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HomeMy WebLinkAboutSUN VALLEY HEIGHTS BLK 2 LT 3 MUNICIPALITY OF ANCHORAGE DE .RTMENT OF HEALTH AND HUMAN SER., ..ES ¢ (/_j '7~ -'~.~ Environmenlal Health Division O / '~ - ~25 %" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl. INSPECTION REPORT Address f'9 LEGAL DESCRIPTION TANKS SEPTIC DISTANCES SEPTIC ABSORPTION TANK FIELD WELL WELL //~ ~- / ~.~-~"-~ LOT LINE FOUNDATION [] HOLDING TYPE OF SYSTEM [] TRENCH ~) BED [~ W. DRAIN [] pipe FT Total absorption area SD FT SO Ff FT Ff Cz a "/- ;77. o ,.. WELLS [] PRIVATE [] OTHER (Identifv) REMARKS: FT ccdily that fide iuspeclien was perlormad accordin9 to all Municipal and Sta[e (Juidelines in ePect oil this date: ~.~/~.~ Health r)~par[ment Appro~a~: .....z~-.~: ,*- '. ~., ENGINEER'S SEAL 72 013 (3/85) MunicipaHtYof Anchorage P.O. BuX 196650 ANCHORAGE, ALASKA 99519-6650 (907) 343-4200 r~X~(kq~L~ Tom Fink, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 12, 1988 Richard L. Nadeau 13220 Mountain Place Anchorage, Alaska 99516 Subject: Lot 3 Block 2 Sun Valley Heights Subdivision Permit ~870259, Tax ~-062-33 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1987. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled this Department for close the permit. the well, a well log needs to be sent to documentation of the installation and to If a private engineer inspected the installation of the on-site sewer system, the original as-built inspection report (three-part form) must be sent to this office for review and approval, and for documentation. Effective January 1, 1988, a new fee schedule is in effect. When re-applying for a new permit, the new fees are; $90.00 for an on-site sewer permit; $50.00 for a well permit; $140.00 for a combined sewer and well permit. If there are any further questions, please call this office at 343-4744. Program Manager On-site Services RWR/ljw enc: Copy of Permit ,.-/- _ . .... /: Ancl;orage Recording Pr,,cir:,::, Alaska, and that FRED WALATKA f~ ASSOCIATES ) . ,,,UNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION . . ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON~I,TE S.E~/AGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT I~HO'~ ~AILIN~ ADDflE~ ~ ~E~L DE~O~IPT~ON · '~ . Well ~ ~ ~ Absorption ~rea Dwelling PERMIT NO. O~STANC~ TO: I ~ %' ~  ~anuf~turer Material No. of C~l~ntl ~iq~ca~city in gallont IF HOME~'~;/ Inllde length Width Liquid depth ~ ~ DISTANCE TO: Weft . :, D~lling PERMIT NO. ~ ~ Manuf~tumr , Material Liquid cI~Iw In ~ilon~ To~I if~fl~ .~mtlon ~rea In~ ~ngth Width ~pth PERMIT  Type of crib :rib diameter ~lb depth Total eff~ti~ a~o~tl~ are~~ ~ · ~ ~a~ ~h Driller Dl~nc~ to lot tl~a PERMIT NO,. , ~ ~ISTANCE TO~ Building f~atl~ ~r I1~ ~tlc tank ~flm~ '~TERIA~ -- . ' ' ' APPROVED DATE LEGAL 72-013 (Rev. 3/78 December 29, 1978 I1780456 Jerry Norton Star Route A Box 172P Anchor~ge, Alaska 99507 Subject: Lot 3 Block 2 Sun Valley tleights Subdivision A permit issued by 