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HomeMy WebLinkAboutT12N R3W SEC 27 LT 46 -Gallons Septic Leach Area Holdina Tank StsmeinInAn Tima MUNICIPALITY OF ANCHORAGE DE tTMEN'r OF HEALTH AND HUMAN SER' ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl. INSPECTION REPORT DISTANCES ~_ TO SEPTIC ABSORPTION WELL FROM ~ TANK FIELD WELL /OOP ~r /oOs l;r LOT LINE FOUNDATION tOm TANKS TYPE OF SYSTEM ~?' TRENCH [~} BED ~ 6-0°~ Ed w. DRAIN [] OTHER WELLS FT FT FT FT ,~ PRIVATE -~'I~T,r-.~.-.-~ [3 OTHER fldentifv)____- REMARKS: FT [ ~.~..4 C~;.~ ~ ~'~-.~-- .. c¢i1¥ Ih~L21his~lspecli9n was pedormed eccordi,u Lo als -- DEli:::' ~' ii ii;.] I:::' [F:'I BI] I ] CUd(1:: I' ,, ) J.!; ,, Ill) .~ [.~i::,.'AVEL Dl!]> III (F i ,, ) '7 ~, () 't'OI/..il. DI]'::' i H {1:: I. ) l(). C) ,5 GRAV!~]. WI]i")fll (F:'I . ) 2.5 ).,C) GRAVI]... ~.l~]'lL]tIi (J:T,,) 36,,() ,0 [":)RAV[H. VOI..IJME: (CLJ~ ",'DS. ) ;~5. () {"~C) J]J. RATI:t'..IG (SQ,, F: l',, !BFi') If::'5 :t.;.;".',': ]: IxIS~ }}...A i i[ ON A I.IF'I STAT]:ON I ,, 0 ,, 0 2 ,, [c:H"Lh I::)¥' k'.he PJun:ic::ipa]:i'~y c)', An(::hI::H'.:~ge (MOA) and Lt.', ,ci}~]<:]l](.:9 c)J /:!lJ.a!L.J<~?).r, :J] V,!:i ].] U:.:Ih~'PC) 'lc) aLI t'l[:h"~ and !i~'[aLi) (:){' Alaska I'C:'ClL~Jr~:em(:"l'iLs {'CH" I:luJ !lief.. I::',,:ic:l;: :[1:: A I I:F::] S'IAIIOi',I ]:S IN';'IAt I..li:D Z[N Alxl AI::;:I:'.':A []OVii~]::::I]i]} £:G' MOA BIJ:I]I.D:I:I",IG FHIi]'4 ( i ) AI",I [::] l:i:E: I F,'. I CAI.. l:::'l!ii:l::;,'l"l 3:'1 AND :[ IxiSI:::'I!:C] :r C)I'.I I"IUSI i!llli: Ii}Iii IA WI:IL !',lO'l F:IL API::"P:i:)VE}) W.:I:IHOIIF AN i~*}.F~CI]::4]:CAL ]:l".l,C!ff:'iiii]];]']:OIq I:~I](:I::'CIRI'i', AP,ID (3) 'FI'IE [:!] ECIR ]:!:',l::ll W i"'II. JS ) I. I ,l::l.l< I I)I:::.L.I::.[, I I', I (,3 [:. I I. ;:~ ] ...I . , . . ..~: ,[ ............... AI:::'J::'i. ] [:;AJ~] ] ;I } ,, J (';Hlii 7wtumc pa y Anchorage P.O. ( 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-ald:ax 4744 TONY KNOWLES. MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 9, 1987 T.L. Pritchett 12806 Davis Street Anchorage, Alaska 99516 Subject: T12N R3W Section 27 Lot 46 On-site Sewer Permit #860302 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1986. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled this Department for close the permit. the well, a well log needs to be sent to documentation of the installation and to If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report (three part form) must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4744. Sincerely,. R.W. Robinson Program Manager On-site Services RWR/ljw enc: copy of permit Municipalily of Anchorage ','~ h ;";~-"/~?// ......... :' ~ 825 "L" Street, Anchorage, Alaska 99502-0650 ¢ ~". Dole R~/,orrell ,; ~ SOILS LOG -- PERCOLATION TEST ¢/%',.. No. 50~5-E .',E,¢ 1 Township, Range, Section: SLOPE SITE PLAN ENCOUNTERED? 2 3 4 5 6 7 8 9- 10- 11 12 13 14 15 16 17 18 19 2O ,~ t~__ t/ IF YES, AT WHAT DepLh lo Water Aller A/O OJAcTe~:.t I~ollile ri,II? Dale: S L 0 P E Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __~'-~ _ (m,nutes,,nch) PERC HOLE DIAMETER TEST RUN BETWEEN ~P FT AND ?' FT COMMENTS PERFORMED BY: ,'' ~ , I ¢~../'? '~-...