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Home My WebLink AboutSPENDLOVE VIEW HEIGHTS BLK 3 LT 7 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 82.5 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [~NEW Laralle Smith 349-2404 ~UPGRADE MAILING ADDRESS SRA Box 1735-K Anchorage~ AK iLEGALDESCRIPTION Lot 7 Bloc 3 Spendlove View Heights LOCATION Upper DeArmoun DISTANCE TO: Well Absorption area Dwelling o_ ~ ].15 ' 6 ' 45 ' E- ~ Manufacturer Material ~ ~ Espinoza Concrete hiq. capacitY1300 in gallons IF HOMEMADE: Inside length W dt 1 , ~; We ~ IDISTANCE TO: I Dwelling ~O 2~ ~ Manufacturer ~ ' "1 r, I Well ~;~ I DISTANCE TO: I ]20' _j u. Z I No. of lines I Length of each line i I 48' ~1- Top of tile to finish grade 4' NO. OFSEDROOMS 4 PERMIT NO. 780214 No, of compartments 2 Liquid depth PERMIT NO. Liquid capacity in gallons Length DISTANCE TO: Class DISTANCE TO: Width Material Foundation Nearest lot line 50' 70' Total length of lines Trench width 48' __ 24 Material beneath tile Depth Crib diameter Crib depth Well Building foundation Depth Driller Building foundation Sewer line Oq'HER PIPE MATERIALS Cast Iron & Plastic SOl L TEST RATING 135 S,F./B.R, INSTALLER A &E C~pentry & General Contractors REMARKS First inspection by Municipality of Anchor~ 72" inches PERMIT NO. 78O214 Oistence between lines Total effective absorption area 576 S.F, PERMIT NO. Total effective absorption area Nearest pt ne Distance to lot line Sept c tank PERMIT NO. [Absorption area(s) Photos taken by installer - 2nd inspection and As Built after completion of systea~. Final inspection instructions given to and cut off excess cleanout pipe. Lot survey As Built included with this. re A[PROV,ED --/ /~;' '"~ "E \TE" ' I~'EGAL 72-013 (Rev. 3/78) 2204 Cleveland Anchorage, Alaska 99503 Performed For Laralle Smith 08t~ Performed 4~ teaa] qescrtDt~o.: Lot 7 B~ock 3 Subd~vts~on~~..~ ~Ja~_~igkt~d. This ~orm Renorts Soils Lon Ye~ Percolation Test_~ .neath Feet Soil Characteristt, cs Brown Sandy Silty Gravel 12 .... Brown Slightly Silty Sandy Gravel with occasional boulders 16-- 18-- Bottom of Test Hole Wa~ ~round Water Encountered? No I¢ Yes. At what Denth? Leadino Date Gr~$s Time Net Time ., 24 Hr_. __~LCL~X n. __.lfl_m t n . . 1,~/ ln~Ln ._LC)._min~ _ _ 1,0 =m i n ...... Depth to H20 Net Dro erce 1 att on -~a--t-e ~ ,,/~ '~ tit nute PrnPo~ed In~ta-~FT~-t~. Seenaoe Pit Drain Field Deoth of Inlet Depth 'To Bo{'~om Of Pit Or Trench____ 're~t P~rformed By ..... c~YS~..~_ Data Certified B~: _cr~ .... Date: SCALE FOLLOWING DESCRIBEO PROPERTT LOT 7, BLOCK 3, SPENDLOVE VIEW HEIGHTS JOHN H~ HERA No, 953-S MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY 'DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, sec~ian.,.tgw~ship, range) Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Mailing Address ,'~, ¢'~-----~ Telephone: (home) Business Telephone (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: 2, TYPE OF RESIDENCE Single-Family Number of bedrooms 3. WATER SUPPLY Individual Well ~k Community [] Public [] Note: If communit.y well system, must have written-confirmation..¢rom the State Department of Environmental Conservation attesting to th legality and status. 4. 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 legality 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 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 flies and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in com. pliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~ 0 ~ f~-d~-~" i~ I',J ~ ~' ~ Telephone ~ dC ~ - ~ ~ ~ ~ Address ~~ ~ ¢ ~ ~ Engineer's Seal 6. DHHS APPROVAL Approved for /~/ bedrooms by Approved ,/~', Disapproved Terms of Conditional Approval Conditional 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 DHHSdonotconductinspections or analyze data before a certificate is issued. TheMunicipalityofAnchorageisnot responsible for errors or omissions in the professional engineer's work. 72-085 (Rev. 7/88) Back Page 2 of 2 WELL DATA Well Classification {/..) 'i;) Well Log Present (Y/N) /'J("/ Date Completed Total Depth ~ ~¢ / Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) ~"O~ MUNICIPALITY OF ANCHORAGE (MOA) Health Aulhorily Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 LegaI Description: ~,OT "~ Depth of Grouting . / SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot '~ [ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results If A, B, C, D.E.C. Approved (Y/N) Yield , (~ ~ ~ Pump Set At ¢~ ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots 7 '2 \ ~ ~ / ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Comments SEPTIC/HOLDING TANK DATA - , , ,* ~ Date installed ~.~7~ Size [ ~b°Oq'/J¢~ No. of Compartments Standpipes (Y/N) ~'~ Air-tight Caps (Y/N) "'/L~ Foundation Cleanout (Y/N) Depression overTank (Y/N) /¢t,~Je S~:'~-~J ('~t4o~d~ Date Last Pumped Pumping/Maintenance Contact on File (Y/N) ' ; for Holding Tank High-Water Alarm (Y/N) .... Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line'-''- To Water Main/Service Line Comments i To Building Foundation ~f' 'Ct To Disposal Field -.~ / To Stream, Pond, Lake or Major Drainage Course 72-028 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed [ ~ 7~ Width of Field ~' Type of System Design Length of Field /--iL~ / / Depth of Field / ,~Gravel Bed Thickness Square Feet of Absortion Area ,~ ~7(¢, Statndpipes Present (Y/N) Depression over Field (Y/N) /~go~¢ 5'¢~,J (¢~J..o¢~ [:)ate of Last Adequacy Test -- ~ '?~4~[¢4, ~ , Results of Last Adequacy Test /~ ~ (~__o ~.7,~'1~ ( 6u I,~ ~'-6 u,, A-d'X?;L SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well I ~O ~ To Property Line To Building Foundation '~ ~'~-5~- ~ To Existing or Abandoned System on / Lot ~ ; On Adjoining Lots To Water Main/Service Line '7 ~ ~ ~ To Cutback (if present) 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 High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments .-~-.--- Dimensions Manhole/Access (Y/N) ~ "Pump Off' L~ ~ /N) Pumping Cycles during Adequacy Test. **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 Signed Company Date MOANo. ~;-f.¢ ~ ~o --0070 Date of Payment Amount: $ Receipt No. ~,~' ", .... ~ Waiver Fee: $ Date of Payment 72-026 (Rev, 7/88) Back Page 2 of 2 NORTHERN TESTING LABORATORIES, INC. 2505 FAIRBANKS STREET ANCHORAGE. ALASKA 99503 907-277-8378 · FAX 274*9645 600 UNIVERSITY PLAZA WEST. SUITE A FAIRB&NKS, ALASKA 99709 907-479-3115 · FAX 479-0547 Ac'teaSe Syst ems P.O. Box 112848 Anchorage, )il. Attn: Tsanara 99511-2848 Date Ar-r'ived: Time Arrived: Date S~npled: Time Ssmp].ed: Date Completed: 03/12/'90 1435 03/12/90 0950 03/14/90 Source: LT,B3 Spendlove S~nple ID#: A031290-12 Parameter Unit A031290-12 ADEC Nitrate-N mS/1 <0.5 10 Francois Rodigari, Anchorage Operations Manager * MCC = Maximum Contaminant Concentration ISAACS PUMPING SERVICE (Norm Tibbetts, Owner) 6218 Quinhagak Street ANCHORAGE, ALASKA 99507 Phone 563-3300 DATE TAX I I /]RECEIVE~ BY TOTAL I I l ,]~,"$ C OlJ bTl' All claims and returned goods MUST be ~ccompanied by this bill 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 GENERAL INFORMATION (a) (b) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name _~ '¥'~?,%~ ~,~ Applicant Address ) ~O~7~ (c) Applicant is (check one): Lending Institution ~; Owner/builde~[3Buyer ~; Other ~ (explain); ) (d) Lending Institution ~--J_/~~k, 'telephone Address (e) Real Estate Company and Agent ...... Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Family/l~D Multi-F~ily [] Other Number of ~edrooms WATER SUPPLY Individual Well,j~c.~ Community [] P~blic [] 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(11/8,u 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 bodrooms 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. ('. ...., ? ..... r<.Z;5,' Name of Firm t,,~ ~.q'v~'?",-,,'~ 'i ~' '~: .~:7 ,.~t ;,?.. ~'- ~t--,.:,_~ ~..... Telephone . .-.L') ~-I; ,) "~ / Approved for ~'¢~_ bedrooms by _~'~ .. ¢ .7 (.~ Date Approved __~¢~'~' Disapprove~/~ Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health ~nd, Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in para§raph 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 anaJyze 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 n MUNICIPALITY OF ANCh~ .AGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) SEP g 1986 C,ECK',ST-26,.472oFE"RUAR¥ 984 RECEIVED Legal Description: L~1'- WELL DATA Well Classification "'~-~_~.',J V~ .~"~¢~- If A, B, C, D,E.C, Approved (Y/N) Well Log Present (Y/N) . !,..~:~ Date Completed t.~..~V...~.~'~,..~,.~.~ Yield 4o Total Depth Lc,~,,4~,,,t4 Cased to. .4-- Depth of Grouting , . Static Water Level . '~-.-.~-. / Pump Set At Casing Height Above Ground I z:¢-// Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) k¢_~_.~_% Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot _ ~ ~ ,.~"~ / ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~ "~_0 ~' ; On Adjoining Lots To Nearest Public Sewer Line ~ //Cf To Nearest Public Sewer Cleanout/Manhole . b,~ ?/~- ' To Nearest Sewer Service Line on. Lot Water Sample Collected by ""~ '~C-~¢%t-t~ ;Date '"~/ Water Sample Test Results _ ~---~&~---Crr-~'"c:¢. --7 Comment~'~C'LGDEcE'- ~1~ ~,'~-'~-C~. _d~/'~3~t ~T¢~¢~ ~- ~-'~ B. SEPTIC/HOLDING TANK DATA Date installed \~O/Z°/'"~/"~:~Size I No. of Compartments CleeRo u,t, (Y/N) Standpipes(Y/N) ~ Air-tight Caps(Y/N)_"'¢~-~ Foundation .~.7 /./ ! / Depression over Tank (Y/N) ~'40 Date Last Pumped . Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well I t To Property Line ~- '+- To Water Main/Service Line '~,'~ Course ~/¢~ ': 'fo Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~ "" "~"~ ,.~J ~ ~4'~ ~E'' 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 Width of Field ~-,4-// 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 ~'O 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 ~:-,~E;~ r.JI_ To Existing or Abandoned System on Lot ; On Adjoining Lots To Water Main/Service Line '~,.~ "f" ~ E.~--'~CL/~O4--(-'¢,"~-o Cutbank (if present) 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 High Water Alarm Level at __ Tested for Electrical Codes (Y/N) Comments __ lc/Access (Y/N) mp Off" Level at __ __ Vent (Y/N) Pumping Cy, luacy Test. Meets MOA ** Check Permitt, I Against HAA Request ** I certify that I I' ~onformed to all tv)CA ancJ HAA guidelines in effect on the date of this inspection. Signed __ Date ~?/_~.j ~ /~ Company V,~r~-'--'--'--'--'--'-~, f~'"'~'6~i~_(r.,.~o. '~'~-- --'7 Receipt No. /.~-~ ~' ~) Date of Payment Amount: $ ~;~¢, ~ Page 2 of 2 72-026 (11/84) · MUNICIPALITY OF ANCHORAGE ENVIRONMENTALTelephone 264-4720 ENGINEERING REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS; Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten (10)days for processing,~l) 1 PROPERTY~WNER ~ ~ PHONE ~ - X,~/<. P~OPEflTY ~ESlDENT (If d'ff r n b } PHONE 2, BUYER PHONE ) MAILING ADDRESS MAll_lNG ADDR ~SS ~ 8. LEGAL DESCRIPTION STREET L~ATION 6. TY~E ~F RESIDENCE NUMBER OF BEDROOMS ~ ~ One ~' Four ~ Other ~ SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7, WATER SUPPLY * ~' ~ INDIVI DUAL ATTACH WELL~. A w~~d for all wells drilled ~' COMMUNITY since June 197~For ~ells drilled prior to that date, give wel~ ~ PUBLIC UTILITY ~pth (~ttach log i 8. S~WAGE DISPOSAL SYSTEM ' ~ INDIvI DUAL/ON-SITE - If system is over two (2) years old an adequacy test's required ~ PUBLIC UTI LITY by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-01 O(3~78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED iNSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS; 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Absorption Area to nearest Lot Line 5, COMMENTS ~ APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY {Title) /--) LEGAL DESCRIPTION 72-010 (Rev. 3/78)