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Home My WebLink AboutSOUTH LAKEWOOD HILLS #1 BLK 4 LT 4South Lokcwood Hills #1 Lot 4 Block 4 #015-151-36 Municipality of Anchorage Page I of 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: ..~1.~, ~:>O<~ ~ 3'7 PID Number: ~t,5" - I.S'/- ~ Name: P~ ~ ~ ~o ~/o ~ Wastewater System: D New. D Upgrade n /oo ~~ ~ ~ ABSORPTION FIELD Phone ~-Z~ ' IN°°IB~'°°ms ~Ch O Shallow Trench OBed OMound / LEGAL DESCRIPTION ,o,,,,,,~: ~~ ~, ~t. ~L/ so ~ v,ele:GPM I Pump Sel It: Fl I Cism; He,g.I A~e Grou~Fi. TANK SEPARATION DISTANCES ~s~.c D Ho~ei~o ~ S.T.E.P. Surface w~,~ ~, ~ - - - LIFT STATION ~.~. I Foundation ,~ ~ -- ' - "Pump On"lev'l'l: I'Pump off"lev"": ~ H'g~ w'l'r '"'m 't: Curtain Pump Make A M~el I Electrical I~lpectio~s pedorme~ I BENCH MARK Remarks: ~A~ tA~/f~ Insp~cti0ns performed by:. F4~ ~c~ ~c Dates. 1st 7/1~/oo r~.................,....... ~ ~... CE 3539 .. ~. Department of Health and Human Services approval ~.~... .. ;~.~ PERMIT NO: SW000237 PID NO: 015-151-36 SWING TIES: FROM: COR."B" COR."C" TO: S.T.C.O. "D" 25' 36' S.T.C.O. "E" 29.5' 40' DBL. C.O."F" 30' 47' TR. C.O. "G" 43' 92.5' PLAN VIEW SCALE: 1" = 30' PAGE 2 OF 2 ## P~ ,, ,, EXISTING 4~' LONG SOIL ABS. TRENCH #F" NEW12 SEPTIC TANK DRIVE TBM LOT 4, BLOCK 4 "--. SO. LAKEWOOD HILLS #1 EXISTING j TRENCH INV. 94.0 FINAL GRADE 4' SOIL COVER NEW 1000 GALLON STEEL SEPTIC TANK PROFILE VIEW NOT TO SCALE FROM ~INV. HOUSE 94.3 LOT 4, BLK. 4, SO. LAKEWOOD HILLS S/D #1 SEPTIC TANK REPLACEMENT AS-BUILT INSPECTION REPORT R. AI'TOP TECl INICAL SERVICES 14530 EClIO STREET ANCI IOP. AGE. ALASKA 99516 SCALE: AS NOTED DRAWN BY TFM JULY, 2000 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-0650 (907) 3434744 7- 7-oo - ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 17, 2000 Expiration Date: Jul 17, 2001 Permit Number: SW000237 Parcel ID: 015-151-36 Legal Description: SOUTH LAKEWOOD HILLS #1 BLK 4 LT 4 Design Engineer: 0019 Flattop Technical Services Site Address: 011100 MAGNOLIA ST Owner Name: PETER & BARBARA SOKOLOV Lot Size: 30400 SQ. FT. Owner Address: 11100 MAGNOLIA Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516-1846 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail 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 1o prevent freezing. Received By: ~'~ ~ Issued By: ~' ~ Date: Date: (VACANT) ', ' ' , , SEPTIC .' ~'~ ....... °" ,, , .. LOT 2 , , . .,' ........................ I ', R 100' , ~mT. ' R UC. / , , ' ,/ , WELL ~ '' t2~ GALLON ', , ~;~;~:~ . I FIBERG~SS ' DRIVE i " , ~~;~"~~ L . LOT 3 SEP~C TANK; ". I .." BLOCK 5 ~H NEW : . STEEL , LOT 4, BLOCK 4 ' ' ' ' SEP~C TANK ', ' SO. ~KEWOOD HIL~ ............. ' SEPTIC LOT 5 , , LOT 6 ~ I , ~ I ', , , I , , , ,, i ' , ~ ~ .... ~. , LOT4, BLK. 4, SOUTH ~K~OOD HILLS -'~,. ~'/ ....... ~ ~[ , WELL AND SEPTIC SYSTEM ? ¥ ~ '-"' ,[ '".~" SITE P~N .~ ~ . ~OP ~C}~C~ SE~C~ 1 INCH ~ 50 FEET ?, ~~ ~ ~ '. D~WN BY TFM · ~re..~.~ .... ~eeeeee~eee~ ~ ,, 14530 ECtIO S~ET .,.,~.... c~- 35s9 .. '~ ~ --.. ~' ~- ~. ~,~ ~L LOCATIONS SHOWN ~E ~PROXIMATE. 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 ~UTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING P.arcel I.D. # 1. GENERAL INFORMATION Complete legal description /-o F ~, H' tlc t~ / Location (site address or directions) e e Property owner /%/-e,- { Z~,-/-~,~t ~o./<o/o~' Dayphone Mailing address - I*1' I OC~' /w~z~>,~ol l=< j (q,~c~o~ ., ,~-~<' Lending agency ~n Lc,~=.c~,,~ Day phone Mailing address Agent Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~/' TYPE OF WATER SUPPLY: . Individual well 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 NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system.. 5. STATEMENT OF INSPECTION BY ENGINEER Se 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 codes, ordinances, and r§gulati.ons in. effect on the date. o~f this inspection. /.z,,~,, Phone Name of Firm r~l~/--/~,,~ 7-,,~A~;¢,,~/.c.~.~,,,;¢~. Address I~l-C,.?0 ~.-4o ..('~. ,. ,,4.^~l.,~-~:ze_r~'~'' Engineer's signature "~"~. ~ ~ DHHS SIGNATURE ~_ Approved for bedrooms, Disapproved. Conditional approval for bedro6ms, with the following stipulations: Additional Comments By: Date The Munici~3ality 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 th eir lending institutions in order to satisfy ce train federal and state requirements. Employees of DH HS 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 & HUMAN Enwronmenta Sennces Dvs,on 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checkllet LogalDescription: L ~ ~ .~ , [~/¢e~.~,,~' ~ /I.~ ~Z~ / PamelI.D.: C~/,~' If A, B, or C, attach ADEC letter. ADEC water system number 81z5' Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION A. WELL DATA Well type ?~', ~' -~/' ¢ Log present (Y/N) ~'¢,~ Date completed Total depth /'7~' Cased to I'rC~ FROM WELL LOG Date of test ~ I ~ 5' 1?.5*- Static water level 10,5' ' ~ o ' Well production ~; g.p.m. '7. _~ Y- WATER SAMPLE RESULTS: g.p.m. Z. o.5' ,.~.,.9-/-~ Otharbacterta ,qo,~ r~,eo,',~,,.'[' Collected by: lC'lc,//.r,,, Coliform C> ~-,=, f Date of sample: 7 / SEPTIC/HOLDING TANK DATA Date installed 7/'/7/Oc' Tanksize Foundation claanout (Y/N) Nitrate Cleanoute (Y/N) . A~. ,4., Number of Compartments ~ N High water alarm (Y/N) Depression (Y/N) Date of Pumping N.&. ('/Ve~,.~) Pumper M.~ ABSORPTION FIELD DATA Deteinstalled ~/~-~'/"r,C Soilrating (g.p.d./fForfffFodrm) ~..~Systemtype Length /Y &' ' Width ~ ~J ' Gravel thickness below pipe Effective absorption area '.': ') ~?Monitodng Tube presem (Y/N) Y Date of adequacy test ~//~.1oo Resutis (Pase/F ,il) Fluid depth in absorptio~ field before test (in.); I 0'7 Fluid depth I I~' ~/,9 (ins) Minutes later:. 1~ 7 Pen:txide treatment (past 12 months) (Y/N) 724326 (Rev. 3,/96)* I o' Total depth Depression over field (Y/N) For "/' bedrooms Immediately after~'%~ gal. water added (in.): I Absorption rate = ~ 6OeP ;;.p.d. /,<na, e.u,~ If yes, give date ~. D. UFT STATION /~J. ~'. Date installed Size in gallons ManholalAccese (Y/N) 'Pump on" level at* 'Pump oft' level at* High water alarm level at* *Datum Cycles ta~ed E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot I :~ o ' On adjacent lots ~> loc, , Absorption field on lot Public sewer main On adjacent lots Public sewer manhole/cleanout /~/- Sewer/septic service line ~ ~" SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation I ~- ' Property line ~_ '7 ' Absorption field Water maln/sewicellne ~. lo ' Surfacewatar/drainage ~> ic.~ ' Wells on adjacent lots ~ roe, SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ~ 3 ' Building foundation · '~ .7 ' Water maln/sewice line Surfacewatar ~ toc, ' Driveway, parking/Vehicle storage area > 5-~ ' Curtain drain Wells on adjacent lots ~. Ioo , Signature Engineer's Name Date ,~-~ I¥ ENGINEER'S CERTIFICATION I certify that I have determined thru field fnspec~ons and mwew of Municipal recoMs .~..~e. abeve sXsrems am in conformance with MOA HAA guidelines in effect on this date. HAA Fee $ ~' Date of Payment Receipt Number 72-o2e (Rev. 3~S)* O?-Ir-O0 H:43 F~-CT£ E~V]RO~M~TAt. a~l~K CT&E Envsronmental Services Inc. T-44Z P.0Z/0Z S~ple Remarks: 1003764001 Fla~op T~c~ica! Sty. L4 B4 SO Lakewood Hills I.,4 B4 SO Lakcwuod DrLug~g Water o Orient 1'O~ Pre-Paid Coli~TO3 Printed Daze/Time 07114~000 16:14 Colbct~ Date~ime 0T/l~ 16:30 Technical DirKtor Strphen CEde Released B~ ~~ 0.$00 u 0.$00 e~/c EPA 300.0 10 ma~ 0?I1Z/00 $ck Total CoLIfo~* 0 coL/1OOmL ~q18 92~2B O?/I~/OD ILAP George P. Wuerch. Mayor Municipali ' of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage. Alaska 99519-6650 hltl3:llwww ck anchor acje.a k.us 343-4744 August14,2000 Bruce B. & Phyllis A. Johnstone 1735 SE Elliott Portland, Oregon 97214 Re: Separation Encroachment of Absorption Field to Water Well, Lot 3 Block 5 South Lakewood Hills #1, P.I.N. 015-151-34 Dear Mr. & Mrs. Johnstone: The property described as Lot 4 Block 4 South Lakewoed Hills #1 recently had the on-site wastewater disposal system and water well evaluated to obtain a Certificate of Health Authority Approval from the Department of Health & Human Services. The engineer performing the evaluation discovered that the water well serving the home on this property is being encroached upon by the wastewater system serving the home on Lot 3 Block 5 South Lakewood Hills #1. According to our records you are the owner of this property. The existing separation is 88 feet from your wastewater absorption field to Lot 4's water well. This water well is located across Magnolia Street to the west as shown on the attached site plan drawn by the engineer working on the approval for Lot 4. The required separation is 100 feet. This is a violation of Chapter 15.65 of the Anchorage Municipal Code of On-Site Wastewater Disposal Systems. The water well on Lot 4 was constructed in August 25, 1975. The trench extension off the seepage pit on your on your property has no documentation in our files. Without this documentation, this office has no alternative than to hold you responsible to resolve this encroachment matter. It is very important that you contact this office either in person or by phone at 343-4744 when you receive this notice. Please contact this office by no later than Friday, August 25, 2000. Sincerely, Dan~h Civil Engineer On-Site Services Program MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Services Waiver Review Worksheet WR#: WR000055 PID~: 015-151-36 HA#: .HA000333 Date Received: July 277 2000 Legal Description: South Lakewood HIlls #1t Lut4r Block 4 Permit: Engineer:. Flattop Technical Services 14530 Echo St.t Anchorage~ AK 99516 Applicant: Peter & Barbara Sokolov Waiver Requested: 88 foot waiver from well on subject property to an un-documented upgrade to the absorption field on Lot 3~ Block 5 of the esme subdivision. Criteria: 1. 2. Special Conditions: 3. Other:. Geology A. Watar Tabte B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: Total: Waiver is Granted: ~. Waiver is not Granted: List Conditions'or Reasons for above: 1~'O J_~TF-t~ /KUI/. ~T /~ Date: ~ -- '2 ~ "40 Rec~: 0000 Amount: 0000 By: D/~/c/ Name of Reviewer Date Paid: 0000 I I /47' ' 1~ 7 . · =~' X=,lf+ 7 C; R. 7.2 I~)~ + {,~ + f~)~. t ~' y' = G~Ruo r~r~z. H. ~ CIVIL & ENVIRONMENTAL ENGI~EER~G * ENERGY CONSERVATION & ANALYSIS TIIEODORE F. MOORE, P.E. 14530 ECHO ST. Pii: (907) 345-1355 ANCHORAGE, ALASKA 99516 July 26, 2000 M.O.A. DHtlS P.O. Box 19~6650 Anchorage, AK 99519-6650 Dear Sirs: By means of this letter we are requesting issuance of a waiver allowing the well on Lot 4, Block 4, South Lakewood Hills # 1 to be approved in its present location, which is approximately 88 feet from an un-documented upgrade to the soil absorption system on Lot 3, Block 5, South Lakewood Hills #1. A site plan, driller's log, soils information, water sample test results and copies of other relevant information are attached to assist you in your review. According to the driller's log, the well was drilled on 8/25175 and has a total depth of 170 feet and a static water level of 105 feet. On July 6 ofthis year I conducted a yield test ofthis well. The initial static water level was 90 feet below the top ofthe two-foot high casing. Steady pumping of 790 gallons of water from the well at the maximum pump output of 7.3 gpm caused the water level inside the casing to be drawn down to 95 feet, but no further. Based on the test data I determined that the total yield of the well is in excess of 7.3 gpm. Water samples collected on July 12, 2000 were found to be satisfactory with the lab test report showing 0 coliform or other bacteria and less than 0.5 mg/I ofnitrate-N. According to the as-built inspection report, the original septic system serving the residence on Lot 3, Block 5, South Lakewood Hills #1 was installed, on October 1, 1971 and consisted ora 1000 gallon steel septic tank which discharged effluent into a 9-foot deep concrete ring seepage pit located 108 feet from the well. Although I could not find a standpipe for this seepage pit, I found where I believe it is located in a shallow, rock-filled depression that is in the right location relative to the well, septic tank and property line. Unfortunately, I also found another standpipe on this lot (made ofF-810 plastic), which is located only 91 feet from the well on Lot 4, Block 4. This standpipe appears to be part of an undocumented upgrade to the septic system, which was constructed some time after the original system. I measured this standpipe to have a total depth of 10 feet, and to contain 79 inches of what smells like septic tank effluent. Based on these observations, I am requesting a waiver allowing the well to be 88 feet from this septic system to allow for a small amount of possible underground extension of the trench closer to the subject well. Since the trench upgrade is undocumented and appears to have been constructed subsequently to the drilling of the subject well, I understand that no waiver review fee will be assessed to the owner ofthe well oh Lot 4, Block 4. The soils test logs for Lot 3, Block 5 and for Lot 4, Block 4 show soil ratings of 217 and 225 square feet per bedroom respectively, which corresponds to a gravelly soil with a significant silt content that has a relatively slow perc rate and therefore should provide good filtration ofseptic tank effluent as it passes through it. The driller's log for the well shows clayey sandy gravel extending down to the level