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Home My WebLink AboutATHANASIUS LT 62B Municipality of Anchorage Page I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report ,.~.: ~E~ dOl4N~kl wastewater System: Q New ~ Upgrade Phone: ~-~0~ IN°'~[~m~ ~ Deep Trench ~ Shallow Trench .Bed ~Mound ~Other Soil Rating: Total Oe~th from original g~d~. LEGAL DESCRIPTION ~'~ GP~s~. Subdivision: Depth to pipe bottom lrom original grade: Gravel depth beneath pipe Tow,s,,p: [~ ~ IRa,ge: i ~ ~ Section: ~ ~ Fill added above original grade: Gravel length: Number of lines: I Dislance WELL: ~ ExiST. ~ New ~ Upgrade Grave~:~l~TH t~ Ft. ~I ~ Ft. Classification (Pri~ lie, A,B.C): Tolal Depth: Cased To: Total absorption area: Pipe materi~l: Driller: Date Drilled: Siatic Water Level:Fl. Installe~MU~ ~T- Date installed: Yield: ~PM IPump Set at: Ft. ICasing Height Ab°ye Ct°uno:Ft. TANK SEPARATION DISTANCES ~Se.~ic c Holding ~ S.T.E.P. To Se~iic Absorption Lift Holding Public/Prwa~e Manufacturer~ ~ Capacity in gallons: From Tank Field Stalion Tank Sewer Lines ~ ~ S~r~. ~ ~ LIFT STATION Water Lot I ~ I Size in gallons: ~ Manulacturer: Line ~ Foundation ~ 5' +10' N/A "pump °w"ove' a': I"Pump °m'evel a': J High w~;tera'arm at: Cudain ~/~ ,. _~ pump Make & Model J Electrical Inspections performed by: Remarks: ~ ~ ~ J~5 ~5 "~" ~bb BENCH MARK Location and Description: . ~ I Assumed Elevation: ENGINEER'S SEAL Inspections performed by: ~.~Q~¢~-~5 _ Dates: 1st Department of Health and Human Services approval .~ ~'~' ~ ..... 72-013 (1~91) MOA 25 Permit No. 5/,v' ~05~7 Page ~' of ~' Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ~1- 5~Z - PID No.: 129.44 I 50' BLH EASE TELE, & ELECT, EASEMEh LOT 62A LOT 628 Cu ~___ / / 4"16' HOPE DUAL '~/ALL ~--~-~ NE~/ 3/4" Cu SEPTIC LINE CLASS C ~/ELL EXISTING SEPTIC EXISTING HOUSE TO BE ABANDONED SPRING 1995 SEPTIC EASEMENT ~ 149.99 I NEW 1,000 GAL SEPTIC TANK ~ EXIST, TANK & TRENCH TO BE ABANDDNED SPRING 1995 · - MONITOR TUBE o - SEWER CLEANOUT - WELL EASEMENT SVClNG TIES: A - C = 21,9 B - C = 115.8 A - D = 16,7 B - D = 134.6 A - E = 72,3 B - E = 154,7 E L E V A T I O N S ~ Trip CLA2S c ~/ELL CASING ~ ASSUMED ELEV = 100.00 (NOT TO SCALE) ! 0-2' ADOED FILL [ .. ~ THI 9~0 TANK ~x89.8~,N, bl 89A ~ ~NXLt Bg,4 MT~ 88.9 ORIGINAL GROUND 0 LEVEL AT~ BED AVG 93.8 ~/~.G~T @ 82.5 79,5 SCALE 1" =60' ENGINEER'S SEAL ~ ¢ "LOUIS A. BUmRA ~ ~?°r~ssm~~ 72-013 A 12Z91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940397 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:DAVENPORT PHEBE & OWNER ADDRESS:19216 MONASTERY DR EAGLE RIVER, AK 99567 PARCEL ID:051302:~-~ DATE ISSUED:10/12/94 EXPIRATION DATE:10/12/95 LEGAL DESCRIPTION: ATHANASIUS LT .~ LOT SIZE: 45090 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: DATE: Registered Civil F]n~i~eer September 23, 1994 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Athanasius, Lots 62A and 62B Narrative Dear Mr. Cross: On behalf of our client, Mr. Bruce Johnson, we are applying for a permit to construct a septic system for Lot 62B. The septic leachbed will be located within the boundaries of a septic easement on LOt 62A Our upgrade leachfield will be located closer than 10' to the existing leach trench, however, our specifications call for removal and backfill with filter sand material of any existing trench area located within five feet of our new bed area. The proposed septic upgrade will have a limited impact on adjacent properties for the following reasons: The surrounding lots are large, and have existing septic sites and water wells. LOt 62B is the exception, as the lot area is encompassed by class "C" well radii. Immediate neighboring septic systems are all +30' distance. Reserve space is not required, as this is considered an upgrade of an existing septic system, even though the house is relocated. However, some reserve area is available within the septic easement. If a future upgrade was necessary, an 18' wide, trapezoid shaped bed could provide 936 square feet of area, with a lot line waiver to 0'. Surface drainage will not be affected and is not a major consideration in our design. A copy of the ADEC waiver for 50' separation of private septic line to class "C" well is attached. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \C:\WPWlN60\WPDOCS\ 1994\91-096A.NAR P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297 SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOTS 62A AND 62B ATHANASIUS 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or subject to modification in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage and Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 1. A new sewer line is to be constructed to the new house, abandoning the existing sewer line from the new house. 2. The portion of the sewer line within 75' of the well shall be dual wall, Schedule 40 I-[DPE pipe, sealed to the existing 4" pipe inside the house foundation with an approved I-IDPE shrink-wrap or "Fernco," type reducer coupling. 1. The bed is to follow the natural land contour to maintain uniform total depth of the bed bottom. 2. The bottom of the bed excavation shall be level, plus or minus 1.5". 3. The total depth of the bed excavation is not to exceed 4.5' at any point. 4. The bed gravel is to be covered with typar fabric mater/al. 5. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the bed is to be finish graded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. 8. The existing tank and leach trench shall be abandoned to Municipal code standards. Any portion of the existing trench within 5' of the new bed shall be excavated and filled with 2' sand (SP) filter. RECOMMENDED L.F. akC. JglEITaL~ ~: TOTAL DEPTH = 4.5' SEPTIC TANK SIZE = 1,000 gallons BED LENGTH = 60' BED WIDTH = 15' SOIL RATING = 0.5 GPD/ft2 BEDROOM CAPACITY = 3 GRAVEL DEPTH = 6" under pipe, 2" over top of pipe, 1' total Twenty-four (24) hours notice required for all inspections. C:\WPWIN60\WPDO CS\ 1994\91-096A.SPC 1 I MONAST£RY 129.44 I ~0' ~LR ~0' TELE, & ELECT, EASEME~ DRIVE S 89°45'25' E LET 62A Z LBT 6 LBT 1 EXISTING SEPTIC 30.00 \ N~ SEPTIC LINE \ CLASS C NEW SEPTIC I TH-1 EASEMENT '~ 149,99 I CLASS C WELL + 150' Lilt LTNE LDT 6 NEW LO00 GAL SEPTIC TANK ~ ABANDON EXISTING TRENCH ANI] TANK N 89"5 i46,98 LOT 5 NO WELL NOTE: THE ABOVE LOT BOUNDARIES ARE AS PER M,0,A, GRID MAPPING. WE CANNOT GUARANTEE ALL EASEMENTS ARE AS SHOWN, -- CLASS ~ELL :/4~ Cu / / LOT 3 EXISTING HOUSE TO BE ABANDONED / S 89'51'50" E Z / ///l~//// /// // I / // - MONITOR TUBE - SEWER CLEANOUT - WELL EASEMENT 105,00 SITE PLAN LEGAL: LOT 628 ATHANASIUS SUB. OWNER: BRUCE JOHNSON CONTRACTOR- N/A JOB # 91-096 DATE: 09/16/94 SCALE 1" =60' EAGLE RIVER ENGINEER/NO SERVICES A P.O. Boz 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-2297 EAGLE RIVER ENGINEERING SERVICES P,O, Box ?73294 EAGLE RIVER, AK 99577 (907) 694-5195 JOB SHEET NO. CALCULATED BY CHECKED BY SCALE OF DATE Three Bedroom Single Family Residence Wastewater generation = 3BR x 150 glxl = 450 glxl Percolation rate = 8.4 min/inch Application rate for bed system = 0.5 gpd/ft: Required area = 450 + 0.5 = 900 ft2 Recommended Bed Dimensions: 900 ft2 + 15' wide = 60' length Total depth = 4.5'.) \C:\WPWIN60\WPDOCSX 1994\91-096A.CAL Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: LEGAL DESCRIPTION: Township, Range, Section: SLOPE SITE PLAN 3 7-. '~.~ 9- ~-,~ ~ ~ WAS GROUND WA 10- ~ ~ '] ENCOUNTERED7 ' ~ IF YES, AT WHAT 12 - ~ ~,~ DEPTH? Depth to Water A~er 1 3 - Monitoring? ~' tO 14 - ~ ?'/'"L~ Reading Da 19 ',~' r~;F::'~ ' "' ~" 20- PERCOLATION RA WATER T~'~ S IO --5EF..G,II'E PLAN'- E Date: c~_ I?..- Gross Net Depth to Net Reading Date Time Time Water Drop E ¢:~'~"1 (m,nutes/,nch) PERC HOLE DIAMETER ~11 TEST RUN BETWEEN '/"J FT AND ~" .FT II COMMENTS INs'rAI, Z,, t.1.,5 SL~rl~.~ HT' '1', $ IZ,,5'~ PERFORMED BY: ~t/~'~-~ I ~----~ r,-) ~"-z CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) SENT §Y:ADEC ANCHORA~E 9-23-94 ; I:3~PM ;ANCHORA~F_/NE~TE~N DO-- 90? 6~4 329?;# 2 WALTER ~ HIC~EL, GOVERNOR DEPT. OF' ENVIRONMENTAL CONSi~RVATI~N ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 (907) 349-7755 September 21, 1994 Mr. Louis Butera, P.E. Eagle River Engineering Services P.O. Box 773294 Eagle River, AK 99577 RE: Lots 62A & 62B, Athanasius SubclMsion - 19240 Monastery Road; ADEC project no. 9521-WV'-257-015. Dear Mr. Butera: This letter is in reference to the materials received in this office September 14, 1994, regarding a waiver of separation c~istance between an existing class "C" well and a proposed private sewer line. The Department has completed ~ review of the submitted information which ¢omained a cover letter, site plan, soils percolation log, we/er sample analysis and sur]'oundJng well logs. Based upon this review the Department has the following comments: Wpivgr ~' Separation Distance: From the information contained in the submittal it appears that a waiver of separation distance for the proposed private sewer line from the existing Class "C" well on lot B Athanasius Subdivision is justifiable. The results from the water samples suDmitted were satisfactory, meeting the acceptable levels for these contaminants as listed under the State Drinking Water Regulations (18 AAC 80.070). The requested waiver is granted in accorclan~e with State Wastewater Disposal Regulations (18 AAC 72.015) and Ddnking Water Regulations. (18 AAC 80.030), subject to the following requirements: Double encasement of all private sewer line within 75 feet of the Class "C" well as indicstecl in the submittal. Where the sewer line crosses the water line there should be at least 18 inches of vertical separation and no sewer line Joints within 9 feet of the water line. Pressure testing of the entire 4" sewer line prior to beginning service to the new on-site septic system to ensure tightness. SENT BY:ADE¢ ANCH01;{ABE ; 9-23-94 ; 1:37P~ ;ANCHORAGE/WESTERN DO-, 907 694 329?;# 3 Mr. Lot~8 Butera, P.E. 2 September 21, lg94 Thank you for your cooperation with this Department, if tl~ere are any questions regarding the above please do not 13ea~tate to call. ML/cf Sincerely, Michael Lu, E.I.T. Environmental Engineer LAND USE AGREEMENT AND EASEMENT FOR SE~IC SYSTEM LEACH FIELD This agreement entered th,s ~ ~ , day of ~~ 1994, be~een Bruce and Monica Johnson, husband and wife, heminaEer referred to as "Johnsons", and Jim and Dolores Ann Patras, husband and wife, and Phebe DavenpoK hereinaEer referred "Patra~Davenpo~'. Whereas, Johnson are the ownem of the following described prope~,to-wit: Lot Sixty-Two-B (62B), ATHANASIUS SUBDIVISION, according to Plat No. 83-404, located in the Anchorage Recording District, Third Judicial District, State of Alaska, (herinafter referred to as Lot 62B and the Patras/Davenport are the owners of the following described property, to-wit: Lot Sixty-Two-A (62A), ATHANASIUS SUBDIVISION, according to Plat No. 83-404, located in the Anchorage Recording District, Third Judicial District, State of Alaska, (hereinafter referred to as Lot 62A) The Patras/Davenport hereby are granting in wdtting an agreement for the Johnsons to install a Septic System Leach Field that would encroach into the south-east corner of the Patras/Davenport Lot 62A. This system would encroach from the south-east corner approximately 6'0 feet north, then run parrallel to the south lot line west approximafley. 