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Home My WebLink AboutVALLEY VIEW TERRACE BLK 1 LT 10 (907) ~61.~122 ~T]~WAI~T TITL]~ THANK YOU FOR yOUR BUSINESS · ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRO, NMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/~ ~R WELL INSPECTION REPORT [] NEW ~PGRADE LOCATION/__.~ 0 L~-] ~ DISTANCE TO: I ~;:~ ~ ar~Ca IL'q;P~a"°"~IIF HOMEMADE: Inside length OZ~ ~~~ ~-- IDiSTANCE TO: Well, . ~ Dwelling Length Width DISTANCE TO: OTHER PIPE MATERIALS REMARKS NO. OF BEDROOMSs /73 ¥idth ,/ Liquid depth ] PERMIT NO. Liquid capacity in gallons t(~dt~, inches tt absorption area ~ inches PERMIT NO. Total effective absorption area Nearest lot line Septic tank Distance to lot line 72-013 (Rev. 3/78) EGAL APPLICANT LOCATION LEGAL BILL WALKEr PO BOX 998 E.R. Lie Bi VRLLEY VIEW TERRACE LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [:'EF'TH= 1:> LEblGTH= r:_'; 6, t]RF~'-/EL [)EF"TH= _c~ THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. 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 OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). RE _r4:J I RE[:, SEF'T I C: TRI'41-::: $ I --'TE= 1£.10£1 6RLLOI'-,~S 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. T~I,] <2> INSPECTIONS RRE REQLIIRE[) BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A HELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR ±50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS PRE AVAILABLE TO INSURE PROPER INSTALLATION. PERbl I T E>~F' I RES DECEtIBER ]:--:1.. ~L9:-:~2 I CERTIFY THAT 1: I AM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. V4. 0 PERFORMED FOR: LEGAL DESCRIPTION: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~ PERCOLATION TEST 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST 3LOPE DATE FERFORMED: ¢'2-- SITE PLAN lO 11 13* 14- 15- WAS GROUND WATER ENCOUNTERED? 17- 18- 20- COMMENTS ,. 8BB 1..,~3 , ,,. O P E Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~/0 (minutes/inch) Y~ j/' TEST RUN BETWEEN ¢ ET AND ~ , FT CERTIFIEDE DATE:2 ~t59 ~/'~ G~-~,TER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-251! N°. INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ~ TANK: DISTANCE FROM WELl LIQUID CAPACITY~f~'~-~'/~,)K~7~;~ GALLONS. NUMBER OF . ~'~-~--~- COMPARTMENTS _~';z-~'~-- ~),//~6. ~-~/~Z'/~-~'~,~ LIQUID INSIDE LENGTH ~T~NSIDE WIDTH ~ DEPTH SEEPAGE SYSTEM:/s"~AGE~ ~ ~ 8~~ OUTSIDE DIA~ ORWIDT~/ , , LENGTH~-..~, DEPTH Ai EACH L EFFECTIVE IN. ABOVE TILE -- DISTANCE FROM WATER WELL: TYPE / DEPTH / , BUILDING FOUNDATION. /SAMPLE LOT LINE ~,SEwER LINE /-~, TANK /, SYSTEM ~'~, CESSPOOl NEAREST OTHER SOURCES DISTANCES: DIAGRAM OF SYSTEM APPROVED,~'~ HEALTH AUTHORITY GAAB-HD-2 GREATE~"~NCHORAGE AREA :'gROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 case No. ~ ~-~ SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT ,~"'~(/.~J-~',~/~Z~;~IAILING ADDRESSf~,~-77. ~HONE NO NAME OF APPLICAN~/~ APPLICATIO~TO INSTALL: S~PTICTANK ~ , SEEPAGE PIT. ~ ,DRAIN~IELB ,OTHER. P~,TEST "ESU~TS A"TICIPATEO DATE OF COMPLETIO"~dd~' ,~ BEUOW TO BE FILLED OUT BY HEg~TH DEPARTMENT ASDES~I~ED BELO~ SiZE ---- ,~PTIG~A~K SIZE ~ ~--~ . ~ '/ ~/~ DIAGRAM OF S~TEM / HEALTH AUTHORITy above described sy tern 1S m accordance with s~,d code. ' ./d-, ,m ;/~ 7- ~/~ ~:~) : DATE APPLICANTS SIGNATUR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND wATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 10 Block 1 Valley ¥iew Terrace Subdivision Location (address or directions) (b) Applicant Name _Scotty Crone Telephone: Home 694-5247 Business Applicant Address P.O, Eo× 77]_567 (c) Applicant is (check one): Lending Institution []; Owner/builder r~x, Buyer []; Other [] (explain); (d) Lending Institution 1st National Bank of Anchorag~relephone Address Attention: Lita (e) Real Estate Company and Agent Address Telephone (t) Mailthe HAAtothefollowingaddress: S & S Engineering SRB 196X Eagle River, Alaska 99577 69~-2979 TYPE OF RESIDENCE Single-Family J~:×Multi-Family [] Number of Bedrooms three (3) Other WATER SUPPLY individual Well ~xx Community [] Public [] Note: If community well sysiem,'must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [~x Public [] Community [] Holding Tank [] Note: If corem unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 [11/84) Page 1 of 2 ENGINEERING FIRM PROVIDING .,~SPECTIONS, TESTS, FILE SEARCH, DA'I ~ 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 all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone Address Date Engineer's Seal DHEP APPROVAL b~ ~-~.~ May 30, 1986 Approved for three(3) bedrooms ,~ te -'~ Approved xxxxxxxxxxxx. Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department 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 the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy ceriain 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 omissions in the professional engineer's work. Page 2 of 2 72-025 (t 1/84) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date --~,,/..//,Z,,~jr'~ 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) ~ ~- ~~ b) Applicant N~me ~. ~ Telephone: HO~u ~9~- ~ 97 Business == Ap~lica~ Addre~ . - ~-~ ~ ~Z~ . (c) Applicant is (check one): Lending Institution D; Owner/builder ~ Buyer ~; Other (d) Lending Institution -~'~ ~'~ ~ Telephone Address ~ (~~/~ .~ (e) Real Estate Company and Agent Address Telephone (f)J-J'-~the HAA to the following address: 3. WATER SUPPLY Individual Well/[~ 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 DISPOSAL Onsite/~ Public [] Community [] Hording Tank r-i Note: If community well sys[em, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDING INSpEcTiONS, TESTS, FILE SEARCH, DATA AND iNFoRMATIoN · ~ As certified by myseal affixed heret0and asof the validation date shown below. I verifythat myinvesfigation 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./t~urthe~' ,verify that based on the information obtained _ ~ frd~the Municipality, Of Anchor;ige files and from-m¥irWestigatiop and mSl~ection, the o'n-site water Supply and/or wastewater disposal'system isin c6mpliance with all Municipal and State codes, ordinances, and regulations in effect on ~ the d~t~ Name of Firrr Address SR~ 196x_ Date . . Approved . ~/ . Disapproved ' r Terms df Conditional Approval - - ~ _ __ -- '/ -' C U 'iON' /he Munc~pahty of Anchorage Department of Health and En?ronmental Protection DHEP) Issues Health Authonty /Approval certificates based solelyuponthe repreSentation,s giv'en in paragraph 5above by an Independent professional / en~)ineerregistered in the State of-Alaska. The DHEP ~loes this as a courtesy to purchasers of homes and their t~nding '/Jnstitutions in order, to satisfy certain federa/and state r~i:ltJirements. Employees of DHEP do not eor~duct inspections or . / analyze databefore acertificate is isst~ed. The Municipality of Anch'orage is not'responsible for er~;ors or ornissi0ns in the professional engineer's:work. - . Page- f 202 ' - 72-025 (il/84) ' . Static Water Level ~/,~ O · Casing Height Above Ground Electrical Wiring in Conduit ) Separation Distances from Well: To Septic/Ne~i'r~-Tank on Lot MUNICIPALITY OF ANCHORAGE (MOP,) I~UNIcIPA~.ii'yI'~ALTH AUTHORITY APPROVAL (HAA) ~NMENTAL ~r._H & -.~c 264-4720 ~OtECr~oN MAR Lega~ Description: ~/ weW° Classificatio~[~ ~ ' I[ A, B, C, D.E.~. Approved (Y/N) Log Prese~N) Date Complete~ ~/7~/ Yield Total Depth ~ ' Cased to ~/t ~ ¢¢ Depth of Grouting Pump Set At Sanitary Seal Casin~) Depression Around Wellhead (Y~ /O0 ~' ; On Adjoining Lots /~t::~L3 To Nearest Edge of Absorption Field on Lot ,/00 r~ ; On Adjoining Lots /O'O To Nearest Public SeWer Line ~/'//~'~ To Nearest Public Sewer Cleanout/Manhole ~"r/j3 To Nearest Sewer Service Line on Lot ~,-~' Water Sample Collected by ,.~ '/~-¢' '~'~/J#'~'/'/~'~ ;Date ...~/'y/4~' Water Sample Test Results .~4-_ '~'/ ~'.~ ,~ Comments B. SEPTIC/HOLDING TANK DATA Date i nst ailed ~;~./~ ~'"h~' Standpipes~N) Depression over Tank (Ye Size ~00 No. of Compartments Air-tight CapCN) Foundation Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /4//o~ Separation Distances from Septic/14e~lic~Tank: To Water-Supply Well ,/~O ! ~' To Property Line ~ I~. 2 Date Last Pumped ; for Cleanout (Y~. To Water Main/Service Line Course Comments Temporary Holding Tank Permit (Y/N) ~/,~'~ To Building Foundation '~) To Disposal Field '2 To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026(11/84) Width of Field ~-'r/".~ !~-"~/ '~ Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Depression over Field (Y,~. Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation ,~ .,~ ! Lot / To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments /*// O'~ ¢,~¢~' Standpipes PresentON) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) ~ rE- 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) //,,~.~.ump Off Level at ~/ //7L'~- 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. Signed *~-'~lCne~n~ Date_- ~ SRB 196x uompany-~ MOA NO. E~ie ~l~r, alask~9~ Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) '~ APPLI( ~,NT FILLS OUT UPPER HA,~'~'ONLY Address ~5 // r~g/~/ 'pr hR-A Z~pCode Lending Institution ~,,~,/1~ 0 ~ ~5 ~, Phone Realty CO. & Agent Phone Address Legal Description Lo f- IO ~/K I U)~)~,~ Ui~ ~ ~ ,,','nc& Type of Residence ultiple Family No. of Bedrooms [] Other Water Supply ~lndividual ATTACH WELL LOG. A well 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 Sewer Disposal ~ Individual Year Individual Installed: /? ~O [] Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RECUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time D~_,.~.¢~..~ O~.,/,._.~'~ ~ Date Date Date Inspector Inspector Inspector Inspector ( ~ APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE ~ ~ Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received 72-023 (3182) ~