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Home My WebLink AboutPETERS CREEK BLK 4 LT 7 oGRE/ ANCHORAGE AREA BO~ Department of Environmental Quality 3330 C Street Anchorage, Alaska gg503 H INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE INSIDE LENGTH INSIDE WIDTH NUMBER OF MATERIAL ~/~ COMPARTMENTS ~'~ LIQUID DEPTH .LIQUID CAPACITY /l~i~ GALLONS. SEEPAGE PIT: NUMBER OF PITS [ . DIAMETER /¢'~OR WIDTH LINING MATERIAL L0(~ CRIB SIZE: DIAMETER ~" BUILDING FOUNDATION ~-~1, NEAREST LOT LINE ADDITIONAL ABSORPTION LENGTH /,,~ I, DEPTH ~ ! DEPTH ('at DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. WELL: BUILDING NEAREST ~--~ NEAREST FOUNDATION ~'L{I LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE , TANK [' , SYSTEM /t¢)~ DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: LOT SLOPE: REMARKS: :orm No. EQ-031 DATE t ¢/'~ /''1'-..~ APPROV ~'' ~ '~ / G.A.A.B. GreaTEr ANCHORAGE Area BOrOUgh D£PARTMENT OF i:'NVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPT,ON ~J~ INSTALLATION OF: SEPTIC TANK TYPe AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH ~ SOIL TEST RESULTS COMPLETION DATE ANTICIPATED PERMIT NO. SEEPAGE PIT ! ! TO BE INSTALLED BY SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT MA,L'NG ADDRESS PHONE ~ DRAIN FIELD OTHER NOTE: THIS PERMIT I$ NOT VALID WITHOUT SOIL TEST 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. DIAGRAM OF SYSTEM SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK / FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALl SEPTIC TANK TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD , DRAIN FIELD , SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, , SEEPAGE PiT TO RIVER, LAKE, STREAM. SEEPAGE PIT /~/' ~ DRAIN FIELD 4~CCAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAge PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUG~,I;I-~GULATIONS REGARDING INSTALLATION. LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF ~/~r"'A"~'R~-'~'C~RAGE AREA~OROUG~ ORDINanCE NO. 28-68 AND THAT TH~ ABOV~ FORM N~Q-01 ~ ~ PERMIT NO. MU~ I C I ~ r~_ I Ty CmF A~CHLaRAGE DEPARTMENT 'iEALTH AND ENVIRONMENTAL ~tTECTION 825 'L- STREET, ANCHORAGE, AK. 9.s.,~.~ 264-4720 I..-IELL PERM I T 780408 ) APPLICANT LOCATION LEGAL MIKE GAVIN C?O SULLIVAN L7 B4 PETERS CREEK SUBD P. O. BOX 197 EAGLE RIVER AK 694-2588 LOT SIZE i0500 SQUARE FEET 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 R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS 8RE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS 8ND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXP I RES DECEMBER -~l.. iL:~78 I CERTIFY THAT i: 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 THE CODES. APPLICANT MIKE GAVIN C?O SULLIVAN ......... ,,,,_______________.' ~--' ~: :. V~. 2 A & 1, DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE694-2588 OWNER OF LAND ,;-~T//~.t; ~'/?,~ / ,O ADDRESS LEGAL DESCRIPT[ON ~£ 7 ,5<t' q DATE-Started ~/*/'r jr Ended PERMIT NUMBER '7,t?'0 <~.0 ~ DEPTH OF WELL STATIC LEVEL OF WATER FT. ~ODRAW DOWN FT, GALS. PER HR KIND OF CASING KIND OF FORMATION: From D Ft. to f Ft. O a~.~ ~dR.~<.~po From From [ Ft. to .)-" Ft. ff~,,~ o ~ ~ Cz..~ /~d~ From~ From ~ ..... Ft. to ~ ~. Ft, -~,O ~'~ o ~ q /~,>o~-~V~-fFrom~ '~ '~[ From From Ft. to Ft. c'_ ~:~ From ?~:~ Ft. to .47t~ Ft. ~'~ From From >C Ft. to ~'~-' Ft. (~Le*~ s~' gR~.,<~ From From ~5-''' Ft. to ~G Ft. From 4~ Ft. to c~' Ft. From c/g Ft. to t~& Ft. From /<,), Ft. to !~ ~ Ft._ From Ft. to__Ft. From Ft. to Ft. From Ft. to Ft From Ft. to Ft From~Ft. to Ft. From__Ft. to Ft. From Ft. to Ft From__ From ~ From From From From From From From From__ Ft. to Ft. Ft. to_ Ft. Ft. to Ft Ft. to__Ft _Ft. to__Ft __Ft. to Ft. Ft. to Ft. Ft. to__Ft __Ft. to Ft. Ft. to Ft. Ft. to Ft, Ft. to Ft, Ft. to Ft, Ft. to Ft, __Ft. to Ft. __Ft. to Ft. Ft. to Ft MISCL. INFORMATION: DRILLER'S NAME 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 ,. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # OS/- iis 1. GENERAL INFORMATION Complete legal description Lot 7; HAA # B£o cE 4; Creek S~bdivision Location (site address or directions) Property owner Mailing, address 25251 Glenn Court Ch~iak~ AK Ken Vernon C/O G~eatland Realty Day phone 11411 Old Glenn Hwy Ea~le River, AK 99577 694-9125 t Lending agency Mailing address Day phone Agent Kathy Gcr~ci/ GREATLAND REALTy Address 11411 Old Glenn Hwq. Eagle River, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 2 TYPE OF WATER SUPPLY: NOTE: Day phone 694-91 99577 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. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: XXX Individual on-site Holding tank Community on-site 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. Name of Firm Address Phone Date / 2. //( / ~,~ DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: 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 federal and state requirements. Employees of DHH$ 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.O25(Rev. 1/91) Back MOA#21 . Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~ '~ ¢'~.Y-- ~ ~-r~_.~._~ d_.~, Parcel I.D. A. Well Data Well type ~ 0 ~ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height __ Wires properly protected FROM WELL LOG Nitrate 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 lin~/J WATfiR~E RESULTS: Date of sample: g.p.m. AT INS ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts {~N) ~ High water alarm (Y~ Date of pumping Tank size ~ c~ c,o Compartments Foundation cleanout (Y~i) ~'~ Depression (Y~ Alarm tested (Y/N) ~/A ~-L,,, ~ ~ Pumper ,.3~_ ~ ~ ~-~-~o L~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ A On adjacent lots To property line ~ 0 ~'~ Absorption field Surface water/drainage '~ o 0 Foundation Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Manufacturer Manhole/Access (Y/N) ~_,.,-- Vent (Y/N) "Pump on" level at "~ at High water alarm level _ ~ Meets MOA electrical codes (Y/N) ~ ~EP~FT STATION TO: WeFon lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length / ?---~ Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot Soil rating (GPD/Ft2) L)I~.--- Width \ '7~ ~ G ravel thickness '7--~, ~ ~' Cleanout present (~N) ¢ Results (12~ail) ~-'5 To building foundation On adjacent lots .~ Surface water Curtain drain System type /_¢ Total depth Depression over field (Y~ for '7_.- Bedrooms After test If yes, give date "-[ On adjacent lots \ ~ ~4- Property line To existing or abandoned system on lot Cutbank ~ LA 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 effe~ ~te of this inspection. Signature Engineer's Name Date / Receipt Number 72-026 (3/93)* Back Date of Payment 7 Waiver Fee $ Date of Payment Receipt Number 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 I t~''~ Z.. ~ HAA # GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Day phone c;1 ~.~ r..-"l \ \ I,' \ Lending agency Day phone Mailing address Agent L~_, ~'¢~,~+~ Day phone Address 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: 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. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 fRev 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 ~'o~',~Jr'""~Jm~ ~-r~q,~z~-~ Phone ~ro'L~//.O~--9°9~ Aooress ~ ~i - ngineer's s gn ture /-/- ~ DHHS' SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. 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 DHHS 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 L( We Log ~, Tota ~ Sani .~,~ Date o' ~ Static ~.~ Well .~ Pump i/~'/~d~ SEPARA-I ~ Soptic/hoh ~ ~bsorption Public of Anchorage h & Human Services PPROVAL CHECKLIST Parcel I.D. O~jI- liT'-7-5- ADEC water system number Driller Casing height · operly protected (Y/N) ,// AT / g.p.m...~ ~ n adjacent lots ~ ~diacont lots Sewer servic6 B. sD~PLI:;N~ ,AN-~ D---ATA Date installed ~o [¥/'~ '~ Cleanouts (Y/N) '"1/ (,.I) High water alarm (Y/N) Date of pumping -p ~<.. ~,o~ ..... , [nanhole/cleanout Petroleum tank Nitrate Other bacteria C~ Collected by: Tank size ~ (:,oO Compartments 7_, Foundation cleanout (Y/N) t,J Depression (Y/N) ~'/~ Alarm tested (Y/N) ~9~ Pumper ~--F-~5 ~P~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ R To property line Z.o ' Surface water/drainage On adjacent lots 4--too' Foundation Absorption field '7,.~ ' ~o.-~o..~Water main/service line "t- I-¢O O ~ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/~~_ Vent (Y/N) "Pump on" lev.el ~ / "Pump off" level at High water alarm level ~) / Cycles tested Meets MOA electrical SEPARATI~CE FROM LIFT STATION TO: Well~c~t~ On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed t o I'~ I'~ 3 Length I 7_.' Width I 'z_' Total absorption area "z_~'8 ~ Depression over field (Y/N) Results (pass/fail) 'P~'~ Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water ,~ ~ OO' Curtain drain Soil rating I=IL~ ¢)~.-I $~)~..5 'mSTSystem type Gravel thickness Cleanouts present (Y/N) Date of adequacy test for ~-- If yes, give date On adjacent lots,,, ~[qb' Property line., To existing or abandoned system on lot Cutbank Water main/service line Driveway, parking/vehicle storage area bedrooms .~ 50' lO' E. ENGINEER'S CERTIFICATION I certify that I ha ve checked, verified, or conformed to all MOA and HAA guidelines in effect on the of this inspection. ;~,/~'~2~~ "'..7~' Signature ~, ~ ~. ~ ~ Engineer's Name ~~ ~~ ~,.~Z.., · Date /-/- ~ 5 ~. ~3~.~ ~, HAA Fee $ /7 '~) "'~:~)~-~ Date of Payment / ~,Z/ ~ eoe, , um er 72-026 (Rev. $/91) Back MOA 2~ Waiver Fee: $ Date of Payment Receipt Number MUNICIPALITY OF ANCH0tLiGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF [{EALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date Ii~.~CI~J)~- ~'l ;[(i~'>(-I (a) Legal Description (include lot. block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name ~'4~'_..~-~:~ C~/(~t .5~. ~r-] Telephon.e.- Home Business Buyer ~ ; Other ~ (explain); (d) Lending Institution Telephone Address (e) Real. Estate Co. & Agent Te ! epho ne LOC'( 7' (f) Mail the HAA to the following address: 2. T~pe of Residence Single-Family~ Number of Bedrooms 3. Water Supply, Individual Well.~-[. Multi-Family~--~ Other (describe) Community ~_~ Public Note: £f community well system, must have written confimuation from the State Department of Environmental Conservation attesting to the legality and status. 4. S__ewase Disposa.1. 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] i,'_.-- 5. Ensineerin8 Firm Providin~ ~nspections, Tests, File Search, Data and Information e 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 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 regula- tions in effect on the date of this inspection. Name of Firm ~ ~% ~roy C. Reid, Jr. / .,:.;. rt /~ / ~ ~ ~;',~ o,~ ~'_~-~ %~..?~'; .:~:'? I I DHEP Approval Approved for Approved X bedrooms Disapproved Conditional Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIO~%L ENGINEER REGISTERED IN TIlE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. F~[PLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCttORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIO~i~L ENGINEER'S WORK. (DHEP SEAL) RR4/eJ/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCF/DRAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well :Log P=esent ~N) Total Depth~) I.