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Home My WebLink AboutSTRUCK LT 2AStruck Lot 2A #015-163-54 GRE/ ER ANCHORAGE AREA BOF-'!JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS !:'~(~7 ~ .:~'"~h-~j~(,(,-~ PHONE~7~ SEPTIC TANK: DISTANCE ' FROM WELL INSIDE LENGTH / .~z_- ' NUMBER OF MANUFACTURER ~"~)O MATERIAL ~/~)C/~-/~"/g'~-- COMPARTMENTS INSIDE WIDTH LIQUID DEPTH ,LIQUID CAPACITY /0(~)~) GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER OR WIDTH /0~, /LENGTH'~'0,/ DEPTH '(/~ / LINING MATERIAL~/~'/~(:~/g~ CRIB SIZE: DIAMETER__DEPTH '(/~*~ DISTANCE FROM: WELL BUILDING FOUNDATION ~7L~ ,/ . / TOTAL EFFECTIVE NEAREST LOT LINE/~'/ . ABSORPTION AREA (WALL AREA) /~--~'~ SQ. FT, ADDITIONAL ABSORPTION WELL: TYPE BUILDING ,~,..~ ~/ / FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEPTIC ~7~/! SEEPAGE SEWER LINE TANK, ' ' , SYSTEM REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. E0-035 DIAGRAM OF SYSTEM APPROVED ~,~'~ .4~_~//- G,A.A.B. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT iNSTALLATION OF: SEPTIC TANK /~00 TYPE AND SIZE OF FACILITY TO SE: SERVED SEEPAGE PIT{~~. -~"~.X. IN FIEL OTHER COMPLETION DATE ANTICIPATED ~"4~'%'L~ l q'~:"~- pFI~MTT VAI TD CINF YFAI~ FINAL INSPECTION= 24 HOUR NOTIC~ REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY TI'ir- SEPTIC TANK SIZE /(J~) TYPE~.t'~R'.] O'lt' (':',~nCY~'~'.RSEEPAGE AREA.SIZE TYPE MINIMUM DIBTANCES. REQUIREMENTB FOUNDATION TO SEEPAGE PIT 20 rte D~RAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL 15 ~e TO NEAREST LOT LINE. DRAIN FIELD WATER MAIN TO SEPTIC TANK 10 10 DRAIN FIELD /00 ~ AREA W£LLS. SEPTIC TANK, 25 f%.. SEEPAGE PIT 100 ft. DRAIN FIELD 50 4 INCH DIAMETER CAST iRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT [ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF ~REATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 2E-68 AND THAT THE ABOVE DATE APPLICANT'S SIGNATURE _ _ . · GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAl QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99509 Case # w 3-- 4-- 5-- 6-- 7-- 8-- 1e- l1- 12-- 13I 14-- Performed For Legal Description: Lot 2 Block This Form Reports Soils Log X - Soil Depth Feet Was Gro If Yes, Test Must Be Logged To 4' Soil Characteristics Well &rsxted Gravel and Sam~l 2il~y Sands Sil% Fine Sand Wix nd Water Encountered? At What Depth? 1{0 Dated Performed Apmil 19, 1978 Subdivision S~ruck Percolation Test Below Proposed Seepage System - IIill I *% Reading Date Gross Time,t Net Time ' Depth to H2(t Net Drop Percolation Rate Minute Proposed Ins~'~-{-~i~: Seei~a~e Pit1{o~ -_Z~a.~e-b Drain Field Depth of Inlet__~b~o--~7~_2~_ ........... ~epth ~o 'B~tt~ ~-~--Pit Or Trenc~F COMMENTS: I meoommenS, a~0 leas2 154 square £ee~ 02 surface area of seepage pi2 set beRroom,_ Ies t Performed BY Hal. ~±de} Dale: April' 19,1973 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description HAA# '-I'-(-~(~f.~'(% Expiration Date: Location (site address or directions) (~ ~- ~- t ~ ~ L L C i¢~ /- Current Property owner(s) ~',~ ~,r~ ~-~ '~t & ~. Day phone Mailing address Lending agency Mailing address Day phone Real Estate Agent 0 1.4, ~1~4,'~ ¢~-ti¢ ?'r¢,~ Day phone Mailing Address '~il( ,~,t %.~_.~._.