HomeMy WebLinkAboutKNIK HEIGHTS BLK G LT 14
GRE~,,ER ANCHORAGE AREA B0k,,dGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska ggs03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
_ MAILING ADDRESS '-~.C2, '~:~ C~''1-~ PHONE
LEGAL DESCRIPTION
SF-PTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
,~ [ ~U.l~Cq= F~..- NUMBER OF
MANUFACTURER ~-&I,\'%A.~ ERIAL _ ~" ~ lg.~<g.~ COMPARTMENTS '"~-'
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY I,~OO GALLONS,
TILE DRAIN FIELD:
DISTANCE FROM WELL~
[ [ TOTAL LENGTH
FOUNDATION ~" C, NEAREST LOT LINE
OF L,NES
NUMBER OF LINES I DISTANCE BETWEEN LINES
ABSORPTION AREA
DEPTH:
FT,
~-~ TRENCH WIDTH~"~(o IN.
LENGTH OF EACH LINE ._~ ~:~ I
DEPTH OF FILTER
TOTAL EFFECTIVE
TOP OF TILE TO FINISH GRADE ~ MATERIAL_ BENEATH TILE
IN, ABOVE TILE IN,
WELL:
TYPE ~'~.'\~ ~(~
FOUNDATION ,
CESSPOOL
APPROVED
_CONSTRUCTION ___¢' DEPTH
NEARES¥ I NEAREST · / SEPTIC SEEPAGE
LOT LINE &5 SEWER LINE/~]~- Ic~7I
TANK , SYSTEM
DISTANCE FROM:
t37+-
OTHER SOD RCES
DISAPPROVED___
REMARKS
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH: I~-tI (~J~'~
PIPE MATERIAL:, L,.~W~.~.. ~~;~
LOT SLOPE:._~
DIAGRAM OF SYSTEM
it
I %'"1
DATE APPROVED
G.A.A.B.
Ti'Il;i;
i,.il!;! i i E~C:it!:i; I';:!l;itt:i; ~;i:E%!i. ii!:,;fi:::Z[Z:, l:::!!",![;:' i"i!.i:!:;'i l;i',l!iZ !;;:!:ii; l'!..tl:;;:h![;i [:' 'l'(;i 't'HI:; {.,i ;[ 'i i .i i i ,i
EiF i'i"il!i; i,ili"t i. E:Oh!F'I
;:::: .' ili",!!),~i;l:4::;i;t'l:.:ti.,![) '!'!-fFVt' 'li'IE:; Ol",h'::i!;!T!; ~!;[!!;!,ilil;t:;i; r:ii;"~":ii:;i'i!;;i"l !"il:::l? l:;;:!:~E!ii);F;:i: iij.,ii.?IF;;:(iiEi),!EN~ ii:::
l:;;;i~iti:; )5 l)!iiii",!(iT:E; ii; :i:!; l:;i:!iiil'il.)i)~:;l .(;i;:, '?t) ]' HCI. i.i[)!ii; i'l(id:;;:E; 'i Hi:::!i",! [i:
GREA. ,_:;R ANCHORAGE AREA BOR. ..JGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
33:~0 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE g74-456!
SEWAGE DISPOSAL SYSTEM --- APPLICATION AND PERMIT
INSTALLATIDN OF: SEPTIC TANK
TYPE AND SIZE Of FACILITY TO BE SERVED
FINANCED THROUGH __
SEEPAGE PIT __
TO SE INSTALLED BY
DRAIN FIELD ., OTHER
COMPLETION DATE ANT]CIPATED
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: g4 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 /h~ ~/~ TYPE
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK (""~ /
FOUNDATION TO SEEPAGE PIT
DRAIN FIELD
SEP"FFE.~f-A~fI(~ , SEEPAGE PIt
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK //(~d) ('
DRAIN FIELD r//I/~ ~ /
WATER MAIN TO SEPTIC TANK ~ /~/
, SEEPAGE PIT ~d2 F
DRAIN FIELD ..- -----'
SEPTIC TANK, ~g¢/¢",) ¢2 ~ SEEPAGE PIT ~/ ~EJ /~
_ _, DRAIN FIELD
TO RIVER, LAKE, STREAM.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
~AVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH Tide REQUIREMENTS OF GREATER ANCHORAGE AREA ~OROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DATE -- APPtJCANT'$ SIGNATURE V
~Q-016(3-7§)
May 12, 1977 R&M No. 751158
John Blount
Box 877
Anchorage, Alaska
Subject: Soils Investigation for Sanitary Sewer System, Lot 14,
Block G, Knik Heights Subdivision, Anchorage, Alaska
Dear Mr. Blount:
At your request of May 10, 1977, we conducted a subsurface soils investi-
gation at the proposed location of the sanitary sewer system on the
subject lot. The investigation complied with those procedures required
by the Municipality of Anchorage, Department of Health and Environmental
Protection.
