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HomeMy WebLinkAboutJOANN LT 75AJoann Lot 75A #051-081-35 ro-uia iriev. serol _. MUNICIPALITY OF ANCHORAGE is ` 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 NAME PHONE �EW C O L Cy Zg7 /% ❑ UPGRADE MAILI DRESS o 5_ S E A/ - S.0 B 196X E. ,e Ale, 9,'77 LEGAL DESCRIPTION �S/v42 St LOCATION BEDROOMS DISTANCE TO: Well Absorption area �. Dwelling ^ PER➢41i'(I jV�O.!5 U Y 0 Zf Gv PZ Manufacturer / E - Mgieri No, of compartments -7 wF J L Liq. a acit in llons C/ IF HOMEMADE: Inside length Width Liquid depth 6 DISTANCE TO: Well Dwelling PERMIT NO, _ F Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well Foundat /� NearestlotAine Z PER MITA b Z„rj ZW No. of line L M cFy p y Total I lipes Trench h Distance bet=egrilings - F—w j�CO inches U F D Top of the to finish grade / Material beneath the 2 inches Total ofja v b orptjgb area i / 7�lf `/ Length Width Depth PERMIT NO, t� 117W Qs F Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line J Class Deptb. Distance to lot line PERMIT NO. J W � DISTANCE TO: uldn fondatio Sewer line Septic tank Absorption area(s) OTHER _ PIPE MATF�1 eC II((11111"'''' � �1. ,t° , SOI L TESTT R RATING 3V9 x /Z INSTALLER RE ARKS Q f E . s. . rn� AL! I q I I• • •.i MUNICIPALITY t DEPT. ENVIRONMENT filar ! �QTLtH!)MA. 'AUG •-•.....--,,� RErriv APPROVED E.fG_jNEERINQ DATE EGA SRB 196K 91VER, ALASKA US" � 3 ro-uia iriev. serol _. s ar 'agr .r s .r, °; r xp'atif"`:A` `sY'-'-' 7s�'s'`FE R s DEPARTMENT OF. HEALTH -AND ENVIRONMENTAL PKOTEC41bN - 825 L STREET,. AiCHARABE :,.AK- '-99W1_,. 264-4720 PERMIT NOs 840584 DATE ISSUED1 07/16/84A. 3, 'APPLICANT¢. C/© S & S ENB'S. AMERICAN EXCAVATION ADDRESSe SRB 196X EAGLE .RIVERp, AK 98577 z' CONTACT PHONE! 694-2974 LEGAL'DESCRIPo, SUONVISIONt--NA E4Tk;.75 BLOCKc { VECTtONs' 5 TOWNSHIPi 15N RAN®Es '11W LOT SFIZEs SA = 1 (SO.FT. Oki ACRES). MASS BEDROOMS.�� ' Listed below are a.options-available to you in deaiga�ant7.yaur septic.- eystem: -Choose the option that best fits your site. _ _ _ _ DEPTH TO, PIPE BOTTOM (FT.) 4.0 4.-0 GRAVEL DEPTH (FT.:) 6.0 0.5 T.5 "rf TOTAL DEPTH (FT.) 10.0 4.5. GRAVEL WIDTH (FT.) 2.5 26.0 5.0 � flRAVEL- LENGTH (FT.) 58.0 **i / iS ` 50.t7 1i.5,. ¢'' GRAVEL VOLUME (CU.YDS.) 52.9 48.1 83.7 TANK SIZE (GALS). 1,.000.0 ** 1,:000_0 ��u i,.a � ii "j, SOIL §fdI-N(3 <8Q.FT./BR) 349 2$4 344 GRAVEL LENGTH > 75 FT. REQUIRES MULTiPL.E-RUNS, (NOT. EXCEE0aN&,3&:.1�T«,. TANK MUST HAVE AT LEAST TWO COMPARTMENTS IV --_-_.----'---- -_._ I certify that: 1: I am €amtliar with the. requireamwrts _for onsite sewea�s and. weekle fmrth by the Municipality of Anchorage (MOA) and, the State of Q-aii a 2. 1 will install the system in aciiordanse- with ail<- and in compliance with the design criteria of this permit. -3. 1 will adhere to all. MOA and: State- of Alaska reguis fid• €,Aw. the *at distances from .any existing well, -wastewater d-ispq%al syd p! or,p,k e9werage systemeh thIs or any adjacent or nearby tot.. y 4. I ,understand that this permit is valid for a maximum df`� 3 b6droams etid.v z`Y any enlargement will require -an additional permjt:. IF A LIFT STATION IS INSTALLED IN AN AREA, COVERED BY MOA BUILD;INS 1900 THEN (2) AN ELECTRIC PrERMIT AND INSPECTION, MUIU B� "' T -A64 ..3AiLL FIAT _E 'T--AAILEIAL IfiISPCd#8N REf C#RxiSI {i'sr L•�',i1`RI(a€A4 Wlti S'I :, BY A"'L:ICEk+t�ileH' EL ?GkZ Q.1404-. X. ,*E� _ • k �qy 5`.&15 E(+(fl'fl. AMERICAN EXCiIiJ#dIbhE: ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE +� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION- PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: A M tag,) LA -r J DATE PERFORMED: -7,13,12Y- LEGAL LEGAL DESCRIPTION: L 'O' -.JC E T it oP�o-r-LIC_ P -'E -:D 516 ,�0� StL—j 2 •may a� KI 7 1. ,. MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION' SLOPE 1fyC, �opv`WAS Date Gross Time Net Time GROUND P� 1 [[(�JUI „� 163RED?ATER �q O L 1� O P IF YES, AT WHAT E DEPTH? 13 �O�ff v 14 15 16 17 18 _I 19 %Wrt A. Seim �j. 16. 146720 -1 PLAN Reading Date Gross Time Net Time Depth to Water Net Drop � 3 h o MI q, 7 Z 7 f4 T IZ1JJf �F% N / G 31p4 PERCOLATION RATE q-0 (minutes/inch) TEST RUN BETWEEN FT AND 7 FT PERFORMEDBY: $ _`'EVGINEERIId{4_ CERTIFIED an --$13¢19@14 SLE FIViiC AIASKA 2sst PH. 694-2579 I 72-008 (6/79) H 4) C>: 1 �s .o` Q HE ad go! .s rz c p W � � i � � g � g ;y e a i °z ° 09 9 a a a a C& °z Oz w cr. w w I� k. L6 w k. LT. v. cc wr G �n cp U �i w >_ Q Z ra J N � W g IIR im./ a 44 � �1 41 A m .,0 45: W i � V i �AUN�I-CDIPPATL�I,�Y OF� -_: j . t rz rS k. tEtJNFiONiAENTAi P $ P.JINN 7: 19Ah ' .� 14 -4: RECtIVED ti O G O O- O O O O O O O O cn $.. mi Q Lam.; (�• b N >00 Z i Ems.• D i Wg 4 f/5 C i f i f f F J (D ti V1 W O O O O O O O O O O O O ? C L� I I I O C C C C C C C C C C C C 2 W v4. k. k. 66 4. L, u, 4. L6 U. L6 W - D Ew., Fes- Z y i - MUNICIPALITY OF ANCHORAGE 2. +' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 t" GENERAL INFORMATION (a) Legal Description (include lot, block, G-7S6L Vo GIl�M Location (address or directions) Application Date section, township, range) (b) Applicant Name ` a /0 �'� Telephone: Applicant Address,67 /Z'�`s (c) Applicant is one): Lending Institution ❑ Vf (d) Lending Institution Address lu_ i/ (e) Real Estate Company and Agent Address Telephone 49 Lb (f) �Ot3tf the HAA to the following adi ,<�' .( ,-7 E� jet y/y I Business JAAA4r Buyer ❑ ; Other ❑ (explain); Telephone TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 15- 3. 3. WATER SUPPLY Individual Well Community ❑ Public ❑ 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 Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11,84) • • 5. 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 Heaith 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 all Municipal and State codes, ordinances, and regulations in effect on the date of this insge44tiQn�vnrrrc�... . Name of Firm Address Date — 6_ DHEP APPROVAL Approved forbedrooms Approved . Disappr, Terms of Conditional Approval Telephone CAUTION �� OF 4 OF 44 ! i9 B.bart ••sa.,` Na. 1457.E a Date The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their ieod,n9 institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct insPecti ns ar analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omiss'ons, professional engineer's work. Page 2 of 2 A. 1.1 • MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & - MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) U I`I Q In CHECKLIST - FEBRUARY 1984 264-4720 AA`�E {(J�� Le I Description: Z %!rte ✓,� fYKJ+r 91 V14 pLM Lor ?t .SS T� rAr ,e,rcA. WELL DATA Well Classification_il2-t JJ T-tr If A, B, C, D.E.C. Approved (Y/N) Well Log Present &J Date Completed 9-8'B�! Total Depth 16k L Cased to L(61 1✓ Depth of Grouting Static Water Level jpcb* Pump Set At Casing Height Above Ground �6A # Sanitary Seal on Casing/1% Electrical Wiring in Conduit &1 Depression Around Wellhead i; t•: Yield A`. 009271 40,J6+-vw% Separation Distances from Well N To Septic/Holding Tank on Lot 4?ULt _ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lo % Ef x ; On, Adjoining Lots 'a' To Nearest Public Sewer Line �� To Nearest Public Sewer it Cleanout/Manhole + To Nearest Sewer Service Line on Lot Water Sample Collected by S $ �aE��"CCAP- tM4 ; Date (o" 44 rb'� Water Sample Test Results2" Comments ,t a • &=� SEPTIC/HOLDING TANK DATA Date Installed 8 -3 -Sq Size d No. of Compartments --L Standpipes©] Air -tight Capsdj>r- Foundation Cleanout ;; Depression over Tank fP Date Last Pumped Pumping/Maintenance Contract on File (Y/N) "A- ;for K Holding Tank High -Water Alarm (Y/N) f " Temporary Holding Tank Permit (Y/N) �a Separation Distances from Septic/Holding Tank: To Water -Supply Well %�� ! To Building Foundation �OrH Y To Property Line %b To Disposal Field A9 To Water Main/Service Line Course Comments Page 1 of 2 72-026(11/84) To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 39 - Type of System Design Date Installed - 3 –L3q Length of Field 5 a t �( Width of Field 36 Depth of Field l�f Gravel Bed Thickness to Square Feet of Absorption Area `8q� Standpipes Presentr y W Depression over Field/pate of Last Adequacy Test ��w Results of Last Adequacy Test N/A Separation Distance from Absorption Field: t To Water -Supply Well go / To Property Line Za r To Building Foundation .�D r To Exist r Abandoned System on Lot ; On Adjoining Lots To Water Main/Service Line � � To Cutbank if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area 30' Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments — Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent(Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA IcertifythatIhave checked, verified, orconformed toall MO andHAAguidelinesineffect onthe dateofthis inspection Signed Date�� +�+��` Company ma MOA No. _95003 s Q Al;q�ii Receipt Npr,r�1 �IUERBf�A 1 3 4 /�P h•g9r Date of Payment pHA �97� �� (� r g'� ! , : X49 •�• Amount: $ ) _ Mbrt A. Sheffer � 2 r �a Page 2 of 2 t841�a�PRnc *" nN� 72-026 (11/84)