HomeMy WebLinkAboutSOUTHPARK #2 BLK 2 LT 9 Onsite File
Southpark # 2
Block 2
Lot 9
#020 - 501 - 32
Mrd
"----.-„---\,, MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
t S i'\ i ENVIRONMENTAL ENGINEERING DIVISION
'' j825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
— ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE JEW
fk- ,�-e g 4-5 `77)^ ❑UPGRADE
MAILING ADDRESS T�
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LEGAL DESCRIPTION
1/L3r w 13L- z <-=,-1-FI--r'ri7zL A-v.-Do "— -2_,C440-693„/-gc3
LOCATION NO.OF BEQ${3OMS -
JC L`Tl-1-- K-- l.:1/4. vi-->
Well Absorption area7/ Dwelling r- / PERMIT�NO.
DISTANCE TO: / .� C,4 -U Q
Uy
I—2 Manufacturer Material No.of con artments
w 4N»`1-} -1 L �4,tZ�
Liq.capacity in gallons Inside length Width Liquiduid d�ept�
.2.-.,1-G IF HOMEMADE: --
WellDwelling PERMIT NO.
D�z DISTANCE TO: - {
O z Q Manufacturer Material Liquid capacity in gallons
In Well Foundation / Nearest lot line r PERMIT NO
w= DISTANCE TO: ( / `� )5 ` jC� E?�%
J LL z No.of lines Length of ach ine Total length/of Ii i Trench width Distance betweeny ;lin sn
I-Z¢ I V ..04,:3
. '' inches N
F Top of tile)o finish/grade Material beneath tile 1" ,� Total effective bsorption area
p a --ry ( L.L.) ` 37_ 1, inches i EL Ili
Length Width Depth ✓ PERMIT NO.
Lu
<I- Type of crib Crib diameter Crib depth Total effective absorption area
as
w
ur Well Building foundation Nearest lot line
u) Well
TO:
J Class Depth Driller Distance to lot line PERMIT NO.
J
w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
GAS; \4.04 , 1) os�'- , p-F PIPS
SOIL TEST RATING
INSTALLER / / /
jZu �.- — N — (-! E)cC_ r
REMARKS
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APPROVED DATE LEGAL :1 1 11S5
72-013 (Rev.3/78)
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. �tj�A 1 � � ��� � �� Of IF:- �PA�������N�� �
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, AK 99501 �~�,�^ - -
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264-4720
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C3P4--E3 ][ 'TEE E3EEWIE:1177c �:"EEFRi ][ - -
PERMIT NO: 840860
DATE ISSUED: 10/09/84
APPLICANT: NACCARATO CONST.
ADDRESS: 2441 AUTUMN CIRCLE
ANCGORAGE, AK 99516
CONTACT PHONE: 345-7920
LEGAL DESCRIP: SUBDIVISION: SOUTH PARK ADD#1 LOT: 9 BLOCK: 2
SECTION: 3 TOWNSHIP: 11N RANGE: 3W
LOT SIZE: 22322 (SQ. FT. OR ACRES)
MAX BEDROOMS: 3
Listed below are the options available to you in designing your septic
system. Choose the option that best fits your site.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
171REEPAC:AVA EcEET3 VJ ~ :1:3FR'Ar I IIM
DEPTH TO PIPE BOTTOM (FT. ) 4. 0 4. 0 • 4. 0
GRAVEL DEPTH (FT. ) 7. 0 0. 5 3. 5
TOTAL DEPTH (FT. ) 11. 0 4. 5 7. 5
GRAVEL WIDTH (FT. ) 2. 5 26. 0 5. 0
GRAVEL LENGTH (FT. ) 77. 0 ** 50. 0 115. 0 **
GRAVEL VOLUME (CU. YDS. ) 53. 5 . 48. 2 85. 2
TANK SIZE (GALS) 1, 000. 0 ** 1, 000. 0 ** 1, 000. 0 **
SOIL RATING (SQ. FT. /BR) 355 287 355
** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH)
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations ,
and in compliance with the design criteria of this permit . '
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well , wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for a maximum of 3 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA *BUILDING CODES
THEN ( 1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS B'uILTS
c�
WILL NOT BE APPROVED WITHOUT AN EL -
ELECTRICAL WORK MUST BE DONE BY A REPORT; AND (3> THE
SIGNED � -
� DATE: �~� ��
L � __ L! ' �~ /�� /' �� 4°4'
APPLICANT: NACCARAIIONST. Ct I
ISSUED BY ^ DATE:
_4110`-./ _ ___�°�k_________ = ____ ��
• / SOILS LOG
MUNICIPALITY OF ANCHORAGE D
• PERCOLATION
• 1 +..r DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
,t 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: DATE PERFORMED: 3/2$/83
LEGAL DESCRIPTION: 22- g 8 M oAAl STR3-o2q Sect. 3 TrI cJ (i 3 N 3‘' 111 ➢`'K /-Jd 2 6 Z L9
SLOPE SITE PLAN -
' 4f OI/GM
( '1 °roe"(•6ro;c,^ s;l+ysandr grovel
GM
RI Q re w N 50i
.Iry so.,),/ 9ra.veI
3 ij I
Iefs o4 l r.e Sava \ zo1
4 N 01
5'—
iii 0
0 g -4 !I I
7 —r.:w r? ii , ci. 2R.
91iik
10 -i! "33.---? f , S7 209; cS%
1M
{ I WAS GROUND WATERS
S
11 'I ENCOUNTERED?
P
12 —ii i
IF YES,AT WHAT E
' DEPTH?
13 —I
6"2 cp;a
1411111i1 Reading Date Gross Net Depth to Net
Time Time Water Drop
It_ 1•5 . 1 3 IS r.yl —
�+� OF Ani 3/28 3.yS 30 .9S .Yb
'� 3''17 — I.4! —
OCo'e Q �� �VIt '1 r 7 3 o 1.2 Y .1 3
9 ,- �4 '.,fir •oQ , y l7 r.4./7 —
0•••e•• • 44444444 x ,) 1."e7
` c.17 I.N 7
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,; eroy C"
eid, Jr.
f 8', No. �r51.E •:.: '
a®.
2 \>�• .� �SIO �� PERCOLATION RATE tq I J (minutes/inch)
TEST RUN BETWEEN 2 Y2 FT AND 3 FT
COMMENTS
Soil 6-z2"W C 117g n 'fE ,
PERFORMED BY: $JQtrt S CERTIFIED BY: DATE: 471/q!g3
72.008 (c/79,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date 3/Z 511/S5-
1. GENERAL INFORMATION
(a) Legal Description (include lot, block,subdivision, section, township, range)
Lit- cj Cit_ Z Sock•T,--P(h2 A- Nom'2
Location (address or directions)
S4=a41-t}3f112t Lo op 1) vc
(b) Applicant Name C E>= N itg-e1TD Telephone: Home S J mousiness 11 -
Applicant Address 24-4- ! Cl RO-E
(c) Applicant is (check one): Lending Institutiory wner/builder 0 ; Buyer 0 ; Other 0 (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address: 5
4- L .3-k-- t„itu_ F:\ tta, •- to
2. TYPE OF RESIDENCE
Single-Famil . Multi-Family 0 Other
Number of Bedrooms .,.�
3. WATER SUPPLY
Individual Well 0 Communite Public 0
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 0 Community 0 Holding Tank 0
Note:I((If community well system,must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
72-025(11;84)
Page 1 of 2
0
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 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 (►1'1I�" /C 1' _ LflL C,3y1ZLTel_ephone n 4-3 �
7 CcIA
Address G1Z(
OO c- \ ' i7 / At<ic_cti?r-t>'e-
Date
e/E-gJ
Engineer's Seal
-• ••- tk
1
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��M•�." .Tat 1,(A •:,9
• THOM A. FISCHER
OQ "-S � CE-6793 •• �e4
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6. DHEP APPROVAL �. I,
Approved for 'T" ' bedrooms by al 4--"--";C; Date
Approved Disapprove. Conditional
Terms of Conditional Approval
SU%
dhep
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health 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 for errors or omissions in the
professional engineer's work.
Page 2 of 2
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE(MOA) DEPT. OF HEALTH &
•
HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION
CHECKLIST-
FEBRUARY 198426 4720 MAR Z 9 1gEih
Legal Description: (.�T ! n �'�! u .1�-Ii
PrDDr\ 9— ?---
A.
Z-
A. WELL DATA
Well Classification C. "nv A%,, rr ' If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) Date Completed Yield
Total Depth Cased to Depth of Grouting
Static Water Level Pump Set At
Casing Height Above Ground Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots
To Nearest Public Sewer Line To Nearest Public Sewer
Cleanout/Manhole To Nearest Sewer Service Line on Lot
Water Sample Collected by ; Date
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed i 43(1 ¢- Size I Z.50 No. of Compartments 2_
Standpipes (Y/N) 1 L.. Air-tight Caps (Y/N) I " Foundation Cleanout (Y/N)
Depression over Tank (Y/N) N-0 Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) NVA"' ; for
Holding Tank High-Water Alarm (YIN) Wei- Temporary Holding Tank Permit (Y/N) N01-
Separation Distances from Septic/Holding Tank:
i
To Water-Supply Well M/6" 25 To Building Foundation 5-5-
To Property Line To Disposal Field
7 /
To Water Main/Service Line Z5 -t- To Stream, Pond, Lake, or Major Drainage
Course IQ iet-
Comments
Page 1of2 `I " 0d
3-(32/15--
72-026(11/8A)
0t 7S72-026(11/84)
F
C. ABSORPTION FIELD DATA .
Soils Rating in Absorption Strata . 55 Type of System Design C.11
Date Installed 'b / I Z-/84- Length
of Field ep /
A cr271Width of Field 31f Depth of Field 14 /•-r. z ! Rk.L)
4-7I �O1 ,�,-,p
Gravel Bed Thickness
Square Feet of Absorption Area 1 3 Standpipes Present (Y/N) 1/406
Depression over Field (Y/N) t0 Date of Last Adequacy Test 1a /1.
Results of Last Adequacy Test `( /A-
Separation Distance from Absorption Field:
„i
To Water-Supply Well 2-5-C) 'i- To Property Line I`7 --
To Building Foundation 14 To Existing or Abandoned System on
Lot N. ; On Adjoining Lots 0 -f-
/
To Water Main/Service Line To Cutbank (if present) tQ/A-
To Stream/Pond/Lake/or Major Drainage Course 1\::1 /A-
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed Dimensions
Size in Gallons Man.: - Access (Y/N)
"Pump On" Level at "Pump Off" Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom eating Against HAA Request **
I certify that I h checke ,f rifled, .r c•nformed to all OA and HAA guidelines in effect on the date of this inspection.
Signed ` S 1 Date j�Za/4:
Company kt> 1-h fi • - ti\W-C 0 ,No'.
Receipt No. \, �F A� ��
4
Date of Payment j.1 ` • �� : �
r* ;
Amount: $ 4 ...11,..-
: neer'se
0 • .t�i
'1 . THOM A. FISCHER
Page 2 of 2 f� ••••CE-6793 44•
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72-026(11/84) . \