HomeMy WebLinkAboutKNIK HEIGHTS BLK C LT 13Knik H
ights
Block ¢
Lot 13
#017-034-31
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program. 4700 S. Bragaw SL
P.O. Box 196650 Anchorage. AK 99519-6650
www. d.anchorage.akus (907) 343-7904
C)
Page of
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. ~ ~/O~_.~)
II D b
LEGAL DESCRIPTION
Well: [] New [] Upgrade
SEPARATION DISTANCES
Septic Absorption Lift Holding
Tank Field Station Tank
PID Number:.' 017-~) 3q-- 3 l
WastewaterSystem: []New ~p~rade
ABSORPTION FIELD
-0- .. ~7 .,.
TANK
LIFT STATION
,~J~Other.
BENCH MARK
Inspections performed by:'~, ~.
Development Services Department
Reviewed and approved by:(""'"~ .~
Approval / /
Date: ~/~'/0 Z-
~111 I \ J
· 2~T~ ~ ~
I ~c~ '"c~c
~ENCH
MARK
0 c~ ~
SCALE,1'-~ FT
AC 57~
~ 4~
~ lVell
49t;h
I
I
L
'"1
I
1£ I
5
TOBBEN SPURKLAND P.£
20:7 IV 15Ttt. AVENUE
ANCN. AK. 99501
(907) 279-5591G
[[LOT 13, BLOCK CKNIKHEIGHT$I
1254! ATHERTON ROAD
MARY R. THOMAS-NEARS
PIB # 017-034-31
SEPTIC SYSIEI~t AS BUILTS
DATE: JUNE 20, 2002
SHEET: 2/55 GRID: 285556
PERMIT # $V0~0161 KNHOCISLB~/G
BXgbtFAX 6/13/2002 ' G-'08 PAGE
1/i RightFAX
Inspection Report
Nunicipality of Anchorage, Building Safety Division
4700 South Bragaw
INSPECT[ON: VOICE 343-8300 INSPECTION: FAX [907)249-7777
INF0:343-8211
Name
Legal'
-~ubdlvlslon
Cnmmenta or hlr~t'!ofl~
BPSCK'S ELECTR.[C-Bill
12541 ATHERTON RD
BK C LT 13
KNIK HEIGHTS
Permit 02-7964
Phone 440-9351
345-2923
Inspection Dat~ 6/14/2002 AH
Septic System- Finished Please Give Inspection report to owner Thanks
Inspection Retro Electrical Reln~ctlon
~'~ NO NONCOHPISANCE OBSERVED
[] CORRECTIONS ESSEN'I'[AL A~ EXPLAINED BELOW
[] W[LLiNsPECT~oNRE-EXAM[NE AT NEXT [] DO NOT CONCEAL UNTIL REINSPECTION
COMMENT~: (for inspector use only)
r
N
Insp~-t or ~'~ I
Date:
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Soufh Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jun 11, 2002
Expiration Date: Jun 11, 2003
Permit Number: SW020161
Legal Description: KNIK HEIGHTS BLK C LT 13
Design Engineer: 0007 Tobben Spurkland, PE
Owner Name: Mary R. Thomas Mears
Owner Address: 12541 ATHERTON RD
ANCHORAGE, AK 99516-2912
Total Bedrooms: 4
Parcel ID: 017-034-31
Site Address: 012541 ATHERTON RD
Lot Size: 43500 SQ. FT.
Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Pdvy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 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.
Received By:
Issued By:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P,O, Box 196650 Anchorage, AK 995t9-6650
www.ci.anchorage.ek.us
(907) 343-7904
ON-SITE SEWERANELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. ~ I"'/- t:) tl
Permit Number
Properly owner(s)
Mailing address (1)
Mailing address (2)
Legal description (Lot, Block & Sub'd.) I..~T
Legal description (Section, Township & Range)
Lot Size ~.~4~ Act e ('/~
Zip Code
Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
~ P-7.1GH
[] Well Only []
[] Water Storage ['~
[] Jacuzzi' []
[] Water Softening Unit []
I certify that the above information is correct. I further certify that this application is being made fcra
Single Family Dwelling and is in accordance wiL.h applicable Municipal Codes.
(Signature of property owner or ~.Jthorized agent)
Permd Fees:
Date of Payment:
Receipt Number:
{Rev. 12100)
Waiver Fees;
Date of Payment:
Receipt Number:
N
1' = ~00
I
I
I
I
I
5
TOBSEN SPURKLAND P.E.
205 W ISTN. AVENUE
AN¢/t. AK. $9501
(907) 279-$915
I ILOT 13,
PID # YY
BLOCK C KNIK HEIGHTS[
125.41 ATNERTON ROAD
I
MARY R. TNOMAS-MF_4RS
SEPTIC SYSTEM DESIGN
DATE: JUNE $, 2002
SHEET: I/$ GRID: 283G
PERMIT # S~/02OXXX KNHOCI$1.BVG
Pedo~med Fcr:
Legal DescnDt~on:
Municipality of Anchorage
Development Services Deparlmen!
Building Safely Divfsion
On-Silo Water and Wastewaler Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci anchoraqe ak.us
{907) 343-7904
Soils Log - Percolation Test
~.z~T i'~ ~- ~-- ~/-~-~"~tl.~- '~l~'l~'3'r~nship. Range,secti°n:
Slope Site Plan
10-
11-
12-
13-
~,. IZ f." ~-~1' ENCOUNTERED? $
L
IF YES, AT WHAT DEPTH? 0
14. Reading Date Gross Time Net Time Depth Io Water' Nel Drca
15-
15-
17-
18-
19-
20-
COMMENTS
PERCOLATION RATE ~ ~ (m,r~e~¢~) PERC HOLE DIAMETER
TEST RUN eE'rWEEN ~ FT AND ~,~ FT
PERFORMED SY: ~ ..~ I ~ ~ CERTIFY THAT THIS TESTY,'A$
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~/tj,//D ~.
Municipality of Anchorage
Development Sc tv ices Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Itragaw Street
P.O. Box 196650 Anchorage. AK 995194650
www.ci.anchorage.ak.us
(907) 343-7904
PROPERTY OWNER AGREEMENT FOR TIlE MAINTENANCE OF AN ON-SITE
WASTEWATER DISPOSAL SYSTEM
agreement, dated--1[O[ [0 ~ '7_.- , is made between the Municipality of Anchorage
Development Services Department {DSD) and the property owner(s) off
14Nl~ t4EIGHr'i' ~l& C. Lo'i'" I%,
This agreement is made for the purpose of maintaining an on-site wastewater disposal system on
the subject property.
The property owners agree to the following:
Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation
statement from a registered professional engineer. This inspection and operation statement shall
verify that tl~ en~:~-~r h%inspected all effluent an.d air pump.s, timers, and alarms, and that any
deficien~aired and that the system Is funetiomng as designed.
(Printed Name) (Printed Name)
.~.h..~_ k~)~e Foregoing Instrument w.a?. ackaowledged before me by
L-. 'Or 0 a%g4 qan this lO'ay or
:ness my s ,
1
~ot~'s printed nme) ~ nt ~ ~
My Comission Expires~ , [~.~
MUNICIPALITY OF ANCHORAGE L
DEl-. ,TMENT OF HEALTH AND HUMAN SER~.
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTIFM AND/OR WELL INSPECTION REPORT
Phon~ts) - P~ N~ ]~ of Bedrooms
~?~-- ~¢/o ~..7oo&~ ~ _
LO, /* 181oc~ [Subd
TANKS
SEPTIC , [~] HOLDING
t
TYPE OF SYSTEM
l ._~,?RENCH ,] BED ~
| D~'ptll [o p~pe ~in Irom
W. IDRAIN [] OTHER
o.~,,,.,.,~o,,~ .5' ~ZT_
Fdl added abo..e original 9rade
~ FT
WELLS
FT
[~] PRIVATE [~ OTHER fldentifv)
Classffmahon tA.I~.C~ /Total Depth Cased to FT
RE~ARKS:
DISTANCES
WELL
SEPTIC ABSORPTION
TANK FIELD
ia'7 / ¢Y ~
¢o I0
WELL
LOT LINE ":~ g
FOUNDATION ~,~__~)
AS-BUILT DIAGRAM {Show Iocahon ct Well. sephc system, ploperty hnes, IouRdatlOD,
~unicipal and ,State ~n eflect ol~ Ihis dale:
I n ~ po c o,~,,,~L~Pe rio r m e d by:
Date
certify Ihat this inspection was parlarmed according Io all
r,, ..~U~.~I~I~ S SEAL
5.'%.°' ',',,,
jUNE 25, 1971
?'2-013 (3;85)
J,, ,) J j, ~J, ii~.!i ](illJl''lIil}liii~l'( :: i,
t:{"(~tl''"l{'i')Ji':] I" Y:t L''[
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SFRVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEOA, OESCmPT,ON:J.,~'T
~ILT
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
SLOPE
(ENGINEER'S SEAL)
Township, Range, Section: '~/~, ~ ~
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth lo Waler Afler
Monitoring? ~JO Dale:
Gross Net Depth to Net
Reading Date
Time Time Water Drop
~ /o ~./k~ s/~
PERCOLATION RATE /~ (minutes/tach) PERC HOLE DIAMETER
TEST RUN BETWEEN 4L~X FT AND ~;~ FT
COMMENTS
PERFORMED BY: '=:::,¢~' ~' ~ I CERIIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFEC'I ON THIS DATE. DATE: *~'~ */'C'~/ //'~ '~¢ 7
7~-008 (Rev. 4/85)
oGR
'ER ANCHORAGE AREA BOF UGH
Department of Environmental quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAMEF~-~-//~///////_/' ff,~-?,~2//--~ MAILING ADDRESS ,~-J"~/'~
LOCATION /~.~'~.//<~2~'.;'--~)/~/ /~'/_2/~'~? LEGAL DESCRIPTION ~2~/__~, ///~¢~/~-/~_....~G//~::~ /~__£. _~'-~.'~-~,~
SEPTIC TANK:
DISTANCE //g2 / NUMBER OF
FROM WELL MANUFACTURER~F-~-2~/~-//~2~ MATERIAl_ -~'~-~'~-~-- COMPARTMENTS ~
INSIDE LENGTH ~ INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY~/ GALLONS.
S E E PA G E P 1T: ~ w/~ ~ ~' ~~'
NUMBER OF PITS~/ DIAMETER/~ /OR WIDTH ~, LENGTH ~, DEPTH
LINING MATERIAL~/~z~/~- CRIB SIZE: DIAMETER~ DEPTH ~ DISTANCE FROM: WELL
BUILDING FOUNDATION ~/, ~ ~/~///~. TOTAL ABSORPTION EFFECTIVE AREA (WALL AREA)~ _SQ. FT.
~,DDITIONAL ABSORPTION
NEAREST LOT LINE~//~ /
WELL:
-F Y P E//(~/~'///-~///~/-~ CONSTRUCTION DEPTH ~ /
BUILDING -- / NEAREST /~ ~ NEAREST ~ {/ SEPTIC /// /
F:OUNDATION~ LOT LINE SEWER LINE TANK / - ~-
CESSPOO~/~~-~ OTHER SOURCES~/~/~ ~/~//(/
DISTANCE FROM:
SEEPAGE /
SYSTEM /-";~ ~L.
~PPROVED DISAPPROVED REMARKS
NSTALLED BY: /~/?~//~/g~/v3-~_
LOT SLOPE: .
]:orm No, EQ-031
DIAGRAM OF SYSTEM
DATE . APPROVED
G.A.A.B.
!/~(((~"ILJIILI_III~I~ILJ 3~30 "c,' STREET ANCHORAGE, ALASKA 99503
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PEP. MIT
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT ~-, DRAIN FIELD -- OTHER
TYPE:AND SIZE OF FACILITY TO BE SERVED ~' ~Z~
so,L TESt RESULTS /'~ ~/ ~ ~:' ~' ~/~" ~ ~X;~ ~ ~ ~?~o~, ~.,~ .~,~ ,~ .OT ~.,. ~,~.o.~ ~o,~ ~.
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: g4 HOUR No'rICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUI' FINAL. INSPECTION bY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION,
MINIMUM DISTAN~E~, REQUIREMENTS
SEPTIC TANK TO seePAge Pit WaLL / ~
WELL. TO SEPTIC TANK
CAST IRON INTO AND OUT OF SEPTIC TANI( AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UND[STURI3ED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
GRAVEL BACKFILL
COHFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I CERTIFY, THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GRE~%R ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DAT~ ~<~ ~----- APPLICANT'S SIGNATURE
?erformed For
Legal ~escrintion: Lot 1.3 Block
'This Form Renorts Soils Loq , ,,ye,~
"0.~ ~es~ is worth a ~housa~d opinio.s"
Dennis Stordahl Date Performed~ ,4-22-74
Subdivision Knik Hieghts S~b.
Percolation Test
Denth
Feet
Soil Characteristics
Organic Overburden
Sandy Gravel GW-GP 8~
Fine Silty Sand SM-2~O
Bottom of Test Pit
Was Ground Water Encountered?
I~ Yes, At what Dent~?
No
I I.
Readinq Date Grnss Time Net Time Depth to H20 Net
'I'
iPercolation Rate Minute
Prnnosed Installation: SeepaGe Pit Drain Field
De~th of Inlet Depth To Bottom Of Pit Or Trench
~'n~ENTS: 166 sq. ft. drainage area required .per h~d~nnm rn~ s~npage ~ib.
Leach Field: 8~ sql., ft. drainage_ar~a required per bedroom
No bedrock or water table to min~
ffest Performed By.Jim Mack Data Certified By: Construction Tesbl~
~ Lab Mm'~gr. Date: 4--22-7~
/ 7~. 7 /'t
30'
'C.)
;c~/~ ' /"= 40'
-/3-
//$
~well
-12-
LASEMENT8 OF RECORD, OTHER THAN
'HOSE SHOWN ON THE REOORD[_:D
'LAT ARE NOT SHOWN HEREON.
AS-BUILT NO CORNERS 8E'F THIS DATE
I hereby certify that I have performed
speetion of the ~onowi.~ described p,'ope,~y: .._/-_~_/_/~__.
Anchorage Recording Precinct, Alaska, and that the improve-
ments situated thereon are within the property lines and do
not overlap or encroach on the property lying adjacent there-
to, that no improvements on property ly/ng adjacent thereto
enc2oach on the premises in question and that there are no
roadways, transmission lines or other visible easements on
said property except as indicated hereon.
Dated at Anchorage, Alaska
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
OF ON-SITE SEWER AND WATER FACILITY
264-4744
~-/ /
Application Date/'/
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directio/ns)
I O__~-q I
(b) Property Owner ~ ,A.
Mailing Address
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Address
(e)
Telephone
Telephone: Home '5~/~'-~ £glO Business
&T~T~ ~ N~ t& Telephone _
Mail the HAA to the followin~ address: or: Check here ,'~,,, if hold for pick up.
List contact person and day phone number below. /' //'
2. TYPE OF RESIDENCE
Single-Family~
~umber of Bedrooms
WATER SUPPLY
Individual WellL~ 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: It 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 tRey 8/861 From
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
fo}' the number of bedrooms and type of structure indicated herein. I further verify 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 :-'."./.,~&.r. ,/..(~.~.:~/ Telephone '" / '.:-
Address
Date
Engineer's Seal
DHHS APPROVAL
Approved for Z'"/-/~/¢ (/'.,~'¢? bedrooms by
Approved ~ Disapproved
Terms of Conditional Approval
Conditional
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 5 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 requirements. 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.
Page 2 of 2 72-025 (Rev 8/861 Back
~N,', .... k~.. · .,~..LI,~I~:IPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
~lt;.. '~ ~ 9 ~7 CHECKLIST- FEBRUARY 1984
264-4720
R.E ¢ IV E D
WELL DATA
LegaIDescription: L¢")'- /'~; r~'. ~_ ~'RI~ ~-J4HI~
Well Classification [~--- ~-~' ~
Well Log Present (Y/N) [~ ~
Total Depth ~ ~ Cased to
Static Water Level ~;~c~
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N) ~
Separation Distances from Well:
To Septic/Holding 'rank on Lot I O"~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line N O~ ~
If A, B, C, D.E.C. Approved (Y/N)
_ Date Completed '~..4_~.. I ~7 7 Yield
>' {¢-~::> Depth of Grouting /~ 0 ~/J~
Pump Set At ~ ~
! f~¢ Sanitary Seal on Casing (Y/N)
2"
Depression Around Wellhead (Y/N) lk~
; On Adjoining Lots
l ~f¢~ ; On Adjoining Lots
To Nearest Public Sewer
Cleanout/Manhole t'~o I~ ~- __ To Nearest Sewer Service Line on Lot > / O
Water Sample Collected by ~, ~, ; Date '~///,.~/~8 7 ~-~-'"'
Water Sample Test Results _ ~,~, - D ~) N ~ '/,t,~,~/,~ O, ~ L// ~t,f,_~'//
Comments
B. SEPTIC/flOi~N,O TANK DATA
Date Installed 7',-~4A-x-
Standpipes (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well /~
To Property Line ,~
To Water Main/Service Line
Size ./~ ~O No. of Compartments ~'L.¢' O
Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N) Y
Date Last Pumped ~'71,~/g.7 ~"
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
course
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11184)
C. ABSORPTION FIELD DATA
J ~(-~ Type of System Design
Soils Rating in Absorpti~n_~_,~//Strata
Date Installed . '"'~//~{,~-"'? Length of Field
Width of Field ~'~.~ ¢ , .. , Depth of Field
Gra¢~l Bed Thickness
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation ~' L_//
Lot
To Water Main/Service Line
/D
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line /
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage ~rea
Comments
D. 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 Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I.h_ave checked, verified, or ¢,¢nformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed
Company MOA No.
Receipt No. //d~ E) / ¢ O O 2~
Date of Pa. yment 4/'~.,,~¢';-:~' _
Amount: $
Page 2 of 2
72-026 (11/84)
Engineer's Seal
r~ g~ ANCHORAGE, ALASKA 99501
CONSULTING ENGINEER TELEPHONE: (907) 279 3916
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOT 13, BLOCK C, KNIK HEIGHTS
LOCATION:
12541 ATHERTON ROAD
OWNER:
GEORGE A. MORRIS
RESIDENCE:
SINGLE FAMILY, TWO BEDROOMS
WELL:
PRIVATE, ON SITE
SEPTIC SYSTEM:
DATE OF PUMPING:
DATE OF TEST:
FROM MUNICIPAL RECORDS:
TANK: STACK STEEL, TWO COMP. 1250 GAL.
ABSORPTION SYSTEM: LOG CRIB
ABSORPTION AREA: 288 SQ. FT.
SOIL RATING: 166
INSTALLATION DATE: JUNE 1974
APRIL 21, 1987
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED ON APRIL 17.
TANK WAS FOUND WITH TWO FEET OF COVER AND WITH
52 INCHES OF LIQUID. TOP OF CRIB WAS 18 INCHES BELOW GROUND. LINE
FROM TANK WAS INSULATED. WATER WAS OBSERVED INTO THE CRIB STAND
PIPE. TEN GALLONS OF WATER CAUSED THE WATER LEVEL TO RISE PAST
THE TEE TO THE TAN~.
TEST RESULT: ~! HIS SYSTEM DOES NOT MEET THE CODE REQUIREMENT
~gF THE MUNICIPALITY OF ANCHORAGE. ~
VISUAL INSPECTION OF THE LOG CRIB SHOWS THAT THE CRIB CAN NOT
ACCEPT WATER FROM THE RESIDENCE WITHOUT OVERFLOWING. IT IS
POSSIBLE GROUNDWATER OR MELT WATER IS AFFECTING THE OPERATION OF
THE CRIB. IT IS MORE LIKELY THAT THE CRIB HAS REACHED THE END OF
ITS USEFUL LIFE AND MUST BE REPLACED. IN ORDER TO REPLACE THE
CRIB A SOILTEST AND GROUND WATER MONITORING FOR A MINIMUM OF
SEVEN DAYS MUST BE PERFORMED. BASED ON THE RESULTS OF A PERCOLA-
TION TEST AND THE OBSERVATION OF ANY POSSIBLE GROUND WATER, THE
MUNICIPAL HEALTH DEPARTMENT WILL ISSUE A PERMIT FOR AN UPGRADE OF
THE ABSORPTION SYSTEM. THE SIZE AND THE COST OF THE REPLACEMENT
SYSTEM CAN NOT BE DETERMINED UNTILL THE SOILCONDITIONS ARE KNOWN.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
CONSULTING ENGINEER TELEPHONE: (907) 279 3916
RESIDENTIAL WELL INSPECTION
LEGAL:
LOT 13, BLOCK C, KNIK HEIGHTS
LOCATION:
12541 ATHERTON ROAD
OWNER:
GEORGE A. MORRIS
TYPE OF WELL
SINGLE FAMILY
WELL LOG AVAILABLE:
NO
INSTALLATION REQUIREMENTS MET: YES
PUMP YIELD:
SIX GALLONS PER MINUTE
DATE OF INSPECTION:
APRIL 21, 1987
TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6
GALLONS PER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE
DRAWDOWN STABILIZED. AT THE BEGINNING OF THE TEST WATER LEVEL WAS
FOUND AT 39 FEET BELOW THE TOP OF CASING. AFTER FIFTEEN MINUTES
OF PUMPING AT 6 GPM WATER LEVEL HAD DROPPED TO 59 FEET AND
REMAINED AT THAT LEVEL FOR THE ANOTHER 30 MINUTES. A TOTAL OF 250
GALLONS WERE DRAWN IN A TIME PERIOD OF 40 MINUTES. THE WELL
RECOVERED TO 41 FEET, OR 90%, IN TEN MINUTES.
TEST
FOR COLIFORMS:
WATER WAS TESTED FOR COLIFORM BACTERIA
NITRATES. NEGATIVE FOR COLIFORMS/~ '
NITRATES 0.34MG/L.~
and
TEST RESULT:
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours.This well surpasses this requirement.
The assessment of the condition of this well applies only to the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from the
surface, and changes in land use and other factors that may
impact the conditions of the aquifer feeding the well.
APPLIC iT FILLS OUT UPPER HAL ONLY
Pioperty Owner
Mailing Address
Zip Code ,,, ,
Buyer
Address Zip Code
Lending Institution ,;r,,~ / :: / i ~' ' /'' ~ < 4'~ , ,~ c- /, / ,'// ~ /i Phone
Address Zip Code
R~alty Co. & Agent Pbone
Address Zip Code
Legal Description ? : ,/ ; ,; ,//~ ~'~i. /~;'~ ' /" /'t:~
Street Locatio~ j ; ,7 4/// //'/'/ :, /~ /,
Type of Residence
E~¢Sihgle Family
t~ Multiple Family
L~ Other
No. of Bedrooms
Water Supply
[~lndividual
[7] Community
[] Public Utility
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
For wells drilled prior to that date. give well depth (attach log if available).
Sewer Disposal
[q-"lndivid ual
Public Utility
Holding Tank
Year Individual Installed: I
When Connected to Public Utility:
NOTE: TI4E INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE! INITIATED.
Time Time Time
Date Date Date
Inspector inspector Inspector
Pield Notes:
~(-~PPROVED BEDROOMS
( ) DISAPPROVED
) CONDITIONAL ,~,~PROVAL*
°ATE
"CONDITIONS OF APPROVAL
Soils Ratin9
) ":i ?"
Dale Sewer Installed
Well To Absorption Area
Well to Tank / I (_::,
Date
Well Log Received
Septic Teck Size
