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Home My WebLink AboutBRUIN PARK BLK 1 LT 7O~ 000 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT . MAILING ADDRESS / LEGAL DESCRIPTION ' ' LOCATION NO. OF BEDROO~ ~, DiSTANCE TO= IWell I Absorption area Dwelling PERMIT NO. ~ ~ Mate No. of compartment~ Liq. capacity in g~llons Inside length Width Liquid depth / ~ ,~ IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO, ~ ~ ~ Manufacturer Material Liquid capacity in gallons Well Foundati Nearest lot line~ ,~1 PERMIT NO. --4~Z No. oflines Length ofeachline~.~ Total length of line~ Trench width_6~nches Distance betweenlines__--~, ~ Top of tile to finish grade~, , - Saterial beneath tile~ Total effective ab~?tion area ~0 inches Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m m DISTANCE TO: , Well Building foundation Nearest lot line ~ Class Depth Driller Distance to lot line i PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank A~sorption area(s) OTHER PIPE MATERIALS SOl L TEST RATING / ~ij INSTALLER APPROVED . DATE LEGAL -013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 'IPHONE I [~I~E W MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS/..~ / I Well Absorption area Dwelling PERMIT NO. DISTANCE TO: ~:t-'F. Manufacturer ~ ¢ M at e~,~~ No. of compartment... m Liq. capacity in g§llons .......... Inside length Width Liquid depth ! ~, ~, Well Dwelling PERMIT NO. DISTANCE TO: ~O _~ ~ Manufacturer Material Liquid capacity in gallons Q Well 7(-- ~ DISTANCE TO: _~ No. oflines Length of each lin~e ~. Total length oflin3.~- Trenchwidth~nches Distance between lines~/,~, ~'~ Top of tile to finish grade~ ,, Material beneath tile/~_ Total effective a~_.~_)on area ¢3 [~z~;;~ inches Length Width Depth PERMIT NO. u~ ~: I- Type of crib Crib diameter Crib depth Total effective absorption area "' Well Building foundation Nearest lot line ~ DISTANCE TO: .~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS ' _.,.,..~ I APPROVED . DATE LEGAL -013 (Rev. 3/78) (~-~ DEPRRTMENT OF HERLTH RND ENVZRONMEN"FRL PROTECTION 825 "L.' STREET., RNC:HORR6E., RK. :5~:5~50:t 264--.4728 .".i!:O~) :t.,-.'2 E. MANOR L. OT :5IZE F"ERHII" NO. < 7'..~EtE158 > RPF:'I... I E:ANT JIM MARSHALL LOCAT I ON POLRR [>F:: I ',,,'E LEGAL. L.'? Bi BRUIN PK S,.-'D T'T'F'E OF SOIL RBSORBTICIN S"r'STEM IS: TR["--NCH I'"IRXIMUM NUMBER CIF BEDROOMS SOIL RATING THE RE6!UIRED SIZE OF THE SOIL. RBSORF'TION SYSTE'.M IS;: TFIE LENGTH D:[MENSION IS THE LENGTFI (1N FEET::' OF'" THE TRENCH OR DF.':AINFIfEL.[::,. THE DEPTH OF A TRENCH OR PIT IS THE DISTRNCE BETt.,.IEEN THE SLIF,'.FACE OF THE!: GROUND RND THE BOTTOf'I OF THE EXC:R',,"ATION '.'; IN FEE'T). THERE IS NO SET I.,.IIDTH FOR TF.:ENCHES. THE GRR',,,'EL DEPTH IS TNE MINIML.IM BEPTH OF GRR',,,'EL. BET[,.IEEN THE OI...ITFALL.. PIPE AND THE BOTTOM OF THE EXCR',,,'ATION '::IN FEET....'. PEI:F-".HIT APPL. I C:RNT HAS "FHE RESF'ONSIBI L.I T"r' TO INFORM TFIIS DEPFIRTMENT DUF?.I'NG THE!: INSTRLLRTION INSF'ECTION".".:.; OF' ANY L4E[_L.S RDJRCENT "FO THIS PROPEP. T'¢ AN[:' THE; NUf'IBER OF RESIDENCES THRT THE I'.IELL ~,.IILL SER",,'E. E';RCKFIL. LING OF RN¥ S"r'STEM ~4ITHOIJT FINRL. INSPECTION RN[:' Rf::'PF.':O","RL. B"," THI:'7:; DEPARTMENT ~,.IILL. BE SUE:JECT TO PROSECUTION. MINIMUM DISTRNI.'.'.:E BETI4EEN la [4EL. L RND AN'¢ ON"'"'-"-';ITE SE[,.IF:IGE: DISPOSRL S"r'STEM I':.-:; :l. Oe~ FEET FOR A PR]',,,'ATE [4EL. L..