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Home My WebLink AboutW SQUARED LT 1 825 L Street* Ancltorage. Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME . ?r MAILING ADDRESS LEGAL DESCRIPTION DISTANCE TO: ~ Absorption area Dwelling Manufacturer ~:- ~._ [ d-~ '~'-/ IL) ~'. I Material Liq. capacity in gallons WeliF H 'Q~EMADE: Inside length /Width NO. OFBEDROOMS PERMIT NO. No, of compartments Liquid depth DISTANCE TO: Dwelling PERMIT NO, Manutacturer Liquid capacity in gallons Foundation Total length,pS li~:es ~ Material beneath tile DISTANCE TO: Well Length of e~ch Nearest Iot~i~e0 I Tren~l~wiJt h inches-- No, of lines Top of tile to finish grade PERMIT NO, ~ ¢ , £ , Distance between/.~:~)~_~'nes, Total effective Length Width Depth PERMIT NO, Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line I PERMIT NO, Building foundation Sewer line Septic tank r~ssor~o~rrea(s) DISTANCE TO: L OTHER PIPE MATERIALS · ~ ,~. ~.~,~/. c4.,~(~' T) '~O : ~'1 ~' ' ~' SOIL TEST RATING ! INSTALLER REMARKS 72-013 (Rev. 5'/78) DATE LEGAL. FERMI ¥ NO. r-lljr-.I z c: z PaL I T'~" OF DEPRRTMENT OF HERLTH FIND EN',/IRONMENTRL PROTECTION 825 'L'" STREET, RNCHORRGE, RI'::. 9950:L IDr-]---S I TE S;EL-.IE~." IJFaGRF~[:aE F'ERI'I :[ T ( 80005g ) RF'PLICRNT PREVO,,." B. HOLLRND INVESTORS REFILT%-' LGOBTIGH 'L,4 \ LEGAL Ti2N R~W S,2:~ C 2~8 LOT SIZE TYPE OF SOIL ABSORPTION S'¢STEM IS: .~RENOM ~.~~~ - MAXIMUM NUMBER OF BEDROOMS = ~ ¢~ SOIL RRTING~SQ FT,/BR)= 225 THE REQUIRED SIZE OE THE SOIL BBSORPTION S'¢%TEM I~' ., -. ' _. THE LENGTH DIMENSION IS THE LENGTH (IN FEE]") OF THE TRENCH OR DRalNFIELD. THE DEPTH GF FI TRENCH OR PIT IS THE DISTFINCE BETWEEN THE SURFACE OF THE GROUND BND THE BOTTOM OF THE EXCB',/RTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRBVEL BETWEEN THE Ot..ITFRL. L PIPE BND THE BOTTOM OF THE EXCBYBTION (IN FEET). RE L--q. IJ I RE:D SEF'T I C: -r fll'-,l I-( :~ I Z[E= _--'i_C:4~Zi PERMIT RPPI_ICFtNT HaS THE RIr. z, PGN..,IBILITV TO INFORM THIS DEPARTMENT DI..IRIN.:~ "FHE INSTBLLBTION INSPECTIONS OF aNN' WELLS FIDJBCENT TO THIS PROPERTY RND THE NUMBER GF RESIDENCES THRT 'FHE WELL WILL SERVE. ...... TI,,-~f2J ,( ;2. ) I I'-.i::,P [::. E.T I 01'-.!'~; tIRE I~:E I.:"::! U I I:~.E E:, BBCKFILLING OF BNY SYSTEM WITHOUT FINBL INSPECTION RND BPPROVFIL B"r' THIS DEF'RR. TMENT WILL BE SUBJECT TO PROSECUTIGN. MINIMUM DISTANCE BETWEEN B WELL FIND aNY ON-SI]"E SEWBGE DISPOSFIL S"PSTEM IS 'l.00 FEET FOR FI PRI"/RTE WELL. OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM R PRIVFITE WELL TO B F'RIVBTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS *?5 FEET. OTHER REQUIREMENTS MRY BPPL'¢. SPECIFICATIONS FIND CONSTRUCTION DIRGRRMS FIRE RVFIILRBLE '¥0 INSURE PROPER INSTaLLaTION. PEF?.f'"I I T I---..{XP ][ RES ID'ECEI"IBER I CERTIF'~r' 'T'HRT :L: I BM F'FIIdlLIBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS aND WELLS RS SET FORTH BY THE MUNICIPBLIT¥ OF RN£:HORRGE, ;~: I WILL INSTALL THE SYSTEM IN 8CCORDFINCE WITH THE CODES. 2: I UNDERST8ND TH8T THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLBRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. BPF'L]C. RNT PREVO ;~ B. HOLLRND -~' ~ '¢ D.TF ................ ISSUED ~ r ..... .~ ................................... ',¢'4. 0 SOILS LOG LEGAL DESCRIPTION: 9 k 10- 11 13- 14- 15- 16 17- 18- 19 2O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAl. PROTECTION Pouch 6-650, Anchorago, Alaska 99502 276-222~ PERCOLATION TEST SOILS LOG -- PERCOLA'rlON TEST S LO P~E SITE PlaN ENCOUNTERED? .Y~ Gross Net Depth to Net Reading Date Time Time ~ Water ..... ............ ~7~ 11~21~ :-: "-~-~ ....... ~-~:. PERCOLATION RATE ~ ~/~-' .{minutes/inch) TEST RUN BETWEEN .~-~/"~ FT AND ~ FT PERFORMED BY: O~J ~ L.