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HomeMy WebLinkAboutSST BLK 2 LT 35,*'S,bT slp 0 1500,00 082 - 20-000 3 `"',UNICIPALITY OF ANCHORAGE, �, Hea. and Environmental Protek )n Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NA .L79- �"�� — MAILING ADDRESS5VO � �"�� ^der rPPHON�%1 LOCATION liO�a� /i�7trrLEGALDESCRIPTION �' `'may ' SEPTIC TANK - DISTANCE /// DISTANCE P�/, , COMPAR O ENTS FROM WELL MANUFACTURER MATERIAL_ /�jS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY""-- GALLONS. rii ran i i r_ii-Z TOTAL LENGTI+� / DISTANCE FROM WELL._L� FOUNDATION___NEAREST LOT LINE.OF LINE _3— # of Lines DISTANCE BETWEEN LINES TRF_NCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA 37S SQ. FT. LENGTH OF EACH LINE f DEPTH OF FILTER l DEPTH: TOP OF TILE l -O FINISH GRADE _—_ MATERIAL BENEATH TILE_ NG. ABOVE TILE IN. SEEPAGE PIT: DIAMETER OR WIDTH—, LENGTH—, DEPTH Log Crib _Rings_ Crib Size:! DIAMETER -__DEPTH DISTANCE FROM: WELL — TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE—_ . ABSORPTION AREA (WALL AREA)_SQ. FT. Well �® / Class: /ifJ D Well Distance To Bldg: Sew Pipe Materials: R .-. -F Rorl r.�rimc Installer: Remarks: e r;G Ti e 0 moi, 0 Q! 107 150o.1 3 i Not 15n F0 15 PET TON -T- it! 117 1^601 Ths K: ����� ^ �..... �_ �������� ����� us 42, W 1: 17, Th! ....... .......... ....... ....... H PHCKHGE PLHNT 1141 BE INSTHLLEO HT THE PERMITTEE'S OPTION SU8JECT TO THE FOLLOWING WI) IT}WAS � ' 1, EITHER H CLHSS I OR II NSF HPPROYED PLHNT MHY BE INSTHLLED` 2 H CONTINUOUS MHINTENHNCE RGREEMENT IS REQUIREW JF H MHINTENHNCE HGREEMENT IS NOT KEPT CURRENT 1jOU MHY BE REQUIRED TO ENLARGE THE SOIL HBSORPTION SYSTEM HND/OR YOU MHY BE �.... .......... ......... ......... ... � SUBJECT TO PROSECCyr IOK ... ... .......... .... ��...... ...... ..... .... .... �_ t bow 0 517 10 1:9 v 1 YG 1 =' 147 43 -1'1: K 3 TQA 05 low FOP U �45�: 11-J] : 11;��� � BHCKFILLING OF HNY SYSTEM WITHOUT FIVIA L INSPECTION HND HPPROVHL BY THIS DEPHRTMENT WILL BE SUBJECT TO PRUSECUTION MINIMUM DISTHNCE BETWEEN H WELL HND HNY ON~SlTE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOGS HRE REQUIRED AND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHYS OF THE WELL COMPLETIUN OTHER REQUIREMENTS MHY HPP1 IFICHTIONS HND CONSTR�CTION DIHGRHMS FIRE AYHILHBLE TO INSURE PROPER INSTHLLHTION �497 04 N % 9 1 - 1 14Z 10 R47 H -h Nil N�T to! �1�1. ��T"'; I CERTIFY THHT 1� I HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS RS SET FORTH BY THE MUNICIPHLITY OF HMCHORRGE. 2 I WILL INSTRLL THE SYSTEM IN HCCORDHNCE WITH THE CODES, ]� I UNDERSTHND THRT THE 04045I0E SENER SYSTEM MAY REQUIRE ENLHRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE TH914 ] BE�ROOMS 5ICAI ED�—_ _en.11r HPPLIC T 9�EPHENS CONST CAA/ 4040 "B" STREET, A ..."<.LAB ANCHORAGE, ALASKA 99503 ZS PHONE: 907.279-258.1 Form MLA -N72 The Drawing Board, Inc., Boa 505. D.11.,, Texas Well M -W DRILLING, INC.' a DRILLING LOG Location (address of: Township, Range, Section, if known; or distance main �I,'o;- .i ).i �,C1�=1C s t�`I� S-Ld?C.t:l_�i i -S 1AM, Allc�;lc:�:?'Ci,,'.rfy _Use of Well Size of casing , Depth of Hole �{ feet Cased to F` ' feet Static water level .50 ft. (abovil) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforation ;'�E� A Well pumping test at 20 gallons per (MUT.) (minute) for 1„ hours with I'M ft: of drawdown from static level. Date of completion % J 6 L7 / WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness V TO TO '' Or t s�nics TO i. Silty'gravel To Silty cobbleo t TO Loose Ux vel TO Sand 92 TO Sandy water F_�Xavel TO TO- O TO- TO -TO- TO NNVWA Certified Contractor Certificate No's. 814 & V13. 2 2 — STATE 5. LEGAL DESCRIPTION D. E RECEIVED INSPECTION APPOINTMENTS STREET LOCATION - TOME TIME TIME 6. TYPE OF RESIDENCE - NUMBER OF BEDROOMS L) r DATE DATE DATE ❑ MULTIPLE FAMILY IIx Three ❑ Six — fl) -9, INSPECTOR INSPECTOR INSPECT�R i,. ❑ COMMUNITY MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEtqn9MMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 • JUL 2 7 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R E C E I FUMES REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER F/-�QItITiES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten -(10) days for processing. 1. PROPERTY OWNER PHONE William Bulchis 349-3100(h) MAILING ADDRESS 608 West 4th Avenue 99501 279-8042(w) PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE263-5563 Kevin Yeager (w) MAILING ADDRESS % Sheffield House 3. LENDING INSTITUTION PHONE National Bank of Alaska 264-2883 MAILING ADDRESS - Pouch 7-025 99510 4. REALTOR/AGENT PHONE Dale Hopkins % Dynamic Realty 279-7611 MAILING ADDRESS 501 West Northern Lights Boulevard 99503 5. LEGAL DESCRIPTION Lot 3 Block 2 SST Subdivision STREET LOCATION - Homestead Trail 6. TYPE OF RESIDENCE - NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other XX SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY IIx Three ❑ Six 7. WATER SUPPLY XX 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.) On file. B. SEWAGE DISPOSAL SYSTEM - XXX INDIVIDUAL/ON-SITE** 1977 YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) U 70nin IR." R/70I THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCENUMBER ❑/SINGLE FAMILY ❑ MULTIPLE FAMILY OF BEDROOMS ElONE ❑ TWO LW /THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY La INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified_LOG PERMIT NUMBER DEPTH OF WELL J DATE DRILLED RECEIVED 3. S AGE DISPOSAL SYSTEM INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified _ PERMIT NUMBER DATE INSTALLED INSTALLER 4y ❑SepticTankor ❑Holding Tank Size: /1- S© If Tank is homemade give dimensions: SOILS RATING L TYPE OF TANK MANUFACTURER - TOTALABSORPTIONAREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ❑ APPROVED FOR f BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE Q U 70nin IR." R/70I e MUNICIPALITY OF ANCHORAC^_'5 ' Departmenc of Health and Environmental Protection �® 825 L Street, Anchorage, Alaska 99501 264-4720 �I-eeqquest for Approval of Individual Sewer and Water Facilities 1. Property Owner J ., Mailing Address: (� 4� ��Phone:���_ 2. Name of Buyer: Mailing Address Phone: 3. Lending Institut' '"' 57 a Mailing Address: �Cc_�i %D 2S�e� Phone: 4. Realtor/Agent: Mailing Address: Phone: 5. Legal Description: /i / — Street Location: /f A 6. Single Family Residence: ( ) Number of Bedrooms: .� Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply: *Individual Well �} Public/Community System ( ) If Individual Well, well depth If Community System, name of system 8. Sewage Disposal System: *tn-site System ) Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. **If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 Bill Bulchis SRA Box 54-C .6nchorage, Alaska 99507 Tobben SpurklAnd P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 S E W E R A D E Q U A C Y T E S T MUNICIPALITY OF ANCHORAGE DEPT. O" ii-,',LT11 & ENVIRONMENU.P4.UiECfION L AUG 1 r1 RECEIVLD Aug. 129 1981 Legal: Lot 39 Block 2, SST S/D Location: On Homestead Lane Owner: Bill Bulchis Residence: Three Bedrooms tJater. On Site Well Sewer: From Municipal Records: Tank Greer, Two Compartments, Steel, 1000 gal Absorption System Trench, 34 feet long, 11 ft deep, 6 ft of gravel Absorption Area 408 sq. ft. Soil Rating 125 Installation Date Sept. 1977 Date of Test: Aug. 11 and 12, 1981 Test Procedure: System was inspected on Aug. 6. Depth of liquid in trench sump was 19''/2 inches. Bottom of sump was 11Y2 feet below ground. +�` z gQkx Tank was pumped on Aug. 10. On Aug. 11 added to the trench sump and the water ^`.�� �...Ajj water was taken: yAt! •'•�`-� a level monotot•ed. The following readings were 49TH Begin fill at 12:30 pm 17 inches. • •••• ••• Add 200 gal 44 /............ .•. Add 200 gal 44 o. 2225-E Add 300 gal 47 JUNE 25, 1971 y �i Add 200 gal 48 \�NAL1S! N,4 Q a Check Aug 12 at 1:30 pm. 22 inches Test Result: Approximately 900 gal. of water was discharged into the trench. During the next 24 hours more than Boo gal was absorbed by the system. The municipal code requirement is 150 gal per bedroom. This system surpasses that requirment. 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 2.64-4111 GFOHGE M. SULLIVAN, N.A YO DLPARTMENT OI- HEALTH AND ENVIRONMENTAL PROTECTION August 4, 1981 William Bulchis 608 West 4th Avenue Anchorage, Alaska 99501 Subject: Lot 3 Block 2 SST Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to () this office from the Chem Lab, 5633 B Street, for our review. (2) Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit and buried. This will need to be reinspected by this office. (3) The septic tank pumped with a receipt submitted to this office. (4) An adequacy test needs to be performed on the existing p,a 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. If there are any further questions, please call this office at 264-4720. Sincerely, James S. Roberts Associate Environmental Specialist JSR/ljw cc: National Bank of Alaska MUNICIPALITY OF ANCHORAC=� DEPARTML OF HEALTH AND ENVIRONMEL )L PROTECTION 825 L Street, Anchoraac-. Alaska 99501 264-4720 Date Received: January 11, 1978 #1: Time 10:30 a.m. #2: Time #3: Time Date 1-13-78 Friday Date Date Insp Pratt Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Mailing Address: 2. Property Owner: Stephens Construction Mailing Address: 1601 East 84th Court 3. Legal Description: Lot 3 Block 2 SST Subdivision 4: Single Family Residence: (X) Multiple Family Residence: ( ) Phone: Phone: 349-4675 Number of Bedrooms: Three Number of Bedrooms: 5. Well System: Individual Well (x) Community/Public System ( ) Permit # Depth of Well Well Log on File ( ) Construction Bacterial Analysis 6. Sewage Disposal System: On-site System (X) Public Utility ( ) SVS Permit # Installed 1977 Installer Septic Tank Size /Aso Manufacturer JN-e�r4wci2K Absorption Area Soils Rate is Sd Material 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 3 Block 2 SST Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved: 02,�N�ca� Date: Disapproved: Date: Department Worksheet: MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection, ® 825 L Street, Anchorage, Alaska 99501 264-4720 i9 _ equest for Approval of Individual Sewer and water Facilities 1. Property Owner: Mailing Address: \L,C) � ���� � Phone: 2. Name of Buyer:,\���\n�> Mailing Address: Phone: 3. Lending Institution: Mailing Address: Phone: 4. Realtor/Agent: Mailing Address: Phone: \� \�o� C > ' 5. Legal Description: �� Street Location: 6. Single Family Residence: (\y Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply: *Individual Well (vy Public/Community System ( ) If Individual Well, well depth If Community System, name of system 8. Sewage Disposal System: "On-site System (vf� Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. **If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77