HomeMy WebLinkAboutCHALET TERRACE LT 5Chalet Terrace
Lot 5
#015-163-36
C
Municipality of Anchorage 4
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program, 4700 S. Bragaw SL
P.O. Box 196650 Anchorage, AK 99519.6650 Page of
www.d.anchorage.sk.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SWO5032.1
PIDNumber. 0IS-1163-36
Nam
Wastewater System: [INew g Upgrade
Ofn O
Aaaaaa'7YYO CUALET C1 u¢
ABSORPTION FIELD
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LEGAL DESCRIPTION
sa R.ft
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it.
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Well:�iiS�L� [:]New
Upgrade.
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SEPARATION DISTANCES
0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
Lift
Holding
PubkWint
M«M W.
aP.atr
From
Tank
Field
Station
Tank
Sewer Line
Gar 0170
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LIFT STATION
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BENCH MARK
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Engineer's Stamp
44
Inspections performed by:
Lars gpwieklariA Dates: 1t1 8 31 D
! 497g
2nd 9 I o
N•
,,. •
Developm nt Services Department Approval
'�
Reviewed and approved by: Date: Ctk:!J Cl
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ALPS AVE
1
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PrP
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Q AC= 50.5' cu 17•
BH= soB1= 45' p= 15• C.
y � r
n 0 25 50 75 107 125 J50 I
SCALE, I' = 50 FT.
I
10
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BANDMB DWAG SYSTEM
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MN SPURIQAND
No. cc -222,5 .•
l0tltltN J U Y.t.
203LOT 5 CHALET TERRACE S/D SEPTIC SYSTEM ASBU/LT
ANCH. AK. K.7H. TH AVENUE 99501 EENUE TOM NELSON DATE: AUC. 10, 2005
907 279-3916 7440 CHALET COURT SHEET.• 2/3 CRID-2640
PERMIT # SV050322 PID / 015-163-36 CHAO5002.DVG
Standard Trenchr
37' LONG
2' Vide
8' Deep
6.0' Serer rock
3' Cover
ELEV. 95.5
SII t
NO SCALE
ELM= 89.2' 12
6.0 Ft of Septic Rock
Effective
-0odo 0
O N
1000 gat SeptJc tank
+.
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c
v
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a
3
w
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O
4
Monitor
Cleanouts
- 3' Cover
ELEV.=99'
NO SCALE ° £CEV.=83'
.�...- �.
' 49th `
36EN SPURKLAND
No. CE -2223 f
1000 gal. septic tank
BENCHMARK BOTTOM/ SIDING
ASSUMED ELEVATION 100'
TOBBEN th Ave AND P.E. LOT 5 CHALET TERRACE SEPTIC SYSTEM ASBUILT
Anchorage
WISth Ave TOM/ NELSON DATE, AcG 16, M4
279-3916age Ak 99501 7440 CILAUT C"r SHEETe 3/3 GRID, 2640
PERMIT I SWO50322 PARCEL ID / 015-163-36 CHAO5003.0WG I
' MUNICIPALITY OFANCHORAGE `\
Development Services Department
On -Site Water d Wastewater Program
4700 South Bragaw Street I \ V
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 26, 2005
Expiration Date: Aug 26, 2006
Permit Number: SWO50322 Parcel ID: 015-163-36
Legal Description: CHALET TERRACE LT 5
Design Engineer: 0007 Tobben Spurkiand, PE Site Address: 007440 CHALET CT
Owner Name: TOM NELSON Lot Size: 13994 SO. FT.
Owner Address: 7440 CHALET CIRCLE Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99516-1163
This permit is for the construction of:
❑✓ Disposal Field Ej Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specked 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (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.
JV l
Received %r
Date: E Z DS
Issued By: __f1' Date: 4540.r
Municipality of Anchorage
--�1 Development Services Department
Building Safety Division
i
i
�! On -Site Water and Wastewater Program
4700 Bragaw St
P.O. Box 196650 Anchorage, AK 99519650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D. ol5- 1103-3(0 Permit Number SW
Property owner(s) om Afekon Day phone 34(e- 1115'-
Mailing
115
Mailing address Zip Code
Site address -4440 Cc4rt Zip Code III Sl(a
Legal description (Lot, Block & Sub'd.) Loi S ct'&I } Terrgw
Legal description (Section, Township & Range)
Lot Size 13an9 Acr /Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms 3
Sewer Only Li Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade kW{1
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Date of Payment:
Date of Payment:
Receipt Number. W4,79 Receipt Number.
(Rev. 09/04)
Spurkland Engineering
Environmental Consulting and Design
SEPTIC SYSTEM DESIGN
CHALET TERRACE LOT 5
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519
August 15, 2005
We are submitting an application for the installation of a septic system upgrade for this lot. The submittal consists of
three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed
improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic
of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic
system design is based on the following:
Replacement System
Testhole 14 R deep
No Groundwater Encountered
Soil Rating. From Testhole 8/4/05.
<I min/in = 12 gal per sq.ft/day
No. of Bedrooms 3
Required Area per Bedroom: 15011.2 -125 sq.ft.
Total area required: 125 x 3 - 375 sq.ft.
Use Deep Trench with 6.0 feet of Rock
Length: 375 sq.ftJ (2.6)= 31.5 feet
Use 35 Feet
SYSTEM CONFIGURATION
1000 GALLON STEEL SEPTIC TANK
DEEP TRENCH
TOTAL LENGTH
35 FT
TOTAL WIDTH
2 FT
TOTAL DEPTH
8 FT
ROCK DEPTH
6 FT
INSULATION
2 IN.
COVER
2 FT MIN.
The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent
lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
203 West 151° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (907) 276-6013, SpurklandEng@gci.net
ALPS AVE
a
Z? \ 1 W 10 G I
\ I zl P I
NAL COURT � S
�tA�
3 150
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G 4
A
A
y
J
x I 2
3
49th
SPumcurm
E!
W
c
(;w6
Sj'�
J
50 O 50 100 150 m 250 3v
SCALE, 1' = 100 FT.
SUODMS/ON SERVED BY CLASS C
WATER SYSTEM.
ONE WELL SUPPLIES WATER
rv�uu�tVEN r.c. I I LU7' G'NALtr7" 7AKfCACE� SIV I I SEPTIC SYSTEM DESIGN I
203 W X 9 AVENUE TOM NELSON DATE: AUG. 10, 2005
ANCH. AK. 99501 7440 CHALET COURT SHEET. 1 3 GRID: 2640
907 T79-3916 /
I PERMIT N SV050XXX PID # 015-163-36 CH405001.17V6 I
1
ALPS AVE
1
1
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1 Q
1 v
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i
I C� CHALCT �
1 � �
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1
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4 I 5
RVS z NEW 575-
1000 GWON S7EEL TANK
" 7REMM
J5 MT LONG
S TEST ROCK
2 RAG/ NVSt"nON C
2 f00T COM (YIN.) 9 ^
25 0 25 50 75 107 125 150 I
SCALE, 1' = 50 FT.
I
10
I
G
_ CESS
NST -:BA
1TIlwl CLEAALC/T `
014W EX1STAG SYSTEM `
6
I
I
- - E..
49th
:i T• BEN SflURICLANO-i.«
No. CE -2225 ll
03 W D7H, A EN E I I LOT 5 CHALET TERRACE S/D I I SEPTIC SYSTEM DESIGN
203 W fSTH. AVENUE
ANCH. AX 99501 TOM NELSON DATE. AUG. 10, 1005
(907) ?79-3916 7440 CHALET COURT SHEET.' 2/3 CRID.1640
PERMIT B 0500xx PID R 015-163-36 CHA05002.DV6
Standard Trench.-
R'
rench:
2' Vide
35' Long
8' Deep
6.0' Sewer rock
2' Insula tion
2' Cover Minimum
Sit t
2'
6.0 Ft of Septic Rock
Effective
-00do
0
0
11
o 42
1000 gat Septic tank
"'
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v
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3
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NO SCALE
1000 gat septic tank
iunntn th AveiVL V.L. I I LOT 5 CHALET TERRACE I I SEPTIC SYSTEM DESIGN I
Ave TORI NELSON DATE, ALG 16, EX
Anchorage9-3916 Ak 99501
279-3916 7110 GUILT COUPE SHEETS 3/? GRIDS 2610
PERMIT J SWO50OXX PARCEL ID / 015-163-36 CHA0500JOW0
Municipality of Anchorage
Development Services Department /
Building Safely Division r
O •a..� On•Sile Water and Wastewater Program
4700 South Bragaw SL
P.O. Box 1966:0 Anchorage. AK 99519.6650 e
www o anchorace.a4.us
(907) 343.7904 '
Soils Log - Percolation Test
Pe'1om'ed For: Tam, Nedllo• Da:e Performed:
LSgal Descrpl.en: Cle jej Tee,,&. Lo+S Township. Range. Section:_
DeJ:h
(Fee
2•
t
,
c.
