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Home My WebLink AboutTHE VILLAGES TIDE VIEW LT 7 MUNICIPALITY OF ANCHORAGE DEPARTMI~NT 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 Foundation C~*.~ Tota, Material benbath tile Depth Crib depth Building foundation Driller Sewer line Material .~ -~.~_~. Width DISTANCE TO: No. of lines I Length of eyFne DISTANCE TO: DISTANCE TO: Building foundation NO. OF BEDROOM~..~ No. of compartments,=~ Liquid depth inches PERMIT NO. Liquid capacity in gallons Total ef fecti~ absorption area Nearest lot line Distance to lot line Septic tank OTHER INSTALLER APPROVED LEGAL PERMIT APPLICAflT LOCATIOfi LEGAL f~LIr~ICI. ~LIT~' OF At'CH., ,~AGE DEPARTMENT OF HEALTH AND ENYIROfIMENTAL F'RoTECTION 825 'L' STREET, Af~CHORAGE, AK. 99501 264-4720 I-4ELL Rr4~' ;~r4--~ Z TE _'~.EI4EF~ ( 79055~ ) SR BOX 1i75 BHUGIRK HARRY MACKEY VILLAGES SC:ENIC PRKWY. 68,8 281-'< LOT ? THE VILLAGES LOT SIZE 64266 SQUARE FEET TYPE OF SOIL RBSORBTION SYSTEM IS: TREHCH MAXIMUM IqUMBER OF BEDROOMS SOIL RATIHG THE REQUIRED SIZE OF THE SOIL ABSORF'TIOf~ SYSTEM IS: DEPTH= 8 LEI'-I ,]TH = 57 GRR'-.-'EL DEPTH= 4 THE LENGTH DIMENSION IS THE LEHGTH (IH FEET) OF THE TREHCH OR DRRINFIELD. THE DEPTH OF A TREHCH OR PIT IS THE DISTAf~CE BETNEEN THE SURFACE OF THE GROUND AND THE BOTTOH OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUH DEPTH OF GRAVEL BETNEEN THE OUTFRLL PIPE Rf~D THE BOTTOM OF THE EXCAVATIOf~ (IH PEET). RE _r-.~U I F-.'ED SEPT I PERMIT APPLICAf~T HAS THE RESPONSIBILITY TO I~FORM THIS DEF'ARTMEf~T DURIHG THE INSTALLATION INSPECTIONS OF ANY 14ELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE 14ELL WILL SERVE. TI-4 E:m ( 2 ) I 1'4$PECT I 01'4S F~RE F-:EQLI I RED BACKFILLING OF Af~Y SYSTEM I4ITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT 14ILL BE SUBJECT TO PROSECUTION. MINIMUfi DISTANCE BETWEEN A NELL AND ANY ON-SITE SEI,IAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE NELL; OR 15~ TO 2~0 PEET FROM ~ PUBLIC HELL DEPEf~DING UPON THE TYPE OF PUBLIC NELL WELL LOGS RRE REQUIREP ~ND MUST BE RETURf~ED TO THE DEPBRTMEHT WITHIf~ 2E~ DRYS OF THE WELL cor,fPLETIO¢I. OTHER REQUIREMENTS MAY RPPLV. SPECIFICATIONS AND CONSTRUCTION DIRGRRMS RRE AVAILABLE TO INSURE PROPER INSTRLLRTION. PERf4 I T E>-'. F' I RES DEOE['IE:ER ~.-.i.- :1_:~ ,--'- _'~- I CERTIFY THAT i: I AM FAMILIAR lqITH THE REQUIREMEf~TS FOR OH-SITE SEIqERS AND 14ELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDAf1CE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEI,IER SYSTEM MAY REQUIRE ENLP~RGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE TFIRf~ ~ BEDROOMS. SIGNED: ........................................ APPLICANT HARRY MRCKEY ISSUED BY_ ............................. DATE_~=J~£:3~_ ..... V~. 2 aPPLICaNT . TYPE OF SOIL ABSORBTION SYSTEM IS: ~ ' ' ', ' MRXINUM NUMBER OF BEDROOMS = THE REQUIRED SIZE OF THE~ SOIL aBSORPTION SYSTEM IS: ' ' DEPTH= f LE~GTH'= 57 THE LENGTH ~Ili[N$IOW ]$ THE LENGTH (IN FEET> OF ,THE TRENCH OR ~RRINFIE[~. THE DEPTH OF R TRENCH~ OR PIT IS THE DI$TRNCE BETWEEN THE SURFACE OF THE GROUND aND THE BOTTOM, OF THE EXCaVaTION (IN FEET>. ' THERE IS NO SET WIDTH, FOR TRENCHES. · ' THE GRAVEL DEPTH I$ THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE RN~ THE BOTTOM OF THE,EXCaVaTION (IN FEET>. , PERMIT aPPLICANT HaS THE.RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING INSTaLLaTION INSPECTIONS.OF RNY WELLS aDJaCENT TO THIS PROPERTY aND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. III TWO (2) INSPECTIOt~ aRE REQLIIEED BACKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION aND RPPROVRL BY THIS DEPARTMENT WIL~ BE SUBJECT TO PROSECUTION. THE MINIMUM DISTANCE BETWEEN'R WELL aND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 3-00 FEET FOR R PRIVATE WELL; OR · ' 3.50 TO 2~8 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED RND MUST BE RETURNED TO THE ~EPRRTIqENT WITHIN ~0 DRYS '.OF THE WELL COMPLETION. OTHER REQUIREMEWT~ MAY aPPLY. ~PECIFICATION5 aND CONSTRUCTION DIaGRaMS aRE aVaILaBLE TO INSURE PROPER INSTaLLaTION. PERrqIT EXPIRE5 DECErIE:ER ~.. I CERTIFY THaT i: I RM FR~IILIRR WITH THE REQUIREMENT~ FOR ON-SITE ~EWERS RN~ WELLS RS SET FORTH BY THE MUNICIPALITY OF aNCHORaGE. 2: I WILL IN$TRLL THE SYSTEM IN aCCORDaNCE WITH THE CODES. 3: I UNDERSTAND THaT THE 'ON-$ITE SEWER $YSTEM MaY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THaN 8 BEDROOMS. Applic~t DRTF V2. 2 f~.~ONSTRUCTION TEST L~B ~ "One TeSt is worth a Thousand Opinions" 2204 Cleveland Anchorage, 'Alaska 99503 277-0231 iPer formed for ~]~ ~- k~ ~. Legal Description:. Lot IT 'Block ~This Form reports: SOILS TEST Date Performed Subdivis ion ~l'tl~f?~.~ '~-/¢.~,~. ~E.~COL~T~O,~ TEST Depth Feet Soil Characteristics ~';as Ground l.;ater Encountered If YES, What depth? Reading Date Gross TLme Net TLme Depth to H20 Net Drainage Percolation Rate Minute Proposed Installation: SEEPAGE PIT ~RAIN FIELD Depth of Inlet __ Depth to Bottom of ~it or Trench ~O:~E~TS: ' /~'~ '~"~' "~;~-'3"~- ~r~_ ~.,./,,.~ · est Performed by ~% Data Certified By: Date : Static wiles I~ull~/~ St,' (IbOVl, below) lind IurIIcI. OJtl sol/mtn. ft. ef drlndowq fto'm erotic fi,Gl. · DltlLLE~I'~: VAT[RIAL LOG (elto 0¢ o~letlol; color, hardness o! drJllifl], I'od Jills content) to to to ts t2 $]NI~ 06 OL 3~ O- ~ 1~ ~IXV31dI$~V~3 IJ - XLd]O I SJSAlWV tAIlS de £~egun _ tl,~d U~ed .Id Porly 2--1-1---72. 2-11-77 75-103 TIDE V I E%.! Cool ,__Cloud.,x +25° F ! ! .5. 5 of ~ Ground l')['$Clt IP T I ON Soil type, co,'oG lc~lu~e, e$llmOled patlJoJe sJlet $omple~ driving notes, d~pths circulation lo~, ~otes on drdhng ease, bits used, etc. Vegotat~ont ._Or.[~a n i c ~P Gravel Poorl~ Graded SP-SM Back Hoe Broke Down U~less otlerwise noted oN somptes ore taken w/l.4"lO ~landofd Pcnettc'mn $om,.~,'cr ~t'ven w,~40 lb hammer. .