HomeMy WebLinkAboutNORTH WOODS BLK 4 LT 16
'" ~ 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
LOCATION ~ NO. OF BEDROOM8
DISTANCE TO:
~ Manufacturer ~~ Materia~/~ C No. of compertments
~ Liq. cepeEitv~gdlons Inside length Width Liquid deptt~
I ~ ~ ~F HOmEmADE:
~ell/ Dwelling PERMIT NO.
~OZ~ ~ DISTANCE TO:
~-~O~< Manufacturer ~/ ~ - ] Material Liquid capacity in gallons
~ Wel~)~ Foundation Nearest lot line PERMIT NO,
~o. of lines ~ ken,th of oach line Total length of li~os
--~ 2) ~ ~ ~ I ~¢ inches
~ ~~ Top of tile to finish grade
O
Length ~idth Depth PERMIT NO,
~ ~ Type of crib ¢//// ~diameter Crib depth Total effective absorption area
-/,
~ Well Building foundation Nearest lot line
m DISTANCE TO:
~ Cla~~ Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER ~ ~ ,
PIPE MATERIALS ~,
RATING
INSTALLER /
.
REMARKS
, ;-~
-)-013 (Rev. 3/78)
Ii
C, ~..,~ -- i~; ZE T' E]
PEF.:MIlT ND ( 8:1.09E'}~.~; ',
[:'EP.~BRTMENT OF' HEFILTH FIN[:, EN'v'tRONMENTFII_ PROTECTION
825 "'L'" STF.'EET, FINCHOR[~GE., RK. 99501
;264-4720
F!F:'PL. I CFIN T
L ."' '." FIT '[ '" Fl
LEGRL
FRf:~F!K E:EZTHERD
F'ETER'"S C:F.:EEK
L :I. 6 E,' 4 NLF.. EH NL JE.,_-', S?E:,
LOT '- ~
::, I z.E
2:'2 :'-" RE S6!URRE FEET
'T~'F'E OF '''" ] - - :: ...... Z S ""' ' r'
=,(.IL HE,=,..RFT[UN S'gSTEM : ]F. EN...H
MFtXI'MUM NLIME~ER OF E~E[:,ROOMS = ~:
SOIL RATING ,:ZS";E,~ F'f,.'E,F: ....... 2':.'"'~
THE RE6¢JIRE[:, :,I~E OF THE SOIL FtE:SORF'TION ._:%..=,TE.f.I.~,.
THE LENGTH DIMENSION IS TFIE LENGTH (IN FEET) OF THE TF.:ENCH OR DRRINF'IEL[:,.
'f'HE DEPTH Of:' R :TRENCH OF.': PIT IS 'THE DISTFtNCE BETP.IEEN THE SURFRCE OF: THE
GROUND RND ]"HE BOTTOM OF' THE Ek:;CFIVFITION (IN FEET).
'THERE IS NO SET I.,.!IDTH FOR TRENCHES.
THE GRR',,,'EL [:,EPTH IS THE MINIMUM DEPTN OF' GRFI',/EL BETNEEN THE OUTFFILL F'IPE
RND TNE E;OTTOM OF' THE EXCR',/RTION (IN FEET).
"- F' ::,~' '-'= :" '-' ' " . HI:, E:,EF'FIR'I"ME.'N]" DLRING THE
PERMIT P,f r"LI..HNT Fff,=, THE F.."E_,F IJN.=,IBILIT'r TO INFORM 1" ' ....
IH.,THLI.~tFION IN%F'E£ZTI]N'.E OF RN'9 NELL=, RE, TR-ENT TO THIS F'ROPERT¥ FIND THE
NUME,'ER OF RESIDENCES 'TI'"IFI"F THE I,.IELL N ILL SERVE.
........... "if'" fl..,..11 C, ,: ....... ...... ,=:.' ":, Z 1'.~ .:.-:.' ....... F' EZ' r.._.. -If- i ,-, II'-,i ':--, Fi F' ............. F IF;-:.' E (%,. ~ i ! F: EE E:..':, ..........
t:':]Fl '":KF I [ I I I'.,IC-~ OF RN'.? - -"*F~, ' '- ' .......'
........... _'".,r.':,u_~ 1.4ITHOLIT F'INF:IL ]I",I:,FEL-T]:Lbt FIND RF'PF-"~,'RI_ B'9 THIS
E:,EPRF.'.TMENT P.IILL BE ':IIE:.TEF:T TO F[,.L.:,EL.U.I..N.
MINIMUM DIS"f'RNCE BETNEEN R klELL FIND I-]NV ON-SITE SENRGE DISPOSFIL. SYSTEM IS
±00 FEET FOR R PRIVRTE: I.,.tE]_L OR :~-5e~ TO 200 FEET FROM R PUE~L. IC: NELL [:,EPENDING
UPON THE T'gPE OF' PUE,'L. IC' P. IEL. L.
MINIMLIM [:,I."-'7'['RNCE FROM FI PRI',,,'RTE 1.4ELL 'TO 8 PRI',?RTE SEWER I_INE IS 25 FEET FIND
TO R COMMUNIT'¢ SEP. IER LINE IS 75 FEET.
OTHER R[DPLtlREMENTS I"IR'-? RPPL. V. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RF.:E
RVFIILKtBLE TO INSURE PROPER INSTRLLRTION.
I CERTIF'.r' TFIFIT
i: I BM FFIMILIRR NITH THE REL:,~UIREMENTS FOR ON-SITE SEI.'.!ERS RN[:, I.,.IELL. S F~S SET
FORTH B"r' TNE MUNICIPFILIT"r' OF t~NCHORFIGE.
2: I I.,.tIL. L iNSTFIL. L THE S"r'STEM IN F!CCORDRNCE NITN THE CO[:'ES.
3: I UNDERSTRND THRT THE ON-SI"FE SE!.4ER S'¢STEM MR'¢ REQUIRE ENLFIRGEMENT IF TFIE
RESIDENCE IS REMODELE[." TO INCLUDE MORE THFfN 3 BEDROOM':!;.
:.:: I GHEr,: ..........................................
I ..... 13EL. B ............ DFITE ......... ',,,'4. 0
,AUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-~50, Anchorage, Al~ka 9~502 276-222f
SOILS LOG -- PERCOLATION TEST
SOILS LOG
PERCO~TION
TEST
PER.OR.ED"O"; F,-~.E IS.~'~o~l
· E~A- DE~CR,.~,O.: LO'('- ! ~, Gl/~ 4
1
2
3-
4
5
6-
7
8
9-
DATE PERFORMED:
SLOPE SITE PLAN
10-
11
12
'13 -
14-
15-
16
17
19
COMMENTS
PERFORMED
WAS GROUND WATER ~~.
ENCOUNTERED? O
P
Jr~bJ~ ~l IF YES. AT WHAT [,~1 E
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
7'A ~,~ o o 7~ n
· CERTIFIED
DATE:
ALASKA { rlUIROFImE FITAL COF1TROL S BUIC $, Inc.
~ngin~¢ri~9 ~ ~,,ironm~nt~l $~udi¢~:
MUNICIPALITY OF ANCHORAGE
ENVIF :',', i.~~ ilq i'A. [.~0 ?re~ ,!
RECEIVED
January 29,1892
Mr. Les Bucholz
Department of Health and Environmental Protection
Pouch 6-650
Anchorage, Alaska
99502
Attn: Les Bucholz
Dear Les:
On the 29th day of January 1982, Alaska Environmental Control
Services Inc. inspected the on-site sewage system for 5 homes
located at Northwoods Subdivision...Lot 10 Block 3
Lot 25 Block 3
Lot 13 Block i
Lot 16 Block 4
Lot 12 Block 1
In my inspection I found a cap missing, and final grade,
needed for Lot 12 Block 1. All construction of the sewage
systems, except for Lot 12 meets Municipality of Anchorage
code. All had dry sump pipes.
If you have any qu
.ease contact me.
Sincerely;
Co Reid Jr., PhD, PE
'President
1220 LUes! 251h A~en~e ,, Anchorage, Alaska 99503 · {907) 278-1361
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~J~)"'~_
OF ON-SITE SEWER AND WATER FACILITY
264-4720
March 3, 1987
Application Date
GENERAL INFORMATION
iai Legal Description (include Iht. block subdivision, section, township, range)
Lot 16, Blo¢~ 4~ Northwoods S~5div~s~on
Location (address or directions)
(b) App~can[ Name AHFC Telephone: Home Business
Applicant Address
(c) Applicant is tcheck one): Lending Insbtut~on []: Owner/builder I~; Buyer []; Other [] (explain); _
(d) Lending institution
Address
(e) Real Estate Company and
Address A~O~
Telephone 276-;
(f) ~i~t~he HAA to the followir
rmo nwealth Mortqa,qe Telephone
Alaska ATTENTION: He~en
gent Red Carpet Sea Hawks/Dan Lee
Alaska
'78
address:
S ~ S ENGINEERING
17034 Eagle Riu~ Loo~ Roa~, Suite 204
E~gl~ Riv~r~ Ala~_~a 99577
TYPE OF RESIDENCE
Single-Family I~ Multi-Family []
Number of Bedrooms .
Other
WATER SUPPLY ~..~.
Individual Well:~ Community[] Public,l~'
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite [] Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation
attesting to the legality and status.
72-025 (11/84)
Page 1 of 2
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WELL DATA
MUNICIPALITY OF ANCHORAGE (MO~.,i
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST -~ FEBRUARY 1984
264,4720
Legal Description: ~.-c,7'
Well Classification
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
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Tes~sults
Comments ~ ~'~ I ~ ~
If A, B, C, D.E.C. Approved ~1)
Date Completed Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
~ ~:'/'~ On AC joining Lots
~-C:z~>/~ ; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
B. SEPTIC/HOLDING TANK DATA
Date Installed ,/~- / 9
Standpipes ~N)
Depression over Tank (Y/~I~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Su ;)ply Well
To Property Line
To Water Main/Service Line
Course ,O/~c
Size /E. 5"c> No. of Compartments
Air-tight Caps aN) Foundation Cleanout
Date Last Pumpea _~r//?-~;~
Temporary Holding Tank Permit (Y/N)
lO"-+
To Building Foundation
To Disposal Field $ /
To Stream. Pond, Lake, or Major Drainage
Comments
Page I of 2
72-026(11/84)
C, ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation ~...
Lot
//:7//~/~_ --~ Type of System Design
Length of Field r,~ ~ / "~
Depth of Field
Gravel Bed Thickness L//
~ Standpipes Present ~N)
Date of Last Adequacy Test ._~ - / ~ - ,~:~ """
!
To Property Line .,,~ CZ
To Existing or Abandoned System on
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
; On Adjoining Lots ~------~
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to alt MOA and HAA guidelines in effect on the date of this inspection.
SignC~d& S ENGINEERING
C 17034 Eagle River Loop Read No. 2.0~.
om a .......... MU^ NO
~.agnlYe myer, ..,das~. ,,=,, '
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72-026 01/84)
Date
MUNiCIPALiTY OF ANCHORAGE
ENviRONMENTAl- SERVICES DIVISION
MAR !, 8 1987
DEPT. OF ENVIRONMENTAL CONSERVATION
b'T£VE coWP£R, GOVERNOR
Telephone: (907)
Address:
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA q9501
274-2533
DATE: March 12~ 1987
PWS I.D.~ 213001
To Whom it May Concern: ~
According to records on file in this office the
Northwoods
Water Regulations
Chu~iak Utilities/
Water System is in compliance with the State Drinking
Sincerely,
~ervisor
Ti'the ' :. Time
Date Date Date
Inspector Inspector Inspector
Comments Conditional Approval
Date Sewer Installed Permit No. Septic Tank Size
Holding Tank Size
Soils Rating Well To Absorption Area Well Log Received
Well to Tank
APPLICANT FILLS OUT LOWER HALF ONLY
~'roperty Owner Bethard ConstruCtion, Inc. Phone_,
SRA Box 1698-K, ~chorage, AK 99507 345-1615
Mailing Address
Buyer
Address
Lending Institution Phone
Address
Realty Co. & Agent RE/~AX Properties, Inc. attn~ Will EAson Phone 7
' 276-2 61
Address 2702 Gambell St., suite I01~ ~chorage, AK 99503
Legal Description Lot 16, Block 4, North Woods
NHN ~{cManus
Street Location
Type~f Residence
Q Single Family
~ Multiple Family No. of Bedrooms
~ Other
Water Supply
~ Individual A~AOH WELL LOG. A well log is requi;ed for all wells drilled since June
~ Gommunity 1975. For wells drilled prior to that date, give well depth (attach log
~ Public Utility available.)
Sew~e Disposal
'~ Individual Year Individual Installed: 1981
~ Public Utility When Connected to Public Utility:
~ Holdin~ Tank
NOTE: THE INSPECTION FEE ~UST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN aE INITIATED.
ALASKA nuil onm r/TAL CO'[ TI OL $ RUIC $, Inc.
~n(lineerin~I 8 ~nuJronmenral Studies
January 29,1892
Mr. Les Bucholz
Department of Health and Environmental Protection
Pouch 6-650
Anchorage, Alaska
99502
Attn: Les Bucholz.
Dear Les:
On the 29th day of January 1982, Alaska Environmental Control'
,Services Inc. inspected the on-site sewage system for 5 homes
located at Northwoods Subdivision...Lot 10 Block 3
Lot 25 Block 3
- Lot 13 Block 1
Lot 16 Block 4
LOt 12 Block 1
In'my inspection I found a cap missing, and final grade,
needed! for Lot 12 Block 1. All construction of the sewage
systems; except for Lot 12 meets Municipality of Anchorage
code. All had dry sump pipes.
If you have any que~4~_..T)~%~$ease contact me.
;,~ ....... Z.,e,¢, _. _ . .
,%?... ~ o,.v~ ~ ~ucere~y,
' ei Jr., PhD, PE
~3~.'".. ~. ~ .o'.~:~ Pres ident
,~ :~:.... .."~ ~,
'-,,.