HomeMy WebLinkAboutVALHALLA #1 BLK 4 LT 12
MUNIGIPALITY OF ANGHORAGE
9EPARTMENT O~ HE^,TH AND HUMAN SERWCES
Environmental Health Division APR I ~ ]99[
.... ora e
825 L Street, Anch g , Alaska 99502, Telephone 264-4720
WELL INSPECTI
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR
~¢~ DISTANCES
H iCh~el ~ A~o~ [~ ~ ~ Tfl SEPTIC ABSORPTION
WELL
~d~r~FROM~ TANK FIELD
~ho.ets) Permd NO. NO. o1 ~rooms WELL
LEGAL DESCRIPTION
Township, Range, Section AS-BUILT DIAGRAM {Show location of well, septic system, properly ~ines, foundation,
TANKS
~ SEPTIC ~ HOLDING
Anchor~e T~ rOOd
~atetial No. of Compartments
TYPE OF SYSTEM ~3~*~ ~ ~s r;,'~ p, i
~TRENCH ~ BED ~ W. DRAIN ~OTHER ~ $~
Depth to pipe bottom from Total depth ~rom obgina~ grade
:ill added above original grade Gravel depth beneath p~pe ~ ~ I
Or~veHength ~' Gravel width)istance between lines ET ~Q~
TOtal absorption area ~i
SO FI FT
installer Date InstaUed
WELLS
~ PRIVATE ~ OTHER tld~ntifv)
Clessigcation (A,B,G) Total Depth ~1 Cased to [1 ~ ? ~
Inslallet Date Installed; :
Municipal an~ Slate guidelines in eilacl 0n Ibis date~
72-013 (3/85)
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW910055
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:NOWLAND MICHAEL A &
OWNER ADDRESS:12015 WILDERNESS RD
ANCHORAGE, AK 99516
DATE ISSUED: 4/10/91
EXPIRATION DATE: 4/10/92
PARCEL ID:01521113
LEGAL DESCRIPTION: VALHALLA #1 BLK 4 LT 12
LOT SIZE: 16055 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
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 (iSAACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS
RECEIVED BY: ~-~'~
DATE:
DATE:
/ 9/
H~£ ,
1
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99S~q
L 12, IS q~ I/ALH/ILLA ~g2
~ tT~ PI-MN
NOT~: T,ltd ~ ,qoV
,,4 .~R b'~ Y ,~D pI~,4F
Al../. AodAT ION~
,4Rt~ A??RO.Xlhr,4 TE
"ER ANCHORAGE AREA EOF' qJGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~t~'~' ,Sg[i~/JP./I MAILING ADDRESS '-~'?Y~),~¢ ~, PHONE ~ )/z/~ %~ ~/
LOCATION ~IJ~¢~./~S' JM~¢ OP~ ~zPP/fl~ LEGAL DESCRIPTION /07,~' ~Z~ . ~ ~/q~/ZF~ ~'~, "
SEPTIC TANK:
DISTANCE D, / NUMBER OF
FROM WELL fleqo. /0f~ MANUFACTURER ~t~t(3K ,~/E~.¢ .MATERiAL~_~ec/. 2~Z¢J /~¥/¢v07 COMPARTMENTS ~O
INSIDE LENGTH ~ INSIDE WIDTH_ ~ LIQUID DEPTH ~ _LIQUID CAPACITY. /OOO GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER OR WIDTH /'~ ', LENGTH~,~, DEPTH
LINING MATERIAL ~,, (,.!/'e(~ CRIB SIZE: DIAMETER~/g(/DEPTH ~ ! DISTANCE FROM:
I ' TOTAL EFFECTIVE
BUILDING FOUNDATION ~ NEAREST LOT LINE
ADDITIONAL ABSORPTION
WELL/?~,.
ABSORPTION AREA (WALL AREA)
WELL: ~,~.Z .<.~t.o-~/% ~/&, /~/ ~
TYPE "~O~4~,t) ~IN/~IV. CONSTRUCTION ~~/ DEPTH DISTANCE FROM:
BUILDING NEAREST /O/¢ NEAREST SEPTIC /¢~J ~AGE /;¢ /
FOUNDATION LOT LINE SEWER LINE TANK , ~%-T~M .
