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Home My WebLink AboutDEER PARK BLK 3 LT 7 !, ; ' MUNICIPALITY OF ANCHORAGE ~" DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~NEW (~J~C- }{ t'~-p}n~ y._t 333-~2-75 r~UPGRADE NAME MAILING AD, D~R ESS · M LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer Well lO0 Liq. capacil IF HOMEMADE: Well DISTANCE TO; , Manufacturer IAbsorption area Inside length Dwelling we. I ~ 0 DISTANCE,~b J~'~ ~--'TO: Length of each li~.~ Foundation ~1~ ~-(~ Total length of line~ Top of tile to finish grade Length Width Type of cfi ~E TO: Material beneath tile Depth pth Depth Driller DISTANCE TO: Building foundation Sewer line OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROVED 72'-0t3 I~v. 3/78) DATE LEGAL Dwelling Width Nearest lot line Trench width I effective absorpti Nearest lot line Septic tank NO. OFBEDROOMS ~,~ PE"M'T9 No. of cOmPc~ments Liquid depth PERMIT NO. allons PERMIT NO..~ (~ Distance betwe~ ines Total effective ab area PERMIT NO. PERMITNO. "~(~t~) ~? Absorption area(sD :;,;: '<.?"~? ,"~ ' ~ ' ,;" ":" "" ' :'.C:' ...... ' - ~ , ."".,. ,, . · , ','*~':..:.~ -.,0, -; · .~,'?~,':4'~-;,''-~-~" · ."-, .~ ...... -'.: !':' ~ .... ' ' ' :.- "' :-'-., .:- c c.-~, ':" ' ¢ ..... [JY" "'" 7" ""~'""~ °~ ';' ~''~'''~.'''''A;'' ,:--k'~-- ~,~-- L" : - -- ..... ' ...... ' ............ ':"': -SI.J-: ?--N ....... O'.' BOX 272 "~""~ ' ......*'- i'.' :'?P,' CHUGIAK, ....... ALASKA 00~7" *" ~ 'T~I't~HON E 688-2759 "';' : ' 7,5 ADDRESS ' ' DATE; Started ' . '?'~/ Ended PERMIT NUMBER '7' ~ 0 ~ ,,~ c/ STATIC LEVEL OF WATER DRAW DOWN FT. '/C:~ . GALS. PERHR '_'C~'~'" !.7. OFCAS,N KIND OF FORMATION: From I' Ft. to ~q- Ft. -From" 'Ft. to__Ft. From~ ~' Ft. t~ .~"'15 Ft. From '~.~ Ft. to ~ ~ Ft From '"~'-]' Ft.'to -.l a / Ft. From From From Ft. O ·. Ft..io ' I From ...Ft. to Ft -ff"~ ~O , From__Ft. to Ft. "Ft. to. Ft. t,, ~,q/"c:%"d From 'Ft. to Ft. Ft. to' Ft. t From Ft. to Ft. Ft. to Ft, ' From~Ft. to Ft. From Ft. to__Ft. Fromm. Ft. to .Ft. From Ft. to Ft. From Ft. to 'Ft. ; From~Ft. to : Ft From Ft. to ,Ft. ~ From_ Ft. to" Ft~ From Ft. to .Ft. From ~ Ft~to Ft ' ' From ?Ft.*to' ' "*'F'(_' '"* ~' i., From ': ' '.' Ft.'to` "; Ft." ~ . _ , From ., ~Ft. to "? Ft.~: ~ ~ .._:_~ ,-. ~" From'a~'~'"::Ft:to'~ ...... Ft.';'-"" :.'" '; ~' '?~-': '-~':. ' From :;;~Ft:'IO':':-.-~:~:FtYc~=~';::,:'-:,- : -::::-'.- [ ,,~,,... ,~, :..; , .,~;,~.,e.~ -~t~,~ .. - , .. .¢,,,. ..... ,... ,. - .... ....,..,~ ....~ .....,,.,,- -,~,.:-: ..... .: - · ... . ....;. I ......... z .......... (~.., ................................................ ;~ ................................ · ...... ~ ........................ ~.? .....~,..~..,~..~..,,~,, ~.X .... s,.. ...... ~ ..... , ....... s ':.~..~< .... .._ ........ :.... .......... . ................ t .... ~.~,.~., ~ ,~,:,..~.x,,~:~,..~ ~.. ~, ,.., ~;~ ..... , ..... .,..~ .... ,%,~, ,-t... . , · PERHI'¢ APPLICANT , LOCATION LEGAL MARt( KRUPIHSKI DEER PARK DR L? B~ DEER PARK I'IU~ICIPf:~LITN' OF . ~CHORf:~GE DEPARTMENT 0F,?--'SALTH AND ENVIRONMENTAL PR--ECTION '825 'L~,.~TREET, ANCHORAGE, RK. 9950~. .... 