This investigation, which was accomplished on May 11, 1977, consisted of
a test hole excavated to a depth of 15 feet below the existing ground
surface. The location of the test hole is shown in attached Drawing A-01.
Excavation was accomplished with a backhoe. A sample was taken at the
depth shown on the soils log in attached Drawing A-01. These will be
held in storage at our lab for approximately six months. In addition,
all material excavated was continuously monitored by an experienced
engineering geologist.
The topography at the excavation site is generally gently-sloping to the
West. At the time of the investigation the site had original vegetation
and ground cover. The top of the test hole was located at original
ground surface.
The soils encountered in the excavation are shown in the test hole log
in Drawing A-01. Groundwater was not encountered in the test hole.
Bedrock was not encountered. Subsurface conditions may vary in other
parts of the lot.
We appreciate this opportunity to be of service to you. Please contact
us if you have any questions concerning this letter.
Very truly yours,
R & M CONSULTANTS, INC.
Jeffr~e~M. Ayr~
Staff Geologist
Jim McCaslin Brown, Ph.D.
Head, Earth Science Department
JMA:RLS:gld
Attachments: Drawings A01, B-01, B-02,
XC: Dept. of Health & Environmental Protection
LOCATION SKETCH
TH_ie 15'
Lot 14, Block G
Knik Heights Subdivision
Not To Scale
Distances shown are approximate
and have not been measured by
surveying methods.
LOG OF TEST HOLE NO, 1
Scale" 1"=3'
0.0~
F. .~ ORGANIC SANDY SILT,
\.__. Brown, Moist
!.0'
GRA%~LLY SILTY SAND,
(SM-GM)
Brown~__Moist -- -- 3.0'
SILT W/SOME SAND,(ML)
Brown, Moist
4.0'
SILTY SAND W/SOME
GRAVEL (SM)
Brown, Moist
9.5'
A ®
GRAVELLY SAND (SW) ~'~
Many Cobblest
Boulder, Brown, Moist
15.T
Groundwater was not encountered.
This log depicts subsurface soils
observed within the test hole at the
location shown.
See Drawings B-01 and B-02 for
explanation of symbols.
2836
/]pROd'~O 751158
CKO: 3MADATE: 5-12-77
CAtE:see above
LOCATION SKETCH AND
TEST HOLE LOG
JOHN BLOUNT
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description Block G, 5ct 14, Knik Heights S/D
Location (sit~ address or directions) :[2941 Shelburne Road
Property owner
Mailing address _12941
Lending agency
Maili n.g address
Kat Odom Day phone 345-6444
Shelburne Raodr Anchoraqe, AK 99516
Day ~hone_
Agent Remax/Bert Dozark Day phone
Address 2600 Cordova St., Suite 100, Anchorage, AK 99503
276-2761
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3 ,
TYPE OF WATER SUPPLY:
Individual well x××
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
STATEMENT OF INSPECTION BY ENGINEER
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 application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and typeofstructureindicated herein. I furtherverifythat 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 [s in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
S & S ENGINEERING (~, ~._ D. Cl .-/~
Name of Firm 17034 E=.qlc M';cr Lccp Rcc'J .%'0. 204 Phone
Eagle River, Alaska 99577
Address ~'
Engineer's signature ,~,~/~/Z /~------- Date ?! /~ /~1~
DHHS SIGNATURE
Approved for -/-/~/~F ~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By:
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates 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. 1/91) Back MOA ~1
Municipality of Anchorage
DEPARTMENT OF HEALTH & FIUMAN SERVIQ.~
Environmental Services Division '",,
825 L Streot, Room 502 · Anchorage, Alaska 99501 · {907)
Health Authority Approval Checklist
LegalDeScription: L,o';- I¥ ~-t~ C- /</v,~ /4~1c,~¢-~- J ParcelI.D.:
A, WELL DATA
Well type ('R, vf~ 'r &
Log present (Y/~ ~ O
Total depth I~, (
Sanitary seal (,~N)
IfA, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to
~v/~ 77
Casing height (above ground)
Wires properly protected ~/N)
Date of test
Static water level
Well production
FROM WELL LOG
g.p.m.
