HomeMy WebLinkAboutBRUIN PARK BLK 4 LT 24 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
NAME 1PHONE ] [~NEW
Dick Hitchcock I 277-5410 [-]UPGRADE
MAILING ADDRESS
2225 Foraker Dr. Anchorage, AK 99503
LEGAL DESCRIPTION
Lot 24 Block 4 Bruin Park Est.
LOCATION NO. OF BEDROOMS
Off Lower O'Malley Road 3
DISTANCE TO: 12 0 '
_o~ 15' 780201
I-- Z Manufacturer Material No. of compartments
~ Sunset Fiberglass Fiberglass 2
Liq, capacity in gallons Inside length Width Liquid depth
1 ~ 000 IF HOMEMADE:
I~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
~O _~ ~ Manufacturer Material Liquid capacity in gallons
C~ Well Foundation Nearest lot line PERMIT NO.
,,-BI, -r DISTANCE TO: 136' 41' 12' 780201
~ ~ ~ No. of lines Length of each line Total length of lines Trench width Distance between lines
F--~ 1 51' 51' 60inches
il- of tile finish Material beneath tile Total effective absorption area
Top
to
grade
m 3 ' 24 inches 357
Length Width Depth PERMIT NO.
uJ
<~ I.- Type of crib Crib diameter Crib depth Total effective absorption area
m Well Building foundation Nearest lot line
u~ DISTANCE TO:
. IClass Depth Driller Distance to lot line PERMIT NO.
.J
"' Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
Castiron & plastic
SOIL TEST RATING
100 S.F./B.R.
INSTALLER
Ellsworth Excavating
REMARKS
Lift station installed on outlet
of tank. Insulation installed ~"~" (~'
~ i/ ~,~ C,~
over drainfield. Bottom of
drainfield trench 4~ above ~.~,
existing
ground
water.
.3/78)
l:::'liEt::ifl'"l I T NC).
1:::1P P L :[ C 1:::1 t",1 'T'
L. 0 C t::I T I O f'.,I
LE(3f:IL.
[:, I CK H I "FCHCO(:::I<:
f": ~:'F: I....OI.,.IEI:~'. . I'IHLL[: T
L. 24 E',4 liii:RI...l!t'.,I Df:lFi:l'::: EST S,.'"I}
2;.Z::.:::5 I::'OI:~'.FtKER [:,1;i: E;~EiESO::!i:
L_ OT :E; t Z E
TYPE OF SC) t I_ FIE:SORE:T' I ON :i.':;'¢S'TEM I S: [:,Rf::l I NF:' ! [EL..[:,
MR',KIMLtM NUME:ER OF E:E[:,RO01"IS =
:Eh] I L F.]::IT I I'.,IG (: SC.:[ F ]",."E:R ) =-' J EtP
'I"HIE REQU I RE[:, :E.:, I ZE O1::' THE SO ! L. FIB:.2;ORP]" I ON SYSTEM I'.E;:
T'HIE t_EIqC:iTH [;.', t MENS t O1'.,I I ti; THE LENGTH ( I N FEET' ) OF:' THE TREI",!CH Oi:;?. [:)RI::I I I",IF: I E'I....I}.
THE [:,EI::'TH O1::' F:I TRENCH OR P Z"r :[.:'..:5 THE D!I-:;T'RNCE BETHEEN THE SUI:;;:F"RCE OF 'T'HE
Gt:;;:Ot_IND I::II",ID THE E:OT'TOM 01::: THE E;;-;;CFIVFITII']N ,::IN FEET).
-IF" il.--.ll [ii.-"...": "'lf"' 11::;.;:: IE tt",.,,il C: ~...~ lb..il ~ llZ:, "1F' F-It Z "_.~,; .'.~;; .. ~?.'g R-Z, nZE, fi::" E: tEE '"'IF"
THE GF;?.R',,,'EI_ DEPTH I:?.q THE MI'NIMUM [:,E.:PTH OF E'iRRVEL. E:ETt.,.IE:EN THE OLrl"I:::F:IL.I .... i='IF'E
I::IN[:' "['HE E?,C)T'TOM OF ]"PIE E::':',CRVFITION ':.'IN I:=EET).
