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HomeMy WebLinkAboutEKLUTNA HEIGHTS BLK 2 LT 3Aooo · 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 IP'ONE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDRO~S PERMIT NO. ~ ~ DISTANCE TO: ' No. of compertme~ ~ Manufacturer Mat~ Liq. ~ gaJlons' IF HOME,DE: I nsi~ ~agth Width' Liqui~depth ~ ~ DISCO: Well DwelHng PERMIT NO. Nearest lot line ~ Well Foundation / O~ ~ PERMIT NO. - inches effective ~o~t~ area No. of lines ~ ~ ~ Material beneath tile Total ~ Top of t,le to finish grade ~ ' ~inches Length Width Depth PERMIT NO. / DISTANCE~ ~ ~ ~ Depth Driller Distance to lot line PERMIT NO, ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS SOl L TEST RA~ N~ - INSTALLER ~ REMARKS D DATE LEGAL 72-013 (P~. 3/78) 8~..., '"L' STREET., ANCHORAGE., AK. :'_..p~:l /~.,~/. ~'v. ~..../ ~,~-,~z~:~ .X'~,,°//:&O O,V ~ - ..', ( TYPE OF SOIL ABSORBTION SYSTEM. ZS: TRENCH MA~:IMUM NUMBER. OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= ~50 THE REQUIR. ED SIZE OF THE 50IL ABSORPTION SYSTEM [:,EP1-H= 11 LE [..]G TFi-- -'~5: C~RR'.~'EL_ E:,EF~T'Fi:= 7 THE LENGTH DIMENSION ~% THE LENGTH KIN FEET) OF THE TRENCH OR DRRZNFZEL. D. THE DEPTH OF R TRENCH OR P~T ~S THE D~STRNCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE E~<CRVRTZON (IN FEET.'.',. THERE ~S NO SET N~DTH FOR TRENCHES. THE GRAVEL DEPTH ~S THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PZF'E AND THE BOTTOM OF THE'E',:¢CRVRTZON (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL. SERVE. BACKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION AND RPPROVRL BY THIS ' DEPARTMENT WILL BE SUBSECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND RNY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FORA PRIVATE WELL~ OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELt_. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERr"I ! T E~--";F' ! RE'--; I['~EC:Er. IBEF~' .--:--: ::L .. l~i-i~- ?:-~- I CERTIFY THAT t: I RM FRMIL. IAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF 'THE RES IE:,ENCE /i'~.'EMODELED TO INCLUDE MORE THAN 4 E:EE:,ROOM~;. RPPLICRNT LINC CONSTR. UCTION INC VS:. 2 ~ ~ ~ SOl LS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99B02 276-222~ SOILS LOG - PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: [] PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS SLOPE , SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN FT AND {minutes/inch) ~ FT PERFORMED BY: CERTIFIED BY: DATE: 72-008 (7/76) JAMES B. RUBERTS, P. E. Star Route Box 8040 Chugiak, Alaska 99567 pn. 688-2017 CERTIFICATION OF INSPECTION OF TEST HOLE AND SOILS LOG I, The undersi§ned registered proTessional civil engineer, hereby certify that on October 22, 1978, I inspected a test hole locateO on the northwestern portion of Lot 3A Block 2,Eklutna Heights Subdivision, that the soils log shown hereon is a representation ot the soils strata observed and that by visual inspection I have determined that a>proper absorption area for sewage disposal effluent from a septic tank would be 150 square feet per bedroom. Natural Ground 0.5'-- Humus Sandy Silt 3.0 Sandy Gravel w/traces of silt 4" minus occasional 6" cobbles 12.2 Sano w/traces of silt 16.7'-- ae Be MUNICIPALITY OF ~NCHO~AGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 DEFT. OF HEALTH ENVIRONMENTAl,. PROTECTIOI~ JUL RECEIVEI Legal Description: ~ ~.~ ~ELL ERTA ..~]/~ .~ ~:r~.//,/e/~~ /~,~/.~ ~11 Classifi~tion ~'~%~ If A, S, ~ C, D.E.C. ~d(~) .~ ~11.~ ~e~nt (~) ~ ~te ~le~d ~ ~ .. Yield ~ Total ~p~ ~,~ ~e----'~ , -- --~ Casing ~ight ~ ~nd ~' Sanit~y ~al on ~sing (Y~)~ Elec~i~l Wi~i~ in ~n~it (Y~) ~a~ ~ .~essi~ ~nd ~l~ad (y~ ~ separation Distances f~cm Well.. To Septic/Holding Tank on Lot To Nearest Edge of Abscx~ption Field on Lot To Nearest Public Sewer Line ; On Adjoining Lots /~ . ; On Adjoining Lots~/.~;~.. To Nearest Public C leanout/Manhole Water Sample Collected By Water Sample Test B~sults Cce~ents ?~// ~~' /~'~. . To Nearest Se~er Service Line on Lot ~ SEPTIC/HOLDING TANK DATA Date Installed </~ 7~ Standpipes /~1) /~5 -'/ Depression ~ve~ Tank (Y~ .... Size /~ 3-0 No. of Cu,~a~tments ~L Air-tight Caps ~/N) /~J.. Foundation Cleanout~) A/ Date Last Pumped ,/~ & / ~ F 9" Pumping/Maintenance Contract on File (Y/~.; fo~ ~ Holding Tank High-Water Alarm (Y/N) ~-~ Tem[x~rary Holding Tank Permit Separation Distances f~cm Septic/Holding Tank: To Water-Supply W~ll /d~ · To Building Foundation /~ F / . To P~operty Line /~ · To Disposal Field ~- / To Water Main/Servi~e Line /DO ~ To Stream, Pond, Lake, c~ Major D~ainage Course /~ ~ [Page 1 of 2] 2-15-84 ABSORPTION FIELD DATA SOils ~ating in Absorption Strata Date Installed Width of Field ~ ~ ~ Type of System Design Length of Field . ~--~/ .$-g Depth of Field /// Gravel Bed Thickness 7 ! Square Feet of Absorption A~ea Dep~ession over Field (Y~ ~/~ --Date-of Last Adequacy Test. Results of Last Adequacy Test Separation Distance f~cm Absorption Field: To Water-Supply Well /~9~ To Building Foundation /~ *- To Existing or Abandoned System on Lot t ; On Adjoining Lots To Water Main/Se=vice Line /m~ ~ To Cutbank(if p~.esent) To Stream/Pond/Lake/or Major D~ainage Course To D~iveway, Pa~king A=ea, or Vehicle Storage A=ea Dat~ Installed Siz9 in Gallons "P~%-~ On" Level at High Wate= Alarm Level at Tested for Electrical Codas(Y/N) Commsnts Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles ~ing Adequacy Test. Meets MDA ** Check Pe~a-~[tted Bed=ocm Rating AgaiD~t HAA Bequest ** I certify that I }lave checked, verified, c= confcm~ed to all MOA HAA Guidelines in effect on the date of this inspection. ~ ____ " Signed~ ,,~,-. ...... ..; :. ~ ~"~ KB1/d5/s , g...ac..,,~,rvr.-.~'r=...; x, I / /I Joe Nielson 6036 Don Caster Drive Anchorage, AK 99502 Tobben Spurkland, P.E. 203 W 15th Ave "C" Suite 203 Anchorage, AK 99501 July l, 1984 WELL INSPECTION LEGAL: Lot 3A, Block 2, Eklutna Heights TYPE OF WELL: Private CASING ABOVE GROUND: 24" WIRES IN CONDUIT: Entire well head in conduit SEPARATION DISTANCES: 100+ to septic tank and trench SURFACE GRADING: Satisfactory LAB TEST: Satisfactory WELL STATIC LEVEL: Unknown WELL YIELD: 0.7 GPM for 13 hours DEPTH OF WELL: Unknown The sustained 4 hour yield of this well is adequate for the residence described on this date. Well pumped at 5 GPM for one hour at end of test period. MUNICIPALITY OF ANCHORAGE ' DMSXON OF fNVI~ HEALTH DEPARTMENT OF HEALTH AND f~rv-IRfINMENTAL PROTECTION APPLICATI.ON flgR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Leg.al Description (include lot, block, subdivision, section, township, range) Location (adck~ss or directions) (b) Applicants Nares O-oz. /I]I'F_/~n/ Appli Add~ess ~ -~.~ '~ ' '~ ' ~ cants - ~ ~ ~ ='= (c) Applicant is (c~ o~) ~ndi~ Institution Bu~ ~; ~he~ ~ (e~lain); (d) ~ndi~ Institution ~1~3~ ~~/ Ad~ess ~ ~ ~ ~6 ~ ~ ~ (e) Telephone 6 2. Type of Residence Single-Family ~ Number of Bedrooms 3, Water Supply Individual Well ~ C~,%unity ~-~ Public ~-~ Note: If c~unity w~ll system, must have written confirmation frc~ the State Department of Environmental Conservation attesting to the legality and status. Is the ~11 adequate for the number of bedrooms specified in this ~Y~N) / 4. Sewage Disposal. Onsite~ Public ~-~ Co.~nity ~-~ Holding Tank ~--~ / Is the wastewate~ disposal system adequate fc~ the number of bedrooms/Y/~) [Page 1 of 2] 2-15-84 5. Engineering Firm Providing Inspections~ Tests, Data and I oertify that I have checked, verified, c~ eonformed to all ~ HAA effect on the date of this inspection S igned~ Add~ess ~ ~ ~ Signed by Date Date Telephone 6. DHEP Approval Approved for Appro~d ~ Terms of Conditional Approval The Municipality of Anchorage Department of Health and Environmental P~otection dces not guarantee the continued satisfactory performance of the water supply and/c~ the wastewater disposal system. This approval indicates that, as of the validation date shown abo~, based o~ the data and infc~mation furnished by an engin~er ~egiste~ed in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bed~o~s and type of structure indicated. (D~EP SEAL) 7. Mail the HAA to the following add~ess: KB2/d5/s [Page 2 of 2] 2-15-84 ~ ~ DATE RECEIVED '' ':' INSPECTION APPOINTMENTS DATE DATE DATE INSPECTOR rNSPECTOR · INSPECTOR~ MUNICIP~LI~ OF ANCHORAGE . MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH  DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO~MENTAL PROT~CHON 825 L Street - Anchorage, Alaska 99501 (~) ENVIRONMENTAL SANITATION DlVISIONTelephone 264-4720 MAY S 9 1981 DIRECTIONS: Complete all parts on page 1. Incomplete requ~ will not be procemd. Please allow ten (10) days for processing. PROPERTY RESIDENT ('If different O~m ab~) ~ PHONE  ~ ~ PHONE 5. LEGAL BESCRIPTION STREET L~,~TI ON ~' 6. TYPE OF RESIDENCE [~]"-~1 NG LE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY I]~'"" INDIVI DuAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC uTI LITY NUMBER OF~BEDROOMS. [] One {~ Four. [] Two [~- Five [] Three [] Six [] Other * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: T~TION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 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 DRI [,.LED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] IN D IVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connectio~;.~/erified INSTALLER []Septic_Tank or [] Holding Tank ', ' Size: /~..~'0 If Tank is homemade SOILS RATING give dimensigns: TYPE OF TANK ' MANUFACTURER TOTAL ABSORPTION AREA ; MATERIAL Absorption Area. to nearest Lot Line 5. ~OM~ENTS I--I APPROVED FOR BEDROOMS [] COND!,TIONAL APPROVAL (letter must accompany certificate) ~D,[~'PP R OV E O DATE BY 72-010 (Rev. 6/79) REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES (Fill out in T~iplicate) ~ ~of perso~ requesting approval, ~ 0 ~ e O~ ~N, Number'of bedrooms in house , ~? , ,,. Water Analysis: a. Baetemial A/F ~ · · b. Detergent . S (3~. data: a. Type ~. ~epth ..... 13/ c. Casing Size Distance from well to closest existing or proposed: 1. Sewer line ,,, I 0 t~ · 2. Septic tank 3. Seepage Area ,.~00 Cesspool' / fro . 5. Property Line.~O0 . 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. . NQN~.. . 7. Sewage disposal system. b. Septic tank capacity in gallons Name of septic tank manufactu.~.$r ~5~o z~ 1. If "home made" show diagram on reverse side of this form. Ce Disposal field om seepafe pit size and type.. Distance to property llne, ~0© to house foundation~ ~ / BEFORE COLLECTING SAMPLE Verification: LTB BGB. Final Membrane Filter Results ~ Time: TNTC = Too Numerous To Count Collformll00ml Pomo -- SAN"'-"~Y PU,VPERS P.O~ BOX 772226 EAGLE RIVER, AK 995_~ 694-2408 Date ~ - '~ ~/19 ~:~'~' To ~ / . 8K 882 STATEMENT CHEMICAL & GEOLOGICAL 'LABORATORIES OF ALASKA, INC. ~ TELEPHONE.(g07) 562-2343 ANCHORAGE INDUSTRIAL CENTER 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: We~Name Mailing ~ddre~ I.D. NO. Phone No. City State Mo. Day Year SAMPLE TYPE: ~Routlne Check Sample (for routine sample with lab ref, no, [] Special Purpose Zip Code ) ~ T]eated Water ~tStreated Water SAMPLE NO. LOCATION , 1' I Time Collected Collected By TO BE COMPLETED BY LABORATORY satlysis shows this Water SAMPLE to be: isfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results, Please send new sample via special delivery mail. Oa,, Rec,lv,d /.- 7- Time Received //.~ Analytical Method: [] Fermentation Tube [~..Membrane Filter Lab Ref. No. Result* Analyst I ~ I rTq I ~ *No. of colomes/lO0 mi. or NO of Po$1hve portions 06-1220 (b) Rev. 1983 BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter. Direct Count Verification: LTB Final Membrane Filter Results TNTC = Too Numerous To Count BGB Date Time: Collformll00ml Collform/lO0ml 825 "L" STREET AI',,ICHORAGE, ALASI<A 99501 (,907) 264-411 t MA YOR f3EP/::F~'I' Mi:!'..q~ O1: ~:/'~ ..~,H AND EhZVIFtOklM{::N',r,&L PFfOT~iCTfON June 3~ 1.:981. Joe Nielsor~ Staz Route Box 987 Chugiak ~ Alaska 99567 Subject: Lot. 3A Block 2 Eklutna Heights Subdivision Approval for.' the individual sewer and water facilities cannot be, granted until tlhe following items have been compl, eted: (1) The water analysis report needs to be submitted to · ~ ~%~ 'E~{is office from the Chem Labr B ~ .6o3 B Street, ~/"" for our review. (2) The,s~.~...[rl-.j,~...,.. tank pumped with a receip-h submitted to this o:Efice,, (3) The depression over the sewer system needs to be filled in and reinspected when it has been completed. If there are a'~v 'f ~ ~'" ..u. L('te questions, please call this office at 2:]4-4720. S-[ncerely, RCP/ljw CC.: Alaska Stat-:ebank 3110 East Northern · .,:.:)ht~ Boulevard 99503 Audrey Mason % Totem Realty Post Off:ice Box 911 99577