HomeMy WebLinkAboutALPINE WOODS BLK 5 LT 3
7/16/2A 24
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231224 PID Number: 015-234-33
Dwelling: N Single Family (SF) M with ADU R Duplex (D) R Two Single Family Project: El New 9 Upgrade
Name
ROBERT BREWSTER
ABSORPTION FIELD
El Deep Trench n Wide Trench n Bed ound
C20 ound
Site Address
5850 ALPINE WOODS; BLOCK 5, LOT 3
El Other
Phone JNumber
of Bedrooms
Soil Rating
Totaldepthoriginal grade
907-244-9515
13
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grad
Ft.
Gravel depth beneath pipe
Ft,
Subdivision Block Lot
ALPINE WOODS; BLOCK 5, LOT 3
Fill added above original
Ft.
Gravel length
Ft
Township Range Section
Gravel width ,*01'
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
T>116 rption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
Ft2
Ft.
Well
N/A
N/A
TANK N Septic [3 S.T.E.P. []Holding [:]Other
Manufacturer
GREER TANK
Capacity
1250 Gal.
Surface Water
1001+
Material
Number of compartments
Lot Line
5'+
NA
H D P E
2
Foundation
,+ 1
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 drainfield Tankto, D3034
Installer
A.C.E.S.
Drainfield 1=4/aIsTm CO/MT D3034
Inspector G.E.G.
BENCH MARK (Assumed elevation) 100.00 ft
Inspectetion 2
lat 10121/2023
das: nd
Location and description
3rd - 4e,
GARAGE DOOR THRESHOLD
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
Engineers Stamp
OF
Conditional Approval: Date
°��P49T
....... .. ......................
Septic System
Approved Date (z,
. . . ...... ...........
rey A. riess: V
ap CE_ 7 5
�pP'Pap.t�IfP1
V V
Note: this approval does not include well permit requiremeritk
i�15�_
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PERMIT NUMBER: PARCEL ID NUMBER:
IOSP231224 RECORD DRAWING 015-234-33
A B
P
43.0 14.9
48.2 183
49.1 18.9
50.3 19.7
NOTE: PIPE LOCATIONS ARE
SHOWN PER GEG SHOTS
TAKEN WITH LEICA DISTO
S910 LASER DISTANCE
METER. SWING -TIES TO
HOUSE CORNERS WERE
GENERATED IN AUTOCAD.
NEW 1250 GALLON GREER
ALPINE WOODS;
BLOCK 5,LOT 2
SERVED BY PUBLIC
WATER SYSTEM
ST1 ,
y, .Z
Q
EXISTING 3
BEDROOM
QHOUSE
GENERAL VICINITY OF KEYBOX PER
O
WATER SYSTEM RECORD DRAWING
ry
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ALPINE WOODS;
BLOCK 5, LOT 4
SERVED BY CLASS
PUBLIC WATER SYSTEM
ENGINEERING -z. SALES � CONSULTING
,-_ , ,w . _�_ ,._ .�, � ..-, ...� � .•x
3701 E. TUDOR ROAD, SUITE 101 "ANCHORAGE, AK 99507 • PHONE (907) 337-6179FA% (907) 336-3246' WESSITE: xmw.gemessengineenny com
PREPARED FOR:
PHONE NUMBER:
PAGE NUMBER:
ROBERT BREWSTER
907-244-9515
2 OF 3
LEGAL DESCRIPTION:
DRAWN BY:
ALPINE WOODS; BLOCK 5, LOT 3
D.J.G.
TYPE OF WORK:
DATE:
SEPTIC TANK RECORD DRAWINGS
6/18/2024
• 4p.
Y�1 '
!........._ ..... .........................
Al
.......... rl 4W
LICENSE +/�I S`,� **4
#AECC884 ,
PERMIT NUMBER: RECORD / �^► PARCEL ID NUMBER:
OSP231224 DRAWING `.7 015-234-33
TOP OF MANHOLE = 96.55
FINAL GRADE = 96.05-96.39
MH1 ST1 16
2" INSULATION PER CONTRACTOR
TOP OF TANK AT INTLET = 90.92 f TOP OF TANK AT OUTLET= 90.88
INVERT OF BUNG AT INLET=a).27 INVERT OF BUNG AT OUTLET =90.02
NEW 1250 GALLON H.D.P.E. SEPTIC TANK
GROUP,OF
Air
GARNESS ENGINEERING
............ ............................. i
ENGINEERING, SALES CONSULTING -
3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE. AK 99507 - PROW (907) 337b179- FAX (997) 3383240' WESSRE: amnr.9ama —ou-ermg.vxn , ......... ........ r
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ` : • . Jef%y A. mess
ROBERT BREWSTER 907-244-9515 3 OF 3 0® Gi E-79 3
LEGAL DESCRIPTION: D_ RAWN BY; �l' •.j�• I 2
ALPINE WOODS; BLOCK 5, LOT 3 Q.J.G./J.L.M. ®FQ •�J ,,,,,.•�-��, 4s
TYPE OF WORK DATE: LICENSE��Ae� �®SS\
SEPTIC TANK PROFILE 8/20/2024 I#AECC884
WOOD RAIL FENCE
OF.A
CO 49 RH `9
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LS-6914
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SLOCKRET WALL —
ASPHALT DRIVEWAY
OCKRET. WALL
THESURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE
OWNER OFRECORD AS OF THEDATE OF THIS SURVEY.
ANY USEOF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS
WRITTEN PERMISSION IS PROVIDED.
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOD/ ANY
CONFLICTS BETNEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS
NOT TO SE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES-
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOUN
HEREON ( UNLESS INDICATED)
NOTE: FENCELINES THAT MAY APPEAR ON THIS PRAYING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHONN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNON AND/OR ICE.
\-73
\7
�jZ—
SEWER PIPE
a YARD LIGHT
AS-BUILT SURVEY 111 = 30 `
NO CORNERS SET THIS DATE
/ HEREBY CERTIFY THAT / HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 3 BLOCK 5 ALPINEWOODSSUE.
A NCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLEIMPROVEMENISStTUATED THEREON AREWITHIN
THE PROPERTYLINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED ATANCHORAGE,ALASKA THIS 257-H DAYOF
DUNE , 2024
15838 232-36233-1237-66
HOLT LAND SURVEYING
93og GROVER DRIVE
ANCHORAGE,AK 99507
9
t
I-6" 33- 1/3- BEND
1-6'' 11-1/4* BEND
STA I * 99.38
2
1-6" 22-1/20 BEND
STA 2+92.56
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1 0' 3jy FINCH DRIVE
j �ti \ • Q� OOYN_(Sff SHEET 3 OF 13)
�( °TEE
1.6 G v, ek v.e
o e 1.6 p+10. l 5 S W
S55 28-SE
i
NOTES:
1. DUCTILE IRON PIPE SHALL BE CLASS 52. i
2. ALL ELEVATIONS ARE TO BOTTOM OF PIPE.
3..ALL SERVICE CONNECTS SHALL BE 3/4" TYPE K
COPPER UNLESS OTHERWISE NOTED. .
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PC. STA. 4+78.87
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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: OSP231224
Work Type: SepticTank Upgrade
Tax Code Number: 01523433000
Site Legal Address: ALPINE WOODS BLK 5 LT 3 G:2738
Site Mailing Address: 5850 ALPINE WOODS DR, Anchorage
Owner: BREWSTER ROBERT A &
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
111cnt S
N
Department
7/31/2023
7/30/2024
36189
❑ Disposal Field Q 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
Received By: C S 5 �I'� j� G r Ci Date:
Issued By: Date: 3 / 702 3
3
Development Services Department P P Phone 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-234-33
Property owner(s) ROBERT BREWSTER Day phone 907-244-9515
Mailing address 5850 ALPINE WOODS DRIVE *ANCHORAGE, AK
Site address 5850 ALPINE WOODS DRIVE -ANCHORAGE, AK
Legal description (Sub'd., Block & Lot) ALPINE WOODS; BLOCK 5, LOT 3
Legal description (Township, Range & Section)
Lot Size
Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) El
Septic Tank
Q
Upgrade X
pg
(w/wo AD U)
Holding Tank
❑
Renewal ❑
Duplex (D) El
Privy
❑
Multiple Dwellings ❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES A WAIVER REQUEST FOR:
Distance:
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: J�? 2 Waiver Fees:
Date of Payment: _ %127123 Date of Payment:
Receipt Number: _ 06 y 07G Receipt Number:
Permit No. (�25192 312 24 Waiver No.
GADevelopment Services\Building Safetyl0n Site Water and Wastewatefforms\Client Forms\Permit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231224, Curtis Townsend, 07/31/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231224, Curtis Townsend, 07/31/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231224, Curtis Townsend, 07/31/23
OF.A
CO 49 R `9
h'Ae�—
s SHANE A. HOLT �� G
LS -6914
,\,°fessiona� �-Qo
N 77 0%
BLOCKRET WALL
ASPHALT DRIVEWAY o
OCKRET. WALL
THESURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE
OWNER OFRECORD AS OF THEDATE OF THIS SURVEY.
ANY USEOF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS
WRITTEN PERMISSION IS PROV/DED.
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOD/ ANY
CONFLICTS BETNEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS
NOT TO SE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES-
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOUN
HEREON ( UNLESS INDICATED)
NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAYING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHONN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNON AND/OR ICE.
WOOD RAIL FENCE
\-73
\7
SEWER PIPE
a YARD LIGHT
AS -BUIL t SURVEY I" =30'
NO CORNERS SET THIS DATE
/HEREBY CERTIFY THA T1 HA VE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 3 BLOCK 5 ALPINEWOODSSUB
A NCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLEIMPROVEMENISStTUATED THEREON AREWITHIN
THE PROPERTYLINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED ATANCHORAGE,ALASKA THIS Lo TH DAYOF
JUL Y 2023
15838 232-36233-1
HOLT LAND SURVEYING
93og GROVER DRIVE
ANCHORAGE,AK 99507
�� rn
o �r
SO o
� oil
BLOCKRET WALL
ASPHALT DRIVEWAY o
OCKRET. WALL
THESURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE
OWNER OFRECORD AS OF THEDATE OF THIS SURVEY.
ANY USEOF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS
WRITTEN PERMISSION IS PROV/DED.
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOD/ ANY
CONFLICTS BETNEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS
NOT TO SE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES-
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOUN
HEREON ( UNLESS INDICATED)
NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAYING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHONN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNON AND/OR ICE.
WOOD RAIL FENCE
\-73
\7
SEWER PIPE
a YARD LIGHT
AS -BUIL t SURVEY I" =30'
NO CORNERS SET THIS DATE
/HEREBY CERTIFY THA T1 HA VE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 3 BLOCK 5 ALPINEWOODSSUB
A NCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLEIMPROVEMENISStTUATED THEREON AREWITHIN
THE PROPERTYLINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED ATANCHORAGE,ALASKA THIS Lo TH DAYOF
JUL Y 2023
15838 232-36233-1
HOLT LAND SURVEYING
93og GROVER DRIVE
ANCHORAGE,AK 99507
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
.- .
ABSORPTION
TANK , FIELD
Address B0, l~'" 3~'(~I' ~~~ ~ SEPTIC WELL
,' ~ 1~'o-5 i~u-,v,~/~. ~x ~0.....0. /4, ~o~-¢_
Township, Range, Section
T~ ~~ ~~~ ~ driveway,AS'BUILT DIAGRAM {Showlocation of well, septic system, prope~ylines, foundatiOn,water bodies, etc.)
~SEPTIC ~ HOLDING .,~1~_ &~r
Capacity in gallons ~
Man~~ ~uf~urer ~ ~ ~ .~l
~,,~,~~~/, ~ /, ~o ,?, -~
Material No, of Co~pa~ments
~ ~t~~> ~'/~ _,,
TYPE OF SYSTEM , ~
Depth to pipe bottom from Total depth from original grade ~=~' ~ ~-~ '~/ ~
°riginai grade ~ /- ~ ET 7--/~ ET-'
Fill added above original grade Gravel depth beneath pipe ( ~ ~
/A ~r~ / / +/- ~ ~ - 7 ~ I' ~ ~2~
Gravel width
Gravellength ~ FT 2, ~ FT /
Total absorption area Distance between lines /,~r ~ [
NumberTines I Sol,t3 Pipe material / ~
~ PRIVATE ~ OTHER (Identify} . ;~
Classification (A,B,C) Total Depth ]Cased t~ ~
REMARKS:
~al~: ENGINEER'~ SE~L
I ~¢~ ~' ~~ c~dilythatth~inspe.ionwaspedormedaocordinotoall ?~: ~
Municipal and State guidelines in effect on this date. ~ / ~. ~/~,0,,.~
Heallh Depadmenl Approvah Date: ~ ~f~::~ ,,;,~
72-013 (3/85)
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICI
825 'L' Street, Anchorage, Alaska 995'02-0650!
SOILS LOG -- PERCOLATION TEST~
PERFORMED FOR:
,_EG^L OES~R,PT,ON:
1
3
4
5
6
7
8
9
I0
.11
12
13
14
15
16
18
19
20
/q L PI
LidO DS
Township, Range, Section: -r/z.
SLOPE
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? P
E
SITE PLAN
Depth to Water Alte~,.>, /
Monitoring? CT--)'
Gross Net Depth to Net
Reading Oaxe Time Time Water Drop
\
x,
"x
-,,,,
PERCOLATION RATE
(m,nutes/inch) PERC HOLE DIAMETER
TEST .RUN BETWEEN __ FTAND ~
~,~1 vis'u~/iff r~-~J ~+ /~-o.~. $~ /~
co.~.~s 5U- ~/,~ ~ , ·
PERFORMED BY;
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
FT
CERTIFY THAT THIS TEST WAS PERFORMED
72-008 (Rev. 4185)
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lOt, block, subdivision, section, township, ran e)
Location (address or directions)
(b) Property owner ~~ , Telephone '(home) ~
Mailing Address ~,Or ~a~ ~~ ~,~~
(c) Lending Institution ~/~ Telephone ~
(d) Real Estate Company and Agent /~-J? A--
Address
Telephone
(e) Mail the HAA to the following address: (or check here ~d for pick up.)
List contact person and day phone number below:
Business
2. TYPE OF RESI. D~/C,E
Single-Family ~ Number of bedrooms ~ ~
3. WATER SUPPLY ~
Individual Well[] Community[~'/ Public[]
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DJ~AL
On-site ~ Public i-i 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.
72-025 (Rev, 7/88) Page 1 of 2
5. 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 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 regul,ati@ns in effect on the date of this inspection.
Name of Firm ~*¢']'~'~¢~'-/,'~1''~'' Telephone ~- 7 '~ (~"~
Address /~' ~---~' ~ ~~ ~ ~~
Date
Engineer's Seal
6. DHHS APPROVAL
Approved for ,_~¢'_jbedrooms by
~ Disapproved
Approved ¢...._.
Terms of Conditional Approval
Date
Conditional
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated 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.
72-025 (Rev, 7/88) Back Page 2 of 2
A. WELL DATA
WolI ~o~ ~resent (Y/~) Date Gomplo~d
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST- FEBRUARY 1984
343-4744
..)egal Description:
Total Depth Cased to Depth of Grouting
Static Water Level Pump Set At
Casing Height Above Ground _ Sanitary Seal o~N)
Electrical Wiring in Conduit (Y/N) _ Depres~,~.~und Wellhead (Y/N)
SEPARATION DISTANCES FROM WELL: J
To Septic/Holding Tank on Lot J ; On Adjoining Lots __
To Nearest Edge of Absorption Field on~.,," ; On Adjoining Lots
To Nearest Public Sewer Line J To Nearest Public Sewer Cteanout/Manhole
To Nearest Sewer Se.~e~.ine on Lot __
Water Sample Col ec.~¢/ __ __ __; Date __
Water Sample Tes esults -, ....
Comments ~'~e A~~----- ~ ~/"~/~l_e,~J~
(~B, C, D.E.C. Approved (Y/N) Y
Yield
B. SEPTIC/HOLDING TANK DATA
Standpipes (Y/N) L.~
Depression over Tank (Y/N)
No. of Compartments ?"
Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N)
~ Date Last'Pumped ~ ~
Pumping/Maintenance Contact on File (Y/N) ~J/,2 ~ ;for Jl~J'/./dr'
Holding Tank High-Water Alarm (Y/N) ~[--' Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well
To Property Line ,;.~ l-~--/,-...
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
To Building Foundation
To Disposal Field
Comments
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~:~
Width of Field '~-
Gravel Bed Thickness
Statndpipes Present (Y/N)
Date of Last Adequacy Test
Square Feet of Absortion 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 '~ I ~)1
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
To Property LineI i~:~I
To Existing or Abandoned System on
; On Adjoining Lots
To Cutback (if present)
Comments
D. LIFT STATION
Date Installed Dimensions ~
in Gallons Manhole/Acc~
'Pump On" Level at ~ __~.u~f" Level at __ __
High Water Alarm Level at [ %~_~ ~ Vent (Y/N)
Tested for ~"~'~"~'~ ~ Pump---~ng C-~cles during Adequacy Test.
Meets MOA Electrical~ ~
Comm~~-''~
**Check Permi~ Bed
I certify that/
inspection.///~/X//
Signed / //.
MOA NO
Against HAA Request**
or conformed to all MOA and HAA g
Receipt No. c~//~ ~
Date of Payment ~'~
Amount: $ / ~ ~"/~ ~-~---,)
72-026 (Rev, 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
on the date of this
ineer's Seal
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE WESTERN DISTRICT OFFICE /
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
STEVE COWPER, GOVERNOR
563-6775
June 18, 1990
FOR: CORWIN & ASSOCIATES
Attn: Bruce Corwin
PWSID: # 213598
According to the records on file in this office, the Alpine Woods
Subdivision Water System is in compliance with the State of
Alaska Drinking Water Regulations.
Sincerely,
VERA E. CRAIG
Environmental Fi ffice.r
VEC:bas
