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Home My WebLink AboutALPINE WOODS BLK 2 LT 8NAME MAILING ADDRESS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVlRONMENI'AL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT .HON E I 'J~CJ~IEw ~ /~ ~ ~ [~]UPGRADE LEGAL DESCRIPTION LOCATION DISTANCE TO: ,~.00 "1~ ~u~l- z Manufacturer i Liq. capacity in gallons ............ ~ Manufaoturer ----- -~- DISTANCE TO: ~, ~ [ No. of h,~e~~--~--~ of each cc I- Top of tile to finish grade - ] Length Width NO. OF BEDROOMS ~_ Dwelling IAbsorption area i ,;,7. Material Inside length Width Dwelling PERMIT NO. 03-0 'to3~ No. of compartments Liquid depth PERMIT NO. Material Liquid capacity in gallons Foundation Total length of lines Material beneath tile Depth Trench width __ ~'O ~inches 12" Distance between lines Total effective absorption area PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: DISTANCE TO: Class Depth Driller Distance to lot line Building foundation Sewer line Septic tank QTHER PiPE MATERIALS SOIL TEST RATING INSTALLER REMARKS i.~l~ PERMIT NO. Absorption area(s) APPROVED DATE -0 72-013 (Rev. 3/78) LEGAL ~l p',~' "-"F OF: Hb.p.,.... l H I-~NL,. ENV I Ror,]P'IENTAL. PROTECT ION ~I'-.,I:.E t , ANCHORAGE. AK c',;',='r' I 825 L. ' .........' ............ '.~'~d..).. 264 '-'-' q. 720 PERHI"I P,t(J D A r'[..ii I S s ! I E D ..". 8504 () 5 () 7 / 09/' 85 CH(M:(L. ESE [)ERE; ~ .... 'C) DOWNEY FINCH DRIVE ANCHORAGE~ AK 99518 345- 1921 I...E[:-,,.d Dlilif:~CRIF': SUBDIVISION: AL. FINE WOODS L. OT: El BLOCK: SIECTION: 23 'TOWNSHIP: 12N RANGE: 3W LOT S t ZE;,", 7?,3600 (SQ. I::"T'. OR ~..,RE.,~) 1..O]" I.. OCA T I O1',1 MAX BiEI)RE, OMS: C~ !....i~ted be1(Dw are the optic)ns 8va'J.].able 'Lo you ].n designing your sep'[.:[c system,, Choose t. he opti. ori that best fits yc)tir site. DEF'TH TO F:'IPE BE)TTOM (F:'T.) GRAVEL. DEF']"H (FI".) TOTAl .... DEF']"H (FT.) (3RAVEL WID'T'H (Fr"r.) GRAVEl .... I....ENGTH (FT.) GRAVE]._ VOL. UME (CLJ. YDS. ) -f'ANt< SIZE (GALS) SOIl ..... ,~1 ING (SQ.F:T../BR) .~.* L'.-¢RF,,,EL.. LENG'TH > '7~ I:::'T'. REQLIIRES MUI....TIF'I...E RUI4,:~ (NO]" EXCEEDING '75 FI". EACH) · ~-~- ]"ANK MLJST IdA zE- A'T' I...E,,.~I TW[] COMF'ARmT'MENTS I c:er't, iry t.l"lat: ].. ]: am familiar' with the requirements for on-site sewers and wells as set fop-Lb by the Munic:ipalit. y of Anchorage (PIOA) and the State of Alaska. 2,, I v¢:[ll insta].], the system in ac(zordar'lce with all MOA codes and pegu].at:f(::n'~s, and :i.n comp].iarice with the design [:PitePia of' this permit. ;3,, I wi].l adher-e to ali. MOA and State of Alaska requirements fop the set back distances fr. om any existing well, wastewater, disposal system c)r' public ~3ewepage syst. em on.this op any adjacent on nearby 1.or. 4,, I under, stand that this permit is val:i.d Cop a maximum of 4 bedrooms and any entar'gemer~t ~.].]. require an add~t:~onal pepmit. I...IF:T S'T'AT]:OIq IS INSTAL..t_EI} :[Iq AN AREA COVERED BY MOA BUIL..DING CODES, (1.) (::d',.! tEL. ECT'RICAL. F:'E:f4:MIT AND-INSF'ECTIOh. I MUS"I' BE OBTAINED; (2'.) AS-BUIL..TS NC)]" BE: AF'F:'Rf.]VE-'.D WITHOLFr AN EI....EC;TF(];E:AL.. INSPECTION REEF'ORT; AND (3) THE E.!.. f!i:CTF;.', l C;(-:'~L. W(] EIS:: I"dUS'T' BE DONE ¢.3";' A I.._ I (]E.;NSE:.D EL. Iii! Ei'.rF;,' I C I AN. DE:F:'AR'I'MEN!" OF ,'"lc. AL. I H .AND tENV II~LNP~E. I4 Tr,.~L F'ROTE:CT I ON f', ..... I S.';TREE:~T, ANCHOF~AGE~, Al< 99501 264- 472 () F'Et:~'H I !" F. tO: '[)A'l'l:= .... ~'~ L:~SLJED: 850405 C) "7 / () 9 i 85 APF:'L. I C P&I'l": · ' ] f' r:, :' (:.; C:'_. AD ,.) r',E ..... CON'TACf' F:'HONE: LEGAL DESCRIP: I....O]' S I ZE: L.O T I...0 C A T I OIq: MAX BEDROC]MS: CHARL..ES E.'". DERE o,.~.. DOWNE~ FINCH DRIVE ANCH[]RAGE, AK 99516 345- 1921 SUBD I V I S I ON: ALP I NE WOODS SECTION: 23 TOWNSHIP: 33600 (SQ.FT. OR ACRES) DOWNEY I=INCH DRIVE 3 12N ~, LOT: 8 ~L..OCK: 2 RANGE: 3~ l_isted below ar.e the options avai].ab!e to ,/ou in designing_ your septic system. C;hoose t. he option that best fits your site. 4.0 4.0 i/~,,/' 12.0 3.5 .£' · 16.0 '7.5 27.0 '7:5. C) :3 .1. · 3 54. i ~ /~ ' 000.0.,' *..*- 1,000. C) ** ,=: :[ 4 225 DEF:'FH '!T) F'IF:'E BO'TTOM (FT.) GRAVEl_ DIEPTH (FT.) TOTAL., DEPTH (F'T'.) GRAVEl .... WIDTH (F"T'.) C";RAVF"L. LEI'JGTH (F'T.) GFi'.AVEI VOI,...LJME (C.;LJ. YDS; ) I"ANK S]Z ZIE (GAL..S) SI) IL F:.~ATII',I["'; (SI;!. FT. /B~) .~* 'l'Ab.ll< ML!ST' HAVE AT I...EAST 'TWO CO~P~F'AR'I"MEN'FS :l: certJ, fv !.hat: 1. t am fami].iar' with tkle r'equirements fop c~n-site sewecs and wells as set. Fc:,r'th by 'Lhe Muni~tipa].it.y'of Anchor'age (MOA) and the State of A].asl<a. 2., I wi].1, inst. a].l th~ syst. em in accordance with all MOA codes and regulat:[ons, and in compliance~with the des:i, gn cPiter'ia o¢ this permit. 3. I w~].l adher~e i:.o ail MOA and St..ate of Alaska Pequirements fop the set. back d:i. stances ¢r.~fn aryv e:xisting well, wastewateP disposal system on public ~.:;~:~.~:.Paqe, , ... :syst:.e~on. this or any adjac:ent, or nearby, lot. 4. I under'stand that 'Lhis pepmit is valid for a maximum of 3 bedpoc, ms and any er~lapaemer'~t ~J. 1]. r'equir'e an additiona], penmit. IF: A L. IF-'I" .S'fA'I"tCIf, J tS INSTAL..L. ED IN AN AREA COVE:RE]) BY MOA BI.JILl)lNG CODES, 'T]dEN (I) A.N EI_IECTF4:IC'AL. F:'ERMIT AND INSF:'ECTION MUST BE OBTAINED; (2) AS-.BUILTS WII...I NOT' BE AF'F:'ROVED W]:'T'I-.~OU]' AN ELEC'TRICAL INSF:'ECTION REC. F'OFCT; AND (:3) THE: MUNICIPALITY OF ANCHORAGE L~' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION . 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST LOG PERCOLATION TEST PERFORMED FOR: ~' '" LEGAL DESCRIPTION: L '. DATE PERFORMED: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS PER~)RMED BY: SLOPE SITE PLAN ..- J WAS GROUND WATER ~, ! S ENCOUNTERED? r. L O P E IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RAT~ (minutes/inch} TEST RUN BETWEEN FT AND ~ FT CERTIFIED BY: DATE: 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Dwision 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) Property owner Mailing address Day phone Lending agency t,J I~'~ Day phone Mailing address r,J Agent ,~.~__~- L~ ~-~ ,-t--~-- '~,r-~,,/~J~-__.. ~'- Day phone Address '~'2-0 I Unless otherwise requested, HAA 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 1f91) Front MOA #21 5. 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. Phone Name of Firm Address A~aska W'<~[or & ' EngineeYs signature bedrooms. DHHS SIGNATURE ~' Approved for Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments (71 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. 1/9! ) Bac~ MOA f¢21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNIC.IPALITY OF A 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 34;~i~i~qENTN.$ERVl ,tUN 2 4 1996 Legal Description: Health Authority Approval Checklist I g,/O Parcel I.D. RECEIVED A. WELL DATA ,~t~,.,~ Well lype (_.ol~4o~a,'r~ If A. B. or C. attach ~EC letter. ~EC water system number ~ I 3~ (Y) Date completed , Sanita~' seal (%t~l, d~ ~~ Cased to _~ Wir~;;;o;he;;,g, hp;(otae%;~ g(~~ Date of test ~~ ~~ Static water level /~ ~ Well production .