HomeMy WebLinkAboutTIMBERLUX #1 BLK A LT 7ANAME 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 PHONE [] NEW MAILING ADDRESS LEGAL DESCRIPTION ~ [Liq. capacity in gaHon~ I IF HOME.DE: Inside length TO: Ii ~ ~nuf~tu~ ~ DISTANCE TO: ~Well .~ ~ Foundation ~ · ~ No. of lines Length of e c~ 'ne ~ DISTANCE TO: Well Building foundation ~ Class Depth Driller ~ DISTANCE TO: Buildlng foundation Sewer line ~]0. OF BEDROOMS Material Width Material "~0 inches PERMIT NO. Total length ~_~.~es Material beneath tile Depth ~ ~{~/~7'"'//}~ Crib depth Liquid depth PERMIT NO. Liquid capagity in gallons Distance between lines inches PERMIT NO, Total effective absorption area Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Septic tank Absorption area(si OTHER PIPE MATERIALS SOl L TEST RATING INSTALLER CM wot. REMARKS APPROVED DATE LEGAL DEPARTMENT Of~tEALTH AND ENVIRONMENTAL F~TECTION 8~.~ L STREET, ANCHORAGE, AK 995(.~1 264-4720 PERMIT qO: 8~(.=.17 DATE I S~UE~D. 06 / 1.8/85 AF'PL I C, ANT: ADDRES,.~. CONTACT PHONE: RANDOLPH W. HON'T'ER 4401 BAYVIEW ANCHORAGE, AK 99516 27~-3916 LEGAL DESCRIP: SUBDIVISION'. TIMBERLUX LOT: 7A BLOCK: A SECTION: 54 TOWNSHIP: 12N RANGE: 5W LOT SIZE: 1.50A (GQ.FT. OR ACREG) MAX BEDROOMS: Listed below are 'the options available to you iii designing your septic system. Choose the ootion that best ~its your site. -[R~--~[]]~-~ BE][) W ~ DRAI ~ DEPTH TO PIPE BOTTOM (FT.) 5.0 6.0 5.0 GRAVEL DEPTH (FY.) 7.0~ 0.5 3.0 TO-I-AL DEPTH (FT.) 12. £~/' 6.5 8.0 GRAVEL WIDTH (FT.) 2..5 / 22.0 5.0 GRAVEL L. ENGTH (FT.) 43.0~/' 41.0 '7g.O GRAVEL VOLUME (CU. YDS. ) 29.9 3~. 5 45.4 TANK SIZE (GALS) 1,000.0 ~ 1,000.0 ~* 1~000.0 ~ SOIL RATING (SQ.FT. /BR) 200 197 200 ** TANK MUST' HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. I am familiar ~ith the requirements ~'or on-site sewers and wells as set 'Forth by the Municipality o£ Anchorage (MOA) and the State oF Alaska. ~. I will install the system _in accordance with all MOA codes and regulations, and in compliance with the design criteria oF this permit.. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances From any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid For a maximum of 3 bedrooms and any enIargement will require an additional permit. IF A LIFT S]"ATIDN IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~- ]'HEN (1). AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (~) AS-BOILTG WILL NOT BE APPROVED WITHOOT AN ELECTRICAL INSF'ECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. S I GNED DATE: APF'LICANT: RANDOLFH W./FIUN~R ISSUED BY ~~DA"FE: PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION F PERCOLATION TEST SOILS LOG - PERCOLATION TEST DATE PERFORMED: LEGAL DESCRIPTION: SLOPE SITE PLAN 10 11 12 13- 14- 15- 16 17- 18- 19- 20- WAS GROUND WATER ~1 S ENCOUNTERED? ~l ~ OL P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop -~o- ~///5/ '-'~ -' -~ -- '~ -° -- ~o,,. ~ o ~ o q V~ qo q 0 / 0 q el~ ~/~ PERCOLATION RATE ]b (minutes/inch) TEST RUN BETWEEN ~ . FTAND ~'~ FT COMMENTS PERFORMED BY: 72-008 (6/79) ANCHORAGE AREA BOR?'$H Departmen3t5;f0 ~nu;i~;n2o~ndtal (~uality Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /'//'g-'/'~7.z¢~--!¢' /-/~c-~/r-/~/ MAILING ADDRESS ..~ ~ LOCATION Z~¢/?/~///~&? "~"/~/~'~ LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER,'~z-/¢~'/'6¢ ~-~'~-'-~I~AT E R IA L INSIDE WIDTH LIQUID DEPTH NUMBER OF ~-~/~-~' COMPARTMENTS ¢~- LIQUID CAPACITY /'~¢~)-~ GALLONS, SEEPAGE PIT: / / NUMBER OF PITS / DIAMETER _ OR WIDTH , LENGTH ~2_/ DEPTH / / LINING MATERIAL¢~ ~-~¢/¢~/'¢/~4~I~B~'SIZE: DIAMETER //¢( DEPTH ~' DISTANCE FROM: WELL /'~¢¢¢' / d~.,~' / ~'~z~ / TOTAL EFFECTIVE .~.~¢¢ / BUILDING FOUNDATION~¢'~f/ , NEAREST LOT LINE · ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION __ LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH DISTANCE FROM: SEPTIC ~..~. /° SEEPAGE TANK"~/ , \SYSTEM DISTANCES: INS/TALLED BY' ¢¢/¢¢' g'¥cc/d'~'~j'~ PIPE MATERIAL: LOT SLOPE: REMARKS: ~/~Z ~/~- Form PW-026 DIAGRAM OF SYSTEM GREATER ANCFIORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION EO,L *EST RESULTS ~-.~ E' PERMIT NO, THIS PERMIT I$ NOT YALID WITHOUT SOIL 1'1~'~T COMPLETION DATE ANTICIPATED pFRHTT VAITB ~NF YFAE SE.TIC TANKS~ZE /dO0 5 ft. FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT ~0 SEPTIC TANK TO SEEPAGE PiT WALL ORA[N FIELD ]-0 fto DRAIN FIELD, WELL TO SEPTIC TANK SEEPAGE PI'I WATER MA~N TO SEPT'C TANE ].0 ft, SEEPAge PIT ]LO ft. DRAIN FIELD ].0 ft. 25 100 fi SE"TIC TANK, ~'. SEEPAGE PiT DRAIN FIELD -- ~V EXCAVATION 5 FEET INTO UNDISTURBED SOIL· 4 INCH DIAMETER CAIST IRON GIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVAGLE CAPS. S£PTIC I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE R&M Civil Engineers ENGImEERING & GEOLOGICAL CONSULTANTS 229 EAST 51st. AVE. - P.O. BOX 6087 - ANCHORAGE, ALASKA 99503 TELEPHONE 907--279-0483 TELEX 090--35419 Geolo#ists Land Surveyors JAMES W. FIOONEY, P. E. %lALCOLM A. MENZ~E$, P.E,, L.S, SAMES H. WELLMAN, P.E. FIALPH Fi, MIGLIACClO Engineering Geologist September 14, 1972 R & M No. 26540-28 Mr. Tom Heath 306 W 22nd Ave #31 Anchorage, Alaska Re: Test Hole and So~l Log Report for Sanitary System Lot 7A, Block A, Tiraberlux Subdivision ~// Dear Mr. Heath: We are submitting herewith the test boring results and our comments regarding so~] conditions encountered at the subject site. This investi- gation was performed in accordance with your request of September i1, 1972,. and those procedures outlined in a letter dated September 13, 197] by 1VLr. Roll Strickland of the Greater Anchorage Area Borough Depart- ra~nt ~J~ Envirollmental Quality. A single test hole was put down within the Lot 7A area for the purpose of defining general subsurface soil conditions ~or the proposed sanitary system. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extended to a total depth of 10.5 feet below ground surface. The final log prepared for the test hole has been included in Drawing A- 01. ' Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & 1VI ENGINEERING & GEOLOGICAL CONSULTANTS James w. Rooney JWR:wb Enclosure xc: Greater Anchorage Area Borough ANCHORAGE FAIFIBANKS JUNEAU 9-12-72 ORGANICS C.OI SANDY SILT { ML) SILTY SANDY GRAVEL (GM) W/COBBLES Med. Dense 10.5' No W(~ter Table Note: Hole excavated with tractor mounted backhoe. Tom Heath Property  Engineering ~Geological Consultants LOG OF TEST BOR NG ANCHO.^e_'' ~A~B~.~S ALASKA ~u.~Au Anchorage Alaska ' ~ 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) Location (address or directions) (b) Applicant Name ~f~/~)¢'~"¢4/ /'~/;/~¢'~ Telephone: Home Applicant Address ¢'¢~/ '~rY'//z~'¢ /¢-~'¢' (c) Business. Applicant is (check one): Lending Institution []; Owner/builder~; Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address ?/~'z~ ? ~¢z~ .¢M,-/,4'~ Telephone ~5~"/~/- '7-:~ X3 (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Farnily~/ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well'S' 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~l~. Public [] Community [] Holding Tank [] Note: If comm unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 ~2-025 (1~/84) ENGINEERING FIRM PROVIDINg. ,NSPECTIONS, TESTS, FILE SEARCH, DA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, verify that my nvestigat on of this Hea th 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 /~'c~'~ Telephone Address /~'~ ~ ~ ~ ~I/~ ~ ~ Date ~' ''//-~ DHEP APPROVAL Approved for Approved J/~ bedrooms by -z~~~, ~ Disapproved Conditional 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 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 :~ 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) (b) (c) Locatio'n' (address 8r 8irections) A~¢;a~t Name ~O~ ~ Telephone: Home ~ Business AppliCant is (check one):%eddCng Institution ~; 0wner/builder~ Buyer D; Other D (explain); (d) (e) (f) Lending Institution. ' ~'' ' Telephone Address ' N'/ Real Estate Company and Agent Telephone ,%E/ -- ~ HAA to the following address', TYPE OF RESIDENCE Single-Famiiyz~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well,~ 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 Onsitej~' 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 PROVIDINL ~SPECTIONS, TESTS, FILE SEARCH, DA' ~ND 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 iaspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in affect on the date of this inspection. Name of Firm Address Date 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 Jn 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) . ~,~c'~O~,~I~IPALITY OF ANCHORAGE (MOA) _~L~, ~O HEALTH AUTHORITY APPROVAL (HAA) " ~ ~,k~ ~ CHECKLIST - FEBRUARY 1984 ~' ' . ~'1 264-4720 ~ ~ ~ LegalDescription: ~ A. WELL DATA Well Classification ~/~ ~ Ii A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y~ ~ Date CompJete~ ~ K~ ~ Yiel~ Total Depth ~21 / Cased to ~¢ ' Depth of Grouting Static Water Level ./~.~ / Pump Set At Above Grou~ Sanitary Seal on Casing Casing Height [lectrica, Wiri~inGon~ ~ '~~~pressio~roundWollhoad(Y~ Separation Distances from Well: l ~ TO Septic/Holding Tank on Lot ~ O 0 ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /00 /~ ; On Adjoining Lots To Nearest Public Sewer Line - ~/~ To Nearest Public Sewer Cleanout/Manhole ~/~ To Nearest Sewer Service Line on Water Sample Collected by ~, ~,~J (~ ~CK. ;Date Water Sample Test Results ~~~ ~ Comments ~ ~R/~ ~~ B. SEPTIC/HOLDING TANK DATA Datelnstalled ~f/~/TZ Size Standpipes t~N) Air-tight Caps ~)N) Depression over'Tank (Y~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) N//~ separation Distances from Septic/Holding Tank: To Water-Supply Well ~ ('~1~) TO Property Line I ~) To Water/Main/Service Line Course lOC -/- Comments No. of Compar[ments Z. Foundation Cleanout (Y~/~ Date Last Pumped ;for ~'//~ . TemPorary Holding Tank Perm t (Y/N) TO Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72 026(11/84) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata "2('~O Type of System Design D~t~!n,stal!ed ~1~7~ T~ ~/~/~ Length of Field ~ Z~/ Width of Field ~J~ J~f ~E~C~ 2,~¢ Depth of Field ¢~¢ )2 Thic .e ? Square Feet of Absorption Area ~7~2~_...Standpipes Present ~") Depression over Field (Y/~}_ Date of Last Adequacy Test Results of Last Adequacy 'rest Separation Distance from Absorption Field: To Water-Supply Well ~ (")(1¢') ~'"'~'~ · _ _ To Property Line To Building Foundation _ ',.~'~ Lot .... ; TO Water Main/Servi~b Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Existing or Abandoned System on ; On Adjoining Lots '~_'.~ To Cutbank (if present) ' /Oo /4- Comments D. LIFT STATION Date Installed Dimensions Size in Gallons "Pump On" Level at Al /f /.~ Manhole/Access (Y/N) "P~ High Water Alarm Level at ~t /' ~ ! 'J ~ Vent(Y/N) Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** I certify that l h ave~.?.e c/I.l.l.l~/d, verifi~, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~"~'/ '?~'"// - Date Company ,//'~'¢.~ MOA No. ~' Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) INVOICE '2102 .Alpine Drilling & Enterprises Domestic Commercial Pump & Water Systems N-° P.O Box 110496 [ Job ame/Loca' (907) 345-0202 *~~ PHONE -- DESCRIPTION AMOUNT ~BOR HOURS RATE AMOUNT TOTAL MATER~AL ~OTAL LABOR Thank You SIGNATURE (I Hereby ^clmow;ed§e lhe Satislactory Completion of ;he Above Described WORK.) TERMS; ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE, SERVICE CHARGE AT RATE OF 1.5% PER MONTH W;LL BE CHARGED ON OVERDUE ACCOUNTS. · '.:l .;';,.~,,.!.-'OLD SEWARD:HIGI~ .~AY //?.~NCHORAGE, r ALASK~' 99518 ' ' ' ~ RESUBMIT SAMPLE Sample rejected ~cause: I,D..N0, (PUBLIC 'SYSTEMS) i ! , , i NAME OF SkSTEM CIRCLE CLASS B RUMBE~ -- SYSTEM ADDRESS CITY STATE ZIP CODE LOCATION WHERE SAMPLE WAS COLLECTED ~/.~ 'COLL?. DY:(SIGNATURE) TYPE OF SAMPLE / (CHECK ONLY ONE THIS COLUMN) ~DRINKING WATER ~/CHECK TREATMENT [] RAW SOURCE WATER [] HEW CONSTRUCTION OR REPAIRS [] OTHER(Specify) []-)CHLORINATED I-1FILTERED ~TREATED OR OTHER IS THIS SAMPLE A CHECK SAMPLE TO A PREVIOUS NON-CONFORMING SAMPLE? E]YES ~'0 PREVIOUS COLLECTION DATE ANALYSIS'REQUESTED (IF OTHER THAN TOTAL COLIFORM) SEND REPORT TO:(PRINT FULL NAME,ADDRESS AND ZIP CODE CHECK ONE OR MORE [] Sample too long in transit. Sample should not be over 30 hours. [-I Sample received too late i~ week I-1Not in proper container [] Leaked out [~ Insufficient information provided. Please read instructions on []Other (Specify) RECEIVED FRO~_Tfi:i; RECEIVED BY DATE ~L/l~,~/~"7 TIME ANaL METHOD: ~MEMBRAHE FILTER ~FERMENTATIOH TUBE Date & Time Started~2~/~-~;~7 Date & Time Completed~-/4.~¢ LABORATORY ~ESULTS [] Other Bacteria ~ Test unsuitable because: [] Confluent Growt~ [] TNTC ~SA SATISFACTORY TISFACTORY [] BACTERIOLOGICAL WATER ANALYSIS RECORD FOR LAD USE ONLY Membr6ne Filter: Direct Count ~ ~) -' Colifom/lOOml ~-~ TOTAL COLIFORMS Verification: LTB BGB F~ FECAL COLIFOR)IS Final Membrane Filter Results Coltform/1OOml : :N OTHER : .. .: Reported BY : Date ,, ~ ~ DA~-E RECEIVED ~W ,, i~ISPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE ,NB.EC,OR 'NBPECTOR MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTm~viRONMENTAL PROTE~ION  826 L Street Alaska 99501 Anchorage, ( ENVIRONMENTAL SANITATION DIVISION APR 2 3 1981 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be proce~ed P ease a ow ten 10 days~? processing. PROFERTY RESIDENT (l~ifferent fr~m'above)~ PHONE 2. BUYER PHONE 15. LEGAL DESCRIPTION STRE TLOCATION' 6. TYPE OF RESIDENCE z NUMBER OF~BEDR~IMS [] One [] Four [] Other__ ~T~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATE SUPPLY ~ INDIVIDUAL~ [] COMMUNITY [] PUBLIC UTI LITY * ATTACH WE LL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log 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. THIS SIDE FOR OFFICIAL USE ONLY ' - 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 NDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade 801LSRATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Linc 5, COMMENTS [2~'~PPROVED FOR --~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~ 72-010 (Rev. 6/79) CHEMICAL& GI~,~LOGICAL LABORATORIES ~.~; ALASKA, INC.~ · TELEPHONE (g07)-279-4014 ANCHORAGE INDUSTRIAL CENTER 274.3364 5633 B Street Drinking water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Phone No. Mailing Address City State Zip Code Mo. Day Year SAMPLE TYPE: [] Routine [3 Check Sample (for routine sample with lab ref. no. ) [] Special Purpose [] Treated Water [] Untreatea Water SAMPLE NO. LOCATION 2 I Time Collected Collected By TO 'BE COMPLETED BY LABORATORY Analys~s shows this Water SAMPLE to be F-I; Satisfactory f[~] Unsatisfactory [] Samole too ong n transit; sample should not be over 48 nours o~a at examination to indicate reliable results. Please send new sample Date Received Time Received Analytical Method: [] Fermentation Tube ,[~ Membrane Filter Lab Ref, No. Result* Analyst *NO. of colonies/lO0 mi or No. of Positive oOttlOnS. READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev, 1978 BACTERIOLOGICALWATER ANALYSIS RECORD Date Collecte($ Source a.m. NO. PreSumpt Ire 10mi ).0mi 10mi 1Omi ]0mi 1.0mi O.lml 24 Hours 48 H~)ur$ Confirmatory 24 Hours Aeri] 28, i981 Fred/Laurel Gregary 8]2 West 58th Avenue Anchorage, Alaska 99502 Subject: Lot 'lA Block A Timberiux Subdivzsien Approval for the individual cannot be granted until the completed: (2) (3) If there are any further questJ.ons, at. 264-4720. sewer and water facilities following items have been The water analysis report needs to be delivered Lc) this office from the Chem Lab, 5633 B Street, for our review. The septic tank pumped with a receipt submitted to this office. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequake according to National Standards. A listi.ng of private firms performing the test is enclosed° 'Phis report needs to be submitted to this office for ouu' review. please call. ~his office Sincerely~ Robert Co Pratt, R.S. Associate Specialist RCP/ijw cc: Alaska Mutual Savings Bank 1503 West 31 Avenue 99503 April ~0~ RECEIVED ADC NO 81D45 Hr. Randolph Hunter 943 W. 6th Avenue Anchorage, Alaska 99501 Re: Adequacy Test for Existing Septic System on Lot 7A Block A, Timberlux Subdivision. Dear Hr. Hunter: At your request our office conducted a percolation adequacy test an your existing septic system at the above-referenced location during the period April 28 thru 30, 1981. You reported that your septic system consists of a 1000 gallon septic tank and seepage pit. The septic tank had not been pumped prior to the percolation test. Since the 3-bedroom house had been occupied up to the time of the test, a normal degree of saturation within the leach field is assumed. In accordance ~ith the Anchorage Municipal Code, Chapter, 15.65, Waste Water Disposal Regulations, any on-site sewage disposal system "shall have adequate capacity to properly dispose of the maximum daily sewage flow." The maximum daily flow is computed at 75 gallons per capita-day (gcpd). Since "the population of dwellings shall be estimated at two persons per sleeping room," the maximum daily sewage flow for your 3-bedroom house is 450 gallons per day (gpd). To test the soil absorption capacity as well as the surge capability of your system, 110 percent of the maximum daily flow or 500 gallons of clear water was added in 50-gallon increments to the seepage pit. The water was obtained from your on-site private well ab its maximum sustained rate of about 5 gallons per minute (gpm). The liquid levels were monitored closely to detect any backup in the septic system. Mr. Randolph,Hunter April 30, 1981 Page -2- The attached Table of Test Data represents the depths o¢ liquld ±n the septic tank and seepage pit, and the quan- tities off water added. The septic tank was determined to be 6.6 feet deep (bottom Of tank to ground surface) with an initial depth of 4.05 feet in the tank. The seepage pit was measured to be 11.1 feet deep with an initial depth of 6.9 feet. 8round elevation at the septic tank standpipe is approximately 0.3 feet lower than the seepage pit standpipe. The attached Summary of Test Results indicates that the liquid level in the seepage pit at the beginning of testing on Day 2 fell to 0.1 feet below ils initial static level on Day 1, dur±ng a recovery period of 24 hours. On Day 3, the level had fallen to 0.1 feet below its static level on Day 2~ during a recovery period of 24 hours. The level in the seepage pit at its highest level during test (8.3 feet) was approximately level with the liquid level in the septic tank. the Based on two days of testing, an average percolation rate for your existing septic system of approximately 560 gpd is indicated. Since an on-site sewage disposal system for a 3-bedroom dwelling must be capable of disposing of 450 gallons of sewage per day, your septic system appears to be functioning satisfactorily at this time. Many factors affect the operation of a soil absorption type of sewage disposal system. Soil type, groundwater depth, age and history of maintenance of the system, and types of waste are a few. This test has been performed in an attempt to determine actual soil absorption capabilities of your septic system under normal useage by considering the degree of saturation of the leach field and surge loads that might be imposed on the system. This test oan only evaluate appar- ent performance at a given point in time, and cannot deter- mine either the condition of the leach field, seepage pit or other components of the septic system, or the depth of the water table. We appreciate the opportunity given to perform this adequacy test. If you have any questions regarding this test~ please contact this o~fioe. Very truly yours~ ALASKA DEVELOPMENT CONSULTANTS Stephen D. Shrader, P.E. Project Manager Hr. Randolph Hunter April 30, 1981 Page -]- No. ADC 81045 SUMMARY Water Added, Seepage Pit Rise in Seepage Pit Rise in Septic Tank OF TEST RESULTS Day 1 Day 2 500 gal 500 gal 1.2' 1.4' Day ) Recovery lime between Test (Hours) Drop in Pit during Recovery Average Absorption Rate (gal/day) 24 I .3' 580 24 1 .5' 535 2-Day Average 560 gpd Adequacy Test for Existing Septic System Owner: Mr. Randolph Hunter Address: 943 W. 6th Avenue, Anchorage, Alaska 99501 Project No. 81045 Legal Description: Components of Septic System: Number of Bedrooms: 3 How long vacant: ........ Test performed by: M. Compton Initial Static Levels: Lot 7A, Block A, Timberlux Subdivision lO00-gal Septic Tank; Seepage Pit Occupied prior to test: Yes X Last pumped: Unknown Water meter/S.N. Septic Tank 4.05 ; Seepage Pit 6.9 No TEST DATA %. : "Liquid Depth, ft* ~--' Water Meter Time Septic Tank Seepage Pit Added, gal Reading, gal Remarks 4/28/81 9:30 4.7 4.1 -0- 30,387 Day 1 Initial LuYulu 9:42 4.7 3.9 50 30,437 9:52 4.7 3.75 100 30,487 10:02 4.7 3.5 150 30,537 10:11 4.7 3.3 200 30,587 10:21 4.7 3.2 250 30,637 10:31 4.7 3.0 300 30,687 10:41 4.7 3.0 350 30,737 10:52 4.65 2.95 400. 30,787 11:03 4.65 2.9 450 30,837 11:14 4.65 2.9 500 30,887 9:03 4.7 4.2 -0- 30,887 4/29/81 9:12 4.7 3.9 50 30,937 9:21 '1 4.7 3.7 100 30,987 9:31 4.65 3.5 150 31,037 9:41 4.65 3.3 200 31,087 9:51 4.65 3.15 250 31~137 *Measured from Top of Standpipe. Owner: Hr.,Rand61ph Hunter Legal Description: Lot 7A Block A, Timberlux Subdivision Project No. 81045 TEST DATA (Cont'd) Liquid Depth, ft Water Meter Time Septic Tank Seepage Pit Added, gal Reading, gal Remarks 10:01 4.65 3.0 300 31,187 10:11 4.65 2.9 . 350 31,237 10:~2 4.65 ~.85 400 · 31,287 10:33 4.65 2.80 450 31,337 10:44 4.65 2.80 500 31,387 9:20 4.65 4.3 -0- -0- 4/30/81 MUNICIPALITY OF ANCHORAGE DEPT. ©~: i *,.4'''', & DEPARTMENT OF HEALTH & ENV RONMENTAL PROTECT O[~NVIROHM[N]/'L ;~.~ 825 L Street * Anch6rage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION 'DEC 2 9 1978 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. LING ADDRESS PROPERTY ~SIDENT {If different from above) PHONE PHONE 3. LENDING INSTITUTION MAI LING ADDR ESS PHONE 4. REALTOR/AGENT 5eLF MAI LING ADDR ESS PHONE 5. LEGAL DESCRIPTION STREET LOCATION V 0 o,'v 6. TYPE bF RESIDENCE NUMBER OF BEDROOMS [] One [] Four ,~3/' SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7. WATER SUPPLY ~ INDIVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~INDIVIDUAL/ON-SITE*~ [] PUBLIC UTI LITY **If individual/on-site, give installation date~l(~o~. If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS []~SI NG LE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY ~ INDIVIDUAL DEPTH OFWELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~]-tf~DIVI DUAL/ON -SITE DATE INSTALLED E~PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: ~)(~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTU~~ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank AbsorI n Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line [~-APPROVED FOR '~ BEDROOMS [~] CONDITIONAL APPROVAL (letter must accompany certificate) E~-'"'-~I SAPP R O V E D ~ //~ 72-010 (Rev, 3/78) 26~4720 1. PROPERTYOWNER Fred/Laurel Gregary MAILINGADDRESS 812 West 58th Avenue SEWER AND WATER FACILITIES 99502 2. LEGAL DESCRIPTION Lot 7A Block A Timberlux Subdivision 3. TYPE DWELLING SINGLE FAMILY RESIDENCE MULTIPLE FAMILY RESIDENCE OTHER (Describe) 4, WATER SUPPLY ~ INDIVIDUAL ED COMMUNITY/PUBLIC -~. SEWAGE D,S.OSAL iST, '~ iNDigiDU~ /oN~ :~ ' : ED PuBLic UTILITY: ' :' '~:: E:] HOLDING TANK (Maintenance Required) , : ~ APPRovED FoR: three BEDROOMs ::: ED DISAPPROVED DATE BY (TITLe)? C .H~___~_J~ & eEOLOglCAL LABORATORIES OF AL,ASKA, INC. P.O. BOX 4-1276 ANCHORAGE, ALASKA 99509 4649 BUSINESS PARK BLVD. Drinking Water Analysis Report for Total Coliform Bacteria TELEPHONE (907) 279-4014 TO BE COMPLETED BY WATER SUPPLIER I.D. NO. Public Water System Mailing Addrees City ' State MO. Day Year SAMPLE DATE: Zip Code SAMPLE TYPE: [] Routine [] Check Sample (for routine with lab reft no. [] Special Purpose sample [] Treated Water [] Untreated Water SAMPLE NO. LOCATION I Time Collected Collected By TO BE COMPLETED BY LABORATORY LABORATORY: NAME ~ ~ ADD~ESS Date Received CITY I-Z' Time Received Analytical Method: [] Fermentation Tube ..t~ Membrane Filter Lab Ref. No. Result* Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18-310 (3-78) 06-1220 (b) Rev. le78 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collected Source Lab. No. 48 Hours 24 Hours EMB Broth 24 hours: Multiple Tube Report: Membrane Filter: Direct Count Veriflcat Ion: LTB Final Membrane Fi esults ~ Broth 48 hours: 10mi Tubes Positive/Total 1Omi Portions Coliform/].O0ml Collform/J. OOml Time' ' 't ~',~-- 7¢ a.m. January 10, 1979 ADC No. 79002 Mrs. Laurel Gregory 812 W. 5$th Avenue Anchorage, Alaska 99502 Re: Adequacy Test for Existing Septic System on Lot 7A, Block A, Timberlux Subdivision. Dear Mrs. Gregory: At your request our office conducted a percolation adequacy test on your existing septic system at the above-referenced location during the period January 5 - 8, 1979. You reported that your septic system consists of a septic tank and seepage pit. This was confirmed by phone with the Muncipality's Department of Health and Environmental Protection. The septic tank had not been pumped prior to the percolation test. Since the 3-bedroom house had been vacant for approx- imately three weeks prior to the test, an extra day of testing was required in an effort to bring the leach field to or near its normal degree of saturation. In accordance with the