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Home My WebLink AboutLot 07, 08urnagain Block 1 16�123�4-,fr GREA? R ANCHORAGE AREA BOR, GH, Department of Environmental ~uality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~'"'.~d/;/,4).S' ,4'~'~,]',,//,-~'~ MAILING ADDRESS ~/~ ~ ~ r'~ PHONE SEPTIC TANK: DISTANCE ,~,Op,~'y ~'~ ,4/ /'~'~/P2 ~/ NUMBER OF FROM WELL '~,~/ MANUFACTURERJ~/'/~,C~ ,3'~(~Z-/2'' MATERIAL J/~"~/~' COMPARTMENTS_ ~ INSIDE LENGTH ~ INSIDE WIDTH ~ LIQUID DEPTH --LIQUID CAPACITY /'~,~,.~d~ GALLONS. SEEPAGE PIT: NUMBER OF PITS ./ DIAMETER LINING MATERIAL /b,::? 5'~/z~ CRIB SIZE: BUILOING FOUNDATION /z/(, NEAREST LOT LINE '~/. OR WIDTH -- , LENGTH ..~ , DEPTH DIAMETER ~ DEPTH ~/ DISTANCE FROM: WELL /'(~),-~ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~'~ SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE ~/,~/~ ~7~ CONSTRUCTION BUILDING / NEAREST // NEAREST FOUNDATION ~A',~' LOT LINE /~ SEWER LINE CESSPOOL ~ OTHER SOURCES APPROVED -- DISAPPROVED DEPTH //~ / DISTANCE FROM: SEPTIC SEEPAGE SYSTEM DISTANCES: INSTALLED BY: /~/////(/g~C/~/~', ~D PIPE MATERIAC: ~/~~Z"~'~'///~ LOT SLOPE: // Form No. EQ-O31 DIAGRAM OF SYSTEM DATE APPROVED /~'~'~C-c~ /~//.-S_~./'A~-2 G.A.A.B. GREATEr ANOH~A~~~OUGH DEPARTMENT OF ENVIRONMENTAL QUALITY SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT PERMIT NO. LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SiZE FINANCED THROUGH SOil TEST RESULTS COMPLETION DATE ANTICIPATED TO BE INSTALLED BY DRAIN FIELD , OTHER . NOTE= THIS PERMIT I$ NOT VALID WITHO T SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. ! MINIMUIV~ DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPtiC TANK TO SEEPAGE PIT WALL SEPT]C TANK ~/~ / .* SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. / WELL TO SEPTIC TANK //~J ~ ! , SEEPAGE PIT. DRAIN FJELD . ALSO CONSIDER AREA WELLS. DRAIN FIELD ~ T/A · SEEPAGE PIT SEPTIC TANK, ~'('*~ / , SEEPAGE PIT DRAIN FIELD I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE Performe~ Legal Description; This Form Reports Soil Test Must Depth Feet Soil 1 i-- B~own silty organics 2 3 6 '8 -- 9 -- '10 i ItECEIyE~RE~, R ANCHORAG£ AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY OCT 9 1973 PM 3330 "c" Street ANCHORAGE, ALASKA 99503 For Thomas, Ros~ing Dated Performed oct. 3, 1973 Lot 8 B.1 ock I Subdivision Turnagain Soils Log xx Percolatior Test Be Logged To 4' Below Proposed Seepage System - Characteristics Gray sand (GP) vfith well graded sand seams below 5' with sandy silt seam 10,5' to 11' Case Was Ground Water Encountered? No ..... · If Yes, At What Depth? Reading Date ' Gross Time Net time Depth to H20 Net Drop Percolation Rate Minute '?'. Proposed' Installation;. See p a g e Pit ×x ..Drain'. Field Depth of Inlet .... Depth to Bottom of P~t o~ Trench 'COMMENTS: 155 square feet of dra'inage area is required per bedroom.'' ' Test Performed BY R,E. Carlisle ALASKA MINERAL & MATERIALS LAB Date Certified BY: Da i;e: MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 016 -123-46 Certificate of On -Site Systems Approval OSC251145 Expiration Date: 4/17/2026 Legal description TURNAGAIN BLK 1 LTS 7 8 Site address 1300 OREN AVE Current property owner(s) MERO DAVID E X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: Original Certificate Date: 5/1/2025 This ertificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject s em(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, evelopment Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 4n -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 01612340 Complete legal description TUrnagain 131 L7&8 Location (site address) 1300 Oren Ave Current property owner(s) Dave Mero 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: Q Private Well serving # 1 yr dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank R Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $_ 0 Date of Payment COSA # JC2-Vl# Waiver Fee $ Date of Payment Waiver # COSA Application_Apr2025.doc COSA Checklist Legal Description: Turnagain 131 L7&8 Parcel ID: 016123q If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled X73 Total depth 112 ft Cased to 112 ft FE -1 Sanitary seal is functioning correctly M Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 04/17/2025 Static water level at beginning of test 28.2 ft. Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficienci COSA Checklist June 2022 Well production at time of test 4.3 gpm Water storage tank volume none gallons Well disinfected for coliform test? ❑ Yes Q No FE -1 Coliform bacteria is Negative Nitrate mg/L n Nitrate less than MRL (ND) Arsenic 9.267 ug/L ❑ Arsenic less than MRL (ND) Collected by PES Date 04/17/25 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results u Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) Effective depth used in Effective depth remaining in in COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS G.CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC & MOA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail, and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore, we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. PES does not have the authority to grant MOA Onsite access to private property. That access must be obtained directly from the property owner. Name of Firm Phone Engineer’s Printed Name Date i 8517Q OREN AVENUE 0 0 M M _ S89057'00"E 100.00 10' CEA Easement shed C N (Book 2982, �L84 ROW Acquisition (Book 485, page 0658) c EE o w tO Ret. wall typ) ti Mi �, Controlled Access eight -of -way "0 o .�-4, �� k per Plat No. 88-110 10m Asphalt 2.2 OH 18.3 N (P 62 0 N O 1.1 OH 1 1/2 Story Frame C:) _ 0 House She 6620o � O j '—18.6— Lot 9 CD 1.5 OH _ 4.1 OH deck Q F— X> OO W Z z to LOT 8 o Well REM LOT 7 SCALE: 1 "= 40' Chain link fence r II NOTE: 11 -4 1. Bearings of ROW acquisition are .p, W rotated 00'13'27 11clockwise to • omatch plat No. P-232 bearings. • I�N.P 100.00 S89057'00"E Unsubdivided 54.39 AS -BUILT NO CORNERS SET THIS DATE This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence, structure or other improvements unless otherwise noted. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. I hereby certify that I have performed a Mortgagee's inspection ��`� 4%W OF A '' in accordance with ASPLS Standards of the following described LOT 8 & Remainder LOT 7, BLOCK 1, ANW property: TURNAOAIN SUBDIVISION �P.• • . •S ow �, . '� ! Anchorage Recording Precinct Alaska and that the g g 49 th , • improvements situated thereon are within the property lines 00 and do not overlap or encroach on the property lying / w adjacent thereto, that no improvements on the property lying • • adjacent thereto encroach on the premises in question and •. lizabeth L. Walatka / that there are no roadways, transmission lines or other �`�� • • 8036 — LS • • �,� r �' visible easements on said property except as indicated F,� • • • • CJ Fo hereon. • . • • . • �,o 4%W SOF �P Dated at Anchorage, Alaska . � ` ESSIONA�` this 23rd day of APRIL , 2025. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED �' L FRED WALATKA &ASSOCIATES, L.L.C. Engineers and Surveyors PLAT ARE NOT SHOWN HEREON E 907-248-1666 UNLESS OTHERWISE NOTED. FB 25-1, pg 49-50 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence, structure or other improvements unless otherwise noted. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation data shown below, I verify that 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 cod, es, ordinances, and regu!atio s in elf. act on the, date of,this in~spection. NameofFirm F: ¢-~/-/~,,¢ '7'-e'c.,fl?,t~( .E'~ ( ,~ Phon Address .~ ¥S30 ~c.4o .¢';/"~ ,,~r~¢bo,'-~'~./ Engin~er'ssignature ¢J~~ ~.-/'~¢¢¢,~-~L Date ~-/.,.T//G/ DHHS SIGNATURE Approved for .,, // t~edrooms. Disapproved. ,:~ ~ _Jco%~ ,'~4- Conditional approval for ~ bedrooms, with the following stipulations: ~r ' - i ,;,' ~ ' - Date_ ~4--~/ The Municipality of Anchorage Depar[ment of Health and Human Services (DHHS) issues Health Authority Approval Cer[ificates 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 anatyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 1/91) Back MOA#21 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 1. GENERAL INFORMATION Complete legal description ' HAA # - Location (site address or directions) I_g'oo Property owner /"-0~ ~ ,..7'¢~,y goW/,',~ Day phone Mailingaddress ~.0. ~o~ I~I~E ~ ~or~/ ~k Lending agency 5~¢~1~ ~r~ Day phone Mailing address ~¢0 ¢ ~ ~¢~. Agent N~el Thomc¢,¢, ~-or:l~ ?