~/.t~,r&'¢ CERTIFIED BY: ¢-~//'/'/ ~,~¢~-/~--{ DATE: ~_J~LJ~__, 72-008 (7/76} ~.j~ MUNICIPALITY OF ANCHORAGE DEPARTMENT O1'" HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITF SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision Application Date Lot 1, W. Squared S/D Location (address or directions) 390! Dora section, township, range) (b) Applicant Name Allen Weiss Applicant Address Telephone: Home Business (c) Applicant is (check one): Lending Institution q; Own~r/b?lder []; I~uyer []; Other [] (explain); __ (d) Lendinglnstitution Centrust Mortgage Co.. Telephone Address 4000 Old Seward Hwy.. Anchorage, Alaska 99503 (e) RealEstateCompanyandAgent P~rk'View Real Estate - Ray Heberer Address 18553 Mills Bay Dr.~ Eagle River, Alaska 99577 Telephone 694-7787 (f) Mailthe HAAtothefollowing address: Corwin & Associates, Inc. 12001 Industry Way, Build. B, Suite 11 Anchorage. Alaska 99515 2. TYPE OF RESIDENCE Single-Family[~: Multi-Family [] Other Number of Bedrooms Three (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:[~ Public [] Community [] Holding Tank [] Note: If corn munity 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) MUNICIPALITY OF' ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAl. INFORMATION fMUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal DeScription (include lot, block, subdivision, section, lownshJp, range) Lot ~,, W. Squared S/D Location (address or directions) 3901 Dora (b) Property Owner Allen Weiss Mailing Address (c) (d) Telephone: Home Bush]ess Lending Institution Centrust Mortq'aqe Co. Telephone Mailing Address 4000 Old Seward Hwy., Anch., Ak. 99503 Real Estate Company and Agent Park View Real Estate - Ray Heberer Address 18553 Mills Bay Dr., Eaqle River, Ak. 99577 Telephone 694-7787 (e) Mail the HAA to the followino address: or: Check here ~], if hold for pick up. List contact person and day phone number below. Corwin & Associates Inc. 4790 Business Park Blvd., Bldq. E-1 Anch., Ak. 99503 TYPE OF RESIDENCE Single-Family [~ Number of Bedrooms ~~__ 3. WATER SUPPLY Individual Well~ Community I"] 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::[:~ 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 I of 2 72-025 IRev 8/861 Fron~ & associates,inc. Consulting Engineers 12001 Industry Way · Bldg. B · Suite Eleven · Anchorage, Alaska 99515 · (907) 345-4440 January 14, 1988 please let us know. ~/e~ truly~urs, -, ' ~/7~eU~tcOrwin, MUNICIPALI~ OF ANCHO~e~ DEPT. OF HEALTH & ENVIRONMENTAL PROTE~ION Mr. Dan Bowles Municipality of Anchorage Department of Health & Human Services 0 ' n-Site Services Division 825 L. Street Anchorage, Alaska 99501 ~,~ -^~UUARED SUBDIVISION 218 3901 DORA ST., ANC~ORAGE~.~ALASKA . BLM LOT On January 7, 1988, Corwin & Associates, Inc. performed a oils test and installed a water monitoring tube on the subject property to assess oils and water level. The depth of the s ' test hole and monitoring tube were 21 ft. from the surface and the test hole was located 26 ft. from the existing sewer system and 56 ft. from the existLng residence. The soils were similar to the original test hole on the property Performed by John Lambe in 1980. The so~ls test was inst~ · ~u UElllZln a b no evidence of ~round~ .... g ackhoe and there was test = w~u~r, el~er as seeps or standing, in the tube hole. We again verified the Water level b monit ' - on January 14, 1988 and a~ai- ~ .... Y or3.ng the ft. depth. = ,, ~= uuoe was dry to the 21 The sketch below indicates the location of the test hole and monitoring tube for your records. We urge your final approval of the health authority approval for this property based o]1 this additional information. Should you have any questions, JAN 1 4 RECEIVED 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 GENERAL INFORMATION (a) Leg,al Description (include lot, (b) .264-4720 ~TCt 'r' C Application Date. 