65- feet, then return. &'O feet to the south lot line forming a rectangle for this encroachmenL 1. This agreement herein is extended to the Johnsons, their heirs, successors and assigns, and the Patras/Davenport, their heirs, successors and assigns. This agreement is perpetual and shall run with the land. 2. Any maintenance or service needed on septic system is the responsibility of the Johnsons, their heirs, successors and assigns hereafter. In w~ess whereof, the parties have executed this agreement the day and year first written J~ruce. Joh g~,dn --'-", A Jim~Patras - -.___/3 ~' Mor~ Johnson / ' ' Dolores Ann Patras ~ ,L~ ~-~ Phebe Davenport /J /qty.2._ StateofAlaska .'~,~ ,f~{ d~ / /~-[C f g.5-'? ? Third Judicial District ~ L~/~N~ry-~in and for Alaslka j n expires: ~,o ~..~u~!q--/ Acknowledged before me, by Bruce Johnson, Monica Johnson, Jim Patras, Dolores Ann Patras, 1994. DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 (907) 349-7755 December 7, 1994 Mr. Louis Butera, P.E. Eagle River Engineering Services P.O. Box 773294 Eagle River, AK 99577 RE: Lots 62A & 62B, Athanasius Subdivision - 19240 Monastery Road; ADEC project no. 9521-WV-257-015. Dear Mr. Butera: This letter is in reference to the materials received in this office November 25, 1994, requesting approval of a waiver of separation distance between an existing class "C" well and a private sewer line. The Department has completed its review of the submitted information which contained a cover letter, an as-built of the newly constructed private sewer line and verification of a pressure test. Based upon this review it appears that the private sewer line (double encasement, HDPE) was constructed in accordance with the previously approved plans by this Department. Therefore, in accordance with State Drinking Water Regulations (18 AAC 80.030) and Wastewater Disposal Regulations (18 AAC 72.015) approval of the waiver for a lesser separation distance between a private sewer line and a Class "C" well is granted. Thank you for your cooperation with this Department, if there are any questions regarding the above please do not hesitate to call. Sincerely, Michael Lu, E.I.T. Environmental Engineer ML/cf CC: Robert Dolan, WW/ADEC/SCRO Art Ronimus, DW/ADEC/SCRO /~-'" MUNICIPALITY OF ANCHORAGE ( DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SLTE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [] NEW 2~'"' ~ V'~ /~ ('~ ~,~IfL,~ ~UPGRADE MAI LING ADDRESS LEGAL DESCRIPTION P' ~' ~ ~-~ ~(~ ~j ~ ~ ~7 LOCATION NO. OF BEDROOMS ] Well I Absorption area Dwelling PERMIT NO, DISTANCE TO: I I ~ Manufacturer ¢~/ ¢¢~/~ ~ Material No, of compartments Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well ~/ Dwelling PERMIT O ~( ,Manufacturer' /~ Material Liquid capacity in gallons ~.- DISTANCE TO: Well //O i ¢ Foundation --~ ) ~z Nearest IotEne~ ~¢/ PERMITNO, ~,~ No. oflines Length of eac line Total le gth of ines wid[h~ Distance between lines ~ / /~ ~7~ Trench ~ ~; Top of tile to finish grade / Material beneath tile Total effective abs ption area ~ Class Depth ~ri~r/ Distance to lot llne PERMIT NO. ~ DISTANCE TO: Budding foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ~ ~'~ ~:~ REMARKsSOILINsTAELERTEST RATIN~/w'~'~ ,/~.~-- ~'7 ~ ~ i~ ~ ~"' ~,, ..,.,,,. __ /¢ Permit # Applicant: Location: Legal Descriptio2: Type of Soil Absorption System I,s: Trench: Drainfield: ~ _ WE~L AND/OR ON-SITE SEWER PERMIT Phone Number: ~ /~/U Lot Size: Seepage Bed: Holding Tan~.' Maximum Number of Bedrooms: ~ x Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). /j//~//~_~ * * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS Permit applicant has the responsibility to inform t~is department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED ~ ~ ~ Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. ~ ~ ~ PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * * I certify that: (!) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more tha~ 3 kedroom~. Date: ~'~ ~'~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] SOILS LOG '~.._ PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4- 5- 6~ 7 8 9- 10 11 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS PERFORMED 72-008 (6/79) DATE PERFORMED: SLOPE SITE PLAN WAS GROUND WATER '~/ ~'~' I~ ENCOUNTERED? O , IF YES, AT WHAT DEPTH? / O Gross Net Depth to Net Reading Date Time Time Water Drop / ~--z~/-~'s I1,~o,~,. in PERCO'AT,ON ,:,ATE TEST RUN BETWEEN 4 ~ FTAND--~' FT (minutes/inch) DATE J~Y/ / APPLh 'hiT FILLS oUT UPPER HAL' 'ONLY Property Owner JIM A~AMg Phone 83 99577 ;88-3080 Mailing Address Zip Code Buyer PATRICK ~' JANE LAMB Address ST ROUTE I BOX ~[60 CHUGIAK AK. 99597 Zip Code Address Zip~ Code Phone Realty Co. P.O.BOX 6~1 EAGLE RIVER AK. Address Zip Code 99577 194-3~87 Legal Description ~0~ Street Locati~ Type of Resi~nce ~ Single Family ~ Multiple Family NO. of Bedroom_ 3 ~ Other ~ Individual A~ACH WELL LOG. A wall log is required for all wells d~illed since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). Sewer Disposal . ~ Individual Year Indiv~ual Installed: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time '. JUN 2 7 1983 ' Municipality "Papt,of Jlea~'h & ( ~PPROVED BEDROOMS ~ *CONDITIONS OF APPROVAL 72.023 (318~) .? 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M, SULLIVAN, MAYOR DEPARTMENT OF HEA~_TH AND ENVIRONMENTAL PROTECTION April 23, 1980 Carmel/J.B. Adams Post Office Box 82 Eagle River, Alaska 99577 Subject: T15N R1W Section 30 Lot 62 Approval for your individual can not be granted until the completed: sewer and water facilities following items have been (1) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. (2) A well log submitted to this department for our review. (3) The septic tank pumped with a receipt submitted to this office. Be sure to have the pumper put the total number of gallons pumped from the tank on the receipt. (4) An adequacy test 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 contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw ~ DATE RECEIVED TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE DEPT. OF DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~~VIRONMENI'/'L 825 L Street - Anchorage, Alaska 99501 ) ENVIRONMENTAL SANITATION DIVISION /~.?R 2 ~ 1980 Telephone 264-4720 RECE! ED 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. PROPERTY OWNER PHONE MAILING ADDR SS 2. BUYER PHONE MAILING ADDRESS 3, LENDING INSTITUTION 1 PRONE I MAI LING AD DR ESS 4. REALTOR/AGENT I PHONE I MAI LING AD DR ESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RE ENCE /NUMBER OF~BEDROOMS ~GLE FAMILY [] One [] Four [] Two [] Five [] MULTIPLE FAMILY []~hree [] Six [] Other WATER SU Y DIVIDUAL* * 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 [3 PUBLIC UTILITY depth (attach log if available.) ~, ~ ~',~'~ 8. SEWAGE DI POSALSYSTEM ~INDIVIDUAL/ON-SITE** / ? ?~ YEAR ON-SITE SYSTEM WAS INSTALLED. [3 PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6179) 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 UTI LITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified - INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [] APPROVED FOR . BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) E~ISAPPROVED DATE BY 72-010 (Rev. 6/79)