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Home My WebLink AboutVALLI VUE ESTATES #2 BLK 1 LT 36AA /~,,, MUNICIPALITY OF ANCHORAGE DE, .tTMENT OF HEALTH AND HUMAN SER\ -:S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT SEPTIC ABSORPTION WELL Address TANK FIELD Phone(s) Permit NO No. of Bedrooms ~ LEGAL DESCRIPTION Township, Range, Section r ~ ~ ~M ~ /~ 0r "rewa~.AS-"UjLTwaler DJAGRAUbodies. elc.)(Sh°w locahon TYPE OF SYSTEM ~ TRENCH ~ BED ~ W. DRAIN ~ OTHER ongmat grade FJ FT Total absorption area Distance be[ween hnes J S~FT FT ~ ~ / WELLS J .,i ~ PRIVATE ~THER (,denlilv} [ Installe, Date Installed: ~ ~ Scale: ~,~ ENGINEEh'S ~ ~ ~ ~ ~/~. Inspections PedormeO by -- ' ' I ce~Jl~ that IhJs inspeclJon was peflornled ~ccordinB to all Municipal and Stale guidelines in egect on this date: ~ Health Depa.ment Approval: ~__ . , ·- r. Date: ./:':~-- 72 013 (3~85) ..... ii.' ....... 0':? ..... LOt.: [._,:~t, !S :i ?: (.:, :I ? 7,'..i:0 (!i~ cl ,, { t. ,, i:~ r' ,::'~i::: i' e!is ) I hereby certify that I have surYeyecl the following A~chor~ge Recording Pre(inet, .~ska. and t~t lhe improvements situaled lhercon are within the propegy lines and do nol overlap or encroach on the property lying adjaccnl thereto, lhat no ~provemenls on. pro? e;'ly lying adjaccm lherelo encroach on the premises in question and that lhere ~e no roadways, transmission lines or olher x'isible easemenls on said prope~y except as indicated hereon. Daled al Anchorage. Alaska day of 19ff'''~ FHED ~'ALATKA & ASSOCIATES I' ,-~"i MUNIC,III~ALITY OF ANCHORAGE ~-.% DL RTMENT OF HEALTH AND HUMAN SER ES Environmental Health Division 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Na.~ DISTANCES Address /1~! C~ ~ ~-~ ~ SEPTIC ABSORPTION /~/0 ~,~ Or/~ ~ ~ ~ TANK FIELD WELL Phone(s) Permd No No of Bedrooms WELL LEGAL OESCRiPTiO. LOT LINE ~ LO~ J Block J Subdivision AS-BUILT DIAGRA~ (Shin Iocahon dj well. septic system, property hnes, Joundahon, TANKS / N ~ SEPTIC ~ HOLDING "*. TYPE OF SYSTEM ~TRENCH O BED ~ W. DRAIN ~OTHER ~ ~ ., Depth to p~pe bottom from Total depth from original grade ~ / FT 'Z,S~ ~ ET ~.7 WELLS ~ PRIVATE ~ OTHER Jldenlilv) REMARKS: I ~ C-re ~ ~, ~c,~ cedify that this inspeclion was peflormed according to all 72 013 (3~85) DEPARI'FIENT I L/ _! AND ENVtRONPiIENTAL 'RO'I"EC-I-ION !q.;.2!ZL.. STREET: ..-'d.,,J- IL, s., ~,L ~ ~,,.~r .......... 264-472C) DA'(E ' '"''~ "' ~ c:~, - z ":,'- UPGRADE ]1 oep'Lily 'Lhat: :t.,, :[ am i:'am:i].iap with 'Lhe ~',equiremer'cLs [c:)r' on-site server's and ~,~e]Is as set fc:,i'th by the Munic::i. palJty c,f' Anclnor'age (MOA) arid 'Lhe Sta'Le oF Alaska~ ;?,, :[ i*~:i.]][ :i.n~t. al]. 'l:.he sys'Lem in acJc:cipcJal'ii::o ~.~iLh ali. MOA ccides arid and in c:c)mp].:i, ance ~,,d.t.h the design cpit. er. ia of th:is i::,em~it.,, 3,, 1 ~,~:i.]1 adhei'(.:~ t.o a:ll MOA a~d State c:)/' Alasl::a ~'equi~-ements {c:m the set baci:: dJ. si:.ar!ces {rom any ~axisting v,~e].].~ ~4ast. ewat~P dtspc)sa], system of public: ]:!::: A !..II:::'"l STA'i"]:ON :iZS ]:NSTALX..IED IN AN ARiEA CDVERIED BY MOA BLJII....DiNG ~30D!ES, i'I-IEN ( :[ ) AI,I !Ei...EC t'R:I:CAI.. PERMZ[T AND ]:NSF'ECTIi]N MUB'F BE OB]'AI NED; (2) AS'-"BUII..TS W II._L. igO'i" DE: AF'F:'I::~OVED W:[ I'HOLI] A!g EL..EC]Ti]:CAI~ :I:NSPEC'F]:ON REF'EtRTii AND (3) I-FIE EL.ECTF~ICFfi_. WORK H!iST :SE DCI!qE BY A L..]:CENS[ED I:.~Zi..ECTF;i~CZAN,, AF:'I:::'L ): CAN]-~ K :[ RI( F:A]'OR Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: '~(t//,' //u'¢ //,~ /~'! Z '~'~'W Township, Range, Section: 4- 5 6 7 8 9 10 11 12 13 14 15- 16- 18- 19- 20- COMMENTS SLOPE IF YES, AT WHAT DEPTH? Monitoring? Date: SITE PLAN I ~,o il I 111 WAS GROUND WATER ENCOUNTER ED? Gross Net Depth to Net Resdlng Date Time Time Water Drop OY C, REID, JR. ~ CE- 225] ~ PERCOLATION RATE 2 Z' ~ (mmute~'inch) PERC HOLE DIAMETER ~ ~ ~ ~ TEST RUN BETWEEN ~ FT AND ~ z~ FT ~ J ~ /~ ~ z~.~ ~../,~ PERFORMED BY; ,'~ ~'~ '~ I' ~'"~.~-"'~ Z~%c--C'ERTIF Y T HAT THIS TEST WAS PER FORM ED IN ACCORDANCE WITH ALL STATE ANO MUNICIPAL GUIDELINES iN EFFECT ON THIS DATE. DATE: _~-,~ ~c ~ ~ L $KA I IIUIROPImI DTAL COFITROL $1 I41JIC1 S, ~nqin~¢rinq 8 ~nuironm~Iol Studi¢~ InC. JUDY LAMB 2600 CORDOVA SUITE I00 ANCHORAGE ALASKA 99503 SELLER-REMAX JUDY LAMB 2600 CORDOVA SUITE 100 ANCHORAGE ALASKA 99503 60571 LEGAL:VALLI VUE #2 BLOCK 1 LOT 36 ADEQUACY TEST FOR SB~ER SYSTEM ADEQUACY TEST DATE--10/21/86 THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 260 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 650 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 3 BEDROOMS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT ~AS PUMPED ON 10/86 , THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. ~ %'1-7* ~.~.~.~'"~"t" ~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION NOV 1 4 RECEIVED 1200 [Ucst 33roi Auenu¢, Suite E; ,. Anchoro§¢, Alaska 99503.(907) 561-5040 ALASKA ENVIRONMENTAL CONTROL SERVI~,, INC, 1200 west 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 ALASKA E]tR%m%TAL CONTROL S~RC;%, I~C. ~in~¢rincj ~ ~nuironm~nl~l Studi~s PERCOLATION TEST DATA SHEET CLIENT ADDRESS' ZIP CODE LEGAL LOCATION ~//~/// ~/ge ~'~ /3~c~ / TOTAL DEPTH OF HOLE ZONE TESTED ¢¢z- ft. ft TO J~ ft MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOI~ DEC ,'3 1986 RECEIVED TH # TEST HOLE DIAMETER. READING ~ CLOCK TIME NET TIME DEPTH TO NET DROP RATE (rain/in) DATUM FINAL PERCOLATION RATE PERFORMED BY MOA ST8~-024 ., SQUARE FOOT/BEDROOM ~4~c5 GRE "ER ANCHORAGE AREA UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME, ~'/~-"~ LOCATION ~'~,~' ~f~ MAILING ADDRESS ~ '~-~'~"~'Y PHONE SEPTIC TANK: DISTANCE ~/A/MA ~~_~/ FROM WELL NUFACTURER . MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY //~*'~ GALLONS. SEEPAGE PIT: NUMBER OF PITS/ DIAMETER OR WIDTH LENGTH DEPTH Z LINING MATERI CRIB SIZE: DIAMETER DEPTH~ DISTANCE FROM: BUILDING FOUNDATION ~ / ~NEAREST LOT LINE ~ /~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) WELL ~-~ SQ. FT, ADDITIONAL ABSORPTION TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION __ LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH NEAREST SEPTIC SEWER LINE TANK REMARKS DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: LOT SLOPE: Form No. EQ-O31 DATE G.A,A,B, GreaTEr ANChOragE ArEa Borough SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT pERMIT NO. INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD TO BE iNSTALLED B OTHER FINANCED THROUGH SOIL TEST RESULTS 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 ~ ~/' TYPe SEEPAGE AREa SIZE TYPE ,...o ~,/ /d/ &-/ ~_~ / /0 / WELL TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD , ALSO CONSIDER AREA WELLS. SEPTIC TANK, /~'~/ (/, SEEPAGE PiT/ ~ / : DRAIN FIELD /l~/ CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB 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 I CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE DESC}~[BED SYSTEM IS IN ACCORDANCE WITH SAID CODE. G[ FER ANCHORAGE AREA BOROUGH Depar'cme~]t of Environmental Quality ' 3330 EIC'~ Street r d~fo Anchorage, Alaska 99503 Perfor r Date perfor.med ~.egal DescriptJ~'n: ~Zw ~ ~~~~ lh~s form reporCs: So~ls log ~ , Percola¢~on test Depth Feet 3-~ 5- 6- 7- 10- 11 ~ 12- 13~ Was ground water encountered? __F[<} If yes, at what depth? ~Reading Date Gross Time Percol at:'l ol. rate mi nui;e ~ Net Time [)rain Field Depth to H20 Net Drop Depth 'cu D,,~tC,, of . Parcel I.D. # 1. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description L~T %~ A Location (site address or directions) lOgO% HAA # Property owner Mailing address Lending agency Mailing address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ ~ TYPE OF WATER SUPPLY: Individual well Community well ,,'2../O f,,O~ Public water NOTE: Day phone If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER 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 application 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 Anchora~ge 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. NameofFirm % ~6~'~1,"/ -~u~[c~[¢-~J Phone Address ¢..0 ~ ~ I ¢~ ~ ~o ~ Engineer's signature ~ ~~ Dato ~/~/~{ So DHHS SIGNATURE ~'"'"'Approved for '"~"h//~ '~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates 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 DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipali{y of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~25 (Rev. 1/91) Back MOA Municipality of Anchorage JUN 0 7 199 , DEPARTMENT OF HEALTH & HUMAN SERVI ,.~CipAi.rlYOFANCH Environmental Services Division ~NVI~ONMENTAL:$ERViCES £ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist LegalDescription:~/a.J,/; t,,/~_bt2. J~L~,~/~ r~[ ParcelI.D~: ~1,~- A. WELL DATA Well type i~A t( If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth Cased to Casing height (above ground) Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date oftest Static water level Well production WATER sAMpLE RESULTS: g.p.m. g.p.m. Coliform Nitrate Other bacteria Date ofsamPle: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed I1~, ! H.,~ --/ Tank size Foundation cleanout (Y/N) "/ Date of Pumping C. ABSORPTION FIELD DATA Date installed Length ~ I Width ~ ~ Number of Compartments ~ Cleanouts (Y/N) . Depression (Y/N) ~ High water alarm (Y/N) ~ Pumper A,,,,A. I Soilrating (~.-~orft~/bdrm) ]7'5' Systemtype Gravel thickness below pipe ~' ' Total dePth Effective absorption area /-1/~, Monitoring Tube present (y/N) y Depression over field (Y/N) ~ Date of adequacy test (~/~ ~/ Results (Pass/Fail) '~ For -~ bedrooms Fluid depth in absorption field before test (in.); ~ Immediately after ~'~o gal. water added (in.): c/fy Fluid depth ~ (ins) Minutes later:. ~ Absorption rate = '~ /~b~ ~ ~;p.d. Peroxide treatment (past 12 months) (y/N) ~ If yes, give date /~// 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested ~S~ze n gallons "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO~'''~ Septic/holding tank o.n lot j,,/ On adjacent lots Absorption field on lot On adjacent lots Public sewer main ~' Public sewer manhole/cleanout Sewer/septic service line.J Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~.. ~ Property line ~.[ ~ Absorption field Water main/service line. ) ~ Surface water/drainage t'q l O Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain Building foundation ~ I Water main/service line "~ I ~ Driveway, parking/vehicle storage area C) Wells on adjacent lots ~"'l/,Zk F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Signature ~ ~ Engineer's Name/--~ ~J~'-'~ --~/'~ ~-t~.~,-~ Date ~[~/~ , HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALI"rY OF ANcHoRAGE DEPT· OF H:ALTH & ENVIRONMENTAL FF, O / ECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ' 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION AUG 2 2 1979 Telephone 264-4720 RECEI VF.D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing, ,. PROPERTYOWNE" S Ps3/ PROPERTY RESIDENT (If different from above) /J, A, PHONE PHONE 2. BUYER ~ ? MAI LING A DDR ESS 3. LENDING INSTITUTION · ~ PHONE M~ILING ADDRESS [ 4. REALTOR/AGENT PHONE LEGAL DESCRIPTION BEET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS E~ One [] Four [] Other__ ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER SUPPLY [] INDIVIDUAL* * ATTACH WELL LOG. A well Ecg is requ'ired for all wells drilled ~] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach Icg if available.) s. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date //~'7~ [2~L INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required [] PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EAc'H REQUEST BEFORE PRocEsSING CAN BE INITIATED. 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 E~] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPI.Y [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED ~PUBLIC UTILITY Connection Verified INSTALLER~""~ 4. ~, []Septic Tank or [] Holding Tank Size: //OO(~) If Tank is homemade SOILS RATING give dimensions: TYPEOFTANK MANUFACTURER .~ ~ TOTAL ABSORPTION AREA MATERIALa~k~AC-"'~ ~r 4. DISTANCES Septic/Holding T ~a Sewer Line Nearest Lot Line WELL 'rD: Absorption Area to nearest Lot Line 5. COMMENTS ~- APPROVED FOR ,~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY LEGAL DESCRIPTION 72-010 (Rev, 3/78)