The URL can be used to link to this page

Home My WebLink AboutRINNER RANCH ESTATES LT 2 January 4, 1982 Gold Crown Enterprises 2916 ED. 68th Ave. Anchorage, AK 99507 Permih ~ 811165 Subject: L2 Rinner Ranch Est. A permit issued by this department for a well and/or sewer system has expired as of December 31, 1981. 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 should be sent to this departmenh to document the installation date. If an engineer inspected the installation of the on--site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, Les ~. Suchholz~Yf~. Program Managert-~ Sewer and Water Program Enclosure: Copy of Permit L:7. F.-:;!:!'.,INE:t:;'. F:FINC:H MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ,Z--J ~;~ oF ON-S,TE SEWER ^ND WATER F^O L,TY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner ~'/~"~' Telephone: Home (c) -/~'/~ ~ //~~ Telephone (d) Real Estate Company and Agent Address /~/ /.} ~/~.~ Mailing Address Lending Institution Mailing Address (e) Business Telephone Mail the HAA to the followina address: or: Check here ,[~'~if hold for pick up. List contact person and dayohone number below. TYPE OF RESIDENCE Single-Family~2~ Number of Bedrooms 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 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 fRev 8/861 Fronl 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 Jn compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Date ~"'"'-~ DHHS APPROVAL Approved for 5 Approved ~ Disapproved Conditional Terms of Conditional Approval Date CAUTION The Municipality of Anchorage Depadment 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 responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 fRev 8/86) Back MUNiCiPALiTY OF ANCHORAGE ~NViRoNM~N'fAL SERVK ~JVISION MUNICIPALITY OF ANCHORAGE (MOA.~ ~988 HEALTH AUTHORITY APPROVAL (HAA) 0 CHECKLIST - FEBRUARY 1984 264-4720 R[CEIV : D WELL DATA Legal Description: /,¢'7--,Z- .,(~/.~)/,/¢7'¢ /¢~,d~?./ ~--~/'%. Well Classification Well Log Present ~N) t Total Depth ~¢ ~ Cased to Static Water Level ~.C'.'.'.~ .~.~/ ' Casing Height Above Ground Electrical Wiring in Conduit (~¢N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot '/'////~ To Nearest Public Sewer Line '~.¢'/'f-: To Nearest Public Sewer Cleanout/Manhole /ar)/¢. To Nearest Sewer Service Line on Lot Water Sample Collected by I//~'~',~ /~' /'J////VI~ ;Date Water Sample Test Results ~/~ '7~ - ~-' A///;~'7~';"'//~£~ ~'~ ~'~/u//fc~Z~' If A, B, C, D.E.C. Approved (Y/N) Date Completed C-Z-/~¢:.Z~ Yield ??' Depth of Grouting Pump Set At //r (~ / Sanitary Seal on Casing~y)N) Depression Around Wellhead (Y~? ; On Adjoining Lots ; On Adjoining Lots B. SEPTIC/HOLDING TANK DATA '~-E~,~ed Size No. of Compartments Standpipes'('~ _ Air-tight Caps (Y/N) Foundation Cleanout (Y/N) DepreSSion over Tank'~,~.~_~____ Date Last Pumped ____ Pumping/MaintenanceContracto~) _____;for Holding Tank High-Water Alarm (Y/N) ~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Hdding Tank.' To Water Main/Service Line To Stream, ~L.~, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA ~.~ in Absorption Strata Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test Square Feet of Area'~,~. Absorption Depression over Field (Y/N) Results of Last Adequacy Test ~ Separation Distance from Absorption Field: ~ ~p To Water-Supply Well arty Line To Building Foundation "%,~ ToTo Existing or Abandoned System on Lot ; On Adjoining Lots "'~. To Water Main/Service Line To Cutbank (if presen~[~,,~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION '~-'~r-at~l~st atled Size in Gall~~-. "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) ~l~acy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I.~¢/~¢h?~ed, ve¥if, ied, or conformed to all MOA an~ HAA guidelines in effect on the date of this inspection. Signed E'~- "/~-~ ~ ~ZCL~/_.~.-- Date Company MOA No. ReceiptNo. ~ Date of Payment % %0 Amount: $ //70 ~ 05 Page 2 of 2 72-026 (11/84) CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INCo ,~.~_~.~'o.'~.o'.,,~"..~,~ FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPI,& for ?Jerk Order ~ 6362 Date Report Printed: t,fAY 2 88 ~ 14:36 Client Sample ZD:L 2, RINNBR RANCN EST. PWSID :UA Collected A?R 28 88 ~ 16:20 hrs, Received APR 28 88 ~ 16:40 hrs, Preserved with :4 des C Client Name : A~CS Client Acct: AggCSRP p.o.li }iON& RgC'D Req ~ Ordered By : A. WIEN Analysis Completed :APR 29 88 Send Reports to: Laboratory Supervrsor :STEPHEN C, EDE I)ABCS ~eleased y : /~ B, 2) ....................... Special Chemlab Re£. ~: 9853 Lab Srapl ID: I },latrix: Water Allowable Parametez Tested Result/Units }4et hod Limits tIITRATE-}I ND(O, lO) n',g/1 EPA 353.2 LO Sample ROUTINE SAI,IPLE, Re~aarke: SM,iPLE COLLECTED BY A. WIEN, Tests Performed See Special Instructions Above UA=Unavailable None Detected '* See Sal.ple Remarks Above Not Analyzed LT=[,ess Than, OT=Greater Than UATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE I NSPECTO R INSPECTOR INSPECTQR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1. PROPERTY OWNER PROPERTY RESI~EN~ ~f different f~o~ ~bove) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LEN,INGIN~TI~t/ ~ ~ ~ ~ ~/1 PHONE MAILING ~DDR ESS ' / PHONE MAIklffiG AD~ESS 5, LEGAL DESCRIPTION STREET LOCATION ~ 6. TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five ~ Three [] Six [] Other 7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] 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.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED, ~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. i'HIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR E~ 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:. If Tank is hOmemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line Nearest Lot Line WELL TO: I Absorption Area to nearest Lot Line 5, '~OMMENTS [~APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79)