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HomeMy WebLinkAboutSCHROEDER LT 45Y t, V) 111- V -� MUNICIPALITY OF ANCH013AGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION O ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE r� NEW NAME W �LL�Rm ��OUSC baW -��3 C ❑UPGRADE MAILING ADDRESS � (� ' Cx RsC5_� q Lc Svc P. LEGAL DESCRIPTION 5�' LOCATION (� OF1V.� NO. OF BEDROOMS Welln Absorptio�n�area f Dwelling `r C7� PERMIT NO. -T©o o O DISTANCE TO: '1 I UX I -Z a Manufacturer Material L No. of compartments n w QYZCf F- V) Liq. capacity in gallons Inside length • , IF HOMEMADE: Width Liquid depth r �� \ Well Dwelling PERMIT NO. O Y DISTANCE T0: — O Z Q Manufacturer Material Liquid capacity in gallons p ell Foundation LL Nearest lot line PERMIT NO. �� 0 p A A - �)'Rf---_ w 2 DISTANCE TO: `\ (� (i 1! J w z No. of lines y Length of each line fl Total length of lings Trench gc{th�t� inches Distance between lines , \ t „ :J A Z w ~ N C Top of the to finish grade » beneath the A A inches Total effective absprnarea tIS-Material Length Width Depth PERMIT NO. w C7 r Type of crib C ib di e Crib depth Total effective absorption area aQ. FL LU W Well Building foundation Nearest lot line rn DISTANCE TO: ass Depth Driller Distance to lot line PERMIT NO. _� _� w Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHERS P PIPE MATERIALS k'j 34. Ay SOIL TEST RATING QQ _ C7 INSTALLER � _ 11 � bQ REMARKS 0 �1 t G' ti Li P V E D__ PW - DATE LEGAL �\ -V-S OR[ WAVA 111 ;Q -i Yj: m C) I IN :A1071101 1 :i-ttttl�lv I PAKIPHY WIMP? UK FOODRAW SO 1 1 RMAT" "m ANn. A PC! i LOW 111 DWIT! FS D 100% 11 A C04 TS 1 F&II(Al (WI.I VIT ATIVI W FS mb KNOM 1 OF f! ;v GO MA A iW IN kip A 1 , I i�; 1��'A i FAR 1104 ON! 4 S MY i V! K OF P110011HP! Qk 1 1 W njqqVLj, Vokpqn! plu olm q Wp: �ul 1 01", 1 i�.i 1: 1 ly, "Al 1 FNEA? Q7 Fv V" r j.., 1 ul im lan r ON 1 i: � '::� 1 , i. i ;:::. A 10 3 1. f l , � F&I r 1 1 1 wo114 T: Ad 1 OWN 1 .I,! Mg, ul' '�''1, 1 H 1 . i. � ! ! 1:., �i 1 1 i rl'! i Ql 1 VA TIM I V P14" Q :S T NA A F"D 11 AM 1 FA A 1. ! k! 11. 1, A AW Fil, YWGANW�c� A 1, f MV � 07 v VY � 4 W P " k : � � I . . I i ! C; i.: 1! ;:J IY 'Il,., IA A W I Q ANK F t11 , &A TO 0011 "Ill k 10: AM 1 47F A i 1 NUMIA IT 1 Q!, 0 & E OEO r ECHNI CAL & ®EVELoPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 6e8 -22M Soils & Foundations Land Development Performed for: Name: ��` ?� rc�cic 'fel. No. "De-1"Z:::��� Mailing Address: Legal Description:. Lam""tragcj m�c�3 Depth eetj Soil Characteristics 0- 2 3- 4 11, e-- 4N�r� n,CICP 4.. 12 13 14� 15 16 e n) e 1 c a . fa��F gree ec.iri� �G Ground Water Encountered: Yes- No If yes, what depth._ Proposed Installation: Seepage Pit. Drain Field. Comments: Date:-�- Performed by: ��- a Y N a Y a Y Q a Y Q00 � n C oma✓ J a , �(DyJ�bV' AQ ct A Y cb Q w %�v ch Lu x V) °m O LU � U Y Q Y a Y � 0 Y Q a Y V � < a n C oma✓ J a , �(DyJ�bV' AQ J � A s Q T v do > a/Jo w i > %�v a Lu x V) °m Q LU � U 0 a Q Y Y oo00 ',J o/J, n C oma✓ , �(DyJ�bV' AQ (=j ; O 3 ''✓o do > a/Jo %�v s MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL 1. GENERAL INFORMATION OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date �G (a) Legal De cription (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant NamewLu'++-y �/1�ir�2�,f�elephone: Home ��3��5 Business 2603 /t o Applicant Address A? 3 l �� ��� ' �� ��' aL—� (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution ���L� t Telephone Address� (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: nc��neermg ,;, SR13 19Gx Eagle River, blaska 9t)S3T ENGINFI-RING FIRIOPROViDlI'­ iNSPFCJIONS,1ESIq. IIIF -FARCH, W� liND j As ",(!IW cad oy !fly s "d lillm!d lwwto mid ;Is of Ille volidatwo I, N1 ,I), 1wij lif,31 ,w, I Vol 11, ll, ?If,- 11 ".(-JI, I III( AuIllolily Applovill slmvvs Olill Ihu, on-sitf, willc[ stjllpiy allf) ill 1111 lw- fum III FIA ;11)fl nflr il, for Ow likifilh''I of hwho. )III'; I11)(I type (If "ti lwlille fidluatr'd lw11'11) IIIOwl —IlIv III d l"I"fqi Ill Hw 1111(w w;l1loil lloill the Ilumcipilhly of Amilimilm' IM", iWil 110111 Illy !III, o!I "Iff wastewfitf'I dr;po!"I 1 s Ii;t('11) is I I I (,(, [I I I flh,lf Icc will,. ;111 M 111 1, Ito"i ruin !,t,ilil f 'k-'. 0wm; lry f-, if)'! it slulaL„irt 111 cr((uct c,!1 Ille daW of 1111'. Name of 1 11 HI Ing Ad (I I uss ir, )ivor, 'Alaska 91MY7 f, DHEP APPIZOVAl- /Appffjv(,cl kif 1w(hoO[w, lly A I (q lw; of Gundihrnlal Appf ov,d 2 of 2 CAU WN -I lie Nlumupifflily of Ancho;,i(j(, I Wom 1111fill! of I Q I n1!11 Ai 11if,; 11 lificilti", kv,t-d solely tip(m Oie wp' t�!,rlll;Vil if! -li.cvl n paTmIrmAl ,;1I Ill Pw 'Aoto of Al,rIkIi 1 he DI IF I' (it), , iW: I W,,v f i 1 t II d '11I lwillf 'Ifi) M511WO011 ll'(wfill (1110 tiilu ?"'jillwnwiii pl p!o analyse dal l hefoi I, a r.(n llficilt(]!"'twd I Ile MI1fl1c;p;1Il[) 111 /\11, I 1,.,Ii I[ ''If, if �, f). 1 111111 ;1(11 1 1 If) I if, professional emlimuct ; wotk 2 of 2 MUNICIPALITY UP ANCHORAGE IAEPT, OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) RNVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) 1 J 7 1986! CHECKLIST - FEBRUARY 1984 r 1k 72 Legal4Description: vvs-C�p%> A. WELL DATA Well Classification V,41 -r If A, B, C, D.E.C. Approved (Y/N)rJ /A'__ Well Log Present®/K _ Date Completed —!' �15 Yield 0-: ! 'AAA/M Total Depth Cased to yD Depth of Grouting 41e Static Water Level /00/ Pump Set At Ive Casing Height Above Ground /� Sanitary Seal on Casing (alit Electrical Wiring in Conduit 6/W Depression Around Wellhead (YO Separation Distances from Well: I fy)�_ To Nearest Edge of Absorption Field on of 10(0' ; On Adjoining Lots _ /0 To Nearest Public Sewer Line OVA To Nearest Public Sewer �QCleanout/Manhole < �t To Nearest Sewer Service Line on Lot Water Sample Collected by �S 6N6/N���2iNG _ ; Date Water Sample Test Results � f i tojel-roiG_L/ 11 Comments �IPCc 1✓LL�r' dc/'Cc / ✓,e`^� To Septic/Holding lolding Tank on Lot _ ; On Adjoining Lots /Oce 7 B. SEPTIC/HOLDING TANK DATA Date Installed I " `L) ` '7 6 Size ! poo No. of Compartments Stand pipes &K Air -tight Caps/,N) Foundation CleanoutX0 Depression over Tank,(Y10 Date Last Pumped — 1-1&-86 Pumping/Maintenance Contract on File (Y/N) __ If— ; for a/ N Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)_ Separation Distances from Septic/JHol ing Tank: To Water -Supply Well To Property Line /D To Water Main/Service Line Course Comments Page 1 of 2 72-026(11/84) To Building Foundation —._ 12, To Disposal Field 15-1 To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata >� Type of System Design 1)(Z)VI1�tt%1 Ti -t -D Date Installed 1'7g Length of Field _ / Width of Field Depth of Field 1-4r j r1'Y Gravel Bed Thickness _ Square Feet of Absorption Area Standpipes PresentO/'Pd) Date of Last Adequacy Test /-Z' ,83 - Depression over Field khN& / Results of Last Adequacy Test �Af/S�FF�OtiJL y Separation Distance from Absorption Field: / To Water -Supply Well /-W To Property Line To Building Foundation /y / To Existing or Abandoned System on Lot N/� ; On Adjoining Lots �� r To Water Main/Service Line To Cutbank (if present) N. To Stream/Pond/Lake/or Major Drainage Course / To Driveway, Parking Area, or Vehicle Storage Area 75 / d• Comments /VioN/ roe/N/, T/dl 1✓JJ ynlS/4�G /M /�/3�GF�Tlv/•! I ��//+4 7r',-�=s'.•. ��'_', (�� r'-� /A'�,. a.�A' f� �. e �Y;�c D. LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at "P mp Off' Level at High Water Alarm Level atVent (Y/N) EE Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA an) HAA guidelines in effect on the date of this inspection Signed a & c rniginearingDate 2 ? 6 ye 0 f 96Xo G7 Company MOA No. �S` nlr'fm x34 ,;tE�vA�, ;k3P{�`�iR Receipt No.rl(il r. LQSG� t ' Sgal 110, 1 4JK Date of Payment Amount: $ Page 2 of 2 72-026 (17/64) HEALTH AUTHORITY APPROVALS Janua7y 25, 1986 ROBERT A.SHAFER CIVIL ENGINEER 694-2979 Mun,icipat.i"ty ob Anchonage aepaittment ob Heatth and Human Seu ices SEWER &WATER 825 L Street MAIN EXTENSIONS Anchonage, Ataska 99501 REFERENCE: Lot 45; Schnoeden Subdivision SEWER &WATER INSPECTION q Reques you a pio hove .the attached Heatth AutholLity Appnovat and issue a wa.iven bon the hon.izonta2 separation distance between the weft and the septic "tank to 9966 beet. ENGINEERING The on -,site waste water d.isposat system was ina"ta ted under. Municipatity STUDIES AND REPORTS penm,i"t #788844 .in September 1978. At that time the Municipat.ity accepted a hon.izon-tat sepakati"on distance between the wett and septic tank at tess than that pnesen.ibed by taw. WELL INSPECTION The topography ,in .this area .is genenatty btat and in accordance with &FLOW TEST the weft tog provided by Jay Witt.iams dkif-Pi_ng -there is a stay tayen between 32 beet and 39 beet white the static water tevet .in ,the wett casing .ia at appnoximatety 100 beet. A risk anatys.is ,indicates that .the wett to atmost supe to be bnee ob any bonm ob contamination, thenebone, SITE PLANS it is our opinion that the hon.izontat separation distaneea pnesen.ibed by 18AAC0.021 ane not nequined .in this case. 16 we ma be ob bunthen se4v.ice, ptease contact us. ROAD DESIGN S " eenety SOILTEST U R A. SHAFER, P.E. AS/s,5 MUNICIPALITY OF AIIC1-10kAGI: PERCOLATION DEPT. OF HEALTH & TEST ENVIRONMENTAL. PROTECTION IAN 2 7 1986 STRUCTURAL 8 MECHANICAL "'y \ / j� \V/ D RECEIVED INSPECTIONS AEaa�a ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN SRB 196X EAGLE RIVER, ALASKA 99577 Municipality of Anchorage February 3, 1986 J A ( t x p6 i ' X ' raiwf Ell J'f N _3 dfa, - P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Robert A. Shafer, P.E. S & S Engineering SRB 196X Eagle River, Alaska 99577 Subject: Lot 45 Schroeder Subdivision Waiver Request, WR86-013 Dear Mr. Shafer: This Department has reviewed your request for a waiver of the separation distance required between a septic tank and well as stipluated by 19 AAC 72.021. The required 100 foot separation has been waived to 96 feet for the subject property. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw 'aVe+ C;jW(�fr. -y- rC_ 1 K/ r I 16M.A2'-79 PleA 77 - MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. Or I::-ALTIf & 825 L Street - Anchorage, Alaska 99501 ENVIRONiVd V'C,A1 i' ..•_:+' [CTION 6. TYPE OFRESIDENCE NUMBER OF BEDROOMS ENVIRONMENTAL ENGINEERING DIVISION MAR 1,9(9 Telephone 264.4720 ❑ Two ❑ Five (r� t REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE RAtRIVIED DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 'I. PROPERTY OWN R 017 Oro u < e---) PHONE � - S� MAI LING ADDRESS ,r + PHONE PROPERTY RESIDENT (If different from above) ❑ PUBLIC UTILITY 2. BUYER B. SEWAGE DISPOSAL SYSTEM PHONE MAILING ADDRESS **If individual/on-site, give installation date__/_. INSTITUTION n 3. LENDIN IN t9 PpLe— /� ? 1' r czzzz PHONE Z MAILING`` ADDRESS by this Department. 4. REALTOR/AGENT PHONE MAILINGADDRESS /J Z25"U C���f�e�i 5. LEGAL DESCRIPTION STREET LOCATION/ z(/a_ 6. TYPE OFRESIDENCE NUMBER OF BEDROOMS XSINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY 5r, Three ❑ Six 7. WATER SUPPLY s INDIVIDUAL.* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, ive well ❑ PUBLIC UTILITY depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM INDIVIDUAL./ON-SITE** **If individual/on-site, give installation date__/_. If system is over two (2) years old an adequacy testis required ❑ PUBLIC UTILITY by this Department. NO'T'E: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) C-�z u. -2Q S (Lc c•t eA THIS SIDE FOR OFFICIAL USE ONLY —�— INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: - NUMBER OF BEDROOMS — 1. TYPE OF RESIDENCE 51 SINGLE FAMILY ❑ MULTIPLE FAMILY ❑ ONE 'ED THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX —� 2. WATER SUPPLY INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified—_ PERMIT NUMBER .-1scje8L`IA— —� DEPTH OF WELL `\0 DATE DRILLED q_ la -IS LOG RECEIVED qq -S- �-'�' _ 3. SEWAGE DISPOSAL SYSTEM 04 INDIV❑UAL/ON -SITE ❑PUBLIC UTILITY_— Connection Verified —= PERMIT NUMBER DATE INSTALLED INSTALLER - 1EISepticTank or El Holding Tankf1� Size:_ If Tank is homemade give dimensions: SOILS RATING r 'TYPE OFTANK MANUFACTURER TOTAL ABSORPTION AREA n`lL gett MATE L 1 c-�1 Nearest Lot Line 4. DISTANCES WELLTO: -Septic/Holding Tank Absorption Area Sewer Line — Absorption Area to nearest Lot Lina 5. COMMENTS L�PPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED — DATE 8Y ( I BY LEGAL ffSCRIPTION r