AT INSPECTION
g.p.m.
WATER SAMPLE RESULTS:
Coliform O Nitrate ~. 9 6
$&SENGINEERING i i / ~, / c~ ~
Date of sample: 17034 Eaole River Loop Road No. 204 Collected by:
Eagle River, Alaska 99577
B. SEPTIC/HOLDING TANK DATA
Date installed ~/~/'7 7 Tanksize
Foundation cleanout ~N) / ~ ~,,~44~¢
Dateof Pumping ~//'/ /q ~ Pumper ~ 'f
Other bacteria
/ 0 o ~ Number of Compartments ;2 Cleanouts ~/N)___
Depression (Y~[.~ /v 0 High water alarm (Y/~ /v 0
C. ABSORPTION FIELD DATA
Date installed ~ / ~ ~ / '7 7
Length ~ ~' Width
Effective absorption area 7
Date of adequacy test h/~,
Soil rating (g,p.d./fF-o~_~
Gravel thickness below pipe
System type T,t,~,~
Total depth )
Monitoring Tube present (~/N) Y'~JDepression over field (Y~I /vo
Results ~/Fall) /~ x _,( For
Fluid depth in absorption field before test (in.); I/C" r~P~'~
Immediately after} 5"J"gal. water added (in.):
Fluid depth I ~ 'l (ins) Minutes later: ,~- .3 Absorption rate = ~/$-0 4 _g.p.d.
Peroxide treatment (past 12 months) (Y/N) ~ d '" ¢ ~',~ '~ ~ If yes, give date
bedrooms
72-026 (Rev. 3/96)*
LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles test~J
Size in gallons ,.,--.--
''Pump on" level at* ,.,..--~'"'"'"'~ "Pump off" level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
/oo ¥
On adjacent lots
On adjacent lots /
Public sewer manhole/cleanout
Lift station
I0~ 4-
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation to -/- Property line ! o + Absorption field
Water main/service line / o + Surface water/drainage /o0 -+ Wells on adjacentlots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line i 0 + Building foundation ~. 0
Surface water I 0 0
Water main/service line
Driveway, parking/vehicle storage area
Wells on adjacent lots !
Curtain drain
ENGINEER'S CERTIFICATION .~,,~'~'~ .~¥~
I cedi~ that I have determined thru field inspections and review of Municipal recor~.(.t~ ~'E¢ ~s are
in confo~ancewit~ ~O4wit ~0~ H~ guid, lines in effect on this date. ~ ?;/' ~ ~;'~
Engineer's Name ~ ~'~'~ ~' ~0~n,~ ~,es,~c. cow~"
Date / / 4 "¢'' ....
HAAFee $ ¢~'-Z) /r'~
Date of Paymen, ///./~'~/?(~
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
NOV-II-g8 08:31 FROM-CTE ENVIRONMENTAL
zt~ CT&EEnvi,onmen,alSe~vieeslnc.
5615301
T-547 P.0Z/03 F-Bsg
CT&E ReL#
Client Nmlte
Projecl Name/#
Caen~ Sample
Ordered By
PW$1I~
986594O0!
