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Home My WebLink AboutBEVERLY HEIGHTS LT 1 ~ MUNICIPALITY OF ANCHORAGE DEF. .I'MENT OF HEALTH AND HUMAN SERV, $ Environmental Health Division 825 "L" Street. Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NafT~e TANKS DISTANCES SEPTIC TANK WELL ~/00 · ABSORPTION ~ ! ~,' t. y" FIEL0 LOTLINE ~d t ~ /~( FOUNDATION ~0t ~ ~t WELL SEPTIC TYPE OF SYSTEM [] HOLDING NO O, Comparlmer~ts ~TRENCH ~ BED D W. DRAIN D OTHER u 9e' s J ,.,,~.~ ($//q/z_.o WELLS / ? ~ 7 ~::PRIVATE [] OTHER Ildentifvl ,,i REMARKS: FT /!/1 . ~.g:~w:2~-'~-~ ..- ~}' .:~ ~-- . .~,'."-.?--: .~ , ~.~-.. HeatthDepaflmentApproval: , ~' ~~ Date. ~'~ ~ '~'"~ '~"~ ' 72-013 [3,85) MUll I C Z P~L I ]-Y OF' A14L]i-~DRA~[~E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROfECTION ~}25 L S~REET, ANCHORAGE, AK 99501 264-47~0 ON--S I TIF- SEIIIER I~ERI~'I I T F'ERM I T NO: [)ATE ISSUED: AFIpL ICANI: ADDRESS: CONIACT PHONE: 87015& UPGRADE -;"o'~-~- ~P~-I]'~/ = ~ ~'~~ JOHN OR PAT REFFETT ~1~ ~ EAGLE RIVER~ AK 99577 694-88:21 L.E~JAI_ DESCRIP: SUBDIVISION: BEVERLY HEIGHTS LOT: 1 SECTION: 10 TOWNSHIF': 15N RANGE: 1W LOT SIZE: ~969~. (GQ.FT. OR ACRES) BLOCK. NA certify that: 1.' I am familiar ~ith the requirements for 2. 5. on-site sewers and wells as set forth by 'the Municipality o~ Anchorage (MOA) and the State of Alaska. I ~ill install the system in accordance with all MOA codes and regulations, and in c~mpliance with the design c~itepia o~ this permit. I will adhere to all MOA and State ~ Alaska ~equirements ~r the set back distances ~com any existing well, wastewater disposal system op public sewerage system ~n this op any adjacent ep nearby l~t. IF A LIFT S~ATION IS INSTALLED IN AN AREA COVERED BY MOA ~UILDING CODES, ]HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL I~NSPECTION REPORT; AND (3) THE. ELECTRICAL WORK MUSI BE DONE BY A LICENSED ELECTRICIAN. SIGNED ~'J~ ~ ~ ~ .~ ~ ',TE: D, ............... ..... PERFORMED FOR: LEGAL DESCRIPTION: DEPTH (FE;T) 1- 2- 3- 4- 5- 6- 7- Munlclpali~ of Anchorage ~,~)~-~Z,. DEPARTMENT OF HEALTH & HUMAN SERVICES ~ ~:~~, 825 "L' Street, Anchorage, Alaska 99502~650 ~ ~. ~...--...~..~- _ SOILS LOG PERCO~TION T ; ~ ~ ~ ~Township, Range, Section: T Z~ ~ SLOPE SITE PLAN N iON 11-- 12-- 13-- 14-- 15-- WAS GROUND WATER ENCOUNTERED? L IF *(ES, AT WHAT O DEPTH? p E ~itoring? ~ 0itt Gross Net Reading Oete Time Time De~th to Net Water Drop 16- 17- 18- lg- 20- PERCOLATION RATE -- (minutes/tach) PERC HOLE DIAMETER COMMENTS 100( O,.~ PERFORMED BY; , /gfl TEST RUN BETWEEN FT AND FT ~ ~11, ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4,85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: "J~'~ ~' ~0 Ioo ID0' ]1 IIIII /00 ' GREATER ANCHORAGE AREA BOR~.GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 NAME LOCATION INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ~_-,,-,e,~,~'-~- MA,LING ADDRESS ,'~'~/~,X _,~' 0/'/¢y/~' ~,O~ ~'~ ~ LEGAL DESCRIPTION ~d ~/ ~E~ ~ ~. SEPTIC TAN K: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER MATErnAL NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH IIQUID CAPACITY/~" ~'~) GALLONS. SEEPAGE PIT; NUMBER OF FITS 4/ DIAMETER OR WlDTH//~/Z'.~/' LENGTH/~../. DEFTH //~ ' LININGMATERIAL~P~ ~//~ CRIBSIZE: DIAMETER~OEPTH ~ DISTANCE FROM: WELL BUILDING FOUNDATIONC5 NEAREST LOT LINE ~ TOTAL EFFECTIVE ~ ADDITIONAL ABSORPTION WELL: BUILDING FOUNDATION CESS.OOL ~2 APPROVED .... CONSTRUCTION NEAREST LOT LINE ~ r~' OTHER SOURCES DISAPPROVED NEAREST . SEWER LINE /~7/"'~' REMARKS DEFTH //~"'~/ DISTANCE FROM= SEPTIC ~ ~ SEEPAGE ~)7 / TANK , SYSTEM DISTANCES: INSTALLED PIPE MATERIAL= LOT SLOPE: DIAGRAM OF SYSTEM DATE ~'/?