Loading...
HomeMy WebLinkAboutGREY LT 1\© NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl_ PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 82_5 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS z/~ .-'O N E 1 ,-~ NEW UPGRADE LEGAL DESCRIPTION F r [Well I Absorption a,ea l Dwelling PERMIT NO, /o / DISTANCE TO: / ~ ~ /E ~ /M~.,,,.~,.,~, ~~ -- I Mat~ria~ No. of compartments ~ ~Lq. capacty riga o~sl t I Insidelengt /Widt~ ~q~ :5~ I DISTANCE TO: ~ ~"~-~ I ~ ~- - ~- - I .......... W~, -~~~ ~7~~ 2'r F I / ~ ~ ~ ~]~ ~ Length of each I .... ~ Fatal length of lines t T ..... h widtl~ - ~tance b~b~een lines ' ~ ~ ~ ~C'~'~¢~ grade .... t ~¢e~Tal beneath tile _ ~ Total ~fective al~rp~tion area ~~ ~ ~i~ ¢ ~ ~~~ Type of cri / ' r b d amete . C '~ epth Tota~ef ~ vea~ ~ ~__r_SOrpt O ~ area .~-'¢'" ~ ~~ TO: ~ ~ Build~oundation ~eares, Io~ line ~ ~ I ........ Building foundation :Sower lin~ ~e~t,% t~,~%7 ........... OTHER PIPE MATERIALS SOIL TEST RATING INSTALL~_ ~/-- ~ LAPPROVED /-) DATE LEGAL !..[!i(Ji!:::!L L..[Y'F :I. BEV; :1. THE t..ENGTH D!i'"IEN':'~i;I ON !iii; THE L. ENGTFI THE DEPTH OF Ft 'l'[;i:l~ii:!'.,!C:l...! O[~'. F'.I:T ]:S 'THE: L':,I::~;TFIN(:::E: E',ETNE!ZN THE:: SL.f!:;i:FF:!C:I!L' OF THE: G!:;i:Ot...IND FIND THE P, Cq'TOM OF THE EiJ:'O:L:FIVFITt ON ,:: :I: 1",I !:::EE:T ::,. 'TH[!i:I:;~:E Z i.:.'i; NO SET !,.!II?T'H I'::O1:;11 Tiq:E]",!CHES. I'HE (}it:;iiF!VEI.. [:,[EF"!"I-! :I: ':'~; T'l'"t[!i: t"! ~ B! I t'"!LIt'"! [:,[~:P'['H OF' I::!N[." THE !BCFI'TOM CtF THE Ei>:iC:FIVI::I'I"ION ( ZN FEi:ET). l:::'!~::F;iff, t :!: "f' F:!PI:::'!... I ~:J:I:::I!'-,!T ,Li!::IS "iq-tE: I:;;ff:Z'.:~.;I::'C!I'.,iS :i: IB I L :[ "1'¥ "1:'1:3 _1: Niz'CiF;;ff,! TH :I: :i:~; D!!~F'F:IF;?.T'MF..':i'.! T' [:,Lt!;;: i F,]i:Ji ]'!."!!Z :[ N:i!;TF:IL.I._I:::!"!'Z ON ! N'i~;F'[!:C:T i ONS OF F'!N"r' I,.!E!..I..S F~l::,..)'l::lC:li-:]q"[' TO TH I Iii; I:;:'i:~?.OF:'E:!:;¥!'"r' FII".![:' !"HE I'.,ll...If"l[ii~lli:!;i: OF [~'.E:ili; ! I:)Et",!CES THI::tT THE 14EI_L !,1 ! LL Eq:ICI<F :!: L!_ Z i"-tG OF::' I::IN"? S"r':~i;"!'EM !4 Z 'T'!~IOUT F: i !",!FIL. :[ i",!SP.'E!:C:T :[ O!",! FfI",I[:' !::IF"!::'[~:CIVFIL. iB"~" T'H I S DI~]:'I:::I!:'?.T'MEN]" !,.!IL.!.. BI{ SI..I[i?,..]'[~'ECT ]"O f"l :I: N I MI..IM D :I: S'I"FII",!CE [?.['-:: T!.'.IE~::[.(N F! I'.!I'ZL.I_ F::IF,I[::' F:IB!"r' ON-S I TE SEii:I.'.IFiGE [:' :f: :!!i;POSI::IL SY:B'TI:~]'"I :!: S ::!.r:i!Ki) F'EE'!" t:::Ol;~l f::! !;':'I:;iiIVFIT!?:: NEI_L OF~: :l.!!."il~)TO .2!Zl~.'3 F:Ii'ZET t:::'F~:(::I!'"I F::I I:::'IJ[~IL..!I]: l,.l[!i:i....L UF'OI",! THE T"r'F'E O1::: PI...I[3L ): C I'!E!..L. MIN:[MUI"! DISTFIIqC:E FF':OM F~ PI::~:IVf::iT[~: I.'.IEL. L. 'T'O F! t::'I:;~:IVFITIZ ;'2.';EI.,.![~::F;?. I...INi:-:: [::i; 2(:.!i l:::'!i!:!~i:"r' TO Fl COI"!MU!",IIT'~" SE!'.IE[;: I...II",!E IS '?5 i'::'E([~:T. O]"Ht:~]~: I:-:.':I!!i:QIJ :1: !:~:EME,NTS f'lFl"¢" I::tI::'F'L.V. S!::'EC: I [:' ]: CFIT _T. Ot"Z:!i; F:IND C:()?'4STF;:UC I" I Cll",I [:' :l: FI[~iFiZ:!h'I'J~; !:::!VI:::IIt_.F:IE',L[i: "1'O II"4:iSt...IfE:[i!: P!:;~i[)F'~:~: :!: C: E I:;;:'1" I F"r' "!" H F! T ::L: I F:IM FFI!'"I!L...T.F!I~: I.'.iI'T'H TFI[:~: F~:[i!:QU!!:;i:[ii]'"II~i]qTS l:::'O~: OI",!-':i;IT!Z !i;E!'.IE,?!!; I::IN[:' !.'IE!..L.S F:!rF:; SET FORTH E?'? THE: MUN 2: ): I.'.!:I:LL Z[i",IS~!':IL.L. THE: ~?'r'rE;"FEM ]:l",l ::::::::::::::::::::::::::::::::::: !4]:7H THE CODES. 2:: I i.J!",I[)IEf;[:STF!N[:' THf::IT THE O!",!