HomeMy WebLinkAboutLAKEWOOD HILLS #4 BLK 1 LT 8 0uood
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GRE '.-R ANCHORAGE AREA BOROU¢''~
DEi,~FITMENT OF ENVIR0~I~IEEITAL 0.UALIT,
3!~00 TUDOR ROAD ANCHOIRAGE, ALASKA gg[~07 27g-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELl
LIQUID CAPACITY__
GALLONS,
NUMBER OF
MATERIAL ~'/f/~'"~,'~z~"~ ,';'~'~ COMPARTMENTS
LIQUID
INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE Pit:
NUMBER OF pIts
LINING MAtERIA~¢:~
NEAREST LOT LINE
OUTSIDE DIAMETER or WIDTH_ /'~4 /
C.~/f/'~'~/~.7"~:~ ,,-~/,"f/c"~.~' DISIANCE FROM WELL ~'~ /
I'OTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
?
, LENGTH /~' , DEPTH
BUILDING FOUNDATION
/
~ SQ, FT.
T'"'~-E"~ FIELD:
DISTANCE FROM WELL '~~UNDATION.
NUMBER OF LINES___ DISTANCE BETWEEN LINES~'~'''~
ABSORPTION AREA_
SQ. FT. LENGTH OF EACH LiNE
., NEAREST LOT LINE
.TRENCH WIDTH
DEPTH: TOP OF TILE TO FINISH GRADE_
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE IN A~'~'O¥C--.-C4LF
WELL: T y p E y~,,,~/ZZ. ~.-/) , DEPTH
NEAREST
LOT LINE/z~/~/~2'-- '~'".~,~/ , SEWER LINE
SEPTIC
TANK
DISTANCE FROM .,.f/,,~-.~/ ~., WATER
, BUILDING FOUNDATION.-/{' ~';~/ d'~',ff/c~8'"AMPLE
,~,~ / SEEPAGE /
, SYSTEM ~:~"'?~ , CESSPOOL..
, NEAREST
OTHER
, SOURC ES"~
DISTANCES:
DIAGRAM OF SYSTEM
: .......
GREATER ANCHORAGE AR~A BORuUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO,
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONe 27 ~)-8686
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
INSTALLATION LOCATION 0 /~//~//~/ ~/- ~/~' ~M~
2228
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
COMPLETION DATE ANTICIPATED
SEEPAGE PIT /~ ! , DRAIJ~ FIELD
OTHER
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INBPEGTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE BUBJEGT TO PROSECUTION,
SEPTIC TANK SIZE /c/~-~0 TYPE '5/~" SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCEB, REQU IREM ENTB
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAge PIT WALL
/
TO NEAREST LOG LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
DRAIN FIELD.
,SEEPAGE PIT , DRAIN FIELD
' EEPAgE PiT /o0
ALSO CONSIDER AREA WELLS.
/0' , SEEPAge P'T
DRAIN FIELD
SEPTIC TANK, ( SEEPAGE PIT ., DRAIN FIELD
TO RIVER, LAKE, STREAM.
_CAST IrON INTO AND OUT OP SEPTIC TANK AND INTO CrIB CROSSING GaP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON ~JL~[~:~P--L~-~ ~Ni ~TI~ tANK AND S~EPAGE Pit
FITTED WITH AIRTIGHT ReMOVABLe CAPS.
oF SYSTEM
DIAGRAM
GRAVEL BACKFILL
CONFORM TO BOROUGH ~ULATIONS REGARDING INSTALLATION.
