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HomeMy WebLinkAboutBENITO BLK 2 LT 2 GREA,E.R ANCHORAGE AREA BOR,..JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 NAME:~_~ LOCATION SEPTIC TANK: DISTANCE FROM WELL INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MANUFACTURER MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY__ GALLONS, TILE DRAIN FIELD: NUMBER OF LINES ~ DISTANCE BETWEEN LINES ABSORPTION AREA ~'i~ DEPTH: TOP OF TILE TO FINISH GRADE NEAREST LOT LINE /O '~ TOTALoF LINEsLENGTH~¢":) /, N/~ TRENCH WIDTH-~IN. TOT AL EFFECTIVE SQ. FT. LENGTH OF EACH LINE ..~O ) DEPTH OF FILTER I 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: SEWER LINE DEPTH: PIPE MATERIAL: P~-~I~''_ LOT SLOPE: REMARKS: Form EQ-032 DIAGRAM OF SYSTEM ~ GrEt gr ANCHORAGE AREA BOF Ughd . 7~,~,h-'/ ~'- //,~FFIlII'llI~\~ DEPARTM~,T OF ~,V,RO.M~.,'A,. QUA,.,T¥ /,.~_,~.._~_h~T NO. -- [~[((UJJ Ull iI;i.~/t/ 3,0 ,'c" S,'R~T. ^,C.OR^G~. ^-,,SKA 9,~0~ ~ SEWAGE DISPOSAL SYSTEM APPLICATION AND PERMIT TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS TO BE INSTALLED BY NOTE-' THIS PERMIT IS NOT VALID WITHOUT SOIL TESt' 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. SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK .,SEEPAGE Pit TO NEAREST LOT Line. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, i, SEEPAGE PIT TO RIVER, LAKE. STREAM. DRAIN FIELD , DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD DIAGRAM OF SYSTEM 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 CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATIJ~)N. LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ,~..BOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. GAAB-HD-I GREATER ANCHORAGE AREA BOROI"~,H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING __ADDRESS LEGAL DESCRiPTiON SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY j GALLONS. .MATERIAL ~'~t,~ ~D~ NUMBER OF COMPARTMENTS ~J /,~-~ ~4 ~- ~"~ ~-g~:~ 7<3 LIQUID INSIDE LENGTH INSIDE WIDTH DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH //~1~ ' LENGTH ~"'7" , DEPTH LINING MATERIAl NEAREST LOT LINE DISTANCE FROM WELL BUILDING FOUNDATION.__ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH ABSORPTION AREA FT. LENGT IN. EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPE /' , DEPTH //'f-,~ DISTANCE FROM '~O WATER ,BUILDING FOUNDATION SAMPLE ~ NEAREST LOT LINE j ~,~' ~' NEAREST SEPTIC ~:~ ! SEEPAGE / OTHER SEWER LINE ~" ., TANK SYSTEM 1"~,/'O , CESSPOOL '"--' , SOURCES__ DIAGRAM OF SYSTEM DATE ,, 70 APPROVED HEALTH AUTHORITY GREATEI ANCHORAGE AREA ' )ROUGH c. No. HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT RESIDENCE ADDRESS ~=7~ - ~ ~ LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK ~' , SEEPAGE PIT. ~ , DRAIN FIELD , OTHER BELOW TO BE FILLED OUT BY REALTR OEPARTMENT ~' . ITT INSTALLA /'0 · THIS IS TO SERVE AS . . pERM 0 ~ ~ :~':~,-~ ," ..;:~ AS BESCRIBED~BELOW. SIZE OF' UNIT TO,BE SERVED ,~/~~';)~~"/'/~ '-'~- ',~-" r ' -{/ ? :SEPTIC TANK SIZE/~ ~ O~YPE ~'SEEPA~E AREA DISTANCES: Health Authority DIAGRAM OF SYSTEM 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. ... , ..... 'i :' :: ~, : '..'~ ' !: ' "' ,' ~''' '""-,,.." APPLICANTS SIGNATURE DATE GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 32? EAGLE STREET ANCHORAGE, ALASKA §§501 CASE # Depth i'eet '7-- Was Ground Water Encountered?