/-¢?~rCq~z Dayphone. Address ::TOO o Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 72-025 (Rev. 1/91) Front MOA #21 NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. ~ -Fo be co~c/~( ~ co'~¢z;t''°'~ of fi/IA TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site PuNic sewer If community well system, provide written confit;mation from State ADEC attest- ing to the legality and status of system. STATEMENT OF INSPECTION BY ENGINEER 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 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 regulatioQs in effect on the date of this inspection.. Engineer's signature ~~ ¢ ~ ' Date 5--/_7 / 19/ By: DHHS SIGNATURE __ Approved for bedrooms. Disapproved. Oond t,ona, approva, for bedrooms, w,th the fo,owing st pu,ations: 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 th is 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. 724)25 (Rev, 1/91) Back MOA #21 Municipality of Anchorage /~ Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. Legal Description: LOT 8 N A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. Date O~test: Static waier level Well flow Pump level FROM WELL LOG Date completed Casedto ~ IIZ Casing height Wires properly protected (Y/N) AT INSPECTION 5/2 t SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ )O ' Absorption field on lot ~ ~O~'~ Public sewer main ~ _-~ ¢oo~ Public sewer Service line ~2 ADEC water system number Jo/73 oR S£FO~S Driller (JNK. ENVIRGNMENTAL SERVICES DIVIStON MAY [ 1991 g.p.m. ?'f' g.p.r ECEIVED ;On adjacent lots ~ 4oo ' ; On adjacent lots Publio sewer manhole/cleanout ~ t~o ' Petroleum tank' NONE WATER sAMpLE F~ESULTS: Coliform d' Nitrate z.. c~. / Other bacteria 0 Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) N High water alarm(Y/N) Date of pumping Collected by: Tank size l ~ ~'~! Foundation cleanout (Y/N) Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~2~ On adjacent lots ..~ ~c,~,' To propertyline ~, ¢o' ~ Surface water/drainage Compartments '~ Depression (Y/N). /V Foundation Water main/service line Absorption field toot 72-076 (Rev. 3/91) Front MOA2! CONTINUED ON BACK PAGE C. LIFT STATION I~, ~. Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed la /~7/72 Soil rating I ~ System type ~ .~-~ ~'~' Length I ~ Width I ?.. Gravel thickness ~ Total depth I~-. Total absorption area ~(2 Cleanouts present (Y/N) /V Depression over field (Y/N) I'¢ Date of adequacy test /~, Results (pass/fa) I~J, ~. for ,. ~ bedrooms Peroxide treatment (past 12 months) (Y/N) , I~(, ~., If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot ~o..~ On adjacent lots To building foundation '~. On adjacent lots ';~ Surface water Curtain drain Property line To existing or abandoned system on Cutbank ;:> ,5'¢' ' Water main/service line Driveway, parking/vehicle storage area E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines inspection. Engineer's Name Date ~"{ ~/ 14AA Fee $ ~.~0 Date of Payment '~' ''~ ~ R e cei pt N u m be r ¢~'"""~ ~'~ 5 ( ~ /~ 72-026 (Rev, 3/91) 8~ck MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEiVIICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska §9518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ~t~P~f 7"ec,4 5%-¢ '3 q¢'- Phone No. Mailing Address City State Zip Code Mo. Day Year SAMPLE TYPE: [~ Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [~ Untreated Water SAMPLE NO. LOCATION - Time Collected Collected By TO BE COMPLETED BY LABORATORY Date Received Time Received Analytical Method: i$ shows this Water SAMPLE to be: sfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Membrane Filter * No. of colonies/lO0 mi, Lab Ref. No. Result* 91.2152" FT-S l-lq Analyst READ INSTRUCTIONS BACTERIOLOGICAL WA~TER ANAJ. Y,,~I.S RECORD / - A.D.E.~ .