~ APPROVED G.A.A.B. O8'E Russell Oyster 694-2774 Soils E~ Foundations GEOTECHNICAL DEVELOPMENT CO.' 8ox 90, Davis St., Eagle River, Alaska 99577 694.2774 or 68~.2280 Ead Ellis \ 688-2280 Land Development SO~L LOG Performed for: Name: Tel, ~1o. Hailing Address: 'Legal ?escrtptton: ~/~7-/ , /~'t,,',~---,~--~,~' ,Z_/'~'~/~//TS Oepth {feet) Sot1 Characteristics 4 5. 6 7 8 g ll 12 Ground Water Encountered: Yes No ~ If yes, what depth Proposed Installation: Seepage Pit ~' Ordn Fie~d' · ' p ANCHORAGE AREA bOr¢/~Gh PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT,', * ~ iNSTA[~TION OF: SEPTIC TANK // [EEPAGE PiT 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. FOUNDATION TO SEEPAGE PIT WE~LTO'E'',O TANK //0 ~ DRAIN FIELD /t~ ALSO CONSIDER AREA WELLS. SE"T'O TA.K./'~O' .SEE.A.E P'T./'~ a o.A,..,ELo /oo INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT . 0 ~ E GEOTECHNICAL 8- DEVELOPMENT Russell Oyster 694-2774 Soils [/Foundations Performed for: Legal DescrSptton: Depth (feet) Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 0 1 2 3 4 5 6 7 8 g 10 11 12 SOIL LO~ CO. £a# B/is 688-228O Land Development Sotl Characteristics Ground Water Encountered: Yes Ho J If yes, what depth Proposed Installation: Seepage Pit / Drain Fle~d Co~ents: Performed by: Date: MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # ('"'~-/'~ - ~T.~-.~. L~.~ HAA# 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location(addressordirections) (b) Property owner ff.U.D.# 0~009~ Telephone: (home) Business (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent ASSOCIATED BROKERS ATTN: Sandy Address 640 ~6t 56th Ave~ Sultz #I: Anchorage, Ak 99503 Telephone ~6~-3333 (e) Mailthe HAAtothefollowing address:(orcheck here ~ifholdforpick up.) Listcontactperson and day phone numberbelow: S & S ENGINEERING IluJ4 Eagle River L~p Road-No. 294 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms 3. WATER SUPPLY Individual Community [] Public I-1 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. ' ' ' ' 4. SEWAGE DISPOSAL On-site [~ Public [] Community CI 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 1 of 2 5. ENGINEERING FIRM PROVIL .G INSPECTIONS, TESTS, FILE SEARCh, DATA AND INFORMATION ' As certi fled by my seal a ffixed hereto and as of the validation date shown bel ow, Ive rify that my investigation of this' Health Authority Approval shows that ti3e 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. ! further verify that based on the information obtained from the Municipality of Anchorage fifes and from my investigation and inspection, the on-site water supply and/or wastewafer disposa~ system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 5 & ,~ ~- .... ~,-~-~,, 17034 E~.~Io River Lcop ~o,~c~ I'.!o. 204 Address l[~ul~ R;~cr, ~.l= d< ~ ~57~ Telephone Date Approved for ~''~ bedrooms b Approved Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of H;alth and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph $ 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, Page 2 of 2 A. WELL DAT~,,.~,,,~.,'~ MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) · CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: ~ Well Classification Total Depth'~-~s"/' Cased to' ~'~/'/' Depth of Grouting Pump Set At. Sanitary Seal on Casinl~/N) Depression Around Wellhead ;'On Adjoining Lots Static Water Level "7~" Casing Height Above Ground ~ j'''~'- Electrical Wiring in Conduit (~/N) y SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field,on Lot 1 '~- ; On Adjoining Lots Nearest Public Sewer Line ~ To To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot '~J~-~ Water Sample Collected by ~:~}1'~ ~-r'~"~- ; Date Wate;Sa_~TTeSt Results ~;~::~.~,~",.-T'Z:~ '-~."T'T .'~ Comment'~"'"t~' ~"'~"'~'1~""1~1~ ~ ~ ~"~'~~. Date Installed IC~-~-~'7 Size "'~"~ No. of Compartments Foundation Cleanout~l) y Date Lest Pu m p"~ --'7.,. ~' -.~ C:) /'J~ ' ; for - ' ' ' Temporary Holding Tank Permit (Y/N) Standpipes4~/N) '"j/ Air-tight CapstaN) Depression over Tank (Y~::' I Pumping/Maintenance Contact on File (Y/N~t/ Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well I ~ To Building Foundation To Property Line ~ c:> I..,L... To Disposal Field To Water Main/Servic~ Line ~ ~ t ,~- To Stream, Pond, Lake or Major Drainage Course Co m m e nt~..~, C~.~_ ~'c:=c>L.- C. ABSORPTION FIELD DATA I/ '/''~''~''1~ '~ · Soils Rating in Absorption Strata ~ . Type of System Design"-T'-'~ Date Installed ~'"~'~:'~ ~'"~ Length of Field ~c:? Width of Field ~ Depth of Field [ ~ Gravel Bed Thickness '"'~ ' ~ Square Feet of Absortion Area -7 ~"'"¢::' ~ Statndpipes Present~) · Depression over Field (Y~ ~.. r'~ Date of L~ast Adequacy Test Resul!~ of Last Adequacy Test ~~'~?~/ ~:~"~;:~---~- SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation I Lot ~--~ ~ To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, o~Vehicle Storage Area ~ c::~ ~'~"- Comments To Property Line ! ~-~ I..~ . To Existin~ or Abandoned System on ; On Adjoining Lots "'~'==-"J"' j/. To Cutback (?.present) D. LIFT STATION "Pump On" Le~ High Water Ale Tested for Meets MOA EI{ Comments Adequacy Test. 72-~ (Re~. 1/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 **Check Permitted I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe. _c~'~.~te~o.f this inspection. Signed ~ Company 17034 ~gle River L~P Road No. 2~ Date MOA No. C / Date of Payment Amount: S / CHEMICAL & GEOLOGICAL ZABORATORIES OF ALASKA, INC. 5633B STREET .ANCHORAGE. ALASKA99518 · TELEPHONE (907)562-2343 FEDERAL TAX I.D. #92-0040440 ~ecei.~ aov 6 93 e x2=4~ Client lcct: ~eq ! Jnaly~t, Co~.to~ :NOV 7 93 ~or~ ~e~OZtl to: Laborito~y Sup,zv~or~_~2E~HE# C. EDE 1)$ & $ [~IKE~IN$ ~IT~ITE-N ~(O.IO) ~J/l EFA 353.2 1990 ROBERT SHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (90~) 694-2979 FAX 694-121 t HEALTH AUTHORITY APPROVAL~ SEWER & WATER INSPECTION REFERENCE: ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST and ~e~ approu,:~, pu~poTeT. $OILTEST STRUCTURAL & MECHANICAL INSPECTIONS The 6ep,t,/.c :t. crfl~ u~6 p~,mped on .la./_;~y rS, 1990 by J/~'6 Ce~6poo~ PwnpZn~. · the ~ep~c adeq~cV ,t.e~t, a tto~ t~t ~ p~o~ on the ~ ~e ~e~enc~ ~op~y. The ~ Zeu~ ~6 d~ do~ ~o ~e ~p ~ ~ ~e ~e ~ Zeu~ d¢~ do~ ~o ~he p~p, and ~e ~ou~ o~.~ Ja~V i5.. From g~ g~t ~ ~u~ ~n~d~ ~e ~ ~e o{ b~.. (The ~b ~e~ {e~ ~-m~F be pT~domo~ ). ' . 11034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA I~955 Seue.'~y Aue~e H.U.P. #0£009~ 1990 On .2,,m,~.~V $I, 1990 :the ~ and v~,.te~. 6V6t~m, ~ '~ poZ~ j~: bevo~ ~he p~6~e ~, ~ c~~. T~ ~6 done bV po~ ~ g~on o~ ~ ~e b~ng.. -The ~V~ ~ ~en ~d'~ ~ ov~g~. Ou~ ~e n~ ~upLe o~ ~V6 ~e ~o~e ~6 ~6h~ o~ o~ ~he ~V6~ a~ a "o~L b~" ~oo ~o~6 ~ ~. Th~e~o;te, 'on 14,,e. ch 9, 1990 u~e ~e-e..t~.o.t. Zr~.ted .the ~ on # d~V6 ~uhen v~e `s~e. cJ ~6~.ng .