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Home My WebLink AboutT15N R1W SEC 5 LT 107T15N R1W Sec 5 Lot 107 #051-082-25 ~UNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ...i,..~--.,,~._~1~.~{_~,) ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ' ~AL DESCRIPT~N - ' ~ {~F/W~~ ~ Material No. of compartments ~ ~ Manufacturer Liq. capacity in g~llons IF HOMEMADE: , ~ Well Dwelling PERMIT NO, ~ ~ ~ DISTANCE TO: Well/~ O / .~ Foundatio~ No. of lines / Length of~ li,~ ?Z Total le~l¢f ,i~s~ Tre~h~idth/K Distanc~bet ween ,ines~ - : Material b eath tile~ ~ ~/' ches Total effe=ive ab~r0tio~ area ~ Building foundation Sewer ~.%.~_~ ~ OTHER ~,~.,,~, , '~s'~r~~ ~ ~;~:, .~o.~ ~_ / _ ~ ~ ~/ , I 3 (Rev. 3~78) I. OiZ:l=t'J' ]] Olq l= ]' [:t J] HI'I ]'] E]I;' I r' r.l.,.. [~,1 F'.;!.r,.i 1 2 '- 3 4 5 8- 9- ,.5'//.. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HI:!ALTH AND ENVIRONMENTAL PROTECTION Pouch 6.950, Anchorage, Alaska 99502 276-222'~ SOILS LOG - PERCOLATION TEST /o7 SLOPE SOILS LOG [] PERCOLATION TEST DATE PER,ORMED:/- '?? SITE PLAN 10 11 12 13 14 15 16 17 18 19- 20- COMMENTS ~'~ ~' ~'~ PERFORMED BY:,~ ""~'~ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? JO/ E Gross Net Depth to Net Reading Date Time Time Water Drop (minutes/inch) PERCOLATION RATE TEST RUN BETWEEN FT AND FT 72 008 (7/76) b GENERAL INFORMATION (a) Legal Description (include lot, bi Lot 107, T15N, R1W~, SEC. 5 Location (address or directions) Sunset Blvd. Chugiak (b) Applicant Name MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DI~,I$1ON OF ENVIRONMENTAL HEAl_TH CERTIFICATE OF:INSPECTION FOR HEALTH AUTHORITY APPROVAL I- OF )N-SITE SEWER AND WATER FACILITY 264-4720 Application Date APRIL 20, 1988 )ck, subdivision, section, township, range) (c) Telephone: Home n/a Business 563-3333 Applicant Address c/o Associated Brokers 640 W. 36t_h Ave. #1 Anchorage,AK ' 99503-5807 Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); H.tJ. D. (d) Lending Institution n/a, Telephone Address (e) Real Estate Company andAgen( ~_arg~f Really Ag.~ent: B~mb Pagent Address P,O. Box 7746'27 Eagle River, AK 99577 Telephone 694-2388 ~ (f) Mail the HAA to the following address: Pick up by enqineem TYPE OF RESIDENCE Single-Family [] Multi-Family [] Number of Bedrooms 4 Other WATER SUPPLY Individual Well [] Community [] Public [] Note: If corn m unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAl. Onsite [] 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) A, WELL DATA Well Classification /'~! ,¢ ~.~ /4¢... ~UNICIPALITY OF ANCHORAGE (MOA) ~EALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984. 264-4.720 Legal Description: S~ · /5-/¢ /~1 ~ If A, B, C, D.E.C. Approved (Y/N) /~'/"/~- Well Log Present (Y/N) Total Depth ¢-.-~' 3 / Static Water Level ? g $"' /~¢/~.,~1 Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ¢.,~i To Nearest Edge of Absorption Field ~n Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results ~¢¢ Comments /1~,,,c.f - ,,~/.,,,~ SEPTIC/HOLDING TANK DATA ,,'t.2 Date Completed /~ 2 ~' e,¢~'~--~2.,~"-¢~' Yield _ Cased tol ~"/~' ' Depth of Grouting ~,~r.' ~'.r Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots f?"¢'~ / /¢~' / ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot /" ; Date Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/HoMing Tank: To Water-Supply Well ~-'~ To Property Line ¢'/'¢ / To Water Main/Service Line Course ~/~ ' /~?