HomeMy WebLinkAboutCHUGACH PARK ESTATES BLK 3 LT 10GREAiFR ANCHORAGE AREA BORL uGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH .
LIQUID CAPACITY /]O-~ GALLONS.
SEEPAGE PiT:
NUMBER OF PITS / DIAMETER __
LINING MATERIALC~/¢'~'~ /
BUILDING FOUNDATION
ADDITIONAL ABSORPTION
OR WIDTH
CRIB SIZE: DIAMETER
NEAREST LOT LINE
LENGTH~__~ DEPTH ~
DEPTH /~¢/ . DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) ~D
SQ. FT.
WELL:
TYPE
BUILDING
FOUNDATION __
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE_
DEPTH DISTANCE FROM:
SEPT lC SEEPAGE
, TANK_ , SYSTEM
REMARKS
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
DATE
APPROVED - ~r ~ .
:/ .A.A.B.
P E R',r,1 'f. T N FL
DEPRF4::TMENT ' HERL. TH RN[:, ENV I F.:ONHEN'T'FH .... '-""':FT'E-:TI
,~..... ± =, E. ..DOR RD.., RNCHORFIGE., RK. ~...
· '" ".' ¢;7 _ "], "':, "':, "1
C) ~'"'-~ -- ,~--~ DE -F E: ~:E: E IL..i E: ~: F:' E: IFC~: ~"'~ ~:: "'l~ ....
· f .~'., ,"~ -"" O ' '
o
F F L..[ _.MN r
LOC RTI O1"4
LEGRL
~,E,E .~F.;O B B I NS
L:I.L'4 B~: CHUG IRK EST
C H t..I G I R K
LOT S I Z E
I'IR:.:,IIIUH NUME:ER OF BEDROOh1S = 3:
F I,.' E,R .. = :tJbO
:501 L. RAT I NG ': '5 :.! ..... '" ',
I"HE RE~.i~UIRED SIZE OF THE '=,F~IL HE,_,LF..FTION S'¢STEhl
THE LENGTH DIMENSION I'=; ]''HE LENGTH ,::IN FEET) OF I'HE TRENCH OR DRRINFIEL. D.
THE DEPTH OF R 'FRENCH OR PIT IS THE DISTRNCE BETNEEN THE '=',UF.:FRCE OF:' THE
GROUND RND THE BOT].'OI"I OF THE E:,<CR',,,'RTION ,::IN FEET::,.
'THERE IS NO SET' N IDTH FOR TRENCHES.
'THE GRR',,,'EL DEPTH IS ].'HE MINIr,IUM DEPTH OF' GF.:RVEL BETNEEN THE OU'T'FRL. L.. PIPE
RND THE BOTTOr'1 OF THE E',:<CR',,,'RT I ON ,:: I N FEE]"::,.
'"It'"' Ik,.l El ,::. ..... ~' .'::, I ~'-J .C~; F" E C: 'F I C, r-,i '.'=_; R F-. E F~.'.: E LT.:.". LJI I E: El [::,
E,H...I'...F I L.L I NG OF RN"r' S'T'STEM t,.I I THOUT F I I'.,IFIL I NSF'ECT I ON FIND FIF'F'RO',,,'FIL. B'T' 't"H ]: S
DEF'RRTMENT 14ILL BE SUE:..TECT TO FR.U_-,E_.I_ITION.
1'"III'.4IMUM [:,ISTRNC:E BETNEEN R NEL_L FIND AN'¢ ON-SITE SENRGE [:,I'=%F'OSRL-
':[.EtE~ FEET FOR R PRIVRTE NELL F~F.: 2OC~ FEET FOE:. R F'UBLIC NELL.
SF'EECI F I CRT IONS RN[:, CONSTRUCT InN DIRGRRMS RRE R',/RILAE:L.E: TO I N'.~;t..tRE F'F.': PE:E'
I NSTRLLR"F I ON.
I CER'T'IF'¢ 'T'HRT
1: I RM.FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RN[::, 1.4E:L..L.S RS SET
FORI"H B~r' THE MUNICIPRLIT'¢ OF RNCHORRGE.
