HomeMy WebLinkAboutBOWERS LT 57ABowers Lot 57A #050-261-29 LOG OF DR' LING by A & L DRILL 1G COMPANY OWNER OF LAND..._heipJ"/ aorto itc DEPTH OF WELL /.6 ADDRESS .l41/..60 toU g (P I K o'/ .-AP 9 f STATIC LEVEL OF WATER FT..._L 3 / WELL SITE DATE -STARTED ..._.01/7 DATE -ENDED ........... KIND OF FORMATION: FROM..._... FT. TO DRAW DOWN FT. I; GALS. PER HR. / r 00 KIND OF CASING..._(v.....�r._�>..�%. .IT +t geoQ FROM ..IT. TO. FT FROM S- .....FT. TO i ‘71' FT FROM.../.) FROM ;-5.- FROM S -? FROM...S A FROM ..._.4.0 S,9•v 4.4h' e c �..j FROM.» IT. TO FT FT TO �s" FT J L e 22 /4j..1/ FROM......._.._......_..fl. TO .FT ine Ff. TO....,/ FT....,(.?.r��G... C t FROM..._.._.._.._.._...FT. TO..._..-.._ ......FT FT. TO 45 - FT.. ��% i v.. VfFROM.......»__.._.......FT. To FT. TO....]...6.._.._.. FT S,f' v0 .Si (7484-1E4 FFRO. G3 FT CC /9 i- 6,q,J4:< FT. To. fl..._ - FROM.. _.PI. TO._....._._...». F"I...._.._..__ 16 FT po i Er sherve t- 6V,5414-74. FROM..._._.._......_...FT. TO XT...._..__...._......_..._ FROM ..._.i?._.!..._...FT. TO FROM ....3....._...FT. TO MISCL. INFORMATION: b 4 SSf n l eoicO DRILLER'S NAME p..cettl 7' GRE'i~-~-'R ANCHORAGE AREA BOk. "$H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ' s .e.// LEGAL DESCRIPTION SEPTIC TANK: DISTANCE p~) / FROM WELL v INSIDE ,ENGTH MANUFACTURER ' '/ MATERIAL ~ COMPARTMENTS INSIDE WIDTH _ LIQUID DEPTH LIQUID CAPACITY/2~'(~GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES / ABSORPTION AREA DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE IN. BUILDING ~'~)/, FOUNDATION CESSPOOL APPROVED CONSTRUCT,ON DEPTH ¢~' ~ DISTANCE FROM: NEAREST '~'"7.~ / NEAREST LOT LINE /~/ , SEWER LINE , OTHER SOURCES DISAPPROVED REMARKS SEPTICp(~ / SEEPAGE TANK , SYSTEM DISTANCES: ___ INSTALLED BY; SEWER LINE DEPTH: PIPE MATERIAL:/// LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM 02. Form EQ-O32 (;RE R ANCHORAGE AREA BO '~GH DEPARTMENT OF ENVIRONMENTAL QUALITY ~O_~.~ PERMIT NO. -- SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION LEGAL DESCRIPTION /~'/;2 : : ~ INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED SEEPAGE PIT , DRAIN FIELD · OTHER FINANCED THROUGH SOIL TeST RESULTS TO BE INSTALLED BY COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL (~UALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. FOUNDATION TO SEPTIC TANK ~ fOUNDATION TO SEEPAGE pIT DRAIN FIELD TO NEAREST LOT LINE. WATER MAIN TO SEPTIC T~NK ALSO CONSIDER AREA WELLS, 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 REGARDING INSTALLATION. ,. ,? .:/: LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AH FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH OR~31NANCE NO. g8-68 AND THAT THE ABOVE O 8' E GEOTECHNICAL ~' DEVELOPMENT 'CO. ', ' f ~ ~t 90, Davls694.2774St., Eagleor 688-2280River' Alaska 99577 -Earl EII/s Soils ~ Foundations / Land Developmen~ ' S0ZL LOG Pe.¢omed fo.: Name: ~ '~~% ~¢>w~ Tel. "o. Depth (feet) Sot1 Character~sHc~ 0 1 4 7 8 Ground Water Encountered: Yes No .,v'"'" If yes, what depth Proposed Installation: Seepage Pit v/Drain Field Commen ts: '~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ October 2, 1975 Mr. Ro~f Strickland 3330 C Street Anchorage Municipality Anchorage, AK Subject: Lot 69, Sec 11, T14N, R2w (Ralph Bowers) Dear Rolf Strickland: This office has no objection to the placement of the septic tank 80 feet from the well and the seepage system 120 feet from the well, as this is a relocation of an existing system forced by a highway project. Sincerely, Regional Environmental Supervisor cc: Ralph Bowers · . O ~ E GEO}~CHNICAL ~ DEVELL~,'MENT CO. Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Soils ~ Foundations Performed for: Legal Description: D_epth (feet) Ead Ellis 688-2280 SOIL LOG Land Development Name: ~x-~', '~'~~ ~'~'_~ Tel. No.~ Hailing Address: ~ ~ g~ ~'~ ~' ~' ~*'~"~7 Soll ~haractertsttcs 2 4 14 15 ld Ground Water Encountered: Yes No ~ If yes, what depth Proposed Installation: Seepage Pit ~'" Drain Fte~d ~'~' Date: . Municipality of Anchorage ` Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AI< 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050 261 294X/6'4+ 1. GENERAL INFORMATION Complete legal description Lot 57A, Bowers Subdivision 08849 COSA # b D3y 3 Expiration Date: I /S f 6 Location (site address) 16780 Eagle River Rd Current Property owner(s) Rod Bowers Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 16780 Eagle River Rd Day phone 229'0870 Eric Bc1Iow -1 Freedom Direct Mortgage Service 2363 South Foothill Dr., San Lake City, UT 84109 Day phone 80V493-6478 Michael Schwartz - Prudential Jack White Realty Day phone 3514228 3801 Centerpoint Drive, Suite 400, Anchorage, AK Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: El Individual On-site ❑ Individual Holding Tank ❑ Community On-site ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application. shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm DHt Consulting Engineers Address 800 E Dimond Blvd.. Suite 3-550 Engineer's Printed Name Dee High 5. DSD SIGNATURE Approved for q bedrooms. Disapproved. Conditional approval for Phone 344-1385 Date 9129/08 esswleas 0.... .y 0 71�DENNIS 'EE HiG a ♦9' • CE 5807 Pc • •F, 4 % (Profess •• bedrooms, with the following stipulations: 4frl'8 s, .. _' •:�; ON-SITE WATER ANU WASTEW PROGRAM ,: .4,050 E01 N i tsltl 111) Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitr• e Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev 11/05) Original Certificate Date: d� Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 57A. Bowers Subdivision A. WELL DATA Well type Private If A, 8, or C provide PWSID # WA Date completed tom/75 Sanitary seal (Y/N) Yes Wiresro rl p pe y protected (YM)ves Total depth 96 ft. Cased to 96 ft. Casing height (above ground) 12 FROM WELL LOG AT INSPECTION Date of test 10/11/75 9/12/08 Static water level 73 ft. 45.7 ft. Well production 25 g.p.m. 10.0 WATER SAMPLE RESULTS: Coiiforrn 0 colonies/100 mL Nitrate 0.431 mg/L Other bacteria 0 colonies/100 mL Arsenic: ND ug/1 Date of sample: 9-10-08 Collected by: Dm Consulting Engineers B. SEPTIC/HOLDING TANK DATA Tank Type/Material Fiberglass/ Sunset Plastics Single Chamber® Parcel ID: 050 261 29 000 14 Well Log (Y/N) Yes g.p.m. in. Date installed 10/10/75 Tank size 1250 gal. Number of Compartments 1 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YM) N/A Date of pumping 9/28/2008 Pumper Denali Sewer & Drain Service C. ABSORPTION FIELD DATA Date installed 10/17115 Soil rating (g.p.d./ft2 or ft2/bdrm) 125 System type Deep trench Length' 67 ft. Width 4 ft. Gravel below pipe 5 ft. Total depth 10.2 ft. Eff. absorption area 670 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/10/08 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 13 in. Water added 1200gal. New depth 430 in. Elapsed Time: 1.440 min. Final fluid depth 13 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) No If yes, give date D. LIFT STATION Date installed Size in gallons 'Pump on' level at _ in. 'Pump off' level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 80.8' Absorption field on lot 94.7' Public sewer main None In this area. Manhole/Access (Y/N) High water alarm level at Meets alarm 8 circuit requirements? On adjacent lots >180' On adjacent lots Public sewer manhole/cleanout None In this area. Sewer /septic service line 50'' Holding tank No holding tanks. Animal containment areas >100' Manure/animal excrete storage areas we' (None noted) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: in. >120' Building foundation 50.5' Property line 31.7 Water main No water main in this area. Wells on adjacent Tots >120' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field 4' Water service line 79' Surface water 'ICU None Hund k ave area. Property line 10.2 Water Service line 94.7' Curtain drain No curtain drains. Building foundation 677 Water main No water mains. Surface water No surface water. Wells on adjacent lots >120' F. COMMENTS: 0 24 hour leakage test was conducted on the tank. lel Added 1200 gallons to field. Driveway, parkingNehicle storage 3' (�3 Measured from tatssire r3nrrnY14 O/r pc -/EG O G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date to f fi��a Dee High �.e ..flee...... 3 %DENNIS 'EE CE X80 ♦�rPr �eyee.Mee •,; Profess `� + COSA Fee $ '7 0 Date of Payment Q—.3 c)— OK Receipt Number 1 j 3 C6 3 (Rev. 11/05) k....•• Waiver Fee $ Date of Payment Receipt Number 64.a O3SIC Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 057D-2 Co / —P( ,r 4 9 1. GENERAL INFORMATION Complete legal description L or 57 A • Location (site address or directions) HAA # IM D;14.2 -bp Expiration Date: �3owGR5 Su/SP. \140er A BOW €4.1,5- ‘941- ys&9'I- 2561 Current Property owner(s) R AL PH 13o w6R.S Day phone le RVer Day phone Mailing' address' Lending agency Mailing address /L2F0 tootle aver t21 NONE 4k gvs91 Real Estate Agent N 0 nt E Mailing Address Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: • Individual Well Individual Water Storage Community Class Well Public Water System L TYPE OF WASTEWATER DISPOSAL: l�f Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or 8 wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER >;� ,;:' ':. As certified by my seal affixed hereto and as of the validation date shown below, !verify Mat trig t, • ,r:,, based on procedures outlined in the Health Authority Approval Guidelines for this applcation:: Shows that I. ::. ' ; : site water supply and/or wastewater disposal system is(are) safe, functional and adequate forahe n i. . ; =: bedrooms and type of structure indicated herein. I further verify that based on the information obtained ' he? ' .' Municipality of Anchorage files and from my investigation and inspection, the on-site_yfaterauppt ,andtoV wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Dbtr Co Ai Sc,4T/416 F AJ Ca /N6E/IS Address POO E. DlmouD (3Lt/O. srE 3-S'IS— Engineer's Printed Name --D6E H/41-/ 5. DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. Phone 3 c/5+= 73 ?S . Date ' r t OF.g1gtocieumiliq �, //t•.. CE -3807 • .� se bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rev. 01)*2) Legal Description: A. WELL DATA Well type aiUgTE 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.clanchorage.ak.us (907) 343-7904 w. O . o 3 SFr - HEALTH AUTHORITY APPROVAL CHECKLIST Lor 574 Cavities Seal. ParcelID: Oso'2I:/-.2c1 • If A, B, or C provide PWSID # NM • Well Log (Y/N) Y Date completed torn/7f Sanitary seal (Y/N) Y v Total depth toj4 ft. Cased to 9G ft. 9y incq> 4vS FROM WELL LOG Date of test ' to/ rr/7- Static water level 73 ft. Well production AS g.p.m. WATER SAMPLE RESULTS: Coliform '©- colonies/100 ml. Nitrate O•Umg./I. Arsenic: N/A mg./l. Date of sample: s//1lb3 B. SEPTIC/HOLDING TANK DATA Sumter %nasriese Tank Type/Material P186L6LA aS / Sstifle CH•n406& Date Installed to/ o/ 9.f Tank size /2.SO gal.- Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y • Depression over tank (Y/N) hl High water alarm (Y/N) N/A Date of pumping VIZtOL Pumper SArarTARV rk/MPeRS Wires properly protected (Y/N) Y Casing height (above ground) /2 in. AT INSPECTION ovrc3/03 V?r ft. g.p.m. Other bacteria 3 colonies/100 ml. Collected by: C. ABSORPTION FIELD DATA Date installed /0!/7/7,4- Length (.7 ft. ro.2 Total depth a tt. Eff. absorption area 41O ft2 Monitoring tube Y® Depression over field td Soil rating (g.p.d./ft2 Width ..Y 47 ft. System type neaP TRENCH Gravel below pipe 5 ft. Date of adequacy test 1°/=303 Results (Pass/Fail) P Fluid depth in absorption field before test 39 sin. Water addedLgal. rvy0 Elapsed Time: _ min. Final fluid depth 39 in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO For bedrooms New depth '/2 in. Absorption rate >= (0°2- g.p.d. If yes, give date © rit Tiff At smear o ♦ neu.o. © QexJ Ay hour tekes # sT- A/e L6hic.•it D. LIFT STATION Date installed Size in gallons "Pump on" level at In "Pump off' level at Datum Cycles tes E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 80.8 / Absorption field on lot 4 '1.7 Public sewer main /3oa6 IA) THIS Asea Sewer /septic service line 50 Lt - Manhole/Acte (Y/N) High wa alarm level at in. Me9t alarm 8 circuit requirements? On adjacent lots 7 /80 On adjacent lots > /20 Public sewer manhole/cleanout 9300J6" ow+ 7101 4ss/1 Holding tank No Mot d 7wMtc$ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation So. IS Property line 3/•7 Mc Lunn-_ / Water main masa TIMWater service line 77 AsnA. Wells on adjacent lots > /20 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line to• Water Service line 9%'7 Curtain drain PO ecadaah 0/8014 NS F. COMMENTS t) hWccod !.J icATV Absorption field 4' 1 Surface water ) /00 mo t% sou m0 .N rigs Asa Building foundation 67. Z Water main 010 tea T6b /^0404 / Surface water No Storage- Driveway, parking/vehicle storage W ATS/C.- Wells on adjacent Tots 7 /20 k4.41.4161€C G4AN ri=0 G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name DEE /-/ib H Date IF /�/ � DE! NI• ?? 0 ir •. CE -5807 4-, t+1l\4 ••• • ctlQQ'••Voi /A\IO HAA Fee S J-76 0 Date of Payment C//c//o 3p Receipt Number- s4 (Rev. 12/01) 3 537 d Waiver Fee $ Date of Payment Receipt Number LOT 59 / I \ \ FND LOT 58 0 24.2 LEGEND 0 CLEAN OUT do/OR MONITORING TUBE \ 0 SEPTIC TANK— STAND PIPE \ 0 DOMESTIC WELL NOTES: \ 1)PROPERTY UNE SHOWN PER OFFICIAL PLAT NO. 84-26 DATED 2-1-84. 2)MEASUREMENTS FROM WELL ARE FROM OUTSIDE FACE OF CASING. 3) TANK & LEACHETH TO TO OUTSIDE EDGES. 4)EXACT DIMENSION OF SEPTIC R�1552.39 TANK ARE UNKNOWN. USED 52 0 X 11.67 LONG. L=366.93 5)TAKENSFROM RECCORDS�FLL 4' WIDE X 67 LONG. 100' PROTECT,,VE tai /GS\ o to 4.0 z z — WELL Fo N 28.2 _ Q4 0. � o 20W LOT 57A 11250 GAL .ASEPTIC TANK \ 100' PROTECTIVE WELL RADIUS I FND 5/8' REBAR t9 \ F 13 150 90 rLEACH FIELD "15' ELECTRICAL I TELECOMMUNICATIONS EASEMENT N89'50'541W 323.55 LOT 69A i 0. 0.. I, Dee High, a Registered Professional Land Surveyor, do hereby certify that • all existing and proposed improvements are shown hereon. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. P'\F, OFAt 5� :L9 TH '9* • 0 ••• • 0 f • DE HIGH : 0 •' •.•• LS -9687 .. ay �i ••••..•••• .ap Dffi CONSULTING ENGINEERS CIVIL • SURVIVING PLANNING Telephone: (007)544-1386 paw (901)344-1583 9M 9. FORM • 99a9 9-146. IN009 n YDS MIS W.O. 03585 COMP. ALE 585CTRID SCALE 1 •=s0• DATE 4/28/03 t.%..•0.f/y14ty LOT 57A BOWERS SUBD. AS—BUILT SURVEY FOR WELL & SEPTIC IMPROVEMENT GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 ,~ · ~ Date Received April 26__~, 197_~6 ~ . n A'~ / ~ Time of Inspection g.'~m. m_.~ ~ .,~ ~ Date of Inspection ~-/~-~/m %-J' REQUEST FOR APPROVAL OF ;a, ~NDIVIDUAL SEWER & WATER FACILITIES FOR Cony. 1. Approval requested by: Mailing Address: Post Office Box 1120, 99510 2. Property Owner: Ralph and Nancy Bowers Mailing Address: Route Box 85, Eagle River Alaska Mutual Savings Bank 99577 Phone: 274-3561 Phone: 694-2561 ~,<,;~14N, R2W Section 11 Portion of Lot 57 and 69 Legal Description: Location: ~-,. '2~,zle Eagle River Road Typ~e,,o,f~<facility to be inspected Single Family Well'Data: Individual - serving one No. of bedrooms 4 A. Type B. Depth C. Construction D. Bacterial Analysis Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: On-site system B. Installer 1. Size /~1,~ 2. Manufa~turer ! 1. Absorption Area ~~. Material E. Disposal Distances: A. Well to: Field: Total Septic tank length of lines ~/ ,'Absorption area ?~ r , $~er Liner/ //, Nearest lot line , Other contamination B. Foundation to septic tank C. Absorption area to nearest lot line , Absorption area EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~--~t for Approval of Individual '~r & Water Facilities L~al D%scripti0n T14N R2W Section 11 Portion of Lot 57 and 69 Comments . Approved is pproved Date ~l~-T&. Approval Valid 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 operatin9 satisfactorily. SIGNED Date EQ-034 (1/74)