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HomeMy WebLinkAboutSPANISH HILLS LT 2 MUNICIPALITY OF ANCHORAGE DE ITMENT OF HEALTH AND HUMAN SER\ -"S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEI~ AND/OR WELL INSPECTION REPORT No el Bedrooms I Townshq), Range, Section TANK8 D/7 ! .g t 0 DISTANCES  SEPTIC ABSORPTION TANK FIELO WELL WELL / ~ O j~, ~ LOT LINE '70 "~ '~" ~. ~ FOUNDATION a~. 0 . j /'7/0 5~5 AS-BUILT DIAGRAM (Show iocahon o] well, septlo system, property hnes, foundahon, SEPTIC [.] HOLDING f TYPE OF SYSTEM '['~TRENCH [] BED [] W. DRAIN [] OTHER SO FT Number oi hnes Sod raImg SO FT Date Ir slalled , WELLS [] OTHER (Identify) ......... j q 0181 []eplh J Cased lo FT FT REMARKS: Scale: J ,.~'~' ENGinEER'S SEAL J Ins[).ochor]s Performed by: .,,;: % ' ('~lJ ,¢g ,~ ::, , I ~ ~~~ codify thai ti, is inspeclion was pedorllled according lo all': "~ [io.. 22 '; ~ [ " ~ '4~ -"'L".: ·. . ,',':"- 72-013 (3/85) [L/i'~£~ DI]ILLING, Inc. P,O, Box 110378 e 10330 Old Seward Highway (907) 3,t9-8535 ANCHORAGE, ALASKA 99511 87-169 DtilLLING LOG Well Owner _~iOJ3!e Eq.u.i tv Use of Well Domes tic Location (address of: Township, Range, Section, if known; or distance main road L~_t__2_ Block 1 Soanish Eills Subdivision Size of casing Static water level Screen ( 6" Depth of Hole_ 350' feet Cased to 304 ' feet 265 ' ft. (aJ~g~e) (below) land surface. Finish of well (check one) open end ( ); ); Perforated (XXX). Original csg broke ~ 212'. 4" steel liner insca~ Describe screen or pcrforation..fror& 180' to 345' - perfd (torch slots) 305-345' Well pumping test at_~3 gallo~'_,s pet' ~.~RW) (minute) for 17 hours with *** ft. of drawdown from static level. ***Could not measure pumping level, bu.t Date of completion 1 _Se_?.ter,_kb_er.__~98__Z.7 had not dra~m down to pump intake. WL~LL LOG Depth in feet frorn ground surface Give details of formations penetrated, size of material, color and 0 fie 103 103 TO 111 l!l TO 143 ]43 TO 204 20~ TO 250 Existing well Water bearing gravel --1 GPM Brown silty gravel -- wet Brown silty gravel __~E-~O~_~ravelly hardpan DEPT. OF HE~,~. ~ RECEIVr t) ?_50 TO 275 275 TO__Z95 Gray_gravelly harman _B~iox:~_grav~j~ly'h_ardpan 29.5 TO ~P8 30~ TO 353. __TO Brown cemented gravel ~- waterbearing -- 1 GFM ~ 304' Brovm cemented gravel -- waterbearing -- 5 GPM el 350' TO TO .TO .TO .TO NWWA Certified Contractor Certificate No's. 814 & 973 1 -- CUSTOMER () 4 !1. ,, / PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES (ENGINEER'S SEAL) · ":': 825 "L" Street, Anchorage, Alaska 99502-0650 ' SOILS LOG -- PERCOLATION TEST Township, Range, Section: LEGAL DESCRIPTION: WAS GROUND WATER ENCOUNTERED? 5 6 7 8 9- 10 11 12 13 14 15 16 17 18 19 2O SLOPE SITE PI. AN IF YES, AT WHAT DEPTH? DeBth lo Wa(er Afler ~O MDnitorin§? Bale: I- N Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~"*"~ (m,nutes/,nch) PERC HOLE DIAMETER ~ ~/ PERFORMED BY: ~ ~ ' ~, ~. CERTI~?