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HomeMy WebLinkAboutTHE LANDINGS BLK 2 LT 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SFRVICES Environmental Health Division 625 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SFWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address ~ TANKS ~EPTIC ~ HOLDING .,~y,,PE OF SYSTEM [] TRENCH [~' BED [~ W. DRAIN E~ OTHER ~J~ SOFT ~,~ WELLS ~I~PRIVATE [] OTHER (Idenlifv) REMARKS: ~uflicipal alld Staid guidelines in ellecl an lids dale: DISTANCES FT SEPTIC TANK 72-013 (3/85) ADSORPTION FIELO WELL FOUNDATION I 0 J ¢01 ~¢) 0j diiveway, water bodies, eta ) -- ~--~ ~)c,~ accordia[i lo ail y tiaa this i:spection was pedormed :1: C;I:I:R'I':IZI::'Y 'II"IA'I ',~ :~",, :!: ~<J:i:l.:l :ir~::rL~::].:J. [.Ii(,:', :::y:::;'Ll:~m iii ================================= ~:['LI~ <~:!:1. I~t(::)(: (:::c::dc,)::: arid d:J?.t:a:.unc:(.:::: fr.c:)m arty G:,:.ci:::'l.:i. lq~j t,,~c.:):t.:t.~, v, Ja~:;(:t.::.~tm::C[:~P ::::::::::::::::::::::::::: ?.:/::i (:<:)m ~::;c)t~.x::.H'i::(j::~ :::;'y:~r~.e:.m (::)it 'Ll"l:i::i c:H" ,'.~:l~y i:d:l.j,'::u:::~:.:r'Y~', cH, rt(:'.~i:u":)y :l.c:i'L. zI,, :[ Lu"i(::ler'?,'f.a:!'id 't'.ha'!:. t.l"l:i.s:; ID(:~PmJ.'~. J.:S Wi.:~].id fO~' a ma:x:i.m:..m'~ c:,f' ::5 a:::l.~::(::l Lu'H:l,:")r'::i'l:.,a:rld {:.l"l/.l'{', '1:.11~.) (::~::l:U:::c:i.'hy <::)~' ['.lie) '{'. c:) l:. ~:/ :l. :sy::v~.(")lit :i.::l ::~; <.iii1 .[~]._~1 {.:.t(j. dJc.[IL ~...t ]. ~ :..HL~.r~. <..~J] ,..,LICIJ. I,:[Hh..I I)(,[ [1/..~ · ....................................... ((::)¢a~'a*::.~') 1:::I:~.51qC,:J:,: ¢,} , I ILII:RI::I IY MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet, WR~C~3 PID% Date Received: ]Legal Descriptioh: Engineer: Permit ~/ Applicant: Waiver Requested: Criteria: 1. Geology: Points: A. Water Table B. Soil $orption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: List Conditions or Date: Waiver is NOT Granted: Reasons for above: · : ~ ~ game of ~evi~wer Rec ~: $~yO:(~-~.-'- Date Paid: ~(~'~'$~ _ CORWIN & ASSOCIATES, IN(;. 4790 Business Park Blvd. Building E Suite 1 ANCHORAGE, ALASKA 99503 Phone 561-6151 JOB - SHEET NO CALCULATED BY CHECKED BY SCALE OF DATE DATE (Ei"~GINEER'S SEAL) Mun*c~pahty of Anchorage , DEPARTMENT OF HEALTH & HUMAN 825 "L" Street, Anchorage, Alaska 995 SOILS LOG -- PERCOLATION 4- 5- 6- 7- 8- 9- 5P CIPALfl¥ OF ANCHORAGE DEPT, OF HEALTH & PROTECTION OCT g ~989 RECEWED 20- Township, Range, Section: SLOPE WAS GROUND WATER ~.~) ENCOUNTERED? SITE PLAN IF YES, AT WHAT O DEPTH? p f~oflilodng? _/ Dzte: __ Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ (minules/inchj PERC HOLE DIAMETER ~ ,- ~ TEST RUN BETWEEN ~ FI/,~,ND ~ FT COMMENTS_ I/__~..~.- ~;~ ~ I~o r~.~./~~ i,/JlJNi¢II~^LITY OF ANCHOR/~E DI~PT, OF HEAL1H & ENViRONMENTAl, PRO'[ECTION 1989 RECEIVED OLD SEklARD I-INV. /77' .t+ ¥ DPqVENA¥ N F:.LL SYSTF_M"LOCATION PLAN OLD SRNARD HI,IX/. ................ ~.~. OETERM NED aY USE OF CLOTH TAPE AND Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERV 825 "L" Street, Anchorage, SOILS LOG -- PERCOLATION ENGINEER'S SEAL) PERFORMED FOR:_,~(-_~ r;--/~,,/~ ~ LOT LEGAL DESCRIPTION: 'T' ~-~ ~ ~V~TE ~1 ~ LANIDI OL 1 $'P PooH7 3'-°d~J 3 4 GM 5 6 7 8 9 10 11 12 13 14 15 16 17, 18- 19- 20- Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? NL o __ IF YES, AT WHAT DEPTH? Depth to Waler After Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE - (mmutes/inchj PERC HOLE DIAMETER 'rEST RUN BETWEEN _ FT AND .FT ACOOROANCEWITHALLSTATEANOMUNIOIPALGUIOELI/~:EFF//NTHISDATE. DATE: MUNICIPALITY OF ANCIIORAGE Hea. and Environmental Protec ~n Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 SEPTIC TANK: . / '~ / > / ,, ¢ TOT.~ ~.¢~_- LINE ~ _OF LINE ~ of Lines I. . o,srArqcE ~EIWEEi'I LINES __W~ __TR~ZN('I[ WIDIII~.~ IN. TOI'AL EFFEC~ IVE SEEPAGE PIF: Log Crib Rings Crib Size: Oh'\ME ItR ._WEPFII ...... DISTANCE FROM: WEt L TOl',n L EFFECTIVE Well ~ Class :~_/~L~J_ - Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: ~j,~ ~ o~ ~room~, %~ Remarks: ~¢'- WATER WELL LOG FOSS DRILLING 1336 Ingra Street WELL OWNER Anchorage, Alaska 99501 SIZE OF CASING~ ~.~_~ DEPTH OF HOLE~L~T. CASED TO .... FT. FEET OF DRAWDOWN. REMARKS DATE COmPLETeD_?-/~ 77 Iii:dE I::'l=ll~i:'l H E N T ILn. I1..,.,I. II II I'.,II...II','II~!~I{!!:F.: OF' EE. II ..... IL = '1 HEi; LEI'qi3TH I:) ;[ I"IE:N:!~ ]; O1'-,I ;[ !:; THE LENGTH ,:: ]; Iq I::'EE-f' ::, OF:' TI..IEZ 'FF:EI',ICH OI:R E:,E'.I::'I ]Z NI::' ;IZ IEI...D 'I'HIE E:,[EI='TH (31::' FI 'fRI~iI'.,ICI-{ E)l~: I:::']:T ]:::; THE [) ]: E;'I'FII'.,IE:E I~E:'I'I,.IEEN THE :;~;IJF~:FrFIE:E (:IF' TI.lIE (?iI:ROLIN[;, I:=II'.,ID TI-IE E:OTTOI"I O1= 'THE E::.::CFWR'I';[ON ,::];I'.,I -fHIEI:;i:E )::E; I'.,IO :E;IE-I' 1,4:1:I:;:,'1'1.-I FEd:;?. '¢I. IE 1:31:;~:l::l'v'lEl.... DI~;I::'"I"H ];F~; "I'I. IE; I','l;[l'.,IZh'l(ll','l DEPTH OF (;JB'.I:~',IE:L. I;~i:ETHE;E;I',I TILE: oI. rI'F'FII..L. F:tI'.,ID THE; E:OTTOM ElF TI.-II~; E;:.::E:F:I',¢'I::'II-):EII'q ,:;ZN FEET:). I,'i]:I'.,!:I:HI.JM [) ]: :iE;'I'I:::INE:I~i; lii:li~:'l'l,.ll;i:Ei'.,I FI 14E:I.I... RI'.,I[) f::li",l"r' ON"-E; ]: 'TIE :E:;EI.,IF:IGE I:;,:l;!ii;l::'Ei!~;l:'~L ~".:.;"r':E;"IEI"I ::l. EIEI t::'Et:;{"I' I:::'O1:;1: I::t I::'I:~'.:(~,,"I:~'i-IE I.,.lli!L.I OR 21;i)EI F~:i:ET FOI:;?. ¢:1 F'UBL];C HEI...t I.,.IEL.I.. I...OCii'Jii; I:::lF.'rh:; I:~:I.EIL:.¢J:[I:;~:EI~, I:'~1"][;, I"ll~J:i~;'l' li31E I:~:E~'FI..Jr;~'.l",ll~ii;I;:, -I'O THE [)IEI:='I::iF?.'IlqlENT I.,.I;[TH;[N 2i:E.I [;:,1:::1'¢:i.:., Ol: t'I"IE P.IE:I.J_. E:Ed"II:::'LIET:[ON. ~;Pli!;C ); I=' ]; IZ:I:::~'I' ]; IZIN'.i!; I':llqE:' (:]:ON'.ii;'I'Fi:LI(]:T];ON D];F:IGf~:F:II'"I!~; I:::II:;i:IE FI',,,'F:I:ILJ:~BI...IE '1"(3 1 M::ii;T FIL.[...FIT :1: SO.lDo LOG -'18- Total Dep'b~ How debermined _b3~ ~ Q-(,) ? :,'/as groundwater encountered Depbh to bedrock, > l-O' Respecb:Fully submit bed, Gary b"0 P].a~or Consul'Ni. ng Geologis'b MUNICIPALITY OF ANCHORAGE ,~ Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICl-'S 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORI'FY APPROVAL OF ON-SITE SEWER AND WATPR FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Mailing Address (d) Real Estate Company and Agent _ Address Telephone f'~7 A (e) Mail the HAA to the following address: (or check here E~f 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 ~' Community [] Public FI Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site E~ 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. 72-02S(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 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 regulations in effect on the date of this inspection. NameofFirm ~/~b'L)//L,/ ;¢ //qL%%~,,~_~ Telephone Address / E.'C~' ~.. . ~) / /U"! ~, f~ g (Z L-- U ~b Engineer's Seal 6, DHHS APPROVAL Approved for~C'~)bedrooms by Approved ~" Disapproved Terms of Conditional Approval Conditional Date The Municipality of Anchorage Department of Health and Human Services (DH HS) 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 DH HS 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. 72-025 (Rev. 7/88) 88ck Page 2 of 2 A. WELL DATA Well Classification MuN~AUTY ~_NViP, ONM~NTAL sERVK;ES DiViSiON MUNICIPALITY OF ANCHORAGE (MOA) Health Authorily Approval (HAA) CHFCKLIST - FEBRUARY 1984 OF ANCHORAG~ 343-4744 OCT 5 1989 Legal Description: If A, B, C, D,E.C. Approved (Y/N) /~,.~/~r Well Log Present (Y/N) k// Total Depth / 2-55' 'Cased to _/~/Z~ Depth of Grouting _ /.)/2/~- Static Water Level .~'~"~ / Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Pump Set At __ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ~:;~/g2~"~ ; On Adjoining Lots To Nearest Public Sewer Line ,,,4.J/~/~ _ To Nearest Public Sewer Cleanout/Manhole _ To Nearest Sewer Service Line on Lot ~/4:'~ / Water Sample Collected by /~)/~ ~/-~/"g~"/ ;Date Water Sample Test Res.Its ~ F-~74~'~-~'~¢[ r~'~~ , B. SI-'PTIC/HOLDING TANK DATA Date Installed _¢I / '? '~ _Size Standpipes (Y/N) ~/ Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) h/~,.._ / {) O(~,~-('No. of Compartments Air-tight Caps (Y/N) k/ Foundation Cleanout (Y/N) ~) Date Last Pumped ; for v~ ./~_. 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 To Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field ~;~-~ / Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test /~' O /~ ~/~,~, Type of System Design / Length of Field ,?'~ '~/ Depth of Field .~ -- ~ ! Gravel Bed Thickness ~ // 8/~' Statndpipes Present (Y/N) //k../ Date of Last Adequacy Test To Building Foundation Lot / To Water Main/Service Line SEPARATION DISTANCE FROM ABSORPTION FIELD: /,,~ TO Water-Supply Well /'~'~ ~ / To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~',~D ~::~/'(-~ / TO Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area. Comments '>~ (-/~t ~'//"' /'~P¢!/_'~/_-~__ '-/~"' /[/~¢TZ~/~/f~ D, LIFT STATION Date installed Dimensions Size in Gallons Manhole/Access "Pump On" Level at "Pump ~f4,U"Eevel at __ __ High Water Alarm Level at /'/~/%,,,/ .,,.-~'~- Vent (Y/N) __ Tested for / ~q Pumping Cycles ~:emtSmeMrOtsA Elect rice' C~ /~ during Adequacy Test. **Check Permi/t~d/~Bedroom Ra~/ng Against HAA Request** I certify that/ h~'v/~,ch, eck J,J~, or conformed to all MOA and HA¢ inspection.// Signed /, /' MOA NO. the date of this Engineer's Seal Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) 8ack Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 DATA SH~r T PROJECT: · LOCATIQN OF ~IEL~C (Legal Description): DATE OF TEST: NELL DEPTH: iS Z FT. DATE DRILLItIG CO!.IPLETED: CASING: q FT SCREEN: DRILLER: · 'STATIC NATER LEVEL (Top of Casing): FT Elapse~ Time Since[ Clock Pumping'Sta.,-~ed/ I Depth to Orawdown Pumping Remarks Time Stopped, Min. ,Nat~r, ft. Recovery Rate, GPM O O o I 1 I Start 30 ' )40 5O }07 ',6o (! hour) 90 .120 ~2 hours 18O~T ~1o 240 (4 hour~) 2S 40 4S 77 ~ C_HEMICAL .,t_ G_E_OLOC, IC, IL_ LABORATORIES O_F_AL,tS.K,4, INC. ~,~ ~'~o.,,~2'~ FEDERAL TAX ID # 92.0040440 Dato ?,sport ?r~nted: ',"CT lO 89 ~ O0:? Coi[ectsd OCT S 89 ~ 10:30 ~ec~','ed OCT 5 89 ~ ll:O0 Special Chemlab l{ei t~: 7885 Lab Snpl ID: i Matt:.×: Parameter Tested !~e:~u] t/Unit s ~,~et hod tn.'J t ~ )IITRI~TE }{ I~D(O.iO) n~/1 EPA 353 2 Sample SM,iPLE COLiZ, CT2D BY B.J.C i'~UNICIPAL TY OF ANCHORAGE HEALTH AND I:-.f',IVIRONMFNTAI. I]BO1rEC'rlON DIVISION OF ENVIRONMEI'JTAI. HEALTH CERTiFiCATE OF INSPECTIC'N FOR I-IEAt.TII AU'ITIORI FY APPROVAl.. OF ON-SITE SEWER AND WATER FACII.IT'¢ 26~l-4720 A,ophcallon Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdwision, sccbon, townahip, range) .... _B1 ock 2 ~:~__]__'_~_h_e_ Land_! ng _S_p&?!y_:i ~_i2,] Location (address or directions) 16040 01 d Seward.Hi gh~9~ ~ 5.p~hor~e..~lz~~ ~.9 .................. q~-'[ ~__~_ (P .... (b) Apphcant Name .__B~%[ Hurph~ _ -relephoee: Iflome ~¢,~z~2~0 ...... Business _~4--] Applicant Address 2.60_4~](L Sewapd ~ghw~y,_Anchqp~e_,..~]Ask¢ (c) Applicant ~s [check one): Lendil~g Institution ~; Owner/buildor El; Doyor [:l; (.)thor Et (explain); (d) (e) (f) AdDress Roal Estate Company and Agent Address Tel6 ~none Mail Uno I-IAA to the followmg address: TYPE OF RESIDENCE Single-Family ~ Multi-Family Number of Bedrooms Thf'ee Other 3. WATER SUPPLY Individual Well L~ Community [] Public [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attestin9 to the legality and status, SI=WAGE DISPOSAL Onsite [~ Public I'~ Community D Holding Tank Note: If commLmity well system, must havo written confirmation from the orate Department of Environmental Conservation attesting to the legality and status. Page 'l of 2 ~z u~ ~l ~ ,., . ~" ,5. ENGINE£RING FIRM PROVIDING Ii~SPECTIONS, TESTS, FILE SEARCH. DATA ~-~,N[-) iNFORMA'ilOi,i ,AS Certified by my seal affixed hereto and as of the validation date shown below, I verify tlat ~qy hlvesti! ~ o~ Of ~hJs l-f( a th AuthorJly Approval shows that the on-site water supply and/or wastowater disposal system is safe. fun¢;I for the number of bedrooms and type of structure indicated herein. I fmiher verify that b~ sod on tho mfurri,xm'm ebt¢ined from lhe Municipality o! Anchorage files and from my investigation and inspection, tho on-s~te wa~tewater disposal system is in compliance with all Municipal and State codes, ordinances, arid re.rju~;d~,,,f,~, ill nifect on the date of this inspection. Nameof Firm _A. [,l. Hurf'it, t Compan,y __ Telephone ...... ~.4_~-;7!~31 Address 80'10 King Street;, Anchorage, Alaska 995~8 Date August 27, 1985 Approved .~/_~.~ Disapproval.C/ Conditional __ Terms of Conditional Approval CAUTION The Muncipality of Anchorage Depadment 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 tho State of Alaska. -['he DHEP does this as a coortesy 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 omiss~ons in the professional engineer's work. Page 2 of 2 WELL DATA MUNICIPALITY OF ANCHORAGE [MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FFBRUARY 1984 264-4720 Block 2 Lot 1 Legal Description: The Landing Subdivision MUNICIPALITY OF ANCHORAGI] DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED Well Classification Si ngl e Fanli 1,y If A, B. C. D.E.C. Approved (Y/N) N/A Well Log Present (Y/N) Yes Date Completed 8-27-85 Yield _ 5 6al./Minute Total Depth __ 125 ' Cased to 51 ' Static Water Level 12 Casing Height Above Ground 2 ' Electrical Wiring in Conduit [Y/N) Yes Separation Distances from We To Septic/Holding Tank on Lot 100' + Depth of Groutiog Pump Set At 123 ' Sanitary Seal on Casing (Y/N) Depresmon Around Wellhead (Y/N) Yes No : On Adjoining Lots 100 ' To Nearest Edge of Absorption Field on Lot __ 100' + To Nearest Public Sewer Line Cleanout/Manhole _ Water Sample Collected by Water Sample Test Results Comments On Adjolmng Lots l O0 ' N/A To Nearest Public Sewer N/A To Nearest Sewer Service Line on Lot Cherie McCracken . Date 8-27-85 Satisfact_ory. Results Attached N/A B. SEPTIC/HOLDING TANK DATA Date Installed 1000 9al Standpipes (Y/N) Yes Air-tight Caps (Y/N) Depression over Tank (Y/N) NO Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septm/Holdmg Tank To Water-Supply Well 100' + To Property Line 20 ' To Water Main/Service L~ne _ N/A Course 9-30-77 Size No. of Compartments 2 Y~s _ Foundation Cleanout (Y/N) _ Date Last Pumped 8-24-85 ' for Temporary Holding Tank Permit (Y/N) Yes To Building Foundation 13 ' To Disposal Field 10 ' 'Fo Stream, Pond, Lake. or Major Drainage Comments 600 gallons of water introduceQ Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 9-30-77 Width of Field 36 inches Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Fi~id: To Water-Supply Well 100 ~ + To Building Foundation l 3 ' Lot N/A 125 sq. ft./dbrm. Type of System Design Tile drained trench Length of Field 28 feet Depth of Field 12 feet Gravel Bed Thickness 8 feet 375 sq. ft. Standpipes Present (Y/N) Yes l'lO Date of Last Adequacy Test 8-27-85 System' is adequate To Water Main/Service Line N/A To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Properly Line 20 ~ To Existing or Abandoned System on ; On Adjoining Lots 100~ + To Cutbank (if present) N/A N/A 50~ + Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test, Meets MOA Comments ** 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 inspection. Allan W. Murfitt Date 8-27-85 ST85-015 Signed Company A.~,~. Receipt No. Date of Payment Amount: $ Hurfitt Company MOA No. Page 2 of 2 72-026 (11/84) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF: HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 . REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Con]ptete all parts on page 1, ]nColllplete requests will not be processed, Please allow ter (10) days for processing, PHON PROPERTY RESIDENT [if different from above) '2. ~IUYER MAI LING A DDR ESS , MAILING ~DDRESS PHONE PHONE I 4. REALI'OR/A(~ENT MAILIN6 ADDRESS · . . PHONE S,~I~'~'"~L. DESCRIPTION ' /~ , ~ -/->/P- .¢ L 6. TYPEOF RESIDENCE ~' NUMBER OF BEDROOMS :~ SINGLE FAMILv ~ One ~ Four ~ Other ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six ~ INDIVIDUAL' ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well aepth ~attach I~g i¢ available.) If system is overtwo [2} vears old an aaerl~V test is required by this DepartmenL [] COMMUNITY [] PUBLIC UTI LITY ~EWAC-'E DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(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 E]~NDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER E]~HN"D1VIDUAL/ON -SITE DATE INSTALLED [~3 PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or E~Holding Tank Size: /~O0 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTDR~ . a...~J TOTAL ABSORPTION AREA MATERIAL '""r' ' ~' ' 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [] CONDITIONAL APPROVAL(letter must accompany certificate) [] DISAPPROVED ~,/~ L EG~I~D ES~'~I P'~l 0 N 72-010 (Rev, 3/78) MUI~C~PADTY OF ANCHQRAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEO~CIPALITY OF ANCHOLAG 82B L Street - Anchorage, Alaska 99501 DEPT. OF tF/,I Ii -- -- . ENVIROIqMEN%'~L P; L;'rE( ~N ~lj( ENVIRONMENTAL ENGINEERING DIVISION Telephone264.4720 0g'[ ~ ~ ~g~ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEiV~.~ ~'~?JL'~TI~t DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processeu, Please ahow ten (10) days for processing. 1, PROPERTY OWNER VlAILING ADORE~ S PROPERTY RESIDENT I f different from above) MA LNG ADIbRE~S ,/ 3. LENDING INSTITUTION ~AILING ADDRESS PHONE PRONE PHONE 5. LEGAL DESCRIPTION STREET LOCATION , ~':~,t(' '-~ v ' 6. TYPE OF R~SIDENCE I~/ SINGLE FAMILY [] MULTIPLE FAMILY 7. WATE!~;LY ~ NDIVIDUAL COMMUNITY PUBLIC UTI LITY 8. SEWAQE DISPOSAL SYSTEM [/~ NDIVIDUAL/ON-SITE** [] PUBLIC UTILITY NUMBER OF BEDROOMS [] One [] Four [] /Two [] Five ~ Three [] Six [] Other ATTACH WELL LOG, A well log is required for all wells drilled since June lg75. For wells drilled prior to that date. [ ye well aeDth (attach log if available.) I If system isover two (2) years old al~ adequacy test IS required ov this Depmtment, 72-010(3/78) NOTE: THE INSPF. CTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE D/~TE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2, WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] 00MMUNITY 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 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~"~APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev. 3/78) 1978 LOt 1 r, .~ ALASKA UIRO m nTAL COmTBOL $ gUIC S, I C. 10/1/82 REC£1v 'D RAYMOND AND JOAN HALEY BOX 10-138 ANCHORAGE AK 99511 SELLER - RAYMOND AND JOAN HALEY SUBDIVISION-LANDING SUBDIVISION BUYER-BUD AND LIZ MURPHY BLOCK-2 LOT-1 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH ~flq AREA OF 375 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 680 GALIJONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK AH)EQUACY THE EXISTING SEPTIC TANK VOLUblE 0]? THIS 3 BEDROOM HOUSE. 1000 IS ADEQUATE FOR 1220 U Jest 25th Aucnue · Anchorage, Alosb 995o3 · (907) 276-1361 ~eptember 23, 1982 Gary D. and Kathle(~n Gaard SRA Box Anchorage, AK 99502 Subject; Lot. 1 Approval for the be granted until Block 2 5~le Landing individual sewer and water faciliti~es cannot the following items hi~.ve been colaplc, ted: 'l%~e water analysis report needs to ])e .qubmitted to this office from the Chore Lab, 5633 P, Street, for our review. ~i An adequacy test needs to t)e ~orformed on t'he oxistinc] leachinq area. '[~%is test will determine if the ~Vs'keln adequate ac:cordJ, nq to National Standards. A lJ. siiit~t; of ~ needs to be submitted ko this off~c~e for our review. Please notify this Department for a reinspc~c'kion when noted discrepancies have beetl coffee-ted. 'If 'thero ara any further qtlestio~s, please call this offics at. 264.-4720. Sincerely, Rr_'lgl/p/EH t,',ncl osuro Rober't C, Pta.k4; Associate Environmental :]l)acia].Jnk