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HomeMy WebLinkAboutKIMBERLY MANOR #2 TR A1  Municipality of Anchorage -" Development Services Department " Building Safety Division On-Site Water and Wastewater Program. 4700 S. Bragaw St. P.O, Box 196650 Anchorage, AK 99519-6650 Page www.ci,anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: ~Lo, OOO~'¥~ PIDNumber: OI7-073'-~ "'"" Pen,,y ~,,~c.~,,';n WastewaterSystem: [] New [] Upgrade 17 Y ~ L~,,,& C~r~/¢ ABSORPTION FIELD r=~<t..C 7' LEGAL DESCRIPTION -'-..,q.~ x~,,: .-'~: "~'~ F. ,.~,~ .,~, ~,~, ~..~'.: .~,. e~-- t.~...~ r,. --,,,m: J Well: _~/~t/.{' ~- [] New [] Upgrade ~: o,~ p,,~s~,~ ~,. c.~o,,~,,-c.'o~:~ TANK SEPARATION DISTANCES ~septic I-]Holding I'-IS.T.E.P. r-IOther. From~ Septic Absorptior Lift Holding Public~fivate~c~ Tank Field Station Tank Sew~rUae ~C. Ao ~'~ 7-'~ ~' I'?..S"~) C,~. ~2~.~.,,~ ~-~,,/-;~ ./~,,~-.f)"z'P°%'. ~,~-~,~,..~: BENCH MARK I~.,~..~ '~n~,~ ~'if~ tni{o "~l.~']'t~ Engineer'sStamp ~,Fl- ..e t~ /./o,, Inspections performed by: ,~'l~c~,/op ~'e¢/..C.'¢ Dates: ~' )1~10,0 .... .. .... ........ ...... Development Services Department Approval PERMIT NO: SW000342 PAGE 2 OF 2 PID NO: 017-073-99 FROM: COR."A" COR."B" TO: ~ ,' , * ...... E LI~ STATION LS. TOP G 97 113 ,,,- P~N VIEW ~N~ 1250 G~LON SCALE: ~" = 30' SEPTICT~K T~CT A-I~ KIMBERLY MANOR SlD J2 SEPTIC TANK INSTAL~TION AS-BUILT INSPECTION REPORT PROFILE VIEW ~woe ~c~m~ s~mCES SCALE: AS NOTED SCALE: ~" = 5' ~4~3o ECIIO S~ D~WN BY TFM ~CIIO~GE, ~S~ ~516 FEBRUARY, 2001 MUNICIPALITY OF ANCHORAGE Department of Health and Human Sen/ices On-Site Sen/ices Program 825 L Street, Room 502 P.O. Box 196550, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 29, 2000 Expiration Date: Aug 29, 2001 Permit Number: SW000342 Legal Description: KIMBERLY MANOR #2 TR A1 Design Engineer: 0019 Flattop Technical Services Owner Name: Penny Zaudrin Owner Addrass: PO Box 111342 Anchorage, AK 99511- Parcel ID: 017-073-99 Site Address: 013450 LAMB DR Lot Size: 87121 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to Apd115, a subsurface soil absorption system under construction dudng freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: TRACT A-2~ TWOLOTS S/D INSTALL FDN. C.O, ABANDON EXISTING 1500 GAL. " SEPTIC TANK .- (COLLAPSIN?! ..' TRACT A-1 KIMBERLEY MANOR S/D #2 EXISTING LIFT STATION INSTALL NEVV GALLON SEPTIC TANK LOT 2, BLOCK 3 KIMBERLEY MANOR S/D #2 TRACT A-l, KIMBERLEY MANOR S/D #2 WELL AND SEPTIC SYSTEM SITE PLAN FLATTOP TECtl]qICAL SERVICES 14530 ECHO STP,.EET ANCIIOP, AGE, ALASKA 99516 I INCH = 50 FEET DRAWN BY TFM AUGUST, 2000 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. i~ [ 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 NAME PHONE MAILING ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO: rA~j /¢A'~I Absorption are. ~ Well / ' Dwelling PERMIT NO. ~ ~ Manufacturer Material No, of compartments ~ ~ ,~iq. capaciW in flallons IF HOMfi~Dfi: InsMe lenflth ~idth liquid depth 0 ~ ~ Manufacturer Material kiquid capacitg in oallons Well / Foundation / Nearest lot line / PERMIT NO. [~ ~ DISTANCE TO: / 0 ~ 7~ [~ Top Of tile tO sh ~rade / Material beneath tilo // Total effective absorption area inches /~o Length Width Depth PERMIT NO. tJ (, ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area [ ~ Well J Building foundation Nearest lot line ~ ~ DISTANCE TO: ¢ Class Depth Ddller Distance to lot line PERMIT NO, DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ~ ~'~ SOIL TEST RATING ~/~ A~ ~'~. INSTALLER REMARKS I . ~ '~:~'~ ~. t,~ ,. APPROVED DATE LEGAL 72-013 (Rev. 3/78) ? Department:~ 'f-~i%~-~d ~nvi~0nmenta~ ?rotection ~ 825 ~l street, Anchorage, AK. ~.~501 264-4720 * * ~ HANDWRITTEN PERMIT * ~ ~ Permit ~?~..D%~OO WELL AND/OR ON-SITE SEWER PERMIT /~ Applicant: ~/~/~ ~~/~ Mailing Address: ~. ~ Location: 7~,~-/ /~ ~ ~ ~, Phone Nu~er: ~ ~ ~' Legal Description: ~ ~ ~'~ '~ Lot Size: Type of Soil ~sorption System Is: Trench: /~ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ~.._ Soil Rating (sq. ft/br) ~/~ The Required Size of the Soil ~sorption System Is:' DEPTH ~.~ LENGIH /~ 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 minim~ depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~ GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the nu~er of 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. Min~ 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. Minim~ distance from a private well to a private sewer line is 25 feet and to a co--unity 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 31~ 1 9 ~ 3 * * I certify that: (!) ~ ~ f~iliar with the requirements for on-site sewers and wells as set forth by the Municipality of ~chorage. (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 r~odeled %o include more ~r~ Signe~: . Issued by: ~pplicant / Date: ~- I,,~. / ~'----'~ [~] SOILS t_OG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST PERCOLATION TEST PERFORMED FOR:' LEG^' DESOR,PT,ON: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17, 18- 19- 20- COMMENTS I IAI SLOPE SITE PLAN / / / WAS GROUND WATER · ' S ENCOUNTERED? l",.J o ~ P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop · "' , ,, .; -48, ~'PERCOLATION RATE (~*']~,~, ! (minutes/inch) TEST RUN BETWEEN ~'{ FT AND ~* FT PERFORMED BY: 72-008 (6/79) CERTIFIED BY: DATE: 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 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 o B WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? DATE PERFORMED: I~--I '7 --~'~ SiTE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop 3895-E COMMENTS PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ~ FT PERFORMED BY: ~O~[25 '-I~r'C]LOI'/!:iG-(Q'I CERTIFIED BY: DATE: 72-008 (6/79) PERMIT NO. APPL I. CANT ~E. bEPHp:F E. NI'4 fr'lF!.[:'_[::~l~ 2:S~±4- MC:PHEE ~2. Li]Ci=IT I ON LAME; I],R. LEGAL TR. R-i [..[ME. ERL. MRNOR LO"F SI;:.i'iE ,~',,,- - , TRENC:H T't'PE OF SO I L REr.:.:;CtRST I IZIN --, t .=,l EM I E;: FT,- E,F...) - MR>:;IMLIM NI_IME[ER IZIF'BEC, F.']EIMS = 4 '_-qIZIIL. F.'.RTZNG ,'9;]:! ...."- 27.