HomeMy WebLinkAboutBELLA VISTA #1 LT 17 N150'013�051�24
GR(--4TER ANCHORAGE AREA BOROV^H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON —SITE SEWAGE DISPOSAL SYSTEM
N° 801
MAILINGNAME J l ` �� �� t S �� ADDRESS :�GX � , CG7�L^��Jli�E PHONE'
LOCATION / cT� �c���,y,: !" 1 +�C/10 dr !�e—LEGAL DESCRIPTION Z6'1/7'11 AJ" �/ l
—L c ✓(' t j,
SEPTIC TANK: `L�— i7/i v� G C�? /, /"— 5..;�;7
DISTANCE FROM WE
LIQUID CAPACITY
TERIAL
GALLONS. INSIDE LENG
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID
DEPTH -
NUMBER OF PITS 1 OUTSIDE DIAMETER OR WIDTH 13 LENGTH Z G/ DEPTH L%
LINING MATERIAL Z. �' //// /
S .DISTANCE FROM WELL ,BUILDING FOUNDATION`S
NEAREST LOT LINE �� r TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) CCC6 F�}`GtC / SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION
FOUN
STANCE BETW
SQ. FT. LENGTH OF EACH LINE
EAREST LOT LINE
CH WIDTH
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: DISTANCE FROM WATER
TYPE DEPTH .,BUILDING FOUNDATION. - SAMPLE NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE SEWER LINE , TANK SYSTEM CESSPOOL , SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
GREA CER ANCHORAGE AREA BOROUGH %�/
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE. ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT '�I / �Gf / �/ MAILING ADDRESS ;j'i� � E�
-`J/ ;� PH PH
INSTALLATION LOCATION 1/ /y. -',�/
LEGAL DESCRIPTION /7 / /:� /k" Li" (f irk/Gf/
INSTALLATION OF: SEPTIC TANK / SEEP�AGE PIT DRAIN FIELD OTHER ,
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH / TO BE INSTALLED BY
SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITH/OUT SOIL TEST
COMPLETION DATE ANTICIPATED
j
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE (� TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
SEEPAGE AREA SIZE,/C"'/`r G-z' � TYPE
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK , SEEPAGE PIT , DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, , SEEPAGE PIT , DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
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.
/J \ HEALTH AUTHORITY
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREAT
DESCRIBED YYJS�TEM IS IN ACCORDANCE WITH SAID CODE. �///J/�
DATE ^%��-1� //� APPLICANT'S SIGNATURE ' -
DIAGRAM OF SYSTEM
ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
t
Depertr ent o; Env rc ,., rital a�?-I i ty
t?-30 "C" Street. Anchorage, Hlaska 90503 - 1 `17a .'
4 l.. Je1L-rS6I
Date Received
Time of Inspection
Data of Inspection
REQUEST FOR APPROVAL OF
INDI`lIDUAL SB!ER & NATER FACILITIES
FOR
V/,,
j 0 7 �L
r/ , O U
?. Approval requested by:
Mailing Address: 3 e33 3 2---
2. Property Owner: ' ��y, Phone:
Hailing Address: _
3. Legal Description: 1-7
—
n, >~ocation: A
5. Type of facilitY to be inspectedv I No. of bedrooms --
6. flell Data:
A. Type B. ' Depth 9'3 C. Construction D. Bacterial Analysis
—
7. Sewage Disposal System:_'
A. installed B. Installer
C. Septic Tank: 1. Size 2. Nianufacturer
E. Se- ge Pit: -ion Area 2. Ma'erial
E. Disposal. Field: Total length o-` lines
8. Distances:
A. i'lell to: Septic tank , Absorption are -a , Sevier Lines
Nearest lot line , Other con.amiration
B. Foundation to septic tank � Abs^rotion area
C. Absorption area to nearest lot 1ir,F
Pago 1 of two pages
of two pages Pequest for Approval '.later Facilities
Legal Description
Comments
VApprovad 'fAV Disapproved Date
Approval Valid for one year fidate signed
t
Greater Anchorage- Area Borough, Department Inf- Environmental Quality
DIAGRAM- OF SYSTr-;,!
I certify that the iinformation contain=d in th-1-S. est for apPrUVd I
jec
accurate representat-ion of the subject se%,.;er and L. and these F, C
are operating satisfactorily.
ST
GN ED
Septelwer 16, 1.174
.3-5 S.enard goad
Anchorage, Alaska
919503
SUs3 EC t . ',later °sup1ply J`:ry .,,,9 dupl ! on WZ; Vista SuL; _ it
iu07 '.0 ibis
jear i1r. iiuniso—I:
The grater s_uppl,y serving the subject ; rcpert=' can►aot be approved at this-
til�::. In ordtc-r for you to Set approval rrol,I this O`epartm,-,sat several dis-
cref3anc1,-1:.S t i11 have to be corrocttac:
i It is a lepartment policy -hat all 'e-A 1 s be at l::a: t
2) --Dug wells must be provided with c u.."a .-Uril ight cover.
3) Pump equipment Cannot be instailzud in the well in a Ffianrirwr
requiri no =ulitrance of ar atte;adant.
b- sealed so no outside seepage can enter.
This $ & Q4 i- v olat-ion ci pr::sLL,Eit ) n i;r,� codes- alad will have to
i- 6te Ir;JM
graded �,'i%i►FI1 6 u-1,p, T�,>t is ;°ecestst of '; :is lwwi;:r.
Haase make ar>rang€:Ila nts vein ti)is office as soon as so i,: oat wc:
caii get this YroblcFFi taken care- of bcfo'c ill winter' Pon--' S se in.
I r1(.`:,a +)t�231.. ( .1,y t�i.,l�:�fr� )iI� - .,�`Jee q— 1 e+'l ;.� �.�`�c-� �v� -.� "apartment.
r i. i:. ; zd3 "a
i . J;-, c, tr-21 J
F1�1�u.:Y°S, Imo. tYr�a:, le p
"rlvi ror. is J vital ion tFKt}1 i'i cL r III
+.-r
r'Ao
740365
RECEIPT FOR CERTIFIED MAIL-30.
plus postage)
SENT TO
POSTMARK
OR DATE
STREET AND NO.
L.S.✓..
(o
P.O., STATE AND ZIP CODE
OPTIONAL SERVICES FOR ADDITIONAL FEES
4r
RETURN IN t. Shows to whom and date delivered ............ 150
With delivery to addressee only ............ 650
RECEIPT 2. Shows to wham, date and where delivered .. 350
�-
SERVICES With delivery to addressee only ............ 850
c
DELIVER TO ADDRESSEE ONLY ........: ............................................. 50d
®
-------------
SPECIAL DELIVERY (extra fee required) ..................••... ••••.•••••
PS Form 3800 NO INSURANCE COVERAGE PROVIDED—
Apr.
(See other side)
1971 NOT FOR INTERNATIONAL MAIL a
GPO : 1972 0 - 460-743
ACE J0yy..--- _ - -..
-ANCHORAGE, ALA SKA.995fl7
_PUSLIG:WORKS DEPARTMENT
i O
6
September 18, 1974
To WHOM IT MAY CWCBRN :
verify that the residence at 7807 Lumbis, Bella Vista
This is to
is connected to the Borough maintained sewer system
Subdivision,.
Very truly yours,
Clinton F. Craw
Construction Coordinator
r -
LTC :bms
c,
Q
i
Jun.-- 16-00 09:38A Ken O'Brien
P.O1
9
�01 TANAINA DRIVE o ANCHORAGE, ALASKA 99502 a (907) 243.0740
WATERWELL - TEST PUMP DEPORT
Conducted by: Anchorage Well & Pump Service, Inc.
