HomeMy WebLinkAboutW G PIPPEL BLK 3 LT 2
GREATER ANCHORAGE AREA BOR UG
Department of Environmental Quality
3330 C Street
Anchorage, A~aska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
PHONE
SEPTIC TANK:
DISTANCE
FROM WELL<~
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
MATERIAL__
NUMBER OF ,,~
COMPARTMENTS
LIQUID DEPTH
.LIQUID CAPACITY /00~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS t/ DIAMETER OR WIDTH/~ , LENGTH~,~, DEPTH
LINING MATERIAL dfl/~"'~ CRIB SIZE: DIAMETER CDEPTH~ ' DISTANCE FROM: WELL./~)~)"
/.~) ~, ~,/,,~ TOTAL EFFECTIVE
BUILDING FOUNDATION NEAREST LOT LINE .- ,,-- '''''~-- ABSORPTION AREA (WALL AREA)~
· SQ. FT.
ADDITIONAL ABSORPTION
WELL: .C~/, $ ~-~-'/4./~-~
TYPE 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:
PIPE M AT E R I A L: _~, "~.~'7""-
LOT SLOPE:
REMARKS: --
Form No, EQ~031
DATE
~un~ cipalitx o~ m~-~chormge
Oepmr~men~ of Hemlth & Environmen~ml Protection
SEWER & WELL PERMIT ISSUANCE LOG
PAGE 30
770039 APPLICANT RICK BROWN
MAILING ADDRESS BOX 206 E.R.
LOCATION CENTER ST
LEGAL L2 BB PIPPLE SUBD
TYPE S
INSPECTION DATE BY DRILLER
~ SEWER i 0
PHONE 694-2SB9
DATE ISSUED 20B77
FI.3:,~rH :[ T N '"
I.JSGFli
THE LENGTH [) I fftEI'.,JS ]1 ON i S 'THE !..,.ENG't~H ,: ]1N F'EE['T ) OF' TFt!~[ '!"N:ENC:H CiR [)R:i~ 1i1NF ~ EL.[':,.
THE: [:,EiPTH OF F:I TE4tENC:H O1~'. F'i['f' IS THE Di[S-FF~F,P2E E:ETHEEN THE SijF::F};~C~{ OF THR
Gf4tOIJN[:, I:~N[:, THE BOTTOH OF' THEi EHC:R',,,'F!i'iON (lIN F'EE:T>.
THE:RE :[E; NO :SET N!i:)TFi FOr4: TF'.ENC:HiP. E;,
THE: GI;?.R',/EL DEPTH :[5; '1"HE h'iN'.,IItqUH DEPTH t:)F 1:7JiRFf,,,'i~:L E~I~{TP.fI~it:~P,i -i-H[C OUTF'iaL[.
FINI3, 'f'FIF: BO'i'TOH OF THE: E'?,:Ci~VFf!'Z ON ,:: i N
FI~-II:IF"[[ i. _ . N'.,h'3 Ii!I:' FII"iI'T' .:,'~ :':, l:. I Hi[I'i'HiLT i::'N",ii::~L :[i",~f~;FIF~:!i:'i l[O?',i FI,[.,~[:, FiF'F'F,?.ii!',,i*I:~L b-- TF,.['::
!),_':-£F'i::~FtTHE:NT !,,.I ]: i,. A. E!',E: SUE:..;rECT FO
i
FOF?.TH E,'¥ THE HUN i[ C: ]i F'FiL. .','.' T'~" OF F:INIi:HOI?.FIGE.
:2: ]1 HZ!..L IH'i:;TI::iL.i.. THE ~;?'L'.rF!F!I,1
l?: :[ I..iN[)Ef~:STFIND THFIT THt.:E
RES]i[)EiNC[i[ IS; I:;;IE!'dODEiI..Ef:) ]"{il iNC[..IJI)[i:: i"i,'.']F~IFZ "l'Pll:::l!q 3 E:I/ZDF?.OCiHS.
FiF'PL. ~ CI::!N T I:~: :[ (:':K 131:~'.OHN
._., ........
~'-:: J:,l..~ E?*~ .................................... DFt"I E':
-' [~ F:T T F: '.? TH FIT
1[ ~l'd FF:Ii'"i i[ L 3: f:1[;~: ['.I i "FH '['PII~: F:E{6!i..I :[ FN::-'HEZh&I'S; FOF::Orr:--:,'"~ TM, ..... b:. cc::__,,.~,,.:~...f;,,:- .... l:~t'.,!l:::, I.,.iEL. L.F5 .... ~a,::. ._b.r' ' ....
]: F' 'l- H,[C
E"GEO7%,CHNICAL 8- DEVELQ MENT
Box 90, Davis St, Eagle River. Alaska 99577
694-2774 or 688-2280
694-2774
Soils 8- Foundations
CO.
Performed for:
Legal Descriotion:~_~s~_,~ _~-.
Earl Ellis
SOIL LO. G 688-2280
Land Development
So 1Characteristic
0
13
:1_5
Ground Water Encountered: Yes____No~ If yes, what depth
Proposed Installation: Seepage Plt___~Drain Field_~___
Comments: ~.~. A.t~ ~__~ ~..~ .., ,. ~4.~. ~<5' .~
Performed by. '~:~ .~.~.z ,,.x' Date:
MUNICIPALITY OF ANCHORAGE (~-'¢'0 -/4~! _/.4'-
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~-~z~C~ -~' - '-'L)//"/!
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date 4~ ~
GENERAL INFORMATION (MUST BE~ COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location' (address or directions)
(b)
P¢0~rti6~'~'r '/¢z,4¢" '~,J//:zz,ee~--' Telephone: Home (~'¢¢--~/~'¢'5'~ Business
Mailing Addrbss 1~5~' '( ~/"f~'/'~ ~ ,-, ~"2¢~Z~' ,~¢~, ~
Mailing Address ~"4~ ~ J/J '
(d) Real Estate c0mpan, a~;gent ;~/~ ~
Address ~
Telephone ~
(e) Mail the HAA to the followln~ address: or: Check here Id for pick up,
List contact person and day phone number below.
TYPE OF RESIDENCE
Single-Family"l~
Number of Bedrooms
WATER SUPPLY
Individual Well~,. ~om'munity [] Public []
Note: If corn m unity 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 (Rev 81861 Front
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e~.ep aZAleUe ~o suo!loedsu! lonpuoo lou op SHHQ J.o saaXoldLU~ 'siueLueJ!nbe~ eiels pue leJepeJ, u!epe3 AJ. slles ol ~@p~o
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.~aau!Sua leUO!ssajmd ~uapuadepu! uB Aq e^oqe ~ qdeJl~eJed u! ua^!5 suo!lelueseJde] @ql uodn/[lUO peseq
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peu!elqo UO!leLUJO~U! eLIYUO paseq leql/[~peA Jeq),Jn¢ I 'u!eJeq peleo!pu! eJnlonJle ~o edA1 pue eLuooJpaq 1o JequJnu eql Jo¢
elBnbepe pue leUO!louni 'e~ee e! LuelsAe leeodeip JeleMalSeM Jo/pue Alddne JeleM el!S-uo eql leLll SMOLle le^oJddv AIpOLilnV
qlleeH S!ql jo uo!le§!lse^u! ALU leqi XJ!JeA I 'MOleq UMOqS elep uo!lePile^ emi Io se pue oleJeq pex!~e lees/ku Aq pe!J!Peo sV
NOIJ.¥1NI~O:INI ON¥ ¥.LYa 'NOSY=IS =1'11=1 'SJ.S=1J. '$NOI.LO=1dSNI ~)NlaI^OBd'INI:IIJ !DNII:I=1=1NI!DN.:i
.g
WELL DATA
Well Classification
Well Log Present (Y~)
Total Depth ~) "¢'/~'¢ f
Static Water Level ~--~
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments (~
MUNICIPALITY OF ANCHORAGE (MO~cr
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
If A. B, C, D.E.C.
__ Date Completed GtH'~-~¢~"~/¢'~' "- --"*'~ ?eld
Cased to ~ ~ ~ Depth of Grouting
~ ~ Pump Set At
Casing Height Above Ground ¢~ g~
Sanitary Seal on Casin N)
Electrical Wiring in Conduit~)~Depression Around Wellhead (Y~
Separation Distances from
To Septic/Holding Tank on Lott~</~ f.~l ; On Adjoining Lots
To Nearest Edge of Absorption ~ ~~1 ; On Adjoining Lots
/~ To Nearest Public Sewer
~/~ Tone,est Sewer Se~ice Line on Lot
~ ~ ~ ;Date
SEPTIC/HOLDING TANK DATA
Date Installed ~,~,~f~')-'~ ! 77~' Size
StandpipesCN) Air-tight CapsCN)
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 C¢~ ~¢~
TO Property Line
To Water Main/Service Line
Course
Comments (J~ //~f_~Tf~'~'~'~ /~r/-,f
No. of Compartments
Foundation Cleanout(~'N)
Date Last Pumped --~
/J//b¢ ;for
Temporary Holding Tank Permit (Y/N) /,.,I/~-
To Building Foundation
To Disposal Field
To Stream, Pond. Lake, or Major Drainage
Page 1 of 2
72-026(H/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed Z.-7-77
Width of Field /~'
Square Feet of Absorption Area ~-.-~
Depression over Field
Results of Last Adequacy~Test
Separation Distance from Absorption Field:
Type of System Design
Length of Field ./~'
Depth of Field
Gravel Bed Thickness ~-~
Standpipes Present ~'q)
Date of Last Adequacy Test
To Water-Supply Well ~ To Property Line
To Building Foundation
Lot
To Water Main/Service Line /d)/'"/'~
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 /d
To Cutbank (if present)
D. LIFT STATION
'~ ~'t/ Dimensions
,,S~i z~~//~ Ma~hoJe/Acc:ss (Y/N)
~p On" Level at % Pump Off Level at
T'egstedW~r Alarm Level at ~ ~;nt (Y/N)
** Check Permitted Bedroom Rating Against HAA Request **
I certify that, ~¢/,~ec/J~/vecfie~, or conformed ,o all MOA a..~d HAA guidelines in effect on the date of this inspection.
S g ned ~¢'~/' '-: ¢ A~-- Date ~ ~ .
Company ~' MOA No. ~ 7'-¢~
Receipt No. ~q~S~ / ~C~%-
Date of P~yment ~(~ ~c~
Amount: $ ~ ~' ~C)
Page 2 of 2
72-026 (11/84)
Jim Sullivar
688-2510
or
'258-2510
745-2510
f ARCTIc
~' PUMP & WE~.L, )
'~ SUPPLY
NWWA CERTIFIED PUMP INSTALLER
Alaska
Distributor
RO. Box 197
Eagle River Alaska
99577
N£ _4219
)ayment due on receipt of invoice unless other arrangements made·
Customer Order No. J Phone~;~ ~~ ~'~ I r= D~te of .~ompl, etion
Address
Qty. Description Price Amount
· Please pay by invoice. All ac'count Past Due will be charged 1V2 0/o.
THANKYOU
NORTHERN TESTING LABORATOR ES
900 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907-479-9115
2505 FAIRBANKB STREET ANCHORAGE, ALASKA 99503 90L277-8378
Alaska Environmental Control
1200 W. 33rd Avenue
Anchorage, Alaska 99508
Date Arrived: 4/19/88
Time Arrived: 0945
Date Sampled: 4/19/88
Time Sampled: 0745
Date Completed: 4/19/88
Source: Private Well
Sample ID~: A041988-1
Parameter Units Result ADEC MCC*
Nitrate-N mM/1 3.5 10
* MCC = Maximum Contaminant Concentration
NORTHEBN TESTING LABOR^TOB Ea,
E00 UNWEBSIT¥ PLAZA WEST, SUITE A FAIRRANK$, ALASKA §9709
2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503
907-479-3115
907-277-8378
Quality Control Report
Client: AK Env. Control
ID#: A041988-1
Listed below are quality control assurance reference samples with a known
concentration prior to analysis. The acceptable limits represent
a 95% confidence interval established by the Environmental Protection
Agency or by our laboratory through repetitive analyses of the
reference sample. The reference samples indicated below were analyzed
at the same time as your sample, ensuring the accuracy of your results.
Standard ID# Parameter Unit QC Result Acceptable Range
EPA 378-12 Nitrate-N mg/1 8.0 7.2 - 8.0
(- ~ate: 4/20/88
James Lawlor/, heraistry Supervisor
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
S2B L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
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.
ADDRESS
PHONE
PHONE
PROPERTY RESIDENT (If different from above)
MAILING ADDRESS
: ZO S-T
PHONE
MAILING ADDRESS
MAILING ADDRESS
STREET LOCATION
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
~ One ~ Four
~ SINGLE FAMILY ~ 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, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~_ INDIVIDUAL/ON-SITE** **if individual/on-site, give installation date' t°~(~ .
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.
72~310(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR I NSP ECTOR INSPECTOR
D~R ECTIONS:
I. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2, WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DR I LLE D
[] 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: /0(~)(:~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
Septic/Holding~.~ Tank Absorption~/~.D0 Area Sewer Line Nearest Lot Line
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
5, COMMENTS
I~'~PPROV ED FOR --~ BEDROOMS
[] CONDITIONAL APPROVAL (Petter must accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev, 3/78)
POUCH 6 650
ANCHORAGE, ALASKA 99502
(907) 279-2511
(;EORGE M SUI I. IVAN,
MA YOR
January 26, 1977
Security Pacific Mortgage Corporation
1101 East Tudor Road
Suite 190
Anchorage, Alaska 99507
Subject: Lot 2 Block 3 W.G. Pipple Subdivision
The individual sewer and water facilities serving the
subject property are inadequate for a three (3) bedroom
home. A new on-site sewer disposal system is mandatory.
To design a sewer system that would be adequate a soil
test must be conducted in the area of the new proposed
seepage trench to determine the specifications.
The requirements for wells is the casing must be extended
a minimum of twelve (12) inches above the natural ground
surface and be closed with a sanitary seal of a type
approved by this department.
The existing pit must be filled with non-porous soil and
the ground sloped to drain away from the well casing
This department can not approve the subject residence
until a new sewer system is constructed, and the well
upgraded, or escrow of funds set aside for the upgrade
by May, 1977.
If there are any further questions, please contact this
office at 279-2511, extension 224 or come by the offices
at the above address.
Sincerely,
John Kennedy
Principal Environmental Control Officer
JK/ljh
· \\%1III I¥// ~-~-- De]~q~tment of Environmental Quality
~ ~'~3~o~-'~'~reet, Anchorage, Alaska 99503 274-4561
~ ~ Date Received January 20,
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1977
1. Approval
Mailing Address: 319 West 5th Avenue
2. Property Owner:
Mailing Address:
requested by: Security Pacific Mortgage Corporation
Phone: 276-1933
Rick Brown Phone: 694-2539
NHN Center Street, Eagle River ~ ~r~
Legal Description: Lot 2 Block ~ W.G. Pipple Subdivision
4. Location:
NHN Center Street
, .~ 5. Type of facility to be insoected Single Family
6.
Well Data:
A. Type
Individual
C. Construction ~9~g~
Sewage Disposal System:
A. Installed ~1956
C. Septic Tank: ]. Size
D. Seepage Pit:
No. of bedrooms 2
B. Depth
D. Bacterial Analysis ~'~
On-site system/ U
x/?7
B. Installer
2. Manufacturer
1. Absorption Area
2. Material
E. Disposal Field:
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
C. Absorption area
Total length of lines
, Absorption area
, Other contamination
., Absorption area
to nearest lot line
, Sewer Lines
EQ-034 (1/74)
Page I of two pages
Page. ~ of t~o pa~es - Req~.~t for Approval of Individual S~.~r & Water Facilities
Legal ~escripti0n Lot 2 Block 2 W.G. Pipple Subdivision
Comments
Approved dA ~^~ Disapproved Date~
~/ Approval~JValid for one year from date signed
Greater Anchorage Area 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)
I~,~r~IClPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
~NIcIPALIT'y OF ANCHORA(~E
DEPT. OF HEALTH & .
f;t4VIRONMENTAL PROTECTION
JAi l 2, 0 1977
RECEIVED
1. Type of Inspection: CMRO
2. Property Owner: Rick Brown
VA zx FHA
CONV.
Mailing Addre~N Center St. Eagler River
Name of Buyer:_ Leonard R. Coile
Day Phone: 694 2539
Addre~¢?81 D Lemon-Elmendorf Day Phone:
Mailing
4. Name of Lending Institution:Security Pacific Moz~gage Corp
MaiEng AddreSs0:11 East Tudor Rd Suite 190
~nchor~ge Alaska 99503
5. Name of Realtor or Agent: Hylen Co.
Mailing Address: Phone: 278 9591
· Lot 2 Block 2 W. G. Pippel S/D
6. Legal Description:
NHN Center .St. Eagle River Ak.
Location :.
753 23~7
Phone: 276 1933
Type of Facility to be Inspected: sfr No. Bdrms.
Water Supply
Type of Supply: Public Utility ,Individual
If Individual, number of dwellings presently served 1
2
If Individual, depth of well
Sewage Disposal System
Type of System:
If
unkn
Public Utility
ndividual, date of installation 1956
Individual (on-site)
72-O03(3/76)
N
AS-BUILT
I hereby certify thai I have surveyed the following
described property: ,L.,~-Z- ~ ~_~_./o~_ ~., _
Anchorage Recording Precinct. Alaska. and that the
nnprovements situated thereon are within the properw
lying adjacent lherele that no improvements on prop-
erty lying adjacent thereto encroach on the premises m
queslion and that there are no ~oadway8, transmission
ines or other visible easements on said property except
as indicated hereon.
Dated at Eagle Rivor, Alaska
this ~'
SCALE: , Registered Land S~veyor No. ~0-LS
1" = q~ Box 456, Eagle River. ~aska
Phone 694-2543