~0' drop. I BO i CLA$$1FICAIIO~ Gravelly Sand (XFS) (~) 125 ~ Ft~ #PO RF J ~utv ,ss; 321 SIZE I# IILLIK(TERS - CORPS OF [NII I~[I$ UNIFOII SOlL°CLR$$tFIC&TIO# J IldJu' j Fin. GRAOAT I ON CURVES I 0 tO 3~ ~0 . ->. $0i1 l~pe, co.'or, esti'oated port/cie s~ze~ s~,*lee driving d~,p~hs circulolion lost, bits used, etc. Sh~et 4 of Tola! Oe,.olh ] 6 Orga_n_ic Siltz Gravel Ground I'/.~te: Toble tocat,~.? //9!o5 £ Die-groin· Gravely Sand Unless oll~,,wise noted oll $¢.~?Ie, are laken w,/t.4"lO $1andard Pcnetrct,~? Sampler drt;'.~n wi140 lb. ha,nm.~t OEPI# · FT CLASSIFICATION JULY JOS~ ~J G R A D A T I 0 N C U R V E S I.,.,,.o ss I c.,c,. DP 0 ~0 ~0 ?0 .IC~ FINES P~OJ[CT Potter I! V Loun~burv & W/O[spt.#o.or IP llPPilI~ ~'~* "0. ~A/~ ~vid Paul ~t~ ¢o.,p~e~ed 2-11-77 ,~ NO 'oject No 75-103 oyect ~'o~e TIDE VID/ LOG Of' FEST BORING ~ ~'~ It~te fro .Iow/ti V tounsbury ~ Associa~.s Sheet f't~9ineer$ -- Surveyors Fotat Depth ~nchorage, . AIopko 'thodU3ed Back tloe f.lounted nn ?Id Potty ,oth-r Cool, Cloudy +25° F ~umplin9 k~q~r Kvasaqer DESCRIPTION Soil lype~ co/or, le~ture, estimated particle size~ sampler driving notes, depths circulation lotto notes on dr//hag ease, bits used, etc. Vegetation: Ground Oepm in rt. !!.~. Time __. ~rg~nir Locah~n Plates £ Diagram: 3 Woler Toble Sandy Gravel SW ._' ',~_rave,l_2,_..Sand vt/ occassional cobble Boulder Stopped Hole 5 Unless otterwlse noted oil somple~ ore taken w/I.4"lO Standard Penelrott~n Sample~ deiven wit40 lb. hammer, 9~ tO JULY 19~2 ~1 HYDROM£1ER A#JLYSIS ! illiVJ[L JEPTH - FT CLA$$IFICiTII4~ Gravelly Sand (F-2) (SM - SP) 150 Sq Ft/bedroc~ ORAl# SI2E IN EILLIL~JT[KS - CORPS 0r [Kill, OilS UXlr011 SOIL CtA$SIFICATIO# J ll0,ul J ~J"~ J I ,1~I ~ LL PI G R A D A T I 0 N C U R V E S J,,,,,,, ss I c.c,. DP FINES _l ~r ?. 6O PBOJ[CT Potter Il V Lounsbury & Assoc __ ~.~.,n,d iov C'~)Nb-~I~i~UC~ICN ~ ~ [,pi. or Ilo smeple/~o. ~ ~vid Pa~ t~. ~?.~¢~,,~ 2-11-77 ~c C~,~p,'eted _2='1.1_-7.Z -- ,yect ~.z 75-103 ~had U. ed _ · ,th.~, Cool, Cl.o. ud_z +25° F LOG Of' TEST LIO£1NG J~t~9£neer$ -- .~urveyOf$ Anchoragc~ . Alaska I~.ck Iqoe Ilo.ullte-Ak_o.n D-3 E~g~ Kvasager llale t.'o 2 Sheet , ~ of 5 lalal O:i)lh 16 Ground I'/otet Table Depth in rt Da.Oe amp//nj D£SC£1PTIO,'I Soil type, co/or, tedute, est/mated particle $/ze~ $omp/e¢ drlvJi~g notes, depths circulatmn lost, notes ~ drilhng eoso~ bits u~ed~ etc. P+ Orqanic nl,I Sandy Gravel ___._Sliqh_t~y.S_~lt~, Sandy Gr~ve___l SP BOlt Locah::~n l'.'~tes £ Diagram. #2 Unless otte~wis.~ ncted aU sample~ are foden w/l.G"tO Stondaed Penetcat~bn Samplee driven wi140 lb. bamm.~. ~rO' drop. JULY Igc. z ~1 OEPT# - FI GRAIN SIZE IN IILLIIOETEI$ - COI~PS Or ENglk~[giS I ~'"' I c..,,, I '",.' 1 CLASSIFICATI~ ~1 ~ LL Pi Silty ~ Gravel (F-l) '(GM) 225 ~ Ft~ UNIrOig SOIL CLASSIFICATION FINES PROJECT Potter Slmole Umtm .i $C ?0 GRADATION H V Lounsbury & As _sgc. tuamittid bi CC~bqskUCTIC~ TEST I2%B I CURVES J,l,,,,= SS c~,c,,d DP David Paul t*oO't.'.~er; Back tloe Ilounted on D-3 · id Peri/ amex Cool, Cloud.'