t::'ERM I T RI:::'PL I C':RNT HRS THE: RESF'ONS I E: I L.. ]: 'T'"r' TO I I",II::ORM T'H I :~.:; [:'EF='F:IR'TMENT E)l_ll:;?. I I",l[!i 'T'HE
I NS'/"F:ILLF:IT Z ON I N':'~;I:":'EC'T' 101'-,1~ OF FIN"r' t.,.IELL::S FI[:'JlaCEI",IT TO TH t S I='ROI::'EI"~'.T'¢ I:::IN[) THE
IqL.IMBER OF' RESI[:,ENCES T'HFIT THE HE!_L t.,.ITL. L SEF.'VE.
........................... ""il-' il..,,.~l I(.".]1~ ,::] ;;~..;.'~:': ]:, ]: ~"~,,1t .':~'~;; F:" tt::.~.:Z C:: -'il"" .".[ It-.') [P-'4] ,".E"]~; I[:::~ E;;.:.." EL'; IF~: E:2 (.~:~ IL.Il ..1[
E:F:tC:KF I L..L..'[. NCii OF' Rl"4"r' S"r'STEM 1.41 THOUT F I NFl[...1. N'SPE':CT .1. ON FIND FIF'PRO'v'Fit.... E:"r' TH I
[:,EI:::'RI:;;:T'MENT I.,.I ! LL. liE:I:' :E!;IJBJECT 'T'O F'RO:SEC.:UTI O1",1.
M I I",11 MLtM [:, I S]"t:::INC:tE I~i!:E'T'I.,.IEEI",I F:I I.,.IELL. I:::11'.,1[) Rl",l"r' ON-S I TE %Eb. IF:IGE f':' I SPOSRI_ S"r':E.';TIEM I :!E;
:t. EIO FLEET FOR 1:=1 F'RIVI=ITI:~: I.,.IELL..~ OR
:.1..50 T(] 200 I='IEET F'ROM I:::1 I:::'UE:L. ZC 1.4EL. L. [:'EPENDZNG L.IPOI"4 THE T"r'PE OF F:'LtliE:L. IC HELl ....
O'T'HIEI:~'. REQU I REMEN"F:~; MFd"r' F:IPF:'L."r'. 2i;F'EC I F I CFIT ~ OI",tS F:II",I[:' CONSTRLICT 1 O1"4 [:, I I:::I(:~iI:;i:F:IMS I::IRE
FIVI::i I L.F:IE:LE TO I I",I~;UI:;.':E PR(IF'ER I N~i.:;TI:::ILLt::IT I O1",1.
I CERTIF"r' THFIT'
i: I F:IM I:::'t::IMII....]:t::II:~: HITH '['HE I:;;:EQUIREI"IEN]"S FOR ON'-SI'FE "2;E!qER:E."; F:IN[:, I.'.IE:L.L..':ii; f:lEi; :Ei;IET
FORT'H B'¢ T'HE MUN I C: I I::'RL I T"r' OF t::It",ICHOF.]::IGE.
2.: I HILt_ !I",I::'2;'T'FtLL ]"HE S"r':Ei;TEH IN FICCCIF.:DI=INCE I.,.ttTH ]"HE COD[='S.
]i:: I I...II"4[:,ER'.E:;TI:::IN[:, "i"HFIT THE OF, I-'SITE SEHER "=:;'¢STL=.M I'"11=1'¢ REQLIIRE EI",ILF:IRGEMEI",I]" IF "l"l'-l[ii:
F?.E:i'];I[:,ENCE: IS REMO[:,EL.E[:, TO INCL. I...I[)E MORE T'HI=II'-,I 3: E':E[:'ROOM:':T,.
2204 Cleveland Anchorage, Alaska 99503
PerforMed Fo~ Mr. & Mrs. Hitchcock Oat~ Pe~¢ormed 4-8-78
Lc,al ~escrt,tton: Lot 2___~4Block 4 ,,.Subdivision
Thts ~orm ReaD,tS Sotls Lo~,, ~ , ,, Percolation Test
Peoth
Feet Sotl Characteristics ,.,
' ~" Topsoil & ~ddish'$ilt _
4
Brown Sandy Gravel
10--
Brown Silty Sand
14
.Gray Sandy Silt with occasional
Gravel
16--
18
Bottom of Test Hole
20
~ I!i_
', I1 -I
I ilil
1
Was ~rounH Water £ncountered? .
