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Home My WebLink AboutSAND LAKE #2 BLK 2 LT 19i MUNICIPALITY OF ANCHORAGE ra' 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 G� i //' ' �L �, PHONE NEW p s�C� i' �.�' �/ j--7 ❑UPGRADE MAILING ADDRESS ji 8 L LEGAL DESCRIPTION `� - L--.;ake2 Sak 0 LOCATION �F ; 111 b) J') e NO. OF BEDROOMS U y DISTANCE TO: Welli Absorption area I t Dwelling PERMIT NO. R l)y\ M< Q LU Manufacturer _ Material No. of compartments Liq. capacity in_galns Inside length IF HOMEMADE: Width Liquid -depth z DISTANCE TO: Well Dwelling PERMIT NO. = z F Manufacturer Material Liquid capacity in gallons w= Well DISTANCE TO: Foundation �. Nearest lot line _ t L t� PERMIT NO, S(��C/f� J LL Z F Z No. of lines Length of each lineC- ` a7 0 Total length of lines Ar / Trench width inches Distance betwefeen lines !> Q F � Top of tile to finish grade,,/ j/ f `— 3(o r Material beneath the � Tot I effewe srtion area �• 7 L� inches w Length Width Depth PERMIT NO. C7 aF w °• LU Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer Iine Septic tank Absorption area(s) OTHER PIPE MATERIALS Q SOIL TEST RATING 17T m 14. INSTALLER r. p L i EACdVdf0rA Co.Q REMARKS V �r Q 1� 9' APPROVED DATE LEGAL ,� ,, o Inc' L tl6. It_f�� MHXIM�M NUM�ER OF BEDROOMS � ] SOIL RATING (SQ FT/BR>= 140 THE REQUIRED SIZE OF THE SOIL HBSORPTTOH��YSTEM IS� L_ E�H I-�� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTHNC� BETWEEN THE SURFHCE OF THE � GROUND HP -ID THE BOTTOM OF THE EXCHYHT�ON (IN FEET) �� 11, _"F3 �� F= E"_ UE� THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GR�VEL B^TWEEN THE OUTFALL'PIPE HND 'THE BOTTOM OF THE EXCHVHTION (IN FEET)� I F f E-L,�� I E�� PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTHLLHTION INSPECTIONS OF RNY WELLS HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES TI -HT THrE' WELL WILL SERVE. _�_ ��U �� 1 �H=ll I---- _7_�� BHCKFILLIN� OF AIN 1-1 SYSTEM WITHOUT FIHHL INSPECTION HNID HPPROVHL BY THIS ~- DEPHRTMENT NILL BE SUE�JECT TO PROSECUTION. MINIMUM DISTHNCE BETWEHN H WELL HND HNY OM --SITE SEWAGE DISPOSHL SYSTEM IS �00 FEET FOR Al PRIVATE NELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPEP-4DINS UPON THE TYPE OF PUBLIC WELL �1INIMUM DISTHNCE FROM H PRIYHTE WELL TOH PRIYHTE SEWER LINE ET HND TO H COMMUNITY SEWER LINE IS 75 FEET OTHER REQUIREMENTS MHY APPLY. SPECI�ICHTIONS HND CONSTRUCTION DIHGRHMS FIRE HVHILHBL� TO INSURE PROPEF� INSTCIL LHTION. T --r E�u N3� I CERTIFY THHT 1� I HM FAMILIAR WITH THE RE0UIREMENTS FOR ON--STTE SEWERS HND WELLS AS SET FORTH BY THE MUNICIPHLITY OF HNCHORHGE 2: I WILL THE M IN HCCORDHNCE WITH THE CODES ]� I UNDERST THHT1 IF SITE SENER SYSTEM MHY REQUIRE ENLHRQEMENT IF THE RESIDENCE IS TO 6NCLUDE MORE THHN ] BEDROOMS. SIGNED� -_% E Y4o ��9 0. .. f. --- .-� �~�� ' DEPARTMENT �HEHLTH HND ENVIRONMEHTH� rT,^ � 'OTECTION HNCHORRGE, HK. 995 1 264 720 PERM I'!