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Home My WebLink AboutMEADOW BROOK BLK 3 LT 10Onsite File Meadow Brook Block 3 Lot 10 #050-192-09 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 h ttp://www.rn u n i.orgf on site On -Site Wastewater Disposal System Permit Permit Number: OSP221126 Work Type: SepticTank Upgrade Tax Code Number: 05019209000 Site Legal Address: MEADOW BROOK BLK 3 LT 10 G:0153 Site Mailing Address: 18110 SANCTUARY DR, Eagle River Owner: REES DAVID M & Design Engineer: CREWDSON ENGINEERING, LLC This permit is for the construction of: Effective Date Expiration Date: enr S ^y + V. 1)clz.irrm�n[ Lot Size in Sq Ft: Total Bedrooms: 5/20/2022 5/20/2023 22507 ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 3 Special Provisions: There is a 10 It Utility Easement along the northwest and west property lines, not shown on the site plan. Easements shall be shown on record drawings. Kecelveo tsy: Date: Issued By: � Date: 5 �o Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-192-09 Property owner(s) David & Elizabeth Rees Day phone 907-854-8939 Mailing address 18110 Sancturary Dr., Eagle River, AK 99577 Site address Same Legal description (Sub'd., Block & Lot) Meadow Brook, Block 3, Lot 10 Legal description (Township, Range & Section) Lot Size 22,507 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank 0 Upgrade El Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 22 S Waiver Fees: Date of Payment: S-1 /(q/ Z Z Date of Payment: Receipt Number: Receipt Number: Permit No. 05P22. I Zh Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc James “Jay” Crewdson, P.E. Email: CELLC.1@outlook.com Cell/Text: (907) 280‐9493 Fax: (907) 688‐2295 PO Box 671389 ● 18368 Amonson Road ● Chugiak, Alaska 99567 May 10, 2022 Onsite Reviewer Municipality of Anchorage On‐site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99519‐6650 Reference: Meadow Brook, Block 3, LOT 10 Septic Tank Upgrade Design Narrative The owner of the 3‐bedroom home would like to replace the existing septic tank. The existing septic tank will be removed in accordance with the code and replaced with a 1000‐gallon or larger new septic tank in accordance with the code. The existing foundation cleanout will be inspected and reused/repaired/replaced to be in accordance with the code. A new double cleanout will be installed within 10 feet of the septic tank outlet in accordance with the code. There are no anticipated probable adverse impacts to adjacent properties if the septic tank upgrade is constructed as designed. Please feel free to contact me if you have any questions. James “Jay” Crewdson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221126, Rebecca Carroll, 05/20/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221126, Rebecca Carroll, 05/20/22 MUNICIPALITY OF ANCHORAGE DEl ,TIVIENT OF HEALTH AND HUMAN SER~ ;S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, TeLephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT TANKS ,F~2-'~SI-~PTIC ~..~--,,r,'>7'/~/C.,- [] HOLDING TYPE OF SYSTEM BED ~ W. DRAIN [] OTHER FT FT WELLS FT FT PRIVATE F'[ ~,'-r'"'~ H E R (Identify) lolal Depth ~asod IO DISTANCES WELL LOT LINE FOUNDATION SEPTIC TANK ABSORPTION FIELD /o/ -~ WELL AS-BUILT DIAGRAM ~Show location ol well. sephc system, properly hnes, foundahOn d(iveway, wale[ I)OdlOS, otc / REMARKS: Scale: /Mi tnspecUons Pedormed by. _j p,,...