Logen
?' �tc9,ac11y
� Saga
• I • �I SoM!
I•
CC':^: ENTS
YrAS CAOUND WATER
NO E.`:000.`SEnEDT ,V
S
IF YES. AT WHAT DEPTH7 ^ L
0
Depth to Vlale, Aher�/ P
I.tonitoring? /Y�:le f
Dale: pAM 05
Reading
Dale
Gross Time
Nel Time
Depth to Water
Ne: D¢.
ERC.
"OLE
FfLLG-D
To
6+1
i•.e�1e
5 ,:we
DR ,i
- D
tA1
uuT�
i
CAR
Twel
I
I
I
I
FErsol ATIC,I PATE .41 FE7C HCLE 0I-.'.IETE4 Wo
TEST Ru•: 9-TvIEM 44 FT AND C; FT
PERFORSiEO BY. Lars p%Alk . I Lam- SP•,.. 9 --CERTIFY THAT 7H15 TEJ i :::,:
PER'OR:-.IED IN ACCORDANCE WITH All STATE All MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: f'
GRE/ 'R ANCHORAGE AREA BOR`' -'GH
' `►� I�� Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME SOU,tIi) C'e,NST,c'Udr�,`%ING ADDRESSs�E'A X /S(o� PHONE 3'1
LOCATION SfirAL L-% 4/ A LEGAL DESCRIPTION/ CJT S CIIA2 ET TC'RR4C F ZQ
SEPTIC TANK:
DISTANCE_ NUMBER OF
T
FROM WELL _! MANUFACTURER SC S%£ MATERIAL S% E'EL COMPARTMENTS
VL 1fy J
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 000 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH I LENGTH DEPTH AwG°
LINING MATERIAL ! CRIB SIZE: DIAMETER2�_-DEPTH-f- DISTANCE FROM: WELLC7'
TOTAL EFFECTIVE
BUILDING FOUNDATION ` NEAREST LOT LINE,` f ABSORPTION AREA (WALL AREA) 02 SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE L&2l 6 2`1 CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK — SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED i REMARKS
DISTANCES: SddWeil DIAGRAM OF SYSTEM
INSTALLED BY: S0y A!-0
cc n/s 7Xo cTi ®.r/
PIPE MATERIAL: CA ST _R0
5A�
y
LOT SLOPE: t�i�> of t
REMARKS:
DATE APPROVED
G.A.A.B.
Form No. EQ -031
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3500 Tl!DCR ROAD F'OUCH x-650
/ ANCHORAGE. ALASKA 99502 /`,�✓ i�G��„ A J�
S�/C l T[..r_PHw,v 279-8666 C11 544- Q
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMITY s�
__ MAILING ADDRESS 99Soz
NAME OF APPLICANT _ ._ _--_----�---- PHONE
INSTALLATION LOCATIO/N
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
`/_ SEEPAGE PIT_
`/
A
DRAIN FIELD . OTHER
r
tM 1. /% -
TYPE AND SIZE OF FACILITY TO BE SERVED '—
L�`�s��xc���
TO BE INSTALLED BY r
SOIL TEST RESULTS �/ �i" NOTEi THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED S�-L"'✓�'^ `
PFRMTT UAL ID (INF YFAR
FINAL INSPECTIONI 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE O TYPESt -P1 Or CQ1'1CYPtPSEEPAGE AREA. SIZE TYPE
MINIMUM DISTANCES. REQUIREMENTS DIAGRAM OF SYSTEM
FOUNDATION TO SEPTIC TANK 5 ft. sR:�%� ••
FOUNDATION TO SEEPAGE PIT 20 ft* . DRAIN FIELD 10 ft.
