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HomeMy WebLinkAboutSNOW CREST VIEW LT 14016 lel oLf Ooo 'f 'b oc-K MUNICIPALITY OF ANCHORAGE DEl•«:RTMENT OF HEALTH AND HUMAN SER' eS . Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name �c L3Blc= �i�-ivK w�U DISTANCES TO FROM SEPTIC ABSORPTION WELL Address 4 1 0AVz L�}�1 � ��� � gss i€3 TANK FIELD WELL �� N/� Phone(s) 3„4LL- G:;` (&O Permit No. No. of Bedrooms req P �a4a v 41 4- ' LOT LINE G d LEGAL DESCRIPTION Lot 1 Block Subdivision /4 — .SA1ZiM✓ 6l2e5%' iJtG FOUNDATION Township, Range, Section 12 Al �� Sm,• 1 5. wt. AS-BUILT DIAGRAM (Show location driveway, water bodies, etc.) of well, septic system, property lines, foundation, TANKS SEPTIC ❑ HOLDING Manufacturer Capacity in gallons ) ?-Jr,-3 Material No. of Compartments 'Z- TYPE OF SYSTEM [TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER AJ 811 ` 2133 (I 3 f o Depth to pipe bottom from Total depth from original grade 5� original grade + FT '7 " FT I}J v Fill added above original grade Gravel depth beneath pipe FT 3 FTGravel '�e" lengthGravel widthB FT 3FTs= I0 Total absorption area Distance between lines �• M /� i „%t a,SZ2`�SOFT Z� FTNumber F of lines Soil rating Ppematerial 2 IX-5- SQ FT ' 4" �� r, Installer Date Installed - c�usr�, _2��t3F, l ' = WELLS J ❑ PRIVATE X OTHER (Identifv) Classification (A,B,C) Total Depth Cased to FT FT Installei Date Installed: REMARKS: Lei,/'%. �iSf �y t S��t�-flC� JJ,/ Scale: X Zl y V �5i uy Affft �.®L Irl FTl .l�/D�nw�./hf•eP@. Inspections Performed by. ®� At/N.l7+rUlGtL OU't'i^✓.( C.riiS 7�r i'a tt S'c4.Jl-saPiy/ ,` Date: �F�- ��.. �°x "y o° 49TH certify that this inspection was performed according to all o °ee °orr Y°°A o r °� Robert D. Schilling F ®® Municipal and Slate guidelines in effect on this date: °° CE - 141 1 °`;' ` Health Department Approval: «ll Date: /L-UIJ (J/85) January 10, 1986 P.0. o' 6650 ANCHORAGE, ALASKA 99502-0650 1,907) 264-4111 T0, l KN'0 1%4L=S. ",r YC'R DEPARTMENT OF HEALTH & HUMAN SERVICES TO: Permit Applicant Subject: Permit # 850641 Lot 14 Snowcrest View Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as -built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, 24' -c ai.U_t Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit 77 _a e/ 33.a" `a'ti.LtSiRi January 10, 1986 P.0. o' 6650 ANCHORAGE, ALASKA 99502-0650 1,907) 264-4111 T0, l KN'0 1%4L=S. ",r YC'R DEPARTMENT OF HEALTH & HUMAN SERVICES TO: Permit Applicant Subject: Permit # 850641 Lot 14 Snowcrest View Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as -built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, 24' -c ai.U_t Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit ^ �.-o!�1 11.7 1 F-". ir-P. 1L._ .1 r 'Ir 10 H=' l[.__ H-1 IF_3 ff:7Z lqff:�* It'.'301 IEH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET., ANCHORAGE, AK 99501 264~4720 cap FM E-3 H- -I- 0:=- IFH' PD4 EH P -c F:������ PERMIT NO: 850641 DATE ISSUED: 10/01/85 \ APPLICANT: DEBBIE FRANKFORD ADDRESS: GEOLAB 1131 E 76TH , ANCHORAGE, AK 99518 CONTACT PHONE: 344~8042 LEGAL DESCRIP: SUBDIVISION: SNOW CREST VIEW LOT: 14 BLOCK: NA SECTION: 19 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 9000 (SQ"FT" OR ACRES) . � MAX BEDROOM- 4 | Listed below are the options available to you in designing your septic sysIL-em^ Choose the option that best your site" �-F_��������A F.3 UH., DEPTH TO PIPE BOTTOM (FT") ` 4.0 4"0 4"0 GRAVEL DEPTH (FT. ) .V � TOTAL DEPTH (FT�0.5 2.0 ") �7"0 4^5 6^/ � GRAVEL WIDTH (FT.) 2^5 20.0 5.0 � GRAVEL LENGTH (FT.) 84"0 ** ` 38.0 70"� � GRAVEL VOLUME (CU YDS ) 27 3 ` . . . 28,2 32.5- � TANK SIZE (GALS) 1,250.0 ** 1,250.0 ** 1,250.0 ** SQIL RATING (SQ.FT./BR) 125 125 125 ** GRAVEL LENGTH > 75 Fl-.. REQUIRES MULTIPLE RUNS (N(TT EXCEEDING 75 FT. EACH) ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS ^ I certify th,�At: ' � 1" I am familiar with the requirementsfor 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 c. -)f Alaska requirements for the set back distances from anyexisting well, wastewater' disposal system or public sewerage system on this or any adjacent or nearby lot" 4. I dhderstaod that this permit is valid for a maximum of 4 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-BUILTS WILL NOT BE,APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WO ELECTRICIAN. SIGNED DATE: -�4-����-���- �APPLICANT: DEBBIE FRANKFORD/ ' " ISSUED BY ^�` DATE: • � I C.. C- Y l F� i} 1 131 E. 715th Avg. -6 10 1 Anchorage, A10SRU 99513 (907) 3A- 4--0042 SOILS PERCOLATION TEST HOLE DATE Job PERFORMEDFOR:.s..j �`._j_6ic/f., � c W-. No. of Dedroorns...__.�� - LE.M DESCRIE"TIOP•J_._..___.__.-:.__,___.m_ SOIL TYPE Time _____/1,�- Nil Depth of Vater Net Drop S !_!J r� DEPTHDESCt2uIPTION // ,v 1 141 7 •. y� f l !•1UYj H1.�-b' Cel) ( it ..:.vi '��__ia�,. SLOPE SITE PLAN L - T P!' J I I 1 Date Time Net Time Leading Depth of Vater Net Drop S !_!J // ,v 1 141 7 •. y� f l !•1UYj H1.�-b' Cel) ( it ..:.vi '��__ia�,. SLOPE SITE PLAN L - T P!' J I I 1 Date Time Net Time Leading Depth of Vater Net Drop S !_!J -------------- - S !_!J 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 ;7-2-3—OV, 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) --T / f- I%I &LO %'/ 21+d jZ 3 tRJ :5 C4 /,I "5,' M, Location (address or directions) 1 / 44 ( D ii 4 Z4 -4j &—_ x�- (b) Applicant Telephone: Home 3 1 57,eo Business `;i44 Applicant Address qf5Lzr3oV4E (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder,; Buyer ❑ ; Other ❑ (explain); - (d) Lending Institution AK AAs oa- Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 4- 3. WATER SUPPLY Individual Well ❑ Community p< 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 OnsiteA Public ❑ Community ❑ 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 72-025 (11 J84) 5. ENGINEERING FIRM PROVIDIht�rINSPECTIONS, TESTS, FILE SEARCH, DA -Y -A 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 �/ ��y! `ry ��°"�� Telephone Address /2-°' 4, z2$-' WVG7 Sic- 9?e 5 /4 Date 7- 23 a Engineer's Seal 14 IZI m 0 A 491—H ' < ..............ae°..�poo°°< Robert D. Schilling e f ®4th" CE - 1411 'snt�a1 ®®� ��®®®®�® 6. DHEP APPROVAL i� l c � re� Approved for bedrooms by Date Approved— Disapproved Conditional Terms of Conditional Approval 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 n 11.15 r ... MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & ` ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 RECEIVED Legal Description: Zo7- 14- A. ¢A. WELL DATA Well Classification �������i y' �� 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 G1log?Z �z B. SEPTIC HOLDING TANK DATA Date Installed -5:�_2-1Z66 Size 12­5"�' No. of Compartments 01 Standpipes (Y/N) y Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) r - Y Depression over Tank (Y/N) ' Y Date Last Pumped �C�z Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) —' Separation Distances fro eptic Holding Tank: To Water -Supply Well To Building Foundation / I �i To Property Line To Disposal Field To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11184) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata S� '� Type of System Design %< Date Installed j Z Length of Field ? Width of Field -- 3 Depth of Field ` Gravel Bed Thickness 3 v Square Feet of Absorption Area 72— Standpipes Present (Y/N) K Depression over Field (Y/N) Date of Last Adequacy Test - _/(JBL -) ` Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation Lot To Water Main/Service Line L ` To Stream/Pond/Lake/or Major Drainage Course r To Property Line !y To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) I To Driveway, Parking Area, or Vehicle Storage Area Comments 415 x3 /e -k A -� S /,4-5 �r �.�.� oi��� <: i�P rte/— /1n�2.i Sa"f� r-✓ri�X_(✓�.._. � /'i^� %,tih eJ. IJP iri.S�.C/ -Z" Ge M.f D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at — High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed a) - Date 7-2-3—SL Company -r� MOA No. , Receipt No. 14 OPS — 601a I Date of Payment " a 5 _5<i 0r S r 4 BILL SHEFFIELD, GOVERNOR UUJJ DEPT. OF ENVIRONMENTAL. CONSERVATION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE_ 437 "E" STREET, SUITE 303 274-2.533 ANCHORAGE, ALASKA 99501 MUNICIPALITY Of ANCHORAGE DpP7, OF HEALTH & ENVIRONMENTAL PROTECTION MUL 2 8198, DATE: July 23, 1986 RECEIVED PWS I.D.# 210391 To Whom it May Concern: According to records on file in this office the SNOWCREST VIEW SOUTH Water Regulations Water System is in compliance with the State Drinking Sincerely, Michael P. Lewis Environmental Engineer * This water system approval is provided for FRANKFORT, James