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Home My WebLink AboutTIMBERLUX #4 BLK 1 LT 10Ti*mberlux 4 Block I Lot 10 #018mw271�93 LOCATION OF WELL 7 BOROUGH SUaDIVISION SECTION QTRS - . -1 . A � . # I All \ I LOCATION/SK ETCH: iLL) (� -) (r�3 _t tD� OK - I-) I - I ?�) S oo � -7 6 OC -3 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING,& WATER MGMT WATER WELL RECORD... WELL OWNER: SECTION I TOWNSHIP 1:1 N 1:1 S IIA"GE I MERIDIAN EIE 11W DEPTHS MEASURED FROM:Elcasing top Oground surface WELL DEPTH: DATE OF COMPLETION BOREHOLE DATA: Depth of hole.__ioa� It Material Type and Color From Depth To Depth of casing: /2, /7 f t. DEPTH TO STATIC WATER LEVEL: & T_ ft below 2 -top of casing El ground surface Date: /--Z �;11-r METHOD OF DRILLING: X ,D4Cair rotary cable tool' El other tZ alk �__u '00 USE OF WELL: �T_dOmOstic El irrigation El monitor El 1 PU Ic s bli upply EJ other CASING STICK-UP: ft. Diam: in. toijkaft Casing type: in. to ft WELL INTAKE OPENING TYPE: 0 open end El screened Perforated P -open hole Depths of openings: — to — ft SCREEN TYPE: Diam: in. Slot/Mesh Size: Length: ft Yo GRAVEL PACK TYPE: Volume used: — Depth to top: V70 GROUT TYPE: !:2 ''t, 1111:111ii ; �iz Depth: from ft to ft DEVELOPMENT METHOD: 6� RECEIVED Duration: , zl PUMPING LEVEL AdD YIELD: APR 29 1999 —ft after _ hrs pumping gpm -l— k4uniclPality of Anchorage PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPIL ON YE No ETI ? _E1 ACTOR INFORMATION: REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: id or Autnofizea rj�bp Date DNR/DIVISION OF MINING & WATER IOGMT 3601 C St, Suite Boo ANCHORAGE AK 99503-5935 Phone (907)269-8639, Fax (907)562-1384 lVdA- Cc)PL( MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970053 DESIGN ENGINEER: OWNER NAME:BODNAR DIRK A & OWNER ADDRESS:4901 RABBIT CREEK RD ANCHORAGE, AK. 9516 PARCEL ID:01827193 LEGAL DESCRIPTION: -fIMBERLUX #4 BLK I LT 10 LOT SIZE: 112989 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF I DATE ISSUED: 4/07/97 EXPIRATION DATE: 4/07/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PRIOR TO INSTALLATION, ENSURE 100 FT. PLUS SEPARATION TO SEPTIC LOCATED OV LOT 2, BLOCK B, POLLOCK SID. RECEIVED BY: ISSUED BY: DATE: !�el �/ DATE: Z-07- IIA / _r/M 15"LUX A z>.t.. No - 4- �—o-r lo (3t -e- / -rltq l3r�,LLUX ,40z>- MO. 4 5� �-O -r z P, "0 " /)0 4tO e e- �-O-r / 8 *��" poc-(,� Se,4 &E- RE El Ilf ED APR 4 1997 f Munigipal f Anchorage m Peol; H@81 & H main Service, RECEIVED APR 7 19ST Mur1fdPallty of Anchorage DePt. Heafth & Human services P, /v J12 r '7 C--S� Al & Aw�, �,j 2, N pp- 0 P 0,5 CZ, VY) 5� �-O -r z P, "0 " /)0 4tO e e- �-O-r / 8 *��" poc-(,� Se,4 &E- RE El Ilf ED APR 4 1997 f Munigipal f Anchorage m Peol; H@81 & H main Service, RECEIVED APR 7 19ST Mur1fdPallty of Anchorage DePt. Heafth & Human services P, /v J12 r '7 C--S� Al & Aw�, �,j 2, q T-6 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION ti P.O. Box 196650 0 Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5�V4 21i C-) PID Number: 0�?s — Q—) \_Cii S Name: r--- A �? I i Wastewater System: 71 New XUpgrade Addr:l,,2, ABSORPTION FIELD Phone No. of Bedrooms: EIDeepTrench CSITallow-French XBed []Mound 710ther LEGAL DESCRIPTION Soil Ratin� Total Dopt�rorn or at grade: il PD/ to Lot: Block: Subdivsron Depth to pipe bottom from original grade. Ft. Gravel depth beneath pipe 0, 5 Ft. Townsthip�, Range: j I section: Fill added above original grade: Gravel length: /V 7— � 0 Ft. 4-,f� Ft. WELL: 1:1 New El Upgrade Gravel width: I 1�7 Number of lines Dieter between lines: I Z Ft. 4�_) Ft. Classification (Private, A,B.C)� Total Depth Cased To Total absorption ar LIZ Pipe material f�!4 3 CE2 Ft. Ft. SQ. FLW NA 12 �F_ Drilter: Date Drilled I Static Water Level. Installer Date tii1led AL4 I Ft. Yield Pump Set at Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Septic 0 Holding 0 