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Home My WebLink AboutKNIK HEIGHTS BLK K LT 9 Z o ~ Z >- 0 Q Z 0 0 0 ~D 0 0 0 q): < Z ? [] SOILS LOG PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 5 6 7 8 9 ~J o ~2 ~3 14 17 18 20 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99E01 264-4720 SOILS LOG- PERCOLATION TEST [] PERCOLATION TEST DATE PERFORMED: JUNE 25, 197[ · ,~' ·, ...... .~ , ,:~,,;" SLOPE SITE PLAN WAS GFIOUND WATER ENCOUNTERED? N ~ SL 'O P E IF YES, ATWHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE COMMENTS (minutes/inch) 72-008 (6/79) TEST RUN ~ETWEEN FT AND -- FT 1 MUNICIPALITY OF' ANCHORAGE DEPARTMENT OF HEALTH & HUMAN S .WC S DIVISION OF ENVIRONMENTAL SERVICES ~ CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (addres~or (b) Properly Ow. er .... ~2~*~_ ' . ' Telephone: Hom~°~) 2¢, - ~¢¢// Business ,: '. ~. .,,,';.." (c) Lending'ln~titut'i;.: ~;~ ~4fl~elephone (d) Real Estate Company a'nd ~nt Address ~ Telephone ~7~ ~ ~7/ (e) Mail the HAA to the lollowino address: or: Check here"~, if hold for pick up. List contact per,.s, pn ?d day phone r~umber below./. TYPE OF RESIDENCE Single-Family'~ Number of Bedrooms WATER SUPPLY Individual Welling' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite*~- Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (Rev 8,861 Front '~JOM s,Je@u!bue leUO!SSejo~d aq~ u! SUO!SS!LUO JO $,lOJJa JOJ- elq!suodsaJ ~ou s! abeJoqouv jo/q!led!o!unR eq/'penss! s! eleo!,qpeo e eJojeq elep eZ~leUe Jo suo!~oedsu! ~3npuo3 ~ou op SHHQ ~o saaXOldLU3 's~ueuJaJ!nbeJ ale,s pue leJapej u!epeo A~s!~es o~ JepJo u! suoBni!lsu! bu!puel J!eqi pue sauJoq ¢o sJaseqoJnd o1 ~s@Hnoo e se s!q~ saop SHHQ eqJ. 'e)tSelV jo e~elS eqi u! peJe~s!baJ Je@uibue leUO!SSajoJd lu@puad@pu! ue Xq e^oqe g qdeJl~eJed u! u@^!8 suo!leiuesaJdaJ aq~ uodn /~lUO paseq s@~eoij!Hao le^oJddv /h, poqinv q~leeH senss! (SHH(]) seo!AJeS ueuJnH pue qHeeH jo ~ue~upedeQ abeJOqOuv jo X~!ledp!unv~ eqJ. NOIi~VO le^oJddV leUO!]!puoo ]o suuJel leUO!l!puoo pe^oJddes!O ')(' pa^oJddV ~:~y~ ~-__ ~ @leg ~ d /'~4~Aq sLuO°Jp@q ~"JVAOJ::Jdd'~/- l°t paA°JddVsHHO '9 elec] WELL DATA Well Classification , ,~ ~.,,~- '5OM'I~NICIPALITY OF ANCHORAGE (MC, ~..,.\-t't OSg%q\C~ HEALTH AUTHORITY APPROVAL (HAA) c,ecKus'r- FeBRUaRY 4984 ~' ~O~' .~ 264-4720 Legal Descnpb Well Log Present~/~4) Total Depth Static Water Level _~ ,,~-~/¢, 5~' / If A, B, C, D.E.C. Approved (Y/N) Date Completed ?"~ '~/ Yield Cased to ~'¢-~ / Depth of Grouting ,,~)/~4 PumpSetAt Casing Height Above Ground Wiring in Conduit(~) Electrical Separation Distances from Well: To Septic/Holding Tank on Lot Sanitary Seal on Casing0N) Depression Around Wellhead (Yi~ ! ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /tiro ;''z~'' ; On Adjoining Lots To Nearest Public Sewer Line ~/~r To Nearest Public Sewer Cleanout/Manhole ,4,///4' ____ To Nearest Sewer Service Line on Lot Water Sample Collected by /"~..5 /4. /.4)/~/ ; Date Water Sample Test Results _~-~' "'l¢~- /l-J/?~""~'-~¢~' .// Comments ~J)~.-~' ~¢-'~'~'J "~'~'~'T~ 4;/"'/ B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y~) Air-tight Caps~N) Depression over Tank (YN~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~J/,,~r Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Serv, ic~:l~_ine Course. ' Comments Size /¢:M'.f~ No. of Compartments Foundation Cleanout (~N) Date Last Pumped d/~r ;for ,,~//~- _ Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage page 1 Of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed '~-/¢' -~/ Width of Field ~ Square Feet of Absorption Area Depression over Field (Y,(~ Results of Last Adequacy Test Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present ~xl) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line To Existing,.or Abandoned System on ; On Adjoining Lots ,~'~ To Cutbank (if present) Comments D, LIFT STATION "~4.~,~._ /~//~ Dimensions Size in Gallons ~ Manhole/Access (Y/N) "Pump On" Level at -~"~.~ "Pump Off" Level at High Water Alarm Level at ~Vent (Y/N) Tested for PuTi'fl~;~ycles~_ Adequacyduring Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request I certify that l ha~.~ec.c~d~.veCifi~ed, or conformed to all MOA and HAA 9 uidelines in effect on the date of this inspection. Signed ~¢--~-~('; ~ Date ~'-~ Company ~ MOA No. Date of Payment F ~ ¢ ~ ~ Amount: $ Page 2 of 2 72-026 (11/84) TIME DATE NSPECTOR MUNICIPALITY OF ANCHORAGE '~A RECEIVED TIME DATE INSPEOT~ MUNICIPALITY OF ANCHORAGE ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC'F~. OF liEALTF' & 82.5 L Street - Anchora§e, Alaska 99501 ENVIRONMENTAL PROTECTION ENVIRONMENTALSANITATION DIVISION JUL ,., 1981 Telepfione 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATF. R AND~:~I.~.,~I~ ES DIFIECTIONS: Comolete all parts on page 1. Incomplete requests will not be processed. Please allow ten {10) days for processing. 1. PROPFRTY OWNER MAILING ADDRESS PROPERTY RESIDENT IIf differe' t from abovel ~.. B U Y.~,,J~ MAILING ADDRESS PHONE PHONE PHON~---- PI-lONE 3, LENDING INSTITUTION MAI L~j)l_q ADDRESS 4, REALTOR/AGENT MAILING ADDRESS 5. LEGAL DESCRIPTION ST R E E,.T-,~OC~ A~TI O N ~ SINGLE FAMILY [Z] MULTIPLE FAMILY NUMBER OF BEDROOMS E] One L] Four [~/wo %~ Five ~3~ Three _-~ Six []] Omer WAT ER SA~J~PL-'~ ~NDIVIDUAL- [] COMMUNITY [] PUBLIC UTILITY ATTACH WELL LOG, A well log ~s required for all wells dri ed since June 1975. For wells drilled prior to that date, give well {tel)th (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM _~y/iNDIVIDUAL/ON-SITE*'~ lq ¢G} f CJ PUBLIC UTILFFY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) DEPARTMENT OF HFALTI~ AND ENVIRONMt~'NTAI, P;IOT[JCTION July 27, 1981 Designs.In Wood; Ltd. Star Route A-Box 2072II Anchorage, Alaska 99507 Subject: Lot 9 Block K Knik [{eights Subdivision Approval for the individual sewer and water facilities cannot be granted until tile following items have been completed: The water, analysis report needs to be submitted ko this office~from the Chem Lab, 5633 B Street, for our review. A we].l log sub~m:u~ted to this office for our files and rovz~.w. If the~e are any further questions, please call this office at 264-4720. Sincerely, Robert C. Prat~, R.So Associate Specialist RCP/ljw cc: First National Bank of Anchorage Post Office Box 4-2090 99509