HomeMy WebLinkAboutCRESTWOOD LT 22tS-oe -aS
~. Municipality of Anchorage Page
" DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: :~'~/~(~ ~)¢>~ / PID Number:
N'~':~ r~ 5+e~, 3~ r~ Wastewater System: ~New ~Upgrade
~~ Z3~? ~ra~,~A~ ~5~3 ABSORPTION FIELD
,
~Phone: ~ -~ D D~pTrench ~Shallow Trench D Bed ~ Mound D Other
T~I Dept~ from origi~ljrade:
LEGAL DESCRIPTION ~""'""": I. ~ ~,o/s~. ~. . ~. Z' - ~. 5 '
Bl~k: _ Su~iv~ion: -- ~pffi to pi~ ~om from ofigi~l g~e: Gm~l de~h ~n~h pi~
T~ship:__ I Range: -- I ~ion: ~ Fill~ad~l --a~/~ original grade: Ft. Gm~l length: ~ Ft.
Grovel width: / I Numar of li~: I ~~ li~:
WEL~is~,h~ D New ~ Upgrade ~ ~ -- ? Ft. / I Ft.
Cl~ifi~fion (~H~t~B,C): Total Dep~ ~ To: To~l a~tion ama: Pi~ ma~Hal:
Ft.
Yin: ~Pump ~t at: ~ ~ ~ght A~ Ground:
~. I ~' TANK
~ SEPARATION DISTANCES ~s~c ~ Holding ~ S.T.E.P.
To ~tic A~i~ Lift H~i~ ~bll~fiv~ Manufacture~ ~c~ in gallons:
/ MateHal:5+e ~
we~r' ! O0~ Ioo~ -- - ~ ~
su~,~ ' ' ~ ~ LI~ STATION
Water 100 ~ /OO ~ ~
Lot , ,~l Size in gal,o~
Line ~ ~ -- --
Foundation J ~/ ~ ~1+-- -- -- ~ "Pump on" I~el at:~~," ' ' .... ala~ at:
Cu~ain Pump ~~d~l I~i~s
Drain ~ ~11~ ~
Remarks: ~re~h r~[~n?ed ~ m ~ ~ i ~ BENCH MARK
L~fion and D~H~ion:
~ J '
Inspections ~fformed by: ~a~~ ~n~an~ Dates: 1st
Depa~menl of Heallh and Hum~n~e~mes approval ~,~....,~,,......,~[~'
72-013 (F~v. ~/~) MOA 2~
PERMIT NUMI~I[R: AS 015--061 --25
SW980521
lO'
j ............ ~ ]~ ~~~~
HO~
~ ...... .~ ............ ~ C03 30.4 25.1
MT3 62.~ 57.8
p~ (~7) ~7-6170~ (~ ~-~46~'-.-
CRES~OOD SUBDIVISION, LOT 22, ~ ..
AS-BUILT OF SEPTIC SYST[~ UPG~D[ "
GREG STEWART 346-1722/786-8608 v~. '-., ~ .."
J.g~. 1 = ~0' ~ OF ~
Rick Mystrom,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci.anchorage.ak.us
January 14, 1999
Jeffrey A. Garness
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B
Anchorage AK, 99504
Subject:
Waiver Request for Lot 22, Crestwood Subdivision
Waiver Request #WR980098-
Parcel ID #015-081-25
As-Built for Permit #SW980321
Dear Mr. Garness:
Your request for a waiver of the required 10 feet horizontal separation from the
on-site wastewater disposal system to property line has been approved. The approved
separation distance is 5.0 feet.
This waiver approval applies to the existing on-site wastewater disposal system to
property line separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-4744.
Sincerely,
Donna C. Mears, E.I.T.
Civil Engineer
On-Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR#~ miD# 015-081-25 Ha#
Date Received: Dec 16, 1998
Legal Description: Lot 22 Crestwood Subdivision
Engineer: Jeff Garness, P.E., Alaska Water & Wastewater Consultants, Inc.
6901 De Bart Road, Suite 2B, Anchorage~ Alaska 99504
Applicant: Greg Stewart
Permit ~ SW98032!
Waiver Requested: Lot line waiver of 5 feet from the absorption field to the
north property line.
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
Special Conditions:
e
3. Other:
Waiver is Granted:
Waiver is NOT Granted:
List Conditions or Reasons for above:
Name of Reviewer
Date:
Rec 9: 04654/8065
By:
Amount: $ 115.00
Date Paid: Dec 16, 1998
Alaska Water & Wastewater Consultants, Inc.
690i Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99fi04
Phone (907) 337-6179 ~ Fax (907) 338-3246
September 30, 1998
Municipality of Anchorage
Department of Health & Human Services
P.O. Box 196650
Anchorage, AK 99519-6650
RECEIVED
DEC 16 1998
Municipality of Ancho,
Oept. Health & Human Se,, ~.,~.
REFERENCE: Lot 22, Crestwood Subdivision
Property line waiver request
Request you issue a five foot property line waiver from the absorption field on the
referenced property to the north property line. We do not anticipate any adverse effects to
the neighboring property with the issuance of this waiver. The well on Lot 23 (north of
thc subject lot) is located over 100 feet from the new drainfield. As can be seen on the
attac~ as-built drawing, the north end of the new drainfield is in the utility easement.
Attached are "Letters of Non-objection" from the utility companies that are involved.
If you require additioT/~ormation, please contact us.
JAG/gk
Alaska Water & Wastewater Consultants, Inc.
690i Debarr Road, Suite 2B N Anchorage - Alaska 99504
Phone (907) 337-6179 N Fax (907) 338-3246
Consulting Engineers
Decemher 16, 1998
Municipality of Anchorage
Departmem of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Attn: Dan Roth
RECEIVED
DEC 16 1998
MUNICIPALITY OF ANCHoRAoaF.
ENVIRONME~ SERVICES DIVISION
Reft As-built Package for Crestwood S/D, Lot 22.
Dear Mr. Roth:
Attached is the as-built package for the septic upgrade on the subject property. As you are aware
from our conversations, and site visit, the location of the drainfield was mo~ due to that fact
that we could not obtain gravity flow if it was located at the originally proposed site. In the
process of relocating the trench the contractor fniled to have the lot line professionally located and
inadvertently placed it several feet into the utility easement. According to the surveyor, the
centerline of the pipes are 1.5 feet and 1.8 feet into the utility easement, the edge of the gravel is
probably as much as 2.5 -3.0 feet into the easement. We have obtained letters of non-objection
from the utility companies and, to be conservative, are requesting a 5 foot lot line waiver from
your delmrtmem. Attached is a check for $115.00 to cover the waiver fee.
In addition to not flagging the lot line the installer did not flag the well radius. Al~er construction,
we "snaked" a rag tape under the shed (which is between the trench and the well) and determined
that the edge of the well casing was only 99.7 feet from the edge of a monitoring tube we
installed at the southwest corner of the trench. Atter an impection by your department we
mutually agreed that filling the monitoring tube pipe (.33 feet in diameter) with dirt would
effectively place the edge of the drainrock 100 feet from well The pipe has been filled with dirt
and cut offhelow grade.
~If you have any~
PreSident rness, R~
k, plcase cailme a 337-6179. Thank you for your assistance.
ENSTAR Natural Gas Company
401 E. International Airport Rd.
P O Box 190288
Anchorage, Alaska 99519-0288
Engineering Dept. Fnx (907) 563-4085
November 9, 1998
Alaska Water & Wastewater Consultants, Inc.
Mr. Jeffrey A. Gamess, P.E., M.S.
7320 East Chester Heights Circle
Anchorage, Alaska 99504
Dear Mr. Amos:
ENSTAR Natural Gas Company has no objection to the septic system cleanout that encroaches
into the utility easement on Lot 22 Crestwood Subdivision as shown on the attached drawing.
If/~u. hav~y~ call meat264-3743.
Dan Wcstervelt
Right of Way Agent
November 9, 1998
,leffrey A. Oamess
Alas~ Water & Wastewater Consultants, Inc.
7320 Fatst Chester Heights Circle
Ane. hornge, Alaska 99504
Dear Mr. Om'ness,
Subject to your agreemmt to inderrm~' the company as set forth below, GCI Cable Inc.
of Alaska has no objection to ~ septic system cleanout encroaching into the utility
easement on the north property line of Crestwood Subdivision Lot 2:2, Block 1. Known
as 9601 Brien Street, city grid 2438.
This letter of non-objection in no way precludes OCI Cable from full use and enjoyment
of any rights it may have within any portion of the utility easement and or the right-of-
way, including unlimiled access for servicing its t~cilities. Also any additional ami
extraordinary costs incurred during any futurc rcquired comlruction, ml:~ir or
reconstruction of GCI's facilities lo accommodate any or all of the encroachments shall
be paid by the pwperty owner.
By signing below, you agree to indemnify and hold OCI Cable harmless,
forever, for any damage, costs, expense (including reasonable attorney's
and injury to any person or property occurring as a result of the
and
liabilities
Please/ad/cate your aooeptanem by signing
address below.
Sincerely.
OSP Design Engineer
~CfO~~
e ,
the
D~e
51~1 Falrl:)anl<$ Street * Anohorage, Alaska 99503 · !)07/788.9260
Cable eervioes provlded Oy GCI Cable,/no,
600 Telephone Avenue · Anchorage, Alaska · 99503-6091 · 907 564-1000
November 12, 1998
Alaska Water & Wastewater Consultants, Inc.
7320 East Chester Heights Circle
Anchorage, Alaska 99504
ATU Telecommunications has no objection to the encroachment of a
septic system clean-out into a platted easement located on Lot 22 of
Crestwood Subdivision, as depicted on the as-built drawing submitted.
Acceptance and use of this letter of non-objection by yourself, your
heirs, your assigns, or your successors, will constitute agreement to
the following stipulations: ~-
ATU will be held harmless, now and forever, ' for any
damages or injury to any person or property as a result of
this encroachment.
Any ATU facility damaged or destroyed as a result of this
encroachment will be repaired at no cost to ATU.
e
Any costs incurred by ATU for special construction
necessitated by this encroachment .will be borne by the
property owner.
Ail applicable safety code regulations will be observed
and maintained.
This letter of non-objection will in no way preclude ATU
from full use and enjoyment of its rights within any
portion of its right-of-way.
Sincerely,
I 'ing
GS\ le\g: mswd\ co r\ nonob\AkWatCon, doc
! 203-14A
G-2438
EN98090
ENCROACHMENT PERMIT
This permit is between Chugach Electric Association, Inc., an Alaska non-profit
electric cooperative, (herein UChugach"), whose address is P. O. Box 196300, Anchorage,
Alaska 99519-6300 and Deloris M. Dannehy, (herein "Permittee") whose address is P.O. Box
230807, Anchorage, Alaska 99523. (
1. Easement. Chugach is the grantee or user of an easement for the construction
and maintenance of electrical facilities, as follows:
Described in that certain written instrument recorded on the 12' day of December
1955, at Volume 126, Page 53, of the records of the Anchorage Recording District,
Seward Meridian, Alaska,
Described in that certain written instrument recorded on the 22"d day of August
1958, at Book E4, Page 102, of the records of the Anchorage Recording District,
Seward Meridian, Alaska,
Dedicated by the plat of the subdivision known as Crest Wood Subdivision,
according to Plat Number P-525, recorded on the 17~h day of May 1960, on file in
the office of the District Recorder, Anchorage Recording District, Seward Meridian,
Alaska,
(herein "Easement") which pertains to the following described real property:
The North Ten Feet (N 10') of Lot 22, Crest Wood Subdivision, according to Plat
Number P-525, recorded on the 17a' day of May 1960, on file in the office of the
District Recorder, Anchorage Recording District, Seward Meridian, Alaska.
Permittee acknowledges the validity of the Easement. Permittee wan'ants and represents that
Permittee is the owner of the fee simple interest in the land subject to the Easement and the
following described real property to which the Easement is adjacent:
Lot 22, Crest Wood Subdivision, according to Plat Number P-525, recorded on the
17a~ day of May 1960, on file in the office of the District Recorder, Anchorage
Recording District, Seward Meridian, Alaska,
(herein uParcel").
Encroachment Permit - Page 1 of 4
2. Encroachment. Permittee proposes to continue the existence of the following
improvement(s) on or within the real property subject to said Easement:
A septic system clean out pipe located approximately 2 feet within said
Easement at a point approximately 108 feet west of the east property line of
said Parcel.
(herein "Encroachment").
3. Permit. Chugach hereby authorizes Permittec to continue thc existence of thc
Encroachment in its proposed location subject to the covenants set forth in this permit.
4. Indemnification. Permittee shall indemnify and hold Chugach harmless from
any claims for personal injury, property damage or other loss arising in any way from the
continuation of the Encroachment.
5. No Expansion or Increase. Permittee shall not in'any way expand or increase
the extent to which the Encroachment occupies any of the real property encumbered by the
Easement without the prior written consent of Chugach. Chugach has no obligation to
provide such consent.
6. No Interest in Real Estate Acquired. Pcrmittcc hereby acknowledges that thc
Encroachment and any additions thereto, even if in violation of this permit, has not and shall
not in the future give rise to any interest or estate in the real property subject to the Easement
or any other real property. Without in any way limiting the foregoing, Permittee
acknowledges that the Encroachment is not adverse to any interest of Chugach and its
continuation is entirely with the permission of Chugach for purposes of the common law
doctrine of adverse possession. This permit creates no interest in the real property subject
to the easement.
7. Modification of Utility Facilities. If the electric utility facilities located within
the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that
portion of Chugach's total costs for such modification which is reasonably attributable to
accommodating or preserving the Encroachment. If such payment is not made within thirty
(30) days of written demand for same, Chugach may terminate this permit in accordance with
paragraph 9, below.
8. Covenants Running with the Land. The obligations of the Permittee arising
from this permit shall be covenants running with the land which shall burden the Parcel and
the Permittee's interest in the land subject to the Easement and shall benefit the Easement.
9. Termination. Chugach may terminate this permit after the giving of thirty (30)
days written notice of such termination if:
Encroachment Permit - Page 2 of 4
a. The Encroachment is enlarged, increased or extended within the real property
affected by the Easement.
b. The Encroachment is damaged by any means to an extent of more than thirty
percent (30%) of its replacement cost at the time of destruction.
c. Permittee fails to make the payment described in paragraph 7, above.
10. Term. This permit shall, if not sooner terminated by Chugach, expire forty
(40) years from the date hereof.
11. Entire Agreement. This written permit constitutes the entire agreement
between the parties with respect to the subject matter hereof and supersedes all other prior
or contemporaneous agreements, oral or written, between the parties. No modifications,
amendments, deletions, additions or alterations of the permit shall be effective unless in
writing and signed by all of the parties hereto.
CHUGACH ELECTRIC PERMITTEE ..~- ...... ,,,,,,,~ ~i~
STA~ OF ~A8~ )
)
THI~ J~IC~ DIS~CT )
foregoing ins~mentwas ac~ow]edgedbefore me ~is ~~ day of
o, ~~ ,1998, by Eugene N. Bjo~md, ~e General M~ager
of Chugach Electric Association, Inc., an Alaska co~oration, on behalf of the eo~oration.
~ate of Alaska
My commission expires 7;/0 '- ~,)3
Encroachment Permit - Page 3 of 4
'. ' ~;TATE OF ALASKA
THIRD JUDICIAL DISTRICT
)
) SS:
)
The foregoing instrument was acknowledged before me this
~~~~ -- 1998, by ~e./or'tg fi].
day of
Nota~ublic in and for thc State of Alaska
My commission expires?__~~~'~~
AFTER RECORDING RETURN TO:
Chugach Electric Association, Inc.
P.O. Box 196300
Anchorage, Alaska 99519-6300
0'/9 5 3'1 ~ me DE -9 PR 3:O0
ANCHORAGE REQUESTED BY
RECORDING DISTRICT ~
Encroachment Permit - Page 4 of 4
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(go7) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 25, 1998
Expiration Date: Aug 25, 1999
Permit Number: SW980321
Legal Description: CRESTWOOD LT 22
Design Engineer: 0041 AK Water & Wastewater Consuita
Owner Name: GREG STEWART
Owner Address: PO BOX 230807
ANCHORAGE , AK 99523-0807
Parcel ID: 015-061-25
Site Address: 009601 BRIEN ST
Lot Size: 49500 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[~ Disposal Field [~] Septic Tank [] Holding Tank [] Privy
[] Private Well
[] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours pdor to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours )..( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: ~_/(-.~ .~[ ~ ~ .(2~_. Date:
Issued By: Date:
Alaska Water & Wastewater Consultants, Inc.
7320 East Chester Heights Circle - Anchorage - Alaska 99~04
(907) 337-6179 ~ Fax (907) 338-3246
Consulting Engineers
August 19, 1998
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Rei~ Septic Upgrade Design for Lot 22, Crestwood Subdivision
To whom it may concern:
The existing 4 bedroom house is served by a private septic system and a private well. The existing
system is documented for a 3 bedroom residence. Our client would like to upgrade this septic
system to meet the 4 bedroom requirements. We propose to install a new 1250 gallon septic tank
and install a new drainfield. One test hole was excavated to the east of of the existing system.
Comments regarding the proposed upgrade design are summarized as follows:
1. SOILS: Attached is the log which shows the soil profile, and the percolation test result. The
proposed upgrade is to be designed around a 30 feet radius of test hole. Below the organics the
soils are a SW material with SP and GP lenses throughout to a depth of 5 feet. At 5 feet, the soils
transition to a SW material with SP pockets/lenses throughout to a depth of 16 feet (bottom of
test hole). No groundwater was encountered during the excavation of the test hole. One soil
percolation test was performed at 7.5 to 8.0 feet which perked out at a rate of <1 minutefmch.
The insuti soils should act as a sand filter.
2. TRENCH DESIGN:
a. Percolation Rate: <1 minutes/'mch
b. Allowable Application Rate: 1.2 gallons/day/t~2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 450 R2
f. Effective Depth: 4 feet
h. Width: 5 feet (minimum)
i. Reduction Factor: 0.50
j. Minimum Length: 50 feet
k. Effective absorption area = 640 ft2 (>625 R2 OK)
1. Maximum depth = 10 feet (at any point)
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPIIY: As can be seen on the attached topography site plan, the lot is generally
flat. In short, there are no slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems, ff you have any questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistance. ~4
Jeff:r~Y ~k., (~ess,~TE., M. S'
Presideht ~
· ~'~-' ~- [ BARRY AVENUE
LOT 1,3. CRESTWOOD S/D, ~ LOT 24, CRESIWOOD S/D,
~ ROCKHILL S/D
............................ - ................................ ~ LOT 3, BLOCK ,3.
............................................................. -~ j ROCKHII I $/D
LOT 15, CRESTWOOD S/D,J-.-
'
. ~ /' ~ "--EXISTING :::~:~'---PROPOSED SEPTIC UPGRADE
· -,. ~,,.,, ~ ..~- HOUSE II (SEE DESIGN. PAGE 2 OF 2)
/ ~ ~ ROCKHILL S/D
I
LOT 16, CRESTWOOD S/D, I LOT 21, CR£SIWOOD S/D,
LOT 17. CRESTWOOD S/D. * LOT 20, CRESTWOOD S/D.
I
,~T.&S]r~ WAT~I~ AND WAS~AT~I~ CONSULTANTS, DNTC. --~
73*0 £. emmmm u~om~ e~eLE. ~¢Homo£. ~
PHONE: (907) 3,:37-6179/FN(: (907) 338-3246
LEGAL DI~CRIPIION:
CRESIWOOD SUSDI¥1SION, LOI 22,
OREO STEWART 346-172~786-8608
'-.. .......... ..-
J.L.M. 1 = 100' 1 OF 2
LOT 1, BLOCK
ROC~IU. S/D
SEPTIC
LOT 4,
I
!
/
% 1 O' ~1~ ~E~E~
- ~ ~ ~I~ING SE~IC T~K
~ ~ ~ TO BE ~DONED COMPL~ELY
~ _ ~ ~ ~tSTING mENCH
/ / I I X g ~ ~ . ~.~LaU~.UN
PROPOSED D~NFIELD
5' WIDE (MINIMUM
~ ¢ I . ~Xl.~T¢~,~ I I~ % V- CLX, W~HED S~
~ ~ / I ~N~L FCO AND
~U] ~~ I INSU~TE LiNE
~ //~ UNDER ~
l
P~E (~ 3~7-6179~: (90~ 3~-~
D[SIGN OF S[PTIC SYST[M UPGRADg
346-1722/786-8608 . -~953
~ :AS]~ WATER & WASTE~rATER CONSULTANTS~ ~C.
7320 ~ ~ ~ ~ * ~~ ~.
J SOIL LOG - PERCO~TION TEST J
LEGAL DESCRI~ION: CRE~OOD SUBDIVISION; L~ 22,
PERFORMED FOR: gREG ~ J .................................
DA~ PERFORMED: 8/12/98
I
TEST HOLE ~1
~ soIL C~SSIFI~TIONS t ISITE P~I~
~ SW / I r=~00'l,, ',
~,~"* WITH SP&GP ~ ~w ~ ~6
7-- ~ ~ ~ · DE~H TO
~ ~ DATE
SR~DWATER
~B~0~
8-- ~o%~ D~ 8/12/98
~0o WITH ~
>~ ~%~c CLOCK ~T TIME WATER LEVEL NET DR~
11 -- ~[ooo~ DATE ~ING TIME (MINUTES) RE'lNG (INCHES)
~%~ 8/12/98~RL~D PE {C ~ 3 TIMES, D~NE[ D~ ~CH ~ME IN <2 MIN.
~ ~o~ ~ 1 10:21 6"
13-- ~o~j 2 10:23 2 MIN.
~o ~ ....
15~ ~ooo~
~o~ ~ .. ~ :...~,,.~
16-- ~ B.O.H. ~i~:'.l J~l
19~ ~~TI~TE <1 (MIN./IN~) J~~ 6
~ TEST ~ BE~E~ 7.5 ~. ~ 8.0
20~
COMMENTS: g~ ~P~ T~EN e 7.5-8.0 ~ DE~H
PERFOMED ~ A~ WA~R · W~ATER I, , CERTI~ T~T
THIS W~ PERFORMED IN ACCORD~CE WI~ ~L STATE ~D MUNICIPAL GUIDEUNES IN EFFECT ON THIS
DATE. DA~:
DEPTH TO DATE
GROUNDWATER
DRY 8/12/98
DRY 8/19/98
GRE ER ANCHORAGE AREA BOE JGH
Department of Environmental QualiW
3330 C Street
Anchorage, Alaska 09§03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE ~1 ~
FROM WELL, .J~_/-
INSIDE LENGTH
~ ~ NUMBER OF
MANUFACTURER, MATERIAL COMPARTMENTS ~
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYi~_ GALLONS.,
TILE DRAIN FIELD:
DISTANCE FROM WELLi~?'~ FOUNDATION
/
ABSORPTION AREA_-~.? -_.~)~
DEPTH: TOP OF TILE TO FINISH GRADE
TYPE
CONSTRUCTION
TOTAL LENGTH
NEAREST LOT LINE OF LINES ~-- 7
W/II~ TRENCH WIDTI--~ IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE .~."'~. 1
~ ! DEPTH OF FILTER !
MATERIAL BENEATH TILE 7 .II'ABOVE TILE IN.
DEPTH DISTANCE F ROM:
BUILDING
FOUNDATION
NEAREST
LOT LINE_
NEAREST SEPTIC SEEPAGE
, SEWER LINE__, TANK , SYSTEM
CESSPOOL
OTHER SOURCES
APPROVED.
DISAPPROVED
REMARKS
DISTANCES:
INSTALLED BY: ,~_~::~)~,tg~ (' t
SEWER LINE DEPTH:
PIPE MATERIAL: ~l~f'~-~_~'1
LOT SLOPE:~ ~
REMARKS:
~i~,~E)IAGRAM OF SYSTEM
Form LQ-032
F'E R M I T NFL
FIF'F'L. I f":A[.ll'
LOC FIT I ]1'.,I
LEGRL.
'
.....
DEF'RRTMENT OF HERLTH
825 '"L'" STREET, RNCHOR~'SE, RK. 9D._,O~ ~ J~l;~ 1'~--
(773:5:5)
BR Z E N
L. 22 E:RES't'WOOD SUBD LOT SIZE D SOOE~ ~QURRE FEET
TYF'E OF S'] I L FIBSORE:T IFIN SYSTEM IS ' TREI'-,ICH
MR::.:;II"IUM NUME:ER OF BEE:,ROOM'--; = 3:
'=; ri I L R FtT I N iS ( S Q F "1-,-." B R ', :1.,::. ~
THE REL-]UIRED "~I ZE OF THE SOIL FtE::50RF'TIOI",I _- T.=TEfl 1:5 ·
[:, E: F" 1- H = :;L -:2: L_ E I'-.i u2~i '¥ H = ;2: ,-- ~ F-. H -.- E L [:, E F" T H = ,--:-'
'T'HE LENGTH [)IMENSION I:5 THE LENG'T'H ,:: IN FEET) OF ]'HE TRENCH CiE: [.',F.:FtlNFIEL. E:,.
'T'HE DEPTH OF' Ft TRENCH OF.'. PIT IS THE D ISTFINF:E BETWEEN THE SUF.:FFtCE OF THE
GF.:OLtND FIND THE BOTTf]M FiF THE EXCF-I'v'A-I'IO[.,t (IN FEET.'.',.
'THERE IS NO SE'T' I,.IIDTH FOR TRENCHES.
THE 6RFIVEL DEPTH I:5 ]"HE MINIMUM DEPTH OF GRFIVEL BETHEE:N THE OLITFFILL PIPE
FIN[:, THE BOTTOM OF THE EXCFI'v'FITION (I[.,t FEET).
F-: E: ":). IJ ][ E: E E:, :_:;. E F' -r' ]: c: 11- R I'-.I i-::" :_-.-5.. I Z _FF__ == :1_ ¢__.:-~ ~_--'-, L~ C_i ~11 L_ L_ C, r'-,,i .-_'~_.
-I-- t.....! c, ,:: 2 ::, T r'-.I S F" E L--: T [ L-I !"-..I S R E" E E: E Ii:.! !.._1 I E: E E:,
E:FIC:KFZLLING OF FINY :5"r'STEI"I WITHF/U'T' FINFIL INSF'EF-:TIF~N FII",ID FIF'F'RO',,,'AL. B'T' THIS
[:,EF'FIRTMENT PI ILL BE SIJBJEC:'T TFi PROSEF:UTION.
MINII"IIJI"I [:,ISTFINC:E BETWEEN R WELL RN[:, RNY ON-SI TE SEWFIGE DISPOSRI_ :5'-r'STEM I:5
d~OE~ FEET FOR FI PF.'.IVFITE WELL OF.'. 20F~ FEET FOR R PUBLIC: NELL.
WELL LOGS RF..'E REQUIRED FINI} MUST BE RETURNED TO THE DEPFIRTMENT WITHIN -..':El DFI"r'S
OF THE WELL COMPLE]"ION
SPECIFICFITIONS FtND CEINSTRUCTIO[.,I [:,IFIGRFIMS FIRE FIVFtlLFIBLE TO INSUF. tE PROPEF-'.
I NSTFILLFIT I ON.
I CERTIF'¥ THRT
±: I AM FAMILIAR WITH THE REQUIREMENTS FOF.: ON-SITE SEWERS AWE:, WELLS FIS SET
FORTH BY THE MUNICIF'RLITY OF RNE:HORRGE.
;-2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
]':: I UN[:,ER:STFIN[:, THFIT THE ON-SITE :SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RES IDENE:E I:5 REMODELED TO INCLUDE MORE THFIN ~: BEDROOMS.
S I GI',IE[:, ' .............................................................
RF'F'L I CFINT FuRE~IJ_,T HOMES
1:5:SUE[)' Ei'T'___
...... [:,ATE ........................
GReaTER ANChORAGe AREA BOROUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
.~o ..c.. STREET A.C.ORAGE, ^LASKA
L~ ~/_ C TELEP.O.£
SEWAGE DIS~0SAL SYSTEM -- APPLICATION AND PERMIT
NAME OF APPLICANT
LEGAL DESCRIPTION /.. OT
INSTALLATION OF: SEPTIC TANK ~ ~ SEEPAGE PIT
PHONE
DRAIN FIELD
TO BE INSTALLED BY
. OTHER
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
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 TYPE SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMEN'T~
FOUNDATION TO SEPTIC TANK
FOUNDATION TO ~t
SEPTIC TANK TO ~~.~WALL
SEPTIC TANK ~-'
.
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, /OO
DRAIN FIELD
, DRAIN FIELD
_7_~ / o o
ALSO CONSIDER AREA WELLS.
., 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.
.,,v...,.=.,.,.. _
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G .A .A .B.
OR
LICENSED DESIGNER
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.
DATE _i~'~/,~, .'~. ~J APPLICANT', SIGNATUR~~
FORM NO. LQ-0!
Performed For
Lenal r)escrintion: Lot 22 Block
This Form Renorts Soils Loa yes
Foremost Homes Date Performed 5/23/77
__Subdivision Cre~w~
Percolation Test
neDth
Feet Soil Characteristics
6" ~'~Ol~ ~ ~:: ~eddish Silt
6--
8--
10--
12
14--
16_
Sandy Gravel
18__
20
Bottom of Test Hole
Was Ground Water Encountered? No
I~ Yes, At what Denth?
Readinq Date Grnss Time Net Time Depth to H20 Net Dronl
} ''
I ''
I '
Percolation Rate Hinute
Prnposed Installation: Seenaoe Pit Drain Field
Deoth of Inlet De~th To Bottom Of Pit Or Trench
C~U!~ENTS: 125 Square. Feet draiDage area required per
Test Performed By --David Paul ~ Date: 5/23/77 LAB
; Zr,..~? a:z
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
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
L 22 Crestwood Subdivision
Location (address or directions)
9601 Brien
(b) Applicant Name GreA Stewart Telephone: Home 346-1722 Business
Applicant Address 9601 Brien AztchoraRe, Ak 99516
(c) Applicant is (check one): Lending Institution [] · Owner/buildetJ~; Buyer []; Other [] (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent
Address
(f)
Telephone
Mailthe HAAtothefolloWing address:
~reg- 764-412~
TYPE OF RE~DENCE
Single-Fa.~mily~ ~[ MUl~i,-Family [] Other
Number ~,! B~lroom~: . ~)~ ,: Three
WA~R SUP~Y, XX
'~ti ~ , .
Individual We~ ~ Commun,ty m Public m
Note: ff ~Ommun~ ~ll ~ystem, mu,t bav~ ~dtten confirmation from th, State D~pa~mont of [nvirom~n~ Gon~ation
atto~tin~ to tho 1~81i~ ~nd ~tatu~.
4. SEWAGE DISPOSAL
Onsite ~[ Public r"! 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 t of 2 72-025 (11/84)
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 Telephone
Address
Date
Engineer's Seal
This office has received written ~onfirmation form the Engineer (Alaska
Environmental Control Services, Inc.) thac the conditions of June 15, 1985
have been met. Therefore, Chis property meets MOA requirements.
DHEP APPROVAL
Approved for ('3) ~'tree
Date
Approved XX DisapprOved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based ~dely 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 inspac'tior~ 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
72-025 (11/84)
ALASKA I IROFImI FITAL COFITROL $1 R'glCI $, II'lC.
I~nynemnt1 & ~nuironmenlal Studies
,~UNICIPALITY OF ANCHORAOE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
June 12, 1985
RECEIVED
Municipality of Anchorage
Department of Health and
Human Services
825 L. Street
Anchorage, Alaska 99501
RE: Crestwood Subdivision Lot 22
On June 11, 1985 we inspected the trench cleanout on the above property.
The broken and bent pipe had been removed and a new section put in. The
cleanout is 2.9' aboveground and capped.
If you have any questions please call this office.
Sin~cerely, ,
~~en Tut4~/~/~
vironmenta 1 Scientist
1200 LUest 33rcl Auenu¢, Suil~ J~, AncJ~oracl¢, Alaska 99503 *[907) 561-5040
MIINICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH ADTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Applicants Name ~,'~:~' _~'~L/~gg~2.~-
(c) Applicant is (check one) LeMi~ Institution ~ ; ~er/builde~
Buyer ~; Other ~ (uplain);
(d) Lending Institution Telephone
Telephone- uome ~usiness
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 ~ Community ~-~ 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: 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]
5. Ensineerin~ Firm Providin~ 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 ~ype of structure indicated herein. I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation an~ inspection, the on-site ~ater supply and/or ~astewater disposal
system is in compliance with all Nunicipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm /~ ~'~ ~ ~ ~ Telephone
,~W ~'-'~ 't'- , X~ ~ <' D,.'z~z.,.-,. / ~ (ENGINEER SF.~) ~. ~,.r"'~~//.,~
.; ..... ..
Approved __~ ~., Dtsappro nditional
/
Terms of Conditional Approval '
THBIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FBDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIOKS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUE~. THE MUNICIPALITY OF ANCHORAG~ IS NOT RESPONSIBLE FOR ERRORS
OR OMISSION5 IN TH~ i~OFESSIONAL ENGINEER'S WORK.
RR4/eJ/D18
[Page 2 of 2]
7-19-84
DIVISION OF ENVIRONHENTAL ~tLTH
DEPARII~NT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
:1. General Information Application Date
(a) Legal Description (include lot, block, subdivision, section, township, rar~e)
Location (address or directions)
(b) Applicants Name 6~/~ff~
Applicants Address
(c) Applicant is (check one) Lendin~ Institution ~--~ ; Owner/builder~~l~'
Buyer ~--~ ; Ocher] [ (~plain); /
(d) Lendi~ Institution Telephone
Address
(e) Real Estate Co. & Agent
Address
(f)
Telephone
Mail the HAA to the following address:
2. Type of Residence
Single-Famtly~
Number of Bedrooms
Multi-Family ~--~
Other (describe)
3. Water Supply
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 ~ ~.;tlil ///
Note: If community well system, mus~ ihava lw~tlten confirmation from the State
Department of Environmental Conservation a,ttesting to the legality and status.
[Page 1 of 2]
Engineering Firm Providin~ Inspections, Tests~ File Search~ Data _~-d Information
As certified by my seal affixed hereto and as of the validation date shown below,
verify that my investigation of this Health Aut.hority Approval sho~s that the on-site
water supply and/or ~aste~ater disposal system is safe, functional and adequate for
the number of bedrooms and ~ype of structure indicated herein. I further verify that,
based on the idomatton obtained from the ~hnicipality of Anchorage files and from my
investigation and inspection, the on-site rater supply and/or ~astewater disposal
systea is in compliance with all ~hmicipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm Telephone
. ,~ / / ._-,.t . _.,~-. . / _. i~. .~'~M..,.,r~/I ~ ~/' ~"
Approved for bedrooms By Da~,,~Y~
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES I~RALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS 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 REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUEE. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/Di8
[Page 2 of 2]
7-19-84
DEPT. OF HEALTH &
~-~ ENVIRONMENTAL PROTECTION
SEPTIC/HOLDING TANK DATA
Date Installed ~,//~/~-'
Size /~'0 NO. Of C~,~a~tments
~ Tank (Y/~ Date Last Pu~d ~/~. ~--
Dep=ession
Pumping/Maintenance ~a~/' ~ File (Y~) ~" f~----~
Holding Ta~ High.ate= ~am (Y~) ~~ ~ldi~.Ta~ ~t (Y~ .
~ation Dista~s ~ ~ptic~oldi~ Ta~:
To ~te~Supply ~11 /~ ~ [ ~' To ~ildi~ F~dati~
To ~rty ~ ~/~' TO ~al Field
To ~ter ~i~=vi~ Li~ ~/~ To S~, ~, ~e, ~ ~j~ ~ai~
[Page 1 of 2] ~-.OO
2-15-84
C, ABSORPTION FIELD E~tTA
De
Soils Rating in Absc~ption S~ata
Date Installed
Width of Field ! !
Square Feet of Absczpti~ A=ea
Dep=ession oven Field (Y~
Results of Last Adequacy 7~st
/~- ~ Type of System Design
Depth of Field /~ /
Gravel Bed Thickness . ~/
~,w . Standpipes Present ~/N)___/__
Date of Last Adsquacy Test ~/~/~%--
Separation Distance f~cm Absorption Field:
To Water-Supply Well //~//~" To Property Line -~/6) /~--
TO BuildiD~ Foundation ~6) ! ~- To Existing c= Abandoned System cn
To Water Main/Senvice Line ~_,~/)Y-- To Cutbank(if present)
To St~eam/Pond/Lake/c~ Majo= D~ainage Course , ~/D~/~
To D~iveway, Parking Area, c~ Vehicle St.c~age Area _ ~9/ . , ·
LIFT STATION
Date Installed
Size in Gallons
"l~mp On" Level at
High Water Alarm Level at
Tested fon
Electrical
(Y/N)
Off" Leal at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Meets MDA
** Check Permitted Bedrocxa Rating AGainst HAA Request
I centify that I have checked, verified, c~ confcz~ed, to all MOA HAA Guid ,i&~ in effect
on the date of khis insp~cticn. . /
2-15-84
ALASKA ErrVIROIlmE[1TAL CO[1TROL II1C.
J~nqincmnq &- J~nuironmcntaJ Studies
CARL JOHNSON
9601BRIEN
ANCHORAGE
SELLER-GREG STEWART
APRIL 10 1985
WILL PICK UP FROM OFFICE
50123
LEGAL:CRESTWOOD BLK LOT 22
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-4/09/85~--~
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH A~ AREA OF 378 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 722 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE. .~'
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 09/07/84 ~
FLOW TEST ON WELL
WELL FLOW DATE-04/09/85
A FLOW TEST WAS PERFORMED ON THE WELL. 722 GALLONS OF WATER WAS
PUMPED AT A RATE OF 6.8 GPM OVER A DURATION OF 2 HOURS.
THE DRAW'DOWN WAS 1 ' WITH A RECOVERY TIME OF 10 MINUTES
AND THE STATIC WATER LEVEL WAS 46.9 FEET.
THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME.
MUNICIPALITY OF ANCH ...... '-
- DEPARTME OF HEALTH AND ENVIRONML .,.._
825~L Street, Anchoraa~. Alaska
264-4720
Date Received:
PROTECTION
99501
September 20, 1977
#1: Time 1:30 p.m. #2: Time #3: Time
Date 9-2~-77 ~/~k/ Date Date
Insp ...~_,c ~ ~2 Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: Alaska Pacific Bank
Mailing Address: 601 West 5th Avenue 99501
Phone:
276-3110
Property Owner:
Mailing Address:
Howard Smith/Foremost Services
2523 Brooke Drive
Phone:
278-3644
3. Legal Description: Lot 22 Crestwood Subdivision
4:
Single Family Residence: (x)
Multiple Family Residence: ( )
Number of Bedrooms: Three
Number of Bedrooms:
5. Well System: Individual Well (x)
Community/Public System ( )
Permit # 77331
Depth of Well 67'5"
Well Log on File
Construction
Bacterial Analysis
Sewage Disposal System:
Permit # 77~1
Septic Tank Size
Absorption Area
On-site System (x~ Public Utility ( )
Installed 1977 Installer
Manufacturer
Soils Rate Material
Distances: Well to Septic Tank
to Sewer Line Nearest Lot line
to Nearest Lot Line
to Absorption Area
Absorption Area
P~ge ~wo' ~ ~
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 22 Crestwood Subdivision
Comments:
Affadavit Attached:
Approved:
Disapproved:
Letter Attached: ( )
Date:
Department Worksheet:
.,' 1UNICIPALITY OF ANCHORAGE ~-,
DEPARTME~'OF HEALTH ANi~ ENVIRONMENTAL PROTECfI~
~10 Ea~ Tudor Road, A~horage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
Type of Inspection: CM RO. _ VA
Property Owner:_ Howard Smith DBA; Foremost
~ Mailing Address: 25~3 Brooke Dr.
Name of BUyer:_
' Mailing'Address:
.Name of Lending Institution:
Mailing Address:_ 601 '~ 5~k-. _
Name of Realtor or Agent: ~
Mailing Address:_ 72zLE_.!~h. ..,
FHA__
CONV
Services
Day Phone:_ 278~'36z~
_ Day Phone:_
_ Phone: 2_~6-.~'I fl 0
Phc, ne: ~-72-0~7q '~,
Type of Facility to be Inspected: ~ n~q ~. ~L~_
i!~$ Water Supply ~:'X::~c:x~:
Type of Supply: Public Utility,__
If Individual, number of dwellings presently served
_ No. Bdrms.~______________~,
_.Individual
oi'1e
If Individual, depth of well _
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
Individual (on-site)
F
Time . ~.__ Time .me
Date Date Date
Inspector Inspector Inspector
Comments Conditional Approval
r
( ) Approved Sedrooms
Date Sewer Installed ~~ Permit No. Septic Tank Size
~ -- ~ Holding Tank Size
Soils Rating Well To Absorption Area Well L~ Received
Well to Tank
APPLICANT FILLS OUT LOWER HALF ONLY
Prope.y Owner ~~ ~ '~0~ .hon~
Mailing Address ~ ~ ~ ~ ~ ~, ~
Buyer ~K ~ ~
Address
Lending
Institution
Address
Realty Co. & Agent --/ OTE' ~-~ C'.F~t ~u'~
Address ~ ~ ~ ~. I~
LegalDescription ~ ~1 ~ ~T~o~d(
Street Location ~ ~t [ ~ ~' ,
Typ~ Residence
~Single Family
~ Multiple Family No. of Bedrooms
~ Other
Wat~upply
~ Individual '~ A~ACH WELL LOG. A well log is required for all wells drill~ since June
~ ~mmunity~ 1975. For wells drilled prior to that date, give well depth (attach log if
~ Public Utilit~ ~ , available.)
Sew~e Disposal
~ Individual Year Individual Installed: ~
~ Public Utility When Connected to Public Utility:,
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
March 1, 1982
Karen K. Koush
Brien St.
Subjectz Lot 22, Crestwood Sub.
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed=
The depression or pit around the well casing needs to be
filled with impervious type soil so that it slopes away
from the well casing.
The water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B Street, for our review.
The septic tank pumped with a receipt submitted to this
department.
An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is
adequate according to National Standards. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
Please notify this department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
Robert C. Pratt
Associate Environmental Specialist
Enclosure
ALASKA erlUlRonmerlTAL COFITROL $1 RUICi $, IrlC.
i~n§incerin9 $ I~nuironmcnlaJ Studies
MUNICIPALITY OF ANCHORA(~E
FIRST ALASKA MORTC~Af~E & ESCROW/RAE
207 W NCRTH~J~N LIGHTS
~~. AK 99503
SR~.~,WR - KAR~q ROUSH BUY~-GR~G ST~IkRT
SU~DIVISION-C~ES~ BiOCK- LOT-22
AD~QUJ~Y TEST FOR S~/~ SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A ~CH WITH AN AREA OF 375 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PA DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 600 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 B~DRfK~ HCI4Eo
THE SEPTIC TANK WAS PUMPED ON 3/11/82 .
SEPTIC TANK AD~QU~L'Y
THE EXISTING SEPTIC ~ VOLUt4E OF
THIS 3 B~DROC~ ~0USE.
1000
1220 U Jest 25th Auenue · Anchoracl¢, Alaska 99503 · (907) 276-1361