HomeMy WebLinkAboutWYNTER PARK #1 BLK 1 LT 12
MUNICIPALITY OF ANCHORAGE
DE RTMENT OF HEALTH AND HUMAN SER, ,ES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT
TANKS
___ ~. SEPTIC
blanulat;tuler
[] HOLDING
TYPE OF SYSTEM
~f'TRENCH [] DE[) [] W. DRAIN C] OTHER
or,glnal glade I ' ~:~ FT ¢:~ ,LO FT
WELLS
[] PRIVATE ~ OTHER {Identify)
Total Depth r'r Cased ~o
REMARK J:
FT
DISTANCES
SEPTIC
TANK
WELL
LOT LINE
FOUNDATION
ABSORPTION
FIELD WELL
by:
S & S ENGINEERING
I. 1 l~te.R%ve~'J.,oe{? Ro~_~LN~20¢,--___ ced~ thai tills inspection was pedormed according to ~11
72-013 (3/85)
(::,.,{, l: :i ty
]. :, i}]
l~:z)r~.i'l ll;!v '~i.t~(~.,, Huri;ic;ipaD:k'l:b c:,f ~'~nc:hcl~'a!],:-:, <l'~l(]]l~) ,;'u'n:l thc) !]i~l'.a'Ii¢,:) c!f
~::],, Ii ~.~:i ii ! :Lt~s't,'~,l ]. ['Ii(! '-i')/!51'.~!lil ]i Ii <:'tc:l:i;c)l'iJEff]c:f) ~,,gli'I.l'i ~zt]t ]. I~t(]ll"i c:c)(IEq!it 4:it'll;l I'i.:gql.t]/;tlL:J
]]:: A I.fl:! S'IA'I"i!]II IS ;ihl!;TAl..l.,lil]} IN AN ARI:i!iA COVlii;f:il:i:[) E:Y MOA BUILD];I',IG
ll-IItN (!) ~1~.1 I~].I~C]I:iIC¥]I. I:::'I]RMIt AND INSF:'l~ii]l]il]lxl !fl!fSI' BI~; E)!;{IAINED~
I.,'i]!ll.. NOI' BE AI:'I::'I<~ WIIHOLIt AN E]..Ii;C'II:i'.IC)AI !]qSF:'Ii)];I];Ot',I I:IE]::'EIRI': ANL) <J;> II. IE
............... . .......
,"~,.:~ ~ i, :~ ~}.l, ,~ ~ ~:'~:~1::;. C/O ~:hM~ I:]',{G {i}',IEI:ER INU
P.O. BOX 6650
ANC~HORP, GE, ALASi'(A 99502-0650
(907) 264-al
DEPAR'I'MENT OF HEALTH & HUMAN SERVICES
January 10, 1986
TO: Permit Applicant
Subject: Permit # 850510
Lot 12 Block 1 Wynter Park Subdivision
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 3]., 1985.
Permits are issued on a calendar year basis by authority of Municipal
Ordinance. A new permit must be obtained from this Department for any
well and/or on-site sewer system not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to this
Department for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system
the original as-built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
$EO/ljw
enc: Copy of Permit
I:::'ERH I T tq[]."
D A ]'b,': I SE~LJED'.'
850~i 1()
()fi / :1.6/8,5
F;:I:'L'D CARPET"'q<ATI'JY C/O S & S ENG'RG
8 I:r( B 196X
12AGLE RIVER~, Al< 99577
694"<2979
BI .OCI<:
I_:i. st(,ad be].ow aP(a the opt.:[orls avai:l, able 'Lo yoL{ in cle~signir~g yOL~P septic
sys't, em. C, hoose the op't, Jon that bes'L ¢i'Ls you~' site.
I)EF'TH "I'CI PIF'E BCITTI]M (FT.) 4.0 4.0 z~., (.)
GF~AVEI.. I)EJI='TH (FT.) 13.0 O. 5 ::~;. 5
'I'OTAI.~. DEPTH , (1="1'%) :l~]. 0 4,, 5 7.5
GF:~AVEL, WIDTH (F'T.) 2,.5 19.0 5.0
GRAVEl.,. I,.EIqGTH (FT.,) ~]9.0 36.0 49,, 0
GR(~VEL, VOI.,,IJME ([;U. YI:)[~,. ) ~2R. 9 25.4 36.3
TANK S Z ZE (Ei~L.S) J. ~ 000.0 ~.~, 1 ~ 000.0 '~"~ 1 ~, 000 ,, 0 .[',~'
SO ]: L RA'I" :[ NG, (SQ. FT. /13R ) 150 :[50 150
.~{..1~. TANK I~tUS'i'' HAVE A'F I..EAS"F TWO COMPARTMEIq"f'EI
(:::el-t i t'y '1', hat '.'
1. I am fami],iap with the requir'emen'Ls
('C)P c)rP-'i!!iit(~ iB(FJ~(F~)I'S and ~Kl, ls as set
Forth by the Murlicil:)a'.l,i'Ly of Anchorage (MOA) arid 'Ll'm, State oF Alaska.
2. t ~li].l ir~s'Lall the sys'L(e~)m in accor'danc+~ ~i'Ll") all M(]~ c:~des and regulations~
and in c:omp].iar)ce ~i'Lh the design criteria oF th:Es per, mit.
:3,, I will adher'e 'Lo all MOA arid S'La'Le (::)~' Alasl<a requiremen'Lc. For 'Lhe se'L bacl::
dis'[,arlces Fi'om alay ~D~(J.~tJ, l'lg Nt:~].I~ ~a~;;t~a'LeP disl::)osa], system (::)r' pul:)lic
seNePag(:] s;ystem 01"1 this o1" arly adjacerrL om' n~)aPby lot.
4,, I (.q'lder, s~',arld that 'LH:i,B I:)el-init is. V~tlid fOP ~:~ IliF~).(;J. ltlL~m CI(' 3 b[.~dr'l:Joms arid
IF A I..II=']' STATI[)Iq ]:SI IN!B'FAIJ.,EI) IN AI',t AREA [',OVIEI:q~]:) BY I~IoF-~ BLIILDING CODH:S.,
THEN (1) AN Ei:I,~.EI]TF~I[;AL F:'ERMI]" AND IIqSF'ISC]"ION MUST BE 13BTAINED; (~)
W]:L.L. NOT BIE (~F'PROVE~:]:) WITI.-.IOUT AN ELEC'I"RICAL INSF'[CC'TION REPOR"F; AND (3) '['I. IE
EI..IECTIRI[',AI..~I< MLlEl'!' BE DONE BY .A I_II:EIqSEH:) EL,ECTRi[;I~N.
/ --
I
PERFORMED FOR:
LEGAL DESCRIPTION:
SOILS LOG
MUNICIPALITY OF ANCHORAGE
[] PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
TEST
825 L, Street, Anchorage, Alaska 99S01 264-4720
SOILS LOG - PERCOLATION TEST
SLOPE SITE PLAN
10
11
13-
14-
15-
16---
17-
18-
19-
20-
COMMENTS
PERFORMED BY:
72-008 (6/79)
I~bert A. She~r
No, 1457-E
IND WATER
O
YES, AT WHAT
EPTH?
Gross Net Depth to Net
Reading Date
Time Time Water Drop
L
PERCOLATION RATE ~J///~ (minutes/inch)
TEST RUN BETWEEN FT AND PT
. Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TES'r
PERFORMED FOR: ~ T//~ DATE PERF,
SLOPE SI'~PLAN
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT
DEPTH? p
E
Deplh to Water AIter,/)~w
~lonitorinD? ~'¢"'~7 Dar .~_
5
6
7
8
9
10
11
12
13
14-
15-
16=
17-
18-
19-
20-
Reading Date Gross Net Depth to Net
Time Time Water Drop
_
PERCOLATION RATE _ (minutes/inch) PERC HOLE DIAMETER
~ , TEST RUN BETWEEN _ ,,..~-'~ F---~-~-'
PERFORmeD ~Y: 3 7034 Eagle River ~p Road No. 2~~/ CERTIFY T~ A~ T~ ~S TEST WAS
- F ALLSTATEANDMUNICIPALGUIDELINES~EFFECTONTHiSDATE. DATE: ~ ./~t/ /~ (~
72-008 (~ev. 4/85)
IN
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
OF INSPECTION FOR HE!ALTH AUTHORITY APPROVAL
CERTIFICATE
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
block, subdivision, section, township, range)/.
(a, Legal Description(include,o,, ~.(.~y~/Z ~:~ ' ~¢ ~ //~;}'/'~/'~,
Location (address or directions)
(b) ApplicantNam~r ¢~ Telephone:Home ¢*~/'*
(c) Applicant is (check one): kenOin~ Institudon ~; Ownor/Builder~; Buyor ~; Othor ~ (explain);
(d) Lending ,nstitutior~/'k~-¢-//~/'
Address _~ O. ~0~ ~
(e) Real Estate Company and Agent
Address
Telephone
(f)
Mail the HAA to the following address: $ & $ ENGINEERING
I-;agle Rlver~ Alaska 99577
TYPE OF RESIDENCE
Single-Family,J~ Multi-Family []
Number of Bedrooms
Other
WATER SUPPLY
Individual Well [] Community [] Public/J~
Note: If community well system, must have written confirmation from the State Department of Environ mental 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.
