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HomeMy WebLinkAboutNORTH WOODS UNIT 4 BLK 18 LT 8Permit No. Page 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 345-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 8, BLK. 18, NORTHWOODS UNIT 4 PID No.: 05106438 of 2 SWING TIES A, B C E I es.4' 44.4'1 7 C 9 LOT 8 J)<~ -- WATER I<EYBOX ~;~ - DIVERTER VALVE: [] - TEST HOLE · - MONrfOR TUBE o - SEWER CLEAN OUT + - WELL PROPOSED LEACH FIELD ,-- EXISTIN(~ LEACH FIELD ~ -- DRIVEWAY ~ FRDNT ENTRY DECK SV CORNER ~ A$SUHE9 ELEV · 100.00' ELEVATIDNS (NDT TD SCALE) /DIVERSION VALVE I",,,,',,.; U,,"-.,' · '~8t.6' TE~T 75.0' TRACT A-1-A 9E.O' 12/28/O,5 MUNICIPALITY OF ANCHORAGE Deve/opment Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 27, 2003 Expiration Date: Oct 26, 2004 Permit Number: SW030462 Legal Description~..NORTH .WOOD~;UNIT~4;BEK-18'LT-8~7 Design Engineer: 0848 Eagle River Engineering Services Owner Name: Charles & Lauri Chambers Owner Address: 23436 Blue Skies Drive CHUGIAK, AK 99567-2391 Parcel ID: 051-064-38 Site Address: 023436 BLUE SKIES DR Lot Size: 28123 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank F-1 Holding Tank I~1 Privy I---I Private Well F-I Water Storage All construction must 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~~[' ~'~ ~,~~J Issued By: ~(~~~ ~ Date:/~.,)/2 7/O..~ ! , '09/03/03 11:27 FAX 907~438437 ~0A LAN~. USE ENFORCE~ENT Municipality of Anch.orhge Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bmgaw St. P.O. Box 1966§0 Anchorage, AK 99519-6650'. www.ci.anchorage;ak.us. , (907) 343-7g04 ON-SITE SEWER/WELL PERMIT APPLIC/~TION FOR a SINGLE FAMILY DWELLING ~OOl Parcel I.D.. Permit Number,SW 0~0~ ~- Propertyowner(s) d.~/t~/.~$ ,~'/--4h~.F- .C~A-rnk~e-'~---~ Dayphone Mailing address (1) 'Z"5~'3 ~ GL~/z- s./c~-&-F. ~.To(="' . Mailing address (2)_ Ct-~[-~ ~F' ' ~ Zip Code Legal description (Lot, Block & Sub'd.)~~~(~ ~ ~ I ~ Legal description (Section, Township & Range) '7_ ~ I ?~ . AcresS~,~ Lot Size THIS APPLICATION IS FOR: Sewer Only ~ .Sewer and Well [~] Sewer Upgrade ~- THIS PROPERTY CONTAINs: Hot Tub I"'1 Swimming Pool F-I. Therapy Pool l'-I Number of Bedrooms Well Only. r'] Water Storage i-'l Jacuzzi [] Water Softening Unit r-I i certify that the above Information Is ~rrect. I further certify that this application Is being made for a $ing~ ~m~ls~D/~w~ng a~ is In acc°rdance with applicabl, e MunicilSal Codes. ($1flnature of property owner or authorized agent) Permit Fees: Waiver Fees:, Receipt Number: ~ 4¢ ~~ ,ecelp, Numbe~: (Re~. t ~00) . Eagle River Engineering Services Louis Butera, P.E. Christot, her R. Wood, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax October 23, 2003 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re.' Northwoods #4, L8, B18 Narrative & Permit Application Dear Mr. Cross: The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are all connected to city water, or are undeveloped, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance, and no private wells within 200'. 3. This permit is for replacement of the septic tank and leachfield system. 4. Drainage will not be affected and is not a major consideration in our design. The existing leachfield will be kept online with the use of a Bull Run diverter valve. This work will not affect the reserve septic areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerel~/ //.