HomeMy WebLinkAboutCOLONIAL PARK BLK 4 LT 15A
/~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMEN'rAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME 1P"ON.E I J NEW
MA,',NG yEss
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOM8
~ ~ DISTANCE TO:
~ Z Manufacturer Material No. of compartments
~ ~ Liq~;~ gallons IF HOMEMADE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well ~/ Dwelling PERMITNO.
O Z ~ Manufacturer/~ Material Liquid capacity in gallons
O Well ~l~ Foundation Nearest lot lin, PER~
Q
Length Width Depth PERMIT NO.
~ ~ Tg~e of crib Crib diameter Crib depth Total effectivo absomtion area
m Well ~ Building foundation Nearest lot line
~ DISTANCE TO:
~ Class~~ Depth, ~ z Driller Distance to lot line PERMIT NO.
~~~ ~ ~/7~
~ m DISTANCE TO: Building fou~ation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS / '~ ~ .~fl '~
SOIL TEST RATING .-
REMARKS
APPROVED S & ~: ~:',~(~ti~:i,~j~;~ D E LEGAL
72-013 (Rev. 3/78)
8 5 () :L 3'7
0 Zl. /:]!; () / 8 5
A F:' !:::' L.. I [;AI',IT:
A D .01:::4 [ii: S S:
CONTAC'I" PHOtxlEE:
L. tEGAJ .... DESCRIP:
L 0 T S I Z I'.':.:.::
MAX BIEDF;'.OOIdS:
GIBBS IEXC]
% S&S I'ZI',IG I NtEER I NG
E A G L E R I V I.::"' R :, A K 9 9 5'77
SUBD ! V I S I ON: COL..EP, I t AL !'":"'AI=::K
SE[]T'ION: '7 'T'OWNSHIF': :L4.1',I
117 19 (SG! ,, I::"'T ,, C. tR ACI::~["i;S )
3
I..;O'T': :1. 5 A B L 0 C K: 4
I::;: A Ix!G E :: 1 W
.Ol!!!]:::"l'"H 'l"C) F::'II:::'E :o[.)1 t JI, (I:::"T',,) 4,, 0 ../.I.,, 0
GI::;:AVIi.:.'].., DIEF:'TH (F:'T ,, ) 5 ,, 0 () ,, 5
'T'OTAI ....DIEF:'"I]"'I (F::'T.) 9., () 4 ,, .'.".5
GI"::.:AVEI .... WIDTH (F"T', ) ,='"',, 5 :Lg,, C:,
GRAVE'].:.. L. IENGTH (I"::'T,) 45 ,, 0 36,, ()
f .... )":r C:' "'"':::' ,q.
GF;'.AVEt ....VOI....UMIE: (..,U YDS )
TANK !ill I ZE (GAL..S) 1, OC)(),, () '~"~'~' ' .1. :, 00(),, () :.~'-~
SOIl .... RAT'INS (SQ, FT, /81"i'.) :LS() :1.5()
· ~"~. 'T'ANI< MUS'I" HAVE Al" LEAS'T' TWO C.r.:P'!F'ARTT'IENTS
I (::: e r 'L :i. f y t h a t: .,
1, I am Cam:i.l:i. ar' w:i.'Ll"~, th(.:.:.:, r'ec:tu:Lr'emer'~.ts 'For' on."."..~:i.t,:.:.:.: se~/,~er's and w(.:~)].:Ls as set
f(:)r"t.l"l by 'Lhe Munic:Li:)at:i.'Ly ,:::)F Anchor'age (MOA) .and 'l:.he S'La'l:.e c:)~' Al.aska.
2,, t w.:i. ll ins't:.al], the system :i.n ac:c:or'dar'~ce ~,,~:i.'Lh al.]. MOA cc)ties and r'egu:La't:.:i, cm~s,
and :Ln c:c)mp].:i, ance ~/,;i'Ll"~ 'l:.h,:~.:.:, des:i, gn cr':i, ter':La c:)F th:Ls per'm:i.t,,
3,, ~[ ~,,~i].]..adher'e 't:.o ali. !d(]A and S'I:.a'L(.:~.) o~' AlLaska r'(,:,:.)C~t..~:[PE.:~fYl({{.)r'~'(.~i~; '[c)r' th{E' S.,)~:'I:.. J::),:~.(:::l-::
d:i. star'~ces Fr'om any existing t.,¢ e :L ]. ', ¥,~as'Le~,x~ater d:Lsp,:::)sal system (:::,r' pub!:LC
se~,~,~.~r'ag,:.z.~ system on tl"~:Ls or' any adj;z~c:ent or' near'by lcd:..,,
3 I] ed r' oc:)m.~ ar'~ c:!
I urlc:ler'sT..ar')d that 'l:h.i.s l::)er'm:L't:. :i.'.:;~ va].:i.d
arly ,.'.:.:.!r'l].ar'gemer'lt w:i.:L], r'(.:.:,~CjLtJ, r".z.~ ar'~ .:':'..'u::Id:i. tic.~na], i:.~e:rm:i.'!:.,,
IF' A I....IF::T STA'I"ION Ic:''',.., IIqS"I"AI....L.I!'.!D 111!',t AN AF?.EA r-n~,='r.;,r::p..,,...,,,c.,.,:......, BY MOA BUII ........... DTIxG CODES,
I: ) ::7 ,." ¥ T *,, ('~ '" ..'P f"~'" T j"' x ..........
T'HI!!i:I',I (1) AN I'~!:I...EC'I"F;.'. ]i CAI_ !...F,,It..T AND 1111,1,.t~I ..... l.,....)l,l MUST BE: OF:'T'AINED: (2) A.S...'.BLiILTS
W]:I....I .... NO'I" BE APF:'I"iOVIED WITHOLVI" AN Ii:T.t..!::.iC'ltt'ICAL. INS!::'EEFI"];ON I,.,:.F JI,.l; AND {3) "f'HE
" ', -"
E1;.EC'i'RI,"2AI .... I/4LIF,,1... I1.J,,:~l bE::. D(..)N[.:.
APPL I CANT''
1 ,:.,,.:. U_ D B Y
.................................... )::) 1 I:=',:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
7
8
10
13
14
1§
17
18
2O
SLOPE
I~bert A. Shmfer
No. 1457-E
COMMENTS
PERFORMED BY:
72-OO8 (6/79)
....... .1. 9_X
PH.
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
S
L
0
P
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE f~////~ (minutes/inch)
TEST RUN BETWEEN FT AND FT
// '/
GRE^,, R ANCHORAGE AREA BORL, dGH
Department of Environmental Qualitv
3330 C Street
Anchorage, Alaska gg§03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME Bud Schulz
LOCATION Eagle River
MAILING ADDRESS Box ~L~X 931 PHONE
LEGAL DESCRIPTION Lo~O 15 A Colonial Park Subdivision
SEPTIC TANK:
DISTANCE
FROM WELL Public
INSIDE LENGTH 8
MANUFACTURER
INSIDE WIDTH
NUMBER OF
Greet MATERIAL Steel COMPARTMENTS 2
~ . . LIQUID DEPTH 4 LIQUID CAPACITY1000 GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL Public
FOUNDATION 9~l'
NEAREST LOT LINE 1'
TOTAL LENGTH
OF LINES
NUMBER OF LINES i
DISTANCE BETWEEN LINES .... TRENCH WIDTH _~6 IN. TOTAL EFFECTIVE
ABSORPTION AREA 504
DEPTH: TOP OF TILE TO FINISH GRADE
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
4' MATERIAL BENEATH TILE__
28'
' 6
9 m. A B~.,3~'~,,,,, .~ I N.
~ ' ,~ (~ ?,.~-¥F~ ~.~ .:.:'~ , .? %'.
~ ~% //~,c~n ~. ~ "7 ~ 7,7 ':¢ '
WELL:
TYPE Public
BUILDING
FOUNDATION__
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE__
REMARKS
SEPTIC
, TANK
DISTANCES:
~¢'~__~1.-i~' FIYe~ DIAGRAM OF SYSTEM
INSTALLED BY: Bud Schulz
SEWER LINE DEPTH: 4'
PIPE MATERIAL: Cast Iron
LOT SLOPE: Gentle
REMARKS:
DATE APPROVED
G.A.A.B.
Form EQ-O32
PERMIT NO.
I"IUN 1' C 1' 1:iL I' T'¥' OF RNCI' RRCIE
DEPRRTMENT ~,- HERLTH 8ND ENVIRONMENTRL . ~'OTECTION
2510 E. TUDOR RD. · RNCHORRGE~ RK, 9950?
276-2221
ON--S I mE SEWER PER~I I T
76i20 )
RPPLICRNT
LOCRTION
LEGRL
FOREHO~T SERVICES, 2523 BROOKWOOD
E.R. RD
Li58 B4 COLONIRL PRRK SUBD LOT SIZE
2?8-3644
ii?19 SQURRE FEET
TYPE OF SOIL flBSORBTION S~TEM IS: TRENCH
MRXIMUM NUMBER OF BEDROOMS
SOIL RflTING
THE REQUIRED SIZE OF THE SOIL RBSORPTION SVSTEM IS:
DEPTH= 12 LENGTH= i9 ~tRRVEL DEPTH= 8
THE LENGTH DIMENSION I$ THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF fl TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
REQU I RED SEPT I C TRNK S I ZE= 1000 C~RLLONS
BRCKFILLIN8 OF ~NV SVSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BV THIS
DEPRRTHENT WILL BE ~UBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL RND ANV ON-SITE SENRGE DI~POSRL SYSTEM IS
100 FEET FOR R PRIVRTE WELL OR 2~B FEET FOR R PUBLIC WELL.
SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER
INSTRLLRTION.
PERM I T ~/RL I D FOR ONE YERR FRO~I X SSUE
I CERTIF~ THRT
1: I RH FRHILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS fiND WELLS RS SET
FORTH BY THE MUNICIPRLIT¥ OF RNCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN RCCOR~RNCE WITHTHE CODES,
3: I UNDERSTRND-THRT THE ON-SITE SEWER SYSTEM MR¥ REQUIRE ENLRRGEMENT
RESIDENC~ODE~~~RE THRN3 BEDROOMS.
/ RPPLICRNT/ FOREROST SERVICES
ISSUED BYe: .... DRTE_ __~_~__ _~_:~?-~
IF THE
Per. formed For
Lenal ~es~ri~tion:
This Form Renorts Soils Lo~
"O.mtesllswo~:halhousa.dopi,ioms"
2204 Cleveland Anchorage, Alaska 99503'
Foremost Construction Date Performed 4/21/76 -
LOt 15A"BI"0ck 4 Subdivision Colonial Park Subd,, ~agle River
Percolation Test
.neoth
Feet
Topsoil Soil Characteristics
~e~sh Slit" ,
6 ,
Sandy Gravel
8--
( GW- GP )
12--
14--,
16~, ,
Bottom of testhole'
18_-No ground water or bedrock
encountered
Was Ground Water £ncountered?,
I¢ Yes, At what Depth?
Readinq Date Gross Time Net Time Depth to H20
Percolation Rate ~linute
Proposed Inst~'llatio~: Seenaoe Pit Drain Field
Deoth of Inlet Depth 'To Bottom Of Pit O~ 'Trench
C~M~ENTS:~et draina e area r '
Net Dron
CONSTRUCTION TEST
j'
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
.Location (site address or directions) 1 ?/~ 5'~._ I~1 ~:~'~ ~-- '~'
e
Property owner
Mailing address
Day phone
Lending agency ~o,,~,~.~dL..,~
Mailing address 1~'55
Agent _~u'~
Address
/~; ,/~--,~.~ Day phone ~'/0 -.~-.~/(. -~,~? ~'-
~ ~ Day phone
Unless otherwise requested,/-/AA will be held for pickup.
NUMBER OF BEDROOMS: .~
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. 1191) Front MOA #21
')~JOM s?eeu!§ue leUO!SSeloJd eql u! SUO!SS!LUO JO SJoJJe Joi elq!suodseJ
iou s! e§eJoqou¥ jo /q!led!o!unlAl eq.L 'penss! s! ejeoU!lJeo e eJo,~eq eJeP ez/~leU~ Jo suo!loedsu! lonpuoo
lou op SHHC] ,~o see~OldLU~ 'slueLueJ!nbeJ elels pu~ I~Jepe~ u!mJeo/ys!les ol JepJo u! suo!lnl!lsu! ~u!puel J!eql pu~
SeLuoq ~O sJeseqoJnd ol XselJ noo e se s!ql seop SHHC] eq.L '~lS~l¥ to e~lS eql u! peJels!lSeJ Jeeu!§ue I~UO!SSeloJd
luepuedepu! u~ ,{q eAoq~ g qd~J§~J~d u! ue^!§ suo!l~lueseJdeJ eql uodn ~lUO pe~q ~ei~OU!lJeO I~^oJddv
~1poqlnv q~l~eH senss! (SHHa) seo!AJeS U~LunH pue qll~eH jo 1UeLUlJedeQ elS~Joqouv jo Xl!l~d!o!unlAI eq.l.
SlUeLUUJOO leUO!~!PPV
:suo!lelnd!ls §U!MOIIO,[ eq~, 41!~ 'swooJpeq
Joj leAoJdde I~UO!l!puoo
'pe^oJddes)a
'SLUOOJpeq ~ JOJ pe^oJddv ~
3~lnmyN~lS SHHa
'9
tlg:aNION3 AEI NOII::):adSNI dO .I. N3iN31VJ. S 'g
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type ~-~-/,~ ~,. If A, B, or C, attach ADEC letter.
Log present (Y/N) Date completed
Total depth Cased to
Sanitary seal (Y/N)
Parcel I.D. 05El -
ADEC water system number
Driller
Casing height
Wires properly protected (Y/N)
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
g.p.m.
AT INSPECTION
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
g.p.m.
'.:;,C T ? ') 1992
RECEIVED
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform
Nitrate Other bacteria
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanouts (Y/N) 7
High water alarm (Y/N)
Date of pumping
Tank size l ~ Compartments
Foundation cleanout (Y/N) ,y Depression' (Y/N)
~//'~ Alarm tested (Y/N) ~//'/~"
Pumper S ~_ ,/.' ~ v"~ ""~ P'~' ~$
f /
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot t,'-[//..~ On adjacent lots
To property line '~ ~O Absorption field
Surface water/drainage ~/~;~
Foundation
Water main/service line
72-026 (Rev, 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
"Pump on" level at
High water alarm level
Meets MOA electrical codes (Y/N)
Manufacturer
Manhole/Access (Y/N)
'~" "Pump off" level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed /'~'A]/~
Length ~ "7 Width
Total absorption area
Depression over field (Y/N)
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
I!
47o
Soil rating / ~-~ System type -~!
Gravel thickness ~,C~ t! .Total depth ~ I
Cleanouts present (Y/N)
Date of adequacy test lO/l&/~
for ,-~ bedrooms
N If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
To building foundation
On adjacent lots ~' .~O
Surface water 1~o !~_ L
Curtain drain I~/0
On adjacent lots ~../Z~. Property line
To existing or abandoned system on lot
Cutbank ~o vl e Water main/serviceline
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
HAA Fee $ / ~,~ o~
Date of Payment /~-~/~ '~ ;2.
Receipt Number c~-5//~ ~, (' V'5''~--~ .)
Waiver Fee: $
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
WALTER J. HICKEL, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3-470
ANCHORAGE, ALASKA 99515
October 21, 1992
Mr. Tobben Spurkland
SUBJECT:
Colonial Park Subdivision
Class "A" Public Water System, PWSID 211562
Dear Mr. Spurkland:
(907) 349~7755
RECEIVED
NOV 199P.
O Muni¢~pah~Y ot
ept/'fo ~k o Anch_ora e
a,,,, ~ HUman SetScrew.
I have completed a review of this office's files concerning the monitoring status of the
above-referenced Class "A" Public Water System and found the following:
The last satisfactory Total Coliform Bacteria Sample results was submitted
to this Department on September 11, 1992. This does meet the provisions
of 18 AAC 80.200(a), of the State Drinking Water Regulations.
The last inorganic Chemical Contaminants Sample results were submitted
to this Department on December 18, 1991. This does meet the provisions
of 18 AAC 80.200(a), of the State Drinking Water Regulations.
The last Radioactive Contaminants Sample results were submitted to the
Department on February 10, 1992. This does meet the provisions of 18
AAC 80.200(a), State Drinking Water Regulations.
The last Organic Chemical Contaminants/Volatile Organic Chemicals were
submitted to this Department on June 8, 1992. This does meet the
provisions of 18 AAC 80.200(a), State Drinking Water Regulations.
Issuance of this letter does not imply that the above-referenced Class "A" Public Water
System is in compliance with other provisions of the State Drinking Regulations.
If you have any questions on the above information, please do not hesitate to contact this
office at 349-7755.
Sincerely,
Michael Lu
Environmental Eng. Asst. II
ML/pf
2X2 sa~t Zn~r~w~Aonal AArport Road
Anedao~age, Alaska 99S02
oon~e~ng b above nuntAoue4 loto.
The on-~ett~ ..~m~, pmL~Uit j76120, 76121
c~n~e~ and declared null and voAd bM ~Ad de,all, mint
on ,Tuly 23, 1976.
~oseph S. ]31a~r,
ONTRACTING . N-' i ERS &
212 E. INTEI~C, TIONAL All, PORT ROAD
, AN Cl~ll~,6 E, ALASKAI99502
August 16, 1976
Municipality of Anchorage
Department of Health and Environmental Protection
2510 East Tudor Road
Anchorage, Alask~ 99507
RE: Lots 15&, 16A & 17A, Block 4
Colonial Park Subdivision
Gentlemen,
This is to certify that we have inspected the septic tank and soil
absorption systems on Lots l~&, 16~ & 17A, Block 4 of Colonial Park
Subdivision and find them to be in compliance with the code and the
'on-site sewer permits. (Permit.No.'s 76120, 76121 & 76122.)
These lots.have good gravel soils with a high percolation rate and
the sewage disposal facilities have been installed in a good quality
of workmanship.
It is our belief that each system will perform very well because the
soils are ideally suited to on-site sewace disposal.
Please call me if further information is required.