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HomeMy WebLinkAboutSEA TURN BLK 1 LT 4SEA-tw�t 51v SOilS ��t�orrn�►-c�►� iLmd'olor Development Services Department 0 Building Safety Divisicn 0 Y J On -Site Water & Wastewater procram 4700 Brayaw Street P.O. 6ax 1S6c.,0 F Marts Begich Anchorage, AK 99519-6650 Maycr w.,Y mu�o.ninn�n. 1907)143-7974 Pump Installation Log Well Drilling Permit Number. SW_ Date of Issue: _ Parcel Identification Number:_ Legal Description Property Owner Name & Address: /j1CiChNv�f- 5ea %rnrn 61 L y Pump Installation Date: -4111&169' pump Intake Depth Below Top of Wen Casing: ?y feet pump Manufacturer's Name: f 4PJ/leA'f Pump Model: S0(fSH4711S42VE Pump Size %Z hp Pitless Adapter Burial Depth: 9 feet pitless Adapter Manufacturer's Name: 9�4 Pitless Adapter Installer: fJ/jl Well Disinfected Upon COmniedon". f Yes Q ivo Method of Disinfection: C hbf;Ne ?0#P/ Comments: Pump Installer Name: 511A)x p4yj)z @ 1140PS Jew Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pomp installation.- 72-01 T (Rev. 3/78) 1C.J MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HE'ALTII & ENVIRO(\IMFN I'AI. P[IO'I'FGTION j, ENVIRONMENTAL ENGINEERING DIVISION 3251. Street - Anrhm-age, Alaska 99601 Telephone i ,4-4720 ON-SITE SEWAGE DISPOSAL SY ;TFM ANWO`{ Ut/ELL INSFIF ;TION RFPC)RT NAME jl /� k, } II—ti ...'rPHOls!rNF.W E_A1PGRADE - — - ---- - - ---- MAILING ADDRESS -,N^ LEGAL DESCRIPTION LOCATION NO. OF B DROOMS Well Absorp on area Dwelling Tt14 DISTANCE TO: 7) / - ` I '% 1- R Manufactur /� Ma ori; NQ e..�.'ISe PERP.�#,T, 0 --Yy�- No. of compartments Litt. c, I acity in gallons Inside IF HOMEMADE:length Width Liquid depth ^ DISTANCE TO: Well Dwelling PFRMIT NO. o z ¢ -- ---- -- ----- T ._ N Manufacturer Material Liquid capacity in gallons Well /� Foundation en( Nearest lotJ ne uJix DISTANCE TO: /b� (( a !I � _�CQ` PERMIT I& z z Lu No. of linesr� Lengti Qjeach linyu i C`' ®� Total elof linos Trench width`` ( e�((J inches_ Distanr/e j�e N eq lines F Lu cc F- p - - _/06 .- Top of the to finish grade e (mob - iii - - -- Material beneath tile inches( Total eff c� rpf on area w Lenyth Width - - -( - Depth �— =-T---�---- ry-----r-- - - PERMIT NO. 0. E­ LU Crib depth Total of fective absorption area Type of crib Crib diameter LLi N DISTANCE TO: Well J Building foundation Neatest lot line J Class -... Depth Driller Distance to lot line it PERMIT NO. J tank w DISTANCE TO: Building foundation Sewer line Septic Absorption mea(s) OTHER - �- Ula_. - f-- PIPE M RIALS _ _ _�_ SOI L TEST RATING INSTALLER/ REMARKS 71 --AT( — -- �I ron ­AFrfFKVFP �_--_-_ DATE L FG AL 72-01 T (Rev. 3/78) 1C.J 'I"YPE OF' SOIL.. ABSORPTICIN S`rISTE[,1 IS: TRENCH Pelf,11-:111MUM N1JMBF'R OF" BEDROC.jr-T..­; = 3 SOIL RATING (S(. -"I F'I*,,,'E:R)--- ;2.165 TFIE REQUIRED SIZE OF THE SOIL. AB.SORPTIOt-.1 SY,5TEM U" F-`7 V-1 L.- P-4 (3 -f- VA IFS" n V I:_:_ P E. -", rZ-. F=" -E... 9--+-:-=-, -1- THE Ll":NGTH DIMENSION ISS THE LEhIGTH FEET) OF TVIE TRENCH OR THE DEPTH OF' A TRENCH OR PIT IS THE DIS"I"ANCE BF-D"WEEN THE .