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HomeMy WebLinkAboutCHALET TERRACE LT 10015 GRE-~:R ANCHORAGE AREA BO~'~,GH Department of Environmental Qualitv 3330 C Street Anchorage, Alaska ggs03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS '~' '~¢?')(' ,~,.~"'1 .~!9/~/~:/¥' PHONE LEGAL DESCRIPTION SEPTIC TANK: DISTANCE ! FROM WELL /~7~ INSIDE LENGTH MANUFACTURER INSIDE WIDTH .S NUM, ER OF / MATERIAL COMPARTMENTS L IQU ID DEPTH LIQUID CAPACITY/'''~'~t'~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL /~'¢ !'/" FOUNDATION /~'~ NUMBER OF LINES ,/ DISTANCE BETWEEN LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE NEAREST LOT LINE /~. I TOTALOF LINES LENGTH,~/S/ ~ /F~/,~ TRENCH WIDTH ~IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE ~,~ I // I DEPTH OF FILTER I MATERIAL BENEATH TILE '~ .~ABOVE TILE ~/ IN. WELL: TYPE _ BUILDING FOUNDATION__ CONS~ DEPTH SEEPAGE SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: /,,/~'rl~. ~::~/-1/.-/1~ // SEWER LINE DEPTH: LOT SLOPE: REMARKS: Form EQ~032 DIAGRAM OF SYSTEM . N G-A.A-B-t~ Gre. R ANCHORAge AREA BO,~ ]GH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456! INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT DRAIN FIELD TYPE AND SIZE OF FAC'LITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT_ TO BE INSTALLED BY COMPLETION DATE ANTICIPATED OTHER NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST 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 DRAIN FIELD MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO S~r--E-P~Z~~ / SEPTIC TANK TO S~ WALL SEPTIC TANK ~ ,~v~ '7 ,DRAIN fIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK ~ , SEEPAGE PIT SEEPAGE AREA SIZE TYPE ~.~JIAGRAM OF SYSTEM ALSO CONSIDEr AREA WELLS. DRAIN FIELD WATER MAIN TO SEPTIC TANK j ~ DRAIN FIELD //~J SEPTIC TANK, /~)~ SEEPAGE PIt TO RIVER, LAKE, STREAM. OFI ' DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP 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. OR LICENSED DESIGNER i CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE Area BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DEBCR,~ED B¥STEM ,S ,N ACCORDA.CE W,T. SA'D CODE. I a l s.~?cer~i fy tha]~t~is home wil 1 contain a maximum of three (3/} be~room_~.s. I understand an upgrj~_ou]/~/be ~ss~_ should more bedrooms be added. DATE 7~//~/ / ~ APPLICANT'S SIGNATURE Performed for ~ _m~d__ c~'~' Legal Descrlptlon.~~-~]] Z~L~2~.g=_ This form reports: 'Soils log~.~ Dep th Feet 1 - 2- 3- 4- 5- 6- 7- 8- GREATER ANCtl0kAGL AP,~A UOROb Department of Environment. al Quality 3330 "C" Street Anchorage, A1 aska 99b03 S()[I,S 1,O(; - PEROI,ATION TEST ;;ate Percolation test If yes, at wi~at depth? Reading Date -Proposed installa~]~-n' Seepage Pit Drain Field Depth of Inlet ............... · Depth"'L~'-U6-~t-O~n--°¥-'pit or trenci, COHMENTS' Gross Time Net Time Depth to Water Net Drop Date' EQ-040 (6/74) MUNICIPALITY OF ANCHORAGE (~ / DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date ¢/~ GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address O[ directions) (b) ProPe4'~)wner 1'~ ~ ~ ~ /~ '~ ' Telephone: Home Mailing Add'rest; ,¢2_~ ~'-- ~ 4;,¢~ Business (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Address Telephone Mail the HAA to the followin(3 address: or: Check here r'-], if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family'~ Number of Bedrooms WATER SUPPLY Well [] Community/~ Public [] Individual Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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 72-025 fRev 8/86~ Front 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 ~:/--L~-~( ~ .-,~-',-~.._ Telephone Address ?? ,,.,~.~ ~ ~ .~y--,~/ /~_~_ .5",'~ Z~ Date----,~/~'/5= DHHS APPROVAL Approved for ~bedrooms by Approved ~ Disapproved Terms of Conditional Approval ~.~,'~~' _~ ~-.~ at e Conditional CAUTION 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 courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state reciuirements. 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. Page 2 of 2 72-025 ~Rev 8/861 Back Well Classification MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4744 Legal Description: I A~/B, C, D.E.C. Approved~'~N.