~;;IS TEST WAS PERFORMED I" I ALLSTATEANDMUNICIPALGU DELNES N EFFECT ON THIS DATE DATE / ~/, /~¢¢ CONSULTING ENGINEER ?03W 15thAVE"C' SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE:{907) 279-3916 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O.BOX 6-6650 ANCHORAGE, ALASKA 99502-0650 MAY 27, 1987 Subject: Ground Water Monitoring Lot 2, Spanish Hills Gentlemen; Because a substantial amount of water was observed in the sump of the drainfield located on subject lot, a test hole was drilled and a monitoring tube installed on on May 11,1987. Total depth of testhole was 15 feet. Ground water was not encountered during drilling, nor was any water observed on May 18, 1987, seven days after installation. Yours ~"~ <_... ,,-R ANCHORAGE AREA BORL ..GH / GREA It ~,,, <~, Department of Environmental Quality ...... 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME~"~'I (-~-- \/~JR ,'c~LjC MAILING ADDRESS~~'>~'~' '~c:s~ ~::~ ,~'~ A PHONE LOCATION LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH_-- INSIDE WIDTH ~ LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY J ~$'OGALLONS TILE DRAIN FIELD: I ~ TOTAL LENGTH ~_3~.0 / DISTANCE FROM WELL _J0o~l~"~ F~OUNDATiON q O NEAREST LOT LINE_ JO OF LINES NUMBER OF LINES I DISTANCE BETWEEN LINES _ J'J/~' TRENCH WIDTH'~/~. IN. TOTAL EFFECTIVE ABSORPTION AREA fl L-~ (.j2 SQ. FT. LENGTH OF EACH LINE ?-) ("¢;> ' DEPTH OF FILTER DEPTI4: TOP OF TILE TO FINISH GRADE q MATERIAL BENEATH TILE ~(¢ IN. ABOVE TILE. ~ IN. WELL: BUILDING FOUNDATION-- CESSPOOL - APPROVED CONSTRUCTION NEAREST NEAREST LOT LINE_--, SEWER LINE__ OTHER SOURCES DISAPPROVED REMARKS DEPTH _ SEPTIC SEEPAGE TANK--, SYSTEM_ DISTANCE FROM: DISTANCe__ INSTALLED BY:(~?~')~- -- SEWER LINE DEPTH: LOT SLOPE: DIAGRAM OF SYSTEM DAT,~Th~]~_ App R OV ED ___C4~_ G.A.A.B. Form LQ-032 'l't"~l:!:: I.. liii:l',IGTI.'~ I::, ): !"!l::l'-,!:i: ]: i::)i'-.!, :!: 15 TH!:: I_.ii'~N('}iTH iI.'11: i::,iiii:i:::"~l'H OF: I::i '!'Fd!i:l",!Cl-~ ~::~t'.~: F':[T :!::i:~; 'i'HE: i:::,:I:F:iF:INCI~:: I~fl::'f'!,.l!:::l::N TI."I!: ~;I..IIRF-'I:.:i(::I::: OF' !'HF:: diF~:Ol..ll'41::, I::~N[::, !"1'41::: I~OT'i"OH O1::: Tiff: I:',:.~',CI:IUFI"I':i:Ot'.,I T'I"]I: Gi:;~:FI',,,'I'~:I i)Ei!:::'"t'H '[ :~5 TI'"tI~: I"! ): H :!: HUH i::,l~:l:::'TII F~NI::, T'I'"II~: E',OTTOH OF' 'fl'"l~: I:i:':/CF:I',,,'FI'f' :i: ON ,:: i:~::I:"I"t'Ii:F: FI C:I...FI:5::~; :[ OFf. :!: :i: l",i:~;i':' I::t]:'F'I4~:O',,,'I:~:I::, F:'I..I:::IHT :i: :1.: F'OI:;i:'i'!. ;::: :I: i.'.l :!: ]..J... :!: l'.,l:~i;"l'(':ll._!. 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FIF'I:;:'!... :i: CI::Ii",I']' I:~'::t<: [.,!F~: ~il'l't' Log o;t.' l~ate~..iai, s 2!-- 6 t o p s o i ! 7~26 gravei 2',/.~49 5().~U8 grayJ, r~h c];:~,y ;md sl,'ia~ I. ~a~,oun'l; 02' water 89--5)7 brownish cla, y and 97.-105 'b~oken :~:'ock~ water MUNICIPALITY OF ANCHORAGE ~ / DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY Appiication Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) / (b) Property Owner ~O~ .~lTy Telephone: Mailing Address ~ 7t~ ~'~'- (c) Lending Institution I-AN Home Telephone Business Mailing Address (d) Real Estate Company and Agent 7m,~ 1~4/"/~ C//~/', ~' Address ~¢J.O I "C" ~ ~ Telephone ~ ~" ~" ~ (e) Mail the HAA to the followina 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~' Communityr-I Publicr-I Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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 fRev 8/861 Front ')~JOAA $,J88U!J~U8 leUO!SSe,toJd aq]. u! SUO!SS!LUO Jo sJoJ.~a Jo,t alq!suodsaJ ].au s! 85eJOqaUv ,tO X].!ledF:)!u nI,N aqJ. 'penss! s! a],eogjpao e o.~o,teq el. ap az,4.1eue Jo suo!:Joadsu! ].3npuoo ].au ap SHHQ ~.o soaXoldLu:q 's~.uat.u@J!nbaJ @].e].s pue leJepeJ, u!e]/Ja3 A].s!l. es al. Jop.