~ CER]IFY~hATTHI~TESTWASPERFORMEDIN ACCORDANCE WITH ALL STALE AND MUNICIPAL GUIDELINES iN EFFECT ON THIS DATE DATE 72-008 (Rev 4/85) SURVEYOR'S CERTIFICATION I HERESY CERTIFY THAT I HAVE SUIIVEYED THE PROPERTY DESCRISEO ON THIS PLAT AND TIlE IMPROVEMENTS SITUATED THEREON ARE LOCATED N 349-6452 349-64§4 DRAWR RY' ~&K CHK* RY , BESSE, EPPS 8~ POTTS 2220 E. 88th, AVE. ANCHORAGE~ ALASKA 99507 ISCALE' I'/=L!O/ lC'C DWO, NO. DEEP TRENCH DESIGN REQUIRED AREA: '/-//~,~ (//-o::~ :,':/r2~L ~,::< :?~h: = /t':JO ~- TRENCH DIMENSIONS REQUIRED: WIDE DEEP LENG'FH , PROPOSED TRENCH DIMENSIONS: ,~- WIDE '~ DFEP ..~ L[-'NGTH EFFECTIVE AREA OF PROPOSED TRENCH TRENCH SECTION: 4" PVC wrrH COVER o ~ NON-TOXIC BARRIER 4'~ DRAINFIELD PIPE SCREENED ROCK STANDPIPE DE, TAIL: STANDPIPES TOTAL TO BE CONNECTED AS SHOWN ON LEFT HOT TO BE CONN[:CTFD AS SHOWN IN TRENCH SECTION PER M.O.A. HEALTH DEPT. STANDARDS ORD. 'l 5.G5 P.O. BOX 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLE$. MA YOR DEPAR?MENT OF HEALTH & HUMAN SERVICES Cleanouts 'x ,I Monitoring Tube DEEP TRENCH DESIGN REQUIRED AREA: /00 ~r~,~ ,, /:; :-.3P :: ,z~CO ~F- TRENCH DIMENSIONS REQUIRED: WIDE SCREENED ROCK DEPTH LENGTH ~R. OP~$ED TRENCH DIMENSIONS: WIDE SCREENED ROCK DEPTH _ LENGTH ~-- ~,~ - COVER EFFECT~E AREA OF ~D TRENCH; ~00 ~ F TRENCH SECTION: 4" PVC WITH TO'rAL DEPTH COVER .NON-TOXIC BARRIER STANDPIPE DETAIL: ,~;~<~ Z~ STANDPIPES TOTAL TO BE CONNECTED AS SHOWN ON LEFT NOT TO BE CONNECTED AS SHOWN IN TRENCH SECTION 4' DRAINFIFLD PIPE SCREENED ROCK PER M.O.A', HEALTH DEPT. STANDARDS ORD. 15.65 A/O 7-5 $..~U RV E¥OR'S CERTIFICATION HEREOY CERTIFY THAT ~ HAVE SURVEYED THE PROPERTY DESCRIRED ON THIS PLAT ANO THE IMPROVEMENTS SITUATED THEREON ARE LOCATED AS SHOWN ON THIS PLAT. DATED THIS -- DAY OF-- ,19--. LEGEND 0 LOT CORNERS FOUNDATION DRAINAGF ARROWS q~ N ..~TO NOTES: I. IT SHALL SE THE RESPONSISILITY OF THE BUILDER OR OWNER TO VERIFY THAT RUILDING LOCATION SROWN MEETS ALL SUBDIVISION COVENANTS AND ZONINS ORDINANCES, E, ~T ~S THE RESPONS]RILITY OF THE BUILDER TO VERIFY ALL ELEVATIONS W[TH RESPECT TO ALt. UTILITIES S, THl~, PLAT REHR~$gRf~ 1HE PARCEL OF PROPERTY DE$CRIRED BELOW TAKEN FROM THE RECORDED PLAT DESCRIBING THAT PARCEL. INSTRUMENT8 RECORDED PRIOR TO OR AFTER TDE FILING OF THE RECORDED PLAT ARE NOT SHOWR ON THIR PLAT. 4. THE INFORMATION ON THIS PLAT ID FOR THE USE OF LENDING INSTITUTIONS RRECIFICALLY TO SHOW ANY CONFLICT8 EETWEEN EXISTING STRUCTURES AND PLATTEO LOT LINES OR EASEMENTS , THE PLAT IS NOT TO SE USED FOR POSI'rlONINO AODITIONAL STRUCTURES OR FENCES, /..o~- 46 ~ZcT~o~l Z7 BESSE, EPPS 5 POT'rS 2220 E. 8Sth. AVE. 349-6452 ANCHORAGE, ALASKA 99507 349-645,1 ~.~WN.T, /71,~K i__SCALE' 1"=40/ C'C DWD."O. OH,,. s v,/,,AT~, ~//'y~'e,.... I F,-U. sR., GR[ _ ANCftORAGE AREA BO , l Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPOR¥ ON-SITE SEWAGE DISPOSAl. 5YSTE~- ........ SEPTIC TANK: DISTANCE FROM WELL_ [~)?- INSIDE LENGTH MANUFACTURER INSIDE WE)TN DISTANCE FROM WELL FOUNDATION NUMBER OF MA ~ COMPARTMENTS TERIAL ~ ' LIQUID DEPTH _ LIQUID CAPACITY /~z)~'o GALLONS. NEAREST LOT LINE TOTAL LENGTH OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACII LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE ..... MATERIAL BENEATH 'rILE IN, ABOVE TILE IN. WELL: TYPE _CONSTRUCTION DEPTH .[DISTANCE FROM: BUILDING NEAREST FOUNDATION LOT LINE NEAREST SEPTIC SEEPAGE SEWER LINE .... TANK /O~-~ SYSFEM CESSPOOl_ . , OTIIER SOURCES __. APPROVED DISAPPROVE[) ._ _REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: ~0~*( ...... REMAF/KS: ~'~)¢~'~ . ~,~4 k ~&.S Form EQ-032 DIAGRAM O1-- SYSTEM Gl:RE =. ANCHORAGE AREA E]c _ ? ~ r~ /~ 'c t~'~ , ~ ~ , "~3' SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO.. NAME Or AP~"-'OAN'" L ¢ © .--</¢'"' ?' ,c ¢%MA'~.'NG ADDRE.~"/~'/¢~ :47','¢// ~?'// INSTALLATION OF: SEPTIC TANK - ~/~ SEEPAGE PIT TYPE AND SIZE OF FACILITY TO BE SERVED ~/~ :/~¢fC~ f~ · FINANCED THROUGH ' TO BE ]NSTALLED BY ., DRAIN FIELD ., OTHER NOTE~ THIS PERMIT IS HOT VALID WITHOUT ~OIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OP ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAl. QUALITY Au~r'HORITY WILL BE SUBJECT TO PROSECUTION. 5 T,,,-E ' '"""-,-;'"' SEPTIC TANK, //'~"~--¢ ~, SEEPAGE PiT /~'~(b . DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FeET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PI3' FITTED WITH AIRTIGHT REMOVABLE CAPS. 6RAVEL BACKFILL CONFORM 'ro BOROUGH REGULATIONS REGARDINg INSTALLATION. [ CERTIFY THAT I AM FAMILIAR WlTN THE REQLJIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBE~ SY$~}EM I /IN AC~C~O~DANCE WITH SAID CODE. ~ ~ 2 FORM NO. EQ-OI 6 T.H. No. 1 6-4-75 Organics 0o0I Sandy Gravel, Trace Silt (GW) 10.0' Silty Sands w/ Some Gravel (SM) No Water Table 15.5' R NOTE: Log Represents Lot 46, Section 27 T12N, R3W, S.M. Consultants inc. ALASKA JUNE. AU Leo Sawyer Property Log of Test Hole Anchorage, Alaska MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Streot - Anchora0e, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVI,~;ION Telephone 264-4720 REQtJEST FOR APPROVAL OF INDIVIDUAL WATFR AND SEWER FACILITIES [31RECTIONS= Complete all parts on page I. Incomnlete reouests will not be processed. Please allow ten (10) days for processing, 1. PROPERTY OWNI"R Vernon D/Janis M. Christianson PHONE 272-2457 MAILING ADDRESS Post Office Box 8828 99508 PROPERTY RESIDENT ( f different from above; )HONE Timothy J Pritchett/Burnice A. Willoya PRONE 277-3575 MAILING ADDRESS 1031 West: 77th Avenue 99502 3-7'LENDI NG INSTITUTION PHONE NATIONAL BANK OF ALASKA 276-1132 MAI LING ADDRESS Pouch 7-025 99510 ~ REALTOR/AGENT PHONE MAILi NG ADDRESS E.LEGAL T12N R3W Section 27 Lot 46 STREET LOCATION ~'. TYPE OF RESIDENCE NtJMBER OF BEDROOMS E] One E~ Four [] Other ~ SINGLE FAMILY ~ Two E3 Five [] MULTIPLE FAMILY BI Three E~] Six WAT~R'SUPPLY I~ NDIVIDUAL* [] COMMUNITY [] ~UBLIC UT LITY 8, SEWAGE DISPOSAL SYSTEM [~ NDIVI DUAL/ON-SITE~ [] PUBLIC UTII_ITY ATTACH WELL LOG. A well og is reauired for all wells drilled since June 1975. For wells drilled prior to that date, give well aeptl~ (attach mg if awdlable. I *' If individual/on-site, give installation date If system is over two (2) years old an adequacy test is reuuired oy this Department NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, ~"2-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY '" DATE' F~ECEIV, ED INSPECTION APPOINTMENTS TIME TIME I TIME DATE DAT~- DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS'. 