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HomeMy WebLinkAboutWOODRIDGE BLK 2 LT 15Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP121276 PID Number: 020-093-23-000 Dwelling: ❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑ Upgrade Name: James Dahler ABSORPTION FIELD 01 Deep Trench F-1ShallowTrench E] Bed F-1Mound Address 4931 Woodridge Circle ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-223-1667 4 1.2 GPD/SF 9.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.5 Ft. Gravel depth beneath pipe 5 0 Ft. Subdivision Block Lot Woodridge 2 15 g Fill added above original grade 0.5 Ft. Gravel length 55 Ft. Township Range Section 11N 3W 3 Gravel width 3.0 Ft, Beds: Number of Lines 1 Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 550 Ft 2 1 N/A Ft. Well 175' N/A N/A N/A TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity I Surface water 100'+ N/A N/A Gal. Material Number of compartments Lot Line 10' N/A N/A NA Foundation $5' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain N/A N/A N/A N/A Gal. Remarks Diverter Valve installed so homeowner Pump on level at in. Pump off level at in. High water alarm at in. can switch between drainfields Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank Tank to ASTM-D3034 drainfield James Dahler (homeowner) DrainfieldASTM-D3034 CO/MT ASTM D303'4 Inspector Greg McConnell P.E. BENCH MARK (Assumed elevation) _100.0 ft Inspection dates: �s` 10/12/12 2�d 10/23/12 Location and description 3d 4"' Garage Concrete Floor Surface COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL , n Conditional Approval: Date.,z' 0. 49 000 GOAY L. Mc0pN • �• Approved ��'�� Date 1 a0�0 j:ZCF 1016,3 N�u�� e �t, .+'.` low ��ONP�.� wNccuUn MUPUIt_a- i - IZ.uoc Ln 00 J W � W O J W W > Ov z z l� \ \�Z O \\� \\ \Z a� \ \�� v OLfi \ O Y a z `t ►--1 W Z Z W d 1- O W (n !n W� W Q Cl) � W O \ Z II \ cn J \ W W W I- cr� \ �.I Z_ <_j< 1 Q J Q S' W O uj CLu v ` �P .N,00 mss' AW Aor : o � 2 4d 0 g o• �cn® AW i ®®l6 • . SAW �F44ft® Z o_ a' 0 xm W � O [� W O � p o � � N w � W U I H p U � rn i/�pQ o� o � ago N N ,- �O�O O Q N .. 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LOCATION DISTANCE TO: ]Well Manufacturer ~ I~ ~.~.~-~ I ABsorp;~o:~area No. of lines Length of each line Top of tile to finish 9rode _b 4 Width Crib diametm Foundation Total length of lines Material beneath tile Depth Crib depth Dwelling Material 'French width '~O inches NO. OF BEDROOMS PERMIT NO. No. of oompartments Liquid depth PERMIT NO, Liquid capach¥ in gallons PERMIT NO, Distance between lines -~q'5 PERMIT NO. Total effective absorption area Well Building foundation Nearest lot line Sewer line Depth DISTANCE TO: Building ~ndation OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER Distance to lot line PERMIT NO. Septic tank Absorption area(s) Fq:!]::/PI 1 I NQ: DA lei: .[SSUI]LO:I E;ONIACT I:::q"IC3NE: 05 / :1. 2 lii~6 BL. OCI::: ,~ ;2 opt i on ~il ava i I ab I e t o you ii~ 1::16.¢s~ :). i.:)1'1 :i. n g yf:;)t.~l' sep't'. ;i. c: MUST ItAVE. Al LEAS] IWO COMP~./R"I'MENTS ] c!.:~J"t:i fy t. hat 1. ] arfl {aifl:L],:j. al' t/,~i'!Lh 'LIp.,:~ f'l::,!<]L~j.r'~!f~16!r'Ul'.!i lop orl.-,~i;i, tE,~ ~5(~;,~WEH"E~ al]d wells as set {ovt. h by 'Ll~e Mun:i4::ipal:i,'Ly oF Ar'lcl'~e~r'ago,;, (MOA) and the State c:,F Alaska. ;;;.',, I w:i, 1]. :(nstal], 'Ll~e systcCm in ac::cor'dal~c:e wiLh all HOA c:cides and cogulat:i.c)rt~h, al]d J. rl (][)r~ll:)] Jar'lc::~); w:i.'LlJ t:.he dc, s:i, gn cr'iL<~p;i.a of' 'Lh:Ls per'm:i.L. 3,, I w:i.].l adhepe 'Lo ail MOA and StaLe of A].asl.::a i'~:~quJ, r'(,.:qn6xrLs fc~l" Ll'~c¢ s~md'.. [:)ac:l< ~B(LCW(:..H'a(~J{':, fSy~B'i'.(.?ifl C)I] 't.h:Ls (;;)1' any ,k<tcl.j;q~l:::l~Df'i't;. Ell' n{zCal'by lo'L. 4,, ]] LtIi(:Jio~I"~=YILaIiC.I thaL 'Lliis pepmi'L J.t~ val:i.d fop a f~ax:i, itH..lnl E)J' 4 bedl*ocx'ns ar'id any c.~ ~ :1 a p ge)mcr rt. IF: A L.IF'I STAT.I;CIhl ]:S iNSI'AL.I...E{D IN Ahl AI::~E.A C[3V[~];;~ED BY MOA BUIL. DING C[3DELS, II-IELN (1) AN EI..E(3FRLI:C~.M... I;)ERMIT AND INSF'Ei]'I'IDN MUST )})[E OB]'AINED; (2) AS."EIUILIS WILl... Ixl(]'l' I.JE AF'PROVEiLD WI'f'HOLI'I' AN IEI..EZCTRICA[. INSF:'IEE;I'JX)I~I I;:REFq]R'Iil AND (;5) ]'lie EI...I:LE;TI:RICAI... WORK MIJ~:3'I BIE DONE BY A I..]:(:.;Elxl',31~:l) IELI~:CFRICIAN,, AF:'PL CAN'I2 E,J. LL.. L..OVEI_A[;I:: PERFORMED FOR: Municipelity of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: gO'qL ~:~:~ I~la~ Z ~t~oa,,~t"~,,~eT°wnship' Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE WAS GROUND WATER ENCOUNTERED? ~/0 SITE PLAN DEPTH? Deplh to Water After M0niloring? _ '--" Reading Date Gross Net Depth to Net Time Time Water Drop . _ - PERCOLATION RATE_~*q. _ (m~nutes/mch) PERC HOLE DIAMETER TESTRUNBETWEEN _ ~ _FTAND ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFF~s.~ ON THIS DATE DATE 72-008 (Rev. 4185) 1201 P.,cNlOIl/iS,t.. 99515 175 SIX INCH WATER WELL DRILLED ............ OUT TO THE DEPTH OF ~19. oo DRILLED AT THE RATE OF PER FOOT, 160-175' ~17.00 p.e..'~, fL. PROPERTY OWNER _ //JR., & /]~&a,,__(J)c/z~ 4 ,.~.,t~) C~.on/O/.~e..,?. 333-6012 LOCATION OF WELL SITE_ DRILLER ~e2up6e. ~ WELL LOG: 0 .... 17~ S,LL.O> ~wzd. t> cjA~.~e.L. 17---39' (j/uztre.6. SeuezwC ,orazz~6 .bou2xt. e~. , vic ~.. 7oZa-L co.o& 0¢- ~e J).'M.2~cF opem_cvtZon.: ~¢19,00 pe.Z ¢~. 76;0--175 ¢'.L; $3,2~95o00 160 c%. ~'17.00 l:.e.*. M-, ./'~o~. CO$'I' INCLUDES ALL LABOR AND MATERIAL FOR GOMPI..ETION OF' SAID DRILLINg. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF ~.% 295.00 THANK YOU VERY MUCH. BERNIE Gl_AU, OF RAMPART DRIL~G~/)/ORKS DATE ,~ u,r?bd Jc SERVICE CHARGEOF 1Va% PER MONTH WILL BE ASSESSED ON PAST DU['-ACCOUNTS, ~¢/.cFe. o I5:1.0 "Tim I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF FNVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 15 Block 2 Woodridge Subdivision Location (address or directions) (b) (c) Property Owner Paul/Lia Cloninge~elephone:Home 333-6012 Business Mailing Address PO BOX 112713, Anchorage, Alaska 99511 Lending Institution Home Savings & Loan Mailing Address Telephone (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followino address: or: Check here [], if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family [~xx Number of Bedrooms 4 (four) WATFR SUPPLY Individual Well J~ 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 Onsit~J~x Public [] Community FI 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 1 of 2 72-025 fray 8!861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AN[:) 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, functional 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 suppJy and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection, Name of Firm Barter & Associates Telephone 346-1170 Address 10461 Hampton Date Engineer's Seal DHHS APPROVAL Approved for 4 (four) Approved ×*XXXXX Disapproved Conditional _ January 6, 1987 Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purohasers of homes and their lending institutions in order to satisfy certain federal and state requirements, Employees of DHHS 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. Page 2 of 2 72-o75 IRev 8'861 Back MUNICIPALITY OF ANCFIORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (e) Legal Description (include lot, block, subdivision, section, township, Location (address or directions) Ro Ap plica n t N a m e "'~0,,¢_~ (b) ~ L~R Cto,~,~P~ Telephone:Home Applicant Address (c) Applicant is (check one): Lending Institution []; (d) (e) Address ~:5 - G_o ~. ~ Business Real Estate Company and Agent Address Telephone ; Buyer []; Other [] (explain); __ (f) Mail the HAA to the following address; TYPE OF RESIDENCE Single-Family I~ Multi-Family [] Number of Bedrooms .~"~'P,.-.- Other 3. WATER SUPPLY Individual Well ~ Community [-] Public [] ': Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. ' /, 4, SEWAGE DISPOSAL Onsite ~ Public [] Community r-i Holding Tank [] Note: Il community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDIN~ ,NSPECTIONS, TESTS, FILE SEARCH, DA ,,. 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, functional 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 regulations in effect on the date of this inspection. Name of Firm ~-~- ~ ~A~.~,~es Telephone Address ~c-,~gl ~,~¢A.¢Jr-¢¢'- Date Engineer's Seal DHEP APPROVAL Approved for ~//'.~4/,-.~ bedrooms by Approved Disapp Terms of Conditional Approval ~ , I ///// Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. 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. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEAI..TH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264~4720 Legal Description: A. WELL DATA Well Classification '¢¢~u~-~re- Well Log Present (Y/N) }/ Total Depth _ Iq¢-~ _ Cased to Static Water Level 46) ~ Casing Height Above Ground Electrica! Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot 16% To Nearest Edge of Absorption Field on Lot __ To Nearest'Public Sewer Line ~' Cleanout/Manhole ~ If A, B, C, D.E.C. Approved (Y/N) Date Completed F~- ~'-~(~ Yield ,..~'c~. ~*,~_t "~ Depth of Grouting Pump Set At ~~. tS+ ~ ~"' Sanitary Seal on Casing (Y/N) Y Depression Around Wellhead (Y/N) _ /Water Sample Collected by W/~ter Sample -l-est Results 'Comments ; On Adjoining Lots [¢~. ~' _; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on ; Date I,~ -~ B. SEPTIC/HOLDING'rANK DATA Date Installed Standpipes (Y/N) "/ __ Air-tight Caps (Y/N) Depression over Tank (Y/N) N 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 f~- ¢'.-- 8G '-'~Size t P_..OO No, of Compartments ¥ _ Foundation Cleanout (Y/N) ¥ Date Last Pumped NEW ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field Comments To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026¢1/84) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALI'H & ENVIRONMENT^L PROTECTION 2 RECEIVED C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed &-12-8/~ Width of Field ~O , 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 Lot To Water Main/Service Line - ' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Commenls Type of System Design Length of Field Depth of Field I ~ '~' Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line ~e,+ To Existing or Abandoned System on ; On Adjoining Lots -- To Cutbank (if present) 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 ** I certify that I have~]eck2, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed J-,f'cJ~ ~ Date ~ 16;19~, Company ~ MOA No. Receipt No. ~ Date of Payment Amount: $ ~¢'~, Page 2 of 2 72-026 (11/84) Engineer's Seal