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Home My WebLink AboutNORTH WOODS BLK 4 LT 18 ~"~t MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION '1 ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ~ ~ ~ . ~.1~,.~I ~' NEW MAI ~G ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS ~ Z Manufacturer ~ ~ ~ ~ Material~ ~ ~ ~ N°' of compartments ~ ~ Liq. caoaciW ia flallons Inside length ~iOth Liquid Oepth I OOO iF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons Q Well / ,~ Foundation I Nearest lot line PERMIT NO. ~ ~o. of H~es Length of each line Total le~ines Troach ~idth Distan~o between lines ~ rop of tile to finish grade~ /~s ~ ~O inches Material beneath tile Total effective absorption area ~ - ~ ~ ~ inches Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot Nine PERMIT NO. Building foundation Sewer Nine Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING i / ~ INSTALLER ~ ~ ~. ..~~ .~EMAR KS ,/ , N ~,-~.. . ......... ..-~ ~ / __ APPR~D F:2 DATE LEGAL 72-013 (Rev. 3/78) PERMIT NO~ APPLICANT STEVEN L. SKAGGS CONST. P.O. BOX [:,. L. OCRTION MCMAMRS RD. LEGAL LOT t8 BLK 4 NORTHWOOD SUB DEPARTMENT OF HEALTH AND ENVIRONMENTAL E'~O.f'ECT'~ON 825 "L~'STREET., RN::HORA 264-4728 CHUGIRK LOT SIZE 20000 SQUARE FEET T'¢PE OF SOIL ABSORPTION SYSTEM IS: TRENCH MRk-;IMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 280 THE REQUIRED SIZE OF' THE SOIL ABSORPTION SYSTEM IS: [:,, E: F' 'T ~.-~ == :.'L ~Z'~ L E ~'-.t 1.3 'T t4 == 8 ..":~ ~]~ F;':. F~ %." E L. [:, E F' ]- ~..4 ;= ~; .f'HE LENGTH DIMENSION IS 'THE LENGTH <IN FEET) OF THE TRENCH OR DRAINF'IELD. THE DEPTH OF IR TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROtJND AN[:, THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SE.f' WIDTH FOR TRENCHES. THE GRA"/EL DEPTH IS THE MINIMUM DEPTH OF GRFI'v'EL BETWEEN TNE OLITFALL PIPE AND TFIE BOT.f'OM OF 'f'HE EXCR',,,'RTION (IN FEET). PERMIT APPLICANT HAS THE RE'_=;PONSIBILIT'¢ TO INFORM THIS DEPARTMENT DURING THE INSTFILLFITION INSPECTIONS OF RN"r' WELLS ADJACENT TO THI'-; PROF'ERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ............... T~.4() (2) I ~*~2:F~EC:T*ZO~-~S R~:E REZQL~IRE[:, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND RPPROYRL BY THIS DEPARTMEN,f' ~ILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS ±00 FEET FOR A PRIVATE WELL OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE T"r'PE OF PUBLIC WELL. MINIMUM DISTANCE FROM ~ PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 F:EET AND 'TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MA"r' APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE A'v'AILRBLE TO INSURE PROPER INSTALLATION. F'EE:f4 ]: T E.',>,;P I E:ES [:,EC:Et'-IE:ER 2-:::L.. I CERTIF"r' THAT ~.: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SI'f'E SEWERS AND WELLS AS SET FORTH BY THE MUNICIF'RLIT'¢ OF ANCHORAGE. 2: I WIL. L INSTALL THE S'¢STEM IN ACCORDANCE WITH THE: CODE'.=-';. 2:: I UN. DERSTAND THA.f' THE ON-SITE SEWER S'T'STEM MAY REQUIRE ENLARGEMENT IF .f'HE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. ~T~STEVEN L. SI~¥qGS CONST. 'SSUED B',U_-~._~~~= ........ E: ATE_~Z~/~/ .... V4.0 Russell Oyster 694-2774 O & E ENG.NEERING & DEVELOr MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Performed for: Name: "~7'~/'/L~/'/ Mailing Address: Legal Description: Lo7- /oc~¢ SOIL LOG Earl Ellis 688-2280 Tel. No g~F-~,¢~ / Depth (feet) 0 Soil Characteristics 11__ PLOT PLAN 12__ 13__ 14 15__ 16__ PERC. TEST Ground Water Encountered: Yes Proposed Installation: Seepage Pit__ Comments: No ~ If yes, what depth. Drain Field__ Performed by: Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL} (a) Legal Description (include lot, block, subdivision, section, township, range) Loca,t~/~ (add(ess or directions) . Mailing Address (c) .~Lcnding Institution 'Mailing Address Telephone: Home Telephone Business (d) Re~lEstateCompanya,'d:',~,gent (,J/:}C/,C [/¢.//i"'?L / T,¢~ - I---y /'J[ Telephone (<2~ +-' ~'~'0~ (e) Mail the HAA to the followina address: or: Check herein, if hold for pick up List contact person and day phone number below. $ & $ ENC~INEERING Eagle EiYer, Alaska 99577 TYPE OF RESIDENCE Single-Family~ Number of Bedrooms WATER SUPPLY Individual Well [] Community [] Public~ . Note: If community well system, must have written confirmation from the State Department of Environme ntal Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite/[~ 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. Page 1 of 2 72-025 fRev 8/86~ Front 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 ail Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~ ~,~'ENGINEERING Address 17034 Eagle Rid'er Loop Road No. 204 Date Telephone DHHS APPROVAL Approved for ~,~-~bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional CAUTION 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. Page 2 of 2 72-025 IRev 8/86) Back MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICFS DIVISION AIJG 2 9 1988 RECEIVED WELL DATA Legal Descripti~,~ L.~;~r" l~ /~/----~-¢¢-~ ~ 73/- Z.Y 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/Manh,ole Water Sample Collected by Water Sample Test Results Comments ~-L~~'~. ~ If A, B, C, D.E.C. ApproVed ~N) 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. SEPTIC/I-'rGLD;,';CTANK DATA Date Installed Standpipes~N) ~,/ Air-tight Caps ~/N) Depression over Tank (Y/t~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ J.,'~ Separation Distances from Septic/~ Tank: Size / ~:~z::2~¢~ No. of Compartments Foundation Cleanout ~N) Date Last Pumped ~ ~'7 ; for Temporary Holding Tank Permit (Y/N) To Water-Supply Well To Property Line To Water Main/Service Line Course Comments To Building Foundation ~ / . To Disposal Field J I i : To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026 IRev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~-~ ~ ~ - Width of Field ~"~' Square Feet of Absorption Area Depression over Field (Y/I~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well "~P I Jr '~)~:2 ~;'/~',f~-'"~ Type of System Design Length of Field ~,~. Depth of Field Gravel Bed Thickness ! ¢.~'~'~::~ ~ Standpipes Present /"/ Date of Last Adequacy Te~t. To Property Line !,~"~ ! To Building Foundation To Existing or Abandoned System on Lot ~U/,~ ;On Adjoining Lots ~ To Water Main/Service Line I ,c, /~/" To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course / ~:2~:) To Driveway, Parking Area, or Vehicle Storage Area /--¢A'7~ /¢~JO/J t--)~J'~:;)l~¢''z'--- ~;~['Z-i ~ , Comments ~,¢f2t,)/'-.~) [¢,J ./~'If~-~ _/--//~l, Jl'~,~ '~"~, /~'--~'¢~/'~.-C.~:~ Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~ycles during Adequacy Test. Meets MOA LIFTSTATION /~ Date Installed High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MO.A and 17tAA guidelines in effect on the date of this inspection. Si, ned S & S ENGINEERING g L)ate 17034 Eagle River Loop Road No. 2~, CompaQ.v ..... ~..~,. ee~'x7 MOA No. ~agle Knvu~, ~', Receipt No..~0~,,~? , (~ Date of Payment ¢~'/]'~' Amount: $ ("~4~) ' O0 Page 2 of 2 72 026 (Rev 8/86/ Back STEV£ COWPER, GOVERNOR iii I~ om Rt Ma~ Concen,~ · Accord~nq to the records on ~le in this oFFice, the ~~b '~-+~'-].-~-~:~--~ .... b~ater System is in compliance ~ith the ,Jat er' Pequlations, Sincenel ~,,, ,, Rona'ld S, Kle;in --~ [-:.-invironmental Field Of'f'icer' DA~E RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE ........... DEPT OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL t'KU/m~;/IU ' 825 L Street - Anchorage, Alaska 99501 ~NVIRONMENTAL P~OTECTION ENVIRONMENTAL SANITATION DIVISION JUN 1_ 6 1981 Telephone :264-4720 r~ rrrIt Ir BI~CTION~: ~omplete all pa~ts on page 1. I~eo~lete ~eques~ ~ill ~oi ~e ~oce~ed. Please allo~ ten {10} da~s for p~ocessing. 1. ~0~ O~N~ PHONE pMAILING~op ~DR J ~ ' R ERT RESl~di~ferent~ ~ '~' PHONE 2 BUYER ~ , ~~ EH 6. TYPE OF RESIDENCE NUMBER oF~BEDROOMS ~]-~SING.LE FAMILY [] MULTIPLE FAMILY [] One [] Four , [] Two [] Five [~..._~h ree [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY ~q ~.-'PUB LIC UTI LITY * 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.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 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 UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALL'ER []Septic Tank or [] Holding Tank Size:. If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank IAbsorption Area ISewer Line ] Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~APPROVED FOR _.~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY ,.~7 72-010 (Rev. 6/79) ~ ' 'APPLIC, .~IT FILLS oUT UPPER HALL ~0NLY ~ Phone P;oPerty Owne~' ~ ,~'~',~" ~ d-~,'~~''~/~'' Mai,i.gAdd,a.. / Id / Phone Lending Institution ~ , ~ z Phone '-- code Address /~7, ~ ~// ~'~ ('~4' ~/~"~ ~ Type of Residence J~ingle Family [] Multiple Family No. of Bedroorm~ '"'-~ [] Other Water Supply [] Individual ATTACH WELL LOG, A well log is required for all wells drilled since'June 1975. []l~C°mmunitYPublic Utility G~\,¢t~'i~0 For wells drilled prior to that date, give well depth (attach log if available}. Sewer Disposal , /,~/ [~lndividual Year Individual InStalled:... []Public Utility When Connected to Public Utility: ~----'-" [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOMEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date /~'~ ~S Inspector Inspector Inspector Inspector MIINICIPALITY OF ANCHORAGE · ~,. DEPT. OF t~=/'.L[.~ O Field Notes: ~C C,r~ ~ ~ o~t~.,I',~NVJ.g.ONMEixII'AL F~.,~(~-CHON ' _ RECEIVED )APPROVED BEDROOM8 *OONDITION8 OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONA~APP~VAL* SoH~ E~Hng D~e ~we~ ~ns~Hed Well To Abso~on A~e~ Well Log ~ece~ved ~ ~ ~ ~ ~ -- ~ -- ~ ( Well ,o Tank Septic T~k Size /O ~ ~L~