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Home My WebLink AboutSANDI HEIGHTS LT 6Aj i Wi 0 WN PMRrkla- 0\-aaa-3g 72-013 (Rev. 9/91) MOA 25 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5cd 61903 zs_PID Number: Name:. Wastewater System: 1:1 New <Upgrade /f/+� L �� h Uel � . Address:ABSORPTION FIELD 933 - K o K T Phone: No. of Bedrooms: 2- f-3--+-34 3 P Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depthl m original grade: C , — GPD/Sq. Ft. Lot:Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe /� C F� A 5 ® HF/44-7_1 , 2-. Ft. 61,45—Ft. Township: Range: Section: Fill added above original grade: Gravel length: �'i,jp Ft. M/vim/tri Ft. Gravel width: Number of lines: Distance between lines: WELL: ❑ New ❑ Upgrade j Classification(Priv ta, A, B,C): Total Depth: Cased To: Total absorption area: Pi a material: 7—M v — Ft. Ft. .S' SQ. Ft. -1; Driller: Date Drilled: Static Water Level: Installer: 5 !�/ Date installed: Zc Ft. Yield:Pump Set at: Casing Height Above Ground: f� TAN K GPM Ft. Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Material: Number of Compartments: Well -00 > 1Dof /� Surface'�� Water LIFT STATION / / �/ Size in gallons: Manuf cturer: Line 7 '% /f "Pump on" level a ump off' level at: High water alarm at: Foundation 'D Curtain �(�, Pump Make & Model Electrical Inspections performed by: Drain T� BENCH MARK Remarks: l Location and Description: C.LY� Al CA Or- PEC_r,L Assumed Elevation VC), D 5 MA Inspections performed by: /%x A— Dates: 1st I . .4 •!, �rJ/�t lGrll T 2nd !J ES M. ;'v IGH `�''•., CF 8841 Department of Health u an ices approval #$.,, e `f .•,.•�.� X's,��e� Reviewed and approved by: ate: .� 72-013 (Rev. 9/91) MOA 25 Permit No. 40_1%S Page -2-- of _f:_ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description:.�pl �E �LL�lF7S LT4,4 PID No N U F Z � Q O � `S E I � II W F� E cnF � � O Z � � O O M O m N F W a v V In Ox I cn zw W H J o 0z U Q o N z € O D Z Q Cn TF< gOF A4 it • U p V 4 • °� A 11 • • r• •• JA • ES .1h' Gii :.g 0 ��+ CE 8841 Y F Z � Q O � Z (7 az Permit No. ,62(e,)� QD 7..5 Page of T- Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: © T 4 PID No. POINT CNR. A CNR. B ELEV. REMARKS C1 68.6 56.0 92.5 INV, OF PIPE C2 58.7 75.2 92.5 INV. OF PIPE M1 59.6 67.5 86.9 MONITORING TUBE a� OF At XII y. ' TH •, JRFdES M. IN GH7 ; CE 8841 P 10 GI- 9TM • • Municipality of Anchorage a DEPARTMENT OF HEALTH & HUMAN SERVICES ��%%f�6•% . 825 "L" Street, Anchorage, Alaska 99502-0650 ; JAMES M. WR1GH SOILS LOG - PERCOLATION TEST CE ya'' PERFORMED FOR: /� f��1L % S ��PI A/ DATE PERFORMED: �/�/✓�/ l��/C,—If TS Township, Range, Section: LEGAL DESCRIPTION: 1 n % SLOPE SITE PLAN DEPTH (FEET) ®/'1 ✓i T/Y !L- `�" �%- 1 2 3 4 5 /AiIV 6 7 8 9 10 11 12 13 14 15 -I 1 w 164----4 0 O %�'O NI 17 18 #-v ` >e 19 WAS GROUND WATER A/0 IF -iz- IF YES, AT WHAT DEPTH? Depth to Winer Agar Manbring? Batt 20 -{ IL—�I PERCOLATION RATE (mmutewinch) PE RC HOLE DIAMETER TEST RUN BETWEEN FT AND FT :OMMENTS IVi� 9E QA /9 6 6 %O✓CG(J/ViFi tT ��/� i4 24 -A iJ F I PERFORMED BY: J/ �rl1/I 2� S /S�l k lei LY �/ ISL%` CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: U2Zq MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 �'uk i o I Cc, Lk,.30pAl % 0 - /"�q ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940375 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:SAVOINI CHARLES W & WENDY W OWNER ADDRESS:9334 KAVIK ST ANCHORAGE, AK 99515 PARCEL ID:01122238 LEGAL DESCRIPTION: SANDI HEIGHTS LT LOT SIZE: 10624 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: W. DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 9/30/94 EXPIRATION DATE: 9/30/95 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: TO HAVE THE TOTAL DEPTH OF THE TRENCH TO BE TEN FEET, IT MUST BE CONFIRMED DURING CONSTRUCTION THAT THERE IS NO BEDROCK TO ADE TH OF 16 FEET. RECEIVED BY: DATE: G l ISSUED BY: � DATE: �/ September 14, 1994 Department of Health and Human Services Anchorage, Alaska Re: Onsite sewer system design for Lot 6A, Sandi Heights Subdivision. Dear DHHS, This is a request for an onsite sewer permit for an existing residence located at the above address. The existing system has been in place about 20 years and has failed. A test pit was excavated located as shown in attached plan view. The soil profile showed a sandy/gravel to a depth of 18 feet with a percolation rate of than 1.3 min/inch. The existing tank about a year old and will remain. .No impacts to the surrounding properties are foreseen. All have onsite systems already and appear to be preforming adequately. The required set -backs are easily obtained within the confines of the lot. The topography of the area is flat. The lot footprint is about 78 feet fronting Brooks Street by 136 feet deep for an area of 10,600 square feet. Sincerely ell414- James M. Wright P.E. _ I_]] I I I IJ I J�`�..- 1 1 -1_ I I ��,I� ILI I J_I JJ !TI 'J� L1JJ-I IJ JJ uT«J -I� UPJ IIII��-'TJ LJ IJ ITT -I 7 I J-�J I=1 rI. '- J -` I-1 IBJ II I r_L J;J 1J�JJ-JJJ� IT ,JTI uJ JJ JIJI u_L.I JJ7_ II_,JJ J_J-Ij J 'JJJ- J 1 i=1I I_IL_L JJ�7r�m�I I- I I_ I I S I I , �y�JII -IJ��I Li J ITU�I I�i�l I I I �� LI LI]]_I 1 I I 11_ _I_ ' I I ! I 1 J=1 I. 1 I LII J Ll _� -I I - J ( I -I I� _TiT{J�_l 1_�_� - l - 1 171 J I [J I.. f � � I J I I I III I I I I� IF -r I I II II I w� I I I I LI uT I r �_ I ❑ I�� ---J.III -I_I J_. 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I.I J Irl I I'L jjl 'I f IC U IJ-- TI . �i IJ _ I, �a • JJ_II 1 J ry�y '• ISI IIJ J JTI�JT7 �°5 �L � ' JJ � _I -I_ J �I I_ _ J 1 1 IJIT 1 ] L IJ �u� U L1 J J_IJ II ! J ITI L L 117 M I I J- IJJJ I_ UJJ I_IJ� I_1 IJ �_ (I f, ��I��I T _I. ��I��I��W T�T� f� 1 1 I J ITTI_l1'I �1�, L: �, , 1 } -I_ 1 qq 1 1 J ! J 1-1 IJ f 1 I I� I I I L T 1_J_I --- I I Ll I I 1 I j --L IJ +I-FII�'lI V I I 17.. I I- I iJ llLI I I� IJ J 1 T�I l-1 I]1TIIJ I_I LJ_JJ _!. L� J uJ iJ_ J-'�i IJ I. 1 _ I�L1 . 1 !_L��iI-IJ,� 1 IJJJJ IJ I 1 I II IJ�-} ! 1 I I�T1 _LJJ. I, I� L 1 1-1 L1._ J_ L♦ a YL _ - ! I. ,�r�l Y .I LI•I�I 11 li IyLI •1 aal �" _.� I��- �- I� I_ 1. L"I I rI 'I t 1 1 - _LJJJ-I _I_I_J.. ITI ! I-1 I_i-I LJJ J_ I I � J._ I - i �� T iTl 1' _I If1 1_ J I�T I�--I- �1J �_ 4.�.�J�1 I_I I � � • } 1 C!�i91 � '. � , I L y,vJl I � .�-ITI II r JI L,_ ` J T 1- f Lrl7 LiJ fJ -H J J -L]- _JIJ T f I- LLL � JI-- u TTI ji - J 1 IJTL 1 1 1 � r J J ` ` L' J r'.. ILI - H 1 1 IJ I I I_ I-_ ,_, III J _( ITI J JJ I_IJ_IJ I_JJ._I II -I I I I_' r -JL,_ J I_ JJJJ JJ I_I I_I_L 1_ LIJ_J1T 1_.I Lf ITI I I ITiJ L _I_LI�IT��IT11�1 -_r _-h _ L u_I_i I II - �I 1 1 J J -I 1 1=1_I J 11J L I 1 J I1 ILLI -I I_I.J ! [ J- T_' L 17H T11 I__ J:I �J ,. _ = l L.J_ VI 1 LrJ-T -I. IJ I I.1 ff __ 1 -f:-_, L L__. _I L._L_I 1 1 1 1 1 J --I�1 1 1 1 1 111 7 TL IJ If J LLl_U J_ -I L 1 2 5 6 Y 9 10 11 12 13 14 15 16 17 tE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST i �`JIiNGTNEER'S;�w, 4 6v:9TH �. 9 J�,',iES M. W GHT . I CE 8841 . _•�' PERFORMED FOR: SCc L1 cC ! i n c7 DATE PEF�FORMED. L oT 6 ejy /E Lit --4 LEGAL DESCRIPTION! ��`/ Township, Range, Section: o�H—I SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS r�4'rIq �- �41'ir/V J WAS GROUND WATER ENCOUNTERED? S T WHAT L O P E Atter Delo 7 9 IF YES, A DEPTH? Depth to Water Mortbrinp? PERCOLATION RATE 1 3 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN Y FT AND 2 rT PERFORMED BY: IWIg °" /T- (dA16- //- % I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE �J 1 72-008 (Rev. 4/85) 4 CD :Is SAUU(\dH LLJ :oP w 78.21 ^ O N 00006'00" W co 0 zLd Q0 0 00 .. Q o 00Ln C) 0 0 Ln Ln0 m N J) w w wm 0-) 00 CDm _ 00 z O w w o z F J cn WE 0 w u CD aisnOH 0 0 = m ONIISIXI z o O m U) � W< w o = w o o — m w o ° Z z m Qw o f U� Q z Q � O 0 0(� � U o I-- m z L Q o O U- O�ys o Q 78.21 ' z w AN 00006'00 W J Q 4' 32' 4" CLEAN OUT PLAN VIEW 32 LIN. FT. 4" PERFORAT S = 0.0`x, 4" MIN. COVE ELEVATION 6'T SECTION LOT 6A, SANDI HEIGHTS _ FROM SEPTIC ® TANK 4"CLEAN OUT MONITORING TUBE FILTER FABRIC ..I 6" FILTER FABRIC FROM SEPTIC TANK 4" PERFORA T FD PIPE DRAIN ROCK MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division of l-- 2 2 2 — 36' 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 v ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NameDISTANCES 0.J. ❑ TRENCH ❑ FROM TO SEPTIC TANK ABSORPTION FIELD WELL Address Total depth from original grade WELL z_ -D FT Phone(s) 2117- Permit No. nom 43 No. of Bedrooms 1 LOT LINE 1 t� � 1 FT LEGAL DESCRIPTION Lot Block Subdivision ol c:> FT Total absorption area Township, Range, Section 2 Distan etween lines AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, etc.) TANKS IN FT 11 A— I I t 2r 7j I I IS 1 1S Pipe material SS� SEPTIC ❑ HOLDING Manufacturer �- SQ FT Capacity in gallons 1 Material WELLS ❑ PRIVATE ❑ OTHER (Identifv) Classification (A,B,C) Total Depth Cased to FT FT REMARKS: S & S ENGINEERING 17034 Eagle River -0' rjar,}!o RiuPr, Alaska 9c< Municipal and State guidelines in ellect on this Health Department Approval IZ-V 10 (J/OD) J1, %�;--1. Inspections Performed by: �5 Date: ("Io,Q /"� /� 11 V'\ that tl's inspesfan as perfor ,ad according to all th i'f- v 00, Date: I 3YFjY y, .v v s o00 4+Qaocl.�sa ^e ;. - n••an eyq o�apx I tart A.. S't' '� :,�; a No, 14-37•t: LvF p�OfiE:�S',Or TYPE OF SYSTEM ❑ TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER De to pipe bottom from Total depth from original grade origins ade FT FT Fill added above nal grade Gravel depth beneath pipe FT FT Gravel length Gravel width FT Total absorption area Distan etween lines SQ FT FT Number of lines Soil rating Pipe material SQ FT Installer Date Installed WELLS ❑ PRIVATE ❑ OTHER (Identifv) Classification (A,B,C) Total Depth Cased to FT FT REMARKS: S & S ENGINEERING 17034 Eagle River -0' rjar,}!o RiuPr, Alaska 9c< Municipal and State guidelines in ellect on this Health Department Approval IZ-V 10 (J/OD) J1, %�;--1. Inspections Performed by: �5 Date: ("Io,Q /"� /� 11 V'\ that tl's inspesfan as perfor ,ad according to all th i'f- v 00, Date: I 3YFjY y, .v v s o00 4+Qaocl.