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Home My WebLink AboutCRESTWOOD LT 3 GREA~R ANCHORAGE AREA BORb~GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION ~l(i:~r~;j t SEPTIC TANK: DISTANCE FROM WELL /~l~)~::T~' MANUFACTURER INSIDE LENGTH INSIDE WIDTH I q~uc~., ~ . LEGAL DESCRIPTION MATERIAL ~-~_ LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPAC IT ,Y/~--OGALLONS. TOTAL LENGTH O,STANCE FROM WELL ~FOUNDAT,ON 9'O,~ r NEAREST LOT L,NE ~,~r OF L,NES ~'/ NUMBER OF LINES t DISTANCE BETWEEN LINES ----' TRENCH WIDTH~ IN. TOTAL EFFECTIVE ABSORPTION AREA'~/-'~u""'f-~.,)~ SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE -- MATERIAL BENEATH TILE TYPE I CONSTRUCT,ON BUILDING NEAREST NEAREST FOUNDATION__ LOT LINE SEWER LINE IN. ABOVE TILE .,~ ~' / DEPTH SEPTIC _ ~_~SEEPAG E TANI~ ~::~c~, SYSTEM IN. DISTANCE FROM: CESSPOOL APPROVED OTHER SOURCES DISAPPROVED DISTANCES: ~-~ INSTALLED BY: SEWER LINE DEPTH: Form EQ-032 DIAGRAM OF SYSTEM PERMIT NO. APPLICANT pICK 8NTHON¥ ,' 252~ DR LOCATI~ B~ LE~ L~ C~ST~ MUN I C I PAL I TV OF ~N"CHOR.RGE DEPARTMENT OF HERLTH RND EN¥IRONMENT~. PROTECTION 2518 E. T~OR RD. , RNCHORR~ AK. 276-2221' ON--~ I mE SEWER PERM I T LOT SIZE 278-~44 49588 SQURRE FEET TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH HAXIMUM NUMBER OF BEDROOMS = 4 SOIL RRTING (SQ FT/BR)= i40 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 8 LENGTH= 7i GRAVEL DEPTH= 4 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). REQU I RED SEPT I C TANK S I ZE= i250 GALLONS BRCKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVAL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWRGE DISPOSRL SYSTEM 100 FEET FOR R PRIVATE WELL OR 280 FEET FOR R PUBLIC WELL SPECIFICRTIONS AND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. PERM I T VAL I D FOR ONE YEAR FROM I$$UE I CERTIFY THAT i: IRM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPALITY OF RNCHORRGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDRNCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. SIGNED:~~ APPLIC :r.ONY - ISSUED B ........ DATE___,= ........ ~-~ Perform~d'for Le.~ Description: This rom reportS: ~r, dAI(:i'MEN'I ur' ilEAL'FH Ax%~, ENVI~(u~'~iL~'~.I'AL PROiECi ION Pou~' 6-650, 9950~' - 2518 E. Tudor R~ ] '~ Anchorage, Alaska ~ ~re~~ ~~,, ~ ~ Date perfo~ed . ~ /~,/~ 7~ Soils tog PercolaCi~ test Depth Feet 6- lO- 12 Was 'ground water encountered? If yes, at what depth? ' ' Reading Date { Gro~s Tirae Net Time Depth to H2O Net Drop ,, ._ l~mo~ /r~'~ Performed By:. Percolation rate minute, Proposed installation: Seepage Pit ..... Drain Field '~ -' llepth of Inlet Depth to bottom of pit or ~re.~ch . . CO~IEHTS: YxCZ~ ~....,,,~' ~/~:j'_,,,9/,,t),~}~ ~--~/~~~ ~~ Certified By: ~~ Date: PERMIT NO. MUN I C I PAL I TY OF ANCHORFIGE DEPARTMENT OF HEALTH AND ENVIRONMENTRL PROTECTION 2510 E. TUDOR RD., ANCHORRGE, RI<. 