HomeMy WebLinkAboutCRESTWOOD LT 24Crestwood
Lot 24
015-361
-08
GREA'~R ANCHORAGE AREA BOR~JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPEC RTI~4PORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~_O'r~O s? "."'""~A,L,NG ADDREss ~~ 3 ~O0/c~. ~0~~--
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH.
MANUFACTURER ~MATE RIAL
~ INSIDE WIDTH LIQUID DEPTH
COMPARTMENTS
LIQUID CAPAC ITY~LONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL FOUNDATION 37
NUMBER OF LINES / DISTANCE BETWEEN LINES
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE
IN. ABOVE TILE ~/' g IN.
TYPE CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION__ LOT LINE__, SEWER LINE__, TANK SYSTEM
CESSPOOL
OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
/ /
PIPE MATERIAL:
.Yo ~J
LOT SLOPE:
REMARKS:
/J
Form LQ-G32
/,~ DIAGRAMQF SYSTEM
f-///' ~/' i /
~,.,~llV · ?' /iv
DATE /g~'/~/~ PAPPROVED ._
G.A.A.B.
74
,2"/
~r'a oe l7 , c la~ ~
od q ~
tt 2
We// do
no ,,.'1/, easq cot,~er'
PERM I T N0. ( ?'7~:~:]-: )
FIF'PL I CFINT
LOCFIT 10['4
LEGFIL
FOREMOST HOblES
i-'l L.! ~'-,~ Z C: ][ .~,¢ R b. ][ 'l-"-'r'"
['iF'
DEPFIRTMENT F~F HEFILTH FIN[:, EN'v'IRONMENTFIL
L=:25 '"L.'" STREET., ANCHORAGE., FIK. 99501. /~/~
2 Pi 2 'E: B R. 00 K E:, F.: I V E 2 TM 8 -_-:: S'-" (
BFIRR'¢ FIVE
L24 CRESTWCICID 'SUB[:,
LCIT SIZE 4E1000 SQUFIRE F'EET
T'¢PE OF SOIL FIBSORBTION SYSTEM IS: TRENCH
t'.tFI?.:IhlLIM NUMBER OF BEDROOMS
SOIL RFITING (SQ FT..."BR)= i. 00
THE REQUIRED SIZE OF THE SOIL.. FIBSORPTION SgSTEM IS:
[::, E:: F' -F H --- :1_ Lib L., E ~-~
THE L. ENGTH [:, I MENS I ON IS THE LENGTH ,::It4 FEE'F) OF THE 'TRENCH OR [:,RRINFtELD.
THE DEPTH OF FI TRENCH OR PIT IS THE [:,I'.STFINCE BETHEEN THE SI...IRFFIE:E OF THE
GROUND FIND, THE BOTTOM OF THE EXCFIVRTION ,:: IN FEET).
THERE IS NO SET H IDTH FOR TRENCHES.
THE GF.'.FIVEL DEPTH IS THE MINIMUM DEPTH OF GRFI',,,'EL BETWEEN THE OUTFRLL_ PIPE
FINE:, THE BOTTOM OF THE EXCFIVRTION (IN FEET).
-1-' ~-~ C, ( 2 _-:, ][ P-~ S F' E C: "1- :I C, r-.l :E; R F-: E F-: E i~-! LI ]: F-: E E:.
BIRCKFILLING OF FIN'¢ SYSTEM WITHOUT FINFIL INSPECTTON FIND FIPPRO',,.'FIL B'¢ THIS
DEPFIRTMENT WILL BE SUBJECT TO PROSECLITION.
MINIMUM DISTFINC:E BETHEEN FI HELL RND RN¥ ON-SITE SEHRGE DISPOL=,Ft[_ E.,YS'FEM IS
· 1K~0 FEET FOR R PRIVFITE WELL OFt 200 FEET FOR FI PUBLIC HELL.
SPECIFICRTIONS FINE:, CONSTRIJCTION [:,II=IGRFIMS FIRE FI',,,'FIILFIBLE TO INSURE PROPER
I NSTFILLFIT I ON.
F'EF-:[.1 I T '-.-"RL_ I r:. F'C~F-': ,_-11~-4E ~"ERF-: F-F-:(DI".-i I '_5 SL.IE
I CERTIF~ THFIT
i: I Fir'1FflMILIRR WITH THE REQIJIREMENTS F'OR ON-SITE SEWERS RND WELLS RS SE]"
FORTH 8~ THE blUNICIPRLIT~ OF 8NCHORRGE.
2: I HILL INSTFILL THE SgSTEM IN RCCORDFINCE WITH THE CODES.
~: I UNDERSTFIND THRT THE ON-SITE SEHER S~STEM blFi9 REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THFIN 3 BEDROOMS.
SIGNED:
FIPPL. ICFINT FOREMOST HOMES
I :.:;:-_-;UED B'T' _[.',RTE ...........................
GREATER ANCHORAGe AREa BOROUGh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT --
~ - ~ ~ -' i ~ ~ PHONE
INSTALLATION Of: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOle TEST RESULTS
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE /~~PE
MINIMUM DISTANCES, REQUIREMEN'I'~/
FOUNDATION TO SEPTI~
FOUNDATION TO ~lT ? ~'. DRAIN FIELD
SEPTIC TANK ., DRAIN FIELD
TO NEAREST LOT LINE.
WELL tO SEPTIC TANK / O~
DRAIN FI ELD ALSO--REA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD ~ ~_g:Z~
SEPTIC TANK, ~, , DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
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.
FORM NO. EQ-01 6 /
Performed For
Lenal Qescrintion: Lot 24 Block
This Korm Renorts Soils LoQ yes
Foremost Homes Date Performed 5/23/77
Subdivision CrestwoQd
Perc0]ati0n Test
nenth
Feet
Soil Characteristics
6" Peat & 6" Reddish Silt
Sandy Gravel
12--
16
18--
20__
Silty Sand
Bottom of Test Hole
Was Ground Water Encountered? No
I~ Yes, At what Denth?
p ] ] I '
IReadinq Date Gross Time Net Time Depth to H20 Net Dron
[ , ·
1, [
I
Percolation Rate )Ii nute
Proposed Installation: Seenaae Pit Drain Field
Den. th of Inlet Denth To Bottom Of Pit Or Trench
CmUr'ENTS' 100 Square .Feet drainaqe area required per hedronm t=rom 1 ~n l l, q ft:
Test Performed By ~~~F~,._ Data Certified B~ONSTRUCTION TEST LA
David Paul ~'~
Date: 5/23/77
Municipality of Anchora9e
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Efmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsi[e
(907) 343-7904
0
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-.361-08
1. GENERAL INFORMATION
Expiration Date: g - ¢'~ ~"' / /
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency -
Mailing address
Real Estate Agent
Mailing address
CRESTWOOD S/D; LOT 24-
9501 BRIEN STREET * ANCHORAGE, AK * 99507
LOUANN ZARKOVICH Day phone 748-1044
9501 BRIEN STREET * ANCHORAGE, AK * 99507
_ Day phone
ED SHELTON W/ PRUDENTIAL dACK WHITE Day phone 563-5500
5801 CENTERPOINT DRIVE #200 * ANCHORAGE, AK * 99505
Unless'otherwise. requesteR COSA ~llbeheldbyDSD ~rpick~.
NUMBER OFBEDROOMS: 5
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well [] Individual On-site []
Individual Water Storage [] Individual Holding tank []
Community Class Well [] Community On-site []
Public Water System [] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF !NSPECT!ON ~Y ENG!NEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on t,he
h;?orrnation obtained fro,,m the Municipality of Anchorage files and from ,my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of instaliation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Phone
337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 ~'/~/
Engineer's Printed Name JEFFREY A. GARNESS, P.Eo Date .
