HomeMy WebLinkAboutRAYMOND TEDROW BLK 4 LT 14
~ DEPARTMENT OF I-IEALTH & ENVIRONMENTAl_ PROTECTION
i ENVIRONMENTAL ENGiNEERiNG DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WELL INSPECTION REPORT
ADDRESS --. ~.~:~ 7 '
DISTANCE TO: I
Manufacture~-- / ~~M ri'
~Liq, ~it~allons~ ~ Inside length
' / ~ ~/-~ / I F HOMEMADE' / I ~h Liquid depth
L~,~ ~ ~ ' J._
~' ~~--' '' ~ ~ [Material Liquid capacity in gallons
DISTANCE TO' /v ~ e~ lin~
~ N~ of lines~ I Length
~ ~ ~ ~ , ~ -- Z~ ~ ~inches ~otal effective ab tionarea
--~~~ ~'~ Oep,~ ' PERMIT NO,
~~--~ Cribdiameter/~ /; C,',[%depth~ Total effective absorption area
Well ~ Building foundation Nearest lot line
--~~~ r~~ ~e~ Distance to lot line PERMIT NO.
=~;;NCE TO; .Building foundation Sewer line tank Absorption area(s)
Septic
OTHER
PIPE MATERIALS
SOIL TEST RATING
REMARKS
DATE
72-013 (Rev. 3~78)
LEGAL
!t!.::'(3N "!'hiE: 'T'¥'F'E E!.~::' f::'(,!!i~!., ( (;;: FIE;L,.L.
?"!/I; N ~i i'!U!'"! !?' ;!: ti!i; FI:::INE:E: FF;:E!t"! F:I F'!:;: 1!1 ","i:::i'i'i!:: !,!E!,..i., ?"O I:::! r:'R ~: ',/1::1 i"E ::'_:;E:i,IE:I:;;: i.. Z ~"!~1 !1 E; ;:~'.} F: EET FIN{:*
'T'Q 1:::~ (:X)!'"F'!U?.,!'("F'./ E;J:~:i..E~:F;;: !.:[NE :i:E; '?,5 F'E:E"r'.
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
4
5
6
8
12
'13
14
18
20
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
[] PERCOLATION
TEST
SITE PLAN
1
COMMENTS
ENCOUNTERED?
'O
P
E
IF YES, ATWHAT
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
:.., PERCOLATION RATE ,,, (minutes/inch)
TEST RUN BETWEEN FT AND -- FT
72-008 (6/79)
MUN C PALITY OF ANCHORAGE
OF HEALTH AND ENVIRONMENTAL PROTECTION
',,:I',: '~;': i:i' DIVISION OF ENVIRONMENTAL HEALTH
YE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
r .~ OF ON~SITE SEWER AND WATER FACILITY
.... " 264-4720
:;i:,' ' Application Date
NFORMATION
Legal Description (include lot, block, subdivision, section, township, range)
: ocat on (address or d rect OhS)
; !:.' : ' ,~2, .,. .1', '- , ,. ,
(~?;¢~licant~Na~.~.~¢~., ~P¢~ Telephone: Home ~¢- O~'~ F Business ~¢~- ~/
(9)~; ~p~li~an[ is ¢check'one): L~nding nst ration C · Owner/bu der ' Bo er ~" '
(d) L~nd~qnstitb'lJen" ~ . ~
"%,.'. ~ ;'¢'~.i'~ '. '~i~ ~ Telephone
Address. 'v. ;'~' ~'
(e) Real Estate Company and Agent _ ~
Address
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family [~/"Multi-Family E]
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.
SEWAGE D/ISPOSAL
Onsite [~ Public []
Cornmunity [] 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)
ENG!NEERING 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 systern is in compliance with aH Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm ~ ~d~'.~ /If~E, Telephone ~'~'/- ~-¢:~ ~
Date
DHEP APPROVAL
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
72-025 (11/84)
WELL DATA
Well Classification
Well Log Present (Y/N)
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
A ~I,~I~,~T - FEBRUARY 1984
r:, Legal I~escription:
~ If A, B, C, D.E.C. Approved (YIN)
Date Completed ,,V/,4 Yield
Depth of Grouting
Pump Set At /'~',/~
A/,//~ Sanitary Seal on Casing (Y/N)
___~. Depression Around Wellhead (Y/N) /V/
Total Depth _ ~/~ Cased to
Static Water Level ,N//,A
Casing Height Above Ground _
Electrical Wiring in Conduit (Y/N)
Separation Distances from Weil:
To Septic/Holding 'Tank On Lot
To Nearest Edge of Absorption Field on/L-o~ "/
To Nearest Public Sewer Line_ J
Cleanout/Manhole. J
Water Sample Collecto~
Water Sample Te~Results
Co m m/~///
,--"/ ; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer j~
To Nearest Sewer Service Lin..e.d'n Lot
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N) ___.~ Air-tight Caps (Y/N) _
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-Supply Well _
To Property Line t'&' /
Water
To
Main/Service
Line
/_/.~/Et'/_ Size /~¢/~/_ No, of Compartments ;~
~ Foundation Cleanout (Y/N)
~Daie Last Pumpe8 '2. '~ ~'~ ~-
/I/b ;for /V/,~
Y
Temporary Holding Tank Permit (Y/N)
~ i~/
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Course
Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ////~
Width of Field
To Water-Supply Well
To Building Foundation
Lot /,//~
To Water Main/Service Line
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
'7,0"
To Stream/Pond/Lake/or Major Drainage Course
Type of System Design ~/---'-'~-'"""/~
Length of Field 2.~ "~
Depth of Field
Gravel Bed Thickness /[//,4
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ;~¢'"~ / '/
To Cutbank (if present) /V,//~
To Driveway, Parking Area, or Vehicle Storage Area, '~ ~
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
C~~Electrical Codes
D~mensior~s.--~
Ma n.b.ol Ae'/~ccess (Y/N)
j.--'"'"~"Pu m p Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
S ignedl certify that. ~//'¢, ..~1 h.ave checked~ verifi_ed,~or, conformedDate to all~M/~/,~¢~ 'CA aqd/HLAA~.~ guidelines in effect on the date of this ins pection.
Company ,/~I~:"'-~: -~' MOA No. ~--~¢
Receipt No. ~ ~ ~
Date of Payment ~-DD ~
Amount: $ ~ ,~
Page 2 of 2
72-026 (11/84)
ALASKA eF1UIROIqm rITAL COF1TROL SeRUICE $, IFIL
~ngin¢¢rmq 8 ~uirom¢~ld Sl~dJcs
GABE STEPHAN
i101 E 76TH AVE
ANCHORAGE ALASKA 99518
SELLER-GABE STEPHAN
02/06/86
GABE STEPHAN
i101 E 76TH AVE
ANCHORAGE ALASKA 99518
60041
LEGAL:RAMOND TEDRO BLOCK 4 LOT 14
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-2/3/86
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 546 SQFTo
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY°
THE SURGE CAPACITY OF THE SYSTEM IS 600 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 4 BEDROOM ltOUSE.
THE SEPTIC TANK/PACRAGE PLANT WAS ?UMPED O~N 2/4/86 .
THIS REPORT DOES NOT VERIFY !FILE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
~ .~ /] ,~ IJ~ .~.~
~ ~ ~ J ~rO~ C. Raid; Jt~ '"
i200 LUcsl 33rd Aucnu¢, Suite J~, Anchoroqe, AIc~sko 99503 o(907) 561-5040
CONTROL SERVI[ ;, INC.
12OO West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 551-5040
SHEET NO __ /
CALCULATED DY -~"~- ~'<~'~'~
CHECKED BY
DATE
DATE
Ir:~f EVb o~' T'~_~dl{
',4.
/'ir '
~4 ' . 4,~'
APPLI(; FILLS (:)UT UPPER HAl ONLY
Mailing Add~ess ///'
Buyer
Zip Code
Phone
Address
Zip Code
Lending Institution ,." ,./~' . ~ .-' ~ / /' ./{ -/ . ("("2 ,
Address .//. .- ,.. -'~ / ~'*' / / .,/~ / // ~/--/ .
.,/~', ' .~
Legal Description Z_,(' :' /~ ,2C;~.~ ¢~ /¢'/:~ ~J~ "~./~'~dt~ , (/~'.
Type of Residence
~-Single Family
~ Multiple Family No. of Bedrooms
~ Other
Phone
Phone
Water Supply
[~ Individual
L~-Community
~ Public Utility
Sewer Disposal
-I~--Individual
[] Public Utility
~ Holding Tank
ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
For wells drilled prior to that date, give well depth (attach Icg if available).
Year Individual Installed:
When Connected to Public Utility:
NOTE: TIlE INSPECTION FrEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time ' -TI e~
Date Dale Date Date
Inspector Inspector Inspector Inspector
DISAPPROVED
CONDI~ONAL AP. PROVAL*
) APPROVED BEDROOMS
'CONDITIONS OF APPROVAL
Soils Rating Date Sewer Installed
Well To Absorption Area
Woil to Tank
Well Log Received
Septic Tank Size
12.023
Oo'co .~;L ] 3, ].Lt., .'_'..t'~d ~ % 1 ooo
Addend um ].'o
or' lo( ]/i 1~1< /~ }~ab;mcmd Tedl:'o~¥ S/I) per-fol~med 10--13,14&lS-1983
I-~t~-o we~o J_~ p]ac:e and capped aL
EnSl)eC~ i_on.
MUNICIPALITY OF ANCHORAGE
DEPARTMEN )F HEALTH AND ENVIRONMENTA
825 L Street, Anchorage. Alaska
~t'
#1: Time
Date
#2:
264-4720
Date Received:
Time
Date
Insp
PROTECTION
99501
November 7, 1977
#3:
Time
Date
Insp
4:
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: Alaska Mutual Savings Bank
Mailing Address: Post Office Box 1068 99577 Phone: 694-9571
Property Owner:
Mailing Address:
Albert F. Bendle
Box 211 99577
Phone:
277-7023/work
Legal Description: Lot 14 Block 4 Raymond Tedrow Subdivision
Single Family Residence: (x) Number of Bedrooms: J
Multiple Family Residence: ( Number of Bedrooms:
Well System:
Permit ~
Construction
Ind:Lvidual Well ( ) Community/Public System (xk
Depth of Well Well Log on File (
Bacterial Analysis
Sewage Disposal System:
Permit #
Septic Tank Size
Absorption Area
On-site System (x) Public Utility (~[$
Installed 1967 Installer
Manufacturer
Soils Rate Material
Distances: We[L1 to Septic Tank
to Sewer Line Nearest Lot line
to Nearest Lot Line
to Absorption Area
Absorption Area
P&ge Two
I;epar'{:ment o~! Health and Environmenha]. P.~:ohechion
Re.lues{ f~(}~' A}}prova]_ ef Individual c, , ~, -
~e~, :.~. and Nater Faci ] J_ki. es
C omme rt[ s:
Department Worksheet:
e
GREAI'ER ANCHORAGE AREA BOROUGH MuNIC~PALII'Y OF AIqCt'IOR;~G2
DEPI. OF HEALIH ~,
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-45~'ivl~°Nl'~M'~AkP~°'mc'n°iN~N
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection:
2. Property Owner:
Mailing Address:
3. Name of Buyer:
Mailing Address:
CMRO VA
Albert F. Bendle
FHA
. Bo~x 21~lm E~gSe Riv~er, Ak 99577]ay Phone
Albert F. Bendle
CONVxxx
277-7023-Kaiser Cement
Box 211, Easle River, %!! 99~.7~ay Phone 277-7023-Kaiser CEment
6. Name of Lending Institution:
Mailing Address: P.O. Box 1068, Eagle River Phone
5. Name of Realtor or Agent: none involved
Mailing Address: Phone
Alaska Mutual Savings Bank
694-9571
Legal Description: Lot 14, Block 4 Raymond Tedrow Subd.
Location: NHN corner of Cornado St. and Echo St.
7. Type of Facility to be inspected:
8. Water Supply
Type of Supply: Public Utility
o
single family No. Bdrms. ~
xxx Individual
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
Individual (on-site)
1967
F
_Q-.037 (1/74)
l. JoveY~]bor 10, 1977
Alaska l.!utual Savin~js l]ank
MortgaSfe Loan f~ection
Post Office ~o~: 1068
i~aqle Y~iv~r~ Alaska 99577
Lot 14 l'~lock 4 Raymond Tedrow Subdivision
~J?he requ(~st for s~wer and water approval will be approw~d
if funds are esorowe~l to connect to the public sew~
~hen it becom~]s available. ~f publi~ s~wer Is not available
by f~opt~mb~r 1, 1978~ the ~scrow~d money %~111 need ~:o be
~s(~d to upgrade th~ ~xistlng system, ~onies should, also,
be es~rowod for any interh~ pumping costs that may be
required during this time.
the upgra([e i:~ n~cassary~ this de. partment can not: giw~
a~.y d~sign specifications ~%ttl the soils ~sst has been
~Cf there are any .=urther q'uestlo~.ls~ pleaso contact this
office., at 26~47200
Rob~rt C;. Pratt
211 99577
December 8, 1977
Municipality of Anchorage
Department of Health and Enviromental Protection
825 L Street
Anchorage, Alaska 99502
RE¢ Albert F. Bendle
Lot 14, Block 4, Raymond Tedrow Subdivision
Dear Mr. Pratt:
Enclosed please find an estimate of cost of $3,000.00 for upgrading
the above named sewer system by Klondike-Alaska, Inc.
For necessary purposes we have multiplied said amount one and a hal~
times to ensure enough funds are available in the event the sewer
system needs repair. If this is acceptable would you please send
your approval of the sewer system as it is now.
Thank you.
Sincerely,
Real Estate Loan Processor
Oecember 22, 1977
Alaska Bank of Comnlerce
712 l~lest 4th Avenue
Anchorage,, Alaska ggSlO
SUBJECT: Lot ]4 block 4 Raymond Tedrow Subdivision
Per your inquiry the subject property has been reviewed regarding
approval of water an se~,~age facilities. This letter serves as an
update of this dep~rtment letter dated November lO, 1977 regarding
the subject property. Public sewer priorities indicate no public
sewer line will be available in 1978, The following two alternatives
a~e presented fo~ your consideration which are acceptable by this
department~
l'he existing sewer should be tested for adequacy. Any
descr~panctes in adequacy are to be upgraded. The upgrad~
consist ~( a soil test and permit and must include the
installation of a 1500 ~allon septic tank. )ntertm pumping
may bn required and should be covered un,er the escrow.
Funds may be set aside for the complete instn'llatton of
an on-site sewer system to serve a 5 bedroom residence and
any interim pumping that may be required. The escrow should
consider a soil test~ permit t~nd pumping. Exact specifications
for the system remain unknown until a soil test is conducted.
Sincerely:~
Les Buchholx
Senior Environmental Specialist
Performed By,
Performed For~
Dates Of I'~spestion~
Legal Deseription~
System DescriptLon~
October 13, 14, and 15, 1983
Lot 14 Blk /4. Raymond Tedrow S/D
The th:cee bedroom home is supplied with water from a eommunit.y ;
water system and utilizes an onstte septic tank and dr~infiel~.' '.- -.
trench for waste water disposal. The 1250 gallon seiitie tank ..
was pumped out on October 15, 1983. :~'
Adequacy Test Proccedure: .'~ '" ,.
~he. system was in normal use before and during the: tes~, ' In ........ ;.
addition to the r, or~al load or~ 'the system a surge load of' 500'~ ':~:
gallons was applied for each of=the first two days e{.,~the ff~st"
The inspecnion stand pipe at tha end-of the dralnfield ~e~ch"'"
was monitored during the test,~ No water was present %,n tKe .... ·"
stand pipe at any time during the test indicating that ~11
water was being absorded into the soil before it could reach "-"
the end of the trertch, T~:ere was no surcharging of the septic
tank or any ~ther ' " ion of failure,
Conc lus iot~ ~
Based on the inspection and tesn preformed this system is in
con:formance with ali. Municipality of Anchorage standards and ' ' '
is currently adequate to handle the wastewater disposal
requirements at this site,
James L, Thode
JLT Engineering : .-' .... -:'' 'J'?',..,..
1546 Eagle River Rd,
Eagle River, Alaska. 99577
· ,,,--. .. . '...:v- ::. -d" ' ': ~-' ,,",:'.:-
Mike Donaldson, Polar Realty
1101 E, ?6th Ave.
Anchorage, Alaska 99507