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HomeMy WebLinkAboutNORTON PARK LT 31B-1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephor~e 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAI LING ADDRESS LEGAL DESCRIPTION I Absorption area ~ ~ Manufacturer ~ [Liq. capacity in gallons ~ ............. Inside length ~ ~ DISTANCE TO: Well Dwelling ~ DISTANCE TO: ~ No. of lines l Lengt, of ~c~e Total lengtJ~ o~ lines P ~ ~ Top of tile to finish~lgrade..~ t Material beneath, tile Length Width Depth ~ Type of crib Crib diameter Crib depth / ~ Well Building foundation DISTANCE TO: ~ lClass_ Depth Driller ___~ ~ DISTANCE TO: Building foundation Sewer line [Dwelling Materia~ Widt ~ IMaterial : I Trenc h-'~i2h inches NO. OF BEDROOMS¢ PERMIT NO. No, of compartments ~2~ Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NQ. Total effectiv.~,~o~tion area PERMIT NO, Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER DATE LEGAL 72-013 ~Rev, ,~78, [:,EF'FIRr/'iEN"/ -.r_- HFHI 'Ii~ i'lItD ErY.,.'[F'~.q.J!'iENirq 'F;OTEE:TIC~N 2::q 'I-HE R:E(.dJI¢;:EE:, _c,.[2;E L]F THE [::, EE F' T bt ..... / L__ F- I' THE LENGTH D~P1EHS~C]N [::; 'IHF LF~'GT'H ,: GR:CK. INC, F¢'~[:, THE 8C~TTOI'I Cd: THE F:'<CFI',.,'F~]'~Ot~ '(!l~ FKET) ~hfE~E ~% NO SE[ [,I[[:'TH THE: GF:~VEL C, EP'rH ~% THE. MZt.~Pu.IM [',FF'%~ OF ~/,~;'P~'..,'E{ E:i:'fNEEN THE OIITFFILL F:'[F'~ RND 'IHE E:OT'FOM OF -rH[: EP:Fff,..'~I-~Fr~ , I~ FEET',. >ER:I'I!I' RF'F't_I'C:I:iIIT HFIS THE [*~_._,[ .h,~ ..... _!,: TO INF~)::M ~14i':", DEF'.P,,~4'T.,iEN] [:,I_IR:ING THE [N:.'I'FtLLFtTIOH IHSF'ECTIO!-~'~, nF P '' ,,[:E , ,,? :~ ~'~(:'_fFiF-'Eh!~ ~0 7hi:-:. ~:'FtlZlV'EJq'l'"r' Ftt',~[:, THE "/LIH[~ER F]F_ [?E"7.,IC, ENC:EC~ THiqY. T,ME mE[i l.!]( L "'-'-' '-_,f ,~-,'[:. 'T- 1 4 s:_-~ ,-' :':-~ ", ! ['-4 ;::: F-' G'.FtC:KF:[I_L INCi OF Fli'-~V '-' "--TEP1 .. z,'r> ~, ~THC:iF -)EPFtF;t-rMEi',~f' I.!ILL E',E '9,1JE',.[,r-',::l ]':) ~GG FEET FOR ~a F%:!'v'~TE HEL~ ; 0:'. tSG 1'0 2CK~ FEET F~40M F~ F'(iE:L!F: lift[ [ C'EF'ENDI~G i_',~:,:l~ THE ]'¢F'E ~qf-- F'I.JBL_IC: NELL.. · IEL. L LOGS RRE REGI..IIRED ~¢fi:, f,l~.~:'f E:: FtETk~RNEC', TO ';HE [:,F'F'RF:TmENT l,li'rt-/I~l 3G Dt~'¢S )F THE I,iELL_ C:Cff'IF't_EffION ~THER F:EC~U~R:EMENT~ MR'¢ RPf:q '¢ :FFC [[:[L~:F~]!L,N~ F¢~;, (iJZ~/E41F'LI(::-I'~ON [:,II~GR:RM~ t]F:E :¢,,,'I~ILRBLE TCI IN%IJRE PR:OF'E[;' iNc'lFd. L ~t'[iFE~ CEF:T[E'-/ THFtT : :[ Fgfl Ft~PIII_IR,q' l,lll'H It-IF F'.:EC,,'!_IIF:EI'Ii-tiYL-, !~F.' Otb 2:IRE %FNFr<':, ~qH£:, ',dELLS FtS SET uRTH E;V THE FiF'F'[ ! I/:i~f.~T ,/~ I, : ,,::::: :::,, ;:::. '" ' ".. :'::::: :;:;:: ~::":::::: :i:: :;' i;:: :: ' : : [ :::i i':;;::"l',:::::. ~' *: N "As-Built" I hereby certify that o survey of the following described property .... ~, .,e..:,.., ,..._ .A~,,,~:'./,: was made on '~../"?,,..~-~,,-:/,. -~ ~z..~ ?'~?~and that the improvements situated thereon are within tho property lines and do'not overlap or encroach.on t~o property adjacent l'heroto~that no Improvementa on property lying adjacent thereto encroach on the promlso~ In question and that there ore no roodways~ transmission linee or other visible easomont~ on said property except as indicated hereon. CONTRACTING ENGINEERS D ASSOC, ?-12 E, International Airport Road Anchorage, Alaska 9950Z Phone: 278-3773 SEAL SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-2221' SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST PERPORMED FOR, ,0,0,'(" /:'///'"/'"~/ LEGAL DESCRIPTION: ~ 3/ ~ ~/~2~'~¢~/ DATE PERFORMED: /"--z, )~ -7 ¢ SLOPE SITE PLAN 10 11 12 13 14- 15- 16 17 18 19 20 WAS GROUND WATER IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS 72-008 (7/76) Pebruary '~, 19~L~, The well at Lot [~].~1 i~orton P:rk ~ubaivision casing is at a depth o£ thc well. i$ ~ ' ~'~ ~ ' ar].lt .... to a t~eptt~ off 58', Anchor Drilling .,.' zfw~ ANDERSON DRILLING 9521NIOKELL CIR. ANCI[. AK. 99507 Hovin On Construction Box 10-2028 Anchorage Alaska 99~11 Lot 51 B~ Norton Park Subdivision 0 to 10 ft. 10 to 20 ft. 20 to 50 ft. 5o to 4o ft. 40 to 50 ft. 5© to 60 ft. 60 to 68 ft. Dirt ~ Sand Sand Sand (fine~ Sand (fine~ WATER WELL LOG Sand (fine & dirty) Sand (fine, dirty & some water) Coarse sand & fine gravel with water. 68 ft. coarse sand with fine gravel, water bearing. 40 ft. Head Test bailed for 1 Hro ~ 5 GPM Draw down to 18 ft. Head stable at that depth. Bottom Hard. Water cleared up while 'test bailing, Rscomend set pump ~ ft. off bottom. Jerry Anderson ~mderson Drilling Co l,'ebzuary 2~ 19~J4' ~_qnv:i. ronlaental ue~-x].ti~ i)ivi~ion ~32~ 1, ~%reet Dear i have inspected the troll at Lot )1, B1 i'<~rton Park Subdivision, aha nz~,ve found it to be in compliance with ali. hunici~tl codes. attached is the water teat and ~e].] i,ot 3:lB1 5s on pubi~c aewer. ',',el k 5:; in the .cequirea ael, back from all sm.;er ].ines, Parcel I.D. # Division of Environmental Services On-Site Services'Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES~NVI TAL SERVICES CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ECEIYEI) 1. GENERAL INFORMATION Complete legal description Lot 31-B-l; Norton Park Subdivision Location (site address or directions) 700 Mar~ Street Anchorage, AK Property owner Mailing address Lending agency Mailing address Don Ifannah 7010 Old Se~vard Hwq. Anchora.~e~ Day phone 349-2014 (w) AK 99518 Day phone Agent Address Shari Boyd/ Jack WF~te, Co. Ancho rag ¢,, 3201 "C" .Rt,,~eet Suite 200 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 5 TYPE OF WATER SUPPLY: Individual well X×X Community well NOTE: Day phone 565-5500 AK 99503 Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWA'rER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. Public sewer XXX 72-025 [Rev 1/~1) Front MOAil21 5. STATEMENT OF INSPECTION BY ENGINEER REQUEST PROPERTY TO BE HOOKED UP TO PUBLIC WATER NO LATER THAN 15, 3ULY 1996. 6. DHHS SIGNATURE 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. S & S ENGINEERING Name of Firm 17034 Eagle River Loop RoadN~2.04 Phone (¢ ¢/ Eagle River, Alaska 995~ Address ,///~'~' ~ / Enginoer'ssignature ~:¢vf :. ~,~ Date -/::'k "" ~': 4, '": - YOU ISSUE A CONDITIONAL HEALTH AUTHORITY APPROVAL. -' ..'. ' "~:~ .'~ ~ ~ ~¢~L~" '~, ~}. ?,.%. CE - 830 l ~,, g~,'. .., .. Approved for bedrooms. Disapproved. Conditional approval for S bedrooms, with the following stipulations: Escrow monies to perform all work necessary to connect to public water and to permanently abandon the existing well as per MOA regulations (Chapter 15.55). . --no LaJae_r tb. an--Ja~-Ly 15, 1996. Additional Comments Monies to remain in escrow until final approv.¢l has been granted from this department. 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 tile 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 responsible for errors or omissions in the professional engineer's work. 72~)25 (Rev. 1/91) Back MOA #21 Municipality of Anchorage ~UNICIPALI'IY o~- ANCI-IOiu~,uu ~ DEPARTMENT OF HEALTH & HUMAN SERI~/'~(~MENTALsERVIcEs DIVI$1~ Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 34~;}/Y'~40 'J 1~g~ Health Authority Approval Checklist Legal Description: LO '~'~ A. WELL DATA Well type /qfi Log preseat (~) '¥ 6 J' Total depth Sanitmy seal (~xl) 'Y ~- 5' If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to ~ ~' Casing height (above ground) Wires properly protected (~N) tv ,7 J' FROM WELL LOG AT INSPECTION Date of test Static water level ~ ~ ~ / Well production g.p.m, g.p.m. WATER S~PLE RESETS: Coliform "0' Date ofs;unple: ';L/'~a /~'/ (o B. SEPTIC/ItOLDING TANK DATA Date installed Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA Date installed Length Width Nitrate ,6hq mS//- Other bacteria_ -~ S & S ENGII~tE£RING Collected by: 17034 Ea{.jle I~iver Loop Road No, 204 c c),~o,.,, ;- ¥ ,J'g. vo~.~ Ea~gle ~iver, Alaska 99577 Tank size Number of Compartments Cleanonts (Y/N) ~ PumperDepression (Y/N) ~r~/NJ/''/''-'' Soil rating (g.p.d.~t2/bdrm) System type Total depth hnmediately after Absorption rate = Effective absorption area Date of adequacy test ///' Results (Pass/Fail) /- Fluid depth io ~on field before test (lo.); /, Fhtid de~ (ins.) Mioutes later: / Peroxide treatmeot (past 12 months) (Y/N) Depression over field (Y/N) __ For bedrooms __ gal. water added (in.): g.p.d. Ifyes, give date D. LIFT STATION Date installed Manhole/Access (Y/N) High xw~ter alarm level at* ~ * Datunl E. SEPARATION DISTANCES Size in gallons .~-~'~ ~~ "Pump ofF' level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ,',; J/I Absorption field on lot.,.7./)--Fi'-~d~._~' Public sewer inain ,~ Sewer/septic service linc ~tt~O~p On adjacent lots ; On adjacent lots ./4 Public s,gwer manhole/clemmut ~ Lift station bY /,4 · -~- ¢~b~..cU b .... q;,~ ~r~,e..t t~.7~$~,3~-~/) SEP~A~ON DISTANCES FROM SE~C~OLDING TANK ON LOT TO: ~- Building foundation .... Prope~ line ~sorptionfield'~ ~" /~ /~.'~ Surface w~~ Wells on adjacent lots Water mailffse~ice line SEPARA~ON DISTANCE F~~~ FIELD ON LOT TO: Building foundation ~ Water mai~ffse~ice line Driveway, parking/vehicle storage area Wells on adjacent lots Proper .ty line F. ENGINEER'S CERTIFICATION I certi~fy that I have determined thrufield_ inspections, and.review of Mumctpal records thq~-tJrg~Ofie's?,~P,~s.~p;:~, % ~.)r, /I; ~,:~ ar in conformance witO ~()zl. l[~J~ guidg~es m effect on this date. ,,,1.%~/ HAA Fee $ ~Z). ~) Waiver Fee $ Rev. 8/95 aSS: haa.wk,doc Date of Payment Receipt Number ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. March 8, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 31-B-I; Norton Park Subdivision Request you issu6 a Conditional H~th Authority Approval on the r~f~r~n~d property. The property is to be connected to public water no later than 15, July 1996. Due to winter weathe~ conditio~ the work ~ unable to be done at this time. If you require additional information, please contact us. Sincerely ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 03/01/1996 10:30 9076941211 S AND S ENGINEERING PAGE 03 CT&E Envlr°~~6ewi~ Inc, ~bO~ Analysie Report Date Director ENVII~ONMEN'I'AI. ~A~,ILIT1E; IN AL~,iKA, 0~LJI;0~NL~,.:~klI)A, ILMN0111. MARYLAN0, N'll(:FIIG~'N, MI$fOUBI, NIiV,/ JE;tSE¥, OHI0. wEST APPLI(' NT.FILLS OUT UPPER HA! ONLY ~ I /'~ Phone Mailing Address Zip Code 7' 2' .~- / ,/ Buyer Address h: ~ ,~, -{ /'~ /, . ,./~ Lending Institution .://~, ( . ~', ,. Address /" -.' ? "~::;r/ Realty Co. & Agent Address Zip Code Zip ()ode Zip Code Phone Phone Street Location //? d ~- ?.,/~! , ./' ..¢/P Type of Residence (~./Sin gle Family Mulliple Family No. of Bedrooms ~ Other Water Supply E~ Individual [] Community ~] Public Utility Sewer Disposal I~ Individual ii [~ Public Utility Holding Tank ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. JFor wells drilled prior to that date, give well depth (attach Icg if available). ', :'~ .(, ~¢~ar Individual installed: ...... "~..., ~ '~ '~ oO~/' t~SL?'&4'~"'¢:~'~k ~When Connected to Public Utility: .... ';, ,~" ¢~ NOTE: THE INSPECTION FEE MUST AOCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time 1-ime Time Time Dale Date Date Date Inspector inspector inspector inspector Fieldc..~7/c..~..~Notes: (. ~ i APPROVED BEDROOMS ) DISAPPROVED ) CONDITIONAL APPROV,AL DATE ~ * _ BY: k! :! .' 'CONDITIONS OF APPROVAL Soils Rating Date Sewer Installed Well To Absorption Area Well to Tank Well Log Received Seplic Tank Size ........................ DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME INSPECTOR INSPECTOR INSPECTOR ./1 DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE "VIRONMENTAL F;:OTECIION DEPARTMENT O. 825 LStreet.Anchorage, Alaska 99501 /XPR 3 981 ENVIRONMENTAL SANITATION DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DI RECTIONS; Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for proc0ssing. 1. PROPERTYO~N~R [ PHONE MAILING ADDRESS PROPERTY ~SID~NT (If different from above} PHONE 2. BUYER PHONE MAI LING ADDRESS 3. LE~m~ ~ST~TUT~d~ [ PHONE MAILING ADDRESS ~ 4. REALTOR/AGeNT [ PHONE MAILING ADDRESS STREETLOCAT, ON 1 6. TYPE'O~ RESID,E~ICE -~ [~ SINGLE FAMILY [] MULTIPLE FAMILY ' NUMB'ER OF~BEDROOM [] One [~ Four [] Two [] Five [] Three [] Six [] Other 7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY F-I PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** ~ PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2. WATER SUPPLY INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [~Holding Tank Size If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank IAbsorption Area Sewer Line Nearest Lot Line 5. COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) ~ DISAPPROVFD DATE BY 72-010 (Rev, 6/79) ( [/ UOTt;!AI:pqns '-.[.X~?d U¢)q.XON ~ ~[z)O'].[[ TT -IO'7 [ '[ S fi 6 e$[S'el ~z' ' SB()U-OT xoq ooTjfZO 'ouI 'uo[qon.:z-4suoD uO ,U~,AOFi I86I 'gI I[-:~dh.z