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Home My WebLink AboutBENITO BLK 2 LT 3 oGREA' ANCHORAGE AREA BOR(' Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska ggs07 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ' NUMBER OF FROM WELL ~'-/_ MANUFACTURER ,_~--~?,/~ .~.¢.,¢, ,..,¢¢2 MATERiAL,_.~///Z~ ~/~(¢~_ COMPARTMENTS INSIDE LENGTH --- INSIDE WIDTH ~- LIQUID DEPTH ~ .LIQUID CAPACITY /M ¢~:;¢2 GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER -- OR WIDTH /~1~/, LENGTH /,7/, DEPTH ~ LINING MATERIAL ~-¥~; CRIB SIZE: DIAMETER~)~DEPTH ~./ DISTANCE FROM: WELL /~2, ~/ TOTAL EFFECTIVE BUILDING FOUNDATION,]~7/, NEAREST LOT LINE~'/ . ABSORPTION AREA (WALL AREA) · .~/z~.~, SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE ,~/2.,~'~// CONSTRUCTION BUILDING NEAREST FOUNDATION ~' , LOT LINE '"'-'- CESSPOOL -- , OTHER SOURCES APPROVED DISAPPROVED · --- DEPTH ~ DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE ~-' , TANK ~,~/, SYSTEM /c~,.~ / REMARKS. INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form PW-026 DIAGRAM OF SYSTEM DATE GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3.500 TL) L'iC~R ROAD F'OUCH A!'4CHORAGE. ALASKA 99502 TEL£PHON£ 279.8G86 PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT PHONE INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT~ DRAIN FIELD OTHER TV,.E AND S,ZE OF FAC,L,T¥ TO .E SE.VEO ' /'¢' "'-/'''- ' "'" ' SOIL TEST RESULTS NOTE= THIS PERMIT IS NOT VALID WITHOUT ~OIL TEST COMPLETION DATE ANTICIPATED pFRMTT VAI.II') ~NF YFAR FINAL INSPECTION: 24 HOUR NOTICI~ REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY TH-- HEALTH DEPARTMBNT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ~/ ~(~' ~ TypE~tP.~'] ~'t" C~nC/"~'~eSEEPAGE AREA SIZE TYPE MINIMUM DI~TANCE~, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT 20 ~e DRAIN FIELD [0 SEPTIC TANK TO SEEPAGE PIT WALL [~ SEPTIC TANK ~ ~e SEEPAGE PIT ~0 ~[e _. DRAIN FIELD [0 ~. DRAIN FIELD ~ / DRAIN FIELD ~/f[ · CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF 1 I:~: ] VI I1UAL SEEPAGE Pre ~/~/d5 / ALSO CONSIDER AREA WELLS. i , S~AG ~ PIT 10 ~:t. EXCAVATION B 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, LICENSED DESIGNER DIAGRAM OF SYSTF. M St'PT1C PiPE k'llll AIRTIGHT CRIB ....~' ~:~*,";: .': EL,' :":":':'~'~ ,' ~: ~; 5' , ~~t~ ~~-' C ] requh'ed whenever 1lee crosses (CRIB ~' ~]NlflUH ABOVE' ~A.TER .. undcr dr~ve~'ay, IABLE ) 4 I.CH SE:~ER CO~SI(:~ R AR~A ~tEL[~. SEEf'AG[ Pi1 EXCAVATIOII BASED ON '~:LL~e I0 PIT- 100' I;0 S[~:[:R Llh~E- 10 ;;U']] ~o TAr;r,- CO" TO I'l't- 120' 4l)'- ~:O' OULY I. 1'0 TA~- 200' Ffl PIT - 200' EAST l~(.tl S[~tER HOUSE ''$TURB£V'---'~ T L.£AS' IRBH SIPHON PIPE GRAVEL HACKFILL l 2i' HINIMUM HEfR[~T t~f Lille , Grede: ~'.per IGQ' or 114" p r foot eXcep~ I0' prec~din tank &tha~ should not exceed ?~, 6" per 100 on flat I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE ~REA BOROUGH ORDINANCE NO. 28-S8 AND THAT THE ABOVE DESCRIBED//~'~SYSTEM~21S IN__ACCORDANCE WITH SAID CODE. MUNICIPALITY.OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING C"'. ~ - ;=~"-) ~3., - i~°[ HAA# ~ t'~ ~ ('"Y~ ,~ ~-~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Lot 3; Block 2; B~ni~' Sttbdivision; Location (address or directions) I0218 Genora Street (b) Property owner Mailing Address (c) Lending Institution Mailing Address Carol Taylor Telephone: (home) 694-4698 . Business 10218 G~nora Str~t Ea,ql~ Rivert Ak. 99577 Telephone (d) Real Estate Company and Agent ' VISTA REALTY ATTN: Kcvin Taylor Address 3000 C Street Suite 101 Anchorage. Alaska 99503 Telephone 562-~4~4 (e) Mail the HAA to the following address: (or check here [~if hold for pick up.) List contact person and day phone number below: 5 & S ENGiNEER,'NG 17034 Eagte River Loop Road No. 204 Eagle River, AlasKa 99572 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms 3. WATER SUPPLY Individual Well [~X Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [] Public,~E. Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev, 7/88) Page 1 of 2 5. 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 end 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 Telephone $ ~,:~ 5 ENGINEERING Address *,; 7~'~,~ ~=~_te River Loop Road No. 204 Date Eagte River, Alaska 99577 / ~,./.~ / ~ 6. DHHS APPROVAL Approved for ~ bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of H'ealth and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7/88) Back Page 2 of 2 A. WELL D~,,C Well Classification "'~--I~:)~ ~J ~ _c-~ ~.~._.~ Well Log Present (Y~j;) /~ Date Completed MUNICIPALITY OF ANCHORAGE (MOA) ~ Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: \_..crr"~ ~ Z- Total Depth ~ Cased to ~ ~ Depth of Grouting ~ Static Water Level (~ Pump Set At If A, B, C, D.E.C. Approved (Y/N) \c~'7 Z. Yield '~o~ Casing Height Above Ground [z~'''~ Electrical Wiring in Conduit {~N) ~{ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Sanitary Seal on Casing ~N) \j Depression Around Wellhead (Y~ '1~ ; On Adjoining Lots --"-' ~"[~ ~N~ ;on Adjoining Lots ---- To Nearest Public Sewer Cleanout/Manhole ~'C)~ ~ To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by '".--' ~, c.~ ,~.~,..~ ~=~_...~,~ L= ; Date ~ 7.,.- '~-cio Water Sample Test Results ~ - ~ ~- ~ __ Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size No. of Compartments ~~~Ai r-tight Caps (Y/N) Found at i on__Date Last p u~3t~'~3~ ) Pumping/Maintenance Contact ~~ ;for i! IPi!!! Ii!!plD!gSi-e~lW~l(~ rE! I F~oLDING TToAm (Y/N) ~~n k ~ermit (Y/N) _ To Property Line ~ To Disposal Field TOT~rLv::: :irnl~la~o r ~ C o~rs e 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design D~.~...nstalled Length of Field Width o'~d Depth of Field ~ Gravel Bed Thickness .~ Square Feet of Ab~ Area _ ___ Statndpipes ~~ _Depr.essio_n over Field (YTN~ . __. Date~.~st-A~equacy Test ~ Results of Last Ad?quacy Test j~ S 7pU/~t~; ,L~t ~,~: ~YET:F~ to ~ To Water-Supply Well _..--J' '""-~_ To Property Line ~____ To Building Foundation J ~. To Existing or Abandoned System on Lot J ; On Adjoin~~ To Water Ma~Line __ _ _ ( To Cutback (if p nt) To S~.~;"Pond,~Lake, or Major Drainage Course ~ To~-Driveway, Parking Area, or Vehicle Storage Area ~ Comments '~3_t-~L.~C__ ~'~,~_~...~-_~ D. LIFT STATION Date Installed Dimensions Si~ Manhole/Access (Y/N) Lev-El-a-t--~ "Pump On .... Pump Off" Level ~t High Water Alarm Level at '""-~-~ ..-----~-'5/ent (Y/N) Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrica~ Com men..~..~ **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date MOA No. Receipt No. ~ Date of Payment Amount: $ /7 72-026 (Rev, 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 Client Name : S -~ S ENGINEERIN6 - -' C1 lent Acct: SN~NGF' ~ P,O,~ ~E RECEIVED Req ~ Ordered By ~ R ~H~FER.~ ;-' S~d Reports to~ l~C & c EN(q~NEERIN~S -': " "~ ~ f /' DATE RECEIVED APPOINTMENTS INSPECTION TIME TIME TIME DATE DATE DATE 'I'NSPECTOR . INSPECTOR ...... INSPECTOR MUNICIPALITY OF ANGHORAGE ' DEPT. OF ~LTH & ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~VIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ' ' "' :;" ~' "~.'":~ //_~~ ' " ENVIRONMENTAL SANITATION DIVISIO REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND 8EWER FACILITIES" DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be proce~ed. Please allow ten (10) days for processing, .: ...'.;,, - ..;-: .'...~, MAILING'ADDRESS CF~t,~I~ ~C~,~, ~_-~,~r ~'5 ' ' PROPERTY RESIDENT (If different frEm above) ~ ~ PHONE :.:. · 2, BUYER '~.~ I~ ~~_, , . PHONE MAILING ADDRESS 3. LENDING INSTITUTION . . . . PHON~.~E -- . .,.. .... 4. REALTOR/AGENT PHONE MAILING ADDRESS " " 'm~F~N~ ' "' I 5. LEGAL DESCRIPTION . STREET LOCATION 6. TYPE OF RESIDENCE I~. SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One J~ Four [] Other__ [] Two [] Five [] Three [] Six -: 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72.0,0 N unicip&lity o{ S25 "l_" STREET F0~?~ )~/ ANCHORAGE, ALASKA 99501 ~-N- tJ_hC~_J¢ (907) 264-4111 GEOF]GF M. SU[ [IVAN, MAYOR AND Er,IVIRONMENTAL PROTECTION October 23, 1980 Frances/Red Carlos 132 Genora Street Eagle River, Alaska 99577 Subject: Lot 3 Block 2 Benito Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report beldelivered to this department from Chem Lab, 5633 B Street, for our review. (2) Locate and expose the well for our inspection to determine property construction. This will need to be re-inspected by this department. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/i~w CC: Lomas and Nettelton 4449 Business Park Boulevard Frank Willis or Doug Taylor % Jack White Company 3201 C Street 99503 99503