S.T.E.P. To Septic Absorption Lift Holding Public/Private MAU Capa�ity in gallons coo From Tank Field Station Tank Sower Lines Well 14- 0 ) Al, A�,� Meter Number of Compartments: Surface Water AIA LIFT STATION Lot A/ A V Size in gallons: Manufacturer: I Line /� Foundation 75' A tilu',A 1 0 "Purn High water alarm at: Curtain Drain I lVoiffj Iiii iii/ C,*, hlotll,�'j Al"e frini Make & Mind I ical Inspections per o Remarks: C ot)j BENCH MARK L C2 6i_,� f )e, L2 _�"i Location and Description '2CII h -)A Assumed Elevation: / �,jr,_4 Tc/& 11 4W, 6 % Inspections performed by: �iZ �O6Q�3ates: 1st A:� ess"eval 0 — -- �P�3 joi F. Size ore 2nd Aqg )F4- i,, 12 in :6—, to '-, 1517 E Vi, 11 1 4 % Aw in all, fiopt! V Department of Health I Human rvices appr al ,*.,- ilk 1090FCrSN Reviewed and approved by: Date:,ii:V 72-013 (Rea, 9/91) MICA 25 PermitNo. SWI�1-0?'30 Page of -3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 9 Anchorage, Alaska 99519-6650 *Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report _+5 Legal Description: Z N R 3 1A) 3 , M, PID No.: 7M13 A (1193) Permit No.6wc� �Oa C) Page of :3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 9 Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description:T[Z/VA,3VQ 51P—C-34, —:�>M PID No.: 7M13 A (1193) - WORM C L 6"101 ........ ... . . .. ............. - .................. ...................... 15�oo r,,;a C, a, J_ 6u�c_ To N o r, - - - - - - - - - - - e -0 SF; F. # 1.517 E PAGE 1 OF 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "Ll' STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940230 DESIGN ENGINEER:JAMES SIZEMOORE & ASSOCIATES OWNER NAME:STIRMAN E A & D J OWNER ADDRESS:4901 RABBIT CREEK RD ANCHORAGE, ALASKA 99516 PARCEL ID:01827193 DATE ISSUED: 7/11/94 EXPIRATION DATE: 7/11/95 LEGAL DESCRIPTION: TIMBERLUX #4 BLK 1 LT 10 LOT SIZE: 112989 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 -AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: CLEAN RECEIVED BY ISSUED BY: Pilo DATE: -7- 0-W PROBABLE IMPACTS TO ADJACENT PROPERTIES A WELLS: The proposed disposal system is designed in accordance with the current 1994 municipal wastewater Disposal Regulations. The proposed system replaces a timber crib that was constructed in the mid 1960's. Since the new disposal system has a septic tank for the solids, and the disposal bed has a sand filtration layer with proper separation of the bottom of the bed to the ground water table, and the separation distances from the wells on adjacent properties is greater than 100 ft., the possible impact on the adjacent wells should be less than the existing timber crib. B) WASTEWATER SYSTEMS The size of this lot should minimize the impact on adjacent wastewater systems. C) RESERVED SPACE/SURFACE AND SUBSURFACE There is enough space on this lot to put in another replacement system and still maintain the required protective radiaa between wells and the disposal system. D) DRAINAGE The location of the disposal system will not iinterfere with any drainage. The area disturbed during construction of the system will be graded and sloped so as to not pond water. :.:r� N 1 1. -i 77' Nip 7' 14 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: 10dn, Ale -,&'— LEGAL DESCRIPTIONT.)Mk,-_/-' L/o,&Aownship, Range, Section: /�_'Aj; SLOPE SITE PLAN 2 - 3 - C9 4- G 5- ob ble-5 E; - 7-- WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L DEPTH? 0 12 P E Depth to Water Afte JQA� f 13- Monitoring? — r.81 --f Date: T1 14 15 16 17 18 19 20 PERCOLATIONRATE / P�_(nninutes/mch) PERC HOLE DIAMETER TESTRUNBETWEEN L5 FTAND Lb FT COMMEN7S_L;f2e— Le—L[ t4,cWh 221-n'rl" F�26�-I-- PERFORMED BY: J I 9t' 290 tEJA4?�QVERTIFY THAT THIS TEST WAS PERFORMED IN v y ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Depth to Water 20 PERCOLATIONRATE / P�_(nninutes/mch) PERC HOLE DIAMETER TESTRUNBETWEEN L5 FTAND Lb FT COMMEN7S_L;f2e— Le—L[ t4,cWh 221-n'rl" F�26�-I-- PERFORMED BY: J I 9t' 290 tEJA4?