%~ Yes, At what Depth? ll'
Readin~ Date Gross TJme Net Ttme Depth to H20 Net Dron
} , ,
Percolation Rate Htnute
Prnnosed Inst~11atton: Seeoaae Ptt Dratn Field
Oeoth of Inlet . ,,Depth 'To"'Bot'tom Of Pit Or Tre'nch
C~fX£NTS:100 sq. Ft. drainage.area reou~r~d n~r ~a~nn~ ~n~ ~,,~ ~' ~ ~'
Test Pe~¢ormed Data
Certified Bj~: CTL
Oate: 4-8-78
pTic
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date 71/~t/~~
GENERAL INFORMATION
(a)
Legal Description (include lot, block, subdivision, section, towns.hi~ca'nge)
Location (address or directions)
(b) Applicant Name "J~)~t~/~.4~r,,--,. Telephone: H~o. me Business
Applicant Address .~:~.~.1' (.,~.r.5_5, '~
(c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other,~ (explain); Z~'~'"~
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f)
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~ Multi-Family []
Number of Bedrooms --~
Other
WATER SUPPLY
Well/[~z Community [] Public []
Individual
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsit 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 (11/84)
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 /' i'~-?L~J~
Address
Date
Engineer's Seal
DHEP APPROVAL
Approved for 17~'z'~ ~"D//bedrooms by
Approved ~' Disapproved
Terms of Conditional Approval
Conditional
Date
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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 (11/84)
WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth v
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
MUNICIPALITY OF ANCHORAGE (MOAt
1~4UNICIPALiTy OF ' ~4~ AL TH AUTHORITY APPROVAL (HAA)
DEI:~ OF HE AN~
ENVIRO~,~ .... ALTH & ~CKLIST - FEBRUARY 19~ ~
'~'v~c~rAL PROTECTION 264-4720
-.0~ O~ ~ Legal D~cription: ~~+~~
EC IV D
~~ J VI~O~L If A B~rov~O (Y/N)
~ Date Completed ~ ~ /~ 7 ~ Yield
Cased to ~ r~ Depth of Grouting ~~
~ ~ / Pump Set At ~
~/ Sanitary Seal on Casing (Y/N)
~ Depression Around Wellhead (Y/N)
//~'~:)/"~/~'"'~ To Nearest Public Sewer
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Man hole
Water Sample Collected by
Water Sample Test Results
Comments
' On Adjoining Lots
;On Adjoining Lots / 5(~)/ '-J'"
/
To Nearest Sewer Service Line on Lot
B. SEPTIC/HOLDING TANK DATA
Date Installed ,~?/7~ Size 10~)0 NO. of Compartments
Standpipes (Y/N) ~"'~:-~ Air-tight Caps (Y/N) V-~-'P Foundation Cleanout (Y/N)
Depression over Tank (Y/N) z4~/'~;) Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) //~///~ 'for
Holding Tank High-Water Alarm (Y/N) ff//~ Temporary Holding Tank Permit (Y/N) ,,¢'~/~'-,
Separation Distances from Septic/Holding Tank:
/
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
To Building Foundation
To Disposal Field , /O !
To Stream, Pond, Lake, or Major Drainage
Comments
Page I of 2
72-02601/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~.,,,.i ~ '
~:~--
Width of Field
MUNiCIPALiTY OF AW 'RAGE
DF_PT. OF HEALTi...
ENVIRONMENTAL PROTECTION
bys[em ueslgn
/
Le t ' I vr'r~,-~'~
Id
Gravel Bed Thickness
Square Feet of Absorption Area '~--~'~ ~'' ~ Standpipes Present
Depression over Field (Y/N, /~. Date of .Last Adequ..~, Te~t
Results of Last Adequacy Test ~~~ ~
Separation Distance from Absorption Field: ~
To Water-Supply Well ' / ~ ~ / To Prope~y Line
To Existing or Abandoned System on
; On Adjoining Lots ~'/'~::~(:~
TO Cutbank (if present)
To Building Foundation '~/ /
Lot
To Water Main/Service Line "~"~'/"7
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed ~:~.~'~/'~ ~'.
