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HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 5 LT 9 ae R~.LL DATA Well Classification MUNICIPALITY OF ANCHOP, AQE ' D~PT. OF HEALTH & -- ENVIRO~qMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) ,jiJ!! !1'~ '"~']~ ,'!, kl CHECKLIST -- FEBRUARY 1984 R E C E i V c n ,egaZ es,cription: If A, B, (r C, D.E.C. Approved(Y/N) Well Log P=esent (Y/N) Total Depth Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances f~cm Well: To Septic/Holding Tank on Lot Cased to Date Completed Pump Set At To Nearest Edge of Absorption Field on Lot' To Nearest Public Se~r Line C leanout/Manhole , Water Sample Collected By Wate~ Sample Test Results Yield Depth of G~outing. Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Se~r Service Line on LOt ; Date B. SEPTIC/HOLDING TANK DATA Date Installed 12-1-~ WSize IZ~F~ ~' NO. of Cu~partmbnts ~_ ~ Standpipes (Y/N) ~ ~ Air-tight Caps (Y/N) ,~.% Foundation Cleanout (Y/N) ~9 Depression over Ta~k (Y/N) 6(b Date Last Pumpe~ ,,~ .~--/~ /~>C/ Pumping/Maintenance Contract on File (Y/N)~iB ; for Holding Tank High-Water Alarm (Y/N) ~j i~ ~ Separation Distances f~cm ~ept~/Holding To Water-Supply Well TO Prope~t~ Line TO Water Main/Service Line I Course Temporary Holding Tank Permit (Y/N) Tank: To Building Foundation ~' To Disposal Field ~' ~ To Stream, Pond, r~ke, c~ Major D~ainage [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD []~TA Soils Rating in Absorption Strata Date Installed 1'2- ~ - ~ ~ ~k Width of Field Square Feet of Absorption Area' Depression over Field (Y/N) ~ Results of Last Adequacy Test /b0~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes P~esent ~N) te of Last Adequacy Test ~ Separation Distance frc~ Absorption Field: To Water-Supply Wall C~,-, ,~lu;~,i~ ~%~ To P~operty Line To Building Foundation ~O~ To Existing or Abandoned System cn Lot ~I~ ; On Adjoining Lots~ To Wate~ Main/Service Line ~ 10' To Cutbank(if present) To Stream/Pond/Lake/c~ Majo~ Drainage Course.. I O© ' To Driveway, Pa~king Area, or Vehicle Storage Area ~ 2 ' Comments ~ ~0~ L4%~o~~-' D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Cu,~ents Dimensions Mar~hole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Check Permitted Bedroc~ Rating Against HAA Request I 'certify that I have checked, ,ratified, or conformed to all MOA on the date of this inspection. [Page 2 of 2] 2-15-84 DMSI~N OF ~'v/~ HEALTH DEPARTMENT OF ~_ALTH AND ~~ PROTECTION APPLICATION FOR HEAL~ NJITNDRI~ APPROVAL CERTIFICATE 1. Gene~al Inf~mation ~%~)plication Date .~'Ai.~V ,1 lq ~'~ (a) [sgal C~scripti? (inclu.c~ 1~, bl~[ ~i~si<~n, section, t~.ship, r3n~) Lo~ation (add~ess o~ di~ec~t~) Applicants N~ ~: T~ ~A~T~ Applicants Ad~ess ~0~ ~. ~OR~THf~! ~ "<~'[~ Address (e) Real Estate Co. & Agent Address Telephone 2. Type of Residenoe Single-Family ~ Number of Bedrcqns 3. %gate_~ Supply Individual Well ~lt i-Family ~ Other (describe) Cocmunity ~ Public ~ Note: If c~,~','.~nity ~11 system, must have written confirmati~ frc~ the State Depa~tm~nt of Envirop~ental Conservation attestinG to t?~ legality and status. Is the ~11 adequate for the number of bedrooms specified in this H~A E~/N) b h t Sewage Disposal Or~ite ~ Public ~-~ C~,,,~nity ~ Holding Tar~ ~ Is the wastewater disposal system adequate fez the ~umber of bedrooms ~N) [Page 1 of 2] 2-15-84 5. En~ineerin~ Firm P~ovidirg Inspections¢ Tests, Data and Information I ~ertify that I have c~ecked, verified, c~ ccnfc~m~d to all MOA HAA Guidelines in effect on the date of this inspection. Date A~£, l~r i~. I (~GINEER SEAL) The Municipality of Anchorage Department of Health and Enviror~ental Protection dces not guarantee the continued satisfactory perfc~mance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shcwn abo~, based on the data and information furnished ky an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedrocr~s and type of structure indicated. ( DI{EP SEAL) 7. Mail the HAA to the following address: _<__.~ ~ Q ~_.~::¥,~ o a.~_~,,_~_f-., ~ '-.3 KB2/d5/s [Page 2 of 2] 2-15-84 ALASKA I IILIIROFImEI1TAL COIqTROL SERI,]ICES, II'lC. ~nqineerJnq 8 ~nuironmcnlrJJ Studies APRIL 30 1984 PETER JARRGUT 207 E NORTHERN LIGHTS ANCHORAGE AK 99503 SELLER - PETER JARROUT BUYER - SUBDIVISION - EAGLE RIVER HEIGHTS BLOCK - 5 LOT - 9 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 500 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 900 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 5/1/84 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. 