Loading...
HomeMy WebLinkAboutSCIMITAR #2 BLK 2 LT 36e *osI- I3a-.�-6 MUNICIPALITY Of ANCHORAGE MUNICIPALITY OF ANCHORAGE: ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF Hi_,'.Lf :^ & �1 ENVIRONMENTAL ENGINEERING DIVISION FNVIROi\Ni[NT;iI. i .L;fLCTION x. _ 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION R0013T ��� -�—�e�AA_—'���� NAME ���N/l/ y✓ ���(_) /lI /L -- -- --- PHONE ,oy„'/j \ NEW PGRADE MAILING ADDRESS - - LEGAL DESCRIPTION Z67- L_(JC/4 &i(l /7 LOCATION 7`c/ L VV 2 1)4111 NO. OF BEDROOMS .3 DISTANCE TO: Well %/�jg _ Absorption area / _ Dwelling _ PERMIT NO. v -„ � t-7 — � _Y 1- 7 W Manufacturer Material No. of compartments r Liq. capacity in �gallons ��� IF HOMEMADE: Inside length Width Liquid depth Y DISTANCE TO: Well Dwelling PERMIT NO. J C7 Z _ _ _ � Z b Manufacturer Material Liquid capacity in gallons w S DISTANCE TO: Well Foundation / "Zo ' / Nearest lot line / PERMIT NO. -7 g D�' o n Z P: z w No. of lines 4 Length of each line 8�� � J J Total len th of lines 10 ` ___ Trench width �(1 inches Distance betty on lines F Top of file to finish grade Material beneath tile Total effective absorption area �s� inches W Length Width Depth PERMIT i. V�1%� l7 a3 I2 Type of crib Crib diameter Crib depth Total effective absorption ai ee0o Lu ••'"a• V) DISTANCE TO: Well Building foundation Nearest lot line �_ ° `�'� .`°e L g J Class Depth Driller Distance to lot line '451RIM oNl s°°° W DISTANCE TO: Building foundation Sewer line Septic tank A 'pttt4i4°Earl P. �` � � % . Earl P. [Ills W Ell -HER NO. 1745-E 01 PIPE MATERIALS PVC P'-*S7'/c_ - SOIL TEST RATING / 7S //t/s M INSTALLER / 12 REMARKS WgTT2 f- ()A13 l=iar a / In t ei) u I�lrcc. e�,c Q� ez i _) 1�LS IS LF_ Opti/STT - APPROVED DATE LEGAL LUT ���A/<. 5c F4 /Z ..:: t �-:. r.i I I ':.: I I 1'. . II '� i -II 1 1 :; ::; I •.1,.r 1 ,-.'L.l I'; _.:: F II I I I 11;.1 r r � . ... .... ........ ..:: t �-:. r.i I I ':.: I I 1'. . II '� i -II 1 1 :; ::; I •.1,.r 1 ,-.'L.l I'; _.:: F II I I I 11;.1 r r � December 31, 1979 ';oht:nv Womac most Off icc i3ox 166 Chugiak, Alaska 99967 _A')KA 99501 Permit , 790626 Subject: Lot 36 Block 2. Scimitar. Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well., a well log should be sent to this department to document: the installation date. :Gf an engineer has inspected the installation of the on-site sewer system, please have them send us the as--bui.lts for our files. If there are any further questions, please contact- this office at 264••4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Speciti-' LNB/1jw enc: Copy of Permit O & E ENGENEERINC & DEVELOI MENi CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694--2774 Performed for: Legal Description Depth (feet) 0 Soil Characteristics SOIL LOG Earl I -Ills 688-2280 Name: / Mk) /r/� Tel. No. . M a i I I n g Address: P 0, 7 3 r� f.8 ip �7 C� ,: �JA.-6:�sC ate/ - <_��=%sT�i O %�/� ._. j ti -f->, ✓1!/')- E''7 Soil Characteristics E 10 12 13 14 15 3 r� ° I I I I 5 i 6 —_ 7 8 E 10 12 13 14 15 PLOT PLAN PERC. TEST 4/4�t v 16 __ Ground Water Encountered: Yes No If yes, what depth-- Proposed epth _ Proposed Installation: Seepage Pit Drain Field C Performed by:'.j(/, //,. " (�` �� Date: r� I I I I i PLOT PLAN PERC. TEST 4/4�t v 16 __ Ground Water Encountered: Yes No If yes, what depth-- Proposed epth _ Proposed Installation: Seepage Pit Drain Field C Performed by:'.j(/, //,. " (�` �� Date: � TV I U 64 4 : K QT"W" M L- 1: -F "W" CA F07 NO IV! K -- "-I Q TO Fif Q & DEPHRTMENT HEHLTH HND ENVIRONMENTHL GAD TECTION 825 fit EEll , HNCHORHGE, HK9ty501 264~4720 I GF I j 1 � R.