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MEADOW BROOK BLK 3 LT 5
Meadow Brook Block 3 Lot 5 #050-192-15 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW020170 PID Number: 050-192-15 Name` SANDRA WOODS Wastewater System: ❑ New ■ Upgrade Y P9 16320 SANCTUARY DRIVE * EAGLE RIVER, AK 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 696-0754 3 0 Deep Trench ■ Shallow Trench O Bed O Mound ❑ Other LEGAL DESCRIPTION Soo Rating: 1.0 Total Depth ham original grade. 8.5-9.0 CPD/Sq. Ft. Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Crawl depth beneath pipe: 3 5 MEADOW BROOK 4.5-5.0 FL 4.0 FL Townshlp: Range: Section: FlII added oboes original grade Grovel length: — — — SEE DWG. FL 45 FL WELL: ❑ New ❑ Upgrade Gravel wkah: 5 Number of line: 1 Dhtarwe between Inn: — Ft. FL Clawiliwt n private, 0.s.C): ToWI Cann Ta Total absorption area Pipe material: I FL FL 450 so. FL D 3034/ F-810 Driller. Date Drilled: Static Water Level: Installs: Cole Metal • AURORA EXCAVATING 5%14-6/30/02 Ylelo:Pump Set &Cwing Height Above Ground: TANK FL Ff. SEPARATION DISTANCES ■Septic 13Holding 13S.T.E.P. 0Other To Septic Absotion Lift Holding Public/private NamdocWror. ANCHORAGE TANK Capacity In gallons: 1000 From Tank Fid Station Tank Sewer Linea Well 200'+ 200'+ — — 25'+ ltotedok STEEL Number of comporWwnts: 2 Surface water 150'+ 100'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — Sin in gallon: manufacturer. Foundation 5°+ 10°+ — — — "Pump on Mal ab Limp ab High water alarm ab Pump Make ENebkal Inspection ps/smed by: Curtain Drain NONE KNOWN Remarks: BENCH MARK Location and Deeaription: GARAGE MANDOOR THRESHOLD Assumed emotion. 100.00 Ft. ENGINEER'S SEAL 0 Inspections performed by: AKWWC, INC. Dates: 1st 5/14/2002. . .. 2nd 6/25/2002 0 3rd 6/30/2002 Development Se ices D a ent Approval -79 `�P"o� o 4�p��0000sioti Reviewed and approved by Date: W/ a 1-1 PERMIT NUMBER: AS—BUILT B 22.25 DRAWING A 26.00 PARCEL ID NUMBER: 050-192-15 SW020170 30.97 26.06 MT1 23.99 C I\ \ EXISTING DRNNFIELD I \ l TOBE SITE A INSTALLED ESR OW \ MT3 \ THp, vv CD2 \ \ \ D DBL3 r r q\ST`R�M 3 B SSE DBL1 \ \ DBLE NEW 1000 GALLON SEPTIC TANK \ ST1 A 28.73 B 22.25 CO1 A 26.00 B 52.63 ST2 30.97 26.06 MT1 23.99 50.55 DBL1 33.29 27.98 CO2 52.92 25.54 DBL2 33.71 28.64 MT2 53.68 26.50 FD 33.81 29.69 MT3 35.42 39.83 ..... DATE: 7/17/2002 k DRAWN BY: . �• C.J.G. ALASKAWA ol"WASTEWATER SCALE: t 1 = 30' 901 DESARR ROAD, SUITE 28 • ANCHORAGE. AK 99504 •PHONE (90])337-b1]9 • FA% (90])330-32L6 EPARED FOR: PHONE NUMBER: - PAGE NUMBER: SANDRA WOODS (907) 696-0754 2 OF 3 ;AL DESCRIPTION: ... MEADOW BROOK SUBDIVISION; LOT 5, BLOCK 3, IE OF WORK: AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 1 r..... .......PA _J ffr Garn S.: E 79 e`O g; esstio�oo ��0400 PARCEL IO NUMBER: PERMIT NUMBER: IN- 050-192-15 SWO2O17O AS-BUILT INSULATED FINAL GRADE PER CONTRACTOR 96.77-97.31 TOP OF TANK AT F� TOP OF TANK AT INLET - 93.78 I OUTLET = 93.81 FILTER FINAL GRADE - 95.14-95.50 r ORIGINA / = 953 U/V L: p vv A. 446 1 k D wNt�/2002 0 �C� .. r4�0 ... ....... Y...., •.V QO C.J.G. /� •' ALASKA. WATER &WASTEWATER SCALE: CONSULTANTS, INC 6901 DEBARR ROAD SUITE 28 ` ANCHORAGE, AK 99504 ' PHONE (907)337-6179 . FAX (907)5383246 N.T.S. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: _.••. _ .,,,, ,.,,� SANDRA WOODS (907) 696-0754 3 OF 3 e Gar ess: 0 �O LEGAL OESORIP'T10N:. o49s •'� -7 � O MEADOW BROOK SUBDIVISION; LOT 5, BLOCK 3, \D e''e •..•...... e��oo TYPE OF WORK: %,0" sof essl0000 PROFILE AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 4000v NEW 1000 GALLON INVERT OF BUNG SEPTIC TANK INVERT OF BUNG AT AT INLET 93.22 OUTLET - 93.05 FILTER FINAL GRADE - 95.14-95.50 r ORIGINA / = 953 U/V L: p vv A. 446 1 k D wNt�/2002 0 �C� .. r4�0 ... ....... Y...., •.V QO C.J.G. /� •' ALASKA. WATER &WASTEWATER SCALE: CONSULTANTS, INC 6901 DEBARR ROAD SUITE 28 ` ANCHORAGE, AK 99504 ' PHONE (907)337-6179 . FAX (907)5383246 N.T.S. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: _.••. _ .,,,, ,.,,� SANDRA WOODS (907) 696-0754 3 OF 3 e Gar ess: 0 �O LEGAL OESORIP'T10N:. o49s •'� -7 � O MEADOW BROOK SUBDIVISION; LOT 5, BLOCK 3, \D e''e •..•...... e��oo TYPE OF WORK: %,0" sof essl0000 PROFILE AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 4000v 05/14/02 TILE 15:55 FAX 1 907 696 3297 MAIL BOXES ETC i I �J IU UYIL1�Y CI..F. btCgl"� / 004 41 ye a ,"r`�r•1M�lI�"11 �xy r•V n n«n.,av!,ss. .. 4 r4 . •t : l ?' +n'•r:� AS -BUILT I hereby certify that I have surveyed the following described properly: LISTS. mm one ao nor ovens or encroaen on imt property lying adjacent thereto, l at no Improvements on propp arty lvl09 adjacent thereto encroach on the premises in question and that there are no roadways, transmission. Unca or other visible easements on said property erteept as indicated hereon. Dated at Engle River, Alaska this. 6_A_day or Ju n 1. .tglL ROBERT C. JORNSON 'x&tj— ' SCALE: t Registered Land Surveyor No. 990•LS i' = 20 Box 45g En plc River, Alaska phone d94-7543 / 3S. 0 • 24 nsfAe Ji L 6ARA&C 'H 4!( y 'j PYIJF,n it y �� Vj SIN&LE STORY v F'PASIE. 42 r I �J IU UYIL1�Y CI..F. btCgl"� / 004 41 ye a ,"r`�r•1M�lI�"11 �xy r•V n n«n.,av!,ss. .. 4 r4 . •t : l ?' +n'•r:� AS -BUILT I hereby certify that I have surveyed the following described properly: LISTS. mm one ao nor ovens or encroaen on imt property lying adjacent thereto, l at no Improvements on propp arty lvl09 adjacent thereto encroach on the premises in question and that there are no roadways, transmission. Unca or other visible easements on said property erteept as indicated hereon. Dated at Engle River, Alaska this. 6_A_day or Ju n 1. .tglL ROBERT C. JORNSON 'x&tj— ' SCALE: t Registered Land Surveyor No. 990•LS i' = 20 Box 45g En plc River, Alaska phone d94-7543 h MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade 1,57 Lo�Z����>✓! Date Issued: Jun 13, 2002 Expiration Date: Jun 13, 2003 Permit Number: SW020170 Parcel ID: 050-192-15 Legal Description: MEADOW BROOK BLK 3 LT 5 Design Engineer: 0041 AK Water & Wastewater Consultan Site Address: 018230 SANCTUARY DR Owner Name: Sandra Woods Lot Size: 12960 SQ. FT. Owner Address: PO BOX 771386 Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER, AK 99577-1386 This permit is for the construction of: Z Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during 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: 3 162— Date: 2 Date: 6 /3G2 Municipality of Anchorage Development Services Department Building Safety Division Sq 6?Y ^ On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O iD" /RaZ—/S Permit Number 5w020170 Property owner(s) SANDRA WOODS Day phone 696-0754 IS23o Mailing address (1) i35-29 SANCTUARY DRIVE * EAGLE RIVER, AK Mailing address (2) Vc> l o -g %-71 5% Zip Code 99577—/396 Legal description (Lot, Block & Sub'd.) LOT 5. BLOCK 3: MEADOW BROOK SUBDIVISION Legal description (Section, Township & Range) N/A Lot Size 19-9 %b Acres/ED Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS INC. Permit Fees: /-I ort cG Waiver Fees;_ Date of Payment: Date of Payment: Receipt Number: C2a0 Receipt Number:. ALASKA WATER & WASTEWATER x ,rossmnew CONSULTANTS, INC. wx�wnnxnixex�xxmx� nwxww. May 23, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System Upgrade for Lot 5, Block 3, Meadow Brook Subdivision To whom it may concern: The existing 3 bedroom house is served by a community water system and a private septic system. A test hole was excavated in the area of the proposed septic system. The septic system will be designed around the 30 foot radius of this test hole. The existing septic system consists of a deep trench type drainfield and a 1000 gallon "bootlegged" septic tank installed on 5/14/2002. The drainfield is in a state of failure. We are proposing to document the septic tank and install a new five foot wide drainfield. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 1.0 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: I& <1 minutes/inch b. Allowable Application Rate: 1.0 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 450 ft2 f. Total Depth: 9 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.50 j. Minimum Length: 45 feet long k Effective absorption area = 450 ft2 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The area for the proposed septic system is approximately a 5%-15% slope running northeast to southwest; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. ;., M.S. NOTE: Attached is a site plan drawing, a design drawing, two soils log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179* Fax: (907) 338-3246 * Website: akwwc.com ITE: ALL PROPERTIES SHOD SERVED BY PUBLIC WATER NO ry r mS n•m �o 1 LOT 7, BLOCK 3 / I MEADOW BROOK S/D JfA°°W eRpOK sl° M .y�Cor h•9 6< LOT BA, BLOCK 3 1 MEADOW BROOK S/DI \\\\\\ MFA°p� VF \TH#1 4,40 POo��gF h/J si0 .- �r "o s epOo,F�Yr tOPOSED DRAINFIELD UPGRADE (SEE DESIGN "DESIGN PAGE 2 OF 2) \ \ y'• 6 M, 40 o�O�� a < k•eR<OC ? \�4 Or OOF¢\\ \ o�e�4 -EXISTING s�0 " SOA 3 HOUBEDROOM £S' / E l Rf ? LOT BB, BLOCK J O i 4 MFAWW BROOK S/D \ + + �2 + �eBl sip EXISTING\ CIA SYSTEM + \ EPTIC9 LOT 9, BLOCK 3 i MEADOW BROOK S/DM (Or 40W9��' (Or 3 40 'wog,• B400k s/O /" r BR � /- 0+ 40 40 04- P40 +\\ Ksio moi'! PpRN�- ,�•-` � �� \ DATE: 5/23/2002 ......... .. ,„. ..................,.. DRAWN BY: .. .. ALASKA WATER & WASTEWATER C.J.G. .."cl)�it x„wnN^«w CONSULTANTS, INC S� 4 H ,J� ............ 6901 DEBARR ROAD, SUITE 2B' ANCHORAGE. AN 99E04' PHONE (90])337-b1]9' FAX (907)338-3246 1" - 100' - WA PREPARED FOR PHONE NUMBER: PAGE NUMBER: r SANDRA WOODS 696-0754 1 OF 2 j, e e .G ..•.. LEGAL DESCRIPTION: ��r C 7953 MEADOW BROOK SUBDIVISION; LOT 5, BLOCK 3 TMPDWORK: p o\�L�'> SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE Q`�V o s10 / ! \ 2e EXISTING DRAINFIELD TO BE\ USED AS A RESERVE SITE li (APPROX. LOCATION) / O r' - PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 9 FEET DEEP MAXIMUM BY 5 FEET WIDE BY 45 FEET LONG. ADD 4 FEET OF CLEAN, WASHED SEWER DRAINROCK. \� o A NOTE: THE CONTRACTOR SHALL ARRANGE TO HAVE A PRE—CONSTRUCTION SITE VISIT WITH THE ENGINEER PRIOR TO CONSTRUCTION OF THE DRAINFIELD. rDRIVEWAY. �150�G 3 B SSE EXISTING 1000 GALLON \ "BOOTLEGGED" SEPTIC \ TANK. INSTALLED ON 5-14-2002 INSTALLLE CLEANOUTS\ NSTALL FLOW \ DNERTER \ \ '�k� a rRcdsR'i s- c sem. DRAWN BY: WATER & WASTEWATER L.G. Lnr alCONSULTANTS INC SCALE: 30 4 �O „ _ ,., A,,,o,,,,,.I'll — SANDRA WOODS (907) 696-0754 2 OF 2 LEGAL DESCRIPTION: MEADOW BROOK SUBDIVISION; LOT 5, BLOCK 3 DESIGN OF PROPOSED SEPTIC SYSTEM UPGRADE ALASKA W.2 _kl LEGAL DESCRIPTION: MEADOW BROOK SUBDIVISION; LOT 5, BLOCK 3, PERFORMED FOR: SANDRA WOODS DATE: 5/15/2002 DEPTH — — (PAGE 1 OF 2) (feet) =_� ORGANICS TEST HOLE #1 1 ML SM/ML w/ GM LENSES THROUGHOUT ao° "`O°°° GW/GM & 11 'bt''°°° SW/SM a"`�°°° MORE SILT , ° 12 °;"o w/ DEPTH SOIL CLASSIFICATIONS DEPTH TO GROUNDWATER DATE DRY • • DRY 5/23/2002 l/w/, i1NN - ��4�i�i OMNI �i�B. - DEPTH TO GROUNDWATER DATE DRY 5/15/2002 DRY 5/23/2002 5/17/02 1 - - „= "evoOK sl° MCor mow eC \ BR �K Mzor2, � BRoo�k s SITE PLAN kS�o 1"=100' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/17/02 1 - - 6" - (UPPER 2 - 3 0" 6" BE CH) 3 - - 6- 4 - 3 0" 6" 5 - - 6" - 6 - 3 0" 6" NOTE: PERCOLATION TEST PERFORM 7D IN GM LENSE PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3.5 FT. AND 4.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB GALL COMMENTS: THE NATURAL SILTY INSITU SOILS SHOULD ACT AS A SAND FILTER. PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W ;S P FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 5 Z LEGAL DESCRIPTION: MEADOW BROOK SUBDIVISION; LOT 5, BLOCK 3, PERFORMED FOR: SANDRA WOODS DATE: 5/15/2002 DEPTH (PAGE 2 OF 2) (feet) TEST HOLE #1 1 6- READING CLOCK TIME SOIL CLASSIFICATIONS NET DROP (INCHES) 7— 7 GW GM GC SW — 2 4 Q C) — 8 ORG CL OL MH — 6 5 °o° o°o o i�� i $ LL 10 SP SM Sc — GH OH / — 6- READING CLOCK TIME NET TIME (MINUTES) 0 NET DROP (INCHES) 7— 7 1 — — 6" — 8 J — 6 5 6" s 3 — 10 ry — 0 — 11 11 6" 5 — 2 12- 1 6" — 6 — 13--1 13 C) 6" 14 17 LiJ W 18 U) DEPTH TO DATE GROUNDWATER OF 2 P PSE 1 SES SEE PAGE 1 OF 2 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/17/02 1 — — 6" — (LOWER 2 — 6 0" 6" BENCH) 3 — — 6" — 4 — 6 0" 6" 5 — — 1 6" — 6 — 6 0" 6" 19 PERCOLATION RATE 1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 7.5 FT. AND 8.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB GALL COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THISA� S PERFORMED IN ACCORDANCE 5 WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: z MUNICIPALITY Or ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 _ =-� ON-SITE SEWAGE DISPOSAL SYS'T`LM AND/OR WELL INSPECTIIOON" REPORT — ANW FAME�___._,_.�---.��-.._-�9--'—w���—_ r❑UPEGRADE IAI LING ADDRESS EGAL DESCRIPTION OCATION NO. OF BEDROOMS Well Absorption area Dwelliny PERMIT NO. - DISTANCE l O: C U a Q Manufacturer Material LU I No. of compartments N h Liq. capacity in gallons Inside length Width Liquid depth IF HOMEMADE: Well Dwelling PERMIT NO. D y DISTANCE TO: O d _ Manufacturer Material Liquid capacity in gallons 2 p Well Foundation Nearest lot line PERMIT NO. j DISTANCE TO: w u- z No. of lines Length of each line Total length of lines Trench width Distance between lines Zw inches R' Q cc N - _ Top of rile to finish gra e i Material beneath tile I - AV Total effective absorption area 0 Length Width Depth PERMIT NO. W OTotal Q p- Type of crib Crib diameter Crib depth effective absorption area w U1 Well — Building foundation Nearest lot line N DISTANCE TO: Class Depth Distance to lot line PERMIT NO. J W Building foundation EDriller ine Septic tank Absorption area (s) DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING Ila INSTALLER 4 44W REMARKS S 1 � n 0 I I 0 APPROVED DATE LEGAL ?? /^ .^��� 4��X Q���� �� ����"�����/�`� DEPHRTMENT � HEHLTH HND ENVlRONMENTHL ROTECTION ^ ` 825 �L� STRE�T, HNCHORHGE/ HK. 99501 264~4720 IF., "..-.o.,; CH: p fE,� 1Io�FE-,:F�,��.,II,,1I 1: / HPPLICHNT FRHNK OSTROM 4520 MHCHLISTER LOCHTIOIII LEGHL LOT 5 BLK I MEHDOW RIDGE EST "1" -E-_ -4� �1 TYPE OF SOIL HBSO�FIT IMN SYSTEM ISTRENCH MHX�MUM NUMBER OF BEDROOMS � ] SOIL RHTING (SQ FT 150 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS: �A.=: ��M Kit "Y R -A tfl� �too got �M R.. ��IF-D, _g", U-- D� � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES THE CiRHVFL DEPTH IS THE OF GR: f:iVE:L 8�TWEEN THE OUTFRLL PIP� HND THE BOTTOM OF THE EXCHVHTION (IN FEET). 9 1 FE F"M X C: ���� 1 �IQDI U--:.0 K-3 lot R.. L. oil 01 SET, PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THHT THE WELL WILL SERVE If- 1-101 C! 12 1. ���H - R 7 �It- ��LJ 1 11- ! IJ..�.,-_-: �-� BHCKFILLIII-IG OF HNY SYSTEM WITHOUT FINHL INSPECTION HND HPPROVAL. BY THIS �EPHRTME-�III T WILL BE SUBJECT TO P�O�ECUTION �INIMUM DISTHNCE BETWEEN H WELL HND HNY ON-! ---.;ITE SEWAGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVRTE WELL TO H PRIVHTE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET OTHER REQUIREMENTS MHY HPPLYSPECIFICHTIONS HND CONSTRUCTION DIHGRHMS HRE HVHILHBLE TO INSURE PROPER INSTHLLHTION 1 7, Flo, I Fk-:L, F_-- 4,00,-, F._, E��:8�UB: E-,-' FR: I CERTIFY THAT 1� I HM FHMILIHR WITH THE AS SET FORTH BY THE MUNICIPHLITY OF HNCHORHGE 2� I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CODES. ]� I UNDERSTHND THHT THE ON~SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS �PPLIj�HNT FRHNK OSTROM ISS11ED V4. 0 9 SOILS LOG MUNICIPALITY OF ANCHORAGE [I PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST DATE PERFORMED: .,ERFORMED FOR: / ��IVI�I LEGAL DESCRIPTION: L �'! `� SLSLOPE—��"�� SITE PLAN TT—Fl � z `�C._/ ✓ ��� D I� I S t�1 5 Yi-i\l !� i 51 +.=" i 3 %+N D 2-t4vCL � 4 0 jdz Ll l ' COC3Bi,.(ffS *wo / Z_ J 8 9 10 `rto `o 11 JU � 12 tai i b�1i\ Uf' 13 14 16 17 18 19 `�yl 20 COMMENTS WAS GROUND WATER /� S �/ �1L L ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? PERCOLATION RATE (minutes/inch) T AND FT TEST RUN BETWEEN -- a'3if�lalwWlPJ CERTIFI PERFORMED BY:-'+st<''+ ttr` ,o-nna rF,/791 DATE: �� 5'T � 0 WAS GROUND WATER /� S �/ �1L L ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? PERCOLATION RATE (minutes/inch) T AND FT TEST RUN BETWEEN -- a'3if�lalwWlPJ CERTIFI PERFORMED BY:-'+st<''+ ttr` ,o-nna rF,/791 DATE: �� Pulan Construction "One Gall Does it All" v w�1GRE, ER ANCHORAGE AREA BOP '1GH S Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE( SEWAGEDISPOSAL SYSTEM NAME_ M�' ( MAILING ADDRESS C �E 1�/c- p_ PHONE LOCATION } (iCtcj^C, LEGAL DESCRIPTION L SEPTIC TANK:. ------- DISTANCE ! NUMBER OF FROM WELL MANUFACTURER �LV— MATERIALS " � `�' COMPARTMENTS00' INSIDE LENGTH _ INSIDE WIDTI-I LIQUID DEPTH LIQUID CAPACITY �1 GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION ADDITIONAL ABSORPTION WELL: 116X . DIAMETER OR WIDTH_, LENGTH—, DEPTH CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL _. TOTAL EFFECTIVE NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. TYPE \_4J✓i,14/.�J�—CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION LOT LINE_ SEWER LINE CE.SSPOOL OTHER SOURCES APPROVED _ DISAPPROVED DISTANCES: — INSTALLED BY: �('J 4`/ � , PIPE MATERIAL:6I& LOT SLOPE: REMARKS: Form No. EQ -031 _ REMARKS_ DATE DEPTH SEPTIC TANK. DIAGRAM OF SYSTEM cl 4 li -0,0,14�'V` c i DISTANCE FROM: SEEPAGE SYSTEM APPROVED G.A.A.B. „Kwn�oi GRE. =R ANCHORAGE AREA BOF '.JGH . e DEPARTMENT OF ENVIf20NM ENTAL QUALITY PERMIT NO 3330 "C”' STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 V SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT P�''- �A T � C�' �-� L/L `� MAILING ADDRESS , 1 ` �' PHONE INSTALLATION LOCATION— LEGAL DESCRIPTION INSTALLATION 01=: SEPTIC TANK � 666 �.9E7 PAGE JPIT __, DRAIN FIELD — OTHER —, TYPE AND SIZE OF FACILITY TO BE SERVED. FINANCED THROUGH .�. _. TO BE INSTALLED BY y L. SOIL TEST RESULTS � C C('""gs"t" NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST � _.—__._ .--_— COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE _'')"" — TYPE MINIMUM DISTANCES, REOUIREMENTS t FOUNDATION TO S17PTIC TANK i FOUNDATION TO SEEPAGE PIT __ —. DRAIN FIELD SEEPAGE AREA SIZE SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT "� �i E) DRAIN FIELD TO NEAREST LOT LINE. t ,/ V/ WELL TO SEPTIC TANK SEEPAGE PIT _— DRAIN FIELD _._—_ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK _ _ SEEPAGE PI'! DRAIN FIELD/_ SEPTIC TANK, -( Cl!) —, SEEPAGE PIT (--EJE�{' DRAIN FIELD _. TO RIVER, LAKE, S REAM. ry 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 BOROUGH REGULATIONS GA ING INSTALLATION. CA �� - -- sG.A,A.B. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENT5 OF GREATER ANCHORAG - REA BOR IGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE ' — APPLICANT'S SIGNATURE FORM NO. EO -016 \ I � 1 I r I. i i i I 1 I I I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENT5 OF GREATER ANCHORAG - REA BOR IGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE ' — APPLICANT'S SIGNATURE FORM NO. EO -016 \ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES, Division of Environmental Services C*D On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # a�.=I-n�A-= \ "' HAA # C 1. GENERAL INFORMATION Complete legal description Lot 5; Block 3; Meadowbnooh Subdivision Location (site address or directions) — 18230 Sancivanu Diu.ve Eaa 2e RivelL, AK Property owner John Gundelc3on Day phone 694-9800 Mailing address 18230 Sano-tuaky DiLive Ea 2e Riven AK 99577 Lending agency Mailing addre Agent Address — Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 v Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) front MOA 021 5. STATEMENT OF INSPECTION SY ENGINEER 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 application 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 Address 17034 Eagle Eagle River, Engineer's signature 6. DHHS SIGNATURE Approved for 3 Disapproved. Conditional approval for Additional Comments 0 RING / % Phone bedrooms. bedrooms, with the following stipulations: Date � — 2 " cf4 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. 