~) Well Log Present (Y/N). Date Completed ~ Total Depth Cased to r L,~D-~Of Grouting Static Water Level -z),---)~/f' Pump Set At Casing Height Above ~ Electrical Wirin, G-irr'~nduit (Y/N) Yield Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot /,~O / ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ,/~;/~ / · On Adjoining Lots To Nearest Public Sewer Line /&././/~z To Nearest Public Sewer CleanoutJManhole "'J'.~/~- To Nearest Sewer Service Line on Lot Water Sample Collected by ,4~,~',/~- ' Date Water Sample Test Results /~ ~)Z?C ~_~--~ ,~7~e ,~ '~/. Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~F/?J'~ Size //Z ~--L.D NO. of Compartments Standpipes ~)N) Air-tight Caps~)/N) Foundation Cleanout~/N) Depression over Tank (Y/~ Date Last Pumped ~/~/~ Pumping/Maintenance Contract on File (Y/N) ~ · for Holding Tank High-Water Alarm (Y/N) ~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: / To Water-Supply Well /~ ~ To Building Foundation To Prope~ ~, ~ ~ ~ To Disposal Field To Wa~ M~01Se~' b~ ~ To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026 fRev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 7/~/?%- Width of Field '-~ ~ Square Feet of Absorption Area Depression over Field (Y~ / Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well / To Building Foundation c~ Lot /,.) ,~e. /t/e~. To Water Main/Service Line ~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field // / Gravel Bed Thickness Standpipes Present t~l) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on · On Adjoining Lots ~ To Cutbank (if present) Comments D, LIFT STATION Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments ~ Manhole/Access (Y/N) / "Pump Off" ~ /~ Vent (Y/N) /..~/~~'~'~ Pumping Cycles during Adequacy Test· Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have_checked, verified.er conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ Date ~'/¢/~" ,'~ Company ,,~.~' ~"'~" ~ MOA NO.~''''P --o Z-¢ Receipt No. / C~O / dj o/~'-- Date of Payment / ~ ~/-- °c~ ~ Amount: $ /'0 0 ~,~'"'" Page 2 of 2 72-026 fRev 8/86~ Back ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 DATE: ~e!mmb~£_l~_l~Z_ PWSID #: ___21110~__ To Whom It May Concern: According to the records on ~ile in this o~ice, the .... CBSL6I .... !EB88~E__SUSQIVI~IQU__ Water System is in compliance with the State o~ Alaska Orinking Water Regulations. Sincerely, Ronald S. Klein Environmental Field O~'~'icer 825 '--'MUNICIPALITY OF ANCHORAGE-' DEPARTMEN, OF HEALTH AND ENVIRONMENTA~ PROTECTION L Street, Anchorage. Alaska 99501 #2: #1: Time Date Insp 264-4720 Date Received: Time Date Insp September 7, 1977 #3: Time Date Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Alaska Statebank Mailing Address: 310 East Northern Liqhts Blvd. Phone: 279r7637 Property Owner: Thomas J. Olive Phone: Mailing Address: % Ken Brown, Yukon Realty 276-6454 3. Legal Description: Lot 10 Chalet Terrace Subdivision 4: Single Family Residence: (xR Multiple Family Residence: ( ) Number of Bedrooms: Three Number of Bedrooms: o Well System: Permit ~ Construction Individual Well ( ) Community/Public System ~ Depth of Well Well Log on File ( ) Bacterial Analysis Sewage Disposal System: On-site Permit # Septic Tank Size Absorption Area Installed Soils Rate Manufacturer ! /O~) Material Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF A' DEPT. OF HEA. UI! ., ENVIRONMENTAL F/.:Oii:~. i-,.~.,, SEP 7 g77 RECE!VED 1. Type of Inspection: CMRO 2. Property Owner: 7~1~~ ~- Mailing Address: //~/~ //¢/,~ VA FHA ,~_ ~/t~, Day Phone: CONV X 3. Name of Buyer: Mailing Address: ,~ 4. Name of Lending Institution: o Mailing Address: Name of Realtor or Agent: ,~. ~P/~ Mailing Add ress: Legal Description: Location: Phone: 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: ~ug~c~t~ ' ~ Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation 72-003(3/76) · ~g~ ~wo Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 10 Chalet Terrace Subdivision Comments: Affadavit Attached Approved: Disapproved: Letter Attached: ( ) Date: Date: Department Worksheet: Se~ember 30, 1977 Thomas Olive % Ken Brown l~kon Realty 4619 Spenard Road Anchorage, Alaska 99503 Subject: Lot 10 Chalet Terrace Subdivision Before this department can approve your loan request subm~tte4 to this offioe, we will require a percolation test be run on your existing sewer system. To have the test run,,you will need to contact R & M Engineering and tell them you need to have your existing seepage trench tested to see if it is adequate for a t~ee(3) bedroom resid~nce. You will also need to have your tank pumped for maintenance purposes. If there are any further questions, please ~ntact this office at 264-4720. Sincerely, Robert C. Pratt, Sanitarian P/lJh Alaska Stateba~k Mortgage Loan 310 East Northern Lights Boulevard 99503 R&M CONSULTANTS, INC, 50z4 CORDOVA · BOX 6087 · ANCHORAGE, ALASKA 99502 · PH. 907-279-0483 · TLX. 090-25360 ENGINEER5 October 7, 1977 R&M No. 751532 Mr. Thomas Jay Olive eRA 389-M. Alps Drive Anchorage, Alaska Subject: Adequacy Test on Sanitary Sewer System, Lot 10, Chalet Terrace Subdivision, Anchorage, Alask~ Dear Mr. Olive: On October 7, 1977, at your request, we conducted a test of the septic system on the above described property. During the test, the liquid level in the septic tank was monitored as water was added to the system. The following table summarizes these measurements. SUMMARY OF MEASUREMENTS Time Liquid Level Meter Reading Top of Standpipe in Gallons 8:17 6.20 8:21 6.15 9:12 6.05 9:26 6.05 9:32 6.15 9:36 6.20 8412.6 8437.2 8757.7 8864.2 8864.2 8864.2 The meter used during the test was a Rockwell 5/8" standard water meter which had been previously calibrated by R&M consultants, Inc. If it is assumed that the three-bedroom house on the property will house 6 people, the average load on the system can be expected to be 450 gallons per day or .31 gallons per minute. During the test the system accepted 451.6 gallons, an amount slightly in excess of the average daily loading in 79 minutes. This indicates an acceptance rate of 5.72 gallons per minute. It appears that the system is accepting effluent at an adequate rate for a three-bedroom house. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA We appreciate being of service to you. If you have any questions concerning this test or this letter, please do not hesitate to contact us. Very truly yours, R & M CONSULTANTS, INC. Richard W. Burg, Jr. Staff Engineer RWB/rds ' Brown, P*~- '~_~5 Head, Earth Sciences Department GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received I~).- ~-~ Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: ~J_~o~c~On, ~-r~ ~ CJi, ~ Mailing Address: ~ 2~ ~f~ ~,bh~ ~hone: ~q~-q~q x~ 2. Property Owner: ~~ - L,~_ ~ ~)~ Phone: ~ Mailing Address: _~Z.P~ ~]~~ 3. Legal Description: ~ ~ ~e,~,~ ~~e~ 4. Location: ~,,~, 5. Type of facility to be inspected ~,~~,~,, No. of bedrooms ~~. 6. Well Data: Om~~~~~ ~ A. Type B. Depth e C. Construction Sewage Disposal System:~]])~n-cu_~L~ A. Installed D. Bacterial Analysis 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 LQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIFALITY OF ANCHORAGE DEPARTMENT OF HEALTH & :ENVIRONMENTAL PROTECTION .DEC 5 1975 'RECEIVED 1. Type of Inspection: CMRO VA 2. Property Owner: OT,ZVE~ ~c~s Jay a_nd E±la Do~b¢ Mailing Address: Alps Avenue 3. Name Of Buyer: N/A Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address: Alaska Statebank 310 E. Northern Liqht~ FHA CONV ~ Day Phone Day Phone Phone 279-7637 ~t. Phone Legal Description: Lot 10: Chal~_t T~_rr~c~_ g/n Location:('~'~ing ~ir~-h nn ;Hllq~ n~x_~_ t~ ri..~h~_t off .~_~,~-~.~ D:?~:_'e 7. Type of Facility to be inspected: 8. Water Supply Type of Supply' No. Bdrms. 3 *Cam~nity. Well Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) EQ-037 (1/74) Page 2 of two pages - Re "for Approval of Individual · & Water Facilities . Legal Description ~' t(]) O_]r~,~)o ¥ ~l~o. Comments Approved Disapproved Date Approval.Valid for one year from date signed Greater 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)