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HomeMy WebLinkAboutPRATOR BLK 9 LT 4 ., Municipality of Anch0rage Page 1 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 Numbe~: 930201. PID Number: 017091.35 Name: Will Friar Wastewater System: [] New F~ Upgrade Address: 14500 Prator Street, Anchoraqe, AK ABSORPTION FIELD Phone: No. of Bedrooms: 345-5762 (H)4 [] Deep Trench [~Shallow Trench [] Bed [] Mound [] Other LEGAL DESCRIPTION Soil Rating: 0.8 ' Total Depth from origina~ grade: GPD/Sq. Ft. 8 · 0 i Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 4 9 Prator 3 · 5 Ft. 4.0 Ft. Township: Range: Section: Fill added above original grade: Gravel length: ',m 0 Ft. 72 Ft. WELL: N/A [] New [] Upgrade Gravelwidth: Numberoflines: Distanc~bet;veenlines: 2.0 Et. 2 Pt. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. 576 SQ. Ft. Driller: Date Drilled: Static Water Level:Installer: Date installed: Ft. ~hitters LandscaDinq 7/12/93 Yield: Pump Set at: Casing Height Above Ground: GPM Ft, Ft, TAN K SEPARATION DISTANCES [] Septic "[] Holding [] S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Material: Number of Compartments: Well 91' 135.5 N/A N/A N/A Surface Water 200+ 200+ N/A N/A N/A LIFT STATION Lot Size in gallons: Manufacturer: Line 76 ' 16.5 ' N/A N/A N/A Foundation 2.7' 72.5' N/A N/A N/A "Pump on" level at: "Pump off" level at: High water alarm at: Curtain Pump Make & Model Electrical Inspections performed by: Drain N/A N/A N/A N/A N/A Remarks: BENCH MARK Location and Description: SW corner of qaraqe entrance stoop J Assumed Elevation: 100.00" _ · - · _ , _ -..7 Inspections performed by: Dates: 1st { ~_~~~" 2nO ~ '_~0~ ~.~,~,°' Department of He, al~and Humcl~ervices approval/ ~;a;,,:.. .' Reviewed and approved by Date: 72-013 (Rev. 9/91) MOA 25 undeveloped lot · /~-cleanouts 16.5' to lot line ~_,~ ~shed x~~X~ooi~o~ c.o.2 c,o. 0 ~ x ~d. ,/ ~ ' . · . '~~~ cle~u~ ~diver~e~ valve~ ~ . (D.V.) ..- ~!1 o,~'se "' ¢ , ,,, ~, ks ~4.0' ~.7' ~4.7%0.2' / , b c a~ e: _~~ u. ~ . / TEL ~07 ~49-1003 /~ .~. cleanouts (4) cleanouts ~ ., Test hole · ':~ top , ' 84.7_ . _ - .... ' septic tar ~~_T~-, ~ ,7~-i ~ ulverter valve outlet : ~ · 943' - 951' 5.5 I,~ '~ ~~ fabric ~~ ' I.." ~ >o< , '1250 ga Ion~ ~ -77.7 trench bottom existing septic 2' . tank. "'~ ~. 71.7' ' test hole ~ottom' ' ~ O~ ~- '~- '" ': ~:~ ~ ~ .... son . ~ JOB DATE: PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES ~,~.~ P.O. BOX 196650, 825 "n" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBE~':SW930201 DESIGN ENGINEER:TED JOHNSON, P.E., L.S. OWNER NAME:FRIAR WILLIAM L & OWNER ADDRESS:14500 PRATOR ST ANCHORAGE, AK 99516 DATE iSSUED: 7/07/93 EXPIRATION DATE: 7/07/94 PARCEL ID:01709135 LEGAL DESCRIPTION: PRATOR BLK 9 LT 4 LOT SIZE: 48811 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. 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 (iSAACS0). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY Bo COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE TOTAL DE,PTH ~OF THE TREN~~ NOT EXCEED 8.0 FEET. P.O. BOX 111790 ANCHORAGE AK 99511-1790 TEL 907 349-1003 IN AK 800 478-1003 FAX 997 344-9936 June 17, 1993 Municipality of Anchorage Departraent of Health and Haman Services On-Site Program, P.O. Box 196650 Anchorage, AK 99519-6650 Reference: 14500 Prator Street, Anchorage, AK, Job # 93386 Enclosed is a design for modifications to the on-site sewage disposal system of the referenced property. These modifications were deemed necessary after performing an adequacy test