__~/O~ F~ 1 If: Yes, At What Depth ,. Location Sketch Reading Date Gross T~me Net Time Depth To H20 ~ ~'Z-e~la~-i ~h' ,,ate~ '1,,"/- '' ......... .t ~ ~ t% l,l,,t..,~ ..... ..,,.,,~,,.,~-- .. , ....... Net Drop Proposed nstallatzon: Seepage Pit Z/ Drain Field Depth Of Inlet ~ , , Dep'~ To B'o't'tom Of' Pi 0 COMMENTS: <~ ..... '-~,j_ , , ,..~_~ '. _.. - . t r '~'enc~ Test PemfoPmed BS,: '~ ....... SCALE $ Scale: 1"=30' 40~ Building ~ setback lin6 from stre~ 5"-S't'-fl~oin which wells are to be located per plat 1!1' F IvE -- Loca.i~n pi drille~. W~ from nli well to be 1 is 120' ring lot se~ar system ' 111' .F~othill' Ave (50') 10' Utility Easement :e from ~er syste Attached is a copy of surveyed adjacent property (owned-by myself), by Robert C. Johnson that verify certain plat layout requirements~ Described property located: Lot 2, Block 2, Benito Subd., SEI/4~ SW1/4, Sec.12, T14~!, ~21,!, S!~, Alaska, Anchorage Recording Precinct, and that the imorovement~ will be situated thereon are w~thin the property lines and will not'overlap or encroach upon the'property lying adjacent thereto, · Harold L, Carlos' Applicantee by A & L DRILLING' COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588 OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE-Startea Y/Y PERMIT NUMBER DEPTH OF WELL STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KIND OF CASING KIND OF FORMATION: From Cc-) Ft. to ~ Ft. From ~2, Ft. to. ~ Ft. From '~ Ft. to ,7~' Ft. From ,~a° Ft. to ~'O Ft. From ~0. Ft. to /~ ~ Ft. From I gt Ft. to /d )' Ft. From Ft. to Ft. From ,, Ft. to Ft. From . Ft. to Ft. From__Ft. to Ft From Ft. to__Ft. From____Ft. to__Ft From Ft. to Ft. From Ft. to Ft.. From Ft. to Ft. From__ Ft. to__ Ft. From__Ft. to Ft. From ~ Ft. to Ft. From~ Ft. to_ _Ft. From ~ Ft. to~.Ft, From~Ft. to_ __Ft From~Ft. to Ft From Ft. to Ft. Fromm. Ft. to Ft. From Ft. to Ft. From~Ft. to Ft. From~Ft. to Ft. From~Ft. to Ft. From Ft. to Ft. From Ft. to~Ft From~Ft. to__Ft. From Ft. to ~Ft. From Ft. to Ft MISCL. INFORMATION: /Oa ~.,~ ,o 7'0 /3~ DRILLER'S NAME i :*' ': ', i.';" ;ii ;: ,;.i::;, ,: MUNICIPALITY:'OF ANCHORAGE ~':~ ~;' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTI°N. " ~.?' ': ". :"; " DIVISION OF ENVIRONMENTAL HEALTH · ';i :'!: : ' : CERT F CATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ::i: i :: ;:':~ :~: ::: OF ON-S TS SEWER:AND ~A~'ER FAC LITY ':'i:'! :'!:':" i..:!i:'.::; :?'! "::;: '' ' 254"4720'? ."' !: : : ',; :: ' ' ~ :: ,';~ AppicationDate~-~- 1. GENERAL INFORMATION : (a) (b) (c) Legal Des.cription (include lot, block, subdivision, sectio.~t0wnship, range) · ' Ap plica n, N a m e (~'//J~/..4¢'./~_.~~ Telephon;: H"°me ~' ~ ~/"°.~ 7-~0 Applicant Addre: '-' /,~,~ ~'~'~ ~,' ~ Applicant is (check one): Lending Institution []; Owner/builder/~'; Buyer []; Other [] (explain); (d) Lending Institution //~ ~"~~~'M Telephone Address ~'~ ~.- ~ (e) Real Estate Company arid Agent ~' Address T e I e~p~..)o n e (f) --~'~he HAA to the following address: : Z¢ :'" ' "' ....... TYPE OF RESIDENCE Single-Family ~ Multi-Family Number of Bedrooms t.~ 3. , WATER SUPPLY Page 1 of 2 Other Individual Well ¢ Community [] Public [] 7;: 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 Enviren mental Conservation attesting to the legality and status. ; · - . .... ,.. :~,ii, 72-025 (11/84) ENGINEERING FIRM PROVIDINt iSPECTIONS,;~ESTS, ~IL~:SEApCH, DA~ ANpJ~,O~MATI,ON,~,~ As cedified by my seal affixed hereto and as of the validation date.