2: I' NILL INSTRLL THE S'¢STEM IN RCCORDRNCE NITH THE C:OE:,ES.
2.':: I UNDERSTRND THR'F 'THE ON-SITE SENER S'¢S'FEM MR'¢ RE6!UIRE ENLRF..'GEMENT IF "['HE
RESIDENCE IS REP1ODELED 'TO INCLUDE MORE THRN 3: BEDROOI'flS.
-
""~.; 113NEE:, · __ '~','I NS_
t "'~;SLIE[:, E:'T' ~~--~:-/--~-- L. -~- --~-- - %- -~---DRTE- ~---~ .............................
2204 Cleveland Anchora~e~ Al~ 9950~
Performed For ~--'~,~m~.~U~F-' Date Performed
Leoal nescrintion: Lot /0 Block~ Subdivision O~,~u~~ ~Rq~r.
This Korm Renort$ Soils Lon I/~ PercOlat(on Test
/
~enth
Feet
Soil Characteristics
/ /
6
8
10
12--
14--
16--
18--
20--
Was Ground Water Encountered?/tYO
I~ Yes, At what Denth?
" I
Readinq Date Gross Time Net Time Depth to H20 Net Dron~
Percolation Rate Hinute
Proposed InstallatiOn: Seenaoe Pit Drain Field
Den. th or'Inlet Denth To Bottom Of Pit Or Trench
/
Test Per,orme, By ~-~~, Data Certified B~~~~
M :[ I'.,i I MLJM [:.', I S"t"t:::INC:I:'E DEi:'T'H[.:J[ii]",t I:::1 14EI....I_ I::II'.,IE:, l::lN'.r' ON-S I 'T'E :~i;EI.,.II:::I('~E [) I '..]i;I::'OSFIt_ S'.,.'S'T'EM I'."il;
:l.l':i~l:.:'.l I:::'E[ET I:::'CIt::i: I:::1 t:::' I:;.'. I ',,,' FI T' E I.,.tE:.]_L. OF?. ;:~'.(..".1C:1 F'IiE!.::..'E.'T' 1::"'O[:?. I"::1 F::' LI E: I_ .'[ C HEI.._L..
P.l[i':L..t_ I_ O []i :iii; FIl::i:liii: I::i'.[ii:(::!l. Jll:~:'.EID I:::Ii'.,IE:, t'"lLl'.ii~T Eft.:!'] t:RE'T'UI:;:'.I'.,Ili:.::D 'T'O THE C,[EI"::'I:;:It('.T'MEiq]" I.,..IITHII'.,I ]i:(~l [:'t"::l"r'S
01::: 'THE I.,.lt.:~:]_i .... I]:OMl:::'l..I.:ii:]"]] CP',I.
O-'l"H[ii]:;?. I:?.[~:1'.~:!1...I ]: F".'.EMEI",tT".iii; I'"II:;:I"P F:II:::'I:::'L"r'. !:!;I:::'EC: I F' I CFtT .'[ O1",1:.::."; FIND C':Cfl",ISTI::?.IJC:T t' ON D I I::'IGt::?.FtM'J.:.';
I:::IVI;::t :[ L..I'::IIi~iL.E 'T'O :[ l",t'.iii;I...ll:;?.E I:::"l::?.Oi:::'Ei]:;:'. I t",I'.i!iYI"F:II...L.f'::tT I (:IN.
I C: liii: t::?. 'I" I t:::'"," 'T'I'"It:::I T'
:1.: I I:::ti"1 F:'F:IMIL..]:F:It:;i'. Hi'TH "I"H[~: I:;~:IE:QI...tlF::EM[.::JI",,ITS F:'"Ot";?. Ot",I-:E;I'TIE '.::.'-;EHli.::.'I:;:'.E; I::'t1",1[:' t.,.l[ii:t..L.:E':.: F:I'.i'.".'; 'SET
I:::'OI';?.'TH Ei?'~" THE MUN I C: 1' I:::'1:::t1_ I "t""r' O1:::' FIt",IC:HOI:~'.I:::I(3E.
