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HomeMy WebLinkAboutMCCONAHA LT 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME []UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO:Well ~- ~ Manufacturer H~ u~ Lq. capacty ngalons length IF Absorption area Dwelling Material Width NO. OF BEDROOMS PERMIT NO. No. of compartments Liquid depth DISTANCE TO: -- / / Length of each line th of lines Top of tile to finish grade Material beneath tile Length Width Depth Dwelling ~ ] Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: Class Depth Driller DISTANCE TO: Building foundation Sewer line OTHER PIPE MATERIALS SOl L TEST RATING~ '~-~"~ INSTALLER R'[MAR"KS Material PERMIT NO. Liquid capacity in gallons line width inches ~IT NO. Distance between lines / 'ERMIT NO. Total effective absorption area Nearest lot line Distance to lot line Sept c tan k PERMIT NO, Absorpt on area(s) 72-013 DATE LEGAL DEPARTMENT OF HEALTH AND ENVIRONIdENTAL. PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264'-4720 FERMI [ NO: DATE I SSt. JED,~ c,..; ...~ 1 HAND WRITTEN 09/04/85 A F:' P I... I C A N T .' ADDRESS: CONTACT FHDNE. DAVID STERLING 5800 E 156TH ANCHORAGE, Al< 345--.5804 995 16 L.[CGAI... DESCR I Ir...': LO]" SIZE: L.,OT LOCAT I (.'.IN: SLIBDI V IS I ON." MCCONAHA SECTION: 2 'TOWNSHIP: llN 2.. 5A (SQ,, ~T. OR ACRES) GOLDENVIE:W DRIVE LOT: I BLOCK: NA RANGE: Icer, tify that:: 1. I am familiap with the r'equir'ements for on-site sewens and wells as set £o~t.h by the Municipality of Anchonage (MOA) and the State of Alaska. 2.'.. I will install the system in accor'danc..e with all MOA codes and ~*egulatiens, and in compliance ~ith the design cr'itepia of this penmit. :5. I will adher'e to all MOA and State ~ Alaska ~-equir'ements fop the .set. back distances rr'om any existing well, wastewate~* disposal system op public sewerage syst. em on t. his cm any adjacent op near'by lot.. IF' A LIF'I" STATIC]N IS INSTALLED IN AN AREA COVERED BY MOA BL.JILDIIqG CODE. S, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2.) AS.~BUILTS WILL NOT BE AF'F:ROV~ITHOUT AN ELECTRICAL. INSF'ECT~ON REF'ORT~ AND (..,3) THE IELECTRICAL WORK M~JT B~INE BY A LICENSED ELECTRICIAn. ' ) SIGNED ~~ ~ ~ % DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street. Anchorage, Alaska 99501 2644720 SOILS LOG- PERCOLATION TEST ~ SO)LS LOG [] PERCOLATION TEST PERFORMED FOR: ~ ~'~ ~'~ - __DATE PERFORMED: LEGAL DESCRIPTION: 42 I ~""3 7 8 9 10 11 12- 14 2O COMMENTS SLOPE SITE PLAN :~ " Gross Net Depth to Net ,~;'Headlng Date Time Time Water Drop PERCOLATION RATE (minutes/inch) -- FT ' PERFORMED BY: "'T'"H-~¥~, [~'~,~C,..t-~. ,,CERTIFIEDBY: INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 3500 EAST TUDOR ROAD INSPECTIONS (907) 563-3464 ADMINISTRATION (907) 786-8211 NAME / PERMIT NO~ STREET ADDRESS ~-' ~'-' ~2' '/"~'~ / PHONE LOT / BLOCK; SUBDIV, / DAT~ ~'~ FOOTING [] ELEC, TEMP. __ [] PLBG, UNDGR, FOUNDATION [] ELEC. SERVICE [] PLBG. ROUGH BOND BEAM [] ELEC. ROUGH [] GAS TEMP FRAMING [] ELEC. FI N...AL _ [] GAS INSULATION [] OTHER.;'~,';-/YT"~' ""/?'~/ [] MECHANICAL SHEETROCK [] '~'*'~":'~;~ .... '~ :~'""~,~-~/ MECH. FINAL __ STRUCT. FINAL [] FIRE FINAL [] PLBG. FINAL OTHER I-- ZONING ~ OTHER [] NO NONCOMPLIANCE OBSERVED [] CORRECTIONS ESSENTIAL AS EXPLAINED BELOW [] WILL REEXAMINE AT NEXT INSPECTION [] DO NOT CONCEAL UNTIL REINSPECTED [] [] [] [] E [] [] [] COMMENTS INSPECTO~ ~ DATE WHEN CORRECTIONS ARE MADE. PLEASE CALL FOR INSPECTION 84-002 (Rev. 2/83) DO NOT REMOVE THIS NOTICE POL .,;t 6-650 ANGt-IORAGE, ALASKA 99502-0650 (907) 264-,4111 TONY KNOWI IS MA YOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION January 31, 1985 TO: Permit Applicant SUBJECT: Permit #: 840971 Lot 1 Mc Conaha Subdivision A permit issued by this Department fox an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as-built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Keith E. Bandt, Supervisor Environmental Engineering Program KEB/Ljw enc: Copy of Permit SWP/057 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ~-~O~'~ [ 1 3 5 6 7 8 SLOPE DATE PERFORMED: OCT- SITE PLAN 10 11 12-- 13 14 15 16 17 18 CE - 3816 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT !t pEPTH? S ~ Date Gross Net Depth to Net Time Time Water Drop 19 20- COMMENTS. PERFORMED BY:_~_ . PERCOLATION RATE [~'~f.._.~'~,~"~ CERTI FI ED BY: FT AND (minutes/inch) __ FT ? MUNICIPALITY OF ANCHORAGE -~ ..... DepartmeD~0f Health and Environmenb-~ Protection ' 825 ~L Street, Anchorage, AK '99501 " 264-4720 Permit ~ ~~0~1 ~' ~ ~ HANDWRITTEN PERMIT ~ ~ ~ ~::~ ON-SITE SEWER PERMIT Applicant: ~/~ ~'~ Mailing Address: ~O Location: /~77~ joL~EDDU,~-~ .... Phone Number: 3~ /~'~ Legal Description: ~o~ / /~/e~-oc/~/~ ~'/~ Lot Size: Type of Soil Absorption System Is: ~~///~_~j · Trench: Drainfield: ~ . Seepage Bed% ~ ~- Holding Tank: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) /~ The Required Size of the Soil Absorption System Is: '~Ez~ ~ 5~,3. D ~ ' WIDTH PTH ~-o LENGTH GRAVEL DEPTH z'~/ '~'~ 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 ~xcavation(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). · * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS * * 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. ~.~ · * * TWO(2) INSPECTIONS AR~,iREQUIRED * * * Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other~requirements may apply. Specifications and construction diagrams are available to insure proper installation. · * * PERMIT EXPIRES DECEMBER 31~ 1 9 * * I certify that: ~(1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if th/D~sidencer~s remodeled to include more that 3 bedrooms. Signe~: Issued by: ~ ~ ApDlicant- SWP/024(1/81) 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 264-4720 App,cat,on Oate GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) (b) (c) Location (address or directions) Applicant Name ~::~-~_~ Applicant Address ~L~ Applicant is (check one): Lendi?g Institution []; Owner/builder~ Buyer []; Other [] (explain); __ Telephone: Home ?~'~"-~"~'~:~- Business (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-FamiliES) Multi-Family [] Number of Bedrooms _ ~ Other WATER SUPPLY Individual Wel~ Community [] Public El 't,, ,U !~' / Note: If community well system, must have written confirmation from the State Department of Environh~ental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~ Pu.b..lic D Cornmunity [] Holding Tank [] Note: If community weI~ system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72 025 (~ 1/84) Page I of 2 ~[NGINEER~NG 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 Autl~odty Approva~ shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for tl~e 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 Name of Firm -~ ~'F4D"~ -~',-~L~ ~,_~z~-~. ~ Telephone - DHEP APPROVAL ' ~ Approved for "'~'"'~' - bedrooms b,y //~' ~'~ Date Approved /'~ Disa~ed Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health 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 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. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & ENVIRONMENTAL PROTECTION 0'4 WELL DATA Well Classification Well Log Present (Y/N) ~1'~ Total Depth (,~4 i Cased to ~ ~ ! ~ Static Water Level 4~.~;3 '. Casing Height Above Ground ~ ~- Electrical Wiring in Condui! (Y/N) ~:~ Separation Distances from Well: To Septic/Holding Tank on Lot J¢:::vt.-~ ~ To Nearest Edge of Absorpbon Field on Lot JS''t) / To Nearest Public,Sewer Line ~ J ~ Cleanout/Manhole L ~. _~."~J ..'~ I, A. B. C, D.E.C. Approved (Y/N) Date Completed ~'. I ~/7'L~ Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) : On Adjoining LOtS : On Adjoining Lots To Nearest Public Sewer Water Sample Collected by Water Sample Test Results Comments ~ J ~ To Nearest Sewer Service Line on Lot ~t,~"( ~ Date ~/~--.~/'~Z,. SEPTIC/HOLDING TANK, DATA Date Installed ' ~ J'~-~/"/~, Size I~:~ (---~e¢~ No. of Compartments Standpipes (Y/N) ~'~ Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) Depression over Tank (Y/N) t,~:::~ Date Last Pumped ~/~'~ /~:~ . Pumping/Maintenance Contract on File (Y/N) ~ /'~ ; f~" -' ~ ' Holding Tank High-Water Alarm (Y/N) I~//~" Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: / ~_. To Water-Supply Well j l,..~""J' ~" To Building Foundation "7 To Property Line ~ ~ ~ To Disposal Field ~"-~ j To Water Main/Service Line ~'_J:~' ~ To Stream, Pond, Lake, or Major Drainage Course Comments Page I of 2 72-026,11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata I~,,J~'-¢/,l~r~,~ '"'- -'~ Date Instal ed ~/~"::~ [~ Width of Field "~Z , Gravel Bed Thickness ~ ~ Square Feet of Absorption Area ~ ~ Standpipes Present (Y/N) Depression over Field (Y/N) ~ Date of Last Adequacy Test Type of System Design Length of Field Depth of Field 4/~=~' · ~,~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well I ~ 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 To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) LIFT STATION . C¢/~[,,~__. ~j~,__ Date Installed~ Dimensions Size in Gallons , I: - ~-~'r~:~X.~ T;',P¢~/ Manhole/Access (Y/N) "Pump On" Level at ~G" ~ "Pump Off" Level at High Water Alarm Level at ~/--~' ~ Vent (Y/N) Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments '. _ _ -- ........ · , . ** Check Permitted Bedroom Rating Against HAA Request ** I certify that l h~,ve ch~"~e 'd, veri~ d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ Date ~"-- Company ¢"~'~'¢~"~-~ ~;~-~ILG~OA No. Receipt No. '~o Date of Payment C~,/_~//~" Amount: $ ~"=~ ~'-~ Page 2 of 2 72-026 (11/84) ' MUNICIPALIT~ OF ANCHORAGE DIVISION OF ENVIRONMENTAL m~.ALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL FROTECTION APPLICATION FOR m~.Af~TH AUTHORITY APPROVAL CERTIFICATE I. General Information Application Date 12-7-84 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 1, McConaha S/D Location (address or directions) 5800 - 156th Avenue (b) Applicants Name Bernard Preston Telephone - Home Business 345-1487 Applicants Address 5800 - 156th Avenue, Anchorage, Alaska 99516 (C) Applicant is (check. one) Lending Institution ~-~; Owner/builder ~; Buyer ~--~ ; Other ~-~ (explain); (d) Lending Institution Telephone Ad~. ss (e) Real Estate Co. & Agent Dynamic Realty, Inc. Doris A. Timperley Address 501 W. Northern Lights Blvd. Anchorage, Alaska 99503 Telephone 279-7611 (f) Mail the HAA to the following address: Type of Residence Single-Family~ Number of Bedrooms Water Supply Individual Well~ Multi-Famtly~--~ Three (3)- Ocher ~describe) Co--unity F--] 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 Corem=icyEoldi Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality aD~ status. [Page 1 of 2] 5. En~ineerin~ Firm Providin~ 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 M~micipality 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. Name of Firm Telephone Address Date (ENGINEER SEAL) ENGINEER'S ORIGINAL STAMP AND SIGNATURE ARE ON FILE WITH D.H.E.P.AND ARE AVAIL- ABLE FOR REVIEW UPON REQUEST. DREP Approval Conditonal X~Rg~ forThree(3)bedrooms Date 12-7-84 Approved Disapproved__ Conditional XX Terms of Conditional Approval This Conditional approval is valid until June 15, 1985 and will expire on that date. The Conditional apprQyal is contincenL upon abandonment of the existinq system and upqradinq to meet D.H.E.P requirements. A permit has been issued for this upqrade and will be renewed for 1985 upon request. CAtEION THE MUNICIPALITY OF ANCHORAGE ~EPARTMENT OF ~LTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES ~ALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAP~ 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 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. (DHEP SEAL) RK4/eJ/D18 [Page 2 of 2] 7-19-84 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 December 6, 1984 Bernard and Loraine Preston 5800 106th Avenue Anchorage, Alaska 99502 SUBJECT: Temporary Waiver 'Horizontal Separation between Absorption Field and Wa.t~er Table, Lot 1, McConaha S/D - Anchorage ( 8521-WA-081 ) Dear Mr. & Mrs. Preston: The Department has reviewed the subject waiver request and temporary waives the horizontal separation between the absorption field and water table to zero feet on the subject property. This temporary waiver expires August 31, 1985, and will allow the property owners time to construct a system which will meet current Wastewater Disposal Regulations 18 AAC 72. Sincerely, r~u~ce E. Erickson District Engineer BEE/dd