--AJRFT:ICE CIF "I"I.-IE C31ROUND AND THE BC.0-roil OF E.x'CA%-IATION ::IN FEE'T). THERE IS NO :;ET * " ::ET 1,11I)TV-1 FOR TREI`.-ICJqEC;, THE GRA'; EL DEPIT-1 P5 TFIE rITNII-R.101 DEPTH OF' GRA1yIEL. BF-114EEN rHE OL.11TAI-I P I PE AhID 'THE F.DC)"I"T01"I OF' THE E.,"'GAwATIOhl (IN FEET). I "T F-1 VA 4--, S." 1 f -1 -H ....... 0 L IL_ Cu EE P-71 L-0 X F��_a CH I N' _. '. R7 L:- F'ERMIT APPL-ICANT THE 1'0 THIS. ClEPARTMENT DURING "I"HE INSTAL.L.ATICII'l IkISF1E1­:TIOI`--I1.--; OF ANY WELLS ADJACErr, -ro -rviis PROPEFi:.T`1` ANI":, THE -4AT TPIE WELL kIILI_ SERVE. NUMf,'DEf,,. OF ..:E:: ... ; TI C - __ I -1 __-T" I RZOV-47 FH F" F E- RL-":! LJ T. F -e F---.. C -- -T- 94 RD E C BAM. , ..OF ANY I-11THOUT FINAL. IP-4SPEC:TICih1 AND APPI?.O%,IAL.. THIS., DEF"'ARTMENT IdILI BE S.L.C.-TEC'T TO PROSE(.,UTIC1I`..L BETWEEN 171 I.-.1ELL. AND At-,Ilr' Cl -.1 -SITE SE1,11.IGE DISPOSAL SYSTEP1 IS :1.00 FEET FOR A PRP.,'ATE lj.IEI-.L OR 150 "rCj 200 FEET FRCjM A PUBL.IC WELJ DEPENI)II"'10, UP1,3t-4 THE J'YPF,". C -F PUBLIC IdEL.I_ DISTANC:E FROM F1 PRP,,JFITE rel LJ P-dq 1 1' IF` F=o L.... I , "T -r, ASA 1 "yo C. F H---1 r-4 0 -­ V 4 F�,­.`." 117`1 k: B. " - .. ... . . " . TO A CoIr11MUhIfTlrI SEkIE', t IhIE 11; -P"; DEPFIR' rrii-- v.j F1 E F -i LTI I AND Ekl%�IIRONPIENITIL_ j I I E. U T 1`4 I WID MUST BE RETURNEC, TO THE 25 L.. STREET, ANCHORAGF..,"., Ak'. 950:1. OTHER RECAUIREMENT.7,' MAY APPL.`i-I. C:PEC*IT1Ci9T1Ot-.IS FIND C'*ONSTRUCTION DIAC3RArV'-., p�..jq j"_-: , IL_ E_. r -,.g p­ TCI PROPER INSTALL T, IE- F " t F.-TRI'TIT NO. .8102fDvJ I,.'^ L--" F - H, H 11 E - E_ IF`�_�, Lo�PJ f"i P F, L I C, A NT JF)ME'S. A. KI N G .398 EAS"T P-4C.I. L I GH TS ,.-:.r..: I_OC�':f',1TI Ot.-I AZAL_GA DR. 1_03i:.IL. LOT 4. E:LJ:` 1 _::.'EATURP-J SUB I OT SIZE SC:!UAP,E FEET 'I"YPE OF' SOIL.. ABSORPTICIN S`rISTE[,1 IS: TRENCH Pelf,11-:111MUM N1JMBF'R OF" BEDROC.jr-T..­; = 3 SOIL RATING (S(. -"I F'I*,,,'E:R)--- ;2.165 TFIE REQUIRED SIZE OF THE SOIL. AB.SORPTIOt-.1 SY,5TEM U" F-`7 V-1 L.- P-4 (3 -f- VA IFS" n V I:_:_ P E. -", rZ-. F=" -E... 9--+-:-=-, -1- THE Ll":NGTH DIMENSION ISS THE LEhIGTH FEET) OF TVIE TRENCH OR THE DEPTH OF' A TRENCH OR PIT IS THE DIS"I"ANCE BF-D"WEEN THE .--AJRFT:ICE CIF "I"I.-IE C31ROUND AND THE BC.0-roil OF E.x'CA%-IATION ::IN FEE'T). THERE IS NO :;ET * " ::ET 1,11I)TV-1 FOR TREI`.-ICJqEC;, THE GRA'; EL DEPIT-1 P5 TFIE rITNII-R.101 DEPTH OF' GRA1yIEL. BF-114EEN rHE OL.11TAI-I P I PE AhID 'THE F.DC)"I"T01"I OF' THE E.,"'GAwATIOhl (IN FEET). I "T F-1 VA 4--, S." 1 f -1 -H ....... 0 L IL_ Cu EE P-71 L-0 X F��_a CH I N' _. '. R7 L:- F'ERMIT APPL-ICANT THE 1'0 THIS. ClEPARTMENT DURING "I"HE INSTAL.L.ATICII'l IkISF1E1­:TIOI`--I1.--; OF ANY WELLS ADJACErr, -ro -rviis PROPEFi:.T`1` ANI":, THE -4AT TPIE WELL kIILI_ SERVE. NUMf,'DEf,,. OF ..:E:: ... ; TI C - __ I -1 __-T" I RZOV-47 FH F" F E- RL-":! LJ T. F -e F---.. C -- -T- 94 RD E C BAM. , ..OF ANY I-11THOUT FINAL. IP-4SPEC:TICih1 AND APPI?.O%,IAL.. THIS., DEF"'ARTMENT IdILI BE S.L.C.