HomeMy WebLinkAboutTHE VILLAGES TIDE VIEW LT 6
-. ~' ! ( ~ 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
D,STA.CETO, iW.'l
L q, capacity i~ gallons
I O ~) 0 IF HOME.DE:
Manufacturer
Inside length Width
Founcla~ (~) '1~
Total length of~s~
Material beneath tile
Length W~dth Depth
Material
Type of crib Crib diameter Crib depth
Well Building foundation
DISTANCE TO:
DISTANCE TO: Building foundation Sewer line
Nearest I~t(~ne~,
Trench W~:~ inches
inches
NO. OF BEDR~MS
No, of constants
Liquid depth
PERMIT NO.
Liquid capacity in gallons
?
Distance between lines
Total effective absorption area
Nearest lot line
D~stance to lot line PERMIT NO.
Septic Sank Absorption area(s)
OTHER
PiPE Mi~E R I A~Sq
SOl L TEST RATINO
REMARKS
72-O13 (Rev. 3/78)
DATE LEGAL
PERItlT NO. ( ?.~OGS? )
APPLICANT KENNETH M HAYSON
LOCATIOH VILLAGES SCEHIC PARKI48Y
LEGAL L6 VILLAGES TIkE VIEH S?D
DEPARTr'IENT" ¢--"' ~'HEALTH AN[~ ENVIRONMENTAL / ~'OTECTIO.N
82:5 'L' STREET, RHCHOR~GE, ~F~::. 995Etl
264-4728
SEI--IER PEAr4 ! T
5'9£11 E 6TH AVE SPA 5-?·
LOT SIZE
TYPE OF SOIL FIBSORF'TI,.ON SYSTEM IS: TRE~NCH
f'IR>,'IHUM NUHBER OF BEDROOHs = 3. SOIL RATING (50. FT/BR)=1¢.~' ~-~,
THE F:EI,'~UIRED SIZE OF THE SOIL RBSO~F'TION _q~r'STEl'l IS;
E:,EF'TH= 12 LEt,4 G fl-I = 24. GRR'..-'EL DEPTH=-= 8
THE LENGTH DIHENSION IS THE LENGTH (IN FEET> OF THE TREHCH OF: DRRINFIEL[:,.
THE DEPTH OF R TRENCH .OF: PIT IS THE DISTRtICE BETHEEN THE SURFACE OF THE
GROUt'iL RN[~ THE BOTTOH OF THE EXCAVATION (IH' FEET>.
THERE IS NO SET' H.I[:,TH FOR TRENCHES.
THE GRAVEL DEPTH IS THE HIHIHUH DEPTH OF GRFIVEL BETHEEN THE OUTFRLL PIPE
AND THE E:OTTOH OF. THE E.XCRVATION (IN FEET>.
F-:Eg'.L' I F.:EIC, SEPT I C TRI'4t::: S I ZE= '1 E~E~8 ~3F4LLOt'-4S
F'ERHIT APPLICFIHT HFiS 'THE RESPONSIBILITY TO INFORM THIS DEF'AF:TMEHT DUF. ItIG THE
INSTALLATION INSPECTIOHS OF ANY HELLS ADJACENT TO. THIS F'ROF'ERT~r' RHD THE
NUHBER OF RESIDENCES THAT THE HELL HILL SERVE.
E:FpZ:KFILLING OF ANY SVSTEH HITHOLIT FINAL INSPECTION AND AF'PRO\.'FIL B'¢ THIS
DEPARTMENT HILL BE SUBJECT TO PROSECUTION.
HIHIHUH DISTANCE BETHEEH R HELL AND RN~r' OtJ-SITE SEI.~RGE DISF'OSRL S'¢STEH IS
10£~ FEET FOF: R PRIVATE HELL OR 150 TO 2CEo"FEET FROH~R PUBLIC 14ELL DEPENDING
UPOH THE TYRE OF PUBLIC HELL
OTHER REQUIREr.lENTS HR'¢ RF'PLM. SF'ECIFICATIOHS RHD CONSTRUCTION DIRGRRHS ARE
ACAILRE:LE TO INSURE PROPER INSTRLLRTIOH.
I CERTIFY THAT '*'* · ''
1: I Rf'l FAHILIAR HITH THE REQUIREMENTS FOR ON--SIT~, SEHER~'AHE:,.'HELLS AS SET
FORTH E:Y THE HUNIClF'RLITY.OF ANCHORAGE.~ L
2: I HILL INSTALL THE S'Y'ST~';'I IN ACCORDANCE H~TH THE' CODES.
