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MOUNTAIN PARK ESTATES BLK 4 LT 5
Mountain Park Estates Block 4 Lot 5 #017-061-34 Municipality of Anchorage !/ Development Services Department :t.. Building Safety Division Onsite Water and Wastewater Program, 0700 Elmore Sl. P.O. Box 196650 Anchorage. AK 9951"650 Page of www.ci.anchorage.sk.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: _SWoRoo63 PID Number: 011-Oto)-3y Nam. Ttieens, S�a•w kc Wastewater System: ❑ New ❑ y Upgrade Addres, 1322. Ccc v Jr�ve ABSORPTION FIELD .� Phone Numbw of BedromR 4 O Deep Tnntn D S"N w Treem O Bed O Mound O other LEGAL DESCRIPTION Boa Rama TotalDapm "m org" and• GPDIFr Fl. 61W d L« In 1 B"IbSN«m '7 Ta I Dn W ppe bobom e•m man« pad• •pt Grav« w dwh tt am PPO 1' Iorw w Tent ' Ft Ft Ta n«t,p Range Sevum F,a arida above mpn« ped• Grew Length Ft. Ft. Well• £ + [--]New Upgrade XIS in Gnr«wmn hi n W1•tas Dwame Mtween Ines Ft. Ft cias«nubm (Pnvat . e. Cf Toa D•P cow Ip. T«« abwrpom "a Pip• Mann« Ft. FL Fr Draer Date DMW Stabc Wear Lew M Wgr Oran Cons Dot • m««t•d Ft r c Zun 5 08 v,«d Pump Set OL casing h"M Abor• Ground TAN K GPM FL FL SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To From Septic Tank Absorption Field Lit Station Holding Tank ubltuPMateaci... Sewer Line W^1 ` TAr% apaoty h50 /` nc11rd. 1L G« wellI Dp'+ M•tmal Slee, Nue 0Coi,W.ts Z Surl.ce Water No LIFT STATION ' le IW iGWN. L« line JC } G« Faundamn L } on Nw at 'Pump am at 11,91, eeew «arm at 5 k1 ;P� in cun«n Dan N.O. Make 61 Elaanul Y,rp•rAms peripnnad by Remans+ BENCH MARK Mon Lcnabw and D•w(,pom1 , . W,MC orabm 100 FL performed by: LAis spmrW-an0 Dates: 1 1* pqInspections ll 2nd .• %E.OF.q j1 r�� �Q:. S.• lr ' Development Services Department Approval i :.49TH4 Conditional Approval Date: .. i ??X�•. LARS e. SFLT.K A'JD (( FSP^ Reviewed and approved by: Date: 'z�0 1�X (Rar O4 ) . N, ABANDONED EXISTING SEPTIC TANKS PER MOA CODE REOUIRMENTS i / M / (ot CANT) / 0 LotI�TALLE\12s0 GAL SEPT/C TANK CONNECT£D� r TO £X/STS DRA1N"'I DS m Lot 5 I — — 4 II Lot 4 MOUNTAIN PARK ESTATES / ��� BLOCK 4 ® cI '� I �.�,•�_ _ _ Lot 7 — I 50 0 50 100 150 Xv 250 300 SCALEr 1' = 100 FT. DOUBLE CL �A•IMI ITn Ca EXIST 1-4 FEET COVER 1e,7U g0 i, Sep tic tank ION T r 4 SPURKLAND Bench Mork BoNom Siding O A' Aseumed Dovaflon = 100' 1203 Wnwu . A'VrtUr I (MOUNTAIN PARK ESTATES BLK 4 IT 5I I SEPT/C SYSTEMASBUILT I 103 W 15TH. AVENUE DATE. JUNE 27, 2008 ANCH. AK. 99501 THOMAS SHARKEY (907) 279-3916 13121 CRESTV/EW DRIVE SHEET. 1/1 GRID. 2938 I PERMIT # SVO80067 PID # 017-061-34 MPEB4L5Dl.dwg I MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water b Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 03, 2008 Expiration Date: Jun 03, 2009 Permit Number. SW080067 Parcel ID: 017-061-34 Legal Description: MOUNTAIN PARK ESTATES BLK 4 LT 5 Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: 013221 CRESTVIEW DR Owner Name: Thomas Sharkey Lot Size: 17600 SO. FT. Owner Address: 13221 CRESTVIEW DR Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516-3119 This permit is for the construction of: ❑ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. Issued By: Date: 6- Date: 6 5_0 d Municipality of Anchorage --` Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Q1_7— O G /— 3 `f Property owner(S) Thomas Sharkey Day phone 240-9201 Mailing address P.O. Box 233425, Anchorage. AK Zip Code 99523 Site address 13221 Crestview Drive Zip Code 99516 Legal description (Sub'd., Block & Lot) Mountain Park Estates Block 4 Lot 5 Legal description (Township, Range & Section) Lot Size Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank 0 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 4 THIS APPLICATION IS AN: Initial ❑ Upgrade El Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of p?opbrty owner or authorized agent) Permit/Rush Fees: _ A % I p Date of Payment: 6's-03 Waiver Fees: Date of Payment: Receipt Number: b 15 Receipt Number: (Rev. 11105) SPUTMand ERPOOR BT00fig Environmental Consulting and Design June 3, 2008 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: EMERGENCY SEPTIC TANK PERMIT APPLICATION MOUNTAIN PARK ESTATES BLOCK 4 LOT 5 We are submitting an application to upgrade the septic tank for this lot. The existing system consists of a 1000 gallon septic tank followed by a 500 gallon septic tank. The] 000 gallon tank has collapsed. Both tanks will be abandon per MOA code requirements and a new 1250 gallon tank will be installed. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. There are no wells within one hundred feet of the proposed replacement site. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There arc no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. S* cc Lars Spu kland, P.E. 203 Nest 151° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng(algci.net ABANDON EXISTING SEPTIC TANKS PER MOA CODE REOU/RMENTS Lot 5 (VACANT) i / /� Lot 5 Lot 6 IN TA1150 GA SEPTIC TANK CONNECT 1 TO £X/STS ORAINFIEL DS m "t4 AINPARK ESTATES>I MOON BL o�K a ® �I Lot 7 1 50 0 50 lx 150 200 250 300 SCALE/ r = 100 FT. DOUBLE CLEANOI "" CONNECT EX/ST DRAIh..l�.. 1-4 FEET COVER 1250 gal. septic tank >F0UNDATION CLEANOUT .0 J. ': �� �.i.....49th i.... 0 X : L • S SPURKLAND fes; NO. CE -11300 ISPURKLAND ENGINEERING I I MOUNTAIN PARK ESTATES BLK 4 IT 5) I SEPTIC SYSTEM DESIGN I 203 W 15TH. AV£NU£ THOMAS SHARKEY DATE: JUNE 3, 2008 ANCH. AK. 99501 SHEET 1 1 GRID: 2938 dont 97o_Tof6 13221 CRfSTV/EW DRIVE PERMIT k PID # MPEB4L5Dl.dw9 Municipality of Anchorage Page I of 3 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: PID Number __OIiOCal34._ Name GAR\i LEMKE Wastewater System: ❑ New gUpgrade Address 13221 CRESTtlIEW UP,ANcN; 995/6 ABSORPTION FIELD Phone' 34S- 3514 No. of edroorl �{ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: 1 Total Depth from original grade 1 • GPD/Sc. FL z Lot: Block: Subdivision: 5 4 Depth to pipe bottom from original grade, Gravel depth beneath pipe MT PARK EST ZIk 1 3 Ft q Ft. Township:Range: 12 N Section: 26 Fill added above original grade: Gravel length: 3 W O'Sit Ft 37 Ft. WELL: Newt ❑ Upgrade Gravel width. Number of lines'. Distancebelwem Ilnba Ext 19-5, I_ 2 (TEei 0 Ft. Classification (Private, A,8 C) Total Depth: Cased To: __ Total absorption area: Pipe material: Ft. Ft. NO so. Ft. 4•" PERF F-810 Driller. Date Drilled: Static Water Level'. Installer: CdN CONSTRJCTION DateInstalled / 9118192 Ft. Yield: Pump Set at: Casing Height Above Ground. TANK CE K(5%/(V �) GPM Ft. Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T. E. P. To septic Absorption Lift Holding Pubhc/Pr,vw. Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Well f iol Material. Number of Compartments: Surface > loot LIFT STATION N. 4.) Lot / Size in gallons: Manufacturer. Line i Foundation 37' "Pump on" level at "Pump off' level at: High water alarm at. Curtain Pump Make & Model Electrical Inspections performed by: Drain Remarks: p v; ���� {rac�v� tAe S P Sfrnfa BENCH MARK (.tea. verl,%Pce iv he co, f, uaus thirea'/1,,maf Lucatiou and Description. GARAGE 5I.A3 AT C NTFR 120-M /E vF -f'¢ u rc off¢ 7�rcnch, <bli F DOO Assumed Elevation. In C4,;o eL4 G. }z nn f-.-ehcl, 4wcr1 C(,Aiec/x•� 100. o Et Flattop Technical Service ENGINEER'S SEAL e tie narfh ¢��e of Me rt- Anchora e, Alaska 9951. ��.gm.E&.�.gZ 98��9 �oOF A� p� . A c. LL Inspections performed by: FJaFh�__Tt Sic Oates:lst 9/ISf9Z ptim. w,�asr'-'�Cw 2nd 9/19/92_ v �. ...... a......... a; ... Department of Health and Human Services approval+ THEODORE F. A' OE CG mu Reviewed and approved b : Date:— 3589 a, mm 72-013 (Rem 9/91) MOA 25 ?-c Permit No. S W 9 Z 0 213 Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report al Description: Lot 5-, 31k, y r-ttn. Park 0-1 PID No.: 0( 70.6/ 3y UPGRADE TRENCH LOCAzlo"t GARAGE CORNERS: A B GJ� r (✓� xYi C,o,�C'' 59 66 N.T. D 46' S9' 72-013 A (Rev. 9/91) MOA 25 a0 i.FOF, T/ o;-; GN 'KY CY AN o-IRH Dr` W0Ct- uTl� ESMT Go„C ti4 P��N vtc-w .Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 I -/'.,PORTION OF TRENCH KP6Rq DC 03034. — C-0 E m r. I i 1"=50 PRG--PPSr+ 5EP rlc S1- ENGINEER'S ...................�. ........�. THECOORE F. MOORE CE -3589 Permit No. S w 9 2° 2/ 3 Page 3 of 3 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: LOT 5 9LK Lf .MT PARk EST, :a I PID No.: _ 0 / 706 t 3 R 125, M T.R.41 79.2' DR`/ 79-nIs41Ac Q 11Une91 cu'er av¢/' Sy5%tm Z— F'r I ker �_. ' DISTR13�-TION PIPE INVERT 92.S' 130TH EµDS Gof%rn of 63.? T. & M. 6/106E' SLAB, CENTER OF DooR 100.0' FRAM EXISTnN6 56PTle SYSTEM Flattop Technical Service 14530 Echo Street ;Anchorage, Alaska 9951 prioFllre� vt6Lv ENGINEER'S SEAL VERT ICA( -5.'l"= S�-O" /Vo /4-0R( ScKc[ ()F A�� � s * 49tH a ;....?? R THEODGkE F.:,1GOrtc ce 35&9 .°;c'< '•. a CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. October 26 1992 14530 ECHO ST. , PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 Susan Oswalt RECEIVED M.O.A.DHHS OCT 2 8 1992 P.O. Box 19-6650 Anchorage, AK 99519 punIciPaiity of Anchorage De t. Health R Human Services Dear Ms. Oswalt: This is in response to your "pink slip" questions regarding the as -built inspection report which we submitted for the recently completed trench upgrade on Lot 5, Block 4, Mountain'Park Estates #1. (1) The septic tanks were not dug up to verify their integrity as part of this project. Since they are only 11 and 10 years old respectively, and `we"did not tie the new trench directly in to them, we had no reason to be digging in that area. The permit did not specify that they were to be dug up. Our field measurements indicated normal fluid depths in the tanks and no depressions were noted in the ground over them, so there were no outwardly visible signs that the tanks might be in failure. (2) In constructing the new soil absorption trench, the contractor dug the SW/NE leg running parallel to the property line first, and the sand stratum extended far enough in this direction to allow a trench leg length of 20 feet. Since this leg was longer than originally anticipated, we were able to start the other leg 5 feet NE of the SW end of the first leg, thereby enabling the second leg to be further away from the well radius and possible trench sidewall cave-ins in the vicinity of test hole #1. This second leg was dug to a length of 17 feet. Since a total trench of 28 feet would have achieved the required absorption area of 500 square feet, the absorption capability of the first 9 feet of sidewall area in this second leg could be totally discounted and still achieve the necessary square footage. By constructing this extra trench length, we incorporated a 33% factor of safety against premature trench failure. I have endeavored to clarify the exact trench lengths on the inspection report which I am returning. Please give me a call if you have further questions on our submittal. Sincerely, Ted Moore, P.E. PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE ienn DEPARTMENT OF HEALTH AND HUMAN SERVICES 9_19_0/9 P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 IS'v ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920231 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:LEMKE GARY R & OWNER ADDRESS:13221 CRESTVIEW DR ANCHORAGE, ALASKA 99516 PARCEL ID:01706134 LEGAL DESCRIPTION: MOUNTAIN PARK EESTATES BLK LT 5 LOT SIZE: 17600 (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: v DATE ISSUED: 8/14/92 EXPIRATION DATE: 8/14/93 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS UPGRADE SYSTEM MUST BE INSTALLED IN ACCORDANCE WITH THE APPROVED ENGINEER'S DESIGN DATED 7/20/92. THERE MUST BE CON- FIRMATION BY THE ENGINEER DURING CONSTRUCTION OF THE TRENCH THAT THE SP STRATUM IS CONTIGUOUS FROM 3 T 12 FEET THROUGH- OUT BOTH LEGS OF THE TRENCH. IF IT IS NOT, THIS OFFICE MUST BE CONTACTED FOR APPROVAL OF ANY MODIFICATION TO THE ORIGINAL ENGINEER'S DESIGN. RECEIVED B ISSUED BY: DATE: DATE. Municipality of Anchorage % Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 14, 1992 Ted Moore, P. E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 A Subject: Waiver Request for Lot 5 Block 4 Mountain Park Estates S/D Waiver Request #WR920037, PID #017-061-34, SW920231 Dear Mr. Moore: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 1 foot from the NW property line. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincer ly, ZZ Robert W. Robinson Acting Program Manager On-site Services CIVIL. & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION &'ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 July 20, 1992 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: J' (of 64 waver r¢qusf The purpose of this letter is to provide the required design narrativeAin support of our application for a permit to upgrade the wastewater disposal facilities on Lot 5, Block 4, Mountain Park Estates S/D #1, located at 13221 Crestview Drive. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. This upgrade is necessary because the absorption rate of the existing septic system has proven to be not adequate for the wastewater load generated by the residence. The proposed upgrade will be constructed in the vicinity of test hole # 1. The native material encountered in test hole #1 between 3' and 16.5' is a medium sand with a measured perc rate of less than 1 minute per inch. As can be seen from the attached sample of material removed from the perc test hole, the material is visually equivalent to "filter sand" and therefore no additional sand filter should be required. Using the soil application rate of 1.2 gpd/ sq. ft. specified in the wastewater ordinance for soils with a perc rate of less than 5 minutes per inch, this 4 bedroom residence requires a total absorption area of (4 x 150)/ 1.2 = 500 square feet. The proposed 30' long ell shaped deep absorption trench with 9' of sewer gravel has a total absorption area of 540 square feet. Since test holes #2 and #3 did not reveal the same sand material, the proposed trench is designed to be as close as possible to test hole #1. In order to accomplish this, a lot line waiver is needed allowing the trench to be as close as 1 foot from the northwest lot line. Since this lot line abuts a road right-of-way, granting the waiver will not impact the ability to construct future wastewater disposal systems on adjoining lots. The topography of the lot is generally level in the area of the proposed construction. It is, however, at approximately 4' lower elevation than the existing soil absorption system. The proposed upgrade, while sized adequately to serve the entire 4 bedroom residence, will be connected in series downstream of the existing septic system to allow utilization of the original system to the maximum extent possible, thereby prolonging the life of the total system. The proposed project will have no impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any impact on reserved space/surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, T Ted Moore, P.E. LOT SC BLK i SEPTIC LOT 7 ELK (I Q� AJC WELL ZOT 5 ELK 4 LoT L+ <VACANT) v � ,i� T.N•�3 .sti n ik 4 Ii4 P 3^ 7RoYo5ED'• aT 30'TRENcH CJN ECT NG L�NE� DRwEwM _ 1 GARq 70 ' HOUSE s�Q.1 OF.A4q q y may: 49TH • ;7 0 r..................�...... SO 0.�............. i... d .THEODOaE f MOORE.• YE d9 CE - "89 Ar !q ExISTIaG -_._ sEPT�c TE h 4 LOT '7 Lor 6 BLk 4 WELL NODS E Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99519 LOT S, BLK 4 MT. PARK EST ** SEPTIC S`ISTEM UPGRADE SITE PLAN SCALE'. I"=50` NOTE: THIS IS Nor DATE I T192 A SVRVE4ED PLAT DWN By: ALL LOCA -T ]DNS ARE APPROXIMATE C LEANouT MONITOR TVSE - 4" PERF PVC F -810 - �E 20 ............. �� THEODU:';z F, :AOORE •• A C EANOET �uNON - PERF A FROM EXISTiNC SEPTIC SYSTEM �A PLAN VIEW CLEANOUT MONITOR TVg ^ / piLTER FA6RrC ' I I i O.S' FILL ABOVC OR161NAL 6RADE 3I,0'P1FC mVERT DEPTH 127 r' 1r EXCAVATiok '1 9,Sr5EwEQ GRAVEL r� 1' .1 Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 SECT ioN A -A 11 LOT 5, SLk 4 MT PARK EST * l UPGRADE TRENCH PLAN AND CROSS-SECTION SCALE: t•' <5r DA'T E : -719-z DtVN RH: CA. Flattop 7eehnicalServices 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 5, Block 4, Mountain Park Estates #1 13221 Crestview Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installation of a 30' long soil absorption trench containing 9.5 feet of sewer gravel. This trench is to be connected in series to the existing soil absorption trench. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the constriction. 1.6 Prior to the start of work, the owner shall arrange for a land surveyor to mark the northwest property line at 10' intervals for 60' southwest of the north property corner. 2.0 Soil absorption system: 2.1 The 12' deep soil absorption trench shall be dug starting at a point l' from the northwest property line and 101' from the well and proceeding in a southeasterly direction keeping 101' away from the well. If the trench sidewall is not stable in the vicinity of test hole #1, temporary plywood forms shall be installed to retain the sewer gravel outside the 100 foot radius from the well while native sand is simultaneously backfilled on the well side of the forms. The forms shall be removed after the gravel is in place. 2.2 The bottom of the excavation shall be level. The trench shall be extended in a southeasterly direction only as far as the sand stratum continues to be as indicated on the log for test hole #1, up to a maximum length of 30'. Additional trench segment(s) as needed shall be dug perpendicular to this segment to achieve the required total absorption area. 2.3 A total of 9.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 9 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 2.4 The 4" non -perforated line bring effluent to the trench shall be connected to the distribution pipe at the north end of the existing soil absorption trench. Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 2.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A. minimum of 3 feet of soil cover is to be placed over the filter fabric. 2.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Pill slopes shall be no steeper than 3:1. 2.7 The owner shall arrange for all areas disturbed by the construction to be covered with 4 inches of topsoil and seeded to promote rapid revegetation. 3.0 Inspections: 3.1 A minimum of 4 engineering inspections will berequired during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of filter fabric, and (4) after final backfill and grading is complete. 3.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. r^ yr ry�� •. FlattopSero xis Technical Serxrs e .. 'E,..•••••.., 14530 Echo Street JOG *.�1 LS Anchorage, Alaska 99516 a0-04-6 ...... �........ Municipality of Anchorage � 0 DEPARTMENT OF HEALTH & HUMAN SERVICES '•• OO* �iHEODORE F. iq I, 825 "L" Street, Anchorage, Alaska 99502-0650 � �, '., CE - 3589 .' SOILS LOG — PERCOLATION TEST �9 �/e '•'•...•,..•••�' PERFORMED FOR: ISA R.Y LEMKE DATE PERFORMED: LEGAL DESCRIPTION: L$ %a MT PARK EST #I Township, Range, Section: SEC iG 7-)2N PLAN I r PT 1 � I SM REDDISH 5AMDy LogM 2 3 4 5 6 7 FS 2' 8 9 10 11 12 13 14 16 17 18 19 20 COMMENTS ML SANDy SILT SP MEDIUM SAND WAS GROUND WATER N ENCOUNTF.nED? IF YES, AT WHAT DEP"rl I? Depth to Water After Monitoring? M-7-- QRr_Date: I � SM LENS DENS£Ly A./92 PACKED SILTY SAN I D Reading Date Gross Net Depth to Net Time Time Water Drop 6 24 9z :44:00 27 3:45:00 2 !z 27 -Y 3:47: 13 2) 4j +Hao 3:47: 50 3 ,y _ 3:48: So 1 20 3/ 3 3 y 3:so: 3o 1 20 '/ 3 23 yz _ 3:52:15 I 20 3/8 3 y9 PERCOLATION RATE < 1 (minutes/inch) PERC HOLE DIAMETER 7 TEST RUN BETWEEN 7.5 FT AND , 7 FT PERFORMED BY: FL[{'T'[Q�- TECH(—_�L/ �— %1�¢,,,t — --_� CC-R11FY THAT 'T HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72.008 (Rev. 4/85) PERCOLATION RATE < 1 (minutes/inch) PERC HOLE DIAMETER 7 TEST RUN BETWEEN 7.5 FT AND , 7 FT PERFORMED BY: FL[{'T'[Q�- TECH(—_�L/ �— %1�¢,,,t — --_� CC-R11FY THAT 'T HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72.008 (Rev. 4/85) Flattop Technical Servicta 14530 Echo Street Anchorage, Alaska 99516 • ..,r Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST T H. #Z .THEODORE F. MOORE �. S�� CE -3589 PERFORMED FOR:_ GARY LEMKE _ _ _ DATE PERFORMED: LEGAL DESCRIPTION: LS, 54 MT PARK EST #I_Township, Range, Section: SEG 2b T DEPTH P.r SLOPE SITjF PL 1 SM REDDISH SANDY LOAM IN 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ML GRAVELLY SILT LENS OF SAND TIGNT, HARD D1661N6 MANY CogeLES LENS OF SILTY SAND 15.14. WAS GROUND WATER ENCOIINTFRFr)? N R3w IF YES, AT WHA"r .L DEPTH? 0 E Depth to Water After DRY Monitoring? _Lf2� &6•C,. Dale: _-±1(,/92 irk. ■�J�I�i1'i,�� Reading Date Gross Net Depth to Net Time Time Water Drop ■ Em FAM mom ■■■.liME■■„■ IF YES, AT WHA"r .L DEPTH? 0 E Depth to Water After DRY Monitoring? _Lf2� &6•C,. Dale: _-±1(,/92 Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE {m1nuteV1nCh) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS PERFORMED 8Y: FLATTOP TEC i"- -'�'� 1-- CERi1FY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFF ECT ON THIS DATE. DATE: . L6 /9 Z_ 72-008 (Rev, 4/85) --- Flattop Technical SeLvicoi* ,p ,.•••'••••.'7I cho eet aAriunc9 • Alaska r �N.....s�...Po Mipality of Anchorage . .}. DEPARTMENT OF HEALTH & HUMAN SERVICES tf0 •HF'ODORE F. MOORE 825 "L" Street, Anchorage, Alaska 99502-0650 d' 1 �..• CE - 3589 SOILS LOG — PERCOLATION TEST 9���e••......••'�p1 TN.*3 PERFORMED FOR: GAS I_EMKE- ..,_ DAIL PERFORMED: 6%2y 9Z ' LEGAL DESCRIPTION: LS. E34 (HT PARK GsT_#I_Iownship, Range, Section: SEC 2(o T)2N. R 3w DEPTH P -r SLOPE SITF,PLAN 1 SM REDDISH SANDY LOAM 2 ML SAr1DY SILT 3 4 ML 6RAVELLN SILT 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS SM 6RAVELLYi SANDY SILT SP FINE CLEAN SAND ML SANDY SILT WAS GROUND WATER Al ENCOUNTERED? 1V 0 5M SILTY SANo IF YES, AT WHAT DEPTII? SP FINE CLEAN Depth to Water Alter DRY SP Monitoring) _116_5 �8.4L Dale: _ 7!!6/'42 SAND M Reading Date Gross Net Depth to Net Time Time Water Drop ■�►�M " MIN ■■■ ■■■LiVIENN■ MEN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE _ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ___. 1'T AND __FT PERFORMEDBY: EZS��TE�FL—S L��_._ I ._s1.._L�t4_'�'.:4__. CERTIFY THAT i HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFI`EC'I ON THIS DATE. DATE. 7/L4 /- Z 72-008 (Rev. 4/85) - NAME [MUM --J.2<PGRADE 0 N9W MAILING ADDRESS LEGAL 0 SCRIPTION LOCATI NO. OF BEDROOMS Well DISTANCE 100 + Absorption area Dwelling /,V PERMIT NO M-3?0 1 Uy Manufacturer , jc Material No. of compartments i.- rn il-ic - gallons vl� I IF HOMEMADE: I insidelength Width Liquid depth WellDveiling I DISTANCE TO: /00-r 112 Ma Mater PERMIT NO — Liquid capacity in gallons DISTANCE TO: WellFoundation /00+ Nearest lot line PERMIT NO. Jof ��z w lines Length of ealls Total length of MI' Trench v,44t� inches Distance between lines I!. I- Top of tile to fin" O. )`10 Material beneath tile 4A inches 4 rich. Total effetti.eabsorot r.,ir eal T I 2,44-z Length Width Uenti, PERMIT NO. I- Type of crib Crib diameter Crib depth Total effective absorption area ul I DISTANCE TO: Weil Nearest lot line Class Depth Oriller Distance to lot line i PERMIT NO. DISTANCE TO: -B,,Idirrq —fundnon Sewer line Septic . tank Absorption area(s) OTHER I wo7 I PIPE MATERIALS IF V6 -k SOf TESTRATtNG INS ALLER :5'oo 6A4. -rAJK A14b sEmza *Jb. -iv;itsice 7 o;r-- Soup )>A,.)r4 &"AA;A. aal 3-17.541 -2U9 ;&-$er AAfb MIA* &P"AAiiffEb. 64MA6-r r,457ii44A AF7&-* !D 644 3 -2J W. ..... ..... . APPROVED I DATELEGAL _F A4 M I MUNICIPALITY OF ANCHORAGE 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 -Torn ,[] l- - PHONE ❑NEW .—, <PGRADE MAILING ADDRESS CK LEGAL D SCRIPTION MT. enc L�5in LOCATIO&_ NO. OF BEDROOMS U Well 100 DISTANCE TO: Absorption area J Dwelling I PERMIT NO�g C)_3? , (� y PZ o.< wF Manufacturer MaterialI No. of compartments rn U) ca 'ty n gallons IF HOMEMADE: Inside length Width Liquid depth DIST�;� Dwelling ) PERMIT NO 3 ^, �F Ma Mater' _ Liquid capacity in gallons m= DISTANCE TO: Well) /11}, /Vit Fou�tion I Nearest lot line / PERMIT NO, J LL z Z w No. of ineS ;...:- Length of eac j - Total length of j )' Trench vv t inches Distance between lines Qcc F 0 Top of rile to fin's rade O �erial beneath the ^ I, inches Total effective absorption4T T"jZ w Length d Width ,- Depth PERMIT NO. aF Type of crib Crib diameter '/- Crib depth Total effective absorption area w DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. w � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER e PIPE MATERIALS SOI TEST RATING a ` l INS ALLER AFIC r i l REMARKS APPROVED//_ 6— 'DATE LEGAL far g T y '`� r ,... 72-013 (Rev. 3/78) .... -. I F-FUL- I 7'7V I Cvlf�,FINC-I-�L:RF-.,.:-Rc:!F� -i- � E DEPARTMENT HEALTH FIND ENVIE .I-X-IM04TAL OTCTION R AGE HF 99 5 U 283-472'10 CS P-4 I -F F-7- E=- G=,6 E- Fe RJ F" RM FR F-9 E-- E=- F-' E-:: F,! r-1 7 -r PERMIT NO. < 8207:. -*80 APPLICAI%IT TOM WIESTERHOF SRH BOX, 2-146,1 99,507 LOCATION CREST%VIEW DRIVE I-EGAL L'LOT SIZE 171001-71 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS 4 SOIL RATING <Si--! FT,,'BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: THE LENGT4 ' I DIMENSION IS - THE LENGTH (IN FEET', THE DEPTH OF A TR.EbICH 6.R" PIT"iS THE 'b--'fSTA-r4tE GROUND AND THE BOTTOM 'OF I THE I El I 'CA . VRTI 11 uY.