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HomeMy WebLinkAboutT15N R1W SEC 18 LT 156T15N R1W SEC 18 Lot 156 #051-231-23 GrcEA I ER ANCHORAGE AREA bURutJGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSALE�//SYSTEM NAME OLA/k#Qdc LJk'4/f•e- MAILING ADDRESS SmA Ar soy oil'6#a.MA' PHONE LOCATIONSO tM1 g&6NWU0o Aloof' /Ma • LEGAL DESCRIPTION 10r /n. Sec /4 T/fAi /1, WSN/ SEPTIC TANK: DISTANCE/ NUMBER OF MATERIAL /al N'S / / COMPARTMENTS di FROM WELL 160'7 MANUFACTURER ..SyctNSe r INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 4 pop GALLONS. SEEPAGE PIT: / 2.'/ /2 'I G NUMBER OF PITS _..1._ //DIIAMETER OR WIDTH— LENGTH_ DEPTH 1 LINING MATERIAL G-F41eR)? i9tCRIB SIZE: DIAMETER DEPTH_C DISTANCE FROM: WELL /00 TOTAL EFFECTIVE �9f� BUILDING FOUNDATION 75 NEAREST LOT LINE 't20 ABSORPTION AREA (WALL AREA) g SQ FT ADDITIONAL ABSORPTION 5o/t Tesr SV cite 6- aG-7S /do a`fleM WELL: TYPE DXk2LeO CONSTRUCTIONNEAREST SEEPAGE CI( DEPTH e4NNkOA'!d DISTANCE FROM: SEPTIC BUILDING D4ze , NEAREST LOT LIE ` 2-c SEWERLINE 41/% TANK/00 ¥ SYSTEM FOUNDATION�00 f CESSPOOL N/' ' OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: Ok- INSTALLED BY: PIPE MATERIAL•Ns T Tem) LOT SLOPE REMARKS• Form No. EQ -031 DIAGRAM OF SYSTEM DATE o//Z/75" APPROVED G.A.A.B. 446 P I-54 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT PERMIT NO NAME OF APPLICANT ( `' ,? Y e » o e .. //i I-,' A e INSTALLATION LOCATION ' /' 7);'70 /7CAUI OS/0 LEGAL DESCRIPTION (0 76-0 GrecF le 71§-N 3 MAILING ADDRESS dar11'-G�r „Y/ C ePHONk J' .1 INSTALLATION OF: SEPTIC TANK Y PIT 2 /n��// ySEEPAGE �t TYPE AND SIZE OF FACILITY TO BE SERVED """` • �'/ FINANCED THROUGH TO BE INSTALLED BY DRAIN. FIELD OTHER SOIL TEST RESULTS trr�nd(/GJ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ,// ✓ 90 TYPE creel,. SEEPAGE AREA SIZE L+'�I �� I TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK F; {-efriars- cam, «cc FOUNDATION TO SEEPAGE PIT 20 DRAIN FIELD / ( / SEPTIC TANK TO SEEPAGE PIT WALL J SEPTIC TANK SEEPAGE PIT © DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK /0"(1/ / SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK, /00' , SEEPAGE PIT /Y0 DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIR CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL. BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE FORM NO. E0 -0I6 APPLICANTS SIGNATURE 28-68 AND THAT THE ABOVE 0 Et E GEOTECHNI CAL Et DEVELOPMENT CO. Russell Oyster 694-2774 Soils & Foundations Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Earl Ellis 688-2280 Land Development Performed for: Name: Tel. No. Mailing Address: LegalDescription: Depth (feet) Soil Characteristics 0 1 2 3 5 6 7 8 9 10 11 12 Ground Water Encountered: Yes No If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: 6e I/i /97S— Performed by: Date: O Et E GEOTECHNICAL Et DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 688-2280 Soils Et Foundations Land Development SOIL LOG Performed for: Name: dr L.4/ZE<vGE .1),e4/4.6- Tel. No. Mailing Address: S7 -.4/G ,Coc'ra /Sax 62-C, C 0 in/c, 4'c Legal Description: La T /576 , SEc. /E;, 7Xr.-v , /2i tic/, Depth (feet) 0 1 2 3 4 5 6 7 8 9 Soil Characteristics NL - j/cr %op soic 10 11 12 et7- j,q,vo6,e/wet. „ CtEp-A✓, c";46-st.es- To 6 " sn go Tra,L/ 7,c Ground Water Encountered: Yes Proposed Installation: Seepage Pit Comments: No — If yes, what depth _ Drain Field /OC) / /3.2 Performed by: � � ` e Date: ,C.alcc ,7C /7 7J Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program •• 4700 South aw St. P.O. Box 196650 Anchorage, AK Br99519-6650 www.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 41-2.31-23 1. GENERAL INFORMATION Complete legal description Ti SN R1 W Sec 1 A tot 1 S6 Location (site address or directions)._]g336 RevPw Av yg AK 995677 .Current Property owners) Dorothy & Clarence Drake Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage CommunityClass Well Public Water System HAA#h501D2 Expiration Date: — TYPE OF WASTEWATER DISPOSAL:. ® Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my nes for this investigation, p on, sows that thepon-si eures waterstlined in the Health upply and/or wastewater Ad sposal system al is(are) safe, functional application, type of structure indicated herein. I further verify that and adequate th for the numbered bedroomsmtheand based on the information obtained from Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Phone (907) 696-6111 . Name of Firro KND ENGINFERING,!fl� Address _ 20441 Ptarmigan Blvd., Fagie River, AK 99577 Engineer's Printed Name Kenneth M. Outfits Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the may change due day tested. The ntosubsurface conditions thow and at t rates may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE ✓ Approved for bedrooms. Disapproved. Conditional approval for Date 01/21/0S �E, aiTatseA4%%111 3 Kenneth M. ; ,�� �, CE 711 43/40 / �r I. • •N• I % 71, �f1 bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory tttufr.