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Home My WebLink AboutALPINE WOODS BLK 2 LT 5 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION i ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage. Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT 1PHONE I I~]NEW MAILING ADDRESS LEGAL DESCRIPTION IWell I Absorption area /3/ Dwelling PERMITNO. ~ ~ DISTANCE TO: no ~ t t ' ~0 / Z Manufacturer Material No, of compartments Liq. capacity in gallons Inside length Width Liquid depth I /~O IF HOME. DE: ~ -- ~ Manufacturer Material Liquid capacity in gallons Well Foundation Nearest lot Hne ~= DISTANCE TO: ~ ~4~// ~_1 / PERMIT NO, ~ ~--~ Length of each line Total length of lines Trench width Distance between lines ~Z~ N°'°flines / Z Z ~Z ~Z inches ~ ~ ~ Top of tile to finish grade / Material beneath tile Total effective absorption area /" Q inches ~ ~ ~ ' Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Cla[s~.~ O ~/~ Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER ~ PIPE MATERIALS REMARKS ~ ~' ~ 72-013 (Rev. 3/78) HUN [ C I F'~L_ I TY OF' DEPARTMENT~OF HEALTH AND ENVIRONMENTAL PROTECTION 82~ L STREET, ANCHORAGE, AK 99501 264-4720 ON,--SITE SEWER PERMIT PERMIT NO: DATE ISSUED: 840624 07/26/84 APPLICANT: ADDRESS: CONTACT PHONE: LEGAL DESCRIP: LOT SIZE: MAX BEDROOMS: BOLIN CONST. 110 1 E. 76 ANCHORAGE, AK 99502 349-6681 SUBDIVISION: ALPINE WOODS SECTION:~.~.°~ TOWNSHIP: 37119 (SQ.FT. OR ACRES) 4 LOT:~z: 12N RANGE: 5W BLOCK-.] LiSted below are the options available to you in designing your septic system. Choose the option that best fits your site. TRE~CI-~ E~ED W. DRAIN DEPTH TO PIPE BOTTOM (FT.) GRAVEL DEPTH (FT.) TOTAL DEPTH(FT.) GRAVEL WIDTH (FT.) GRAVEL LENGTH (FT.) GRAVEL VOLUME (OU.YDS.) TANK SIZE (GALS) SOIL RATING (SQ.FT./BR) 4.(} 4.5 4.0 12.0 0.5 3.5 16.0 5.0 7.5 '-3 25 20.0 5.0 21.0 38.0 .~4.0 2~4.3 28. I 40.0 1,250.0 ** 1,250.0 ** 1,250.0 ** 125 125 125 ** TANK] MUST HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the'Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria o£ this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances £rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid ~or a maximum o£ 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILt_ NOT BE APF'ROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THeE S IGNEDELECTRICAL WORK~~~MUS~~E BY~ICENSED ELECTRICIAN. DATE: 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: [~; tt [~)f~ ~¢ c~,,~ DATE PERFORMED: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 J J SITE PLAN SLOPE ~v~L WAS GROUND WATER S L ENCOUNTERED? t'~§ O P E IF YES, AT WHAT DEP'~H? la ~ Gross Net Depth to Net Reading Date Tirr~ Time Water Drop PERCOLATION RATE (minutes/inch) COMMENTS TEST RUN BETWEEN FT AND FT PERFORMED BY: ~rr,-~ CERTIFIED BY: DATE: 72-008 (6/79) DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 To Whom it May Concern: According to records on file in this office the~~C~'. Water Regulations Water System is in compliance with the State Drinking Sincerely, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~/~/~'~ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name&g ~"~.,l.~,l~(,O'~l Telephone: Home~-~7'77o'~' Business Applicant Address ~;)~ ~ ~/~ , ~~ ~, ~/~ ~~ (c) Applicant is (check one): Lending Institution ~ ;~builder~' Buyer ~ ' Other ~ (explain); (d) Lending Institution ~/~'~ ~~C~ ~T~ ~~ Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family]~i~ Multi-Family [] Number of Bedrooms '~ Other WATER SUPPLY Individual Well [] Community~ 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 OnsiteJ~i~ Public [] Community [] Holding Tank i-I Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. ,/Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 regulations in effect on the date of this inspection. Name of Firm~,~__~_/'~'~~,~,-~F-~ Telephone Address /,~0~i.~ ~~ ~ ~ ~~; Date Approved Disapproved ' Conditional Terms of Conditional Approval Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 requirements. 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. Page 2 of 2 72-025 (11/84) WELL DATA ~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) ~ _. L CHECKLIST- FEBRUARY 1984 284-4,2o R F C F Legal Descriptign: f~. ~'~&¢~ ~~5--IV E D Well Log Present (Y/N) ~f~/~' (2r-Date Completed it..~/~ Yield Total Depth ~J~/i~-- Cased to ~//~' Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distar~ce~'fro~ Well: ? To Septic/Holding Tank on Lot Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results ~~)0/'~ 'On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer __ To Nearest Sewer Service Line on Lot · Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~__ Standpipes~N) Depression over Tank (Y~...) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ,,~ To Property Line ~ To Water Main/Service Line Course / O0 Size /~<~,..,~"O No. of Compartments ~ Air-tight Caps(~N) Foundation Cleanout(~) Date Last Pumped ~ / ~1.~/~,_ 'for &"ll'4~ Temporary Holding Tank Permit (Y/N) ~'7//~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84} C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed */~¢ Width of Field ,.~o,,~ 1 Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test Type of System Design Length of Field Depth of Field Gravel Bed Thickness /,¢~ / Standpipes Present (~N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Dra nage Course To Driveway, Parking Area, or Vehk'.le Storage Area Comments LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Ratin Signed Company 4~---'~ Receipt No. ~ ~ "~ / . Date of Payment ~ - '_5 Amount: Page 2 of 2 72-026 tl 1/84) To Property Line '~¢ '" To Existing or Abandoned System on · On Adjoining Lots ~'~O ! To Cutbank (if present) ~/~' /OO~ Dimensions Manhole/Access (Y/N) I~/~ "Pump Off" Level at ~L)/~, Vent (Y/N) fO/~. Pumping Cycles during Adequacy Test. Meets MOA Against HAA Request ** ~r conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date '~-/- '~ ~ MOA No. ,c~;~'_~--- ~c.~Y