HomeMy WebLinkAboutSUNSET HILLS BLK C LT 11LoT'
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF FIEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELL INSPECTION REPORT
PHONE [ []NEW
NAME
LEGAL DESCRIPTION
LOCATION
DISTANCE 'FO:
NO. OF BEDROOMSW
Manufacturer No. of colTpartments
Liq IF HOMEMADE: Width ,~,.~, Liquid depth
Well Dwelling PERMIT NO.
DISTANCE TO:
Manufacturer Material Li¢luid capacity in gallons
F°undati°n~.l~g ~' Nearestlotlinell~'
DISTANCE TO:
No. of lines Length of each line~, Total length of lines Trench width
Top of tile to finish grade ~1 Material beneath tile ~ ~ inches
Length Widti~ Depth
Type of crib Crib diameter
Well
DISTANCE TO:
Depth
Building foundation
DISTANCE TO:
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
PERM,T NO. :Z
Distance between line. s~.
To t al e f ,eof~.9~) t~ ~r ea
PERMIT NO.
Crib depth Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line ~PERMIT NO.
Sewer line Septic tank IAbs°rpti°n area(s)
APPROVED
72-013 (Rev. 3/78)
DATE
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^' ~UNICIPAI-ITY OF ANCHORAGE
~(~ ~~-~'~J~'~ Department ~f Health and Environmental ~rotection
825 L Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT * * ~
Permit ~ ~.C~% %~
~ND/OR ON-SITE SEWER PERMIT
Applicant: /~F~. ~f%t~_ ( Mailing Address:
Location, ~Q~¢} ~. Phone Nu~er:
Type of Soil ~sorption System Is:
Trench: Drainfield:
Maximum Number of Bedrooms:
Size:
Seepage Bedl Holding
Soil Rating(sq.ft/br)
Tank:
The Required Size of the Soil Absorption System Is:
DEPTH LENGTH . GRAVEL. DEPTH WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /2~'-0 GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion~
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31¢ 1 9 $ 2 * * *
I certify that:
(1) I am familiar with 'the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the//~s~d.~/gce~s remodeled to include more that~3/bedrooms.
app, zcant
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION ,/~ P~E.?~._COLATION
825 L. Street, Anchorage, Alaska 99501 264.4~ICIPALITY OF ANCHORAd~:~
SOILS LOG - PERCOLATION TES'~NvI~ -, ~.' ~I;,A. rko E'.
J
LEGAL DESOR,PT,ON:
2
~.~..~3
'4
5
6
7
8
9
SLOPE SITE PLAN
~--~10
11
12
13
14-
15~
16-
17~
18-
19-
20-
COMMENTS
~_r~ ~'4 ~tZ~ st, ~/~.
PERFORMED BY:
%/e'/ 3
72-008 (6/79}
MC /z'ccccJ ,~l I+ WAS GROUND WATER
~ ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Reading Date Gross Net Depth to Net
_'Fime Time Water ~D~
I ~,.,~ tO;Z41 ~...- &9'
O~
IotSI lO ,77 ,OG
,f~ l~ :51 io ,5f' .0'1
PERCOLATION RATE ~ ~ - (minutes/inch)
TEST RUN BETWEEN ~' '*~ FT AND '~/ FT
CERTIFIED B~ ~ DATE:
ALASKA erluiRolameriTAL COFITBOL $ RUIC65, IBC.
~nqin¢¢rinq 6 ~,~ir.o,,n¢,l,~l
SPECIFICATIONS FOR ELEVATED BED ALTERN~kTIVE WASTEWATER
TREATMENT SYSTEM~. LOT Il,BLOCK C, SUNSET HIL{,S SUBDIVISION
1,0 GENERAL
1ol THE DRAWINg;S, SHEETS 1, SHALL BE A PART OF THIS
SPECIFICATION.
I. 2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE
REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND
ENVIRONMENTAL PROTECTION PERMIT.
2.0 THE LIFT STATION
2.1 THE STOCK MATERIAL FOR THE LIFT STATION SHALL BE EITHER
GALVANIZED STEI']L (ASTM A-4444-76), OR ALUMINU~t CULVERT,
CAPABLE OF BURIAL TO ].0
2.2 THE 24" PIPF, FOR THE LIFT STATION SHALL I{AVE A WELDED
WATER TIGHT BOTTOM OF THE SAJME THICKNESS AND
COMPOSITIOn[ AS THE CULVERT.
2.3 ALL PENETRATIONS OF THE LIFT STATION SHALL BE WELDED
AND WATER TIGHT. ALL WELDS SI{ALL I~E CLEANED OF SLAG.
WELDS ON GALVANIZED STEEL WILL BE SPRAYED WITH ZINC
RICH PAINT OR COATED WITH BITUMASTIC.
2~4 THE TOP CAP SHALL BE RAIN TIGHT AND SECURELY FASTENED
WITH SCREWS.
2°5 ALL ELECTRICAL FITTINGS AND CONNECTIONS IN THE I,IFT
STATION SHAL,D' IIEET I'HE REQUIREMENTS FOR A WATER TIGHT
SERVICE.
2.6 THERE SHALL BE A ItlG~! LEVI~L ALARM SET AT THE LEVF, L OF
THE SOIl{, PIPE FROM THE SEPTIC TANK. THE BUZZER SHALL
BE LOCATED NEAR THE ELECTRICAL COHTROI, PANEL OR IN A
LOCATION DESIGNATED BY THE HOMEOWNER.
2.7 TIlE SUMP P~MI~ SHALL BE CAPABLE OF DELIVERING l0 GPM AT
A HEAD OF 20 FEET.
2.8 TI]E SUMP PU~iP SHALL BE SUSPENDED NOT LESS THAN 6 INCITES
OFF THE BOTTOM OF THE LIFT STATIOH WIT}I A ~HAI~ OR
NYLON LINE.
1220 ~Jcsl 25th J/ucnu¢ o A,¢hor~§¢, Al~sk~ 99503 ~' (907) 276-136~
ALASKA £NVIRONIV--NTAL
CONTROl.. S£RVICL , INC.
!220 West 25th Avenue
ANCHORAGI£, ALASKA 99503
Phone 276-1361
· L
1.. UI-XE'I"FII\NE FOAM coHOULD [:[: ,tl'[:!_l r; 1('
/, I} E t:~T H
BEI..OW GROUND SIJRFACr:.. ' ,:'I,
2,: COAT BOTTO~ 2 FEFT
-~ ~ ~- - .
4, SEE SPECIFICATIONS FO[~ 14ATCCqALC,
OF 4
Il\JCl t,
PAIN 1'.
F E: E T
L_IF-r
GROUND
(}l-I/-\.lhl ()ii NYLOI',I ROP[f!
F'UIqP IK)WER CORD
ALARM CORD
.//
4" STEEl NIPPI..E--~
. [qETAI.. CAt:: WITH
,FILL. ET WELD
/ALI. AROL ND
1/t"T0 q" COI.JPI_ING
\~ ;I
!~ Nf r NIPPI_E
..... j 1,~_~ FLEX HOSE
~ CI'I[! C K VALVE
plJh~lp
ALASKA enUIROFImeFITAL COIqTROL SeRUIC $, IrlC.
~n§il~¢¢rincI ~ ~uironmental $1udies
04/09/82
NORTHERN ADJUSTERS
2609 ARCTIC BLVD
ANCHORAGE AK 99503
MUNICIPALITY OF ANCHORAGE
R, ECEIYED
SELLER - BRANDEL BUYEIR-BRANDEL
SUBDIVISION-SUNS~ HII~LS B]~X/K..-C LOT-il
ADF3QUACY TEST FOR SEWER SYST~I~
THE TYPE OF ABSORPTION SYST~]%I IS A (/RIB WITH AN UNKNOWN AREA.
THE SYSTEM IS CAPABLE OF ACCEPTING 270 GALLONS OF WATER PER DAY.
q~E SURGE CAPACITY OF THE SYSTMM IS 1750 GALLONS.
BA~t~ UPON THE Tg~T DATA THE SYSTEM IS NOT ACCEPTABLE FOIl A
HOME OF 4 BEDROOMS.
SEPTIC TANK ADEQUACY
[PHE EXISTING SEPTIC TANK VOLUME OF
THIS 4 BEDRCOM HOUSE.
1250 IS ADEQUATE
1220 We$I 251h ~ucnu¢ ·/~ncbrc~§c, /~lc~sb 99503 · {907) 276-1301
,p
.£
(e.~eol't'd~.a,l, u! %no I'['[,l)
SHIJ, IqlDVR ~,LVa dNV ~DVt'h[[S qVI'RIIAI6NI
30 qVAO'8~dV HO.i £SH~O~M
· IeAo~dd~ ~o ~.ep ~q~ ~u!~oIIo~ ~oX ouo ~o~ p!I~A ~! I~Ao~d¢I¥
:suoj~!puo3
qr4NNOS~I[ld &N~h&HVdHd HiqV~H IEI J,[lO ~E[qqld 2~ O&
peu:x,S a~eG ~u~o:Iddv :o ecm.%<~u:;'[S
'o~peT~ou>{ Kut ~o %soq oq:~ o:~ :~oe4c~oo puc onaa s! m4o~ stq~ uo uoz~.euiaojux, eq& '6
'odoTs punoaU jo uo!~oea!p pue
~uo!~ooI esnoq ~uo]leooI '[Iob%'~sou!I 4:b~odod~ :uo!$nmaofu! m!~oIIo~ eq~.
,'--- ................. fiq peuiao-.I-4ed a. se,k uo.~3~Too,xed
.....- '~' - --'-- ~'~---- -S~'EnSO~ %sO.L uo!%eTooaad
HEALTH AUTHORITY APPROVAL
iNDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SY$1'Ei
PART I.--.TO BE COMPLETED BY FHA
INSURING OFFICE
_F~e. de~ral~ _H%ming Ac~'l. nist~ratto~n_
MORTGAGOR OR SPONSOR
Gerald T. Goard
~UBDIVISION NAME
Sunset Iiills Subdivision
TOTAL NUMBER:
BASEMENT
'-- ~SERIAL NO,
MORTGAGEE
National 1Bank of Alaska
Box~60.g~ Anchorage, Alaska 60-008983
BLOCK NO.
WATER SUPPLY BY:
[] Public system
2
lYes
] New installation
~] Community system
SEWAGE DISPOSAl, BY:
-'1 Public system ~,] Coll:lmunity system
J ean attic or other area be mado Into
additional bedrooms?
(If Yes, how many~/
t SYSTEM DESIGNED FOR
[] Individual r4o. o~ ~o-,~s. o^.~^o~ ms,~s^t
[] Individual 4 ~ Yes ~ No
PART II.---TO BE COMPLETED BY HEALTH DIEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
It is the opinion of the [] State [] County Local Department of Health that this individual water-supply system
[] is {~ is not satisfactory asa domestic water supply for the subject property.
is the opinion of the [] State []
It
County
tern with proper maintenance:
~'[~ Can be expected to function satisfactorily, and
~s not likely to create an insanitary condition
Local Department of llealth that this indi/vidual sewage-disposal sys-
[-] Cannot he expected to function satisfactorily
DATE ' SIGNATURE TITLE
PART III.~FOR USE OF FHA OFFICE
TO THE CHIEF UNDERWRITER:
I have reviewed the ~bregoing and the pertinent FHA Compliance Inspection Report, and recolnmend that'the
Individual water-supply system be considered ~] Acceptable [] Not Acceptable
Sewage disposal be considered [_~] Acceptable [] NEt Acceptable.
SIGNATURE [] CHIEF ARCHITECT
DEPUTY FOR CHffP ARCHIIECT
FHA Form 2573
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Roy. July 1958
· v 'Au~ j! 'sl!q!qxa paAo~ddu q~ya Aldtuo2 aon_~oD-[] saop~.~] uoD~llmSuI
/
'Ilar, pa~o~t [] 'llam ~n(I [] 'llaa~ ua^?G [] 'lla~a poII!JG.G~ :moJj tlddns Jmu^x lunp!a!pul
O J2 'aU]l ~h~ado~d ~uoJj tuosj :~uq las 2u}l[oax
· stua~*Xs Fsods!p-agutaas pu* alddns-aa~u;~, l~npFqpu} q~oq qa!a~ padola^ap gu!aq ~n,~ ~m .rS] aau J~J pooqsoqql~?u u! sa!lsodoJd
WIISAS Alddfl$-illlVgA IvFlalAIONI~NOIID3dSNI ~10 /itOdt~t
'/apude~ p!nb!l ImO&
WIJ, SAS IVSOdSI~I"IOVA~t$ lvn(11AIONI~NOIJ, DIdSNI :lO J. UOdtU
Lot 11, ~loc'k
I
I
I
I
/ INDIVIDUAL WATER SUPPLY
Seclion of Sanitation and Englnee~lng
ACTION ON REQUEST FOR BACTERIOLOGICAL WATER ANALYSIS
examfnulion-ho~ b~en ¢omplolod,
Ilecord~ in thf~ office indicate this Individual P~y.~t~ Wafe~: Supply to be ot______8~llsi~cto~y Questionable. . .Unsat siacto~y
Ancly~ls shows ~1~ SAMPLE to bo __Satisfactory.
If un "Unsat{sfaclo~y" or "Questionable" status is indicated above, you should take Immediate action ~s recommended below,
closed leaflet, "Drink Ii
2. Improve you~ up~lng ~ See bulletin HBE-8-2
3, Improve your cistern ~ ~ee bulletin H8E-6-3
4. Improve your dug wetl ~ ~ee bulletin HSE-8.4
5. Improve your d~Iven well ~ ~ee bulletin HSE-6-5
7. Relocate your well to a ~afe location In relationship to your sewage disposal system ~ See bulletin H~E-15
9. Sample too long tn t~n~it~ sample should not bo over 4B hours old ~t examiu~tlon to indicate reliable ~esult~,
Please send new ~ample,
10. Contact you~ nearest [~ Local He~tth Depaflment or ~ Alaska liealth Depa~hnent Banitation office for
I1. ~his ~: a ~ud~ce water ~ou~e and subJec~ to pollution by man ~nd anhnal~, An approved w~ter ~upply source
INDI~][I)UAL VJATBR SUPPLY
ALASK~k DEPARTMENT OF HEALTE[
Section of Sanitation and Engineerhlg
Request for Bacteriol?glcal Analysis
I-Pleas~ Look on Reverse of]
Sheet for Slun~_p~le~ Colleetio./
L ,~ J
~. ~o ......... fi:.[;..~...[:.:..;.}.!}~. ......
Water sample collected by.. ...~.. ........ ~,....~., .f.[..Z.-;_~..~. .............................. ~:.~..,.~...'~...
(Name of person collecting sample) (Date) / (Time)
Water sample collected ~rom [] Kitchen tap; [] Bathroom tap;,~Basem, ent tap;
o o.,e~ (,,~,,, ,,~:'-:' ............ : ............. .~.....-...:..........~/::~ ........... ~......;:::.~: ...........
Aad~e~ premise w~ere ~ource ~ located ........ ~.....~d.x~.~.z-..~..(,..:..~'..- ~ ~ ...................... ~......~..~'~
,,,,,.~o~ ~o"e-.~' ~~ ........... :~~~-- ............................... : ............ :.. .............................................. :. ................
' (Name) (Box ~o. or su'eet address (City;
Please pl~ce ~n "X" In t~e box before Items w~lc~ b~t describe yom' w~er supply:
~OU~OE: Well -- ~ Dug,~rlven, ~ Drilled, [~ Bored
~ ~prlng, ~] Olstern, ~ Ot~er (list) ...............................................................................................................
~ Oreek, ~ ~lver, ~ L~ke, ~ Pond ..................................................................................................................
DU~ ~LL
OR 0ISTE~N OONST~gCTION: W~lls ~ ~ Wood, ~ Concrete ~t~l, ~ ~le, ~ Brick or Concrete Block
Top -- ~ Wood, ~onorete~ M~t~l, [~ Open Top
LC)0ATIO~: ~ In b~ement, ~ Basemen~ offset, ~ Under ~o~e, ~ In y~rd
Other ............................................... : .....................................................................................................................................
DISTANOE TO: But d~n~ se~er or o~her drainage D~Do.. ~.:?......fee~ Septic %~nk .~...fee~ Tile f~old ..............
fee~, S~ep~e Pl~ ~,~, Cesspool .... .......... feo~, P~V~....2~... feet. O~her ~ssible ~ouroes
of contamination (1~).....~ ................................................................................................................................
~TERI~:BuHdln~ se~e~ -- ~s~ ~on, ~ Wood, ~ THe, ~ Fibre DIDe, ~ Asbestos cemen~
Jo~n~ m~e~l -- ~De...~ .......................................................................................................................................
GENER~ I~OR~ON: Does ~a~e~ become muddy
~hen? .......................................................................................................................................................
Dlameler of welL.....~ ............................................ depth
..........................................................
~e]l ~asing ma~erial...~.....~x~ ......... diameter .................... dop%h ..................................
~m o~ ~o~ p,~ ............ ~L~!~._._~..!~.~ .............................................................................
Wa~er depth from bo%~m ........ ~....~. .........................................................................................
Pump loea~ion:~In well, ~ Offse~ in basement, ~ In basemen~
In u%t]l~y ~m, [~ On %oD of ~ell
[~ O~he~ (~) ........................................................................................................
PURPOSE Q~ ~X~I~TION' Illness suspec%ed9 ~ yes ~]no Ne~v sou'ce of supply~ yes, ~ no
Remar~~ ~ ........................................................................................................................................................
PLEASE DRAW A~J~E SPACE BELOW. ~IS SK~CH SHOULD SHOW I~CATION OF HOUSE, WA~
SUPPLY SOURCE, SEPTIC TANK, SE~R, DRAIN LI~$ OR O5~ SOURCES OF POLLU~ON ~D DISTANCES
BE~.EE~ WAT~ SUPPLY SOURCE AND A~ OF ~OVE FAC~ITI~,
.... ' E
SAMPLES MUST BE SUBMITTED IN CONTAINERS PROVIDED BY THE ALASKA DEPARTM NT OF HEALT