CESSPOOL
APPROVED
OTHER SOURCES_
DISAPPROVED
REMARKS
DISTANCES:
INSTALLED BY: ~'J)
PIPE MATERIAL: &EL ~sl-~aot4 _
LOT SLOPE:
REMARKS: ~-~/
Form NO. EQ-031
DIAGRAM OF SYSTEM
DATE ~/2//,L0 .9.5~;/97~ APPROVED ,/t~tZb',UL L G.A,A,B.
GREATEr ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
33~0 IICII STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274--4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME OF APPLICANT
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK ~
TYPE AND SIZE OF FACILITY TO BE SERVED--
FINANCED THROUGH--
· OTHER
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.
MINIMUM EJISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT-
WELL ~O SEPT'C TANK /([) D , SEEPAGE PIT
WATER MAIN TO SEPTIC TANK '
SEEPAGE ~IT
CAST IRON INTO AND OUT OP SEPTIC TANK AND INTO CRIB CROSSING GAP OF
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREAT~R~NCHORA(;~ AREA BOROUGH ORDINANCE NO, 28.68 AND THAT THE ABOVE
DESCRIBED ~YSTEM IS IN ACCORDANCE WITH SAID CODE. /// / ,
PA !!~ ~i' C'F E~Iu[P, OH!%hi',L
~I~ '~ 3500 TUDOP
,
-~o~{CHORA ,E ALASKA 995n2
Performed For
Lemal
This
~ 0 I~ E ~][___ S E Iq DE lq Date Performed
Description: Lot I~- Block ~ _Suhdivision__~_~/_~l/Jj~___L~
Form Re~orts Soils Lofl_~ Percolation Test
1
Qepth
Feet
Reading Date Gross Time
Net Time
Depth to H20
Net Dr. p,
Percolation Rate
Proposed ln_~t~T)-~f~-{}7[/: fie~'r-,~rle Pit._X_ .......... Prawn Field
Depth of Inlet Depth To Bott. em r)f Pit
Cn~ENTS. . · ~--- / ........
Test Performed Bv
March 14, 1973.
WILLIAM A. £GAR, GOVERflOR
SOUTHC£NTRAL REGIONA£ OFFICE
Mr. Robert Senden
c/o Service Henshew
5577 Abbott Road
Anchorage, Alaska
SUBJECT: Lot 12, Block 4 Yalhalla Subdivision
Dear Mr, Senden: '
We have reviewed your situation in light of the interpretation of
the 40,C03 Sq. Ft. -20,000 Sq. Ft. requirement ccrtained in Section
18 AAC 72.C30 of the Department of Envircnmental Conservation Y. aste
Water Regdiations. It is our finding that since you had ownership
of the lot on or before February 5, i973 and That you fntend to
construct a private residence for your personal use, that this particular
Section of the Waste Water Regulations is not applicable in your case.
We would however advise you that of course all existin§'Borou~
Regulations are in effect and are applicable in all cases excapt
where State requirements are more stringent.
Yours truly,
Kyle % Clierry (~.)
Regional Environmental
Engineer
cc: GAAB-DEQ~'
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 .__.z_~
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
(b)
(c)
(d)
(e)
Location (address or Oirectionsl
l ~O l5 ~',l~t~ro ~.s~ fid ~ /'rno%rovqe
Applicant Name Co..cmo~ NyJ'/'zfczO Telephone: Home 3//0~' 7~¢'6"O"" Business
~f
Applicant is (check one): Lending Institution []; Owner/builder ~(,; Buyer []; Other D (explain);
Address
Real Estate Company and Agent
Address
Telephone
(f)
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family ~] Multi-Family []
Number of Bedrooms...~
Other
WATER SUPPLY
Individual Well [] Community [] Public []
Note: If comm unity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite ~ Pnblic [] 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
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage flies and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with ali Municipal end State codes, ordinances, and regulations in effect on
the date of this inspection.
