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Home My WebLink AboutSOUTHPARK #2 BLK 2 LT 15P3 a 4 4_[— MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264.4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE, EW fl ... ❑ UPGRADE MAILING ADDRESS Civet LEGAL DESCRIPTION 18�L 9..Jal.J��c�.d( LOCATION 91 S ve NO. OF BEDROOMS 4 'WC+MMN.rI Absorption area Dwellin DISTANCE TO: T'Y r gO PERMIT NO. D Y_ W Q Manufacturer Material No. of compartments N Liq. capacity in gallons a IF HOMEMADE: Inside length Width Liquid epth d Y J t�$ Well Dwelling DISTANCE T0: PERMIT NO. _? FQ- Manufacturer Material Liquid capacity in gallons m= DISTANCE TO: CA VA k4 Foundation/ Nearest lot lin PERMIT O_ —11&Z Z W No. of lines Length of eac Total length c;Jines Tre4.13 n h width 0 Distance between lines R F O Top of ti e_to finish grade Material beneath rile 4. Inches ) '�pP, ^j':b / 0. S Total effectv-absorption area inches len t,1>Width ept PERMIT NO. Wd Type of cri Crib diameter Crib depth Total effective absorption Brea w DISTANCE TO: Well Building foundation Nearest lot line -� J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO:. Building foundation Sewer line Septic tank Absorption steals) OTHER PIPE MATERIALS _ SOIL TEST RATING INSTALLER REMAR /S� 'f .�..,......,,qs�� 0 iy 0 TH 1:9.' 1 mac'. CE -3816 APPROVED- DATE LEGAL a. 72-013 (Rev. 3/781 ,* f..., ML1h4 I (--I i . -1L I'7'V 01F' F1haCf?'FlGE J DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK 95561 264-4726 ANCHORAGE 694-2131 EAGLE RIVER uha—S I TE E= EWER F-ER:M I -T- PERMIT NO. 836995 APPLICANT: LEVINE LEVINE PHONE: 345-3521 ADDRESS: PO BOX 4-566 ANCHORAGE, AK 99502 LEGAL DESCRIPTION - SUBDIVISION: SOUTH PARK BLOCK: 2 LOT: 15 LOT SIZE 26666 SQ.FT. TOWNSHIP: XXX RANGE: XX SECTION: XX MAXIMUM NUMBER OF BEDROOMS = 4 SOIL -RATING = 125 125 125 (SQ.FT./BR) LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR SITE. - - - - - - - - - - - - - - - - - - - - TFREr4C-_ CQE!S I Gt-4 WIDTH = 2.5 FT. LENGTH = 84.6 FT. ! NOTE ! - ?75 FT. REQUIRES TWO TRENCHES TOTAL DEPTH 5.0 FT. ! NOTE ! - REQUIRES INSULATION GRAVEL DEPTH = 3:0 FT. ! NOTE ! - MAY REQUIRE LIFT STATION GRAVEL VOLUME _ 27.2 CU. YR5. TANK SIZE = 1,256.6 GALLONS (TWO COMPARTMENT TANK) EatEL:), 01 n3 31 Gta WIDTH 26:6 FT. LENGTH = 40.0 FT. TOTAL DEPTH 4.0 FT. GRAVEL DEPTH 0.5 FT. ! NOTE ! - MAY REQUIRE LIFT STATION GRAVEL VOLUME = 29.6 CU. YDS. TANK SIZE = 1,250.0 GALLONS (TWO COMPARTMENT TANK) W 10xE L}F~�Fii I N F I EL[? C:+E�3 I (3 r-4 WIDTH 5. 0 FT. LENGTH 88.0 FT. ! NOTE ! - 375 FT. REQUIRES TWO TRENCHES TOTAL DEPTH = 4.0 FT. ! NOTE ! - REQUIRES INSULATION GRAVEL DEPTH = 1.0 FT. !'NOTE ! - MAY REQUIRE LIFT STATION GRAVEL VOLUME = 24.4 CU.YDS. YDS. TANK SIZE = 1,250.0 GALLONS (TWO COMPARTMENT TANK) I CERTIFY THAT: 1. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE AND THE STATE OF ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES AND HAVE RECEIVED A COPY OF THE CODE SUMMARY AND DIAGRAM ATTACHMENTS WHICH IS PART OF THIS PERMIT. 3, I UNDERSTAND THRT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM PERSONNEL DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE: IF A LIFT STATION IS INSTALLED. AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED. AS-BUILTS CANNOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT. THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED: --------------- APPLICANT: LEVINE LEVINE ISSUED BY: ------ - DATE: 09/30/83Yd se _-,. PERFORMED FOR LEGAL DESCRIPT 1 1M 2- 3 c 4 • o: 6 '/ c 7 10 e 12 13 % tp 14 15 SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION 825 L Street, Anchorage, Alaska 89501 266-6720 TEST SOILS LOG — PERCOLATION TEST -N—Hoc X DATE PERFORMED: / f �S r;+Wny.rlcgvAq .CCS Z `OtAT �v K\� CTRAVEL- (G W— G P) 100 SFArm , .5 is tJOi S+L TY (.TRgVt`L C4 m) Faa.T Z33 sF/8�N1, WAS GROUND WATER S ENCOUNTERED? �O L O P IF YES, AT WHAT E DEPTH) g0?. "0 wgTLn 16 a 17 r n• f s LI►gTFI� epwano r. ,..:.' . 