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Home My WebLink AboutTALUS WEST #2 BLK 5 LT 21Talus West -#2 Block 5 Lot 21 #015-202-51 · Municipality of Anchorage Page / of 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: ~c>.--~ PID Number: Name: Wastewater System: D New ~Upgrade Address: ABSORPTION FIELD Phone: [ No, of ~rooms: ~Deep Trench ~ Shallow Trench ~ Bed D Mound D Other Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION ~. ~ ~ws~. ~. /~' Block: Subdiv~ion: ~ Depth to pipe bosom from original grade: Gravel depth beneath pipe LOt: ~[ ~ ~ ~ '~ ~ Ft. ~ Ft. Township: ~ Range: [ Section: Fill added above original grsde: Gravel length: ~ ~ ~ Ft. ~ /5~ Ft. r~ Gravel width: Number of lines: l Distance ~e~een lines: WELL: ~ New ~ Upg ~ Ft. ~ Ft, Classification (Private, A,B,O): T~Ft' Cased To: Total absorption area: Pipe material: Driller: ~ ~ DateDfiged: StaticWaterLevel: Ins~: Dateinst fled: ~ GPM~Pump Set at: Fi, I Casing Height Ab°ye Gr°u;;: TANK SEPARATION DISTANCES ~s~ptic ~ Ho~din~ ~S.T.E.P. To Septic Absorption Lift Holding ~ublic/Private ~anufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~~ 0~ Weft ll~t ]~t I~' ~ Material: Number of Compa~ments: su~aco -- ~ LIFT STATION Water l ~O ~ l om ~ I ~~ Lot [ ~ { Size in gallons: ~Manufacturer: Line ~ J ~1 ~ ~ ~ ~ A~- ~ ~ ~ "Pump on" level at: I-Pump~' level at: High wa~er aIarm at: Foundation ~l ~.~ ~ ~ -- ~j ~ Pump Make & Model ~ Electrical Inspections pedormed by: Drain BENCH MARK Remarks:~3cev~ ~~ &Am~ Location and Description: Assumed Elevation: [nspections peNormed by: S~~ ~ Dates: 1si ~/~[~ 2nd e/~ [~ Department of Health and Human Se~ices approval Reviewed and approved by' ~~ ~ ~ Date: ~-/~' · ~// ~ - 72-013 (Rev. 9/91) MOA25 P,I.D. NO. 015-208-51 AS-BUILT PERmT NO, WASTEWATER ABSORPTION SYSTEM LOT 21, BLOCK 5 TALUS WEST S/D, ADDN 2 EXIST'G DRAINFIELD TO BE REUSED~ SWING TIES cni A ~ B T1 ~ ~ 23.7 i46,7i LS i J 28.8 i54.0i ci 19o,? i ?o,? i C3 ~73,3 i 45.7 ~ M2 ~ 92.7 C4 ?'.... "-;;!'~ . ".../ ./ /~OUSE .' %"... %! ~,I~. ?' / :~ MARK ../ ~'..... ? '".~.. 4'.... E~ 00~' · ' ,-.~ " %. -"~~ ' ! EXIST'G_~ WELL ~. / / / ..' L ..... 2~ ...... --~ / NEW 1250g STATION 1 118' ~RASS VALVE TH~ - FLOW 6/ BUTH FIELD 58'x3'xT' NORTH FIELD 52'x3'x7' C,\Work\21-5TAL,DWG DESIGN PERC RATE, 4@ MIN/INCH SOIL RATE, 333SF/DR 3BP HOUSE 1~000 SF REQUIRED 2 DEEP TRENCHES 7~ EFFECTIVE, 5;~ LONG EACF 1456 SF TOTAL PREPARED FBR~ Ken ~ Atene p~lmer 11651 Wilderness Drive Anchorage, AK 99516 (907) 275-9147 PANNDNE ENG, SVC P, 0, BOX 142025 ANCHORAGE, ALASKA 99514 272-8218 Phone & F~x DATE, 9-9-98 SCALE, 1'~"o~ AS-BUILT P. Ln. NO, 015-202-51 Z W AS-BUILT BETAILS WASTEWATER ABSORPTION SYSTEM LOT 21, BLOCK 5 TALUS WEST S/D, ADDN Z Ld C,\Work\21-STAL,))WG lnON¥390 W d PREPARE~ FOR, Kem & Alene palmer 11651 Wilderness Drive Anchorage, AK 99516 (907) 875-9147 PANNONE ENG, SVC, P, O, BOX 148085 ANCHORAGE, ALASKA 99514 874-0308, 272-8218 FAX DATE, 929-98 NOT TO SCALE , AS-BUILT ~ Municipality of Anchorage 825 L Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: A~~~ DATE LEGAL DESCRIPTION: Township, Range, Section: 2 3- 4- 5- 6 7 8 9 10 11 12- 13- 14- 15- 16- 17-- 18 19 20 WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN S IF YES, AT WHAT ~/;~/vi I-'~ ~_ C~ DEPTH? '1,'-'"'~ p -~ (:3~"-~ E ~ ~ L"~"....