HomeMy WebLinkAboutWATERS LT 12B
(~,~/ MUNICIPALITY OF ANCHORAGE
,DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
~ ~ Manufacturer Material .
m ~ ~ Liq. capacity in gallons Inside length Width Liquid depth
IF HOME,DE:
~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O ~ Manufacturer Material Liquid capacity in gallons
Q Well Foundation Near~st lot ,inzo ,,
Mo, of linest Length ~ I~e Total ,ength?~ Trenc~&h inches Distance ~7~bez e lines
~ To. of tilo to finish grade ~ ~ Material beneath tile 7~ ,nc.es . . .7~,on area
OTHER
-'
INSTALLER ~
72-0 Rev. 3178) ~
,--.) ~-,~-- .'~ % -1- ~-;
P~R. PilT NO. ( 790464 )
FIPPL I CFINT M FI)-:} HFITCH
LOCFIT I ON HILLCREST DRIVE
LEGFIL LJ.~-B I,.1FITERS SZD
T'¢PE OF SOIL FISSORBTION S'¢STEM IS: TREN~H
HSXIMUM NLIHBER OF BEDROOHS = 8 SOIL RFITING
THE REIZ~LI[RED SIZE OF THE SOIL FIBSOR. PTZON Sk'STEM I5:
DEPFtRTMENT O~.:-~d-~EFILTH FIND ENVIRC$1MENTFIL f:'xr~.dTERTIfW I/XL'0~"'"/3-
025 "L'" STREET., FINCFIOR. FIG[, FII<. 9S~50:L ~ ~SJ
- . -
THE LENGTH DIHENStON IS THE LENGTt4 (IN FEET) OF THE TRENCH OR DRFIINF'IEL.D.
THE DEPTFI OF R TRENCFI OR [:'IT IS THE DISTRNCE BETWEEN THE SURFRCE OF' THE
GROUND FIND 'THE BOTTOM OF' THE EXCFIVFITION (IN FEET).
]'HERE IS NO SET WIDTH FOR TF.'.ENCHES.
THE GR. RVEL DEPTH IS; THE MINIMUM [:,EPTH OF GRFI'¥'Et_ BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF 'THE EXCFIVRTION (IN FEET).
F'ERMIT FIPF'LICFINT I Itl.. THE RE_,FON=,IE, ILIT~ TO INFORM ]NI--', DEPFIRTMENT [:,LIRING TFIE
' c .... ': ': ..... ': R[,'.JHCEN7 TO TtqlS FF_FEF] r RN[:' 'THE:
IN_ FMLL~TIuN IN_FE.L. FILN.. OF RN'T' IJELLZ;, ' ....
NUMBER OF RE_,IEENCE_, THRT THE WELL WII_L _EF. E.
E, HL.k. FILLINa OF FINer' ..,¥z, FEM WITHOUT FIHRL IN...,FE_.TION FIND FIPPROVFIL E?¥' THI::,
DEF'RRTMENT WILL E,F :,UE,..TEu'[ 'FEi FRu_,EC. UTIuN.
MINIMUM DISTRNCE BETWEEN FI WELL FIND RN"r' ON-SITE SEWRGE [:'ISPOSRL S"/STEM IS
:t.E~O FEET FOR FI PRI',,"FITE: WELL; OR
2~.5';0 TO 200 FEET FROM FI PUBLIC: WELL DEPENDING UPON THE T'¢PE OF PUBLIC WELL.
OTHER REQUIREMENTS MR"r' FIPPL'T'. SPECIFICRTIONS RN[:' CONSTRUCTION DIRGRFIMS FIRE
FI",,'RILFIBLE TO INSURE PROPER INSTFIL. LFITION.
F'EF.."~'-I ]: -IF' E,--,F ]: F.E_. £:. EL-E. Ir ~IL, EF-. 3:fl .... :l ..........
I CERTIF:~ THFtT
~.: I FIM FFIMILI¢IR WITH THE REQUIREMENTS FOR ON-SITE SEWERS
FORTH B"r' THE MUNICIPFILIT'¢ OF RNC:HORFIGE.
2: I 1.4ILL INSTFILL THE S"r'STEM IN RCCORDFINCE WITH THE CODES.
Z(: I UNDERSTFIND THFIT THE ON-SITE SEI.4ER ~'¢STEM MFI'¢ RE64UIRE ENLFIRGEMENT
RE'..~I[)E~~.:]L.E[:, TO INCLUE:E MORE THHN ::: E:E[:ROuM:.:,.
RF'F'LICFINT MRs.:, FINT_.H
- - , .? .
Z_,-,LIEB .......~=~-~ ......... ~.~ ...................... ~*r~r~ .......................
