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MCKINLEY HEIGHTS #2 BLK 1 LT 1
2 Li MUNICIPALITY OF ANCHORAGE �jv,Cnt_ On -Site Water & Wastewater Program �o S PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.inuni.org/onsite Departnnent On -Site Wastewater Disposal System Permit Permit Number: OSP231191 Effective Date: 11/4/2023 Work Type: Septic Upgrade Expiration Date: 11/3/2024 Tax Code Number: 05125170000 Site Legal Address: MCKINLEY HEIGHTS #2 BLK 1 LT 1 G:0957 Site Mailing Address: 17925 HOLLOW ST, Chugiak Owner: WEHR 2008 FAMILY TRUST Lot Size in Sq Ft: 48713 Design Engineer: FIRST WATER CONSULTING Total Bedrooms: 4 This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: • If there will be a COSA, a non -objection for the well in the Road Reservation will be required. Date: Issued By: Date: 1 Z MUNICIPALITY OF ANCHORAGE o �Frz f,, c; Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 051-251-70 Property owner(s) LARRY & CAROLYN WEHR ...TRUST... Mailing address PO BOX 670607 CHUGIAK, AK 99567 Site address 17925 HOLLOW STREET CHUGIAK, AK 99567 Day phone Legal description (Sub'd., Block & Lot) MCKINLEY HEIGHTS #2 BLOCK Legal description (Township, Range & Section) Lot Size 48,713 Sq. Ft. Number of Bedrooms LOT 1 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ® Initial ❑ Single Family (SF) X❑ (w/wo ADU) Septic Tank X❑ Upgrade X❑ Duplex (D) ElHolding Tank ❑ Renewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signatur_e of_property owner or authorized agent) Permit/Rush Fees: Z 2 S ff370Waiver Fees: _ Date of Payment: / 120-23 1 �//Z13ate of Payment: Receipt Number: I S 'D y Receipt Number: Permit No. 3!( Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! October 31, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: MCKINLEY HEIGHTS #2 BLOCK 1, LOT 2 The property owner has decided to upgrade the whole septic system to accommodate 4 bedrooms and requested we obtain a permit to upgrade the system of the above referenced lot. We propose to install two trenches with 2 of MOA filter sand and 1500-gallon tank to serve the existing 4-bedroom residence as shown on the design. The design is based on the recent test hole conducted in the fall of 2023. No groundwater was observed at test hole excavation or monitoring. The slopes are moderate to flat at 0-3% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231191, Deb Wockenfuss, 11/04/23 FIRST WATER CONSULTING DESIGN CALCS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. MCKINLEY HEIGHTS #2 BLOCK 1, LOT 1 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231191, Deb Wockenfuss, 11/04/23 FIRST WATER CONSULTING MCKINLEY HEIGHTS #2 BLOCK 1, LOT 1 DESIGN DETAILS: NO KNOWN WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM. VERIFY & STAKE ANY ENCROACHMENTS. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231191, Deb Wockenfuss, 11/04/23 3030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL : MCKINLEY HTS. #2 B1, L1 PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10/16/23 DEPTH FEET OG SOILS 1 2 ORG/OL/FILL 3 4 5 6 GW/sw 7 8 9 10 11 12 13 14 15 16 17 18 SW BOTTOM 1 19 BOH 20 Reading Date Gross Time Net Time Depth to Water Net Drop 9/12/23 2 min 6 6 6 6 6 6 6 6 6 6 6 6 PERCOLATION RATE <1 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 10/16/23 TESTHOLE # 23-1 DATE PERFORMED: 9/12/23 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: RAPID ABSORBING GW SOILS USE FILTER VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: LARY & CAROLYN WEHR 10/16/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231191, Deb Wockenfuss, 11/04/23 (L=31.46, R=20.00) (0=90.07'32") / /l T •r I /117", 7 L_V I I ,L_\/vX (PLAT 71-148) LEGEND DFq4w+ - : 4 Ili + , • TRAVIS J. BARIL �• LS 112374 ` • .� ++� X Z�P I R - FOUND REBAR ELECTRIC METER ':.. NOUS p GAS METER `7 ... 0 0 20 POWER POLE 80 Z ❑T TELEPHONE BOX "' O J. PROPERTY LINE I , V — — ADJACENT PROPERTY LINE — OHE — OVERHEAD POWERLINE I - - - - EASEMENT 1 XXX MEASURED DATA (XXX) RECORD DATA PER PLAT 71-148 PAVEDyDRIVEWAY - ..: k `y �r •'r� , . ._ .,,. i r r _ r 7 o C] tri O,/i LIJ to W A!� s';;. ��� 1N _ i o w C] o rY 743 ..f V. �::. ; 1 � o -� VEL `.: '' O 1 DFq4w+ - : 4 Ili + , • TRAVIS J. BARIL �• LS 112374 ` • .� ++� X Z�P I R - SCALE IN FEET MCCLINTOCK LAND ASSOMAMS, INC. 16942 NORTH EAGLE RIVER LOOP ROAD EAGLE RIVER, ALASKA 99577-7801 (907) 694-4499 LICENSE No. AECC596 FIELD WORK DATE: 7-14-2023 PARTY CHIEF: BWS DRAWN DATE: 7-20-2023 DRAWN BY: BWS CANYON DRIVE (S89' 59' 00"E 139.96') 5EPTIC 215ER5 O TELECOMMUNICATIONS PEDASTAL LOT 1 BLOCK 1 (PLAT 71-148) 3' ROW FOR ROADWAY & PUBLIC UTILITIES 5ATELLITE DI5H NOUS ; 10X20' 0 0 20 40 80 Z SCALE IN FEET MCCLINTOCK LAND ASSOMAMS, INC. 16942 NORTH EAGLE RIVER LOOP ROAD EAGLE RIVER, ALASKA 99577-7801 (907) 694-4499 LICENSE No. AECC596 FIELD WORK DATE: 7-14-2023 PARTY CHIEF: BWS DRAWN DATE: 7-20-2023 DRAWN BY: BWS CANYON DRIVE (S89' 59' 00"E 139.96') 5EPTIC 215ER5 O TELECOMMUNICATIONS PEDASTAL LOT 1 BLOCK 1 (PLAT 71-148) 3' ROW FOR ROADWAY & PUBLIC UTILITIES S89' 51' 19"E 159.27' (S89' 59' 00"E 160.00') I -r v I . di_ v /.�i( i (PLAT 71-148) AS- I hereby certify that I have, or someone under my supervision has, inspected the property described as: LOT 1 BLOCK 1 McKINLEY HEIGHTS #2 SUBDIVISION (PLAT 71-148) ANCHORAGE Recording District The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property, except as indicated hereon. No lot corners have been set. The property dimensions shown are from the record plat and ore not necessariiy as wt may have measured. The improvement locations ore approximate and have been determined only to the extent that enables us to determine if there ore any encroachments onto or off of the lot_ Drafting and reproduction may produce graphic inconsistencies; therefore scaling should not he attempted to determine unshown dimensions. This drawing is not adequate for additional construction ar for determining the exact location of property lines. Only easements from the recorded subdivision plot noted above are shown hereon and it is the respansibllity of the owner to determine if any other easements, covenants, or restrictions exist. ® McClintock Land Associates, Inc. (MLA) 2023 This document is copyrighted and is authorized to be used for one real property Lronsactlon or project only. Any copy is to he considered unauthorized unless it hears an original surveyor's signature (usually in blue ink) or a stamp showing recorder's office data. Copyright restrictions (but not re—use restrictions) ore waived if this document has been offici011y recorded. Lending institutions may also make additionol copies for their own records. Liability to MLA is limited to fees received for this project. FIELD BOOK: LOCAL FORM PLOT SCALE: 1"=40' GRID: NW0957 DWG NAME: AB23-166 JOB N0: 23-166 5ATELLITE DI5H NOUS ; 10X20' I � I cn 1 J. CACHE I , V 1 SHED 12X20' /1� i �. I [ I 1 I 1.0' PAVEDyDRIVEWAY - ..: k `y �r •'r� , . ._ .,,. i r w o C] tri O,/i LIJ to W A!� s';;. ��� 1N _ i o w C] o rY V. �::. ; 1 � o -� VEL `.: '' O a �. '..RA ., . I: �' 1 v v ... �,i,. `.- 1 Z 47.7' 6. A ',: GA�G� � � ' -'3 A , 4 I � n 48.1'// ,_'s'..A I F— i , V o r- CO } ❑ 9 S89' 51' 19"E 159.27' (S89' 59' 00"E 160.00') I -r v I . di_ v /.�i( i (PLAT 71-148) AS- I hereby certify that I have, or someone under my supervision has, inspected the property described as: LOT 1 BLOCK 1 McKINLEY HEIGHTS #2 SUBDIVISION (PLAT 71-148) ANCHORAGE Recording District The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property, except as indicated hereon. No lot corners have been set. The property dimensions shown are from the record plat and ore not necessariiy as wt may have measured. The improvement locations ore approximate and have been determined only to the extent that enables us to determine if there ore any encroachments onto or off of the lot_ Drafting and reproduction may produce graphic inconsistencies; therefore scaling should not he attempted to determine unshown dimensions. This drawing is not adequate for additional construction ar for determining the exact location of property lines. Only easements from the recorded subdivision plot noted above are shown hereon and it is the respansibllity of the owner to determine if any other easements, covenants, or restrictions exist. ® McClintock Land Associates, Inc. (MLA) 2023 This document is copyrighted and is authorized to be used for one real property Lronsactlon or project only. Any copy is to he considered unauthorized unless it hears an original surveyor's signature (usually in blue ink) or a stamp showing recorder's office data. Copyright restrictions (but not re—use restrictions) ore waived if this document has been offici011y recorded. Lending institutions may also make additionol copies for their own records. Liability to MLA is limited to fees received for this project. FIELD BOOK: LOCAL FORM PLOT SCALE: 1"=40' GRID: NW0957 DWG NAME: AB23-166 JOB N0: 23-166 NAME// MAILING D?RESS.~ ¢' ~ , MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT I ONE T [3 UPGRADE ILEGAL DESCRIPTION ,~,~ ./ .... ~ . LOCATION~, .~ i / Well -- , ~ IAbsorpton area Dwel ng I ~ I DISTANCE TO: J /~¢ / I %~ Width ', ~2 ..L ~ Manufacturer ~ ~ ~ ~' Materia m Liq capacity n~ ons [ nsdelength ' j / '~ S ~ t IF HOMEMADE: J DISTANCE 'TO: /7'~¢..!~¢) / ~,. FoumJation No. of lines ./ j Length of %a~fne,~ Total length of lineL Top of tile to finish grade cj Material beneath tile 4~Jj.d t h ~th Crib dlarneter~, ~-~ Crib depd~ Depth I Driller Building foundation Sewer line ~~¢~;*] ~earest to~¢tine , I Trench I ~ inches NO. OFBEDROOMS No. of compartments Liquid depth -~_iquid capacity PERMIT NO, Distance between lines Total effective~ab26,f~kion area inches ~ ,~> ,~ c ,/~ PERMIT NO. r, >3~L.~~p t i o n a r e a ~'/ Distance to lot line / PERMIT NO. Septic tank ] Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING ~ INSTALL_ER RE~RKS ~-~R OV E D 13 (Fleu. 3/78) DATE LEGAL PERMIT NO. ,.': 820974 ) RPPL. ICFINT LRRR~' HEHR [_[)CRT t ON LEGFIL. L:L 8:L MCKINL. E~' HEIGH"FS TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH MR;:<IMUM IqUMBER OF' BEDROOMS = 3: SOIL RRTING (SQ .FT,-'"BR)= SF.:2 4476 SKI RE:, CHUGIRK 99567 688-9024 LOT SIZE 99'9999 SQUFIRE FEET ]-HE: REQUIF::ED SIZE ]F THE SOIL PE,_-.LRFTt .N S'¢STEM IS' THE L. ENGTH DIMENSION iS ']'HE LENGTH (IN FEET) OF THE TRENCH OR DRRtNF'IEL.D. THE [:'EPTH OF' R "FRENCH OR PIT IS THE DISTRNCE BETWEEN THE SUF-'.FFICE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). TNERE IS NO SET WIDTH FOR TRENCHES. THE: GRR","EL DEPTH IS THE MINIMUM DEPTN (:iF GRFt',,"EL BETWEEN THE OU]"FFtLL. PIPE FIN[''' THE BOTTOM OF THE EXCR'","STION (IN FEE:']'). HFFLI..HNT HRS THE P-.E.=,FLNz..[BILI'I'r 'FO INFORM THI°._' DEPRRTMENT DURING ]'HE INSTRLLFITION II~=.FEUTIUN.=', ElF' RN"r' HELLS RDJRCENT 'FO THIS FF, LFEF-.T'? RND THE NUMBEF.: OF RESIDENCES THFIT THE WELL t,.IILL .=,ER','E. ........... "'r~.,-~c, ,:] ~...:, .':, :]: lt'-,].~.; F-F£ c:-F ]: C, tP,]c.--'; RF:EZ F-: E::],Z4 LJ Z I~:E£) ......... ERCKFILLING OF FIN'¢ S'¢STEM WI]'HOUT FTNFIL INSPECTION RND RPF"F.:OVRL. B:r' THIS DEPRRTMEN]" 1.4ILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNC.:E BETWEEN R WELL RND RNY ON-SITE SEHRGE DISPOSRL SYSTEM IS 100 FEEl' FOR Ft PRI',,,'ATE WELL OR ±50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE T'¢F'E OF PUBLIC I.,.IELL MINIMLIM DISTRNCE FROM R PRIVATE WELL TO R PRI'¢RTE SEI,,.tER LINE IS 25 FEET FIND TO B COMMUNiT:¢ SEWER LINE IS 75 FEET. . OTHER REQt.IIREMEN-['S MFt'-t RPPL. Y. SPECIFICFITIONS RND CONSTRUCTION DIAGRFIMS FIRE R',,,'RILRBL. E TO INSURE PROPER INSTRL. LRTION. F'IE:]iRtP~t Z IF' LS;'=-CF" Z F-: ET.C.S; [:. ES: C: E ~'-ll E: E F::': -_-:-: :t. .. .1 I CERTIF'¥' THRT ±: I BM FRMIL. IBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND b.tELLS RS SET FORTH B'¢ THE MUNICIPRLIT'¢ OF RNCHORRGE. 2: I klILL INSTBLL THE Sb'STEM IN RCCORDRNCE WITH THE CODES. 2: I LINDERSTRND THRT THE ON-SITE SEWER S'¢STEM MR'¢ REQUIRE ENL. RRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN Z. BEDROOMS. V4. I~;I O&E ENG,NEERING & DEVELO, Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 MENT CO. Russell Oyster 694-2774 Performed for: Name: //~ ~/~ ~¥/'~'/ Mailing Address: ~ ~ Z Legal Description: .Z~-~- ~ _~-~/~cz': ? Depth (feet) Soil Characteristics 0 1__ 2__ 3__ 4__ 5__ 6__ 7__ 8__ 9__ 10__ SOIL LOG Earl ~111~ 688=2280 PLOT PLAN 11__ 12__ 13__ PERC. TEST 14__ 151 161 Ground Water Encountered: Yes.__ Proposed Installation: Seepage Pit Comments: No__ z-'~" If yes, what depth Drain Field ~ Performed by: - A r ~' ~-.~,, ~/ Date: GPrATER ANCHORAGE AREA BOROt HEALTH DEPARTMENT 327 EAGLE ST, ANCHORAGE, ALASKA 99501 279-25! 1 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: ADDRESS /'/~ ~}~ PHONE. DISTANCE FROM WELL ~xx · LIQUID CAPACITY , ~ ,-' - .GALLONS. ,'f --4· ~-~, .. NUMBER OF MATERIAL (. ~. /~ /~ Z~ -,~ / COMPARTMENTS ,, i~ i -~';~ ';' ~ '1 LIQUID INSIDE LENGTH INSIDE WIDTH DEPTH~ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS /' OUTSIDE DIAMETER__ LINING MATERIAL__~ NEAREST LOT LINE OR WIDTH , LENGTH / ? , DEPTH DISTANCE FROM WELL_ , BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA FOUNDATION. DISTANCE BETWEEN LINES SQ. ET. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE , NEAREST LOT LINE TRENCH WIDTH TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE _iN. ABOVE TILE__ WELL: TYPE -/:;- ~'; ~ ~: "~ DEPTH ,, ~.. x LOT LINE /'d ;:; ~ /' NEAREST ,/ ~ / SEPTIC · SEWER LINE ~ , TANK DISTANCE FROM WATER BUILDING FOUNDATION. ~ / ./i~ ~. , , SAMPLE NEAREST / ;, ..{,- / SEEPAGE ~ ; OTHER , SYSTEM z/ '~ ~ , CESSPOOL ~ - _, SOURCES DIAGRAM OF SYSTEM DISTANCES: ~' ,_' 7 1:? - HEALTH AUTHORITY DATE /~x/ '~L /7 Z; ~t APPROVED /, GAAB-HD-2 GREATEk 327 Eagle St. kNCHORAGE AREA HEALTH DEPARTMENT Anchorage, Alaska 99501 )ROUGH 279-2511 Case N o. -- SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT PHONE NO. NAME OF APPLICANT RESIDENCE ADDRESS. LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY MAILING ADDRESS LOCATION OF INSTALLATION ., SEEPAGE PIT. ~ ,DRAIN FIELD. FINANCED THROUGH ~' >,> //:' TO BE INSTALLED BY A ~'/' / PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ,OTHER_ THIS IS TO SERVE AS N/& t, :;:<) , PERMIT TO INSTALL A ~, :, ?'~'>: '/.'/[ '/~)~? AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED :~ _. SEPTIC TANK SIZE /?::i"i ~(:' TYPE J'~>/"~:~/i'~/'SEEPAOE AREA ') ~;7 ' ~'' TYPE DIAGRAM OF SYSTEIV1 'Health Authority · 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. DATE : ]: ) ' ,. APPLICANTS S GNATURE ; / ~I~'* TER ANCHOI~A~3E AREA HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCAT,ON _£[EGAL DESC,mON '::Z'" ..' .'m:'./ /;' SEPTIC TANK: / /.~/ V'.~:, ~',~) DISTANCE FRO~ WELLd~., (X~:T~ - . ~ATERIA, ~ ~e~7 ~CO~PARr~eNTs~U~BE~ OF ,) LIQUID CAPACITY:~: -- /~D __GALLONS. iNSIDE LENGTH ~7." ~ID~-~ LIQUID - DEPTH SEEPAGE SYSTE_M_.. SEEPAGE PIT: .UmER OF LINING MATERIAL NEAREST LOT UNE- ..l~ _OUTSIDE DIAMETER i OR WIDTH 1/7 / I 'DISTANCE FROM WELL~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREAl TILE DRAIN FIELD: · L[NGIH . DEPTH__~'I · BUILDING FOUNDATION__/ ) Ol DISTANCE FROM WELL_ NUMBER OF LINES ABSORPTION AREA_., DEPTH: TOP OF TILE TO FINISH GRADE WELL: TYPE Z~)~/'CL ~?~-D , NEAREST Lo~ UNE /~ . __. SEWER LIN' ~ DISTANCES: ,F~)= uo FOUNDATION -.% . . NEAREST LOT LINE TRENCH WIDTH i DISTANCE BETWEEN LINES __SQ. FT. LENGTH OF EACH LINE TOTAL LENGTH · OF LINES ... ,IN'. tOTaL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE_ DEPTH [ I~ ~ i DISTA;,~JCE FROM ~ ! WATER 3UIL~ING FOUNDATION SAMPLE ,~1~ . NEAREST SEEPAGE //~;IC -"'~'~ OTHERo rEM, , CES ,~OL , $ URCES OF SYSTEM, DATE APPROVED GAA~) HD I GRFATER ANCHORAGE AREA BOROUGH 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 WELT MATERiAL.~ ~:,~,. · LIQUID CAPACITY GALLONS. INSIDE LENGTH_ NUMBER OF COMPARTMENTS .INSIDE WIDTH___. LIQUID DEPTH_ SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL ~?~"~: NEAREST LOT LINE ':~Z~ SEEPAGE PIT: __ OUTSIDE DIAMETER. OR W,DTE, / 7 DISTANCE FROM WELL_ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) / ENaTH '7 7 . DEPTH BUILDING FOUNDATION SQ. FT. TILE DRAIN FIELD: DISTANCE F ROM-"~E LI NUMBER OF, LINES ABSORPTION AREA FOUNDATION , NEAREST LOT LINE DISTANCE BETWEEN'LiNES TREN ~H~WiDTH SQ. FT. LENGTH OF EACH LINE TOTAL LENGTH OF LINES_ - ~. .- ' '"~' IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE_ IN. ABOVE TILE WELL: TYPE /)/~.7L~L; ~ , DEPTH /~! ? / LOT LINE 7/~' c' L' ? NEAREST /S'_/ SEPTIC DISTANCE FROM ,BUILDING FOUNDATION ~-:, SAMPLE ~2 ~ / SEEPAGE SYSTEM , NEAREST OTHER -- , SOURCES__ DISTANCES: DIAGRAM OF SYSTEM DATE · / ' ' HEALTHXOTHO~ITY ' * OAAB HD- I GP"~:~,TER ANCHORAGE AREA BORO~'~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM : . ADDRESS~r~'~ ~ SEPTIC TANK: ~ £- 7g DISTANCE FROM WELL~--~ '/~)~'~ 7~ MATERIAL_ LI©UID CAPACITY~_~ -- //..2~)~ GALLONS. PHONE LIQUID DEPTH _ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS..__/ LINING MATERIA~ ~//7 S TILE DRAIN FIELD: DISTANCE FROM WELt __ -- NUMBER OF LINES OUTSIDE DIAMETER_ OR WIDTH / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) __ FOUNDATION DISTANCE BETWEEN LINES. , NEAREST LOT LINE_ TRENCH WIDTH LENGTH_ DEPTH BUILDING FOUNDATION TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE IN. ABOVE TILE.-- DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE WELL: TYPE. D/~t C£ '~.~? DEPTH 10'2-! DISTANCE FROM 6/. WATER , ~ ,BUILDING FOUNDATION. SAMPLE +' x LOT LINE IOD NEAREST '~/ SEEPAGE _ , s~w~R NX svs~M_ . , C~SS~OOL_ AM OF SYSTEM NEAREST OTHER SOURCES DISTANCES: ff.~ -:o r~~ F= ~z lid GREATEL _ ,NCHORAGE AREA _ 9ROUGH Ca eNs. HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT ' ~ r, ,/x ~, . MAILING ADDRESS ~ ,m2~:'.}~ . PHONE N NAME 0F APPLICANT ' '-' > ' ' ~ RESIDENCE ADDRESS LOCATION OF INSTALLATION LEGAL DESCRIPTION__ APPLICATION TO INSTALL: SEPTIC TANK : , SEEPAGE PIT__+ DRAIN FIELD. TO SERVE THE FOLLOWING FACILITY ~ ~/ FINANCED THROUGH .- ~ TO BE INSTALLED BY_ PERCOLATION TEST RESULTS ,OTHER. ANTICIPATED DATE OF COMPLETION' BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ~ , ~,.-.x,PERMi TO INSTALLA AS DESCRIBED BELOW· SIZE OF UNIT TO BE SERVED __. SEPTIC TANK SIZE ' ; TYPE i'x'~;EEPAGEAREA , :.' ~ , ;:YyPE DIAGRAM OF SYSTEM DISTANCES: Health Authority 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. APPLICANTS SIGNATURE GAAB HD-I Gr '~%ER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 27~-,Z511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ADDRESS '~ ;~" J LEGAL DESCRIPTION PHONE SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY GALLONS. MATERIAl Z~ ~,:;~,,/~:~.,? ~2_~:' NUMBER OF ~ - COMPARTMENTS INSIDE LENGTH ..... INSIDE WIDTH __ ___DEPTH___ SEEPAGE SYSTEM: NUMBER OF PITS. LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH DISTANCE FROM WELL_ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)_ LENGTH , DEPTH , BUILDING FOUNDATION.__ .... SQ. Ff. TILE DRAIN FIELD: DISTANCE FROM WELl NUMBER OF LINES ABSORP]'i©'N' ~REA DEPTH: TOP OF TILE TO FINISH GRADE FOUN!DATION , NEAREST LOT LINE DISTANCE B~TWEEN LINES ' TRENG~ WIDTH SQ. Fkh,~,,.,LBNGTH (~F EACH LINE TOTAL LENGTH OF LINES DEPTH OF FILTER MATERIAL BENEATH TILE_ IN. ABOVE TILE_ WELL: ~ ' ~ TYP E_L't~ ~""/[~' ~( , DEPTH · NEAREST LOT LJNE , SEWER LINE .... DISTANCE FROM , BUILDING FOUNDATION SEPTIC I dt~ ~ SEEPAGE , TANK ' , SYSTEM_ WATER SAMPLE , CESSPOOL , NEAREST OTHER , SOURCES.__ DISTANCES: "~ .'. /7~' r' DIAGRAM OF SYSTEM 4 APPROVED DATE ..x.;) ,." HEALTH AU[HC ) TV GREATE[ . NCHORAGE AREA HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAIVIE OF APPLICANT RESIDENCE ADDRESS APPLICATION TO INSTALL: SEPTIC TANK , SEEPAGE PIT ,DRAIN FIELD FINANCED THROUGH ,._~E2Z.,¢-L ~'~'- TO BE INSTALLED BY ,~-~¢~'¢Y~// PERC0kATION TEST RESULTS ,/,5~ -~[~ ANTICIPATED BATE OF 60MPkETION BELOW TO BE FILLED DDT BY HEALTH DEPARTMENT MAILING ADDRESS Z;'~-~: ~ NO. LOCATION OF INSTALLATION .., OTHER THIS IS TO SERVE AS ,/~'q~, /¢/~L"iL:~-'~/~3"~ , PERMIT TO INSTALL A Cr~'Z~¢~~ .AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ,_:>/-)/)/27>3 . SEPTIC TANK SIZE /~?~ TYPE ~'SEEPAGE AREA ~.¢6' ~' TYPE DIAGRA~ 0F SYSTEM DISTANCES: alth Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the ab°ye described system is in aTrdance with said c°de' '~ ./? PEF'E~R'Ff'IENI" ,.,, HEALTH t';~ND ENV!RONHENTAL , ,<OTECTION ;;F:5±E,~ E, 'TUDOR RD., ANCHORRGE, RK. 99587 27(:;¢-222i < 7~Slii ) Fit:::'PL. ! C:FINi" L ]CFFI' :f. ON L :'. -:','- *:',' .... :'t..~rj5 CHI..IGII:':I,k'. FtI< L[ I.:F.,' HFIHILTON u,.,", . f%LINLb.~ HE,KbHF.: St) f4E':.,L:h I :.:, :(SD LOT BiLii I[,'L.'~.d.. HCK .! NLEY "'r ....... :' 5'.~-~r,3~:9 S~:IUFIRE FEEl' HINiMUM DISTANCE E:ETWEEN R WELL RND RN¥ ON-SiTE SEWAGE DISPOSAL SYSTEM IS i¢}~IE~ FEET FOR FI PR}:VRTE WELL OR 2E~O F'EET FOR ;';I PUBLIC WELL. WELL LOGS FIRE REf=~UIREP RND MUST E:E RETURNED TO THE PEPRRTHENT WI1}IIN ]:~ DRYS OF TIE WELL COHPLETION. SPECIFICFrI'IONS RND CONSTRUCI'ION DIRGRRMS FIRE FiVAILFIBL. E 'f'(] INSURE PROPER I NSi'[:IL.LRT I ON. I ]~{R']'): FY THFYF i: 7: FIH FAHiL. Ii':IR WI'f'H THE RE6:¢J):REHENTS FOR ON~"SI'i'E SEWERS RND HELLS AS SE"r ~' NL. HV~ P f'Uk:'"' '[ I't PY., ' THE i¥1L N:[CIPRL.:[I'Y OF ........... " ........ 2: ]: WiLL ]:NS)';F~IyL. THE SYSI"EH IN RCCOR[)i:INCE WITH THE CODES ~ / ,.'/ ' /'w¢:-- '* FIPPL I C:RNT ~RRSJ HFIH): L. TON