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Home My WebLink AboutSKYLINE VIEW BLK 3 LT 3LOT ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ,'/7// ' P'ONE ///¢-,/~:/~: ~-"~, ~ ,_5'~,' ~DP~RADE -0gOAT,ON /~ ' : BEDROOM8__~ ----.~" DISTANCE TO: WeirDo ../L. ] Absorptii~n a~rea/(,.~ Dwglin~.~.)/',~/~' ! PERMIT N O...~,[ ~.~: ~"~-~' / ~M_a~ ,/~'~J '~' No. of compartments ~ I- Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth ~ v DISTANCE TO: Well Dwelling PERMIT NO. O 2~ <~ Manufacturer ][ ~ ' ~ - ~ Material Liquid capacity in gallons DISTANCE TO'. ~.~ ~ Found~i~Of~ [ Nearest lot I~le / PERMIT NO.~-~ ~i ~ No. of lines Length o~ ,~e Total le,~, li~s Trench ~idth ,f Distance b~ne~ ~ ~ Top of tile to finish grade Material beneath tile , % I ~F" Total i ' ~ inches Length Width Depth PERMIT NO, m Well Building foundation Nearest lot line ~ DISTANCE TO: ~" Clas~/[ -~'7- ~ Driller Distance to lot line PERMITNO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER ~IPE MATERIALS kJ ~ / ~NSTAL~ REMARKS / :~ ( ~o ~ / ~ ,~ Z ~... ~, 0~_ 4~ ~. ~ p~.~ r: h;;,..%,;,,.,,., ...... /I-l'~.~..~.0 72-013 (Rev. 3/78) PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2o COMMENTS PERFORMED BY: 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorago, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ENCOUNTERED? ---. ,~. SOl LS LOG PERCOLATION TEST PERCOLATION RATE TEST RUN BETWEEN SITE PLAN Date Gross Net Depth to Net Time Time Water Drop ........ (mimJtos/inch) Fl' AND FT PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13- 14 15 16 17 18 19 2O COMMENTS PERFORMED BY: '2-008 (G/79} MUNICIPALITY OF ANCHORAGE DEPARTMEN] OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ~ ~ DATE PERFORMED: SLOPE SITE PLAN WAS GROUND WATER ENCOUNIERED? rF YES, AT WHAT DEPTH? ~ SOILS LOG [] PERCOLATION TEST Gl eSS Date Time "/' 4 ?':'¢¥ ' - Reading Net Depth to Net 'rime Water Drop PERCOLATION RATE TEST RUN BETWEEN N/~--- _------ ( mi n u ~es/i nch ) FT AND CERTIFIED ~ FT STATE OF AI_ASKA DEPARTMENT OF ENVlRONMFNTAt. CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE for PUBLIC WATER SYSTEMS APPROVAL TO CONSTRUCT Plans for the construction or modification of by approved. public water system located ., Alaska, submitted In accordance with 18 AAC 80.100 have been reviewed and are [] conditionally approved (see attached conditions). BY TITLE DATE If construction has not started within two years of the approval date, this certificate Is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order no, or descriptive rolerence) Approved by Date C. APPROVAL TO OPERATE ']'he "APPROVAL TO OPERATE" section must he completed and signed by the Department before any water is made available to tho public. The construction of the public water system was completed on _.(date). The system Is hereby granted Interim approval to operate for 90 days following the completion date. BY . TITLE ~' DATE ? ' As-built plans submitted during the k~terlm approval period, or an Inspection by the Departrnent, has confirmed the system was constructed,according to the approved plans. Tho system is hereby granted final approval to operate. : BY TITLE DATE q407 (Rev. 11183) DISTDIBUTION: 1. WHITE. ENGINEER (Complele Section 6) 2. YELLOW - WATER SYSTEM PILE (Complete Section C) 3. PINK. ENGINEERtMUNI-BOROUGH (Complete Section C) 4. GOLDENROD · MUNI.BOROUGH (Complete Section A) MUNICIP. ALITY. OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPART[,~ENT OF [~]~ALTH AND ENVIRONMENTAl, PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Lgg~,l Description (include_lot, b~ock,~ubdi~ision, section, township, range) Location (address or directions) ~ Applicants Address (c) Applicant is (check one) Lending Ins Buyer [----~ ; Other [~ (explain); (d) Lending Institution Telephoae - ltome Business Telephone Address (e) Rea]. Estate Co. & Agent Address Telepho me (f) Mail the HAA to the following address: .[f~yj2e of Residence Single-Family~~' bluiti~Family ~iLq O~he~ <d~b~> Number of Bedrooms ._~c Water S~i~_ Note: If community well system, must have ~itten confimnation from the State Department of Environmental Conservation attesting to the legality and status. Onsit~ Public ~-~ Community ~--~ Holding Tank Note: If commnnity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing..~_ ..... Inspections,. Testsz File Search.z` Data and Information As certified by my seal affixed hereto and as of the validation date sho~m below, I verify that my investigation of this Health Authority Approval 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 ali_ Municipal and State codes, ordinances, and regula'- tions in effect on the date of this inspection. Name of Firm Telephone Address Date ~¢.~p,,.~ ~., ~ · Approved for bedrooms By Approved /', Disapproved Terms of Cond~-~-sn~~ Approval CAUTION THE MUNICIPALITY OF ANCHORAGE I)EPARTMENT OF ltEALTH AN]) ENVIRO~RdENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOIgLY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER KEGISTERED IN THE STATE OF ALASKA. TIlE DHEP DOES THIS AS A COURTESY TO PURC}hiSERS OF HOMES AND THEIR I~]NDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDEILAL AND STATE REQUIRE- MENTS. E~[PLOYEES OF DHEP DO NO'~ CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOk ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK, (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ae MUN~CtP~L~ OF ~NC~SE imm) H~ ~O~TY ~PROV~ (~) CHECKLIST - FEBRUARY 1984 WELL DATA Well Class i f icat ion~d~/~/~. Well Lcg P~esent~- /62%) Total Depth //~ ~-./a Cased to Static Water Le, vel /~h~ / Casing Height Above Ground Elect=leal Wiring in Conduit .((.~?N) Separation. Distances f~om Well: To SePtic/Holding 'Tank on Lot ~gPtO ~- To~Nea~es'~ Edge, of Absorption Field on Lot ; On Adjoining Lots ~00 ~ ; On Adjoining Lots Be DATA Date Installg_d ~/ff~,_~_~z~ Size Standpipe~Y~ Ai~-tigh~ Caps~) No. of C~nts Foundation Cleanout ~p~ession o~ Ta~ (~ ~te ~st P~d ~,'~ P~ing~intenanm ~n~a~ ~ File (~)/~/~ ; fo~__ Holding Ta~ High-Wate~ Alam~i ~~ ~a~y Holdi~ Tank Petit (Y~) Separation Distanms ~ ~ptic~olding Tank: To Water-Supply ~11 ~70 ( ~ To ~ilding Foundation To ~o~ty Li~ /~ ~ To Dis~sal Field ~ / To ~te~ Main/Se~vim Lim Course /~PO 7A To Stream, Pond, Lake, Or 'Major D~ainage Conments [Page 1 of 2] 2~15-84 HEI~IICAL & GEOi~OGICAL LABOt~ATORIES OF ALASKA~ INC. ' ' ~E~PHo~ (907)562-2343 ANcHoRaGE iNDU~'AL CENTER - ~ 5533 B Street ~ Drinking Wat~ r, Analysis Repo~ for Total Coliform Bacteria TO BE COMPLETED BY WATER SYSTEM: Mo. ~ Day [] Routine ~ ' ~ Check Semple (for routine sample wlth lab ref. no eclal Pu~ose 3 I. , I. NATER SUPPLIER .~'_~ (.) See ~ on ~ac~ ,D. NO. Phone N~,- .. State, Zip I [] Treated Water ./~.~ntreated Water Time 'TO BE ICOMPLETED BY LABORATORY sa aly. zsis shows this Water SAMPLE to be: tiSffactory t [] Unsatisfactory [] sample too long in transit; sample should not be ever 30 hours old at examination to Indicate reliable results, Please send new sample via special delivery mall. Date Received ~.~__ Time Received /'~ (~ F Analytical Method: [] Fermentallon Tube ~D~,Membrane Filter LaboRer, No. Result* Analyst READ INSTRUCTIONS BEFORE. COLLECTING SAMPLE {~.1220 (b) BACTER IO LOG ICAL. WATER Row. 1983 , ~ Membrane Filter. Direct Count Verification: LTB ANALYSIS RECORD Collformll00ml F~lnal Membrane Filter Res~llts _..[___~____~.~ Coll,ormll0Om, ; 'r~,~ __ TN'TC = Too Numerous To Coun~ TO ~l~ 4S 472 SIGNED SEND PARTS 1 AND 3 WITH CARBON INTACT PART 3 WILL RE RETURNED WITH REPLY. DATE ment procedure for sources of contamination within 'the 20b fe~t p~)~ tective radius. Should you have any questions, please do not hesitate to contact me. Sincerely, bill H. Lamoreaux, P.