HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 3 LT 33
MUNICIPAI_ITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
QN-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE
MAI LING ADDRESS
LEGAL DESCRIPTION
LOCATION
DISTANCE TO:
DISTANCE
Well Absorption area ,
IoO /0
Inside len~gt h
IF HOMEMADE:
Well
DISTANCE TO: / 0~) '
No. of(tines Length of q~ch
Top of tile to finish grade
Dwelling
Materiat,.. /.
Width
Dwelling
%-,-. ~Vlal:'drial · _ __ ~-
FoundS[ion .~ .,q Neal~ -
' J
Totel length of lipe~ I Trench
Material beneatl~ tile
Width Depth
Type of crib Crih depth .........
Well foundation
DISTANCE TO:
.inches
NO. OF BEDROOMS, d)
PER MIT NO'(~-~¢~/0 0
No, of compartments
Liquid depth
PERMIT NO,
Liquid capacity in'g~llons
PERMIT NO. I:~/ O ~ / 7
Distance betw en lines
Total effe"'~r~lon area
PERMIT NO.
Total effective abs.orptiOn area "~
~eaTeEf Cot line
Depth Driller Distance to lot line
Building foundation Sewer line Septic tank
DISTANCE TO:
PERMIT NO.
Absorpt on area(s}
OTHER
PIPE MATERIALS
SOl L TEST R,g,T~NG . ,
INSTALLER
REMARKS
APPROVED /~) DATE LEGAL
"I"$"PE OF' SO:IL. FtBSORF'T ]: ON S'T'STEH ]:S: TF::EI'.ICH
HFI,'.':', :[ MUM NUMBEF: OF' BEE:,Roor,'IS .... :i. SOIL F.':Fi'I"II'.~Ei <:SC! F'T,..'F.','Fi:::,= ,'35
"I"HE F:EIZ~IJIF::E:E:, SIZE OF THE SOIL FIBSORF'T]:ON S"r'S'FE:H I'.:;:
It::. E: Il:'"-":" '"'r Edt :=: :.:iL. ~2..:~ ti..._.. E:: !t"dl :J:::::~ '"11"" I1-..11 .... 2.:~" :S:" ~f~ IFC" ~:~ %." Ii:-~ II ..... E::::. E: F'::" '"Il'"' 11--.~ ........ ,.-'~;
THE LEI"~I":iTH [:,IHEi",P.:.:IOI'.,I IS THE L..EI'*~GTH ,::IN F'EE"I"> OF THE TF::E.:.'I",tCH t:l[~.'. Df::I":IINI::IELD.
THE [.'.'EPTH OF'" F] TRENCH OF.:: F:':E"f' IS THE Di':;TFINCE BE:TF!.EEN THE :~IJF::F:FIC:E OF THE:
GF:OLINB', FINE:' THE DO't"TCII'q OF THE EF::CR',,,'FIT I ON ,:.' ]: N FEET ::'.
THE:RE IS NO SET FIIE:,'I"I4 FOF,' 'I"F.%NCHES.
THIS GRF:I',,,'EL DEPTH IS; 1"HE M:[IqIMUH E:,EPTH [:IF GRFI',,,'EL. BETI.,.IEEiq THE: OUTF"FILL. PIPE
F:llq[::, 'T'HE E~OT't"OH OF THE E',:.:',C:IZCWFI"I":[ ["IN ( ]: N FEET ::,.
PE:RH I T RE:'F'L. I I::RN'T' HtaS 'THE: RE5;POf.,IS I E~ :[ L. I T*r' TO :[ NFORM TH l S DE:PRRTHE.:.'NT DLIR I I"4G 'T'HE
I NSTF~LLFI'T'I' ON i I",IS;F'EC:TZ ONS OF: FtN"r' PJ[:LLS RE.',,;rRCENT TO TH :[ IF.; F'RC'ff:'E:F.:T'T' F:INE:, "I"HE
NUHIF.flER [)F:' I:?.EE; Z DENC:E:S 'I"HI::¢F THE I.,.IEI_L P.!:[ LL SERVE.
................... ""F II....tlC:~ ,:: :.:&:: ::. 3E ~",q"ST:: F" J'S£ C:"'¥" :Il: C:, Ii'-,,~.EF.;; F~tI:~."E IG:;'.'E.-.E C.:~. L~ 2:: E::'.' E: I[Z: ..................
