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Home My WebLink AboutROLLING HILLS ESTATES BLK C LT 11 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION i ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE I [] NEW MAILINGADD~ES8 LEGAL DESCRIPTION ~0Til ~Lo6~ C ~ I~OLL~ [4~cc~ NO, OF BEDROOMS LOCATION 7ffqq Well Absorpti ~ Dwellin ( PERMIT NO. DISTANCE TO: ~' °~r~' ~ '-- ~ ~ Material No. of com~ments ~ Z MAnufacturer ~ P Liq, ca,city in gallons Inside length Width~ Liquid depth ~ ~ O IF HOMEMADE: ~¢~/'~ ~ ~ ~DISTA~ Well Dwelling PERMIT NO. · ...... ~ ~ ~ Manufacturer /~ r~ tv, a~u, ;~1 ~ Liquid capacity in gallons ~ m ~ ~ { ~ ~ ~ inches Total effective absorptio~rea ~ ~ ~ Top of tile to f~h ~a~ Material beneath the O ' ¢ "~ PERMIT NO. ~ ~~ Width Depth ~ ~ ~C~ Total effective absorption area Tvpe of crib Crib diameter pth ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller ~ Distance to lot line PERMIT NO. ~ DISTANCE 'O: Building foundation Sewer line Septic tank PIPE MATERIALS SOIL TEST RATING 5--I I INSTALLER 7 LEGAL DE:SC:RIP~ ! F!T :: 'r ZE!: ',: MAX o:'¥'~,r'~p~*,l :- .......... ( .......... )!,I ,, :3 [ OW, L,I J. I ....... 6A 'St:) ,, ~:::'¥' rjr 3 DEF"T'H TO F'II:='E: BCIT'T'C]M (F'T~) GRAVE],... DI~i:F:q"H (F'I",, .' I"C)TAL DIE]:::']"H (F"!". ; GRAVE].... W!D]'H (I:::]"~ ;' GF;:AVEL.. LE]qGTH (I:::'T,,) GRAVEL. VOL..UMEi: (CU~ YDS,, ) TANK .'.'!i~ :I: Z E (GALS) SC) I !.... RAT I NG (SD ,, F:T ,, /BR ) · ~-.~ TANK MUST HAVE:.' AT !..EAST TWt'] L,,.~I-I-A ~'oi"-'Lh .by the Mun:i. cipal:i.t:y of' AnchF~r'age (MOA) and the State 2,, I ?,~i].l :i. nstal! 'Ll"~e~ system :Ln acc,:::)r'dance with all MOA c::q)des and r'e>gu:!.atic)r'~s, 3,, ]: ?~:[.].]. adhePe t(:) a].]. MOA anti Stat,:.:.)) (::~'? Alaska r, equ:i. Pe)'ments ['c:m 'Lh,:e set h).ac:k se~z~m.)Pa(~:je syst..E:.:,m c:)n 'Lhis cH" any a(::ijac:en'l:, or' n~.?,.)aPJ::)y any en].ar'geme)nt ~,~J.].:l. rt?quiPe afl a(::IcJ:EtJ, ctF~a).Z ]:F: A L.]:F:'T STA]":[ON IS INSTAL..LEED IN AN ARE:A COVERE:D BY MOA BU:!:LD]:NG CE)DE~:S THIEN ( 1 ) AN ELECYTR:[CAL. F'EI::E'.M ]:T AND ]: NSI:::'I~E:CT!" :I: ON MUST BEE: OBTA:!:NED~ C:2) AS.....BU ]:LTS WILL. NC)T BE: APF:'ROVED W]:TI..~OLFF AN E~t.,..ECTRICAL.. !NSF'E~CTION F~'.EPORT; AND (3) 'T'HE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST "ERPORMED FOR: ~, ~I~T L_ ~,~jGE ho-r I1 FLoc~c. C_ DATE PERFORMED: ~'~J ~ ~_~ I I ')q ~'~' LEGAL DESCRIPTION: 10 11 SLOPE SITE PLAN 12 13 14 17 20 C. Reid, Jr. COMMENTS PERFORMED BY: J~ · G~bO~)J WAS GROUND WATER ENCOUNTERED7 fES, AT WHAT Gross Net Depth to Net f Reading Date Time Time Water Drop n ~3 ~H o o ,~o i~ ~ ?, ,0 o,~ o.1~ PERCOLATION RATE TEST RUN BETWEEN 'TF'~ ~'0 17.3'FF 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# ~¢t~()ir~i-~ 1. GENERAL INFORMATION Complete legal description Lot 11; Block "C"; Ro~in~ Hills Estates Location (site address or directions) 7449 Bailey Drive Property owner Mailing address Lending agency Mailing address Patrick ~ Gretchen Voris Day phone 248-7455 7449 Bailey Drive Anchorage. Alaska 99502 Day phone Agent O.~2~.~.~.n M~..x'.na JACK WHITE COMPANY 3201 C ~St~e~t Sure 100 Address Anchorage. Alaska 99503 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: NOTE: Day phone 762-3105 Individual well Community well Public water 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 XX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72~025 (Rev. 1/91) Front MOA #21 5. 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 type of structure indicated herein. I further verify that 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 is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Ad dress Engineer's signature Phone Date DHHS SIGNATURE Approved for Disapproved. 