LICENSED DESIGNER
~:RTIFYDT~Ts:EAM[;~NMI~RWDI~NHcT~i~:IA;DEMcEoNDTE: OF GREATER ANCHORAge ARima Bor~C~N;eXB-6S AND THAT THE ABOVE
DAT~;~{//~? ~l/F~(-~' APPLICANT'S SIC NATUREI X //~ ~/-'~//'?/ ~T
G,,EATER ANCHORAGE AREA BOROU,
DEPARTMENT OF ENVIRON~IENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
Performed For ~/~
Legal Bescriotion: Lot
This Form Reoorts Soils Log
CASE #
Date Performed .~__~//2~//~-~
Subdi vi si on /¢/k~,oe/ ~?~X/-/~
Percolation Test
BeDth
Feet
9 ~
Soil Characteristics
· i
Was Ground Water Encountered?~5~ d'?o
I~ Yes, At what Depth? ["~---~---~~--' ~Z-
/
,¥
Readin~
Date
ercolation Rate
Proposed Instal
De~th of Inlet
CnM~ENTS:
Gross Time
Net Time
. ~O Hinute
ation: SeeDaqe Pit ~x Drain Field
~_~' Depth To Bottom Of Pit Or Trench_zL~/
Test Performed B.y
Data (ertified By:
Date:
! ®
oO
MUNIC.IPALITY OF ANCHORAGE
DIVISION OF 6]~vi[RONMENTAL
DEPAiYfMENT OF HEALTH AND ENVIRONMENTAL
APPLICATION FOR HEALTH M3THORITY APPROVAl, CEIYfIFICATE
1. C~r. eral Info~',~tion Application Date 5-30-84
(a) Legal Description (include lot, block, subdivision, section, tcwnship, range)
Lot 8, B__ lock 1, Lakewood HJ.ll%..#4,~_~5.$.3,~T]=2_N~R3W_,__S_M ....
Location (add~ess or directions)
10501 Elias Drive
(b) Applicants Nan~ Sylvia Williams Telejphone 346-2072
Applicants Address 10501 Elias Drive Anchor_a_g_e_, Alask___a
(C) A..Dplicant is (ch~d~ one) Lending Institution ~_--~; Owner/builder F--[ ;
O h,.r e . .ainl ' '
(d) l'mnding Institution First National Bank of A3~chorage %%lephone 276-6300
Address 646 w. 4th Ave Anchorage, Alaska
(e) Rea]. Estate Coo & Agent
Address
None
Te le phone
20 _T_zpe.~ of Residence
Single-Family ~L~ Multi-Fami].y ~[ Other (describe)
Nomb~r of Pedrcmms .... _t
3. Wa ter_ _~ppJ.~!
Note: If ~unity %911 system, n~st have w~itten oanfirmation f~om the State
Department of Environmental Conservation attesting to tS~ legality and status,
Is the ~11 adequate fo~ the number of bed~ocms specified in this HAA (Y/N)
Is the wastewater disposal si;stem adequate for the s.tmbe, r of l~drocms (Y/N)
[Pa~D 1 of 2]
2-].5-84
5..i.~,n~ineerinq Firm Providin_g_I_nspecti_ons, ~lbsts, Data and Information
I c~rt. ify that I have checked, verified, or confornmd to all MOA HAA Guicleli~s in
~:,ffecu on the date of this inspection.
Signed Date
N~ne of Firm Arctic En~ Inc.
Te leph(me 561-134 5
Adddfess 1506 West 36th Ave., Ste. 201
Signed bi; William T. Hawley
Date 5-30-84
(ENGINEER SEAL)
"App~ovc-~for-~ ............ ~ol~
Date .....
The Municipality of Anchoraga Depa~tn~nt of l~alth and Enviro~antal Protection dce.s
not ~A~arantee t[~3 continued satisfactory perfo~.'mance of t[~ wate~ supply and/or the
wastewate~ disposal system. ~lis approval indicates that, as of the validation date
sho~n above, based cn the data and information furnished bi; an engir, eer registered in
the State of Alaska, the wate~ supply .-~nd wastewater disposal system is safe and func-
tional for the numbe~ of bedrooms and type of structure ir. dicated.
