(b) Al~p!icant 'Name ~~ /~ Telephone: Home -5~'~/' ~'/-5~,~ Business
(c) ~;pplicant !s (check bne):,Lending Institution [] · Owner/builder'S; Buyer []; Other [] (explain);
(d) Lending~ln~iitu[ion" ~.///~1~ Telephone
Address A///~
(e) Real Estate Company and Agent ~z/~,~
Address /C//~,-~
Telephone A//,'~
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~ Multi-Family []
Number of Bedrooms -'~
Other
WATER SUPPLY
Individual Well~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite'~[. Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
I~NGINEERING FIRM PROVIDII~.,., INSPECTIONS, TESTS, FILE SEARCH, Dh. A AND INFORMATION
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 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. !
Name of Firm Telephone :~"~' ) -~"~
Address
Date
DHEP APPROVAL
Approved for '/~-- ~-'~bed rooms by ~l~~'~
Approved ~ ~, Disapproved Conditional
Terms of Conditional Approval
Date
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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.
Page 2 of 2
72-O25 (11/84)
~UNiCIPALITY OF ANCHO~AG2.....
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
RECEIVED
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description'
WELL DATA
Well Classification ~,~'/~"/¢'~ If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y,4~- Date Completed /~:~'e"' /~)75" Yield
Total Dept~ ~ Cased ~ Depth of Grouting
Casing Height Above Ground /t ~7 ~
Sanitary Seal on Casing N)
Electrical Wiring in ConduitS) Depression Around Wellhead (Y~
Separation Distances from Well:
To Septic/Holding Tank on Lot ~ ~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line ,/~O
Cleanout/Manhole /dO"
Water Sample Collected by ,/~'~'~
Water Sample Test Results
Comments ~/~ /~/~F..~ ~ '7--~T
· On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
~//'~ 'Date 7-//-~
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes~)N) Air-tight Caps~N)
Depression over Tank (Y~.)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ~ ~-~
To Property Line ~ ! "~
To Water Main/Service Line
Course /dO
4 #~V'~/~/'~Size /~'0 ~ No. of Compartments
Foundation Cleanout (Y~)
Date Last Pumped
'for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y~_~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-S~pply Well
To Building Foundation
Lot /0
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness ~"/
Standpipes Present~q)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots /~
To Cutbank (if present)
·
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Man hole/Access~)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certifyth at I ha_v,~ ch~j; ked, ~e_rified, or conformed to al IMOA and HAA guidelines in effect on the date of this inspection.
Signed~'~' ~I~/-/"'"'~- Date 7,.~~_~o'~,
Company /~-~'
Receipt NO.
Date of Payment
Amount: $ ~)~
Page 2 of 2
72-026 (11/84)
Well' Classification
t4ell LoG P~esent (Y/~)
Total Depth Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring 'in Conduit .(,,Y/N)
Separation Distan~s f~cm Well:
To Septic/Holding Tank on Lot
TO Nea~$t Edge of Absorption Field on Lot
To Nearest Public Se~r Line
CIe a ncu t/M a nho le
Water Sample Collected By
Water Sample Test ]~esults
MUNICIPALITY OF ANCHORAGE (MCA)
}{EAL~T{ AI~OR~TY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
L-~al Descrip. Zion: ~O*/ '"
,_ C..,I
If A, B, c~ C, D.E.C. Approved(Y/N)
Date Co,t31e ted Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casin9 (Y/Ni
Depression..around Wellhead (Y/N)
; On Adjoining.Lots.
: On Adjoinin~ Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; I3ate
B. SEPTIC/HOLDING TANK [~ATA,
"Bate Installed Size No. of Ccmpa~tm~,nts
StandD.i. pes (Y/N) Air-tiGht Caps .(Y/N) Foundation Cleanout-(Y/N)
Depression ove~ Tank .(Y/N) , Date Last Pumped
Pumping/Maintenancs Contract cn File (Y/N) ; fo~ I
Holding Tank High-Ware= Alarm .(Y/N) Temporary Holdi~ Tank Permit .!Y/N)
Sepa]:ation Distancss f~rcm Septic/}ioldlng Tan. k:
To-Water-Supply Well To Building Foundation
To P~operty Li~e To Disposal Field
TO Water Main/Servics Lirs
To Stream, Pond, take, c~ Major D~ainaGe
Cotnr se
Cc~ents
iP~ge 1 of 2]
2-15-84
· ~ '~./~RPTION FI ELD. _[]ATA ·
Soils Rating in Absorpt'on Strata
Date Installed
width of Field
Square Feet of AbscrDtio~ A=ea
Dep=esston over F~ield (Y/N) Date of Last Adequacy Test
Results of Last A6equacy Test
Separation Distance f~o~ Ab~c~ptio~ Field:
To Water-Supply W~ll
To Building Founda.tion
Lot
To Water Mair%/Service Line To Cutbank(if present)
To Stn~eam/Pond/Lake/c= Majo= D=ainage Course
To D~iveway, Parking A~ea, c= Vehicle Stc=a~e Area
Type of System Design
Langth of Field ,
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
To Property Line
TO Existing or Abandoned System cn .
; On Adjoinin~ Lots , .
De
LIFT STATION
Size in Gallons
"Pump On" Leal at /~ ~'
High Water Alarm ~e~l at
Te s ted .for
Electrical Cod~ ~%~N) ,~)
** Check Pemmitted Bedroom Rating A~3ainst HAA Request
I. certify that I have checked, ~erified, c~ co~fo~med to all MOA HAA Guidelines in effect
Company ~/2~ ~_ ~.~- .. .~-- ~~ MOA No.
KB1/dS/s
[Pa~e 2 of 2]
ENGINEERS
SEAL
Manhole/Access ~) '
"P~mp Off" Level at ~ (I
Pumping Cycles du=ing Adequacy' Test. Meets MOA
unicip .tYof
Anchorage
P.O. ~- ~X 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
September 3, 1986
Alan Wien
Alaska Environmental Control Services
1200 West 33 Avenue, suite B
Anchorage, Alaska 99503
Subject: Lot 1 Block 19 Clarbert Subdivision
Waiver Request, WR86-120
Dear Mr. Wien:
This department has granted your request for a waiver of the 100 foot
separation required between the lift station and well on the subject
lot. This waiver is based on your assessment that the lift station is
in good condition with no leakage or significant corrosion evident.
Future approvals may require a re-inspection of the septic tank and lift
station. This waiver remains in effect only as long as the septic
tank and lift station remain in satisfactory condition.
This waiver is valid for the existing three bedroom single family
dwelling only.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
ALASKA B,,dlRO[lllleI1TAL COIqTROL $1 1 dlC1 $, IrlC.
J~nqin~¢pinq C- ~nuironmcnlal ~tlicli~s
Municipality of Anchorage
825 L Street
Anchorage, Alaska 99501
Attn: Steve Morris
Re: Lot 1, Block 19, Clarbert Subdivision
August 26, 1986
MUNICiPAL/T? OP
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
RECEIVED
In our request for a waiver of the septic tank to well distance, we
forgot to request the waiver for the lift station. The inspection
report from the Electric Doctor has a note from Alan Wien which notes
that the integrity of the lift station is sound. Alan cycled it several
times. The pump functioned well. He feels that it is in excellent
condition. There are no leaks that he could see. I do not believe the
waivered distance would create a health problem.
Please include the waiver of distance from the well to the lift station
from 100 feet to 86 feet.
If you have any questions, please let me know.
Since~/y,
~l~ero~ Re~d~, JJ~"/ PhD., P.E.
1200 LUcst 33r(J Aucnu¢, Suite B · Anchorage, Alaska 99503 .(907) 561-5040
ALASKA
I~FIUIROFIm6FITAL COFITROL $1~RUIC65, IRC.
~nqincerinq [, ~nuironmcnlal Sludi~s
1200 LUest 33rd Auenue, Sui|e B eAnchoraqe, Alaska 99503.(901) 561-5040
TO
ALASKA E,,,dlROFImI FITAL COFITROL $1Zi ulCl $, IFIC.
J~n§ineerincI 6 J~nuironmentol Studies
STEVEN FOX
2988 CLARBERT COURT
ANCHORAGE ALASKA 99507
SELLER-SAME
JULY 30 1986
STEVEN FOX
2988 CLARBERT COURT
ANCHORAGE ALASKA 99507
60371
LEGAL:CLARBERT BLOCK 19 LOT 1
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-JULY 11 1986
THE TYPE OF ABSORPTION SYSTEM IS A DRAINFIELD WITH AN AREA OF 256 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 895 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE F0R
THIS 3 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 3ULY 14 1986
THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
FLOW TEST ON WELL
WELL FLOW DATE-JULY 11 1986
A FLOW TEST WAS PERFORMED 0N THE WELL. 895 GALLONS 0F WATER WAS
PUMPED AT A RATE OF 5.6 GPM OVER A DURATION OF 2.6 HOURS.
THE DRAWDOWN WAS 23.4 ' WITH A RECOVERY TIME OF 30 MINUTES
AND THE STATIC WATER LEVEL WAS 34.3 FEET.
THE WELL IS ADEQUATE FOR THIS 8 BEDROOM HOME.
~*~ 1200 ~est 33rd Auenue, Suite B · ~nchoroge, Alaska ggS03
ALASKA ,,dlIgOFImEFITAL COFITROL $Eh. ICE$. II'lC.
~nclineerinc1 6- ~nuironmentol Studies
July 30, 1986
Municipality of Anchorage
Department of Health &
Human Services
825 L. Street
Anchorage, Alaska 99501
Re: Lot 1, Block 19, Ctarbert Subdivision
The above referenced lot consists of a 3 bedroom single family dwelling
served with a private well and on-site sewage disposal system. There is
no well log available. The well was drilled approximately 1973. Per
the homeowner, the well is approximately 75 feet deep. The original
sewer system was installed in approximately 1973. The as-built has no
date on it. The absorption area was upgraded on July 25, 1983 to a
drainfield 40 feet long, 5 feet wide and 4.5 feet deep. The application
and permit dated August 17, 1973 has a waiver written on it per Joe
Blair of the MOA for the separation distance from the well to septic
tank to be 50 feet. The actual distance is 66 feet. The tank is a 1000
gallon, steel, 2 compartment tank.
