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HomeMy WebLinkAboutRAYMOND TEDROW BLK 4 LT 18J 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 IPHONE [] NEW Well Absorption area Dwelling ~g I D I S TAN C_._E..~.T ~O: I I ~ul-~ <~ ~/Manu factu~r. ~.~--- //"~ / ~ ~ 7~'~/~-'~ ~- ~ Material ~ [Liq. capacity in gallons IF HOMEMADE: ~ Inside length W dth ~/ mmc~o: Iw~'' ,r /,- ~ i~ ~~/~ I IMaterial O,STANCETO: uJ U No. of lines ,/ ~p of tile to finish g~. / / D?-ANCETO: Class /~'~'~ _ l DI TANOETO Width Crib d ipt e r/p Well Build.~rfoundation Found,,~,.9,~ / ,~ Nearest lot line/ 'rotal I~t,i~f li~'er,~ Trench,.~[¢4 ~eri~ beno~hctile ~¢~ if ~epth / PIPE MATERIALS SOIL TEST RATII~ Crib depth Building foundation Driller Sewer line OTHER I NSTA L L E/R"/ -- -- REMARKS ' ,.- : · ,~ ; ~f3 (¢l%v. 3/78) NO. OF BEDROOMS No. of compartments Liquid depth PERMIT NO, Liquid capacitv in gallons I~E._R M IT NO. Total effective absorption area Nearest lot line Distance to lot line PERMIT NO, Septic tank Absorption area(s) ti""!i tl.....ii tt%lJ 3J~ Il':-2: ~1[: ,, '"' F:;::li IL,.... :~', "'ti'"' ~-*~'"~' C31 f ~:::::~ fi"'~ C: IF"~ HL:::~ H;~ fll H:',:~i [::'E:F'FIF~'.TI'iE:NT OF' ]-'IEEI:::JI_"FH FIND E hi, Ii,: .t,lldE:i,llPL F'F?F'TE~C:T:[CIIq I::IF:'F'L, :[ (::I:::II",IT * ..:i' :E i"l ].,.t ]~ L.L,, ~ F:It"'I?E~; F'H" NEE: i'iFF,:':; :K i'li,,.li'l i",IL.li'iE:E~F?. OF' F E:'C:'~'Cti]Ii'"t'.E~; ~: ~; 3 '[ L,. f;'.FIT ]: I'.,tC~ = ..L,x ..... L ..... L ...... I:::'T. ,. i.,. Z :E~;"FE~IT~:, E}:I~}~L,,OI,,.t F:ff;:IE[ 'THEE F' F'T ]] 31",1~q5 FI',,,'F4 ~ [_FIE:L,.[~ TO ¥O1_1 ~[ I",! I[:,E[S I ;[]ii",t ]'. I',,ICS ',~-' ~ .l~' Sq;k~]F'T ~ C: .~ .; ] E:I I. 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PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST LEGA. DESCR,PT,O.: /-"ICJ PERCOLATION TEST 10 11 12 13 14 15 16 I7 18 19 2O COMMENTS PERFORMED BY: PERCOLATION [RATE I'~ (minutes/inch) TEST RUN BETWEEN . FT AND ~ FT E:!GINi~E[:~IN0t CERTIFIED ~ ~ DATE WAS GROUND WATER ./~ SL ENCOUNTERED? . O P E IF YES, ATWHAT Gross Net Depth to Net Reading Date Time Time Water Drop 72-008 (6/79) ADEGUACY TEST WATER AND SEWER INSPECT[ON WELL INSPECTIONS AND FLOWTEST SITE PLANS ROAD DESIGN SOILTEST ON SITE. WASTE WATER DISPOSAL SYSTEM DESIGN ~XCAVATION WORK November 15, 1983 ROBERT A, SHAFER CIVIL ENGIN£ER 694-2979 Ms. Beverly Bowers Century 21, Heritage Homes SRB 126 Eagle River Road Eagle River, AK 99577 Re: Lot 18; Block 4; Raymond Tedrow Subdivision Dear Ms. Bowers: A sewer system adequacy test was performed on the system located on the referenced property as yo6 requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was full of water and had to be pumped. After pumping, the water was placed back into the seepage pit and after a period of 24 hours approximately 57 gallons had percolated out of the crib. Ib can be concluded from this test that the septic tank is adequate for a three bedroom residence. However, the seepage pit appears to only be percolating a sufficient amount of water for a one and one-half bedroom residence. It will be necessary to have the absorption area upgraded before it can be considered adequate for a three bedroom home. SRB 196X EAGLE RIVER, ALASKA 99577 Ms. Beverly Bowers Century 21, Heritage Homes November 15, 1983 Page 2 Per your request we are making arrangements to have the system ~pgraded at this time° If I can be of further service, please do not hesitate to call me. cc: Municipality of Anchorage . · Department of Health and Environmental Protection GP'~,TER ANCHORAGE AREA BOROU~-H HEAl. TH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 09501 27~:2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL_ LIQUID CAPACITY I GALLONS. /,.~"~L,~'~ NUMBER OF MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUISIDE DIAMETER OR WIDTH ~i~ , LENGTH '~' , DEPTH LINING MAIERIAL _. DISTANCE FROM WELL BUILDING FOUNDATION____ NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA} ~-'~'~ ~] SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELl. NUMBER OF LINES ABSORPTION AREA TOTAL LENGTH .1 ,~FOUNDATION. , NEARESLLOT LINE OF LINES , SO, FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FiNiSH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPE~,'(.,,~/d//.~,/ ~.//,,,~ DISTANCE FROM WATER , BUILDING FOUNDATION.. SAMPLE NEAREST SEPTIC SEEPAGE LOT LINE ., SEWER LINE , TANK , SYSTEM , CESSPOOl DIAGRAM OF SYSTEM DISTANCES: , NEAREST OTEIER , SOURCES__ DATE GAAB-H D-2 ANCHORAGE AREA' )ROUGH HEALTIt DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT Case No, NAME 0 F APPLICANT_z~.t~ RESIDENCE ADDRESS_ LEGAL DESCRIPTION, APPLICATION TO INSTALL: SEPTIC TANK_..~" MAILING ADDRESS ~//~ /-'~/~'~'~ ~' LOCATION OF INSTALLATION '~'~'~ ., SEEPAGE PIT ~' , DRAIN FIELD. . TO SERVE THE FOLLOWING FACILITY ."~ THROUGH ~-. Z_~_ TO BE INSTALLED BY. FINANCED PERCOLATION TEST RESULTS ,~'~'~ ANTICIPATED DATE OF COMPLE"I'ION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ., OTHER .. T"IS IS TO SERVE AS _AS DESCRIBED BELOW. _, SEPTIC TANK SIZE ./~yz~'-~ , PERMIT TO INSTALL A ~""~ SiZE DF UN,T TO BE SERVED TYPE ~/'...-~'~"~'~ SEEPAGE AREA_ TYPE DIAGRAM 0F SYSTEM DISTANCES: /~/certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. DATE_ ~ 26~/?7[' APPLICANTS SIGNATURE : ~..'Z_- Thc w,tm' for thc? subjoct lot 5.s s,i,Pliod via tho skinny by this i~epart~cnt on April 27, 1970. APPLI( :;NT FILLS OUT UPPER HA' ONLY Property Owner '.- t Mailing Address .~/.~ "7 ~j:( ¢: (. (/ Zip Code [' b--' , Lending Institution ~ ~ddres~ '&j": ' / * .... ~ ~( (:;-/( :"-'( 4~ ( t-~_. Zip Code Type of Residence ~ Single Family [] Multiple Family No. of Bedrooms [] Other Water Supply ~co~'v'dua' C' ~':--' :~ '~' c_ mmunity t~' Public Utility Sewer Disposal ~ Individual [] Public Utility [] Holding Tank Phone Phone Phone ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available). Year Individual Installed: 1~' 41 When Connected to Public Utility: NOTE: THE INSPECTION PEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Date Inspector Field Notes: Time Date Date Inspector Inspector Time Date leepector MUNICIPALI'rY OF ANCI4ORAGE DEPT. OF HEALTH I=NVIRONM~NI'AL PROYECfION RECEI .ED :~) APPROVED BEDROOMS DISAPPROVE[) ( ) CONDFFIONAt- APPROVAL* DATE ~, / ~ ,~ ~¢"~'~ ~ *CONDITIONS OF APPROVAL Soils Ratieg 72.023 (3182) Date Sewer Instslled Well To Absorption Area Well to Tank Well Log Received Septic Tank Size DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME INSPECTOR iNSPECTOR INSPECTOR  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOEP'I. OF HEALfH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL pROT'~CTI©H ENVIRONMENTAL SANITATION DIVISION T~lephone 264-4720 DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing. PROPERTY RESIDENT (If different from ahove¢~ i PHONE 2. BUYER , ~ PHON~ MAILING ADDRESS 3. LENDINGINS~I~U~ION~ ~ , ~ PHONE MA[~NG ADDRESS ~ /. 4. R~R/AGENT ~ PRONE 5. LEGAL DESCRIP"rlON STREET LOCATION 6, TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROQMS [] One [] Four [] Other [] Two [] Five [~ Three [] Six 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY 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,) 8. SEWAGE DISPOSAL SYSTEM ~ INDIViDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM 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 [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC U'FILITY Connection Verified INSTALLER []Septic ~rar~ pr [] Holding Tank Size: {~)~.)O If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank Abs ea Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS ~-"~ R 0 V E D FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY ~ 72-010 (Rev. 6/79) EXCAVATION ROBERTA. SHAFER WORK Greatland Red Carpet Realty A[PTENTION: Joyce Gardner P.O. Box 633 Eagle River, Alaska 99577 Dear Mrs. Gardner, CIVIL ENGINEER 694-2979 October 28,, 198]. MUNICIPALI I:Y DE:Pi. RECEIVED Reference: Lot 18: Block 4: Raymond Tedrow Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and Verified 'to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours approximately 889 gallons had percolated out of the crib. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is current].y functioning adequately. However, the system cannot be guaranteed against subsequent failure. If we may be of further service, please do not hesitate to call. since~ly, /¢ cc: Municipality of Anchorage Department of ~ealth and Environmental Protection SRB 196X EAGLE RIVER, ALASKA it25 "1 "Si ANCt!ORA(:!:, ?,,i Al[i(/', (907) ?iifi 4 October 9, 1981 Jim/Betty Day % Joyce Gardner Red Carpet Great[Land Post Office Box 633 Eagle River, Alaska 99577 Subject: Lot ]_8 Block 4 Raymond Tedrow Subdivision Approval for the individual sewer and water faci]_ities cannot be granted until, the following items have been completed: (1) The standpipes to the on~-site sewer system need to located and possibly raised above ground ]_eve]_. (2) The septic tank pumped with a receipt submitted to this office. (3) An adequacy test needs to be performed on the existing leaching area. This test will determine if 'the system is adequate according to National_ Standards. A listing of private firms performing the test is enclosed. This report will need to be submitted to th~s off,ce for our review. If there are any further questions, please call this O~f~ce at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist c /ljw cc: Security Pacific Denali Towers 2550 Denali Street 99503 MUNICIPALITY OF ANCHORAGE ~UNICIPA~ DEPAR,MENT OP.EAL,H EN.I.ONMENTA' PROTEO' 825 L Street - Ancboraoe, Alaska 99501 ~ ~INM ,, ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 R EQU EST FOR APPROVAL OF INDIV, DUAL WATER AND DIRECTIONS: Complate all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) 1. P~ERTY OWNER ~ P~DPERTY RESIDENT (If different frof~ above) PHONE ~. EUY~R '- ' PHON MAILING MAILING ADDRESS ~ ~ 4, REALTOR/AGENT ~ PHON~ MAILING ADDRESS ; 7/ 6, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One E] Four ~.-'~'SIN6 LE FAM LY ~Two El Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER SUPPLY [] Other [] NDIVIDUAL* I~COMMUNITY [~] PUBI_ C 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 f available,) SEWAGE DISPOSAL SYSTEM [2~'"~N D i V l D UA L/ON.Si TE** [] PUBLIC UTILITY f individual/on-site, give installation date )'/U"/PI f system is over two (2) years old an adequacy test is required by this Department. NOTE; THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] I NDIVI DUAL/ON -SITE DATE INSTALLED E~ PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line §. COMMENTS [~}-'~APPROV ED FOR .~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED / / LEGAL DESCRIPTION 72-010 (Rev. 3~78) July 6, 1979 Gene & Rebecca Kuth 6701 'Fiffany Terrace Anchorage, Alaska 99507 BUBJECT: Lot 18 P~lock 4 Raymond '£edrow Approval for your individual sewer and watem facilities will not b~ granted until the following items have been complsted: A four (4) inch cast t~on cleanout be installed to th8 septic tank and/or leaching area. Notify this department for a re-inspection when descrepancies have been corrected. If there are any further questions please co~tact this office at 264-4720. ' Sincerely, Robert Co Pratt, R.So Associate Specialist RCP/ea Ted Forsi and Associates, Inc. 124 East Seventh Avenue · Anchorage, Alaska 99501 · (907) 274-9517 P.O. Box 2470 · Soldotna, Alaska 99669 · (907) 262-5531 July 13, 1979 Rebecca Kuth 6701 Tiffany Terrace Anchorage, AK 99507 Subject: Septic System Inspection for Lot 18, Block 4, Raymond Tedrow Subdivision Dear Mrs. Kuth: On July 11, 1979 we performed an adequacy test on the subject septic system. The system was saturated with water at a rate of 150 + Gal/Hour for 31 hours. The system continued to accept this quantity of water with no backup into the septic tank. (The water was added into the septic tank C.O.) Additionally, after the test was performed, further information became avialable and~ with the assistance of a metal detector~ the C.O. to the seepage pit was located. An attached drawing shows its location. After completion of the test the septic tank was pumped. If you have any further questions or we can be of further service to you, please contact us. Sincerely, ASS( TED FORSI & ~IATES, INC. aorWhit~ Inspector NLW/es Encl. Engineering · Planning · Surve{jing Ted ForsiAssociates, inc. 124 East Seventh Avenue · Anchorage, Alaska 99501 u (907) 274-9517 · P.O. Box 2470 · Soldotne, Alaska 99669 · (907) 262-5531 July 13, 1979 MUNICIPALITY OF ANCHORAGE DEPT. OF i!:2.\LTH & ENVIRON/v~ENTAL P~OFECTION Rebecca Kuth 6701 Tiffany Terrace Anchorage, AK 99!507 Subject: Septic System Inspection for Lot 18, Block 4, Raymond Tedrow Subdivision JUL 1. 7 1979 RECEIVED Dear Mrs. Kuth: On July 11, 1979 we performed an adequacy test on the subject septic system. The system was saturated with water at a rate of 150 + Gal/Hour for 31 hours. The system continued to accept this quantity of water with no backup into the septic tank. (The water was added into the septic tank C.O.) Additionally, after the test was performed, further information became avialable and, with the assistance of a metal detector, the C.O. to the seepage pit was located. An attached drawing shows its location. After completion of the test the septic tank was pumped. If you have any further questions or we can be of further service to you, please contact us. Sincerely, TED FORSI & ASSOCIATES, INC. m,W/cs Encl. Lynn Whitmore Inspector FHA Form 25Z3 FEDERAL HOUSING ADMIN~STRATION J~udgel Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE Anchorcge, Alaska MORTGAGOR OR SPONSOR Smith, Dewey SUBDIVISION NAME Raymond T_edrow S/D__ TOTAL NUMBERz BASEMENT E]¥es WATER SUPPLY BY: E] Public system SEWAGE DISPOSAL BYI [] Public system MORTGAGEE The SERIAL NO. lj202 First Natiom~] Ba~k_of An_ctlora s 590]~%0~0 0xxyO('''~ PROPERTY ADDRESS NHN ~nhn Str~h (~] e River] OCK~ NO. ,' LOT]~NO. ]New installation Cern attic or other area bo mad® Into additional Iredroorns? (if Yes, how many~) [~ Yes}~ ~o 'J~g Community system ~_]Individual E] Community system Individual SYSTEM DESIGNED FOR "' Yes [] No PART II..--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [] State [-] County '!~--~.. Local Department of Health that this individual water-supply system ~1 is ~ is not satisfactory as a domestic water snpply for the subject property. / It is the opinion of the [] State [] County ~ Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: Can be expected to function satisfactorily, and F1 Cannot be expected to function satisfactorily is not likely to create an insanitary condition -~ATE SIGNATURE , . /? J TITLE / :" .',/ / ' ,"/ // i .'~ /.. /! ,' -:-'~, ,. Tile Disposal Fiold: Distance from: Well, Total length of tile lines, Trench width Length of each line Type of filter material: [] Gravel. feet; foundation, feet; nearest lot line at [] front, [] side, [] rear, feet. Number of lines, Distance between lines, inches. Total effective absorption area in bottom of trenches feet. Depth, top of tile to finish grade, [] Broken stone. Other Depth of filter material beneath tile,~ inches. Depth of filter material over tile, Seepage Ptta: Number of pits ..... Outside diameter, feet. Depth, feet. Lining material Distance from: Well, feet; building foundation, feet; nearest lot line at [] front, [] side, [] rear, Inspection made by: [] State. [] County. [] Local Health Authority. Inspected by. Date of inspection 19 (TITLK) fret. square feet. inches. inches. REPORT OF INSPECTION~INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main,__ feet. Size of main, inches. Individual wells [] are [] are not customary in neighborhood. Give most recent record of failure of wells m immediate v~cinity to furnish adequate supply of water Properties in neighborh~×xt [] are [] are not being developed with both individual water-supply and sewage-disposal systems. Lot size:, feet wide, feet deep. Dwelling set back from front property line, feet. Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Distance of well from: Building fl~undation cast iron sewer, feet; tile sewer, seepage pit, feet; cesspool, Well construction: Diameter~ inches. Total depth, _feet. Type of casing, Approximate depth tn pumping level of water in well,, feet. Approximate yield, Sealed watertight to depth of feet. Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No. ~ump: [] Shallow well. [] Deep well. Length of drop pipe,__ feet. Pump capacity, la, cared in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit. Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No. Type of storage: [] Pressure. [] Gravity. Capacity, gallons. Has bacteriological examinatkm of water been made? [] Yes. [] No. If answer is "yes," give date Quality of water [] is [] is not satisfactory for human consumption. Installation [] does [] does not comply with approved exhibits, if any. Inspection made by: [] State. [] County. [] Lotal Health Authority. Inspected by Date of inspection 19__ feet; nearest lot line at [] front, [] side, [] rear, feet; septic tank, feet; disposal field, feet; other sources of possible pollution, }'eet. Depth of casing, _gallons per minute. .gallons per minute. , 19 (TITLE) feet, feet; feet. MUNICIPALITY OF ANCHORAG!- '~0~ DEPARTMENT _,: ·HEALTH AND ENVIRONMENTAL 2ROTECTION 1st Ins ctzon: Tzme O3~k~t~r 2nd In~pectlon: frame &-;7-77 ~/~5 ~ V ' '~ ~~~ '- REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Alaska Mutual Savings Bank Mailing Address: 601 West 5th Avenue Phone: 274-3561 Property Owner: Mailing Address ~ Leonard M/Catherine Shear Post Office Box 95 99577 Phone: 694-9240 3. Legal Description: Lot 18 Block 4 Raymond Tedrow Subdivision 4. Single Family Residence: (x) Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms: Well Data: Type Construction Public Utility Sewage Disposal System: Permit ~t Septic Tank Size Absorption Area Depth Bacterial Analysis Installed Manufacturer Soils Rate ?O~ Well Log Filed ( ) On-sihe system ~x) Public Utility 19'71 Installer Distances: Well -to Septic Tank /{2//z'~. to Sewer Lines A~-~ Nearest Lot Line Absorption Area to Nearest Lot Line Material 1~ <~ to Absorption Area Paae Two Department of Health and Environmental Protect'~_on Request for Approval of Individual Sewer and Water Facilities Legal Description: Cormnent s: Lot 18 Block 4 Raymond Tedrow Subdivision Affadavit Attached: ( ) Lette~ Attached: ( 'Depar'kment Worksheet: [ '10 '2. Municipality of Anchorage Environmental Protection 825 L S~reet Anchorage, Alaska 99501 REQUEST FOR APPROVAL'OF INDIVIDUAL SEWER & WATER FACILITIES MUNICIPALITY OF ANCHORA<3S DEPT. OF HEALTH & ENVIRONMENI'AL PROTECTION APR '/1977 ·RECEIVED· Type of Inspection: Property Owner: Mailing Address: .CMRO VA FHA Shear, Leonard M. & Catherine CONV .x P. O. Box 95 Eaqle River, Alaska 9957~aY_P__h0ne 694-9240 Hame o'F Buyer: Kuth~ Gene R. & Rebecca A. 5709 Ladd Drive Nail.lng Address: Anchoraqe,. Alas.ka 9950.4.. D~y Phone 333-.2970 Name of Lending 'Institution: Alaska Mutual Savinqs Bank 601 W. 5th. Avenue Mailing Address: Anchorage, Alaska 99501 Phone 274-3561 Name of Realtor or Agent: .' ~.$~nard D. Anthony (AREA) . . . PI OI ]30X 24'9 957~0~e ..... Hailing'Address: ~~er, Alaska 9 694-9555 Legal DescriptiUn:' - Lot 18, Block 4,' Raymond TedroW ~ub. Location: Echo Street off Coronado Sf_r~t in F. agl~_ River " .7. Type of Facility to be inspect'ed: ~'8. Water Supply Type Of' SUpply: PuSlic Utility Residenc.e N0. Bdfms. 3 x Individual : If' Individual, 'hum'bet of dwetli'n§s, pre'~ently seFved If Individual, depth, of well Sewage Disposal'SYstem Type .of S~stem: Public Utility individual (on-site) x _ .i.. ........... If Individual,, date of installation 1971