'this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by autherity of Municipal ordinancoo If you have drilled the well, a well leg should be sent to this department to document the installation date° If there are any further questions, please contact this office at 264~4720. Sincerely, Les No Buchholz, RcS. Senior Environmental Specialist LNB/ljw enc: copy of permit ~..] PERMI'F NEX DEPRRTMEi",IT OF I-.IEFtLTH FIND F.:NVIR. ONMENTF-[I.. F'ROTECTIOi'..I 8Z.5 '"L'" -~TREE'F, FII.,ICHORFIGE., FIE. ,Z~J~"-~t---S I 'F ~:-': S EI.,,-IEIF~". I....II:"F..2-'iI~:II::II::,[E RPPL I CRNT LOCRT I ON LEOFIL JERF,'Y NORTON MOUNTFIIN PLRCE L 2: B ;2 SUN VFILLIEY HTS SRR DOX ~Z2P LO'T SIZE _~.:880:.':: '::';(;!LIFIRE FEET I'YF'E OF SOIL RBSORBTION SYSTEM IS: TRENCFI MRV, IMUH NUMBER OF BEDROOMS = 4 SOIL RRTING (Sg! FF?BR)= :1.40 '['HE REQLIIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: TNE L, ENGTH DIMENSION IS THE: LENGTH (IN FEE:T) OF THE TRENCM OR DRRINF:[ELD. THE DEPTH OF R TRENCM OR PIl' IS THE DISTRNCE BETWEEN THE SURFRCE OP THE GROUND RND THE BOTTOM OF THE E',:4CRVRT~ON (ZN FEET). Tt4ERE IS NO SET WID'FI4 FOR TRENCHES, THE GRRVEL DEPTH I5 TIdE MINIMUM DEPTH OF GRFIVEL DETHEEN 'ri.E: CIUTFRLL P:[F:'E FIND THE BOTTOM OF THE E~(CRVRTION (IN FEET), PERMI'I' RPPL. ICFINT HFIS Tt4E RESPONSIE,'ILITY TEl INF'ORM TI-tIE: DEPRF.'.TMENT DLIRING THE INSTFILLATION INSPECTIONS OF: Rf',I'¢ HELLS RD,.TFICENT 'FO "I'I4IS PROPERTY FIN[) THE NUMBER OF RESIDENCES TNRT TME WELL WILL SERVE. BFtCKFILLING OF' RNY SYSTEM WITFIOIJT FINRL INSPECTION RN[:, RF'F"F'.OVFIL. E:'¢ THIS, [:,EPRRTMENT HILL DE SUE:JECT 'FEI F'ROSECUTION. MINIMtJM DISTANCE BETWEEN A WEL.L AND RNY ON'-"SITE SEWKIGE DISF:'OSFIL SYSTEM IS t00 FEET FOR FI PRIVRTE WELL; CIR ±50 TO 20E~ FEET FROM R PUBLIC HELL DEPENDING UPON THE TYPE OF' PLIDI..IC HELL.. OTHER RELDUIREMENTS MFI¥ RPPLY. SPECIFICF~TIONF-; RND CONSTRUC:TION DIlaGRFff,IS RRE FtVRII..RBLE TO INSURE PROF'ER INSTRL.LRTION. I CERTIFY THRT ±: I RM FRMIL..IRR WITH THE REQUIREMENTS FOR ON'"SITE SEWERS RND WELLS FIS :SE:'I" FORTN BY TNE MUNICIPR[_I'/'¢ OF' FINCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN FICCORDRNCE WITW THE CODES. :$: I UNDERSTRND THRT THE ON-.SITE SEHER SYSTEM MflY RE:6!UIRE ENLRRGEMEN'F II:' THE RESIDENCE :IS REMO~:LED TO INCLLIDE MORE THFIN 4 DEDROOMS. S I GNED: ....... ~~..~ ~--~/ ISSUED E,~ C~~.;,.-~E/-~ ....... DRTE_~ ............................... January 4, 19'78 Jerry Norton Star Route A Box ].72-'P Anchorage, Alaska 99507 Subject: Lot 3 Block 2 Sun Valley Heights Subdivision Permit 977792 A permit issued by this department for well and/or sewer system has expired° Permits are issued on a calendar year basis, as stated on .the permit, by authority of Municipal ordinance° If you have drilled the well, a well log should, be sent to this department to doc%u~ent the ins~'allation date° If there are any further questions, please contact this office at 264-4720° Sincerely, Health and Environmental Protection Sewer and Water Section HI':'PI_ J. I-;l~'lh,/I IJ.)I£:R 1 ) Cli"J I'"IF:IXiML.li"'I NI._IHI-~H=J:~: LII= I:i:b..L:,l-,?Cll)H',~; = ~; BFII::I-::;FJiL.rl..].NI:ii OF FIh,I'T' ._,T._IL.ll I,It'IHUIJI F If.,IHt_ ll'.,l':,l.'l:=l:l £~ 1'.,I I-~1'-,11:, I-fl-'l::'k'~]',,,'l-II I:i:"r' IHJ%:, I;d;LI='FIF?.IHEN PiIL. L BE ~,l..ll:i..ll:...:l l l.I t-'l~:llb,[:l :Ill I LII"4 I-1"4l I.H,FI -I,I f", I fl' !1.11: C;AAB HD- I G£ TER ANCHORAGE ARI='A BOROI' H D~:,~ARTI~IENT OF ENVIRONMENTAL QUALI~. 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION J)~', /)~KF/O~(~/.) h/:)0C~ LEGAL DESCRIPTION. SEPTIC TANK: NUMBER OF DISTANCE FROM WELL~)J~JJ~/-,U/'FI/ R~J~___MATERIAt ~-I'I~.JC' ~'~]~".~._.~ .COMPARTMENTS. ' IAI_ :l-t~ LIQUIO LIQUID CAPACITY J,~5'O GALLONS. iNSiDE LENGTH INSIDE WIDTH. DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / __OUTSIDE DIAMETER_ LINING MATERIAL '~' ~"O~O~e ~/~S NEAREST LOT LINE ~__~R~)X ~-~' '~z'/~,~$/ ~ TOTAL EFFECIIVE ABSORPTION AREA (WALL AREA) -- __OR WlDTII__~_~____, LENGTH~ __, DEPTH DISTANCE FROM WELL (/~/~)~.L~._./~T~/_~_~J~*t~ . BUILDING FOUNDATION~L~J~J?~'J~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WEL[ FOUNDATION. . NUMBER OF LINES DISTANCE 8ETWE~.J.JN~'SJ/- TRENCH WIDTH ABSORPTION AREA SQ, F~? LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE~/ DEPTH OF FILTER MATERIAL BENEATH TILE WELL: TYPE~/#J~/,I~/Jt'~ /,~L,/~ DEPTH r/ DISTANCE FROM ~ WATER NEAREST 4~/ SEPTIC ~ SEEPAGE LOT LINE ~"'-~ , SEWER LINE ., TANK , SYSTEM ...... CESSPOOL. TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE NEAREST OTHER ,SOURCES DIAGRAM OF SYSTEM DISTANCES: -%1L T~'I'~ 1~5'~'/' BLt O,~r I~or~ I~, ~ bcdroo~,~ ~Ot]b G .A.A.B. '~ GREA,ER ANCHORAGE AREA BOR,.JUGH SFWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME Of APPLICANT --/' -/ MAILING ADDRESS ~J~[¢'~'¢ -~'J,¢<~- /~:~E~PNONE - SOIL TEST RESULTS '~,-~'~-~/7/¢/~2~'~':4~'~¢¢~ NOTE: Tttl8 PERMIT IS NOT VALID WITHOUT 8OIL FIN2L INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY BYSTEM WITHOUT FINAL INSPECTION BY TIdE HEAl. TH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROBECUTION. SEPTIC TANK SiZE /~/'r'~ '~¢~// ~ TYPE , ¢/~.;'~ SEEPAGE AREA size ':~ ~-;~')- /~'- ~ TYPE / ~/~" FOUNDATION TO SEPTIC TANK POUNDATION TO SEEPAGE PIT :~'/~3 ., DRAIN fIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPtiC TANK /~ DRAIN FIELD , ALSO CONS]DER AREA WELLS, , SEEPAGE PIT CAST IRON INTO AND OUT Of SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEETINTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT F[TTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH A*"U T N~R ITY OR LICENSED DESIGNER DESCRIBEDI CERTIFY THATsYsTEMI AMisFAMILIAR[N ACCORDANcEWITH THEwiTHREQUIREMENTSsAiD CO D E, OF GREATER, i ~j¢~/ .//~A CHORAG E, AREA BOROUGH~ ': ORDINANCE~· NO, 28-68 AND THAT THE ABOVE I',ILIN ]: C ;[ PI:IL '.l' T~r· OF-' RNC:H~:)RF~f..