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Home My WebLink AboutLAKEWOOD HILLS LT 16 GAAB-HD- I GRE,~ATER ANCHORAGE AREA BOROLL~H ~ HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-:z:~11 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM · ADDRESS NAME PHONE. SEPTIC TANK: DISTANCE FROM WELt (~"O I LIQUID CAPACITY / ~)O~-) ~/'' GALLONS· MATERIAL ~ C~/~'/~'k~- '~ ~[-0 C,~ NUMBER OF ~ COMPARTMENTS INSIDE LENGTH ~ ~'i q' INSIDE WIDTH L~ UID ~1-! SEEPAGE SYSTEM: NUMBER OF PITS~ LINING MATERIAL NEAREST LOI LINE SEEPAGE PIT: OUTSIDE DIAMETER /O0' '* OR WIDTH DISTANCE FROM WELl TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,LENGTH ~;,~ ' ,DEPTH ~-~ BUILDING FOUNDATION ~ "~ ~:~(~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELl NUMBER OF LINES ABSORPTION AREA FOUNDATION , NEAREST LOT LINE DISTANCE BETWEEN LINES TRENCH WIDTH SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE' IN. ABOVE TILE WELL: LOT LINE TYPE t.,,~v, cuu~t~"h'~:JJ)'/) DEPTH ~,~D,~ i DISTANCE FROM JO I ' WATER ,BUILDING FOUNDATION. : SAMPLE__ NEAREST SEPTIC ,~ ~' SEEPAGE j OOI , SEWER LINE , TANK . SYSTEM , CESSPOOL , NEAREST OTHER ,SOURCES DISTANCES: D--fi: ,fo' DIAGRAM OF SYSTEM " · GREATEL ..NCHORAGE No. / gb GAAB-HD22 327 Eagle St. SEWAGE AREA ROUGH HEALTH DEPARTMENT [ 279-2511 Anchorage, Alaska 995 b~c) NAME OF APPLICANT ;~? .//;c?.~;77~ RESIDENCE ADDRESS r/-/--:z s,~-/~- /'9r5,,c-. LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK. TO SERVE THE FOLLOWING FACILITY ...4'/z-,,r/e ,, SEEPAGE PIT ~ , DRAIN FIELD MAILING ADDRESS /¢-r~.~o~o,;'<~--- PHONE NO. - , OTHER FINANCED THROUGH ////o?.f ~. , TO BE INSTALLED BY PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS · SEPTIC TANK SIZE DISTANCES: /g~/'2. //]//~//W'ff/W&-5' , PER~IT TO INSTALL A S~~ 5'/~/--~ , AS DESCRIBED BELOW. SIZE OF UNITTO BESERVED ~ ~/~o~ ~~ /000 TYPE ~C[~ , SEEPAGE AREA~TYPE CO~' DIAGRA~ OF SYSTE~ / ' Health Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. iTER ANCHORAGE AREA BOROUGH ,' HEALTH DEPART!~ENT CASE 327 EAGLE STREET ' ANCHORAGEs AL^SKA'99501 Le ~al Deserz~tlon: ~ot/~ Block This Fomm Reports a~ So~ls Log~2~ Depth Fee~ Location Sketch Soil Characteristics Was Ground Water Encountered? ....... at Depth " Date Gmoss Time Net Time ?roDosed Instaliat3~on: Seepage Pit ~< Drain Field Data Certified MUNICIPALITY OF ANCHORAGB DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 ,~ Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) /~3~D///&L~,/~E/~ Property owner Mailing address Lending agency:.. / ~/;~¢t-~-~ ~ Day phone Mailing address Agent _~J Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Fronl MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I yerify that my investigation of this Health Authority Approval applicatio~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 ba.sed 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 -..~'/~'LH ~-o")?,~/-,zJ/'~'~:5' Address ~, ~0~ //~/ ~~ ~ Engineer's signature ,/~~ d ' bedrooms. DHHS SIGNATURE Approved for ~' Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date 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 purchasem of homes and their lending institutions in order to satisfy certain federal and state requirements. Em ployees of DHHS do not condu~t 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. 72qY25 (Rev. 1/91) Back MOA If21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Legal Description: ~.~)'T ///~ Z/ox/d'~c'w~)/~.~/_.~ Parcel I.D. If A. B, or C. attach ADEC letter. ADEC water system number Date completed /~ ~ Driller Cased to ~;~;'J ' Casing height Wires properly protected (Y/N) /-r/ FROM WELL LOG AT INSPECTION Date of test ~ ,/~,~ Static water level /~ ~ Well flow ¢.~ g.p.m. ~. ~ ~. Pump ~eve~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~' ~E~~ ~ ~.O,~ ; On adjacent lots Absorption field on lot /~ t~f~. ~ ~ ~., On adjacent lots Public sewer main ~ Public sewer manhole/cleanout ~ Petroleum ta'nk ~a Sewer service line WATER SAMPLE RESULTS: Coliform ~d/~)'5 ~c~cT~rJru Nitrate ,¢, ,~n~/~ Other bacteria J ~ . . Date of sample: ~ -/~ - ~ Z Collected by: ~ ~n3]E~ B. SEPTIC/HOLDING TANK DATA Date installed /,~ '~' Tank size /~DO -~Q/. ~ Cleanouts (Y/N) ~ Foundation cleanout (Y/N) /k/ High water alarm (Y/N) A/',z~ Alarm tested (Y/N) Date of pumping ~-/_,R --,.0 ~ Pumper ' -~'5 <~,~(-_5' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~'~' On adjacent lots ~Z~C~ ~ F°u ndation To property line ~,~~ Absorption field ~ 7' ' Surface water/drainage /~/0')?~ ~/ZT/O/zo'/~',/~z'~ /~ ~'~:~'~'. Compartments ~77E ~' Depression (Y/N) /~ /8' Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) ~_.~~" Vent (Y/N) "Pump on" level at "Pu~vel at High water alarm level ~ esteo Meets MOA electrical codes (Y/N) SEPA~TATION ~/:¢e44n%n lot On adjacbn't I~(~ ....... Surface water D. ABSORPTION FIELD DATA Date installed ~ ~,¢.¢¢_.~/3 ~.~ ,~' ,7'7' Soil rating Length ~ ' ¢~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) /O/~.~..~ for Peroxide treatment (past 12 months) (Y/N) /V' Gravel thickness (o" '~ Cleanouts present (Y/N) Date of adequacy test__ System type Total depth bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /~g~/ On adjacent lots ~T,~2~,~z~' Property line -_,~67/'6 To building foundation ~,?~/C. /¢~-¢ ~7/ Toexisting or abandoned system on lot On adjacent lots ~¢~L~ Cutbank /%/ Water main/service line /¢',~ Surface water /~/O~ /C¢u~d/u)/J'J)/~/~¢'Dr veway, parking/vehicle storage area Curtain drain /~/0'27¢ 4~ ~'/~.~/~ F~?OI~ /~OY~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection, Signature ~, ~,~ Engineer's Name Date HAA Fee $ /7~ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL rABORArOR¥ A DIVISION OF COMMERCIAL TESTING & ENgINEERInG C0. 5633 ~ ~TREET ANCHORAGE, ALA~ ~0518 T~LEPHONE (g07} ~2-2343 FAX'. (~7) ~61-53D1 ~ze~e~Va~ ~l~h : h~ Cl~e~t Ne~ ~3 ~ L ~ CON~TANT~ O~deted ~y Sen~ gepo~ta to: ~or~metet ~eeul~ Un~t; ~e~hv~ hi. low,hie NI~R~E-g ~.5 ~4/1 EPA ~$3.2 lO ~e;na;ks: -',.~, · . .... · ...... ,... .... ~.~=..... .... ND- None Detected "See S~mple [em,~rk~ ~bov~ Member o! the $G8 Group (8ocl~)te (~enerale de Survelllen~e) ,~~, ~-~UNICIPAL~TY OF ANCt ;f,~-2~i~\ · DnPARTiqEN, - ~EALTH ANO ENV~RO kNTA 'ROTECT~ON ~[~y~))" ' 825 L[ ~reet, Ancherane. Alaska 99501 ~ ~: Time _ eR6~' / ~2: Time ~3: Time Date ~O~OlqW Date ~ Da~e 1 REQUEST FOR APPROVAL OF INDIVIDUAL S',EWER AND WATER FACILITIES /~ ~~k~ % Mary Ann Dodge 1. Lending Institu-z~on%~ ~ ~e~.'u First_~ ~' N~atio,~,ai Bank of ~choraqe Mailing Address: Post Office Bo~20"~'510 Phone: 276-6300/572 Sa 2. Property Owner: Robert/Barba~n rhenke ~hone: Mai~ing Address: % ~ep W~dwell%[ Jack White Co~pan~ ~ 277-1553 3. Legal Des~ri~{'ion· Lotk!6 ~%od Hills S~bdivision 4: Single Fami Ey[ Res J denen~~: : Number~of ~edrooms: Multiple Family Residehf,.g: ( ) Np~ber of Begrooms: _____ 5. Well SystemS Ina, ivia~l well (x[//Co~mnunity/Public Sys%em ( ) Permz~ ~f ~ ~ Depth of ,Well Well Log on Fzle ) Construction ~,,," Bacterial Analysis / 6. Sewage Disposal System: ~-site System (x) Public Uhi!ity ( ) Permit # Installed /~ Installer Septic Tank Size /~ Manufacturer 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Page K%¢o Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 16 Lakewood Hills Subdivision Comltlent s: Affadavit Attached: ( ) Approved: ~~ Disapproved: Letter Attached: ( ) Date: Department Worksheet: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES Iv~JNICIPALITY OF ANCHORAG[- DEPT. OF HEALTH & ENVIRONtV~ENTAL PROTECTION SEP 3 9 lg77 RECEIVED Type of nspection: CMRO VA FHA Property Owner: Robert and Barbara Ann Marhenke CONY x · Mailing Address:, NHN Hillside Dr. Anch. Day Phone: Name of Buyer: Darrel R. and Suzanne E. Renner Mailing Address: 2510 E, Tudor Rd. Anch. Day Phone: 279-2775 4. Name of Lending Institution: The First National Bank of Anchorage Mailing Address: P. O. Bo'x 720 Anchorage, Ak. Phone: 276-6300 x572 5. Name of Realtor or Agent: Ken Wardwell Jack White Co. Mailing Address:. 3201 C St. Anchorage, Ak. Phone: 277-1553 6. Legal Description: Lot 16 Lakew~od Hills Location: NHN Hillside Dr. Anchorage, Ak. 7. Type of Facility to be Inspected:, 8. Water Supply Type of Supply: SFR No. Bdrms. Public Utility Individual Well If Individual, number of dWellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) Septic Mary Ann Dodge R.E. 276=6300 x572 9/26/77 72-003(3/76) /~ 'dNICIPALITY OF ANCHORAGE "' ~'~2Z~--'~ ~) "~.~ Department of Health and Environmental Protect.~on _ Mailing Address: ~_OSP %~~- Phone:~p ~1%~ o o Name of Buyer: Mailing Address: Phone: Mailing PZddress: / Phone: Realtor/Agent: Mailing Address: Phone: Street Location: ~ .~[.~% ~, O~ e' ~~ Single Family Residence: ~' Number of Bedrooms: ~ Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: * Individual Well If Individual_ Well, well depth ~O Public/Con~nunity System If Con. unity System, name of system Sewage Disposal System: *~Dn-site System ~/~ Public System ( ) If On-site System, date of installation: ( ) *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can bo initiated, 3/77 December 13, 1977 R&M No. 751548 Jean Pope 2174 Arcadia Anchorage, Alaska 99503' Subject: Adequacy Test on Sanitary Sewer System; Lots 15 & 16, Lakewood Hills, Anchorage, Alaska Dear Mrs. Pope: On December 12, 1977 at your request, we conducted a test of the septic system on the above described property. During the test the liquid levels of the septic tank and seepage pit were monitored as water was added to the system. The following table summarizes these observations: Time Liquid Level Liquid Level Gallons Septic Tank, Feet Seepage Pit, Feet Introduced 10:16 3.0 6.15 25 10:27 2.9 6.1 25 10:50 2.9 6.1 25 11:03 2.9 6.05 40 11:38 2.9 6.05 35 12:00 2.9 6.08 Ail liquid levels were from the top of the standpipe. The meter used is a Rockwell 5/8" standard water meter previously calibrated by R & M Consultants, Inc. If the 2 bedroom residence is to house 4 people, the average load on the system can be expected to be 300 gallons per day or 0.20 gallons per minute. During the test, the system accepted 150 gallons, or 50% of the daily load in 6.6 minutes. This is an effuent acceptance rate of 2.27 gallons per minute of the test time. We conclude that the system is disposing of effluent at an adequate rate for a two bedroom residence. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA DecEmber 13, 1977 Jean Pope Page -2- We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or letter or if we may be of additional service. Sincerely, R & M CONSULTANTS, INC. Robert L..Schraeder Associate WFA/RLS/kah De~ember 6~ 1977 Alaska National Bank of ~he North % Jay Kennedy 3301 C ~tr~et, Calais II Anchorage, Alaska 99503 Subject: Lot 15 and 16 Lakewood Hills S~bdivision Evidently there has b~n an upgrade on the exist~'~g sewer system serving the above sub6~ct property. This, then, will require a percolation test performed by R & M Engineering. Please refer to the letter dated l~ovember 30, 1977~ if the system fails to meet the adequ=cy test. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S; Sanitarian RCP/lJh~ ~~ November 30, 1977 Alaska National Bank of the North % Jay Kennedy 3301 C Street~ Calais II ~%chorage, Alaska 99503 Subject: Lot 15 and 16 Lakewood Hills Subdivision Before we may approve the request for the sewer and water fa~ilities, we will need to know the location of the well so that we can ~nspect it to see if it meets code. We, also, will require a percolation test on the existing system so that we can make a determination on its adequacy. If it fails to pass the percolation test, an upgrade will be necessary. Before any construction b&~ns, a permit must be obtained through this office. If there are any further questions~ please conRact this office at 264-4720~ Sincerely, Robert C. Pratt, R. So Sanitarian RCP/lJh cc: D. Jean Pope 4000 Harrison 99503