~ g.p.m. ~ g.p.m. WATER S~LE~ Coliform ~ Nitrate Other ba~~ ~le: Collected by: B. SE~IC~OLD~GTANKDATA ~-w ~ u~w,c t/2*/~S Date installed Ta~ size [ ~0 Number of Comp~ments ~ Cle~outs (Y~) Foundation cle~out (Y~) ~ ~ Depression (Y~) ~ High water alam (Y~ ~ Date of Pumping ~/~ Pumper ~ ?~ ~ / C. ABSOR~ION ~LD DATA ~X~ ~ ~o~ . Date installed ¢/~¢ Soil rating (g.p.d./fl: or ft:~d~) Z ~+ System b~e ~ LenDh ~ 7 / ~/ / Width Gravel thic~ess below pipe / g Total depth Effective abso,tion area e e ~ Monitoring Tube present(Y~:)'~ ~epression over field (Y Date of adequacy test 6/I ~/~g Results (PassWml)P~ For ~ bedrooms - " ~" Fluid depth i~ abso~tio~ field besom test (m.): ~7, ~ Immediately ~cr t ~ i ~ ~al. wmcr added (m): Fiuiddcpth ~ (i~s.)~i[mtcs later: ~ /~ ~bso~tionratc = ~ ~ g.p.d. Peroxide trc~u~cm (pas~ 1: momhs) (Y~) N~~ I~ycs, ~ivc date D.c"L"f~STATION F.J/¢~- Date in~ mo Size iii gallons Manhole/Access (Y/N) ~vel at* "Pump off' level at* High water alarm level at* *Datum Cycles tested SEPARATION DISTANCES S~CES FROM WELL ON LOT TO: b,J//~- Septic/holding tank on 1~ S~e Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: / Building foundation ~ ~ t_~ Properly line '~j ~ ! Absorption field , Water main/service line >;O t Surface water/drainage ~.~o0 Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 4-'O ~'" Ioo Surface water Curtain drain F. ENGINEER'S CERTIFICATION . / I certiZv that I have dgtgrmined thru J/eld inmections and review of Municipal recor~~e~~j~ore m confi)rman~td~OA H~,~lines m effect on this date. / ~ Signature ~/~/)/ /V [ ~ N~I~ .......................................................................................... ! Water main/service line ~. t o opt'os ,,r~ Driveway, parking/vehicle storage area '~-'/~'/ / / ~S -gu ~ c7 Wells on adjacent lots Property line [0 HAA Fee * ~{,~ Date of ?ayment (.../~2~Z//~ 6~ Receipt Number Waiver Fee $ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Jun-20-96 762- 1858 O1:26P Bonnie Mehner LOT 8, BLOCK 2 ..... AS BUILT ---~ -- ,~' Mt~NIq:IPALITY OF ANcHOR/"GE , DF. PARTM~'4' C)¢ HEALTH ~ FNVIRONMF. NTALPROTFCTION , r~v1RONM~NTAL ENGINEERING DIVISION ONmSITE SEWAGE D~sPoSAL SYSTEM AND/OR WELL IN~ECTION REPORT "' ' ~,,~,~ ~,~ ...... ~,t,~.~ · /.t ~ ¢ - 2 J r,'~~ .......... 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# C)\~ GENERAL INFORMATION Complete legal description Lot 8; Block 2; Alpine Woods Subdivision Location (site address or directions) 6511 Downe. y Finch Driv6, Anchoracj6 Property owner Mailing address CORNERSTONE BUILDERS 17510 Snowcr~st Lan~ Day phone 345-6338 Lending agency Mailing address Day phone Agent B~th Simpson / THE SIMPSON COMPANY Day phone 345-1932 Address 12350 Industry W~y A~h.n~g~.; A£~brz 99515 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well xxxx Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. NOTE: 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXXXX Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72-025 (Rev. 1/91) Front MOA #21 5. 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 Address Engineer's signature S & $ ENGINEERING 17034 Eagle River Loop Road No. 204 Fa~l~, Piver, Alaska 99577 DHHS SIGNATURE Approved for Disapproved. Conditional Phone /-~Z?,~_~.~,~ed roo ms. approval for bedrooms, with the following stipulations: Additional Comments 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. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services ^...ov^. Legal Description' L~/~¢'~; J;;Jg/~P/AJ~~: ~/~ ~'//p Parcel I.D. A. WELL DATA Well type ~.)~,4/vtbf/t) Log present (Y/N) Total depth Sanitary seal (Y/N) If ~ B, or C, attach ADEC letter. Date completed Cased to ADEC water system number ~J//¢ Driller ~/~ Casing height Wires properly protected (Y/N) Date of test Static water level / Well flow Pump level FROM WELL LOG g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot C~'~ Absorption field on lot r2~O0 ~7L AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer main Sewer service line WATER SAMPLE RESULTS:/I~)//~ Coliform /lj/~ Date of sample: /~/~ El. SEPTIC/HOLDING TANK DATA Cleanouts ~/N) High water alarm (Y/~._) / Date of pumping hJ//~ - Nitrate Public sewer manhole/cleanout Petroleum tank /U//~ /v'/~ Other bacteria Collected by: Date installed ~_c~_ ~ Tank size I~,~ d-R-(_- Compartments Foundation cleanout(Y/Nf Y~ ~" ~ ~'~ ~epression (Y/~ Alarm tested (Y/~ ~ ~ ~ ~ Pumper SEPARATION DISTANOES FRO~ SEPTIO/HOLDIN~ TANK TO: Well(s) on lot ~ ~06 'e To property line ~ ~ Surface water/drainage On adjacent lots Foundation ~ t Absorption field )~ Water main/service line o2~r'/ 72-026 (Rev. 7/91 ) Front ~t ~:~ ~'/~ i?_~PdP-.,T ~-/~ ~-'~-~S CONTINUED ON BACK PAGE C_..o, Lo~-~o ~/-%- ~ ~ '"--~LIFT STATION ~/~ ~ ~d.r~///¢ _ Manufacturer ~ Size i n gal I ° n s~'"'~'"~--,,_-'7~'""--~ .....,, ,. Man h ole/Acce~~'~-) Vent (Y/N) ~~~ "Pump off" level at S~,STANCE FROM LIF: S/ell on ,o, On ;~'c~t ;~:ts Surf~ D. ABSORPTION FIELD DATA ~ Date installed ~-~- 8~ Soil rating '~ ¢~/~/ &F~/L System type~--~p ~~ Length ~ / Width S Gravelthickness /~ Total depth /( Total absorption area ~ ~ / Cleanouts present ~N) OrE ~ ~¢ ~ oF T~ Depression over field (Y/~ ~6 Date of adequacy test ~ - ~ ~. Results(pass/fail) ~ ~ ~W ~7~ for ~ bedrooms Peroxide treatment (past 12 months)(Y/~ ~ If yes, give date ~/~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water t66 Curtain drain /~Ot~ ~'/~ ~ On adjacent lots ~Tq, Od '/' Property line 4(~' 4 To existing or abandoned system on lot Cutbank /t/~¢ Water main/service line 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 $ & Si ENGINEERING 17034 Eagle River Lc~op Road No. 204 Signature Eagle River, Alaska Engineer's Name Date HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 DEPT. OF ENVIRON MENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 WALTER J. HICKEL, GOVERNOR (907) 349-7755 Januaw 29,1993 Mr. Roger Shafer S & S Engineering SUBJECT: Alpine Woods Subdivision Class "A" Public Water System, PWSID 213598 Dear Mr. Shafer: I have c~)mpleted 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 C_oJ!form Bacteria Sample results was submitted to this Department on January 18, 1993. This _does me~eet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last ~ic ChemicaJ_Contaminants Sample results were submitted to this, Department on July 28, 1992. This_drm-~_~m. Eee_t the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last Ra____dioactLw Contaminants Sample results were submitted to the Department on October 30, 1992. This. does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. The last Or~nic Chemical Contaminants/Volatile Organic Chemical (VOC) were submitted to this Department on June 24, 1992. Based on analysis of the previous VOC samples results have been satisfactory. 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. il