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HomeMy WebLinkAboutNEAR POINT LT 1B-2Onsite File Near Point Lot IB -2 PID# 041-021-78 Formerly - Stuckagain Heights - Stuckagain Heights - Near Point Lt 1 - Near Point Lt 1 A - Near Point Lt 16 Tr E Tr E2 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Pax: (907) 343-7997 http://www.muni.arg/onsite On -Site Wastewater Disposal System Permit Permit number: OSP221165 Work Type: Septic Upgrade Tax Code Number: 04102178000 Site Legal Address: NEAR POINT LT 1B-2 G:2043 Site Mailing Address: 9921 NEARPOINT DR, Anchorage Owner: HENRI JOSEPH R & ALETHA W Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: mcnr 0 r. t](:17i11't1liL'Ili 6/6/2022 6/6/2023 276950 CEJ Disposal Field CEJ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65, Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 3 Special Provisions: 1. A test hole shall be completed and the existing absorption field shall be documented to close out this permit. Based on the results of the test hole, if the existing absorption field is not adequately sized or does not meet code required separations to seasonal high groundwater or impermeables, a change order shall be submitted for a field upgrade. The design of the alternate field shall also be confirmed and shown on the record drawings (or change order, if required). 2. The water service line shall be located prior to construction to verify minimum 10 ft separation to the septic system. The water service line shall be shown on the record drawing. 3. If the existing driveway is to remain, a shared access agreement shall be recorded to close out this permit. If a new driveway is provided for the Proposed Lot 1 C, contractor shall ensure it is not routed over the septic system. Digitally signed by Veronica Pope DN: cn=Veronica Pope, c=US, o=Forge Engineering, email=office@forgecivil.com Received By: Date: 2022.06.06 16:36:10 -08'00' Issued By: Date: i Date: ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 041-021-78 Property owner(s) Joe Henri Day phone 907-333-7505 Mailing address PO Box 210556 Anchorage, AK, 99521 Site address 9921 Nearpoint Drive Legal description (Sub'd., Block & Lot) Near Point Lot 1 B-2 (Proposed Lot 1 C) Legal description (Township, Range & Section) Lot Size 276,950 (60,000) Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑x Septic Tank ❑x Upgrade ❑X (w/wo AD U) Holding Tank ❑ Renewal ElDuplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. g�w (Signature of property owner or authorized agent) Permit/Rush Fees: `� 5` 5/ Waiver Fees: Date of Payment: 5��/�L02-? Date of Payment: Receipt Number: O&IFY7,6 Receipt Number: Permit No. 0� P'20 1 Waiver No. Permit App_:;- : .:c May 26, 2022 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Near Point Lot 1 B-2 (Proposed Lot 1C) – Nearpoint Drive Septic system design Dear On-Site Services Engineer: The owner of the above lot intends to subdivide his lot into two separate lots in the near future, and the proposed subject lot has an existing undocumented system. We are therefore submitting this permit application for the replacement of the existing tank, as well as retroactive approval for the existing trench. A test hole will be dug at the time of tank installation, in addition to exposing a portion of the existing trench to verify that its dimensions are adequate for the existing building or intended application of less than 450 gallons per day. If soil conditions, groundwater, and/or dimensions of the existing trench do not meet municipal spec, a change order and redesign will be submitted for the installation of a new trench. The attached site plan identifies the location of the home as well as the septic location and proposed alternate site. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes toward the northwest with grades less than 25%. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Elevations are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. Wells on adjacent lots are shown. The new septic tank will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the existing trench. The alternate design will be verified and recorded in the record drawings once soils are verified. Please refer to the attached plan pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221165, Rebecca Carroll, 06/06/22 Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER 1"=100' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND NEAR POINT LOT 1 B-2 (PROPOSED LOT 1C) FEET 0 100 200 NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS.BURNING BUSH DRIVE6/6/2022 NE A R P O I N T D R I V E EXISTING BUILDING EXISTING BUILDING EXISTING BUILDING 10' T&E EASEMENT 10' T&E EASEMENT 10' T&E EASEMENT 10' UTILITY EASEMENT 10' T&E EASEMENT EXISTING WELL w/ 100' RADIUS EXISTING WELLS w/ 100' RADII950960970940 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221165, Rebecca Carroll, 06/06/22 Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER 1"=50' NEW 1000-GAL SEPTIC TANK w/ 20" MANWAY MAINTAIN 5' FROM EXISTING TRENCH CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND NEAR POINT LOT 1 B-2 (PROPOSED LOT 1C) FEET 0 50 100 FCO NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM. THIS LOT IS SERVED BY A COMMUNITY WATER SYSTEM. ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. 6/6/2022 NE A R P O I N T D R I V E EXISTING BUILDING 3 BEDROOMS OR LESS EXISTING BUILDING 10' T&E EASEMENT 10' UTILITY EASEMENT EXISTING WELL EXISTING WELL w/ 100' RADIUS EXPOSE PORTION OF EXISTING UNDOCUMENTED TRENCH TO VERIFY DIMENSIONS DECOMMISSION EXISTING TANK PER UPC PROPOSED CONFIRMATION TEST HOLE INSTALL CO AT MIDPOINT BETWEEN BUILDING & TANK 2CO POTENTIAL ALTERNATE SITE: DESIGN CRITERIA TO BE VERIFIED AT TIME OF TEST HOLE PROPOSED PROPERTY LINES ADJACENT LOT SEPTIC AREA 980 960 950 970 LOCATE WATERLINE DURING CONSTRUCTION TO VERIFY 10' SEPARATION FROM SEPTIC TANK & FIELD ESTIMATED LOCATION OF WATERLINE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221165, Rebecca Carroll, 06/06/22 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2 i - 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT IB -2, NEAR POINT SUBDIVISION PERFORMED FOR: JOE HENRI DATE: 8/14/2013 PROJECTNo.: PARCEL ID#: TECHNICIAN: M. ANDERSON TEST HOLE 2 OB/OG a a e b D 4 a WELL GRADED GRAVEL WITH SAND a GW/GP a a a a BOH @ 14' SLOPE 2% 49th_•: MICHAEL E. ANDERSON NO. CE -4381 SI I L KLAN SFF SITE PLAN Y i 9 WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH? DEPTH OF WATER AFTER MONITORING'. NONE 5% DATE OF MONITORING'. 10/3/2013 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) WATER D (INCHES) NET DROP I (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 8/16 1 10:02/10:12 10 .50"/7.75" 7.25" 2 10:13/10:23 10 .38"/7.50" 7.12" 3 10:24/10:44 10 .50"/7.62" 7.12" 4 10:45/10:55 10 .63"/7.75" 7.12" 5 10:56/11:06 10 .38"/7.50" 7.12" 6 11:07/11:17 10 .50"/7.62" 7.12" PERCOLATION RATE: 1.4 (MINANCH) PERC. HOLE DIA. 611 (INCHES) TEST RUN BETWEEN: 2.5 FT. and 3.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 8/23/13 3 E OF aUS M DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 March 14, 1990 Mr. Hank Wilson Construction Engineering, Inc. 9601 Buddy Werner Dr. Anchorage, Alaska 99510 STEVE COWPER, GOVERNOR 563-6775 SUBJECT: LOT 1 and 2 BLOCK 2; NEAR POINT S/D, ANCHORAGE 9021 -FA -056, 9021 -DA -081, 9021 -WA -019, PWSID #214853 Dear idr. Wilson: The Department has reviewed the Engineer As -built plans for the subject projects. Final approval is hereby given for the sewer and water systems and the appropriate "Certificates to Operate" are attached. Our records indicate the correct PWSID number is 214853 for the subject water system. Please disregard the incorrect PWSID #216025 assigned in my December 19, 1989 letter. System classification and population figures are based upon plan review information provided. The water system is therefore classified as a "Class A" system. Although, due to the current low occupancy, for sampling purposes, the water system will be classified as a "Class C" water system. Any future expansion of this project will require additional approval from this office. Thank you, Cindy Thomas Environmental Engineer ATTACHMENTS cc: Lynette Dean, Drinking Water, SCRO CT:bas o �sr STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE DAALwSw' for PUBLIC WATER SYSTEMS A. APPROVAL TO CONSTRUCT Plans for the ceNeftHetiQagermodificstIon of it, fr Z� �� �� ^� SIVA igIPAg public water system located in �mP Alaska, submitted In accordance with 18 AAC 80.100 by have been reviewed and are approved. ❑ conditionally approved (see attached conditions). BY TITLE DATE It construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order m. or descriptive reference) Approved by Date C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water is made available to the public. CCc> The construction of the �-��- public water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. BY TITLE DATE As -built plans submitted during the interim approval period, or an inspection by the Department, has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. BY TITLE `� DATE IB.(HOT (Rev. 1/183) DISTRIBUTION: 1. WHITE - ENGINEER (Complete Section C) 2. YELLOW - WATER SYSTEM FILE (Complete Section C) 3. PINK - ENGINEERIMUNI-BOROUGH (Complete Section C) I. GOLDENROD - MUNI -BOROUGH (Complete Section A) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) March 9, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Nearpoint Subdivision — S12022-1 Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: The existing absorption trench on Lot 16-2 of the proposed Nearpoint Subdivision is located 2' from the southwest comer of Lot 1 B-1. A lot line waiver is therefore required. Soils on these lots are clean gravel with sand and silt with percolation rates less than 5 minutes per inch. Migration of effluent is unlikely. Placement of the trench in this area does not impact Lot 1113-11 as the septic reserve area is more than 35' from the trench. In addition, the location of the trench does not impact the proposed location of the well on that lot. We recommend a waiver be issued allowing the trench to be 2' from the property line. Sincerely, Michael E. Anderson, P.E. MICHAEL E ANDERSON ;k No. CE 4381 ,,ii Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program menr S, �= P a` y, n N epartment **** VARIANCE/WAIVER REVIEW **** Waiver#: OSPI41038 COSA#: Permit#: _ PID#: Legal Description: S12022-1 proposed Nearpoint Lot 1 B Engineer. Anderson Engineering Applicant: Your request for a waiver of the required 10 feet horizontal separation from the existing absorption field for Lot 1B-2 to the proposed property line has been approved. The approved separation distance is 2.0 feet. In addition, the proposed subdivision septic reserved area is approved to be within 50' of an excessive slope. See the engineers letter and site plan. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................ .................................................. I Waiver is Granted: X Waiver is not Granted: Date: Approved by: , L �' ame of Reviewer ................................ 0............................ Y4................ **** VARIANCE/WAIVER REVIEW **** STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPROVAL OF ON-SITE RESIDENTIAL WATER AND SEWER SYSTEMS PROPERTY DESCRIPTION Block a SuGElrlsion o. U.S. Survey Lot 1 s,s �� I.k �/O j Av,-Sl � Certificate Iasu,(W for Applicati011 MW t.J _ 0lfT — O L � This ap al does not constitute a guarantee of any kind, explicit or Im , as to the performance of the water s and wastewater disposal systems. WAT PPLY A recent water sample was tested a and Bet Department of Environmental Conservation drink - Ing water standards for total c ' orm bacteria. Name 1111171 WASTEWATER DISPOSAL The domestic wastewater system was: ❑ inspected by the Department of Environmental Conservation and found to be in compliance with applicable requirements of 18 AAC 72; 1 inspected by a Professional Engineer who certifies that the system complies with applicable re- quirements of 18 AAC 72; ❑ installed by a Certified Installer who certifies that the system complies with applicable requirements of 18 AAC 72; or ❑ tested by a Professional Engineer who certifies that the performance of the system is satisfactory and that the system complies with the minimum separation distances specified in 18 AAC 72. This approval is valid for a El single family I multi -family unit with a total of �� bedrooms. Nama y ^ Tills Oale 1804041Rev. BIBS) DISTRIBUTION: WHITE—BANKILENDING INSTITUTION; CANARY—APPLICANT; PINK—DEPARTMENT ENVIRONMEN7;,.7 {TION nox fl�oog �ranz Ily®>i mII; �iaa nu®uz. Gi;, AJLAtg- :A 00501' 0,11-7,71L4 JAN 10 1979 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE 17TI-iOF-• DRILLED AT THE RATE OF —879.00 PER FOOT. PROPERTY OWNER —D 1'�4-4�t� &y- Ba.Lt�.c Btdvw P.O.Box 4-1136 99509 LOCATION OF WELL SITE �tlaI�/ � r_�c �GcLD r „4e_ii /145 (crr i S2 jcA j-70,, ----- DRILLER Be4n,te CLau aC AWrPaw D&ttt nq Wotk4_ . WELL LOG: 0-----46' C.Lean gAaueL with 15% 4and and .thin 4t&eak4 o� cla*. 46---128' Bedtock.. R 4ed imen taAr t tock. 128--132' A 9,WAU at tock Oho! .Anj 4ome ptoduc toa of watR t. A p044Z&te 1/2 9AL 732--286' Sed.imen.tn I tock. 286--2911 A potou4 tack 4hauTZq a watp-t ptoduCALon olt one CgPIL 291--347' SedZnenAaAik '1.02• Some gtanttz da.V.e". 347--3551 Potou.o tack 4how4nq. Two 9 I. To.ta.L wat" ptoductton 0� 3 7/2 9PIR 4hou.td improve .to a po444,& e 4 1/2 9M. To.tat water Ptoducti.on pee 24 hoot -time. .jwme 4hoU.Ld show suet 6000 gxIA4. Water 4,tand 60 .deet oIt 4u&f_ace. One Ho/t4e SUbme44t&A.e Pump 4houW be i"taLLed. -ten jt e og bottom. 7o.t4U 0044 oIt Dt t in4: $6745.00 - / �D�F� ' 1 Wet- Seal: $22.00 �:JI , SCI '!lzq, s COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF $6767.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART ILLING WORKS DATE Dec. 14-t, 7978 SERVICE CHARGE OF IV.% PER MONTH L BE ASSESSED ON PAST DUE ACCOUNTS. F L �}.STATE OF ALASKA �JeGYn(II I L 7-Z DEPARTMENT OF NATURAL RESOURCES % DIVISION OF GEOLOGICAL AND GEOPHYSICAL SURVEYS WATER WELL RECORD LOCATION OF WELL BOROUGH I SUBDIVISION I LOT BLOGK I SECTION QTRS TOWNSHIP RANGEMERIDIAN []NE S W DIRECTIONS WELL OWNER: . MEASURING POINT: ❑ top of casing I Aground surface Q other: - - BOREHOLE DATA: Deoth LEMARKS WELL DEPTH: DATE OF COMPLETION:- Depth of hole:?0 ft Depth of casings_.yjft--��, - STATIC WATER LEVEL: q3 ft. Date METHOD OF DRILLING: ❑ air rotary' - }cable tool []other: - WIJ- i CtQ.USE OF WELL: domestic ❑irrigation ❑monitor ❑ public supply ❑ other: CASING: Stick-up_.ft. Diam: /4in WELL INTAKE: ❑ open end ❑ screened �j ❑ perforated open hole Depths of openings: to _ft SCREEN TYPE: Diam: _in Slot/Mesh Size: Length: ft Set Between and ft GRAVEL PACK TYPE: Volume used: to top: GROUT TYPE: Volume: Depth: from ft to ft DEVELOPMENT METHOD: 9epAeY` Duration: 1140bt C S PUMPING LEVEL AND YIELD: _J�< ft after_' hrs pumpinggpm PUMP INTAKE -DEPTH: ft Horsepower: Date Pump Installed - - :ONTRACTOR INFORMATION: - WATER CHEMISTRY SAMPLE TAKEN? ❑ yes ®no /�In Well disinfected upon completion? [1 yes ®no �DYYI co IrU C [�/c��� egist red Bus' Name PLEASE MAIL WHITE COPY OF LOG WITHIN 45 DAYS TO: ignature of kuth ized Representative DGGS 9 _// l0 PO BOX 77-2116 EAGLE RIVER, AK. 99577 ate d? • ,,;, #�*Vvx or ALASISA a y ' DzvJmTH, -.1T or wxTuRAL ansoxmcas DIVISION Or GNOLOGICAL AND 620PRISICAL StfAmm WATER WELL RECORD BOROUGH SUBDIV2810N LOT 8LOCJ( "CT'" QTRS TOWNSHIP RANGE MERIDIAN off Xlear vinr /fit � /�/�' % s w S'ewe : S"', Heil rG 11sLL D!P'1'B: DaITiR OT COIIPLRTIOit: IMSURXM. DOZNV: Otop of caning ground surface other: Depth of holt: ft Depth of casings ft ,� SOREHOLL DASA: Depth Material type an color From, o SZATIC 11ATElt LRVZLt 3„ft . • Date .• a t METHOD OF -DRILLING: ❑air (cable tool rotary other: )MA"Brows)Use Of WELL: Pdomeatic ❑irrigation ❑monitor ❑public supply other: -� CASING: Stick-up L't Diann: � in Q ) a!;toeb, oo — �h WELL INTAKE: 13 open end ❑ acreened ' (] perforated IRopen hole Depth$ of openings: to ft SCREEN TYPE: Diam: in Slot/Mesh Sire: Length: ft Set between�.,and —ft GRAVEL PACK TYPE: Volume used: Depth to tops GROUT TYPE: Volume: Depth: from �! ft to _ ft DEVELOPMENT METHOD: Re; lir h • } Duration:,,_Mile" n S REMARKS MAR 1 Z 1993 PUMPING LEVEL AND YIELD: ,,,,,U&ft after hrs pumping_.?.._gpm DNRpUBLIC 11IM, CLv'lZP PUMP INTAKE DZPTH:/&tXft Horsepower: / Date Pump=natalleafa-'-." CONTRACTOR INFORMATION: �. . . n. igATER CHEMISTRY SAMPLE TAKEN? yen �no z'b"n Regis PLEASE MAIL WHITE COPY OF LOG NXrbgZN 45 DAYS TO: Signature of V!.hp&xed ReprtaentaL ve DGGS PO BOX 77-2126 Date ER. - 99577 �f� A-45 t#/37 CURVE TABLE CURVE RADIUS TANGENT LENGTH DELTA CHORD CH.BEARING WR) 373.46' 100.04' 195.48' 29059'36" 193.25' S 05006'45"W C1 M 373.46' 99.97' 195.36' 29058'19" 193.14' S 05°07'17"W C2 373.46' 86.72' 170.41' 26.08'41" 168.94' S 07°02'10"W C3 373.46' 12.48' 24.95' 3°49'38" 24.94' S 07.57'30"E C4(R 20.00' 20.00' 31.42' 90°00'00" 28.28' N 35007'02"E C4 M 20.00' 20.02' 31.44' 90003'36" 28.30' N 35°10'51"E C5 R 468.93' 161.84' 311.67' 38004'54" 305.97' S 80050'31"E C5 M 468.93' 161.89' 311.76' 38005'32" 306.05' S 80048'41"E C6 468.93' 21.04' 42.05' 5908'18" 42.04' N 82°42'42"E C7 468.93' 138.70' 269.71' 32.57'13" 266.00' S 78014'32"E LEGEND LINE TABLE MONUMENT AS DESCRIBED HEREON COURSE BEARING DISTANCE • FOUND 5/8" REBAR L1 R N 00007'37'W 82.56' L1 M N 00.1O'17'"W 82.31' I- SET 5/8" X 30" REBAR WITH YELLOW L2 R N 89.56'56E 100.00' PLASTIC CAP STAMPED "LS -6091" L2 M N 89.58'02 E 100.05' L3 R S 00°03'04' E 1.15' (R) RECORD DIMENSION PER PLAT N0. 89-110 L3{M S 00°04'021 1.13' L4 R N BO 07'02"E 88.01' (M) MEASURED DIMENSION THIS SURVEY L4 M N 8006'43"E 87.97' GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 2000 E. DOWUNG RD., SUITE 8 ANCHORAGE, ALASKA 99507 PHONE 248-5454 TE GRISW2043 I D 3/4/2014 F.B. JOB NO. NPS182 I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. R IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDMSION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE S- Izozz-( NEAR POINT SUBDIVISION PROPOSED LOTS 1 B-1 & 1 B-2 111=100' 0 ----------- �,`� 61 67. 46-04" 10' T. & E. ESMT. �=4944•£ 7 N 10' UTIL. ESMT. 7J o, SEPTIC SYSi EM Z r-- ------------------- S 89059'33"E 255.83'(M) S 89°58'49"E 255.37'(Rl PROPOSED g{ LOT 1 B-2 276,950 S.F. � /;Z- EXISrNG BUILDING WELL 10' 1. & E. ESMT. 1 ------ N 39°57'05"E 250.07'(M) N 39°56'56"E 250.00'(R) ri v EXISTING eMo N ^ 2 2 L2 BUILDING 10' 1. & E. ESMT. 1 ------ N 39°57'05"E 250.07'(M) N 39°56'56"E 250.00'(R) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION \ 825 L Street - Anchorage, Alaska .99501 Telephone 2.64-4720 \ ON-SITE SEWAGE DISPOSAL SYSTEM ANO/OR WELL INSPECTION REPORT NAMEC PHONEE �w, "yO e iN G.^!V fZ� qNEW ? ISO ❑ UPGRADE 1 I ---- — — —� MAILINGADDRESOS, J3Q 35,, /4n.i�l-�, //�-1/. Rq 510 ® LEGAL DESCRIPTION X A4 LOCATION AUG /< /$ - �4-i•� /-� rs NO. OF BEDROOMS 9 DISTANCE T0: Well 0 ¢-/00 Absorpt n area y D elling_ �" PERMIT NO. f0 Y uQ Manufacturer L r�r��.� /4, Ma ��,e74 N�of �.rtments F c7 rn I Liq. capacity in allons .9 /aao IF HOMEMADE: Inside length — Width — Liquid depth p�Y DISTANCE T0: W _ D _ PEPnnIT n D H Ma ufacturer Material Liquid capacity in gallons O w DISTANCE TO: Well /Q (j Fou dation Z Nearest lot line f /p PERMIT NO. T J LL z No. of I s Le�th of e�h 'ne Total Ian t�h of lines Trei h v dtl� Distance between lines H 'F (O i inches Top tile tofinish Material beneath tile Total effective area F of grade d � e 0 absorption 71t, o - inches Length Width Depth PERMIT NO. ru Q aI— Type of crib Crib diameter Crib depth Total effective absorption area wa DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J W � DISTANCE TO: Building foundation Sewer line Soptic tank Absorption areals) OTHER PIPE MA- s 7-,S /y ��3O3l _ SOIL TEST RATING INSTALLER _ Aj REMARKS o a R.+I f%• 7W / I S e P/olz IS — 'j M406 700 lft-rie'466 a, "�e: rar mc.",d 5- h um $ Log y' e 603M .'. , re^n ano NQ. 17'2-P.' aaa t A! June 22, 1968 ;r • p ,..x.F�; < �t Fi's mit" APPROVED DATE LEGAL -------- /0 �1 U� N092 z 9, 72-013 (Rev. 3/78) CONSTRUCTING ENGINEERS, CIVIL ENGINEERING AND LAND SURVEYING SRA BOXQ060 ANCHORAGE, ALASKA 99507 1907) 3440817 _ To whom it may concern: MUNICIPALITY OF ANCHORAGE INDEPT. OF I ALTH & 1`V VIRONMENTAL NOTEC_�I,)N MAR, 3 `1 1981 RECEIVED March 29, 1981 Re 'Tract E Stuckagain Hts. Waste Disposal System The attached documents are for a system T inspected in the fall of 1978. The originals have been lost. I remember the soil, the approximate depth of the trench, size and number of septic tanks and approximate length of trench and that there was a mu- nicipal permit. Recent measurement of cleanouts and vents agrees closely with what I remember. The uniform Plumbing Code and Manual of Septic Tank Practice analysi� s s one T feels reasonable and proper for the existing structure. Based on the foregoing I feel the existing system is adequate. A i6X� �A' , Jia !� h� 9qqqft • +rr +i�]:1 ��':.(A tee. G� E�jO b�" aG :1 P ➢PA pAQP i' - {r47P^CCOInv P�non/+P P'}4P 4.p a6 �} '= r NO. 1732-I; June 22, 1963 ," rf�•;°a CONSTRUCTING ENGINEERS, INC. CIVIL ENGINEERING AND LAND SURVEYING SRA BOX-PO60 ANCHORAGE, ALASKA 99507 MUNICIPALITY OF ANCHORAGE (907)344-0817 DEPT. OF HEALTH & ENVIRONMENT,\L F, �- T ECTION MAR 3 1 1981 RECEIVED On -Site Waste Disposal System - Tract E Stuckagain Hts. From Uniform Plumbing Code, Table 1-2, p.187 A 9-br home requires 11950 gal. septic Existing spetic = 2,000 gal. Adequate From Manual of Septic Tank Practice, fig. 22, p.55 1,750 gal septic, n= 1,250 gal/day Soil test: 85 s.f./br = perc rate? 2 Table 11, p.96 Application rate w 3.5 g/d/s.f. e 1,250 _ 358 s.f. Y.5 Existing trench has approximately 770 s.f. Based on the above guidelines, I feel the existing system is adequate. h CA ' �� ry a as o 0 r" go •ann„q�roo:.enoo-.o ;, an ee.n. an r�32-E, JUne 22, 1968 ;fl•,. , <.4 TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BE = 6 1501L RATING (Sc! FT/BR )= lof..".1 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �L� lL_FFl%4l_3v_lrl-l� 7mw_!:3 -4. 'THE LENGTH DIMENSION 15 T14E LENGTH (IN FEET) OF THE TRENCH OF DRAINFIE'l-D. THE DEPTH OF A TRENCH OR PIT 15 THE DISTANCE BETWEEN THE S-URFACE OF 'THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES., THE GRAVEL DEPTH 15 THE MINIMUM DEPTH OF GRAVEL, BETWEEN THE OUTFALL FIT.PT.- AND THE BOTTOM OF THE EXCAVATION (IN FEET). -Vfqr-41-4 PERMIT APPLICANT HAS 'THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DUR'ING ri-ir- INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE:. NUMBER OF RESIDENCES 'THAT THE WELL WILL SERVE. "r t4 f --i < ;_2 > I ir-41:is f=11 EF f,__ -IF I cl r_4 � "rte E-7- Fa F.: f".-! k-) I F -m U---- ...... BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION FIND APPROVAL BY DEPARTMENT WILL BE SUI:3JECT TO PROSECUTI13N. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON --SITE SEWAGE DISPOSAL 1,; 100 FEET FOR A PRIVATE WELL.; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIOr4S FIND CON5*TRL.lCTlON ARE AVAILABLE TO INSURE PROPER INSTALLATION. F• C---- � r-1 I _U EF oe-< IF` I FR' EE *F- U -'no F.: f_: EF PI U-3 PE Fe. 2�1_- I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE SEWERS FIND WELLS `15, SET FORTH BY THE MUNICIPALITY OF ANCHORAGE, 2: 1 WILL, INSTALL THE SYSTEM IN ACCORDANCE WITH THE ff.lDEl:,-,. , I UNDERSTAND THAT THE ON --SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF' TFIE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 6 BEDROOMS. S 10 N E D APPLICANT SRI -TIC" B ILDERS (J. PETERSONS.) ISSUED BY U 0 151rl�7� y I - 3 1"-1 LJ P4 I C_� 3: F- I-. I `T" "-e 0 F7 r-41:. F-11:.. ' f-ri 03 FE DEPARTMENT OF HEALTH FIND ENVIRONMENTAL PRf_fTECTI0t--1 FIVG_ 1-2V 14,_ 825 'L' STREET, ANCHORAGE.- AF;. 99501 264-4720 cera - CE: -rEK X 1 - PERMIT NO. r. 780956 ) APPLICANT BALTIC BUILDERS rJ. PETE PO BO.',' 4-41--1-:6. 99509 2', -;*9 LOCATION DAVID DR LEGAL TRACT E STUCKAGAIN HTS LOT SIZE 87-ZOOO SQUARE FFET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BE = 6 1501L RATING (Sc! FT/BR )= lof..".1 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �L� lL_FFl%4l_3v_lrl-l� 7mw_!:3 -4. 'THE LENGTH DIMENSION 15 T14E LENGTH (IN FEET) OF THE TRENCH OF DRAINFIE'l-D. THE DEPTH OF A TRENCH OR PIT 15 THE DISTANCE BETWEEN THE S-URFACE OF 'THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES., THE GRAVEL DEPTH 15 THE MINIMUM DEPTH OF GRAVEL, BETWEEN THE OUTFALL FIT.PT.- AND THE BOTTOM OF THE EXCAVATION (IN FEET). -Vfqr-41-4 PERMIT APPLICANT HAS 'THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DUR'ING ri-ir- INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE:. NUMBER OF RESIDENCES 'THAT THE WELL WILL SERVE. "r t4 f --i < ;_2 > I ir-41:is f=11 EF f,__ -IF I cl r_4 � "rte E-7- Fa F.: f".-! k-) I F -m U---- ...... BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION FIND APPROVAL BY DEPARTMENT WILL BE SUI:3JECT TO PROSECUTI13N. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON --SITE SEWAGE DISPOSAL 1,; 100 FEET FOR A PRIVATE WELL.; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIOr4S FIND CON5*TRL.lCTlON ARE AVAILABLE TO INSURE PROPER INSTALLATION. F• C---- � r-1 I _U EF oe-< IF` I FR' EE *F- U -'no F.: f_: EF PI U-3 PE Fe. 2�1_- I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE SEWERS FIND WELLS `15, SET FORTH BY THE MUNICIPALITY OF ANCHORAGE, 2: 1 WILL, INSTALL THE SYSTEM IN ACCORDANCE WITH THE ff.lDEl:,-,. , I UNDERSTAND THAT THE ON --SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF' TFIE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 6 BEDROOMS. S 10 N E D APPLICANT SRI -TIC" B ILDERS (J. PETERSONS.) ISSUED BY U 0 151rl�7� y I - 3 lJONTRACTINB ENG INEF,4k 212 E. INTE G AND SL RVEYING IIONAL Al PORT ROAD E Al ASK 99502 �lx SOILS LOG Cl PERCOLATION TEST PERFORMED FOR: ets t DATE PERFORMED: \ Q"e_ LEGAL DESCRIPTION: ��.-QL-�C S'T V C. KN(MTS SLOPE SITE PLAN ✓' A 2- 3 3 _ 4- 5- 6- 7- 10- 11 5 67 10 11 - 12- 13 2 13 14 -f 4 17 18 19 ov�c�NtLs S�,N Dy PCZ v C 1,_ (G.W) \00 S� 80 go -t- #'J' 01;:- Nou WAS GROUND WATER �,` �- - O L ENCOUNTERED) 1V P --� E, I i IF YES, AT WHAT DEPTH? Reading Date Grose Time Net Time Depth to Water Net Drop L i j I I j fi I WAS GROUND WATER �,` �- - O L ENCOUNTERED) 1V P --� E, I i IF YES, AT WHAT DEPTH? Reading Date Grose Time Net Time Depth to Water Net Drop 20 L-1 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN -- FT AND FT COMMENTS PERFORMED 8Y: lC Vo CERTIFIED BY; — DATE: G' —79 72008 (7/76) 'ONTRACTINC ENGINE�jk 212 E. INTE ANC110 pil r & h roglc. G AND SgRVEYING rIONAL AlPORT ROAD E, ALASK 99502 VEs�$ K SOILS LOG Cl PERCOLATION TEST PERFORMED FOR: oe AQJ,nv" DATE PERFORMED: G —& —, (�_ LEGAL DESCRIPTION: T�14�T C STV �LPtL-,A. I N 'i --V (�- - 1► t�}�SLOPE SITE PLAN T LTI r I i -kNMV LLy SANp - - - — A i I f I 1 2 Q � 1 3 r -a— -- �-- -- J } + - N1�y C�Q4�v F_ ►. `GW�- G1 F t C —r- 7 I I 8- 10 10 11 12 13 14 15 16 17 18 COMMENTS WAS GROUND WATER ENCOUNTERED? SA1�oy GP3Wr_�(6w)IF YES, AT WHAT / DEPTH? %07r'b an or, r4 o \- L O P Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT AND --- FT PERFORMED BY: �_-o k-�-- - CERTIFIED BY: i'S DATE: G —8;"7 S 72-006 (7/76) CONTRACTING ENGINEF,,K 212 E. INTEP �NCIN&°SOC. G AND S RVEYIN- riONAL Al PORT ROAD E, ALASK 99502 0 SOILS LOG Cl PERCOLATION TEST =e4 P ONE PERFORMED FOR: Tof--u ¢ hr DATE PERFORMED: Ou�.c ��1� _ n rr LEGAL. DESCRIPTION: S�UGkq,� �fu I�GTS SU en, SLOPE SITE PLAN ME IL j 2 t - - --, ---- 4- 5 5 6- 7 7 6 9 _ � 10- 11 Q 12- 13- 4 14- 15- a 15 16 17 16 19 20 SL\ctlo tk- ISWXy SINNOy GVNVc - l00 _ 60-M M 0>; "OLC_ WAS GROUND WATER— j D S ENCOUNTERED? j�J L E -_ IF YES, AT WHAT -"--,- f-�----I--- DEPTH? Reading Date Gross Time Net Time Depth to Water Not Drop PERCOLATION RATE--(minutes/inch) TEST RUN BETWEEN FT AND — FT PERFORMED BY: /O i&a /. CERTIFIED BY: 72-008 (7/76) !� DATE: 0.91 LS LOJi MUNICIPALITY OF ANCHORAGE 0 PERCOLATION \` DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST Pouch 6850, AnchwnW, Ala*$ 99604 2762221 SOILS LOG - PERCOLATION TEST ft# PERFORMEb FOR:y !� �L N DATE PERFORMED: I LEGAL DESCRIPTION: / A �� I t l� A a rN TGPLAN S T TEST RUN BETWEEN r i+,vim i COMMENTS /I L�% %% L'/v Gfd 3 LJQ U L/1 Lg fIL 0 /•R i� TU l PERFORMED BY: �/i /�.% f M ez L �a CERTIFIED BY: DATE: 72.098 (7/7W e �42l\ qyG V,¢_( 1 0 S � L"',d, � l �-f;- 6o�Alp. 0000 .�.• . of �OMNONON•••••e•e.p ,ivj•�,, ... e .00�• Ralph B. Joke' • P,10. 1.995.N. t �``,� 1` PRG ESS t" ENVIRONMENT;`. F,.<;, °CTION �®X Il309so .2W.f U IlR�UvrI0- A i�a�U(DRZAC;ICfl �ILAgIlfA 0000 a4ldl-7714 JAN 1 0 1979 SIX INCH WATER WELL. DRILLED AND CASED OUT TO THE TSE�F-• DRILLED AT THE RATE OF —319,00 PER FOOT. PROPERTY OWNER O L_ LOCATION OF WELL SI Btden4 P.O.Box 4-1 DRILLER BeArzLe C.Lau4 of RampcU DA.l.(.(--i.n.q bJo&kj. WELL LOG: 0-----46' C.Lwn 9nave L with, 75% .jand anal -titin 4t&,ea 46---128' Bedrock. R 4 nock.. 128--132' A g4XU r Lan Mack 4how.inq flame p&oduc UarL o.� watec. A )2044.ib. e, 1/2 gPllt. 132--286' S nock. 286--291' R po tom nock .JhowUW a wate& pno&tc ti.oa o C ome. WRi. 291--347' Sed,i en aAij nock. Some 9nan i to .Layer. 347--355' PonauA nock .jhotair4 Two gPIR. Totat water pnaductLon 4 3 1/2 gPIR .choudd .improve .to a po j4 t,&,Le 4 1/2 gPIR. To -tat wa.ten Pnaduc tioa p.en 24 hour •time lAaae 4hou,Ld .show oven 6000 9.atj. LJatRi. 4tanL 60 .deet o� 4unface. One KoAze Su,bme,,ut&l e Amp 4houtd be Uwta f.Ced -ten..-eet og- bottom. Totai. Coat 4 I)2tt tn4: 96745.00 We,Lt Sea.L: 96220 00 ' �. Go 9 e t; COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 36767000 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART IL!_ING WORKS DATE_ Der-. 14-t, 1978 * ti t SERVICE CHARGE 0F 1%z% PER MONTHL BE ASSESSED ON PAST DUE ACCOUNTS. J!, 1,:., u I I �N 'G: I Of D I FI 1. 11. 1) f i:. :K. f t 'EC:WIL. I I TF11 I V. I l Il..I fj t. (9--- /CC D 1:1 , f �� If�fI 437E Street vJ [� I I I I I I[� ii/il)� � SV, A� Second ge, �«� 11,9501 Anchorage, AlAK 5JR1107o�3� �: �'9��Q6' fib��: i f:�Ei. 9'Q�`v s `' Ri'��� P.O. Box 1207 Soldolna, Alaska 99669 SOUIHCfPllibl! RC GI!7A?ii I/f NCF 007) 2625210 P.O. pox 1064 WawHa, Alaska 99687 007) 37&5038 March 24, 1981 MUN���Pgt�TY pF FNVIRpNMENTA� v EcpNE Ralph B. Jokela Contracting Engineers & Associates A 26 19fil 212 East International Airport Road R���/ Anchorage, AK 99502 E� Subject: Tract E-2, Stukagain Heights Subdivision Contaminate Separation Waiver Request Dear Mr. Jokela: We have reviewed your report concerning the surface and 'subsurface conditions of Tract E-2 of the Stuckagain Heights Subdivision, We hereby grant a waiver of: 18 AAC 80.02.0 which requires a minimum separation d=istance of 150 feet between a class "C" well and a septic system to 107 feet for the subject lot. We request that the owner contact the Anchorage Municipal Department of Health and Environmental Protection to ensure that the existing on --sate septic system will meet the additional wastewater loading posted by conversion of: the single family residence to a multi -family residence. If you have any questions, feel free to contact me. cc: L Municipality of Anchorage D,H.E.D, 825 L Street Anchorage, AK 99501 Joseph R. Henri Post Office Box 357 Anchorage., AK 99510 TLN/j1h 3LH Sincerely, r Thomas L. Murrell Environmental Engineer �1 L INSPECTION APPOINTMENTS DATE RECEIVED cal. 4 TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTO OIQ I� MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT] OIfNVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 0* MAR 4 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 204-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all Parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PR(?PERTYOWNER n I _ - - PHONE MAILING AD KESS ,-:Po u 3s PROPERTY RESIDEN`% �(If different from above) PHONE �!�A/ 2. BUYER lit— PHONE MAILING ADDRESS NDING �---, 3. T I / r7' f � I C.� J-�-ham / �.• lf�— P HONE MAI ADDRESS r PHONE 4. REALTOR/AGENT �/ MAILING ADDRESS - - 5. LEG DESCRIPTION I _7 //Cp-cSr E- 2— STREET LOCATION `/Jr�py - 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ SINGLE FAMILY ❑ One ❑ Four ❑ Other_ ❑ Two ❑ Five ,,$a, MULTIPLE FAMILY ❑ Three ❑ Six 3. WATER SUPPLY * INDIVIDUAL.- ATTACH WELL LOG. A well log is required for all wells drilled ( COMMUNITY since June 1975. For wells drilled prior to that date, give well EJ PUBLIC UTILITY depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** �� YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) , p�11 /% _ ()-rx-+9 1.1.C.r Lk) i f �w �j�✓ �—LIdZ�I�'�R'1w �� re7 ` -?.�., �.,� �/ �k /5C-��-�;(.c � 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER n11,, �C) — _x 1%N 0A, DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER \ DATE INSTALLED INSTALLER ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING � TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 1 \ M ---APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79)