NameofFirm ~(~Z~"~O/e 7'~C~,,~,¢~( .~£u'~'ce.f Telephone
Address
Date /~o./y ~ I~'~'
Approved for Z,/b,'[.O.~ _. bedrooms by, ~' Date
Approved .,~' DisapproVed Conditi~.
Terms of Conditional Approval
Engineer's Seal
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
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Lo, i.
Legal Description:
MUNICIPALITY OF ANCHORAGI!
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTIOi'I
I EGEWED
WELL DATA
Well Classification /'~"~lu~f'~ If A, B, C, D.E.C. Approved (Y/N) ~t,/'J
Well Log Present (Y/N) IV Date Completed J'nz.~ ~'/¢'/Z.~ Yield
Total Depth .~' ~2 £~ Cased to ~7 ~,,.~z Depth of Grouting
Static Water Level ?~'l Pump Set At Kd
Casing Height Above Ground jif a Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) tt~ Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot J 0~' ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot J ~) J~ L',~, ; On Adjoining Lots '~.
To Nearest Public Sewer Line
Cleanout/Manhole N,
Water Sample Collected by
Water Sample Test Results
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot N,/~.
; Date ,5- /;Z~ /~L~'
Comments
B. SEPTIC/HOLDING TANK DATA
Size
iOOO ¢):e¥(
Date Installed
Standpipes (Y/N) ~ Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N) N,A.
Holding Tank High-Water Alarm (Y/N) . N,,'?,
Separation Distances from Septic/Holding Tank:
To Water-Supply Well I ~'
To Property Line '~
To Water Main/Service Line
Course '~ t00'
No. of Compartments
Foundation Cleanout (Y/N)
Date Last Pumped
; for N,/J.
Temporary Holding Tank Permit (Y/N) N,Ig.
To Building Foundation 8~
To Disposal Field ~:],~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11184)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /'/ / ~ ¢ [ 7. ~
Width of Field i~¢
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot_ J'~,J~.
,¢6'
To Water Main/Service Line I~,A.
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
1o/l? /?H
To Property Line j 7,~"
To Existing or Abandoned System on
; On Adjoining Lots '~ i'~O ¢
To Cutbank (if present)
'-? [00 '
Comments
D. LIFT STATION j~,/),
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Bating Against NAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ,°~,~'/~'~-i¢~'''6 ~' ~'/'~'~ Date
Company /-'="{~"~/~J~
Receipt No. _~zJ[ ~ ED /~
Date of Payment
Amount: $ Z/~
Page 2 of 2
72-026 (11/84)
~-~q~r
~ XTHE~ORE F. MOORE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMBNTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all paris oil page 1. Incomplete requests will not De processed. Please allow ten(lO) days for processing.
1. PROPERTY OWN ER PHONE
J.P, & Diane R. Pace ......
MAILING ADDRESS
~2015 Wilde~esS St~ee~
PROPERTY RESIDENT ( f different from above)
Oa~maz~. F. & DazLu~ Nys%uen
2, BUYER
Carm~n F. & Dann~ N,ystuen
MAILING ADDRESS
PHONE
3~b~-7849
PHONE
3L¢,-7849
, 1201~ Wilderness S%reet~ Anohora~e~ Alaska 99~07
3. LENDING INSTITUTION
Co~t Mortgage Compaz~v
MAI LiNG ADDRESS
P.Q. BO~ 1200~ Ancho~age~ Alaska
4. REALTOR/AGENT
~o~e
IPHONE
2?9-O665
PHONE
MA LING ADDRESS
§, LEGAL OESCRIPTION
STREET LOCA~T~N
1201~ Wilderness St~ee%, Anchorage, Alaska
99507
6, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
[] SINGLE FAMILY [] Two [] Five
~ MULTIPLE FAMILY [] Three [] Six
[] Other
7. WATER SUPPLY
[] INDIVIDUAL*
COMMUNITY
PUBLIC UTI L[TY
ATTACH WELL LOG, A well log is required for al wells drilled
since June 197~. For wells drilled prior to thatdate, give well
de~th (attach log if available.)
8, SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE~
PUBLIC UTILITY
*'If individua/on-site, give installation Dale
If system is Dy6- two (2) veers Did an adequacy test is reouired
by this Department.
NOTE: TH E INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
Coast Mortgage Co
4797 Business Perk Blvd., Suite 4, P.O. Box 1200, Anchorage, Alaska 99510, Phone (907) 279-0665
October 20, 1978
Laura Ward
Enviromental Health Department
Water & Sewer Section
825 L. Street
Anchorage, Alaska 99501
RE:
Health Inspection
Lot 12, Block 4, VALHALLA SUBDIVISION
Pace, J. P & Diane
Dear Ms. Ward:
I am enclosing the report on the water test, Engineers report on the
adequacy of the sewer, and a receipt showing the septic tank on the
captioned property has been pumped.
With these enclosures you should now be in position to issue your
Certificate of Approval.
Your prompt attention to this matter will be greatly appreciated.
Mortgage Loan Processor
Enc
/mmu
Ted Fors and Associates
107 West Sixth Avenue, Suite 205 · Anchorage, Alaska 99501 · (907) 274-9517
October 18, 1978
Ms. Michelle Nelson
Coast Mortgage
P.O. Box 1200
Anchorage, AK 99510
subject: Adequacy test for septic system
Lot 12, Block 4, Valhalla Subdivision
Dear Ms. Nelson;
On October 17, 1978, we performed tests to determine the adequacy
of the septic system which serves the subject property. Based on
the percolation rate of the seepage pit, the system will adequately
serve the three bedroom house on this lot. On the same date, Issac's
Pumping Service delivered 1,000 gallons of water and they also pumped
the septic tank. This was all part of the adequacy test and a receipt
for this work is attached.
If you have any questions or we can be of further service to you,
please feel free to contact us.
Sincerely,
TED FORSI AND ASSOCIATES
Lynn Whitmore
Engineering and Survey Coordinator
NLW/psk
Attachment
cc: Les Bucholtz
Coast Mortgage Co
MUNICIPALITY ~)F ANCHORAGE
4797 Businees Park BIvd., Suite 4, P.O, Box 1200, Anchorage, Alaska 99510, Phone (9.~7~::i~TH &
ENVIRoNMENtAL
October 13, 1978
OCT 6
RECEIVED
L~u~a Ward
Enviromental Health Department
Water & Sewer Section
825 L. Street
Anchorage, Alaska 99~01
Re: Health Inspection
Lot 12, Block ~, VALHALLA SUBDIVISION
Dear Ms. Ward:
It is my understanding that your office will not issue a Certificate
of Approval on the captioned property until you have received the
following:
Report on Water results from Chem Lab;
Engineers report on the adequacy of the sewer;
Receipt showing septic ta~_k has been pumped.
With this letter I am enclosing copies of Chem Lab's report on the
water sample. The remaining two items have been ordered, and I will
see that they reach yoo_r office when they are completed.
Should auything be needed in addition to the above, I would appreciate
it if you would contact me at 27~-066~.
~Sincerely~ ~ .~
Michelle M. Nelson (Mrs.)
Mortgage Loan Processor
C C o
Department of Environmental Quality
3330 %" Street, Anchorage, Alaska 99503 274-4561
"~'--~---~--~ Date Received February
11, 1977
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.
l. Approval requested by: Alaska Bank of Conmlerce
4.
5.
6.
Mailing Address:
Property Owner:
Pouch 7-012
Gary P./Sheila Bader
Phone: 279-5641 x 317
~7~ -
Phone: -1151 (mrs.)
Mailing Address: 12015 Wilderness Drive
Legal Description: Lot 12 Block 4 Valhalla #1
Location: 12015 Wilderness Drive
Type of facility to be inspected Single Family
Well Data:
A. Type Individual
C. Construction
Sewage Disposal System:
A. Installed 1973
No. of bedrooms 3
B. Depth
D. Bacterial Analysis
On-site system
B. Installer
104'
C. Septic Tank: 1. Size
D. Seepage Pit: 1. Absorption Area
E. Disposal Field: Total length of lines
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
2. Manufacturer
2. Material
, Absorption area
, Other contamination
, Absorption area
C. Absorption area to nearest lot line
, Sewer Lines
EQ-O34 (1/74) Page 1 of two pages
P~g~ 2 of two pages - Req it for Approval of Individual S ~r & Water Facilities
Legal Description Lot 12 Block 4 Valhalla #1
Comments
Approved
I'-~( ~~.A~/Disapproved
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)
ENVI~~'E~HON 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
I:~~ 1§-/'~' REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
RECEIVED
1. Type of Inspection: CMRO. VA FHA
2. Property Owner: Bader~ Gary P. & Sheila
Mailing Address: 12015 Wilderness Road
3. Name of Buyer: Pace, Jospeh P. Jr, &D±ane R.
Mailing Address: 3444 International Airport Day Phone: 243-4316
4. Nameof Lendinglnstitution: Alaska Bank of Commerce
Mailing Address: Pouch 7012
Name of Realtor or Agent: Penny Pefanis/ Marston
Mailing Address: 2804 Northern Lights Blvd
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
~:NVIRONMENTAL PROTECTION
FEB I 1977
RECEIVED
CONV.×
DayPhone:276-1151 (her work)
Phone: 279-5641
Realty
Phone:. .... 277-3511
extension 317
Legal Description: Lot 12 BLock 4 Valhalla Subdivision #1
12015 Wilderness Road
Location:
Type of Facility to be Inspected:
SFD
No, Bdrms. three
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
104 feet
If Individual, depth of well
one
Individual
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
1973
X
Individual(on-site)
(at time house was built)
72-003(3/76)
~ GREATER ANCHORAGE AREA BOROUGH
~q~'nn T,, Department of Environmental Quality
· 0 3500 Tudor Road, Anchorage, Alaska 99507 279-8686
6~ Time of Inspection
. [ ~ b_~ Date of InspectionS7
; ~ {0 ~ REQUEST FOR APPROVAL OF
<~uN ~ I~IVIDUAL SBWER & WATER FACILITIES % '
Address: ~ ~ Phone
~ ~ ..~Phone
Type of Facility to b.. ~nspected: ~
Wel] Data:
A. Type
C. Construction
Sewage Dts.~osal System:
A. Installed / ~</~ B.
C.-Septic Tank: 1. Size ./~d'~y~2.
D. Seepage Pit~ 1. Size z/~O~/ 2,
Disposal Field:
Installer
Manufactorer
Total Length of Lines --~,,
Distances:
A. Well To:
, Nearest Lot Line /~ /~z~ , Other Con'tamination
Foundation to Septic Tank 2l~ / "~ Absorption Area
Absorption Area to Nearest Lot Line ZZ~y /
/~c/ /, Sewer Lines
Request for Approval of k
Page Two
9, Comments: ~ /Z ~//<
ividua] Sewer & Water Facilitie~
Year Prom Date Sfgned~//
Greater Anchorage Area Borough, Department of Environmenta] Quality
D%AGRAM OF SYSTBM
.3 ~°~H ~0/
I certify that the information contained in this request for approval to be a true
and accurate representation of the sub.iect sewer and water facilities located at:
,)uno 6, lg73
Coast Mortgage C~,~pany
Carolyn i~arrera
P.(). Box 1200
At)chorsge, Alaska 99510
SUBJECT: Lot 12, I)lock 4, Valhalla Subdivision #1
l)ear Ms. Barrel'a:
Yhe sewer system on tho sub.~ect 'lot ~.~as installed in compliance
with borm~gh la~ April 24, 1972.
Yhe ~ell was drilled a~ a la,er date. It is a six inch casing
and is p~'operly sealed. The depth Js unknown. N~ wa%er sample
was ~ake~ pendtnq hookup o¢ the electricity. A co~y of ~he
water report will be sent following a sampling.
Sincerely,
SUSml E. Otckerson
Sanitarian I
Robert Senden