~ Dale I S 8, S ENGINEERING = __ conily that)his insp. eclJon was poriorumd according lo all -l~O-~4~[~--~r Loop Road No. 204 ~/~ /~ -~ Date ~--~Z_ PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9-- 10 11 12 13 14 15 16- 17 18 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section: ~/V'.M'/ /~.~ ~" ~. ~'(--/~ SLOPE SITE PLAN ¢ '-,. '-., .... x, WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT Beplh l0 Water Altar / -- hlonitorino? f Date: Gross Net Depth to Net Reading Date Time Time Water Drop ,_%- L, / .' ~ ~ ~- ~/~" /,¥q /~;~ q ~/~," / ~ ~ /~ ,, ~ /~" /,~,, PERCOLATION RATE . TEST RUN BETWEEN "~'~ (minutes/tach) PERC HOLE DIAMETER PERFORMED BY' __~p/v'~ ~.~'~ CERTIFY TH~AT THIS TEST WAS · MUNICIPAL GUI DELI ~ ECTON THIS DATE DATE ~'"/~ ACCORDANCE WITH ALL STATE AND · · / 72-008 (Rev. 4/85) PERFORMED IN SCALE PERFORMED FOR: ~'~ C~"~, / Municipality of Anchorage DEPARTMENT OF HEAL'f'H & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~--~";"/~ ~<:.-.,~ /V/g~,',~,,¢..¢~'~.. Township, Range, Section: //../~'//~_~ ¢~.f/~'-c_ /~._ 5 ~t/~-5, SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT -- O DEPTH? ~ p E Oeplh Io Water AIt~r Monitorino? t,.J~-/~' Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (mlnutes,qnch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ~F'~T AND FT COMMENTS PERFORMED BY: ~O~M~//~~ CERTIFY THAT '~HIS TEST WAS PERFORMED IN ACCO R DA N CE Wl~ *~ L'~*'E~~ L G ~ ;; ~~T ON THIS DATE- DA~E: 72-008 (Rev. 4/85) GREA. :R ANCHORAGE AREA BOR.. ,GH ',, ' / Department of Environmental Quality '~" .... 3330 C Street Anchorage, Alaska 99503 NAME INSP[Cl'i6N REPOttT ON:siT[ sEW~G[ DISPOSAl. SYSTEM SEPTIC TANK: D,S -ANCE NUMBEROF FROM WELl_ ' MANUFACFURER ~ MATERIAL COMPARTMENTS INSIDE LENGTH t.~ __ __ INSIDE WIDTH __ LIQUID DEPTH LIQUID CAPACITY/~:;~e~¢) GALLONS. TILE DRAIN FIELD: ~.O~ /~//%- (j " TOTAL LENGTH / DISTANCE FROM WELL ' FOUNDATION NEAREST LOT LINE /(} OF IINES ~ / NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH W DTt .~ IN TOTAL EFFECTIVE ABSORP'F,ON AREA o>~C(~ / - SD. FT. LENGTH OF EACH LINE / DEPTH OF FILTER //L~ " DEPTI4: TOP OF TILE TO FINISH GRADE '~ ~/7 - ,~ _ .MAFERIAL BENEATH 'FILE IN. /~BOVE TILE IN. WELL:/~ CONS~ RUC'I ION DEP-rN BUll DING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION --, LO]' LINE __ , SEWER LINE , TANK SYSTEM CESSPOOL OTIIER SOURCES DISTANCE FROM: APPROVED DISTANCES: DISAPPROVED .REMARKS .2> SEWER LINE DEPTPI: LOT SLOPE: REMARKS: DATE DIAGRAM OF SYSTEM APPROVED Form EQ-032 I"11:::1;:.:: :11MI...IM I"dI. Jl"ll!ii:lL~]:;il OF:' I~ii:Ei]],l:;~:[u]l','tl!i; .... ]: :iii;O :[ I... i?.F::IT ]i I'.dl] ,:i '.iii;I;ii! I::'T,.."E:Fi: :: ...... 'FHEZ !?.Jii!]~:!l...I ]: I:;i:li!!]]:, :~i; ]i ;~liill (]1::: "I"F'IIi::i ]il;II ]: L. I::II?,:iii;[)F;i:F::'"F ]~ lin :, .~.;'l'Eil" :I; :i~; ' -I'l'flii{ I...Iii~I",IC!i'T'H [:, ]; MI!i]",I'.E; Z 01",1 i[ iE: 'I'I-IE; I.]!!]",tl]i'T'H ,:i ]i N F:'Iii]R]" i:, I]F: 'Tl'"llifl "['Fi?.I!~]'.,II]I-] [11:;?. I],l:;?.l:::t -I"HEi [:,EZF:"r'H OF' FI 'T'I:;~:E]'.,I[:H OR F' ]i T ]Z :El 'T'HEi D ill i~;']'I::II",IC:Ei E:E]"HEEN "l"F.II~il :!i!il. ll:;i,l:::'£::l ]:Eli 01::: 'r'l...IE!; !iF:i]l NJ", i:::li'.,ll]:, 'THEi E:i" "l"'l"[ih'l i'" ~::' "I"HE~ Ii :.: ii :::l'v'l:l]' ]i ] I'.1 ,:; ]i N F::'Eti~]' 'i"HEI:;;rE ii: '.'