The URL can be used to link to this page

Home My WebLink AboutSKYWAY PARK ESTATES BLK 7 LT 3 Municipality of Anchorage Page / o! ~/ 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: ~W/cl105%l PID Number: OIC~ IoZo~ Name: 2,&~>, ~P. OC~o~ Wastewater System: ~New ~ Upgrade Address: ~7o~ ~oo ~. ABSORPTION FIELD Phone: No. of Bedrooms: ~ ~ Deep Trench ~ Shallow Trench ~Bed ~ Mound ~ Other LEGAL DESCRIPTION soi.....o: O, ~ GPO/Sq. Ft. Total Depth fr~iginal grade: Subdivision: Depth to pipe boaom from original grade: Gravel depth beneath pipe Range: J Fill added above original grade: Gravel length: WELL: Q New ~ Upgrade Grave~: ~ /~ Ft. ~I ~'-~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption ares: Pipe material: Driller: Dste Drilled: Static Water Level: InstaJ~: /~&o~ Date installed: Yield:GPM J Pump Set at: Ft. J Casing Height Above Ground:Ft. TANK SEPARATION DISTANCES ~eptio ~ Holding U S.T.E.P. TO Seplic Absorption Lift Holding Public/Priva~ Manufacturer: Capacity in gallons: From Tank FT Field ~T Station Tank Sewer Lines ~ ~ ~ I ~ ~ Well ~ ~ ~ ~ Material: ~ Number of Co~artments: w~t~ ~ LIFT STATION Lot ~ ~ ~ Size in gallons: Manufacluror; F°undati°n ¢ Z~ ~ ~ "Pump °n" level at: I "Pump °ff" level at: [ High water alarm at: Cu~ain .... ) ~ Pump Make & Model I Electrical Inspections pedormed by: Drain I Remarks: ~ ~ ~¢~ ~¢~ BENCH MARK Location and Description: Assumed Elevation: Department of Health and Human Services approval ,, ,,~. ¢ ~ 72-013 (1/91) MOA 25 Permit No. ~V/~ID ~ / Page Z of ¢ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box '196650 · Anchorage, Alaska 995'19-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report ~tn PVC, o 72-013 A (2/91) MOA 25 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SE:RVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: I' 10- 11 13- 14- 15- 16- 17- 18- 19- 20- !!CEIVED 1 0 19~2 ;ipa ity of ARchoragG ,~alth & Human Services Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? DEPTH? Depth to Waler Alter ~AonilorJflg? Date: SITE PLAN Gross Net Depth to Net Time ('M'=°r) Water Reading Cate Time (.,.'~ Drop 61~) &o :5o s/~ ,, PERFORMED BY: ~l ~.~(¢ ~ODr~ __ , ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) PERCOLATION RATE ~ (minutes/tach) PERC HOLE DIAMETER ~-~// TEST RUN BETWEEN ~] FT AND _ -~_FT CERTIFY THAT TNIS TEST WAS PERFORMED IN DATE: /ler., Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN SFRVICES 025 "L" Street, ARchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION:__~ 3/ 2 3- 7- 13- 14- I5 16 17 18 19[ 20 ~ ~'T'i~_~) ~.~S DATE PERFORMED: Township, Range, Section: CEIVED 1 0 1992 )Blity of ARchorage Ith & Human 8ervioes SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? -- pO E [leplh Io Water Alter Monitoring? Dole: Reading Date Gross ~/ } Net( Time /-I~ Time ~q Water Drop __ ~/" PERCOLATION RATE .'g'~O (minutes/tach) PERC HOLE DIAMETER TEST RUN BETWEEN ~:~ FT AND ~ FT COMMENTS '"7-¢J I.-% -/~:,~'~- ~ ~o~.'~&~ ~ ~ ~P'~/~ ~)~b ¢1 ~b~ G ~,~ ~T PERFORMED BY: /V~ 4./-)-/~ ~¢'42 D ,~P_~ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THiS DATE. DATE' 72-008 (Rev. 4/85) PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910331 DESIGN ENGINEER:MICHAEL BRODIE, P. ]3. OWNER NAME:OLSON ZANA R OWNER ADDRESS:1701 WOO BLVD ANCHORAGE, ALASKA 99516 DATE ISSUED:10/15/91 EXPIRATION DATE:10/15/92 PARCEL ID:01910203 LEGAL DESCRIPTION: SKYWAY PARK ESTATES BLK 3 7 LT LOT SIZE: 67300 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: _ Probable hnpacts Narrallve Legal Description: Lot 3, Block 7, Skyway Park Estates The disposal field will have no impacts on Lot 2 to the east of the subject lot or Lot 8 to the south of Woo Boulevard. However, the parcels to the north and east will be partially impacted. The parcels adjacent to the northeastern half of the northern property line of Lot 3 will not be able to place a well within 100 feet of the proposed subsurface disposal system to be located on Lot 3. A small section of the southwest corner of the Klatt Elementary School site, located to the north of Lot 3, will be unavailable for the placement of a water well. Additionally, a small portion along the western property line of the adjacent Lot 4 will not be available for the placement of a well. The placement of the on-site wastewater disposal system on Lot 3 does not render any of the adjacent parcels undevelopable. The Anchorage Water and Wastewater Utility (AWWU) services all parcels to the north of Lot 3 with both water and sewer systems. All other lots adjacent to the subject property are serviced by a AWWU water system. PARK ESTATES LOT 3~ BLOCK 7, SKYWAY Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, ARchorage, Alaska 99502-.0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: 4 L~-~ ~ ~.