FIND WELLS RS.'; ..,ET
IF:' THE
G,,~'TER ANCHORAGE AREA BORO" '!
k~,~,.~/ HEALTH DEPARTMENT ~
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N? 259
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
NUMBER OB [L~i_Q~U
COMPARTMENTS
INSIDE WIDTH__DEPTH
SEEPAGE SYSTE ./k~?~SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
/
NEAREST LOT LINE
OUTSIDE DIAMETER
OR WIDTH , LENGTH , DEPTH
DISTANCE FROM WELl J ~L) >~J~( , BUILDINg FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~'~.~//-/~ SQ. FT.
TILE DRAIN FIELD:
ii~ FOUNDATIO ,NeAR. EST%Ot LINE /~ . OF LINE. S/'~
DISTAN OMWELL /. / ~ /IN.
N {[S~ / '~"---~'/ ~'WIDTH T [F~
AJ~SORPTION AREA. SQ. FT. LENGTH OF EACH LINE
IN. ABOVE TILE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE
WELL: ~l 0 ~6 ~ 4'f/ ~ I,';//~'J ~- .~" (v~, ] t~.~ ~ /I~.~iSTANCE FROM WATER
TYPE. DEPTH · BUILDING FOUNDATION. SAMPLE
NEAREST SEPTIC SEEPAGE
LOT LINE . SEWER LINE .. TANK , SYSTEM , CESSPOOL
., NEAREST
OTHER
, SOURCES__
DISTANCES:
DATE
DIAGRAM OF SYSTEM
APPROVED
HEALTH AUTHORITY
GAAB-HD-2
GREATE~ NCHORAGE AREA ,~ )ROU, GH Case No.
327 Eagle St. Anchorage, Alaska 99501 ¢~-'t 679.2511 t~f/?
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
F,N^NCED THROUOH
PERCOLATION TEST RESULTS
RES,.E" A...ESSDF ,.STALLAT'O"
LEGAL DESCRIPTION ~ /~ ~ ~ T~'~ ff~ ~, Xl iR ~
~ ,SEEPAGE PIT ~ , DRAIN FIELD ., OTHER.
TO BE INSTALLED BY. ~ · ~'~?/? ~
ANTICIPATED DATE OF COMPLETION ~'~ ~
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ..~zi.,~,.~.¢.~ ~ , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
, SEPTIC TANK SIZE )7,-%-0 TYPE ~%]-e'~( SEEPAGE AREA
BI~ TEM
DISTANCES:
I certify that I am familiar with the requirements of Greater Anchorage Are. a. B. grough Qrdj~nce ,,No.,, 28-68,arl~tl~at~., ./" ~th'eL'
above descrloea system IS In accoraance wire SalU uu . /~/ '
~EATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT '~.~
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
CASE #
Performed For Michael George
Legal Descrzpt~on. L t 12B Bloc~ ,,.
This Form Reports a: So~-"~'~-Log xx
Depth
Feet
6~
12~
Date Performed 10/,5/70
'subd~i~iiion Water
~Percolation Test- '
Soil Characteristics
gray sandy gravel (GW)
gray gravelly sand (SP)
sandy silt with few gravel
(ML)
Was Ground ;'later ;2 .~ t. ? \'~l
n~oun ered _ no _
If Yes, A' ~'a'~ Depth__ .
Location Sketch
I . . H20 ~'~
Grosset Time Depth To N{
i'_Tii ..........
F"oDDbe.:~.n~t '~'l~Seepage Pit xx Draih Field
Dep~ Of Inlet Depth To Bottom Of Pl~ Om Tpenc~
COMMENIS: --' - .....
107 square,feet of drainage surfa~e~rea'is red'ired ~er'bed~oo~=~ 9rib'
bottom set ~ 8.,5' depth ,,
Test Pe~for~d By~ R. E. Carlis%~, , , ~ese reco~endations are com~ted
from visual obse~/vations and based
on the unified classification system.
Data Certified By: National Testin~ Service Inc
Date:
MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL P~::OTECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
82B L Street- Anchorage, Alaska 0§B01 JUE 2 ? 1979
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
IDIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
I1. PROPERTY OWNER PHONE
VIAILING ADDRESS ·
PROPERTY RESIDENT (If different from above)
PH~)NE
2. BUYER
/IAI LING ADDR ESS
3. LENDI G INSTITUTION
PHONE .~3["~
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] FOL~' [] Other__
/[] SINGLE FAMILY [~-/Two [] Five
E[~ MULTIPLE FAMILY [] Three [] SixL_". '/~",~X~
WATER SU PLY
7. ~J~ iNDiViDUAL~
[] COMMUNITY
I~] PUBLIC UTI LITY
* 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 (attach log if available.) ~ ~z'~-/' ~
8. SEWAGE DISPOSAL SYSTEM
[~ INDIVIDUAL/ON-SITE~
**If individual/on-site, give installation date /'//---?" ~'/
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.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY .,
~ DATE RECEIVED '
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR I N~PECTO R
DIRECTIONS:
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 UTI LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDI VI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTI LITY
Connection Verified
INSTALLER
[~]Septic Tank or [] Holding Tank
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA - MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line ] Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
/A PROVED FOR __F BEDROOMS/3
[~--'~ONDITIONAL APPROVAL (~etter must a~oro~an¥ certificate)
LEGAL DESCRIPTION
72-010 (Rev, 3/78)
JAY S. HAMMOND, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION
SOUTIICE~TRAL RECIO~AL OFFICE
September 6, 1979
Max Hatch
P.O. Box 833
~agle River, Alaska 99577
Subject: Lot 12B, Waters Subdivision
MUNICI?ALiT¥, 0;- ANCHORAGE
RECEIVED
Dear Mr. Hatch:
We have reviewed your request for a separation distance
waiver for the well serving an existing duplex located
on the subject lot. Specifically, the waiver would allow
the sewage absorption trench to be located no closer than
100 feet from the well. Your request is hereby approved
for the features with which this department is concerned.
The decision was made based on the fact that there are some
rather impe~eable layers between the ground surface and the
aquifer and because of the relatively large lot sizes.
Please feel free to contact me at 274-5527 if we can be of
any further assistance.
James O. Starr
gnvironmental gngineer
cc: DHEP
ief
18-06LH
DAVID A. SLENKAMP
ROBERT A. SHAFER
MECHANICAL ENGINEER
694-9055
August 10, 1979
CIVIL ENGINEER
694-2979
,MUNIcIPALffy OF ANCHORAGE
DRPT, OF b-,~LT/-I &
EJ~VtRONMENTAL PROTECTION
Mr. Max Hatch
Box 833
E~gle t'dver, ~laska
99577
R_ECEIVED
Dear Vm, Hatch~
Reference: Lot 12B; Whter Subdivision
At your request a sewer system adeau~oy test ~ms preformed on the ~ystem
servin~ the four-plex (8 bedroom) apartment located on the referenced
property, ~tc test '.~s preformed on August 6 and 7, ~979,
The septic tank was pumped snd approximately 15OO g~llons w,~s removed.
I.A~W. Municipality records show that a 1500 gallon septic tank ~s
installed in October 1979 to serve a (6 bedroom) triplex apartment.
I regret to ir~form you theft your septic tank is not adequate for
8 bedrooms. A ndnimtm~ capacity of 2500 g~llons is reOnired.
~ne seepage pit was full of ~,mter and appro~m~te'Iy 1200 g~llons ~ms ren~ved.
The pit %.ms then recharged with approximately ].200 gallons of fresh
%rater. After a 2/. hour period approximotely 433 &~llons had percolated
from the pit. This is only adequate for 2.9 bedrooms.
It can be concluded from the above test that your system is not adequate
and will require upgrading to add approxi~knte!y 1000 gallons to the
septic tsnk capacity and an absorption trench for 5.1 bedroom, A permit
for the upgrading of the ~ystem can be obtained from the M~,~nicipality
Health and Enviornmental Protection offiee~ 825 L. ~treet~ Anchorage.
ii' we can be of further service to you~ ple~se do not hesitate to call.
~~y yours~
ttaslth and F-a~vi~,rnmentsl Protection ggenoy
Coast Mortgage Company
SRB 196X EAGLE RIVER,ALASKA
9HA Form 2573
~-: Budget Bureau Ha. 63.R0296
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
INSURING OFFICE
Anchorage, Alaska
PART i.~TO BE COMPLETED BY FHA
MORTGAGEE
SERIAL NO,
111:011401
MORTGAGOR OR SPONSOR
Michael Goatee
SUBDIVISION NAME
PROPERTY ADDRESS
NItN Htllcrest Drive, Chu~tak
TOTAL NUMBER:
BASEMENT
U1Yes [].No
~'-~New installation
6
WATIR SUPPLY BYz
ri Public system [] Community system
SEWAGE DISPOSAL BY~
[] Public system [] Community system [] Individual
additional bedrooms?
(If Yes, how manyF)
do. SYSTEM DESIGNED FOR
Individual
§ []Yes []No
PART IL--TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
It is the opinion of the [] State [] County [] Local Department of Health that this individual water-supply system
[] is [] is not satisfactory as a domestic water supply for the subject property.
It is the opinion of the [] State [] County [] Local Department of Health that this individual sewage-disposal sys-
tem with proper maintenance:
[] Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily
is not likely to create an insanitary condition
J TITLE
~eb. 9, 1971
PART III.~FOR USE OF FHA OFFICE
TO THE CHIEF UNDERWRITER:
I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the
Individual water-supply system be considered [] Acceptable [] Not Acceptable
Sewage disposal be considered [] Acceptable [] Not Acceptable.
; DATE SIGNATURE
] CHIEF ARCHITECT
] DEPUTY FOR CHIEF ARCHITECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form 25iZ
Rev. July 1958
REPORT OF INSPECTIONwlNDIVIDUAL SEWAGE-DISPOSAL SYSTEM
PRIMARY TREATMENT consists of [] Septic tank. [] Cesspool.
Septic Tank:
Distance from well,__feet. Material,
Total liquid capacity,
Inside length, feet. Inside width,.
Celspool~
Distance from: Well feet; foundation,
Inside diameter, feet. Depth,
gallons. Capacity inlet compartment,
ii?et. Liquid depth,__
gallons.
feet.
feet; nearest lot line at [] front, [] side, [] rear.
feet. Liquid capacity. _gallons. Lining material
[] Seepage pits, Other _
Depth of filter material over tile,
feet; foundation, feet; nearest lot line at [] front, [] side. [] rear,
feet. Number of lines, Distance between lines,
__inches. Total effective absorption area in bottom of trenches,
feet. Depth, top of tile to finish grade,
[] Broken stone. Other
inches.
__ feet.
feet.
square feet.
.inches.
inches.
Depth, fee(. Lining material
feet; nearest lot line at [] front, [] side, [] rear, __
[] Local Health Authority.
Inspected by
REPORT OF INSPECTIONwlNDIVIDUAL WATER-SUPPLY SYSTEM
Distance to nearest public water main, feet. Size of main, inches.
lmlivklual wells [] are [] are not customary in neighbgrhood.
Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water
Properties in neighborlu×~d [] are [] are not being developed with both individual water-supply and sewage-disposal systems.
D~t size: .feet wide, .feet deep. Dwelling scl back from front property line, feet.
Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well.
Distance of we~l from:
Building fnundation,
seepage pit,
feet; tile sewer,
.feet; cesspool,
feet; nearest lot line at [] front, [] side, [] rear,
tbet; septic tank, feet; disposal field,
feet; other sources or' possible pollution, ireet.
Diameter, inches. Total depth, feet Type of casing,
Approximate depth to pumping level of water in well feet. Approximate yield,
Sealed watertight to depth of feet.
Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill.
Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No.
~om~= [] Shallow well. [] Deep well. Length of drop pipe, feet. Pump capacity,
lx~cated in: [] Basement. [] pumproom off basement. [] Pumphouse above ground. [] Pump pit.
pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No.
Type of storage: [] Pressure, [] Gravity. Capacity,. gallons.
Has bacteriological examination of water been made? [] Yes. [] No. If answer is "yes," give date
Quality of water [] is [] is not satisfactory for human consumption.
Installation [] does [] does not comply with approved exhibits, if any.
Inspection made by: [] State, [~ County. [] Loc'al Health Authority.
Inspected by
Date of inspection , 19
Depth of casing,
gallons per minute.
gallons per minute.
.19
feet;
feet.
GPO 889-088
4
~.~GREATERANCHORAGE AREA BOROU6'H
HEALTH DEPARTMENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
279-2Sll
RHQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND I~ATER FACILITIES
FOR
Address
Property O~ner
Legal Description
Type o£ Facility to be Inspected~ ~-~A~ ~,'
N~ber of Bedrooms
Well Data:
~. Bactorial ~nalya~s
Phone
6. Sewage Disposal System:
Septic Tank (If homemade, show diagram on back)
2. Age / ~ 7t~.
.... .A~proval Request for Se~_~e ~ ,tVater Facilities
P, age
B. Seepage Pit
:~. Size ~'~'7 33'---/ .~7/ //2/
C, Disposal Field
1. Number o£ Lines ~/f~z~
2. Total Length /~//.~
Required Measurements
A.
B.
C.
D.
E.
F.
G.
H.
Well to Septic Tank
Well to Seepage Pit /~.~
Well to Sewer Line ~
Well to Property Line ~/~
Well to Other Possible Contamination
Foundation to Septic Tank
Foundation to Seepage Pit f~ /
Seepage Pit to Property Line~
CO,~4ENTS:
APPROVED:
¢/
DISAPPROVED:
DATE:
APPROVAL VALID FOR ONE YEAR FRO~I DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEAL~] DEPARTMENT
EDll70