% Depth 1o Water After "-~-"~"~'~ Monitoring? /~"~' Date: c~[~[~r~ Reading Date Gross Net Depth to Net Time Time Water Drop '~l~lq ~ II.'c."c~ -- ~//-4- PERCOLATION RATE q ~[~ (minutes/inch) PERC HOLE DIAMETER TEST RUN E~ETWEEN ~ FT AND ~ FT COMMENTS ' PERFORMED BY: I .~-~'~"~/t]/~]/'~A,//~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED DATE:. ?[~u/ ~ ~ MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Serv/ces Program 825 L Street, Room 502 P.O, Box 196050, Anchorage, AK 99519-6650 (9O7) 343-4744 noon ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 31, 1998 Expiration Date: Aug 31, 1999 Permit Number: SW980330 Legal Description: TALUS WEST #2 BLK 5 LT 21 Design Engineer: 0062 Steven R. Pannone Owner Name: KEN & ALENE PALMER Owner Address: 11651 WILDERNESS DR ANCHORAGE , AK 99516-2230 Parcel ID: 015-202-51 Site Address: 011651 WILDERNESS DR Lot Size: 51662 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. Steven R. Pannone, P.E. Consulting Engineer (907) 272-8218 P.O. Box 142025 Anchorage, Alaska, 99514 (907)272-8218 Fax August 20, 1998 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 21, Block 5 Talus West Subdivision, Emergency Septic upgrade System Permit Gentlemen: My fi.tm was contacted to test the existing septic system for the referenced lot. The liquid level was found to be 4 inches deep in the foundation clean-ont, and above the lateral pipe of the field. We conducted two test holes on August 13, 1998 for a the upgrade system design. The soils report and a percolation test results are attached. No ground water was encountered. No bedrock was encountered in the test hole. The lot is approximately 0.96 acres in size. Lot 21 slopes to the northwest at a rate of approximately 2-3 percent. The north eastern portion of the lot rises approximately 5 feet and then levels off. The proposed installation will be located on the northern portion of the lot. A S.T.E.P. tank will need to be installed to serve the new field. The existing field will be reused. A diverter valve will be installed after the tank to control the direction of the effluent flow. Double clean-outs will be installed after the tank and diverter valve. The proposed location is greater than 100 feet away from the existfl~g well serving fids property and 25 feet fi.om the water service lines. The surrounding wells are located greater than 100 feet fi.om the proposed installation. The proposed installation will not affect rite future development of the surrom~ding or existing lots. See the attached design. Please contact me at 272-8218 or 227-3522 if you have rely questions about the proposed installation. Sincerely, Steven R. Pamtone, P.E. Attachments: P,I,D, NO, 015-202-51 DESIGN PERMIT WASTZWATER ~BSDRPTInN SYSTEM LnT 21 5 T~LUS WEST S/D, ADDN ! ~,.