HomeMy WebLinkAboutMCMAHON #2 BLK 8 LT 15
krcev uoiuu 16)
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231147
PID Number: 017-361-56
Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
Layne & Beth Adams
A ORPTION FIELD
❑ D Trench F] Wide Trench ❑ Bed ❑ Mound
Site Address
13041 Hinchey Place
Other
Phone
Number
of Bedrooms
Soil Rating
Total depth from original grade
4
/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original Lde Gravel depth beneath pipe
Ft.
Subdivision Block Lot
McMahon #2 8
15
Fill added above original grade G I length
Ft. Ft.
Township Range
Section
Gravel width
Ft.
Beds: Number of Lines
Disa between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between cher
From
Tank
Field
Tank
Line
Ftz
Well
>100'
N/A
N/A
N/A
>25
TANK 1�1 Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Greer
Capacity
1250 Gal.
Surface Water
>100'
N/A
N/A
N/A
Material
Plastic
Number of compartments
2
Lot Line
>5'
N/A
N/A
N/A
NA
Foundation
>1o,
N/A
N/A
NIA
TATION
Manufacture Capacity
Remarks
Gal.
Alarm location Electric d by
Installer
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
A+ Home Services
Drainfield D3034 CO/MT D3034
Inspector B Schiller
BENCH MARK (Assumed elevation) 100 ft
Inspection 1s` 7/20/23
Location and description
2
da:3rd t
Bottom of siding @corner of home
4
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval:
Date
tS'
Septic System
rzr) Schiller •:�
�••• Benja12
Approved
Date
� ��F�Fa C918/232��-gr�
�� �'ROfESSV4
Note: this approval does not include well permit requirements.
krcev uoiuu 16)
PERMIT #OSP2311147 PID # 017-361-56
BLOCK l 7 I \ l
-g LOT 6�+
l
LOT I
I /
BLOCK 7 LOT 7
k
70,
° Uriury& If 11
t /
C) DEC
O -
J%
LOT 15
/ t NEW 1250-GAL
FCO SEPTIC TANK
EXISTING 33' TRENCH TO
2C0
BM REMAIN IN SERVICE
LOT 14
BLOCK 9 LOT 7
f� BLOCK 9 LOT &BLOCK 9 LOT 9
EHGINEFRING `' `t
-Imbe—,q`®h� A B LEGEND
�"� "`• �S MH 18.5 49.4
•M SV 19.9 53.4 CO - CLEANOUT
•' AS -BUILT PLAN 2CO 20.5 55.9 2C0 -DOUBLE CLEANOUT
FCO - FOUNDATION CLEAN(
• -U
FSFLOW SPLITTER VALVE
Benja• i 0 50 100 MH - MANHOLE
CE 2MT - MONITORING TUBE
911912FEET
�FOpROFESSIONPd 1 "=50' SV - SEPTIC VENT
®�®ioa`11.. TH - TEST HOLE
PERMIT #OSP2311147
ENGINEERING
P I Q # 017-361-56
PROFILE AS -BUILT
(NO SCALE)
TM
. . �--�
• • Benjan Schiller ..' .
��Fc •. CE 192592
� �slF�Fo � 9.1!23• � .��C��.�
����_ PROFES510NP ,,e
IZAI
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231147
Work Type: SepticTank Upgrade
Tax Code Number: 01736156000
Site Legal Address: MCMAHON #2 BLK 8 LT 15 G:2835
Site Mailing Address: 13041 HINCHEY PL, Anchorage
Owner: ADAMS LAYNE G & BETH C
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
�'LAN ent
�° S<:
Department
6/15/2023
6/14/2024
26798
❑ Disposal Field R1 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
tA&J 4r, ro e -
Issued By:
Date:
Date:
4
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 017-361-56
Property owner(s) Layne Adams
Mailing address 13041 Hinchey Place, Anchorage, AK 99516
Site address 13041 Hinchey Place
Day phone 907-223-0473
Legal description (Sub'd., Block & Lot) McMahon #2 Block 8 Lot 15
Legal description (Township, Range & Section)
Lot Size 26,798 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(M all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) ❑X
Septic Tank
❑X
Upgrade ❑X
(w/wo ADU)
Holding Tank
❑
Renewal ❑
Duplex (D) ❑
Privy
❑
Multiple Dwellings ❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 2 Z Waiver Fees:
Date of Payment:
Receipt Number: b 3 6 Z G 0
Permit No. DS(' 2 3((-17
Permit App_' -'-:-:'- c
Date of Payment:
Receipt Number:
Waiver No.
June 7, 2023
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: McMahon #2 Block 8 Lot 15 - 13041 Hinchey Place
Septic Tank Replacement
Dear On-Site Services Engineer:
The owner of the above lot has a septic tank that has reached its end of useful life, so we are
submitting this permit application for its replacement. The attached site plan identifies the location
of the home as well as the wells and septic location. No conflicts exist between this proposed
system and any other wells or septic system, whether on this lot or adjacent lots. We are replacing
the septic tank with the same size designed for 4 bedrooms.
The new septic tank will be a minimum of 100’ from all wells and surface water. Please refer to
the attached plan for the septic design. If this design is followed, there will be no adverse impacts
to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231147, Deb Wockenfuss, 06/15/23
//
//
//
//
//
/
/
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=50'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
2CO
McMAHON #2, BLOCK 8 LOT 15
FEET
0 50 100
FCO
TAIG
A
D
R
I
VE
4
-
B
D
R
M
H
O
M
E
SEPTIC PLAN
6/7/23
HI
N
C
H
E
Y
P
L
A
C
E
10' UTILIT
Y
EASE
MENT
EXISTING 33' TRENCH TO
REMAIN IN SERVICE
NEW 1250-GAL
SEPTIC TANK
DECOMMISSION
EXISTING TANK
PER UPC
DECK
'
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231147, Deb Wockenfuss, 06/15/23
Gg
V 0 nt p �SE,�T
L a
i_0 se•• .-
l{ SroaY. 1 -
p
FAAMF b
I � - I„� NOt15E nI
so 0...
,o
147, ;p LocKlar,
0 0
t 4 h
Il+
R. so s
o - SG.aLF P,-30,
•9 q _ 0 _ .q3o o- - •
Dt.. _ C ....- _. ..
✓E
E+,?';✓J;:�7> C)F RiCOPM OTHER PIAN -
MGSE 57`OWN ON THE. RECORDED
PIAT, ARL NOT SHO'.VN HEREON. - \�
At aNu - No Cw m sN ih4 ax epml xo. Paw m
FILE
1 he bV cMily mat 1 nava wrvWpE the mlbwing dumbed O M, Lpt LS e1od B
M n��Nov s�eo. No. Andwntp reawding PN inw, Awb, and tW
tM improwmenw e,unted (Moon aw within etw pm"rty ling and do nm wrwbp w of /$ tlf^/VT(j
,mrwM on IM W� MV roilw ad*mt thMm. 04t m 4nwww u W wpwm O't(.PIP
1pno adjmp l th«ato *.roach on tM "mm N d Rian and that Intra ax na raad"m Pe la,�NaNEN x•
vmmm g iMmm w Q~ Vbu" MNmw1u on Y(d wpDawY "Ca" a Induaud
�a«NaaaxawNN�MaNwa=a
. ®��� tiraala MiltbnM .i�
Anchorage, Abdo /8 PEL3. I9B T
tie
Anchorage,
Andwra
Qe-od
~MUNICIPALITY OF ANCHORAGE
Heal i and Environmental Protec on
Fourth Floor West
825 L Street
Anchorage, Alaska 99501
279-2511, x 224, 225
INSPECTION REPORT ONLSITE SEWAGE DISPOSAL SYSTEM
tcA. PHONE
LOCATION
~-4:~ ~/"~'M Al LIN G AD D R ESS
LEGAL DESCRIPTION Lo'-~- /-~- .~ iI¢ ~ ~/( C ~J/J/~_(J~I~ C/~
SEPTIC TANK:
DISTANCE 0,
FROM W ELL_~- tvIA[4UFACTURER
IHSIDE LENGTH__ INSIDE WIDTH__
MATERIAL
LIQUID DEPTH
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY/~'2_.~ GALLONS.
TILE DRAIN FIELD: '
TOTAL LENGTH....~.~ i
DISTANCE FROM WELL~/~-_~__FOUNDATION NEAREST LOT LINE_ OF LINE
~ of Lines DISTANCE BETWEEN LINES _ TRENCH WIDTH~ - IN. TO1-AL EFFECTIVE
ABmORPTION AREA_~.~'(¢~ ' SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER L f ~"'!
DEPTIi: TOP OF TILE 10 FINISH GRADE MATERIAL BENEATH TILE_ .f~. ABOVE TILE IN.
SEEPAGE PIT:
Log Crib Rings
BUILDING FOUNDATION_
DIP, METER _ OR WIDTH _ IZENG'FH_ DEPTH
Crib Si~e: DIA[V~ETER .... DEPTH_ DISTANCE FROM: WELL
TOTAl._ EFFECTIVE
NEAREST LOT LINE___ ABSORPTION AREA (WALL AREA) __ __
SQ. FT.
Well
Class: Depth:
Well Distance To: Lot Line
Bldg: Sewe~ L~ne:
Pipe Materials: ~
~ of Bedroom~k
Installer: ~C~ ~
Remarks: ~
D AT E~I~/'~ ~~'~~l APPROVED
PiF'F:'L. i[ CHIN
t... CI C: FI I ]i ILl N
IP.Ib. L[Ei'.~t3TH L.~IPIEN~;tON i:~:; THE Ir. EN[~,iH (ii'.4 F:E:E'i') ElF' /'HE 'It;~:ENCH
iHiE i)IEF'i'H I:]F' R ~i'RENCFI Clfi;'. I:'].]- Z~; I'HE [)Z~;'iFINC:tE E[E'f'bJlEEN THE blJ~:F'FICE OF ikttE
U~L]I.JNC, FINO lHb: Eff)"t'[{:]lq CIF I HE EF:',ClaVfa't]:ON
I HENE ZE; NO :5[E'T NIt)TH FOR "If~'.ENCFIE:5.
'iHE GIRFIV[CL DEF'TH 2[:5 F[..tE f,ltNZf,ii. Ji',l DEPTH OF G~'.R',,,'EL BE'f'NEEN 'f'FIE OIJTFf.~LL
HND 'i'HE: E~C)'T"i'OPi OF' fl-IF: ~J;=.~t::fiVFtTZON (~N
FI F"FICt.(F:IGE PLFIN'I t"lFI'-r' BE tNS;f'F]LI_ED FIT 'THE PERPt:[]"i'E:E'".'E; OPTION E;L.IBOECT ]"EI THE
I-:'CILLO!.,.! ]. N(fi C:Oi'.,!D ~ 't':t. EINS:
· J... E: :[ 'f'HE:R FI CL.RS'Z'; I O1';.: ]:]: NSF' FIPPF.'.O',,,'ED PLFINI' I"lFl"r' E~E ]:N~;"I'FILLE[::'.
FI I~:I.)Ni')~Nt. Jt]LIE; P1FI:[NtENFINCE FII3REEPiENT ]:% R'EL:aU:[F.':ED. :iF' F:I MR :[ N'f'EI"41':tF,IC:b:
Fit3k.'J:EtCi'"tEl'at' :[.'.:; 1'40'1~ I".::EF'-!' CURP..'E:N'i '¢OU f'll':l"r' BE I~:EL;:!U :[ RE[:' ]'O ENLRRC~IE ]'FIE
88r:5Of-'4::I:::'-I'iEIN S"r'S'i"El"l FIN[),,"Ot~.' "r'OU HFI"r' i:.::E $1...tE:..J'ECT "1'O F:'ROS;EE:U't'ION.
'-' '" '"" ~'-
E:FICi<:F]:L.i...:t:NEi Eli':' FII",I¥ .'E;"r'2;TEH N]:"f'HEIU"I" FZNFIL ]:f-,DL:;F'EC']"[EIN F:iN[::' HFFN. ¢-L TH:[:E;
D F:. h' la t:,:: i'HIEN 1 t.,.I :1: EL. BE: ':.:.'. R 1 ECl' TO F'F.' '" ': E :.' U '1":[ -' N.
I"11NiHLJH D]:S'/'FINL::E: E~E:'i"t.,.IEiSN R NELl... laND FIN¥ ON-2;I'Tb: '_:.;ENIRGb.: [::, ]: 2.:,PCK:3Ftl.... ::-:,'-/Si'.FLH ]:2;
j.~:j.~{:i i.::'.I:~.iEi F'LIF.' l.-I PI.~.'.]:',,,'FII'E NELL CIR ;:-.'~l:_;IE~ FEE[ I..:'OI4". FI PUBL]:C NEt_L..
.b.li:~:.L..L i~...l::]l:::i'.Ei; l-:lt:;.'.,~.: F;'.EI.,:!LIIRE[::, FIN];' PiLtS-I BE RETURNED 'iCi THE DEPRRTMEI'.,tI' 14L I-TH:IN
OF I"I--1E NELL.
OI'HEE i.;~tlE6!LI:[t;,'.E:i"IENI'% t"iFI¥ FIF'PL¥. %PEC:[F:[CFI'i ]:OHS FIND C::ONS;'I*F:'.Ut:::'T'ZON [.':,'tLI:::II31~:FIH% FIk::E
H',,,'FI]:I...FIE[L.E 1"0 :[N2;UP:'.E PROPER ZNS'I'RLt....FIT:[ON.
~ ISI:EP.:i' ]: FY 'i'HFI1
J.: .1. Fif,1 FFIf,li'LJ:Fti.;..' f.4:1:11-.I 'THE t~:EL..!UZIa:EP1EN'I'::, F:OF.'.
k'CIi.4: ] H E:"r' 'THE PlUM :[ C :[ F>FIt... J: 'f'¥ 13F' RNCHEIRRGE.
2: :l: W.[L...L :[NS'I'IaL.L "i¥tE S'-/S'i"EM :IN FICCOi~'.I)RNCE M:[TH THIS UODiE:5.
:Z:: ]. UNt.::,EP.'.Si;'f'RND 'I'I-tFI'I- 'I'NE: ON-',E;ZTE '.SEt.4EI-:i: S;"r'E;TEH t"IFI'¢ i:;~:E:L:.!J]:F.'.E Ei'-,IL.Ri;;::[SEPIE:I"aT .~F' 'fHtE
h:.'. l::: 2; J: [::,E:NE:E ]: ¢~; Ia'.EI"ICIi::,EL~::, TO :[~Ii-"Z~Jt..II::,E
GARY ' PLAYER VENTURES
CONSULTING GEOLOGIST
BOX 476-M, STAR ROUTE A · ANCHORAGE, ALASKA 99507 " PHONE 344-7071
WATER WE-LL LOG
FOSS DRILLING ~
1336 Ingra Street
Anchorage, Alaska 99501
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
NOV z 1977
RECEIVED
USE OF WELL H~~
SIZE OF CA~ING ~//DEPTH OF HOLE/~/~T.
STATIC WATER LEVEL ~],~ ~' 1~o
F~ oF D~OWN.
REMARKS
DATE COMPLETED
CA~ED TO / yq
YIET,~ ~ GAL.PER.MIN. WITH
FT ·
PUMP TO BE SET AT~
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
ApplicationDate
GENERAL INFORMATION fMUST BE COMPLETED PRIOR '~O SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Properly Owner ~E~ Telephone: Home
Business
Mailing Address
(c)
(d)
Lending Institution
Mailing Address
Real Estate Company and Agent
Address
Telephone
(e)
Mail the HAA to the followinq address: or' Check here'[.~, if ho d for pick up.
List contact person and day phone number below. '_~ /')
2. TYPE OF RESI.~NCE
Single-Family [~'
Number of Bedrooms
WATER SUPPLY
Individual Welling,, 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 8/86~ Front
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
ins ection
Name of Fi;'~ Telephone
Engineer's Seal
DHHS APPROVAL
Approved for -~C,:, ~-,* ~"'~/')bedrooms by .-~-- -~ ~'' ''~
Approved /~ Disapproved Conditional
Date /- :z~ -~':~-
Terms of Conditional Approval
CAUTION
The Municipality of Anchorage Department of Health and Human Services fDHHS) 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 (MOA)
WELL DATA
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description:
Well Classification
Well Log Present (Y/N)
Total Depth /Iv. Cl Cased to / ~ q
Static Water Level I ~
Casing Height Above Ground ~L(~ t~
Electrical Wiring in Conduit (Y/N) y
Separation Distances from Well:
To Septic/Holding Tank on Lot /~,
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole ~ UM"d L~
Water Sample Collected by ~ ~
Water Sample Test Results
Comments
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~/l~/~7 Yield
Depth of Grouting l'~ d:)
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellt-iead (Y/N)
; On Adjoini,ng Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot ,
; Date
I-ito,
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (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:
(~. 12, 7 7 Size / ~._'~O No. of Compartments 'T~L~'L~
Air-tight Caps (Y/N) ~"~ Foundation Cleanout (Y/N)
Date Last Pumped ,~ ~.to
Temporary Holding Tank Permit (Y/N)
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
Comments
To Building Foundation J ~
To Disposal Field I ~
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well /
To Building Foundation "~'/O~r~
Lot IN/ O
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots t
To Cutbank (if present)
/No tv/
D. LIFT STATION
Date installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I hav_~e checked, verified, or conformed to allCMOA and HAA guidelines in effect on the date of this inspection.
· ~ d-" 1/,2
Signed ~-,~ ~/~-~'~ Date I/~7'o
Company MOA No.
Receipt No. / 0 O/ 00~ .. ~'::~:' "~ '~
Amount: $ -- ~0¢ O~ fir's? ~." "~ "~/'~,' Engineer's Seal
CONSULTING ENGINEER
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3916
S E P T I C S Y S T E M ~9~~ T E S T
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM:
LOT 15, BLOCK 8, McMAHON
13041 HINCHEY PLACE
WILLIAM A. LOCKARD
SINGLE FAMILY, FOUR BEDROOMS
PRIVATE, ON SITE
FROM MUNICIPAL RECORDS:
TANK: GREER STEEL, TWO COMP.
ABSORPTION SYSTEM: TRENCH
ABSORPTION AREA:
SOIL RATING: 85
INSTALLATION DATE:
;
1250 GAL.
396 SQ.FT.
SEPTEMBER 1977
DATE OF PUMPING: MAY 20, 1986. ROTA-ROOTER
DATE OF TEST:
JANUARY 21, 1987
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND
WITH FOUR FEET OF COVER AND 49 INCHES OF LIQUID.
TRENCH CLEAN-OUT WAS 5.5 FEET DEEP AND DRY. TRENCH SUMP WAS 12
FEET DEEP AND HAD A LIQUID DEPTH OF 27 INCHES.
WATER WAS ADDED TO THE TRENCH CLEAN-OUT AT A CONSTANT RATE OF 6
GALLONS PER MINUTE WHILE THE WATER LEVELS IN THE TANK AND SUMP
WERE MONITORED. THE TANK LEVEL REMAIN CONSTANT WHILE THE WATER
LEVEL IN THE TANK ROSE A TOTAL OF 9. 5 INCHES WITH 350 GALLONS OF
WATER ADDED. .THE INFILTRATION RATE WAS MONITORED FOR 75
MINUTES. DURING THAT INTERVAL THE WATER LEVEL IN THE SUMP DROPPED
3.25 INCHES, INDICATING AN INFILTRATION RATE IN EXCESS OF 150
GALLONS DURING THAT TIME.
TEST RESULT:
THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
CONSULTING ENGINEER
i 203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3916
RESIDENTIAL WELL INSPECTION
LEGAL:
LOCATION:
OWNER:
TYPE OF WELL:
WELL LOG AVAILABLE:
INSTALLATION REQUIREMENTS MET: YES
WELL YIELD FROM WELL LOG:
LOT 15. BLOCK 8, McMAHON
13041 HINCHEY PLACE
WILLIAM A. LOCKARD ~
SINGLE FAMILY ~"'
5 GALLONS PER MINUTE
PUMP YIELD:
6 GALLONS PER MINUTE
DATE OF INSPECTION:
JANUARY 21, 1987
TEST PROCEDURE: WELL 'WAS PUMPED AT A CONSTANT RATE OF 6
GALLONS PER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. THE WELL
WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER LEVEL WAS
FOUND AT 144 FEET BELOW TOP OF CASING. WATER LEVEL DROPPED TO
145 FEET DURING PUMPING AND RECOVERED TO 144 IMMEDIATELY ON PUMP
SHUT DOWN. THE WELL WAS PUMPED FOR 60 MINUTES. A TOTAL OF 350
GALLONS WERE REMOVED.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
JANUARY 16, 1987. TEST WAS NEGATIVE.
TEST RESULT:
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours.This well surpasses this requirement.
The assessment of the.condition of this well applies only to the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from the
surface, and changes in land use and other factors that may
impact the conditions of the aquifer feeding the well.
DAT'~RECEIVED
~ INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR I NSPECTOR(~ .-4. [,
.... ,,~ r~: ^~iFHC)RAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
PROTE~JON
DEPA~T~ENT OF HEALTH · ENVl ~ON~ENTAL P~OTE~NMENTAL'' ""~
825 L Street - Anchorage, Alaska 99501
. SEP 2 2 1980
ENVIRONMENTAL SANITATION DIVISION
REQUEST'~'FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACl LITI ES
DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be proce~ed. Please allow ten (10) days for processing.
1. PROPERTY OWNER PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2. BUYE. PHONE
MAILING ADDRESS
3. LENDING INSTITUTION PHONE
MAILING ADDRESS
4. REALTOR/AGENT ~ J PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
,,-.L_ ~ T'
STREET LOCATI ON
6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One [~ Four
[~]'- SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
7. WATER SUPPLY
ITM 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**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
I
THIS SIDE FOR OFFICIAL USE ONLY
1, TYPE OF RESIDENCE NUMBER OF BEDROOM,S
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] 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
E~ INDIVIDUAL/ON -SITE DATE INSTALLED
Connection Verified iNSTALLER
[]Septic Tank or [] Holding Tank
Size: I,~¢-~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank ]Absorption Area ISewer Line Nearest Lot Line
WELL TO:I '
Absorption Area to nearest Lot Line
5. COMMENTS
[~APPROVED FOR ~' BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED ///~
72-010 (Rev. 6/79)
#1: Time
Date
Insp
~--~ MUNICIPALITY OF ANCHORA~E~
DEPARTM ~ OF HEALTH AND ENVIRONME~ ~L PROTECTION
825 L Street, Anchorage. Alasfa 99501
264-4720
Date Received: February 24~ 1978
#2: Time ~3: Time
Date Date
Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request: Alaska Pacific Bank
Mailing Address: Post Office Box 420 99510 Phone:
2. Property Owner: Charles E. Jackson
Mailing Address: Star Route A Box 1582N 99507
Phone: 344-0491
3. Legal Description: Lot 15 Block 8 Mc Mahon Subdivision
4: Single Family Residence: (x)
Multiple Family Residence: ( )
Number of Bedrooms: Three
Number of Bedrooms:
5. Well System: Individual well (x) Community/Public System ( ) ~
Permit # Depth of Well 156' Well Log on File (~/
Construction
Bacterial Analysis
o
Sewage Disposal System: On-site System (x) Public Utility ( )
Permit ~ Installed Installer
Septic Tank Size
Absorption Area
Distances: Well to Septic Tank
to Sewer Line Nearest Lot line
Manufacturer
Soils Rate Material
to Absorption Area
Absorption Area
to Nearest Lot Line
Page Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 15 Block 8 Mc Mahon Subdivision
Comments:
Affadavit Attached
Approved:
Disapproved:
Letter Attached: )
Date
Date
Department Worksheet:
~-o9~ -~,? ~6~: o~ ~ llVLM IVNOIIVNB:]INI ~OJ ION
(~p:~ ~o eaS) --QqnlAOBd ]gVII]AO0 ]ONVI]IISNI ON
IL6I
00~£ uaau.a $,~
3~¥0 BO Ol IN35
~BVfll$Od
(e:Belsod snld) ;~0£ 91VIAJ a31JIJ. B33 BOJ /dlqO3B
P
~ MUNICIPALITY OF ANCHORAG~
6',//----~----\\~ i Department of Health and Environmental Protection
~[~-%l~/J~/~/~/ 825 L Street, ~chorage, Alaska 99501 ·
" 264-4720 ..................
' uest for Approval of Individual Sewer and Water Facilities
1. Property Owner: ~ ~ '~
Mailing Address: ~y~ ~~ ~-~~ Phone: J~
e
Name of Buyer:
Mailing Address: Phone:
Lending In s titution: ~Z~u~ ~-~ F~~
Mailing Address: ~~ ~/~-~;. '~'~/]Z'/,~''~ Phone:
Realtor/Agent:
Mailing Address:
5. Legal Desc.ription:
Street Location
Phone:
6. Single Family Residence: (~Number of Bedrooms:
Multiple Family Residence:
( ) Number of Bedrooms:
o
Water Supply:~. *Individual Well
If Individual Well, well depth
Public/Community System
If Community System, name of system
8. Sewage Disposal System: *~Dn-site System (~ublic System
If On-site System, date of installation:
( )
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
.test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77
IO
~lN-r,~r~l/ ,_~7-,.~'E-E'T Nooo o?' oo'
~h86
157,61
E]
%
60.00
O{
?
MATCH LINE N ~o 02'11
SEE' SHEET 2 I { t75.00 .-.'.,-~
C
Z
C
<.
I
I
17500
17§.00
/
(.,4
.0
204.40
-
CO° 06' O0"W ~'5.o4--
l_J ~-'
NO'AKN ~o06' ~'~
a LJ O~
® ®
:_.,'
0
Z
i._,~ i'-.i -- 5,',, U E~ []) i "¥/i D E~f [fi