where the aquifer was first encountered at 147 feet. This type ofmaterial (when found at significant depths) usually has a per¢ rate in excess orS0 minutes per inch. The fact that the static water level was found to be at 90 feet indicates that the aquifer is in fact confined by impermeable overlying soils, and thus should be very well protected from contamination originating in close proximity to it near the surface. The fact that the recently collected water samples showed neither bacteria ofany sort nor any detectable nitrates is further indication that the aquifer is well protected from contamination, which means that the requested waiver can be safely granted without concern as to public health. The following is a breakdown of how waiver analysis points could be assigned using DEC's 1985 "Separation Distance Waiver Guidelines for SCRO'. Category Points Distance to water table (88') Soil sorption (sand with clay) Soil type (soil with pert rate >50 min./inch) Water table gradient (0% parallel to ground surface) Horizontal separation (88') Total 6.2 2.5 3 2.9 2.5 17.1 Based on this point assignment it appears that the requested waiver can be granted, as the well should be almost sure to be free from any form ofcontamination from household sewage. The recent clean water sample provides further support for this determination. Please feel free to give me a call if you have any questions on this analysis, and otherwise please proceed with issuance of the requested waiver and HAA certificate allowing the sale of this house to be finalized. Sincerely, Ted Moore, P.E. cc: Peter and Barbara Sokolov ' . i i~i~ ~ I LOT 1 , . ~:~'~ ........ ~ ~ j BLOCK 5 , SEPTIC -. ~ , ANEA o ;~,: ......~... SEPTIC · ' LOT 2 ,' C.O.- ,~ , I ' UNDOCUMENTED , . ~--M.T. / El , ', [, ,"~ .~ R I00' ~, /~ UPGRADE ,TRENCH ', EXISTING ,' : /~/---SOIL ABS. TRENCH /- ' Id ~ WI=I I ----/ NEW 1250 GAL. :~.:~i:~!~::~ I ' ~ PIT TANK : '~ .. _ I...' ', , SO. LAKEWOOD HILLS ' , I ........................................... , I LOT 5 '- , SEPTIC -. ' .-. ..... -[ - I BLOCK 5 '-. , AREA . ' , , ,,, ' ; I ~ ~.'.~.;~,... .. ,.~¥ 4" ; ,, LOT 4, BLK. 4, SOUTH LAKEWOOD HILLS WELL AND SEPTIC SYSTEM ' SITE PLAN F~ATTOP TECI IN,CA]. SERVICES 1 INCH = 50 FEET 14530 EC[IO STI~ET DRAWN BY TFM · ' ~C] lOP'GE, ALAS~ 995 ! 6 JULY, 2000 ' -. NOTE: THIS IS NOT A SURVEYED PLAT. ' '-. - - ' ALL LOCATIONS SHOWN ARE APPROXIMATE. LOCATION WATER ~ LOG FOSS DRILLING 1~36 Ir~ra Street Anchorage, Alaska 99}01 SIZE OF FEET OF DATE COMPLZT~D I'UMP TO BE SET rOI ItOI __tO__ ItO . ,tO__ Hi, rd '. !' :..' ====================================== :::::::::::::::::::::..:: : . ::'.'.':.' :.-_': ........ J ........... : .......... -~ ............... ....... : ........... : ...... i ....... '~-.4 ...... Page: i Document Name: untitled PARCEL: 015-151-34-000-01 CARD: 01 OF 01 RESIDENTI~J~ SINGLE F~24ILY STATUS: RENUMBERED TO/FROM: 000-000-00-000-00 JOHNSTONE BRUCE B 50% & SOUTH LAKEWOOD HILLS #1 JOHNSTONE PHYLLIS A 50% BLK 5 LT 3 1735 SE ELLIOTT PORTLAND OR 97214 0000 SITE 11101 MAGNOLIA ST LOT SIZE: 30,400 ---DATE CHANGED ....... DEED CHANGED---' ZONE : R6 OWNER : 06/24/98 BOOK : 3270 PAGE: TAX DIST: 002 ADDRESS: 07/07/00 DATE : 06/15/98 GRID : 444444 HRA # : - PLAT : 00-0000 NOTES : PLAT P-611 .................................. ASSESSMENT HISTORY ...................... ---LAND .... BUILDING .... TOTAL--- FINAL VALUE 1998: 32,400 166,600 199,000 FINAL VALUE 1999: 32,400 178,000 210,400 --EXEMPTION FINAL VALUE 2000: 39,900 181,300 221,200 ..... TYPE-- EXEMPT VALUE 2000: 0 0 0 STATE'EXEMPT 2000: 0 FINAL VALUE 2000: 221,200 -COMM COUNC MID-HILLSID Date: 8/14/ 0 Time: 08:11:25 AM GRE/ .R ANCHORAGE AREA BOR,,' 'GH Department of Environmental Quality 3330 ¢ Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM W E LL~'a~O · INSIDE LENGTH MANUFACTURER~L~'- .UMBEROF MATERIAL COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/~-~'-(OGALLONS. TILE DRAIN FIELD: ~ L~ c~ / / TOTAL LENGTH / DISTANCE FROM WEL ' FOUNDATION .NEAREST LOT LINE /c~ OF LINES Z~Z~ NUMBER OF LINES [ DISTANCE BETWEEN LINES TRENCH WIDTH 3 / IN. TOTAL EFFECTIVE ABSORPTION AREA ~-~ ~ SQ. FT. LENGTH OF EACH LINE ~ / DEPTH: TOP OF TILE TO FINISH GRADE c~- / DEPTH OF FILTER ~ iN/~.AB MATERIAL BENEATH TILE v/Z:) / I~ /? OVE TILE IN. WELL: TYPE .~ CONSTRUCTION __DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST FOUNDATION__ LOT LINE .... 5EWER LINE SEPTIC SEEPAGE TANK . SYSTEM CESSPOOL OTHER SOURCES APPROVED -- DISAPPROVED DISTANCES: INSTALLED BY: ~ SEWER LINE DEPTH: REMARKS: .,~IAGRAM OF SYSTEM DATE '~/ ~APPROVED ~-~t.t~ ~ Form EQ-032 GRe.,/--'~..'R ANCHORAGe AReA BOF"~GH DEP :MENTOFEN*'RONMENT^LQUAL'T ', : TELEPHONE Z74-4561 ~' ~ SEWAGE DISPOSAL SYSTEM ~ APPLIC~TIOH ~HD PERMIT FINAL INSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT I~ C~ / DRAIN FIELO ~ ~ ~ TO NEAREST LOT LINE, WATER MAIN TO SEPTIC TANK ! DIAGRAM OF SYSTEM I CERTIFYTNAT ' AM FAMILIAR WITH THE ~EQUIREMENT$ OF GR£A ER R 'R -- ~R~D/~ ~;(~'~ ;e,'."o.'t~ .rcr Steye S2r~_ers_e_n- ~a~ ?~.'f~r~,~ 22 June '~;i~ Tc~.e £eports a: Sctla LoF ~ ?e~:a;.~to~, '.est Feet 2 Gm The se81ments had a high cobble and boulder content. there was also a very high. coarse s~nd content. The water content was moderate and the sediments were com- pact. There were some bodies of coarse-sand toward the top. LOCAT 1 OH 5K~ TCH -}. Was Crour, d Water I! yes, At What Dept!~?.. Tcat . By: WATER WF/~L LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 SIZE OF CA~ING(~"DEPTH OF HOLE/~FTo CASED TO / STATIC WATER LEVEL ./ P4' FT. YIELD ~ GALoPEHoMIN. WITH REM/Lm~S DATE COMPLETED GRATER ANCHO~E AREA BOROUGH Department of Enwronmental Quality 33.~ )"--~ ~~.~ F 30 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received /0-?- 7~ ~~L~L~ Time of Inspection~ Date of Inspection~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR C., o N I/ 1. Approval requested by: ?~[7~ ~y-~ Y~ ~'~_~-~-~o_~, Mailing Address: ~ ~o~ ~, ~~ ~~ Phone: ~ 2. Property Owner: ~~ ~c~~ Pho~~-~ Mailing Address: ~ ~y~ ~ ~ I~ I ~ 3. Legal Description: ~ ~. ~ ~ ~c~j~ _ - . . 4. Location: ~ ~ ~ ~ ~ ~ ~. 5. Type of facility to be inspected ~ No. of bedrooms 6. Well Data: A. Type B. Depth C. Construction 7. Sewage Disposal System: D. Bacterial Analysis Be A. Installed q-~5-- 7~<' C. Septic Tank: 1. Size I~o O. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines ~/~ Distances: A. Well to: Septic tank -TY/~~ , Absorption area B. Installer 2. Manufacturer ,~t~- 2. Material ~.~-.~ 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 3330 SREATER ANCUORAGE AREA BOP,OUGH ~epartment of Environmental Quality ,,r,,-..,~ Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF ZS,3IVIDUAL SEWER & %,,%TEP, FACILITIES 1. Type of In~ection: C~,IRO VA FHA 2 Property O¥~ner: ~l~on ..~/vrn~on · __ ! Mailing Address: J~r ~/¢ ~ ,~l'~j~//'~Dey Phone Nailing Address: ~K~X e-~/ ~K~.~ Day Phone 4. Name of Lending Institution: CONV ~ Mailing Address: Name of Realto~_ent: Mailing Ad ~[~s: Phone 6. Legal Description: ~/~t Location: ' Type of Fac~l~t~ to be ~nspected: No. Bdrms. e Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Indiv~du.1, date of installation Individual (on-site) ~ Rag~ 2 of two pages - Re~'"~'~for Approval of Individual ?'""~& Water Facilities Legal Description Comments Approved Approval ,Valid for one year from date signed Greater Anchorage Aria 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) 06-1220~) 'Rev. T~73 - - INDMDUAL AHD SEMI-PUBLIC BACTERIOLOGICAL" WATER AHALYSIS INDIV DUAL ~[] - SEMI-PUBLtC [] CHLORINE RESIDUAL PPM . ~ ~ REPORT RESULTS TO CITY ZIP CODE Lab No. OFFICE COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY LOCATION: [] Yes [] No [] Quett~ono~)le i ! SANITARIAN'S REMARKS READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMpL~ o6.~oib) BACTERIOLOGICAL WATER ANALYSIS RECORD I~ev. ]973 )C .,... '7 '~ DIR£CTIONS FOR COLLECTING SAMPLES OF 'WATER FOR BACTERIOLOGICAL EXAMINATION Read Carefull)t and Follow Instrucfiens Exactly Bear in mlnd that water analysis deals with materials present in very minute quanthles. The least care- lessness in collecting and handling may give rise to results which are misleading. Samples are accepted at the reglonal laboratories in the early part of the week (Monday-Wednesday) unless there is an emergency or prior arrangements have been made. Arrangements should be made to have the water samples reach the laboratory as quickly as possible and within 48 hours after colleclJon. After 48 hours, the significance of the bacteriological analysis is impaired. In collecting samples from TAPS or PUMPS proceed as follows: (a) Thoroughly flush lap or pump by allowing water to run freely for five minutes. (b) Shut off water and flame the outlet with larch or burning paper. The flame should not be merely passed over the outlet but should be applied until fixture shows indication of being hot. Flame should be directed against inside edge. (d) Open fixture so that a small stream flows. Remove bottle from mailing ~ube. Hold bottle by the lower half in one hand and with the other remove the screw cap with the fingers, leaving fall protecting cover in place. Fill the botlle to the shoulder. Replace cap with fall cover, screwing firmly into place but da net apply prel-. sure which will split cap. (e) Pack bottle carefully in mailing tube enclosing this completed information sheet. DO NOT COLLECT SAMPLES FROM FIRE HYDRANTS, YARD HYDRANTS, DRINKING FOUNTAINS OR SIMILAR OUTLETS WHICH ARE DIFFICULT TO DISINFECT PROPERLY. STERILE WATER SAMPLE BOTTLES ARE AVAILABLE UPON REQUEST FROM: Dept. of Health & SOc~oJ Services · ~uthcenlral Regional ~nTlar;an 338 DenotJ Street° MacKay Bldg. Ancl~oroge, AlosJ~a 9950! DepL el Health &Social Services NoH~ern ~eglonal ~an;tarJon Fairbanks, Alaska 99701 'Or DidrJct Off;eel Jn I~o;rbanl~, Juneau, Ketchikan, K~diah, Nome, Palmer, .Seld0tna and Vatdaz. Consult local telephone dlreaery for sanilotJan offices lock'ecl In lheJe comrnunJtJes. Anchorage areot¢onlact O~eate~ Anchorage Area Borough Department ef £n'~Jron. mental QuaGIy.