HomeMy WebLinkAboutHANSEN SAND LAKE LT 7B
Municipality of Anchorage Page I of
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
Name: ~ ~)N~U~ ~~. Wastewater System: D New ~Upgrade
Address:go I'0 ~ ~3.~ ABSORPTION FIELD
Phone: ] No. of Bedrooms: ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other
LEGAL DESCRIPTION so""""'.:/¢2 GP~'Sq.F'. T°ta'D"pthf~°m°i'~a'grade:
Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Fill added above original grade: Gravel length:
WE LL: E New ~ U pg rede Gravel ~,:~, j'~ Number of lines: Distance between lines:
Classification (Private, A,B,C): Total Depth: Ft. Cased To: Ft. Total absorption a~ SQ. Ft. ~'~Pipe material:~ ~{~
Driller'. Date Drilled: Static Water Level:Ft. Installer:~c~ ~~ / Date i~stalled:~/~ ~" ~ 0
Yield: GPM I Pump Set at: Ft. Casing Height Above Ground:Ft. TANK
I
SEPARATION DISTANCES ~ s~.tio ~ Ho~ing ~ S.T.E.P.
To Septic Absorption Lift Holding ~ubl~c/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines
Material: Number of Compa~ments:
Surf.~ LIFT STATION
Lot Size in gallons: Manufacturer:
Line ~ C) ~ ~
Foundation ~ 0 ~ ~ "Pump on' level at: I "Pump off" level at: High water alarm at:
CurtainDrain.[~0 ~ ~]~ Pump Make & Model Electrical Inspections pedormed by:
Remarks: ~/ST/~'6 ~'V'U~a 'U~N~ BENCH MARK
Fo~Np ~'r~ No p~ FEcT~, LocationandDescription:~¢~¢,
Assumed Elevation:
Inspections performed by: Dates: 1st '" '""~ ........... ?'
Department of H~lt~d Hu~ervices app?va,,, ~. '~''~,: ',,
Reviewed and approved ' Date: ~ ,.: .....
72-013 (1/91)MOA 25
1000 6AL SUNSET TANK
,
TOM
15 0
Cl']-2225 r~
I5 30 45 60 75 9'0
SCALD ! = 30 FT,
T3M~ 5ARAG£ SLA3
ELEV, 100. O0
TOBBEN SPURKLAND P,E,
~03 W ]STH, AVENUE
ANON. AK. 99501
LOT 7A & 73 HANSEN SAND LAKE
SEC TOWN RANGE
3610 ~ 73
SEPTIC SYSTEM AS]BUILT
DATE, JULY S, 1993
SHEET, 1/3 GRID, 8I£6
9IVERTER VALVE
$
3'~/ide
40' Long
I0' Deep
5' Sewer Rock
5' Cover
lO' MIN.
GAL, TANK
EXISTING TRENCH
M/mo £! 140
5 £t oF' Septic Rock
TDBBEN SPURKLAND P,E,
203 W15th Ave
Anchorcge Ak 99501
~ // 5' Cover
/
N~ SCALE
LOT 7A HANSEN SAND LAKE
T]£N
PA TRICK ~3R9. AVE,
Exist, 5round
1000 gal, septic tank
TOM GARAGE FLOOR ~:'; c,
SEPTIC SYSTE-~' DESIG~
D~TE, JUL ~ ~ ~993
SHEET: 3/3.~~. OR~, 8]~6
ANCHORAGE, ALASKA 99501
(907) 279-5916
TEMPORARY SANITARY SEWER EASEHENT
The following described sanitary sewer easement is a temporary
easement for a residential sewer line going from the residence on
Lot 7B Hansen Sand Lake Addition~ to the septic system located on
Lot 7A Hansen Sand Lake Addition. (File ~ 70-30! Anchorage Re-'
cording District, Alaska ) described as follows:
Beginning at the Northwest corner of Lot 7B,
'Thence S89-55'W along the north property line a distance of 50
feet,
Thence S O-05'E, a distance of 37 feet more or less to a 4-inch
foundation cleanout, to the true point Of Beginning:
Thence N53W, along the center line of a 10 feet wide sanitary
sewer easement~ a distance 43~ more or less to a 4-inch pipe;
Thence S89-55~W~ a distance of 45 feet to the west property line
of Lot 7A, said point being the end of this easement;
An additional temporal sanitary easement, for the benefit of Lot
7B, is described as follows:
The North 50 feet of the West 30 feet of Lot 7A, Hansen Sand lake
Addition.
