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HomeMy WebLinkAboutGREENLAND BLK 7 LT 7 ,TER ANCHORAGE AREA B IOtJGH Department o[ Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTE/Vt MAILING ADDRESS ~,O,,'L,~-~ I("¥JL"'~-/' ,~""~//¢?'';' -.%7/,' · PHONE SEPTIC TANK: DISTANCE FROM WELL '~-$-/ INSIDE LENGTH MAN U FACTU RE R ~/2//'d o.:~'/~ - ~ INSIDE WIDTH ~' MATERIAL NUMBER OF COMPARTMENTS_ / LIQUID DEPTH LIQUID CAPACITY ,:-' .~ (] GALLONS. SEEPAGE PIT: ¢/.' / t z NUMBER OF PITS / DIAMETER ___OR WIDTH'~Z, LENGTH[~~', DEPTH ~ LINING MATERIAL/DF/ {V~¢II';", CRIB SIZE: DIAMETER(~,c~ DEPTH /~," DISTANCE: FROM: / / ,' TOTAL EFFECTIVE BUILDING FOUNDATION/-~[ NEAREST LOT LINE/'D WELL ABSORPTION AREA (WALL AREA) z~/[~ ~-, SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED / CONSTRUCTION ~'~" [ ~'/_(,?iL},~ I)L)~.;)?<,~//~13b DEPTH __ NEAREST f NEAREST f.t~ SEPTIC ;/,..~_ LOT LINE /0 '¢ SEWER LINE lO TANK OTHER SOURCES__ DISAPPROVED REMARKS DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: d'l,)/~i/td/../;":'./~r~'r PIPE MATERIAL.:L?~? /~'~-'~!. LOT SLOPE: APPROVED I"'~':l,.f.:2--~. (.-. ~¢,-f'l.,: .~, G.A.A.B. SEWAGE GRIEATFLiR ANC;,PtOFRAGE AIREA E3Of~OLJGH DISPOSAL SYSTEM- . APPLICAT[OFI AND PERMIiT t~INIM!JI~4 DI~tTAAI~;B~, EII~QUIRF:M[NT5 SIP%lC TANK TO SEEPAGE PIT WALL- 15 TO N[AREST LOT LINE. ,~ [ WATER MAIN 1'O SEPTIC TANK -- 1]~&9 ..... SEEPAGE PIT __].0 DRAIN FIELD ].0 AREA $1ZE~ · TYPE GREATER ANCHORAGE AREA BOROUGH DEPAR'FMF£NI' OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For ~T~]~,_~_~ T.<el/;~,oA(~e Dated Performed Legal Description: Lo-~-~-~ /Bl~ck __ Subdivision This Form Reports Soils Log_/ Percolation Test - Soil Test Must Be I.ogged To 4' Below Proposed Seepage System Depth Feet Soil Characteristics 10-- 11-- 12-- 13=- 14-- Was Ground Water Encountered?_j~x If Yes, At What Depth? Reading Date Gross Time Net Time Depth to li20 Net Prep L 1 'Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit or Trench ....... CO?ENTS_] ~_~ .~,0 4' }'~' b~?' F~ ~ , '__ __ ~ _, ~- " Test Performed BY. ~,~ ~.~ Date Certified BY: Date: MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section - Parcel I.D. 015-171-18 ANCHORAGE Certificate of On -Site Systems Approval 9. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: "I — k(- Z0 2-0 Complete legal description GREENLAND BLK 7 LT 7 Location (site address) 11251 LIPSCOMB STANCH, AK Current property owner(s) Mailing address Real estate agent SCOTT & JAIME SCHMUNK 2. TYPE OF DWELLING: [71 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Fx� 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 $ `J 3-0 � Date of Payment 2- af/ Z U Receipt Number _1L 1 (17 Z COSA# t�C. Z© 10 5�0 Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 6-3-20 49TH •°: 6. DSD SIGNATURE System #1 Approved for 4 bedrooms •'°''s •.✓zs._.✓. V MICHAEL N. ANDERSON ; System #2 Approved for bedrooms CE- 9 69 Disapproved ��§ l�£� 2t2f7,.•.�co�� k ��pROrESS10'A��'� Conditional approval for bedrooms, with the following stipulatlb�i3�0���� JI►iU11� , I By: Original Certificate Date: .-^/'ZC) z -y 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: GREENLAND BLK 7 LT 7 if more than 1 septic system on lot: COSA Checklist # of A. WELL DATA W Well log is filed with Onsite (or attached) Date drilled UN Total depth 40'+ ft Cased to *Un ft ® Sanitary seal is functioning correctly 7 Wires are properly protected Casing height (above ground) 20"+ in. Date of flow test for COSA 1127/20 Static water level at beginning of test 32 ft. Comments * From MOA records depth is 78' B. TANK DATA Age of tank(s) 12 years Tank type/material StEt'ISt EEL Measured operating fluid level in septic tank 28" Q Standpipes/foundation cleanout per record drawing Date of pumping 1/27/20 D. ABSORPTION FIELD DATA Which system tested (date installed) 11/25108 ❑ ALL standpipes present per record drawing Total measured depth from grade 12.4 ft (max) Measured depth to pipe invert from grade 3.3 ft (min) ❑ N/A — pressurized field W Monitor tubes go to bottom of effective. If not, state