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¥
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V}L.i ~.UO~Sl~A!pq~ olyueg
10566 t~-lselV 'o~m~mpuv
OBD' xoi]
(6L/9 '^eEl) 0 LO-i;Z.
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, ~::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
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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