HomeMy WebLinkAboutHENKINS BLK 1 LT 7
% Municipality of Anchorage Page
· : 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
Permit Number: ~ I/CZ ~/~ Z,~::P PID Number:
Name: ~~ ~Y D% Wastewater System: U New ~ Upgrade
Address: P,~.' ~ 77~ ~ ~ .. ABSORPTION FIELD
Phone: ~_~ ~ lNo, of Be~ooms: ~Dee~Trench D Shallow Trench D Bed ~ Mound ~ Other
LEGAL DESCRIPTION so, Rating:
B~ock: Subdiv~ion: Depth to pips bottom from original grade: Gravel depth beneath pipe
_~ Range: ~ ~ ~ I Section: ~ ~ Fill added above__original grade:~ Ft. Gravel length:~ / Ft.
Township:)~
WELL: ~ New O~Upgrade Gravel width: / Number of lines: Distance between lines:
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe materiah
Date installed:
Driller: -- Date Drilled: Static Water Levek Installer:
Yield: Pump Set at: Casing Height Above Ground:
[O GPM ~/~ Ft. ~ ' Ft. TANK
SEPARATION DISTANCES ~Septic a Holding a S.T,E.P.
To Septic Absorption Lift Holding Pubiic/PrWate'Manufacturer: Capacity in gallons:
From Tank Fie~d Station Tank Sewer Lines
Material: Number of Compa~ments:
Su~ao~ ' ' ~ ~ LIFT STATION
Water ~ ~o ~ /~o~
Lot
t "Pump on" level at: I "Pump off'; level at: High water alarm at:
Foundation
1
0
I
Cu~ain ~ ~ Pump Make & Modet I Electrical Inspections performed by:
Drain
I
Remarks: ~o~o~o~ ~.o~ ~ _ BENCH MARK
Location and Description:
I Assumed Elevation:
ENGINEER'S SEAL
Inspections performed by: David R. Dayton P.E. Dates: 1st
2~10 Donalar St. ~, ~ ~ ~os~n~ C. COWA~ /,~
Chueiak, Alaska 99567 2nd ~ '~'""'~ .............. '
Department of Health and Human Services approval
~eviaweO and approved ~y: ~ Date:/2 - / ~ ~ ..... ~ ....
Permit No.
SW940390 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
LOT 7, BLOCK 1, HENKINS SUBD.
Legal Description:
9, -'-'-~.4~/ NEW I
:1ooo GAL I'% _
TANK
50' RIGHT OF VACATION
MT1
05129219
PID No.:
~,8 .7' NO WATER FOUND
8-27-94
~V
SCALE 1" = 40'
WELL
ROBERT C, COWAN
CE - 8801
72-013 A (Rev. 9/91) MOA 25
er/t.fieh rfll ug
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759
OF LAND
ADDRESS
LECALDESCRI ,ON L 7
DATE - Started
~ Y~ Y DEI'TH OF WELL d q
f V W ' ' ~
, STATICLE EL OF ATERFT. 6
. Ft. ~ d~/( gd~ 4"~v~ Fromm'' FI. lo Fl. ~
~'~,~ i~ ~ From ; Ft. to. Ft.
_ ~
rt.% ~/t ~ from n. ~o rt.
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rij,~' '~ ' . ~ :.. : ~:/..~-~'I: ~ :--. ,... ....
~Ft. ~'~ ~' ~';om '. FI. to Ft..
Ft. From ': Ft. to · Fl.
PERMIT NUMBER
KIND OF FORMATION:
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: From -~V'~:'
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DEC 1 1995
"~' Mu~o,i)anLy Ol ~fIohorag~
Dept, Health & Hum~ Serv]cea
DRILLER'S NAME .
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW940390
DESIGN ENGINEER:DAVID R. DAYTON, P.E.
OWNER NAME:LYDY ROBERT L & WENDY L
OWNER ADDRESS:P.O. BOX 773203 HWY
EAGLE RIVER, AK 99567
PARCEL ID:05129219
LEGAL DESCRIPTION: HENKINS BLK 1 LT 7
LOT SIZE: 20038 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 HOURS)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY:
DATE:
DATE:
PERFORMED FOR: ~-~
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
L~ DY . -
DATE
LEGAL DESCRIPTION:
1
2
3
4
5
6
,'~oWnship, Range, Section:
SLOPE
10
WAS GROUND WATER
ENCOUNTERED?
11
12
13
14
15
16
17
18
19-
20-
COMI~ENTS
SITE PLAN
IF YES, AT WHAT
DEPTH?
Depth to Water After / DalP:
Monitoring?
S
L
O
P
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
/-~'~(minutes/inch) PERC HOLE DIAMETER __
FTAND <~' FT
PERFORMED BY:: 202'0 DOl'la'ar St. I ~/~/~ Z J~'~"/~CERTIFY THAT TI:IlS TE~ST WAS PERFORMED IN
ACCOR DAN C E WiTH ALL S~T~A~-~EI~N~DAM~?N~i~A~L~GTui D E LiN ES iN EF F ECT ON (HiS DATF_ DATE: ~/"~/.~ '
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
5
6
10
12
19-
20-
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
: '. DATE
Tdwnship, Ran§e, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? P
E
Oept~l to Water After, / ~_~,~;
Monitoring? /(~ ~' Date:
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
~/~ , /q~,
I ., ~- _ 7 ~' /o I "- ,Zy,./ lY~
U ~ ~-~ /o . 1,.- z~ /~
TEST RUN BETWEEN
(minutes'inch) PERC HOLE DIAMETER
_ FT AND OC'¢ FT
David R. Dayton p.E. . ~ ,
.- ,o,,o,o..,.,,. . .
PERFORMED BY: ~.~_ __.~_T..,_ _, _ ..~..-~I ERTIFY THAT T IS TEsT WAS P~ERFORMED IN
.... ,,.., ........... ----'-
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE, DATE:
D. R. DAYTON, P.E., R.L.S.
20210 Donalar Chugiak, Alaska 9@567
(907) 696-2417
September 24, 1994
Lot 7, Blk 1, Henkins Subdivision
Well & Septic.System
The proposed septic system will serve a 3 bedroom hc~e on the subject lot.
The lot, alomqwi%hthe adjacent vacated Right of Way, has ample room for the
system as well as a reserve area. The soils are adequate to support an on-site
system.
The Driginal lot has a 30 ft. wide MEA easement along the Northwesterly
boundary. The septic system will be partially in the easement. MEAhas no
objection to this. ( see attached MEA Statement of Non-Objection)
The proposed system will have no measurable impact on wells or septic systems
on neighboring lots. There will be no significant impact on reserved areas
or on drainage.
STATEMENT OF NON-OBJECTION FOR' ENCROACHMENT
WITHIN UTILITY EASEMENT
'4
Matanuska Electric Association, Inc. (MEA) has no objection with the location of
a' septic system and associated facilities within the utility easement
along the northwesterly boundary of the fbllowing'property;
Lot 7, Block 1, HENKINS SUB
in the Anchorage Recording
Situated in Section 30, Tow
[VISION, according to Plat No. P-387, filed
istrict, Third Judicial District, State of Alaska.
ship 15 North, Range I West, Seward Meridian.
Matanuska Electric Association, Inc.
General Manager or his Representative
September 21, 1994
Date
MEA ACKNOWLEDGEMENT
STATE OF ALASKA ) '.....':... .,. ..;
) SS. ~"', -. ':.)~
THIRD 3UDICIAL DISTRICT ) ~ .:. ~ :: ' >,,- :,"i. '., :-
The foregoing agreement was acknow'!edged before me this 21st ~
day of Se~mber 1994 by Robert Mau, P.E
Notary Public for the State oi Alaska
My commission expires: ~- 2-6c, ~ ~
333.1/1210.1
4 R. G, YLVI~qAK,ER ~