Loading...
HomeMy WebLinkAboutMCMAHON BLK 3 LT 6McMahon B10 k 3 Lot 6 #017-042-06 ISUBMITTAJ APR 26 [uiC Inspection Report_1-1-12.doc Municipality of Anchorage Community Development Department Page ( of On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: DSP f 1 12.R & PID Number: O (? - 0 4 2— 0 (v ❑ New EkUpgrade Name: un z S'J u n G, ABSORPTION FIELD Lf�Deep Trench ❑Shallow Trench _]Bed E] Mound El Other Address Z GeL40 rlru� Cr reit, { Phone Number of Bedrooms Soil Rating / l / � GPD/SF Total depth from original grade gi f r 7f Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 41 Ft. Gravel depth beneath pipe � �i Ft. Subdivision / 117 H tl Block Lot 3 Fill added above original grade Ft. 40 "r� Gravel length �// /r Ft. Township Range Section Gravel width Z 0 Ft. I Beds: Number of Linp IDistance between lines I/ Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area Qs/ FP Number of trenches Dist. between trenches Ft. Well /OB r4- �( A �l` 1,(� j;0� TANK ❑ Septic E]S.T.E.P. ❑ Holding E] Other ManufaAlcturer /7-hc'v1 �OMle_' Capacity I ('LS0 Gal. SurfaceWater (VJ/ tod'A NA Material e ( Number of compartments eP Z Lot Line r 2a r 2d �, Foundation 21tF LIFT STATION Manufacturer Capacity Curtain Drain Ik r7 OW e) Gal. Remarks Pump on level at in, Pump vel at in. High water alarm at in. Pump m and model Electrical Inspections performed by Installer� {— 1 (Z. -C eJAi,, . �. PIPE MATERIAL House to tank ';u3rf drainfed '503q Drainfeld -ry n3t{ CO/MT 'gs3c4 Inspector NII L t c `� �. BENCHMARK (Assumed elevation) / ®p f Inspection �, dates: t ; �0 r 7/1 2n° / 77 /I '/.bD Location and description LI - ?e-y4¢G'ji Permit No. 0SP111296 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: MCMAHON BLK 3, LOT 6 PID No.: 017-042-06 IC05MT. v v i C04� \ CO3 '(/ 02 � 100' EXISTING WELL RADIUS BENCH, CONCRETE SLAB MARK A 8 FCO C01 18 34 0'+— — —_JZL— 5 TCO 20 6 TJ322 38 o;ddd3 23 39 V �VE 23 39 M \ 58 75 CO \ 26 40 I I I I I EXISTING HOUSE J \\\ SCALE: SEPTIC SECTIOF*p Cl. N.T.S. T � - UII T \ T�Jo' � r 49 11� MICHAEL N. No.�'E On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP111296 Tax Code Number: 01704206000 Work Type: Septic Upgrade Permit Effective Dates: October 21, 2011 to October 20, 2012 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Subdivision: MCMAHON Site Legal Address: MCMAHON BLK 3 LT 6 G:2835 Owner/Address: STONE BARTON N & BABB-STONE NANCY 12640 FURROW CREEK RD ANCHORAGE AK 995160000 Site Mailing Address: 12640 FURROW CREEK RD, Anchorage Lot Size in Sq Ft: 39580 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: n Issued By: �.• j t^�1,n/','�liza, Av111elu� Date: Z01-2111,1 Date: l 17 1 MUNICIPALITY G Community Development Department \ Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel 1. D. 0( j - Oq 2 - U (o Property owner(s) Day phone Mailing address r row tr-e,.�t Site address C_ - Legal description (Sub'd., Block & Lot) m d�P A 0 -h (3 , Legal description (Township, Range & Section) Lot Size __5 `f' 51W Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Field "'� Initial F-1Absorption Septic Tank Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature property owner or autnonzed agent) Permit/Rush Fees: 5-15-D Waiver Fees: Date of Payment: Date of Payment: Receipt Number: ;�-A � c� 5 A (AU(c-7 Receipt Number: Permit No. ('r 11�1 Waiver No. GABuilding\On Site\Forms\Client Forms\Permit App_01 041 1.doc (Rev. 1/11) Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 Oct. 12, 2011 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: McMahon Subd. Blk 3, Lot 6 To Whom it may concern: This is a request for a replacement septic system permit on the above referenced lot. The existing system has failed and needs replacing. A new test hole was completed by Lar Spurkland Engineering (LSE) and typically shows sandy silts SM to sandy gravel SP/GP for the full 19 foot depth, see soils log. No perc was done by LSE therefore a new one was completed for this submittal. The perc was measured at less than 1 minute per inch. The sandy material is over 50 percent sand therefore a simple deep trench will be used. None of the neighboring properties will be impacted by this upgrade since most have functioning systems or are served by AWWU. The slope at the site is 12 percent on the north side of the driveway then changes to 2-3 percent south of the driveway area. No cut banks or slopes over 25 percent exist within 200 feet of the proposed installation. Please call me if you have any questions. Sincerely Mic a . Anderson, P.E. DESIGN CRITERIA: Y' 4 BDRM X 150 = 600 GPD SOILS = 600/1.0 = 600 GPD 600 GA/ Z = 50' Z.,ytN✓� - (1) TRENCH 10.0' DEEP 6.0' EFFECTIVE 2.0' WIDE 50' LONG C�f'S'Vf'weIt� I I I MOUND OVER (TH#1) o GRADE 1 ORG 3 SM FILTER FABRIC SP/GP -3.04"0 PIPE 5 SEWER ROCK USM -s.0 i 1s Septic Design Prepared for NANCY & BART STONE McMAHON, BLOCK 3, LOT 6 Anchorage, Alaska Michael N. Anderson, RE DATE: 4661 NATRONA AVE. DRAWN: ANCHORAGE, ALASKA 99516 345-3377 / FAX:345-1391 SCALE: .•���`OF i 49 TH ':: ♦, ................... ..................................:....... r 10/19/2011 ��\? MICHAEL No.. ANDERSON: i DJR •♦♦�S' •' No. CE 4 1 "=100 �1...... .* ��I SS` _-- EXISTING SEPTIC` _ -McMAH0N AVE - 1 11 McMAHON S/D O BLOCK 2, LOT 1 McMAHON S/D PROPERTY LINE BLOCK 3, LOT 5 1 l WELL o LOT SERVED BY \ \ `� — I COMMUNITY w WATER WELL _ i `�----_ w EXISTING WELL I I GREATER 200' 100' RADIUS AWAY. \ GRACE #1 S/D \ \ McMAHON S/D ------ LOT 1A-1 \ \ BLOCK 3, LOT 6 / 0— \ \ EXISTING HOUSE w \ILj McMAHDN S/D BLOCK 2, LOT 21 I N— EXISTING SEPTIC \ \\ �' �#• P \ \ WELL 1\\ \ McMAHON S/D /' \ \ BLOCK 3, LOT 7A FURROW ROAD \ _CREEK - WELL Septic Design Prepared for NANCY & BART STONE McMAHON, BLOCK 3, LOT 6 Anchorage, Alaska Michael N. Anderson, RE DATE: 4661 NATRONA AVE. DRAWN: ANCHORAGE, ALASKA 99516 345-3377 / FAX:345-1391 SCALE: .•���`OF i 49 TH ':: ♦, ................... ..................................:....... r 10/19/2011 ��\? MICHAEL No.. ANDERSON: i DJR •♦♦�S' •' No. CE 4 1 "=100 �1...... .* ��I SS` SEPTIC\ GENERAL NOTES 1 ADDITIONAL PERC REQUIRED IF THE NEW TRENCH IS OUTSIDE THE L —30' RADIUS. 10, 7IN UTI rry ", 1, �y— N NEW 1250 TANK 11 yoh E4ASECM-Ekif 7----- 1 1 EXISTING TANK TO PUMPED AND CRUSHED PER MOA CODE. ---------- EXISTING HOUSE PROPERTY LINE SEPTIC Septic Design Prepared for NANCY & BART STONE McMAHON, BLOCK 3, LOT 6 Anchorage, Alaska Michael N. Anderson, REJ DATE: 10/19/2011 4661 NATRONA AVE. DRAWN: DJR ANCHORAGE, ALASKA 99516 345-3377 / FAX: 345-1391 1 SCALE: 1"=50' I! OF Al Municipality of Anchorage 01% y NGINEL>®.•.��, Development Services Department oo * - ,49TH •• �4z e�� Building Safety Division �...: .. ...... • ...... ` On -Site Water and Wastewater Program 4700 Elmore Road �•• ••••••••••••••••••� P.O. Box 196650 Anchorage, AK 99507 �/ -JO MICHAEL N. ANDERSON www.ci.anchorage.ak.us t •• CE -94 9 >;`°- (907) 343-7904 •�f •. `'. Soils Log - Percolation Test Performed For: %� rr roc u "16 r Date Performed: V �711 Legal Description: Township, Range, Section: 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19 - COMMENTS WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? f`% V�JJ o Depth to Water After P Monitoring? E Date: Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop n /f G " P4 it l� /r G F'tKUUL/i I IUN KP, I It: lz„ ( (minutes/inch) " ,t PERC HOLE DIAMETER (41 TESTRUN�TWEEN �FT AND�FT Voln 4 f eA- Cr^. ��1 /b• Gr✓ S. i�Lr ' (IS c G1►.a.e n ]`�� [y t 5 kuw 4• I r" �,, / t °., o l„5 k�w�I r" ,, I k PERFORMED BY: t 1 ke-4 4, I CERTIFY THAT THIS TESTVVA5 PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: le Ylr PerfonnedFor. Date Performed: Legal Pesctipflaw Township, Range, Section: Depth J_ Depth 3--, 4- 6 7- 9- 12- 13- 14- i 15 16- 17- 20 - WAS GROUND WATER ENCOUNTERED? "I',— [PYES, AT VVHA1 DEPTH? L Depth to Water After P Monitoring? E Date: Site Plan I I Reading I Date I Gross Tire I Net I ime I Depth to Water I Net Drop I PERCOLATION RATE. FERC HOLE DIAMETER TEST RUN BETWEEN FT AND 7T COIAWIENT,S, V- -ERFORMED BY: CERTty TI iA7 THIS FES I VVA13 PERFORMED IN ACCORDANCE WITH ALCSTATE AND MUNICIPAL GUIDELINES IN EFFCT ON THIS DATE. DATE: Municipality of Anchorage — w Development Services Department Building Safety Division on -Ste Water and wastewater Prograrn I? 4700 Elmore Road 1 J�Jl.t . ...... P,O. Box 196650 Anchorage, AK 99507 SIPL-s (907) 343-: 904 Soils Loa - Percolation Test PerfonnedFor. Date Performed: Legal Pesctipflaw Township, Range, Section: Depth J_ Depth 3--, 4- 6 7- 9- 12- 13- 14- i 15 16- 17- 20 - WAS GROUND WATER ENCOUNTERED? "I',— [PYES, AT VVHA1 DEPTH? L Depth to Water After P Monitoring? E Date: Site Plan I I Reading I Date I Gross Tire I Net I ime I Depth to Water I Net Drop I PERCOLATION RATE. FERC HOLE DIAMETER TEST RUN BETWEEN FT AND 7T COIAWIENT,S, V- -ERFORMED BY: CERTty TI iA7 THIS FES I VVA13 PERFORMED IN ACCORDANCE WITH ALCSTATE AND MUNICIPAL GUIDELINES IN EFFCT ON THIS DATE. DATE: GREk, R ANCHORAGE AREA BOR JH nnDepartment of Environmental Quality 3330 C Street Anchorage, Alaska 99503 o� � ova,/ pp INSPECTION REPORT ON-SITE SEWAGE DISSP7O/S,{AL SYSTEM NAME L'11 i1'R �!y,(3f3 A fADDRESS 3dM a;6� +71_ BJPH0NE � LOCATION Fbi 6e. X~!_i LEGAL DESCRIPTION #4y� CIV4800 � ' 65� SEPTIC TANK: DISTANCE i jj j NUMBER OF FROM WELL J .T MANUFACTURER a MATERIAL ��� / COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY ��'GALLONS. TILE DRAIN FIELD: TOTAL DISTANCE FROM WELLA10 t V FOUNDATION ® 3 NEAREST LOT LINE 0 OF LINES LENGTH / i NUMBER OF LINES DISTANCE BETWEEN LINES /1///f TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA 6100 SQ. FT. LENGTH OF EACH LINE J /1 6 DEPTH OF FILTER J DEPTH: NO OF TILE TO FINISH GRADE J7 i' MATERIAL BENEATH TILE�AYs�ABOVE TILE �IN. WELL: `u@ T- I)&)(I e f) TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE , TANK , SYSTEM_ REMARKS DISTANCES: DIAGRAM OF SYSTEM ' L wif-11 - BY:1 ��)Rd INSTALLED SEWER LINE DEPTH: �© PIPE MATERIAL:toot c 14r{�'7S - ,P 1,AgT lERIfjAL�:t tT.�L�J` S/If..41 e"Ic kip / ��4�1 0 LOT SLOPE: REMARKS: _•� DATE ���� 'APPROVED;_ .'� - G.A.A.B. Form EQ -032 L DEPHRTMENT Or HEALTH AND ENVIRONMENTHL r.//TECTION /���� .,` ` ^ ^ 2510 E. TUDOR RD�/ HNCHORHGE/ Al 99507 � 276~2221 f�~ / pvL� owl p"I EN c!) 141_0; Z -T Q 1:21 kor W1 Q F�v PERMIT NO (76069) � ]492235 SRH BOX 4764 FURROW CRK RD OFF HijFFMHN LEGHL L6 B] MCMHHON SUBD LOT SIZE ]9588 SQFT TYPE OF SOIL HBSORPTION SYSTEMTRENCH NUM8ER OF BEDROOMS 4 SOIL RHTING/SQFT/ THE REQUIRED SIZE OF THE SOIL H8SORPTION SYSTEM IS:DEPTHW 11 LENGTH= 42 85714��857l4 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE HND N THE �XCHVHTI�BOTTOM IS 7 FT THERE IS NO SET WIDTH FOR TRENCHES� FOR DRHINFIELDS/THE WIDTH IS �FT. THE DEPTH OF TRENCH OR PIT IS THE DISTHNCE BETWEEN THE GROUND SURFHCE 8ND THE 8OTT8M CO-, THE EXCHVHTIONL THE L�NGTH DlMENS1�N lS THE LENGTH OF EACH SIDE FOR H PIT OR THE LENGTH OF THE TRENCH/ 8R D�HINFIELD THE REQUIRED SEPTlC TANK SIZE IS 1250 GHLLONS BHCKFlLLMG OF HNY WITHOUT FINHL INSPECT -'ION BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTANCE FR8M WELL.� TO HNY SEPTIC THNK/PHCKHGE PLHNT OR SOIL HBSQRPTION SYSTEM IS 100 FT FOR H PRIVHTEWELL HND 200 FT FOR H PUBLIC WELL WELL LOGS MUST BE RETURNED TU THE DEPARTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION, SPECIFICHTIONS HND CONSTRUCTION DIAGRAM,; HRE HVHILHBLE TO INSURE PROPER I CERTIFY THAT l HM FAMILIAR WITH THE REQUIREMEMTS FOR OnSITE SEWERS AND WELLS HS SETFORTH BY THE M8NICIPHLITY OF HNCHORHGE AND WILL INSTALL IN ACCORDANCE WITH THE C8DE SIGNED ........ ........ ISSBED B ��E� �»��4y^�.��� r ANCHORAGE MFAIRBANKS CONSULTANTS, INC. JUNEAU 249 EAST 51ST AVENUE P.O, BOX 8087 ANCHORAGE, ALASKA 99503 • TELEPHONE 907-279.0483 TELEX 090-35419 March 22, 1976 Mr. Wilber Dittbrender SRA Box 476Y, Anchorage, Alaska 99507 R & M No. 656207 RE: Test Hole and Soul Log Report for Sanitary System Lot 6 Block 3 Mcmann Subdivision Dear Mr. Dittbrender: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of March 12, 1976 and those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Greater Anchorage Area Bourough, Department of Environmental Quality. A single test hole was put down within the Lot 6 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 20.0 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not -encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M CONSULTANTS, INC. James W. Rooneyl� t) Vice President JWR/pe No Scale Log represents Location of Test Hole Lot 6 Block 3 Mcmann Subdivision Consultants Inc. ANCHORAGE FAIRBANKS ALASKA - JUNEAU DIE /l 3-2 -76- SCALE ,. _ , [DOWN ii. Y- CHKD BY ;41?7a T. H. 1 3-19-76 0.0' ORGANICS v� a n_ 5' SILTY SAND Grading to Sandy Silt W/ Trace gravel (SMNL) .. X No Water Table I Wilber Dittbrender Log of Test Hole Anchorage, Alaska PROD. NO. :IWO NO. N -OI SAND, TRACE SILT ' TRACE GRAVEL (SP) o� 11.0' " SAND, SOME SILT- ILTTRACE TRACE GRAVEL (SM)� 12.5' SILTY SAND Grading to Sandy Silt W/ Trace gravel (SMNL) .. X No Water Table I Wilber Dittbrender Log of Test Hole Anchorage, Alaska PROD. NO. :IWO NO. N -OI 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 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) ` Location (address or directions) (b) Applicant Name Alm 'r✓//� Telephone: Home Business Applicant Address A0• 1Ra>( ng 6dltr-nJ111 Cee /04 /A (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent — Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3 Telephone 3. 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 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. 72-025 (11/84) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION N 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. Name of Firm Telephone Address Date 5 a��/ ^'✓iL ,fir_ %u✓�i /� b t . ��//�FcC i£% 71V A r I*dA AV-* Ot;6r's Ekal eggs s�- DHEP APPROVA Approved for I Li bedrooms by j Approved— Disapproved Terms of Conditional Approval Conditional CAUTION •• s s• Ike 9.f•..• *If ••• so �• soy • •ss•osssfs•s•V s`s°^ .`o�`ovR� � o om OYC. �RwiNCE' 2251 . s •p so c.� 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) 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 Z--,7 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) C(/ Location (address or directions) j (b)' Applicant Name Now" �� u�—Telephone: Home Business Applicant Address (c) _ Applicant is (check one): Lending Institution ❑ ; Owner/builder D ; Buyer ❑ ;Other ❑ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-FamilArMulti-Family ❑ Other Number of Bedrooms Telephone 3. WATER SUPPLY Individual Welt 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 J24 Public ❑ Community ❑ Holding Tank ❑ Note: Ifcommunity 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) 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. ,� wG , Telephone Name of Firm // Address Date ZZ •.��'a��@ of AL 6. DHEP APPROVA Approved for / bedrooms by Approved Disap Terms of Conditional Approval A, sot �i �• I o J . PROFESSION ce Conditional C�_� 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 79-095 (11/84) MUNICIPAL17y OF AN s ENVIRONMENTAL ePr. OF HE,gLrcHOfGE MUNICIPALITY OF ANCHORAGE (MOA) PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 JA 2 �gg6 264-4720 Legal Description: �,— iaAJi 75WI A. WELL DATA i Well Classification PG't If A, B, C, D.E.C. Approved (Y/N) 4 N Date Completed (AAS MOW"t Yield Well Log Present (Y,9_ f� Total Depth Ile C Cased to 90 Depth of Grouting uw, Static Water Level Pump Set At 64"k Casing Height Above Ground 10A Sanitary Seal on Casing 9) Electrical Wiring in Conduit (Y/l% Depression Around Wellhead6N) fi Separation Distances from Well: r i To Septic/Holding Tank on Lot `t ; On Adjoining Lots% %Qd r � To Nearest Edge of Absorption Field on Lot ��� ;On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole x sp To Nearest Sewer Service Line on Lot 5 Water Sample Collected by�L�CS �� ;Date O� Water Sample Test Results �csll`S�c�e Comments �eCd wc,"euCr/ C D(RGCr 1 (OGtG� QOfI ISO UG / r7 ��£ fJ SLI ( GG (�V G 4th ! /i CL B. SEPTIC/HOLDING TANK DATA Date Installed Size 1,P No. of Compartments ^ StandpipesN) Air -tight Cap %N) Foundation CleanouGIN)) Depression over Tank (Y/6) Date Last Pumped Pumping/Maintenance Contract on File (Y/N)e Ld ; for 6t1 Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)� Separation Distances from Septic/Holding Tank: � / To Water -Supply Well /VD !,66r t 5eu To Building Foundation % f To Property Line To Disposal Field �© To Water Main/Service LineTo Stream, Pond, Lake, or Major Drainage Course —&-&I / Comments Page 1 of 2 72-026(11/84) 4 's 3 /VC �`KV4cvUt C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed A=<(-7ra Length of Field K2 Width of Field - 2.5 Depth of Field fir` /3 / Gravel Bed Thickness Square Feet of Absorption Area J� ��j Standpipes Present ON) Depression over Field (Y� Date of Last Adequacy Test Results of Last Adequacy Test�(`> Separation Distance from Absorption Field: To Water -Supply Well //0 f To Property Line �® ) fi To Building Foundation 1 To Existing or Abandoned System on A 1A Lot ; On Adjoining Lots To Water Main/Service Line G% 2�__ To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course 4T7 X00 I To Driveway, Parking Area, or Vehicle Storage Ar Comments�`�D$c7%cam, Gl�.�jOrr D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/ Comments Dime s ole/Access (Y/N) "Pump Off" Level at Vent (Y/N) "' Check Permitted Bedroom Rating Against HAA Request "` / Pumping Cycles during Adequacy Test. Meets MOA I certify that I have cheAked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed �� -.� Date��•��E��F Q CompanytzG�iMOA .`��•ee . oosy 'g •. o Receipt No. 15-7 <6 d , '• 6 Date of Payment 0' •. . •••Y• out Amount: Amount: $ s�+ o roy C. Retd, Jr. to No. 2251.E Page 2 of 2 72-026 (1 1Y84) ALASKA RUIROWnTAL COnTROL SCR US, InC. Engineering & 6nuironmental Studies 01/22/86 HOME EQUITY SELLER—PHILLIP BEAN WALNUT CREEK CALIFORNIA 94546 HOME EQUITY/ATTN TEAM #2 MS LILLIAN EDWARDS P 0 BOX 8026 CASE # 362-135 60014 LEGAL:MCMAHONN SUBDIVISION BLOCK 3 LOT 6 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE -1/15/86 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 600 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 450 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PAC RAGE PLANT WAS PUMPED ON 1/6/86 . THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. FLOW TEST ON WELL WELL FLOW DATE -1/15/86 A FLOW TEST WAS PERFORMED ON THE WELL. 450 GALLONS OF WATER WAS PUMPED AT A RATE OF 5 GPM OVER A DURATION OF 3 HOURS. THE DRAWDOWN WAS 3 ' WITH A RECOVERY TIME OF 60 MINUTES AND THE STATIC WATER LEVEL WAS 66 FEET. THE WELL IS _ADEQUATE FOR THIS 3 BEDROOM HOME. 44 fr�� � R• Ke9099eb rA.0096e eOeN••.