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Home My WebLink AboutALPINE VILLAGE BLK 2 LT 2 GREA,,'R ANCHORAGE AREA BOR ,GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MAILING ADDRESS MANUFACTURER ~ INSIDE WIDTH MATE R IA[~-~ LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID C A PA C I TYL~_~/'G A L LO N S. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ) ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE / TOTAL LENGTH , FOUNDATION /~) '¢'- NEAREST LOT LINE '--~'"¢'" OF LINES DISTANCE BETWEEN LINES /~///~' TRENCH WlDTH-~ IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE DEPTHOFFILTER , MATERIAL BENEATH TILE ~ ~ ABOVE TILE IN. WELL: TYPE BUILDING FOUNDATION__ CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE_ OTHER SOURCES DISAPPROVED NEAREST SEWER LINE__ DEPTH SEPTIC SEEPAGE TANK SYSTEM REMARKS DISTANCE FROM: DISTANCES: IN STALLED BY SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE:_ REMARKS: DIAGRAM OF SYSTEM G.A.A.B. ~ Form LQ-032 P~rmit ~ MUNICIPALITY OF ANCHORAGE ~ Health and Environmenta L Street, Anchorage, AK. Department 825 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND/OR ON-SITE SEWER PERMIT Mailing Address: Phone Number: ?rotection 99501 LOcation: Legal De script TYpe of Soil Absorption System Is: Trench: ------ Drainfield: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) ~" The Required Size of the Soil Absorption System Is: 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 S~HOLDING) TANK SIZE = ~.0~ 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 feet 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 the~..r~idence is remode%~d to S igne~i]].~ //~. p'p 1 ic ant sewer system ma~equire enlargement if include m~~~ooms. Issued b~ GREA R ANCHORAGE Area BOR DEPARTMENT OF ENVIRONMENTAL QUALITY 33:30 "C" STREET ANCHORAGE, ALASKA 9950:3 TELEPHONE 274-456 ! ;Ch SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT v, SEEPAGE PiT , DRAIN FI'ILI~D f~"Off~I~'-- ~ , NOTE~ T~'PE~MIT I~ NOT VALID WITHOUT ~OIL TE~T COMPLETION DATE ANTICIPATED 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. DIAGRAM OF MINIMUM DISTANCES, REQUIREMENTS / FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO ~PIT~WA~LL SEPTIC TANK ., SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPT, TANK / DRAIN FIELD DRAIN ~ , DRAIN / SEEPAGE PIT /~--~ , ALSO CONSIDER AREA WELLS, WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. 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. CONFORM TO BOROUGH REGU~LATIONS 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 FO~ NO. EQ-016 < 0 ANCHOr.. ~GE WATER & WASTEW Anchorage, Alaska 99!:,03 November 21, 1983 Know/es M¢~yor Owued by the Mfmmip~lity of A~cl~c, rm, Tv Re: Alpine Village ~135 To Whom It May Concern Alpine Village Lateral Sewer Improvement District has been awarded to DLW Contractors Inc. for construction in 1984. It is anticipated that a notice to proceed for construction will be given to the contractor on or around June 1, 1984. Once the notice to proceed is issued, the contractor, has under the contract with the Municipality of Anchorage, thirty (30) calendar days to complete the project. If there are an)y questions pertaining to this matter~ please contact me at 276-2258. BAIRD, P.E. Engineering Construction Supervisor Anchorage Water & Wastewater Utility DEB:JWB:dmw GREATER ANCHORAGE AREA BOROUG" Jepartment of Environmental Qua 3330 "C" Street Anchorage, A1 aska 99503 /~ ~ ~ SOILS LOG - PEROLATION TEST Performed for /~.~Z.~ ,x/~,~<~_~ Date PerfomeO Legal Descrip~i~,'i~]~:;~~T~ ~ ~ ~K~;.-~ 'Z.?c~ This form reports: Soils log g ~percolation test Depth Feet 4- 5- 6- 7- 14 Was ground water encountered? If yes, at what depth? Reading Date Gross Time Net Time Depth to Water Net Drop Percolation rate minute. .Proposed installatl=-~-n-:--~-e~ipa--ge Pit Drain Field i)epth of Inlet .................... . Depth--t-o-~b~ot~t-~-m--o-f-'i)it or trench COMHE['~TS: -P ~. ~z ?-~-~m-e- d' - B-y-i '~ '_ i ~ ~_ ~ ~__-i'~..~=~;?_~_~-. EQ-- 040 (6174) 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 ' GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Day phone 5'ql- ~'"/-/~/9o~ Lending agency Day phone Mailing address Agent Address ~ /~WX Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: -7'H/&'E~'~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 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: 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#21 5. 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. 5'~ *0e o c~4-/~'~-/'4._ Phone ,4 T'T'&c/4 Name of Firm Address Engineer's signature bedrooms. ~dr. r,, - 7_.oo o Date DH. ~/SIGNATURE v Approved for '"~'%~EF_.-~ Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality 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. 72-47'z5(Rev. 1/91) Back MOA#21 Legal Description: ./Z- ~Z, ,55 '/" / ?.. ~ A. Well Data Well type '~ Municipality of Anchorage ., ~.,~s~.~v,~.~: Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Log present (Y/N) Parcel I.D. If A, B, or C, attach ADEC letter. ADEC water system number t',,/ Date completed UM~.~uOuJkJ Driller Total depth G (:3 ' Sanitary seal (Y/N) Y Cased to FROM WELL LOG Date of test Static water level Well flow Pump level1 ~ O f Casing height Wires properly protected (Y/N) ~' AT INSPECTION 4,5-t g.p.m. (,,, (,, g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot A J//*~4 Public sewer main ,5 5 Sewer service line ~' ~' WATER SAMPLE RESULTS: ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank /~,./o ~J~- ,,./fA I~o ' Coliform o Nitrate Z ~/~ Z.. Other bacteria Date of sample: 7. -I 3' ' ?~ Collected by: ,/,4, B. SEPTICIHOLDING TANK DATA "-' ~J/,4 /fAu,/U(c..¢/~,~-~. ,.5~f.,cP~'--f*'~ (~,z}//~ Da---'~talled Tank size Compartments Cleanou~_ Foundation cleanout (Y/N) __Depression (~ High water alarm (Y/N)-'"'"'""'"'---~_ Alarm tested (Y/N~-~~ Date of pumping -""'""'"'"'---~ ~ ~I~~~ SEPARATION DISTANCES FROM~NG TANK"T~.~ Well(s) on lot ~ On adjacent lots ~eu~3,,~ation T_o~ Absorption field Water main~ 72.026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION installed Size allons Vent (Y/N) High water Meets MOA electrical SEPARATION DISTANCE "Pump on" level at (Y/N) LIFT STATION TO: Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Well on lot D. ABSORPTION FIELD DATA Date installed Length Width Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) SEPARATION DISTANCE ~n adjacent lots water Soil ~PD/Ft2) System type Total depth Cleanout Depression over field (Y/N) (pasS/fail) __ for Bedrooms FIELD TO: If date Well on lot To building foun¢ On ad drain On adjacent lots Property To existing or abandoned system on lot Cutbank Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines Signature Engineer's Name ," o~.~'2'; ~-"/t.)~ ~'5/,44, A4; ¢z)//-So/v" Date ~ ,~ ~ '~ / ~'~<:5~ HAA Fee $ ,. ~ J Date of Payment ~:>xO//2- ¢ / ¢~G' Receipt Number~'''*/'~'' ~(~"Z~. 7 ¢ Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back '3 .E 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 July 28, 1986 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 2, Bloc[< 2, Alpine Village Subdivision, Sec. 5, T12N, R3W, Location (address or directions) 7216 Zurich Street Anchorage, Alaska 99507 (b) Applicant Name Gary Fugate Telephone: Home 344- 1387 Business Applicant Address Same (c) Applicant is (check one): Lending Institution [] ' Owner/builder ~]; Buyer [] ' Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) MailtheHAAtothefollowingaddress: Call when ready for pickup at 344-1387 or 562-3252 TYPE OF RESIDENCE Single-Family ~"1 Multi-Family Number of Bedrooms T h r Other WATER SUPPLY Individual Well P~I Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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 flies 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. NameofFirm CRW Engi. neerJng Group Telephone 562-3252 Address 3900 Arctic Boulevard, #203 Anchorage, Alaska 99503 Date ,Tuly 28, 1986 Engineer's Seal DHEP APPROVAL/- ..... Approved for (./~' (~-~'drooms by / Approved ~.~ Disapproved ~. Conditional lorms o~ Gonditiona) Approval 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 72-025 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Lot 2, Block 2, Alpine Legal Description: Village Subdivision Well Classification Well Log Present (Y/N) Total De pth 6 0 ' Cased to Static Water Level 4 6 ' Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Welt: To Septic/Holding Tank on Lot Private If A, B, C, D.E.C. Approved (Y/N) N/A No Date Completed Unknown Yield 4 GPM 60 ' Depth of Grouting Unknown Pump Set At 5 7,5 1 1 2" + Sanitary Seal on Casing (Y/N) Yes Yes No Depression Around Wellhead (Y/N) N / A ; On Adjoining Lots N / A To Nearest Edge of Absorption Field on Lot N / A · On Adjoining Lots N / A To Nearest Public Sewer Line-55=~' '(se e Cleanout/Manhole 1 4 2 ' Water Sample