Anchorage Municipal Code, Chapter 15.65, Waste Water Disposal Regulations, any on-site sewage disposal system "shall have adequate capacity to properly dispose of the maximum daily sewage flow." The maximum daily flow is computed at 75 gallons per capita-day (gcpd). Since "the population of dwellinqs shall be estimated at two persons per sleeping room," the maximum daily sewage flow for your 3-bedroom house is 450 gallons per day (gpd). To test the soil absorption capacity as well as the surge capability of your system, 110 percent of the maximum daily flow or 495 gallons of clear water was added in 50-gallon increments to the seepage pit. The water was obtained from your on-site private well at its maximum sustained rate of about 5 gallons per minute (gpm). The liquid levels in both the seepage pit and the septic tank were monitored closely to detect any backup in the system. Mrs. Laurel Gregory January 10, 1979 Page -2- The attached Table of Test Data represents the depths of liquid in the septic tank and seepage pit, and the quantities of water added. The septic tank was determined to be 7 feet deep (bottom of tank to ground surface) with an initial depth of 4.05 feet in the tank. The seepage pit was measured to be 11.1 feet deep with an initial depth of 3.9 feet. Ground elevation at the septic tank standpipe is approximately 0.3 feet lower than at the seepage pit standpipe. The follbwing Summary of Test Results indicates that, after saturating the leach field on Day 1, the level in the seepage pit at the beginning of testing on Day 3 had fallen to within 0.1 feet of its static level on Day 2, during a recovery period of 20 hours. On Day 4, the level in the seepage pit fell to 0.3 feet below the static level on Day 3, during a recovery period of 28 hours. This results in an average rate of fall of water level in the seepage pit of 0.1 feet per hour, including the recovery period after saturation on Day 1. The level of water in the seepage pit at its highest level during the test (7.5 feet) was approximately 0.3 feet below the liquid level in the septic tank. However, since normal useage is not likely to see the entire daily load imposed on the system in a t-hour period, coupled with the fact that the system recovered to within 0.1 feet of its static level, this is not expected to present a Droblem. Based on the 2 days of testing, a percolation rate for your existing seDtic system of 570 to 490 gpd is indicated. Since a sewaqe disposal system for a 3-bedroom dwellinq must be caDable of disposinq of 450 qallons of sewaqe per day, vour septic system apDears to be functing satisfactorily at this time. Manv factors affect the operation of a soil absorption type of sewage disposal svstem. Soil tvpe, groundwater depth, age and history of maintenance of the system, and types of waste are a few. This test has been performed in an attempt to model actual soil absorption capabilities of your septic system under normal useage by considerinq the deqree of saturation of the leach field and surge loads that might be imposed on the system. This test can only evaluate apparent Derformance at a given point in time, and cannot determine either the condition of the leach field, seepage Dit or other components of the septic system, or the depth of the water table. We appreciate the opportunity given to Der test. If you have any questions regarding contact this office. Very truly vours, ALASKA DEVELOPMENT CONSULTANTS Stephen D. Shrader, P.E. Project Manager TABLE OF TEST DATA Time Depth in Depth in Wtr Meter Septic Tank Seepage Pit Added Reading 11:18am 4.05' 3.9' 0.0 11:34 3.8' 4.3' 50.0 11:44 3.95' 4.8' 40.0 11:53 4.0' 5.1' 30.0 12:01pm 4.0' 5.25' 30.0 12:13 3.8' 6.0' 50.0 12:24 3.9' 6.35' 50.0 12:34 3.9' 6.7' 50.0 12:50 3.9' 6.8' 60.0 1:02 3.85' 7.0' 50.0 1:13 4.0' 7.1' 50.0 1:23 3.9' 7.15' 35.0 2:27pm 2:38 2:50 3:02 3:15 3:27 3:38 3:50 4:02 4:14 4:26 4:38 4.05' 4.1 4.1 4.1 4.1 4.1 4.1 4.1 4.1 4.1 4.1 5.0' 0.0 50.0 90.0 120.0 150.0 200.0 250.0 300.0 360.0 410.0 460.0 495.0 0.0 507.1 5.5' 50.0 557.1 5.9' 51.0 608.1 6.4' 49.4 657.5 6.8' 49.6 707.1 6.8' 50.0 757.1 7.0' 50.0 807.1 7.1' 51.5 858.6 7.2' 48.5 907.1 7.3' 50.0 957.1 7.3' 46.2 1003.3 Remarks 1-5-79 Static levels Saturate field End Saturation Day 1. 