~ ¢'~f' Size ~ /.:z¢,,¢ d,-, No. of Compartments O.,v ,¢ Air-tight Caps (Y/N) ~' Foundation Cleanout (Y/N) Date Last Pumped .4~,,.~ ,.. ,'/ ; for Temporary Holding Tank Permit (Y/N) Comments Page 1 of 2 72-026(11/84) To Building Foundation // To Disposal Field 2'2' / To Stream, Pond, Lake, or Major Drainage ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field ~'~/ Square Feet of Absorption Area ,~'¢O ~i~ Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ,/,ca · To Building Foundation -"'-'¢ Lot To Water Main/Service Line t/,~ / To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field ;~ Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ,'",2'~ · To Cutbank (if present) Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~'~"~ Date Company ,~.~'~' /~"*~' Z¢,~.¢,, ,¢,-,,, MOA No. Receipt No. /O / Date Of Payment Z//'--~ ¢ -- ¢E:~ Amount: $ /,/~,~/~ O ¢--) r's Seal Page 2 of 2 72-026 (I 1/84) IVRJNICIPALITY OF ANCI-tORAGE DEPARI'IVIENT'OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL I-IEALTH CERTIFICATE OF INSPECTION FOR HEALTH AU FFIORITY APPROVAL OF ~N-SFIE SEWER AND WATER FACILITY 264-4?20 Application Dar _ - GENERAL INFORMATION Legal Description (include lot. b!ock, subdivision, section, towr2ship, range) "- ~') -' ~ ..5'- Location (address or directions)~, ~ -- (b) A~l~an, Name~~~___ Telephone: Home~-~.~ Business (c) Applicant is (check one): Lendil~g Institution ~; Owner/b~l¢~; Buyer D; Other D (explain); (d) Lending Institution L__ Telephone _ ~ ....... (e) ~eal Estate Company and Agent ~ ~ / Address (fff~f-the HAA to the following address: TYPE OF RESIDENCE Single-Family/~ Multi-Family [] Number of Bedrooms .... WATER SUPPLY Individual Well"~ Community [] Other : Public [] 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/~ Public E'] Communityl~ Holding Tank Note: If community we system, must have written confirmation from the State Department of Enwronmental Conservation attesting to the legality and status. Page 1 of 2 ENGINEERING FIRM PROVIDING INS~EC'rlONS, TESTS, FILE SEARCH, DATA AN[) INFORMATION As certified by my seal alii×ed hereto and as of the validation date shown below, I verify that ray investigation of this Health Authority Approval shows that the on-sit~ water supply and/or wastewater dispQsal system is safe, functional and adequate for the number of bedrooms arrd type of structure indicated herein. ~ 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, ordiaances, and regulations in effect on tho date of this inspection. ~ Name of Firm 9 & ~: ~';,'](~)lNi:l:;t{liq¢~ Telephone Date DNEPAP,,OVA,. Approved for ~_~-'~','~'~_~. bedrooms by /'~ Disapproved Approved ____-/% Terms of Conditional Approval ~:.~t~.,',tA./.~" Date Conditional CAUTION Tile Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upo,h the representations given in paragraph 5 above by an independent professional engineer registered in the State of Ala4ka. The DFIEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain fe,deral 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-o25 (11/84) . B. MUNICIPALITY OF ANCHORAGE (MOA) 4EALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 198'1 264-4720 Legal Description: Jt/iUNICIP^LIIY OF AN(,, DEPf, OF ttEALTH & ENVIRONMENTAL WELL DATA Well Log Present ~-Y~ Date Compl~ Total Depth [/,~O~ Cased to Static Water Level ~ i Casing Height Above Ground ___ Electrical Wiring in Conduitl~J~_ Separation Distances from Well: To Septic/Holding Tank on Lot __ To Nearest Edge of Absorptioe Field!on To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Commerltsp ¢"'~/O ~'. If A, B, C, D.E.C. Approved (Y/N) _ ~' Yield Depth of Grouting -----~' Pump Set At Sanitary Seal on Casing(~¢' Depression Around Wellhead _; On Adjoining Lots Adjoining Lots /¢O" , Nearest Public Sewer ~rest Sewer Service Line on Lot '-~"~ ;Date To SEPTIC/HOLDING TANK DATA Date Installed ~""~' Size! ~.-).o"?.:;p Compartments / ~'~'-' StandpipeslC~',,N)" Air-tight Caps4~C?~N)"_ Foundation Cleanout,.(,¥'~ Depression over Tank,(,,Y~ ; I /~//,~.~ Date Last Pumped Pumping/Maintenance Contract on ~ile (Y/N) ; for Holding Tank High-Water Alarm (Y/~4) /~,~.~- _ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Fl(~lding T~.~/k~' To Water-Supply Well ~/--~-.~ / To Building Foundation ~ / To Property Line /~ ~ ~ To Disposal Field _ ~ z'~ To Water Main/Service Line ~ '~ Course ~~ /~ Comments __ ; ,/~ lCF~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field ¢'~ Results of Last Adequacy Test _ Separation Distance from Absorption Field: To Water-Supply Well ,//~)'~""~ To Building Foundation _ ,~"?_) Lot /v'//~ - Type of System Design Length of Field /""~O" Depth of Field 7 Gravel Bed Thickness -.¢" Standpipes Presen (~J~ Date of Last Adequacy Test ~"' '~' ~'"'"¢'="~- To Water Main/Service Line '..~-.~/'' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments . fi: y~'~J~J :~. To Property Line To Existing or Abandoned System on On Adjoining Lots o~ To Cutb.ank (if present) ,,cZ',,. z'¢'7 D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments Signed ~E~iiNr~ C°mp,~9~/,~L~ ~iVE , ¢ MOA No. Receipt No. : - ~'~ ) Date of Payment ~" ~- ~5 Amount: $ A~~ ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all.,.M OA/a nd._HAA guidelines in effect on the date of this inspection. Date __ ,~//~' / ~ Page 2 of 2 72-026 (1U84) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE i 825 L Street - Anchorage, Alaska 99501 J:NVIRONM~N, TAL P~or[cTION ENVI ONMEN'rAL ENGINEERING DIVISION $1 1979: Telephone 264-4720 REQUEST FOR APPROVAL QF INDIVIDUAL WATER AND ~1~ ~/~!~) DI RECTIDNS: Complete all parts on page 1. [nconlpiete requests will not be processed· Please allow ten (I O) days for processing. PHONE 1, P P ERTY OWNER PROPER~Y RESI DENT (If d~rent from above] 2, UYER . MA~ING ADDRE~8 ~ LENDING INSTITUT~ ~AILING ADDRESS 4, REALTOR/AGENT PHONE '~. L[~G/~L E~ESCRIPTION STREET LOCA'FION NUMBER OF BED OOMS 6. TYPE OF RESIDENCE '~ [] One F~ Four ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7, WATER SUPPLY INDIVIDUAL' [] COMMUNITY [] PUBLIC UTILITY ~ SEWAGE DISPOSAL SYSTEM iNDiVi DUAL/ON.SiTE~ [] PUBLIC UTILITY Other ATTACH WELL LOG. A well log is required for aH wells drilled since June 1975 [:or wells drilled prior to that date, give wel · ! ¢lepth (attach log if available,) / (¢ "if individual/on-site, give installation eat(, / ~ 17[ If system is over two (2) coats old an adequacy test is rec Jired [~¥ this Departrnent. --NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME -- DATE DATE DATE I NSPECTO R I NSPECTO