Loading...
HomeMy WebLinkAboutEKLUTNA WEST LT 11 MUNICIPALITY OF ANCHORAGE ~...~/~r- {;~7~---~/,,Z. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~_.~--~t/~'/7-J ENVIRONMENTAL ENGINEERING DIVISION ~_~2 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [~'I~EW r'-IUPGRADE LEGAL DESCRIPTION LOCATION ~~ ~ NO OF BEDROOMS I I Well AbsorPtion area I Dwelling ~ · PERMIT NO. ~ (J vDISTANCE To: Id_~:~,,,~,~ W,,/2 I 7' I /~ ~/~ ~ Z I Manufacturer ~ ~ ~O Material~ No, of~mpartments ~ ~Liq. capacity in gallons ~ ............ I Inside length I Width Liquid depth 7 ~ ~S~IsTANCE TO: ~ Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING REMARKS APPROVED 72-013 (Rev. 3/78) DATE LEGAL PERMIT NO. ~UUN I C )%AL I TV OF DEPARTMENT uF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, 2~4-4720 ON--S I TE SEWER PERM I T ( 8000i4 ) APPLICANT LOCATION LEGAL GLENN LAWYER TINA DR LT. li EKLUTNA WEST PO BX 85~ ANCH ~508 LOT SIZE 255?? SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 10 LENGTH= 49 GRAVEL DEPTH---- 4 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>. REQU I RED SEPT I C TANK S ! ZF -1.000 GAL10NS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. THO < ~?) I NSPFCT IONS ARE RE[~U I RED 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 R PRIVATE WELL OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 8ND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. APPLICANT GLENN LAWYER I iS _U~~ ¥4. 0 · [:,I!ii:PF:IR'T'Mliii]',I"I ,:':' l'..lli~]::lt....]"H 1::11",11];t1~. IEl",l'v' i t';ilOIqMEI'.JTF:It ..'I:;;:CFI"I~!i)]:T I (]1',t 82.5 "L.'" S"I"REET., F:INCH(]I:;-:I::tGI!!!b I;;IK. '.:E!;; t1~:: fl......ll lliiiiii: It~:i F" lEE: E;ii:: Ii'"dl ]1:: ']i .... I....0]" :!ii; I ;;iiilii!; *l"l.-II!ii: LEI",I(.:.iTH t:::, I MENS I (iN I :,:f!; '1"HE LENG'¥'H ,( I i'.,I IZ'EE"I'' ) OF' THE 'T'REt",tCH 01:;]'. I} I:;..' F:1:1: NF:'I EL.I}. THE I}EF:"T'H 01::' i:::1 TREI'.K::H OR PIT ].'i~:; "t"HE [:,IS]"I::tI'.,IC:E E.:ETI.,.IEEt",I 'T'HI!!i: StjI::~iI:::fzI(:::E 01::' THE (:iil:;i:CflJl'.,ll]:, I::IN[:, THE E:OTTOM 01:::' THE ti!~i:-:',Cf::l',,,'l::lT :[ 01'.,I ,( I Iq FEE'T' ). "I"HI!!!]:;i:E IS I'.,10 SET 14II}'T'H FOR 'T'RENCHE':'i!;. "FI...lli~: GRF:I'v'EL. [)EPTH I S THE M I I'.,I I MUM t}I.~:F"T'H 01::' L'":if;::F:tVEL. t~',ETI.,.IEEt",I THE OUTFI::II...L I:::' I F'E FIN[:, "f'HE IE',O"I"TI]M OF THE E::.::CI:::I',,,'f:t'T' ]: 0t',t ( I I'.,1 Fr~:I:..'i:T ::,. I CER'T'II:::'"r' 'THF:IT :1.: I I:::IM F'f::tMIL]:t:::tI:;~: b.lt']"H 'T'HE I:;.:E(i:!IJIf;~:EMEI",ITS F:'OR OI'-J-SITE SEI.,.IIi.:.]:;i:S I::11",1[:, 1.,.IELL':'!i; I::IS SET FOIq:TH B"r' TI'"IE t'"ItJN :1: C I PI::IL. I 'T'"r' Ot::' F:tNCHCIRF:IGE. 2: ]: 141LL I NSTFtL..I.... THE S"r".:}.';TEM :[ N ::::::::::::::::::::::::::::::::: b.1:1: TH THE CODES. ::ii:: I IJI'.,I[:,EI::~:':~;'T'F:II",i[) THf:IT THE ON-SITE SEI.,.IEI;i: S"r".~i;TEM t"IFI'~" RE(i:!LIIRliE: Et"JLI:::IRGEMENT IF THE t:',;:ES :( t:.':,ENCE I S I~:EMOi:)EI....ED 'TO INCL. I...IE:,E MOI:;~'.E 'T'Ht"':IN :ii: I.:~',EE:,ROOMS. S :1: ,::i,l'..tE.:::,: ...~i,:..i.:.:;/i~./.~ .iiiii,:::,~~~~ ~ ..................... :,: .......................... ................. Russe# Oyster 694-2774 Soils ~ Foundations Performed for: GEO'~'~_~CHNI CAL ~ DEVEL~'PMENT CO. Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 // Legal Description; /--eTFF Depth (feet) SOIL LOG Earl E/lis 688-2280 Lend Development Tel. No, ~'-~- O ~ ,4,/m, Soil Characteristic) Ground Water Encountered: Yes Proposed Installation: Seepage Pit , Comments: ~-~ ~_~.~. ~..u~. No ~/~ If yes, wh~t depth Drain Field / Performed by: I Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-472O Application Date ~/"~ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Zo 7 /I., ?- Location (address or directions) (b) Applicant Name ].~,,-')/u D el?/~,~, s',/-: / Telephone: Home ~ ~" '. ~ ?o .~ Business · Applicant Address '~''~ /"~%J~ ,,' (:~,~ ,~2/ e,/c //~ ,~'¢'-~4",~ (c) Applicant is (check one): Lending Institution []; Owner/builder [~; Buyer []; Other [] (explain); Telephone (d) Lendinglnstitution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family J~ Multi-FamilyJ-I Number of Bedrooms Other WATER SUPPLY Individual Well [] Community [] PublicJ~] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank F1 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84} Page I of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposat system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ,/'/l-'-'d" _S' --1-'~- ~- Telephone .~-(7_,~ /] ~ y ~]~ Address / ~ ~ L~ LC ~,~ r- ~ ~., .¢~o ~, DHEP APPROVAL,~:.-?~ ~~~ ~'~'~ ~'~'~ Approved for '~_~'~E:.~ bedrooms by ¢--~-- ate Approved /~ Disapproved Conditional"~ Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Heatth and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy eertain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MU NICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION APR 1 6 CHECKLIST- F BRUARY 1984 264.~120 Legal Description:. e ~~-- WELL DATA Well ClassificationZ3//.,rub//C - ,-~)'~- ~u ,'3 Well Log Present (Y/N) Total Depth ~ Cased to Static Water Level Casing Heigh~Above Groune Electrical Wiring in Conduit (Y/N) Separation Distances from Well: If A, B, C, D.E.C. Approved (Y/N) Date Completed Yield Depth of Grouting To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line CleanoutlManhole J Water Sample Collected by J Water Sample Test Results/~- Comments /" Pump Set At /J Sanitary Seal on Casi/jp~/N) Depression Aro/pr~Wellhead (Y/N) ;~On ~djoining Lots j,~; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date B, SEPTIC/HOLDING TANK DATA Date Installed ~//~//,¢,P Size / ¢~ O No. of Compartments Standpipesd~N) Air-tight Caps,/N) Foundation Cleanout~/N) Depress,on over Tank (Y/(~ Date Last Pumped ~./'~,/'~'~'- Pumping/Maintenance Contract on File (Y/N) /t//',z~ ; for Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line ~'D~ To Water Main/Service Line .¢b./-~-~ Codrse Temporary Holding Tank Permit (Y)N) /,-/ To Building Foundation To Disposal Field To Stream. Pond, Lake. or Major Drainage Commen~s /~.,/"'~/ Page 1 of 2 72-026~11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field , 13o Square Feet of Absorption Area ~ ~Z Depression over Field (Y~) Results of Last Adequacy T~st ,~/~--~ ~,~ Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation ~--/ Lot To Water Main/Service Line ~,~ ~" To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field ~"2. / Depth of Field Gravel Bed Thickness Standpipes Present ~N) Date of Last Adequacy Test To Property Line ~/~-' ~ ~-~ ~/ J'~/'~/ /'~,~/ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) 5'-D-/ / D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comment~..~ J Dimensions J ~/iN~ )t Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have_checked, verifie~, or conformed to all MOA and HAA guidelines in effect on the date of this inspection Signed ~~-/J~ Date ~'/',,//'Y / ~:> ~ Company ~ ,,~-c S .~. c_ MOA No. # Receipt No. ~ 77~"(o ~ Date of Payment '5/-/4, Amount: $ ~ ~'~-~¢~ ~ Page 2 of 2 72-026 (11/84) ALASKA e,',dlROFImeFITAL COFITROL Sel uiCeS, ~nqi~eerin§ $ [~nuironmentol Studies APRIL 15 1986 DAN DEN~EOSKI BOX 153 O'IUGI 3K ALASKA 99567 SELLER- SA~E WILL PICK UP FROM CUR OFFICE 60156 LEGAL:EKLUTNAWEST/LOT 11 ADEQ53CY TEST K:R SEWER SYSTEM ADEQ_JPCY TEST DATE-APRIL 1# 1986 THE TYPE CI:: 315SCRPTION SYSTEM IS A TRENCH WITH fin AREA OF 62# S~. THE SYSTEM IS CAPABLE CF 3r2OSPTING #50 C2~LONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 5#0 C~LONS. BASED UPON THE TEST DATA THE SYSTEM I S AEEEPT3BLE FCR A SEPTIC TAI'~, THE EXISTING SEPTIC TAI~ ~ OF 1000 IS 3DEQJATE FOR THIS 3 BEBRCX2M HCUSE. THE SEPTIC TAMX/PPI~ PLANT WAS ~ED ON 3PRIL 2# 1985 . 1200 UJesl 33r~1 Auenue, Suite [~. Anchoraqe, Alasku 99503 .(907) 561-50/40 JOB ALASKA ENVIRONMENTAL CONTROL SERVI('~'~, INC. 1200 West 33rd Aven,,~, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO. CALCULATED BY OF DATE CHECKED BY SCALE ' Ap'pL~I~NT FILLS OUT UPPER HA['-~ INLY Address Zip Code , Streel Looati~ Type of Resi~noe ingle Family Multiple Family No. of Bedroo~ ~ Other . Water Supply D I~dlvidual A~ACH WELL LOG. A w~l Icg is required for all weis drilled since Ju~ 1975. ~Gommunity For wells drilled prior to that date, eve well depth (attach Icg if available). D Public Utility Sewer Disposal ~ndividual Year Indiv~ua, Installed: D Public Dility When Connected to Public Utility: ~ Holding T~nk NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time TimL~4 ~ f/~ Date Date Date Dateq . q -~(:J-. O \UJ*'~ Inspector Inspector Inspector Inspector MU.N mD,^,UTY OF Ah!CH©RAGE ...~'- ~ DFPT O~ ~"T'I.T'~ '. .~ ~NVI~ ~. 4~,.2r, 'A_ r .40 z*.. ;'4 SEP ? I982 RECEIVE ( ~ } APPROVED BEDROOM$ 'CONDITION8 OF APPROVAL ( ) DISAP~OVED { ) OONOITIONAL APPROVAL' Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ~ '~) ~ ~ ~ ~., Well to Tank Septic T~k Size 72.023 (3/82) '~' ~)~A T~ RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE PROTECTIO~EPT' OF I-~ DEPARTMENT OF HEALTH & ENVIRONMENTAL :ALT~, &  E~IRONMENTAL F;;OTECTION 825 L Street - Anchora~, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION ['~AY ? 1980 Telephone 264-4720 ~/TIF~ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~I~,~ DIRECTIONS: Complete all parts on page 1. Incomplete requ~ will not be proce~ed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MAILING ADDRE~ ' ~OPERTY RESIDENT (1~ different from above) PHONE If 2, aUYEE MAILING ADDRESS PHONE 3. ~ING INSTITUTION ~AILiNG ADDRESS 4. REALTOR/AGENT ~ J PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION J- /I E'/dA, $. g .DId STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other~ 7. WATER SUPPLY [] INDIVIDUAL* ~ COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM --~ INDIVIDUAL/ON-SITE** --~/Z~/~,~,0 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) 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY ,. ,. THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SlX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE F-r PUBLIC UTILITY Connection Verified [-~Septic Tank or []Holding Tank Size:~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATEINSTALLED INSTALLER MAN U FACTU R E R~/~i_~~ MATERIAL Septic/Holding Tank IAbsorption Area [Sewer Line INearest Lot Line 5. COMMENTS DATE [~'~PPROV ED FOR .~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72.010 (Rev. 6/79) January 3, 1978 Glenn Lawyer Post Office Box 8533 Anchorage, Alaska 99508 s~hject= Lot 11 Eklutna West Subdivision Permit %77391 A permit issued by this department for well and/or sewer system has expired. Pe=~its are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Health and Environmental Protection Sewer and Water Section