HomeMy WebLinkAboutVALLI VUE ESTATES #1 BLK 1 LT 19
: Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Numbe~L~C~ ~D~ 0 ~ PID Number: C31~'- ~11--~0
N~,: ~ ~ ~~ ~~ Wastewater System: D New ~Opgrade
Address: ~OG ~0~~. co~ ABSORPTION FIELD
Phone: ~G--~tl~ JNo. of~rooms: ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other
Soil Rating: 5~ Total Depth fr°m °rigina[ grade:
LEGAL DESCRIPTION ( A,,.~[~ -~ ~/s,~,. ~.~'~
Subdiv~[on?~~ ~ Depth to pipe bosom from original~rade: Gravel depth beneath pipe
Township: /liRa"ge:/IlSecU ~ Fill added *~ above ~ original~.~ grad~ Ft. Gravel length: ~ / Ft.
Gravel width: Number of lines: Distance baleen lines:
~ New ~ Upgrade / /~ / Ft. ~ ~ Ft.
Classification (Priva~~~ Total~Depth: ~d TO: Ft. Total absorption~oarea: SQ. Ft. Pipe~o~material: ~
Date install d:
Driller: StaDc Water Level: Installer:
' : Casing Heig oveGround:
Y~GPM JPump Set at: Ft.I ~ TANK
SEPARATION DISTANCES ~s,,tic ~ ,o~in, ~ S.T.~.P.
TO ~ Absorption Lift Holding 'ublic/Private Ma.ufacturer: ~ Capacity in ga,lo.,:
From ~k/ Fierd Station Tank Sewer Lines
Well- ~1. ~ N/~ ~ ~D,+ Materiah ~, Number~ompa.ments:
Sudace ~
Water ~00t~ I~ ~ /
leo+ LIFT STATION
Line ~O/+ I~~
Foundatio~ /~ ~/~ ~ "Pump on" level at~~l a~larm at:
Cu~ainDrain ~1' "/~ ~/~ ~ IE'ectricalinspecti°nspe~°rmedby:
Remarks: ~ ~ ~ ~ ~ BENCH MARK
Location and Description:
ENGmNE~'~AL
~' , r A¢~7~
Inspections peMormed by; ~~c ~ Dates:lst /~]~ ~/;~Z.~'~ '~
Department of Heal~ and Human Se~ices approval "~:~, ~:~:'~,~%,
- Date://-/~-~
Reviewed and approved by:. . _ '"~,~,
72-013 (Rev. 9/91) MOA 25
A TO COl = 37.5
B TO CO1 = 57
A 7[3 CD2 = 41,5
]) TO C02 = 60
A TO C03 = 47
B TO C03 = 63
A TO MT! = 38
B TO MT1 = 55
A TO NT2 = 51
B TO NT2 -- 36
A TO C04 = 45,5
B 10 C04 = 28
C TD S1 = 13
D TO Si = 81,5
C TO S2 = 82
D TO S2 = 88
C TD BULL RUN = 32
D TO BULL RUN = 37
AS- BU] LT DW6,
DOUBLE TREE COURT
LOCATION OF KEYBOX,
CONTRACTDR EXPDSED,
TEST
TEST HOLE
EXISTING 4 BEDROOM
HOUSE
DOUBLE
EXISTING 1500 GAL
TANK
ZABEL FILTER
RUN' VALVE
EXISTING SEEPAGE PIT
RINGS,
UTILITY EASEMENT
SEPTIC AS-BUILT
PREPARED FOR:
PREPARED BY~
DATE:
LF1T 19, BK 1, VALLI VUE ESTATES,
JIM RAFFUSE
ALASKA WATER & WASTEWATER
10/23/97 ! DRAWN~ GARNESS ISCALE~ 1' = 30'
SW970309
aS-BUILT
NGTE, FGR LOCATION OF THE CLEAN-GUTS AND MONITORING TUBES, SEE THE 30 SCALE SITE PLAN,
THE INVERT AT THE DOUBLE CLEAN-OUTg BOWNgTREAM
FRGM THE SEPTIC TANK = 100,05, THE DROP FROM THE
CLEAN-OUTS TO THE BEG INVERT : 6,~4 FEET,
4 INCH DIA, PERF~RATEG PIPE
-INSTALLED LEVEL, MAXIMUM VARIANCE
DF ,0! FEET FROM LEVEL,
97,6+
FILTER FABRIC OVER
DF BRAINRGCK
x
5,0 5.0 --
SAN~ FILTER, 2 FEET THICK LAYER GF LAKE OTIS
GRAVEL AN~ CENTRAL PAVING PRODUCTS WINTER
ROA~ SANB,
1, ORIGINAL GRADE = 95.2 TG 98,0
2, BOTTOM DF EXCAVATION = 91,67 (AT HIGHEST SPOT), TD = 3,5 TO 6,33 FEET,
3, TOP OF ~AND : 93,67 TO 93,71, 2'+ OF SAND
4, DRAINPIPE INVERT = 94,26
DRAINROCK DEPTH = ,55 TD ,59 FEET = 6,5' TO 7,0 INCHES,
5, FINAL GRADE = 97,6+, MIN, COVER = 3,0
SEPTIC UPGRADE: LOT 1% BK 1, VALLI VUE ESTATES
PREPARED F~]R: JIM RAFFUSE
ALASKA WATER & ~/ASTE~/ATER
DATE, 9/5/97 I DkdN: GARNESS I SCAL£: NTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE
MOA
1 OF 1
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW970308
DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES
OWNER NANE:RAFFUSE JIM R &
OWNER ADDRESS:6906 DOUBLE TREE CT
ANCHORAGE,ALASKA 99504
DATE ISSUED: 9/11/97
EXPIRATION DATE: 9/11/98
PARCEL ID:01531120
LEGAL DESCRIPTION:
VALLI IU3E ESTATES #1 BLK
1 LT 19
LOT SIZE: 20857 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS
RECEIVED BY:
DATE:
DATE:
8471 Brookridge Drive N Anchorage N Alaska 99504
(90"/) 337-6179 ~ Fax (90'7) 335-3246
Consulting Engineers
September 5, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Sewer Upgrade for Lot 19, Bk 1, Valli Vue S/ID.
To whom it may concern:
The existing 4 bedroom house is served by a private septic system and a community well. The
existing seepage pit (concrete rings) is failed, and must be upgraded. Comments regarding the
proposed upgrade are summarized as follows:
1. SOILS: Attached is a log which shows the soil profile, and the percolation test results.
Throughout the depth of the TH, the soil is primarily will graded gravel, with some lenses of sand.
At a depth of 5.0 feet to 5.5 feet the percolation rate was less than 1 minute/inch. No
groundwater, bedrock, or impermeable soil was encountered to a depth of 12.5 feet.
2. TRENCH DESIGN:
a. Percolation Rate: <1 minutes/inch, so sand filter is required
b. Allowable Application Rate: .7 gallons/day/fl2 for bed system with sand filter
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 857 ft2
f. Effective Depth: .5 feet
g. Reduction Factor = N/A
h. Width: 15 feet minimum
i. Minimum Length: 58 feet
j Effective absorption area = 870 ft2 (>857 ft2 OK)
We are proposing to install a "Bull Run" valve so that flow can be periodically alternated between
the old seepage pit, and the new bed system.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
upgrade.
4. TOPOGRAPHY: The lot slopes downward from east to west at a slope of approximately
10%. There may be some localized spots where the slope slightly exceeds 10%, but this should
not be a concern because the soil porosity dictates that the wastewater will move downward very
rapidly. In short, there will be virtually no lateral migration of the wastewater. Based upon my
assessment of the site, there does not appear to be any slopes which would compromise the
proposed design.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, or on my digital pager at
1,800-481-1162. Thank you for your assistance.
Sincerely,
ALL THE LOTS TO THE NORTH OF
DOUBLE TREE COURT ARE IN VALLI
VUE ESTATES, AND ARE ON COMMUNITY
-- DOUBLE TREE COURT
LOT 18, BK 1
VALLI VUE
ESTATES, COMM.
WATER AND PVT,
SEPTIC SYSTEM,
LOT 80, BKI VALLI
VUE ESTATES, COMM.
WATER & PVT, SEPTIC
SYSTEM,
OMALLEY ROAD
LOT 81, HILLSIDE PARK P.U,B.
COMMUNITY WATER SYSTEM &
PVT, SEPTIC SYSTEM.
