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HomeMy WebLinkAboutSHRYOCK LT 2.l I- _ _--_ _ - -_- �_� =tr-. �` , �_ - �� - Municipality of Anchorage Page of _ 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 a Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: 016 — a52 _ d k Name. n Wastewater System: ❑ New Jpgrade �L rCtx ar �q 20 ,ti�r�- v, A ABSORPTION BSORPTION FIELD Phone: No. of Bedrooms: Zap Trench ❑Shallow Trench ❑Bed ❑Mound IJ Other LEGAL DESCRIPTION Soil Rating: D Total Depth from original grade: U GPD/Sq. Ft. Lot: Block:pp Subdivision: Depth to pipe bottom from original g ade: Gravel depth beneath pipe a.. o`"' .... J oc Z. Ft. Fill added above original grade: Ft. Gravel length: TownsshhiP: Range: Section: g 1 — .L FL 3 A Ft. WELL: El New ❑Upgrade Graveldei4W v&�aji q Number of lines: Distance between lines: Ft. 1 Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: FL FL :Q SO. Ft. AS rfM .303q 6 ! Driller: Date Drilled: Static Water Level: Installer: Date intailed: Ft. i 117 Z.s' 9 �- Yield: Pump Set at: Casing Height Above Ground: TAN K GPM Ft. Ft. SEPARATION DISTANCES eptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: rte-, Capacity in gallons: From Tank Field Station Tank Sewer Lines A%A k— Well13y I r _ Material: Number of Compartments: Surface Water —` �® LIFT STATION Lot �. i� — Size in gallons: Manufacturer: Line pi 3 Foundation.3 Q .... ^_-, ._-- "Pump on" level at: 'Pump off" level at: High water alarm at: Curtain �, Pump Make & Model Electrical Inspections performed by: Drain Remarks: BENCH MARK o/d f Location and Description: Assumed Elevation: ap, R n ENGiNEi2'S SEAL / I tl f' Itio �� Inspections performed by: Dates: 1 st z 2nd Department of Heal 11d Hu a�n ervices approval t Reviewed and approved b Date: .� 72-013 (1/91) MOA 25 Well I I I ' '• I I I 5 ; I I I 6 44 I i I 36-1 I I I ' '• • I I I I -,r/- Well I Well I I I I I I I I I I I I I I I I I I Ifs, x � ,ems wa�•n,:o a,snc ,A oc.^a--`s} I 4i {� 125 0 25 50 75 100 125 150 '�� ' :�i >,T' : SCALE- 1' = 50 FT _— a -----1 L- -L ---- ------- - - - - -_ II UBBEN P.E. I I LOT P SHRY ROCK SIB SEPTIC SYSTEM ASHUILT 203 W 15TH, AVENUE SEC 33 Tl2N R3W DATE NOV, 30 1992 279-1916 M75 AK, 99501 2920 NUGGET LANE SHEET, 213 GRID, 3034 O NEW 1000 GAL TANK EXISTING CRIB O /^'� e Standard T1 38' LONG TOTAL 7' DEEP 5' OF SEWER ROCK 3' rein, Co ver P additional Fill or 2' insulation insulate line under 2' INSULATION Mira f; 140 Y 5 Feet of Sep tic Rock NO SCALE Cleanouts Monitor ,4 i19iL1 89, 4 1000 GAL TANK ANCHORAGE TANK W65 11/11/9c' 83 98.4 INSULATION TBM FIRST FLOOR ASSUMED ELEV. 100,00 TOBBEN SPURKLAND RE, I I LOF 2 SHRY ROCK SIDI Sit; WMIHM gMUm I 203 W15TH, AVENUE SECTION 33, T12N R3W DATE, NOV, 30, 1992 ANCH, AK, 99501 nuall r,1rr1 Fnpn SHEET, .?/? GRID, 3034 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON—SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920394 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:GUILFORD LEONARD L & OWNER ADDRESS:2920 NUGGET LA ANCHORAGE, ALASKA 99516 PARCEL ID:01825208 LEGAL DESCRIPTION: SHRYOCK LT 2 LOT SIZE: 16745 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED:11/23/92 EXPIRATION DATE:11/23/93 ///Zs -A/7 7--5- 1. -S 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: t 9,4Aipvn.E C R 1 d P/PoP►E1?4 y RECEIVED BY: ISSUED BY: DATE:. u %1�1e(�� DATE: //`.Z.3 —'q 2 203 W 15th, Avenue, Suite 206 AtICHDRABE, ALASKA 97501 (907) 279-3916 SEPTIC SYSTEM DESIGN L -OT 2SHRY 14OCK S/D TURK GUILFORD (3f, cm.md waktc.41, 'Irctrich From bi.isl-. klov. 4 1992 ,3 m j. r i I I rod Arc,<a por '0c,,cJr-c-)c.)rnu 1. 1"'.; 1") / . r.:3 - -- .1. C.'17 11 '5 q 4: L ("ircn.fnd (:i r I A 11 Cl a LA It - f <:A C: Eil L F C.s rl C: I l'c:)t;al. 6) +copt 9 IIJ Top c)f Lank 2(.) a.nc tars bolow orcm.md A t..t I If r c) i,.0 t (J V4 <::rt. e:? I, rat: 1) ch,tring l 1�lcr P. orn (:).f: rock 7 4:c-mA� c)f I....