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HomeMy WebLinkAboutHERITAGE HEIGHTS LT 21GREL. ]ER ANCHORAGE AREA BOE_jJGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION SEPTIC TAN K: g//~l~ ~,~ Ol '~ FROM WELL ,¢~,'~-~"~, MANUFACTURER ' INSIDE LENGTH INSIDE WIDTH MATER,AL LIQUID DEPTH NUMBER OF / COMPARTMENTS LIQUID CAPACITY/~,~)GALLONS, TILE DRAIN FIELD: DISTANCE FROM WELL(--~,~ FOUNDATION //O! NEAREST LOT LINE OF LINES NUMBER OF LINES ;Z-- DISTANCE BETWEEN LINES //~/~¢-. . TRENCH WIDTH"¢/-'~'M"IN. TOTAL EFFECTIVE ABSORPTION AREA ~'J;)~'t/~ ",~') SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE. '/~f~ MATERIAL BENEAT. TILE ~" ¢ ABOVE TILE 7 IN. WELL: TYPE BUILDING FOUNDATION CESSPOOL NEAREST ~~~ LOT LINE ,~,.,.~.-,~,.B-"E~TER LI~_.,.,...,.,~TANK OTHER SOURCES DEPTH _ SEEPAGE SYSTEM DISTANCE FROM: APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: ///~/~r.~'.'/-'~/I,/ SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: / REMARKS: Form EQ-032 DIAGRAM OF SYSTEM GrE~ER ANCHORAGE Area BOrOUgh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 27/1-4561 INSTALLATION LOCATION PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT MAILING ADDRESS , //"~"~'/'/'~//I PHONE INSTALLATION OF: SEPTIC TANK . SEEPAGE PIT ~ DRA N P~L~-D , OTHER ~ F,NANCED THROUGH : ~ /Z./L __ / ~- NOTE; THIS P NOT VALID WITHOUT SOIL '11~S1' SOIL TEST RESULTS r COMPLETION DATE ANTICIPATED 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. MINIMUM DISTANCES, REQUIREMENTS S CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF FOUNDATION TO SEPTIC TANK FOUNDATION TO /,~ ~' ' ~'"~"~'~ S~PTIC TANK TO S~'T WALL /~ ) SEPTIC TANK , SEEPAGE PIT DRAI~ WELL TO SEPTIC TANK ' 'V~ ~ SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK /~ r SEEPAGE PIT DRAIN FIELD TO RIVER. LAKE, STREAM. ~XCAVATION 5 FE~T INTO UNDISTURSE~ SOIL 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED With AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH REGULATION~ REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. j ~.~y 15, 1975 R&M NO. 562027 b~. Harry Foosness 1436 Matterhorn Anchorage, Alaska RE: Test tIole and Soil Log Report for Sanitary System Lot 21 Heritage Heights Subdivision Dear Mr. Foosness: We are submitting herewith the test boring results and our co~aents regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of May 10, 1975, and those procedures ounlined in a letter dated December 19, 1974, by Mr. Rolf strick!and of the Greater Anchorage Area Borough Department of Environ~ental Quality. A single-Lest hole was put down within the Lot 21 area for the purpose of defining general subsurface soil conditions for the proposed s~mnitary system. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extended 'to a total depth of 14.0 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-0t. Ground water was not encountered in the test hole. We aonreciate being graven this opport,mnity to be of service to vo,, Should you have any questions with regard to the above~ please do not hesitate to contact us. Very -truly yours, R & M CONSULTANTS, INC. JJames W. Rooney Vice-Pres J.denE Encl. ~xc: GAAB T.H. No. 1 5-10-75 0.0' ORGANIC [4ATERI AL ORGANIC SILT, Some Sand 2.5' GP~AVELLY SAND, Trace Silt (SP) 5.5t S~NDY GP~A\rEL, Trace Silt (SW) No Water Table 14.0' T.D. NOTE: Test hole extended with tractor mounted backhoe. Log Represents Lot 21 Heritage Heights Subdivision Engineering 8~ Geological Consuifanfs Inc. ALASKA .UNEAU Harry Foosness Buil~er Log of Test Hole Anchorage, Alaska MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 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. # GENERAL INFORMATION Complete legal description Lot Al; H~itage Heights Location (site address or directions) Property owner Mailing address Lending agency James Bend~ 601 5th Avenue 6031 Yukon Road Anchoraqe, AK Suite 5.'~ Or. Day phone Anchorage, AK Day phone. 162-3110 99501 Mailing address Agent Bonnie Mehner/JACK WHITE CO. Address 3201 "C" S.