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SST BLK 2 LT 5
SST Lot 5 Block 2 #015-082-22 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division ' 825 `'L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES SEPTIC ABSORPTION WELL A areae FROM TANK FIELD IC�[ rJ_ WELL Phones) Permit No No of Bedrooms LOT LINE LEGAL DESCRIPTION Lot BOC ,. � $nbtllVlslOn FOUNDATION - •—r `> - Township, Range, Section -� - AS -BUILT DIAGRAM (Show location of well, septic system, property Imes, foundation, driveway, water bodies, etc)! - t TANKS SEPTIC ❑ HOLDING Manufacturer Capacity in gallons E" '-'s t Material No. of Compartments TYPE OF SYSTEM - - I TRENCH ❑ BED ❑ W. DRAIN ❑OTHER C7 Depth to pipe bottom from Total depth from original grade / I -e i'A original grade % FT 6 ` 1` FT�� Fill added above original grade Gravel depth beneath pipe �) FT FT S" Gravel len h� 9t Gravel width FT ;, FT Total absorption area Distance between Imes C Z SO FT FT Number of lines - $oil rating J Pipe material- ZQC) SQ FT �-_,L. n 111 Installer V 1 L Date Installed L' WELLS PRIVATE ❑ OTHER (Identifv) Class, icabon (A,B,C) Total Depth Cased to [ FT FT Installer `;/ Date Installed. 7v� � J 4 REMARKS: " fi t / Scale: I / S ENGINEERS SEAL r .' ) � ' ' v . cl ', I pections Perform tl by. /r� h C�L_S C I A. �,, ' Date. l s `A /i^•'u/q / e- certify aidThis inspection was perloNned according to all 5 Municipal and State guidelines in effect on this date: U Health Department Approval: Date: % 72-013 (3/85) MUNICIPALITY OF ANC140RAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION I?AN 1 1989 DECEIVED ,vI ,t/ 8556 27E 3 0/• 55(Q� NSS SS 54� 30/.6¢( i /✓8i�5659A✓ 299,67(,2) 299. ?.93/5 oC EsAe/N4 LEGEND ® Primary momtment recovered e Iron pipe and/or rebai ro corersd O ""x 30"robot set }hk.wrvey PREPARED FOR / i 4 DRWN BY, 6455 I DATE. ///1da' SCALE- / =50 ' SNEETNO / of / CNCKD BY.-gPG Wo. IVO. I F.B. NO. 29 GRID 2439 AS -BUILT 6075 S. S. T S Z &1&0. ,Llov�, E sdt�v rh = /JJE/13Ut'Ea 60.05 I 0¢_0037 -O40/00� '2= 443.od /14.3.00 I .�l /✓8i�5659A✓ 299,67(,2) 299. ?.93/5 oC EsAe/N4 LEGEND ® Primary momtment recovered e Iron pipe and/or rebai ro corersd O ""x 30"robot set }hk.wrvey PREPARED FOR / i 4 DRWN BY, 6455 I DATE. ///1da' SCALE- / =50 ' SNEETNO / of / CNCKD BY.-gPG Wo. IVO. I F.B. NO. 29 GRID 2439 AS -BUILT 6075 S. S. T S Z &1&0. ,Llov�, E sdt�v rh = /JJE/13Ut'Ea 60.05 I / hereby certify that an accurate survey of the following described property- - '5-5,7-, S64�D, was made on //MFee and that the improvements situated thereon are within the property tines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property tying adjacent thereto encroach On the premises in QCestian and that More are no roadways, transmission lines or other visible easements on sold property except as indicated hereon. Doted at Anchorage, A/aska, this 30f day, of A/ d. )S6 0"?, & PREPARED BY CORW/N & ASSOCIATES 1000 E. DIMOND BLVD. SUITE 205 ANCHORAGE, ALASKA 99515 (907J 522-1311 f 4 I .�l �0 / hereby certify that an accurate survey of the following described property- - '5-5,7-, S64�D, was made on //MFee and that the improvements situated thereon are within the property tines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property tying adjacent thereto encroach On the premises in QCestian and that More are no roadways, transmission lines or other visible easements on sold property except as indicated hereon. Doted at Anchorage, A/aska, this 30f day, of A/ d. )S6 0"?, & PREPARED BY CORW/N & ASSOCIATES 1000 E. DIMOND BLVD. SUITE 205 ANCHORAGE, ALASKA 99515 (907J 