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Home My WebLink AboutMEADOW RIDGE ESTATES NORTH ADD BLK 5 LT 3(T PCJDLI-.) kA 2, P,6 :,e, 5 C 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 0*@ 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME T Linc Coiss�ruci�sori, PHONE ;KNEW _f as.. 333�Z3S¢ ❑UPGRADE MAILING ADDRESS /GoS Sona Circ% � , /9ii�ijp/a� 9So¢ LEGAL DESCRIPTION Z4013, eB/xl. S, �ledaw ,eidy� �S ir'�s LOCATION • . Pers cema.E NO. OF BEDROOMS 2 se Well ,rt Absorption area DISTANCE TO: • Dimling 'r PERMIT NO. 74607.3 Z Manufacturer • 1 X /0', Material�/� � z771.'t3/ No. of compartments ,L p Liq. capacity n gallons IF HOMEMADE: Inside length Width Liquid depth �DZ DISTANCE TO: Well Dwelling PERMIT NO. I?FQ- Manufacturer Material Liquid capacity in gallons w= Well DISTANCE TO: �OM/Isarll/ Foundation Nearest lot line • PERMIT NO. .W.1 W Z W No. of Imes/ Length of each line ntin /O Total length of li i s Trench width p7-3 Distance between Ii t F-aZC6 tc t- Top of ule to hmsh grade 24 inches Matenel beneath tde C Total el(ecGve absorption area O OZYars'j S' • teiy� PV4& 't 2 n — . � inches W Length Width Depth PERMIT NO. as- Wd W Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line - J W Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption steals) OTHER PIPE MATERIALS I ' G • r Oq inc/vd�:yG.O.-s7�o.iv,o.,�eu,�o�d.y® f•! 5011.:;";;A"ING or Zo PPZ_, r.$,*e ,i , i¢ STM 30340 Same qS 0i VI S nex L INSTALLER L AW s dp,Pe -C O., 4nc lief X.+G Oo /• Pr ar de 0 Asra z7sy Oil .rs: I olbas d v:A /,it►: s wal all aKS n / NO —. Xl— s a'w- sX s , ' eoctEFsY oda' QfrEr i�•s�Ls/ifo�'ien � Broin . toAi/G siyio�e�vw�f 6m,n1 /oced. •T�tecc t Gnj 1 APPROVED 1t7 YDS n - a.a "• qTE LEGAL .�... ..5, ' 6 S No 3co% p 72-013 ��•»� lRev. 3/78) ♦C +l am11 z!rt+ arc MUNI 1=1 PFIL- I TY OF ANGHORFiGE DEPARTMENT)aHEALTH AND ENVIRONMENTAL j_'.R.OTECTION 1 825 STREET, ANCHORAGE, AK. 9: A v + 264-4720 P 0 F(;L ON -55 I T E SEWER PERM I T PERMIT NO. < 780373 ) L/NK G1 � LI APPLICANT -4�CONSTRUCTION INC. 1605 SANYA CIRCLE 337-6310 LOCATION SUNSET ST LEGAL L3 B5 MEADOW RIDGE EST LOT SIZE 30000 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEMS: TREE NCH i MAXIMUM NUMBER OF BEDROOMS = 3 !� S'O'IL RATING (SQ FT/BR)= /100 THE REQUIRED SIZE OF THE SOIL RBSORPC+jJ_SYSTEM ,IS:: em E>EPTH= 10 LENC3-r 1Ijj1L) iiG''ii�xRnVE:L DEPTH= 63) THE LENGTH DIMENSION IS THE LENGTH (IF! 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 CIN 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 CIN FEET). 'Z SD ;o -e y Ao9M REGZU I REO SEPT I C TANK S I ZE= 3.000 C3RLL13NS 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. --- TWO <2> FERE REC,)l.a I RED> 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. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXP I RES i]E(�==MOER 31.. 1SO_70 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 THE CODES. 3: I UNDERSTAND)THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS'REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED:__1 _lf 1= l r\APPLICRNT ISSUED BY V� LING CONSTRUCTION INC. N, V3. 2 n GARY PLAYER VEN TURES CONSULTING GEOLOGIST DOX 476•M, STAR ROUTE A • ANCHORAGE. ALASKA 99507 • PHONE 344.7071 SOILS LOG Performed for—L, Location j eA-exs Soil Type Water Level Remarks 0 2 4 6 8 w G to M a 12 a, a 14 . 16 18 20 S -/I"1 Total Depth of Excavation Material at Total Depth Groundwater Bedrock O-Y"�Not Reached /k—)-'V`ot Reached Depth, if Reached Depth, if Reached Classification Method 0-)asVisual ( ) Sieve Analysis ( ) Cary P. Player, Consulting Geologist 21— 141 wl4v^ S% G w SM-. ReCaVy\ \eN\'0k I00 -k' t2JLA(o�,,.aVV\ 'ice 51 v, d ,.Ok F v Q r� Total Depth of Excavation Material at Total Depth Groundwater Bedrock O-Y"�Not Reached /k—)-'V`ot Reached Depth, if Reached Depth, if Reached Classification Method 0-)asVisual ( ) Sieve Analysis ( ) Cary P. Player, Consulting Geologist 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 LD.