~o u! suo!].n],!~.su! bu!pual .~!eq~. pue sauJoq ,to sJaseqa.md al Xsa:unoo e se s!q]. soap SHHQ eq..L 'e~SelV ~.o al.e.lS aq~. u! pa.Jel, mbaJ .~aau!bua leUO!SSOj, oJd ].uapuadapu! ue Xq a^oqe S qde.16eJed u! u@^!8 suo!lel, uesoJdaJ aq~, uodn .41uo paseq saleoiJ.!~Jao le^o.idd'¢ X].poq].nv ql. leOH sanssf (SHHC]) sao!^JeS ueuJnH puc q]/leOH ,to ~,u@uuped@c] abeJOqOU¥ jo ~].!ledp!un!AI eqJ. NOIJ. PI¥9 le^oJddV reuo¢!puoo ,to SLU,JOJ. pe^oJddes!d ~' p@^o~dd¥ '1¥A0 Udd'V SHHCI '9 'uo!loa-dsu! 9!ql jo alep aLil ua loa,t,to uf suo!lelnOaJ pue 'saoueu!pJo '9apoo a],e:lS pue led!o!unh! lie q:l!M eoUo!ldLUoO u! S! LUm, S.,(S lesods!p JaleMa].seM Jo/puc Xlddns JaleM al!s-ua eq), 'uof].oadsu! pue uoileO!lsaAu! XLU LUO.I,t pue sel!J aOBJoqauv ,to /;l!ledF:)!un~ aql LUOJt paulelqo UOgeLUJOJ. U! alii UO paseq leq]. e],enbape pue leUO!].ounj 'alee qlleaH s!q],,~o uof:leO!),SOAU! XUJ leql ,(J. po^ I 'Moraq UMOqS a:lep ua!loP!lO^ aq]~,to se pue olaJoq pa×!,t,te peas XuJ Xq pa!Hpb:2 sV NOII¥1NI:IO-INI QN~ vJ.¥a 'HOld'~]S :I'11-1 'SJ.S~lZ 'SNOI/O::IdSNI 9NIQIAOI:td ~t:tl..-I 9NII:I':I:iNION:I .§ MUNICIPALITY OF ANCHORAGE (MOA) ..... c)~'/,,h~',' h .... ,. (I~IEALTH~ AUTHORITY APPROVAL (HAA) ~'~\c~?.~i~t '.;~:;/~ ': "~ ~'"' ..... CHECKLIST-FEBRUARY 1984 ~.M~ V,~O~¢~ 264-4720 WELL DATA Well Classification Well Log Present (Y/N) Total Depth ~,.~- C) Static Water Level ';' /,2" Legal Description: 5--_-~ ¢.6, 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 If A, B, C, D.E.C. Approved (Y/N) t"///,~ Date Completed q//*/¢¢ '~ Yield Depth of Grouting Pump Set At ~o T'FO Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) I O,~ ; On Adjoining Lots I 2,. ~// ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments N 12 1'4 ~. To Nearest Public Sewer NI.O IQ ~. To Nearest Sewer Service Line on Lot ~ ! '~ B. SEPTIC/HOLDING TANK DATA Date Installed /7 "7 Standpipes (Y/N) O/'¢¢.,-- Depression over Tank (Y/N) To Water-Supply Well To Property Line To Water Main/Service Line Course Size /~'~(~) No, of Compartments Air-tight Caps (Y/N) _ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: Foundation Cleanout (Y/N) Date Last Pumped ~/z./~ ~////"~-- ; for Temporary Holding Tank Permit (Y/N) To Building Foundation f To Disposal Field / L~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 7/7 ~ Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot /~/62/~//::~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ,~ To Cutbank (if present) Comments L,FT STA.,O. NO 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, verifieC~or conformed to ail MOA and HAA guidelines in effect on the date of this inspection. Signed .~,~ Date Company / MOA No. Receipt No. /O Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 ' GENERAL INFORMATION /MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) PropeHyOwner ~O~ ~u~T~ Telephone: Home Business Mailing Address ~, (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent (e) Address Telephone Mail the HAA to the followina address: or: Check here~.~ if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family, S,, Number of Bedrooms WATER SUPPLY ~ 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 / 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 IRev 8/flRI F/onl 'HJOM s,Jaeu!Sue leUOiSSe~o~d aLI~ U! SUO~SS~UJO ~o SJO~a ~o~ elq!suodse~ ~ou s! aSe~oq3uv ¢o/~!led!olun~ @q_L 'penss! s! eleoil!pe3 e a~o~eq e~ep azXieue ~o suo!