The URL can be used to link to this page

Home My WebLink AboutT15N R1W SEC 30 LT 82A unic p h Yo Anehor e P.O. BL~."196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONYKNOWLE~ MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES S~ptember 21, 1987 Steven W. Eng, P.E. District Engineer Alaska Department of Environmental Conservation 3601 C Street, Suite 1334 Anchorage, Alaska 99503 Subject: Status of On-site Wastewater Disposal Systems, Lot 2 Sleepy Acres Subdivision, Anchorage Lot 82A, Section 30, T15N, R1W, SM, Eagle River Dear Mr. Eng: You have requested an update on the status of two Septic systems that were originally determined to be installed in violation of the four foot ground water separation requirement. I have enclosed final as-builts of these two systems which were modified in order to meet this four foot separation requirement. The Sleepy Acres system was originally installed in early June of 1987. Mr. Ted Moore, P.E., was hired by Equitable Relocation to perform an independent evaluation of. the septic system. In the process, of this evaluation, Mr. Moore determined that the system was installed at or near the water table. Mr. Moore supplied DHHS with this information. Department staff conducted an independent evaluation of the system by measuring the elevation of the water table in relation to the base of the system. These measurements indicated that the bed was indeed installed in the water table. Mr. Shafer was informed of the situation and he agreed to modify the system in order to meet the required four foot separation to ground water. Four feet of imported sand were hauled in and placed beneath the bed. At the time of the installation, department staff verified that the installation met the separation requirements by measuring the elevations of the base of the system and the level of water in an adjacent testhole. It should be noted that Mr. Shafer was also required to demonstrate that the receiving strata perked at a rate of 60 minutes per inch or less. This perc test was witnessed by department staff. The as-built of the system was approved by the department after these improvements were accomplished. The mound system on Lot 82A in Eagle River was also modified to meet the four foot separation requirement to the water table. In October of 1986, two to four feet of additional sand was hauled in and placed beneath the mound in order to achieve the desired separation. The mound was reinspected by department staff in July of this year. In addition to raising the bed to meet the four foot separation requirement, fill had been hauled in and the entire mound area had been regraded to provide for improved surface drainage. Monitor tubes and cleanouts in the mound were found to be dry even after six months of use. Although the mound system is installed in an area that is marginally suited for on-site disposal systems at best, the department is confident that the system is functioning adequately at the present time and is not contaminating ground water. Despite the improvements noted above, it should be stated that the as-built was approved by the department with great reluctance. The department has recently instituted a random inspection program. Engineers are required to notify the department when an on-site system is being constructed. Staff members now oversee the installation and engineer inspections of approximately 20% of the private systems installed within the municipality. This program should prevent or at least reduce some of the gross oversights that have occurred recently. If you have further questions regarding this matter please give me a call at 343-4744. Robert W. Robinson Manager, On-site Services cc Gus Andress, P.E. Manager, On-site/Water Quality Programs /-"- MUNICIPALITY OF ANCHORAGE /~% DE ~ITMENT OF HEALTH AND HUMAN SER\ -=S Environmental Health Division 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Phone{~)' ermit NO. c5-~ /- 52~ F~o2~ I LEGAL DESCRIPTION SEPTIC TANKS ~/.S'~"/,4/'~. /~Oa~) [] HOLDING TRENCH /,5-/2. TYPE OF SYSTEM/--//O .,~_~F~.Ip~). ~ W. DRAIN g OTHER Total depth from original grade Gravel depth beneath pipe Gravel width Distance between lines SO FI ~ ~ ~ /~ 7~ WELLS FT FT FT FT y PRIVATE REMARKS: [] OTHER (Identify) Total Depth FT Cased to Date Installed: FT S & $ ENGINE~N~ Health Department Approval: DISTANCES FROM~ SEPTIC ABSORPTION WELL TANK FIELD WELL /Do, LOT LINE /'~ ~ /0 ~ ~/0 ~ FOUNDATION 0"~0 ' ~3 -/~ ~ ' AS-BUILT DIAGRAM [Show Iocahon ol well, septic system, properIy lines, foundation, driveway, water bodies, etc.) Inspections Performed by: cedify Ihst this inspection was pedormed occording to all Date: DEF:'ARTMEN]' OF HEAL_TH AND ENVIRONMENTAL. F'ROTECTION 825 L STREET, ANCHORAGE, AK 9950:1. CONTACT f .