~L) t I, DPI'J L"I & ~ J '~l~ ~-~TO .~ ~ ~ DATE PERFORMED: LEOAL .ESCRIPTION:~"T ~, &~. '7 "~ Township. Range, Section: O[~1~ ~' SLOPE SITE PLAN 6 ! 8 9 - Boo 10 - WAS GROUND WATER ENCOUNTERED? 11 s IF YES, AT WHAT ~J/~b~, L DEPTH? ~ pO E Depthto WalerAfler. 1 13- Moniloring? N~ WA~r~,~. Date: Gross (1~.) Net &.~) Depth to Net Reading Date Time Time * Water Drop O o ~J 0 ~o il/~" 14- 15- IS .~' 16 - ~rso'r-r~.,uk O1~ 17- 19- 20- PERCOLATION RATE JT~O (minutes/tach) PERC HOLE DIAMETER TEST RUN BETWEEN __ ~-- FTAND ~ FT COMMENTS '"'~l ~' [.~.~'~'~ O/'''-j I~) ~ D~ ~(~P'~ Fo~. PERFORMED BY: __~ I~ ~t~. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: ~, ~ / I~ 72-~8 (Rev, 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~) ~ T ~ JL~"'TO ~" ~ DATE PERFORMED: Township, Range, Section: 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WASGROUNOWATER ENCOUNTERED? / DEPTH? J/"\ pO SLOPE SITE PLAN Depth Io Water Alter 1 Monitoring? ~ ~k/A.le,~., Date: E Gross '1%) Net (l~t ~-~) Depth t° Net l '~ Reading Date Time (~%! Time Water Drop J 30 PERCOLATION RATE ~5' ~ (m~nuLes/~nch) PERC HOLE DIAMETER PERFORMED BY: J~t/~t~'~L~ ~r"~'~J)l ~ I CERTIFY THAT THIS TEST WAS PERFORMED iN ACCORDANCEWlTHALLSTATEANDMUNICIPALGUIDELINESINEFFECTONTHISDATE. DATE: (~)~', (~/ ~(~I 72-008 (Rev. 4/85) 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 01910203 HAA# GENERAl. INFORMATION Complete legal description Lot 3, Blk. 7, Skyway Park Estates Anchorage, Alaska Location (site address or directions 1701 Woo Boulevard Anchorage, Alaska Pr~'l~brty owner llana Olsen Maiii~§'a0dress 1310 E. Dimond, Suite Dayphone 34'4-3544 #4, Anchorage, Alaska 99515 L. ending agency Seattle Mortgage Co. Day phone 562-5626 Mailinga~Jdress 580 E. 34th Ave. Anchoraqe, Alaska 99503 Agent Susan Van Zandt Dayphone 562-5626 Address Same qA~dec, s~rwise requested, ! IAA-witl-be-hCd~'oc-piek~t~ 3 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water X (AWWU) NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of sys(em. 72-025 (Rev, 1/91) 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 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 Michael Brodie 833 W. 22nd Anchorage, Address Engineer's signature ~/~-//r~~ Phone Alaska 99503 272-8873 Date SIGNATURE Approved for /~-'~"~- [¢~ bedrooms. Disapproved. Conditional approval for 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 responsibre for errors or omissions in the professional engineer's work. {Rev. 1/9I) Beck MOA ~21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 3, Blk. 7, Skyway Park parcel i.D. 01910203 Estates A. WELL DATA Well type N/A Water Service Provided by Anchorage Water and Wastewater Utility ( AWW U ) If A, B, or C, attach ADEC letter, ADEC water system number Log present(Y/N) Date completed ' Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELl.. LOG Date of test Static water level Well flow Pump level SFPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot g.p.m. AT INSPECTION ; On adjacent lots g.p.m. ~ ch Absorption field on lot ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate _ _ Other bacteria Date of sample: Collected by: B. SFPTIC/HOLDING TANK DATA Date installed .10/25 & 10/26/9~anksize 1250 Gallon Cleanouta (Y/N) Y Foundation cleanout (Y/N) Y High wa.t~r alm'm (Y/N) Dateoi, pumping New Tank and System Compartments Depression (Y/N) Alarm tested (Y/N) N/A Pumper N/A 2 Snow Cover SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot No Well ' On adjacent lots +/'- 350 Feet Foundation 5 Feet To property line 65 Feet Absorption field 16 Feet Watermain/serviceline 120 / Surface water/drainage Approx. 1400 Feet (Cook Inlet) 33 Feet 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed N/A Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed Z0/25 & 10/26/91 Soilrating Length 101 Feet Width 16 Feet Total absorption area 1,616 sqFeet Depression over field (Y/N) Snow Cover Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) N SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot No Well On adjacent lots +/- Surface water 0.3 GPD/sqFTsystem type Gravel thickness '"Z/Foot ~' ~' Cleanouts present (Y/N) Date of adequacy test for If yes, give date Bed Totaldepth 4.9 Feet Y New System N/A bedrooms 350 Feet Propertyline 51 Feet To building foundation 24 Feet To existing or abandoned system on lot N/A On adjacent lots +/- 240 Feetcutbank N/A Watermain/serviceline125/48 Feet Surface water +/- 1400 Feet (Cook inlet.)Driveway, parking/vehicle storage area 31 Feet Curtain drain N/A E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect Michael Brodie Engineer's Name Date e of this inspection. HAAFee$ /~'0 Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number