HomeMy WebLinkAboutSEQUOIA ESTATES BLK 1 LT 16Sequoia Estates
Lot 16
alock 1
#017-152-16
Jun 30 11 05:04p Beau Maxim 19073391985
Mark Begich
Mayor
Development Services bepar*ment
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmoce
P.O. 8.ox 196650
Anchorage, AK 99507
www. muni.orq/onsi?¢
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SW
Date of Issue:
Parcel Identification Number:
Legal Description
SEQUOIA ESTATES BLK 1 LT 16
Pump Installation Date: 0/02/11
Properly Owner Name & Address:
ROBERT A. VALANTAS
'6630 GUNN[SON DR
ANCHORAGE, AK; 99516
Pump Intake Depth Below Top of Well Casing: z'm. feet
Pump Manufacturer's Name: GOULDS
Pump Model: 05SBOZ4-12CL
Pump Size 3/4 bp
Pitless Adapter Burial Depth: t0 feet
Pitless Adapter Manufacturer's Name: CAMBEL
Pitless Adapter Installer:
Well Disinfected Upon Completion? [] Yes [] No
Method of Disinfection: RECIRCULATED USING CHLORINE PELLETS
Comments:
Pump Installer Name: BEAU MAXIM
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Municipality of Anchorage Page 1 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES BIVlSION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW000256 PIDNumber: 017-152-16
N~r.e: Wastewater System: [] New Z3 Upgrade
Robert Valantas
Add~e~s~0 Gunnison Dr. Anch., AK 99516 ABSORPTION
FIELD
IND. of Bedrooms:
Phone: 345--7065 . Four ( 4 ) [] DeepTrench [] Shallow Trench [] Bed E] Mound E] Other
Soil Rabng: Total Depth from origlnal grade:
LEGAL· DESCRIPTION GFD/Sq. Pt.
Su bdivkslon: Deplh to pipe bottom from original 9fade; Gravel depth beneath pipe
Lot: 1 6 Bl~k: 1 Sequoia Estates Pt. Ft.
Township: J Range: J Section: Fill added above original grade: Gravel length:
I
Ft. Ft.
WELL: [] New · E] Upgrade Gravelwidth; Number of {ines: IDistancebeiweenlines:
Ft. Ft.
ClasSification (Private. A,B.C): Total Depth: Cased TO: Total absorption area: Pipe material;
Existing Ft. Ft. SO. Ft
Driller: Date Drilled: Static Water Le~ek Installen 7 / 2 6 /
GPMIPump set at: Ft.I F~ TANK
SEPARATION DISTANCES ~Septic E] Holding [] S.T_E.P.
From Tank Field Station Ta.k Sew~rLines ! Anchorage Tank t ? 250
Wel~ > 100 ' Steel Two
Surface > 100' ' ' LIFT STATION - N/A
Remarks: Septic Tank Only Placed BENCH MARK
Under This Permit. Concrete Landinq at Bottom of
· . Front · Stairway.
Inspections pedormed by: MEA Dates: 1st 7/26/00,~,,~¢ '**,~-~;¢,¢'~*.',-,¢, ~,.~ ,o~%~ .¢.~,
Depadment of Health and Human Se~ices a reval .¢.
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744
On-Site Wastewater Disposal System or Well Inspection Report
Page 2 of 3
Permit Number SW000256
PID No. 017-152-16
GUNNISON DRIVE
Existing
Well
[istin(
/
Jocati(
Bedroom
House ~i- J
Not Exact)
NOTE:
Locations Not Surveyed. May. Not
Be Exact.
A B
S1 10.9 15.0
S2 19.2 21.4
C2 24.7 22.7
C3 26.3 22.9
PLAN AS-BUILT
SCALE1"=40'
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number SW000256
Page 3 of 3
PID No. 017-152-16
90.26
96.1
1 , 250 ~Gal
Sep. Tank ~ 90,06
To Existing
Absorption Bed
7' 6.9'
NOTE: Septic Tank and Post Tank Cleanouts Placed
Un~er This Permit. Existing Absorption Bed
Remains in Place.
PROFILE AS-BUILT
1" = 10'
'~£z.L
i]
N. 8D %:5'0 '. OC)"P'v: /~G. ?o '
WEST BENSON BLVD. 272-9231
"HORAGE, ALASKA 99503 582-5291
.AL DESCRIPTION: ·
.43
PLEASE NOTE; It Il Ihl contrect
LEGEND: SET FOUND
El8" REBAR · O
HUB & TACK I~ ~
MONUMENT ~ ~)
At-CAP ~ ~)
PK NAIL X
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 25, 2000
Expiration Date: Jul 25, 2001
Permit Number: SW000256
Legal Description: SEQUOIA ESTATES BLK 1 LT 16
Design Engineer: 0014 Anderson Engineering
Owner Name: Robert Valantas
Owner Address: 6630 Gunnison Dr.
Anchorage, AK 99516-3716
Parcel ID: 017-152-16
Site Address: 006630 GUNNISON DR
Lot Size: 49460 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [~ Septic Tank [] Holding Tank ~] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
July 25, 2000
Municipality of Anchorage
Department of Health and Human Services
825 ~'L" Street
Anchorage, AK 99502-0650
Subject: Lot 16 Block 1 Sequoia Estates Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The septic tank serving the four bedroom home on Lot 16, Block 1, Sequoia Estates
Subdivision has failed and must be replaced immediately to prevent a potential health
hazard and damage to private property We are therefore app y ng for a permit to olace
a new septic tank at the same location as the old tank to serve the new house. The
attached Site Plan and backup documentaticn identify the location and configuration of
the existing septic system and the location of the new tank. It also shows the location
of the oroposed well and its proximity to the septic system on this lot. The configuration
of the septic system will not change and all separation distances currently in place will
be maintained.
The ground surface on the lot slopes in all directions from the house location. The new
septic tank will be ptaced in a fairly flat area. The existing tank will be pumped, crushed
and either removee from the site or buried in place.
If the system is constructed in accordance with our design the following statements
apply:
The system, if constructed as designed will have no adverse impact on the wells
in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
The system, if constructed as designed, wilt have no adverse im pact on drainage
patterns in the area. The current drainage pattern will be
Sincerely,
Michael E. Anderson, P.E.
Attachments
LOT 16, BLOCK 1, SEQUOIA ESTATES SUBDIVSION
Existing
Well
GUNNISON DRIVE
Bedroom
House
Existin
~Absorpt
Trench
New 1,250 Gall,
Septic Tank
Tank
sCOpE OF W
1. Remove
2. Place Ne
3. Place Tw
4. Reconne
5. Regrade
6. Revegeta
RK:
nd Dispose Existing Septic Tank.
1,250 Gallon Septic Tank.
New Post Tank Cleanouts.
Existing-Absorption Trench.
,11 Disturbed Areas.
a Area As Required.
SITE PLAN
SCALE 1" = 40'
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 16, BLOCK 1, SEQUOIA ESTATES SUBDIVISION
GENERAL:
The scope of this project includes the pumping, crushing and removal
or burial in place of the existing 1,250 gallon septic tanks and the
procurement and placement of a new 1,250 gallon septic tank at the
location shown on the Site Plan. It also includes the construction of
two new post tank cleanouts. All disturbed areas must then be
regarded. A minimum of 4' of cover is required over the septic tank or
2" of insulation and 2' of cover.
Construction shall be in accordance with the approved site plan,
design drawings, Municipal Permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater
Disposal Regulations.
The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the
location of all lot lines.
Unless specifically agreed otherwise, the Contractor shall be
responsible for final grading areas subsequently depressed from soil
settling. Property owner shall be responsible for revegetation of
affected areas unless specifically agreed otherwise.
Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their own systems must receive
prior approval from D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. The new 1,250 gallon septic tank must be procured from an approved
source and installed at the location shown on the plans.
A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
3. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
4. Alt standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct
burial insulation.
A foundation cleanout shall be installed one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drainfield.
Lot 16, Block 1, Sequoia Estates
July 25, 2000
Page 2 of 3
7. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAINFIELD CONSTRUCTION (NOT THIS PROJECT):
1. The drainfietd shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. Rock should then be placed over the pipe
to provide a minimum of 2" of cover.
A silt barrier or geotextile fabric must be placed between the drainfieid
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
Contractor shall verify the septic tank and drainfield are a minimum
100' away from any private water wells in the area, 150' from a Class
"C" Well or 200' from any community well.
Direct bury insulation must be placed over the distribution system if
less than 3' of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trenches to drain away.
A minimum 2' of accepting soil is required below the drainfield rock for
a 5' wide trench. Contractor shall verify this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic
tank manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated
and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and
ASTM D2662 or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
~ Caulder, Fernco, or equal). '
Lot 16, Block 1, Sequoia Estates
July 25, 2000
Page 3 of 3
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing
the #200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These
inspections must be conducted under the supervision of a professional
engineer registered in the State of Alaska. The first inspection must be
conducted after the excavation of trenches, beds or pits and before the
installation of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement of the
geotextile fabric, gravel, distribution piping, standpipes, cleaneuts and
insulation. No backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction
notes for use in preparing the certified as-built of the completed system.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
~AME
VIAl LING ADDRESS
LEGAL DESCRIPTION
LOCATION ¢'
DISTANCE TO: I/Vt +
Manufacturer
[..iq.
IF HOMEMADE:
DISTANCE TO:
Manufacturer
IAbsorption area ~L~ ~ /
Inside length
13 I
D,w~lling
Material
NO. OFBEDROOMS
PERMIT NO.
No. of compartments
Liquid depth
Well Dwelling PERMIT NO.
Liquid capacity in gallons
F/~d at ion~..
Total length of I)nes
Material beneath tile
Depth
Crib depth
II ,
DISTANCE TO: 1~71~ ¢,
~_en th of Ch line
No. of,,.es O'
Top of tile to finish grade
Length
Width
Crib diameter
I Material
Nearest lot Ii b - !
Trenct) width
' C'~)' inches
Type of crib
Well Building foundation
DISTANCE TO:
Class Depth Driller
DISTANCE TO: Building foundation Sewer line
OTHER
PIPE MATERIALS
SOl L TE"~T~ RATING
INSTALLER
REMX~KS /
~'NEW
[] UPGRADE
P~E~.~)T NO.. .
Distance between lines _~..!
Total ~ffe~ti~ve.~sorp~.ion ~r. ea
Total effective absorption area
Nearest lot line
Distance to lot line PERMIT NO.
Sept c tank Absorption area(s)
APPROVED
DATE
LEGAL
72-013 (Rev. 3/78}
'DEF'RR. TNEN'F OF HERLTH RND EN',,,'IR-NMENTRL F'F.'_-TEI-:TION
825 '"L'" STREET, RNCHORRGE, RK '..--~95~.'-11.
254-472F_~ : FINCHORAGE 5'_--.~4-2i]:i : EF~GLE RIVER
PERMIT NO. 8S±0]:4
APPLICFINT: NEW i.,.tOR. LD INC PHONE: ]:45-~:854
R[:,[:,F.:ESS: PO BO.N :Li±]:±4
FINCHORAGE.. RI.::: S~95±:L
LE.~H,_ [:,ES,-.RiF'TI]N - SUB[:,IVISION: SEQUOIA BLOCK: - LOT
LOT SIZE 0 SQ. FT. TOWNSHIP: - RANGE - SECTION: -
I'tRXIMLIM NUMBER OF BEDROOMS = 4 SOIL RRTING= '.i?,-" .±,.'?,--' ±?? ,::SQ. FT. ,.."DR)
LISTED BEL. OW RF.:E THE OPTIONS AYFiILABLE TO YOU IN DESIGNING YOUR SEPTIC
SYSTEM. CHOOSE THE OPTION THRT BEST FITS YOUR SITE.
I.,.Ii[.,TH = 2. 5 FT.
LENGTH = ±±8. 0 FT. NOTE ' - _-:."7'5 FT. REQUIRES TWO TRENCHES
5 FT. NOTE ~ - REQUIRES INSULRTION
0 FT. NOTE ' - MFIY REQUIRE LIFT STRTION
2 CU. YDS.
0 GFtLLONS ,::"FRO COHPAF.:TMENT TRNK)
TOTRL DEPTH = 5.
GRRVEL DEPTH = ]-':.
GRR',,,'Et_ ',,,'OLUMF: = ]:8.
TFtNK SIZE = ±., ~5L'.~.
W I [:,TH = 24.
LENGTH = 48.
TOTAL DEPTH = . 4.
GRFI',,,'EL DEPTH = 0.
GRAVEL VOLUME = 42.
TANK S i -.'-'E = ±., 250. 0
WIDTH = 5. 0
LENGTH = ±24.0
TOTAL DEPTH = 4.5
GRAVEL DEPTH = ±.
GRAVEL VOLUME = 24.
TANK SIZE = ±,250.
I CERTIFY TFiFtT:
FT..
FT.
FT.
C'U. YDS.
GALLONS ,::TWO COMPFIRTMENT TANK)
][ E L [:, [:, E S ][ "3
FT.
FT. NOTE - }-?5 FT. REQUIRES TWO TRENCHES
FT.
FT. t'-,IOTE .- MAY REQLIIRE LIFT STATION
CIJ. YDS.