~I.,IIE.. AI..A-'::)KA C[]NT~ BAI\IK C/O S8~S ENGINEERING EAGLE RIVER, AK 995'77 694-2979 SU[{DIVISION: NA LOT: 82A SECTION: 30 TOWNSHIF': 15N RANGE: tW c~,:.~ ,:] "~ (~.~,~. ~ F I ~ OR ACRES ) BLOCK: NA :l.~ I am famJ.].iar~ wi'Lb 'LJ'l':~ 2. ~'op on-sit~?, sewePs anti ~,~ells a~i set foPth by 'Lhe l~lunicipal:i, ty o[ Ancho~age (MOA) and the State of Alaska. I ~d.].l insta].l the sysCem in ac:(:::o[~dance with a].I MOA codes and Pegu:l. at~i. ons, and in compliance with the design cpitepia oF this pePmit, :[ will adhePe to all MOA and S'Lat. e ~' Alaska ~ecluir'emen'l'..s ~'c:~~ the set back disf. ances fPom any existing well, wast. e~at, e~~ disposal system or public sewer'age system on 'Lhis (:m any adjac:ent c:)p neapby lcd:. IF A I.]:F:'T srI'AT]:OI'~] IS INS'TAL. LED If'.! AN AREA COVERED BY MOA BUIL.DINt¢ CODES, THEN (1) AN ELE:CTRICAL. PERMI'T AND INEiF'ECTION MUST BE OBTAINED; (2) AS-BUILTS W]:L.L. I'~IOT BE£ APF:]:ROVE:D W:[]'HC1U] Al'-,! ELECTRICAL INSPE[]TION REF'ORT; AND (3) THE ELECTRICAL WOF,.'K MUST BE: DONEE BY A LICE]"-1,~3ED ELECTRIC:lAN. S I GNIED AF'P[. i [::AN'T: IS,SUED BY AL_,!~,SF:]A [,(),[ .J"[ ,, ['~AI 4K PERFORMED FOR: LEGAL DESCRIPTION: 1 -- 2 3 4 5 6- 7- 8- 10- 11 12 13 14 15 16 17 18 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES. 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION 'I'EST ~ ,/~ Township, Range, Sectibn: SLOPE ,q SITE PI,AN WASGROUNDWATER ENCOUNTERED? IF YES, AT WHAT DEPTH? O epth lo Water Alter ~' Gross N~t Depth to Net Readin§ Date Time Time Water Drop . ,, ,. ~ ,y>> ~1~" _ PERI'ORMEDBY: ,,.~ I~ ~-a'~ --([-- 1~ / CERTIFY THAT ~HIS TXST WAS PERFORMEO IN ACCORDANCE W~t"~.~~IDELI~CT O2THiS DATE. DATE: ~CALE /;'~% MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PRoTEcTION ENVIRONIVIE N'FAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ~ UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOOATION NO. OF BEDROOM8 Materi I No. of compartments Manufacturer ~ ~_~ Li~c~ in gallons IF HOME.DE: Insid~ength Width Liquid depth DISTANCE TO; Well /~ /~ Foundatio~O f~ Nearest lot [i~ '~ PERMIT NO. ~ ~ No. oflin~ Leng h f~8 I' ' Total lo.~f.nos Trenchwidt~ inches Olsta.cebetwoe. li.es.~s ' ~ ~ TOp of tile to finish grade Material beneath tile ~ inches Length Width Depth PERMIT NO. m Well / ' Building foundation Nearest lot line e DISTANCE TO: ~ Class Depth ~ ~%~ ~ D istancetolotline P ERMITNO. ~ Building fo~a~o~ ~ Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS PFc SOl L TEST RATING INSTALLER REMARKS 3 (Rev, 3/7 Permit ~_~UNICIPALITY OF ANCHORAGE Department f Health and EnvironmentaX-~rotection 825 ~ Street, Anchorage, AK. ~9501 264-4720 * * * HANDWRITTEN PERMIT ~ ~ ~ ON-SITE SEWER PERMIT Location: Legal Description: L~ ~-~ Type of Soil AbsorptiOn System Is: Phone Number: Lot size: Trench: ~--~Drainfield: Seepage Bed: __Holding Tank: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH ~ LENGTH IBC/ _ GRAVEL DEPTH C.~'._.] ] WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department, will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion° Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site the ~esidence is remodeled to ~p~licant ~' ' SWP/024 (1/81) I~1 '~--~ 'MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, A~aska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG [] PERCOLATION TEST DATE PERFORMED: X~/~ SLOPE t SITE PLAN 1 2 3 5 6 7 8 /Z, 10 11 12 13-- 14 15 16 17 18 19 20 COMMENTS ~ E 47¢;. ~ DEPT.?'P"ES'"T'g"AT Rohe~ ~qo. 1457-E Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~_q TEST RUN BETWEEN FT minutes/inch) t( CERTIFIEDE ?