-SITI{[~: !~;EI'.IEI:~: '[?'r'ST[~]"I Mfr'? I;::E(~&.ItP. I~: ENLI:::!!:;;:(FJEME]"J'? ~i:::' THE B:ES ! I::qE!",!C:E ~: S REM(3DELELP' TO ]: NCL. U[:'E !"'IOI:~:E THFII",I ':!. BE[:'[;:(:)Oi-'!'.~;. ZX l~: ::'L. :,: (::~fJT .,? :,: M l:;;: i SI.:::E~: ................................................................ .,. ............. ................... .......... :__.........,. .... , ............ NAME -- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT [] NEW ~:/PG R AD E ~OCATION NO. OF BEDROOMS IWel, ~ ~ , Absorption area Dwel/i PERM ITN~/ '.. DISTANCE TO: Manufacturer {Li{. capacity in ga onsl Inside length / ~ ~ ~ F HOMEMADE: DISTANCE TO: Well~ ~ ~Dwelling PERMITNO. Manufacturer / ~/ f ~" ~Material Liquidcapacityingallons No, of lines ......... Length of each line Total length of lines ~ I Trench width Distance between lines / I ~ ~z / ~2 ~ '1 inches tde to flmsh grade ~ngth Width Depth PERMIT NO. Type of crib ~/ ~ibdiameter Crib depth Total effective absorptiona,ea ~DIST~N~T~: ~ Wel, Building foundation ICbss ~ ~ Depth - Driller ~~ PERMIT NO. ~ANCE TO Budding foundation Sewe~ line OTHER PIPE MATERIALS SOIL TEST RATING ,4 APPROVED LEGAL !r'li::l::.:;]]!"lU!"t I'., It','IE:t!~];;: CIF' E:Ei)~;:(3C~HS .... E..,, E::L F '¥' il-....,~ ....... THE 'THE; E:,ET:'TH I:IF I:1 '!"[;;E]6I(::H I];IFi: F']:T IS THE; D ZST!::II'.,ICE E',i~:THE;E%I 'I'T.II~:; :];iJ~:FFI(';;IJ~; ('II:::' '!'H!E GF;?.CH.JFI!::, FINE:, THE ".'HE ';~'.:.VF:.. [: F3:'"I"H I ~::; THE: .',1 ! H i FILIH !",E;F"T'F.! (:IF' ('~iF;:F!',,,'EI... ~ETI,.!E:EI'.,I 'THIE : .. ".?'F!_.I !:::' ]: PIE F!I'.,E) THE ii3()FT(:~h'i O1::' THE E;::<;E:FI'v'I:::I-I"]:Ed'.4 ,:; Il",! FEET). - :-i i1.T , t" [::..G" .. i::IPF'I.. :l: CFIi'4T HFI:.:.'; "r'Hl'~: RE:fSP(:H'.,!:!:_:; :1: E', Z L .f. T':' 'T'(:) :[ I'.,IF:'OP;:H "l-hi T '::; !:::,E:F'F:IF:'T'H~.::h!T ",t IF'" I'.,F":i THE :f:i'-l'):i':"l:::l ....... Ft'.':f'fl'.,! ]:h,Ji!}:;F'i:i:(:::T:[Ol'.,!? I:iF I:;II",I'T' I-,!!-:'I._L':: !::I[::'.]'I:;ICEi",IT TO 'f'HT?.; F'r::i::I::'Ei~:'T".r' Ri'4D TI'4, E!: HLIr,!E:t:ii:i:;i: OF I:; '. IE ':": ]: DEN :::F:.::'-::!; THFf'f' THE: 14E::L L. 14 :ri ..... i::iE!:., E. !','! ! ~.,I ]: !',!L!!',! !:::, I STFII'.ilCE BI~]TI.,I!E!!::~'.,I I;';..' !,.!EL.!... F:fi'.,IE:, I::iI'.:!V OiH-:'!:; :[ TIE :~;E'I,IF:iGE E:, :l.!2:.iEi !:::iEfET F'E~F: !::! P~?.](',,,'I;:I"['!E H!!::iI...I... EIF..: :]..5E¢ TO 2~!u;.)!:::'EE'T' FF:Eff"t FI !:'l J i:.', !... I (": UF:'IJ)!'.,I THE TYF'!E OF Pt..IEfl...]:C I',I!t',iIHLII"! D!:::;TFIt'.,!E;E!; I:'F:Oh! I::1 .r.:',~:]i'v'F!TE I.,.If::L!... 'T'O F! PFi'.I',,,'RT!::: SE;!.4!i:f:~: !..INE i!i~ii; ?.!!:; FEET "IQ !:;;I CEH"!HUH];T'T' SDiI,.IEF:~ L.i(HE :[:~i; 7~:.i FEET. O'TFI!i:I;'. RE(.%I I F?.E]"!E;N"!"::i; r,IF!'./ F:IPF'!..H. SF:'E(i: I F I CFI-f' ir. ot,.,!:!~; i::f!,.,!!) !::t'v'l:::! i!; !....,¢:1[~,,!..!~; T'() ! i'.,IS;I_.II:;:~; F'I-?OPEF: I t',ISTFiI....!...FiT 1!1 :[ C:E:F;:-I" I F:'"r' 'I"HF!T ::1..: ]: F!h! F:'I'"':I!'"I:[I..:(Flf~: I,.I):TH THE: FOI:;::TH !3"r' THE: !'dLIN:t:C:(F'RL:I:'I"¢ OF:' RNCH(:)R:FIGE:. ;:~:: :l: !.,.!:!:L..L IH:E;TRM.. THE :5"r'STE:H :IN FI(:::(::ORDFINCE !.,lZ-l'!l THE E:E~[::'EG:;. Z:: :1: I. JhiE:'EF::STFINE:' FhlFI'T~T'iE: ON'-'S:I:TE ::~EI,.I~:~F: ::"r'STEH !4FI'T' F:EO;;il..I:[I:;::E: EI",i~.!:ZlIt::(:ii::HE:I",FF il:;:' 'T'F!t:E f;':::'q': ')l::h!(::[:: ]::: ~:: EF'It:il)E!~:~:, '~'!:1 \ ~'"SO~LS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 ?64-4720 SOILS LOG - PERCOI.ATION TEST [~/~PERCO LATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 5 6 7 8 SLOPE SITE PLAN 10- 11 12 --13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER S ENCOUNTERED? ~/~o~ ~ P E IF YES, ATWHAT ~ DEPTH? ~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ,~- ff (minutes/inch) CERTIFIEDB.: ~' / 72-008 (6/79) oGRE 'ER ANCHORAGE AREA BOr Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 'UGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM MAILING ADDRESS ~)C, ~,~t::t,,~ L: PHONE SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH / MANUFACTURER MATERIAL NUMBER OF COMPARTMENTS INSIDE WIDTH __LIQUID DEPTH LIQUID CAPACITY_ ''~) ~-( GALLONS. SEEPAGE PIT: / NUMBER OF PITS / DIAMETER OR WIDTH~)L/'-: LENGTH'';~ ;~(~EPTH - CRIB SIZE: "DIAMETER__.DEPTH DISTANCE FROM: WELL · ~? TOTAL EFFECTIVE BUILDING FOUNDATION____ NEAREST LOT LINE''~ t0/:- ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED NEAREST SEWER LINE REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK ____ SYSTEM DISTANCES: INSTALLED BY: PIPE MATERIAL: Form NO, EQ-031 DIAGRAM OF SYSTEM APPROVED G.A.A.B. / GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMBNTAL QUALITY PERMIT NO. 3330 "C" STIFF., .ET ANCHORAGE, ALASKA 99503 / SAWAGE DISPOSAL SYSTEM ~ APPLICATION ANg P~RMIT L~GAL DESCRIPTION '/-' ~, INSTALLATION OF: SEPTIC TANK SEEPAGE PIT ...... DRAIN FIELD , OTNER COMPLETIDN DATE ANTICIPATED ...... FINAL INSPECTION: 24 NOU~ NOTICE RE(~tJIREB, BACKFILLING OF ANY SYSTF:M WITHOUT FiNAl INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL (.!UALITY AUTHORITY WILL BE SUBJECT FO PROSECUTION. / Y/ TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, _J/~2(~I'~ . SEEPAGE PIT , SEEPAGE PIT__(?'~k' DRAIN EIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. TO RIVER, LAKE, STREAM, /9 2/¢'x-g ' T,PE EXCAVA'f'ION S FEET INTO UNDI~R~I~-SOiFL~ .... GRAVEL BACt{FILL ' CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. LICENSED D R I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GRE/~TER ANCHORAGE AREA BO~OUGN ORDINANCE NO, 28-68 AND THAT THE ABOVE 3500 I'UDOR ROAD ANCHORAGE,, ALASKA 99502 ...... . ... ~.av P,'zte Performo/ AugJ.~t'20, i973 . 'H~?'Ft~Pa'ieeu N<sF Douglas ~,' ........ Legal Description: Lot t Block Subdivision. G~. This Form Reports Soils-L~g x~ Depth Feet 12~ Soil Characteristics Brown silt .,,77 ~""-- (ML) Gray sandy silty gravel (GM) dense with coarse gravel vez'y dense by 13 Very dense gravelly silt Was Ground Water En'cou~tered? N__9__.o If Yes,'At What Depth?_~, ...... Reading Date ?ercol te Gross Time Net Time ~[{nu te Depth to H20 Net Dro Proposed InstaT~'~-~70n' ' Seepage Pit xx Drain Field O, ~nlet Depth To Bottom Of Pit Or Trench Depth ~ ~ CONMENTS~' 228 ?_~.~t of drainage area is~ bedroom at ~th of 3' to 14' ~7~"~~~y.. R., E, Carlisle .... ~,, ~ " D a t e: ~g~~ :.,~.,,~,o~ MINERAL & MATBR~LS LAB, INC; M PT. O! N VHt NMENT % CONSER¥ T]ON September 21, 1973. WILL~AMA EGAN,, GOVERNOR 338 DENALI STREET /J4ACKAYBUILDING. ANCHORAGE 995(71 Mr. Rol:f Strickland Dept. of Environmental Quality Greater Anchorage Area Borough 3330 C Street Anchorage, Alaska 99503 SUBJECT: Lot l, Grey Subdivision Dear Mr. Strickland: As the installation proposed will correct an existing deficient system on the site, we have no objection to the installation ef the septic tank within 55 ft. of the water well. It still will be necessary that the seepage pit be located 100 ft. from the water well. The above specifically applies to a waiver from 18 AAC 72.020 (c) (2) with regard to the septic l:ank being located 100 ft. from any private water well. If you desire further clarification on the above please do not hesitate to contact me. Yours truly, Re§~onal Environmental Un~noe~ cc: William J. Schlege]_ 0/¢ 7/2 /o MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR '1'O SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Locatiorj ,(,sddreee o6,¢irect, ions) _ ~,~' · (b) ,.Propffdy O~ner~¢ ¢/,',,~2)/-~/ .. Teephone: Home (C) Lend ng nstitulion,~J~,6(: ~;~¢.'~ ~/) 1 Telephone Madmg'A~reSs (d) Real Estate Compan~-~gent Address' - .,t:",.~'/¢¢:¢.' ~',/%~,~¢l.d?.¢-//.-d:d: / Business ' ,, , . ,,-: ~.~T -/~'-/. J~.~,., Telephone (e) Mail the HAA to the followina address: or: Check here , if hold for pick up. List contact person and day phone number below. ~ 4, :/' ' /'~/.:" < . 4 / ' TYPE OF RESIDENCE Single-Family ~j~ Number of Bedrooms WATER SUPPLY Individual Well'J~ Community [-I Publicf-1 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~' Public [] Community [] Holding Tank F'I 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 72-025 (Rev 81861 Fronl 'HJOM S,JaeU!6Ue leUO!SS@joJd eq] u~ suommLuo JO sJoJJa Joj alq!suodsaJ ]ou s! e6eJoqou¥ jo ~l!lTdp!unl/~ eql 'penss! s! e~eo!j!~eo T eJo~eq elTp eZ~ITUT JO s~o!~o~d~u! ~onpuoo ]ou op SHHQ ~o seaAoldUJ3 'sluauueJ!nbeJ e~eis pue ITJape~ u!Tpao ,~]s!~Ts o] Jap Jo u] suo!~n~!lsu! bu!pual J!eql pue s@Luoq jo sJaseqoJnd ol ,~sepnoo T sT J~au~bua iTuo!ss@~oJd ]uapuedepu! uT ~q a^oqT S qde]6TJTd u! ua^!b suo!~T~uaseJdeJ e^o~ddv A]!Joq~nV q~leeH senss! ($HHQ) sao!^JeS ueuJnH put qlleaH NOl.l. rl¥o iTuo!l!puoo iT^oJddV iTuo!l!puoo Jo suJJe/ p@AoJddTs!a ~ pe^oJddV qYAOBdd¥ SHHO elTO 'uo.~oedsu! s!qi jo elTp uo loelje u! suo!JTIneeJ put 'SeOUTU!pJo 'sepoo elTIS put iTd!o!un~ lit ql!M eouT!lduJoo U! S! UJelSAS ITsods!p JeITMelSeM Jo/puT ,qddns JalTM el!s-uo @q~ 'uo!~oedsu! put UO!ITS!iSe^U! ,~uJ LUOJJ pUT Sel!J e6TJoqouv jo ,~!lTd!o!unv~l eq~ uJoJl peu!T~qo UO!ITLUJO~U! eq~ uo pesTq 1Tql ,~lpe^ j@qpn~ I 'u!eJeq pelTo!pu! eJnlonJls jo ed,~l pue sLuooJpeq bo Jequunu eq~ elTnbepe put iTuo!~oun~ 'e~Ts s! uJ els,~s jTsods!p ~e~TMelSTM Jo/puT ,qdd ns JelTM elm-uo eql ~Tq~ SMOqS ITAoJddv/qiJoq~nv qllTeH s!ql jo uo!lee!lse^u! ,~LU ~eq~/{J!JeA J 'MOJeq UMOqS elTp UO!JTp!IT^ eql ,Io se pue meJeq pexil~T iTes ALU/~q pe!l!~Jeo sV NOII~MOJNI aNY ¥±¥a 'HO~S 311~ 'S/Se/'SNOI/O3dSNI 9NIQIAOBd ~WIJ 9NIM39NIDN3 MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF ANCHORA~ALTH AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH & CHECKLIST - FEBRUARY 1984 ENVIRONMENTAL PROTECTION !AUG 1_ 8 1988 WELL D^T^ RECEIVED 264-4720 Legal Description: Well Classification '~~'1V~/0/~-'4¢' If A, B, C, D.E.C. Approved (Y/N) ,'~/'/~J Well Log Present (Y~_.).. Date Completed ¢'/,~/&"~/'~/ Yield ~ ~? Total Depth /~ ' ~-- Cased to /~ '~ Depth of Grouting ~/~ , Static Water Level ~ ~' Pump Set At /~ ~ Casing Height Above Ground Electrical Wiring in ConduitON) Separation Distances from Well: To Septic/Holding Tank on Lot Sanitary Seal on Casingi~lN) Depression Around Wellhead (Y~) ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~ # ~ ; On Adjoining Lots To Nearest Public Sewer Line /¢~' '¢' To Nearest Public Sewer Cleanout/Manhole /¢,,¢1 ,¢- To Nearest Sewer Service Line on Lot Water Sample Collected by ~"~-'"~ '~' ~/~'~'~'/ ; Date ~""' Water Sample Test Results .,~¢ 7" ~ ,~/?"-~'/~r~ Comments ~ ~)~'~,-¢' ~'~'~'f'~ 7~¢r$r · B. SEPTIC/HOLDING TANK DATA Date Installed StandpipesON) Air-tight CapsON) Depression over Tank (Y~I Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~'~/,~ Separation Distances from Septic/Holding Tank: · Size /a~'~'~ No. of Compartments Foundation Gleanout (Y~) Date Last Pumped Temporary Holding Tank Permit (Y/N) To Water-Supply Well 'J~ To.Property Line To Water Main/Service Line Course To Building Foundation '~r ~ ~' To Disposal Field /¢q¢ ¢" To Stream, Pond, Lake, or Major Drainage 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 Gravel Bed Thickness Standpipes Presen~xl) Date of Last Adequacy Test Square Feet of Absorption Area Depression over Field (Y(~) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well "")(' ¢"~ To Building Foundation '"~ ¢.~'.~ ~' Lot S¢4/'/~4/~,~' ; On Adjoining Lots To Water Main/Service Line /~/'¢' To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course ,/~,~1 To Driveway, Parking Area, or Vehicle Storage Area .'~ "' ¢' Comments ~ )r.f~,/C,,f~,~¢' /r-.)~ To Property Line ""J /" ~ To Existing or Abandoned System on D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level Tested for Electrical Codes (Y/N) Dimensions ~ Manhole/Access ~N) "Pump Off" Level Vent CN) Pumping Cycles during Adequacy Test1 Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have.checked, v~trified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ ~/~"~"~ Date Company ~e~ MOA No. Date of Payment 72-026 (1~/84) Tom Fink, Mayor / unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 30, 1988 Lee Reid, P.E. Alaska Environmental Control Services, Inc. 1412 West 33 Avenue Anchorage, Alaska 99503 Subject: Waiver Request for Lot 1 Grey Subdivision Waiver Request #WR88-050, Dear Mr. Reid: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is well to field standpipe 93 feet; the well to lift station 94 feet; the well to septic tank cleanout 53 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljw~6 ALASKA eFIUIROFlmeTAL COI1TROL SeRUICeS, IFIC. En§incerin§ $ ~nuir0nmcnl01 Studies MUNICIPALITY OF ANCHORA(~E DEPT. OF HEALTH & 9 g g ENVIRONMENTAL PROTECTION ,.c, ~.r~l I G~'c?y St!bdJv}sJQ!~ RECEIVED \ Ileal I;h Auhho~'J ~y JnspecLJon shm~u'; the sepa]-a~ion rl:is~en({~ 6Pom well Lo absorptJ, on Field standpJ, pe N} be 93 ~ect, and well. to ]~fl stat. ion 94 feet, aiuJ we1! to tank c]eanout p;ipe 53 fee~. AL[ached J'.; q ~,~ive.- ~rom AT}EC For well to tank, The M~sorption field and !iftstatir)n was upgra~ie i()/6-8], insi~eci:ed by the MOA and ',he asbucilt: shuws J02 feel from ~,.'e]J to absovi, hio~ Field and 95 feel ko Ilk't: stal. Jon. The soil. is a GM rai:ed ak 230 with ~round writer n{: ~3 CoaL. There is uo we~! !os avaJlab}e. 'fh~ Lotql 6epLh and casing depth is 188 Feet. Static water dr~wdowt} of 2 feet, 'the loL Js ]eve] with the house between the we]! and A]so, khe L:ren(:h standpipe :is 3 fee[ From Lhe east }et line. the trench would be al)proxima, teJy !.5 Feet. This bo?ders ]ets o:[ Rendol~ St~b(livJsiel~. BoLh of khcse lots a}'~ {.'ont~et t/(d Lo p~] ii(: watoP, lherefoFe, a letteP of lION ohjoclJon s)lould no~ be Deeded since Ne veqqest ihak you ?'ant a waiver l?roiu we]] to absorption fle]d 93 feei, ...... ~Lion 94 Fce~ and absol'p~i()n q;illcct'e ] y, 1200 LUcsl 33rd Auenu¢. Suile B.Anchoroo¢, Ahsko 99503,[907] 561-50,10 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA~ INCa ~ ~ FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order ~ 8433 Date Report Printed: AUG i1 88 @ 09:40 Client Sample ID:L1, BI GREY PWSID :UA Collected AUG 8 88 @ 17:20 hrs. Received AUG 9 88 @ ll:O0 hrs. Preserved with :4 DEG. C Client Name : AECS Client Acct: AKECBRP P.O.~ NONE REC'D Req ~ Ordered By : A. WEIN Analysis Completed :AUG lO 88 Sand Reports to: Laboratory Supervi~or,:STEPNEN C. EDE I)AECS Released Ey: Special Instruct: Chemlab Re£ #: 2i47 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result/Units Method Limits NITRATE-N ND(O.iO) mg/1 EPA 353.2 10 Sample ROUTINE SAMPLE Remarks: SAMPLE COLLECTED BY A,W. Tests Performed ' See Special Inetruction8 Above UA-Unavailable None Detected "See Sample Remarks Above Not Analyzed LT=Lees Than, GT-Greater Than Alpine Drilling & Enterprises ncP.O Box 110496 Domestic -- Commercial Pump & Water Systems INVOICE N° Z499 Job Name / Location QUANTITY DESCRIPTION AMOUNT LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Comptelion ol the Above Described Work.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE, SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. NOTE: ~ny purpose other than f~nanc~nl[ ~::~ u o':'-..-'~:, boundary or fence II nee, ~;~ '~Z/'fl '-~ "' ~ EASEMENTS OF RECORD, OTHER THAN '~.~ THOSE SHOWN ON THE RECORDED AS-BUILT NO CORNERS SET THIS DATE N Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property Lines and do not over]ap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Ala~ka I hereby certify that I have performed a Mortagee's in- spection of the following described properi2z: 0 · BBI~T-# K'IlIONMENT&L CONSERVATION ~, ~ . September 21, 1973. Mr. Roll Strickland Dept. of Environmental Quality Greater Anchorage Area Borough 3330 C Street -':,Anchorage, Alaska 99503 .:'~ SUIL~CT:'" Lot 1, Grey Subdivision .,? Dear Mr. Strickland: ,-.'r. ' - As the'installation proposed will correct an existing ':'~ '; deficient system on the site, we have no ~bJection to the installation of the septic tank within 59 ft. of the water - ~ell~ It still will be necessary that the seepage pit be located~100 ft. from the water well. "~";'/'~"'~'""'A~C;'?, ~-a~!¥e-!~eci~!cally ~pplies to a yaiver from 18 '.~ locat;.v-u t~ t~Y wl~n regar~ to the septic tank being *.'i*~¥'*'~';:,!~ d 100 ft. from any private water well. If you desire '-;,:,~L..,[~"~. ~urther clarification on the above please do not hesitate to contact me., Yours truly, aeg~onai Bnviron~ental ~niineer cc: ~illiam J. Schlegel SEP -'-" 19/3 AB~RPTION EIELD DATA Soils Rating in Abso~ptic~ Strata Date Installed Width of Field ~ Square Feet of ~['~c~tic~ A~ea Standpipes Present (Y/N) Depression ov~,F,i~ld,. (Y/N) ' Dat~ of last Adequacy Results of .LaSt<'A~equac~ Test Separation i)istanc~ ,frcm Absc~ption Field: To Nater-Supply Well To Building Foandation Lot To Wate~ Ma ~,n/Service Line Type of System Design Length of Field Depth of Field Gravel Bed 2hickness To Property Li~e TO Existip~3 or Abandc~ed System (in ; On Adjoining Lots To Cutbaakiif present) To Stream/q:, nd/Lake/c~, Majo~ D~ainage C~Durse To Dr iw~way, Parking A~ea, c~ Vehicle Storage Area D. LI~T STATION Date Installed Size in Gallons o." /Lo" High Water ~larm Level a~' 'rested fo~ ~ ... Co3~rents/Z/~' ~.