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HomeMy WebLinkAboutSEQUOIA ESTATES BLK 1 LT 17Onsite File Sequoia Estates Block 1 Lot 17 #017-152-17 Municipality of Anchorage On -Site Water and Wastewater Section ° (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211397 PID Number: 017-152-17 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Q Upgrade Name Jay Farmwald & Rita Norton ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench Q Bed ❑ Mound Site Address 6600 Gunnison Dr, Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 350-1648 4 0.8 GPD/SF 4.9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.4 Ft. Gravel depth beneath pipe 0.5Ft. Subdivision Block Lot Sequoia Estates 1 17 Fill added above original grade 0.1 Ft. Gravel length 50 Ft. Township Range Section Gravel width 18 Ft. Beds: Number of Lines 3 Distance between lines 6 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 900 Ft2 Ft. Well >100' >1 00' N/A N/A >25 TANK ❑. Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,250 Gal. Surface water > 100' > 100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' 0' > 1 0' N/A N/A LIFT STATION Manufacturer Capacity Remarks Septic tank, bed, & line from tank to bed Gal. are all insulated. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Glacier Masonry Drainfield D3034 CO/MTD3034 Inspector J. Millette / L. Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection 15 10/8/21 10/11/21 Location and description dates: 2°d t Bottom of siding a@ point A 3rd 4 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp )F 1 bo Conditional Approval: Date eel, eP�°°°'`°°"°�qSo�® •°�°` ®�® � 49th �um°mim mmnmm°.mama...Jj��j a d6mmmms® g mmnm .°aevenemmmmmmmmuuummmmmmnmmmmm.....`. . MICHAEL E. ANDERSON c No. CE -4381 ®�� Septic System Approved Date % #0%011/2/21°°"° � Note: this approval does not include well permit requirements. trcev ucivu_iu/ 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH#1 PERMIT # OSP211397 PID # 017-152-17 SEQUOIA ESTATES SUB, BLOCK 1 LOT 17 A B 2CO1 21.5 MH 22.6 SV 25.9 A B 2CO2 27.2 FD 30.5 MT1 63.0 CO1 65.4 13.0 15.1 19.9 22.0 26.5 57.4 59.1 FEET 0 50 100 GUNNISON D R I V E 4-BDRM HOME November 2, 2021 10' UTILITY EASEMENT 20' DRAINAGE AND WALKWAY EASEMENT2CO1 2CO2 FD CO3 MT2 MT1 MT4 MT3 CO2CO6 CO5 CO4 NEW 50' LONG x 18' WIDE ABSORPTION BED NEW 1250-GAL SEPTIC TANK w/ 20" MANWAY EXISTING TANK REMOVED & DISPOSED OF BOTH NORTH CORNERS OF EXISTING FIELD WERE EXPOSED AT CONSTRUCTION & 6' SEPARATION TO NEW BED CONFIRMED EXISTING FIELD TO REMAIN IN SERVICE FOR FUTURE USE EXISTING WELLS w/ 100' RADII 810 800 790 780 770 805 810 CO1 SV MH PLAN AS-BUILT CO2 71.5 CO3 77.5 MT2 79.6 MT3 85.0 CO4 85.6 CO5 90.3 CO6 94.9 65.4 71.4 74.3 65.8 67.2 72.6 77.8 MT4 97.980.7 PROFILE AS-BUILT (NO SCALE) 92.9 88.1 93.6 99.02COMH SV1250 GAL SEPTIC TANK 94.7 FINISH GRADE 50' DRAINFIELD ROCKMT TH#1NO GROUNDWATER 9/7/21 89.7 90.2 COCO82.6 89.7 90.2 94.6 ORIGINAL GRADE MT2CO92.7 November 2, 2021 PERMIT # OSP211397 PID # 017-152-17 SEQUOIA ESTATES SUB, BLOCK 1 LOT 17 2" INSULATION 2" INSULATION GUNNISON DRIVE= 8499E ............... ............. M � r= 600.00 L= 173.15 _ 10' Utility Easement:7 ° f° I ° °� Septic vent (typ) i/Vell I ° °° ° NT N U) W r cle) O — 4-' o Co 0 Cn c en °L6 Cf) tts CL ° I Fire pit Manhole • 24.5 h 24_n j 40.3 I I C: E 0 Ca W I CU 0 N co C: O N ,4:6 �- - co 3.0 deck N CD 3.5 21.5 9.0 O cn 7. 0 Co �o� 2 Story Frame House 0 �0 12.0 0 deck 12.0 Ret. wall (typ) LOT 17 co CD 00N T C) 0 Z Lot 16 SCALE: V= 50' .`NX` ! X 1 of A �1 BW �• • v ow *• elk 00 li • . • • • • • • • • F• 00 ' %�.. 4 .... . . .... Elizabeth L. Walatka • o • • 8036 - LS • ®� '` F . . , r �QF SfQt�A � ES� AS -BUILT NO CORNERS SET THIS DATE S89°56'00"E 172.50 1 hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following Rabbit Creek Subd. described property: LOT 17, BLOCK 1, SEQUOIA ESTATES Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 13th day of October , 2021. EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES, L.L.C. THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON BE Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 21-0, pg 22-23 & 33-35 907-248-1606 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. x00V-t4 -60 rn rt m rr a> y cn H. 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J W m m O n =- i y a a r• m m �1 a rr m m m C r• m 0 .7 m C O a ft rr O rn C m 0 rr a a a m m 0 m C a• C m a. a rr 0 rr rr - MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite ❑n -Site Wastewater ❑isposai System Permit Permit Number: OSP211397 Work Type: Septic Upgrade Tax Code Number: 01715217000 Site Legal Address: SEQUOIA ESTATES BILK 1 LT 17 6:2939 Site Mailing Address: 6600 GUNNISON DR, Anchorage Owner: FARMWALD JAY ALAN & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: ment a Department Lot Size in Sq Ft: Total Bedrooms: 9/17/2021 9/17/2022 49048 Q Disposal Field CJI Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage Al! construction shall be in accordance with: 1. The attached approvers 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing }. Special Provisions: Prior to future COSA approval: ' 1) Permit 03 0347 for a 1200 sq ft building addition shall be closed out (a certificate of occupancy was never obtained). 2) A right-of-way encroachment permit shall be obtained for the well located in the utility easement. Veronica Pope GE 2021.09.17 Received By: 09:51:40 -08'00' Issued By: Date: q Date: r 7 •��� 4 MUNICIPALITY OF ANCHORAGE Community Development Department `fie ' Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-152-17 Property owner(s) Jay Farmwald & Rita Norton Day phone 350-1648 Mailing address 6600 Gunnison Dr, Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Sequoia Estates Sub, Block 1 Lot 17 Legal description (Township, Range & Section) Lot Size 49,048 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (N all that apply) Absorption Field ❑X Septic Tank IN Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) ❑X Upgrade (w/wo ADU) ❑X Renewal ElDuplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 595 Date of Payment: 5 a 0,2 Receipt Number: 0 11 Sa() Permit No. OSPZ 11:39 7 Permit App_::- : :'-.,:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. September 13, 2021 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 9/13/21 Subject: Sequoia Estates B1 L17 – 6600 Gunnison Drive Septic system design Dear On-Site Services Engineer: The owner of the above lot has a 4-bedroom home with a failed septic on the property, so we are submitting this permit application for the construction of a new septic system. The attached site plan identifies the location of the home as well as the existing well, and proposed new septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes toward the road steeply near the back of the lot, but near the front the slopes are much milder. It is in that flatter area that the new septic system is located. There are no slopes greater than 25% within 50 feet downslope of the proposed septic site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new bed will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. The existing site is located more than 6’ away. Please refer to the attached test hole log, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211397, Rebecca Carroll, 09/17/21 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH#1 SEQUOIA ESTATES SUB, BLOCK 1 LOT 17 FEET 0 50 100 NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. GUNNI SON DRIVE 4-BDRM HOME September 10, 2021 10' UTILITY EASEMENT 20' DRAINAGE AND WALKWAY EASEMENT2CO 2CO FD CO MT MT MT MT CO COCO C O CO NEW 50' LONG x 18' WIDE ABSORPTION BED NEW 1250-GAL SEPTIC TANK w/ 20" MANWAY INSTALL DOUBLE CLEANOUTS AT INLET & OUTLET DECOMMISSION EXISTING TANK PER UPC EXPOSE BOTH NORTH CORNERS OF EXISTING FIELD TO CONFIRM AT LEAST 6' SEPARATION FROM NEW FIELD PRIOR TO CONSTRUCTION EXISTING FIELD TO REMAIN IN SERVICE FOR FUTURE USE EXISTING WELLS w/ 100' RADII 810 800 790 780 770 805 8 10 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211397, Rebecca Carroll, 09/17/21 SEQUOIA ESTATES SUB, BLOCK 1 LOT 17 TYPICAL BED SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER BED TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER BEDS AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 18' 4' 5" DESIGN FACTORS:SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 2.9 MIN/IN APPLICATION RATE: 0.8 GPD/SF SHALLOW BED SYSTEM 1,250-GAL SEPTIC TANK BOTTOM OF BED: 5' 6" BELOW GRADE FLOW LINE ELEVATION: 5' BELOW GRADE TOP OF BED: 6" ABOVE GRADE 600 GPD / 0.8 GPD/SF = 750 SF OF BED REQUIRED (900 SF SPECIFIED) September 10, 2021 6" 6" 3' 3'6' 6' 6" GEOTEXTILE FABRIC Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211397, Rebecca Carroll, 09/17/21 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) J. MILLETTE DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? 2.9 6 3 4 8/30 1 2 3 4 5 6 GM (SILTY SANDY GRAVEL) Professional Engineers Stamp: NO NONE 9/7/21 SEQUOIA ESTATES SUB, BLOCK 1 LOT 17 8/27/21 017-152-17 JAY FARMWALD 2:401 2 3 4 5 6 3 0 16 / 7 8 16 2:51 3:02 3:13 3:24 3:35 2' OB 10 September 10, 2021 10 10 10 10 10 3 0 16 / 7 3 16 3 0 16 / 6 10 16 3 0 16 / 6 8 16 3 0 16 / 6 9 16 3 0 16 / 6 8 16 4 8 16 4 3 16 3 10 16 3 8 16 3 9 16 3 8 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211397, Rebecca Carroll, 09/17/21 LOT 2 \EL FND LO•i 9 A 14Neee ��uOs�I�N N��• John T. lovast Fcg �S No. 153771 rl �OffSS10NAV �w _ FIND 1/2' Its LOT 8 BLOCK 2 911.2 T LVERT 18"0 OF ! GUNNISON DRIVE nre600' Re 11 Ip' II �_ - UTILITY 809.0 L— 173.15' EA9 M�NT B 1314.5 I l9B FND 2-1/21 AL. CA I � I i I ' I � I ' N. 830 06 30 12.0 also OTESs SET a/e" R@- " S. 88'56'00"E. 172. . It shall be the responsibility of the builder or owner to verify hat building location shown seats all subdivision covenants and oning ordinances. It is the responsibility of the builder to verify all lavation with respect to all utilities. This plat represents the parcel of property described below &Nen froom the recorded plat describing that parcal. Instruments ecordod prior to or after the filing of the recorded plat are of shown. 2.0 �FNO 5/fi�.Y z6"b WELL LOT 16 'UBMITTA� APR 15 2003 63 -G3(f3- 3RETCHEN STULLER S/B" RB I hereby certify that I have surveyed the following described property : LOT 1 7 , BLOCK I, SEQUOIA ESTATES SUBDIVISION as recorded in the Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are located as shown In this plat. )WN. N.V.��r� i I p7ivE'WAY AS BUILT SURVEY II i e1e.o :KD. J.T.L II = 2 ® '-DRAIN FIELD ® CLEAN OUT _ Z Ili e n � 11 W it SEPTIC ® P TANK _�� e21.0 z d NO. 66-4 'rel .-mz! ACNORAe E, ALASKA sell P 82-375 N I azt of OD I cwo4iv£ N r1Wn Nn I nT I 0 / I I6 I ax o z V,=a' II \ ass I-d II i [gt I Va 241' CULVERT `= USE zOtV� PRO EC 783.0— 3 M �y h l u� In - ogate , 0 0 a Vi Work shall be done as shown on this plot plan. Approved � plans and specifi- !ations shall not be changed modified Z or altered without first obtaining a valid itange order. OTESs SET a/e" R@- " S. 88'56'00"E. 172. . It shall be the responsibility of the builder or owner to verify hat building location shown seats all subdivision covenants and oning ordinances. It is the responsibility of the builder to verify all lavation with respect to all utilities. This plat represents the parcel of property described below &Nen froom the recorded plat describing that parcal. Instruments ecordod prior to or after the filing of the recorded plat are of shown. 2.0 �FNO 5/fi�.Y z6"b WELL LOT 16 'UBMITTA� APR 15 2003 63 -G3(f3- 3RETCHEN STULLER S/B" RB I hereby certify that I have surveyed the following described property : LOT 1 7 , BLOCK I, SEQUOIA ESTATES SUBDIVISION as recorded in the Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are located as shown In this plat. )WN. N.V.��r� AS BUILT SURVEY FB. 86-1 :KD. J.T.L LOT 179 BLOCK I GRID. 2939 JTL ENGINEERING CO. )ATE:. 1—Z6 -it 7 P.O. Box II0684, SEOUOIA.ESTATES SUBDIVISION PROJ. NO. 66-4 'rel .-mz! ACNORAe E, ALASKA sell P 82-375 F (n' 444-614A r1Wn Nn I nT I Jun 07 " 9 09:58a Anchc­age Well,', Pump SEw 90724?0742 Oe"Velopment Services h eprwtment Building Safety bivision Or -Site Water Wnstewater Program 4700 Elmore Roar! P.O. pox 144650 ArIchoragre, AK 99507 (907) 3113-7904 PlUmp Installation Loci well Drilling Permit Nut,jber: SjtN.. .Parted Identif a ti.It °turn ex; S a �'sf a-�es tg L 1 `7' f°ulap Insraliatlo, Dare: Pump Intake Dept3x : c-,jhm Top of 1.�'ell Caslna:��s?�`J feet Pump Maslufactvirer's I\Tattle: 1 _,71IC: ,<T -_T I Pump Modit: 'Z Zi !S: (Z9 �f'uatlp Slae7 LFII Pitless Adapter Burial Dept#1: 1 ? feet j Pitless Adapter 14 fallufactrrer's Nawe: Pitiess Adapter bistalisl•: r Well Disinfected Dport Completion"� YeS _) No Method Ofbisiufecaon: ' `� C=oMments: l iytllnfr Installer Name: AAc or Date of issue: -property owner'_i:ime &� Adc€re,s:kr r- —� r rul-I)o 1 0olp S�Yutire, J-kl Atten;i _ ___.—=._ on: The r u :jp sta'ttrr proVide, a pi-,-,- _nstal;aiion l• g :c :17H D5D within Y! days or putr.F inst?)la,io z. MUNICIPALITY OF ANCHORAGE s DE 1TMENT OF HEALTH AND HUMAN SER' =S Environmental Health Division } 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Auma DISTANCES FROM SEPTIC TANK ABSORPTION FIELD WELL AddressTO U ' WELL Ili I � u, t Phone s) Permitjtlo- , ( No. of edrooms ._,_ LOT LINE ''%/'�/� •---- LEGAL DESCRIPTION Lot Block Subdivision FOUNDATION Township, Range, Section --�i AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway. water bodies, etc.) TANKS ^/ V SEPTIC ❑ HOLDING FH F ii It, i -S Dr 6 - Man turer u ac " Capacity in gallo 5 s '7 Ir i Material No. of Compartments TYPE OF SYSTEM ❑ TRENCH IYI BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from / original grade 5- FT r� Total depth from original grade / • ® LFT / fo v Fill added above original gradeGravel FT depth beneath pipe ! FT Gravel length v I� FT Gravel width ` ✓" ! FT Total absorption area�a✓ 9®O SO FT Distance between lines j to. 0 FT Number of lines Soil rating 1 SQ FT Pipe maternall `//1 J 1' PFrI 3CG Installer i ''c Date Installed is WELLS �O j ❑ PRIVATE ❑ OTHER fldentity) Classification (A,B,C) Total Depth FT Cased to FT Insiallei Date Installed: REMARKS: it � � � �• e n fi t L r Q_ ,, -(�•^• o� SDale: T F Inspec -o s P rtorm d I—, -ENIPMEEA .� SEAL "' C� f 3 i off:` �r J °eo . CE -5283 ' I ; e 1 :, `C• y ca 'Sit i >v, Date: ` Pullen was pe�ormed d oidiog to ail Ilial IN i Municipal '7 Municipal and State guidelines in effect on Ihis dale: c Health Department Approval: Date: �� �i /2-U13 (3/85) M1. NI1=IPAL_IT;' OF .,NCHORAGE DEPARTMENT OF HEALTH '_ D ENVIRONMENTAL FRQTECT ON 825 L STREET. ANCHORAGE, AK 99501 254-4720 ON --SITE SEWER PERMIT PERMIT NO: 860IB4 DATE ISSUED.tui l9 E6 APPLICANT: ACREAGE SYSTEMS INC ADDRESS. 601 E.NORTERN LIGHTS ANCHORAGE, AK 9950; CONTACT PHONE: 276-6552 LEGAL GESCRIP: SUBDIVISION: SEOUOIA EST. LOT: 17 BLOCK- 1 SECTION: 26 TOWNSHIP: 122 RANGE: 3N LOT SIZE: 49200 159,FT. OR ACRES; MAX BEDROOMS: 4 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. I cErtifv that: 1, I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska, 2, I will install the system in accordance with all MON codes and regulations, and in compliance with the design criteria of this permit. ', i will adhere to all MOR and State of Alaska requirements for the set hack distances from any Existing we'll, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 4 bedrooms and any enlargement will require an additional per:ait. IF A LIFT STATiQ.1 IS INSTALLED IN AN AREA COVERED BY MOA BUILD'lNG CODES, THEN (11 AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS -BOIL TS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT: AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED „v. APPLICANT: ACREAi= :YSTE S Ifo. EI7 DEPTH TO PIPE BOTTOM IFT.) GRAVEL DEPTH (FT.) TOTAL DEPTH (FT.`' 1.0 7 0 GRAVEL WIDTH (FT.; 20. GRAVEL LENGTH (FT,I u' 0 sB .; 88.' GRAVEL VOLUME (Ci,Y8S.7 6 2 ,2 TANK SIZE MLS) mno,0 " 152 0,f) 1,250. '- Soil RATING. (SO.FT,!BR) 125 125 GRAVEL LENGTH ? 75 FT. REFEIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT, EACH) r TANS: RUST HAVE AT LEAST THO COMPARTMENTS - - - - - - - - - - - - - - - - I cErtifv that: 1, I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska, 2, I will install the system in accordance with all MON codes and regulations, and in compliance with the design criteria of this permit. ', i will adhere to all MOR and State of Alaska requirements for the set hack distances from any Existing we'll, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 4 bedrooms and any enlargement will require an additional per:ait. IF A LIFT STATiQ.1 IS INSTALLED IN AN AREA COVERED BY MOA BUILD'lNG CODES, THEN (11 AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS -BOIL TS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT: AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED „v. APPLICANT: ACREAi= :YSTE S Ifo. 4 , � -AP oS �G'rf-V'4 ` Yfs/Vy)n r r�f+�s 1� SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: IyEW WORLD "No - - DATE PERFORM LEGAL DESCRIPTION: DEPTH /� / ! _.. (FEET) -. - Of?67 ^ 7/ w IC -5 2 3 4 t-- — 6 Z - Q 7_ u09 9 •2 - O°"�WAS GROUND WATER 11 n ENCOUNTERED? 'Q 12 a a _ 614,ry 5Apl gK IF YES, AT WHAT Z' �srfl�l V �. (�j' 1W DEPTH? 13 SLOPE SITE PLAN MINNIMP Date wwwWwwwom 14 ■■EMEM 7i1E■■' e 15 S//n%% .54/Y!2 Jai 16 OF 4� Z -g - 17 l`AeaB9••OO��Fi G� Ye� eta' 4, E 6 y 1��� �irf� w CVY B46 0•N BBCOOi{CA 0 r 19 `�� `;• n Earl R. Barnardon 4'.,E` SITE PLAN MINNIMP Date wwwWwwwom Net Time ■■EMEM 7i1E■■' Net Drop ■■■■■■■■■■ iiiie��ii■ ■■■■■■■■■■ Reading Date Gross Time Net Time Depth to Water Net Drop 20fl • 754-E ° tC�lB'••aoee'* e• �,��'`'0 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS_e Td�l�� T / �`' ri 4z PERFOR ED BY: t��f (�/j��/� ��fw�tr�2, CERTIFIEDBY: Wa m��- �►� ��,�-�Q�� z� ate; I , f�QBh, c�I� 72-008 (6/79) fl� (.IRJc`WI , 801`lam®�j (Y' ai&N l L r- a+ aT 15 �T • r DATE: �M l 1 Q86 Aocils fl uNtJISoN i OT G' Tha aC�urucy (o' u r1L a6„ ob,5 —,F v -I (20(yu(51 W411s1 +I T esI NaLC Lol>yTION� "'aN — b��s�� IKEA l I I I �u-e r„un�- -+CEMENT �� 4v a6 Cloal �a,�e 1 nf�d noT U) k J\ Vul La 1 7 I F Rc LEGEND ?ROt05Ep WELL O EXISTING NAC—Lk O G EXISTING sl*T SgSTgM 0 TE5T 40k -c LoCFttloN L <e pTlC SYSTEM I i xIsT1NGo 0 ��TIC 7 � �� s 'zac+•azz sc mcc:_ - -'.1 Lo+ 11 n� ^6 uca J. Corvrn liz.SO _ I (- �No. CE -5223 n a 4 0�E ;1C^".;yam SEWER SYSTEM LOCATION PLAN Lot, 1 `l Block: X311' UU_ F i ll<•XtJ''y)`1(•IM, on". [[�� J �z�.lN.xy1F�a aU�dx Prepared for: ACREAGE SYSTEMS Date: -7 Li- u i�QI ;'' r COM & associates,inc. Consulting Engineers 4790 Business Park Blvd. • Bldg. D • Suite One • Anchorage, Alaska 99503 • (907) 561-6151 June 10, 1986 Municipality of Anchorage Department of Health and Human Services 9th and "L" Streets Anchorage, Alaska 99501 SUBJECT: LOT 17, BLOCK 11 SEQUOIA ESTATES Gentlemen: This is to clarify the existence of a culvert in the 20 foot drainage and walkway easement on the western border of this property. Since the culvert is in place, there is no reason for separation distances which are required for open channel or stream flow. Should you have any further questions or need any additional information, please let us know. Very truly yours, & AS/SOPIATES, INC. Bruce � Corwin, P.E. Presi e t BJC/ WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological & Geophysical Surveys Drilling Permit No. OCATION OF WELL (Please complete either to, Ib or Ic.) A.D.L. No. la. Borough Subdivision LotBlock Ib. 1/4 qt rs. Section No. Township N Range E❑ Meridian S1 �+ t/ r—of_of—of— S❑ � AWE) Ic. DISTANCE ANP DIREC I M ROAD INTERSECTI NS 3. OWNER 0 WELL,' Address' Street Address and Area of Well Location . Feet Below 2. WELL LOG Surface Material Type Top Bottom 4. WELL D TH: (tinal) ft. 5. TE OF COMPLETION 2/ 6. ❑ Cable tool 'Rotary ❑ Driven ❑ Dug ❑ Auger ❑ Jetted ❑ Bored p Other: 7. USE:)kDomestic ❑ Public Supply ❑ Industry ❑ Irrigation ❑ Recharge ❑ Commerical Test Well ❑ Other: a 8. CASING: ❑ Threaded ((Welded diam '/ in. To ft. Depth Weight/7 lbs./ft. diam. in. To ft. Depth Stickup - � ft. 17 9. FINISH OF WELL: 4/ Type: Diameter: Slot eh Size: Length: Set between ft. and ft. Backfilling pack fv pGravel G 10. STATIC WATER LEVEL: % i ft. D ❑ Above orBelow land surto Date Equipment used: I I . PUMPI LEVEL below land surface and YIE,I� �y aft. after 1 hra. Pum Pinq--G�--g.p.m. ft. after hrs. pumping g.P.m. GNo 0 �,(� ` N �Qj �� �v 12. GROUTING Well Grouted: ❑ Yea ❑ No •_ Material: 0 Neat Cement E]Other: v 13. PUMP: (if available) HP Length of Drop Pipe ft. capacity 9 -P.M. ❑ Subm. ❑ Jet ❑ Centrificai ❑ Other 14. REMARKS: 16. WATER WELL CONTRACTORS CERTIFICATION: ���//////���' 15. Water Temperature — ° ❑ F C This Wel w?s drille u der u�sd action and this report is true to ille best of k�ledge and belief; Registered�d Business No a /f61Y1 Contract Number / Address: Signed: Date: Authorized Repr entative Form 02-WWR (11/81) Copy Distribution: WHITE-Stote DGGS, PINK -Driller, CANARY -Customer N r 0 0 z 0 APPLICANT: ALPINE DRILLING ADDRESS: PQ.BOX 110496 ANCHORAGE, AK 99511 CONTACT PHONE: 345~O202 LEGAL DESCRIP: SUBDIVISION: SESQUOIA ESTATES LOT: 17 BLOCK: 1 SECTION: 26 TOWNSHlP: 12N RANGE: 3W LOT SIZE: 49048 (SQ. FF. OR ACRES> I certiIfy that: 1. I any Familiar with the requirements for on~site sewers and wells as set Forth by the Municipality of Anchorage (MOA) and the State o� Alaska" 2" I will install the system in accordance with all MOA codes and regulations: and in compliance with the design criteria ol this permit. 3. I will adhere to all MOA and State of Alaska or the set back distances from any existing well�j wastewater disposal system or public sewerage system on this or any adjacent or, nearby lot. SIGNED DATE: OL/� 7�������`� APPLICANT: ALPINE WILLANG �v � ISSUED BY DATE: ------------ ...... � �171" Adsm ED ����JE,.� ^, DEPARTMENT UF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET� ANCHORAGE, AK 99501 ^ 264~4720 ^ 1:1 SA W I -1 - M UP M E... L. 101 EE FIT 1-1 [/ 1 -1- 1-PERMIT P 1ER M, I -1NO: 860349 DATE ISSUED: 09/15/86 APPLICANT: ALPINE DRILLING ADDRESS: PQ.BOX 110496 ANCHORAGE, AK 99511 CONTACT PHONE: 345~O202 LEGAL DESCRIP: SUBDIVISION: SESQUOIA ESTATES LOT: 17 BLOCK: 1 SECTION: 26 TOWNSHlP: 12N RANGE: 3W LOT SIZE: 49048 (SQ. FF. OR ACRES> I certiIfy that: 1. I any Familiar with the requirements for on~site sewers and wells as set Forth by the Municipality of Anchorage (MOA) and the State o� Alaska" 2" I will install the system in accordance with all MOA codes and regulations: and in compliance with the design criteria ol this permit. 3. I will adhere to all MOA and State of Alaska or the set back distances from any existing well�j wastewater disposal system or public sewerage system on this or any adjacent or, nearby lot. SIGNED DATE: OL/� 7�������`� APPLICANT: ALPINE WILLANG �v � ISSUED BY DATE: ------------ ...... � 7 pro U tj 50AI %\j � i o o' Urn ur/LlI �JAIT (c F -8c. J2 a -Y'A. (5 W A 51 Tavr 0- 1 V lP-RQT- LOCA-rlo We 't BCD b 1 A eNr 0 ' P Lu 'PROP'0 S G b u Si lu 7 C -LL - 0 0 Exarintc, SepTvc TC -5-r 4CILS Lo4- 1-1 1'72.sof 6,_LE SEWER SYSTEM LOCATION PLAN 4 1-0 N N . ..... Lot: 'St'N 0MIN't Block: Subd* SEQ001A c-s-rA-rE5 1' '0 OM Prepared fbr: is I sre ms AcRAGE Date: 'IMAMR fq B LO `OT t w � e VfL � al \ " ►AYE [YENTi' FND e/i' H9 NOTES SIT s/9• NO/'r &4906'00" 5E. 172. 1. It shall be the responsibility of the builder or owner to verify that building location shown cleats all subdivision covenants and zoning ordinances. 2. It is the responsibility of the builder to verify all elevations with respect to all utilities. 3. This plat represents the parcel of property described below taken F the rscot plat describing that parcel. Instruments recorded prior to or after the filing of the recorded plat are not shown. G4 I hereby certify that i have surveyed the following described property, LOT 17. BLOCK 1, SEQUOIA ESTATES SUBDIVISION as recorded in the Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are located as shown In this plat. DWN. N.V. J/ E PLOT PLAN FB, 86-I OCK I CKD. J.T. L DATE: 25AUG S6 JTL ENGINEERING ►.0.- sox 11066 . AGNORAt E,. ALASKA 99511 148-AS4a LOT 17, BL SEQUOIA -ESTATES SUBDIVIS104 P 82-375 GRID. 2939 PROJ. NO. 86-4 !11' � CIA.YEHT �ASSUML T>rM EL■91z.0 .� s 1114-v\ 9ea'--FND 2-1/1*AL. CA 'FK i' Its it, e • LOT 8 BLOCK 2 I i sem_ 117.0 � 1 1 i 1 1 tl 1 Veit Ie4 N E .GUNNISON DRIVE M.830Ob1b0 412.0 • G e09.0 11.0 R • 600' L-173.15' 10 i, fN0 E UTILITY EAE SENT WELL =1isto ! +'•CHAIN FIELD1 1 w CLEAN OUT ♦ - • i r npmc'_a �E11.0 Z I TANK Y 221_0 � LOT 16 FKOFWi_D p-ssctY Nw?:S = 71.0 4 NOTES SIT s/9• NO/'r &4906'00" 5E. 172. 1. It shall be the responsibility of the builder or owner to verify that building location shown cleats all subdivision covenants and zoning ordinances. 2. It is the responsibility of the builder to verify all elevations with respect to all utilities. 3. This plat represents the parcel of property described below taken F the rscot plat describing that parcel. Instruments recorded prior to or after the filing of the recorded plat are not shown. G4 I hereby certify that i have surveyed the following described property, LOT 17. BLOCK 1, SEQUOIA ESTATES SUBDIVISION as recorded in the Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are located as shown In this plat. DWN. N.V. J/ E PLOT PLAN FB, 86-I OCK I CKD. J.T. L DATE: 25AUG S6 JTL ENGINEERING ►.0.- sox 11066 . AGNORAt E,. ALASKA 99511 148-AS4a LOT 17, BL SEQUOIA -ESTATES SUBDIVIS104 P 82-375 GRID. 2939 PROJ. NO. 86-4 !11' � CIA.YEHT • r) s sl 3 e • 117.0 � of w • G NOTES SIT s/9• NO/'r &4906'00" 5E. 172. 1. It shall be the responsibility of the builder or owner to verify that building location shown cleats all subdivision covenants and zoning ordinances. 2. It is the responsibility of the builder to verify all elevations with respect to all utilities. 3. This plat represents the parcel of property described below taken F the rscot plat describing that parcel. Instruments recorded prior to or after the filing of the recorded plat are not shown. G4 I hereby certify that i have surveyed the following described property, LOT 17. BLOCK 1, SEQUOIA ESTATES SUBDIVISION as recorded in the Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are located as shown In this plat. DWN. N.V. J/ E PLOT PLAN FB, 86-I OCK I CKD. J.T. L DATE: 25AUG S6 JTL ENGINEERING ►.0.- sox 11066 . AGNORAt E,. ALASKA 99511 148-AS4a LOT 17, BL SEQUOIA -ESTATES SUBDIVIS104 P 82-375 GRID. 2939 PROJ. NO. 86-4 _MUNICIPALITY OF ANCHORAGE� r Department 7 Health and Environmentaiprotection 825 1, Street, Anchorage, AK. 0501 264-4720 # # # HANDWRITTEN PERMIT # # Permit Q,���(� WELL AND ON-SITE SEWER PERMIT �qsli Applicant: Mailing Address: PZ) 26Le Location: Phone Number: Legal Description: L-1 -7 mot Type of Soil Absorption System Is: G Trench: X" Drainfield: Seepage Bed: Maximum Number of Bedrooms: _� Soil Rating(sq.f Size: Holding Tank: t/br) The Required Size of the Soil Absorption System Is: DEPTH LENGTH_ _ GRAVEL DEPTH WIDTH 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). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ �� GALLONS # # 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. * # * TWO(Z) INSPECTIONS ARE REQUIRED # # # 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 is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. # # # PERMIT EXPIRES DECEMBER 31, 1 9 u 3 # # # I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 14 bedr oms. Signed: AIssued by: Appli nt Date: SWPAN (1)81) MUNICIPALITY OF ANCHORAGE \) DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG - PERCOLATION TEST PERFORMED LEGAL DESCRIPTI Gross DEPTH Depth to (FEET) 1 Date Time 2 Water 3 4 - 5 b .o 6 `. NEI,r/ WORLD LAND CO L07' !7 31-OCK ! SEOuD/A SLOPE ORGANICS _ BROWhN SA/YDY L0A/'7J-M S [L rY ,3ArrDY GRAVEL �W • a� U°0 8 jg _ .SANDY GRAV5L-. W1 rH s o, - Cotes L s t 4 x ) G.W . .d WAS GROUND WATER ENCOUNTERED? /yo 12 o p i Y IF YES, AT WHAT 5>Li/ SAND/ DEPTH? 13-o .O GRAVEL V 14 91 15 51Z -Ty —,Zv9/YD 5/✓1 16 Or A17 c` i m 19 .e e/3 • •A Earl R. Barnard <' ' V / ❑ PERCOLATION TEST DATE PERFORMED: al�3 TS SITE PLAN 7 13 / /R?. ry Iv (sb n 0 20 4r. ` e 754E g gg,` •®5e°e , N, e et J °4 ee °a'+ed P�n� , PERCOLATION RATE (minutes/inch �'vZ Tge7 'd n 1i1�hn�'t�S10+ TEST RUN BETWEEN FT AND FT COMMENTS ��/JhTiP/tG�T" C,E.°slH �ifL,[Z-15 Z5%WA—rF( %—// PERFORMED BY: r� �� (Z2 j2 Z4 la ✓ (CERTIFIED BY:-th-- lix"? 72-008 (6/79) Gross Net Depth to Net Reading Date Time Time Water Drop �A 6a�Q p Y: ' - P'�ge enae ae> °z5 ea°°ems Se • 1 , t ° l' °e arnar 754-E � 20 4r. ` e 754E g gg,` •®5e°e , N, e et J °4 ee °a'+ed P�n� , PERCOLATION RATE (minutes/inch �'vZ Tge7 'd n 1i1�hn�'t�S10+ TEST RUN BETWEEN FT AND FT COMMENTS ��/JhTiP/tG�T" C,E.°slH �ifL,[Z-15 Z5%WA—rF( %—// PERFORMED BY: r� �� (Z2 j2 Z4 la ✓ (CERTIFIED BY:-th-- lix"? 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY ?S 264-4720 Application Date n 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L l 7 01/4 = 7,� i/Z /V lf, u" d%EC: 26 Location (address or directions) �OL�/SO�1% (b) Applicant Name �! Ay/� TE RM&01-6 Telephone: Home Business p���� Sy�� Applicant Address k u' � �^ ��N�I / D� 4�C� r-L� ' / /`✓�i6 (c) Applicant is (check one),*Len log Institution ❑ ; Owner/builder 0; Buyer ❑ ; Other ❑ (explain); .a. (d) Lending Institution -1 HS�V 44t17-6161 %9,4nd 4 Telephone (n Address 0Lrl1� c1 FR,46C (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: W f L-1__ I"( 4t 2. TYPE OF RESIDENCE Single -Family ER Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well W Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note- If community well system, must have written confirmation from the State Departmentof Environmental conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 (ven 0 gZ0-U zloze6ed •worn s,aaaui6ua leuolssaload all ui suoissiwo Ao saoaaa Aol alglsuodsaa lou si obuAolouy to Al!ledlolunA all •ponssi si aleollllaao a ajolaq ejep az (leue Ao suoiloadsui lonpuoo lou op d3H(] 10 saaAoldw3 •sluawwinbei alels pue lejapal uielaao Alsilus of aapao ui suoilnl!lsul bulpuel alalj pue sawol to siaseloand of (salinoo a se s111 saop d3H4 all Ts sely 10 WIS all ul 109aals16W aaaul6u8 leuolssaload luopuedopul ue (q anoge g ydeAujud ui uaAlb suolleluasaadaa all uodn Slolos paseq saleoll!jaao lenoaddy Al!jollny 411eaH sonssl (d3H4) uolloaload leluawuoalAu3 pue 111eaH to luawlieda(] 96eaolouy to Al!ledlounyi all NOunvo lenoaddy leuolllpuo0 to swial leuoll!puoO panoaddesl(] panoAddy ----- ZA�<�� aje(] (q swooapeq d7 aol panojddy J lVAO!lddV d3H4 9 ale(] aaPPV 9 C, auogdalal s J J WAH 10 aweN 1 •uoiloodsui slgl jo alep all uo loalla ui suolleln69a pue'seoueulpio'sepoo ajejS pus ledlolunVq Ile lj!M eoue11dwoo ul sl walsls lesodslp aalernalsum Ao/pus Alddns aaleM alls-uo all 'uolloodsul pue u011e611sanu1 (w woal pue sal!1 96eaogouy to (jlledlolunw all woal paulelgo uoljewaolul all uo paseq jell Al!aaA aallinl ! ulajeq polsolpul aanlonals to adRl pue swooapaq to aagwnu all jol alenbape pue leuollounl'ales sl wals (s lesodslp aalernalsem ao/pue (lddns jalem al!s-uo all jell srnols lenoaddy (juoljny llleaH s"41 10 uolle61jsanu! AW jell Aj!aaA ! 'Molaq urnols alep uo!jep!IeA 41110 se pue ojaaal pax!1je leas Aw (q pa!j!Uao sy NOIIVWHOdNI ONV V1V0 `HOHV3S 3314 `S1S31 `SNOIlOUSNl ONIOIA08d Wdl.3 ON1833NION3 '9 el F P�T' F�\C MUNICIPALITY OF ANCHORAGE (MOA) �& ��Q�o� HEALTH AUTHORITY APPROVAL (HAA) �G\o��P 4ACHECKLIST - FEBRUARY 1984 264-4720 Legal Description: 7 _506101,4 )��5T A. WELL DATA Well Classification PA 111441E If A, B. C, D.E.C. Ap roved (Y/N) Well Log Present (ON) Date Completed R z Yield Total Depth 22� � Cased to 22Q Depth of Grouting V114 Static Water Level /9 Pump Set At u/VAI/Vow/y i Casing Height Above Ground 2,9Sanitary Seal on Casing ON) Electrical Wiring in Conduit ON) Depression Around Wellhead (Yo Separation Distances from Well: y To Septic/Holding Tank on Lot �t / ; On Adjoining Lots /00 To Nearest Edge of Absorption Field on Lot On Adjoining Lots /00 To Nearest Public Sewer Line Af 1A To Nearest Public Sewer Cleanout/Manhole�f i/ fTo Nearest Sewer Service Line on Lot �/q Water Sample Collected by J AI rc aL ; Date -422-197 Y JF Water Sample Test Results .T/sF,4Qf-0AY � Comments B. SEPTIC/HOLDING TANK DAJA Date Installed 'i Size 12-,5 No. of Compartments Standpipes &N) Air -tight Caps ®/N) Foundation Cleanout Y j Date Last Pumped N) Depression over Tank (Y(�v Pumping/Maintenance Contract on File (Y/N) /V ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well �t q To Building Foundation 1r « 4j %4- i To Property Line To Disposal Field t To Water Main/Service Line N //� To Stream, Pond, Lake, or Major Drainage Course 10C ' ,Comments Page 1 of 2 Y 72-026(11/84) 1-17 6/ . 515Qu0iA E-�T C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ' S� Type of System Design/ -J Date Installed 7�i���� Length of Field 'r-0 /'� Width of Field (� Depth of Field 7,0 / Gravel Bed Thickness �Q• Square Feet of Absorption Area 700 ✓ Standpipes Present (9/N) Depression over Field (Y/O Results of Last Adequacy Test Separation Distance from Absorption Field Date of Last Adequacy Test 11//4 ''//moi To Water -Supply Well loth/ To Property Line 7.� i To Building Foundation15--1f To Existing or Abandoned System on Lot /V On Adjoining Lots �d / To Water Main/Service Line �� To Cutbank (if present) IV14 r To Stream/Pond/Lake/or Major Drainage Course ---too To Driveway, Parking Area, or Vehicle Storage Area _i_21T Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "PumD Offer el at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I ha e E d, v rifie%or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date /7.��� OF Ater CompanyMOA No.�/��� °°°�°..•...��s0� rv� ••v 4n Receipt No. i yr � d Date of Payment 73— Amount: $ l 0 d °mob — il %`714Cr`% I�X/ Page 2 of 2 72-026 (11/64) ALASKA ENVIRONMENTAL joB L L7 I3 (_ S_E QLf Cl 4 S 7 f CONTROL SERVICE ,; INC. SHEET No -. _ of 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 CALCULATED BY �1 F5f DATE - (907) 561-5040 ATE_(907)561-5040 CHECKED BY- DATE- - i WEI L 140u.5E 40 43 tt 14,11111C/o C/o v�w�y � c/Q