~:: ~¢: /::i " roi 000000000000 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) T15N R1W Section 30 Lot 82A Location (address or directions) Stephanie Boulevard (b) Properly Owner Ak Continental Ban~Jephone:Home Business 562-0880 Mailing Address Lake Otis/Tudor (c) (d) Lending Institution City Mortqaqe Mailing Address Telephone Real Estate Company and Agent Brent Schlosstein % Re/Max of Eaqle River Address PO Box 848, Eaqle River, Alaska 99577 Telephone 694-4200 Mail the HAA to the followin(~ address: or: Check here I-I, if hold for pick up. List contact person and day phone number below. S & S Engineering 17034 Eagle River Loop Road ~204 Eagle River, Alaska 99577 (e) TYPE OF RESIDENCE Single-Family rRx Number of Bedrooms two (2) 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. 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 fRev 8/861 Front 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 S & S Enqineerinq Telephone Address 17034 Eaqle River Loop Road #204 Date Engineer's Seal This department has received written confirmation from the engineer regarding the Conditional Approval of December 3, 1986. The corrections have been accomplished and an inspection has been completed by the above engineer. The subject property meets with Municipal standards and is now approved. DHHS APPROVAL Approved for two (2) Approved XXXXXXXX bedrooms by Disapproved Conditional Date July 2, 1987 Terms of Conditional Approval CAUTION 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. Page 2 of 2 72-025 fRev 8/86) Back HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ROBERT A. SHAFER CIVIL ENGINEER 694-2979 June 25, 1987 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTJOJ~ Municipality of Anchorage Departmeat of Health and Human Services 825 L Street Anchorage, Alaska 99501 RECEIVED ATTENTION: Steve Morris REFERENCE: Lot 82A; Section 30; TI5N~ RIW The following additional information is provided to answer your questions resulting from your site visit and our request for final Health Authority Approval dated June 14, 1987. The soil properties in this area have moderate limitations that in our opinion have been overcome by the speclal design and installation of a mound system. In addition the curtain drain has artificially drained the area above and under the mound. The soils are poorly p~rmeable as indicated by our previous soil test dated March 30, 1983. It is our opinion that the water §eneath this poorly permeable layer is under hydrostatic head and therefore when th~se layers are penelrated by a testhole the water level rises in the casing to a level above the free water zone in the soil. The mound system appears to be in excelleat condition and from all indication is working well. The monitoring t~bes are dry even though the system has been in use for over six months. In the design of the mound system o~ly the organic layers w~re removed. By not penetrating the poorly p~meable soils we have avoided the artesian effect beneath the mound. If yo~ additiona ~AS/ss inform~on, please eontactus. ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN SRB 196X EAGLE RIVER, ALASKA 99577 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 Ma~ 16~ 1986 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 82Ai T15N; RIW; Section $0 Location (address or directions) . Stephan~'e Bo~evard (b) Applicant Name Alash~z Co~(;iner¢.¢.~ B~(~fephone: Home Business $b2-0880 Applicant Address Lake Otis and Tudo% Anehora.qe/Tom Harrison (c) Applicant is (check one): Lending institution []; Owner/builder ~; Buyer []; Other [] (explain); ~, (d) Lending Institution Cit~/ Mortgage Telephone Address Anchorace (e) Real Estate Company and Agent Re/Max of Ea~qle River/Bre~ S¢~osst~in Address P.O. Bo~ 848, Eagl6 ~v~, Al~k~ 99577 Telephone 694-4200 (f) ,~th~e HAA to the following address: S ~ S E~g~ne~ng SRB 196X Eagl~ RZver, Alaska 99577 0rd~red by Bre~- Re/Max 2. TYpE 'OF RESIDENCE Single-Family ~ Mfi !-Fami y [] Other Number of c~.,~e~rooms 3.. WATER SUPPLY ' Individual Well ~] ,~x, Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite[] Public[] Community[] Holding Tank [] Note: If corn m unity well system, must have written confirmation from the State Depart merit of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 (tl/84} ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATI~)N As certified by my seal affixed hereto and as of the validation date shown below, I verify th at 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 insJ~ection. S& S ENGINEERING ~; ~Z/-- Name of Firm Telephone SRl~ 196X Address . ,, ~ ,'~ ..... ~J~.~i. ~ ~ UUL ~ ~ I~UO Date DHEP APPROVAL Approved for '~,~'~ ~'~'~ bedrooms by ~ - '~o.-~.~.~ Date Approved ~'~'~ Disapproved~ ~ Conditional Terms of Conditional Approval CA~TION The Muncipality of Anchorage Depadment of Health and Environmental Protection (DHEP) issues Health Authority Approval cedificates 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 cou~esy to purchasers of homes and their lending institutions in order to satisfy cedain federal and state requirements, Employees of DHEP do not conduct inspections or analyze data before a cedificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MO~) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: MUNICIPALITY OF ANCHORAg~ DFPT. OF HEALTH & ENVIP, ONMENTAL PROTECTION RECEIVED WELL DATA Well Classification Well Log Present Total Depth / ~,,~- Static Water Level IfA, B, C, D.E.C. Approved (Y/N) Date Completed ~-~ ~ ~:~" ~ '~ Yield Cased to '~'~'"- · Depth of Grouting ~ ~ J ~- ~ Pump Set At Casing Height Above Ground Electrical Wiring in Condui Yt~j~)~_ Separation, Distances from Well: Sanitary Seal on Casing~0,N~ Depression Around Wellhead To Septic/Holding Tank on Lot //d)-~ ~ ¢'- ; On Adjoining Lots To Nearest Edge of Absorption Field 0n Lot ~,/~ ~"~ ; On Adjoining Lots To Nearest Public Sewer Line ¢k~ J2k~ To Nearest Public Sewer Cleanout/Manhole ~ To Nearest Sewer Service Line on Comments / B. SEPTIC/HOLDING TANK DATA Date Installed Stand pipes ~.bJ~. Air-tight CaPS ~_,PN.) Depression over Tank Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well /'¢)b I '~' To Property Line ~ ~ ~-- To Water M2!n/Service Line Size (/~O o No. of Compartments ~' Foundation Clean out~//J~v- Date Last Pumped /v'~ ~ '~¢',~ ; for ~ Temporary Holding Tank Permit (Y/N) _ To Building Foundation To Disposal Field Course To Stream, Pond, Lake, or Major Drainage Comments Page I 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 .¢~/~...~. Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well TO Building Foundation ~' ,'% / Lot /~(~- Type of System Design ~fCcr'¢¢~ [-'~¢.~::~ Length of Field ~] Depth of Field ~ ~2~ ~ravelBedThickness ~ ~ ~/~ Standpipes Presen~/~ To Water M'~rin/Service Line '~'::~ / c-- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Date of,~/~dequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots -~ To Cutbank (if present) Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** 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 S & S ENGINEERING Date JUL 2 9 SRB 196X Company MOA No, ~"~(_..¢.~o ..~ Receipt No. _ q(~, ~, Date of Payment Amount: $ Page 2 of 2 72-028 (11/84) APPLI¢' '~NT FILLS OUT UPPER HAI~ '~ ONLY '..~ Proper ty OV(-,~er ~ ~:.~l t ~ C , , Phone* Address Zip'Code b:~ 0 ~ ~ Zip Code T,me Time Time Time ?,,(~j~ ~/~ Inspector Inspeclor Inspector Inspector Soils Rating D.~ate~J~rwer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size · ! ~: AppLIC~'NT FILLS OUT uPPER HAl" "IONLY /U~ ' Property Owner Phone ~' ~ zip Code q Mailing Address ~ ~ ~. r~y ~ ~/ q~ ~ ' I' Buyer Address Zip Code '" . . Phone Address Zip Code Realty Co. & A~nt Phone Address Zip Code Legal Description ~ ~_)~)~ ~ ~ ~, L~ ~ ~ ~' J~ ~ [ Slreel Locati~ Type of Resi~nce ~ingle Family ~ Multiple Family No. of Bedrooms g Other Water Supply ~lndividual A~ACH WELL LOG. A well log Js required for all wells drilled since June 1975. ~ Communily For wells drilled prior to lhat date, give well depth (attach log if avalleble). ~ Public Utility Sewer Disposal ~ndividual Year individual Installed: ~ Public ~gity When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ;~,.,o,~~S 'CONDITIONS OF APPROVAL CONDITIONA' APPROVAL' .._.q.0 DATE ~ --2 ~"' ~ ~ soi,s Rati.g Date .~wer ,nsta,ed We, TO Absorption Area Well Log ~eceived ~ ~ Well tO Tank Septic T~k Size