276-222i ( 76~32 ) APPLICANT LOCATION LEGAL FOREMOST SERVICES. B['-R-RY '~ L~ CRESTWOOD SUBD 2525 BROOK DRIVE LOT SIZE 278-~G44 49000 SQUARE FEET MINIMUM DISTANCE BETWEEN R WELL AND ANY 0N-SITE SEWAGE DISPOSAL SYSTEM IS t00 FEET FOR A PRIVATE WELL OR 280 FEET FOR R PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T VAL I D FOR ONE YEAR FROM I$SUE I CERT I FY THAT i' I AM FAMILIAR WITH THE REQUIREMENTS FOR 0N-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1. GENERAL INFORMATION Complete legal description Lot $; Cr~z~oorl SubdJ. u~ion; Location (site address or directions) 6051 B~rr~/ Property owner Mailing address Lending agency Mailing address A.H.F.C. #11660 Day phone 561-1900 A,~ ~_a 99503 Day phone Agent Kim Lan~. MARSTON REAL ESTATE Address 2804 w~,~ Nn~,~_h~n L,/~g/~f'~ Blvd.: Anchorage.; Ak. Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well Y,X Community well Public water NOTE: Day phone 248-2804 99503 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Y,X Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 g STATEMENT OF INSPECTION BY ENGINEER 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 application 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. Phone Name of Firm Address ~ 703-~ Eagle River Loop Road No, Eagle River, Alaska 9.9.57.7_ Engineer's signature DHHS SIGNATURE ~/. Approved for ~-- Disapproved, Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtes~ to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements, Employees of DHHS 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. 72-025(Rev. 1/91) Back MOA#21 · /~.-~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~-,~o'~ ~ ;("~_.~O~d Parcel I.D. A. WELL DATA Well type .~d~~ If A, B, or C, attach ADEC letter. Log present (Y/N) I,1 Date completed, Total depth ~' I ' Cased to /'-~L. O ~ ADEC water system number /J//,~ / ia - l I- ~ b Driller Casing height I Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG Date of test (D - ! I - '-~ ~, Static water level ~ '~ Well flow ! I~ Pump level L) ~ SEPARATION DISTANCES FROM WELL TO: t Septic/holding tank on lot Absorption field on lot Public sewer main Public sewer service line g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~' ~"/~C._..'/-'C,/' ff Nitrate Date of sample: -~ - Z ~- ~. ! ~R~l'.5'~RC.~"~tOf'b}F.:z~Otherbacteria_ . . Collected by: ---,~'~ ~ ~ ~"~J~ } I0 ~'~,~-~' / fd5 B. SEPTIC/HOLDING TANK DATA Date insta,ed ~ Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size I .2.. ~-~ ~ ~ I Compartments [ Foundation cleanout (Y/N) L,/ Depression (Y/N) kJ ~ Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: I Well(s) on lot [,,OtO '~' On adjacent lots //'DE) - ! ' I To property line ! 0 'lc- AbsOrption field ~.. 0 I Surface water/drainage { O0 ~" -/" Foundation Water main/service line ]0 72-0'~6 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) ;'~':;;i . ~ :~~~ '~ ~vel at ' ' 'Manhole/A(Manufa High water alarm level Cy( Meets MOA eleCtricaI Codes (Y/N) '~ sEpARATION DisTANCE FROM LIFT sTATIoN 3'~ Well on lot _ On adjacent lots '~,' · D. ABSORPTION FIELD DATA Date installed I Length ~ c~ i Width Total absorption.lalrea Depression. over field (Y/N) Results (pass/fait)' ~ I~ ~ ~ for [ Peroxide treatment (past 12 months) (Y/N) &J/iq SEPARATION'DISTANCE FROM ABSORPTION FIELD TO: Well on lot ! C3~ ~-~ On adjacent lots ,/~ L~ Gravel thickness Cleanouts Date o To building foundation On adjacent lots ./ I Surface water ,/Co_('~ 'lL. Curtain drain. To existing or ab~ Cutbank .~_) !