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Home My WebLink AboutT12N R3W SEC 27 LT 41B RE/ ANCHORAGE AREA BOR Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON'SITE SEWAGE DISPOSAL SYSTEM LOCATI ON SEPTIC TANK: DISTANCE ~ . ~' ., , . NUMBER OF FROM WELL~-(L'g7¢ --- MANUFACTURER ~ MATER AL_'~c~.2~F¢)/¢I~_~ COMPARTMENTS INSIDE LENGTH "-- INSIDE WIDTH '-- LIQUID DEPTH LIQUID CAPACITY~(")O GALLONS. TOTAL LENGTH ,~. DISTANCE FROM WELL L~- ~)' i j _FOUNDATION ! ~ 01 NEAREST LOT LINE ~(0~ ._OF LINES. NUMBER OF LINES I---- DISTANCE BETWEEN LINES "-- TRENCH WIDTI-1~¢2~ IN. TOTAL EFFECTIVE ABSORPTION AREA ';~-~_7~ ~-~ -- SQ. FT. LENGTH OF EACH LINE _ '~ j - DEPTH: TOP OF TILE TO FINISH GRADE '~)-:; DEPTH OF FILTER $ ~ MATERIAL BENEATH TILE _ ~f~. ABOVE TILE ___IN. WELL: TYPE ~.-l_ ~"k ~,k~__. '~. BUILDING FOUNDATION _ , CONST RUCTION C.k ~I~N~ .~,1 ( *~.. NEAREST NEAREST LOT LINE ___ SEWER LINE -- SEP F lC 'rANK DEPTH DISTANCE FROM: SEEPAGE SYSTEM __/ 2~' i CESSPOOL _ , OTHER SOURCES APPROVED . ___ DISAPPROVED D,STANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: ~/-'¢'~'1 ¢ ~,t~ _ LOT SLOPE: t)0V.2 i~ ~'fl 't'0 '¢ -- REMARKS: _REMARKS DATE ~//Z ~ DIAGRAM OF SYSTEM w~ll / -', ,,: [¢cv,,~,,, p Form EQ 032 GREA ANCHORAGE AREA BOF DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCAT'ON ~/~ /~I~ /~ ¢~I] ~¢~ INSTALLATION OF: SEPTIC TANK TYPE AND SIZE Ct~ FACILITY TO BE SERVED SEEPAGE PIT DRAIN FIELD -- TO BE INSTALLED BY ~'-{" //% NOTEI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION*. SEPTIC TANK SIZE ~//~--(~},/~/~L-/ TYPE ~-~(~('//Fl~~ //~;,/~/~g/./~'/EE/~P~AGE AREA SIZE ~'~1~ ~/~/~/' MINIMUM DISTANCES, REQUIREMEN~ SEPTiC TANK TO SEEPAGE PiTWALL~? ~/'/~'(~z~ /,,~(~/'~7'~) [2/:'~/~/~/~'/~/~'~' / SEPTIC TANK, / O¢(~ SEEPAGE PIT SEEPAGE PIT DRAIN FIELD CAs'r IRON INTD AND OUT Of SEPTIC TANK AND INTO CRIB CROSSING GAP EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED WITH AI~TIGHT REMOVABLE CAPS. ,:- j...?, -- . CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION, DIAGRA CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of GREATER ANCHORAGE A EA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SY TEM I<' IN ACCORDANCE WITH SAID CODE' ~ ANCI,IOR~GU ~ AI,Af:KA CAS,q # The sediments Were fair loose with a low water content. The Gw-Gm contact was erratic so the ten foot indication .ep~esents an average. Gw Reading t)ate Location Skotch Bross Depth To /120 Drain :ield Net' D~op Ce lI' fied For' T...Ak..80.~:k~; ............................................................................................ Location . D.e.&~;:l~l D ll;'l . I~O.~.~ ......................................................................... Date Completed .612.11.7.5 ........................................................................ Depth of well ...~.89...P~fiO.~ ........................................................................... Size o~ casing ~ ~ ..~oh .............................................................................................. Distance tc wa;er. ......... Z.6.8....~.~.¢~ ........ :: ............................................. DistanCa to wa~er while pumph~g . ............. ~.~,~..~.~.~.,_....;, ................. of ....... ~ ~ .................. gallons per I certify the aboy~ truc,a~ld correct. .d......r.......:._c.,...... .............. ~...c,. :~ ............ D'riller' FOSS DIlILLIN¢~t 1336 INGRA PH. 279-2849 ANCHORAGF,, )ti,ASEA 99501 We advise you to attach this certificate to your deed, MtJNICIPAkI~Y OF DEPT. OF Hi I:NVIRONMENTAL 00,'1' 1 RECEI' MUNICIPALrTY 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 CERTIFICATE OF HEALTH AU'FHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # (2 /~' - C.'.cf~2 _ ;A_ f~. 1, GENERAL INFORMATION Complete legal description HAA # c/; _ '-~ Location (site address or directions) Z/c~(.?/ )'~. AVVt4,¢L;¢1 Mailing address Lending agency Mailing address Address Dayphone .~----~ L/'¢ - Day phone Day phone ZT?)' 7;..~ /. Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ 'N TYPE OF WATER SUPPLY: Individual well I./ Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: 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 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the 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 obtaine~l 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, ordinances, and regulations in effect on the date of this inspection. Nameof Firm / ~"-"----~t.~.~ H --~,c ,- ~¢~.~vt~-/~ '[~'~, '~-__.,. Phone Address ~.~o~ ~ /.:~/--~'~l /~ ,P-/~ -% o Engineer's signature Date DHHS SIGNATURE Approved for Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy cer[ain federal and state requirements. Employees of DHHS 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. Legal Description: __ A. WELL DATA Municipality of Anchoraoe DEPARTMENT OF HFALTH & HUMA~N SERVICES,, Environmental Services Division 825"L" Street, Room 502 ® Anchorage, Alaska 99501 · (907) 3~,~-4744 Health Authority Approval Ch~.cklist . Parcol I.D.: Well type q~, Log present (Y/N) Total depth San]taG, seal (Y/N) Date of test Static water level Well prodaction WATER SAMPLE RESULTS: y Date completed ' Wires properly protected (Y/N) y FROM WELL LOG AT INSPECTION __ g.p.m. . If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above groand) Oo'Tt~-~/~ Other bacteria ~ Collected by: -T-, ~ Nitrate g,p.ln. SEPTIC/HOLDING TANK DATA Date installed ~//7R~/.7~' Tanksize Foundation clcanout (Y/N) ¥0 Date of Pmnping __/"~/t~, ABSORPTION FIELD DATA Date installed ~7~ Length ~/ I Width Effective absorptim~ area. ~ Date or adequacy test ~ Depression (Y/N) /NJ High water alamo] (Y/N) Nmnber of Compartments_ ~ Cleanonts (Y/N) y _ N/a, _ System type '"] .~1 e-/-7 __ Total depth ! [ Depression over field (Y/N) N For ,.~ bedrooms Soil rating (g.p.d,/ft2 or ft~/bdrn0. J ~ D ~ I Gravel thickness below pipe _ Monitoring Tabe present(Y/N), y Results (Pass/Fail) Flaid depth ia absorption field before test (in,); "~,'.~ I nmediately after~al, water added (in.): Fhdd depth__~3,.~.(ins.) Miautcs later: ,.~29,~(~) Absorptioo rate = '~ q ~L~L¢) g.p.d. Peroxide treatment (past 12 months) (Y/N) ~'N\ If yes, give date Date installed Size in gallons Manhole/Access (Y/N) 'Tump on' level at* "Pump off' level at* High water alarm level at* *Datmn Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holdingtankm~lot 10'1' Jc~5.~o~xc[~i~ ;Onadjacentlots Absorption field on lot ) / ]O On adjacent lots Pablic sewer main Sewer/septic service line /"//.4 Pnblic sewer manhole/cleanout ~D~ / Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation '~'-~h.:' Property line ~' ,,;~C) Absorption field I~D Water main/service line /'>/or2> Surface water/drailmge lX/o~-e_ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Boilding foundation ,~.~E) ! Water main/service line I Snfface water ~o ~ E Driveway, parkinWvehicle storage area Curtain drain N/0 Wells on adjacent lots ENG~ER~S CERTIFICATION ' ' ' i cert~y that I have determined thru field inspectwns and review of Mun~cipal~:eCor~¢: that the above in conformance with MOA IIAA gutdehnes m effect on this date. Engineer s Name ~4~b~ ~pOr~ ~' ~' Engill~efing Sea! Here HAA Fee $ Receipt Number Rev, 8/95 eSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 -02-2~ I0:21 Jim Williams Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: HAA Lot41B, Sec. 27, T12N, R3W PID 018-092-.36 Febmmy21,1996 Gentlemen; The well casing has been extended to 18" above ground level, with sanitary seal and conduit. The smnp at the end of the trench is a 6-inch Orangeburg. Caps for this kind of pipe is not available. A 6-inch flowerpot filled with soil was inserted in the top of the pipe serving as a cap. The PVC pipes adjacent to the tank was found to be com~ected to the first standpipe of the tank. The purpose of this pipe was to act as a cleanout for the discharged pipe from the RV. Hope this satisfy your concern about this HAA. Yours T. Spurkl/~d P.E. -- ~ MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVl RONMENTAL PROT~(~ONMENTAL P~',OTECTION ENVIRONMENTALSANITATION DIVISION 0C'[' 4 1980 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Iflcomp]ete requests will not be processed, Please allow ten (10) days for processing, ~ REALTOR/AGENT ~ I PRONE MAILING ADDRESS STREET LOC/ATION // ,% ,- //2 SINGLE FAMILY MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four 'wo [] Five 'hree [~ Six [] Other 7. WATER S~JP"PLY ~] INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY ATTACH WELL. LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) SEWAGE DISPOSAL SYSTEM [~" iNDiVi DUAL/ON.SiTE*" [] PUBLIC UTI LITY --- NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCI:SSING CAN BE INITIATED, YEAR ON-SITE SYSTEM WAS INSTALLED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDiViDUAL/ON -SITE DATE INSTALLED [~PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line J Nearest Lot Line I WELLTO: Absorption Area to nearest Lot Line B. COMMENTS E~'"'/APP ROVE D FOR _~ BEDROOMS [] CONDITIONAL APPROVAL (letter mnst accompanV certificate) [] DISAPPROVED !~ DATE BY 72-010 (Rev. 6/79) 8155 Cranberry St, Anchorage, Alaska 99502 Phone(907) 243-5302 Mr. Tom Scott PoO~Box 10-729 5outh Station Anchorage~ Alaska 99511 Oct. R~ 1980 S ~; W E R A D E Q U A C Y T E S T Legal: Location: Owner: Re sidence Wat er: ~;ewer: ])ate of Test: Test Procedure: Test Re s~lt: Lot 41B, S0c.27, T12N, R31,4 SM. Mile T/~ DeArmond Road Tom Scott Three Bedroons, Two Storey On Site Well i,¥om Municipal Records: Tank: 1000 gal. Fiberglass-- Gunset absorption System: Trench. 21 feet long Total Absorption Area: 336 sq. ft,, feet of grave].. October 22 and 23~,~980 System was :inspected on Oct. 19, 1980. Tank was found half full and qT/~ inches of water was measured in the trench. On October 22 1500 gallons of water was dumped into the trench and the tank p~nped. The following measurements were taken; Time Water level in Trench Start of test 16~ inches Add 1555 gal 35~ Octeber 23 ~ 9.3Cam 14.0 inches The full amount of the 1500 gallons had been absorbed by the system in a 24 hour period. This system pu~,~ the requirements ef the ~:{Rnicipality. --. ~ .~ ~ ~ ~:~.)., J~[ 25, 1971 ,~