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Home My WebLink AboutBIRCH TREE ESTATES BLK 1 LT 13 GRE' 'ER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS -~./-/ ~/~/~".~ LEGAL DESCRIPTION ~_.L..~_.~'~ ~_~ SEPTIC TANK: DISTANCE/~z//~'.-~'Z.~/ FROM WELL//)~'~ ,MANUFACTURER /~'~.__.~-- NUMBER OF MATERIAL C~)/v/~-, COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH __ '-- .LIQUID CAPACITY///~'~[2_/) GALLONS. SEEPAGE PIT: / NUMBER OF PITS // DIAMETER ~ OR WIDTH /'.~, LENGTH///~, DEPTH LINING MATERIAL~--¢~~ CRIB SIZE: DIAMETER ~ DEPTH ~' DISTANCE FROM: WELL '/'~-~-=", . ,/ TOTAL EFFECTIVE BUILDING FOUNDATION ~//'~ NEAREST LOT LINF-_~2~::2 / , ABSORPTION AREA (WALL AREA) -~'~ , SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE .///(~/~///'/'-~J-~'~- CONSTRUCTION .~¢~'"/-~/~'--~' DEPTH //~/"~/ /'~-./'~.]' . DISTANCE FROM: BUILDING .~ ,' NEAREST ~_. NEAREST SEPTtC~ / SEEPAGE//..:2/~ / FOUNDATION~'~'~/ , LOT LINE //~/2, SEWER LINE-~.~'' ~, TANK /'~/-~, .SYSTEM CESSPOOL..,"~.~/~/~-'~;-, OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES:-/~-- :.~ /~,,~ ' ,,~ z-~ C~- .,,~'.¢--'.,.~.~.~./~/.' INSTALLED BY: ~ ~/g/~ . PIPE MATERIAL: ~ LOT SLOPE: REMA R KS: ./~/:~- ~~" Form No, EQ-031 DIAGRAM OF SYSTEM APPROVED G.A,A,B. DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456! SEWAGE DISPOSAL SYSTEM ,, , APPLICATION AND PERMIT PERMIT NO, PHONE INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD OTHER FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS /~ /~/~ ~~ NOTE= THIS PERMIT IS NOT VALID WITHOUT ~lL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. TYPE _~C'f~ ~----~ MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK "~/ FOUNDATION TO SEEPAGE PiT ~'~'~K--~ SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ~ / , SEEPAGE PiT SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM TO NEAREST LOT LINE. WELL TO SEPTIC TANK J~'~) . SEEPAGE PIT DRAIN FIELD J~:~-~ / · ALSO CONSIDER AREA WELLS. WATER MA,N TO SEPT,C TANK /O ' · SEEPAGE PIT /~' DRAIN FIELD /~ SEPTIC TANK, ~ / TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOLE. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEl. BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G .A .A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE AB~OVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. FORM NO. EQ-01 6 GRr~TER ANCHORAGE AREA BOROUGH Dep~l ent of Environmemtal Quality 3330 "C" Street Anchorage, Alaska 99503 o~,,,,,"i,rr,,:4, .., .. ~ ... for Mr. Leonard Wa~er Date performed De.,scription: Lot 13 Block 1, ~ Estate6 form ~ '* ' ~/~~ ~a. tion test .... po~ .s. Soils log ~ ~ Nay 6, 197,4 Depth ",j' .................... 2 - Gm Sand Gravel 88-~ilt Olay ~Eilt Well graded gravel t ~and mm Gm Sand Grave~ ~ ~ilt Was ground water encountered? Nil If yes, at what depth? Date Gross Time Net Time Depth to H20 !,!et %n ~m mmmnt~mm, you shou],d ba~l o= ohlor~na~~tr ware=before using. 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.# EJ~-"I-'~L\\-,-~--,~-' LL~) 1. GENERAL INFORMATION Complete legal description Lot 13, CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Haa # ~ ~2~o~ .~(__~ r~.Z~ Block 1,-~Est,, T12N R3W Sec. 34 Locati,on (site address or directions) 5045 E. 145th Ave. .Anchorage ~. Property"Owner Mailing address · Lending agency National 9az~ of Alaska Day phone .contact person: Mar'.~ Pippin Ma!ling address 1500 ~,7 Benson Blvd;'~Ar~nhnr~P AN qqsoq Ageni Crawford Real Estate (contact:Doug Schmedler) Day phone Address 3380 c Street, Suite 110, Anchoraqe, AK 99503 Mr':,· Bruce Palmer Day phone (509)455-7479 · 3629 West Indian Trail Road, Spokane, W~ 99208 257-3094 562-5592 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 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. 4. TYPE OFWASTEWATER DISPOSAL: Individual on-site x 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 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that'my investigation of this Health Authority Approval application 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 inspection. Name of Firm Environmenta~ ~qement, Inc. //// Address 907 E. DowlinqA,/~e 21, 'Anchorage, Engineer's sig n~~.,~,-.-~-,--~ Phone (907) 562-2580 99518 Date ,//~- / ~- ~ DHHS SIGNATURE ~'"'" Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze, data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev, I/91) Back MOA~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 13, Block if T12N R3W Sec. 34 A. Well Data Birchtree Est. Parcel I.D. Well type Private Log present (Y/N) N Total depth 116 ft. Sanitary seal (Y/N) Y If A, B, or C, attach ADEC letter. ADEC water system number Date completed Un]~ow~ Driller Unk~ow~ Cased to 40+ft. Casing height 2 ft. Wires properly protected (Y/N) y 6 in frc~ G.L. FROM WELL LOG Date of test Static Water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot. 104 F~. Absorption field on lot 13Q, ft. Public sewer main N/A. Sewer service line N/A. AT INSPECTION 10-7-93 97 ft. from top of casing g.p.m. 4 g.p.m. ; On adjacent lots 300+ ft. ; On adjacent lots Public sewer manhole/cleanout N/A, Petroleum tank rtl WATER SAMPLE RESULTS: 0 /100 mi Coliform Date of sample: 3_0-7-93 Nitrate .10 mg/L Collected by: Other bacteria D. Neogi B. SEPTIC/HOLDING TANK DATA Date installed 9/~74 .~ Cleanouts (Y/N) y' High water alarm (Y/N) N Date of pumping 10-18-93 Tank size !QOD. Ga,~., Compartments Foundation cleanout (Y/N) N (~?a Depression (Y/N) Pumper Roto Rooter SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ] n~ ~+ On adjacent lots To property line '1 O+, Ft,~ Absorption field 26. ,,:Ft,, Surface wateddrainage None obs~rv~ Foundation 4R Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed f~ Size in gallons Vent (Y/N) High water alarm level On adjacent lots N/A "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Total absorption area Date of adequacy test Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water Date installed 9/74 Soil rating (GPD/Ft2) 85 sq ft~ec~o(:~System type CRIB Length 14 ft. Width 14 f~-_, Gravel thickness 6 f~-. Total depth 'In ~=~-; 336 sq ft. Cleanout present (Y/N) Y Depression over field (Y/N) N 10/7/93 Results (pass/fail) Pass for 3 Bedrooms Water level in absorption field before test 5 ft. 2 in from ]:x:)ttc~ After test 5 ft. 2 in. from bottom Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 130 ft. On adjacent lots 100+ Et. Property line 20 ft. To building foundation 74 ft. To existing or abandoned system on lot N/A On adjacent lots 20+ ft. Cutbank N/A Water main/service line N/A Surface water 100+ ft. Curtain drain N/A Driveway, parking/vehicle storage area 24 ft. E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conform_ed to all MOA and HAA guidelines in eff~ ~f. this inspection. SignatureEngineer'~e, x, _~.~/') ,,'~" HAA Fee $ Waiver Fee $ Date of Payment Receipt Number Date of Payment Receipt Number 72-026 (3/93)* Back COMMERCIAL. TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES Chemlab Ref,~ :93.5348-1 Client Sample ID :5045 E. 145TH AVE Matrix :WATER REPORT of ANALYSIS 5633 B STREET ANCHORAGE. AK 99518 TEL: {907l 562-2343 FAX' 1'907] 561.5301 Client Name :ENVIRONMENTAL MGMT INC (EMI) Ordered By :DHRUBA NEOGI Project Name : ProJect~ PWSID :UA Sample Remarks: ROUTINE SAMPLE COLLECTED BY: DHRUBA NEOGI. WORK Order :71894 Report Completed :10/i3/93 Collected :10/07/93 @ 09:10 hrs. Received :10/07/93 @ 16:40 hrs. Technical Director :S~. 9~ Released By : / QC Parameter Results Oual units Allowable Ext, Anal Method Limits Date Date Init Nitrate. N 0.10 U mg/L EPA 353.2/300.0 10 10/08 CMR * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than ENVIRONMEHTAL SERVICES IN ALASKA, COLORADO, UTAH, ILI..INOIS, OHIO. MARYLAND, WEST VIRGINIA, NEW ,JERSEY, SOUTH CAROLINA