HomeMy WebLinkAboutHANSEN SAND LAKE LT 11A
LEGALZESCRIPTION _
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAl.. PROTECTION
ENVIRONMENTAt. ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Tele!)hone 264-4720
ON-SITE SEWAGE DISPOSAl.. SYSTEM AND/OR WELL INSPECTION REPORT
Materia
Width ~'~
Material
Fou ndation~,~ // Nearest lot ~,~
Total leng~/ot l,,l~es I Trench ~,
· inches
Material beneath tile
inches
I J Well v /'~ /' Absorptioq area.
., I DISTANCE TO:
[[i Man.ract.rer/'--X
. E,O*MADE, ,.side,angth
~ Z~ ~ DISTANCE TO: Well Dwelling
~O_~ I Manufacturer
-, "'- :~ I No. of lines
i~1- Top of tile t~finish grade
Lu ILength Width-- Iq Depth
~ ~- ~ Crib diamete~ Crib depth
I DISTANCE TO:
~, IClass Depth Driller
.~ I Building foundation Sewer line
DISTANCE
TO:
NO. O F~DROOMS
No. of com~.ents
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO. ~'~(~ /~.
D ista rice betw~?4 .
Total eff~e~i~.~rption area
PERMIT NO.
Total effective absorption area
Building foundation Nearest lot line
Distance to lot line PERMIT NO.
Septic tank
Absorption area(s)
OTHER
PIPE MATF;~,R I ALS
SOIL TEST RATING
APPROV~~ DATE LEGAL
PEF.:M I T NO.
BPPLICANT
LOCBTION
LEJ3RL
~-li_INI L] I F""-'~L. I T'~' OF RNC:H~="-RRGE
DEPRRTMENT C HERLTH RND ENVIRONMENTBL ~ )TECTION
825 'L' STREET, RNCHORBGE, BK. DD50i
264-4?20
( 800184 )
BILLIE KIMBRLL
,-4:~_-.. JEWEL LBKE F..D
Lt.{R HBNSEN _R ~D LRKE
742_.5: JEHEL LBKE RD
LOT .~ I.~E
248-0465
~:~00 SQUARE FEET
TYPE OF SOIL RB_,ORFTION =~_TEM IS: TRENCH
I ' :.lJ I L RRTING
MA',,'~:IMUM N_IMBER OF BEDROOMS =
THE REQUIRED SIZE OF THE SOIL BBSORPTION SYSTEM IS:
[)EPTH=, ~.2 t E[-~GTH~= 2~$ ~SRR~EL DEF"TH= 8
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRBINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFBCE OF THE
GROUND BND THE BOTTOM OF THE E×CBVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRBVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFBLL PIPE
BND THE BOTTOM OF THE E×CBVBTION (IN FEET).
RF.,;~iJIRED SEPTIC: TR[-~K: SIZE= ~LOOE~
PERMIT BPPLICBNT HBS THE RESPONSIBILITY TO INFORM THIS DEPRRTHENT DURING THE
INSTBLLRTION INSPECTIONS OF RNY HELLS RDJBCENT TO THIS PROPERTY BND THE
NUMBER OF RESIDENCES THBT THE WELL HILL SERVE.
Tb~C, (2) I [4SF'ECTI,][-~S RRE REQLIIREC,
BRCKFILLING OF RN9 SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL B9 THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DiSTRNCE BETWEEN R WELL RND RN9 ON-SITE SEWRGE DISPOSRL
· 88 FEET FOR R PRIVRTE WELL OR ~58 TO 288 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND
TO R COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MR9 RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
F'ER~-4 I T E>~-:F' I F-:ES DE~]E~-IBEF-: _~t.. i-q-80
I CERTIFY THRT
t: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND HELLS RS SET
FORTH BY THE MUNICIPRLITY OF RNCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN RCCORDBNCE WITH THE CODES.
~: I UNDERSTBND THBT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
RF'PL I CRNT
I .... UE[: BY_
V4. 0
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
8
10
.~.~2
~3
14
17
18
2O
COMMENTS
MUNICIPALITY OF ANCHORAGE
[] PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
TEST
/o
Pouch 6-650, Anchorage, Alaska 99502 276-222~'
SOILS LOG -- PERCOLATION TEST
~ J,,,"~ DATE PERFORMED:
SLOPE
WAS GROUND WATER
E.OOU.TERED?
IF YES, AT WHAT
Gross Net Depth to Net
Reading Date Time Time Water Drop
---
PERCOLATION RATE .
