HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 4 LT 13GRE/.,.~:R ANCHORAGE AREA BOR,.JGH
Department of Environmental Quality
3330 C street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCAT,ON /_,~,u~_.'~/'~e_.~_ ~ LEGAL DESCR,PT,ON
SEPTIC TANK:
DISTANCE
FROM WELL~
INSIDE LENGTH
MANUFACTURER CJi. ~-' ~'~ MAT E R I AL ~'"J--~---~ ~ J
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPAC ITY/O~<:~GA LLON S.
DISTANCE FROM WELL
NUMBER OEL,NES /
FOUNDATION
DISTANCE BETWEEN LINES
TOTAL LENGTH
NEAREST LOT LINE ~2 OF LINES
TRENCH WIDTI~ IN. TOTAL EFFECTIVE
ABSORPT,ON AREA q-~6~ .~?U ¢ sq. FT.
~' ~/~Z /~ ~
DEPTH: TOP OF TILE TO FINISH GRADE ~/
LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE
r72- IN/~, ~BOVE TILE
WELL:
TYPE ¢/~}~4 ~,~.) t",~'/ CONST RUCTION : DEPTH
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION__ LOT LINE__ SEWER LINE , TANK__ SYSTEM
IN.
DISTANCE FROM:
CESSPOOL
OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DrSTANCES:
SEWER LINE DEPTH:
REMARKS:
DIAGRAM OF SYSTEM
Form EG~-032
F'ERMIT NO. ,'
FFLI ~.HH r
LOCRT I ON
LEF~RL
T I MBEF.: ENTEg. F F.I_ E-,
L~REE [:,R
LiZ-: B4 ',,,'RLL. I \,'UE
LOT _, T,.NE
3: ~ '--' - ± ? 2 2
~dd,',=,4 SQURRE FEET
T~CF'E OF SOIL HE,_uRETIuN _,~_TEtl IS: TRENCH
MH,-'-,]i't.I1 NUMEEF.' OF EEDRF,-d'"IS = ~:
_,LIL RlaTING "'-- ,
~._,C.. F F,.."BR.:,=
THE RE)_ IRE[, :,'-I"~",.NE OF THE '= .... - Il_ FtBSORPTt0N '='_ ¢_IEfI' '=" ' I:5:
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRFiINFIELD.
'THE DEPTH OF R TRENCH OR PIT IS ]'HE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND FIND THE BOTTOM OF THE EXCR'v'RTION (IN FEET).
THERE IS NO SET WI[:,TH FOR TRENCHES.
THE GRRVEL DEPTN IS THE MINIMUM DEPTH OF GRR',,CEL BETWEEI'4 7'HE OUTFRLL PIPE
FIN[:, TIRE BOTTOM OF THE E~,.',CRVRTION (IN FEET;:,.
E, Ruk. FILLIN= OF RNY =¢=,[EH HITHOUT FINRI_ tN_FE..TIJN RND taPPROVRI_ E,¢ TIII_,
DEPRRTr,IENT HILL BE _,UBJEL. T TO FRu_,EL.~tTII ~,
MINIMUM DISTRNCE BETWEEN Fi WELL RND RN'¢ ON--SITE SEWRGE DISPOSRL SYSTEM IS
t.E~EI FEET FOR R PRI',,,'FtTE WELL OR 2~3E~ FEET FOR I~ PUBLIC HELL.
SF'EC:IFICRTIONS FIND CONSTRIJCTION DIFIGRRMS FIRE R'v'RILFIBLE TO INSLIRE F'ROPER
I NSTFILL. RTI ON.
t CERTIF'¢ THRT
2L: I BM FRMILIBR [4ITH THE REQUIREMENTS FOR ON-SITE '-'-;EWER'-=.; FiND WELLS RS SET
FORTH B'¢ THE I"IUNICIPRLIT'¢ OF RNCHORFtGE.
2: I HILL INSTRLL THE S'¢STEM IN RCCORDRNCE HITH THE CQ[:,ES.
]~: I UNDERSTBND THRT THE ON-SITE SEWER '-'-;'¢STEM MR'¢ REQUIRE ENLRRGEMENT IF' THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN Z~ BEDROOMS.
p
s I,: NED: ............
FtPPL I CFINT 'TIMBER ENTEF..'PF: I SES
Performed For
Dep th
..Feet
3-
6-
?-
8-
]3-
25t6 h'. '.! udor Road
Anchorage, Alaska
27fl-2221
M()II,S 1,0(1 - I'I';I~()I,A'I'I()N TI':ST
Timber Enterprises ;);!re Perf'o-rlm:d 9/15/16
Flat
F
Was ground water encountered?
If yes, at what depth?
Reading Date Gross Time Net Time Uepth to Water Net Urop
Perco]a[ion ra[e minu
· Propos ed i ns ta 11 ai~? "g~a~e P i t Ora i ,) I'i e I d
Dcp[h of Inlet ................. . ~epUff~"i~h'~X~F~-F'fit or trench
COI,IMENTS: ............................
I{Q 040 (6/74) ~lo~arm A. Orabn P.E.
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
GENERAL INFORMATION
(a) Lega Description (include Iot~ block, subdivision, section, township, range)
Location (aaaress or directions, .-
(b) Applicant Name ~ ~[~ Telephone: Home -~-~/~ Business
Appucan[ Address ~
(c) Applicant is (check one): Lending Institution ~; Owner/build ; Buyer ~; Other D (explain);
(d) Lending Institution Telephone
- Address
[e) Real Estate Company and Agent
Address
. _ . Telephone
'.'~.. :?.i'~:(fi Mail the HAA to the following address:
2. TYPE OF RESIDENCE
. Single-Family'[" Multi-Faro [y []
Nu -nber of Bedroom~ 3
3." WATER SUPPLY
Other
[] Community.,,~ Public []
Individual
Well
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
SEWAGE DISPOSAL
Onsite.~ Public [] Commumty [] Holding Tank []
Note: If community well sys[em, must have written confirmation from the State Departmen[ of Environmental Conservation .......
attesting [o the legality ane status.
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~NVIRONMm~m"~"
A. WELL
Well Classification ~/~-'J¢ //¢-
MUNICIPALITY OF ANCHORAGE (MO~j'
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description; Z
If A, B, C, D.E.C. Approved (Y/N) ~'¢
Well Log Present (Y/N)
Total Depth
Date Completed
Cased to Depth of Grouting
Yield
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Welh
To Septic/H~lding Tank on Lot
Pump Set At J
Sanitary Seal on Casin~
Depre~s~lhead (Y/N)
f//~//'),/~ ~/~ ~j O i n, n g Lots
~/Y: On Ac{joining Lots
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line ~'
Cleanout/Manhole ~
Water Sample Collected~
Water Sample Test R./e. sdlts
Com me~,~,,//
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
SEPTIC/HOLDING TANK DATA
Date i nst ailed //////~¢~/~'~:2 Size //~ 0~) No. of Compartments 2-
Standpipes (Y/N) ,~ Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/,N)
Depression over Tank (Y/N) ~ Date Last Pumped ~'-/~-/
Pumping/Maintenance Contract on File (Y/N) /~'~ :for
Holding Tank High-Water Alarm (Y/N) /~/,~ Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ~' ~'¢~ / To Building Foundation J~ /
To Property Line ~ / To Disposal Field ,//'~ /
To Water Main/Service Line ~'/~ /
Course
Co m men ts //~/¢_ .,~ ~/~_ ?.,~/~/~/"¢-/~'~'-¢/~
To Stream, Pond, Lake, or Major Drainage
Parle I of 2
72 026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata /~m-,~ Type of System Design
Date Installed /'/,//'/(~¢"/7~:2 Length of Field -..~,~ /
Width of Field ~""~:;'// ~ /
Depth of Field
Gravel B~Id Thickness
Square Feet of Absorption Area '~'~-~...¢~] Y, Standpipes Present (Y/N)
Depression over Field (Y/N) / ~ - .~,~. .Date of Last Adequacy Test .
Results of Last Adequacy Test ,~'~g"r~r)~'~ j'~ Z'~
Separation Distance from Absorption Field:
To Water-Supply Well ~ ~)~ / L~'~:'} /
To Properly Line
To Building Foundation ¢~'/¢/ / To Existing or Abandoned System on
Lot /~'2.~,~[-¢~ ; On Adjoining Lots ~-~-'~
/
To Water Main/Service Line To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area ~ ~'c""2 !
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
/(j("/~ Dimensi
Manholt (Y/N)
~l ~ p Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check
I certify t~'
Signed
Corn
Receipt No,
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Be
)m Rating Against HAA Request **
or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
--" Date 7///~O'/de~7
MUN[CIPALI'fY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
AUG 7 1987
Engineer's Seal
RECEIVED
SEPTIC ADEQUACY TEST RESULTS
Legal Description:
Address: /~3OO
O.ner:
Date of Inspection:
RESULTS:
WATER SYSTEM:
The above test information has been verified and systems
functioned as described. We do not provide any guarantee on
the long term performance of the system due to operations and
conditions beyond our control. If the system is used as
intended, the results will remain similar.
Certified:
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA q9501
STEVE COWPER, GOVERNOR
Telephone: (907)
Address:
274-~533
DATE
PWS 1.0.# J~," :3 ¢ c,
To Whom it May Concern:
According to records on file in this office the \ /',~ ' J~, <
Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
I NS~ INSPECTOR INSPECTOR
J~dUNICIPALIT~ OF ANCHORAGE
DEPT, OF HEALTH &
MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL pROTECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street- Anchorage. Alaska 99501 S E P 1 0 1980
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 RECEIVED
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.
1. PROPERTY OWNER ,~ PHONE
PROPERTY RESIDENT (H diffe(e~ fr~m above) PHONE
2, BUYER ~ ~ PHONE
3. LENDING INSTITUTION PRONE
4, REALTOR/AGENT PHONE
MAILING ADDRESS
;TR RET LOCATION
TYPE OF RESIDENCE
[~SINGLE FAMILY
[] MULTIPLE FAMILY
~UMBER OF~BEDROOMS
One ~ Four ~ Other~
~Two ~ Five
Three ~ Six
7. WATER SUPPLY
~ INDIVIDUAL* ATTACH WELL LOG. A Icg required
is
for
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** -'z~-'Tz~; YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
EEl INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INBTALLER
[]Septic Tank or []Holding Tank (~-~/..~i~¢ ~','.~) (4!/%
Size: lO(~)0 If Tank is homemade SOILS RATIN6
give dimensions:
TYPE OF TANK MANUFACTURER LC./
TOTAL ABSORPTION AREA MATERIAL
WELL TO:
5. COMMENTS
~VED FOR ._~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72-010 (Rev, 6/79)