~.e~:, Su.C~e 100 Anchorage, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well 4 'v D~dy phone 99501 NOTE: 762-3110 Public water ' X×X 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 NOTE: XXX Public sewer 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~21 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 further verify that based on the information obtained from the Municipality of Anchorage files and from my inves_ti_gation 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 $ & _~__.NG!_~.!~R!NG ,.~,. Phone ~ ~'~-'Z~,;~' ~ /i In,moor's s~naturo Dato Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 DH HS 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 - (~ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Descripti°n: ~' 6 ~' ,'~.2' ~ ~/'L'1'i¢7~ ~ Parcel I.D. f~) / ~'- -- A. Well Data ~- lC Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller Total depth Cased to Casing height ,//// Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECT/~ Date of test Static water level Well flow g.p .g.p.m. Pump level1 SEPARATION DISTANCES FROM Septic/holding tank on lot ; On adjacent lots Absorption field on lot J ; On adjacent lots Public sewer main ~ Public sewer manhole/cleanout Sewer service line .~ Petroleum tank WATE~LE RESULTS:  j~m Nitrate Other bacteria /,~ate of sample: Collected by: B, SEPTIC~ANK DATA Date installed ~---¢' / / ~/"~ ~"-- Tank size (' ~-- ~'~-~ Compartments Cleanout~'~l) y~ Foundation cleanou~) ~ Depression (Y~ High water alarm ('~__~"~ .,/,_Jo Alarm tested (Y/N) -"~// Date of pumping ~"/~'/c~,,.~ Pumper /~t'F ~-~/t't~ SEPARATION DISTANCES FROM SEPTIC/HS~'"-BtNC:~ANK TO: Well(s) on lot//,./~b,,O' ~ On adjacent lots ,,~rO¢'~-/~'~- Foundation To property line ~ ~ Water main/service line Surface water/drainage Absorption field .~' ¢'~ 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pu..mt~C~evel at High water alarm level Meets MOA electrical codes (Y/N) SEPARATISM LIFT STATION TO: Well.~o'F Surface water On adjacent lots D. ABSORPTION FIELD DATA Date installed ~:~ / / ~/'~ ~ Length ~(~) / Width Soil rating (GPD/FF) / ~5 '~/~ ~ Gravel thickness -~' { System type Total depth Total absorption area :~(~ Er¢PI¢ )~Cleanout present) Date of adequacy test ~/"~¢ / ~ ~, ResultsAp~ail) - ~ - Water level in absorption field before test . Peroxide treatment (past 12 months) (Y/N) / JS ro cTr©,,,3 pJ ,oo T SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Depression over field (~/~, for After test If yes, give date Well on lot /{_]o,0~~-- To building foundation On adjacent lots -~'~ /./--r Surface water //._3~_.~ re__ Driveway, parking/vehicle storage area Curtain drain /~O.~J~- E. ENGINEER'S CERTIFICATION Bedrooms /LJo~ ~ %_~Property line On adjacent lots To existing or abandoned system on lot Cutbank A-Jo.x-Jo-r- /°/?~¢J~'C2--Water main/service line I certify that I have checked, ve~fiedr~r conformed to all MOA and HAA guidelines in effect on the date of this inspection. ·, '~c .' ?.!,.;'~'' :~', ~: ',.v, Signature Date ~ lie River, Alaska 99577~~ ,~,~, , ' ~" '<4,",.. : HAA Fee $ ,¢~ LOC ~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTA'L HEALTH ~(~(~ CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL -- OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ¢.~//~//0~ GENERAL INFORMATION (a) Legal Des.cription (include lot, block, subdivision, section, township, range) Location (address or directiops) ' (b) Applicant Name ~-~-.~///~/"P"~, Telephone: Home~ ~, , // Business~~ Applicant Address /~/ /~~ ~/~ Z~ ~ ~ ~... ~ (c) Applicant is (check one): Lending Institution Owner/b der ~; Buyer ~; Other ~(explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Hail the HAA to the following address: TYPE OF RESIDENCE Single-Family' Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY , Individual Well [] Community [] Public/~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL . Onsite~" Public [] Community [] Holding Tank [] Note:/" 'If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) 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..