TEST RUN BETWEEN
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, section, township, range)
Lot ll-A Hansen Sand Lake Subdivision
Location (address or directions)
7423 Jewel Lake Road
(b) Applicant Name Jack Bedient Telephone: Home 243-8371 Business
Applicant Address 7423 Jewel Lake Road
(c) Applicant is (check one): Lending Institution 1'1; Owner/builder [~; Buyer []; Other [] (explain);
(d) Lending Institution Bank of the North
Address
Telephone
(e) Real Estate Company and Agent
Address
Telephone
Mail the HAA to the following address: . \
Jack Bedient ~\'
7423 Jewel Lake Road .,' .~'/'
Anchorage. Alaska 99502
/~/I
(f)
TYPE OF RESIDENCE
Single-Family ~: Multi-Family []
Number of Bedrooms three (3)
Other
WATER SUPPLY
individual Well ~ Community [] 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 ~: 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.
72-025 (11/84)
Page 1 of 2
ENGINEERING FIRM PROVIDINL~ INSPECTIONS, TESTS, FILE SEARCH, DA ~A 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 Telephone
Address
Date
This department has received written confirmation from the engineer, OceanTech,
regarding the conditional of February 7, 1985. This property is now fully
approved.
Engineer's Seal
DHEP APPROVAL '~" 'I
Approved forl three(3)':'bedrooms by
Approved xxx~x , D sapproved
Terms of Conditional ~p'pro~l
/il:~\\\ ,'
~ Date September 30,1985
Conditional
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
September 24, 1985
Municipality of Anchorage
Division of Environmental Health
Department of Health and Environmental Protection
ATTN: Mr. Keith Bandt
RE: Pit Well - Lot 11-A Hanson Lake Subdivision
OceanTech
Mr. Bandt:
In reference to Ocean Technology, Ltd.'s letter dated January 28,
1985, the pit well located on the property was in violation of
the MOA guidelines for Health Authority Approvals in that there
was no pit drain to daylight. The violation has been corrected
by eliminating the pit and by raising the casing and pitless
adapter to above ground level.
If you have any questions, please contact me at our new number,
563-2060.
Sincerely,
OCEAN TECHNOLOGY, LTD.
Duane E. Carson, P.E.
Civil Engineer
DEC:ma
5333 Fairbanks Street, Suite 11 /Anchorage, Alaska 99518/Telephone (907) 563-2060
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date 1/25/85
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot ll-A Hansen Sand. Lake Subdivision
Location (address or directions) 7423 Jewel Lake Road
243-8371
(b) Applicants Name Jack Bedient Telephone - Home Business 276-2797
Applicants Address 7423 Jewel Lake Road
(c) Applicant ~s (check one) Lending Institution ~--~ ; Owner/builder~--~ ;
Buyer ~ ; Other~--~. (explain);
(d) Lending Institution Bank of the North Telephone
Address "C" Street
(e) Real Estate Co. & Agen~ N/A
Address
(f)
Telephone
Mail the HAA to the following address:
Jack Bedient
7423 Jewel Lake Road
Anchorage. Ala~Pm qqSN?
2. Type of Residence
Single-Family~
Number of Bedrooms
3. Water Supply
Individual Well.~.
Multi-Family~
3
Other (describe)
Community ~-~ Public ~-~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
Sewage Disposal
On ite Pu iic Co m nity ank
Note: If community well system, must have writte~ confirmation from the State
Department of Environmental ¢onsei-vation attesting to the legality and status.
[Page 1 of 2]
5. Engineering Firm Providing Inspections, Tests~ Fil~ 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 regula-
tions in effect on the date of this inspection.
Name of Firm
Address
Date
Note:
Ocean Technology Ltd.
2502 West Northern Lights Blvd.
1/24/85
Approval conditional to
resolving pitwell
inadequacies; see
attached letter° ~
6. DHEP Approval
Approved for //~/bedrooms
· A~p~v~d ~ Disapproved
(ENGINEER SEAL)
Conditional
Telephone 248-3888
~ ~,'-. CE - 3995
Date
CAUTION
THE I~dNICIPALITY OF ANCHORAGE DEPARTMENT OF' H~ALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS 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 ~ND
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.
RR4/ejID18
[Page Z of 2]
(DHEP SEAL)
A®
WELL DATA
Well Classification
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUR~ORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Legal Description:
Well Log P~esent (Y/N) No Date Completed .Unknown
Total Depth 105' Cased to ~ UnknownF~,~J~pth of C~outing.
Static Water Level Unknown ~----~AT~t~ 101'
L-11A Hansen Sand Lake Subdivision
Private If A, B, c~ C, D.E.C. Approved(Y/N) n/a
Yield ~ 6 gpm
n/a
Casing Height Above Ground 1.5'
Electrical Wiring in Conduit (Y/N)~ No ~ ~
Separation Distances f~om Well:
To Septic/Holding Tank on Lot 100'+
To Nearest Edge of AbsoI~ption Field on Lot 100'+
To Nearest Public Sewer Line 178'
Sanitary Seal on Casing (Y/N)Yes
Dei~ession A~ound Wellhead (Y/N)No
; On Adjoining Lots 100'+
; On Adjoining Lots 100'+
To Nearest Public Sewer
Cleanout/Manhole n/a To Nearest Sewer Service Line on Lot
Water Sample Collected By M. Hagan ; Date 1-17-85
Water Sample Test Results
Cc~ents Pit well 8.5' below ground level w/ pit covered and sides property
lined with cement blocks. No floor covering and no drain.
80'+
B. SEPTIC/HOLDING TANK DATA
Date Installed 6-9-80 Size 1000 gal. , No. of CQt%>artments 2
Standpipes (Y/N) Yes Air-tight Caps (Y/N)Yes Foundation Cleanout (Y/N) No. __
Depression ove~ Tank (Y/N) No Date Last Pumped ~ //-- ~ ~ ~%~ ~ ~
Pumping/Maintenance Contract on File (Y/N) n/a ; for n/a
Holding Tank High-Wate~ Alarm (Y/N) n/a Temporary Holding Tank Permit (Y/N) n/a
Separation Distances f~om Septic/Holding Tank:
TO Water-Supply Well 100'+
To Property Line 13'
To Water Main/Service Line 30'+
Course n/a
To Building Foundation 12'
To Disposal Field 5'
To Stream, Pond, Lake, c~ Major D~ainage
Con, rents
[Page 1 of 2]
2-15-84
Ce
ABSORPTION FIELD DATA
125 sq. ft.
Soils Rating in Absorption Strata per bedroom
Date Installed 6-9-80
Width of Field 3'
Square Feet of Absorption Area 375
Depression over Field (Y/N) No
Results of Last Adequacy Test Adeqnate
Separation Distance from Absorption Field:
To Water-Supply Well 124' To P~operty Line
Type of System Design Trench
Length of Field 31 '
Depth of Field 12'
Gravel Bed Thickness 8'
Standpipes P~esent (Y/N) Yes
Date of Last Adequacy Test 1-17-85
To Building Foundation 54'
Lot 107' ; On Adjoining Lots None located
TO Water Main/Service Line 30'+ To Cutbank(if present)
To Stream/P0nd/Lake/o~ Major Drainage Co~n~se n/a
To Driveway, Parking Area, c~ Vehicle Storage Area 36'
Coat,tents
To Existing or Abandoned System cn
n/a
D. 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)
~umping Cycles du~ing Adequacy Test.
Meets MOA
Comments
Company Ocean Technolog~Ltd.
KB1/d5/s
[Page 2 of 2]
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, oF conformed to all MOA HAA Guidelines in effect
Signed Date 1/25/85 f~.o° ^ ~i~¢~%. t
~ ~r)% Patrick A. Beau~ffi .' ~ I
MOA NO. ST84-034
2-15-84
February 7, 1985
Municipality of Anchorage
Department of Health and Environmental
Protection
825 "L" Street
Anchorage, Alaska 99501
ATTN: Mr. John Kennedy
RE: Depth of Well Casing, Lot 11-A,
Subdivision
OceanTech
Hansen Sand Lake
Mr. Kennedy:
As we discussed on the telephone yesterday~ you required
verification of the depth of well casing for the subject
property.
This morning, our technician, Mr. Mike Hagan, inspected the well
and sounded the casing at a depth of 40 feet.
We believe this fulfills all the requirements for Mr. Jack
Bedient,.the owner of the subject property, to obtain his Health
Authority Approval.
Sincerely,
OCEAN TECHNOLOGY, LTD.
Patrick A. Beaugard, P.E.
Engineering Manager
PAB:ma
, . ......
I985
O~riO I/l/~ef Al,',rfh~rn I inht~ tRIvrt I Anr~h~r~n~ Al~.~k~ 9.qBr).c~ I Tg.l~.nhon~. 907/248-3888 / Telex 26-485
NOTE: PLEASE WRITE CLEARLY TO INSURE
PROPER WARRANTY REGISTRATION SUBMERSIBLE PUMPS
~ ~ . . - .... ~. c,~ h ~,,- ,.. ,~ ..... ~,.t. ~/L
' . 7 ~ ~ -, -
- . .... r . - Pump Setting
Well ID . C:" _ ..... Depth / ~'>~ ' _. . Flow {GPH}
Puml; for N,~w Well ~
-" Othe~
· Olher
Ihtless Adapter m~talled [~ Yes 0
Summer Cottage ~ Sprinkling ~ Commercial
; ; Plumbe, :~ ump Speclahst [~ Ha,dware Deaer L~ Owner
· ..'~,,,.-,,, ,,.,-,,p ,,.,,,,,,,,,,-, 1_/,,7 -, - .,~ '
.,, :..~ . . /~ ~,c~ ......... If old pump wo~ lubmerlible: Three Wire
': "~ " ~ '~" ' ~ REEf JACKET -- WARRANTY REGISTRATION
Two Wke