~At~--~.f~ Check Perm/tted Bedroom Rating Against HAA Request ** ¢~['titv thak ' hav~ d%ecked, verified, or c~forn~d to ali. ~OA HA~\ C~idelines in effec KB1/dS/s ENGINEERS SEAL APPLI~ ,NT FILLS OUT UPPER HA 'ONLY Mailing Address Address Lending Institution Address Phone ./ ,..: .- Zip Code 7~'> / .' (. Zip Code Phone ( ~. ' ~ ~? 7,7 ./'/, ·, · ..., ,' ,'>~ _Address .;,/;, o ;., ' ¢[~/~ ~'~'~ 0,'., Legal Description / ~-> f / ¢: (- ~:~ l '- 4L '' , ~', . Street Locati~ E.~-c.,: /~ ,~ d{ ¢ ~) ~. :~ ~" Type of Residence ~Single Family ~Multiple Family No. of Bedrooms Q Other ZipCode ,-:' '- ~ Phone Water Supply ]E Individual Community [] Public Utility Sewer Disposal ATTACH WELl_. LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available}. /~'.lndividua 'Public Utility L~ Holding Tank Year Individual installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time ~ime [)ate Date Date Inspector Inspector Inspector Inspe~r Time Date~ Field Notes: ( ) D~SAPPROW[~ I CONDmONA~. %PROVAL' *CONDITIONS OF APPROVAL Soils Rating Date Sewer Installed '].._ Well To AbsorpUon Area /'& ',~ Well to Tank :~ iWell Log Received Septic Tank Size INSPECTIC'~",, REPORT MUNICIPALITY OF ANCHORAge, BUILDING SAFET'Y DIVISION 3500 EAST TUDOR ROAD INSPECTIONS (907) 563-3464 ADMINISTRATION (907) 756-8211 NAME ~ i / J STREET ADDRESS ..:' '.-' LOT / ~ BLOCK t IPERMITNO "; ' / PHONE /[)ATE :' ' FOOTING [] ELEC. TEMP. FOUNDATION _. [] ELEC. SERVICE ___ BOND BEAM __ [] ELEC. ROUGH __ FRAMING [] ELEC. FINAL INSULATION [] OTHER , SHEETROCK __ [] /-,J/-? d.?? STRUCT. FINAL __ [] FIRE FINAL OTHER [~ ZONING [] PLBG. UNDGR. [] PLBG. ROUGH [] GAS TEMP .... GAS MECHANICAL MECH. FINAL __ [] PLBG. FINAL -__ [] OTHER [] NO NONCOMPLIANCE OBSERVED [] WILL REEXAMINE AT NEXT INSPECTION [] CORRECTIONS ESSENTIAL AS EXPLAINED BELOW [] DO NOT CONCEAL UNTIL REINSPECTED COMMENTS " ¢.. i,, '"'" f.z/iA, :' INSPECTOR ()ATE WHEN CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION_ DO NOT REMOVE THIS NOTICE 84-002 (Rev. 2/83) .. ~ k,/W DATE RECEIVED INSPECTION APPOINTMENTS T, E T,ME T,Mf: DATE DATE DATE INSPECTOR INSPECTOR INSPECT~B ~ICIPALI~ OF ANCHORAGE MUNICIPALITY OF ANCHORAGE D~PT. O[: H;ALTH &  D~PARTM~T OF HEALTN & ENVIRONMENTAL PROT~OTIO~N~JRONMENrAL h,:O[ECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION JU!. 2 1901 Telephone 264-4720 R E C E I V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIR[CTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing, 1, PROPERTYOWN~R~. '~' ) '~'? ~ I PHONE MAILING ~DDRESS PHONE PROPER~RESIDENT (If different from ~bove) 2, BDY~ PHONE - MAILING ADDRESS 3, LENDING INSTITUTION / PHONE MAILING ADD~ESS - ~, PHONE , REALTOR/AGENT ~/~ I t~]/~ MAI LING ADDRESS &l 5. LEGAL DESCRI.PTI0,N~(:,~- LoT ~-/'~:* ~c~j S~J K.~D. STREET LOCATION ~ One ~ Four ~~ SINGLE FAMILY ~ Two ~] Five ~ MULTIPLE FAMILY ~ Three ~ Six Other 7. WATER SUPPLY [~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for allweIIs drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available,) 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALl_ED. 1~ ~ /.z ~- "'2, ..... ~'~''..-- ~ -,; v . PUBLIC UTILITY NOTE:TH INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 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 [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size:.