3 bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ..~c v-rt,4. ,~..t ~ ~y Date 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 federaJ 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. 72~25 (Rev, 1/91) Back MOA#21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT ((~ /~L~C, ~-~ou_,~J~ ~t~.~ ~Parcel !.D A. WELL DATA Well type ~\U~r~(F-- Log present (Y/~ Total depth Sanitary seal ~N) If A, B. or C. attach ADEC letter. ADEC water system number Date completed ~ ]c~fo-.~ Driller / ~, Cased to I~L r Casing height 18~r Wires properly protected (~N) ~/~ FROM WELL LOG AT INSPECTION Date of test UN .A-UA-I~ c~_,~~~ ~_ Static water level ,/~ ~'~ ~ Well flow ~, g.p.m. (~,'-~c Pump level '~.c~ ~+ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer serviCe line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank (0o a WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: c~_~c~ ,~ - ~::C7~--J~ Other bacteria Collected by: ~'~ ~ ~.rOGl*J~-E/ZUvO B. SEPTIC/HOLDING TANK DATA Date installed ~c{~,~> Tank size /00~ ~L Compartments Cleanouts (~/N) (~J~- 'Foundation cleanout (Y/~ ~-~o Depression (Y/l~ High water alarm (Y/{~ /"-)/~ Alarm tested (Y/(~ Date of pumping pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~(~ To property line ~-~,~ Surface water/drainage On adjacent lots AbsOrption field /0o '+ Foundation water main 'service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE FT STATION, ~ ..... at~d ~/~ M n~anu~acturer ~~ Size in gallon'~'~._, a o e/ ccess (~J~'~_ Vent (Y/N) -'""~"~-o~ ~ ~--~- "Pump off" level at High water alarm level . ~.~-'~;~'~ Cycles tested ___ Meets MOA electrical ~ ~ SEPARA~CE FROM LIFT STATION TO: ~ ~pRdot On adjacent Iols Surface water '"----. / Soil rating //~ t""""""""'~=,~'~ System type ~//7' ! Gravel thickness ~ Total depth Cleanouts present ~::~/N) ~'~' Date of adequacy test for ~0'( ~.A)~)~J If yes, give date D. ABSORPTION FIELD DATA / Date installed /<~ ~ ~ / / Length .~0 ~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) ~:>AC~$ Peroxide treatment (past 12 months) (Y/~_~ bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on.lot /00 '¢' To building foundation ~+- On adjacent lots ~ "/' Surface water lO0 '~c Curtain drain ~JO/,~F_._ ~-.~,J6U~ On adjacent lots /~ '/" Property line To existing or abandoned system on lot Cutbank /v/~ Water main/service line 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 Signature Engineer's Name Date 5 & S ENGINEERING 17034 Eagle River Loop Road No. 204 E=.3!= R'."/e~, ~l=,l~n 99577 HAAFee$ /~O,-~ Date of Payment ~'~ ( ~ ~ // c~ ¢-, .. Receipt Number ¢2 Z/O'~ ¢ on 1ha.date of this inspection. ',* , '*~'~2~'- No. 8215 .~ 4~ Waiver Fee: $ Date of Payment Receipt Number /..~x,x CHEMICAL & GEOLOGICAL L~., BORATORY Jell&Ifil lty : ~' (./. ....... MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~}E~O CO~ Telephone: Home Applicant Address Business (c) Applicant is (check one): Lending Institution []; Owner/builder/~ Buyer []; Other [] (explain); (d) Lending lnstitution /~LA~iCA- CONI-'EfJTCN'TAf--- Telephone Address (e) Real Estate Company and, Agent Address Telephone (f) Mail the HAA to the following address: tc -dP TYPE OF RESIDENCE Single-Family~ Multi-Family [] Other Number of Bedrooms --~ (~/"¢~ ~"~) WATER SUPPLY Well'~ Community [] Public [] Individual Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite"l~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 '~JOt~ s,Jeeu!bue leUO!SSejoJd CHi u! suo!ss!uJo Jo s Jo J Jo Jo~ elq!suodsaJ ~ou s! eSeJoqou¥ ~o ~!led!o!un!AI eH/'penss! $! a~eo!