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Home My WebLink AboutPANORAMA TERRACE BLK 2 LT 9 /~-., MUNICIPALITY OF ANCHORAGE DEL ITMENT OF HEALTH AND HUMAN SER~ :S ~ '~ ~' Environmental Health Division * 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ^ddress wm Phone(s) I Permit No. No. of 8~0~oom~ WELL I ¢ I ~ FOUNDATION Township, Range, Section ~% /~ ~/ ~ ~ ~ ~ (~ AS-BUILT DIAGRAM (Show location of well, septic system, property hnes, loundat,on, driveway, water bodies, etc.) TANKS p¢,,~ Ck, /.h 4 ~ SEPTIC ~ HOLDING ~anufacturer Capacity in gatlons TYPE OF SYSTEM ~, ~ TRENCH ~ BED ~ Wl D RAJ N ~ OTHER .~ ~¢;~ Depth to plpe bottom lrom Total depth from original grade / ~'"~ /// original grade 9, O FI t 3,0 FI i ~ ~ Fill added above original grade Gravel depth beneath pipe Total absl~rpnon area Distance between tines ~/. C/t,t,~ ~7~ SQFTj N,/~, ET ~pi ~ ~ Number ol lines Soil rating Pipe material Installer Date Installed ~~ _ ~ PRIVATE ~ OTHER fldentifv) / Classfficauon (A,B,C) Total Depth F~ Cased to ~ ~[~ FI ~ REMARKS: ~n~e~ ~. ~au,~y ~ /E~o,'[ ~ I ~~ ~ ~ cedily that this inspection was pedormed according to all Municipal and State ouideiines in ellect on this dale: [~O~-ef~e~ /6 /¢~ Health Depaament Approval: _ ~ ~ .._~ ~ ..... / ~ .,;... 72-013 (3/85) L, .I Al'x t ' b. ,11 1, ~-1~:.~.~)..., I'1 AND E]',IVIRONMENT'AL :O. TECTION 2 6 4-. 4. 7 2 () ,-t:.!:ll.1:T NO: .!,,d';! Ii::. ] !:3SUED :~ APPL I CAN'T' ~ ROGER HIEAD '76:31 GR I FFI ]'H ANCHOF~AGE~ AK 56:1.-1:1.48 L.,E:GAL !)ESCF:,' ! P = L. 0 T S I Z E: ~ E.I"~RA ..,E. ,:~/D L..O"F." SUBD .1: V I S I (;;)hl: PANORAMA ............... ~ .... ' 9 SEJ]'¥ I [)N: 13 I L t,,, Nc: h .~. 1' : T 12N F:~ANGE: R:3W 1., 9A, rS(;!. F'T. OR AC'RES) E L[)CI ....... I c ¢.:;.:. r' t :i. f' y t, h a'L ',: ]1.. .1: am familiar' with t, he: r'equ:i.r'e:mer'rl:.s for', c)r'l-.sit, e sebJE})t"s al'id i/~(.:~lls aS Se?E.' f'or'th by t, he Munic:i, pality oF Anchc. r'age (MOA) and the State oF Alaska. 2,, I will inst, al! the %yste:,m ir] ac:cor'danc:e ~,~:i.'Lh all MC}A codes 4Mqd ~.1"! ccm'q::)l:i, ance with the design cr'iter':i.a of t. his per'mit,. 3. .1: ~wi;t.l aclher'e t.o all MOA and St, at.e of Alaska r'eqLt:i, pefflerTLs for' t. he set. back clist, ar'lces t'r'om any ex:i. st,:i.r'lg well, wastek~at, ep d:i. sposal system or' publ:i.c sewer'age syst. em on t.h:i.s or' any ad.;jac:ent of neapby lot.. IF:' A I...;!I:::"T' ST'AT..1;E}N .1:S INE~T'AI_I_IED IN AN ARIEA COVEI;~ED BY MOA BUILDIBIB CODES, ]"HEN (1) AN ELECT'F;:ZCAL. F::'EF~.MZT AND I'NSF'ECTZON MUST BEE OBTAINE](;)~ (2) AS-BUIL. TS M:[L..L. NCrF BE AF'F:'F;:OVED WI"f'HOUT AN IF. ELE.;CYFR.1:CAL.. INSPIL;:CT];ON REP[)R"f'; AND (5) 'T!HE: EI....ECTF;: I CAL.. MOR'.K MUST BIE DONE: BY A L I CE;I'q,'SE](:) EEL. IEC'T'FR .1: C I AN. ThrIll- 06. pTI'f 4- 47 TPFT T#bT I#o~,I ~o ~VSTEi~ O0~'u TO ~0' I'#E?6N~I3L~' 47 /"'"', /--'", [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: I0 /'Z? /C9~ 1 42/- 2 3 4 5 6 7 / 8 9 SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER S L OOc¢.J~,,~¢y/ ~r'~ ENCOUNTERED? N O I P IF YES, AT WHAT So~ CO~ ~l~ DEPTH? ~THEODORE F. MOORE CE - 3589 eeo Gross Net Depth to Net Reading Date Time Time 0,k~) Water Drop 1 3 'aa ~o ~ 7 Yz COMMENTS )LATION RATE I ~' 0 (minutes/inch) TES?."~RUN BETWEEN ~', 0 . FT AND ~'~,.5~- FT 72-008 (6/79) /. o'r' $ 1,1530 l::.cho Street 2lnchorcrge, Alaska 99516 I i .6)( 5 i7-_~ LOT' 9, DLh' ~, PA NO ~A M A ' '-FE. R R. PAr'~ : GR~"--'TER ANCHORAGE AREA BOROL" ~ D~rARTMENT OF ENVIRONI~IENTAL QUALI~, 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING -- -~ ~ ADDRESS '~'~/~ ~'~'~'~ ~ PHONE ...... '/~'~:!/~/)c?Z '~(~[:f //~/.V/~-' ~:.LEGAL DESCRIPTION /~,~rl¢~r~/7~c. '~'/'~:p/Z~)~ t~(~r ~ Z?Z/~'~ SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY GALLONS. NUMBER OF MATERIAL ,~'~'~K'; ~7'~:Z. COMPARTMENTS INSIDE LENGTH .... INSIDE WIDTH LIQUID DEPTH. .... SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH /~ / · ~ , LENGTH / '7 / DEPTH DISTANCE FROM WELL /~.'~'/~'~-;{) /{;~'; BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) '~ ~-~ SQ, FT. TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION , NEAREST .LC)JLJJ~---~ NUMBER OF LINES DISTANGE-BETW'J~I~' LINES TRENCH WIDTH ABSORPTION AREA ~ SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE-- WELL: TYPE ~')1~(~':;_ :i') /IL&'1 / DISTANCE FROM , DEPTH , BUILDING FOUNDATION.. NEAREST SEPTIC SEEPAGE LOT LINE , SEWER LINE ., TANK , SYSTEM. WATER SAMPLE __, CESSPOOl NEAREST OTHER , SOURCES DISTANCES: /.t/oc ~C '1'- "7 DIAGRAM OF SYSTEM // G.A.A.B. GrEalER ANCHORAGE AREA BOR~JUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA S9502 TELEPHONe 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. 2199 MAILING ADDRESS PHONE INSTALLATION OF: SEPTIC TANK EEPAGE PIT DRAIN FIELD OTHER SOIL TEST RESULTS ~ ~' /f~J/~/~ff~ NOTE: THIB PERMIT lB NOT VALID WITHOUT BOIL TEBT COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE · HEALTH DEPARTMENT AUTHORITY WILL BE BUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUiREMENTB FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ~! TO NEAR~ST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD SEEPAGE PIT WATER MAIN TO SEPT C TANK f(~ DRAIN FIELD ~/[0 /~ SEPTIC TANK. ~ SEEPAGE Pit TO RIVER. LAKE STREAM. DRAIN FIELD ALSO CONSIDER AREA WELLS. DIAGRAM OF SYSTEM CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS· "GRAVEL BACKFILL CONFORM TO B~EGULATIONS REGARDING ~NSTALLATiON. UTHORITY OR LICENSED DESIGNER I CERTIE~ T REATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE GREATER ANCHORAGE AREA BOROUGH DEPA~"~ENT OF ENVIRONMENTAL QUALi 3500 TUDOR ROAD ANCHORAGE; ALASKA 99502 CASE Performed For Bill Zebeck Legal Description: Lot 9 Blockz This Form Reports Soils~g Date Performed 5/30/72 'SubdiviSion Panarama Terrace x Percolation Test Depth Feet Soil Characteristics Brown Silty Sand (SM) Was Ground Water Encountered? If Yes, At What Depth? Gray Sandy Gravel (GW) and Sand (SW) Reading Date Gross Time Net Time Depth to H20 Net Drop nute Proposed Insta'tlation: Seepage Pit Drain Field Depth Of Inlet Depth To Bgtton~ O,f Pit ~'~' Trench COMMENTS: 100 square feet of drainage area is require~ peroe~room De. ow 3' depth, N Test Performed By R. E. Carlisle Data Certified By:National Testing Services Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE oF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) 7d$t ¢::r'; (b) Applicant Name ~°,~~r' h(e~e~ Telephone:Home -~0~'-~0"'7~" Business '~'~'-1,5"~'7 Applicant Address v 7~-,'~ { ~-----'/"~ .~' ~-'{ ~ //} n c ~ O/'-<~-~'~ .,~ (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); (d) Lending Institution ~ r.x ~' .'~'n~c.r~' ,~'n~'t', Telephone Address ~ ~ ~ ~o ~a~e/ ~ (e) Real Estate Company and Agent ~, ~' ( ~ ~;~t ~ Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [] Multi-Family[] Number of Bedrooms Other WATER SUPPLY Individual Well [] Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite I~ 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 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ,, 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 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. NameofFirm F(c~,,-/-ej~ ~Ch~;¢c~/' ~'~'~'~'c~/' Telephone ~-I~ Address ) ~ d ~C&O ~ ~ ~C~O~ ~ ~ Date ~~ {~ /~ Seal DHEP APPROVAL Approved for ~ Approved ' /.', Disapproved Terms of Conditional Approva! bedrooms by ,~~~ ~ Conditional Date //-- / 7-- (:~' CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 i11/84i MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: MUNICIPALITY OF ANCHORAGI~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION NOV 1 RECEIVED WELL DATA Well Classification Well Log Present (Y/N) N Total Depth '~lO' o~'f Cased to Static water Level {~ 3' ' Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: fir'] ~'~/"~-- If A, B, C, D.E.C. Approved (Y/N) Date Completed Iq 71 Yield ~ 210' Depth of Grouting Pump Set At ~, Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot { 0 '~ ~ '/~ ~', O. ; On Adjoining LOts To Nearest Edge of Absorption Field on Lot ~ I~" J~ ¢,0.; On Adjoining Lots Tc Nearest Public Sewer Line N~,/~. To Nearest Public Sewer ~ (00~ Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments .~/-~ eX,v, To Nearest Sewer Service Line on Lot ; Date ~'/~"~ B. SEPTIC/HOLDING TANK DATA To Property Line To Water Main/Service Line Course Comments Date Installed J I/~"/~ 80~ Standpipes (Y/N) J~ Depression over Tank (Y/N) ~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Su pply Well i 0 ~ ' ~0' ,~! ~ ~ ~.~-'~ ,~((o,,, Size I '&C'OOq'~( NO. of Compartments Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) Date Last Pumped N, tk IN¢ ,~. ; for ~J' ~'' lbl,/I-. Temporary. Holding Tank Permit (Y/N) ,~, To Building Foundation {~' ~ To Disposal Field ¢ ,~ ~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026111/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~1 / [~' / ~'~' Width of Field ~ ~ '~~~ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot ~'/(~o{r,',~ Type of System Design -'r Length of Field ~-~_. i Depth of Field I ~ I Gravel Bed Thickness ~ ~ ~,,~--~,~c/"~',/¢ ) Standpipes Present (Y/N) Date of Last Adequacy Test To Water Main/Service Line ~, To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments N~--~..~ 3 /~,~r~ ~c/t To Property Line ~J-' To Existing or Abandoned System on ; On Adjoining Lots ~ -~'¢::~ I To Cutbank (if present) /N,/J. D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed~"/'-'~_/~'"'~--~ ~ ~:'~- Date Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal ~L"~ ~ DA~E RECEIVED · :., INSPECTION APPOINTMENTS ;,TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSPECTOi;K DEPARTMENT OF HEALTH& ENVIRONMENTAL PROTECTI~/IRONM~NTAL PROTECTION, 825 L Street - Anchorage, Alaska 99501 APR 1 2 1983 ENVl FIONMENTAL SANITATION DIVISION Telephone 264-4720 'RECEIVED REQUEST FOR APPROVAL OF NDIVIDUAL WATER AND SEWER--FACILITIES DIRECTIONS: Complete all parts oil page PHONE 1. PROPERTY OWNER MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS] - 3. LENDING INSTITUTION I PHONE MAILING ADDRESS 4, REALTOR/AGENT I PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATI~)N 6. TYPE OF RESIDENCE ~] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF ~B EDR~,~MS [] One ~ Four [] Two --I Five [~ Three --I Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM IND VIDUAL/ON-SITE** [] 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.) '~)~. 1~'¢I 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 NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [~Septic Tank or []Holding Tank Size: j~){~) If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/H°lding Tank IAbs°rpti°n Area ISeWer Line INearest L°t Line Absorption Area to nearest Lot Line 5, COMMENTS ' I~APPROVED FOR "~' BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED .~ DATE BY ~___~._ - (?-- .. 72-010 ( Rev. 6/79) April 18, 1983 Roger D. ~tead SR Box 2045E Anchorage, Ak 99507 Subjects Refinancing Only, Lot 9, Block 2, Panorar. la 'I'errace Approval for the individual sewer and water ~acitities cannot be granted until the follo~ing items have Deen completed= tThe water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. The septic tank pumped with a receipt sub~itted to this department. ~ An adequacy test needs to be ~rformed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of ~nls report ~orivate firms performing the test is enclosed. ~'' ~ needs to be submltt.¢.~ to this office ~or our review. o The application shows the number of bedrooms exceeds the number the on-site sewer syste.~ was originally designed for. An upgrade will be required. Prior to any upgrade, a peri, it needs to be issued from this department. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Enclosure Robert C. Pratt Speclatlot Associate Environmental ~ "~ ~ RP20/ej/E1 SR' B0X-2045E Anchoragei Ak.' LEGAL: OWNER: Roger Head Tank: ' AbsOrption '-~ - ' -i S~stem: _ .._Log~Crib ' 'i ~bil: -~ ~. - -~ ApProval-i_ EST DATE.~ Apr%t30, 1983 May 16, 1983 --2-- PROCEDURE: House watE prior to Water from When 200 gallons had been full. This standpipe intothe ~rib. Total rise in liquid level in the c inches, which corr~sp°nds'to_a 47 gallons per inch. The septic tank Was then pumped, and monitoring was carried out for 2 hours .25 RESULTS: COMMENTS: The plot of absorption vs. time yielded a daily absorption capacity of 480 gallons The required absorption c~ for a is 450 .gpd. The sy Anchorage requirements. Pumping O~ the3septic tank was very diffJ .,7 >0 9 LEGEND, / ,.~ SURVEYOR'S CERTIFICATE ~ PLAT APPROVAL~ ...... 191-388 DT%001240 Lot 0 "PANORAMA TERRACE SUBDIVISION NWl/4, Section I$, T. 12N.,R,3W., Sew. Me~, Alaska Dickinson-Oswald ~ Associates Anchorage. Alaska 00' 1 I/-50/621 M.P.O. FB 2:0 I 2:-4 134-72