~hown below, I verify that my investigation of t~is HeaRh Authority Approval shows tNat the on-site water supply and/or wastewater disposal system is safe, functional and adequate lot the number of bedrooms and type of structure indicated herein, I fudher verify that based on tBe 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 S 8 S EN~INEERIN~ Telephone ~ ~ SRB 196X Address ~GLE RIVER, AK ~V57i JUL 6 1986 Date o DHEP APPROVAL Approved for '~'~'"'~"~ ._bedr6oms by ""~' '~~ Approved Disapproved Conditional Terms of Conditional Appc.oval 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 par~,graph 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) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 JVJUNICIPALITY OF ANCHORAGE. DEPT. OF HE/',LTH & ENVIRONMENTAL PROTECTION Legal Description: WELL DATA Well Classification Welt Log Present (Y~). Total Depth k) d(---, Cased to Static Water Level ~ t. Casing Height Above Ground Electrical Wiring in Conduit (~N) Separation Distances from Well: To Septic/I-Loldh'rg Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results If A, B, C, D.E.C. Approved (Y/N) Date Completed ~- 1 ~'J I Yield I~ ~ Depth of Grouting ~ Pump Set At t,,'~ Sanitary Seal on Casing ~N) Depression Around Wellhead (Y~J~) ; On Adjoining Lots ; On Adjoining Lots t C'c~~Jr' ' ~l~' To Nearest Public Sewer 1311~ To Nearest Sewer Service Line on Lot B. SEPTIC~ TANK DATA To Water-Supply Well To Property Line To Water Main/Service Line Course Date Installed Standpipes Ld~N) Air-tight Caps Depression over Tank (Y/{~ Pumping/Maintenance Contract on File (Y/NI,.~ Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/.bleld~g Tank: . tc~t~ Size I ~..~ No. of Compartments Foundation Cleanout (Y/J:~ Date Last Pumped '~ - I -' ~ ~/A ;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) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed t c, - ~ Width of Field '3)~, ~' Square Feet of Absorption Area Depression over Field (Y/~J~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well J~ ~ ~ / 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 (~/N) Date of Last Adequacy Test To Property Line I ~ To Existing or Abandoned System on ; On Adjoining Lots ~ ~ I~ To Cutba~I~if present) D. LIFT STATION 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) ~P~mp Off" Level at-- -- /j~ Vent (Y/N) ' umping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** , cert~y~, ~t i~i~elc~j:~'ified, or conformed to ail MOA and HAA guidelines in effect on the date of this inspection. Signei~ ~ Com~," ,~,~,,'- Receipt NO. Date of Payment Amount: $ Date II II P, ~noc ~'~ MOA No. _~j>',~q~Oo .~ Page 2 of 2 72-026 (11/84) ' nicipality of Anchorage P,O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES July 10, 1986 Robert A. Shafer, P.E. S & S Engineering SRB 196-X Eagle River, Alaska 99577 Subject: Lot 2 Block 2 Benito Subdivision Waiver Request, WR86-096 Dear Mr. Shafer: Your request for a waiver of the minimum separation distance required between the leachfield and well on the subject property has been approved. This distance has been waived to 98 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw MUNICiPALiTY ~ !.' ANCiiOi<AGE DEPARTMEN'! OF HEALTH AYD [~U,'~AN ~ERVI'~.~.:~',~ WAIVER REV~?d '~;C%itSt{EEI' h,~(, i N EEg.. SRB 196X ~GLE RIVER, Al(~-/~/ ..................................................... CRITERIA: l) Geology: Po [ n ¢:.s: A. Water Table _ B. Soil Sorptlon %,o C. Permeability \ D. Water Table Gradient '__.