The URL can be used to link to this page

Home My WebLink AboutSOUTHPARK #2 BLK 3 LT 8~CF~s Dt,/t.,Io~ ,/,.~ ~ ~,IDW ~- 0~ MUNICIPALITY OF ANCHOHAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES ~N,.~L,C ,~ \ V ~.9 Environmental Health Division 825 'L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name /~.~/g~ ~ Jo[~'~,,. DISTANCES ~ SEPTIC ABSORPTION WELL Addre~ TANK FIELD ' ~o~ mc.,.~.o. LOT LINE ~// ~ /~]z~ ~ 3 ~ '-~ ~ ~' drivew~y, water bodies, etc.) TANKS ~ SEPTIC ~ HOLDING / TYPE OF SYSTEM ~: . , G ? FT J~/ FT ~Z Z ~ FT ~/~ FT / y7~/~.$ /o / / WELLS ~ PRIVATE ~ OTHER (Identifv) z, ~,.J . - Municipal and State guidelines in ellecl on Ihis date: /0 / z -// ~ ~. 72-013 (3/85) ALASKA eI1UIROnlllEI1TAL CONTROL SERUICES, IllC. October 13, 1987 Department of Health & Human Services 825 L Street Anchorage, Alaska 99501 Attn: Steve Morris Re: Lot 8, Block 3, South Park #2 Subdivision When Lot 9 was developed there was a encroachment on this lot. Earth was pushed over our testhole. The monitor tube has been removed. Pieces of the pipe were found on the lot. It is not feasible a this time to dig a new testhole as there are felled trees over the proposal area for a system. Per our telephone conversation, I request that a conditional permit be issued that states that a monitor tube be installed and monitored for 7 days before construction of the system starts. A letter reporting the monitoring results is to be sent to the MOA. If you have any questions, please let me know. Sincerely, Lero~Reid Jr., Phd, PE President 1200 LUcst 33rd J~u~nu¢, Suite J~ · J~nchera(l¢, Alaska 99503"(907) 561-5040 ,'%% have E~rveyed" the following' described I hereby%certify that I property:. ~T ~ ~--~ ~ ~ ~,~,v,~,~ ~ ~. ~ ~d ~at ~e pro~sed ~prov~ents and drainage patterns are as sho~ hereon ......... EXCLUSION NOTE: - - It is the.responsibility of the owner or builder, prior to construction, to verify proposed building grade relative to finished grade and. utilities connections, and to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AGUA FRIA SURVEYORS 9024 VANGUARD DRIVE Anchoroge, Alosko 99507 ~49- 4688 )ate',-°''~'z'~ JScole I"= s.oJ Grid ~zm. JW.O. e'~ J fb e't-W.._ PERFORMED FOR: MUNICIPALITY OF AI~.L~PALiTY OF ANCHORAGE / DEPT. OF HEALTH & f/~ PERCOLATION ENVBtE)p4~f~,~.I~-d~cI~9~ILTH AND ENVIRONMENTAL PROTECTION OCT ~ ~_7S LOG - PERCOLATION TEST RECEIVED LEGAL DESCRIPTION: 1 2 3 4 6- 7 8 9. 11 13- 14- 15- 16- 17- 18- orerqe-bro..or SLOPE WASGROUNDWATER '~0 ~ ENCOUNTERED? ~ E IF YES, AT WHET DEPTH? SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop .~ PERCOLATION RATE ~:~)~ (minutes/inch) ~' '=~ TEST RUN BETWEEN ,~' VT AND FT PERFORMED BY: /~VC/~ ' CERTIFIED BY: DATE: 72-008 (6/79) PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 6 7 8 9 11 13- 14~ 1§- 16- 17- 18 19 COMMENT~ MUN!CIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST /~l~OI LS LOG PERCOLATION TEST SLOPE L SITE PLAN WAS GROUNO ,ATER ENCOUNTEREO? E IF YES, AT WH~,T DEPTH7 (o"c C. Re/d, -- No. 2251.E e Gross Net Depth to Net Reading Date Time Time Water Drop ~z ~,~ 3 /1?z qoz z,5'9 ,/Z, ' ,/o~ z ~'~ ~1 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN ~7~,'' FT AND ~ ,, FT PERFORMEDBY: _~'~' CERTIFIED BY: DATE: ]/'~) ,~,~ 72-008 (6/79) PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 6 7 8 9 10- 11 13 14 15 16 17 18 194 201 COMMENT,~ MUNICIPALITY OF ANCHORAGE OEPART~iENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST LOG PERCOLATION TEST - SLOPE SITE PLAN C. Reid, Jr. No. 2251-E WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? P Gross Net Depth to Net Reading Date Time Time Water Drop I /p /D 3. , z/i ~/~ I .' I~ ~ , ~ ~ ~ / .'..~,,5' /o ~,7~ PERCOLATION RATE /,."~ (minutes/inch) TEST RUN BETWEEN ':~ ~ FT AND J(/ FT /&,~ --&-o~ 3 4,, PERFORMED BY: L~P~ '~,~ CERTIFIED BY: DATE: ~'~,~ ,oC~ ~:~ 72-008 (6/79) ALASKA enUIROnmenTAL CONTROL SeRUlCeS, IrlC. ~n§ineerin§ & ~nuJronmentel Stu,Jies October 23, 198~ Municipality of Anchorage Department of Health & Human Services 825 L Street Anchorage, Ak. 99501 Re: South Park #2 Subdivision, Block $, Lot 8 On October 23, 1987, Alaska Environmental Control Services, Inc. checked the water level of the monitor tube located on the above mentioned lot. The water monitor was dry down to 14 feet. If you have any questions, please feel free to contact our offices. Thank you. Sincerely, Leroy C. Reid Jr., PhD, PE President ~UNICIPALITY OF ANCHORA~B DEPT. OF HEALTH ENVIRONMENTAL PROI'I~CfI~;~bJ OCT 2 REC EIVFD 1200 LUcsl 33rcJ J~ucnu¢. Suil¢ ~. J~ncJlore§¢, Alaske 99503 .[907] 561-5040 ALASKA ENVIRONMENTAL CONTROL SERVICF~',INC. 1200 West 33rd Avenue, Suite B .ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO ~ OF CALC.L^TED .Y X, t~. ,d DAT~ CHECKED BY. DATE SCALE ~¢ ~,~ E~tRONMENTAL PROTECT[O~ ,/%% 'I hereb~certify that I have ~rveyed the following' described and that ~he proposed improvements and drainage patterns are as shown hereon.. .......... EXCLUSION NOTE: It is the.responsibility of the owner or builder, prior to construction, to verify proposed building grade relative, to finished grade and utilities connections, and to determine' the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AGUA FRIA SURVEYORS 9024 VANGUARD DRIVE Anchorege, Alaska 99507 E,49- 4688 ~ote''~''~'~'~ Jscole I"=.~-.oJGrid~-~'~' Jw.o.e Jfb~-~ Location (site address or directions 4~'~0 Som~hpark Bluff D~.~v~. · - . ; ,,- ,', i t ~- ., Property owner Richard Johnson Mailing address a agency g address lO'less oth NUMBER:( sur i: ,ii'. ~i ' IndiVid Public 4650 Southpark Bluff Driv~ Day phone 522-1181 Anchorage, AK 99516 Day phone ing EiOF WASTE , : lndi~id~a ·- ~mmun 5. STATEMENT OF INSPECTION' BY' ENGINEER 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 applicatiOn shows that the on-site water supply ano/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 myinvestlgation and inspeCtion; the on-site water supply and/or wastewater disposal system isin compliance withall Municipal and State codes, ordinances,and regulations in effect on the date of this inspection. Name of Firm Engineer's signature 'Phone' DHHS SIGNATURE Approved for bedrooms. 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 bHHS d°es thisas a Courtesy to purchasers of h0mes > ::,, andtheirlendinginstitutionsinordertOsatisfyCertain federalandststerequ rements EmployeeSOfDHHSdo not .,. i' conduct inspections or analyze data before a cert f cate S ssued '[he: Municipality of Anchorage is not: "~' responsible for errors o~ omissions in the professional engineer's W0rk: Municipality of Anchorage ,~ Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A, Well Data Well type ~ Log present (Y/N) Parcel I.D. I~B, or C, attach ADEC letter. ADEC water system number Date completed .Driller ....---~"~ .Cased to __ Casing height __Wires pmp~ FROM WELL.~~~- AT INSPECTION Total depth Sanitary seal (Y/N) Date of test Static water level Well tlow~ Pu~4e~ell SEPAR,~TION DISTANCES FROM WELL TO: Septic ......... g tank on lot Absorption field on lot .g.p.m. g.p.m. ; On adjacent lots ; On adjacent lots Tank size /0()(.) ~_~L.- Compartments ~-- ' Foundation cleanout(~N) '~'~-S Depression (Y~j;) Alarm tested (Y/N) Public sewer main Public sewer manhole/cleanou. J-----'~- Sewer service line _ Pet~ cWc~oEr~SAMPLE RESUL~e Other bacteria Collected by: B. SEPTIC/H~.....~ TANK DATA Date installed /O/~/ ~ Cleanouts ~_~) High water alarm (Y.~ ....'.Jo Date of pumping ~.,~//~(/~'- Pumper _~__,~/4~1(' ~ SEPARATION DISTANCES FROM SEPTIC/~-'-~,: .":-'.,',~ TANK TO: ,voga~ to,,'c6s6~o'r- Well(s) on lot oo~l~ ~n adjacent lots ~o r/ TO pmpe~y line [ 0 r~ Absorption field ~ / ~ Sudace water/drainage ~00 ~ Foundation ~- ~. Water main/service line { CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Manhole/Access (Y/N) Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATIO~TION TO: ~ On adjacent Io~ts O. ABSORPTION FIELD DATA Surface water Date installed /0/~9 ?/~G Soil rating (GPD/FF) Z~,,~"/~ Systemtype Leah CPP Wi~h Z - Gravelthi~ness Tota~depth /O '~ Total ab~etion area ¢ ~ ~ ~ Cleanout present) ~¢ Depressbn over field (Y~.~ Date of adequacy test ¢//~ [ ~ ¢ Results ~ail) P~ for ¢~ Bedrooms Water level in ab~tion field before test / ~ ~ /~ After test ~" Peroxide treatment (past12 months) (Y/N) ~O~ ~ Ifyes, g~edate SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot /k.]OhJ~ /D~cd~SC:'/,J/'~On adjacent lots ~_oO r.