HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 19COnsite File
Eagle River
Valley
Ranchettes
Lot 19C
#050-223-32
~GRE/~"2, ANCHORAGE AREA BOP'~H
Department of Environmental Quality
3330 CStreet
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING ADDRESS~°X ~/(~ ~'~i'~'~ ~J~ PHONE '2:~ 5'7~7
SEPTIC TANK;
DISTANCE NUMBER OF
FROM WELL MANUFACTURER. /1~'~';11'~ MATER,AL t~/~ COMP^.TMENTS /
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH_
LIQUID CAPACITY /~? GALLONS.
SEEPAGE PIT:
NUMBER OF P,TS / . D,AME~ER ('~'~ OR W~DT, /~', LENGT, /b~ DEPTH ~'
LINING MATERIAL ~/(-~, CRIB SIZE: DIAMETER /'/' DEPTH ~1 DISTANCE FROM: WELL
BUILDING FOUNDATION...~I, NEAREST LOT LINE ~ TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) ~?~:>~/
ADDITIONAL ABSORPTION .
WELL:
TYPE ~.~/ U.~/?./.~ CONSTRUCT,ON DEPT. D,STANCE F.OM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE. TANK_ , SYSTEM
CESSPOOL
OTHER SOURCES
APPROVED DISAPPROVED. REMARKS
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY:
PIPE MATERIAl
LOT SLOPE:
REMARKS:
Form No. EQ-O31
V G.A.A.B. -
;GREATER ANCHORAgE:AREA rBOROUGH
3330 "C" STREET , ~ANCHORAGE, ALASKA 99503
TELEPHONE Z74-4561 ,
PERMIT NO.
SEWAGE DISPOSAL SYSTEM ,,--APPLICATION AND PERMIT ~3)-~,"?ff~ '7
OF
INSTAkLATION OF= ' SEPTIC TANK ~ /SEEPAGE PIT ..... ~ DRAIN FIELD , OTHER
: ;:: ..... ....... __......,,. _.........~ ......
FINANCED THROUGH · ,
SOIL TEST RESULTS ~ '~, : : '~ +::'''~' ~ '}: ::~:[ ...... :' :NOTE', :THI8 PERMIt-IS NOT.VALID WITHOUT ~IL.~
r
F'INAL INSPECTIOns' 24'~0U~ N0~iCE'REQUIRED. BACKFILLING OF' 'ANY'SYSTEM WITHOUT fINAL .INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK . - , , , · . ~
/
MINIMUM DISTANCES, REQUIREMENT~ ....................... :;~ ' ..... ' DIAGRAM .OF SYSTEM
FOUNDATION TO SEPTIC 'TANK ~ ~ , i
FOUNDATION TO SEEPAGE PIT -~'~([~) . DRAIN FIELD
SEPTIC TANK SEEPAGE PIT '~O DRAIN FIEL~
W TONEARESTLDTL,NE.LC,
WATER MAIN TO SEPTIC TANK ' ;SEEP. AGE PIT
DRAIN FIELD
SEPTIC TANK. ., SEEPAGE PIT , DRAIN FIELD
TO RIVER, LAKE, STREAM. ' : ~: ~,~ ~
4 INCH DIAMETEI~ CAst IRON SIPHON PIPES· ON SEPTIC TANK AND SEEPAGE Pit
GRAVEL BACKFILL* i %"' , ' !"; T:~ : ' ' ....'. ~,
CONFORM TO BOROUGH R/~GULATIONS REGARDING INSTALLATION.
L../ ~__~ G:^..... *
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHOR~,~E AREA BOROUGH ORDINANCE NO.'28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE~ '
BLOCK
ADDRESS
a
O l
LOTfSl C
Kevbox As-Built
Date "Work "Perfo'rmed
A.h
Condition of Keybox/Comments .
COSA Checklist
Legal Description: EAGLE RIVER VALLEY RANCHETTES LOT 19C Parcel ID: 050-223-32
If more than 1 septic system on lot: COSA Checklist #
of
Structure served by this system
A. WELL DATA – PUBLIC WATER
Well log is filed with Onsite (or attached)
Date drilled
Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date of Sample
Comments __________________________________________________________________________________
B. TANK DATA
Age of tank(s) 48 years
Tank type/material SEPTIC / CONCRETE
Measured operating fluid level in septic tank 69”
Standpipes/foundation cleanout per record drawing
Date of pumping 4/12/21
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 1973 CRIB
ALL standpipes present per record drawing
Total measured depth from grade *10.9 ft (max)
Measured depth to pipe invert from grade *3.8 ft (min)
N/A – pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective *6’+ CRIB ED PER DCO / CRIB ELEV.
Code-required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Adequacy test date 4/13/2021
Results Pass For 3 bedrooms
Fluid depth prior to test 60 in
Water added 450 gal
New depth 72 in
Elapsed time 75 min
Final fluid depth 60 in
Absorption rate 450 gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Comments/Deficiencies: 2003 TRENCH MONITORING TUBE WAS DRY.
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100’
Yes if No
ft
Neighboring Tank > 100’ Yes if No
ft
Absorption Field on Lot > 100’ Yes if No
ft
Neighboring Absorption Fields > 100’
Yes if No
ft
Community Sewer Main > 75’ Yes if No
ft
Community Sewer Manhole/Cleanout > 100’
Yes if No
ft
Private Sewer/Septic Line > 25’ Yes if No
ft
Holding Tank > 100’ Yes if No
ft
Animal Containment > 50’ Yes if No
ft
Manure/Animal Excreta Storage > 100’
Yes if No
ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Property Line > 5’ Yes if No
ft
Absorption Field > 5’ Yes if No
ft
Water Main > 10’ Yes if No
ft
Water Service Line > 10’ Yes if No
ft
Surface Water > 100’ Yes if No
ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No
ft
Community Wells > 200’ Yes if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10’ Yes if No
ft
Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No
ft
Water Service Line > 10’ Yes if No
ft
Surface Water > 100’ Yes if No
ft
If absorption field is under driveway comment below
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No
F. ENGINEER’S 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 COSA guidelines in effect on this date.
4/14/21
FCj
,,
I
ASBUI _.' SFwARD & iSS()CIATE'S Lt N1) S<+R -k''`G f)94-0
HEREBY CERTIFY THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY=
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS
INDICATED, IT IS THE RESPONSI3I LI TY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
EASE MENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI—
YISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
USMIT
APR 2 5 2011,
SCALE=
DATE• .r
y� %v
GRID=
FB:
DRAWN.
,O/Jjf
'.':'T-.' ." '. :~:'~ .... ::.v .': -.:~>',;~_ ~ ...... Division of Enwmnmen~l Se~i~
...... : .-... . . .. - ,. ~;. P.O. Box 1~0 Anchorage, Al~ka "9~1~0
~:~¢~:~:,CERTI~lCA~.OF H~LTH AUTHORI~;, .,.~_ ,~.~ ~.~,~:~..~:
'~0R'A SINGLE FAMILY' DWE~I~'G
D
.. ':- ;-- "-':---~ Complete legal d~cn tion :: ..................... - '.-.~ .........
........... , ...... Lo~ ........................
...... '+'-T.< .-~--~..~ .--~,~-. -~-,~,~.,~,_.~r.,,.lllUlVlrdUz~I W~ii~-- .¥
~4, ~*. ~-::- -- .... "-"-" ' ;;- ~.<-~'~-~; Communitv .well ,,-~',~-~..:;~:..~.'.-;. -~--
='?.~.7:e-'.~'~NOT~ lf communttx well svstem-a rovide w t '
r tten con
...: 5-.-.4... :,~PE OF WAS~A~R DISPOSA~ --
,- .. ::. ..
.' .* .... ..:.:,:..¢: ~fl~bymys~laffix~hemtoand~gft~evalld.,,. ~to d tesh~wn~low, lven~thatmy'::.rr:.:-
~ ' :.' ' :~. ~.~ ?. inv~tigation of this H~lth A~hoH~ Approval appli~tion shows that ~e on-site water supply
' an~or w~ewater dis~! ~em is ~f~, ~n~ional ~d ad~uate for the'number of ~rooms-
. ~' '; ,.:~;.~ ;; and ~ 0f ~m~re Indi~t~ heroin. I fu~her veri~ that ~ on the info~ation ob~in~ kom
· ":... ... ~:': } the Muni~i~aii~fh~h~0 ~1~ and fro~-~-i~a~0n and"inS~[0h,'ih
' c .'~}~ ...... :,~ .... '~-~-~c~',.,¢~- ~.~. ~.~.,--?;-~--~-.,~'~-'~ .-'.-:: - ........ .'. ....
' :... : '.- '. :"~upply ancot w~r d~o~ ~m ~ in eomph~ w~th all Mum~pal and ~to e~,. ~'.
-' · ' "~"~:C:" ':' '~' ~'* ~'~'~:~ ~ '~ "?- ~-.--~ · :-. ~" 7".-~'.~,.'. '.~2.,.';.' ": . ':- ~ ~ · '-"~ "..~. · ,' ..... ' ..... "
...... ' ~'' Name of Fi~ ". ~g~e~' ~g~ S~ces ........... PhOne"' 694-5~95 ......... ,,
., ~ .... ,.,.~..~'<e,...; Add~ .-- .-'."-:?- P;O; ~x '7'/3294 ;-- ~a~e ~ve~. ~ '- 99577-'.~"~'~'~,~.~.~?,:'~>
. ... :.....,;..,
:~ ;':~:: ~:..q~:~ ~e ~umcl~h~ of Anchorage ~ent of H~lth and ,Hum~ ~ (DHHS) i~u~ Hea~ Au~on~.~:;,,
-.' ':F'.;, :: :;; +:¢;:~[ pm~,o~al.eng,~r.~~ t~ the Sate of ~: ~.DU~S d~.[~.~,a~7~ to p~m~m of.~om~ ..? :: .
~: ~: ~; i;;. ;:{', .~,;~:~:}~d th~ii'~ing'~tttU~,~'in'~e~ t° ~.~!n.f~ ~ sa~u'm~e~:}E~plw~ ~f D~H.HS d~.n~t ~:, '..:
' Municipality of Anchorage
Department ~f'He~fil{i-i::~a Hd~b.'~"~e~ices
HEALTH AUTHORITY APPROVAL CHECKLIST
Well type ~d6~-t ~ If A, B, or C, attach ADEC letter. ADEC water system number.
Log present (Y/N) Date completed Driller
depth .Cased to ~ ~ .Casing hei.,~/
Total
Sanitary seal (Y/N) .Wires properly protected~N~
. '... FROM WELL LOG . AT I.NS.,~>TION
Date of test
Static water level
Well flow ' . g.p. . g.p.m.
Pump level1 ' '. i'.
SEPARATION DisTANcEs FROM WE
Septic/holding tank on lot ; On adjacent lots
Absorption lield on lot
Public sewer main
Sewer service line ..... ././
WATER' S~SULTS:
D~at~ of sample:
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
Nitrate .Other bacteria
Collected by:
B. SEPTi~G TANK DATA
Date installed I ~ /'2 ~
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Tank size / OO O Compartments,
Foundation cleanout (Y/N) V ~ ~ Depression (Y/N)
A//,,~ Alarm tested (Y/N)
~/~' ~./?~ Pumper --~'/~
SEPARATION DISTANCES FROM SEPTIC/i-IQt;~3~NG TANK TO:
Well(s) on lot
To property line
Sudace water/drainage
On adjacent lots
Absorption tie.!d
Foundation
Water mai~ line
/0'
7z.e2s ~). Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
"Pump on' level at
Manufacturer
Manh°~vel at
High water alarm level ~ycles tested
Meets MOA eiec~,rical codes (Y/N)
O~FT
SEPARATI STATION TO: .... ,.
~ - ' On adjacent lots Surface water
- D, ABSORPTION FIELD DATA
: Date installed Soil rating (GPD/FF) .,... ,e..,,.~ ,System type
· Length' //,, ' W'~h /[~ ~ Gravel thickness -"~' ~ ·Total depth ///
Total al~0~tion area ~L/c ~ Cleanoutpresent(Y/N) ~/~.5 DePressionovert'ield(Y/N)
": Date of adequacylest. .. ~:/~.~ ?~ Results(pass/fail) /~$$ 'for
· - ,'Water level in absorption field before test 5'h "' ' ' Nter test 3 ~' ''~
'~' Peroxide treatment (past 12 months) (Y/N) /',//~ If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot. /,//,4
To building foundation
On adjacent lots -/-
Surface water
Curtain drain -~/A
,On adjacent lots
- ~- g.d~" Property line ~'/D /
To existing or abandoned system on lot /4//4
Cutbank /.//.4 Water main/sewieeline "3.r' ~'~.-.,;~
Driveway, parking/vehicle storage area ~ ~..5 ~
E. ENGINEER'S CERTIFICATION
I c~r~y that I have checked, verified, or conformed to all MOA and HAA guidelines in effect.o?.the d..ate of ~is inspec~on.
,' - ' .,.::...:
Date ,'T
Date of Payment
72-o~e rr33)' aac~
Waiver Fee $
Dale of Payment'
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date'
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range) .,,-t £
Location (address or directions)
~-'~'~-~=~-~'-'~ Telephone: Home ."~.5'" 7- BY~ Business
(b) Applicant Nam~ ~ ~
, Applicant Address' ~ ~
(c) Applicant is (chec~ one): Lending Institution ~; Owner/builder ~; Buyer ~; Other~ (explain);
(d) Lending Institution'~~~ ~~Telephone
(e) Real ~tate ~ompanyand Agent ~~ ~
Address
(f)'-M311-the HAA to the following address:
TYPE OF RESIDENCE
.Single-Family~ Multi-Family []
Number of Bedrooms ~o
Other
WATER SUPPLY
Individual Well r'l Community Fl Public,,~
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page I o! 2
SEWAGE DISPOSAL
Onsite/J~ 'Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation lrom the State Department of Environmental Conservation
attesting to the legality and status.
72-025 (I 1/84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA'AND INFORMATION
As certified by my seal alfixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval 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, Ihe 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 $ & S F.r~ineerlr~g Telephone
SRB 196x
Address
Date
Approved v"~ Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees 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.
Page 2 of ~
?2-025 (11/e4)
WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth
Static Water Level
MUNICIPALITY OF ANCHORAGE (MOA/
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Descrip~on:
MAR 1 ? 198
RECEIVED
If A, a, C, D.E.C. Approved
Date Completed j Yield
Cased to ~;;iJ p} ~..f G rou t i n g
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot 7~ ~,~ t ¥
To Nearest Edge of Absorption Field on Lot ~ ~' ~'
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
"pr'q5 Z.t off,'-/"-
To Nearest Public Sewer Line
Cleanout/Manhole
Water sample Collected by
Water sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed
Sta nd pipes (~;~N3"' k'~'
Depression over Tank (~'/~'
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
~paration Distanc~ from ~ptic/Holding Tank:
TO Water-Supply Well
To Prope~y Line
To Water Main/Se~,~e Line
Course
Size ,'/O~~74~) No. of Compartments /~' ~
Air-tight Caps~l~ y~"~ Foundation Cleanout '~
Date Last Pum~d ~/~
~/~ ; for
Tem~rary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
' Comments
Page 1 of 2
72-026(11/84)
ABSORPTION I~IELD DATA
Soiis Rating in Absorption Strata
Date Installed f~:~'"~',-~'
Width of Field
Square Feet of Absorption Area
Depression over Field (~'~
Results of Last Adequacy Test
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present(~J~j'
Date of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well ~..ro i ~' 7~ '~'~'-~/--- To Property Line
To Building Foundation 'z'~o ~ ~" To Existing or Abandoned System on
Lot '~'//,t--- ; On Adjoining Lots
To Water Main/O=,,;ce Line '~' ~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (WN)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Date ---~ --~"-~--~ ;~::~ ~'
MOA No. ~>.-~--~'~
Signed ~~,ia~
Company SR~ 1~
.Eagle .e.l~... &lask~ ~"~S?/'
Receipt No. '~ ~ ~ q~
Date of Payment ~)~ ~
Amount: $ ~
Page 2 of 2
72-026(11~84)
DEPT. OF ENVIRONMENTAL CONSER%~kTION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BIL'I."~IE'FFIELD, GOT/ERrOR
Telephone:
Address:
274-2533
To Whom it May Concern:
According to records on file in this office the
Water Regulations
Water System is in compliance with the State Drinking
Sincerely,
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received April 9, 1976
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
voa,
Time of Inspection ~F~%/~) ~,~.
Date of Inspection ~
l. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
4.
5.
6.
e
Spokane Mortgage Company
3201 C Street, Suite 250
Alan Main
Phone:
Phone:
PSC %2 Box 3841, Elmendorf Air Force Base
Legal Description: Lot 19C Eagle River Valley Ranchettes
Location: NHN Whirlaway Road
277-0543
694-9627
Type of facility to be inspected Single Family No. of bedrooms 3
Well Data:
Co.m.unity System
A. Type
C. Construction
Sewage Disposal System:
A. Installed
C. Septic Tank: 1.
D. Seepage Pit: 1.
B. Depth
D. Bacterial Analysis
On-site system
7 5 B. Installer ~/,~//~
Size ~)~C~ 2. Manufacturer
Absorption Area /J 7'YF- Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank
, Absorption area
, 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
,'.1 I:.::::~c,,~ GREATER ANCHORAGE ARE;, BOROUGH
Department of Environmental Quality
~:;2510 E. Tudor Rd. 99507 276-2221 x283 (Lora)
Type of Inspection: CMRO
Property Owner: Alan Main
Mailing AddreSs:
-. 3. ,Name of Buyer: .Dennis Fish
Mn'iling Address:
VA x FHA CONV
PSC~#2, Box 3841
Elmendorf'Air Force Base, Ak.
Day Phone 694:9627
602 South Klevin Day Phone
Name of Lending Institution: Spokane. Mort. ga'ge CJmpany
Mailing Address: 3201 "C' Street, Suite'250.
Name of Realtor or A~ent: .. Shem., Ine.
Mailing Address: 2o44 E. Northern Lights
694:2i42
Phone 277-054~ ~,
Phone. 276-'~565
6.. Legal Description:'
Location' ' I~tN Wbtrlava7 Roa~
Ea~le Rtver~ Ala)ka ....
7. .Type of Facility to be inspected:
:'8. L~ater Supply
Lot 19C, Eagle River Valiey Ranchette~.'
single family:
No. Bdrms'. 3
Community
***Type of Supply: ' P~zb%d~ Utility ..~ I'ndividual
e~ .
If Individual, number of dwellings pres nuly..serv~d
If Individual, depth of well
Sewage Disposal-System
Ty~e .of S~stbm: Public Utility "
If'Individual, date of installation
Individual (on-sitq)
"Unknown
***water system approved VA per .Dick Borneman of'the VA.
'Page 2 of two pages - Re~'-~st for Approval of Individual ~-":.r & Water Facilities
Legal Description Lot 19C Eagle River Valley Ranchettes
Comments
Approved
?__~Disapproved Date
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 opera/~g satisfactorily.
e
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road· Anchorage· Alaska 99507 279-8686
Date Received // ~_3
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Aoproval Requested By: Reeves & Cousineau
Address: 902 South Lane Anchorage AK 99504
Prooerty Owner: Same
Legal Description:
Phone~
Phones
Lot 19C Eagle River Vall~Y, Ranchette~
Location:
5. Type of Facility to be Inspected:
Number of Bedrooms: 2-3 (two - thr~e)
6. Well Data: Community Water
A. Type B.
C. Construction D.
7.' Sewage DisJ)osal System: ' · .
A. Installed 1973
C..Septic Tank: 1.
D. Seepage Pit: 1.
E. Disposal Field:
Distances:
A.
Sinqle F~mi]¥ Belling
Depth
Bacterial Analysis'
· 'B. Installer Hamiltnn Wyr~w~in0
Size 1000 9a~s Manufacturer'N~milfnn
Size 16x/6 · 2. Material ~nnr~
Total. Length of Lines
Well To: Septic Tank
· Nearest Lot Line
Foundation to Septic Tank
· Absorption Area
· Other Contamination
") Absorption Area
Absorption Area to Nearest Lot Line
· Sewer Lines
Req~e,~t for Approval of Inalvtdual Sewer & Water Facilities
Pa .,'I e Two
9. Comments:
Approval Valid for One Year 'From Date Signed
Anchorage Area Borough, Department of Environmental Quality
DIAGRA~ OF SYSTE~:
I certif}' that the information contained in this request for approval to be a true
an,~ accurate representation of the sub.iect sewer and water facilities located at:
Signed Date