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX P~RMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED ' 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED E~PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AR EA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [~"'/APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 IRev. 3/78) 1. Type of Inspection: 2. Property Owner: MUNICIPALITY OF ANCHORAGE O£PADITMEN'r OF ENVIRONMENTAL QUALITY 825 "L" street 279 2511 8251:{l~Vl~g~F~)R APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRO VA Vernon D. & Janis M. Christianson FHA CONV x Mailing Address: Name of Buyer: P.O. Box 8828 Anchorage, AK 99508 Day Phone Timothy J. Pritchett & Burnice A. Willoya .349~1.458 Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address: 1031 West 77th Anchorage, AK 99502Day Phone National Bank of Alaska 277-3575 Pouch 7-025 Anchorage, AK 9951~hone NONE 2'76-1132 Phone 6. Legal Description: Lot 46, T12N. R3W, Section 27 Location: 1 Block west of Davis Road Anchorage, Alaska 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: HOME No. Bdrn~s. Public Utility Individual X 2 If Individual number of dwellings presently served If Individual depth of well Sewage Disposal System Type of Systom: Public Utility If Individual, date of installation Individual (on-site) X EQ-037 (I/74) and wa'toy app~'oval~ m~voral J.t~r~ will A l?ercola'~-cLon tom% mugt bo run on, the who a):~ qua).:lfJ.c,:~ tO d{O tt)~ test. (3} The ~;itni'ka.~::y seal on th,~ well c;aain<r r,~ust be If thez'e are any ftB'the.~: ,.{uerltion~¢~. ploam~, contact mo at 2fi4-.4720. A~mocia*;e PX?/3,Jw National Bauk of Alaska ~Ort;~atfr~ Loau Division Pouch 7-025 99510 ALA t A geptember 27, 1925 Hr, Vernon Christianson .P. t). Box 8828 Anchorage, Alaska 99508 ] E¥ LIIPMUNT [ tlN IILTANJT,t; 5905 OLD SEWARD HIGHWAY ANCHORAGF. ALASKA 99502 ADC No. 28099 Adequacy Test on Existing Septic System, oe ~ara Meridian, Alaska. J}ear ivlr, ChrlStl~nson; At your request~ v/e performed an adequacy test on the existing septic system located on the above referenced lot on September 26~ 19'78. %'he following table represents the depth of ]iquJ. d in the septic tank. The tank was determined to haw} an initial depth of 5.96'. Since the addJ tion of approximately 60 gallons only raised the liquid level about 0.~ feet~ momentarJ]ey~ the bank was as,sumed to he fuji or at the outlet level. Stmlraary of HeasuPements · 'd ])epth of ],s_qu~ Meter Reading ~'Inm~e -~in Se ~.ic Tank~ in Gallons R~em~.__!r_k,~ 12:20 pm 3.94 ' 318,, 0 Begin ri'est 1:45 pm 4-.10' 401,2 8).2 gal/85 rain = 1.0 gpm) 6:20 pm 3.94' 5Z~5,9 222.9 gal/2~0 rain 0,,9 gpm) hlnd Test Meter used d. urJng the test was a ~/Z~,, standard water meter borrowed from the Anchorage '.~'iaber UtilJ. ty. '£he septJ_c tank was pumped on Septembor 25~ 1978 by a local pumper. The septJc bank was filled with fresh water from the on-site well on the afternoon of September 2~ 1928. Since the house concorned was occupJed, it is assumed that the leach field Jn question was Vernon ChrisL,:ic. nson at its normal degree of saturation. To fu. rther insure normal saturation and to :I'J.1]. any possible storage in the system, appro×imateiy 60 gallons of water was added to Lbo tank before beginning tho Li hour percolation test. ]if it ia assumed that this 2 bedroom house will house five poop].e, l;he average daily load on the disposal system can be expected to be .3'75 ga]_lon.s per day. The maximum hourly load on the system can be expected to be about 0.8 gallons per minute (gpm). Sihce the existing disposal system accepted 0.9 to I.O gpm with no significant change in level Jn the tank, it can be concluded that the system is presently performing in a satisfactory manner f/or a private resiaenee. if you have any questions concerning this tesl;~ please do not hesitate to cai] our office. Verb, truly yours, ~ D. Shrader, ?roject i,ianager P.O. BOX 4-1276 ANCHORAGE, ALASKA .%009 ,;,. 46~9 BUSINL:SS PARK BI_VD, TE Lt-;PHONE (eOT) 270-4014 Drln[dng Water Analysis Report for Total Coliform ~acteria TO BE COMPLI':.TED BY WAFER SUI"PIJER ID. NO. City Slate Zip Code Mo, Day Year SAMPLE TYPE: (] Routine I] Check Sample (for routilre salnple with lab ref, no. ) IZ~Special Purpose ~/%.4'~ Treated Water Untreated Water SAMPLE NO 1 2 3 4 5 LOCA [ION I_ . _ j Time Collected Collected By TO BE COMPLETED BY I.AI3ORA'rORY LABORA-FORY: 611EH & GE0 I~BS OF AK., INC. NAME 4649 BUSINESS PARK BLVD. ADDRESS ~1Clt E;P, zN3 E, ALASKA . _ CITY Date Received ~*-~2- ~J)'_ Time Received /~ .?';~-- ._ Analytical Method: I~] Fermentation Tube 'd~'~ em brane Filter Lab Reft No. Result* Analyst J LJ..J I READ INSTRUCTIONS BEFORE COLLEC'rlNG SAMPLE Form No. 18310(3 78) 06-1220 (b) Rev, ]978 BACTERIOLOGICAL WATER ANALYSIS RECORD GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 %" Street, Anchorage, Alaska 99503 274=4561 :'~ ~>:, ~.~/¢i~ ,.~,' ~~¢J Date Received Time of Inspection Date of Inspection 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. Location: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 5. Type of facility to be inspected No of bedrooms '" Wel 1 Data: A. Type ..~7, ¢'~ ~ ,' 2~'- ~ .(: ! C. Construction ~.~/zw¢¢;~=~__~ /~/¢/~_ _ B. Depth Sewage Disposal System: A. Installed __~-~v/'/¢. . B. ~nstaller C. Septic Tank: 1. Size ~/~,~-, 2. Manufacturer D. Seepage Pit: 1. Absorption Area ~/F~ 2. Material E. Disposal Field: Total length of lines ~//</~, Distances: A, Well to: Septic tank Nearest lot line //~ ~ B. Foundation to septic tank C. Absorption area to nearest 'lot line __ Absorption area Sewer Lines , Other contamination - , Absorption area EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - R~ ~ for Approval of Individual & Water Facilities Legal Description Comments, ~//~</c ~ Approved Disapproved Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 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) ANCHORAGE AREA BOROUGH GREATER Department of Environmental Quality 3330 "C" St Anchorage Alaska 99503 - 274--4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA x FHA 2. Property Owner: Rob~L~rt ~, ~erdon, ~r. Mailing Address: Box 318, SRA, Anch. 9950~_Aay 3. Name of Buyer: Richard Julian Cruz CONV Phone 344-6509 Mailing Address: star Route A , Box 325A ~y Phone 344-2191 4. Name of Lending Institution: Coast Mor~. a~e Mailing Address: 5. Name of Realtor or Mailing Address: Phone 2??-0805 ~Z~_LI_~i~_ Phone 279-0665 Agent: Starn Real Estate _5~04 cop_m_~__T. o Legal Description: "T12N, R3W, S__ec. 27, Lot 46" · Tu~-,~eft Location' 1/4 way up DeArmoun: Turn left on Davis St.~ ~/zmrst Street: First house on left.., green w/attached garage. 7. Type of Facility to be inspected: home No. Bdrms. 2 8. Water Supply Type of Supply: Public Utility Individual x If Individual, number of dwellings presently served i If Individual, depth of well 160' 9. Sewage Disposal System Type of System: Public Utility __ Individual (on-site) If Individual, date of installation 1968 x EQ-037 4 , 1-5 7+ !$Oruft Dr nc o CUSTOMER'S ORDER 907 -NAME 3 DAl E 4.x,9126 ADDRESS CITY, STATE, ZIP SOLD BY Cl PADSE. RETD j RAID CUT I �ximf _ I iiiiii 11,1161''ll 1111 MICRON!, BY c KEEP THIS SUP -FOR -RE -FE -REN -CE---