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GRE? ER ANCHORAGE,AREA BO""' UGH
Department ~3E0n;irs~rn2;ntal Quality
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LEGAL DESCRIPTION . I i~"..~5~ '
SEPTIC TANK:
DISTANCE /0[~
FROM WELL
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
MATE RiAL ~)~~ NUMBER OF j
_ COMPARTMENTS
LIQUID DEPTH .LIQUID CAPACITY /('~Z~}L~3 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
BUILDING FOUNDATION
ADDITIONAL ABSORPTION
DIAMETER
CRIB SIZE:
NEAREST LOT LINE__
· OR WIDTH LENGTH DEPTH /(}"
DIAMETER '~ DEPTH DISTANCE FROM: WELL /~"~ ¢
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) ~2~ ¢ SQ. FT.
WELL:
TYPE "~/Z //~ Ed CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST
SEWER LINE
REMARKS
SEPTIC /~..~ ~ SEEPAGE
TANK . SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form NO. EQ-031
DIAGRAM OF SYSTEM
DATE
~//G,A,A.B.
GREATEr ANCHOrAgE ArEA Borough
DEPARTMENT OF ENVIRONMENTAL QUALITY
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
/.?.'
SOIL TEST RESULTS ~ NOTE: THIS PERMIT IS NOT VALID WITHOUT ~OIL TE~T
~EPARTMENT OF ERVIRONMENTAL OUALITY AUTHORITY ~ILL BE SUBJECT TO ~ROSECUTION.
MINIMUM DISTANCES, RE~/UIREMENTS
FOUNDATION TO SEPTIC TANK
~OUNDATION TO SEEPAGE PIT ~0'"
. DRAIN FIELD
SEPTIC TANK TO SEEPAGE Pit WALL
SEPTIC TANK -~ . SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK Y~/~
DRAIN FIELD
SEEPAGE AREA SIZE
/0:
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
SEPTIC TANK, ., SEEPAGE PIT
TO RIVER. LAKE, STREAM.
., 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 PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
Gi~AVEL BACKFILL
BOROUGH ULATIONS REGARDING INSTALLATION.
E
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
/ -
OEr EGEOTECHNICAL Er DEVELOPMENTCO.
Box 90, Davis St,, Eagle River, Alaska 99577
694-2774 or 688-2280
Russe# Oyster Ead Ellis
688-2280
694-2774
Soils ~ Foundations Land Development
SOIL LOG
Performed for: Name: ~i~J '~,.~qV~,a~, .Tel,
Hatltng Address: ~(~.~o~ ~ ~,~
'Legal Description: t(3 ~ "~ ~A~ ~ ~ ~x~ ~
~ ~oll Characteristtc~ ~ov,~- ,~
Ground Water Encountered:
Proposed Installation: Seepage Pit~
Yes__No__ If yes, what depth
v/ Drain Field
Performed by.'
?~
'MEMORANDUM
State of Alaska
TO:
Greater Anchorage Area Borough
Department of Environmental Quality
3500 Tudor Road
Anchorage, Alaska 99507
DATE : 6/30/72
FROM:
APPROVED:
SUBJECT~
Miss Mary C. Ynostroza
Social LWorker I
Anchorage DO
Mrs. Mildred L. Hayes
(Acting) District Representative
In order to complete a foster home'investigation, I Will need a water
analysis at the home of Mr. & Mrs. Jack Johnson of 20 Crestview Lane
Eagle River, Alaska 99507. Although Mrs. Johnson is not employed you
might perhaps like to give her a call before you go out. The phone
aumber is 694-2708.
Thank you for your cooperation.
NCY/rh
I{ECEIYE~
July 17, 1972
Hiss Mary C. Ynostroza
Social Worker
Alaska Department of Health and Social Services
Subject: Inspection of water and sewage systems for Foster
Home approval.
Dear Miss Ynostroza:
Per your request, the water and sewage systems at the home
of Mr. & Mrs. Jack Johnson of 20 Crestvtew Lane, Eagle River,
was inspected by this office on July 13, 1972.
Inspection and review of records indicate these systems meet
minimum requirements of this department.
If this office can be of any further assistance, do not hesitate
contact us.
SincerelY,
to
Joe Blair
Sanitarian II
mb
GREATER AlqCHOR&GE AREA BOROUGH ~
Department of Environmental Quality
3500 Tudor Road, Anchorage· Alaska 99507 279-8686
Date Rece~ve%__~
Time of Inspection___2~OO~V~
Date of !nsnection___7__ta]_7~
REO. UEST FOR APC:ROVAL OF
INDIVIDUAl, .,~4~,, & ...... PACI!.IT!~S
Foster Home
Approval Requested By: Mary Co Y~ostro~a
Address:___Alaska Da~ar~me__nt of Health and $oct~! Serve
Property Owner: ~r. & Mrs, Jack Johnson
Legal Description:
Phone:
Phone: 694-2708
Location:
20 Crestview L~ne, Eagle River
5. Type of Facility to be Iospected: .
Number of Bedrooms: three
6. Well Data:
A. Type Drilled
C. Construction
7. Sewage Disoosal System:
A. Installed
C. Septic Tank: 1. Size
D. Seepage Pit: 1. Size
Single Family
B. Depth 133'
D, Bacteria]Analysis
8. Installer
2. ~anufacturer
2, Material
Disposal Field: Total Length of Lines
Distances:
A. Well To: Septic Tank , Absorption Area
· Sewer Lines
Nearest Lot Line , Other Contamination
Foundation to Septic Tank "~ Ab§orption Area 33~6"--
Absorption Area to Nearest Lot Line
-~- /3que~ for Approval of I/~'~,vidua] Sewer & '#afar Facilities' "'-~
P~ge T~o
9. Comments:
Aporoved Disaooroved Date__
Aporova~ u,a,.~d ~ for One Year From Date S~oned.
Greater Anchorage Area Borough, Department of 5nviz'on~enta] Quality
D!AG~^M OF SYSTE~
I certify that the information contained in this request for approval to be a true
and accurate representation of the subject sewer and water faci_itles located at:
Signed Date