~e cl~o,~t~e ou~ o~ ,the ~V6:~. On I~,~ch 16, 1990 ~ '~.mp,[ed. Once aga.~, ,the ~u.t.~ `shov~..c~ "o,t. hee. bacte,~b~" ,too ~e,tou6 :to coum.~. · the ~ on ,the ~e~eed p.'toper,tV ,to be. `s~ue~ bV a 6~{~V ~. The ~ on Lot ~, Beu~V H~g~ ~ 427 The ~ on Lot 146, Z6 ~45 ~. deep ~ the m~jo~V o{ ~ TUE ?:14 ~, Dc-'* ,..,~.,.,~ dram. I~. ti. fl, ~eplb I0. STATIC WATER LEV[Lt c OCT--~--~O TU~ ALASKA PURE WATER PRODUCTS 129 W. $3rcl. Avenue Anchorage, Alaska {)9518 Ph. (907) 563-$770 FAX (907) 563-5502 O~ot~r 18, 1990 Associated Brokers 640 W. 86th Ave. Anchorage, N~. 99503 whom It may'concern, The purpose of this letter Is to discuss the recommended method o! removing methane kern the potal~e water at LI Beverly Estates. Methane, being a volat;le and flammable gas, Is a $1gnlfigant hazard when encountered In a water supply. It must, thorei'ore, be removed before the water may, be safely ut~ized. Methane, since It Is so volatile (meaning It will dissipate to the atmosphere easily), b easily removed from water utilizing a process known as passive aeration. In this pro. cass, the water is sprayed Into a tank whlch IS vented to atmosphere. The methane Nil separate lrom Ihe water at this time. A vent line from the top of thls tank to out- side of the building allows the methane to be removed from the facility, Since meth- ane Is signlflgantly lighter than alr, It will dlssTpate to the atmosphere with no r;sk to property, From the bottom of this separation tank, water is drawn to a beo=ter pump which will provide prossur'¢ed water to the home. We have, In the past, utilized thts methodology, w~th DEC approval, for the treatment of this type of problem. It Is a simple design with a minimum of equipment Involved. There Is no periodic maintenance Involved on this type of system, making It all the moro attractive. If we may' answer an), questions, or cla.'lfiy spe~lc points o! the design, please call. Slr,,Cerely, Bdan Watson Commerolal/lndustdal Div. OCT-- ~'~'~--~O TI..I~' ? : 1 ~. A$$O~" I AT£~ )3ROl~r~ RS ~, ) He , P , O5 1 I/2' PVC $CH g0 'TO SERVICE ~ch GARA~iE 220 g~on ga~var~ze~ tank fvr~ce ..~.~.&.-.~.~.~.~.~.~.~.~. ~ . ~203 ~-/./-~.~,/-~,~.~ ,~'~ ~ ~ ~.~.~.~.~.,.,.,.,.~,.~.~ ASSOOIATED BROKERS L1 BEVERLY HEIGHTS 129 ~. ,~ AvenUe Ancho~'~e. AIL ~$18 Ph. (907) S$3-g770 FAX ~1~3.5502 NO SCALE EL~:VATION 0 I GARAGE f~ Ih~ oonligur~_!k',n, ~ garage ~ ~.ee~ to be bee. led. 7his is the preferred coalk3uralion. Due to ~e tox~ ~tum ~. , [Project: ~. ASSOCIATED BROKERS o · L1 BEVERLY HEIGHTS 0 AJar,~ka P~® Wa~er producls 129 W. 53~d Ave. Ph. {9073 563-3770 FAX 563*5502 NO SCALE METHANE REMOVAL SYSTEM LAYOUT #1 APPLICr .T FILLS OUT UPPER HAL""' NLY Phone Type of Resl<tence I-1 Multiple Family r-I Community i-I Public Utility Sewer Disposal Public Uulity ~] Holding Tank Phons ATI'ACH WELL LOG. A well log Is required lot all walls dHled since June 1975. For walls (killed p¢ior to Ihat date, give well depth (attach log If available). Year Individual Installed: I '~) '~ (.,, When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PflOCESSING CAN SE INITIATED. Time Time Time Date Date Date Inspector Inspector Inspector Time Fteld Notes: pl~.