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HomeMy WebLinkAboutCONTOUR ACRES #3 BLK 2 LT 4Contour Acres #3 Block 2 Lot 4 #017-451-14 0 MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ` % httpalwww.muni.org/onsite EL' __ NoI)(tiirtnl� nt 4NCR '� On-Site Water System Permit Permit Number: OSP191249 Effective Date: 6/25/2019 Work Type: Well Initial Expiration Date: 6/24/2020 Tax Code Number: 01745114000 Site Legal Address: CONTOUR ACRES #3 BLK 2 LT 4 G:2837 Site Mailing Address: 5204 COUNTRY CLUB LN, Anchorage Owner: SCHLERETH HERBERT M & Lot Size in Sq Ft: 159430 Design Engineer: Total Bedrooms: 5 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy Il Private Well 0 Water Storage All construction shall 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 (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. To close out this permit, please provide the following: a) Well log b) Pump install log c)Water sample results for total coliform, nitrates and arsenic. 2. If any of the wells are taken out of service, as defined by AMC 15.55, they shall be decommissioned and a decommissioning log shall be submitted to the MOA. OF Received By: Date: / Issued By: / • ' Date: b a 5 MUNICIPALITY OF ANCHORAGE Development Services Department " ,;,7 Phone: 907- 43-7904 On-Site Water & Wastewater Section F . u -7 97 (;) fieWit 0 j-19 ON-SITE SEPTIC/WELL PERMIT APPLICATION 1-6 Parcel I.D. 0 17 q` 1 / O� 6 i� L9�� �� Property owner(s) )3 SC4/elee rt-) Day phone"36 - Mailing address /e) / co 3 Site address Ld f 41 3L4- a ('D,u/c . .Qc/ees 3 Legal description (Sub d., Block & Lot) 20� t� C44. 4, 44--If , ClS7 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (IE all that apply) Absorption Field ❑ Initial 12/- Single Family (SF) Er (w/wo ADU) Septic Tank ❑ Upgrade ❑ Duplex (p) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of prope y owner or authorized agent) Permit/Rush Fees: o9-5 Waiver Fees: Date of Payment: /a61/9 Date of Payment: Receipt Number: t A3G1Receipt Number: (ASP/q/ .0(/9 Permit No. Waiver No. G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc - own-Ry CIv_b_ j. ANE - C. .. vy 9 2�6 . T 7-----• ------_ � a• o 53 .6370 rte, •2,, \';: ". : �.S t o ; Vii.. �N .\ O a ` - Li- ")::11::k:. CC /� /��'_e a --5,-"'1-1) :IN.'. �},?, 4.K,, p `�� V o ti:,�: O 7t v Uig( UO !-)CLC kY: :s'9 s:-i°, i a5 s • _ .. �7e ,`,� r3!w-:.2Nz,P \ u24_ yam J .r..i!.;w..',...• w e _ "--...A. Cra Li:VI Q¢� G pA o 2 1 I).). i F ^.2 f �qb O x �p,,r P � ST1B � ` W 1 „ - 5e „ k`k \. • v n I O ii I 5ep+ic vents/43 �. I 1 Y 1 S 89 ' 3-9' oo” W '163 .So ' Recer,�;f;ed 8-3o-9od/( AS 6 Ull.7 SURVEY /,/o Corners . I hereby certify that I have surveyed the following 4��2.. L 0T II B1k. 2, \ described property: , • ,1 f;:, � � CONTOUR A C ES AoD,J 3 '' •.r.•1•�,';. .•; - `; Anchorage Recording Precinct, Alaska, and that thi \\ �,; ,. ,';. improvements situated thereon are within the propert: i e" lines and do not overlap or encroach on the propert: %-'�" lying adjacent thereto, that no improvements on prop i �- erty lying adjacent thereto encroach on the premises ii S C/-21 LE 1 - _ -60 • i' �; . Fred V+;,;at;:c: question and that there are no roadways, transmissioi 4 �sT•°• NO. 22...5.S °' ` 7Z� lines or other visible easements on said property excep es<(; *.,a ''o as indicated hereon. pa•.......=•',;.=, ° FSSiON 4' Dated at Anchorage, Alaska 164 0�1►��.�`�'a- this /� day of ,-,1°17 , 19 7 y EAc.-'`"•' !. Cc RECORD, OT'H!P THAN FRED WALATKA & ASSOCIATES 1r-!.-2''''..- ON THE £EC^.'E F.a 7Y -6 pa 73 Engineers and Surveyors P.• Ak: N;'.' SHOWN HEkEON, Municipality of Anchorage Page 1--of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 .On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW000294 PIDNumber: 017-451-14 ~.-: · Wastewater System: [:3 New' :X~ Upgrade Herb Schlereth Add~2~)4 Country'.Club Lane anch., AK 99!~16. ABSORPTION FIELD Ph°"3e~5-1740 Four {4) n Deep Trench ~lShallow'Trench [3Bed nMound I-IOther ' ' Ft FL 500 " $O.'Ft ASTM D303~ PvC Existinq, · ' ' :' ' · ' · ' .... ~-' o~1 *' ' -I" ' ' ' ..... ' .... ' ~m~ ' z~ ~ ~ ~ ~ ~ Anchorage Tank . .'1 , 250' · -'.'. '":Wel~' ,100' >1007 N/A N/A'* .. >25' Steel .' -.'. ~ Two (2) .... * - '. Su.a~. ,100" >1'00' .N/A N/A N/A ' ' '.-LI~STATION- N'/A': ' u~L°t .."'5'" >'10'' 'N/A N/A N/A ' ~,i, ga,o~:. . ..,[Ma"~' . .. ".' "." ':. · ,. ' .. . Drain ......... ~emarks: Zabel .Flow Diverter .Val~e :-' BENCH MARK '" Placed ,~nd' Existing' " Absorption. Cri~ Bottom Step ~f'Stairway FrOm Opper "~ 'Tied in ;for' Future u~e'. ' Zxisting DeC~-": .... "": "" .... "" ' :" ; ~"' .. '.-.~ . '~ · . ..... · ... .':' .: .: '.;.. .: -. · ...'.. ~.~W..~.- .. .~..~.:~,~{; 'Inspections Pe,o~ b~ N~A ' Dates: ls, '8/29/00~ ~~~ ~~ ," Depa~me'nt 0f Heal~and.Hpman~e~ices 'aPproval · :}~'' '~ '.~'~:: ~ Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 -Anchorage, AK 99519-6650 -343-4744 On-Site Wastewater Disposal System or Weft Inspection Report Permit Number SW000294 PID No. 017-451-14 - COUNTRy CLUB LANE .. . "LEGEND '. '.' '~ . S ; Sep~i6.Vent Pipe .. .' '! CO-- CleAnout ! · M '-'Monitor Tube · , "1' 'Dg' ;.zabel Flow Diverter Valve · S1 · 55.7. 50.5 ,S2 : 57.8 .. 57.7 C4 94.3 98.2 C5 ' :94.9 .: 98.4 M1 - ' 97,4 96.4 C6 98.4 86.8 Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744' On-Site Wastewate{ Disposal System or Well Inspectioh R~port Permit Number SW000294 PID No. 017-451-14 98.8 u: oo ,'~ 17' 20* I ha LM 1z L AN r RY Yy Ll - C CC) Q- "�Z T5 16 W�e ra '�'e a.3 Po X 9Y, Coro' Y iii � eo Ven 5 87'.5-f' 00" W '463 —5-0' �A SCI�)LL (60 No. 2 0 21 Recerii{;eo' r� As 6UILT SUVE I hereby certify that I have surveyed the following11 zi AQ I 7 PECORD, OTHER, THAN THF PECCIR� I --'- F. B, 7y -b P4 73 R M H, E re E 0 N. described property: C- 0,V7 0 UP A CR LS A DpiJ. –3 Anchorage Recording Precinct, Alaska, and that thi improvements situated thereon are within the propert3 lines and do not overlap or encroach on the propert3 lying adjacent thereto, that no improvements on prop erty lying adjacent thereto encroach on the premises it question and that there are no roadways, transmission lines or other visible easements on said property excep as indicated hereon. Dated at Anchorage, Alaska 10 f4 J'/ this day of FRED WAI.,ATKA & ASSOCIATES Engineers and Surveyors MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEtNATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 11, 2000 Expiration Date: Aug 11. 2001 Permit Number: SW000294 Legal Description: CONTOUR ACRES #3 BLK 2 LT 4 Design Engineer: 0014 Anderson Engineering Owner Name: Herb Schlerath Owner Address: 5204 Country Club Lane Anchorage. AK 99516- Parcel ID: 017-451-14 Site Address: 005240 COUNTRY CLUB LN Lot Size: 159430 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage 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 ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date: _~-///-~ ANDERSON ENGINEERING P.O. BOX.240773 .. ~ . ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) August 1, 2000 Municipality of Anchorage Department of Health and Human Services 825 "L" Street Anchorage, AK 99502-0650 Subjecb Lot 4, Block 2, Contour Acres Subdivision No. 3 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Servic.es Engineer:. ' The ~xisting absorption crib on Lot 4, Block 2', Contour Acres Subdivision No. 3 has failed and must be replaced. We are therefore applying for a permit to construct a new septic tank and 'absorption system on the lot to serve the four-bedroom home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in .the design. It also shows .the location of the existing wells on the lot and their proximity to the septic system on this lot. The existing septic tank and absorption crib will be abandoned in place..The pipe to the tank will be ca pped to prevent intrusion of groundwater and other debris. The tank will then be pumped. - Two test holes were pla~:ed on the lot in the 'area Of the new absorption trench. Well graded sand was encountered with some gravel and trace amounts of silt. The matedal percolated at a rate 'of 2 minutes per inch. No groundwater was encountered in the excavation, but was noted in Test Hole No. 1 at 15' below the surface during the monitoring pedod. Test Hole No. 2 remained dry.. We have therefore designed a 5' wide absorption trench with 4' of gravel beneath the distribution pipe. The total length of the trench will be 50'. The total depth of the trench from odginal grade will be 7.5'. The ground surface on the lot slopes from north to south at approximately 2%. It also slopes from west to east again at 0% to 1%. The new trench will be constructed parallel to the contours in conformance with Municipal requirements. Grading will be accomplished to assure surface drainage is away from the new trench. If the system is constructed in accordance with our design the following statements apply: ]. The ~ystem, if constructed as designed, will have no adverse impact on tl~e wells in the area or those to be constructed in the future; 2. The system, if constructed as designed, will have no adverSe impact on existing septic systems in the area or those to be constructed in the future. Lot 4, Block 2, Contour Acres No. 3 August 1, 2000 Page Two The system, if constructed as designed, will have no adverse impact On reserve space, either surface or subsurface, on any lots located in the area. o The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Andersonl P.E. Attachments t , --L ~o I Lene.: :'. I THIS PROJECT NOTE: 'Nd .ConfLicts. With Wells in the Ar~a. AREA MAP ../ COUNTRY CLUB LANE Well SCOPE OF WORK: 1. Verify the Foundation Cleanout. Place New if Necessary. 2. Intercept Existing Service Line at Location Shown. 3. Place New 1,250 Gallon Septic Tank. 4. Place 2 Post Tank Cleanouts. 5, Construct New 50' Long X 5' Wide X 4' Effective Depth Absorption Trench. 6. Pump Existing Septic Tank. 7. Cap Pipe to Existing Tank and Abandon. 8. Regrade All Disturbed Areas.' 9. Revegetate Area As Required. Asphalt Existi Exisftn¢ 5' Wide x 50' Long x. 4' Effective Depth Absorption Trench SITE SCALE 1" t ~Cr.~-..%...y~ LOT 4, BLOCK 2, CONTOUR ACRES DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rat~: 2 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Dralnfield Rock 4Bedrooms X 150 GPD 11.2 GPD/SF -- 500 SF of Absorption Area 5000 SFI5 LF (Width)*.5 (Red. Factor) = 50 LF Trench Length Therefore: Construct 50' Long X 5' Wide X 4' Effective Depth Absorption Trench. Verify Foundation Cleanout and Replace if Necessary. Flowline Elevation In Trench to be 3.5' Below Original Ground Surface. Total Depth to be 7.5'. Existing Septic Tank and Absorption Crib to be Abandoned in Place for Possible Future Use. · / / 2 Insulation .5' or 3 ~ Cover 4" PVC (}[oles Down)· Drainfield Rock NOTE: · TYPICAL WIDE TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. · Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater.. ~ ,~ Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCO~TION TEST Pe orm For: Legal Description: lot 4. Bt~k 2. Contour Acres Subdivision OG/OL SW with Gravel SLOPE SITE PLAN North South Yes No See Site Plan 1 11 Was Groundwater Encountered? If Yes, What Depth? Depth to Water After Monitoring Date: 15' 8/1/00 12 13 14 15 16 17 18 Bottom of Test Hole Reading Date Gross Net Depth To Net Time Time Water Drop I 27-Jul 10:20 .375" 2 10:30 10 5.25" 4.125" 3 10:31 .25" 4 10:41 10 5.25" 5" 5 10:42 .25" 6 10:52 1 0 5.25" 5" 21 Perc. Rate: 2 Min./Inch, Perc. Hole Diameter: 6" Test Run Between 4 Ft. and 5 Ft. Comments: Perc. Cavity Presoaked Prior to Test. Performed By: Mi~<e Anderson. I, J~3~.-.~[~3~ Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 7/27100 Municipali~ of Anchorage SOILS LOG - PERCO~TION TEST Pe~ormed For: Herb Schlereth Date Pe~ormed~~~ Legal Description: Lot 4. Block 2. Contour Acres Subdivision SLOPE SITE P~N NoRh OG/OL See Site Plan SW with Gravel South Was Groundwater Encountered? Yes S If Yes, ~at Depth? No L I Depth to Water O After Monitoring None P 11 Date: 811/00 E Reading Date Gross Net Depth To Net Time Time Water Drop I 27-Jul 10:25 .25" 2 10:35 10 5.25" 5" 3 10:36 .25" 4 10:46 10 5.25" 5" 5 10:47 .25" 6 10:57 10 5.25" 5" 12 13 14 15 16 Bottom of Test Hole 17 18 · Perc. Rate: 2 Min./inch Perc. Hole Diameter: 6" ~ 21 Test Run Between 4 Ft. and 5 Ft. Comments: Perc. Cavity Presoaked Prior to Test. Performed By: Mike Anderson. I, ~ Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 7/27/00 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 4, BLOCK 2, CONTOUR ACRES GENERAL: The scope of this project includes the procurement and placement of a new 1,250 gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 50' long X 5' wide X 4' effective depth absorption trench at the location shown. Distribution pipe will be placed at 3.5' below the odginal ground surface. The total depth of the trench from odginal ground will be 7.5'. Mounding over the trench will be required to provide a minimum of 3.0' of protective cover. The existing concrete septic tank and absorption crib are to be abandoned in place with the pipe leading to the tank capped to prevent intrusion of groundwater or debris. The existing tank should be pumped to remove all septic waste. The existing system will then remain in place for possible use in the future if necessary. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250 gallon septic tank must be be procured from an approved source and installed at the location shown on the plans. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be suffici,ently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct budal insulation. Lot 4, Block 2, Contour Acres August 1, 2000 Page 2 of 3 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfi(~Id shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area su'rrounding the absorption trenches to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and ,solid). Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). Lot 4, Block 2, Contour Acres August 1, 2000 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabdc, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. MUNICIPALITY OF ANCHORAGE MEMORANDUM DATE: TO: FROM: SUBJECT: A~gust 28, 1990 Accounting & Budget, DHHS Fourth Floor On-site Services, DHHS Fifth Floor Request for Refund - Account 92570-9426 Please make arrangements for the following refund. After researching the application for permit issuance it was discovered the dwelling is a duplex. The MOA does not have jurisdiction over duplexes. Thank you. Janette R. Schlereth 225 East Fireweed Anchorage, Alaska 99503 Lot 4 BLock 2 Contour Acres #3 Well permit application Account 9 2570-9426 Amount: $50.00 Receipt 922139/2901 Laura J. Montgomery On-site Services cc: File GRE, ER ANCHORAGE AREA BOI Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 JGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /-/E~E~ ~'~'~//~'~-~AILING ADDRESS ~ ~ LOCATION ~"~/--/--~//~,~'-~/ ~"?,~/~'~' ~,'z~E LEGAL DESCRIPTION / SEPTIC TANK: D,:STANCE FROM WELL INSIDE LENGTH NUMBER OF MANUFACTURER ~/-'g*~' '~"~'~¢~TERIAg ~'~g'~'~- COMPARTMENTS / INSIDE WIDTH .LIQUID DEPTH .LIQUID CAPACITY /.,~L.~'-~ .GALLONS. SEEPAGE PIT: / _ /~.// / NUMBER Of PITS // DIAMETER I~ OR WIDTH -.~:/~ LENGTh, ~PTH / LINING MATERIAL~p ~'~/'/ "~//~I'~SlZE: DIAMETER /.DEPTH .