HomeMy WebLinkAboutT11N R2W SEC 28 SE4SE4 N OF CREEK
.,
f~' MUNICIPALITY OF ANCHORAGE
· DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
MAILING ADDRESS
/ NO. OF BEDROOMS
LOCATION
/ ~ ~0 IF HOME.DE:
, ~ Well ~ Dwelling PERMIT NO,
O ~ ~ Manufacturer Material Liquid capacity in gallons
~ Well Foundation / Nearest lot line , PERMIT NO,
Top of tile to finis~ grade Material beneath tile Total effective absorption area
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
m Well Building foundation Nearest lot line
m DISTANCE TO:
~ Class Depth Driller Distance to lot llne PERMIT NO,
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
72-013 (Rev. 3/78)
PERPIlT
BPPLICBNT
LOCRTION
LEGRL
CEPRRTMENT-~ HEFILTH FIND ENVIRAN',IEhTRL ~*{CTEC'.TIoN ~,.-/J
825 "L STREET., RNCHORRGE., RK. ;~>~ di
264-4720
( ,:,~.~, ~4 )
,ULMR FLIj:,., STEVE S~¢VER :,RH f~,e,i N. RNC:H. z. 44-~54
SEC:,=.":'-'1::,
~LOT SIZE 999999 SQI_IRRE FEET·
,= .... ,,-- - , , - '--' "-- " I S [:,RR I NFI EL[:,
T:¢PE AF ..,L1L Hb_uF..FTIuN _,T_,TEtl :
HRXII',ILIH NUHE~ER OF BE[:,ROONS = 4
'=- .._L... FT,. E,R.:'-
_,uIL RFITING "=,:" " '- ±00
THE REQUIRE[:, _,I.=E OF THE SIZIIL RE:SOF.:F'TION S'¢STEt"i IS:
'~ · ', .... ,2ui F: R "..." E L [:.EF'TH= '~=:
[.:,EF'TH= . 5 LEi--~ = ~ H-- 47
]'HE LENGTH [:,IHENSION IS THE LENGTH (IN FEET}, OF THE T~EN_.H OR DRRINFiELD.
THE [:,EPTH OF ~ TREN_.H OR PIT I=, THE [.I_,T~NL.E BETNEEN THE =,L~FM_.E OF THE
SRO_N[, RN[:, THE E:OTTOM OF THE E',:.O]:R',,,'RTIGN ('IN FEET],.
THE TRE~-~C:FI l--~ Z [:,TH Z ~] 5. EiEi~Z1 FEET.
'- ~RM,EL 8ETHEEN THE OUTFRLL PIPE
THE GRRVEL [:,EPTH Iz, THE MINIMUN DEPTH OF P '-',~
RN[:, THE BOTTOM OF THE EXC:R'v'RTION (IN FEET]:,.
PERMIT HPFLI_.HNT HRS THE RESPI]NSIBILIT"r' TO IhlFuRP1 THIS [:,EPFtRTMENT DIIF'ING THE
iN:.-,THLLHTIUN- ' ..... ihl.:,FEL. TIuN-,' ' .... .'-- OF FIN~' NELLS R[:,.TFIF:ENT. _ TO THIS FF_PERTT' '- '" FIN[:, 'THE
NUHBER OF RESIDENCES THFtT THE WELL HILL
T~4Ci < 2 }' Z P-~SF'EC:T :[ C,~-.~'--~ FIE:E F-:E L:'-.~L] T F-:E[:'
BRCKFILLING OF RNM S'-¢'STEM 'NITHOUT FINRL INSPECTION RN[:' RF'PRO",,'RL B'~ THIS
DEPBRTI"IENT NILL BE SUBJECT TO PROSECUTION.
i'iINIMUM DISTRNCE BETWEEN R WELL RN[:, RN'¢ ON-SITE SENRGE DISPOSRL S~'STEM IS
i00 FEET EOF..' R PRIVBTE WELL OR 15F'i TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPOf:~ THE TgPE OF PUBLIC HELL
MINIMUM DISTRNCE FROM B PRIVRTE HELL TO R PRIVRTE SEWER LINE IS 25 FEET RN[:'
TO R COI"IMUNITM SEWER LINE IS 75 FEET.
OTHER REQUiREHENTS I'lR"r' RPPL'¢. SPECIFICRTIONS ~N[:' CONSTRUCTION DIRGRRMS RRE
94RtLRBLE TO INSURE PROPER INSTRLLRTION.
F"EF-:[-.~ Z T E.--.F 'ir RE_. [:.EE:E~'--IE:EF.."
CEF.:T I F~r' THRT
i: I FIl'"i FRI"IILtRF-: NITH THE REQUIF-:EI"IENTS F']R UN-_ITE SEHERS FIND P.IELLS RS SET
FERTH E:"r' THE HUNICIPFtLtT"r' GF FtNCHZRRGE.
