HomeMy WebLinkAboutFINLEY LT 2Findley
Lot 2
#015-112-45
—
MUNICIPALITY OF ANCHORAGE
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
S+QUP-h
�1p%„t
PHONE
�_(
XNEW
1 11 UPGRADE
MAILING ADDRESS
11 `134o No II lo198
LEGAL DESCRIPTION
L
i 610 k ( F� Ir 5j,1
i,. a/vj,f,6,
LOCATION �-
FI
��r-i
NO. OF BEDROOMS 4
I(�
tt. '1i t
O Y
DISTANCE TO:
Well
bsorption area
Dwelling `�
IVQ•� i
PERMIT NO.84 I] 4
"r �'1 V
Q
Manufacturer
Greg
Material �e /Q
No. of compartments AD
W t
f
z
rn
Liq. rapacity in gallons
1Z U
1 IF HOMEMADE:
Inside length
Width
Liquid depth
DMZ
DISTANCE TO:
Well
Dwelling
PERMIT NO.
SF
Manufacturer
4, ILOV
Material
Liquid capacity in gallons
W =
DISTANCE TO:
Well,/ 1
�FJJ�� Nq
Foundation 1
Nearest lot line
20 44
PERMIT NO.
6401 CI6
J u- Z
Z w
No. of lines
Length of each line
Total len th of I'n s
Trench idth
Distance between lines
F
O O
inches
cc F
Top of tile to finish grade r1
3r
Material beneath tile ,�//
Total effective sorption Aga
Lr
0
Y T
y.� inches1,5_2
�.�
W
Length
Width
Depth
PERMIT NO.
(7
a a
W
Type of crib
Crib diameter
Crib depth
Total effective absorption area
LU
y
DISTANCE TO:
Well
Building foundation
Nearest lot line
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
;t
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption areals)
OTHER
�
PIPE MATERIALS
pvL
1
SOILTEST RATING
Sed- 5,005
286 ff"IlUroomi
367, ad' 6,
INSTALLER
(�
�A /' // r t Q
Aqti /"far GnStruC. b� EX 64-069
co +
REMARKS
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U WZU Jj54AL)e.
INVNV
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-toti
APPROVED
DATE LEGAL
104 Z gAck
r;v\ 147 SKS ,��
s—Z -L
/2-U13 (Hev. 3/ /61
4
RETURN TO: Division of Geological and i yslcal Surveys (DGGS) STATE OF ALASKA
3001 Porcupine Drive (Telephone: 2776615) DEPARTMENT OF NATURAL RESOURCES
Anchorage, Alaska 99501
W A T E R W E L L R E C O R D
Drilling Company Name U.S.G.S. Local No.
Drilling Permit No.
LOCATION OF WELL Please complete either la, ib, or Ic. A.D.L. No.
Ia. Borough Subdivision Lot Block lb. Fraction Section No. Township Range Meridian
N/S E/W
lc. Distance and Direction from Road Intersections 3. OWNER OF WELL:
Address:
Street Address and Area of Well Location
2. WELL LOG Feet Below 4. WELL DEPTH: (completed) Surface Elevation Date of
Surface completion
Material Type Top Bottom ft.
5, ❑ Cable tool []Rotary ❑ Driven ❑ Dug
❑ Auger ❑ Jetted ❑ Bored ❑ Other:
6. USE: ❑ Domestic []Public Supply ❑ Industry
❑ Irrigation ❑ Recharge ❑ Commercial
[]Test Well ❑ Other:
7. CASING: ❑ Threaded ❑ Welded
In. to ft. Depth Weight lbs/ft.
in. to ft. Depth
8. FINISH OF WELL:
Type; Diameter:
Slot/Mesh Size: Length:
Set between ft. and ft.
Fittings:
9, STATIC WATER LEVEL: ft.