~ OR 150 'TO 280 FEET FROM A PL.IBL. IC P.IELL DEPENDING UPON TFIE T'¢F'E OF F'UBL. IC I.,.IE[...I ..... [,.IEL. L LOGS ARE F..'EI.';!UIF..'ED RND MLI2';T BE F..'ETI..JF.'.NED TO THE DEPRRTMENT P~I't"HIN ::!i:~.:) E:,F::t"r':!ii; OF THE klELL COMPLETION. OTHEF:'. REt'..:!UIF.:EMENTS MR"r' APPL."r'. SPECZFIC:ATIONS f:C'4D CONSTF.:UCTION [::'IF:~GF.:F:If'IS A',,,'AIL. F:IE~LE TO INSURE PROF'EF.': INSTRLLRTZON. I CERTIF"~,' THAT i: I RM FRMIL..IAR 1.4ITH THE RE~;!LIIREMENTS FOR ON-SITE SEI.4ER:."'.!; RND F.IE!:L.L.S FOF.:TH B'¢ THE MUNICIPALIT'¢ OF RNC:NORAGE. 2: I [4IL. L INSTRLL. THE S'¢S'FEM IN ACCORDRNCE [4ITH THE CODES. .~:: I UNDERSTAND THRT THE ON'-SITE SE~qER S'¢STEM MA"r' REC!UIF4:E E:['LF~RGEI"IENT IF:' TI"ilE RESI[)ENC:E: I:"::; REMODELE[:, TO INCLUDE MOF. tE THAN 4 BEDROOMS. December 29, 1978 %780019 Jim Marshal 300 ½ East Manor Anchorage, Alaska 99501 Subject~ Lot 7 Block i Bruin Park Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/lJw enc: copy of permit PERMIT NO. DEPBRTMENT OF HEAL. TH 8ND ENVIRONMENTAL PROTECTION 825 'L~ STREET, ANCHORRGE, AK. 99501 264-4?20 ~IELL F~-4[:, ~];~-4--S;ITE .SEL.JEF: F'EF:rd IT ( 7800t9 ) RPPLICANT JIM MRRSHRL LOCATION POLAR DR LEGAL L? B~ BRUIN PK SUB ~00 i/2 E. MANOR LOT SIZE 279 ?2G~ 20000 SQUBRE FEET TYPE OF SOIL 88SORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= ~50 THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: [:, E F' 'T ~-t = :L 2 L E ~-~ L] T H = 4 __~: ~_] F.: fl '...' E L [:, E P T H == THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE E~CAVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVRTION (IN FEET). ~-".'E Pl!L~ I F.:E[:, SEF'T I mS: TRr-~F::: S I ZE= li~: 5 ~Z~ ~Zi~-tC.[_ F' 8 C: k-:: ~ mS E P L ~ ~-I T C~ F' T I i__~.1 I=1 PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE"S OPTION SLIBJECT TO THE FOLL. OWING CONDITIONS: t. EITHER A CLASS I OR II NSF 8PPRO'v'ED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MBINTENANCE 8GREEMENT IS REQUIRED. IF A MRINTENANC:E AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENL. BRGE THE SOIL. ABSORPTION SYSTEM AND..-'OR YOU MAY BE SUBJECT TO PROSECUTION. .......... ]'L.3m2m ('~) I ~-4LSF'EC:TIm]e~4'---~. t~2 ~E~]]L] I F~2[:. BACKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION AND ~PPROVAL BY THIS DEPBRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL 8ND ANY ON-SITE SEWAGE DISPOSAL SYSTEbi IS i00 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST 8E RETURNED TO THE DEPARTMENT WITHIN ]~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MBY APPLY. SPECIFICATIONS AND CONSTRUCTION DIBGRAMS ARE AVRILABLE TO INSURE PROPER INSTALLATION, F' E F-::". r"l I 'T E ::-:: F' I R E S [:, E ,2: E ~'1 E: E R _:~: :.'L .. :L D ? :~: I C:ERTIFY THBT t: I BM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPBLITY OF ANCHORAGE. 2: I WILL I NST8LL THE SYSTEM IN ACCORDANCE WITH THE CODE'-'-;. 3:: I UNDERSTRND THBT THE ON-SITE SEWER SYSTEM MRY REQIJIRE ENLARGEMENT IF' THE RESIDENCE IS REMODELED TO INCLUDE MORE THBN 4 BEDROOMS. RPPL I CANT J I M MARSHAL REaM r't-C3NSULTANTS, INC. 50z4 COROOVA B BOX 6087 · ANCHORAGE, ALASKA 99502 · PH. 907~279-0483 Im TLX. 090-25360 January 20, 1978 R&M No. 851101 Mr. Jim Marshal 300% E. Manor Anchorage, Alaska 99501 Subject: Soil Investigation for Sanitary Sewer System, Lot 7 Block 1, Bruin Park Subdivision, Anchorage, Alaska Dear Mr. Marshall:. At the request of your agent Mr. Verne Rappe, we conducted a subsurface soils investigation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage Department of Health and Environmental Protection. This investigation, which was accomplished on January 18, 1978, consisted of a test hole excavated to a depth of 14 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. Excavation was accomplished with a backhoe. Samples were taken at the depths shown on the soils log in Drawing A-01. The samples will be held in storage at our lab for approximately six months. In addition, all material excavated was continuously monitored by an experienced engineering geologist. The topography at the excavation site is generally rolling. At the time of the investigation the site had original vegetation consisting of alder, spruce and birch. The top of the test hole was located at original ground surface. The soils encountered in the excavation are shown in the test hole log in Drawing A-01. The symbols used in Drawing A-01 are explained in Drawings B-01 and B-02. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without apparent surficial evidence of the change. Groundwater was not encountered. Bedrock was not encountered. At the time the hole was exca- vated seasonal frost was present from the surface to a depth of 1.5 feet_a Permafrost was not encountered. '-- Based on the visual classification of the soil and the requirements set forth by the Municipa~rage, a percolation test was not necessary within the test hole on the subject lot.'~' ANCHORAGE FAIRBANKS JUNEAU VALDE? WASILLA January 20, 1978 Mr. Jim Marshal Page -2- We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or we can be of additional service. Very truly yours, R&M CONSULTANTS, INC. Jim McCaslin Brown Head, Earth Science Department JMB/kah LOCATION SKETCH N TEST HOLE 1 ~O~ Distances shown are approximate and have not been measured by surveying methods. TEST HOLE LOG NO. 1 Scale: 1"-3' 1-18-78 0! SANDY SILT (SM), Rusty, Brown, some organics, 3 " of humus at surface 1.5' SAND WITH SOME GRAVEL (SP)' Gray to brownish gray, medium dense, slightly moist 1 12' SANDY GRAVEL WITH SOME SILT (~), Gray, medium 2 dense, moist 14'T.D. Groundwater was not encountered. This log depicts subsurface soils observed within the test hole at the location shown. See Drawings B-01 and B-02 for ex- planation of symbols. ~, ',,.~. ~ ~$,.( ~ ~ ~lder, .p~o~ .~o coz~t~uct~on, ~ verl~.v ~ / '.. '~ ~' .~k~ ~ ?p~eo ounamg gra~e relative ~ '~*'~'.[~'.~ ~ned.gm~e a~ utility connections and LOT SURVEY CERTIFICATION Plat File No. Zoning District Anchorage Recording District, Alaska LEGEND: ~ B~ass Cop Monument ® Iron Pipe · Steel Pin ~3 Survvey Hub ~ Tack ~.,¢u~ ~ T 7 REVISIONS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 7 Block 1 Bruin Park Subdivision Location (address or directions) 11001 Polar Drive (b) Applicant Name Larry Marshall Telephone: Home 349-8065 Business 264-4589 Applicant Address 11001 Polar Drive (c) Applicant is (check one): Lending Institution [] ' Owner/builder l~x:Buyer [] ' Other [] (explain); (d) Lending Institution 1st National Bank of Anchoragqrelephone 265-3809 Address 201 West 36th Avenue~ P.O, 4-2090, A.nchorage~ Alaska 99509-2090 (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [k Multi-Family [] Other Number of Bedrooms three (3) WATER SUPPLY Individual Well I~ Community [] 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 DISPOSAL Onsite [~xxm°ublic [] 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 2 ' 72-025 (11/84) ENGINEERING FIRM PROVIDI, iNSPECTIONS, TESTS, FILE SEARCH, D ~, AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown I~elow, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone Address Date Engineer's Seal This department has received from the engineer(Besse, Epps & Potts) written confirmation regarding the conditional approval of April 21, 1986. The property has been reinspected by the above engineer and the conditional has been removed. This property is now fully approved. DHEP APPROVAL Approved for three(3) Approved xxxxxx bedrooms ~~"~=~~ ate Disapproved Conditional May 13, 1986 Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to s.atisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the. professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name ~-/-~-~' Applicant Address Applicant is (check one): Lending Institution [] ' Owner/builder,S].'; Buyer [] · Other [] (explain); Telephone: Home -~~Business Address ,?, ~ / ~-? ~ ~ (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms ~.~ Other WATER SUPPLY Individual Well~l~ Community [] 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 DISPOSAL Onsite/[~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm / Address ~--~. ~'--0 Date '~/1 ~/~' Telephone Engir~eer's Seal Approved for Approved __ Disapproved Conditional Terms of Co.d t ona, ^pprova, CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOm) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST ' FEBRUARY 1984 264-4720 Legal Description: Z- "~ A. WELL DATA Well Classification ~/~Z~i-~- Well Log Present (Y/N) ,yE,~ v Total Depth /x/.~ ~ Cased to Static Water Level "7/, ~' Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot · If A, B, C, D.E.C. Approved (Y/N) Date Completed ;~'//C.b/'7C~ Yield I / ' ' ' ~-~ / + Depth of Grouting /- Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ~' /V'E /O,Z(' FT' ; On Adjoining Lots /~.~'O'+ ~r To Nearest Edge of Absorption Field on Lot //~- F"/- ; On Adjoining Lots To Nearest Public Sewer Line ~,~//q To Nearest Public Sewer Cleanout/Manhole ,~J/.~- To Nearest Sewer Service Line on Lot Water Sample Collected by '-'-- ~ J '-T~" - ' Water Sample Test Results Comments ~,. ~' ~rEy B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well IO~ To Property Line .-.5-O'~ To Water Main/Service Line Course ~/t/~r Comments :.~E'~ ~ Size I Z.~'C~ K"~ No. of Compartments Air-tight Caps (Y/N) 4~,~--~ Foundation Cleanout (Y/N) L,~--~ Date Last Pumped ! / ~J~ / / /",/'//J ;for Temporary Holding Tank Permit (Y/N) ~//.~ To Building Foundation To Disposal Field /~-- F"/-- To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field ~- Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line Type of System Design Length of Field ....=.~" Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line /~c-- ,C.r-- To Existing or Abandoned System on ;On Adjoining Lots ~,/?'.A (if present) ~(//~ To Cutbank D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Com merits ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. Receipt No. ~-7'"7 ~ Date of Payment Amount: $ ~ ~'"'0,...~0 Page 2 of 2 72-026 (11/84) Loc~tion-. BESSE, EPPS & POTTS 2220 EAST 88 AVENUE ANCHORAGE, AK 99507 (907) 349-6451 Subdivision: Lot: Block: Client's Name: Address: Initial Reading on Meter: /--/~/;7_- Prcfl, lc.t.]oa Ratm: ,:~. F GPM 24-Hour CapacityS.~l~- C~l]c~a BESSE, L:'" PS & POTTS May 9, 1986 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED Municipality of Anchorage Department of Health and Environmental Protection 825 L Street Anchorage, AK 99501 Re: Adequacy Test - Lot 7, Block 1, Bruin Park Subdivision Gentlemen: On May 9, 1986 we reinspected subject site, and the owners have placed the well's electrical wiring in conduit as required. If you have any questions, do not hesitate to contact me at 349-6451. sincerely, smh ENGINEERING, PLANNING, SURVEYING 2220 E. 88th Ave./Anchorage, Alaska 99507/Telephone 907-349-6451/344-1352 "Providing a quality personalized service to those building Alaska's future" ;,~:.~!..:. *~ ~ : ': ' - DEPARTMENTOF HEALTH& ENVIRONMENTAL PROTECTI~IRON~ )IRECTIONS:' Compl'ete a pa~ on page 1, Ineompl~ie r~ Will no~ proembd. Please allow ten (! 0) da~s ~r ProceSsing. 1. PROPERTY OWNER ' , , . ' .... I MA L NGADDRES8 , /' - PROPERTY RESIDENT ( f d ff~e-~t from aBo~e) / ' PHONE MAILING ADDRESS LE~ING INSTITUTION' ~ ' ' ~ 4. R~[TOR/AGENT ' ' '1 PHONE MAIL N~ ADDRESS ' 'tSTR ET'OOAT ON " ' .... "' : I - [6.- TYPE OF ~ESIDEI~CE ' ' , ~ ' ' ' '"NdMB~R bFBEDRooMs "' ' ' ' ' '~ I -'1 :I ~ ~'N~LEFAMILY ' : ' ~ ~One ~ Four ~ Othe~ I ~ i - ' ~: Two ~ Five ' "" ~ : ~ MULTIPLE FAMILY ~- Three ~ Six ' I 7. WATER SUPPL,~ ' . , ~ ' ' -' ~ INDIVIDUAL* ,-' , ~ A~ACH-WELL LOG, A well log is required for ~11 wells d,~llJ~d I ~ COMMUNITY since June 1975, For wells drilled prior to that dat~, give Well _ ~ PUBLIC UTI L~TY ", ' ~pt~ (attac~ I~o if available,) ~.-SEWA~E DISPOSALSYSTE~ '-' ' ' "'-' "' " ' - '" ; ~ iNDiViDUAL/ON.SiTE~ If~ndw~dual/on-site, give installation date ~: . /~ · ~ PUBLIC UTI EITY If system Is over two {2) years old an adequacy test is required by th D ~ ......... ~ -~ : is. aPartment; , .- ~./ . , . , t ~OTE:-THE INSPECTION FEE MUST AccoMPANY B" ' BE EAcH-REQUE~t EFORE p~oCESslN~ CAN DATE THIS SIDE FOR OFFICIAL USE ONLY I NSPECTI ON APPOI NTM ENTS I N SP E CTO R DIRECTIONS: 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connect on Verif ed 3. SEWAGE DisPOSAL SYSTEM I--IINDIVIDUAL/ON -SITE [] PUBLIC UTI LITY Connection Verified []Sept[c,Tankor [] Holding Tank Size: /°t',5"~ if Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO~ Absorption Area to nearest Lot Line 5.~ COMMENTS TIME DATE REC ~IVED TIME DATE DATE INSPECTOR INSPECTOR NUMBER OFBEDROOMg [] ONE [] - THREE [] FIVE [] TWO [] FOUR [] SiX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED OTHER PERMIT NUMBER SOl LS RATING DATE INSTALLED INSTALLER Sewer Line I Nearest Lot Line MANUFACTURER[ MATERIAL 'Septic/Holding. Tank-IAb~orption Area [~"~APPROV E D FOR z~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) .r--I DISAPPROVED DATE 72-010 (Rev. 3/78) August 13, 1979 Larry E. Marshall 300½ East Manor Anchorage, Alaska 99501 Subject: Lot 7 Block ]. Bruin Park Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: (1 A well log submitted to this department. (2 The top of the well casing sealed with a sanitary seal so that it is water tight. (3 The water analysis report be delivered to this office from Chem Lab, 5633 B Street~ for our review. Please notify this department for a re-inspection when the noted descrepancies have been corrected. If there are further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: First National Bank of Anchorage % George Post Office Box 4-2090 99509