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HomeMy WebLinkAboutDANIEL LT 2 01 DanLel S/ P La PARCEL � 051 092 51 000 li MUNICIPALITY OF ANCHORAGE �;'' • f r--- DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION r ENVIRONMENTAL ENGINEERING DIVISION 825 L Street-Anchorage,Alaska 99501 Telephone 264-4720 \— / ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME$/��GG - " ( U..5' -z- � 233/ ❑UPGRADE MAILING ADDR v< l7 C44tf-111 LEGAL DESCRIPTI n�iz 111 (s �'' �� LOCATION /°` / NO.OF BEDRieS �"� ,g/ rC.4 L�LtO .., W II (.� Absor tion ar``a Dwellin ( -1 P RMIT� NAg DISTANCE TO: f T L}, -�AL���i�fg/ ) ti r ~a Q Manufacturer ^r eec M e e / No.of compartments Z W L. L / G H Liq. apa gallons Inside length Width Liquid depth /Z� IF HOMEMADE: D Y DISTANCE TO: Well ` , Dwelling PERMIT NO. .�L7Z /V oz< Manufacturer Material Liquid capacity in gallons I- O Well Foundation Nearest lot line PERMIT NO. -r= DISTANCE TO: W w LL Z No.of lines Length/ea h Ike Total length of lines Trench width Distance between lines F-Z W �i inches ▪F Top of tile to finish grade Material beneath tile Total effective absorption area cc o inches Length 6 ( , Width 22 l 4, Depth ( PEFZN117NceLh QType of crib Crib diameter Crib depth Tot f �ive absarption area —J w M� /6 L" to '`+ DISTANCE TO: Well 14 8uildif founflatgon Nearest lot line go f 4 Class Depth Driller I Distance to lot line PERMIT NO. 65 Ari SZ'/NL 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS 1,oP - VC 54 " .. SOIL TEST RATING �� GI{ INSTALLER �{ �.... rt ( . 22. REMARKS J _ 0r. i—i c, v4-141 1-44.-tp �j Aier 1 /' hLC -'e I L'a if to lcr &) /;: om / ,Q cy�gw"y lyg '7O( 9�T c�}� G' iJeG1 6)4r/fly' C. e �4., aa„ •...., r - G0„ '� 1k), «a • `t 777W (/” t,J(.. d , ,.c.: '. ..y' Q�O o-iCil 17 ey.• r/{ tl4 f•,. N . 1457 - .- ^f0).P9•••e•s•a �.0 .rr • �a� ' Gr'E5&l�`� ''� APP'OV: DATE LEGAL 1/7 ..� /2Pee- e 7 -I 3 (Rev.3/78) MUNICIPALITY OF ANCHORAGE Department Health and Environmenta_ rotection 825 L Street, Anchorage, AK. 99501 264-4720 * * HANDWRITTEN PERMIT * * * ,1// W L ItIR ON-SITE SEWER PERMIT / p Applicant : �LCLICIVS @0kj-0- Mailing Address : f- O f Location: N Q' O V 1p.5Phone Number : C9 Ar-r- .,g2.; ( Legal Description: L 4J iq 4 3\GL Ib Lot Size: 4 d Type of Soil Absorption System Is : Trench: Drainfield: Seepage Bed : k"---Holding Tank: Maximum Number of Bedrooms : 3— Soil Rating (sq.ft/br) The Required Size of the Soil Absorption System Is : DEPTH ' LENGTH 020 X6O . GRAVEL DEPTH 0/6-- WIDTH The length dimension is the length (in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation (in feet) . There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation (in feet) . * * REQUIRED SEPTIC(HOLDING) TANK SIZE = l� ) GALLONS * * 'ermit applicant has the responsibility to inform this department during the .nstallation inspections of any wells adjacent to this property and the number residences that the well will serve. * # * TWO(2) INSPECTIONS ARE REQUIRED * * * 3ackfilling of any system without final inspection and approval by this department rill be subject to prosecution. linimum distance between a well and any on-site sewage disposal system is 100 feet :or a private well or 150 to 200 feet from a public well depending upon the type >f public well. Minimum distance from a private well to a private sewer line _s 25 feet and to a community sewer line is 75 feet. Well logs are required :nd must be returned to this department within 30 days of the well completion. )ther requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1 I certify that : (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may re• ire enlargement if the residence is remodeled to include more that b -dro ms. ^ � � Issued b Signed: ('� y : 1 Applica''_ / Date : - SWP/024 (1/81) 0 O SOI LS LOG MUNICIPALITY OF ANCHORAGE t t DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION O PERCOLATION -.) ` , TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 �-' SOILS LOG - PERCOLATION TEST '7-.7 J PERFORMED FOR: ./L i ^�� C /JS DATE PERFORMED: �OC ( ,f---I LEGAL DESCRIPTION: L 2 D / Ir\ )) e (3 ( o DEPTH 2 // 1 /0 /' SLOPE SITE PLAN (FE` , 1 I ': � /-lici ,74 s/4 7T I _ / ✓� //o U 2I4 6.1) /2 (0i/ pro - 1/4 - - ..e° y -i/øri'iLllow �u . 5 - `vim TES 41, 6 - -"---' 7 - ..----t_._ fxrS 121/C y s p'c Tr 7 `7 /C . --.�- l�7 c� c 9 - 10 - 1 1 - WAS GROUND WATER e ( L 1 J ENCOUNTERED? O 12 - E /7--41 —T- IE YES,AT WHAT ' DEPTH? - 13 - 14 -1Reading Date Gross Net Depth to Net Time Time Water Drop 15 - 4 K s; itO`ler/ t. ;; ,._•-,., - r<' . 18 - 4.3 No. 1.4.5.;°-E •'°-E .: '6Jii 4.19 - %e-Psipej• rrt^;ti`;! 20 - _//4 PERCOLATION RATE _Iminutes/inch) /� r /� TEST RUN BETWEEN `FT —A/ND FT COMMENTS r ' /Af (� a ,,,- 2 l -eqe. � fccu ar / / /� / 2 (- PERFORMED BY: • !J `-1•�6�Ne/F�/ /V 4.---- CERTIFIED BY: '( DATE tit-CI C-7 c---7 72-008 (6/79) t - _ t. a }AS Er SOILS LOG MUNICIPALITY OF ANCHORAGE • ' \ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION _','. 1 ) Pouch 6-650, Anchorage,Alaska 99602 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: �/4,4...././EL -�liB.0/l//.S/1Zi1/ DATE PERFORMED: ,.....5-/f/B/ LEGAL DESCRIPTION: GOT 7 SEC_ 7-/-_--Tif./ .Q/ AI/ A "- SLOPE LOPE r - —SITE PLAN DEPTH TOP S/-,/L - • � �/ , �/Fy -57g r i TLI i I 1Z. ( 1 1 ci I I I - • 0,c. _Ste-rY 2 - / ; s,1,� )/ I 1 1 ! I � 6/0,14/_-z- 3 , i ---+ -1— .. . . __ _i O. (7./e./< -/ -:- / !_i_i. _1 . . _ ' -1_- 5 - `•i', ,-'//.elle/tG-74- C N tine1 ,lT - 8 - • . /3o' 9 - 0i --1 - sc..,LC. i/=zoo/ o ; 10 - (-9 G/zdvGt!/.rTE, - _ _ 11 - WAS GROUND WATER S j , O ENCOUNTERED? , Y ---5- L C �i O 12Q'sj IF YES, AT WHAT E 1 13 . DEPTH? / ,' i I I—i F 14 - Reading Date Gross Net Depth to Net Time Time Water Drop 15 - OF .1 4. III -• // s//¢ s ¢c( ,'. 16 - _c /• •••' f 9 ' .S:_a 0*49TH `t.. -4 :_,t a1 6-s" ,5-:,s-4* A.i/A/ 3.4,/ r••..•.„•113 z.er# ,5--',3-4 .{.4` S6" , .- e:;. 4rM/ze Z•B// 18 - # c__ . Earl R. Barnard �� 2 a' - g ..- "z- , /� 's % 7s ' �i s.Z% 6 "oma 4/Ili,/ z-- " 19 - fat-9c••••. .••'••F�� Z-B" h •-e-,‘ "' 20 - „,4.0 I V:ROF �L+ ,..<72/1 6- -/z 4{/////. 2.0''' PERCOLATION RATE /- 6 7 (minutes/inch) TEST RUN BETWEEN FT AND 7 FT COMMENTS 8.5" S'..4-: AtSe,,, , ''/s, A?E'A AgG'iQ Z3 ',' 'e9.::-.971g .Qec en.f e--,- /t/O�d- A9AX/M+/Ai 7-.76--,7,47/1 OE�ry to '1 �'L/'- 47?/o/l/,e /j9E- 'EO PERFORMED BY: /!A/ce' �.4TFS CERTIFIED BY: L ,'R,� /1 1Y,�`V4aATE: ' r / 1q8/ 72-006(7/76) 1 0 22- 41 SO SHEETS , 22-142 100 SHEETS AMPAO 22-144 200 SHEETS C M2/,1 (1/0/.Z .733" -- 5 50 .7 ,, o ; OZ °- fa / y f v �� \\\ \1 1 \ / N\/r, \ 1 JarrOSb2/Z f`� p o n e Q C P ,Q 00 00 Q C1 0 0 ° on p Q CoA �/ a ,o0CCI O o P ' ° o P O 0C3 c� 0 0 ' n CJ p cn0 C, .. \//, v ^ a - O 00 .9 9 '� e o �� Q, oc 1,7 GD rvg3,, s//I 7111/ h.() 2"/' v.