~iE DEPRRTHENT OF HERL. TH RND ENVIRONMENTRL PROTECTION ~2~ C E;TREET, RNCHORRGE, RL. RSKR ~5~S~ ~'.74-45,5~ PERH~T NO. ( ) L. OCRTION NR M'F PLRCE LEGRL 1.2~ B2 SUN VRLL[E~' HGTS LOT SIZE 38~)~0 S~FI" MINIMUM D~STRNCE FROM N~LL. TO RNa" SEPTIC TRNK/PRCKRGE PLRNT OR SOIL RBSORPT~ON 5;~STEM I5 ~.0~9 FT FOR R PRIVRTE NELL- RND 2C~0 FT FOR R PUBLIC NELL. WELL LOGS MUST ~)E RETLIRNED TO THE DEPRRTNENT NITHIN ~ DR~S OF THE NELL_ COHPLETION. SPECIFICRTION~ RND CONSTRUCTION DIRGRRMS RRE RVRILRBL. E TO INSURE PROPER ]:NSTRLLRT I ON. I C:ERTIFN.' THRT I RM FRMILIRR NITH THE RE6i!UIREMENTS FOR ON-SITE SEMEn. 5 RND NELLS RS; 5;ET FORTFI B'q TFIE MUNICIPRLIT~' OF RNCHORRGE RND MILL INSTRLL IN RCCORDRNC:E NITH THE CODE. 0 0 H STATE OF ALASKA DEPARTMENT OF FNVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE for PUBLIC WATER SYSTEMS A. APPROVAL TO CONSTRUCT Plans for the construction or modification of ~ ~-, ~ public water system located , Alaska, submitted In accordance with 18 AAC 80.100 by approved. have been reviewed and are [] conditionally approved (see attached conditions). DY TITLE DATE If construction has not started within two years of the approval date, this certificate Is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE! ORDERS Change (conlract order no. or descriptive reference) Approved by Date APPROVAL TO OPERATE The "APPROVAL 're OPERATE" section must be completed and signed by the Department before any water Is made available to the public. The construction of the public water system was completed on (date). The system is hereby granted Interim approval to operate for 90 days following the completion date. BY TITLE CATE As-built plans submitted during the interim approval period, or an inspection by the Department, has confirmed the system was constructed according to the approved plans, The system is hereby granted final approval to operate. DISTRIBUTION: 1, WHITE - ENGINEER (Complete Section C) 2. YELLOW - WATER SYSTEM FILE (Complete SeeUon C) 3. PINK · ENGINEER/MUNI,DOROUGH (Complete Section C) 18u9407 (Rev. 11/83) 4, GOLOENROD - MUNI-BOROUGH (Complete Section A) 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, sect.ion, township, range) ¢,/-. 5~ /~,///-,~? .~,~ ¢,'~ //~,, . //~ ~ z /~ Location (address or directions) ...... } ~ ,~ ~ o ,~ 7'~. ~/~ c ~_ (b) (c) Applicant Name . '_~,-~%%_¢.,z_ /L/c,- 7%,,-,. Telephone: Home 6"-)~_/~_~-~7~- ~-g_ Business Applicant Address ~ ~, ~.~ ~,,4,~.r~. ~f_)---,..~ Applicant is (check one): Lending Institution []; Owner/builder)~'; Buyer []; Other [] (explain); (d) Lending Institution C"~, Z~ /"~2,~'~-']~_,~_r_'-._,~ Telephone Address ~ ~'& / ~ ~' ~ ~"~ ~ '~ //~ ~ (e) Real Estate Company and Agent ~ ~Z_ ~ ~ ~ ~'~_~ ~ o ~ ~ Address ~o ' ~ ~7' . Telephone (f) Mail the FJ.AA to the following address: TYPE OF RESIDENCE Single-Famil'~' Multi-Family h Number of Bedrooms Other WATER SUPPLY Individual Wetl [] Community'_I('" Public O Note: If community well system, must have written confirmation from the State Department el Environmentel Conservati .o,n attesting to the legality and status. ,~.5¢-Z'/;~0.. ~., SEWAGE DISPOSAt. Onsit Public [] Community D Holding Tank L~" ENGINEERING FIRM PROVIDING INSPECTIONS, 'rESTS, FILE SEARCN, DATA AND INFORMATION As certified by my seal afhxed hereto and as of the validation date showo below, I verify that my investigation of this Hoalti'~ Authority Approval sllows that the aa-site water supply and/or wastewater disposal system is safe, functional aod 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 ~ ¢ ~ ~/~ 5 Address _ ~ %-~- ~-~ ~-- Engineer's Seal Approved for '~¢¢~__~'_~ b e d r o o m s by _ ~,~_~..~'~"~'_~ :~'¢ Terms of Conditional Approval ¢' CAUCrfON The Muncipality of Anchorage Department of Health and Environmental Protection {DHEP) issues Health Authority Approval certificates based solely upon the represent,a!i(~ns! qwen in paragraph 5 above by an independent professional engineer registered in th(; State of Alaska. Th8 D~iEP does this as a courtesy to purchasers of homes and their lending institutions ill order to satisfy certain federal aud sta~e r~quirements. 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. Pa¢le. ?. of '2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal ?escript~on: ,/4, ~' MUNICIPALITY OF ANCHORAGE DEPI', OF HEALTH & ENVIRONMENTAL PROTECTION APR 0 RECEIVED .,,¢/,¢' 5,,.,, WELL DATA Well Classification Well Log Present (Y/N) Total Depth Casea [o _ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot TO Nearest Edge of Absorpuon Field on LOt _ If A. B. C. D.E.C. Approvea (Y/N) Date Completed Yield Depth of Grouting Pump Set At _ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots : On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results To Nearest Public Sewer '1'o Nearest Sewer Service Line on Lot Date Comments B. SEPTIC/HOLDING TANK DAT/~ Date Installed Standpipes (Y/N) ,~ Air-tight Caps (Y/N) Depression over Tank (Y/NJ /%/ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) . Separation Distances from Septm/Nolding Tank: To Water-Supply Well /¢¢ / To Property Line /o To Water Main/Service Line /o '/ Course Size /'=~' ~-~ No, of Compartments ~ ?/- Founaauon Cleanout [YIN /I,,/ Date Last Pumpeo ~_/"7~,~'/,E'¢,// for ~ _ Temporary Flolding Tank Permit (Y/N) ~ To Building Foundation _/¢ · To r) sposal Field /?" To Stream Ponc LaKe or Major Drainage Comments Page 1 of 2 72 026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /~ ? 2¢ Width of Field 3~' /' Square Feet of Absorption Area ,~ Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /'¢'~ To Building Foundation ,¢'~ Lot ~/'¢- / To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course ¥o Driveway, Parking Area. or Vehicle Storage Area Type of System Design Length of Field ?-~ / Depth of Field /~" Gravel Bed Thickness ~ / Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line - "~'- To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Comments LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, ~.,¢conformed to all I,.,1OA end HAA guidelines in effect on the date of this inspection. Signed ~~ Date_ Receipt No. ~ ~)~ %~ Date of Payment /J-I~-~% Amount: