HomeMy WebLinkAboutMCMAHON BLK 1 LT 15
Name
LAWRENCE & KATHLEEN TRAXINGER
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
DISTANCES
Address
3801 McMahon Ave., Anchorage, AK
Phone(s) 3~'5--6556 I P~3~_ INo. ol~edrooms
LEGAL DESCRIPTION
Lot 1 5 ~ I B,ock 1 Subd~vis~o. McMahon
Township, Range, Section T12N,R3W, Section 28
TANKS
[~ SEPTIC [] HOLDING
Manutacturer Capacity in gallons
Greer 2000
Material No. of Compadments
coated steel 2
TYPE OF SYSTEM
[~TRENCH [] BED [] W, DRAIN [] OTHER
Depth to pipe bottom from
original grade
~_. ~ FT
Fill added above original grade
.5~ ET
Gravel length
58 FT
Total absorption area
870 $0 FT
Number of lines I Soil rating
1 I 125 S0 FT
Total depth Item original grade
12~
Gravel depth beneath pipe
7.5
ravel width
2.5
NA
Pipe material C * I an
PVC (ASTM
Date Installed
11/7/90
Installer
L. Traxinger
WELLS
[] PRIVATE
[] OTHER (Identifv}
Total Depth I Cased to
Date
lO/23/9o
Classification (A,B,C)
Individual
Alpine Drilling
REMARKS: See attached sheet for
measurements to On-Site system cleanou'
SEPTIC
TANK
ABSORPTION WELL
FIELD
~/ELL 121 141
LOT LINE 34 31 ]_1
FOUNDATION 20 35.5 72
AS-BUILT DIAGRAM (Show Iocabon of well, septic system, property lines, foundation,
driveway, water bodies, etc.)
I Stanley ,,,Br~u,s.t .~; :.,.~.
Municipal and State guidehnes In ellect
Health Department Approval:
72-013 (3/85)
Scale: ]tl_~¢] t
InspectiOlls P~r-Yo'r'med by:
S. Brust
;1/7/90
cedily that this inspection was perl0rmed according t0 all
ENGINEER'S SEAL
lANK ~lC,rI'.
IJC,D, I
lOO,7
PLAN
~ ~ FlcMAHF1N AVENUE
%~1 TRENCH
,,\
x,,,,
SEPTIC
TANK
MUNICIPALITY OF ANCHORAGI~
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
NOV g 6 1990
RECEIVED
- DWELLING ~r'~
~\ q7,'1-4 --/
~----- .~6.~i '
. . .,,.,.,o,,..,.., IPREIFZLEI
DATUM FOR ELEVATIONS I3 A~.~,LIF1ED, BM, ELEV=lOO
IS AT NW CDRNER OF CONCRETE \~/hLK hT NW CRRNER
nF DWELLING,
i 491
qO. 986-E
DRAWN S ,B,
CHECKED BY;S, B, .
DATE ~ 1
AS Noted
BRUST & ASSOCIATES
ENGINEERS-PLANNERS -SURVEYORS
1610 DIMOND DRIVF
ANCHORAGE
ON-SITE' SYSTEM PROFILE
LOT 15, BLOCK
McMAHON SUBDIVISION
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
RECEIVED
BRUST & ASSOCIATES
Engineers - Planners - Surveyors
1610 Dimond Drive
Anchorage, Alaska 99507
(907) 562-7878
October 29, 1990
MUNICIPALITY OF ANCHOJ~GE~
DEPT. OF HEALTH &-
ENVIRONMENTAL PROTECTION
RECEIVED
Mr. John Smith, P.E.
Program Manager, On-Site Services
Anchorage Department of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
RE: Lot 15, Block 1
McMahon Subdivision
Dear Mr. Smith~
The following information is presented in connection with an
application for on-site disposal for the referenced lot. Enclosed
are the following.
Well Log
Soils Logs (2)
Perc Test readings (2)
Perc Test Graph & Calculation of Absorption Area
Site Plans (3 Sheets)
The existing septic system is not adequate. The system has had a
history of backups, with pumping required on a periodic basis.
The septic tank presently encroaches on the 100' protective well
radius for Lot 16.
The proposed system will remove this encroachment. It will also
increase the seperation distance from the existing seepage pit to
the well on Lot 5. The new distances to the next two closest wells
are 136' and 171' respectively.
Spot elevations are shown on the site plans. The maximum slope in
the general area is about 4%.
The trench system has been designed with only one cleanout just
downstream of the septic tank, as there would only be a 10'
seperation if two were used.
Please let me know if you have any questions.
Sincerely, ~
Stanley Brust, P.E.
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological ~ GeophysicolSurveys
LocATIoN .OF WELL (Please complete either lat lb or lc.) A.D.[,. No.
'e-IIBoro'e~" . Sahd,v~a~o. .o, G,oak ,h:ll '/,qtr,. Sac.on .o. To...hlP.rl .onge EElMar~dle~
Street Address and Area: of ~ell Location
Material Type Top ' Bottom ~'
~ ' / ' 7. USE:~Oomeltic Supply
9. FINISH OF WELL:
./~ Set between fl and fl.
/ Sackfilling Gravel pack '*''
..'~ 0 AbOve or ..~ Below lend i~urf~ Dot'e
~ ~/ Equipment used:
II. PUMPING LEVEL below !and surfaCe and YIELD
: DEPT. OF HEAL~ ff &
~WK~NM~NTAL P~C~TE~ION 12,GROUTING Well Grouted: ~ YeS ~No
.Moterlol: ~ Neet Cemenl ~ Other:
~0 '5. PU~P: (if o,olloble) HP
Lenglh of Drop Pipe fi. capacity g.p.m.
"~Ci i gM 0 Subm. 0 del 0 Centrific=l 0 Other
I~. REMARKS:
16, WATER WELL CONTRACTOR'S CERTIFICATION;
15. Water Temperature ~o ~ F ~ C
This~.~,~~zra~well w~ drille nder y' ri dicti .... d this report is true to the~besJ~// of my knowledge and belief;
/~ ut ~rlzed~ R~pres~t lye
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9-
BRUST & ASSOCIATES
Engineers - Planners - Surveyors
1610 Dimond Drive
Anchorage, Alaska 99507
(907) 562-7878
SOILS LOG- PERCOLATION TEST
DATE PERFORMED:
SLOPE
SITE PLAN
10
11
12
13
14
15
16
17-
18-
19
20
COMMENTS
PERFOF~MED BY:
WAS GROUND WATER JO S
L
ENCOUNTERED? O
DEPTH? ., ~7 :~ ~ ~
Gross Net Depth to Net
Reading Date Time Time Water Drop
I
PERCOLATION RATE '-~' -~ ~ . (minutes/inch)
, FT AND
CERTIFIED BY: % ' 2'-:2:7 '/% / DATE:~
BRUST & ASSOCIATES
Engineers - Planners - Surveyors
1610 Dimond Drive
Anchorage, Alaska 99507
(907) 562-7878
SOILS LOG- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
4
5-
6
7
8
DATE PERFORMED:
SLOPE SITE PLAN
I
10
11
12
13
14
15
16
17
18
19
20-
WAS GROUND WATER
ENCOUNTERED
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~' ' ~ '7
TEST RUN BETWEEN ~ '~ · FT AND
(minutes/inch)
.%
I
t f - '"" ' '
I · , i ' i
I i '"/ I, ' < ""'
" , '?','":.O,,' ! '
FtEH "' ~P-'-'"".~ ""' ~ "" '~
I I !. c ,u, ~0
THERE ARE NO PUBLIC- WELL-"-_-: ~;'iTN!N
DATUI4 FOR ELEVATIONS IS ASSUHED, BN, ELEV. 100,
AT Nb~ CORNER OF CONCRETE "~.LK AT N",,/ CDP. NER DF ~,,/ELLING
AT LtS,~.l,
GZN~AL LA¥OU~
2HECKEDBY; S.B.
DA'rE ~ ~_0/29/90 ENGINEERS'PLANNERS'SURVEYORS ,
SCALEi ]"=].00 ' 1610 DIMOND DRIVF ANCHORAGE LOT 15, BLOCK 1 ~ 1
ALASKA
¢OeNUME~R~ 90-7 (9071562-7878 99507 HcHAHON SUBDIYTSION OF 3
~ PLAN
¢¢: ~ HcHAHBN AVENUE
~ ~ y ~- ~ .-~
HBTE~ ALL I'4ATER~ALS AND P~B_~DU,.E3 TB CBMPLY
¥/ZTH A~
DAT[_IH FOR LLLN/'Ai/OIM%; Z$ Ri.,"¢LI?ILLI St,, ELE"V'=IO0
. _ L. Or-.IURE~L 'k~]'ALK' AT NW
IS AT NW CORNFR OF .... -' =- . '7~." F.