�1 b2'Cdda.a 7Ait fr aa'bog r eo/1 a-7,/S(v/ Cv.g.0?2//- /� _ (//c7: 4.4.1'e 07 pr/vs (-7 7/ ' pt//fry 0 22-141 50 SHEETS // l 22-142 100 SHEETS ""' 22-144 200 SHEETS � -7f/ ,_ ' n1 L04/ 2.04/cT f d:" A4 3/A N C/ 70 a N dhens 4- 541 0 „ 0 - 0 F' . • ()JrrctfirbBri1LingRCug by DOCCo.dba SULLIVAN WATER WELLS P.O.BOX 272,CHUGIAK,ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND DEPTH OF WELL __ __ ADDRESS _ STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION_ DRAW DOWN FT. DATE-Started Ended GALS. PER HR PERMIT NUMBER KIND OF CASING __ KIND OF FORMATION: From Ft. to Ft. From _ Ft. to Ft. From Ft. to Ft. — From Ft. to_ Ft. From Ft. to Ft. From Ft. to Ft. From Ft.to Ft. From Ft. to _Ft From Ft. to Ft. From -___ Ft. to Ft MUNICIPALITY OF ANCHORAGE From Ft. to Ft. From Ft. to DEP1FtOF HEALTH & ENVIRONMENTAL PROTECTION From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft.to 1144Y 191986 From Ft. to Ft. From Ft. to____R EC E I V E D From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From t. to Ft. From Ft. to Ft. Fri i 4 Ft.to Ft. From Ft. to Ft. FroJn Ft. to Ft. From Ft. to Ft. V y �D From Ft.to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft.to Ft MISCL. INFORMATION: DRILLER'S NAME 0 0 , • 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 c Application Date 5///Q 1. GENERAL INFORMATION (a) LegDescription (include lot, block, subdivision, section, township, range) ece- Z /O VL : .) 614--J Location (address or direction` ) / y 7 - 4 (b) Applicant Name I A J.,___41.4,01.4.24,_Telephone: Home If-34/SS- Business —177-3Syer Applicant Addres/ (To. 0/y 70 'S'5"3 c-;� a,.2 /p9s- 7 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer 0 ; Other 0 (explain); (d) Lending Institution "A-7W1� •u�n...Telephone /� Address czo-q,c, — /� 00/ P` z'`'e,,'-,"-J (e) Real Estate Company and Agent D Address Telephone (f) Mail the HAA to the following address: S&S ENGINEERING SR B 196X EAGLE RIVER,AK 99577 2. TYPE OF RESIDENCE Single-Family kr Multi-Family 0 Other Number of Bedrooms .g 3. WATER SUPPLY Individual Well 0' Community 0 Public 0 Note:If community well system,must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public 0 Community 0 Holding Tank 0 Note:If community well system,must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025(11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION • ' 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 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 regulations in effect on the date of this inspection. S&I ENGINEERING Name of Firm SR B 196X Telephone Address EAGIE RIVER,AK 995/7 Date MAY I 7 1986 „� Of A t,,�s%i Ise A. Shwlec ; cL'ii i`� ,•.• Flo. 144r-k :`,A V` •• * '1/4,&M 6. DHEP APPROVAL • Approved for f1''"e �� V �'`'�e— bedrooms by � A .23P-1-1"--•' Date s—ZQ —vo „------- Approved 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 • MUNICIPALITY OF ANCHORAGE(MOA) MUNICIPALITY OF AIiAARi AUTHORITY APPROVAL (HAA) DEPT. OF HEAL ENVIRONMENTAL PROTECTcNECKLIST- FEBRRUARY 1984 264- 0 Mpg( 191986 Legal Description: L Z �.4�i ,///4Ls s` A. WELL DATA RECEIVED s, r ^% Well Classification E If A, B, C, D.EE.C. Approved (YIN) Well Log Present (93.0---- Date Completed /--.5/ Yield ,S-6/ 14 Total Depth /0 1 7« Cased to /C) ' / Depth of Grouting Static Water Level ' 7/0 ' Pump Set At /‹ Casing Height Above Ground Z n f Sanitary Seal on CasingNPN) Electrical Wiring in Conduit apd)' Depression Around Wellhead (af ' Separation Distances from Well: J.s� CI To Septic/Holding Tank on Lot f� / ; On Adjoining Lots S To Nearest Edge of Absorption Field on Lo Y /Z0' ; On Adjoining Lots �0 To Nearest Public Sewer Line /-(/� To Nearest Public Sewer r Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ¢I S ef-t 4.tN E. -Lug! b ; Date -•-•"/,-.9C9 Water Sample Test Results ,S-Ac---ri4. A;k--- - r-.,'C. Y Comments B. SEPTIC/HOLDING TANK DATA Date Installed /Z-/Z.- 8/ Size I ZSb No. of Compartments Z Standpipes Air-tight Caps6'N Foundation Cleanout (N6{ Depression over Tank.( // Date Last Pumped 5--6 —86 Pumping/Maintenance Contract on File (Y/N) /s/4_ ; for — Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ( Z.--c• To Building Foundation To Property Line 20 t } To Disposal Field A- To Water-Ahairn`Service Line �� To Stream, Pond, Lake, or Major Drainage Course 1P Comments Page 1 of 2 72-026(11184) C. ABSORPTION FIELD DATA • Soils Rating in Absorption Strata /Z S °Mt Type of System Design • Date Installed /Z-/Z - S / Length of Field Zid j Width of Field Z-7 Depth of Field I Ti iI /- Gravel Bed Thickness Square Feet of Absorption Area b/ t P Standpipes Present(.] Depression over Field (Y Date of Last Adequacy Test S-- /Z�' G Results of Last Adequacy Test Sf.-T/S ,,4-C 7--0.Gr Separation Distance from Absorption Field: Z To Water-Supply Well /7o To Property Line ° To Building Foundation Z.-/ r� To Existing or Abandoned System on �� I - Lot ; On Adjoining Lots To Water tvillif,/Service Line 3`� To Cutbank (if pr sent) To Stream/Pond/Lake/or Major Drainage Course ��Aa-- To Driveway, Parking Area, or Vehicle Storage Area 30 , .- Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at 1 (� Vent (Y/N) Tested for 1'� Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) 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. Signed S&S ENGINEERING Date MAY 17 1986 Companyslt B 196X MOA No.0-5-'m.? ...7s 0 v4��`'�t� EAGLE RIVER AI5 99577 ••••,* 4 it Receipt No. -3c�S -1- `'`t\ 'C, ;�� . k •.....i.S • c2 '. • Date of Payment J I a\- 0 * 49D-.! ',/ * F, Amount: $ (�S ��� � �, � •.•. ? o►al�lbsbwt A. 51•ier S14 Q IIS ��"• No. 1457-V •o• ,�, Page 2 of 2 ,at`fz,•- \,..' A. 72-026(11/84) Municipality P.O. BOX 196650 ANCHORAGE, ALASKA 99519-6650 of k (907) 264-4111 Anchorage IFF TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH&HUMAN SERVICES May 30, 1986 Robert A. Shafer, P.E. S & S Engineering SRB 196-X Eagle River, Alaska 99577 Subject: Lot 2 Daniel Subdivision Waiver Request, WR86-060 Dear Mr. Shafer: Your request for a waiver of the required 100 foot separation between the subject lot and the septic tank on the adjacent property (Lot 1) has been granted. The required distance has been waived to 95 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw -ettytit p r. ' ROBERT A.SHAFER CIVIL ENGINEER A / 694-2979 May 17, 19 k 6 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & fyC ENVIRONMENTAL PROTECTIOP( E t RIVER.AL HEALTH AUTHORITY MAY 1 1986 APPROVALS MunLc-Lpa Lty o6 Anchorage RECEIVED Department of Health and Human Services SEWER&WATER 825 L Street MAIN EXTENSIONS Anchokage, A-easfza 99501 ATTENTION: Steve Morn-L6 SEWER&WATER REFERENCE: Lot 2; Dan.LaIs Subdivision INSPECTION Request you appkove the attached Health Authority AppLLeation and issue a waiver oti 95 beet hon.Lzontae separation distance between the wet and the septic tank onp•the adjacent propvcty. The septic tanfz t a.- seated ENGINEERING STUDIES w,i.th water ti. ht cou LLvi s.,,pThe to a na h in the area A envtaete AND REPORTS 6.lat. The static wa-ten .levee in the weft is approx-cmateey 40 Beet below the sunbace. The strata between the water levee and the suk6ace cons.is.its mostly ob clay and gravel. with the water being pnov.ided nom saturated sand stone at a depth os approx-c.mateey 162 lieet much o.6 the strata between WELL INSPECTION &FLOW TEST the static wa vc .levee and the watvc source .is blue clay, silt and graved. It -.6 aur opinion that the hon.izontal sepanat-Lon distance between the wet on this pnopenty and the sept-Le tank on the adjacent property .is SITE PLANS adequate and the hon.-zon a..e separation distances pnescrd.bed by 1SAAC72.021 are not requ.ined in this case. 16 we ' • be o6 6urther svcv.i.ce, please contact us. ROAD DESIGN S-L vneey 1d. SOIL TEST i' � A, SHAFER, P.E. 1rRO R' Vss PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN SRB 196X EAGLE RIVER,ALASKA 99577 0 ri5.• nyri4, . • N�� ROBERT A.SHAFER � '� �� CIVIL ENGINEER / A694-2979 May 22, 1986 fq CEf RI V ER.Al.PS�,P MUNICIPALITY OF ANCHORAGE HEALTH AUTHORITY DEPT. OF HEALTH & APPROVALS ENVIRONMENTAL PROTECTION Mun.LcLpatity o6 Anchoaage MAY 2 31986 Depaatment o6 Health and Human Seay.Lces SEWER&WATER 825 L Staeet MAIN EXTENSIONS Anchoaage, Atasfza 99501 RECEIVED ATTENTION: Steve MoxvL6 ' . ' - SEWER&WATER REFERENCE: Lot 2; Dan,Lats Subdivision INSPECTION This Le-tten, pnovLdes additional Ln6onma i.on to oak Le--tek dated May 17, 1986 in accoadance with oua telephone conveasat.ion dated May 22, 1986. In accordance with .Ln6oamation avaitabte, it appeaas that a peached ENGINEERING STUDIES watea table could be aestin on Q cls aavet to ea at a aox.cmatet AND REPORTS 9 y, g y pp y 8 beet and may have a seasonae high watea Levet at appaoximatety 5 beet below the sua6ace o6 the ground. This wa-ten, table is assumed to Stow in the same d..aection as the scope o6 the gaound on -the sua6ace. Though -the area -i.s aeeatcivety Etat these .is a gen ee scope in the oposAte dAaect-Lon WELL INSPECTION &FLOW TEST 6aom the wep D. 16 the above assumption is coaaect and the watea table should become pottuted 6aom a 6a,ieuae in -the septic tank on the adjoining paopeaty SITE PLANS the watea should kun away 6aom the we—U casing, theae6oae e2Lm.Lnat.Lng any poss.LbAPity o6 contamination aaound the well casing. It should also be noted that the blue clay indicated on the wat tog between the depth o6 65 and 142 beet wAIL paov-Lde an adequate seat and is at .feast equal to a non-sha.Lnfz concrete gaout-i.ng. ROAD DESIGN 16 we may be o6 6uathea seav-i.ce, please contact us. S.Lnc ety, SOIL TEST _VA /'08 . HAFER, P.E. PERCOLATION I 'P .-S/46 TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN SRB 196X EAGLE RIVER,ALASKA 99577 i ime� Time .e ( l Date Date Date --Z6e_tez, 4eA7 s.`"2 2-- Inspector Inspector Inspector r, a � Comments Conditional Approval �f 14-0-0 Not CeNLO...tj rextkoet, 64)9- 3 Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY 1 Property Owner Phone G.S.K. CONSTUUSTRUCTION Mailing Address 6105 A-3, Palmer, Ak 99645 745-2553 Buyer Jerry & Frances Judd Address P. 0. Box 39, Chugiak, AK Lending Institution Phone 1st National Bank of Anchorage Address 4th & G Branch Realty Co. &Agent Phone W Totem Realty, Inc./William J. Schlegel Address 724 E. 15th Avenue, Anchorage, AK 99501 • 272-0571 Legal Description Lot 7, Section 8, T15N, R1W, S.M. 5 • Street Location Birchwood Loop Road G.. 2 eP/J 4/ Type of Residence k; Single Family ❑ Multiple Family No. of Bedrooms 3 ❑ Other Water Supply j1 Individual ATTACH WELL LOG. A well log is required for all wells drilled since June ❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if ❑ Public Utility available.) Sewage Disposal tl Individual Year Individual Installed: 1981 ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.