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Home My WebLink AboutKASILOF HILLS BLK 2 LT 12 "~AME 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 PHONE MAILING ADDRESS LEGAL DESCRIPTION LOCATION ~2:: DISTANCE TO: u ~.O No ' -J z :;' . of lines F-:-~: I __ ~I~ Top of tile to finish ~ Length ~: I- I Type of crib -- ~ Cles~ ~ I DISTANCE TO: DISTANCE TO: ] Well /'{ (~ Manufacturer ~,'~.~ ~. ,~. Cz~' Liq, capacity in gallons ...... f/CPC.'} ~') IF HO~wmw~D E: DISTANCE TO' Well Manufacturer We, ,4'0 Length of each line ,~'-~ s-s;_,~ ~.o rede Width Crib diameter Well Depth Building foundation OTHER PIPE MATERIALS SOIL TEST RATING '323 INSTALLER .... Absorption area Dwelling ,~ 0 'J- J,? Material .~ ,TCe~., / Width NO. OF BEDROOMS PERMIT NO. No, of compartments Liquid depth Inside length Dwelling PERMIT NO. Mate[iai Liquid capacity in gallons F°undati°~? O ¢- ..'~.~ Total length of lines Material benea~'~ (lie Depth Crib depth Building foundation Nearest lot line / 0 '/~ Driller Trench width ~'00 inches inches PERMIT REMARKS Sewer line z'f- oW APPROVED DATE Distance between lines , Total effective absorption area .- / q' J PERMIT NO. Total effective absorption area Nearest lot line LEGAL Distance to lot line PERMIT NO, Septic tank ~ Absorption area(s) '">fit* C:Cd"~I'i"I::I C T i:::t E I. I: I:::l':::' 2 ]; ' , . .. I:I '1 ,I, f TIi!:::IT ::I.., :[ I::I1'"1 F:I:::II'"I]:I..,II::II:?. I,I]:"!'!'-'1 ]"1'1!.~: i:;i:!:.D:!i...i:(!:;i:ii!]'i!::l",lT:Ei; I:::'l:)l:;~: Ct"t"'"~i]:TE: :~!:;IEF.tlEI:;;::i~; I:::11",![:' I.,.!I:]:L.I..:'; I::lfJ :i:;li:"l" F:rOI:;;:TH Ei',"!" THE: I'"I ... Ff ]' I:: ]; !:::'I::!I.., ]: 'T'T' ()1'::' t:::ll"~f2t'lf"t:;;'l'::lf:iF: "HI:]I:::t> I:::ll".![> ]'HIE :~;FF:ITli~: CIt::' [::ll....I;::l:~ii;[':::F::l. :::' Z I.,.tiL, L. ]:I",I:i!;"t"I:IL.I.. 'TtilE '" ," ...... :, : .... I'I ]:i',l !:::lC:C:l:ll:;~:l::,l:::!l'.,h::li:: ....... , .t. "I"H I:::IL.L. I'"ICII::I CCI[:,tE!:i; FIN[> F;:E:(:iLI[.J:::FT' I OI",IE;., F:IF,I[> I I",I C:I:IHI:::'I... ]: I:::IHC:I:: ..,.! '[ 'I"1'I 'l"liE: [:,!:i2E; i I:il",i C:i:.':: :i: 'FI!:I:;i: ]: I::1 I:ii::: 'i'li :[ ::; I:::'[!i:l:;;:i'i :[ T. ~:.:i: I.,.I:[L.L. F:![:,hli!i:[~:tE TO t::i[..L, i'if'F. [::ih,i[:, :iii;'l']::t'T'E: f':i;::' [::]l.Fiiii;['(l::l i:;;: i:::)';;! l i'l:;?E:HEi'.,Fl"::i! I:::C[:;: 'T'HF:: :~:;E:f' [:' ;I: :!!;TF:Ii",i(::E!::!; Fl:;;:Oi'l t'::iH'¥' [::=; :[ :ii:T :[ I'.,il:i I.,.liEl_..1 ...... t.,.!f::l::i; T'[i[1-,.lt:::l]'l!:i]N;: (, ]' '[~ I:::'C :ill I:iL. :"r':i..:;TE:l'l ()1:;;: [::'1 E: L / .... :5iE!,.!I:[I::~:F:iG[!i: :E;'¢:i~;'T'F]"I Of",! 'i'l'"i]::i!i; OF;: I:::ff',l'T' t:::![:'..:h:::lE, tii::i",FT' 1:)¢;: iqF3:'l!'U"~r I.F'f". ':t.. I LIF,![::'EF:::~:TTFIF,I[) 'FHF:FF 'FH :[ 'J~; , I::: F. I . :t: :5 ","i:::1[.. ]; [:' [::'1:][;i: ¢:1 i'IF:t;:':; I I"it...ll"i F I:': :!: E~E;[:'i:';:gICd¥1:!!; I:::1i",11::' F:lhF'r' .:hi[..F:li;;: :i['~HI::'HT I'! :[ i....L. F?.E(:¢.J Z F::F:: F:ff',i F:t[:'i::' :[ T [ :: i"!Fti... I:::'i:Ji:l:;:l"l :[ 't". " ~] ~OILS L6G MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST DATE PERFORMED: LEGAL DESCRIPTION: OL 1 2 3 4 5 6 7 8 9 10-- 13 14 15 16 17 18 19 2O COMMENTS PERFORMED BY: ~ ~'~4 72-008 (6/79) ~/..OF,-K. ~ L,O'T' 12- 'r~-hJ '~,~'~ SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? _ ~,~ IF YES, AT WHAT DEPTH? b 7,." Reading Date Gross Net Depth to Net Time Time Water Drop ~ ~'~ 5 ~ ~,~ ,5~ ,05 PERCOLATION RATE TEST RUN BETWEEN / Vier' CERT, F,ED BY: / Box 1369, l~;T.~n ROI3TE A ANCHORA(~E~ /~[~ASKA ? INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF _905 ~/: DRILLED aT THE rAtE Of ~-~__ PEr FOOT. LOCATION OF WELL SITe DRILLEr BedO2~; ~ WELL LOG: 0----17 ' ~7-"36' 36---48' PROPERTY OWNEr MUNICIPALITY OP ANCHOI%4(~E DEPT. Of: HEALTH & ENVIRONMENTAL PROTECTION ~ wt 70 $z. 1/2 ~PIi'~ ?,todw~:4or~ ~ ~p ,to ~ ~,P~ ~ 185 ~,t, 180 ~t, o,~ ~ ~tz~xt4z~ 4~, c4~4z~. 1.6 ~ ~ ~. ~ ~o~ ~ ~ ~. ' o -//5 COST INCLUDES ALL ~BOR AND ~ATE~IAL FOR COMPL~ION Or SAID DnlL~ING. ' WRITE CHECK PAYABLE TO RABPART DRILLING WORKS FOR THE 8U~ OF, ~71~.00 THANK YOU VERY MUCH. DAT~' BERNIE CLAUS OF RAMPART DRILLING WORKS PAST ~, ae ;',IUNK:ii'AI HEALTH ~O~TY ~PROV~ (~) ,JAI'4 7 1985 C~I~ - F~RU~Y 1984 ~ ~ ~m ~TA ~? LegalDescription: ~e, /~, Well Classification ppfb~(~ If A, B, ~ C, D.E.C. App, o~d(Y~) Well ~ ~esent ~) ~te (~leted ~'~f~-',S'~ Yield .~ Total ~D~ ~3~f~' ~d to 5'~ ~pth of ~outin~ Casing ~ight ~ G~ound /' Sanit~ ~al on Casing ~) Elec~i~l Wiring in ~nduit ~> ~ession ~ound ~l~ead <~ ~p~ation Distanms ~ ~11: I O~ TO ~ptic~olding Ta~ m ~ [/~ ; ~ ~joining Lots . To ~amst ~ge of ~so=ption Field on ~t //0 ~0 ; ~ Adjoining ~ts... /~.~f- To No.est ~blic ~m~ Line , J To ~est Public Clean~t~a~ol~ ----~.'a To ~est ~ ~rvi~ Li~ on ~t ~ate= S~ Co:.~ ~ , ~.~0~ ~ ~t~ ~ 6'~V ~ B. SEPTIC/HOLDING TANK DATA Date Installed ~ _f ~. ~z~ Size /OCCP No. of Ca,~a~tmm, nts Stan~i~s ~,/NI Air-tight C~p~ C~: ~o=~tion C~o~t ~ession o~ Ta~ (Y~ ~te ~'t ~d P~inD&intenan~ ~n=a= ~ File (Y~) /~; for Holding Tam High-Ware= ~a~ (Y~) ~/~ ~ra~ Holdin~ Tank ~it (Y~)~/~ ~p~ation Distan~s ~ ~p>ic~olding Tank: To Wate=-Supply ~11 //¢~ To ~ildinw F~ndation To ~o~rty Li~ , /~ To Disposal Field ~3,5~ ' To ~ter ~i~e=vi~ Li~ ~/~ To S~e~, Pond, ~ke, ~ ~jor ~aina~ CO~ ~/~ Receipt Date Paid: Amount: [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata .~ ~ ~ Type of System Design Width of Field ~H/ ~ ~p~ of Field Grail ~d Thick.ss S~e Feet of ~s~ption ~ea /~~ Stan~ims ~esent <~N) ~p=ession ove= Field (Y~ ~te of ~st a~a~ Test Results of ~st Ade~a~ ~st Sep~ation Distan~ f~ ~s~ption Field: To Existing or' ~ndo~d System To ~t~(if pre~nt) To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/c= Major D~ainage Course To D~iveway, Parking A~ea,~ c~ Vehicle S, torage A~ea D. LIFT STATION Date Installed Size in Gallons "Pump O~" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Meets MOA ** Check Permitted Bedroom Rating Against HAA ~quest I certify that I have checked, verified, or confc~T~ed to all MOA HAA Guidelines in effect on the date of this inspection. KB1/d5/s [Page 2 of 2] 2-15-84 ~JN%CIPALITY OF ANCHORAGE " DIVISION OF ENVIRONMENTAL HRALTH DEPARTMENT OF iIEALTH AND ENVIRONmeNTAL PROTECTION APPLICATION FOR HE~LTH AUTHORITY. APPROVAl. CERTIFICATE 1o General Information Application Date ///z// J (a) Legal! Description (include lot~ ,b%ock, subdivisio, n, sectio% to,mship~ range) Location (address or direction~) (b) Applicants Name Applicants Address (C) Applicant is (check o~e)Le~di~g Institutio, Buyer ~ ; Other ~1 (~plain); (e) Real Estate Co. & Agen~ Address (f) Telephone Mail the HAA to the following -address: . ...::~:/j/.. ?:/::,:'; - ~ ,. ....... :_::.:_,_ ~_U_~ ..... ~5_Jt:," 2o T~j~ of Residence Single-Family Number of Bedrooms 3. Water Individual Well Multi-Family Other (describe) Community i~': Public [~ Note: If community well system, must have written confirmation from the State Departmeng of Environmental Conservation attesting to the legality and status° 4, S~e?~osal Onsite :~.~ Public ~: Community ~_.: Holding Tank ~q[ Note: If community well system, must have written confirmation from ~he State Department of Environmental Conservation attesting to the legality and status° [Page ! of 2] 5o En~jneerin~ Firm ?_r_ofidin Ins ctions Test_~z_~i_~_~ S___e~ar__c]!a Data and Information As certified by my seal affixed hereto and as of the valtdaClon date sho~a/ below~ I verify that my invescigatlon of this Health Authority Approval shows tha~ ~he ou-si~e water supply and/or was~ewaEer disposal sysEem is safe, functlons%, and adequate for ~he number of bedrooms and ~ype of s~ruc~ure indica~ed herein.. I further verify that~ based on ~he i~o~atfon ob~ain~ from the ~nicipality of Anchorage files and from my lnves~i~a~ion ~d inspection, th~ on~si~e ~Her supply and/or wastewater disposal system is in compliance ~th all ~nicipal and State codes~ ordinances, and regula~ tions in effec~ on ~he date of Hhis inspec~ion. (ENGINEER SEAL) D~F ~ Approved for .~ bedrooms Approved ~z,~_~ Disapproved Terms of Conditional Approval By ConditJ CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ILEALTI{ AND ENVIRON-MENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON T}~ REPRESENT~- ATiONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE ST-ATE OF ALASIQk. TIlE DHEP DOES THIS AS A CObqlTESY TO PURCR&SERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDEIi~IL AND STATE REQUIRE-, MENTS, 'F24PLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICAI% IS ISSUED° THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN 1%lE PROFESSIONAL ENGINEER'S WORK~ (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7.=19~84