-TEC'T TO PROSE(.,UTIC1I`..L BETWEEN 171 I.-.1ELL. AND At-,Ilr' Cl -.1 -SITE SE1,11.IGE DISPOSAL SYSTEP1 IS :1.00 FEET FOR A PRP.,'ATE lj.IEI-.L OR 150 "rCj 200 FEET FRCjM A PUBL.IC WELJ DEPENI)II"'10, UP1,3t-4 THE J'YPF,". C -F PUBLIC IdEL.I_ DISTANC:E FROM F1 PRP,,JFITE WEI-1- TO A F,RIVATE SEWER I -INE IS 25 FEET At-ff) TO A CoIr11MUhIfTlrI SEkIE', t IhIE 11; -P"; FEET. WEI_I_ LOGS ARE REQUIREC, WID MUST BE RETURNEC, TO THE DE,'PAP,­rM[­­NT IdIll-M-1 DAT.. -- OF' 'THE IxIEL.J.- COI%1P[_.r-.'TION. OTHER RECAUIREMENT.7,' MAY APPL.`i-I. C:PEC*IT1Ci9T1Ot-.IS FIND C'*ONSTRUCTION DIAC3RArV'-., ARE." TCI PROPER INSTALL ATIC-M. mi '.Ir "T F=o T. F�-! IL` "_E�' I,.'^ L--" F - H, H 11 E - E_ IF`�_�, .1. CERT IFIi-I 1: 1 AM FAM IL.IFIR WITH THE f`,,.EG,!UIREP1Et.,ITS FOR Ot-1-SITE AkID 1.-.!EI-L.S 1:'ORTH BY THE FlUNICIF"AL-ITY OF ANCHORFIGE. I -I"HE-1, SI, ­;TEM It. -I ACCORDANCE WITH TFIE CODES, I UNDERSTAND -rwrr 'FHE r i'm : ;EIIER S_YSTEII Mt 'i' REQ LY RE IF TFIE IS REMODEL.ED "I'l) INCLL.IDE MORE THAI'l BEDROOM;. FlIPPL61 JAM.'E. A. IscA IC-il, BIT'.. F "-To D.D IF7 ���11 1�n fr EH'" DEPARTMENT HEALTH HND ENVIRONMENTHL 01"Ei.71ION 825 'L/ STREET/ ANCHORAGE/ RK. 99501 264-4720 ���� ���� �3�� ~~���E� ����� ��F������"� PERMIT Nf-). ( 810155 ) FIPPLI{�HVT JAMES H. K*IN8 .7.'0 E: E. 1`10F.THERN LIGHTS' 279�74�4 LO:AT 1 ON HZHLGH DF.'. LEGAL LOT 4 BLK 1 SEH --TURN SUB LOT SIZE 51347 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM TRENCH � _ MHXIMUM NUMBER OF BEDROOMS � 5 SOIL RATING THE REQUIRFz'.D SIZE OF THE SOIL HBS T O TEM IS: R:=n 1- RA -D L_ E -Z" r-4 Ci 7, Fl F-� NoOFF L_ Ca U. l!'=' -1 IFA::;;;:;;:: -4 THE LENGTH DIMENSION IS THE LENGTH (IN FEET} OF TME TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFHCE 0F THE GROOND HND THE BOTTOM OF THE EXCHVHTI8N (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH I:5, THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL. PIPE AND THE BOTTOM OF THE EXCHYHTION (IN FEET). ������� ����� ������ � � ������ ������� ������ �����~���� PERMIT APPLICANT HH"z; THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THAI" THE WELL WILL SERVE. �q �.Il C'" � �� ������������� ���� ������ E�� �F�EE� BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION HND HPPROVHL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DI5THNCE BETWEEN H WELL HND ANY ON-SITE SEWAGE DI5PQSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 208 FEET FROM A PUBLIC NELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINDMUM DISTANCE FROM H PRIVHTE WELL TO H PRIVATE.- SEHER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. WFE-LL LOGS FIRE REQUIRED AND MUST BE RETURIED TO THE' C-EPARTM041" 1-41THIN -130 I)I'Vi'S OF THE WELL CQMPLETION. OTHER REC..'UMEMENTS MY APF'I,,,.\/. SPEC"IFICATIONS AND CONSTRUCTION DI-iGRHMS ARE HVHILHBLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT 1: I AM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND NELLS HS SET FORTH BY THE MUNICIPHLITY OF RN[:HORHGE. 2� I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTHND THHT THE ON~SITE SEWER SY5TE�� MHY RE8UIR� EN�HRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS. SIGNEU'� SOILS LOG ICIPALITY OF ANCHORAGE DEPT. OF HEALTH & NMENTAL r,:c�r[CTION MUNICIPALITY OF ANCHORAGE 6 PERCOLATION u DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST PR 9 1981 Pouch seeo• Anchorage, Arlt. IIS 276.2ss1 R �" ED SOILS LOG a PERCOLATION TEST PERFORMED FOR: Tim King DATEPERFORMED: April 9, 1981 SF>��(c.ivv gam- L.�t�• LEGAL DESCRIPTION: Lot 4_Block 1, G-�n-Subdivision 1__ . SLOPE SITE PLAN 1 2 Date Grou Time Net Time o i6.. o:. 3 _•:'�, 20 Min. 10 Min. 9 3/4 22 ---. 4 4-9-81 30 Min. 10 Min. 10 4 2" .o 4-9-81 5 10 Min. 10 3/4 5 4-9-81 s ° e' , 13 14 15 16 17 1s 19 20 Organics and organic silt, dark brown, top frozen. (Pt -OL) Silty -.sand, brown, moist, stiff, contains organics and some gravels. Gravelly -sand, brown, moist, loose, rounded to sub rounded gravels, minor amount of fines. (SP) Gravelly -silty -sand, gray, compact to dense, moist, rounded particles to boulder size. (GM -SM) O Cn CD V1 O WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? IN NOON■■, N _ NOON■■' NOMEN■ N■■N�1 ■■■■� ■nom ■ ■■N■N1 ■ ■ No o l �� E — —I — I Reading Date Grou Time Net Time Depth to Water Net Drop 2 4-9-81 20 Min. 10 Min. 9 3/4 22 3 4-9-81 30 Min. 10 Min. 10 4 2" 4 4-9-81 40 Min. 10 Min. 10 3/4 5 4-9-81 50 Min. 10 Min. 11 %" 6 4-9-81 60 Min. 10 Min. 11 5/16 5/1611 PERCOLATION RATE 32 TEST RUN BETWEEN COMMENTS Percolation data from gravelly -silty -sand. PERFORMED BY: Hoard Grey& Assoc.. Inc. CERTIFIED 5 �'* Richard A. Lowman iP,% NO. 4077.E •: �`�� DATE: April 9, 1981 IlTlox 1061-0919 swr/w," llouwrf. A A*N4u.,uloiw-xca-q, SIX INCH VIATER VVELL DRIL-LED AND CASED OUTTO THri". DEPTH 0RILIXDAT,rHERA` E0r- 021.0(1____.._._ PER Fooll, PROPERTY OWNER.,-.. — ----- .... ..... LOCATION Or WEI-L DRILLER Wl--,LL LOG - with -'45io' ctoor� I os ---- --- --- . ..... 19—j")8 hca,ffif,, f.; o. 4cmd coo(l ch'wt (mviu(!4. ai.�, 12(',' Th,".5 314 ,,)hou,t(.1 Cfvlt 00 p,(?.4. P,i V COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLEXION Of SAID DMLLING. WRITE CHR.CK PAYABLEETO RAMPART DRILLING WORKS rOfj'27 10, ooR THE SUM or THANK YOU VERY MUCH. BMMU CLAUS OF RAMPART DRILLING WORKS GrRVICC CHARGE0 F I%% PER MONTH W11-1- 817 AsGEr)f-jT;'4D UN PAST D1.11" A 0 U NT G, 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 Date2/°✓%7 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) GOT y B!_K / SEA%Ue&I S(JBD, SECT/oN 35 7-/ZAl K3W Location (address or directions) 590/ 14ZALEA (b) Applicant Name T/M KIA1 G Telephone: Home 31/ 5 - S 9 70 Business Applicant Address 5701 AZALEA (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ;Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: C A! L a wNE2 Fn/z /�-'ICZU o 2. TYPE OF RESIDENCE Single -Family g Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Telephone 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 g 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. 