¢_ Propertyline /O 4- To building foundation //O ['~- To existing or abandoned system on lot /L)O¢36 On adjacent lots LO e,./~ Cutbank /~',5' F~om [.0~¢~ water main/service line / O ~ Sudace water /¢~ Curtain drain ~O~J~ E. ENGINEER'S CERTIFICATION OF' "/'~4E.~C.H - g/..16HTL.Y Driveway, parking/vehicle storage area .~'~ Engineers ~ , ,/.,I Date Eagle ~ver, Alaska 99577 HAA Fee $ ~)z:) ~, ~ Date of Payment '~/,_T Waiver Fee Date of Payment Receipt Number 72-026 (3/93)' Back MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4?44 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING ,~ ~ - f'-') ~,_ ~::~ - [ ~D~ HAA# L"~ ~'~ ?~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Des~c~[~tf~.~.¢ude 10t, block, subdivision, section, township, range) LO~ (ad ~¢e~r~2 pr&~;~%'~:~¢ ~%~* Telephone: (home)~ __Business (c) Lending institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following 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 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 legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. 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 th is 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 [n effect on the date of this inspection, Name of Firm /, '~"~, Telephone 2 ~'-~5'-o'-'~''-''--~ Address Date 6. D HHS APPROVAL .,~.~,~~~ Approved for ,'~ bedrooms by .- _ Date -/, ./- Approved ,;"~ Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 72-025 (Rev. 7/88) BaCK Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) .... Ge Health Authority Approval (HAA) ~UNiC!~A~ITt,.~..~a~.~t"~tStoNCHECKLIST - FEBRUARY 1984 343-4744 Legal Description: A. WELL DATA ~C~t~I~'D Well ClassificatiOn : ~--.(:~/~/~ · I~,~B, C, D.E.C. Approvedl~N) ent (Y/N) Date Completed Yield Cased to Depth of Grouting __ Static Water Le~el~e~, Pump Set At __ Casing Height Above Grou~,,,.,x~ Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) ~_ Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WEL~ , To Septic/Holding Tank on Lot ~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~ ; On Adjoining Lots To Nearest Public Sewer Line To Nearest~anout/Manhole To Nearest Sewer Service Line on LOt Date Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA To Water'Mgi~TSe[vice Li~¢~_~ ~ To Stream, Pond; ~ake or ~or Drainage Coupe Comment 5~ ~M~F ~ ) Date Installed /t'~-~?- I~ ~7 Size .](..)~)~.,~c. No. of Compartments ~ Standpipes ~N) Air-tight Caps ~) Foundation Cleanout Depression over Tank (Y~ Date Last Pumped ~ Pumping/Ma~t,~'F~nt~gt on File (Y/N) ~(~ ; for ~ Holding T~i~h-~"f~"~[~(Y/N) ~0 Temporary Holding Tank Permit SEPAR~O~ DIS~~'~EPTIC/HOLDING TANK: TO Wa~r-Sup~y ~ll ~ ~: To Buildino Foundation~ 1o D~sposal Field ~ ~ 72-026 {Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field c.:~' ~o ~'' Square Feet of Abso~n Area Depression over Fiel~) _ ~]o Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Suppl~/Well To Building Foundation Lot To Water Main/Service Line Type of System Design Length of Field ~'; Depth of Field /O / Gravel Bed Thickness ~ ' Statndpipes Present'q) Date of Last Adequacy Test To Stream, Pond, Lake, or Major Drainage Course /(¢~ ~'- To Driveway, Parking Area, or Vehicle Storage Area //~ Comments? To Property Line ,/~-~ ~ ,-~To Existing or A,bandoned System on ; On Adjoining Lots ~-¢/~ To Cutback (if present) ~/"~ D~. I~TATION sDi%tz in~ "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 Vent (Y/N) ----'-~'"~..~mping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that l have checked, verified, or conformed to all MOA and HAA guide;~:~h~:e'~ 4~li~the date of this ~ ~/~ ..... /~ng~eer's Seal Date ~'~ Receipt No. Date of Payment Amount: 72-026 (Rev. 7188) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 / DEPT. OF ENVIRONMENTAL CONSERVATION/ / ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 316 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 DATE: March 17, 1989 PWSID: 213475 To Whom It May Concern: According to the records on file in this office, the SOUTH PARK TERRACE S/D is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, VERA E. CRAIG Environmental Flel~t officer