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Home My WebLink AboutBENITO BLK 3 LT 9000 GAAB-HD-I GRr6,TER ANCHORAGE AREA BORO~'GH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION ~-~_.,¢~-,~ .5P,C"". LEGAL DESCRIPTION ~" ~ ~ ~'~ PHONE __ SEPTIC TANK: DISTANCE FROM WELl LIQUID CAPACITY MATERIAL COMPARTMENTS GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE OUTSIDE DIAMETER OR WIDTH /2- DISTANCE FROM WELL ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ¢ LENGTH BUILDING FOUNDATION__ ZZ TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA FOUNDATION .DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE NEAREST LOT LINE TOTAL LENGTH OF LINES TRENCH WIDTH IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE__ WELL: TYPE /llO°"r' y,~:"r '~i~i/~,J.~,~ DISTANCE FROM WATER DEPTH BUILDING FOUNDATION · SAMPLE NEAREST SEPThC SEEPAGE LOT LINE SEWER LINE , TANK SYSTEM , CESSPOOL DIAGRAM OF SYSTEM DISTANCES: ., NEAREST OTHER , SOURCES__ DATE / / APPROVED GREATE,. ANCHORAGE AREA OROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 CaseNo. ~'[ SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT RESIDENCE ADDRESS. LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK ~ V~/SEEPAGE PIT TO SERVE THE FOLLOWING FACILITY 3 ~/// ,L~/'CN~;~IuJ MAILING ADDRESS ~ ~;~ ~'PHONE ~;;~'-Z~;~/NO LOCATION OF INSTALLATION , DRAIN FIELD , OTHER FINANCED THROUGH TO BE INSTALLED BY PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ~/~' '=~/¢ ~l~J"f , PERMIT TO I NSTA LL A AS DESCRIBED BELOW, SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE /~)O(..) TYPE ~0~1 SEEPAGE AR DISTANCES: t c f:/ll 4x.,o Health Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. ,REATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 CASE Legal De$¢~zption: Lot ....~_Block 2 Subdivision This Form Repomts a: Soils Log, L~.~ ..... ~.'.~emcolatio'n Test ' --' . ... Depth Feet 2-- 5--- Was G~ound Water Encountemed? -If Yes, At What Depth__ Location Sketch Reading Date Gross Time ' Net Time Depth To H20 Net Dmop .-....~_ Pmop.)sed Instal-l~a~ion:' Seepage Pit ~--- Dmain Field · Depth Of Inlet ~t/7/~oq//7 Deptb~ To B~ottom Of Pit O~ T~ench' tg"" -"" ' COMMENTS: Test Pe~fommed By:,_p~C~ 0 ........ 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 1. GENERAL INFORMATION Application Date (al Location (address or directions) _ A pplic ~-ntNa me/)'"~ ,/~,~t~-~ Telephone: Ho me (b) Business Applicant Address ~.._~ .~Z~~ /~-,~ f/~,~-~. / _ , (c) Applicant is (check one): Lending Institution [] · Owner/builder []; Buyer [] ' Other,J~' (explain); (d) Lending lnstitution ~~.'~.~_~M-~ __z~"~ Telephone Address Real Estate Company and Agent (el Address Telephone (f~~ HAA to the following address: TYPE OF RESIDENCE Single-Familyfli( Multi-Family [] Number of Bedrooms ~.~' Other 3. WATER SUPPLY Individual Well~/ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental 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 Conservati0r attesting to the legality and status. Page 1 of 2 72-02,5 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATI(~"~ , As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation~'~}~. Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional a': ..~ for the number of bedrooms and type of structure indicated herein. I further verify that based on the informati0~ from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supp~ wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and r~gulations in e~ the date of this inspection. '~ Name of Firm ~__ Telephone .~ $ & $ ~nglneering '~ Address ....... '_ -- q~ DHEP APPROVAL Approved for -PA,---e'-¢h-~drooms by A_.p..p,r_o,~¥.e_d ~ Dis~'~ved Con/~'o./n al 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) WELL DATA Well Classification Well Log Present (Y/(~) Total Depth L),¢... Static Water Level MUNICIPALITY OF ANCHORAGE (MOA~ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 JAN 1986 Legal Description: If A, B, C, D.E.C. Approved (Y/N) ~"~,/~ Date Completed ,~I:~¢¢'~, I~ Yield A'~:)IJ¢' Depth of Grouting Pump Set At Sanitary Seal on Casing ~N) Depression Around Wellhead (Y/~) Cased to Casing Height Above Ground Electrical Wiring in Conduit~J~N) Separation Distances from Well: / To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /~ 'On Adjoining Lots t,,) ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole =1~ ~ ~ To Nearest Sewer Service Line on Lot ~-5 Water Sample Collected by ~- ~ ~"~(-~ I~..