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Home My WebLink AboutTRAILS END BLK 5 LT 10rails End Block 5 Lot 10 #015-192-31 09/25/2012 00:22 9072430742 AWPS, 1NC. Develop rent Services Department Building Safety Division On -Site Water & Wastewater Program 70 feet 4700 Bragcw Street pcorp,,ps P.O. Sox 196650 MarkBegich .A choroge, AK 99519-6650 Mayor wv+..mcni.,ra/.ns�re (407; 343-7504 Pu p Installation Log Well Drilling Permit Number: SW_ Date of Issue: Parcel Identification Number: Method of Disinfection: PAGE 01/01 e. 1. .•. � - - Legal Description %ray i +'s yti aL Property Owner Name & Address: Ti '~ 7MAAW&e lC Pump Installation Date: Pump Intake Depth Below Top of Well Casing 70 feet Pump,M2nufaeturer'sName: A pot pcorp,,ps Pump Model: 7AJ / .Z Pump Size p;,_ hp Pitless Adapter Burial Depth: / Q feet Pitless Adapter 'lanufacfirer's Name: Pitless Adapter fustailer: j Well Disinfected Upon Coutplettn09—Yes F No Method of Disinfection: Comments: , Pump installer Name: 4U.1 17!5 Attention: The pump installer shall provide a pi nip installation log to the DSD within 30 days of pump installation. " 'f '~ MUNICIPALITY OF ANCHORAGE ( ' ~ t 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 NAME ('~e_ ~ ~ ~)01~. 3~q-?o ~ UPGRADE MAILING ADDRESS LEGAL DESCRIPTION ~ LOCATION NO. OF BEDROOMS ~ DISTANCE TO: OP t~ l1 * ~ No. of compar~ment, ~.u~u.r ~ ~ ~..i.,~e ~ ( Liq. capacity in gallons Inside length Width Liquid depth ~ ~ ~ IF HOME.DE: ~O~ Well Dwelling PERMIT NO. DISTANCE TO: O Z < Manufacturer Materiat Liquid ca.city in ~llons NO. of lines ~ Length of each line )oral length Of lines Trench width. ~ Total ef f~tive ~ TOp of tile to finish grad~ / ' Materiel beneath ~ile ~( :'~'~' ~/00~ Length Width ~pth PERMIT ~ ~ Type of crib Crib diameter Crib depth Total ef f~ti~ absorption area ~ Well Building f~ndation Nearest lot line ~ DISTANCE TO: ~ ~l~s).i- O~ ~ Depth Driller Ddtance to lot line PERMIT NO. ~ Building foundation Se~r line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PiPE MATERIALS :~ SOIL TEST RATIN~ b INIC,PAL~ )F A I~C,~CE EPT. OF 72-013 (Rev. 3/781 ~ILJ~ I C I/~& I TV OF DEF'ARTMEHT uF' HEALTH AHD ENVIRONHENTAL ~ROTECTION 825 L STREET, 8HCHORBGE, ~K 99501 264-4720 0~--$ I Tr'- _~.-.EI4ER .~% I-4ELL F'EF,;[4 I T PERHIT riO: DATE ISSUE[): 04/~0/84 APPLICAHT: ADDRESS: COHTRCT PHONE: GORDON HOLFE 300 DEERFIELD DR. ANCHORAGE, RI( 99515 ~49-7026 LEGAL DESCRIP: SUBDIVISIOfI: TRAILS END SECTION: 24 TOHNSHIP: 12H LOT SIZE: .SA (SO. FT. OR ACRES) MAX BEDROOMS: 3 LISTED BELOH ARE THE OPTIOHS AVAILABLE TO YOU SYSTEM. cHOOSE THE OPTION,THAT BEST FITS YOUR SITE..' OEPTH TO PIPE 80TTOr'I (FT.> 4.0 GRAVEL DEPTH (FT.) 5.0 TOTAL DEPTH <FT. > ~.0 GRAVEL HIDTH (FT.) 2.5 GRAVEL LEHGTH (FT.> 109.0 GRAVEL VOLUHE (CU. YPS. > 55.5 TANK SIZE (GALS> 1,000.0 SOIL RATIHG (SO. FT.?AR> LOT: 10 BLOCK: 5 RANGE: 3H IN DESIGHING YOUR SEPTIC E:ED 14. DAR I 1'4 4.0 4.0 0.5 3.5 .. 4.5 7.5 26.0 5.0 52. 0 117. 0 49. 1 86. 6 t, 000. 0 *:',: i, OOO. 0 **' 290 ** GRAVEL LEHGTH > 75 FT. REQUIRES HI_ILTIPLE P...UHS (NOT EXCEEDING 75 FT. EACH> ."..:* TANK MUST HAVE AT LEAST THO COMPRRTHEHTS I CERTIFY THAT: t. i AH FAHILIAR HITH THE REQUIREMENTS FOR ON-SITE SEHERS RND HELLS AS SET FORTH BN~ THE MUNICIPALITY OF ANCHORAGE <MOA> RHB THE STATE OF ALASKA. 2. I HILL IHSTRLL THE SYSTEH IN ACCORDANCE HITH ALL MOA CODES Rf.4O REGULATIONS, AND IH COMPLIANCE. HITH THE DESIOH CRITERIA OF THIS PERMIT. ~. I HILL ADHERE TO 8LL, HOR RN~ STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCES FROH ANY EXISTING HELL, HRSTEHRTER BISPOSRL SYSTEH OR PUBLIC SEHERRGE SYSTEH ON THIS OR RNY ADJACENT OR NERRBY LOT. 4. I UNDERSTRHB THAT THIS PERMIT I5 VALID FOR R HRXIHUH OF ~ BEDROOHS AND ANY ENLARGEMENT HILL REQLIRE RN ADDITIONAL PERHIT.' IF 8 LIFT STATION IS INSTALLED IH RH RRER COVERE~ BY f'lOR BUILDING 60BE$, THEH (i> 8H ELECTRICAL PERHIT 8HD IHSF'ECTION MUST BE OBTRIHED$ (2> RS-E:UILT$ HILL NOT BE RPF'ROVED HITHOUT RH ELECTRICAL INSPECTION REPORT~ AND (~> THE PERFORMED FOR: LEGAL DESCRiPTiON; 3 4 5 6- 7- 8 9 10 11 12 13 14 15 16 17. 18- 19- 20- PERFORMED BY: 72.006 (6/79) i MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVlRONMEN'TAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SLOPE [~/SOILS LOG '~' [~ PERCOLATION TEST DATE PERFORMED: SITE PLAN WAS GROUND WATER a,~/ ENCOUNTERED? /'~' Ii YES, AT WHAT DEPTH? # Gross Net Depth to Net ReadingDate Time Time Water Drop ~/~ ~,.,,' _. ,~.~ ._. - ~ ~' . L~ .~' I!:~ ~ ,~'~ PE.COLAT,O. RATE · ,~>'~-' ...:,,., TEST RUN R~EEN .. ...~ ~ . -1~ / PERCOLRTION_TEST DATA SHEET ADDRESS ZIP CODE ,, TOTAL DEPTH OF HOLE ZONE TESTED ~-~ ft TO ~JJ,1 ft TH # ~-- TEST HOLE DIAHETER ~p~' READING # CLOCK TIME NET TIME DEPTH TO NET DROP RATE (mtn)in) OAT UM ( FILIAL PERCOLATION I lATE "~'(~0 (mtn/tn) .' .: . · .. · . ,..".:: .. ,~enmea well :.-:~'::..,-,:."~ ..:' ,:::' ..........-.. · . ... .'. . .. :, ·, :: .. ., - ...*.:..~,.'.*.... , ,:.".. .*.': ',.,~ l 1140 Polar Dr. ANC~ORA~i. At,ASKA 99516 ..... ) ".' .' ... . ....... . . . . ~..,..,.,. ;' : ,. .:.,,: MUNICIPALITY OF ANCHORAGE 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 (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or dLrections) (b) Applicant Name ~/~o~ J<~ Telephone: Homo -------'------ .Busines~ (c) Applicant is (check one): Lending Institution ~ ~ilder ~; Buyer ~; Other ~ (explain); (d) (e) Lending Institution'{~.-~~ ~--~) j3~. Telephone Address ?_..~_?"~-~'~- Real Estate Company and Agent ~,~'~_'~ce_ ~ ~ ~ following address: TYPE OF RESIDENCE Single-Family J~ Multi-Familyrl Other Number of Bedrooms ~ WATER SUPPLY Individual Well J~ Community ri Public ri Note: If comm unity~' well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 o! 2 SEWAGE DISPOSAL Onsite'J~ Publicri Communityrl Holding Tankri Note: Il community well system, must have written confirmation from the State Department of Environmental Conservat on attesting to the legality and status. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe. functional and Ior the number of bedrooms and type of structure indicated herein. I further verify that based on the information obt~r~ed from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply a~'~,'or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in aP, act on the date of this inspection. Name of Firm //~:C"7...~ _~..~-,~... Telephone ~ Address Date Engineer's Se~l 6. DHEP APPROVJ~ ~ '~ ..-- Approved for ' ~.~.q~-,3.~ooms by ,' te L Approved ' ~/'~' i ;Disapproved '''j Conditiona~ J'~ Terms of Conditional Approval CAUTION The Muncipalit¥ of Anchorage Department of Health and Environmental Protection (DHEP) issues Hea~th Approval certificates based solely upon the representations given in paragraph $ above by an independent engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspec~o~'~ analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for eh'om or omissions professional engineer's work. Page 2 of 2 , MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: MUN~CIPAUT~ OF ANCHORAGE DEFT. OF HEALTH & ENVI~:)NMENTAL PROTECTION /,UG 2219 WELL DATA Well Classification ~1 b ~.-"'~'- If A. B, C, D.E.C. Approved (Y/NJ . Date Completed ~/'~ 5//~"~/' Yield Well Log Present~)N) Total Depth ? ~'~/ Cased to /../z/' / Static Water Level ~ Casing Height Above Ground Electrical Wiring in Cond~N) Separation Distances from Well: To Septic/Holding Tank on Lot Depth of Grouting Pump Set At Sanitary Seal on Casing'~N) Depression Around Wellhead"lq~ [~)~/'X'" ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /[~)/}to''' '- On Adjoining Lots TO Nearest Public Sewer Line ...,c)'/,,'f To Nearest Public Sewer Cleanout/Manho,e ~./"~"~'"* To Nearest Sewer Service Line on, Lot/ Water Sample Collected by ~,~ ; Date ~//./3~''~''"'' Water Sample Test Results J~""~:~' 7-/~/~',,~7"g)?~ V' , . , _ -- SEPTIC/HOLDING TANK DATA Date Installed ~/7~/W Size Standpipes ~N) Air-tight Caps~N) Depression over Tank,,~ .--~/~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well /0~~'/ TO Property Line ~/(~"' To Water Main/service Line 'F' Course I t)~)O ' No. of Compartments Foundation Cleano.ut'~)N) Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) Comments To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~,.~' ~-- ~ Date Installed ~//~, ./~-]/ Width of Field ~- ,~'-! Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test Separation Distance from Absorption Field: -/-17/'~ 'Y' 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 ,:::~q'/"~-- / / Type of System Design Length of Field //~ · ~'~'~'"' Depth of Field ? / Gravel Bed Thickness Standpipes Pres~nf~N) Date of Last Adequacy Test , {/ To Property Line L2 ~ / To Existing or Abandoned System on ; On Adjoining Lots 7'-~;.-.-~ 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) ) Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments '* Check Permitted Bedroom Rating Against HAA Request °* I certify t h ,~,~ ave~h/~ k/~d, verified, or conformed to all MOA~ and HAA guidelines in effect on the date of this inspection. Signed /-..-~////~. -~-....._ Date ~ ~_~ ~ Receipt No. ~7 Date of Payment Amount: $ Page 2 of 2