2: i 14 1L.L.. I I",ISTFII.,..L.. "I"Ht.:~.: S"PST'EM I t",1 I::IC:C:Ot:~:DFIt",IC:E I.,.t.'[ "1"1'"1 'THli:J:
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HF~ILTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTI(t~
APPLIC~%TION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date
(a) Legal/Description (include lot, block, subdivision, section, township, ra~e)
.ID
Location (address or directions)
(b) Applicants Name
(c) Applicant is (c~ o~) ~nding Institution ~; ~er~uil~~%
Bu~r~ ; ~her~ (e~lain); '
(d) ~nding Institution ~ ~ ~f)X~'7'~7~ ~elepho~_~--E~>
Ad, ess
(e) Real Estate Co. & Agent
Address
Telephone
2. T~n~e of Residence
Single-Famil~
Number of Bedrocms
Multi-Family
Other (describe)
3. Water Supply
Individual Well~ Co~mm/nity~--~° Public~--~
Ncte: If crmmunity ~11 system, must have writte~n confirmation frcm the State
5~part~ent of Environmental Conservation attesting to the legality and status.
Is the ~11 adequate for the number of bedrcoms specified in this H~R ~)
4. Sewage Disposal,
Onsit~~.- Public ~ Court, unity ~ Holding Tapk
Is the wastewater disposal system adequate fc~ the number of kedrocms
[Page 1 of 2]
2-15-84
5. Engineering Firm Providinq inspections, Tests, Data a~d Information
I ~ertify that I haa~hecked, verified, or conformed to all MOA HAA Guidelines
effect on~'/~~-~--~/-'~~//('~t~~j~cti°n' ~/~/~.~/.
Signed ~ Da te
Fir~//r~ Telephone / ,/z - ~
Name
of
in
Address
Date
6. DHEP ~t~proval
Approv~ d for
Appro~d-~d-~
(ENGINEER SEAL)
Disap~oved ~ Conditional
Terms of Conditional Approval
The Municipality of Ancho~a~ Department of Health and Enviror~rental Protection dces
not guarantee t?~. c~ntinued satisfactory perfc~mance of t~m water supply and/or the
wastewate~ disposal system. This approval indicates that, as of the valida~--ion date
shown abo~, based c~ the data and information furnished ky an engineer registered in
the State of Alaska, the water supply and wastewater disposal system is safe and func-
tional for the ~nnber of bedrocms auTd type of structure indicate~.
( DHEP' SEAL)
7. Mail the HAA to the following address:
KB2/d5/s
[Page :2 of 2]
2-15-84
MUNICIPALITY OF ANCHOPAGE (MOa)
HEALTH AUTHORITY ~PROVAL (HAA)
Chq~CKLIST - FEBRUARY 1984
A. WELL DATA
Well Classification_ _ ~,~
TOtal Depth-"-~ Cased to
Static Water Level
Casing Height Above Ground /~
Electrical Wiring in Conduit ~
Separation Distancss f~om Well:
If A, B, o~ C, D.E.C. Approved(Y/N)
Date Completed ~, ~%,,~ Yield~
40 ~- Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y~
Depression A~ound 1Wellhead
To SepticS_ Tank on Lot .... /~O ~ ; On Adjoini~.g Lots
To Nearest Edge of Abso~%~tion Field on Lot /d30/-~ ; On Adjoining Lots
To Nearest Public Se~r Line /~ /;~ .... To Nearest Public Se~r
Cleancut/Manhole /~ ! ;~ To Nearest Sewer Service Line on Lot
Water Sample Collected By ~ .'~ ~/~/~//~ Date
Water Sample Test Results. ~'~/9 ~/v/c~dT'O/~ ~/.
B. D TA
Date Installed //~ ~ 7~ Size / L5~2~) ~-Z,4'L- NO. of Ccn%::)aTztments
Standings ~) Aid-tight Caps ~) ... Foundation Ci~~':"~
~ession o~ Ta~ (Y~ ~t~ ~st P%~d ~~/~
P~ing~inte~n~ ~n~a~ G% File (Y~) ~., for .~~Z
H. oldin9 Ta~ Hig-h Wate~ ~a~ (Y~) ~ _~ '~~y Holdi~ Tank ~it (Y/~) ,~-
~p~ation Distan~s ~ ~ptic~oldin9 Ta~:
To Water-Supply ~11 /~ / ~ To ~ilding F~ndation
To ~te~ ~in/~vi~ Li~ To S~e~, ~, ~e, ~ ~jow ~aina~
Cc~
Con~ents
[Page 1 of 2]
/_o'7- /o,
2-15-84
C. ABSORPTION FIELD DATA'
Soils Rating in Abso=gtion St=ara
Width of Field ~ ?
/~ ~/~- Type of System Design
Length of Field ~) /
Depth of Field ~ /
Gravel Bed Thickness ~ /
Square Feet of Absorption A=ea ~ ~ Standpipes P=esent ~/JN)~
Depression over Field (Y/~ 'Date of Last Adequacy Te~--~-~
Bssults of Last Adequacy Test
Separation Distance frcm Absorption Field:
To Water-Supply Well /~)O /7L To P=operty Line /O
TO Building Foundation '~ ~ To Existing ,or Abandoned System cn
To Water ain/Service Line Z/A To Cut ¢if p esent) /0
To Stream/Pond/Lake/or Majo= D~ainage Course /V/~
To D~iveway, Parking A=ea, or Vehicle Storage A=ea /~ /-~
Cc~Tents
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Din~nsions
Manhole/access (Y/N)
/~~ Off" Level at
' Vent (Y/N)
Rm~in~~s du=ing Adequacy Test.
Meets MOA
Cc~msnts
**
** Check Permitted Bedgown Rating AGainst HAA Request
iojj~i~tthat I_%~e che~ed,.verified, c~ confcm~ed to all MOA HAA Guidelines in effect
Si ed~-, ~,~~~~/~' Dat..~//~/~'
~-"~// MOA Nb.
Company
KB1/d5/s ~ ~;aL~ RIV~ -~t~S~<^~
[Page 2 of 2]
2-15-84
APPLI( ,NT FILLS OUT UPPER HAl ONLY
Owner
Property
AddressJ ;~ ~'~ '~ Zip
Code
Lending Institution ,[~.t~:~ ~~.- :¢t~!(~. ~.~.~ .7~ ~9~/~ .... Phone
Address ~' ['""[ ~'["~"~ C~ I ~()~ ~(~ Zip Code
,~a~y Co. ~ A~ '~ (F~ [~ r-z ~....t ~-~_ ,hon~
Ad~ress bt~::glg(') ~ I---~( ~:~ ?.::~1~ Zip Co~e
Locati~ ....
Street
Type of Resi~nce
S~ngle Family
Multiple Family No. of Bedroo~
~ Other
Water Supply
.~ Individual ATTACH WELL LOG, A wall Icg is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach Icg if available).
~ Public Utility
Sewer Disposal
Individual Year Individual Installed: .~
~u~lic ~tilitg Whon Connoctod to ~ublic OtiHty:
~ Holdino Tank
Time Time Time Time
Date Date Date
Inspector Inspector Inspector Inspector
Field Nol~ ~,~)
( ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ' ) CONDITIONAL APPROVAL'
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
~ __~'~-"~ V Well to Tank Septic
I00~
Size
/!
72-023 (3182)
EXCAVATION
ROBERT A. SHAFER
WORK CIVIL ENGINEER
694-2979
March 29 -
OEP · .. :"
Dear Mr.
~¢
Reference: Lot 10: Block 3: Chugiak Park Estates Subdivision
A' sewer system adequacy test was performed on the system located
on the referenced property, as you requested. The septic tahk was
pumped and was verified to have a capacity of 1000 gallons. The
absorption trench was tested by a continuous flow of 520 gallons
of water over a period of 24 hours without any adverse effect on
the system.
It can be concluded from this test that the waste water disposal
system serving the three bedroom residence located on this property
is currently functioning adequately. However, the system cannot
be guaranteed against subsequent failures.
If we may be of further service, please do not hesitate to contact
US. /
since r'~ ~.~/'/"?
RAS/s s
cc: The Realty Center
ATTENTION: Don LaMaster
Municipality of Anchorage
Department of Health and Environmental Protection
SRB 196X EAGLE RIVER, ALASKA