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Home My WebLink AboutWENTWORTH BLK 1 LT 27LoT GR~:ATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCAnON SEPTIC TANK: MAILING %7~ ¢:--,~ ~/'~-'~ :~ % ~ ADDRESS ;f'~' '¢7/~/) ~ PHONE ~/~ ,-~ X LEGAL DESCRIPTION%~-'~7. ~'/ ~¢'~7~. ~ DISTANCE FROM WELl "7¢*' / LIQUID CAPACITY ',~ -0' ,, ~ E; GALLONS. /2~ ~ ~. COMPARJMENTS / MATERIAL /~ / ,~ ~ t LIQUID INSIDE LENGTH INSIDE WIDTH ,>~ Y DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS. LINING MATERIAL NEAREST LO[ LINE. .OUTSIDE DIAMETER OR WIDTH /~'- / , DISTANCE FROM WELL ~"-' / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH //2 '~ .. , DEPTH , BUiLDiNG FOUNDATION. 2 2'~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELt NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE FOUNDATION , NEAREST LOT LINE DISTANCE BETWEEN LINES TRENCH WIDTH SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILt. TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: T y p E ~7./t?/~ ~, ~.=-?j , DEPTH LOT LINE "~ ~- / NEAREST ,~/~) / " . SEWER LINE DISTANCE FROM ~ ~., / WATER · BUILDING FOUNDATION. · SAMPLE , NEAREST SEPTIC "7~ / SEEPAGE /~ ¢'~ / .~ . OTHER ., TANK SYSTEM . CESSPOOL . SOURCES__ DISTANCES: ij~?,,,::~ 7¢/ DIAGRAM OF SYSTEM DATE APPROVED GREATEK~ANCHORAGE AREA ~ROUGH Ca,eS°. HEALTH DEPARTMENT ~ ~7EagleSt. Anchorage, Alaska99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT d~/-;~6/'~, \7~/[/-~~ MAILINGAOBRESS ~'~2¢'~---~ / RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH PERCOLATION TEST RESULTS BELOW TO BE FILLER OUT BY HEALTH DEPARTMENT LOCATION OF INSTALLATION TO BE INSTALLED BY T.,S ,s To SERVE AS ,,¢/Z'; ,T¢/¢ ~5 , PE.M,T TO .NSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE /~C:>C:) TYPE ~SEEPAGE AREA DIAGRAM OF SYSTEM DISTANCES: /~//L-/ / HoaRh ~uthodW DATE that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the described system is in accordance with said code. ~'englneerlng group-- Brian D. Looney Stc~ff Engineer 3900 Arctic Bivd.oSuite 203 Office (907) 562-3252 Anchorage, Alaska 99503 Home (907) 346-3980 [CIPALITY OF ANCHORAGE )N OF ENVIRONMENTAL HEALTH · ]~LLTH AND ENVIRONMENTAL PROTECTION ~ALTH AUTHORITY APPROVAL CERTIFICATE Application Date April 1985 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 27, Block 1, Wentwbrth Subdivision, Sec 28~ T13N~ R3W Location (address or directions) 3321 E. 41st Ave. (b) Applicants Name Doug Schmedlen Telephone - Home 563-3554 Business 333-1414 Applicants Address 3321 E. 41 st. Ave. (c) Applicant is (check one) Lending Institution ~ ; Owner/builder ~ Buyer ~ ;'Other ~ (explain); (d) Lending Institution ~.~.~z~.~~ ' ~.~ ~, ~, Telephone Address ~ / ~ ~z~ ~ ~ ~ , ~ (e) Real Estate Co. & Agent _ Pncific P~nlfy - (Jerry Ward) Address Telephone 276-4506 (f) Mail the H~ to the following_ address: ~ype of Residence Single-Family~ Number of Bedrooms Multi-Family three Other (describe) 3. Water Supply n ividual Well community f--q Public f--q Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal. \\~lllI! 17/' Note: If community well system, m~s~tllhMy~ '~rklt~nlconfirmation from ~he State Departmemt of Eavironmental Conservati~ ~t, testing to the legality and statue. [Page 1 of 2] 5o Engineering Firm Providing Inspections, 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, functionsl 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 regula- tions in effect on the date of this inspection. Name· of Firm CRW ENGINEERING GROUP Telephone Address 3900 Arctic Blvd., Suite 203, Anchora~ (ENGINEER SEAL) Approved Di sappr ~~itional Terms of Co~ Approval ~ -- Bate CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF AI~ASKA. THE DREP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- b~NTS. 