HomeMy WebLinkAboutTALUS WEST #1 BLK 3 LT 20
GRFA -,LR ANCHORAGE AREA BOR6,:GH
Department of I:nvironmental QusJity
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING ADDRESS ~' 't--C~) ~(~(' ()" ~'~
SEPTIC TANK:
DISTANCE /~
FROM WELL I-
INSIDE LENGTH ")~
MANUFACTURER ~ ' MATERIAL
INSIDE WIDTH_____ LIQUID DEPTH
NUMBER OF
COMPARTMENTS
TILE DRAIN FIELD:
DISTANCE FROM WELL )?~FOUNDATION
NUMBER OF LINES '/ DISTANCE BETWEEN LINES
ABSORPTION AREA /)// (')4¢.) / SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE 7 / DEPTH OF FILTER /(.~,>,.6~ .
MATERIAL BENEATH TILE ROVE TILE
¢ / TOTAL LENGTH,...-~<~'''/)
NEAREST LOT LINE_/''~ ''/~ OF LINES {)
TRENCH WIDTH -'~ IN. TOTAL EFFECTIVE
WELL:
~v~ F' ~, CONSTRUCTION DEPTH
TYPE
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK,-- SYSTEM
CESSPOOL - OTHER SOURCES
APPROVED . DISAPPROVED REMARKS
DISTANCE FROM:
DISTANCES:
INSTALLED
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:-
REMARKS:
DIAGRAM OF SYSTEM
DATE~'' ~ ~APPROVED C'~,~¢~ G.A.A.B. ~'/~/~F ~¢'"~'
IL..IE L L Ft !'-4 E:.
PERMIT NO. " =~.,'~,,'~ )
RPF'LICRNT
LOCRT I 0N
LEGRL
BUB WII<E
..... ~II~ULE
L;:-'O 6-'.. TRLUS WEST
DEPRRTMENT..:,.% .- OF HERLTH FIN[:' ENVIRONMENTRL F;~:OTEC]'ION
.... J.o E. TUDOR R[:'.., RNCHORRGE., RI<.
__ ][ TE SEB-~EF*:
_,RH i.~ ...... R 2~:44-,42:L4
LOT =,I~.E 2±±22 _,~IJHRE FEE]"
T'¢F'E OF --,uIL RB_-,OF.E, TI_N S'¢STEM IS: TF. EN_.H
MFI::<IMIJM NUMBER OF BEDRuOtl_, = 4
SCIIL RFITING ,::SI..:! FT,,"BR)=
THE REb. I_IF..ED SIZE OF THE -,uIL RBSORF'TION _,~_,TEtt IS:
THE LENGTH DIMERSION IS THE LENGTH ,::~'.~ FEET) oF THE TREN,H-' -' 3R [:,RRINFIEL[:,.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE E)4CRVRTION (IN FEET).
THERE IS NO SET WI[:,TH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCR',,,'RTION (IN FEET).
F'Ft~]:t~:]FIL--iE F'L_Flf-.~T F-." E ~_:-~ L~ Z F-::EC [:.
EITHER R bLR=,=, I OR II NSF RPF'RO',/ED F'LRNT HFI'¢ E,E INSTRLLED.
R ~uNTIIqUO0_, MFIINTEI~IRNCE RGREEMENT IS; RET.!JIRE[,. IF FI MRtNTENRNC:E
FIF~REEMENT IE; NOT LEFT CURRENT '¢BU MR'¢ BE F..EL4UIF..ED TO ENLRRGE THE SOIl_
RBu, uRFTIdN _,~_,TEI1 MND,.uR '-r'OIJ MR'¢ BE -,OE, JEbT TO F'ROSECUTION.
IF R L. LH_-, I =~r~TEI1 I=, IISE[:, THE LENGTH IS 5:~. 0 FEET.
IF R ULH .... II S'¢STEM I--, USE[:, THE LENGTH IS ~0 F~ET.
E, ML.F, FILLIN.~ OF RN~r' --,~=,TEfl NITHQIJT FINRL IN:,FE_.TI.N FIND RPF'ROVRL B'¢ THIS
DEPRRI'MENT WILL BE :,UBJEL. T TO PRESEC_TION.
MINIMUM DISTRNCE BETWEEN R WELL BND RNS' ON-SITE SEWRGE DISPOSRL S'¢STEM IS
±00 FEET FOR R PR. IVRTE [,JELL OR 200 FEET FOR'. FI F'UBLIC [,JELL..
WELL LOGS RRE RE[,!UIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN 2:El DR'CS
OF THE [,JELL COMPLETION.
SPECIFICBTIONS FIND CONSTRUCTION DIRGRRMS RF.:E RVRILFIBLE TO INSURE PF:OP[CF~:
I NSTFILLRT I ON.