Collected by B. Lo Water Sample Test Results S a t i s f Comments See attached le minimummseparat Public Sewer Li SEPTIC/HOLDING TANK DATA N / A 'corem _ ) To Nearest Public Sewer To Nearest Sewer Service Line on Lot oney ', Date July 24, actory 25' 1986 tter dated Aug~ut 31~ 1983 from DEC waiving ion distance requirements between well and ne. - Public Sewer Date Installed Standpipes (Y/N) Air-tight Caps (Y/N) Depression over Tank (Y/N) 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 Size No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA N/A - Public Sewer Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) ~ Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION N/A - Public Sewer Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating.Against HAA Request ** I certify th~,J-~,~~f~:c2f°rmed t° all MOA and HAA guidelines in effect °n the date of this inspection. Signed ~,,~r ~ ~,-,,--'~.--'~ ~--,,--~.¢ Date Company CRW Engineering MOA No. ,~T-85-253 Group Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal DEPT. OF ENVIRONMENTAL CONSERVATION / August 31, 1983 BILL SHEFFIELD, GOVERNOR Telephone: Addrer~: 274-2533 437 "E" Street Suite 200 Anchorage, AK 99501 Ms. Vicki L. Sloppy Assistant Administrator Anchorage Water & Wastewater Utilities 3000 Arctic Boulevard Anchorage, AK 99503 RE: Plans and. Specifications Approval Well Regulation Waiver Alpine Village LID 135, S82-2 Dear Ms. Sloppy: Thank you for the plans and specifications and engineers report in request of well regulation waivers for the referenced project under your letter of August 23, 1983. The construction of the referenced project will consist of furnishing and installing an estimated 2,960 linear feet of 8 inch ductile iron sanitary sewer line and other related appurtenances in the Alpine Village and O'Brien Subdivisions. The plans and specifications are approved for matters of concern to this Department. In accordance with Title 18 of the Alaska Administrative Code Chapter 72 (18 AAC 72.021.a), a Mr. William P. Hamm, P.E., submitted a report for ADEC's review and consideration to waive established separation distances to construct, maintain and operate portions of Alpine Village LID No. 135 closer to drinking water sources. More particularly, construction of the referenced project will require a waiver to encroach upon the well radius of ten wells adjacent to this project. The wells are located along.Bern, Zurich and O'Brien Streets between E. 72nd and E. 74th Streets. In recognition of the report and the plans and specifications for the proposed sewer line, the following separation distances are approved instead of that required in Table A of 18 AAC 72.021. Separation distances of 20 and 64 feet between a private well on Lot 8, West Side of Bern Street (between E. 72nd and E. 74th Streets) and proposed sewer line and nearest cleanout respectively. 2. Separation distance of 55 feet between a private well on Lot 2, West Sideof Zurich Street (between E. 72nd and E. 74th Streets) and proposed sewer line. Ms. V. Sloppy S82-2 August 31, 1983 Page 2 3. Separation distance of 52 feet between a private well on Lot 3, West Side of Zurich Street (between E. 72nd and E. 74th Streets) and proposed sewer line. Separation distances 0f'43 and 81 feet between a privQte well on Lot 5, West Side of Zurich Street (between E. 72na and E. 7¢th Streets) and proposed sewer line and nearest manhole respectively. Separation distances of 52 and 81 feet between a private well on. Lot 7, West Side of Zurich Street (between E. 72nd and E · 74th Streets) -and proposed sewer line and nearest manhole respectively. 6. Separation distances of 47 and 54 feet between a private well on Lot 9, West Side of Zurich Street (between E. 72na and E. 74th Streets) and proposed sewer line and nearest manhole respectively. o Separation distance of 93 feet between a private well on Lot 10, East Side of' Bern Street {between E. 72nd and E. 74th Streets) and proposed nearest manhole. 8. Separation distance of 57 feet between a Qrivate well on Lot 6, East Side of Zurich Street (between E. 72no and E. 74th Streets), and proposed sewer line. a 9. Separation distance of 40 feet between ~drivate well on Lot 7, East Side of Zurich Street (between E. 72 and E. 74th Streets) and proposed sewer line. 10. Separation distance of 43 feet between a private well on Lot 3A, West Side of O'Brien Street (between E. 72nd and E. 74th Streets) and proposed sewer line. The Department finds that the special manholes detailed in the plans and specifications as an acceptable solution to the separation distance problem between manhole and well. Within the special manholes, the sewer line's flanged pipe is mechanically sealed and gasketed to prevent leakage of any sewage into the manhole. With the above in mind and by reviewing the pertinent characteristics of piping materials to be used, the pipe's most feasible alignment and the limited soil information, this Department f~nds the above separation distances as adequate protection of the private water sources. Please forward copies of. the bid tabulations, the signed construction contract and notice-to-proceed related to construction when they are available. Ms. V. Sloppy S82-2 August 31, 1983 Page 3 This letter serves as written confirmation of the verbal approval given to you by phone on August 26, 1983. Si ncerel y, G re~' a~gee~ Construction Grants Engineer GM/dj f / ~_ FF = 187.84 I I SI~£T I II I I I MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 ae Well Classification Well Log P=esent (Y/N) Total Depth ~ ~; Static Water Level Q ~ / . Casing Height Above Ground Electrical Wiring in Conduit Date Ccapleted Pump Set At If A, B, c~ C, D.E.C. App=oved(Y/N) SO' Sanitary Seal on Casing (Y/N)~/ Depression A~ound Wellhead (Y/N) ~ Sepa=ation Distances f=cm Well: To Se tio/Hold. ng not.. . To Nearest Edge cf Absorption Field on Lot ~//~t ; To Nearest Public Sewe~ Line _ .. T%~,_ /+ ' To Nea=est Public Sewer ' Cleanout/Manhole ) f7~)/~c To Nearest Sewer Service Line on Lot Water Sample Collected By Water Sample Test .Results ; On Adjoining Lots On Adjoining Lots SEPTICfHOLDING TANK raTA --- ~ 0~:, ~_. [ 0__._ Size Air-tight Caps (Y/N) Date Last Pumped Date Installed Standpipes (..Y/N) Dap=ession over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit Separation Distances from Septic/Holding Tank: To Wat~=-Supply Wall To Building Foundation To P~operty Line To Water Mairv'Se~vice Line Course No. of Cc~pa~tments Foundation Cleanout (Y/N) (Y/N) To Disposal Field To Stream, Pond, Lake, c~ Major D~ainage Comze.nts [Page 1 of .2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absc~ption A~ea Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test Separation Distan~ frcm Absc~ption Field: To Water-Supply W~ll To Building Foundation Lot ; On Adjoining Lots To Water Main/Service Line To Cutbank(if ~esent) To Stream/Pond/Lake/c~ Major D~ainage Course To D~iveway, Pa~king A~ea, c~ Vehicle Stc~age A~ea Cc~ents To Property Line To Existing or Abandoned System cn Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Cc~ments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets ~)A ** Check Permitted Bed~ocm Rating Against HAA Bequest I ~ertify that I have checked, verified, c~ conformed to all MOA HAA _Gg~~' in effect on the date of this Signed . [Pa~ 2 of 2] 2-15-84 DEPT. OF ENVIRONMENTAL CONSERVATION $OLITflCENTRAL REGIONAL OFFICE JAY S. HAMMOND, Governor SOUTHCENTRAL REGIONAL OFFICE MACKAY BLDG. .338 DENALI STREET ANCHORAGE 99501 June 24, 1975 Mr. Bob Neale Department of Environmental Quality Greater Anchorage Area Borough 3330 C Street Anchorage, AK 99503 Subject: Lot 2, Block 2, Alpine Village Subdivision Dear Mr. Neale: This office has no objections to the location of the septic tank at least 65 feet from the well on the subject project. We will require that the seepage system be located 100 feet from the well. Very truly yours, Kyl~J. ~erry, P.~ Regional Environmental Supervisor GFG/dma APPLI(' NT FILLS OUT UPPER HAl ONLY Property Owner ~i~~ · "~/ J~'- ~T i,,; (A!./../..,,, J-,.- /__:" -...- Phone Address Zip Code Lending Institution J '-;; /' j',l/ /~' ,;' Address ~? ~ · i:~T;~'- ~ Realty Co, & Agent Phone Address Zip Code Street Location ?,,? ,Jla: ~ ~ , y' / C //7/' Typo of Residence ; Single Family Multiple Family No. of Bedrooms .. Water Supply [~. Individual ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach Icg 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 REQUEST BEFORE PROCESSING CAN BE INITIATED. Time I Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: '),, ~ MUNICIPALITY OF ANCHORAGE ~.~~ PEPT. OF H~,".LTI- I ~': I=NVIRONMENTAL PROTECTION ( ) APPROVED BEDROOMS . ,. *CONDITIONS ~APPROVAL ('~') CONDITIONAL APPROVAL* f ~X//~ ~/ '~/// , / Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size ~---,~ 72.023 (3/82) ~ ! ~ ,~