264-4720 NELL E~D Or~--S ITE S~[qER PERrq I T 4200 5AN ROBERTO ~ ~875 LOT SIZE 40000 SQLIRRE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TREHCH : . MRXIMUH HUMBER OF BEDROOMS'= 3 SOIL RRTING (SQ FT/BR>= 210 · ~; ' · THE REQUIRED SIZE OF THE SOIL RE:5ORPTION SYSTEM IS: " DEPTH---~ '1 4 ' LEI'-.IGTH=_--. '-~'2 G R R'-..~EL DEPTH= ::1..0 ~THE LEHGTH DIMENSION IS THE LEHGT FEET) OF THE TRENCH OR DRAIHFIELD. THE DEBTH OF R TRENCH OR PIT IS THE .DISTANCE BETHEEN THE SURFRCE OF THE GROUND". AND THE BOTTOM OF THE EXCAVATION (IH FEET>. THERE IS HO SET NIDTH FOR TREHCHES. THE GRRVEL DEPTH I~ THE MINIHUM DEPTH OF GRAVEL BETHEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IH FEET). RE('4U I P, ED SFPT I C TRt,IK $ I ZE= 'I 0£-~0 GRLLot.~S PERMIT APPLICANT HAS THE RESPONSIBILITY TO IHFORM THIS DEPARTMENT DURING THE IHSTALLRTION INSPECTIONS OF RNY HELLS RDJRCENT 'TO THI~ PROPERTY RND THE ',NUMBER OF RE5IDEHCES THAT THE'HELL HILL SERVE. ...: .... TNO ( 2 ) I t4SPECT I~t~S ARE REGII_I I RED BRCKFILLIHG OF ANY S~5TEf'I HITHOUT FINRL INSPECTION AND RPPROVRL BY THIS ' DEPARTMENT HILL BE SUBJECT TO PROSECUTION. MIHIMUM DISTANCE BETHEEN R HELL RN~ RNY ON-SITE SEHRGE DISPOSRL S~STEM lee FEET FOR R PRIVATE HELL~ OR &Se TO 2ee FEET FROM ~.PUBLIC HELL DEPEHDING' UPON THE T~PE OF PUBLIC HELL. HELL LOGS RRE REQUIRED AND MUST BE RETURHED TO THE DEPARTMENT HITHIN 3e DRYS OF THE HELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICRTIONS AND CONSTRUCTION DIRGRRMS ARE RVRILRBLE TO INSURE PROPER INSTALLATION. F::ERI'-I I T EXP I RES DEOEI~'IBER __.~'1 .. '1 _~. 7_~'. I CERTIFY THRT .' l: IRM FRMILIRR HITH THE REQUIREMENTS FbR ON-SITE SEHERS AND HELLS RS SET FORTH BY THE MUNICIPALITY OF RNCHORRGE. 2: I NILL INSTALL THE SYSTEM IN flCCORDR~JCE HITH THE CODES. -~: I UNDERSTflND THRT THE ON-SITE SEHER ,SYSTEM MRY REQUIRE ENLARGEMENT IF THE RESIDEHCE IS REMODELED TO INCLUDE MORE THRN 3 BEDROOHS. SIGNED: RPPLICRNT MARK I(RUPINSKI ISSUED BY. ' DEPARTMEN OF HEALTH AHD EHYIRONMEHTJ....,PROTECTIOH ~ ~" " 825' /L' STREET, ANCHORAGE, AK.' , ~ ~' ' 264-472~ ' RPFLICRNT g I ~J ' , , b ' ~TYPE OF 50IL~RBS~BTION SYSTE~ IS:, HRXIMUM NUMBER OF BEDROOM~ =~ , SOIL RRTIN THE REQUIRED SIZE OF THE, 50IL RB~ORPTIOti SY~TE~,f IS: DEF'TH~ /~ CEr~GTH=:~8 GER';.'EL, DEPTH= THE LENGTH DIMENSZOH IS THE LENGTH (ZN FEET> OF .THE TEEI~OH OR DRRINFIECD; THE DEPTH OF R TRENCH, OR PIT ~5 THE DISTRNCE BETWEEN THE 5URFRCE OF THE. GROUND RND THE BOTTOM, OF THE EXCRVRT[OH (IH FEET>. ,' THERE ~ t~O SET HIDTH, FOR TRENCHE~. , ' THE GRAVEL DEPTH I~ THE MINIMUfi DEPTH OF GRAVEL BETHEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE. EXCAVATION (IH FEET>. PERMIT APPLICANT HAS THE. RESPONSIBILITY TO INFORM THIS DEPARTMEHT DURING THE j INSTALLATION INSPECTION_~,OF ANY WELL5 ADJACENT TO THIS PROPERTY AND THE NUMBER OF RE~IDENCE~ THAT THE WELL WILL 5ER~:E." , ' BRCKF%LLZNG OF ANY ~Y~TEH WZTHOUT FZHRL [HSPECT[Ot~ AND APPROVAL BY TH[~ DEPRRTMEHT WIL~ BE 5LIBJECT TO PROSECUTION. HINIMUM DISTANCE BETWEEN'R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEH I~ ~lOO FEET FOR R PRIVATE WELL~ OR ~15~ TO 2~ FEET FROM R PUBLIC WELL DEPENDING UF'ON THE TYPE OF PUBLIC WELL. WELL LOG~ ARE REQUIRED AND MUST BE RETURNED TO THE DEPRRTI'IENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENT~ MAY APPLY. ~PECIFICRTIONS AND CONSTRUCTION DIRGRRH~ ARE AVAILABLE TO IHSLIRE PROPER INSTALLRTIOH. F'ERI"I 1' T EXP 1- RES DECEr-IBEE _?..-1 .. I CERTIFY THAT ;' l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS AS SET FORTH BY THE MUNICIPALITY OF AN.CHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDAHCE WITH THE CODES. 5: I UNDERSTAND THAT THE 'ON-~ITE SEHER SYSTEM MAY REQUIRE EHLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN S BEDROOMS. IS~I_IED . _ , , Y~. ~ PLAYIER VI NTURE$ cor'ISULTING ,GEOLOGIST SOILS LOG Test l'it "C" Performed for ~'?].]a Vista As$o¢iotes, Inc. I/o cat ion Uate,, , At the boundary of Lots 7 and 8, Block'S, Deer Park Sub. · ,....,.,...~ A].ao..a. (see Location [-:ap) Soil Type. Water Level kemarks 0 2 4- 6 S:': .. O-1.5 Sand, silty, tan, loose. $i'1 1.5-11.0 Sand, silt:,', gray-brp%m, gravelly, dense; with lenses of poorly graded fine sand and ver.v stiff to hard ', ~' sandy silt. .. = ..... PERCOLATION I~TE:. 20 minutes/inch ,..- Interval "perked" from 5 feet to 7 feet : below ground level. SP 11".0-17.0 Sand, r;ray-brm.m, fine grained, gravel. ~__ ... ly, with lenses of silty sand and hard sandy silt Groundwater ~:) Not Reached Depth, if Reached Classification Hethod. 16 Total Depth of Excavation ~7' Material at Total ])epth Bedrock (y) Not Reached Depth, if Reached (4) Visual ( ) Sieve Analysis () SP 'Gary F. Player, Consulting Geologist 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# 1. GENERAL INFORMATION Complete legal description Lot 7; ~oek 3; Deer Pa~k S~bdivZslo, Location (site address or directions) Chuglak, AK 99687 Property owner Mailing address Lending agency Mailing address Agent Address Mark Krupinsky Day phone P.O. Box 670331 Chu~Z~kt AK 99567 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ',4 TYPE OF WATER SUPPLY: Individual well XY, X 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. 72~25 (Rev, 1/91) F~ont MOA~I21 5. STATEMENT OF INSPECTION BY ENGINEER Sm 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 obtained from the Municipality of Anchorage files and from my inves!i.,qation 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 ,o.n the date of this inspection. ~,"~66 e~SelV '~eAla Name of Firm t-o= 'm; paoli dool J;~!a elS;~ Phone ONla Address Engine,s signature DHHS SIGNATURE /'~_ Approved for / Disapprbved, Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date '/il'Ill'Ii 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 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. 1/91) Bacl~ MOAI2! Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Descriptlon:~-O'f' "~ ~t~-~. ~)~..~t,~ ?~L4..-'5/~ Parcel I.D. If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~::, .-' ~-'"] ~ Driller A. Well Data Log present ~N) ~ Total depth \ oc~~ ~ '* Sanitary seal {~YN) D~te of test Static' water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: ' Septic/holding tank on lot ~ .c) ~ Absorption field on lot Public Sewer main Sewer service line WATER SAMPLE RESULTS: Cased Io ~ o" t.