HomeMy WebLinkAboutARVESON LT 7!
~UNICIPALITY OF ANCHORAGE
Hea .~ and Environmental Prote~ 3n
Fourth Floor West
825 L Street
Anchorage, Alaska 99501
264-4720
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING ADDRESS5/~/'~]L
LEGAL DESCRIPTION
PHONE
SEPTIC TANK:
DISTANCE ,,
~OM WELL/IO'r ' ~
INSIDE LENGTH
MANUFACTURER ~~J'~-- MATE RIAL~~
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY Z,g~'~GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL~)~_f~__FOUNDATION ,,W~'~ [~4~_NEAREST LOT LINE ~ ' TOTALOF LINE LENGTH ~
of .i.es / D,STANCEBETWEENL,NES TRENCHW,DTH&__ ,N. TOTAL FFECT,VE
ABSORPTION AREA /'/"'~"~ SQ. FT. LENGTH OF EACH LINE -- 5~"~
DEPTH
OF
FILTER
!
DEPTlt: TOP OF TILE TO FINISH GRADE /'~ ~
MATERIAL BENEATH TILE_ -' ,¢JII'fCABOVE TILE - - IN.
SEEPAGE PIT:
Log Crib Rings
BUILDING FOUNDATION__
DIAMETER__OR WIDTH .... fENGTH ,, DEPTH
Crib Size:i DIAMETER___DEPTH .... DISTANCE FROM: WELL
TOTAL EFFECTIVE
, NEAREST LOT LINE__ ABSORPTION AREA (WALL AREA)
SQ. FT.
Well
Class: Depth:
Well Distance To: Lot Line
Bldg: Sewer Line:
Pipe Materials: ~~ .
~ of Bedrooms: ~
Installer: .~-.
Remarks: ' I
DATE/~¢/'7 ~PROVED
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PERFORMED FOR:
LEGAL DESCRIPTION:
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COMMENTS
~ SOl LS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6.650, Anchorage, Alaska 99502 276-2224
[] PERCOLATION
TEST
SOILS LOG - PERCOLATION TEST
DAT~ PERFORMED: ~- / #' 7 7
Laf 7
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
- )
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN FT AND FT
DATE:
72-008 (7/76)
KIHS WELL DRILLING
P.O. Box 3-142 ECB
ANCHORAGE. AK 99501
PHONE 344-3792
DR I LLER'S WELL L'OG
CUSTOMER I~. ~ l~llott
1741-$I SaA, Aae~, AK 999O7
LOCATION
Lot ? Arveso~ SubdivJs~on
(off ~e~e Road)
SIZE 6" DEPTH ~ CASING DEPTH _1~ GROUTING DEPTH
YIELD 20 + _,mm STATIC WATER LEVEL __iE,:!_' HOW TESTED
PUMP INSTALLED ~r owmae, TYPE _1~ _~/~ ~
FORMATIONS ENCOUNTERED AhD APPROPRIATE DEPTHS
I TO ~8 :k, oae ,~e~Vel
;7,8 TO 65 Sand
178
:].84
TO
__ TO x7$
__ TO 184
__TO
TO
saad w/some ola~ w/oooaelo~a! ~oulde~ .
X, oo. Be' ~avel w/~te= & some silt ~te= at bott~ - 5~
TO
__ TO
MUNICIPALITY
OF
ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
CERTIFICATE OF INSPECTION FO~ HEALTH AUTHORITY APPROVAL
OF ON-SITE 8EWE~ AND WATE~ FACILITY
264-4744
Application Date
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 7; Arveson Subdivision
February 4, 1988
(b)
Location (address or directions)
11141 Shady Lane off O'Malle¥
Property Owner ABFC Telephone: Home
Mailing Address
Business
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent 2001 REALTY/Ricky Doran
Address 1345 West 9th Avenue, Anchorage, Alaska 99501
Telephone 276-2001
Mail the HAA to the followin(3 address: or: Check here ~], if hold for pick up.
List contact person and day phone number below.
S & S ENGINEERING/694-2979 \
17034 Eagle River Loop Road, Suite 204
Eagle River, Alaska 99577
ordered by Ricky Doran
(e)
TYPE OF RESIDENCE
Single-Family ~
Number of Bedrooms
WATER SUPPLY
Individual Well ~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite [] Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page I of 2 72-025 (Rev 8/R6) Front
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 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 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 .S & S ENGINEI=~IMC. Telephone
Address 17034 Eagle itiYer L,~op Road No. 204
Eagle River, Alaska ~'~577
Date Z~"- //~
DHHS APPROVAL
Approved for /-~,,~ ~--~bedrooms by
Approved ,~ Disapproved
Terms of Conditional Approval
' Conditional
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
Page 2 of 2 72-025 fRev 8/86) Back
WELL DATA
Well Classification'" ---~'
Well Log Present ({~N)
Total Depth [ ~>~- t Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit~i~/N)
Separation Distances from Well:
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4744
Legal Description:
If A, B, C, D.E.C. Approved (Y/N)
Date Completed
/E~g~
/C2~ I -~ Yield
Depth of Grouting
Pump Set At I.~, /~,
Sanitary Seal on casing (~:N)
Depression Around Wellhead (Y/I~
To Septic/Hel-d~ng Tank on Lot //O C) / '¢' ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot / c~c~ /¢ ; On Adjoining Lots
To Nearest Public Sewer Line /'J/& To Nearest Public Sewer
Cleanout/Manhole I'J/. ~ To Nearest Sewer Service Line on Lot
Water Sample Collected by ~ ~ ~ /,.j~,/~ -~--~z=.,w~/,,,/~ ;Date
Water Sampl'e Test Results .% ~t._,i~f c.~___~~~
Comments ~-[ ~-t_-~.-- F~ c) t.~)
B. SEPTIC/H~L-B~NG TANK DATA
Date Installed /Cc~-Z--/ -~'.'2T'Size /c:x.~c~ No. of Compartments ~
Standpipes ~N) Air-tight CapstaN) Foundation Cleanout '~N)
Depression over Tank (Y,~). Date Last Pumped .~c ~__ ~ - ~5,~
Pumping/Maintenance Contract on File (Y/N) I',J/y.~_ ; for
Holding Tank High-Water Alarm (Y/N) rd//4 Temporary Holding Tank Permit (Y/N) ~
Separation Distances from Septic/H~ Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course /'J'/A-
f Ol...f
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page I of 2
72-026 fRev 8t861 Front
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /
Width of Field
Square Feet of Absorption Area
Depression over Field (Y~I~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
/ c~o
To Water-Supply Well
To Building Foundation
Lot
TO Water Main/Service Line
f, Jo Dat~ of Last Adequacy...Test
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field ~ ~_//
I
Depth of Field /)
Gravel Bed Thickness
Standpipes Present t~/N)
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
'~-C~ /4.
LIFT STATION ~"
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed S & S ENGINEERING
17034 Eagle River Loop Road No.I~
Compan~.=;!_- R!ver. ~!,_,d,,~ e9~77 MOA No.
Receipt No. /~ 0 / O 0 ~ ~
Date of Payment 9////9~
Amount: $ / ~~
Page 2 of 2
72-026 (Rev 8/86) Back
563~ s&SrREETGEOLOGICAL LABORATORIES OF ALASKA, INC. ~ -'~
~~ ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
~ FEDERAL TAX ID # 92-0040440 ~
ANALYSIS P, gPORT BY SAlabLE for Work Order t 5054 Date Repot Printed: 1~ 9 ~ Q 08:13
CI lent ~ple ID:LT 7
1~$I1)
Col lected FEB 4 ~ ~ 15:40 hfs,
Received FEB 4 ~ Q 16:00 hrs.
Pre~rved vlth
CI lent Name: $ & S
Client Acct:
P.O.I OA
Req #
Ordered By : JP~!
Analysis Collated :FEB 8 88
Laboratory Supervisor :~I'EPHI~I C.
Released By: ~
Special
Instruct:
Send Reports to:
1)$ & S I~IOINEERINO
2)
Chemlab Ref ~: 9021 Lab Smpl ID: I Natrix: Water
Al lovable
Parameter Tested Result/Units Nethod Limits
NITI~TE-N 0.66 rog/! EPA 353.2 10
Seaple ROIfI'INE~LE
Remarks:
I Tests Performed ~ See Special Instructions N)ove
HI)= None Detected MM See Sample Remrks Above
N~= Not Analyzed LT=Less Than, 6T=6reater Than
U~.~dnavai l able
A CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA.;'.INC.
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
Name S & $ [NGiiqEEi~G' Phone No.
17034 Eagl,.- ~'--~iv~p Road No. 2~
Mailing Address ~gle River, Alas~.~577
City State
Mo. Day Year
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
t-_I Special Purpose
Zip Code
[] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION
3 I
5
Time
Collected
Collected
· By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
'~ Satisfactory
[] Unsatisfactory
[~.Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received
Time Received
Analytical Method:
Membrane Filter
No. of colonies/100 mi.
Lal~ Ref. No. Result*
I F-Fq
I FT-I
I FTq
Analyst
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane Filter: Direct Count
Verification:
Final Membrane F ~. r~_e¢lts~,~
Reported By
Coilform/100ml
TNTC - Too Numberous To Count
OB - Other Bacteria
Date
Time:
BGB
Coilformll00ml
PART I OF Z REMAINDER TO FOLLOW
APPLI¢ NT FILLS OUT UPPER HAt ONLY
Property,~Owner ~) ~ ~ /~, .DPv'~ o ~ 5 Phone
Uallin~ Addre~ ..j"~ ~
Buyer ~.~ ~ ..... Z ~1 ....
Address Zip Code
Lending Institutioh ~.~.~,,~ /~o~.~e Phone
Address ~
RealtyCo.&A~nt ~'~"t ~1- ~ .... - .... Phone
Type of Resi~nce
Single Family
Multiple Family No. of Bedroo~
~ Other
Water Supply
.~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal
.~' Individual Year Indiv~ual Installed:
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED.
Date Date Date DatL- ~-
Inspector Inspector Inspector Inspector
1'3) APPROVED BEDROO.S 'COND,T,ONS O~ APPROVA~
I ) D,SAPPROV~D
I ) COND,T,O.A. APP,~.V.A~'
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
/0 - ? ~ we, to Tank Sep.c Ta.k S~ze
72-023 (3182)
ALASKA b iUIROI me[1TAL COBTROL Se dlCe$, I[1C.
FRONTIER MORTAGE/ATTN SANDI
2702 GAMBELL STREET SUITE 103
ANCHORAGE AK 99503
JUNE 20 1983
~UIVIClp,4Li7¥
JUN ~
SELLER - DON BROOKS
SUBDIV IS ION-ARVES ON
BUYER-
BLOCK-7 LOT-0
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 450 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON 6/20/83 .
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF
THIS 3 BEDROOM HOUSE.
-,._"'",Z OP
~.......:....?~i~.
.~5~,.' ~_" ... v-..; ~,
~. ~e~d, Jr. 2, .~
,,...~
1000
IS ADEQUATE FOR
1200 U Jest 33rcl Auenu¢, Suite B * Anchorctq¢, Alaska 99503 * [907) 276-1361
June 14, 1983
Donald Brooks
SRA Box 1760-B
Anchorage, AK 99507
Subject: Lot 7, Arveson Subdivision
Approval for the individual sewer and water facilities cannot
be 9ranted until tile following items have been completed:
The septic tank pumped with a receipt submitted to this
department.
An adequacy test needs to be performed on the existing
leaching area. '£his 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 office for our revie%;.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected, tf there are any
further questions, please call tl~is office at 264-4720.
Sincerely,
Enclosure
Robert C. Pratt
Associate Environmental Specialist
RP17/ej/E2
, 1, , ,- DATE~RECEiV ED .
~ & INSPECTION APPOINTMENTS . .~ .
'rIME TIME
TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPE
' · ' J~N~'ClPALI3Y OF ANCHOKA(~
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
~---~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECI'IEI~iRONMENTAL PROTECTION
lt¢4[~)) ENVI"ONMENTAL SANITATION DIVISION .....
Telephone 2644720 ,
· - · -RECEIVED -
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests wifl not be processed. Please allow ten (10) days for processing.
. , 'R I PHONE "
I PROPERTY OWNE
2. BUYER ) r
MAILING. ADDRESS
3, LENDII~G INSTITUTION ' I PHONE i ,
MAI LING ADDRESS '
4, REALTOR/AGENT I PHONE'
MAILING. '~. ADDRESS r L , , ,
E, LE6/~L DESCRIPTION
~TREET LOCATION
6. TYPE OF RESIDENCE ,/ NUMBER OF~BEDROOMS
~ SINGLE FAMILY
[] MULTIPLE FAMILY
7. WATER'SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY -
[] One [] Four
[] Two [] Five
[] Other
~ Three [] Six
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells dritled prior to that date, give well
depth (,attach log if available.)
8. SEWAG~ DISPOSAL SYSTEM
I~ INDIVIDUAL/ON-SITE '7~'~ YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPO~,L SYSTEM
[] IN DI VI DUAL/ON -SIT E
[]PUBLIC UTILITY
Connection Verified
[]Septic ~Ta~l~or [] Holding Tank
Size: ']g~ If Tank is homemade
give dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
THIS SIDE FOR OFFICIAL USE ONLY
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SiX
[] OTHER
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
MANUFACTURER
MATERIAL
Septic/Holding Tank IAbsorption Area
I
JSewer Line
]Neares~ Lot Lihe
5. COMMENTS
DATE
[] APPROVED FOR BEDROOMS
~ CONDITIONAL APPROVAL (letter must accompany certificate)
[~ISAPPROVED
['5
72-010 (Rev. 6/79)
fiaunicipali
Anchorage
825 "L" STREET ~4
ANCHORAGE, ALASKA 99~!~,~ ~
<907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DL"PARTMEN r OF HEALTH AND ENVIRONMENTAL PROTECTION
July 17, 1980
Donald/Celeste Brooks
% Kimbrough Owen
Marston Real Estate
2804 West Northern Lights Boulevard
Anchorage, Alaska 99503
Subject: Lot 7 Arveson Subdivision
Approval for your individual sewer and water facilities
can not be granted until the following items have been
completed:
(1)
(2)
The water facilities were not turned on for this
department to obtain a water sample for analysis.
Please re-schedule an appointment in order for
us to take the sample.
The septic tank pumped with a receipt submitted to
this department.
If there are any further questions, please call this
department at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: Coast Mortgage Company
4797 Business Park Boulevard
99503