HomeMy WebLinkAboutTIMBERLUX #3 BLK G LT 8Timb
flux
Block
Lot 8
#018-271-62
,~ MUNICIPALITY OF ANCHORAGE
Dli~TMENT OF HEALTH AND HUMAN SER~ES
' Environmental Health Division
825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Address ~ T0 SEPTIC ABSORPTION
~ ~ 3 i ~e~f ~r;¥~ A~c~ /~¢ ~ ~FROM ~ TANK FIELD WELL
Phone(s)~ ~ Permd~O~ ~'No NO ~0.o.m~ WELL
LEOAL DESCRI"TION~ LOT LINE
TANKS
TYPE OF SYSTEM
~ TRENCH ~BED ~ W. DRAIN U OTHER ~
Fi~12,,l%~.(~added above orlginal~ grade~ ~' ) FT Gravel deplh beneath prpe ~ ET
WELLS
[1
REMARKS:
' ~~~ O cedif' 'hal this inspe"ion Was pedormed according 'o all
Municipal and State guid~me~ellec, on this dale:
HeallhDepa.mentApprovah ~ ~' ~~ Da,e:
72-013 (3/85)
DEPARTMEIxFT OF HEAL'¥H AND ENVIRONMENTAL PROTEC]-I£~N
825 L STREET, ANCHORAGE.~ AK 99501
264-4720
F:'ERM t'T NO:
DATE ISSUED:
8 El '~ "9 6
0 4/Z::'. 1/G6
AFE L.I CAI tI .
¢-:d]I.)RE.:~ ..:
CONTACT F'HONE:
DAN HOLX. I:NGSWOR'TH
623:[ NEWT' DRIVE
ANCHORAGE, Al::: 9950?
562-0582
L. EGAL DESCRIP: SUBDIVISION: TIMBERLUX LOT: 8 BLOCK:
SECTION: 34 TOWNSHIP: 12N RANGE: 3W
LOT SIZE:: 5Zl. 600 (SQ.F:T. OR ACRES)
Listed below ape the options available to you in designing you~ septic
system. Choose the option that best fits yOLtP site,,
DEF'"iH TO PIF'E,BOT]-OM (F'T.) ~."~ 5 ~'~-
E~RAVEL DEF'"rH (F'].) O.~
TOTAL DEPTH (FT.) *' 0
GRAVEL LENGTH (FT.)
GRAVEL VOLUME (t]U.YI)S.) ~5
TANK GIZE (GAl_S) 1,C 1)0/~0 ~.*.
~'~ DEPTH TO FIFE:. BOI'"FOM .... :,..,.~ PI'. REQi ]F-,E.~ .~NSJLLTI[)N
~-~ DE. FT.~ TI]) F']:PE BOT'T'OM -.. 4.0 FI-. MaY REQUIRE A LIF"T S]~I iON
TANN MUST HAVE A'T LEAS"I 'TWO C,(.I%-AI~TH,:.N[=
I oep'Lily that:
I am familiar w:i.t.h the requirements for' on-site sewePs and wells as set
¢onth by t. he Municipality oi Anc:honage (MOA) and the State of Alaska.
I will inetalt the system in accopdance with all MOA codes and Pegulatiens,
and in compliance with the design cPitePia oF this pePmit,,
:3. I ~i].l adhePe t.e all MOA and State of Alaska PequiPements fop the set back
distances fPom any exiet:i, ng well, wastewateP disposal system op public
sewepage svstem on t. his on any adjacent i:)~ nearby lot.
4., I urlder'st, and that 'Llais per'mit is valid fop a maximum of 3 bedP~oms and
any enlapgement, will pequiPe an additional pePmit.
IF A LIFT STATION IS INSTAL. LED' IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN EI..ECTRICAL F-:'ERMIT AND INSPECTIOI'4 MUST BE OBTAINED; (2) AS-BUll_TS
WILL.. NO'F BE APF-'ROVED WI]HOUT AN ELECTRICAL. INSPECTION REPORT; AND (3) THE
ELECTRICAL WOR~MUST BE DONE BY A LICE:NSED ELECTRICIAN.
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99511i 264-4720
[] PERCOLATION
TEST
SOILS LOG - PERCOLATION TEST
-- ~. SLOPE
2 GP
3
t Z~ ._.~.~r.l~_'i"~t~.
4
5-
7
9. Girl
10-
11
13-
14-
15-
16-
17-
18-
19-
20-
COMMENTS
72-008 (6/79)
ENCOUNTERED? ~
O
P
,,"E,~.~.~;AT~RAT 7~.~I~,/~E
Reading Date Gross Net Depth to Net
· Time Time Water Drop
U
PERCOLATION RATE . ~'i. /,,~,(m~0uteshnch)
TES3~ RUN BETWEEN ~,~,~'ND '
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEET NO, OF
DATE
~-2251
MUNICIPALITY OF ANCHORAGE
· ~ Department Health and Environmenta ~otection
.~ ' 825 Street, Anchorage, AK. ~-~
264-4720 /~
* * * HANDWRITTEN PERMIT * * *
Permit % ~%%~
WELL AND~ ON-SITE SEWER PERMIT
Location: ~ Phone Number: ~3~=~-~ ~ ~'~9_~ .
Legal Description: ~'~ ~ ~ .~,"~.~~t<. ~O~::~ize:
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed~ 6--" Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH c~ / ~ ~
/
LENGTH /7[ GRAVEL DEPTH ~ WIDTH ~/--/'
The length dimension is the length(in 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(in 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(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~ GALLONS * *
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) INSPECTIONS ARE REQUIRED * * *
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
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * *
I certify that:'
(i) 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 codes.
(3) I understand that the on-site sewer system may /~quire enlargement if
t~ residence is remodeled to inslude more~~rooms.
~pplic~nt ~Date:
system is 100 feet
SWP/024 (1/81)
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 2B4-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
SLOPE
6
7
8
9
SITE PLAN
10
11-
12
13
14
15-
16-
17-
18-
19-
WAS GROUND WATER y~
ENCOUNTERED?
Gross Net Depth to Net
Reading Date
Time Time Water Drop
20-
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN FT AND -- FT
COMMENTS
72-008 (6/79)
CERTIFIED BY:
P.O. 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264~4111
TONYKNOWLE&
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
June 23, 1986
Dan Hollingsworth'
6231 Newt Drive
Anchorage, Alaska
99507
Subject:
Lot 8 Block G Timberlux Subdivision
On-site Sewer & Well Permit #860096 - Issued April 22,
i986
On May 20, 1986, The Anchorage Assembly approved a new ordinance
regulating on-site wastewater disposal systems (septic systems).
Ail septic systems constructed after the effective date of this
ordinance are subject to the provisions of this ordinance,
Our records show that you currently hold a permit for the installation
of a septic system, We strongly urge that you contact this office
prior to constructing your system. Any changes in the code that could
impact the construction requirements of your septic system will be
identified and brought to your atte~tion. Please contact the
· Environmental Services Division at 264-4720.
Thank you for your cooperation.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/SSM/ljw
B~ CROSS-SECTIO~~
SAND FILTER SPECIFICATIONS
Sieve Size (mm)
Percent Passing' by Weight
~ (4.75)
#10 (2)
#60 (0.25)
#200 (0.074)
100
75 - 100
5 - 75
0 - 15
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner D~,~
Mailing address 19 3
Lending agency
Mailing address
Agent N. A
I 0 ~ 4o'. 13 ¢ /~ro,~ 1~
Day phone
_ Day phone
,/ ,
- Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
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:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev. 1/91) Front MOA#21
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'9
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
ON-SITE WASTEWATER DISPOSAL SYSTEM INSPECTION
ENGINEER FIELD AUDIT
LEGAL DESCRIPTION:
ENGINEER: 7-~ ~ ~0~ ~
EXCAVATOR: .~. ,~.
AUDITOR: ~A~' ]~Or/~.
COMMENTS:
AUDITOR:
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: /'er ~ J~Z~ ~ TIPIR~RL~y Parcel I.D.
A. WELL DATA
Well type ~1[' 1 VA'rE
Log present (Y/N)
Total depth } 2 2 '
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter.
Date completed
Cased to 12 2'
FROM WELL LOG
Date of test .3/2 ~ / ~12
Static water level 55' ~
Well flow I~ o~'
Pump level ~ ~
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot I I c~
Absorption field on lot 130 '
Public sewer main ~ Ioo ~
Sewer service line ! JO
ADEC water system number
Ill, IR& Driller
Casing height
Wires properly protected (Y/N)
AT INSPECTION
ltcl'
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout ~/oo ~
Petroleum tank
WATER SAMPLE RESULTS:
Coliform 0 col
Date of Sample: ' ~( /
Nitrate d.~3 ~,/'.,~
Collected by:
Other bacteria ~ col/lc, o,
F/./]TTOP TECg 5v'c5
B. SEPTIC/HOLDING TANK DATA
Date installed II/Io / '" ' '~' "':-' I
ti(:,,' k~ ' ' Tankmze
Cleanouts (Y/N) ~ i~ ~
,' Foundation ~eanout (Y/N) ¥
High water alarm (Y/N) -. N,A,
Date of pumping ~.A, / A~.~ /~,uJ~' I,~ ~n .f.~) Pumper /~,,4,.
SEPARATION DISTA~..~,CL.'.S,FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot I J ~ -- ,;' ~,' ,,
',',- "' 'OnadJacentlots '~/00 Foundation
TopropertYline ~ (P~/ Absorption field ~ .~'/
Surface water/drainage ~ lOC)'
Compartments
Depression (Y/N) oaS~ev~
15'
Water main/service line
72-026 (Rev. 7/9l) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" level at
· Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed I1 //c,/~
Length ~2 ' Width IS
Total absorption area 75(o ~ '
Depression over field (Y/N) ~!~ ol~5£~v-~b (~f0w ¢ov~,~ Date of adequacy test
Results (pass/fail) '~A $ S for ~
Peroxide treatment (past 12 months) (Y/N) '~
Soil rating 175' ~'//~'DRr~ System type
Gravel thickness I Total depth
Cleanouts present (Y/N) Y
If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot t ~o On adjacent lots '~. /00 Property line
To building foundation /.5' ~ To existing or abandoned system on lot
On adjacent lots ~ Io Cutbank ~/00 Watermain/serviceline
Surface water "~ 100 / (~ I Io' I Driveway, parking/vehicle storage area ~ z/O /
Curtain drain ~/O0/ i~c~r~: t~o~,,/or ~ ~ ~ll ~,~.'c ~ ~
I cedify that I have checke¢ verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
E. ENGINEER'S CERTIFICATION
Signature ~'~-'~
Engineer'sName ~-'b~'oVor~- F, l"toor~.
Date ,A f~ r'~ l
HAA Fee $ /'7'~)'~
Date of Payment ~'~-/v~ -~-----~
Receipt Number ,,~..~
Waiver Fee: $
Date of payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21