The above described temporary sanitary easements will be automat-
ically vacated when the septic system located on Lot 7A, and
serving the residence on Lot 7B is no longer required.
Sworn ap~ subscribe~,, before me this 9th day of July, 1993.
Notary ~ ~
My Commission Expire~;
May 19, 199~
62
I
i000 GAL SUNSET TANK
I
I
I5 30 45 ~0
SCALE; 1' -- 30 FT.
7% 90
TBM' GARAGE SLAB
ELEV, 100, O0
TBBBEN SPURKLAND P.E.
803 W 15TH, AVENUE
ANCH. AK. 99501
LOT 7A & 7B HANSEN SANB LAKE
SEC~fOWN RANGE
3610 W 73
SEPTIC SYSTEM AS~UILT
I)~qTE, JULY S, 1993
SHEET, I/3 GRII), 2126
PAGE 1 OF 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
t 0,., c~
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930159
DESIGN ENGINEER:TOBBEN SPURKLAND, P.E.
OWNER NAME:DONAHUE PATRICK M &
OWNER ADDRESS:3610 WEST 73RD AVE
ANCHORAGE AK 99502
DATE ISSUED: 6/16/93
EXPIRATION DATE: 6/16/94
PARCEL ID:01215340
LEGAL DESCRIPTION: HANSEN SAND LAKE LT 7~
LOT SIZE: 7709 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
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
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
ENGINEER WILL PROVIDE COPY OF RECORDED EASEMENT BETWEEN LOT
7A AN LOT 7B. HOUSE IS ON 7B SYSTEM IS ON LOT 7A.
SEPARATION BETWEEN NEW SYSTEM AND OLD SYSTEM IS APPROVED AT
10 FT. ENGINEER MUST VERIFY INTEGRITY OF EXISTING SEPTIC
TANK.
RECEIVED BY:
ISSUED BY:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
DATE:
DATE:
PAGE 2 OF 2
LST
20~ W }5th. AYenoe, Stdte 206
ANCHORAGE~ ALASKA 99501
(907) 279-3916
SEPTIC SYSTEM DESIGN
7A & 7B HA i~S EI~ SAND LAKE
PATRICK DONAHUE
i ~.~()/i ,, 2 ::= 125 '.-.'sq ,, .f 'i: ....
i::;,'oc: k :0e,obl
:l. ()
5.5
Nt..tfiiJ:) 8r (]'~:£,4° .-, ,~ K(.K, ..... ."-""=~
I...er~gtfi of """ ..............
SYST E~lil
,:: .... ' :l.() :=: :]';7. ::'
CONFIGURATION
STANDARD TRENCH
TOTAL LENGTH
TOTAL WIDTH
TOTAL DEPTH
ROCK DEPTH
COVER
SEPTIC TANK
40 FT.
5 FT.
10 FT.
5 FT.
5 FT.
i000 GAL. EXISTIN~
ABANDON EXISTING SYSTEM
'i"h(.~) instat].atic~n o.f th:i.s ~?-,epti¢: ~i~ysd:~:.~m will not !::~rever'fi: we?,!s
f rom 13e :i. r'u~'i:.a]. :i. ed on the adjacer',.'~: i ¢:)t~i~. Pub:i. :i, ~::: water" and ~ew~,r" :i. ~.
~vai].al:~:Le t¢ ali. (fi:.~,w;~i,::~i:)e..d lots ir'~ the are with the ~>.'Cel::,tion of
I..ot 7
']'? ] E' r ,$? ~i J"" E~? I"i [) d 6)) V (}:':' ]. (::) p E::~ d C) r i'] ~':t '{'.] L.I t"' ~:i ].. " t.l "~ ........ r~( E / !i~, t..( J] f~ U F f 4~ E ~:'? d I' ¢~1 :i. I"l a g ('~}?
courses on this or ti~e ad,jacent lots.
