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HomeMy WebLinkAboutSCIMITAR #2 BLK 2 LT 33,1 — � � .�� — — ISI x' e� z �� ' � �S1- �3�.- SI MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMEN'TAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM Anka/OR WFLI_ INSPECTION REPORT '-�`--""�.---�---___�_..-�__�_.._�__.._�_----_.-_..____.A_._ NAME PFIONE L�NEW� - `.�.� MAILING ADD LEGAL DESCRIPTION LOCATION -� NO. OF BEDRB S U Y Well / Z� Absorption area p ` { DISTANCE TO: C Dwelling PERMIT NO. �:� y.• u i Q Manufacturer /� Material No. of compartments_ W rn Liq. capacity in gall ns IF HOMEMADE: Inside length Width Liquid depth DISTA Well Dwelling PERMIT NO. Manu r Material Liquid capacity in gallons -r = LLI DISTANCE TO: Well - J �7 Foundation G4 / ._ Nearesi lot line �j PERMIT NO. °� LL 2 Z LU No. of lines Length of e ch line Total leng h of lines Trench width — Distance between lines I-. CC _ -7 _ _ � L inches cc F Top of til, to finish grade -q f,/ ' _ Materia beneath the of Total effective absorptition area 12 W sG T m inches % J- e" J- wW Length Width Depth PERMIT NO. U Q F- Q WLU Type of c ' Crib diameter _ Crib depth _ Total effective absorption area rn [STAN Well Building foundation Nearest lot line W W Class .f Depth Building foundation Driller Sewer line Distance to lot line FARMIT NO. — Septic tanksorption area(s) OTHER i PIPE MATERIALS , •,w SOI L TEST RATI NG INSTALyLIE� REMARKS c, a 1 { 7 i s i e c. OV ED DATE LEGAL <� - / O iIAN�. "MUNICIPALITY OF ANCHORAGE 10.0/0 ly/8< Department Health and Environmental rotection 825 L Street, Anchorage, AK. 99501 _ 264-4720 L'. Imo/ # HANDWRITTEN PERMIT a 6 � bWELL AND`, ON-SITE SEWER PERMIT 'S ������_ Applicant: ��E�i/�t� Mailing Address: _/d=�vy 2 Location: �L t�L(Jc c)ck Phone Number: Jam..— Legal Description: S<</ -A Lel � 2 Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: _ Seepage Bed: Holding Tank: _ Maximum Number of Bedrooms: Soil Rating(sq.ft/br) Q (fa The Required Size of the Soil Absorption System Is: C� DEPTH LENGTH �3Qx S z GRAVEL. DEPTH WIDTH _ The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ ��� GALLONS # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * *..H. TWO(2) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on --site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedroom Signed: !� , _ .� >/ Issued by: Applicant Date: '-c� 606 u Lia r�--�— SWP/024(1/81) �!� 17 h -cam ��< �v� E(' .. '� c1c"C l qt) ® & E ENG AEERINC & ®EVEL®: 10E:NT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 686-2280 Bussell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 1-7 7-,; E/ �c��/ST •C1C'T-icy&/ Performed for: Name:__ Tel. No. Mailing Address: /-r� [ 2, C)` e /� /� Ale `l `7J 6 % Legal Description: �'T .� /JG <�c� C //Ti�%�_ �yi� C��� �'T 2— Depth Depth (feet) Soil Characteristics 0 _ _ _s 1 A4Z- / r f� o �� �T � ^— 5�-,ties Y ��� G/� c� b' J •f✓,��.5° 2 2 4 5 r�cc. i F--& r 6 7 8 —_ �7 10 11 . 2- e �)C> *06, 4- 12 --13 o =-O til 4 /_ ��i 7- 13 14 15 16 T To z IA/ dy 2- /--)/Z . PLOT PLAN PEHC. TEST Ground Water Encountered: Yes L"�'No If yes, what depth 1- �;T Proposed Installation: Seepage Pit Drain Field— Comments: ield Comments: � s`!.