~o~d~u! ~3npuoo ~ou op SHHC] ~o s@@/,olduJ=t 's~uaLue~inb@~ e~e~s pue le~epe~ u!e~,~@3/,,Ls!les oi ~ep~o u~ suo!~n~i~su! 8uipuel ~ieq~ pu~ s@uJogj ~o s~@seLIoJnd O~ ~sepno3 e se siq~ seop SHHQ aLi j_ 'e~sel¥ to e~e~S aq~ u! pe~a~s!Eie~ ~au~l~ua I~UOiSSe~o~d ~uepu@depu! ue Xq e^oqe cj Llde~Ci~ed u! ue^i8 suo!~e~uasa~deJ @LI~ uodn ~lUO peseq s@~eo!~iPa3 le^o~dd¥ ~poLJ~nV q~leeH senss! (SHHQ) sa3!^Je$ ueuJnH pue LI~IeaH ~o ~UaLupedec] aSe~OLIOU¥ ~O ,~!led!o!unJN eL4/ NOI.Lm/O leAOJdd'¢ II~UO!~!puoo ~o SLUJe.L leUO!~!puoo p@AoJddes!Q -~ p@AoJddV eleUSiS, o/,~1~.~. /~q suJooJpaq ~ Jo, p@^oJddvl~f^O ~lclcl~ iVlUNIcIPALt~y OF q ~ A. WELL DATA 0 Pd P-A Well Classification p Well Log Present (Y/N). ,/N/' MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 · If A, B, C, D.E~C. Approved (Y/N) . Total Depth ?~ ,~¢ .~,) Cased to Static Water Level ,.-~ 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 To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by _ Water Sample Test Results Com ? Depth of Grouting ~'~ O~',,¢ 1'~. Pump Set At /.-gO 7- ~'-© ~/-~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) _ ; On Adjoining Lots /-// ; On Adjoining Lots To Nearest Public Sewer Nearest Sewer Service Line on B. SEPTIC/HOLDING TANK DATA Date Installed '~/~ Standpipes (Y/N) Depression over Tank (Y/N) Size /~-- ~0 No. of Compartments Air-tight Caps (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) J~///-N Separation Distances from Septic/Holding Tank: To Water-Supply Well [O ~ To Property Line ,~-~ P Foundation Oleanout .(Y/N) Date Last Pumped ~'//~-/~'- 7 ¢/^ ; for Temporary Holding Tank Permit (Y/N) To Water Main/Service Line Course To Building Foundation _ ~F To Disposal Field / ~) To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026 fRev 8/861 Front C. ABSORPTION FIELD DATA Strata Soils Rating in Ab~,rption Date Installed _ '7//'p? Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /,¢~' V To Building Foundation /2/~'~ To Water Main/Service Line 0/0 To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field ,.~,~ / Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adeq_~uacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ,~ 7'I'~ To Cutbank (if present) Comments D. 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, verifieCgor conformed to all MOA at~d HAA guidelines in effect on the date of this inspection. Signed . 06-[~e.~/ Date Company MOA No. Receipt NO, _ /'/~ Date of Payment Amount: $ Page 2 of 2 72-026 (Rev 8/86~ Back Engineer's Seal MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALIH DEPAFS£MENT OF HI/~i,TH AND ENVIRONMENTAL PROTECTION APPLIC~VI'ICN FOR [-]?~AL'IH AUTHORITY APPROVAl, CEK~rlFICATE 1, G~F~eual In:forw~tion Application Date (a) Legal Description (inclu¢~ lot, blcck, subdivisicn, section, township, range) Locaticn (ad,ess or directions) (c) eplicant is (check o~)Imnding Institution C'-[ ; e~nerpouiler (d) ~nding Institution __Telephone Adc~ress (e) leal $statte Co. a Agent Address Te lc phor~ 2. T.~ of ~,~.,.den_~, Single-Family Number of Redrooms Other (describe) 3. ~tey Su.~=ljf~ Individual Well ~-?~]i Community t~_~, ~blic ~ Note: If ~nity ~ll system, must ha~ ~itten ~nf~m~tion frcm ~e State T~par~ent cf ~viro~ntal Conservation attesting '~o t~ legality ~d status. Is ~e ~1]. adequate for the n~r of ~c~ s~cified in this [~ ~) Onsite _~.~j[ Rfiolic ~--~ C~m~unit!; t~I Holding Tank Is the v~stewate.~ dispcsal system adequate fcr the hunter of ~dr~ras [Page 1 of 2] 2-15-84 and Information I ¢:m~ztify that I have checked, ve...fzec, or oonforraed to all MOA HAA G~idalir. es in ins~etion. effect on t~-,(~te of ~t~i}~_ , , Signed by ( ENGINEER SF~dL) Ternzs of Conditional Approval ~l]~e Municipa].ity off Anchorage Departaent of Health and Env].rc~enta! P~ctection does not guarantee the continued satisfactory ~erform~nc~ of the water supply and/or the wastewater disDcsal system. This approval indicates that, as of the validation date shcwn above, based on the data and info~mation furnished L7 an engineer registered J.n the State o~ klaska, the water supply and wastewater disposal system is safe and func~ tional for the number of ~e. dro~nns and type of structure indicated. ( E{~EP SEAL) 7. Mail the HAA to the fol!c3,~ing address: KB2/d5/s [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNICIPALITY ~ DEPT. OF HEALTH ENVIRONMENTAL PROTECTIOI~ .RECEIVED Total Depth /(p,~-~/ Cased to .//~,J~,.~x~, Depth/of Ghzouting /U/z~-. Static Water Level ~L4~x~ Pu~r%~ Set At. Casing Height Above Ground /./~ ' Electrical Wiring in ConduitS) Separation Distances f~n Well: To Septic/Holdin~ Tank cm Lot /~{.~? To Nearest Edge of Absc~ption Field on Lot Sanitary Seal on Casing ~N) Dep~essiom A~ound Wellhead (Y~ ; On Adjoining Lots /:~'// ; On Adjoining LOTS._. TO Nearest Public Sew~ Line /~,/~z~ TO Nearest Public Sews~ C leanout/Manhole /U ,/,~ To Neap:st Se%~ Service Li~e on Lot ~: Water Sample Collected By ~/~ , Date ~,/~3 25~/~ B. SEPTIC/HOLDING TANK 5alTA Date Installed 7/~ Size /j2~5-f> No. of Ccmpa~tments Standpipes ~) / Air-tight Caps _~N) Foundation Cleanout (Y/N) Depression ove~ Tank (Y~ Date Last Pumped ~/~_/~ ~' - C-~%1~=-~.>' Pumping/Maintenanc~ Contra .ct, o~ File (Y/N) ~//~ ; fo~ Holding TaPJc High-Water Alarm (Y/N) /Q/~- Temporary Holding Tank Pe~-~,it (Y/N)/V/~ Sep. a~ation Distano~s f~c~a. Septic/Holding Tank: To Water-Supply Well /~! To Building Foundation To lh~ctDe~ty Line ~/ ...... To Disposal Field_ To Water Main/Servios Line A7[,.~ , To Stream, Pond, lake c~ Major D~ainage [Pa~e 1 of 2] 2-15-84 [Z ;;o Z: ~e~] · ~s~ ~,nb~m~ 6u3ar~ ssIDKD ALASKA B UIRO[lme[ITAL CO[ITROL Sel mlCeS, IRC. ~nqineerinq 6 {~nuiro~menlol $ludies MARCH 29 1984 RUSSELL BABCOCK POST OFFICE BOX 8026 WALNUT CREEK CA 94596 SELLER - TRANS AMERICAN RELOCATION BUYER - SUBDIVISION - SPANISH HILLS BLOCK - LOT - 2 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 946 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. FLOW TEST ON WELL THE WELL FLOW RATE WAS 1.5 GPM FOR 2 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. 1200 LUcsl 33rd Aucnu¢, Sun¢ B o Anchora§¢. Al~sk~ 99503'{907) 561-5040 DAT~:' RECEIVED TiME TIME TIME DATE DATE DATE I INSPECTOR INSPECTOR I NSPECTO~ MUNICIPALITY OF ANCHORAGE MUNICIPALI~ OF ANCHORAGE  DEPARTME~TOFHEALTH&ENVlRONME~TALPROTECT,~PT. OF HEA~TIt & 825 L Street - Anchorage, Alaska 99501 ~[~NMENTAL f~:o'r~CTION E~VIRONMENTAL SA~ITATIO~ DIVISION JLiN g 1981 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing, 1, PROPERTY OWNER PROPERTY RESIDENT (If different from above) ~ PHONE 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION ~ ' . . . . ....... HONE MAI ~ING ADDRESS I'E. LEGAL DESCRIPTIO~2//,C~ 6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS ~ SINGLE FAMILY ~ One ~ Four ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7. WATER SUPPLY Other INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach log if available,) J~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANy EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ..o,o,.e...,, - I THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS 1, TYPE OF RESIDENCE I~] SINGLE FAMILY [] ONE [] THREE [] FIVE E~ OTHER [] MULTIPLE FAMILY [] TWO [~ FOUR [] SIX ~ERMIT NUMBER 2. WATER SUPPLY [~ INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED PERMIT NUMBER 3, SEWAGE DISPOSAL SYSTEM ~INDIVIDUAL/ON -SITE DATE INSTALLED E~PUBLIC UTI EITY Connection Verified INSTALLER []Septic Tank or []Holding Tank S ze If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [] CONDITIONAL APPROVAL (letter must accompany certificate) ~ DISAPPROVED ~/~ DATE ~/ \\- 72-010 (Rev, 6/79) 82."5 "L" S"FREET A,', CluOl~l\(:~:, Al_A, I', A d. ::,d (907) 2C14-41 'i I i'~AYOFI June 15, 19dl John/Sharon O'Hera Post. Office Box 10-1632 Anchorage, Alaska 99511 Subject: Lot 2 Spanish Hills Subd:Lvision Approval for th.e individual sewer and water fac].lities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to this office from the Chem I..ab, 5633 B Street, for our review. Effective June 1, ].981, the lab fee is $20.00. ill {:here are ar{y further questions, please call this office at 264-4720. Sincere].y, Robert C. Pratt, R.S Associate Specialist RCP/ljw ~ - ,. DF,~EC~ INSPECTION APPOINTMENTS ~,~ TIME TIME ~/~//0~. TIME DATE DATE DATE~) _ INSPECTOR DEPARTMENT OF HEALTH & ENVl RONMENTAL PROTEOTION DEPT, OF  825 L $t~eet - Anchorage, Al~k~ 99501 ENVIRONME[~LqL ENVIRONMENTAL SANITATION DIVISION ~/[I'~Y +~ 1980 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be p~o~essed, Please allow ten (10) days for processing, PHONE 1, PROPERTY OWNE~ MAILING ADDRESS P~OPE~TY RESIbENT {If different from above) ~Y PHONE 3, LENDING INSTIEU~ON MAILING ADDRESS ~.' REA~TOR/AGE~ ' MAI LING ADDRESS LEGAL DESCRIPTION ,"~ TREET LOCATION .,~ ? ~' TYPE OF RESIDENCE '"'-~/~ .bJ.~rMBER OF,BEDROOMS [] One ~ Four  ., SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. Awell Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8, SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON'SITE** /e~'~ YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE'. THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) ~.~-~ 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY THIS SIDE FOR OFFICIAL USE ONLY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3, SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] OTHER [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED E~Septic Tank or []Holding Tank Size: ,~ /~Sz~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4, DISTANCES WELL TO: Absorption Area to nearest Lot Line INSTALLER SOILS RATING MANUFACTURER MATERIAL Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot 5. COMMENTS E~APPROV E D FOR 4 BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE I BY & 72-010 (Rev. 6/79)