# 051–h3^ III HAA# IJ QSSL71Ln_ 1. GENERAL INFORMATION Complete legal description O e- s " (lM4- V-� (lA A 114 cy\ Location (site address or directions) Property owner Mailing address Lending agency P.= bze' c7+1 o twu,.^ Day phone _ < e:•-/ (u -q-- E IL.0 —N Day phone 4 Qi yy,ti v Mailing address Agent kLdLL, C Day phone 614– 11 1121– Address G At'C 4 L � titel, �c& l I q 11 C �-e H Ih 4L urn. Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 25 I/ ' 1 t y3i Dcil.m 0.: r- (2n 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 V Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72 -WS (A.v. V91( Front MOA 621 Municipality of Anchorage AL AEML Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: % t teAdeotr 21ce" Parcel I.D. A. Well Data e Well type //A i I If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth Cased to Casing height Sanitary seal (Y/N) Wires property protected (YM) FROM WELL LOG Date of test Static water level Well flow Pump levell SEPARATION DISTANCES FROM WELL TO: AT INSPECTION MUNICIPALITY OF ANCHORAGE kOWENTAL SERVICES DIVISION 7 1993 g.p.m. g.p.m. Septic/holding tank on lot ; On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA RECEIVED bacteria Date Installed r' Q 7 d Tank size 1 ,� 6-0 Compartments Cleanouts (YM) Foundation cleanout (YM) _Depression (Y/N) r� High water alar (Y/N) N/A Alarm tested (YM) Kl� Date of pumping Alp 19 g/2 Pumper 1 15 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot N On adjacent lots 14//� Foundation 13. 5 To property line i t/0 Absorption field Water main/service line 7 / O Surface wale drainage 47u� 7 / 00 72.028 lMsl. Front CONTINUED ON BACK PAGE C. LIFT STATION N/4 Date Installed Manufacturer Size in gallons Manhole/Access (YM) Vent (Y/N) 'Pump on" level at 'Pump off" Level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Cycles tested Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed 1176 Soil rating (GPD/Ft2) /&0C14 type �2R KC`/ Length L:5 Width oilGravel thickness 25-1Total depth 9./2 Total absorption area go f Cleanout present (Y/N) ��Depression over field (Y/N) Date of adequacy test 6101 If 3 Results (pass/fail) for Bedrooms Water level In absorption field before test s-3 YY After test S'7 fw ct-d-wJ " 50 a *45,9"4;&f Peroxide treatment (past 12 months) (Y/N) \4 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot h/ /A On adjacent lots Property line To building foundation I �?_ To existing or abandoned system on lot M kt. On adjacent lots a-e� Cutbank tj d N -e Water main/service line > / (7 Surface water >ry-e Driveway, parking/vehicle storage area vtaP.� Curtain drain 1,410 E. ENGINEER'S CERTIFICATION I certify that I have checked, veri(ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ` C': Signature �':..,• .:`r.. r Engineer's Name T - ,J+ ..i Date \� C. _ r. J / J HAA Fee $ Waiver Fee $ Date of Payment 3— J 6 yj / Date of Payment Receipt Number o7 SI %� 80 6) Receipt Number. 72-028 (=)• Back S. 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. NameofFirm 66{ti ✓✓VddKJ! Pe Phone a79 --m l 6 Address O Li/ fJ � _ / Engineer's signature �L Date ��[93 6. DSIGNATURE .7 Approved for r'`A� �J bedrooms. 0 Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments J� Date & - 3 - 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 engineers work. r2 -M Mw. 1191) 8Wk MOA 921 T - SP IJFZICILAhIID, Fes' - E 6751 W. DIMOND BLVD. ANCHORAGE, ALASKA 99502-3904 (907) 242-5095 Municipality of Anchorage May 24, 1993 Division of Environmental Health Department of Health and Social Services 02O I Street Anchorage, Alaska 99501 Subject: Need of Pumping Lot 3 Block 5 Meadow Ridge Estate Gentlemen; We inspected the tank on subject property and observed no sludge or scum in the second compartment. According to 15.65.160 8.3. pumping is not required. V.V. r• r miy:, t ..;r: .r SFkg:Pl aryLE� +i E. MUNICIPALITY OF ANCHORAGE ARL • 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 'Q Parcel I.D. # w (( HAA # 1. GENERAL INFORMATION [ Complete legal description Location (site address or directions) isz2�zd Za- e fes• Ak Proerty owner Day phone ,,Mai ling'iddress Lending agency Day phone Mailirig•address Agerit Day phone Address Unless otherwise requested, HAA will held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 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 Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 7V=5 (Nw.1/91) Front MOA 121 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 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 � / � Phone l9G -G//J Address �E 77 Engineer's signature".., Date 6. " DHHS SIGNATURE Approved forte bedrooms. Disapproved. Conditional approval for Additional Comments By: bedrooms, with the following stipulations: 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 courtesyto purchasers of homes and their lending institutions in orderto 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. rata m... vat) e.a Mw m RECEIVED Municipality of Anchorage AUG 17 1999 6 DEPARTMENT OF HEALTH & HUMAN SERVICESwmapAuTy of Environmental Services Division MWUMEWAL SE 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 y ,�/v Health Authority Approval Checklist Legal Description: ZP1. //I ✓'5-/*/l�6yi('� Zs7 Parcell.D.: A. WELL DATA Well type A, B, or C, attach A C letter. ADEC water system number Log present (YM) Total depth Sanitary seal (YM) Cased to FROM WELL LOG Date of test Static water level Well production 9— p.m-WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate Casing hohf (above ground) protected (YM) AT INSPECTION Other bacteria Collected by Data installed 2Tank size /.2 SD Number of Compartments Geanouts (YM)—L Foundation cleanout (YM) _� Depression (Y/N) _Q/ High water alarm (YM) AIA i Date of Pumping Pumper .,Wt C. ABSORPTION FIELD DATA Date installed Ma4 7e Soli rating w p,ddr r fFlbd AQ Q System type 1 � c Length &. Width v Gravel thickness below pipe �2Total depth 1Q— Effective absorption area `IZ0 4 Monitoring Tube present (YM)` L Depression over fleld (YM) A` Date of adequacy test TT�j'� Results (PassfFall) � For Z71 bedrooms Fluid depth In absorption field before test On.); _1L -_ Imnvxkately after k%-) gal. water added On.): Fluid depth _(L_ (Ins) Minutes later. SIO/nrk, Absorption rate : 1.0D 4' a.p.d. Permdde treatment (past 12 months) (YM) N If yes, give data A%t+ 72-M (Rev. 3r r Date installed Size in gallons _ Manhola/Access (Y/N) "Pump on" level ar High water alarm level at* `Datum Cyclestested / E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding bink on lot Absorption field on lot Public sewer main Sewer /septic service line off"level at* On adjacent lots On adjacent lots Public sewer manhole/cleanout _ Litt station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation /D r/ Property Ilne /O �4 Absorption field /D Water maintservice line g5 Surface water/drainage AQ 4 Wells on adjacent IM SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: r� Properly Ane /O � -/" Building foundation /D -/ Water maiNsenrice line o75 Surface water /02) r f Driveway, parldngIvehide storage area &) �f Curtain drain /0 r f Wells on adjacent lots o7V O "4 F. ENGINEER'S CERTIFICATION I cer* that I have determined fMu field kopecOons and review of Munfdpal In confom►ance with M HAA grddegnes In effect on this dale. Signature Engineer's Name S Date fhZ HAA Fee $_0 1� ` Date of Payment 7 Receipt Number S J`—� 7 7 72-028 (Rev. 3198)" Waiver Fee $ Date of Payment Receipt Number '`1SyStsms are �P�cEOF q�1 ........gs h 1 yP *0�.....w.......�.