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
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· .......................................
((::)¢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