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Home My WebLink AboutWYNTER PARK #1 BLK 2 LT 16Wynter Park Block 2 Lot 16 #051-492- ! 7 ~', 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 PHONE · [] UPGRADE MAILING ADD'SS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS DISTANCE TO: IW°II ~/~ ~ ~ ~Bso,Otion ar.a . , ~ 2 Manufacturer ~. Material .. - No. of compartb3ents ~ ~ Eiq, capacity in ~allons Inside length Width Liquid depth Well PERMIT NO. ~z~ ~ ~ ~n~t~,~r~STA'CE TO; ~_ ~ ~ Material Liquid capacity in gallons Ne. of lines~' Length of eacb line . ~/[f Total lengthoflines Trench width. _ inches ~ Top of tile to f ishgrad~ / Materialbenoath~,lS' ~O i,ches ~O ~ ~ea Total effective a orptio ~a Length Width Depth PERMIT ~ Type of crib Crib diameter C Totel effective absorption area ~ Well ~uildin~foundatian Nearest lot line ~ DISTANC~ TO: ~ C[ass Deptb Driller Distance to lot line PERMIT NO. DISTA~C E~ [oundat,on Sewer line Septic tank Absorption area(si OTHER PIPE MATERIALS SQIL TEST RATING INSTALLER REMARKS APPROVED ~ ~ ~o~ 1~8A , DA~-E / LEGAL/2 72-013 (Rev. 3~78) QGRE '""ER ANCHORAGE AREA B0r'"UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: qL::fAt I ff/q$ FROM WELt MATERIAL INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS ~' LIQUID CAPACITY //~][]~'~ GALLONS. SEEPAGE PIT: NUMBER OF PITS .NING MATERIAL BUILDING FOUNDATION__ ADDITIONAL ABSORPTION / t 7~ DIAMETER ~"'~' OR WIDTH /q~, LENGTH q, DEPTH I CRIB SIZE: DIAMETER,~'~'' DEPTH ~"~*' DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE 27' ABSORPTION AREA (WALL AREA) SQ. FT. WELL: C ' TYPE O~//~'~/,~ [~// BUILDING FOUNDATION __ CESSPOOL APPROVED CONSTRUCTION DEPTH DISTANCE FROM: NEAREST NEAREST SEPTIC SEEPAGE LOT LINE SEWER LINE TANK SYSTEM OTHER SOURCES DISAPPROVED REMARKS DISTANCES~ INSTALLED BY: PIPE MATERIAl-: LOT SLOPE: REMARKS: Form No, EQ-031 DIAGRAM OF SYSTEM .. --J ?P APPROV i/'¢~ ¢/~ ~(~ TG,A.A.B. DEPARTMENT O~ rlERL. TH RND ENVIRONMEN"FRL F..JTECTION 825 L STREET~ ANCHORAGE., AK 99501 264-4720 PERMIT NO: ,DRTE ISSUED: RPPLICRNT: ADDRESS: CONTACT PHONE: ON--2~; ][ ']FE=_" 0404D8 06?2±/84 C?O S & S ENGCG. SRB i96X EAGLE RIVER, 694-2979 GARY FRISE 99577 LEGAL DESCRIP! I..OT SIZE: ['lAbl BEC, ROOMS: SUBDIVISION: WVNTER PARK SECTION: 10 TOWNSFIIP: 2~6~7 (SGL FT. OR ACRES) ,I. LOT: i6 BLOCK: 2 RANGE: IW LISTED BELOW ARE '['FIE OPTIONS RVRILRBLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE TME OPTION THAT BEST PITS YOUR SITE. DEPTH TO PIPE BOTTOM (F]".) 4.0 4.0 4.0 EiRAVEL DEPTH (FT.).. ,. 5.0 0.5 TOTAL DEPTH.(FT. ) 9.0 4.5 7.5 GRAVEL WIDTH (FT.) 2.5 · i0.0 5.0 GRAVEL LENGTH (FT.) tg.O t9,0 14.0 GRRVEL VOLUME (CU. YDS. ) 6.6 7.0 TANK SIZE (GALS) ~000.0 ** t, 000.0 ** 1,000.0 SOIL RATING (SQ. FT./BR) t25 ~.25 t25 TANK MUST HAVE AT LEAST TWO COMPARTMENTS I CERTIFY THAT: .1. I RM I'-RMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITV OF ANCHORAGE (MOA) AND THE STATE OF ALASKA, 2. I WILl_ INSTALL. THE SYSTEM IN RCCOR[:,ANCE HITFI ALL MOA CODES AND REGI.JLRTIOI'.~S., AND IN COMPL. IRNCE WITH TFIE DESIGN CRITERIA OF THIS PERMIT,' ~. I WILL. RDMERE TO 'ALL I"lOR AND STATE OF RLRSKR REQUIREMENTS FOR THE SET BACK DISTANCES FROM RNV EXISTZNG WELL, WRSTEWRTER DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ON THIS OR RNM RD..TRCENT OR NERRB'¢ LOT. 4. I UNC, ERS'FRND THAT THIS PERMIT IS VALID FOR R MAXIMUM OF i BEDROOMS RI'.4D ANY ENLRRGEI'IENT HILL REQUIRE RN ADDITIONAL PERMIT. .IF R LIFT STATION-IS 'INSTALLED IN RN AREA COVERED BY MOA BUILDING CODES., ]'WEN (.1) RN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) RS-BUIL]"S WILL NOT BE APPROVED WITHOUT AN ELECTRICAl_ INSPECTION REPORT; AND (~) THE ELECTRICAL WBRK MUST BE [:,ONE 89 R LICENSED ELECTRICIAN. RF'PLICRNT: C,."O , & ~ ENG'G .~RR'q FAIRE ISSUED BY SOILS LOG PERFORMED FOR: LEGAL DESCRIPTION: 2 3 4 ? 8 § 10 ~2 13 14 18 2O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF REALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST DATE PERFORMED: %JcT-- WAS GROUND W^TER COMMENTS 0 E IF YES, AT WHAT DEPTH? · Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ' '///,~ (minutes/inch) TEST RUN BETWEEN FT:~N~) ' -- FT PERFORMED ~.: ,'- 72-008 (6/79) · ?..:. - 4~'¥ ~.M~.N,T. ,O?, INSP. ECTION~BY. ENGINEER: L .::.., :~ ~ ~ by. my ~al a~x~ hereto and:as'of.~e ~ahda~on date sh~ ~ ~' vefi~ ~at'm~;X;;~;~-;~A-: , ;: ,. .~s~ on pr~ures ou~m~ m ~e. Heal~.Au~od~'A~Dro~ Gbdeine~'fof~i~afi3 :,: :?. ,,,,~ ~,~ ~[ ~pply,~n~9[:~s[e~ter, d~s~k~tem~s(am)?~fe,:~n~onal andiad~uate foF~e n~mber of" - ': , '¢;., '.: '-: ~r~ms and ~ of s~ure ?di~t~ereln;A '~r,~fi~ .... ~,-.'-'a~d r~ul~ons in eff~ at ~6'~e of i~s~lla~6n.;.' ', :. :.. ;' ... r '' ':' - . '.': .., ....;: .... :...}.. :~. ...,. ..... ,. :. · - -Address , ~ ....... .,~,..,. ,.... . - . ,. ~.., · .... , , ,, . ~glneedsPnnledName~... ~l ,.<~,, ,~o~ --~ f~ ,~ ~, ~ , . - ~,,.,,,..,.,,. ,, ..... ~,, cCon~iti~n~l appro~r6r:; ....... :.~rooms. ~fi ~e,f611o~ng ~pulaaons:, · , :'- '.-; ..... , ~ ';~,;": .','?, .... . ,. ,, ., ', , .~.' L '~,' ~,', ",,,'":.., :'~;;';" ~".'/-,,,';'..:-. ........ '' ' " ~. ;? ..... ,.4. '~ * .... ~, -., ~ ~, ",:*t .... '. · ~',:;', ,* , 'j' ,'"',~:,.:~u~ E.,-..~ , :,- ·, , ,Addl~onal Comments ....................... : ....,.~. . .~ .. ~u~,w,., ~WAT~P ~n, ,...~-:~ '. ',': - , ,~ ~ ,., ' ~: .. WASTEWATER:;:,.,: .- ......... ~ ,.. ~ 4. ' , ' ~; .... :. :. ~*~'r~', ' '-' ' ' ......... . .... ,~_ . , .......... ;;:;. '~:'_ ..... : ; '. . · .-. r. A~achments:. · .".~ . .'..' ..-.; .: · ,.- - *..: -... ' ' - ~ ...... . .: ~Checkhst,.; ........ X . . '. ~ . ..Maintenance Agreements.. .... . · Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Pmg=m 4700 Sau~ Bragaw St. P.O. Box 196650 A~cho=ge. AK g9519-6650 www,ct.anchomge.ak, us (907) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDesc~iptlon:LoT' Jb 8Locke ,~ t~Jy~'Te,'<- /~l-~K"~/ParcellD:O,,~/-/'/q~3-)7 A. WELL DATA wen type ~ Date completed Total depth Date of test Static water level Well production WATER SAMPLE R~8~? Coliform ~¢51onies/100 mi. Nitrate mg./I. Ame' 'Bj~-''''~ mg./t Date Of Sample: If A. B, or C provide PWSID # ~11fi31 Well Log (Y/N) ~ ~:mnitary seal (Y/N) Wires pm~(Y/N). lt. FROM WE~sad to It. ~lght (above ground). ~ g.pm. g.p.m. in. Ot~er bacteria Collected by: colonies/100 mi. B. SEPTIC/HOLDING TANK DATA Tank TypeUa~.~al Tank. s~e"/oo gaL' "- Nu~r~~n~ ~ ;~hdauon ~eanom ' mp~n ~r ~nk ~ ~o Dam ~ pumping ~7/o~ Pum~r ~ ~ ~ c. ~SSO~ON RELD O~ O~~ ins=ll~ ~{~/~ ' ~il =ting (g.p.d.~ or ~) /~ o I ' T~lde~ O ~ff. Eft. a~o~nama3~ ~ Mon~dngm~ ~ Dam of ad~ mst ~/&~/o~ Resu~all) P~r~ ~~: ~o ~n. F~lflu~de~3~ in. ~ mj~naflon ~a~nt (~st 12 ~.) ~ & ~). ~o~ · Date instated ?/~-~t cleanouts(~/~) W .r High water alan~ (Y~) ~' 0 System type. C,~O Gravel below pipe. (o It. Depression over field /v o For '~ bedrooms g.p.d. O. UFT STATION Date installed Size in gallons Manh~' 'Pump on' level et in. 'Pump off' ~el ~~r alarm level at Datum ~-------'""-"'~cJes tested .~........~..._~ Meets alarm & circuit requirements? E. SEPARATION DISTANCES in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorpfion field on lot Public sewer main On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: ! Building foundation Water main / O Water service line Walls on adjacent lots Absorption field Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Pmberty line /o (~ Building foundation I 0 Water Sewice line /o -~ Surface water ,/oo Curtain drain~O,~, k:~ve~,~' Wells on adjacent lots ~oO Water main /o '/- D~veway, paddng/vehicte storage ,J"a ''''/ F. COMMENI~ G. ENGINEER'S CERTIFICATION I cerdfy that I have determined through field inspec~ons and review of Municipal records that the above systems am in conformance with MOA HAA guidelines in effect on this date. Engineer'ePrintedNama ~D~IL~r ~'. ~'~uv~/ Data -7 / lo Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number .'% It is the r Io l to comm~n~ng ;onstrucflon. : PR~I, IMIHARy · I ~ereby certify that I hav/~ lurvcyed the following described property: ~.OTT /'~.., '~/~,,c~ ~' ~ : pos~ ~p~ovemen~, ~ ~hnne4 t~e~eon by ~e will be within the p~p~y lines ind will on'Ibc prop~y on no ~sdwos ~ar other visible ease- ~en~ on ~ald pro~ except DaSd at ~'~. ·,.. ~ ,~ - BoxiS~S~Rlver. Al~a , ,