522-1311 . MUNICIPALITY OF ANCHORApE Depariment of Health & Human Services 825 L Street, Anchorage, Alaska �9501 343 ON - SITE SEWER PERMIT Permit Number: 8002?2 Upgrade Date Issued: 12/22/88 Engineer Designed Ow:er Name: r NMA Owner Address: 0201 ^C' SV R hEl SU%TE 505 AAU|iJAl.": 99�03 Day Phone: 561-0823 Par c, 1 Ad: 015-0��-��� Lot Legal: Subdivision: SST Lot: 5 Block: 2 Section: 14 Townshipi 12N Range: 3W Lot Size 498a3 (sq.1t, or acres) Max bedrooms: This Permit: 3 Total Capacity: 3 SEPlIC [ANK: Minimum total septic Lank capaci1y: 1,0U0 gallons" Each septic tank must have at least 2 compartments` Depth to top of septic Lank(s) < 4"0 f�sL requires insulation over tank(s). �xSl*i PER ENSlNEERS ATTACGED DESUAN. NOTIFY DHHS PRIOR To EAC// 1N6PLCTIUN" |H[S PERMIT EXPIRES 12/31/89 A NEW PERMIT WILL BL it u /F THE SYSTEM I3 14_1F INSTALLED ON OR 9EFORE THAT DATE, 0I6 PERMIT 1G ISSUED FOR lHE EXISTING 3 BEDROOM SINGLE FAMILY DWELLING ONLY., I CERTIFY THMV 1" I am familiar with the requirements for on-site sewers and wells as set ;Lk by the Municipality of Anchorage (MOA) and the State of Alaska" w,11 install the system in accordance with all MOM codes and regulations, and in compliance with the design criteria of this permit. 3, k w�l1 adhere to all MOA and State of Alaska requirements for the set back di*|ances from any existing well, wastewater disposal system or public sewerage sysnem on this or any adjacent or nearby lot. 4, i understand that this permit is valid for a maximum of 3 bedrooms. I also undersLand that 11e capacity of the total system is 3 bedrooms and a/�y enl t W11L an additional permit� "~-'��-�J/--- ----��/--�-- ----7----T�--- lssu �~7a ����--��^-�------ DAT�: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: / /`'�/"�/ 1 DATE PER C r LEGAL DESCRIPTION: / / l Township, Range, Section: r t5s7- vL ,o SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 al WAS GROUND WATER ENCOUNTERED? S T WHAT L D l P 15� E Aft er Oate: O��4 1 -1 ffl] t)o IF VESA DEPTH? i Depth to Wate C53/7� �l<(� Manitoring7 _� er PERCOLATION RATE (minutesnnch) PERC HOLE DIAMETER TEST RUN BETWEEf4 7 FT AND Z' 0 FT --- COMMENTS rr�V7GC-C G / 'l.�//GZ.� L/" /.-,( _¢11 ./ i�z� PERFORMED BY: I ERTIFV THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINE /I EFFECT L)I THIS DATE. DATE. 72-008 (Rev. 4/85) N 10 IF VESA DEPTH? i Depth to Wate C53/7� �l<(� Manitoring7 _� er PERCOLATION RATE (minutesnnch) PERC HOLE DIAMETER TEST RUN BETWEEf4 7 FT AND Z' 0 FT --- COMMENTS rr�V7GC-C G / 'l.�//GZ.� L/" /.-,( _¢11 ./ i�z� PERFORMED BY: I ERTIFV THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINE /I EFFECT L)I THIS DATE. DATE. 72-008 (Rev. 4/85) f/89�5659�✓ 299,67 (�) 299.</(�'i% PIIS/$ OF BEG Fl N6 LEGEND ® Primary monument recovered • troo p/po and/or radar recovered 0 418 it 30e rodai set Mlswrvey PREPARED FOR, �ic/MA D WN BY, WS'S PATE: ///.3o Py SCALES /-=So SHEETNO. / of / CHOYD BY.- 67L w.4 NO 1 F.B. NO. Z9 GRID 1-139 AS -BUIL T Z 075 S. 5, 77S 61&Z, Q = PtrYo.E'G LYTTA 1 hereby certify /hal on accurate survey of the following described property- Z,0T,5- , 5:5,T: S&JZ0, was mode on /I zF/ Ad and that the improvements situated thereon are withln the property /hies and do not overtop or encroach on the property lying adj470e0t thereto, that no improvements on property tying adjacent thereto encroach on the premises in question and that there are rra roadways, tranSmieS%On Nnas cr other visible easements on said property orcept as indicated hereon. Daled at Anchorage, AAlask�af, f/W -3O day, of h! L.3 No. 4/07.5 PREPARED BY CORWIN & ASSOCIATES 1000 E. DIMOND BLVD. SUITE 205 ANCHORAGE, ALASKA 99515 (907) 522-1311 N eeRJ• Caveata� '1 E'lAG cc e+ �p �.,' 4' oL,o� 3a/55�} Flo sssae5 PS562iE fn i+or ,V d5 CEJ (�v ) 1 �= 0/- 0,37 or'o/00 Z= ¢43.00' 4Ga.o0 `gyp C= 3/m0 3/.cs I c.o• r f/89�5659�✓ 299,67 (�) 299.</(�'i% PIIS/$ OF BEG Fl N6 LEGEND ® Primary monument recovered • troo p/po and/or radar recovered 0 418 it 30e rodai set Mlswrvey PREPARED FOR, �ic/MA D WN BY, WS'S PATE: ///.3o Py SCALES /-=So SHEETNO. / of / CHOYD BY.- 67L w.4 NO 1 F.B. NO. Z9 GRID 1-139 AS -BUIL T Z 075 S. 5, 77S 61&Z, Q = PtrYo.E'G LYTTA 1 hereby certify /hal on accurate survey of the following described property- Z,0T,5- , 5:5,T: S&JZ0, was mode on /I zF/ Ad and that the improvements situated thereon are withln the property /hies and do not overtop or encroach on the property lying adj470e0t thereto, that no improvements on property tying adjacent thereto encroach on the premises in question and that there are rra roadways, tranSmieS%On Nnas cr other visible easements on said property orcept as indicated hereon. Daled at Anchorage, AAlask�af, f/W -3O day, of h! L.3 No. 4/07.5 PREPARED BY CORWIN & ASSOCIATES 1000 E. DIMOND BLVD. SUITE 205 ANCHORAGE, ALASKA 99515 (907) 522-1311 MUNICIPALITY OF ANCHORAGE Heajo and Environmental Prote*n Fourth Floor Nie St 825 L Street Anchorage, Alaska 99503 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM STEQ Ant CoNsf-- 1A L t N At oaI_'_` S - Pti0NE 5©o NEAR (.(;,.ATIO r 4A6S ERp kvlm, `�(PgrJ t EGAI uE>csTlPnor, SEPTIC TAHK Nq WcLI cul, II_C C�y� N__—COMPARTMENTS- LIQUID OF h1AFFRIAL _�!� L.._.__—___—COMPARTMENTS- I'��'�UL LIQUID LEPT11 I%� _1QUID CAPACITYk91-SiGALLONS. TILE DRAIN FIELD: + - F'i TOtAL LENGTH V7 I Rp 1 W;1 -.LL _-._----r=0urJLATI(.v_h8-., -- -NEAREST (_OT LINE_*_ 50_ -_OF LINE �3 u01SE Lines k J-- ( - TRFN(ai DI,( v, CL I3Lr,vELry I Ir FS ISLR A^IIOTH,7j4a. IN. TT OAL EFFECTIVE —. F` SQ. FT. LENGTH OF E��CII UNF 43 _ Df ill I OF FILTLR f,EI If MAI IIFNrATI4 1 1 J F � � inl ARnAlA TII C � w SEEPAGE PIT WIDTH LESNGrH_, DEPTH -- - i.ocf Crib Kings_ Crib Size; CIAn4ETEIiL`CPrIr_ DISTANCE FROM: WELL _ TOT:'?L EFFECTIVE f'Gtl;dDl,l IO,'1_ NE :REST LOT LINE_ _ AESORPTION AREA (WALL AREA) SQ. FT. si.I Die-st once To: Lo' Aline Line: :iaLcr.ials: -' m TH� �EQ/iInF� Sl7E 8F THE S0lL 9R�ORPTION SYSTEM IS� �����V_ ������It-�=� ' � THF L�NGTH DTHENSI0N I� THF |ENGTH (IN FEET) OF THF TREN�H OR DRHI�F1ELD� THF DFP0F A TRENCH OR PIT IS THE »ISTHNCE BETWEEN THE SURF�CE OF THE GR1 11 tN0 HHD THF BqTTOM OF THE EXCHY�TI9N (I� FEET) THERF ] N SET WI4 FOR TRFNCHES THE GRHyB DEPTH 7S THE MINIMUw DEPTH OF GRH;Ei BETWEEN THE OUTFHLL PTPE HND THE BOTT0t,! 0F THE FXCH�HTI0N (IN FE[T) �A IF,� F, I If if it���� it 7 ji:-*�����_ --------- ������� �V_���if� -------_— H PHCKHGE PLHNT MH; RF INSTHilEn HT THE PERMITTEE'S OPTTO@ SnBJECT TO THE Fn|L0W[hili C0WDITIONS� 1[IT�ER H CLHS� I 0R lT NSF HPPROYFP PLHNT M�Y BE INSTHLLED 2 H C8NTINUHit Ml 4lif) ENi-1NCE HGREEMENT I� REQUIRED IF H j, i: �GREEI. 1E141 }S N0T KEPT CURRENT Y1 11 MHY BE REQUI�ED TD ENLHRGE THE �8IL HRSORPT]ON SY�TEM HNC/OR YOU MRY BE SUBJECT TO PR0SECUTION �....... ����������.... ...... �������......... ..... ������� �HCkF!LLING OF �N� SYSTFM ��THOUT FINHL INSPECTIQN HND i::iPP�OVHL BY THIS DEPHRTMENT WlLL �F SU8JECT T0 PROSECUTI0N MI�IMHM DIS�HNCF BFTNEEN H WELL i-:11 AD HNY ON–SITE SE�HGE DISPOSHL SYST�M I� 1�0 FEET F0R � PRTVOTEWELi- 0R 208 FEET FOR H PUBLIC WELL ' UElJ- |OGS HRE �EQ|]TND MUSTHE D�PHRTHENT W7T�IN ]0 DHYS OF TH[ WBJ COMpLFT�O@ OTHER RFQUTRF��NTS MHY I iPPLYSPEClFICHTIONS HND CONSTR||CTION DIHGRHMS HRE HVH�i�RLE TO )NSURF PRO��R lNSTHLiHTI0N �.4-if f������� �It- �, 7c: 7 a l CERTIFY THHT 1 I 6M FHMIL�HR WITH THE REQUIREMENTS I. ON–SITE SEWFRS F0�T�f RY TM� MUNICIP��LITY 0F HNCHORHGE � I WILL INSrI it THE SYSTEM I� HCCORDHNC� WITH THE C0DES ]� } ||NDERSTHN0 THRT THF ON–SITF SEWER SYSTEM MHY REQUIRE RESI�ENCE I� REMODEiEV TO INCLUDE M0RE THHN ] REDRDOHS v HND uELLS HS SET ENLHRGEMEmT IF 7HE well OPNAY OF M -W DRILLING INC. �►nr� �°yyEP�S.� �O��F W-ALni .. "^^`�/V AL PAOIE-Motj OcC2 81977 4� DRILLING LOG RECEIVED_ )� Veal Burleson Construction -` Use of Well T, —Use Location (address of: Township, Range, Section, if known; or distance main road Lot 5 Bl'k ' SST Subdivision, Anchorage Size of casing `' � � Depth of Hole--1-6-3---feet Cased to 16 5 feet Static water level 7 J ft. (iWQ15 (below) land surface. Finish of well (check one) open end ( Xx ) Screen ( ); Perforated ( ), Describe screen or perforation N/A Well pumping test at 8 gallons per (ld6iii (minute) for 1 ---hours with 100 i;gt, of drawdown from static level Date of completion 12 / 2/ 7 7 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 Casing stickup —2 —To Organics 3 TO 33 Silty hardpan 33 TO 45 Loose gravel 45 TO 60 Loose gravel 60 TO 70 Silty gravelly hardpan 70TO so Sandy gavel 30 —To -10 5 Silty hardpan 105 T0__L2 0 Sandy gravel` 120 T0_143 Clav 143 TO 150 Silty 150 0__L6 1) Clay 150 Tn 165 Sandy water gravel NWms n .wrt.a n.......� Nos. 814 & 978 2 — STATE M� MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES A Division of Environmental Services Onsite Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 015-082-22-000 HAA # 1. GENERAL INFORMATION Complete legal description SST SUBDIVISION- LOT 5 BLOCK 2 Location (site address or directions) 9641 HOMESTEAD TRAIL ANCHORAGE. AK 99516 Property owner NANCY & WAYNE HAERER Day phone (907) 346-4239 Mailing address 9641 HOMSTEAD TRAIL ANCHORAGE AK 99516 Lending agency Mailing address Day phone Agent NEIL THOMAS W/ COLDWELL BANKER Day phone (907) 265-9106 Address 2601 "C° STREET ANCHORAGE ALASKA 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 XXX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC ing to the legality and status of system. 72-025 (Rev. 1191) Front MOA #21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,000.00 at, or prior to, closing for the engineering services provided. 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 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 investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal arid State codes, ordinances, and regulations in effect on the date of this inspection. 1/,: � Name of Firm Phone (907) 337-6179 Engineer's Signature � tv v / Date Ci /,C/cc In conducting this evaluation, AWWC, Inc. att}�m t d to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and M A tlHH Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water o0�0p �O usage of the family being served by the system. These conditions are outside the control of o OFA p� the evaluator of the system. Satisfactory test results do not guarantee future performance o iN of the system, nor do they guarantee that there are no hidden defects or encroachments. DOS / •. AWWC, Inc. can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report is for the sole benefit of the owner listed above. Any , reliance upon or use of this report by any other Person orParty is not authorized, r Q.. - .�........ nor will it confer any legal right whatsoever. Ql.� J fre. A. Garness: 6. DHHS SIGNATURE � Approved for bedrooms Disapproved Conditional approval for Additional Comments M —7953 bedrooms, with the following stipulations: Date !0' /3-00 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. 1191) Back MOA #21 Computer Version RECEIVED Municipality of Anchorage SEP 2 5 2000 . DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MU,N�I�l�,Q� ITY OF ANCHO 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (13C&AA@>a AAL SERVICES Health Authority Approval Checklist Legal Description: S.S.T. SUBDIVISION; LOT 5, BLOCK 2, Parcel I.D.: 015-082-22-000 A. WELL DATA Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (YIN) Y Date completed 12/2/77 Total depth 165' Cased to 165' Casing height (above ground) 27" Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES FROM WELL LOG AT INSPECTION Date of test 12/2/77 9/14/00 Static water level Well production 8 g.p.m. 3.9 g. P.M. WATER SAMPLE RESULTS: Coliform 0 Nitrate 0.500 mq/L Other bacteria 0 Date of sample: 9/15/00 Collected by: A.W.W.C., INC. B. SEPTIC/HOLDING TANK DATA Date installed 11/4/77 Tank size 1250 Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression (YIN) NO High water alarm (YIN) N/A Date of Pumping 9/14/00 Pumper NORTHLAND PUMPING C. ABSORPTION FIELD DATA *MEASURED IN FIELD ON 9/14/00 Date installed 1/10/89 Soil rating (g.p.d./ft2 o bdrm 200 System type TRENCH Length 54' Width 2.5' Gravel thickness below pipe 9' Total depth *9.6' Effective absorption area 972 SQ_ Fr. Monitoring Tube present (Y/N) YES Depression overfield (YIN) NO Date of adequacy test 9/14/00 Results (Pass/Fail) PASSED For 3 Bedrooms Fluid depth in absorption field before test (in.); 10.5" Immediately after 1321 gal. water added (in.): 31.5" Fluid depth 8" (ins) Minutes later: 1078 Absorption rate = 450+ Peroxide treatment (past 12 months) (YIN) N/A If yes, give 72-026 (Rev. 3196p Computer version D. LIFT STATION Date installed Size in Manhole/Access (Y/N) "Pump on" lev High water alarm level at* *Datum E. SEPARATION DISTANCES "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septio/holding tank on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer/septic service line 25'+ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field 5'+ Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main/service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage area 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. ENGINEER'S I certify that I of Municipat n with MOA HA, Signature_ Engineer's field inspections and review systems are in conformance :)n this date. A. GARNESS HAA Fee $ ZX� • d>0 Date of Payment l/zs—/a % Receipt Number ?U' 72-M (Rev. 3196)" Computer Version Waiver Fee $ Date of Payment Receipt Number p W A ness.- S. E-7953 m, O ..... ~�4 h.e�_•� •cPw ALASKA WATER & WASTEWATER CONSULTANTS, INC. -- October 12, 2000 Municipality of Anchorage Dept. of Health & Human Services On Site Services Section 825 L Street Anchorage, Alaska 99501 ATTN: Jeff Poet Subject: Lot 5, Block 2, S.S.T. Subdivision, Health Authority Approval Dear Mr. Poet, During the adequacy and well flow testing on the subject lot, we noted that the septic tank had only one cleanout, not two as shown on the Municipal inspection report and on a subsequent inspection report by Bruce Corwin. As a result, we required the property owner to dig down to the septic tank and install a second cleanout. On October 11, 2000, the tank was exposed. We found the second compartment of the tank is covered with a blind manhole; that is, there never was a second cleanout. In addition, in 1977 only a single cleanout was required. We would appreciate it if your would now expedite the Health Authority Approval. If you have any questions, pleas, contact me at 337-6179/FAX 338-3246. M.S. 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwe,com ALASKA. WATER & WASTEWATER -- - CONSULTANTS, INC. -- - October 12, 2000 Municipality of Anchorage Dept. of Health & Human Services On Site Services Section 825 L Street Anchorage, Alaska 99501 ATTN: Jeff Poet Subject: Lot 5, Block 2, S.S.T. Subdivision, Monitoring pipe Dear Mr. Poet, During the adequacy test, the following measurements were taken prior to the addition of water: Top of monitoring pipe to bottom of system, 147.5" Top of monitoring pipe to bottom of invert, 110.0" Top of monitoring pipe to top of standing water, 137.0" Stick up on monitoring pipe, 32.0" It is apparent that the monitoring tube does not reach the bottom of the 9' of effective depth of gravel. However, with the addition of 1321 gallons of water the field rose from 137" to 116" BTOP (a total of 21"). Twenty four hours later the water had dropped to 139.5" BTOP. The amount of cover over the trench in the area of the monitoring tube is obviously much less than what is shown on the inspection report. I trust this additions information adequately addresses your concerns. questions, please cont ct me at 337-6179/FAX 338-3246. ?J., M.S. 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwe.com If you have any 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 l.D.# b/5__ C 8 a--- -I a_ 1. GENERAL INFORMATION Complete legal description L4 .5, 6t0c/c z SS i SID Location (site address or directions) C1 6 411 I-4�r"E Is _r - � Property owner C"7e-irlE- I M Day phone Mailing address goo Z', Ste., 313(00 995/ Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site x Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(R..1/91) Front MOAN21 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 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 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 Nferd Phone Address —1/2- Engineers /2 Engineers signature 6. DHHS SIGNATURE X Approved for Disapproved. Conditional approval for Additional Comments By: bedrooms. Date /Z / 6 /96 P ` n l Df •oeryOH '=h !Op bedrooms, with the following stipulations: Date l - /S-- y7 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 courtesyto 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-M(Ray./181) Back MOA#21 MUNICIPALITY Of ANGI01PAGt ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES DEC p �99ri Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4 C C 1 "E 3A Health Authority Approval Checklist Legal Description: 6.0 -/ ,S, Q I-0 )< -� A. WELL DATA 5 s 'T Parcel I.D.: n/ 5- 0 F -;2- Well type PI -1 c/ ¢ t; -L If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ! e'' Date completed Total depth 1 ✓� I Cased to 77 Casing height (above ground) c27. Sanitary Sanitary seal (Y/N) 4L& -s Wires properly protected (YIN) I Date of test Static water level Well production FROM WELL LOG Z- a -*7y WATER SAMPLE RESULTS: 70 ` Coliform N _ Nitrate Date of sample: /a - 3- B. - B. SEPTIC/HOLDING TANK DATA ATINSPECTION g.p.m. d. g.p.m. o . / Other bacteria Collected by: S :5-W 4 L f" Date installed // - /- 7"/ Tank size /;2-5Z) Number of Compartments -2 Cleanouts (Y/N) Foundation cleanout (YIN) e-6 Depression (Y/N) A -A) High water alarm (Y/N) !I%/} Date of Pumping 9 db - 9 �; Pumper IV o�-A 1A-,4- 72e C. ABSORPTION FEELD DATA //-- 4._7-/, Date installed I — t I - 8 9 Soil rating (g.p.d./ftz or ft2/bdrm) d o System type Length 541 Width Gravel thickness below pipe 9 Total depth / 7 9 86)z Effective absorption area 9 77- Monitoring Tube present(Y/N) P,S Depression over field (Y/N) AI D Date of adequacy test 9 - ;i o - 9' to Results (Pass/Fail) ;�70 SS For 3 bedrooms r Fluid depth in absorption field before test (in.); /7 o Immediately after JgaJ. water added (in.): 4'� S- .' Fluid depth / 9 If (ins.) Minutes later: A4" rS Absorption rate = 4413-a i -- Peroxide treatment (past 12 months) (YRS A D If yes, give date D. LIFT STATION Date installed Manhole/Access(Y/N) High water alarm level at* E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / 00 1* : On adjacent lots at* Absorption field on lot / ® O ; On adjacent lots Public sewer main ti/i Public sewer manhole/cleanout A14 Sewer /septic service line .P-5/-/" Lift station /v SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation /O1 Property line Water main/service line .a C✓ t'Surface water/drainage d /t Absorption field / / f/f Wells on adjacent lots � O o SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation P-61 )p Water main/service line / ei / � .Z S / -f' Surface water O Driveway, parking/vehicle storage area Curtain drain .5b/ f Wells on adjacent lots F. ENGINEER'S CERTIFICATION /00/-/ Propertv line CO 1 certify that I have determined thru field inspections and review of Municipal recbrds that the: above systems are in conformance with Al A guidel nes in effect on this date. Signature // // / Engineer's Name `/lJt ,w -f' rpr -e 44�e n Here Date (2 �Co f 9 r, HAA Fee $ � , 0-D Date of Payment lzho /9 yo TI Receipt Number c2✓�i ��Z/ r Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number NHAWTHORNE-ENGINEERING September 25, 1996 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 ATTN: Dan Roth Subject: Lot 5, Block 2, SST Subdivision Dear Dan: 7127 OLD SEwAeo HIGHWAY ANCHORAGE, ALASKA 99518 907-344-4711 5 tiP � 1;,1995 muni: 1palM o uman Sere cea Dept. Health & H During the adequacy test/well flow on the above property, we noted that there was only one cleanout on the septic tank. The original inspection report notes the placement of two cleanouts. Upon additional review of the file, however, it appears that the second cleanout was probably never installed. Our clients wish to have a determination made on the need for this cleanout since they won't be marketing the property until December. Our justification for this request is as follows: 1. In 1977, although a two compartment tank was required, only one cleanout was required. 2. A metal detector was utilized during the inspection to locate a pipe remnant. There was no indication of a broken pipe.. srevkav Kec�cs 3. I have contacted �te€a��-6reet�of Greer tank. He reports that Greer didn't begin to make 2 compartment tanks until 1979. In addition, since we were able to pump 1000 gallons from the tank, it is very likely that this is only a single compartment tank. 3. In 1989 FNMA hired Corwin and Associates to move a portion of the seepage trench which encroached on the neighboring property. At that time Corwin also provided an as -built survey which was used for the permit. According to that survey, only a single cleanout was present. There was a separation of 10 feet between the cleanout and the first trench cleanout. Later, on the inspection report, a tank and two cleanouts were drawn in; however, the distance from the trench cleanout to the tank is pictured as 10 feet. Our field measurements verify that the exact distance between the two pipes is 10 feet. This indicates to us that the second pipe was not there during the upgrade. Page 2 Dan Roth 4. In 1992 our clients