~.. District,Office Coordinator BHL/msm cc: Robbie Robinson (MOA) // C. ABSORPTION FIELD DATA Soils Rating in Absorption St=ara Date Installed A~ p-a/ Width of Field J~? ~' Square Feet of Absorption Area Depression over Field (~ Results of Last Adequacy Test Separation Distance frown Absorption Field: : To Water-Supply Well ~ CD .~ To P~operty Line /O -~-- To Building Foundation /~C) To Existing or Abandoned System on Lot ~7//0- ; On Adjoining IxDts {w~ ~ O~ ¢~/. TO Water Main/Service Line /~ ~-- To Cutbank(if present) /4~ /<k To Stream/Pond/Lake/o~ Major D~ainage Course /~z /,ACk- TO Driveway, Parking Area, o~ vehicle Storage Area ~.~D ~ Con~nts D. LIFT STATION Date Installed Size in Gallons "th/mp O~" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Dimensions ~ Manhole/Access (Y/N) [a/ / J/~rp Off" Level at ~/' {/ Ik) Vent .(Y/N) Pumping Cycles du~ing Adequa~ ~st, Meets MOA Con. nra ** C~]eck Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, oF conformed to all MOA HAA Guidelines in effect on the date of this inspection. - ', KB1/d5/s ~'' ~"' 0~4~ [Pa~ 2 of 2] 2-15-84 JAY S. HAMMOND, Governor SOUP/CENTRAL REGIONAl. OFFICE ,t/ 50UTIICENTRAL REGIONAL OFFICE NACKA'I' BLDG. 33~ DENA[I STREET ANCNORAGE 99501 ].975 ?h' ~ ......... E Lan?; P,O, Bo>: 58! A CM o5. al:~ Ali 99567 Subjec'i:: Lot 3 Block 3 Skyline Subdivision Dear ?.i:', Lang: I'{e ha:Te no objections to the use o:[ 'the exSsting semi~pub].ic v.:ater supply on the subject lots as long a:: the proper pro'c, ective rad:.5 are ~a in.'tained cons ist. ent with 'the se::i- pub] 5c regu] a tions t,'h5 cfi: were :in effect fc~' Ju].y 1975. YOl!?:$ trttl.Y ~ Regional ]:nv:ironne:~'ga] Supervisor' cc: Ro!:f Strickland August 31, 1972 Mr. James B. Roberts, Professional Engineer %Lacquer En~erpris(:s 56t)t; Eas~ Mi'ley S~ree~ Anchorage, Alaska 99504 Sui)ject: Sel, i-Public t.lell Serving Lots 3A, 3B and 3C of Block 3, Skyline Vit-?w Subdivision i)ear 14r. Roberts: ]'ilU (~reager Ancllorage Area Boroug',~, Departmen'~ of Environmental Quality nas recelw:d and reviewed tii,~, t,.ngille(;rin.q plans for i;hc subject project. We find that these plans are approved for all conditions witi~ w~icn this D~:[,artment is concerned ?rov'tdintJ tn~ '?r~llowin(.I conditions are met: l) Tna~ tile full 120' protective radius around ti}e suio,.je, ct we. ll is recorded by easement witi~ copies supplied to this office, That bacterial and chemical analysis ar~: run on til~ well once the project is COlnpl~.:te and are be submitted with ~h~, as,-builL en~.lineerin§ plans. That a COlnple~e set of as-built engineering plans i.s ~o be sublnil:ted '~o tills office prior to utiliza- tion of 'it~=: we'll as a semi-public well. Simuld you have any questions re~jarding our review of these plans, please con[ar:g tile undersig,ed, Sincere/y~ ilo'if Strickland, R.S. Chief Sanitarian b b cc: Mr. Kyle Cilerry, SCRO Mr. Skip Edinger, Public Works De. partmcnt DEPT. OF ENVIRONMENTAL CONSERVATION 0 -- JUNEAU ~801 August 29, 1972 Mr. Skip Edinger P.O. Box 91 Eagle River, Alaska Subject: Water Systems for Lot 3, Block 3 Skyline View Subdivision- Chugiak Dear Mr. Edinger: We have completed our review of the proposed water system and have the following comments: 1. Gate valves should be provided, in the waterline at convenient points to provide maintenance capabilities. 2. Ail waterline should be disinfected in accordance with either City of Anchorage or CAU Water Specs before use. 3. We must know the pipe material and burial depth for the waterline. At least 10 feet is required. 4. Chemical and bacteriological test results must be fur- nished this office prior to use of the system. 5. Thaw wires should be provided for each household connec- tion. 6. The final depth of the well must be submitted with a general log. ., We view these points as minor only; and with the understanding that the above information will be forthcoming, the plans and specifications for this project are approved for the features with which this Department is concerned. yOurs truly, Cherr?