depth into effective ❑® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies: none COSA Checklist yellow sheet Parcel ID: 015-171-18 Structure served by this system _ Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 1.89 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by MNA Date of Sample 5/27120 C. LIFT STATION ❑ Required maintenance completed Age of lift station 11 years Lift station material steel Comments: See L&S Services did the service Adequacy test date NEW Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 86 in Water added 600+ gal New depth ' u4 in Elapsed time 1440 min Final fluid depth 84 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' 0✓ Yes Community Sewer Manhole/Cleanout > 100' r, Yes if No ft j]✓ Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10'✓Q Animal Containment > 50' 7 Yes if No ft 0 Yes if No ft Yes if No ft Water Service Line > 10' F✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' 0 Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water > 100' MM Yes if No ft Property Line > 5' Q✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10'✓Q ft Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' F✓ 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' 21 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No *3'0 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' Q Yes if No ft F. ENGINEER'S COMMENTS * 2' Lot line waiver in MOA file. G. ENGINEER'S CERTIFICATION I certify that l 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. COSA Checklist yellow sheet sea o .%?e 4eeeooioea A 'M'ICHAEL a es osoe0000ese < MICHAEL N.. ANDERSON MUNICIPAUTY9F ANCHORAGE !40�-343 7904 K" }} L if'a S'! , Maintenance e Log =?^ ,'S .p . 4 SC'j�t(GI�?C; 41- 4 rC}Cti +S kd>F t s, w e,>r •# kSt ?iii j' ' tJl d C? �1t� Pui''3pin, C)Rt j ' F Ci ; # Lift Station: h plur v ba ke -Effluent f4€er cleaned •'-c trot `loaf cleaned }es, iso -proper float settings confirmed � s L.. 1per&�;tion ` attstac ,ory 4f�.-"*.E9-0 t (so .Alarm Systern: -Dedicated electrical alarm chrct,,it ,,res r i o -Audible and visual alarm inside dvieliing �no "rola °'.' S}rStetT? O ratlUr'?at'CSrc GtC3 riot SatiSfa-tQr Manhole Riser -Ground water intrusion at riser to tank connection es no' -Ground water intrusion around pipe penetrations es no•bleep hole functionales no -tvlanhote lid Functional insulated es no Properly secured es no Other I -All manufacturer required inspections and maintenance completed0,Les no Comments': D~te: To: From: Subject: MUNICIPALITY OF ANCHORAGE MEMORANDUM March 15, 1995 DHHS Accounting & Budget On-Site Services, DHHS Request for Refund - Account #2570-9426 Please make tile necessary arrangements for the following refund. The Engineering firm withdrew the request for Health Authority Approval. Please refund the $300.00 fee and send it to the address listed below. S & S Engineering 17034 North Eagle River Loop Rd, Suite 204 Eagle River, AK 99577 Recept#25788 Amount: $300.00 Account # 2570-9426 Legal Property Description: Lot 7, Block 7, Greenland Subdivision Kathy Bouschor On-Site Services cc: File ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN E~TENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST March 13, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of H~lth and Human S~rvices Attn: Robbie Robinson P.0. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 7; Block 7; Gr6e~and Subdivision 11251 Lipscomb Street D~ar Robbie, The attempt to obtain a Health Authority Approval on the referenced property has been cancelled. Please d~continu~ any review that is b~in9 done on this property and refund thc M.0.A.H.A.A f~ that was paid by S & S Engineering. If you require additional information please contact us. PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE W/~ST EWATE R OISPOSAL SYSTEM DESIGN RECEIVED MAR 1 I. 1995 ~V~uruo,Pahiy ol Anchorage [:,)¢pt. H¢¢l~h & Human Service~ 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 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. # _.~ ~J__~ ._ \ ~ ~ .. \ 0~ NAA# 1. GENERAL INFORMATION Complete legal description Lot 7~ Block 7; Greenland Subdivision Location (site address or directions) Property owner Mailing address 11251 L~pScomb Street Anchorage, AK Clair Floyd ~.. Day phone 11251 Lipscomb Street Anchorage, AK 99516 346-3580 276-2174 Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: XXX 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. 1/9~) Front MOA#21 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 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 $ & $ ENGINEERING Phone 17034 Eagle River Loop ~°ad Address E~c,!e ~!~~. Alnslca [ncneer's signature ~ DHHS SIGNATURE ~ ~ __ Approved for '~ bedrooms. __ Conditional approval foP~.~_ _~ Additional C bedrooms ,ith the g stipulations: By: Date Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-o7 A. Well Data Well type Parcel I.D. Log present (Y~) Total depth Sanitary seal If A, B, or C, attach ADEC letter. ADEC water system number ~//'/~ Date completed ~ / ~' 7Z- Driller ~1~ Cased to ~LE.3 L/.- Casing height //~' Wires properly protectedL~) '7/E3~ AT INSPECTION FROM WELL LOG ..// Date of test Static water level Well flow Pump level1 ,/ SEPARATION DISTANCES FROM WELL TO: Septic/l:~t~ir~ tank on lot Absorption field on lot Public sewer main Sewer service line ~ m ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout / O0 Petroleum tank WATER SAMPLE RESULTS: Coliform ~)~/~t/~ ~- Dateofsamp(e..f~.~/g~¢/~- Nitrate .~/Z $/¢/,~ ~ Collected by: Other bacteria ~///o~ ~ B. SEPTIC/HCL3:NC TANK DATA Date installed lO~/Z~ /~ Tanksize /~'O -~:l/__ZO/~' Compartments / Cleanouts ~N) Y~- ~ Foundation cleanout (Y~__~ /'U)C3 Depression~N) High water alarm (Y/~. ,Av/O Alarm tested (Y/N) /f///.~ Date of pumping ?/~1/ ~ Pumper 0_¢~.L27'~ po//tc/o//t)~ _ SEPARATION DISTANCES FROM SEPTIC,~ ........ TANK TO: Well(s) on lot '75" ~''-~'- On adjacent lots ~(~ To property line / 0~¥ Absorption field Surface water/drainage /~/~ .~ ~~ /~& ~~%/o~ ~u/~/~ 72-026(~)*Fr~, ~__ ~ ~ ~¢~%~/~/~ ~/~¢ CONTINUED ON BACK PAGE Foundation /0 Water main/service line C. LIFT STATION Date installed Size in gallons /Wo 6 P/?~ ~-~'~ ~- Manufacturer ~ Manhol~ "Pump on" level at ~ "Pump off" Level at ~ Cycles tested Vent (Y/N) High water alarm level Meets MOA electrical code~ ~ SEPARATION DI/$.T-AI~E FROM LIFT STATION TO: /.W. elPo~n lot On adjacent lots Sudace water D. ABSORPTION FIELD DATA Date installed "~'[~¢-/?~-~-~ Soilrating(GPD/FF) /o~/~ ~c Systemtype Length -7~. "~- Width '~-7w~ Gravel thickness Total absorption area 7Vt--7~-~ Date of adequacy test 3/30 / ~( ~ Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Cleanout present ~_)N) Results ~/fail) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: '-~-"-~, Total depth ~¢-~,~ 0 ) Depression over field (Y/N) After test ~ If yes, g~e date ~/~ Bedrooms Well on lot >~/~ To building foundation On adjacent lots '-/'~,'~ Property line To existing or abandoned system on lot Cutbank ,,,t./Oj',Jd. /~e$~ ~f'--~Water main/service line HAA Fee $ -~ O O .- (~-"~ Date of Payment Receipt Number (~ ~ 5/ "~ Receipt Number Waiver Fee $ :. ' :' Date of Payment Date On adjacent lots /O Surface water/JO/,J~ ~J/#,.)/CO F ?/'/..~r-d'y. Driveway, parking/vehicle storage area Curtain drain /~0/JF~ E. ENGINEER'S CERTIFICATION I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature "' Engineer's Name N.(; ..... DEPARTM 825 MUNICIPALITY OF ANCHORAGE OF HEALTH AND ENVIRONME~ _ PROTECTION L Street, Anehorao~. Alaska 99501 264-4720 Date Received: December 28, 1977 Time (~,'~'~'~') ~nl __ Date #2: Time #3: Time Date Date Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Peoples Bank and Trust Mailing Address: Pouch 7-007 99510 Phone~79-7511/242 Property Owner: Clair A/Bemma Lue Floyd Mailing Address: Star Route A Box 1721 99507 Phone: 344-2154 3. Legal Description: Lot 7 Block 7 Greenland Subdivismon 4: '7. Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Four Number of Bedrooms: Well System: Permit ~ Construction Individual well (x) Community/Public System ( ) Depth of Well ~ Well Log on File ~[~ _ Bacterial Analysis Sewage Disposal System: On-site System (x) Public Utility ( ) Permit # Installed ~c'~ 7'2-- Installer Septic Tank Size ;_2~O Manufacturer _~[~~% . Absorption Area ~6~ Soils Rate ~ Material Distances: Well to Septic Tank '7~' to Absorption Area __~Q[ .... to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHOllAGE DEPARTMENT OF HEALTH AN[) ENVIRONMENTAL PflOTECTION 825 L E;~reet.~ Anc:horo,~je.~ Alaska !)950:1. 2']9-~25].1~ exi:. 224, 22b REQUEST FOR APPROVAL OF INDIVIDUAL SEWER ami WATER i::hOll,,ll"lES 1. Type of Inspection: VA ....................... FIIA ..................... CONV__~ .......... 2. Property Owner: ........... ~Z. ~_&¢._ ~ .~. ~_ _~ Ma.ling Address:_.S~ ~_~..~?.~,...~_~O~.~,. ~ ......... Day Phonu ...... ~J~_~SA ................. 3. Name of Buyer: .......... _~%~.~.~. dress' S~ Da~ Mailing Ad .................................................................. 4. Name o[ Lending Institution: ........ Mailing Address: ........................................................................... ~U~ 7007 ~ ~or e ............... .. 279-7511 E~ 242 5. Name of Realtor or Agent: ............~..~_ Mailing Address: .................. [o "m ~ LIPS~ 7. Type of Facility to bo Inspected: ........ _S_~_I~_ ............................................... No. 8drms .......... 8. Wa!er Supply W~,T, & S~IC ~P~V~ 'l'yp~ of Supply: Public Utility ............................. Individual ............................................. If Individual, number of dwellinD; presently served If Individual, depth of well 9. Sewage Disposal System ~ & S~ZC ~P~V~ Type of System: Public Utility ........................... Individual (on-sit0) If Individual, date of installation 72-003(3/713) Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 7 Block 7 Greenland Subdivision Comments: Affadavit Attached: (' Letter Attached: ( ) Approved: Disapproved: Department WorksheeL: Febr~a'ry 1, 1978 Clair A./B~m~a Lue Floyd $~:ar Route A Box 1721 Anchor a~3e, Alaska 99507 Subje~t~ Request for Approval of Child Care ~acilitias Lot 7 Block '7 Greenland ~gubdivision On the basis of your letter dated January 26~ 1978, this department can not approve your plan~ for a day care center for the fo!lowing' reasons: ~Total of twenty(20) (:hildren would require you to have a mint~tlm of 150' protective radius between your w~ll and any se%~r sy~%e~o (2) The sewer syst~,~ is not large ~nough to acco~aod~te this type of condition. The main reason for the disapproval is the n~muber of children at tho day care center, even tho%~gh you h~ve only five(5) to six(6) ~hildren at on~ timbale, the 'total v;outd reach twenty(20) throu~jhout a day~ If t~re are any further questions, pleas(~ contact this offic(~ at 26~.~4720~ ~?~obert C. Pratt, Sanitarian RCP/ljh Mike Brunet Permit Officer GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska Date Received ;-~' ~, ( J' (~1~' "' ~ ,~ /vt ./,/' ,t REQUUST FO~ APcROVAL OF 2. Prooer~y O~ner Location: Type of Facility to be I~specked: · , Number of" 3edrooms: ..... __ 6. Well Time of Insoection (~' '%F~) ...... Date of Insoection Phone.. Phone: '7. 0'' C°nstructi°nZ~{JT'LZ~-k~f ___ D. ~aoterial Analysis Sewage Disoosa]. Svstem: lO ~ A. %he,ailed ~¢ /'~ ZZ~ 8. Installer ~J~.~?. Zda:/'~ C. Septic 'rank= 1. Size /Z5-'6 2. D. Seepage Pit: ].. Size.~Z~'3J~¢ 2. Disposal Field: Total Length of Lines Distances: A. Well To: / Septic Tank_f/_¢~ ...... , Absorption Area /0o , Sewer Lines , Nearest, Lot I,ine ~(-~ /- , Other Contamination~:~¢~-¢/ ,.'-*, · Foundati o~ to Seot:i c, Tank~ '5'/ "~ Ab~orotion. Area.___:,:Z.~//. Absorption Area to Nearest Lot Line ~P,5' · Recc~eg.t for Approval of Individual Sewer & Water Facilities Page Two 9, Comments: A.ooroved -¢/,~'~4. ..,,/~x2~.'~.,' " ' Disapproved Date d~3~2tz /¢~/~ Approval Valid for One Year From Date Signed Greater Anchorage Area Borouah, Deparfimen~ of Environ~ren%a] Quality DIAGRAM OF SYSTE~ I certify that the information contained in this request for approval to be a true and accurate representat~.on of the subject sewer and water facilities located