❑ Above ❑Below land surface
Type of Measurement:
10. PUMPING LEVEL below land surface
ft. after hrs. pumping 9 -13 -m -
ft. after hrs. pumping g.P.m•
11. WELL HEAD COMPLETION: ❑ In Approved Pit
❑ Pltless Adapter Inches above grade
12. GROUTING: Well Grouted: ❑ Yes ❑ No
MUNIC &-woRAGF Material: ❑ Neat Cement ❑ Other:
PR TELT 13. PUMP: (If available) HP
Length of Drop Pipe ft. capacity 9-P-11
SEPn4 1 Type: ❑ Submers lb le ❑ Reciprocating
❑ Jet ❑ Other:
14. REMARKS:
15. WATER WELL CONTRACTOR'S CERTIFICATION:
This well was drilled under my jurisdiction and this report Is true to the best of my knowledge and belief:
Registered Business Name Contract License Number
Address:
Signed: %- I i Date: r �i
Authorized Representative
Form 02-WWR Copy Distribution: WHITE - State DGGS, PINK - Driller, CANARY - Customer
,
Ilk 1111,4 1 C:: .F I ''IF F- ������Fl EE
DEPHRTMENT HEHLTH AND ENYIRONMENTHL :OTECTION
825 L STREET, ANCHORAGE, HK 99501
264-4720
11 u 0-4 ..... ���� ����� � ���� ���M 1 'T_
PERMIT NO:
DATE ISSUED
APPLICANT
ADDF.'ESS:
CONTACT PHONE
LEGAL DESCRIP
LOT SIZE:
MFG,.' BEDROOMS
840198
04/17/84
STEVEN R��f�M�^
�
11840 HILLTOP SRA 1�uB
HNCHORHGE, :4,-���
561~2]66
SUBDIVISION� FINLEY
SECTION15 TOWNSHIP: 12N
1.12H(SQ. FT. OR ACRES)
4
LOT: 2, BLOCK: 1
RANGE: ]W
LISTED BELOW HRE THE OPTIONS HVHILHBLE TO YOU IN DESIGNING YOUR
SEPTIC
SYSTEM. CHOOSE OPTION THHT BEST FITS Y01JR SITE.
�..... .... ... ..... ..... ��... ..... �.... �... ... �����������������������
7- E111-4 C: 11-A E". EE.- E> 1-11.
EZ"F?.Fl IE 1174
ClEPTH TO PIPE BOTTOM (FT. ) 4.0 4.0
4.0
GRHVEL DEPTH (FT. 57' 0. 5
2. 5
TOTAL DEPTH (FT. ) 7.5 4.5
6.5
GRAVEL WIDTH (�T. ) 2.5 29.0
5.0
GRAVEL LENGTH (FT. 0 ** 56.0
162.0 **
GRAVEL VOYDS) 67.4 60.1
90.0
TANK SIZE (GHLS) I... 2r- 0 *:1,1/250. 0 ** 1,250.
0 **
�OIL F;.lATING (SQ.FT. /BR) ]18 267
/
]18
** GRHVEL LENGTH } 75 FT, REQUIRES MULTIPLE RUNS (NOT EXCEEDING
75 FT. EACH'
** TANK MUST HAVE HT LEAST TWO COMPHRTMENTS
... .... ..... .... ..... �..... ..... ..... ... ����.... .... �..... ����������������������
I CERT�FY THHT�
J.. .1 HM FHMILIHR WITH THE REQUIREMENTS FOR SEWERS AND
WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOH) AND THE -STATE
OF ALAS[ -."'A.
2 I WILL INSTALL THE SYSTEM IN HCCORDHNCE WITH HLL MOH CODES
HND/REGULHTIONS/
AND IN COMPLIHNCE WITH THE DESIGN CRITERIA OF THIS PERMIT.
] I WILL HDHERE TO HLL MOH AND STHTE OF HLHSKH REQUIREMENTS
FOR THE SET BHCK
DISTHNCES FROM ANY EXISTING WELL, WASTEWATER DISPOSAL SYSTEM
OR PUBLIC
SEWERHGE SYSTEM ON THIS OR ANY HDJHCENT OR NEARBY LOT.
4. I UNDERSTHND THAT THIS PERMIT IS VALID FOR H MHXIMUM OF 4
BEDROOMS AND
ANY ENLARGEMENT WILL REQUIRE AN HDDITIONHL PERMIT.
IF H LIFT STATION IS INSTALLED IN HN AREA COVERED BY MOH BUILDING CODES,
THEN (1) AN El ECTRICHL PERUIT AND INSPECTION MUST BE OBTHINED/ (2) HS--BUILTS
WILL NOT BE HPPROVED WITHOUT HN ELECTRICAL INSPECTION REPORT/ HND (]) THE
ELECTRICHL WORK MUST BE DONE BY H LICENSED ELECTRICIAN.
SIGNED ��� DHTE�
�����x�,-��._-���^��^`��.~�_�_�_____�_
- - r
HPPLICHNT ST
ISSUED B DATE:
-.... .... .... .... .... ~�-~ ---T�r---�r
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL i ROTECTIONII PERCOLATION
ST
625 L. Street, Anchorage, Alaska 99501 264-4?20
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: b/AMFrlr FjA2.dy DATE PERFORMED:
LEGAL DESCRIPTION: GOYi L 0i /y- SEC . /� U01 A r1Z&9j' SUBD/V/S/OJV 1
DEPTH SLOPE SITEPLAN
(FEET) TO PSa/L ��—� i I --�—�I
1
2-
3
4 bM
5-
6-
7 67 G.
9
10 jM
11
12
it
Fi, it tmom To r tkyl
su Ty S ANor 6RAve-L
W/ SAaD 'wimses,
MDIs f0 peKj�';
7
F2, 111`141 6RAv4-c.y s/try
S4N0, moss I i7dnsc
13 Y&e1 di
14 M1 Piz co-owe'sb
15-
16-
17-
18-
19-
20-
51s1B 20 �� �0_ ' 4 Melvin R. Nichols
It, No 4113E
COMMENTS BBC�ar 'Ti•�Rs Al
PERFORMED BY:
^A5911 TMIL446
72.008 (6/79)
WAS GROUND WATER S
ENCOUNTERED? No L
O
P
IF YES, AT WHAT E
DEPTH?
0
Reading
Date
Gross
Net
Depth to
Net
Time
Time
Water
Drop
"V-72
11:07
74/4. „
Z
//:37
30
r1w
3
M
w
t
33
:36
A
N
r
G
yr o
PERCOLATION RATE 367
TEST RUN BETWEEN FT AND _•.
CERTIFIED B
�.,........;. RIS► ��
�9+1
SIM*
j
W SOILS LOG
MUNICIPALITY OF ANCHORAGE
PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
' 025 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR:%A/�te5— f.L/_y��. y DATE PERFORMED:
LEGAL DESCRIPTION: G�Oy1,- L.lj1_/y_- -5ein . /% (407- a it /&Lg S91 PlYI
DEPTH 1 SLOPE SITE PLAN
(FEET) lOPSOIG
1
2
3
4-
5-
6-
7 567
8
9
10-
11
0 11
12
-r
Fit 8,c0wm Tn 4.(4y
511Ty s /}nlpy ae vdm
W1 sAND Lemscs•
01401.$ 10 1pehrst
A0..c, q►.cn At;
0
F2, G441 GRAvB�,4V 5/1,7y
54,v 0, 7410is 1, O�nst
t3 qa^d du
y�
14 77;1 Piz CoAPI. EYLb
15
17
18
19
20
We f,//
COM M E N T S _-Liax-,L
PERFORMED BY:
ii�/35Ky 72�1L/'i8
72-008 (6/19)
WAS GROUND WATER S
ENCOUNTERED? NO L
0
P
IF YES, AT WHAT E
DEPTH?
r
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
7yYy"
2
d:J7
30
3
I
%
At
�l
14 :io
Imo,
PERCOLATION RATE •S
TEST RUN BETWEEN FT AND s�L�
CERTIFIED BY:
I�tjn• � •�%fiy1)
49L ;
viLJf ��•.y.w►""-
' 4
w,
00 No. I
y�nolvicLa. _nlichola—� ,,..
r
L A0
Aw
"Ql8 •.••.• ••' �. w
1
.J
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date/8 4 __
(a) Legal Description (include lot, block, subdivision, section, township, range)
1 o i 2_ ami r` EA)i r y _1U -ry 2
Location (address or directions)
FI'A)LrY S'T 01E l�/�C-45
(b) Applicants Name.STE)L Curt, d Telephone - Home,3fi4._7ZjjBusinesss;kt::: 366
Applicants AddressI),L[ rox) .59 A,ucii /IA -
(c)
(c) Applic�is (cheek one) Lending Institution
Buyer ; Other [� (explain);
Owner/builder ;
(d) Lending Institution Telephone
Address
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
_ ✓(� /1�• 1 /il iii
Gu
2. Type of Residence
Single -Family Multi -Family
Number of Bedrooms q-
3. Water Supply
Individual Well �z Community =
Other (describe
Public =
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite � Public Community Holding Tank
Note: If community well system, must have written confirmation from the State
"e Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 21
a
Firm Providing Inspections, Tests, File Search, Data and Informa,
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 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 regula-
tions in effect on the date of this inspection.
i
Name of Firm (f s /,.V cL_
Address
Date
6. DHEP Approval
.1d
(ENGINEER
Approved for bedrooms
Approved Disapproved
Terms of Conditional Approval
CAUTION
Telephone SW / �-4-o4o
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2] 7-19-84
OF
MUNICIPALITY OF ANCHORAGE
DEPT. OF HMU111 &
ENVIRONMENTALLNi�IeCFION
MUNICIPALITY OF ANCHORAGE (MOA) NOV 11984
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984 RECEIVED
Legal Description: L o 't Z d no
A. WELL DATA _ i` 11.1v4ey Shin TIaPi ftJW See.IS _
Well Classification PRIVAtF If A, B, or C, D.E.C. Approved(Y/N) A) t-4
Well Log Present t jDN) Date Completed d/Za/g9 Yield GpA
Total Depth /80, Cased to /8o' Depth of Grouting Li/VK,vow u
Static Water Level J $ 21 Pump Set At 1-7'1
Casing Height Above Ground Z.1 Sanitary Seal on Casing Ml)
Electrical Wiring in Conduit 6h) Depression Around Wbllhead (Y/J,)
Separation Distances from Wbll:
To Septic/Holding Tank on Lot ,) 100, y. � On Adjoining Lots
To Nearest Edge of Absorption Field on Lot Jpg �,� ; On Adjoining Lots >1 O t/ 14)
To Nearest Public Sewer Line �JL/1 To Nearest Public Sewer
Cleancut/Manhole .4,, It -1 To Nearest Sewer Service Line on Lot Zz q
Water Sample Collected By _ ; Date 1111WAI 41
Water Sample Test Results
- -
Ccmngnts Pee %= is J.i PB.0 Fidtn N16AlsvQd��i, - �'�l�wninr �C�EI
W1 N let.
B. SEPTIC/HOLDING TANK DATA
Date Installed 2 Z 9eq Size J,2 _SO No. of Compartments 2
Standpipes (k) Air -tight Caps 0A) Foundation Cleanout ft)
Depression over Tank (Y Date Last Pumped �,//1,--A
Pumping/Maintenanos Contract on File (Y/N) ; for _ ter, //-
Holding Tank High -Water Alarm (YM) Adla Temporary Holding Tank Permit (YM)
Separation Distances from Septic/Holding Tank:
To Water -Supply Nbll L00,4 To Building Foundation
To Property Line To Disposal Field 7
To Water Main/Service Line _ 4_/ f1,4 To Stream, Pond, Lake, or Major Drainage
Course it-) ),-a --r�
Comments p/r.P-rA590;4T loll&n AlkAgaregiyur
Receipt # dq6
Date Paid: -
Amount: cam_
(Page 1 of 21
2-15-84
L 2 �IfV/_y S/v
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Type of System Design I -NE /c 14
Date Installed S/z Length of Field Igoe
Width of Field 3' Depth of Field 7.$'
Gravel Bed Thickness 4-1
Square Feet of Absorption Area /5 zo o I, Standpipes Present
Depression over Field (Y/ep Date of Last Adequacy Test
Results of Last Adequacy Test 61",/ -1
Separation Distance from Absorption Field:
To Water -Supply M11 1) 109 To Property Line 20'
To Building Foundation 1.1 3 Ll- To Existing or Abandoned System on
Lot AJIy) On Adjoining Lots 30'
To Water Main/Service Line ^Al%g To Cutbank(if present) A/�11
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area��—
ComTents pQP /!S/3�i iT 1) PERltia M&AeSy/td9AlfgU _
D. LIFT STATION
Date Installed Dnsions
Size in Gallons Manhole cess (Y/N)
"Pump On" Level at ' Off" Level at
High Water Alarm Level at Vent (YIN)
rested for Pumping Cycles ing Adequacy Test. Meets MDA
Electrical Codes(Y/N
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conforrred to all MOA HAA Guidelines in effect
on the date of this inspection.
--
"IV;;
A`,'4s�
Signed w Date
�.......
�Qw�.QF
Il8
Compan CG �,Ou C, MOA No. ST$it. -0E-4
see
......
cn : le y C. Reid, Jr.,,:.
o. 2251•E s.•�c.s
[Page 2 of 21
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2-15-84