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HomeMy WebLinkAboutSCHULZ LT 4OSO IL.oLwa- I'l i '\, I MUNICIPALITY OF ANCHORAGE DEPARIiVIENT 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 PHO/NE L] _NEW NAME l 11`1�PGRADE_ MAILING ADDRESS CJ LEGAL DESCRIPTION LD T- 7"7 </ •3 LOCATION NO. OF BEDROOMS Well Absorption area Dwelling PERMIT O. DISTANCE TO: % % J_.' /V Vy NZ Lu N Manufacturer /'s Material _ C - No. of compartments tn Liq. capacity in gallons Inside length Width Liquid depth IF HOMEMADE: Well Dwelling PERMIT NO. O y DISTANCE TO: p Z q at Merial Liquid capacity in gallons Manufacturer x h- p w T DISTANCE TO: Well FoundationNearest / a1I .._ Q r lot line //o, PERMIT NO. r r r 'U'a 2W No. of lines Length of each line CJ G Total length of line - Trench width 1� 61 inches Distance between lines ~ Q r- F_ Top of file to finish grade �/ Material beneath tile 17 n / ,>; inches Total effective absorption area Cr" Length Width Depth PERMIT NO. w O Q F Type of crib Crib diameter Crib depth Total effective absorption area as w Lu Well Building foundation Nearest lot line N DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J w � Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: _ OTHER PIPE MATERIALS rL '� SOIIIL T�EfJyS-T- RA\TING (l 7 r/ JvA �J LR�J� REMARKS 0) c' r_= ., rev 6 lea U s ,� Dir Ve (4) 040 0 P -J L 4 a it - old s74_ rYllf'd re hz /A• I?r`u Sit- VJ, ,ne D'F -illi— /D✓� a7✓tU () h l rt f _c-! /l /7C (/r �4r' G1'fl ✓F APPROVE DATEJ LEGAL 4 � 0 / --,a -9 a MUNICIPALITY OF ANCHORAGE Department f Health and Environmenta- ?rotection P 825 Street, Anchorage, AK. .9501 ���� r 264-4720 # HANDWRITTEN PERMIT Permit #�if;1 !iCIs - �nMTT Applicant: �'1. f�J%d/i' c� _ Mailing Address:,�J�D ' Location: Phone Number:— Legal Description: /,O %r- Z,.e_'L Lot Size: Type of Soil Absorption System Is: Trench: j.--- Drainfield: a Seepage Bed; Holding Tank: Maximum Number of Bedrooms: Soil Rating (sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH _ _ O LENGTH __ GRAVEL DEPTH 4 WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface 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 outfall pipe and the bottom of the excavation(in feet). IMP * * REQUIRED SEPTICSIZE _ , GALLONS # 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(2) INSPECTIONS ARE REQUIRED # # 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 private well or 150 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 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 ,E I certify that: (1) 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residenc s remodeled to include more that edrooms. Signed: - a e �" Issued by: plicant Date: SWP/024(1/81) GREI �,. ANCHORAGE AREA BOR d.jH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM — [–� — -3 PHONE ONE NAME -['.1--/`I-�`�-�J-MAIL.ING ADDRESS �/�� - -� LEGAL DESCRIPTIONCr LOCATION SEPTIC TANK: NUMBER OF DISTANCE MATERIAL --' L —COMPARTMENTS FROM WELLMANUFACTUREI INSIDE LENGTH INSIDE WIDTH _ - LIQUID DEPTH _ LIQUID CAPACITY �n�G LLONS. .Tltf -DRAIN F�FEL-�D: TOTAL LENGTH /�%�%�FOUNDATION_ / NEAREST LOT LINE_. r7 / OF LINES DISTANCE FROM WELL L / / NUMBER OF LINES! _DISTANCE BETWEEN LINES TRENCH WIDTH 3CJIN. TOTAL EFFECTIVE 77' ABSORPTION AREA _ SQ. FT. LENGTH OF EACH LINE --L DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE J?�MATERIAL BENEATH TILE IN. ABOVE TILE_ --_IN. WELL: T EI,-Ly-0 9> --CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION LOT LINE _ , SEWER LINE CESSPOOL——. OTHER SOURCES-. APPROVED_. _ _--DISAPPROVED__ _REMARKS DISTANCES: p- C_' _ /00 1/ INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: v �_ - LOT SLOPE: REMARKS: DEPTH SEPTIC SEEPAGE TANK SYSTEM_ DIAGRAM OF SYSTEM r IL3 A, PJ) GI 40 A lot) �l DATE -_2 r. G.A.A.B. DISTANCE FROM: CiRE/ A111CHORAGE AREA BOF �•n PERMIT NO. DEPARTMENT RTMENT OF CNVIROPIM [,NTAL QUALITY - 4P _ La// �i /// IllJll 3330 '•C-- STREET ANCHORAGE, ALASKA 99503 /iler u 3/Z �,G Nc't'j1lt67 >. Ili TELEPHONE 274-4561 l• Q N f p�• '�� eo SEWAGE DpSPO/AL SYSTEM APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION MAILING ADDRESS _'( PHONE Sta4-' _ SEEPAGE PIT_ ��---. DRAIN FIELD _---. OTHER -• INSTALLATION OF: SEPTIC TANK --- --- TYPE AND SIZE OF FACILITY TO BE SERVED _- FINANCED THROUGH _ _ "TO BE INSTALLED BY—/{--V4=*)� — - — -- %� .`�(% /��Y/� / L,i�/�•� ' .— NOTR: 'T'HIS PERM17' 15 NOT VA4.ID 1NITH®UT SOIL TEST SOIL 'TEST RESULTS COMPLETION DATE AN1"I CIPATED ----- --- FINAL INSPECTION: 24 HOUR NOTICE RrOUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. � —f t 7 - SEPTIC TANK SIZE _L/-` �>`'� - TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION l"O SEPTIC 'TANK -- FOUNDATION TO SEEPAGE PIT r SEPTIC TANK TO SEEPAGE PIT WALL -'— SEPTIC 7AN1C SEEPAGE PIT TO NEAREST LOT LINE. SEEPAGE[ AREA SIZETYPE - SeT PI777'7rt�1�A/6f,. D��N��'�rr' DIAGFiO SKSITFM DRAIN FIELD DRAIN FIELD /6) — s � WELL TO SEPTIC TANK-�c%(?--- _ SEEPAGE PIT DRAIN FIELD _-- ----- --. ALSO CONSIDER AREA WELLS. WATER MAIN T -O SEPTIC TANK SEEPAGE PIT DRAIN FIELD -- SEPTIC "TANK. /�){� y --. SEEPAGE PIT /e-� /- DRAIN FIELD TO RIVER, LAKE, STREAM, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEETINTO UNDISTURBED SO11-, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC 'TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL 13ACKFII_L CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. - - -_ - G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. 7� �j DATE •-'� APPLICANT'S SIGNATURE -- FORM 140. E61-01 6 I sNl�a GREATER ANC1101<l GL A i.A NROIJ,, i)epartment of Env'i roninen I_al Qua 1 "i Ly 3330 °C" Street Anchorage , Al as ka 91ho,j huffs 1,0(; PER01,111ON TEST Performed for Legal Description 7i(c-OSidr(J_ on - PerolatiLest___ This form reports: Soils log_ — v — -- - — - Depth Feet 2- 14 - /j%�� Was ground water encountered.? If ves , at woa t depth? / V .FJ f- Readiny e�1. -q L.- Date Gross Time_ _ TNet Time Depth to—water.- [let tiroh Percolation rate 3_ U Proposed installation: 3eepige Pit v-� Grain Field _ __ __ Depth of Inlet .. Depth tc bottom of pit or lrenci _ C011f1ENTS: .� - � •� r__(�_ l�.V�l_N_�a Ca �_ __04— — _ N - - — -- ---- -- - --- -, --= iate r ' Performed f;y: �-�r_%J'JK1_•tL� _ _ Certifiicd [3y:��PiV,,/�__—___ .A -W DRILLING., INC. DRILLING LOG Well Owner —Use of Well Location (address of: Township, Range, Section, if known; or distance main road -- Size of casing —'Depth of Hole feet Cased tofeet Static water level ft. (above) (below) land surface. Finish of well (check one) open end Screen ( - ); Perforated Describe screen or perforation Well pumping test at gallons per (hb&) (minute) forhourswith ft. of drawdown from static level. Date of completion Depth in feet from ground surface I TO— TO— TO— TO— WELL LOG Give details of formations penetrated, size of material, color and hardness FI-Vr j �17 TO - 17'J 2 — STATE Fl 1,.! 11 Ill F. I,." I J* I I �:, Ei: Ir! I I. I . 1: 1 . I,.,I Ci . is ;'r" --Bila.. f.il -A. ) :I: (:; Fl 11.4 1 1; : Ij I.- ftnil.-L- S C: 1-1 U L.. F'I 'I .. J: cl I.. 'I Iii:fyj:al__ C 1 -11 11 1 I tF I F,: 1 FI 1:;' li::: F,E::Fi� I' FA ORE Do! M 1 .. ..... .... .... I.) FIT F:. Time APPL1( .IVT FILLS OUT UPPER FiAI C)IVLY Prup;`rty Ow+ler �) r_;-, r, +... .J I, ;\ y �,,, I •, -'_. Time ! FPhone( Mailing Address �-,_ �. ,� 1• 1--; , ,. ,� ;�� •y-_ Zip Code Buyer "� I . - `-jam. f ,_ ,.. } Date Date r Address Inspector Zip Code_i- Lending Institution t" i Phone ..1 Address -- - \ - - •- i.:,... - Zip Code - Really Co. & Agent , < 1 i >`, �',. ` I -. \ <. , " Phone �_,_ - - Address � � � - - � � ., i".. Zip Code - ts-7 C-. Legal Description Street Location Type of Residence ❑ Single Family f E9 Multiple Family No. of Bedrooms ❑ Other Water Su ly dividual I I I \ a( _ ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. yg�'�- kL"J Community - -( For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility`—" <3�D7� C/(--) Sewer Disposal OlJ.r 7 L-oc_� _- Q Individual Year Individual Installed: -' j O Public Utility When Connected to Public Utility: 11 Holding Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time ! Date Date Date Date Inspector Inspector Inspector Inspector nn Field Notes: "` `/C����JJJJ l C. MUNICIPA111Y OF ANCHORAGE OF ts-7 C-. CEPT. IENVIRO\NV- 1TAL PkJicCTION f f (S ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' '— `t , DATE 1l1 _ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Tank Size Well to Tank Septic 72029 (9182) �� John a Il( I J I'l ( I y Oh --L te :lj t I b j to c t : f.,(,)t 4 -)ubdivision lipprovell An- the sewor and xviabir he E 1 r a rt t (-'. d 1.1 n t i 1 t rl (o I ovi i to I i t o 1 n s t I a N/ c W 40 11 01 n j) 1. 0 t to (l wilmit proof to dlim offj,(3r? ryt withcor Statty O.K.C. approvint c){ !--! ) o cLass "C'u I or that w11 W, t w t. h[ two 1 lo It li :3r V 0 f-; 1.1 C;1:. I,ot P 1. 0 rls ! I o t i Ey t I-I i 1, DO L),,) r t urto n t, A: o r a rn i n ri ixc- L i on 0 1 1, not, dism"valujim; iinve Ivuen correctrid. It dusym ara any turth(3r Atimi at 264-470A Cory Ijillisj, R.,;. Actill:j Scmor N lvhlLer P-roqravl i-mn;-uJor CIV'74/ej/(%J. Nov. 10, 1983 Remax Realty Lorraine Miner P.O. Box 848 Eagle River, Ak. 99577 4Jater well flow test for Lot 4, Schultz, Sub., Eagle Raver, Ak. Static level of well v 69 ft. Pumped well. for two hours at 5 GPM. The pumping level draw down was 4 ft. 611. The draw down level stabilized at 73 ft. 6" within the first 10 minutes. Considering the stability c6 the pumping level l saw no reason to con- tinue pumping the well beyond the two hour period, William R. Magnuson, Owner q ALASKA 6IiJIR0nmenTAL COnTnOL HUM, InC. �ngineerinq & enuironmenial Studies MUNICIPALft'r ^F ANC!-!ORAGE August 25, 1983 ENVIRONiJ N171. PROTeCTION Municipality of Anchorage Department of Health & Environmental Protection 825 L. Street k V" C E. Anchorage, Ak. 99501 Re: Health Authority On August 15, 1983 our company collected a water sample from the house located on Lot 4 Block 0 Schultz Subdivision. The property owner is John M. White. The water analysis was satisfactory. A copy of the report is attached. The well is located 106.1 feet from the leach field. The electrical wires are encased in conduit. All the standpipes are capped. The well casing stands approximately 1 foot above the ground. The well has a sanitary seal. 641 liii A 1. ae°°uu°u® u°no.H.r til P' a asaea+nvn a�ti'�4d1 u.e.. n• '�,i i 1 • {' �} �` •o Leroy C. Reid, Jr. GQpJ� 2251 e Q� �pHOFESSII�N��.. 1200 blest 33rd Auenue, Suite B • Anchorage, Nosh 99503 • (907) 276-1361 AKA ENVIRONMENTAL .ONTROL SERVICES IC, 1220 West 25th Avenue Suite B ANCHORAGE. ALASKA 99503 276.1361 279.2917 JOB — - — - - - '--- SHEET NO CALCULATED BY__. CHECKED By — nnn— �a Or __ DATE DAT[ cl 4 f' ar \4? 133.6 f ` F e� e O ACS . n.e .°e s.eneee .. 9� I Lor C. Roid, Jr 14�LP�be o. 2251•E �Of �4�F '°0•..�.on..•.'e4�FGy 1/� DEPARTM, 825 MUNICIPALITY OF ANCHORAGP ,F HEALTH AND ENVIRONMEN L Street, AnchoraaR, Alaska 264-4720 PROTECTION 99501 Date Received: March 20, 1978 #1: Time #2: Time #3: Time Date- ��,AS: Date Date Insp I�nn,L'/ Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska Statebank Mailing Address: 310 East Northern Lights Blvd. Phone: 279-7636 2. Property Owner: Charles Schulz Phone: Mailing Address: Box 931 99577 % Wayne Simmons, Great Land Realty 694-9-9125 Lgil 9a3 1 3. Legal Description: Lot 4 Schulz Subdivision #1 4: Single Family Residence: (x) Number of Bedrooms: Three Multiple Family Residence: ( ) Number of Bedrooms: 5. Well System: Individual Well ( ) Community/Public System ( ) Permit It Depth of Well — Well Log on File ( ) Construction Bacterial Analysis 6. Sewage Disposal System: On-site System__'(' ) Public Utility ( ) Permit # Installed i�l C� _ Installer Septic Tank Size q 06 Manufacturer Absorption Area _^ Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot. Line PageTwo Department of Health and Environmental Protection Request for Approval of Individual Sewer and WaterFacilities Legal Description: Lot 4 Schulz Subdivision #1 _ Comments: Affadavit Attached: ) Letter_ Attached: ( ) Approved: Date:•7_ Disapproved: _ Date:_ _ Department Worksheet: 1. 2. 3 am MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES Type of Inspection: CMRO VA FHA D . +., n,., o.• Charles Schulz 1-1 _ Mailing Address: Box 931, Eagle River 99577 Day Phone: Name of Buyer: John M. White, Jr. and Judith M. White Mailing Address: Day Phone: Name of Lending Institution: Alaska Statebank CONV xR 276-3656 Ex. 232 Mailing Address: 310 E. Northern Lights Blvd. _Phone: 279-7637 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description:_ 7 n. 91 Simmons. Greatland Realtv Lot 4. Schulz Subdivision No. 1 Location: Eagle River, Alaska Phone: 694-9125 Type of Facility to be Inspected: single family residence No. Bdrms.-- Water Supply Type of Supply: Public Utility--Individual-- If tility Individual_If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation - 72-003(3/76) 3 HOT LINE _^ HOUSING PUBLIC FACILITIES _ NOISE �7 SEWER & WATER SOMPLAINTANT: ADDRESS: _ NATURE OF COMPLAINT: Greater Anchorage Area Borough Department of Environmental Quality COMPLAINT AND ACTION FORM AIR POLLUTION JUNK AUTOS NUISANCE OTHER LOCATION OF OF COMPLAINT: J /mat - Ir Q) CASE NO. / S DATE ��- - � - 7 INVEST: RESPONSIBLE PARTY -- ADDRESS PHONE NUMBER RECORD OF CONTACTS AND CORRESPONDENCE -- Date Time Comments W�(l% ,cICE TIME & DATE COMPLAINTANT CALLED BACK Use Reverse Side of Form for Further Comments rr-I fl Fil.­ I FEN 'T' F" Er FN I.. M U P-4 T' 0 1 CH N :- C'H P11 F Fi C. -11- DAI E N'T C:I-CJSED ITE hIFffURE -IMPI-A I N'T AREA CIDCE jRREP-j'J' D I .:PO'S I TIDN PDA[) CFISE CIFFILDE I REI H" F f I J - : 'A, ED 6 "1 REF *2 Dli-1 HEFAIAI'A E: BUD CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction of In public water system located , Alaska, submitted in accordance with 18 AAC 80.100 by_AjC_ (F Q I rely,, wr mo i ` t ej ( &v4� c1 J _��_(:_have been reviewed and are IX approved. O conditionally approved (see attached conditions). TITLE DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract order no.Approved by Date or descriptive reference' 1 i,�12� 0 j l?:l!J 71 C (.� ! S .0 4t C 't' U l i� -.1 -�'1. 1 •_ I •Z dl � The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE The construction of the_ /or S; x# k1 public water system was completed on_�— /V — P� �/ v (date). The system is hereby granted interim approval to operate for 90 days following the completion date. DATE As -built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. tr ave TITLE DATE