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
7These condi_tions are outside the co_ntr~ 9f the_evaluator of the_system. Satisfac_tory_ tes_t
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the sYstem will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5, DSD SIGNATURE
Approved for __?
bedrooms.
Disapproved.
Conditional approval for.
PROGRAU ..'
bedrooms, with the following stipulations:
Attachments: COSA
Septic System Advisory
Well Flow Advisory
(Rev. 11t05)
//J,
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
//~'~~'~ Original Certificate Date:
Legal Description:
A. WELL DATA
Well type PRIVATE
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS
CRESTWOOD S/D; LOT 24
Date completed
Total depth 112
*ASSUMED BASED UPON SURROUNDING
If A, B, or C provide PWSID# N/A
6/1977 Sanitary seal (Y/N) YES
ff. Cased to *40'+ .ft.
FROM WELL LOG
Date of test 6/1977
Static water level 54
Well production 10
WATER SAMPLE RESULTS:
Coliform ~i~,~,,. colonies/lO0 mi:
Arsenic: ;~ IF')ug./L.
SEPTIC/HOLDING TANK DATA
Tank Type/Material
Tanksize 1000 gal.
.ft.
g.p.m.
APPROVAL CHECKLIST
Parcel ID: 015-361-08
WELL LOGS. SEE ATTACHED.
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 12+
AT INSPECTION
5/17/2011
6O
3.8+
ft.
g.p.m.
GEG, Ltd.
Nitrate~:g;~'~mg IL Collected by:
Date of sample: 5/17/2011
*4" ABS CLEANOUT INSIDE GARAGE. VERIFIED BY GEG
SEPTIC/PLASTIC Date installed
Number of Compartments 2 Cleanouts (Y/N)
in.
DURING INSPECTION.
Foundation cleanout (Y/N)*YES Depression over tank (Y/N) NO
6/8/1977
YES
High water alarm (Y/N) N/A
Date of pumping~O h 3/~.0 I 0 Pumper,
ABSORPTION FIELD DATA
Date installed 6/8/'1977
Length 23 ft.
AROUND THE CLOCK PUMPING
Total depth * 11.0 ft. Eft. absorption area 322 ft2 Monitoring tube YES
Date of adequacy test 5/17/2011 Results (Pass/Fail) PASS
Fluid depth in absorption field before test DRY in. Water added 600 gal.
Elapsed Time: - min. Final fluid depth DRY in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN
NOTE: MONITORING TUBE ONLY EXTENDS 63 INCHES BELOW INVERT.
Depression over field. NO
For 3 bedrooms
New depth DRY i'n.
Absorption rate >= 450+ g.p.d.
If yes, give date -
TOTAL DEPTH IS CALCULATED.
System type TRENCH
Gravel below pipe 7
I'BELOW EXISTING GRADEI
Soil rating (g.p.d./ft2or~ 100
Width 3 ft.
D. LIFT STATION
Date installed
"Pump on" level at in.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Size in gallons Manhole/Access ~ ~
"Pump off" level_a~. High water alarm level at
Cycles tested Meets alarm & circuit requirements?
100'+
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'-I-
Animal containment areas 50'+
in.
On adjacent lots, 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main N,/A Water service line. 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line i~~ ~
Water service line 10'+ Surface water 100%
Curtain drain NONE KNOWN Wells on adjacent lots. 100'+
Absorption field, 5'+
Surface water 100'+
Building foundation 10'+ Water main
N/A
Driveway, parking/vehicle storage 10'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date
COSA Fee $
Date of Payment
Receipt Number
(Rev, 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage
Community Development Department
Development Services Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On-Site Systems Approval # 111172
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
24 of Crestwood subdivision. This inspection revealed a nitrate
~6ri~entr~ati6h 6f 6:52 ~illigrarn~ '~'~r liter (mg/L) was rep6~ed for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
,~OL,,k~
LEGEND:
· StNI Pin
~ ~rve~ Hub a
h~eby ce~Jfy that
UPDATED A~BUJL"[
~at ~he improvements ;itunted [hereon ere w~thi'---~ ! ' -
~d do no~ o~rlap or e~ on ~ ~ Wo~ lira
)at no improvements On p~---- j i -' Y ~ ~l ~0, ~ ~.. ~ ee~j
IW or o[h~ yisibJe ~men~ on ~id pro~y ~c~t M
~NSTRU~TING ~NGINEERS ¢ ~" "~ ~
~A .o~ ~ ~.~ho,~.. A,.~. e~7 'lt{~t t~~
~0 3DVc~ EOqG 3O!JJO X3(I3J OLLB-~t~£--L06 1~T :/I llO~/8l/gO
MUNICIPALITY OF ANCHORAGE
' DIVISION OF ENVIRONMENTAL HEALTH
DEP~RTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
! / '
(a) Lega.1 Description (include lot, bl.ock, subdivision, section, township, range)
Location (address or directions)
(b) Applicants Name ~[
Appli ant, address
(c) Applicant is (check one) Lending Institution
Buyer~ ; Other~--~.~explain);
(d) Lending Institution ,.'
Telephone
Address
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. Type of Residence
Single-Family ~
/
Number of Bedrooms
Multi-Family ~--~
Other (describe)
3. Water Supply
Individual Well~ Communtty~-~
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,,
Onsite~ Public ~-~ Community ~ Holding Tank ~--~
"
Note: community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
En~ineerin~ Firm Providin~ Ins~ections~ Tes.ts~ 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 orr-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 M~,nicipality of Anchorage files and from my
investigation and inspection, the on-site ~ater supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Telephone
' (ENGINEER SEAL)
_
Approved for '~, .-- bedrooms By
Approved ~ Disapproved
Coaditiona~
Terms of Conditional Approval '
CADTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASF~ SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 A~OVE BY AN INDgPENDENT I~OFE$$IONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE I~tEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7-19-84
MUNICIPALITY OF ANCHO~ (MOA)
HEALTH AUTHORITY APPRDVAL (HAA)
CHECKLIST - FEBRiIARY 1984
Legal Description:
Be
[Pa~e 1 of 2]
Veil Classifi~tion f/~/~
Vell L~ I~esent ~'~)
To l ,,
S~tic ~te~ ~1 ~ /
Casing ~ight ~ ~nd '
Elec~i~l Wi~i~ in ~it ~)
~p~ation Dis~s ~ ~11:
To ~ptic~oldi~ Ta~ ~ ~t /q~/~
To ~a~st ~ of ~s~tion Field ~ ~t
To ~est ~blic ~= Li~ ~/~
If A, B, c~ C, D.E.C. Approved(Y/N)
Date Cc~leted
Pump Set At
; On Adjoining Lots > l~e
/~D'~- ; On Adjoining Lots
To Nearest Public Sewer
Cleancut/Manhole ~ l~- To Nearest Sewer__/,Se.~vice Line on Lot S~/~
WaterS ample Collected By ~... ; Date ~/6/~
Water Sample Test Results. . ~; ,'~/~ .
S~.PT~C/NOLD~NG TANK E~TA
E~te Install~d . /~/~/~ Size / ~ No. cf C~a~t~nts ~
Starx~pil~s ) . Air-ti~t Caps ) F~n~tion Cleaner (~
~p~ession over Tar~ (Y )~ Dat~ [~st ~n%~ed ~ ~/~'~
~-n%~ing/94ainte~n<~ C~nt~ac~ on Fi]~ (Y/N) ; f<~ ;~;~
Holding Tack High~teY Alam (Y/N) ~J~ Ten%Dote~y Holdi~ Tank ~t (Y~) t~
~uation Distanes ~ ~ptic~olding Ta~:
To ~ter-Supply ~11 /q,~/~ To ~ildiw F~n~ti~ /~'~
To ~rty Lira 7~/~ To Uis~al Field ~ /
To ~ter ~ip/~Yvie Lic~ ~ {~/~ To' S~ea, ~nd, ~, ~ ~jor ~aina~
C~nts
2-~-84
C. ABSORPTION FIELD E~TA
Soils Rating in Absc~pti.on Strata
Date Installed
Width of Field
~Squa~e Feet of Absc~ption A~ea
Depression over Field (,,Y~)
~6~Resul~ of Last Adequacy Test
Type of System Design
Length of Field ~ /
Depth of Field //'
Gravel Bed Thickness 7/
Star. pipes P~esent
Date of Last Adequacy Test ~_~/~/
Separation Distance f~cm Abscz/3tion Field:
To Water-Supply Well /~-~
To Building Foundation ~/~ To Existing
Lot /~/~ ; On ~djoining Lots
To Water Main/Service nine
To St~eam/Pond/Lake/c~ Majo~ DrainaGe Course
To Driveway, Pa~king A~ea,
/ ~ /
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level
Tested for ~-
slY/N)
/Anoess (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumpfhg Cycles du~ing Adequacy Test.
** Check Permitted Bedroom Rating Aga'inst HAA Request
I oertify that I have checked, ~ified, c~ ~onfCZn~ed to all ~DA HAA Guidelines in effect
on the date of this i. nspecticn.
Signed ~N3~4u ~?b~/~ Date
KB1/d5/s
[Page 2 of 2]
2-15-84
6nUIROI m6FIT^L COFITROL S I' IC S,
Enqin¢¢rinq G (!nui~onmenlul Sludics
AUGUST 20 1984
AL & MARCI STAUFFER
9501 BRIAN
ANC}tORAGE AK
sRr,T,~R - ~ REALTY
SU]~)MSION - (~ES~
AD~gQU;~Y TEST FOR S~ATER SYSTEM
~ Ti'PE OF ABSORPTION SYSTEM IS A ~ WITH AN AREA OF 322 SQFT.
THE SYSTEM IS CAPABLE OF A(XIEF~ING 450 GALIX)NS OF WATER P~ DAY.
THE SURGE CAPACITY OF THE SYST~4 IS 903 GALLONS.
BASED UPON ~ TEST DATA ~E SYS~ IS ACCEPTABLE FOR A
3 Pm~EKX~ ~.
THE SEPTIC ~ ~ PUMP~]ON 8/16/84 .
SEPTIC ~ AD~BQUACY
THE EXISTING SEPTIC TANK ~DLLI~E OF 1000 IS AD~B~UATE FOR
THIS 3 R~R(XIsl ~0USE.
1200 LUcst 33rd Aucnue. Suite E~eAnchoraq¢. Alaska 99503-/907) 561-50~10
DATE RECEIVED
~ ' INSPECTION APPOINTMENTS
TII~'E TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. ~F
825 L Street - Anchora~, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION
Telephone 264~720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~ [~Bl~ D
DIRECTIONS: Complete all parts on page 1. Incomplet~ requ~ will ~ot bi procs~. Please allow ten (10) days for processing.
1. P~PERTY OWNE?~ IPHONE
MAI~ING ADDRESS
PROPerTY RESIDENT (If different fro~ above) / PHONE
2. BUYER PHONE
MAILING ADDRESS
3. LENDING INSTITUTION I PHONE
MAI LING ~BDRESS
4. REALTOR/AGENT PHONE
MAIlinG ~DDR ESS
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE ~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One [] Four
[] Two [] Five
~ Three [] Six
[] Other
7. WATER SUPPLY
~ INDIVIDUAL* it3.