[::IFIIZ:KI::' I I_.L 1' I",IG OF FtI",I'¢ '.".:.;':"::5'TE:I"J t.'41 "I"HOIJT F'.'[ I",IFIL. I NSF'EC:T .T. O[",J FIi",IE:J Fff:'F'F.:O',,,'FIL.. EPT' "l"hl ]: S
.DEF'FIF::TMEI",IT I.'.1:1: L.L BE SI..IB..TEC'f' 'T'O F'F:C~S[EC:LIT ]: ON.
H.II",J:[h'lUi'd [>IS'f'RI"4CE: E~E'I'HEE:N FI 1.4EL. L I::11",![:' RNV ON-SITE '-:;EI.'.IF~GE E:'I:F.;F:'O:,-.-;Flt... '.F.;"r'STE:H
::l..EIE't F'EET FOR FI PI~'.]:VFtTE I.,.IEL.L. 13[~: J. SE1 TO 2EIEf FEET F"'F.:OH FI PUBLIC: I.,.IEL. L DEPEF.NE:'ZNG
I...IF'ON THE T'T'F"E: OF" F'UE~L. IC I.'.I[£L.L.
HII",IZH[..IH I:." :[ STFII",ICE FF'!OH FI F'I:~tZ',,,'FtTE I.,.IEL..L. 1"O FI F'F~'.ZVR'f'E :..SEP.IEF~: L. II",IE :IS; 25 FEET FIN[)
TO F:I C:OHHUN:[TV SE'P.IEF:'. L,.Ii",l[£ ].'fF.; ?'E:.i FEET.
CKf'I'"IE:Fi: [~EL:4U:[tRE:HENTS i'dFl'¢ FIF'PL."r'. ':SF'EC:[FICIaT]:OI"~5; FtNB" C:OIqE;TI;:UCT:[C~N E:' ].' IaGF.:FIHL:; FIRE
FI',,,'Ft.~ I...FIE~LE TO :[ I",ISLIRE F'F?OF'EF~i ]: I",ISTFtL. L. FI"[':[ ON.
I CER'T'IF'.r' THFIT
:1..: Z RP1 FFIM]:L.f. RR 14:[TH 'rile F.:EC!UIF:'.EMEN'f'S FOR ON-:F.;ITIE SE:P.IERS k~NE:, NELLS RS SET
FO[E:'TH Ei:'.¢ THE MUIq :[ C :[ [:'RI... I T'-¢ OF FtNCHOr4:FiGE.
;2: I I.,.I:[[.L :[NS"I"FIL. L. THE S'T'S';'F[.~:H IN RCCOR[>IaNCE 1.4I'I"H THE CODES.
2::: I UNDEF;'.S'f'F~IqD THFt'T THE ON-SI'f'E :F.;EP. IEF.'. s'.r"=;"rEr,1 MR'¢ F'.EC¢..IIF'.E ENLFIRGEHENT :IF' THE
I:::E:SIDEI'.,ICE.: :[5.; REhlOE:,E:LEE:, 1"O INCL..UD, E h'IOF:'.E THlaI'.,I 4 BEDF~::OOMS.
,:-': ......................................................................................................................... :.'Z' /
FIF'F'L :I:~EI" L. J: ~",ll~.: I::i_~iI',~ST~:[,,Ii:::"r~[ CII',,I
< ..... / 'TI_)
December 31, 1979
Linc (onstrnctlon
1605 Sanya C.]rcle
Anchorage, AJ. aska
9950,1
Permit {i 7900z3~
Subject: Lot _% BLock ~ Ri ver 7- , ,
, V~.(.~, Estates Subdivision
A oermit issued by '-' ~"
, ~n~.o deparnmenn for we].l and/or sewer
system has expired.
Permits are issued or: a calendar year basis, as stated on
the permit, by au'hilorit, y of }~unicipa! ordinance.
If you have dr~l]ed ......... ~ e. ,.~_~_~, a well log should be sent
to this department to document the in. st. allation date.
If an engineer has inspected the installation of the
aS-OtllA zS
on-sihe sewer svstem. , :~_~-i~ase~ have them send us the ' ''"'
for eur files.
i F tn :.:r>.. are any iurther c~t:es;' lon~ please coat,.ct', t~q!s
~ 700
office at 2 ~,~-4 ~ .
L N B / i j w
enc: Copy off Pertain
I_OT ':::; I ZE
MI;:IXIMIJM I',JIIMI'~EI~: OF' f~tZ[)I;~':CI('}MS := ,':I,
THE F:f~I';;!I..t I Fi:E]) .~.; 1 2:E 01= THE SO I 1. I::IBSOIq:PT I 01',I S'./STEM ]: S:
TI-'~E I..EIqG]"Id P I I"IEi',IS ): ON I S THE I_Et'.,IGTI.-t ,;: I i'.,t FEE:T) OF THE "I'I;::[;(]",I('~:H i::iB~ [)~;:]::'t 1 J",][::' ! 17):! [..'L
THE I?'EPTH OF FI TF4:E'I",ICH OF.'! P.T,T Ii!:; THIE I::']:STI=tI",IC:t}: E:ETMEEN TIW=: SI,.~;.:FF~CE O1':' THI:=
GB'.OUI",I[~ FIi",II) THE E:OTTOr'I OF TIE EXCFI'v'FIT}:OI",I (l Iq F:EI:£T).
THEP. E 1 5 NO -":.':ET [',1:[ [:'TId FOP. TF.',I}ii",ICHES.
T'HI=' Gt;~ffxI",,'EI.. [:'EPTH )'.S 'file MIM:[I'"II,,IM I)f"::F"IT't
IqBID THE
I='f'(Fi'.M i 'f' FtPF:'L. I CFti",IT I'IFIS ']'H~ P, ESF'OI',IS I E: I L, I T'¢ TO 1' lqFOf.e.M TH I ?¢ [:'t:[I='FIF. tTMEI",IT !)l,..ll;i: I l"~l(:!i
'f lq '= ]' Fl l ....... .IJ=ITI :N ,?,N'ZF'Ff':TTf'II'.,I~; rlF RIq¥ 111..1..I,.,:, I":ID..YFI(~:f!!:I',~'f' TO THI?_:, :.r,,..F~'mr-.. · L,. -, FIN[) 'T'tdF:
NI..IMEiEI:;' CF f.~=:,ll..f!,lqL, b.:, THF:tT TI,tE NEI,,,L NII...I .....
E.H~..I.-..[-1LLiF,If~:i CF I::1F,1¥ S'¢STF:M b.I'J:TI-JOUI' F]~f.,tFtL, INSF'ECI":(r'i'.t l::)f.,ID ':I='F:'F.:CVFtl. F!;"r' 'f'H]:S
[)EI::'FIf;i!'f'i'"IIi{N"I' I.,.I I I_L E:E SIJI~,.T[=C T TO PI-;,'.(3SECI,JTI Otq.
MLIM [1:,
FEET FOF.:
T'O ;2E%) FEE'T Fr4'.OM fl PUE',I..I'C t,t E IL.. [.. I::,EF'EI'.~DII',tG I..JI:::'ON TH[i: "rvF'E OF I':'I. IBI )7(? NEI.I..
CrfHER REQI. Jtr4;:EMEIqTS t,IRY RPF'I.'¢.
LI::IBL. E T'O I NSt,It~E F'RCfl:'ER I I'..IS'I'FIL. LRT :1: Oi'4.
I CER]".f.F'¢ THWf'
±: ): I=IM I='FIM]:LIFII~': I.'.IITH TI4E F..'E(.:!tJII;i'.EMENT:5 I=OR ON'-S):TE '.'~:]IEI.,.IE]I;:S FIN[:' I,.IEI..I..':;
F'OR'I'H F::,"¢ THE HUiq ~ C I F'FIL I T'¢ OF RNCHORRGE.
2: I 14);[..1.. !N':7.,Tf:II..I.. THE :=;'¢STEM IN RCCOI;:C, FtNCE 14]:'rH 'Fll. IE: CODES.
}i:: I I..It",ID[:~f.i%TFIN[:, 'f'HRT THE Oi",I-S ]: T[_'( ~',EI,IE~: S'¢STEI"t I"IF:I"," F;'.FJQIJlF~'.[_:: I:~I",IL.FIRGEHIZNT tF:' 'FI'II!(
SOILS LOG
PERFORMED FOR:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchoragn, Alaska 99502 276-222'~
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: L6~- ~ 6/k '3
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
[] PERCOLATION
TEST
SLOPE
,
SITE PLAN
WAS GROUND WATER~ ~'~,~/
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date
Time Time Water Drop
(minutes/inch)
FT
PERCOLATION RATE
TEST RUN BETWEEN
FT AND
72-OO8 (7/76)
I:::i J:::'J::'L. ]i (]:FIJ"~
J..[i~ i]~ FI L
..,[:.i.. ,I. "~' 'T'HI::I'I"
;].' I I:::11'1 t::'I::11'"1i1...I1::1~;?, t.'.t.'[TH THE P.:E:(.:-!IJiI('.EJI'"II'CI",tT!~;
I;:l::lt:;~:"['l"'l IJi!',"~' 'TIDE I"'tl I"1 :[ 'J I F'I::IL ]: 'F"," OF' FIt",IC:HCH:;.':FI(]iE.
;'.::' ]: I,.I]:t..~L II",I:~:;'T'FtL. I._. THE: -' ,c .........
' I :' ~ l:' I E'I'I 3:f'''1 FI(::C:CII:;iiE:'FIt'''tC:[C l''l I TH ''l''l'l'lti~: I~:1:] 1''[:'':2
:~; i 6if",llii£D: ............ ___.___ ....
John
~la~-[t!~ Rzva,_, Alaska 99577
· .. -, ' '--, .a '~ and/or on-site
s~wer installation on Lot 3 Block 3 River View Estates
Subd~v:~s~on ha~: ex~trad '~'* ~ the issue
year ~
lln the even% you. s'ki].l }plan to ins%all %he well anti/or
on-site sewer syatom~ a ne~,~ permit is required. The original
soil test may be used %o obtain a current permit.
If the welt has boon drJ. lled~ a v/ell ].o(! shollld bo
to th:t.: ~apartment %0 d. ocum~nt the insCaJ ]at:~.on
~ff you have any clal~s~:ions regarding' %he above nlatte~
-. .~ ' 'blme~iatoly at 264-4720
please contact ~n:ts office -
sincerely
Les ~1o Buchholz~ R.S,~
Senior' Environ)uen'ka]. Specialisl:
'ANI~/1 j h
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
General Information
Application Date
township, range)
Location (address or dir.ections)
(b) Applicants Name~~j
(e) appl~a~n~_~a (cheCk one) ~end~ng
Buyer ~ ~ Other ~ (
(d) Lending Institution
Telephone
Real
Estate
Co.&
Agent ~~.~_
Address
(f) --M~T1~ the HAA to the following address:
'.:., ~IiVEi:t, AOI,.SI'(& g95'/f
2. ~Ty_p_e____o_f_ Residence
®
Single-Family~,~
Number of Bedrooms
biulti-Family ~
Other (describe)
Note: If community well system~ must have %r~itten confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
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]
5. _En_sineerin_g Firm Providin_g_~In__sp_egt_i_o_np,_~T_e_s.t_~_~' File Searchk.pata and Information
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 ,~ystem is safe, functional and adequate for
the number of bedrooms and t~ype of structure indicated herein.- I further verify that,
based on the information obtained from the Mnnicipality of Anchorage files and from my
investigation and inspection, the on-site ~mter supply and/or wastewater disposal
system is in compliance ~_th all Mamicipal and State codes, ordinances, and regmla-
tions in effect on the date of this inspection°
Name of Firm Telephone
Address
DHEP ~
Approved ~or /~mz ~ bedrooma
Approved ~ Disapproved
Conditional
Terms of Conditional Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ~r~,ALTH AND E~!IRObR~BNTAL FROTECTION
(DHEF) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTER~~O
IN THE STATE OF ALASKA. THE DHEP DOES %~tIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTI'I~JTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTSo EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. TIlE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR gRRDRS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK°
(DHEP SEAL)
RR4/eJ/Ol8
[Page 2 of 2]
7-19-84
MUNICIPALITY OF ANCHORAGE (MeAlNVIRO~NiAL~ F,<ULC~ON
HEALTH AUTHORITY APPROVAL (HAA} [~ ~ i-- ' Jr ', ~ ~ 1~ ~
CHECKLIST- FEBRUARY 1984
2oOal~scripfion:
WELL DATA
Well Classification
Well Log Present'N)
Total Depth _ .~--/ Cased to
Static Water Level '-
Casing Height Above Ground
Electrical Wiring in Conduit
Separation Distances from Well:
To Septic/Hoidlng Tank on Lot
To Nearest Edge of Absorption Field on Lot
'~/
To Nearest Public Sewer Line_ ~_
Cleanout/Manhole
If A, B, C, D.E.C. Approved (Y/N)
Date Completed I ~,- 'Z-I ~ "~ Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casing(.~4)
Depression Around Wellhead (Ye
; On Adjoining Lots
· On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on
Water Sample Collected by '~<'~ ~ ~,~.%(_.~t/k.~,C=c~--c2.~4Z-Z~; Date
Water SampleCest Results
Comments /~ /~ %~.J~t,.~, F~,.--F,S:~,~ "Tt~:~ .'.~-k~Dk¢-~
B. SEPTIC/~ TANK DATA
Date Installed
Standpipes~N)
Depression over Tank (Y~.
Pumping/Maintenance Contract on File (Y/N)
/
Holding Tank High-Water Alarm (Y/N) /A
Separation Distances from Septic/,M4~kC~q9 Tank:
To Water-Supply Well ~- ~ ~'~'
To Property Line \ ~> ~ ~'
To Water A4amCService, Line ~,~ 4-
Course ~/~
Size_ ~. ~ '~ No. of Compartments ~ /
Air-tight Caps ~:~'4) Foundation Clean5 t~4[~ ;
Date Last Pumped f~, -'Z~.'~ -'¢% '~'~'-'-
~"~/,~ ; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation ~
To Disposal Field ~,~.t:, ~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(1U84)
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:
To Water-Supply Well
To Building Foundation
Lot
Type of System Design
Length of Field
Depth of Field ~ ~
Gravel Bed Thickness r~ 'Z-.,
Standpipes Present(~Jq)
Date of Last Adequacy Test
To Water Main/Service Line ~ ( ~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line [ C~ ~,'~
To Existing or Abandoned System on
; On Adjoining Lots
re ~t.Cutbank (if present)lO/CA
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
/~ "Pump Off"VentLevel(y/N)at
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MO/A and HAA g uidelines in effect on the date of this inspection.
Signed Date 6/.~.-~/,¢~,~~'
Companv. SRB t98)~ MOA No. ~ ~
Receipt NO.~' ~9!79.~9 S~'~ ~
Date of PaymentS&" ~%
Amount: $ A5 ~
Page 2 of 2
72-026 (11/84)
TIME TiME " TIME
INSPECTOr/
MU~ICIPALI~ OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPt. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~IRONMENTAL PROTECTION
825 L Street - Ancheraoe, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION MAR 2 1981
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~~I~I~~
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing,
1, PROPERTY OWNER PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If differen~ from above) PHONE
MAILING ADDRESS
3, LENDING INSTITUTION ] PHONE
MAILING ADDRESS
4, REALTOR/AGENT ~ PHONE
MAILING ADDRESS
5, LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE NUMBER OF,.BEDROOMS
[] One [] Four
[~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
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 UTILITY
Connection Verified
INSTALLER
[]Septic TaRgQr [] Holding Tank
Size: / Z)~O. If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER (~ .
TOTAL ABSQRPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding/~)~.~ ,Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
B, COMMENTS
[~APPROVED FOR "~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY
72-010 (Rev. 6/79)
82o "L" SI-BEET
ANCHORAGI::,/\LASKA 99!501
(907) 264-41!1
GEORGE M, SULtJVAN,
MAYOg
I)t~l'tR rrU;xJi ()F !IIALI'Ii AN,r) ENVIRONMENTAI-I)l?O''l:c'rlON
Marc:h 19, 1981
Barbara R. Gross
Post offi.ce Box ].161
Lagle River, Alaska 99577
Subject: Lot 3 l:lock 3 River View Estates Subdivision
Approval for the ]ndividual sewer and water facilities
cannot he granted unti. 1 the followJ.ng items have been
completed:
(1) The water analysis report: needs to be delivered
to this office from the Chem Lab; 5633 B Street,
for our ~view.
(2) A well [Log submitted to Lhis office for revmew.
If there are any further questions, please call th~s
office at 264.-4720.
Sincerely,
Robert C. Praqt, R.S.
Associate Specialist
RCP/ljw
cc: First National Bank of Anchorage
Post Office Box 4-2090 99509