«rrrr,((i % j :• ON-SITE • G� • WATER AO : m WASTE WATER% J�IO•• Maintenance Agreements 'iiin Supplemental Engineer's Report Other • Original Certificate Date* • ' 2- ` 0,5� Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragw P.O. Box 196650 Anchoragee St. AK 99519-6650 www.clanchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description T15N R1 W SEC 1 g LOT 156 Parcel 10:_ OS_ 1 _231 A. WELL DATA Well type nrIVete If A, B, or C provide PWSID # Well Log (Y/N)J_ Date completed Est. 1965 Sanitary seal (Y/N)J_ Wires ro P PeriY protected (YM) Total depth Est 61 ft. Cased to *31 ft. Casing height (above ground) �= FROM WELL LOG AT INSPECTION 1/12/0 21 ft. g.p.m. Date of test Static water level Web production WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml.Nltrate jja_rp9.A.Other bacteria 0 colonies/100 mi. Date of sample: 1 /13/05 Collected by KND nein er+na tar ft. g.p.m Arsenic: jag mg./1. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SFPTI �ate Number of Compartments installed 8/12/197 Tank size 1000 gal. Cleanouts (Y/N) X Foundation cleanout (Y/N) Y Depression over tank (Y/N)ILHlgh water alarm (Y/N) jy Date of pumping 3/18/05 Pumper SANITARY C. ABSORPTION FIELD DATA Date installed8/12/1975 Soil rating (g.p.d./flz or ft'/bdrm) 1 Ol) System type Length 12 ft. Width , ]2 ft.Gravel belowi p pe Crib Death 6 ft. Total depth y} ft. Eff. absorption area 864 flz Monitoring tube y Depression over field N Date of adequacy test__3/18/05 Results (Pass/Fail) .-EMI_ For bedrooms Fluid depth in absorption field before test Q in. Water added 700 gal. New dept_ in. Elapsed Time: Ala min. Final fluid depthj92 in Absorption rate >= 45p� g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Y /TNTI If yes, give date 2/i 6lOS D. LIFT STATION _ Date installed Manhole/Access (YIN) — in.High water alarm level at "Pump on" level at in. Meets alarm 8 circuit requirements? Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100, On adjacent lots 1 0 O' + Absorption field on lot 100'+ On adjacent Tots Public sewer main 75'+ Public sewer manhole/cleanout t 00+ Sewer /septic service line25'+ Holding tank 1 00 + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation •O' Property line „Vs Absorption field 5 ' + Water service line 1 0' + Surface water 1 0 0' + Size in gallons `Pump off' level at Cycles tested in. Water main 10'+ Wells on adjacent Tots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 1 0' + Water main 1 0 + --� 'Surface water 1 0 0_.' + Driveway, paddng/VOhicle storage Water Service Iine�Q.f._ Curtain drain SO'+ Wells on adjacent lots F. COMMENTS • •: •l•. , 1• •: l •K •I 1..1 • •, u•. •.:. .c ./. .16 II ul -•• 1 • a •: ,1� -•c 1 • 1•.• l • •. . •I 1 • . • Is.l • u' 1 I. I • • • 1 • 1 • • 1 u . 1 •1,1A 1 11- •• • •' . •.• 1 • ' • 1 I" • .1 —the y . 1 • 1 • • 1 • Y 11 - - n • 1 - 1 • 1 : 1 G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that theabove sey onn ttems his idate. conformance with MOA HAA guidelines Engineer's Printed Name cgnnetb M Duffus Date HAA Fee 1.10 Date of Payment 3 arl o Receipt Number �$— (Rev. 12/01) • • 11 •60,1 - 1 - ; -',�� of •A? 44, r J 1 . Kennoth M. Dul 4' ,W Waiver Fee $ _ Date of Payment Receipt Number FESS' e' ' ")ar Road ESP.,H 4 . y� • 7e AS -BUILT I hereby certify that 1 have surveyed the following desc ibed property L F! L v i r�.• •'c.�f to /S 7 ti 61 r tLid ..4 t1. Anchorage Recording precinct, Alaska: and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. - • Dated at Eagle River, Alaska this o ;ray of .1 2�L ROBERT C. JOHNSON 'c et 1 ..�..L Registeredd Surveyor No. 660-1-5 Phone 56, E (907) 69 Eagle River, Alaska 99577 -2543 AAROW PUMP Cit WEU SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 • Fax (907) 333-8976 Palmer. (907) 745-9077 • Eagle River. (907) 622-9335 CUSTOMER J-/ d rn;17 trt. I Vej L Iit Eflle. -ti />V `377J415 OHO 6875 AMOUNT HOURS AMOUNT TOTAL MATERIAL TOTAL LABOR W�jK ORDE•ED BY h DATE COMP. Thank You TOTAL LABOR PAY THIS AMOUNT SIGNATURE (1 Hereby Acknowledge the Satisfactory Completion of the Above Described Work.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.