/ +25° F ....... ~,'~ ~,i~'~'r Kvasaeer of 5 Ground I~ler Oel, m in Ez t'~ DESCRIPTION S~i! type, color, Ie~tore, estimated £orhcl~ size~ sampler driving notes, depths circulation los% notes on dr//hng ease, bHi used, etc. Vegetation: Location Hgte$ £ Table B].ue Grey Si].t Unles~ oltetwise noted o11$ample~ o~e token w/I.4*'lO ttanda~d Penetroh~* Ssmpler driven w/i4O Ib. P. amm.~t SO=drop. CASE NUMBER PETITION FOR DATE RECEIVED DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PLATTING OR PLANNING AND ZONING CASE REVIEW REZONING SPECIAL EXCErpT.. ION VACATION RE~UBDIVI$1ON ~,~ COMMENTS: Hewttt V. Lounsbury & Associates oF ~O~a~:H, Lounsbury for Plat of The V111aqes Ttde Vtew A Subdivision of US Goverr~ent lots 7,8,9,10 & S1/2 SE 1/4 #W 1/4 SN 1/4 and N 1/2 NE 1/2 SW 1/4 SW 1/4, Sec 3, T 11 N, R3N, S.M. Alaska ENVIRONMENTAL SANITATION: ~PUBLIC WJ~?fl NOT AVAILABLE _ UBLIC SEWI~ NOT AVAILABLE TO SERVICE PETITION AREA. , -, . ~DER ~ S-4335 P~11mtna~y S~ T~*t~ adulate far ~ept~C syst'm~ p~tn~ sotls tests and~ercolatto~~ tests. ENVIRONMENTAL ENGINEERING: 71.014 1. GENERAL INFORMATION, :Complete legal descrip~on MUNICIPALITY OF ANCHORAGE DEPARTMENT OF. HEALTH & HUMAN· SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Location (site address or directions). _ . .. _ ..... .... ~"~i~O I'~ ~) ~m-~-/~ Co c~t¢ .. Lending a~gency Day phone Mailing address Agent ' Day phone Address ' -' '" ................ ..'.,-r:". .... q '.;_"47..' ~ ~,'. ,-"' '.' ....... " Unless otherwise re uested, 'HAA will be r p~ckup.:'~!;SL .... ? ~- ' ~' ...... NUMBER OF BEDROOMS: .~ ~ - ~.~. ~1 . 3. TYPE OF WATER SUPPLY: .... .---::-~=_---:.---~-~, ndividual~we ~.~-. ..... ............... Public water e 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 ~ewer 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 As certified by my seal affixed hereto and as of the validation date shown below, I v(trify that my investigation of this Health Authority Approval application shows that the on-site water s. upply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms.' and type of structure indicated herein. I ffJrther 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 oh the date of this inspection. Name of Firm' '~'v~)~-'~O~J ~,J~I~.'-~-- F/,i~& Phone Address ~. EO~ ~O 77Y ~C~O~6~ ~gin~fssignature ~ ~ ~ Z.?,~-' 9110 Approved for- ~ bedrooms. Cor~dition~.l~ approval for · ..-f/,,,:...~ Additional Comments ' be~rooms~' With the'following'stipulations: .... 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. Empl6yees 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 & Human Services - HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L~ 7,VIL~I~ '['l~)~Vj~l~f/'~. Parcel I.D. A. WELL DATA well type ~'iJDt~/ID{I)~ Log present (Y/N) Y Total depth I~)~ §anitary seal (Y/N) y If A, B, or C, attach ADEC letter. ADEC water syst6m number Datecompleted 1 1,ol7 · Driller~'[~ Casedto ' ~ el Casing height Wires properly protected (Y/N) FROM WELL LOG Date_.Al