~ THE RE$1_IIRE[, _-,I,=E IZIF THE SI]IL. REr:;-IF.'PTION ':'¢$TEM IS: [:" E F' 'T H = :.t. Z-~ IL_. El F~ ~::~ qF- H = ._ 5 ia Fi: F~ %.' E L- ,=,.':,.~ .... ~ =,.~;TREE:T., RNCHI.-.IRRGE., RK. "~':, 27'_a-2:5'1. t 77672 ) ]:49 5874 · J '2000 Si.".-:!UFIRE FEET THE LENGTH [:,IMENSION IF; THE LENGTH ,'IN FEET> OF THE TRENCH OR [:,RRINFiEI_[:'. THE [:,EPTH OF' R TRENCH OR PIT IS THE; [:,ISTRNCE BETWEEN THE SURF'RCE ElF THE GROUNI} RNE:, 'I"HE BO]"TOM ]F THE E::-::CRVRTION (IN FEET). .... ;'' IF; -. ' .... f"' -'-' tHE. I..E NO SE'I" WI[:,TH FnR IREN_.HE=,. THE GRR',,/EL I.]EPTH ZS THE MtN[MLIM DEPTH OF GRR'v'EL BE FHEEN THE OUTFRL. L. F'ZPE AND THE E:CTTOM OF THE: E~.:)Z:A',,,'FITION <IN FEET). F'R[:KRGE PLRNT MR'¢ BE INSTRLL. ED RT THE F'ERMITI'EE'"S OPI'ION El EJEE:T TO THE FOLL. OWI NG E 3ND I T IONS: 1. EITHER R [:I._RSS I ':R II NSF RF'F'ROVE[:' F'L~NT MF¢¢ 8E INSTRLLE[:'. 2. ~ C ZNTIN.OUE; MRINTENBNCE RGREEMENT IS REQUIRED. IF R MRINTENRNCE RGREEMENT IS NOT KEPT CURRENT '¢OU NR'¢ BE REQIJIRED TO ENI_RRGE THE SOIL. RBSORF'TION :,~:,fEf'l RND,."OR '¢OIJ i"IR'T' BE SI_IS.TEPT TO F'ROSECUTION. ,-,,q ', THOUT FINRL INSPECTION RNE:, RPPRO',,,'RL B'¢ THIS -.rN6 OF RN'¢ .=,,_TE. fl WI E:RCKF I L.L., ' .' '- -' T "' F'RFrqEF:UTION. [:,EPRRTMENT WILL BE .:,..IE,..EL.T TO -- - .., - . - .~ -i ,- ....... - "1- '-" MINIMUM [:,ISTRNCE E, EIWEEI R WEI_L RN[:, RN'¢ LN-=,I1E SEWRGE [:,I=,FJ=,HL S~'E;TEM iO0 FEET FOR R PRIVRTE WELl_ OR 200 FEET FOR R PUBLIC WELL. ]I"HE~ REQUIREMENTS MR'¢ RF'PL.'¢. ~;F'E[:IFICRTIONS RN[:, CONSTRUCTION E:,IRGRRMS RRE ,- .... f'O ]'N'~II~'E PROPER INSI"RL. LRTION. R~ HILHELE ~ ~.~.f ~ 'T I CERTIFY THAT ,- ......,,- .1.. I AM FRMIL. iRR WII"H "FHE REL..-.!I_IIREMEN"FE; FIR ON-E;ITE :.,EWER..:, RN[:' I-4EL. L.S RS; '.E;ET FORTH B't' THE MUNICIPRI-IT'¢ OF RNCHORRGE-- .......... ............... "'"'";~"~':'1 IN R-'r"nF.'l:,Hl'.l~:E HI'fH THE L. uE.E ,. 2: I WIL~,tMLL~. ................. ~....c. ,-"r_-H~.r;, c,¢,:,TEM f'lR'¢ F.'E':)JIRE ENLRRGEMEN'T' '" R~FP~_ ]~(~N~' JOEL-SEPH&PENN't' MHE:'E:'U,:':, IF THE N.° 889 '.._ ~ HEALTH DEPARTMENT , "~ .... ~ 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 " INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ,/~2~) 7z~, ADDRESS LEGAL DESCRIPTION ~ .~':, ~C~ -~/.5 PHONE __ LIQUID CAPACITY / ~'~ GALLONS. MATERIAL INSIDE LENGTH NUMBER OF COMPARTMENTS INSIDE WIDTH DEPTH_ SEEPAGE SYSTEM: NUMBER OF PITS L,NING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER f . /Z} OR WIDTH /~ ~:? ,'~TH ,DEPTH D,STANCE EROM WELL / . BUILDING FOUNDATION -7 .2 TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) /~'~ C'/~(~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER O F,.LI I<,rESN ABSORPTION AREA TOTAL LENGTH ~.porui~IDA.TION_ NEAR_ESVL'OT LI~'~ OF LINES /~DISTANCE BETWEEN LIN~S~' . TRENCH WIDTH ~-~ .... .-~ IN. TOTAL I~VE.E~. SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE WELL: TYPE~lv,~ ;//(?d/~r 7 DEPTH LOT LINE /'f/~' / f' NEAREST SEPTIC , SEWER LINE ~- ,TANK DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE__ ............. k/dj( ;~: ',>.t b~;,~,~,~l,~',~ 1' Bi~'~-.~~.~( 0 c/-~/ /Q, ~I~j~MPLE , NEAREST , SYSTEM . CESSPOOL , SOURCES ~ DISTANCES: c'/ DIAGRAM OF SYSTEM : ~, - . '~ . .-; ~ · .-~ - .~. : · : - "cl .. . - ~ - f.. E:""' '; : :: ; ~' ' ' :": '[ :. - ~:71.~ ~ - :" _ /. : : , .~' ~- ~ : , ' - : .... ' : : 71 : d't' ' . ~ ~ ' : .: '~ : .... ~ . ': ; : - ~. ~ - :.. . ' 'k'~':l~' Y '": -:-'~/"-'t :.--~ ' ~ : ' ~ : . ' ~ ~ : - ' ~ : i : i ' : DATE H E-.~LTH AUTHORITY gREa~'~ ANCHORAGE AREA BO~' h DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO, ~ 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION Al,ID PERMIT 'EGaL ,,ESCR,PT,ON Y-w INSTALLATION OF: SEPTIC TANK SEEPAGE PIT v 7?'" PHONE FINANCED THROUGH TO be INSTAllED bY lC /' ~-' '(~' ~ '~"~'¢/~ '~. (:(> ~_2 ~> l~;'~ soil TEST RESULTS NOTE: THIS PERMIT I$ NOT VALID WITHOUT SOIL TEST cOmPLETiON DaTe a~TiCiPatEd ~ ~ ~ FINAL INSPECTION: 24 HOUR__~O~JCE~REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL SE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK / FOUNDATION TO SEEPAGE PiT ~-~J , DRAIN FIELD / SEPTIC TaNK TO SEEPage PiT Wall / '~ SEPTIC TANK _, SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. / WEILTOSEPT,CTANK 5-0 ,BEEPAGEP,T DRAIN FIELD ALSO CONblDER AREA WELLS. WATER MA,N TO SEPT,B TANK /0 ~' SEEPAGE PIT / DRAIN FIELD SEPTIC TANK. . SEEPAGE PIT j DRAIN FIELD TO RIVER, LAKE, STREAM. DIAGRAM OF SYSTEM CAST 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 E~OROUGH ~:~EGULATIONS REGARDING INSTALLATION. DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, //~ ~ ~-~-f THAT THE abOVE Per, for'med Fo~'__ ~Jt'~ ~/0~ . Legal Des¢~,iption: Lot Block . . This Fc~m Reports a: Depth Fee~ Soll ?roD~sed Installation:' Seepage Pit, //'- · Drain Field Depth Of inlet Depth To Bottom Of Pit Or ~'r.ncn- '' Date:---'~ ' ' ~ ',.: ..~": ~:..~: ,.~ ':'. :7 ~ /~ . ,' , . , .. ....... ' '~ '~'2:;" '¥',, "".'". ' ';.. ' Reading Date Gmoss Timej Net Time Depth ,To H20 Ne~ Drop .... t ..... {5 ;; 'i - : e z'c'ole,'?.%oh ' ' . .... __4., January 3, 1978 Joseph/Penny Maddox 3914 Mc Phee 92 Anchorage, Alaska 99502 Subject: Tract A-1 Kimberly Manor ~ ~ Permit 977672 A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on 'the permitv by authority of Municipal ordinance° If you have drilled the well, a Well log should be sent to this department to document the installation date° If there are any further questions, please contact this office at 264-4720o Sincerely, Health and Environmental Protection Sewer and water Section GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330'"C!' Street, Anchorage, Alaska 99503 274-4561 Date Received //~ Time of Inspection REQUBST FOR APPROVAL' OF I~IVIDUAL SEWER & WA~R FACILITIES FOR 5. Type of Facility to be InsPected:_~.,,~¢~ Number of Bedrooms: 6. Well Data: 'l. A. Type C. Construction Sewage Dtsoosal System: A. C. O. B. Depth,,. D. Bacterial Analysis Septic Tank: 1, 'Size/'~_~V~,_ 2. ManufacturerJ-/""~/~ Seepage Pit: 1, Size ~. Material Disposal F~eld: Total Length of L~nes Distances: A, Well. To: Bo C. Septic Tsnk...