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HomeMy WebLinkAboutHERITAGE PARK BLK 1 LT 13 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 I~'NEW NAME LOCATION Well .~ dA ! DISTANCE TO: ~ Manufacturer Liq~c~n gallons F HOMEMADE: Manufacturer ~ Well ~ D~STA,CE TO: I No.o,,,n.s Top of tde to flmsh fade Length Width Type of crib Crib diameter Well DISTANCE TO: Cla~ / Depth ' Building foundation DISTANCE TO: Absorl~;~ a~ea Inside length Dwelling Foundatio~g 1 Total length o,~P~.~s.~ Material beneath tile Depth Crib depth Building foundation Briller Sewer line PHONE E~UPGRADE W dth Material Nearest ~in~e )~_ Trench w dt~.~ ~)nches NO. OF BEDROOMS3 No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT N~,_~,O,~OO, / , PERMIT NO. tTotal'effective absorption area Nearest lot line Distance to lot line Septic tank PERMIT NO. Absorption area(s) OTHER PiPE MATERIALS SOl L TEST RATING INSTALLER REMARKS DATE LEGAL PERMIT NO. [:'EF'ARTMENT: HEALTH AND ENViF.'ON"IENTE'~,F:OTEE:TION 825 'L'" STREET., ANCHORAGE., AK. 995£~t 264-4720 ( 83:0281 ) APPLICANT LOCATION LEGAL DEVCON ENT. INC. 541i OLD SEWARD HWY. LOT t3 BLK · HERITAGE PARK SUB LOT SIZE' 56i-i082 9999 SQUARE FEET T'¢PE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF' BEDROOMS SOIL RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [:.EF'TH= ±El ' LE~qGTH= 2:2 ,] F-: F~'¢ E L E:.EF' TH= ,'5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAtNFIELD. THE DEPTH OF A TRENCH OR PIT iS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REL::!Lt I F."E[:. SEF'T I C: TFt~'4~:C S ]; ZE= ±EtE~E~ ,_SF~LLC,~4S PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T~4C, (2) Z F~'_:.F'E,]T~C,~5 R~:E ~:F,~¢JI F~FC, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMIJM DISTANCE BETWEEN R WELL AND ANY ON-SITE ~EWM=E DISPOSAL SYSTEM ,IS ±00 FEET FOR A PRIVATE NELL OR ±50 TO 200 FEET FROM B PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC NELL. MINIMUt'I DISTANCE FROM R F'RIVRTE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS RND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'EF-:I'"I I T E;;-;F' I F-:ES [:,EC:E["IBEF: E---1 . -1 I CERTIFY THAT ±: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF' ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN RCCOR[:,RNCE WITH THE CODES. ]:: I UNDE~RND THAT THE ON-SITE SEWER SYSTEM MAY REQLIIRE ENLARGEMENT IF THE RESI[:,ENC:E/' 'I~ R. EMODELED TO ~'~CLUBE MORE THAN ]: BEDROOMS. . ~PPLIC~NT DE~%~N ENT. INC. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 I~. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG ~- PERCOLATION TEST SOILS LOG PERCOLAIlON TEST PERFORMED FOR: }-J~ (~ LEGAL DESCRIPTION: L O"~"' 1 2 ~-4 5 6 7 8 · "~ 10 12 13 18 19 ' "':' ~' 2O DATE E EOR ED: ZI--I ¢---93 SLOPE (~ SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 15' © Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND __ FT PERFORMED BY: CERTIFIED BY: ~ * ...... 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~! ~)~ _ ~,C~/-/9 OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 13: Block 1; Heritage Park Subdivision August 31, 1987 Location (address or directions) Ivy Home Circle Alaska Housing Business Property Owner Telephone: Home Mailing Address (b) (c) (d) Lending institution GMAC Mailing Address Telephone Real Estate Company and Agent HERITAGE REAL ESTATE/Suzanne Cool Address 18550 Eagle River Road, Eagle River, Alaska 99577 Telephone 694-4994 (e) Mailthe HAAtothefoltowinaaddress:or:Checkhere~,ifholdforpickup. Listcontactpersonand day phone numberbelow. S & S ENGINEERING/694-2979 17034 Eagle River Loop Road, S~t~ 204 99577 TYPE OF RESIDENCE Single-Family I~ Number of Bedrooms ordered by Suzanne Cool 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. 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) Fronl 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. Name of Firm $ & $ Address 17034 Eagle Ri~er Loep Road No. 204 Eagle River, Alaska Date Telephone DHHS APPROVAL Approved for 3 bedrooms by Approved .;>~ Disapproved Terms of Conditional Approval / ~Date 7-4-87 Conditional CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) 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 DH HS does th is 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 8/8618ack MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) Well Classification Well Log Present (Y/N) Total Depth Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/14efol~g Tank on Lot If A, B, C, D.E.C. Approved (Y/N) Date Completed yield Cased to Pump Set At i~ / Depth of Grouting Sanitary Seat on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot "~c;, ~.'~ ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments B. SEPTIC/HOL-Dllq~ TANK DATA Date Installed t~ ~'~/ ~ ~"~ Size ~. ~:~ No. of Compartments Standpipes~/N) Air-tight CapsC~Z:TN) Foundation Cleanout~N) Depression over Tank (Y/~:~ r-~ / Date Last Pumped Pumping/Maintenance Contract on File (Y/N) //~ ; for Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well "~-¢~ ~-4~ To Building Foundation To Property Line / E;~ /-¢" To Disposal Field To Water Main/Service Line ~/z:~ /'/" To Stream, Pond, Lake, or Major Drainage Course ~ ./'¢:~' 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 Results of Last Adequacy Test Separation Distance from Absorption Field: Length of Field Depth of Field Gravel Bed Thickness Lc, Standpipes Present Date of Last Adequacy Test Type of System Design To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area I To Property Line ! c~ To Existing or Abandoned System on ; On Adjoining Lots '~/"7~' To Cutbank (if present) ./~ /.1~--~ Comments 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 have checked, verified, or conformed to all M/QA and HAA guidelines in effect on the date of this inspection. Signed$ &____.$ ENGINEERING Da' 17034 Eagle River Loop Receipt No. ~'¢ Date of Payment 72-026 (11/84) - APPLI(~.NT FILLS OUT UPPER HAE ONLY Property~)wner~ _ ~ .~(.~/~ ~ ~:~./~.~.~)~..~.~..~ Phone . -~ Realty Co. & A~nt ~ Ty~Res[~nce ~Single Family '~ ...... ~'~ ' ~ Multiple Family No. of Bedroo~ ~ Other Water Supply midUal -- i/ ~ ~ A~ACH WELL LOG. A w~l Icg is required for all wells drilled since June 1975. unity~ ~ ~ ~ . For wells drilled prior to that date, give well depth (attach Icg if available). ~ Public Utility Sewer~sposal ~ndividua, .Year Individual Installed:_ ~ Public Utility When Connected to Public Utility: ~ Holding Tank . NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ~ ~ ..~'-¢:1~ '~ ~ ~ C~ ~,~ MUNICIPALITYDEPT. oFOFH~ALTJlANCHOP'A~E ~ ~..~ CD, ENVIRONM2NTAL PROTECTION OCT 1 :~' RECEIVED (,~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE ' 8 - Soils Ratinn ~ Date Sewer Installed Well To Absorption Area Well Log Received ~:~'"' 2"'~ .~ Well to Tank Cg~'~' ~1~' Septic Tank Size 4~0 ~e. October IA, i9~3 Devcon Enterprises 5411 Old Seward Llighway Anchorage, AK Q9502 Subject: Lot 13, ~61oCk 1, Heritage Park, Eagle iiiver --;~ water ~%acll_cleu cannot Approval ~:.or t~'~e individual se~er ,.~n,., '- ' ~' ' be granted until the followin9 items have been ~', o ¥,i de~;ression over the sewer system ~.~ili need to noted discrepancies have been corrected, iE chafe are any further questions, please call this ofilice at Sincerely, Cory v~lil'I~-~ .~l.,'~. Acting Sewer & Water Prograia ~4anagc' t'