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Home My WebLink AboutHERITAGE HEIGHTS LT 8GREAi,._ . ANCHO RAGE AREA Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ,~'~V~ FCX~ ~(,~ MAILING ADDRESS ~--~ L~) /grcaL'~ ¢ PHONE ~-7~ -_¢5b'Z~4 SEPTIC TANK: DISTANCE FROM WELL '~ INSIDE LENGTH MANUFACTURER INSIDE WIDTH MATERIAL COm-cv'¢'~e NUMBER OF COMPARTMENTS J LIQUID DEPTH LIQUID CAPACITY~-O00 GALLONS. "~ FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE ~"'~ TOTAL LENGTH FOUNDATION ~)~II NEAREST LOT LINE P'31 OF LINES '~'~k~ DISTANCE BETWEEN LINES ~'~[~ TRENCH WIDTH~O IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE ¢~bI DEPTH OF FILTER MATERIAL BENEATH TILE ~ I IN. ABOVE TILE ~9 IN. WELL: (~ (/~-u. ~ c~'4r~: v~' FOUNDATION , LOT ~bl~ LIl~b~-- _ CESSPOOL ~~~R ~U~ ~ APPROVE~ DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: REMARKS: APPROVED G.A.A.B.'~ ('~ Form LQ-032 GreaTEr ANCHOrAgE ArEa Borough DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT SEEPAGE PIT , DRAIN FIELD TO BE INSTALLED BY PERMIT NO. INSTALLATION OF: SEPTIC TANK//~/f~ TYPE AND SIZE OF FACILITY TO BE SERVED ~-~ FINANCED THROUGH COMPLETION DATE ANTICIPATED · OTHER NOTE: THIS PERMIT iS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. TYPE i MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK SI / FOUNDATION TO SEEPAGE PIT L~) , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL /~ ~ , SEEPAGE PIT jO ( SEPTIC TANK ~ TO NEAREST LOT LINE. DRAIN fielD t WELL TO SEPTIC TANK / ~ ~ , SEEPAGE Pit ~O ~ DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK /O~f , SEEPAGE PIT / DRAIN FIELD SEPTIC TANK, SEEPAGE PIT (O¢~ , 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. GRAVEL BACKPILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDIN/~NCE NO. 28-68 AND THAT THE ABOVE This form reports: SoilslO~21og~ Depth Feet 2- 3- 4- 5- 6- 7- 8- 9- lO- ll - 12- 13- 14- ~,~-~-dREATER ANCIIORAGE ARiA BOROUG'h Department of Environmental Quality 3330 "C" Street Anchorage, Alaska 99503 SOILS i,O(; -- PEROI,ATION TEST //~ Percolation test _. Perform~d ~ /~ ~/~- Was ground water encountered? If yes, at wila~ depth? Reading Date Gross Time Net Time Percolation rate minute. -Proposed installa'~T~n: Seepage Pit Drain Field Depth of Inlet ................. · Depth t-d'-~bT~n-~:¢--pit or trench COMMENTS: EQ-040 (6174) Depth to Water Net Urop Date: 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 1. GENERAL INFORMATION Complete legal description HAA # Lot 8; Heritaqe Heiqhts Location (site address or directions) 6060 Yukon Road Property owner Mailing address JaniFa-~ks ~ (~ · ~ 1200 N. Nash Street ~228 Day phone Arlington, VA 279-7611 22209 Lending ag?,nCy Mailing address Day phone Agent Address Day phone o Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water xxx If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: XXX 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 STATEMENT OF INSPECTION BY ENGINEER 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 application 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 inves~tigation 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. Phone Name of Firm Address Engineer's signature __ Date D..s s.o..TU.* X . Approved for 7'~do (,~1..~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. 72-025(Rev. 1/91) Back MOA ~21 Municipality of Anchorage /~ Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L.~,?- ~ /~/~r~rr, er_~E [--/ETGRT-~ ~'//~ Parcel I.D. A. Well Data Well type /C'O~/--/C. Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Date completed Cased to Driller Casing height Wires properly protected (Y/N) AT INSPECTION~ / MUNICiPALiTY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION SEP 1 2; 199;~ FROM WELL LOG Well flow .g.p.m. Pump level1 . -L T~ SEPARATION DISTANCES FROM WEL Septic/holding tank on lot ,// ; On adjacent lots AbsorptiOnpublic sewerfieldmain°n lot // ; On adjacent lots Sewer service line / C~h~~P~ESRESULTS: D~e of sample: Public sewer manhole/cleanout Petroleum tank Nitrate Collected by: g.p.m. RECEIVED Other bacteria B. SEPTIC/i'I~'~3H~rTANK DATA Date installed Cleanouts(~)/N) y~.