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Home My WebLink AboutSEACLIFF BLK 1 LT 15eac 1iff Block 1 Lot 15 #011-221-16 y t ,, OF ANCHORAGE _'JIUNICIPALITY _ r*reLg DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ®NEW 337-3055 1 0UPGRADE MAILING ADDRESS 149 Michael Ct. LEGAL DESCRIPTION Lot 3x4 Block 1 Sea Cliff Subdivision LOCATION NO. OF BEDROOMS Shore Crest Drive 3 Well Absorption area Dwelling PERMIT NO. Vy DISTANCE TO: i[ommunity Wat r 61 18, 780386 t z Manufacturer Material — No. of compartments LU Steel 2 Liq. capacity in gallons 1000 IF HOMEMADE: Inside length Width Liquid depth ❑ Y DISTANCE TO: Well Dwelling PERMIT NO. =O z z Ia„ Manufacturer Material Liquid capacity in gallons ❑ DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. Lu = 30' 2 9r 7903196 J LL Z Distance between lines No. of lines 1 Length of each line Total length of lines Trench width P z r t n inches --------- Top of tile to finish grade - Material beneath the ¢ F Tota eff_ct a abs tion area ❑ 71 72 inches 4q.�. Length Width Depth PERMIT NO. LU a Q F- Type of crib Crib diameter Crib depth Total effective absorption area o. a w W DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS Cast iron & plasticperforate( SOIL TEST RATING Pips:. 110 S.F./B.R. INSTALLER Glacier Excavatin REMARKS �{ae+aapd96 ¢ aaga O fJ1_r `Sf ` s � i V Ah �g •' �'�' ao 4°voeaeeo 00 o eoaeae+a,. s`^ ,j�dy i, b! - Qaal A. tausain TTI APP OVED DATE LEGAL Z-+ olnev. o//o) / / MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SO FT/BR)= 110 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ca E: F> -r " -_ q L_ E: "o"r o FR " *vp E: L_ ci e Fzs -r " - es THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A 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 AND THE BOTTOM OF THE EXCAVATION <IN FEET). :E3E:F1'-rlG -runt A-RDOC-71 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. --- -rW U-1 <;2 > I " k=--- F=" U C�'r I "_ ":-S. F4 FZ U SEC -1 k-1 I F;,> E: Cx BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM 15 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F::D* [-= R M I 'r E: X F=* I R E-='er r-, FE I::- IErMEI Ei- FZ =-- _-L . -1 L=am c I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. 5 1 G N E D7.- --- �ee .ZGL,5" APPLICANT THOMAS JOSEK C_0_N_S:KCTI0N f4Q--......Y-Z6-78 - ISSUED BY -_ -----___.-.._-..-.._.__-__DATE_______________ ..... DATE-- V3.2 DEPARTMENT ALTH - -- - - - - - -- - - - AND EN - VIRONMENTAL r -r:T I ON 104,4AY 025 ':-,fREET, ANC4 13RAGE, AK. 99bvii- 264-4720 I -VF= '.�_ FE t -A E: Fes' F- FE F7,- M I -r PERMIT' I NO. t 780.3036 APPLICANT THOMAS JOSEPH CONSTRUCT 149 MICHAEL. CT 337-3055 LOCATION SHORECREST DRIVE LEGAL Lf�*/81 SEA CLIFF S/D LOT SIZE 16000 SQUARE FEET t-) TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SO FT/BR)= 110 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ca E: F> -r " -_ q L_ E: "o"r o FR " *vp E: L_ ci e Fzs -r " - es THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A 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 AND THE BOTTOM OF THE EXCAVATION <IN FEET). :E3E:F1'-rlG -runt A-RDOC-71 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. --- -rW U-1 <;2 > I " k=--- F=" U C�'r I "_ ":-S. F4 FZ U SEC -1 k-1 I F;,> E: Cx BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM 15 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F::D* [-= R M I 'r E: X F=* I R E-='er r-, FE I::- IErMEI Ei- FZ =-- _-L . -1 L=am c I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. 5 1 G N E D7.- --- �ee .ZGL,5" APPLICANT THOMAS JOSEK C_0_N_S:KCTI0N f4Q--......Y-Z6-78 - ISSUED BY -_ -----___.-.._-..-.._.__-__DATE_______________ ..... DATE-- V3.2 �nstzuetton moist /- ►_ "one tett is,eonh a thousand 00"lont"` 2204 Cleveland Anchorage, Alaska 99503 Performed For Glacier Excavating _Date Performed 5-25-78 Lenal neserintion: Lot jLi4Bloek_..j—Subdivision sea cliff suba;v,Gin This Form Renorts Soils Loo Yes Percolation Test_ !tenth Feet Soil Characteristics 2 Brown Silty Sand 4 Reddish Silt 6Brown Sandy Gravel — 6— 10 — Brown Sand 12- 14- 16— is— Bottom 2- 14-16— ls— 20— Bottom 'of test hole Was Ground Water Encountered? NO If Yes, At what Depth? ti 0 �MMMM "• ==an irsai� Readinq Date Gross Time Net Time Depth to H2O Net Oron Percolation Rate Flinute Prnposed Installation: -Seenaee Pit Drain Field Deoth of Inlet Dept To Bottom Of Pit Or rent CAMIJENTS: 125 Sq. Ft. drainage Area ranniraA P-cr T'gjgnnrpm 91 f-., l$, 85 Sq. Ft. draina e area ' 77 7 Test Performed By _ Data Certified By: CTL David Paul Date: 5-25-78 Municipality of Anchorage • -� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 B Street ` P.O. Boxox 119 19 519 Anchorage, AK 995196650 L/ � www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. D I I - ZZ I - COSA# 1. GENERAL INFORMATION Expiration Date: Cl —1 ( O Complete legal description SEACLIFF: BLOCK 1, LOT 15 Location (site address) 5316 SHORECREST DRIVE 'ANCHORAGE, AK 99502 Current Property owner(s) CAROLYN SAMSON Day phone Mailing address Lending agency Mailing address 5316 SHORECREST DRIVE *ANCHORAGE, AK 99502 Day phone 248-9302 Real Estate Agent PEGGY FRENCH W/REMAX Day phone 243-ID569 Mailing address 110 W. 38TH SUITE 100 *ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowr(ers. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l verify that Guidelines for this application, investigation, based on procedures outlined in the Certificate of On -Site Systems App pP 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. 1 further verify that based on the information obtained from the Municipality of Anchorage riles 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 Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SURE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described tho 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, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. 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 or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Phone 337-6179 Date 9 oq _ood�opp oQaQ_�. OF A _ ��pppl * : 9 ¢, Garn ss.- i 0000 y ,CE- �c`G Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the (flowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Other OF A& \��G�Q •,• •'•. 4'0 jam: • ON-SITE •••'Gis WATER AND WASTEWATER PROGRAM By: �a e_ �� i�2Original Certificate Date:_ G —Q )Rev 11N5) -\ Municipality of Anchorage j • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SEACLIFF; BLOCK 1, LOT 15 Parcel ID: O A. WELL DATA Well type CLASS 'A' If A, B, or C provide PWSID# 210485 Well Log (YIN) Date completed Sanitary seal (Y/N)_ Wires properly protected (YIN) Total depth - ft. Cased to ft. Casing height (abo round) in. FROM WELL LOG AT IN TION Date of test Static water level ft.' ft. Well production g.p:m. g.p.m. WATER SAMPLE RESU Coliform colonies/100 ml. Nitrate mg./L. , Other bacteria - colonies/100 ml. A Ic: ug./L. Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA *INSIDE CRALWSPACE. Tank Type/Material SEPTIC/STEEL Date installed 7/26/78 Tank size '1000 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (YIN) *YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 8/4/09 Pumper ISAACS PUMPING C. ABSORPTION FIELD DATA Low EXISTING 0aAoe Date installed 7/26/79 Soil rating (g.p.d./fe/bdr 110 System type TRENCH Length 29 ft. Width 5 ft. Gravel below pipe 6 ft. Total depth *12.41 ft. Eff. absorption area 348 ft' Monitoring tube YES Depression over field NO Date of adequacy test 6/6/09 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth In absorption field before test 48 In. Water added 5100 gal. New depth 59 in. Elapsed Time: 355 min. Final fluid depth 48, in. Absorption rate >= 450+ g•p.d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN if yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" leve High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service lin On adjacent On adjacent lots Holding tank COMMUNITY WELL manhole/cleanout Anim 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 't 0'+ Surface water 100'+ Driveway, parking/vehicle storage "'0' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PVr/200'+ PUBLIC F. COMMENTS PER INSPECTION REPORT DATED7/26/1978. ••PORTION of DRAINFlELD IS UNDER DRIVEWAY. SUMP IS EIiCASED IN STEEL CASINO WITH STEEL CAP.. APPROVED AS—IS IN 1995. G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections and O e review of Municipal records that the above systems are in p' conformance with MOA COSA guidelines in effect on this date.*. Engineer's Printed Name JEFFREY A. GARNESS 0 •j Date COSA Fee A L1 9 D Waiver Fee $ Date of Payment/ 07 Date of Payment Receipt Number 07? 197 Receipt Number (Rev. 11105) x saaL r.�a . N , m SURWY CVrMCAT10N eo Prepared by OF Robert E. Johns, Jr. & Assoc. �ti s 1wrlw �M�i11 �'t� N Professional Lend Surveyors /�K D AMQ T17M a MtOl ...... ►. r �.A {h � 9oa1x � n � 501 lM SF, Il.o. Plot F74 FLA. l M,11 L ✓t.� .. Owl 1.VV Y 1 9-04-05 skml rpm Cn.�za+r. ACEVAT a 121 r-` -On-O� SZQ424 $209 v mwi sa Rq . ,..._ .r..Lg.. sy+ .,r y _x•102 Lot is Siad; 1 .SEscliif r'1 Wi,j::ijT SJ,gx � � 1 �� i e•waa/.� M � FL OT FLA.,`:'3 R LCT '.. IT 114 TIM.' RM=NCN'.C_--I1.TT Cr-" 3•.Jtl it CM C'aN�, VMMCR T7 CTaI.Y T4e.•'.2 167P%C*AM--.74-7 A.N.Aoa CRCJWO ANb 1.F t&. %,U 'G2 CCNVTz'C'RCx. T %Irr Y PqC�".. 7 =1=1wO CRAZZ MLAT�.2 llx.+wl /ML9� VW-" WTfG mrlkwd.R St=*A Xi MIYL'M.aY7, TO FINPlp CRACC Alta U" --r CCXsI[OT:CMC ANO TO OCT UZIC RTt_. A.?. WOwa M T1.C. A. CO ATS LCCAM . CLARY. • •1•IOM TMC CXST--W= Cr ANY CA IN"' 3. COM_NAMT7 OR RC3'bC'IC143 MAv ORCWdT 90w1( MMOVV f C1T3 "ON O^N® 6=4 ACD 7nlO' OC NC' Ao!"AX CH TM'. R=CR--= 5`C.^IVI7iCN PLAT. ALL DISTANCZS AAA PLCCWD VNLl=S L7i£t NC C1t.:.X$TAMCr� EHC'.J AM AS -C %.T C U= FCA CW:'t=T•CN CR rpt C.1A.`9N1.6 ilG.1'C.1,tY LR 7D.CC LM.I. '.1.'^...t"'.?"_.."�.� Y^ " :i.:.� '.i::."aS.~X C;ZY .1•a' ,lt�•w.:.. T.�i jm3 L.17-1 1 Cw y ?.:k w C*bf CF Tili iLl"2Y.. USF- O!TAM.CSS RFYA1_C" 2CALM 7C7Yw`LT"".,,`M MAY CAl1w LL'R':F'9 H Y.'ALS CHAZ MECHANICAL Plumbing, Heating & Refrigeration 4620 Edinburgh Drive Anchorage, Alaska 995Ga, N° 5835 Date Starting Time Work Ordered By By / Date / Time 1Starting <8 _ ag_� 7OXrTaken JOB ADDRESS NAME STREE PHONI Si 9b" ALL WORK C.O.D. ONE HOUR MINIMUM CHARGE. LABOR RATE l�Z for the first h r and for each 1h hour thereafter with +h hour minimums. WORK TO BE DONE :1,.An, C W 0 \p n ,.n ttti• WORK AUTHORIZED BY MATERIAL EQUIPMENT PAID BY 0 PERMITS I hereby acknowledge the satisfactory completion of the above work and billing. I agree TOTAL ► to pay any fees Incurred to collect payment in full. 11h% per month service charge on past due accounts. SIGNATURE 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 ofahis 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 furtherverify 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 V ct on the date of this inspection. Alaska a er & Name of Firm W 71 mr terServlcDr. es Phone' -A- '337—(a 179 Anc 1 K9. k Address Engineer's signature JA Date { 114- ri 5 ... OFA 9 . P twxH '• •• Rf�n y Y g 4ti B . S r y A. Garness I� • CE -7953 x �c�AO AW 6. DHHS SIGNATURE _. 0� °ROFESSNP"d O Approved for. bedrooms. I Disapproved Conditional approval for bedrooms, with the following stipulations: Additional Comments,' 41'It_�li Al, Date �--_ CAUTION r ,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 i . 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. a l :1 72-025(R".1/01) Back MOAN21 a : - Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 15- A. S A. Well Data P,l< L SGA CUA Parcel I.D. 0 c)lj-z2.1-1(0—CDC Well type c0m`111 ly _3013, or C, attach ADEC letter. ADEC water system number (Y/N) Date completed Driller . Total Sanitary seal Date of test Static water level Well flow Pump levell Cased to FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ITER SAMP RESULTS: ifor e of sample: Casing height Wires properly protected (Y/N) g.p.m. AT INSPECTION On adlakent lots ; On adjacent I blic sewer Petroleum tank Collected by: B. SEPTIC/HOLDING TANK DATA -� 2 bB 10 ob Date installed � Tank size Other bacteria partments G Cleanouts (Y/N) `/ S Foundation cleanout (Y/N) N O Depression (Y/N) WD High water alarm (Y/N) N 1,4, Alarm tested (Y/N) N /14 Date of pumping I/i 4� 95 Pumper C>L-D HC t7o� DS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Q caNs,s, t gSuR-��'f Well� s) on lot N'On adjacent lots N/A Foundation P.s-BN�l-i Cj � To property line 401 Absorption field (el t Water main/service line IO uro�w�w� Surface water/drainage K10 "I—= ygSf2D Lwin ) = >) oo 72-026(3/93)• Front CONTINUED ON BACK PAGE rn C: o z n zv 9.p -m. ._. r r , Q0 y O mT <> C.n i C C y G: Z Other bacteria partments G Cleanouts (Y/N) `/ S Foundation cleanout (Y/N) N O Depression (Y/N) WD High water alarm (Y/N) N 1,4, Alarm tested (Y/N) N /14 Date of pumping I/i 4� 95 Pumper C>L-D HC t7o� DS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Q caNs,s, t gSuR-��'f Well� s) on lot N'On adjacent lots N/A Foundation P.s-BN�l-i Cj � To property line 401 Absorption field (el t Water main/service line IO uro�w�w� Surface water/drainage K10 "I—= ygSf2D Lwin ) = >) oo 72-026(3/93)• Front CONTINUED ON BACK PAGE �j C. IFT STATION 0.3 In ? vi TT Date insta ted,` Manufacturer ? Size in gallons \ �� Manhole/Access (Y/N Vent (Y/N) "Pump bn'" Ievel at "Pump off" Level at High water alarm level Cycles tested Meets MOA electrical codes YIN h 1 Ln SEPARATIOND NCE FROM LIFT STATION TO: J oon lot On adjacent lots Surface water u y D. ABSORPTION FIELD DATA S A,"—`(�C 46�0 coves LC----ff ry� I10'F2 9. R.. Date installed Z� 7 8 Soil rating (GPD/Ft2) System type - f5 C- i Length 2 q Width 5 Gravel thickness (0 Total depth d� Total absorption area 348 'F r Z Cleanout present (Y/N) Depression over field (Y/N) NO II Date of adequacy test I 5 Results (pass/fail) T" SS for Bedrooms / "21rr _ r �� _� 00H — - Water level in absorption field before test _4 z - After test 9 Peroxide treatment (past 12 months) (Y/N) N 1A If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: �+ PL-2Well on lot rl'/'• On adjacent lots Property line 40 To building foundation 3� / CID To existing or abandoned system on lot w1A » oGP_� Cutbank 50 r Water main/service line > 1U/0 On adjacent lots r�Vr+IGr.�owrJ ObBS E2V� b2POJ OF i1Gli // i� Sol,, water wNF_ k,3 : > i oo� Driveway, parking/vehicle storage area is 1.3 D9 -NLA ay�COovF� Curtain drain N P1 (NSPac ;-iorJ R -S paryT l� L-,14�,7-a_D 7/7-(./`7e E. ENGINEER'S CERTIFICATION PG�P_ s r,r-_ FIsXr 1/14/,?g- certify /14/`lscertify that I have checked, verified, or co formed to all MOA and HAA guidelines in effect on the date of this inspection. 6 O• Signature � •.^s� car ay ub>: '_. „ 6s Engineer's Nam °°°�•°• •• •• Fr y A. Garners WJ Date CE•79s3 °e•o : •( .V L.(J �pROFESSIC V'�\.� � igen n HAA Fee $ _� �� ' oZ� Waiver Fee $ Date of Payment - �7-��" �} -tom Date of Payment Receipt Number �'�� Gam, Receipt Number 72-026 (3/93)' Back Alaska Water & Wastewater Services "Preserving The Last Frontier" January 17, 1995 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: HAA, Lot 15, Bk 1, Sea Cliff S/D To whom it may concern: The subject property is served by community water, and an individual onsite septic system. The trench had 52.5" of standing water in it on 1/14/95. Per the initial inspection report, dated 7/26/78, the trench is 72 inches deep (currently 73% full). I introduced water into it at a rate of 5.63 gpm for a total of 80 minutes (450 gallons). The liquid level rose only 4.5". The system recovered completely in less than 50 minutes. Based upon this data the system was deemed to be adequate for a 3 bedroom house (450 gpd). The clean-out at the beginning of the trench had a blockage in it on 1/14/95_ This was discovered when I tried to introduce water into it, and within several minutes water began to flow out onto the ground. The homeowners arranged to repair this (see attached statement). (VOTE= The adequacy of a septic system is influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of septic tank pumping, usage of biological additives), condition of drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age), type of substances deposited in septic system (cigarette butts, sanitary napkins, mise objects), and the amount of water being introduced on a continual basis_ Consequently, the results of this adequacy test are only valid for the specific day of the test. If you have any question, please call me a 337 -6179 - Sincerely, Carness, P.E., M_S_ ltant RECEIVED JAN 1 91995 Municipality of Anchorage Dept. Health & Human Services Telephone: (907) 337-6179 • Fax: (907) 338-3246 . 8471 Brookridge Drive . Anchorage, Alaska 99504 �INVOICCEE 20FONW4,./ O V 92 SEWER AND DRA N$ lza&ce CLEANING SERVICE 7iew�c tkc Z3satw' • P.O. BOX 112688 PHONE345.2513 ANCHORAGE, ALASKA 99511-2688 L Jot)Address 7 Joo.-r J (DATE SALESMAN TERMpS-80DAYS b CUSTOMERQRDEAN ROTO -ROOTER SERVICE CALL HRS. a STEAM THAWING TRIPCHARGE HRS. HRS. OVERTIMECHARGE HRS. ADDITIONAL LABOR CHARGE HRS. a k'PUMPINGSERVICE' C.�(GAL.) HRS - RS.HYDRO•JETSERVICE HYDRO -JET SERVICE MRS. MATERIALS PLEASE PAY FROM THIS INVOICE TOTAL FOOTAGE CLEANED OR THAWED_.. BLADESUSED--/ PROBABLE CAUSE OF STOPPAGE�'"�^"ti L +T JOBNOTGUARANTEED RF UjCfVING EASON WORKACCEPTEDBY 07 . r.' As Built N.0006'V'✓ 143. w, • � QnB � ,f CASc'h1"r-PJTS OF RcCORD, OTHER 7HAN THOSE 5HO1"/FJ Oi,J i H R:CMD;:D PLAT, ARS: NOT SHOWN HR -60,4, �} No Cornets Fwt This. Data �' [cook No, Page No, r ' 1 I hereby certify that I hove WrVoysd the following dowribod proporty, Lot =wlock CL 11-F /J• ..._ _ Anahorn;e raeording' Proeinct, Alalka, and that the improvernmta lituated thereon ars within the property Met and do not OVarlap or' encroach on the proporty, lying adjacent thereto, that no imptoyanNntl on property lying Bdjo Cont thereto encroach on the premirol In quallion and that then are no roLdwayl, ir6mmuuon liner or other visible to"monts on raid property except as indicated her•On. AnchorBpe, Alaska - ? _ jzmhe 19 �1- r `'p�J�S►.3 � a��uJ�a l N H•II Nee Me lNea MlM�re • ,`•. .r•..INN1N•••r•.�.•n Hr K(� , yt• �Pronla Htlrionen 1( tri •a• fto, 1301-5 r• j;OF r y OIFSSIWIA4 � A]. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL �1 g9_Aag'�9 8 OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, GST /.!;� j32,0eg /:-,Sc7�Cuf6 `i ��l /j .'Q9 Location (address or directions) (b) Property Owner` `e,4R6d `,4 Telephone: Home -,2 T3 — Z43 Business Mailing Address ' (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent SJtr� f c�ikD� Address Telephone (e) Mail the HAA to the following address: or: Check here ❑, if hold for pick up. List contact person and day hone number below. ,mss wic,�. �ic,� u P 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms - 3. WATER SUPPLY Individual Well ❑ Communityx 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 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (Rev 8/861 Front Z_ii vi — 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 /��4! j Telephone` Address /T�'d �•� 3� /%tom 3tri j3 y! f,//i5o3 Date r�d.af y►.�ata 9 da00'..q r vj� • T •:'� 6 �. .. . 00004000t 0o •• ...•,g Is ROY C. REID, JR. : $ # CEE220er: a. vr � •1 •: C�1� 4F 1.-/••.....••• b �t 6. DHHS APPROVAL / Approved forl'1+� (J'� bedrooms by Date —c /Gzae- Approved Disapproved Terms of Conditional Approval Conditional CAUTION 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 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. Page 2 of 2 _ 72-025 (Rev 8/861 Back MUNICIPALITY OF ANCHORAGE (MOF4/MUNIcIp HEALTH AUTHORITY APPROVAL (HAA) ENVIRON Mt�1AL ALITyOFgNC}�p CHECKLIST RAGE - FEBRUARY 1984 264-4720 SERVNCEgp F /VISION' 1(jN n, �9 Legal Description: yi �� 13J /�/fez7�T 1988 A. WELL DATA RECEl VE Well Classification If A, B, C, D.E.C. Approved(�/N) IA 2-10y ell Log Present (Y/N) Date Completed Yield Total De Cased to Depth of Grouting Static Water Leve Pump Set At Casing Height Above Grou 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 ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ; On A ing Lots To Nearest Public Sewer Line To Nearest Public Se Cleanout/Manhole To Nearest Sewer Service Line o of Water Sample Collected by ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed �'-�� 1'r Size No. of Compartments Standpipes 6))N) Air -tight Caps Y/N) Foundation Cleanout (Y N)) Depression over Tank (YO Date Last Pumped �'"" � ✓'6 �5 Pumping/Maintenance Contract on File (Y/N)%/4 for Holding Tank High -Water Alarm (Y/N) A Temporary Holding Tank Permit (Y/N)l Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line D To Building Foundation To Disposal Field s 0 To Water Main/Service Line J0 % To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata //0 Type of System Design i Date Installed 7-;,6- Length of Field z Width of Field � / Depth of Field /_3 Square Feet of Absorption Area N Depression over Field (Y&I jj — Results of Last Adequacy Test Gravel Bed Thickness T� ✓ Standpipes Present 6)N) Date of Last Adequacy Test''" A7 -Z Separation Distance from Absorption Field: To Water -Supply Well 2 To Building Foundation Lot To Water Main/Service Line •f' To Property Line To Existing or Abandoned System on On Adjoining Lots ;2-6 To Cutbank (if present) N To Stream/Pond/Lake/or Major Drainage Course /61U To Driveway, Parking Area, or Vehicle Storage Area 7t'i1.14if ulle,-/` R111,5Alll 1' .7 °oEl' )J13'4w49 N✓Wrkua, Comments — D. LIFT STATION Date Fa alled Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I hav�e/peck] v/erifi d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed / `�� ' G _ Date (0-/b -q Company N 5 MOA No. -) ' OF At �'Qk �1/J ��°eceeooe000e b'4b� Receipt No. Date of Payment— o �+�° 49TH e� Amount: $ +1e *go a C9e ea SaDf o LER C. REID JR. " pj Page 72-026 (11/84) STEVE COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 DATE: 6-Z-96 ---------------- PWSID #: ZkOgas ------------------ To Whom It May Concern: 563-6775 According to the records on file in this office, the ------------ _F 1(J ------_— Water System is in compliance with the -- -P_a,& ----�`- State of Alaska Drinking Water Regulations. Sincerely. Ronald Lein Y" Environmental Field Officer RSK:sa K 5. LEGAL DESCRIPTION MUNICIPALITY Cl- ANCh10PrA011- MUNICIPALITY OF ANCHORAGE DEPT. C. - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTICpNr./I�4ON),r;r_i�jia(. DEPARTMENT 825 L Street - Anchorage, Alaska 99501 5316 Shorecrest Drive ENVIRONMENTAL ENGINEERING DIVISION 6. TYPE OF RESIDENCE Telephone 264-4720 R PA�fL� �4 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER ❑ MULTIPLE FAMILY PHONE Barbara C. Kalmbach 243-2483 MAILING ADDRESS AZ COMMUNITY 5316 Shorecrest Drive 99502 ❑ PUBLIC UTILITY PROPERTY RESIDENT (If different from above) 8. SEWAGEDISPOSALSYSTEM PHONE 2. BUYER - **If individual/on-site, give installation date 1978 PHONE MAILING ADDRESS ❑ PUBLIC UTILITY 3. LENDING INSTITUTION NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. PHONE Alaska Mutual Savings Bank % Pat 274-2511 MAILING ADDRESS Post Office Box 1120 99510 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION Lot--1=Y'Block 1 Seacliff Subdivision STREET LOCATION 5316 Shorecrest Drive 99502 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One :KX Four ❑ Other XZ SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled AZ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGEDISPOSALSYSTEM **If individual/on-site, give installation date 1978 �� INDIVIDUAL/ON-SITE** 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. n 72-010(3/78) i0l-0 POLLD)l l Olt C Et(5 l�_nq L) l I �I% t00A clh-ADL16A l gc-tL J '024 /4 A'l' L' af'o / 2'e3 n ] 4t eAV bUDL.LI/d a i-Ate-P-� .� - LLD l2 LL1l C l rn l� !+`1G�61LO !� 1f b Alar A001 f��l cit f/1 tea c c,cz . THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE - INSPECTOR INSPECTOR INSPECTOR " DI R ECTI ONS: - 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 DR I LLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER " DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: 1 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank - Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 6�4 G. PROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78) Alaska Mutual Savi s Banl�oRAGE �NICIPALITY C. AN 5th & F STREET • P. O. BOX 1120 • ANCHORAGtEAI,.PCSKA-99510-1 ENVIROtiw'ENTAL p70iLcTION September 14, 1979 St1 1 RECEIVED Municipality of Anchorage Department of Health & Environmental Protection 9th and L Streets Anchorage, Alaska 99501 Ladies & Gentlemen: In July of 1978 Mr. Thomas Joseph, builder, ordered an on-site sewage disposal system inspection on Lot 14, Block 1, Seacliff Subd. He also ordered a soils test which was performed on 5/25/78 on the same property. Both reports show the existing house on the lot. However, the subject property was actually Lot 15, Block 1, Seacliff Subdivision. Lot 14, Block 1, is a vacant lot owned by Mr. R. J. Rhodes whose phone is 243-5515. In a phone call to Mr. Rhodes on September 13, 1979, I verified that he does own Lot 14, Block 1, that there is no house on the lot and there)also is no disposal system on that lot. That information, along with the fact that we have in the construction file, as provided by the builder, the appropriate inspection reports, we submit as evidence that the original lot designation was incorrect. We would greatly appreciate your correcting the records to reflect that. I am also attaching a request for approval of the septic system. Thank you for your help. Si/ ncerely, i P t o en Loan Officer Enc. " MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONY 2. Property Owner: Barbara C. Kalmbach Mailing Address: 5316 Shorecrest Drive Day Phone: 243-2483 3. Name of Buyer: Mailing Address: Day Phone: 4. Name of Lending Institution: Alaska Mutual Savings Bank Mailing Address: P.O. Box 1120, Anchorage 9951OPhone: 274-2551 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description:_ E Phone: Lot 15, Block 1, Seacliff Subdivision Location: 5316 Shorecrest Drive (inspection report #780386 — 7/26/78) Type of Facility to be Inspected: septic system No. Bdrms.. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site) X If Individual, date of installation 5/78 72-003(3/76)