~ ~ ~,-~ EXIST'~ TANK ABANDON IN PLACE NEW 50'x5'x3' ]]rive WELL / 4EW 1,250 " S,T, EP, 100' WELL RADIUS INSTALL DIVERTER & DOUBLE CLEAN-OUTS .............. ~ Sumstone Cir C,\Work\2I-5TAL,DWG DESIGN PERC RATE, SOIL RATE, 333SF/BR 33R HOUSE 1,OOO SF REQUIRED 2 DEEP TRENCHES 5' EFFECTIVE, 50' LONG EACF lOOO SF TOTAL PREPARED FOR: Ken & Alene p~lmer 11651 Wilcterme~s )]rive Anchorage, AK 99516 (907) 275-9147 PANNBNE ENG, SVC P, D, BOX 142025 ANCHBRAGE, ALASKA 99514 278-8818 Phone & F6x ]ATE, 8-20-98 I DESIGN ~CALE, 1'=100' ,. Pti. D, NO. 015-202-51 LOT DESIGN DETAILS PERMIT WASTEWATER ABSORPTION SYSTEM 21, BLOCK 5 TALUS WEST S/D, ADDM 2 Z C~ W W W L 13_ lnON~393 C,\Work\21-~TAL,DWG PREPARED FOR, Ken & Aleme palmer 11651 Wilderness Drive Anchor~Qe, AK 99516 (907) 875-9147 PANNDNE ENG, SVC, P, D, BOX 142025 ANCHORAGE, ALASKA 99514 874-0308, 872-8218 FAX ~ATEI 8-19-96 NOT TO SCALE DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~L~'tJ~'~'"'~A/~cV/~'~- LEGAL DESCRIPTION: 7' 8- 9- 10- 11 12 13 14 15 16 17I 18- 19- 20- Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN Depth lo Water Alter Monitoring? ~ De(e: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ____ FT AND FT COMMENTS PERFORMED BY: ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL 3 4- 5 6 7 8 9 10 11 12 13 14 15 16 17 '18- 19- 20- Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S I F YES, AT WHAT OL DEPTH? PE Oeplh to Water Alter SITE PLAN Gross Net Depth ~- ~ Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN '~- FT AND ~ FT COMMENTS PERFORMED BY: ~' [~A''%~/~-~c~/'')(''~ I ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 4~)/'/'.,~ [ ~ ~ 72-008 (Rev. 4/85} INSPECTION I Post~i~ Fax Note 7671 ~/-rI£N CO_RR~c"370N~ AI~ MADE, Pr,~Lg£ C.4LL FOR lNSPEC370N DO NOT t?-E.~,fOFq~ ~ NOTYC, F. Bea~r.t~ and Environmental Protec,<.~.? Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ONLSITE SEWAGE DISPOSAL SYSTEM LEGAL DESCR,PT'ON L.T.21 SEPTIC TANK: DISTANCE FROM W~_LL./O,,3'/ INSIDE LENGTH MANUFACTURER ~'T ~' MATERIAL NUMBER OF COMPARTMENTS LIQUID CAPACITY GALLONS. DISTANCE [:ROM WELL I~''~ FOUNDATION c~' ! ~ of Lines ___/ DISTANCE BETWEEN LINES ABSORPTION AREA ~¢~)~) _ SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEpTIh TOP OF TILE ~O FINISH GRADE ~MATERIAL BENEATH TILE ~7 .J~, ABOVE TILE NEAREST LOT LINE /L~/OF TOTAL LINE LENGTH '/~/'~ TRENC;, WIDTH~~-''''- IN. TOTAL EFFECTIVE SEEPAGE PIT: DIAMETER OR WIDTH EENGTH__, OEPTH Log Crib Rings BUILDING FOUNDATION__ __ Crib Size:i DIAMETER___DEPTH OISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE -- . ABSORPTtON AREA (WALL.~.¢.~) Well Class: Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: ~.~ # of Bedrooms~ Installer: ~J~ Remarks: ' ~' <¢; h SQ. FT. DAT~')-' ~'*~ '- 77APPROVE . ., , ,~ E:,EF, Fi1,~.:'I"1,,'IENT Ei,~__.,iEf':IL'FFI RN[> EI'.,IV I I~:ONMEN'f'f:iL. I:%¢ [FEC:T I ON ~4 H',-.H-I~.HLiL. FIK. f. ,:,.~ ....... B. EEI .... : ......... . , :- ~..~ E~ L~ L_ F~ ~.~ ~Z:. ,j ~ --- .~. J. -F ~ .::~ F=' b..~ N~=' F~~ F'ERMIT NO. ( ............ '" " HF -LI-.HNI L.. Ii:ll~:l::l"l' :1: lIN LEGRL C:HRF.:LES H.~ GH'T. H ]. LE.'Ek-.NE ...... ,.- ',--' _ HE_t 'IW'F'E OF SOIL REp. E;IZREFF]'3N :,T:,lLfl I:,. I,iFI;,'-;IHIJH I'.tL.IhlEtEI(: 17.)F EIEDRCIOf'IS = THE REIE.:!I_I]iF.'.ED F.;IZE EIF THE SL.IIL REr_:I"IF~:F'I'ION _,-¢_,[EI1 "-: E:" El F' -fi-" H = :1 ...... IL_. ISE Ih4~ CD '"It"' H = .={ i~: ,l lt~." R "-."" E.: tL_ ~l- E: ~ ~ H THE I_E'NL3TH [:,It'lEN':SIOi"4 tS 'T'HE LENIiTH ,.'