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HomeMy WebLinkAboutROVIER BLK 1 LT 5 ,locK MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONIVIENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME LEGAL DESCRIPTION LOCATION Well DISTANCE TO: Manufacturer PHONE Liq. capacity in gallons We:lF HOMEMAD~E: [DwellinglnSide length Absorption area 'MateriaIDWelling W dth NO. OF BEDROOMS PERMIT NO. No. of compartments Liquid depth PERMIT NO. DISTANCE TO: Manufacturer Material Liquid capacity in gallons DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. No. of lines Length of each line Total length of lines Trench width inches Distance between lines Top of tile to finish grade Material beneath the Total effective absorption area inches Length-~.~. Type of crib,~/~r. DISTANCE TO: DISTANCE TO: Width Depth Crib depth Building foundation Driller Crib diameter Well Dep/th, B~ilding f~undation Sewer line OTHEFI PIPE MATERIALS [] NEW ~ UPGRADE SOIL TEST RATING INSTALLER R EMAR KS PERMIT NO. Total effective absorption area ~ // Nearest lot line/~, / Distance to lot line PERMIT NO. I septic ta~,7~ I Absorption area<s, APPROVED DATE LEGAL 72-013 (Rev. 3/78) F'ERMt T NO.'. DATE ISSUED: · AF'PL I CAN'T: ADDRESS: CONTACT PHONE: DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, Al'::.' 99501 264-4720 ON .... S ][ -rE SEWE~R F"ERP~-I · 07/25/84 ' KONNI SNYDER 724 E. 15TH ANCHORAGE, AK 99501 LEGAL DESCR IF': LOT SIZE: oLBDIV~olON~ ROVIER' SECTION: 35 TOWNSHIP: 12N 360A0 (SQ.FT. OR ACRES) LOT: 5 ELOCF .... 1 RANGE: 3W I certify that: 1. I am ¢amiliar' with the requirement? fop on-site sewers and wells as Set £orth by the Municipality o,r Anchorage (MOA) and the State o~' Alaska. 2. I will install the system in accordance with all MOA codes and regulations~ and in compliance with the design criteria o£ this permit. 3. I will adhere to ali. MOA and State o¢ Alaska requirements for the set back distances From any existing ,e].l.~ wastewa't, er disposal system or public sewerage system on this or any adjacent ,or nearby lot. IF A LiFT STATION IS INSTALLED IN AN AREA'COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL F'ERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED DATE: APPLICANT: KONNI SNYDER / . ~ . ' 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 7 8 9 10 11 12 13 14 15 16 17 18 19 SLOPE DATE PERFORMED: SITE PLAN --It WAS GROUND WATER ~ SL ENCOUNTERED? O P IF YES, AT WHAT I E DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~0 ' i~ '- I~ 20 1~ :~--~ ~ ,'55 ~,,"~ PERCOLATION RATE I;~)~ (71~ '~:~ (minutes/rn~ ' ~ co~s__~l' ~*~i~x. -1~-~%~ t ro~/~ ~ .~1~1~1~ ~'1~'_ 72-008 (6/79) ' / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAl PROTECTION 825 L, Btreet, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14- 15- 16- 17 18 19- 20- COMMENTS DATE PER FORMED: ! .,4 L~ ~ ~' ~ SLOPE SITE PLAN PERFORMED .72-008 (6/7~) WAS GROUND WATER I~ ENCOUNTERED? \~5 0 P IF YES, AT WHAT ! E DEPTH? a/ 4.- Gross Net Depth to Reading Date Time Time Water PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN CERTIFIED BY: FT AND I FT 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-- 7 8 9 10 11 12 13, 14- 15 19 2O DATE PERFORMED: ~,~ .,.~k..~ ~._ OCl~t~- .h SLOPE ti+ SITE PLAN WAS GROUND WATER ENCOUNTERED? Y~-S ~ O P E IF YES, AT WHAT ,.~ / DEPTH? ~ Gross Net Depth to Net Reading Date Time Time Water Drop .¢.t.¢ RUN BETWEEN FT AND __ FT ~0¢ ~r~ 9 CERTIFIED BY: DATE: 72-008 (6/79) 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 LEGAL DESCRmT~ON: ~T C \ ~U~' 7. ~% 7 w 11 12 F ,s.',,4 13 14 15 16¸ 17, 18 19 20 SLOPE DATE PERFORMED: ~ ~t~'L '~'~ WAS GROUND WATER ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? SITE PLAN I Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN FT AND COMMENTS ~-'~'1, O ~/~(~{'~ ,T_..~-'0'~ --.L.N~T~LL~_~ ~-~'~-~ PERFORMED BY: ¢~ ~'O~ CERTIFIED BY: (minutes/inch) ~ FT 72-008 (6/79) DEPT. OF EN¥]RONM~NTAL CON~RV&T~ON SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 July 3, 1984 .Alaska Environmental Control Services, Inc. 1200 Wo 33rd Avenue, Suite B Anchorage, Alaska 99503 Dear Sir: SUbject:· Waiver Request - On-site Facilities Lot 5, Block l, Rovier Subdivision Based upon tile information provided in your letter of June 6, 1984, a waiver request from the required 100 feet separation distance to 97 feet from the well to septic tank is approved. Sincerely, DS/msm cc: Robbie Robinson (MOA) GRE,,,ER ANCHORAGE AREA BOR ,,JGH Department of EnvironmentsI Quslity 3330 C Street Anchorsge, Al~sk8 ggS03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS 'g C~'J~ LI'-- ,J(~i~3 PHONE SEPTIC TANK: DISTANCE FROM WELL MATE RI AL ._3~,~ NUMBER OF COM PA RTM ENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY '2C'¢'~O GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: FOUNDATION NEAREST LOT LINE DISTANCE BETWEEN LINES TRENCH WIDTH-- SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE__~ TOTAL LEN~..~) t OF LINES IN. TOTAL EFFECTIVE ABOVE TILE /'-'/ IN. Well: "~ BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE __ OTHER SOURCES DISAPPROVED DEPTH NEAREST SEPTIC SEEPAGE SEWER LINE__ TANK__ SYSTEM DISTANCE FROM: REMARKS DISTANCES: DIAGRAM OF SYSTEM SEWER LINE DEPTH: PIPE MATERIAL' LOT SLOPE: REMARKS: DATE 2('~ APPROVED '~(~"00' G.A,A,B. Form LQ-032 PERMIT NO. BF'PLICANT LOCBTION LEGSL RRBSIT CREEK RD 1_.5 RL ~IER _sUBD D_I..LI~-,! I C: ~ ~'IaL I T"r" ,-iF- FtI'-.I¢"'-'F'i~ ..*F-:FtG'E [:EF'8RTMENT- OF HESLTH 8ND -~IVIF.:CIN£'IEN'~L F:~OTECTION 25±0 E. TUDOR RD.., ~NC:HIDR~GE, F~K ....... 276,-222i O~'~.--S ][ TE "-- -- - BO.'-'< LOT SIZE :~6000 SQURF..E FEET TYPE OF qnlL RBSERBTION =~=,TEM IS: TRENCH f,lR;:<Iblt.lr'! NUMBER OF BEDROOMS = _.3: SOIL RFtTING (SQ FT,,"BR)= ~_42 THE REQUIRE[:, SIZE OF THE SOIL aBSORPTION SYSTEM 'IS: [:.. F I1:' 1' t != 9 LE l'-~,3'l- H = ~.~-:: .~--; GRR%-"EL THE LENGTH DIMENSION IS THE LENGTH ,-':IN FEET) OF THE TRENCH OF.: DF.'.RINFIEL. D. THE DEPTH OF R TRENCH OR PIT IS 'THE: DISTRNCE E:ETPIEEN THE: SLIRFRCE OF THE GROUND, aND THE BOTTOM OF THE EXCAVRTION (IN FEET). THERE IS NO SET NID, TN FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRaVEl_ BETNEEN THE OUTFRLL PIPE aND THE BOTTOM OF THE EXCaVaTION (IN FEET). .... '¢4:E,;!IIJ :!: RilE:, SEF"T T C: BRCKFILLING OF RNY SYSTEM 1.4tTHOUT FINFIL INSPECTION FIND FIPPRO'v'AL BY THIS DEPARTMENT NIL[. BE SUBJECT TO PRO:-SECUTION. i"IINIMUM DISTANCE BETNEEN FI NELL RND FtNY ON-SITE SENFIGE DISPOSRL SMSTEi"I IS :.'LEIO FEET FOR R PRI'v'FITE GIELL OR 200 FEET FOR FI PUBLIC NELL. NELL LOGS'RRE REQUIRED FIND MUST BE RETURNED TO THE DEPFtRTNENT NITHIN 3:0 DRYS OF }'HE WELL COMPLETION. SPECIFICRTIONS RND CONSTRUCTION D, tRGRRMS RRE R',/RI[~IgE:LE TO IN:,JF.E PROPER INSTRLLRT ION. I C:ERTIFY THAT i: I AM FRMILIRR NITH THE REQUIREMENTS FOR ON-SITE SENERS RN[:, NELLS RE; SET FORTH BY THE MUNI...IPHLIT, OF' RNE:HORRGE. '~': i NI/.L IN_ rHLL THE _,~=,TEM IN RC:C:OF.~[:,RNCE NITH THE COD, ES. 3:: I UNDERSTAND THaT THE ON-SITE SENER '-,T.:TEM MAY REQIIIRE ENLRR. GEMENT IF' THE RESIDENCE IS REMODELED.TO INC.LUDE MORE THRN 2: BEDF.:OOMS. APF'LICRNT BIL~RISTY Engineering Geolo~ ~ Mining a Geophysics ~ Gr~l~dwater a Petroleum May 24, 197'6 Mr. Rolf Strickland, R. S. Chief Sanitarian Dept. of Health and Environmental Protection Municipality of Anchorage RE: Soils test on Lot 5, Rovier Subdivision Dear Mr. Strickland: . Upon performing a soils test on the above property for a sewage disposal permit, a soil type was encountered which is not covered by a soils characteristics/square feet per bedroom conversion table supplied by your office. In order to obtain an accurate value for the test, I was compelled to interpolate a value for this soil. The type encountered was a moderately well graded gravel and sand mixture with few lines, which would fit between GP and GW on the Unified Soil Classification chart. Since no value is given for GP soils on the con- version table, I chose a value for the subject soil type based upon my experience gained from performing ntumerous soil and percolation tests in the Anchorage area. I believe that 110 square feet per bedroom is a reasonable value for this soil. Sincerely, ALASKA GEOLOGICAL CONSULTANTS, INC. Jay K. Turner Geologist JKT/gp 702 West 32nd Avenue ~ Anchorage, Alaska 99503 e Telephone: (907) 277-7601 MgNICIPALITY OF ANCHORAGE ~ Department of Health and EnvironmenLal Protection SOILS LOG Performed for Bill Christy Date Performed 5/21 and 5/24 Legal Description Lot 5, Rovier Subdivismon 6 lO ~2 0 - 2' - Silty Sand, SM Square feet per bedroom = 250 2 - 3' - silty, sandy gravel - GM Square feet per bedroom = 225 Moderately well graded gravel and sand GW-GP Square feet per bedroom = 110 6.5 - 7.5'-Silty gravel - GM - sq. ft. Der bdrm.. = 225 7.5 - 16'- Moderately well graded gravel and sand - GW - GP Square feet per bedroom - 110 Average percolation rate from soils log 142 square feel per bedroom Date Percolation Rate Net Time Depth Net Drop minute Well Log ,,0~0~ .......... ~~..~..-.. ............ ~.~...~~ ...... ~~ .................... Date completed ....... ~.'("~.~..' ..... ,~.'..~..,,, ...... l~..~ .............................. Depth of well .... ~...~z~~.~'.~~~..~~ft~ SiZe of casing ......z~ .............................................. Distance to water..~~.~ .... ~~ ................................................ while pumping ~:~ ~_ · ~ at DiSt~ce to water '.~~ .... ~ rate of~...~~~~ .... gallons per hour. Formation from to . Driller DELTA DRILLING'COM PANY SRA Box' 394 g ANCHORAGE, ALASKA 99507 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL ~E. ALTH DEPARTMENT OF NEALTH AND E ~N};IRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address .or directions) (b) Applicants Name f/ Applicants Address "'I'~-1 : .:-' - (c) Applicant is (check one) Lending Institution F--~ ; Owner/builder ~ ; Buyer ~ ; Other ~ (explain); ~:.,, : (c,~'_ ./ ..... ~,~ (d) Lending Institution ]~? ,~ I'~J,:~/../.A.. f~"~ ,-i~..{'-' //',,~ /'~, Telephone Address -- ' (e) Real Estate Co. & Agent i~_/~-:y;,lv~ ~,_.,~I~,'L ~?;i:i; .... ,~ ) , j Telephone .'-),'~7 .~ - ~'~ ~i,~'~? / ~ail the ~ to the £ollo~±ng address: Telephone - Home Business ? ~ ?~(~ ;: '~/ ' ';L f 2. T~pe of Residence Single-Family~ Number of Bedrooms blulti-FamilyF--~ Other (describe) 3. Water Supply- Individual Well ~ Community ~---] Public F-~ Note: If community well system~ must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal 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. Engineering Firm Providing Inspections~ Tests~ File Search~ Data 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 system is safe, function~_l 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 Address/~:~:'~ /L,':,~" ' ' ~ ' ' ' "" ' DHEP Approval z ~ ' .' :c~ .5 -- · ~.~% No. 2251-E .~':.,' ~. / / Approved ~ Disapproved__ Condition~ __ 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 ~N INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN TtiE 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 ~EQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. ~ MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ae MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HA_A) CHECKLIST - FEBRUARY 1984 MUNICIPALITY OF ANCHORAOE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION AUG 2, 0 lg J Well Classification Well. Log P~esent _~N) L0tc RECEIVED £/ If A, B, c~ C, D.E.C. Approved(Y/N) Date Cc~pleted 6-/~L/?~ Yield Total Depth /~.~ ~' Cased to Static Water Level _5-2 ~ Casing He ight Above Ground /, Electrical Wiring in Conduit ~TN~ Separation Distances f~cm Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot ~/~O/ To Nearest Public Sewer Line /23 ~ Depth of Grouting/u~/c~ u~&///o~ Pump Set A't ;U~ ~f///~ Sanitary Seal on Casing ~/N)<~) Depression Around Wellhead (Y~ ; On Adjoining Lots. ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ~/'/F To Nearest Sewer Service Line on Lot Water San~ple Collected By ~ Tu~r~q(~ ; Date Water Sample Test _Results $K¢~-~c~_%~ C~ments~¢~ ~3f./'(~a~'7~ ~-/~/~ ~£~_~ ~-/&/~/ B. SEPTIC/HOLDING TANK DATA Date Installed ¢}/7~:~ Size ./DOC3 No. of Cut~arta~nts ~ Standpipes 0/N) Air-tight Caps (~/N) Foundation Cleanout ~) ~p~ession o~ Ta~ (Y~ ~te ~st P~d ~~ P~ing~intenan~ ~n~a~ ~ File (Y~) t~/~ .; fo~ ~ Holding Ta~ High-Wate~ ~a~ (Y~) ~/~ ~a~y Holding Tank ~t (Y~)~/~ ~p~ation Distance ~ ~ptic~olding Ta~: To Water-Supply ~i1 ~ To ~ilding F~ndation ~ ~ To Property Line To Water Main/Service Line To Disposal Field ~/~3 To Stream, Pond, Lake, c~ Major Drainage Course [Page 1 of 21 2=15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~.~ Width of Field ~! / Square Feet of Absorption A~ea Depression over Field (Y~ Results of Last Adequacy Test Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes P~esent ~/N) Date of .Last Adequacy Test ~/F~ Separation Distance fr(~n Absorption Field: / To Water-Supply Well /0~ ~ To P~ope~ty Line To Building Foundation ~T 6/9 ~ ~/ To Existing or Abandoned System cn Lot ~Q '~ ; On Adjoining Lots ~ ~o ? To Water Main/Service Line ~A[ ' To Cutbank(if present) To Stream/Pond/Lake/o~ Major D~ainage Course To D~iveway, Parking Area, or Vehicle Storage Area~/~, ~.~,~/~ LIFT STATION Date Installed Size in Gallons ".Pump On" Level at High Water Alam't!. Level at Tested fo~ Electrical Codes(Y/N) ~//~ Dinensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pun~ping Cycles du~ing Adequacy Test. Meets MOA Counts ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformmd to all MOA on the date of this inspection. Signed Company KB1/d5/s [Page 2 of 2] 2-15-84 ALASKA ENVIRONMENTAL CONTROL SERVIC?-",r INC. 1200 West 33rd Avenu~ Suite B ANCHORAGE, ALASKA 99503 Phone 276-1361 JOB SHEET NO.. CHECKED BY. SCALE: /,' LC3 ¸OF 2 DATE ~crt. ~ C/c, ..... DEPT. OFENVIRONMENTAL CONSERVATION SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 BILL .~IEFFIELD, GOVERNO~ Telephone: Address: 274-2533 July 3, 1984 Alaska Environmental Control Services, Inc. 1200 W. 33rd Avenue, Suite B Anchorage, Alaska 99503 Dear Sir: S~bject: Waiver Request - On-site Facilities Lot 5, Block 1, Rovier Subdivision Based upon the information provided in your letter of June 6, t984, a waiver request from the required lO0 feet separation distance to 97 feet from the well to septic tank is approved. Sincerely, Environmental Engineer DS/msm cc: Robbie Robinson (MOA) ALASKA eiiLIIROIlmeI1TAL cOrlTROL S[ [4uIC[ S, I[1C. ~nqineer'in§ § ~nuironmenlCll $1ucli~s MALY 31 1984 KONNI SNYDER 724 E 15THAV~NUE ANCHORAGE AK 99501 S]~.F,T,N~R - TOT~bl REALTY BUYER - SUBDIVISION - ROVIER BLOCK - 1 LOT - 5 ADEQUACY TEST FOR S~NER SYS%3~M THE TYPE OF ABSORPTION SYST~Vl IS A TRENCH WITH AN AREA OF 480 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 300 GAT,]'ONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYST~bl IS 255 GAT,TONS. BASED UPON THE TEST DATA THE SYST~VI IS NOT ACCEPTABLE FOR A H(lVfE OF 3 BEDROOMS. THE SEPTIC TANK WAS PUMPED 0N5/25/84 . FLOW TEST ON WRLT, THE WR, r,T. FLOW RATE WAS 5.6 GPM FOR 2 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. 1200 [Uesl 33r~ Aoenue. Suite [~,/~nchor,~qe. Alosko 99503 ,(907) 561-5040 ~' CUSTOMER'S ORDER NO. PHONE DATE ADDRESS - DEPT. OF H-=Al. TH & ~'. MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION · ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION i 825 L Street - Anchorage, Alaska 99501 ENVIBONMENTAL ENGINEEBING DIVISION TelePhone 264-4720 R E C E I V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be proce~ed. Please allow ten (10) days for processing. 1. PROPERTY OWNER ~ PHONE MAILING ADDRESS PROPERTY R'ESIDENT (If different from above} PHONE 2. BUYER · MAILING ADDRESS , . 3. LENDING INSTITUTION PHONE MAILtNG ADDRESS 4. REALTOR/AGE~ ~ PHONE ~A~ U NG ADDR ESS 5. LEGAL DESCRIPTION TR EET LOCATION S. TYPE OF RESIDENCE ~f'~SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four [] Other [] Two [] Five []~""'~Th ree [] Six 7. WATER SUPPLY I~"~ INDIVI DUA'L* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM [J~ N DIVI DUAL/ON-SITE** [] PUBLIC UTILITY * 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,) **If individual/on-site, give installation date If 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. 72-01 0(3/78) THIS SIDE FOR OFFICIAL USE ONL, DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP ECTOR 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 []INDIVIDUAL/ON -SITE DATE INSTALLED [~] PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: ~/~)O~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Sapti¢/Holding Tank Absorption Area Sewer Line I Naarest Lot Line 1 WELL TO: Absorption Area to nearast Lot Line 5. COMMENTS ~"~APP ROVE D FOR _'~ BEDROOMS [] CONDITIONAL APPROVAL (letter must acco~.~ny certificate) LEGAL DESCRIPTION 72-010 (Rev. 3/78) August 13, 1979 James/Anita Paull Star Route A Box 455-B Anchorage, Alaska 99507 Subject: Lot 5 Rovier Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been ~eted: ·,~' i ~[l)~hhe top of the well casing sealed with a sanitary seal ~[~ X~so/~ \ that it is water tight. ((~\J The water analysis report be delivered to this office ~.~5~from~ --'~Chem Lab, 5633 B Street, for our review. [\ ~V~/, )? The septic tank pumped with a receipt submitted to Please notifty this department for a re-inspection when the noted descrepancies have been corrected. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Security Pacific Mortgage 1011 East Tudor Road - Suite 190 Esther Bumgardner % Totem Realty 724 East 15th Avenue 99501 99507 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received December 2, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF Kennedy INDIVIDUAL SEWER & WATER FACILITIES FOR 10:30 a.m. 12-3-76 Friday Cony. 1. Approval requested by: Mailing Address: Property Owner: Mailing Address: First National Bank of Anchorage Post Office Box 720 Kent T. & Constanoe Brakken star Route 3. Legal Description: Lot 5 Block 1 Rovier ,4. Phone: 276-6,300 Phone: 344-9661 work "6 · Location: Rabbit Creek Road, see map Type of facility to be inspected Single Family Well Data: No. of bedrooms A. Type Individual B. Depth D. Bacterial Analysis C. COnstruction Sewage Disposal System: A. Installed /~7~, C. Septic Tank: 1. Onsite system B, Installer Size ~ 2. Manufacturer D. Seepage Pit: 1. Absorption Area ~/').~,' 2. Material E. Disposal Field: Total length of lines L/~x) ' Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , Absorption area , Other contamination Sewer Lines , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Paqe 2 of two pages - Re~"~st f6r Approval of Individual "-'~er & Water Facilities L~ega 1 Description Lot 5 Block 1 Rovier Comments Approv~lsapproved Approval~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM c'ertify that the information contained in this request for a~Proval 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) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA 2. Property Owner: Kent T. & Constance Anne Brakken CONV X Mailing Address: Star Rn,~¢~ R~hh~ Name of Buyer: same as above Day Phone: no'..: home phone 344-9661 bus. phone Mailing Address: 4. Name of Lending Institution: Mailing Address: P.O. Box 720 5. Name of Realtor or Agent: none Mailing Address: 6. Legal Description: Lot 5 Blk 1 Rovier Location: Rabbit Creek Road Day Phone: First National Bank of Anchorage Phone: 27~-6300 Phone: 7. Type of Facility to be Inspected: Single Family 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation No. Bdrms. 2 72-003(3/76) ,Individual x one Individual (on-site) × Please return tO Paula M. Cranmer @ First National Bank of Anchorage P.O. Box 720 Anchorage, Alaska 99510