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Home My WebLink AboutSIEFKER #2 LT A-8BQGREA R ANCHORAGE AREA BOR' Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 GH INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM NAME ~;2'/ C~ M^,U,NG ADDRESS ,¢/yt?~'~×/ %~'~ P.ONE .~'Z/-_l~/-- LOCATI ON SEPTIC TANK: DISTANCE FROM WELL p/~'O,~ff{$Lz/~V]ANUFACTURER .~7~/,/~,~ INSIDE LENGTH -~ INSIDE WIDTH NUMBER OF / MATERIA ' '~' _ COMPARTMENTS_ LIQUID DEPI'H ...... .LIQUID CAPACITY_ ~;~O GALLONS, SEEPAGE PIT: NUMBER OF PITS /. DIAMETER_/'~ OR WlDTH.Z.~, LENGTH-_~,' DEPTH ( LINING MATERIAL~'Z'z%/2~'/,t',~, CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL I)hJ~_~. BUILDING FOUNDATION ,:t"~ , NEAREST LOT LINE ~'q / TOTAL EFFECTIVE ~/~ FT. . ABSORPTION AREA (WALL AREA) .SQ. ADDITIONAL ABSORPTION WELL: TYPE ,'/~,,'~/"~/'J~- e~ / CONSTRUCTION BUILDING ~-~:~--- . NEAREST- ..... FOUNDATION LOT LINE DEPTH DISTANCE FROM: NEAREST ....... SEPTIC .._~-~ SEEPAGE SEWER LINE TANK SYSTEM CESSPOOL'~-~ APPROVED ' OTHER SOURCES DISAPPROVED REMARKS '~'~ ...... DISTANCES: INSTALLED BY:--~:~g//}.r~1 ./~q"--~'-~. PIPE MATERIAL: LOT SLOPE: /"-~:' '~i'-~ Form PW.026 't DIAGRAM OF SYSTEM G.A.A.B, ~-[f.~t/ GREAT[:.R ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT PERMIT NO. INSTALLATION LOCATION /~'~ L[~/)~/(~ LEGAL DESC.IPTION %-~/'¢:'-/~''~-~''' ~ ' ~ INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED BO'L TEST .ESULTS COMPLET'ON DATE DRAIN FIELD OTHER TO .E ,NSTALLED BY ~~ NOTE, THIS PERMIT IS NOT VAglD WITHOUT pFRMIT :~jLI.T.D_ ONE' YFAR FINAL INSPECTIONI 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY ~.YSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILl. BE SUBJECT TO PROSECUTION. SERT,C TAN'< MINIMUM DISTANCES, REQUIREMENTS 5 ft, FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT 20 ft. ORA, N mELD 10 ft. ~;EPTIC TANK TO SEEPAGE PIT WALl 15 ~'~ ~ .C;EPTIC TANK 5 f ~ ' i SEEPAGE PIT 20 ft.__. DRAIN FIELD 10 ft. TO NEAREST LOT LINE. WELL TO SEPTIC TANK WATER MAIN TO SEPTIC TANK DRAIN FIELD 10 ft. SEEPAGE PI'I ALSO CONSIDER AREA WELLS. BEPTIC TANK. 25 ft., SEEPAGE PIT 100 ft. , DRAIN FIELD .~0 ft~ I I 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 PITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVE[. I~ACKFII. L CONFDRM TO BOROUGH REGULATIONS REGARDING INSTALLATION, HEALTH AUTHORITY OR LICENSED DESIGNER / IIOUS£ SEPTIC . /CRIB tank & tha, should 6' per 100 on fl~t I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AAEA B~OUGH ORDINANCE NO. 2S-68 AND THAT THE ABOVE DESCRIBED BYSTEM IS IN ACCORDANCE WITH SAID CODE. G ATER ANC~IORAG[ ARES..'~OROI~I:. DEPARTMEN-F OF EN\/!RON~!EI'~i AL 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Legal Oescrintion: Lot ~,~..B1 oc k ...... Subdivision This Form Reoorts Soils Lo~ CASE # Percolation Test 2 3, 5 6 7 8 9 l0 QeDth Feet Soil Characteristics Was Ground Water Encountered? ~ ~?o^ If Yes, At what Depth? Readinq Date Gross Time Net Time _~enth to H20 Net Drop Percolation Rate ~i i n u t e Proposed Inst~'l-'~t--i-~'~': Seemaae Pit Prain Field Deoth of Inlet ..................................................................... Test Performed By Date: EMT Number, of P~droom ) Othe~ (d~ scribe ) 3. Ware:l: S_u_~i. ~l~te: Iff ~.~nity ~].1 system, must ha~ ~m'it~n ~nfiirn~tion f~c~ the State [Mp:~t[~nt cf ~wiro~ltal Co~orvation attesting to t~ legality ~d status. Is the ~11 aa.:~ate foF the n,a~r of ~ s~cified in this ~A~)~. ]:s t}~ was~wate~ dist.:al, system adequate f~z 't'~ ga~t~r of I~dr:~/~/t~l) [Pa~: 1 of 2] 2--15-84 5..?]~nwineerinq Firm Providin I~~ctions, Tests, Bata and Inforn~ation certify that I hav~ checked, verified, o~ conformed to all MOA [~AA Q]idolil-~s in effedt on the chute of this inspectiO, o Date. [)ate _ephor~ ( ENGINEER SEAL) 6. DHEP Approval. Approved for Approved ~ Disapp. oved ~-_~ Conditional ~[~e ~uniei~alfCy off ~cho~ta~ ~nk off I~a].kh and gnvi~ol~n~al PuoCeckJ.On d~s hoC ~auanLee the con~J.nued ~J.s~aetory ~u~o~n~ off t~ wa~e~ supply a~/ou the wastewakeu dis~sal system. ~ia appuoval indiea~s that~ as off ~ valida¢ion sha,,n a~, ~sed on kl~ ~a and in~o~,~gion ffL~,nished ~ an engi~er ~egfsCeued in Che State off Ktaska~ ~e ~eu supply and wa~tewa~eu dis[~sal system is sa~e and ~un~ ~ional fioL, the n~u off ~dr~ ~d ~y~ off s~ue~u~e indicated. (DHEP SI'~XL ) Mail the HAA to t~ follcwing address: KS2/d5/s [Pa~ 2 of 2J Well Log P~esent (.Y~ Total Depth ~~_ Cased to Static Water Level _ Casing Height Above Ground Electrical Wiring in Conduit ~N) Separation Distances f~cm Well: MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OE ANCHORA(~ HEALTH AL1THORIT¥ APPROVAL (HAA) DEPT. OF HEALTH & I~NVIRONMENTAL PROTECTION RECEIVED If A, B, c~ C, D.E.C. Approved(Y/N) Date Completed _~_~~ Yield ~~_ Depth of Sanitary Seal on CaSing ~/N) Depression A~ound Wellhead (~'~.~ To Septic/Holding Tank on Lot /Dd ~- ,.. ; On Adjoining Lots.~_ To Nearest Edge of Absorption Field on Lotl~__~_ ; On Adjoining Lots ~./'~ To Nearest Public Sewer Line /w_~ To Nearest Public Sewer Cleanout/Manhole 4///;F To Nearest .Sewer Service Li~ on LOt ~ate. Sample Collected By ~J~r~, , Date Water Sample Test R~.sults .~~ B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes~N) Size __~_~Q~_ No. of Ccn~a~tments / Air-tight Caps~Foundation Cleanout~Y/N) Depression over Tank (Y~ Date Last Pumped~ Pumping/Maintenance Contract on File (Y/N~_/J/~__; for Holding Tank High-Wate~ Ala~mJY/N) ~//~_Tempo~ary Holding Tank Permit (Y~/N~).~--_~ Separation Distances frcm Septic/Holding Tank: To Water-Supply Well /~P~/v~' To Building Foundaticn /_~/~ To P~ope~ty Line $~'~ To Disposal Field . To Weter Main/Service Line Vu/D / To Stream, Pond~ Lake, c~ Major D~ainage Corm~nts ~~C~ ? [Page i of 2] 2~].5~84 Ce ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed.. ~./~ Width of Field _. /7 / Square Feet of Absorption A~ea .. Type of System Design ~/~ Length of .Field .... /7/ Depth of Field ~ LO ' Gravel P~d Thickness ~ ! Standpipes P~esent ~N) Depression over Field (,Y~ Date of last Adequacy Test Separation Distan~ ~ ~so~ption Field: To ~te~-Supply ~11 /~O~ ~ To ~o~rty Li~ To Building ~oun~tion ~ ~2~ To Existing or ~ndo~d System Lot ,~/~ ; ~ ~joining ~ts To Wate~ Main/~vi~ Line .~¢~I~ To ~t~(if pre~nt) ~/~ To Stre~ond~ke/~ Majo~ ~aina~ C~se ~/~ To ~iveway, Parki~ ~ea, ~ Vehicle st~a~ ~ea_ D. LIFT STATION DaSd Size in Gall~n~ "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Col~ rlts Dims ns ions ~ ! /Ma~ole/Access (Y/N) ~ Vent (Y/N) Pumping Cycles ~~acy Test. Meets MOA ** Check Permitted Bedroom Rating Against ~1~31 Request ** I certify that I have checked, verified, o~ conformsd to all MOA HAA Guidelines in effect on the date~of this inspection. /1 KB1/d5/s F 7 [Pa~e 2 of 2] Date 2-15-84 ALASKA ,iiLIIROFIm FITAL COF1TROL $ I dlC S, IFIL ~n§JneerJn~ $ ~nvJronmenlal $1udJcs JUNE 27 1984 CHARLES GILBERT 11200 JEROME STRE~P ANCHORAGE AK 99516 SELLER - CHARLES GILBERT BUYER - SUBDIVISION - SIEFKER ~BI.J~F~-~-~ 8B ADEQUACY TEST FOR SEWER SYSTN~4 THE rI~PE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 408 SQ~T. THE SYSTEM IS CAPABLE OF ACCEPTING 300 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 472 GAT,TONS. BASED UPON THE TEST DATA ~iE SYSTEM IS ACCEPTABLE ~IDR A 2 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ONMAY 8 ]984 THE WELL FLOW RATE WAS 3.5 GPM FOR 2.3 ItOUP~S. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME 0~].250 iS THIS 2 BEDROOM HOUSE. ADEQUATE FOR 1200 ~Ucsl 33rd Auenue. SuJlg [~ · Anchore§¢. ,~laska 99503 , (907) 561-50~10 ALASKA B,,LIIROFImeFITAL COF1TROL SehdlCe$. IFIC. ~nqinecrin§ 6 Enuironmcn~al $Iudics June 26, 1984 Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 Attn: Keith Bandt Legal: Lot A Block 8B Siefker Subdivision Dear Keith: A flow test was performed on the well at the above property on June 26, 1984. The static water level was at ~12~+7' Over 450 gallons of water was pumped at a rate ~f~.5 gpm with a drawdown of 18.1'. The recovery time was 12~"~i~utes. I consider this well adequate for domestic useage in this 2 bedroom house. Please contact me if you have any questions. Approved: Sincerely, ;;r:;;i;:alScientist 1200 UJcsl 33rd Aucnu¢. Suil¢ ~ ~,Anchoraf¢. Alaska 99503,(907) 561-50z10 ~ L Street, Anchorage. Alaska Date Received: #1: Time .0~a.m. #2: Time /~/~)~[ Date 10-27-77 Thursday Insp Buchholz Date 11-~-7'7/~ );~/ Insp ~'~W .~ ~ %./~/3 PROTECTION 99501 October 2~, 1977 #3: Time /~. Dat 11 -77 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska Mutual Savings Bank Mailing Address: Post Office Box 1120 99510 Phone: 274-3561/244 2. Property Owner: William/Sharon Jones Phone: 264-4267 Mailing Address: Box 1741 Star Route A 99507 3. Legal Description: Lo~8ABtSiefker Subdivision 4: Single Family Residence: (~ Number of Bedrooms: 'd Two ,~/ . Multiple'Family Residence: ( ) Number of Bedrooms: Well System: Permit # N/~ Construction Individual Well (~ Con~unity/Pub!ic System ( ) Depth of Well 176' Well Log on File Bacterial Analysis Sewage Disposal System: Permit # Septic Tank Size Absorption Area On-site System (x) Public Utility ( ) Installed 1973 Installer .~'~ /~O Manufacturer. Soils Rate /~ Material ~/~ Distances: Well to Septic Tank to Absorpt~on~Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 8AB Siefker Subdivision Comments: Affadavit Attached: (') Approved: Disapproved Letter Attached: ( ) Date: //"~'~ Date: Department Worksheet: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONI~IENTAL PROTECTION 2~l'0"E-a~-Tudor Ro~,A~Al'~ska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES __CONV 1. Type of Inspection: CMRO VA FHA 2. Property Owner:_ /___~////~.//z/¢/-~ ~,. Mailing Address: t~ Mailing Address: %~ 4. Name of Lending Institution~Z~~/~/~Z' Mailing Address: ? 5. Name of Realtor or Agent: Mailing Address: Legal Description: Location: Phone: Type of Facility to be Inspected: No. Bdrms. Water Supply Type of Supply: Public Utility. If Individual, number of dwellings presently served If Individual, depth of well /~'/~ / ,Individual / Sewage Disposal System Type of System: Public Utility If Individual, date of installation / Individual (on-site). 72-003(3/76) MUNICIPALITY OF ANCHORAGE DEPARTMEb' OF HEALTH AND ENVIRONMENT" 825 ~ Street, Anchorage, Alas. 2'79-2511, ext. 224 or 225 ~~%J~'~ Date Received: PROTECT 99501 May 24, 1977 #2: Time 1 ~)~~ / #3: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: First National Bank of Anchorage % Marie IiamS Mailing Address: Post Office Box 720 99510 ___ Phone: 276-6300/483__ 2. Property Owner: Bill Jones Phone: 274-2525 Mailing Address: NHN Jerome Street 3. Legal Description: Lot A8B Seifker Subdivision #2 4: Single Family Residence: ~ Number of Bedrooms: Multiple Family Residence: ( ) Nun~ber of Bedrooms: 5. Well System: Individual well ( ~ Community/Public System ( ) , Permit # ~/". Depth ~ell ~ Well Log on File (~¢ Construction _~/~~_ ~ ~~-~ ' Bacterial Analysis Sewage Disposal System: On-site System~ix). . ~' ~ Public Utility ( ) Permit ~ , ~/ ,,-- Installed . Installer ~ ~, . Septic Tank Size /~f~O ~ Manufacturer ~ ~/~_~/~ . . / - Absorption Area ~ ~ Soils Rate /~ Material __/ __ Distances: Well to Septic Tank ~3 ~' ' to Absorption Area ~ ~ / ~o Sewer Line ~ % /~ Nearest Lot line ~'~ / Absorption Area %o Nearest Lot Line ..~ / Page T~o Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot ASB Seifker Subdivision Comments: Affadavit Attached: ~(' ) Letter Attached: ( ) Approved: /~.~ Date: Disapproved: ~~_~~/_~ Date: Department Worksheet: / 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: CMRO 2. Property Owner: Bill Jones VA FHA CONV. Mailing Address: NHN Jerc~e St Day Phone: 274-2525 3. Name of Buyer: F~ward A. Gliva & Kathleen M, Gliva Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: Tot A-8~B, Seifker S/D 4221 Euclair 02 Day Phone: 333-8566 First National Bank of Anchorage P. O. Box 720 Phone: 276-6300 ext 483 none Phone: Location: NHN Jerome St Anchorage, Alas]~ 7. Type of Facility to be Inspected: Existing SFR 8. Water Supply Type of Supply: Public Utility_ If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation No. Bdrms.. 2 Individual Individual (on-site). x Marie Iiams 5/23/77 72-003(3/76)