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INSPECTION RE.P.0~RT_O_~N~-$ITE SEWAGE DISPOSAL SYSTEM
~ ~ /~ "-"--17----~ .............. 0/'/ ,~
Location ~7/5 Z ' ' ,:Tz' L a' ' ' ~ ......
SEPTIC TANK: Distance f~om well~ate~ial~L-l~ Numbe~ of compartments /
Liquid c~pac~ty ~ zallons, Inside len~th._~
' ~.- Inside wldth~iquid dep~h~
SEEPAGE SYSTEM: SeepaKe Pit: Number of pits~utside diameter
· ,./ , / / . ~
~rzdth /~ ~ length./2~ , depth~__~ l~ninE material ~ZJ~L , Distance from
well~ S~l~'~uilding fo~dation ~ , neamest lot line__----Total effects, ye
absorption area (wall amea)~~ sq,
TILE DRAIN FIELD: Distance f~om well___, fo~dation ,,, nearest lot line
Total len~h of linas_~_ Nu~er of lines.~.~istance between lines Trench
width .... ~n, Total e-:fectzve absorption area~q, ft. Length of each llne
Depth: Top of tile to finish grade Depth of filter material beneath
tile in. Above 'tile
_: ~ ~ ep~n~ ~ , dish. ce from b~ld~ng fo~dation
~_~ nearest
lot line____~ nearest sewer line~ septic tank
_~, seepage syste~ .....
cesspool .......... ~ other sources
DISTANCES:
DIAGRAM OF SYSTEM
SEWAGE DISPOSAL SYSTEM - APPLICATION &
. -. :"<71,
L~ , , ~- ,, .
Application to Install: Septic tank /, Seepage pit__, Drain field~,
To Serve the Following Facility .... /f>~/j, ~.~ ~
f .- ~ .... po/~. .
Financed Through ('o~<~!5 To b~ In~all~d
Percolation Test Results .............. '
~ : .... ~nttolpated Date of CompletionO<~
BELOW TO ~E FILLED O~ BY HEALTH DEPARTHENT
This is to serve as
DISTANCES:
Ar e a.~~Type
DIAGRAM OF SYSTEM
I certify that I am familiar 'with the requirements of Greater Anchorage Area Borough
Ordinance No. 28-68 and that the above described system is in accordance with said code,
(; HI<I2.. BY' ............... DATE ...................
,~5~ ~ E~T ~xiO ..... OF ..........
J O ,.'3 NO ...................
t
MUNICIPALITY OF ANCHORAGE
) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
~~ 825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOFI 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.
MAILING ADDRESS
PROPERTY RESIDENT (If different from'above) -- PHONE
.HON.
MA~ING
3. LENDING INSTITUTION I PHON~
MAILING ADDRESS
4. REALTOR/AGENT PHONE'
MAI LING ADDR E~S ,
LEGA'L DESCRIPTION
STREET LOCATION / /
6, TYPE OF RESIDENCE
~ SINGLE FAMILY
[] V1ULTIPLE FAMILY
7. WATER SUPPLY
INDIVIDUAL'~
[] COMMUNITY
[] PUBLIC UTILITY
NUMBER OF BEDR~MS
[] One I~ Four [] Other
[] Two [] Five
Three [] Six
ATTACH WELL LOG. A well log ~s required for all wells drilled
since June 1975. For wells drilled ~rior to that date, !live wel
depth (attach log if available.)
S, SEWAGE DISPOSAL SYSTEM
~;~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTIL TY
'~If individual/on-site, give installation date
If system is over two (2) years old an adeouacy test is required
by this Depar[ment.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
NSPECTOR' INSPECTOR INSPECTOR
D~RECTIONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[~ INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDLJAL/ON -SITE DATE INSTALLED
[~]PUBLIC UTILITY (~._ (_~ ~7
Connection Verified INSTALLER
[]Septic Tank or E~] Holding Tank
Size:_ /~~:2~ IfTank ishomemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4, DISTANCES Septic/Holding Tank Absorption Area ISewer Line Nearest Lot Line
WELL TO:
I
Absorption Area to nearest Lot Line
[] APPROVED FOR BEDROOMS
[~[~,'/CONDITIONAL A[~PROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
Tony Know/es
Mayor
ANCH
-V GE WATER & SEWER
3000 Arctic Boulevard
Anchorage, Alaska 99503
(907) 277-7622
'LITIE
Owned by the Municipahty
o! Anchorage
June 28, 1982
~: I~/nn Lindquist
Pe~' Gregg Subdivision Block 2, ~_ot 3
Sewer Availability S82-76
.The Anc_horage Water and Wastewater Utility presently has no sewer main
fronting the subject property.
Hamanchu, Inc., has presented plans to ~3 and has intentions of
extending municipal sewer to serve Lot 2 of Gregg Subdivision. The
engineer for the developer is Centrum Engineering and has estimated
project costs to be $51,410.00. AV~'~3 does have a sewer extension
agreement with the developer.
If you ~have any questions, please contact t_his office.
Sincerely,
Private Develo~.nent Supervisor
Dachorage Water & Wastewater Utility
PC: deb
PENINSULA
E NGINE:E:RING
June 24, 1982
Marry Plunker
Marston Realty
2804 W. Northern Lights Blvd.
Anchorage, AK 99503
RE: Lot 3 Block 2, Gregg Subdivision
Adequacy Test Sewage Absorption System
Dear Marry:
As per your request I have performed the adequacy test on the above
legally described lot in accordance with the Muncipality of Anchorage
recommended standard procedures.
The system consist of a septic tank (1,500 gallons) with a concrete
ring seepage pit located approximately 50 feet southeast of the ex-
isting split entry home and approximately 27 feet apart. This is
consistant with the very sketchy records that the Municipality has
on file.
The septic tank was pumped prior to beginning the test and approxi-
mately 1500 gallons were removed. Upon application of water into
the seepage pit via the standpipe the level in the septic tank began
co rise rapidly after only 70 gallons we~'e added. This is fa~ below
the required daily load of a 3 or 4 bedroom home, so I had no al-
ternative but to conclude that the system is inadequate as is.
Wayne Her~derson PE
If I can be of any further assistance on this matter please call.
Sincerely
Pumping receipt
2820 "C" Street Suite fi3 Anci]orage AK 99503
PENINSULA
ENGINEERING
ADEQUACY TEST
T 1 NE (mi n )
CI ient:
Address:
I,ega [:
Sy$ Lent:
MarLy Plunket
4100 Dailey
Lot 3 Block 2 gregg Subdivision
Septic Tank and Seepage Pit
I)EPT'll ..... I fl'fl ;'1:1 I-- .......
SI';I"I'[C TANK Sl';151b\t;E ['l.'l' _~_[~l)m) IOVfE
%fte~ pmpg
Start Lest
10 m i n
20 m i n
30 rain
m i n
m i n
m i n
m i n
m i n
m J I~
m i n
nl i n
Init]
65
O5
O5
O6
11
1
1
Test termJ
of absorpt
back into
lng adequa
37
7
3
38
38
75
3
'tO'rAh WA'FI,~R
ADDEI) ~a].) _
0 0
0 0
7 gpm 0
7 gpm 70
7 gpm 140
0 140
minutes becam
:ept effluent.
]erefore syste~
e of failure
Rapid run
not functior
aated after 3(
ion area to ac
septic tank. T
Lely.
,97/% '~-%
Subjoct: Lot. 3 Block 2 Gregg .%ubdivi:~ion
A. pi)row~l for tzhe indivi,hml sewer and water facili'tiea conno'L
granted uuti! the ~ollowlng ii:ems bore heen cora~lei;.ed:
the well for our inS[)eoi:.iop. -ho teterrlin~ proper
'P'he .~;c'.l)kJc %aBk pllm~m,ed vrilth a receLpi- submitt, ed to t'hi,9.
T!~e septic tank pumped with a receipt .c'-ub~,~it'he'.d to this
deparkmenq. 'Phc total num'oer of qal. l~ons
the actual number of gallons pu~at~ed, q.q~Jm .i.s %o w:~rify
aJ.~e of t:h<~ sep'tJc t-.ank,
Jeachinq nroa. Thi~i test
adeqt!ate at, cordino to N'a%ional
prJ. Vat:e firw~s per:~orraiug f.!~e t_esi-: :is
!'1 !~ c ]_OStlre
CHEMICAL & C, ,OGICAL LABORATORIES . ALASKA, INC~ ~
-- TELEPHONE (907)-279.4014 ANCHORAGE INDUSTRIAL CENTER
274-3364 5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
Water System Name
I,D. NO,
Phone N!o,
Mailing Address ' '-
City State
Mo. Day Year
Zip Code
SAMPLE TYPE:
[] Routine
[:] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO,
, I
1
4 1
I
LOCATION
I
1
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[];Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
[]' Membrane Filter
Lab Ref. No. Result*
J
. J F-I-1
*No of colonies/lO0 mi or No of Positive portions.
Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev. [978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collected Source
Time Received __ 3.m, Lab. NO.
Presumptive ~.0ml 10mi [0mi 10mi ]*0mi 1,0mi O,]*ml
24 Hours
48 Hours
Confirmatory
24 Hours
48 Hours
EMB
Multiple Tube Report=
Membrane Filter= Direct Count
verification= LTB
Final Membrane Filter Results_
Reported By ~
Broth 24 hours~ Broth 48 hours=
].Omi Tubas Posltlve/'rotal ZOml Portions
Collform/lO0ml
Collform/10Oml
Date
GREATER ANCHORAGE AREA BOROUGH
Department of Bnvironmental Quality
B500 Tudor Road, Anchorage, Alaska 99507 279-8686
Time of Insoection
Date of Insoection
2. ProoeYty O~ner:
3. Legal Description:
4o Location:
1. Aoproval Requested By:
Address: Phone:
Type of Facility to be Inspected:
Number of' Bedrooms:
d. Well Data:
A. Type
C. Construction
7. Sewage Disoosal System:
Ao Installed
C. Septic 'rank: lo Size
B. Depth
O. Bacterial Analysis
B. Installer
2. Manufacturer
D. Seepage Pit: 1. Size 2. Material
2. Disposal F~eld: Total Length of Lines
Distances:
A. Well To: Septic Tank ................. , Absorption Area
, Nearest go~ Line , Other Contamination
B. Foundation to Septic Tank '~ gb§orotion Area
C. Absorption Area to Nearest Ldb Line
Sewer Lines
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection __//Cgr'~O
Date of Inspection /- ~ ] -~/
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
3. Legal Description: /---~ ~_
4. Location:
5. Type of facility to be inspected
6. Well Data:
A. Type
C. Construction
FOR
Phone:
Phone:
-'g½ ~,~/~?_~..~_~/~, No. o f bed ro om s ~m~..
B. Depth "~Z'
D. Bacterial Analysis
Sewage Disposal System:
A. Installed _5/-~_]_~
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
B. Installer
1. Size //~9~2~2 ~/~2. Manufacturer
1. Absorption Area 2. Material
Total length of lines
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,,~est for Approval of Individual b_.,,~,' & Water Facilities
Legal Description /z~ ~.~___~_~_ ~__~_~Z_~
Comments
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I 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
FO-HS4 (1/74/
Request for ^porova
Page Two
9. Comments:
1 of Inoividual Sewer & Water Facilitie.
Aporoved Disapproved Date
Approval Valid for One Year Fro~ Date Signed
Greater Anchorage Area Borouoh, De?artment of Environmental Duality
D!AGRA~ OF SYST~
I certify that the information contained in this request for approval to be a true
and accurate representation of the subject sewer' and water facilities located
Signed Date
Address: ?!;one:
2.
Owne'r:
4o Local:ion;
Number of Bedrooms:
We].]. Data:
C. Cons%ruc ki ona, g _ I), )acl;ei'j a ]
E. Disposal F~.eld: Tot:a] Length of 13. rms .......
Di s'i;ances:
/ ~ ~'
A. We]J. To: Se?)~,.; '['ar,k /,~,C;) , Absorpl;ion Area /.~ , Sewer Lines
, NeaYerd: Lot l,lne..J(Z__'t ........ , Ot:.her Cont,]minat~or~ ....... ,- ............. ~.~,0
Absorption Area Lo ,~'!earesL I,ot f. ine ........................................................................... ·
2equest for Approval
t~ag~ Two
Comments:
Greater Anchorage. Area P, oro,mb, Dec¢',~, ',1' .,r ~- · .~. ~ .
, .. or r~V~?D r~.nl
()
I cer~ci'fy tha'r, the ~nfors~ation cont~.Sneq
~ u, ~)o~'o'rat i'o be a 'l;rue
and accurate represen'hal;i
S~gne, d !)a f.e