- .Casing height ~ Wires properly protected ~)'N) FROM WELL LOG AT INSPECTION ~'0, 0 g.p.m. "~, '~ 'Y g.p.m,.--.. ; On adjacent lots ~ \ g)~, ~ ; on adjacent lots ~ .Public sewer manhole/cleanout ~ ~ ~ Petroleum tank '7---~' Coliform ',~ '~ Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Collected by: .Other bacteria ~:) $ & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Date installed J ~1 "/~ Tank size '~ c:~ Compartments ~ Cleanouts~/N) ,./ Foundation cleanoutt~YN) y Depression (¥d~ ,~ High water alarm ('~) ~ Alarm tested (Y/N) '-~'~V~, Date of pumping '"J-' ~'.-.-°t~> Pumper -'~"_I~.-,('.~--~;SP~,(3 L_ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot \'D C~ \ On adjacent lots To property line I o ~ ,,t.- Absorption field Surface water/drainage I c::>~ ~ ~ Foundation ~ ~ '~-~o ~ Water main/service line \ c::,''~' 72-026 (3/93)° Front CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level ~ tested Meets MOA electrica~ ~' On adjacent I~t-s D. ABSORPTION FIELD DATA Date installed . .\ %.~c~ : Total absorption.a'Fea.. (.~,~ L, ~' Date of adequaw test ~ ~ [ ~-~ water level In ~b~n t~ld before test Manufacturer Manhole/Access (Y/N) .~.-~ Surface water Soil rating (GPD/Ft') "~ ~,~ ~ { ~'¢'"-' System type .Gravel thickness ~ it Total depth Cleanout present ~/N) Results~l~ail) Peroxide treatment (past 12 months) (Y~..! SEPARATION DISTANCE FROM ABSORPTION FIELD On adjacent lots Depression over lield (Y~.]) ,lot ~ ,Bedrooms ' Aftertest If yes, give date Property line To existing or abandofied system on lot Cutbank ~\~ Water mairvservic'e line Driveway, par~inc'vehicle storage area Well on lot To building foundatiOn On adjacent lots ~c, Surface water Curtain'drain ~/I~ E. ENGINEER'S lCERTIFICATION .', . I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe~e~l~ ".'tla~e.of this inspecEon. ' ~ . ~ ---'~.¢ 0~; ~ '% · : .. Eagle River, Alaska 9~571 ,.-n,,in~,,.o ~,,.,,,,,,. c.~ / Date ?/,,S ~' / ~ / ' ' ~(--~~~.~ ' / / . HM Fee $ J '"'1 ~, OC:> Waiver Fee $ Date of Payment ~- ~, -C'l ~ Date of Payment Receipt Number gk{ C~,-)~.~ jcl ~,,.~..~ Receipt Number 72-025 (3/93)' Back ENVIRONMENTAL LABORATORY SERVICES s.N¢,,,~ REPORT of ANALYSIS Chemlab Ref.~ :93.3459-9 Client Sample ID :L7 B3 D~PARK S/D Matrix :WATER 5633 B STREET ANCHORAGE. AK 99518 TEL: (907) 562-2343 FAX: (907) 561-5301 Client Name :S & S ~GIN~ING Ordered By :R. Project Name : ProJect~ : PWSID :UA WORK Order :68433 Report Completed :07/20/93 Collected :07/i5/93 @ 14:10 hrs. Received :07/16/93 @ 14:15 hrs. Technical Director:S~P~E~ C. EDE__ Released By :~.~--~ Sample Remarks: ROUTINE SAMPLE COLLEC~ BY: RAY. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init Nitrate-N 0.10 U mg/L EPA 353.2/300.0 10 07/19 LLH * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than ~S~S Member of the SGS Group (Soci6t~ O~n~rale ~e Surveillance) ENVIRONMENTAL SERVICES 1. ALASKA. COLORADO, UTAH. ILLINOIS, O.,O, MARYLAND, WEST VIRGINIA, NEW JERSEY. SOUTH CAROLINA