~' DISTANCE FROM: WELL BUILDING FOUNDATION ~'~' / , NEAREST LOT LINE ':=~ ~ TOTAL EFFECTIVE · ABSORPTION AREA (WALL AREA) '-~¢J;c'J _SQ. FT. ADDITIONAL ABSORPTION ¢~'~'/~/-~ ~'/~¢~,,a~'~-~' ,~,~' ,~,~.~ ~.~,/Z~7~~-- ~ ,~,~" (/'~ / WELL: TYPE ,,~,,~/~:/,'~,,;'?~'~'"' BUILDING FOUNDATION CESSPOOL ~ APPROVED NEAREST ~_ NEAREST __ , LOT LINE /g~ , SEWER LINE , OTHER SOURCES DISAPPROVED REMARKS SEPTIC ~ ~z SEEPAGE TANK -- , SYSTEM DISTANCE FROM: DISTANCES: INSTALLED BY: ~/-'~ ~/'~/~:~ PIPE MATERIAl' LOT SLOPE: ~'~m ~ ~/'g¢~// REMARKS: ~-~t~¢?,~/~-~ ~_~'/~-/~_~ /~,~, ~J ,,~,~/~_ ~,~ DIAGRAM Of SYSTEM DATE Form PW-026 '3aog QIVS H~IM 3DNVaaODDV NI SI ~£~ a3alaOS3a 3AOBV 3HZ ~VHZ aNV Bg'gZ 'ON 3DNVNlaaO NgROaO~ V3aV 3gVa ~NV a3%V3)40 -~O S%N3~3alnb3a 3H~ HLIM aVIql~V4 ~V I /VH~ A411a]g I W~IJ.SAS .-I0 'NOIJ. Y']'IY/SNI E)NIQaYE)'=I~ SNOIJ.¥-]rlg'3~ HE)I-IOMOFI OJ. 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SNI A9 Q3"I']¥.LSNI :aa O.L J. ld 30Vci'4':l S /IWJl3d tiNY NOIIV~nddV -- W3/SAS 'lVSOdSlfl 39V/~3S DEPARTHENT OF ENViRONI~Ehi/~L ~t,ALIi~':' 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE # Performed For ~-~-~--~ ~l\1~,~-~-~ Date Performed ~>~-~ Legal Descri~,tion: Lot c~ Block SI_ Subdivision ~-----o~- _~¢~ -.S ~'~ '~'~ This ~orm Re~orts Soils Loll ~( Percolation Test ~e~th Feet Soil Characteristics 3 Was Ground Water Encountered? ///~ 6'7 ~----~-~-T--T--] '/"ii'i.. I~ Vas, At what Depth? i _~_--F~~~ ~ Reading Date Gross T~me Net T~me Denth to H20 Net Percolation Rate !linute Proposed Installation: Se~:~a~e Pit Den. th of Inlet De~th c n ~!~ E N T S: ! (~ ~ .l~_z~___~_._a..~o~. P,r~in Field To Bottem Of Pit Or Trench. Test Performed ta Certif'ied g,/ Date 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received August 26, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF Pratt INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. Alaska Mutual Savings Bank % Betty C. Dayton 10:30 am 8-31-76 Tuesday Post Office Box 1120 Herbert Schlereth 225 East Fireweed Lane Phone: 274-3561 Phone: 277-5548 3. Legal Description: Lot 4 Block 2 Contour Acres ~3 4. Location: NHN Country Club Lane 5. Type of facility to be inspected Single Family 6. Well Data: Individual A. Type C. Construction 7. Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: B. Depth No. of bedrooms 4 , Sewer Lines D. Bacterial Analysis 1. Size 1. Absorption Area E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank , Absorption area Nearest lot line ,, Other contamination B. Foundation to septic tank ., Absorption area C. Absorption area to nearest lot line On-site system B. Installer 2. Manufacturer 2. Material EQ-034 (1/74) Page 1 of two pages 1. Type of Inspection: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRO VA FHA CONV ZZX~ 2. Property Owner' ~erbert Schlereth Mailing Address: 225 E Fireweed Name of Buyer: refinance (Herbert Schlereth) Day Phone: 277-55~8 Mailing Address:. 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address: sa3]te as a'DOV e Day Phone: Alaska Mutual Savings Bank Rnw ll2~ Phone: none Phone: Legal Description: Lot ~ Blk 2 Contour Acres 3rd Addn. Location: NHN Country Club Lane same as above 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: single family Public Utility No. Bdrms. .Individual well If Individual, number of dwellings presently served If Individual, depth of well ? Sewage Disposal System Type of System: Public Utility one Individual (on-site), If Individual, date of installation ? B~TTY C. DAYTON, ASSISTANT SECRETARY ALASKA MUTUAL SAVINGS BANK ~TH ~( F STREET BOX ! ! 20 ANCHORAGE, ALASKA 995~O 72-003(3/76) TELEPHONE 907 274-3t~6! Page 2 of two pages - R~ st for Approval of Individual ~er & Water Facilities Legal Description Lot 4 Block 2 Contour Acres #3 Comments Approved i~_Q ~/~.. Disapproved Date ~/'3~/~, 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)