- NO. ( �2 ��7 9 - � Y 5 k' E_�� ( HPPLICHNTSTEVE CHRLSON/JSCHNELL 7801 HRLENE LOCHTIO� WILCOX/W8OTH 26]~245] LE8HL L19 B2 SHWD LAKE #2 L(}T SIZE 6750 SQUARE FEET MHXIM�M NUM�ER OF BEDROOMS � ] SOIL RATING (SQ FT/BR>= 140 THE REQUIRED SIZE OF THE SOIL HBSORPTTOH��YSTEM IS� L_ E�H I-�� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTHNC� BETWEEN THE SURFHCE OF THE � GROUND HP -ID THE BOTTOM OF THE EXCHYHT�ON (IN FEET) �� 11, _"F3 �� F= E"_ UE� THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GR�VEL B^TWEEN THE OUTFALL'PIPE HND 'THE BOTTOM OF THE EXCHVHTION (IN FEET)� I F f E-L,�� I E�� PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTHLLHTION INSPECTIONS OF RNY WELLS HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES TI -HT THrE' WELL WILL SERVE. _�_ ��U �� 1 �H=ll I---- _7_�� BHCKFILLIN� OF AIN 1-1 SYSTEM WITHOUT FIHHL INSPECTION HNID HPPROVHL BY THIS ~- DEPHRTMENT NILL BE SUE�JECT TO PROSECUTION. MINIMUM DISTHNCE BETWEHN H WELL HND HNY OM --SITE SEWAGE DISPOSHL SYSTEM IS �00 FEET FOR Al PRIVATE NELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPEP-4DINS UPON THE TYPE OF PUBLIC WELL �1INIMUM DISTHNCE FROM H PRIYHTE WELL TOH PRIYHTE SEWER LINE ET HND TO H COMMUNITY SEWER LINE IS 75 FEET OTHER REQUIREMENTS MHY APPLY. SPECI�ICHTIONS HND CONSTRUCTION DIHGRHMS FIRE HVHILHBL� TO INSURE PROPEF� INSTCIL LHTION. T --r E�u N3� I CERTIFY THHT 1� I HM FAMILIAR WITH THE RE0UIREMENTS FOR ON--STTE SEWERS HND WELLS AS SET FORTH BY THE MUNICIPHLITY OF HNCHORHGE 2: I WILL THE M IN HCCORDHNCE WITH THE CODES ]� I UNDERST THHT1 IF SITE SENER SYSTEM MHY REQUIRE ENLHRQEMENT IF THE RESIDENCE IS TO 6NCLUDE MORE THHN ] BEDROOMS. SIGNED� -_% E Y4o STAJLEY BRUST AM ASSOCIATEf� � _ �� Phone 344 -fes!+ � SOILS LOG 'ENGINEERS dGINEERS SURVEYORS PLNCERS ❑ PERCOLATION 1610 Dimond Drive, Anchorage, Alaska 99507 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: Za7I -Lf %i DEPTH (FEET)�`s G, / YY 1 / 10 65c I'/ SLOPE 14'O�. ....... . l 15 :49TH ;y 16 / ..... .:, 17 NO. 18�Lt'� 119 c COMMENTS Reading Date Gross Net r I Time Time Depth to Net Water Drop C 11 WAS GROUND WATERS ENCOUNTERED? L O 12 P IF YES, AT WHAT E 13 DEPTH? 14'O�. ....... . l 15 :49TH ;y 16 / ..... .:, 17 NO. 18�Lt'� 119 c COMMENTS Reading Date Gross Net r I Time Time Depth to Net Water Drop C PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: 1/'� {1/ CERTIFIEDBY: ��✓�'�! DATE: 72-008 (6/79) STATE OF ALASKA Department of Environmental Conservation 437 E. Street Ste. 200 Anchorage, Alaska 99504 Attn. Bruce Erickson RE: Lots 18, 19, 20, 21, Block 2, Sand Lake Subdivision #2 Mr. Erickson, We hereby request a waiver for your normal distance requirement of 150 feet down to 100 feet between our proposed community well and septic systems. Attached is a drawing illustrating the proposed water service to four houses to be built from a community well to be located on Lot 21. The well and main service line will be confined to a 10 foot easement we will dedicate along the east property lines of all four lots. The septic systems . will be confined to the back.25 feet (west 25 feet) of each lot. The soils have perked at.between 125 and 150 on lots 4, 5, & 6 directly behind indicating we should have no difficulty in confining our septic systems within an area that will insure a 100 foot minimum distance requirement from the well. We would appreciate your processing our request as soon as possible. Please contact me immediately if you need further information. Thank you. Steven E. Carlson office: '276-1333 home 248-0786 7801 Arlene Anchorage, Ak 99502 0 •* v 0 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information (a) Legal Descr Application Date /7 #14y' r9 $G (include lot, block, subdivision, section, township range) %C Z SAIJbU. v=- *2. 3 /0 T/ZN 2 `�� Location (address or directions) 8eSy wlIcv;c AMcHr•rPL.A-f F 0't - (b) Applicants Name je-rr } Dt-YjyNRynl A tz-iAd£noVTelephone - Home)17-59y�Pusiness -?f4. 1 7$9 Applicants Address 3930 k i—tA it 64`i Cl ec fe A tJC_,k0Ka3:! ,kX c1 C( 5'}5 (c) Applicant is (check one) Lending Institution ; Owner/builder Buyer El ; Other [�;:j (explain); CE FINANO+ J& (d) Lending Institution Nck+jcV a( BA h K cj Atets et Telephone Address P O N?< 7 0? 5- An ckcva-•yc 9 15 1 0 (e) Real Estate Co. & Agent Address NA Telephone NA (f) Mail the HAA to the following address: 0WA10( i.s +r -L P i c -K 61P 2. Type of Residence Single -Family FI Multi -Family Number of Bedrooms 2, Br__ 3. Water SuDDl Other (describe) Individual Well M Community M Public '„ pW S 1. A' ZI "7L Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite [�El Public E:7 Community 1=1 Holding Tank = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. (Page 1 of 2] 5. Engineering 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 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 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 regula- tions in effect on the date of this inspection. Name of Firm COO S ��15/rlC.�s'S� 1�1C� Telephone �6-Zaa-U J I Address Date 5-i 9-'rL 6. DHEP Approval Approved bedrooms Approved Disapproved Terms of Conditional Approval CAUTION Conditional t e 22 65 THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A L ,4. CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE HEALTHDEPT. OF ENVIRONMENTAL PROTECTION MAY 1 '� 1996 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. UCUYED Legal Description: L/4 82. 5AND LR14E *7- 05/°a 7' '"L0 tLy W Well Classification G If A, B. cr C, D.E.C. Approved(Y/N) y Well Log Present (Y/N) Date Ccupleted Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Tbllhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected By Date Water Sample Test Results Continents PW3 I C) 21 4 1 IL SEG c-OmPLIr tJCC`, cE2-r. B. SEPTIC/HOLDING TANK DATA Date Installed 7- ? -8Z Size /o °p,¢ No. of Ccmpartments Z Standpipes (Y/N) % Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) N Date Last Pumped $4-L3 -,pb Pumping/Mainterance Contract on File (Y/N) A,� ; for Holding Tank High -Water Alarm (Y/N) N#4 Temporary Holding Tank Permit (Y/N) )u4 Separation Distances from Septic/Holding Tank: To Water -Supply T\b11 4- /oa ' To Building Foundation Z o To Property Line /5- 0 To Disposal Field /o ' To Water Main/Service Lire + 3o' To Stream, Pord, Lake, Cr Major