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HILLSIDE HEIGHTS LTS 2 & 4
Hillside Heights Lot 2 & 4 #015-092-78 MUNICIPALITY OF ANCHORAGE C~ DEPARTMENT OF HEALTH & ENVIRONMEN'rAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION -~. 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ~'NEw ~AI LIN O ~ ~ ~AD S~/ /~ · ~/~-O ~ ~( ~ ~ ~ ~ ~/~ ~ UPGRADE ~GAL DESCRIPTION LOCATION NO, OF BEDROOMS Well ~O >~ /~ lAbsorption area Dwelling PER~I~ NO. ~ DISTANCETO: P~o~,~ /00~ I~0/ ~ ~1- ~ Manufacturer I~ ~ ~ ~ ~ ~ Sat~ -- No. of compartments Liq. capacity in gallons Inside length Width - Liquid depth /~ ~-~ IF HOMEMADE: ~l Well ~ Foundation Nearest lot line PE~IT NO. i ;~ DISTANCE TO: lO0f ~ ~f~ ~ ,~ Distance between lines ~ ~ i ~ No. of lines L h ch Total le~gth, f Iii;es , ~ Trenc~dth ' ~ Top of tile to finish grade Material beneath~ ~ Total effe rive abso ption ~ Typeofcrib ~~diameter/ Cribdepth ~~ ~taleffectiveabs°r"ti°n ~"' Class~ Depth Driller Distance to lot line ~7~ Absorption area(s) ~ DISTANCE TO: Building foundation Sewer Pine Septic ' OTHER PIPE MATERIALS x vc I - 4 SOIL TEST RATIN6 , , ~' ~,~. APPROVED DATE LEGAL 72-013 {Rev. 3/78 DPPER D LL NO 7529 E. 6th Avenue o Anchorage, Alaska 99504 o (90'7) 333~6435 July 14, 1984 Mr_. Grog Groenweg The following information is your copy of the well log for the property located at Lot 2, Iii llsido Ileights Subdivision~ This should be retained as your permanent record of in]provements to your property. WELL LOG 0 7'0 5 Feet Top soil 5 11 Sand, grave] ]_1 1.5 Sandy si] t 15 28 Silty sand, grave] 28 32 Si]. t, gravel 32 40 Silty sand, grave] 40 45 Gravel 45 51 Fine sand 51 75 Sand, guavel 75 78 Sand 78 85 Sand, gravel 85 96 Grave ] 96 101 Find sand, silt 101 103 Sand, gravel !03 115 Fine sand, silt 1]_5 117 Sand, gravel ]17 121 Silt ]_21 138 Sandy si!t, gravel ].38 142 Fine sand, silt ]42 146 Sand, graven 146 152 Silt ]52 157 Silt, gravel 15'? 160 Sand, gravel ] 60 173 Fine sand 173 181 Silt 181 190 Sand, gravel 190 200 Grave] WATER 10 GALLONS PEP, MINUTE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION UUL 2 61984 RECEIVED PERMIT N0: [::'RTE ' '=':' ] ..... LIED: P F FL1L. NN'I: RD[:,F.:ESS: C:ONTFIC:T PHONE: i-'1 LI t'-,I I C: :[ I- ~ L I T °T' m_--~ F- R 1'4 C: ~-I ~ .... ~,H" -- F'jE-- DEF'RRTMENT iDF HEFILTH AND EN',,,'IRONHENTRL PF.:OTECTION ,:,¢~.J L :,] REEl., RNC:t40F.:RGE., RK '9':¢501 ,::e:,4- :$, 2L4 C~i'4--:=~; ][ 'T"E SEPJIEF..: ~:: 1.4ELE_ F"E [~:r'l 1[ -1F E,'40279 GREGORY L GROENUHEG :LS:L7 GARDEN STREET ~NCHORBBGE, RK DEPTH TO PIPE BOTTOM (FL~'.', GRRVE:L DEPTH ,::FT. ) TOT,R,L DEPTH ':FT. :':,/~¢ 3F'R~EL HZCTH 'FT' ,3Rfl',/EI.. LENGTH ,..FT~-¢~ ~v:-'~"'-"~"n mu "/OLUME '::CU. '¢[','=.. _,. ) TFINK '- =,IaE (GRLS) SOIL RRTING ':S'~ FT. ,.'"BR) LE:GBBL DESCRIP: SUE:DIYISION: HILLSIDE HEIGHTS LOT: 2 BLOCK: Nfl SECTION: .~.2: TOHNSHIP: :L2N RANGE: ]:H LOT SIZE: 4900~ (SQ. FT. OR BBC:RES) L~STED BELOI4 ~RE THE EF'T~:NS ~S,~L~BL.E TO YOU ~N DESiGNiNG Y]UR SEPT~E: SYSTEM. CHOOSE THE OF'T~ON THaT BEST F~TS YOUR k ~ ¢. O 4. 0 4. ;. , ~:~., 0.5 3.5 ' :{9.0 ~. 0 ~3. O. 36. 0 49. 0 % 0 *:+:/>~. i., 000. 0 :+:,+: TRNK MUST HRVE RT LERST THO COMPRRTMEN'rS I CERTIF? TI-IRT: t. I RM FRMILIRR HITH THE REQUIREMENTS FOR. ON-SITE SEI.4ERS BBND HELLS RS SET FORTH BY THE MUNICIPRI_ITY OF FINCHORFIGE (MOBB) FIND THE STFITE OF RLRSKR. 2. I HILL INSTRLL THE SYSTEM IN RCCORDBBNCE HITH RLL MOFI CODES BBND REGULRTIONS., FiND IN COMPLIBBNCE I.,.IITt4 ]"FIE DESIGN CRITERIR OF' THIS PERMIT. ]:. I HILL FIDHERE TO RLL MOR FIN[:, STBBTE OF RL. FI'-';KR REQUIREMENTS FOR ]'HE SET B~CK [:,I':]TBBNCES FF.:OM RNY EXISTING HELL., HRSTFHRTEF.: DISPOSRL. '::]YS]'EM OR PUBLIC SEHERFIGE SYSTEM ON THIS OR BNY R[:,JBBCENT OR NERRBY LOT. 4. I UNDERSTFIND THBBT THIS F'ERI'tIT IS VFtLID FOR R MRXIMUM OF 2: BEDROOMS RND RNY ENLFIRGEMENT H ILL REL.]U I RE FIN RD[:,I T I ONRL PERM I T. IF' A LIFT STflTION IS INSTFtLLED IN fin BBREFI CO',,,'ERED BY i'tOBB BUIL[:,tNG CODES, THEN Ed..'., FIN ELECTRICRL PER. MIT RND INSPECTION MUST BE OB]"FIINED.~ (2) FIS-BUILTS HILL NOT BE FIPF'ROVED HITHOUT FiN ELECTRICRL INSPECTION F,'EF'ORT.~ FiND ,::3:) THE ELEC.'TRICFiL HORK MUST BE [:,ONE BY Fi LICENSED ELECTRICIRN. ISsuEr:, BY ' ' . ~. /] ~ DFITE: t....0'1': ;2: Iii:LOCI.:::: I'.,11:::1 F;:FII",I(]E': 31.,.I <Permit ~: 820954 · January 31, ].983 TO: Permit Applicant Subject: Lot 2 Hillside Heights Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued ena calendar year basis, as stated en the permit, by authority of Municipal Ordinance. If you have drilled the well, a well. log needs te be senh to this department for documentation of the installation date and te close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-~builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincere~) Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/].jw enc: Copy ef Permit SWP/057 PERMIT NO. l'~ IL.# I'-.1 I ¢2: ][, . a L I T"-r' C~ F R ~'-.I ,:: H ,;-: F! ~3 E [:,EPRRTMENT GF HERLTH RND EN',/IRONMENTRL PROTECTION ,'_--,'25 "L" STREET, RNCHGRRGE., FIK. 9S~50& 264-4720 l-,.! E b L. ~:~ ~-.~ [::, ,]~ I'-.~ --.."_--; ][ T' E K-'_"; E" ~---~ i F;.' P E] R i"1 :E T' ,:: 82F1954 ) RPPL. I CRNT LOCFIT I ON I_EGFIL GREGORY L. GROENEWEG L2 HILLSIDE HEIGHTS t517 GRRDEN ST 99504 LOT SIZE TVF'E: OF SOIL RBSORPTION SYSTEM IS: TRENCH 279-0±56 999999 SQURRE FEET MRXIMUM NUMBER OF BE[:,ROOMS = 5 SOIL RRTING (SQ FT,/BR)= ±50 THE REQUIRED SIZE OF THE SOIL RBSORPTION SVSTEM IS: E::, E F" T H :--- :[ E-I L_ EE i"-.I G TH---'- ~:-_-; ]: ,3 F: f:1%," E] L E':, E P T ~-~ --.= ¢_._:; THE LENGTH [:, I MENS I ON IS THE LENGTH (IN FEET) OF THE TRENCH OR DRFIINFIELD. THE DEPTH OF FI TRENCH OR PIT IS THE [:,I'-]TRNCE BETWEEN ]'HE SURFFICE OF ]'HE GROUND RND THE BOTTOM OF THE E:4CRVFITION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRFIVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE FIND THE BOTTOM OF ]'HE EXCRVRTION (IN FEET). F'ERMIT RPPLIC:RNT HRS THE RF'SPONSIBILIT'-r' TO INFORbl THIS DEF'FIRTMENT [."URING THE INSTRLLRTION INSPECTIONS OF RN"r' WELLS RDJRCENT TO THiS PROPERT'¢ RND THE NUMBER OF RESI[:'ENC:ES THRT THE WELL WILL SERVE. T~-40 ( ~--~ ]:' ~: NSPEC:-T I I--.I~',~--¢-'; F~F~:E ~,:': E L--:! El :[ F-:E[) BRCKFII_LING OF RN'T' S'¢STIEM WITHOUT FINRL INSPECTION RND RPPRO',,,'RL B'T' THIS DEPRRTMIENT.,,I.4ILL BE SUBJECT TO PROSECUTION. I'dlNIMUM DISTRNCE BETWEEN R WELL. RND RNY ON-SITE SEWRGE DISPOSFIL S'T'STEM IS J-00 FEET FOR R PRIVRTE WELL OR &50 TO 208 FEET FROM R PUBLIC I.'.IELL DEPEN[:'ING UPON THE T'¢PE OF PUBLIC WELL MINIMLIM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET FIN[:' TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS FIRE F.:EG.]UIRED RND blUST BE RETURNED TO 'rile DEPRF.:TblENT WITHIN 30 E:,FI'¢S OF ]'HE WELL COMPLETION. OTHER REQUIREMENTS MR'.¢ RF'F'LY. SF'ECIFICRTIONS RND CONSTRUCTION DIRGRRMS RF.'.E RVRILRBI_E TO INSURE F'ROPER INS"rRLLRTION. PER f,1 I 'T E3 ~-:: F~ 'i: l:,]:E $ [) E C: E I"'ll~, E F-: 3:±.,, I CERTIF'¢ THRT i: I FIM FFIMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS IlS SET FORTH BV THE MUNICIPFILIT'¢ OF RNCHORRGE. 2: I WILL INSTRLL THIF S'¢STEM IN RCCORDRNCE WITH THE CODES. Z':: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MFI'¢ REC..!UIRE ENLRRGEMENT IF THE RESIDENCE IS REMODEL.lSD TO INCLUDE MORE THRN 5 BEDROOMS. 'v'4. 0 MUNICIPALITY OF ANCHORAGE DEPAR3'MENTOF HEALTH AND ENVIRONMENTAL PROTEC[ION Pouch 6-650, Anc:~ora~, Alask~ 9950:2 276-222~' 3 4 5 6 7 8 9 10 · 11 , 12 13 14 15 16 t7 18 2O SOILS LOG - PERCOLATION TEST S LOIS E SITE PLAN ..... ~' ! : (minutes !,nch) PER CO-LATION RATE 'z;~'-- ~. _~.TEST FIUN BETWEEN FT AND ,~;OMM ENTS '~ P~RFORMFO BY ~ FT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAl. PROTECTION DIVISION OF ENVIRONMENTAl. HEALTH CERTIFICATE O[-- INSPECTION FOR HEALTH AUTH©RITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~'--/,~' GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location~r~r aa;'e s ............ ' (b) Business (c) App ~.l~ar~t is 4che~k ong);.~L,end ng tnst tutlon D; Owner/builder ~ uyer [~'.]; Other L-] (explain); (d) Lending I.slJtut,bn,~Z~/~ .... ~.¢¢~ Telephone (e) Real Estate Company and Agent ~}~'_. ' gff~h. Address Telephone (f) Mail the FIAA to the following address: TYPE OF RESIDENCE Single-FamilybC~ Multi-Family [] Number of Bedrooms Other WATER SUPPI.Y Individual Well [~" Community ~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~'~ Public [] Community E] Holding Tank E~] Note: if community well system, must have written confirmation from the State Department of Er~vironmental Conservation attesting to the legality and status. Page 1 of 2 72-025 {11/84) 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 investi9ation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, iunctional and adequate for the number ol bedrooms and type of structure indicated heroin I further verify that based on the information obtained from the Municipality of A~chorage 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 Address _/~:~5 Date _~_~ Approved for ~.~ '~:!~)edroo m s,,b~/ Approved ' /_._.~_~_~ !~ Disapp,~)~ Terms of Conditional Approval _ ~ditional CAUTION 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 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUNicIPALITY OF ANCHORA~t; DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION CHECKLIST - FEBRUARY 1984 284.4,20 I ECEIVED Well Classification ~/[~;~T/~ ~' If A, B, C, D.E.C. Approved (Y/N) Well Log Presen~'~) Date Completed _ ~_"~-tJ~,~ / ./~/-_,~/ Yield Total Depth ,.,~..~ ( Cased to ~...~OO ' Depth of Grouting ~ Static Water Level _~Ot - Pump Set At Casing Height Above Ground "~./ Electrical Wiring in ConduitS) Separation Distances from Well: Sanitary Seal on Casino,S) Depression Around Wellhead To Septic/Holding Tank on Lot ~I'~"'~_ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Lide'_ ~fk,J J~ To Nearest Public Sewer Cleanout/Manhole _ Water Sample Collected by __k~r~ _~/,~. ;Date --~/~'-'/-"~-{J~-- Water Sample Test Results Comments .~ ~_'_'~J~ .~ ~'~/~t c__"~O ~ '~ H B. SEPTIC/HOLDING TANK DATA StandpipeS~N) Air-tight Caps (~N) Depression over Tank Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ Separation Distances from Septic/Holding Tank: ioo To Water-Supply Well _ To Property Line To Water Main/Service Line ~ Course . ~ ~,~I ~J~/~l ~ ~--~ Comments -,.' :..-~ . No, of Compartments Foundation Cleanou~-~N) Date Last Pumped _~r., :for Temporary Holding Tank Pel:'mit (Y/N) ~Z/~ To Building Foundation To Disposal Field _ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 C. ABSORPTION FIELD DATA Width of Field Square Feet of Absorption Area ~"7,-.~. ~'~! ~'~ Depression over Field (Y'~) Results of Last Adequacy Test '~ ~ Separation Distance from Absorption~Field: To Water-Supply Well /D~ '~'- To Building Foundation ~ ~ To Water Main/Service Line 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~YN) Date of Last Adequacy Test To Properly Line ~"~ To Existing or Abandoned ; On Adjoining Lots ~/~-' ^ To Cutbank (if present) Comments System on D. LIFT STATION Date Installed ~ Dimensions Size in Oalloma-...-~ ~ / l~Manhole/Access (y/N) "Pump On" Level a_ -~- "Pump Off" Level at High Water Alarm Level at Tested for ~Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify th at j.h. ave .check. cd, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~/~'~,/~_~,~2.~._"//'~/--"/// Date ~.~-//-..?~ _,~,~-'" Company i~,, ~J~--% MOA No. ~"-_~,_~"--0~ Y Receipt No. ~ ~-3 ~'~ ~ '~ ~ Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal