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HomeMy WebLinkAboutSWANEE SLOPES LT 1212 MUNICIPALITY OF ANCHORAGE · DE,.~/tTMENT OF HEALTH AND HUMAN SER'L..~ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES TYPE OF SYSTEM ~TRENCH ~BED ~ W. DRAIN ~PRIVATE D OTHER Jldenlifv) L S" g S ENGINEERING Mummpal and S I nt I a 72-013 (3185) -EFdl]. I NO: L A I c. 1 ,..~,.~UE..D., 86() :L 67 UPGRADE 06 / I2/86 AF'F:'L.. I CANT: ADDRESS: CONTACT F'HONE: VIVIAN MCCDNNEI_L.. BOX 79 i CHUGIAh(, AK 99567 688-2416 LEGAL LEiT SI ZE:~" S!.JBD 1( V I S I ON: .::~WANE. E L-%.OF'ES LOT: ._:, SECT ! Obi 75.45 (SQ. FT. OR ~,~..,~: S. ~. LO .,,I... NA certi f'y that: ~!.,, I am Cami].iar wi'Lh the pequipement, s 3. {op on.-si'Le se~ers and ~.~el!s as set ¢orth by the Mun~.c~.pa!ity o~' Anchopage (MOA) and the State o~' Alaska. I will ins'[.a].l the system in accordance wi'l:.h ail MOA cc)des and regular it)ns, and in comp].:i, ance ~,~it:.h the des:i, gn c:riteria of' Chis permi{,, t (*ci.].l adhere to alJ. MOA and State (3¢ A!aska recluiremer!t.s f'(]l' the set back distances from any existing well~, k~as'[.[~ater d:i. sposa], system or publ:i.c se~.~erage system on th:i.s c:m any adjacent or nearby ]Lot.. ZF:' A L. IFrT S'I"AT];OIq IS INSTALJ...E)} I1'4 AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN IELJECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS""BUILTS WILJ- NO]" BE APPROVED IgI'T'HE]UT AN IELECTRICAL INSF'EC;TION REI::'ORT; AND (3) THE ELECTRICAL WORK IdI.JST BE DONE BY A L]:CENSED ELEC-I'RICIAN. AF:'PL ~ CANT~ V I V ~ AN MCCC}IqlxlELI .... S & S ENGINEERING SR B 196X F~.GLE RIVER~ AK 99577 "JUN 5 1986 SUBJECt: ~-c:~ ~k..~MPU1'ATtON SHEEq' DATE: SH~' JUNo~ 5 1986 CKD . Lq 0 'o i 3 d JUN 5 19,86 ]C '0 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DE~CRIPTION: ~'~'~ 1 2 3 4 5- 6- 7- 8- 10- 11 13- 14- 15 16 17 18 19 2O ~J',,~',.J~ ~'~L..~7~'~ Township, Range, Section:.,-r'l.~l,~ '[7~\~,J' SLOPE SIT~E PLAN ) WAS GROUND WATER ENCOUNTERED? DEPTH? . E Depth l0 Water Alter ~ ' Monitoring7 -- ~'/~ Dote: '~'~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~'~ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN __ FTAND __ COMMENTS $ & $ ENG!NEE~!Nr.; /./ PERFORMED BY: EAGLE RIVER, AK 99577~ ~~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDE~~~~HIS DATE. 72-008 (Rev. 4/85) FT CERTIFY THAT '[HIS TEST WAS PERFORMED IN 0 &' E.EI~.~NEERING &' DEVELOA.jiENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333-5240 Russell Oyster 694 2774 Civil Engineering Soils 8- Foundations Legal Desoription: Lo~ urou~dz,,atez· ~ncountersd: Earl Ellis 333 5240 Surveying Land Development Ye s %/ No Depth Depth feet Soil Classification Area Calculations ~/ 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 3 Swanee Slope Subdivision Location (address or directions) (b) Applicant Name Vivian Mc Connell Telephone: Home 688-2416 Business 688-2416 Applicant Address Box 791 Chugiak, Alaska 99577 (c) Applicant is (check one): Lending Institution []; Owner/builder [~g Buyer []; Other [] (explain); (d) Lending Institution Address ALASKA USA FEDERAL CREDIT UNI~elephone (e) Real Estate Company and Agent Address Telephone Mail the HAA to the following address: TYPE OF RESIDENCE /' Single-Family ~:×Multi-Family [] Number of Bedrooms three(3} (f) Other WATER SUPPLY Individual Well [~xx 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 ~x Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Oepadment of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVII~,~ INSPECTIONS, TESTS, FILE SEARCH, L,-~'A AND INFORMATION As certified by my seal affixed hereto and as of the validation d~te 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 suppJy 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 Corwin & Associates Telephone Address Date Engineer's.Seal This department has received written confirmation from the engineer regarding the Conditional Approval of June 13, 1986.~-~-~£ The corrections have been accomplished and an inspection has been completed by the engineer. The subject property meets with Municipal standards and is now approved. DHEPAPPROVAL ' ~ Approved for ~hree(3) bedrooms by - Approved XXX~ Disapproved Conditional Terms of C6nditional A~pmval Date September 10, 1986 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 engineerls work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE ~.j ENVIRONMENTAL PROTECTION !DIVISION OF ENVIRONMENTAL HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY 264-4720 ship, range) ~i (c) Telephone:Home ~0 ~ ~',~ L{, [ (~O Business (~o ~ (~-~:~ L! ,licant Address '~'~.%, ('%-"~. ~ C[I ~' k, ~ 4 f,~ IC[ I~, C~ (~l_/~'-~ '~ Applicant is [check one): Lending Institution []: Owner/builder..,. K; Buyer []; Other [] (explain); id) Lending Institution Address Telephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family I~Multi-~Family Number of Bedrooms Other 3. WATER SUPPLY Individual Well [~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmenlai Consei vation attesting to the legality end status. 