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Home My WebLink AboutHERITAGE PARK BLK 2 LT 9 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 LOCATION NO. OF BEDROOMS ~ Manufact,rer ~/~ ! Mater~ ~ ~ Liq. Inside length Width PERMIT NO, No. of compartments Liquid depth Material Nearest lot line Trench widt~_l~O inches iF HOMEMADE: Well Dwelling PERMIT NO. DISTANCE TO: Manufacturer Liquid capacity in gallons Foundation DISTANCE TO: Well Length of each line,~ Total length of %ese; / No. of lines Top of tile to finish grade Length Width Crib diameter Material beneath tile (¢2 ] ir,~cs Depth Crib depth Distance betwee, lines Total effective absorption area Type of crib Well Building foundation Nearest lot line DISTANCE TO: Class j~j,/,~ 47 ~ Depth Driller Distance to lot line PERMIT NO. Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER DATE LEGAL F'ERMIT NO. DEPARTMENT, .... HEFILTH FIND EN',,,'IF. ONMENTRL' ..::I-ITECTiL-IN ._~~'~, '~ ¢ ,_,':";'~_ '" L"' STF-:EET., RNRHOF-:RGE., AK. _'~'~-~ ['-'m 'l ..... [:,E',,,'CON ,::BILL L-:UF.'JTHERS LDE:2 HERITAGE F'RRK OLD SENRRE:, HIGHNFI'¢ LOT SIZE ,9 7. ,.-.4. ,9. '~. '9 Sg!LIRRE FEET RPF'L I C:FINT LOC:AT I ON LEGAL TYPE OF SOIL FIBSORF'TION SYSTEM IS: TRENCH MR;:-:; t MUM NUMBER OF BEC, ROOMS = ]~ SOIL RFITING ,::SO. FT/BR)= THE REL.]UIRED SIZE OF THE SOIL FIBSORPTION SYSTEM IS: [:,EF'TH= i2 L_ E ~'-,~ ¢J T'H = i-=:2 Ci F-: R %-' E L E:.EF'TH= 6 THE LENGTH [.',IMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE [:,ISTRNCE BETNEEN THE SURFACE OF THE GROUND FIN[:' THE BOTTOM OF THE ENCR',,,'FITION (IN FEET). THERE IS NO SET HIDTH FOR TRENCHES. THE GRFIVE[_ DEPTH IS THE MINIMUM DEPTH OF GRFtVEL BETNEEN THE OUTFFILL PIPE FIN[''' THE BOTTOM OF THE E,'.,',CR',,.'RTION (IN FEET). F'ERMIT FIPF'LICRNT HFI':; THE F.:ESP]NSIBILITY TEl INFORM THIS [:,EF'RRTMENT DI_IRINF~ THE INSTFtLLFtTION INSF'ECTIONS OF RN'¢ NELLS FI[,JFICENT TO THIS PROF'ERT".,-' AN[:, THE NUME:EF.: OF RESIDENCES THAT THE NELL HILL =,ER,E. -FI~-.~C, .:- ¢- ':, ][ ~'-~5PEE:T ][ C, t'-~ '_----; FIF:E F.'Ei--~I ~ ][ F:E[:, BRZKFILLING OF FINY SYSTEM NITHOUT FINFIL INSF'ECTION RN[:, RF'F'R]',,,'FIL E:'¢ TFIIS [:,EPRRTMENT HILL BE SUE:JECT TO PF.:OSECUTION. MINIMUM DISTANCE BETHEEN R NELL AND FINY ON--SITE SENRGE DISPOSFIL SYSTEM IS ±E~E~ FEET FOR FI PRI',,,'F~TE NELL OR ±5E~ TO 2E~E~ FEET FROM R PUBLIC HELL [:DEF'ENDING UPON THE TYPE OF PUBLIC NELL. MINIMUM [.',ISTRNCE FROM FI PRI',,,'F~TE HELL TO F~ PRI'¢RTE SEI.,.IER LINE IS 25 FEET AND TO Ft COMMUNITY SENER LINE IS 75 FEET. OTHER REQUIREMENTS MAY RPPL'¢. SPECIFICATIONS AND CONSTRUCTION DIRGRFIMS ARE FIVRILBE:LE TO INSURE PROPER INSTFILLRTION. F:EF-:~'I ][ T' E~-::P ][ F:E~S, [::,E,Z:Et'-IE:EE: _---.::t.. iD:E:]: I CERTIFY THFIT ±: I FIM FFIMILIBR HITH THE REQUIREMENTS FOR ON-SITE SEHERS Rh,!D HELLS ets SET FORTH 8Y 'THE MUNICIF'FILI TY OF RNCHORFtGE. :2: I HILL INSTALL THE SYSTEM IN FICCORDFINCE WiTH THE CODES. ]:: I UNDERSTAND THAT THE ON-SITE %EHER SYSTEM MRY REg!UiRE ENL~RGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE 'THI=IN ]: BEDROOMS. ~PLIC:RNT [:EvE:ON ~E:ILL. CLIRI_ITHERG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVI RONIVIENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 5 6 7 8 9 10 'SLOPE 13 14 15 16 17 18 19¸ 2O DATE PERFORMED: ~"-- SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN FT AND (minutes/in( ~ FT COMMENTS PEREORMED .Y: P,. CERT,E,ED BY: DATE: 72-008 [6/79) MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel i.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING <~.~' <~- ./~/t/- 7// HAA # ',~-~c,~ ,~ -~(~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) (b) Location (address or directions) PropertY owner ~-"'~'~'~-'~ Mailing Address (c) Lending Institution Telephone: (home) ~-'¢1~ ~usiness Telephone Mailing Address (d) (e) Real Estate Company and Agent Address ~0 ~~ '~~ Telephone ~ Mail the HAA to the following address: (or check hereof hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eagle RNer Loop Road Eagle River, Alaska TYPE OF RESIDENCE Single-Family¢~ Number of bedrooms WATER SUPPLY Individual Well [] Community d Publiclj~C-- Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. SEWAGE DISPOSAL On-site[~ 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. z2-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION L. 