Loading...
HomeMy WebLinkAboutSCHROEDER LT 490,0 J fiOS A � w RLOvl 0►- Lv 4'(V� .5 /�:' (tom v t c_ j( j— MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 264-4720 \� 825 L Street - Anchorage, Alaska 99501 Telephone ON-SITE SEVVAGI-- DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAM[ �.` PHONE - NEW CC � �� ❑ UPGRADE /� �I S � � �� a le _ 'L�.,J-C� � ill s MAILING ADDR SS_ U u -7 70`i 7 2 F� A7. '2,;� %57 7 LEGAL DESC IPTION L Z/ LOCATION TIq NO. OF BEDROOMS ---7 DISTANCE TO: }� / Absorption,�[ea/ Dw�eullii� PERIT / 6 CR4anufacturer/� �> / Mata) No. of compartments Liq. r, acity in gallons IF HOMEMADE: Inside length Width Liquid depth,_ J U 9 DISTANCE TO: Well Dwelling/ n f� Material PERMIT NO. Liquid in U z < .0 I� Manufacturer / �'"� capacity gallons p DISTANCE TO: Well Fo ati(n � Nearest.) lined PER IT / - �-e ui u. 2 w No. of lines / / LengthIifie t' Total len inps V Trench w h %/ L9 inches Distance bet �e n ,ij / F-. -- -- Top of rile to finish grade Material beneath file // 4L9 Total effe ve ab rti n area _ � 9 j inches L Length Width Depth PERMIT NO. W 4 F• Type of crib Crib diameterr epth Total effective absorption area A n w w V) Well DISTANCE TO: Building foundation — Nearest lot line J CI�0-. D �-, � Driller — Distance to lot line PERMIT NO. w Bu i ing foundation DISTANCE TO: Sewer line Septic tank Absorption areas) OTHER PIPE PAATBRIALS SOILTESI"RATING IN � ALLER I v REMARKS 42 o at i �, wsse •• a �e . •.,,• t n. �'" d/ -berl A. Sh6or : r4`'aF ,i2 �. J No. 1457-E m .� EGTALLFIVE A � �g��tlnrs= APPROVEp: ,�fl"II j�,^a� t� DATE 7 r A �ERMIT NO: )ATE ISSUED: \PPLICANT: �DDRESS: "ONTACT PHONE: ^ .EGAL DESCRIP: .OT SIZE: 1AX BEDROOMS: H -T U P% H X W 3f, to% L. X -F "e U F= 11 ,, 11 11 -111[:)������� DEPARTMENT OF AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHOR8GE, AK 99501 264-4720 840816 09/25/84 ' C» DUANE ��USE % S&S ENGINEERING EAGLE RIVER� AK 99577 694~2979 SUBDIVISION: SCHROEDER SECTION: 2 TOWNSHIP: 141NI 12400 (SQ"FT" OR ACRES) 3 .isted below are the options available to you iystem" Choose the option thatt ~~~~~�~-�~�~��� be�iit fits your )EPTH TO PIPE BOTTOM (FT.) 4.0 �RAVEL DEPTH (FT.) 4"0 `OTAL DEPTH (FT") 8"0 �RAVEL WIDTH (FT") 2.5 �R�yEL LENGTH (FT") 32"O �RAVEL VOLUME (CU^YIMS "> 13"4 ^ANK SIZE (GALS) 1�000.0 ** 30I1- RATING (SQ"FT./BR> 85 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS LOT: 49 BLOCK: NA RANGE: 2W in designing your septic ' site. 4^0 4.0 0.5 3.5 4"5 7.5 14.0 5"0 28"0 28.0 14.6 20"8 1,000.0 ** 1�000.0 ** 85 85 � certi4'y that: 1" I am 4,aill iliar with the requireme1-1ts f,or onand wells as set {orth by the Municipality oj Anchorage (MOA) and the State of, Alaska" 2" I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria o this permit" 3" I will adhere to all MOA and State o{ Alaskat requirements 1*o1- the set back distances �rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot" 4" I understand that thispermit is valid i'or a maximum oand any enlargement will require an additional permit. :F A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES� `HEN (1) ST BE OBTAINED; (2) AS~BUILTS ]ILL NOT ECTION REPORT; AND (3) THE �LECTRICA CTRICIAN. 1I0NED DATE: �P1-:11.ICA1\1T ~ ~ ~ SSUED BY DATE: ''�-� C X SOILS LOG MUNICIPALITY OF ANCHORAGE Cl PERCOLATION o DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ��� DATE PERFORMED: LEGAL DESCRIPTION:/ De, cy SLOPE S TE PLAN �EPTH . TO 2 l' 0 3 C0 d 4 �. 5 U 7 d 2) Gross Time 8 Depth to Water Net Drop .0 9 J- G 3 10 C', a 11 of 12 13 14- 15 16 P 17 18- 81920 19- 20 COMMENTS PERFORMED 72-008 (6/79) p e ,� •Y �� R.•Qyh�rf/i , V e t1o. 1457.8^•,��� t.+y WAS GROUND WATER S ENCOUNTERED? `) L -- O P E IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 3 t 1 ` WAS GROUND WATER S ENCOUNTERED? `) L -- O P E IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN CERTI FI FT AN (minutes/inch) FT DATE OWNER OF LAND ADDRESS LEGAL DESCRIPTI DATE, - Started — PERMIT NUMBER AT iffing! log V.�Trjp.i irb Dr by DOC Co. dba SULLI"N WATER WELLS P.O. BOX 272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 Ended DEPTH OF WELL STATIC LEVEL OF WATER FT DRAW DOWN FT. GALS. PER HR KIND OF CASING KIND OF FORMATION: From Ft. to Ft. From Ft. to Ft. From—Ft. to Ft. From Ft. to Ft. toFt. FromFt. to MU Ft. to Ft. From DEPT. OF HEALTH & Ft. to�N From Ft. to Ft. From Ft. to Ft JAN 2 19 85 From Ft. to Ft. From Ft. to Ft. From_ Ft. to Ft. From Ft. to FtR EC E IV F D From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: I� �1111J�I.iiy`►[.lOOL I MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Le a2 cript u (�nc1ude }'ot, block., ,dubdivisiong section, township, range) Lo on ( dress or d rections) (b) Applicants NaP (. f,'o Telephone Home Business O %�© % C) f9. Applicants Address (c) Applicant is (check one) Lending Institution ; Owner/builder ; Buyer ; Other (explain); (d) Lending Institution Telephone Ads s --� (e) Real Estate Co. & Agent Address Tle ho/ne (f) ail tie HAA to the following address: 1 s e 2AC,1111r2V,IN1 �j„ ;a - - n, t•� �]11I°=F7 119 b���i , r�`°i� _ 2. 112e of Residence Single--FamilY� Number of Bedrooms 3. Water Supply Multi—Family Other (describe) Individual Well Community Public 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 Onsit: l Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Wage 1 of 2 ] J 5.;ineering 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 onsite 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 Address GR.- napar- vA Rhl, E Sna?_37�, A Date r r.. ° v u _ n (E ;. a e ..o ,eo..•8 4tabari A. she 2z CLI o. SCC\�e� 6. DEEP Approval c Approved for bedrooms By - R Telephone Date /-- y Approved Disapproved Conditional �a Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DEEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- AT'IONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAI, ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DEEP 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 DEEP 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. (DEEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19®84 MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 'JAN 2 9985 Legal Description: A. WELL DATA r' If A proved(Y/N) Well Classification ��/�"� , B, or C. D.E.C. Well Log Present /N) Date Completed 9 B Yield Total Depth 00 / `7 « __ Cased to 40 1 4- Depth of Grouting® Static Water Level 0 Pump Set At J, K, Casing Height Above Ground ?,_0 0 Sanitary Seal on Casing - Electrical Wiring in Conduit (VN) Depression Around Wellhead (Y _ Separation Distances from Well: To Septic/Ucidi=j Tank on Lot /D3 on Adjoining Lots./ 6) C) _ To Nearest Edge of Absorption Field on Lot on Adjoining Lots / Do To Nearest Public Sewer Line //� To Nearest Public Sewer i Cleancut/Manhole 1 To Nearest Sewer Service Line on Lot Water Sample Collected By 51'S + NXi/Z, ,; Date Z ,.- Z7 Water Sample Test Results�S�/�1R� - Comments A We'1.L_ /oto 1_' / t�O'T .> a.)yu u 4),J, 6xc 6s , &>9 , B. SEPTIC/ TANK DATA Date Installed /0 "3 `b+ Size /000 No. of Ccapartments 7 Standpipes tN) Air -tight Caps /N) Foundation Cleanouti) Depression over 'rank (YAP.Date Last Pumped�VJ Pumping/Maintenance Contract on File (Y/N) llk _; for �;" _ Holding Tank High -Water Alarm (YM) N Temporary Holding Tank Permit Separation Distances fran Septic g. Tank: To Water -Supply Well. /03 To Building Foundation /0 l_ _ To Property Line To Disposal Field To Water Main/Service Line N/A To Stream, Pond, Lake, Cr Major Drainage Course IJ/A Comments — Receipt # 1b Date Paid: ,�_ Amount: �� [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA D. Soils Rating in Absorption Strata ems}'., _Type of System Design�UJ� Date Installed f D " 3 - Length of Field 37- _ Width of Field ® _ Depth of Field 0 Gravel Bed Thickness[ Square Feet of Absorption Area f Standpipes Present (LM) Depression over Field (Yo Date of Last Acbquacy Test 1116� Results of Last Adequacy 'lest Separation Distance from Absorption Field: To Water -Supply Well /�I To Property Line U_ _- s To Building Foundation S g or � �� To Existing Abandoned System cn �_ Lot N/A ; On Adjoining Lots 30 To Water Main/Service Line j To Cutbank(if rp went) To Stream/Pond/Lake/or Major Drainage Course N To Driveway, Parking Area, or Vehicle Storage Area T7 r) _--- Comments. LIFT STATION Date Installed Gallons Manhole/Access at a j hum Off" Level at S i zs._n "Pump On Dimensions High Water Alarm Tested for Electrical Codes Comments Vent (YM) e -- Cycles during Adequacy lost. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request o I certify that I have checked, verified, or me conford to all MOA HAA Gu3dt on the date of this inspection. Signed—Date &L3 Lf1 �{ sFt>l�s C . Company MOA No. KB1/d5/s [Page 2 of 21 ines in effect ,burl A. ShAfer Ne, 1457-L _ 5 2-15-84