~ Address Date Engineer's Seal DHEP APPROVAL /~. Approved for./~:¢""(~J~/~)~ bedrooms by Approved ~,./~ Disapproved Terms of Conditional Approval Conditional 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 72-025 (1 ~/84) MUNtCJp^UTY OF ANcHORAOE ENV~RONMC~NTAL sERViCES DIViSiON 1988 WEL' £1VED MUNICIPALITY OF ANCHORAGE (MO'J~ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description,: / Well Classification _ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) . Date Completed · Yield Total Depth Cased to ___ Depth of Grouting Static Water Level .... Pump Set At Casing Height Above Ground __ ___ Sanitary ~¢~;asing (Y/N) Electrical Wiring in Conduit (Y/N) . I )~epr..e '9-s~r°und Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot It? h ~ ;On Adj~)ining Lots To Nearest Edge of Absorption Field on/~? ; On Adjoining Lots To Nearest Public Sewer L ne / To Nearest Public Sewer Cleanout/Manhole-../~'/ To Nearest Sewer Service Line on Lot Water Sample ColI~PDy ; Date Water Sampl~et'Results Com SEPTIC/HOLDING TANK DATA Date installed ~,~,/~.~--~' Size /~,~ ~'d~) No. of .Cqmpartments / Standpipes (Y/N) ~ Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N) //~/ Depression over Tank (Y/N) /f~/ Date Last Pumped '~///~ O/~ ~:~ Pumping/Maintenance Contract on File (Y/N) ?J///~ ; for Holding Tank High-Water Alarm (Y/N) /(~.~ .~. Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course / To Building Foundation ~ / To Disposal Field /~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 12-026{11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /~ Date Installed Width of Field ,';~ ! To Water-Supply Well To Building Foundation Lot Square Feet of Absorption Area ~'~ .~¢ ,~-~,¢¢///"2~ Standpipes Present (Y/N) Depression over Field (Y/N) ~/n Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: / To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness ! TO Property Line ~;";"~,~ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) ,u/,4- D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at / "Pump O~ High Water Alarm Level at /jJ~ent (Y/N) Tested for /-..-'~'~-~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~ /~"' Comments Check ed Be ~..)RatingAgainstHAARequest I certify tha/I ~/~,~eck. e¢t, v.e'rified, or conformed to all MOA apd HAA guidelines in effect on the date of this inspection. Signed //////'~////~-~ ' Date ~//,~/ Compa/y v~¢~.//¢~-.~ ~-.M CA No./S ~?"-~ ' ~..~7~ Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (1~/84) : APPLIC' NT FILLS OUT UPPER HAt- ONLY · ~'-J '~" Phone(Her wk. Prop~rtyOC'~aer Steve & Rosemary Nickles ~ -' 243-5889) ·" Zil~ Code Mailing Address SRA R~x ~.GY. Anchorage_~ AK 99507 349-5243hm. Buyer Richard and Shirlee Johnson Address Zip Code Phone Lending Institution ~laska Pacific Zip Code Address Realty Co. & Agent CO1 dwel 1 Banker Jack White Company/E1 liot Lawson Phone Address .qPrll "C" gr.: g.'i'l'_~ l~fl.. Anchnrag~. AK Zip Code 99503 277-1553 Lega~aescr,pt~on Lot 21, Heritage Heights Subdivision Street Location i~0~1 ~lul~nn Type of Residence ~ Single Family ~ ~ ~ Multiple,Family No. of'Bedro(~rns [] Other Water Supply [] Individual A~ACH WELL LOG. A wetl Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available).  Community Public Utility Sewer Disposal ;~] Individual Year Individual Installed: [] Public Utility When Connected to,Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REC3JEST BEFORE F~qOCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ~' --~ '~ '~ ~ ~j~ ~c~p' ~ ~ ~-~ I MUNICIPALJ~ OF ANCHORAGE ~ DEPT. OF HEALTH ~ ~j~l~,~;~ ~.0. e~.~ ~/~~ ~.