¢_¢ ~ /c-c}' Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual Onlsite [] Individual Holding Tank [] Community On-site [] Public Sewer The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Cedificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independem professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served b? a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for prope.rties served by Class A or B wells or a public water system. The Municipaiit~ of Anchorage is not responsible for errors or omissions in the professional engineer's work. 5, STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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 verity 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Nameof Firm I ,~ bb-~,., ~j ,~ t,~i. ¢\¢_..¢,,¢2 "~. ~---- Phone Address ,~ ~ '~ /.5" ~ ~ ~ ~ Engineer's Printed Name ~_ <~ u ¢~t ~ ~ Date DHHS SIGNATURE J Approved for ~ bedrooms. Disapproved. Conditional approval for __ ENGINEER'S bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other // Expiration Date: / "- - Original Certificate Date: ~,~ -/-' 4~ ~ Reissue 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 GENERAL INFORMATION Complete legal description Lc-T Location (site address or directions) Property owner '~'~/~/'~,/,,/ Day phone Mailing address Lending agency Day phone Mailin. g address. Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER 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 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. I further verify 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 codea, ordinances, and regulations in effect on the date of this inspection. NameofFirm i o¢/¢<~t "~t'"-l~'~"'¢ ~.~'~ Phone ~L'TCL-~I~ _ Address ~ :~ 'yE, /'~'~¢~¢'7 __ __~ ~-~ 9 /~'~ r---~l. ~( ?'Z~'o I Engineer's signature ~ ~~ Date DHHS SIGNATURE ~ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with th'e following stipulations: Additional Comments 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. ("' Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 RO. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 RECEIVED MUNICIPALITY OF ANCHORAGE Vm~NMENTAL SERVICF~ tm,',- Legal Description: HEALTH AUTHORITY APPROVAL CHECKLIST LOT Parcel I.D.: A. WELL DATA Well type ~ Date completed Total depth ~ ,/~ I ft IfA, B, or C provide PWSID # __ Sanitary seal ~/ Cased to ,~:l ft FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ¢ colonies/lO0 mi Date of sample: /7/-7- 60 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Date installed l ft g.p.m Nitrate [,0'1 mg/I Collected by: '~.¢-~ , gal Tank size J O-c~ o Well Log Wires properly protected )/ Casing height (above ground) ,~/ in. AT INSPECTION ~ g.p.m Other bacteria ¢ colonies/lO0 mi Number of Compartments Cleanouts Y Foundationcleanout / Date of pumping /1/- ~' - ~ C. ABSORPTION FIELD DATA Date installed '~ ~'"/~ Soil rating (g.p.d./ft2 or ft2/bdrm) . . Length I ~" ft Width ,,~-O ft Gravel below pipe ~ ft Total depth t~"~ft Effective absorption area ¢5~, f¢ Monitoring tube Date of adequacy test W/7//oo Results (Pass/Fail) Fluid depth in absorption fiel,d before test /~O in Elapsed Time: ~2c/~,-¢ rrfi~- Final fluid depth in Any rejuvenation treatment (past 12 mo.) (Y/N & type) Depression over tank 'N High water alarm Pumper hi . Depression over field For ?~ bedrooms Water added ~,5',P gal. New depth 7Z) in. ~ ~' Absorption rate >= ,V,~ O g.p.d. If yes, give date __ 72-026 (Rev. 01/00)* D. LIFT STATION Date installed "Pump on" level at Datum in E. SEPARATION DISTANCES Size in gallons~~''~ "Pump ~JeCel at in Cy~ested Manhole/Access High water alarm level at __ in Meets alarm & circuit requirements ' SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/li'tt~[uiiuf~un lot Absorption field on lot I C,'~ Public sewer main Sewer/septic service line '~ On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main ~,,~- Drainage ~t I ~ Property line ) ¢ Water service line Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~/~ Building foundation ,,~ '~ Water main Water Service line ./%~5- Curtain drain l'J- I O Absorption field Surface water Surface water ~',,,t / Wells on adjacent lots Driveway, parking/vehicle storage F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name '"T*, Date Pc HAA Fee $ ~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)* 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # 1. GENERAL INFORMATION Complete legal description Lot 2A; S~uck SubdZvision Property owner Mailing address Location (site address or directions) A~ch(¢rage. AK P¢~ter & Ann Gle~ilSmann 11461 Hill Circle. Anchorage 11461 H~ZI Circle Day phone Lending agency Mailing address Day phone Agent Day phone Address 243-1112 (Ann ~ work) 346-3974 ¢v6 lv me. sag6 Unlesg otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well XXX 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 XXX NOTE: If community wastewater system, provide written confirmation from State ADEC .. attesting to the legality and status of system. 72-025 (Rev. 7/91) Front MOA 921 5. STATEMENT OF INSPECTION BY ENGINEER 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 application shows that the on-site water supply and/or wastewater disposal systerfi 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 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 . ,, t, ,~,.., ....~ Address 17034 Eagle Rive~' Loop Eoad No. 204 Eagle klver~/41a$1(a ~$?~' Engineer's signature Phone Date DHHS SIGNATURE ¢('_ Approved for ~',',¢-Z~,~.z? bedrooms. Disappro~/ed. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: 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. 72025 (Rev. 1/91) Back MOA#21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /~'}? ~).,Z~/ ~'7/~(~/(" ~'/~) Parcel I.D. A. WELL DATA Welltype ~C~''q~-- IfA, B, orC, attach ADEC letter. ADEC water system number /~'//'~ Log present (Y/~) /~d Date completed ~ ~/~ Driller /~/~ Total depth ~ ~- Cased to ~'/- Casing height Sanitary seal d/N) F~i~ -~- Wires properly protected (~N) FROM WELL LOG AT INSPECTION Date of test Static water level h ~'~' Well flow / g.p.m. '"-"~ , t Pump level / (:::)~ ' '/- SEPARATION DISTANCES FROM WELL TO: Septic/~ tank on lot '~zl' ~ ; On adjacent lots Absorption field on lot /~ 'F ; On adjacent lots Public sewer main ~ Public Sewer manhole/cleanOut Petroleum tank ~/~ Sewer Sen/ice line WATER SAMPLE RESULTS: Coliform (~ Nitrate Date of sample: Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts ~/N) High water alarm (Y~) Date of pumping Tank size ~/¢0~) ~,/~._ Compartments O/dE Foundation cleanout ~,¢~) ~/~ -- Depression (Y/~¢) /U4 ~ /~//,~, Alarm tested (Y/¢ /~/~ ~-~-~'~, Pumper .~ i~/V'//~. ~ ~¢J~lO~C SEPARATION DISTANCES FROM SEPTIC/~ TANK TO: Weiw::;) on lot ~ ~ TO prop,~rty line ~0 ~+ Surface water/drainage On adjacent lots 100 "-k Foundation ,/.3. Absorption field '¢~ / Water main/service line ¢~' :¢ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION D a"~A'fe-icm~.al I e d ~'~J'/~ Manufacturer Size in gallons'~-~'~'~-~ ~,,, Manhol~ Meets MOA electr~__ D. ABSORPTION FIELD DATA / ~oT~ %~&~c~c. s/¢ Date installed ~ -¢9..- '~.~ Soil rating IgOf~ /g/C System type ~,¢~F'¢¢_~ Length ¢9.O i ~_ Width /~ '~" Gravelthickness 6'P'~P-Z¢, Totaldepth Total absorption area ~-g.~G c"/' Cleanouts present ¢~N) _O~ ~' 2-%~'~-~RC-r;~ P7 T Depression over field (Y/~) /'Lie Date of adequacy test ~ -~-~ Results (pass/fail) P~f ¢% ~ for ~ "- bedrooms Peroxide treatment (past 12 months)(Y/(]~I~ AJt)-f ~/d¢~ rd If yes, ~ive date ~- SEPARATION DISTANCE ,:ROM ABSORPTION FIELD TO: /*'1"'-/~ ~ l'~'~'' ~'¢'¢~' Well on lot /¢)0 '~ On adjacent lots /~0 Property line To building foundation ~0 ~' To existing or abandoned system on lot On adjacent lots .E~ Cutbank ~Water main/service line Surface water /00 '~- Driveway, parking/vehicle storage area 0/- Curtain drain ~)~.~ ~ ~_./~.~/,~h¢ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in he date of this inspection. $ & $ ENGINEERING ~:' ,;! ,' Signature 17034 Eagle River Loop Road No, ~04 ~: ,. ' ~.~ac;~k~ I.tivet., Alaska ~9577 ~ ~,,,~.%,. Engineer's Name :~ ,:¢; ::*"~",~' ~ HAA Fee $ / Date of Payment Waiver Fee: $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPAR'i~IENT OF HE~TH AND ENVIRONMENTAL PROTECTION APPLICATION FOR I{EALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) _~/~f~C~¢f4Telephone - Home (b) Applicants Name (c) (c ec one) ena*ng nst tu on Buyer ~ , Other ~ (explain); (d) Lending Ims~itution Telephone Business Address (e) Real Estate Co. & Agent (f) Mail the HAA to the following address: Type of Residence Single-Family., Number of Bedrooms Multi-Family~ Other (describe) Water Supply- Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Sewage Dispo~ 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] 5~ ~ngineering Firm Providing Inspections, Tests, File Search~ Data and Information As certified by my seal affixed hereto and as of the validation date shown below, verify that my investigation of this Health Authority Approval shows that the water supply and/or wastewater disposal system is safe, fm~ctional and adequate for the number of bedrooms and type of structure indicated herein. I further verify based on the information obtained from the Municipality of Anchorage files and investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection° Name of Firm Date DHEP Approval Approved for ~) bedrooms Disapproved __ Conditional Approved __ Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ~IEALTN AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES }IEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENt- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. TH]~ DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. ~MPLOYEES 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ae MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification Well Lcg P~esent (Y~ ///$f%/~E~ /%73 Date Cont~leted Total Depth 7~ ~/, ~ Cased t6 //~ Static Water L~vel ~/o Log~ Pump Set At Casing Height Abov~ Ground L~ (: Lo< ?-f~ g+~c~., If A, B, or C, D.E.C. Approved(Y/N) ~/o ~ Yield ~, Depth of G~ting ~ L~// Sanit~y ~al on Casin~ ~) Electrical Wiring in Conduit ~) Depression Around ~llhead (Y~'~ To S~ptic/Holding Tank on Lot~ To Nea=est Edge of Absorption Fiel~'~on~tt //~ ,~p ; On Adjoining Lots To Nearest Public Sewe= Line /~h To Nearest Public Sewer Cleanout/Sanhole ~//~4 To Nearest Sewer Service Line on LOt /~h Water Sample Collected By ~, ~/~//-/~ ; Date Wate~ Sample Test P~sults ~P ~/~- F~ ~r ~//,~/~--~ ' SEPTIC/HOLDING TANK DATA Date ~nstalled ~/~/Z~ Si~ Z~/~ Standpipes ~N) Ai_~-tight Caps ~/N) Depression ove~ Tank (Y~_~ Date Last Pumped NO. of Cc,,~0a~tm~nts / Foundation Cleanout (Y~ Pumping/Maintenance Contract on File (Y/N)/[/// ; for Holding Tank High-Wate~ ~a~ (Y~) ~ ~ra~y Holdi~ Tank Permit (Y~) ~p~ation Distan~s ~~olding Tank: To Water-Supply ~11 ~ ~ ~ To ~ildin~ F~ndati~ /~ To ~o~rty ni~ 3~'/~ '~ TO Dis~sal Field TO ~ter Main/Se~vi~ Li~ '~ TO S~e~; Pond, ~e, ~ ~jor ~aina~ /00/~ ~ [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field /~-~ Square Feet of Absorption A~ea Depression ove~ Field (Y~ Results of Last Adequacy Test /~'~ ~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~ ~1 Standpipes P~esent ~N) Date of Last Adequacy Test Separation Distance f~om Absorption Field: To Water-Supply Well //~ ' ~ To P~operty Line /~d~h~ To Building Foundation ~ / ~ To Existin~ Or Abandoned System on Lot /V//~ __~ On Adjoining Lots To Wate~ Main/Service Line /%///4 To Cutbank( if p~esent) To St~eam/Pond/Lake/c~ Majo~ D~ainage Ccu~se To D~ivewa¥, Pa~king A~ea, o~ Vehicle Sto~age A~ea Counts ~/~-~/~___~ /~63/~/ ~/~/Z3/~//~ De Date Installed ~ Dimensions / Size in Gallons ~ Manhole/~.A~Y/N) "Pum~ On" Level at __ ~ .~f" Level at. High Wate~ Alarm Level at ~ Vent (Y/N) Tested for // Pumping Cyc~'lc~s~du~ing Adequacy Test. Electrical Co/~) Co~r~s-'/ ~ Meets MOA *~ Check Permitted Bedroom Rating A~ainst HAA Request ** I certify that I have checked, verified, o~ conformed to all MOA HAA Guidelines in effect on the date of this inspectic3n. Signed , ,, Date Company /~'_~ MOA No. ~d-~ .... ' ...... '~'~5-84 DEPT. OF ENVIRONMENTAL CONSERVATION / Anchorage Western District Office 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 August 22, 1984 BILL SHEFFIELD, GOVERNOR 274-2533 RE: Struck S/D, Lot 2A, Water Well To whom it may concern: The well on referenced property was installed subject to the regulations in effect on August 2, 1973. Since the system has not been modified and remains adequate, the conditions and regulations in effect during installation still hold. Therefore the system meets State of Alaska standards and is considered approved. Sincerely, es F. Hayd~/~ Environmental Field Officer JFH/dd ALASKA i l LIIBOnllll nTAL CO ITBOL $ kulCES, Iric. ~nqineedncI ~, ~nuironmental ~tudie~ August 16,1984 Barbara Gardner Lee Houston & Associates Anchorage, AK Seller - Lee Houston & AssocLates Buyer - Subdivision - Struck Block - 0 Lot - 2A Adequacy Test For Sewer System The type of absorption system is a crib with an area of 456 Sq. Ft. The system is capable of accepting 4~0 gallons'of water per day. The surge capacity of the system is 697 gallons. Based upon the test data the system is acceptable for a home of 3 bedrooms. The septic tank was pumpea on 8-15-84 Flow Test on Well The we1! flow rate was 6.4 GPM for 2 hours. Septic Tank Adequacy The existing septic tank volume of 1000 is adequate for this 3 bedroom house. 1200 U.lest 33rcl Aucnu¢. Suit~ B "AncNor,:lg¢. Alos <, 995o ,{9o7) 561-50/J0 " APPLIC~'NT FILLS OUT UPPER HA[~-'~!ONLY Maging Addre~ Zip Code 1 ¢,~.; Buyer /- ~(~ ~ (4 ~ Zip Code Address Lending Institution Phone Zip Code Address Legal Description ~07 -)~ %~'U¢~ -~"/~, Water Supply ~& ~ ¢< Date Date Date Date Inspector Inspector Inspector Inspector RECEIVED ( ) APPROVED BEDROOMS *GONDITION8 OF APPROVAL ( )OONDITIONAL APPROO~L' Soils Rating Date ~wer Installed Well To Absorption Area / ~ ' ~ Well Log ~eceived 72023(3/82) Decen)er 13~ 1983 Dave Rebol Subject: Lot 2A Struck [3ub. Approval for the individual sewer and water facilities cannot be c~rante~ until the following items have been comp!eted~ o The water facilities were not tt~rned on at the ti~e of the sche<]nled inspectioa. Please call this office for another appointment. %~he septic tank pnmped with a receipt submitted to this department. o An adequacy test needs to be performed on the existing leaching area. This test will determine if the svstem is adequate according to National Stendards. A listing of ~orivate firms performing the test is enclosed. This report [leeds to be submitted to this office for our review. Locate and expose the cleanout to the seepage pit and/or leaching area for our inspection. ~3?his is to insure the minimum distance requirements are met between tho well and Please notify this department for a reinspection when the noted discrepancies have been co~ected. If there are any fu~the~ questions~ please call this office ~t 264-4720. Sincerely, Jim Roberts AsSOCl~te Environmental Specialist JR98/p/EH Enclosure ~,~arston Real Estate Attn~ !,~arty P!unkett/Dean Pefanis 26'04 W. }~orthern Lights Anchorage, AK 99503 ',~' DAT~E RECEIVED · ~ 'Y;'--' INSPECTION APPOINTMENTS ~ TIME TIME :~,:x~/ TIME / ~UNICIPALr~ OF ANCHORAGE BUNIOIPALITY OF ANCHORAGE D[PT. OF HEALTH & 99~01 ENVl RONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE DIRECTIONS: Complete all parts on p'age 1. Incomplete reques~ wile not be processed, Please allow ten (10) davs for processing. MAILING ADDRESS PROPERTY RESIDEN~ (If different from abovp) PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6, TYPE OF RESIDENCE ,~ SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY INDIVIDUAL* COMMUNITY [] PUBLIC UTI LITY 8. SEWAGE DISPOSAL SYSTEM .~ INDIVIDUAL/ON:SITE** [] PUBLIC UTI LITY NUMBER OF~BEDROOMS ~ One ~ ~ Other ~ ATTACH W[kk LOG. A well Io~ is roquired for all wells drilled since 3une 1~7~. For wells drillod prior to that date, ~i~e well NOTE: THE 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 [] tNDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []PUBLIC[] INDIVIDUAL/ONuTiLiTY -SITE DATE INSTALLED ~ ~.~. c~ 3 Connection Verified INSTALLER E~]Septic Tank or [] Holding Tank Size: _~J~_(~)_ I f Tank is homemade SOILS RATING tl ye dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Tank Absorption Area 4. DISTANCES Septic/Holding / ~10 Sewer Line Nearest Lot Line WELLTO: Absorption Area to nearest Lot Line 5. CUM[ViE NTS ~APPROVED FOR ~_~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010(Rev. 6/79) ErlUlROnmEnTAL COFITROL S( RUICES, IFIC. ~ncjin¢¢rin§ $ ~nuironmental Sfuclies MAY 23 1981 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PRO'F~CTION JUl_ 2 r/1981 RECEIVED ALASKA STAT~ANK/KATHYDERSH~4 310 E NORTHERN LIGHTS BLVD ANCHORAGE AK 99503 SRLT;~R - DAVID MATLOCK SUBDMS ION-STRUCK BLOCK-0 LOT-2A THE TYPE OF ABSORPTION SYST~4 IS A PIT WITH AN AREA OF 456 SQFT. THE SYSTEM IS CAPABLE OF ACk. TING 450 GALLONS OF W~TER PER DAY. 9~HE SOILS RATING OF ~ SYSTEM AT ~ONSTRUCTION WAS 154 AND NOW IS 152 SQ~T/ B~DROOM. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 7/23/81 . 1220 I~est 251h/~uenue ·/~nchoroqe,/~laska 99503 * (907) 276-1361 ANCHORAGE, ALASKA 99501 (907) 264-4111 OEO O M. SULL,VA MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION June 26, 1981 Dave/Carol Matlock % Nila Kretzinger Banner Realty 6917 Old Seward Highway Anchorage, Alaska 99502 Subject: Lot 2A Struck Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) (2) (3) The water analysis report needs to be submitted to this office from the Chem Lab,' ~633 B Street, for our review. The septic tank pumped with a receipt submitted to this office. An adequacy test needs to be performed on the existing leaching area. This test Nill determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. If there are any further questions, please call this office at 264-4720. The application shows the number of bedrooms exceeds the number the sewer system was originally designed for. An upgrade will be required. Prior to any upgrade, a permit needs to be obtained from this office. A 500 gallon septic tank needs to be installed. Sincerely, Robert C. Pratt~ R.S. Associate Specialist RCP/ljw