4. SEWAGE Onsite I~',;:;,P,,~blic U;~]~Community [] Holding Tank [] Note: If community;well system must have wr tten confirmation from the State Department of Environmental Conservation a testing to'the legality and status 5.; ENGINEERING FIRM PROVI~ INSPECTI( As certif~.ad by my seal affixed hereto and ~ Authority Approval shows that the on-site water for the number of bedrooms and type of structure indi~ from the Municipality of Anchorage files and from wastewater disposal system is in compliance with all Muni the date of this ins~)ectiop. Address Date Z// ..~U../t~t ! Tel6 ¢~w~c/A AND INFORMATION I,~,erify that my nvest gat on of th,~ls Health I system is safe, functional and adequate 'that based on tim information obtained the on-site water supply and/or ~ces, and regulations in effect on Engineer's Seal DHEP APPROVAL , Approved for '¢'-¢~--~-c"'¢)bedroomsby?(~-~ ,,,42- '~77~-~.~.,-~¢- Date Approved ~ Disapproved Conditional Terms of ConditJonal Approval The Muncipality of Anchorage Departm~ent of' Health and Environmental Protection (DHEP} issues Health Authonty 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 purchao~rs of .omes 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 ?2-025 (11184) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) JUN 0 CHECKLIST - FEBRUARY 1984 264-4720 .ELL OATA VM *ell Classification ~.kC~ ~*'~('~LI~-.~ IfA, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) /~ (~ Date Completed /o ' .~-~¢ "~ ~ Yield Total Depth lJ~ ~ ''~ Cased to_ [[~' ~ DePth of Grouting Static Water Level ] J 01 Pump Set At MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Sanitary Seal on Casing (Y/N) . y~ Depression Around Wellhead (Y/N) ~ 0 To Septic/Holding Tank on Lot (~ ! '~ ~'¢~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot J ~0 t ,¢¢.¢¢~; On Adjoining Lots + /OOI To Nearest Public Sewer Line /~/A To Nearest Public Sewer ! Cleanout/Manhole ~//f-~ To Nearest Sewer Service Line on Lot /~/~f Water Sample Collected by /,. ~,~/2~t"' ;Date ~*~ Water Sample Test Results ~Q~.-~J/~b£ ~ SEPTIC/HOLDING TANK DATA Date Installed ~, Size No. of Compartments Standp pes (Y/N) '%'%,_ Air-tight Caps (Y/N) Foundation Clean_gut (Y/N) Depressi ~°n over Tank (y/N)~"'~ ' Date ~~ ~ Pumping/Maintenance Contract on~ ~-/ ';for/) Holding Tank High-Water Alarm {Y/.N!,. _ ,~....~~ Holding Tank~ Separation Distances from Septic/H~nk: To Water-Supply Well ~ To Building Foundation Prope~'''~- To Disposal Field To To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/841 C. ABSORPTION FIELD DATA Soils Rating inlAbsorption Strata Type of System Design Length of Field Depth of Field / Gravel Bed Thickness / Standpipe/nt (Y/N) Date o~,~/Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: ~ / To Water-Supply Well To Building Foundation Lot / On Adjoining Lots To Water Main/Service Line To Stream/Pond/La~inage Course TC~ ~ Area. or Vehicle Storage Area To Existing or Abandoned System on To Cutbank (if present) D. LIFT STATION Date Installe~ Size in Gal,l, on% Vent (Y/N) > Tested for ~ Pumping Cycles during Adequacy Meets MOA Electrical Co~ ~'""~--~ _ _ ~ Comments Dimensions Manhole/Access (Y/N) "Pump 0 ff.~..evekat-~-~'--- I certify t hr~t/I;(¢~,e chec,~eO¢, verified, or conformed to all MOA and HAA guideli nes in effect on the date of this inspection. Signed /~/( "~ ~ Date ~ ~) / ~' Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal ~'o~a~han Bettridge ~ DVM P.0. Box Eagle River, Alaska 99577 May 45, d986 Department o£ Health and Human Services Municipality of Anchorage P.O. Box 496650 Anchorage, Alaska 99519-665© To Whom It May Concern: I am aware that the McConnell's drain field for their septic system is presently on my property which is adjacent to thiers. They have my approval to continue to use this drain£ield until July 45, q986. Yours truly~ ~ . ~/onathan Bettridge, DVM MUNICIPALITY OF ANCHORAGE ~i'i ' ?? ', ~ ' ~ :~  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION I~ = ,' , ' / ' ~ Telephone 264-4720 ,~ ~ ~ ' ' REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES GAL DESCRIP ION STREET:AT,ON 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ One ~ Four ~ Other ~SiNGLEFAMILY ~ Two ~ Five MULTIPLE FAMILY Three ~ Six 7. WATER SUPPLY  INDIVIDUAL* //~- ! * ATTACH WELL LOG. A well log is requ'ired for all wells drilled since June 1975. For wells drilled prior to that date, give,~ ~-weB COMMUNITY depth (attach log if available.) --,.,;i~N [] PUBLIC UTI LITY S. SEWAGE DISPOSAL SYSTEM' / ~..~/.~_ · *If individual/on-site, give installation date / 7/"-,~' ~ ~,/,~NDIVI DUAL/ON-SITE** If system is over two (2) years old an adequacy ~est is required [] PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPEC~fOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMRER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER E~]Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) []~--~ DISAPPROV ED DATE BY (Title) /7 LEGAL DESCRIPTION 72-010 (Rev, 3/78) Chugfak, Ala ~ka Swanee Slopes Lot 3 BIRCH DR. [B607