( LItEP SEAL)
7. ~ail the HAA to the fol].cT~ing address:
XB2/dS/s
[Page 2 of 21 .'X
2~- 15--84
WELL ~11WH ~0
flOV~OHDNV ~0 ~IlVdlDINfl~
Well Classification ~rivate
Well ~ ~esent (Y~) N
Total ~p~ 115' ~d to
Static Water ~1 72 1/2'
cas~n~_~!gh~ ~ .~nd 12" +
~c~ical Wiring in ~nduit (Y~) N
To ~ptic~olding Ta~ ~ ~t 60'
To ~a~est ~ of ~so~ption Field on Lot
To Newest ~blic ~ Line N/A
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
LEGAL: Lot 8, Blk 1, Lakewood Hills sub.#4
If A, B, or C, D.E.C. Approved(Y/N)
Date Complete d
115'
Pump Set At
N/A
unknown Yield 12 gpm
__Depth of Groutinq N/A
110'
Sanitary Seal on Casing (Y/N) Y
Depression AroundWellhead (Y/N) N
; On AdjoiniJg Lots 100.+
; On Adjoining Lots zoo' +
To Nearest Public Sewer
Cleancut/Manhole N/A TO Nearest Sewer Service Line on Lot ~JA ~-
Water Sample Collected By T. Hawley ; Date__ 5-25-84
Water Sample Test Results Satisfactory for Total Coliform~¢//'
C~fR~nts Well yield ~est performed by Arctic Engineers at 12 gpm, DD=~
Recharge time = 5 minutes ___ . __~
B. SEPTIC/HOLDING TANK DATA
Date Installed 7-72
Standpipes (Y/N) Y
Depression ove~ Tank (Y/N)
/0.~0'-0
Size _ .~fr~al NO. of Cc~partm~nts 2
Air-tight Caps (Y/N)______Y__~YFoundation Cleanout (Y/N) N
N Date Last Pumped 5-25-84
Pumping/Maintenance Contract on File (Y/N) N/A ; for
Holding Tank High-Wate= Alarm (Y~) NTA Tempora=y Holding Tank Permit iYJq) N/A
Separation Distances f~c~ Septic/Holding Tank:
To Water-Supply~ll 60'
To Property Line 10' +
To Water Main/service Line N/A
Course N/A .- .......
To Building Foundation_____3~2
TO Disposal Field .25'
To Stream, Pond, Lake, or Major D~ainage
Comments ~MOA Records show 1000 gal tank, pumper sa_id 1250 - ?
[Page 1 off 2]
2~15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed July 1972
Width of Field 10
Square Feet of Absorption A~ea
Depression over Field (Y/N) N
Results of Last Adequacy Test
85 Type of System Design Pit
Length of Field 10
Depth of Field 6
Gravel Bed Thickness ~Dk~-d~ .....
240 Standpipes Present (Y/N) Y
Date'of Last Adequacy Test 5-25-84
Satisfactory
Separation Distanoe from Absor~t~n/__>_~Field:
To Water-Supply Well /~ 8~,/~--/ '~ To Property Line 46'
To Building Foundation 48' To Existing or Abandoned System c~
Lot N/A ; On Adjoining Lots 100'+
To Water Main/Service Line 10'+ To Cutbank(if present) N/A
TO Stream/Pond/Lake/c~ Major Drainage Course N/A
To D~iveway, Parking Area, or Vehicle Storage Area 10' +
C~nts Adequacy Test by Arctic Engineers - ABS capacity more than 1000 ~allons per da5
D. LIFT STATION
N/A
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alaz-m Lsvel at
Tested for
Electrical Codes (Y/N)
Dir~ensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Meets MOA
C~nts
** Check Permitted Bedrocm Rating Against HAA Request
I certify that I have checked, verified, or conformed to all MOA HAA Gu~]9.1ines...in effect
on the date of this inspection.
Signed Date 5-30-84
Col~pany Ar~-~r, E~ ..... -r~- MOA NO. ST84-001 ~ ~"~ ~~_.Zf~3'~¢.~ '~ ~" ........ '~
2 of 2]
[Page
2-15-84
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER '
,4 ~ ~ -.,--- 5633 B Street
Drinking Water Analysis Report for Total Coliform,' Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM: [ [ } [ [ [ [ (*) See h on'back
~ I,D, NO,
Water System Name Phone No.
· ~ State
MO. Day { Year
Mailing Address
Zip Co~e
SAMPLE TYPE:
,~D Routine
Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreat~ .... ~ter
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination to
Indicate reliable results. Please send new
sample via special delivery mail.
Date Received ,.~""'-~'
Time Received
Analytical Method:
[] Fermentallon Tube
SAMPLE
NO.
1
2
3
4
5
Tim
LOCATION Collec
I
J
I
I
Collect, By
ISAACS pUMPING SERVICE
(,Norm Tibbetts, Owner)
6218 Quinhagak Street
ANCHORAGE, ALASKA 99507
Phone 563.3300
06.1220 (b) BA(
Rev, 1683
READ INSTRUCTIONS
BEFORE
Membrane Filter. Dlrec
Verification: LTB__
Final Membrane Filler
Reported By
COLLECTING SAMPLE TNTC = Too Nun
884
dST be
DEPT. OF ENVIRONMENTAL CONSERVATION
SOUTHCENTRAL REGIONAL OFFICE
437 "E" STREET, SUITE 200
ANCHORAGE, ALASKA 9950l
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
July ll, 1984
Arctic Engineers Inc.
1506 W. 36th Avenue
Anchorage, Alaska 99503
Dear Sir:
MUNICIPALITY OF ANCHORAGe]
[)EFT. OF HEALTH &
ENVIRONMENFAL PROTECTION,
k :CEfVED
Subject: Horizontal Well to Septic Tank Soil Absorption System
Waiver Lot 8, Block 1, Lakewood Hills Subdivision (8521-WA-002)
The Department has reviewed the subject waiver reque§t'and"'hereby approves
Grand Father Rights for the 60 feet separation between the septic tank and
private well. The Department hereby denies the waiver request to reduce
the separation between the well and soil aborption system to 83 ft,
because the system was not originally installed in accordance with the
Greater Anchorage Borough Permit issued June 8, 1972 and because there
appears to be no physical reasons which make the 100 feet requirement
~.learl~ not necessary.
Sincerely,
Er~kson(~~-~~-~'
Environmental Engineer
BEE/msm
cc: Robbie Robinson (HOA)
I,IUNICIPALi'TY OF ANCIIOf?A6E
DEPAR'FiqENT OF HEALTI~ AND ENVlRON~,~ENTAi__ PROT[~CTtON
825 L ShreeL, Anchoraue. Alaska 99501
~;~lP.~' ~a~o llec(~iv(~d: November 16, 1977
~2 : [ ~ i!~ ~ ' ' ' % ' ; 3 l]~l~:~ ' ' '
k~,Ql.r',:>., ,?OR APPROVAl', OJf INDIA,F1 )UAL I;}!;N}.'iR AND NA'£'ER FACI]3. ')?;Fi!;S
Mailing Adci~,:e s s: 3201 C Street 99503 Ph. on c,: 277=1553
2. Prol'.erhy O'../ncu.-: Merrill Lynch Relocation Mgmet Phone: 206-455-3013
blailing A{M.:'ess: 10655 NE 4th, Suite 705, Bellevue, Washington 98004
3. Legal !)esc:b-iptior,: Lot 8 Block 1 Lakewood Hills #4 Subdivision
Number of Bed_~:ooms: Three
We]
5. ~' .1 Syst:em: 'I'ud-[vidt a'l Well (x) Communit:y/PublJ.c SysLem (
Permit: ti ..........................Depth of Well ............................ Well Log on ]"ile ( )
Consl-rncLion Bacter:h.t]_ Analysis
6, Sewage Disposal .... 5 ot:.a: Oil-si. t0 SysLe]n (x)
li'ub]_i¢: UL:il.:it-y ( )
Permit -~ Installed ~-~} 1-- InsLal]_er
Sept. ic ';.'ank $i:.;e /OOO blanufacb, urer
Absorpt:Lon Area ...................... Soils N. atc ................. Hater:]_al .__~, .............. i.__
Diskances: Well
to o,.we.. I,:inc Nc:are:;
t':o Nearest Lot
Page Two
Request for A}?proval of Individual Sewe]:' and WaLe]' Facil:itJ.es
C(DIO~E~ll [: s:
Disapproved: Da t.e:
Department Worksheet:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
Nov. 16, 1977
4. Name of Lending Institution:
Mailing Address:
5. Name of Realtor or Agent:
1. Type of Inspection: CMRO. VA STATE of FHA CONV
ALASKA
2. Property Owner; ~' 7 ? LUnch R~?~cRt¢on Manage_merit Inc,
10655 N.E. 4th... Suite 705
Mailing Address: ~7 ?~,,,~; wA 98004 Day Phone: (206) 455-3013
3. Name of Buyer: ~TB~t ~nc7 Sylv~ W~ ~liams
Mailing Address: 2019 Waldron Dr,Anchorage 99507 Day Phone:.. 344-5360
State of Alaska (will close thru Brokers Title Co.)