~ {~] ~PP~OVED ( ) D~SAPffiOVED ( ) CONDIT~NAL APPROVAL' DATE / ~ ~ ~-- ~ ~ *CONDITIONS OF APPROVAL Soils Rating Date ~wer Installed Well To A~,sorption Area Well tO Tank ~ Well Log Received ~eptic Tunk Size January 10, 1983 Kenneth and Margaret Barber P.O. Box 322 Chugiak, AK 99567 Subject: Lot 1 Beverly Heights Subdivision Approval for the individual sewer and %~ater facilities cannot be granted until the following items have been completed: The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. The septic tank pumped with a receipt submitted to this department. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to ~{ational Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our revie%;. The well casing needs to be extended twelve (12) inches above ground level. 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, Jnl 6/p/EH Enclosure Jim Roberts Associate Environmental Specialist EXCAVATION WORK January 15, 1983 ROBERT A. SHAFER ClVlLENGINEER 694-2979 Red Carpet Realty ATTENTION: Terry Kruger P.O. Box 633 Eagle River, Alaska 99577 Dear Mr. Kruger, Reference: Lot 1: Beverly Heights Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1250 gallons. The seepage pit was charged with 800 gallons of fresh water and after a period of 24 hours all the water which had been added to the system had percolated away. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed subsequent failures. If we may be of further service, please do not hesitate to call. Sincerely, .~// / '/~AS/ss cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR AppROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF ANCHO~E DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION AUG 2 6 1976 RECEIVED 1. Type of Inspection: CMRO VA VA 2. Property Owner: R~y Mailing Address: 3.. Name of Buyer: ~e~th & ~c~L~et P~-rber Mailing Address: 4. Name of Lending Institution: Mailing Addre~: ~;5 ~ 5. Name of Realtor or Agent: ~ols~ Mailing Address: 101 B. [~1 ~o~[ 6. Legal Description: ~[ I Beverly Bot~h~s Sub. Location: FHA CONV Day Phone: Day Phone: Phone: L.tlalker Phone: Chu~iak 278-9526 Beverly Drive off Birchwood Loop South--1 ~le from Glen Hwy 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation House No. edrms. ~ Individual XX Individual (on-site) xx Please call Realtor (Ray L Ifalker) if z entry to house is required. 272-1~1 72-003(3/76) GREATER ANCHORAGE ARES% BOROUGH Department of Environmental Quality · 3330 "C" Street, Anchorage, Alaska 99503 274-4561 . Date Received August 26, Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1976 voa. Approval requested by: United Bank Alaska Mailing Address: 645 G Street Phone: 278-9526 2. Property Owner: Ray Emmons Phone: Mailing Address: % Ray L. Walker, Polar Realty 272-1541 3. Legal Description: Lot 1 Beverly Heights Subdivision Location: Beverly Drive off of South Birchwood Loop, 1 mile in Type of facility to be inspected Single Family No. ofbe4%6oms 3 Well Data: Individual A. Type C. Construction Sewage Disposal System: A. Installed 1975 C. Septic Tank: 1. D. Seepage Pit: 1. B. Depth 158' D. Bacterial Analysis On-site system B. Installer Size 2. Manufacturer / 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 (~ Page 2 of two ,p'~ges - Retest for Approval of Individual .'~'~.r & Water Facilities Legal Description Lot 1 Beverly Reights subclivision Calmlents Approve~) ~ _ ~,C~_isapproved Oate ~;~-,~'- 7.~ Approval ~¥alld for one year fro~ date signed Greater Anchorage Ar&a Borough, Department of Environmental Ouality DIAGR/~4 OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. 'SIGNED Date EQ-034 (1/74)