•e� ----------- C. .....00•sC. i 'jr..' 4�1 �� 9Fa Y•M r. e',�l. aa.'.'1��� 1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) 561-5040 Anchorage Well Pump Service U 7 a` `c 4) E } O N F� a January 20, 1986 O C O O } LL o Mr. Phil Bean 12640 Furrow Creek Road Anchorage AK � Re: Water well located at o Lot 6, Block McMahon Subdivision • Dear Mr. Bean: rt 6901 Tanaina Drive • Anchorage, Alaska a Based on service work done by our company in 1981 -a at the above mentioned lot we have the following C information for you: iu Depth 90' Pump intake setting 86' Static level 54' Drawdown 14' @ 6 gpm a o Our experience is that all wells are cased to the a full depth (90') in that vicinity. We hope this information is helpful to you. • Sincerely, E L/PUMP SERVICE CHO.T.R;gwa E d a a a3 Jamesy Owner c a ZI) sr a 3 H a a E 0 a x 0 Domestic and Industrial Pump Sales and Service a Water Well Service, Water Treatment and Conditioning 10 ,o o, O N �o O V N A W 0 V 0 C a a `C a� E `0 m m rn 0 3 0 7 E ro C 0 N_ C 0 a E a N `o 0 >a C C 0 a� 0 a O n. 5. LEGAL DESCRIPTION DA`FE RECEIVED INSPECTION APPOINTMENTS M� � � -sum TIME TIME - TIME II 6. TYPE OFRESIDENCENUMBER lel DATE DATE DATE ❑ Two ❑ Five ❑ MULTIPLE FAMILY ('} INSPECTOR INSPECTO INSPECTOR * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY PA ITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEd.LTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEc-MMIRONMENT,AL f:?-iECTION 825 L Street - Anchorage, Alaska 99501 • J 1198 ENVIRONMENTAL SANITATION DIVISION Telephone 264.4720 D E C E�,, kp REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACIL�T DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER ID;" I4 `R - PHONE EAS o 34 3 MAILING ADDRESS Au CnScq PROPERTY RESIDENT (If different from above) PHONE 2. BUYER �H� PHONE ! MAILING ADDRESS 3. LENDING INSTITUTION Q LAsh-c-h PHONE MAILING ADDRESS V�� 1 4. REALTOR/AGENT i PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION 3J LoT M� � � -sum STREET LO(C�ATIQN '7:7_1 HJ \OtJ 6. TYPE OFRESIDENCENUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ED Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY 19 INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM W, INDIVIDUAL/ON-SITE** ./ // 1Q t b YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) _ I � n 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: Q b If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ED"APPROVEDFOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79) ALASKA MUIROn11cnTAL C011TROL OURS, Inc. Engineering & Snuironmental Studies 7/7/81 DAN MCMAHON SRA BOX 1561 T ANCHORAGE AK 99507 MUNICIPALITY OF ANCHORAGE DEPT. OF H', --`LTH & ENVIRONMENTAL FWTECTION JUL 8 1"1 RECEIVED SELLER — DAN MCMAHON SUBDIVISION—MCMAHON BLOCK -3 LOT -6 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 600 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SOILS RATING OF THE SYSTEM AT CONSTRUCTION WAS 150 AND NOW IS 200 SQFT/ BEDROOM. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 7/7/81-41 OF A4 N5 . G%!�" O °PQ ouOOOSP�'I�i Oft r.. itU, . Mof 1220 West 25Th Auenue • Anchorage, Alaska 99503 • (901) 276-1361