GRLLONS ,:.'TP.IF~ Cc~MPARTMENT TRNK)
±. i A!'"t Ft~MILIAR WI]'FI THE REQLtlREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPFtLIT!~.' OF FINCHORAGE AN[:, THE STATE OF ALASK8.
2. I WILL INSTF~LL THE SYSTEM IN BCCORE:,RNCE WiTH THE CODES AND HAVE RECEI',,,'ED
FI COPY OF TFIE CODE SUMMARY AND [:,IRGRRM ATTACHMENTS HHICH IS PART OF THIS
PERM I T.
3:. I UN[)ERSTRND THBT THE ON-SiTE SEWER SYSTEM I"IBY REQLIIRE ENLARGEMENT IF THE
RESIDENCE iS REMODELE[:, TO INCLUDE MORE THAN 4 BEDROOMS.'
PERMIT AF'F'LIE:FINT N~qS THE RESPONSIBILITY TO INFORM PERSONNEL DURING
THE INSTFILLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AN[:,
THE NLIMBER OF' RESIDENCES THFIT THE WELL WILL SERVE.
IF' ~ LIFT STATION i~ INSTALLED., B~.,I ELECTRICAL PERMIT AND INSPECTION MUST
BE OBTAINED. i::IS-BUIL]'S CANNOT BE 8PPRO',,,'ED WITHOUT 8N ELECTRIC8L tNSPEE:TION
REPORT~ THE ELECTRiE:BL WORK MUST DE DONE BY 8 LICENSED ELECTRIE:IBN.
S I GNE[:,: ~~'~~~
SOILS dbG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
LEGAL DESCRIPTION: ~"~' ~:~'~'" ~ ~:~
2
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
-'~-~C'~ '~,,,..~.) (~o.~::~ WASg~ROUNDWATER
~'~,,l~ (~.,".~ (~'4~.~ ENCOUNTERED?
DEPTH?
SLOPE SITE PLAN
r_.~~ s
L
O
P
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
· z '.q~ o , ~b
PERCOLATION RATE ~J ~ ~ (minutes/i
CERTIFIED BY: ~t - ~
DATE:
72-O08 (6/79)
Alaska F~p. viron, mentat Con. trol
k~er_ vice, Inc.
12(i)0 h'est 33rd Avenue, Suite
A r~ci%oraqe, Alaska 99503
Subject: As-Ruilt, Lot ' ~ Se,it c)qa Subdivision
f',.ear ~4ro Reid:
The er, giDoer"s as-buitts ~:hic.h }lave beep, submitted to tbi~= offic~
are Dot wit},il~ tho p~ra!-~otors of the oD-site iD~tslla~.iol~ permit
issued by thi~ depsrtr~oDt, The discrepancy tigteO below will
n~ed to be addressed before this depart~-~o~t cad ~ccop';- the sub-
mitred engir, eer's as-buitts,
,.% request foF 6 ~oo{'~ waiver betweot% ~=~.. ~-')~n~'~, bed
and lot line ,'-~ior to septic syster,~ iDstal]atioD,
ALASKA
b, UIROrlmeF1TAL COI TROL SI hulC{!S, InC.
I~nclineePJncI 8 ~nuironmenlal Studies
June 28, 1984
Department of Health & Environmental Protection
825 L. Street
Anchorage, Alaska 99501
Attn: John Kennedy
MUNICIPALITY OF ANCHORA(31~
DEPT. OF HEALTH &
ENVIRONMENTAl. PROTECTION
J U N 9, 9 1984
.RECEIVED
Dear John:
Reference my phone call of the June 27, 1984 for Sequoia Estates Lot 16.
The inspection form dated 12/5/83 shows the distance to the edge of the
bed to the lot line of 6 feet which is 4 feet closer than the 10 foot
minimum requir~nt. In early December of last year we contacted the
Health Department and asked if this would be acceptable and we were
told that it would be. However, at that time you and I beth know that
documentations of waivers were not being done but it was on a word
basis. We have looked at the situation and have found that there are no
on-site sewer systems located adjacent to this lot and we doubt that
this will create a problem in the future. The soils were 177
sqft/bedroom and the soils are such that the ground water flow curve
would be such that one would not expect it to cross that lot line under
these circumstances. We there by request that you waive the 10 foot
distance.
If you have any questions please let me know.
Sincerely yours,
PE
1200 UJest 33rd Aucnu¢. Suite [~. Anchora§¢. Alaska 99503.(907) 561-50/10
ALASKA
iUll OI Ill F TAL COF1TI OL
I~nqineeHnq 6 I~nuironmenlol Studies
May 9, 1984
Department of Health and
Environmental Protection
825 L Street
Anchorage, Alaska 99501
Attn: John Kennedy
RE: Lot 16 Sequoia Subdivision
iVlUNICIPALITY OF ANCHORAGI~
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTIOI~
1984 C) c)
.RECEIVED'
John:
I have reviewed the information available in our office concerning
this property, and do not know if this matter has ever been resolved.
From speaking with Jim Green, the inspector, it appears that this took
place during the transition period in which information concerning the
necessity of clearing waivers during the inspection was just reaching
our office. Up to this time, it was fairly routine to obtain a waiver
of 5 feet to the lot line in property with space restrictions.
Overall, I believe that this matter is tied to communication problems
between our office and yours, and would like to clear up any questions
which you may have.
The placement of the system within 6 feet of the property line does
not pose any health problem, and is situated within the clearly
defined property lines, ensuring that no disputes will arise over its
placement. I am aware that prior approval by the DHEP should have
been obtained, but considering the circumstances and general confusion
over procedures, it would appear that this matter can be best resolved
by obtaining a written waiver via DHEP. Should you have any further
questions, please contact my office. /
Sincerely, (~/~ (. /~ [
Harald R. g~hlers
Environmental Engineer
1200 LUgsl 33rd Aucnu¢. $ui1¢ B, Anchoro§e. Alosko 99503'[907) 56~-5040
A'LASKA ENVIRONI~r-'TAL Jo.. /-~
CONTROL A.-,..~,~lr.l~Vl~l:.~., INC. SHEET NO* OF
1200 West 33rd Avenue Suite B
ANCHORAGE, ALASKA 99503 CALCULATED BY ~ OD DATE
Phone 276-:136].
CHECKED BY DATE
.... Ma~ch ~5,84
Static Water Level 198
f~et
Gallons Per Minute 6
Draw Down N/A feet
Total Feet of ~asing 2i8
Type Material Drilled:
feet to
'10 feet Silty clay
feet
to. 40 feet fine sand
40 feet
tO 1,13 feet Clay
113 feet tO 117 feet Gravel/clay ,
117 f~et tO 145 feet Clay eravel w/i mnm water
145 foot to 120 foot C]a~ I ?r~vol
155) to 218 gravel w/ water
Hefty Drilling
S.R.A. Box 1553 H
Anchorage ,Alaska
995O7
(b) Applicants Nam~ L,~c_~u2~)o~[Q ~o~e~ ~. ~uC_
Applicants Add~e~s,s ~ tO 5-C)~NQU$7~ UJ~
(c) Applicant is (Che'ck one) Lending Institution
muye~ F----}; Othe~ ~ (explain);
(d) Lending Institution
Telephone % ~ ~'- '~'~_"/
~-~; Owner/builder ~;
Telephone P. ';G, - 19 I I
Address ~qS' ~ % ~z~-~-~ T
(e) Real Estate Co. & Agent
Telephone
2. T_~oe of Residence
Single-Family ~
Number of Bedrooms
Multi-Fancily ~
Other (describe)
3. Water Supply
Note: If cc~[~.~nity well system, must have w~itten confitn~ation f~cm the State
Department of Environmental Conservation attesting to the legality and status.
·
Is the well adequate fo~ the number of bedrccms specified in this HAA ) ~
4. _Sewage Disposal
Onsite ~ Public ~-~ Coi~uP, ity E~ Holding Tank ~-~
Is the wastewater disposal system adequate fc~ the numbe~ of bedrocks ~;~N)
2-15-84
Engineering Firm P~oviding Inspections, Tests, Data and Information
I certify that I have checked, verified, oF conformed to all ~DA HAA Guidelines in
Nam~ of Firm ~¢-5 Telephone ~-~[-5-OYO
Address
s gned by
Date
I oo u
(ENGINEER SEAL)
6. DHEP Approval
Approved for
Approved ~
~- kedroc~s
Disapproved
Te~s of Conditional Approval
Conditional
Date
The Municipality of Anchorage Depaz, tment of Health and Environmental P~otection dces
not guarantee the continued satisfactory performance of the water supply and/or the
wastewater disposal system. This approval indicates that, as of the validation date
shown above, based on the data and information furnished by an engineer ~egistered in
the State of Alaska, the water supply and wastewate~ disposal system is safe and func-
tional for the number of badrccms and type of structure indicated.
(DHEP SEAL)
7. Mail the HAA to the following address:
'
KB2/d5/s
[gage 2 oE 2]
2-15-84
MUNICIPALI?f OF ANCHORAGE (MOA)
HEALTH AU~qO~ APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Wgll .Classification ~
Well Log p~eSent~N) ~O >
~.~N'IC~*Ln"¢ 9F ANC"WO.I~k~I~
O.EFF. OF HEALTH
ENVIRONMENTAL PROT~"I'IO~ i
JUL 9, '1984
Legal Description: ~T/EI ~£ 5~4o~A
Total Depth~ 2J~'
Static Water Level-~
Casing Height Above Ground ~'
Electrical Wiring in Conduit~_(~N) ~ ~
Separation Distances f~c~ Well:
To Septic/Holding Tank on Lot /~-~, ~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line ~J J/~.-
Cased to ~- ,~l~"
/9' '2' At
If A, B, c:~ C, D.E,C. Approved(Y/N) ~/~
Date Completed ~-I..S- -- ~ y Yie~ ~//~,i~~
Depth of G~outing
sanitary seal on Casing ~)~5
Depression Around Wellhead (Y~
; On Adjoining Lots ~-~
; On Adjoining Lots G-T
To Nearest Public Sewer
Cleanout/Manhole ~ To Nearest sewer Service Lir~ on Lot ;~/f~-
Water Sample Collected By ~0~ C-oOQ~ ; Date -~s-~ FY /3:~o~
Water S~le ~st ~sults ~ ~ ~
~te Installed~ I~-~-~ Si~ I~O NO. ~ C~nts ~ ~'
Cleanout ~)
Sta~pi~s~) ~ Air-tight ~ps ~) ~3
Foundation
~pression o~r Ta~ (Y~ ~O ~te ~st P~d ~ ~
P~ing~intenan~ ~n~a~ ~ File (Y~) ~ ; for
Holding Ta~ High-Wate~ Ala~ (Y~) ~ ~ ~~ Holdi~ Tank ~t (Y~) ~[~
Sep~ation Distance ~ ~ptic~olding Ta~:
To Water-sUpply ~11 /5'q.q ~ To ~ilding F~ndati~ /O. ~'
To ~o~ty Li~ ~, 0~ To Dis~sal Field ~ ~ ~ I
To~t~~ ~_ ~ ~vi~ Li~ ~ ~ To S~e~, Pond, ~e, ~ ~3or ~alna~
cou~~: &[~ ?~
. '",: .... :; '..,':2,,~% · .....
[Page 1 of 2] 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed $' IP--5--q--~ Length of Field
Width of Field ~ ~.~t!
Square Feet of Absorption Area
Depression over Field (Y~_$~ 6dO
Results of Last Adequacy Test
Type of System Design
Gravel Bed Thickness ~-
~]~- Standpipes P~.esent ~N)
Date of last Adequacy Test
Separation Distanc~ f~om Absorption Field:
To Water-Supply Well /~ ~ To P~operty Line
~, q To Existing or Abandonsd System cn
; On Adjoining Lots ~_ ,
17 ~- To Cutbank(if present) ~-
To Building Foundation ~P
Lot ~ %
To Water Main/Service Line
To Stream/Pond/Take/c~ Major D~ainage Course ~//~
To D~iveway, Parking Area, o~ Vehicle Storage Area
Comments .~--fn4(~ ~,~ ~ %~]~ ~1~'.
De
Date Installed
Size in Gallons
"Pump O~" ]level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Dirge ns ions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
Meets MOA
Combatants
** Check Permitted Bedroom Rating Against HAA I~mquest
I certify that I have checked, verified, o~ conformed to all MOA HAA Guidelines in effect
on the date of this i~pe~ ction.
S igne d .
7£C5
KB1/d5/s
[Page 2 of 2]
ai
2-15-84
ALASKA
ellOIROrlmerITAL COI1TBOL
~nclincerinq $ ~nuironmcnlal Studies
InC.
July 12, 1984
Department of Health and
Environmental Protection
825 L Street
Anchorage, Alaska 99501
Attn: Keith Bandt
Legal: Lot 16 Block 1
Dear Keith:
Sequoia Estates
On July 3, 1984 I inspected the well on the above property.
The well wires were in conduit which was attached to the well
seal. This complies with the conditional approval granted by
your department.
If you have any questions please contact me at 561-5040.
Approved:
Sincerely,
urner
(Environmental Scientist
1200 LUest 33rd Aucnue. Suite ~ o Anchoraqe. Alaska 99503 ,/907) 561-50~J0