-� PERMIT NO ( 811125 ) MOIL ICRNT GREGG H TURNBULL P. IVER 694�]999 LOCHTICIA TMid HR DRIVE LEGHL LOT ]6 BLK 2 SCIMITHR SUB LOT SIZE 58000 SQUHRE FEET MINIMUM DISTHNCE BETWEEN H NELL HND HNY ON~SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR R PRIVHTE NEL. OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM H PRIVHTE NELL TO H PRIVHTE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEEK WELL LOGS HRE REQUIRED HND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION OTHER REQUIREMENTS MHY HPPLY. SPECIFICHTIONS HND CONSTRUCTION DIHGRHMS HRE HYHILHBLE TO INSURE INSTRLLHT[OPA. Q 1TRE No! M JE "I- EVE X F" 1: IT! NET YET Q 1H CD ERE M Q 15E FQ: ��" K lot E3 f L I CERTIFY THRT 1 I HM FHMILIHR WITH THE REQUIREMENTS FOR ON~SITE SEWERS HND WELLS HS SET FORTH BY THE MUNICIPHLITY OF HNCHORHGE 2� I NILL INSTHLL THE SYSTEM IN HCCORDANCE WITH THE CODES SIGNED� �� ---~—~~—�--~~~ 1 LL ..... ... _... ...... .... OR it: NO I IF :0 11 0 �V 11 ' DEPHRTME�T O� HEHLTH HHD CITY IRONMENTHL PxdTECTlON 825 'L' STREET/ ��CHORHQE/ HK99501 264-4720 IF PERMIT NO. ( 790061 ) RPPLICHNT JOHNNY WOMHC PO BOX 166 CHUGlHK �88 9149 iOCHTION ~EGH�. L]6 B2 SCIMITHR S/D L[D~ SIZE 587]6 SQUHRE FEET MINIMUM DISTRNCE BETWEEN H WELL MAD MYON~SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVRTE WELL/ OR 150 CO FROM R PUBLIC WELL UPON THE TYPE OF PUB1.IC WELL WELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ]0 0RYS OF THE WELL COMPLETION. OTHER REQUIR��ENTS �HY HPPLYSPECIFICATIONS HND CONSTRUCTION DIHGRHMS HRE AYHII TO PROPER L1-:1TION. 0-8 37 0- E::�������� ���������� ��L� I CERTIFY THHT 1� I HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS HS 5ET FORTH BY THE MUNICIPALITY OF HNCHORHGE. 2� I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CODES � SIGNE0� H�P�I�HNT ��HN�Y WOMHC ` ISSUED Y� ~ .~~..... .....DHTE-�~f a December_ 31, 1.979 Johnny Womac Post Office Be,< 166 Chugial:, `Ilaska 99567 Permit � 790061 Subject: Lot 36 Block 2 Sciriitar Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calenda.i: year basis, as stated on the permit, by authority of Municipal o3rdi.nance. if you have drilled the well, a well. log should be sent to this department to document t_he installation date. If an engineer has inspected the installation of the on -•site sewer system, please have then; send us the as--builts for our files. If there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Speer st LNB/ljw one: Copy of Permit 21 MA Jto Q coN F FH F F+ H EF fa F+ F+ F+ H w O O O Flo C� O O W � W � 6�""'crJVIFN` N�'tFfVTq�nR�C1�CTIF�V Je W W i 3 i w 1,9f 7 O Q � 0 0 8 O © d Q Q O H F 3 A C4 C4 a W C4 C4 OG C4 W `i O O O O 0 O O O 0 O O O O a W C4 w zV. o W w o 0 0 0 0 0 0 0 0 0 0 0 CG w I O x CG tx r� "4 a CG C4 C4 a: CG CG w w w w w w u. w w z m m a Q' � 0 Y Y 4ft V Q J a a+ J a Y a J D � on a I W I �i W V) X Q W � m U LL LL H 0 a F FH F F+ H EF fa F+ F+ F+ H w O O O Flo C� O O W � W � 6�""'crJVIFN` N�'tFfVTq�nR�C1�CTIF�V Je W W i 3 i w 1,9f 7 O Q � 0 0 8 O © d Q Q O H F 3 A C4 C4 a W C4 C4 OG C4 W `i O O O O 0 O O O 0 O O O O a W C4 w zV. o W w o 0 0 0 0 0 0 0 0 0 0 0 CG w I O x CG tx r� "4 a CG C4 C4 a: CG CG w w w w w w u. w w z MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES �} Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 1-2 ~ 1 HAA # 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Lot 36; B.2ock 2; Subd S�uni�an ivision Add 12 20273 Tutwaa, Dkive Property owner Steve R. Johnstone Day phone 688-4539 Mailing address HC 79 Box 146 Chugiak,_A2as a. 99567 Lending agency Mailing address Agent Y1UU I uoJ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADF-C attesting to the legality and status of system. 