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Home My WebLink AboutZODIAK MANOR ALASKA BLK 4 LT 28 ANCHORAGE AREA B0r 'qH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME _ MAILING ADDRESS /~¢~'0, ~/?,,~/ -< 'Z~ ~...~] ,~./¢~, _ PHONE LOCATION LEGAL DESCRIPTION ~'~ ~ ~ ¢,~~, SEPTIC TANK: DISTANCE FROM WELL MANUFACTURER INSIDE LENGTH INSIDE WIDTH MATERIAL NUMBER OF _ COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY /OoO GALLONS. SEEPAGE PIT: NUMBER OF PITS / ADDITIONAL ABSORPTION DIAMETER_ ~ OR WIDTH /'~, ____ CRIB SIZE: DIAMETER NEAREST LOT LINE,~)' LE N GI'H~(-~, DEPTH J/ DEPTHS_ DISTANCE FROM: WELL /¢_~g2 TOTAL. EFFECTIVE ABSORPTION AREA (WALL AREA) 7~"/ _SQ. FT. WELL: TYPE _'~/'~ c''~'/'c~ ' CONSTRUCTION CESSPOOL - , OTHER SOURCES APPROVED ~'// _DISAPPROVED _ g~/Cd.,~.~-.¢''~ ''~ '~ ~'~'(~ DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK __, SYSTEM REMARKS DISTANCES: PIPE MATERIAL: Form No, EQ-031 oGRE' '"ER ANCHORAGE AREA BOr 'UGH Department of [:nvironmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING ADDRESS LEGAL SEPTIC TANK: DISTANCE FROM WELL//f~0 ~ANUFACTURER ,~/(~ MATERIAl INSIDE LENGTI-I _ INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS .LIQUID CAPACITY /~)(~)0 GALLONS. SEEPAGE PIT: ....... , NUMBER OF PITS / DIAMETER OR WIDTH/'-%~. LENGTH/~_-,' DEPTH LINING MA'¥ERIAL~~/ ~/~J(CRIBSIZE: DIAMEFER ~'DEPTH ~ DISTANCE FROM: BUILDING FOUNDATION ~ NEAREST LOT LINE ~D ~ TOTAL EFFECTIVE . ABSORPTION AREA (WALL AREA) ~/--¢~ .SQ. FT. ADDITIONAL ABSORPTION TYPE BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES__ DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK, SYSTEM _ DISAPPROVED____ REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: PIPE MATERIAL: //~/~,'/~ LOT SLOPE: REMARKS: Form NO, EQ-031 G.A.A.B. / PERMIT NO. DEPFIRTMENT Ok 825 "L" ( 780415 ) RPPLIC~NT L.OC¢tTION LEGFlL IMRE DEJONV PLUTO DRIVE L28 84 ZODIAK MRNOR SUBD, 8?24 PLUTO DRIVE LOT SIZE 276-4602 12~8 S6~URRE FEET TYPE OF SOIL 8BSORBTION SY2;TEM IS: TRENCH MRXlMUM NUMBER OF' BEDROOMS = 5 SOIL RFITINO (S6! F:T,'/BR)= 250 THE REQUIRED SIZE: OF THE SOIL. RBSORP'TION SVSTEM IS: TME LENGTH DIMENSION IS THE LENGTI4 <IN FEET) OF THE TRENCH OR DRRINF]:EL[:,. THE DEPTH OF 8 TRENCM OR PIT ~S THE DISTRNCE BETHEEN THE SURFPiCE OF THE GROUND FIND THE BO'¥TOM OF THE E~'.;C:FtVRTION (IN FEE;T). THERE IS NO SET NIDTH FOR TRENCHES. THE (~RRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BIETHEEN THE OU'rFRLL PIPE RND THE BOTTOM OF THE EXCBVFITION (IN FEET). PERMIT FIPPLICFtNT HFIS ]'HE RESPONSIBILITY TO INFORM THIS DEPFiRTI'"IENT DUf~:INO THE INSTFtLLFITION INSPECTIONS OF RNV !.4ELLS FIDJFICENT TO THIS PROPERTV FIND THE NUMBER OF RESIDENCES THRT ]'HE WEI..L WILL SERVE. BFICKFIL_I_ING OF RNV SVSTF.'M WITHOUT FINRI_ INSPECTION RND BPPROVRL B"r' THIS DEPBRTMENT WII_L BE SUBJECT TO PROSECUTION. MINIMUf'I DISTFIMCE BETNEEN R HELl.. FIND EINY ON-SITE SEWRGE DISPOSRL SYSTEr'I IS ~8 FEE]' FOR R PRIVATE 1.4ELL; OR ~.Se "fO 2Be FEET FROM R PtJBI..1C WELL DEPENDING UPON THIS T'¢PE OF PUBLIC WEL. L. OTHER REC4UIREMEMTS 1,1RV FIPF'L'¢. SPECIFICBTIONS RND COI'.4STRUCTION [)IRGRFIMS RRE f4VR~LRBLE TO ~NSURE PROPER ~NSTRLLRT[ON. I CERTIF'¢ THRT 1: IRM F~I'IILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS I~S SET FORTH BV THE MUNICIPFILITY OF RNCHORFIOE. 2: I WILL INSTRLL THE S'¢STEI'I IN RCCORDRNCE WITH THE OODES. 3: I UNDERSTRNO THAT THE ON-SITE SEWER SVSTEM MRV REQUIRE ENLRRGEMENT IF TME RESIt)fi}N~3E. IS R~[~.?~T~:NC:I.UDE FIOI:~E THRN 5 BEDROOI'SS. GREATER ANCHORAGE AREA BOROUGH BEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.- SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT COMPL. ETION DATE ANTICIPATED NOTEI THIB PERMIT IS NOT VALID WITHOUT SOIL TES'I' FINAL INSPECTION: 24 NOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION, :'~'~' ~' EPAGE AREA SIZE /~ /~ E MINIMUM DI,~TANCE$, REQUIREMENTB FOUNDATION TO SEPTIC TANK FOUNDATION TO seePAGE PIT SEPTIC TANK TO SEEPAGE PIT WAL{ SEPTIC TANK TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAiN TO SEPTIC TANK DRAIN FIELD TO RIVER. LAKE, STREAM. DRAIN FIELD .... DRAIN FIELD - ., SEEPAGE PIT __ ./~/ 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. DIAGRAM OF SYSTEM GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DESCRIBED SYSTEM IS In ACCORDANCE WITH SAID CODE.I CERTIFY T~-IAT I AM FAMILIAR WITH THE REQUIREMENTS OF ~ ~.~..GREA CHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND '}'HAT THE ABOVE ~ ~/ //?~/(~/ APPLICANT'S SIGNATURL/~ GREATER ANCHORAGE AREA E~OROUGI-~ SEWAGE DISPOSAL SYSTEM ~- APPLICATION AND PERMIT NAME Of APPLICANT-'~*~q'-~ -- ~///~L~?4J~ ~* MAILING ADDRESS ~/~ ~" *~ ~* /-~ ~--~PHONE TYPe ANd $1ZL Of fACilitY TO be servED -.-- 7/~ NOTE= TH[8 PERMIT IS NOT VALID WITHOUT 80lb SEPTIC TANK SIZE /~'~ ~k~ TYPE 2-0 / WeL. TO SEPTIC 'rANK /~) / SEEPAGE P,~ /~ SEPTIC TANK, /O-v / / ¢ , 5gEPAGE Pit -- ----, DRAIN FIELD OR Performed For BodneP-Wag~eP Inc. Date Performed Legal ~escrintion: Lot2~ Block ~+ This ~orm Re~orts Soils Loq ~s 4-22-74 Subdivision Zodiak Hanor Percolation Test ~eoth Feet Soil Characteristics 1 -- Overbumden Si~ty Gravely Sand thruout; depth Bottom of Test pit -1~'~ ft. Nas 6round Water Encountered? No If Yes, At what Depth? .%. · Reading Date G Y.,'J s s Time Net Time Depth to H20 Perco'lation Rate !!i nut,:, Proposed Inst~l 1~'~ .... ~,~,l;: Sea~:o[m Pit ~,~s Drain Field Depth of Islet "~ ~ otb To Bottom Of Pit Or NO b :d]~oc' c)z' ~..', :r.' ..... L~ ~ be2. ow seepage pJb Net Droll l'rench '~est Performed By Jr,, Mac.: Data Certified By: Construction Bate: MUNICIPALITY OF ANCHORAGI" DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH cERTiFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE sEWEB AND WATER FACILITY 264-4720 Apptication Date - ~,¢~Z~--~--~-- GENERAL iNFORMATiON Legal Description (include lot, block, subdivision, section, township, range) Location (address or directioes) Telephone: Home ::-'-'-'-'-'-'-'-'-~6~f~l~ Business ~'~'~'~'~'~'~'~'~'~--~:L~'Z'-- explain); ~ 7elephone (d) Lending Institution -~¢ Address (e) Real Estate Company and Agent Address Telephone Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~ Multi-FamilY El Other Number oI Bedrooms _~lCf-,-~-~-~--~ WATER SUPPLY individual Well [~L Community[Z] public ~ ~fir marion from the State Oepartr~nent ol Env,ronmental Conservatl°n Note: Il community well system, must have written 6o. ' attesting to the legality and status. sEWAGE DISPOSAL Onsite ~'. Public [] Community [] Holding Tank F'] Note: ti community wetl system, must have written confirmation from the State attesting to the legality and status. Department oI Environmental Conservation Page I of 2 ENGINE£HH,,tG 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 arrd adequate for the number of bedrooms and type of structure indicated herein. [ further verily 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 ~;~¢,r'~,~:r~.ecl¢;Ic,~ Telephone _="~¢r(,, Itr'/~ Address ~(~[ ~f~,~,~'~t,J ~r-.k '~ qO,~l~ Date ~-~ 'R~ Engineer's Seal DHEP APPROVAL Approved for Approved i)edroomsby__/'4~'¢'~' /~)' '""')/~"/~">'~'-~" Date 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 tile 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 tl~eir lending institutions in order to satisfy certain federal and state requirements. Employees el DHEP do not conduct inspections or analyze data before a cedificate 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 AUTHOR|TY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: . MUNICIPALITY OF ANCftORAGE DEPT. OF HI!ALTH & ENVIRONMENTAL PROTliCTION CJAR o 4 lg88 R :r :IVED_ WELL DATA Well Classification Well Log Present (Y/N) ~--- Total Depth ¢_~n,~ Cased to Static Water Level ~(~ ~ Casing Fleight Above Ground ___ Electrical Wiring in Conduit (Y/N) Separation Distances from Well: If A, B, C, D.E.C. Approved (Y/N) -~ Date Completed ¢~1~.~,~. Yield Depth of Grouting ~ PumP Set At ~.l~¢~,~,- Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) . To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot _ To Nearest Public Sewer Line Cleanout/Manhole _ Water Sample Collected by D~I_. Water Sample Test Results Y ; On Adjoining Lots 1~' t~'~" ; On Adjoining Lots i0'~3 ___ To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Comments SEPTIC/HOLDING TANK DAT% ~,)t? a>~' ~¢ ¢'~-~'~¢¢/~1 Date Installed ~/~'~ Size. __ NO. of Compartments -'.~ Standpipes (Y/N) _ ~ Air-tight Caps (Y/N) ~/ __ Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) . ~-- Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ To Property Line _ _~-~ TO Water Main/Service Line -'": ~ Date Last Pumped ; fei' Temporary Holding Tank permit (Y/N) To Building Foundation 4~ To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field .~, "~ Type of System Design Length of Field Depth of Field I Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well . I ~ To Building Foundation ,,~ Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line ,~"~ To Existing or Abandoned System on ; On Adjoining Lots ~ (~"~ ~ To Cutbank (if present) LIFT STATION Date Installed % Dimensions J ,,S, ize in Gallons_ '"~.~. Man/(Y/N) _ Pump On" Level at ~ .-/'~Pump Off" Level at _ High Water Alarm Level at ~ Vent (Y/N) __ Tested for ~./"/ ~...~Pumping..._ Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) _./~ ~ Comments J ~ ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have ch.e, cked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ ~ Date ~- -~,~(~ Company ~&-~.~-- ~ &~,~c;~lz$ MOA No. ~m ~-ZZ~ Receipt No. *~ R'~'~ '~ Date of Payment '~'-~-~ Amount: $ ~ ~ o~ Engineer's Seal Page 2 of 2 72-026 (1 $/84) '--.'- O^TE RECEIVED (. INSPI:CTION APPOINTMENTS ~[ME I TIME TIME ' IN PECTOR ~SPECTOR INSPECTOR~ -- ~NVIRONMEN h,'& MUNICIPALITY OF ANCHORAGE 825 g Street- Anchorage, Alaska 99501 MAR 2 4 1980 ~ ENVIRONMENTAl. SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing. ~1 LING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. RUYE~ PHONE ~AI LING ADDR ESS 3, LENDING INSTITUTION ¢ PHONE MAILING APl)RES 4. R"~TO~?ENT ' ' PHONE MAILING AD~R ESS ~, LEGAL DESCRIPTION ~TR LET LOCATION 6. TYPE OF RESIDENCE ~iUMBER OF~BEDROOMS [] One ~ Four ~ SINGLE FAMILY Z~] Two ~ Five [] MULTIPLE FAMILY L~_ Three [] Six [] Other WATE UPPLY NDIVIDUAL* ' ATTACH WELl. LOG. A we ng s required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that aate, give wel [] PUBLIC UTI LITY depth (attach Icg if available.) 8, SEWAGE DISPOSAL SYSTEM I~ INDIVIDUAL/ON-SITE"* ~/'~ YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTI LITY .~.~a/~,. NOTE: THE INSPECTION FEE MUST ACCOMPANY [;ACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] OTHER [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] I NDIVI DUAL/ON -SITE E~ PUBLIC UTILITY Connection Verified []Septic Tank or []Holding Tank Size: / OC~ If Tank is homemade give d~ TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: , Absorption Area to nearest Lot Line PERMIT NUMBER INSTALLER SOl LS RATING MANUFACTURER MATERIAL Septic/Holding Tank Absorotion Area Sewer Line INearest Lot Line 5, COMMENTS DATE I~APPROVED FOR ~,~2'~ BEDROOMS [] CONDITIONAL APPROVAL (latter must accompany certificate) [] DISAPPROVEDBY~'~ C~ 72-010 (Rev. 6/79) ~.~__~ MUNICIPALITY OF ANCHORAGE //~j~ , DEPARTM~N ~)F iEALTH AND ENVIRONMENT '[[k~[~/i 8~2~ ], Street, Anchorac~, Alaska _.- I~ ~p ~ ~'~ DaEe Received =2: REQUEol FOR APPROVAL OF PROTECT I ON 9950] Septe_raber 14, 1977 Time ~L~) ~ Insp ~ ...... Lending Institution Request: ___ Mailing Address:' INDIVIDUAL SEWER AND WATER FACILITIES~z<~_~_ Phone: Properny Owner: . ([{q~me_qui_ty) Co~_~[r Phone: Mailing Address: -~ Clair Ramsey3_ Jack White Co.~ 277-1553 3. Legal Description: Lot 28 Block 4 Zodiak Manor 4: Single Family Residence: (x) Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Well System: Individual well (x) Community/Public System ( ) Permit = Depth ef Well Well Log on File Consnruc uion Bacterial Analysis 6. Sewage Disposal Sysaem: On-site Sysnem (x) Public Utility ( ) Permit ,[ Ins~al].od ~9 7~_.~,Ins=aller ~ Septic Tank Size . I,*OO Manufacturer Absorption Area '~.. Soils ~ate * S~ Material Distances: Well to Septic Tank to Abserption Area to Sewer Line~ Nearest Lot line Absorption Area Page Two D~partment of IIealth and Envlronmenmal ProLec'mlon Reguest for Approw~l ¢)~ individual Sewer and Water Pac~].~ties Legal Description: Lot 28 Block 4 Zodiak Manor Subdivision Attached: Department Worksheet_: GREATER ANCHORAGE AREA BOROUGH } Department of Environmental Quality ~,i~-~o, Anchorage, A1 aska 99503 - 27'4~6561 REQUEST FOR APPROVAL OF ,~,...~:~.~'a--~ INDIVIDUAL SEWER & WATER FACILITIES ~ Type of Inspection. CMRO ~ VA ~~HA Mailing Address: Day Phone Name of Lending Institution: Phone Mailing Address: _ Name of Realtor or Agent: CZ~±r ~am~¥ 5ack Wh±te ~x Mailing Address: 3~01 C St. 99S03 Phone ~77-Z~53 Legal Description: Lot 28, Blk 4, .Zodiak Manor Location: Zodiak Manor 7. 'Type of Facility to 8. Water Supply be inspected: house Type of Supply: Public If Individual, 'number of If Individual, depth of well not kno~m Sewage Disposal ·System Type of System: Public Utility . If Individual, date of installation No. Bdrms. ~ B Utility . Individual XXX dwellings presently served one Individual (on-site) not k~ox,m XXX MUNICIPALITY OF ANCHORAGE DEPARTMENT OF FIE/~LTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION .'~ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ,'. CERTIFICATE OF INSPECTION SEWER AND WATER FACiLiTIES 1, PROPERTY OWNER '., MAILING ADDRESS 2. LEGAL DESCRIPTION 3. TYPE DWELLING ./ I~/'SINGLE FAMIt_Y RESIDENCE MULTIPLE FAMILY RESIDENCE OTHER (Describe) ~. WATER SUPPt. Y INDIVIDDAL COMMUNITY/PUBLIC SEWAGE DISPOSAL. F__-i/- INDIVIDUAL/ON*SITE [Z3 PUBLIC UI'ILI"i'Y [13 HOLDING TANK (Maintenance Required) ~' APPROVED FOR ___~) ...... BEDROOMS LT_] CONDITIONAL APPROVAL (See Attached) E_q DISAPPROVED DATE 72-014 (3t78) - BY (TI'rLE) ., /) 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 Mailing Address: Property Owner: Phone: Phone: Mailing Address: 3. Legal Description: ~ ,~'~ 4. Location: /~,~,~r~,), _.~)~_.~_ 5. Type of facility to be inspected 6. Well Data: C. Construction 7. Sewage Disposal System: No. of bedrooms B. Depth D. Bacterial Analysis ~,/~_~ C. Septic 'Tank: l. Size~/~O _ 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank _, Absorption area /g~ __., Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Req..~st for Approval of Individual S~ .er & Water Facilities Approved Greater Anchorage Area Borough, Department of Environmental Quality Approval Valid 'For one year from date signed DIAGRAM OF SYSTEM I certify that the information contained in this request fer 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) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-~4561 Date Received~.~3.~.~~._.~_C'L.~( Time of Inspection Date of Inspection~-,~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. Location: ,~ ~'~1 5. Type of facility to be inspected~,~_/~ 6. Well Data: [(~_~-L~, NO. of bedrooms c~ _ A. Type B. Depth C. Construction D. Bacterial Analysis Sewage Disposal System: ~'~L~-~ A. Installed B. Installer//· C. Septic l'ank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area ., Sewer Lines ..... , Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re st for Approval of Individual er & Water Facilities Legal Description c~¥k{ :~ ~lc~ L~ ~-r,i~n~. ~-'~:~t~w~, Comments App~val ~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) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALI'FY 3330 "C" Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNiCiFALITY OF ANCHORAQ~ DEFA~hLi i'.!T OF H~ALFH & JA FI :i. 9 RELt:IV[D Type of Inspection: CMRO VA FHA CONV__~ Property Owner: Mailing Address: Name of Buyer: ~ Mailing Address: Day Phone Day Phone .~-.~-~; 4. Name of Lending Institution: Mailing Address: 5, Name of Realtor or Agent:_~Z~/~/ Mailing Address: Phone ~- 7 ~-~ -:~ / / 6. Legal Description: _/-- a-~'Z£/ 7, Type of Facility to be inspected: / 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System .z~.,_~..~. ) ./ ,d:;',Cd'. _ No, Bdrms. ? Individual Type of System: Public Utility Individual (on-site) If Individual, date of installation ~/k',~z..-¢-- ..,¢/..~z' ~.~ /.~Zz/~? EQ-037 (1/74) NEP'FUNIE .... i~¥ / / 12 151 -~}>- 12 Y 158 Hidden Lake Area Reference Map-P12 N~vember 3~ 1977 Clair Ramsay Jack Whit~ Company 3201 C Str~e~ ~%¢horag'~, Alaska 99503 Subj¢:ct~ Lot 28 Block 4 Zodlak Manor Subdivision ~%n adaquacy t~st on t;h(~ se~r system for '~h~ subje~e prope, r ty failed. Al% up%trade of th~ absorption area consisting of a leach-. line added to the existing s~apaga pit is r~quired. Specifications for the upgrade ars a,~l follows: Length '-' thirty-two(32) ~e~t Graw~l depth - eight(8) legit 9.~otal dopth to be the same as tho existing pit. A permi%: is required and a fee of $20.00 is required for the If there are any further questions, please contact this office at 264-4'720. Sincerely, Les N. Bue~'~olz, R.,~. Sanitarian -2'1- % I hereby certify thrtt I ]lave surveyed the following