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HomeMy WebLinkAboutSCHROEDER LT 79'Schroeder Sip C);D OSZ Mob L(D � Llw 6►ocrK UNICIPALITY OF ANCHORAGE He& and Environmental Protea _in Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SSEWAC,�E DISPOSAL ;YSTUA C1q � _ NAME 1 4 ��-r`w � __ MAILING ADDRESS. -_R�r' ���__f_! IXC-p��__ PHONE �'7 L_OCAT-ION Ali.«• �'./ _. LEGAL DESCRIPTION ,.'1��-kl-zof- Ir 41 SEPTIC TANK: DISTANCE jNUMBER OF 1 I rc FROM WELL � � 15�1=_ MANUFACTURER��hc�_ MATERIAL __-��,��`�-� COMPARTMENTS INSIDE LENGTH INSIDE WIDE -H___ - LIQUID DEPTH _LIQUID CAPACITY /CDO GALLONS. ------------ 1 TI(_E DRAIN I TOTAL LENGTH a� J DISTANCE FROM WELLIUv_+_FOUNDATION._�j- _NEARESST LOT LINE__�_`OF LINE _ `� _O( # of Lines DISTANCE BETWEEN LINES __TRENCH VJIUTHIO IN. TOTAL EFFECTIVE ABSORPTION AREA _ __-�___� r'__ SQ. FT. LENGTH OF EACH LINE �i DEPTH OF FILTER P� DEPTH: TOP OF TILE E0 FINISH GRADE _t"MATERIAL [3ENEAlH'FILE _c[ _12—IN. ABOVE TILE IN. SEEPAGE PIT : DIAMETER ---OR WIDTH __., LENGTH__, DEPTH Log Crib _Rings_ Crib Size: DIAMETER____DEPTH__ DISTANCE FROM: WELL_�_�. TOTAL EFFECTIVE BUILDING FOUNDATIONNEAREST LOT LINE ABSORPTION AREA (WALL. AREA) -__SQ. FT. We 1 ]_ el� , Class: _L-gd Depth: 1� 7 Wel]_ Distance To: Lot Line Bldg: _4o ` Sewer Line: -- Pipe Materials: © CZa-�_ 4 of: Bedrooms: Installer: Remarks: Soz 1 4 — i - I �- I ! ! l i 1-� - -i- --- - - -- -�- - - I ! I Ise � -a , l !-0112P - -Pi J - -- ---- DATE �tq1"_7 APPROVED f �-- ,J+j VQ_1 i IT 0 Et E GEO -CHNI CAL & ®EVEL. , MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Ear! Ellis 694-27t SOIL LOG 688-2280 Soils Er Foundations Land Development Performed for: Name:f Tel. No. �t$ Mailing Address:-�j\`\`►�� r �— legal Description:�� Depth (feet) 52i1— Characteristics, 0 1 2 3 4 5 6 7 0 10 12 13 14 15 16 I 6J Ground Water Encountered: YesR y No If yes, what depth��_ Proposed Installation: Seepage Pit—_ Drain Field Comments:— - ­S�-'—" Performa ,7 �� July :laf 1977 TO. MOTI It May C011COM lIT3U C^P Lot 79 Schroeder Subdivision On-ni.te Sewer and Watebr 'vhis office has no otbjootion to placing a divrelling On the above, subject lot if the dwollinq :is not. wet plurnaccl or occupied until the nacessa.ry well and on--•si lto sewer parmi.trs are obtained and the Installation cit' carne- Is inspected and approved by this cieparty-,i nt.. If trhoro ara any further questions, please contact this office at 279-2511, c xtension 224 or 225. incerely, Joseph S. Blair, R.+`a. Environmental .3ervi.ces Manage JSB/ l j h M -W DRILLING, INC. DRILLING LOG Well Owner ---- Location (address of: Township, Range, Section, if known; or distance main -Use of Well Size of casing Depth of Hole feet Cased to Static water level —ft. (above) (below) land surface. Finish of well (check one) open end Screen Perforated Describe screen or perforation______L_ Well pumping test atgallonsper (hour) (minute) forhours with ofdrawdown from static level. Date of completion — .ueptn in feet from ground surface TO— TO- -TO- -TO— TO— TO— TO— TO— TO- WELL LOG 2 — STAfE7 - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Dyscription (include lot, block, subdivision, section, township, range) Location, (address or directions) (b) Applicant Applicant Address Telephone: Home3� 5�� �O�r BusinessY -�S U/ U (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other (explain); (d) Lending Institution _ ( Telephone Address ��C'G�in J -Gt c,� xJ — //�� .o/ (e) Real Estate Company and Agent Address Telephone (f) . he HAA to the following address: S� 2. TYPE OF RESIDENCE Single -Family k Multi -Family ❑ Other Number of Bedrooms O- 5(� 3 p777 Zvi/✓ 3. WATER SUPPLY Individual Well Community CI 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 Onsite ❑ PublicIIN 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. Page 1 of 2 72-025(11/84) 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 regulations in effect on the date of this inspection. Name of FirmTelephone —S A b'Fngiheor<irrq Address 4RIL-19Ar Date Eagle 12iver, Alaska 99.41m, 6. DHEP APPROVAL Approved for Approved �► �sF. GF �;��a� SeaAg lft yacnr `ufa• ° ��. 41awrQ •.,...a.. s 1467.6 ; w ja ,�hAu TM'��•]F bedrooms by/'�y'a, ! �, ,.-..1 Date Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/04) DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOH) MAR O 5 HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 RECEIVED 264-4720 / r7 Legal Description: _1�..�`5��/2d�91� A. WELL DATA Well Classification �(L l of (*N -T- If A, B, C, D.E.C. Approved (Y/N) r� Well Log Present ON,- Date Completed W �O� r77 ViId Total Depth b Cased to J 7 1 Depth of Grouting Static Water Level ;Loi Pump Set At Casing Height Above Ground — Electrical Wiring in Conduit (91W e /lir Sanitary Seal on Casing �/m Depression Around Wellhead (YQ Separation Distances from Well: X To Septic/Holding Tank on Lot %� / On Adjoining Lots©p F To Nearest Edge of Absorption Field on Lot [ W ; On Adjoining Lots ` i To Nearest Public Sewer Line _ 7s a To Nearest Public Sewer Cleanout/Manhole �aD r -/— To Nearest Sewer Service Line on Lot Water Sample Collected by 5�S nt�1nl�rr�Jn(6 — ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) — _ Air -tight Caps (Y/N) No. of Compartments Foundation Cleanout(Y/N) Depression over Tank (Y/N) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for — Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line To Water Main/Service Line To Building Foundation To Disposal Field __ To Stream, Pond, Lake, or Major Drainage Course Comments�� bivoK-ug Clnl Z -Z$ �(� T_0 0"ift,i Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Square Feet of Absorption Area - ate of Last Adequacy "rest Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well - To Building Foundation Lot To Water Main/Service Line ------ To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Dimensions Manhole/Access (Y/N) Size in Gallons" pump "Pump Off" Level at .— "Pump On" Level at _ Vent (Y/N) _ High Water Alarm Level at f Y" Pumping Cycles during Adequacy Test. Meets MOA Tested for — Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 5 & S Engin rig Date 3r Y— Signed _Si U" u R a�_.t cwt MOA No. Company E Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/841 APPLII IVT FILLS OUT UPPER HA 'ONLY Time Time - t%ne Propr+rlY Owner - _,. - � ' �.:. ..� - - .. Mailing Address -- / - ;,y i %, �/ �:�_% Zip Code �� Buyer /i Inspector I , ;'J • . ,-. ->'p� P t Address "Municipality of Anchorage" r_ ilk de Lending Institution ,�„_ - _' -;"rI c','i", , - Phone ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE —f -R3 5 / s, 4 BY:046i� Address Zip Code Date Sewer Installed Realty Co. & Agent i%�:-/-��-.,.',%/� /9r /' / Septic Tank Size Phone Address'.- / •%/ .; �... :�' j -: - /< /'/�, Zip Code L i.. Legal Description -� - Street Location j, » /ZiZ611 - Type of Residence OSingle Family Multiple Family No. of Bedrooms ❑ Other Water Supply ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Individual For wells drilled prior to that date, give well depth (attach log if available). ❑ Community ❑ Public Utility Sewer Disposal Individual Year Individual Installed: /z�_%� ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date / ��- cs Inspector Inspector Inspector Inspector Field Notes: APR 0 61993 �.� "Municipality of Anchorage" "Dept. of Health & Envirnpplgptat-Rrot�ciivFir� ( 6, -)--APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE —f -R3 5 / s, 4 BY:046i� Soils Rating. Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72023 131821 s Debbie McLaren Dynamic Realty P.O. Box 1796 Eaqle River, Alaska Dear Ms. McLaren, EXCAVATION WORK 99577 April 10, 1983 Reference: Lot 79; Schroeder subdivision ROBERT A. SHAFER CIVIL ENGINEER 694-2979 A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of 491 gallons of water over a period of 24 hours without any adverse effect on the system. it can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. it should also be noted that the well wires have been placed into conduit and now are in conformance with the Municipal code, 1f we may be of further service, please do not hesitate to contact US. , Sincee�; R BF�RT-A �S`IY ?E'R, P.L. AS/ss cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA l 1) O. BOX 754 LAG1_I RIVER, ALASKA 99577 il;00 604-2131 L>I: P;Ih TP,41: Ali UI h! "d i1t ."idU r 1 11 '.i Frd(jsI. PRO'i F.CIION April 7, 1983 Michael Coles Box 45 Eagle River, Alaska SUBJECT: Lot 79 Schroeder Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. The septic tank pumped with a receipt submitted to this office. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Please notify this department for a reinspection when the noted descrepancies have been corrected. If there are any further questions, please call. this office at 6911-2131. Sinc rely, Les $ucliic Environmental Divi�i n Eagle River Office 1\/r—�� �Kal•�..II If�A Yn wlrllllmA/1Q� 5. LEGAL DESCRIPTION—�— I�hf I 11.. +.- MUNICIPALITY OF ANCHORAGE hM.i Ift\1 I',VT CfiION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONENyI�` 825 L Street - Anchorage, Alaska 99501 ® MAR 2 3 1981 ENVIRONMENTAL ENGINEERING DIVISION NUMBER OF BEDROOMS Telephone 264.4720 R -E I V E 0 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1. PROPERTYOWNER 7. WATER SUPPLY PHONE James A. and Helen F. Bari iol _ 694-2557 MAILING ADDRESS ❑ PUBLIC UTILITY Box 45, Davis Street, Eagle River, Alaska 99577 8. SEWAGE DISPOSAL SYSTEM PF30PERTY RESIDENT (If different from above) _ PHONE 2. BUYER PHONE Joseph A. & Rhonda K. Nielson ❑ PUBLIC UTILITY 694-2557 MAILING ADDRESS SR Box 987, Chugiak, Alaska 99567 3. LENDING INSTITUTION PHONE Alaska Mutual (Smitty) 274--3561 MAILING ADDRESS Anchorage, Alaska 4. REALTOR/AGENT �� PHONE Sun Realty/Alma M. Werre 694-2509 MAILING ADDRESS P.O. Box 1201, F.agle P.iver, Alaska 99577 5. LEGAL DESCRIPTION—�— s Lot 79, Schroeder Subdivision STREET LOCATION Box 45, Davis Street 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other__ 29 SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY E Three ❑ Six 7. WATER SUPPLY TK INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM s **If individual/on-site, give installation date, --Lq—\ _ INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE P130CESSING CAN BE INITIATED. 72-010(3/78) I �I f �} 0 THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS TIME DATE NSPECTOR INSPECTOR INSPECTOR DIRECTIONS: — 'I. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY �e ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL -- — ❑ COMMUNITY ❑ PUBLIC UTILITY DATE DRILLED Connection Verified LOG RECEIVED —�---- 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified .— DATE INSTALLED ------ INSTALLER ❑SepticTank or EJ Holding Tank Size: U� If Tank is homemade give dimensions: — SOI LS RATING — TYPE OF TANK MANUFACTURER o -- TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area SeweTT ne Nearest Lot Line Absorption Area to nearest Lot Line — — 5. COMMENTS --' — --- TJX APPROVED FOR _� _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY ITitle) -- � L -3 -� C nGALDESCRIPTION '— -- 72-010 1RIRa„ 'Anal flICIPALITY OF ANCHORAGE DEPARTMEN. " HEALTH AND. ENVIRONMENTA PROTECTION 825 L Street, Anchoraap., Alaska 99501 264-4720 #1: Time 9:30 a.m. #2 Date 11-2-77 Wednesday Date Received: November 1, 1977 ^_ Time #3: Time Date Date Insp Willis Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Veteran's Administration Mailing Address: _ _ Phone: _ 2. Property Owner: Ronald Schwi.ger - Phone: 694-9837 Mailing Address: Box .194 Mercy Drive 99577 3. .Legal Description: Lot 79 Schroeder Subdivision 4: Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Three Number of Bedrooms: 5. Well System: Individual Well (x) Community/Public System ( ) Permit # ( S Depth of Well S71 4 Well Log on File Construction AMA" Bacterial Analysis _^ _ 6. Sewage Dis - po �s fal System: On-site System (x) Public Utility ( ) Permit # ( JwInstalled 1977 Installer��►- Septic Tank Size ( 4000 Manufacturer Absorption Area 01(Soils Rate _ Material �!1e Cj _ �-- 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line ^_ Absorption Area to Nearest Lot Line Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 79 Schroeder Subdivision comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved: — bate: Disapproved:Date: Department Worksheet: 5c) �" w MUNICIPALITY OF ANCHORAG II-)-� Department of health and Environmental P.r.otection rm p `t��({! _. 825 L Street, Anchorage, Alasl. r 99501 264 4770 vequcst for Approval of Individual Sewer and Water Facilities hies 1 . Property Owner: Mailing Address��/`/c/ -/fit ! cy—©a--5_[<'.--v_tfPhone: `%Y:.3? 2 4. Name of Buyer: tJ/ /vi fr L L--� --�-�' G C�---- - — -- - — Mailing Address: Lending Institution riaili.ng Address: Realtor/Agent: Mailing Address: . 41� /// /--- --- --- 5. Legal- Descri pL-ion: o T 7 t r- e c t Location: U �/6/ S---------_— --- 6 r Sincile Family Residence: Number of Bedrooms: Phone: Phone: Phone: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: * Individual. Well (vj Publi-c/Conununi-ty System ( ) If Individual Well, wel.l- depth ._S-z"m-_- If Community System, name of system Sewage Disposal System: "'On-site System (6:'jyy Public System ( ) If On-site System, date of insi.ailation: *NOTE: A tae:Ll .Log is required on ALL wells drilled since F,j75� **If on-site sewer system is over two(2) years olci, an adequacy Lest is reduii:ed by this cieparL-ment. A Pee of $25.00 must accompany each request before processing can be ir:itiated. 3/77