,=.: i NILL iN_TI'ILL THE _,T_,TEIt IN IRCCORDRNCE NITH THE Uu[.E--,. -
3: I UNDERSTRND THFtT THE ON-SITE SEWER _.,"r_TEH MFI"," REOUIRE ENLFtRGEHENT IF THE
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L,.Street, Anchorage, Alaska 99501 264-4720
~" SOILS LOG- PERCOLATION TEST
[] PERCOLATION
TEST
DATE PERFORMED:
SLOPE SITE PLAN
DEPTH
~,~ ~; N,
1
10-
?,~ ?/~ ]
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
13-
14-
15-
16-
17-
18-
19-
20-
COMMENTS
PERFORMED BY: ,~ / ,~ 7LC ~"~
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE /~ () .~//~/~'/*~- (minutesJinch)
TEST RUN BETWEEN FT AND FT
CERTIFIED BY: ~
72-008 (6/79)
~'~,WATER WELL RECORD
STATE OF ALASKA
OEPARTMENT OF NATURAL RESOURES
Division of Geological ~ GeophysicolSurveys
LOCATION OF WELL CPleese complete e~the, la, lb or lc.) A~D~I- N~ ' :~?~ ~7' :~
j~\ ~{~/'~[ --of--of--of -;-- sE] W[~
DISTANCE AND DIRECTION FROM ROAO iNTERSECTIONS 3. OWNER OF WELL:
E'
15. Wafer Temperature o ~ F ~ C
--~ ' A~f~ori~e~ ~epr~sentut"ive
Permit #
Applicant:
Location:
MUNICIPALITY 0F ANCHORAGE
Department.~xf Health and Environmenta?~rotection
825 ~ Street, Anchorage, AK. ~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND~~SEWER PERMIT
Phone Number: ~O~-~S~/
Legal Description: ~((~C~ ~-~ ~P~%'~ ~ Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: __ Holding Tank:
Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) '~
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 SEPTI~HOLDING) TANK SIZE = 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 8 3 * * *
I certify that:'
(!) 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
i~~~~ that ~ bedrooms.
the residenc is remodeled to include more
Signe~: Issued by: ~ ~~
Applicant
Date: [f~ ~/~
SWP/024 (1/81)
I
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
H AA # \.1 ~ ,(;L,~ ,, % L~
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Portion of SE1/4, SE1/4, TllN, R2W, Sec.28 (~
Location(addressordirections)
A portion of SE1/4, SE1/4 Sec.28, TllN, R2W, SM,
Rainbow Valley more particularly described in: Bk, 483, Pg. 0182
Anchorage Recording District.
(b) PropertyownerAlaska Housinq Finance ~hone:(home) Business561-1900
Mailing Address 235 E. 8th Ave. Anchoraqe, AK 99503
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the following address: (or check here ri, if hold for pick up.)
List cont.act person and day phone number below:
PJck up by Engineer
2. TYPE OF RESIDENCE
Single-Family [] Number of bedrooms 4
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 th legality and status.
4. SEWAGE DISPOSAL
On-site:~l Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88) Page 1 of 2
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Well ClasSification /¢/'/'''~/'~
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744 ¢/~-
Legal Description: ?¢¢/-/'~'
Well Log Present (Y/N) "Y Date Completed /'¢~'/,/~' ~
Total Depth 5~2 / Cased to ~.4"~ / Depth of Grouting
Static Water Level ¢"~' / ,,¢,¢,,,¢ ,.~..,,~ .¢,,r ,,~..~ Pump Set At --~ /
Casing Height Above Ground /,,2./' Sanitary Seal on Casing (Y/N) /v
Electrical Wiring in Conduit (Y/N) ? Depression Around Wellhead (Y/N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot ~' ~'0 x ; On Adjoining Lots ¢'/'~
To Nearest Edge of Absorption Field on Lot /¢¢2' ; On Adjoining Lots
To Nearest Public Sewer Line /v//4~ To Nearest Public Sewer Cleanout/Mahhole '~'~'
To Nearest Sewer Service Line on Lot _~'¢ /
Water Sample Collected by z=~,~,.~.,.. ; Date /,¢ - 3'-,¢
Water Sample Test Results ~',¢/~;~-*"-- ~ ¢¢ '¢~'/'¢~"~= = .4'./
Comments ~ ~,'¢~, ~ -"f/~.,~/'-/·
If A, B, C, D.E.C. Approved (Y/N)
Yield ~- ?- 25- ~,'¢,'~
SEPTIC/HOLDING TANK DATA
Date Installed ~/¢ 2 Size
StandpiPes (Y/N) ? Air-tight Caps (Y/N) /v
Depression over Tank (Y/N)
Pumping/Maintenance Contact on:Fi!~ (Y/N)
Holding Tank High-Water Alarm (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To WaterTSupply Well
To Property Line ~'/¢
To Water Main/Service Line
/'~ ~ No, of Compartments
Foundation Cleanout (Y/N)
Date Last pumped /~/¢~
; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field /?
To Stream, Pond, Lake or Major Drainage Course
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
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well /¢¢~ ~
To Building Foundation /? '
Lot /,//,4
To Water Main/Service Line '"/~
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Statndpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line ¢'/¢ '
To Existing or Abandoned System on
; On Adjoining Lots "' ~,¢ '
To Cutback (if present) '~,~'
D. LIFT STATION /~'~/
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**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. ~.':' '~.?.' .r ;'
Signed ~ -.-.-.-.-.-.-.-.-.~ -
Company
P. 0. Box 773294 ; '; E~gtnee~', Seal
Date /~./ Eagle River. AK ~77
MOA No. ~'Z-~¢-,¢% 894~5~95 .~;
Receipt No. ¢.~ ,/V ~' ~,~/~,.~'-'~z(/ )
Date of Payment
Amount: $
72-026 (Rev. 7188) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
Tom Fink,
Mayor
nicip Hty of nchor ¢
Department of Health and Human Services
825 "L" Street
P.O. Box 196(~50 Anchorage, Alaska 99519-6650
343-4744
October 31, 1989
Lou Butera, P.E.
Eagle River Engineering Services
PO Box 773294
Eagle River, Alaska 99577
Subject:
Waiver Request for TllN R2W Section 28 SE~ SE~
N of Creek
Waiver Request #WR890060, PID #090-051-08, HA890407
Dear Mr Butera:
Your request for waiver of the required 100 foot separation of
a septic system to a private well has been approved. The
approved separation distance is 90 feet.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincerely,
Civil Engineer
On-site Services
DJR/ljw#6
ANALYSIS RE?ORT BY SA}{PLE for Wozk Orde! $ 17282
Client Sample ID:kAI~BOW VALLEY ?OEIIOH O? SE 1/4 SE i/4
?~3ID :UA
Co!!ect~d 9C] 3 ~? ~ 17:25 ~.
Client Na~ : EAGLE RIVES
Client Acer : EAGLERP
P.O.{ ~9RE ~ECEIVED
Ord~r6d Ey :
Special RAINDO~ VALLEY PORYIOR OF SE I/~ BY S/~ l/~ ?ll~ R2W SEC. 2~ SN
Ch~:~ab Eei {: 7562 Lab S~pl ID: I ~t~ix:
~!!c~able
Pzremct~ Seated Ee~clt/Dnit~ ~ethod
!;~,i7~-}; i.l V~/1 EPA 353.2
[ EAGLE RIVER ENGINEERING SERVICES
Lou Butera, P.E.
P.O. Box 773294
Eagle River, Alaska 99577
Telephone [907} 694-5196
October 17, 1989
Mr. John Smith, P,E.
M.O.A./D.H.H.S.
825 L Street
Anchorage, AK 99501
Re: Portion of NE~, NE~,
Rainbow Valley
Dear Mr. Smith,
TllN, R2W, Sec.28
MUNICIPALITY OF ANCHOP,/~-.-~
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
OCT 1 ? 1989
RECEIVED
On behalf of our client, A.H.F.C., we are applying :for a minor
variance of well to septic tank distance for the single family
dwelling on the above referenced property.
The septic system was installed in Aug. of 1983 with proper
couplings on the septic tank connections as required at that time.
The well was installed in Sept. of !988 and was placed 90' from the
septic tank location. The leachfield is at +100' distance.
The well log shows the well to be 59' deep. Prom 25'-54', the
well penetrates clay bearing layers that act as a confining layer
or aquiclude. This is evidenced by the fact that water below this
level is under pressure to the point where static artisan levels
are 4~ above !and surface flowing at 3.75 G.P.M.. The land slope
is favorable with land surface sloping away from the well toward
the tank at 5 - 10~. The house is directly between the well and
septic tank locations. The tank integrity is good as determined
by age and observations through the tank cleanouts. Water samples
are satisfactory. The population density of this area is low with
average size of 5-10 acres.
If you have any further questions regarding this matter,
please call me at 694-5195.
Sincerely,
Louis A. Butera, P.E.
APPLIC 'NT FILLS OUT UPPER HAi " ONLY
Buyer
Address Zip Code
Lendin9 Institution ~ ~X~ [~--¢ ~ ~-'~-& Phone
Address ~% [~(~
Realty CO. & Agent Phone
Address Zip Code
Street Locati~
Type of Resi~nce
Single Family
~ultiplO Family No. of
~ Other
Water Supply
~lndividUalCommunity ~.~~- A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
For wells drilled prior to that date, 9ive weq depth (attach log if available).
~ Public Utility
Sewer Disposal
Year Individual Installed:
Individual
~ublic Utility When Connected to Public Utility:
~ Holdin9 Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Field Notes: N)UNICIPALITY OF ANCHORAGE
/~.,.,.,.,.,.,.,.,.,~//.~ DEPT. OF HF,,',LFt
RECEIVED
( ) CONDIT~NAL A~PROVAL*
Soil t Date ~wer Installed Well To Absorption Aree / ~ / Well Log Received
~ y- ~-- r 'S WelltoTank /~ Septic T~k Size
72 023 (3182)