CHECKEDeY; S.B. AND SPOT ELEVATIONS
OATEi !0/29/90 ENGINEE~-~N~-SU~O~
SCALE~ AS NO~D 1610DIMOND DRIVE ~RAGE ~o~ ~5, BLOOEi
A~KA
dOeNUM~a~ 90-7 ~90T~562-7878 99~T NeMAHON SUBDIVISION
~w..,~ s.B. ~~ ~ ASSOCIATES
~ALEi i"=1OO' 16IODIMOND DEIVF ~C~RAGE' LOT 15, BLOCK 1 ~ 3
. A~KA o~ 3
~ 99~7 ~e~n~ON SUBDIVISION
GRE, : 'R ANCHORAGE AREA BOR' ",GH
~t~M~I~/]J~ Department of Environmental Quality
'~ 3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
~/?~ ;~0?MBER OF
DISTANCE /~¢~/ ' ' z~-° '
,:¢.~.~,,~,~¢//_~ -~,~---~--~/,MATERIAL --,~-'~"~'¢-,~-L. COMPARTMENTS ~
FROM WELL/'Fv/'~,~r//t'/MANUFACTURER '~¢ ' '
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY -/~z~-)~z'/ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS ¢/ DIAMETER_ OR WIDTH ~/¢¢,/LENGTH .4~ /DEPTH ~ /
LINING MATERIAL ? '~¢~' ~'¢~-¢'~:'~1B SIZE: DIAMETER BERTH ~¢' DISTANCE FROM: WELL ,/~/~¢~' /7~/'
BUILDING FOUNDATION ,~/ NEAREST LOT LINE ~// / TOTAL EFFECTIVE
, ABSORPTION AREA (WALL AREA) ¢'~/~¢') / SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE
BUILDING NEAREST NEAREST
FOUNDATION __ LOT LINE SEWER LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
, . TANK SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form PW-026
D~GRAM OF SYSTEM
DATE
GREATER ANCHORAGE AREA BOROUGH
o- DEPARTMENT OF ENVIEONMENTAL QUALITY PERMIT NO.
3500 TUpO ~ ROAD , I-'OUCH 6-650
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
~ // O"AIN F{ELD OTHER
(f~/~"~' TO BE INSTALLED BY
SOiL TEST EESULTS .'~ / ,/~' d~/~ m¢/E NOTE, THIS PERMIT IS NOT VALID WITHOUT
pFR~IT VAI lB ONF YFA~
FINAL INSPEGTION~ 24 HOUR NOTl~ REQUIRED. BACKFILLING OF ANY SYSTEM WITHODT FINAL IN~E~TIO~
H~A~T~ O~A~T~E~Y AUTHO~I~ WILL B~ ~U~J~T YO pROSECUTION,
MINIMUM DISTANCES, REQUIREMENTS
5 fl,.
F~%DATION TO SEPTIC TANK
20 f~, DRAm FIELD
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK 5 f~9 SEEPAGE Pit ~, DRAIN FIELD
DRAIN FIELD
WATER ~A~N TO SEPTm TANK l0
~"Am ~LD l0
SEPTIC TANK, 25 ft. SEEPAGE PIT 100 ft. DRAm FIELD 50 ft . .. C ! r89utr('4 ul ....... }fn0 crosses
I;0 S[~:E[ tili[- 10' I Grade: l .per 1O0' J
CONFORM TO BOROUGH REGUNATION~ REGARDING INSTALLATION. J, lJltU.~ OlSTt~CtDJ~ J [.CASI ]RO~ SIHt0H PIpE
I CERTIFY THAY I A~ FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE A~EA BOROUGH ORDINANCE NO. ~8-B8 AND THAT THE ABOVE
~. .ATER ANCHORAGE AREA BOROU
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
'CASE #
Performed For '/'~
Legal Description: Lot IS Block I
This Form Reoorts Soils Log
Date Performed ~
Subdivision M ¢/Ngmm~
Percolation Test
gepth
Feet
1
5
6__
7
8
9
l0
Soil Characteristics
Was Ground Water Encountered? ,/~0 ~?o^
If Yes, At what Depth?
Reading I Date Gross Time Net Time Depth to H20 Net Drop
,
Percolation Rate Hinute
Proposed Installation: S.eeDage Pit Drain Field
Demth of Inlet Depth To Bottom Of Pit Or Trench
COMMENTS:
Test Performed By .'T~,~ ~,~, ~
Data Certified By:'
Date:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
P roe,,.D.# H^A# i¥/¢
GENERAL INFORMATION
Complete legal description ~/~
Locatio~,(site address or directions)
. :' ~.; ~.. ';.,
Property owner .,~,¢~¢7~
Mailing address -'~ ~ o
Lending. .':agency ~--~/7~
Mailing' address '~
Agent ,7
Address p~_~ 0 %'-- ~~ '¢z--///~' ~MX¢
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~
TYPE OF WATER SUPPLY:
NOTE:
Individual well
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
I~ community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA/t21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seat 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 ~z~'-~'~' o)Z .,~,~..~; ,~:~ Phone ~"~
Address ./~/~ ~/~~ ~/~, ~~~
Date
Engineer's signature
DHHS SIGNATURE
/%- Approved for ~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
By: ...~OH-~ ~t~l. rfq+ Date
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 DH HS 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.
72-925 (Rev. 1/91) Back MOA #21
' /'.--.-~"~ Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~"/,Si ,~-~// /?'//~ ~/~',~, )~'/Parcel I.D.
A. WELL DATA
Well type ?~-~/~-z/~// If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
APR 29 1991
RECEIVED
Date of test
Static water level
Well flow
Pump level
Date completed /" ~-5/~:~/'') Driller ./~h/~'
Cased to Y~' Casing height ,/' ,~//
Wires properly protected (Y/N) /
FROM WELL LOG
o
g.p.m,
AT INSPECTION
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot /,~Z...,/
Absorption field on lot
Public sewer main ,A/'/~
Public sewer service line ,/'~/'/~
; On adjacent lots
; On adjacent tots
Public sewer manhole/cleanout
/
Petroleum tank //~'/
WATER SAMPLE RESULTS:
Coliform ~r~.~-~'~ ~ 7~7 Nitrate
Date of sample: ,~//~' ~//~//.
Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed /,;,/~/~:'6)
Cleanouts (Y/N) ~..
High water alarm (Y/N) ///',~
Date of pumping ./t/~/' ~--~.~'~'z-~'~/' ~ ~--~/~ /.-<
SEPARATION DISTANCES FROM SEpTIC/HOLDING TANK TO:
Well(s) on lot /,~-/ ' On adjacent lots /O ~
To property line ~ / Absorption field / ~
Surface water/drainage -/////~
Alarm tested (Y/N)
Tank size ~ o ~ ~ Compartments ~
Foundation cleanout (Y/N) /,~/~ ,~ Depression (Y/N)
Foundation ,~ 0
Water main/service line ~'~'~
72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/N)
"Pump on" level at
Man ufactu rer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Wel~ on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length -~~'o¢' Width
Total absorption area
Depression over field (Y/N)
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
Soil rating //,"~ ~-- System type
Gravel thickness ~ ,~"" Total depth
Cleanouts present (Y/N)
Date of adequacy test /
for
/V'/~ If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /.z?// On adjacent lots
To building foundation -'¢"%'~ '~
On adjacent lots J '~
Surface water ,/3~,,,~
Curtain drain
Property line
To existing or abandoned system on lot
Cutbank ,"t"/,'''¢ Water main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I cerhfy' that I have checked, verified, or conformed to all MOA and HAA guidelines in effect.~.~,~,~,~.~,,~,~on th¢~ate~ ~°f this inspection.
O'F
. ....
.... ~ : TH '.~
Engineer's Name ~'~xx~ )~J / ~'"~,'~~ '" ~
HAA Fee $ /
[)ate of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING
5633 B STREET ANCHORAGE, ALASKA99518 TELEPHONE (907)562-2343
ANALYSIS REPORT BY SAMPLE for WORKorder$ 33607
Date Report Printed: APR 26 91 @ 12:04
FAX: (907) 561-5301
Client Sample ID:L15 BI. MC~HON
PWSID :UA
Collected APR 24 91 @ 06:00 hre.
Received APR 24 91 @ 08:50
Preserved with :AS REQUIRED
Client Name :BRUST & ASSOC
Client Acct :BRUSTAT
BPO # PO # NONE RECEIVED
Req $
Ordered By :S. ERUST
Analysis Completed :APR 26 91 Send Repo~te to:
Released By :/~x~~~=
Chemlab Ref #: 911605 Lab Smpl ID: 1 Matrix: WATER
Allowable
Paxamete~ Tested Result Units Method Limits
NITRATE-N 6.1 mE/1 EPA 353.2 10
Sample ROUTINE SAMPLE COLLECTED BY: S. BRUST.
Remarks:
I Tests Pezformed See Special Instructions Above UA-Unavailable
ND- None Detected "See Sample Remarks hbo~e
NA- Not Analyzed LT-Less Than. GT-Greater Than
2r IVED
APR 2 9 1991
WATER WELL RECORD
STATE Of ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological ~ Geophysical Surveys
.:. :uilorage
· tu;r~afl Services
Or,,,i.g ,er.,, Ne. /
: A.D.L. NO.
la.llBoro'ugh . Subd v lin, Lot Block ih. II l/4qtrs. Section No. Township ND Range Er-] Merldiafl
ic.jlBiSTANCE ANODiRECTiON FROM ROAD iNTE.SECTiONS~ ~~ 5, OWNER OF WELL:Address:
Fee, Below 4. WELL DEPTH: {,,n~') 5. DATE OF~%LET'O~
9. FINISH OF
Set between ft. and fl.
' ,~ / 8ackfl lng Gravel pack
~ ff. after ' hrs. pumping g.p.m.
~Z.~ROUTm~ we, Grouted: ~ Ye~ ~o
& ~ 'Material: ONeat Cement OOth'r:
; ·
15. PUMP: (~f avalloble) HP
Length of Drop Pipe ~ft. copaoity g.p.m.
~ su~.. D ~,t D c,.,m~ D o~,~
14. EEMARKS:
16. WATER WE~L CONTRACTOR'S CERTIFICATION: o
15. Water Temperature ~ ~ F ~ C
Thl~ w~ll ,a~ drille~ndar ~y ~grl~dJclion and this raport Is lrue to t~be~ of my knowledge ond belief;
~ ~,aislered ,.~usine s s ~ame/..- . Co.troc..~ License/ .~Number ....
/A ut ~rizedr Repres~tallvo
Form OZ-WWR (11/81) Copy OJslrJbution; WHITE' State DGGS~ PIN~-Driller~ CANARY-Customer
APPLIC-NT FILLS OUT UPPER HAL'- '3NLY
Pro[~erty O~vner ./. [~ icj t t' ,,t/L ~ ...~ "I ~. r'~' ~ ~ ~/~ ~-~' Phone
Buyer
Address: Zip Code
Lending Institution /~/~ s ~z? ~ ~ Fl ]'~'~j L~r~J , ~ U~z'~ u~ Phone
Realty Co. & Agent Phone
Address Zip Code
LegalDescription z~ ~7/~-- ~/a[ /~ I /~,~!~ 4a~ ~o ~.
Street Locati~ ~ ~ O I ~']d ~ z, J, ,I ~
Type of Resi~nce ~
~Single Family
~ Multiple Family No. of Bedroom
~ Other
Water Supply
~ Individual A~ACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
D Community For wells drilled prior to that date, give well depth (attach Icg if available).
~ Public Utility ~_~- /~/' ~,i~ 2 ~ ~
Sewer Disposal
~- Individual Year Individual Installed: /~ ~ ~
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Lo?-
Time Time Time Time
Date Date Date Date/~ /q~ ~_,~
Inspector Inspector Inspector Inspector
Field Notes: MUNICIPALITY OF ANCHORAGE
( ) APPROVED BEDROOMS
Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received
72-023 (31~)
December 21~ 1983
Lawrence J. and Kathleen A. Traxin~er
SRA Box 1574T
Anchora(je, AK 995U7
Subject: Lot 15, Block 1, i'4c~dahon Subdivision
Approval for tb.e individual sewer and water facilities cannot
be granted until t~'te follovlin~j items have been
o T~]e septic tank pumped t,;ith a receipt submitted to this
depart~nent.
o Locate and expose the cleanout to the seepage pit and/or
leaching' area for our inspection. This is to insure the
/' minimu~ distance requirements are met between the well and
sewer systen~.
number ~on-s, it~wer~ste~ ~-¢as ori(jinally designed
for. A~grade~l ~quired. Prior to any up(,jrade, a
permit ,~ds to be issued ~ron] this depart'(~ent.
o Ar~ ~q~e~-~/~ needs %o De pertor,~le%~ oR. ~h6. ex].s~.ln.j
leachiJ%(3 area. ']~}~s---t~_..~u~ determine 1~ tile syste~J~
adequat~ ¢ccording to NationaliSm%Shale<n% ..... A listin%J of
priv¢/yi~ performi,]q the test is enctose~% ....
need'~ t~ b~ubmitteO to this o~ice ~or our review.
Please /notify this Department ~or a reinspection when the
noted discrepancies have been corrected. If there are any
furth~ questions, please call this o~fice at 264-47Z0.
Jim Roberts
· JR14/ej/E1
.,' Enclosure
Associate Environmental Specialist