On July 11, 1986, I performed an adequacy test, well flow test and
Health Authority inspection. Adequacy and well flow results are
attached. During the adequacy test, the septic tank maintained a normal
full level with no fluctuations. The entire lot is relatively flat.
The house is located between the well and the septic tank. The water
sample taken July 11, 1986 is free of coliform bacteria.
Due to the above conditions, and that prior approval has been issued, we
request that you reissue a waiver of the required separation distance
from well to septic tank to 66 feet.
If you have any questions, please call me.
Sincerely,
Alan Wien
Engineering Technician
1200 LU¢st 33roi ~ucnu¢, Suite [~ * AncF, oro§¢, Al sko 99503.(907) 561-501.10
ALASKA ENVIRONMENTAL
CONTROL SERVICF" INC.
1200 West 33rd Avenue Suite B
ANCHORAGE, ALASKA 99503
Phone 561-5040
SHEET NO OF
CHECKED BY
SCALE /:.~O
DATE
3500 Tudor Road,
GREATER ANCHORAGE AREA BOROUGH
Department of £nvtronmental Quality
Anchorage, Alaska 99507 279-8686
Date Received
Ttme of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Aoproval Requested By: .......
Address~
Number of Bedrooms
'~ell Data:
A. Type ~2. lc B. Depth /~ ~-'"
C. Construction ~ D. Bacterial Analysis
7. Sewage Dtsgosal.System:
A. Installed B.
C. Septic Tank: 1. Size /~00 2.
D. Seepage Pit: 1. Size -~ 2.
Ma nufa cturer_5~e F-~
Materta 1
Disposal Field: Total Length of Lines
Distances:
A. Well To:
C.
, Absorption Area
Septic Tank._~_~
, Nearest Lot Line , Other Contamination
Foundation to Septic Tank ~/ '
· ~ AbSorption Area
Absorption Area to Nearest Lot Line /~ '/7~9
, Sewer Lines
Requas_t,,for Approval of I'
Page Two
9. Comments:
· ldual 5ewer & w~ter Paclllgle
poroval Valid for One Year From Date Signed
Greater A~chor~ge Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
h
I certtf7 that the information contained in this request for approval to be a true
and accurate representation of the sub~ect sewer and water facilities located at:
Stgned ~~ ~. ~ Date
April 9, 1973
Alaskd Hutual Sav~nqs bank
Fifth Avenue
t;,nchora~)e ~ Al ask,~
L]as~ 1~'~,~, of !iorth H~lf of ^:..~ovarn~enC Lo~ ~.s,"" TlS,i,
RLJiJ - 2g~$ Clarbert Court
1]~,=r Sir:
b?on your request, the v~ater and sewer focilities s~Jrvi~s-
tlr)e ~b~ve lot w~re in~nect6d by this ~cnart~ent on April ~,
17.73. ~,~ tn~c ~i,~, I uas unahl~ ~u locate: eiLhcr the ~iI
cr s:~fficient proof of the location an~ Cype of se~.~a]c sysC~'.,~
serving the dwellinc. Tt)erefore, I a~ u~l~ble to either approve
or disapprove the subject faciliti~s.
tf yo~J have ~ny questions? ~lease con,.~ct chis of6ice ~ 27~'i-.i~.]61
bi ncc. rely,
Sani tari an
J~
cc: 'Si~veri Fox
· 3500 Tudor Road· Anchorage· Alaska 99507 279z8686
'Date ReceiveO
· ~ ~ I~IVIDUAL S~W~R & WA~R FACILITIES
1. A~proval Re~ested By: ,.~,~ .... ><'~ . , ,:::: ': '
' ,K;,- ~ ~:~
Address: Phone
............ ':~' ~ · . ~ .... ~-". Phone'
5Type of Fac~Z[[y [o be ~nspec[ed= -::'? ~, ,-,~: :"~ '
NumbeT of BedTooms: ~ ,
5. Well Data: '~--~ .... ~.-' .... ' ....
A. T~e
C.~ Construction
7. Sewage Dis.°osal System:
C. --Septic Tank: 1. size
D. Seepage Pit: ~. Size
2. Manufacturer
2. Material
E. Disposal Field: Total Length of Lines
8. Distances:
A. Well To: Septic Tank
· Absorption Area
, Sewer Lines
· Nearest Lot Line
· Other Contamination
B. Foundation to Septic Tank
"> Ab'~orption Area
C. Absorption Area to Nearest Lot Line
Re'qUe~,t for Approval of ~
, Paqe Two
9. Comments:
vidual Sewer & Water Facilitie
Apgrova] 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 sub.iect sewer and water facilities located at:
Signed Date