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HomeMy WebLinkAboutSHACKLETON LT 24 E2 W66'�1)IJf.IJILA F_- M,rIs.:'r1 001 /"s 1- 1---C1 c� IN f- SVsre P Municipality of Anchorage Page of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: In1in — 1 11�n Name: _ Wastewater System: ElNew ❑ Upgrade o s Address: 13 1Zib u✓ 'r ABSORPTION FIELD Phone: No. of Bedrooms: 6 ®,7 ❑Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 1 �5 GPD/Sq. Ft. 1 e, Lot: p Block: j Subjdji��vi !!'L ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe if lf, F L U VI.a col- f.�©I� Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel length: 2 p� 3 6 Ft. Ft. WELL: El New El Upgrade • Gravel depth: Number of lines: ! Distance between lines: Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. �/ Ut,tro" �� 7 SQ. Ft. 1 VCM Driller: Date Drilled: Static Water Level: Installer: nn Date installed:�7 2 Ft. Yield:Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Well / Material: Number of Compartments: Surface Water �//� M!/� �� Z/)";�'� At LIFT STATION Lot 33 `� �. — ,,,/- t Size in gallons: Manufacturer: Line I r 1/�! ! Foundation "Pump on" level at: "Pump off" level at: High water alarm at: Curtain �r T/�T` 1i f// �/ T/ Pump Make 8 Model Electrical Inspections performed by: Drain 1 14\, 'C Remarks: BENCH MARK A Location and Description: 1J Assumed Elevation: Ft E fl&MEftfIIi,%SEAL i .. sd :escWo^°eea 7 p f✓ p f li„ Le .17� �,7 1 U4 `e o -- ®C ea nea aee+ Dates: 1st Inspections performed by: ea +•'� oo.o oec seooeae ees a 2nd ff �e Tr ben Spurkland Department of Health and Human Services approval {tQpe9.eceo^o�a� tv Reviewed and approved by: Date: 72-013 (1/91) MOA 25 1--)0LuVAt✓t-4T'NT- uN Permit No. Page a' ofIP Municipality of Anchorage f/i9B DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: V// foto E 7z, Lo+ 2 L se_l oat,0_eAw,^ PID No.: z 72-013 A (2191) MOA 25 e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: I qUvVtetA DATE LEGAL DESCRIPTION: I ja& t= 7/a �o Zq Township, Range, Section: EPTH ��' �(��� SLOPE �M 1 2 3- EE<.T) 1y LS t: Net Time Depth to Water Net Drop 4 lr�Lo�ei� RME■. 5 L� KL 6 7 J v V MENNEN 'F i vie Sa,,A � ONE w , o 9 u MENEREMNIME 10 WAS GROUND WATER ■■ MEMOMEMMEM ■'I111:91M ■■■■ ENCOUNTERED?_ S 11 IF YES, AT WHAT L O 12 • d d " - DEPTH? P E 13 Depth to Water After b t% Z 9( �r Monitoring? Date: 14- 1 5 415 •• d� 16- 17 E [r 18- 19- VA 819VA a 17 tENG NEE i I � 4' & �� � sy F k 5� a `t✓, �� L®%SO D'003 app OV090 p000 mae u+aao� -' �n0 �� eo Bo oo aCY_� d o T 6Len Siw land < CE -2225 J. D 00- 4 e PERF RM SITE PLAN ■■.■E'E■N■. Gross Time Net Time Depth to Water Net Drop ■■ RME■. E1MENORNME01■ ■IMM■■■N■■E MENNEN ONE ■■.■■E■ ■■■ MENEREMNIME ■■ MEMOMEMMEM ■'I111:91M ■■■■ Reading Date Gross Time Net Time Depth to Water Net Drop 20 0 L L^ PERCOLATION RATE < (minutes/inch) PERC HOLE DIAMETER F , 1 TEST RUN BETWEEN FT AND FT .� COMMENTS M PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STA E AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) 4.i -i J I 070 I .'5S -re, &A&V Z.a 24-E PaD ¢gC1L- o6% 2 3 A 4- R?44rr RID a LOT SURVEY CERTIFICATION W 66{ OF Lot '2-4-- , Bloat – -Area Sq. Ft. plat File T�igtrict _ — An11alRecorai8!�fGRPHReeidence of: le the reaponstblUtY of th* oWner builder, Prior to construction. to verity =p��,ed =i1din6 ffQ�de relative to t1n- WfOC grI and Rt1116Y CaPt+e0140'm i to neae�n, wva tug r" eoa atef w ttfMoh do nat aPPOU On thO reowood xnbd;s. lion Pi::i:. 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WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) E • Health Authority Approval (HAA) iv���.�, CHECKLIST - FEBRUARY 1984 i 343-4744 R Legal Description: SZ T U RL I C, WAr7 P 2. qV Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Date Completed Depth of Grouting Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments If A, B, C, D.E.C. Approved (Y/N) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA g, 3 �y.� XS >< 7,j— Date Installed _19 Ity PP Size 1a50PX No. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) �- Depression over Tank (Y/N) N Date Last Pumped Alii A,4e. Ccss Pumping/Maintenance Contact on File (Y/N) N1A ; for W& Holding Tank High -Water Alarm (Y/N) WDA Temporary Holding Tank Permit (Y/N) /A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: K� 1 To Water -Supply Well IVIA To Building Foundation To Property Line f ® To Disposal Field To Water Main/Service Line 1 a To Stream, Pond, Lake or Major Drainage Course NZA Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA I a t�-) �4-" Soils Rating inA}a�orption Strata Uvl",n � Type of System Design ,� Date Installed' I atv8,. 6a 8-J; Length of Field 3B Width 64 Field Depth of Field t Gravel Bed Thickness Sq e eet` sortion Area U "&-tom Statndpipes Present (Y/N) /�/ De1�Tpre�ss�o�iver Field (Y/N) I`( Date of Last Adequacy Test x`26 q� Res�c f Last Adequacy Test ss % o r 3 BtcYdtl wr s SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well Nl^ To Property Line To Building Foundation b To Existing or Abandoned System on Lot NZA ; On Adjoining Lots > 3 6 To Water Main/Service Line > _,25,To Cutback (if present) N To Stream, Pond, Lake, or Major Drainage Course N/A To Driveway, Parking Area, or Vehicle Storage Area O Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) **Check Permitted Bedroom Rating Against HAA Request** "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA g defines in effect on the date of this inspection. Signed Company l bb «c �p U r1I_Layw-Q Date �� Y; lob l4 `tEngineer's Seal MOA No. o¢sc n6oee oano�o,¢¢¢a ¢a cam.,. •r� CR-fI .:J ay, �lk..9cC Receipt No.2-2 0 f Receipt No_ " ,R.J - 0 Date of Payment Waiver Fee: $ Amount: $ 176 Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 LEGAL: LOCATION: OWNER : RESIDENCE: WELL: 6751W.D08N0BLVD. ANCHORAGE, ALASKA Y9502~J90M (Y07>248^5095 SEPTIC SYSTEM ADEQUACY TEST W66 E1/2 Lot 24 Schackelton S/D 131 W Klatt Road Thomas Schilke Single Family; 3 Bedrooms Public Water SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: 3 Bedroom System TANK: Concrete 1250 One Cc -impart ABSORPTION SYSTEM: Concrete Block Crib and Trench ABSORPTION AREA: Unknown OIATING SL R : Unknown INSTALLATION DATE: 1968 DATE OF LAST PUMPING: Anch. Cess Pool April 61 1991 DATE OF TEST: April 2, 1991 TEST PROCEDURE: System was and measured. Tank was found with 3.5 feet of cover and with a liquid level of 46 inch~ es, Crib was 9 feet deep and had a liquid depth of 61 inches. Trench sump was 11"5 feet deep with 7.5 feet of liquid^ 350 gallons of clean water was added to the crib while the water levels in the tank, the crib, and the trench sump were monitored. The water level in the tank rose 2"5 inches, while the level in the crib and the sump rose 21 inches. Ten minutes after the water was shut off, the tank level was back to normal, the crib and sump levels had dropped 4 inches. After an additional 20 minutes the crib and sump levels dropped 8 inches more. After 5 hours all the water levels were back to the same levels as prior to the test. These observations indicate that the septic system can absorb more than 350 gallons of water in a 5 hour period" TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE The operational life of all septic systems depends on the local soil conditions; groundwater levels that may fluctuate dUr1Og L. �e ye a rv �Dd the #ater uage of the family being served u~ �Ds lqy�vWm" + t.^e evaluator of this septic system. We cantherefore not give any estimate of how long this system will function satisfactory for current or future occupants. T l� 19 MAY 21 19" 1 Muneckpu�liF`t� Ci! ia::�i1G opt, HOW Dj jUi lx�n sa• ces