~!Heo e eJo~eq elep eZXleUe JO suo!~3@dsu! ~9npuo9 ~ou op cl=lMC] ~o see,~oiduJ-:J 'slueuJeJ!nbeJ e~els pub le~epe~, u!e~Jeo X~s!~es ol JepJo u! suo!~n~!~su! 8u!puel J!eq~ pue seuJoq ~o sJeSeLloJnd o~ ,~se~Jno9 e se s!q~ seop d3H(3 eqJ. '~SelV ~o e~e~,S' eLl~, u! peJ@~s!SeJ Jeeu!bue leuo!ssa~oJd ~uepuedepu! ue ~q e^oqe g qd~§~¢~d u! ua^!§ suo!~e~ueseJdeJ eq~ uodn ,~lalOS peseq se~eo!~!peo le^oJdd¥ /~l!Joqlnv q~l~eH senss! (cI=IHC]) uo!loelo~8 le~UeLUUOJ!AUq pue q~leeH ~o lUeUJ1Jed@Q e6eJOqOUV ~o ,~!l~d!oun!AI eq/ NOIJ. nvo leuo!~!puoo le^oJddv leUO!~!puoo jo suJJe± pe^oJddes!c] ~ pe^oJddv ,~q suJooJpeq ~ Joj pe^oJdd¥ "IVAO~ddV d=IHQ MUNICIPALITY OF ANCHORAGE FNVlRONMENTAL SERVICES DIVISlONMUNICIPALITY OF ANCHORAGE (MOA) · - HEALTH AUTHORITY APPROVAL (HAA) JUJ~ ~ ]987 CHECKLIST- FEBRUARY 1984 264-4744 R E C E I V E D Legal Description: WELL DATA Well Classification Well Log Present (Y/N) Total Depth i~r~ Cased to Static Water Level -7~! Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: If A, B, C, D.E.C. Appr ~ ~Y~N) Date Completed ~-~-J~ 1~'~ ~) Yield .-'F'A/,,5 7'¢~'= Depth of QroutJng Pump Set At / ~ I~ Sanitary Seal on Casing (Y/N) y~ Depression Around Wellhead (Y/N) To Septic/Holding .Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line .-F I00/ Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ; On Adjoining Lots "~0Oc "'""; On Adjoining Lots To Nearest Public Sewer Nearest Sewer Service Line on ;Date SEPTIC/HOLDING TANK DATA ,ze 'O O .o.o, Standpipes (Y/N) ~;E~'I'3~') Air-tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line TO Water Main/Service Line '~fi ~' Course Date Last Pumped ~/~'~'~'7 ~ ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~'~'/ To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026 (Rev 8/863 Fronl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 1 "7~. ,¢5/c:/'J~,~FY~ Type of System Design Date Installed J/)r/~ 7-';~ /¢¢~' ,/' Length of Field ~:lC)I v" Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well '~/00~ To Building Foundation--;~:2/ Lot Depth of Field 14 Gravel Bed Thickness ~/ ! Standpipes Present (Y/N) Date of Last Adequacy Test To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line /(~ / ; On Adjoining Lots To Existing or Abandoned System on + I0/ To Cutbank (if present) '75' LIFT~TION 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) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that~avechecked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company ~)'2J~}~¢-(~¢ ~(4 MOA NO. Receipt No. £0 0/0 o ~ Date of Payment (~/.~'/' ~ ,~ Amount: $ /d~ ~ Page 2 of 2 72 026 fRev 8/861 Back Loc~tion: BPkTqSE, EPPS & POTTS 2220 EAST 88 AV~WUE ~NCHORA~, AK 99507 (907) 349-6451 WATF2{ WELL TF~ST / Date: Subdivision: Lot: Block: Client's Name: Address: Initial Reading on Meter: Production Rate: ~.7/ GPM 24-Hour Capacity~ C~lloas A* I-I()ME SERVICES, INC 15900 Francesca Drive Anchorage, Alaska 99516 345-1890 or 345-2444 CUSTOMER Anohorage $9507 Block C Lot 11 Rolling Hil~ INVOICE DATE DESCRIPTION AMOUNT d/~/$7/ P~'~ Septic 75 7449 Bally TOTAL 75. O0 REM KS = AR .~ ~ ~ t 4 , . , ~ 1, .~ , or o .~ . ~ ~ ~ ~ ~ .... .... /[)~ Gallons Septic Cesspool Holding Tank Standpipes Time [] PROBLEM AREA--CALL FOR MORE INFORMATION [] NEEDS TO BE DONE AGAIN IN 6 MONTHS [~G°od Shape [] Sludge buildup on bottom [] Floater on top [] Jim cap missing or [] Cut standpipe to 1' above ground [] Needs Septictrine needs replacing NOF THEF{N TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A 2505 FAIRBANKS STREET FAIRBANKS, ALASKA 99709 ANCHORAGE, ALASKA 99503 907479-3115 907-277-8378 Quality Control Report Client: Besse. Epps & Ports ID~: A060887-1 Listed below are quality control assurance reference samples with a known concentration prior to analysis. The acceptable limits represent a 95% confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring the accuracy of your results. Sample~ Parameter Unit Result Acceptable Limit EPA WS378-6 Nitrate-N mg/L 0.92 0.84 - 1.02 Date' 6/09/87 Carol ~Z. Garrison, Vice-President MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL ~E. ALTH DEPARTMENT OF N~.ALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE Information Application Date ..: (a) Legal Description (include lo% bloc_k, subdivision, section, township, range) !~':/~"..' ".' Location (address or direction) ' . (b / Z~3-37t2 ' ) Applicants Name R. ~f~ Telephone - Home Business (c) applioant is (ah~ak ona) Le~i~ lns~itution ~ ~ ~r/b~ld~r ~ ~ (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Cf) Telephone Mail the HAA to the following address: e Type of Residence Single-Family~ Number of Bedrooms Multi-Family ~--~ Other (describe) Water Supply Individual Well .~. Community ~-~ Public ~--~ Note: If community well s-/stem, 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 Environmental Conservation attesting to the legality and status. [Page 1 of 2] E~ineering Firm Providin~ Inspectious~ Tests~ File Search~ Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of. Chis Health Authority Approval shows that the on-si=e wa~er supply and/or wsstewater disposal system is safe, functional and adequate for =he number of bedrooms and type of structure indicated herein.- I further verify that, based on the information ob=ainad from the Municipality of Anchorage files and from my investigation and inspection, the om-site water supply and/or wastewater disposal sys=em is in compliance with all Municipal and State codes, ordinances, and re§ula- tions in ~fect on the date of this inspection. N.m of Firm Address (ENGINEER SEAL) D~R.P Approval Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ~ALTH AND ENVIRONMENTAL PROTECTION (DEEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGI~rEER KEGISTE~ IN THE STATE OF ALASKA. THE DREP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND TN~IR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR E1LRORS OR OMISSIONS LN THE PROFESSIONAL ENGINEER'S WORK. RR4/eJ/D18 [Page 2 of 2] (DHEP SEAL) 7-19-84 Well Classification ~1'~,/~ Well Log P=esent (Y~ Total Depth , ;~7_~(~) Cased to Static Water Level , 7~' ~ Casing Height Above Ground I' 2_' Electrical Wiring in Conduit ~N) Separation Distances frcm Well: "~x MUNICIPALITY OF ANCHORAG2 D!!i~'l-, OF I-iEAL-i'..I ~ MUNICIPALITY OF ANCHORAGE (MOA) £hiVIFdJiqM~N'I-AL PitOiEC~iON mn O TY (m) u, ll" 2 1985 C~LI~ - F~RU~Y 1984 Legal Description: ~¢ 7~ If A, 8, ~ C, D.E.C. ~o~d(Y~) ~ ~te ~le~d ~q~. /~ Yield~ Pump Set At Depth of G=outing Sanitary Seal on Casing ~N) Depression Around Wellhead (Y_~ To Septic/Holding Tank on Lot ~ ~ ; On Adjoining Lots ~- ,TCI~Nearest Edge of Absorption Field on Lot /06/~ ; On Adjoining Lots ~- To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manhole ~//~ / To Nearest Sewer Service Line on Lot ///~ Water Sample Collected By ~ ~'F?