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Home My WebLink AboutTODDS HALF ACRE oGRE~rER ANCHORAGE AREA BOR'~JGH Anchorage, AIsska gg§03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM · OCATION LEGAL DESCRIPT,O. SEPTIC TANK: DISTANCE '~_~,~.~. FROM WELL MANUFACTURER INSIDE LENGTH INSIDE WIDTH NUMBER OF COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY [L.)~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA ~'~ FOUNDATION DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE NEAREST LOT LINE TOTAL LENGTH OF LINES TRENCH WIDTH /-/Z'-~*/IN. TOTAL EFFECTIVE MATERIAL BENEATH TILE '} ! __ IN. ABOVE TILE (/'//' IN. WELL: TYPE__ CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE , SEWER LINE ., TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISTANCES: __ DISAPPROVED REMARKS ~STEM iNSTALLED By: ~'--C~ SEWER LINE DEPTH: PIPE MATERIAL~'~ LOT SLOPE: REMARKS: D ATE ~/'/)/'/) (~- Form EQ-032 GReATEr ANCHORAGE AREA BorOUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274[-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME Of APPLICANT INSTALLATION OF: SEPTIC TANK /~O SEEPAGE Pit · DRAIN FIELD PHONE , OTHER FINANCED THROUGH SOIL TEST RESULTS TO BE INSTALLED BY COMPLETION DATE ANTICIPATED . FINAL ~NSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCBB, REQUIREMENTS I FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE ~ ~ ~ DRAIN FIELD SEPTIC TANK TO SEEPAGE TO NEAREST LOT LINE. WELL. TO SEPTIC TANK ~ ALSO CONSIDER AREA WELLS. SEEPAGE PIT ., DRAIN FIELD CAST iRON INTO AND OUT OF SEPTIC TANK AND iNTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED 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 R ARDING INSTALLATION. DIAGRAM OF SYSTEM I CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, MUNICIPALITY OF ANCHORAGE Departm6~ of Health and Environmental k.~hection SOILS LOG ~Ei~COLATiON TEST Performed for Hill's Excavating Legal Description 3706 W. 78th Avenue ~UNICIPALITY OF ANCHORAOE DEPT OF tEAL;;- & ENVIRONMENI'^L PRO~ ECTION RECEI!VED Date Performed 8/5/76 6 16 18 0 - t. 5' Topsoil 1.5- 5.5' Sandy silty fill - SM 290 square feet per bedroom 5.5-16' Moderately well graded sand - SW 120 square feet per bedroom Total Depth = 16 feet No groundwater encountered. AVERAGE SQUARE FEET PER BEDROOM = 156 visual (No percolation test performed due to SW material) Date Net Time Depth Net Drop minute NORTH~,~S~ EXPLORATION SERVICES, INC. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0joe-- ,~ Y~ -/~'- % HAA # 1. GENERAL INFORMATION Complete legal description 'HALF Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~" ''~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER, 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 application 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 disposat system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm ~ ~,~/¢~-~4 ~uc'~/-L~t-¢-¢¢ ~-~ Address ~o~ I,¢/ /.5-/-¢/ H' ~-~ Engineer's signature ~'~.. ~-:~]L~.,{,L-~-(?-¢~'~'') Date Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: By: Additional Comments 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 ragistered 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. 72-025 (Rev, 1/91) Back MOA ~r21 t~UNICm^U~ 0,'= mVmONM~/a.~VlC~S D~ ON Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Se~ices Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-47~ Health Authority Approval Checklist LegalDescription: T~gZ)])~ ]'*I/:J. LF A'(--i~l~-, ParcelI.D.: A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date completed Casedto Date of test Static water level If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Well production g.p.m. ~'. LC)) g.p.m. WATER SAMPLE RESULTS: Coliform N P Nitrate Date or sample: ~ /~'"]/t~ '7 B. SEPTIC/HOLDING TANK DATA N~A Date installed Tank size ~N~ ~) Other bacteria Collected by: Number of Compartments __ Cleanouts (Y/N)__ Foundation cleanout(Y/N) Depression (Y/N) High water alarm (Y/N) Date of Pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil ra~tin~g~(g.p.d./fl2 or ft2flodrm)' System type Length Width Gravel thickness below pipe Total depth Effective absorption area Date of adequacy test Monitoring Tube present(Y/N) Results (Pass/Fail) Depression over field (Y/N) __ For bedrooms Fluid depth in absorption field before test (in.); Immediately alter gal. water added (in.): Fluid depth (ins.) Minutes later: Absorption rate = g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date O. LIFT STATION ~,~/ /A Date installed Size in gallons Manhole/Access (Y/N) "Primp on' level at* "Pnmp off" level at* High water alarm level at* *Datunl Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot }~4//fi~ Absorption field on lot ~d/tl:X- Pnblie sewer main ~ ,~t ~P ~ Sewer/septic service line ; On adjacent lots ; On adjacent lots Pnblic sewer manhole/clealmnt Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorptiol~ field t q ~'~ Water main/service line Surface water/drainage Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Water main/service line Snrface water Driveway, parking/vehicle storage area Cnrtain drain Wells on adjacent lots Property line F. ENGINEER'S CERTIFICATION :' ' I certify that 1 have determined thrufield inspections and review of Municipal ,'fcq!'d} that ttib abov~ 'systems are, in conformance with ~IOA H~ guidelines in effect on this date. · / Date t q 7 HAAF¢o $ 3 /5~D Date o£ Payment "~ .//_]/~,/77 , Receipt Number ~ ~ '7~\~'~ Rev. 8/95 DSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number ZUL-02-1997 16:25 CT&E ESI ANCHORAGE ~t~_~ CT&E Environmental Se~i~es Inc. 90?5615301 P.0~/03 CT&E Ref,# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSI~ 973370001 Tobben Sp~kla~d P,E. Todd's Half Aree Todd's Half Acre Drintdng Water Smnple Remarks: Client PO# Printed Date/Time 07/02/97 13:45 Collected Date/Time 06/27/97 08:30 Received Date/Time 06/27/97 08:4.5 Technical Director: Stephen C. Ede Resutts 0,100 U 0,100 mg/k SN18 6500-NO3F 10 ~.~ 0 co[/lOOmL $M18 9222B Init 07/24/97 THU 08:13 FAX 907 562 0824 A'NWU ENGINEERING January 27, 1984 ~]002 43? E Street Suite 2110 : Anchorage AK 99501 ' :':: ns ~nd .spe¢tfi~at'tons for.the subject pro'j~ct. · horizontal separation distances '' 'sewer horizontal separation to.2'5.ft.' · separat'ion to SO'i~t~i' ' separation t6iSS',.:ft, ' 11' to sewer separat.i-~n to '&$:'~E~' · 'for the i'tems..:Wi'th ~h'iCh:. ~s the-permit requ~r&~'. . · .-:.,.. ef'sewe~age systems. will necessitate.~he Submi~sq~ ' ' ~:'.: ~ill Cohsequently mandate that .a'.profes- .. ~f this project so as to be ab'ie gement for this inspection ~ork is 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. Location: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "¢" Street, Anchorage, Alaska 99503 274-4561 Date Received July 26, 1976 Time Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR v,ao Lomas and Nettleton Company 4449 Business Park Boulevard William R. Todd Box 4616 Phone: 274-7661 Phone: 344-7167/272-8551 T12N R4W Section 11 S½ NW~ NW¼ 3706 West 78th Avenue Single Family No. of bedrooms 4 5. Type of facility to be inspected 6. Well Data: Individual A. Type C. Construction Sewage Disposal System: A., Installed ~/3t/~ C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area B. Depth D. Bacterial Analysis On-site System - 10 - 15 years old. B. Installer 2. Manufacturer 2. Material E. Disposal Field: Total length of lines , Absorption area Other contamination , Absorption area Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line , Sewer Lines EQ-034 (1/74) Page 1 of two pages Pa~e 2 of two pages - ReL..~.st for Approval of Individual ~.jer & Water Facilities Legal Descr~iption T12N R4W Section 11 S~ NW~ NW~ Comments Approved ~ [- Disapproved Date Approval iValid for one year from date signed Greater Anchorage Area Borough, Department of Environmental DIAGRAM OF SYSTEM Quality certify that the information Contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION JUL 2 6 1976 .RECEIVED 1. Type of Inspection: CM RO.__ ~ FHA CONV__ Property Owner: w4 1 1 ~ am ~- Box 4616 Mailing Address: Day Phone: 344-7.].67/272-8551 3. Name of Buyer: Denis O'Brien Mailing Address: 7048 Timothy Day Phone: 4. Name of Lending Institution: The T.omas & Nettl~ton Co. Mailing Address: 4449 Business Park Blvd. 5. Name of Realtor or Agent: M~ry P. McNutt Mailing Address: 815 W. 5th Phone:. 6. Legal Description: S~, ~W ~, NW ¼¢ Sec 11, T 12~q, R4Wo 344-0881 Phone:274-7661 272-6494 S.M. Alaska Location: 3706 W 78th, Anchoraqe 7. Type of Facility to be Inspected: Home 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 296 Feet 9. Sewage Disposal System · Type of System: Public Utility If Individual, date of installation 10 to 15 yrs No. Bdrms..4 Individual X Individual (on-site). X 72-003(3/76)