~,~//' , Absorption Area/~.~/ , Sewer Lines , Nearest Lot l, ine~¢~ , Other Contamination~~ . FoundatiOn to Septic T~nk~/ / '¥ AbSorption Area /~ / Absorption Area to Nearest Lot Line ~ ~ ~ECEIVE~) GREATER ANCHORAGE AREk BOROUGH Department of Environmental Quality NOV 81973 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 ~. OF ENVIRONMENTAL QUALITY REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA xx 2. Property Owner: cox, James w. and Barbara A. Mailing Address: P.O. Box 1006~ Anchorage 9950 FHA CONV 279-4481 Day Phone Mr. Cox 3. Name ~f Buyer: HENNESSY~ James T. and Michelle L. Star Route A. - Box 413 344-7858 Mailing Address: Anchorage~ Alaska 99507 Day Phone Mrs. Hennessy 4. Name of Lending Institution: Alaska Bank of Cormnerce Pouch 7012 Mailing Address: Anchorage~ Alaska 99510 Name of Realtor or Agent: Bowden Co. Realtors 907 W. Northern Lights Blvd. Mailing Address: Anchora_~ Alaska 99503 Phone 279-5641 (E. McCall) Phone 277-1482 6. Legal Description: Tract_A-l, Kimberly. Manor s__Lp_, #2 Location: Hillside and DeArmoun Roads~__p~perty of_f of Lamb Road 7. Tyoe of Facility to be inspected: 8. Water Supply single family residence NO, Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 119 ft. 9, Sewage Disposal System Type ,of S~stem: Public Utility If Individual, date of installation REQUESTED BY: Alaska Bank of Commerce Pouch 7012, Anchorage, Alaska 99510 B. A. Oswald - Loan Processor Individual (on-site) October, 1972 one ,~equast-for Approval of'~£n~ivi(~ual Sewer ~ Wate'r Faoilit"1'e~J Page Two 9. Comments; ,,~.~,~f_~z-.'~-~ ~ (~/~ ~~ Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water fac~!itles located at: signed Date GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR 1. APPROVAL REQUESTED BY: 4 TYPE FACILITY TO BE INSPECTED: o NUMBER OF BEDROOMS: WELL DATA: ,, A. TYPE B. D E P T H C. SIZE E. BACTERIAL ANALYS I S ./~ "~,~ SEWAGE DISPOSAL SYSTEM: SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BAC~) 3. MANUFACTURER 4. INSTALLER ~APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO 7~ B. SEEPAGE PIT 1. SIZE 2. LINING C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B C D E F G WELL TO SEEPAGE PIT WELL TO SEWER LINE WELL TO PROPERTY LINE WELL TO OTHER POSSIBLE CONTAMINATION FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT H SEEPAGE PIT TO PROPERTY LINE COMMENTS: APPROVED: DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY October 1~ 1971 (Jill Hathaway St. Rt. A Ilex rtoS~A A~{chorage, Alaska Sl~bject: Tract A1 Kimberlv Nanor ,'-'~ Dear Hr. Hathaway: An inspection of the subject Property k~as madf~ tmday Oct~ had failed. T~ie cesspool is apProxi;)k~..ly 6:j r~ot froF, ~he well. 'Fh¢~ well was locatad in the basement u~de~ an out,- ~id(~ porch and the basement is at grou)~d love). Before approval for the sewer a)}d water ~ystei))s car~ be giv- proper Ut~tances from the ~¢)). If there are any qu~:~stfons ~,.~,~e to contac~ Sincere)v, Lynn S. Coad Et~vt ronmenta I Sp~,ctalist cc: James Cox