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. Telephone ',¢~' ~'~~ ~ S & S ENGINEERING 17034 Eagle Ri~er Loop Road No. 204 Eagle River, Alaska 99577 Name of Firm Address Date 6. DHHS APPROVAL Approved for ,~ Approved .'~X/ Terms of Conditional Approval bedrooms by Disapproved Conditional Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph $ 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. 72-025 (Rev. 7/88) Back Page 2 of 2 A. WELL DATA Well Classification Well Log Present (Y/N) Total Depth Cased to __ Static Water Level . Casing Height Above Ground MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: L.,c~l ^ · Date Completed Deptb of Grouting 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 To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments If A, B, C, D.E.C. Approved (Y/N) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On AdjOining Lots ; On Adjoining Lots To Nearest Public Sewer Cieanout/Manhole ; Date B. SEPTIC/HOLDING//~ANK DATA Date Installed ~'~/~'~') Size t, ~ No. of Compartments Standpipes~/N) ~/ Air:tight Caps ~N) y Foundation Cleanout Depression over Tank (Y~P~ ~ ~ Qate Last Pumped Pumping/Maintenance Contact on File (Y/N) /~ ; for Holding Tank High-Water Alarm (Y/N) I'~/~' Temporary Holding Tank Permit SEPARATION DISTANCES FROM SEPTIC/HOLEHNG TANK: ' · ; T'o Water-SupPly Well ~-~ ~'~ To Property Line t, ~ +- To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course · Comments '~"~¢')~ To Building Foundation To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ;~ 'Z/'7 Width of Field "Z¢-,~' Square Feet of Absortion Area '¢'//~-~/L.-- Type of System Design Length of Field Depth of Field Gravel Bed Thickness '''~5 Statndpipes Present(C;~N) Depression over Field (Y/4Cj~ ~ Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation '~'~¢'~* Lot I~/~ To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking' Area, or Vehicle Storage Area To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~ ~ ~4- To Cutback (if present) ~/,~ · Comments Date Installed "Pump On" Level at ~ High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Pumpin~~cy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines irt:reffect on the date of this inspection. ', "~"¥~'~ . Signed ~ & ~ ~NGIN~RhNG ~ ,, ~'~ .. Company 17034 Eagle Ri~er b°°P "°a' No. 204 ~~'~ MOANo. ~'-~ %/ ~; Receipt No. 4~)'-~' c~O 7~L~' ~-Y ,~' ~ Date of Payment .--'"'4::w-/"' ~ ~o~ '¢~ Amount: $ ./"..~ 4:~ ,cc, 72-026 (Rev. 7/88) Back Receipt No. _ Waiver Fee: $ Date of Payment Page 2 of 2 APPLIC ?T FILLS OUT UPPER HA[ . ONLY Property, Owner "Devcon Enterprises, Inc. Phone Mailing Address 5411 Old Seward Highway, Anchorage, Alaska zip Code 99502 561-1082 Buyer J. Patrick Foley Address ~ Tradition Avenue, Eagle River, Alaska zip Code 99577 Lending Institution Phone First National Bank of Anchorage Address Eastchester Office, Anchorage, Alaska Zip Code 265-3745 Realty Co.& Agent Century 21 Heritage Homes & Investments, Inc. Phone Tom & Carolyn Szymanski Address 207 E. /~1'.~-.,-*~-.~..-. T4'~/,.~-. 'm^..1 ..... ~ ._~. ..... ^t~ZiPCode ..... 263-2406 Lega~ Description Lot 9 Block 2 Heritage ~ark ~ Eagle River, Alaska Street Locatio~ ~ Tradition Avenue Type of R~sidence ~ _ .. ~] Single Family ' [] Multiple Family No. of Bedroorne 3 [] Other Water Supply [] Individual AI-I'ACH WELL LOG. A well log is required for all wells drilled since June 1975. ~] Community ~) ~' ~ ~_.~--_... For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility Sewer Disposal ~ Individual Year Individual Installed: '19~~ [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE iNITIATED. Time Time Time Time Date Date Date Date(~ - ~-r'r~a- Inspector Inspector Inspector Inspector Field Notes: ~ ~.,. ~, ~ MUNICIPALITY OF ANCHOP~GE DEPT. OF H~ALTH ~ ~$~ ENVI~ONM:NTAL PROTECTION . ~ I,.00 ECEtVED (~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPmOVED ( ) CONDITIONAL APPROVAL* DATE ~ Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received / ~ ~. ~ ~ -~ ~ Well to Tank ~ ' Septic m~k Size /~O O 72.023 (3182)