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Home My WebLink AboutSOUTHPARK BLK 3 LT 8 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM/~ INSPECTION REPORT NAME [] UPGRADE LEGAL DESCRIPTION LOCATION DISTANCE TO: Well Absorption area Width &.JoU._F' L,b l "'IU NO. OF BEDROOMS PERM,T NO. , l No. of compartments Liquid depth MIT NO. DISTANCE TO: No. of lines 1 DISTANCE TO: Material Depth Crib depth Building fo~on Driller Sewer line Nearest lot line PERMIT NO.~/O~/~ Distance between lines Total inches Total effective absorpt~ Nearest lot line/ Distance to lot line /PERMIT NO. I Septic tank ~- ' ~-~- Absorpt~or~area (s) OTHER PIPE MATERIALS SOl L TEST RATING INSTALLER (] ! REMARKS APPRO ED DATE LEGAL 72-B1~ (Rev. BI?8) C~P~.I--~'; ][ TE PERMIT NO~ ( 8t058± ) RPPLICRNT JRMES E. LOCRTION BLUFF DR. LEGRL DEPFIRTMENT OF HEFILTH RN[:' ENVIRONMENTRL PROTECTION 8::-"5 'L' STREET., FINCHORFIGE., ~K. 5~E~50i 2El4-4720 '.:-_-] E !-,I E-E R P E] F.Z" ~'.'~ :[ BLEES 240:L RRSPBERRV RD. LOT 8 BLK ~ SOUTH PBRK LOT' SIZE Tb'PE OF SOIL FIBSORPTION S9STEM IS: TRENCH MFINIMUM NUMBER OF BEDROOMS = 4 SOIL RFITING (SQ FT/BR)= 24--~- 252_-< /oso S5500 SQUFIRE FEET :1.6.5 , TFIE REQUIF.!E[:,'-I-'~E.::. ~_ OF THE '-'=.uIL' FIE._,CF. FTILN-"-- ' ' ] '-'"-_-.~=TEII' IS: ,,,--.~/ /-- P' B IMEN_,ION IS TH[S:f_n.['~TN .~IN FEETi' 7. F THE TRENCH OR DRFIINFIELD. TNE DEPTH OF Fi TRENCH u..~ FI[ I_-, THE DISTRNCE EEINEEN THE .=,I_I~FR_.E OF ]"HE GROUND RND THE BOTTOM OF THE EXCFI',,,'FITION (IN FEET). ' THERE IS NO SET WIDTH FOR TRENCHES. THE GRFIVEL. DEPTH IS THE MINIMUM DEPTH OF GRFIVEL. BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE Ek.:CFI',,,'FITION (IN FEET::'. [-~:E _f;4Ll I F4:E[:, L~-;EF"]- I: C: TRP-.IK S ! ZE='= 1,;-25~Zi ~_3~'~ L L 0t'-~'..-] PERMIT FIPPL. ICBNT HFIS THE RESPONSIBILITY TO INFORM THIS DEPFIRTMENT DURING THE INSTRLLFITION INSPECTIONS OF FIN9 WELLS FIDJFICENT TO THIS PROF'ERT~ RND THE NUMBER OF RESIDENCES THFIT THE ~ELL. WILL SERVE. 8FtCKFILLING OF FIN'T' S'¢STEM WITHOUT FINFIL INSPECTION FIND FIPPROVRL B~? THIS DEPFiRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTFINCE BETWEEN Fi WELL FiND RN? ON-SITE SEWFIGE DISPOSRL S'¢STEM IS J. 00 FEET FOR R PRIVFITE WELL OR J.50 TO 20E4 FEET FROM Fi PUBLIC WELL DEPENDING UPON THE T'T'PE OF PUBLIC WELL MINIMUM DISTFINCE FROM Fi PRIVFITE NELL TO Fi PRIVRTE SEWER LINE IS 25 FEET FIND TO R COMMUNIT'¢ SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MR'¢ FIF'PLV. SPECIFICFITIONS FIND CONSTRUCTION DIFIGRFIMS FIRE RVRILRBLE TO INSURE PROPER INSTRLLFITION. F"EEF~:f'"'I ][ T' E%~:P I F.:E;S [:,EC:EI"IE:ER Z-:::L.. J_9. 8:.1L I CERTIF'¢ THFtT :L: I FiM FRMILIFIR WITH THE REQUIREMENTS FOR ON-.SITE SEWERS FIND WELLS FIS SET FORTH BN' THE MUNICIPRLIT'¢ OF FINCHORRGE. 2: I WILL INSTFILL THE S'¢STEM IN RCCORDRNCE WITH THE CODES. 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 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township,~.ar~ge) Location (address or directions) (b) Applicant Name ,,~,r~ ~'~L.~c'~-~' Telephone: Home ,~/--/'~---,/'r3c~,.-) Business Applicant Address (c) Applicant is (check one): Lending Institution [] ;.Owner/builder/~; Buyer []; Other [] (explain); (d) Lending Institution [~(].~/~ Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family/~] Multi-Family [] Number of Bedrooms 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. ~ SEWAGE DISPOSAL Onsite/~r~ Pablic [] 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, Page 1 of 2 72-025 (~,~) ENGINEERING FIRM PROVIDIh~ INSPECTIONS, TESTS, FILE SEARCH, DA ~ ,~ 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~'~--'f~%-%~ (""'~-~"~'~,~:'~ Address ~ ~' ~ Engineer's Seal .~. ,;.~ DHEP APPROVAL ~ ,, Approv, ed'for~ ~,' I ~,~, , bedrooms by ./~'~ ¢' ' ~ Apl~r0ved X' ,~,/~,' ~,i D~sapproved Conditional Terms of Cooditi~nal ,~pp,rgv~,l 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 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 Legal Description: ~_ WELL DATA WellCJassification /"?.~/Y?/YTOfJ 1...~__ _ IfA, B,C,D.E.C. Approved{Y/N) Well Log Present (Y/N) Date Completed Yield~ .-~' Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary .~a ol-~n Casing (Y/N) Electrical Wiring in Conduit (Y/N) Dpes~ion Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ~.~t/ ; On Adjoining Lots To Nearest Edge of Absorption Field on..J..etr' ; On Adjoining Lots To Nearest Public Sewer Line / To Nearest Public Sewer CleanoutJManhole / To Nearest Sewer Service Line on Lot Water Sample Collectedly ; Date Water Samp~st Results Comp~Cnts B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) ~ Fht Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) / Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course Comments Page 1 of 2 72-026 IRev 8/861 Front Size /~'~-Y-~ ~';r No. of Compartments 2 F°undati°nClean°ut(Y/N) 1 Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage MUNICIPALITY OF ANCHORAGE DEPT. OF Ht:ALTH & ENVIRONMENTAL PROTECTION 2 2198 RECEIVED ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date installed '7/o°f Width of Field / ~'h/ 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 f.T~cJ2 Lot To Water Main/Service Line To Stream/Pond/Lake/or Mejor Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Length of Field /?/i7 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) /c~+ ~,- Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) / "Pump Off" Level at / / ~Id~umping Cycles during Adequacy Test. Meets MOA Page 2 of 2 72 026 fRev 8/861 Back ** Check Permitted Bedroom..~Rati~g Against HAA Request ** , I certify that I have-chegk~d,~qe~'ifi~d, ¢/~conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signe~~ ~-,~ ~ Date Company~., ~}/~7~. MOA NO. / ReceiptNo. ~O / ~¢/ Date of Payment /&/t ~. RILL SHEFFIELD, GOVERNOR DEPT. O~ EN%'IR / ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 274-Z533 DATE: December 10, 1986 PWS I.D.# 213475 To Whom it May Concern: According to records on file in this office the Water Regulations SOUTH PARK TERRACE Water System is in compliance with the State Drinking Sincerely, ~egiona~l s~itarian Supervisor HOME SERVICES INVOICE # 1458 15900 Francesca Drive Anchorage, Alaska 99516 345-1890 or 345*2444 CUSTOMER .T-i~ ~:~1~8 4330 Southpark Bluff Drive 345-6886 Block Lot DATE DESCRIPTION AMOUNT 65 00 1.2-22-86 Pump Septic ~ , ': /~ ~ T~AL ~ ~ REMARK ';C~ /~ ~ Gallons ~tic Oesspool StandpiPes Time ~ P~OBLEM A~EA--OALL FO~ MO~E INFORMATION D NEEDS TO BE DONE AGAIN NTHS ~ Good Shape ~ludge buildup on bottom r on top ~ Jim cap missing or ~ Cut standpipe to 1' above ground ~Needs Septictrine needs replacing --PLEASE PAY FROM THIS INVOICE--