72-025 (Rev. 1191) Froni MOA 121 Municipality of Anchorage Department of Health & Human Services 11 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: f-t%-rkle-S6arcelI.D. A<v,O. A� Z — A. WELL DATA Well type `(LY'J A� If A, B, or C, attach ADEC letter. ADEC water system number ' `A. — Log present ON) � Date completed --A(:>- I Co - 0 Driller __ 1_Px�I Total depth 3 LIQ Cased to 1 QS' Casing height 0 Sanitary seal &N) Wires properly protected((j'$/N) FROM WELL LOG AT INSPECTION lu �} V) Date of test 10 -IV 9-k Static water level 3yo C a LLA Well flow5,� E5T d g.p m. '? Pump level y� 1��, 5 — C-3 � ! t t n SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot --deo ; On adjacent lots _ 100 �k Absorption field on lot too _ ; On adjacent lots — t on 4 Public sewer main °!L� Public sewer manhole/cleanout _ Sewer service line 2 (� Petroleum tank WATER SAMPLE RESULTS: Coliform O 6,0L -11100A Date of sample: g=-7>Iq Nitrateti F � �`�� '"` A Other bacteria d Z Collected by: S & S ENGINEERING 17034 Eagle River Loop Road No. B. SEPTIC/HOLDING TANK DATA ATA Eagle River, Alaska 99577 � Date installed ��flTank size t v art- Compartments 2 _ Cleanouts ON) Foundation cleanout (VN) —'q-- Depression (Y/,M IJ High water alarm (YAW) Date of pumping 0i FM 41arm tested (Y/N) — I/n Pumper T/z. Gf ss®oaG SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wel I(s) on lot l n C> `X On adjacent lots 1 bo , k To property line I (71 Absorption field Surface water/drainage 1 t�>o> ' k Foundation a Water main/service line / 0 1 I 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE CHEMICAL & GEOLOGICAL, LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Client Sample ID L36 B2 SCIMITAR S/D #2 PWSID UA Collected AUG 24 91. @ 10:00 hrs. Received AUG 25 92 0 14:36 hrs. Preserved with AS REQUIRED Analysis Completed : AUG 27 92 Laboratory Supepe isPHEN C. EDE Released By IA�— ANALYSIS RESULTS for INVOICE # 57470 Chemlab Ref.# 92.4439 Sample # 1 Matrix: WATER Client Name :S & S ENGINEERING Client Acct :SNSENGP BPO# Req# Ordered By :ROGER SHAFER Send Reports to: 1)S & S ENGINEERING 2) PO# :NONE RECEIVED ................................................................. Parameter ..----------------------------------------------------------------------------------------------------------------------------------- —...................................................,...�.__...,: Results Units Method Allowable Limits NITRATE-N 0.54 mg/l EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: RAY. Remarks: 1 Tests Performed See Special Instructions Above UA-Unayailable ND= None Detected See Sample Remarks Above NA- Not Analyzed LT -Gess Than, GT -Greater Than r2i isms Member of the SGS Group (Societe Gendrale de Surveillance) A COMMERCIAL TESTING & ENGINEERING CO. AIS DIV CHEMICAL & GEOLOGICAL LABORATORY ueogerogr � TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM I.D. # K PRIVATE WATER SYSTEM TO BE COMPLETED BY LABORATORY .s Final Membrane FII exults Coliform/100 ml Reported By G It Date —_ Z TNTC = Too Numerous To Count �6od Time: a.m. OB = Other Bacteria p.m. ;fid?8GS Member of the S( PART ONE: OF TWO REMAINDFI2 Tn vnl I ma Analysis shows this Water SAMPLE to be: Name satisfactory S & S ENGINEERING Phone No. 17034 Eagle River Loop Road No 204 Mailing Address Eagle River, Alaska 99577 EJ Unsatisfactory ❑ Sample too long in transit; sample should cay riot be over 30 hours old at examination staleZJp Code to indicate reliable results. Please send SAMPLE DATE: new sample via special delivery mail. Mo. Day Year Date Received �J �% & SAMPLE TYPE: Time Received / VE Routine El Check Sample (for routine sample Analytical Method: Membrane Filter with lab ref. no. ❑ Treated Water ❑ Special Purpose ❑ Untreated Water " No. of colonies/100 ml. SAMPLE No. LOCATION Time Collected t I �� Z Collected By Lab Ref. No. Result* Analyst lU'. U Dpi F—M 2 L �� r•1 rCr�10 `L` Z I 92.4439 m 3 I — m ____�--_-I� {'+ C