HomeMy WebLinkAboutFORELAND VIEW BLK 1 LT 4Foreland View
Block 1
Lot 4
#017-401-44
MUNICIPALITY OF ANCHORAGE 401
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
NAME
PHONE
ERNEW
C -so CO ST
4;r6-2-78-7
❑UPGRADE
MAILING ADDRESS
PC. 0 )10905- a
9F,6-11
LEGAL DESCRIPTION
L t 6n, o f z szS
LOCATION
Sw
NO. OF BROOMS
.v.so.v e'r,
UM
DISTANCE TO: Wall ` y I
!U3
Absorption area I
lJ
Dwelling f]Q I
333
PER{p��1 NO.q+
V Q/O
~a Q
ManufacturerG RCC
Mate���
No. of co rtments
W P.
L
u!
Liq .�
c acity in gallons
/s"O
IF HOMEMADE:
Inside length
Width
Liquid depth
_
d
Z
DI STANCE TO:
Well
��--
Dwelling
PERMIT O.
ALO
0z'1
S
Manufacturer
Material
Liquid capacity in gallons
W =
DISTANCE TO:
Well I 7 I
Foundation sn I
C
Nearest lot lin�9 I
PER8Q 1� .Q®
rj
j LL Z
FZw
No. of lines'
Length of e� et
Total length o lines /
Trench widt� r
Distance been lines
G F
¢
Top of tile to finish grade /
Material beneath the
e
Total effectiv absorpf re
[]
inches
4
Length ��
Width
Depth
PERMIT NO.
w
6 F
an.
W
Type of crib r-.--_
Crib diameter -
Crib depth
Total effective absorption area
y
DISTANCE TO: r
Well
Building foundation
Nearest lot line
J
Clas
Depth ^_ _
Driller �_.
Distance to lot line
PERMIT NO.
DISTANCE TO:
Building foundation
Sewer line
Septic tank r
Absorption area(s)
737'
OTHER
PIPE MATERIALS
v
+
CA5T;"ft UC O 30
0
SOIL TEST RATING I
1
23)'�
INSTALLER
NEWWA0 Ex e f 6�
s
00
sS
REMARKS
IAJSQ 1 .tJ Quait rAVK,
P 7717Keac IOIt eo
/
r
�/�RB9lLi � V s. OSCUALOT ii-ly-BCI.
��
Pers w .4T -0 7-ili-
I
0
IL
q
APPROVED I DATE LEGAL
#Lll P, //2o/gy_ L
/'l`
4 di
FoeELA-4jb: 1W'?36U ScSc ZS'
72-013 (Rev. 3/78)
. .QRS -d .LL L+ � H^ i'^t Kw- .L I 9""_ 9'.f■W Tw ��£M�97;tG �.
:I}E4?412TMEN7 OP HEALyT4i:AND� ENVIkOWN9NTAL PROTECTIONRE
82$ L STET, ANCHORAGE, Ak 995(11
:264--4724
E tM I T; NO: '840908
TE 'ISSiuew 10125/84
F'PLIGANT: CARLESON CONSTR.
"DDRESS: P O BOX 110905
ANCHORAGE, AK 99511
,;ONTACT PHONE: 346-2787
SAL DESCRIFq $4►Ak1vieiON: FORELAND VIEW LOT: '4
SECTION: 25 TOWNSHIP: 12N RANGE: 3W
T I -. ". 46598 (SQ.FT. OR ACRES)
t LOCATION; KENAI CIRCLE 'OFF UPPER DEARMOUN
X $EDROOMS. 4
E
4 �._
BLQCK-w, 1
fisted below are the options available to you in designing your septic
the option that best fits your site.
�+ystem_ -Choose
" 'T 1FZE=P C:," - - SEE? - - W,. IDFRA I P4
PTH TO PIPE BOT -TOM (FT.) 4.0 4.0 4.0
(t L DEPTH (FT.) 6.0 0.5 3.5
`
RL DEPTH(FT:) 10.0 4.5 7.5
Of VEL' WIDTH (FT.) 26.0 5.0
AVE L "LENGTH (FT.) 77.O 5A.0 100..0 �a*
AVE{ VQLUME (GU.YDS.)
4 =49.2 74.1
s` K SIZE (GALS)1, 2 S2. a1 1,.2S? i0 1, 250. 0 �a�a
lI MATING (SQ. FT.
IBR)
1 RAVEL LENGTH >,75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EtCF13 `,
x`atat,TANK MUST HAVE AT LEAST TWO COMPARTMENTS
V
sortify that:
1 Iam familiar with the requirements for on-site sewers and we1.1�-ate
forth by the Municipality of Anchorage (MOA) and the State, of AT
'
az
I'
. ;will. install the system in accordance with all MOA codes: and reg;,ai��,'
'
and in compliance with the desigh criteria of this permit.
3 I. will adhere to all MOA and State of Alaska -requirements for the se$ bear
Ifffitance'e from any existing well, wastewater disposal'system i
or pµble
Werage or
system'oh this any adjacent or nearby lot:
.4a ,.understand that this permit is valid for a maximum of 4 bedrooms ao-#k,
any'enlargement will require an additional permit.
«A LTF!'STATION fS INSTALLED IN AN AREA COVERED: BY MOA;,8UILDING CODES,
ELECTRICAL, PERMIT AND INSPECTION MUST BE OBTAINED, (r^_) A5 B�4TLFfi,'
8E �P,ROVEIi WITHOUT AN
ELECTRICAL INSPECTION f3EPORT-1-A'ND (ZO `THE
TROAL WORK MUST A
•F#E DONE BY LICENSED ELECTRICIAN. '.'
'� #ATEn 1�A ��L :.
3�lxti
IN .,41"TR.
i
/
2
3
4
5
6
7
a8
9
10
11
12
13
14;
15
19
20
PERFORMED
72.006 (6/79)
w GRIIkUeLy, y S/�T� /s�0
IUVN/ t ott l LUYei �(K�P
Qu��a� ala
4-a
aR1A1E[G f S�i� � 5/�
JJ� WAS GROUND WATER S
(Alm 6461St // / c4w5! ENCOUNTERED? IA 17 O
P
IF YES, AT WHAT E
DEPTH?
,r A
Reading
Date
Gross
Time
LY SOILS LOG
Depth to
Water
Net
Drop
44
aD
1096
MUNICIPALITY OF ANCHORAGE
Q5fl
�PERCO CATION
• r
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(a SG
®
o.
TEST
825 L Street, Anchorage, Alaska 99507 264-0720
C7. TO
SOILS/ LOG — PERCOLATION TEST
PERFORMED FOR: �tje
�//
-DATEPERFORMED:
5r1L1 �(Ah 41�c C�t 0G.�1
o -/o
{30
-^ 4;d"uj
�n 81eck
546,
LEGAL DESCRIPTION:
f
3
J#- /c/
1//6
DEPTH
6).yl -
SLOPE
SITE PLAN
2
3
4
5
6
7
a8
9
10
11
12
13
14;
15
19
20
PERFORMED
72.006 (6/79)
w GRIIkUeLy, y S/�T� /s�0
IUVN/ t ott l LUYei �(K�P
Qu��a� ala
4-a
aR1A1E[G f S�i� � 5/�
JJ� WAS GROUND WATER S
(Alm 6461St // / c4w5! ENCOUNTERED? IA 17 O
P
IF YES, AT WHAT E
DEPTH?
,r A
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
44
aD
1096
Q5fl
(a SG
a
o.
uja
/05,6
C7. TO
/o
O. -Jo
o -/o
{30
l/06
0.50
3
10' 3
1//6
l0-
6).yl -
0.0,7
N
Jo a3
1136 '
/o
b. 1.0
O,OS
N
// c r/3c
/O
ol o GtY?
of
-Z 'J
1136 1/
0.5 0-'/3
0.0
PERCOLATION RATE
1 TEST RUN BETWEEN
a
4 eP a
/D
CERTIFIED BY:
Ggihute3(inchl
1004 ��
....
DATE: `
5'
Ik
PERFORMED
LEGAL DESC
2-
3-
4-
5-
6-
7
8-
9-
10-
11
-10-11
12-
13
14-
15-
16-
17-
18-
19-
20 -
COMMENTS=
MUNICIPALITY OF ANCHORAGE rte// RCO D�
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION "� PERCOLATION
TEST
625 L. Street, Anchorage, Alaska 99501 _ 2644720
SOILS LOG — PERCOLATION TEST
DATE PERFORMED:
W &*4vEZy y psz�k0
4lel6f510
P'li f ala COM
NL GRA�E�G9 s,4+«lY s��r
// / WAS GROUND WATER S
4,0? (40;S(j d�uu ENCOUNTERED? l/Li7 OL
P
IF YES, AT WHAT E
DEPTH? /
�,rr J.J.
Reading
Date -.
Gross
Time
Net
Time
Depth to
Water
Net
Drop
aD
10 96
a"
f
` .1013
(06-6
O
D.
ow
(ly0
1054
p.5'O
re -as
10
o.yo
f2.10
o
11Io4
o.so
g
1114
1!a
o -W
160
1116
0.60
H
10-x3
11,24
to
0.112
pA5
N
nu It3o
/0
rmv 0,v-2
08
C
to Z'o
1136 /
D.5/ O.
o -o
PERCOLATION RATEla. limi�tt (minutes/inch)
TEST RUN BETWEEN .-C�0 FT AND S FT l(/�
d 1.-•.-_ n., J �4 /D.0 bo.� k
U
—"Olk ANCHORAGEw ALASKA 00502
344-7,714
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 1404
DRILLED AT THE RATE OF $23.00 PER FOOT.
PROPERTY OWNER fly' ,lob Ca2Le-oaa Ca4.tvjoa Cofwt. 346-2`78'7
LOCATION OF WELL SITE B1k. Sub.!\ 7C �i�Lt , YL
DRILLER
WELL LOG:
0----22' S -i. -W gAque. 45%
22- -52' CoaRAe yAwe.L with 25,a cCaz,�. Seve-tat 4mait .&outde u
52---79' R congiomenmte mateA at. lueathened bnakea bedrock.
79--140' BedJLOck. A o nock w.Lth watet phodtwAiaa of .two f"I 4taatUlc1
fAaa 79ft to 874. Ro new wat<A, Ole" un t LL 138 .to 142 A. A panou4 type nock
.in -th,i4 a2ea 4 Lotd.in4 an a.dcL�ona.L 2 1/2 to 3 W111. Atoduct i on ho des .ion a white- at
5 to 5 1/2 aPlii &.then dnap4 down. a 4t tq/vt amount. The tata{../_aotage .ice 144 pt.
(Jateh coiner back up to w.Lth in 45 .fit o. 4unfac_e. 1/2 fio&4e 5ubmeA4 ,&te- Puaja 4hou.Cd
be. ZL4ta ted 20 Jt off bottom,. L'atcz d.6 pumped (cteat)
MUNICIPALITY OF ANMO"
DEPT. OF HEALTH &
Goat a� D& Gorey; 523.00 pec %t "4*N0WTA6JQd*Gj�Nq Tota.L D&tiLiagg coat.
MAR 2 51985
RECEIVED
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 03220.00
THANK YOU VERY MUCH.
BERNIE CLAUS OF RAMPART DRILLING WORKS
DATE Rovemben 24th., 1984 7?�
SERVICE CHARGE 0F I%z% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNTS.
0 MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date 3 _ Zy - '?S�
(a) Legal Description (include lot, block, subdivision, section, township, range)
L 5� 3/ /t.70/ S 2-.5", Ti 2 .v , / 3 e_v. Si
(address or directionf
so CIPM —
(b) Applicants Name /e- c,4 ��
Applicants
U
i U !� U f �C /L �Cf41ZYv10U tj
J Telephone - Home 3•(� &
/_g It
9-7
(c) Applicant is (check one) Lending Institution ; Owner/builder, ;
Buyer M ; Other E --::l (explain);
(d) Lending Institution Telephone
Ad _Ws
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
GU/ L L Rl C /< Lir`?
2. Type of Residence
Single -Family F71 Multi -Family
Number of Bedrooms
Other (describe)
3. 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.
4. Sewage Disposal
Onsite Public Community El 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]
0
E
t
J
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 onsite
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 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 regula-
tions in effect on the date of this inspection.
Name of Firm 00,oF 6-7A7 Sr5 5/%''�TFalenhone .3 7 �•}z�'�
Address ���� /dC!c ��ed.�f s-- 8��� �• ^ • `" Yo` 9C' f t/C_
Date>. ,
z-
}� NO. 1732E
(ENGINEER SEAL) ��
6. DHEP Approval ®,
Approved for u�' bedrooms ^ Dates }
Approved ' Disapproved Conditional
Terms of Conditional Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS- EMPLOYEES OF DHEP 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2] 7-19-84
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
MUM
9M 0 Z 8VA
CHECKLIST - FEBRUARY 1984 N0I1031O Nd 7l1N3WNOTAN3
I HiIb3H 40 UAO
Legal Description: dO:LLnpd�ONnN
Foil C C./4�' 7 U lC U.-IyC C./4�'� l (C U.I "�� �Cy
Well Classification w I ✓�L F S 7� i T (Z i
- If A, B, Cr C, D.E.C. Approved(Y/N)
Well Log Present (Y/N) Date Completed //- z V ---?5/ Yield
Total Depth /YO � Cased to '7q ' Depth of Grouting�,
Static Water Level s /j /ou l Pump Set At /25/
Casing Height ht Above Gro nd / S
Sanitary Seal on Casing (Y/N) /
Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N)
Separation Distances fran Well:
To Septic/Holding Tank on Lot ( c) 3 ; On Adjoining Lots t 1 0
To Nearest Edge of Absorption Field on Lot 13 %' ; On Adjoining Lots t io O '
To Nearest Public Seder Lire To Nearest Public Sewer
Cleanout/Manhole fy//Iq To Nearest Sewer Service Line on Lot 7 �I '
Water Sample Collected By Date
Water Sample Test Results;
i/? R1'q1J1PA2 T )/?/GC
B. SEPTIC/HOLDING TANK DATA
Date Installed %/- Z d -fl/ Size /Z D No. of Compartments
Standpipes (Y/N) i Air -tight Caps (Y/N) Y Foundation Clearout (Y/N)
Depression over Tank (Y/N) /) Date Last Pumped N.L �J
Pumping/Maintenance Contract on File (Y/N) A ; for
Holding Tank High -Water Alarm (Y/N) ti/ /-} Temporary Holding Tank Permit (Y/N)
Separation Distances fran Septic/Holding Tank:
To Water -Supply Wall / G 3 To Building Foundation 3 S
To Property Line 3 7 To Disposal Field /S
To Water Main/Service Lire To Stream, Pond, Lake, cr Major Drainage
Course ti//1
Comments SEP /--/C, -5 1S i C/z 1 /2/4 i /9
TR 5/— 0Z � i,U iv,$).4 c:. 7 -
Receipt
Receipt #
Date Paid:
Amount: L(S-vC.%
[Page 1 of 21
2-1s-84
C. ABSORPTION FIELD DATA •
Soils Rating in Absorption Strata Z 3 / Type of System Design %/2E/L'6 N
Date Installed //- Z a " k 5/ Length of Field -7 7
Width of Field 3' Depth of Field /O'
Gravel Bed Thickness
Square Feet of Absorption Area Standpipes Present (Y/N) y
Depression over Field (Y/N) tj Date of Last Adequacy Test NC �
Results of Last Adequacy Mast T/7
Separation Distance from Absorption Field:
To Water -Supply 'Well /.371 To Property Line
3i
To Building Foundation -5-11— To Existing or Abandoned System on
Lot :� ; On Adjoining Lots -1— U /
To Water Main/Service Line % D To Cutbank(if present) "14
To Stream/Pond/Lake/or Major Drainage Course :'
To Driveway, Parking Area, or Vehicle Storage Area z5o '
Comments ✓D/f.(J 4A%E,5 .G,VS/tf"Gj/orl/
D. LIFT STATION — N�
Date Installed Dimensions
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA HAA in effect
on the date of this inspection.
Signed Date
Date�D
Company l �a�IJ` ��5/a-✓ si c� MOA No. S'i
KB1/d5/s
(Page 2 of 21
Swa 2:4 1968
2-15-54