The URL can be used to link to this page

Home My WebLink AboutT12N R3W SEC 25 E2SE4NW4NW4NW4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Township, Range, Section TANKS SEPTIC [] HOLDING Material Capacgy in gallons TYPE OF SYSTEM ~ TRENCH [] DRAIN [] OTHER BED W. Depth to pipe bottom from Total depth from original grade original grade ,,~ FT Fill added above original grade Gravel depth benealh pipe ~ FT ~_~ Gravel length Gravel width Total absorption area Distance between lines ~00 SQF1 WELLS ~ PRIVATE ~ OTHER (Identifv) Classificagon (A,B,C) Total Depth FT Cased to InsteYer Date Installed: DISTANCES WELL LOT LINE :FOUNDATION SEPTIC TANK 120' P, BSORPTION WELL FIELD 3 AS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundano~, driveway, water bodies, e~c.) REMARKS: Da:e: ~-/-?O I ~1~ ~ ~0 ~X0 W cedifylhatthisinspe~ionwaspedormedaccordJnoloall Municipal and Slate guidelines in effect on this date: /I/ 72-013 (3/85) ZNFOF;:!"! .b,J"C,I"J,S~ I::'['RZk)F;..' T[i ;(NSPEC'I']:[!NE'; EW ENJ3]ENEEI:R~ ]:f AI::'I'E:F~ C)!:::!:;ZL;;IZ I'I[:)~I:;:S~, [;AI.L, 5zi:::,P'".d'6E~I AND LEAVE: A IdESSA(~)E. 'iHI~:;¢ F:'!ZF~I"iiT IEXF']:I::~ES 12/J;I/S~C¢ AN.O VAL..:[D F(]F~ A S];NE)L,E F;AM]],,Y I.'4(]NE,, PERFORMED FOR' ~ ~/ ~ ~. DATE PE~ 1 2 3- 4- 5- 6- 7 8 9 10 11 12 13- 14- 15- 18--- 17 18 19 20 WAS GROUND WATER ENCOUNTERED? PERCOLATION RATE TEST RUN BETWEEN FT AND WITH A~ STATE AND MUNICIPAL ~UIO~N~S IN ~F~ ON ~15 OAT~ OAT~ ~ ~ , ~ GRE/~ ~,< ANCHORAGE AREA BOI~._,'H f~H~)) Depart ment of Environmental Quality ~ 3330 C Street Anchorage, Alaska 99503 NAME /~{~/ LOCATION INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ~J/'} ~'1 ~'//'~_~ MAILING ADD'SS~ LEGAL DESCRIPTION SEPTIC TANK: DISTANCE t/~ FROM WELL-- INSIDE LENGTH MANUFACTURER INSIDE WIDTH / NUM.EROF MATERIAL ~/~ ~ ~)/'~ COMPARTMENTS LIQUID DEPTH I_IQUID CAPACITY /0~ O GALLONS. SEEPAGE PIT: NUMBER OF PITS / LINING MATERIAL LC BUILDING FOUNDATION__ ADDITIONAL ABSORPTION DIAMETER OR WIDTH LENGTH DEPTH NEAREST LOT LINE ~"~)/ TOTAL EFFECTIVE · ABSORPTION AREA (WALL AREA) '7 ? ~' SQ. FT. WELL: TYPE Pr;~f~ CONSTRUCT,ON ~~'~/ DEPTH /~?' D,STANCEFROM: .U.LD,NGz_7~NEAREST NEAREST SEPTIC/~)~; SEEPAGE I1% FOUNDATION __ LOT LINE SEWER LINE TANK / ~' , SYSTEM CESSPOOL OTHER SOURCES APPROVED J~"A PP ROY ED DISTANCES: INSTALLED BY PIPE MATERIAL.: LOT SLOPE: REMARKS: ~v;ll ~ll z' Form No. EQ-031 DIAGRAM OF SYSTEM GReaTER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY INSTALLATION LOCATION T~O~BE INSTA LE B - PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT C fL,NGADDRESS :4' PHONE OTHER THIS PERMIT 15 NOT VALID WITHOUT BOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE I Type SEEPAGE AREA SIZE TYPE FOUNDATION TO SEPTIC TANK SEPTIC TANK TO SEEPAGE Pit WALE SEEPAGE PIT SEPTIC TANK TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD ~ f DRAIN FIELD ALSO CONEIDER AREA WELLS. SEEPAGE PIT WATER MAIN TO SEPTIC TANK 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 O~ SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. - I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM ES IN ACCORDANCE WITH SAID CODE. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# (~'~'"~ - ,~,..~, \_(,~o] HAA# ~°\ GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address. Agent Address Day phone Day phone Day phone NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water Unless otherwise requested, HAA will be held for pickup. 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: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ~21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, ! 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /~J~-'lZ$O,J -~"',,,J L,,~'I.~.'-ILI~,I~, Phone ~;~- q.~Z ~, Engineer's signature ~1/~~ ~ -/t~/'~'-'~' Date 7//~'/~-~ DHHS SIGNATURE .,/~ Approved fo r ~--c'-~'f'~ C/~/,) Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, ALASKA 99524 July 29, 1993 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Attention: Susan Oswalt RECEIVED JUL ~ 9 1993 Municipality of Anchorage Dept. Health & Human Services Subject: E2SE4NW4NW4NW4S25T 12NR3W Health Authority Approval Dear Susan: The monitor tubes and cleanouts serving the septic system on this property have been reestablished, repositioned and capped to reflect original as-built condition. In addition, the well seal has been secured. The owners of the property have also been told to establish an alternate vehicle access to the front of the house other than over the drainfield trench. They now intend to go around the trench on the rare occassion that access to the front of the house is necessary. Hopefully, this will satisfy the comments noted on your review and the Health Authority Certification can be issued. Sincerely, Michael E. Anderson, P.E. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Descr pt on A. Well Data ParcelI.D. O/"7'~ /-/~/- ~ ~ Well type Log present (Y/N) Total depth ~ /~,~' ~ Sanitary seal (Y/N) /v~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed .~/~'~ ~ Driller Cased to .~/~.~/ Casing height Wires properly protected (Y/N) FROM WELL LOG Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot /~ j Public sewer main ."~/~'~ Sewer service line ,'~ ,:~',C~: .g.p.m. AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout /)////' Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate ~,. ~,~'~/.//_- Other bacteria Collected by: ~. B. SEPTIC/~ TANK DATA Date installed ,~/~,/~'g) Cleanouts (Y/N) F High water alarm (Y/N) ,,~',~/'- Date of pumping Tank size /,'~'C, ~2,~/~. Compartments Foundation cleanout (Y/N) ~ Depression (Y/N) Alarm tested (Y/N) '~/~0/~,.~ Pumper .,/~ ~. SEPARATION DISTANCES FROM SEPTiC/HOLDING TANK TO: Well(s) on lot -- /"/~ On adjacent lots To property line ~' ' Absorption field ~'~" ' Surface water/drainage >/~'~:;' / Foundation ~' Water..mcJa/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION /V'///~ _ Manufacturer Manhole/Access (Y/N) Vent (Y~N)__~ ;'egeht sW~rAa; rel~t i :cVa~ lc o d es (Y/N) .~lt~6t On adiaeent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ¢'-~ / Width Total absorption area ¢o¢,:~,~ Date of adeq.acy test T/~.~ Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/Ft2) ,X. ¢ Gravel thickness Cleanout present (Y/N) Results (pass/fail) System type /)" Depression over field (Y/N) /~,¢-.4 .,~ for /~ Bedrooms After test If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /¢~ / To building foundation On adjacent lots ~'/o,¢~ Surface water ~/~:2 Curtain drain /?/~" On adjacent lots ~ /~/~'"~:~ Property line To existing or abandoned system on lot Cutbank /~'.,~.-¢'~ Water,'aaa~n/service line Driveway, parking/vehicle storage area ~' /~:~' E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA ~ 'nspection. Engineer's Name Date ?~/~/-, ./¢~ HAA Fee $ /"~D 'O-?-~ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES s,~oE,90~ RE~DRT of ANALYSIS Chemlab Ref.~ :93.3368-1 Client Sample ID :E 1/2, SE 1/4, NW 1/4, NW 1/4, NW 1/4,~ Matrix :WATER 5633 B STREET ANCHORAGE, AK 99518 TEL: (907) 562-2349 FAX: (907) 561 5301 Client Name :ANDERSON ENGINEERING WORK Order :68255 Ordered By : Report Completed :07/15/93 Project Name : Collected :07/12/93 @ 22:00 hrs. Project~ : Received :07/13/93 @ 12:35 hrs. PWSID :UA Technical Director:STEPHEN. C. EDE Released By ~ T12N, R3W, S25. NO I~ORMATION Sample Remarks: ROUTINE SAMPLE COLLECTED BY: A.H. WRITTEN ON TAG, SAMPLE INFORMATION OBTAINED FROM COLIFORM SHEET. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init Nitrate-N 3.50 mg/L EPA 353.2/300.0 10 07/15 LLH * See Special Instructions Above UA = Unavailable *'~ See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than ~sr~s Member of the SGS Group (SocietY. G~n6rale de Surveillance) ENVIRONMENTAL SERVICES IN ALASY~,, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: ~o-Ko/~/ ~;/;~16~/'~ Mailing Address: ~ ~ ~g ~ /~/ ~ ~A~hhone: 2. Property Owner: X~p~ ~/J~F//~ Phone: Mailing Address: 3. Legal Description: ~ C~ ~ ~'~~~ 4. Location: Type of facility to be inspected Well Data: C. ~ o n s_t mu c t i o n, ~'~ jC;z-w'(? 7. Sewage Disposal System: Z_~ ~_/))~ ~. G -~/~/~./o'j~b ed r o om s ~ B. Depth D. Bacterial Analysis ~ ~/.~/~J A. Installed /~//-/~ B. Installer C. Septic Tank: 1. Size ,/~--~ 2. Manufacturer D. Seepage Pit: 1. Absorption Area ~f~'~ 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank ~/~ ~ , Absorption area Nearest lot line /~-_qc , Other contamination B. Foundation to'septic tank ~-~-~ ~ , Absorption area C. Absorption area to nearest lot lihe ~-~ ~ Sewer Lines -I EQ-034 (1/74) Page 1 of two pages Page 2 of tv/o pages -,~Req~''- ,~.?~or Approval of IndividualS~ ~,~ Water Facilities ~g~l~'Description --~//~ ~/7_ ~-~._ ,~///.~9./~ Size__ ~'-- ~r~/~ /~xY~Z~ Approve . . _ _ Disapproved Date/~9 Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) 3330 SEP 6 1974 GREATER ANCHORAGE AR[:/; BOROUGH Deoartment of Environmental Quality ~r.o~,~o~,~Nr~ St., Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA FHA 2. Property Owner: .-'_ .---J-'_'_ , _. --'. -_-. _ Mailing Address: __ ~m~.~ D_ay Phone 3. Name of Buyer: 'r ' · __ ' 'j - ~-'l'~-- . Mailing Address:~-~N~ Day Phone CONV ~ titution: 4. Name of Lending Ins Mailing Address: -~~ 5. Name of Realtor or Agent: ~__~_~ Mailing Address: Legal Description: 6. 'F~ ---- Location: o Type of Facility to be inspecte~,:~(~-~' No. Bdrms. Hater Supply / Type of Supply: Public Utility Individual ~f Individual, number of dwellings presently served If Individual, deoth of well 9. Sewage Disoosal- System Type,of S~stem: Public Utility Individual (on-site) If Individual, date of installation October 7, ~974 qrindle '~Fll t St',!)han !nteroational Airport qd. Alaska ,,d,l,~t.· Grin<Her [:.re, per~:y in the 'l!,l .... 1/4 o SAP.~ ,.,m6, T1~',~. R3W, S,~!. ~s hr.. ...... t th~ on-si~e s~v,.'er ,'m :,:a~:or ?acilities a~c .h,. 'U,m sewer SysiX)il appears to cm~$is(: oF a septic tank i)! coniunc'~ion ~-dth a seenaqe pi~. '?~e see~)aee pit is no'~ amprove,i by this as ii' is unknm,h iF i~~, sized?or-~pwa~e ~', Io,7.' ~'~'*~ ~'' ..~ c~ ti~a't the ~Pit uas jjl~talled 'in ~ and haz not bc>eq utilized since installation. ' :qccorQt Ilq .se,fl i;os'~ of 2a9 ~quare feet ~)ar bedroom a 33 X 33 with a 6 foot crib or a 22 N 22 with a 9 foot crib seepage pi't v/ill have ~o be installed. ..... r ...... 1. uill apprvve [;he system as 15; if funds are t)u't in escro,~/ to u~grade t'~e sewer gVste~n. [;i Lynn S. Coad l. SC/ah ~G rEATE R :AN G HO RAGE ARE:A -130 RO UG H~ Ms. C. S. McKechnie, R. S. Department of Eh' ' .... ~ental Quality Greater Anchorag 3330 C Street Anchorage, Ala~ Dear Ms. McKecl August 30, 1974 SEP 9 1974 AM D~.~I. 0/: IL N~'A£ aJUAJlT¥ system on my pz : ,,,.gust 26, 1974 regarding sewage disposal One of the for that lot in sewage disposal ~ installed in 1967 slabs° I was assul a further precaution 1972 and I'm sure his which was your identi£. *ok before closing the purchase agreement o contact the borough about the existing . best of my knowledge the system was ~e foundation, underground plumbing and system was acceptable to the borough. As ,n Thiel, R. E. make a soils test in August is in your files ender Parcel 18 Section 25 number° I can't honestly an give you the best informa all your questions with certainty, but I will ~n I can from here° 1. I was told it is 1000 gal. concrete 2. I don't know° The underground plumbing in the house is all Cast Iron. 3.'~ I was told it is an 8 x 8 x 8 seepage pit° 4. Please refer to the above paragraph and your files. 5o As far as I know the seepage pit is 10' from the septic tank° 6. By closest estimation the distance is 43'. 7. Approximately 40'o I have not tried to circumvent the Borough regarding the sanitary features of this house° The systems, I feel, are adequate° Your approval would be appreciated. Yourslruly~ is good for sewage disposal i. this general arsa. The soil '~ ~ - higi~ water table. will also show if Chis is a ~.,tock or a anticipate ~haC Chere is hoC). bca~ ~c, ~.,~o)pbH)n ar(m, (~ could locate ~he .,epCic "' ~' ' ' Page Two August 26, 1974 It is nuted the house is for sale and vacaut ~ the prudent tiFae. ~he sys~el~i ts being used it ~st r~et Borough Code, Host likely, Chore is a lending institution involved in ~iie sale, ~hey will ~quest ~i~is U~q~arLm~nt's approval on Che sewer and ~ater systei~ reasons ~e )~Jsp~ctfully requus~ your a~tention to this r,)atCer construction seaso)), I am e)'closen~ a copy of ~i~(~ ~orouqh Si ncerely, NUISANCE COMPLAINT FORM Complainant's Name: ~x~_~ ,~/~. Street Address: ~-~ ~ ~ -:~ Phone No. ~/~-~/ Box No. ~ Description of Complaint: ~=~-~ -/~J~x~~-~ //~-/~"~ Name of Person Against Whom Complaint is Made: Owner of Property Where Nuisance Exists: Owner's Address:,~ ~/,~/~/~ ~//~-'7 Phone No..~ ~7=md~-¢~- Location of Complaint: ~,~ ~-~- /~~ ~ /~:: :/7-~/~--~: '~treet Address: ~ ~: Person Receiving Complaint:~~~Date: ~/~' I certify that such statement of facts is true to the best of my be- lief and knowledge. I request that the foregoing matter be investi- gated and that appropriate action to testify to the facts stated in if necessary. thereafter be taken. I am willing the foregoing complaint in court Complainant REPORT OF ACTION TAKEN Investigator: . ~'~, Date Investigated: Action Taken: ~-~ DATE COMPLAINANT WAS CALLED REGARDING DISPOSITION OF COMPLAINT: August 6, *1974 Harold H. 6rtndle ~900 Illmnna Avenue Anchorage, Alaska 99503 SUBJECT: On-site sewage dispose1 system REA Rd. - S~? 330' of E l/Z, E 1/2, ~ 1/4~ ~t~ 1/4, fl~ 1/4. Section 25, T12~, ~, Dear Mr. Grtndle: Xt has ¢o~e to our attention that a sewer system was installed at the above location without a permit and inspection Crc~ this Department. Please be advised that this is in violation of the Greater Anchorage Area Borough Ordinance, Sm~age Disposal ~r~ctices Section l, Chapter 9, Article VI, Sec- tion 9-71, paragraph A. ¥ou~ attentim~ to this matter in contacting me at you~ earliest convenience will be appreciated. Sincerely, C. S. HcKechnte, [nviro~ental Control Officer III CSM/ko cc: ~alt Stephan- POLAR REALTY lO0'West International Airport Road Anchorage, Alaska 99§03