The:, j:)rc¥:~osed sep'Li c: sys'i:.ern w:i. i i nc:,t', c:har'~g,,.:~? t:he g~q-'~eral si op,'z:, o.F
th,r-.~ ,2d'"E~/:~.. Por'Jd:~. I"1~:) aiq(:~/cir C:{::rF~C~.~-.'tit'"~.~L~iCH'I Of f~:Lti"'f:C~.C:~E:' r'L.H'~C~'~:'~: ~'..KJ. ]. ]. not
r'esult .From this inst'.ailat:i, on~
"t"htE, e:,x:i.!~i'~;.:~.l'i(~! t]t'-(E:,l']izh is r~.:,:F~cirte;,cJ tel have:, 8 ~:e;,et or more) o~: se;,wc~.:,r'
t'"clck . ac:c:ci~'dJ.f'ig t:o AMC i5.65. ()60. iE]. ].0 , t'.lae separ'at:i, on di stai-'lc::6~
ki~i~,t'.i~e:,E, ri thE:, 0:,x i st i r'iEjl 'Ll'-E:~rich ~;~r'i,:::J thE:, l::,r'c¥:ic:,se~cl must'. I:)e twi ce the
a l:erl .Fcx::rl: ut:i.t:i, ty easement~ th:i.s separation can riot bile medE:et. We
ing the:, new tr'e~nc:h i0 .Feet o.f.f the:, 1 c)'l:: I :i.n~:?. I...ot corner ar'e
S,'.:.:.:,pt i c: System )i}()i:,~i ',.In
Lcd: 7A 8,: 7B Han~.,~r',, SAnd Lake
3
4
PU~,
¢ ~/A TEl?
1
I
~/ES T SE VEIV T Y
'WI
II ~/ACA~VI
I'
I
q[I--- 7
IIi ~!
Iii
!
]4
,5'0 0 50 100 150 £00 8b'O 300
£CALE; )" = ~00 £'T,
TBt~BEN SPURKL. AND P,E,
203 W ]STH, AVENUE
ANCI4. AK. 9950i
L§~' 7A & 7,~ HAN$£N SAND LAI(£
SEE TDiFN RA.NOE
36}0 ~./ 73
SEP'rIc SYSTEM DESIGN
DATE: hAY 2_6, 1993
SHEET, 1/3 GR[D, 2_]2.5
A/E~/ 7~E/VCH
--_J
II~fS TAL L .D~UBL E £'L £ANOUTS
EX]ST, ]000 6AL SUNSET
i I
]S 0 15
SCAL £';
CE-2225
45 ~0
] = 30 FL
75
TO~EN SPURKLAND P.E,
203 W ]STH, AVENUE
ANCH, AK, 99501
SEPTIC SY$IEH DESIGN
]]AI'E, MA'/ 26~ 1993
SHEET, I/3 GR[D, £]£6
EXIST, 1000 GAL, rANK
S'Wide
40' Long
10' 9eep
5' Sewer Rock
5' Cover
BI$CDNNECT£XIST. T£ENCH
lO' MIN.
Cleanou~5
/
5' Cover
Nir'a £~ i40 ~>~.=~o<>ooo~o~
Septic Rock /
ND SCALE
EX[S TIN6 TRENCH
/~Monit:or
Ground
1000 gal. septic tank
~M
ASSUMEBELE, 100.00 FT
]BBEN SPURKLAND P,E,
803 ~lSth Ave
Anchorage AR 99501
L[TT 7A HAIV£EN SAND LAKE
SECTIDN 6 TYSN
PA[RICK DDNAHUE, 3610 W 73R~, AVE,
SEPTIC SYSTEH ~ES]GN
DATE, JUNE ~ 1993
SHEET, 3/3 GRIg,~IS~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
· E AL DESCR,PT,ON: 7A
1
3 -~'~
4
5
6
7
8
9
10
11
12
13-
14-
15-
16 °~4
17 ~/4-
18-
19-
20-
Township, Range, Section:
WAS GROUND WATER ~
ENCOUNTERED? ~ ~
S
IF YES, AT WHAT ~ ~
DEPTH? P
E
SITE PLAN
Depth to Water AIt~r . Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ,0~ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~' FT AND FT
COMMENTS
PERFORMED BY: ~k.. I ~"~ ¢'~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE-DATE:
72-008 (Rev. 4/85)
GRE, ANCHORAGE AREA BO[f 'IGH
Department of Environmental Ouality
3330 C Street
Anchorage, Alaska gg503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME .Z)I~L,~-A/~' icJll"~LLa,,'~2/.. MAILING ADDRESS ..~3~--0
LOCATION J.,C). 7-~',0 ,/~-,
LEGAL DESCRIPTION
PHONE ~/-
SEPTIC TANK:
DISTANCE
FROM WELl
INSIDE LENGTH
MANUFACTURER 2'~ "'~/"~
INSIDE WIDTH
NUMBER OF
MATERIAL ,/~//~L~L/~ ~ COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACITY /~'~GALLONS.
TILE DRAIN
DISTANCE FROM WELL'~' ~ FOUNDATION
NUMBER OF LINES / DISTANCE BETWEEN LINES
,ABSORPTION AREA ~-~'7 ~, C7 I
DEPTH: TOP OF TILE TO FINISH GRADE
NEAREST LOT LINE
TOTAL LENGTH
/~, I OF LINES .:3
TRENCH WIDTH IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE /
DEPTH OF FILTER
'~' # MATERIAL BENEATH TILE /~) '~ IN. ABOVE TILE
IN.
WELL:
TYPE :TM-'° / t,) / o ~-4A CON ST R UCT ION-~' TI"~OS~'~
BUILDING NEAREST NEAREST
FOUNDATION__ LOT LINE SEWER LINE
DEPTH
CESSPOOl. , OTHER SOURCES
APPROVED""" D'T"S APP ROVE D
REMARKS
S E PTJ,~- SEEPAGE,...
TANK SYSTEM
DISTANCE FROM:
DISTANCES: ~ ~(~
INSTALLED BY: ----~'~7'/~/'J~F~F---- ~---/V',f...
SEWER LINE DEPTH:
PIPE MATERIAL, C?/:)~'7- -~'-,~4),'L/ ,~
LOT SLOPE:
REMARKS:
DATE
DIAGRAM OF SYSTEM
Form EQ-O32
(;RE, ER ANCHORAGE AREA BO UGH
~DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE~ ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL/SYSTE/v~-- APPLICATION AND PERMIT
PERMIT NO..
NAME Of APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION ~J
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILitY TO BE SERVED
FINANCED THROUGH
so,L TEST RESULTS
/
COMPLETION DATE ANTICIPATED
SEEPAGE PIT DRAIN FIELD , OTHER ~ ·
NOTE:~ THIS PERI,lIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 Hour NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL iNSPECTION BY THE
DEPARTMENT O~ ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
MINIMUM I~ISTANCES, REQUIREMENTs
FOUNDATION TO SEPTIC TANK ~ /
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD ~
SEPTIC TANK, '/'¢~"~ ~
· SEEPAGE ~T
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
., SEEPAGE PIt / ~'~ , 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.
DIAGRAM OF SYSTEM
GRAVEL BACKFILL
CONFORM TO BOROUgh REGULATIONS REGAR~STALLATION.
LICENSED DESIGNER
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 SAIOCODE. I also certify that this home will contain a maximum of
three, (3)~bedrooms. I understand an upgrade would be~necessary should more bedrooms be added.
August 1, 1975
R & M No. 562077
Darlene Hallback
3350 West 69th Avenue
Anchorage, Alaska
RE,: Test Hole and Soil Log Report for Sanitary System
Lots 7A & 7B, Hanson Sand Lake Addition Subdivision
Dear ~s. Ha!lback:
We are subraitting herewith the test boring results and our comments regarding
soil conditions encountered at the subject site. This investigation was per-
formed in accordance with your request of 7-30-75 and those procedures outlined
in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Greater Anchor-
age Area Borough Department of Envirommental Quality.
A single test hole was put down within the Lot 7A and 7B area for the purpose
of defining general subsurface soil conditions for the proposed sanitary system.
Excavation was accomplished with an auger type drilling rig and the test hole
was extended to a total depth of 25.0 feet below ground surface. The final
leg prepared for the test hole has been included in Drawing A-01.
Ground water was not encountered in the test hole.
We appreciate being given this opportunity to be of service to you. Should you
have any questions with regard to the above, please do not hesitate to contact
us.
Very truly yours,
R & bl CONSULTANTS, INC.
Vice President
xc: GAAB
T.H.-1
7-30-75
ORGAI,[iCS
: '.1
SILT, TRACE SAND
SA!qDt TRACE SILT
Medi~am grain
Bro%.~ (SP)
NO WATER TABLE
0.0~
2~01
25.0'
Log represents
Lots 7A & 7B
Hanson Sand Lake
Addition Subdivision
Engineering ~ Geological'Consultants'Inc.
ANCHORAGe FAI~RANKS ALASKA JuNeau
Hallback Property
Log of Test Hole
AnchOrage, Alaska
[OATE 7--31--75 IsCALE 1"=4' IDWN DY ~,'~D j.~HKD BY WED ]P~OJ. NO. 5620?7 ~1 .
.L
.. _, .... :
N :.2 '::!.L
ceR~y tna~ I nave survoyec~ ',~e following
////,L xI~>V .:Xl/V/I LA,{'/.:: //..: ...:'AZ.
Anchorage Recording Precinct, Alaska, and that
improvements situa(ed thereon are xvithin the property
lines and do not overlap or encroach on the property
lying adjacent thereto, ~ha~ no improvemenls on prop-
erty lying adjacent thereto encroach on the premises in
question and that there are no ':oadways, transmission
lines or o~her visib]e easements o~ said property except
as indicated hereon.
Da~ed at Anchorage, A1as]m
/72 z:d a.y o:. J/AL/ . ,.:-
this. __ - , .,,__: _:__
FRiSD ¥;,rAL,&Ti,h,i ~
Engineers and Surveyors
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519~6650
343-4744
Parcel I.D.
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property 'owner
Mailing address
Lending agency
Mailing address
Day phone
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
NOTE:
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
s~uewwoo leUO!llPPV
:$uop, elndp, s 8UIMOIIO~ eH), qjlM 'suJooJpeq
Jol le^oJdde leUOBipuo0
'suaooJpeq
'pe^oJddes!Cl
Joj pe^oJddv ~
~tan.LVN~lS SHHO
'9
,, t:I=EtNIIDN=I Ali NOI.LO:idSNI -10 .LN~]IN:~.L¥.LS '~
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. Well Data
Well type ~
Log present (Y/N) N
I~/'~'NS~ b,I - --~-l'q L'~ Parcel I.D.
Ol;Z - /5- 3 L/ O
Total depth ~ ~.~
Sanitary seal (Y/N) y
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ~ ~ 7,~ Driller
Cased to ~ ~ Casing height
Wires properly protected (Y/N)
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level1
.g.p.m.
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main ~ /f,~O /
Sewer service line ~ ~,~'(~
AT INSPECTION
.; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout '~,
Petroleum tank ~,0/4 ~'~
g.p.m. ~ c~
~0
WATER SAMPLE RESULTS:
Coliform Nitrate
Date of sample:
~,~_~ <"" Other bacteria
Collected by: '%~ ~
B. SEPTIC/HOLDING TANK DATA
Date installed ~//]~/7.~ ~'~- Tank size it (.P-(2¢_~ --
Cleanouts (Y/N) 7 Foundation cleanout (Y/N) y
High water alarm (Y/N) [*'C/A,
Date of pumping ~/' Pumper
Compartments
Depression (Y/N)
Alarm tested (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot /L~E:}
To property line ! ~)
Surface water/drainage
On adjacent lots
Absorption field
Foundation q 0
--Water main/service line '~ ~'~ O
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C, LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
Soil rating (GPD/Ft2) /,~ ~ System type
Width '~'~ ( Gravel thickness ,¢)-- ! Total depth
/'¢0'"~ Cleanout present (Y/N) y Depression over field (Y/N)
~/~///--~- Results (pass/fail) ~'-'~ for
~'~///z~ After test
~',,~ t.~) If yes, give date
/0
Bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot I 0 ~ On adjacent lots ~ / ~ Property line
TO building foundation ~2 ~ To existing or abandoned system on lot
On adjacent lots N 0 14 'EL Cutbank ~ 0 IR ,¢-_. Water main/service line
Surface water '~ LO 1,1 ~._ Driveway, parking/vehicle storage area
Curtain drain '1~ 0 i//~
E. ENGINI--ER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines;in.." ~ffe/c?~on..... the¢date of_ this inspection.
HAAFee$ / 7¢~-~
Date of Payment
72-026 (3/93)* Back
Waiver Fee,$
Date of Payment
Receipt Number
COMMERCIAL TESTING & ENGINEERING CO.
ENVIRONMENTAL LABORATORY SERVICES
s,~cE,9o8 REPORT of ANALYSIS
Chemlab Ref.~ t93o2913-1
Client Sample ID iL7 HANSEN/$AND LAKE
Matrix ~WATER
5633 B STREET
ANCHORAGE, AK 99518
TEL: (907) 562-2343
FAX: [907) 561-5301
Client Name :TOBBEN SPURKUAND, PoE. WORK Order :67415
Ordered By : Report Completed :06/24/93
Project Name ~ Collected :06/21/93 @ hrs~
Projects : Received :06/21/93 @ i3:45 hrso
PWSID :UA ~echnical Director=STEPHEN C~ EDE
R~leased By : - 2'
Sample Remarks= SAfLP£J~ COLLECTED BY: UA.
QC Allowable E×t, Anal
Parameter Results Qual Mnits Method Limits Date Date Znit
Nitrate-N 0,10 U mg/L EPA 353.2/300o0 10 06/23 LLH
~ See Special Instructions Above UA = Unavailab].e
~'~ See Sample Remarks A~ve NA = No't Analyzed
U = Undetected, Reported value is the practical quantification limit. LT = Le~s Than
D = Secondary ~ilutiono GT = Greater Than
Member of the SGS Group (Soci~tb G~nOrale de Surveillance)
ENVIRONMENTAL SERVICES IN ALASKA, COLORADO UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY. SOUTH CAROLINA '
C_/AL ]'~'ST]NG & ENGINEERING CO, AK DIV
CHEM1C4L & GEOLOGICAL LABORATORY
TELEPHCNE (907) 562-2343 5633 B Street
Anchorage, Alaska 995 ~ 8
Drinking Water Analysis Rep0d for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
E~"PRIVATE WATER SYSTEM
f?
Name j_ Phc~e No.
M ailing Address
C~y
SAMPLE DATE:
Mo. Day
7PE:
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
SAMPLE
No. LOCATION
41
Stste Zip Code
[] Treated Water
'~eated Water
Time
Collected
1 :aa
J
I
Collected
By
TO BE COMPLETED BY' LABORATORY
Analysis shows this Water SAMPLE to be:
//~Satisfactory
[] Unsatisfactory
[] Sample too long in transit;sample should
not be over 30 hours old .at examination
to indicate reliable results; Please send
new sample via special d~livery mail.
Date Rec~iYed t'~ '~ ~
Time Rece~ve,~ ~-- Z~ t~ 4_;
Analytical Method: Membrane Filter
* No. of colonies/100 mL
~ ~. ~of Ne. Result*
~3.2P~3 ~ ~ ~
, I-F-I
I F-q-q
Analyst
BACTERIOLOGICAL WATER ANALYSIS
Membrane Filter: Direct Count
Verification: LSB BGB
RECORD
Coliform/100 mi
READ INSTRUCTIONS
BEFORE
TNTC- -
Fecal Coliform Confirmation
COLLECTING SAMPLE Final Membrane Filter Results ~'
Reported By ~. ~ Date
Too Numerous To Count Time:
OB = Other Bacteria
~SG!
PART ONE OF TWO
REMAINDER TO FOLLOW
Coliform/100 mi
a.m.
porn.
,~r~
~ DATI~R ECEIVED
~' INSPECTION APPOINTME~TS~
TIME
TIME TIME
DATE DATE ~ ~ /~ DATE
INSPECTOR INSPECTOR I NSPECT~
MUNICIPALI~ OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT~IRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
EffiVI~O~ME~T~k S~IT~TIO~ DIVISIO~
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be proce~ed. Please allow ten (10) days for processing,
PHONE
MAI LING ADDRESS
PROPERTY RESIDENT {If different from above)
PHONE
2. Y R
M~I LING AD~R~ ~ ~ '~ - z~" /
4.~/~ALTOR/AGEN[ , / , p. ~ . .-'~ ~ [ PHONE
STREET LOCATION
6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One [] Four [] Other__
J~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY J~ Three [] Six
7. WATER SUPPLY [] INDIVIDUAL*
[] COMMUNITY
PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8, SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[~] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL ; DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
[]Septic Tank or []Holding Tank
Size: ~_/...~)O If Tank is homemade
SOl
LS
RATING
t
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
1
WELL TO:
Absorption Area to nearest Lot Line
5, COMMENTS
~ APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY
72-010 (Rev. 6/79)
Tobben Spurkland P.E.
8155 Cranberry St.
Anchorage, Alaska 99502
Phone (907) 243-5302
Duane Hallback
3610 W 73rd ~veo
Lnchorage, ~laska 99502
June 18, 1981
Legal
Location
Owner
Residence
Water
Sewer
Date of Test
Test i~z, ocedure
Test Result°
Tank
Absorption System
Absorption Area
Soil Rating
Installation Date
June 15, 1981
EWER ADEQUACY TEST
Lot 7A, Hansen- Sand Lake S/D
3610 W 73rd Ave.
Duane Hallback
Two Storey, 3-Bedrooms, Single Family
On Site Well
~Tom Minicipal Records
1000 gal. Sunset Plastic
Trench, 9 feet of gravel
576 sq.£t.
150
Sept. 1975
System was inspected on June 9thoTank is located under
concrete driveway and trench on west side of drive.
4~ cleanout to trench is dry, 4" sump has 8'-1" of water in
it. Total depth of sump 12'-2".
On June 15th water was added to the tank at a steady rate of
3.3 gal per min. A total of 462 gal was added without any
rise in the water level in tank or sump. Tank was pumpes on
June 16.
The system accepted 462 gal of water without any sign o£
backup ia an~ part o£ the system.
This system meets the municipsJ. Requrements for a three
bedroom house
DEPA~ql?dENi',.~'~ ~iEALll~ AND Ei'~ViiRONM[:NJAL P! OFECTiON
June 2, 1.981
Duane/Dar2ene tIallback
;,u].0 West 73 Avenue
· --" ~:~- Alaska 9u.~02
Subject: Lot 7Bt 'lA Hansen Sand ]Lake Subdivision
Approval for the indiv:idual sewer and water facilities
cannot be granted until the following items have been
completed:
(i.)
The water analysis_report... . needs to .oe submitted
to tn._~s office from the Chem Lab~ 5633 B St.:
for our rev iowo
~-~ ..... 4 e+' submitted
2) The septic tank pumped with a ~ .... ,. ~
te this office~
3)
An adequacy test needs to be performed on the exising
leaching area. This test will determine if[ the system
is adequate according to National Standard. s~ A listing
of private firms performing the -test is enclosed, This
report needs to be submitted to this office from the
engineer for our review,
.~.z there are any furthe:r questions, .' "~
p.~ea~.~ call this office
at 264-4720.
S incer e 1 y,
Robert C, Pratt~ R~S,,
Associate Specialist
RCP/lj w
cc: National Bank of Alaska
Pouch 7-025 99510
Connie YoshJmura
% Dynamic Realty
'n West'
,.] ~. . Northe:i:n Lights lBl..vd.
99503
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received July 6, 1976
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
9:00 a.m.
7-8-76 Pratt
Conv.
l. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
Peoples Bank and T~ust
Pouch 7007, 99501
Duane~Hallback . (mrs)
Phone:
Phone: 344-7037 work)
3. Legal Description: Lot 7B Hanson Subdivision
4. Location:
See directions
Type of facility to be inspected
Well Data:
A. Type
C~ ConstruCtion
Sewage Disposal System:
A. Installed
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
Distances:
No, of bedrooms
B. Depth
D. Bacterial Analysis
On-site system
B. Installer
1. Size 2. Manufacturer
1. Absorption Area 2. Material
Total length of lines
A. Well to: Septic tank tOOl-t~ , Absorption area !~¢~
Nearest lot line , Other contamination .~
B. FOundation to septic tank , Absorption area
C. Absorption area to nearest lot line
Sewer Lines __
EQ.-034 (1/74) Page 1 of two pages
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
1. Type of Inspection:
2. Property Owner: Duane Hallback
Mailing Address:
3. Name of Buyer:
CMRO__VA
(mrs.)
FHA
Day Phone:
CONV
344-7037 work
Mailing Address:
4. Name of Lending Institution: Peoples
Mailing Address: :Pouch 7007,
5. Name of Realtor or Agent:
Mailing Address:
6. Legal Description:
Day Phone:
Bank and Trust
99510
Phone:
Phone:
Lot 7B Hanson Sub. Sand Lake Area
Location:
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
Single Family
No. Bdrms.
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)
72-003(3/76)
Page 2 of two p~ges - Re~-'~t for Approval of Individual
Leljal Description Lot 7B Hanson Subdivision
~)r & Water Facilities
Comments
Approved
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)