~ ~l~fl.4~..~ ; Date ~ - q - Water Sample Test Results ~'~ ~,~t Comments ~V,.~ ~¢--~ ~~ '~, ~ t~..~ [~-'-%~1"'~1.~ B, SEPTIC/HOLDING TANK DATA Date installed Standpipes (Y/N) Air-tight Caps (Y/N) Depression over Tank (Y/N) 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 Size No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area i,~ Depression over Field (Y/N) Results 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 Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION 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) l"Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that t have checked, verified, or conformed to all MOA a. nd I-JAA~uidelines Signed s &S Enalneer|.g, Date uompany ,~,~ ~iYer, ~I~:-~ ~ MOA No Receipt No. ~ H O ) Date of Payment ~ - 1% ' ~ Amount: $ ~ ~ ~ Page 2 of 2 72-026 (11/84) in effect on the date of this inspection. SAMPLE DATA SHEET (use continuation sheet for Class A & B) PROJECT: \~/~.b.j~'~-~ ~ ~ ~~ DATE OF TEST: L~AT[ON ~ ~LL (Lega~ Description): ~~ ~~ ~l~ WELL DEPTH: ~,~ FT. CASING: ~~ FT SCREEN: DATE DRILLING C~PLETED:_~~, lq ~ DRILLER: t STATIC WATER LEVEL (Top of Casing): ~' ~t FT DATE: . k- ~-~ - Elapsed Time Since Clock Pumping Started/ Depth to Drawdown/ Pumping Remarks Time Stopped;, Min. Water. ft. Rec_ove~ Rate. GPM ~Lt~ 0 ~f~l ~ (swl) 0 0 Start ~,,~ 5 ~' . ~ , ,. ~, ~ _, , DEPT. OF HEALTH & '-' izo (z '~0urs') 180 (3 hours) ..... ' m ,. RECOVERY 10 .. , mm m Ju L ~ ,,, unicipality of nchora ¢ P.O. BOX 665O ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES. MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 20, 1986 Robert A. Shafer, P.E. S & S Engineering SRB 196X Eagle River, Alaska 99577 Subject: Lot 9 BLock 3 Benito Subdivision Wai~er Request, WR86-002 Dear Mr. Shafer: This Department hereby grants a waiver of the horizontal separation distance required by 18 AAC 72.021. The required distance between the well and public sewer line has been waived to 46 feet. Sincerely, Stephen S. Morris Civil Engineer On-Site Services SSM/ljw ROBERTA. SHAFER CIVIL ENGINEER 694-2979 January 11, 1986 !ViUNICIPALiTY OF ANCHORAGE DEPT. OF HEALTH & - HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 ATTENTION: Susan 0swalt JJ'~JVIRONMENTAL PROTECTION JAN 3 1986 R'ECEIV[D REFERENCE: Lot 9; Block 3; Benito Subdivision Request you approve the attached Health Authority Approval and grant a waiver for the horizontal separation distances between the on-site well and the public sewer installed in Genora Street. Public sewer installed under Benito LID No. 50-5 on Bear Paw Circle provided for horizontal separation distance between the public sewer and the well of 50 feet. This was in accordance with laws which were in existance at the time of installation. When the public sewer was installed in Genora Street to the east of the referenced property 50 lineal feet of ductile iron pipe was installed to provide for well protection for the well on the referenced property. The horizontal separation distance which appears to exist is 46 feet. The law that governed at that time would have required 50 feet. Attached for your information is a copy of the Municipal as-built plan showing the well on lot 9 with respect to the public sewer on both Bear Paw Circle and Genora Street. If we may be of further service, please contact us. : OB~RT A. SHAFER, P.E. /RAS/ss SRB 196X EAGLE RIVER, ALASKA 99577 O~/ONV ~o ,o. ~c rtl IT1 z ~ 0 ~ Z 0 0 I .... ~L-IFGE NORA STREE'~ ! G ~- - '*' - - 0 -:- - I SE.E SHE. F'T 5 Mu cipality of Anchorage 3000 ARCTIC BOULEVARD ANCHORAGE, ALASKA 99503 (907) 277-7622 GEORGE M. SULLIVAN, MAYOR MUNICIPALITY OF ANCHORAGE DEPT. OF i i:!:,<',Ll'i..I & ENVIRONMENTAL P;:',OTECTION DEPARTMENT OF ENTERPRISE ACTIVITIES Sewer & Water Utility AUG 1 ~ 1979 RECEIVED August 13, 1979 Municipality of Anchorage Environmental Protection Agency 825 "L" Street Anchorage, Alaska 99501 Referenne: Benito Subdivision Block 3, Lot 9 Eagle River Alaska This is confirmation that the above the Municipal sanitary sewer system. and approved July 10, 1975. property is connected to The connection was made . Mac e C~stomer Service Supervisor Anchorage Sewer Utility OF ANCHOP. AGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED :- * . MUNICIPALITY O1='~_ AGE DEPT. Or ,- _ .... ON . ~_~-% . ,,~ ,,,,..I~,,.,.,,*..~t,..2~~:.~o~ ,o, .~ ~ ~ RECE[~ OlR~CTIONa= Comp ete ~11 part~ on page 1. Incomplete reque~ Will no~ ~=~ed, Please allow ten (1 O) days for processing· MAILING ADDRESS - ' I PROPERTY RESIDENT (If d~ent from above) ' ' ' ~ONE 2., BU R - PHONE ~AILING ADDRESS ' ' ' : ' ' ' ........... ~. L~mNamSr~gZ~ON ........... ," '~ .~0~'~ ........ MAILING ADDRESS ' 4. REALTOR/AGENT ' , I PHONE MAI brNG ADDRESS ' '. ~ ' ' 5 LEGALDE~C IP ION .................. - .............. ~ $1NGLEFAMtLY [] One ~ Four [] Other [] Two [] 'Five ~ [] MUETIPLEFAMILY [] Three [] Six 7. WATER SUPPLY I ~ INDIVIDUAL* * ATTACH WELL LOG, A welt log is required for allWel s dril ed I _[Z] COMMUNITY 'since June 1975. For wells 1 [] PU, B,~C UTlUTY d.pth (attach ~og if av.~ ab e.I, [] ** If ~ndlwdua/on-s te, g ve nsta at on date I ,,.,v,~,o..~,,~ .. · F~ I ~ If system is over two (2) years old an adequacy test is required t /~, PUBLIC UTI LITY by this Department. ' ............. , ....... 72~10(3/78) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: DATE RECEIVED 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] TWO [] FOUR [] FIVE [] SlX [] OTHER 2. WATER SUPPLY [] iNDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOl LS RATING TYPE OF TANK MANUFACTUREI~ TOTAL ABSORPTION AREA MATERIAL 4. DIS'I;ANCE'S WELL TO: Absorpti(~n Area to nearest Lot Line Septic/Holding Tank KRENIK INC., REALTORS® 9101 Jewel Lake Road Anchorage, Alaska 99502 Bus (907) 243-3212 Res. (907) 333-7403 GAlL SAVAGE Associate Each Office Is Independently Owned And Operated IAbsorption Area ISewer Line ] Nearest Lot Line 5. 'COMMENTS [~;;]"~APPROV E D FOR [] CONDITIONAL APPROVAL (letter must a [] DISAPPROVED LEGAL DESCRIPTION mpany certificate) _~ BEDROOM~ )~f L ~tter ~usta~b, 72-010 (Rev. 3/78) ' ~" MUNICIPALITY OF ANCHORAGE DEPT. O;' ~ "'!-'!:~ & .... ~ ' L DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC~tI~II~O~''~V[''qlA 825 L Street - Anchorage, Alaska 99501 3LIN 2 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ~DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be proc~d; Please allow ten (10) days {or; 1. PROP~TY OWNER ~ PHONE MAI LIN~ ADDRESS PBOPE~TY RESIDENT (If different from above) PHONE 2' BUYER PHONE MAI LING ADD~ESS 3, LENDING INSTITUTION J PHONE MAILING ADDRESS ~~; '~0' ~,~c~t .~~. 4. REALTOR/AGENT ~ PHONE ~e,,vTu ~ y ,~ iJ,, MAILINg ADD,E88 ET LO~ATION TYPE OF RESIDENCE ' SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS One ~ Four [] Two [] Five [] Three [] Six Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 197§. For wells drilled prior t.o that date, give well depth (attach log if available.) q~¢ ~'~,~ !' / **If individual/on-site, give installation date_ ~ ~'. F/6 If system is over two (2) years old an adequacy test is required by this Department. , NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) MUNICIPALITY OF ANCHORAG= DEPT. OF HEALTH & ~' ENVIRONMENTAL PROTECTION RECEIVED March 25, 1975 File No.: 4-1 GREATER ANCHORAGE AREA B .{OUGH 3330 CSTREET, ANCHORAGE. ALASKA 99503 DEPARTMENT OF ENVIRONMENTAL QUALITY Z74-4561 Mr. Stephen E. Reynolds NHN Bear Paw Circle Eagle River, Alaska 99577 Dear Mr. Reynolds: It has been brought to our attention that public sewer is available to Block 3, Lot 9, Benito Subdivision. According to Greater Anchorage Area Borough Ordinance, Chapter 16, Article 16.45, Section 16.45.050: "Septic tank-seepage system sewage disposal facilities shall not be installed or used on any premises where sanitary sewers are available within seventy (70) feet of the nearest lot ·line of said premises ...". The Greater Anchorage Area Borough Public Works Department has checked their records and they indicate that your structure (s) is not connected to the sanitary sewer. Would you please check your records to verify that the structure(s) is or is not connected and notify us immediately if your records indicate that a connection has been made. If we do not hear from you within seven (7) days, we will assume that our records are correct. We, therefore, 'request you connect any and all structures located on the subject property to public sewer during the 1975 construction season. You must apply for a connection permit from the permit officer for the Greater Anchorage Area Borough, 3500 East Tudor Road. If you have any questions regarding the above, please do not hesitate to contact the permit officer at 279-8686, extension 259, or the Department of Environmental Quality at 274~4561, extension 141. eLnCerel~ ~ver District Sanitarian JL/lw RECEIPT FOR CERTIFIED MAIL--30~! (plus postage) SENT TO POSTMARK OR DATE STREET AND NO, P,O., STATE AND ZIP CODE OPTIONAL SERVICES FOR ADDITIONAL FEES RETURN 1. Shews to whom and date delivered ........... ~5~ RECEIPT SERVICES With delivery to addressee only ............ 65¢ 2. Shows to whom, date and where delivered .. 35¢ With delivery to addressee only ............ 85¢ DELIV_ER_TO ADDRESSEE` ONLY ................ ~....~=,...._.~...,..,,,.~:......~,=, 50~ SPECIAL DELIVERY (extro fee required) .................................... PS Form NO INSURANCE COVERAGE PROVIDED-- (,See ofher side) Apr. 1971 3800 NOT FOR INTERNATIONAL MAIL ,~ GPO: ]9?2 o - 460-?43 March 25, 1975 File No.: 4-1 GREATE,{ ANCHORAGE AREA BOROUGH 3330 C STREET, ANCHORAGE, ALASKA 99503 DEPARTMENT OF' ENVIRONMENTAL QUALITY 274-456 ! Mr. Stephen E. Reynolds NHN Bear Paw Circle Eagle River, Alaska 99577 Dear Mr. Reynolds: It has been brought to our attention that public sewer is available to Block 3, Lot 9, Benito Subdivision. According to Greater Anchorage Area Borough Ordinance, Chapter 16, Article 16.45, Section 16.45.050: "Septic tank-seepage system sewage disposal facilities shall not be installed or used on any premises where sanitary sewers are available within seventy (70) feet of the nearest lot line of said premises ...". The Greater Anchorage Area Borough Public Works Department has checked their records and they indicate that your structure (s) is not connected to the sanitary sewer. Would you please check your records to verify that the structure(s) is or is not connected and notify us immediately if your records indicate that a connection has been made. If we do not hear from you within seven (7) days, we will assume that our records are correct. We, therefore, 'request you connect any and all structures located on the subject property to public sewer during the 1975 construction season. You must apply for a connection permit from the permit officer for the Greater Anchorage Area Borough, 3500 East Tudor Road. If you have any questions regarding the above, please do not hesitate to contact the permit officer at 279-8686, extension 259, or the Department of Environmental Quality at 274-4561, extension 141. ncerel~ ;~ver District Sanitarian JL/lw NUISANCE COMPLAINT FORM ~Do~r.lption of Complaint: Name of Person Against Whom Complaint is Made: Owner of Property Where Nuisance Exists: Owner's Address: Location of Complaint: Phone No. Person Receiving Complaint :----~_______~Date: I certify that such statement of facts is true to the best of my belief and know- ledge. I request that the foregoing matter be investigated and that appropriate action thereafter be taken, I am willing to testify to the facts stated in the foregoing complaint in court if Complainant Date Investigated: Action Taken: REPORT OF ACTION TAKEN DATE COMPLAINANT WAS CALLED REGARDII~G DISPOSITION OF COMPLAINT: