The URL can be used to link to this page

Home My WebLink AboutSPRING FOREST BLK 2 LT 1L.o*T" 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 INSPFCTION REPORT NAME ~-AILING ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO: ~ g~ ]~,~ ~ Material Manufacturer I Well/~,,i '~ ~ '~ ~z~ ~. Absorption area Dwelling L q, capacity ia ga Ions [ Wdth /,2; &'-(.) IF HOMEMADE: I Inside length DISTANCE TO: Well I Dwelling NO. OF BEDROOMS PERMIT NO./ ,/ o No, of compartments Liquid depth PERMIT NO. Material Well ~:~/~ z,,h Length of each line NO. of lines / 8-3 Foundation Nearest lot line PERMIT NO. DISTANCE TO: Distance between lines Top of tile to finish grade / Width Total length of Material beneath tile Depth Length Trench width .~ L¢:~ inches inches Liquid capacitv in gallons Total effective absorption area PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation DISTANCE TO: Depth Driller Building foundation Sewer line Class DISTANCE TO: OTHER PIPE MATERIALS pvc. ~:/ SOIL TEST RATING INSTALLER REMARKS DATE p' Nearest lot line Distance to lot line PERMIT NO. Septic tank Absorpt on area(s) · I APPROVED 72-013 (Rev, 3/78) LEGAL PERMIT NO: DRTE ISSUE[.',: FIF'F'L I C:RN"I': R[:,DRESS: CONTACT PHONE: LEGAL DESCRIF': LO'T SIZE: MFIX E:EDRO01"I"S: [:,EPRRTMENT C HERLTH RND ENYIRONMENTRL. ~ }TECTION 825 I_ STREET., ANCHORAGE., RE 9950± 264-4720 Cll'-.l--"=~, I I-E] 2-; E&,-IEF:-: F'EF~:I"I ][ 3- 8404i0 05,..'~1,,"84 NORTFIBRNK CONTRRCTOR 2:52t. KNIK R[.,ICHORRGE¢ RK DD502: 268-6850 '~IIBDI'v'I'~InN: SF'RING FOF..E:,T SECTION: :t.4 TOHNSHIP: i2N 414'?D (SC..!. FT. OF.: ACRES) 4 LOT: l RANGE: -._'.:N BLORK: 2 LISTED BELOH ARE TNE OPTIONS R',/RII. RBLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEI"I. 'CHOOSE THE OPTION THFtT BEST FITS YOUR SITE. DEPTH TO PIPE BOTTOM (FT.) 4. 0 4. GRAVEL [:,EPTH (FT.) 6. 0 0. TO'TRL DE:PTH (FT.) t0. 0 4. GRAVEL HIDTFI (FT.) 2. 5 29. GRAVEL LENGTFI ,::FT. ) t08. 0 ** 56. GRAVEL VOLUME (CU. YDS. ) 65. 0 60. TRNK SIZE (GALS::, i, 250. 0 :+=:~: l., 250. SOIL RATING ,::SQ. FT. ,."8R) 2:24 270 ** GRAVEL LENGTH } 75 FT. 4. 0 --'.':.5 7.5 5.0 t40. 0 t.., 250. 0 2:24 REQUIRES MULTIPLE RUNS (NOT EXCEEDING ?5 FT. EACH) *.'+.' TANK MUST HAVE RTL. ERST THO COtdPRRTMENT-c; I CERTIFY THRT: d.. I RI',1 FAMILIAR NITH THE: F'E.~.IIF.'.EI',IENTS FOR ON-SI'rE ;.,EI4EF._, AND 1.4ELLS RS SET FORTH BY TFIE MUNICIPALITY OF FINCHORRGE (MOA) AND THE STATE OF ALASKA. I HII_L IN_,TPLL THE SYSTEM IN RCCOR[:,RNCE WITH ALL MOA CODES AND kEi~I...ILRTIuN .... AND IN COMPLIANCE HITFI THE DESIGN [::R~TERIR OF THIS PERMIT.. ~:. I HILL ADHERE ;f'O RL.L. MOA AND STATE OF RLRDKR REQUIREMENTS FOR THE SET E:~CK DZS'I'RNCE~ FROM ANY EXISTING NELL¢ HRSTEWWFER DISPOSAL 5'~'STEI','I OR PUBLIC SEI.,.IERFIGE SYSTEM ON THIS.OR ANY flDJRCENT OR NEARBY LOT. 4. I LINDERSTRND TFIRT 'fHIS PERNIT IS ',/RLID FOR R MRXINUId OF 4 E:EDROOHS AN[:, ANY ENLARGEMENT WILL REQUIRE RN ADDITIONAL PERMIT. IF R THEN HILL ELECTRICAL WORK MUST E:E DONE E:'¢ R LIC:ENSED ELECTRICIAN. SI GNE D ~.~ _~_--~~ [:,RTE ~PF- 'L I..HN" .... F: NORTH~:R~4K CONTRRCTOR LIFT Y]TRTION IS INSTALLED IN RN RF;.':EER COVERED BY MOA BUILDING CODES;., (1) RN ELECTRICFIL F'ERMIT AND INSPECTION MUST BE OBTRINE[:,.; ,:;2) RS-BUILTS NOT E:E RF'PRCR,'E[:, HITHOUT RN ELEETRICRL INSPECTION FP..F_F:T, RN[:, ,']', THE MUNICIPALITY OF ANCHORAGE '- DEPARTMENT OF HEALTH AN[) ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST J~PER~CO LATION TEST PERFORMED FOR: LEGAL DESCRfPTION:. 2 ¢1~L- 3 4 5 "i 7 8 9 10 11 12 13 14 15 ~,: .16 1 7 18 .lg 2O COMMENTS ,,~ SLOPE SITE PLAN PERFORMED BY; <~,.~ , Gross Net Depth to Net ' .Reading Date ~,~ . Time Time Water [Stop ~/~0 3,~ ~' ,,~Fi ~ I, ~ .. tq~ O lO t, Zg ~0 I~ I ~.~ ,3~.9 ~,,~/,,,,, PERCOLATION RATE TEST RUN BETWEEN ii:,':(:: MUNICIPALITY OF ANCltORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF iH'iALTIt /UND ENVIRONMENTAL PROTECTION APPLICATION FOR ttEALTh AUTHORITY APPROVAL CERTIFICATE General Information Application Date_ . (a) Legal Description (include lot, block, subdivision, section, to~ship, range) Location (address or directions) , Business Applicants ~ddress (c) Applicant is (check one) Lending Institution :iii ; Other. lll (e×plai ,); (d) Lending Institution Owuer bu~ lder pal. Telephone Address Rea]. Estate"C6.' & Agent Address Telephone (f) Mail the IiAA to the following address: .%j~yp~e~_pf Res idence Single-Family ~ Number of Bedrooms Multi-Famil y Other 'describe) Water S u p. ~:l_y_ Indlvidua:I Well. Community :1 Public Note: If community well system, must have ~-itten co~}irmation from the State Department of Environmental Conservation attesting to the legality and status. 4o Seaage Disposal Onsite /'~ _ Public {-:i1 Commnnity :.~... Holding Tank ~_~ ( Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and statgs. [Page 1. of 2] Engineering Firm Provi~_:_n.j~_~n~__!.pe_~t~._io_]!~.,__]re~ File Se_aj'_ch_, 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 ~nicipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with ail Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm : ~./;~'. Telephone . '~.~ / --.~ '"o ..X ~, ~ ~ ~ " Address j,?~;?!: /~) '-' "~ ~ ,5~~ '> ,'t~,'~/Kqi'~'- /~/~ / Date ........... ~ v- ..... a;'~ '~ ~ '%e~ ~ ~-'' .:? ," ¥) ~ ~l '~d ~/g~.· ~ '. ' 'O*p . ~ ~% / Approved ..~._ Disapproved ........ Conditional Terms of Conditional Approval. CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DtlEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESEN~r- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER RJ~GISTERED IN THE STATE OF ALASKA. THE DHEP DOES 'IR{IS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDEtGkL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED, THE MUNICIPALITY OF JaNCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) Ra4/ej/D18 [~.age 2 of 2] 7-19-84 A® MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 WELL DATA Well Classification ~/~/~//~?~'~ Well Log Present (Y/N) ~ ~ Total ~p~% ~ Card to Static Water ~1 ~ Casing ~ight ~ve Ground ~ Elec~iCa~ wiring in Conduit (Y~) ~ Legal Description: __f./ B, or C, D.E.C. Approve ) Date Completed ~1~ Yield ~1~ Depth of Grouting ~/~ Pump Set At Sanitary Seal on Casing Depression A~ound Wellhead ( Y/N Cle ancu t/Ma nho le Water Sample COllected By Water Sample Test P~sults Con~nts Separation DistanCes f~om Well: To Septic/Holding Tank on Lot ~ F~O--' ; On Adjoining Lots ~ To Nearest Edge of Absorption Field on Lot ~)~)F ; On Adjoining Lots.__ .~. TO Nearest Public Sewe~ Line ~t~ To Nearest Public Sewer ~%/~ To Nearest Sewer Service Line on Lot ;Date ~/~ B. SEPTIC/HOLDING TANK DATA Date Installed ~/~ StandpiDes si~ /2~ Ai~-tight Caps ~/N) No. of Compartmsnts Foundation Cleanout ~N) Depression ove~ Tank .(¥~t~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N)JJ//~ ; for HoldinG Tank High-Wate~ Alarm (Y/N) ~7//9- Temporary Holding Tank Permit (Y/N) Separation Distanoss :f~omS~.~t~cj/Jplding To Water'Supply Well.. To Property Line 5~! ~-- ~To~ Water Main/Service Line Tank: To Building Foundation To Disposal Field /O ~ ~- To Stream, Pond, lake, or Major Drainage ~F~Page 1 of 2] Receipt 9 ~0~?'~'~ al Date Paid: (b/%%l\%cJ Amount: CI~' ~ , IOCD 2-15-84 C. ABSORPTION FIELD DATA De Soils Rating in Absorption Strata Date Installed ~/~ Width of Field ~,/..~ Square Feet of Absorption A~ea Depression over Field _(_Y.~ Results of Last Adequacy Test ~ ,~// Type of System Design Length of Field ~3 / Depth of Field /~ '~ Gravel Bed Thickness ~'~ /~ Standpipes Ih~esent ~N) Date of Last Adequacy Test Separation Distance from Absorpti~Dn Field: To Water-Supply Well · To P~operty Line ~2~ / To Building Foundation ~ Lot ~ /~ ; To Wate~ Main/~vi~ Line .....~ / To St~e~ond~ke/o~ Majo~ ~aina~ C~se To ~iveway, Pa~kinu ~ea, o~ Vehicle Stora~ ~ea Counts ~~~~ LIFT STATION Date Installed i ~i~-~ ~ "Pump ~" ~vel at /~~ Off" ~vei at High Water ~ ~vel at ~ Vent (Y~)-- ~ ~ Tested fo= / ~ing Cycles du~ing Adequa~ Test. ~ets ~A Eleetrica~~) ** Check Permitted Bedrcom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA on the date of~ this ir~pectio~. KB1/d5/s [Page 2 of 2] BILL SHEFFIELD.. GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: SOUTHCENTRAL REGIONAL OFFICE 437 "E' STREET, SUITE 200 ANCHORAGE, ALASKA 99501 274-2533 To Whom It May Concern: cordi nq.to records _ Water Regulations. on file in this office the ~ .. Water System is in complian~ with~Fh~ State Drinking Sincerely,