Size in Gallons
"Pump On" Level at .~J//'
High Water Alarm Level at
Tested for /~5- c~.c.,j~.~
Electrical Codes (Y/N)
Dimensions ~:~('( ~ ~ ~ <~ i!
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 **
' certify t~_, ~e ch~yif~por conformed to all MOA and HAA.,guidelines in effect on the date of this inspection.
Signee~//'/~__'~~ Date '~/~'/~:'~>
Company~~~- MOANo. ~--/~~-~/~
Receipt No. "~
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Engineer's Seal
October 12, 1970
Riclhard Hitchcock
2225 Foraker
Anchoragu, Alaska
Subject~ Lot 24 Block 4 Bruin Park Subdivision
The request for sewer and water approval can not be
granted at thi~ time.
The well serving the subject lot is also shared by Lot 23.
~is puts the well under a classification of Community
Class C. A C~munity Class C well re(p/ires a 150 foot
separation between the Class C well and any sewer system.
The sewer systems on both lots do not meet the ~riteria.
In order to get approval, the sewer systems on Lot 23 and
24 will need to be relocated so they are 150 feet away
from the well. You must also get approval from the
State Department of Environmental Conservation.
Another alternative would be to have the neighboring
lot drill his own well so that both wells would be
classified as private.
Both wells being private woul~ then meet this department's
approval, as long aa they are one-hundred(Il0) feet away from
any sewer system.
If there are any questions, please contact this office
at 264-4720.
Sincerely,
Robert C. Pratt,
Associate Specialist
RCP/lJw
c~ Home Federal Savings and Loan Assouiation
535 D Street 99501
4, Number-off.bedrooms in house. ~ .- .
5. ~atem. Anal~sls:
b. Detergent
'~' .... 6.~ .We.]_l data:
~ ~' c. Casin~ Size._
de
Distance from well to closest existing or proposed:
1. Sewer llne ~ .
2. Septic tank~ 2&
!
3, Seepage Area .~~.,/~ ' .
q. Cesspool~
5. Property hineS.
Other sources of possible contamination, i.e., creeks, lakes,
houses, ham, drainage ditch, etc.
Sewage disposal system.
a, Age of system,
b.
Septic tank capacity in gallons
c. Name of septic tank manufactum~r ~'/',/~f'~,/~..L~/.
1. If "home made" show diagram on reverse side of this form.
d.' Disposal field or seepage pit size and type~
- 1. 'Distance to proper~y., ~.ine m/d ~.~
to house fo~dation~d
.e. Pe~colatio~ Test~e. sults
~.~ . f. Percolation Test performed, by ......... .' . -: .... .
~...~_he foilowing info,at,on: p~ope~y lines;.w~ll location, house location,
~ic tank location, disposal area location, location of percolation tea%,
a~ dt~etion of ground slope.
g. The ~~ti~ on this form ~s true and cor~ct to the best of my knowledge.
% Signature ~f Applicant Date Si ed
TO BE FILLED OUT BY HEALTH DEPARTt.1ENT PERSONNEL
,~- ~e above described sanitary facilities are hereby approved, subject to the
Conditions:
The above described sanitary facilities are disapproved for the following
reasons:
~ 'c .¢ '~ .... Date' .~!' ' , :',~[,i'.,~. / ..... "
""' the date of approval.
..-' CPJ:cw
September 18, 1970
Veteran's Administra~on
P.a. Box 1399
Anchorage, Alaska 99501
SUBJECT: 8~w~{2'"an~.,,Water Systems for
'~6ts 23 and 24, Block 4,
// / Bruin Park)Subdivision
Dear Slrs: '~ ('"\,..~
An inspection of the subject residence revealed that the sewer
system consisted of a septic tank and seepage pit. Wa~er to
the residence is supplied by a shallow dug well located under
the house. A water sample was taken from the well and was
satisfactory.
The sewer system meets with this departments approval but the
dug well must be replaced with a drilled well located beslde
the house to meet with our approval.
Sincerely yours,
CLIFFORD P. JUDKINS, R,S.
Administrative Director
John
Sanitarian
cm