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Home My WebLink AboutDORA #2 LT 6 Z PERMir. T NO~ DE:PRRTMEI'.~'!" C'¢::' HEFIL..'I"!--I FIND ENVIRONMENTFIL. '*'°OTEC':TION 825 '", STF.'.EE"I"., FINCHORFIGE., FIK. 9~ ~:'L 264-4?20 ~..-..1I lEE b.. L_ F" El .~." Ir,1 l: 'T ,{ 8:t J. Oq. 7' FIPF'L t CF"ff',H" L..OCRT I ON L.EGFIL T. STEI.,.tFIRT C:ONSTRUCTION LE; DORFI 2 L6 DOF..'FI 2 842E~ I,.I I L.L I WR C I RC:LE LOT SIZE ;.2.00C~E'~ SQURRE; FEE]" MINIMUM [:'ISTFINC'E BE'f'WEE:N R t.,.IELL. FIND .eNY ON-SITE SEWRG[.'.'i DISPOSRL SYSTE:M IS t00 FE:'ET FOR Fl PRI',,'RTE WELL OR 150 TO 20E~ FEET FROM R F'LIBLIC WEL. L DEPENDING UF'ON THE TYPE OF PUBLIC WELl_. MINIMUM [:,IE;TRNCE FF.'.OM FI PRIVFITE NELL TO FI PF.'.IVFITE SEWER LINE IS 25 FEET FIND TO R COMMUNIT'T' SEWER LINE IS '75 FEET. WEI...L I.._CIGS RRE REIi.!t.IIRED RND MUST BE RETURNED TO 'THE DEPFIRTMENT H ITHIN 3{i,~ DFI'.PS OF TFIE WELL COMPL. ETION. OTHER REL:~UIREMENTS MR'T' RF'PL'¢. SPECIF'ICRTIONS RND CONSTRUC:TIOI'4 [:,IFIGRFIMS FIRE R'v'RILFIBL. E TO INSURE F'ROPER INS"['RLLRTION. t CERT I F'T' 'f'HFI'f.' :.t.: I RM F'FIMILIFIR W:I:TFI THE RE:6!UIREMENTS FOR ON-SITE SEWERS RND WELLS F:IS SET FORTH B"r' THE t'tUN I C I PR[.. I T'T' OF FINCHORRGE. ;2: I t.,.ItI_L..~FILL ]"FIE S'¢"'":TE~'I ~:ORE:,FINI::E WITH THE CODES. '}i, I GN .Fi[:,: ~~_ ~_ .._~__~___.. ........................... ',,,'4. 0 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 Parcel I.D. # 014-251-23 HAA # V-I ~ ~ (~ (~ L~ .3 1. GENERAL INFORMATION Complete legal description Dora II, Lot 6 Location (site address or directions) 8406 Rosal~d Street, A~chorage Property owner A~lcn & Barbara Felt Day phone 563-0016 Mailing address 8406 RosalL~d Street, A~chorage, A~ 99507 Lending agency Mailing address Agent Address N/A Day phone N/A Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 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. 72-025 (Rev. 1/91) Front MOA #21 ')pOM S,Je@U!§Ue leUO!SSeJoJd eH1 u! suo!ss!uuo JO s JO Jig JOj elq!suodseJ ~ou s! ebeJoqouv ~o ~!led!o!unl/~ eq.L 'penss! s! m, eo!j!~@o e eJojeq e~ep eZ~leUe Jo suo!~oedsu! ~onpuoo ~ou op SHFIQ ~o see/,old UJ:l 'mueu~eJ!nbeJ me~s pue leJepej u!e~eo/gsp, es o~, JepJo u! suo!~n~p, su! §u!puel J!eq~ pue seu~oq jo sJeseqoJnd m, Xse~noo e se s!q~ seop SHHQ eq.L 'e~Sel¥ jo e~m,$ eq~ u! peJe~s!BeJ Jeeu!Bue leUO!SSejoJd luepuedepu! ue Xq eAoqe g qdeJbeJed u! ue^!b suop, e~ueseJdeJ eq~ uodn XlUO peseq se~eo!j!~eO le^oJdd¥ ~l!Joq~,nv qlleeH senss! (SHNQ) seo!MeS ue~unH pue q~leeH ,~o ~,ueu~edeQ eBeJoqou¥ ~o ~!led!o!unlAI eqj. sluewwoo leUO!l!PpV. :suop, elndp, s OU!MOIIOj. eq~, q:J.!M 'suJooJpeq Jo.t leAoJdde leUO!j!puoo 'peAoJddes!O 'suJooJpeq Jo~ peAoJddv ~ 3~In£~NIDIS SHHO LL§66 ~ 'AaAT~ eTbe.q '~'6E£LL xo~ 'O'(] sseJppv 'uo!~oedsu! s!q3 Jo e~ep eq~ uo ~oe~e u! suo!~eln§eJ pue 'seoueu!p~o 'sepoo e~e~S pue led!o!unv~ lie q~!M eoUe!ldgUoo u! s! LUe~SXS lesods!p ~e~eMe~Se~ ~o/pue Xlddns Je3e~ el!s-uo eq3 'uo!~oedsu! puc uo!~e§!3se^u! XuJ LUO~J puc Sel!J eDeJoqou¥ ~o X~!led!o!unv~ LuoJj peu!e3qo UO!3eLU]O~U! eq~ uo peseq 3eq~ Xjpe^ Jeq~n~ I 'u!e~eq pe~eo!pu! e~n~onJ~s ~o edX~ pue s~uoo~peq ~o ~eq~unu eq~ Jo~ elenbepe pue leUO!3oun~ 'e~es s! gue~sXs lesods!p Je~eMe~Se~ ]o/pue Xlddns Je~eM e~!s-uo eq3 leq~ s~oqs uo!3eo!ldde le^o~ddv X3poq3n¥ q31eeH s!ql ~o ALU :leq:~, XJpeA I 'MOleq UMOqS m, ep uop, ep!le^ eql jo se puc o),eJeq pex!j,[e leds ALu Aq pe!,q~JeO sv '9 t:I=I=JNI!DN=I AG NOI/O=,dSNI dO /N31N=IJ.V/S 'g Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type P/21Vm'E-, Log present (Y/N) Total depth //! Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. Date completed () ~//~//~'/ Driller Cased to I// ~ Casing height Wires properly protected (Y/N) ADEC water system number /v/,4 P~M~/ ~7-~ Y FROM WELL LOG Date of test 0 4 / ~'/ Static water level ~ '~ i Well flow / ~ Pump level (j/q/~/V~/.CA/ ' g.p.m. AT INSPECTION ~/~--4//? ~- MUNICIPALITY OF ANCHORAGE ENVIRONMENTAl- SERVICES DIVISION S,ZP 1, !~9~ I0 g.p.m. RECEIVED Septic/I,~4~j tank on lot Absorption field on lot Public sewer main ~/ Sewer service line SEPARATION DISTANCES FROM WELL TO: /y'/~l ; On adjacent lots /V/,,4 ;7~On adjacent lots i/vs'r,4l~E.~ /lq 17 ~1 / ?~. ~[~. ~/~4N~'Public sewer manhole/cleanout ~D I Petroleum tank NON[, WATER SAMPLE RESULTS: Coliform -~ Nitrate Date of sample: D'~/I'/~/¢' ~ D/- Other bacteria Collected by: ~/V~//~J~Z~,~ B. SEPTIC/J~I~'I~ TANK DATA Date installed Tank size Cleanouts (Y/N) . Foundation cleanout (Y/N) ~-~ Depression (Y/N) water alarm (Y/N) . ~~~d (Y/N) High Date of pumping \.h. / Pumper SEPARATION DISTANCES FROM~NG TANK TO: Well(s) on lot ,--/ On adjacent lots Foundation To property line / AbsorPtion field Water main/service line 72-02~ (~¥. 7/~) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level 1~.~ Meets MOA electrical codes ~/~ SEPARATION~NCE FROM LIFT STATION TO: Well o~3A~t On adjacent lots Manufacturer ~ ss (Y/N) "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed Soil rating Sy.~m type Length Width Gravel thickness J Total depth Total absorption area Cleanou~(Y/N) Depression over field (Y/N) __~,et~ of adequacy test Results (paSs/fail) .\ ~ ,,~ for ~ If Peroxide treatment (past 12 months) (Y/N) ~,~ yes, give date: SEPARATION DISTANCE FROM.~:~RPTION FIELD TO: Well on lot ~ On adjacent Iots~Propertyline TO~ ~;ladi~tfl~i~d~tio~,~,~ To e,,,,. Cutbank xisting or abv~e~nme~ ~sS~v~c~i~t Surface wat~p~ Driveway, parking/vehicle storage area drain E. ENGINEER'S CERTIFICATION bedrooms I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature ~ Engineer's Name ~ ''~' z~,~ ~ Date ~//~/~"~- HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev, 3/91) Back MOA 21 SEP 17 '9~ 09:11 HORTHERH TESTIHG, AHCHORA~E P.4/£ ~agle River Engineering P.O. Box 773294 Eagle Riveg AK 99577 Attn'.. Louis Butera Our Lab #: ~ocat£on/P~oJect: ¥ou~ Sample Sample Matrix: Comments: Hethod Par$~eter NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS. ALASKA 99701 (907) 456.3116. FA~, 456.31~5 2505 FAIRBANKS STREET ANCHORAGE, ALA,~KA 99503 (907) 277,,~37~: * FAX ~74.g645 aepo=t Date: 09/1'7/92 A120332 Dora Lot 6 Water Date A==ived~ 09/11/92 Date Sampled: 09'/11/92 Time Sampled: 1300 Collected iB¥: MP ~DL = Method Detection Limit Flag Definitions S = Below Regulatory Min. H = Above Regulato=y Max. E = Below Detection Limit Estimated Value Date HDL Analyzed mg/1 0.1 09116/92 Microbiology Supervisor APPLIC FILLS OUT UPPER HAL ONLY Property Owner ~ 0 ~ ~?~'~ O, /~. O .,..~,~/~y~. Phone Mailing Addre~ 2 ~ ~ ~ ~)3 ~ ~./,~ D ~'~ ~ ~ ~ ? j~: Zip Code ~ 7 ~ Y ?' ~ f ~ ~ Buyer Address ~'~ ~-. Zip Code Lending Institution Phone Address Zip Code Realty Co. & Agent Phone Address Zip Code Legal 9escript~n ~ ~? ~ ~ 0 ~ ~ ~ ~ ~ ~ ~/~/J i O~ Street Locati~ ~ ~ '~ ~-, ;~'~' ~'F Type of Resi~nce ~Single Family ~ Multiple Family No. of Bedroo~ ~ ~ Other Water Supply A~ACH WELL LOG. A wall log is required for all wells drilled since June 1975. ~lndividual ~O ~ ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal .lndivldual Year Indiv~ual Installed: Public Utility When Connected to Public Utility: ~ ~ ,Z ~ J Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector In spec,[Q~, Field Notes: ~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONM2NTAL PROTECTION MAY 2 3 1983 RECEIVED ("~) APPRo~/ED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72-023 (3182) ~ MUNICIPALITY OF ANCHORAGE _ Vi~T~. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~ ' ~__ ~ ~ 825 L Street - Anchorage, Alaaka 99501 EN T S ' h iOVO 1981 ~ Telephone ~4~720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS; Complete all parts on page 1. Incomplete requ~ will not ~ proceed. Please allow ten (10) days for processing. MAI LING ADDRESS PROPERTY RESIDENT (If different from above) PHONE MAILING ADDRESS ii] SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 5. LEGAL DESCRIPTION STREET LOCATION 6.- TYPE OF ~ESIDENC~ ........ NUMBER OF~B~DROOMS ' ' ~ One ~ Four ~ Other ~ Two ~ Five ~ Three ~ Six * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well 8. SEWAGE DISPOSAL SYSl~EM [] INDIVIDUAL/ON-SITE** PUBLIC UTILITY depth (attach log if available.) 'YEAR ON.SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVI DUAL/ON -SITE []PUBLIC UTILITY Connection Verified THIS SIDE FOR OFFICIAL USE ONLY [] ONE [] TWO NUMBER OF BEDROOMS [] THREE [] FIVE [] FOUR [] SiX [] OTHER []Septic Tank or [] Holding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE I NSTALi-ED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank IAbsorption Area Isewer Line INearest Lot Line 5. COMMENTS DATE [] APPROVED FOR z:~ BEDROOMS [~ONDITION'AL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~ .-' 72-010 (Rev, 6/79) 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-41 '11 GEORGE M. SUI tlVAN, %OAYO}~ DEPARTMENT OF HEAL'I-H AND ENVIRONMENTAL PROTECTION November 23, 1981 T. Stewart Construction 8420 Williwa Circle Anchorage, Alaska 99504 Approval for the following properties cannot be granted until the following items have been completed: Lot 5 Dora II Subdivision: At the time of the scheduled inspection, the water was too turbid in order to obtain a sample. Lot 6 Dora II Subdivision: The well needs to be exposed for our inspection. The water report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. Lot 10 Dora II Subdivision: At the time of the scheduled inspection, the outside faucet was not on in order to obtain a sample from. The well needs to be exposed for our inspection. Please notify this office for a reinspection when the noted descrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw lil:OHfiF M. Sldl..LIVAN, F/lAY 01'I I)F'U;\IiIIVlI:N'I ()1:: ltl:Al Iit /\ND l:[',lVIl~t)r\~i,~[ NIAI PfIOTFCTIOt',I November 30, 1981 T. Stewart Construction 8420 Williwa Circle Anchorage, Alaska 99504 Subject: Lot 6 Dora II Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The well casing needs to be extended twelve(12) inches above ground level. This will need to be reinspected after completion. If there are any further questions, please call this office at 264-4720. Sincerely,. Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: First National Bank of Anchorage Post Office Box 4-2090 99509 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Sanitation Division 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 CERTIFICATE OF INSPECTION SEWER AND WATER FACILITIES PROPERTY OWNER T. Stewart Construction MAILING ADDRESS 8420 Williwa Circle 2. LEGAL DESCRIPTION Lot 6 Dora II Subdivision SINGLE FAMILY RESIDENCE MULTIPLE FAMILY RESIDENCE 3. TYPE DWELLING INDIVIDUAL COMMUNITY/PUBLIC 4. WATER SUPPLY 5. SEWAGE DISPOSAL INDIVIDUAL/ON-SITE PUBLIC UTILITY [] HOLDING TANK (Maintenance Required) APPROVED FOR two BEDROOMS E3 CONDITIONAL APPROVAL (See Attached) DISAPPROVED { BY (TITLE; Novermber 1~, 1981 72-014 (3/78) EL3 OTHER (DescriBe) SEA, L,,