HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 4 LT 3
GRE ,.ER ANCHORAGE AREA BOE,.JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK: (?/_ J4L ~-0 ge ~/
FROM WELL MANUFACTURER
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH
NUMBER OF
COMPARTMENTS f
LIQUID CAPAC TY/~,~~ GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL~¢~¢/~-4~ , FOUNDATION /0 "~ NEAREST LOT LINE
NUMBER OF LINES // DISTANCE BETWEEN LINES
ABSORPTION AREA ~/O SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADB ~ ~/~ MATERIAL BENEATH TILE
TOTAL LENGT~ /
OF LINES ~' /
~'~ABOV E TILE F IN.
TYPE _
BUILDING
FOUNDATION__
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST SEPTIC
SEWER LINE__, TANK__
REMARKS
DEPTH
SEEPAGE
SYSTEM
DISTANCE FROM:
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED B '
SEWER LINE DEPTH:
REMARKS:
Form ED-032
GR~ ZR ANCHORAGE AREA BOF:~%'JGH
· ~/~ DEPARTMENT OF ENVIRONMENTAL QUALITY
·~lilllll IIl~\ 3330 I'C" STREET ANCHORAGE, ALASKA 99503
C,, ~ . ~.c S~WAGe DISPOSAL SYSTEM ~ APPLICATION AND PERMIT
~ ~'~ mc. ,~-, .~ ~,, . L.~ ?"~ ~ . . , ~ /
pERMIT NO,--
TYPE AND SIZE OF FAC]LIT¥ TO BE SERVED .~/~/~
j '~""~' ~ NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
SOIL TEST RESULTS ./
~OmplETiON DATE ANTICIPATED(~ C/ r~ ~"J~ ~=/~ ~ ~
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 SEEPAGE PIT ~-- ~.) ¢' DRA[N FIELD
DIAGRAM OF SYSTEM
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS. ~
.,.51,' n,'+/,, ,'/ f ,
CONFORM TO BOROUGH~EGU'-- ' 'L~O;?R:~:RD[NG INSTALLATION.
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE A~EA BOROUGH ORD[NAHCE NO. 28-68 AND THAT THE ABOVE
DESC~IBED~EM ~SY~ TEM I ~H ACCORDANCE WITH SAID CODE.
DATE I~/?[.~ APPLICANT'S SIGNATURE ~~ ~/~.~1~
//
GRE^m.."R BO '%G"
ANCHORAGE AREA
DEPARTMENT OF ENVIRONMENTAL QUALITY
SEWAGE DISPOSAL SYSTEM -- APPLICATION, AND PERMIT
/ "
LEGAL DESCRIPTION ~ r~ ,7"
INSTALLATION OE~ SEPTIC TANK
FINANCED THROUGH
SOIL TEST RESULTS
NOTE: THIS PERMIT IS NOT VALID WITHOUT SO,IL TEST
i' r ,,-'! 5 ~"2'/ ~,' n /.2
COMPLETION DATE ANTICIPATED ~ f~" ~' P
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SU~ECT TO PROSECUTION.
SEPTIC TANK SIZE / ,'~ ~ 6 F~ I/ / "' ' '/
MINIMUM DISTANCES, REQUIREMENTS
SEPTIC TANK TO SEEPAGE PiT WALL / I d /':'?i'~ ri /' /' ~( ¥"?/ ,
TO NEAREST LOT LINE,
WELL TO SEPTIC TANK // ~!~2 (~
DRAIN FIELD f' ~';]~'~
,//'// I &,' SEEPAO~ AREA SIZE ('4' :.'(J~ /if :
DIAGRAM OF SYSTEM
SEEPAGE PIT
AL,~O CONSIDER AREA WELLS,
SEEPAGE PIT
CAST I~ON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION ~ FEET ]NTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST lEON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
/' '" '~" / d~; ~" ~' "'/''~ '"-~-/
FITTED
WITH
AIRTIGHT
REMOVABLE
CAPS.
'~ ~: ' / 7 "~7~ '/ ·
.:,,:,, ,: ,, .,..,.. ?. ,..
*ATE' / "/' / '/ ~ APPLICANT'S SIGNATURE '": .... i f'"'~:;' ...........:'-~ .....