• earl P Ellis ` ne..eec '— Ki Performed by: ?ru _ Date: Z� z 7 h2_rf �f DOC Co. dba SULLMN WATERWM.IS P. 0. BOX 272, CHUGIAK, ALASKA 99567 c TELEPHONE 688-2759 -1 OWNER OF LAND DEPTI OF WELL _Y ADDRESS v STATIC LEVEL OF WATER F T LEGAL DESCRIPTION ___!:_J DRAW DOWN FT. DATE - Started Ended GALS. PER HR PERMIT NUMBER KIND OF FORMATION KIND OFCASING- From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. NICIPA � OF % HEA'0H PR ��F From Ft. to Ft.ENTAL 7, From Ft. Ft. From Ft. to I Ft. __L L_ Ft. to___u From Ft. to Ft. %2 Ft. t o IN I - From Ft. to r Ft. From'l From- Ft. to Ft. F�roni Ft. to t. _/:�qr From1 Ft. to _14 Ft. From __Ft. to— _FL -------- From Ft. to Ft---; From _Ft. to--- Ft. From Ft. to Ft. From_ Ft. to ----Ft. From�•'/_Ft. to Ft. Lo:_' From —Ft. to -------Ft.--- From o-------Ft.--- From Ft. to From ------Ft. Ft. Fronl______Ft. to- From-- Ft. to From ---Ft. to Ft. From —Ft. to—Ft. From Ft. to Ft. From_ Ft. toFt MISCL. INFORMATION: From Ft. to__—Ft. Froin—Ft. toFt Froni____Ft. to—Ft. From —Ft. to ----Ft. DRILLER'S NAME Municipality of Anchorage Department of Health and Human Services C11'lh5 Torn Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 May 24, 1994 Dean M. Powell 20189 Tulwar Drive Chugiak, Alaska 99567 6356 _;' Subject: Lot ,?,2 Block 2 Scimitar Subdivision #2 Permit #SW930120, PID #051-132-51 The subject permit, issued May 24, 1993 by this office for a single family well and/or on-site wastewater system, has expired as of May 24, 1994. A new permit must be obtained from this office for a well. and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincer -y, Obert W. Robinson Acting Program Manager On-site Services Copy of Permit MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930120 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:POWELL DEAN M & SALLY M OWNER ADDRESS:20189 TULWAR DR CHUGIAK, ALASKA 99567 PARCEL ID:05113251 LEGAL DESCRIPTION: SCIMITAR #2 SLK LOT SIZE: 42541 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT 2 LT 33 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 5/24/93 EXPIRATION DATE: 5/24/94 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PR RECEIVED B ISSUED BY: �= �y DATE: 9_� DATE: )-'Z ¢ _ y,3 , f lieV ,M `+S••'':i ' I� J� A� C Q �' n o •-'n 'M 4 n ,: I•{ '.,, 'i C), �_ � I 4,� I(�/. •�r ••�s��'Yd. [i'`°' ii o u G p i.. iye \ rQ : •.'d �- r, •l1 u u v ii 'c •: ii '(t �� u: U I 1 W C. all_ � I uu • l 9 V J) �� V 1'I V L V !1, � °I \ $ �•• i71 � .`,.4% :° � � � p n n n y .i u c "r Y )') N . '1 U°° w J U7. All dL aN s9 °ri ��30 z'ZZ Vii' o'Z. Z a11 o� 7. '%,g-7 !IN �"1� v o�fGi � U7. All dL aN s9 °ri ��30 z'ZZ Vii' o'Z. Z a11 o� 7. '%,g-7 D J YJ (, v D J YJ ifwg DOC Co,,,,,3 R E F I V E D SULLIVAN WATER WELLS JUN 141994 P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688.2759 MunicfpalltycfAnchor, , Dept. Health & I*itnan OWNER OF LAND DEPTH01-WELL e ADDRESS _ —�— LEGAL DESCRIPTION DATE - Started Ended _ PERMIT NUMBER LLt l �lQU k'((i2-,l- KIND OF FORMATION: From—Ft. From From o to—Ft... Ft. to Ft..— Ft. From Ft. to Ft. From From Ft. to Ft. tom—Ft.-� Ft. From From Ft. to Ft. to Ft. l ' Ft. " From From Ft. to_ Ft. to—Ft, - Ft. - From From Ft. to Ft. to Ft. Ft. From From _ ! Ft. to Ft. _ Ft. to Ft. From Ft. to _ Ft. From Ft. to _ Ft. From Froin Ft. to Ft. to Ft. Ft. Ft. From___- -Ft. to— MISCL. INFORMATION: STA I IC LEVEL OF %NATE- R FT. 1)R.1W DOWN FT. GALS. PER HR KIND OF CASING ' —-- -- From.