1200 g. Jcst 33rcl J~ucnu¢, SLtit¢ [~ · J~nchor'c~§¢, Alaska 99503 · {907) 276-1361 January 3, 1978 United Bank Alaska 645 G Street Anhhoraqe, Alaska 99501 Subject; Lot 9 Block 5 Eagle River Heights Subdivision Th~s department recognize~ the co~munity water supply as an approved source. If the duplex is connected to the public sewer, the ~roperty would be /n compliance with health codes. If there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/lJh File ..~ir. ~tev,m Oz, aad P.O, Box 104 I~le RIv~r, A~iaaka 995'/7 It has ~ bl~oug~ to our ~oMi~ that public oewor i~ ~vidhble to Lot 9. l~loc~ $, 1~o Rlve~* H~s SubdivJsitm. Chapter Id, 'Septic tank-seepafe systam ~ew~e dtsposol f~fles ~h~l ~ be ~s~ ~ ~ ~ P~ w~ ~t~ ~s are a~t~e ~t~ ~ (V0) f~t of ~ ne~ i~ line or If we do not hesr i~,o~fl you within seven (?) days, we will ~ssume that oaf r~'oL, ds m'e ___et~*j.e~. We, therefore, ~quest you csmne~:.l any and Zuty SO, You must q)ply for a emuneoflon permit fFom the L'MFmtI o~f'l(Mu* fro' the ~ ~A~, S~ E~ ~ Ro~. ffy~ have ~ que~s ~, ~~ ~ ~ t~ D~~ ~ ~th ~ En~~ siaoe _l , Lee Buehhols, R.S. saattat*tan LZ/lw GAAB HD I GRrATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 2~9-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ~ROM WELL G/~/llrl~, H~.O LIQUID CAPACITY .~_.~ .~:~ GALLONS. MATERIAL INSIDE LENGTH NUMBER OF COMPARTMENTS ~/~e~c ~'rL t=4~ INSIDE WIDTH DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER LINING MATERIAL ~'-' NEAREST LOT LINE OR WIDTH DISTANCE FROM WELL ~--~_~/~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO~INISH GRADE . WELL: TYPE ,.~l I.-C'~'D , DEPTH NEAREST SEPTIC LOT LINE ~/'~'~ , SEWER LINE ~ ~-- , TANK FOUNDATION ~LINE DIST~~ TRENCH WIDTH ,,,,,,,,..,~_~. F1L LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE DISTANCE FROM , BUILDING FOUNDATION. ,. ~"'I~xDIN6',~OUNDATION/ 'ff~ /' so. ET. TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WATER .~ / SAMPLE I~/4 , NEAREST SEEPAGE OTHER ~ , SYSTEM ¢~/~ , CESSPOOL ~ , SOURCES DIAGRAM OF SYSTEM DISTANCES: ,'~ ~ ,~- -// /~-7~: D DATE APPROVED HEALTH AUTHORITY GAAB-HD-2 GREATEI 327 Eagle St. %NCHORAGE AREA Y )ROUGH HEALTH DEPARTMENT Anchorage, Alaska 99501 279-2511 Case No. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT RESIDENCE ADDRESS LEGAL DESCRIPTION. APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH ~'/-¢" A TO BE INSTALLED BY PERCOLATION TEST RESULTS MA~UNG ^DORESS ~ ~--) 7 PHONE~O.?~/--~'~/7 LOCATION OF ~NSTALLAT~DN SEEPAGE PIT /'~ ,DRAIN FIELD ,OTHER ;/. /~---~//L3~/~NTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ~/~ ' ~/ ,~,~ ~ ,PERMITTO INSTALLA AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ~'~ SEPTIC TANK SIZE ,/~.~"~ TYPE~/--'~'~~ SEEPAGE AREA DIAGRAM OF SYSTEM DISTANCES: ~OMI,40/,J(T~ LU&'TE£ ! O se- -: c 7 ~/~ H~alth Authority /l' certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above system described is in accordance with said code. DATE APPLICANTS SIGNATU R ' ~"~,,,-~ FHA Forn~ 23'73 Form Approved Rev July 1958 -- FEDERAL HOUSING ADMINISTRATION -- Budget Bureau No. 63-R296.§ HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFiC~ ' MO~TGAGE~ SERIAL NO. MORTGAGOR OR SPONSOR [ ~uBDi~I$10h NAME TOTAL Nu~ER: - ' J - ~ -- ~ BASEMENT LIVING UNITS ! BEDROOMS BATHS WATER SUPPLY BY: [~ Public system [-~ Community system SEWAGE DISPOSAL BY: [] Public system [] Community system PROPERTY ADDRESS New installation [BlOcK riO. LOT NO. Can attic or other area be made into additional bedrooms? (If Yes, how many~) NO. ~SYSTEM DESIGNED FOR --]Individual ~] Individual n Yes ~ No PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT ~EALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the n State N County [~ Local Department of Health that this individual water-supply system ~ is ~ is not satisfactory as a domestic water supply for the subject property, J~J~l.X{~ ~[A'llil~ It is the opinion of the [--] State [] County [] Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: [~Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily is not likely to create an insanitary condition DATE SIGNA~r~RE // /: TITLE NOTE: The health ~horJty should complete the appropriate opinion statement above and o~x date, signature and title in the spaces urovld~ Use of the above grid for Health Department Inspector's sketch as well as use of the back of this form is at the option of the health authority. PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that 'the Individual water-supply system be considered [] Acceptable [--] Not Acceptable Sewage disposal be considered [] Acceptable [~] Not Acceptable. DATE SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ~J CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT FHA Form 2573 Rev. July 1958