test · ' ' Static water level " ' ' Well flow SEPARATION DISTANCES FROM WELL TO:' Septic/holding tank on lot lei t Absorption field on lot ~J /~) Z. Public sewer main "~ Public sewer service line WATER sAMPLE'RESULTS: -'Dateofsample: ~/~/~! j B. SEPTIC~IOtffi~ TANK DATA Date Installed ~]7~ . Cleanouts (Y/N) g.p.m. Nitrate ~'~-I'1 ~,/~ q/~/' Collected by: Tank size 1000 AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Other bacteria Compartments ~ Foundation cleanout (Y/N) ~J/ Depression (Y/N) Ala;mtested(Y/N) [.[//~ ' High water alarm (Y/N) Date of pumping SEPARATION DISTANCES FROM SEPTIC,' ......... TANK TO: Well(s) on lot IO[/ On adjacent lots ~ ~OD~ Foundation I~1 To propertyline Absorption field ~,'~ Watermain/serviceline ( ~1 Surface water/drainage ~ I(~)~ 72-026(R~.~1) F¢~t MOA21 CONTINUED ON BACK PAGE C. LIFT STATION ~ed Size~ Meets MOA e~ectrical c0des'(WN) ~ D. ABSORPTION FIELD DATA Date Installed Ler~gih '~'~' Width.~~/'' Gravelthickness ,~t/ ,, . ' ' "Total depth'-:~ To!~l.'~bsorption._area Depress on over field (Y/N) . Results (pass/fail) Peroxide treatment (past 12 months) (¥/,~) Well on lot I~)~t ' ' To building foundation' ~'~ On adiaeent lots Surface water. Curtain drain SEPARATION DISTANCE FROM ABSORPTION FIELD TO: ' On adjacentlots ~2t~/ Property line To existing or abandoned system op Cutbank ~ Water main/se~ice line Driveway. parking/vehicle storage area ENGINEER'S CERTIFICATION Z~/ O~ ~r~ I ce~i~ that l have checked, verified, or conforme~o alt and es tn effec~nlh , ,, , 72-026 (Rev. 3/91) BeCk MOA21 HAA Fee $ Waiver Fee: $ "- Date of Payment Date of Payment % Receipt Number ) Receipt Number Cl~anoqts, present (Y,/.N): 'r.' Date of adequacY' te~t," ~l If yes, give date bedrooms ' ~ CHEMICAL & GEOLOGICAL LABORATORY · A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE. ALASKA 99518 TELEPHONE (907) 562.2343 FAX: (907) 561-5301 Coll.:to4 10C 9 91 ! H:30 Es. Client Client ~e~e~ ChemlAb Ss! l: 9140~0 Lob SaR1 I~: i htrtx: PazaMte: Tested Seeult Omtts Method Lt~ttt Sample SOW£I~ SAMPlE COLLECTED IX: A.H. More ~etoctod "Sea Sample SIMZEI iboye Hot t~l~ t?-[,,, Thn, ~-Cziate: Th~ ~,.~ ~ Mernbe, of the SOS Group (Socit, te G~nerare de Surveillance) ROCKFORD CORPORATION P. O. Box 111706 ANCHORAGE, AK 99511 (907) 344-4551 SHEET NO. OF ~,~ 1 '= ~0' Permit No. "-- Page of ' '" Municipality of Anchorage 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 APPLIC'-~IT FILLS OUT'UPPER HAL'-~:ONLY Buyer ~ C' ~ /' Address ) Zip Code No. o! Bedrooms Street Locatlm ri Multiple Family n Other r-~ Public Utility C] Holding Tank Zip Code zip ~e Phone Phone ATTACH WELL LOG. A we~l log Is required for all wells drifted Since June 1975. For wells drilled prior to that date, give well depth (attach log if available). Year Individual Installed: When Connected to Public UtiUty: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE P~OCESSING CAN BE INITIATED. Time Date Inspector Time Time Date Date lC') ~ ~q_c~% I ,%~,9 (3) APPROVED B~OROOMS ) DISAPPROVED 'CONDITIONS OF APPROVAL Time J~4UNICIPALITY OF ANCHORAGE PEPT, OF H=/'.LTtl C~ £NViRO,'~'~: NTAL PRC)T~CTION SEP 2 8 RECEIVED ALASKA I uIROriI 6I TAL CORTROL SeRu CeS, linC. ~n(lin¢~rin~I ~, J~noironm~nl~l Slu~Ji~$ RF. cEIX/ED OC'( ~ 7 ~%S3 OCTOBER 11 1983 GORDON PHILLIPS P.O. BOX 11-1351 ANCHORAOE AK 99511 SELLER - GORDON PHILLIPS BUYER SUBDIVISION - THE VILLAGES TIDE VIEW BLOCK - 0 LOT - 7 ADEQUACY TEST FOR SEWER SYSTEH THE TYPE OF ABSORPTION SYSTE~f IS A TRENCH WITH AN AREA OF 450 SQFT. THE SYSTg~t IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 676 GALLONS. BASED UPON THE TEST DATA THE SYSTF2t IS ACCEPTABLE FOR A 3 BEDROOM THE SEPTIC TANK WAS PU~PED ON 10/12/83 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLU~E OF 1000 IS ADEQUATE FOR THIS 3 BEDROOH HOUSE. '~ ~ *.,.~ ..: e%~~ 1200 UJcsl 33roi Aucnu¢. $ui1¢ B · Antron'acid. Alas[a ~503 · (~07) 276-1361 INSPECTION APPOINTMENTS TIME TIME DATE DATE INSP~T~ INSPECTOR TIME DATE INSPECTOR MU~'13CIP,ALI1,y Or ~r~LJ-IUF, AGE MUNICIPALITY OF ANCHORAGE -._ ~EPT. OF H~ALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~IRO~ENTAL P~OTE~ION 825 L Sir.t- A~hor,.. AI~. ~1 N 0V 2 8 1979 ENVIRONMENTAL SANITATION DIVISION Tele~one ~7~ RD EI. ED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts o. page 1. Incomplete reques~ will not be procee,~41d. Please allow ten (10) days for processing. 1. PROPERTY OWNER Harry A. and Madeline M. Mackey MAILING ADDRESS St. Rt. Box ~ 1175, Chugiak, Alaska PROPERTY RESIDENT (If different from above) N/A 2. BUYER ^DOG°rd°n~ss "nd Brenda wht MAILING 99567 PHONE PHONE 2/~-8810 3. LENDING INSTITUTION Alaska Mutual Savings - Branch on 31st. MAILING ADDRESS PHONE 27~- 2551 4. REALTOR/AGENT None MAILING ADDRESS PHONE 5. LEGAL DESCRIPTION Lot 7, The Villages . STREET LOCATION Village Scenic Prkv. 6. TYPE OF RESIDENCE [~ SINGLE FAMILY [] MULTIPLE FAMILY 7. WATE UPPLY ~ INDIVIDUAL' I--I COMMUNITY [--I PUBLIC UTILITY 8. SEWAGE DISPOSALSYSTEM . [~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY Tideview Subdivision Anchorage, Ak. NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five ~[] Three [] Six [] Other · 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.) 1979 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72.010 (Rev. 6/79) L~ 1. TYPE OF RESIDENCE .* THIS SIDE FOR OFFICIAL USE ONL~ 'NUMBER OF BEDROOMS SINGLE FAMILY MULTIPLE FAMILY I'-I ONE [] THREE I-'1 FIVE I'-I TWO I--I FOUR [] SlX 2. WATER SUPPLY [] INDIVIDUAL- [] · cOMMUNITY [] PUBLIC UTI LITY .' Connection Verified 3, SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or I-'lHolding Tank Size:)~(~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER MANUFACTURER MATERIAL ~ Septic/Holding Tank IAb$orpt[on As'aa . Sewer Line f--I OTHER INeare~! Lot Line D ' DISAPPROVED DATE I BY APPROVED FOR BEDROOMS CONDITIONAL APPROVAL (letter must accompany certificate) 72.010 (Rev. 6/79)