72-025 (Rev. 1/911 BaBk MOA 921 Date Dat / '' 'J I�Y< ' �>.6 E1•.:, .ex.............a6n• g. ,' ri#. taac•� .��x •tj� `s, .......: y:;?try 1y°. bedrooms, with the following stipulations: Date � — 2 " cf4 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. 72-025 (Rev. 1/911 BaBk MOA 921 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: —Lr6- 6- -�> t-�FraC69-Doi, b Parcel I.D. A. Well Data Well type HCt'` If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) completed Total depth Cased to Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow — Driller Wires proper) retic ed (Y/N) _ z - w O AT INSPECTION y P,jjr�p levell -- SEPARATION DISTANCES FROM WELL TO: 14- Septic/holding tank on lot 200 Absorption field on lot 11?Q° `/4- Public sewer main —P1 Sewer service line WATER SAMPLE RESULTS: Coliform , ��' Nitrate B. SEPTIC/HOLDING TANK DATA On adjacent lots On adjacent lots sewer manhole/cleanout Petroleum lected by: Other bacteria Date installed /2L. Tank size /boo Compartments Cleanouts&N) 7V —Foundation cleanout (YQ Depression ` High water alarm NO / Alarm tested (Y/N) Date of pumping s 1-25- % Pumper -YW, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot _ 200 On adjacent lots ;'A To property line /0 _Absorption field Surface water/drainage _ /b,,) 72-026 (3193)' Front ndation Water main/service line f s / F CONTINUED ON BACK PAGE fn 06 J W LL.9 p LI9 a LIJ U Z On adjacent lots On adjacent lots sewer manhole/cleanout Petroleum lected by: Other bacteria Date installed /2L. Tank size /boo Compartments Cleanouts&N) 7V —Foundation cleanout (YQ Depression ` High water alarm NO / Alarm tested (Y/N) Date of pumping s 1-25- % Pumper -YW, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot _ 200 On adjacent lots ;'A To property line /0 _Absorption field Surface water/drainage _ /b,,) 72-026 (3193)' Front ndation Water main/service line f s / F CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) _ "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DIST, D. ABSORPTION FIELD DATA LIFT STATION TO: On adjacent lots Manufacturer Manhole/Access (Y/N) 'Pump el at Surface water Date installed / 5 7S Soil rating (GPD/Ft2) BS� System type T,-_ �,/ Length Width 360 " Gravel thickness Total depth B Total absorption area 400 Cleanout present/N) _Depression over field (`/�/ Date of adequacy test%t -9'F- Result ail) PASS for 3 Bedroom,- Water edroomWater level in absorption field before test 3s' After test Peroxide treatment (past 12 months) (Y6) r Af If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 2a B / On adjacent lots � ti- Property line To building foundation 16 14 To existing or abandoned system on lot _ On adjacent lots 3d Cutbank 1J'41 Water main/service line Surface water 1150 Driveway, parking/vehicle storage area Curtain drain ^1/4 E. ENGINEER'S CERTIFICATION I certify that / have checked, verified, or conformed to all d HAA guidelines in effect on the e of his inspection. 5�, J.? �� e3Gtfd Signature ING >; Engineer's Nam aVIU River, alaslca 99� � a o. �4 Date HAA Fee $ Waiver Fee $ Date of Payment �� 21 Date of Payment Receipt Number 25 ci SCJ Receipt Number 72-026 (3/93)' Back rTUNICIPALITY OF ANCHORAGC DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF IMALTH AND ENVIRONMENTAL PROTECTION APPLPCA ION FOR L AT•TH AUTHORITY APPROVAL CERTIFICATE 1. Genual Inforimitiot� )(�� Application Date ; f (a) 7,e„ � Descxipt:iot (ialclude Tatlack, subdivision, section, township, range) ...,...w.�•...!__:�� ......._�.: ..�s...,-« �::.Y _ ,� -� '� � y� _ Location (address or directions) ) J !9 / 77' �e6/ 1.•.. }.