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Home My WebLink AboutNORTH SLOPE #1 BLK 3 LT 2 · ~ Municipality of Anchorage Page [ of'-'~---~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~Lx~ ~_~-~]~--[ ~ PID Number: Naff~.[~ ~[~ Wastewater System: .~ew ~ Upgrade Address: ~~ ~ ~~ .~ I~. ABSORPTION FIELD Phone:~~~ No.~drooms: ~eepTrench '~ ;hallow Trench ~Bed ~Mound ~Other Total Dept~rom original grade: LEGAL DESCRIPTION Soil Rating: ~'~GPD/Sq. Ft. ~ / Lot: ~ Block:~ ~~d~;~] Depth to pipe bottom from origin~r~de: Ft' Gravel depth beneath pipe ~' Ft. Township: Range: ~ection: Fill added above original grade: Gravel length: ~/ ~'~ ~L I F~. WELL: ~ New ~ Upgrade Grave~h:~l~ ~t. Numberoflines: Distance between lines: ~ , ~' ~t. ification (Private, A,B,C): Total Depth: Cased To: Total absorption area: P~pe material:~ ~ ~ Ft. Ft. ~ SQ. Ft. Driller: Date Drilled: Static Water Level: Installer: Dat~ ins~~ Yield: ~ Pump Set at: Casing Height Above Ground: GPM~ Ft. Ft. TANK SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P. To Septic Absorption Li~ Holding ~ublic/Private ~anufacturer: Capacity in gallons: Fro~ Tank Field Station Tank S .... Lines ~~~~ ~O. Well ~1 ~/ ~ ~ ~,+ Materia~~ N,~be, %mpadments: Surface W.ter [¢'~ 1~ ~ ~ ~ LIFT STATION Lot Size in gallons: Manufacturer: Line ~D~ ~l~ ~ ~ ~oun~tio*~ ~, ~ ~ ~ "..~.on"....,~t:~"~~~.~ .... : Cudain ~ectrical Inspections pedormed by: Drai. ~ O¢~ ~ ON~ PumpMa~ Remarks: BENCH MARK Location and Description: J Assumed Elevation: ~ ~, Inspections p e r f o r ~&¢¢}'~t;~g~.r~*~"oaa' "0' ~4. ..... Dates' 1st% ~0¢_ ~ ['~ Ataska 99577 ' Department of Heal,~ ~~j~ approval Reviewed and approved by: ¢¢~//¢./'~/~- Date: ~~ 72-013 (1/91) MOA25 Permit No. '~['~"~l~' Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ~[~"~-'- ~ ~ [~E~r'r-"~'-- PID No.: {-P~-----~l 1~- 72-013 A (Rev. 9/91) MOA 25 t PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920216 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:PRICE TRAVIS OWNER ADDRESS:2739 East 154th Ave. Anchorage Ak. 99516-3974 DATE ISSUED: 8/11/92 EXPIRATION DATE: 8/11/93 PARCEL ID:05051117 LEGAL DESCRIPTION: NORTH SLOPE #1 BLK 3 LT 2 LOT SIZE: 43260 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~ ~' ISSUED'BY: ~O~7~ ~f~44t~¢ DATE' DATE: Tom Fink, Mayor 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 30, 1992 Travis Price 2739 East 154th Avenue Anchorage, Alaska 99516-3974 Subject: Lot 2 Block 3 North Slope Subdivision Permit 9SW910183, PID 9050-511-17 The subject permit, issued July 5, 1991 by this office for a single family well and/or on-site wastewater system, has expired as of July 5, 1992. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $200.00 for an on-site wastewater permit; $75.00 for a well permit and $275.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sin~cerely, /J / On-site Services enc: Copy of Permit PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910183 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:PRICE TRAVIS OWNER ADDRESS:2739 EAST 154TH ANCHORAGE, AK 99516 DATE ISSUED: 7/05/91 EXPIRATION DATE: 7/05/92 PARCEL ID:05051117 LEGAL DESCRIPTION: NORTH SLOPE #1 BLK 3 LT 2 LOT SIZE: 43260 (SQ. FT.} NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST NOTIFY DHHS AT LEAST TWO HOURS PRIOR TO EACH RECEIVED BY: , DATE: ISSUED BY: -~ O [-~ ~YlAi T~ DATE: June 18, 1991 ROBERTSHAFER, P.E, ROGERSHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 2; Block 3; North Slope #I PER~IT REQUEST NARRATIFE Request you issue a p~rmit to drill a private w~ll and install the proposed septic system in accordance with our attached design dated June 18, 1991. The property is currently vacant. The property is located on a hillside with all adjacent properties curre~y vacant. Due to the large lot sizes we a~ticipate no adverse effects on n~ighboring properties by the installation of the proposed we~l and septic. If you require additional information for your review, please contact US. Sincerely, "R~OBERT A. [SHAF'[R, RJS/gm 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE / / SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ~-~-' [~> "~ ~'~"~ ~ DATE PERFORMED: ]~c:~Jr Township, Range, Section: .~ [..~. ~ ~ SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 I0 11 12 13 14 15 16- 17 18 19 2O WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Deplh to Water A?~. ~ Monitoring? Y~[~"'"'~/ Da[e: ~ ' ~-"~ ~ PERCOLATION RATE ~,1~:> (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT COMMENTS / / PERFORMED ~gle River~ Alaska $9577 ' - - I /// I ~/ · ~ ' ~HII~Y THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES I~ECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Reading Date Gross Net Depth to Net Time Time Water Drop t "--' '-*-'./.+ -~ , ~.,~ ,.~ -. z~, (~)'~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: I0 11 12 13 14- 15 16 17 18 19 2O DATE PERFORMED: Township, Range, Section: SLOPE WAS GROUND WATER . j'j~,* ENCOUNTERED? S ,E YES, AT WRAT ' ~ DEPTH? t/ P E Depth 1o Water ,After ' (.o- ~ ~ ( Monitoring? [ ~ Date: SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER ~ ~ TEST RUN BETWEEN ~ FT AND ~' FT COMMENTS ~-- -- J" ~ .... ~. _, ............ ~? ' ' - ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACGORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES~FF~T ON THIS DATE. DATE: 72-008 (Rev. 4/85)