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Home My WebLink AboutWOODBOURNE BLK 2 LT 7 MUNICIPALITY OF ANCHORAGE DL rMENT OF HEALTH AND HUMAN SER, 3 ~ / ~ ~,~> J Environmental Health Division JS25 %" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl. INSPECTION REPORT Address LEGAL DESCRIPTION TANKS ~i( SEPTIC off TA [] HOLDING TYPE OF SYSTEM TRENCH "~ BED J~ W. DRAIN [] OTHER ~-~ f--.~ FT FT ~ Ft WELLS ~,, PRIVATE [] OTHER (Identify) t ' - 12 P-: ~ F'r FT REMARKS: DISTANCES ~R 0 M~ SEPTIC ABSOflPTION TANK FIELD WELL WELL / I o /~0 /' -- LOT LINE ,'~ 0 "(' ~ ~ -j' ~ 0 '1" FOUNDATION ~_ WELL Inspections Perlormed by: , I~lunJcipal and 81~le guidelJ[leS in elfecl on this da(e: __ ceflily thai lids inspection was perlornled accordillg Io 811 ENGINEERS SEAL :' ;'%' 4?--' ! ', ,'~ 72-013 (3/85) ~ 4°- T- .or ,,p~oo o. ,,..~,,,., .,,,~*.,,~,o~ :,,,,, , . , '.*. ~.~ Anchor,ge Recording P,,oinct, Alaska I hereby corlify that I hove surveyed ihe property shown and described in question and thatthere are no roadweys, uti!ity Ilnes or other visible /~.0 = ~0~.~ Prepared by: (',907.]2?9-6£00 Property l.. , urro v R~/~t~r~d L~nd Surveyor ~19 W, Eighth Ave. Anohor~g~Alos~o 99~1 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 13- 14- 16- 17- 18- 19 20 ~' 'J~ '~ / (ENGINEER'S SEAL Municipality of Anchorage ,-~, ','- · ' DEPARTMENT OF HEALTH & HUMAN SERVICES ~ ~?o° ' " 825 "L" Street, Anchorage, Alaska 99502-0650 ~ ~r · 4 9 ~ ~ SOILS LOG -- PERCOLATION 'rEST '~ ~,t /~'. JUNE 2b, LOW ~, ~ ~, ~oOb~0og~nship, Range, Section: ~ ~'~ I'~N ',' SLO.~ S~T~ ~A~ ' WAS GROUND WATER ENCOUNTERED? S L 0 P E IF YES, AT WHAT DEPTH? [leplh to Waler Alter fdonllorlno? ~0 Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minu[es/inch) PERC HOLE DIAMETER TEST BUN BETWEEN FT AND FT ^CCOROANOEW'T"^ELSTA/TE^NDMUN'OP^LGUDELNES'NE OTON'N,SO^,E ATE 'L l , 'Ze7 IN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 10 11 12 13 14- 15- 17- 18- 19- 20- 1 2 3 (ENGINEER'S ,SEAL) DATE PER FOR~¢?'C-~ ~ Township, Range, Section: S SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? [tepth lo Water Aftor Date' _~J/~/~7 Monitoring? N O . _ I- N Reading Date Gross Net Depth to Net Time Time Water Drop ~/~ o 0 0 ~. - _~ ~7/ fB i" '~ '7' 7[~ ," COMMENTS PERFORMED. : ACCORDANCE WlTFI ALL STATE AND MUNiCiPAL GUiDELiNES iN EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85} PERCOLATION RATE /-~,~ (m~nules/inch) PERC HOLE DIAMETER __ TEST RUN SETWEEN (~ FTAND ~,"~ FT CERTIFY THAT THIS TEST WAS PERFORMED IN a) Total lot area available for original plus the replacement septic system at Woodbourne Block #2, Lot #7: Lot Area = 94500 sq. ft. Less well radius and house Less lot setback requirements Less road area 14' by 200' Less organic disposal pit area 94,500 7,850 13,700 2,800 10,000 Available area remaining for a replacement septic system (four bedroom house requires 8,000 sq. ft. ) 60,i50 sq. ft. b) Topography of the lot consists of a gentle constant slope toward the northwest corner of the lot. There no surface water. 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 YJg GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner ~ .~,'A ~ O/~ Mailing Address 'Z..O (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Telephone: Home ,~,~"" ?