__ Ft. to ---Fl. - _ 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. Fro m_Ft, to --r- —Ft. From ---Ft. o—_ to----Ft.-- _Ft._I I ' From Ft. to Ft. From Ft. to Ft. From Ft. DRILLER'S NAME MUNICIPALITY OF ANCHORAGE a 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 i Application Date 1116 — 1. GENERAL INFORMATION (a) Legal Description (include loot, block, subdivision, section, township, range) y Location (address or directions) -1n-�! (b) Applicant Name Telephone: Home __ Business_ Applicant Address e (c) Applicant is (check one): Lending Ins i-utfn ❑ ; Owner/builder 0 ; Buyer 0 ; Other (explain); ��1 n (d) Lending Institution Address Telephone (e) Real Estate Company and Agent __ ` _eye___ ' Address Telephone (f) 1v09r y e HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family [ ] Other Number of Bedrooms 3. WATER SUPPLY Individual Well Iq 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 Onsite Public 0 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 iJ Q`'"' "'" 5. ENGINEERING FIRM PROVIDING . .SPEC`f'IONS, TESTS, Frll_E SEARCH, DAi. ND INFORMATION 6. k 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 frorn 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. -, re Name of Firm Address �=aH- Date Z,76 r ,prn, Telephone DHEP APPROV r Approved for � _? bedrooms byW� Approved 1,-�� Disapproved — Conditional Terms of Conditional Approval lu 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 (nion) 5 EJ c ne 4 Ju- 14�i'/ 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 (nion) MUNICIPALITY OF ANCHORAGE (MOA)MUNICIPALITY OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) DEPT. OF lirALTIi & CHECKLIST - FEBRUARY 1984 ENVIRONMENTAL PROTECTION 264-4720 Legal Description: L,33 .< `L9 D _ A. WELL DATA Well Classification _ �✓ If A, B, C, D.E.C. Approved (Y/N)/1L Well Log Present (VN) Date Completed _ - B/ _ Yield 2..0 Q_t0 {f_f Total Depth L120 CasedtoDepth of Grouting -` Static Water Level __13 Pump Set At H Casing Height Above Ground _;;oo- Sanitary Seal on Casing dJ%) Electrical Wiring in Conduit¢/N) Separation Distances from Well: Depression Around Wellhead (YQ To Septic/Holding "tank on Lot / o 7� ; On Adjoining Lots / 0-c> ia To Nearest Edge of Absorption Field on Lot ,l/1 .; On Adjoining Lots To Nearest Public Sewer line P`' /'. To Nearest Public Sewer Cleanout/Manhole tj /- ,� To Nearest Sewer Service Line on Lot acs Water Sample Collected by Ga i Gly �r /"J_ ey::-'f/r4 Date i=LL ' � Water Sample Test Results Comments��n" T Sr S_ t jttil / tf/Et-f i� +��F-ss Q� ZoC�PH °� c�-s£-� i�`i'n r33�c�2�✓�rL, B. SEPTIC/NBUW�`a TANK DATA Date Installed lc7 I Size 1 No. of Compartments 21 Standpipes 6�YN) Air -tight Caps (*N) _ _ Foundation Cleanout (Y/&7P__ Depression over Tank (Yo — Date Last Pumped Ce) Pumping/Maintenance Contract on File (Y/N) h ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding "rank Permit (Y/N) Separation Distances from Septic/kioldfng Tank: To Water -Supply Well _ t o Z To Building Foundation -2- { I To Property Line —__A.42 t "� To Water Main/Service Line Course la Comments Page 1 of 2 72-026111/841 To Disposal Field To Stream, Pond, Lake, or Major Drainage Time me — Date Date Date Inspector Inspector Inspector Comments — — � � l Approval l , y, mit -t�44 •t-,Q`-, i P-a4p_.