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GRE/ -r_ ANCHORAGE AREA BOR` "^4
Department of Environmental Quality
11�^�� 3330 C Street
Anchorage, Alaska 99503
/, INSPECTION REPORT ON-SITE SEWAGE DISPOS,4L SYSTEM _
NAME( IQUIIU mG{2SOCftiL 1 MAILING ADDRESS / M&6, e/tel, ei /_ pJHONE (iC�,�q z �ffg
LOCATION LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE NUMBER OF
FROM WELL U a MANUFACTURER S�4"C a MATERIAL ��7� _—COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH _LIQUID DEPTH LIQUID CAPACITY GALLONS.
SEEPAGE PIT:
NUMBER OF PITS —�_. DIAMETER 7V/ OR WIDTH /z LENGTH -Ll' DEPTH
LINING MATERIAL(MAU-rr CRIB SIZE: DIAMETER _DEPTH DISTANCE FROM: WELL
BUILDING FOUNDATION�, NEAREST LOT LINE ABSORPTIONCAREA (WALL AREA) ZC� SQ. FT.
ADDITIONAL ABSORPTION
WELL: C /
TYPE `{ n��t E -d CONSTRUCTION J 11041
DEPTH DISTANCE FROM:
BUILDING
NEAREST
SEPTI
FOUNDATION w I�IJ, LOT LINE— SEWERS INE TANKC —9L, SYSTEMS
CESSPOOL OTHER SOURCES
APPROVED « DISAPPROVED REMARK
DISTANCES:
INSTALLED BY:
U)M/ /0 51 At 1490'
PIPE / MATERIAL:
C (1 ��1 �ew
LOT SLOPE: LU /
REMARKS:
-tea-611—k—
V
t a cr 1r � lrCcU� �Ol lu' r 1a�7_
Form No. EQ -031
DIAGRAM OF SYSTEM
No
APPROVE
G.A.A.B.
v
„F„opIIIIo11II< GREATER 1 NCHORAGiw AREA BOROUGH
P LJ I9`
v DEPARTMENT OF ENVIRONMENTAL QUALITY
W n
x I) 3330 "C” STREET ANCHORAGE, ALASKA 99503
e ✓ F
TELEPHONE Z74-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
,F_ OF APPLICANT
ASTALLATION LOCA
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
TYPE: AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
PERMIT NO
MAILING ADDRESS -sem �� M ��C ""”" J PHONE �
SEEPAGE PIT---_X--
TO BE INSTALLED BY
DRAIN FIELD __ OTHER
NOTE: THIS PFRMIT 15 NOT VALID WI'PHOUT =J TF T
FINAL INSPECTION: 24 HOUR NOTICE: REQUIRED. BACKFILLING OF ANY SYS'CI?M WITHOUT FINAL. INSPECTION BY THE
DG:PARPMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL DE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE �Mm TYPE
MINIMUM DISTANCES. RIEQUIRFMEPlTS
SEEPAGE AREA SIZE ! 2 - - -LYPF`-E'--
0
FOUNDATION TO SEPTIC TANK-
.
FOUNDATION TO SEEPAGE PIT _O- DRAIN FI EL,D _.
SEPTIC TANK TO SEEPAGE_ PIT WALL / ---
SEPTIC TANK __-__-__, SEEPAGE PIT �'O / DRAIN FIELD -
I'O NEAREST LOT LINE.
WELL TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD FIELD -_ - ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD -
SEEPAGE PIT
SEPTIC TANK _-f -. SEEPAGE PIT �✓ 0, _. DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OFSEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
h INCH DIAME'I-ER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL F-3ACKF'II_,L
DIAGRAM OF SYSTk=M
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION,
G.A.A.B.
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2868 AND THAITHE ABOVE
DESC IS.D SYSTEM
��////I�SQIN ACCORDANCE WITH SAID CODE.
DAT - �--y'- APPLICANT'S SIGNATURE�ddG!"-��-.-1�.`
SAMPLE COLLECTED 6Y__.
JL,EC
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- 1 Size /D�>� ' .� 2 •- �. - ______ _ -- -_
C iun:. —�
U. 2: ) .g0 PII t; 1 . HbSOrpvion r Cr. 2• CCiV..--
F. sJosal ield: lotaength c; es ---_ -
ces:
r,. to: S_pi,ic tCn _ _ _%
0t'ner ccr1iar�.i 'tion ----------- - ---
dcaresc 1Gt iine --
C-^
hbsGrpclon ar --'
3. a, -c i on to sep c -i c tan's ----_-------- -
C
C, so;"ption area o nearest lot ,"Ine — —------_ ----
X0010
Page 2•o -P two pages - h..,.ast for Approval of Individual ,aer & Water Facilities
Legal Description
Comments
Approv e
Disapproved
Date
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM 01: SYSTEM
I certify that the intormaT-iun uviivall— ,,, —.- -
accurate representation of the subject sewer and water facilities and these a
are operating satisfactorily.
Date
SIGNED
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received September 7, 1973
Time of Inspection_ 1:30 pm
J Date of Inspection September 10
REquEST FOR APPROVAL OF
INDIVIDUAL SEWER & 'NATER FACILITIES
FOR
1. Aoprovai
Requested
�• B.
Realty -y -`P___
By; Smiley's
Address;
Box 1086
Eagle River
AK 99577 Phone
2. Property Owner:
Phone :-
3. Legal Description:_ Lot 53, Schroeder Subdivision
ion -----
4. Location: Carla Street
5. Type of Facility to be Inspected :_Side Fames D%yelll•nq _,-.._
Number of Bedrooms: Three (3)
6. well Data:
A •
Type Drilled
�• B.
Depth
50'
C,
Construction Standard
D.
Bacterial
Analysis Uns sFi M, 73
--3-
7. Sewage Disoosal System:
A. Installed 1973__ B. Installer R g�Wood� R�
C, Septic Tank: I. Size 1000 Gal 2• Manufacturer. _ 51GiS_.Sf'`P1
D. Seepage Pit: 1. Size 48X12X12X62•
E. Disposal Field: Total Length of Lines—__--_ -
8, Di.star,ces:
Absorption Area , Sewer Lines
A, '?I«ll To: Septic Tank_��,___,, P _.111Q�---
Nearest Lot Lino , Other Contamination �•
Foundation to Septic Tank, Absorption Area 50'
C. Absorption Area to Nearest Lot I.ine�1� , 9' _�i
Requast for Approval of Individual Sewer & Water Faoilitieb
Page Two
a_ Comments:
Disapproved
Dateq/p 73
17 Approval Valid for OWYear From Date Signed
ater Anchorage Area Borough, Department of Environmental Quality
DTAGRAM OF SYSTEM
T certify that the information contained In enis rCyuua� •�� u,N_e---
and accurate representation of the subject sewer and water facilities located at:
Signed -
e
Date_-
IU73
Fodural HOOSW A" nistratiOn
31A �QSQ nth MOM
Anchormo
AttontiOn: Pon MOMR11
SIMOECT: WAter 5uPPlV for Lot 03, Schroudur S"DAIVIsion.
wr Sir: lot has producod a ser,es of unlatisfy4ory wor
Tho woll on too i""Iect as 00en iris owycral W"us
yworylorioaLion Of t5a watur SuPPlY h
samnlus. UN On tQu Z. RajoinNg JUL!, (lots OR n"6
also RhQn wmamu
to bo avail. W9110 a"" VDIPA fran both Opy w"lls have Wen tch- -
04) Q latyfawry so'" SU0911c; in the i"medim aroo it saMi
. 0 hinropar
Of all thn uthpr atisfactury wator i Q
th,j thu wator jrklcm oi AL 51 ccult! hu LAO CRUSL 01
,yj con5truction. d t"o holur)
be drillua pro-
Tnere arc Wo v011 casino' " to' lot that 1"Id11 onca lulled at)
,,,,ajJp matarial, A 11 1
fillyd wid; urp W,i,,, ,d skould praVidc %atisfactory
jt,out a sourcy nf COMM,
wa Ler. Wo to
If furtnw- dlarifkatiOn 0" this sunject is necded, PIMM
000tact me.
vyry sincormlY ;ours,
icon K Lee, O,S,
Eye River DistricL Sa"itarion
sr