on the subject site. We excavated around the septic rank and found it intact an usable. On excavation of th¢~SeePage 'pit? we found that it was overflowing at the top and determined that a new disposal system would be appropriate. We investigated the soils to the west of the existing seepage pit. (The:site§lopeS to the west at about 4%. We performed a soils test near the center of a likely drain field location and found it to be silty sand3' gravel material (GM). The Water table was inot encountered, nor Was there evidence of a seasonal water table in the test pit. We determined the most economical system would be to install a deep trench under four feet of native material. This determination was based on the uniformity of the soils encountered in that location (GM). We believe this is the most desirable location for a disposal system on this parcel where it will operate most effectively and efficiently. The system as designed complies with all Municipal and State regulations in effect at this time. If you have any questions about this system, please feel free to call us for clarificati~ol~,a[e available for further phone consultations. Should an additional visit to the site be nece~a~'~e~_F ~e ~at visit to meet yo~ ne~s. REGISTERED PROFESSIONAL ENGINEERS BUILDING INSPECTIONS INVESTIGATIVE ENGINEERING LiTiGATION SUPPORT CONSTRUCTION MANAGEMENT SM · Municipality of Anchorage DEPARTMENT OF HEALTH'& HUMAN SERVICES 825 "L'.' Street, Anchorage, Alaska 99502-0650 SOILS LOG ~-- PERCOLATION TEST 6 7 9' 10 11-- 12 13 15- 16 17 '18 19 20, COMMENTS ' WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN IF YES, AT WHAT DEPTH? · .~ - ,~ ~-~,~,: .e.,,.,,.~,. ' Dep~ to Water After Reading Date ~" PERCO].ATION RATE __ TEST RUN BETWEEN _ (~ro$$ Net Depth ;to Time Water (minutes/inch} PERC HOLE DIAMETER FT Net ' Drop PERFORMED BY: ' ' "1 ', CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNiCiPAL GUIDELINES iN EFFECT ON THiS DATE, DATE: 72.008 ~Rev · Permit No. 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: 2' Th,~oc . Johnson E 5191 o°., .~' "... undeveloped lot /cleanou~s shed 5' to lot line proposed '~/"~- monitor tubes droinfield I~o-iH#1 new c!eanouts ' -' ~ ' ~,ell house Scale: 1"= 50'. ~ ' .' /// No~e: {Existing seepage to be abandoned ~/~r~~ Connect dra nfeld to exlsfl~9 sepfic ~an~~~~ JOB DATE : ; General Purpose Worksheet Subject Fide No. Of J~ate RECEIVE :JUL 1 1993 Municipality of AnchOrage Dept. Health & Human Services AR3B-6287 TRANSMISSION From: ~ // - ~ ZZ~, J RECEIVED 'JUL 1 1993 Municipality of Anchorage Depl-, Health & Human ServiCes Hun,, FROH : NEWTON RECEIVED dUL 1 1993 Munioipality of Anohorege Dept. Health & Human Servic$~ undeveloped Io( , x' cleanou(s (5) .10' to lot line /_~~shed J ~rai~field ('~fTS~l new cleanouts (5} ~ x.'. CE5191 Z~' . I~ ~0~.o ~ GrEA~.~.r ANCHORAGE AREA BOR~.~GH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASka 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO, PHONE -- INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED SEEPAGE PIT FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED DRAIN FIELD , OTHER TO BE INSTALLED BY NOTE: THIS PERMIT iS NOT VALID WITHOUT SOIL TEST 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. TYPE ./~/~:)/~J ~ f~ SEEPAGE AREA SIZE MINIMUM DISTANCES, REQUIREMENTS SEPTIC TANK TO SEEPAGE PIT WALL /,~,~ SEPTIC TANK L~ I SEEPAGE PIT TO~EAREST LOT LINE. DRAIN FIELD uRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT /~?'/ I0/ TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIS CROSSING GAP Of EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIt FITTED WITH AIRTIGHT REMOVABLE GAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM i CERTIFY THAT IAM FAMiliar WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCe NO. 28-68 AND THAT THE ABOVE DAT APPLICANT'S SIGNATURE LQ-016{3-75) Parcel I.D. # 01 7Nc)1~ 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 HAA # 1. GENERAL INFORMATION Complete legal description Lot 4 Block 9 Prator Subdivision Lgcatio~(~ite address or directions) - ' ,14~0B .: Pra~;, Street, Anchorage, AK Prop~¢ty~ owner ':'Will Friar Mailing'address 't;~500 Prator Street, Anchorage, Lending agency' Day phone ~-~ Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 '~ TYPE OF WATER SUPPLY: Individual well x Community well NOTE: Public water 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. X 72-025 {Rev. 1/91) Front MOA #21 o STATEMENT OF INSPECTION BY ENGINEER 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_tLgation 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 Criteri~ Alaska Engineers Phone 349-1003 Address P.O. Bo~790, /~Qhorage, AK 99511-1790 Engineer's signature Date 7/] 4/93 ' TheoriZe A. Johnson, P.E., L.S. D~IGNATURE · Approved for ~L DisapprOved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in pa~ragraph 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-O25 (Rev, 1;91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST L4 B9 Prator Legal Description: ParcelI.D. 01709135 A. Well Data Well type ~__ Log present (Y/N) Total depth 160 Sanitary seal (Y/N) Y FROM WELL LOG Date of test Static water level Well flow Pump level1 If A, B, or C, attach ADEC letter. ADEC water system number Date completed 1968 Driller Cased to 40 Casing height Wires properly protected (Y/N) ¥ ATINSPECTION 7/13/93 110.6' g.p.m. 3.2 g.p.m. 150' SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 91' Absorption field on lot 135.5 ' Public sewer main Sewer service line N/A ; On adjacent lots 100+ ; On adjacent lots 100+ Public sewer manhole/cleanout N?A Petroleum tank N/A WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 197-~. - Tank size 1,250 Compartments 2 Cleanout$ {WN) ¥ "~ Foundation cleanout (Y/N) N Depression (Y/N) High water alarm (WN) 1,1 ~ Alarm tested (Y/N) _ , ., :: ~ Pumoer- Date of pumping , , ~; SEPARATION DISTANCES FR~M SEPTIC/HOLDING TANK TO: N Well(s) on lot To property line 76 ' On adjacent lots 100+ Foundation 2.7 ' Absorption field 72' Water main/service line 79' Surface water/drainage 200+ 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) N,/A High water alarm level "Pump on" level at Manufacturer f~/A Manhole/Access (Y/N) N/A N/A "Pump off" Level at N/A Cycles tested N/A Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot N/A On adjacent lots D. ABSORPTION FIELD DATA Date installed 7/]_2/93 Length 72~ Width 2 ' Total absorption area ~76 ¢~2 Cleanout present (Y/N) Date of adequacy test New System ¢93020]Ftesults (pass/fail) Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) N SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 135.5' Well on lot To building foundation 72.5 ' On adjacent lots 200+ Surface water 200+ Curtain drain E. ENGINEER'S CERTIFICATION Surface water HAA Fee $ / 7 Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number Signature/~.~ /~ --' Enginec(r's Name Theodore A. ,7ohnson, P.B., L.S. Date 7/]_4/93 I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. On adjacent lots 200+ Property line ]_6.5 ' To existing or abandoned system on lot 60 ' Cutbank [~/A Water main/service line ] 22' Driveway, parking/vehicle storage area ~05' Soil rating (GPD/Ft2) 0. &GPD/ft2 System type Shallow drainfield Gravel thickness 4 ' Total depth 8.0' y Depression over field (Y/N) N Pass for 4 Bedrooms After test . If yes, give date 09:17 CT&E ENUIRONHENTAL LAB SERUICES ~ 9073449~36 N0.751 Q02 COMMBRCIALTBSTING & ENGINEERING CO. ENVIRONMI.~NTAL LABORATORY ~ERVICE$ Chemlab Ref.~ Client Gample ID Matrix :WA~R Client Name :CRITERIUM AK EN~R Ordered By : R~PORT of ANALYSIS ,6633 B STREET ANCHORAGE, AK 995~8 ]'EL: (907) 592-F343 FAX; (907) 561-530~ WORK Order :68281 Report Completed :07/19/93 Collected :07/13/93 @ 22:50 hrs. Received ~07/14/9B @ 10t25 hfs. Technical Director~S~PH_F±N/C. FJ~[ Project Name ProJect~ PWSID Sample Remarks: ROL~INE SAt~PL~ COLLECTED BY: E~J0 ~[%~NESSF. J3 BY TAJ. parameter Allowable Ext. Anal Results Qual units Method Limits Date Date Init Nitrate-N 0 m~/L EPA 353.2/300.0 i0 07/15 LLH .......................................... UA = Unavailable * Gee ~pecial ~nstructlons ;~Dove NA = Not Analyzed ** See Sample Remark~ A~ve ' U = Undetected, Reported value is the practical ~antification limit. ~T = Less Than ET = Greater ~han D = Secondary dilution. INSPECTION APPOINTMENTS TiM~;~.~~, ~ TiME TIME DATE DATE DATE ! INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~T. OF HEALTH &  825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL pRoTECTiON ENVIRONMENTAL SANITATION DIVISION ~'~,f 2 6 ~981 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND S~~'~ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing, 1. PROPERTY OWNER '~ ~ PHONE MAILING ADDR~S PROPERTY R ESI DE~T (I} d~fferent from above) ~ PHONE 2. BUYER PHONE MAILING ADDRESS 3, LENDING INSTITUTION ] PHONE MAILING ADDRESS 4. REALTOR/AGENT ~ PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION STREET LOOAT,ON 6. TYPE OF RESIDENCE SINGLE FAMILY MULTIPLE FAMILY NUMBER OF~B EDROOMS [] One ~ Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * 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** ~i~ YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH ~EOUEST BEFORE P~OCESSING CA~ BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~SINGLE FAMILY E~] ONE [~] THREE [~ FIVE BI 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 ~/NDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] HoIding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION~,R EA MATERIAL 4. DISTANCES Septic/Holdin§ Tank Absorption Area Sewer Line I Neares"t'~ot Line I WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS ~/~APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) DATE BY . -~ 72-O10 (Rev. 6/79) 825 "L" STR!:~:? i',NCii()RAOF, /\l ASi<A 99501 (907} 76.", fii'ii ~/:O,q't;/~ .':. /R/!_L/VA>/ ,%1.4 Y O R June 2, 198i. !)av±d G~ Doscher Star Rout_e A Box 445 '~,1 -~ "~-a 507 Subject: Lot 4 Block 9 Prater Suod]_v!sLon Approtra. 1 for the individ%;.al sewer and water cannot be granted until '[:he following items have been completed: (1) ~.h_: water -~ '~ : z~-' ' ~ ~r.,a:~l~.: .... reporL needs to be submitted to ' ~ ~0:~ '~ C ' ~ '' ~' th:s o.~f .....(..~rom the Chem Lab, 5633 B ,.,t~ee~., for cur review, {2) ~h.: septic tank pumped wi'th a receipt submitted to hl:, is office. 3 ) An adequacy test needs to be performed on the e×isting leaching area_ This tesh will determ:[ne if t. he system is adequate according to Nat. iona! Standards~ A listing ef private firms performJ.ng hhe test is enclosed. This .>U_~.~I ...... ~O tfll. S c)f~iee 'for our ~et:,),. ,~ needs to be ~-,--~-,r, :~/~ ' ' r e :L ve¥/. ..h., .... office If hhere are any further questions~ please cal.]. at 264-4720~ Sincerely, Rober'h C. Praht~ R~S, _~ssoc..a he RCP/1 j w iiomt.-' Federal ,Savings and Lea_ri 535 D Stree{: 99501 MATERIALS T~TI~ ~ILS E~INEERI~ _ 2204 Cleveland Ave. " 710 Third Ave. RO. Box IO-IIZ6 P.O. Box 2540 An~ornge~AK. 99511 Foirbanks~AK.99707 277-02~1 452-1Z 67 - 456-5155 S[._jT I C SYSTEM ADEQUACY REPORT JOB NO. 81-1567 DATE OF REPORT June 17, 1981 DATE OF TEST LEGAL DESCRIPTION ' LOT 4 . .., BLOCK 9 , Prattor OR. .SECTION , T__N, R__W, S.M. SUBDIVISION ~ ALASKA PERFORMED FOR' David Doscher SRA Box 445 Anchorage, Alaska 99507 266-5269 PHONE NO. REQUESTED BY: PHONE NO. TYPE OF SYSTEM ' [] SEPTIC TANK - SIZE 1250 [] CRIB OR SEEPAGE PIT [] LEACH FIELD NUMBER OF BEDROOMS SEPTIC TANK WAS PUMPED [] YES [] NO ABSORPTION RATE: AVERAGE 2-4 HOURS 600 GALLONS. SURGE RATE.' 480 GALLONS IN 48 MINUTES. NOTES a OBSERVATIONS' DAY 1 DAY 2 DAY 3 TANK CRIB TANK CRIB TANK CRIB init, 54 3/4" 88 3/4" 55 3/4" 82 1/4,, 55 7/8,, 74 7/8!! 48Q gal.54 3/4" 82 3/8" 54 1/4,, 75 1/4" 120 g~l. ,~.rgP- 54 3/4" 73 1/2" TEST PERFORMED BY:. REPORT PREPARED BY: MoB. APPROVED BY: Kinney R. Bmxrar ''- I /~' '"--J "--...:,d,~IICIPALITY OF ANCHORAG '~,' /~ . . . ~ MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION , : ~~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION L s...., - A.o.o.a.e.A. sk H 0V 1 5 1979 ENVIRONMENTAL ENGINEERING DIVISION ~EQUEST FO~ APPROVAL OF INDIVIDUAL ~ATEfl AND SE~ER FACILITIES DIRECTIONS: Complete ell p~rts on pege ], Incomplete requests will not be processed. Please ellow ten (]0) devs for processing. 1. PROPERTY OWNER, ~ PHONE MAILING ADDRES~ P~OPE~TY ~ESIDENT (If differ~ from above) L) ~ PHONE PHONE MAI~G ADDB[SS 3, LE~DI~G INSTITUTION ~ ~ I PHONE MAILING ADDRESS 4. REA~OR/AGENT PHONE MAI LING ADDRESS 5, LEGAL DESCRIPTION STREET LOCATIO 6. TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One ~ Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY (~ INDIVI DUAL* ~ I,~C~_~ ~'¢~¥~ ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.} 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) -- ' ~7~ ":;7~ [ :'~ [ ,(~.0~¢~-, t~/'~''' .... THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NU~IBER 2, WATER SUPPLY E3 INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVl DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []HoldingTank Size: . If Tank is homemade ~ SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line' WELL TO: Absorption Area to i~earest Lot Line ~]----APP ROV E D FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) DATE BY LEGAL DESCRIPTION 72-010 (Rev, 3/78) 'L_.x ') 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M, SULLIVAN, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION November 20, 1979 Barbara B. Jenson 4611 Business Park Boulevard Anchorage, Alaska 99503 Subject: Lot 4 Block 9 Prator Subdivision David Vladimiroff Property Approval for the individual sewer and water facilities can not be granted until the following items have been completed: (1) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. (2) The septic tank pumped with a receipt submitted to this office. ' (3) Locate the standpipe to the septic'tank for our inspection. (4) The standpipes to the neighboring sewer systems must be exposed so that the distance between the well and sewer systems can be verified. In the event the sewer system on the neighboring lot is to close to the semi-public well, an approval can not be sent to the lending agency. Please notify this department for a re-inspection when the above has been located. If there are any further questions, please contact this office at 264-4270. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw -::~:.:::'-- '-, ,I. ,:~" ,.~- ¢~-'~>:'. ..... ,1UN [ C I PAL I TY OF ANCHORAGL.~2~ZUNiOPALiTF ~p >,V,C~,OP~:GE::. , .: : ~~ "~ ~:De~ar:Emen:t~:': bf::H.e'a~l.th and g~vir°nmental P'~Ot~-e~i~:',?,:~'~ ~i:':: i:::::~ · : :. ~: :. ~'/'~,~/ :- : 82S 'L S~et, Anchorage, Alaska ~I~'~'MF*"]"I'~:~')F~CT!ON"~.. ~l.l~j)}/. : :~ 279--2511, ext. 224, 225 · · i . : '~ ~equest for Approval of Individual Sewer and Water Facilities 1. Property Owner Mailing Address: Phone: Mailing Address: Phone: 4. Realtor/Agent: ~/~ ~T~' ~, OU~/~A3~ Mailing Address: Legal Description: Street Location: / Phone: e Single Family Residence: Multiple Family Residence: Number of Bedrooms: _ Number of Bedrooms: 7. Water Supply: *Individual Well ~ If Individual Well, well depth /~ If community system, name of system sewage Disposal System: On-site System If On-site System, date of installation:' pUblic/Community System ( ) Public System ( ) *NOTE: A well log is required on ALL wells drilled since 6/75. ;DEPARTMENT~;~dH HEA~'FH'-AND ENV~IRO'NMEN~A~ -,;~OTEC~I~~ 825 L street, ~ochorage, Alaska 995;0].¢~% ~'~  Date Received: Ma~g.h 31, 1977 l~~i~. 10:00 a.m. 2nd Inspectzon: Tzme 10.00 a.m~ Date 4-4-77 MOnday Date 4-5-77 Tuesd Inspector Kennedy Inspec%or KennedY REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. i,ending Institution Request: Alaska Mutual SaviD&LS Bank Mailing Address: Post Office Box 1120 99510 Phone: 274-3561 o Property Owner: William L. Hubbard Mailing Address; Star Route A Box 445 99507 Legal Description: Lot 4 Block 9 Prator Subdivision Phone: 344-2016 Single Family Residence: (x) Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Well Data: Type~ ~"~ : Construction Bacterial"'knalysis 6. Sewage Disposal System: On-site system Well Log Filed ( ) Public Utility ( ) Permit ~ Installed 1968 Septic Tank Size Installer Manufacturer Absorption Area Soils Rate Distances: Well to Septic Tank / /~ / to Sewer Lines NeareSt: Lot Line Material to Absorption Area Absorption Area to Nearest Lot Line ~P'ag~ TWO m-'-' Department of Health and Environmental Protection . Request for Approval of Individual Sewer~and Water Facilities Legal Description: Lot 4 Block 9 ~rator Subdivision Letter Attached: ( ) Date: Af fadavit Attached Approved: Disapproved: Department worksheet: April 11, 1977 Alaska Mutual Savings Bank Mortgage Loan Section Post office Box 1120 Anchorage, Alaska 99510 Subject: Lot 4 Block 9 Prator Subdivision The Municipality require~lent for wells is that the oasing be extended a minimum of twelve (12) inches above grou3~d level and be closed with a sanitary seal of a type approved by this department~ The existing pit must be filled with earth by a non-porous type and the ground sloped to drain away from the well casing° This department can not grant final approvel until the well is upgraded, and a 1,250 gallon septic tank is installed. However~ temporary approval will be granted i~ funds are escrowed for the upgrades. If there are any furthere questions, plesse contact this office at 279-2511, extension 224 or 225. Sincerely, John Kennedy Principal Environmental Control officer JK/ljh cc: Mr. William L. Hubbard Star Route A Box 445 99507