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Home My WebLink AboutLAZY ACRES LT 16 C, AAB-HD-] TER ANCHORAGE AREA BOROI DI:I"/~RTMENT OF ENVIRONMENTAL QUALI'I 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL. ~'~/-),-~',-'~-/~. LIQUID CAPACITY /,'~(-~-" __GALLONS. INSIDE LENGTH NUMBER OF _COMPARIMENTS ~ LIQUID INSIDE WIDTH ~ DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS /' OUTSIDE DIAMETER ~ OR WIDTH ...... ~__'"'~-"'_,"'LENGTH___/----~'- , DEPTH~~- LINING MATERIAL___..~- ~' d'~-'''" .~."¢~' ~S'~_~_. DISTANCE FROM WELL ~.~.~.4~-~_ ./'~,,~...~.,¥'..~_L, BUILDING FOUNDATION ~,"~..~ NEAREST LOT LINE_ ~'J '~ '7~...~/--/~-__. TOTAL EFFECTIVE ABSORPTION AREA (WALl AREA) ~'~<~'~'"'~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES~--'~__ ABSORPlI~A DEPTH: TOP OF life 10 EINISH GRADE ..~,'-F'O-O N DA lION ~ EST LOT LINE. DISTANCE BETWEEN LINES ~..RENCH WIDTH __ SQ. FT. LENGTH OF EACH LINE .... DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE ~.~- WATER _ SAMPLE WELL: DISTANCE FROM TYPE ~'~5'M/~"". DEPTH ~"-'"~ , BUILDING FOUNDATION. NEAREST .~,...~.~ SEPTIC ~...~.~..~£ EEP AG E LOT LINE ~ , SEWER LINE TANK , SYSTEM ..... 'c""--"i-CESSPOOL DIAGRAM OF SYSTEM DISTANCES: NEAREST OTHER SOURCES__ DAlE G.A.A.B. GAAB-H D-2 GREATE 327 Eagle St. ANCHORAGE AREA HEALTH DEPARTMEWI Anchorage, Alaska 99501 8ROUGH 279-2511 Case N o..-~> SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT [u~oLL--E~ RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH -~¢~ L ~ LOCATION OF INSTALLATION_O ~ , DRAIN FIELD PERCOLATION TEST RESULTS SEEPAGE PIT BT tZl ,q TO BE INSTALLED BY_. ~/~&~ ~.- , OTHER_ /dgO j~, I)P-~-iL ANTICIPATED DATE OF COMPLETION :25,'? ,,/q r.- A.~',."7¢-.~__. BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS 1'0 SERVE AS ..~2]~~ i~.t2.""~- , PERMIT TO INSTALL A ASDESCRIBFD BELOW. SIZE OF UNIT TO BE SERVED . SEPTIC TANK SIZE [000 DISTANCES: TYPE (?2-/'¥\~qk):.[:'§EEPAGE AREA TYPE _~=.~_~ DIAGRAM OF SYSTEM I AUTHOF~IT¥ LICENSED DESIGNER I certify that I am familiar with the requh'ements of Greater Anchorage Area Borough Ordinance, No. 2~-68 and that the above described system is in accordance with saidI1 code. DATE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAl. PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CER-FIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date .~,j"~'~'~/___'2~.~,_ GENERAt. INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name __~ ~'. Weiss Telephone: Home 344-~8906 Business Applicant Address B341 Poke~ Circle.~ Anchorage Als. ska 9950? Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer [3; Other ~ (explain); (d) Lending Institution Address Telephone (e) Real Estate Company and Agent .... })a,o.t.ffi.c T,~o.~_lfia._~o~%'L$~f~y__~-suxskm~.n~.~a,~;en£_ Address .__l_2'.~Taz(_t_u_$~.Z~%Yi~,~v.~da-o~,%~-~-~.Kaska q~51 5 Telephone ~(L~=oe: T~-1444 (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~ M~Jlti-Family Number of Bedrooms Other WATER SUPPLY Individual Well [] Community E] Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, 4. 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 01/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TEST.;, FILE SEARCH, DATA At'iD INFORMATION Ascerlified by myseal aifixed hereto and as of the validation date shown I)elow, I verify that my mvest~ga:,op ollnCs ideailh Authority Approval shows that tho on-.site water supply and/or wastowater dmposal system ~s safe, funct~or bl¢nc acec~ale for the number of bedrooms and type of structure indicated herein. I fudhe¢ verify that based on d~e ~nfcrmat on cbta ned from the Municipality of Anchorage tiles and from my investigation and inspection, the on-s~te water supp;7 and cr wastewater disposal system is m compliance with all Municipal and State codes, ordinances, and reguiat~ons n effect the date of this inspection. '~ Name of Firm ..~¢ '~¢c./~,~tC~/ ~¢,-~c¢~ Telephone ~ Date --:_~ Approved ............ ?'erms of Conditional Approval CAUTION The Muncipality of Anchorage [)epartment of Health and Environmental Protection (DHEP) issues Hea~ih A~tho~ity Approval certificates based solely upon the representations given in paragraph 5 above by an indep~ndem profe, ssior~e! engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes ~nd the:r lending institufioris in order to satisfy certain federal and state requirements. Employees of DHEP do not conduc~ inspections or analy~e data before a certificate is issued, The Municipality of Anchorage is not responsible for errors or omitS!OhS in the professional engineer's work. Page 2 of 2 72-025 (11104) WELL DATA ~ N~, Well Classification Well Log Present (Y/N) Total Depth _ Static Water Level MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: J-O~!' MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAl. PROTECTION 26 If A, B, C, E).E.C. Approved (Y/N) Date Completed Yield Cased to Depth of Grouting Pump Set At 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 Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~/::4d / Standpipes (Y/N) ~ Air-tight Gaps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~,~/~ To Property Line _ (~,,~4' ' To Water Main/Service Line ~ ~ ¢ Course '7~ LoOt Size I ¢oO No. of Compartments '?-- Foundation Cleanout (,Y/N) ~J Date Last Pumped ~/~' / .~ ~ ~"-- - · for ~,l,/] . Temporary Holding Tank Permit (Y/N) N,/]. To Building Foundation ¢¢¢ I To Disposal Field ~,'~ / To Stream, Pond, Lake, or Major Drainage Cornments Page 1 of 2 72-026(11/84) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ?/'~'d / '7/' Width of Field Square Feet of Absorption Area Depression over Field (Y/N) //¢'Df~t'¢ Type of System Design Length of Field I Depth of Field Gravel Bed Thickness &~,~ Cr.r. rJr Standpipes Present (Y/N) Y' J .~ Date of Last Adequacy Test .~/2_.-.y/~'~ '~'~/ Results of Last Adequacy Test S~.~c,~r"~,' Separation Distance from Absorption Field: To Water-Supply Well N,~' , ~ ~¢¢ To Building Foundation Lot N,A, ; On Adjoining Lots To Water Main/Service Line ~ I I,q~ To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course _~ (c.,)O ' To Driveway, Parking Area, or Vehicle Storage Area ~ f¢O~ ! '1 To Existing or Abandoned System on Comments 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 MOA and HAA guidelines in effect on the date of this inspection. Signed v..~,~._ Receipt Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) APPLI¢ ,qT FILLS OUT UPPER HAl. ONLY Lending tnstituiion AddreSs Zip Oode ~¢A · :-~ L¢¢ x ~ ~,.~ ...... ,/.~,~ ,.~ / , ~"¢" . ,- ......... ~..,/ ...... . Phone / Type of Resi~nce ~ingle Family ~ Multiple Family No. of Bedroo~ Water Supply ~ In¢lvidual A~ACH WELL LOG. A w~l Icg Is required for all wells drilled since June 1975. ~mmunlty For wells drilled prior to that date, give well depth (attach Icg il available). D Public Utility Sewer Disposal ~ Public Utility When Connected 1o Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Tlr'ne Time Date Date Date Date Insp~tor Insp~tor Insp~lor Insp~tor (~) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received 4-~&~d) Well to Tank Septic T~k Size 72-023 (3182) ALASKA EIUIROFlmI FITAL COFITIROL $ I UIC S, IF1C. ~n§inecrin§ 6 ~,~ironm~ntol $1udies 9/24/82 MUNICIPALITY OF ANCHORAGE ENVh :~ ' ~ ' .... I [¢ECEIV SAFECO TITLE COMPANY 3201 C STREET/SUITE 101 ANCHORAGE AK 99503 SELLER - GUS WEBB BUYER-MARY WEISS SUBDIVISION-LAZY ACRES BLOCK- LOT-16 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 288 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 700 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3 BEDROOM HOUSE. ~.'~ ~eroy~. Reid Jr -~.~p~. ......... _~v~ 1000 IS ADEQUATE FOR 1220 U Jest 25Ih Au(roue · ADchor~§6,/~loske 99503 · (907) 276-1361