�QVERTIFY THAT THIS TEST WAS PERFORMED IN v y ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # Cl 6— ?-Itl?�:' 1. GENERAL INFORMATION HAA It Complete legal description Lc:�-r- I S& Location (site add . ross�or directions) 7'c I r2c�Ab Prope r rty _ owner"'�Ll?_ Day phone Mailing address Lending agency Day phone Mailing address Agent __PAtA_2)01).k)AQ_ Dayphone -z_41t1-11zjjj-- Address zn-r _,�5u(7_6T /&0 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: �' � vl��t Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-=(P�.1191) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified bymyseal affixed heretcand asof the validation date shown below, I verifythat my investigation of this Health Authority Approval application 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 `i'A/V/j0't"a Phone Address /o—aFs-q A A)c- 14 1 A V__ '�) �'5/ 0 Engineer's signature Date A? S 6. DHHS..- SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for — bedrooms, with the following stipulations: Additional Comments Zo UITIC Date— 3-Z Z 9 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 theStateof Alaska. The DHHS does this as a courtesy to purchasers of homes andtheirlending institutions in order to satisfy certain federal and state requirements. Employeesof DHHSdonot conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. M-025(Flev.lM) 8�k MOA� RECEIVED Municipality of Anchorage MAR 10 1999 DEPARTMENT OF HEALTH & HUMAN SERVIC@&ICIPALITY OFAI14LAIUR Environmental Services Division ENVIRONMENTAL SERVICES I)J& 825 L Street, Room 502 - Anchorage, Alaska 99501 - (907) 343-4744 Health Authority Approval Checklist Legal Description: Llo R 1 —1 IM-18ag2l-oy- S:lt 4 14 Parcel I.D.: Q IS - Z7 I - q'-"? A. WELL DATA Well type --�PP 10 A -r -LE If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth Ligg- — Cased to (' C Sanitary seal (Y/N) Date of test Static water level Well production FROM WELL LOG 61— 1 -j q WATER SAMPLE RESULTS: Z'5- 1 9 -p -m - 41-ir-717 Casing height (above ground) -70 Wires properly protected (Y/N) Go] iform Nitrate -3 - i'5 - Date of sample: 3116" Collectedby: B. SEPTIC/HOLDING TANK DATA AT INSPECTION �3 4 3. 2_ 9 -P.M. Other bacteria '— 6�:' — Dateinstalled &/111'roj Tanksize /,f:>c>0 Number of Compartments �— Cleanouts (Y/N)--r Foundation cleanout (Y/N) Y Depression (Y/N) A) High water alarm (Y/N) Home Date of Pumping 14 /'TT Pumper A :- S\� C- C. ABSORPTION FIELD DATA �/SA�lb F Lr-Aat- Date installed E51111 ? Soil rating(��or ft2/bdrm) 41�P7 System type '�� C�n Length Width j.L' Gravel thickness below pipe 0-,S- Total depth Z Effective absorption area ? 5 Monitoring Tube present (Y/N)__�L Depression over field (Y/N) A) Date of adequacy test 3 9, C1 Results (Pass/Fail)'�?AS-r, For --3 bedrooms Fluid depth in absorption field before test (in.); — Immediately after QS0 gal. water added (in.): 46 Fluid depth — (ins) Minutes later: Iq q0 Absorption rate = g.p.d. Peroxide treatment (past 12 months) (YIN) If yes, give date 72-026 (Rev. 3/96)* D. LIFTSTATION Date installed Size in Manhole/Access (Y/N) P �nlevel at* — "Pump off" level at* High water alarm level at� fr*Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot — 0 -?-. 6 / //I -e On adjacent lots Absorption field on lot /oc,+ On adjacent lots / 6,0 t - Public sewer main A-1 Public sewer manhole/cleanout Sewer /septic service line Lift station / C70 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: IVIA Foundation -3 Zi I — Property line' 16>4 Absorption field q0 I Water main/service line 40 1 --Surface water/drainage /Lvo 4 Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: /enc + Property line 10t- Building foundation 93 0 ( - Water main/service line /00 '-f' Surface water /00 Driveway, parking/vehicle storage area /Cvt- Curtain drain /00+ Wells on adjacent lots /(�;,o F. ENGINEER'S CERTIFICATION i certify that I have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signature.__�� Engineer'sName Date HAA Fee $ �3 DD , O�D Date of Payment 3 //c Receipt Number L/7 72-026 (Rev. 3t96)* Waiver Fee $ Date of Payment Receipt Number 0 are AS -BUILT WASTEWATER ABSORPTION SYSTEM Lot 10, BLock 1 TIMBERLUX NOA EXIST'G 1000 g Z'�P7PTTr TAKIV A -Tl -34.3' A -T2=40,0' 1=47.3' 2=51.2' Cl\Work\1G-lTLUX.DWG 4 .............. PREPARED FOR1 '�77a ` en nnone BeLa Bodnar CE 8149 C/O Remax Properties AV 2600 Cordova Street, Anchorage, AK 99503 (907) 244-4415 Pannone Erg, Svc, P. 0. BOX 142025 100 ANCHORAGE, ALASKA 99514 Suite 272-8218. PHONE & FAX AS -BUILT da 5. L"ILDESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS K� STREET LOCATION TIME TIME TIME (--' C " — DATE DATE DATE 0 Two 11 Five El MULTIPLE FAMILY 6j INSPECTOR INSPrCTOR. INSPECTOR *ATTACH WELL LOG. Awell log is required forall wellsdrilled El COMMUNITY since June 1975. For wells drilled prior to that date, give well MUNICIPALITY OF ANCHORAGE MUNICIP ALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOVNVI DEPT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 RONMENTAL RRO'ECDON 0 49�, ENVIRONMENTAL SANITATION DIVISION P Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER kk ElI DIRECTIONS: Completeall parts or) page 1. Incomplete requestswill notbeprocessed. Pleaseallowten (10) daysfor processing. 1, P�Q PHONE NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 9 MAILING ADDRESS U_ � Q'k'v-�2_ PROPERTY RESIDENT (if different from above) PHONE 2. BUYER PHONE -2 �+ -4 !-f')Q '�_ ��Cf MAILING ADDRESS iL 3. LENDING 16TATION C i�__ PHONE MAILING ADDRESS 4. REALTOR/AGFNT MAILINg AD�ESS 5. L"ILDESCRIPTION il L_ !�K- 7?7(?- K� STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS El , One 11 Four El Other SINGLEFAMILY 0 Two 11 Five El MULTIPLE FAMILY Three Ej Six 7. WATER SUPPLY N:r INDIVIDUAL* *ATTACH WELL LOG. Awell log is required forall wellsdrilled El COMMUNITY since June 1975. For wells drilled prior to that date, give well ID PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM !K_ INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. 17�1 PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 9 72-010 (Rev. 6/79) IV THIS SIDE FOR OFFICIAL USE ONIL T 1. TYPE OF RESIDENCE E SINGLE FAMILY 0 MULTIPLE FAMILY NUMBER OF BEDROOMS E ONE El THREE 1:1 FIVE ED TWO 0 FOUR ED S I X E-1 OTHER 2. WATER SUPPLY 0 INDIVIDUAL El COMMUNITY ID PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM EIINDIVIDUAL/ON -SITE EJPUBLIC UTILITY Connection Verified — PERMIT NUMBER DATEINSTALLED INSTALLER _MLS ESO pt] T k or 0 Holding Tank Size. If Tank is homemade give dimensions: RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDR 0 LD CONDITIONAL APPROVAL etter m cerl if icate) E!�— DISAPPROVED DATE 'F) �Z_ � 72-010 (Rev. 6/79) CIVIL'- STRUCTURAL . GLECTRICAL . MECHANIC& TECTONICB INCORPORATED ENGINEERS & SURVEYORS SEPTIC SYSTEM ADEQUACY TEST DATE 11/3/80 CLIENT: Name Scott Ulmer Address Box 520 Homer, AK 99603 S- 108 LAND SURVEYING MUNICIPALITY OF ANCHORAGE DEPT. OF I�-ALTH & ENVIROWiENTAIL �..O[ECTION 6 '1980 RECL I VED Telephone 235-8595 LEGAL DESCRIPTION: Parcel 9C, Sec. 34, T12N, R3W, S.M., Alaska (proposed Lot 10, Block I, Timberlux Subdivision Addition No. 4) SEPTIC TANK: LEACH PIT: DRAIN FIELD: Material Type Unknown Size 1250 gal. X Number Bedrooms 3 Required Tank Size 1250 gal. Surcharge Test 600 gal. water; 0.80 (150 x No. bedrooms) min. Rate of percolation 1700 gal./day Sludge condition in tank: Pumped 10/15/80 Remarks: Tank volume determined by Isaacs Pumping Service (see attachment). Leaching of surcharge was complete in 7 hours, 25 minutes. System is functional and adequate. P.O. BOX 4-2265 ANCHORAGE, -- 1;1 y -� 15'�Lc- ALASKA 99509 C 9073