HomeMy WebLinkAboutT12N R3W SEC 17 PTN
Municipality of Anchorage
Community Development Department
On -Site Water and Wastewater Program
4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - hftp://www.muni.org/onsite - (907) 343-7904
Legal Address:
Subdivision
T IA� R 3 LA) Section / ?
Block Lot P? -)V
Lot P TAI / 9 Y-1 0, M'a I
On-site Water & Wastewater Program certified contractor performing the well decommissIgning:
N me:
' `.Q V.\ Signature:/'_____,I�
Company-
wv\��C;Y\ wot4- we&. I Vic -
Well decommissioning date 1-(P-/7 Method of decommissioning: AMC 15.55.06OLI a.R b.E1 C.
Location: Use the space below to provide a drawing of the property showing the following items;
• North arrow
® Decommissioned well,
• Other water wells on the property,
• Two separate swing -tie distances for each well shown on the drawing,
Note: The swing -tie distances shall be measured from either permanent structures or the property comers.
0' M&IIP—Y
Safety\On Site Water and WastewateftFonnsXClient
MUNICIPALITY OF ANCHORAGE ,
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME I IPHONE
MAI LI N~DDR ESS
LEGAL DESCRIPTION
LOCATION NO. OF B~OMS
D,S ANCE O: I '
~ ~ ManufactureG~~' ~ - Ma~~ No. of compartments
i Liq. ~n gallons IF HOME.DE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well Dwelling PERMIT NO,
O ~ ~ Manufacturer Material Liquid capacity in gallons
D ~ell- /~. Foundation7 ''~ Nearest lot line PERMIT~
No. oflines / Length of ea~line Total~f~es Trench ~ Distanc~ lines
_ ,_, ' ~ ~ ' . inches Tota] ----~bsorpti on~2
~ ~ ~ Top of tile to finish ~d~ Mater,al beneath tile ~ inches area
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
SOIL TEST RAT~ . ('~X [ ~"
~ ~ ,~fit ~ '~ ~,
72-013 Rev. 3/78)
F'ERH I T I'.,1(].
FI I: :' P L I iS: FI N T
[ L ] FIT t ] N
LEGRL
FOSTER
_I'~HL LE 'r
T:!.2NF'.:~:I,.I S:!.7 F'PIF.'iCEL 6;
[:,EPFIRTMENT Of HEFILTH FIND EN',,,'tROI'.,IHENTI::IL. F'ro3TEE:TIEd','g
':":'"i '" L. "' STREET., Rt'.,I ] HORSGE., Fhk:.
;-]:64-47;;i:O
LOT S I
E~ 'E C~I..IRRE FEET
T'¢F'E OF '.:.5OIL RE:SORE:TION ::.r: t E. fl IS: "['F:ENCH
MR::.:; I MUH i'.,IUME:IL:]~;: OF E:E[:,ROOMS; = 3 '~.';O I L. RI::~]" I i'.46 ,:: SC! F]",.."E~R ::, = J..,4.;;l
THE RE~;!UIRE[:, S:[;..ZE OF THE SOIL FIESORF'TION S'¢STEM IS:
THE L. ENGTH [:,Ifr'IEI'.,IE;:!:EII'-,I IS THE LENGTH ,::IN I::'EET) OF THE TRENCH OR [:,RRINFIEL.[:,.
THE DEPTH OF R TRENCH (:iF.:.' PIT IL::; THE [)ISTFINCE BE]"I4EEN THE SURFFICE OF THE
GROLII'.,I[:, lIND THE BO'rTC)M OF THE Ei:.,iCR',/FITI. ON ()~N FEET).
THEF.:E l'S NO SET !4IDTH FOF..' TRENCHES.
THE "" ' '/- '-' :r.r~ ', ~:-
.aF..--,El_ [:'EF'TH I.::, THE i"Ili"~IMUM [:'EP]~H OF .... r;,'-,,,,'"' EET,EEN "rilE ]I ITF'FtL_ F'IF'E:
FIN[:, THE E:Er'i"TOM nF THE E,..,..h,d'IION (ZN FE'E]~). '- ' ' ...... - '- .
F'Eli;:f'IlT FIF'F'L. ICFINT HFIS THE F.E_-',F_.4z, tE, ZLI TO INFOIq:M THIS [:,EPt:IR]'MENT [:,UF.':Ii"~G "rile
I NSTRL. LFFr I O1'-.1 I IqSF'EE:T~' ONE; OF FIi'-,i"r' WELLS FIDJFlr':ENT TO TH I '-"'~; PROI::'ERT'T' RI'-,I[:, THE
NUMBER OF KE:.:, :I:I],ENCE'.'5 THR'I" ]"HE WEL. L W. ILL SEF. i',,,'E.
E - L.I...F ]. L.L .'[ NG OF' Flig,"¢ S'¢STEH I.,.! I THOIJ'I" F'I NF1L I NSF'ECTt ON FIND FIPF'RO",/FII... E:"r'
E:'EF'FIF.::THENT !4ZL. L BE SUEL.TEE:'I" TO F'ROSECUT~ON.
HII'.,IIMUM DIS"rI::INCE BE'F~.4EEI'.,! R klELL RI'.,IC, FIN'T' Oi'.,I-SITE SEFIRGE [.':,ISPO'.:.i;RL. S'¢STEM IE;
;t(!lE~ FEET FOR F:I PRIVFITE WELL.; OR '
:Lr'5(]~ TO ;:Z(i)E~ FEET FROM Fi PUBL. IC I.,.IELL [:,EPEI'.,IDING I...tF'[It'-,I THE T'T'PE OF F.'LIEILZC FIEL.L..
OTHER REI:]IJ!REMENTS i"1Ft'T' FIF'I::'L'T'. SF'ECIF!CRT!ON:5 RN[.':, COI'-,ISTRIJCTION DIFfGRRMS FiRE
F:I',/F~IL_ABLE TO INSUF,'.E PROPE:R INSTRLL.FtTIFIN.
:[ CEI:i:T I F'¢ THRT
:;..: )~ FIM FRi"IlLIRF.'..k!ITH THE REi..]UtREHENTS FOR ON-SITE SEWERS RI'.,IB, 14EL. LS RS SET
Fi]R]"H B'T' THE HUNICIPFILIT'T' OF' RNCHORFtGE.
2::: t 14ILL Itq'.:~;"I'RLL THE S'.r'STEH IN F:ICCORD!::fNCE ktlTt4 THE CO[:,ES.
3: I UNDERSTRND THRT ]"HE OI'.,!-E;ITE SE!4ER S'.r'2;-rEM f'lR'¢ RE~]]LIIRE ENLFtRGEI'dENT If-:' THE
RE:E;II]:,EI'.4E:E IS REMO[)ELED TO I NCL. UDE MOF.'.E THFIN 3 BEDROOMS.
E; l Gi'.,!E[:, '
FIPPL I CFINT FOE;TEl:;.:
~M_UNICIPALITY OF ANCHORAGEs-.
Department.' ~ Health and Environmenta 'protection~
825 L Street, ~chorage, AK. 99501 '
-~ ~ * * * HANDWRITTEN PERMIT * * *
Permit ~
~~ ~ /OR ON-SITE SEWER PERMIT
Applicant: ~~ ~0~, . Mailing Address: S~
Location:~ ,~y~'-~~ ~ .. Phone Numar:
Legal Description: ~~ Lot Size:
Type of Soil ~sorption System Is: ~/~ ~
Trench:~' Drainfield: Seepage Bed: Holding Tank:
Maxim~ N~b~rooms: ~ Soil Rating(sq.ft/br)
~C.'~ ~uire~_~i~oil ~sorption Sy~s: '
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of t~ ground and
the bottom of the excavation(in feet). There is no set width fo~ trenches.
The gravel depth is the minimum depth of gravel between the out,all pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE :-~'~; ~¢,/~,mGALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department.
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 $ 3 * * * ~
I certify that~
(!) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on=site sewer system may require enlargement if
the residence is remodeled to include more t~3 be~r~
Date: ·
SWP/024(1/81)
'~ ' 2204 Cleveland Anchorage, Alaska 99503'
/teoal Qescrintion: Lo--Block '~ ~Su'bd]visqnn .... ~_ _ _
[This Form Re~orts So~Is Loq ~S Percolation Test
2
4
8
10
14
16
18
20
nenth
Feet
Soil Characteristics
Was Ground Water Encountered?
IF Yes, At what Depth?
i,'?] ; , i I J
Readinq Date/?~ ~u~.-~qoss Time Net Time Depth to H20 Net Dron
~ 7:/;~"~
I :
Percolation Rate Hinute
Prnnosed In. sta'llation: Seenaoe Pit Drain Field__
, Den. th of InLe_t ~ Depth To Bottom Of Pit 0f Tr. ench
v x ifi - :
Test Performed By J/'//~/' /~'/~ Data Cert ed
i m
PO ;"4 6-650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
MA YOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
May 14, 1984
Evelyn Foster
1941 O'Malley Road
Anchorage, Alaska
99516
Subject: T12N R3W Section 17 Parcel 6
As per your request, in examining our files, it was discovered
that in July 1978 a permit to install an on-site sewer system
was issued for the subject property(copy enclosed), ttowever,
this department has no record of the final results(as-builts)
of the installation. The department requires that a final
inspection of the on-site sewer system be conducted and red0rded
with the department, otherwise the installation is considered
by the !department as being illegal°
Adequacy test: In response to your question concerning adequacy
test, the local banks, before granting a loan are requiring
certification of the well and sewer disposal system. This :is not
a Municipality of Anchorage requirement. It is a requirement
of the lending institution, just a service the MOA provides, upon
the lending institutions request.
If there are any further questions, please call this office at
264-4720.
Sincerely,
John Kennedy
Engineering Tech II
JK/ljw
December 29, 1978
Mro Foster
Star Route A box 1789
Anchorage, Alaska 99502
Subjects T12N R3W Section 17 Parcel 6
A permit issued by this department for well and/or
sewer system has expired.
Permits are issued on a calendar year basis, as stated
on the permit, by authority of Municipal ordinance.
If you have drilled the well, a well log should be
sent to this department to document the installation
date.
If there are any further questions, please contact
this office at 264-4720.
Sincerely~
Les No Buchholz, R.S.
Senior Environmental Specialist
LNB/ljw
enc~ copy of per, it
ALASKA BllUIROrlmeI1TAL COIhTROL SeltEIICeS, IIIC.
MAY 23 1983
EVELYN FOSTER
SRA BOX 1784
ANCHORAGE AK 99502
SELLER - EVELYN FOSTER BUYER-
SUBDIVISION-T12N R3W SECTION 17 PARCEL 6 BLOCK- LOT-
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN UNKNOWN AREA.
THE SYSTEM IS CAPABLE OF ACCEPTING ~8~ GALLONS O~ WATER PER DAY.
THE SURGE CAPACITY OF. THE SYSTEM IS 34-5 'GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A
HOME OP 3 BEDROOMS. ISAACS PUMPING SERVICE
(Norm Tibbetts, Owner)
, -/ 6218 Quinhagak Street
SEPTIC TANK ADEQUACY ~:: ANCHORAGE, ALASKA 99507
~ Phone 344-0114563.3300
1200 LUcst 33rJ Aucnu¢, Suite
4644
All claims and go
accompanied by this bill.
MUST be
~l'hank~ou
GREATER ANCHORAGE AREA BOROUGH
Department of 5nvfronmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Date Received /~
Date of Insoection :,~.,,~Q
REQUEST FOR APPROVAL OF
I!N~!VIDUAL SE~'~/ER & WATER FACILITIES
~, _ '/i '/.
1. A~proval Requested By:
,
~. ~,~ ~.o~, ~ :'e~, :<~ :~./: ~/~>' 4~~ -~
Number of Bedrooms:
e
Sewage DisRosal System: ~
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1o Sizef~ . 2. Material /'~/~d~
E. Dtsposa] F~eld: Total Length of Lines -
A, Welt Tot Septic Tank . Absorption Area
, Nearest Lot Line
· Other Contamination
Foundation to S.ntic Tank
' > Ab,~orptien Area
C. AbsorDtfon Area to Nearest Lot Line
Request for Approval of Indivldua] S-ewer & Water Facilities
Page Two
~Appro~a! ';slid ~or One Y, ar From Da~e Signed
Greater Anchorage Are~ 8orough, Deear%ment of Environmental Quality
D~AG~;., OF SYSTE3;.
I certify that the information contained in this request for approval to be a true
and accurate representation of the m]b~ect sewer and water facilities located at:
' Signe~ Date
December lq-, 1971
Ur. Robert Gleason
St. Rt. 'A ~ox 1789
Anchorage, Alaska 99502
5ubJ~ct: On-site Sewer Installation~ Section 17,
T12N, R3N, S.M.
Dear ~lr. Gleason:
On June 7:. 1971 you obtained a permit fro~ this
F~artr,?~nt for the installation of an on-sit~ se,~er
sysi;~m to be installed at th~J above locatior~.
Pleas,~ advise %his Department if the syst(~m has been
installed or if you wish yo~r permit kept valid in our
files.
Sincerely,
C. Stl,.? ?cKechnic
Environ~entat Control Officer
st
GREATER ANCHORAGE AREA BORuUGH
/~/~J 3500 TUDOR ROAD POUCH 6-650
~/\~ · ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
OTHER
INSTALLATION OF: SEPTIC TANK X SEEPAGE Pit ~ DRAIN FIELD
SOIL TESTRESULTS \~\
COMPLETION DATE ANTICIPATED -- '
FINAL INSPECTION: 24 HOUR NOTICE REQUIRERS\ BACKFILLING Of ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJE(~,T TO PROSECUTION.
SEPTIC TANK SIZE ~'~--I~ TYPE ~ \\ SEEPAGE AREA SIZE '"~ ~ TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT /~/
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK ., SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
NOTE: THIS PERMIT I$ NOT VALID WITHOUT SOIL TEST
DRAIN FIELD
DRAIN FIELD
{~0 ~
SEEPAGE PIT .
ALSO CONSIDER AREA W
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
' /~0"
S[PTIC TANK, ~ ~- SEEPAGE PIT
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK A
GAP OF
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO ~OROUGH F~EGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
I CERTIFY~AT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH
DESCR SYSTEM IS IN ACCORDANCE WITH SAID CODE,
NANCE NO. 28-68 AND THAT THE ABOVE
June 26, 1973
Cheryl Nangle
Marston Realty
2804 Northern Lights
Anchorage, Alaska 99503
SUBJECT: SW1/4, SEll4, Sb~on 17, Tt2N, R3W, S~
Dear Mrs. Nangle:
The subject property was inspected by this office on June 12, 1973.
This office had no record of sewage installment on subject property;
we do however have a statement from the owner indicating the presence of
a septic tank and seepage pit. The system was installed in 1954.
According to this information the system meets ~) distance requirements.
This well was inspected and is properly sealed. The water was satisfactory.
Sincerely,
Susan E. Dickerson
Sanitarian I
lb
?R
June 5, 1973
Robert J. Gleason
~ox 1712
,}uneau, Alaska 99801
SUBJECT: Section 17, T12N, R3W, SM
016-061-07
Dear Mr. Gleason:
Recently this office received a request for inspection of the sewer
and water facilities on the subject lot. At the time of the request,
it was indicated that your systmn was installed about 1953. Assessing
records show construction in 1954.
In 1971 yoLm were issued a permit to install a full sewage system, The
permit is still being held by this office since no final inspection was
ever done. This office sent letters in 1972 and lg73 requesting
information on this installation, but received no reply from you.
Failure to receive an inspection ef an installation is in violation
of GreaterAnchorage Area Borough law,
This office will not approve the'sewer and water system on your lot for
loan purposes, until such time as you provide an explanation of the
apparent inconsistency in our records.
~ suggest you contact this office so we can arrange a satisfactory
solution to the problem.
Sincerely,
Susan E. Dickerson
Sanitarian I
lb
RECEIPT FOR CERTIFIED MAIL--30~! (plus postage)
SENT TO POSTMARK
OR DATE
STREET AND NO.
P.O., STATE AND ZIP CODE
OPTIONAL S~RVICES FOR ADDITIONAL FEES
RETURN ~1~ 1."Shows to wham and date delivered ........... 15¢ ''
With delivery to addressee only ............
RECEIPT 2. SAews to w~em, date and where dalivered .. 35¢
SERVICES With delivery to addressee only ............
DELIVER TO ADDRESSEE ONLY ...................................................... §Od
SPECIAL DELIVERY (e~xtra f~required) ....................................
PS Form 3800 NO INSURANCE COVERAGE PROVIDED-- (See other s~de)
Apr. 1971 NOT FOR INTERNATIONAL MAIL
U-S. POSTAL SERVICE'
aUl~ ~
DE~, OF ENVIRoNMeNTAL QUALITy
~ Postmark of D~livering Office
SENDER INSTRUCTIONS
GREATER