( -.m gUl c1f, 'I remichI SYSTEM CONVIGURAT ION STANDARD TRENCH 'TOTAL LENGTH 30 FT. TOTAL WIDTH 3 FT_ TOTALDEPT" 7 FT. ROCK DEPTH 5 FT. COVER 3 FT. FILL I FT OR INSULATION 211 INSULATE LINE FROM TANK TO TRENCH WITH 2" INSULATION SEPTIC TANK 1000 GAL. ABANDON EXISTING SYSTEM PUMP AND INSPECT EXISTING TANK DETERMINE SIZE, INSPECT AND RE— PLACE BAFFLES IF necessary, IN— STALL MEC14ANICAL WATER PROOF CAULDER COUPLINGS. Cc., I F V I" C.) C The installation of this septic system will not prevent wells from be installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lo -Ls° The proposed septic system will not change the general slope of the area. Ponding and/or concentrati.on of surface runoff will not result from this in�;itallation. The existing concrete septic tmnk will be inspected and replaced if found not to meet the structural requirements of the Munici~ palJ.ty. High groundwater during breakup is common in this area. The soil on this lot is free draining. The lot slopes toward the road. The back of the lot slopes staeply to the south. Bused on my observations Nugget Lane defines the groundwater boundary of flow from the north" There is no flow from the south^ The ground level on the north side of Nugget Lane is approximately 3 feet below road elevation^ 6 feet separation to to -days ground water ufficient to protect this installation. Septic System Design Lot 2 Shry rock S/D 1 I I w 1 Well I /SEEPAGE PIT I III I I �I I I I Well 1 Well NUGGET LA o=ff, --- ----� -- 1 I LOT ,? I I Wel LO 2 00 �P III T la III I II i , I I I 1�YI I I I LOT 4 I I I I I tA_-- r , 50 0 50 100 150 200 250 300 SCALE' 1' = 100 FT, SPURKLAND P.E. 203 W LGT 2 SHRY RUCK SIB SEPTIC SYSTEM DESIGN 203 W 15TH, AVENUE SEC 33 WN R3W DATE, NOV. 9, 1992 ANCH, AK. 99501 2980 NUGGET 1.4NE SHEET 1/3 GRID, 3034 I I ( I I well I I I I I I I I I I I I NE TRENCH 1 _– — _=-- -� a oleI f i I I I '�1''•.•1 f ♦f �♦ I1 I I I I ♦ 1 f•1 1 1 1 1141 I CRIB ¢ wdu I I I i I I I I I I I :'.''' ASSUMED LOCATION I I I I I I I I I I I I I I I I I I I I I I I I We(( I I I I IY Wel( I I I I i I I I I i I I I I I I I I I i t I I f I I I I I I 1 1 .` 125 I IS 0 25 50 75 100 I I 125 150 I– I SCALE. 1' = 50 FT, L__�___ TCBBEN SPURKLAND P.E. LOT LO SHRK ROCK SIB SYSTEM DESIGN 203 W 15TH, AVENUE AK. 99501 SEC 33 T12N R3W EDAM NOV. 91992ANCH, 2920 NU56ET LANE 2/3 GRID, 3034 FXUTTNr TRFNrH O EXISTING CONCRETE TANK/ NEW 1000 GAL TANK EXISTING CRIB O Standard Tren - 38' LONG TOTAL 7' DEEP 5' OF SEWER ROCK 3' Min, Cover 1' additional Fill or 2" insula tion insulate line under Mira Fi 140 5 Feet of' eptic 11-1 NO SCALE LX1S11% StPIIC TANK VERIFY INTEGRITY, BAFFLES CAULDER COUPLINGS FVISED- NOV, 20, 1992 Ii UDZU1IrurcrctHivL r,t, I ( LOT 2 SHRY ROCK SID I I SEPTIC SYSTEM DESIGN I AN W1 K, AVENUE SECTION 33, TIEN R3W DATE NOV 10, 1992 qn7) P7q ggi995Di TURK GUILFORD SHEET ,V.? GRIDi 3034 ® Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: t.t.1�� DATE PERFORMED: ,�I��a z• - LEGAL DESCRIPTION: eli Township Range Section: '"rev -t -.i Qzz-, Se -L T SLOPE SITE PLAN F�) 2 % �oo Loarw N 3 0 , SOLAItat 2 4 u� Gvros.V—C 0. �^ 5 11 12 13 e 14 15 16 4e- 17 C 19 WAS GROUND WATER ENCOUNTERED? O S IF YES, AT WHAT L O DEPTH? p E Depth to Water After ► 1L Monitoring? J� Date: `titi `�Z Reading Date Gross Time Net Depth to Time Water Net Drop ICS tI l z :3© pr -e- Smo 13 n 2 3 . 4D 12.'z. 5 a 10 1 a'z 3 0 ot�) 10 1 1 1023` 4:Ia 1 0 1 3 4 1 t Ll :2.v to 20 I I Q r, ILII PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND `a FT COMMENTS 1/moi Q L� PERFORMED BY. —_ � 1 p ^ --S�-5 CERTIFY THAT THIS TEST /WASS PERFORMED IN '// ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: t4 ` L? 2- 72-008 (Rev. 4785) GREG { -R ANCHORAGE AREA BORA jGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 IINN/SPECTION REPORT ON-SITE SEWAGE DISPOSAL. SYSTEM ve NAME eI ///��7��y /1 MAILING ADDRESS!