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GRF, 'ER ANCHORAGE AREA BOROU~'4
DI~P]~RTMENT OF ENVIRONMENTAL QUALI'I'~/
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~'~/'/~'~-~
LOCATION
MAILINGADDRESS ~ 9Z'~"/ ~("¢?'~C~<-~Z~¢~"~/' PHONE
LEGAL DESCRIPTION /~'z~
SEPTIC TANK:
DISTANCE EROM WELl
LIQUID CAPACITY ~
GALLONS. INSIDE LENGTH
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID
.DEPTH
'"'"S~_ SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:
OR WIDTH , LENGTH , DEPTH
DISTANCE FROM WELL ~DING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ.
"'"I'TL~ R A I N FIELD: "
C~~,~.~
DISTAN , FOUNDATION , NEAREST LOT LINE
ABSORPTION AREA SQ. FT. LENGTH OF EACH ~.
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
.DEPTH OF FILTER MATERIAL BENEATH TILE
DISTANCE FROM WATER
WELL: TYPE ~/-f~g/~) DEPTH ., BUILDING FOUNDATION. SAMPLE , NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE ,TANK , SYSTEM , CESSPOOl , SOURCES__
G.A,A.B.
/
GRE"~'~'R ANCHORAGE AREA BOROUGH
DEPARTMENT OF' ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-550
ANCHORAGE, ALASKA 99502
TELEPHONE 279-9686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO..-
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
, OTHER
TO BE INSTALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT ~OIL ITE$?
FINAL INBPECTION~ 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
~E~IC TANK SIZE., ~- '~' ' TYPE· SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
DIAGRAM OF SYSTEM
FOUNDATION TO SEEPAGE PiT
SEPTIC TANK TO SEEPAGE PIT WALL __ ~)
,/
SEPTIC TANK / ~ . SEEPAGE PIT
TO NEAREST LOT LINE. ·
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK,'~--) '~'- , SEEPAGE PIT I
TO RIVER. LAKE. STREAM.
· DRAIN FIELD
., DRAIN FIELD
· SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
, DRAIN FIELD
CA~r IRON~_~J~T-O~AND-OUT--OF~Ep_TJ~_.TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL, BACKFILJ.
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
HEALTHOR~EAUTHO Ty~
LICENSED D R
I CERTIFY THAT t AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM I$ IN ACCORDANCE WITH SAID CODE.
DATE C~7 ~ APPLICANT'S \
GREATER ANCHORAGE AREA BOROUGH
Department of 5nvironmental Quality
3500 Tudor Road, Anchorage, Alaska 99507' 279-8686
Date Received
Time of Inspection
RSQUEST FOR APPROVAL OF
INDIVIDUAL SSUER & WATER FACILITIES
FOR
A. Type
C. Construction
B. Depth__
D. Bacterial Analysis'
Sewage Disoosal System:
A. Znstalted -i --q<5,
C. Septic Tank: 1. Size
D. Seepage Pit: 1. Size
8. Installer
2. ~aterial
E. Disposal Field: Total Length of Lines
Distances:
A. Well To:
Septic Tank~Z)/~ orption Ar
; Nearest Lot Line , Other Contamination
Foundation to Septic Tank "~ Ab§orotion Area
'Absorption Area to Nearest Lot Line
9~, Sewer Lines
~eq~est for Approval off'iv!dual Sawer & Water Pacflitie~'/
Page Two
9. Comments:
Aporo ~ ved / /
Approval Valid for One Year Prom Date Sio. ned
Greater Anchorage Area Borough, DeF~rtment of ~nvironmenta] Quality
D~AGRAM OF SYSTF~
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 located at:
Signed Date
I~#A florin 2~7S
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SE'W'AGE DISPOSAL SYSIEM
~NSURINO OFFICE : /,~,ORTGAGEE i SERIAL NO
Anchorage, Alaska First National Bank of Anchorage~ ...........................
MOIITGAOOR O!~ SPONSO~ ......... r '
Grant and Velma Ziemer 2401 Raspberry Road, Anchorage,Alaska 99502
$outhwood Park s/g
1 ~ 2 ; 1
SEWAGE DISPOSAL
PART Il,r--TO
HEALTH DEPARTMENT INSPELTIOR S SKETCH
.... ! Yes ~ No ,
July 27, 1972
Grant & Velma Ziemer
2401 Raspberry Road
Anchorage, Alaska 99502
Subject: Lot 50, Block 4, Southwood Park Subdivision
Dear Mr.& Hrs. Ztemer;
An inspection of the subject property revealed.that the sewer
system consisted of three cesspools. One served the kitchen,
one served the washing machine and one served the bathroom.
The water syste~)ts~approved and is supolied by Central Alaska
Utilities.
To comply with Greater Anchorage Area Borough ordinance 25-6~,
a septic tank will ~eed to be installed to intercept all waste
~ater coming 'fro)~ tile house. These wastes include hutaan excreta,
laundry water, sink water and toilet wastes. T. he effluent
the septic tank )~ay ~o to one or all of the exststi~g cesspools,
if they are still functioning properly at the time of the
installation of the tank.
This letter is to serve notice that the sewer system will need
to be upgraded as mentioned and approved within 30 days of the
receipt of this letter. A permit to install the septic ta~)k will
~)eed to be obtained from this office before ~beKwork be~ns.
If you have any difficulty in up~rading :he sys':e~) in the specified
~m(od of time, ...... ! contact this office for a possible
extension of~'~
Sincerely
Lynn S. Coed
Sanitarian
mb
ccL Les 8uchholz
~nvironmental Control Officer
Depa~tmemt of Env&ro~me~al Qu~!&ty
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Date Received ~////7
Time of Inspection
Date of Insnection
r,..O.,~'~P"]'PqT.~. FOR APcROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOF~
A. True B. Deo%h
C, Cons%ruction D, Bacteria]
ocstem.
7. Sewage Disoosat ~' ·
A. Installed 8. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Size 2o Material
~. Disposal Field: Total Length of Lines
8. Distances:
A. Well To: Septic Tank
, Nearest Lot Line
B. Foundation to Septic Tank
, Absorption Area , Sewer Lines
, Other Contamination
"> Ab§orption Area
Absorption Area to Nearest Lot Line
Re~est for Aporoval of i ;vidual Sewer & Weter Facilit~k
%..._.~omme nts:
,&,p?~,oval ',~3~.iO ~Or One. '~_.ar -to,;, ~a,~e -5 ~
Greater Anchorage Area Borough, Oo~a~tment '~,~ Env~?ron~enta] Quality
O!AG~,~AI,~ OF SYSTE.t',~
I certify that the information contaJ, ned in this request for approval to be a true
,~c~ sewer and Water facilities located at:
and accurate representation of %he sub~o *
Signed Date