(~,2~. ..... E. [iorizontai Separation ~,~ WAIVER iS: graated, with cendic~o~s ].i.~;ted belc~w: riot g~anted £~.,r ~:e_:tso~m ifs?~:d be~.ow: DAf'E: ROBERT A. SHAFER July 6, 1986 CIVIL ENGINEER 694-2979 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITEPLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 ATTENTION: Steve Morris REFERENCE: Lot 2; Block RECEIVED ~nito Subdivision Request you approve the attached Health Authority Approval and issue a waiver to the horizontal separation distances between the private well and absorption trench located on the referenced property. Attached for your review in addition to Health Authority Approval application requirements is a plot plan and a complete waiver review worksheet. Based upon the risk analysis shown it is our opinion that the horizontal separation distances prescribed by 18AAC72.021 are not required in this cas e. If we may be of further service, please contact us. Sin c e~l~'~) Po~o SAS/ss SRB 196X EAGLE RIVER, ALASKA 99577 February 25, 1970 !4r. Harold L. Carlos Box 049 Ei~enclor£ Air Force Base Anchorage, Alaska 99506 SUB. CT: Lot 2, Block 2, Benito Subdivisim .ear ~qr, Carlos: This letter is to indicate that an approved individual water supply in conjunction with an approved se~r system can be located on the subject lot. Our files indicate the ~ell depth ~ill be frc~ 80~ to I10~ deep. Sincerely, M~inistrative Director R~S: rn BY: ~nvtron~ncal Health 5up~rvisor *poII~U! ueoq set~ ~lsls .~oa po,~o,td(h~ u¥ ~OZ'££ZOIO-III 'oN V}L.i ~.UO~Sl~A!pq~ olyueg 10566 t~-lselV 'o~m~mpuv OBD' xoi] (6L/9 '^eEl) 0 LO-i;Z. 'Q:a.L~flJ. INI q8 NV3 9NISSqOOIJd 31:lOd:a9 IS:ano:al:l HO~:a ANVdlNODOV .LSrlIAI 3qd NOI.L33dSNI qH.L :::I.LON ' C] :t "I 'I V/SN I SV~ IAIq/SAS ::I/IS-NO EIV~A ,',.LrlI.Ln Ol'lSnd [] , ~::t.LI$-NO/-IVn(] IA IQ N I ~ H::IISAS q~fSOdSIO 3DVM:I$ '8 ('elqel!e^e ~t! 6Ol qom4e) q~dap ila~ a^!§ 'a~.ep :l. eq:~ o~ Jo!Jcl PellpP Slle~ ~o-t 'gL6L aunl" aou!s Pall!Jp Slla~ iie Joj. pa~!nbaJ s! 6oI Ila~ V 'DO'l I-ElM H0¥/J.¥. A.LI-I I.LN Ol'lSnd [] A.LINN~I~O0 [] ,-IYno IAIC]NI ....[~- Aqddl'lS 1:I3.L~fM x!S [] aaJq.L ~ a^!-I [] o/~1 [] Jeq:l-O [] .lno:l [] auo [] S~O01:l(]:l B'~-IO U38~nN *'11~V:l :l-Id I.L'I n ~ [] A-I II~'v':J :t-I E) N I S.......~ 3ON:aOlS:q:i dO adA.L '9~ 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 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY / ~3 -- Connection Verified INSTALLER {-~Septic Tank or [] Holding Tank Size: //O4~O If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL A.SORPT,ON AREA MATER,A' A~sor~tion Aroa to noarest Lot kine 5. COMMENTS ~ APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [~DISAPPROVED 72-010 (Rev, 6/79) DAVID A. SLENKAMP ROBERT A. SHAFER MECHANICAL ENGINEER 694-9055 May 17, 1981 A CIVIL ENGINEER MUNICIPALITY OF NCHO~.~979 DEPT. OF I-!~,~,LTii & ENVIRONMENT Sun Realty ATTENTION: Darlene Nicholaysen P.O. Box.1201 Eagle River, Alaska 99577 RECEIVED Dear Darlene, Reference: Lot 2: Block 2: Benito Subdivision: William Stock property A sewage system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to the crib had per- colated out. It can be concluced from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. ~owever is cannot be guaranteed against subsequent failures. If we may be of further assistance, please do not hesitate to call. Sincerely, cc: Alaska Bank of Commerce ATTENTION: Carol Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA E ....E RIVER AREA GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received September 24, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. l. Approval requested by: First Natioanl Bank of Anchorage Mailing Address: Post Office Box 720 Phone: 279-4481 x 483 2. Property Owner: Joseph C. & Arlene F. Mc Cowen Phone: 694-2274 Mailing Address: Post Office Box 123 Foothill Avenue, 99577 3. Legal Description: Lot 2 Block 2 Benito Subdivision 4. Location: NHN Foothill Drive Type of facility to be inspected Single Family No. of bedrooms Well Data: ? A. Type Individual B. Depth ( C. Construction ~ D. Bacterial Analysis 7. Sewage Disposal System: A. Installed C. Septic Tank: 1. Size D. Seepage Pit: E. Disposal Field: 8. Distances: A. Well to: Septic tank Nearest lot line On-site system /~7~ B. Installer 2. Manufacturer 3 1. Absorption Area Total length of lines B. Foundation to septic tank C. Absorption area to nearest lot line 2. Material , Absorption area , Other contamination , Absorption area , Sewer Lines EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~' ~ for Approval of Individual ? - & Water Facilities Legal Description Lot 2 Block 2 Benito Subdivision Comments Approved ~_ Disapproved Date Appro)rJlValid 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 subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owner: Joseph C. & _/~le. ne F. M~en Mailing Address: P,O, BOx 123 Foothill Ave. Eagle River, AK 3. Name of Buyer: William S, & Barbara $, Stock Mailing Address: 1224 Richardson Vista ~351; Bldg 16 4. Name of Lending Institution: Mailing Address: P.O. Box 720 Name of Realtor or Agent: No~e Mailing Address: Legal Description: Z~)t 2; Block 2 Location: N[-~ Vc-z~-_hi] ] Av~_. FHA MUNICIPAIJTY OF /',IqCttORAG~! DEP'I. OF I-tEA!.Tk[ c?, ENVIRONMENTAl. PRO Ilfq'FlON SEP 2 4 1976 RECEIVED CONV X Day Phone 694-2274 99577 Day Phone First National Bank of Anchorage Anchorage~ AK 276-7047 99510 Phone 279-4481 ext. 483 Benito S./D Eagl~ River Phone 7. Type of Facility to be inspected' 8. Water Supply Type of Supply' No. Bd(ms. 3 Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) X EQ-037 (1/74) Marie Iiam~ 9/21/76 J:orln Approved ~.!~)IVIDUAL \:'.//~,'i'~:''~ t ........ ~, ~, ~ ~)e~ A. ""'"' { ................ __[ ........ ~ZLLc U L~L'. ~')'l-'iJl-}'lIlJi-l'I) i - i[{{-]~l]f 1 i'll'iii'ill II~}[{-' iii'Il]III[ ~]'~ ' ~-~ l- ' l'/ --f-~ i -{- I ~ ] { I f-l- {-1 I { { I [ I [ i [ ~ '-f ~ {-(i-") E-fi I {', ~'~ ~, i I-I'I'i-i' ~- I 1 ] ~ I'l I { I i'I [ I 'I } ~ - - I- !-I i I t--i"[ / [ I ~ -f'~-i--I ! ! ~ '~ J Ii' -i i'~-I I il LI'i ~ 1t I I Ii' Ii i I II 1 i [~ I'l l-Ill II ~ I I 'l ~ I ! ~ ~ i' ' i ' ~ i ~ ~ -{ I l- - i [ '{ ~ / i ' r 1' ~'[ t ' I- ']- I'l F'FI I'J-- I I '{- - : [ ~ .... ~ i i ) I __.) i ~ i1 il ~ I1 I I ~ i ./ J ] -I -l=[ r [ [ Lt=-i -U F---__T ~ l', i l- I ~ ;' i' i'li - t-/ - ' I'--T"I ...... I-F '1't [-I-}TI'F[-E-I']F'i-[ 71 I-- 1'I-E-I i -', ~ ~ i i I i ; I t t i ~ I b I I i I ! I l~ t I ll-I'i Il I'Y'I-T'I I I I I l'-I i-I't"/-//ll l-I Fl I-I-KI I ! 1 -~' -- i ~- I ..... I~- ' Iii l' t II~ F il i F'i'Y iF- 1-' I ...... ~ .... I'-q-~-l~i-'l l~'--f'fTf ~-KF' t ~ ~ : ~ I i i t i f I I f ].1 I ' l- ~T i' -1 l-IT"l-" 'I--[-I'/-I'"I-/-F I--Ti .... F-r--F- 'qli" -,-I I , 1I'll {-l-t J-I l~l ['l i'l ti --]l= ']-]'-F-E'T-'I"F'F]SFFI'-'I-ITIT'I'ITI-fSEF t-K ..... f'T 7--I ~ {,. ! ~s not ~::~isfactory as a ch~,nesti( ,x, atcr supply for thc subject property. thc t~)iniJn of tlic F~'] Stare j ]County j~-5~'} Local Dq>zirtmcnt of )'teatth that this individual sawage-disposal sys- C:_n b~ c:.q':'cct~,i to function satis,qic,orily, a,,d l.;)1 Ca,mot hc expected to fln,ctio~, sndsfactorih, .,-". ~ .Z ..