BACTERIOLOGICAL •0 READ INSTRUCTIONS WATER ANALYSIS RECORD Membrane Filter: Direct Count //-�� C/ BEFORE Verification: LSB ColifornU100 mi BGS COLLECTING SAMPLE Fecal Collform Confirmation Final Membrane FII exults Coliform/100 ml Reported By G It Date —_ Z TNTC = Too Numerous To Count �6od Time: a.m. OB = Other Bacteria p.m. ;fid?8GS Member of the S( PART ONE: OF TWO REMAINDFI2 Tn vnl I ma Time Date Inspector APPL-Ir NT PICKS OUT UPPER SIA ONLY Property r =r Carolyn Vanator Phone Mailing Address SR21 a-'' n��_6 Zip Code tcr�`T Buyer - Address Zip Code Lending Institution Phone Address zip Code "Municipality of P,tnchc!ago "Dept, Realty Co. & Agent Commonwealh1i Area Inc. P.O. Box 249 Phone Eva Lokna Address Eagle River 694-9555 APPROVED BEDROOMS zip Code Q n _" __ 'CONDITIONS OF APPROVAL Legal Description LT. -- 36, Blk 2 Scimitar Subdivision Unit # 2 Street Location Tulwar Drive Type of Residence Single Family DATE ❑ Multiple Family No. of Bedrooms -'3 ❑ Other -- Water Supply Well to Tank --- r?i. Individual ❑ Community ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Public Utility For wells drilled prior to that date, give well depth (attach log if available). Sewer Disposal rW Individual ❑ Public Utility Year Individual Installed: ❑ Holding Tank When Connected to Public Utility: - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Date Inspector Time — Dale Inspector TimeTime Date — Inspector I/ Date Inspector Field Notes: �'L,li`-�- Y�;_o AUG 2 91983 "Municipality of P,tnchc!ago "Dept, of Hoalth & - __ _ ___ Environmental Prate tl�o APPROVED BEDROOMS _" __ 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received __� Well to Tank Septic Tank Size /-0 00 j. i,doc.K Z I C! h, OW j. L. LW Dn o f I v ri , a oja I i77. ve, t.) U 11= C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) Pump off' level at Cycles tested — Meets MOA electrical codes (Y/N SEPARATION ANCE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA pa zj-vt Date installed I(;1- 1 `I On adjacent lots Surface water Soil rating 1115-'VOIR System type l~ AL1 t Length Width so Gravel thickness —Total depth Total absorption area lob e-' Cleanouts present &N) Depression over field (Y& - �-� Date of adequacy test Results fail) F" for —_ Tr1G «) bedrooms Peroxide treatment (Past 12 months) (Y�a pC alo %JAJ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot !o e, (� On adjacent lotsI p?v �� + Property line__16\\ I� To building foundation o To existing or abandoned system on lot On adjacent lots -i0 ( Cutbank N A- Surface water Curtain drain t_�` E. ENGINEER'S CERTIFICATION tid Water main/service line d (k Driveway, parking/vehicle storage area _ — 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. t:9 1q ooa99op� Pel res 5& S IvNGINFERING �' o a"°n 0 oQ P 17034 Eactle River Loop Road �� � "#�_�' °a FP Signature d-Utrt.-�Q4- r- ,9 `��r�, +� a Eagle hive.: Alaska 99577 �o� Engineer's Name n X Date 1�1-)-`-L- HAA Fee $ �� ®` d -O Date of Payment r l Receipt Number Waiver Fee: $ Date of Payment Receipt Number i J, 'J. No. 82{b �'�•q a �'`f. 5. STATEMENT OF INSPECTION BY ENGINEER 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 application 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 furtherverify 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 Firmu Phone Address 17034 Eagle River Loop Road No. 204 Each a River: Alaska Engineer's signature 6. DHHS SIGNATURE Approved for %GAttbedrooms. Disapproved. Conditional approval for Additional Comments auric Date — 2 �-�0 AV �AIgYG,Ofe,e��a,R,e,Y,9 e ROGcR J. �HAFER ( 6" .e No. 6215 pROFESSidNP bedrooms, with the following stipulations: Date _ Z The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. 72-025 (Rev. 1/91) Back MOA U21