I.; In B~ G Knik Ht~
L[ 1~ Blk G ~ik H~s
D~g Water
Sample Remarks:
Cliem
Printed Date/Time 11/10/98 17:16
Collected DatedTi~ne 11/06/98 16:30
Received Dale/Tllxte 11/06/98 16:55
Technical Director: Stephen C. Ede
Atlo~&b~e Prep AnalySis
o
~.96
0.100 n~lL EPA 300.~
10 r~
11/05/98 RMV
11/09/90 11/09/98
NOV"11-g8 08:32 FROM-CTE ENVIRONMENTAL
T-$47 P.03/03
CT&E Environmental Services Inc.
Laboratoey Diviamn
200 W. Pott.r Drive
)rinking Water Analysis Report for Total Coliform Bacteria A.~,o.~0..
Tol. (~71 562-2343
M~T'BE'~MPLETED BY WA~'~R
~ PUIJLIC WATERS~/STEM I.D.
~' PRIVATE WATER SYSTEM
~'~,~ sm~ ~,~..-'a~l~6~ GI NEERING
'r,o.~.,m~'' ]ZP:~.-~,;: ~;.~. Loop Ro,*d No. 204 '
Eaglo Rivm', Al~k~ ~9S.?~,
5end Re~ul~
Year
Treated Wa[er
Unlrea;ed Water
SAMPLE DATE:
Monttl
SAMPLE TYPE:
~lC ~outille
[] Rep~a, Sample (for routine ~nmple
with Iai} reL no. J '
0 Sp~ial Pu~ose
SAMPLE LOCATION
CoBlrtlEffl[$:
Fax: 1907t 561-5301
TO BI~ COMPL£TI~D BY LABORATORY
Analysa shows this Wat~ SAMPL~ to
~ Sa~sfacm~
Staple ovm ~0 hou~ Did. rusulB maF
aox ~ ov~ 48 hours old at ex~inau~
to indicate rehuble
new ~ple ~a ~ecml~eliy~ mail.
* Num~ofco~omeelO0 mL
Jun
Time Collgt~l
Collected By
Phoned
:-/: ],,),% P o ~ c .
BACT~OLOOlC~ W&~R AN~YSIS ~CO~
MMO-MUG Re, mit: Total Coliform
Membrane Filter: Direc~ Coanl
Yerificalto~]: LTB
Fecal Colifo~ Confi~a~oa
Final Memb~ne ~lter gmul~
BGB
Date: . Tittle:
Client notified of unsatisfactory r~sul~:
Spo~ wi~h
Tame
E. Ca//
Colonic/100 mi
COLIFIRM
Cgllforlla/100 raj
~~ Mom..r of ~r~e li¢38 Group ($~ciom GOnerale 0e gmve,llence)
ENVIRONMENTAL FACILITIES IN ALASFda.. CALIFORNIA, FLORIDA. ILLINOIS, MARYLAND. MICHIGAN. MI$8OUI~I, NE-~V JERSEY, OHIO. WriST vIRG/NtA
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # _~\'-~- ~'~'-'l,--~ _~u\ % NAA # ~ ~ ~-~/~;-% °t°~b
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
o
Property owner
Mailing address
Lending agency
Mailing address
Agent p6b b,~
Address ~ ~0 o
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State AD£C
attesting to the legality and status of system.
72-025 (Rev, l191) Fronl MOA~21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my sea! affixed hereto and as of the validation date shown below, I
investigation of this Health Authority Approval application s~ows that the on-site water suopiy
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and Wpeofstructure indicated herein. ! fu~herverifythat based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspec~ion, the on-site wa:er
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.
A e cV
Name of Firm ~ ~ t'~fl Phone
/~ -/~-~
Engineer's signature ~~~ ~ ~c Date V/I~
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates 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. 1191) Back MOA #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: !..o'/' I~'/] ,,¢//-~ ~ /.r;~, tz HCr~ Parcel I.D.
A. WELL DATA
Well type
Log present (Y/N)
Total depth ~:~
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number N,,4.
N Date completed ~ I~)-z7 Driller ~n ~,
I ~"..~ Cased to :~ ~'-~ Casing height ~'¢'~
y. L_ Wires properly protected (Y/N) y .t-
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
SFPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot l 3 o' ' ~ ('.o.
Public sewer main hLA.
Sewer service line ~ 5'~'
AT INSPECTION
~//~/~a
/'t5' '
g.p.m. '~, 3'.¢ g.p.m.
Id',? '
; On adjacent lots ;:::, ~oo'
; On adjacent lots > ~oo'
Public sewer manhole/cleanout N.A.
Petroleum tank
WATER SAMPLE RESULTS:
Coliform <:::1 col
Date of sample:
Nitrate '~.O ~/~
Other bacteria
Collected by: F(~/'I~, 7"¢cA
B, SEPTIC/HOLDING TANK DATA
Date installed ~'{2o /'77 Tanksize IOC, o ~,~/ Compartments
Cleanouts (Y/N) ~ Foundation cleanout (Y/N) __-~,~.r;¢/~ ~.,,~4 Depression (Y/N)
High water alarm (Y/N) hI, A. Alarm tested (Y/N) /~, ,4.
Date of pumping ¢ / ~ / q/ /' Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot I D~' :~;,-¢r,, (.c,. Onadjacentlots ::> lc, o'
Topropertyline ~> f°~ Absorption field
Surface water/drainage
N
Foundation ~1'7' ;~¢~ c.o,
Water main/serviceline > 5~o'
,. :~
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION hJ, /I-,
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/N)
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed (/~o ('7?
Length ~O' Width
Total absorption area
Depression over field (Y/N)
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
Soil rating I ~-5' m//rJ'cf,-,~ System type
Gravel thickness ~ ' Total depth /
Cleanouts present (Y/N) Y
Date of adequacy test
for :~ bedrooms
/~lo,~e I-~¢o~,,~ o.¢" Ifyes. givedate Ah,A,
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot I 3' 5' ' ~--o,-~ c'. ~,
To building foundation ~'0'
On adjacent lots '> -?¢' '
Surface water ;>. Ioo'
Curtain drain None Seen
Onadjacentlots :> /o~,' Propertyline ~ fo'
To existing or abandoned system on lot /~.,4.
Cutbank N.4, Water main/service line > 5'0 '
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection,
Signature ~~ ~'~
Engineer's Name
Date /4-/~ ~ ! /~,,
HAA Fee $ /7° ,('~)
Date of Payment
Receipt Number
A
¥ .,THEODOR2 F. k&OORE~
Waiver Fee: $
Date of Payment
Receipt Number
APPLIC FILLS OUT UPPER HAL' ONLY
Lending Institution / , ~. . f L
~ealty Go. & A~nt Phon~
/
~ddress /¢.~¢" Zip Code
Type of Resi~nce
~ Single Family
~ Multiple Family No. of Bedroo~
~ Olher
Water Supply
~ Individual -~-~ =} / / ATTACH WELL LOG, A w¢l log Is required for all wells drilled since June 1975.
~ Community] For wells drilled prior to thai date, give well depth (atlach log if available).
~ Public Utility I. ~b L/L~L..
Sewer Disposal
;~. Individual -}'~.~h-}3 - / L.3%~/ ~ ¢-~' ~ ~ Year Individual m~tamm~d:
~ Public Utility When Connecled to Public Utiliiy:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
c:..,.'.\"-~' C~- '\~'~ Ii-'"
Date Date Date Date
Inspector Inspector Inspirer Inspirer
~UNJCJPALI~Y OF ANCHORAGE
DFOT C~ ?': ~r~ ~,
RECE[VI i)
(~) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL'
DATE ~' ~ ~ ~
Soils Rating Date ~wer Inslalled Well To Absorption Area ~/~5 o Well Log Received
5-q~ Well ,o Tank ~/~c> Septic T~k Size
72-023
November 19, 1.982
[',Is. Mary Blount
Rou't(} fi, Box 17~
Quincy, Florida
Subject: Lot 1.4 B].oc]~ G Knik fk.~i(fhtf3 ,qubdivi:3ion
Approval for thc individual sm~er and wahcr facilities cannot
~c (jranted until the ]:oLlowj. t~9 items havo bo(n] completed:
'c~ o k~ w(2!l loq submitted to this office for our fileq
~,~¢2~ review'
~ ..'3E .Phe water analysis report need~; to be submitted to this
~b*~ office from the Chem l,ab, 5633 B Street, for
review.
