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Home My WebLink AboutHERITAGE PARK BLK 1 LT 20 ~u./ 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 ~JNEW [] UPGRADE LOCATION Well _ iL, I DISTANCE TO: I Manufacturer )¢/ ' Liq capacity In gallons I ,,~, ' ~(./~_~ F nuDE ...... : DISTANCE TO: Well I Manufacturer No. of lines ~ I Length of ea~hJine '~ I ~r~ Top of tile to finish grade Length Width Type of crib Crib diameter Well DISTANCE TO: C]ass~ / [~ Y Depth F~[(~ /~ Bui d ng foundation DISTANCE TO: Absorption are/~/~_~ / Dwelling , / Inside length Width Dwelling Material Foundation)/~ ~ Nearest lot line /~--,-"- Total length~,~ ~es Trench width ,~ ~ inches Material beneath tile ~, / Depth OTHER PiPE MATERIALS SOIL TEST RATING INSTAL~R / ~___~ REMARKS -/ Crib depth Distance betwee~n~.~s/z./~ , Total effective absorption area PERMIT NO. Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) LEGAL 5--7 NO. OF BEDROO.~ PERMIT NO. No. of compartments~, Liquid depth PERMIT NO. Liquid capacity in gallons Total effective absorption area PERMIT NO. BPPLICRNT DEVCON ENT. INC. 541t OLD SEHRRD HWY. LOCRTiON LEGRL LOT 20 BLK ± HERITBGE F'BRK SUB LOT SIZE TYPE OF SOIL RBSORPTION SYSTEM IS: "FRENCH MBNIMUM NUMBER OF BEDROOMS = 3 SOIL RRTING (SQ FT?BR)= 85 THE REQUIRED SIZE OF THE SOIL BBSORPTION'SYSTEM IS: [:.EF'TH= 1(~ LE~,3TH= 2;7' ,3F:F~%~E~ C, FF"T~- 56i-i082 9999 SQLIRRE FEET THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRb'EL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). F.: E L---.~Lt 'f F-:F[:. "_-]FF'T ]: C: TR~'-.~-:C ~5 ]; ZE= 1,;_--~ ~-_E----~,-E~ LSRLLC,~'-.~'_-~. PERMIT RPPLIC8NT HRS THE RESPONSIBILIT'¢ TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RN'¢ HELLS RDJRCENT TO THIS PROPERTY FIND THE NUMBER OF RESIDENCES THRT THE WELL WILL SER'v'E. T~-~C, (2) Z ~-~;F'EE:TZ C,~-~S ~]~:E ~:Ee;4L~Z F:E[:. BRCKFILLING OF RN9 SMSTEM WITHOUT FINRL INSPECTION RND RPPROVRL B~¢ THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETHEEN R WELL RND RN'¢ ON-SITE SEWRGE DISPOSRL Bb"_=;TEM IS ±~R FEET FOR R PRI'¢RTE HELL OR ±50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE T'¢PE OF PUBLIC HELL MINIMUM DISTRNCE FROM R PRI'v'RTE HELL TO R PRI'v'RTE SEHER LINE IS 2'---'5 FEET RND TO R COMMUNIT'¢ SEHER LINE IS 75 FEET. OTHER REQUIREMENTS MR'¢ RF'PL"r'. SPECIF!CBTIONB RND CONSTRUCTION DIRGRRMS RRE R'v'RILRBLE TO INSURE PROPER INSTBLLRTION. F"EF:fr-~ Z T F::-::F' Z F-:ES [:,EC:EI'-'~E:EF-: 3:t.,, iL=-,-:--]_--:3: i CERTIF'¢ THRT 1: i BM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEHERS RND HELLS RS SET FORTH B'¢ THE MUNICIPRLiT'¢ OF RNCHOR8GE. 2: I WILL INSTRLL THE S'¢STEM IN RCCORDRNCE WITH THE CODES. 3:: I UNDERSTRND THRT THE ON-SITE SEWER S'¢STEM MR'¢ REQUIRE ENLRRGEMENT IF THE RE~IDENC:E ~S REMO[:,ELE[:, TO INCL U[:,E MORE THRN 3: BEDROOMS. I S~UE[:, BOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 ~, 4 5 6 7 8 9 ,.~.~ 10 11 12 13 DEPTH DATE PERFORMED: SLOPE (~ SITE PLAN ENCOUNTERED? IF YES, AT WHAT DEPTH? 14 15 16 17 18 19 2O p'ou ~T ~, A VE- Gros~ Net Depth to Net Reading Date Tima Time Water Drop (minutes/inch) PERCOLATION RATE TEST RUN BETWEEN FT AND ~ FT COMMENTS PERFORMED BY: 72-008 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 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Descciption (include lot, block, subdivision, sectipn, township, range) Location (address or directions) (b) Property Owner ~ T(~lephone: Home Mailing Address Business (c) Lending institution Telephone Mailing Address (d) Real Estate ComPany and Agent///~_/~z~'~.,~, ,~ ~/~_~c,~ ~ //~2~.~__ ./~'J ~~ Address / ~ ~ ~~ ~~~ ~~ ~~~ ~~ Telephone (e) Mail the HAA to the followina address: or; Check here~, if hold for pick up. List contact person and day phone number below. , ~ TYPE OF RESIDENCE Single-Family ~¢~ Number of Bedrooms 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 8/86t 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 the date of this inspection. Name of Firm $ & $ ~HG!NFF-I~ING Address 17034 Eagle RiYer Loop Road Eagle Rtver~ Alaska 9~577 Date DHHS APPROVAL Approved for rP edrooms Approved ~ _ Disapproved Terms of Conditional Approval 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 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 (Rev 8/861 Back MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION· JUN 29 1988 RECEIVED CHECKLIST - FEBRUARY 1984 264-4744 Legal Dc'scrintian" -~ WELL DATA 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/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by f'~ If A, B, C. D.E.C. Approved~) Date Completed Yield Cased to Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots "~_.,~6;~ I.~¢ ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Water Sample Test Results Comment~: ~'-.-~. O. B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes(~N) y Air-tight Capsd~N) Depression over Tank (Y/~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/HoM~T, ank: To Water-Supply Well ~ '~ I TO Property Lin'e ~ ~ To Water Main/Service Line 'Course \ 'C::::~;::~ J¢ Comments '~'~ ~.--~'¢'~t'-~ L..~ Size \ ~ NO. of Compartments y Foundation Cleanout ~;~N) ~/' 4- Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) t To Building Foundation To Disposal Field ~ ~ · . To Stream, Pond, Lake, or Major D~'ainage Page I Of 2 72-026 (Rev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/~¢~;) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~ ~'''~ To Property Line To Building Foundation~.~ Lot Type of System Design Length of Field Depth of Field ~-' Gravel Bed Thickness Standpipes Present ~:~:~N) Date of Last Adequacy Test To Existing or Abandoned System on ; On Adjoining Lots '¢~0 t"Jr-' To Cutbank ,(if present) To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments "Pump On" Level at ~ High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~¢4z~.ng Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all .M,~ an~AA guidelines in effect on the date of this inspection. Signeds 8~ ENGINEERING Date ~'"/'~,"~/ Compa'J~,034 Eagle River Loop Read No, ~A No, ~gle River, Aiask:a Receipt No. '"~¢,¢~/// Date of Payment ~ "~ ~ ''~¢'~ Amount: $ //' 'F~-) ' O ~ Page 2 of 2 MUNICIPALITY OF ANCHORAG~ ENVIRONMENTAL SERVICES DIVISION 72-026fRev 8~861 Back RECEIVED