~ Nr] :!!iil!~i"l" H ]'. I],"l"H I::'(]Fi: .... :~ E~]'.IF' I'~1:::';-: 'l-Hlii!i [~il:;li:::l'v'[?l [:,llii]::"l"H i['.E; 'FI..~E I"'I ]i N i[ HUH [H!!]:::"TH I'"l:::' ':' ': ..... .. F.,, t~:.l., l{?,l~!!]"l.,.ll!~]{i!]'.,I "I"]...IE i-'il 'r'I:::'F:iL.L. F::' I:::11'.,1[:, 'T'HIEi Eui"T'I"[iM i]1[-~' THE'. ....... ,'., · , ~ I]J",J i:: ]: j,.,J F:'j~!~ii:'rl' ]] CI~]:;?.]']:F::'"r' "I"HI::'I'T ::1..: i[ I::IH F::'F::Ih'I]iL_]iI::I~q'. H~'T'H "I'HEi] Fi:I:]!]]:!U][I;?.Ii~:]'"II:~]",I'I"Ii~; I:::[ll:;?. CIl",l'""i~i;]]"Fl!!i] l!i!;IJ:].'.lli~]:;?.:!ii; I:::11",1[:' I.'.llili]..~l...:!il; I::II!!!i I:::OI:;i:TH li?'r' ]"HIE] HI..)Iq]:[]:'.I]I:::'FIL..]i]'"d OF: 2: :ti H ii] L.L. Z I",IZTI:::IL.I..~ "l"Hlii~ ~iii?'r'~i;'t"lii]"l ]i I",1 I'::I[:[:OF~'.[:'F:II",I[]E:.' H ii] TH 'l'Hliiil ]:: ]] I.Jl",ll]'E:]::~::iii;]'l:::lNE:, ]'HI:':I'T' -I'I"~E ON'"'I!B]]"I"I~: '.iii;l:~iil.,.ll!!i]:;~: :!i?'r'lii.:,]"E~l'"l I"'lF:t~'r' I:;~'.t!~(i:!I..I]iI:;~:E] E]",lL...l:::lF;i:[iiEi]','ll!i!]~..IT i1~1::' "FHEil Fi:l~i]i:~;]]l],llil]'.,l[:l~ ][:i~; I?.l~'~]'"lO[:,E:]....fiff]]:, "1'1] ]]l'.,ICl._l...ll]:,li:{ I'"i[ll::~:l!i~ 'l"l-..ll:::ll'.,! ]: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222~ SOILS LOG - PERCOLATION TEST PERFORMED FOR:~ ,? dC- . ,-_..L~:.I / [ LEGAL DESCRIPTION: j ,'")"~ 1 2 3 4 5 6 [] PERCOLATION TEST DATE PERFORMED: '~--:~' "': ~: .,. ,, :/,: IO:'~ ~--C~..~ ~ :. SiTE PLAN 8 9 '10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER ENCOUNTERED7 dO , IF YES, AT WHAT DEPTH? COMMENTS_ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE [minutes/inch) TEST RUN BETWEEN -- FT AND . FT ,~ :" 0 ,' 4 ~/o1~,,~, n> ?~ ~ov... ~,h~, '' ~ £'~r':'~' CERTIFIED BY: ~"JD~O.n'~'~-~ ~' _DATE: 72-008 (7/76) MUNICIPALITY OF ANCHORAGE ~.~ ~> 0 DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 H86-1307 Application Date .GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL/ (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 10 Block 3 Meadowbrook Subdivision (b) Location (address or directions) 18110 Sanctuary Property Owner Betsy Rees Mailing Address Telephone: Home 694-9604 Business (c) Lending Institution United Bank Alaska Mailing Address Telephone Anchorage, Alaska (d) Real Estate Company and Agent Address Telephone MailtheHAAtothefollowinaaddress:or;Checkhere[], ifholdforpickup, Listcontactpersonanddayphonenumberbelow. S & S Engineering 17034 Eagle River Loop Road ~204 Eagle River, Alaska 99577 (e) TYPE OF RESIDENCE Single-Family [~x Number of Bedrooms three(31 WATER SUPPLY Individual Well [] Community [] Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [~x 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 I of 2 72-025 IRev 8;861 From ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the vaJidation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water suppJy 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 S & S Engineerinq Telephone Address 17034 Eagle River Loop Raod #204, Eagle River 99577 Date Engineer'sSeal This department has received written confirmation from the engineer regarding the Conditional Approval of December 6, 1986. The corrections have been accomplished and an inspection has been completed by the engineer. The subject property meets with Municipal standards and is now approved. A copy of the as-built is attached for your information. Approved for three ( 3 )bedrooms by ApprovedXXXXXXXXXX Disapproved Terms of Conditional Approval Date August 10, 1987 Conditional CAUTION 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. Pa~u ~ of 2 72 025 fRev 8/'861 Back MUNICIPALITY OF ANCHORAGE D,~PT~ OF HEALT~-J & ENVt~Oh,k.~[NI'AL F~ROI ECTION RECEIVED ROBERTA, SHAFER August 9, 1987 CIVIL ENGINEER 694-2979 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECT[ON & FLOW TEST Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 10; Block 3; Meadowbrook Subdivision A conditional Health Authority Approval was issued on the referenced property in December, 1986. In order to satisfy the conditions of this approval an upgrade of the absorption area was required. An upgrade of the system was performed under MOA permit #870187 and a copy of the on~site sewage disposal system inspection report is attached. Request you issue a final HAA at this time. / Sincerely, , I'ROBERT,"A. SHAFER, P.E. SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN SRB 196X EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAl PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILI'rY 264-4720 GENERAL INFORMATION (b) Legal Des/cription (include lot, ,bl..~ock, subdivision, section, township, range) Location (address or directLons) Applicant Name~~' .~., Telephone: Home ~_~;;~'~//'-.-¢': Oy Business Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder/~; Buyer []; Other [] (explain); (d) Lending Institution ~~-.-- ,/~"~""~_ Telephone Address ~'~,¢'~,~-~.-~ , /'~.¢~'~,---~¢~, (e) Real Estate Company and Agent Address _.~one (f) ' 4~a~the HAA to the following address: TYPE OF RESIDENCE Single-Family,¢~]/ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well [] Community [] Public,.[~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsitei Public [] Community [] Holding Tan]([] Note: if cbmmunity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, Page 1 of 2 72 025(11,8,1) ENGINEEFIING FIRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, DA~A 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, 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 ~ S E,~',.IC,~N~6 Address SR 1~ ! Date EAGLE Telephone Excavate existing absorption area to determine condition of horizontal percolation pipe and replace if necessary° Install monitoring tube in existing trench. Examine soils to determine accuracy of original soil test. , ,.-. - I /~ 'x'~ ' -- ,~' ~¢ -,~,~ ,' Approved for ~ bedrooms by Approved __ Disapproved Terms of Conditional Approval ~'~'/~O CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the 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 requirements, Employees of DHEP 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. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MO~; HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot '~ ¢, o To NeArest Edge of Absorption Field on Lot Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) * + ; On Adjoining Lots ~--¢¢/"J- Z..c,~ ~-P ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments To Nearest PubLic Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed _1! - ~ -'~ Size Standpipes (~/N) Air-tight Caps (~/N) Depression over Tank (y/~.r.~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ Separation Distances from Septic/Holding Tank: No. of Compartments Foundation Cleanout (Y/I~. Date Last Pumped ~- - Z.. -~,~ t-J(/~ ; for Temporary Holding 'rank Permit (Y/N) To Water-Supply Well To Property Line To Water Main/Service Line Course ~'~/~1 To Building Foundation ,.~ /, To Disposal Field ~_ c~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) 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 I,,~f, Type of System Design / Length of Field Depth of Field / Gravel Bed Thickness Standpipes Present ~.~P'N) Date of Last Adequacy Test To Property Line /o To Existing or Abandoned System on ; On Adjoining Lots ~.¢ '¢' To Cutbank (if present) "'~/~ To Water Main/Service Line /o To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ~'~ Comments ~r.,.~,~7'c='~'~ ,'~.~c,,, ¢-c,u.~ ~'~' D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify~ ~l~N~R~ied, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ __. 1..~_Ax Date Compar~[.~ RIVER;AK09577 MOA No. ~ Receipt No. Date of Payment (,_o c'~ . (-.~ (~,~ Amount: $ Page 2 of 2 72-026 (~ 1/84) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received February 4, 1977 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Conv. James E. Davis 1670 Crescent 99504 Phone: Phone: 276-7777 3. Legal Description: Lot 10 Block 3 Meadow Brook Subdivision 4. Location: Sanc~ur¥1 Driv~ 5. Type of facility to be inspected 6. Well Data: A. Type Public Utility C. Construction Single Family No. of bedrooms 2 B. Depth D. Bacterial Analysis 7. Sewage Disposal System: On-site system, Permit ~76850 A. Installed C. Septic Tank: D. Seepage Pit: 1976 B. Installer ('~'[N~L~.% ~-~d 1. Size ~,F~][-~(~>~. 2. Manufacturer ~,~.%~ ~o,.~,~__ 1. Absorption Area ~q!~O~>~' 2. Material ~k~z~?.~a. Total length of lines ~I E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , Absorption area , Other contamination , Absorption area C. Absorption area to nearest lot line , Sewer Lines EQ-034 (1/74) Page 1 of two pages Call Jo Davis ?1o Childs when ready 27( 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 777MUNIClPALI'IY OI: ANCtlOIU.,GF. DEPT. O1: HFALTH & ENVIRONMEN'iAL P~<OTECTIC:~ FEB 4 1977 1. Type of Inspection: CMRO 2. Property Owner: James. E. Davis Mailing Address:_],670 Crescent VA F HA. .CONV~xxxxxx - Enterprise Const. Co. Day Phone: 276-7777 3. Name of Buyer: Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Day Phone: Phone: JO Davis - Executive REalty Mailing Address:_ 2810 C Street Phone: Legal Description: I,ot 10 Block 3 Meadowbrook Sub Eagle Location: Sanctuary Drive 276-7777 River 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utility XX 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. g ,I ndividual .Individual (on-site) N~w 1 076 72-003(3/76) Page 2 of two pages - Ret st for Approval of Individual ~ ~r & Water Facilities Legal Description Lot 10 Block 3 Meadow Brook Comments Approved~ ~/~ Disapproved Apprq~]]YValid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval 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)