experienced a sewage backup into the dwelling. Acreage Systems dug up both ends of the tank and found them broken. As a result, repairs were made to the lines and two foundation cleanouts, sweeping in opposite directions, were added to the line. It seems reasonable that a broken or missing cleanout would have been replaced at this time; in fact it was not. We have had an excavator examine the site; the conclusion is that it is possible to do more harm than good if we attempt to establish a second cleanout. In addition, it appears that this attempt would probably prove fruitless since we believe that the tank is only one compartment. Since we do not wish to excavate during winter months, I would appreciate having a ruling on this issue as soon as possible. If you have any questions on my request, please contact me at 344-4711. Sincerely, Neil Hawthorne, P. E. N Hawthorne Engineering Ar N C-1 L p -A/ 912-6 �96, Time APPLIONT FILLS OUT UPPER HAI* ONLY Time Property Owner \ — [PlooeMailing Time li)--„ry r �# Address ��Zip Code Buyer �IL�1;-tri a'-oi`] Date Address /'u i ,iii-'. {'_}, ,- �,er;_`�: .-•/[.A Zip Code .S %7 Lending Institution -� '17 A/ �. ;. A/ Phone Address l '!ir1 Z, riot c!f d"C-1Jc., ,i i -h Zip Code Field Notes: Realty Co. & Agent Phone Address"' -c, 11_/ -/iri Zip Code y% ->,S 4 7� ��t\ Legal Description 0 5j 3toc&. - 51 i ,. ;3 br V r> (d IV Street Location �• 7���,f ;� v: �y ;�.. !�_ Type of Residence RE Single Family —3' ❑ Multiple Family No. of Bedrooms ( ) DISAPPROVED -- ❑ Other Water Supply Soils Rating �. Individual Well To Absorption Area WELL LOG. A well log is required for all wells drilled FFe since June 1975. ❑ Community s drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal Individual Year Individual Installed: Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: MUNICIPALITY OF ANCHORAGE EN` IR r'. f,..-:.UION RE ( 'Y'APPROVED BEDROOMS —3' 'CONDITIONS OF APPROVAL ( ) DISAPPROVED -- ( ) CONDITIONAL APP OVAL': DATE BY: )-i:-- Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72023 i Wl ti r 0 430 0-'e D -Y vc MUNICIPALITY OF ANCHORAGE - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION _ 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL ENGINEERING DIVISION 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. 1. PROPERTY OWNER q PHONE U ':f 3-a /7 MAI ING AD RESS L,um/V PROPERTY�jRESIDENT (If different from abopve)` PHONE r ' 6 J J 2. BUYERPHONE ATTACH WELL LOG. A well log is required for all wells drilled C� O Alb J since June 1975. For wells drilled prior to that date, give well MAILING ADDRESS 3. LENDING INSTITUTION PHONE G K S G /� I U V a C� INDIVIDUAL/ON-SITE** **If MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 0'& � -e" t QA 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ® Three Cl 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 C� INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date lelll If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) G THIS SIDE FOR OFFICIAL USE ONLY 0 , INSPECTION APPOINTMENTS DATE RECEIVED .. TIME - TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 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 ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑SepticTank or El Holding Tank Sizer,�If Tank is homemade give dimensions: SOILS RATING � <0 TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ? lir A. 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS I& "APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE �- 3, ` BY (Title) I tZ�i- " / � V LEGAL DESCRIPTION 72-010 72-010 (Rev. 3/78) 0-