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Home My WebLink AboutSUMMIT ESTATES BLK 3 LT 6 GRE rER ANCHORAGE AREA BOk, UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELl INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY__ FOUNDATION NEAREST LOT LINE DISTANCE BETWEEN LINES TRENCH WIDTH'~'~ IN. GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA "~ ~ ~ DEPTH: TOP OF TILE TO FINISH GRADE FT. LENGTH OF EACH LINE DEPTH OF FILTER TOTAL LENGTH OF LINES TOTAL EFFECTIVE IN, ABOVE TILE ~ IN, WELL: TYPE _ BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION DEPTH NEAREST NEAREST SEPTIC SEEPAGE LOT LINE SEWER LINE . TANK SYSTEM , OTHER SOURCES __ DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY:,-~ SEWER LINE DEPTH: ~ "~ I PIPE MATERIAL' REMARKS: DIAGRAM OF SYSTEM DATE G.A.A.B. PERMIT NO. --- ' "" - I T II--llUl~"-.~ ~.. L- ]~ F ~'~!__ .. DEPFIRTMEi~.~T OF HEFILTH FIND EN',,,'IRI]NMENTFIL PROTE.':TION c RNC:HCIRRGE, Ri':.'.'. DD50i '='":'~ *"L'" ...,TREET., *-,- .~,..q _ ,'1,~. , ¢.,. ...... :l.::b _,RM E,O,.., 77-C: LOT SIZE TYF'E OF SI]IL FtBSORBTION =,-r_,TEI1 Ib~ ' r* MFI::-',IMUM NUMBER OF BEDROOMS = ~ .:,LIL EHFIN~ FT.'"'BR)= THE REQUIRED --,I~:.E OF THE ..,OIL HBc, L. RFT]LN 'gb'S,TEM :t..-.._ L.. E F,l C-iT H = 24 F- e'.-~.'.." "::' L [:,EF'TH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRFtlNFIELD. THE DEPTH OF R TRENC:H OR PIT IS THE DISTFtNCE BETWEEN THE SURFFICE OF THE GROUND AND THE BOTTOM OF ]'HE E::.::C:FIVRTION (IN FEET). ]'HERE IS NO SET WIDTH FNR 'fREN_.HE=. THE GRI:F/EL. [:,EPTH IS THE MINIMUM [:,EPTH OF GRI=t\"EL E:ETWEEN THE OUTFFlLL PIPE FIND THE BOTTOM OF THE E',.*:;CFt',,¢FITION (IN FEET). F. F~ C: I-::] FI ~-3 E F'L. FIN T n]) F"-T' ][ R FRL. k.H~E, PLANT f'IRY E,E IH_THL. I-E[ RT THE F'ER, MITTEE'"S , N. __ . FOLLOW I NG F:OND I T IONS: Z. EZTHER R ~LH_,_ [ UR. ~[ N_F RPPRO'¢ED FI._HNT f,IR~ BE ZNSTRLLED, 2. R CONTINUOIJS MAINTENANCE HuREEME[~T IS REStJIRED IF R MAINTENANCE RGREEf,IENT ~S NOT KEPT CLIRRENT '¢OIJ blR¥ BE REQtJZRED TO ENI...HE-~E THE RBSORPT[ON :,¢=TEfl RND20R YOIJ MAY BE btJE,~EU] TO PRESEEUT~ON 'TI~.J F_'n ,:: 2 1:, ~1 !'-,,15 P E C:'T Z n]~t'-~S F-IF:E F;~:F] L--:.~ gl I F-:EtB, BACKFILLING OF RN'¢ SMS'f'EM WITHOUT FINRL INSPECTION RND BPPRO'v'I'~L B'¢ THIS DEPFlRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUH DISTFlNCE BETWEEN R WELL. FIND FIN'¢ ON-SITE SEWAGE DISPOSAL SMSTEM IS t00 FEET FOR R PRI',,,'RTE WELL. OR 200 FEET FOR Ft PUBLIC WELL. OTHER REQUIREMENTS I'dFI9 FIPPL'¢. SPECIFIE:FITIONS AND CONSTRUCTION [:,IFIGRRHS RRE Ft',/FIILFIBLE TO INSURE PROF'ER tNSTRL. LFITION. F"ER~'"I ~ -r E.'=-:: F' I ~-%:E--~-T. [:,EC:Ef-IBEF: 3::.~.. :i-'-B ?'-,~ I CERTIFY THFlT t: IRM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS FlS SET FORTH 89 THE MUNICIPRLIT'¢ OF ANCHORAGE. 2: I WILL INSTRL. L THE S'¢STEM IN FtCCORDRNCE WITH THE CODES. ~: I UNDERSTAND THFtT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLFtRGEMENT IF THE RESIE:,ENCE IS REMODELE[:, TO INCLUDE P1JF..E THFlN -'-. BEDROCHS. SIGNED: ...... ~~ ~ APPLICANT AL__ ,=,= ., '" . _I:Er--Z_ ................... [:,FlTE ........................... I _,_,UE[. B'¢ - - - -' ---'~'-.- -~= ............... Y2:. 0 GR~'~TER ANCHORAGE AREA BORO~/"~H i I HEALTH DEPARTMENT ~ ~ 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: MAILING ADD RESS/~/~J~ ~-'~ p H O N Ej~,;Z,.~/~ DISTANCE FROM WEL~'~ LIQUID CAPACITY /~' ~'~ GALLONS. NUMBER OF MATERIAL ~2 r-/,~-,~'~''~-- COMPARTMENTS INSIDE LENGTH / INSIDE WIDTH ~ LIQUID DEPTH__ SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH /,,,~' / LENGTH /..~ / '~ , , DEPTH DISTANCE FROM WEL ~/.~,.~z--~'.,;~ ,,) FOUNDATIO~ ~ ~ , BUILDING TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~/~ SQ, FT. TILE DRAIN FIELD: DISTANCE FROM WELl ,/ ~'"~, OUNDATION . NEAREST LOT LINE NUMBER~ DISTANCE tETWEEN LINES ~ ABSO~ION ADE T/H: TOP oFARET.LE TO FINISH GRADE SQ. F ~.~NGTH~[1 ER MAiEi;,AL~ LE ~/BENE,~' H TILE TOTAL LENGTH OF LINES ~TTTT~T~IVE IN. ABOVE TILE ~'7;~'¢'~ '~"~'~'~ ~ DISTANCE FROM ,.,,../ WATER WELL: TYPE ~'/~/"~'~?'~ , DEPTH , BUILDING EOUNDATION. SAMPLE NEAREST ~, T EPTIC / SEEPAGE ~ LOT LINE / SEWER LINE ANK , SYSTEM , CESSPOOl z..-'~, ' N EAREST OTHER SOURCES DISTANCES: DIAGRAM OE SYSTEM OAA~-HD-2 GREATE1{ ,NCHORAGE AREA i. ROUGH '~ -/ HEALTH DEI~ARTM"ENT'J 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case No. &~ SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPL,CANT 76 APPLICATION TO INSTALL: SEPTIC TANK ~ ,SEEPAGE PIT ~ ,DRAIN FIELD ,OTHER TO SERVE THE FOLLOWlUG FACILITY FINANCED THROUGH ~]~ ~ PERCOLATION TEST RESULTS ~: ~/&g~Y" ' ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ~, 7D4~ ~/~ , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNF[,TO BE SERVED ~ ~ ,~,~' ~) /~ TYPE '~ SEEPAGE AREA TYPE DIAGRAM OF SYSTEM · SE,~TIC TANK SIZE DISTANCES: ¢~, L~ H AUTHOF~ I~Y I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance ;No. 28-68 and that t? above described system is in accordance with said code. //l/~9 2'- //~/~ ~//~/fi~ ~/'~ /~:~" ~REATE~. ANCHORA~-£, AREA HEALTH D~SPARTMENT 327 EAGLE STREET ANCHORAGE~ ALASKA' 99501 CASE - " " ~1 Date Performed Performed F or_~~~_~. ~.~.. ~ Legal Descrip~~~- '~ ~dzvaszon~~c This Form Reports a: Sozls Log ' ~/_ _ .Percolat].on Tes~____ Depth Feet Soil Charae~;eristics Location Sketch Date Gross Time Net Time Depth To H20 Net Drop Reading Proposed InstalIatzon: Seepage Pzt ~ DDain Depth Of Inlet___ ~::'~i '~--1)epth To Bottom Of ~OM:4rN~.~ ~,',*'¢ ...... ' .... ') ~- ~- · ~ t. , ~ ~ "' ' Data Certified By:~fx) 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. Ct CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (s te address or directions) ~'~'5/'O -~'" Property owner Mailing address Lending agency Mailing address Agent Address Day phone ~ 7~ ~,~O Day phone Day phone 2. NUMBER OF BEDROOMS: 3, TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 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 ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 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 tlfiis 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 A~J ~)6'7/- $0~ /~,/,',)'~c:TZ, l~J6 Phone Address ~.O. ~2,~ Z5/1~'7'"2'~' /~ (~/O/t,~'e'¢- ~ Engineer's signature ~-~cC ~" ~ Date DHHS SIGNATURE ~:~_ Approved for __ Disapproved. ,~/~ bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH H S does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA ~21 , (~ Municipality of Anchorage · I Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ['O''r~ ~1 B/.o (_~'~..~) ~'~ ~ rr" ~'/~a~l I.D. A. WELL DATA Welltype/~,lDl~;~)d~L- IfA, B, orC, attach ADEC letter. ADEC water system number Log present (Y/N) ~J Date completed /~]'7~) ~ Driller Totaldepth '7~ ~ ~ Cased to ~' ~ ~ Casing height Sanitary seal (Y/N) t/ Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG AT INSPECTION ! g.p.m. Absorption field on lot Public sewer main Public sewer service line SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 7~"~ /o~ I.I ,a Jc~O u.~ .d Y ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank ~/A ! ,/Z$'" + WATER SAMPLE RESULTS: Coliform O Date of sample: '7/I Z./~/ Nitrate /V~/.,,//. Other bacteria Collected by: /~C/~J /~,~ B. SEPTIC/HOLDING TANK D~TA D ate i n st aii ed ~/~ "///~] '~O Cleanouts (Y/N) Y High water alarm (Y/N) Date of pumping Tank size /~g) 0 ~ ~_~ZI4.~ Compartments Foundation cleanout (Y/N) "J Depression (Y/N) /k~ / ~ Alarm tested (Y/N) /~/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (s) on lot '?~ j On adjacent lots /~-5~'1 ''j- Foundation To property line Surface water/drainage Absorption field /5-0~ Water main/service line 72-0~6 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer _ Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA ~ #/~' I - 'z.. DateinstaHed /"]YCV,'°/,zZ4~)e3) ~')'~?? _Soilrati,pg ZS FT;/~,,~VLSystemtypo ~:"W'T~'c44 Length ~i~ ~ Width Grave thickness ~ z/~tTota depth Total absorption area Depression 0~er field (Y/N) /%/ Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Cleanouts present (Y/N) Date of adequacy test for .~ if yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /~)~) / To building foundation On adjacent lots ,I~ lA Surface water /J/~ Curtain drain /~J/A I On adjacent lots '~" "¢" Property line .~1 To existing or abandoned system on lot Cutbank "~/~ 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, ir~ effect of this inspection. Engineer'sName I~IC¢'I,ZI~-L, I~' ~j~O;~ °ate HAA Fee $ Date of Payment Reoeipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS REPORT BY SAMPLE fox WORRoxder~ 36145 Date Repozt Printed: SUL 15 91 @ 17:06 Client Sample ID:G. BUSSE L6 B3 SUI4~IT ESTATES PNSID :UA Collected dUL 12 91 @ 13:00 h~s. Received dUL 12 91 ~ 17:30 h~s. P~ese~ved with :AS REQUIRED Client Name :ROCKFORD CORP Client Aeot :ROC~OR BPO t PO ~ NONE RECEIVED Req t Ordered By :MICHAEL E ANDERSON Ahalysis Completed :JUL 1E 91 Send Reports to: Laboratory Supe~vi}or. :~EPHEN C. EDE i)ROCKFORD CORP Released By :~ Chemlab Ref {: 913373 Lab Smpl ID: 1 Matrix: WATER Allowable Para~ete[ Tested Result Units Method Liraits NITRATE-N 2.4 rng/I EPA 353.2 lO Sample ROUTINE SA}dPLE COLLECTED BY: A. HARDE, ~ITNESSED BY G, BUSSEY. ge~a~ks: 1 Tests Performed ' See Special Instructions Above UA=Unavailable ND- None Detected ~' See Sample Remarks Above NA- Not Analyzed LT~Less Than, GT-Greater Than ~.~ S~S Member of the SGS Group (Socidtd G~ndrale de Surveillance) __. ~* ,. APPLIC~ ~JT FILLS OUT UPPER HAL~:ONLY Realty Co. & Agent Legal Type of Resi~nce ~'~-al}?-%~ ~~ A~ACH WELL LOG. A w~l Icg is required for all wells drilled since June 1975. Sewer Disposal ual Year Individual Installed:. Time Time Time Time Date Date Date Date~ -~ Inspector Inspector Inspector Insp~tor MUNICIpALI~ OF ANCHO~G~ DEPT. O~ H~ALTH FCEIVED (~ ) APPHOVED BEOHOOMS 'GONDITION8 OF APD~OVAL ( ) OISAPmOVED Soils Rating Date ~wer Installed Well TO Absorption Area Well LO0 Received ~-q% ~...] ) Well to Tank Septic T~k Size ALASKA tzHUIROnmenTAL CONTROL set,dices, InC. ~n§i~eeri,9 ~, ~nuiro~m~ntul $1u~lies JUNE 17 1983 FRONTIER MORTGAGE/ATTN SUE 4497 BUSINESS PARK BLVD ANCHORAGE AK 99507 SELLER - BUDDY SMITH BUYER-GARY A BUSSE SUBDIVISION-SUMMIT ESTATES BLOCK-3 LOT-6 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT/TRENCH WITH AN AREA OF 512 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 720 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 292 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. The upgrade on this system done in 1977 appears to be slightly higher than the normal level in the crib by a difference of approximately 0.5 feet. Once the system reached the level, additional water was added to fill the field. At thi~ point the system adequacy was established. It is recommended that the old crib be treated with Hydrogen Peroxide sometime in the near future to reestablish it's original or near original drainage characteristics. This would reduce the dependency on the upgraded t~r,~d reduce the high water levels in the septic tank. ~.~ OF ~'~ ~..'"'~"..7~. 12oo Wcs133rtl Au~nue, Suite B · Anchoruge, Alusk~ 99503 · {907/ 276-1361 Nay 9, 1983 Buddy G. and Nancy Diane Smith 5540 E. 98th Anchorage~ Ak .~9507 Subject~ Lot 6, Block 3, Summit Estates Approval for the individual sewer and water facilities cannot be granted until the following items have been completed~ ~£he top of the well casing should be sealed so that it is water tight. The water analysis z:eport needs to be subn~itted to this office from the Chem Lab, 5633 B Street, for our review. %'he septic tank pumped with a receipt submitted to this department o o An adequacy test needs to be performed on the existing leaching area. This test will determine i~ the system is adequate according to National Standards. A listing of private firias performing the test is enclosed. '].'his report needs to be submitted to this office [or our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions~ please call this office at 264-4720. Sincerely, Enclosure RP33/ej/E1 Robert C. Pratt Associate Lnvlronmenta TIME TIME~ M]''E / DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE N AL PROTECT DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVlRONME T ~iRONMENTAL PEOTECTION L Street Anchorage, Alaska 99501 825 ENVIRONMENTALSANITATION DIVISION ! 9 i981 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~I-~I-F~I ~-'~Lt['~ DIRECTIONS: Complete all parts oil page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE PHONE MAILING ADDRESS 4. REALTOR/AGENT ~ I PHONE MAILING ADDRESS STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OFtBEDROOMS [] One [] Four ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other__ 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY 8. SEWAGE DISPOSAL SYSTEM J~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach log if available.) ~,~,~ ~_)E,.A~R,~O ,}/%~E ~'~,~,~,:¢WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY ' ' 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE E~""~TH R E E [] FIVE [] OTHER [~MU LTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY ~INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED AGE DISPOSAL SYSTEM PERMIT NUMBER VI DUAL/ON -SITE DATE INSTALLED ~IPUBLIC UTILITY Connection Verified EZ]Septic Tank or E~] Holding Tank J Size: /./~¢.,)~:2 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding<~//O~.~ ~ Tank Absorption? ~¢~¢Area ,* Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~;]"~P R OV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accornpany/certi~ficate) [] DISAPPROVED DATE BY ~.~/~._ 72-010 (Rev, 6/79) 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT O1'- HEALTH AND ENVIRONMENTAL PROTECTION June 23, 1981 Ross A./Jill M. Fosberg Star Route A Box 77C Anchorage, Alaska 99507 Subject: Lot 6 Block 3 Summit Estates Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis'report needs to be submitted to this office from the, Chem Lab, 5633 B Street, for our review. (2) The septic tank pumped wi~h a receipt submitted to this office. If there are any further questions, please call this office at 264-4720. Sincerely, James S. Roberts Environmental Speciaolist JSR/ljw cc: Home Federal Savings and Loan 535 D ,Street 99501 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received ~ Time of Inspection 1. Approval requested by: Date of Inspection Mailing Address: 2. Property Owner: ~ 3. Legal uescrlp~lon!~~ 4. Location: ~..~0'~ 5. Type of facility to be inspected REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR / - Phone: Phone: NO. of bedrooms o Well Data: A. lype~~ ,~-~L./-~L..~), B. Depth C. Construction Sewage Disposal System: D. Bacterial Analysis A. Installed C. Septic Tank: 1. D. Seepage Pit: 1. E. Disposal B. Installer ~/q~' Size L~(~ 2. Manufacturer ~'~ Absorption AreaJ~'/~ 2. Material Field:Total length of lines o Distances: A. Well to: Septic tank ~) · , Absorption area , Sewer Lines Nearest lot line B. Foundation to septic tank , Other contamination /~! , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages ' .~r & Water Facilities Page' 2 of two pages - Re st for Approval of Individual ~., LegaT Description ff~ ~ ~/~ ~~ Comments Approved /z~c~F~.c~ ~'-~}-~--~-~.t-' Disapproved Date 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)