~ Membrane Filter; Direct Count (~ Coliformtl00 mi BEFORE COLLECTING SANIPLE Verilication: LTB BGB Final Membrane Filter Results ColiformtlOo mi Reported By ,~ --~--~k~'~ ~-,. i _ Date ._~--_¢~c:~ / TNTC -- Too Numerous To Count OB = Other Bacteria PART ONE OF T~O REiIAINDER TO FOLLOW CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 AMALYSI$ REPORT BY SAMPLE for WORRozde~ 3440E Date Report P~inted: II{AY 22 91 ~ 19:09 FAX:(907) 561-5301 Client Sa.,pl~ ID:LB El TURNAGAIR FRONT SPIGOT Client Name :FLATTOP TECHNICAL SRV FWSiD :DA Client Acct :FLATTO? Collected }MY 21 91 ~ 14:30 hrs. BPO i PO ~ N0~E RECEIVED Received MAY 21 91 ~ 15;45 hrs. Req $ Preserved uith :AS REQUIRED Ordered By :UA 3end Reports to: Completed :I,~Y 22 91 Laboratory Suoervicor :STEPHEIi U. EDE 1)~LATTOP TECHNICAL SRV / ShemIab Ref ~: 912152 Lab S]~pl ID: 1 ~at~ix: WATER Allowable Parameter Tested Re,nit Units Method nil~ts MITRATE-N IID(D.iO) ~g/l EPA 353.2 Sample ROUTINE SAMPLE COLLECTED BY: T.F. MOORE. T~sts Pezfor~d ' See Special !nst~uctions Above UAgUnavailable None Detected *~ See Sample Remarks Abowe t]ot Analyzed LTiLess Than, GT=Ozeater Than o 4. 5. 6. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Approval requested by: Mailing Address: Property Owner: Mailing Address: ~f~- ~ Legal Description: Location: Type of facility to be inspected ~?J-~7 P ho ne: Phone: / No. of bedrooms Well Data: A. Type ~~. -- C. Construction Sewage Disposal System: A. Installed /~"]-~ C, Septic Tank: D, Seepage Pit: E. Disposal Field: B. Depth D. Bacterial Analysis B. Installer 1. Size 1~-~ 2. Manufacturer 1. Absorption Area ~ .~ ~2. Material Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line __ , Absorption area Other contamination , Absorption area Sewer Lines , EQ-034 (1/74) Page I of two pages Page ~ of two pages - R ~.. st for Approval Legal Description of Individual .~er & Water Facilities Comments Approved ~-~ ~._ ~/~ Disapproved Date ~__~C~ Approval Valid for one year from date signed Greater Anchorage Ar~a 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) 333O 'GREATER ANCHORAGE AREI~ BOROUGH Department of Environmental Quality "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. TYpe of Inspection: CMRO VA FNA CONV ×xxx 2. Property Owner: Thomas R. Rosling " '<'~ 99507 '" Mailing Address: S1L~, Box 1368, Anchorage D~_)t Phone 344-3901 .,.. 3. Name of Buyer: Thomas R. Rosling :. (Business) Mailing Address: SAME 0a_y Phone 344-6013 4. ~ame of Lending Institution: The First National Bank of Anchorage, South Center Branch Mailing Address: Box 4-2090, Anchorage, 99509Phone 274-1521 Name of Realtor or Agent: None Mailing Address: Phone 6. Legal Description: Lot 8, Block 1, Tnrnagain S/D Location: NHN Oren St. Anchorage, Alaska 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public If Individual, number of Single Family NO. Bdrms, ~ 4 Utility Individual xxxx dwellings presently served One If Individual, depth o'f well Unknown Sewage Disposal' System Type ,of S>stem: Public Utility If Individual, date o'f installation Individual on-site) xxx Unknown 06-1220[a) ~ev. 1973 DATE ~ '~ .h~LA~''''''' DEPARTMENT OF HEALTH AND SOCIAL Sr'-'"CES DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC B ,A.~C ?.,E R ~LO G lC A L ~: WATER ANALYSIS INDIVIDUAL [] SEMI-PUBLIC [] CHLORINE RESIDUAL PPM REPORT RESULTS TO ADDRESS OF SOURCE ZIP ICODE - COMPLETE THIS SECTION ONLY IF WA.I'ER I~ AN~]ICDIVIDUAL SUPPLY [] No READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE Lab No. OFFICE -~.naJysls shows Ibis Water SAMPLE to be: [] SaUsfactory [] Unsatlsfaclory Et Quesllonable [] Samp]e too tong in transB'; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample· [] BotUe broken i~ transit, please send new sample· SANITARIAN'S REMARKS o6-122o ~bl / BA~TE~IOI~oGICAL WATER ANALYSIS R~CORD Rev. 1973 ~'~ t j ~> / ~,~ ]/ C ~} arn "~; · Date Received ~/ ~'-~ , ~ Time Received ~ ' ~ ~ob. No. Lactose Broth T0cc 10cc 10cc 10cc 10cc t.0cc 1.0cc 24 Hours 24 Hours --48 Hours EMB __ AGAR Lactose Broth, 24 hrs. 48 hrs. Gram's stczln Coliform Densib (Mosl probable No. per 100cc} MF ResuBs be: t.~ Absen~t) Reported by This analysis indicates Col~form;Organlsm~to