72-o25 [n/84)
Page 1 of 2
NO IJ. rtvo
- i~uo!l!puo0
pe^oJdd~s!a ~ peAoJddV'
'JYAO~JddV dgHa '9
euoqdale~
/.Zg66 a)~SelV '~eH~l el5~3 sseJppv
'ON pao~t dOO'l ~e/~la ell~ ~: L LUJH to eUJBN
9NlJ~Nl9N~J~o~edsu! siql Jo elBp
uo JoeJJe u! suoBBinDaJ pub '$eOUBU!pJO 'sepoo eJB1S pub IBd!o!unv~ lie qi!M egU~!ldUUoo u! s! uJelS~s IesOds!p JgJ~MgJS8M
Jo/puB ,qddns JelBM el!S-UO eql 'uo!loedsu! pub UOBBS!lSeAU! ,~LU LUOJJ pUB SeI!J e~BJOqOUV JO ,~l!lBd!o[unv~ eqi uJoJj
peu!elqo uo!jBuJJoju! etjj MO pesBq 1Bqi ,~J!JeA JeqpnJ I 'u!eJ@q peJBo!pu! eJn~onJls ~o ed/[~ pub SLUOOJpeq ~0 JeqLunu eq~ JoJ
eisnbepB pub I~UO!lounl 'ej~s si LUeIS,~S I~sods!p JeiBMelSBM Jo/puB ,qddns JejBM e~!s-uo eql leq~ SMOqS le^oJddv/[ipoqlnv
, qIIBeH s!ql ~o UO!iB§BSaAU! ,~LU jBqj,~j!Je^ I 'MOleq UMOqS elBp UoBBp!IB^ eql JO se pu~ oleJeq pBx!JIB lses XLU ,~q pe!J!P@O SV
NOIJ. VWEIOJNI aNY V.LV(] 'HOEIV3S 3'11d 'SIS~J. 'SNOI.LO~dSNI 9NlalAOIdd INlJl-I 9NlIJ33NION3
.g
WELL DATA
MUNICIPALITY OF ~-,,-~CH(M~4~CIPALITY OF ANCHORAGE (MO~l
.P.ow
' PEOTECTCONcHECKLIST - FEBRUARY 1984
JUL 6 g87 264-4720
RECEIVED
Well Classification /¢'-/- If A. B. C, D.E,C. Approved~N)
Welh ogL.~resent (Y/N) Date Comp,mea Y~
Total Depth'"'-~_ ~ Cased to Depth of Grouting ~/
Static Water Level~'~'-~ PumpSe~.DAt~'~-
Casing Height Above Ground _~_ Sa~I]W r~y SeeJ on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) ~"'~/Depression Around Wellhead (Y/N)
Separation Distances from Well: /.~.-~'
To Septic/14oldi~ Tenk on Lot ~./'"-~ ~ /,j'- ~'~ing'"- Lots
To Nearest Edge of Absor 'l:).t. io~n Field on Lot ?¢~ ; On Adjoining ~
To Nearest Pu;l~ne To Nearest Public Sewer
C~a~ ho, le~ ~ To Nearest Sewer Service Line on Lot
Wat~--Sample Collected by : Date
Water Sample Test Results
Comments
SEP']'IC/FI~ TANK DATA
Date InstalleR~"-Z'¢/- ~'7 Size /~)~O~ No.
of Compartments
StandpipesON) _ Air-tight CapsON) Foundation Cleanout (~N)
Depression over Tank (Y/~ Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) . ~/' ~ for
Holding Tank High-Water Alarm (Y/N)ILJ//~4-~/rL Temporary Holding Tank Permit fY/N) /,,tJ'/,/-~
Separation Distances from Septic/.He--Tank:
To Water-Supply Well ~.~:g:)
TO Property Line
To Water Main/Service Line /"~)
Course
To Building Foundation ~...~ I.~
To Disoosal Field ,'/,~'
'Fo Stream Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well ~.'~:::'~ /"~'
To Building Foundation ~_~.,.¢.
Lot "Q/,~
/'~'~ ~/,¢~ Type of System Design
Length of Field '2-'¢)
Depth of Field /'~
Gravel Bed Thickness ~'~"
z¢&'/-lz '¢ Standpipes Presen~N)
/4.//~ Date of Last Adequacy Test
To Water Main/Service Line ,/z::;, ! '/-
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ~/./....
To C,~b,~k (if present) /'J,~
D. LIFT STATION
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments~~'~
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at ~---~-~
** Check Permitted Bedroom Rating Against HAA Bequest **
,~(~i~lll~lNl~l~l~ecked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Date 4/~a~//'~7
MOA No. ~,~--¢-)¢ ~
£a~Jo RJvor~ AIniRa 9~77
Company
No. ¢
Date of Payment ~ ~ ~
Amount: $ /~, OD
Page 2 of 2
72-026 {11/84)
NkuNIctPALITY 0~: ANCHOr^GE
~NviRONMENTAL sERvICES DiViSioN
, JUL 6 1987
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA gg501
7~lephone: (907}
Address;
274-2533
DATE: Ju]_¥ 2, 1.__987
PWS 1.0.# 21143]
To Whom it May Concern:
According to records on file in this office the
Water Regulations
[)AWN WATER CO,
Water System is in compliance with the State Drinking
for monthly bacteriological smnpling.*
Sincerely,
M~chae~ ~, Lew~s
NUrE:
However, our records indicate that DAWN WATER CO. is
a grom~dwater source, and as such, is required to sample
PRIMARY INDRGANICS ever7 three (3) years. The last PRIMARY
INDRGANICS smnpling on file is; 2-16-83 A current
sal~ole is due IMqEDIATELY.' .......... '