HomeMy WebLinkAboutZANTHA VISTA BLK A LT 2
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U /,z4,:v 144 y. i
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M,UNl'C"'lP"",,,PqUlTY ccrxr- ANCHORAGE
MAIM=
Develoornent Services Deparmient Rhone: 907-343-7204
A
Ori -Site Water,& v,Vastewater _17-ection Fax: 901-343-7997
Pump Instailation Log
Well Drillimy 11crin-11 Nwinbxor: Date of Issue:
Par cef Identification ,NT,,a0e,-: 5--f72— 0
Leaai D?: cri.ption
Blvck
Lot
Property Owner N.-iirecEa Address:
6F 0
Tan,4j n,
V
Pu. -n!,- Iniblialion Daie:.i
Pump Intake Depth rlekNvTop of'W?ll
feet
Pump M-Anufacruni's Nrmke�
Pump iModul-.
Pump Sizo: — " �111:gyL --hp
flitless Adopter Burial Depth:. i: felA
Pine!!! Adapter iNlanufacturers
PffieSs Adapter Insraller...:k
W01' Disinfected Lpon Compledor? Yes Ej :gin
Method of Disirfection:
collillunik:
Pump ITISI.IlHor Name -r;-
compaln:
-3 �zL_,,L,2fz�s :7_ 2,?,
State•. 7 -
ZIP.
Asterktio- . 1 1, 5 U " I
w Thu p"mip inslaller ShalO prov;'(3z. a Pump instollatior io,, w, On-site withill -;(.) `a�r oFp nin insallation.
Address
Phone(s)
Lot I Block
MUNICIPALITY OF ANCHORAGF
DE~ ITMENT OF HEALTH AN[) HUMAN SER\ JS
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPFCTION REPORT
DISTANCES
SEPTIC ABSORPTION
TANK FIELD
Permit No /No. o, ~;rooms WELL
FOUNDATION
WELL
TANKS
[] SEPTIC [] HOLDING
TYPE OF SYSTEM
_TRENCH [] BED [] W, DRAiN [] OTHER
AS-BUILT DIAGRAM (Show [ocatlo¢ el well sephc syslem, property hnes, Ioundebon,
Fill added above original grade
[] PRIVATE ~J OTHER fldentifv)
Installe~ f ale i~st-alled:
RFMARKS:
Scale: I' -' ~O
Inspections Pedormed b
lecli0n was pedOrnled according to all
Municipal and State gt
Health Depadmenl Approval: --.
72-013 (3/85)
ENGINEER'S SEAL
,, ;~ o ~!. ,~ , ,~'~)
:,~. [~¢~/%f- . ',,
GAAB kid I
Gr': ~I'ER ANCHORAGE AREA BORO[~"'H
HEALTH DEPARTMENT
327 I:'AGLI:' ST. ANCHORAGE, ALASKA 99501 279-2511
iNSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
D~STANCE
LIQUID CAPAC}TY.
GALLONS.
MATERIAL ,~' ,~,~o .~.,/~,, NUMBER OF
.COMRARTMENTS
9' ~ L'OU'D ~--'
INSIDE LENGTH INSIDE WIDTH DEPTH_~
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERSAI
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER ,LENGTH , DEPTH
(~ 0/'~ C~..,~r~'*.~.. BUILDING FOUNDATION
. TOIAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~OO SQ. FT.
OR WIDTH.
D~STANCE FROM WELL
TII_E DRAIN FIELD:
TOTAL LENGTH
DISTANCE PROM WELL FOUNDATION , NEAREST LOT LINE__ , OF LINES
NUMBER OF LINES _DISTANCE BETWEEN LINES____ TRENCH WIDTH
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH IILE tN. ABOVE TILE.
TYPE .0EPT. .BU,LD,N EO NDA.,ON. SAMPLE , NEAR..
WELL:
IN. TOTAL EFFECTIVE
DISTANCE FROM WATER
NEARESt SEPTIC ,~,.~' SEEPAGE //OO!
LOT LINE ., SEWER LINE , TANK , SYSTEM , CESSPOOL
DIAGRAM OF SYSTEM
OTHER
, SOURCES__
DISTANCES:
A-b =
HEALTH AUIHORIIY
DArE APPROVED0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorago, Abska 99501 264-4720
SOILS LOG -- PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
1
2
3
4
5
6
7
8
9
SLOPE
DATE PERFORMED:_~/~
/ ' SlTE/PLA~'
10
11
12
13
17
18
lg
20 4~..:,;:-~
WAS GROUND WATER
"r/~ ,.,.,~.~JZ,... E,.,CO,~NTERED? /¢' _ ~
~OIFDEPTH?YES'ATWHAT ~/.,.,~¢~ A/Q, E
COMMENTS
PERFORMED
Reading Date Gross Net Depth to Net
Time Time Water Drop
.7/I ~ I
PERCOLATION RATE
TEST RUN BETWEEN -?~_'~ ! FT AND
CERTIFIED BY: 'T~,
(minutes/inch)
/0 __ ~T
72-008 (6/79)
, i MUNICIPALITY OF ANCHORAGE'
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ii :
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL,
OF ON-SITE SEWER AND WATER FACILITY
264-4720 :,
GENERAL INFORMATION
(a)
(b)
(c)
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Name [~/~.~_~ Telephone: Home ~V4 '
I
Applicant Address
Application'Date. ~ *~"glr I ~ ~ ~
Business
Applicant is (check one): Lending Institution []; Owner/builder ~; Buyer []; Other [] (explain);
(d) Lending Institution ~,[~..m_ '~..~, [~e_ Telephone
Address JO1 ~ ~f...4,4 .~-~%,4 ~
(e) Real Estate Company and Agent ~O~
Address
Teleph.one
(l) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single-Family ~, Multi-Family [] Other
Number of Bedrooms
WATER SUPPLY
individual Well~ Commu'nity [] 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
NO~:~t'~f c~om mP;bnlii,; ~el, .' ~:,~, Ur~i~;t ~ave Hw~il2ienngc~;~ i [rr~tion from the State Department of Environmental Conservation
attesting to the legality and status. ~
Page 1 of 2 72.025(11/84)
5. ENGINEERING FIRM PROVID Nb NSPECT ONS TEST=
., ,-,, .. ~,-,- v,.-,-,[m~.,n, u~l/~ A~u INPURMAT ONh:~ r I[ ~ :' ~ I I '
As ce~ified by my seal affixed hereto and as of the varidation 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 fu~her verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-ske water supply and/or
w~stewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the dete of this inspections. ~_
Address / ~ ~ /~ '
Engineer's Seal
· 6.
DHEP AI~ROVAL{?~ /~
Approved /~,,Y DisauDrovecF Con i'
Terms of Condilior)~l Approve{
CAUTION.
The Muncipality of Anchorage DePartment of Healt'~ and Environmentm 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 end their lending
institutions in order to 8atisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate i8 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)
WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth
Static Water Level
MUNICIPALITY OF ANCFIORAG;~
MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEAt.TEl &
HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION
· 1986
CHECKLIST- FEBRUARY 1984 ,IIiI ~ ,.~
264-4720
'~ If A, B, C, D.E.C. ,~pproved (Y/N)
Y' Pete Completed __ ',~/~') Yield
· ,"?~-" '1 / ;il ..~
Cased to /,---~ Depth of Grouting
Casing Height Above Ground ___/,~-//
Electrical Wiring in Conduit (Y/N) ~Y
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot -~,,~)/ ; On Adjoining Lots '~./~ /
To Nearest Public Sewer Line /vy~/,z~ To Nearest Public Sewer
Cleanout/Manhole ~//:~ To Nearest Sewer Service Line on Lot
Water Sample Collected by .-~), &4,*~./.V' ;Date .,~/~Z/~''
; On Adjoining Lots -,'~,Z~ /
Water Sample Test Results
Comments
SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N) y /
Depression over Tank (Y/N) A~.tir-tinh
Caps
(Y/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 ~,,,2
To Property Line ' ~'~.~-~ /
To Water Main/Service ALi7 _ ~._ ~',~'~") Course
__ No. of Compartments /"
y Foundation Cleanout (Y/N)
Date Last Pumped
Temporary Holding Tank Permit (Y/N)
To Building Foundation"~'"~
To Disposal Field
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 I ~ ~ Type of System Design
Date Installed ~
Width of Field ~ Depth of Field I
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last A. dequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ~ -.~_~/
To Cutbank (if present)
Separation Distance from Absorption Field:
To Water-Supply Well
h
To Building Foundation _
Lot A///
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area __
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 **
I certify th,a~ have checked, verified, oY~onformed to,,~ll MOA 8nd HAA guidelines in effect on the date of this inspection.
Signed '~,., ~.~, ?'~~/ Date
Company /'- MOA No.
ReceiptNo. ~O~J ~OI ~
Date of Payment ~ ~.,~ ~
4..
Page 2 of 2
.:-,t .'.:
'..W ~ ~ ~ ANCHORAGE, ALASKA 99501
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
SEPTIC SYSTEM
ADEQUACY TEST
LEGAL: ]LOTS 2 & 3, BLOCK A, ZANTHA VISTA
LOCATION: 10900 TRAILS END
OWNER:
WAYNE BOEDECKER
RESIDENCE:
WELL:
SINGLE FAMILY, FOUR BEDROOMS
PRIVATE, ON SITE
SEPTIC SYSTEM:
FROM MUNICIPAL RECORDS:
TANK: STEEL, ONE COMP. 1250 GAL.
ABSORPTION SYSTEM: CONCRETE CRIB AND TRENCH
ABSORPTION AREA: CRIB 300 SQ. FT.
TRENCH 270 SQ. FT.
SOIL RATING: 100
INSTALLATION DATE: 1969 AND 1982
DATE OF PUMPING: JULY 26, 1986. ANCHORAGE CESSPOOL PUMPING
DATE OF TEST:
JULY 7, 1986
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS
FOUND WITH 5 FEET OF COVER AND WITH 44
INCHES OF LIQUID. CRIB WAS FOUND TEN FEET DEEP AND WITH 4 FEET OF
LIQUID. SUMP FOR TRENCH WAS 11 FEET DEEP AND WITH 5 FEET OF
LIQUID.
WATER WAS ADDED TO THE TRENCH AT A CONSTANT RATE OF 6 GALLONS PER
MINUTE. THE WATER LEVELS IN THE 'DANK AND SUMP WERE MONITORED. A
TOTAL OF 450 GALLONS WERE ADDED. THIS CAUSED THE WATER LEVEL IN
THE SUMP TO RISE 11 INCHES. THE INFILTRATION WAS MONITORED FOR
FOURTY MINUTES. DURING THIS PERIOD THE WATER LEVEL IN THE SUMP
WENT DOWN 8.5 INCHES.
TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends en the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of ~,~'~e~,~.~q. system. We can therefore not give any estimate of
hc~.~.~g~h~tem w~ll continue to meet the o erational re ui-
"J~ '_ 4 '~'~ , . . P q
~nts ~ the.:,~gnlclpallty and State.
~,.~ ..... ~. ~,,;
'-..,,; ~ ~ ~ ANCHORAGE, ALASKA 99501
CONSULTING ENGINEER TELEPHONE: 1907) 279-3916
RESIDENTIAL
WELL
INSPECTION
LEGAL:
LOCATION:
OWNER:
TYPE OF WELL:
WELL LOG AVAILABLE:
INSTALLATION REQUIREMENTS
WELL YIELD FROM WELL LOG:
WELL YIELD FROM TEST:
PUMP YIELD:
DATE OF INSPECTION:
TEST PROCEDURE:
LOTS 2 & 3, BLOCK A, ZANTHA VISTA
10900 TRAILS END
WAYNE BOEDECKER
SINGLE FAMILY
YES
MET: YES
3 GALLONS PER HOUR
.75 GALLONS PER MINUTE AT MAX
DRAWDOWN
4-5 GALLONS PER MINUTE
JULY 7, 1986
WELL WAS PUMPED DRY AND THE RECHARGE RATE
MONITORED WITH AN ACOUSTIC PROBE. STATIC
WATER LEVEL WAS FOUND AT 37 FET BELOW TOP OF CASING. TOTAL WELL
DEPTB WAS FOUND TO BE 75 FEET. WELL RECHARGED TO 70 FEET IN TEN
MINUTES. THE RECHARGE RATE DROPPED OFF AS THE WELL CASING FILLED
UP. BETWEEN 59 FEET AND 48 FEET THE RATE WAS .45 GALLONS PER
MINUTE.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
JULY 9, 1986. TEST WAS NEGATIVE.
TEST RESULT:
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours.This well surpasses this requirement.
The assessment of the condition of this well applies only to 'the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from 'the
surf2.,a~,~%~4~changes in land use and other factors that may
im~, ~./.~h~%tions of the aquifer feeding the well.
~',~.'~ ,~ "~'~h~i~
~ ,' JUNE 2a~1971 .~