1-6-79 Static levels Begin test End test - Day 2 12:38 4~1' 5.1' 0.0 12:40pm 12:46 12:55 1:05 1:15 1:28 1:38 1:49 2:00 2:29 4.1' 4.1 4.1 4.1 4.1 4.1 4.1 4.1 4.1 4.1 1,009.0 5.9' 70.0 1079.0 6.1' 30.0 1109.0 6.6' 50.0 1159,0 6.8' 50.0 1209.0 7.0' 50.0 1259.0 7.2' 60.0 1319.0 7.3' 40.0 1359.0 7.4' 50.0 1409.0 7.5' 50.0 1459.0 7.5' 45.0 1504.0 6:30pm 4.1' 4.8' 0.0 1-7-79, Static levels, begin test. End test - Day 3 Final level 1-8-79; Day 4 Wtr Added, Seepage Pit Rise in Seepage Pit Rise in Septic Tank Gallons Wtr Added per Ft of Rise (gal/ft) SUMMARY OF TEST RESULTS Day 1 495 gal 3.25' 0.0' Day 2 496 gal 2.3' 0.0' Day 3 495 gal 2.4' 0.0' 152 216 206 Day 4 0 0 Recovery Time between Tests (Hours) Drop in Pit during Recovery Average Rate Fall (ft/hr) Average Absorption rate (gal/day) 25 hr 2.15' 0.09' 328 20 hr 2.2' 0.11' 570 28 hr 2.7' 0.10' 494 ,0l 3NI9 109 Ol NOIIVAV3X:I )130B0~8 3AOBV BnlNINllAJ ,9 (]NV 398¥/U3/¥M 3AOBV Bfl~JlNIIN ,t HON~8/~9¥d~S JO ~Oll08 [~ 3did OB±VBO~B3d, .LNIOr-J. 3AOBV d¥3 HIlM 3did alg'OS (NMOa SNOI I YB O:lkl3d) ~dld H±d3a ~3AVB9 XZ ~R~INIW / ~V~I$ UO '~3AIH Ol HON3BI aNY :~±ON 3d015 %90~ %Z 3S~OH ONV NN¥& N33MI38 3Nll[~ 13A31 3~ld 031VU0dB~d[~] 3d09S S$0B3¥ O399V~SNI H3N3B±[~] ~HgI~B3±VM NNV± 31~d3S ~0 IBq&flO ONV ±39NI [] -aB039¥ G~]qVLSNI HON~aL ~9¥~S1~ dV3 J. HglJ. BIV HIIM lflONV393 d¥3 LHglIUI¥ H~IM ±flONV393 NOUI±SV3,,~[~ NOBI/SV3 3H.L dO 33¥9d N[ O3SR 3B AVIN ~EO~O INJ.SV 3did 31J.SVgd (qdld ,,~) 9 I05 03BBRISIONfl OJ-NI NOB I ISV3 ,~ WnlNINI~ AHd~'J:l~)OdOJ. -13A3-1 NO HON3kl/ -I~'OId~kJ. -- 133HS)IO3H0 NOl.l. O3dSNI-3kJd 0~L~*~9~ auoqdala I NOIlO~/O~d 9¥/N3~NO~IAN~ ~ HI'IV:IH ~O /N3~l~¥d]O ~9¥~OHON~ 30 AII]¥dlOIN~ mm me× Department of Environmental Quality ~ 3330 "C"Ltr~ Anchorage, Alaska 99503 274-4561 / ~. ~'~'~..~ Date Received Auqus 11, 1976 -~' ~9<~~J(Bt/L ~/U~t/ Time of Inspection /~'~ ~ ~ I~ ~Af~ REQUEST FOR APPROVAL OF /~. ~ ~ ~"~ INDIVIDUAL SEWER & WATER FACILITIES FOR .1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 5. 6. Conv. United Bank of Alaska % Suzanne welger 645 G Street Thomas B. Heath % Toni BroWn, Jack White Co. Lot 7A Block A Timberlux Subdivision Phone: 278-9526 Phone: 277-1553 Location: Type of facility to be inspected Single Family Well Data: Individual A. Type C. Construction No, of bedrooms 3 Sewage Disposal Al Installed C. Septic Tank: D. Seepage Pit: System: On-site system 1973 B. Depth 350' D. Bacterial Analysis 1. Size B. Installer 1. Absorption Area 2. Manufacturer E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line Total length of lines 2. Material Sewer Lines /~'~ , Absorption area /~0 , Other contamination , Absorption area EQ-034 (1/74) Page 1 of two pages Requ~ August MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECT Oi~ 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: 2. Property Owner: Mailing Address: 3, Name of Buyer: CMRO VA FHA CONY XX× THOMAS B. HEATH (moved to Virginia) 8ontact Toni Brown. Jack White Company DayPhone: 277-1553 Fred Gregory o o Mailing Address: Name of Lending Institution: Mailing Address: Name of Realtor or Agent: Mailing Address: Legal Description: Location: 6359 Colgate Drive Day Phone: 344-4539 United Bank Alaska (Attn: Suzanne Wel~er[ ~/~ ~(_~' ~7-~-z~ Phone: 278-9526 Toni Brown .. Jack White Company 3201 "C" Street Phone: 277-1553 Lot 7A, Block A, Timberlux Sub. 9/10 mi~e up Rabbit Creek Road, Turn right at driveway. A Justus Cedar home. Type of Facility to be Inspected: Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 350 ~ septic and well '.No. Bdrms. single family dwelling ~three __Individual one Sewage Disposal System Type of System: Public Utility If Individual, d~te of installation appx. '73 ~ndividual (on-site) NOTE: '~ //~) Please call' T~-ni ~ .. 277-1553 when tests completed--- I'll hand carry to the bank. thanks 72-OO3( 3/76) P e 2 of two pages - Re(X-~t for Approval of Individual ?~-X~.r & Water Facilities r'egal Description Lot 7A Block A Timberlux Subdivision Comments Approved Disapproved Date ~//:J~-~ 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 operating satisfactorily. SIGNED Date EQ-034 (1/74) ~¢~L£ I'*° $~' r~ordlflg ~r~Jnct, ~o~a, and ~al ~e are ~ ro~ ~ J~ ~