HomeMy WebLinkAboutT15N R1W SEC 3 SE4SE4SW4SW4
Municipality of Anchorage Page __ of __
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~ PID Number: ~) ~\ -- ~'~JnQ-
Na~,./~], ~~ Wastewater System: ~~/~
Address: ~f5~/~.ABSO RPTION FIELD
Phone: ~Noof~rooms: ~DeepTrench ~ Shallow Trench ~Bed ~Mound ~Other
Soil R~ting: Total Depth f~ original grade:
LEGAL DESCRIPTION /, ~ GPD/Sq. Ft.
~'~L°t:// ~ ~Bl°Ck:r' ~/~ Subdivision: Depth to pipe bott0m fr0m original grade:~ Ft. Gravel depth beneath pipe~ Ft.
Township: ~ Rang~: ) J Sect~ Fill addedaboveodginalgrade: Gr~vellength:
WELL: ~~ ~ Upgrade Gravelwidth:2. ~ Ft, / I ~ Ft.NumberOflines: D~stancebeweenlines:
Classification (Private, A,B~): Total Depth: Cased TO:t Total absorption area: Pipe material:
Drill : Date Drilled: StaticWater Level: Installer: Date installed:
Yield: I Pump Set at: I Casing Height Above Ground:
GPM Ft. / + ~,. ¢~/%V/~ TANK
SEPARATION DISTANCES ~eptio ~ Holding ~ S.T.E.P.
To Septic Absorption Lilt HoMing Public/Private Manuf cturer: Capacity in gallons:
From Tank Field St ali on Tank Sewer Lines ~ //~ /
Surface
CurtainDrain ~ ~/~ ~ Pump~el ~ Electrical Inspections performed by:
Remarks: ,?~/,~ ~ :~//~ BENCHMARK
. / ,-
Inspections performed ~ .... ~6 _ . Dates: 1st ..... , .
Reviewed and approved by: Date ¢ .,,~,,
72-013 (Rev 9/91) MOA 25
Permit No.
N/A Page
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 e. Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: SE1/4.SE1/4,SW1/4,S~EC.5 T15N,R1W;S.M.,AK. PID No.: N/A
GARAGE
DRIVEWAY
CO1
1250 GAL.
CONCRETE
SEPTIC TANK
(INSTALLED
1~9)
CO1
C02
C03
MT
MT C03
/
· NO WATER FOUND /
/
34.0 la2~ I
lal.o H4O~l /
1250 GAL
CONCRETE TANK
(1969) LINEOVERH6AD POWER
/--EXISTING TRENCH .
/ (1~) /
/ /
/--MONITOR TUBE
/ ~/~/~) /
72-013 A (2/91} MOA 25
Municipality of Anchorage
DEPARTMENT Of HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
& ,'/:
PERFORMED FOR: - ~ · DATE PERFO
LEGALOESCRiPTiON:~I//J/,~/;~¢~.~,~C~Jl./~,S~,CJy~ Township, Range, Section: *~r'-/,)'",/,,../) ,/'~[/_~ ~ ~/ / ~/ ~' / SLOPE SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
11
IF YES, AT WHAT
DEPTH?
15-
16-
17-
18-
19-
20 - PERCOLATION RATE ..H~mutes/inch) PERC HOLEJ~ME'T~ER '~
PeRFORmeD ~Y: ~ ~ ~ ~p~--~ i ~~ ~IFY THa~ ~hlS T~St WAS P~R~ORmD in
72-008 (Rev. 4/~) Eagle River, AlasEa 99577 ~
PO ~, ,-,H 6-650
ANCHORAGE, Al ASKA 99502-06,50
(907) 2~64 4111
<Permit ~: 821187
.January 31, 1983
TO: Permit Applicant
Subject: T15N R1W Section 3 SE¼ SE¼ SW¼ SW¼
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, please call this office
at 264-4720.
Sincerely)
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
Permit
Applicant:
Location:
Leqal Description: ?Z~N ~/~
Type of Soil Absorption System Is:
Trench: Drainfield:
Maximum Number of Bedrooms:
MUNICIPALITY 0F ANCHORAGE
Department['-%Health and Environmental~ ~otection
825 Street, Anchorage, AK. _~501
* ~ ~ HANDWRITTEN PERMIT * * *
WELL AND/OR ON-SITE SEWER PERMIT
~V~7~-/~, ?/~,~. Mailing Address: '90'
~/F--t~t'. Phone Number: ~--J~ F~ ~,
Seepage Bell /' Holding Tank:
Soil Rating(sq.ft/br) ~f
The Required Size of the Soil_~tbsorption System Is: '
DEPTH ----- .LENGTH ---- 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 = ~0 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.