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
/777
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
F--I~'ING LE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
[~NDIVIDUAL
[] COMMUNITY
[] PUBLIC UTI LITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
~IN DIVI DUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]Septic Tank or I--IHolding Tank
Size: / ~ ¢) D If Tank is homemade
give dimensions:
[] ONE
[] TWO
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOl LS RATING
NUMBER OF BEDROOMS
[~"~TH R EE
[] FOUR
TY,EOF TA.K 7-- MA. UFACTURER .¢__¢~. ~,
'TOTAL A,SORPT,O. A. EA~ ',- ..~ MATER,A' ~<..
Septic/Holding Tank
4. DISTANCES
WELL TO:
[] FIVE
[] SlX
Absorption Area to nearest Lot Line
IAbsorption Area ]Sewer Line
[] OTHER
INearest Lot Line
5. COMMENTS
DATE
~PPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED ~
72-010 ( Rev. 6/79)
((,)0'7) 264411 I
DEPARTMENT OF HEALTH AN[3 [:NVIR()rqrvIENTAL PROTECTION
October 8, 1981
Alvin P. Stauffer
Star Route A Box 85J
Anchorage, Alaska 99507
Subject: Lot 24 Crestwood Subdivision
Approval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
(i)
The water analysis report needs to be submitted to
this office from the Chem Lab, 5633 B Street, for
our review.
(2)
The well seal needs to be tightened so that it is
water tight.
(3)
The wires to the well head are in violation of the
Municipality of Anchorage codes and must be placed
in conduit.
Please notify this" office for a reinspection when the
noted descrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
James S. Roberts
Associate Environmental Specialist
JSR/ljw
cc: Alaska Pacific Bank
Post Office Box 420
99510
,~-'"'~. MUNI C I PA,L I T~ .....
~'~"~ DEPARTME,~-~ OF HEAL'f'I-J A~D ,f_~VIRONMEN'. , 'ROTECTION
Insp ~ ' Insp Insp
1977
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: Alaska Pacific Bank
Mailing Address: 601 West 5th Avenue
Phone: 276-3110
2. Property Owner:
Mai~ing Address:
Howard Smith/Foremost Homes
2523 Brooke Drive
Phone: 278-3644
3. Legal Description: Lot 24 Crestwood Subdivision
4:
Single Family Residence: (x)
Multiple Family Residence: ( )
Number of Bedrooms: Three
Number of Bedrooms:
o
Well System:
Permit #
Individual Well (x) Community/Public System ( )
77333 Depth of Well 112' Well Log on File
Construction
Bacterial Analysis
e
Sewage Disposal System:
Permit # 77333
Septic Tank Size
Absorption Area
On-site System (x) Public Utility ( )
Installed 1977 Installer
Manufacturer
Soils Rate Material
Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest'Lot line Absorption Area
to Nearest Lot Line
Page Two ~ v
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 24 Crestwood Subdivision
Comments:
Affadavit Attached:
Approved: ~
Letter Attached: ( )
Disapproved: Date:
UNICIPALITY OF ANCHORAGE
DEPARTMEI~OF HEALTH AND ~NVIRONMENTAL PROTECTION!~,
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
Type of Inspection:,· CM RO VA
Property Owner:~owa~d Sm±~h D~A; ~o~emo~t
Mailing Address: ~.~ B~ooke D~.
Name of Buyer~ ~
Mailing Address:
Name of Lendin, Institution: ~_~_3~c&_~
Mailing Address: ~0~] ~_.
Name of Realtor or Agent: Totem
Mailing Address:_~~_..,~ ~h
.FHA
Services
Day Phone:
_CONV ~
Day Phone:.
._ Phone: 2_~? G-~l '1 0
Phone: 272-057q
Type of Facility to be Inspected:_ ~-; n ~'1 P, ~rn~;_~;~
Water Supply ~~
_ No. Bdrms._~
If Individual, depth of well
Sewage Disposal System
Type of System:
If Individual
Type of Supply: Public Utility
If Individual, number of dwellings presently served
Public Utility
date of installation. 6-'19-77
.Individual
o~qe
Individual (on-site)