-~.: I UNDERSTAND THAT THE .OH-SITE SEHER SYSTEr'I HI-3'~' RE~'.,LIIRE ENLARGEMENT IF THE
RESIDENCE IS F:EHODELED:TO .INCLUDE MORE THAN ~ BEDROOHS.
S I GNED: __
RFPLICAHT KENHETH t,1 HR.r_,ON _
I-,1L. Ir-.I :I I.'~'~ F-'Ftl_ .'[ T"r' I':~F~
[~EPRRTPIEHT~ HERLTH ,SND EN'v'I RC,iI:'IEHTRI.~"~ROTEC:T I ON
~.~ STF:EET, FffII:F(ORRGE, RK. $'
F'ERIqlT IlO. ( ) '
PL I CANT ~.(2 '"
CPE OF SOIL RE:SORBTIC~N ~'¢STEPI IS:
AX IHLIH MLIMBER OF E:EDPOOrlS = 'c
E. OIL RFtTIHI', (SQ FT/E:R)= x,.;-~
REQUIRED SIZE OF THE SOIl. Re. SORPTIC~[I E.Y_~TEI'I I~:
SQUARE FEET
THE LENGTH DIMENSION IS THE LEHGTH (it~ FEET> OF THE TREHCH OR ORRIHFIELD.
THE DEP.TH OF R TREHCH OR PI~ IS THE DISTANCE E:ETNEEH THE SLmRFRCE OF THE
QROLIN[) R~l[) THE BOTTOM OF THE EXCR'¢RTIOH (IH FEET>.
THERE I~ HO SET HIDTH FOR TREI4CHE5.
THE GRRVEL DEPTH IS THE MINIHLIpI DEPTH OF GRRVEL BETHEEN THE OLITFFiLL PIPE
AMD THE BOTTOM OF THE EXCRVRTIOt4 (IN FEET).
ERI'IlT RPPLICRMT HR$ THE RESPOftSIP, ILIT~r' TO IIIFOF:i'1 THIS DEPRF:THEtlT DURIHQ THE
4$TRLLFITIOI'I IHSF'ECTIOIqS OF Rtl',' IdELLS RDJRCENT TO THIS PROPERTY END THE
JMBER OF EESIDEI'ICES THRT THE HELL MILL SERVE.
----- Tl-lg--m ( 2 ) ! I'..iSF'EL-:.T T m31'45 FIRE F:EC'4LI T
~CKFILLING OF Rl'l¥ SYSTEM t4ITHOLIT FINAL INSPECTIOH I~HD RFmF'ROVRL B~' THIS
--PflRTFIEHT HILL BE SUBJECT TO F'EO-C, ECUTION.
ItlIHUH DISTFIHCE E:ETHEEN R HELL END Ri'lM OH-~ITE SEt. IRGE DISPOSRL ~MSTEM IS
~ FEET FO~ R F'RIVRTE HELL; OR
50 TO 2(~0 FEET FROM R F'UE:L[C HELL DEPENDING LIPOH THE TYPE OF PUBLIC HELL
ELL LOGS ERE REQUIRED RHD MLIST BE RETURHED TO THE DEPRRTHEHT HITHIN 30 DRYS
= THE HELL COHPLETIOH.
THEE REC~UIREPIENT~ MRS' RPPL¥. SPECIFICRTIOHS AHf) COHSTRUCTION DIRGRRM3 ERE
¢RILRBLE TO IHSURE PROPER IrlSTRLLRTION.
PERt.1 I T E,-~:F· I RE-__---. [:.EL-:Er-IBE~' _'~.:t. .
iCERT IF¥ THRT
: I RM FFIMILIRE I4ITH THE REOUIREHEHTS FOR OH-SITE SEI.IERS RHD NELLS RS SET
.iRTH E:Y THE HUh/ICIPRLITY OF R,qCHORRGE.
: I NILL INSTRLL THE SYS'f'Er.I Itl RCCORDRHCE HITH THE CODES.
: I UNDER.C-,TRND THRT TI4E OH-SITE SEHEE SYSTEII HAY REQUIRE EHLARGEMENT IF THE
~SIDENCE IS REMODELED TO INCLUDE HORE TH~,q ] BEDROOHS
V3. 2
--'CONSTRUCTION TEST L~B
"One Test is worth a Thousand Opinions"
2204 Cleveland Anchorage, Alaska 99503 277-0231
Perfonned for Ken Havson
Legal Description: Lot 6 ..Block
This Form reports: SOILS TEST yes
Date Performed 10/25/79
Subdivision Villages, Tide View
PERCOLATION TEST
Depth
Feet
6"
Soil Characteristics
Reddish silt
Brown Sandy Gravel
(GW)
Bottom of Test Hole
~'~s Ground ~';ater Encountered
If YES, What depth?
No
Reading I Date
Gross TLme
Net TLme
Depth to H20
Net Drainage
Percolation Rate
Proposed Installation:
Depth of Inlet
CO~4ENTS: 125 s~uare feet drainaqe
Test Performed by f~~
D. Paul
Minute
SEEPAGE PIT DRAIN FIELD
Depth to Bottom of Pit or Trench
area Der bedroom.
Data Certified By: Construction Test Lab
Date : 10/26/79
December 29, 1978
~771045
Tom Jungwirth
1105 West 11th Avenue
Anchorage, Alaska 99501
SubJectz Lot 6 Villages Tideview Su~ivision
A permit issued by this department for well and/or
sewer system has expired.
Permits are issued on a calendar year basis, as stated
on the permit, by authority of Municipal ordinance.
If you have drilled the well, a well log should be
sent to this department to document the installation
date.
If there are any further questions, please contact
this office~at 264-4720.
Sincerely,
Les N. Buchholz, R.S.
Senior Environmental Specialist
u / Jw
encz copy of permit
PERMIT HO.
r~,_'N ~: C 'r _?.~.. L I TY OF F~ r.iC_.H~_..F~ i::1 GE
DEPARTMENT [ .HEflLTH nj.iD EN./IRONMEJ,-~TRL ! ~TECTION
APPLICRNT
LOCRTION
LEGRL
825 'L
~ELL I--IreD
( ??1045 )
TOM JUJ,.,IGWIRTH
TH~ VILLHGES
L6 VILLRGES TIDEVIEW SUB
STREET, ANCHORAGE, PK. ~
264-4720
O'~--S I TE SEWER PE~-.~ I T
1105 H IITH 277 4840
~_~T SIZE 67000 SQURRE PEEl
TYPE OF SOIL RESORPTION SYSTEM IS: TREJ,-,ICH
MRXIMUM Nur'IBER OF BEDROOMS = ~ SOIL RR~I~G (SD FT?BR)= 150
THE REQUIRED SIZE OF THE SOIL RESORPTION SYST~c~:
DEPTH= 11 LE[~GTH=--.J~R GRR%~EL DEPTH=
THE LENGTH DIHENSION IS THE LEJ,,IGTH <IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEM THE SURFRCE OF THE
GROLIJ,.,ID AJ,',ID THE BOTTOM OF THE EXCRVRTION~FEET>.
THERE I~ NO SET WIDTH FOR TRENCHES. / , ,,
THE GRR~EL DEPTH I~ THE.MI?IMUrl DEPTH ~GRRvEL BETWEEN THE OUTFRLL PIPE
. RND THE BOTTOM OF THE E>,CA./RTION
FcEQLIIRED SEPTIC TR~IZE= ~ GRLLO[~S
/,
PRCKRGE PLR~T C~PT
R PRCKRGE PLRNT MRY BE [NSTRLLED RT THE PERM[TTEE'S OPTION SUBJECT TO THE
FOLLOWING CONDITIONS:
I. EITHER R CLASS I OR II NSF RPPP~ED PLRNT MRY BE INSTRLLED.
2. R CONTINUOU~ MRIH~ENRNCE RGRE~Et~ I~ REQUIRED.. IF R MRIHTENRNCE
RGREEMENT IS NOT kEPT CURREHT ~J MR~ BE REQUIRED TO ENLRRGE THE SOIL
_
T~WO ~ ~ ~ ~ ~P~ · O~W~ ~R~ R~U · ~ED
BSCKFILLING,0F 8NY SYSTEM HITHOUT~L INSPECTION 8ND 8PPROYSL BY THIS
DEPRRTMEHT tIILL BE SUBJECT TO PR~TION.
WELL LOGS PRE REQUIRED RtlD MU~T/B~ETURNED TO THE DEPRRTMENT WITHIN
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MRY RPP,LY. ISPE~IFICRTION5 RND CONSTRUCTION DIRGRRr,I~ PRE
RYRILRBLE TO I,.,~URE PROPER~~TIQN.
PERt-1 I T EXP I RE~ECEr~BER
I CERTIFY THRT
1: I AM FRMILIRR WITH THE REQUIREMENTS FOR OJ,.,I-SITE SEWERS AND WELLS RS SET
FORTH E:Y THE MUNICIPRLITY OF RJ,,ICHORRGE.
2: I WILL INSTRLL THE SYSTEH IN RCCORDRNCE WITH THE CODES.
~: I UJ,.,IDERSTRND THRT THE OJ,.,I-SITE SEHER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
GARY PLAYER
VENTURES
CONSULTING GEOLOGIST
· PHONE 344-707!