^/)7��%G ����� PHONE �r LOCATION LEGAL DESCRIPTION C// SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER INSIDE WIDTH MATERIAL NUMBER OF COMPARTMENTS LIQUID DEPTH ---LIQUID CAPACITY-_ GALLONS. I I"=QFCFCnv r1CLu: ?TOTAL TOTAL LENGTH ` DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE_OF LINES �v NUMBER OF LINES DISTANCE BETWEEN LINES -_ TRENCH WIDT IN. TOTAL EFFECTIVE ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE WELL: ROM= SQ. FT. LENGTH OF EACH LINE / DEPTH OF FILTER /� MATERIAL BENEATH TILE- `Ew © IN. ABOVE TILE CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION LOT LINE __ SEWER LINE CESSPOOL OTHER SOURCES APPROVED__- DISAPPROVED DISTANCES: INSTALLED BY.1C��J�x SEWER LINE DEPTH: PIPE MATERIAL:_ CSM// < - %5 AL LOT SLOPE: /� REMARKS: /�6 .'W Form EQ -032 REMARKS q 6P �l R DEPTH SEPTIC SEEPAGE TANK SYSTEM_ DIAGRAM OF SYSTEM DAT? �"e(O APPROVED G.A.A.B. IN. DISTANCE FROM: fir -f- ° GREA aR ANCHORAGE AREA BOR JGH ///� /y /lam -7,'l il9 /A cJ "�LIJ vhx Ih/ r/1 d b DEPARTMENT OF ENVIRONMENTAL QUALITY t-_1 ` PUJ__ �_�LI''ERMIT NO. 3330 ";" STREET ANCHORAGE, ALASKA 99503 i :LLL- Y TELEPHONE 254�.' ht[U II.M1\• SEWAGE DISPOSAL SYSTEM a- APPLICATION AND PERMIT NAME OF APPLICANT"'� 9\ „�� �- �� MAILING ADDRESS /-��/,,�Un PHONE°� - `5/ — INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH /C 0 `t' SEEPAGE PIT TO BE INSTALLED BY DRAIN FIELD OTHER SOIL TEST" RESULTS Z "J �' _ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED X V' FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK _ SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD __ WATER MAIN TO SEPTIC TANK DRAIN FIELD SEEPAGE AREA SIZE_ DRAIN FIELD DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT SEPTIC TANK, SEEPAGE PIT —_ DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION v FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST "IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A,B. Oft LICENSED DESIGNER TYPE .� W`/6' DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE RECIUIREMENTS OE GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2868 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE --_- ' - r-L� APPLICANT'S SIGNATURE EQ -01 6(3-76) e� R & M CONSULTANTS, INC. 299 EAST 61 ST. AVE. - BG% BG97 - ANC..RAGE, AK. 99602 P.H. 907 279 GQB3 - TLX. 090 25390 October 22, 1976 Mrs. R. D. Maio SRA BOX 4017 Anchorage, Alaska 99507 R & M No. 656316 RE: Test Hole and Soil Log Report for Sanitary System Lot 2, Shyrock Subdivision Dear Mrs. Maio: We are submitting herewith the test hole results and our comments regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of October 21, 1976, and those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Muncipality of Anchorage Department of Environmental Quality. A single trench was put down within the subject site area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with a tractor -mounted backhoe and the trench was extended to a total depth of 14 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Groundwater was not encountered in the test hole while drilling. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M CONSULTANTS, INC. James W. Rooney Vice President JWR/sc xc: Municipality of Anchorage ANCHORAGE FAIRBANKS JUNEAU 10/21/76 T. H. 1 0.0' SILTY SAND W/SOME ORGANIC MATERIAL, Slightly Moist 1.0' GRAVELLY SAND w — — 2.0' SILTY SAND _ -- — — 3.0' SAND W/SOME GRAVEL, TRACE SILT SANDY SILT W/SOME GRAVEL — — — — — — — 10.5' SAND 11.0' SANDY SILT 14.0' T.D. NO WATER TABLE EDWN:Ae o tF.Br � �l R&M CONSULTANTS INC LOG OF TRENCH GRID 10 2l 76 uws ..awm�.e c....... svwv�.ow�SITYROCK SUBDIVISION PROJ.NO- 656316: LOT 2 DWG. N0. A-01 /2 6 NUISANCE COMPLAINT FORM Complainant's Name:/f�/� Street Address: 33,,;?0 G Phone No,?, _Box Box No. Description of Complaint: /�—CP®9� �Ps�4j,-�.�'�m Name of Person Against Whom Complaint is Made: Owner of Property inhere Nuisance Exists: `���00�9/voe- Owner's Address:Xz-ffor-- &. �,�'�Ri� T_Phone No. Location of Complaint: �j���� �1�/Or �r� a. Go�Ze AN B�9C. eta Sisreet Address:t6�-e �IF.J_A,;:7-- Person Receiving Compl ai nt:,fow 4WIge _Date: y%191ZI I certify that such statement of facts is true to the best of my Le - lief and knowledge. I request that the.foregoinn matter be investi- gated and that appropriate action thereafter be taken. I am willing to testify to the facts stated in the foregoing cumplaint in court if necessary-. Comr)I a i n a n t REPORT OF ACTION TAKEN Investigator: ..,�-1/O_%%®s/�/ Date Investigated:J_��/�®� 'i�/l•�� A c t i o n T a k e n: o� -' ole-'' %,d`s/.6-0.fi�Nc r%s+i Zo .fs-✓ ACA-,,1r,� DATE COMPLAINANT WAS CALLED REGARDING DISPOSITION OF COMPLAINT: ,e&�/�..�" 4/13 J c r o i,i c.K A i 0 X c; 1 cy ir l'. 911 �,) 5 0 u Q c c Survil, Lots I nw! 4, Shry0J! 5/11 it I,, u L u c a e 6 o n L L) L 2 , .5: i ry u c ? 5 0: 1 1 0 Z11 qac-iull oil yuur scnj Q (1 11 11)73, and y r i i %n i r s vi 1: i o n A Lij Jell f i Cr, i a 11 d On r i i 19 1 Q7<'. T.I , , U � I I I k"'(:,i L1 0 1'] 1r) i, I `�; I I, yoc!-, "utAi Vi �-,i o I! - .0 I i I S (.J' V -i LIOLS I ind vi,;j, 11I: i �, o/ -11ti; i ro;i p 1) 1, 1,. 0 v: U I' s a r V i n L u i. 1 Th i s i i ii v i u I a L i u 11 u ,11111 t, (�, 1, PJ k ,i w)i i rl i S r a t 1 V 11 C 0 i C: u 1 1; 1) i, l� [ac.ti (111 265 51a Ar supply. rh u u 11 -- S i La s umn r i,Y s i n vo I vc (= Vj i 1 1 11 VC' j-, U 1) k Ilie V( c, h Ila rc d d i s j. u n t: c: 6l;q py -F r(,I;i !,11e w, I no I L ( Il CllaU P, u1 'LI i -1 "? or t "I C; U c' it (i ( 0'i t 1`1 i S W 0 11 d i S C Q 11 t 1 1`1 LI C 6 . f1, P01 -111i t Mis L lic obtai net frois thi s department for the Um 11:(:'('!1'.1"' i ns to I I a I j itl. is ro-'collifilic.,11 clod i m the if;eanti me that: YOU WUVL 3"jur wo wr te(; oil a rc�fu I ar 1:)as i s to protect, file ncul Ljj Of Ullyc)II(: i&-1 ijXi ng V1 a L e r . '" "PPY"ciate Y01W alillfr-unt will-linness to cooperate in -;his ;,tut -ter anc, your visit to our Office on Jq!ril I d, I �1 -/ a , '(:0 di S C: U S s i.- jj i !; situation. I f You have any questions, pl vasc jo not pic,si tate to Contact LIS. trl'e 'look forward to workin�j vji-t:lj you. Sincerely, n v i ro (I I-iQ n t it I C u r, t ro 1 0 -f f i r iii: L-mclosure cc: Rolf Strickland MUNICIPALITY N < ANCHORAGE Development Services Department On -Site Water & Wastewater Section Parcel 1. D. 018 252 08 Phone- 907-343-7904 -- Fax. 907-343-7997 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description SHRYOCK LOT 2 Location (site address = 2-920-N-11GG-E—T Expiration Date:.j 0 _20 —2-0 GEJ Current-property-owner(s) TIMOTHY QUIRK -Day-ph Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 9 12. P0 coog iC( Waiver Fee $ Date of Payment 7��,Zo Date of Payment Receipt Number. 006390 Receipt Number COSA # DSG 20 I )) g Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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 (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 6/30/2020 of A. /- i.CP• • n• • Sof- �1► i* 49 TH- 6_DSD SIGNATURE_- �_ • • _ _• . System #1 Approved for _2— bedrooms rr • CHARLES G BALZARI91� j System #2 Approved for bedrooms r�}�F���. CE -13854 Disapproved � PROFESSIONP� ate.» Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: �r--Z, d —2 - The The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory Arsenic A_d_visory Other C COSA Checklist Legal Description: SHRYOCK LOT 2 Parcel ID: 018 252 08 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test +3.1 gpm Date drilled UNK Water storage tank volume NA gallons Total depth UNK ft Well disinfected for coliform test? ❑ Yes 9 No Cased to +40 ft ❑v Coliform bacteria is Negative ❑� Sanitary seal is functioning correctly Nitrate mg/L 0 Nitrate less than MRL (ND) ❑e Wires are properly protected Arsenic ug/L ❑Q Arsenic less than MRL (ND) - —Casing height -(above ground)+12 in..Collected-by C—.Balzarini _ Date of flow test for COSA 6/25/20 Date of Sample 6/26/20 Static water level at beginning of test 88 ft. Comments B. TANK DATA Age of tank(s) 28 years Tank type/material steel Measured operating fluid level in septic tank 48.75 ❑s Standpipes/foundation cleanout per record drawing Date of pumping 12/12/19 D. ABSORPTION FIELD DATA TRENCH Which system tested (date installed) 11/92 0 ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field 0 Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: tank levels verified confirmed to be within limits established by Policy W.05 Adequacy test date 6/25/20 Results Q Pass For 2 bedrooms Fluid depth prior to test 48 in Water added 300 gal New depth 56 in Elapsed time 1440 min F0 Code -required soil cover over field Final fluid depth 46 in ❑ System presoaked Absorption rate 300 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO date of test) Gallons introduced gallons If yes, ,enter date NA Comments/Deficiencies: system was 75-80% full prior to testing. Standpipes repaired/extended. -measured effective depth of trench was 5.3' COSA Checklist yellow sheet 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' El Yes Community Sewer Manhole/Cleanout > 100' ft If absorption field is under driveway comment below r Yes if No ft 0✓ Yes if No ft Neighboring Tank > 100' F/71 Yes if No ft Private Sewer/Septic Line > 25' 7 Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' ✓0 Yes Animal Containment > 50'✓Q Yes if No ft 0✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft F,/ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) -Build ing-Foundations-> 10' ❑✓ -Yesif-No ft Surface Water? 100 E]Yes if -No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' 0✓ Yes if No ft Water Service Line > 10' Q✓ 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' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' ®✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS Cleanouts repaired. Recommend pro -active replacement of tank and drain -field in next few years and/or connect to old trench system. Engineer verified standpipes per inspection report. G. ENGINEER'S CERTIFICATION 1 certify that / 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. 7/5/20 COSA Checklist yellow sheet OF A4.q �l 49 TH rJ CHARLES G BALZARI91 CE -13854 ,•�`�� �IlF�F�PROFESSIONP,�.r� MUNPIX.�PAUTV OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On -Site Water and Wastewater Section `<': Fax: 343-7997 www.muni.org/onsite Septic Tank Advisory --- �art" fioate=of=0-=s-ite—Systems-Approval-#OSC 201318 ---Sub-diision ;-S-hrvack-bt-2 — -- Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 26 years old. Typical replacement costs range from $8,000 to $11,000. A leaking septic tank could possibly contaminate surrounding wells. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. WV zSr 4- a �. k, Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org � n a Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # C01 A A 7�2, 0A 1. GENERAL INFORMATION HAA # Q C, _Sc E(,-/, Complete legal description ko JG S V-.(DC'L S/1) Location (site address or directions) U-gq te��11 All Property owner G u-�L P,,Q /lug Y� Day phone 3YS_ 39!Iz. Mailing address�/�Z-d0 �Ld p► A ° —�� Lending agency Ism r i �na4.s.�di wL Day phone Mailing add W Agent �Cp; �a�... Day phone J Ys =36&-o Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 3. 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. 4. TYPE OF WASTEWATER DISPOSAL: / Individual on-site V 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. 72-025 (Rev. 1/91) Front MOA 1121 5. STATEMENT OF INSPECTION BY ENGINEER 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 furtherverify 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. Name of Firm b��('t �P.�Y1r—.a.k..crC ��— _Phone 94q-191,6 Address a b 3 I,l�/ i J 4-4 �4 P,&_k, Engineer's signature 6. DHHS SIGNATURE Approved for 9L bedrooms. Disapproved. _ Date Conditional approval for bedrooms, with the following stipulations: Additional Comments Date 2� 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. Employees 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. 72-025 (Rev. 1/91) Back MOA #21 a Municipality of Anchorage Department of Health & Human Services Mi HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo 1 2- S_ 0 P Parcel I.D. n j n — AE; 2 —0 S A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ' 4 Date completed �� I 1_7 3__ Driller Total depth i / O z Cased to Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot —12) Absorption field on lot 1t' CJ A Z -t Casing height Ir�3 Wires properly protected (Y/N) AT INSPECTION Public sewer main �y��°—� Public sewer manhole/cleanout Sewer service line Petroleum tank N 61 )�/ C WATER SAMPLE RESULTS: Coliform 10 / Nitrate IN Other bacteria _ Date of sample: f I I °y `L Collected by: e, dL B. SEPTIC/HOLDING TANK DATA Date installed t t 1 210-1 q, -- Tank size j "_Q � Compartments Cleanouts (Y/N) y Foundation cleanout (Y/N) X_ Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) Date of pumping �! iUc Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wel I(s) on lot / $ o On adjacent lots 1 2",m Foundation 3 D To property line Absorption field `' Water main/service line i g O Surface water/drainage 72-026 (Rev. 7/91)Front CONTINUED ON BACK PAGE r,n p - A C oz _ z g.p.m. iii o M 71D Z On adjacent lots 1 On adjacent lots Public sewer main �y��°—� Public sewer manhole/cleanout Sewer service line Petroleum tank N 61 )�/ C WATER SAMPLE RESULTS: Coliform 10 / Nitrate IN Other bacteria _ Date of sample: f I I °y `L Collected by: e, dL B. SEPTIC/HOLDING TANK DATA Date installed t t 1 210-1 q, -- Tank size j "_Q � Compartments Cleanouts (Y/N) y Foundation cleanout (Y/N) X_ Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) Date of pumping �! iUc Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wel I(s) on lot / $ o On adjacent lots 1 2",m Foundation 3 D To property line Absorption field `' Water main/service line i g O Surface water/drainage 72-026 (Rev. 7/91)Front CONTINUED ON BACK PAGE C. LIFT STATION l� Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots 'Pump off' level at Cycles tested Surface water _ Date installed I t `17- l 9 t- Soil rating o r© System type 1 'r e' 4,/4 Length 3 n _ Width _75 Gravel thickness Total depth Total absorption area Y> 18 O Cleanouts present (Y/N) Y Depression over field (Y/N) Date of adequacy test ` !� Results (pass/fail) T for bedrooms Peroxide treatment (past 12 months) (Y/N) ! `G_ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on 190lot ') 0 On adjacent lots 105 Property line M To building foundation71 �- To existing or abandoned system on lot 1 On adjacent lots > I ' Cutbank N 0 WL 4?_— Water main/service line �7 J- D Surface water N O A � Driveway, parking/vehicle storage area i Curtain drain 0 tR E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on,the date of this inspection. Signature " 1 ' Engineer's Namey b �O� N 9A 01 Vk Uk� Date jI1%0l� HAA Fee $ Waiver Fee: $ Date of Payment _1',L,01-1 ?= Date of Payment Receipt Number Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343 FAX: (907) 561-5301 Client Sample ID 2920 NUGGET LANE PWSID UA Collected OCT 29 92 @ 12:00 hre. Received OCT 29 92 @ 15:30 hxs. Preserved with AS REQUIRED Analysis Completed OCT 30 92 Laboratory Supervisor TEPNEN C. EDE Released By :7 ANALYSIS RESULTS for INVOICE # 60124 Chemlab Ref.# 92.6046 Sample # 1 Matrix: WATER Client Name :TOBBEN SPURKLAND, P.E. Client Acct :TOBBENS BPO# PO# :NONE RECEIVED Req# Ordered By Send Reports to: 1)TOBBEN SPURKLAND, P.E. 2) Parameter -------------------------------------------------------------------------------------------------------------- ...............................................................,............................,........ Results Units Method Allowable Limits NITRATE-N ND(0.10) mg/l EPA 353.2/300.0 10 Sample ROUTINE SAMPLE COLLECTED BY: STUART. Remarks: .......................... 1 Teets Performed ND- None Detected NA- Not Analyzed ...,.................................................................................................... See Special Instructions Above UA -Unavailable " See Sample Remarks Above LT -Less Than, GT -Greater Than law? E3GS Member of the SGS Group (Societe Gdnerale de Surveillance) 5. LE DES,BIPTION DATE RECEIVED INSPECTION APPOINTMENTSe�_ TIME TIME - TIME 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS 0 SINGLE FAMILY DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR.�� / A1j GR MUNICIPALITY OF ANCHORAGE ppNI�ly���RRDENlPT. OF 1:-ALTI1 & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIBNMEIIL-.L 'TECTIONI 825 L Street - Anchorage, Alaska 99501 - MAR ; 1980 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 ECEIVED -RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROP RTY OWN - PHONE Y MAILING ADDRESS mlDINDIVIDUAL/ON-SITE** PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LEND INSTITUTION PHONE MAILIN DRESS 4.R�Ej �-/Q, R/AGENT �� ,� PHONE MAILING ADDRESS 5. LE DES,BIPTION // STREET �._O ATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS 0 SINGLE FAMILY El Four ❑ Other ,❑One _ IV Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUP LY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM - mlDINDIVIDUAL/ON-SITE** P(=fCinlc 3(a.YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 72-010 (Rev. 6/79) - UP30 "C" Sttr�negt, Ancnorage,-- �U"� \ Date Received November 29, 1976 Time of Inspection 1/:A-)dO 11ry(_ Date of Inspection a 1-I1Io9 REQUEST FOR APPROVAL OF 18Ltc`t&A, (J INDIVIDUAL SEWER & WATER FACILITIES FOR V.A. 1. Approval requested by: Dynamic Realty o Mike Messick Mailing Address: 5Q1 West Northern Lights Blvd._ Phone: 279-7611 2. Property Owner: Mary Carol Maio Phone: 344-4003 Mailing Address: Star Route A Box 4017 3. Legal Description: Lot 2 Shyrock Subdivision 4. Location: Nugget Lane, 5th house on the right 5. Type of facility to be inspected Single Family No. of bedrooms 2 6. Well Data: A. Type Individual B. Depth 97' C. Construction G$li✓J�y D. Bacterial Analysis 7. Sewage Disposal System: On—site system (__lac/2nro A. Installed 1-917 /1T7(61 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. 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 Paye 2 of two pages - Re st for Approval of Individual er & Water Facilities Legal Description Lot 2 Shyrock Subdivision Comments -- Approve Disapproved Date Z� AppYLy�, l,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information convimuu it, — lo .-- „ accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. Date SIGNED EQ -034 (1/74) 1. Type of Inspection 2. 3. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY -9339 E' StFeet, Anchorage, Alaska 995V `� 4 45fr7- -2- 7,r� - 1 2!/ rZ5/.z Ti�o� Ga vti REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRO VA FHA CONV Property Owner: �j�, Mailing Address: SM42Y / —� Day Phone Name of Buyer: Mailing Address: Day Phone 4. Name of Lending Institution: Mailing Address: _- Phone 5. Name of Realtor or Agent: Mailing Address: 4X, ire otr`� !i�Phone 6. Legal Description: I 91 Location: Type of Facility to be inspected: No, 11 c4—/vim_—No. Bdrms. 12 Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served ,y If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation 6 EQ -037 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Qualitv 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received 6r Time of Inspection -4Q—Pe `" / . 06 Date of Inspection ems, REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Anproval Requested BY:,�jr�/c/C_�✓ct�_Elf�f%J^ �i�e!����✓� pJ Phone: � 2. property Owner: �%20i�� /('�� /��C�" Phone 3. Legal Description: .� ��� fj>/�yL'L/ /YJ�• _e_ 4. Locat on:^�✓!/ 6�7'i,%� _._. �__._ s.. 5. Tvre of Facility to be Inspected: --Z/ Numher of Bedrooms: .-e a_ 6. Well Data: A. Typed/UATfi /eAS�_. B. Depthr; C. Construction fflj&-,Pe — D. Bacterial Analysis 7. Sewage Disoosal.System: A. Installed /lsJilDl,9c3. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: I. Size- 2. Materia l L. Disposal Field: Total Length of Lines�� 8. Distances: A. 'Nr,li To: Septic Tan k j —, Absorption Area—L 7 , Sewer Lines Nearest Lot Line o2 Other Contamination B. Foundation to Septic -Tank (f Absorption Area C. Ahsorption Area to Nearest Lot Line Rema,jst for Approval of 1% tviouai sewer a vvar.er raclfi 4"' Paye Two 9. Comments: "/f a Aor) r.oved �� r isapproved Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM T certify that the information contained in this request for approval to be a true and accurate representation of the subiect sewer and water facilities located at: Signed Pate Request for Approval of Individual Sewer & Water Facilities Page Two 9. Comments: _� 7/�2s �a�Lc'T����/�✓cam• G'�"�=i�'�� /CIDT- Aprroved Disar.proved-V/J��.e�� Date�� Approval Valid for One Year. F -o^ Date Signed Greater Anchorage Area Borough, Department of Environrrental Quality DIAG?ATA OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subiect sewer and Nater facilities located at: Signed Date 1 GREATER ANCHORAGE AREA 130ROUGH Department of Environmental (duality 3500 Tudor Road, Anchorage$ Alaska 99507 279-9696 Date Received Time of Inspection_. Date of Inspection���q REgUEST FOR VfuROVAL OF INDIVIDUAL, SEINER & 'NATER FACILITIES I FOR Aoproval Requested 83,i: � /`►�' –!�� ��/�J `�= Address: 2. Prooerty Owner,— ­–:i 3. Legal Description: -?/; 4, Location: Phon ��79-0py'" 9� Phone 5. Type of Farilit /'to he Inspect d: _ Number of Bedrooms: 6. Nell Data: A. Type __. C. Construction 7. Sewage Disposal System: A. Installed 3. Depth D. Bacterial Analysis 3. Installer C. Septic Tank: l.. Size _ _ 2. Manufacturer --- D, Seepage Pit: I. Size-- 2. Material. E. Total ?length of Lines Disposal Field: B. Distances: A. Well To: Septic Tank—----., Absorption Area �, Sewer Lines Nearest. Lot Line, Other Contamination B. Foundation to `ootic Tank _ � s;, Absorption Area C. Absorption Area to Nearest Lot Line — g r)a"rt?.?(' d, of Invironmgr{ 11 01_?111ty 1 350,cj'a(,r `�•„3, A?„ho age, Alpsla 12'19.9eR6 _� � i✓` �1 ilii{;<'-:e(:ea.vr;('___!._�.�_�.�6n._/ _';'.,e_._Y, Ti.:rr+e of Tnsnection A0_1"11_ r ?.��? t: e o'r Tns; r? r, r. , 1. on-- ---•-.-..�w.--_� ..__�_�_.r 1. Aoprova7 Requested 1'' F� .�/�L l�� ��z �i����67 /E��- n..,_.._ • Addr. ess C�� ;one . 3 „ti . 2. Prooerty Ownei : Phone: y�_ f �' ...�_... _ ���....�..�.......�-�.�...�.�..-�..__u..�._.._-.. 3. Legal. Description: ,- v..._,.._._.. 4. Location: 5. Tv -pe of Fac; :i l.it:v to be Tr 3 ;e(-+.ec': NUr?]ber of 13adr.00rea: 6. Well Data: A. Tvne 3. Depth C. Construction I). 9acterlal Ana l.;si.s 7. Sewage Disoosal S'vstem: A 3. Instal.lar C. Septic Tank. 1, Sizw 7, Manufact?lrex D, Seepage Pit: 1... Size 2, tulaf.era.al. E, Disposal. Field: Tota] i,-ngth of T,i.nes 8. D15tancos: A. We] l To: Septic '1'�,nk , Absorption Area Sevier Lines Nparesi: Lo;, I,i.ne Otl!^r Cor:t.arniIla tion B, Foundation tc; Ser,tis; "lank Ahsovptlun Ar,aa C. Absoroi;ion Area ti) Nsarsst, Lot, Line; l W T certu fl, that the information contpine-1 In this request or approval to be a true and accurate represenhiiI., :�I .. thn ;,. );ac;, s;nw )a .r' acid 7r�ll:n-r faei.l.it.lrJ, ior8'Loci atrl Request for Anoroval of "sividual ":ewer. ( 'Waf.nr r=3c9.li.ti�' C qee Two �a 9. Comments :r gr_. E .r Je l 4 9• P", '' � _ - C ' °.e fl�.�.. 1,4 Apnroved Disc"nYoved ?ate 4p` x'0'281 rBi.J.O for IIaF �i a.r 1...x1 )8{.F? ", Pd Greater Anchorage Are -i ?Orot,Icj,?. 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Z 6'PE O C/) co N o 0 o Lo. w e � °� V) � Z- 41 _ 0'09 n s @ c o T n �° °o to V) , ° i o`o i c u s. 0'g v to O .9 N I o o -o V Na � o� �w N E 4� �: OL [73 O + ) O ,9 Nj v N- m a--+ N O o^ 3 CL m I � L 2Z L c m. o to O a c i Ln CD u to L88 a�N� F°Sd'D Q J — LL- torn3 to p o, Ln m o'oe 9G'L66 a,.00 so ,00s i N CL t„ s ( o @ o ate, u A i o0 a) Z3- 0 Lu cnIn E 3: On) o CL) I U @ c V '� 11 I Z3 O �— O ' CD d a� ' N o O LL (] ( Q® I c N o i u S i N J Q I I ham+ L O C O /O•• a Zo �r twi w I w 1f67 va), N E a rrrti�t FLEG`S`:� `.i `% I I ICT i aci FL- w ¢ ¢����\������ i o VWy X (J i; C7 N m 4