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Home My WebLink AboutWYNTER PARK #1 BLK 1 LT 9QGREA/ ANCHORAGE AREA BOROu,.,t Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM FROM WELL.~' ~' - MANUFAC'FURER-")~al''~'/' NUMBER OF COMPARTMENTS INSIDE LENGTH SEEPAGE PIT: NUMBER OF PITS __~.. / INSIDE WIDTH LIQUID DEPTN ...... LIQUID CAPACITY_/~"~'~) GALLONS. D,AMETFR _//8 OR W,OT,/__~_,: LENGT,~_/Z: OEPT, ~ ' BUILDING FOUNDATION , NEAREST LOT LINE ABSORPTION AREA (WALL AREA) .SQ. FT. ADDITIONALABSORPTION /~// ' TYPE CONSTRUCTION DEP1 H DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE TANK __, SYSTEM CESSPDOL OTNER SOURCES APPROVED __I_ DISAPPROVE[) REMARKS__ DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: ........ LOT SLOPE: REMARKS: ~:~/~ ~/~- /Cd /..~/2,¢~. Form No. EQ-031 GREA1 ~.NCHORAGE: AREA BOR( DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANOHORAGE~ ALASKA 99503 TELEPHONE 274-456 I PERMIT NO.- SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUgh SOil 'reST RESULTS PHONE SeePAGE,PITv_ * DRAIN FIELD , OTHER To.E ,MSTALLEO "¥ NOTE~ THIS PERMI'T IS NOT VALID WITHOUT SOIL TESl COMPLETION DATE ANTICIPATED-- 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 MINIMUM DISTANCES, REQUIR£MENTS FOUNDATION -to SEPTIC TANK*~ FOUNDATION tO SEEPAGe P~T SEPTIC TANK TO SEEPAGE Pit WALL , DRAIN FIELD iS'- SEEPAGE AREA SIZE SEEPAge PIT ]~! ALSO CONSIDER AREA WELLS. SEEPAGE PIT 4 INCH D.I.AMETE~R CA__ST lEON S]PH, ON~PIPES ON SEPTIC TANK AND SEEPAGE PIT GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING [N / ~ / DIAGRAM OF SYSTEM ~//~ I CERTIFY THAT// AM DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, DATE APPLICANT'S SIGNATURE uI~EAT[R ANCIIOR/\(iI: AIq.A UORU[JGh IJep~rtmenL of Environn]eI~Lal (]ualJ Ly 3330 "C" StreeL Anchorage, Alaska 99503 S()II,S hOG I'I~IIOhATION TEST Legal Uescription: This forln reports: Soils '1og_,.¥2:_~ ................ Percolation Lest ........................... bep ~h Feet 1 O - '~' 2- 3 - '&'- 5~ 6 - 7- 8- C-W ' lO- ll 12- 13- 14- Was ground water encountered? __[~[~ .... If yes, at whaL depl;h? .......... Reading i)a te Gross 'fi me Net Time Depth to Water t~et bro}) Percolation rate minute. -Proposed stallat~on: Seepage Pit Urain Field E(~ 040 (6/74) ANCHORA6E/U~ST~N DISTRICT OFFICE ~1601 C STREET SUJ.'FE 1334 ANCHCRA~E, ALASKA 99503 STEVE COWPER, GOVERNOR OAFE: To klhom It Mav Concern: Accor'dinq to the recor'ds on File in this oFFice, the .... State o~ Alaska Or'inl~inq I,later ReqJlations. APPLI( NT FILLS OUT. UPPER HAl, ONLY Property Owner ~/)/.1~. /~/,~,'J~', /~",~, ,:;~ ~ C~:, ~//'~; ~ /~/~ /~ ~ ~ Phone Lending Instilution ~) / ( ~ / ~,~' ~ '-; ,~-Y~ Z -~ ~' ~ Phone Realty Co, & Agent ~.~ ~:~ ~f ~Z ) ,.~;:~ 12 ~ ~ j..[ ~_.} ~ ~ ~ Phone Type of Residence Single Family Water Supply ~ Individual F:~,~-~ ~ L~ Year Individual Installed: Time Time Date Date Date Date Inspoctor Field Notes: ~ APPROVED BEDROOMS )DISAPPROVED ) DONDIT,ONALAPPROVAL' *CONDITIONS OF APPROVAL Soils Rallng Date Sewer Inslalled Well To Absorption Area Well to Tank ~.c~ 1/..~-. ~,~.. Well Log Received Septic Tank Size ~ ~_~(Z~ ~ EXCAVATION '7 ROBERT A. SHAFER WORK CIVIL ENGINEER 694.2979 March 6, 1983 Dale Guttierrez Star Route 2 Box 4620 chugi ak, A 1 a~ka 99 567 Dear Mr. Guttierre~, Reference: Lot 9: Block 1: Wynterpark Subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was tested by chargifiggthe system with 1000 gallons of fresh water and after a period of 24 hours all the water Qhich had been added to the crib had percolated out. It can be concluded from this test that the waste water disposal system serving the three bedroom trailer located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. If'we may be of further service, us. cc: Municipality of Anchorage Department of Health and Environmental please do not hesitate to contact Protection SRB 195X EAGLE RIVER, ALASKA MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL. SERVICES 343-4744 .~' % ~RTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ~, ~-~._ ~'-.*,~M OITE SEWER AND WATER FACILITY FOR '"2 ~. ' v,~-~, . SINGL. E FAMILY DWELLING Parcel I.D.\~'Cf ~-,~\.,L\c~ \- LA.~-/ HAA # _ " ~-\~°~°t~'h~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) _LOT 9; Block I; W~nter Park ¢[ Location (address or directions) NHN Park Drive (b) Property owner A.H.F,C.#14~25 Mailing Address Telephone: (home) Business (c) Lending Institution Ma Ing Address Telephone (d) Real Estate Company and Agent ~'A¢,~ Wt~?TE Cf~MPANV ~,TTN, I y,dn B,~j¢.~ Address 10928 Eagle River Road, EaRle River, Al~ 99577 Telephone 6g~-4~00 (e) Mail the HAA to the following address: (or oheok here ~if hold for pick up.) List oonJ8ot person and day phone number below: S & S ENGINEERING 17034 Eaqle RI,vet Loop Road Ne. 204 Eagle River, Alaska ~9577 2. TYPE OF RESIDENCE Single-Family[~( Number of bedrooms 3 3. WATER SUPPLY Individual.Well [] Community [] Public ~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~]X Public [] Community [] Holding Tank [] Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72o025 (Rev. 7t88) Page 1 of 2 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 investigation of this Health Authority Approval 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 obtained 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. Name of Firm Address Date S & S ENGiNEI=RING 17034 Eagle River Loop Road No, 204 Eagle River~ Alaska Telephone 6. DHHS APPROVAL Approved f o r~'~L Approved ~ Disapproved Conditional Terms of Conditional Approval ,,"~f~'~ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 certain 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. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 A, WELL DATA Well Classification _ Well Lo9 Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Date Completed 343-4744 Legal Des~cription: Depth of Grouting If A, B, C, D.E.C. Approvedq~E;hN) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ; On Adjoining Lots ~ ~ ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results '~'. ~'-'~ ' ~'~- ~P, '~ Comments B. SEPTIC/HOLDING TANK DATA Date Installed \c>~l¢,_~¢:j' Size Standpipes ¢~N) ~ \ ~;:~¢:::~ No. of Compartments Air-tight Caps t~N) ___"¢_ Foundation Cleanout Pumped'~'~ ~ ~ \ -- ~ Depression over Tank (Y/I~ ['"-~ i~& ,~)ate//~ I_est Pumping/Mainteeance Contact on File (Y/N)~/~ ~oMin~ lank ~igh-Water Alarm (Y/~) 'rom~orary Holdin~ Tank ~armit (Y/~) sEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line ,~1~ To Building Foundation To Stream, Pond, Lake or Major Drainage Course Comments ..~/4~ 72-026 (Rev 7/88)Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ ~ -"" ~ ~'~---~ Width of Field Type of System Design ~'~ Length of Field \'Z~ ~ Depth of Field \ ,,.-.-.-.-.-.-.-.-~ Square Feet of Absortion Area Depression over Field (Y/j~ Results of Last Adequacy Test Gravel Bed Thickness '7.-.---~ % ~ Statndpipes Present ~ Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Founda~i.i.i.i~? Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line To Existing or Abandoned System on ; On Adjoining Lots "~"~ To Cutback (if present) r~ ,//% Comments D. LIFT STATION t~ /~ Date~alled ,,S, ize inG~ 'Pump On" Level aT-'----.._ High Water Alarm Level a~ Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~ ~les during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this S & $ ENGINEERING 17034 E,~glo River F~gie-Rtve", ~.l~ska g95~ inspection. Signed Company Date MOA No. Receipt No.. Waiver Fee: $ Date of Payment Page 2 of 2 72-O26 (Rev. 7/88) Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APP~'~ 264-4744 Application Date '"~'"7'"" GPNERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) · Location (address or directions) lb) Proper y Owner. Telephone: Home Mailing Address (c) Lending Institution Telephone Mailing Address Business (d) Real Estate ~;ompany and Agent ,'~"~¢'t'"...,.,1/.~ .~'Y~f3 .~'~.? ~_.,F'~. ~ Address ~ ~ ~ ~t~ ~ ~. Telephone ~'~ ~ ~ (e) Mail the HAA to the folJowina address: or: Check here~if held for pick up. List contact person and day phone number below. S,., ° ,., ~' ~ ..... 17034 Ea~lle River L~K~p Read Ne. 204 Eagle River, Alaska 9957/ TYPE OF RESIDENCE Single-Family~t~ Number of Bedrooms WATER SUPPLY Individual Well [] Community [] Peblic,,~i~~-- 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 [] Holding 'rank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72 025 fRev 8/861 Front NOIJ. rl¥O leAoJddv leUO!J!puo0 jo suJJe/ '9 euoqdeleI LUJ!:~ ;o eWBN 'uo)loedsu) s!ql 1o el~p uo )oalje u! suo)lBlnSeJ pub 'SeOUBUIpJO 'sepoo elBi$ pue IBd!o)un~ lib qlfM eoueHduJoo u! s! uJeis4s lesods!p JelBMe)SBM Jo/pue ,qddns Ja)eM al!B-uo eql 'uo!loadsu! pub uo!lBS!lse^u! ,~Lu LUOJJ pUB selU e§B~oqouv ~o Xl!lBd!olunR ali) LUOJJ peu!B)qo UO!)eLUJO~U! e)enbape pub leUO!lounj qIIBeH B!q) 1o uo!le6gse^u!/~uJ NOI.L¥1NI:IOJNI .g MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF ANCHO~LTH AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH & CHECKLIST- FEBRUARY 1984. ENVIRONMENTAL PROTECTION JUL 1. 988 WE,L DATA RECEIVED Well Classification /~ 264-4744 Legal Descril~tion: ~::~'T-...¢~_ '~[,..--¢16~ / If A, B, C, D.E.C. Approvedd~N) Well Log Present (Y/N) Total Depth Cased to _ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot "~¢ ~ To Nearest Edge of Absorption Field on Lot "~c~Jc-- To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments '~'k¢'~ ' ~-~' ~ Date Completed Yield _ Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SF'PTIC/HOi.'DtNG._TANK DATA Date Installed \'C~-L¢-'~~' Size __\ 4;:;;L"~(:~ No. of Compartments Standpipes ¢~N) V Air-tight Caps~'~N) ~/' Foundation Cleanout (Y~ Depression over Tank (V~) ~'-~- T Date Last Pumped Pumping/Maintenance Cont~r,a. ct o~ File (Y/N)~, t""% f/~ _;for Holding Tank Higb-Water A.,, .a m (/N) //~ Temporary klolding Tank Permit (Y/N) Separalion Distances from Septic/Ho!dir~j_Tank: To Water-Supply Well ____ '~.-c~c::~ To Property Line 1 ~ To Water Main/Service Line L'.-?- ~ '~- course ~ ~ ,L To Building Foundstion ~ I~ TO Disposal Field / ~ / To Strearn, Pond, Lake, or Major Drainage Page 1 of 2 72~026 fRev B/861 Fronl ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~;'~" %/~-~' Type of System Design Date Installed \ ~ ~ ~ - -~ ~ Length of Field \ ~ Width of Field Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test Depth of Field \ Gravel Bed Thickness Standpipes Present Date of Last Adequacy Test' Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Properly Line To Water Main/Service Line \ ~ I ¢¢ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Comments Date Installed Size in~ ..~.~ "Pump On" Level at High Water Alarm Level at ~ Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~~Test. Meets MOA Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all/~,A anZ HAA guidelines in effect on the date of this inspection. Si g n e d c 4~rc..cEN6! NI= ER I NG Date .~/ ~-~ c--~e Ri~er Loop Road No. 2~ /~ Comparl~~" ~"~" ~ MOA No. Eagle Eiver~ AlasKa No. Date of Payment L~7 ~ [~ -- ~ Amount:S / 7 ~ Page 2 of 2