~-~ ~--Cased, to Static Water Level MUNICIPALITY OF ANCHORAGB DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOh[ AU6 ;~ 2 1984 Casing Height Above Ground !, Z ~ Sanitary '~al on Casing!~) Electrical Wiring in Conduit _~) Depression Around Wellhead .(,,Y~ Separation Distances f~cm Well: '"; .On Adjoining Lots,, To Septic/Holding Tank on Lot ! 0~+ / ~- TO Nearest Edge of Absc~tion Fie~d on LotI OO~"' /~-', On Ad~3oin'~ng Lots /O~/J~/"~'"' TO Nearest Public Sewe~ Line ~) ~ ~ To NeareSt Public Se~r- - ' ¢lean~t/~an~ole ~3/6 ~o Nearest wate~ sam~e ~st ~sults (Z)F~:~ U~[t~, ~-Or._~ F3) ~/FI~T~-~ ,, [ / .............. B. SEPTIC/HOLDING TANK DATA Date Installed I~O./~/.:~S' Size ,,, ~ Standpipes ~) Air-tight Caps NO. of Ccmpa=tmsnts ~ Foundation Cleanout ,.(Y~ Depression over Tank (,Y~, Date ~st ~d ~u\~ ~1, IqEN Pumping/Maintenance Contzaet on File (Y~) ~!~ f~ ~I~/ ' ~p~ation Distan~s ~ ~ptic~Qlding Tank: To Wate=-Supply ~11 ~.~/' To ~ilding F~dati~ ~/ ~ ~ To ~o~rty Li~ ~ ~ ~ To Dis~al Field ~ /~ To ~ter Mai~=vi~ Li~ ~) /~. To' S~e~, Pond, ~e, ~ Majo~ ~aina~ Co~ .... [Page 1 of 2] 2-15-84 C. A~ORPTION FIELD DATA Soils Rating in Absorption Stmata Date Installed ~0 { .~ O3 width of Field 1,7/ Square Feet of Absorption A~ea Depression over Field (Y~ Results of Last ~dequacy Test ./~~ Separation Distance f~cm Absc~ption Field: To Building Foundation ~7-~ ~-- To Existing or Abando_~gd System cn Lot_. ~J/~ ; On Adjoining Lots . ='~.. C3~-t~ To Water Main/Service Line ~_~--~ To Cutbank(if present) To Stream/Pond/Lake/c~ Major D~ainage Course t.OO~ To D~ivewa.~, Pa~king Area, c~ Vehicle Stc~age A=ea ~.~i~-/~-- ~O~;~t% ~' Type of System Desi~. ~~f~- ~ng~ of Field -'~ ~/ ~' ' ' ~p~ of Field & ~~ D. LIFT STATION Date Installed Dimensions Size in Gal~s Manhole~) High Water Alarm Le~ ~/" Vent (Y/N) Tested for , _~2~mping Cycles du~ing Adequacy Test. Electrical' Codes(Y/N) / Meets MOA ** Check Permitted Bedrocm Rating A~ainst HAA Request ** I certify that I have checked, verified, c~ confcz~d to all MOA HAA Guidelines in effect on the date 9~ this inspection. KB1/d5/s [Page 2 of 2] 2-15-84 ALASKA e UIROFlmeI1TAL CO[/TROL SeRdlCe$, I[1C. I~nclinee,'i,~,:l & Enui,'onme,~l Studi~s AUGUST 20 1984 MICHAEL GAVIN S R BOX 1060 CHUGIAK AK 99567 SESLER - ~{A FINANCE REALTY BUYER - SUBDIVISION - PETERS CREEK BLOCK - 4 LOT - 7 ADEQUACY TEST FOR S]5~ER SYSTE~4 THE TYPE OF ABSORPTION SYSTEM IS A SEEPAGE PIT WITH AN AREA OF 288 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 300 GALLONS OF W~TER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 483 GAT,TONS. BASED UPON THE TEST DATA ~HE SYSTEM IS ACCEPTABLE FOR A 2 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON JULY 31 1984 . FLC~ TEST ON THE WELL FL~ RATE WAS 6 GPM FOR 3 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 2 BEDROOM HOUSE. ~,e u,,if%_ 1~. 22o1.E '"%%:~ ~ .:27: ~'-:-',;.."; .... 1200 LU~sI 33rd Aucnu¢. Suite B* Anchora§¢. Alosko 99503.(907) 561o50/~0 Time MUNICIPALITY OF ANCHORAG. Time !~' Dat~ InspectorRECE! ED Inspecto~_. Inspoctor~) Comments ~ Conditional Approval Date Sewer Installed Permit No. Septic Tank Size /~ --~ Holding Tank Size So118 Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Street Location Typ~ Residence ~lngle Family ~ Multiple Family No, of Bedrooms ~ ~ Other Wa~upply ~ndividual A~ACH WELL LOG. A well log Is required for all wells drilled since June g Community 1975. For wells drilled prior to that date, give well depth (attach log if ~ Public Utllit~ available,) ~ndivldual Year Individual ~nstalled: g Public Utility · When Connected to Public Utility:. ~ Holding Tank , ~ .... NOTE: THE INSPECTION FEE ~UST ~CO~PANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,