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Home My WebLink AboutFLAT TOP VIEW #1 BLK 2 LT 11 E80'Flattop View Block 2 Lot 11 E80' 8-391-93 Municipality of Anchorage Page ! of · ~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: Name: · .~o~,4 ~.~r~ Wastewater System: [] New [] Upgrade Address:.~,~ '~ ABSORPTION FIELD ~~ No of Bedrooms: ~ Deep~ D Shallow Trench ~ Bed ~ Mo~ Other Phone: Soil Rating:~D/Sq~ ~t II Total Dep~iginal grade: Lot: '~ LEGALBIock:DESCRIPTION~ Subd.vision:~. ~O~ ~l~' I 3epthtop,~bottomfromorig,n.l~ ~pth beneath pipe FI WELL: ~ New D Upgrade Gravel width:~FI I Number o~l Distance ~tw~ lines:Fl Class,hcat,on,Pnvate. A.B.C):~, V~ TotalDepm:~, Ft CaseuTo:~ ~ Fl Tomlabso~ea: SO Fi Pipemateria,: Dale Dr,lieU: S~al,c Waier Level: In~ Date instalmed: Yield: I Pump Set al: Casing Height Above Ground: )~ o.- .,. ~ ~, TANK SEPARATION DISTANCES ~ Septic ~olding m S.T.E.P. TO Sepbc Absorphon Lmfl Holding ~ubhc Pr~vale Manufacturer: Capacity in gallons: Material: Number of Compartments: We, ~ Sudace Remarks: BENCH MARK Locabon and Descriphon: I Assumed Elevation: ENGINEER'S SEAL Inspections performed by: Dates: 1st ~ ~.~ .....~...~ Department o[ Health and Human Services approval ~{.~.. ;.. ~. ~,0 ...' Reviewed and approved by: Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage. Alaska 99501 Telephone 264-4720 ON~ITE SEWAGE DISPOSA~._~T_EM~&ID~OR WELL INSPECTION REPORT AILING ADDRESS "GAL DESCRIPTION :)CATION ~ ~ NO. OF BEDROOMS Liq. capacity tn gallons I IF HOMEMADE: DISTANCE TO: Wellc~l~ ~ Manufacturer ~ _ I Well DISTANCE TOT--~ , No. of lines I Length of each line Top of t,le to finisi~ grade :lass De,tn DISTANCE TO: Building foundation OTHER IAt3sorDtlon area [ D,,~elling ~ , ~J '~. ~_Clvlaterial I Dwelling.~ ~./ IFounqat]on Nearest tot line ~ inches PERMIT NO. No. of coml3artment$ PERMIT NO.c~,~_. ~).~ ~/_ Liquicl capaci]3/in ~llons PERMIT NO. Distance bergen lines IMaterml beneath tile Driller Sewec.t~e IPE MATERIALS OIL. TEST RATING qSTALLER EMARKS PPROVED DATE LEGAL {Rev. 3~78) '~aC~_y~a DSO r13tlO n area inches~~'~ -- __ I PERMITNO. Nearest lot line DisTance to lot line PERMIT NO. Sel3tic tank · ~ MUNICIPALITY OF ANCHORAGE 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 · IPRONE I NEW MAILING~D~RESS ...... LEGAL DESCRIPTION ~ / - LOCATION ~ ' NO. OF BEDROOMS ~ Z Manufacturer ~ Material No. of compartments Liq. capacity in gallons IF HOME.DE: Inside length W~dth ~ ~ ~ ~ DISTANCE TO: Well~ .~ Dwelling3 ~/ PERMIT NO.E~~ . o z M3teria~ Liquid capa;~lons O Z ~ Manufacturer Q Nearest lot hne ~ Z ~~~Well Foundation PERMIT ~ No. of lines Length of each line ~ inches ~ k Top of tde to finish grade Material beneath the ~ ~so~tion area ~ inches W~dth Depth PERMIT ~ k Type of crib Crib diameter ~~ ~absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller D~stance to lot hne PERMIT NO. ~ DISTANCE TO Building foundation I ~gwe~ Septic tank Absorption area(s) SOIL TEST RATING I ~ ._ ~. INSTALLER ~ ~1~ ,~,~ APPROVED DATE LEGAL TI~ ~ ~ 72-013 (Rev. 3/78) ~. F'ERMIT [)ATE ISSUED: APPLICANT: ADDRESS: · CONTACT PHONE: DEF. ARTMEN18502480~..' ,8=.o. ~__ :' HOLDING .> ~ OF L ][oTR~ET~ oHEAI-TH T ' '~E -TANK ~I o AhlD~.6~ ANCHORA~_~ z. 1.-47~ _ . ENVIRONMENTAL ..... . ~ ~ '( ' 3 F< ~r _. A~ F _." ~[-.~ oo=,] -. ~,. F'F(O]'ECT I ON ~ 1... .... -~- . ~~ 05/.3~/85 . . . .' ~ '~~ ~OHN & MARY T HANISZE~SKI '. 200 W 34. TF, ~953~--,~ ~~ ANCHORAGE~ AK' 99~L.¢ 562-2277 LEGAL DESCRIP: LO]' SIZE: LOT LOCATION: SUBDIVISION: FLAT TOP VIEW SECTION: 28 TOWNSHIP: t4000 (SQ. FT. OR ACRES) DEARMOUN ROAD LOT: E 80'-11 BLO~.,' .... RANGE: 3W I certi£y that: 1. I am £amiliar ~ith the requiremen£'s £or on-site s~wors and wellc; a~ ~;.mL ~orth by {h~ Municipality o[ Anchorag~ (MOA) and th~ Stat~ o~ Alaska. ~. I will install the system in accordance 'with all MOA c~des and. re,~ulati~n~,,,' and in'compliance ~ith th~ design critePia bf thJ. s p~)rm, it. 3. I will adhere to all MOA and State o~ Alaska requirem~nts for the s~t back distances from any ~xisting ~e~ll, waste~,;a't.~r disposal ~ys'b~m or public sew~rag~ system on this or any adjacent or n,~arby lot. IF A~LIFT STATION IS INSTALLED IN P~N AREA COVERED BY MOA E'UILDII'.~G THEH (1) AN ELECTRICAL F'ERMIT AND INSPECTION MUST BE OBTAINED; (2) AS.-BU!LTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THeE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. . ,. · ,. ................. .... MUNICIPALITY OF ANCHORAGE 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 MAILING A~R ESS gqqo ~o' Lot' ~1 LOCATIO~ DISTANCE TO: Manufacturer Well DISTANCE TO: NO. OFBEDROOMS Absorption area , Dwelling ~.~(~ , PERMITNO. ~)C~O '7 / IF HOME.DE: Inside lengt~ Width ~- Liquid dept~. Dwelling PERMIT NO. . ~ound~tion , Nearest,o, Iine , ,ERM,TNO. ~ 0~0 7'! DISTANCE TO: (~ No. of lines Length of es~e Total length of lines Trench width inches ,o finish grade ~, Material beneath tile ~ ~ Total .ffec vel ~t~n area Length th Depth PERMIT NO. diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line 'DISTANCE TO: Depth Driller Distance to lot line PERMIT NO. Building foundation s DISTANCE TO: SOIL TEST RATING OTHER Septictank [O 0 ' Absorption area(s) ' PP ED 72-013 (Rev. 3/78) DATE . LEGAL ·" .',." DEPARTMENT OF HEfl~.TH AND ENVIRONMENTAL PROTECTION.~,~-~ · 825 'L' STREET, ANCHORAGE, AK. ~501 264-472~ ON--SITE ~[4ER PERMIT ~-J~' ~ APPLICANT HERMAN ~ CHARLOTTE WARRi~O BOX 8498 ANCHORAGE ~58S ~74-54~ OC ZON LEGAL [~...~O~'EOT'll'"B'"'Z"FKAT'?OP"YIEW~7 LOT SIZE 14eec SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ~l~-- SOIL RATING (SQ FT?BR>= 250 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= ~!_~ LFNGTH-- ~ GRA"..-"EL DEPTH= 8 THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURF8CE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTF~LL PIPE 8ND THE BOTTOM OF THE EXCflV~TION <IN FEET>. REQU I RED SEPT I 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. · TWO ( ? > I ~'~SPECT IONS 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 A PRIVRTE WELL OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS ~5 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PFRr~ I T ~<P I RES I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~' I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. APPLICANT H~__~&~ CHARLOTTE W~RRACK MUNI~IPA'LI:rY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99602 276-222~ SOILS LOG -- PERCOLATION TEST SOILS LO(; PERCOLATION TEST · EGALDESCRIPTiON:/~e¢4o,~ v~,~ ~/ /o/// 1 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15 16 17 18 19 2O COMMENTS PERFORMED BY: 72-008 (7/76) DATE PERFORMED: h~/~. ~/~ ~ WAS GROUND WATER ~? /. ~l, fe ENCOUNTERED7 IF YES, AT WHAT ~ "/~ , DEPTH? SLOPE SITE PLAN S Reading Date Gross Net Depth to Net Time Time Water Drop 0 ~t/,%o /~:oo o C" J /~: so .,gt) ?.T" /, J'" ~ I1:~ o Zo ?. o I, ~- 3 /4'so3o IO.3~s- /. CERTIFIED BY: : e~ DATE: ~TATF. OF ALASKA l)EPAl%T~EIqT OF NATURAL . RESOu~C~-S DIVISION OF ~EOL0~ICAL AND G£0P/iY$ICAt SURVEYS WATEP. WELL RECORD ;CATION OF WELL ~,~.1-~. ~. L~tlz ... r~ . u~ ~F. ASURING POINT: ~.~tOp ~f casing ~ground su=face [],,~he=: BOREHOLE DATA: Depth type a~a color , HERIDIAN De~h of hole:_,I_q.,'.~_ itl I o, c s,n : "--,tI I STAtiC WAIER ~:%%:L: .~'~ ft. Date MET'IOD OF DRILLING: ~ir rotary USZ OF WELL: ~d~mestic ~.irrigation ~monitor CAS::NG: S tic k- uu../.~/~*~_..f t. Diam: 6 .. in WELl, INTAKE: [] o[:~_n end ~screened [] pecforar.,.~d []open hole Dept.h~ of ope:nimngS: ~ ~:C',.___it $CP4!:EN TYPE: Diam: in $101'/He.-h Size: Length: ft 3et Bet ween aud ft PACK TYPL': used: Depth to top: CONTRACTOR INFORMATION: eg~stered Business Name $1 ture of Authorized Representative Date GROUT TYP-'.: Vclume: Depth: from ft to ft "1 "/ ~'~I~G LEVEL ~D YIELD: I~ft after ~ hr~ pumping ~.~m ~'~ IHTm:E DEPTH: ~ ~ft ~orsepower: Date Pump Installed ~ 5.~/ -~ A'ATE:% C}{EllISTP. Y S~4PLE TAKEN? ~yes Well disinfected upon completion? ~yes PLf&ASE MAIL WHITE COPY OF LOG WITHIN 45 DA~ TO: DGGS PO BOX 77-2116 EAGLE RIVER, AK. 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SWg10259 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:H._~ JOHN R OWNER ADDRESS:PO BOX 91278 ANCHORAGE, AK 99509 DATE ISSUED: EXPIRATION DATE: PARCEL ID:01839193 LEGAL DESCRIPTION: FLAT TOP VIEW #1 BLK 2 LT 11 E 80',SEC 28, T12N, R3W, SM LOT SIZE: 11200 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM 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 (ISAAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. PAGE 1 OF 1 8/30/91 8/30/92 SPECIAL PROVISIONS: DATE:_~~Z~