HomeMy WebLinkAboutNETTLETON ACRES #2 LT 3
MUNICIPALITY OF: ANCItORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 26444720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE [ .~j!~EW
o.,v Co. I []DPGRADE
MAILING ADDRESS
LOCATION Zt~/~ ~ OVZ~.~ NO. OF,_~BEDROOMS
I WelJ . A~orption area ~'-~lling ' PERMIT 0.
ILiq. capacity in gallons I ........ I Inside length Width Liquid depth --
B e ~ DISTANCE T¢ell Dwell,n. _/ PERMIT NO~
~ ~ Manufacture I Material Liqui ,~Ety in gallons
- ~~~ .. ~ ~ Foundation ~ . ]Nearestl0~Jine ~ER~I~NO.
~ ~ ~ ~~h of eaCh~ige Total len~h of ICes I Trench width Distance between lines
~~ ~Bh g?? Material De~ .. M Total erreD, lye a~sorptlon apea
~ I Lenq~ ~ ~:idth Depth ~ ~ _ PER~ITNO.
~ -.Z~STAN - -~ Building founda,~ Nearest ,~lln~ -
OTHER
PIPE MATERIALS ' '~
SOIL TEST RATING
REMARKS
APPROVED
72-013 (Rev. 3/78)
-/
FI F' F' L ! C FIIq 'r
L '3r' R'T I
t.,.. E'.' I~j F:I I...
DEF'F::lr~::THEI'.,KF I.-I[EI:::!I...'FH FINE:, E]q','IIq":i'-DtENTFqL ETEZTION
..HP..LE.::,L hi C:C NiST.
L.. I '.RHI ~1
L :~:/~',tE T T I_. E T Cd'.,! RF:F.:ES
TI'rlF'E OF SI:I]~L hE,:,.I.f t.l:_l',t :E;"rlSTEI'"I .'[.'j-~;'
HFI;:.::]:f"IUh'I NLP1E~E'R CF' E:EE:,F..:CIC~hlS =
THE: Fi:E:I'j:!IJIFRE:D SIZE:~s'%7_OF' THE :5OIL RE:SOF.~F'TION~S'.r'S'T ~:1"1 I'E;:. ~~~)
IE:. E F" 'T ,.-, :== ::L ;~ ~. E N ,:~ T' H .......... ;~:: ',3, F~: ,~ %." E L C:~ E F"-'~'"' H ........ ,~ ", ~
Tr.iE LENGTH DZP1ENSZON I9 THE LENG'TH ,::ZN FEET::, OF THE TRENCH OR DRFIINF::'IEL. D.
TFIE DEPTFI OF FI TRENCH OR F:'IT tS THE DISTRNCE BE'THEEN THE: SUF:F::FICE OF' ]"HE
C~F'.OI...IND FIN[:, THE BOTTOM OF THE EXE:FI',,,'FIT ~ ON ,:: ~ N FEET ::,.
THERE I:5 NO SET HIDTH FOR TRENCHES;.
THE GRR',,,'EL DEF'TH ]:S '1"HE H~NIHLIH DEP'FH OF GF:FI'v'EL E~ETHEEI'.,I THE OLITFFILL. F'~F'E
FINE:, THE: E:OTTC~H OF TFtE E:=:CFI',,,'FIT ~ ON < Z hi F'EET ::,.
F'E:'F.'M"T FIF:'PL. IL-RHT k'IR.S 'r'HE ...... ,"' _
...... F: E =,F .Ihl_,:., I E: I L l Tq.' TO l I'.,IFF F.'H TH I S DEF'I:qF;KFHENT r2,1_lFR I NG THE
BISTFiLLRT ~ Clf.,I ZNLqF, ECT I Cff.,IS OF Rf.,t'¢ HELLS RE:,...TFiCENT TO TH Z S PF.':OI::'EF.~Th.' FIND THE
hI_MEEF.: CF' F::[E:SIF.:,ENCES 'THRT THE: HELL H.T, LL :LS, EI~:',,,'F.
E:F:P::::KF'"IL, L, IN(.) LqF' FIN'T' :5'~"S"I"EI'"I 14ITHOLIT FINflL IIq:SF'ECTIOI'.~ FIND RFrf~ ': ' ...." '"P I.... E:"r' "I"HZ':::'._,
DEI::'FIFRTHENT t,.IILL~ DE SIJB..TECT TO F'F.'ZSEZ .TZZN.
PIlI'.,IIP'IL.IH [:,ISTFINCE E,[.I,~IEE. I'.,I tq HELL. I::INE:, FIl'.,l'.r'
::LOZI FEET F'CI[,:: FI f'F' ",,~" ' ' kg" ".. :, 1 HELL. E:,E:PEI'.~!D.T.I'.,IC:i
· .l ,HirE. I.,]EL.L OFf: J.....u TID ;~E~O F'EET F'ROH I::1 F E'L 'L-:
.F:"::N THE' T"r'F'E OF F'IJEL 'lC I.,.IEL[ ....
I"I.T.I",I]HUM E:'I:.-T, TF1NCE FROH I"q F[,:.I ,hire HELL TO la FF,.T.'v'FYFE 5;EHEF;: LINIE
TD R CCtP'Ih'ILINIT'?' :,E. LtE. F:. LZNE: Z:5 ,."r~, FFET.
14EL. L LJ.T.,3S; %.E F.:E:QLIIRED FIND HU'E,T DE F.:ETJF'N[~'[, TF~ TFIE DEF'FIRTh'IENT I.,.IZTlaZN ~:O Bi'ir:;
I": F' THE.~ HELL.. "." HF'LE:T l 'l H.
R[:.f1[.~ll.::, I'"IFt'¢ FJF'Fq_'¢. .::,PEC.T. FICFI"F'I':H'F FiND CONSTRJC:TIi-iN [::,ZFIGRRH:S H[:.[.'.
R',,,'FI I L. FIE,'LE T -J ]: hIE, F:'F' F'F.':IDF'[ER I NS"I'FILLRT I CIN.
I E:EI:RTIF'¥ THFIT
1.: I FIH F:FIMILIF!F'. HITH TFIE: F::E:L.-~LIIf~:EMEI'.,ITS FOR Oi'.,I-L"SIT[C SEHEF,'S RN[::, P.IE:LI...::.:; FI:.:..; :'SET
F'OF,:'.TH E::'t' THE HUiqlCIF'FIL. IT'¢ OF FINC:HOI'~'.FIGE.
2.: ! HII..J... It'.,I:STRI_L THE SWS'TE:]"I IN FIC:C:OF~'.DFINCE HITH THE COl)E?,,.
~:: I UNE:,EI~:'STFtND THFIT THE Ot'.,f-:'.SITE :SEFIER ::S'¢s'r'EH HFI'T' r?.EL:.!LIIF~'.E E[I'.,ILFIF;i:GEHENT IF THE:
RE::SIC, ENC:E IS; F~:EMODELEI)'f'O INCLUDE HOF.:E THFIN
5 ] GNEr;, . ................................................................... ~'~-s . /~/~=c Z)
FIPF'L :I: CFINT CRRLES;OI'.,t CON"_':;T. CCI
J~/"'SOI LS LOG
PERFORMED FOR:
I.EGAL DESCRIPTION:
: ,vlUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Aleska 99501 2~ ~.720
SOILS LOG- PERCOLATION TEST
[] PERCOLATION
TEST
DATE PERFORMED: . (,"~1
5
6
8
9
~0
~3
~6
~7
~8
~9
20
COMMENTS
NO. 1732,E
Juno 22, 1968
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
s
L
0
P
E
Reading Date Gross Net Depth to Net
Time Time W~ter Drop
PERCOLATION RATE Iminutes/inch)
TEST RUN BETWEEN FT AND FT
72-008 (6/79)
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 725
I:::)RILLED AT THE RATE Of ,~,2'/000 PEr FOOT.
PROPERTY OWNER
DRILLER
WELL LOG:
723 .... 725t 7.bze. C~a~J~L. 4ho~.tn.¢ c* q.i.~c!, o.fi. tao~ze~. 3 ZcJ 4 ~?liZ v~d.th. SO fe.e;L o.f.
Co.o4 o.fi /,)eJ~J. Se.c_d.: ~/.~ ..... vv
COST INCLUDES ALL LABOR AND MATERIAL FOr COMPLETION OF SAID DRILLING.
7 o oo
~NRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THF SUM OF
THANK YOU VERY MUCH,
DATE
BERNIE CLAUS OF RAMPART DRILLING WORKS
~ERVlOe CHArgEOF ~V~% PER MONTH WILL BE A~SE[SED ON PA~T DUEACCOUNT~.
',': ' ;':' '= :~ DEPARTMENT OF HEALTH AND ENvIR°NMEN~'AL"PR°TE'CTI°N ::::
· ;:: DIVISION OF ENVIRONMENTAL HEALTH ;'~ ~i::~! ~:: ::? "
'(a) Lega~escription (includeJot, block, subdivisi~section, t0wnship, range)
Applicant ~am~/~ ~2~
Applicant Address ~d~
(c) Applicant is (check one): Lending Institution
(explain);
(d)Lending Institution e (~ ~-~ A'(~ Telephone
Address
(e)Real Estate Company and Agent
Address
Telephone
(f) Mail the HAAto the
f~ll~owing address:
2. TYPE OF RESIDENCE
~...... - ../Mulli?Familv [] :. Other
Single-Family
Number of Bedrooms .... ~
3? WATER SUPPLY
Page 1 of 2
IndividuaI 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.
Onsite/~/ Public[] community• Holding Tank[] :::~ . ' ' i::' i ~:
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status. · ·
ENGINEERING FIRM PROVIDIF,~ INSPECTIONS, TESTS, FILE SEARCH, D~..A AND INFORMATION
As certified by my seal affixed hereto and es 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 westewater 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 rites and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with afl Municipal and State codes, ordinances, and regulations in effect on
the date f-thisi~speot'on.
Name of Firm /-~,~¢-s-~-~~ ~-~'~,-'¢2~..~ ~' --~'~ Telephone
Address _ ~'~-~ .~--,¢¢--~ ~-- . .
Date ~ '-'-//3 -
DHEP APPROVAL
Approved for * ' C bedrooms
Approved Disapproved ConOitional
T~rms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
,~pproval 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 certain 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.
: '; J.: : ' :,; ':;, ; ; .; ' -' ·
· i; , :, (;\:: :. ; :"; '; , ': ~'. : ! ,':~ ~.'~.' ; , , ;' : · · :
MUNICIPALi-P,* oF ANCRo/~AG~
DEPT. OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MO,~,i ENVIRONMENTAL PROTECTION
HEALTH AUTHORITY APPROVAL (HAA) ilt \i O ':i 1986.'
CHECKLIST- FEBRUARY 1984 ' ' ~
Legal Description: ~/~ ¢ .
WELL DATA
Well Classification -- ~-F /~/.,4/¢.//_y. If A, B, C. D.E.C. Approved (Y/N)
Well Log Presen~"~N) .%/'.~¢ 7:~ Dat/Completed ~.~'.~f'-'/-E~'"'-' r~'¢?/~ Yield
Total Depth /~-~ .~ Cased to /L~%¢'- /
Static Water Level _ ~;-~'~
Casing Height Above Ground ___.'.~.~¢
Electrical Wiring in Condui~tN)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot /'¢,'¢'¢~ /Tz- ; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer ServiCe Line on LOt
Depth of Grouting
Pump Set At ~/.-/d/-"~¢~'¢¢,'!//
Sanitary seal on Casin~) ~/-
Depression Around Wellhead (Yc~
; On Adjoining Lots ,-'/¢~'¢¢
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments - -~-~-~--
B. SEPTIC/HOLDING TANK DATA
Date Installed ..~" .-,~._-/-- ~/' Size-.d- ~'-~'~ No. of Compartments
Standpipe~l)~'¢ Air-tig~Ca~N) ~,~.~_~ Foundation Cleanout~)
Depression over Tank (~ ,~/~ , , Date Last Pumped
Pu mping/Maintenance Co~tract on File (Y/~~¢ ;for ~ /
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ~ ~ / ~
To Property Line -,-=~ ~ ~ To Disposal Field ,-~
TO Water Main/Service~ine /~~- /~ T0 Stream, Pond, Lake.
or
Major
Drainage
Course ~/ ~'~ ~/ ~ ~-'~ ....
_ Temporary Holding Tank Permit (Y/N)
/
To Building Foundation
Page 1 of 2
72-026(11/84)
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Length of Field -~'~
Depth of Field
Gravel Bed Thickness
Standpipes Present. N)
Depression over Field (v~ /,~/,? Date of Last Adequacy Test
Results of Last Adequacy Test ~/7/% ~¢
/
Separation Distance from Absorption Field:
/ /
To Water-Supply Well /¢ ~ ~' To Prope~y Line ~
To Building FoundatiOn ~ ~ To Existin~ or Abandoned System on
/ ~ ~ _ ~__
Lot ~.¢~ ~/~-~,%¢~, ; On Adjoining Lots
To ~in/Service Line ,_~ /~ ~o C~present) ~.~.~
To Stream/Pond/Lake/or Major Drainage Course .~.~ -~
To Driveway, Parking Area, or Vehicle Storage Area ~¢~* /~
Comments ~>~ -~/.¢(~ ~'~ ~ ~(~ ~
LIFT 8T~TIO~
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that ~ave c h..~/~ed, verified, or conformed to all MOA and HAA guideli nas in effect on the date of this inspection.
Signed ~"~/-"¢~ ,-~'~ ,~---~ Date ~'-/'-~ ~-¢~
CompanyZb/~,~ ,~¢~,% MOA No.
ReceiptNo. %~ O~l O
Date of Payment
Amount: $
Page 2 of 2
J &unicipah Yof
Anchorage
P.O. B~. 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TON Y KNO WLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
July 8, 1986
Carey Meyer, P.E.
Besse, Epps and Potts
2220 East 88th Avenue
Anchorage, Alaska .99507
Subject: Lot 3 Bl~oZ~-Nettleton Acres Subdivision #2
Waiver Request, WR86-087
Dear Mr. Meyer:
This department has granted your request for a waiver of 100 foot
separation required between a septic tank and well on the subject
lot. This distance has been waived to 97 feet.
This waiver is valid for the existing three bedroom single family
dwelling only.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
June 16, 1986
John Kennedy
DHEP
825 "L" Street
Anchorage, Alaska 99509
MUNICIPALITY OF ANCHORAQFz
DEPT. OF HEALTH &
~NVIRONMENTAL PROTECTION
? o 1986
REC iVI D
Health Authority Approval
Variance Request
Settleton Acres No. 2, Lot
Dear John:
We have completed the testing and application preparation
regarding acquiring a Health Authority Approval for the
above-referenced lot and have identified a deficiency.
The deficiency identified is that the septic tank is closer than
100 feet from the well. The 1981 on-site sewer inspection
report was approved by the Municipality of Anchorage showing the
tank's installation and indicating a 100' separation° This is
not the case; the actual separation is 97'.
We request a variance to the requirement that the tank be 100
feet from the well for the following reasons:
The system has functioned with no adverse health impacts.
satisfactory water sample test result was obtained. The
well is cased to greater than 40 feet.
2. The existing house sits between the well and the tank.
3. The system was approved by MOA in 1981.
Should you have any additional questions, please feel free to
con~ct me at 349-6451.
Very truly yours,
Carey ,~..JMey~ PE
smh
ENGINEERING, PLANNING, SURVEYING
2220 E. 88th Ave./Anchorage,. Alaska 99507/Telephone 907-349..6451 /,~o/~,4.1352.
"Providing a quality personalized service to those building Alaska's future"
8ES~E, EPPS &
2220 EAST 88 AVENUE
ANCHOfiA~, AK 99507
(907) 349-6451
WATER ~'~r.r. T~SST
Location:
Client's Name:
Tester:
Initial Reading on Meter:
Rate:/mt,-' ~ GPM 24-Hour Capacity... C~llc~s
NUMBER I I ~ [APPROVAL
NAME ,
ADDRESS ,,~'-
/
SHIP FROM ~ SPECIAL INSTRUCTIONS --
~ STORE
~ STOCK
DI~T,
This purchase Is made under my
SearsChargo Acconnl Sacurlly Agree-
menl or my SeamChorge Modernizing
Credit Plan Account Securlly Agree-
ment which Is incorporated herein by
reference. This sale Is subject to lhe
approval of the Credit Sales Depart.
maul of Soars, Roebuck aad Co.
X
PURCHASED BY
I1 Ihe sale is on Easy Payment Mod-
arnlzlag Credit Plau (EP/MCP), use
applicable contract form.
this purchase is made under my
Discover Cardmember Agreement
Which Is incarporated herein by refer,
enco and I a~Jthorize the Issder to pay
Sears. This sale is subject to the
approval of the Discover Credil Card
Department.
X
PURCHASFD BY
THIS IS PART
DESCRIPTION
REGULAR
PRICE
/,.:~,..., ~,.) ;:., ,.~. ~
i .., ,:",/,., /,' :::'"'"
___OF A _ PART ORDER.
for shopping at $~_J~/~$
SELLING SELLING
REDUCTION PRICE
SALES I~'
TAX
DEPOSIT
PLEASE RETAIN THIS COPY FOR COMPARISON WITH YOUR MONTHLY STATEMENT,
OR IN CASE OF RETURN OR EXCHANGE.
16087-100 8/85 Seato Forme Management BALANCE
TIME
. MUNICIPALITY OF ANCHORAGE MUNI~LI~F ANCHORAGE
(~4
~ Telephone 264~4720
~EQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~IVI~
DIRECTIONS; Complete allparts on page 1. Incompleto requests w not be processed Please allow ten 10) days for processing.
1. PROP~RTYOWNER ' PHONE ' '
MAI L'l ~ A~DR ESS
PROPERTY R~SIDE~T (If di'ffeFent from'above]~ ' PHONE
2. BUYER / / ' PHONE
MAI L~ADD
MAtLI G DDR~S' -
5. LEGAL 'DESCRIPTION - - /
STREET LOCATION ,/ -
' NUMBER OF BEDROOMS
6, TYPEOF R~SlDENCE ~ One ~] Four ~ Other
~ SINGLE FAMILY ~ Two ~ Five
~ ~ULTIPLE FAMILY ~ Three ~] Six
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**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
I PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBUC UT UTY
Connection Verified INSTALLER '
[]Septic Tank or E3Holding Tank
Size: /~)~:~ If Tank is homemade SOILS RATING
§ive dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area ]Sewer Line Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
5, COMMENTS
d/;:PPROVEDFOR ,BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)'
[~] DISAPPROVED
72-010 (Rev. 6/79)
DIRECTIONS TO PROPERTY TO BE INSFECTED
Sewer and Water Program
Note:
be sure to put colour of house or other
landmarks that will make it easy for the
inspector to find. Accurate directions
will save time and not cause delays in
scheduling.
SWP/025