- z.-- 4`3 -- __ Date Sewer Installed _ Permit No. Septic Tank Size �— — Holding Tank Size. Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Ownerl�� ailing Address ��[>�U ( V. 8w/� o Phone — (P'4 de/ e'XX(A�- fJ/i —� — er (� e� c �nd0� 1 Address` — �t �7 SIJ ' �C Lending Institution l Phone Address ��/�/ /r�. JLL('4, — — Realty Co. &Agent — Phone Address Legal Tescription / 3J /( ,; Street Location Typyf Residence i9 Single Family ❑ Multiple Family No. of Bedrooms 13 U Other— WatSupply % Individual ATTACH WELL LOG. A well log is required for all wells drilled since June U Community 1975. For wells drilled prior to that date, give well depth (attach log If Public Utility availab le. _U A� ---al SewagelDisposal Year U Public Utility When Individual Installed: Connected to Public Utility:-- _U HoldinQTank�-- NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 't'hc�odore .J.Mi ssicTe ormoral Deli.very Chucl.i.ak, ATC y IR, 1902 ^ubject:- lot 33, Block 2, Sci.mi.tar /[) roar 'dr.. ''1.ss,i_ric q�Z'e AmDroval. for the individual sewor. and Wnter. f.IC - i.t.i_rS cirnnot he granted. until tho following iteral have Neon compl_(t.rsc!-' ° The wall. ca.;i.nct nr nds to hp extende(l twelve (1.2) inches vtbovo ground level. rxnosec3 wires to the well_ head are, in violati-on of the i:luni.cioal ity of Anchorage codos and must be encarm(l in conaui.t. rho ciepressi.on over the sewer System wi_ll need to be :fi.l.l.er! �So that surfaco water drains away 'irom tho St?wor ys'l:pm. `rhe «rater se.implo could not he taken due to silt content (turbidity) . The well should be 1:1u mhed cloar by turni.nq on a garden hose until_ clear water is ev .d.e..nt ov^r an extended Por:i.od of time, Plea, ,e contact t. -.his departrnent for a r_a .wimi)li.nci appointment-.. Pleame notify this dei-xartment :for e -i re_i nspection when the noted di_scrnpanci.es have: been correc_'t_od. TF ther:? are any further questi.onrs, nlcase call thi off ice a.L 264--472(). Sa.neerr:ly, Robert C. Pratt. Associate rnvironm(-ntal_ SpeciMA— 5T' CC Y (Ic:mo 1;nFior Fl,emrl.or r AFTI C. A13SORPTION FIELD DATA Soils Rating in Absorption Strata �' — Type of System Design ( a Length of Field a S I C"(4Date Installed r Depth of Field Width of Field ---1~� h Gravel Bed Thickness — Square Feet of Absorption Area rl� ) � — Standpipes Present PN) Depression over Field (Y/0 Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well -- ( (I I _ To Property Line To Existing or Abandoned System on On Adjoining Lots r� d- — r� � To Cutbank (if present) To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course 7J rs I k To Driveway, Parking Area, or Vehicle Storage Area i SQ�LR- r Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) -- " L I t "Pump Off' Level at Pump On eve a High Water Alarm Level at -- Vent (Y/N) — pC cles during Adequacy Test. Meets MOA Tested for Electrical Codes (Y/N) Comments umping y ** 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. Signed Date e'l *g� Company�MJI_ II 11,E Sli.� Z57 14 MOA No. - Receipt No. - a F: Date o ay m - Amount: $ `'��� Page 2 of 2 72-026 (11/84) �TbgripR. tarz ' t<Ica. i+t:i7•E *'i•'a'E' y ata, of f{i ,fir