SOILS LOG
Date
Soil Type Water Level
Remarks
0
16
18 -
2O
Total Depth of Excavation lo }~terial at Total Depth
Groundwater
Depth, ii Reached__
Bedrock
~f~Not Reached
Depth, if Reached
Classification Method
~Vtsual
( ) Sieve Analysis
()
Cary.F. Player, Consulting Geologist
WELL CONSTRDCTION LaD
Drllll,s Co. 'v'~1,nP9 T')t'~IZ~n~ ~ 'l;~ter~r~5~ '
OrlllorYerno~ ~-,~ ~Towell Type of rlgCa'blO'''tO0'!
Well ownerT01~ ,J"Tk?A~wlrth
Well location: (address & lesal description) ~.C)t 6t ~'~0 ¥111a§o~!
Tide ViwSub.
· Depth of well -')~'J_O ft. Cn,l,g: depth 34c ft. d~,m. ~ I,.
Static water ~.vel 20~ ft. (~. below) land turfJce. Oatel--20--~
Flfllth of well: (open-end. ~~~
Oescrlbe Intervalo end Ilze:
W~II yield tested by (pumping. bailing, air) at
Yor houri with .ft. of drawdown from otatlc level.
Depth below lend
surface Iff feet
USGS no.
Date well completed
Nearest community
Location oketch of remarks
Bailed well down and
~al/ml.. r~cover~ of well
1~320 gallons per day
DRILLER'S WATERfAL LOG
Dive description ef otrato penetrated
(size of material, cclero hardness ef drilling, and water content)
0 to 12
12 ,n 15
tn 32
to 190
190 to 200
tO
tO
to
tO
~0
to
bro~m gravely till
gravely brown till with water
s~it~ gray clay ~:ith gravel
bedrock l~rova in color
gray-blmck rock
grayish conglomerate rock
gray-blac~ rock '
1~ ~oepagc
· 182~ .~ ~.nn
MUNICIPALITY OF A~CHORAGE ,MUNrCIPALh-Y CF ANCHOP,.AGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOII,~T. O;t I. :ALTt-I &
825 L S~r~t -A~¢~. Ala~, 99501 E~ ~'/120N!.~NTAL P~OT~CTIO~..~
i:NvIROa~iENTAL ENGINEEaIN~ DIVISION SEP - ?
Telephone 2644720
.,:O.,E.',',=o. ^,'P.OV,.,:o,:,,,,oi_v,,::,u,,,. w..,',',:. ^.,:,
DIRECTIONS: Complete ell parts on page 1. Incomplet~ reque~t~ will not be proofread. Please allow ~ 10I d~ys for
I. PROP~.RTY OWNER PHONE
P"ONE
2. BUYER PHONE
MAILING ADDRESS
~. LENDING INSTITUTION
MAILING ADDRESS
4. REALTOR/AGENT
MAILING ADDRESS
PHONE
PHONE
E. LEGAL DESCRIPTION
STREET LOCATION
'~'~- ~I~A~
~. TYPE OF R~IDENCE
SINGLE FAMILY
MULTIPLE FAMILY
7. WATER SU~LY
INDIVIDUAL*
COMMUNITY
PUBLIC UTILITY
INblVIDUA~ON-SITE"
PUBLIC UTILITY
NUMBER OF I~EDROOM~
I--] One [] Four [] Other
I--I Two [] Five
[] Three [] Six
· ATFACH WEI'L LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach Io~ if available.)
"If individual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST AccoMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
724)10(3/78)
TIME
DATE
INSPECTOR
DIRECTIONS:
~ THIS SIDE FOR OFFICIAL USE ONLY "
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME
DATE DATE
INSPECTOR INSPECTOR
1. TYPE OF RESIDENCE -
[] SINGLE FAMILY
[] MULTIPLE FAMILY
[] ONE
[] TWO
2o WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTI LITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
[] INDIVI DUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]Septic Tank or [] Holding Tank
Size:. If Tank is homemade SOILS RATING
give dimensions: ' ·
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
PERMIT NUMBER
DATEINSTALLED
INSTALLER
4. DISTANCES
WELLTO:
Absorption Area to nearest Lot Line
Sept*c/Holding Tank
COMMENTS
. , NUMBER OF BEDROOMS
[] THREE '[] FIVE
[] FOUR [] SIX
[] OTHER
IAbsorption Area is., Line I Nearest Lot Line
DATE
LEGAL DESCRIPTION
[] APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must accon~pany certificate)
[~DISAPPROVED
72-010 (Rev. 3/78)