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Home My WebLink AboutALPINE TERRACE BLK 3 LT 80 \A C�eveiopnent Services Department Building Safety Divisicn On -Sita Wcter &Wastewater program 4700 Sragaw Street 0t n; ?.0 Bax 196650 Mark 6egich Anchorage,,Al" 99519-6650 Mayor www muni.arn/ansiTE (907)243-7904 pump Installation Log Well Drilling Permit Number: SW_ Date of Issue: _ Parcel Identification Number:_ Legal Description Property Owner Name & Address: /-A L P1146 T e R (SIG_ '� ,✓llr�u�zL G-3 _s�? pump Installation Date: pump Intake Depth Below Tap of Well Casing: e/Ofeet pump Manufacturer's Name: �2 j< J- ,,j Pump Model: 7 'FL11V7 505 oZ3 Pump Size hp Pitless Adapter Burial Depth: 8' feet nn Pitless Adapter Manufacturer's Name: ✓:�'b tis Pitiess Adapter Installer: n) ✓+ ',Veil Disinfected Upoa Completian?'�es No Method of Disinfection: C L, L J . 1 0 Comments: [� Pump Installer Name: �� 1�Laf Y\ All Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installaticm. 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) (b) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) . r Applicant Name ~0.~ ~u~k5 Telephone: Home Applicant Address ~q ff ' '715q Business (c) Applicant is (check one): Lending Institution [] · Owner/builder []1"'Buyer []; Other [] (explain); (d) Lending Institution LM~,>-f-~ Address ,400 L,~ -~"~'F (e) Real Estate Company and Agent Address Telephone Telephone (f) Mail the HAA to the following(..~dress: TYPE OF RESIDENCE Single-Family [~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 Onsite [~Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 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 adequ, ate 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 in~spection. . ,/, Name of Firm O~'o~.c~, Telephone Date 30 d?r,'l: Enginf~er's Seal Approved for Approved bedrooms by /l, Disapprove¢ · · Condition~a;._~ Date Terms of Conditional Approval 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) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAY 0 9 Legal Descri~,~Tg, WELL DATA Well Classification Well Log Present (Y/N) Total Depth Static Water Level Casing Height Above Ground .Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot 1") f' ~ ~/O.~-. If A, B, C, D.E.C. Approved (Y/N) I j~ Date Completed Cased to Depth of Grouting Pump Set At ~' Sanitary Seal on Casing (Y/N) ~ Depression Around Wellhead (Y/N) I · On Adjoining Lots /00 ~ ! ' · On Adjoining Lots To Nearest Public Sewer To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ~//~ Cleanout/Manhole /q/~ To Nearest Sewer Service Line on Lot Water Sample Collected by /. O(;~,r' ; Date ~(~ Water Sample Test Results ~-u,.~ ,.~;~, .Ti~_ ¢ Comments B. SEPTIC/HOLDING TANK DATA Date Installed / ?b$ Standpipes (Y/N) U ~ / Depression over Tank (Y/N) Pumping/Maintenance Cc ntract on File (Y/N) / Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding 'Tank: To Water-Supply Wel /~)O t To Property Line ~ To Water Main/Service Line Course /~O ~ '/' Size 1,~50 'P ~'~ No. of Compartments Air-tight Caps (Y/N) y ~,~ Foundation Cleanout (Y/N) Date Last Pumped ::5' ' I - /N/A ;for -- Temporary Holding Tank Permit (Y/N) To Building Foundation To Iisll®sal Field Te Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field LutA. To Building Foundation Lot . To Water Main/Service Line Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well j ~.1 Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N)' Date of Last Adequacy Test ; On Adjoining Lots To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course . ,/OO f To Driveway, Parking Area, or Vehicle Storage Area ~) Comments u To Property Line ~0 ~' To Existing or Abandoned System on Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Pe~rr I certify Com Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) tted Be/m Rating Against HAA Request ** ;ire ch~d, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ¢~"'/~-'~' "~ ~' Date 30 (~Sf'~[! ~6~f¢ IN"qlCE ~ - 013 813 "/~ ~ ~~ CLEANING SERVICE ~ ~ ~" P.O. BOX 112688 Job Address PHONE 345-2513 ANCHORAGE, ALASKA 99511-2688 ROTOR ROOTER SERVICE CALL HRS. (~, STEAM THAWING HRS. TRIP CHARGE HRS. OVERTIME CHARGE HRS, ADDITIONAL LABOR CHARGE HRS. PUMPING SERVICE ///~/~O1~(GAL) HRS HYDRO-JET SERVICE HRS PLEASE PAY FRGM THIS INVOICE CUSTOMER ORDER # TOTAL TOTAL FOOTAGE CLEANED OR THAWED BLADES USED PROBABLE CAUSE OF STOPF~AGE ~~A. (~") J~ APPLIC 'iT FILLS OUT UPPER HAL' JNLY Prop~, tyOWn6r Authur F. & Jean M. Johnson Phone 385--0793 Mailing Address SR Box 2392, Anchorage, AK. mpCode 99507 Buyer Joseph P. & Judith H. Burroughs Address ~ Zip Code Lending Institution Alaska Mutual Bank (Benson Branmbl~ Phone [~R~}l;{]~,.~r;~ 00 }l< .... z,p Code 99509 274-3561 Address Realty Co.&Agent Associated Brokers Thc. Phone Lof~se D. Campbell 563-3333 Address ~i.~ W ?Rt:h dl Anehnr~[~_= Legal Description L8 B3 Alpine Terrace Street Location ~.1830 Circle Dr['. Typ.e of Residence 3~J[ Single Family [] Multiple Family No. of Bedrooms [] Other wate, Su,p~y Well Drilled 1965 ATTACH WELL LOG. A wetl log is required for all wells drilled since June 197,5. _.~ ~nd~v~dua~ NO log available [] Community For wells..ddlled prior to that date, give well depth (attach log if available). [] Pub,cUt,~ty Depth is 43fL Sewer Disposal ~] Individual Year Individual Installed: ~-9 6 5 '~ Public Utility When Connected to Public Utility: _I~./_A_ [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time '~ Time Date Date Dat,~e Date Inspector Inspector Inspector InspeCtor /\ Field Note~ , DEPT. ( ) DISAPmOVED ( ) CONDITIONAL A~ROV~ w ~ Soils Rating Date ~wer Installed Well To Absorption Area /~ 0 ~ Well Log Received /~ ~ Well to Tank /'~ '7 Septic T~k Size 72-023 (3182) STEVEN A. JOHNSON P. O. Box 76 Chugiak, Alaska 99567 (907) 688-3085 August 2, 1983 Arthur F. Johnson P. O. Box 2392 Star Route Anchorage, Alaska 99507 Re: Septic system adequacy test results Dear Mr. Johnson: Transmitted herein are the results of an adequacy test I performed on a septic system serving a four-bedroom residence located on Lot 8, Block 3 of Alpine Terrace Subdivision. Existin~ System Design The system in service at the time of this test consisted of a 1250 gallon concrete two compartment septic tank and a concrete ring seepage pit. Four-inch diameter cast iron pipe was used in constructing the system. The system was installed in 1965. Adequacy Test Results Adequacy testing was begun on June 19 and completed on June 20, 1983. During the course of the test, 1600 gallons were added to the septic tank at a rate of 4 gallons per minute. The fluid level in the septic tank was monitored as the test volume was added. Based on my measurements of the fluid level in the septic tank and the rate at which water was added to the septic system, I conclude that this septic system at the time of the adequacy test: has an absorption rate in excess of 200 gallons per bedroom per day; August 2, 1983 Arthur F. Johnson Page 2 is capable of absorbing 265 gallons in 49 minutes which is equivalent to a short-term surge rate of 5.4 gallons per minute. Thank you for contacting me regarding your adequacy test. you have questions. Please call if