LOT 1, LAKE- LOT 8, LAKE-
WOOD HILLS, WOOD HILLS,
PVT WELL & PVT WELL &
SEPTIC, WELL SEPTIC. WELL
IS DN SOUTH IS ON SOUTH
END OF LaT. END DF LOT,
NDTEJ THIS IS NDT A SURVEY, THE LOCATION DF ALL WELLS~ SEPTIC SYSTEMS,
AND STRUCTURES IS APPROXIMATE, THE CONTRACTOR SHALL VERIFY THE SEPARATION
DISTANCE FRDM THE SEPTIC SYSTEM UPGRADE TO ALL WELLS ON ADJACENT LOTS,
SEPTIC UPGRA]]E~ LOT 19, BK 1, VALLI VUE ESTATES.
PREPARED FDR~ JIM RAFFUSE
PREPARED BY~ ALASKA ~/ATER & ~/ASTEWATER
DATE, 9/5/97 J DRA'w'N~ GARNESS JSCALE, 1' = 100'
NOTE, THE CONTRACTOR SHALL HAVE THE PROPERTY LINES, AND/OR THE
UTILITY EASEMENT, IN THE VICINITY OF THE SEPTIC UPGRADE, FLAGGED
BY A REGISTERED LAND SURVEYOR,
NEW 15' x 58' DED
WITH SAND FILTER
DOUBLE TREE COURT
GENERAL LOCATION DF KEYBDX. CONTRACTOR
SHALL VERIFY THE LOCATION DF THE BOX, AND THE
WATER SERVICE LINE, SO AS TD ENSURE THAT THE NEW
DRAINFIELD IS GREATER THAN lO FEET AWAY.
TEST HOLE
EXISTING 4 BEDROOM
HOUSE
lO' UTILITY EASEMENT
HAS HOLES, INSTALL
1250 GALLON TANK,
C/D
RUN' VALVE
EXISTING SEEPAGE PIT
RINGS,
DN
IF
W
W
W
W
SEPTIC UPGRADE,
PREPARED FOR~
PREPARED BY~
DATE~ 9/5/97
LOT 19, BK 1, VALLI VUE ESTATES,
JIM RAFFUSE
ALASKA WATER & WASTEWATER
! DRAWN: GARNESS ISCALE~ 1' = 30'
NOTE, FOR LOCATION OF THE CLEAN-OUTS AND MONITORING TUDES, SEE THE 30 SCALE SITE PLAN, THE MATERIALS
AND CONSTRUCTION PRACTICES SHALL COMPLY WITH M,O,A~ DEPT OF HEALTH AND HUMAN SERVICES GUIDELINES,
SOIL OVER BED SHALL DE GRADED
THAT SURFACE DRAINAGE DOES
NOT POND OVER THE BED,
-~ FOOT MIN, COVER OVER TOP
OF DRAINPIPE. IF COVER IS LESS
THAN 3 FEET, PROVIDE ~ INCHES
DF DDARD INSULATION,
4 INCH DIA, PERFORATED PIPE
-INSTALLED LEVEL, MAXIMUM VARIANCE
DF ,Ol FEET FROM LEVEL,
6 INCHES OF DRAINROCK
UNDER THE PIPE, AND 2
-INCHES OVER THE TOP DF
THE PIPE,
FILTER FA)RIC OVER
- TOP OF DRAINRDCK
x
5,0
SAND FILTER SHALL BE A ~' LAYER OF LAKE OTIS
GRAVEL. THE TOP DF THE SAND SHALL BE LEVEL
WITH A MAXIMUM VARIATION OF ~ INCHES BETWEEN
THE HIGH AND LOW SPOTS,
SEPTIC UPGRADE: LOT 19, BK 1, VALLI VUE ESTATES
PREPARED FOR: JIM RAFFUSE
ALASKA ~/ATER & ~/ASTE~/ATER
DATE, 9/5/97 I ]]~/N~ GARNESS I SCALE:
NTS
PERFORMED FOR:
1
2
3-
6
7
8
9
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
Municipality of Anchorage
DEPARTMENT OF ,EA'TN & ,UMA. SERWCES ~':
825 "L" Street, Anchorage, Alaska 99502-0650
01~ U~F~SE DATE PERFORMi~.~~
~ Township, Range, Section:
SLOPE SiTE PLAN
WAS GROUND WATER r~\
o
ENCOUNTERED?
S
IF YES, AT WHAT ~ - i
DEPTH?
E
Depth to Water Alter~.,.j? ~/
Meniloring? ~-"~ '-/" Dale: ~.~
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~- I [minutes/inch} PERC HOLE DIAMETER ,
TEST RUN BETWEEN '-~ FTAND ~'~-Q' FT
72-008 (Rev. 4/85)
R+ HOHE SERUICES, INC.
HOME SERVICES
1fig)0 Francesca Drive
Anchorage, Alaska 99516
i~45.1890 or ~4,6-2444
INVOICE
CUSTOMER
' J, D. Cellar~
6906 Doul)le[re~
Anchorage, li~la-.J,a 9f',lC
Block Lot 3,1 c -1;; 1 ?
DATE DESCRIPTION AMOUNT
4-16-87 Pumn ~,e~,tlo .... C, 3,00
Remo',l ari~,'lspo~a! ofol,~ tahk " , .,] l~O,
~ ....... i ,.i: 898, O0
~,~,~ '.~,-~ ~ ', ,.",.' ~h" ~ -,.,~,. ) ..... ='~'. ~0,00
T~L ~900,~00
~UARKS
~[~:..~ .~ ,/
., Gallons Septic Cesspool Standpipe~ Time
~ ~OBLEM AREA--CALL FOR MORE INFORMATION
~ NEEDS ~ BE DONE AGAIN IN 6 MONTHS
~ Good Shape D Sludge buildup on bottom ~ Floater on top
~ Jim cap missing or ~ Cut standpipe to 1' above groun~ ~ Needs Septlctrlne
needs replacing
roi FASE FAY FROM THIS INVOICE--
R+ HOHE SERUICES, INC, OGS P04
THANK YOU!
PUSHY EXCAVATING
HOME SERVICES, INC. 085 P09
Puuhy Excmv mt
ZNUOICE #
~CCOUNT #
3~774
1 OF
7
15980 FR~NC£SCR DR.
6906 DOUBLETREE COURT
RNCHORAG£, ALRBKR
7
24-16-87
GRi~"~TER ANCHORAGE AREA BOROU"'"'~!
D=.~RTMENT OF ENVIRONMENTAL 0. UALI'i. '
3500 TUDOR ROAD ANCHORAGE· ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING
ADDRESS '""~""~'
LEGAL DESCRIPTION ~7'
PHONE
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY /~ GALLONS.
MATERIAL L~-(-(-(-(-(-(-(-(-~ ~- 'z
INSIDE LENGTH.
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID
DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER "~ OR WIDTH /~)
(~O/~J~2~,'~ ,Il I,n~S . DISTANCE FROM WELl
/
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH /'7 , DEPTH
BUILDING FOUNDATION
.SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE
NUMBER OF LINES DISTANCE BETWEEN LINES .~'- TRENCH WIDTH
ABSORPTION AREA ~H OF EACH LINE
DEPTH: TOP OF TILE TO Dlfqliq~ GRADE DEPTH OF FILTER MATERIAL BENEATH TILE_
TOTAL LENGTH
. OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
DISTANCE FROM WATER
WELL:
TYPE (_'U.'~?//~///~'/'~/ , DEPTH . BUILDING
FOUNDATION
SAMPLE
NEAREST SEPTIC SEEPAGE
LOT LINE , SEWER LINE TANK , SYSTEM , CESSPOOl
, NEAREST
OTHER
, SOURCES
DISTANCES:
6LLL ~ p,,~,-K I
DIAGRAM OF SYSTEM
LOT L. ll?,6
G.A.A.B.
GRE~,,(ER ANCHORAGE AREA BONOUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK ~ SEEPAGE P T X · , DRAIN FIELD · . OTHER -
MINIMUM DISTANCES, REOUIREMENTS
FOUNDATION TO SEPTIC TANK
SEPTIC TANK TO SEEPAGE PiT WALL
DRAIN FIELD
DIAGRAM OF SYSTEM
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
· SEEPAGE PIT
SEPT[C TANK. .. SEEPAGE PIT . -. DRAIN FIELD
TO RIVER, LAKE· STREAM.
CAST IRON INTO AND OUT OF SEPT[C TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
GRAVEL BACKFILL
CONFORM TO BORO REGULATIONS REGARDING INSTALLATION.
/ / HEALTH AUTHORITY
LICENSED DESIGNER
[ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO- 28'68 AND THAT THE ABOVE
DATE ~f 'DESCRIB D SYSTEM IS IN,ACCORDANCE WITH SA][~ CODE. / ..... ~/~/,~
DEPARI'I'~F. IiF OF EHVIROIIP'~I'ii.'",L Q/!AL
3508 TUDOR
ANCHORAGE, ALASKA 99502
Performed ForJohn Tuttle
Leeal Descriotion: Lot Block__
This Form Reoorts Soils Log XX
Date Performed 3 August~.72
Subdivision Valley Vue
Percolation Test
qeoth
Feet Soil Characteristics
1 To__p-
Soil
2~
The sediments were very
loose with a high cobble
and sand oontent.
6GIW
7
8--
9__
I
Was Ground Water Encountered? No ~?o~
If Yes, At what Depth?
Reading Date Gross Time Net Time
Percolation Rate
Slooey west
~- L---i- i I t I ,
Denth to H20 Net Pr'onl
Minute
Proposed Installation:. .,q e~ ;~ qe I . ' P i t.___X~ ........... Dr a'i -. ,~ ~ e'l d:
Deoth of Inlet.__~_4 £e,e-~ .............. Depth To Bottem Of Pit Or Trench_l~f~ei
cn~ff~ENTS: ~ ~.tMtt]i~aq.._f_t/hd_rA~
Test Performed By
'-. "'~"~' ' ~ 'MUNICIPALITY; OF ANC~(~RAGE
(,~"",1 Department of Health & Human Se~ices: .
~ . DIVISION OF ENVIRONMENTAL SERVICES
. . ~. ~ - ~,~ . ~ ,~_ 343-4744:.~? . ~'~,~;,:h~,~_:~ ,',,' ......... ~::~ ~':-~
.-., .. ~ ~' .. CERTIFICATE CE NSPECTION FOR HEALTH AUTHORITY APPROVAL CE'
ON-S TE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING ~.: _. ['~.;-. - :~.
ParcelI. D.~ ~~-~(~' ~ ......... HAA~ ~~5~[D '
1, GENERAL INYORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range} ....
Lot 19; Blo~ I; Valli Vue~Subdivision ~
Location (address or directions) - · -
6906 Dou~b£~btee ¢ou.,'~, Anchorage, Alaska
(b)
Property owner
Mailing Address
J.D. CcZ.~.rs Telephone: (home) 346-1517
6906 Dou§l~tr~e Cou.~t,, Anchorag~ Alaska 99516
Business
(c) Lending Institution GMAC MORTGAGE Telephone
279-3581
Mailing Address
(d)
Real Estate Company and Agent '
Address
Telephone'
(e) Mail the HAA to the following address: (or ch~'h8¥eY~, if hold for pick ~p.)
List contact person and day phone number below:
S & S ENGINEERING/694-297.9
17054 Eagle River Loo~ Road. Suite 204 :-
Eagle River. Alaska 99577
2. TYPE OF RESIDENCE
Single-Family,~{:3 Number of bedrooms
4~
3. WATER SUPPLY
Individual Well i-I Community [] Public []
Note;,.. f..commun t -weJJ s s, tem-must have,written confirj*nation from.the State., D .e, partment,of Er~vi[on~ental
; "' ~"':'" "~':~"~' :'L;onservazlon" '?attesting-':" ''y:'~''' ~":' !~!";to ~n'~gam~'~'"' ~" "~.~1"' ~:' status:~.": .'..,; ::.~..~,,~;.:.-',~J-~ ~.,:.:J ~ ~:--.~" ~:' ............ -~;.~-:.~;.,
4. SEWAGE DISPOSAL'_** . =. :':i ,',r~ ?~'..... ,:,' , .., '-: ':-,, ~- ~- ;~
On-site,[Z' t~r Public'E] ~': :.Community D/ 'Holding Tank []
- Note: If community well system, must.have written conhrmat]?n from il~ staie Del:;~rtmen~ of Environrfl~ialr
c0nservati0r~ ~affesting' ~) tl-Je' I~'gail~)~'d ~taiu~. ' · ' '" '"' : ....... .. ...., ~,.: .:..~ ;.
Page 1 of 2
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A. WELL DA'I~~
Well Classification
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:
A
I'ct If A, B, C, D.E.C. Approved {~N) y
Date Completed Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
Well Log Present (Y/N)
Total Depth Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot '"'~e;2~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Com merits '~. '~J. ~.
; Date
B. SEPTIC/HOLDING TANK DATA
Date Installed J~Z-~ Size
Standpipes (~'N) 7 Air-tight Caps (~?N)
Depression over Tank (Y/f[Cj~
Pumping/Maintenance Contact on File (Y/N~j
Holding Tank High-Water Alarm (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well "~;2G'I
To Property Line \
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
Comments ~ ~-/~-~!~='"¢1c:~
NO. of Compartments ¢-*
¥ Foundation Cleanout CN) ~/
h/ /Date Last Pumped ~ ~ I'~, - ~ I
; for -~- /
Temporary Hol'ding Tank Permit (Y/N) /~
To Building Foundation
To Disposal Field
72-026 (Rev. 7/88) Front Pagce 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~ ~ '~ --
Width of Field \,c:~
Square Feet of Absortion Area
Depression over Field (Y~;).
Length of Field \-7 I
Depth of Field ~ ~
Gravel Bed Thickness ~'~ ~
Statndpipes Present (![~/N)
Date of Last Adequacy Test '"-2 ~ ~q I
Type of System Design
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well
TOLotBUilding Foundatioi~
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutback (if present)
\~c~,t 4-
D. LIFT~ATION
Date I~
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.
Signed
Company
Date
MOA No.
Receipt No.
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
0 '
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE DISTRICT OFFICE
3601 C STREET, SUITE 322 .~,
ANCHORAGE, ALASKA 99503
FOR: Roger
S & S Engineering
~ "'~' ' ' ' PW-IS D #21'060-5
WALTER J, NICKEL, GOVERNOR
563-6775
March 19, 1991
My review of the records on'file in this office reveals that the
Valli Vue S/D Class A Public Water System is in compliance'with the
provisions of 18 AAC 80.060, State of Alaska Drinking Water
Regulations.
Sincerely,
Tiraoth~. Karnowsk~-
Environmental ~nginoor
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
)IRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10i days for processing~ ,
PROPERTY OWNER
Roger Nunley
PHONE
344-1997
MAILING ADDRESS
6906 Double Tree Court 99507
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAI LING ADDR ESS
3. LENDING INSTITUTION ~ PHONE
National Bank of Alaska J 276-1132
MAI LING ADDR ESS
Pouch 7-025 99510
4. REALTOR/AGENT
Clair Ramsey % Jack White Company
JPHONE
277-1553
MAI LING ADDR ESS
3201 C Street 99503
5. LEGAL DESCRIPTION
LOt 19 Block 1 Valli Vue Estates Subdivision
STREET LOCATION
6906 Double Tree Court
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One ~ Four [] Other__
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
7. WATER SUPPLY
[] INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
xxx~ COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available,)
8. SEWAGE DISPOSAL SYSTEM
XX~] INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date 1972
If system is over two (2) years old an adequacy test is required
[] PUBLIC UTI LITY by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72~)10(3/78)
THIS SIDE FOR OFFICIAL USE ONL,
I DATE RECEIVED
I NSP ECTI ON_APl?O] NTM
TIME i
RECEIPT FOrt CERTIFIEI] MAIL.--30~ (plus._ postage)
DATE
i T~I STREET AND NO.
iNSPECTOR I
DIRECTIONS: i ]'~("~ P.O., STATE AND ZIP CODE
'~" --RETU~:~i I~ ~[ Shows to whom and date~l~d ..:~-t5~~
--1 (~ ~EGIAL DEUVEeY (ox~xtr~ ~ee ,o~[ulrod) .................................... ___ __
1. TYPE OF RESIDENCE i ~ PS Form 3800 NO INSURANCE COVERAGE PROVIDED-- (See ofher slde)
] Apr, 1971 NOT FOR IHTERliATIONAL I~IAIL *opo:~z o-4eo-?is
[~;~SI NG LE FAMILY
[] MULTIPLE FAMILY ]-- ~ TWO---- ~ FOUR [] SlX
2. WATER SUPPLY
coDiVIDUAL DEPTH OF WELL
MMUNITY
[] PUBLIC UTILITY
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[~'~]'DIVIDUAL/ON -SITE DATE INSTALLED
[~ic Tank or [] Holding Tank
Size: ) ~-~"/-~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TA~Z.~ MANUFA~.~,.~
TOTAL ABSORPTION:~, ~' ¢~' AREA MATERIAL. ~1~ ~ I ~t Nearest
5, COMMENT8
riP'APPROVED FOR /.~ BEDROOMS
[] CONDITIONAL APPROVAL (letter mu~_~ accompany certificate)
: [3 DISAPPROVED ""//~
72-010 (Rev. 3/78)
APPLI('- NT FILLS OUT UPPER HAt ONLY
P~o~rtyOwn;r ~onathan and Beverly Goldsmith ~-725-
21 Oakland Hills, Aiken, S.C. 29801 4830
Mailing Address Zip Code
Buyer J.D. & Judith Cellars
3241 Boniface Parkway, AnChorage, Alaska 99507
Address Zip Code
Lending Institution United Bank of Aia~ka [ ~/kox~ ~k~ \~c~ ~.~_ Phone
4040 E. 36th, Anch. Ak. 99503~ ' 276-1911
Address ~, Zip Code
Realty Co. & Agent kGary Moore/Lee Houston & Assoc. Ltd. Phone
507 W. N. Lights Blvd., Anch. Ak. 99503 276-5909
Address Zip Code
Legal Description Blk 1, Lot 19, Valli-Vue Subdv. ~/1
6906 DoubleTree Ct., Anch. Ak. 99503
Street Location
Type of Residence
[~ Single Family4
[] Multiple Family NO. of Bedrooms
[] Other
Water Supply
,nd,v,dua, A ACNWELL,OS. Aw ,,og' ,e u' ed'o,a"we"sd'"'eds'nce u e g '
G~mmunity For wells drilled prior to that date, give well depth (attach Icg if available).
[] Public Utility
Sewer Disposal 19 7 3
~ Individual Year Individual Installed:
[] Public Utility When Connected to Public Utgity:
~] Holding Tank
NOTE: THE iNSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
C~ L~.~\
Date ~.~.'~
Inspector InspeClor Inspector Inspector
Field Notes:
/'~ , 4 ~ MUNICIPALITY OF ANCHORAGE
~VIRO*M2NTAL pROTECi'iON
RECEIVED
~)' APPROVED BEDBOOMS 'CONDITIONS OF APPROVAL
(
( } DISAPPROVED
( } CONDITI~)NAL~pPROVA~L' ~
Soils Rating Date Sewer Inslalled Well To Absorption Area Well Log Received
~ ~/~ -~ .~...~ Well to Tank ' ~. Septic T~nk Size /
72.023
ALASKA E IidlROnmEIITAL COllTROL SERu CES,
~n§incerin§ 6 ~n~ironmcnldl SIo~lies
InC.
NOVEMBER 30 1983
UNITED BANK OF ALASKA/ATTN MARVELLA ROADIFER
440 E 36TH AVENUE
ANCHORAGE m~ 99S03
SELLER - JONATHAN P. GOLDSMITH BUYER - ~1)~-~
SUBDIVISION - VALLI VUE #1 BLOCK - 1 LOT - 19
RECEIVED
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 348 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 4 BEDROOM HOUSE.
1200 JlJcsl 33rd /~uenu¢. Suile B ·/~nchorQ§e./~hsh 99503 · (907) 276-1361
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of }nspection: CMRO VA
2. Property Owner: Roger Nunle¥
Mailing Address: 6906 Double Tree Court
3~ Name of Buyer: Johnathon P. Goldsmith
FHA CONV XXXX
Day Phone 344-1997
Mailing Address: SILA Box 35H - Anchorage
4. Name of Lending Institution: N.B.A.
Mailing Address: NothernLights & C.
5. Name of Realtor or
Mailing Address:
Day Phone 344-4645
Phone 276-1132
Agent: Clair Ramsey - Jack White Co.
3201 C St. Phone 277-1553
Legal Description: Lot 19, Blk 1, Valli Vue Estates #1
Location: 6906 Qouble Tree Court
7. Type of Facility to be inspected:
8. Water Supply
Type of Supply: Public Utility
~f Individual,
If Individual,
Sewage Disposal
number of'dwellings
depth of well
System
Type of System: Public Utility .__
If Individual, date of installation
No. Bdrms, 4
Individual connnunity well
presently served
Individual (on-site)
1972
~UNICIPALIIY OF ANCHORAG2
DEPT. OF HEALTH
FtqV]RONMENTAL PROI'EC1
1978
RECEIVED