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 showh 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 thgt' 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 Firm 67V#d&1j F7tnj 6//JE7__-7?_0V r Telephone Z76 – 3770 Address 1057 e,cjt"C?T Agc, 01" Gc AL. Date Z l/ % 7 6. DHEP APPROVAL Approved for Approved bedrooms byr�"�^ a' ! r'""� Date �^ Disapproved Conditional _ Terms of Conditional Approval dhep CAUTION Engineer's Seal 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 (11/84) Municipaitty ®f Anchorage February 2.2, 1987 P.O.. X 196650 ANCHORAGE, ALASKA 99519-6650 (907)264-4111 TONY KNO WLES. MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Michael E. Anderson, P.E. Quadra Engineering, Inc. 1057 West Fireweed Lane, Suite 230 Anchorage, Alaska 99503-1736 Subject: Lot 4 Block 1 Seaturn Subdivision Waiver Request WR87-016 Dear Mr. Anderson: Your request for a waiver of the 100 foot separation required between the septic tank and well on the subject property has been granted. This distance has been waived to 77 feet. Your analysis of site conditions indicates that the well is almost sure to be free of any form of contamination from household sewage resulting from the well's proximity to the septic tank. This analysis was performed in accordance with guidelines established by the Alaska Department of Environmental Conservation. This waiver is valid for the existing three bedroom single family dwelling only. Upgrades or enlargements of the existing septic system will void this waiver. Sincerely, Stephen S. Morris Civil Engineer On-site Services 1057 WEST FIREWEED LANE, SUITE 230 ANCHORAGE, ALASKA 99503-1736 (907) 276-3770 DATAFAX NO. (907) 279-5092 ANCHORAGE a JUNEAU 0 BETHEL • February 10, 1987 I.Ti E GINEERING, ING. Municipality of Anchorage Dept. of Health & Environmental Protection 825 "L" Street Anchorage, Alaska 99502 Subject: Lot 4, Block 1, Seaturn Subd. Separation distance wavier Attention: Jim Morris Gentlemen: MUNICIPALITY OF ANCHORAGE '-[PT. OF HEALTH & ENVIr;'l"iNMENTAL PROTECTION FEB 1 '997 R, ECEIVED This letter is a followup to a telephone conversation concerning the separation distance (77 feet) between the well and septic tank on the subject property. The separation distance waiver issued in 1981 by John Kennedy of your staff has recently been determined to be invalid. Soil characteristics on the property, vertical and horizontal separation distances and recent pumping draw down information for the well and septic system are included for your review. The separation distance waiver guidelines for SCRO were used to determine the well is almost sure to be free from any form of contamination from household sewage. According to the guidelines the rating for this system should allow a separation wavier. We are requesting that such a wavier be issued. Please contact me at 276--3770 with your evaluation or if you have further questions. Sinerely yours, W? LCJL41 (E Michael E. Anderson, P.E. MEA:rr c�I pSv�G�CIO ALITY OF ANCHORAGE (MOA) vZPS`\ SFQ- HEA,rL�TH AUTHORITY APPROVAL (HAA) {:HECKLISBUARY 1964 264-4720 Legal Description: X07 y 86acK / S>F'.47-uk_n1 A. WELL DATA 06SuBA. S$'cTJOM , -3 S- r2. N le _� w Well Classification PriyAT-a:) Srnr�L If A, B, C, D.E.C. Approved (Y/N) N, A Well Log Present (Y/N) __y__Date Completed Yield s fpiYJ Total Depth Cased to 128 Depth of Grouting /VOnIE Static Water Level (03 to° Pump Set At — (- rY. Casing Height Above Ground / % Sanitary Seal on Casing (Y/N) }/ Electrical Wiring in Conduit (Y/N)y Depression Around Wellhead (Y/N) N Separation Distances from Well: rasa --••- To Septic/Holding Tank on Lot > > _ ; On Adjoining Lots 7-0c) To Nearest Edge of Absorption Field on Lot On Adjoining Lots 1 ! r To Nearest Public Sewer Line 500' A To Nearest Public Sewer Cleanout/Manhol,e _ S4 4000' + To Nearest Sewer Service Line on Lot Water Sample Collected by ©UADRA f M'�rAD.DEAf ; Date 7 Water Sample Test Results SAT is Ir'AGTYJi, V Comments WELL IS AZF—CPURTF DfSTAhicE TC> SE rlc 7"AN►4 1AlA1UE"TL (Sr 2At,trE6 ay J: kCeAINE'AV G-)8-81 B. SEPTIC/HOLDING TANK DATA Date Installed (0-/8-6( -Size 12 -SO No. of Compartments Z _ Standpipes (Y/N) Y Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) V Depression over Tank (Y/N) Al Date Last Pumped 1 ?87 _ Pumping/Maintenance Contract on File (Y/N) y ; for 1767 Holding Tank High -Water Alarm (Y/N) At, A, Temporary Holding Tank Permit (Y/N) A1- �• Separation Distances from Septic/Holding Tank: To Water -Supply Well 17 r To Building Foundation To Property Line & SI _ To Disposal Field 7r To Water Main/Service Line _ b 1 _ To Stream, Pond, Lake, or Major Drainage Course NONE= /N AREA - Comments _ S_ tc TAIaYL 15 6bE<V0AT"fs. Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Z (0 5 Type of System Design Date Installed 6-18-81 Length of Field ! Z 7 - Width Width of Field Z&11 Depth of Field q&" Square Feet of Absorption Area Depression over Field (Y/N) f Results of Last Adequacy Test TEAS: Separation Distance from Absorption Field: To Water -Supply Well /b0 To Building Foundation 7S(. r Gravel Bed Thickness q8 Standpipes Present (Y/N) Date of Last Adequacy Test Z % Z 187 To Property Line 5 To Existing or Abandoned System on Lot NONE . ; On Adjoining Lots 100' h To Water Main/Service Line q8 To Cutbank (if present) N0A1 E To Stream/Pond/Lake/or Major Drainage Course AIOT JAl AREA To Driveway, Parking Area, or Vehicle Storage Area D FR I E W A C OSS F-5 OV69- ,4 OeO27-70NJ Comments 6 of ) OF -rHEr A SSoRprior4 W g tCEI 15 AT LECA-tr /0' 43&nNeATIk f`0akSt r=N GRA7At= D. LIFT STATION /0 • ?q, Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at _ Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certifythat I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed 1� C ./� Date Company ��gdlLli/GAi.C,• MOA No. Receipt No. Date of Payment 2l �( OF 41, 1111 Amount: $ /©Of� �`E*a,. ` oN� �� Engineer's Seal Cc"),9-�v� ��f6� Page 2 of 2 72-026 (11/84) l0r .__ Z IJ i � AN/ , � ��/y-�/-,; qtr , ;�. c:,1�1/`EC:�s• �'r: �' 1 C F/t7 En-Yf� LJ If / ASI to 1 � 1 � 1 1! i wer s��ry S�Np, i I �I?AVFL ./Ze, /0 1.0 _'.C> LSO 401 E. FIREWEED LANE ANCHORAGE, ALASKA 99503-2197 (907) 276-3770 JOB ,//M �Ci 7�r y' '40EQ SHEET NO. OF CALCULATED BY _ DATE CHECKED BY DATE SCALE QC,4W DOWN 4,47A - AAEQuAGK /'ESL � f/J 414-1 /.5" G ri J � II 'coo H /7-1 Z :30 - DATE RECEIVED INSPECTION APPOINTMENTS / TIME TIME TIME 6. TYPE OF RESIDENCE cAr `o DATE DATE DATE ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six INSPECTOR INSPECTOR INSPECTOR * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY n MUNICIPALITY OF ANCHORAGE depth (attach log if available.) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT ECTI oWJNICIPALITY OF ANCHORAGE 825 L Street - Anchorage, Alaska 99501 DEPT. OF I ;EACfi i u 10 _YEAR ON-SITE SYSTEM WAS INSTALLED. ENVIRONMENTAI. F .01ECTION ENVIRONMENTAL SANITATION DIVISION 0* Telephone 264.4720 or, i� 1` )l REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE:TTe D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten 00) days for processing. 1. PROPERTY OWNER MAI LING ADDRESS - � ay C 6'la/z�ll, &,Cn L t t `, �- - PROPERTY RESIDENT (If different from above) -}� �G11Lh - PHONE - - qS S '70 2. BUYER - - - Zo - PHONE MAILING ADDRESS' 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGE PHONE MAILING ADDR SS - - - 5. LEGAL DESCRI TI Co Soapz� STREET L� TI� 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other PQ SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY - XI 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.) B. SEWAGE DISPOSAL SYSTEM p� p, D9INDIVIDUAL/ON-SITE** 10 _YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-070 (Rev. 6/79) 4 _ iJ ���/�/(/(`///� V L1u.eepj1C THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ _ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: / 500 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS L APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE /� I/ -A BY c [� 72-010 (Rev. 6/79) Y 0! ^! C-APLP(L� Pa is Cab Clvy lir` I)FPi,i? M!<A=((il-I{IHI.IH'V 11-^:.`..I ,--.11=filr.l pRO-1ICi!f)N1 Nr, )LU Vs �'Lcu- 46 October 26, 1981 James A King 308 East Northern Lights Boulevard Anchorage, Alaska 99503 Subject: Lot 4 Block 1 Seaturn Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1.) A well log needs to be submitted to this office for our files and review. J (2) The water analyis report needs to be subjnitt.ed to this office from the Chem Lab, 5633 B Street, for our review. (3) Asecond cleanout needs to be installed to the septic tank. This will need to be reinspected by this off.":i_ce jQl� Perri after it has been completed. If there are any further questions, please call this office at 2644720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw