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Home My WebLink AboutTIMBERLUX #2 BLK H LT 9,2 7/ '-'/¢'. LOT" ~,.,/ MUNICIPALITY OF ANCHORAGE · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Tel.ephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME F~,.~s "~ ~l~. ~,O~e'~ PHONE ~NEW ~fl ~ql ~ UPGRADE ~AILING ADDRESS ~.o,~ DSSCm,T~O, LOCATION NO. OF BEDROOMS ~ ~ DISTANCE TO; JWell ~00 I Abs°rpti°n area~ Dwelling Liq, capacity in gallons Inside length Width L]quld depth ~000 IF HOME.DE: ~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ Manufacturer Material Liquid capacity in gallons PER IT D Well Foundation Nearest lot line ~ ~ DISTANCE TO: I00 '~ ~ ~ ~ ~ ~ Top of tile to finish grade ~. Material beneath tile Total ~ffecdve abso~tionsrea Length Width Depth ¢ PERMIT NO, ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, ~ DISTANCE TO: Ruilding foundation Sewer line Septic tank Absorption area(s) PIPE MATERIALS SOIL TEST RATING ~ . INSTALLER APPROVED DATE LEGAL 72-013 IRev. 3/78I PERMIT NO. i'.lllJl'-.! I ,.:: ! F~e--IL I T~." C,F Ri'-.iC:H~'-'RR,.aE ~_.~/ DEPARTMENT 6~"HERLTH AN[:, ENV I RONMENTRL i..,...~TECT I ON ~) 825 '"L" STREET., ANCHORAGE,, RFC 99501 ,~r~> 264-4720 ~4ELL Ri4[.'"' E, ['~ -- :----; I Ti 5E~,~EF.: PER~4 I T ( 8209~2 ) APPLICANT LOCATION LEGAL FEJES DEVELOPMENT L9 BH TIMBERLUX 6917 OLD SEWARD HIGHWAY LOT SIZE 99502 ~49-669± 999999 SQURRE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRRINFIELD MRXtMUM NUMBER OF BEDROOMS BOIL RATING (SQ FTZBR)= !60 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [)EPTH= 5 LEI'-~,.STH= --¢.8 i.3RR%-'EL [;"EPTH= 2 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THE TRE[-~CH ~IDTH IS 5. ~Zl¢~3 FEET. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REwg!L! I RED SEPT I C: TR~'-~-;: _'S. I ZE= 1OOO 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. TI4Ci (2) I f4SPE£:TI Clf4S REdE F~EQUIREC. BACKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION RND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC NELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PER~'! ~ T E:'-(-.F" I RES DECEI-'IBEF-' I CERTIF'¢ THAT 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH B'¢ THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. Z~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REF~E:,ELED Tr~ INCLUDE MORE THAN ~ BEDROOMS. ~~.' ........... RPPLICRNT FEJES D~/ELOPMENT TgST MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG" PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15- 16- 17- 18- 19- 20- COMMENTS ~_~/ ~-;/,,~ SLOPE DATE PERFORMED: WASGROUNDWATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN FEREOR,~EO 72-008 (6/79) Reading Date Gross Net Depth to Net ¢ Time Time Water ,.~¢ Drop / 91,/ 0 o ~. '~ PERCOLATION RATE / ¢'~ - ~, ,' , ;.~lnjnL~tes/~nch) TEST RUN BETWEEN 14o ~.~ ' ' ~" ..... ' ' ' STAR ].ROUTE A ANCIIOI~A(~E~ ALASKA 99~0~ SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF ,!?,~3o00 PEr FOOt. "'~' ~' ~cu'e. Lot~.en.L C!,~;~ ?-'e~e~ 337-2,272 P~OPERTY OWNER ~'~'~ ~ DRILLER 2~$=9897 WELL LOG: 0 .... 26~ S.L!At> ~a.n~tj. ~.~.u'eZo 30',5 26 ....65~ Corpse. ~.~. 92--102' ~'O'~t c~c~k,.~ 75f~ ~zc~geA ~ 780 .fic~t: /;4140.00 WRITE CHECK PAYABLE TO RAMPART DRILLINg WORKS FOR THE SUM OF COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLINg. S4140. O0 DaTE THANK YOU vErY MUCH. BERNIE CLAUS OF RAMPART DRILLINg WORKS SERVICE CHARGEOF I~% PER MONTH WILL BE ASSESSED ON PAST MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONI~ENTAL HEAJ~TH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information × / Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicants Name ~ _~b~)~. Telephone - Home Business (a) (b) Applicants Address (c) Applicant is (check one) Lending Institution ~--~; Owner/buildCr~ ¢ - Buyer ~ ; Other~ (explain); (d) Lending. Institution Telephone Address (e) Real Estate Coo & Agent Address Telephone (f) Mail the H~ to the follpwing address: 2. T_y..p=~_of Residence Single-Family~ Number of Bedrooms 3o Water Suppl~.- Individual Well~ Multi-Family~ Other (describe) Community ~ Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposa~ll 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 i of 2] Engineering Firm Providing Inspections~ Test~,__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 files and from my investigation and inspection, the on-site water supply and/or wastewat~r disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection° ! ~c3~7-~ Telephone ~-~_~__ Date ~ ~ ~'~ (ENGINEER SEAL) DH._.EP ApprovalS, Approved for ~ ~ Approved ~ bedrooms By "~V Disapproved '~ ional -- Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA° THE DREP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES ~ND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] - 7-19-84 MUNICIPALITY zANCHO,RAOE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION A. W~LL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description Well Classification Well Log P~esent (Y/N) Total Depth /(~50 ~ / Cased to APR 2 $ RECEIVED Static Water L~vel ~¢ ~¢~ ~.~_?s~ Pump Set At Casing Height Above Ground Electrical Wi~ing in Conduit (Y/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line -- ~ ~-~ Sanitary Seal on Casing (Y/N) ~ Depression A~ound Wellhead (Y/N) A/ ; On Adjoining Lots /~)a~ ; On Adjoining Lots To Nearest Public Sewer Cleancut/Manhole /Y~ Wate~ Sample Collected By wate~ Sample Test Results Comments To Nearest Se~ Service Line on Lot B. SEPTIC/HOLDING TANK DATA Date Installed /6/~7~ Standpipes (Y/N) Y Depression ove~ Tank (Y/N) Size Ai~-tight Caps (Y/N) Date Last Pumped No. of Ccmpartm=.nts ~ Foundaticn Cleanout (Y/N) ~ Pumping/Maintenance Contract cc% File (Y/N) -- ; for -- Holding Tank High-Wate~ Alarm (Y/N) ~ Temporary Holding Tank Permit (Y/N) Separation Distances f~om Septic/Holding Tank: To Water-Supply Well /50~- To Building Foundation To P~operty Lir~ /6 ~-~ To Disposal Field ~ To Water Main/Service Line Course To Stream, Pond, Lake, c~ Major D~ainag~ Cements [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /LO~.~ Type of System Design Date Installed /~/<~ ~_ Length of Field ~ ~ ~ Width of Field ~ ~ ~D~ of Field Grail ~d ~iek~ss S~e Feet of ~s~tion'~ea ~ ?~ Stan~i~s ~e~nt .(Y~) ~p~ession ove~ Field (Y~) ~ ~ of ~st ~a~ ~st~ Results of ~st ~a~ ~st m-- ~$ ~/~ ~ ~--~ ~ ~p~ation Dista~ ~ ~s~ption Field: To Building Foun~tion ~ 3o~- To Existing or ~ndo~d System Lot ~/~ · ; ~ ~joining ~ts To Wate~ Main/~vi~ Line ~ To ~t~(if ~e~nt) To St~e~ond~ke/~ ~jo~ ~ai~ ~ To ~i~way, Pa~ki~ ~ea, ~ Vehicle St~a~ ~ea Counts Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Co~ents Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA ** Check Permitted Bed~oc~ Rating AGainst HAA ~quest I certify that I have checked, verified, c~ conformed to all MOA HAA Gu on the date of tJ~is inspection. Signed <~L~?tSL~., Date Company ~..~,,~_~'/~ ~r/< MOA NO. KB1/dL/s in effect [Page 2 of 2] 2-15-84 Location: Client's Name: Address: BESSE, EPPS & PO~S 2220 EAST 88 AVENUE ANCHORAGE, AK 99507 (907) 349-6451 Tester: Initial Reading o~ Meter: /~/ Production Rate: ~, / GPM 24--Hour Capacit~ · INSPECTION APPOINTM ENTS t ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] Other [] One [] Four J~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER SUPPLY ~1~ INDI¥1DUAL* * ATTACH WELL LOG. A well Icg is required for all wells drilled [~ COMMUNITY since June 1975. For wells drilled pr[or to that date, give well [] PUBLIC UTI LITY depth (attach lo§ if available.) 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-,SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS E~--'--SI NG LE FAMILY [] ONE [~TH R E E E} FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SiX 2, WATER SUPPLY PERMIT NUMEER ~ INDIVIDUAL DEPTH OF WELL /~.Z.~-~ , ~' <~ ' ~ COMMUNITY DATE DRILLED ~ PUBLIC UTILITY ~ [~ ~ ~ Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~INDIVIDUAL/ON -SITE DATE INSTALLED ~PUBLIC UTILITY /g ~ / - ~' Connection Verified INSTALLER ~Septic Tank or ~ Holding Tank / g ~ Size: /~ ~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER Tank Absorption Area Sewer Line 4, DISTANCESwELL TO: Septic/Holding /~ /Z~ . Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~ CO~DITIO~Ak AP~BOVAk {lettor must accompang certificate~ DATE BY 72 010 (Rev, 6/79) ' APPLI(_,~?T FILLS OUT UPPER HA~.~: ONLY Lending [nstltution~ Phono Type of Resi~nce Single Family Water Supply ~ Individual A~ACH WELL LOG. A w~[ log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available); ~ Public Utility ~ Individual Year Individual Installed: Public Utility When Connected to Public Utifity: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector ,¢./-;,.~ 0 F_NVIR,)hlk.:t,,A. [ ':_~ 2 5 1983 RECEIVED ( ) CONDiTiONAL APPROVAL' DA,=rj= .~-~. ~ ~-'~ / Soils Rating Date Sewer Installed Well To Absorption Area //-b~'~ Well Log Received / ~ ~ // ~__ / - 4¢' t~,~ Well to Tank ,~¢¢'*~) Septic Tank Size / ENGINEERS PLANNERS SURV.EYORS 2820 "C' STREET, SUITE NO, 3 ANCHORAGE, ALASKA 99503 PHONE (907) 272-9231 SURVEY CERTIFICATION: J hereby certify that I have surveyed the property shown and described hereon and that the improvements situated thereon are within the property lines and no encroachments exist other than noted, NOTE: It is the contractor's responsibility to check top of foundation in relation to finish grade and building setbacks relation to lot lines and easements, LEGAL DESCRIPTION: LEGEND: · 5/8 REE~ARSET O 5/8 REE~AR POUND (~ 2"x2" HUB & TACK SET ~ EX[STING ELEVS. DATUM ASSUMED CHKD: 22,//4: SCALE: /d~/