~ el Business Telephone Address Telephone (e) Mail the HAA to the followino address: or: Check here [~ if hold for pick up. phone number below. List contact person and day -.~ ,,,~ ,~~ ~,'~ 'q. ~ q I ~ TYPE OF RESIDENCE Single-Family/~ Number of Bedrooms WATI--R 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: Iffcommunity well system, must have written confirmatior~ from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 fRev 8/86i Fronl leUO!SSajoJd aqi u! euo!ee!Luo Jo sJoJJe Joj elqjeuodseJ jou s! e6eJoqouv ~o/%j!led!o!un~ eq/'penes! e! eleo!j!peo e aJo~9q 81ep eZ/~leUe Jo suo!loedsu! lonpuoo lou op SNH(] jo S~e~oIdLU~ 'elUeLUeJ!nbeJ ~jeje pLJe leJepe~ u!eJJeO ,{is!lee oj JepJo uf suoiJni]lsu! 6u!puel J!eql pue seuJoq jo sJeseqoJnd oi,~sel,lno3 e se siqj seop SH Ha eqJ. 'e)~Sel¥ jo elel$ eql u! peJels¢~eJ ~aau!Oue leUO!SSejoJd luepuedepu! ue/,q a^oqe B qdeJl~eJed u! ua^!8 suo!lelueseJdeJ alii uodn ,{lUO p@seq sejeolJ!~Je3 le^oJdd¥ /~lpolilnv qlfeeH sense! (SHHQ) sag!AJeS ueuJnH pue liII~eH jo ~U@LUpedea aOeJoqouv jo ,%!led!o!unl/N eqJ. leUO!j!puoo leAoJddv leuo!i!puoo jo suJJe.L pe^oJddBsiC] ~ p~AoJdd¥' ,{q euJooJpeq .~ JOj pe^oJddv T~AOl:ldd~' SHHa '9 lees s. JeeU!eU3 .g I. Ig/PALITY OF ANCHORAGE (MOA) ~ ¢¢~ ENVIRONMENTAL $ ERViC ~1~ ~'~ U .u ,.. ( ) CHECKLIST - FEBRUARY 1984 ~'J~,~,R 2 5 J~!~88 264-4720 - .. Legal Description: J.,~_'"r "Tt/''~ ~ ''~ - R[CEIVED WELL DATA Well Classification ~--', ~--- -¢-~ IfA, B, C, D.E.C. Approved (Y/N) ~ Well Log Present (Y/N) ~/* _ Date Completed _ I ~, J ~", ~,"~ Yield Total Depth. I.~ ? __ Cased to __ J ~"~ Depth of Grouting ,~ 0~¢'~. Static Water Level / I Casing Height Above Ground /~.~ Electrical Wiring in Conduit (Y/N) ,,~ Separation Distances from Well: To Septic/Holding Tank on Lot Pump Set At ~, e ~' 'TO/-4 Sanitary Seal on Casing (Y/N) ~ Depression Around Wellhead (Y/N) ~ ; On Adjoin ng Lots To Nearest Edge of Absorption Field on Lot _ / ~,O ¢' To Nearest Public Sewer Line Cleanout/Man hole Water Sample Collected by _ Water Sample Test Results __ Comments ; On Adjoining Lots __ To Nearest Public Sewer Nearest Sewer Service Line on Lot ;Date _ I. ! ,. B. SEPTIC/HOLDING TANK DATA Date Installed ~ ~ '"~ _ Size 1~¢'~'*.,~O No. of Compartments _ T Standpipes (Y/N) "T~¢:~ Air-tight Caps (Y/N) ~'~'/' Foundation Cleanout (Y/N) Depression over Tank (Y/N) t~/ Date Last Pumped ~"~_ To Property Line To Water Main/Service Line Course Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well /~' ~ Temporary Holding Tank Permit (Y/N) J~//'/~,~ To Building Foundation ~ "~' To Disposal Field / O To 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/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation ~""O Lot ~'~ I~ ~/~'' To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test '/7 5/-5' TO Property Line To Existing or Abandoned System on ;On Adjoining Lots ~¢ To Cutbank (if present) NoN Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments Check Permitted Bedroom Rating Against HAA Request Is~rn ief~ t hat~,ve c~c° n f~ratrreed~¢A~g uidelines in effect °n t he date °f t his inspecti°n' Company MOA No. Receipt No. Page 2 of 2 72-026 I11/84} Engineer's Seal