HomeMy WebLinkAboutSAND LAKE #2 BLK 6 LT 16AO
4 n k w,., 1 0'5
HeF h and Environmental Prore ion
Fourth Floor West
825 L Street
Anchorage, Alaska 99501
279-2511, x 224, 225
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
N AM MAILING ADDRESS PHONE
L06 AT 10 N� L F G A L 1) E SC R I PT 10 N A-&-Sq&-4 4--e�—Lc-
r�,[��TICTIANK:
ISI AN C E; NUMBER OF
FROM WC11-2e-92�& MANUFACTURER MATERIAL ��A------COMPARTMENTS--
;r) rE--PTH I-IQUID CAPACITY&OP90-GALLONS.
INSIDE LF.NGTH- INSIUE WIDYH--� LIQU
FiFi n
/00 TOTAL LENGTH
Di.�TANCE FROM WELL
6;V--------NEARES1 LOT -.--.--OF LINE
AIIA '2 IN. TOTAL EFFECTIVE
# of L,-Lnes DISTANCE BETWEEN LINES RENC14 WIDTIF&
ABSORP-II()TJ AREA SQ. FT. LENG FH OF FACI I LINE
DEPTH OF FILTER
---7
DEPTH: TOP OF TILE TO FINISH GRADE -MATERIAL BENEATH FILE ABOVE TILE IN.
S I, . EPAGL PIT:
DIAMETER ---OR WIDTH LENGTH- DEPTH
Log Crib _Rings— Crib Size: DIAME-FER--.—DEPTH-- DISTANCE FROM: WELL——
-fOTAL EFFECTIVE.
B0ILDING-FO',jJ'\j1DATI0N- NEAREST LOT LINE---- A0SORPT1`ON AREA (WALL AREA) -----SQ. FT.
Well
Class: Dept h:
Well,,Dist� Lnce To: Lot Line
Bldg,, Sewer Line:
Pipe lfaE��i`als:A��3
of Bedrooms: U
Installer.
,RemaVks-.
DAT5=�,�(�171 APPROV
--J -
DAT5=�,�(�171 APPROV
~ . ` .DEPHRTMENT �
110,11,10 FIND ENYIRONMENTH| `ROTECT1O `��`����^`-
PERMIT M ( 76649 )
HPPLICHNT 80] N PRICE 279-1100
LOCHTION WILCOX ST
LEGHL L16 86 SHNDLAKE SUBD #2 LOT SIZE 6750 SQUHRE FEET
TYPE OF SOIL HBSORBTlON SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS z ] SOIL RHTING (SQ FT/8R)M, 85
THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS�
�> Fi---nm [F-1- 'T
- E -.1i
�Llq:�fi
��
-'1F' �. - -: Fit low
4UP Inn L.
Kv. inn 104 1- 1-1 15
THE
LENGTH
DIMENSION
FINAL INSPECTION
IS THE LENGTH (IN FEET)
OF THE
TRENCH OR DRHINFlB-D
THE
DEPTH OF
H
TRENCH
OR PIT IS THE DISTHNCE
BETNEEN
THE SURFACE OF THE
GROUND
HND
THE
BOTTOM
OF THE EXC8YHTIGN (IN
FEET)
OR
THERE
IS NO
SET
WIDTH
FOR T�ENCHES
MUST
8E RETURNED TO THE
THE
GRHVEL
DEPTH
IS THE
MINIMUM DEPTH OF GRHVEL
BETNEEN
THE OUTFRLL P{PE
HND
THE BOTTOM
CONSTRUCTION
OF THE
EXCHVRTION (IN FEET).
TG INSURE PROPER
INSTHLLHTI(DN.
-i -F, too PSH K 11; 1: W K M. wHy��
11- F::91 P-- Jr. P--,; ii:Z) F, to: 107 131 C3 FwT ��AX 0!1 Ew.
I CERTlF
�H0
57 MEZ
CD T-
1: c2p M 10 601 up-'
UO--, �!! P., -i! F, �:: u:�
BRCKFILLING OF
HNY
SYSTEM
WITHOUT
FINAL INSPECTION
HND HPPROVHL BY THIS
DEPHRTMENT WILL
BE
SUBJECT
TO PROSECUTION.
MINIMUM DISTHNCE
BETWEEN
H
WELL
HND HNY ON-SITE SEWHGE
DISPOSHL SYSTEM lS
100 FEET FOR
H PRIYHTE
WELL
OR
200 FEET FOR H PUBLIC
WELL
WELL LOGS HRE
REQUIRED
HND
MUST
8E RETURNED TO THE
DEPHRTMENT NITHlN ]0 DHY5
OF THE WELL COMPLETIO��
SPECIFICHTIONS
HND
CONSTRUCTION
DIHGRHMS RRE HVHILRBLE
TG INSURE PROPER
INSTHLLHTI(DN.
11- F::91 P-- Jr. P--,; ii:Z) F, to: 107 131 C3 FwT ��AX 0!1 Ew.
I CERTlF
THHT
1: I HM FHMILlHR
WITH
THE REQUIREMENTS
FOR ON~SITE
SEWERS HND NELLS HS SET
FORTH BY
THE MUNICIPHLITY
OF
HNCHORRGE.
2: I WILL
INSTALL THE
SYSTEM
IN HCCORDRNCE
NITH
THE CODES
]� I UNDERSTHND
THHT THE
ON~SITE
SENER
SYSTEM
MHY REQUIRE EHLRRGEMEMT IF THE
RESIDENCE
IS REMODELED
TO INCLUDE
MORE
THH� ]
BEDROOMS
SIGNED�
JERRY STOCK
" N
'I I
2221 E. Northern Lights Blvd. 11203
STRUCTURAL ENGINEERING ANCHORAGE, ALASKA
CIVIL ENGINEERING
CONSTRUCTION ENGINEERING
SURVEYING — LAND AND CONSTRUCTION PHONE (907) 274-7711
July 15, 1976
Mr. Mark* Forest
6641 E. 8th Avenue
Anchorage, Alaska
Re: Soils Review for Individual Sanitary Systems
Dear Mark:
As per your, request, I did inspect the general and specific area for deter-
mination of soils capability on the following properties.
Lots 14, 15, C16, 17 Sand Lake Subdivision #2
I find that the soils over the entire.four lot area are generally as follows:
Surface to 1. 5 ft. depth - loam and organic (dry) to 1. 5 to 35 ft. and below
coarse sands and gravel.
The above determination of soils and depths was made by visual inspection
of the proposed construction site wherein the surface material had been re-
moved to a depth of appro ' ximately Z. 5 to 3. 0 ft. Additional depth and
classification of soils was determined by inspection of a large commercial
sand and gravel pit just south of and within 200 feet of this property, as
well as roadway excavation embankments within 300 to 500 feet north.
I hereby certify the soils as adequate for individual Sanitary systems on
said lot 14, 15, 16, 17 of Sand Lake Subdivision No. 2.
Yours truly,
P E
. C TR EPI=ICES
le L. Cutler, P. E. / L. S.
0(., Ca'a 6ko-m-
UcivJ"
F111 eXA-1-N i h Q -t
4oroo-o&i-o
4"
-0�0- A
C'�
I)ale L. Cutler
No. 1904-E
_g' - 90 -
�e
So
71
/)ZI
YY
;TYTII
0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH 8t 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. # C)� - � - 1 —'2) -1) — 2L �
1. GENERAL INFORMATION
Complete legal description Lc) -F 1(,.7
P D � \1 I (:� I rx�j 4* 'z
HAA # �-A 1,2-\ q �) OLQ1
BLOC -K, G , -SA..�JD LAY -E
Location (site address or directions) -2 4- w i L-cc)X -s-TeEj-=7.) AQ C -14c.) eA.46F-
ALA,SV_A -1 019507—
Property owner �A /A i C VYI-A Day phone W/4
Mailing address
Lending agency pq 1A
Mailing address t4 /A
Day phone A//4
Agent c4izis s4aNNum INC - Day phone E5257 -Z
Address Z09 Y4 - P"MOM-0 BLYD, A�ZC64 A� '99915
Unless otherwise requested, HAA will be held for pickup. !PLf2-4-3F ��L-P F�OZ
up Wy AN�4'-N
2. NUMBER OF BEDROOMS.
3. ' 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.
4. 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 MOAN21
5. 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 disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
6. DHHS SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for
'Si��11��Phone
3 3 -7 - (,) -7 1?
Date— 1 /57/9Z_
n�%'V%JT4
OF
WIMA
rness
J
<(K/
X
01
`
OFESV3'�'
bedrooms, with the following stipulations:
Additional Comments -
By: A7zn DateZ– 1212 -
CAUTION
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 registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto 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 #21
Municipality of Anchorage za�
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST AN
Legal Description: LOT - I EL06V, & — Parcel I.D.
.SA,J,40 S/D #-Z
A. WELL DATA
Well type IND 0 If A, B, or C, attach ADEC letter. ADEC water system number NIA
Log present (Y/N)
Datecompleted Driller s"I"Ity :sGLF
29Z AS PGA pgorAR of
Total depth
ER5Ar)OrJ WITH 'Z 0 Z
—Casedto c,01%" -Casing height -F)
&I DNS -\I Se LF
rry > M
Sanitary seal (Y/N)
Wires properly protected (Y/N) 4=j
rTJ coo
FROM WELL LOG AT INSPECTION >
Date of test
Z
U N yw ow tQ
Z3 2 '"0' PEA w" 13 f Gr--- r Z5 D,
static water level
im
x
Well flow
1Z
9 -P.M. (0 9 6 g.p.m. F6 ie, %Z& H I �) U I'F- S .
Pump level
0 N \�aQ Ow IQ 007- 0-9seeNF'o
U
De,b.wDowri wAs OwUq 4r
=TWIASO
LVISCO
T ML"T'
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
0 To
,-10(0 tZ 100 IVQKS 014 LOT'$ 9 10
F�Ssv — ; On adjacent lots -
�-
I-zo r -F -F -,r -m sumP e 094ijawew eLacy. & J SA&JDLAVA
'-M
Absorption field on lot or 'MttdCW - 5JEE CdVU LEr-CSO� ; On adjacent lots�� t 10 A65oQ?.7-)0jJ F I ELPS 6,-J
L.WrS.9. 10;� BY, 4G) SAOJDLAkEl*�Z
Public sewer main
Public sewer manhole/cleanout
Sewer service line N )A
WATER SAMPLE RESULTS:
Coliform Nitrate
Petroleum tank
.4, . I en
Other bacteria
Date of sample: �2_ Pao ./ 'i I . Collected by: C�A-em ats L
B. SEPTIC/HOLDING TANK DATA
Date installed (a/(I /-7-7 Tank size 1000 (2'0'L- Compartments TWO
Cleanouts(Y/N) Foundation cleanout (Y/N) Depression (Y/N) NO
High water alarm (Y/N) N
Date of pumping 1 -2- L I
Alarm tested (Y/N)
Pumper (�F—SSPOOL PLO-IP1,AJ(�7-
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
101Z 0 FeZOM L/O QJ
161 Lo -r -2-7 -(6 -ro -rANK qc)
Well(s) on lot On adjacent lots TO —Foundation —
66TIM4,TE > 10 FT. OPPOSITF-
,T)MA'Mp (R 0
To property line -5 rEsr -Absorption field Asc-vf"IjArO'La�kwatermain/service line s%PS% or H -MSF -
__S G P 'r I e- -M" K Q 1)
Surface water/drainage �LA,
72-026 (Rev. 7/91) Front Q PEA imvriAL 1.AS?ee_-n0N Qeft&r 43/11/'77 CONTINUED ON BACK PAGE
g) PGA r-lsuo NF_ASVRE_"F-,J-r oti I/5-kiz
LIFT STATION
Date in I A[ed
Size in gallons
Vent (Y/N) "Pu n" level at
High water alarm level 77=
Meets MOA electrical codes (Y/N�__�
Manufacturer
Manhole/Access ff
SEPARATIONJD4,9-TA-NCE FROM LIFT STATION TO:
lot — On adjacent lots
D. ABSORPTION FIELD DATA
"Pump off" level at
Cycles tested
ater
Date installed (a A I Z-7 -7 Soil rating G -5- —System type TP F-J'�3 C �-k
Length - Iza Width 3 -Gravel thickness —Totaldepth 0 /
Total absorption area 25F/ No - ONLy Sump ar-61,Jw46.
Cleanouts present (Y/N) cJF- 1'0.S�JcP - sGE C>f4
rz.[=Mv�, CL�w
Depression over field (Y/N) N
Date of adequacy test / / 5- 1 q2 -
Results (pass/fail) PA ss for _nA_aaE% — bedrooms
Peroxide treatment (past 12 months) (Y/N) Nn If yes, give date N44
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
t zo ' -ro "svmP " (;_1 I
_rQ'5�jcg wcu, SEO COVE/�-'
9(0
Well on lot SGGI On adjacent lots LOr Property line -
To building foundation 45 Feer (2)
— To existing or abandoned system on lot
ur�v,,,30WN- Ir -p 10".
On adjacent lots (IovsO- LErTEe--Cutbank 1A, —Water main/service line— GtDS-S of- 140USE
Ir i_,� arzuRVED 'TU-O�T-
Surface water — N /A Driveway, parking/vehicle storage area q-eJS_,JC,14 1,C u?'POISA D9n\rF_LuAY
Curtain drain N,6A
E. ENGINEER'S CERTIFICATION
I certify that / have checked, verified, or
PG�2. �wtTtAL W -_-P0(2_1- 13/() /77
pE_P_ FIELD MEASveS�-tE�Xr OtJ /V/q
to all MOA and HAA guidelines in effect inspection.
I
Signature
Engineer's N/,
Date / I V -9-; -1
HAA Fee $ 17007) Waiver Fee: $
Date of Payment / - / () -- Date of Payment
Receipt Number �,33 Receipt Number
72-026 (Rev. 3/91) Back MOA 21
Alaska Water & Wastewater Services
"Preserving the Last Frontier"
January 5, 1992
Municipality of Anchorage
Deoartment of Health and Human Services
Division of Environmental Services
On --Site Services Section
P-0- Box 196650
Anchor -age, Alaska 9951-6-66SO
Ref- Health Authority Approval (HAA) Application for Lot-
16� Block 6, Sandlake Subdivision #2.
To whom it may concern:
Attached is the HAA application for the subject lot. An
adequacy test was run on the well by pumping 6.95 GPM for a
total of 120 minutes. The total volume pumped was 8.31
gallons- The draptidown on the well was only two feet.
Consequently, the well tesi
was deemed to be adequate -
introducing water into ".he
beginning of the trench) at
f tes.
total o 150 minut
introduced was 1036 gallons.
was monitored at the sump�
entire test- In short, the
bedroom house (1450 GPM).
was discontinued and tha wall
The septic system was tested by
trench "sump" (located at the
an average rate of 6-91 GRI, for
The total volume of water
The liquid.level, in the -trench
and did not rise during the
system is adequate for a, three
The following is a itemi.7ed list of c�ome of Lhe concf�rn-.i
regarding this particular systara-
i- The well log on record at DHHS did not state the depth
to which the well tvas cased.- I contacted the driller,
Sidney Self, at 344-3248. He indicated that the -well wa-.s�
cased to the bottom. During my site visit, I shined a light
down the well. and was able to observe casing as far as the
light would travel-
2- According Lo the inspection report, dated 8/11/7-7, the
trench does not have a clean-out at the end, but is capped
i nstead . In adclition, the ins.r.-)ection report stlates tha.t tha
absorption field is located 20 feet from the nearost jot
line. According to my field the trench "sump"
is located. approximately 8 feet from the street. This
leaves sofite doubt about the. validity of the inspoction
report. COIIS,-�qUently, due to poor as -built drawings, it is
impos-�ible 1-o vorifly the length of the tranch or the
location vihere it ends on the property (or if the trench is
even on, the propert,,!). To complicate matters further, the
adjacer-ft lots (lots 15 and 17� block 6, Sandlake 42) were
3&7- ro 179'
Telephone - Fax 338-3246 0 8471 Brookridge Drive 0 Anchorage, Alaska 99504
constructed the same way (with DHHS approval.). In short, it
is not possible to verify separation distance between
absorption fields on the adjacent lots.
3. If the trench runs parallel to the east property line,
as the inspection report implies, a portion of -it is located
under the existing driveway.
4- Since the end of the existing trench cannot be located,
it is not possible to verify the separation distance from
wells on adjacent lots and the end of the trenc h -
Consequently, separation distances were measured from the
trench "Sump". The closest well to the "sump" is located 96
feet away on lot 8, block 7. A waiver was obtained on this
well, in September of 1977, for a separation distance of 96
f ea t .
5- The well is located in the southwest corner of the lot.
The closest septic tanks and absorption fields, based upon
DHHS inspection reports, are located on lots 9 and 10, block
6, Sandlake #2. The separation distance to the septic tanks
appears to be slightly greater than 100 feet; however, this
could only be verified. by performing an as -built survey,
since a- direct measurement. is not possible due- to the
presence of fences and structuires. These septic systems
(lots 9 & 10) were installed after the well on lot 16.
6. It is imperative that any potential buyer understand
that the existing system is approaching 15 years old and
that the steel septic tank may be reaching the end of its
useful life. The next IMmeowner should anticipate replacing
the septic tank sometime in the next five Years -
If all goes well, please hold the HAA for pick -UP- if you
have any questions, please call me.
Sincerely,
J Xffey A. ��arness, P -E.
Owner/Consultant
rushl. wps
JAG/jag
mi i�_ i riAL-i I T UF Milt-nUMMUE
DEPA HEALTH AND ENVIRONMENTAL., 'ROTECTION
G
Anchoracrr=!, Alaska 99501
�825' )IL Street,
264-4720
Date Received: October 14, 1977
#1: Time 9:3 a.m. #2: Time #3: Time
1 .
2.
Date
10-18-77 Tuesday
Date
Date
Insp
Buchholz
Insp
Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WAT FACILITIES
C)
Lending Institution Request: Alaska Mutual Savinqs B13ank
Mailing Address: Post Office Box 1120 99510 Phone.
Property Owner: Jerry S. Stock Phone: 272-4789
Mailing Address: 1402 West 27th Avenue 99503
3. Legal Description: Lot 16 Block 6 Sand Lake Subdivision
Wilcox street
4: Single Family Residence: (x) Number of Bedrooms: Three
multiple -Family Residence: ( )
5. Well System: Individual Well (x)
Permit # Depth of Well
Construction
Number of Bedrooms:
community/Public System ( )
292 ' Well Log on File ( )
Bacterial Analysis
6. sewage Disposal System: On-site System (x) Public Utility
Permit # Installed Installer
V
Septic Tank Size
Absorption Area
Manufacturer
Soils Rate
7. Distances: Well to Septic Tank
to.sewer Line
to Nearest Lot Line
Nearest Lot line
Material
to Absorption Area
Absorption Area
Pagp Two Health and Environmental Protection
Department of
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 16 Block 6 Sand Lake Subdivision
Comments:
Affadavit Attached: ( )
Letter Attached: ( )
Approved: (OD1 kcl E L) Date:
0
Disapproved: Date:
Department Worksheet:
I
i-46NICIPALITY OF ANCHORAGE
Department of Health and Environmental Protection,''".
825 L Street, Anchorage, Alaska 99501''
264-4720
equest for Approval of Individual Sewer and Water Fla,ci 1 1 ities
1. Property Owner: ,,) E �-r
2.
3.
ME
go
Mailing Address: 0 L_ UL-) 2- Phone: c2 2Z— q
Name of Buyer: M 11 1� e
Mailing Address: — �j 0 M..'Z — Phone: N 6 �J !��.
Lending Institution: K t M J TQ k I AV 1 tj
Mailing Address: P, B_(!� 0? -hone:
Realtor/Agent: FA P 0. (? �- I , � & 9 t)z ukj 1-1�-
Mailing Address:
Leaal Description: L o I I to —
Street Location: LAJ S T.
Phone:
S
6. Single Family Residence: Number of Bedrooms: - 3
multiple Family Residence: Number of Bedrooms:
7. Water supply: *Individual Well ()� Public/community System
If Individual Well, well depth a 92
If Community System, name of system
8. Sewage Disposal System: On-site System Public System
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77