20-�• a COMMENTS 6 Reeding Date Gross Time Nei Time Depth to Wates Net Drop I c/z9I IZ: IS Q Ts' — Z 9/Z9/W 12144 31 M;N %'y4 • Z ya 4 7fill js 1:1y z5.114 1 73/4" 1 I 0 9"/-% z: 1 a Is NI 11 %8'" I Y PERCOLATION RATE Z5". 5- - (mmuteshncn) TEST RUN BETWEEN FT AND Ft PERFORMEDBY int laHfnp CERTIFIEDBY 77-006 (6179 DATE MuniciPality of Anchorage Developmeilttervices Department Building Safety Division Onsite Water & Wastewater Prograin 4700 South Bragaw SL, P.O. Box 196650 Anchorage. AK 99519.6650 www.d.anchorage.ek.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 020 HAA# 0600QD, 1. GENERAL INFORMATION Expiration Date: — — D Complete legal description SOOT ARK SUBDMSION /2: LOT 15 BLOCK 2 Individual On-site K Individual Water Storage ❑ Location (site address or directions) 4661 SOUTFj]?ARK BLUFF DRIVE • ANCHORAGE AK 99506 Current Property owners) Mailing address Lending agency Mailing address Real Estate Agent - Mailing address JOHN AND PAT MOYLAND Day phone (907) 345-7466 4661 SOUTH PARK BLUFF DRIVE • ANCHORAGE. AK 99506 Day phone CAROL BUTLER w/ REMAX PROPERTIES Day phone 727-4488 110 WEST 38TH SUITE 100 • ANCHORAGE. AK. 99503 Unless otherwise requested. HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site K Individual Water Storage ❑ Individual Holding tank ❑ Community Class Weil ❑ Community On-site ❑ Public Water System 0 Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. AS -BUILT SURVEY SCALE: 1"-4(r 1 HEREBY CERTIFY THAT 1 HAVE PERFORMED A MORTGAGEES INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 15. BLOCK 2. SOUTHPARK SUB, ADDH. NO.2 KA AND THAT THE INFORMATION HEREON IS FOR THE USE OFLENDAS MENTS AND NOTTO SE USE SHON ANY CONFLIRSSETNAL THEHVISIB EE MPGRpOVEING DISTRICT.MENTS SITUATED THEREON ARE STRUCTMESORFElSTNGSTRMTLlRESANDPLX DLOTUNE90R EASEMENTS ND LS NOT TO BE USED FOR POSITIONNG ADDITIONAL THIN THE PROPERTY LINES AND THAT NO VISIBLE ENCELINES EASEMENTS a RECORD. OTTER THAN THOSE SNOYM ON THE RECORDED PLAT. APE NOT MIOYm HEREON. ENCROACHMENTS EXIST OTHER THAN NOTED. NOTE ANY FENCELNES SHDVN ARE LOCATED ARPROXBIAIELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES DATED FEABRUARY ANCHORAGE. ALASKA 20D0SHIS J OR LOCATE STRUCTURES HOLT LAND SURVEYING ANY PAVING BHDYAI MAY BE APPROXIMATE DUE M SNON CONODIOFIS. TEL 3AS-5513 t ANCHORAGE CESSPOOL PUMPING {, ALASKA PUMPING k 11240 LILLIAN LANE ANCHORAGE, AK 99515-2918 " 344-2632 or 344-2453 PHONE WK. PHONE WiE - H1A - � / E. � � ~' Zp•IJ � NAME ADlam`/5y-): �{l�ryirz DRESS / I/ry�/t J ttk(It�11rIIK �•K � ..• CHARGE ON ACCWNT PLEASE PAY BY MW.SCE •' DASHdHEG( /NGE. .� PUMPED SEPTIC SYSTEM - 1 CC PUMPED HOLDING TANK .. _ .,/✓ I4D Ro APPROXIMATE GALLONS` -. FT. EXTRA HOSE CHARGE O 30C " // ,' DP1 ER CUSiO4ER G'y`LUPE/ TOTAL P57 V {/ - �, - MONTHLY ERVICE CHARGE ON ACCOVNiS PAST DUE. 13125 7hank`You _by.y.fio•NEBf CUS71Mp .Ung xm MUNICIPALITY OF ANCHORAGE • '� Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # -- _ 020-052-89 HAA # i4 u9 2qlAIn s 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 15, Block 2, South Park #2 Location (address or directions) 4661 South Park Bluff Drive (b) Property owner FnTr Telephone: (home) Business 269-3577 Mailing Address -_4100 Bonifaice Parkway, P.Q Any 196639, anrhnragp, AK 99579-fifi19 (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: P.O. BOX 11790 —P-4 J iso,, 3401 _100D 2. TYPE OF RESIDENCE Single -Family P Number of bedrooms 4 3. WATER SUPPLY Individual Well ❑ CommunityZ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Q 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. 72 -MS (Re.. Tree) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 Q-11 Alaska ElAWneezr Telephone 149-1003 Date May 25, 199i Theo a A. Johnson , c E 5191 : <` ,fin i 6. DHHS APPROVAL (//� �( /� Approved for � ^ bcdrlms by ��'�^�`� &.0� Date 6_3 _f3 Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7/ee) Beck Page 2 of 2 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST' Legal Description: Lot 15, Block 2, South Park #2 Parcel I.D. 020-052-89 A. WELL DATA Well type ;:: If A, B, or C, attach ADEC letter. ADEC water system. number- NA Log present (Y/N) NA Date completed NA Driller NA Total depth NA Cased to Nn Casing height Sanitary seal (Y/N) NA Wires properly protected (Y/N) NA FROM WELL LOG AT INSPECTION Date of test NA NA ^ 4* Static water levelpg4 Well flow rB1 g.p.m. 9 -p.m - x Pump level I&4 NA e SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot i1F1 ; On adjacent lots NP Absorption field on lot NA ; On adjacent lots NA Public sewer main k Public sewer manhole/cleanout NA Public sewer service line Nn Petroleum tank Nn WATER SAMPLE RESULTS: Coliform NA Nitrate NA Other bacteria NA Date of sample: NA Collected by: NA B. SEPTIC/HOLDING TANK DATA Date installed 2-27-84 Tank size 1,250 gallons Compartments 2 Cleanouts (Y/N) y Foundation cleanout (Y/N) Y Depre§sion V/N) N High water alarm (Y/N) Nn Alarm tested (Y/N) NA' Date of pumping 5AS491 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot NA On adjacent lots NA Foundation 16' To property line 20' Absorption field Water main/service line '41;' Surface water/drainage4 * From MOP. records. 72-025(Rev.&91)Fmm MOA 21 -. - '.CONTINUED ONBACK PAGE C. LIFT STATION Date installed NA Manufacturer NA Size in gallons NA Manhole/Access (Y/N) NA Vent (Y/N) NA "Pump on" level at NA "Pump off' level at NA High water alarm level Meets MOA electrical codes (Y/N) _gym Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot NA On adjacent lots NA Surface water NA D. ABSORPTION FIELD DATA pate"installed 2-27-84 Soil rating CM -(a1* System type Trench Length 60' a`' " Width 10+ Gravel thickness 81r," Total depth 11,61, Total absorption area i x2n Cleanouts present (Y/N) y Depression over field (Y/N) N Date of adequacy test 5-20-93 Results (pass/fail) Pass for 4 bedrooms Peroxide treatment (pest 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot NA (CcamunitV) On adjacent lots Uk Property line 17' To building foundation 20' To existing or abandoned system on lot NA On adjacent lots 1nn+ Cutbank NA Water main/service line 45' Surface water 100+ Driveway, parking/vehicle storage area 65' Curtain drain **A E. ENGINEER'S CERTIFICATION i certify that I have les Name Th Date 5/24/93 verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. .. HAA Fee $ /7 0.d2 Date of Payment ReceiptNumber oZ 7 �D� 2: - 72-026 (Rev. 3/01) Back MOA 21 Waiver Fee: $ _ Date of Payment Receipt Number ... ... h;o ra A, Johnson k� CE 5191 �o SAY: lrP, (� E or fWALTER J. H/CKEL, GOVERNOR DEPT. OUIFJENVIRONMENTALCONSERRVATIONN ANCHORAGE DISTRICT OFFICE (907) 349-7755 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 May 25, 1993 Mr. Ted Johnson Criterium Alaska Engineers P.O. Box 111790 Anchorage, Alaska 99511-1790 SUBJECT: Lot 15, Block 2, (4661 Southpark Bluff Dr.), Southpark #2 Class "A" Public Water System, PWSID 213475 Dear Mr. Johnson: I have completed a review of this office's files concerning the monitoring status of the above -referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on April 1, 1993. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 2. The last inorganic Chemical Contaminants Sample results were submitted to this Department on May 6, 1993. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 3. The last Radioactive Contaminants Sample results were submitted to the Department on December 1, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. 4. The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC) were submitted to this Department on November 6, 1991. Based on analysis of the previous VOC samples results have been satisfactory. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above -referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. Unless otherwise noted, this letter is valid for 30 days and is for the specified legal description noted above only. Mr. Ted Johnson May 25, 1993 Page 2 If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, '� Michael Lu Environmental Eng. Asst. 11