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Home My WebLink AboutT12N R3W SEC 15 W2SW4NW4NE4 PARCEL 3AJan 17 22 07:31 p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section 04—: Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number: 015 051 QQ Date of Issue: Legal Description Block Lot Property Owner Name & Address: T12N R3W SEC 15 GORDON CLAWSON W2SW4NW4NE4 5010 ABBOTT ROAD PARCEL 3A I ANCHORAGE, AK 99507 Pump Installation Date: 01 _ 14 _ 2022 Pump Intake Depth Below Top of Well Casing: 235 feet Pump Manufacturer's Name: Pump Model: O i Pump Size: 3/4 hp REDJACKET Pitless Adapter Burial Depth: 10 Pitless Adapter Manufacturer's Name: feet MARTINSON Pitless Adapter Installer: ANCHORAGE WELL & PUMP SERVICE Well Disinfected Upon Completion? ❑ Yes ❑ No Method of Disinfection: PELLETS Comments: Pump Installer Name: ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET Company: ANCHORAGE, AK 99518 907-243-0740 Mailing Address: City: State: Zip: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. GENERAL INFORMATION (a) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF FIEALTH AND ENVIRONMENTAl. PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date /LI- ('i' ~ (...,o Legal Description (ilrclude lot, block, subdivision, section, township, range) '7/ ,-v' .,,.¢ Location (address or directions) _ ............. (b) Applicant Name ~'¢~--~¢¢'2? Telephone: Home ~'~¢/~- Business ::¢//¢' ~:% (c) Applicant is (chock one): Lending Institution D; Owner/builder [~Buyer ~; Other ~ (explain); (d) Lending hrstitution _L'~ ~/~-\(.L. _ Address (e) Real Estate Colnpany and Agent /'~/~:~ Address Telephone (~) Mail the HAA to the following address: /7/0/~'/ TYPE OF RESIDENCE Single-Family [Lq/Multi-Family [] Number ot Bedrooms __ Other WATER SUPPLY ledividua[ Well L~ Community [] Public [] Note: If colmnunity well system, must have written confirnration from the State Departmerrt of EnvironmeCrtal Cooservation attesting to the legality and status. SEWAGE DISPOSAL. Onsite ~Public [] Community [] Holding Tank [] " f Note: It community well system, must have written confirmation from tire State Deparhr~ent o Environmental Conservation atlesting to the legality and status. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal alfixed hereto and as of tile validation date shown below, I verily that my investigalion of this klealth Authority Approval shows that tile 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 sopply and/or wastewater disposal system is in compliance with all MunicipaJ~nd State codes, ordinances, and regulations in effect on the date of this inspection. ~¢~ ~'-¢t ~ z. ~ Name of Firm _~~ ~ ~ ...... ~ ~% ~ Telephone ~ ~' ~ :.. .... Engineel's Seal Approved Disapproved Conditional See conditions beloW. ~ Terms oIConditionalApproval . (l) Install a 1~L250 gallon septic tank or add 1,000 gallon, septic tank to the exsiting 500 gallop, septic tank. (2) Engiueer to verify, ±n writing, that ali sewage (including grey water) is directed through the septic tank before enteriqg the absorption area. Funds escrowed to assure work is completed no later than June 30, 1986. 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 A. W~LL DATA MUNICIPALITY OF ANCHORAGE (MOA) H~k~L~{ AUTHORITY APPROVAL (HAA) CHF. CKLIST - FEBRUARY 1984 Well Classification r',~ ~//~/~/ Well Log P~esent (Y/N) /~& Total Depth_ ~J~'6; ~ ~d ~ Static Wate~ ~1 ~ ~ Casing Hsight ~ G~nd ~ ~ ~' Elec~ical Wi~in~ in ~nduit (Y~) .~ ~p~ation Distan~s ~ ~11: To ~ptic~oldin~ Ta~ ~ ~t ~-~/~ ~ DEPT. OE HEAl. TH & ENVIRONMENTAL PROTECTION Legal Description: c, D.E.¢. ~ ~o" - Depth of G~outin~ ~/~ Sanit~y ~al on Casing (Y~),~ ~ession ~,~- ; On Adjoining Lots ~/~o To Nearest Edge of Absorption Field on Lot ~3 ~-~ ,~,,$" C~ Adjoining Lots ~/~" · o Newest ~blie ~' Line - Wate~ S~le Colle~ed By. Wate~ S~le Test ~sults SEPTIC/HOLDING TANK DATA Standpipes .(Y/N) 7~ .Ai~-tight Caps (Y/N) , ~/,~.~_ Foundation,,//_ Cleanout .(Y/N) ~/~ Deimesszon ove~ Tank (3/N) /F~ Date Last Pumped Pumping/Maintenance Contract on File .(Y/N) /4/~ ; fo~ Holding Tank High-Wate~ Alarm (Y/N) /F~ ].%mpo~a~y Holding Tank Permit .(Y/N) Separation Distances f~.om Septic/Holding Tank: To P~ope,'~ty Lins ~/~ ro To Disposal F~eld .~ '£o W~te~. Main/Sarvzce Line ~. ~/~,/~z~f,, To Ht~eam, Pond, Lake, c~ Major D~ainage Date Paid :---~'-q-~' Amount: [Page 1 of 2] 2-15-84 Soils Rating in Absorption Strata Date .Installed .//~F~ ~_~. Width of Field ~/~.~-u~ Type of System Design Length of Field Depth of Field e Feet of Abs6rptzon A~ea ~-~/~,~ Standpipes P~esent (Y/N) Depression ove~ Field (Y~) ~ ~ of ~st A~a~ Test ~ Results of ~st ~e~a~ ~st ~z~3~z&~r ~ ~ Sep~ation Distan~ f~ ~s~ptlon Field: To ~te~-Supply ~11 ~-~ ~ ~ ~. To ~o~rty Li~ /f~ / To Buildin~ Foundation ~ ~ To Existin~ or ~ndo~d System Lot ~/~ ; ~ ~joininG ~ts ~ /~3 / -- ~ ~'f~ ~,~_ To Wate~ Main/~vi~ Line ~/~/Z,~ To ~t~(if p~e~nt) ~ To St~e~ond~e/~ Majo~ ~aina~ C~se ~ /~ / TO ~iveway, Pa~ki~ ~ea, ~ Vehicle St~a~ ~ea ~ ~m / Co nt m D. LIFT STATION Date Installed Size in Gallons "Pump on" Level at High Water Alarm Level at Tested fo~ Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Msets MOA Comments ** Check Permitted Bedroom Rating Against HAA R~quest ** ~/ --/~/~-~-' I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect Signed°n the date~/~~ction. Date ~//~ -- KB1/d5/s [Pa~ 2 of 2] ENGINEERS 2-15-84 Inspector Date Inspector Date - Ios~oetor Condltlenal Approva Date 8ewer Installed ~.-',, Permit No. Soils Ratln§ Well To Abserption Area Well to Tank Septic Tank Size Holding Tank Size Well LO{) Received Proesr[y Owner Mailing Address Lending Inetitutlon Address Realty Co. & Agent Address APPLICANT FILLS OUT LOWER HALF ONLY Phone Phone Legal Description Street Location Phone Type)o~ Residense /~1 Single Family [] Multiele Pamily No. of Bedrooms [] Other Wate/"~Supply "[] Individual [] Cornmunay [J Public Utility Sew,~ Disposal ndividual C Public Utility [~ Holdin~Tank ATTACH WELL LOG. A well log s reaeired for all wells drilled slncs dune 1975. For wells drilled prior to mat date give we aeptll (attach log if When Connected to Public Utility;. NOTE: THE; INSPECTION FEE IVIUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. BRUST & ASSOCIATES Engineers - Planners - Surveyors 1610 Dimond Drive Anchorage, Alaska 99507 (907) 562-7878 April 7, 1986 Anchorage Department of Health & Social Services 825 L Street Anchorage, Alaska Parcel 3A, Section 15, T12N, R3W, S[2 Waiver of seperation distances, and waiver for septic tank size. According to #1 were installed attached as-built scale. Municipal files the septic tank and seepage pit in 1964. Seepage pit #2 was added later. The drawing shows the locations of the cleanouts to An adequacy test was run of the system in 1982. At that time it was determined that the plumbing consisted of two systems. Waste from the toilets went directly to the septic tank. Ali. other liquid wastes discharged to seepage pit #1... Effluent'from the septic tank discharged to seepage pit #1.' Effluent from seepage pit #1 discharged to seepage pit #2. Because the septic tank receives a limited amount of liquid wastes the detention time is high and volume for settling is not needed. It is therefore felt that the 500 gallon capacity is adequate for this site. ~ The Well is located 5~.~ feet from the septic tank cleanout, and ~$.2 feet from the cleanout for seepage pit #1. The ground elevation at the well is about 10 feet higher than the ground at the septic tank. There is a steep slope away from the well to the south. 7here ms a~strea?,~!on the property, indicating ground water flow is to the s~'u~-~~ This system is located on a 5 acre site. Based on the foregoing it is felt that this system wlll continue to provide ~!~-~ :,:~- satisfactory service with no hazard to health or to the environment. It is therefore recommended that waivers for seperation distance and septic tank size be granted. Sincerely, Stanley Brust, PE AS-BUILT No CORNERS SET THIS [)ATE ! hereby certify that I have performed a Movtgagee's inspection of the following described property: ~ Anchorage Recording Pre~inct, Alaska, and that the improvements situated thereon are within the prope/'ty l¥iug adjacent thereto, that no Lmprovement-s on prop- in q, uestion and that there are:. no roadways, trans- erty except as Indicated hereon. Dated at Anchorage, Alaska HEWITT V. LOI3r~SBLq~.Y & A$$OCLA'££$ Engineers, Surveyors & Plannar~ STANLEY BRUST & ASSOCIATES Engineer~ . Planners - Surveyors 1317 East 74th Avenue Anchorage, Alaska 9950'7 (907) 349-6577 PTIC SYSTEM ADEQUACY REPORT LEGAL DESCRIPTION ' LOT , BLOCK SUBDIVISION , T /~':_N , R '~ W S.M. , ALASKA PERFORMED FOR: REQUESTED TYPE OF SYSTEM' NUMBER OF BEDROOMS . SEPTIC TANK WAS PUMPED 153 YES SEPTIC TANK - SiZE ~°"//'*'f'"~GAt-IONS EB-/CRIB OR SEEPAGE] PIT LEACH FIELD 1 .) 3'7 ~ ~, 'I~- /0, 2- STANLEY BRUST & ASSOCIATES Engineers - Planners - Surveyors 1317 East 74th Avenue Anchorage, Alaska 99507 (907) 349-6577 May 2, 1982 Re; 82-15 Adequacy Test Mr. David Froula 5010 Abbot Rd. Anchorage, Ak. 99507 Adequacy Test at Parcel 3A, Sec. 15, T12N, R3W $ 225.00 Paid in Full