~ . ENViRONMENTAL PROTECTION ( c[ ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ~--~ WelltoTank ~0~ ' ~ Septic T~k Size /~0 72.023 (3182) August !0, f.983 Steve & Rosemary Nickles SPJ% Box 65Y Anchorage, AK 99507 Subject: Lot 21 Heritage IIeights Subdivision Approval for the individual sewer and water facilities cannot be 9ranted until the following items have been completed: The septic tank pumped ~lith a receipt submitted to this department. An adequacy test needs to be performed on the existing leaching area. This test will determine if the. syste~a is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. o %'he standpipe to the se%.;er system need caps on the~]. Please notify this Department for a reinspection when the noted discrepancies have been corrected.' If there are any further questions, please call this office at 264-4720. Sincerely, CW1/p/E Enclosure Cory Willis, R.S. CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 Rosemary Nickles SRA Box 65-Y Anchorage, Alaska 99507 SEWER ADEQUACY September 2, 1983 TEST MUNICIPALITY OF ANCHORAGE DEPF. OF HSALTH & RECEIVED LEGAL STREET ADDRESS OWNER RESIDENCE WATER SYSTEM SEWER SYSTEM DATE OF TEST TEST PROCEDURE Lot 21, Heritage Height 6031 Yukon Drive Rosemary Nickles Four Bedroom Single Family Community Well From Municipal Records: Tank 1250- gal Stack Steel Absorbtion System Trench Absorbtion Area 500 sq. ft. Installation Date June 1975 August 30, 1983 System was inspected on August 29, 1983. Liquid level in tank was 48 inches, in 4-inch sump 55½ inches and in 6-inch sump 12 inches These sumps are not perforated and are there- fore not in hydraulic conection with the trenches. On August 30,2500 gal. of liquid was dumped into the system via the 6-inch sump. No inflow was observed into the tank and the 4-inch sump. The trenches absorbed all of this water This system are still meeting the Municipal Requirements. ~ F,~ DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR .MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI ~IVIRONMENTAL PROTECTIO~ 825 L Street - Anchorage, Alaska 99501 ENWRONMENTAL SANiTATiON D V S ON FEB i981 Telepho,e 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1. PROPERTY OWNER j PHONE George M. & Becky J. Nelson 349-1946 MAILING ADDRESS SRA Box 62A, Anchorage, AK 99507 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE Lloyd S. & Rosemary Nickles 349-5243 MAILING ADDRESS SRA Box 14515, Anchorage, AK 99502 3. 'LENDING INSTITUTION J PHONE 1st National Bank of Anchorage, South CenterJ 276-6300 MAILING ADDRESS 4. REALTOR/AGENT PHONE Jack White Company (Elliot Lawson) 277-1553 MAI LING ADDRESS 3201 C Street, Anchorage, AK 99503 *NOTE: Please send all correspondence re: this approval to Elliot Lawson at Jack White Co. Contact Ms. NelSon for access to home for water sample ..... THANKS!! 5. LEGAL DESCRIPTION Lot 21, Heritage Heights Subdivision STREET LOCATION 6031 Yukon Road 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One ~;[ Four [] Other [] SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY [] iNDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY *ATTACH WELL LOG. Awell log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SiTE** [] PUBLIC UTILITY approx. 1975 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ""[~ SINGLE FAMILY [~ ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO ~ FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL ~ COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~ INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY [,~- \l o- Connection Verified INSTALLER ~]Septic Tank or [] Holding Tank ("~. ~ ~ ,~ _~ .¢~-'C~ Size: \ ~,~-F~'~ If Tank is homemade SOILS RATING give dimensions: I ~'~J.~ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line B. COMMENTS r~l APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev, 6/79) Tobben Spu&l M P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 Elliott Lawson ,lack White Co. 3201 C ' ..... Anchorage~ Alaska 99503 March6~ 198I SEWER ADE~UAC Y TEST Legal; Strret Address ~ Owr{~r I Re,~ideace ~ Water System Sewer Sy~,:;t em Date of Test~ Test Procedure i~t 21~ ileritage a~l~ht. 6031 Yukon Drive Georg, i.~el ~mzi : Cc~m~uit ~ Well From Municipal Records: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 6 1981 RECEIVED : Tank ~2.~0 g;-~l. Stack Steel : Absorpt ion Sy~.te~n Trench .5 feet of gravel AbsorptJ. on ~'~a 5~ feet Installation Date~ ' ~un~ 1975 March 4and 5, 1981 System was inspected ~zd p~ml~d on M~ch 3~ 198% The 4 inch s~p on the 15-foot log was 8'-.4" deep with a liquid depth of 59 inches. Th~ 6 inch su~zp was 9'-~ deep with 35 inches of liquid. The h inch drain enters the stump 48 inches above thr bottom~ The s~p is not perforated. Tauk is 9 fe~t belom ground. On March 4th. the trench was ch,~rged with 1250 gal of uater. ~t following readings of the wa~er level in the 6 inch sump was taken. The wetter entered the system via this sump. Water Volume O 50o !000 1250 Check oil March 5 Water level ~n Ii illci'l s~,p Since the 6 inch a~mp is not I,iq~id depth 4~ perfor~ted the water level t;.t,ez~ch can not bo determined by meastiring the lextel in the sump. However the systea accepted !250 gal of watei~ without being ~;urcharged~ Since the i.~iter level in the 4 inch pipe was 5 ~lches lower than what measured prior to the test the conclusion must be that the syntem absorbed the 12~ ga! plu~ additional water during the 24 ;bourse This's%¢stem clearly 825"[" T~-'v- - . S, ANCHORAGE, ALASKA 99.501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR Of:P/',NT~:iI~N i ©F IiEA[.FH :\ND ENVIRONMENT;',,L PROTECTION March 3, i981 George M./Becky J. Nelson Star Route A Box 62A Anchorage, Alaska 99507 Subject: Lot 21 Heritage Heights Subdivision Approval fel. your individual sewer and water facilities cannot be 9ranted until the following items have been completed: (1) The septic tank pumped with a receipt submitted to this office. (2) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. If there are any further questions, please call this office a't 264-4720. Sincerely, Robert C. Pratt,. R.S, Associate Specialist RCP/ljw CC: Elliot Lawson % Jack White Company 3201 C Street - Suite 100 99503 FirsU Na[iona! Bank of Anchorage Post Office Box 4-2090 99509 /~"~ _.,~; // GREATER ANCHORAGE AREA BOROUGH ~1~' /~//~ ,,m, ~Department of Environmental Quality ~d~/3330 "c" Street, Anchorage, Alaska 99503 274-4561  ~>t~/ ~ ~ Date Received -- _---- t9 ~ Time of Inspection - . ~*-~ *-~ Date of Inspection ~~/_~ ~ INDIVIDUAL SEWER & WATER FACILITIES FOR Mailing Address: ~- ~ - 4. 5. 6. 2. Property Owner: ~.~,.~. ~ A)~ Phone: Mailing Address: lC~ Legal Description: Location: Type of facility to be inspected Well Data: ~ A. Type B. Depth C. Construction No. of bedrooms D. Bacterial Analysis e A. Installed C. Septic Tank: D. Seepage Pit: E. Disposal Field: Sewage Disposal System: ~ I~ B. Installer //~/~x~z~? ~_~ 1. Size /~~/ 2. Manufacture~-~-~ 1. Absorption ~:e~aa~ 2. Material - 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 'GREATER ANCHORAGE AREA BOROUGH· Department' of Environmental Quality 2330 "C" St., Anchorage, Alaska 99502 274-4561 'REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES · l. Type of i'ns'pection: 2, Prope'r'ty Owner: Mailing Address: 2. Name of Buyer: Mailing Address: .CMRO VA FHA CONV ,Harry Foosness 1436 Matterhorn, Anch. .Day Phone 277-3794 ..'i' ~org.e M. Nelson SRA Box 62A,·Anch Day Ph°ne 274-4072 Name of Lending Institution: National ]Bank of A][aska EH, %~\~ ~ Mailing Address: P.o. Box 3-3859 ' Phone 279-2506 Ex20 Name of Realtor or Agent: Mailing Address: .npne , , Phone 6.. Legal Descripti0n:' Lot 21Heritag,e,,H~i~hts LO C a t i o n: '6031 Yukon' Rd (GAAB Parcel f~015-061-61) :: 7. .Type of Facility to 4 Water Supply Type of Supply: Septic Tank . be inspected: for ~-gl= F~mily NO. Bdrms. residence .Public Utility xx ind~vidual If If Individua'l, depth of well Sewage Disposal'System · Type.of S~st'em: Publi'c Utility If·individual, date of nstallation Individual, number .of dwellings Presen.tly ·served Individual (on-site) xx 1975 · P~ge 2 of two pages - Reqt t for Approval of Individual Sc ~ & Water Facilities Legal Description Comments ApProved Disapproved Date ~J6 Appr~F~F-~alid for one year from date signed Greater Anchorag~'~A~a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and ~ccurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74)