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Home My WebLink AboutHANSEN SAND LAKE LT 8 W2 GRE ANCHORAGE AREA BOF ' JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 NAME LOCATION SEPTIC TANK: DISTANCE ~7'/.~ FROM WELL INSIDE LENGTH INSPECTION REPORT ON-SITE SEWAGE DISPOS~_~L SYSTEM MAILING ADDR~-SS ~:~--~-~-- ~-~, ?~/~ LEGAL DESCRIPTION ~.~{~ r MANUFACTURER NUMBER OF MATERIAL COMPARTMENTS INSIDE WIDTH .LIQUID DEPTH __.LIQUID CAPACITY //O~ GALLONS. NUMBER OF PITS __ LINING MATERIAL BUILDING FOUNDATION__ ADDITIONAL ABSORPTION DIAMETER OR WIDTH__ CRIB SIZE: DIAMETER NEAREST LOT LINE-~~h-~) . LENGTH DEPTH DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~/L/~"~ SQ. FT. WELL: TYPe BUILDING FOUNDATION __ CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES_ DISAPPROVED DEPTH NEAREST SEPTIC~ SEWER LINE TANK DISTANCE FROM: SEEPAGE ~. ~ SYSTEM m/ REMARKS DISTANCES: INSTALLED BY: ?~ PIPE MATERIAL: LOT SLOPE: REMARKS~ Form No. EQ-031 DIAGRAM OF SYSTEM DATE~ --/~ % APPROVED G.A.A.B. 'O GREATER ANCHORAGE ARea BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT NAME OF APPL,GANT //~'r/f ~/ t ~''/~:~ MA,L,NG AODREBS 37 C ~- lO' 7/-/''T'/~ 'NSTALLAT,ON =0~''O. ~ 7 Z 5~7~ INSTALLATION OF: SEPTIC TANK S~m~m Eli,' - . DRAIN FIELD ~ OTHER . FINANCED THROUGH TO BE iNSTA LED BY COMPLETION DATE ANtICiPATED ~ ~ PHONE FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT~ .. DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALl SEPTIC TANK .. SEEPAGE PIT~' DRA,N F,ELD /~ O ' WATER MAIN TO SEPTIC TANK /O r DRAIN FIELD /' ~5"""2 ~' SEPTIC TANK, ~r SEEPAG~ PIT /~ r TO RIVER, LAKE STREAM. DIAGRAM OF SYSTEM j DRAIN FIELD / . SEEPAGE PIT / ~' ~ ALSO CONSIDER AREA WELLS. SEEPAGE PIT CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIb3 CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURSED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-§8 AND THAT THE ABOVE DESCRI2D SYSTE~?fS IN ACCORDANCE WITH SAID CODE. ~' ' : 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Perfo'rmed For Henry Ford Date Performed June 11, 1973 Legal Descrip't'ion: Lot . Block Subdivision Hanson Sand Lake (W i/2o£Blk8) This Form Reports Soils 'Log x~ ~er-~-F-~-lation Test Depth Feet 2-- 3-- 5-- 6-- 7-- Soil Gray clayey silt Gray silty sand and Sand Characteristics (ML) (SM) (SP) Water Whs Ground Water Encountered? Yes If Yes,'At What Depth? 9.0" I te nute .'. · ProPosed Insta)"lation: Seepage Pit Drain Field xx Depth Of Inlet Depth To Bottom Of Pit Or Trench COMMENTS: 230 sq. ft of drainage area is requ.ired per bedroom in this seepage field, kept-~' minimum of 4 J~eet above the water table indicated. Test Performed By R'. E. Car~s~e D'~'ta .Certif"i'ed By: ALASKA MINERAL. & MATERIALS. LAB,' INC ~ · i Da t e :. June 14, 1973 : Reading Date Gross Time 'i '!1 ...... ,?' , Net Time i Depth to H 0 ] Net Drop MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMEI~T OF HEALTH AND ENVIRONMENTAL PROTECTION APPLI.CATION FOR ~r~.ALTH AUTHORITY APPROVAL CERTIFICATE 1 General Information Application Date ~-- (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) ~.zj. (b) Applicants Name /~///f",~- Applicants Address ~7 (c) Applicant is (check. on~e) Lending Institution ~ ; Owner/builder ,~ Buyer ~ ; Other ~ (explain); (d) Lending Institution /~(i /~f~Z~z~z- /~,~. Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to ~the following address: 2. T_~e of ReSidence Single-Family,~, Number of Bedrooms 3o Water Suppl~- Individual Well~ Multi"Family ~ / Other (describe) Community~ Public~ 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 ~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. _E~Firm Providin~ Inspections, Tests3 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 regula- tions in effect on the date of this inspection. ~ ~/f Telephone Name of Firm ~-7~Z~ ~./~.~ z ' / ¢~'CC% No. ';0s~ ,~'.'...'. ..... * ..... 1 Approval / ~;~p~2%~ ' .~-~'~.:¥.::~" Te~s o io CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONbiENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CObfDUCT 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° (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 As [~IIUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ' [JNVIRONMENTAL PROTECTIOI~ MUNICIPALITY OF ANCHORAGE (MOA) r3gl ~g 1Q~ P OVAL'( ) ,RECEIVED' c C LZS - '198, Legal Description: . /~d~ .~D Well Classification ~t~ ~//~/~/V Well Log P~esent (Y/N) ~ Total Depth '2~ ~ ~d to Static Water ~1 ~ ~ Casing ~ight ~ G~nd Elec~i~l Wiring in ~nduit (Y~) If A, B, c~ C, D.E.C. Approved(Y/N) 1//~2-/7~ yield ~-0 C~ Date Completed '-- Depth of G~outing. -- ~ Pump Set At I/ ~ Sanits~y Seal on Casing (Y/N) ~ Separation Distances f~om Well: A To Septic/}{olding Tank on Lot To Nearest Edge of Absorption Field on Lot ; On Adjoining. 5~ts N//~ ; On AdjoiningLots ~ To ~Nea~e.st Public Se~ To Nearest Sewe~ Service Line on ~--~ w ',',',',',',',',',~> ;Date To Nearest Public Sewe~ Line Cleancut/Manhole /~..~ / Wate~ Sample Collected By V~' Wate~ Sample Test ~esults No. of CoJ~a~.tn~nts Foundation Cleanout (Y/N) SEPTICi~OLDING TANK DATA /V: Date Installed Size Standpipes (Y/~) Ai~-tight Caps (Y/N) Depression ove~ Tank (Y/N) Date Last Pumped Pumping/Maintenance Contract on File .(Y/~) ; fo~ Holding Tank High-Wate~ Alarm (Y/N) · Temporary Holding Tank Permit (Y/N) Separation Distances f~am Septic/Holding Tank: To Water-Supply Well To Building Foundation To P~ope~ty Line To Disposal Field __ To Wate~ Main/Service Li~ To' Stream, Pond~ Lake, c~ Majo~ D~ainage Course Co.,~ents ABSORPTION FIELD DATA ~//~ Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of AbsorptionA~ea Dap~ession over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service ~ine Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes P~esent (Y/N) Date of Last Adequacy Test To P~operty Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank(if present) To Stream/Pond~Lake/o~ Major D~ainage Course To D~iveway, Parkin~ Area, c~ Vehicle Storage Area Comments D. 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 du~ing Adequacy Test. Meets MOA Co~'t~nt s ** Check Permitted Bedroom Rating AGainst HAA Request ** I certify that I have checked, verified, or conforwed to all MOA HAA Guidelines in effect on the date of this inspection. ..... Signed Date 7 [Page 2 of 23 2-15-84 Location: BESSE~ EPPS & POITS 2220 FA~I' 88 AVE1TdE ANCHORAGE, AK 99507 (907) ' 349-6451 Date: Subdivision: Lot: Block: Client's Nam: ~ddress: Tester: ~. %%/, Initial Rmadir~ on Meter: Production Rate: &..~ GPM 24-Hour Capacity. ~ Gallons SEWER ENCASEMENT JOf~ PL~*i'~5~ AROUND' PIPE FORM ......... t- .... -~ ..... ~ ~?~ NOTE - I. Concrete shall have a min.¢ompreselve strength of ;5OOO P.S.I. 2. Sewer connect to be incased as per detail above a rain of 25' Radia~ from existing well head. M.O.A. D,H,E. P. DOte ~'~ ~ c~ -oC~