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Home My WebLink AboutSANDY BEACH LT 9AOnsite File Sandy Beach Lot 9A #011-112-50 MUNICIPALITY OF ANCHORAGE Department of Health and Human Sen/ices On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 9951~-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Dec 04, 1998 Expiration Date: Dec 04, 1999 Permit Number: SW980458 Legal Description: SANDY BEACH LT 9 Design Engineer. 0802 Boysen & Associates Owner Name: John E. Bums Owner Address: 5122 Strawben'y Road Anchorage, AK 99502-1921 Parcel ID: 011-112-17 Site Address: 005122 STRAWBERRY RD Lot Size: 24500 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. 5. The following special provisions. Received By: Issued By: Date: t ~-°"~' ' ~' Date: 12.q'? '"'" '"'" COPY ' ';'-'-,;;'~,, ::.~".:~4 ...... , .~,, ....; ,.~$- r~umc~pa t¥ ot Anchorage ',,, ...,. ~.~. .. ~... ~,.,:~..,..,~, ~ DepL Health & Human So.Ices SANDY BEACH SUBDMSION LOT 9! BASIS OF B[ARING~ LOT lO 1"=20' LEGEND TtJ T~.~,~' Hole. -,, ~, ,,.,,,..,,,m. ~,.* I, ~5~... '":'"" ' RECEIVED Municipality of AnChorage DepL Health & Human Se~ices Municipality ot AnChorage Dept. Health & Human RECEIVED I~OV ,30 Municipality u, !Dept, Health & Human Sat~;ce5 '/'PI (,v z:), z)a,,,? ~ gl ~: o waft'er ~~,_~~~ ~ 'I.'~'I'. b'),>~ ~,~. I.. ~- :~-n, i f ~.- - ~ ........ 7,-~ 7, ~<~ , ~;~ ~' '/, . ''.. .', ~'~v ~ ..~.~"~. ~ I '~',/'-; .~ ' ". ',1 · ', ~z z *1~' 4~/~'' ~ ~j' ~--~o.. ~.;~-,. ~e,~ 6 = 3 Ta per ro~,~, ~, RECEIVED NOV 30 1998 Municipality et Anchorage Dept. Health &Human Services LABORATORY TEST REPORT CLIENT: Mr. Dick Bo sen PROJECT: Se~c S stem_ ......... A · CLIENT ADDRESS: P.O. Box 110737 - Anchorage, AlasKa 99511 3' 2' 1 112' 1' PROPOSED USE: _Septic System SOURCE: In - Situ SAMPLED FROM: Auger Grab LOCATION:-Lot 9. San~v Beach Subdiwslon____ SiZE Di~¥~JTION CLASSIFICATION UNIF1EO , GRAVEL 112' 3/8' #4 #8 #10 #16 #20 #30 #40 #50 #60 lO0 99 96 84 16 #100 #200 .02MM SUBMITIeD BY: Chent DATE SAMPLED: 10112198: DEFTH: s.o · 20.0 R&M PROJECT: 851003_ LAB NO.: 8425 ,- FIELD NO.: n/a DATE REPORTED: 10113/98' DATE RECEIVED: ~0112198. COMPACTION FAA (X~TiM UM MOISTURE: WEIGHT LOOSE: GRNN SIZE DISTRIBUTION CHART GRAIN SIZE [mm] ~'T. TESTED: 848 GMS. i COARSE ~ SI~C FiNE $la~c LrTERiOUS MAT. ORGANIC CONTENT %' L.A. A~qASION LOSS: MOLSI'UI~ D4~Jsrl'y RELATIOflSNJP 1.0 4 MOISTURE - PERCENT DKJ R&M CLASSIFICATION: ~ed sand with silt. ~EMARKS; NOV Municipality o1 AncnoragG DepL Health & Human Services FI'IA Form 2573 Rev. July 1958 FEDERAL HOUSING ADMINISTRATION Form Approved Budget Bureau No. 63-R296 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM INSURING OFFICE Anchore~e~ MORTGAGOR OR SPONSOR PART I.--TO BE COMPLETED BY FHA IMORTGAGEE I SERIAL NO. / The Fl~st ~attonal ~mk o£ Ancho~ag~ 60-00807~ (for Stem Reslty) SUBDIVISION NAME PROPERTY ADDRESS Anchorage Bandy Beach Subdivision T~OT A~ N~MB~R: ] BASEMENT Yes [] No ] Nexv installation WATER SUPPLY BY: ~'] Public system [] Community system SEWAGE DISPOSAL BY: ~--] PubJJc system ~] Community system BLOCK NO. LOT NO. ICon attic or othllr ~r~a b~ m~do ~to additional bedrooms? ~ I ¥ s h an ,J,/tJ Yes L_J No basement SYSTEM DESIGNED FOR ~ Individual NO.O~ 'f~Yes [~'~ 8DRMS, GARBAGE DISPOSAL [] Individual ~ o PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH REPORT OF INSPECTION~INDIVIDIJAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT ¢onsiscs O£ [~ Scpdc ~gnk. [] CeSspool. Septic Tank~ Completely. 045 Sixth Ave. 71"ue.~day~ l'Vednesaay IND.I~H)UAL WATER SUPPLy / Pl~,s~ .t,oo~ on ~ Reverse . / Sheet for Sample CO~ectfo ALASKAD~P~NTOF~AI'~H /_~t~otlon~. n, Section oi Sanitation ~d ~eer~g Result for Bacteriological Analysi~ j~ ocnen tap; ~j Bath~ ..... ~,,, rap; ~ ~asement ta~; (Time) adar~s Premise wh~-~ [~ Other (hsd .............. =~ ~'~o~.~ to ?~, {5~/~ ~/P ,--~ ~"""/'"'",</5.-:~..<?L.> '~" ...... -~ ................. ?~:..~ ..... :~ ..~. ~..~ .~ , . ~ ~ / . .,~ ......... ~._~-~.~ OR OISTE N n~ ~ Lake, ~ Pond.. ' .......................... ~er .... en ~ouse, ~ In Yard DIBT~0~ TO: Building sewer or Other -, '"~ ...................... ~7": .......................... ~ ~ Oas~ lro~ .... '"'~' ................................................. ' e p Slble sources ~oin~ material , ~ wooa, ~ ~lle, ~ ~lbre Pipe, ~ ~sbes~os cement INFO~ON: Does water become mUdd~ ov discolored? ~ ~es, ~ When ~ ~eng~h of d ..... ' .............. ~&~;'"'~[- · m~_ _ '"'7'"'W .............. ' ....... Wa~' . ,up Pipe ......... ' ...... ~meter .......~ _, . ' .......................... feet =~ aep~h fro~ bo~,_[ ............................... ' ........... uepth ....... Pump location: ~ fn well, ~ Offse~ in base FHA Form 2S73 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART L--TO 'BE COMPLETED BY FHA INSURING OF~ICF MORTGAGEE I SPREAL NO. MORTGAGOR OR SPONSOR ~L~r ~) ~' ~ PROPERTY ADDRESS ~ (for S~ ~o~ge ~UBDIVIS~ON ~AME Yes No WATER SUPPLY BY: .' [] Public system S~WAGE DISPOSAL BY* [] Public system [] New installation F~ Community system RLOCK~NO. I LOTTO. . ,' Individual~ 2 ~ Y~ ~ No · [] Community system -- PART IL--TO BE COMPLETED BY HEALTH DEPARTMENT ", HEALTH DEPARTMENT INSPECTOR'S SXPTCH REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TIIIATMINT consists of ~ Septic unk. [] Cesspool. Inside diameter, feet, l~pth, feet, Liquid capacity, ~CONDARy ~ItEATR~NT consista of [] Tile dispu~l field, [~$eep3ge pits. Othe~ Tile D~q)os~l Fleldr Distance from: Well. To~ length of tile lines. Trench width, t,.flgth of each line, .gallons. Lining material feet; foundation, f~c~.2~_eazest Io~ linc at [] front, [] side, [] rear feet. Number of lines, Distance between lines, inches. Toza~ effective absorption asea in bottom of trenches, fe~:. Depth, top of tile to finish grade., Type of filter material: n Guvel. n Brokm srooe. Delxh of filter material beneath tile. inch~s. Depth of filter material over tile.. Number of pits / , Outside diameter Distance from: Well: Date of insPeCti~m feet; building foundation, -- squ~re feet. inches. inches. ~' feet. Lining material ' /'- ~ , feet; ne'~est lot llne at n front, Aside, f-I rear.-~.-~-F..- fett. Inspection ~ bl~ [] ~te. r-I Count-/. ~[[~Local ltealth Authority. Inspected REPORT OF INSPECTION~INDIVIDUA'L~WATER-SUPPLY SYSTEM Distance to nearest public water ma n. t'eet. Size of main inches. . Individual Wells ~ate f~ are not customary in neighborhood. Give mos. t recent record of faille of wells in immediate vicinity to furnish adequate supply'of watet Properties in neighhorhood~aze ~ ate not being developed with both individual water-supply and sewag~d~ ..~p~osa~. systend. Lot size:~feet wide '~O'.S2/eet deep. Dwelling set back from front property line~ Individual ~ater. supply from:~rilled well. n Driven ~cll.'.,.. ""'[] Dug. .well. [] Bored... well. I~stance of well froml CaSt it~n sewer. /7,~e '~ feet; tile sewer, , feet; septic tank1 - ¢e~; disposal field. · feet; seepag~ pit, ' feet; cesspool, feet; other sources of possible pollution, feec~ A~l~X.~ran~ae~lg~tPtthotilp~m?/ gTi~doe~t~¢~ mr. Type of casing, ~ ,~,/Oepthofcasi,g,~eet n et feet. Approximate yield,..~gallons ~per minute. Exterio~ space around casing sealed with: [] Cement grout. I-I Puddled clay. ~j~ Ordinary backfill. Well covet: [] Concrete. [] Wood. ~Metal. Openings in well covet wasertight:~ Yes. [] No. Puml~ [] Shallow ~ell. 1~ Deep well. Length of drop pipe. feet. Pump capacity,. Located in: [] Basement. I-I Pumproom off basement. [] Pumphouze above ground. [] Pump pit. Pumproom properly drained: '~ Yes. [] No. Pump mva~n~ watertight: ~ Yes. [] No. . Type of storage: ~ Pressure. [] Gravity. Capadty, gallons. Has bacteriologkal examination of water been made? '~Yes. I-INo. If answet is "yes," give date ~) ~'/0 -- , 19~ Quality of water ~ is n is not satisfactory for human consumption. . Installation ~ does r-I does not comply with approved exhibits, if any. " Inspection made by: [] State. n County. [~(Local ttealth Authority. ~. _ Ce_ /./) Iospeaed by Date of inspection , 19 , (Trrt~l .. gallons pet minute.