..,OpL!(.' 'kaD]< pt]!X]DO(2 with a receipt submitto(i ko this
N~ff, b~~ An adequacy teat: needf~ to be })~rfo~med on the ,'~,"~'-'
· - leaehinq
adeq,tal-'e accordJ, nq to Hational ~t:andards, A ].istinq
private
~l.~ms performinq the test is nnc]~se:i. This report
needa to t)c submitted to this office for our review,
,., t,21l ..J [. z~3~; to the . .:..~cr sVstom, ne(ed capg on thc~m.
'~"~ I lca~e notify this l)o~artment for a reinspection when the
'hC~-~:f~ noted discre])ancies have been corrected, If-th..rc,'~ - · are any
x further questions, please ca].l this office at: 264-4720.
o in¢,erc. 1 ~ ,
i1i)22 7/p/Eli
EIIC1OfltlUQ
Robert C. Pratt
Associat;e Et%viro!~m<~nta! S~)ecialist
November ].9, 1982
l:aury and Patri(;ia Reitlc.~3
2531 '?7. 79th
Anchoraqe, A~{ 99502
Subjech: Lot 14 Block (; Iinik iloights Sn,bdivisien
App)roval for the individual $.-..;wer_ and water fnciliti(h,~ ca!mot
be guan'h¢!:(] ulltil thc foil. owing it_ems have beop_ co.,.npleted:
o ix woJ. 1 log :RlbmJ. tted ho this office for our fiJos and
rOV J. OVl.
o 'J?ho wat(;}: al'la].ysis rc¥)ollt need~ to be subm:[tt(;d ko this
office from the Chcm Lab, 5633 B Street, fo~? our
o Thc, ~eptic tank pumped with a rcceJ, pt submitted to this
d o p a 17 t. men t o
An adequacy test needs kc) be })erfo~med on the existing
leaching area. Thi. s test will dote~?~/J, ne if the system is
adequate accotT{Jinq to National Standards. A listiNq of
})rivnte firms performing tho test is enclosed, This
needs to be st~J)mittod 'to this of~ic.e fOL' out~ revJ. ew,
o '.L'he, L3ta.~ldpiDe to 'the sewer syf3tem n(}ed caps e!~ then~,.
P!:.;asp. notify this De} ortment .L [ {1 17(~J.!II~DOCiiJ. OFI ~t11(}i'~ Lli,.
noted discr'epancies have been cort'ected. If there are anv
further? quo~tionn, pi. ease ca].l this office
nco. re ly,
RP22:}/p/F,H
Robert C, Pratt
Asso(]iate t'~r~vi)Fonr~m, nt0t S~ecJ. a].J. sk
CONSULTING ENGINEER
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (90'7) 279-3916
January 31, 1983
Harry & Patricia Reitler
2531 West 79th Drive
Anchorage, At( 99502
SEWER ADEQUACY TEST
MUNICIPALITY OF ANC,HORAGI]
ENVIR Jl ~,'.,:~ ,,,L. i .,4,
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WATER:
SEWER:
DATE OF TEST:
TEST PROCEDURE:
Lot 14, Block G, Knik Heights S/D
12941 Shelbourne
John Blount
Three-bedroom, single family
On-site well
From Municipal Records.
Tank - Sunset Plastic, 1,000 gallon, two compartments
Absorption System - Trench, 8 feet of rock, 38 feet
long
Absorption Area - 375 square feet
Soil Rating - 125
Installation Date - June 1977
January 28, 29, 1983
System was inspected on January 28, 1983. Tank was
empty, drain field was dry.
1,000 gallons of liquid was dumped into drain field
sump, causing a water depth of 72 inches in sump.
Next day sump was dry.
System absorbed 1,000 gallons of liquid in less than 24
hours. There was no indication of a formation of or-
ganic mat. This system meets the Municipal Code Re-
quirements,