Phone:
Jack White Companv: Attn: Elliot Lawson
Mailing Address: 3201 c Street, Anchoraqe, 99503 Phorle: 277-1553
Legal Description: Lot 8, Block 1, Lakewood Hills #4
Location: From Hillside Dr. qo up Upper O'Malley to 1st road on left (sign shows
Elies Drive)... turn left on Elies Dr. and go 0.2 miles.., home will be
on right side. (It sits back from the road, has natural cedar siding
exterior, and has a Jack White sign on the outside.., home now VACANT)
Type of Facility to be Inspected: Sinqle-familv home No. Bdrms. 3
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility.
If Individual, date of installation
Individual xxx
One
Believe well to be 115' deep with water at 80' level
.Individual (on-site)
Unknown
XXX
./ NOTE: IF YOU NEED ACCESS TO THE HOME, PLEASE CONTACT ELLIOT LAWSON AT
~' JACK WHITE COMPANY (277-1553) AS HOME IS NOW VACANT .... WILL GIVE
~.~.:.. INSPECTOR THE KEYS OR WHATEVER .... ~h~ks'~ '~ .
:~'~ .... Elliot Lawson
72-003(3/76)
06-1220(a) Rev. 1978
DATE
ALAS DEPARTMENT OF HEALTH AND SOCIAL SEi ,ES
DIVISION OF PUBLIC HEALTH
INDIVIDUAL AND SEMI-PUBLIC
BACTERIOLOGICAL WATER ANALYSIS
INDIVIDUAL
SEMI-PUBLIC [] CHLORINE RESIDUAL PPM
REPORT RESULTS TO
NAME
ADDRESS
CITY
ADDRESS
OF SOURCE .'
-- ZiP CODE
COMPLETE THIS SECTION
ONLY IF WATER IS AN INDIVIpUAL SUPPLY
SAMPLE COLLECTED BY "'
DATE COLLECTED TIME COLLECTED
Well- ~ Dug [] Driven [] Drilled ~ Bored
SOURCE: [] Spring [- Cislern [] Olher
Dug Well or Cistern Canslruction:
Walls--[] Wood [] Concrele [] Metal [] Tile Brick o~
Top -- [] Wood [] Concrete [] Metal [] Open Top[] Concrete
LOCATION:
[] In Basement [] Basement Offset [] Under House
[]In Yard [] Other ~
Building Sewer Sepllc
DISTANCE TO: or Other Drainage Pipe. Feet. Tank Feet·
Tile Seepage Cess~
Field Feet. Pit Feel. Pool Feet. Privy_ Feet.
Other Possible
MATERIAL: Building Sewer- [] Casl Iron [] Wood [] Tile [] Fibre [] Asbestos
[] Plastic Joint Material - Type Cement
GENERAL: Does Waler Become Muddy or Discolored? [] Yes [] No
When?
Diameter of Well Depth i i ', Feet.
Well Casing
Material Diameter Depth
Le~glh of Water Depth
Drop Pipe -- From Bottom Feel.
Offset in In Utility
PUMP LOCATION~ [] In Well [] Basemenl [] In Basement [] Room
On Top
[] Of Well [] Other
Lab No.
OFFICE
AflbJysis shows this Water SAMPLE to be:
~ Salistaclory
[] Unsatisfactory
[] Questionable
[] Sample too long in transit; sample should not be over 48
hours old at examlnaHon lo indicate relJable resuhs. Please
send new sample.
[] Bottle broken in transit, please send new sample.
SANITARIAN'S REMARKS
PURPOSE OF EXAMINATION: Illness Suspected?
New Source of Supply? [] Yes [] No
READ INSTRUCTIONS
ON
REVERSE SIDE
BEFORE
COLLECTING SAMPLE
[] Yes [] No"
Repairs to System? [] Yes [] No Signature
064220 (b) BAcTERIOLoGICAL WATER ANALYSIS RECORD
Rev. 1973
Dale Received ]t i" ' i · : om
. ~ t !. '------Time Received : ' pm Lab, No.
Lactose Broth 1Otc lOcc lOcc lOcc 10cc 1.0cc 1.0cc
24 Hours
48 Hours ~ .
Brilliant Green
24 Hours
48 Hours
EMB AGAR
Laclose Broth, 24 hrs. 48 hrs .... Gram's slain
Coliform Density (Mosl probable No. per 100cc)
MF Results
Reporled by ~ :'
This analysis indicates Coliform Organisms to be:
Dale
Absent