~/' ~ Date I/7/~-- Water Sample Test Results ~J~ ~Stan~i~s ~) Air-tight Caps (Y~) Fcun~tion Cleanout (Y~ ~ession o~ Ta~ (Y~ ~te ~st ~d P~ing~intenan~ ~n~a~ ~ File (Y~)/f/~ ; Holding Ta~ Hi~h-Wate~ ~at~m (Y~) ~/~ ~~y Holdi~ Ta~ ~rmit (Y~) Separation Distances from Septic,~/Holding To Water-Supply Well ~ / ~ TO Property Line ~ ~ '~ To Water Main~Service Line course /QO' gF Receipt ~ Date Paid: Amount: Tank: To Building Foundation To Disposal Field ~ TO Stream, Pond, Lake, c~ Major D=ainage [Page 1 of 2] 2-15-84 Soils Rating in Absorption Strata /~'Z~-=~' /f'~-/~J Type%f Sys~m ~si~~ / w~th o~ ~e~ ~k~~ ~ o~ ~e~ 7. ~ ~. ~p~ession ~e~ Field (Y~ ~ of ~st ~a~ ~st /=//~/~' Sep~ation Distan~ ~ ~s~ption Field: · o s~e~ond~e/~ ~3o~ ~ ~ ~/~ ~ · o ~, ~ ~a, ~ v.,~. S=a~ ~.a ~/~ ~ D. LIFT STATION Date Installed DiKensions Size in Gallons , i'"~ Manhole/Ac~) "P~,%~ On" Level at ~ I / ~, "~ Level at. High Water Ala~u, Level at ; ~ /.//~" Vent (Y/N) Tested for ~ing Cycles d~ing Adequacy Test. M~ets MOA Electrical Codes (Yy ** Check Permitted Bed~ocm Rating Against HAA ~quest I certify that I have checked, verified, c~ confomred to all MOA HAA Guidelines in effect on the date of th~s~nspection. signed Date '~ _ . ~_~.~...' '--~.~ [page 2 of 2] 2-15-84 ALASKA e dllRonmerlTAL COI1TIROL IllC. ~n§i~eerinq 6 [~nuironm~nM $1uaies January 23, 1985 Department of Health and Environmental Protection 825 L. Street Anchorage, Alaska 99501 Re: Lot 11, Block C, Rolling Hills Well Test for Single Family Residence On January 7, 1985 we performed a flow test on the well at the above property. There is no access to the well, which is buried at present, so we were unable to get drawdown and recovery data. The flow rate was 7.0 gpm for 100 minutes with over 700 gallons being pumped. I consider the well adquate for this 3 bedroom home. If you have any questions, please call. Sincerely, Approved by: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection ~- '~)-o-~'~ Approval requested by: Mailing Address: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Phone: 2. Property Owner: J~~ ~~~ Phone: Mailing Address: 3. Legal Description: 4. Location: ~. lype ~ g. ~epth C. Construction ~. Bacterial ~nalys~s 7. Sewage Disposal System: A. Installed / C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line B. Installer 2. Manufacturer 2. Material , Absorption area ¢4 , Other contamination /~ , Absorption area , Sewer Lines Page 2 of two pages - Re L ~gal Description st for Approval of Individual Water Facilities Comments Approved Disapproved Date -~/~S-/~_ ~'~ 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) GREATER ANCHORAGE AREA BOROUGH.~. 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 FHA CONV _ × 2. Property Owner: Vernon W, and Joanne Torres Mai.ling Address: 7449 Bailey Dr, Anch, Day Phone$44-5007 H 3. Name of Buyer: G,Robert and Harriet Lange Mailing Address: Boxm:4-Z c/o Alyeska Pipe,Day Phone277-80~3 265-8262 4. Name of Lending Institution: Alaska Bank of Co~erce Mai]ing Address: main office ~hone 279-5641 (Marge Walker) 5. Name of Realtor or Agent: Bowden Realtors- sellin~ agent: Barbara Bowden Mailing Address: 6. ption: Phone 277-1452 Please call Mrs. Bowden before going out as buyer would like to accompany. Lot ii~ Blk. CF Rolling Hills Sub. Location: 7449 Bailey Dr, Anchorage 7. Type of Facility to be inspected: 8. Water Supply Type of Su'pply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well . ,~'~'m~/~~ 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation single family No. Bdrms. 3 X One Individual (on-site) FI1-GR7 l1 /74'1 Deaf Sirs: It is ~y understanding that the banks will not finanoe a home unless the well and septic system meet the Borough~ standard. This is to inform ~ou that I will locate my well when the weather will allow and will have the pipe per standard placed above ground. If~ in case~ the well is not the proper distance from the Cesspool, I agree to relocate the cesspool ~o meet the Borough standard. Thank you for your consideration in the matter. Sincerely, Vernon W, Torres