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HomeMy WebLinkAboutPENNINGTON PARK BLK 3 LT 6,.5 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT '- [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LoT LOCAT'ONKallerOar r/e ] Well ^ z~,~..',~ I Absgrj~tio. n.~rea I DISTANCE TO: IVOT II'1 I /d ~ u~ I Liq,7~C~lt~ n gal i OhS IF HOMEMADE: , Inside length 6 .. ~ DISTANCE TO' IWell I Dwelling ~0~-~ Manufacturer ~' I I Well Foundation u~ ::I: I DISTANCE TO: I j u. Z I No. of lines j Length of e~e~hjlj~e Total leJ?g~o~lines  1- Top of tile to finish grade / ~ Material beneath tile I Length Width Depth ~ I- ~- Crib diamete~ Crib dept~ ~ ~ ........ ~ Well Building foundation iCl~ss Depth Driller ~' [ ~T¥ Building foundatlo~ Sewer h n'~--~" e Dwelling~ Width Material Nearest lot line Trench widt~l~ilnches inches ~ubc~i vi s~ ~ v~ NO. OFBEDROOMS No. of c~.artments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines ~ Total effec,~.~s~tion area I PERMIT NO. Total effective absorption ~rea Nearest lot line Distance to lot line PERMIT NO. Septic tank Absorption area(s) OTHER PIPE MATERIALS . SOIL TEST RATING INSTALLER APPROVED DATE LEGAL 72-013 (Rev. 3/78) Box 1369, STAR I~OUTE A ANCHORAGE, ALASKA 99502 344-7714 SIX INCH WATEr WELL DRILLED AND CASED OUT TO THE DEPTH OF i DRILLED AT ThE RATE OF ,.?o.'~ f~(~ PER FOOT. PROPERTY OWNER LOCATION OF WELL SITE. "~ ............ DRILLER WELL LOG: COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF THANK YOU VERY MUCH. DATE. BERNIE CLAUS OF RAMPART DRILLING WORKS SERVICE CHARGE 0 F I~% PER MONTH W ASSESSED ON PAST DUE ACCOUNTS. ,,, O i"-llUll'-.i :[. ,-: 'f I:- 'C'lL 1-' T"'r" C'F RI%IC:H ..... © DEF'RRTMENT L HERLTH RND EI'.,IVIRAI'.,IMENTRL , .OTECTI01",I :__.-:25 '"L" STF.'.EET., RNCHORRGE., RI<. 3'._.9.50::L 264-472¢~ I--..IELL RI'-.IE:, ,'-ir'-,,I--5 I TE 5EI..-.,IEF.: F'EF'~:i"-I 'ir T' F'ER.M I T NO. ( L=:2:¢'~'135 ) APPLICANT STEYEN GEHLHAUSEN 64? E. LOCATION LEGAL L6 B~ PENNINGTON PARK TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH 78TH 99502 LOT SIZE 349-8i40 999999 SQUARE FEET MAXIMUM NUMBER OF BEDROOMS SO I L RAT ING ($Q FT,,"BR) = 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [:,EF'TH= t2 LEt-~GTH= 24 GRR'-..'EL [:'EF'TH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). E: E 'C;! IJ I F-: E [:. $ E F' T I C: T R t-~ ~::: '.=--; I Z E = t ~':'-~ L~ L-]-~ u3 R L L Cu ~-~ ~; PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T'L.~E, (2) I [-~SF'E~Z:T[,3[-~S RE:E F:E~;!LiI F:EE:, BRCKFILLING OF RNY SYSTEM NITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT WILL BE SUBSECT TO PROSECUTION. MINIPtUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS ±00. FEET FOR R PRIVATE WELL OR ±50 TO 200 FEET FROM R PUBLIC NELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND, 'TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 OF THE NELL COMPLETION. OTHER REQUIREMENTS FlAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRRbtS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'EE:IPl ][ T E;=-,;F' I ~'E$ E:,EE:EI"IE:EIE: "~c1.. I CERTIFY THAT ~L: I RM FRMIL. IFtR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FOF:'.TH BY THE ~IUNIRIPFtLIT~ OF ANCHORAGE. 2' I WiLL INSIRLL-THE sY_sTEM IN ACCOR[:,RNCE WITH THE CODES. 3.: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ]: BEDROOMS. RF'F'L I CANT S T E',,.'EN GEHLHRUSEN I SSLIE[:, E:Y .... [:,RTE_ '.,,'4. E)t:F'/tdq Ifv1~ fxji OF l l[/\t,l't} /\ND 121XJ\lli:iiE':%q[ I',.l','-\! J'11(j) fl~Cll;~J ~Permit ~: 820812 .January 31, 1983 TO: Permit Applicant Subject: Lot 6 Block 3 Pennington Park Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerel% Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 PERMIT NO. r-lLIl'~ I C I r'F:IL I T~r" OF FII'4'::I-' iRI=IGE~[ '/~_~r-- DEPRRTMENT HEALTH AND ENVIRONMENTAL .:OTECTION 825 "L" STREET., ANCHORAGE, AK. 9_g501 - 264-4720 bIELL RI"4D ON--S I Ti SEWER PERM I T APPLICANT LOCATION LEGAL STEVE GEHLHAUSEN LT. 6 BLK.~ PENNINGTON PK. 647 E 78 ANCH LOT SIZE ~49-8140 20000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING 4SQ FT?BR)= i25 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 12 LE~'-IGTH= 27 ,]RAVEL DEPTH= 7 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ~:EQLI I ~:EB, SEPT I C TAr4F( S I ZE= 1000 GALLE, r4S PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T&40 <2> I ~SPECTIO~S PRE REC4LmlRED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM A PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXP I RES DECEMBER ~l., 1S~82 I CERTIFY THAT i: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELEDTO INCLUDE MORE THAN ~ BEDROOMS. RPPL I C~RNT STEVE ~E~L. HAUSEN Steven A. Johnson P.O. Box 76 Chugiak, AK 99567 Phone: 907-688-3085 C SOILS LOG - PERCOLATION TEST [] SOl LS LOG [] PERCOLATION TEST PERFORMED FOR: Jon Benoist DATE PERFORMED: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Lot 6 Block 3 Pennin6ton Park Sub. SLOPE 0'-1' gravelly silt (ML) 275 1'-4' red brown well graded sand w/ some gravel (SW) 125 ft27bm silty sand (SM) 250 5'-16' red brown well graded sand w/ some gravel (SW) 125 ft27bm Total Depth 16' SITE PLAN WAS GROUND WATER ENCOUNTERED;) IF YES, AT WHAT DEPTH? Gross Net Depth to Date Time Time Water PERCOLATION RATE (minutes/inch) COMMENTS PERFORMED BY: 72-OO8 (7/76) TEST RUN BETWEEN FT AND ET lot topo~fraphy is irregular, sloping generally to the N and W, . drainage is good Steven A, Johnson CERTIFIEOBY: ~_ ('~. /),t~k.,~ . ATE '.~_~] 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 June Application Date 3, 1985 GENERALINFORMATION (a) LegalDescription(includelot, block, subdivision, section, township, range)' Lot 6, Bk. 3, Pennington Park Subd.; Sec 10, TllN, R3W, S.M. Locati0n(addressordirections) 5510 Kallander Drive, Anchorage, AK 99516 (b) Applicant Name Steven Gehlhausen Telephone: Home 345-5952 Business 563-3377 Applicant Address ~510 Kallander Drive, Anchorage, AK 99516 (c) Applicant is (check one): Lending Institution [] ' Owner/builder ~ · Buyer []; Other [] (explain); ~, (d) Lending Institution Home Savings and Loan Address 1OO1 E. Benson Blvd.~ Anchora6e~ (e) Real Estate Company and Agent Remax, Attn: Ester Address 1000 E._D_imond Blvd., Anchorage, AK Telephone 522-103© (f) Mail the HAA to the following address: Hold for pickup Telephone 272-1451 AK 99508 Bumgardner 99515 TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms Three Other WATER SUPPLY Individual Well IK'I 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 (11/84) ,41 5. 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. Alaska Soil Testing and Engineering 561-7453 Name of Firm Telephone 6100 A Street, Anchorage, AK 99502 Address Date April 24, 1985 ST85-260 DHEP APPROVA~ ~'.~,> <......-T.....~/~ Approved for' ~~' _ bed room s b~~~~'~- ~-'-'~--~ Approved ~ Disapproved Conditional Terms of Conditional Approval Date 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 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 5-13-83 Date Installed 60 ±nches Width of Field -- 125 ft2/ bdrm Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy TestN-/A SYstem Separation Distance from Absorption Field: 112 ft. To Water-SupplY Well 27 ft. To Building Foundation 4o7 ft2 in use trench Shallow Type of System Design 44 ft. Length of Field 4.8 ft. Depth of Field 3.5 ft. Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy TestN/A~' System ±n use -less less than two years.__ 26 ft. To Prope~y Line To Existing or Abandoned System on 160 ft. Lot lO+ ft. To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments · On Adjoining Lots To Cutbank (if present) 51 ft. 100+ Absorption field in use less Occupancy 10-3-83' ft. ft. than two years. Ref. than 2 years. to 5 ft. high road cut ~ve cut. Certificate of D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checke, d.cve~ified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ~~ Date June l, 1985 Signed ST85-260 Ak Soil Testing & EngrMoA No. Company Amount: $ Receipt NO. -~ ~~ Date of Payment ~ '--~-~ ' ~'~-" Page 2 of 2 72-026 (11/84) APPLI¢ FILLS OUT UPPER HAL ONLY Buyer Address /~ ~ ~ Zip Code Realty Co. & A~nt Phone mily : Multiple Family No. of Bedroo~ : Other Warty .~lndividual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ~dividual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Insl~tor Field Notes: t~" ~ ~ t,~ MUNICIPALITYOF ANCHORAGE DEPT. OF H5>,LTH ~,, ,RECEIVED d'~ ) APPROVED BEB~OOMS 'CONDmONS OF APPROVAL ( ) D~SAPPROVED ( I COND~TJON~.APP~OVAL' Soils Rating Date 8ewer Installed Well To Absorption Area Well Log Received (....~ ~ J~'~ // .~ --~' ~ Well to Tank Septic Tank Size ~ "~ ~, 72-023 (3182) ALASKA eIIuIROFIITleFITAL COFITROL SeRblCl $, IFIC. October 7, 1983 Department of Health & Environmental Protection 825 L. Street Anchorage, Alaska 99501 Attn: Robbie Robinson Dear Robbie: On October 6, 1983 our company inspected the sewer system & well on Pennington Park Subdivision, Block 3, Lot 6. All the standpipes are capped. The well stands approximately 2 feet above ground level. The well has a sanitary seal and the wire are encased in conduit. The well is located 100 feet from the sewer system and any neighboring systems. The water sample was satisfactory and a copy of the report is attached. If you have any question please feel free to contact us. Sincerely, Laura/6~ar EnvirOnmental Specialist Approved: ~v~...'- C~&. ~ ..'5~~' ~ ~o. 2251-E N~UNIO?ALITY OF ANC'r4ORAGE RO~g~N t ~ - / RECEIVED 1200 LUest 33rd Auenue, Suite ~ · Anchoroq¢, Alaska 99503 · (907) 276-1361 DATE: TO: FROM: SUBJECT: icipality of Anch¢ MEMORANDUM October 25, 1983 Laura Crow Environmental Health Division Request for Refunds - Account # 2460 Please make arrangements for the following refunds; one has had a private engineer do the inspections, one is canceling the permit and will put in a complete on-site sewer system later next year. Steve Gehlausen 647 East 78th Avenue, Apt. B4 Anchorage, Alaska 99502 Receipt ~ 261096 Amount $~0 L4~,O~ Sewer and Water other Lot 6 Block 3 Pennington Park Subdivision Health Authority Request Lynne Vanderburg Post Office Box 772 Girdwood, Alaska 99587 Receipt # 263793 Amount $20.00 On-site Sewer ~Permit Lot 18 Block 25 Timberline Subdivision Thank you. Laura J. Ward Office Associate Sewer and Water Program LJW attachements 91-010 (4/76)