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Home My WebLink AboutT12N R3W SEC 15 LT 118A MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 TeJephone 264-4720 LEGAL DESCRIPTION P~"~W~II '~ I 01 '}-~bsorption area OlSTANCETO: tO0~ [ ~ ~, Dwellin' L~7 ~t Manufacturer ~ Material ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT P H-~'N E {~ UPGRADE Liq. capacit I F E: I aside length DISTANCE TQ: Well Dwelling Manufacturer DISTANCE TO: No. of lines ~ Top of tile to finish grade Length Type of crib Crib diameter Well DISTANCE TO: Class Depth Width DISTANCE TO: Btlilding fotmdation Material Nearest lot line,~) NO. OF 8EDR )MS PERMIT Liquid depth PERMIT NO, Liquid capacity in gallons 3. NO. Crib depth Total effective absorption area Building foundation Nearest lot tine Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROVED 72-013 (Rev. 3/78) DATE LEGAL HUN Z C :1: PRL I T'¢ OF FINL-:HORF:IEiE DEPFIRTHENT OF HEFtLTH FIND ENVIRONHENTF~L PROTECTION ,.,~5 L -,TREE r., RNCHORBGE., FIK 9950i 264'-,1720 PERMIT NO: DFITE ISSLIED: .=. I T'E~ 840Z.59 0 5,.'"2:1 ,.."8 4 -- E_ I~1 E F4. F="EF:i~"i I T FIPPL I CFINI": FI[. DF.:E ...... CONTFIL-:T PNONE: LEGFtL [~E..,L. RIP: LnT LOT LOCATION: I"IFI)4 E:EDROOFIS: LFIRRY H. NEFIS SRR BON ±?27-RR ~46-247J. SUBDIVISION: NB ~ECTION: ~.5 TOHNSHIP: 45_~00 (SO. FT. OR RCRES) PFICER PLFICE Ri",lD 2LO'J. ST tg,/E 4 LOT: J.'i.8R :L2N RRNGE: 3H BLOCK: NR LI_TE.D E, ELO[.I FIRE 'FNE OPTIONS FIVRILFIE:LE TO '¢OU tN [::,E'~*I]NING "r'OLIR -- ' '" - bEFTIL. SVSTEI"I. CHuU_,E THE ¢IPTIFIN THFIT E,L~T FITS 'COl JR '= .... - , - _,I rE. 'T F,:~ EE N C: F~ Ei." E DEPTN TO PIPE BOTTOH (FT.) 4. 0 4. 0 GRFIVEL DEPTH <F'T. ) 4. 5~ 0. 5 TOTRL DEPTH (F'T.) 8. 5' 4. 5 GRRVEL HIDTH (F'T.) 2. 5 20. 0 GRFIVEL LENG'FN (FT.) 62. 8, ]~8. El GRR'¢EL VOLUHE (C:U. '¢[:'S. ) 28. 7 28. ~ SOIL RRTING (BQ. FT. /BR) i38 i25 =+='+' TRNK I ItJ=,l HFIVE FIT LEH_T TWO C:Fd'"IF'FIRTMENTS 4.0 2.".5 7.5 5. 0' (;5. 0 Z. 4. 8 -'1., 250. 0 ::L50 I CERTIF'¢ TNFIT: i. ~ RH F¢~I'IILIRR HITH 'THE RE6!UIREI'IENTS FOR ON-SITE SEHERS FIND HELLS laC: SET FORTH D'T' THE MLINICIF'FILZTV OF FINCHORIZ~GE (I"IOFI) FiND THE STRTE OF FtLFISKFI. I HILL IN_THLL ']'HE '='"--' ',' :,?-~IEil IN FICCORDRNCE N ITH FILL MOFI CODES FIND REGULBTIONS., RND IN C:OHF'LIFINCE HITH THE: DESIGN CRITERIFI OF THIS FERHIT. 2.':. I HILL FIDNEF',E TO taLL I'IOFI FIN[:, STFITE OF RLFISKFI RE6~UtREPIENTS FOR THE SET D~CK [:,ZS'FFiNr.;ES FROM RN"r' FNIE;TING HELL, HFISTEHR'I"ER DISPOSRL S'¢STEM OR PUBLIC: SEHERFIGE SYSTEM ON THIE; OF,' RN'¢ RDJRCENT OF.: NERRB"r' LOT. 4. I UNDERSTRHD THRT 'f'NIS F'ERMIT IS '¢FILID FOE: Ft HFtXIMUH OF 4 BEDROOMS FIN[:, FIN9 ENLFIRGEPIENT 14ILL RECIUIRE FIN FIDDITIIgNRL PEF.,III]. IF Fl LIFT STRTION IN"; INSTRLLED IN FfN FIREF:I CO',?ERED E:'¢ MOB E, LIIL. C.[NL~ L. THEN ('~.') RN ELEF:I'RIF:FI[ PERHIT t~ND INSPEIZ:TION MIJ'_-]T E,E OBTFIINE:D.~ <2) H--, EL.lILT.:, HILL NOT BE FIF'PF.:OVE[:, HITHOUT FiN EL. EL':TF.:ICFIL IN=,FEC. TI]N REPCRT RN[:, *._.,.., THE ELECTF.'ICFIL H-, (' HUqT F~E ~l]. : ......... , · I~,~ .... [-f4E ET FI LIu[.~Nz, E:D ELECTRICIFIN. :IPF'LICRNT: L. FIRR"r' k~ NE':FIS --C- ................... Department Y Health and Environmenta' rotection 825 _ Street, Anchorage, AK. ~301 264-4720 HANDWRITTEN PERMIT * * * Permit ~ ~ WELL AND/{:I~ ON-SITE SEWER PERMIT Location: Phone Number: ~F, Legal Description: L/~;~ 7Q~ ~[~J ~./~ Lot Size: Type of Soil Absorptioh System Is: Trench: _k/ Drainfield: . Seepage Bed~ Holding Tank: Maximum Number of Bedrooms: ~'-'~ ~' .Smil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH ~ _ LENGTH ~/ . GRAVEL DEPTH ~'J WIDTH '~1~ ~g" 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 the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). · * REQUIRED SEPTIC(HOLDING) TANK SIZE = /.Z..c--(~ GALLONS * * 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. · * * TW0(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 8 3 * * * I certify that: (i) (2) (3) the residence is remodeled Signe~: ~~]~ Applicant I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. I will install the system in accordance with codes. I understand that the on-site sewer system may require enlargement if to include more that 3 bedrooms. Issued by: /..,z~. Date: swI~/O 24 (1/81) Permit It Applicant: Location: mu~l~lKA~ll¥ Uh ANCHO~A6E Department f Health and Environmenta ?rotection 825 ~ Street, Anchorage, AK. ~9501 264-4720 * * * HANDWRITTEN PERMIT * * * ~!~O~%~LL, AND/q~ ON-SITE SEWER PERMIT Mailing Address: ,oC Legal Description: ~/(gA -//~&J ~¢~ Type of Soil Absorption System Is: Trench: / Drainfield: Seepage Bed: Maximum Number of Bedrooms: . x% DEPTH The Required ~ LENGTH Holding Tank: Soil Rating(sq.ft/br) /k ~__ Size of the Soil Absorption System Is: ~/ GRAVEL DEPTH ~/ WIDTH 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 the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum~ depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~-~ . GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent te this property and the number of residences that the wel]L 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 8 3 * * * I certify that: (1) I am f~iliar 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 include more that ~bedrooms. :esidence is remodeled to Sign e~_~.~-~_ ~ 1 i~'an~ Issued by: Date: SWP/024(1/81) ............... I. hi . ~ S ~ .... M... Performed for Legal Descripti'on: This form reports: '"'ATER ANCliORAGE AREA BOROUGH Dew .ment of Environmental Quality 3330 "C" Street Anchorage, Alaska 99503 ~/d'~J~ /%xc~/~,-~ Da t e per f or me d Soils'log J Percolation test Depth Feet 1 2- 3- 4- §- 6- 7- 8- 10- ll- 12- 14- Was ground water encountered? If yes, at what depth? Reading '1 Date Gross Time Net Time Depth to H20!' Net Drop ~{rc~lation rte minute. Proposed installation: Seepage Pit Drain Field Depth of Inlet Dep't'~' to bottom of pit or trench COMMENTS: Performed By: ~t ~.~.~/-~.~:_.(' Certified By: ~w/~. ~ .S~ ~ ' _ Date: ...... qng Engineers 6, Associates 2. East International Airport Rd, Suite 204 ANCHORAGE, ALASKA 99502 (907) 278.3773 SOILS LOG - PERCOLATION TEST SOILS LOG [] PERCOLATION TEST PEREORMED FOR;__I""~ LEGAL DESCRIPTION; 1 2 3 5 6 7' 8- 10- 11 13- 16 17, 19- 20- DATE PERFORMED: SLOPE SITE PLAN WAS GROUND WATER O P IF YES, AT WHAT E DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS ~Permit #: '~20173 January 31, ].983 TO: Permit Applicant Subject: T12N R3W Section 15 Lot 1].8}, A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. 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 needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, p_lease call this office at 264-4720. Sincerel.~I Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 MUNICIPALITY OF ANCHORAGE ' DIVISION OF I~VfRONMENTAL HEA}TfIH DEPAI~i/~ENT OF HFALTH AND E~VIRF~MENTAL [~R(~rECTION APPLICATI(IM FOR HF~ILTH AIII~IOR]iTY APPROVAL CERTIFICATE 1. General Information ADplieation Date (a) Legal D~sc~iption (include lot, block, subdivision, section, township, range) (d) I~nding Institution __' ..... re lephone Address (e) t~al Estate Co. & Agent Add~:ess Othe]: (describe) Individual. Well F~ Ccm~m~nity ~.--~ Public ~ Note: If (~mlmity ~].1 system, must have ~'it~)n ~nfi~'mtion fr~n ~e State ~paF~nt of ~vi~o~ntal Con~)rvation attesting to t~ legality and status. Is the ~11 adequate foF the numar of ~ s~cified in this ~ 4~ ~wa~. Di~R~~ Onsite ~ ~blic ~I ~r~nity ~ Holding Tank Is the wastewater dis~sal system adsquate f~ the n~l, of ~c~q [Pa~e 1 of 2] 2-15-84 5. ' ' d In~_~_gtimns, Tests, B~ta and Information I ¢~rtify that I have checked, verified, or (~nfor~d to all ~A H~ ~i~ effect on the date of this insl~ction. , ....... ( ENGINEER SEAL) Approved Eo~' App~'oved ~__~.,~ Disapp~,ovad r---~t Temrs of Conditional App.'oval Conditional Date 'Ihe Municipality of Anchor-age Dapa~tn~nt of Haalth and Envirorm~ntal P~'otection d~s not ~arant~e tl~ continued satisfactory ~mfo~n~ of t~ watel, supply and/~ the was~wate~ dis~sal system. ~is approva3 indicabas that, as of t~ al~dation (~ ~ . sh~ a~)~, ~s~d on t~ ~ta and info~tion f~nished ~ ~ ~l~er registered in the State of ~aska, die ~t:e~ supply and wastewater disposal system is safe and fun~ tional for the numbe~ o~ [~c~ and ty~ of strl~ctu~,e indicated. ( IlqEP SEAL) 7. Mail the liAA to tt~ followiP~ adc~ess: Kn2/d5/s [Page 2 of 21 SLEEPER, INC. 8050 Oki Seward FligSway Anchorage, Alaska 99502 8usiness (907) 344-2501 Residence (907) 346-2400 YVONNE ELMORE Sates Associate 2-15-84 A® MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AU1T{ORITY APPROVAL (HAA) CHECKLI&~ - FEBRUARY 1984 MUNICIPALITY OF ANCHORA(~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION JUL 3 1984 Well Classification _JD,~i'~J~_ .'~.~_.__ Well ~g t>~esent Total Depth... Static Wate~ ~1 ~~~ PU~ ~,t A't~~~ Casing ~ight Sanit~y F~al on Casing If A, B, a~ C, D.E.C. Approved(Y/N) k2/~ Date C~Npleted (O/~%/c~Y'zeld_~C2~,v' . . Eleet~ioal Wi]:inG in Conduit ~/N) Separation Distances f~cm Well: To Septic/Holding Tank on Lot .Z~3~~ / To Nearest Edge of Absorption Field on To Nearest Public Sewe~ Line Depression Around Wellhead Cleancut/Manhole ~3//~ __ To Nearest Sewe~ Service Line on Lot Water Sample Collected By .... .~J~T, ,~ __; Date__ <~/~ ~/Z~ Water Sample Test Results .%~~? Comments ; On Adjoining Lots _; On Adjoining Lots__~.~o~ To Nearest Public Sewer B..~EPTIC/HOLDING TANK DATA Date Installed ~5~y Size __ / 2_ A-C.') __ NO. of Ccmpart~mnts Standp:Lges _~.~/N) _Ai~-tight Caps ~Y[~N) Foundation Cleanout ~/N) __ Depression ove~ Tank _(.Y~% .... Date ~st Pumped Pumping/Maintenanc~ Contr. aet on File .(Y/N) /~//~; for ;~/~ ' Holding Tank High-Wate~ Alarm (_Y/N) ;~/~ T~mgo~a~y Holdir~ Tank Permit Separation Distances f.~cm Septic/Holding Tank: To WateL,-Supply Well _. /O~ To Building Fc~lndaticn_ ~/~/ To Property Line .3/I To ]Disposal Field _. To Water ~ai.n/Serviee Line ~g_J~_____ To S~eam, Pond, [2~ke, c~ Major D~ainage [Page 1 of 2] 2-..15-84 Ce ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~-/~ width of Field J/~ / Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~.~'-/ square Feet of Absorption A~ea _%-{/? ~ Standpipes P~esent ~/~.) Dep=ession ove~ Field (Y~ ~te of ~st A~a~ Test ~/~ Results of ~st ~a~ ~st Separation Distan~ f~ ~so=ption Field: To ~te~-Supply ~11 ~/~ TO Building Foundation ~O Lot ~ ; To Wate= Main/~=vi~ Line ~/~ To ~t~(if pre~nt) To St=e~ond~ke/~ Majo= ~aina~ C~se TO ~iveway, Pa=ki~ ~ea, ~ Vehicle St~a~ ~ea ¢/~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Wate= Ala~mLevel at Tested for A~¢~_ Electrical Codes(Y/N) ~J~ Comments Oir~nsions Manhole/Access (Y/N) "Pump Off" Level at. Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA ** Check Pe=mitted Bedroom Rating Against HAA l~queSt I certify that I have checked, verified, o~ confo=m~d to all MOA on the date of this inspection. S i gne d ~/~ ~..F~ ~.~ Date Company KB1/d5/s [Page 2 of 2] HAA Guidelines in effect 2-15-84