HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 8A
~' 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
~UPGRADE
Total e f f~li~ 8bsorptio~ 8rea
Type of crib Crib d' eter
~/~ Cribdepth Total eff~ti~absorptionerea
Well Building foundation Nearest lot line
DISTANCE TO:
Class[~ ~[~ ~ Driller D,stance to lot line PERMIT NO.
Building foundation/' Se~r line Septic tank Absorption area(sD
DISTANCE
TO:
OTHER
SOIL TEST RA ~
KS &~ ~ J
,~ 3/78J ·
G?~TER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
,OCAT,O~----~/~ ~'
SEPTIC TANK:/
DISTANCE FROM WELL %"~ ('"'"~
LIQU;D CAPACI;Y
ADDRESC:/~X ~-~ ~' ~ ~ PHONE
~ ': '~'~ /I~EOAL OESCR,PT,ON .Z ~ X--
/ ,%../_~ ~../ .UMBEROF
MATERIAl ~OMPARTMENTS
GALLONS. INSIDE LEN IO~H~ ~"'~/~'/'~'INSIOE WIDTH/~C
DEPIH__
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
SEEPAGE PIT:
OUTSIDE DIAMEIER
NEAREST lOT LINE
ORW,DT. /"~''.,E.GT, /~" DEP,,
DISTANCE FROM WE~ ~ ~Y' X · BUILDING FOUNDATION
TILE DRAIN FIELD: '-
DISTANCE FROM WELl , FOUNDATION ~ NEAREST LOT LINE
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE .- I~EPj~'H O,,~ FILTER MATERIAL BENEATH TILE
WELL: ~---~:-~'~/ WATER
DEPI'H . BUILDING FOUNDATION SAMPLE
NEAREST SEPTIC SEEPAGE
LOT LINE , SEWER LINE TANK , SYSTEM ~ CESSPOOl
TOTAL LENGTH
· OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
NEAREST
OTHER
,SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
PERMIT NO.
MUN m C:: m m T'T' OF
825 'k STREET, ANCHORAGE, AK. .q~ .
· ' · 264-4720
Ol'4--S T TE SEl.JER PERM I T
( 800609 )
APPLICANT JANET ARCHIBALD BOX ~0 MAN 0 WAR E. R.
LOCATION MAN 0 WAR ................ ,' ..
LEGAL ~.Lom"'AR EAGLE RIVER ~LLEY-~RN. LOT SIZE
16500 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: DRAINFIELD
MAXIMUM NUMBER OF BEDROOMS
SOIL RATING (SO FT/BR)= 2~4
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTH= 5 1Er4GTH= 82 GRAVEL DEPTH=
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THE TREr4Ch t~TDTH IS 5. ~ FEET.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCRYRTION (IN FEET).
REQUIRED SEPtiC TANK SIZE= '1000 GALLONS
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TLdO (2) I r-ISPECT I OI'4S ARE REQU I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO R COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERM I T E×P 1' RES DECErIBER 21~ 1~80
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF R~'~CHORRBE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THAT THE/~N-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE I~DELED~ ~CLUDE MORE THAN ~ BEDROOMS.
PERMIT NO.
MUr.d I C: I P~q,L I T'-,' OF' i=tNCHIj~l=lOE:
DEPARTMENT ~ .~ERLTH AND EHVIRON~EHTRL / ~TECTION
825 '~ STREET, ANCHORAGE,
264-4720
800602 >
APPLICANT
LOCATION
LEGAL
JANET ARCHIBALD BOX 30 MRNOF WAR EAGLE RIVER 694-9125
MAN Of WAR
,LAP EAGLE 'RIVER VRLL¥ RRNCHETTt LOT SIT_E 16500 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = ~ SOIL RATING ~T/BR)= 234
DEPTH= ::::LO LE,.dOTH= ~l ~ GRiml....,I%L D~PTH: 6
THE LENGTH DIMENSION IS THE LENGTH (IN T) Of T~ TRENqH or DRRINFIELD.
THE DEPTH OF R TRENCH OR PI~ ~ T~DIS BETWE~ THE~SURFRCE OF THE
GROUN{> AND THE BOTTOM OF THE ~CRVRTI]N ')' XX /
THERE IS NO SET WIDTH FOE ,HES. ~ /
THE GRAVEL DEPTH IS THE DEPTH BETWE~I/THE OUTFRLL PIPE
AMD THE BOTTOM Of THE (IN ~
REQUIREI SEPT TI ~K ".~ GRLLO~S
PERMIT RPPLICR~
INSTALLATION
NUMBER Of
HAS THE ;IBIL 'Y TO It DURING THE
PECTIONS OF TO THIS PROPERTY THE
THAT THE L SERVE.
BACKFILLING OF
DEPRRTMEMT WILL BI
2 > I ['.dSP :CT Or'dS PRE
SYSTEM WI] ON AND RPPRO~
SUBJECT TO
MINIMUM DISTANCE E
100 FEET FOR A PRI~
UPOH THE TYPE Of
MINIMUM DISTRHCE
TO A COMMUNITY SEWER
OTHER REQUIREMENTS
AVAILABLE TO INSURE
TWEEN R WELL AHY ON-SITE SEWAGE SY~ IS
WELL OR 150 '0 200 FEET WELL
_IC WELL.
R PRIVATE WEL TO R PRIVATE FEET AND
INE IS 75 FEE'
APPLY. SPEC AND DIAGRAMS PRE
~ER IMSTALLR"ION.
PERM T T E:~P
l: I AM FAMILIAR WITH THE REQO EM[ ITS ~OR~N-S~'T AND WELLS RS SET
~ORTH BY THE MUNICIPALITY OF ANCHORAGE.
~: I WILL INSTALL THE SYSTEM Itt RCCORDRM~E WI1]FF/THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMEHT IF THE
RESIDENCE IS REMODELED TO IMCLUDE MORE THR~ D BEDROOMS.
APPLIC~HT '~A~ A~CHIBALD
V4. 0
GREATEI. ANCHORAGE AREA....ROUGH Cas. No./3/
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT. Joe Dotterweich MAILING ADDRESS Box 754 E.R. ,PHONENO.
RESIDENCE ADDRESS LOCATION OF INSTALLATION E.R. Valle? Ra~¢~,ettes
I,~ of of N
LEGAL DESCRIPTION Lot 8-A ,,3 2t.;3 Sec? T14 Range 'dSM
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED .THROUGH,
PERCOLATION TEST RESULTS
X , SEEPAGE PIT X , DRAIN FIELD , OTHER
Mobile Home
TO BE INSTALLED BY Dan C. Bell
ANTICIPATED DATE OF COMPLETION ~ June 69
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ~''
'~"'~,~¢Z*4l) ,PERMIT TO INSTALLA ,~4-,/'~/_/ZX,~' ...o~-~ ~
.SE~IC TANK SIZE /~ TYPE~~z/ SEEPAGE AREA ~ ' TYPE ~/
~*~ DIAGRAM OF SYSTEM ~
DISTANCES:
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that thc
above described system is in accordance with said code.
DATE '~'-/~~ APPLICANTS SIGNATURE
PERFORMED FOR:
LEGAL'DESCRIPTION:
1
2
3
4-
5-
6-
7-
8
9,
......-- 10-
11
13.-
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOl LS LOG -- PERCOLATION TEST
SLOPE
14,
15-
16'
18-
19
aotmn A.
20
COMMENTS
PERFORMED SY:
r'l SOILS LOG
PERCOLATION
TEST
DATE PERFORMED: /?~7~0
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
/ /~ ~'//~.p
:'~ ~/ /. '
~ :_ ~ ~ ~~,,~, ~'.
am TEST RUN BETWEEN ~F' I TAND ~ FT
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE 0 ~' 0
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF EN~RONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORI~ APPROVAL
OF ON-SITE SEWER AND WATER FACILI~
2~744
Application Date Septe~be.~. ~I , 1987
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot. block, subdivision, section, township, range)
Lot SA; E~l~-e RZu~. Fa.f..f. ey R~nch~t~6
Location (address or directions)
(b) Property Owner Brad L~6on Telephone: Home Business
Mailing Address '~'~509 H~.~l.~t~' .~6, C~.~.6~.~t~, 0~OR 994~9
(c) Lending Institution Telephone
Mailing Address
(d) Real Estate Company and Agent RED CARP~/GREATLA~ REALTY - K~F G~a~
Address P. 0. Bo~ 6~, E~e ~u~, ~6~ 99577
Telephone 694-9125
(e)
Mail the HAA to the followino address: oR Check here ~]. If hold for pick up.
List contact person and day phone number below.
S & S ENGINEERING/694-~979
17054 E,',qt.e RZue~ Loop Ro~d, S~ gO4
Eaq.~e P. Zue.~, AZa.6~t 99577
TYPE OF RESIDENCE
Single-Family []
Number of Bedrooms
WATER SUPPLY
Individual Well [] Community [] Public ~
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite~ Public[] Community[] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 IRev 8 86~ Freel
5. 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 Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verily that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm S & $ ENGINEERING
17034 Eagla River Loop Road No. 204
Address
Date
Telephone
Approved for ~bedrooms by _
Approved .~;;~ Disapproved __ Conditional
Terms of Conditional Approval
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph S above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state recluirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
MUNICIPALITY OF ANCHORAGE (MOA)
c.~OA~.C~IEA. LTH AUTHORITY APPROVAL (HAA)
., . ~.C,?~.L,T( O~t~$ ~,~,~,0~ CHECKLIS~UARY 1~
~ ,,,~c~ ' .. * ' ' .
' ~ ~om Legal Description: ~ r~ ~c~ ~v~
'
Well Classification . I1 A, B, C, D.E.C. Approved ~)
Well Log Present (Y/N) ' Date Completed ' Yield
Total Depth Cased to Depth of Grouting
Static Water Level Pump Set At ' ' '
~sing Height Above Ground Sanita~ ~al on ~asing (Y/N)
Electrical Wiring in Conduit {Y/N) Depression Around Wellhead (Y/N)
~paration Distances from Well: ', . .
To Septic/Holding Tank on Lot ~ ~ ~: ' ; On Adjoining Lo~
To Nearest Edge of Absorption Field on Lot ~/~ ; On Adjoining Lots
To Nearest Public Sewer Line .... To Nearest Public ~wer ~
Cleanou~Manhole To Nearest ~wer Se~ice Line on Lot
Water Sample Collected by ; Date
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (~TN) Air-tight Caps ~N)
Depression over Tank ('~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) '/'J[~
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
TO Prope..rty Line Iol4'
To Water M~in/Service Line I°l~r
Course '
No. of Compartments ~
Foundation Cleanout(~N)
Date Last Pumped '~-~'~' -- ~ ~
Comments
/~/[/-~r'/^ ; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation ~ i
sposal Field, ·
To Stream, Pond. Lake,'or Major Drainage
Page 1 of 2
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:
To Water-Supply Well ~.. oo ' -./
To Building Foundation ~.3 r
Lot
Type of System Design
Length of Field
Depth of Field "~ .~.
Gravel Bed Thickness
Standpipes Present
Date of Last Adequacy Test
To Water Main/Service Line ! ~, t+
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ~,~!
~///3tO Cutbank (if present)
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments '
· Dimensions.
Manhole/Access (Y/N)
"Pump Oft" Level at
Vent (WN)
Pumping Cycles during Adequacy'Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and, HAA guidelines in effect on the date of this inspection.
~ato ol Payment
Page 2 of 2
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
3601 "C" STREET. SUITE 1334
ANCHORAGE, ALASKA 99503
STEVE COWPER, GOVERNOR
563-6775
DATE:
PUSID ~:
To Uhom It May Concern:
According to the records on file in this office, the _/[J_j~_~_[~ .....
State of Alaska Drinki,ng Uater Regulations.
Sincerely,
Environmental Field Oftricer