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Home My WebLink AboutMCMAHON #2 BLK 10 LT 6 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMEN'rAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME IPHONE I NEW I~)~J~'-i'"7~l~J ~I~JTt.~-.t~_I..~"'~I~'~'~Z.~-"-."~ ._~z~ .~4 ~:~ ! ~ UPGRADE MAI LING ADDRESS LEGAL DESCRIPTION LOCATION Well I DISTANCE TO: I ~-- Z [ Manufacturer u) ILiq. capacity in gallons IF HOMEMADE: ~,~ DISTANCE TO: IWell m I I Well ~U ;T' ~ No. of lines , Length of each line ,~zu~ I J I ~ ~'<~ ~ Top of tile to fin!sh grade Well ~ IClass Depth ~ I Building foundation DISTANCE TO: NO. OFBEDROOMS Absorption area Dwelling PERMIT NO. Material No. of compartments Inside length Width Liquid depth Dwelling PERMIT NO. Foundation Total length of lines Material beneath tile Depth Crib depth Material Nearest lot line 4o F~ Trench width inches inches Building foundation Liquid capacity in gallons PERMIT NO. Distanc~o~en lines Total effective absorption area PERMIT NO. Total effective absorption area Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS DATE LEGAL APPROVED By: ^lv~n R. Zeman P.E. 72-013 (Rev. 3/78) Fll:::' I:::' L ! C I:::1 BI 'T' LC)Cf:l]" I ON L. E I}'.i I:::i L LE"r'DEN L..T. 6 BI<. d..~) P1Ci"IF!HOh! 2~EIEICIE~ SC!I...IRRE FEET T'T'F'E OF SO I L. I:::![.:.':'.Z:;Oi:;:E',T ]: O1".! s'¢s"i"r:.:]','l I s: ]"RENC:H M!'::!XIi','IIJM NLtMBEI:~: OF:' E~EE:,ROOMS = 4 SOIL RFiTIi'.,IG (SQ FT,."BR)= l.E~el II--liE F?.E(;:!tJ '[ !:;;'.El) S :1: ZE OF THE SO.T. L FIE;SORF'T ! ON S'¢STEM I S: THE L..Ei'q(3TH E:, I MIENS I (ill',! ! Ei; THE LEt'.4GTH ( I N F'EET ::, OF THE TRENCH CIR DIRF:I I t'.4F I EI....[:,. "FI.-IE.~: [)IEF:'TH OF Ft TRENCH OR Pt"I" IS THE DISTFINCE t-3E]"I.,.IEEIq TFIE '.Z:;URFFICF::i: OF: THE EiF?.OLJt'.,ID FIN[) THE BO]"T()M OF: THE E,"-.:;C::!::I',,,'F:tTIOt'.,t ,.'.'ZN FEET). "r'HEF..:E .T.S NO SET t.,.IZ[:,TH F'OR TRIENCHES. THE: Gt:;.:R'v'EL. B',Ei::'TH IS THE I"I. I t'.,tIMLIM [:,EP]"H OF Gt:;?.F:i',,,'EL E',ETt4EEN THE OUTFF:IL.I.... F:' .'I: F:'E Flh![:, THE BOTTCiM OF THE EXCI::I',,,'I:::ITZOt",I ,:.' Iix! F'EET). F'tERM :!: "F F:!I:::'PL I CIaN'T' F.!FI':'E; THE RESF'OI'-,tS I B I L.. ! T"r' TO I NFCIi:;?.M "f'H I S DEF:'RRTMIEt",FI" DIjI:;.:: ]: [",!G THE ]: f',iSTFIIJ..J::IT :[ O1",1 :.f. N:BF'ECT I O1",I':.~; O1:::' I::lN"r' I.,.!EIJ._S F!E:'JF:ICE:.'NT 'T'O TH Z S F'ROF:'ER't"T' I:::II",ID THE I",II...IME:ER OF I:;i:ES]:DENCE':~; '1"I'"I1:::I't" THE HELL HILL. SE.R',,,'E. 'T' t!.....II ell ,::: 2:C."~ ]:,, % Ih.~ %::.:; It::::::" EE.: C: T' % C:) ["~,-~ ::Ei; t!:::::t] ~:;~: ~E] .F;~: E: C;;:~ LIt % ?: lEE:: .LE..: ..................... f3F:IE:KFt Lt.... t IqG OF I::tN'T' S'.r'STEM W I "f'HOUT F I I'.4FIL I NSPEC:T Z Otq FIND I::tPF"ROVF:It.. E¢.r' "t"1..'t t S DEI::'F:!RT.hlEN"I" 14ZL. L. BE...' SIJBJEC]" TO PI:~:OSECLtTION. MIN]:MIJM [:,ISTFtNCE [E:E"i"!4EEt'-,! Ft WELL RI',IE:, F!I",I'T' Oi",I-SZTE :SEI.,.IFIGE DISF'OE;F:I!.... S'.r'STEr"! I:i.'.:; ::L.gC'~ FEliE]" FOR I::'t F:'RZ',/t::!"I"E I.,.IELL.~ O1:;:'. :L513 TO ;:~.b;::'H;iCI I:::'EE]" I'-':'ROM t'":1 PUE',LtC !4ELL DEF'Ef.,!DIi",IG I..IPON THE 'F'T't::'E (:iF F'UBL. IC !.,.!iEI....L. HELL. LOGS FIRE: r.;.:Et:.:!UIRED FIN[:, t"'tLI':-.;T [?,E RETLIt::~tlqED TO THE: t}EF'Ftt:;;:TME]qT [,.IITHIhl ]:El DF:f"r'S OF THE HELL CL")PIPL. ETtON. OTHER REC!U Z I~::E!"!ENT:E; MFI"r' i::IPPL.'T'. SPEC I I::' .!: RF:IT I Ol",I'}.; FIND CONSTF?.!...tCTZ ON D ~ FI(:~iRFIM:i.('; FIRE FI","FI I L. faE:L.E TO I t'-,!':~;IJF.:E PI:~:OF'ER I NSTt::IL.[.J=IT I O1",!. ! CERTt F::'"r' "t"F'IRT :I.L: i F:!["1 FF:tMIL. I I:::IF~: HI'FI-! THE REC[IJIREMENTS I:::'OR OI',I-SI't"E SEI.,.IE[';?.:E; I::li",tD [,.IEL!....S Fl:!!!; SET F:'ORTH E:'T' THE MUI",I I C Z F:'FIL I T'T' OF I:::INC:HORFtGE. 2: ]: 1.,.!II....L. II",!L:STFILL THE S"r'STE!"! II",l FIC:C:OI:;?.DF!?',!CE !.,.!:['f.'f'"l THE CO[:,ES. 3':: t LII",IE:,EI:RSTt::tN[:, "t]'"IFIT THE ON'""SITE SEt.qER S"?STEM MF:!')I:~:EC!UI!;?.E ENL_F:IRGEMENT ]:F TIdE Iq:E:51 [:'E't",ICE t :B F.:[!~]'"!(][~'~%O ]: bl~::L. IjE:'E/d~ i::~1:~: "FI"II::II",! 4 E',EE:'R(]OMS. ':T:; i[ GI'.,IE£:: ~.'~....~~.~ -. .................................. z/ //~ /tAi /.~-~ / PLAYER coNSULTING GEOLOGIST BOX 476-M, STAR ROUTE: A - ANC}]ORAGE:, ALASKA 99507 ~' PHONE: SOILS LOG Performed for ~ (fkA/vl~' ~/',~'~ttS¢~' Date · ~ 8 ~ 12 ~ 14 16 t8 2O Soil Type Water Level Remarks Total Depth of Excavation :Groundwater ~Not Reached Depth, if Reached Classification Method ~)~Visual ( ) Sieve Analysis () Material at Total Depth Bedrock ~Not Reached Depth, if Reached Gary F. Player, Consulting Geologist FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 ",,. ; · ) ~ ~/~9 ~1 USE'OF WELL /~. ~D''VP'~ ~ SIZE OF CA~ING~_DEPTH OF HOLE~_~;T. C/b$ED TO ~ ~ FT. STATIC WATER LEVEL ~"~ FT. YIELD ~ GALoPER.MIN. WITH ~ PEET OF DRAWDOWN. REMARKS DATE COMPLETk'~ PUMP TO BE SET AT ,.Oto /~ / ~ to~ ~_to~ ~o~ ~0__ __tO__ to to to to ___to tO__ to__ to__ __to tO____ tO ,, to__ 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 Parcel I.D. # (~\-)- .~t~,- 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# Lot 6; B~oek 10; MeMahon Subdivision #2 3501 Leyden Road Location (site address or directions) 3501 L6yd~n Road Property owner Mailing address Lending agency Anchorage, AK 99516 St6v6n Dahn Day phone 3501L6~d6n Rd. Anchora~t AK 99516 345-4702 Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX 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 #21 5. STATEMENT OF INSPECTION BY 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 .~ ~..~ .NC;IN..RINC. .... J"'~'~ Phone g~F'Z¢7? 17034 Eagle Ri~r L~Ro.d ~ Engineer's signature ~~~~ Date DHHS SIGNATURE · ~'_ Approved for ..~z~'~/--y') bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: _ · _ _ 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 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. 1/91) 8ack MOA#21 ~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:/~o'T'~::::~; ~:~:::~[¢ / ,/~ ¢//~/~=~ ~/¢:~ Parcel I.D. ¢//¢%Z_/,~__ A. WELL DATA Well type Log present I~/N) Total depth Sanitary seal ,~(~N) if A, B, or C, attach ADEC letter. ADEC water system number Date completed £/-,~)'-~- ~ Driller ~ Cased to Casing height Y~--~ -- Wires properly protected~/N) ~'~-~ FROM WELL LOG Date of test Static water level ~-~- Well flow E.> Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot I(~ fA- Absorption field on lot Ir'O/',O ~ Public sewer main Sewer service line 0~/~ g.p.m. ; On adjacent lots AT INSPECTION ;0. adjacent lots Public sewer manhoie/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform (~ ~' Nitrate Date of sample: Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts ((:~N) High water alarm Date of pumping Tank size f/¢~.~ O/~(- Foundation cleanout (~/N) ~'~-E Compartments Depression (Y/~__~ //U0 Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /00 'f On adjacent lots To property line /'0 '/' Absorption field Surface water/drainage /~ ~z Foundation Water main/service line /0 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE Size in gallons '""'"'"'""~_ Manhole/Access (Y/N~ Vent (Y/N)__'~Pump on~_ /~"Pump off" level at High water alarm level ~ycles tested Meets MOA electrical codes,~.,~_~ SEPARATION D~ROM UFT STATION TO: Well on Iots.~'- On adjacent lots Surface water D.~ON FIELD DATA Date installed Soil rating /(~ S~'¢/L~/?-- System type Length ~-~ f Total absorption area Depression over field (Y/~) Results (pass/fail) Peroxide treatment (past 12 months) (Y/(~ Width ~:~ ,r Gravel thickness /O t Total depth /---/,,~ 0 -~f:= f Cleanouts present ~)~N) ~' /'~0 Date of adequacy test ~:¥qJ% for ~ - bedrooms /~. ~¢300o~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot [~/~.0 On adjacent lots ~/(~ '~ Property line TO building foundation ¢.~.~C~ ' To existing or abandoned system on lot Onadjacentlots ~ + Cutbank ~ Water main/service line Surface water /~ ~ Driveway, parking/vehicle storage area Curtain drain ~ E. ENGINEER'S CERTIFICATION I certify that I all MOA and HAA guidelines in effect on ~.d~f.~;~f this in~ction. Engineer s Nam~to34 ~..1~;:';; ~ 7U34 Eagle River L~p Road No, Date Eagle River, Alaska 99~77 HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number ........... ~,l u.~a~ br"~VIRLINHENTAL LAB SERVICES NO. 691 [PC' ENVIRONMENTAL i.,~8ORATOR¥ ~ERVICI~$ Chemlab Re£.~ :93.2057-~ Client S~ple ID ~L6 B~0 MCMA~N S/D $2 :WATER Client Name :S & $ ENGINEERING WO~ Order Order~By :P~Y ReF~rt Completed P~oJect Name : Collected P~oJect# ; Neceived PWSID :UA 5633 B STREET ANCHORAGE. AK 99518 TEL: (g07) 56Z-2343 FAX: (907) 661-~301 t65856 ~05/06/9~ @ i5t45 hr~ :05/07/93 @ 16:00 hfs Technical Director :STF~H]~_.C. F~E . ~ample Re~rks: ROUTIt~ 5AbUP~ COY~,ECT~X) BY: J.~. QC Ai!owe~le Ext, Ansi Parameter Results Qual. Units Method Limits Date D~te Init NITRATE-N 0.74 ~0/1 EPh 3>3.z/300.0 10 05/10 LtM * See Special Instructions kbove Ua = Unavailable ** See Sample Remarks A~ve NA ~ Not ~%alyzed U = U~etected, Re~rted value i~ the practical q%~Yi~ication limit. LT = Less ~ D = ~econdary dilution. GT = Greater ~an ENVIRONMENTAL SERVICES IN ALASKA, COLORAr',O, UTAH, ILLINOIS, OHIO, MARYLANQ, WES'~ VIRGINIA, NEW JERSEY, SOUTH CAROLINA 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 Parcel I.D. # I~~''~ - ~,Lo~ - ~-_-~oj HAA # ~(~o~\~;) ~L.~'"~ GENERAL INFORMATION Complete legal description Lot 6; Block:'lO; McMahon subdivision~ Location (site address or directions) 3501 ., Property owner Don and Vicky Keefer Day phone 345-5241 Mailing address Lending agency Mailing address Day phone Beth Simpson/SIMPSON REALTY ' Agent Address P.O. Box 112342, Anchorage, Alaska 99511 Un/ess otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual.well Community well Public water 345-6644 Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site 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 (Rev11/91) Front MOA ~t21 5. STATEMENT OF INSPECTION BY 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 S & S ENGINEERING Address 17034 Eagle RiYer Loop Road Eagle River, Alaska 99577 Engineer's signature Phone DHHS SIGNATURE /¢~ Approved for Disapproved. ~bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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, 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: .Zo"/u _~ i ~/_¢~J<~'_ ! o ~/1~.~.~1 o~-~Parcel I.D. A. WELL DATA Well type ,~.,~ If A, B, or C, attach ADEC letter. Log present (Y/N) Total depth sanitary seal (Y/N) L~ ADEC water system number Date completed z..f.-Z.~- ~ Driller ~'~-~ Cased to /_n ~ ' Casing height .--' Wires properly protected (Y/N) h '" g.p.m. ~. z~, FROM WELL LOG Date of test /..f Static water level ~- 2 ' Well flow Pump level AT INSPECTION _~ ~: g.p.m~ ,-., < Z / loc , SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /~ ~ / Absorption field on lot / ~ O Public sewer main Public sewer service line ; On adjacent lots On adjacent lots / O O -/- Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: ;f~ - '-~ -- ~'/ Nitrate ,~,~."~'~ .-~.C...'-/.~f'~ (~. ~_~ Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed -_~'-1~-7~ Tanksize /~--~"-0 ~/~1 Compartments Cleanouts (Y/N) C/ ~' Foundation cleanout (Y/N) L~ ~' Depression (Y/N) High water alarm (Y/N) ~/~ Alarm tested (Y/N) . .'/,,)//4 :. Date of pumping ! ~ -/I ~D · SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ( OO To property line I ~ Surface water/drainage Foundation =~ l-f Water main/service line ! 0 /-/' 72-O~6 (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) sEPA'RATION DISTANCE FROM LIFT ~TATIO Well on lot On adjacent lots '~ Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed - ~'- Length ~ ~ Width Total absorption area Depression oVer field (Y/N) Results (pass/f~il) Peroxide treatment (past 12 months) Soil rating ./LOC ~//~/~ Sy~ste,r~)tvpe ~-,~)C~k Gravel thickness ~ I'/( ~tal depth ~ Date of adequacy test / ~ - / for /~ AJ / Y~' If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water '! 620 Curtain drain On adjacent lots (' f")O 'Y Property line 2 ~' To existing or abandoned system on lot t+ Cutbank ~o/t~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effefit~<oo..tC~e~l~,te of this inspection. Signature ~ ~ ~ ~u~m~ ;:..~0:.:'>:' "': ~¢~ 17034 Eagle R~ L~ Read Ne, ~ ~ f' Engineer's Nam~a~j~ ~wr, ~,..~.' '--'-- .....~=~ Date of Payment' Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment ?1 Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. Client Sample ID:L6 BlO ~AHOH $/D PW~ID Collected AUG ? ~ecel~ lO~ 7 91 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX:(907) 561-5301 Client A¢ct ~eq ! Ordered By : sand ~epolte to: tnal~sis Completed :~UG ~ 9i 1)$ & 8 ENGI~[~I~G Laboratory Supez¥ieo[ :B~tt~ C. ~D~ 2) Chemlab Eel I: 91~974 Lab ~mpi ID: 1 Matrix: W~TER Allowable parameter ~ested gea~lt Units ~ethod Limits ...................................................................................... Sample ROUTINE SAMPLE i Testa performed * Bee Special Instructions Above UA=Unavailable ~D- None 9etecte~ "See sample ~ema~ke Above Hk- Not Ar~lyzed LT-Lese Than, GT-Greater Than , D~E RECEIVED , , iNSPECTiON APPOINTMENTS TIME TIME TIME MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO~'iI~iT~I~MEN~,AL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION JU~ 8 1981 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND ~~I~ES DIRECTIONS: Complete aH parts on page I. Incomplete requests will not be proce~ed. Please allow ten (10) days for processing. PHONE MAI LING ADDRESS PROPERTY RESIDENT (If diffe~nt from a~ove) ~ ~ ' PHONE pHONE MAILING ADDRESS MAI~I~G 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS ' [] One ~,~ Four SINGLE FAMILY ~ [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY I NDIVIDUAL* COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 197§. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM ~ iNDiViDUAL/ON.SiTE~ [] PUBLIC UTILITY ,YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. I THIS SIDE FOR OFFICIAL USE ONLY '1 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY BI ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []PUBLIC[]INDIVIDUAL/ONuTILITY -SITE DATE INSTALLED ~r-~ ~ Connection Verified INSTALLER E~Septic Tank or [] Holding Tank Size: }..~_~-'~1 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL' ~ ~ 4. DISTANCES Septic/Holding Tank Absorption Area ISewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [~ApPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must acc~,i~pan¥ certificate) [] DISAPPROVED 72-010 (Rev, 6/79) 825 "1_' STREET ANCHO~-iAGE, AI_ASi<A 9!}501 (907) 2644111 Gi'OR(',-iJ M. SULI..IVAN', !M:PAi-ITM[.N'FOF HEALTH A.',~D ENVIRONM~!.,I;Ai F'!]OIECTiOI',f July 10~ 1981 Don Clark % Kruyne and Wendt 634 K Street Anchorage, Alaska 99501 "~ .... Subject: Lot: 6 Block l0 Mc Mahon Subdivision #2 Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (i) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our reeiew. (2) The septic tank pumped with a receipt submitted to this office for our reveJ, w. if there are any questions, please call this office at 264-4720 o Sincerelye Robert C, Pratt Associat. e e'.2 '~' ' ~_ RCP/ljw CC: First National. Bank of Anchorage Mortgaqe Loan Department Post Office Box '720 99510 MOENING-GREY & ASSOCIATES, INC. GEOLOGISTS AND ENGINEERS 715 L STREET, SUITE 6 ANCHORAGE, ALASKA 99501 TELEPHONE 274-2:~ 14 July 17, 1978 ~~_~ · Municipality of Anchorage Department of Health & Environmental Protection Environmental Engineering Division 825 L Street Anchorage, Alaska 99501 Attn: Bob Pratt Re: Inspection of on-site sewer installations Dear Mr. Pratt: In response to your request of July 14, 1978, we are submitting the following information regarding septic tank size: Dwayne Melchert- Leter permit from Municipality authorizing upgrade of trench only. Information on existing tank in Municipal records. Mountain Enterprises-Permit No:780156-I~'~ or~~ 780108 780109 Septic tank installations inspected by Municipal personnel. We inspected the trenches. Paul Garner- Permit No:780381 Septic tank size inadvertently omitted from field inspection reports. A 1000 gallon fiberglass tank was installed at this site. A review of our files indicates all other permits contain tank capacities. Please advise if you have any questions. Sincerely, HJG/lg ~'*" MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION . ,.i ~ '~ 825 L Street - Anchorage. Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION ',': -:' ~ .- -'" Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete ail parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER D J~ J ~ . PHONE MAILING ADD~ESS PROPERTY RESIDENT {If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LEND~G IN~ITUTI~ ~ ~, ,~~~~ PHONE 4. R E~TOR/A~ PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOOATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS · [] One ~ Four ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Thr~e [] Six [] Other 7. WATER SUPPLY J~ INDIVIDUAL~ 'ATTACH WELL LOG. Awell Icg is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date /'4 ,~)~· /?~¢ If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY by this Department, NOTE: THE INSPECTION FEE MUST ACCOIVIPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (3/78) THIS SIDE FOR OFFICIAL USE ONL. DATE RECEIVED INSPECTION APPOINTMENTS TiME TIME TIME -I~T E DATE DATE ~SPEC'FOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER oF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3.; SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [_-i]INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [~i] Septic_Tank o~9~r ~] Holding Tank Size: ~"~ If Tank is homemade SOILS RATING give d i n~/e~sl'~'n°s: -:FYPE OF TANK MANUFACTURER ~-OTA L ABSORPTION AR EA MATERIAL.~ ~ '~' DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [~ APPROVED FOR ~' BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED '-~AT E BY (Title) --~FGAL DESCRIPTION 72-010 (Rev. 3/78)