Drainage Course 4 /00 Comments VJEL'- To .5 tF PT IG 5EPAJZA-r10&✓ WAIUftP 'Ta "o' eopy A 1 -1 AC4t,P_ Receipt # Date Paid: S /y Amount: G37eFy (Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / `%0 Type of System Design jleeouGK Date Installed 7- i - 8 Z- Length of Field ✓�� Width of Field S ' Depth of Field Gravel Bed Thickness 3 ' Square Feet of Absorption Area 11.30 A/ z_ Standpipes Present (YM) Y Depression over Field (YM) Al Date of Last Adequacy Test Results of Last Adequacy Test A dt qua +e. ((3 cam 1,�� C . w o 3 �� Separation Distance from Absorption Field: To Water -Supply Well 4 / o o ' To Property Line IAF To Building Foundation t Z o� To Existing or Abandoned System on Lot ti 4 ; On Adjoining Lots f /s' To water Main/Service Line Y-7-0 To Cutbank(if went) ti/fi To Stream/Pond/Lake/or Major Drainage Course f /00 ' To Drivewayr Parking Area, or Vehicle Storage Area f zo Conan nts S r-t7c, 4?"91-704E- 79* -0,44 /-srz- /G�oi' � i h 4A, D. LIFT STATION W . ►�* Date 7Ti�lled Size in Gallons "Pump On" revel at High Water Alarm Level at Tested for Electrical Codes(Y Lr Comments Dimensions Manhole/Access (Y "Pump Off" vel at Vent (Y/N) Cycles dura dequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA.H1 on the date //offthis inspection. Signed 44V&)e-4-- Date ✓r-1'7-tPy Company G'dyJ�r��iis MOA No. Cvlsigcerx �rt v KB1/d5/s [Page 2 of 21 in effect a Juno 22, 1468 2-15-84 DEPT. OF ENVIRONMENTAL. CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE : S /g In PWS I .D.# ,L 1- 6 / Z BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 To Whom it May Concern: According to records on file in this office the Z� .5 ZG Z Water System is in compliance with the State Drinking Water Regulations Sincerely, �UfJ�� Time APPLIC 'NT FILLS OUT UPPER HAC "ONLY PropertyOwner�J/,✓)%� ��y��1 101 tC ,)Y-1�.�,� / Phoney! MailingAddress '} +� T :i7%- !C Zip Code - Buyer Date Address Zip Code Lending Institution�/(y=� jlr�t[I>'� .: �/=-L)jy�CjC L) Phone Address Zip Code ,26/ 0sss-) Realty Co. & Agent �� % f,)�1 (�� evw c j � ✓r' r `07.1 Phone Address ,. �(, (J - . - - 112 L . Zip Code %�563 Legal Description �,�t,,,� / oTl'r Street Location (I-) APPROVED BEDROOMS *CONDITIONS OF APPROVAL Type of Residence ( ) d0NDITIONAL APPROVAL' Single Family DATE % U+�`- -� a-- d -L_ ❑ Multiple Family No- of Bedrooms_ Well To Absorption Area ❑ Other Water Supply Septic Tank Size 72.023 6B'A -❑. Individual 'LCommunity - - - ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Public Utility For wells drilled prior to that date, give well depth (attach log if available). SeDisposal 'N ndividual `) - _ MCA x��3� � Year Individual Installed: ❑ Public Utility ❑ Holding Tank t �-� �. When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date - Date Date 10 a a -la Inspector Inspector Inspector Inspector V'YQ Yt Field Notes: MUNICI- DFPT OF P. C, D i 2 1 1982 RECEIVED (I-) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) d0NDITIONAL APPROVAL' DATE % U+�`- -� a-- d -L_ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72.023 6B'A