HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 3 LT 24
~GRE~"~R ANCHORAGE AREA BO?~IGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
MAILING ADDRESS
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER
NUMBER OF
/
MATERIAL ~~C~''~ . COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY /~-A"-O GALLONs.
SEEPAGE PIT: .~ # X' ~g~c Ib','(..~o/
NUMBER OF PITS__/ DIAMETER __ OR WIDTH LENGTH DEPT~H;Z-/3 I
BUILDING FOUNDATION NEAREST LOT LINE ABSORPTION AREA (WALL AREA) ~ Z/ .SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE ~9'~'¢ ~/ ' CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS.
DISTANCES: DIAGRAM OF SYSTEM ,~
INSTALLED BY: ~/gs~ ~-
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DATE ~' ~-' 75/ APPROVE~'~-'-'~-- ~f~. ~
G.A.A.B.
' GRe:ATER ANCHORAGE AREA BOROUGH d"/-'r/'~ ~/~
~"~ PERMIT NO,
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C"STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
NAME OF APPLICANT
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
LEGAL DESCRI
TYPE AND SiZE OF FACILITY TO BE SERVED ~'-- ~ '~/ ~ r' /~
FINANCED THROUGH TO BE INSTALLED BY
SOIL TEST RESULTS / ~--~/~_/~ ~F~-/~ ~//~l
, OTHER,
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL, TEST
COMPLET]ON 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.
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK ~- SEEPAGE PIT ~ DRAIN FIELD TO NEAREST LOT LINE.
WELL TO sEP¢C
DRAIN FIELD ALSO CONSIDER AREA WELLS.
TYPE
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
SE~T~¢ TANK, /,~ ~ r /,~ ~ /
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEETINTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST iRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WiTH AIRTIGHT REMOVABLE CAPS.
GRAVEL EAC:KFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-§8 AND THAT THE ABOVE
DATE APPLI,ANT'S Si'NATURE . '
Performed For
Legal Description:
This Form Reports Soils
Soil
Depth
Feet
12--
14~
16
GL'~'I.R/--% ANCIIORAGI: AREA BOROUG,,
DEPARTMENT OF ENVIRONMENTAL QUAI. ITY
3330 "C" Street
ANCHORAGE, ALASKA 99503
Gary Candee
Lot 23 & 2~lock 3
Log · xx
Test Must Be Logged To 4'
Soil Characteristics
Case #
Dated Performed_AprilS, 1974
Subdi'vision Unit2-ValleyViewEstates
Percolation Test
Below Proposed Seepage System -
Amorphous granular peat
-Fine to medium, clayey gravel GM
Coarse, clayey sandy gravel
GM
Uniform fine sand with trace of Silt SM
Uniform medium sand with trace of
clay and silt
Was Ground Water Encountered?
If Yes, At What Depth?
SP
No
Lot 24
Lot 23
Reading Date
'Pe rcol ati on, Rate
Gross Time
Mi nute
Net Time
Depth to H20
Net Drop
Proposed
Depth of
COMMENTS:
Installation: Seepage Pit xx Drain Field
Inlet Depth io Bottom of--Pit or Trench
Based onBoroughstandards, we recommend 195 sq. ~.per bedroom.
Test Performed BY JohnJameson/HowardJ.Grey Date Certified BY:
ALASKA MINERAL & MATERIALS LAB Date: ....................
/~:-'~artment of Envirol~mental Quali:~--~
~ater and Sewer Questionnaire
Subdivision
Owner's Name:
Mailing Address:
Block .~ , Lot
Questions:
1. How many bedrooms are now in your house? ~ ~
2. How many bedrooms were in the house at the time of purchase? ~
3. Were the basement bedroom walls "roughed in" at the time of purchase?
4. Was the basem~,nt bathroom plumbing "roughed in" at the time of
purchase? k/.~
5. Did the realtor or builder inform you that you would have to enlarge the
existing sewer system if you finished the basement bedroom (s)? ~}~, /
6. If on a pu~l/c water supply, do you always have an adequate supply of
water?
/
7. Is the pressure always adequate?
8. Who was the builder? ~g
9. Who was the home purchased from?
OTHER COMMENTS:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
OF ON-SITE SEWER AND WATER FACILITY
· 264-4744
Application Date
GENERAL INFORMATION ·(MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
(c) ~.e~,,.d~g In~itut. ion; ~,/¢)',,A~..._/'~C~-,/,K ,¢- .~2/"c,"..5',¢-¢.z¢' Telephone
(d) Real ~;a;;;(~:~'~q¢ ~l~d Agent ,~'/~'7~/ ~.¢F',~.)~-~TE
Telephone ~' ~ / ~ ~'
Mail the HAA to the followino address: or; Check here~ Jf hold for pick up.
List contact person and day phone number below.
(e)
2. TYPE OF RESIDENCE
Single-Fam[ly~
Number of Bedrooms
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.
SEWAGE DISPOSAL
Onsite~L Public [] Community [] Holding Tank []
Note: If corn munity well system, must have written confirmation from the State De
attesting to the legality and status.
}artment of Environmental Conservation
Page 1 of 2 72-025 fray 8/861 Front
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NOIJ. N¥O
'9
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
MUNICIPALITY OF ANCHORAGE 264-4720
ENVIRONMENTAL SERVICES DIVISION Legal Description:
SEP - 7 1988
Well Classification IVED If A, B, O, D.E.C. Approved CN)
resent (Y/N) Date Completed Yield
Cased to __ Depth of Grouting __
__ __ _ Pump Set At __
Casing Height Above'"~ __ __ Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (~__ Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot ~ ; On Adjoining Lots __
Edge of Absorption Field on Lot ~oining Lots __
To
Nearest
To Nearest Public Sewer Line ~__ To NeareSt Pu~bfi~ewer
Cleanout/Manhole __ To Nearest Sewer Service'"bh:l~ot
Water Sample Collected by ; Date
Water Sample Test Results
Comments
sEpTIC/HOLDING TANK DATA
Date Installed ~'"'~'~/~ Size
Standpipes~N) Air-tight Caps(~N)
Depression over Tank (Y,~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
No. of Compartments
Foundation Cleanout(~}N)
Date Last Pumped
~J/~ ;for
Temporary Holding Tank Permit (Y/N) "u//'~'
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72 026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date installed ~"
Width of Field
Square Feet of Absorption Area
Depression over Field
Results of Last Adequacy Test
Type of System Design
Length of Field ~O/~
Depth of Field /~/-
Gravel Bed Thickness ~' ·
Standpipes Present ~N)
Date of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
To Property Line
Lot ~///4 ¢
To Water Main/Service Line ./¢ ¢'
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Existing or Abandoned System on
; On Adjoining Lots ~'~
To Cutbank (if present)
Comments
D. LIFT STATION
"Pump On" Level at ~
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
~ ~'~..- Vent (Y/N)
-~~ng Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify t hat I ha.~/c~ec.~d,/v.e~fied, or conformed to all MOA and
Signed /.~.¢-----E- ~,,//,-,~--~ Date ¢~' ~
Company ~ MOA No. O~
Receipt No. ~0'~ . ~"~)~ ~
Date of Payment ~/~/~
Amou.t: _
Page 2 of 2
HAA guidelines in effect on the date of this inspection.
2251
~, ~, ~ ~- ,
72-026 (11/84)
ANCHORAGE, ALASKA 99503
STEVE COWPER, GOVERNOR
563-6775
DATE: August 25, 1988
PWSID: 210605
To Whom It May Concern:
According to the records on ?ile in this o??ice,
SUBOIVIStON Water System .is in compliance uith
Alaska Drinking Water Regulations,
the VALLI-VUE
the State o?
Please note that departmental records indicate that the public
water system was installed prior to the 1978 implementation o?
the Alaska Drinking Water Plan Review regulations. No as-built
plans have been reviewed or approved by the department, nor are
any necessary. Since the system has submitted acceptable water
samples on a regular basis and received a satis?actory sanitary
survey evaluation by the department, the system is acceptable
under the standards in e??ect at the time o¢ installation. An
o??icial "Certi?icate to Operate" may be issued upon receiving a
complete set o? as-built plans, Any expansion o? the water
system a?ter 1978 will require plan review and the issuance o? a
"Certi?icate o? Operation" permit.
I? you have any questions, please contact me ~t the Anchorage/-
Western District o??ice.
MPL:pkk j
Sincerely,
Michael P. Leuis, PE
Environmental Engineer
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 ~/~'/R* ~,
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
L~a~g~,(ad~ress'o(d~r~b~[ons) ,
(c) AppliCant ~(¢he~ o~e}: E~dd~ng Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain);
(d) Lending ]nstitu~ion¢ ~ Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
Telephone: Home ~ i'11~1~.~? Business
TYPE OF RESIDENCE
Single-Familyl~ Mu[ti-Family []
Number of Bedrooms ~
Other
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
OnsiteJ~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 {11/84)
.5.
ENGINEERING FIRM PROVIDINg. JSPECTIONS, TESTS, FILE SEARCH, DA* ND 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 flies 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
Address / ~P~
Date
Telephone
DHEP APPROVAL
Approved for ~ ~,) bedrooms by
Approved ,..~.... Disapproved
Terms of Conditional Approval
Conditional
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 certain 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 (11/84)
,~,.O% MUNICIPALITY OF ANCHORAGE (MOA)
* r-,xO: ,,-,'~ HEALTH AUTHORITY APPROVAL (HAA)
,~ '¢ ~,,&~ CHECKLIST - FEBRUARY 1984
~'~ ~ ~ Legal Descrpton ~ ~2~
WELL D~[ ~ ~'
Well Classification ~:~M~ONZ~ff ifA, B, C, D.E.C. Approved ~N) ~5'
Well Log Present (Y/N) Date Completed Yield
~:;;'C D~t;:r Level __ Case~ ,o ~ Depths, ~o~;,~ge, At
Casing Height Above Ground __ _ ~ Sanitary Seal on Ca~~
Electrical Wiring in Conduit (Y/N) Depression Ar~llhead (Y/N)
To Septic/Holding Tank onLot /~ /~ ~Adjd,~L~s
To Nearest Edge of Absorption Field on Lotl ~; ~ Adj~W~ L~s
To Nearest Public Sewer Line ~ To Nearest Public Sewer
CleanouVManhole ~To Nearest Sewer Service Line on Lot
Water Sample Collected by ~ ; Date
Water Sample Test Results /~
Comments
B. SEPTIC/HOLDING TANK DATA
Standpipes (~'N)
Depression over Tank (Y(~I
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
TO Water-Supply Well 200
To Properly Line ~',,~/.'cz.
