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HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 1 LT 53 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ~- ~,~ Iz ~ Y J~ ~¢~. ~ SEPTIC ABSOBPTION WELL Phone(s)~j_ J~l¢~ Permit No.~ ~'7~ NO. of ~rooms. WELL Lot J Bloc Subdivision Township, Range, Section T JCM ~ ~ ~ ~ ~ i ~ AS-BUILTDIAGRAM(ShowlocaUonoIwell sepUcsystem, propey nes, loundat, on, ~ ~ , driveway, water bodies, etc. J T~NKS ~ SEPTIC ~ HOLDING Manutadtuler Capacity in gallons Material NO OI Compadments TYPE OF SYSTEM ~TRENCH ~ BED ~ W, DRAIN ~OTHER Depth ,o pipe bottom from Total depth from o,,g,nal grade r-- original grade ~ Fill added above origJnat grade Gr vel depth beCeath pipe ~ravel length / j width ~ J F 80 FT I WELLS ~ PRIVATE ~ OTHER [Idenlifv) ClassdicaUon (A,8,C) Total Deplh FI Cased [o FT RE~ARKS: J Scale:~ ~ :'EN~JNEER'$ SEAL I ~ ¢¢'¢ ~ %~ ~'¢ ~' cedily that this inspection was pedormed accordi.¢o ,11 State guidelines Heallb Department 72-013 (3/85) I I M U N I [', I F' A I- I "[' Y 0 F A N C* H 0 R A G E Depar't. ment. {::)~ I.lea]t.h & Humar~ Services [:) N .... S I T [i~. S E F:' T i C ]' A N K P E R H I ]' 05102 189 Owne~i* I',.la rne ~ I::)t4n e r. ,~.1 ,.I r r~. ,.~, ... Day f'hc:)l]~! ~ ,..~6 ..- P a f' c: e ]. i d: I:) :I 5'-' 1R:3'-() 8 L..o{ l_e.-'gal: !ih.,d::~divisJ;:H'~:~ VALI..I VU[E :I'1:;?. Lc, t.= 53 B:Lock~ Sec:tic:,r~[ 14 Tc, wnship= 12, N Range:~ :3W 1...cR. Size ;20073 (sq,, ft,, cm acr'es) Max :Sedi*ooms: 'This F'epmit.~ 5 Total Capacity: 5 ~?EF':"T I C TANK :; M :i. n i mum ' Eac:h sept.:ic: tank(s) < 4,() '['H"Y~ F'Ii!RMIT "¢ .¢:~c~ : .... ,ct:, A''r:'' :: '~ THE COI..LAF,L]D '1" ... ~ ] ...... UI..D F:OR THE I~¢.1 ._.-,I,,_MIJql OF: . (?)AL.!....ON SEI:::'TIL; "f'ANK, '"1 ,"1]. ...... :~ PERMIT EXPIRES ON _' ';'-'~ '_ _ ]: CER"f']:F¥ THAT: i am Cami],iaf' wi'Lb the r'equ:i,i'em~::~r"rLs 3. CoP on-'siCe sewer's and wells as set For-th by t. he MLtni(=ipa].i'Ly oF Anchor'age (PIO~) al'id thud E~tat. e OF ala[~k~. I will install 'Lhe system ~n ~c:ccH"danc:e ~*d.'l:.h all IdOA codes and and in c:c, mp].iance wit. h the design cpJ.'~.~;~pi8. 0[' this pel*mi'L, I will adher'e t.o all MOA arid StaCe oF Alaska pequ:i. Pements ~'of the set. bac:k d:i.~i;,tal]c:~:,s ¢pom ally exi~'(:[f]g we}.l~, ~,[c~s;tev~;~.t. E41" disposal sys'(.e!~ op public sewer-age ~ciyst. em c)n ti'lis of any adjac:ent of iq((~ap!:;iy I under'~?,tand that. this per'mi'L :Ls va]. al. so under's'Land t. hat. t. he c;apac:i'Ly , any ceF~],ar'oemE, n~. ~g:[]]. P6~qLt:i. Pe}~ an ach S :i. {.':~ n ~:.} d: J:ssued ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 NAME PHONE MAILING ADDRESS Z~o -~OUNb'T'I~C-E ,~N~, AK qc76i~ LEGAL DESCRIPTION /' ' I Manufacturer~Ncli TANt~ q. capacity in gallons IF HOMEMADE: DISTANCE TO: IWell [] NEW [~UPORADE ~.o~T' ~C5 ~LOOM I ~/ALLI ~./L)~ LOCATION I D ISTANCETO: I A~,~r,,.~.,~ Dwelling W dth Manufacturer Top of tile to finish grade Width Inside length Dwelling Material Founda'tion " N~are?! I .~ ~,~ inches Total 1~,9,~.~of lines Trench ~;idth Mgterial beneath tile ~ ~ inches ~)epth NO. OF BEDROO~S 5 PERM IT NO. No. of comp~ments Liquid depth PERMIT NO, Liq~Jid capacity in gallons Distance between lines Total effective absorption area 7'?o PERMIT NO. Length Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: 31ass Depth Driller Distance to lot line Building foundation Sewer line Septic tank DISTANCE TO: OTHER PIPE MATERIALS SOl L TEST RATING INSTALLER REMARKS APPROVED DATE LEGAL I I '" ' ' MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE [~] NEIN NAME K MAILING ADDRESS LEGAL DESCRIPTION LOCATION / NO. OF BEDROO~S D Z Manufacturer Material No. of comp~tments ~ ~ Liq. capacity in gallons Inside length Width Liquid depth ~ IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO, O ~ ~ Manufacturer Material Liquid capacity in gallons Distance between lines -- Trench width ,. ~ Top o, tilo to finish ~rade ~ ~ M~torial b~noath tilo ~ i~lchosinch~s Total o f fo~r pt[on oroa ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RAIING INSTALLER 72-013 (Rev, 3/78) I I DEF'ARTMENT OF NEALTH AND E'NVIRONMENTAL PRC]TECTION 825' L STREET, ANCHORASE~ AK 99501 264-472']0 :'ERM I'T NO: 85]612 [)A"FI£ ISSUED: 09/220/85 '-~PPL I CANT: MARK FRYER :~DDRESS: 6650 ROUND TREE ANCHORAGE, AK 99507 ~X]N'T'ACT F'H[]NE: 279-3916 SEE~ER F>EF<M ]] ESAL DESCRIP: SUBDIVISION: VALLIVUE ESTATES LOT: 53 SECTION: 14 ]"OWNSHIP: 12N RANGE: 3W ..OT SIZE: 20000 (SQ.FT. OR ACRES) dAX BEDROOMS: 5 BLOCK: 1 .lsted below ap_e the options avaiIable to you zn designing youp septic sys't',ef~. [.I oo=e the option that best fi'Ls yoLtP site. )EPTH 'IO F'IPE BOTTOM (FI-.) 3RAVEL DEPTH (FT.) '"OTAL DEPTH (F'T.) ~RAVEL WIDTFi (FT.) 9R~VEL I_.ENGTH (FT.) 3RAVEL VOLUME (CU. YDS.) I"ANI.::: SIZE (SAI_.S) :;Oil. RA]"I NG (S{~. F'T. /BR) ~"'~ GRAVEL LENSI-H -K-.~. 'TANI< MUS"F J. 0.0 , 75 FT. REQUIRES IdUL'i'IF'LE I~t. JNS HAVE A'] LEAST TWO COMPAR]-IdENTS 4.0 3.5 7.5 5.0 60.0 500.. 0 *~ 150 (NO]" £XCEEDIIqG 75 FT. EACH) cer'ti £y that: I am ~amiliaP with the PequiPements tel on-~ite sewel~s and wells a~ set £oPth .b,~ the Municipality of Anchopage (MOA) and the State oI Alaska. 2. I will install the system in accopdance with all MOA codes and ~egulatiens, and itl compliance with the design cr'itePia of this pePmit.. I w].lI adhePe t.o ail 'MOA and State ~£ Alaska Pequipements top the set back distances ~Pom any e>,'ist'ing well, wastewater, disposal system oP public 4. I undePstand that this pepmit is valid fop a maximum o¢ 5 bedr'ooms arid ar'~y enIarger~lerd:, will requil-e an additional permit. :' A LIFT STATIOIq IS INSTALLED IN APl 'AREA CO~[:I,,E.D' '~ ....... BY MOA EUILD]Nb' CODES,. ]-IElq (1) AN ELECTRICAL F:'ERMIT AND IIqSF'ECTION MUST BE OBTAINED; (2) ~IL.1; N[]]~ BE AF'PROVED WITHOUT AN ELE~4:ICAL INSF'ECTIC]N REF:'0RTL AND (3) "rilE U.,.EE,-FRICAL WORK IdI.JST BE DONE BY A [lICeNSED EL.ECTRIC~Alxf. ' :~F'PL:fE,ANT: MARK I::RYEI~ :SSUED BY DATE: J ! 3 ~ILT~/ 4 5 SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82~ L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST DATE PERFORMED: VV ~L6~? ~C [] PERCOLATION TEST SITE PLAN 10 11 12 13 14 15 16 17 18 19 2O COMMENTS JUN~ 25. ~971 ,~ ,WAS RO NDWATE" ENCOUNTERED? O P E iF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ ~ / ~'Q (minutes/inch) TEST RUN BETWEEN FT AND FT /'iV F_l~ r-E /~ t) oF u P~ ~/4 b gg PERFORMED BY: ~, .5.~ 72-008 (6/79) GRE/" R ANCHORAGE AREA EOF JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS ~ ~:) /~2'¢'~1,!¢'~1 ///¢¢~/~ PHONE ~c~/~'/~'~'~"~, SEPTIC TANK: DISTANCE :,/,~ () /~(" /~- MATERIAl FROM WELL MANUFACTURER ';- : INSIDE LENGTH -- INSIDE WIDTH LIQUID DEPTH COMPARTMENTS .LIQUID CAPACITY //~/~/~ O GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL~ BUILDING FOUNDATION ~ ADDITIONAL ABSORPTI ~_~ 1~ .A.. / ~ LENGTH:,"',/. DEPTH J DIAMETER~---/~-~'~~-: OR WIDTH ~ , ~ t i WELL ~0/I///¢/' ~//[~. CRIB SIZE: DIAMETER ge DEPTH ~ DISTANCE FROM: ~ 0 /+. TOTAL EFFECTIVE NEAREST LOT LINE ABSORPTION AREA (WALL AREA) /~/-~ '~ / ~ S~. FT. TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH DISTANCE FROM: NEAREST sePtiC SEEPAGE SEWER LINE TANK , SYSTEM REMARKS DISTANCES: LOT SLOPE: REMARKS: Form NO. EQ-031 DIAGRAM OF SYSTEM I I Greater ANCHORAGe AREA BOROUGH~-~ -- PERMIT NO. DEPARTMENT OF ENVIRONMENTAL QUALITY SEWAG£ DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT MAILING ADDRESS PHONE INSTALlaTION lOCATION ~/ ~~/~ /~/~ ~K~ INSTALLATION OF: SEPTIC TANK ~ ~ OTHER SEEPAGE Pit ~ ,DRAIN FIELD TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH ~ ~ ~ // TO BE I'STALLED BY / ~ / / $O[l T~ST RESULTS /~ /~ NOTE, T'IS PERMIT I$ NOT VALID WIT"OUT FINAL INSPECTION: 24 HOUR NOT'CE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY Will BE SUBJECT TO PROSECUTION. ! DIAGRAM OF BY~,TEM MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT "~ (~)/ , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT ., DRAIN FIELD TO NEAREST LOT LINE ~ ' WELL TO SEPTIC TANK ~ ~ , SEEPAGE PIT DRAIN F~ELD ALSO CONS}DER AREA WELLS. WATER MAIN TO SEPTIC TANK /~ , SEEPAGE CAST IRON INTO AND OUT Of SEPTIC TANK AND INTO CRIB CROSSINg GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit FiTTeD WITH AIRTight rEMOVABLe CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REgarDiNg INSTALLATION. CREATE NCHORA A BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ' GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed Legal Description:/ Lot ~-~ Block This Form Reports Soils Log ,~ Soil Test Must Be Logged To 4~ Depth Feet Soil Characteristics For ~ ~ C©~-tr~-~cr~ Dated Performed ~-~ / Subdivision__~q~¢ Percolation Test Below Proposed Seepage System 2-- 3-- 4-- 5-- 6-- 7-- w 9-- lO- ll- 12-- 13-- 14-- Was Ground Water Encountered? If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Drop _ I Percolation Rate Minute Proposed Installation: Seepage Pit Depth of Inlet Depth to COMMENTS: /~ Bottom of Drain Field Pit or Trench /~- ~ ~ Date Certified BY: Test Performed BY Date: 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. # k'~,~/-'~ - ~ ¢-~.~ -- C'~ HAA # ~:~o~ GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone 5~ / -." '/&,/~ Day phone Day phone, Agent Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 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. TYPE OF WASTEWATER DISPOSAL: 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~)25 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify tha my investigation of this Hea~th 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 further verify that based on the information obtained from the Munic pality of Anchorage flies 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: /- ~'~~ 'P ~- Phone ~_~_~ ~¢ -,~-o ~¢~ Address (P 7 ~-/ p¢.~_ ~ / t*c.f ¢,-~_.~ ' -- Engineer's signature bedrooms. DHHS SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for ~ bedrooms, with the following stipulations: Additional COmments Date 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. 72-025 (Rev, 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type A Log present (Y/N) Total depth If A, B, or C, attach ADEC letter. Date completed Cased to ADEC water system number Driller Casing height Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Wires properly protected (Y/N) FROM WELL LOG g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ ~' ~ o Absorption field on lot Public sewer main Public sewer service line WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Other bacteria Collected by: g.p.m. Compartments 1 + Depression (Y/N) Foundation. B. SEPTIC/HOLDING TANK DATA Date installed ,~ ~ ~ - --' ~ Tank size Cleanouts (Y/N) ~'~ Foundation cleanout (Y/N) High water alarm (Y/N) b//,o~ Alarm tested (Y/N) Date of pumping /-'/. ,.,~. 9/ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot t'"Y'//A- On adjacent lots /"~/'/~ To property line Absorption field Surface water/drainage Water main/service line 72q326 (Rev. 3/91)Front MOA21 ' , CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPAFIATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed / Length ;.~--- Width Tolal absorption area 77 Depression over field (Y/N) h7/ Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating ,/,.S~O System type Gravel thickness 7 / Total depth Cleanouts present (Y/N) '"/' Date of adequacy test (7/- 7~¢?' for -:~ bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well oil lot To building foundation On adjacent lots Surface water /'///~- Curtain drain On adjacent lots /'y'/"~3, Property line To existing or abandoned system on lot ~,~ '~ Cutbank /"/~'~- Water main/service line ) ~' © Driveway, parking/vehicle storage area zT/~ E. ENGINEER'S CERTIFICATION I c(.rtify that I have checked, verified, or conformed to all MOA and HAA gu eJines'ln ~fect on the date of this inspection. HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 f/: ,' Waiver Fee: $ Date of Payment Receipt Number I ! DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 WALTER J. HIOKEL, GOVERNOR 563-6775 April 30, 1991 FOR: Mr. Tobben Spurkland PWSID #210605 Valli Vue S/D My review of the records on file in this office reveals that the Valli Vue S/D Class A Public Water System is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Sincerely, /1 Keven K. Kleweno Environmental Engineer I I 6751 ~, DIHO~D BLUD. A~CHORABE~ ALASK~ 99502-3904 (907) 24B-5095 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WELl: Lot 55~ Block l~ Vatli Vue 6650 Roundtree Mark Fryer Single Familya 5 Bedreems Class A F'WSID 210605 SEPTIC SYSTEM: FROM MUNICIPAL RECSRDS: TANK: Gr'eer Steel ABSORPTION SYSTEM: ABSORPTION AREA: SOIL RA'T'I NG: INSTALLATION DATE: DATE OF LAST PUMPING: Anc:h. (3ess Pool 5 Bedr'oc)m System 1000 Anchor'age Tank 500. Crib and Trench 452 + 770 Sq. 150 ~ 1985 DATE DF TEST: April 29~ 1991 TEST PROCEDURE: System was inspected and measured. Tank was ~otl~]d with .Four ~eet o~ cover' and with a liquid level of 50 inches. (]r'ib was 93 inches cleep and contained 3S inches e~ liq- L~id. "Frencl'~ monitor tube was 9.5 .Feet deep with 10 :inches water'. 575 gallons o.~ clean water was added to the trench while the water levels in the tank and the monitor tube were monitored. The water level :i.n the tank did not. change~ while the level in t. he monitor roee 13 inches. During the next t~Jo hours the water' level dropped 7.5 inches~ ind:i, catir'ig that more than 400 gallons e~ water had been abeorbed. TEST RESULT: Depar'tment the Health and Social Services the Municipality of Anchorage. NOTE The operat:[onal l:i.~,:e ef all septic systems depends on the local soil. cc)nclitions~ groundwater levels that may ~:luctuate during the year',~ and the water usage o4: the -family being served by the system. These conditions are outside the control of the eva]uater o¢ 'hh:[s septic system. We can t. herefore not give any estimate o-¢ how long this system will Cunc;tien satis{actory 'Eot GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street~ Anchorage, Alaska 99503 274-4561 Date Received ~/~ Time of Inspection Date of Inspection 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 5'/~ Phone: Phone: 3. Legal Description: /--- 4. Location: 5. Type of facility to be inspected 6. Well Data.~ C. Construction B. Depth D. Bacterial Analysis Sewage Disposal System: A. Installed / ~7 ~ B. Installer ~ ~ Z~ ~/~ C. Septic Tank: 1. Size /~/~2. Manufacturer D. Seepage Pit: 1. Absorptio~'A~F6~ /7L~~ 2. Material E. Disposal Field: Total length of lines Distances: ~__~c/".-~,..--,_~ L~c.~ A. Well to: Septic tank Nearest lot line a~t~' , Absorption area B. Foundation to septic tank C. Absorption area' to nearest lot line __ , Sewer Lines __ , Other contamination ~ C7 ! , Absorption area L]--~/ EQ-034 (1/74) Page 1 of two pages I i Page 2 of two pages - Request for Approval of Individual S..,er & Water Facilities L~gal Description Approve ~ ~.~-~~~, ~ Disapproved Oate~-- ~ 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) 3330 'GREATER ANCHORAGE AREA 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 FHA CONV 2. Property Owner: /~L)~?D£Za ~P~)~g~zg~a~F~)xY ~/~ ~- 3. Name of Buyer: ~ ~/~ ~-~.~ Mailing Address: ~_ ~, ~F/mr~m~, DaS Phone 4. Name of Lending Institution: ~,~/<x~ ~z~ c~m/~r o Legal Description: Location: 8. Hater Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type,of S~stem: Public Utility Individual (on-site) If Individual, date of installation I I !artment of Environmental Qualit' ,.Tater and Sewer Questionnaire Date June 4-75 , Time 2 p.m. Subdivision Valli Vue Estates Owner's Name: MARK AND ALYCEMAE FRYER , Block 1 , Lot 53 Mailing Address: SRA 31F Anchorage, Alaska 99507 Questions: 1. How many bedrooms are now in your house? 5 2. How many bedrooms were in the house at the time of purchase? 3. 2 Were the basement bedroom walls "roughed in" at the time of purchase? yes 4. Was the basement bathroom plumbing "roughed in" at the time of purchase? yes 5. Did the realtor or builder inform you that you would have to enlarge the existing sewer system if you finished the basement bedroom (s) ? no 6. If on a public w, ater supply, do you always have an adequate supply of water? n/a 7. Is the pressure always adequate? 8. Who was the builder? Dale Wagner 9. Who was the home purchased from? yes Dale Wagner OTHER COMMENTS: The water system we are currently using is a community private water system.