Performed for ///~e~ £~,4~#~/~-~
Legal Description: Z:o~ S ,3/~ .~
This form reports: Soils log v
GREATER ANCHORAGL AREA DOROU
Department of [nvironmen[al Quality
3330 "C" Street
Anchorage, Alaska 99503
SOILS I,O(i I~EROt,ATION TEST
Depth
Feet
4- Q~ ~
5-
6-
7-
8-
9-
10-
11
13-
~as groun ' encountered?
Date Perforu,~-,:} . .~_J~_k~7_~__
Percolation test
If yes. at what depth[
leading
Date Gross Time Net Time ~ pth to Water Net ;Oro~
Percolation rate minute,
.Proposed installatio~.-i--'Se~e~a--ge Pit Drain Field
Depth of Inle~ ............... · Dept¥~'n~-~F'pit or trench ......................
COM~.IENTS: .__~ ~j~_f_ ~_~ ......................................................................
EQ-040 (6/74)
Test Hole 2 Elevation: Existing Ground
Lot 3, Block 4
W.O. #17378
Depth in Feet
From To
Soil Description
0.0' 16.5'
NFS, sandy gravel, GP-GM, grayish
tan, damp, trace of silt, poorly
graded, some cobbles 12.0' to
16.0', Group D
Bottom of Test Hole:
16,5'
Frost Line:
None Observed
Free Water Level:
None Observed
Sample Depth
Type of
M, !Sample' Group
5500~6600' DAMP G D
10.0'-11.5' DAMP G D
15.0'-16.5' DAMP G D
Remarks:
Type of Sample, G = Grab
Group refers to similar material, this study only
?STATEMENT
LITTLE DIPPER EXCAVATING
P, O:'Box 4-]1Y3 ............
Anchorage, Alaska 99509
TOPS 3409-D
~ ........ ;7~m'JSTOM~ ............................ , LOCATION
~o. OR O,~ER NO. I LO* .LOC~
~c~ ~c~. ~ c.o.d.
~ 020] CO~C SAgO 0207 BkDG.
0202 MASON SAND 0208 FILTER SAND
0203 PEA GRAVEL 0209 CRUSHED SAND
04 '~ lY~ CONC AGG 0210 OVERSIZE
~6~~ ~ CONC AGG 0211 WINTER SAND
o~o~ ~.~ ~s~ o~ Dnmv~w~y ~mx
022__ CHIPS ~ 0213 TOP SOIL
0214 PIT RUN
DELIVERY CHARGE
~ sou~cu 1% Service Charge on Past Due AC
Annual Percentage Rat .12~ ,
JOB OR O~DER NO. J LOT N~ BLOCK
CHARGE~ CASH ~ C.O.D. ~ ~,ELIV~,~Y ~PICK-UP
0202 MASON SAND 0208 FILTE~ SAND
0203 PEA GRAVEL 0209 CRUSHED SAND
0206 D-I BASE 0212 DRIVEWAY MIX
022~ CHIPS 02~3 TOP SOIL
0214 PiT RUN
DELIVERY CHARGE
1% Service Charge on Past Du~
Annual Percentage Rate ~2% ~J' , ,
c:///-?~?/~/)~ ANCHORAGE SAND and GRAVEL CO., iNC.
Date .rf_),/ ~2 ~/ ./~ 1813East lstAve. Anchorage, Alaska9950i Phone274-5691
3617-2 .
/ ~...~
'- 1% Service Charge on Past Due Ac n~-- f~///
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
,d/,,;-- HAA#
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
{:: ~C~ ¢~_,¢_. Day phone /V'/~-
q-~OoP-- ~ D~.
Day phone.
Day phone ~-'G/-~.Z~ ~ 6
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~ '~-
TYPE OF WATER SUPPLY:
NOTE:
Individual well
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Fronl MOA #21
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I:I':I::INI9N~I A8 NOI/O=IdSNI JO J.N~IN::I/VJ.S 'G
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Le§al Description: Parcel I.D.
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Cased to
lOB, or C, attach ADEC le_tter. ADEC water system number
"/,,//Pr- Date completed ~ /f~- Driller ~//[-
~/'~ Casing height /v//~
FROM WELL LOG
Wires properly protected (Y/N)
AT INSPECTION
test
Static
Well flow
Pump level
LL TO:
SEPARATIQ, N DISTANCE5
Septic/holding tank on lot
Absorption fieid on'lot t,',
Public sewer main ....
Sewer service line ,. '
g.p.m.
WATER SAMPLE
Coliform Nitrate
~A~i'[e of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA /'¢u~'F-'~'~ pL~¢~¢ -cp,,u~
Date installed ~-/"~/'~ (~ ~ Tank size l Z~o-L~
Cleanout~ (Y/N) ~/'J~---~ Foundation cleanout (Y/N)
High water alarm (Y/N)
Date of pumping
acent lots
On adjacent lots
Compartments
Depression (Y/N)
Alarm tested (Y/N)
Pumper ¢'~_,.~.-
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot A///¢c On adjacent lots
-
To propertyline ~"r~-VEJ~- Absorption field
Surface water/drainage
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
D ate '1 n sf~.....~ _ Manufacturer ~
Size in gallons ___~--.~~ Manhol~
~ legal (wYitNe)r aid r m leve~ s/"Pump °n~~_ Cycles tested'''~, "Pump °fi' level at ~
Meets MOA ele~____ ~
Well on lot On adjacent lots Surface water
D. ABSORPTION FIELD DATA
Date installed
Length
Width ~__ Gravel thickness
Total absorption area
Depression over field (Y/N)
Results (pass/fail) ____ P~'-'&¢> .~_.~1~
Peroxide treatment (past 12 months) (Y/N) __ N/~
System type '-T'~c~/C'~f~
(~, I~) Total depth ! 2``/~
Creanouts present (Y/N) 'YI~'<~ {~ ~¢/-¢¢0~
Date of adequacy test 2'/~"~/c~'-3
for F;oc~ ¢... bedrooms
If yes, give date /d//~
SEPARATION DISTANCE FROM ABSORPTION FIELD TO: .~.~
Wellonlot /~ /~r Onadjacentlots ~' teO¢ ~F__2~- ..
eov6J~ ~-d'¢, Propertyline SF-E-
To building foundation ~-~/ ® To existing or abandoned system on lot
On adjacent lots
~rc&, Cutbank
Surface water /'/¢'~-~-'
Curtain drain ~/~
E. ENGINEER'S CERTIFICATION
I certify that I have checked, ~,~rified, or conformed to all MOA and HAA
Signature ~~/~
Engineer's Name
Date
/¥//~- Water main/service line_
Driveway, parking/vehicle storage area ~2p/°/_)~ ~-'~ c~l/)lF~:~ o~
of this inspection,
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
72 026 (Roy 3/91) Back MOA 21
TEL No.907-565-4418 · Rpr 2,95 15:59 No.OI2 Pi02
.... ~ .,- ~. ~..,.,. ~. :...,.,.. :.,,-.- . .,., 2~0~.
cRNESL~r-FISHER~ .J , -.. ~ , .... ,.. ~ ....... , ~ .
...... ~ , ~ ~ ,,~...,.... ~,.~ . . ..,.~, . , ,, ¢,., ,. . ~ .~,¥... ,
· ' ' , ~ ~(~ W& ~ · .'" ~' ;. ;f."." "' ' 2 .' '?. ' TM .' "
: HM. 34~202~ ~ ~. ~(,.~.~.. , ., ~.~....:., ~., .,. ~ / ~'~¢~.~ ~., ~,,,~,. ~...... ROBERT ~HAF~R,P.E
I~20~ON~:~R~ D.EIVEff~-~ ., .~".~ ¢:' :~'C,~ ~" ~t~'~=,~%.~ ~ '~. ROGER 8HAFER, P.E.
ANCHO~RK. 99516 ~ .:'.','~ ~:~' ' .~.~,,>~,~'. '.~ )~,:~ ~ ~:~:"' 'e."~ ?.";~ I '% . ~ .
., ~,.::~. ,.~.~.,~;,.. ..~ ..~,:, .... ,,.,, ... ,. ~ ..~ -'
7~ G STRE~ ~U~ ~ ~ ' . .~.~.~ "~' ~" '~ " ~ '"' ~ """ '. · '
;~%4:¢.~ *~?'¢' · :4.:; .'."- ¢ ~ ~,~~ "
For /¢ ' ' ?:~",,. · ""~" .... : '" .1'7Y¢~%~% i~. L?:~Z'" ~:.. , ' ' '
eEROOLRTION
1EST
T~.RMS ARE DUD ON R~CEIPT
CHARGF~S'~F 1.5% AFTER 60 DAYS
WASTE WATER 17034 EAGLE RIVER LOOP, 8UITE204~ EAGLE RIVER, ALASKA 9957'/
ROADO~$1GN
SOl,TEST
PERCOLATION
TEST
METER TOTAt VOL, LIQI rI.D. LEV! IL
TZMB READING (Gal. ) SiT. M.T. aM.T.
