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Home My WebLink AboutT15N R1W SEC 8 LT 129 3330 C Street Anchorage, Alaska 9!)503 · . INSPECTION REPORT ON-SITE SI:WAGE DISPOSAL ' ..... - .... ~ ....__ SY ...... NA, E .A,L,N SEPTIC TANK: DISTANCE FROM WELL ..__ INSIDE LENGTH ...... COMPARTMENTS J_IQUlD CAPACI'I Y '-/&~~b~T-~- GAL'LONS'~'~ i~£.'~:i' ICqq¢/ NUMBER OF PITS ........ DIAMETER __.__OIR WIDTFI ( INING MATERIAL CRIB SIZE: DIAMETER___DEPTII__ E)ISTANCE FROMt WELL. TOTAL. EFFECq IVE BUILDING FOUNDt\TION. _ , NEAREST LO[ LINE .... ABSORPTION AREA (WALL. AREA) Z'[~t __sq. F'r. ADDITIONAL ABSORPTION _ WELL: BUll. DING FOUNDA l ION CESSPOOl CONS I'RUCTION. 5 ~"v"~'! ~_~.?'L .... [3EPTN .......... DISTANCE FROM: NEAREST NEARESF SEPFIC SEEPAGE L_OT LINE ........ SEWER LINE _. 'rANK ..... SYS'FEM O'FHE R SOURCES .......... APPROVED ..... DISAPPh'OVED B NSFALL ED y: - _ LOT SLOPE: GRE*.[ER ANCHORAGE AREA BOi..~UGH DEPARTMENT OF ENVIRONMENTAl. QUALITY SEWAGE DISPOSAL SYS'TEM -- APPLICATION AND PERMIT :INANOED TNI~OUGH . "INAL INSPECTION: 24 HOUR NOTICi': REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPI~,CTION BY THI~ )EPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE ~UBJECT TO PROSI~CUTION. WELL TO SEPTIC TANK DIAGRAM OI~ SYSTEM WATER MAIN TO SEPTIC TANK - SEEPAGE PIT DRAIN FIELD U J Lot 129 Sec.8 T15N R1W NEWTON DRILLING July, 1 3 Water well. for home use. Size of casing 6" steel. Depth H0is 0ased to 64'8". Statio water level 24' be].ow land surface Pinish of well- open end. Well pumps 3~15__~ at first pumping, minute. Total storage _De_j~h~tn__.~fe e t from____sur fao e. O' to 20'4" 20'4" to 31~11'' 31'11" to 47'6" 47 ' 6" to 50 ' to 65' 65' to 66'7" then drops to ~ per Dirt, Gravel and small rook. Hard pan Olan& [Sand (mixed) Olay & G¥~vol (w~-ter-bearlng at 50' ~ gal a min.) 01ay & Gravel Gravel (w~ter bearing) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HI:!ALTH CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL. OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (e) Legal Description (include lot, block, subdivision, section, township, range) Lot 129 T15N R1W Sec. 8 3/16/86 Location(addressordirections) _ Jayhawk Drive (b) Applicant NameR°n Wild Telephone: Home688-288:]- Business688-2881 Applicant Address Box 70~ Chugiak~ AK 99567 (c) Applicant is (check on.e): Lending Institution []; Owner/builder [~]; Buyer []; Other [] (explain); (d) Lending Institution First National Bank Address _Ea~le River, Alaska (e) Real Estate Company and Agent N/A Address Telephone 694-23~03 Telephone (l) Mail the HAA to tile following address: pickup b~¥ engineer TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms 4 Other WATER SUPPLY Individual Well [] Community [] Public [] Note: II 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 [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation altesting to Ihe legality and status. Page 1 o! 2 72 025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION " As certified by my seal alfixed hereto and as of the validation date shown below, I verify that my investigation of this H,ealth 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 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 aed State codes, ordinances, and regulations in effect on the date of this inspection. /~'~.~ / ' ~ " ~ ~.~,/~,- ~F ~,'1 I~j ~e~'~'~,~/~,~,, ~ ~_ .~. ~.~ N~me of Firm T~ephone Address EAGLE RIVER ENGINEERING 8EBVIOE8 D~te ~//~/~ ~ ~GLE RIVER, AK 99577 ~07BO~ 694-5195 ............ ~ ,, o ineer's Seal Approved ~Z,Y% Disapproved Conditional / Terms of Conditional Approval CAUTION The Muncipelity of Anchorage Department of Health and Environmental Protection (DHEP) issues Hearth Authority Approval certificates based solely upon the representations 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 requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible lor errors or omissions in the professional engineer's work, Page 2 of 2 72-025 (11/04) MUNICIPALITY OF ANCHORAGE HEAt. TH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Descripuon: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVII~ONMENT^I, PROTECTION A. WELL DATA Well Classification ,2¢3¢'~ / g4 '~/~ Well Log Present (Y/N) _ ?/ Total Depth ~ ¢ / _ Cased to Static Water Level ,~, 5-, ~- / Casing Height Above Ground /~' Electrical Wiring in Conduit (Y/N) _ /V Separation Distances frorn Well: / To Septic/Holding Tank on Lot / / To Nearest Edge of Absorption Field on Lol To Nearest Public Sewer Line. Cleanout/Manhole Date Completed __ ~ ~" Death of Grouting /'~/~ Pure ~ Set At /'~ ~-¢~*~" Sanitary Sea on Casing (Y/N) ~ Deoresmon Around Wellhead (Y/N) Water Sample Collected by Water Sample 'rest Results If A. B. C. D.E,C. Approved (Y/N) ,~,-, (? /5 ~Z Yield : On Adjoining Lots ,I ZO '~ : On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service L ne on Lot : Date __ 'Z//////E 7c~ Y~ Comments B. SEPTIC/HOLDING 'rANK DATA Date Instelled 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 Septm/Holdmg Tank: To Water-Supply Well _ To Property Line To Water Main/Service Line Course ¢-/¢~" Size /~--~ ¢~/ No, of Compartments Air-tight Caps (Y/NI ~ Foundation Cleanout (Y/N) _ Date Last Pure ~ed ~/ ,,4//¢¢ for Temporary Holding Tank Permit (Y/N) _ To Building Foundation To Disposa Field To Stream. Pond. LaKe. or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /~' Width of Field Square Feet of Absorption Area ..,.D, 2 2 Cz` Depression over Field (Y/N) ,4/ Results of Last Adequacy Test Type of System Design Length of Field ~'~' / Depth of Field .,~',~ ,-~ Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To StreamlPond/Lake/or Major Drainage Course _ To Property Line ~',~5'-/ To Existing or Abandoned System on ; On Adjoining Lots f ~'~:' / To Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area '*/o / Comments ~v.~,:~'¢/ .-¢.~,r'/~',,~ ~,~z_~,."~-;~"~/' ~.~.,~ /~, Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** 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. Signed Y~~-- Date Company ,Z~', ./~,,/.~-, ~/ MOA No. Receipt No. ~q~ ~ Date of Payment ~ ~- ~-(&~ Amount: $ ~ ~ ~ h "~ ¢ ~-;~*. ~ %. (~ ~ngmeer's Seal