R INSPECTOR DIRECTIONS; 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER I~INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER I~]Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~APP ROV ED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accomp~y c~tiri~ate) LEGAL DESCRIPTION 72-010 (Rev, 3/78) August 31, 1979 Bob Wilson % Skyway Realty 3202 Spenard Road Anchorage, Alaska 99503 Subject: T15N R1W S~ction 5 Lot ]07 Dear Mr. Wilson: , The existing sewer $~stem oh the above subject property has failed to pass the adequacy test performed. Therefore, an upgrade of the sewer system will be required. Prior to the upgrade a soils ~est will need to be performed so that a permit can be issued by this department. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S! Associate Specialist RCP/ljw DA'/ID A. SLENKAMP ,., -r,,nl,mm :Lo~,bed on t?e rmfm'6nced pI'ooerty, In oddit:ton ', :,,~' t, ~9 I,he Yrmuox'l., *] ~o:l.l ].oE ~n g[~ketS.on September ~ 1979 ~ , , .q, !, !;o ~mql",d,- t;tm ;M~:?ol'pi;],on ~3'r'~m~l ~q~, ob'hnSned~ (cop7 att~ohod). q '-'~l.ln? a,~r~L?at~m' ~.rqr~ "rr['Hnr,d, , nd n].]. ~tol, k .to' donstruct 7' ~ ',", 'i ~'. "7':~'~'LC]. ~.mn Lnspected b.v tis ~ oony o~ o~ ." :" ' ....... ~ }'~, '~' ~tll'l;}~t,l' rtql~,r]' of ',~ :'Ol~ pier ,m do not h~sitoge 8138 198X I!^OLE RIVER,ALASKA [)AVID A, SLENKAMI~ MECI4ANICAL ENGINEER 694-9O55 ROBERT A, SIIAFER CIVIL ENGINEER 694-2979 Skyway Real'by ATTN: Bob M'L1 son 3202 ,~?enard Road AnehorF38e, Aladca 99503 Dear 1,h'~ Wilson~ Reference: Lot ].07, Dear Mr~ Wilson~ August 18, ]-979 '.PI_ 5N, RI¥.r IViUNICIPALiTy OF ANCHORAGE hNVIRONM~NTm ~ _ ! .& RECEIVED A sewer sysbem sdequocy,'bes% waspm* orlt,'d.~ on 'bhe ryd.om located on refereDced property on ~Uf~lrfl; 11_3 and ].4, 1979, per you:r request. The sop~..o tank was pumped and fDund t,,~ havo a capaciby of appro>:J_mateL[y 1250 [:ali. ohs wb:i. ch fi s adequate for e 4 bedroo]:i house, The seepago pit w~s fu].~_ o[' water and had to be pu. pM. Approz'Jma'i:ei 250 gallons o~ ,,rater vms removed before %he er&b went e~::p%y., The syst:em was 'cechai-[ed wJtii appr9} [mo'Lely 250 gallons of fresh water which oolap].o'be]y' f:l].].erl bhe oi'Jb, A,?ber ~ per:tod of 24 taken lnctlc,, be a loss of appro;¢i i-rely ] 57 I regret 'bo.~'n.fm'~ you ~:,ho seepage pi'l; 'J.s :inadecBmte in crib ca?c'll;y and prov:i_ded l)erco].a'b:io~i of sufficicn~ waLer for a one l)edroom home, r ....... 't;o; b;ivo, ~,he . ,,( Tit will be )lOC ..... t, . '" "'~";¢" .. U8 :cOqll~Lrod '[,o ob'b::;in a: permiL From 'bhe Delmrb'melit Df ' se2:'vioe.' do 11015 }qe'J;ibab¢; bo cai]. on ]::[' we ('.~ui be oJ' f'upLhor] '" pleqr;e / Dopar't,mmt of ~le~:l.'Uh mx~ Enviornmm)tn~ Preteet:~on Alaska I ac.d. 2. c }Buff( ' -~he.r'cby certify that I have surveyed the followin described property: .Y/I. ....... Anchorage Recording Precinct, Alaska, and that im n'ovements situated thereo a'e within the p operty lines and do not overlap or encroach on the p~operty lying adjacent ti ereto, that no improvement n rop- erty lying adjacent tlle'e o encroach on tile ~ni~s 1 ~ ~uestion aad that t e e are no roadways, transmission hnes or other vislb e easements on sa d property except as indicated hereto. Dated at Eagle River, Alaska ROk~ERT C. JOIINSO ~' · , a, le Rivee, Alask Phone 694-25~3 a