/*,oa lq¢,-, ~? /: ~ /J.%
ROBERT 8HAFER,
ROGER 8HAFER,
Cl%;k ENGIN£i~S
(907) 094.2979
FAX 094-1 ~tl
COMMBNT$
ON SLTE
WABTEWAT£R
DISPO~AL~YST£M 4 ?n'~ I~anl ~= I:IIVER LOOP', ~IIITI~]~O&. EAGLE RIVER. ALASKA 99517
DEPT. OF ENVIRONMENTAL CONSERVATION
WALTER J. HICKEL, GOVERNOR
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3-470
ANCHORAGE, ALASKA 99515
March 30, 1993
(907) 349-7755
Mr. Jeff Garness
8471 Brookridge Drive
Anchorage, Alaska 99504
SUBJECT: Valli Vue Estates #2
Class "A" Public Water System, PWSID 210605
Dear Mr. Garness:
I have completed a review of this office's files concerning the monitoring status of the
above-referenced Class "A" Public Water System and found the following:
The last satisfactory Total Coliform Bacteria Sample results Was submitted
to this Department on March 4, 1993. This does meet the provisions of 18
AAC 80.200(a), of the State Drinking Water Regulations.
The last inorganic Chemical Contaminants Sample results were submitted
to this Department on August 13, 1992. This does meet the provisions of
18 AAC 80.200(a), of the State Drinking Water Regulations.
The last Radioactive Contaminants Sample results were submitted to the
Department on December 2, 1992. This does meet the provisions of 18
AAC 80.200(a), State Drinking Water Regulations.
The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC)
were submitted to this Department on November 12, 1991. Based on
analysis of the previous VOC samples results have been satisfactory. This
does meet the provisions of 18 AAC 80.200(a), State Drinking Water
Regulations.
Issuance of this letter does not imply that the above-referenced Class "A" Pub c Water
System is in compliance with other provisions of the State Drinking Regulations.
Mr. Jeff Garness
March 30, 1993
Page 2
If you have any questions on the above information, please do not hesitate to contact this
office at 349-7755.
Sincerely,
Michael Lu
Environmental Eng. Asst. II
TEL No,907-565-44~
Mar 29,95 15:24 No.Oll P..O$
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~hi I~o~m~tt :~tu~md th~r~n ~r* within t~ ~ro~rty Iln~; IM do ~ot o~rlep or ~'/ ~ ~ ~
Iylng adJeoent thereto en~r~Ch O0 the premi~ In qu~t~n Ind that there arena r~y~, ~¢.~et~e~e~e~e~ · ,'
tranlmbllOn linl; Or Other vllibll il~eti an a~ pr~ except ii'lndl~t~ hw~n. ~]U-, ~ ',~t,/,'/,; .... ~ '
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............ . .... , ...... , ....... ,.~. ~
April 5, 1993
Alaska Water & Wastewater Services
Frontier"
Hunicipality of Anchorage
Department of Health and Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Health Authority Approval (HAA), Lot 5, Block 4,
Valli Vue
To whom it may concern:
1. General Discussion Regarding Adequacy Tests: The
subject septic system was constructed in 1976, and tested
for adequacy in January of 1984, and twice in March of 1993.
In order to understand the existing condition of the system
:it is imperative that I explain and interpret each of the
tests. They are summarized as follows:
ai January 1984 adequacy test performed by Toben
Spurkland, P.E.: In Mr. Spurkland's report he stated that
the sump was full of septic waste, and that it was not
connected to perforated drain pipe in the trench. I believe
he was implying that t'he scmp is const'r'ucted ~ith solid pip~
Consequently, he did not attempt to monitor the liquid level
:in the trench via the sump, but instead pumped 675 gallons
into the system, through the clean-out at the beginning of
the trench, and monitored the liquid level in the septic
tank. Nater did not back up into the septic tank,
therefore, he deemed the system to be adequate for a 4
bedroom house.
During one of my site visits I probed around in the sump
(with a wire bent at 90 degrees, and attached to the end of
a stick) to see if I could feel any perforations in the sump
below the liquid level. I was unable to detect any with
· this rather "primitive" technique. Based upon these
findings it is my belief that the original installation was
a rather unique type which was being used during that era by
Dr. Leroy Reid. This design utilized a solid pipe in the
sump and the drain pipe in the trench was installed with the
holes facing up, rather than down. Systems of this type
operate with the drain pipe completely full. 2"~ is
Telephone - Fax 358-3246 · 8471 Brookridge Drive · Anchorage, Alaska 99504
b. March 18, 1995 adequacy test performed by $ & S
Engineering: The results of this test are attached. It can
be seen in reviewing the results that a total of 1557
gallons of water was introduced into the trench over a
period of 4 hours and 40 minutes. During the first
minutes of the test (67 gallons total) the liquid level in
the sump rose 1.5 inches, and during the next 50 minutes
(267 gallons total) it only rose an additional .5 inches.
believe the initial 1.5 inch rise in the sump was due to the
fact that the drain pipe was not full prior to the beginning
of the test. The adequacy test form prepared by S & S did
not indicate whether this was the case or not. Regardless,
the liquid level in the sump did not rise after that point
even though an additional 1090 gallons was introduced over
the next ~ hours and 40 minutes (6.3 gpm). According to the
test data, while the liquid level in the sump remained
constant, the liquid level in the septic tank rose
possible that the perceived rise in the septic tank liquid
level was due to a rotation of the float which caused it to
break free from scum and rise .5 inches. Another possible
reason could have been the operation of a sump pump (if one
c. March 27, 1995 test performed by ~laska Water
Waste~ater Services: Before the test was started I noted
that the liquid level in the sump was about 3 feet below the
elevation of the trench drain pipe which intersects it. I
performed the test by introducing water, into the clean-out
at the beginning of the trench, at an average rate of 4.11
gpm for a total of 245 minutes (1000 gallons). During the
initial 10 minutes of the test I noted that the liquid level
in the sump rose (2'-11") until the top of the drainpipe was
elightly submerged. This mould be consistent with the
theory that the system is a "Dr. Reid" type design with the
drain pipe perforation facing up. The liquid level in the
sump did not rise during the rest of the test, nor did the
water back-up into the septic tank. Based upon the fact
that the home was currently occupied, and the system was
able to handle the normal daily flow and this 1000 gallon
"slug" dose, the system was deemed to be adequate for a 4
bedroom house (600 gpd).
2. Separation Distance to Adjacent Septic Systems and
Property Lines: The septic systems on the adjacent lots
were not documented in the DHHS files, and the clean-outs
were covered with snow during my site visit, consequently, Z
was unable to verify the separation distance to the subject
systems. Attached is a copy of the most recent as-built
survey which clearly indicates that the distance to the
nearest lot lines is far enough to ensure that distances to
nearby septic systems are not a concern.
$. Separation Distance from Septic System to Nearby Wells:
The ValIi Vue ~2 subdivision is served by a community well.
The closest private well to the subject septic system is
located on Lot 5, Craig Subdivision. Z only verified this
separation distance to be greater than 100 feet.
4. Date Septic Tank was Pumped and Name of Pumper: The
date the septic tank was pumped and the name of the pumper
is unknown. Pumping was performed at the request of S & S
Engineering. Their invoice to the homeowner, and their
check, is attached.
If you have any questions, please call me a 537-6179.
Sincerely, ~
NOT'E: ThC ad¢quacLv of a ss~ic system is influ¢n~'¢d by
numerous fact'ors, inolud$ng, but no~ ]~llti~ ted to, SeaSOytal
of b~o]og.~c~] addStSves), condStSon of draSn pS~e and p.~pe
/cEnts ('wh~:c'h can be damaged by seSsm.~c ac'tS~/i ~}' and
deterior'at~ ~i th age.), type of substances d~posi ted in
objects.), and ~'t'~e amount of water being ~ntr'oduced on a
oont~nua] bas~$. Co~seG, uefTtly, the r'esults of th~s ad~'qua~lv
JAG/jag
Harrisl.wps
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRO~R4ENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1o General Information Application Date ~
(a) Legal Doscrimtion (include lot~ block~ subdivision, section, township_~ rang?)
Location (address or directions)
~r ,'.~ .'1/ ]-.~tr~,/ Telephone- Home Business
(b) Applicants Name
Applicants ~dress
(c) Applicant is (c~eck one) Lending Institution ~ ~ O~mer/builder ~ ;
B~er ~_~ ; Ornery___[ (explain);
(d) Lending institution Telephone
Address
(e) Real Estate Co. & Agent
Address f-o-2
Telephone
(f) Mail the I~A to the following address:
2. T~e of Residence
Single~Family..~
Number of Bedrooms
3o Water Sup 1~
Individual Well~
Multi-Family ~
Other (describe)
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
0nsite~--~ 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]
5- ~eering Firm Providing Inspections, Tests_~_File Search, Data an___~d Information
A~ 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
~m~er supply and/or wastewater disposal system is safe~ functional and adequate for
t~e nnmber of bedrooms and type of structure indicated herein° I further verify that,
~a~ed ~m the information obtained from the ~nicipality of Anchorage files and from my
i~vestigation a~d imspec~ion~ the on-site water supply and/or wastewater disposal
mystem is in compliance with all Municipal and State codes~ ordinances, and regula~
~ions in effee~ on the date of thio inspection°
5'~P Ap. proval
Approved fo r ~-~-3~i~2 ~z~bed r o oms
Approvad ~ Disapproved
Ter~s of Conditional Approval
Telephone
CAUTION
%~ }~2~ICIPALITY OF J~CHORAGE DEPARTMENT OF ~ALTH AND ENVIRONMENTAL PROTECTION
(D~P) ISSb~S t~THAUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON T~ REPRESEN~-
ATIO~iS GIVEN ~; PAP~IGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
!N %~ STATE OF_ ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES
T=~EiR !abiDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
~S. ~LPLOYEE$ OF ~HEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTiFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIO~ ~ THE PROFESSIONAL ENGINEER'S WOR~
P, R4/ej/DI8
[Page 2 of 2]
(DHEP SEAL)
7-19-84
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
WELL DATA
Well Classification Cc'c cc'fL////// If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) Date Completed Yield
I¢.UNIC!PALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
Total Depth Cased to
Static Water Level
Casing Height Ab(~ve Ground
Electrical Wiring ir~,Conduit (Y~N)
Separation Distances from Well:
To Septic/Holding Tank on Lot ,¢. O'C2 !
To Nearest Edge of Absorption Field on Lot _OO¢? I
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
RE6EIVED
Loc
Depth of Grouting
' Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining'Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed z~/'/7~
Standpipes (Y/N) Ot'~l~-
Depression over Tank (Y/N)
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 '
Size l¢~--50 No. of Compartments
Air-tight Caps (Y/N) ~/ Foundation Cleanout (Y/N)
Date,ast Pumped
N/A '; for ~/A
Temporary Holding Tank Permit (Y/N)
To Building Foundation ' . ~ ~ ......
To Disposal Field I~ ~
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~//IC/7
Width of Field
Square Feet of Absorptioa Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot N
'¥o 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 ~--'/
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
E cH
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
NoN~'
Comments
D. LIFT STATION I"t 0 f',l E:::
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, v. erifie(~,3~r conformed to all MpA and HAA guidelines in effect on the date of this inspection,
Signed ~ ,..Date
~-,-k I,,, '~//MOA NO.
Company
Recei pt No. "~ .~"") '~'~-'7
Date of Payment ~" '~ '-~
~c:~ Engineer's Seal
Amount: $ q'~ ....
Page 2 of 2
72-026 (11/84)
~203 W. 15th AVE "C" SUITE 203
....... "{AGE. ALASKA 99501
tONE; (907) 279-3916
TEST
WATER SYSTEM:
SEPTIC SYSTEM:
DATE OF PUMPING:
DATE OF TEST:
TEST PROCEDURE:
TEST RESULT:
COMMUNITY SYSTEM
FROM MUNICIPAL RECORDS:
TANK: 1250 GAL.
COMP.
ABSORPTION SYSTEM:
ABSORPTION AREA:
SOIL RATING: 85
INSTALLATION DATE:
SUNSET PLASTIC
TRENCH
340 SQ.FT.
APRIL 1976
ONE
JANUARY 3, 1984
JANUARY 23, 1984
THE SYSTEM WAS NOT TESTED SINCE THE PREVIOUS
TEST WAS LESS THAN 24 MONTHS AGO.
WHEN THE SYSTEM WAS TESTED IN JANUARY 1984 IT
WAS FOUND TO MEET THE MUNICIPAL REQUIREMENTS
The operational life of all septic
systems depends on the local soil conditions,
groundwater levels that may fluctuate during
the year, and the water usage of the family
being served by the system, These conditions
are outside the control of the evaluator of
this septic system. We can therefore not 9ire
any estimate of how long the system will
continue to meet the operational requirements
of the Municipality and State.
CONSULTING ENGINEER
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3916
Elliot Lawson
Coldwell-Banker,Jack White
3201 C Street
Anchorage, Alaska 99503
Co.
SEPTIC SYSTEM ADEQUACY TEST
January 23,1984
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WATER'SYSTEM:
SEPTIC SYSTEM:
DATE OF TEST:
TEST PROCEDURE:
--
TE~ '~RESO'L~:
LOT 3,BLOCK 4,VALLI VUE SUBDIVISION
10020 LONE TREE
LINDA MORRISON
4 BEDROOM, SINGLE FAMILY
COMMUNITY SYSTEM
FROM MUNICIPAL RECORDS:
TANK:
Sunset Plastic
1250 gal, Single Compartment
ABSORPTION SYSTEM:
ABSORPTION AREA:
SOIL RATING:
INSTALLATION DATE:
Trench, 21 ft. long
. of rock. ~'7 ,'
340 sq.ft. ~ f
85
April 1976
JANUARY 23, 1984
System was inspected on January 22,1984. 6 inch
sump was full of septic waste. Total depth more
than 10 feet. Sump is not connected to perforated
pipe in trench. 4-inch CO was dry. Tank was 11
feet deep with 48.5 inches of liquid.
Standpipes were in place, 12 inches--or more
above ground and with airtight caps installed.
On January 23 water was added to the trench at a
steady rate of 7.5 gallons per minute. The
water-level in the tank was monitored. A total
of 675 gallons was added to the system. The
water level in the tank remained at 48.5 inches.
This system absorbed 675 gallons in a time
period of 90 minutes without any rise in the
waterlevel in the tank. The acctual absorption-rate
of the drainfield could not be measured,but
since the system is presently in use by the
residents of the dwelling and since the system
accepted a shockloading in excess of the 24-hour
requirement for a four-bedroom house,it must be
considered to meet the Municipal Requirements.
APPLICANT FILLS OUT UPPER HAF"-'~,ONLY
Pr°P°'~t'yOwn~'r~ Linda L. Bass Morrison
Mailing Address 'SRA Box 2g-B. Anchnra(~. Al< zip Code qq~7
Buyer ~Lawrence V. and Cl~arla L. ~a~icek
Address Zip Code
La,drag m~t,m~o, National Bank of Alaska Phone
Address Zip Code
Realty Co. & Agent Coldwel 1 Banker Jack White C0mpany... E11 lot Lawson Phone
Address 3201 "C" St.~. Suite 100, Anch°raaP_:. AK Zip Code gO.~Q3 277-1~A
Legal OescriptionLot 3, Block 4, Vallivue //2
Street Looatio. 10020 Lone Tree Drive
Type of Residence
~[] Single Family
[] Other .
[] Individual ' ATTACH WELL LOG. A well Icg is required for ~11 wells drilled since June 1~75.
Sewer Disposal
X[] Individual Year Individual Installed: 1976
[] Public Utility When Connected to Public Utility:
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN SE INITIATED.
Field Notes: MUNICIPAUTY OF ANCHO~fi
DEPT. OF H~ALTH &
~NVIKONM~NTAL pKoTECTION
Soils Rating Date ~wer InstaPed Well To Absorption Area Well Log Received
Well to Tank Septic T~k Size / ~ .~ ~
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
Date of Inspection
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Phone:
Phone:
3. Legal Description: ~)~ ~ &/~z/'
4. Location: O~~r ~~
5. Type of facility to be inspected ~ ~
6. Well Data: ~
A. Type ~~ ~
C. Construction ~
7. Sewage Disposal System:
B. Installer
A. Installed
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
1. Size ,/,~SO
1. Absorption Area
Total length Of lines
No. of bedrooms
B. Depth
D. Bacterial Analysis
2. Manufacturer _~~
2. Material
8. Distances:
A. Well to: Septic tank
, Absorption area
, Sewer Lines ,
Nearest lot line
, Other contamination
B. Foundation to septic tank
, Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
. .P~a~je~2 of two pages - Re'~ 'st for Approval of Individua~l ~'~er & Water Facilities
!
Comments
Approved ~ ~~ Disapproved Date ~-~/
Ap~rova~l/~Valid for one year from date signed
Greater Ancho~.~r6a Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)