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. ,,., RR4/ej/D18 [Page 2 of 2] / I / I 7-19-84 ao Well Classification Private Well Log Pmesent (Y/N) No Total Depth 47 ' Cased to 4 ? ' Static Water Level 1 2 ' Pump Set At Casing Height Above Ground I 2 '~ - Electrical Wiring in Conduit (Y/N) Yes Separation Distances f=om Well: To Septic/Iqolding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line 125 ' Cleanout/Manhole 1 ? 0 ' · . .~..~ Samgle Collected By B. Looney Water Sample Test Result ~ ~cceDtm.b] e MUNICIPALITY OF ~-CHC~RAOE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) APR 2 lg8,5 c. c Li= - R E C E IV E D Legal Description: Lot 27~ Block 1, If A, B, ~ C, D.E.C. ~p~o~d(Y~) ~te ~91eted ~ 969 Yield ~ G~H . ~g~ of G~tin~ Unknown · Sanit~y ~al on ~sing (Y~) Yes ~ession ~ound ~l~ead (Y~) ; ~ ~joining ~ts : N / A ; ~ Adjoining ~ts N/A To ~est ~blic To ~est ~ ~Vi~ Li~ on ~t 60' ; ~te 3/~2/85 Cup,tents Be SEPTIC/HOLDING TANK DATA N/A Date Installed Size ~ No. of Compartments Alt-tight' ~ps (Y/N) Foundation Cleanout (Y/N) Standpipes (Y/N) Depression over Tank (Y/N) Date ba~t Pumped Pumping/Maintenance Contract on File (Y/N~ ; for Alarm (Y/N) ~Tempora~y Holding Tank Permit (Y/N) Holding Tank High-Water Tank'~x~ . Separation Distances f~cm Septic/Holding To Bui~ing Foundatioq To Water-Supply Well To Property Line To Dis~al Field To Water Main/Se=vice Line To Stme~n~Pond, Lake, c= Major D~ainage Course Comnents [Page 1 of 2] 2-15-84 ABSORPTION FIELD DATA Soils Rating in Absorption Strata __ Date Installed Width of Field Square Feet of Absorption A~ea Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To k~ter-SupplyW~ll To Building Foundation Lot To Water Main/Service Line To Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes P~esent (Y/N) of Last Adgquacy Test Line ting Or Abandoned System cn ; On Adjoining Lots To ) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking A~ea, or Vehicle Storage A~ea Cormnsnts D. LIFT STATION N/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Conm~nts \ \ Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ing Cycles during Adequacy Test. M~ets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conform~=d to all MOA HAA Gui~ in effect on the date of this inspection. KB1/d5/s - [Page 2 of 2] 2-15-84 /~l/~:~__~?~ MUNICIPALITY OF AN CH ORACle, ~. DEPART~/N_~'¥ OF HEALTH AND ENVIRONMEI~-JL PROTECTION t/%,.~F~.'~;'.~/.I ' 825 L Street, Anchoraa~, Alaska 99501 \\~ ~';// ! 