-I THERE IS NO -SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINTIMUM, DEPTH OF GRF i AND THE BOTTOM OF THE EXCAVATION I (1? -,f FEET:.' ELD. -f- T -r'F-i P-4 K" 7--� F= �5 C-0 (a F:1 L -L- C1 P E: C -II 19 T- F"F—= C� !E; E: F� PERMIT APPLICANT �jS, THE RESPONSIBILITY 'TO INFORM THIS DEPARTMENT DURING THE _HF 1 4 "ItHt", INSTALLATION INSPECTIONS OF. -THIS, PR.101,E- . F40r5, NUMBER OF RESIDENCES THAT THE !I! -LL !.JILL SERVE - I I I I - I 1. -- 1 1 BACKFILLIP-,!G OF ANY SYSTEM WITHOUT FINAL ECT"'TO DEPARTMENT WILL BE Sbe,-J MINIMUM DISTAP-4CE BET14EEN. A WELL AND At,4Y 100 FEET FORA PRIVAtIf OEU 15e0 2U UPON THE TYPE OF PUBLIC WELL. C, MMT-JnTC MCI' I TO fl --SITE SEWAGE DISPOSAL SYSTEM IS MINIMUM DISIFINUL FKUM TO A COMMUNITY SEt-JER LINE IS 75 FEET OTHER REID. U T REMENTS MAY OFPLy� SPECIFICATIONS AND CONSTRUCTION DIAJRAMS FIRE AVAILABLE TO INSURE PROPER INSTALLATIriN.. I CERTIFY THAT 1: 1 All FAMILIAR: WITH FORTH BY THE MUNICIPAL 2: 1 WILL INSTALL THE 3: 1 UNDERSTAND THAT RESIDENCE IS REMIjDELE SIGNED ISSUED HPPL TE SEWERS AND WELLS AS SET THE CODES. This will upgradt sewer system to four(4) bedroom. Add 500 g -a 116 -in- " -'t a .... nk'at outlet of 1,000 gallon tank. ee attached V4.0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION - 825 L Street- Anchorage, Alaska 99504 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT _.EW NAM .:.. .. 6�V ����^ /�� HONE_. _ PGRADE MAILING ADDRESS I41 Ar �4/ rKl 'f JT. LEGAL PESCRIPTION LOCATION', T pl)FiLU _ � NO. OF BE OMS 3 Uy ' DISTANCE TO: WelAbsorption rea /�a, Dwelling I PERM NO. a z w Q Manufacturer � r7-� Material J/e—,'7 ) J� -.C.� No. of partments rn F Liq. �gatydin gallons Cl CI C.? IF HOMEMADE: Inside length Width Liquid depth JOZ DISTANCE TO: Well Dwelling PERMIT NO. _ H Manufacturer Material Liquid capacity in gallons Foundatk Nearest lot line PERMITDISTANCEtOI-l%'� No. of lines Length o ea Total len of lines Trench G inches Distance b`tyv fines /Cl ,Top F.W of the tofinish grade Material beneath rile inches Total effecti a absorption area Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effectiveabsorption area w rn DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATE IALS n 00 SOIL TEST Rlli V + INSTACLE . T�C JF'Ufat uses ® t REMARKS )t a APPROVED DATE LEGAL J 72-013 (Rev. 3N.W t�8UN I r_` _" Rr-a1_ I T�,° r--# F Fa9�8� M"°"+� r—ic x� a�, r 1 DEPARTMENT •, F 1 91RONMENTAL k7ltE6 TION � HEALTH AND 5 / 05 �Lt STREET. APdC FROE 455 1 _ bd Et leF? EF*t'l I T S PERMIT NO. 810101 � Idio�u,c APPLICANT THOMAS WESTTERHOF SRA 2141 ANCH LOCATION CREST+IE4d CSR t . .w . . LEGAL LOTS" T f. EST LOT SIZE 17000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS _ = SOIL RATING «.Q FT/BR'— 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ��E l r;a, !ff* C`°IE F: TI—1 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH _OR DPAINFIELD. r... THE— THE DEPTH OF A TRENCH OR' PIT IS THE— 6'ISTANCr BETWEEN -THE 5UR:FA,CE L'�F THE 13ROi SND AND THE BOTTOM OF THE E`.C.MVATION (IN FEET. THERE IS NO SET WIDTH FOR`TRENCHES. THE GRAVEL DEPTH IS THE PIIMIMUf4 DEPTH OF GRAVEL'BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE E{CAVATION iI'IN FEET). FE:��t_7I F SC? QEF T I r TIF�t lF� I 2!f== aAII_l_f_Y��l= PERMIT APPLICANT , HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE IN..TALLATICQd IPdSPEi TiO}lti O flt4' 4dELLG CEIaT T THISPROfiER74' AND THE NUMBER OF.IRES IDENi:,�ES THAT THE WEL1 WILL SERVE. T1 In < —° `° I i t F= T I ClN<—; F=l F"E FREEG)U I F;L> EZC* BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION ASD APPROVALE�4HIS ..t•. ]...,. ov. q. xY'. i n 4 R `ic .a ta.. W a'. . .n. ... -%,k_ ...: P° DEPARTMENT WILL BE SL1BrttTOS PPOSECUTIOr. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS µ 100 FEET FOR. A PPI%'ATE WELL` OR"1t.O TO tb_f IttT"Fi=OM A PUBLIC 1dELL C:EPEhdDIh�G UPON THE TYPE OF F: lbCf WELL MINIMUM DISTANCE FROM A PRIVATE 14ELL TO A PRIVATE SEWER LINE I' 25 FEET AND Ti i A COMMUNITY SEWER LIhIE I �� BEET WELL LOGS ARE REQUIRED AND MIiST BE`RETURNED TO THE DEPARTMENT WITHIN Fad DAYS OF THE WELL COMPLETIOFI:' OTHER REQUIREMENTS HAY'APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER'INSTALLATION. I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS .ET FORTH BY THE MOO IPALITY OF A4CH� AGE 1 WILL INSTALL THE SYSTEM IN A'&_'6060NCE WITH'THE CODES. _.. n ?: I UNDERSTAND THk 'THE ON=SITE SEtdE Y'TEM `MAY REQUIRE ENLARGEMENT IF THE ry RESIDENCE_ IS l.REMUDELEG TO 1.0CL.UDE MO .E THAN BEDRUOME. —-------- APPLICAN THOMAS WESTT HOF r ISSUED BY -- _ ATE__ — 1 � V4. 0 MUNICIPALITY OF ANCHORAGE Department Health and Environmenta rotection 825 Street, Anchorage, AK. 264-4720 # # # HANDWRITTEN PERMIT # # Permit # W 0R ON-SITE SEWER PERMIT e- Applicant:�� l %P 57P �� 0� Mailing Address: � elq /f C7C Location: Phone Number: Legal Description: L5 6 /iI f �� ��C ' SrLot Size: / 7,'4 0 C Type of Soil Absorption System Is: Trench: /_ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) / The Required Size of the Soil Absorption System IS: DEPTH // LENGTH. GRAVEL DEPTH WIDTH 1? 0 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). s /� * * 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 I 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 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, 1932## 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 esidence i r mo led to include more that bedrooms. Signed: /// Issued by: t ctic. Applicant Date: SWP/024(1/81) AYJcif %600 Q�t COntr^" ng Engineers & Associates SOILS LOG 212 East International Airport Rd. f. .._. .::..'.•Sulte 204 ANCHORAGE, ALASKA 99502 ❑ PERCOLATION _... TEST (907) 278.3773 �,_.. SOILS LOG -PERCOLATION TEST PERFORMED FOR:tf nh i'+'^��•�` DATE PERFORMED: 0 LEGAL DESCRIPTION:, 1 2 3 4 / 5 6 7 / 8 WAS GROUND WATERS L OC ENCOUNTERED? PD 9 IF YES, AT WHAT E 10 DEPTH? 11 • 12 13 14 15 w 16 17 am 19 OYJCxht c`.6 Skw 'C> SITE PLAN �S P ^.SW) WAS GROUND WATERS L OC ENCOUNTERED? PD -C -a oVhw 1 Y�al1 karaw SI� IF YES, AT WHAT E / 650sP/$4'J DEPTH? OF 4 �1+� < �j yah a �, :• Ralph B. okela No. 1995.E Reading A Date Gross Time Net Time Depth to ,Water Net Drop w 20 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS PERFORMED BY: 1/O11C-e CERTIFIED BYDATE: 1-7 C- 1 Time - "7-7N—':: exab+'fixuwa+: ' ,ef4w APPLI NT FILLS OUT U0..ER HA ONLY �Phone *� Property Owner fz, �—+' ,�� ZipCode Mailing Address Date Inspector Inspector Buyer Inspector Inspector Field Notes: " � .. Zip Code Address ,,. .. .. ,... , Lending Institution .... ,.,. .: .... .. �. .- ..... ,; L5 ,o"t Phone Address ' :. Zip Code y {,rj _. . y _... ... ... .:, .. ,..-. Phone Realty Co. & Agent Zip Code Address ( APPROVED BEDROOMS Legal Description ...�. �9' 1 �7 , r? °.i o4: Street Location Type of Residence. [Y6"Ingle Family _— ❑ Multiple Family No. of Bedroom ❑ Other _... ._ ;.... ....... Water Supply ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. 1 . Individual Installed For wells drilled prior to that date, give well depth (attach log if available). ❑ Community* - Well Log Received ❑ Public Utility Sewer Disposal .... .: , �.. 4 Individual Year Individual Installed. LJ Public Utility When Connected to Public Utili y: . ❑ Holding Tank . ._ ._-,. �...... � ,.. W,...w EEFO NOTE: THE INSPECTION FEE MUST ACCOMPANY ACN FiEWSTEBRE PROCESSfNG CAN BE INITIATED: Time - Time Time Time Date Date Date Date Inspector Inspector .. Inspector Inspector Field Notes: ,,. .. .. ,... , ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPRO)(AL` c DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank ]P029 (Wtl a GRE /' -q ANCHORAGE AREA BOfJGH �✓�"°"we��..-:' _ .. 6 PERMIT NO. ... .. 3330 ^C• STREET Y - ANCHORAGE, ALASKA99503� 4 DEPARTW1EfVTELEPHONE 274-q5 IALQUALIT 4 Me r+`d SEWAGE .DISPOSAL SYSTEM —APPLICATION AND, PERMIT J O MAILING ADDRESS PHONE •� /� rl-3 NAME OF APPLICANT I I f INSTALLATION LOCATION�{- 17— ., LEGAL DESCRIPTION ✓� DRAIN FIELD OTHER INSTALLATION OF: SEPTIC TANK SEEPAGE PITC-rV G• TYPE AND SIZE OF FACILITY TO BE SERVED��� FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED FINAL INSPE( DEPARTMENT SEPTIC TANK SIZE < 1 v ICE REQ TO BE INS' EI THISPER IT NOT VALID WITHOUT SOIL TEST. A SY TEM WITHOUT FINAL INSPECTION BY THE. CT T PROSECUTION. MINIMUM DISTANCES, REQUIREME rml Ls FOUNDATION TO SEPTIC TANK / FOUNDATION TO SEEPAGE PIT v" "{ DRA 1 FIELD SEPTIC TANK TO SEEPAGE PIT WALL— ' SEPTIC TANKy SEEPAGE PIT F r DRAIN FIEL¢'�rt. TO NEAREST LOT LINE. :.... WELL TO SEPTIC TANKS SEE AGE PIT. DRAIN FIELD S CONSIDERAREA WELLS.. WATER MAIN TO SEPTIC TANK EPAOE 1 i DRAIN FIELD SEPTIC TANK.. SEEPAGE T RAIN FIELD. TO RIVER. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF,. EXCAVATION 3 FEET INTO .UNDISTURBED SOIL. q INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS vrJ GRAVEL BACKFILL aC71-p CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. A— OR LICENSED DESIGNER c =/l IZE TYPE T-•C''r sa.`G- � I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO 28-68 AND THAT THE ABOVE DESCRIBED S STEM IS IN ACCORDANCE WITH SAID CODE. DATE ` APPLICANT'S SIGNATURE FORM NO. EO -016 Performed for Legal Descrip This form re6 Depth Feet 1 - GREATER ANCHORAGE AREA BOROU Department of Environmental Qu, 'Ity 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - PEROLATION TEST Date Performed ts: Soils log Y Percolation test Was ground water encountered? NU __ If If yes, at what depth? ReadingDate Gross Time Net Time Depth to Water Net Drop Percolation rate minute. Proposed installation: Seepage Pit_ Drain Field Depth of Inlet __— Depth to bottom of pit or trench COMfIENTS: EQ -040 (6/74) q. ,0%epartmentoi En'vironme*ntal Qu ty 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - PEROLATION TEST Performed for Legal Description: This form reports*: s- I og Depth Feet YNA Ve.( C6W-GP� 3 4- 5 6 - 5, L + , S4 tj d CS m - a- t'36) 7- s - 10 - 11 - 12 - 13 - S/0100 Date Performed M 14 /S" 130 11o* Was ground water encountered? if yes, at what depth? Reading I Date Gross Time I Net Time �Depth to Water Net ............... Percolation- rate _ minute. P, Drain Field -Proposed installaflforF it Seepage it or trench Depth to bottom of j)cptii of Inlet C01.111EINTS: baEe: Performed Certified EQ -040 (6/74) Dotten Drilling Co. BOX 10056 SOUTH STATION 12061 JOHN'S ROAD ANCHORAGE, ALASKA 99511 PHONE 344-1952 'Nell log for property at Mountain Park Estates sub divisi.on, lot 5, block 11. Well completed October, 1.981. Death: 280'. Casing: 6" ID. Static level: 65' off bottom. Production: 8 UPM. `Pan silt/sand, with boulders 0 22 Broom silty sand 22 28 Brown sandy silt 28 52 Brown till 52 94 Brown silt, tight & dry 94 186 Brown till, sand & gravel, wet 186 193 Brown till, dry 193 195 Olive drab till., dry 195 2011. Alternat=ing water sand & gravel & till.. The 204 279 water was weak & very dirty. Water sand & gravel that was strong 280 & clear. Drilled by:u�yw�S%i� �� A DDI IT FILLS OUT UPPER,HAt""�' Phone WioPerty OSener L /,Ei %L MallingAddress " " Zip Code " 7 Address �Otv 1 `''r 1s.�-a} P Zip Code / 7 S Phone LendingInstitution Zip Code Address Y I"r f• ..✓. , . ". . - .. Phone Realty Co. & Agent Zip Code Address Legal Description y,•,r,� p „a .� a ".,,\\ ,. .. . , . Street Location Type of Residence .." '. Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Water SuPPIY 2 Individual ATTACH WELL LOG., A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give we7f depth (attach log rf available). ❑ Public Utility Sewer Disposal 'xF=f Individual Year Individual Installed. , ❑ Public Utility When Connected to Public Utility: " C Holding Tank_ I ., ,,.. .M ". _ ., 1 NOTE: THE INSPECTION FEE UST ACCOMPAMC'EACH'�REW_EST BEFORE PROCESSING CAN BE IMTI"ATEb., C SCG 40l� �... Time ..... Time _.. ... Time Time Date Date Date Date Inspector Inspector P Inspector Inspector • GE Field Notes: DEPT. OF HEALTH P ENVIRONMENTAL PROTECTION 0 3,;s>o SEP 16 1983 RECEIVED 7 . .YL- 6 lir a 'CONDITIONS OF APPROVAL. ( APPROVED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL- DATE % 2, B Soils Rall g Date Sewer Installed Well Lo Received Well To Absorption Area /6-.r 9 v l�^ Sephc Tank Size Well to Tank �a--o n 023 OW) W4 IM ALASKA 6huiR011 11TAL C011TROL Lehi"M, Inc. engineerinq & enuironmental Studies October 21, 1983 Department of Health & Environmental Protection 825 L. Street Anchorage, Alaska 99501 Attn: Jim Roberts Re: Mt. Park Estates NF1 Block 4 Lot 5 Dear Mr. Roberts: In reply to our conversation on the telephone about Mountain Park Estates #1 Block 4, Lot 5 which was inspected on June 9, 1982. The one bedroom addition to the on-site septic system was installed at a gravel depth of 5 to 9 1/2 feet. The soil at this depth was sandy and I visually rated them as 150 sq. ft/bedroom as per Municipal files. Sincerely,GA Jim Green Civil Engineer MUNIGIP AL1 oor�P;�GHORA^OG1`1 WN1 O �ECE,v ED. 1200 West 33rd Auenue, Suite 13 • Anchorage, Alaska 99503 • (907) 276-1361 I 1� Lot 5; i31.ock 4, mte.. Park Zzt.atCS 'pyroval for th irad viaual sewer, andwit irsdiliti��c�anrs�t oe granx.F�„c� ur�M theThe dojV=i0n,0r Pit around the well CaSing needs to filly 111A impervious type soil so that it: ; jopes away from the wo 1 cgsi sj ° aXpoSed electrical Wires to the Sell head arm A y6laiiIon of the t4s�PliCiC1C2Y 1t;� L73: (�a:iL}':f3U u"i *,�£� G"x” deS and 0i rSt ""aft— in il a t in ronNit. a0an uzf3k"+�jt ac test ?a4eC4`.3 pq be performed On the existing jeachinif a3rea Tib testt Will determine it the hif.`tem 3:3 ade" autar agcogdIng t, National Standards. A listing LAS ;3.. i�lrxt#3 :Y7$ per.to"'.Y1 :I `.j" too test is Qnniosea. needs to be submitted to this Off ice for oar, :C!Alel . �. i FaX})t>: 0 the clea#`tc.<4t to the S3i*�°v>d[32 pit �t:�.:,,%�3i f� le aca r.ng tare .: fur our iYsfSPtP"h s } , to yi the 7.iels Lrriyr~ r{eQrtCM%tWv 1 vre'( we {Y'h Y1i sewer system. ° The G"3'gi.;34''t;;.l"'�.3 ai:3 ":i11 i.t`at which have uL �v "2 2%t1'17 �ktt'ar`{Y to this office. are not�aXte in The araz��tcrrs >� ted o �itrs installation perMit ,issued `Aft 's ri�saart��trzt. t� s i :;4.9Ci "3i4 FtW1L?w ,P a.3.S i4F't''d QQ corrected iBi fqm the S . i se"ia�artment, n r".CtOPt too please notify this Department for a reinsnec„.ti0s when t&+ n c;rrcctea ithe age in noted `i crepancinsev bee A fur:tner clVestions, ple=ase call srtis obficaY at TOM t'1S za UC ioat'' uFsVir�3'��'�s3.1 �7 �4.''l cili�a� /' e- c. 4 ,,ell ;z AFll z %a c.. . NHAW'THORNE-ENGI SERING *t0I'HR-,'M BOULEVARD ..... NHAVJTHORNE - ENGINEERING 7127 Oid Seward Highway soma October 7, 1983 AMh AK 99502 344-4711 ^zye;-nL sK„ assns Mr. Robert Robinson 6107 2;z;t ' 609 Anchorage Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 RE: Adequacy Test, Lot 5, Block 4, Mt. Park Estates Seller - Doug Beecher Buyer - Dan Donaldson Dear Mr. Robinson, On October 5 and 6, 1983 I performed an adequacy test for the soil absorption system on the above referenced property. The property owner inadvertently had the 1,000 gallon septic tank pumped on October 3, 1983 so it was doubly important that 1 conduct the test on two successive days to insure that the system would function without a prior two day rest. October 5, 1983 I had 700 gallons added to the field through the south observation pipe over a 15 minute period. No water ran from the field into the 500 gallon septic tank until we approached 700 gallons. At that point the water level in the tank rose 1 inch. October 6, 1983 I had 700 to 750 gallons applied in the same manner over a 25 minute period. Again no water ran back into the tank until we neared the 700 gallon mark. Water level of the tank rose Ik inches and then dropped 3/4 inch over the next 8 minutes while no water was added to the field. I feel that the system is adequate for t e "''existingfour` bedroom` . , ,.. house. 'However, there are a couple things the new owners should be.., aware,. of: north observation- pipe, one tank access_ pipe, and the ---south mEen vation pipe have been damaged because theyare ASTM 3034 PVC -here has been some recent site grading. These pipes should paired. 2. The field accepts a 700 gallon surge flow but begins backing up at that point. Since the field's water volume is around 3,000 gallons or more it is obvious that partial clogging has occured. This is normal, but since the lot is so small and no replacement site is available, I recommend field rejuvenation using hydrogen peroxide at the owner's earliest convenience. The best time for that activity would be when the house is not being used for 10 days or more. Sincerely, Neil Hawthorne cc: Dan Donaldson Municipality of Anchorage Department of Health and Human Services Tom Pink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 April 21, 1988 Alan C. Wien Engineering Technician Alaska Environmental Control Services, Inc. 1200 West 33rd Avenue, Suite B Anchorage, Alaska 99503 Subject: Waiver Request For Lot 5 Block 4 Mt. Park Estates #1 Waiver Request Number WR88-015 Dear Mr. Wien: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 4 feet from the standpipe in the absorption trench on the subject property to the lot line for lot 6. The waiver was issued pursuant to the required letter of non -objection submitted to the department from the recorded owner of Lot 6 Block 4 Mt. Park Estates. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, '�9� � I?e-a Daniel J. Roth Civil Engineer On -Site Services cc: Gus Andress, P.E., Manager On -Site Services/Water Quality Programs. ALASKA HUIR0Il 11TAL COIITROL SRUIUS' Inc. a Enyneerinq b Enuironmental Studies April 8, 1988 Municipality of Anchorage Department of Health & Human Services 825 L Street Anchorage, AK. 99501 Re: Lot 5, Block 4, Mountain Park Estates #1 From the Health Authority Inspection on the subject lot, the trench standpipe was found to be 4 feet from the lot line.- See attached diagram. This lot line borders lot 6, block 4. The trench does not encroach on any other wells or sewer systems. Also attached is a letter from the owner of lot 6, block 4 stating he does not object to the encroachment on the lot line. We request that you grant the appropriate waiver. I€ you have any questions, please call. Sincerely, Approved by: PE Alan C. Wien Engineering Technician FH�'&Nici SOC Cy0 nn F 1 e �S� 'f��. 41988 /��S�Oti F/SFO 1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 •(907) 561-5040 moa 01 2A N' N. Seer /acti 6Fi 7AA1K ev�zG -L_ y-. • N p G9j s A770 y� � 2GL C / 1"SO " °I N r 514 � -� f2B38 i �a'urit!rY E.lsEnf v% FO_ soq 9 e / �°r'� — X26.44 N,B6`�9E 7.S �� FA -,5•i/ -,ST °AS -Built" 1 hereby cartify that a survey of the following described property doe,, T ,,V /moi R," EsrerEs was made on and that the jmprovements situated thereon are vrlthln the property lines and do not overlap or encroach on the property adjacent tharctoIthat no Improvements on property lying adjacent thereto encroach on the promises In question and that there are no roadways, transmission lines or other vielbla easements on said prdporty except as Indicated hereon. Datod a! Anchorage , Alaska, this day of CONTRACTING ENGINEERS a AS 212 E. International Airport Road , Anchorage, Alosko 99502 Phona: 273-3773 �� ;y Qt- F•,,r j��, F t crn oa e • G t� Donald 0. 'Sc,, NO. 2233•S06 o' SEAL March 25, 1988 %r�o�>....awner of Lot 6 Block 4 Mt. Park 4�t- #1, do not object to the Lot 5 Block 4 sewer system encroachment on my west lot line. /Vm� Municipality of Anchorage • -- Development Services Department :' _ Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _O 1 —r - 0,6 - 3 Y HAA # U 1VL 0 Expiration Date: 1. GENERAL INFORMATION Complete legal description _I -of 9'1 Ule. ele yr Mouhl�r'#^ Pa. -k Crr6htr Location (site address or directions) t 3 22 1 rvtvirw p.;,, Current Property owner(s) Don ,rl t;y.ck. kef-emir Day phone 866 — 1c-99 Mailing address _r 3 2i 1 cpw/- irecu Dr1 wo AAt1+. Ak 99s1� Lending agency 4(a1%ca Sf. 1 -far Toles t%cre we1;,. Day phone Mailing address /v-cwP Real Estate Agent Ah t / TAo m of <olr/cu ell 13k-dosket ,, Day phone Z 6S —9 / o L< Mailing Address ZSzs ��''sF.- -( .Je luo /F, cao�u�v� At- 99So-r Unless otherwise requested, HAA will be held by DSD for pickup. P ldoor a eu it N,er 7-Ac,,,,r 4?-/ 2. NUMBER OF BEDROOMS y 265-9106 ct,R.., rfsA rnrw.r it 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site 14 Individual Water Storage ❑ Individual Holding tank •❑ Community Class Well ❑ Community On-site' ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 Health Authority 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 tion, the on-site water supply and/or Municipality of Anchorage files and from my investigation and inspec wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. A [n cw ac of c,r'roa SAA Name of Firm If ►e4/ <cl�n,<a� Sem✓%c�i Phone Address rN53o Cc 4e St A..cho<oqr Engineer's Printed Name T%oo dog Date Mai rti �r. 5. DSD SIGNATURE fl" °°°"E r. µooae, s bedrooms. ,e,.A•, CE -358 4 Approved for. _ YEN . Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Supplemental Engineer's Report Septic System Advisory Well Flow Advisory Other (R.v. 01107) Original Certificate Date: 3 Municipality of Anchorage .•o!, by Development Services Department Building Safety Division i.. On -Site Water & Wastewater Program ' •' ` ` 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lr, f 5-, !3 le, c t� M my� ^ * ,. N r k -r,<. Parcel ID: 40/ '7 -,0 67 - 3 A. WELL DATA Well type Pv t If A, B, or C provide PWSID # Date completed 10/61 Sanitary seal (Y/N) Total depth 2 8o ft. Cased to 26o ft. FROM WELL LOG Date of test 10 / 6 1 Static water level 215- ft. Well production 6 g.p.m. WATER SAMPLE RESULTS: Coliform _Q_colonies/100 ml. Nitrate 0.796 mg./I. Well Log (Y/N) Y Wires properly protected (Y/N) Casing height (above ground) Y in. AT INSPECTION to / 7/GY 2 29 ft. 3 7 g.p.m. Other bacteria _colonies/100 ml. Arsenic: mg.11. Date of sample: 3 /y /o,r Collected by: - Fi« f/e. T« t SSC_ B. SEPTIC/HOLDING TANK DATA Tank Type/Material Se k c / V-oe / Date installed —3'/ z7 IS . 0 lJ Tank size o civ gal. Number of Compartments �_ Cleanouts (YIN) r Foundation cleanout (YIN) r Depression over tank (Y/N) At High water alarm (Y/N) N. 4. Dateofpumping 6/1.1 101/ Pumper A�/c Re, At - C. ABSORPTION FIELD DATA x/19 r22 I.2 g,.rA/Ff 2 / Is'u a'/aar« Date installed 6 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 co 0' System type i2-/cc,4 ?7 Length ' ft. Width 2.t ft. Gravel below 9 pipe ft. Total depths ft. Eff. absorption area 6r; i ft' �- Monitoring tube Y Depression over field N ,1 NSb Date of adequacy test 1,9 / '7 / 0Y Results (Pass/Fail) P -V For Y bedrooms IBJ lW T-IACA Fluid depth in absorption field before test Sl in. Water added 696 gal. New depth6Y Y in. Elapsed Time: I '!r min. Final fluid depth 59.11 in. Absorption rate >= 6(:10 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) AIUAL re/roe fra( If yes, give date M. A D. LIFT STATION N• A- Date installed 'Pump on' level at _ in. Datum E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N) 'Pump off' level at _ in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 'x IG V Absorption field on lot l o r Public sewer main N • h• On adjacent lots > IE R ' On adjacent lots -> r� a Public sewer manhole/cleanout N.A Sewer /septic service line Z S Holding tank At. 4, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S Property line S' Absorption field �T. Water main M.I. Water service line > Fes'' Surface water 7 rc'" Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: (:.t�arvir' S//b//94J N• �. Property line I' Building foundation ! o • Water main Water Service line - Fo ' Surface water > 1012 ' Driveway, parking/vehicle storage S' Curtain drain No^t Soin Wells on adjacent lots c 1-03' F. COMMENTS G. ENGINEER'S CERTIFICATION .,.�' ..:'.� '•��„��, �€ 1 certify that i have determined through field inspections and r .......................•.. - review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. •......... ••• .41 . THEODORE F. MOORE•� !E Engineer's Printed Name TAa o da �� F• M a -/ 1 • •. CE -3569 , •''� r Date HAA Fee S Waiver Fee S Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 12/01) a =� Municipality of Anchorage m Development Services Department 1` Building Safety Division On -Site Water and Wastewater Program Sd ETY 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951M650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O 1'7� 061 – 3 HAA # Expiration Date: 1. GENERAL INFORMATION ' j — Complete legal description%310c4 JY�ctnfzi,ro PQ�k �s/zE,4� Location (site address or directions) 13 2 Z/ Over! vieee> pry ve� _ Current Propertyowners) i�aniel i 1/ecki ke%rns Day phone _86'9 -1,�;9_9_ Mailing address Lending agency Mailing address 1322/ Drive, /}nCtiOr�/, f}k- 99_�_J Day phone Real Estate Agent kufh�eroae/22 i Proof- 1/*h:A� Day phone 2'73 –=730 Mailing Address y'ZyJ 0t3" Sy. Ghor«4C, At< 9,9S0_3 V Unless otherwise requested, HAA will he held by DSD for pickupp 1 e�ccie,Ca l / kcr,iAy Ftrnan oOe Z 2. NUMBER OF BEDROOMS: '7J C' Zz3--7,302 w14n 6-4h i 3. TYPE OF WATER SUPPLY: ' TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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'balid 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 Health Authority 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 Fla_ /-%,o % rcAn) <,a/ Phone Address IY5 3a Fc4o S�•, Arc�ivro /��c995/6 Engineer's Printed Name Date I o / r Y /O;K 5.' DSD SIGNATURE °°• sOe�i a.dlr®lOe Approved for bedrooms. :...I. a® THEOD01te F. MOORS Disapproved, cs 3e89 Conditional approval for bedrooms, with the following stipula�.ar� Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: 01 0 y Original Certificate Date: (Rev. 01/02) 1�1UUlVl�)A. Development Build r inn-GltP WLi+PI 'Q„ Qaum e4 yf �5 *fent, A e ry _ >stuccr,. rti I?, /^ask =ST. Parcel ID: 017,-061-3y . w,x :n y� r t s � _ .r'h "�'��Sais�'.��*�,+a. 4 � `3��� �""&','w-�+z„�✓ry;s :,`"` . ,'�* s �i; If B�or C protide PWSIb # ^ e T Log (1�7�7�Y , $/ � Sapitaryseal(Y/N).� Wvesproperlyprot`ecte�(IIN� �' in. _/Lft. Cased to ft. Casing height (above groun ,colornes . m . i ra e , .'� mg.. er ac err co ornes m'I. mg.. ate o samp e: m oy i erta e� lc SAee/ Date.installed S'! 27/S/ eO 'gal. Number of Compartments 'Z Cleanouts (Y/N)SOMIMOVIN Y :anou Depression sver Tank High water alarm ( /N) if ny 21_"l � yam,' Pumper R�� l��o few 0" 3 est s ,..., ,. �3rcyx. •.s:4x,. a: a "a �` "'-"�i S/zv��� Soilratirig (g.p.d./ftZorft2/bdrm) +s�+�i/a�..,Systemtype; Trench .y s ft _ Width a ft.; Gravel below pipe ft. s ft off absorption area _ftp Morptorinq tube Depression over field a .: acy es Results (Pass/Fail) Parr For I bedrooms ecv FNenc�+ absorption fi Id before test'in. Waterad,cleclOK gal New depth6fil in .°, s 5 min. Final ffuiddepth %^in, Absorption rate >= oi3 g p d inn fraa m'an rT�c4 m'n ! k mP % bn® rye-n.,r �i If vor. ni�P riafP line I ,OCT -13-2004 13:50 PRUDENTIAL VISTA REAL EST _ fftf�.891L� FIA _ .��, Robert E. Johns, Jr. & Assoc. 6`L*.."a.�:.""' '�p'�• "• �• `��rm"R'0K'OTb� «.`::: t9."L.:... f' % ANCNOpAw t= •DMm w� 1WOw.wZ uwa sneer RPF PIOt R. NOr fDUNDA710N LS -KILT I RSR Wyt+Yf �41e..Yr iY COtetl QT�'v���r 10-10-04 DX REJ . � . 1 -0 Os1I ....n...« a ,..' ... «. «:« ....... ....•.ONpn ••• x � � ,,,"7,. + oroa0 10-10-04 End 2938 w.o. 24835 =� - • : % 4121—S PENAL STiwcrJRE Ap.NAyf ti." ,�� _d Lot S, 4 ;,��-�-+••�•+��- Par '� MMountainn Park Estates Subdivision or s avc SURVEY TYRE 5 AA80LS O �wwcnd ALX/L1 b • SVMAR � ASPHALT ORAN= , • ; rwc anaeAwe ATM6t M)"PIEW ❑ ow P.w ... At -•ALT ... UR' •Pitot, .. TDomwoO .0-.0-o, WOOD Fact CONORM 00 r ASStREO {Ltit: META. FENCE WOOD DECK PLOT PLANS • LOT "SURVEY ' "m , IT IS THE REWONSINUTY OP"7ME. WAMN OR OMNOL PRR)R TO •I ONLY TM06E MPROVEMiwn AMOW OROUNO AND VISIBLE WALL BE CONSTRUCTION. Ta VCRIAY MORD= OUWNNO AOE REtAMW 81619.0"W TO FINISHED .: SHOW4 FIgNa , PM JA COMO OOTA. AIOCWALKS. DRIVEWAYS• DWI! AND UTWTY CWVICU Md TO OCTPFJIRE - THE EXISTENCE OF ANY EA�/7$ ODVFNNM OR Mi$TFOC71ams I -MAY PwmT =ME IMPROVICUmm PROM MONO AMiN AND LOCATED WHICH 00 NOT APPEAR 09 MA REOOM 2 s UNDER NO CIRO"ANCEY SOAP AN AS-4MYM UM FOU 0 5 IC11a1 OR FOR I "TA 1C BOLYJOARY OR FENCE UNESr. TOTAL P.01 b '� ��.in. .rte �• alb 9'00'. y,3'.00 SURVEY CERMFICA101• ' �a�„ - :• Prepared by ,OTfA _ .��, Robert E. Johns, Jr. & Assoc. 6`L*.."a.�:.""' '�p'�• "• �• Prolesaionai Land Surveyors «.`::: t9."L.:... f' % ANCNOpAw t= •DMm w� 1WOw.wZ {t 8 % A RPF PIOt R. NOr fDUNDA710N LS -KILT ' w 11 '• - 10-10-04 DX REJ C'A•dled e>R REJ 1 -0 Os1I ....n...« a ,..' ... «. «:« ....... ....•.ONpn ••• x � � ,,,"7,. + oroa0 10-10-04 End 2938 w.o. 24835 =� - • : % 4121—S PENAL STiwcrJRE Ap.NAyf ti." ,�� _d Lot S, 4 ;,��-�-+••�•+��- Par '� MMountainn Park Estates Subdivision or s avc SURVEY TYRE 5 AA80LS O �wwcnd ALX/L1 b • SVMAR � ASPHALT ORAN= , • ; rwc anaeAwe ATM6t M)"PIEW ❑ ow P.w ... At -•ALT ... UR' •Pitot, .. TDomwoO .0-.0-o, WOOD Fact CONORM 00 r ASStREO {Ltit: META. FENCE WOOD DECK PLOT PLANS • LOT "SURVEY ' "m , IT IS THE REWONSINUTY OP"7ME. WAMN OR OMNOL PRR)R TO •I ONLY TM06E MPROVEMiwn AMOW OROUNO AND VISIBLE WALL BE CONSTRUCTION. Ta VCRIAY MORD= OUWNNO AOE REtAMW 81619.0"W TO FINISHED .: SHOW4 FIgNa , PM JA COMO OOTA. AIOCWALKS. DRIVEWAYS• DWI! AND UTWTY CWVICU Md TO OCTPFJIRE .� CM -AM SHOW W TMOR APPMOMATL LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EA�/7$ ODVFNNM OR Mi$TFOC71ams I -MAY PwmT =ME IMPROVICUmm PROM MONO AMiN AND LOCATED WHICH 00 NOT APPEAR 09 MA REOOM 2 A UNDER NO CIRO"ANCEY SOAP AN AS-4MYM UM FOU 0 5 IC11a1 OR FOR I "TA 1C BOLYJOARY OR FENCE UNESr. TOTAL P.01 Municipality of Anchorage Development Services Department • ane Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Flattop Technical Services Legal description: Mountain Park Estates. Block 4. Lot 5 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on _ ❑ Calculation error in design. _ ❑ Additional soils information needed. ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. _ ❑ Topographic information missing or inadequate. _ ❑ Incomplete; missing _ ❑ Incomplete; missing _ ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. — ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ® Other. Areas reserved for the original and replacement disposal f driveways or parking areas over them. ice.- Pa -s„ ods drzo�wal c".n.oJa o� o claps .�'t.>rd -� awa dr: o.x,,�a,.� �•a�.aa% , Name of reviewer: Julie Makela, P. E. Date: 10/21/2004 JAm I%1�I Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section CaD P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR SINGLE FAMILY DWELLING Parcel l.D.## 0f7-061 -3Y HAA# "S5nw2 1. GENERAL INFORMATION Complete legal description Lar S, 6/Fc H /Yi Per t rtoL[r 6/4%f #y Location (site address or directions) l32 2/ CnvAv�ew 0.1�� Property owner ;v £ ku Nn'X t -e'^ ke- Mailing address Lending agency Mailing address Agent Oe -6 L74e' 771-5 ^ R«1i E1,4ze Address 7 2_'l E 1S''`' i4 -e. An Clio Day phone Af,,ctia !;,! , A4C 1996-16 Day phone 7 z> -Go as - Day phone 2 72 'OS -71 A c 993 G i Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: y 3. TYPE OF WATER SUPPLY: Individual well ✓ Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-M(Rev.1/91) Front MOA#21 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm )_ lu><'b-t, TeC11n /ccul Sc- c1 Phone 31/5-13>S Address / `/S" U =c� o S�•. Ahs/�v �agP /�/c 9516 '-STT Engineer's signature �� �✓ Date Oc)�e� 7, /999 AAN "f�@�"o°s°eomas�.a9 ao ao ,may .51000 o o°oo°ooa000eooeooe ooss 6. DHHS SIGNATURE Approved for E6 vR bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: UlTIC Date /0- / ,P- The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ]2-029(Pe.1/91) Back MOAW1 .a.,. ,gym ,. x»n , w>,:.�. �a... .mss .,.vrM,>a�..x, .., „_„>, .. VL 1 Vo, 1777 . Municipality of Anchorage MUNICIPALITY OF ANLHr k DEPARTMENT OP HEALTH&'HVWN,SERVi NMEW,da seRyICES u, Environmental Services„Divlglon . F'_ 825 L Street, Room 502 • Anchara&, Alaska 99501 • (907) 343-4744 -� ^y � � _ �a4 � Heart �lutitorlty Approval C�tec�Chst crrption of 3` rs1 �” y ` H Fn Jia rlT�s Ar 4# t Parcel I D ©1 � 06/ 3 x/ �`� `'"��s�.�z*...�N`er"i,:n"�,�,'i"`+'"s '� �"ne • N 3: `� r�, �W`�` [ a'� i �� a t«" � ,%;, w."aaa ,x'� Ra r_i a' C(�z'^n z?x e€ � � m^+i^� T w?k.. re *,;, -.„, - �• e v t If A B or C attach ADEC letter. ADEC water system number M.A. ^� .. ��r ."&�=d f s„s � 1. s^<_ ?R :'s'*s .-r .3:2r, xa.a�ax ti ..»,, , +' xia� �' ,a�`,,..��sxa+n.�. , •-a> _ .9P ^,� � ..:;..�f. °: >ent(Y�Nj"` Date completed. O�%� ,, Wlresproperly protected (Y/I AM" Hs3..�y`°,`"'� 7",", "'ha'a','vTx'�.<ka ....^.nw.+"-..S��s., fi'L'��3,.. gpm y 2 -g-P.M. 4a, Aal%•p%w�' 9Sf`etiv ."� a. A,a.1 4 . (4a/Y' -f r'C wrv+ Se 1-« a rv..,. .+ ..C.v ..: _.....� ., wK Nitrate I < < 8 r v ¢¢/ Other bacteria None rename 4.0( �e }M�Wila?:?t.',x'%`n.'"x.~�/raaY«-e'r.. Cnllartaei hir L[fFrid CC:4li]i Lci/ e1-4-eeei ra Jn/vn WHIN 'Ale°kk�� +-!,Ap is 'tS�— 4— ? vm'.v1zM£v:+i. +/ 4A i q'f S p K tl F J� 4 �*2 ..% .? t ' P" ` ,� . :e ^''T„"] -ah (C —size 7 Number ofComp"ar m�""e"n`ts Z Cieanouts (Y/N)� j�{,•,,3raa.^W.r.2.i%-`"i'��m"•i”r°°,vd"°i*s,'e"i"l'T,„ry,$,ii`''#'�6'9`w-va°ra�..,�rs.,y:','w�^z*.. "-4': nouyty, ) Y Depression (Y/N) N Hlgh water alarm (Y/N) N�4 �,..�'"'k, 7 % Z tir Soil rai Z � . ..., 9 (9.p.d./ttz or ft2/bdrm) rs_3 a�Systemtype-i �eo�, Width Gravel thickness below pipe yy _Total depth 9z on a iso Monttorieg Tube present (Y/N)�_ Depression over field (Y/N) V _. wMx'��'e�'`'S`''`i �"'kss.� r ��a. tt...'a .�,� ➢ �. x x x �. y fes %�2l� Results (Pas _.al j Pass For `� bedrooms anK on lot -^- u c un actacent tots 'on `lo,t 10 f On adjacent lots > tyo wens on aclacent tots vo E LVGYIVl/' �Slurrif �/tY/Y are ince with MOA HAA guidelines in effect on this date. e � /, /7-7-J ., 4. , CE -3589 MUNICIPALITY OF ANCHORAGE O/ DEPARTMENT OF HEALTH A HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES n 2 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL tS Q w1� OF ON-SITE SEWER ANDWATER FACILITY 264-4744 Application Date- 1. ate 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, sec o township, range) Lo? L < LOC9 � )177 AW 673 % � %I'LA e31J 5w2 2-(, Location (address or directions) l3z-z.! CRt3T✓irzJ' (b) Property Owner Mailing Address— (c) ddress (c) Lending Institution Mailing Address (d) Real Estate Company and ,A/gent _ Address ��y Telephone (e) Mail the HAA to the followino addr, List contact person and day phone 2. -TYPE OF RESIDENCE Single -Family Number of Bedrooms Telephone: Home Telephone 671--) Ts tss: or: Check here Lfi if hold for pick up. number below.,, 1 17 Business 3. WATER SUPPLY Individual Well 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 Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 7M2e (Rev B/M Front BDee i99ie nadl szo-zL Z 10 Z abed >IJom sIaau!6ua leuo!ssa;oJd ay1 u! suo!ss!wo Jo sJoJJa Jo; alq!suodsoi lou s! a6eJoyouy;o /1!led!o!unlry ayl ,panss! si aleogpoo a wo;aq elep azAleue Jo suo!loadsut lonpuoo lou op SHHo ;o saaloldw3 'sluawaimbaJ alels pue leJapa; u!e3Jao /`;sges of JaPJo ui suoilnl!lsu! bu!pual J!ayl Pue sawoy;o sJaseyoJnd o1lsalJnoo a se s!y1 saoP SHHO ay1 e>Isely;o alulS ay1 u! paJals!6aJ Jaauibue leuo!ssa;oJd luapuadapu! ue Aq anoge g ydekejed u! u9n!6 suo!3eluasaidaJ ay1 uodn A1uo paseq saInip Jao enoJddy /,luoylny y11e81-1 sanss! (SHHa) saoi/uaS uewnH pue y11e9H;o luawpedao a6eJoyouy;o /l!led!o!unW ayi NOIIf1Vo !snoJddy leuo!1!puoo;o swJa1 leuo!3!puoo A panoJddes!p �— PanaJddy a3eO' �� v // TI (q swooJpaq Jo; panoJddy (/ O '%LTJ/ IVAOHddV SHHO '9 .0+W wIw`0 ,6 �cuo�ssa- dp, p8 ', ,......,Ar ci�'� •tSZZ-30 � � +41 leas S,J 3tdyC bi' 'olu Ao ...•- r 3Q ale0 IV -Vie/- ze ssaJPPV Ohcs.� �� auoydalal Sa3� wJid ;o aweN / ,uo!loadsui s!yl;o alep ay1 uo loaya ul Suoyeln6aJ pue'saoueu!pJo'sapoo a3e3S pue led!o!unW lie yl!m aous!!dwoo ui s! walsAs lesods!p Jalemalsem Jo/pue AIddns Jalem al!s-uo ayi 'uogoadsui pue uo!3E6!lsanui (w woJ; pus sal!; a6eJoyouy ;o ,Q!led!oiunyl ayl moi; pauielgo uogswJo;ui ayi uo paseq leyl A;Pan JaylJn; 1 u!ajaq poleo!pui aJnlongs;o ad/3 pue swooJpaq;o Jagwnu ayl Jo; alenbape pue leuogoun;'a;es si walsAs lesods!p Jalemalsem Jo/pue Alddns Jalem el!s-uo ayl leyl smogs !enaddy /luoylny WleaH SIyl;o uo!ls6!ls9nu!,(w leyl41.18A 1'mo19q umoys aiep uo!lep!len ayl to se pue o39J8y pax!;;e leas Aw Aq pa!;!1Jao sV NOIIVWHOdNI CNV VIVO `HOHV3S 3IId `S1S31 `SNO1103dSNl JNICIAOkld WHId JNId33Nl"JN3 '9 MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF ANCH09WTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL SERVICES DIVISISPECKLIST - FEBRUARY1984 264-4744 / APF 14 1988 Legal Description: �ol3z°f/ %9T" Wk QST / TiY 23vJ $CG 2-G A. WELL DATA RECEIVED Well Classification �/'� If A, B, C, D.E.C. rove A ppdY/N. ( ) Well Log Present(Y N) Date Completed SI Yield Total Depth 7_e6 / Cased to 2 ey Depth of Grouting Static Water Level Z `/ Pump Set At i Casing Height Above Ground Z• 3 Sanitary Seal on Casing (9N) Electrical Wiring in Conduit &) Depression Around Wellhead (Y1 Separation Distances from Well: To Septic/Holding Tank on Lot l04 On Adjoining Lots To Nearest Edge of Absorption Field on Lot 117- On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole ✓i To Nearest Sewer Service Line on Lot 7, t Water Sample Collected by e 5 �' /r� ; Date 3' /6 " ,f � Water Sample Test Results mt i _aa Ai/Tzf-le3 "6 -- Comments CP u1LZL iZzl `cST /Li 88.trklATcr, B. SEPTIC/HOLDING TANK DATA 5--L7-66/ /647J 2— Date Installed - 9"8'y Size 5°D No. of Compartments / StandpipesoN) Air -tight Caps &N) Foundation Cleanout (Y© Depression over Tank (Yo Date Last Pumped 3'"/� _9T OSi9Re 5 Pumping/Maintenance Contract on File (Y/N) ,r}V19 ; for A11— Holding Tank High -Water Alarm (Y/N) A)'10 Temporary Holding Tank Permit (Y/N) F=— Separation Distances from_Septic/Holding Tank: To Water -Supply Well /d t To Building Foundation To Property Line,Mn ` i To Disposal Field '" "" To Stream, Pond, Lake, or Major Drainage To Water Maln%Service Lme /� ,� 1 9 Comments' Page 1 of 2 72-026 IRzv. 8/861 Front. G S' B $ /iit %�r9rzK QST � C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata sU Type of System Design Date Installed Length of Field 57 --t- Width Width of Field 3 Depth of Field /L Gravel Bed Thickness Y ° Square Feet of Absorption Area Depression over Field (Y6— Results of Last Adequacy Test Standpipes Present) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well °�° To Property Line 4 / To Building Foundation yL To Existing or Abandoned System on Lot > 5 S�JZti/ rZOL145 On Adjoining Lots 't To Water Main/Service Line /v -�To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course /o --D °d - To Driveway, Parking Area, or Vehicle Storage Area /U Comments D. LIFT STATION Da ailed . Size in Gallons --� "Pump On" Level at _ High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments - Dimensions Manhole/Access (Y/N) 72-026 lRev. 8 — "Pump Off' Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Cycles during Adequacy Test. Meets MOA I certifythat l h/a$v ec d, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection Signed 1114' Date Company LS MOA No. $2 A4 84 Receipt No. Date of Payment v .- '/eeei• soe seem mme:mp+ Amount:$ _ /% E e al oees eme ene memo em, C. REID, JR. e I •9 Page 2 of 2 Qr,�p�s9S9m mm Otl /861 Back �. ..�... ,. .. , .. .:.,,.. .» .„ ....___, __.,.,—»,....._. DAT RECEI ED ' 5. LEGAL DESCRIPTION , TION APPOINTRENTS- TIsTSPE'C,_ �.......,.,...;. TIME�- ._-.-..,..:..-__ TIME - __ __--,,....>,......,—........... TIME _....,,--, .,_... ..:....... STREET `LOC ION -- .DATE '.. ."""_° 6. TYPE Of RESIDENCE .DATE DATE lX SINGLE FAMILY 11 ❑ `MULTIPLE, FAMILY INSPECTOR '-"`."�'""""'""`"""". INSPECTOR \^_ INSPECTOR. NCHORAGE JS( INDIVIDUAL"_.__ 'ATT MUNIC Q COMMUNITY MENTAL PROTECTION MUNICIPALITY OF,ANCHORAGE ENVIR -r1pq� - - depth DEPARTMENT OF,HEALTH&ENVIRONMENTAL PROTECTION $1S L S{reet-`Anch.mge, Alaska 9 S. SEWAGE DISP'QSALSVSTt=171'"` --_ ENVIRONMENTAL,SANITATION DIVISION [[ [ \ / C „p I Telephone 264 4720 �- G C L V L REQUESTF,OR APPROVAL OF INp„DIVIDUAL WATER AND SEWER FACILITfES sed. Please allo.ten (10) days for processing. DIRECTIONS: Complete all parts on page 1. Ineompletelegoests will not, o"e procesw 1.PROPERTY 'iSWTTER _.-...,-.._M..._...-..,..._...._,—„.,..,,v_,.,.u. PHONE __.. 5317 NOTE:,THE INSPECTION FEE MUST ACCOMPANY E MAILING ADDRESS.`,.„, '72-610(Rev. PROPERTY RESIDENT (if different from aopve)` PHONE 4.BUYER' _._.,_. ...............J.�....,,�,,......ao..�... .amu ...". .... PHONE ec a ..... MAI ING DRESS 3. .LENDING INSTITUTION ". "”' "'"`"""°"'^""`��*p�� PHONE MAILING ADDRESS EALTOR/ GENT' 4. REALTOR/AGENT- Al MAILING ADD ESS.., EA ❑ ,_One , _,_, FourOther Q "Two'" ':.❑ Flve' three L7 Sl�xa,�,,ry„ ACH WELL LO2i A VMI log" iseq rul for all wells drilled June 175 ,orwefls rl led poor to that date give well (attach log if aval a1 ble) YEAR -ON-SITE SYSTEM WAS INSTALLED REQUEST BEFORE PROCESSING CAN BE"INITIATED. ' 5. LEGAL DESCRIPTION , STREET `LOC ION -- 6. TYPE Of RESIDENCE lX SINGLE FAMILY 11 ❑ `MULTIPLE, FAMILY .,m..v-uwv. .xtv^ z 1NATER`SUPP_,�_ Wafla4F•ID%T^*fhMIWA�. JS( INDIVIDUAL"_.__ 'ATT Q COMMUNITY since ❑ PUBLIC UTILITY , ..._" - - depth S. SEWAGE DISP'QSALSVSTt=171'"` --_ . INDIVIDUAL/ONmSITE*`,- _, E:1 PUBLIC -UTILITY _- , NOTE:,THE INSPECTION FEE MUST ACCOMPANY E 6/79) '72-610(Rev. ❑ ,_One , _,_, FourOther Q "Two'" ':.❑ Flve' three L7 Sl�xa,�,,ry„ ACH WELL LO2i A VMI log" iseq rul for all wells drilled June 175 ,orwefls rl led poor to that date give well (attach log if aval a1 ble) YEAR -ON-SITE SYSTEM WAS INSTALLED REQUEST BEFORE PROCESSING CAN BE"INITIATED. THIS SIDE FOR OFFICIAL USE ONLY _ 1. TYPE OF RESIDENCE NUMBER OFBEDROOMS '" ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER -- ❑ INDIVIDUAL DEPTH OF WELL ❑. COMMUNITY DATE DRI LLED ❑ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ` ❑INDIVIDUAL/ON SITE----- =PUBLIC UTILITY DATEINSTALLED Connection Verified. .:—, _ ... ..... ......... INSTALLER SOILS RATwG' ""' ❑SepticTankor =Holding Tank Size: �- � If Tanks homemade give dimensions: TYPE OF TANKMANUFACTURER _.. ,-...__ . ., .._.,.. _„ ....,,.. TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS PPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED -..... .. _. DATE /L .� ✓r