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Home My WebLink AboutHILLCREST BLK 1 LT 5 oGREA, ANCHORAGE AREA BORr Department of Environment (~uality 3500 Tudor Road Anchorage, Alaska 99507 NAME INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATI ON SLmt~T'tC TAN K: DISTANCE FROM WELl INSIDE LENGTH MANUIFACTURER: 4' ~ -f~_'/~- INSIDE WIDTH MATERIAL LIQUID DEPTH __ NUMBER OF COMPARTMENTS__ / LIQUID CAPACITY~':~'::':''~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL .... NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE _ FOUNDATION DISTANCE BETWEEN LINES NEAREST LOT LINE TOTAL LENGTH OF LINES .TRENCH WID-rH _ IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EAClt LINE DEPTIFI OF: FILTER MATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED _CONSTRUCTION NEAREST NEAREST LO'[ LINE SEWER LINE OTHER SOURCES DISAPPROVE[) .DEPTH SEPTIC SEEPAGE TANK , SYSTEM REMARKS DISTANCE FROM: DISTANCES: DIAGRAM OF SYSTEM INSTAL_LED BY: SEWER LiNE DEPTH: PIPE MATERIAL: C,~--~ LOT SLOPE: REMARKS: Form PW.027 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. INSTALLATION LOCATION~ ~ SEEPAGE PIT.. DRAIN FIELD , OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST rESULTS COMPLETION DATE ANTICIPATED TO BE INSTALLED BY NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL FINAL INSPECTION: 24 HOUR NOTICE REQUIRED· BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL be SUBJECT TO PROSECUTION· SIZE ~v~L{'~' SEEPAGE AREA SIZE TYPE FOUN~^T,ON TO ~I,C. TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE Pit WALL. S~PTIC TANK~'~' ~- SEEPAGE PIt TO NEAREST LOT LINE, · DRAIN FIELD ., SEEPAGE PIT ALSO CONSIDER AREA WELLS, WATER MAIN TO SEPTIC TANK DRArN FIELD SEPTIC TANK, ' , SEEPAGE PIT TO RIVER. LAKE, STREAM. SEEPAGE PIT DRAIN FIELD CAST lEON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GaP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL, 4 INCH DIAMETER CAST lEON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH a[rtlghT REMOVABLE CAPS. DIAGRAM OF SYSTEM GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING ]N~/~LLAT[ON. OR LICENSED DESIGNER I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DescR[SED SYSTEM IS IN ACCORDANCE WITH SAID CODE· DATE 7 ': APPLICANT'S ~)F ~NVHR()NMF. NTAH~ ~I~NSF, R¥,'%TION September' 6, 1974. Department of Environmental Quality Greater Anchorage Area Borough 3330 C Street Anchorage, Alaska 99503 EGAN, GOVERNOR 338 DENALI STREET ~,',!~l ~,, SUBJECT: Lots 3,4, & 5, BIk. I, Hillcrest Subdivision (Terry) Gent Jemen: We have no objection to two trailers which are to be located on the subject propert'i'es being connected to a single well and each trailer being served by a holding tank located at least 100 feet from the well. This situation is not adequately covered by the Wastewater Disposal Regulations and I was not able to find any one at home in Juneau to give an interpretation. Yours truly, KyJe J. Cherry, P.F. Regional Environmental Engineer MLINICIPAt. ITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTI-I AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date -Z~ '/ GENERAL INFORMATION (a) Legal/.~.Descripti°n~5__ (include,.~ / lot, block,//.~.a/,/subdivisi°n'L/-"2~&'-secti°n'/t°wns ~ p,.c~.Z/~)rangp) Location (address or directions) /c~ App,,ca..t is ~c,~o,. one~: Le.d~ng ,ns,tution n; Owner,,:,der ~; ~uyer []; Othe~e×p,a~.X Address ~'~J~' 2~; (e) Rea, Estate Company and Agent Telephone // (f) -'~ailqhe ~AA to the following address: 2. TYPE OF RESIDENCE Single-Famil,~ Multi-Family[] ther N u m her of ~)~d rooms __~LE"__ ~_~t WATER SUPPLY Individual Wel~ 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 Publi,~/~.. 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 (11,84) 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, l 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 i~vestigation and i~spection, the omsJte water supply and/or wastewater disposal system is in compliance with all Municipal a~d State codes, ordinances, and regulations i~ effect on the date o~ this inspection. Name of Firm 8 & ~ ~:~I~B~I~F~ Telephone ~ ~/¢ ~ ~/' Address ~¢6~ Date ............. ;"~ ........ Approved for ~-¢' bedrooms by Date Approved ~ Disapproved . Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the ropresentations 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 ~s not responsible for errors or omissions in the professional engineer's work. We 11 Class ificatio~n 9P/£1Y ; Well Log P~esent~) Total Depth /~/ ' Cased to Static Water Level ~/~" Casing Height Above Ground F. lectEical Wiring in Conduit(!~/~) Separation Distances fEcm Well: To Septic/Holding Tank o~ Lot /~/,//''~ To NeaEest Edge of AbsoEption Field on Lot, MUNICIPALITY OF ANCHORAGE (MOA) HEALT ALU OR TY APPROVAL (HaA) CHECKLIST - FEBRUARY 1984 Legal Description: ~- ; On Adjoining Lots ~ On Adjoining Lots To Nearest Public Sewer Line C leanout/Manhole /OD ( .7/- Wate~ Sample Collected By~ ~I~ ~.~/~-/~/~ ~ Date Water Sample Test Results C~m~nts ~/[J NY~ / , ~c~- f '~- TO Nearest Public Sewer To Nearest Sewer Service Line on Lot SEPTI( 'PAN/< DATA I~te Standpipes De[yEession over Tank Pumping/Maintenance Contract Holding Tank High-Water AlaEm Separation Distances f~cm Sep To Water-Supply Well To Property Line To Water Main/Service Course Comments Size Aid-tight Caps Date No. of (,Y/N) Holding Tank Pe~-.~t (Y~/N) To Buildin¢ To Disposal Field To Stream, Pond, Lake, ~Major DEainag~ Receipt Date Paid: Amount: [Page 1 of 2] 2-15-84 C. ABsoRPTION FIELD DATA Soils Rating in Absorption Strata .Installed of Field Square .~t of Absorption A~ea Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Ih~esen' Field (Y/N) . / ~ Date of Last Adequacy Sep=ation ~e f~om Abs~tio~ F~.'~ To Water-Supply ,~11 J To P~operty To Building ' ' To Exist~ Lot ; On Adjoining Lots To Water Main/Service .ne To To St~eam/Pond/Lake/c~ or D~ainage To D~iveway, Pa~king Area, Vehicle Area Co~Lents or Abandoned System cn [ if present) D. LIFT STATION Date Installed Size in Gallons "P~m~p On" Level at High Water Alarm Leve] Tested for Electrical Codes ~ Co~m~nts Pumping (Y/N) Level at Vent (Y/N) Adequacy Test. Meets MOA ** Check I certify on the date Signed Co,~any KBl/d5/s Bedrcom Rating A~ainst HAA Request I have checked, verified, c~ eonform~d to this inspection. Dat~/~ MOA No. in effect [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION A3PLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. C~neral Information Application Date _/~ '- ~'~--(~ L/ (a) Legal Description (include lot~. block, subdivision, section, township, range) t t, /1 ' Location (address or directions) Telephone - Business (c) Applicant is (check one) Lending Insti~ution_~ Owner/builder [~'; Buyer ~ ; Other ~ (explain); ___.~".~'2///~ /- ; (d) Lending Institution _~fz"/tfh/~ /Z*~//~ Telephone A~ss Telephone (f) the HAA to the following address: g~L~qlCIPAI.Iw OF ,o ,x [' ~:'i~II[q~RIN{~ ]~IRON~a~NTAL PROTECTION '", "- ,..,-' ........, ,~, 'BEC 2 T~of Residence Single-Family~ Number of Bedrooms Multi-Family Other (describe) ® [Page 1 of 2] _Water S_______qu~ "/L' /.~/:~ /~ .5 ~.Z]2. ~ ~= ~ 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, Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status° 5. ~n~ineerin8 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 waetewater 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 wmter supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula~ tions in effect on the date of this inspection° ° Name of Firm Telephone Date ' , t~,>~ ~ ~7.9 ~ ~-~,~.~ -- Approved ~ Disapproved ~ Co~ition~ 7~ Te~s of Condi~ion~ Approval CAUTION TttE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES tIEALTH ALri'HORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GI~rEN IN PA_RAGllAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF I{OMES AND Tt~IR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL A/~D STATE REQUIRE- MENTSo 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 A~AHglH 0~1¥~3 S -- (]'lO · I ~ I ] ~,BSOTT ROAD .~5'¢4'£ 117550 '~ s /~ ......................... . ......... I/ ............... : ,o ' ' -- ~ ..... '1 o I I / I I I I / / / """ ' s , J,,'pol ,,oo I 'o'°l~?° I ,o~ I ~oool*°.o° I~°°° / T,~'ACT TRACT Sd¢plVI j~d- /,.CE' FILED $o