~/) // Christoplf6fl~. Wood, P.E./ Senior Engineer L2003\03 -054 S £Fr~cNARP, ATIW.DOC Eagle River Engineering Services Louis Butera, P.E. Christopher R. Wood, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM - MOA CERTIFIED INSTALLER LEGAL: Norihwoods ~4, L8 BI8 October 23, 2003 A. GENERAL 1. The replacement septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. Ail excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. Any remaining open test hole excavations shall be filled and monitor tube removed. SEPTIC TANK The existing sewer piping from the house to the tank shall be utilized. New Septic Tank shall be a minimum of 1,000 gallon tank of MOA approved construction, insulated, or place with 4' of soil cover, min. TRENCH The trench is to follow the naturaliand contour to maintain uniform total depth of the trench bottom. The bottom of the trench shall be level, plus or minus 1.5", and shall be located no deeper than 11' below top of original ground surface. The existing trench shall be connected to the new system with a Bull-Run type diversion valve. The trench gravel shall be covered with typar fabric material. Natural soil shall be placed over the trench to a minimum depth of 3, or 2" ofinsulation and 2' ofsoil. The area over the trench is to be mounded, or finish graded to prevent ponding of surface water runoff. Care shall be taken to ensure that the required fill depth is maintained over the entire trench. The septic tank and leaehfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well, and is the Contractor's responsibility to verify. B. 1. 2. Co 4. 5. 6. m RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = (NTE) 11' GRAVEL DEPTH = 7' under pipe, 2" over pipe TRENCH LENGTH = 54' TRENCH WIDTH = 3' SOIL RATING = 0.6 GPD/ft2 BEDROOM CAPACITY = 3 SEPTIC TANK = 1000 Gal. Twenty-four (24) hours notice required for all inspections. ~2003\03-054Trench- spec.doc LO~ 7 o ~C~ ,~ . .:' ~ .~ ' ~ . ,~ . ~ ~ ~ . · 0 ~. · ~ ~ ..~ ~ · ' .- ~ · . p · N~ [~m~ Of r~olh~ lh~ ~,~ mown~d~d ~=1 ~r~.ml · . I~ ~. Anc~omg~ ~cc~lng Ol~l~lcl~ AI.,~.~ .nd Ih~l Iht Improvtm~nl, ,llu~l~d Ih~ ~opar~ IIn~, and ~onol ow~l.~ or ~ncroach on Ihi ~m~I~ I~ln~ ad]oc~nl Ih.l ne Imp~ov~mlnll on lh~ prop~rl~ Illng o~].C~nl ~w~llo. and Ih.l Ih~r~ afl no ro.dw.~, Ir~n~ml~Iion IIn~l O~lid al Anchoro~, AIo~o, Ihl~ ~Ho _da~ of._ ~. 19~ , ,'~ eYI IIo. I O~,,,r C ,~'...4 /'.'1'8 £ /( $ dob n~. ~. /7~ ~ Book no. Drowh ~ C.~, Checked Stall /~.~' ClI~ gr!d N~Z Survey Illll ALASKA TECH Anchoraqe, Alaska 9~J501 .._ ,.~ ~. ~7~: EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 03-054 Calculated By: CW Date: 10/23/2003 Legal: Northwoods ~ L 8 B 18 Single Family 3 Bedroom Dwelling TEST HOLE 1 Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = Pemolation rate = Wastewater application rate = Required absorption area = Trench width (W) = Grovel depth (D) = 450 gallons 16 minutes per inch 0.6 gallons per day per square foot 750 square feet 3 feet 7 feet Required length = Required absorption area / 2 / D Required length = 750 / 2 Required length = 54 feet Total Excavation Depth = 10.5 feet / 7 03-054_Cal.xls 8:30 PM10/23/2003 PER.ORMED FOR:'E SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION:, N'O~'~ {/.Joo~5 J:t'~ (, ¢(, , ~[do TownshiP, Range, Section: 6 7 8 9 10 '11 12 13 14 15 16 17 18 1 3 4 :' SLOPE SITE PLAN WAS GROUND WATER DEPTH? Deplh Io Waler Aller lilonllorlng7 ENCOUNTERED? ,AJO =i I I I · ,,,~./.o/~¢~ I I I I/I I I I I I Reading I Date Gross Time Net Depth to Net Time Water Drop 19 20 PERCOLATION RATE ] ~) {minutes/inch) PERC HOLE DIAMETER ' TEST RUN BETWEEN ~ FTAND , 7 FT COMMENTS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT dN THIS DATE. DATE: ' //~ ~ -.3- '? -- ~, ~ 72,,.008 (Rev. 4/85)  / "~, 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 IP_HDNE I MAILING ADDRESS ~1 . , ~bsorotion aroa . D~ollin~ ~fi~MIT ~0. ~ Z Manufacturer ~ Material ~ of compartments Liq. capacity in gallons Inside length Width Liquid depth /~ ~ IF HOMEMADE: ~ ~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO, O Z ~ Manufacturer Material Liquid capacity in gallons Well_ ~ . Foundation Nearest lot line / PERMIT NO. ~% DISTANCE TO: ~ t~ ~ ~ /~ ~. ~ ~ Z No, of lines Length of each lin~ Total length of lines / Trench wid~h¢ DistanCe ~e~een lines' ~-- ~~ ~/' 0 / 7~ ~ inches ~ ~ Top of ti~e to fini grade Material beneath the PIPE MATERIALS SOl L TEST R~G ~. ~..~. · · -~,,,..~, ~,~ ?~ ~o. 2225-E 72-013 (Rev. 3/78) HA~ANN CONSTRUCTION CO., INC, P.O. Box 617 Eagle River, Alaska 995?7 Oct. 6, 1983 Cory Willis Municipality of Anchorage Pouch 6-650 Aachorage, Alaska Dear Mr. Willis: MUNICIPALITY OF ANCHORA(~E ~EPT. OF HEALTH & I::NVIRONM~NTAL PROTFcTION RECEIVED Referring to your letter dated October 3, 1983. The subject septic installations for Lbt 6, Block 1, Hamann Subdivision #~, and Lot 8, Block 18, Northwood Phase #4. The above lots were installed with a berm over the septic drainfield, thus raising the finished grade to a point 1½ feet above the existing grade at the time of the soils log for lot 6, Hamann Subdivision; and 1 foot above the existing grade at time of soils log for Lot 8, Northwood Phase #4. This effectively raises the level of the trench and drainfield to accepted Municipal limits. If there is any further question, please contact my engineer, Tobben Spurkland, who has been in contact with your office on this matter. Sincerely, Robert J. 'H~mann Hamann Construction Co,, Inc. October 3, t9~3 tiamman Cons~raction P, O. Box 617 Eagle River, AK 99577 Lot 6~ Block i, Ha~ruaaa Subdivision ,~]. Lot 8, Block 18, ~orthwooa P~ase ~4 This departraent is unable to accept the submitted as-buiits for the above on-site installations. Lot 6 is only 4.5 feet above bedrock while Lot 8 shows tile trench to ~oe 1 foot deeper than the soils test allows. If you have any further questions please call the emjlneen', or ti%is depart~uent. Progra..'a 'i'o[~be n Spurkland 293 ,,,~. 15til Aveilue hnchorage, Ar{ 99501 I MUNICIPALITY OF ANCHORAGE Department/~'f Health and EnvironmentaT~rotection - 825 Street, Anchorage, AK. ~9501F~ .- · 264'4720 Applicant: ~ Mailing Address: hocation: Phone/Number: I~egal Description: ~ _~ ~/~f~' ~~~t Size:_ _ T~pe of Soil Absorption System Is: Trench: Drainfield:~7 Seepage Bed: Holding Tank:~ Maximum Number of Bedrooms: Soil Rating(sq.ft/br) ~/~ The Required Size of the Soil Absorption System Is:' DEPTH 0~l LENGTH __~l GRAVEL DEPTH ,,.~' WIDTH ~'-- The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HUt'DTNG) TANK SIZE TM f~OO GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number or,residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is~ 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days Of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 $ 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is re modeled to inc'lude more t~edroo~/ ~ Signed: ~ ~/~-~ .... ~/ Issued by: Applicant Date: SWP/024 (1/81) 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 PERFORMED FOR: LEGAL DESCRIPTION:, 1 2 ~ 3 4 5 6 -- 8 9 10 11 12 13 14 15 164 17 18 19 20- DATE PERFORMED: SITE PLAN SLOPE COMMENTS WAS GROUND WATER S ENCOUNTERED? ~/O L O P IF YES, AT WHAT E DEPTH? ReadingDate Gross Net Depth to Net Time Time Water Drop / //..,,..,,- /,,.,,,,,et,,./,, ~ " /Ave .,,,,.,,., ~-,/5, .. Z " // ,z'r, " PERCOLATION RATE / ~ (minutes/inch) TEST RUN BETWEEN '~ FT AND ~ 4 FT PERFORMED ~Y: /. ~1, ~ CERTIFIED BY: T~,~ DATE: 72-008 (6/79) 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 1. GENERAL INFORMATION Complete legal description Location (site address or directions) ,¢~'~,~&~ '/~z¢~ -~z,,,-~~ _/'~/~- Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent Address Unless otherwise requested; HAA will be held for pickup. NUMBER OF BEDROOMS: --~ ''~ TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer 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 #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. David R. Dayton P.E. Name of Firm ~.~'.0 D~..-.=!=r ?.. Chugiak, Alaska 99567 Address ~ ~ ~ Engineer's signature ~/./~'/~ ~' DHHS SIGNATURE Approved for Disapproved. Conditional approval for Phone bedrooms. bedrooms, with the following stipulations: Additional Comments 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 DH HS 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 ¢0nduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the p?ofessional engineer's work. 72-025(Ray. I/gl) Back MOA#21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST IAF~B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height A. Well Data Well type ~/~,~/Ct Log present (Y/N) Total depth Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line Wires properly protected (Y/N) AT INSPECTION g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~/~ Cleanouts (Y/N) ~/ High water alarm (Y/N) Date of pumping Tank size ./~ Compartments Foundation cleanout (Y/N) "// Depression (Y/N) /f--//~- Alarm tested (Y/N) ,o/'~'/~'/ / / ,/~//5'?~/ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Surface water/drainage On adjacent lots ,'u'/~ Foundation / Absorption field /O Water main/service line (oo~ 72-020 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION 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 Length 7~;;) Total absorption area Date of adequacy test Width Soil rating (GPD/Ft2) ~.2. -5'~-~J,~~Z--- System type Cleanout present (Y/N) Results (pass/fail) Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Gravel thickness ¥ Total depth ~ Depression over field (Y/N) for --~ Bedrooms After test ~-'c~.~/~ _*~'~ ~- If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water / Curtain drain On adjacent lots /v//~ Property line /~'~ To existing or abandoned system on lot Cutbank /.~,~/' Water main/service line /~f 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 ?//~///'~/ HAA Fee $ I::)avJd R. Dayton P.E. 20210 Do-~!~.. 5;~. Chugtak, Alaska 9956? Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number D. R. DAYTON, P.E., R.L.S. ~ Chugiak, Alaska 99567 20210 Donalar (9O7) 696-2417 April 9, 1994 ADEQUACY TEST Legal Description: Lot 8, Blk 18, Northwoods Subd. Addn #4 Date of Test: April 7, 1994 Septic Tank: 1,000 gallon, 2 comparhnent, steel tank Absorption System: 70' long x 4' wide x 6'deep trench Soils Rating: 212 sq ft. per bedroom Requirements: 3 BR - 450 gallons per day (DHH~ Records) (DHHS Records) (DHHS Records) Test: Water was pumped into the trench while measuring volume, time and water levelrise. After the pumping was stopped, the water level drop was measured at regular intervals. The results were PlOtted on a graph of t~me and gallons absorbed and extrapolated to 24 hrs. Results: . The system is currently functioning adequately for a 3 BR home. There was 58" of water standing in the leachfield at the time of the test on 4/7/94. This indicates that 80% of the leachfield may be surcharged and therefore the remaining life of ~e leachfield may be limoted. APPLIC"~IT FILLS OUT UPPER HAL~%ONLY Property O~n~ /'~'/~x' ~ // Phone Phone Address ¢2 /'c;,, Zip Code / 2 w' ,"¢ Phone Type of Residence ¢ingle Family Multiple Family No. of Bedrooms ~ Other Water Supply ~ Individual A~ACH WELL LOG. A w~l Icg is required for all w~ls drilled since June 1975. ~.~ommunity For wells drilled prior to that date, give well depth (attach Icg if available), ~ Public Utility Sewer Disposal / ~lndividual Year Individual Installed: ~Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Datelo-"'7 Inspector Inspector Inspector Inspector Field Notes: NO ~ j'¢:> r MUNICIPALITY OF ANCHORAGE -.~ DEPT. OF HEALTH ENVIRONM2NTAL PP.O~CnON ~., ., OCT _' : RECEIVED ( '~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE ~'~,,Ta ~' / ~ ~ 3 Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ?-tq-¢3 Well to Tank Septic T~k Size 72-023 (3182) Octob~.~r 10, 1983 Chambers Construction 403 ~'-~. 'iTM Anchorage, ~%laska 99503 SubDect: Lot 8~ Slock 18 Northwoods Phase iV Approval ~or the individual sewer and water facilities cannot be granted until tile ~otiowing items nave be~n completed~ o The permit for the installation ot the on-site sewer system will expire Dece~ber 3t, 19S3. We have not received the as-builts o~ the installation in this o~iice. If a private engineer inspected the syste~'~ please send us the report for our files and review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any ~urther questions, please call this office at 264-4720. [~incereiy~ Cory Willis cw67/E2/s