HomeMy WebLinkAboutSTELIOES LT 1
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 PHONE ~NEW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF B~DROOMS
IdEp,v,
] We;~o/ AbsorPtion area
DISTANCE TO: [ /O ~ Dwelling/o / PERMIT NO.~
~ Liq. capacit in gallons Inside length Width Liquid depth
/
, ~ Well Dwelling PERMIT NO.
~OZ DISTANCE TO:
O Z ~ Manufacturer Material Liquid capacity in gallons
9 Well ! Foundation /~,~ Nearest I°t lin~ ~ ~ PERMIT NO-~o~ ~ /
~ DISTANCE TO:
No. oflines / Len~thofeachlin~, ,motallength~es, Trenchwldt~inches Distance between lines ~,
~ ~ Top of tile to finish grade ~ Material beneath tile ~ Total effective absorption area
Length Width Depth PERMIT NO,
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well ~uilding foundation Nearest lot line
~ DISTANCE
~ Class Depth Driller Distance to ~ot [Jne PERMIT NO.
~ Building foundation Sewer llne Segtic tank A~sorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
REMARKS //0,
APPROVED /z DATE LEGAL
(Rev. 3/7 __ ~
PERMIT NO.
RPPLICRNT JIMMV N RNDERSON
LOCRTION TURKS TURN
LEGRL Li STELIEOES ~
T"r'F'E GF=,OIL'-- RB_,uRFTIOH"=- ' · '='...,.r_,TEM"--
r'IR,~-::IMLIM NUMBER OF E, EDRouM_, = _-.:: :,LIL RRTING (=,Q FT,--'BR)=
THE REQLIIRED SIZE OF THE SOIL RE,=,LRPTILN _-,&=,TEM I=,.
LOT _,I~.E 40500 c, QURRE FEET
E:. t-~ P Tl-] = '1;2 L Ei'-~3TH = S':--. 2 GR I=:IVEL DEPTH=
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTBNCE BETWEEN THE SURFRCE' OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). '
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRB',/EL DEPTFI IS TFIE MINIMUM DEPTH OF GRRVEL BETWEEN THE"OUTFRLL PIPE
RND THE BOTTOM OF THE EXCR',,,'RTION (IN FEET).
-F:EL-'~. L~ ][ F:E[:' SEF"T "r C: TR [-~F-'-' S I ZE= '"! ~.Z,~-Z~O
F'ERMIT RF'PLICRNT HRS THE RE_PuN.:,IEILIT~' TO INFORM THIS [:,EPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RNV HELL=. RDJRCENT TO THIS PROPERTS RND THE
NUMEER OF RESIDENCES THRT THE WELL HILL _ER/E.
..... T~40 .{ 2 ':' I [-~$PE~]T I O[-~S RF.:E RE,Z-~L~ I RE[:,
8RL. KFILLINb OF RN"r' =,~_,TEH WITHOUT FINBL IN=,PEL. TILN RN[:' HP~'~:_ ~n~- THIS
DEPRR. TMENT WILL BE SUBJECT TO FRO_,ELUTION.
MINIMUM DISTRNCE BETWEEN R WELL RND RN~ ON-SITE SENRGE DISPOSRL SgSTEM IS
· 00 FEET FOR R PRIVRTE WELL OR ~50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE T~PE OF PUBLIC HELL.
MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND
TO R COMMUNITV SEWER LINE IS 75 FEET.
WELL LOGS RRE REQUIRED BND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DR~S
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MR~ BPPLg. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
I CERTIFY THRT
±: I BM FRMILIRR NITFI THE REQUIREMENTS FOR ON-SITE SEWERS RND HELLS RS SET
FORTH BY THE MUNICIPRLIT¥ OF RNCHORRGE.
2: I WILL INSTRLL THE SS'STEM IN RCCORDRNCE WITH THE CODES.
~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MR9 REQUIRE ENLRRGEMENT IF THE
?RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
/ ?,P ?I NT N NDERSON
IS Y' __DRTE .... V4. 0
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4-
5-
6-
7-
8-
14-
16-
17-
'18-
20-
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
[] PERCOLATION
TEST
SOILS LOG - PERCOLATION TEST
SLOPE
DATE PERFORMED: q/i' I ~)(~
~, ~A-U ~ u/.c A ~~ ~p
SITE PLAN
,I~M[IIIIIII I
I'~rl t-6r'~ I~1 I
'JJI F~II ~LI-~I I
WASG.~NDWATE. K/O S~
ENCOUNTERED?
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
:-:-,-
'~.
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN FT AND -- FT
CERTIFIED BY:
72-008 (6/79)
BOX 130.~), STAR I~o~rE /~k A~/CHoRAGE, ALA~IKA 99502
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF
$79°00 PER FOOT.
~ ,oa~de"~or~ 34-4-7683 .276-6610
DRILLED AT THE RATE OF
PROPERTY OWNER
LOCATION OF WELL SITE
DRILLER
2 Bu.
WELL LOG:
o ..... 24-' ~. ~ ,>t,ct4 ~,~.. 3o°~ c~.
24---360' Bed,roc~. ft ,~ed~en,ea~ ,~oc~.
JUN 24 i§83
RECEIVED
273--275' Rn. a;aea .ah. oo>tn.g c~ .amadd. cmoun2L o~. ~aa.t.e,'~
34-5--34-8'
7o~
340
ro.tad. Co4~ o~ ~.,dd.d..~: ~19.00 ~e,¢ ,,,~. X 360 Fee. t: ~6840.00
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPL1ErION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF
THANK YOU VERY MUCH. " BERNIE CLAUS O.~-EAMPAR; DRILLINO
· SERVICE CHARGE OF 1~% PER MONTH WILL BE ASSESSED ON PAST D ACCO .
~-~ MUNICIPALITY OF ANCHORAGE ~.~.~
DEPART~ 'l' OF HEALTH AND ENVIRONMENTAL F~ ,rECTION
DIVI~IO,14 OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
App,cat,on Daie
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
~ !zTo I %~RK.5 ~u~
(b) Applicant Name ~O~ ~gF¢~C~%elephone: Homo ~q~ r q~7~ Business
ApplicantAddress ~.2701 TOR~ ~)R~ · hNgff, ~E ~5/(~
(c) Applicant is (check one): LenSing Institution ~; Owner/builder~'; Buyer ~; Other ~ (explain);
(d) L,e'r]ding institution -' .,
..,..:<;,
Ad~ir6ss, ,. ,;,..
(e) Real Estate Company and Agent
Telephone
Address
Telephone
(f) Mail the HAA to th~ fqllowing address:
TYPE OF RESIDENCE
Single-Family..[~' Multi-Family []
Number of Bedrooms ~
Other
WATER SUPPLY
Individual Well,J~' Community [] Public []
Note: If community well sys[em, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsitej~ Public [] Community [] Holding Tank []
Note: If community we system, must have written confirmation from the State Department of Environmental Conservati°n
attesting to the legality and status.
72-025 (11/84)
Page I of 2
ENG'INEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of lhe validation date shown below, I verify that rny 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
Address fZOO.
Telephone
DHEP APPROVAL
Approved for_¢ ) edrooms
~ ~ Disapproved
Terms of Conditional Approval
Conditional
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 I11/84)
MUNICIPALITY OF ANCHORAGE (MO~j
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH
ENVIRONME~,,~ , . &
~'~AL PROTECTION
uu 12 o lg88
Legal Description'
WELL DATA
Well Classification INDllJzDd - If~A, B, C, D.E.C. Approved (Y/N) (~/'//~' ~//' .
well Log Present ~N)~,~ /~ Date Completed, /O/'/~r / . ~ld¢~ ~ ,-~//¢O ~/~'
Total Depth ~ Cased to ~ ~0 Depth of Groubng
Static Water Level ~ ,~¢,~/ PumpSetAt /0~.~/ ~ ~T~O~
Casing Height Above Ground ~ ~/ Sanitary Seal on ~asing ~N)
Electrical Wiring in Conduit ~N) Depression Around Wellhead (Y~
Separation Distances from Well:
To Septic/Holding Tank on Lot I ,/O/'¢- ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot - /~O/~" ; On Adjoining Lots
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments ~) ~,~c
/Od) / '/-
/DM /'-/-
~,[//~ To Nearest Public Sewer /~.
/~//"~- TO Nearest Sewer Service Line on Lot .
SEPTIC/HOLDING TANK DATA
Datelnstalled I0/~1/~0 Size [0OO No. of Compartments
Standpipes ~yN} Air-tight Caps ~N)
Depression over Tank (Y~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
TO Water-Supply Well Ill0
TO Property Line .~¢')
-
To Water Main/SenLice Line
' Course .' ' /0¢')
Comments
Foundation Cleanout ~/N)
Date Last Pumped ~/, ~/~2~'*
Temporary Holding Tank Permit (Y/N)
To Building Foundation /(~ /
To Disposal Field '/2-- /
To Stream. Pond, Lake. or Major Drainage
Page,1 of 2 ..... ~
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed [ ~)/3 ~/~
Width of Field ~
Square Feet of Absorption Area
Depression over Field (YIn)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation /0
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 (~N)
Date of Last Adequacy Test
To Property Line ZC)/'
To Existing or Abandoned System on
; On Adjoining Lots .i'~0 /'~L-
TO Cutbank (if present) f'~/./~
/PO
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 /
Dimensions
"P.ump-Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify t hat J,h ave~g!~.ed, v. eriJied, orgonformed to all MOA and IdAA guidelines in
Signed ~ ~/('//gcCz.,~/.,~.,~. ~ Date ~¢/~ ~/~
-' /
Oompany ~C~,/~O, MOA No. ~ Z¢
Receipt No. '5%~c~
Date of Payment ~-~0 ~
Amount: $ ~¢~
TFbcH 6 FS co6
72-026 (11/84)
effect on the date of this inspection.
ALASKA ENVIRONMENTAL
CONTROL SERVI(~, INC.
1200 West 33rd Aver~ue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
HOO-~E.
ALASKA
e dlROFImE I TAL COI TROL Sidled'ICeS, IrlC.
SUSAN ..........
ANCHORAGE ALASKA
99516.
SELLER-SAME
JUNE 19 1986
SUSAN
ANCHORAGE ALASKA
99516.
60281
LEOAL:STELIOS BLOCK 0 LOT I
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE JUNE 13 1986
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 384 SQFT,
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS.
BASED UPON TttE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON JUNE 13 1986
THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
FLOW TEST ON WELL
WELL FLOW DATE-JUNE 13 1986
THE WELL FLOW RATE WAS 2.5 GPM FOR 3 HOURS.
TIlE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME.
1200 ~Jesl 33rd /~ucnu¢, Suile ~ ,,An&oraqe, AIo*k~ 99503 ,.[907) 561-5040
APPLI('"?NT FILLS OUT UPPER HAl ONLY
Buyer ,.
Address Zip Code
Lending Institution Phone
Address Zip Code
Address Code
LegalDescription [~gJ~ [ }~J~[[()(>~ ~0~.~
Type of Residence
Single Family
~'~ultiple Family NO, of Bedrooms ~
[] Other
Water Supply
~,~lndIvidual !~ ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
[] Community ..~_.(. ~ ,~)d~ For wells drilled prior to that date, give well depth (attach log if available).
[] Public Utility~ -
Sewer Disposal
U] Public Utgity When Connected to Pul>fie Utility:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
MUNICIPALITy OF ANCHORAGE
r~ i/~ ) (.~jOA DEPT. OF HEALTH &
~'~?l~J~ '~' ENVIRONMENTALPROTECTION
(g ~_.. Well to Tank ILgC) ,~ Septic T~k Size J
72.023 (3/82)
~immy N. Anderson
SI{A i]ox 2418
Anchorage, AK 99507
Sabject: Lot 1, .~te].ioes ~Jubdivision
Approval foL' t[~e individual set~er and water kr'aci].itios caanot
be granted until tile following item, s have been completed:
~' ' ~ - -~ anal sis report needs to be submitted to this
~office ~rol~l the Chenl Lab~ 5633 B Street, ~:or our review.
o 'i'he septic tank pumped with a receipt sub~altted no th~s
department.
¥Zhe depression over the sewer system will need to be filled
so that surface water drains away fro~ the sewer systera.
Please notify this Department ]2or a reinspection when the
~noted discrepancies have been corrected. If, th~e ~ any
'further questions~ pi. ease call this office an 20~1-472u.
~ incere ly,
CW2/ej/E2
Cory
e ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REOUEST FOR APPROVAL OF INDIVIDUAL 1NATER AND SEW[~B~'
)IRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. .f ~ PHONE
PHONE
PHONE
PROPERTY RESIDEI~T (if different from above)
M^,',NG^ODRESS d o
LENDING INS IT TION ~ ~ . PHONE
4. REALTOR/AGEN~ ~ PHONE
STREET LOCATIdlN , ~ / ' ' ' ~
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
~ ~ ~ Four ~ Other
~ SINGLE FAMILY ~ Five
~ MULTIPLE FAMILY ~ ~ Six
7. WATER SUPPLY
tj~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM 1~ INDIVIDUAL/ON-SITE~
[] PUBLIC UTI LITY
42/
**If individual/on-site, give installation date //~ f.
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE ~/IUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE CATE
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
L~ COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
E~Septic Tank or []Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
[] CONDITIONAL APPROVAL (letter must accompany certificate)
E~"~ISAPP ROV ED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev, 3/78)
pality o[ Ancl orage
MEMORANDUM
DATE: February 6, 1978 File No.:
TO: Jerry Weaver-Planning Department ~/~>(~~'~//~./~
~no~: John W. Lynn - Environmental Engineering - DHEP
SU~P£CT: Stel ioes Subdivision #S-4657
Profile indicates adequate soils for on-site septic systems. Obviously
Soils Information must be forthcoming, as weather permits, to comply
wi th State La~d and this Department' s regul ati ors prior to. construction.¢
eeri ng
JWL:lmp
June 28, 1978 R&M No. 851544
Mr. George Stelios
Box 393A SRA
Anchorage, AlaskJ 99507
Subject: Adequacy Test on Existing Sanitary Sewer SystDm; SW¼, NE¼, NW%,
Section 25, T12N, R3W, $.M., Alaska
Dear Mr. Stelios:
At your request of June 26, 1978, we conducted a test of the septic system on
the above described property.
During the test the liquid level in the septic tank was monitored as water
was added to the system.
table:
The measurements are summarized in the following
Liquid Level Below Top Total Gallons
Time of Standpipe Added
9:40 8.2 0
9:47 8.2 25
10:03 8.0 75
10:21 8.0 100
10:45 8.1 100
11:00 8.2 100
The meter used during the test was a Rockwell 5/8" standard water meter which
had previously been calibrated by R&M Consultants, Inc.
If the 2 bedroom residence on the property is to house 4 people, the average
load on the system can be expected to be 300 gallons per day or .21 gallons
per minute. During the test, the system accepted 100 gallons in 80 minutes.
This indicates an average effluent acceptance rate of approximately 1.25
gallons per minute at the time of the test.
Because the house on the lot is occupied, we assume that the leach field was
at its normal degree of saturation. We can therefore conclude that the
system is disposing of effluent at an adequate rate for a 2 bedroom resi-
dence.
June 28, 1978
Mr. George Stelios
Page -2-
We appreciate this opportunity to be of service to you.
you have any questions concerning this test or if we
service.
Very truly yours,
R&M CONSULTANTS, 'INC.
Lynne Kosikowski -
Staff Geologist
JMB/kah
Please contact us if
can be of additional