264-4720 ~'~i3~ INN Date Recelvea: February 22, #1: Time I; ', ;~ ~YI #2: Time #3: Time Date ~. Date Date Insp 1~)~, W · Insp Insp 1978 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: National Bank of Alaska Mailing Address: Pouch 7-025 99510 Phone: 265-2881 2. Property Owner: James W. La Belle Phone: Mailing Address: % Henry Kim/Polar Realty - 272-1541 3e Se Legal Description: Lot 27 Block 1 Wentworth Subdivision 3321 East 41st Avenue Single Family Residence: ~ Number of Bedrooms: Three Multiple Family Residence: ( ) Number of Bedrooms: Well System: Permit # Construction Individual Well ~ ) Community/Public System ( ) Depth of Well Well Log on File Bacterial Analysis. Sewage Disposal Permit ~ Septic Tank Size Absorption Area System: On-site System ( ) Public Utility Installed Installer Manufacturer Soils Rate Material Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line ~age Two, Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 27 Block 1 Wentworth Subdivision Comments: Affadavit Attached: /~) Approved: Disapproved: Letter Attached: ( ) Date: Date: Department Worksheet: llVfl lVNOI/VNH]LNI MOJ --O301AOHd ]9V83AO3 33NV8flSNI OH 008~ ~so~ Sd ~O£--'llVfl 031.-11/~133 80J .Ldl3331:1 ? (~,lsod snld . ;]~ ' MUNICIPALITY OF ANCHORr r~ ~.~. Department of Health and Environme~al Protection ~ //~ 825 L Street, Anchorage, Alaska 99501 264-4720 ~' uest for Approval of Individual Sewerland water Facilities 1. Property Owner: James W. LaBe]le Mailing Address: General Delivery~ Anchorage, Ak. Phone: NA 2. Name of Buyer: Pan Young Kim Mailing Address: 1336 West 23rd Avenue Phone: 276-6239 Lending Institution: National Bank of A~l~aska Mailing Address: Pouch 70257 Anchorage, Ak. 99503 Phone: 265-288] Realtor/Agent: Henry Kim / Polar ReaLty Mailing Address: lO1 E, Intl Airport Road Phone: 272-1541 Legal Description: Lot 27, Block 1, Wentworth $/D Street Location: 3321 East 4let Avenue, Anchorage, Alaska 99504 Single Family Residence: (X~ Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply: *Individual Well (×) Public/Community System ( ) If Individual Well, well depth Unknown If Community System, name of system 8 o Sewage Disposal System: *~n-site System ( ) Public System If On-site System, date of installation: NA x) *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy Seat is required by this department. A fee of $25.00 must accompany each request ~be~ie~ip~,~sing can be initiated. 3/77 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ~j~30 "C~,Street, Anchorage, Alaska 99503 274-4561 ~L~/~/I Date Received ,~ ~u, Time of Inspect-~'on 1. Approval requested by:v4~x¢ _~~~ 4. 5. 6. Mailing Address: Property Owner: Mailing Address: "~'~.~.~,,/ 24/~-/- Legal Description: /~,~? ~/~ ~/~ Location: .~ .~21 ~ ~/~ Phone: Phone: Type of facility to be inspected Well Data: A. Type r~,/ ' C. Construction Or J~- Sewage Disposal System: A. Installed B. Depth D. Bacterial Analysis B. Installer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area 2. Manufacturer 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line , Absorption area , Other contamination , Sewer Lines __ B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line __ EQ-034 (1/74) Page I of two pages Leqa' Description are o[)e,-'ating ~a, tisfactor~l',/. September 6, 1974 First ;lational Bank Po O. ~ox 4~2090 Anchorage, Alaska 99509 Attention: Ann L. Boisvert Re: Lot 27, Block l, Wentworth Subdivision 3321 East 41st Avenue [)ear ~1'iss Uoisvert: ihe subject i>roperty has been connected tu public sewer. · Fees and assessments have been paid, and meets this Department's approval. If you have any fur'~her questions, please feel free to conLac~ me at 274.-4561, extension 135. Sincerely, Les $uchholz, R.S., Sanitarian LB/ko GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Approval requested by: Mailing Address: Phone: 2. Property Owner: Phone: ~,-y-?O Mailing Address: ~ ~ /~, 3. Legal Description: ~ ~ ~ ~/ ~//~Z~/-2/d~ ~X 5. Type of facility to be inspected ~, ~ J~O. of bedrooms 6. Well Data: A. Type ~~. B. Depth C. Construction ~ D. Bacterial Analysis .- 7. Sewage Disposal System: ~-~/ ~ ~ ~ A. Installed /~ B. Installer C. Septic Tank: 1. Size ~0 2. Manufacturer D. Seepage Pit: I. Absorption Area 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank ~d~' , Absorption area Nearest lot line /D ~m~, Other contamination B. Foundation to septic tank ~t~ C. Absorption area to nearest lot line Sewer Lines __ , Absorption area EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~st for Approval of Individual ~er & Water Facilities ~L~gal Description Z_ ~ ~ ~ / /~/~/~X ~////. ~Approval Valid 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 £0-034 (]/74) Jane MalarYey Real Estate Corner of Alaska 2909 Arctic Blvd. Anchorage, Alaska 99§03 SUBJECT: P Block 1 ~lentworth Sewer and water facilities serving Lot .7, 33~1 East ~ls'~ Avenue Dear Mrs. ~-.!alarvey: The above facilities were inspected by this C'e~art~ient on q~'ch 14, 1974 with t)m follo~dng noted: The water serving the subject lot Is via a )}rivate ~,~elt located 22' south of the dwc, lli~g ~md t:)~ east of the west lot lhm. The w~ll construction is satisfactory. septic tank and adjoining s~.~,pa=~ pit. At the t'~;e, putlic ~ewer is available to the subject lot. According to State and ~Yeat~r AncboraQe Area Ordinances, a. dwelling must connect to the public sewer tf tt ts avatlohl(~ to the lot~ Therefore, this Depart~ i:;ent :,dll give tm:porary al)prowfl on the sub}eot sewer facilities pending the e.~crm: of fund~ needed to connect the ~v~ilm>le the dwelling on the subject lot !o j~-m~ This connection )~ust occur on or extension 135. ~incer(,lY, Tim ?.umfel t~ )LS., Sanitarian TR/ko n , ~ayne Ellis I/ % INDIVIDUAL SEWAGE ~ND WATER FACILITIE$~ (Fill out in T~iplicate) ~. ~a~ .of person ~questzng apprgval .Wa~e~.iLr~y~ is: b, Detergent, We~ dar a: b. Dept~ .... .~7/ ', c, Casing Size Distance fro~ well to closest existing or proposed: 1. Sewer line / · 2. Septic tank ?', 3, Seepage Area Cesspool~ 5. Property Line Other sources of possible contamination, i.e., creeks, lakes, houses, barn~ dmainage ditch, e~c. Sewage disposal system. a. sofeystam . b. Septic tank capacity in gallons ~ c. Mama of septic tank manufactu~e~ .~/z~.~- ~ 1. If "home made" show diagram on reverse side of this form. d.' Disposal field oP seepage and t~e~ ~~ 1. Distance to pmope~-~ne to house fo~dation,. ~. Percolation. Test ~results ..f. Percolation Test performed by .... · Use the reverse.side of this form to show diagram, Diagram should include he foilowlng information: ~operty lines~.well location, houselocatzon, ~%~p~ic tank location, disposal area location, location of percolation test~ a~ direction of ground slope, 9. The l~f-or~nation on this form is true and correct to the best of my knowledge. Signature of Applicant Date Signed TO BE FILLED OUT BY HEALTH DEPART{.IENT PERSONNEL Qe above described sanitary facilities are hereby approved, subject to the ......... ~l~owin~ con4~ions: Conditions: The above described sanitary facilities are disapproved for the following reasons: '--Approval is valid for one year following the date of approval. ~ CPJ:cw