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HomeMy WebLinkAboutCRESTWOOD LT 19Crestwood Lot 19 #015-061-22 GREA~,:R ANCHORAGE AREA BOR.~IGH Department of Environmental Qualitv 3330 C Street Anchorage, Alaska gg§03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~'~O-;P .Ho,~'s MA,LING ADDRESS 0~:~ 3 ~~, ~.o~ SEPTIC TANK: DISTANCE FROM WELL MANUFACTURER INSIDE LENGTH ~' INSIDE WIDTH DISTANCE FROM WELL FOUNDATION NUMBER OF LINES ~ DISTANCE BETWEEN LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE WELL: flf ~,,~.~,.,~"L..-,<-~ COMPARTMENTS J LIQUID DEPTH /'~L I QU I D C APAC I TY/O~GAOLLONS. SQ. FT. LENGTH OF EACH LINE 3 /' DEPTH OF FILTER ~,'~/' "~' MATERIAL BENEATH TILE IN. ABOVE TILE TYPE CONSTRUCTION / ~0 TOTAL LENGTH96-- NEAREST LOT LINE OF LINES f ~/-- )2 TRENCH WIDTH IN. TOTAL EFFECTIVE ?~,N. DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE__ SEWER LINE__, TANK__ SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: SEWER LINE DEPTH: Form EQ-032 DIAGRAM OF SYSTEM DATE APPROVED G.A.A.B. FIF'PL I CFlNT I... C ':'FI T I 0 N i_E'.GFIL_ I_':,EF'FtRTMENT F)F HEFtLTH FIND, EN'v'IRI"INMENTFIL. PROTECT IlioN 825 "/..." '.E;TREE'I".. FINI]:HI]RFII:..'iE., FlK. 9'.:)50i 2?9-25ii C, P-~ --- :E: ::[ "T" E:: "_'-EL; E: i--41E FOF.:EI"I FIL:;T H .If'lE.=, Bt~! I E N [:,R LJ..9 ] F.'ESTNf_' ]E:, SIJE',C, "t" '¢ F' E 0 F 'E; E t L R B S 0 R E:"f' I 0 N :5'-r' L=; T' E M I S ' t" R E N F: Id I"'IFIX t MI..tM NLIME:ER C F E:EE:,F.:OOM:E; = :.':i: :E;O I L F.:R'I" I NG ,:: '.-.--.,Ii.! FT,-."SR ::, = ±27:5 THE RE(;!LIZRED SIZE OF THE E;OIL FtSSORF']"I(]N S'¢:E;]"EM I:5 ' IE:, E: F:' -F H = :_'.--Z; L.. E.E !'-,I i:Ei -T' H = ,4 ";:~ L':_~ F..: Fi %-" E: 1 .... [.T.:, EE F" -I- H =-= ~:1t- THE LENGTH [:, I MENS t ON IS THE LENGTH ,::IN FEE-['::, OF THE TRENCH I]IR DRRINFIELt}. THE [.',EF'TH OF R TRENCH OR F'IT I E; THE [:,ISTFINCE E:ETWEEN THE 'SLIRFF~CE OF TIdE GROLtND FIN[:, THE BOTTOM OF ]"HE EXCFIVFtTtON (IN FEET). THERE IS NO SET WI[:,TH FOR TRENCHES. THE GRFt',,,'EL. [:,EF'TH IL:; THE MINIML.IM DEF'T'H C)F GRRVEI .... BETNEEN 'THE OUTFFILL PIPE FIND T'HE BOTTOM OF THE E::.::CFt',,,'FtTION ( IN FEET'). I~:: EZ G:~ El :]; F--: E: IE:, :..-7. E] F" -f" I C: 'T la J"-.~ I-::] :.:_-; :[ ;-~--_ E = ::L IE:-~ ~_.T-~ ~-Z-~ tT:~ R L_ IL_ C~ b,,i '2--3 BRCKFII_LING OF FtN'¢ :_q','~TEM b~ITHOU't' FINFIL. INSPECTION FINC, FIF'PROVFIL B"r' THIS [:,EF'FIRTMENT NZLL BE '_:,UBJECT TO F'ROL=;EF:I..ITION. MtNIMLIM DI S'T'taNI::E E:ETNEEN A FJEZI_L AND, FIN'¢ ON-SI]"E SEb. IFtGE [:,i SF'OSFIL_ S'¢STEM I S 2..E)E) FEET FOR R PR I',,,'flTE NEL. L. OR ;2:C~E~ FE:E:T FOR R PUBLIC NEL. L.. 14ELI_ LOGS ARE RE:QUIRE[:, AND MUST BE RE'rI.JRNE[:, -ro THE DEPRRTMENT N ITHIN OF THE WELL E:OMPL. ET ION. SPECI F'I CRT IONS RN[:, CONSTRUCT I ON D I flGRflMS RRE: fl',,,'R IL. flBLE -ro INSURE PROF'ER I NS ]"~LI_ R T I ON. I C E [4..' "[' I F' 'T' T H Ft-I- :1.: I FlM FFlMILIFlF.: WITH THE REQUIREMENTS FOR ON-SITE SENE:R:E, FINE:, NELLS FlS SET FORTH Btr' THE MUNICIPFlLIT'¢ OF FlNCHC~F.:FlGE. 2: t NiLI_ INSTFtLL THE: S'¢E;TEM IN FiCCOF.:E:,flNC:E NITH THE CO[:,ES. ii:: I UNDERSTFlND THFtT THE ON-SITE SENER L--.,'x'STEM I"tFt'¢ REQUIRE ENLFlRGEMENT IF THE RES J: E:,ENCE IS REMODEl_ED TO INCLU[:,E MORE THFlN '-7-': BEDROOMS. E; I G N E [:, ' FlF'F'L I CFINT FF~F.:EMOST HOME::.; I S E; U E [:, E 'T'. .............................................................. [:,R T E .......................................... GREaTeR aNChORAGE ARea BOROUGH DEPARTMENT Of ENVIRONMENTAL QUALITY SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT '"STALLAT,O. 'OCAT,O. /3 /";' e---"~ ~,''" LEGAL DESCRIPTION /~-~ ii ~.~ ~- [ ? INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH so,L TEST RESULTS /~,£ A SEEPAGE PiT DRAIN FIELD OTHER TO BE INSTALLED BY NOTE: THIS PERMIT IS NOT VALID WITHOUT ~K)IL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TAnk size /~ TYPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE Pit . DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL . ~%~GE Pit SEPTIC TANK TO NEAREST LOT LINE. WELL TO SEPTIC TANK /{~(~ DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, ., DRAIN FIELD ALSO CONSIDER AREA WELLS. SEEPAGE PIT SEEPAGE PIT /~'~/ DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. O.Ao.~..- L, CE.SE. DES,G.E. DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE /'.-'Z..~7.-- ~ ~' 77 AFPL'CA.T'S S,G.ATU.~__~-~.~-) ~'-~'~.'-.'.-'~ FORM NO. EQ-OI ~ Performed For Leoal Oescrintion: Lot 1~ Block~ This Korm Renort$ Soils Loo "On~ ~r~ t~ ~o~h a ~h~sand op~nlon~" Foremost Homes Date Performed Subdt vi s i on Crestwood yes 5/23/77 Percolation Test Penth Feet Soil Characteristics 6 Sandy Gravel 10-- Bottom of Tes~ Hole 16-- 20 Was Ground Water Encountered? No I~ Yes, At what Denth? Readinq Date Grnss Time Net Time Depth to H20 Net Dron i Percolation Rate )linute Prnnosed Insthllation: Seenaoe Pit Drain Field Deoth of Inlet Depth To Bottom Of Pit Or Trench C~M~ENTS: 125 Square Feetdra~nmge arum Test Performed By ~_ ~~ Data Certified BY: CONSTRUCTION TEST David Paul ~ Date: 5/23/77 LAB ! ; 17 ~o~ ~o-tfo,,~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 · www.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _ 015-061-22 '1. GENERAL INFORMATION Expiration Date: Complete legal description CRESTWOOD LOT 19 Location (site address or directions) 9751 f3RIEN JUDY KALPAKOFF Current Property owner(s) __ Mailing address Lending agency Day phone 346-3187 JUDY KALPAKOFF C/O MANNY ESCOBEOO PRUDENTIAL JACK WHITE Day phone Mailing address Real Estate Agent Mailing address MANNY ESCOBEDO w/ PRUDENTIAL JACK WHITE Day phone 762-5854 3201 "C" STREET SUITE 200 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska, Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a pedod of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: ,Naska Water and Wastewater Consultants, Inc. shall be patd $1,0OO. OO at, or pdor I to closing for the engfneadng services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As cerb'fied by my seal affixed hereto and as of the va#dation da te shown below, I redly that my investigation, based on proc~lures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supp~ and/or wastawater disposal system is(are) safe, fun~'onal and adequate for the number of bedrooms and tyl~e of structure Indicated herein. I further vedfy that based on the Informab'on obtained from the Municipality of,Anchorage files and from my investigation and Inspection, the on-site water supply and/or waste~¥ater disposal system is(are) in compliance w~th all applicable Municipal and State codes, ordinances, and regulab'ons in effect at the time of installation. Name of Firm . ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD. SUITE 2B * ANCHORACE, AK 99504- Engineer's PHnted Name JEFFREY A. CA~N£SS. P.E. Engineer's Comments: sc~an~ous engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The mportad results described the perf~tttance of the system under the Conditions encountered at the lime of the t~t, and separation distances measured 10 readily identifiable features. The operattonal lite {~f all wells and septic systems depend on the local softs candit~'on, groundwater levels that may tiuctuate during7 the year, and the water usage of the fam#y being sen/ed by the s~tam. These conditions are outs/do the control of tho e~aluator of the system. Satisfacfoo/ test results do not guarantae future perfon'nar~ of the system, nor do they guarantee that there are no h/dEan defects or encreachmenta. AWWC, In~ can therefore not prm/ide any werren~ or future estimate of how long tho system will c~ntinue to meet the operetiona! requlremants of the ADEC or MOA DSD. The content of this report Is for tho Sole benefit of the owner listed above. Any reliance upon or use of this report by any uther pe~on or lxerty Is not a~thc#zed, nor will lt confer any legal rlght whatsoever. DSD SIGNATURE · ~ Approved for '~ bedrooms. Disappmved.' Conditional approval for . Phone. 337-6179 ON-SITE ~: WATERAND ~. bedims, wi~ ~e fllo~ng s~pulaUon~ : WASTEWATER : ~ ~ ~. PROG~M .~ ~ ~ <O~ ~ .x~ Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manltenance Agreements Supplemental Engineer's Reort Other Odglnal Certificate Date:m ~ - -.g, c~ _~) / Municipality of Anchorage Development Services Department Building 8afe~ Division On. Site Water & Wastewater Pmg~m 4700 South Bmgaw 6t. P.O. Box 196650 Ancl~xage, AK 99519-6650 www.ci.snchomge.ak.us HEALTH AUTHORITY APPROVAL CHECKLIST LegslDescrlption: CRESTWOOO SUB01VtSION; LOT 19 ParcellD: 015-061-22 W~LL DATA YES Well type PRIVATE.. If A, B, or C provide PWSID~ N/A Well Log (Y/N)_ .- Date completed _ 7/77 ? Sonita~/seal (Y/N) YES. Wires properly protected (Y/N) Y£S Total depth 69 .ft. Cased to 69 lt. Casing height (above ground) 16 in. AT INSPECTION / 9/2oo 52 .ft. Date of test Static water level Well production WAIER SAMPLE RESULTS: Collfom~ ~ _ colonies/100 rnl. Date of sample: 3/19/200 i B. SEPTICRiOLDING TANK DATA FROM WELL LOG 7/77 ? 52 ,,lt. 10 . g,p,m. Tank Type/Material FIBERGLASS _ Tank size 1000 gal. Number of CompartmentS 2 . Foundation deanout (Y/N) *YE~ 6.1 , g.p.m. Other bacteria ~ AWWC, INC. Collected by: J*CLEANOUT INSIDE I~ATNROOI~] Date installed _ . colonies/100 mi. Cleanouts(Y/N). 6/77 YES Depression over tank (Y/N) ~O_ High water alarm (Y/N)_ DENALI Date of pumping 3/16/2001 Pumper C. ABSORirnON FIELD DATA Ee°rr0u OF M.T. lEI[LOW GROUN0 LEV~ Date installed. 6/77 .. Soil rating (g.p.dJ~r~) 125. System [~ TRENCH Length 10, 21. & 24.lt Width 4 .lt. Gravel below pipe 2 lt. Total depth .5.4-6.6_fl. Eft. absorDtion area:°37(} ltz Monitoring tube YES. Depression over field NO _ Dats of adequacy test 3/19/2001_ Results(Pass/Fell) PASS For_ 3 .bedrooms Fluid depth in absorption fleld befom tSst 0 _in. Wateradded 712 gal. Newdepth 0 .in. Elapsed TIme: - min. Final fluid depth _ - in. Abso~tlon rote >= 450 + .. g.p.d. Any reju,,~nation treatment (past l~~NtsG 0.6; RF. D. LIFT STATION E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Data insta ed. Size in gallons_ ~ "Pump on' level et in. 'Pum~ High water alarm level at in. Cycles tasted Meets alarm & circuit requirements?. Septic tanlUlllt station on lot. 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25% On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout _ Holding tank. N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5% Absorption field. Water main 10'+ Water sewice line. 10'+ Surface water. Wells on adjacent lots _ 100'+ 5'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line. 10'+ Water se~ce line 10'+ Curtain dmln. NONE KNOWN F. COMMENTS Building foundation I 0'~- Surface water 100' + Walls on adjacent lots 10o'+ Water main 10'+ Driveway, perking/vehicle storage. 50'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems ere In conformance with MOA HAA guidelines in effect on this date. Engineer's Printed NaPte . JEFFREY ^. Data ..7/~.~/O, GARNESS HAA Fees .~,~ - Data ot Payment. --~/6Q"//~/' Receipt Number waker Fee $. Data of Payment Receipt Number 11:17 FI~-CTE ENVII~8~NTAI. .j~__ CT&E Environmental Services tnc. 5615301 T-766 P.02/0S F-625 CT&E Ret'.# Client Name Project NameM Client Sample ID Matrix Ordered Sample Remarks: 1011359001 Client AK. Water & Wastewater Consultants Inc. l~rint ~d D~tr./Tlme 03~3~1 12:06 9751 B~en Lt 19 ~es~ Celle~ted Dat~lme 03/19~1 13:30 9751 Bti~ Lt 19 Ocs~d R~ Dat~l~ 03~0~1 8:33 ~g Water Technl~ Dieter Stephen C. Ede 0 ReIea~ By P.~uh, PQL Unlnl Method Limils Date Date Init Nir~te-N 4.09 0.500 mg/L EPA300.0 10max 03/20/01 SCL ~tcrob:l. ologY Laborat:o~"y Total Colifom~ 0 co]/lOOmL SMI 8 9.?.22~ O3/2O/O I KAP MUNICIPALITY OF ANCHORAGE DEPARTMEN~F HEALTH AND. ENVIRONMENT,.~PROTECTION. I ~ 825 L Street, Anchorage. Alaska 99501 264-4720 Date Received: November 2~, 1977 #1: Time 10:30 a.m. #2: Time #3: Time Date 11-3-77 Thursday Date Date Insp Pratt Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Alaska Pacific Bank Mailing Address: 601 West 5th Avenue 99501 Phone: 276-3110 Property Owner: Mailing Address: HOward M. Smith Star Route A Box 85-K 99507 Phone: 349-4631 3. Legal Description: Lot 19 Crestwood Subdivision 4: Single Family Residence: (x) Multiple'Family Residence: ( ) Number of Bedrooms: Four Number of Bedrooms: 5. Well System: Individual well (x) Community/Public System ( ) Permit # Depth of Well 69' Well Log on File (x) ~ Bacterial Analysis Construction ,,.' Sewage DispOsal System: On-site System (x) Public Utility ( ) Permit # Installed 1977 Installer Septic Tank Size Manufacturer Absorption Area Soils Rate Material Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line P~e Two Department of Health and Environmental Protection · Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 19 Crestwood Subdivision Comments: Affadavit Attached: Approved: Disapproved: Letter Attached: ( ) Date: Department Worksheet: iling :IPALITY OF AI~CHORAGE AND ENVIRONME Alaska F.;FOR APPROVAL OF .~ WATER FACILiTiES , Foremost Instltut~bn:_~n ~ ~hd'~'fi¢ B~'3k Mailing AddresS~ :Reai~orgr Agent~ m~;m P~lty ng Addre~: ':~ T_~T ,~9 C~s~wOod Sub. Ins~ct~d .... ~ ~:~m~lv~' "" ..... ~ ' ' ply,,, ~~ ~'~'~ Type of Su~tY: .2 ~'~ ' P~bli~ Utility number of dwellings ~r~ntly se~ed IA'. Services Day 995o7 ~ Day _ Phone: Phone:_ .No. _lndividu~ one Individual