* * * 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 2 * * *
I certify that:
(1) 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 unde~tand that the on-site sewer system may require enlargement if
the .~idence/~s remodel~to include more th%~¢, bedrooms.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS
LOG
PERCOLATION
TEST
3 b
4-
5-
6-
7-
8-
9-
10-
11
13-
14
15-
17
18
20
'J S~_OPE ~ SITE PLAN
WAS GROUND WATER
ENCOUNTERED? ~'"~ (:~-'" SL
E
IF YES, AT WHAT
Gross --~ Net Depth to Net
Reading Date Time '~- Time ~//1~. Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
COMMENTS
PERFORMED BY:
i:''72-008 (6/79)
CERTIFIE
Arctic Engineers
1506 W. 36th Avenue
Anchorage, Alaska 99503
,lAy ,~ #A~¥0#0, ~OI~RNOR
437 E. Street
SECOND FLOOR
ANCHORAGE, ALASKA 9950!
(907) 274-2533
P.O. BOX 515
KODIAK, ALASKA 99615
(907) 486-3350
P,O BOX 1207
SOLDOTNA. ALASKA 99669
(907) 262-5210
P.O. BOX 1709
VALDEZ, ALASKA 99686
(907) 835-4698
P.O. BOX 1064
WASILLA, ALASKA 99687
(907) 3 76~5038
Dear Mr. Yanoshek:
Subject: Ben & Doris Guild Condo Project, Peters Creek
(8321-FA-152) and (8321-DA-089)
We have reviewed the plans and specifications for the subject project.
The project is hereby approved for construction for the items with which
this Department is concerned. This letter constitutes the permit required
by A.S. 46.03.720(a) for approval of sewerage systems.
Enclosed with this letter is a "Certificate to Construct" for the drinking
water system. The "Approval to Operate" section of the certificate must
be completed by a representat{ve of this Department prior to placing the
system in operation.
Sincerely,
Erickson
Env±ronmental Engineer
BEE/msm
Enclosure
cc: Mr. Ben Guild
Box 498A
Chugiak, Alaska
99507
SEWAGE DISPOSAL SYSTEM - APPLICATION ~ PERMIT
......... ~Legal Description,,,,
Application to Install: Septic tank~. Seepage pit__, Drain fleld~. Other
To Serve the FollowinE Facility., ,
Finanoed Through_ To he Installed by
Percolation Test Results_~ , , , Anticipated Date of Completion
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
_as described helowo Size of
....... · ~Dtic tank size~ Type .... Seepage A~ea_
DISTANCES: ~ DIAGRAM OF SYSTEM
PA. ~
I certify that I am familiar 'with the requirements of Greater Anchorage Area Borough
Ordinance No. 28-~S and that the above described system is in accordance with said code.
· INSPE TIO PORT~ ON-SITE SEWAGE DISPOSAL ~TEM
SEPTIC T~:
capaci~y~"'/<-~: ~gAllons. Inside len~h~ns~de width~iquid depth_
SEEPAGE SYSTEM:
Seepage Pit: Nu~er of pits~utslde diameter~r wldth_ , len~h~,
depth. _, lining materlal__ . Distance from we~, building
(wall
foundation~, nearest lot line~__ Total effective abso~i0n area area)~q.
TILE DRAIN FIELD:
Distance 'from we]~, fo~dation~__, nearest lot line__~ To~al len~h
of lines~ Nu~er of lines Distance between lines 'Trench width in.
To~al effective absorption area_ ~q. ft. Length of each line
Depth: Top of tile to finish grade~epth of filter material beneath
~ile~nches. Above tile
Type~!.~'~c~:~:~st~ce from building fo~datfon~ _~ nearest lot neares~
sewer line//,;/ septic tank ~/, seepage Sys~er~ cesspool /~-/, other sources
Health Authority
~AG~M OF SYSTEM
/
(Rev;I/91) Front MOA#21
5. STATEMENT OF INSPECTION BY ENGINEER
:. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigabon of th~s Health Authority Approval apphcaflon,shows~.that the on-s~te water supply
' and/or wastewater disposal,system is safe, functional and adequate for the number of bedr0o~n~'
and type of structure indicated herein. I furtherverify that based on the information obtained from
the Municipality of Anchorage files.an,d from~ my investigation and. nspect on,
supply ~nd/or Wastewater'~di~posal's~,~tem!iS, lncompi'ianC'e'with all Uuhici ~
'Ordin~hc~s; andr'regulaii0'n~;in effect dn the daie 'of thi~ in.41~ecti~0n~i' ' "':"
Nameof Firm ' s ' ~ ,",!¢Ptione
.,6. :,;',-D, HHS., SIGNATURE
Disapproved.
Conditional aplsrovat for bedrooms, with'the following stipulations:
Additional Comments
By: _/
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
Pr°fessional engineer registered in the State of Alaska. The DHHS dOes this aS a courtesy to purchasers of homes
,,an~d'their lending nSt t~t ons n order, to sat Stycerta n, fede~,a racld siaie requ i~e~entS'Emp oyees'of DHHSd~rr ot
conduct inspeCtibns Or analyze data: before=ia: Certificate: iS issued. ,The MuniCipality of AnChorage; S no~':
: responsible'fOr errors or omissions~in the professional engiheerfS Work;
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
A. Well Data
We,, type, h'X/XX
Log present (Y/~ /U"o
Total depth
Sanitary seal (~q)
Date of test
Static water level
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ./',c~ ~ ~, Driller ~-
r7..~ :~4~ Cased to ,~ r F 7'+ casing height
y.~. ~ -~ Wires properly protected (Y~)
FROM WELL LOG AT INSPECTION
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
/
Septic/~ tank on lot t'~
Absorption field on lot /'~'"'-
Public sewer main /~] //~
Sewer service line
g.p.m.
; On adjacent lots
; On adjacent lots ~'~20 7/-
Public sewer manhole/cleanout /~///'~
WATER SAMPLE RESULTS:
Coliform (~ Nitrate
Date of sample: ¢/¢ °/~ ¢ + ¢/2~/¢~ Collected bY:
(/~,/(~/¢~ ~.//~ Other bacteria
$ & S ENGINEERING
Eagle {-Ii.er, Alaska 99~77
Compadments /
Foundation cleanout (YJ~ /~-2~ Depression (Y~
~/~ Alarm te~'ted (Y/N)
B. SEPTIC/t-:I~I=~N~ TANK DATA
Date installed /¢~ q Tank size
Cleanout (.~N)
High water alarm (Y/N)
Date of pumping Pumper
SEPARATION DISTANCES FROM SEPTIC~ TANK TO:
Well(s) on lot "~¢'~- ~0 On adjacent lots /:~) ~-~
To property mine ~ (~ Absorption field ~O ( ~
Sudace water/drainage ~ ~ ~ /~ ~ ~
Foundation
Water.-j~a~¢service line
CONTINUED ON BACK PAGE
72-026 (3/93)* Front : :.. ::
C. LIFT STATION
Date installed Manufacturer
High water alarm level Cycles tested
~des (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot j On adjacent lots
Surtace water
D. ABSORPTION FIELD DATA
Date installed /~'~'
Length ,.~--O f
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y~"N) /
Width
~ %~ If yes, give date
~..,L Gravel thickness ~.~ /
.-- Total depth ~ !
Cleanoutpresen (Y~)/_Ve: Depression over field (Y~ ,~'~'~
Results (pass/fail) .~-",'¢~ --~ -~% for Z Bedrooms
After test
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
To building foundation
On adjacent lots /'f/"~/'J ~:~ Cutbank
Surface water ,/<::::2~
Curtain drain ,///C
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
Signature ........
Engineer's Na~034 EaCe River I~e//¢1~o~ No, 204
E~ole River, Alaska ~/Y~7.// _ / / '
HAA Fee $
Date of Payment ''~'
Receipt Number ~.~' ~ ~
Waiver Fee $
Date of Payment
Receipt Number
72-026 (3/93)* Back
GREATER ANCHORAGE AREA BOROUGH LY3f~/L~ ~]~z~' ~-)
Department of Environmental Quality ..~..~J,
330 "C" Street, Anchorage,~qlaska 99503 274-4561 ~
~ Date Received May 4, 1976
Date of Inspection /!
INDIVIDUAL SEWER & WATER FACILITIES
FOR
~.~.
1. Approval 'requested by: First National Bank of Anchorage,
Post Office Box 4-2090, 99509
Mailing Address:
2. Property Owner:
Mailing Address:
Doris M. Williams
Southcenter Br.anch
Phone: 274-1521 x 12
Phone: 688-2315
Post Office Box 498A, Chugiak 99567
3. Legal Description: T15N Rlw Section 3 SE¼ SE¼ SW~ SW~
4. Location: Mile 22 Glen Highway
Type of facility to be inspected Single Family
6. Well Data:
A. Type
Individual - serving one
No. of bedrooms 4
B. Depth
D. Bacterial Analysis
On-site system
C. Construction
Sewage Disposal System:
A. Installed 1969
C. Septic Tank: 1. Size
D. Seepage Pit:
B. Installer
2. Manufacturer
2. Material
, Absorption area
, Other contamination
l. Absorption Area
E. Disposal Field: Total length.of lines
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
C. Absorption area to nearest lot line
, Absorption area
, Sewer Lines __
EQ-034 (1/74) Page I of two pages
Page~ ~2 of two ~age~ - ReX-~st for Approval of Individual ~er & Water Facilities
Legal Description T15N R1W Section 3 SE~ SE¼ SW¼ SW~
Comments
Approved Disapproved Date
/
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
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 operati,n~sati sfax~tori ly.
EQ-034 (1/74)
Date
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C' Street, Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO VA XXXX
2. Property Owner: Doris M. Williams, Pd.
FHA CONV __
Mailing Address: P.O. Box 498A , Chuglak, Ak.
Name of Buyer: same
Day Phone 688-2315
Mailing Address: same
4. Name of Lending Institution:
Mailing Address: P.O.Box 4-2090, Anch. Ak. 99509
5. Name of Realtor or Agent: None
Mailing Address: --
Day Phone 688-2315
The First National Bank of Anchorage, South Center Br.
Phone 274--1521 , Ext. 12
Phone
6. Legal Description: SE 1/4, SE 1/4, Sw 1/4, SW 1/4 of Section 3, T15N, R1W, Seward M~r.
Location: on mile 22 Glenn Highway~ left turn of Hiway opposite Homestead Road.
7. Type of Facility to be inspected:
8. Water Supply
Type of Supply:
1 Family House No. Bdrms. 4
Public Utility Individual
well
If individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation 1969
3 persons - 1 dwelling
Individual (on-site) Septic Tank
EQ-037 (1/74)
REQUBST FOR APPROVAB OF
~___~_'~ ./ INDIVIDUAL SENAGE AND WATER FACILITIES
(Fill out in Triplicate) .~
Name .of person requesting approval
., ,-
2," .~ame of proper~ytqwner
3, Lggal~ deacriptioq
4, Number-of~ j~edrooms in house
/ '~ ,..~ ~ a. Bact~ial ~
b. Date~gent~
6o
We]_l data:
a. Type
c, Casing Size,
Sewage disposal system.
b, Septic tank capacity in gallons
Seepage A~ea
5. Property nine..
6. Other soupc~S of possible/contamination
houses, barn, dmaina~e ditch, etc. . :~ ..
Name of septic tank manufacturer
1. If "home made" show diagram on reverse side of this form,
Disposal field or seepage pit size and type
1, Distance to property line to house foundation .... .
~ Percolations, T~st ~r~eul~s
f. Percolation Test performed by
Use the reverse ,side of this form to show diagram. Diagram should include
'~he foil,owing infommation: p~operty lines~.well location, house location,
~'~c tank location, disposal area location, location of percolation test,
a~ d~rection of ground slops,
n thzs form zs t~rue and ~rect to the best of my knowledge.
/S,ignature of Applicant ~te S~f~ned
/
FILLED OUT BY HEALTH DEPARTMENT PERSONNEL
........... '£he,,.. above, described sanitaryfacilities' ' ' are hereby approved, subje, ct to. the. .
~ollowzn~ conditions: -
Condition.s:
The abovedescrzbed' sanitary f · ·
acll~tmes are disapproved for the following
reasons:
"'Signature of ~f~ief~.' p ...... ~-m,, ~
...... " '": '- Date ~'~q.,~:f-
Approval is valid for one yearfollow~ng' the date of approval.
CPJ:cw