//) (O¢? If Tank is homemade SOl LS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS PPROVED FOR ~ 3EDROOMS / L._' .NDITIONAL A~ROVAL (letter must accompany certificate) ~ DISAPPROVED DATE ^LASKA I rlUIROrlmI rlTAL COrlTROL SeRUlCe$, IFIL ~n§ineerinq ~ ~nuironmenl(~l Slu~lies 7/28/81 MUNICIPALITY OF AF!CHOR'~,GE DEFT OF :L ' ~, ENVIPOh?,',3i',.; 'L : , C :ON RECEIVED NATIONAL BK OF AK 301 W NORTHERN LIGHTS ANCHORAGE AK 99504 SELLER - LES BEAR SUBDIVISION-GREY SUBDIVISION BLOCK-1 LOT--1 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 100 GALLONS OF WATER PER DAY. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME BEDROOMS. ' ........................................................... 1220 ~Uest 25th ~ucnu¢ · ,~nchor~cje, Alosb 99503 · (907) 276-1361 }: ~AF 1Ml:'XJ r c~F t1! ,'~[.1 U ANt3 l: qVIFtONMENTA( P[tO Fl!C1 ION July 9, 1981 Doris E./Lester M. Bear % Ruth La Bart National Bank of Alaska Pouch 7.-025 Anchorage, Alaska 99510 Subject: Lot 1 Block 1 Gray Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to [~this office from the Chem Lab~ 5633 B Street, for our review. '1(2) (3) Expose the well for our inspection to determine proper construction, also to insure minimum distance requirements are met between the well and sewer system. The neighboring wells and on--site sewer systems need to be located so that distance measurements can be taken to insure proper radius,, (4) Expose the septic tank manhole to verify its existance. (5) The septic tank pumped with a receipt submitted to this department. The 'total numbe, r of gallons pumped need to be on the receipt and verified by a registered engineer as to the acutal number of gallons pumped. This is to verify the size of the septic tank. Doris E./Lester M. Bear .July 9, 1981 Page Two (6) An adequacy test needs to be performed on the existing leaching area. This test will determine ~f the system /q~C-/~' adequate according to Standards. A listing is National of private firms performing the test is enclosed. ~ '- report needs to be submitted to this office for our review. Please notify this office for a reinspection when the noted descrepancies have been corrected. If there are any further questions, please call this office a.t 264-.4720. Sincerely, James S. Roberts Environmental Specialist JSR/ljw CC: James A./Linda K. Riske 2941 West 80th Avenue, Apt. A 99502 J'uiy .1.5, ~981 Doc:i.s I'~./Lester 5'1~ Bear % Rut.h La Bari? Nat~oi).al Bank of Alaska Pc)ueh 7-025 Anchorage, Alaska. 995].0 Subject: Lot 1. Block 1 G~:ay Subdivision Th:t.s is a ~c)l].ow up 1.:.t.t. cr t:o (,L. letter of July 9, 19o.t.. A visual inspection of t:hc~ oil-site ~;ew.o.r arlO water~ fac:ilit:.ie:q; revealed the following: (1) J. he wail. is J.n a pJ.t The casing needs to extended twelve(12) inches above ground love], and capped with a sanitary seal so [:hat. .it J.s water' tight. The depr'esskon need3 to be :[i).led in wJkh imperv:ious type sc>il so that ].t: slopes a~.,~ay ]':fora (2) The absorpkion area of t. he sewer is~ky.~.six(26) feet from the well. The sepa~rat:ig~ )lefluJrement between vioiai:ion of' Mt,micJ pal ordinal:es ~i~t. g~.~d~ and Lhe sept~{; .pt. ii~j~dl---- ~ *it'~ -the event thc adequacy te~t passo' Jr' wot '1( be ............... '~dv sab'( n -o mov: i-be we] If t:hex'e ar(~ any ftlJ:"kl'!er.' quest;ions, please calJl lzhis office at 264-,1720. S J ncexel, y,