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Home My WebLink AboutSUMMIT ESTATES BLK 2 LT 15 (~) ~+~./ MUNICIPALITY OF ANCHORAGE ., O ~ 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 ~ ??--?$/,.¢' [] NEW NAME ~ 0 '"' //~/ ~ Y~ PHONF ~ ~UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS ~ ~ Manufacturor ~atodal ~o. of compartmonts ~ ~ Liq. capacity in gallons Inside lenoth Width Liquid depth IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons PERMI NO, Length of each line Total length of lines Trench width Distance between lines ~ ~ Top of tile to Material beneath tile Total effec~iE¢ absorption ~ d--¢ inches ~--~ ~ Length Width Depth PERMIT NO, ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, ~ Rui]ding foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: PIPE MATERIALS SOIL TEST RATING REMARKS _ . APPROVED DATE LEGA~ 72-013 (Rev. 3/78) LCIT ::, Z .-.:.l,: :l_ E E EIEi SI]:!i._IF~RE F'EET TYF'E OF SOZL RBSORF'-FZON -'"- ..... !S: :, ~ :, [ El I ]"RENCH I"IRNI.',I.H NUI',lSER OF EE[,R'.:]M'5 = 3 SOIL RFFf'tNG (Sg! FT,/E~R)=~ 85 TP!E RF' ............. :) I PgE, _. I ,..- OF TFIE .:,U I L RE:SORF"T' I ON SYSTEM 'r; :.:,,: .' THE LENGTH [:,IMENSION IS THE LENG'I,'H (IN FEET) OF THE TRE!'-,!CH OR [>RI,:Ii!',iFZELD. 'THE DEPTH OF' FI TF'.ENC:H OR PIT IS THE DIS;TRNCE DETI4EEN THE SURF'ROE OF THE GROUND FINE:, THE E:O'rTOP1 OF THE EXCRVR'['ION (IN FEET). THERE IS NO SET I.,.!:[D-I'H FOR TRENCHES. TI,-iE GRFI',,,'EIr_. DEPTH IS THE i"tZNIMUF! DEPTH OF GRR',,,'EL 8ET!.qEEtq 'THE OU'TFFILL PZF'E RND THE BOTTOM OF' ']-PIE E'?,:CRVFITZON .'::IN FEET:>. PERMIT PiPPLZCRi'.,I]" HR'_=; THE RESPONSIBILITY TO ZI'.JFOR?! THZS DEF'FIR-I"MENT DURING THE iNSTRLLRTIOI'.,! INS;F'ECTIOIqS OF F!NV F.!ELLS RI.')JFiCEi'.,!T TO THIS:; PROPERTY RND THE NUMBER OF RESI[:,ENCES THRT THE WELL WILL SERVE. E',fiC:KFtL. LING OF RNY _, 'r ._,'[ Ef P.IITHOUT F:INF!L IN.:,Fr.._ !.[1~1 ,! RI',R ,~:!F'F'RCIVF!L ElY "r,4'r,q t}EF'RRTMENT I,.III..[ ..... E S JE JECT TO PRE'SEC .. T I ';N. HZNtNLIH DiSTFtNCE BETFIEEN I::I 14ELL FINE:, £4N',¢ ON-SITE SE~,.!FIGE [:,ISPOSFIL. SYSTEN IS ±E~O FEET FOR R PRIVFFFE NELL OR :LSO TO 200 FEET FROM R F'UBLIC HELL DEPENDZNG UPON 'THE TYPE OF PUBLIC !,!ELL. !"1IN;(P!UM [:,ISTRNCE FF.:OM R PRI',,,'FtTE NELL TO FI PRIVFtTE SEklER LINE 15; 25 !:'EET TO 1:~ COHHUi'.,!ITV E;EI4EI,~: LINE IE; 'FEi FEET. OTHER REg~UIREHEIqTS f'lR"r' RPPLY. SPECIFICRTION$ FIND C:ONST,q:UCTION DIRGRRI"IS RRE FI'v'RiLRBLE TO INSURE PROPEl,;:: !NSTF!LLR-FION. i C:ERT!FY THRT ±: ! RI',1 FRH!LIRR 1.4tTH THE REg!UIREMENTS FOR ON-L::;ITE SEWERS F:IND !.4ELLS F~S SET FORTH BV THE I"!UNtCIPF~LITY OF RI'.,ICI,4ORRGE. 2: I I,.iII_L IHSTRL. L THE S'.?STEM IN RC:CORDRNCE !,.!ITH THE CODES. 3: I UNDERSTRN[:, THFIT THE ON-SI-f'E SE!.,.IER SYSTEI"i i',!RV REC]UIRE ENLRFe. GEi"IENT 'IF TFIE RESiPENCE _TS REHODELE[;, TO Ii",!CLUDE HORE TH,qi'.,i 3 BEPF'.OOHS. [ S S U E [) _,..._._,._. _ _ _ oGRE/ :R ANCHORAGE AREA BO $H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATI ON .... SEPTIC TANK: DISTANCE NUMBER OF FROM WELL /~.-)~)! MANUFACTURER ~'~.,,g.~:;W MATERIAL /)/~$.~] COMPARTMENTS INSIDE WIDTH LIQUID DEPTH INSIDE LENGTH LIQUID CAPACITY/f~O(~) GALLONS. DISTANCE FROM WELL ,/_~/~! FOUNDATION /(?' '~' ABSORPTION AREA C~9~ SQ. FT. DEPTH: TOP OF TILE TO FINISH GRADE ~ NEAREST LOT LINE ~J-~ I TOTALOF LINES LENGTH/i? ! TRENCH WIDTH~/ IN. TOTAL EFFECTIVE LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE J~/ IN. ABOVE TILE ~ IN, WELL: TYPE ~0"//#0 BUILDING FOUNDATION CESSPOOl APPROVED NEAREST LOT LINE OTHER SOURCES DISAPPROVED CONSTRUCTION NEAREST SEWER LINE DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK,_ SYSTEM REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATE RI AL: ~57;'~ ~'/ LOT SLOPE: REMARKS: Form ~Q-032 NAME OF APPLICANT greaTEr ANCHOrAgE Area DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C"STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCE~, REQUIREMENT~ FOUNDATION TO SEEPAGE Pit 2 (~) / , DRAIN FIELD SEPTICTANKTOBEEPAGE PITWALL // ~ / SEPTIC TANK _, SEePaGE PIT ~// TO NEAREST LOT LINE. WATER MAIN TO SEPTIC TANK ~J SEPT'OTANK./// SEEPaGEP,T /CO¢-¢ DRAIN FIELD f , SEEPAGE PIT , ALSO CONSIDER AREA WELLS. D.A,N FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION ~ FEET INTO UNDISTURBED 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH R ULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM I CERTIFY THAT AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DES RIBED SYSTEM IS IN ACCORDANCE WITH SAle) CODE, ~ ~/ GREATER ANCtlORAGE AREA Department of Environmental Quality 3330 "C" Street Anchorage, Alaska 99503 SO[I,S l,OEl - PEI~.OI,ATION TEST Performed for ~,d/d~'~,~,,./'' /2~;~'~-~-'~- Legal DescripT--i~o}~-~-~/~-~x/~'~'9- ~;'b~Xo~' This form reports: Soils lOgr~/ Date Performed. Percolation ~est Depth Feet 1 2- 10- 13- 14 - Was ground water encountered? If yes, at what depth? Reading Date Gross Time Net Time Percolation F-a-re mi nute. -Proposed-installa~-o}l-:- --S~-6~'~ge P~tptl-~i~-o'~b-~-~?~-~zr-i)jDra~nDe t or trenchField ................... Depth of Inlet ............. · COMHENTS: Performed By :~{Z~{:iZz2.-_._~c~d.___fiert' fl ed By :. Date: gq-040 (~/74) Depth to Water Net Drop ~ MUNICIPALITY OF ANCHORAGE '~' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHD RITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY 264-4720 Application Date J¢¢'/~ GENERAL NFORMATION (a) Legal Description (include lot. block, subdivision, secuon, township, range) Location (address or direction~ (b) Applicant Name ~(~ G~O/~ Telephone: Home Bus,ness 3~ ~,~,/~' Applicant is [check one): Lending Institution []; Owner/builder iR'; Buyer []; Other [] (explain); (c) (d) Lend~ng Institubon Address Telephone (e) Real Estate Company end Agent Address Telepnone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY individual Well ~ Community [] Public [] 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,~ Public [] Community [] Holding Tank [] Note: If commumty well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 ($1/84) Page 1 of 2 ENGINEERING FIRM PROVlDIU~INSPECTIONS, TESTS, FILE SEARCH, [;~_.~ AND INFORMATIOI~I As certified by my seal affixed hereto and as of the validation date shown be'iow, I verify that my investigation of this Health Authority Approval 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 disposat system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~ ~__~.~ Address IZ~)/9 ~ Date ,"~7/'~'~, Telephone DHEP APPROVAL Approved for "~'~'"~" bedrooms by ~ Approved ~ Disapproved Terms of Conditional Approval '"'~'~""~-'"'"'% Date Conditional. CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their tending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) (~""~; MUNICIPALITY OF ANCHORAGE (M HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ANI~IOP~ CHECKLIST - FEBRUARY 1984 OEPT, OF HEALTH & 264-4720 EJ'~qlP. ONMENTAL PROTE~I'IOJ~J Legal Description: MAY 2 2 1986 WELL DATA RECEIVED Well Classification I, AJ,OLI/I ~1~/-.. If A, B, C, D.E.C. Approved (Y/N) Date Completed (.//[JK/I/~.~I./iL/ Yield Well Log Present (Y/~ Total Depth ?h ~3~' '~'Cased to ~7/o ~'1 "~Depth of Grouting /V'/~. . Static Water Level 2 ~, ~ ~(2~ Pump Set At O/~//~/~0 Casing Height Above Ground ~ ~' ! Sanitary Seal on Casing ~)'N) Electrical Wiring in Conduit (~}'N) Depressi'on Around Wellhead (Y,~ Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by 3, Water Sample Test Results ; On Adjoining Lots C~,~" / ; On Adjoining Lots j~O To Nearest Public Sewer To Nearest Sewer Service Line on Lot ;Date B. SEPTIC/HOLDING TANK DATA Date Installed ~'~Size Standpipes {~N) Air-tight Caps Depression over Tank (Y/~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /~/~ Separation Distances from Septic/Holding Tank: TO Water-Supply Well fO/ / TO Property Line ,~0 / To Water Main/Service Line /~// Course / ~15 No. of Compartments Foundation Cleanout (Y~'~ Date Last Pumped 'for /V//~' Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field 7 / To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~-//,~ Width of Field Square Feet of Absorption Area Depression over Field (Y~) Results of Last Adequacy Test Separation Distance from Absorption Field: Type of System Design Length of Field ~.~/ Depth of Field ',7~ ,,~- Gravel Bed Thickness /¢~ -~- Standpipes Present t(~N) Date of Last Adequacy Test To Water-Supply Well ¢,.~" /' To Building Foundation ~ 7 / Lot / / / To Water Main/Service Line N'/.,4 To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line ,,~) / TO Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) /'~'/,,~ Comments D. LIFT STATION Date Installed Size ia Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions ' ~1 Manhole/Access ~ "Pum~evel at ~ Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permit dt~Bedroom Rating Against HAA Request ** I certify that I h av~,.checked~eflfi~d.,pr cqrfformed to .aL MOA and HAA guidelines in effect on the date of this inspection. signed Receipt NO. '-~'i~L'~,~:D~, Date of Payment Amount: $ ~ Page 2 of 2 72-026 (11/84) unicip litYof P.O. B ~O~196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARlfMENT OF HEALTH & HUMAN SERVICES June 4, 1986 Jeffery T. Kaitchuck Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 15 Block 2 Sun~it Estates Subdivision Waiver Request - WR86-062 Dear Mr. Ka±tchuck: Your request for a waiver of the i00 foot separation distance required between a well and absorption field has been approved for the subject lot. This distance has been waived to 95 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw ALASKA -, dIRO[IIll I1TAL COFITROL SelvOICe$, II1C. RICHARD GELARDIN 5651 EAST 98TH AVENUE ANCHORAGE ALASKA 99516 SELLER-SAME 5/21/86 RICHARD GELARDIN 5651 EAST 98TH AVENUE ANCHORAGE ALASKA 99516 60218 LEGAL:SUMMIT ESTATES BLOCK 2 LOT 15 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-5/14/86 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 459 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY, THE SURGE CAPACITY OF THE SYSTEM IS 744 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 8 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 8 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 5/15/86 . THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. FLOW TEST ON WELL WELL FLOW DATE-5~14~86 AND THE STATIC WATER LEVEL WAS THE WELL IS ADEQUATE FOR THIS 8 I....~~.¢~;..~.....:.;..,~ ~f~-, ~ .~. ~L~ A FLOW TEST WAS PERFORMED ON THE WELL. 744 PUMPED AT A RATE OF 9.S GP~ OVER A DURATION OF THE DRAWDOWN WAS ~ ' WITH A RECOVERY TIME OF 28.65 FEET. BEDROOM HOME. GALLONS OF WATER WAS 1.85 HOURS, 10 MINUTES 1200 LUesl 33rd Auenuc, Suile [~,/~nchordqe, Alaska 99503 · (907) 561-50z~0 ALASKA UIROFIIlleFITAL CO[1TROL I~nqineeHn§ 6 ~nuironmenl~l $1udies InC. 20, 1986 Municipality of Anchorage Department of Health and Human Services 825 L. Street Anchorage, Alaska 99501 RE: Summit Estates Block 2, Lot 15 The above referenced lot consists of a 8-bedroom single family dwelling served with a on-site individual well and sewage disposal system. The sewer system was upgraded on May 24, 1982 and consists of a trench with 459 sq. ft. of absorption area. On May 14, 1986 we performed a health authority inspection on the subject lot and found that the closest edge of the absorption area is 95' from the well. When the upgrade was performed, it could not go west because of the old system and the neighbors well. It could not go north because they hit sewage. This was the only place to put the system without interfering with neighboring systems and wells. The ground surface from the well slopes down towards the absorption area. The water sample taken on May 14, 1986 is free of coliform bacteria. We feel that this condition will not promote a health hazard. Therefore, we request that you grant a waiver for the separation distance between the well and absorption area to 95' If you have any questions feel free to contact me at 561-5040. Sincerely, Jeffrey T. Kaitchuck Engineering Technician Approved by: 1200 LUgsl 33rd J~ugnue, 5]]Jlg [~*Anchoro§¢, J~leske 99503.(907) 551-5040 / ' /~T?'f~¢ItME/~'..~j~2- n~vo~cl~ N° 337t " 'M-W DRILLING INC. DATE ~-~/ '/~/'~4~ UNIT ANCHORAGE, ALASKA 99511 QTY. MATERIALS / LEGAL DESCffilPTION DESCRIPTION OF WORK DATES All charges shall be paid in full within ten ~ ~ prior to drilling. The custo'mer shall pay in- r ~ ~ p ..~ MATERIALS IFROM ABOVEI terest at the rate of I ~/~ % per month on any / amount not paid within ten days. Failure to pay may result in a lien against the property. ALASKA ENVIRON~'C-NTAL CONTROL SERVIC~.~, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO OF CHECKED BY 1'~ 20' SCALF ~ OATE , 37,5' UJI~LL Date Date Date . Inspector Inspector Inspector Comments ~ / ~.,L.Z~/~..~ ConditionalApproval ~ ~ .)__~-gO_-i_~) Approved Bedrooms i ( ) D sspp;'cvod (~) Cond?d3:~sl Approval Date Sewer Installed Permit Ne. ~_ ~ Septi'c T~nk Size ~ ~ Holding Tank Size Soils Rating Well TO Absorption Area ~ ~ Well Log Received Well to Tank Property Owner ~%t ~" ~ /~ /¢~ Pho~ ~/~. Buyer ~/c ~ (~ ~l ~. ~/4~ Lending Institution / :~ ~4 [¢~ .... / ~'¢'(' ¢ ~ ~ ¢' ~-~ ~ Phone Address ~ ¢~ ~ ~ ¢:' Rea[tyCo,&Agent ~.~ Ce-~ //~ /~ - ~ Phone' Address ~3o / /4~'~ ~, ~ ~ /~ //,.~ ~ ~ ~ Legal Description ~ ~ 7 ' / ~ /~ //~ ~ ~ ~ / ~ ~ r 7'~ 7~ ~ Street Location ~ Type~esidence ~ Single Family B Multiple Family No. of Bedrooms B Other Wate~ply ~ Individual A~AOH WELL LOG, A Well Icg is required for all wells drilled since June ~ Community 1975. For wells drilled prior to that date, give well depth (attach Icg if ~ Public Utility available.) Sewa~fsposal B Individual Year Individual Installed:_ ~ Public Utility When Connected to Public Utility: ~ Hofdin~ Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. :p~oldaOm uao~ @A~K smoky Du!aoiIo~ ~q9 I!~un po~u~a5 oq ~ouu~a sa!%~I~a~ ~o~e~ pu~ zo~as I~nP~A~PU~ aq~ ~o~ I~ao~ddv 566 X~a~n~ pI~uo~ 'aM ^L^$KA EnUIRO[1MEnTAL CO[1TROL SE UIC $, I~mlin¢crincl ~- ~nuironmentol Studies InC. 3/9/82 A'IUNICIPALITy OF ANCHORAG[ MELGIBBONS 88301 ARTIC BLVD ANCHORAGE AK 99502 sRr,T,RR - MURREY DONALD SUBDIVISION-SUMMIT ESTATES BUYER-RICHARD C~k~,ARDIG BLOCK-2 LOT-15 ADEQUACY TEST FOR SEWER SYST~ THE TYPE OF ABSORPTION SYSTMM IS A PIT WITH AN AREA OF 272 SQFT. THE SYSTMM IS CAPABLE OF ACCEPTING 130 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF ~tE SYSTMM IS 138 GALLONS. BASED UPON ~ TEST DATA THE SYSTMM IS NOT ACCEPTABLE FOR A HOME OF 3 B~DROOMS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3 B~DROOM HOUSE. 1000 IS ADEQUATE FOR 1220 Wesl 251h Aucnu¢ · Anchoracl¢, Alaska 99503 · (907) 276-1361 ~-~',~ , MUNICIPALITY OF ANCHORAF-~ · ;/~'~\\ ~ DEPARTM xT OF HEALTH AND ENVIRONMEi. ;\L PROTECTION ~ i,'~'~" i 82~ L Street, Anchorage, AlaSka 99501~~ ~' ~- ~t. 279-2511, ext. 224 or 225 ~ ~q~ ~' Date Received: July 18 ~1: Time ;; ~ ~2: Time ~3: Time Date ~-~1~-~7 ~ Date Date Insp ~io ~J ~ Insp Insp REQUEST FOR APPROVAL ~F INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Security Pacific Mortgage Corporation Mailing Address: 1011 East Tudor Road, Suite 190 Phone: 276-1933 2. Property Owner: Joy/Kenneth J. Ludy Phone: Mailing Address: Star Route A Box 79X 99502 274-2525/w Legal Description: Lot 15 Block 2 Summit Estates Subdivision 4: Single Fami'ly Residence: (x) Number of Bedrooms: Three Multiple Family Residence: ( ) Number of Bedrooms: ~- Well System: Permit # Construction Individual well (x) Conm]unity/Public System ( ) Depth of Well Well Log on File Bacterial Analysis ( ) Sewage Disposal System: On-site System Sx~ Public Utility Permit # Installed 1975 Installer. Septic Tank Size ~ ~ Manufacturer Absorption Area is Rate 7. Distances: Well to Sewer Line ( ) Material ~ I~,,~,, _ to Septic Tank /~~ to Absorption Area /~ Nearest Lot line Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHORAGE .... ", '~' ' '[ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [;qi~l', (;i;;;' [., r ~ ' ,~ 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 ~ ?iTl:7)i'[~,',qi II'/'.1. /./h ):flON REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO..~VA ~ 2. Property Owner: LUDY, Joy & Kenneth J. Mailing Address: SRA Box 79 X~ Anch, Ak 99502 3. Name of Buyer: FURRAY, Donald and Marj orie FHA ,;:JL, ;, - }-', 'I _CONV contact her thru Uept Day Phone.°f Parks & Red 274-2525 Mailing Address:. 409 MLm~ford #4, ~_ch, A~ 99504Day Phone:. 277-5989 4. Name of Lending Institution: S£CUR~ PACIFIC ~ORTGAG~ CO~ORATION Mailing AddreSs: 1011 ~ast Tudor Road Suite 190 Phone: 276-1933 anch. ak 99507 5. Name of Realtor or Agent: no~e Mailing Address: Phone: Legal Description: Lot 15~ Blk 2, SU~T ESTATBS S/D Location: NHN E~st 90th~ Anchorage~ Alaksa 99502 7. Type of Facility to be Inspected: Single Fmnil¥ 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility. If Individual, date of installation No. Bdrms. Individual XX ] 3 IndividUal (on-site) 72-003(3176) P.~e Two Department of Request for Approval Health and Environmental Protection of Individual Sewer and Water Facilities Legal Description: Lot 15 Block 2 Summit Estates Subdivision Comments: Affadavit Attached Approve~/%~____ D~sappro~ed:'' ' ~ Letter Attached: ( ) Date: Date: Department Worksheet: 1. Approval'requested 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 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR ~~__~_,.~z Phone: ~.~. No. of bedrooms Mailing Address: Property Owner: Mailing Address: Legal Description: Location: Type of facility to be inspected 6. Well Data: C. Construction ~~, B. Depth D. Bacterial Analysis Sewage Disposal System: A. Installed~/~-- B. Installer C. Septic Tank: 1. Size ~(~)~L 2. Manufa'cturer~,~ D. Seepage Pit: l'. Absorption Area ~-- 2. Material E. Disposal Field: Total length of lines /0 / 8. Distances: A. Well to: Septic tank/~~ , Absorption area , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank' ~ , Absorption area C. AbsorptiOn area to nearest lot line EQ-034 (1/74) Page I of two pages Page 2 of two pages - Reqd~c for Approval Legal Description of Individual Se & Water Facilities Comments Approved ~, ~J~t~ Disapproved Date ~xx~/?j / 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 r Type of Inspection: CMRO VA FHA CONV xx Property Owner: Donald B. and Virginia R. Hoffman Mailing Address: N}~N E. 90th Avenue Anchorage, Alaska Name of Buyer: Kenneth J. Ludy .99507 Day Phone None Mailing Address: 3101 Brookside Dr. DaN _ Anchorage, AlasNa Name of Lending Institution: Spokane MortgageCo. Phone 277-4513 Mailing Address: 523w. 8th AVenue Phone Anchorage, Alaska Name of Realtor or Agent: Inga sprague @ Skyway Realty 277-0543 Mailing Address: 3202 Spenard Rd. Anchorage, Alaska Phone 274-8561 6. Legal Description: Lot 15, Block 2, Summit Estates Subd. Loca ti on: NHN E. 90th Avenue, Anchorage, Alaska 7. Type of Facility to 8. Water Supply Type of Supply: If Individual, If Individual, 9. Sewage Disposal System Type of System: Public If be inspected: Public Utility number of dwellings depth of well ~ Utility Individual, date of installation Residence N o. B d r m s. 3 Individual xx presently served One Individual (on-site) xx June, 1975 EQ-037 (1/74)