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Home My WebLink AboutVALLI VUE ESTATES #2 BLK 6 LT 7 I QGRI'--TER ANCHORAGE AREA BO" )UGH Department :~3E0n;irs~rner~;ntal Quality Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME UJILL. IAIH A , .%,H 17-1-t LOCATION OA/I/~LL4~y /~,0, ~ /~0/~/~/'~) LEGAL DESCRIPTION SEPTIC TANK: DISTANCE ~1::> I) [~/~l (~ FROM WELL WA-~.~- MANUFACTURER ~ r~-~- INSIDE LENGTH INSIDE WIDTH PHONE ~,~5::~ -- (~ 7 8 ~:~ ~ V~L~I V~2~ ~ST,~ NUMBER OF MATERIAl ~-~_~g COMPARTMENTS LIQUID DEPTH ~-~ .LIQUID CAPACITY ( ~O GALLONS. SEEPAGE PIT: NUMBER OF PITS ~ DIAMETER ~ OR WIDTH ~'~/. LENGTH~z/, DEPTH I ~ / LINING MATERIAL /~)/~J/~-~T~CRIB SIZE: DIAMETER4 DEPTH . DISTANCE FROM: WELL BUILDING FOUNDATION Z~'/, NEAREST LOT LINE-~,~) / TOTAL EFFECTIVE . . ABSORPTION AREA (WALL AREA) ~ SQ. FT. ADDITIONAl: ABSORPTION WELL: TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK SYSTEM REMARKS DISTANCES: DIAGRAM OF SYSTEM LOT SLOPE: REMARKS: Pt~OpCRT¥ Zg' I 14. '~ TANK ~'l~OPO~Eb FAN, 7' G,A,A,B. - M GREATEr ANCHOrAgE AREA BorougH DEPARTMENT OF ENVIRONMENTAL QUALITY SEWAGE DISPOSAL SYSTEM -- APPLiCATiON AND PERMIT PERMIT NO. INSTALLATION LOCATION COmPlETION DATE ANTI~IPA+ED _, OTHER NOTE: THIS PERMIT 15 NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHOR}TY WILL BE SUBJECT TO PROSECUTION. FOUNDATION TO SEPTIC TANK SEPtiC TANK TO SEEPAge Pit WAll WELL TO SEPTIC TANK /00 WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, J,/t2d) , SEEPAGE PIT TO RIVER, LAKE, STREAM. ALSO CONSIDER AREA WELLS. SEEP^~E P~T /0 / 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 F]TTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER [ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DEP'. i'MENT OF ENvIRnN,~'~'' 3500 TUDOR ROAD ANCNORAGE, ALASKA 99502 CASE Performed For W±Zliam A. Smith Legal Description: Lot Block This Form Reports Soils~g S 1/2 of Lot 25 Sec. 21 TS-12 .Depth Feet Soil Characteristics / Gray and brown silty sand (SM) 3--/ and gray sand (SW) intermixed (180 sq. ft. per bedroom) Date Performed 9/8~71 Subdivision T~'i6n Test 6-- Gray sand 7-- ' (125 sq. (SW) ft./bedroom) W~s Ground Water Encountered? If Yes, At What Depth? no L-~. ]_] /.j j Reading COMMENTS: The average sq. ft Date Gross I Time R3W Proposed InstaT]~-~-~on: Depth Of Inlet Seepage to H20 Net Drop Trench Net Time, Depth Pit Drain Field Depth To Bottom Of Pit Or to 9'-deep i_s 150 of drainage area required o~..~ crib from 3' ~edr~om. e rformed By ~. ~. ~arlzsle NATIONAL TESTING SERVICES. INC, Date: 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 ~-.~'- \ \ HAA # GENERAL INFORMATION Complete'legal description Location (site address or directions) Property owner Mailing address Lending agency Mailin. g address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~/ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 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, I/91) Front MOA#21 DHHS SIGNATURE 'v/ Approved for 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 Anchorage 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. Name of Firm ~;b~,,~/~-¢.,<'/.~,,~L~.,¢~/'," Phone~/~Y.] ?~//,¢ --/d ~..~ Address EngineeCs signature Date Disapproved. bedrooms. Conditional approval for bedrooms, With the following stipulations: Additione~ Comments 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 DH HS 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 enginee¢s work. I Municipality of Anchorage MAR 0 J 1999 /~ DEPARTMENT OF HEALTH & HUMAN SER~I~B~uT¥ o~: Environmental Services Division ENVIRONMENTAL SERVICES DIVI$10 825 L Street, Room 502, Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: ~'~""' ~..~*~p4.~/~/~'z-~-./~-~/z~,~',,¢/~"~-~,~' ~,~ Parcel I.D.:. A. WELL DATA Welltype ,~',...-~-,cJ.-, IfA, B, orC, attach ADEC letter. ADEC water system number -~/'~ Log present (Y/N) Total depth Sanitary seal (Y/N) Date completed Cased to FROM WELL LOG Date of test Static water level Well production ~of ~ample: g.p.m, g.p.m. Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~/'¢'4/~'-¢' Tank size /'gs'~g) ~"~'~Number of Compartments / Cleanouts (Y/N). Foundation cleanout (Y/N) x~/ Depression (Y/N) /~ High water alarm (Y/N) Date of PUmping ~¢/~' Pumper C. ABSORPTION FIELD DATA Date installed Length -~- ' Width Soilrafing (g.p.d./ft~orff~/bdrm) /'~"~'~' Systemtype ,'~? / Gravel thickness below pipe ~/ '¢ Total depth Effective absorption area ~/~',Z-'~'/'~' Monitoring Tube present (y/N) ,Y' Date of adequacy test "¢/'~ Results (Pass/Fail) Fluid depth in absorption field before test (in.); "~/'~/ Fluid depth ,~.5 ,~ (ins) Minutes later: --~/ Peroxide treatment (past 12 months) (Y/N) Depression over field (Y/N) For ~ bedrooms Immediately after~-,~/gal, water added (in.): Absorption rate = ,~'~'~ g.p.d. If yes, give date ---'- 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on"l ,vel at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main On adjacent lots sewer manhole/cleanout Lift station ,~, SEPARATION DISTANCES FROM S~EPTIC/HOLDING TANK ON LOTTO: Foundation ~'~'/· Property line ,~4) ~r~/ Absorption field Water main/service line ~,,~/~z'~Z Surface water/drainage/~¢ "~/¢'~/ Wells on adjacent lots SEPARATION DISTANCE FROMASSORPTION FIELD ON LOTTO: Property line "~ '¢ ~-~z Building foundation -~ ,~ ',~'/'. Water main/service line Surface water /CPU '/-,¢<'/ Driveway. parking/vehicle storage area ~'¢'"f',~-~ Curtain drain ~¢,,<- ¢', Wells on adjacent lots ,~ o F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recor~, t.~ ~b~..~fms are in confo~ance with M~A H~uidelines in effect on this date. ~,~' H~Fee $ ~¢ '~ Waiver Fee $ Date of Payment ~ ~ Date of Payment Receipt Number ~--fi~ ~ //~'fi 72-026 (Rev. 3/96)* D A T~'E RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP E CTO R,~ ~,~...,~ MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~PT. OF H2AI.T,I & 825 L Street - Anchorage, Alaska 99501 EHVIRONMENTAL P~O fECTIO~ { ENVIRONMENTAL SANITATION DIVISION lq0V Z 4 1980 Telephone 264-4720 REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND S~I~ ~ DIRECTIONS: Complete all parts o~) page 1. Incomplete requests will not be proce~ed. Please'allow ten (10) days for processing. PHONE PROPERTY RESIDENT (If different from above) PHONE PHONE MAILING ADDRESS 4. REALTOR/AGENT I PHONE I MAILING ADDRESS 5, LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One ~ Four ~ SINGLE FAMILY E3 Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7, WATER SUPPLY [] INDIVIDUAL~ * ATTACH WELL LOG. A well log is required for all wells drilled ~ COMMUNITY since June 1975. For wells drilled prior to that date, flive well [] PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM .~I~ INDIVIDUAL/ON-SITE'* i ~"'7,.~ ,YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY' EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. (Rev. , 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 [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] IN DIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER E]Septic Tank or [~ Holding Tank Size: 1.2.5-O If Tank is homemade SOILS RATING give dimensions: / TYPE OF TANK MANUFACTURER .,~_~ 'OTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [~APPROVEDFOR Z~ 13EDROOMS [] CONDITIONAL APPROVAL (letter must accg~any certificate) DATE [ (~'~--~"~'~[] DISAPPROVED 72-010 (Rev, 6/79) Mr. Ken Czajkowski SRA Box 31-B Anchorage,Alaska 99507 Tobben Spurl land P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 MUNICIPALITY OF ANCHORAG~ i~NViRONMr-N rAL PkOTECTJON NOV ~ 6 1980 1980 SEWER ADEQUACY TEST Legal: Street Address: Owner: Residence: Water: Sewer System: Date of Test: Test Procedure: Lot 7, Block 6, Valley View Estate ~ 2 6671Roundtree Drive Ken Czajkowski 4 Bedrooms, split level Community Well From Nunicipal Z~ecords: 1250 gs-1. steel tank, one compartment, Greer Concrete rings seepagepit. 4 feet diameter, six feet deep. Absorption Area: 632 sq. ft. Soil Rating 150. November 20, 1980 System was inspected on Hovember 18. Pit is 16 feet deep with a 3.5 feet cleanout. Liquid .level in pit was 35 inches. Water was tricking into pit. On Nonember 20 crib was charged with 500 gal. of wa~er. The following measurements of the liquid level in the crib was taken: Begin Test Add 3O0 gal Add 200 gal End water charge at 11.50 ~m. Check at 12.15pm Check at 2.30 pm. 31 inches 41 inches 48 inches 45 inches 29 inches Test Result: The total charge o£ 5oo gal. was absorbed in less than 2.5 hours. This System meets the absorption requirements of the municipal code, ~C~ ,~_%.'' A ~...~.~.;.;. ~ -~:').~ 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR ~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION November 18, 1980 Kenneth Czajkowski Star Route A Box 3lB Anchorage, Alaska 99507 Subject: Lot 7 Block 6 Valli Vue Estates Subdivision #2 Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) The septic tank pumped with a receipt submitted to this offlce. (2) An adequacy test be performed on the existing leaching area. This test will determine if the system'.is adequate according to National Standards. A ligting of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. If there are any further questions, please Call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Amfac Mortgage Corporation 401 East Northern Lights Boulevard Suite 212 99503 , 'oartment of Environmental QuahV Water and Sewer Questionnaire Subdivision Owner's Name: Mailing Address: 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 purehase?_~_~ 4. Was the basement bathroom plumbing "roughed in" at the time of purchase? 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 public water supply, do you always have an adequate supply of water? 7. Is the pressure always adequate? 8. Who was the builder? '~'i9 9. Who was the home purchased from? OTHER COMMENTS: