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HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #1 BLK 7 LT 1Thunderbird Heights #1 Block 7 Lot 1 #051-581-05 k .E„ I Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201264 PID Number: 051-581-05 Dwelling: ❑® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade Name Rachel and Mark Clayton ABSORPTION FIELD ❑ D Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 24550 Thunderbird Dr ❑ Other Phone Number of Bedrooms Soil RatingTotal depth from original grade 4 PD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from origin rade t, Gravel depth beneath pipe Subdivision Block Lot Thunderbird Heights #1 7 1 Ft. Fill added above original grade Ft, ravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines istance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. be \renches From Tank Field Tank Line Ftz Ft. Well NA NA NA > 25' TANK A Septic ❑® S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1500 Gal. Surface Water > 100' NA NA Material Number of compartments Lot Line >10' NA NA NA plastic 2 Foundation >10' NA NA LIFT STATION Manufacturer Capacity Remarks 2" insulation over tank Greer 1500 Gal. Alarm location interior house Electrical installed by Jonathan Dowd Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Territory North Drainfield CO/MT Inspector Curtis Townsend BENCH MARK (Assumed elevation) 100 ft Inspdection 1s` 10/31/20 2�� 11/5/20 Location and description 3`d 01 top of deck ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional 0'. Approval: Date e000 ^_� •.. � .."tea ,� �• ItsL.•T wns nd' x Septic System ' • °ate z 2 z ��FGA No. C 11904.., Approved Date 2 2N Z I i9 ��lF?f0 '� Note: this approval oes not include well permit requirements. k .E„ I w w Z Q �: zZY<WZZw Ar :z'a��® ZaOi door oZ <zQ z�0 10 � 3:- :Ow !n°� 1 Y x¢00¢ www a_Uti= ALL �Q: _ ~U t s3 U)�~ �- k o¢Lio ®�v�:: U o OHO N zcoo 1— UJ AN 4v \ LLI CDww moi., mow¢ ouz zwZ:2 ®) \ o o�o�~F�zn F �X~ t—ZZOM6 d N J O cyCO x Yw Wwo �5;[If Of co U O U u N 11 C �L Z (n 0 0OQ o�Z J�Q O N �— C L�OYUZ� >ry LI) U) N u 0:2z¢DO0Lij Ln w¢ _lLv w X Ln J~ Z �jO LL = - 0- m mom¢;.- I-- U aw Ir ¢ O (5 - N t- LO r � 0) o Q C Y z J T ¢ 0- 0 ti L(. 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The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The 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 (2417). 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 Received B� Issued By: 3 Date: f Date: I Zz) 4 MUNICIPALITY F ANCHORAGE Development Services Department'` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 051-581-05 Property owner(s) CLAYTON RACHEL & MARK Mailing address PO Box 670210 Chugiak Site address 24550 Thunderbird Dr Chugiak AK 99567 Day phone Legal description (Sub'd., Block & Lot) THUNDERBIRD HEIGHTS #1 Legal description (Township, Range & Section) Lot Size 29,231 Sq. Ft. Number of Bedrooms 4 BLK 7 LT 1 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single-Famil (SF) El Septic Tank El Upgrade 0 (v�fwo ADIJ� Duplex (D) ❑ Holding Tank ❑ Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal)C des. � —�­ /I �'/ (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. d S PZ 01 z (�O L/ Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safetyl0n Site Water and WastewaterTorms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201264, Deb Wockenfuss, 07/31/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201264, Deb Wockenfuss, 07/31/20 /l1.— r r' • — Municipality of Anchorage Page ► of Z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL -SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -SW 9gdg01 PID Number: eS/Sf/OS Na A) — F SUE 4 Sf77L-,t/ Wastewater System: ❑ New ,Upgrade Address: atirs'o , D,e. ABSORPTION FIELD pheAe EAGtE AvM 996-&7 No. of Bedrooms: O Dee Trench Shallow Trench O Bed O Mound O Other P LEGAL DESCRIPTION Soil Rating: 0. S GPD/Sq. Ft. Total Depth from original grade: Z7 Lot: Block: -7-' Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe / fl /AD /EC-tf-S / .5 Ft. 9.9 Ft. Township: Range: Section: Fill added above original grade: Gravel length: y� 2.3 X. P1 Ft. WELL: ❑ New ❑ Upgrade Gravel width: Numberoflines: Distance tweenlines: S Ft. / Ft. Classification (Private, A,B,C): 67VST— Total Depth: Cased To: Total absorption area: Pipe material: /"U,BL/L Ft. Ft. %SM So. Ft STN+ D ?43c1 V. C. Driller: Date Drilled: Static Water Level: Inst Iter. Date Installed: Ft. rE xe_4V T7XC- o -io -9'/ Yield:Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES XSeptic EXK7' O Holding XS.T.E.P. To Septic Absorption Lift HoldingPublic/Private Manufacturer Capacity In gallons: From Tank Field Station Tank Sewer Lines,- 12 -CO Welt' 200 f Zoo 't 'Z 4'f" 2r,f- Material: STELrG. Number of Compartments: Z Surface /ao'>< me 't ,Va LIFT STATION Lot Line 2p, �' 2 �' Size In gallons: Manufacturer: s>?o fLcx�oR,4GE T.q.c�t Foundation /S- / G 0 t 0 Zy z "Pump on" ���at: "Pump off" level at: High water alarm at: /P" Sri Curtain N0� K� IUA) Pump Make d Model Electrical Inspections performed by: Drain OS/ OS'Hh' Ep',r Etcc7-Jt►c Remarks:ts-s-&-c ty'41vez ;?Eatzrr BENCH MARK Location and Description: ZAPM " F .eeo9/"Z Assumed Elevation: QO.Od LL ENGINEER'S SEAL OF C:0 4e 'S�,��`� S & S ENGINEERING 17034 Eagle River Loop Road, N*. 204 .` tt; Inspections performed b . Ea le Rive Alaska 99577/0-7-7- P P Y' a .�► Dates: �0-2�-;: • „...,.,„...s;..... V. 2nd i0 -2➢-94 2nd , N�:,c.•.� [. `��d�`'l`soaCE Department Heah� Human Ecol of S rvices a royal PP Reviewed and approved by-� Date: 11 .�,”t ".. ”,"„ m,,., Z5 Permit NoSW940401 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description UNDERBIRD HEIGHTS# 1, BLOCK 7, LOT 1 PID No.: 05158105 t 113.8' 112.3' (11T1) FINAL GRADE (MT2) ...0.1.................COZ ... ,.............. ............................. ;................................. ...... ........ ....,.... 99.5' ION IST. 94.7' [ 1250 GAL94.5' 500 G 4.3' SR 110.1' ......................................... ......S_T..... ................ ... a.......................... S.T.E.P. ....................................... d. . iSYSTEM06.6'............................................................ (.MTI& MT2) N.T.S. A 100.6' NO WATER FOUND I A B FCO 6;0— 26,84 C01 17.1 30.9 CO2 24.2 36.9: E1H 25.6 37.4: MTI 77.0 94.2 j I j t I( < .........................................9.......................... ........... � �...............•..........................................i........ E ' £ oEcK DRIVE WAY EXISTII!G t .............................. ............ .EXIST.; .... 1250 •GAL:....SEPTIC...TANK..........................:................... e ........................... ........ ....................... Koos, NEW 500 GAL S.T.E.P CO2 ` F A C01 T.N EXCAVATED AT THE N e OF COfNSTRUCTION ............................ .... .....{ ...... ........_........ ..... .............i.... ........ ........... ............_ M UTI + 1' FROM P /L 1'•�� II1' .»». ......... Nrw )RmFIELD rj r SCALE 1' - 40, •8' FROM PA i I I In I ROBERT C. COWAN CE -8801 �:•,d I�s F,,: •..................• (€ Zlil FPOFESS��`t�y E "-w1i P11/ 1— 11/09/1994 10:27 9076941211 S AND S ENGINEERING PAGE 02 FROM Cs i nm's r.noi ED'S 9LECTRIC INC.*VAUM .t. AM"MOr, AL"KA "M ANCHORACE (my)m4w Fax tT44w i . 505 ENGROUMING i 17034 EAGLE RIVER f,00P RD. EAGLE RIVER ALK. ' SUBJECT LIF!' STATION AT -LOT: 1 BLK.7 TH MER BIRD SUB. M` 24450 DOM BIRD` M. EKLVIM ALK. TMB EL =cAL WIRING ON THE Lin STATION ON SUBJECT JOB SAS INSTALLED iN AcopmCB WITH All LOCAL. GODES + NBC. RBQUIRMPM IV - PAGE MUNICIPALITY OF ANCHORAGE IOIaSIRq DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT 1 OF 1 12-:00 pm PERMIT NUMBER:SW940401 DATE ISSUED:10/17/94 DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE:10/17/95 OWNER NAME:SETTEN ADRIE & SUE A OWNER ADDRESS:24550 THUNDERBIRD DR EAGLE RIVER, ALASKA 99567 PARCEL ID:05158105 LEGAL DESCRIPTION: THUNDERBIRD HEIGHTS 41 BLK 7 LT 1 LOT SIZE: 29231 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL SOILS TEST TO A MINIMUM DEPTH OF 10 FEET AND SUBMIT IT WITH TH)? XBJJ;LT/,Y15�PECTION REPORT. RECEIVED BY: ISSUED BY: DATE: /O X7 DATE: lo - / 7- 9¢ ' �"n9irr Z4? ';t./ g� A-44� lb F1 October 4, 1994 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX 694-1211 HEALTHAUTHORTTY APPROVALS Mu.ni.ci.pat ty os Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 SEWER &WATER Anchorage, Ataska 99519-6650 MAW EXTENSIONS REFERENCE: Lot 1; Btock 7; Thunderbi4d Heights Subdivision SEWER & WATER INSPECTION Request you issue a eAmit t0 4 y p upgrade the septic system senvcng .the bouh bedaoom house on the neberencapropeaty. ENGINEERING STUDIES A test hate was excavated and a peAcotaii.on test perbonmed. The ANDREPORTS approximate tocati.on o6 the teat hate is .Located on the attached site plan. The monitoni.ng tube within the teat hate has been checked and bound to WELL INSPECTION be dry. & FLOW TEST An adequacy test per6onmed on the existing system bot Heatth Authority Approvat purposea bound the absorption capacity o6 the system to be inadequate. SITE PLANS Attached is the proposed upgrade design. This property is served by Pubtic water. ROAD DESIGN We do not anticipate any adverse e66ecta on neighboring properties by the in6ta tation o6 the proposed septic system. There ante no protective wet radii which encAoach upon the pnopeAty. SOILTEST 16 you requiAe additionat i,n6o4mation p.tease contact as. PERCOLATION TEST Sinceaety, STRUCTURAL& wv. - MECHANICAL WSPECTIONS ROBERT C. COWAN, P.E. RCC/JA/gk ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 EAGLE RIVER, ALASKA 99577 4'y. lrr� OF Z k7 C 9p `f. U + Li O > co C6 ap LI U) XAM I ox ` BIRD o N z i cr .. v, LLI � `"mow a o a U omcco cr z� 0� a z F- ai aN zaO 0 v5 mN UNd O E; m� J WwmZ=WW IAJ rn a3W MOO j 0Z3Z0a �� v 0 V) Z W w Y M C-n<=: W O>- (X rr P� O cv U of Zao-� J w ?� 1 �0 u wWaa.. Q WWN mH0 o Wd`x NNw m Q wV)ce La CL p O in wh=N- aNWNZWZ Z mWQ H O Q Liz _O O CL co LAJ N �z Iz� r- 1s . j34 NjFN JLj j 1- V) (f) �OU 4-1 = m Z .0 1 1 ~ z � 1 1 6S N Q W n. F., o a 0 Nx 1 cnf.-O 1 Z ) ) _ Von FOO V O � F J yc.>w N N N W ►fir w _j 0a N r, V I a U Iw W h OMa 8�IL P./ ` w a l•ON M-K Liti�iAn S ����waOFZ7 IS L.I W'Z 2:HQ11011 pZ-IV Ooo 40 �NZ0 ►.yO JVO 7wWI`z F_/,AO-'wN �. Q� O W� JLOLjai �m_�.O WHLJ O. � ��'ct N �v)'tw; WMa�N� /�! O WQ w 4 1I:--�1--JJ a' ✓O(n LQ mOQ LnLj W sr�tll �Nw..IO a In a- — I a a �aN—.-.- a a (1. �a � W 31115 aavandn ROBERT SHAFER, P.E. ROGER SHAFER, P.E. A ,� ON-SITE WASTEWATER VISPOSAL SYSTEM CIVIL ENGINEERS CONSTRUCTION PRACTICES F X ssaizi9 and MATERIAL SPECIFICATIONS HEALTH AUrHORrry APPROVALS REFERENCE: Lot 1; Block 7; Thunderbikd Heights Subdiv.i.6.ion GENERAL: SEWER &WATER 1. The scope o6 th.i6 project dnctudeb the iota Cation o6 a 500 MAIN EXTENSIONS gaUon 6eptic tank e66tuent pumping (S.T.E.P.) ay6tem and a puzzur.ized abzorpt.ion wade drain6ield to serve the hour bedroom res.tdence .Located on the re6erenced property and excavation o6 the ex.i6t.ing 1250 gaUon septic tank to veri6y INSPECTIONNATER .it6 .integrity. 16 the .integrity o6 the exi6ting septic. tank d.6 pooh the ex,i.6ting zeptic tank .c6 to be abandoned and a new 1500 gatton zeptic tank W uent pump 6y6tem .i.n6taP.Led. 16 the .integkity o6 the ex.izt.ing septic. tank it good, then a 500 ENGINEERING STUDIES gatton ti6t station d.6 to be in6taUed. At6o the ex.i.6t.ing AND REPORTS teach6.ietd Z6 to be abandoned .in pta.ce. 2. Con6tnuction zhatt be .in accordance with the approved z to ptan and de6.ign draw.cnga, Municipat permit with any special WELL INSPECTION provi6ion6 or condo tcon6, and att appti.cabte State and &FLOW TEST Municipal Wa6tewater Diapo6at Regutati.on6. 3. The contractor zhatt be 4e6pon6.ibte 6or obtaining any neee6sary underground ut Lity toeate6. SITE PLANS 4. Unle66 6peci6.tcatty agreed otherw.ize, the property owner zhatt be re6pon6.ibte 6or 6.ina£ grading a4ea6 zubsequentty depressed 6rom 6oit 6ettting. On all teaeh6ield mound &yatems, the ROAD DESIGN property owner shall be re6pon6.ibte 6or ensuhing a satd.66actory vegetation growth over the mounded area. 5. Contractors .Ln6tatting wastewater di.6po6at systems must be SOILTEST cert.i6.ied by the Mun.ieipat Health. Department 6or system .cn6tat tation6. Owners .in6taU-ing thew own systems mu6t all o receive prior approval 6rom the Municipal Heattth. Department. PERCOLATION TEST SEPTIC TANK INSTALLATION: 1. A S.T.E.P 6y6tem .c.6 to be con6tructed by a certi.6.ied 6eptic. tank manu6acturer. Construction 6haU .include two 4" eleanout6 STRUCTURAL& MECHANICAL Jot pumping accu6. INSPECTIONS 2. The S.T.E.P. system 6haU be 6u66icien ty bedded to prevent 6ettL.ing or 6hi6ting o6 the tank. ONSITE WASTE WATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 9 EAGLE RIVER, ALASKA 99577 Page Two Lot 1; Btock 7; Thundekb.itd Heights Subdivi6.ion October 4, 1994 3. Att etandp.ipes on the S.T.E.P. Ayetem 6hatt extend a m.tnimum 06 12 .inche6 above Jinat grade. 4. S.T.E.P. systema .in6taUed with. .Leas than 4' o6 covet ahal.l be .insulated. 5. A 6oundation cleanout shat be .in6taUed one to bout beet 6tom the building 6oundation. In the .Zine between the tank and the teach6ield there Aha t be two adjacent cleanout6 (untess an e66luent pumping 6y6tem exi6t6 within the 6epti.c tank). Thebe cleanout6 shall be .Located on undi6tunbed Ao.i.E not mote than 10' atom the tank. The 6i'tst cleanout, .in tine, shaft be to clean toward the teach6.ield. The 6econd cleanout Ahatt be to clean to=td the Aeptic tank. 6. F.inat grading over the S.T.E.P. Ay6tem Ahatt be such that a po4itive slope ex.i6t6 away atom the S.T.E.P. sy6tem. PRESSURIZED WIDE DRAINFIELD INSTALLATION: 1. Excavate the proposed d4ai.n6.ieCd to the dimen6.ion6 shown on the design. The bottom o6 the excavation 6hatt be w.fth.i.n. 2 .inche6 o6 .Level. 16 the 6.idewa -4 of bottom o6 the excavation become 6meated, they must be naked of sehatched (toughed up) be6ote gtavel (6ewet tock) pP.acement. 2. The diatt.ibution piping .ie to be o6 PVC (ASTM D3034 of equal). Att jo.int6 ate to be solvent cemented. 3. The di.Att.ibution pipes ate to be embedded .in sewer tock. Cate should be taken to backjitt in such a way as to ptevent damage to thepiping Ayetem. 4. S-iP.t battier mater at must be .in6tatted between the 6.inaL gtavel tayet and the native Aoit baek6.i t. En6ute the si.et banni.et covens the entivice gtavet 46un6ace be6ote ptaeing back6.itt. 5. Baekjitt over the 6.inal gtavel .Layer mu6t not be .leas than twenty -bout (24) .inches. In6utati.on mu6t be .insta ted when the back6.i.Zt depth i6 .less than thi&ty-6.i.x. (36) inehe6. Page Three Lox 1; Btock 7; Thunderb-ud Heights Subdivision October 4, 1994 MINIMUM MATERIAL SPECIFICATIONS: I. Any septic tank propoaed got installation must be constructed by a Mun.icipatty approved Septic tank manu6actuner. 2. The 6otZowcng pipe mater.iatz ane appnoved bon use .in septic system .instaU.ati,om .in. the Muni,cipat ty o6 Anchorage: Type o,( Pipe Pekgorated Soti.d Cast Iron yes Yes ASTM D3034 (PVC) Yes yes ASTM F810 (HDPE) Yes No ASThf D2662 (ABS) Yes Yes Use o6 a type o6 pipe other than Listed above must be appnoved by the inspecting eng.i.neen. 3. Insatation 6haZt be at .Least 2" thick extruded ducect bwti.at potystyrene (Dow Chem.icae Company Styro6oam HI on equae). 4. Septic tank .intet6 and outtets aha t be 6.i tted with watertight coupt Ings (Cau,der, Fernco, or equal). 5. A penmeabte nontoxic s tt banni.eh (TypaA 3401, M-uca6.i 140/N, on equal) must be .in6ta ted between the 6tnat teach6.ietd gravet .gayer and the native soil back6itt. 6. Att teach6tetd gravee (sewer nock) ahatt be 0.5"-2.5" acneened gravet with te-66 than 3% passing .the 0200 sieve. 7. When sand is being used as a jitter matenia.t, its gnadati.on speci6.ication6 must con6oam to current M.O.A. or D.E.C. kequ.itement6. INSPECTIONS: Typically there w tt be a minimum o6 three (3) inspections %equiAed during the .inatattaii.on o6 the wastewwateh di.6po6at system. These .inspections Witt occuA as 6otPtows : 1. The b.ucst inspection must be conducted a6ter the excavation o6 ditch", pits, trenches, on beds and be6ore the instattation o6 any gravet. A septic tank may be set in ptace, but may not be back6.c Peed Wore this .inspection. Page Four Lot 1; Btock 7; Thunderb.ucd Heights October 4, 1994 2. The second inspection must be conducted a6ter the ptacement o6 .the 6 it barrier, gravet, diathibution tines, standpipes, cteanouta, and insutation, but be6o4e the ptacement o6 any other back6.cit. 3. The jinat .inspection .is to occur upon 6.i.nat grading o6 the property. 06ten there w tt be move than these 3 inspections %equiaed, especi.atty with. the .inetaU-ati.on 06 mu tipte trenched, sand jitters, pnessukized distribution systems, etc. Thus, the .inspecting eng.ineen .is to be contacted at .feast 24 houka prior to the start o6 conztkuction. 16 necessary, a pre -construction meeting w ttZ take pta.ce on -,6 te. The inspecting eng.ineen w tt not coordinate, direct or controt .in any way the contAactor'a activities. The owner shaU contract with the contractor to per6orm the work outP,ined .in these 4peci.6.icati.ons and ptans and in accordance with the attached M.O.A. permit. These Witt be no conthactuae arrangement existing between the contractor and S & S Engineering. S 9 S Eng.i.neeh,i.ng shaf a be the owner's representative and w tt .inspect the work as stated above to document the contractor14 activities. F.inat acceptance o6 the contractor's work rests with the owner and the M.O.A. S 9 S Engine ng shaU have no tiabitity to the owner or to others 6or acts on omissions o6 the contractor or any other persona per6o4m.ing work on this project or the 6ai ake o6 the contractor to canny out the work .in accordance with these construction documents. S 9 S Eng.ineer.ing'a .inspecting engineer Witt not be rezpons.ibte 6o,% the construction means, methods, techniques, sequence, procedures or the satiety precautions .incident to this project. C NTRACT R INSTALLER 0 PERFORMED FOR: LEGAL DESCRIPTION F-- I O Q 13- 14- 15- 16- 17- 18- 19 3141516171819 20 COMMENTS WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L 0 DEPTH? I' P E Depthto Wafer Air Monis Monitoring? WTI— pats S�n'`� PERCOLATION RATE 411, (minutes/inch) PERC HOLE DIAMETER b r TEST RUN BETWEEN r6 FT AND 6'5� FT PERFORMED BY:��5� �IN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINFFECT ON THIS DATE. DATE:�D' 72-008 (Rev. 4185) PERFi LEGA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 TEST RUN BETWEEN 2p•S FT AND t=FT COMMENTS —_ PERFORMED BY: 1?1r SA6,4 FLr I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI N EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4185) MUNICIPALITY OF ANCHORAGE r 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 S SK!l G S -Z I ❑ UPGRADE MAILING ADDRESS f.n AV LEGAL DESCRIPTION Ll 7 E S LOCATION NO. OF BEDROOMS T J r7E 12 (L v Well Absorption area DISTANCE T0: C T / Dwelling { / PERMIT NO. Y V NQ F -Z a Q Manufacturer Material No. of compartments wI h STC 2- Liq. capacity in gallons Inside len th j p IF HOMEMADE: g Width Li Liquid de q depth b Z DISTANCE T0: Well Dwelling PERMIT NO. _?� Manufacturer Material Liquid capacity in gallons w= Well DISTANCE TO: u� Ai ry Foundation 30 / Nearest lot line PERMIT NO. LL Z No. of lines Length of each line 3 '¢ Total length of lines Trench width N A" Distance between lines ►-Q¢ H W/ Top of rile to finish grade d 2/ inches Material beneath rile (p Total effective absorption area O 3 inches L / w Length Width Depth PERMIT NO. U Q I•- W o. Type of crib Crib diameter Crib depth Total effective absorption area rn DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER J PIPE MATERIALS VG. SOIL TEST RATING INSTALLER SC O REMARKS U N � � e h J / i LD#LI�J APPROVED DATE LEGAL - l I Q`J2 MUNICIPALITY OF ANCHORAGE Department r-� Health and Environmental^"otection 825 Street, Anchorage, AK. .jr501 ~.. 264-4720 * * * HANDWRITTEN PERMIT Permit tt 8?r�9,2G . WML A /W ON-SITE SEWER PERMIT Applicant: ,gGgt �i��,SfQuGt`in» Mailing Address: f?O. B� d e a.ai,¢ktA:7`%%7 Location: r%4) P/u) Sec. �S Phone Number: /eF38-;z83[ Legal Description: ;gyp}/ 46/k? n&,0JrAAV ,4 14rS Add #( Lot Size: a p,JI .RL Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed:.. ✓ Holding..T nk ­ Maximum Number of Bedrooms:_ Soil_Rating(sq.ft/br). JeS The Required Size of the Soil..Absorption System.Is: DEPTH . 3,5� _,LENGTHCJ ',_.GRAVEL DEPTH �S� 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-.SEP.TIC(HOLDING) TANK SIZE..GALLONS.,* Permit applicant --- 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(2) INSPECTIONS ARE REQUIRED * # Backfilling of any system without final. inspection.and...approval.by this departmen will be subject to prosecution. Minimum distance.between.a well.and any on-site sewage disposal: system is 100 fee fora private well.or_,150 to -200 feetf _rom-..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_7may apply. 'Specifications -and construction.diagrams. are available to insure,proper.installation. * * * PERMIT EXPIRES -DECEMBER 3L 1.9 3 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-si-te:sewer system may require enlargement if., the residence_is:remodeled to include more that 3 bedrooms. Signed: _ Issued by : Q�to. `_�Vo(� Applicant Date: "In the event that a lift station is installed an electrical permit and Inspection must be SWP/024 (1/81) obtained. As-builts cannot be approved un- til the electrical inspection Is received In this office. The electrical work must be per- formed by a licensed electrician." . tT--'-••-------- j�^nc:i •'r; ro'r..aISrYT:tTVTrTSV1.---....: ,......._.. .. Ir. _. Department of Health ane. Environmental 'Protection ter¢ C25 L taltrect, Anchorage, AK. 264-4720 lit IJ. #''HANDWRITTEN PERMIT G c (_ /6t ON-SITE SEVIER PERMIT ie t5 �))Z�s��utnr, Mailing Address: -r,r& t�s,2,s Phone Number: ilrPr ';F L - ,�1 Description: f j11 rY ,P` Lot Size: - !!,of Soil Absorption System Is: rench: _ Drainfield: Seepage Deal, � infolding Tz�n�ks:, imum •!Somber of Uedrooms: _ ib moil •ratin9(rq.ft/br) 'i The Required Size of the Soil Absorption System Is: 14H LENGTH� P . GRAVEL DEPTH ��'� � �� � � WtDTti •-�3�1� i`;length dimension -is the length(in feet) of the trench or•drainficld. The pth of,a trench or pit is the distance between the surface of the ground and, i'ibottom of -the excavation(in feet). There is no set width for trenches.-. !`;gravel depth -is the minimum depth of gravel between the outfall pipe and i''ibottom of the excavation(in•feet). * ` REQUIRED SEPT] C(HOLDI NG) ..TANK SIZE = j -a-.5— _GALLONS it applicant:hais the responsibility to inform this clepartment•during the illation inspections of any wells adjacent to this property and the number itidences that the well will serve. . x TWO(2) INSPECTIONS ARE REQUIRED.* a e rifling of any system without final .Inspection .and approval -by this department. be subject -to prosecution. tum distance between a well and any on-site sewage disposal system is 100 feet ,•. i' private well or 150 to 20D feet from a public well depending upon the type iblic well. 14inimum distance .,from a private well to a private sewer line i'.feet anu to a community sewer -line is 75 feet. Well lags are required i.ust be returned to this department within.3D clays of the well completion. 11reguirements may apply. Specifications and construction diagrams are 'able to insure proper installation. « « a PERMIT EXPIRES DECEMBER 31, 1 9 3 3 * ' ert3fy that: (1) I am familiar with the requirements for -on-site viewers 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 3 bedrooms. ncd: Issued by:_in' Applicant G�rG Date Of '7n lha cvc:rd (hest A lift station is inMelled rn ol�ciricrt pcirrdl rind ina:pc.ctlon must bo 1/024(1/81) oblrined. tx-1 ills asnnot be. tq)provod un- til the olcwlacal irLspeclion is rocoivcd In thls i' office.. IN, Occirical work mua JPv roar- iorru t,y h Keened elcxarit-ID , r r'1 RJ .SOILS LOG MUNICIPALITY OF ANCHORAGE t t PERCOLATION 1325 (' •..ry DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ � . 925 L. Street, Anchorage, Alaska 99501 2644720 TEST f 1 SOILS LOG — PERCOLATION TEST 1 PERFORMED FOR: 65K Cons}�uC•�tor. DATE PERFORMED: LEGAL DESCRIPTION: 47T Zee 0/0 6,rd 0-, T/6 W. �e/L+// J/y DEPTF{ SLOPE SITE P- LAN 1 _ AAT 2 /j ac. I 3- 4- 5 4 5 • J 8 9- 10- 12- 13- 14- 15- 16- 17- 18- 191 101213141516171819 ScJ - i✓.zc,4',e wed 64AI4s/ - /a�sQ fE/scocUorl �+- � % ScooC �T TEST NoGE Ja WAre-{e 60-rTom 'or HocE 11 WAS GROUND WATER S ENCOUNTERED? {�_ L O P IF YES, AT WHAT E DEPTH? %.1' fE Na.d/ro.�cp Fd,CSr7/F L1t^3r,.( w/ry A/o lcf4C4 /q/ C t ✓t C . Reading Date Gross �•�.••••• AtSi{�4`i¢' Net Time r:• atele•'9I Drop * !4936+, �' (minutes/inch) .....:.. J / �• C.Lo Yer� laver nc FT AND FT COMMENTSAele�,d o. •. V .y^PFiG �4'T /�i� ,S, �J��"af ��M /iTtJ A6e)77-Z14 ZAP-< PERFORMED BY: 15?eaw.cP A��Ys(; 4 T/d� , C CERTIFIED BY: �, �� /1LfDATE: i 'ESS10�` - 72-008 (6/79) PERCOLATION RATE (minutes/inch) J ' TEST RUN BETWEEN FT AND FT COMMENTSAele�,d ie',P66^o//t�2/ .y^PFiG �4'T /�i� ,S, �J��"af ��M /iTtJ A6e)77-Z14 ZAP-< PERFORMED BY: 15?eaw.cP A��Ys(; 4 T/d� , C CERTIFIED BY: �, �� /1LfDATE: Eh'SS-e>0 72-008 (6/79) \ Municipality of Anchorage2�.. • % Development Services Department Building Safety Division On -Site Water and Wastewater Program , r 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. COSA# 610343 Expiration Date: _ 9 – 241 — og 1. GENERAL INFORMATION Complete legal description Lot 1 Block 7 Thunderbird Heights #1 Location (site address) 24550 Thunderbird Drive. Chugiak, AK 99567 Current Property owner(s) Walter McCrumb & Carmen Cianfrani Day phone 688-0621 Mailing address Lending agency Mailing address P.O. Box 672321, Chugiak, AK 99567 Day phone Real Estate Agent Sherry Sap I?@ ReMax Day phone 317-6302 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System 19 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ 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 homeowners. 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 sample results. (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, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 8/14/07 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the perforrr=ce of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. •����aaaa The operational life of all wells and septic systems depend on the local soil condition, ground water ���•�� a,a44 levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions arc outside the control of the evaluator of this system. All systems eventually fail and 40 satisfactory ten results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future V —00 performance nor give any estimate of how long the system will continue to meet the operational " r 0 requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed i � Steven R. P none/ above. Any reliance upon or use of this report by any other person or party is not authorized nor will it 0" No. CE 81499�yy confer any legal right whatsoever. 5. DSD SIGNATURE 4114.- sla :•' Approved for 4- bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: i� s2 - O "7 (R« Ilft Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 Bragew Street P.O. Box 198050 Anchorage, AK 995198850 www.muni.org/onsfte (907) 3437904 CERTIFICATE OF ONSITE SYSTEMS APPROVAL CHECKLIST � _ . � . .� •a. h u • r.v .T, is � _ . _ � • : � '' A. WELL DATA Wen type 9m Date comp) Total depth ft. Date of test Static water level Well production WATER SAMPLERS If A, B, or C provide PWSID 0 Sanitary seal (YM)— toIto FROM WELL LOG ft. g.p.m. JLTS: : colonies/100 mL mgA B. SEPTICINOLDING TANK DATA Nitrate mg/L Well Log (Y/N) Wires properlyjXotgUed (Y/N) (above ground) in. AT INSPECTION ft. Other bacteria oolonies/100 mL Date of sample: _ Collected by: Tank Type/Material Anchorage Tank Steel Date installed 911511983 Tank size 1250 gal. Number of Compartments j Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Do gi on over tank (Y/N) y High water alarm (YM) Date of pumping `r Pumperl5 C. ABSORPTION FIELD DATA Data installed 911511983 Soil rating (g.p.d.Atz or fe/bdnn)125 System type Bed Length 1011= IqZ ft. Width / fit ft. Gravel below pipe 0.5 ft. Total depth —f, ft. ER. absorption area Z&te Monitoring tube Y Depression over field y Date of adequacy test 7"12 V ©' – Results (Pass/Fail) Paas For 4 bedrooms Fluid depth in adsorption field before test Q in. Water addedffl gal. New depth4 in. Elapsed Time:,U min. Final fluid depth Q in. Absorption rate >= 800► g. p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date D. LIFT STATION Date installed /0/27 l f Y Size In gallons S'vo ManhoWAccess (Y/N) ( P, S "Pump on" level at 7E in. -Pump ofP level at 1A in. High water alarm level at 3 If in. Datum TS -7 r -c!jt of —L Cycles tested Iq Meets alarm b circuit requirements? [ U e S E. SEPARATION DISTANCES DISTANCES FROM WELL ON LOT TO: Septic tankilift s on lot _ Absorption field on lot Public sewer main Sewer /servtce line _ Ani containment areas _ On adjacent lots On adjacent lots Public sewer manhole/cleanout tank storage areas •1 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: nn Building foundation 5+ Property lure Z 0 +'T Absorption field r Water main 50+ Water service line 25+ Surface water 100+ Wells on adjacent iota 200+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 50+ Water Service line 25+ Surface water 100+ Driveway. parkingNehide storage 25+ Curtain drain None Observed Wells on adjacent lots ++ F. COMMENTS This is the cid 1983 bed reamnected in .lulu 2007 when the 1994 bed failed, L Vd T u s7a t .����wpeees G. ENGINEER'S CERTIFICATION �.PC� ♦♦♦ 1 car* that 1 have determined through field inspectlons and C ,• �,� ♦♦♦ review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. i tSteven R. Pannone/i Engineer's Printed Name Steven R. Pannone. RE ♦♦♦� t� N,. Ce 8149 r C Date ♦♦♦i•�Dy��.�� COSA Fee E V Date of Payment 2I A5 0 Receipt Number ` 4?0 / p (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number %SBUILT-NO CORNERS SET THIS DATE. HEREBY CERTIFY THAT I HAVE SURVEYED THE DLLOWING DESCRIBED PROPERTY: DITEDACFTAS . ITIS THE RESPONSIBILITYOTHE VNER TO DETERMINE THE EXISTENCE OF ANY , COVENANTS OR CH DOTNOT APPEAR ON THE RECORDEDIONS SUBDI- SION PLAT. UNDER NO CIRCUMSTANCES SHOULD I DATA FENCE LINES, OR FOBE R ESOTggLIISH NRG BOUND - !Y LINES. SCALE: -- — ""„.dint, b94-082 / DATE: �F OF A ° GRID: FB: Dvene Me.k Sewed r IS -p91 t DRAWN: +� ° n74}•s*ks `l- � Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET To: Steve Pannone Legal description: Thunderbird Heights #1 Block 7 lot 1 ❑Permit ®C.O.S.A. ❑Inspection Report The attached paperwork has been reviewed and Is being returned for the following reasons: 1. Distance tank to property line. I-- 2. Distance tank to absorption field, .,`nn 3. Distance absorption field to property line. / ft L UJ •6v v —r ks 4. High water alarm. / 6-:�Oj Name of reviewer: Leff Date: August 28, 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICE$ + 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 I.D. # S I S- gl 0 S' HAA # 14A 40606 a 1. GENERAL INFORMATION Complete legal description 'Lot 1; Mock �7;• -T` unden6•ucd "Heigham -41 Location (site address or directions) 24550 Thundea6•vcd Dni.ve Chugiak, AK Property owner Adh,io_ and Suo Sotton Day phone 688-3398 Mailing address P.O. Box 670613 Chugiak. AK 99567 Lending agency Day phone Mailing address Agent Vi4gini.a KohSie.ed/ REMAX OF EAGLE RIVER Day phone ~ 694-4200 Address 16600 Centek6.ie.fd Ative Eag.fe Riven AK 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well • Community well y XXX ; w : '; %; Public • L-: water — �= NOTE: If community well system, provide written confirmation from State Ing to the legality and status of system: Ad&; attest;-; 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 attesting to the legality and status of system. 7 . • . n-M(Rw.1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and• as of the validation date shown below, l verity 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 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 effect on the date of this inspection. Name of Firm S & S ENGINErpiNr Phone �q j —�?_ti i 17034 Eagle River Loop Road No. 2W Address Eao►e Of... Engineer's signature -_ 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Date Ii /I /cIry Conditional approval for bedrooms, with the following stipulations: Additional Comments = 1 - 1 - - 1. /J'I Date By: 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 courtesy to purchasers of homes and theirlending 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 (Rev. V91) Baek MOA 121 ® Municipality of Anchorage AiRL Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description-7HyA1DEF3/RD NlE6r17-s-10/1, RLact-7 Parcel I.D. DS/SF/OS Lor / A. Well Data Well type _A If A, B, or C, attach ADEC letter. ADEC water system number Log present (YO d/a Date completed 'rl fps- - Driller &A Total depth '_&41#- Cased to Casing height N/X- Sanitary seal (Y/N) 41t- Wires properly protected (YM) .41 FROM WELL LOG AT INSPECTION Z Date of test = N 0 Static water level < a Well flow g.p.m. g.p.m, o� N Pump tevelt d o V w SEPARATION DISTANCES FROM WELL TO: zo Septic/ tank on lot 20614- ; On adjacent lots '4• - W Absorption field on lot zoo r+ ; On adjacent lots zoo Public sewer main zs- 'f- Public sewer manhole/cleanout 05 Sewer service line z s `4- Petroleum tank AJ/0- WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/1111111111111M TANK DATA Collected by: Other bacteria Date installed oW 9-/4--93 Tank size /ZSa Compartments Z Cleanouts (9 ff V) Vgg Foundation cleanout (.Y)N) Var Depression (Yo A( o High water alarm (Y&__ /Vo Alarm tested (VQ 0o Date of pumping 9 - iy -9 y Pumper .T. R. 'r GErr?c=�L � SEPARATION DISTANCES FROM SEPTIC/HONG TANK TO: Well(s) on lot �c d On adjacent lots ago ',�— Foundation /S' To property line 29Absorption field Sa' Water main/service line /0" - Surface water/drainage 140 r -/- 72-026( )o Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed /0 -30 -9'/ Manufacturer / , Ham.4e6- Size in gallons .fes Manhole/Access (DN) Y& -s Vent (Y(Ay /clo "Pump on" level at 2F" 'Purrs off" Level at /P ° High water alarm level rzf Cycles tested Meets MOA electrical codes (Y)N) YES' SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot 2-00 14- On adjacent lots' 206 '4- Surface water, D. ABSORPTION FIELD DATA eStuR/zr-c� !�//DE Date installed /o -3d - 94/ Soil rating (GPD/Ftz) O.P System type Length P/ Width Ir Gravel thickness Y•S Total depth 7.z' Total absorption area ?so Cleanout present (Y& .Uo Depression over field (YO ,ULI Oateofadequacytest�u/A- N sys7c++Results(pass/fai1) .0/a— for d/a- Bedrooms Water level in absorption field before test .uIZA— After test Peroxide treatment (past 12 months)(1 Nf� .tla NSA`- - If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: w Well on lot 2c6'*- On adjacent lots zoo �,-- Property line To building foundation a F' To existing or abandoned system on lot y0 t On adjacent lots /o '1- Cutbank SU' Water main/service line i0 't - Surface water fav '>' Driveway, parking/vehicle storage area Curtain drain wAJ SBL- 1Jk? vLe LGQ JEST E. ENGINEER'S CERTIFICATION I certify that I have checked, verified or conformed to all MOA and HAA guldelines in effect on the date of this inspection. OF ku �. ot'. Signature Engineer's Name .'...... ROCIRCE-IIIIOI COWAN Date 1 r r Y .Z HAA Fee $ ' °o U Waiver Fee $ W2i as Date of Payment Date of Payment ((- a'"qq Receipt Number 60 NSCO tvS �° Receipt Number 60`f S 6t'T 5 6 72-026 (3143)• Bads 89 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUNI Y OF ANCHORAGE DEPT. OF HEALTH & CHECKLIST - FEBRUARY 1984 ENVIRONMENTAL PROTECTION A. WELL DATA APR 2 S 1984 REIVED Well Classification If A, B. or C. D.E.C. Appr (Y ) Well Log Present (Y/N) Date Completed•, Yield Total Depth Cased to Depth of Grouting Static Water LevelSet At mp Casing Height Above Ground Sanitary Seal on Casing (YIN) Electrical Wiring in Conduit (Y 14 Depression Around Wellhead (YIN) Separation Distances, frau Well: / - To Septic/Holding Tank cn Lot C-1 .... ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots To Nearest Public_Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected By Date Water Sample Test Results Cam nts B. SEPTIC/HOLDING TANK DATA Date Insta?'I %J SIP f 3 Size 2 50' No. of Carpartments G� Standpipes) Air -tight Caps (Y ) Foundation Cleanout (Y Depression over Tank ) Date Last umped Pumping/Maintenance Contract on File ( for Holding Tank High -Water Alarm (Yi T Jjai Terporary Holding Tank Permit (Y Separation Distances frau Septic/Holding Tank: f� J To Water -Supply Wrll Dbs kAJ4 -ZL To Building Foundationy To Property Line To Disposal Field f To Water-MaWService Line 4' To Stream, Pond, Lake, or Major Drainage Course I /✓ ) f<) /L " cc / V 1aeArl6 4J ar W4GV :51le = cVvG (Page 1 of 21 gl34yklq �-K- .'00 2 -15 -PA C. ABSORPTION FIELD DATA I in Absorption Strata 2- Type of System Design(/ Soils Rating orp � Date Installed �,� j ngth of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area 1-52 Standpipes Present Depression over Field (dw1))ate. of last Adequacy Test-- Results estResults of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply tel` c�w61,,J 'l To Property Line To Building Foundati'o/n3c� To Existing or Abandoned System on Lot /A/ Z,,LOn Adjoining Lots O To Water 44e4vVService Line, � T- To Cutbank(if 2resent) / To Stream/Pond/Lake/cr Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area /� 1 Comments t l ' el s1. iU CC w U it -4 D. LIFT STATION Date Installed _ Dimensions Size in Gallons Manhole/Access (YIN) "Pump On" Level at IA 'Pump Off" Level at High Water Alarm Level at tJ Vent (YIN) Tested for ing Cycles during Adequacy Test. Meets MOA Electrical Codes(Y/N) Comments Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, cr conformed to all MOA HAA Guidelines in effect on the date of this inspection. S a : INCIN5FIRIM-3 LL �y Signed P. cRB 99Gx Date i -r L: Itt t_(lr h wrli vv/I C any { 2 T / MOA NV. IfAA [Page 2 of 21 2-15-84 S& November 1, 1994 ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. CML ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTHAUTHORITY APPROVALS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street SEWER&WATER P.O. BOX 196650 MAIN EXTENSIONS Anchorage, Alaska 99519-6650 NSPECTIONR REFERENCE: Lot 1 Block 7 Thunderbird Heights Subdivision 41/ ENGINEERING STUDIES Request you issue a Health Authority Approval on the AND REPORTS referenced property and grant a waiver for the horizontal separation distance between the leachfield and the property line at 1 ft. WELL INSPECTION After the property line was flagged and during construction &FLOW TEST of the leachfield we found the area best suited for the system was 1 ft. from the property line. We do not anticipate any adverse affects on the adjacent properties. SITE PLANS If we may be of further service please contact us. Sincerel ROAD DESIGN /Engineering nd L Shafer /l Tqqhnician SOIL TEST W�` Robert C. Cowan, P.E. PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:—k;i4r Se=� DATE LEGAL DESCRIPTION:Lar 1 ,ft4oWnship, Range, Section: pyty O!: SLOPE 1 2 611P/Ltc,a•r StL;r 3 YJR `o 4- 5- 6- 7 5 67 8 10 F2,o,r' 11 12- 13- 14- 15- 16- 17- 18- 19- 20- WAS 21314151617181920 COMMENTS WAS GROUND WATER ENCOUNTERED? SITE IF YES, AT WHAT 1. ■■■■■■■■■■ ReadingI Date I Gross I Net I Depth to I Net Time Time Water Dr 1 9CATION RATE (minutes/inch) PERC HOLE DIAMETER RUN BETWEEN FT AND FT PERFORMED BY: 02n4 f" "c- 11 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE 72.008 (Rev. 4/85) TG /� CERTIFY THAT THIS TEST WAS PERFORMED IN IN EFFECT ON THIS DATE. DATE: I unicipahtyy of Anchor e C* Department of Health and Human Services Rick Mystrom, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 December 12, 1994 Mr. Robert C. Cowan S & S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River, AK 99577 Subject: Waiver Request for: Lot 1, Block 7, Thunderbird Heights #1 Waiver Approval: # WR940068 Dear Mr. Cowan: Your request for waiver(s) of the required 10 foot horizontal separation of an absorption field to a lot line has been approved. The approved separation distance(s) are: Absorption Field to Property Line 1 foot This waiver approval applies to the existing absorption field to lot line separation only. Any future upgrades to either will require all separation distances be met or another approval be obtained from this department. Sincerely Robert W. Robinson Civil Engineer On -Site Services kb • _ r 1 MUNICIPALITY OF ANCHORAGu Department of Health and Human Services On-site Services Section WR# WR940068 PID# Waiver Review Worksheet 051-581-05 Date Received: 11-02-94 HA# HA940600 Permit # Legal Description: Lt. 1, Blk. 71 Thunderbird Heights #1 Engineer: S & S Engineering 703 Eagle River Loop Road, Suite 204 Eagle River, AK 99577 Applicant: Adrie and Sue Setten Waiver Requested: Absorption Field to Property Line - 1 fnnt Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: Rec #: 00456 (7656) Amount: $.115.00 Date Paid: 11-02-94 MWICIPP.LT_TY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARi NT OF HEALTH AND ENVIRONME;vTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL. CERTIFICATE 1. General Information Application Date j-20 -� Y (a) Legal L--scr l Loca (include,J,ot, black, ar ,directions) section, tcwrship, range) (b) Applicants Nacre (I— S fC Co . J- T Telephones Applicants Address (c) Applicant is (check � --�• o -n -e) Lending Institution Owner/builder,�; ! Buyer Other (explain); (d) Lending Institution Te lephcne Address (e) Real Estate Co. & Agent'CSG',/% Lame 7<:- -- VL/, I • l/%%U;raIr f- -,e- Address {Address Telephone 4eZO O - 2. Type of RL s ide rce Sirgle-Family M iilti-Family Number of Bedrecns '2� Water Supply Individual Wall Ccn=rity Other (describe) Public L /4-Sf A -- Note: If camunity well system, must have written confirmation from the State Department of Envircrm ntal Conservation attesting to the legality and status. Is the well adequate for the number of bedroans specified in this HAA A ) ' 4. Sewage Disposal Ors itePublic Ccmmainity Holding Tank Is the wastewater disposal system adequate for the number of bedroc= (/N) [Page 1 of 21 2-15-84 ("IN �1 5. Engineering Firm Providing Inspections, 'Tests, Data and Information I certify that a checked, verified, or conformed to all MOA HAA Guidelines in effect on date f5$tiyj,nspection. Signed Name Address Signed by -- --........... Date (ENGINEER SEAL) of Aji �� ... •. u jcc ,.+�>/3�/l/�! I 6.DHEP Approval ' Approved for bedroars By �c-�.�.e_ c- Date �D Approved Disapproved Conditional , Terms of Conditional Approval The Municipality of Anchorage Department of Health and Envirormental Protection rices not guarantee the continued satisfactory performance of the water supply anal/or the wastewater disposal system. This approval indicates that, as cf the validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is sate and furc- tional for the number of bedrooms and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 21 2-15-84 6 O 6 d BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (9071 274-2533 Address: 437 E Street Suite 200 Anchorage, AK 99501 April 27, 1984 PWS I.D. #211431 To Whom It May Concern: According to records on file in this office the Dawn Water System, Wynter Park Subdivision is in compliance with the State Drinking Water Regulations. Sincerely, James F. Hayden Environmental Fi Id Officer JFH/msm cc: Hr. Robert Shafer