~ W Driveway, parking/vel E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA S & S ENGINEERING 17034 E~gle River Loop Road No. Signature Eagle KiVe£, ~'" Engineer's Name ~ate ~/~~ / HAA Fee $ ~ Date of Payment Receipt Number Waiver Fee Date of Pa Receipt N( :urer , ~ess ,(Y/N) *";Pump off" level at es tested Surface water System type Total depth bedrooms present (Y/N) adequacy test - .If yes, give date Property line ~--- 0 ~ndoned ,system on lot A//~ rater main/service line ! ~ ~ ~icle storage area ~-' ./5;) uidelines in effect on t..he~.~e~ of this inspection. ment tuber 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL I. ABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Client Sample ID:L3 C~E~IlI30I) 3/D Client ]late :S & $ EIlGINEE~IIiG PWSID :UA ~e~ved ~I 23 9~ e ~6:00 ~,. bq P~esoxv~ w~th Analysis Caploted :IAI 24 9l Send ll, opo~ts to: Laboratory Supe~;Lt/~PHll C._ SDS m mm mm u mmmmmm mmmmmmm mmom mmmmmmm mmmmm mmmm mmaam mommm mmmem mmomm mgm mmm m mmm Chahb hf t: 912207 Lab bp1 ID: Allo.blo PaE~to~ Tost~ ~o8~t U~ts bt~ L~tm NIT~TE-N 3.2 ~/1 gPA 353.2 ~0 Se~le ltO~IIIE SAJ~L! COLLSC~ED BY: I~.D.J. P, en~zks: hit8 ~ozmd * See ~c2~ I~tz~t2oM Above Ui-U~v~l~le None ~tected ** ~e ~le ~b Above Not A~ed LT-Lea, Thn,. 6T-Gzeatez ?hn GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received February 23, 1977 Time of Inspection 2:0~O,/~.m. Date of Inspection 2-24~77 JK REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Cony. l. Approval requested by: Alaska Bank of Commerce % Carolyn Barrara Mailing Address: 712 West 4th Avenue Phone: 279-5641 2. Property Owner: Howard Smith Phone: 278-3644 Mailing Address: 2523 Brooke Drive 3. Legal Description: Lot 3 Crestwood Subdivision 4. Location: Off of Birch Road, left on Barry 5. Type of facility to be inspected Sincjle Fa_mily 6. Well Data: A. Type C. Construction 7. Sewage Disposal System: No. of bedrooms Permit #76332, well log attached and in Individual B. Depth 91' ~-~ D. Bacterial Analysis F' On-site system, Permit ~76193 2 A. Installed 1976 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages M L~C I PALl TY.~O.E .~CHORAGE ~-~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTI~I~INIClPAUTY OF ~ 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 DEPT. OE~HEALTH & * ENVIRONMENTAL PROTECTIQI~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA, 2. Property Owner: Howard Smith Mailing Address: 2523 Brooke Dr. Day Phone: 3. Name of Buyer: Gary A. Taylor ~ Att; Carolyn Barrara Day Phone: 4. Name of Lending Institution:Alaska Ba.~.k Of Commerce Mailing Address: 7'12 West z~th Ave 5. Name of Realtor or Agent: Totem Realty ~Sth & Gambel Mailing Address: 6. Legal De~riptionL.°t 3-Crestwood Subdivision Phon~.79-56¥1 Phone.272-057'1 (Three) Locationgff Birch=Left on Barry 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Single Family Public Utility. No. Bdrms?) ri~/O . , .Individual If Individual, number of dwellings presently served If Individual, depth of well 9'1 ) Ninety-one Sewage Disposal System Type of System: Public Utility 5-76 If Individual, date of installation One feet Individual (on-site)~:xxx~cx~:~c~c ' :'. ~,,~ 72-003(3/76) Page .2 of two pages L~§~l D~scription Req t for Approval of Individual S Lot 3 Crestwood Subdivision r & Water Facilities Comments Approved Disapproved .Valid for one year from date signed Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74)