'l iqg~ block, subdivision, section, township, range) Location (address or directions) Applicant Name .~/'~,~' ~()~/'~ ~ Telephone: Home Business _ Applicant Address (c) Applicant is (check one): Lending Institution.'~; Owner/builde[ [] (d) Lending Institution ~ Address (e) Real Estate Company and Agent Address (f) ; Buyer E]; Other [] (explain); Telephone 'Telephone ~ ~'q'- 7'7 ? 7 Mail the HAA to the following aedress: · Single-Family ~r Multi-Family [] Other Number of .Bedrooms ~'~ 3. WATER SUPPLY Individual Well [~/Community [] Public [] ' Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. 4. SEWAGE ~ISPOSAL Onsite ~ 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. 72-025 (11/84) Page 1 of 2 ENGINEERING FIRM PROVIDING iNSPECTIONS, '¥ESTS, FILE SEARCH, DATA AND iNFORMATION seal atfi×ed hereto and as of the validation date shown below, ~ verify that my investigation of this Health As certified by my that the on-site water supply and/or wastewater disposal system is safe, functional and adequate Authority Approval shows for tile 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, end regulations in effect on Name of Firm ~~' Address ~¢~¢t¢, , Date ~~ ' ¢ ,, ~gineer's Seal DHEP APPROVAL ApproVed for ~ bedrooms by Date Disapprov - -- -- - 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 MUNICIPALITY OF ANCHORAGE (MO,~ MUNICIPALITy OF ANCHORAGE HEALTH AUTHORI'rY APPROVAL (HAA) :ENVIRONMENTAL SERVICES DIVISION CHECKLIST - FEBRUARY 1984 264-4720 l-)l'_"(~; .~ _',, .~987 Legal Description: Well GlassJficatJon I' If A, B, C, D.E,G, Approved (Y/N) Well Log Present (Y/N) .fl0 _ Date Completed [,U.'I, /,~tl,.3r'x Yield Total Depth ~t Cased to '7~'' Depth of Grouting fl,~ Static Water Level ~'/.~/I Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) ~¢,.~)e ~...~ Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding 'rank on Lot /Om f ; On Adjoining Lots TO Nearest Edge of Absorption Field on Lot /¢~ ! ; On Adjoining Lots To Nearest Public Sewer Liner;/?~/l. TO Nearest Public Sewer Cleanout/Manhole ~ __ To Nearest Sewer Service Line on Lot Water Sample Collected by d ' Water Sample Test Results . B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) (,~jg~ ~ Depression over Tank (Y/N) /~J ('J Pu mping/Maintenaace Contract on File (Y~(~t/~r/~/ Holding Tank High-Water Alarm (Y/N) ~ . Separation Distances from Septic/Fielding Tank: To Water-Supply Well _ ~ To Property Line ~O To Water Main/Service Line _ Course Comments Size ~0~. NO. of Compartments_ U~Lt_~ ~ Air-tight Caps (Y/N) ~z__ Foundation Cleanout (Y/N) ,/~ O Date Last Pumped ~;:~ ~'~-'~'~, ~¢~___. ; for '~ Temporary Holding Tank Permit (Y/N) ~ To Building Foundation (~O I To Disposal Field ,~O ~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorpti?n Strata -~z~~-~ Type o! System Design Date Installed ~--~J~ Length ot Field Width of Field ~ Depth of Field Gravel Bed Thickness ea /(D(.,) ,(~¢L~~ Standpipes Present (Y/N) Square Feet of A P ~ ~_ _ ..... Date of Last Adequacy Depression over Field (Y/N) ~~~ ~ L. %~%~-' ~ Results of Last Adequacy Test ~ ~ ' Separation Distance from Absorption Field: Prope~y Line ~ To Water-SupplY Well ~ ~ _ To To Building Foundation --~ To Existing or Abandoned System on ~ ; On Ad,0,ning Lots ~~ -~ Lot -- To Cutbank (if present) ~ ~ ~ To Water Main/Service Line -~-~~ Stream/Pond/Lake/or Major Drainage Course ~ LIFT STATION Date Installed ~n~;~:cess (y/N) _~~ . " I at Ratin( Against HAA Request ,~~m . . _ g ..... d to all MOA and HAA guidelines m eitect on the date of this inspection Receipt No. ~~ Engineer s Sea Date of Payment Page 2 o~ 2 ,CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ,~:~" ~ 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ,~-'""~'~~ FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAHPI',g Client PO~ ~ VERBAL Req #: Client ~mpl ID: LOT 2 (BLM 218) He,pie Rec'd : DEC 21 87 Ordered By : Send Reports To: CORWIN & ASSOC Work Order No. : 443? Client Account : CORWINP Date Report Printed: DEC 23 87 G 15:49 Releaged Dy : 2.~(.~ Reports Address #2 1200 INDUSTRY WAY, BI,DG D, #11 ANCHORAGE, AK. 99515 Special COLLECTED 12-21-87 BY P. JONES Instruct: Chenllab Ref #: 8671 Lab ~pl ID~ i Matrix: Water Allowable Parameter Tested Result/Unit8 Method Limits NITRATE-N ND(0.10) mg/I 10 MUNICIPALITY OF ANCHORAGE ENVIRONMENI'AI. SERVICES DIVISION ]987 RECEIVED Ha~ple ROGTINE SAMPLE Remarks: ANALYSIS COMPLETED: 12-21-87 LABORATORY SUPERVISOR: STEPHEN C. ~DE~a:;~ ~. ~,'~-/ 1 Tests Performed * See Special Instructions Above ND= None Detected ** See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Greater Than MUNICIPALITY OF ANCHORA~ ~D(~ DIVISION OF ENVIRONMENTAL HEALTH APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTII"ICATE$~ 1. General Information Application Date (a) Legal Description (include lot, ~ock, subdivision s~ction~ township, range) Location (~ddress or directioas) --~ (b) Applicants Nam*._~J:.,f~t~. ~,72~Tel~houa - aGree Business (c) (d) Applioants Address Applicant is (check one) Lending Institution [--~ ; Owner/bu*~do~-~ ; Other ] (e plain); Lending Institution Telephone Address (e) Real Estate Co. & Agent _~tf~_¥.~_._~_~L~:.~.e. / (f) Mail the H~ to the following ~dress: 2. i£~_R~sidence. Single-Family~ Number of Bedrooms ~. wat~ s~,~AZ' Multi-Family Other (describe) Note: If community well system~ must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4..S e~_~? e2~Dj: s po_._~s a~l Onsite ~ Public ~ Community C2[ Holding Tank ~--5 Note: If community well system, must have written co~ffirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] E~ineering_ Firm Providin~._~.__~_.__.Inseections,_v..~ ------~__Tests' File Search~ Data and 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 aud 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 ~rlth all Nunicipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Address Date ])HEP A~prova~. Approved for -~ Approved ])ed rooms Disapproved Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPAR2%~ENT 0I;; HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY Ai~PROVAL CERTIFICATES BASEl) SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPtl 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN TIlE STATE OF ALASKA. THE DtlEP DOES Tills AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAl, AND STATE i~QUIRE-- MENTS. 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 TNE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 A. W~LL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY A~OPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: Well Log P~esent .(.Y/N) Total Depth_~u~ Cased to Static Water Leve! -- Casin9 Height Above Ground . Electrical Wiring in Conduit .!.Y/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line MUNICIPALITY OF ANCHORAQ~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION If A, B, O~ C, D.E.C. App~oved.(Y/N) ~/A Date Ccmpleted ~ ~%~4,q Yield__~_~_, ~- ~ k~ ~+~ Depth of Grouting. ~x///% o~ --' Pump Set At [~M ~ Sanitary Seal on Casing (~Y/N)~ Depression A~ound Wellhead Water Sample Collected By Water Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed . 0~___~_ Size.. /~,~O ~ No. of Cc~pa~tments __~.~a~ Standpi~s ~) ~ _~i~-tight Caps ~) ~ ,_ Foundation Cleanout 3Y~ P~ing~intenan~ ~n~a~ ~ File (Y~)~/~ ; fo~ Holding Ta~ High-Wate~ Ala~ (Y~) ~/~ %%~a~y Holdi~ Tank ~r~t Sep~ation Distan~s ~ ~ptic~{olding Tank: To Water-Supply Well To ]hsoperty Line ~O/a . TO Water Main/Service Lin~ ,.. Comments To Building Foundation~= ~/ To Disposal Field / '7 To.Stream, Pond, Lake, c~ Major Drainage [Page ! of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Bating in Absorption Strata Date ~talled _ ~_? ~ I, / q ~O width of Field __ 56 f~ Square Feet of Absorption A~ea _ ~_ _ Type of System Design . Length of Field Depth of Field /~ Gravel Bed Thickness _~ '~) .._ Standpipes P~esent (Y~) Date of Last Adequacy Test DeL:~ession over Field (__Y/N) ~ _ Results of Last AdeqUacy Test ~c~ ~.C~ Separation Distance f~om Absorption Field: To Water-Supply Well % O O ~ To p~operty Line To Building Foundation ~ ~7 To Existing or Abandoned System on Lot ¥/~ ...~ ~ ~joining ~ts ____ TO Wate~ Main/Service Line b~//~ . To cutbank~(if present) _~_~//~ To Stream/POnd/~ke/O~ Majo~ D~ainage Course To D~iveway, Pa~kin~ A~ea, o~ Vehicle Sto~a~e A~ea Comments .. _ De LIFT STATI .ON_ Date Installed Size. in Gallons '!Pu]~p On" Level at . High Wate~ Ala~mLevel at Tested for ElectFical CodeS(_~Y~N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. ~ets MOA ** Check Permitted Bed~oc~ Rating Against HAA Request I ceFtify that I have checked, verified, o~ confo~msd to all MOA on the date of th~s i~speetion.~ ! · KB1/d5/s [Page 2 of 2] HAA Guidelines in effect '&o .. 2-Z5-8~ CONSULTING ENGINEER ~ [~)~[~c~ ANCHORAGE ALASKA 99501 TELE PHONE: (907; 279-3916 JERRY DEWHURST REMAX REALTY 2902 GAMBLE STREET ANCHORAGE, ALSKA 99503 RESIDENTIAL WELL JULY 19, 1984 INSPECTION LEGAL Lot 1, W-Square Subdivision LOCATION 3901 Dora Avenue OWNER White, Gall and Walter TYPE OF WELL Residential WELL LOG AWAILABLE No INSTALLATION REQUIREMENTS MET Yes WELL YIELD FROM WELL LOG Unknown DATE OF TEST July 14, 1984 !PEST PROCEDURE On July 13, the well was pumped at a rate of 5 gpm. After 20 minutes the waterflow slowed down to a trickle. The well could not sustain a pumping rate of 5gpm. On July 14 the well was pumped at approxima- tely 1 gallon per minute for 10 hours. Water pumed was metered. Drawdown in well was not monitored due to obstruction to well probe. At a well depth of 90 feet the probe became hung up in something. 570 gallons was removed from well. TEST FOR COLIFORMS The well water was tested for Coliforms on July 19. Test was negative. This well will not support heavy withdrawals of water like lawnwatering. The well does ~eet the Municipal requirements for domestic water use. This assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may chang~ due to subsurface conditions that may not be observed from the surface, changes in land use and other factors that may impact the conditions of the aquifer feeding the well. ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER 'rELEPHONE: (907) 279-3916 JERRY DEWHURST REMAX REALTY 2902 GAMBLE STREET ANCHORAGE, ALASKA 99503 JULY 19,1984 SEPTIC SYSTEM AREQUA.C_Y TEST LEGAL LOCATION OWNER RESIDENCE WATER SYSTEM SEPTIC SYSTEM DATE OF TEST TEST PROCEDURE TES~ RESULT Lot 1, W-Square Subdivision 3901 Dora Avenue White,Gail and Walter Single Family, Three Bedrooms On Site Well FROM MUNICIPAL RECORDS: TANK:No record, 1250 gal from pumping receipt. ABSORPTION SYSTEM:Deep trench, 65 feet long,12 feet deep,6 feet of rock. ABSORPTION AREA:780 sq.ft. SOIL RATING: 225 INSTALLATION DATE:April 1980 7/14/84 Drainfield was charged with water at a steady flow of 1 gpm. A total of 570 gallons of water was added to the trench. 