�sa ^e ;. - n••an eyq o�apx I tart A.. S't' '� :,�; a No, 14-37•t: LvF p�OfiE:�S',Or MUN{ClPALl[Y OF ANCHORAGE Departmeni of Health to Human Services . ~ 825 L Street, Anchorage, Alaska 99501 343"4720 ' ON-Sl[E SEPliC f A N! K P E R 11 1T ��m��[��8 Permit Number: 900078 Upgrade ` Daie T``'::�uedl : 04/24/90 Engineer Designed Owcp, Name: H^ U" D. Day Phone: Owner Address: 605 W" 4TH AVENUE 271~2792 ANCHORAGE, AK 99501 Parcel Id: 011-222~38 Lot Legal: Subdivision: SANDI HEIGHTS Lot: 6A Block: NA Section: 15 [ownship: 12N Range: 4W Lot Szze 1V624 (sq.ft, or acres> Max 8edrooms: This PermiL: 3 Tntal Capacity: 3 SL�|1C |ANK: Minimum total septic tank capacity: 1,00O gallons. Each sepLic Lank must have at least P: compartments. Depth to top of septic tank(s) ;eet requires insulation over tank(s). NOW l EXPIAS UECEM8ER 31, 1990, l CERllFY /HHN 1. 1 am /mull |iar NOh the Mquirements 1m on'site sewers and wed Los as set forth by the MunicipaliLy of Anchorage (MOA) and o{ Alaska, 2. 1 will insL0111 the system in accordance with all MOA codes and regulations; and in comp1iance with the design criLeria of this permit, 3, l will adhere Lo a11 MOA and State o{ Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot, 4. l that this is Wr o[ 3 bedrooms. l understand permit valid a maysimum also understand that the capacity of the t.oial system is 3 bedrooms and uny enlargement wi1l require an additional permit" MUNICIPALITY OF ANCHORAGE ; ® "DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 82.5 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME__ 1r(1�aa�_ ! 6 10 P k PHONE � `�t;�j �� NEW PGRADE MAILING ADDRESS 1� , LEGAII, DESCRIPTI N/� �I R kj�I I+ LOCATION NO. OF BEDROOMS 0 V Y Well � DISTANCE TO: k- l tom. 77 ! ,lll Absorption area Dwelling PERMI � � ' _ a Q wF Manufacturer Material No. of compartments w Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth ❑Y J(D2 DISTANCE TO: Well Dwelling PERMIT NO. 02< Manufacturer Material Liquid capacity in gallons ❑ w = DISTANCE TO: We , oundation Nearest I t1ine PERMIT NO. J LL z F z W No. of lines Lengtbof each line Total length of lines Trencp�idth Distance LU lines inches f.. ❑,, Top of tile to finish grade Material beneath the Total effecti bsorption area inches w C7 Length Width Depth PERMIT NO. a. F LU Type of crib Crib diameter Crib depth Total effective absorption area hWell DISTANCE TO: Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS Hj az� SOIL TES RAT INSTALLER j +tl sb A D DATE LEGAL rz-uta lnev. J/ 1b) ___4 ` DEPARTMENT 825 , ^ ` cl lr-.g-_-S-5 I -r F=� PERMIT NO. ( 800299 ) APPLICANT JOHN RALPH LOCATION KHVIK ST. LEGAL L 68 5AyVDI HTS ` HEALTH AND ENVIROMMENTHL ?OTECTI{}N M-r��77T� STREET/ ANCHORAGE, HK. 9` 1 [\�c_<y`(l'Q^g[l 264~4��0 �� 9]]4 KAVIK 24]� LOT SIZE 15000 SQURRE-FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MHXIMUM NUMBER OF BEDROOMS � ] SOIL RHTINQ (SQ FT/BR)� 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: 1 92.1 L_r--rAa-lF"= �2.0 93F;?'n%0E:R �F�'* F�ll -F H� � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIEL[> THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO -SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT' DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. -T- 9.4 C-1 :2 1 V-4 0—S. F='k_= 0 -r I RD r -J F� Fe.� �� BHCKFILLINQ OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM @ PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ��P1 I -IF I Fz?E::E; �� 2:1L, �_0=4f::_3 C-1 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS AS SET FORTH By THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. 14, SIGNED: NFRA PH ISSUED BY_�.�=��-_~L��~-~_DATE --------------- Y4.0 GAAB-HD-1 . GRf SER ANCHURAUE AKtA ISUKUUI y DE'vATMENT OF ENVIRONMENTAL QUALIhi 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279.8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING 1 ( PHONE - NAME --LA \ ri! +YIJJ'//: _ ADDRESS A J fir'. -617 < l/s/�✓l 'I . LOCATION ' %� 7 /li'h %� LEGAL DESCRIPTION :-6114! SEPTIC TANK: NUMBER OF DISTANCE FROM WELL �' %i77/1')//rl/�Ir MATERIAL `&O Ar- ��` COMPARTMENTS LIQUID CAPACITY GALLONS. INSIDE LENGTH SEEPAGE SYSTEM: SEEPAGE PIT: LIQUID INSIDE WIDTH DEPTH NUMBER OF PITS 1 OUTSIDE DIAMETER -- OR WIDTH , LENGTH %" , DEPTH /- % , LINING MATERIAL leen crfi) DISTANCE FROM WELL �'t` tli'Jl' !!I , BUILDING FOUNDATION , NEAREST LOT TILE DRAIN FIELD: TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) FT. TOTAL LENGTH DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE OF LINES NUMBER OF LINES DISTANCE BETWEEN LIyE$ —y� TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE _ DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE W ELL:DISTANCE TYPE /1-1. TYP( /1. , FROM WATER DEPTH ,BUILDING FOUNDATION. SAMPLE , NEAREST NEAREST SEPTIC SEEPAGE OTHER LOT LINE SEWER LINE , TANK , SYSTEM _ , CESSPOOL , SOURCES_ DIAGRAM OF SYSTEM DISTANCES: i �t:IL_ GliLPasi"-lYbal %' .. ,.. ....... - �ct7i�� 11tn� AtJ, 1 I� DATE i 1772 /!.1 , % `i APPROVED kIl/'LC_ /))arj/1li ci, G.A.A.B. E• B t; Municipality of Anchorage s678 �=-, ,� Z On-Site Water and Wastewater Program 3 a , (907) 343-7904 �< • <•:►,. .add T Y Certificate of On-Site Systems Appro Arn 1019 Parcel I.D.011-222-38 Expiration Date. • 1,-Y^ c.-/ L9 1. GENERAL INFORMATION: Complete legal description SANDI HEIGHTS; LOT 6A Location (site address) 9334 KAVIK STREET*ANCHORAGE,AK 99502 Current Property owner(s) CHUCH AND WENDY SAVOINI Day phone 230-1190 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ � Waiver Fee $ Date of Payment 4M/19 Date of Payment Receipt Number 0326 oZC') Receipt Number COSA# aiq f 1O& Waiver# 5. 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, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Gamess Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: V d e�( In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and 00�00�.‘ industry practices. The reported results describe the condition of the system/s on the date/s of the ' OF A I OQ4 evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells ,:.:=2:7_,K P�.• 7V/��0 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, Q'- •. �) f On groundwater levels (that may fluctuate during the year), quality of construction (materials and ,i 4 • TH IIS �*VO • • workmanship), and the water usage of the family utilizing the system/s. These conditions can vary,and ..•••.• ••• •• ••AM, •••• •.••• are outside the control of GEG. Satisfactory test results do not guarantee future performance of the Q system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of / (I . ,' V the well or septic system. GEG makes no representation whether an alternative well or septic system 0 -'fr.) A. Cornu s o can be installed on the property in the event either of the current systems fail to perform adequately in Qi1 • CE— • Q� the future. The content of this report is for the sole benefit of the person/party that retained GEG to Or,' ' , •• .<-0 perform the evaluation. Reliance upon the information provided in this report by any other person or Z 0,_ •..,,,,,..••' ��°o party (including subsequent property purchasers) is not authorized. nor will it confer any legal right �Q GIp�ofess�0 6' whatsoever. ��4OoQ4 � P� 4 6. DSp SIGNATURE System #1 Approved for --- 3 bedrooms System #2 Approved for bedrooms �\�`-=i '"(`tiy5, l" •(, Disapproved S` Conditional approval for bedrooms, with the follq vin:• . • .OP), t '': ,-t 464,t,;t4ti i 0 -rte ----------- By: --------S .1..-\__ Original Certificate Date: `7 - l z _1 r The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist ---7 Nitrate Advisory Septic System Advisory Arsenic Advisory ` Well Flow Advisory Other_'t�cO d u/iS r 01" (-–i k v-A-..r C. - If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: SANDI HEIGHTS; LOT 6A Parcel ID: 011-222-38 A. WELL DATA Well type COMMUNITY If A, B, or C provide PWSID# 210485 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (abo - •round) in. FROM WELL LOG AT I -` CTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RES : Coliform colonies/100 ml. Nitrate mg./L. Collected by: enic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA SEPTIC TANK LIQUID LEVELS WERE IN THE NORMAL OPERATING RANGE ON 4/5/2019 (49-49.5") Tank Type/Material SEPTIC/STEEL Date installed 4/26/90 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y//N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/3° t 6 Pumper M A D..J,e.-CAf PUMP0rd(r, / I /\ "'\ ST'f -1-iC- C. ABSORPTION FIELDDAA !*BELOW EXISTING GRADE AT MONITORING TUBE Date installed 10/29/94 Soil rating g.p.d./ or ft2/bdrm) 1.2 System type DEEP TRENCH Length 35 ft. Width 1.5 ft. Gravel below pipe 5.5 ft. Total depth *9.7+ ft. Eff. absorption area 385 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 5/25/18 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 524 gal. New depth 25 in. Elapsed Time: 303 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date – • MONITORING TUBE EXTENDS 60 INCHES BELOW THE INVERT • MONITORING TUBE DRY DURING GEG INSPECTION ON 4/5/2019 D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at .. wa er alarm level at in. - . •• Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WELL Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main '•• . sewer manhole/cleanout Sewer/septic service line Holding tank - . containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation *54. Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+PVT&200'+PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation **10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+PVT&200'+PUBLIC F. COMMENTS *MET CODE AT TIME OF INSTALLATION **5.5 FEET TO SHED G. ENGINEER'S CERTIFICATION .`P,.•••" .,1+.�C... I certifythat I have determined through field inspections and • 9 ,•I \ �•*•�� 9 P �� /.. . •• review of Municipal records that the above systems are in •1, • • conformance with MOA COSA guidelines in effect on this I. 1 • date. ♦�•: J f r y4 •. Garness i V Engineer's Printed Name JEFFREY A.GARNESS Vjp;; C — •5 ;.�: *"...y Is Date / 9 '44 PROFESS\��•• LICENSE ��lii"`ok* #AECCBB4 (Rev.10/12/12) MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 1 • H r ) 907-343-7904 On-Site Water and Wastewater Section \ "'r / Fax: 343-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On-Site Systems Approval #0SC191106 Subdivision: Sandi Heights Lot 6A Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 29 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like.— It �a+l V. a T' � J d yit + 4.. 1 :Y'Y. t ••. +b• ar • - Pts w. P ._ --':,,, ,'-r.' - ''''.1-: - , OW, %itC' .,,,-,\--:`'?"' --- - - -- ''' - 0 • sp fi . 4 Mailing Address:P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org %� Municipality of Anchorage On-Site Water and Wastewater Program (''' 20 20 • �� l (907) 343-7904 ► s 1 T Y Certificate of On-Site Systems Approv68L9 �ti � Parcel I.D. 011-222-38 Expiration Date: s-36 —1 7 1. GENERAL INFORMATION: Complete legal description SANDI HEIGHTS; LOT6A Location (site address) 9334 Kavik St.*Anchorage 99502 Current Property owner(s) Chuck&Wendy Savoini Day phone 230-1190 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Ei Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: =/-7—N-1) COSA to be released to engiri er, unless otherwise requested by the engineer. COSA Fee $ 6 0 - Waiver Fee $ Date of Payment CO 2( —1g. Date of Payment Receipt Number OC)-72-2 G Receipt Number COSA# (-CIg `�g D Waiver# 5. 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, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: (7) 4)i 00000pp O In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o OF A 4�Q in accordance with the guidelines and regulations established by the Municipality of Anchorage and •.• •'• qt 'cn � industry practices. The reported results describe the condition of the system/s on the date/s of the p••.\_' / VO evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells ' ,Tr ' 4* H \\ '.3 VO and septic systems depend upon a variety of variables, including but not limited to, soil conditions, g groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary,and ��... are outside the control of GEG. Satisfactory test results do not guarantee future performance of the - fr- �G.n ss. system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of '009 '. CE 79 3 the well or septic system. GEG makes no representation whether an alternative well or septic system s / c O can be installed on the property in the event either of the current systems fail to perform adequately in Q�f�rP b4' �co� the future. The content of this report is for the sole benefit of the person/party that retained GEG to 0'P ofess��00\ perform the evaluation. Reliance upon the information provided in this report by any other person or �1O000o�Q party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE 2( System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Q�� OF�V�ho Conditional approval forbedrooms, with the following) tipula TE Ci WATER INN° v WAST CWATFR `C) PROGRAM =' • By: Original Certificate Date: �j'2:2.- 1� The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10.12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: SANDI HEIGHTS; LOT 6A Parcel ID: 011-222-38 A. WELL DATA Well typecoMMUNIT' If A, B, or C provide PWSID# 210485 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N Total depth ft. Cased to ft. Casing height(ab• - •round) in. FROM WELL LOG AT I CTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RES : Coliform colonies/100 ml. Nitrate mg./L. Collected by: • enic: ug./L. Date of sample: 28 YEAR OLD STEEL SEPTIC TANK IS B. SEPTIC/HOLDING TANK DATA APPROACHING THE END OF IT'S USEFUL LIFE Tank Type/Material SEPTIC/STEEL Date installed 4/26/90 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) N/A Date of pumping 51/30 /1 $ Pumper k4 Q ba0.--‘,0 C. ABSORPTION FIELD DATA •BELOW EXISTING GRADE AT MONITORING TUBE Date installed 10/29/94 Soil rating •.p.d./' or ft2/bdrm) 1.2 System type DEEP TRENCH Length 35 ft. Width 1.5 ft. Gravel below pipe 5.5 ft. Total depth *9.7+ ft. Eff. absorption area 385 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 5/25/18 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 524 gal. New depth 25 in. Elapsed Time: 303 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date — MONITORING TUBE EXTENDS 60 INCHES BELOW THE INVERT • D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off'level at '• wa er alarm level at in. •- --- Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WELL Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main '•• ' sewer manhole/cleanout Sewer/septic service line Holding tank - - containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation *5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+PVT&200'+PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation **10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+PVT&200'+ PUBLIC F. COMMENTS *MET CODE AT TIME OF INSTALLATION **5.5 FEET TO SHED '.l%* %*li G. ENGINEER'S CERTIFICATION �.��....OF l . ..„. a �; •a ' .1 I certify that!have determined through field inspections andr. 9 . review of Municipal records that the above systems are in • d conformance with MOA COSA guidelines in effect on this ••• • date. °•�^ f• A. arne :4�/i Engineer's Printed Name JEFFREY A.GARNESS •••J' DE7 Q••;:•��:i Date 6/6/i •4.OFESS\ � •� LICENSE tit„” #AECC884 (Rev.10/12/12) MUNICIPALITY OF ANCHORAGE • DEVELOPMENT SERVICES DEPARTMENT Q___.- f r 907-343-7904 On-Site Water and Wastewater Sectionj' Fax:343-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On-Site Systems Approval # OSC181282 Subdivision: Sandi Heights, Lot: 6A The septic tank for this property is 28 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. t ,. Fes's X144, ,, ;y. ;; .•„ '.` �` t,. ., ; .1G. 7., �"--y#77 .. 11:. - '. � ; '14:'sa ret+ `�' It. .0 ' � d' g , is , „ , , ... • • Yx.:y 11 • t.^� $(.- v: �R ,k f, v,r.'l .,y 22 Mailing Address: P.0.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org N 89 58' W 135.86 L yvc�Q F -_99000 RET WALL 0 VI - y..i DOG RUN i 20.0 �..__ -14.9 ' 'ONE FLOOR IN DOG RUN IA ASPHALT DRIVEWA• o 24.1 9�E CONCH L. F,-; i J1o.1 J L� 0 • o „ _ 1-- 3 + I bd` WI (/ Y � oN co ..J o iQ0 a ) Z� J Z i. ST C co ii o 3Z I--. .• .. 2> Q , 24.1 42.1 1 I- F- I A• WOOD FENCE 1 _ - - - - - - - - _C11f11PLLINK FJ NCL N 89 58' W 135.86 _0000pp � oP� OFA-7/6' 40 49 rH 1� f300 0 4. oOi_7(42ne.,4i /4//d" (7g Q�� SHANE A.HOLT � Is OO AS-BUILT SURVEY SCALE 1 " " 20 F 04�°,. LS-6914 yli0 17(ONNGNS St' �M11 LIVE 4A 'O/essior.al �o� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY �ODpppoo'' '' OF THE FOLLOWING DESCRIBED PROPERTY LOT 6A,SANDI HEIGHTS I ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE THF INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND IS THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES. IMPROVEMENTS. OR FENCELINES. EXIST OTHER THAN NOTED. EASEMENTS OF RECORD. OTHER THAN THOSE APPEARING ON THE RECORD PLAT . ARE NOT SHOWN DATED AT ANCHORAGE,ALASKA THIS 7TH DAY OF HEREON ( UNLESS INDICATED) JUNE , 2018 NOTE. FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LAN)SURVEYING 9309 GROVER DRIVE ANCHORAGL.AK 9 9'' 3040,FB 188-54 907-345-5513 MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services] DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # �� 1 — � ` �� HAA # t IAM \ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) 9334 Kauik (b) Property owner Mailing Address (c) Lending Institution Mailing Address HUD # 111-028267-203 Telephone: (home) Telephone (d) Real Estate Company and Agent ROGERS REALTY ATTN • Ed To teu Address 8301 Arctic Btvd. Anchona e Ak. 99518 Telephone (e) Mail the HAA to the following address: (or check here [,�Xif hold for pick up.) List contact person and day phone number below: 5 & 5 ENGINEERING Eagle River, Alaska 99577 2. TYPE OF RESIDENCE i Business Single -Family WX Number of bedrooms - 3. WATER SUPPLY Individual Well ❑ Community KX Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site INX Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE 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 regulations in effect on the date of this inspection. Name of Firm 5 B. S Telephone Address 17034 Eagle River Loop Road No, 204 EagTe-1Ti—Yer,-1Maskm 99577 Date na.+vw n•� ......... IIIIII�� a��ca � lay A b'X} A. wh xfcr' .qtr s y .V rl�rrLS J,yt��J 6. DHHS APPROVAL Approved for/—/bedrooms b _ Date °5 Approved v Disapproved Conditional Terms of Conditional Approval _ The Municipality of Anchorage Department of Health and Human Services (DF -IHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above byan 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 orderto 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. 7/88) Back Page 2 of 2 & "'0 A. WELL DATAO Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) i CHECKLIST - FEBRUARY 1984 - 343-4744 Date Completed Electrical Wiring in Conduit (Y/N) Legal Description: b h` Depth of Grouting SEPARATION DISTANCES FROM WELL: t To Septic/Holding Tank on Lot iLoc) If A, B, C, D.E.C. Approved (VN) y Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots t To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by To Nearest Public Sewer Cleanout/Manhole Water Sample Test Results Comments a� s 3p 4- ; Date B. SEPTIC/HOLDING TANK DATA Date Installed q r��nSize lyu0 No. of Compartments Z - Standpipes kN9N) = Air -tight Caps (M) T Foundation Cleanout (M) Depression over Tank (Y&S� ►'� gate Last Pumped t Pumping/Maintenance Contact on File (Y/N) P 'JA ; for Holding Tank High -Water Alarm (Y/N) P Temporary Holding Tank Permit (Y/N) A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: t To Water -Supply Well -Z"5:;0 To Building Foundation la To Property Line 1 0 To Disposal Field t �' To Water Main/Service Line d t To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev. vse) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata e,-5 Type of System Design C4:n Date Installed I12 ' B/So Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absortion AreaJ�v�i ¢''rLs>-�. Statndpipes Presentcp�/N) Depression over Field (Y/p3 Results of Last Adequacy Test Date of Last Adequacy Test c:) --- ?.A .. _. '2, ,2n SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Wellyk To Property Line To Building Foundati)(�n Lot a ; On Adjoining Lots To Existing or Abandoned System on To Water Main/Service Line 1 k=> k To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course to u q- rl�/I—% To Driveway, Parking Area, or Vehicle Storage Area 4 - Comments `�`f S f '"'I 1�� Soho �� c9ne IT L_ ___C65571 1_ ( D. LIFT STATION Date Ins led Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe inspection. s & S ENGINEERING �. Signed 7034 E [2ivwY I_aen FPfsaa nth sur Company Eagle River, Alaska 99577 Date �� C MOA No.�� Receipt No. c2 / 0 or Date of Payment 1-, f -36-\\n Amount: $ i J0 06 Receipt No. _ Waiver Fee: $ Date of Payment 72-026 (Rev- 7/8B) Back Page 2 of 2 d ate `6+-1 1 STEVE COWPER, GOVERNOR l �L.� DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 April 27, 1990 S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 PWSID: #210485 563-6775 According to the records on file in this office, the Seacliff Subdivision Water System is in compliance with the State of Alaska Drinking Water Regulations. Sinc ely, FZZ 6,711 1 VERA E. CRAIG Environmental Fiel Officer VEC:bas MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE X -r- -- 1. General Information Application Date _/�� (a) Legal Description (include.lot block, subdivision, section, township, range) 31D SANi>y GT5 Location (address or directions) (b) Applicants Name /' ? P Tele hone - Home Business // Applicants Address�� (c) Applicant is (check one) Lending Institution y�uilder Buyer ; Other (explain); -� (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single-Family04- Multi -Family Number of Bedrooms 3. Water Supply Other (describe) individual Well El Community r7gD 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 Diso� sal Onsite Public Community E:1Holding Tank ED Xj Note: f community well system, must have written confirmation from the State X/ Department of Environmental Conservation attesting to the legality and status. J [Page 1 of 2] L' M 1_� Engineering Firm Providing Inspections, Tests, File 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 (f L<!�I_ Telephone Address Date 1�4q� (ENGINEER SEAL) DHEP Approval Approved for '� �-bedrooms 7 Approved ✓ Disapproved Terms of Conditional Approval ` CAUTION Co y�.oy C . Reid, Jr,o No 22a s �„ ,",.Date ate THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ,HEALTH 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 AND 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 21 7-19-84 ' MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST FEBRUARY 1984 Legal Description: ��OT r oV-f14720 OMAN 7 : �`/CfS N011031ONd WlN3WN0211AN3 A. WELL DATA 9 18 H11V3H d0 '1d30 3QVd0HDNV d0 All1bdlDlNf11N Well Classification Ifp, C, D.E.C. Approved Y�V) ct- e ,) 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 Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well To Septic/Holding Tank on Lot 't'PO8 On Adjoining Lots y 9 To Nearest Edge of Absorption Field on Lot On Adjoining Lots l�%9 To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 4V7: Water Sample Collected by Jy� -- ; Date Water Samp Comments B. SEPTIC/HOLDING TANK DATA Date Installed 701— Size 1000 No. of Compartments StandpipesAir-tight Cap (Y N) Foundation Cleanout (Y )� Depression over Tank (YO Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ,7 ; for Holding Tank High -Water Alarm (Y/N) 'Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well j� &Z-00 7 To Building Foundation /,0 To Property Line Z Z ( To Disposal Field Il To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage n F, Page 1 of 2 72-026(11/84) u C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �� Type of System Design Date Installed Length of Field r :Z�/ Width of Fieldj2 .� I r Depth of Field Gravel Bed Thickness Square Feet of Absorption Area 36D 9� y Standpipes Present ®Y N) ` Depression over Field (Y/V Date of Last Adequacy Test Results of Last Adequacy Test f 2d7J7 Separation Distance from Absorption Field: To Water -Supply Well t Leo � " To Property Line cctt 1 To Building Foundation n A Aro, To Existing or Abandoned System on Lot t%ffi W IMkU "G.91M.., ; On Adjoining Lots ,r �D 1, -X,- To Water Main/Service Line + DA) utbank (if oresentl P10 - To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, orAVehicle Storage Ar Comments � �YLQU1�1{�ilp)!(�9�uL1 t'J�bY lI & & UJ(AAN•>?J,CA q)\5kgh &,t` 0 1q: D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) — Comments O i i Dimensions M n ole/Access 'P ff" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request'* I certify that I have checked, verified, or conformed to all MOAnd H A guidelines in effect on the date of this inspection. Signed Date Company MOANo. ST'C;—op_o, Receipt No. tj�� v _ •�a�� A1r® Date of Payment "�y"7 �f. OF 44��oa Amount: $ A50 ��••• °O.• 9ineer's Seal 4M• Page 2 of 2 Q� ° leray C. Reid, Jr, a (} No. 2251•E 72-026 (11/84) ''F•/l ,��y 50248 ALASKA enUIROnMenTAL COnTROL SMUIUS, InC. 6ngineerinq & enuironmental Studies JULY 8 1985 DAVID & DEBBIE RIPPIE SELLER—SAME DAVID & DEBBIE RIPPIE 9334 KAVIK 9334 KAVIK ANCHORAGE ALASKA ANCHORAGE ALASKA 99515 99515 LEGAL:SANDI HEIGHTS BLOCK 0 LOT 6A ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE—JUNE 5 1985 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH/CRIB WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 688 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON JUNE 6 1985 A of .44. CO a�OO Daoye.�aj'{9+�04o®{obe W *0 4IP-1v °P'-• �Il (,-Otto* 00SB`U o3'OOUBi q D:M G Le y C. Reid, Jr. ; ; ��AiPJ om® No. 2251-E yn` fji 1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) 561-5040 a Q BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMEN'T'AL CONSERVA'T'ION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 DATE PWS I.D.# To Whom it May Concern: According to records on file in this office theUU , Water System is in compliance with the State Drinking Water Regulations Sincerely, Q 5. LEGAL DESCRIPTION/, L.0 -r SiX A �- DATE RECEIVED - INSPECTION APPOINTMENTS C->—IRCET ��c �l2 �t Ai< g9S� TIME TIME IV TIME ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six DATE DATE DATE since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) INSPECTOR INSPECTOR INSPECTO MUN� I CHORALE ENVIRONMENTAL Ft;OTECTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 J U I 1 9980 • ENVIRONMENTAL SANITATION DIVISION REGtVED 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 for processing. PHONE 1. PROPERTYOWNER � MAILINGADDRESS // ``�n _ 1 3 �� Kfl V X !q NC_H UIZI-jG F PHONE PROPERTY RESIDENT (If different from above) PHONE 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT yu/<anj 2 PrL Y PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION/, L.0 -r SiX A �- SflND( 1-lc(Ut1iS SU1301v151�� 1 Th STREET LOCATION q-nL- KAVil< C->—IRCET ��c �l2 �t Ai< g9S� =TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ED Four ❑ Other �,/ .I� SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM p, �( INDIVIDUAL/ON-SITE** � 1�`� YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) (J`� 4 t l 0—C (.�, THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE El PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING 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) ❑ DISAPPROVED DATE (� }, BY 72-010 (Rev. 6/79) July 9f In3o John V. & Marilyn E.e-10" 93311 %-avik iuichora.ge, Alaska. 99502 Subject` Lot Wle Sandi lfeigbta SLt'C9divis3.on zAp rnval fraz your individual sasrar and water facilities can not be granted until the following tions hhve been comtpleted' (1) fbb septic tank plamped with h receipt sub+giitecl to thio office. p) Idwquacy test be performed on the existing leaching area. This test will deter -mine if the system is adeclaate . arcorc'tix,ig to National Standards. A listing of prcbvate f irns peg: for7ming the test is enclosed. This report needs to be submitted to this de:partnIent for aur review- (3) e;vie —(3) A four (4) inch cast iron cleanout noods to be installed in the septic tank and/or leaching area. please notify this department for a re-pinsVectiOn When the noted Clescre-pancies have been correcte(. Of there- are any questions, T)lease contact 4.:11cbisoffice at 264-47210. s inc E -'rely �.obert C. Pratte R -S. Aallociate Speciiilist -Rai�V' .a.,ts cc.Yukon Realty 4619 Spanard Rd. 99503