Owner: Neil Van Vleet Address: 7817 Lumbis, Anchorage, AK 99518
Well Location: 7817 Lumbis
Well Information: Total Depth: 256 Depth of Casing: 256
Screen From: NA To: NA Casing Size: 6
Screen Dlam: NA Screen Slot: NA
Remarks:
Pump Infromation:
Pump On:
Pump Off:
TIMF-
10:00
10:05
10:10
10:15
10:30
11:00
11:30
12:00
12:30
1:00
1:30
2:00
Intake Depth: 74 Pump Size: 1HP Air Line Depth: Electronics
Static Water Level: 28 Average Discharge 3.5 GPM
GPM Max Drawdown: N/A
Time: 10:00 AM Date: 6/15100
Time: 2:00 PM Date: 6115/00
WATER LEVEL
Feet
Meters
59
18.10
59
18.00
58
17.80
58
17.80
58
17.70
62
18.80
63
19.10
63
19.10
63
19.10
63
19.10
63
19.20
64
19.40
PUMP OFF
FLOW GPM
METER
COMMENTS
6.00
8771580
CTV
6.60
8771610
CTV
4.80
8771634
CTV
3.20
8771650
CTV
2.90
8771693
OTV
3.50
8771800
OTV
3.40
8771898
OTV
3.40
8772001
OTV
3.40
8772103
OTV
3.40
8772204
OTV
3.50
6772307
OTV
3.70
8772419
OTV
WATER SYSTEM SERVICES 0 DOMESTIC AND INDUSTRIAL PUMP SOLES AND SERVICE
,Jun-16-00 09:39A Ken O'Brien
P_02
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001 TANAINA DRIVE ® ANCHORAGE, ALASKA 99509 ® (907) 243-0740
RECOVERY
WATER LEVEL
TIME
Feet Meters FLOW GPM
2:00
64 19.40
2:06
52 16.00
2:10
45 13.70
2:15
39 11.90
2:20
35 10.70
2:30
33 10.00
2:35
30 9.00
2:40
29 8.80
2:45
28 8.70
2:50
28 8.70
2,55
28 8.70
END TEST
METER COMMENTS
6115/00 14:55
WATER SYSTEM SERVICES 6 DOMESTIC RND INDUSTRIRL PUMP SRIES AND SERVICE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section ik
P.O. Box 196650 Anchorage, Alaska 99519-6650
(907)343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
Parcel I.D. # 013-051-24 HAA #t000jj0 zo
1. GENERAL INFORMATION
Complete legal description BELLA VISTA SUBDIVISION #1 • LOT 17 Ad 1,5-0 1
Location (site address or directions) 7817 LUMBIS STREET ANCHORAGE AK 99518
Property owner NEAL AND COLLEEN VAN VLEE" Day phone (907) 344-8574
Mailing address 7817 LUMBIS STREET ANCHORAGE AK 99518
Lending agency
Mailing address
Day phone
Agent TERRIE PISA w/ JACK WHITE Day phone (907) 563-5500
Address _3201 "C" STREET SUITE 200 ANCHORAGE_ AK 99503
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well xxx
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 OF WASTEWATER DISPOSAL:
Individual on -site
Holding Tank
Community on -site
Public sewer xxx
NOTE: if community wastewater system, provide written confirmation from State ADEC
ing to the legality and status of system.
72-025 (Rev. 1/91) Front MOA#21 Computer Version
Note: Alaska Water and Wastewater Consultants, Inc, shall be paid $800.00 at,
or prior to, closing for the engineering services provided.
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 Muni ip 1 and State codes, ordinances, and regulations in effect
on the date of this inspection. / 7�
Name of Firm
Address
Phone (907) 337-6179
Engineer's Signature _ Date (0142,400
In conducting this evaluation, AWWC, n . a mpted to ovide a thorough, conscientious engineering analysis of the
system in accordance with ADEC and MOA HHS Guidelines & Regulations. The reported results described the
performance of the system under the conditions encountered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of all wells and septic systems depend
on the local soils condition, ground water levels that may fluctuate during the year, and the water
usage of the family being served by the system. These conditions are outside the control of o 4
the evaluator of the system. Satisfactory test results do not guarantee future performance v sp4
of the system, nor do they guarantee that there are no hidden defects or encroachments.
AWWC, Inc, can therefore not provide any warranty for future estimate of how long the p •,-�
system will continue to meet the operational requirements of the ADEC or MOA DHHS. ..... .... .. ...........
The content of this report is for the sole benefit of the owner listed above. Any
reliance upon or use of this report by any other person or parry is not authorized, .............. ......... .
nor will it confer any legal right whatsoever. QO f y A. Garness,�
6. DHHS SIGNATURE �0 9,sy'• E-7953
✓Approved for 3 bedrooms
Disapproved
Conditional approval for
Additional Comments
0
kafro f e s sio�_Gc
bedrooms, with the following stipulations:
Date 4' Z 3-0 n
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 Computer Version
Municipality of Anchorage
. DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division+l
825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744
Health Authority Approval Checklist
Legal Description: BELLA VISTA SUBDIVISION #1; LOT 17 Parcel I.D.: 013-051-24
A. WELL DATA
Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A
Logresent /N NO PRIOR TO 9/1977 *SOIL IS MOUNDED
p ) Date completed AROUND WELL HEAD
Total depth 256' Cased to 40'+ Casing height (above ground) *11 "
Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
FROM WELL LOG AT INSPECTION
Date of test **6/4/2000
G
Static water level �� L� 25'
N�
Well production g.p.m. 3.5 g.p.m.
**2nd WELL FLOW TEST
WATER SAMPLE RESULTS: PERFORMED BY ANCHORAGE
WELL & PUMP SERVICES
Coliform 0 Nitrate- 0.59 mg/L Other bacteria 0
Date of sample: 6/4/2000 Collected by: A.W.W.C., INC.
B. SEPTIC/HOLDING TANK DATA PUBLIC SEWER
Date installed Tank size Number of Com ar Cleanouts (Y/N)
Foundation cleanout (Y/N)
Date of Pumn.ipa-
C. ABSORPTION FIELD DATA
Date installed
Length
Effective absorption area
Width
Date of adequacy test
Fluid depth in absorption field before
Fluid depth
(Y/N) High water alarm (Y/N)
Pumper
PUBLIC SEWER
Soil rating (g.p.d./ft2 or ft2/bdrm)
Gravel thickness below pipe
Monitoring Tube present (Y
Results Ra ail)
) Minutes later:
Immediately after_
Absorption rate =
System type
T
epression over field (YIN)
For
_peroxide treatment (past 12 months) (Y/N) If yes, give date
72-026 (Rev. 3/96)' Computer Version
gal. water added (in.):
Bedrooms
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level
a
Size
level at*,
*Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot N/A
Absorption field on lot N/A
Public sewer main 50'+
Sewer/septic service line UNKNOWN
"Pump off"level at*
On adjacent lots N/A
On adjacent lots N/A
Public sewer manhole/cleanout 50'+
Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation Property line
Water main/service line Surface water/drainage
SEPARATION DISTANCES FROM ABSORPTION FIELD O TO:
Property line Bu' oundation
Surface water
F. ENGINEER'S
I certify that I
of Municipal n
with MOA
Signature
-
PUBLIC SEWER
.Absorption field
�adjacentots _
Water main/service line
Driveway, parking/vehicle storage area
Wells on adjacent lots
field inspections and review
systems are in conformance
on this date.
Engineer's Name i JEFFREY A. GARNESS
Date 7-2-W
HAA Fee $ c? 4
Date of Payment
Receipt Number
72-026 (Rev. 3/96)* Computer Version
Waiver Fee $
Date of Payment
Receipt Number.
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I 30 REBAR
40.0'
EAST 78th AVENUE - -
EAST 175.00'
v,
N
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;W, WELL
GRAVEL
DRIVEWAY
26.0'
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'777777-
--- -
LOT 17
(N 150')
26,250 sq. ft.
x x x x
FENCE
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x x m
LOT 16A
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WEST 175.00'
OF
LOT 17 =
(REMAINDER) �. 9
*: 49 L
... ...... ..;
Buku Sal' �o
LS-14837
EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE
RECORDED SUBDIVISION PLAT (P-173), ARE NOT SHOWN
AS -BUILT
HEREON.THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY
SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE.
FOLLOWING DESCRIBED PROPERTY:
UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE
USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR
NORTH 150' OF LOT 17, BELLA VISTA SUBDIVISION No.1
ESTABLISHING PROPERTY BOUNDARIES.
THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY
ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT
PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION
THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
SURVEY STANDARDS.
WITHIN THE PROPERTY LINES AND NO VISIBLE
ENCROACHMENTS EXIST EXCEPTAS INDICATED.
THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY
DATED THIS 6th DAY OF AUGUST, 2021, ATANCHORAGE,
TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR
ALASKA.
ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR IS A
VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE
LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED
FIXED HEIGHT
FOR SERVICES IN PREPARATION OF THIS PRODUCT.
LLC C.O.A. 122554
Land Surveying Services 907.290.8949
JOB # 21160
1 NO CORNERS SET THIS DATE
I SCALE 1" = 40'
225 W 23rd Ave., Anchorage, AK 99503 WWW.FIXEDHEIGHT COM