� ) (U) Applicants Name � �� � �� 'LelePhonev Dome � �Busines_s'/��zy_2_ if Applicants Address r�= >�'' a -• ��k /�� 4 =�'� (. .,� (c) Applicant: is (check one) Lending Institut; on Buyer. ; Other �Y,� (explain); (d) Lending Institution -) zJ Telephone Address (e) Real Estate Co. & Agent f ✓� / d -�'----��v �—� �� 47 Address f / Telephone (f) 11ay the HAA to the following address: 2. ape of- Residence Single—Family f Multi—Family Other (describe) ----- ---- � Number of Bedrooms 3. Water Supply Individual Well 1_1 Communityw Public Note: If community well system, must have written confirmation from the State Department of Environmental. Conservation attesting to the legality and status. 4. Sewage Dis osal Onsite 144 Public F=1 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 21 I to" 1 wynnyll , oil As MUM; ed bY OY sual of final n2rann cud as of the validation date zowa buL011, verifY that my QvesUdnoina of hij hcairh AuthoMay Approvai shows Lh1L thE_ water Eapply aad/oy wasuawaLcz h _opus 1system is safe, functional and adequace rar Che aumbar K Kdrauas , ! type at strucaure indica .ed heroin. 1 fuethar verify thav, based Ga Lho in,,cAaLyop o5ziincd -jam ch2 saulcipality of AnchorLyle Mes jinx! 11 y,, _1y I investilaviou =d T"Spectwin, Eha oy-q.w (001"ar SuPPY MOW wasunwater disposa-i. Wauem is 12 nunplianna APA W. �,niulnal and State codes, ordinances, and vagals- tions !A eftocc an ahm 4W W Wi. Auspeaticn. Name or Ykiii Address Date - 6. DHFP ApprovZ. CAUT KOH I -, _!, NCRO&N !ij �H AND MMOCKT OTIM0-i ' (DUEP) QUES MULTH WIMITY APMOV.-Ll f5f CATES BASEL WELT GAON "71 MAZZYNT - ATIONS GIVEN Pf FAni,2A20 5 MOVE W AN PROF nVUISTSM5, 1N THE STATE 02 ALASKI. !HE MU DOU WS AS A COMM 70 QFQTo372W OF KUME's i!`�NDLNQ TKAWTUM A A URDER 11 MMY .1 MEW (�'�',' A50 40TH RROW& AP" INTiS I�MVLOMZS U 2145 A) 'A: 7 COMM MUCTTONS 02 AWALYM DAM CERTIFICATE M 0SUD, q YU 301MMUTY W AMUCRAGE Q SOT IESPONSIBIE VOR MORS OR MISSIONS LM :QF WEP SMAL) alk/e!/018 [Page 2 OF 21 )-W-KA DEPT. OF HEALTH & JVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MAR 19 19H.V, CHECKLIST.' - FEBRUARY 1984 R E C`— , A. WELL DATA Legal Decri.pt',on�_ s, t75 Well Classification If A, B, or Cr D.E.C. Approve ) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to __/ Depth of Grouting�� Static Water Level Casing Height Above Ground / y Sanitary Seal on Casing (Y/N) _ Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) _ Separation Distances from Well: To SepticAiei-}inn Tank on Lot �7L On Adjoining Lots Zoo To Nearest Edge of Absorption Field on Lot*Z0J ; On Adjoining Lots 200 To Nearest Public Sewer Line o Nearest Public Sewer Cleanout/Manhole 14X0 Ne est rice Line on Lot Water Sample Collected By Water Sample Test Results Comments /W/ 0 B. SEPTICLMOMMn TANK DATA L,A, r Date Install%� 1 ZS Size 100 No. of Ccmpartments Standpipes/(Y//2i' �T Air -tight Caps Foundati n Cleanout Depression over Tank ,(Y /N)/ Date Last P d7 Pumping/Maintenance Contract on F le (Y for Holding Tank High -Water Alarm (Y Temporary Holding Tank Permit (Y/d(l^_ Separation Distances from Septic/�ie Tank: To Water -Supply Well _ 2—OD To Building Foundation_ To Property Line �© To Disposal Field To Water Main/Service Line ` To Stream, Pond, Lake, or Major Drainage Course _ /"t/ L 7`-/ F �- convents .06 I l) &L Receipt # c Date Paid: - Amount: ''(�5 ) (Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA G Soils Rating in Absorption Strata Type of System Design Date.Installed Length of Field 17ZO Width of Field 3 Depth of Field Gravel Bed Thickness c5 Square Feet of Absorption area Standpipes Present (Y f Depression over Field /N Date of Last Adequacy Test /G b? Results of Last Adequacy 'lest )a -7/51 Separation Distance from Absorption Field: To Water -Supply Well ZOO -/- To Property Line l To Building Foundation 3.3 r To Existing or'Abandoned System on Lot /'yU jr� ; On Adjoining Lots :30 _/__ To Water Main/Service Line /0-,(- To Cutbank(if present) IUD To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area SD Comments n,,LD r�j t'_ D. LIFT STATION Date Installed Dimensions Size in GallonsMa e/A ss (YIN) "Pump On" Level at " 'vel at High Water Alarm Level at Vent (YIN) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(Y/N) Comments Check Permitted Bedroan Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed i ` ENGINilrsfiih z Date 3? �� /(J//q �9 - 0� � t� QiRT-ivm9— Company w,i. I IVlas. ALASKA tNNU y %A)'� MOA No .lS a� j��•° � U4i°5��� , � y E KB1/d5/s (Page 2 of 21 Uwurt A, ,SWor `<< Na, 1457-i: 2-15-84 E'yril 9, 1975 Federal Housing Atkidnistration 334 Wost Uh Aventy A-iiaxura-;o AX 99501 SUBJECT:eaJECi: Wt 5 Bloch 3 Widow i dow Brook Subdivision, l3Sir. The subject lot: is not available to public sewer, and it is not ecnuom- ieally feasible to sere the lot: wits- public :ower at this tim. m r -slut: semir system, if installed to local s1wific ations, shoidd provictei adequate smago disposal: until such time as public sower is availablea Sincerely, Eaglu Rivor District Sanitarian JPLIsr y4 TfiC%Of AUI , e yw i GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality �I°�-eo,A,„y -3330 "C” Street, Anchorage, Alaska 99503 2744561 Date Received February 27, 1976 c,�_ P Time of Inspection Date of Inspection„ _ REQUEST FOR APPROVAL OFb- INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Lomas & Nettleton Mailing Address: 2. Property Owner: Adams Construction Mailing Address: Box 337, Eagle River 99577 3. Legal Description: Lot 5 Block 3 Meadow Brook 4. Location: Santuary Drive, Eagle River Phone: Phone: 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Public Utility A. Type _� B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: on—site system. A. Installed 1975 B. Installer C. Septic 'rank: 1. Size ���� 2. Manufacturere D. Seepage Pit: 1. Absorption Area 3100 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank �, Absorption area , Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ --034 (1/74) Page 1 of two pages Page 2 of two pages - Re( >t for Approval of Individual : ar & Water Facilities Legal Description Lot 5 Block 3 Meadow Brook Subdivision Comments Approved �—��/ Disapproved Date'�0/ 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 facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date 5. Name of Realtor or Agent: :!� .n % 1119— -.QI I I" Mailing Address: C;'q Phone _ �e/- 2- 4 6. Legal Description: __ l /',o �3�1a 3 /y%c�4cJb�"eco �< Civ b L-ocation: 7. Type of Facility to be inspected: No. Bdrms. _. S. Water Supply Type of Supply: Public Utility Individual _. If Individual, number of dwellings presently served If Individual, depth of well -- -- 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) -- If Individual, date of installation 9 7 •� EQ -037 (1/74) MUNICIPALITY OF ANCHORAGE MUNK,11'/,i-11v (;r /,NCHOka,E)e 1. Type of Inspection: DEPARTMENT OF ENVIRONMENTAL QUALITY �3330 " C" Street, Anchorage, Alaska 99503 — 274-4561 DrPi. 0[' I1f;1.11i '< lily1VIROhfMki.IlAf. Pf:C)7LC11c)P} 2. Property Owner: _._ Q vv� Gi v h S l v_� L b Mailing Address: Bo X 3 VimV Day Phone Il//91J'� 1�U REQUEST FOR APPROVAL OF P P(`3. 1Esjf INDIVIDUAL SEWER and WATER FACILITIES 5 p' 5. Name of Realtor or Agent: :!� .n % 1119— -.QI I I" Mailing Address: C;'q Phone _ �e/- 2- 4 6. Legal Description: __ l /',o �3�1a 3 /y%c�4cJb�"eco �< Civ b L-ocation: 7. Type of Facility to be inspected: No. Bdrms. _. S. Water Supply Type of Supply: Public Utility Individual _. If Individual, number of dwellings presently served If Individual, depth of well -- -- 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) -- If Individual, date of installation 9 7 •� EQ -037 (1/74) CONV 1. Type of Inspection: CMRO VA - FHA -� 2. Property Owner: _._ Q vv� Gi v h S l v_� L b Mailing Address: Bo X 3 VimV Day Phone P P(`3. L Name of Buyer: (` t Mailing Address: ^ter ^.�//i C)Day Phone i_`�J-1 13 UDS: