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HomeMy WebLinkAboutWICKLUND LT 24H GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time Rf Ins ?o. Date oi~q~spection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. 5. 6. Location: Type of facility to be inspected Well Data: A. Type,S. Phone: /-/~?., ~ 7 Phone: No. of bedrooms B. Depth ~ ~-~ C. Construction ~//~/~.. D. Bacterial Analysis Sewage Disposal System~ , .~ , A. nstalled nstaller C. Septic Tank: 1. Size ~ 2. Manufacturer D. Seepage Pit: 1. Absorption Area .-,---- 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank ~ , Absorption area--/~:-~% Sewer Lines Nearest lot line~_~'~contamination B. Foundation to septic tank ',-~ Absorption area -~ C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~.~st for Approval of Individual ~.~Jer & Water Facilities Legal Description Approved Disapproved Date Approval Valid for one year from date signed Greater Anchorage Ar~a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 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) GREATER ANCHOR~G~ AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL 3500 TUDOR ROAD ANCHORAGE, ALASKA 279-8686 REQUEST FOR APPROVAL INDIVIDUAL SEWER AND WATER FOR APPROVAL REQUESTED BY: ADDRESS: PHONE: QUALITY 99507 DATE RECEIVED: //-.-P~ ~/ INSPECT: //- TIME: -j~) ] ~'7 ~ ' 2. PROPERTY OWNER: 3. LEGAL DESCRIPTION: 4. TYPE FACILITY TO BE NUMBER OF BEDROOMS: 5. WELL DATA: A. TYPE B. DEPTH C. SIZE D. E. 6. SEWAGE INSPECTED: /, '~'~ ~- PHONE: STREET: ~/~)7 /D,/2 ~/" CONSTRUCTION BACTERIAL ANALYSIS DISPOSAL SYSTEM: ?/ ,/ SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON 1. SIZE /2JO 2. A G E /2:f~(V? o ~e?/7 BACK) 3. MANUFACTURER 4. INSTALLER APPROVAL REQUEST FOR SEWER PAGE TWO & WATER FACILITIES B. SEEPAGE PIT 1. SIZE 2. LINING lC. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT C. WELL TO SEWER LINE D. E. F. G. H. WELL TO PROPERTY LINE WELL TO OTHER POSSIBLE CONTAMINATION '~- FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEEPAGE PIT TO PROPERTY LINE 8. COMMENTS:' PROVED: DATE: /~-L~-~'~! DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY FHA Form 2573 Rev. July 1958 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART L--TO BE COMPLETED BY FHA Form Approved Budgel Bureau No. 63-R296.S INSURING OFFICE MORTGAGOR OR SPONSOR Richard Lee & Rebecca Rose SUBDIVISION NAME MORTGAGEE SERIAL NO. VA #175-690 pIPROPERT¥ ADDRESS 4~07 Piper Street, Anchorage, Alaska BLOCK NO. , o£ Wickltmd TOTAL NUMBBR: LIVING UNITS BEDROOMS WATER SUPPLY BYz ~ Public system SEWAGE DISPOSAL BYz [] Public system BASEMENT [] Yes [] No ] New installation --]Community system "-]Community system Can attic or other area be mad~o E~-(J addlt{onql bedrOoms? (If Yes, how many{t) SYSTEM DESIGNED FOR PART II.rata BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [] State [] County [] Local Department of Health that this individual water-supply system [~ is [] is not satisfactory as a domestic water supply for the subject property. It is the opinion of the [] State [] County [] Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: fi ctonl and Cannot be expected to function satisfactorily [] Can be expected to function satis a ' y, ~ [] ' is not likely to creatg'~anitarv condition ~'~9 spaces provided. ' health authority. PART III.mFOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-supply system be considered [] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. DATE SIGNATURF HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ]CHIEF ARCHITFCT DEPUTY FOR CHIEF ARCHITECT FHA Form 25~ Rev. July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT consists of [] Septic tank. [] Cesspool. Septic Tank: Distance from well,__.feel. Material Number of compartments Total liqukl capacity, galhms. Capacity inlet compartment,_ Inside length, feet. Blside widtfi, f~et. Liquid depth~ feet. Cesspool: Distance from: WeU feet; foundation, feet; ucarest lot line at [] front1 [] side, [] real Inside diameler, feet. Depth,. feet. Liquid capacity gallons. Lining material SlCONOARY TREATMENT consists of [] Tile disposal field. [] Seepage pits. Other gallons. Tile Disposal Field: Distance from: Well1 T~tal length of file lines, Trench width Length of each line,._ feet; foundation, feet; nearest lot line at [] front, [] side, [] rear,, feet. feet. Number of lines, Distance between lines, feet. inches. Total effective absorption area in bottom of trenches square feet. feet. Depth, top of tile to finish grade, inches. Type of filter material: [] Gravel. [] Broken stone. Other. Depth of filter material beneath tire, inches. Depth of filter material over tile, _inches. Seepage Pits: Number of pits__ . . Outside diameter, feet. Depth, feet. Lining material Distance from: Well, feet; building foundafionl feet; nearest lot line at [] front, [] side, [] rear, feet. Inspection made by: [] State. [] County. [] Local Health Authority. Inspected by. Date of inspecti.n 19 REPORT OF INSPECTION~INDIVIDUAL WATER-SUPPLY SYSTEM Properties in neighborhood [] are [] are not being developed with both individual water-supply and sewage-disposal systems. kot size: feet wide,___ feet deep. Dwelling set back from front property line,, feet. Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Distance of well from: Building founda6on, cast iron sewer, seepage pit, .feet; cesspool, inches. Total depth, feet; nearest lot line at [] front, [] side, [] rear,__ fbet; septic tank, feet; disposal field, feet; other sources of possible pollution, ~'eet. Depth of easing, .gallons per minute. 19 feet. Type of casing,. feet. Approximate yield, Approximate depth to pumping level of water in well, Sealed watertight to depth of feet. Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrele. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No. Pump~ [] Shallow well. [] Deep well. Length of drop pipe, feet. Pump capacity, i~>cated in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] P~lmp pit. Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No. Tylx. nf storage: [] Pressure, [] Gravity. Capacity,. gallons. Has bacteriological examination of water been made? [] Yes. [] No, If answer is "yes,7 give date__. Quality of water [] is [] is not satisfactory for human consumption. Installation [] does [] does not comply with approved exhibits, if any. Inspection made by: [] State. [] County. [] Local Health Authority. Inspected by Date of inspection , 19 gallons per miuute. feet; / /j 'f Vo~oran~ ~in~.st~ation [,~'V f P.O. Ilex I~gD [ x / ~chorage, Al~ka 99501 t~ickl~d S~vtsion, 4507 Piper ,in inspection of the subject pr~mises showed that ~ater is supplied via a drilled well ~id~ is 62' deep. A water sample from the well w~ satisfactoW, ~e sewer system com;istod o~f a..'.mptic tat)k and a seepage pit both of which v;erc located ~h~n the protectiVe radius allowed for a sea,-public well. To receive our a~)roval, the SOl)tic tm~k ~u~t )~ moved to at least 80' £rom tho ~11 ~md the so,page pit ~mst be aOvcd to at lo,mt 120' from the wello '~e system at p~'esent is in ~rlolation of the Ala~ka z~dmini~trative Code, Titl~ 7. t)ivi~i~ 1, Qmpter 2, Subdmpter 1~ Water Sul~ply. ~e sewo~ m~d water facility should ~ ~gra~d to ~met the State Code · Sincerely, CLIFFORD P. JUDKINS, R.S. Administrative Director JRL:~ cc: b~tcalf Rcalty BY: John R~ Lee, Sanitarian Nat e zx.3knalys is: a. Baci-e~ial b, Detergent data: a. Type _. / ¢. Casing Size /.~ ~/ . d, Distance fPom well existing or pPoposed: ~/~ 1. SeweP line, , 2, Septic tank 3, Seepaga P~opemty Lina Othep sourcem of poss~%e contamination houses, bapn~ drainage ditch, etc. Sewagn~ disposal system. a. Age of syste~ ;/, , b. Septic tank capacity in gallons c. Name of septic tank manufactu~ 1. If "home made" show diagram on reverse Side of this fomm. Disposal field or seepgge pit size and type 1. Distance to pmoper~y, line to house foundation .e. Perco~ati~ 'Test ~r~ suits ~~_,~ Uf. 'Percolation Test performed by ........... ~ . se the reverse,Side of this forTM to show dlafPam. Diagra~ should include he ~oilowing information: ~moperty lines;.w~ll location, house location, %:t~rt~c tank locatlon, dlsposa~ area location, location of percolation test, a~.,~dtrection of ground slope. 9. The ~f~orl~atl~n .on this form is true and compeer to the best of my knowledge. Signature of Applicant T~0~ BE FILLED OUT BY HEALTH DEPARTMENT PE~$OH,NEL Date Szgned ~e above described sanitary facilities are hereby approved, subjec~ to the .......... ~l~w~n~ con~ons: Conditions: The above described sanitary facilities ~re disapproved for the following -- Approval is valid for one year following ~he date of approval. ~ CPJ:cw June 16, 1970 Sommerville Well Drilling Star Rt. A, Box 1773 Anchorage, Alaska State of Alaska Department of Health and Welfare MacKay Building Anchorage, Alaska 99501 Gentlemen: This is to advise that we have been contracted by Mrs. Phyllis Mayberry to drill a well on her property at 4507 Piper Street, Anchorage. The well will be completed within the next four weeks. If other information is needed, please let us know. Sincerely yours, SOMMERVILLE WELL DRILLING dv cc: Mrs. Phyllis Mayberry The well is to be drilled at the back of the lot~ 112 ft from the cesspool and 72 ft from the septic tank. July 1~ 1970 Veterans' Ach~inistration Anchorage, Alaska Subjects Sewer system for 4S07 Piper Street Dear Sirs Our Department has been contacted by Sommerville Well Drilling Company and he is going to drill a well at the subject residence in compliance with local cedes, The sewer system as related previously consists o£ a septic tank and seepage pit and meets with this ~partmen~'s approval. ~pon completion o£ the well, a safe supply o£ potable water should be assured. Sincerely, CLIFFORD P, J~)KINS, R.S, Administrative Director JRL:Jt John R. Lee Sanitarian GReATeR ANCHORAGE AREA BOROUGB~ HE^LIH DEPARTbiENT 327 EAG~ ST~ET ~, AL~ 99501 279-2511 TO WHO~ IT ¥~Y CONCERN: SUBJECT: Resubdivision of Lot 24C August 14, 1970 An agreement has been made that shall limit d~velopm~nt of the s~bject land until public sewer or water is available. This agreement is as follows: A. Single family on-site sewer and water systems shall be installed on the following lots only: LOT 24H The remaining lots in this Subdivision shall only be developed when public sewer or water becomes available. Should either of these utilities become available, the owners of these properties shall contact this Department to affect a new agreement prior to development. This agreement is signed and agreed to by beth the Greater Anchorage Area Borough Health Department and (Reah & Delbert R. Niblett ), current owner of the subject land. Prbpert? O~ner This is to certify that on the (lst) day of (September. 197~ .before me, the under- signed Notary Public in and for the State of Alaska, duly commss~oned and sworn, personally appeared (Delbert R. Niblett & Reah Niblett ], known to me and to me known to be the individuals named in and who executed the foregoing instrdment, and acknowledged to me, earl1 for himself and not for the other, that ~Jley signed and sealed the sam~ as their voluntary act and deed for the uses and purposes therein set forth. IN WITNPSS ~EP~OF, I have hereto set my hand and official seal the day and year ~_'~st above written. Notary' Public ~[fi'and -For Alask~ ~ ~ Commission Expires. ~/24/71. 770 / GREATER .J21C , p 104 West l~orthern Lights Boulevard Anchorage, Alaska 99503 S~- 2094 .... " Date; 8/4/70 Engineer ~ e~ ~ CI;i~F ;fgCtiO~GE: Fire iIarshat F~th Dep3~f~fl~ ~ ~ '~ ~nic,~pal Light & Po*~er Department Sand Lake Fire De~)~me. nt ~ ~ub'iic Works Dapar'~ment School District '~?~/~' ~ T~lephona Str, ee~ Flames ~'°~4~4 Traffic Engineer Tax ~sessor '~ . I~ater Utility . . GAB Telecom~nications~ Inc. 14atanuska Electric ~soclation Hatanuska Telephone ~ociatiou Assistant Superintendent of 14ails Status:Final BOROUGH: Alaska Department of Highways ~laska Railroad Anchorage Nanural Gas Corp. Central Alaska Utilities Chugach Electric Association Re: ~{%iR%~I~JM~X / Resubdivision Description of Property: See attached plat. / ~21~I~i~]IiRLK Emery Mayberry Gentlemen: Petition has been received by the Greater Anchorage Area Borough P!annin~ and Zoo%lng Co,mission for the pro~osedresubdivision of subject property. Attached is a copy of ~%s proposed plat. Will you please submit your comments in writing~ specifying any easements or other requirements that your department or agency ~ay need. If we do not hear frem you by ,8~_21/7Q .__, we will assume that you do not wish to submit any co~nts. If you have no further use for the attached print, please return it ~lth your comments. Planning Department Enclosure ROAD E. 46th AVE. LE6END ~ 2. £SE/DLL VICINIT~f MAP CERTIFICATE OF OWNERSHIP & DEDiCATiON: NOTARYS ACKNOWLEDGEMENT Subscribed and sworn ~o me this r~ day of .PLAT APPROVAL Plat approved by the Municipa} platting outhority this " - DTI002226 It. AT OF WICKLUND SUBDIVISION ' mon~Jmenl~ oil of~er monume~s, and Iote~ hove ~ .~ ~ ADDTN ~ l, LOT 24K ' · ',~E?:~:~ ..~. ENGINEERING LEGEND: CERTIFICATE OF OWNERSHIp AND DEDICATION DTI002228 WICKLUND SUBDIVISION RESUBDIVI$10N OF LOT 24 C NE~/4 SECTION 35, TISN, R3W, SM, ALASKA 1970-1618._ TUDOR RD. PLAT APPROVAL Plot opproved by the P/offing Authority thls~_day of June ,1978. AVE. DEED O~ i~U~T B~,V£FICI,4~IE$ ..... ' DT1002227 C'/C~' TR A 150 WIC~UND SUBD. ~DDN. I ~T ~L fiND WICKLUND SUBD. LOT ~M A RESUBD~tSION ~ LOT 24K WICKLUND SUBDIVISION ~ E~GI~ERf AN~ORA~. ALASKA 104-48 Sm ~Xs PSS2A 8, ?7-272 for r~c. bdr~'.