2~ hours after the start of the test 450 gallons had been absorbed by the soil. Both the tank and the sump of the drainfield was monitored. The water level in the tank did not change during the test. The water level in the sump rose with the charging of the trench. The tank was pumped on July 14, 1984. This system meets the requirements of the Municipality of Anchorage as of the day the system was tested. There is no quarantee that · the system will continue to meet these requi- rements. The operational life of all septic system 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. D~-E RECEIVED INSPECTION APPOINTMENTS DATE ~ DATF DATE MUNICIPALITY OF ANCHORAGE ~UN'cIPAU~ OF ANCHO,A~E ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO~ENT,,,~"R OTECTiON ENVIRONMENTAL SANITATION DIVISION FI~ 6 1980 Telephone 264-4720 REQiJEST FOR APPROVAL OF INDIVIDUAL WATER AND S~,~ ~L~PES DIRECTIONS: Complete all parts on page 1, Incomplete requests will not I)e processed, Please allow ten {10) days for processing· 1, PROPERTY OWNER PHONE ILING ADDR~S PROPERTY RESIDENT (If different from above) MAILING ADDRESS MAILING ADDRESS 4. REALTOR/AGENT LEGAL DESCRIPTION STREET LOC :TION 6. TYPE OF REolDENCE NUMBER OF~BEDROOMS One [] Four [] Other ,J~ SINGLE FAMILY "~ Two [] Five £~ MULTIPLE FAMILY [] Three [] Six '7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8, SEWAGE DISPOSAL SYSTEM * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (atta¢l~ log if available.) ~ INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY · 1. TYPE OF RESIDENCE NUMBER OF BI:DROOMS .... [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER . [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAl. DEPTH OF WELL E] COMMUNITY DATE DFilLLED [] PUBLIC UTI LITY Connection Verified__ LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER EZ] I NDIVI DUAL/ON -SITE DATE INSTALLED Connection Verified NSTALLER ~Septic Tank or ~Holdin9 Tank Size:. If Tank is honlemade ~OIL8 HATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AR~A MATERIAL 4. DISTANCES Septic/Ho~dingTank Absorption Area Sewer Line ~ Nearest Lot Line WELL TO: - Absorption Area to nearest Lot Line 5, COMMENTS ~ CONDITIONAL APPROVAL (letter ~ccompany certificate) Fcoruary 8, 1980 Beth ~olland % Investors Realty 4241 B Street ~.~ L:uita Anohoraqe, Alaska 99503 SubJeob: ¢.1,,N I~3W Sucks. on 33 ~x)t 218 (~4zy L. ~ro. vo Approval for the ind,~w~dal sewer and water f · ' · can not be granted unu~l the followin~ it0us have been com:pl, ete(~; (1) '.¢he water analysis repo. rt b.a dielivered to this from Chem Lab, 5633 B ~ .... ~ , . , (2) ',:-~, -, , , ,;-,.po,:,e khe ~,~1], for olir a. nspeotaon to de'terr~liae propclr conf~trtlo.kion, also to inspire 'l:h~ :~il%.~:,~ltl~ reqt%ir~ttents are mot J)etween your well and s~wer system. (3) The o;4isting cesspool has failed.. ,,,~o~.era Will need to ba installed. Prior to up,~rado a soils test n'lus'~ be obtaJnod so that a iaay be i~s~le(1 by this doparl:laeni~t. A .la.]t3.ng of approved soils ongineors is enclosed. P.l. eae~ notify this department for a re"'inspec,kion vlhon tlle ~lotod d¢~sore,)allc~ · ,, '~ ,.~n,.aou cji.kS o:~fJ, ce at 264"4720~ ~lirloerely, Robort C. Pratt, R.S, Aoooc~a~c. Specialist: National F, ank of Ai~hh.-,.~ Pouch Mr. Da~ Repalee Anchouage~ Alaska 99§0X Propom~d Fouu-b~uoom house ~eau Mu, Rapalem{ ~he sewe~ end wate~ sye~em~ seuvin~ the ,mub~ee~ residence appuoval. aeptic tank in conjunction with tho eni,~ln2 seepage area. The point at leaot §0 fast £~em the well. P~iou to backfilling thi~ ~eptlo tank installation, pleaee have the pmopmuty owneu ~ontaot this office faa final l, opaotion and appuoval. $1ncevely, DAVID R. Lo DUNCAN~ M, D, Medical Dl~e~ou Roger N. Lausterer Star Route A, Box 490-K Anchorage, Alaska BY{ Santtavi. an Mr. Frank Lee Route C, Box 55 Palmer, Al8ska 99~e~~