SEPTIC TANK TO SEEPAGE PIT WALL 15 ft.
SEPTIC TANK 5 ft• , SEEPAGE PIT 20 ft. DRAIN FIELD 10 ft.
TO NEAREST L�ANK
LINE.
WELL TO SEPTIC SEEPA E PI T
DRAIN FIELD ALSO CONS ELLS.
WATER MAIN TO SEPTIC TANK 10 ft, . SEEPAGE PIT 10 ft,
DRAIN FIELD 10 ft.
SEPTIC TANK, 25 ft*, SEEPAGE PIT 100 ft*-, DRAIN FIELD —5-0—Aft-11—
TO
5-0fte.TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 3 FEET INTO UNDISTURBED SOIL.
4" CAST IRON SIPHON i
SEPTIC PIPE WITH AIRTIGHT CRIB
1A(:i: % CA PS y
CAST
Leveler
CAST IRON
INTO
UNDISTL,RRED SOIL
IM % :dI NIRU;I MINIMUM
C I required whenever line crosses
under driveway.
NIIJ .."iR4 I!EL1.
O_I ?�I f.iiCfS
I I: !'1 :'?!1L AL
1(1 PIT- 100'
L(' SE6LR LINE- 10'
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT „I'1 -PUBLIC
FITTED WITH AIRTIGHT REMOVABLE CAPS.
10 TANK- PO"
In Cif- 120'
LO 51 ::Ell. I.IN - AO
40• -EV MILY
GRAVEL BACKFILL
EAST IROrI snNEr,
IINf
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
PIII(t IC
I
1iI 'I7 - 200'
100-2.0' ORLv
CA` T 12(!1 SEVER
4200,74rv.-
!.I I:E
<OIIPCE (IF
"".AN:'NATION
HEALTH A THORITY
OR
I
LICENSED DESIGNER
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS FGREATER ANCHORAGE AREA
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE 4 1 :� APPLICANT'S SIGNATU
•NRAYEL PACOILL�
AROUND CRIB. -
(CRIB 4' NININUM ABOVE NATER
TABLE)
4 INCH SEWER LINE.
COHSIN R ARTA HELLS.
SEEPAGE Pit EXCAV01011 BASEn ON 16E.LL'� •
SOIL TEST.
Grade: V.per 110'
or 1/4' pr foo:
except 10' precFAinq
HOUSE tank i Cha, should I
not exceed 7..
6' per 100 on flat
terrains.
CAST I1`011, SEPTIC
11I:'E S TANK %
INTO l!Y- �' ---I 4 INCH
I,ISTI!P.F.0CAST IRON SIPHON PIPE
SOIL
- �SEEPAGE PIT
`.J
CRIB
GRAVEL UACKFILL
T
20' MINIMUM
-.- �- NEAPEST LOT LINE _ I
ORDIN/C4Ct NO, 26-E8 AND THAT THE ABOVE
I
if Was (=round Water Enc^ ,nterArt?
onstsuctlon Etst -2,L
"One "a is Woral a d►osand opham"
21629 TUDOR ROAD. ANCNORASE. ALASKA •9007 • T&LtnrpM■ 23>-6472
Performed For Religble Builders Date. Performed 10.4-72
Legal Oescrintion: Lot 5 Block Subdivision Chalet Terrace
This Form Renorts Soils Loq yes Percolation Test
nenth
`Pet
Soil rhAr:irtarictirs
IF Yes, At wha' heath?
E RPadinq ( Date Gross Time
`r o
Net Time i Reith to H2O Net Dron
Percolation Rate Minute
PronoseO Insta�Ttion: Seenaae Pit YES Drain Field
Deoth of Inlet Denth To Bottom Of Pit Or Trenc,
CAMNENTS : 85 sq. ft. drainage area required per bedroom
Pio bedrock or water table four ft. below seepage pit
Test Performed B �%
Y LGA-- Data Certified By : CORSTRIIG"rZGK '73
Manager ,Date: 10-4-72. .
I$
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVI&ON OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
1645s-
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
1,,of 5 Ch 7
"E.40
0
JCF 771.41 AJ R 3 w SEC �
Location (address or directions)
7y&ld Ck4.ty4 (%"z�
(b) Applicant Name T Nrllsoh Telephone: Home Business
Applicant Address 7V qQ C—h A 1Ff Ck Q exe-ko e� A AAs KA
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder X; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
✓4
TYPE OF RESIDENCE
Single -Family Multi -Family ❑
Number of Bedrooms 13
Other
3. WATER SUPPLY
Individual Well ❑ CommunityX 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 K 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 (1 184)
5. 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 r (iYtUiQd/1/Y�€sl7ccQ ill 1141 SW2,4S Telephonq
Address 1204 ��ESf 33AV 4"CA0"4n9 ET
Date V'Ves" -
6. DHEP APPR
Approved for bedro y
Approved — Disa00pvE
Terms of Conditional Approval
pF AL- 4
10%
� oy C. Reid, 1r.
No. 2251-E .;
iggersaai,.ti s�
;�^ i-E.SS` ,.;
e ;
_ Date
Conditi
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
72-025 (11/84)
• gra=' _ ._�
t'. MUNICIPALITY OF ANCHORAGt
DIVISION OF ENVIROMXNTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
I. General Information Application Date
l
(a) Legal Description (include lot, block, subdivision, section, township, range)
A
Location (address or directions)
(b) Applicants Name Telephone -Home Business
Applicants Address 7q Lt C Ck-4-l_� i C! POW_*LC'2 `�-" `5ik-
(c) Applicant is (check one) Lending Institution Owner/builder +;
Buyer E___1 ; Other E::l (explain);
(d) Lending Institution
Address
(e) Real Estate Co. & Agent $�
Address
Telephone
(f) Mail the
HAA to
the following
address:
2. TXpe of Residence
Single -Family
�6
Number of Bedrooms
:Multi -Family
Other (describe)
3. Water Supply
10
Individual Well Community Public
Telephone
Note: If community well system, must have written confirmation `ram the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite Public 7-1 Community Holding Tank
Note: I community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[gage 1 of 21 /��
5• 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, _
verify that my investigation of this Health Authority Approval shows that the on-ai_
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 ry
investigation and inspection, the on-site water 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.
Name of Firm `j di' Telephone 1-5TW
Address / Z•IT V Id 3�'3-Lc
Date
�C I"/
r�/ (ENGINEER /SEAL) 0 *� +`'irk
iY t! JL C- 9162 £�G�+ e/eP r' t:> Z /1Ll�f/ y. T Jt ?/ / 7 t - "`.. Cs err •a. �aa7be/,sloe d z j
6. DEEP Approval !,r �9 �� �'� roy C. r?etcir. r
ilio 2
Approved for bedrooms " �„:"'
Approved Disapproved q Cbnditional z. -�
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRES=i -
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERZD
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES k1D
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 21
7-19-84
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
MUNICIPALITY OF ANCHORAGE (mm) A 11D R u Z
HEALTH AUTHORITY APPROVAL (HAA) RECEIVED
CHECKLIST - FEBRUARY 1984
Legal Description: /.or 61191-E
A. WELL DATA Tf-f2JE�RC' fJ� �U Gtl"[
Well Classification rlk IfA, , or C, D.7E C. Approve /N) t
44�
h
Well Log Present (Y/N) �Date Completed I � Yield_
Total Depth 1-)(,4, Cased to �� A- Depth of Grouting
Static Water Level ��/� Pump Set At K-) 1A
Casing Height Above Ground Iy I Sanitary Seal on Casing (Y/N) k
Electrical Wiring in Conduit (YM) ��� Depression Around Wellhead (Y/N)"'-
Separation Distances frau Well: ll
To Septic/Holding Tank on Lot ovp-5 On Adjoining Lots.I�
To Nearest Edge of Absorption Field on Lot / 2 ®; On Adjoining Lots
To Nearest Public Sewer Line r42f- To Nearest Public Sewer
Cleancut/Manhole 7 -A --Th Nearest Sewer Service Line on Lot W44
Water Sample Collected By Date >c-' (k
Water Sample Test Results r,4
B. SEPTIC/HOLDING TANK DATA
Date Installed Size 161bo No. of Compartments
S tandp ipe s �) Air -tight Caps (YA)) 1 Foundat i n Cleanou ( )
Depression over Tank (Y ) Date Last Pumped ,Z
Pumping/Maintenance Contract on File (Y ) for
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y )
Separation Distances fran Septic/Holding Tank:
J
To Water -Supply Well r�� To Building Foundation
To Property Line f �D� To Disposal Field
To Water Main/Service Line 4-&-e To Stream, Pond, Lake, or Major Drainage
Course 1,
Comments
(Page 1 of 21 �� T
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Wz Type of System Design
Date Installed `fl Length of Field J
Width of Field �a� Depth of Field
Gravel Bed Thickness t'D
Square Feet of Absorption Area .26R4� Standpipes Present 61h)
Depression over Field (YAT Date of Last Adequacy Test
Results of Last Adequacy Zest ��� sL�L� 4r.-
Separation
2Separation Distance from Absorption Field:
To Water -Supply Well �°i5 To Property Line �-
To Building Foundation 34D� To Existing or Abandoned System cn
Lot N sib on Adjoining Lots f- 30
To Water Main/Service Line To Cutbank(if present)
To Stream/Pond/Lake/cr Major Drainage Course -t- ! OD
To Driveway, Parking Area, cr Vehicle Storage Area rj' J
Cawents _
D. LIFT STATION
Date Installed
Size in Gallons
"Pump on" Level at
High Water Alarm Level at
Tested for l
Electrical
Comments
Dimensions
Manh ss (YM)
Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy lbst. Meets MOA
** Check Permitted Bedroam Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA'HAA Guidelines in effect
on the date of this i rection.
Signed [yah r2.1 Date J
Company S hIOA No. "� 0
1
KB1/d5/s �c /It ILa�C
�xk,•a(��t� l' cz G G7� t�`2ti7ti �!!P
C -C -TJ 07X
[Page 2 of 21�
I
qw F
•
I�• •..•
•0• •ail•®.
1 ✓. ap .a
. aa..R ��
eroy C.
Rei•, Jr.
No. 2257-x:
2-15-84
ALASKA C UIROWWAL COnTROL SPURS, InC.
engineerinq & Enuironmental Studies
APRIL 19, 1985
FRED HEAD
TAYLORED CONSTRUCTION
50140
LEGAL: CHALET TERRACE LOT 5
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A ;AE;Cfi WITH AN AREA OF 288
SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 677 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 12/27/84.
of At
!Of000 004
JW see
� oeo weo w++• u
p.0/•
�S
.��
rey C. Re! rl, Jr -
1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503-(907) 561-5040
D BILL SHEFFIELD, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907)
Address:
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303 274-2533
ANCHORAGE, ALASKA 99501
DATE: // 100-5
PWS I . D . # ,?///d6,
To Whom it May Concern:
According to records on file in this office the
Water System is in compliance with the State Drinking
Water Regulations
/Sincerely,
/;-7 /:ze-
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
DATE: �//z S
PWS I .D.# 011166
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
To Whom it May Concern:
According to records on file in this office the
Water System is in compliance with the State Drinking
Water Regulations
Sincerely, j
DATE: 4�P&e/'�' /v --
PWS
To Whom it May Concern:
According to rec rds on file in'this office the
eq6444ater System is in compliance with the State Drinking
Water Regulations
Sincerely,
j"
ry
BILL SHEFFIELD, GOVERNOR
"J
DEPT. OF ENVIRONMENTAL CONSERVATION
Telephone: (907)
Address:
ANCHORAGE/WESTERN
DISTRICT
OFFICE
437 "E" STREET, SUITE 303
274-2533
ANCHORAGE, ALASKA
99501
DATE: 4�P&e/'�' /v --
PWS
To Whom it May Concern:
According to rec rds on file in'this office the
eq6444ater System is in compliance with the State Drinking
Water Regulations
Sincerely,