To Water Main/Service Line ~
Course '/ OO
Size
Air-tight Caps
No. of Compartments /
Foundation Cleano~t ~'N)
Date Last Pumped ~/~'/~:~, z,-.'-
:,o,
Temporary Holding Tank Permit (Y/N) ~/~
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(1~/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata / ~-
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well 2 O0 / ''~
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
Type of System Design
Length of Field -~' 0 z~
Depth of Field
Gravel Bed Thickness ¢)"
Standpipes Present ~/N) .
Date of Last Adequacy Test
L/
To Property Line ~.0 ~'¢'
To Existing or Abandoned System on
; On Adjoining Lots 20
To Cutbank (if present)
IO0 /-P
Comments
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~__
"Pump "'Level at
¢ //~'- ~Ver~t (Y/N) ~
/,~J Pumping Cycles during Adequacy Test. Meets MOA
Comments J
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I ha)le~c~e.c.k~C_~verifi, ed, or conformed to all MOA end HAA guidelines in effect on the date of this inspection.
Signed ~~ Date ~
Company ~F~ /~, MOA No. ~- 0¢~
ReceiptNo. ~0 0 ~ 000~
Date of Payment ~/*~
Amount: $ ~ ~
Paso 2 of 2
72-026 (IU84}
ALASKA B,,dlBOflmeflTAL COIITI OL
~nqincerJnq 8 ~nubonmental StuJJes
IflC.
SHIRLEY TOMBLINSON
C/O MARSTON REALESTATE
2804 W NORTHERN LIGHTS BLVD
ANCHORAGE ALASKA 99517
SELLER-RAY KAWAL
09/08/86
SHIRLEY TOMBLINSON
C/O MARSTON REALESTATE
2804 W NORTHERN LIGHTS BLVD
ANCHORAGE ALASKA 99517
60473
LEGAL:VALLI VUE #2 BLOCK 3 LOT 24
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-09/05/86
THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 864 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 904 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.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 09/08/86 .
THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
1200 West 33r(I Avenue, $ui1¢ ~,,Anchor~§¢, /~l~sb 99503,(907) 561-5040
ALASKA ENVIRON!~-"NTAL JcB
CONTROL SERVICEo, INC. ~(~ ~. BH~ET NO.
1200 West 33rd Avenue. Suite B
ANCHORAGE, ALASKA 99503 CALCULATBD BY
(907) 561-5040
CHECKED BY.
sc^~E 1%30'
rue ~
~^~ ,/~/~ __
DATE
DEPT. OF ENVIRONM T
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BILL SHEFFIELD, GOVERNOR
7'elephone: (907)
Address:
274-~533
DATE: September 3, 1986
PWS I.D.# 210605
To Whom it May Concern:
According to records on file in this office the VATLIEVIEW
Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
Regional Sanitarian Supervisor
t~JviU~clPALITY OF AIj(ICHORAGE
DEPT. OF HEAIJTH &
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 LStreet-Anchorage, Alaska 99501 SEP 2 1978
ENVIRONMENTAL ENGINEERING DIVISION
Te,ep. one 26.720 RECEIVED
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 (10) days for processing.
MAILING ADDRESS
PROOf E~R T y R E~D E,~-T (l~it~fl'~ent from a~ ~
PHONE
PHONE
3. LENDING INSTITUTION PHONE
MAI LING ADDR ESS
PHONE
REALTOR/AGENT
MAI LING ADDR ESS
5. LEGAL DESCRIPTION
TREET LOCATION
Joo 0,4 /dAn
S. TYPE OP RESIDENCE ~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF BEDROOMS
[] One ~ Four
[] Two [] Five
[] Three [] Six
[] Other
7. WATER SUPPLY
[] I NDIVI DUAL* * ATTACH WELL LOG. A well Icg is required 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.)
8, SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date Ic~-J~.
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 ONLY
.' DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR ~ NSP ECTO R INSPECTOR
--DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] 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
[]Septic Tank or [] Holding Tank
Size: l~'~"b If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES WELL TO: Septic/Ho]ding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[~;]~'~-APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
LEGAL DESCRIPTION
72-010 (Rev, 3/78)