(' 1i-5-71 {" ;: :.? ....'x.,'-'. ; : ' , . EnvironJnent~l Specialist have rc-,?i=w,d thc l~)[C[~OiIl~ and the j)ertincnt FiIA (]olnpliance lnspccdon Report, and feCOillIBctld that the tnu',i~d v:~,cr-supply systc,',, I,= co,,sid,:n:d ~'l Accq,tat, le i] I "'"' Accet, t~ble GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: TIME: REQUEST FOR APPROVAL OF INDIVI'DUAL SEWER AND WATER FACILITIES FOR APPROVAL REQUESTED BY: i}O~_~. PHONE: 2. PROPERTY OWNER: ~- -~ ~ ~ PHONE: / NUMBER OF BEDROOMS' . ~ ' ,~ WELL DATA B. DEPTH C. SIZE D. CONSTRUCTION SEWAGE DISPOSAL SYSTEM: SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 2. AGE //¢. c~('? , 3. MANUFACTURER /~ ,~?//~:~. 4. INSTALLER APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO SEEPAGE PIT SIZE Z 2. L I N I NG ~2~-:~?~~ DI~SAL FIELD 1. NIA~,BER OF LINES 2 TOTtL'~'~bENGTH REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. C. D. WELL TO SEEPAGE PIT WELL TO SEWER LINE ~ELL TO PROPERTY LINE 1,~-...-/ E.. WELL TO OTHER POSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK ~"T2~ ~ G. FOUNDATION TO SEEPAGE PIT ]'7 H. SEEPAGE PIT TO PROPERTY LINE ~ 8. COMMENTS: A P P ROVE D :~ ~2~-~q ~f/~~ S AP P ROVE D: DATE: /i/ ~- ~T'-'..~ "~/ DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY FHA Farm 2~S73 Form Approved Rev. July 1958 FEDtRAL HOUSING ADMINISTRATION Budget Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.mTO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. Alaska State Bank Anchorage~ Alaska Box 2~0, Anchorage~ Alaska/ 111-010233-203 MORTGAGOR OR SPONSOR PROPERTV ADDRESS Harold L.-~ols ~ ~ Foothill Drive SUBDIVISION NAME [ BLOCK NO. ~T NO~ Benito 2 TOTAL NUMBER: Can attic or other area be made into BASEMENT ~-1 New installation additional bedrooms? LIVING UNITS BEDROOMS BATHS (If Yes, how man¥~) WATER SUPPLY BY: SYSTEM DESIGNED FOR SEWAGE DISPOSAL BY: ['--1 Public system [--] Community system [~ Individual 3 ~1 Yes ~ No PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH ~---~ ,_' ~_ -~ ~-~, _~ _ ~._ - _ ~- ---~ ~---- _~-_-~ ~ -- ~-~- -~ , ..... . ...... 4-7_ 7. - It is the opinion of the r-J State r-J County J'~ Local Department of Health that this individual water-supply system ~ is N is not satisfactory as a domestic water supply for the subject property. It is the opinion of the D State J--J County [~] Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: ~ Can be expected to function satisfactorily, and ~-1 Cannot be expected to function satisfactorily is not likely to create an insanitary condition Sept. 30, lg70 NOTE: The health aut~ority/s~ould complete the appropriate opinion statement above and affix date, signature and title in the spaces provided. Use of the above grid for Health Department Inspector's sketch as well as use of the back of this farm is at the option of the health authority. PART III.~FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that'the Individual water-supply system be considered D Acceptable [~ Not Acceptable Sewage disposal be considered [~] Acceptable r-'! Not Acceptable. DATE SIGNATURE J~J CHIEF ARCHITECT  DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2S73 Rev. July 1958