~ High water alarm (Y/~ Tank size Foundation cleanout Y~) Date of pumping ~//~_ J/? ~ Pumper. SEPARATION DISTANCES FROM SEPTICA=I~L=~IiI~G-TANK TO: Well(s) on lot /..~E ?~E/-~2'- On adjacent lots To property line /C) r.~___ Absorption field ~- Surface water/drainage /(_.gO ~ ~A(- Compartments / ~'"~ Depression (Y(~ ~ Alarm tested (Y/N) ?.,//~ Foundation ,~' 7'-- Water main/service line /'(~ ~- 72-026 (3/93). Front CONTIN U E D ON BACK PAGE C, LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM. J_IF:F--ST~TION TO: Well on I.~t-.----~'~~ On adjacent lots D, ABSORPTION FIELD DATA Date installed Length ~'~' / Total absorption area Date of adequacy test Water level in absorption field before test Width '~ ~ ~ ~;~ Cleanout present~N) F/z' / ¢; Results~ail) Manufacturer Manhole/Access (Y/N) "Pump off" Level at~ .Cycles tested ~ Surface water Soil rating (GPD/FF) /.~0-///c3/'¢-~ Gravelthickness ~' ~ Peroxide treatment (past 12 months) (Y/N) System type Total depth /,~ / Depression over field (Y~:~) for ~--~¢~ ~'~-~?) _Bedrooms After test ~::>"~ ~'¢-/' If yes. give date ,,t///~- Well on lot To building foundation On adjacent lots Sudace water /¢')E? SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots / c-~ ~/-- Property line To existing or abandoned system on lot / Cutbank/J~,'Jd [>4/~.~- f'JT-- Water main/service line Driveway, parking/vehicle storage area ~:~ / Curtain drain /'~o/~'~ /~'/kJ ~ ~/'J E, ENGINEER'S CERTIFICATION I cerb'fy that I have checked, verified, or conformed to all MOA and HAA Signature I7034 E~gle Ri r Loop Road Englneegs Name ~r Lo . / Baole Riv~lasEa ~77 ,:' ,:b'.,:' HAA Fee $ ~-~*0 O, Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number -- '7 DATE RECEIVED " INSPECTION APPOINTMENTS TME TIME TIME DAT.E . / DATE DATE , N S p E C./T~O R .j../ ' NSPECTOR ' NSPECTOR :: MUNICIPALITY OF ANCHORAGEI=Niv DEPT. OF HEALTH & · fl ' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTrONIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ( ) 'IOV 9 1979 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ( \ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days fgr ~;ocess~ PHONE 1. PROPER~.~WNER MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE MA,L,N ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS PHONE 4 REALTOR/AGENT MAI LING ADDRESS STREET LOCATION 6. TYPE OF RESIDENC~/ NUMBER-'OF~BEDROOMS ~ ,~ One [~] Four SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 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. SEW/~GE DISPOSAL SYSTEM /~ INDIVIDUAL/ON'SITE** /¢7¢2~''~ YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REO. UEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 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 '~ I NDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTI LITY ~.~- ~,~ - ---~ ~, Connection Verified INSTALLER '[~Septic Tank or [~] Holding Tank Size: \l~)l:~L---~ If Tank is homemade ' SOl LS RATING give dimensions: ~ ~. L----') TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS / APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany c_eEtificate) [] DISAPPROVED DATE BY 72 010 (Rev. 6/79) MATERIALS TESTING · QUALITY CONTROL SOILS ENGINEERING 2204 Cleveland Ave. RO. Box 10-1126 Anchorage,AK. g95ll 277-0251 710 Third Ave. P.O. Box 254.0 Fairbanks, AK. 99707 452-1267- zi56-5155 SF_.PT C ADEQUACY SYSTEM REPORT JOB NO. CTL 79-267 DATE OF REPORT 11/7/79 DATE OF TEST 11/5/79 LEGAL DESCRIPTION ' LOT 8 BLOCK OR SECTION Her±~aqe He±qhts SUBDIVISION , T N, R W, S.M. , ALASKA PERFORMED FOR: Western Enterprises 4101 Arctic Boulevard Anchorage, Alaska 99503 PHONE NO. REQUESTED BY: Phil Powelson PHONE NO. TYPE OF SYSTEM ' NUMBER OF BEDROOMS SEPTIC TANK WAS PUMPED r~yEs [] NO ABSORPTION RATE: AVERAGE 24 HOURS 600 SURGE RATE: 500 GALLONS IN 20 SEPTIC TANK - SIZE [] CRIB OR SEEPAGE PIT LEACH FIELD GALLONS. MI NUTES. 1250 GALLONS NOTES & OBSERVATIONS' , APPROVED BY: TEST PERFORMED BY: D.P, REPORT PREPARED BY: D.P.