F"EF:I'-'I I T ~"FtL. I E~ FC~I~-: OI'.tE °T'EF~t~-: F-F:C~tPl ]1 .... L~E
I CER'TIFM THBT
i: IRM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BM THE MUNICIPBLIT~ OF RNCHORRGE.
2: I WILL INSTBLL THE SgSTEM IN RCCORDRNCE WITH THE CODES.
~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MR~' REQUIRE ENLRRGEMENT IF TFIE
RESIDENCE IS R. EHODELED TO INCLUDE MERE~ ' THRN ,4 BEDROOMS.
SI~NE[:,: .... ~__~~, ' ~ ......................
MFPLI ~HN] E, UB H I F..E
I ~SUED b T__l~ ................ ~ F:,RTF
I 'M-W DRILLING, INC.
Well Owner
h!ri~ht O~nst rueti,-~m
DRILLING LOG
Location
Use of ~el] ~)om.
address Of: Township, Range, Section, if known; or distance main road_
Size of casing.
Static water level:'30
Screen ( ); Perforated (
Describe screen or perforation
Well pumping test at 15 gallons per
of drawdown from static level.
Date of completion I0/! 2/'75
Depth of Hole 135' feet Casedto_ !35f~ feet
ft. ~b0ve) (below) land surface. Finish of well (check one) open 'end ( )C( );
(minute) for. i hours with
ft.
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
O .TO 2 Casin~ Stickuo
2 TO ~
50
!00
128
OrGanics
TO 50 Silty Gravel
- TO o_?, Sand
.TO. !00
.TO ! 28
Silty Gravel
Silty Gravel
S~ndv Gravel - Water
TO 135
.TO
TO..
TO.
TO
TO
.TO
TO
TO
N~ArWA Certified Contrac/
Cert~mate lqo%. 814 ~k
!
/
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
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
Talus West, Lot 20, Block 3 ~/
Location (address or directions)
4521 Snowcup Circle
(b) Property owner Loren Daiman Telephone: (home) 345-4929Business
Mailing Address 4521 Snowcup Circle, Anchorage
(c) Lending Institution
Mailing Address
Telephone
(d)
Real Estate Company and Agent
Address 2600 Cordova,
Telephone 276-2761
Remax/Mary Dee
Anchora.~e
Beauschmann
(e)
Mail the HAA to the following address: (or check here E~ if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Number of bedrooms
Single-Family
3. WATER SUPPLY
Individual Well ~X
4
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 [] 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 th is
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functiona 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 ail Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
696-1700
Mountain Engineering Telephone
Name of Firm
10251 Crestview East Eagle River, Al{ 99577
Address
6/0A/90
Date
6. DHHS APPROVAL
Approved for _z~ bedrooms by
Approved-- }~. _Disapproved
Terms of Conditional Approval
_Conditional
The Municipality of Anchorage Department of Health 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 insp~ct!ons
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
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
OF ANCHORAGE 343-4744
~.~,vigOHN~ENTAL S£~'v[C¢S DIVIStOH
Talus West,
Legal Description:
4521 Snowcup Circle
Well Classification e
Well Log Present (Y/N) Yes Date Completed
Total Depth
Static water Level 66 '
Casing Height Above G[ound 1.. 9'
Electrical Wiring in Conduit (Y/N) Yes
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot >100 '
To Nearest Edge of Absorption Field on Lot
L20,
IfA, B, C, D.E.C. Approved (Y/N)
10/12/76. Yield 6 gpm
135'*Casedto 135'* Depth of Grouting Unknown
Pump Set At Unknown
Sanitary Seal on Casing (Y/N)
No
n/a
Depression Around Wellhead (Y/N)
>100'
; On Adjoining Lots >100'
; On Adjoining Lots > 100 '
To Nearest Public Sewer Line n/a To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line On Lot > 50 '
Water Sample Collected by Mountain Engineering ; Date 5/31/90
Water Sample Test Results Passed - Col±£orms & Nitrates
n/a
B3
Comments *Per Well Log 10/12/76
B. SEPTIC/HOLDING TANK DATA
Date Installed 10./78. Size
Standpipes (Y/N) ¥~s Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Con[act on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
1250 No. of Compartments 3
Yes Foundation Cleanout (Y/N) Yes
Date Last Pumped ' 3/28/90
; for
Temporary Holding Tank Permit (Y/N) n/a
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well > 100 '
To Property Line > 5 '
To Water Main/Service Line > 20 '
To Stream, Pond, Lake or Major Drainage Course
Comments *Per As-n~ui!t 10/20/76
To Building Foundation ;> 5 '
To Disposal Field 12,' *
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed 1
Width of Field
Square Feet of Absortion Area
Depression over Field (Y/N)
Results of Last Adequacy Test
2?5 s£/bed~< Type of System Design
Length of Field 55
Depth of Field 1 ?
Gravel Bed Thickness 10 '
;~, 1 O0 sf~'k Statndpipes Present (Y/N)
No Date of Last Adequacy Test
Pa.~sed -' 4 Bedroom Residence
Deep Trench$$
Yes
6/2/90
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well
To Building Foundation > 20'
Lot n/a
To Water Main/Service Line > 50 '
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments *Poz. HCA HAA 6,/1~3,/77
· ~,~,~^~ ^.,__~,.,~ i+ !0/20/76
To Property Line >10 '
To Existing or Abandoned System on
; On Adjoining Lots n./a
To Cutback (if present)
n,/a
D. LIFT STATION
Date Installed n/a
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request** .:.
I certify that I have checked, verified, or conformed to all MOA,:and
inspection. .
Signed
Company Mountain Eng'inee-~ing
Date 6/4/90
MOA No. C,kRJ--0( ~
Receipt No, ( ~:.2 /
Date of Payment
Amount: $
72-026 (Rev 7188) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
elid~§':'in, effect on the date of this
Engineer's Seal
HOME SERVICES, INC
INVOICE # 4 Z~ 2 2
CUSTOMER
15900 Francesca Drive
Anchorage, Alaska 99516
345-1890 or 345-2444
Loren & Bernet%a Datman
4521 Snowcup Circle
Anchorage, Alaska 99516
Block ~t
DATE DESCRIPTION AMOUNT
}3-28-90 Pump Septic $80 00
?:30
REMARKS
]2~ Gallons ~ptic __ Leach Area Holding Tank ~ Standpipes );~ ~e
D PROBLEM AREA--CALL FOR MORE INFORMATION
~E6S TO BE DONE AGAIN IN 6 MONTHS
~ Good Shape ~ Sludge buildup on bottom ~ Floater on top
Q Jim cap missing or ~ Cut standpipe to 1' above ground D Needs Septictrine
needs replacing
CUSTOMER COPY -- KEEP FOR YOUR RECORDS
--PLEASE PAY FROM THIS INVOICE--
ACHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
[] PUBLIC WATER SYSTEM I.D.#
~ PRIVATE WATER SYSTEM
Name r ..... [
Mailing Address '~'
City ~_) State
SAMPLE DATE: ~ ~ ~
Mo. Day Year
Phone No.
Zip Code
SAMPLE TYPE:
Routine
Check Sample (for routine
with lab ref. no.
[] Special Purpose
sample
) E~. Treated Water
Untreated Water
SAMPLE
NO. LOCATION
2 I
4 I
Time Collected
Collected By
s l
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
tisfsctory
I I Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sampie via speciaJ delivery mail.
Date Received
Time Received
Analytical Method: Membrane Filter
* No. of colonies/100 mi.
Lab Ref. No. Result*
Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICAL WATER ANALYSIS RECORD
Membrane Filter. Direct Count 0
Verification: LTB BGB
Final Membrane Filter Results Collform/100ml
Reported By ~ nete [~-/"'-?('~
Time: /~.>'"7 3-?.~ a.m.
PART ONE OF TWO
REMAINDER TO FOLLOW
TNTC = Too Numberous To Count
OB = Other Bacteria
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET .ANCHORAGE, ALASKA99518 · TELEPHONE (907) 562~2343
FEDERAL TAX I,D. #92-0040440
ANALYSIS REPORT BY SAbtPLE for ~ork Orde~ ~ 22152
Date Report Printed: JUN 4 90 ~ 15:17
Client Sample ID:L20 B3 TALUS WEST
PWEID :UA
Collected NAY 31 90 ~ 11:50 hrs.
Received ]dAY 31 90 @ 14:55 hrs.
Presezved with :AS REQUIRED
Client Name : MOUNTAIN ENGINEERING
Client Acer : MTWENGN
P.O.$ NONE RECEIVED
Req $
Ordered By :
Analysis Completed :JUN 1 90 Send Reporta to:
Laboratory Super~lsgr :SY~WEN C. EDE 1)MOUNTAIN ENGINEERING
Relea.ed By :~ ~___.... ~ 2)
Special HOLD FOR PICK UP.
Instruct:
Chemlab Ref #: 901624 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Teated Result Units ~ethod Limits
NITRATE-N HD(O.IO) mg/1 EPA 353.2 10
Sample ROUTINE SAMPLE.
Remarks: SAMPLE COLLECTED BY LOCKYER.
1 Tests Performed * See Special Instzuctiona Above HA=Unavailable
ND~ None Detected "See Sample Remarks Above
NA* Not Analyzed LT=Les~ Then, CT=Greater Than
TANKS · STRUCTURAL STEEL · WELDING
P.O. BOX 190708
2921 INTERNATIONAL AIRPORT ROAD
TELEPHONE 243-2455
ANCHORAGE, ALASKA 99519~708
June 8, 1990
t~nicipality of Anchorage
Purchasing
P.O. Box 196650
Anchorage, Alaska 99519-6650
Attn: Robbie Robinson
Re: Jet Aeration Tanks
Gentlemen:
In regard to size limitations on Jet Aeration Septic Tanks. Greer
Tank, Inc., up until approximately 1980, had manufactured this
system per customer requirements - ranging from 500 gallon to
8,000 gallon capacity.
-~hank Ypu.
Sincerely,
GREER TANK, INC.
Assistant Manager
WCA/km
£4
#1: Time
Date
!nsp
DEPARTMEI, j0F?EALTH AND ENVIRONMENI~
825 ' L Street, Anchorage, Alaska
279-'-25]_1, ext. 224 or 225
PROTECTION
9950]_
Date Received: June 8, 1977
1:30 p.m. #2~ Time #3:
Date
6-9-77 Thurs
K~ (~DF~J~ Insp
Time
Date
Insp ............
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATERF. ACILIflES· '
· 1. Lending Institution Request: Alaska Statebank
Mailing Address: 310 East Northern Lights
Phone: 279-7637
2. Property Owner: Dick/Mary Wright Phone: 344-4214
Mailing Address:
Star Route A Box 1585A 99507
3. Legal Description: Lot 20 Block 3 Talus West Subdivision
Fami].y Residence: (x) Number of Bedrooms: __.~'- ~'
4:
Single
Multiple Family Residence: ( ) Number of Bedrooms:
5. Well System: Individual Well (x) Co~mmunity/Public System ( )
Permit # '~& '? & 7 Dept~ of~el]. / ~ ~-- /
Well Log on File
_~...~~ ...... Bacterial Analysis ~3 ,~
Construction -"~
6. Sewage Disposal System: On~s_te System (x) Public Utility ( )
Permit ~ ~ ~ ~ Installed 1977 Instal
- __ ...... -- : __ ler __~~ ......
Septic Tank Size .~_.~__~ _ Manufacture~_ ~_i~~
Absorption Area //eO ~3 ~oils Rate P ?~-~ Material /~ --
7o
Distances Well to Septic Tank O.'~- to Absorption Area
to
Sewer
Line
~')( '~-- Nearest I,ot line ... :2.h Absorption Area
to Nearest Lot ine .....
· ' Department of Health and Environmental Protection
Request for Approval o.[ individt'tal Sewer and Water Feci]_it{es
Luga.L Description: __~o__~t.....2_Q0_~Bl_9oq.~_3~
Comnonts:
Af fadavit Attached
D~sapproved:
]letter Acuached: ( )
Date:
Department Worksheet:
06.12201a Rev lo7q
5- -? ,.'~ / /
AL,~ ,.(A DEPARTMENT OF HEALTH AND SOCIAL SE~ ~.ES
OIVISION OETUI~LIC NE/~ LTH
INDIVIDUAL AND SEMI-PUI~LIC
BACTERIOLOGICAL WATER ANALYSIS
]FFICE
~noivsls shows this Water SAMPLE to De;
SANITARIAN'S REMARKS
COMPLETE THIS SECTION
ONLY IF WATER IS AN IND,.IVIDUAL SUPPLY~..-
)ATE COLLECTED (, .,./~c~/- ,~/,?-- ~ ~IME COLLECTED" /-
Droo Pine. Offset in From Bottom Feet
PUMP LOCATION ~] n We [] ~asemer [] n Basement [] Room
READ INSTRUCTIONS
ON
REVERSE SIDE
BEFORE
COLLECTING SAMPLE
06.1220 (bi
R~v 1973 BACTERIOLOG CAL WATER ANALYSIS RECORD
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
~nchorage, Alaska 99504
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
DEPT. Oi:
JUN 8 ','
1. Type of Inspection: CMRO VA
2. Property Owner: l~e,~c ~rl ~t? W~-~_~h~:
Mailing Address: ~//~/) ~ /~
3. Name of Buyer: e~a; ~h~ll~ ~_ ~a ~ ?_
Mailing Address: ~0~ ~e~ ~007~ ~oho~e~ ~.
4. Name of Lending Institution: AL~e ~e ~-~
Mailing Address: ]Z0 ~. ~o. ~h~e ~Zv~.
5. Name of Realtor or Agent: 0he~ ~o~
FHA CONM X
Mailing Address:
Legal Description:
Location:
Day Phone:
Phone: 279-7637
Realty. Inc.
270-7611
gO1 N. Lights Blvd. Phone:
Lot 20, Blk. 3. Talus Wes2 S/D
Snowoun Circle
Dwelling
No. Bdrms. 3
Individual x
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation 1977
Individual (on-site). x
72 003(3/76)