.IN FEET> OF THE -i"RENC:H OF;'. D1,RF:III",IFIf£LE:'. THE C, EF'TI7 'iIF R I I..EN..H .f, F'I"f' I--, THE [:,ISTRNIZE BEf'HEEN ']"HE: SURF'FIIZE 13F /'HE GFe':IJND FIND THE BI3-f'TOH OF: THE EXCR'v'RT:[ON ,:: IN., FEET>. " . ..,El HI[:'TH FLR 1F..ENL. HE-- 1,:'IF'E t'HEF?.E: I.=, NI3 ,z ......... Il'' I ' ;' - I I I THE GRF~',,,'EL L. EF~H I.-:, '1'HE HIN~PII_IH E:,EPTH OF GRR',,,'EL BEI"HEEN THE; RND THE: BC)T'I"OH OF THE E,:..,I....H~ HI .[-N ':: IN FEET>. ....... ........ F:~ F~ ~: b-:: Ft ~:~ ~ F E- ~--~ ~"~ ~F~-L L~-~ ~''~ · .-, .-. ' -', ......... D F'ERH:[TTEE'"S F~F'T~OF~ ':: B'fE'F:T TO 'iHE ......... ' _.LH-- ~ OR ]:~ NSF N-F~_?E[ FL. HNT h1~'¢ BL.. ~N- HLLEI... ~,, E~ IHER R . ...,:.,:. ..._,_, .,.,, ... .., ..,. .,:. · ,: ...... z... ~. ~ L. EN~ ~NIJ_I.:~ -.., .... , · · -,.--. ....... :_.IL ,-": ....... , bJ~'T'HOUT FZNRL INSF'ECI"~ON FIND RF'PF~EP',"RI- EP¢ ' ..... ':' E:FIIi:KFILL. ING I:)F AN'T' .:,N-,I El1 IHI-, E,E SUBJECT TILl P~'-qECLI-F] ON. E:,EF'AR't"PlENI" t.,11 L.L '"' - - - :,E~ffmE Bix I__,HL .~N.=,IEIt f,IINII'tUH DiSTRNCE E~ETHEEN R HELL. FIN[> RN'¢ ON-'SI'1,'E '-" '"I ...... '-:' ':' '-" ......... " ~FIE~ FEET FIq~t R PRt',,,'R'TE HELL JF. ;::'~aR FEET I~-B R PUBLIC HEL. L _ ,,:' - - [.Fir_, HELL Lt. Jm:, HLE RE';,IIIF:ED AND flU:,l BE RE'1,'URNE[:' TO THE t)EPRI~:Tt"IENT 1.4iTHIN OF THE HELL CEIHPLETION. ~ ....... , ' -,I' ":': Tq ':;F'E"tFICA"[:NS AND F'F~N':'t'PI "'TION [:,iRGi;:Rf'IS _ HER ~:E.,..IRE.HEN -. HAY AF'F'L"r'. - -. - R 'v'R I L R B L E 'T'O :[ N S U R E F'R O F' E R I N E;T R L L FI-r I O N. F" ~: ~: ~ ~ '"~" ~ -- ~ F ~ F~: ~: ~ ES:. ~% CZ: E: ~.1 ~ ~ ~N: ~: ::L .. -" "=~ '-~=" "~=" I E E'[~'.'I" I F"r' THFII' . _,: .... ::. .... :i.: I FII','I Ff:fi',IlLIFIF.: HITH THE F, EL:.!IJIREHEN-F'-';d; FOR _N _,)ilL. SEI.,IEF;:S RN[:, HELLS f:lS Fq1,~"/-H E,T THE fl_NI_IFHI.-J.I OF HN...H_r4H.~E .. , .......... :' '::1"- ~' "'t IN FIE:CORI::,flNCE HITH "I"F'IE .... ':' '":" :[ b. IILL ]:Nz, IHLL. I'HE: _,~_~c -, , = · ,:', ,:"~ -' ',' I',i. _-_l~t.I I h.E EFaI_FIF4:GE "tENT i F' THE Z;.:: 1 _I',tL)Efi"._,I-IIqL~ THFIT 'THE FH'4-S:!:TE '::;IE:I.,.IEI::~: _,T'_,IEtl PllR"d .-,= .......... c' :;'F ....... DE El." "1,'~' ]:'.,IZ:LLI[:,E IqOtRE THRN F~ E:EE:,Fd3OHS. F..E_,].E.,ENL-E ] .......... 1_1 ....... :4' ' ,,~ , - FiF'F'L I CFINT C.:HFIR LES HIGHT ~' ..................... · WELL CCNSTMGCTION LOG Z) 'fi,, Drillin~ Co. Briller c~d ~?~V Type of ri;~ /~ Date well completed Well location: (address & legal description) ~ / .~ ~ Location sketch or remarks Cepth of well ~'~ / ft. Casing: depth V'~-~ ~'ft. diam. ~' in. Static water level ~0 ft. (above. ~e~ {and surface. Cate Finish of well: (~screefl, pertorated, open-hole, other) Describe intervals and size: Well yield tested ~y (pumping, bailing,~at /~ gal/min. for ~ ho~rs with ~ ft. of drawdown from static level. DRILLER'S MATERIAL LOG Depth below land Give description of strata penetrated surface in feet (size of material, color, hardness of drilling, and water content) __to to to to to __to __to __.to to. f �bga91071 L 1 29 • eipality ®i Anchorage ite Water and Wastewater Program 5 � w (907) 343-7904 s a E T Y 2`LL016B6 ertificate of On -Site Systems Approval Parcel I.D. 015-202-51 Expiration Date: )072--Z C 1. GENERAL INFORMATION: Complete legal description Talus West #2: Block 5 Lot 21 Location (site address) 11651 Wilderness Drive *Anchorage, AK Current Property owner(s) Geri Chaney Day phone 272-3863 Mailing address 11651 Wilderness Drive *Anchorage, AK Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community, Class Well ❑ Community ❑ Public Water -System❑ Public Sewer ❑ WaiverNadance request for. Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 1936 Waiver Fee $ Date of Payment o'Z`eZ 1 / g Date of Payment Receipt Number MOO$ Receipt Number COSA # 05C_ 191,53 1R3 Waiver 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: ��► i In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms • / e arr„sS.1 Cn, .7.. V`am pr n�� ll\ �s+� a #AECC884 System #2 Approved for bedrooms Disapproved \\�``�G�Q IpS.IT YtQFrrr(jr(�r Conditional approval for bedrooms, with the fol`�i\stip lations:y�%� I�/ UN SITE �m"` HND WA m STEW DGAM %ro.Q o , IN v Z/11, j)) By: Original Certificate Date: r2 z90 — The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist C Septic System Advisory Well Flow Advisory COSA blue sheet_10.10.12.doc Nitrate Advisory Arsenic Advisory Other Legal Description: Talus West #2; Block 5, Lot 21 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA OR Well log is filed with Onsite (or attached) Date drilled 813177 Total depth 50 ft Cased to 50 ft FOR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 7/8/19 Static water level at beginning of test 17.6 ft. Comments *Condition of steel STEP tank is unknown Par t 015-202-51 Structure served by this system Well production at time of test 5.2+ gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 4.34 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by 6/28/19 Date of Sample GEG, Ltd. B. TANK DATA C. LIFT STATION Age of tank(s) 21 years ❑ Required maintenance completed Tank type/material STEP/steel Age of lift station 21 years Measured operating fluid level in septic tank *31 Lift station material steel FOR Standpipes/foundation cleanout per record drawing Comments: Date of pumping 7/16/2019 D. ABSORPTION FIELD DATA Which system tested (date installed) *1998 Adequacy test date 7/8/19 ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade **10.75 ft (max) Fluid depth prior to test 30 in Measured depth to pipe invert from grade 3.3 ft (min) Water added 474 gal ❑ N/A — pressurized field New depth 48 in ❑ Monitor tubes go to bottom of effective. If not, state 125 depth into effective Elapsed time min ❑ Code -required soil cover over field Final fluid depth 40 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced n/a gallons _ If yes, enter date Comments/Defciencies:_'Tested east trench only, Condition of west trench is unknown. Sump in 1977 trench was dry to 134" below top of pipe. "At MTI COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No *5+ Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft 7/ Yes if No Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑✓ Yes if No ❑✓ Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100' E✓ Yes if No _ Property Line > 5' F/ Yes if No ft Wells on Adjacent Lots: Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100'✓0 Yes if No _ Water Main > 10' 0✓ Yes if No ft Community Wells > 200' 0✓ Yes if No _ Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) ft ft ft ft ft ft ft ft Building Foundation > 10' ❑✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft ** Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ✓❑ Yes if No'. ft F. ENGINEER'S COMMENTS _ *Met code at time of installation **Separation distances to undocumented "dogleg" of 1977 drainfield is unknown. G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet #AECC884 DEVELOPMENT SERVICES DEPARTMENT I '� On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC191323 Subdivision: Talus West #2 Block 5 Lot 21 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 21 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. i4llUNIC1PALI.7ry fi tt..r•,rNCH RA(,1; c j•� 'tom .�s•.yn,t,- .. :.an � r..• --~. '' ! Maintonan Log 11 �, na.. - - _ -.____ — C. Strom•. n.ldr +e- Lla- ' . ._� t=moi rr<I:!, r_L•.Lnt l uzi�� •Gmu�,., t.,,,,- u,�,r ,� uyJ �` • rr •1 •Clpr._�a Q71].I r'ir.lr.'Pry C�.� •P:O^nr x:31 •.: r.11:.�9 GS-t' T ...t Yt" •'�'-�'6:I sr r•I,+G:riCr) ,,I,nrni Gro tyU�( 4";' .Aua""e CFI(•. v. alc.',i .l lfrrrn !1av16 CsSe.TifY, 1 •Atarrr! Syph_•, d2+rnhgl¢.g/s�car.--,.}..��, tsa[stl�r�ath�t��crl I ! •arrJq i1 W,�rrr enVu:�4n n: hner r;5 L'!nk GonnBCfiG, V�� -K3rrtu,''?1 •.va;.+; In!rur��n nrCarnd Oipc pGrnJr::ftorr._ •'.t.rn y.i „" 1 •Kv,._R F.I.. hrnrrLonW r ' Ir,sul.i:cu Cyrc � r� P!aGeKy Sn!cu:e,3 �STt �. ., Li`l �:•� _ ' "A"! r!anufrt;-tur!nr rC-gtur..v ,nspcch C7t5 itch ntcunf�manrn Complclr;.j �� -�tp �amnrr..,tM. ...................... . bld�nCc Pr�vldor r Unto: of malntenanct c-=orrDarty _j I jet s; iSC! yI P �cc- $:•mature. `� � j- Date�_.:wt�:j�Gi I 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 99519.6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-202-51 1. GENERAL INFORMATION HAA#C9 !V n Yb Expiration Date: 3 — 9 — D jT__ Complete legal description Talus W. Addition #2, Blk 5, Lot 21 Location (site address or directions) 11651 Wildemess Dr. Current Property owner(s) Guy & Shirley Morgan Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 11651 Wilderness Dr., Anchorage, 99516 Day phone Lori Hackenberger Day phone 727-4444 Go Dynamic Properties, 3111 C Street, Suite 100, Anchorage, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 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 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. J 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat 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. l 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 Watkins Engineering, Inc. Phone 349-1851 Address P.O. Box 110443, Anchorage, AK 99511-0443 Engineer's Printed Name Cindy W. Ellis Date /2.3.0 'f 5. DSD SIGNATURE Approved for '2 bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: WASTEWATER Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By 4 Original Certificate Date: 2 9_0 rpe . Dim) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water d Wastewater Program 4700 South Bragew St. P.O. Box 196650 Anchorage, AK 99519 650 www.muni.orglonsite (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Descdpdw: Talus W. Addition #$ Bit; 6. Lot 21 Parcel ID: 015-202-51 A. WELL DATA Weti type Pri If A, B, or C provide PWSID # Date completed•}n Sanitary seal (YIN) Y Total depth 50 ft. Cased 10 R. FROM WELL LOG Date of test 8-3.77 Static water level 30 ft. Well production 15 g.p.m. WATER SAMPLE RESULTS: conform 0 colonles/100 mi. Nitrate 2.7 mg.A. Arsenic: NA mg.A. Date of sample: ""O1 B. SEPTICfHOLDING TANK DATA Tank Type/Matertel steel Tank size 'm°ITEP gal. Number of Compartment 2 Well Log (YIN) Y Wires property protected (Y/N) Y Casing height (above ground) 29 in. AT INSPECTION 11-25-04 29 in 3.3 g.p.m. Other bacteria 0 colonkW100 ml. Collected by: Cindy Ellis Date installed 911if96 Cleanout (YIN) Foundation cleanout (YIN) Y Depression over tank (Y/N) n High water alar (YIN) Y Date of pumping 11/29104 Pumper A+ Home Services C. ABSORPTION FIELD DATA Date Installed 9/8198 Soil rating (g.p.d.e or fe/bdr) 0_45 System typo deep trench Length 104 ft. Width 3.0 ft. Gravel below pipe 7.0 ft. Total depth 11__0 it. ER. absorption area 1456 fta Monitoring tube Y Depression over field Data of adequacy test 11/26!04 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 27 In. Water added 913 gal. New depth 37.5 in. Parwed Time: 173 min. Final fluid depth 3&0 In. Absorption rate >= -I& y 50 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) no If yes. give date D. LIFT STATION Date installed 911119e `Pump on' level at V in. Datum bottom of tank E. SEPARATION DISTANCES Size in ganons 1250 STEP "Pump oft level at in. Cycles tested 3 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAlft station on lot 107 Absorption field on lot 115 Public sewer main 100* Sewer /septic service one 84 Manhole/Access (V/N) High water alarm level at 34 in. Meets alarm b circuit requirements? Yes On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/deanout 100• Holding tank 100* SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 20 Water main 100+ Wells on adjacent lots 100* Property line 75 Absorption Heid 10 Water service line 55 Surface water 100* SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1S Building foundation 33 Water main 100* Water Service line e0 Surface water 100+ Driveway perkingNs dde storage 40+ Curtain drain NA Wells on adjacent lots 100+ F. COMMENTS �� Tested the 1998 field. The original field had 25" fluid depth. ,Sp . G. ENGINEER'S CERTIFICATION I car* that I have determined thnwgh field Inspections and review of Municipal records that the above systems are in Ci y W Ellis i contbrmance with MOA HAA guidelines in effect on this date. CE . ies" Engineer's Printed Name Cindy W. Ellis �q`� 12 ;3 g'f.• '"r'�SsicHN-cR�' Date a -3- 0 HAA Fee E Waiver Fee S Date of Payment /%Z%7Ioq Date of Payment Receipt Number cOi 3 Sy k Receipt Number (Rev. 12/01) 11/=:/2004 15:17 9072617551 MARY LORI PAGE 02 VF - r a�la� a.._.: 4 SCALF- I t r ae 0 . - h .wv +• �� rte. � I• � .y. ou to 4 to ' Qtr/ �� :iY�.��}� . 1 e � r� / •`•. •hG — -- twat. tt TELE. e5M'r lcld.� O 1I B9' SG' 7-0 "W 206,07 AS -BUILT NO CORNERS SET THIS DATE . rr.s two. rev ti wu►Z�.l.,r\\1 EASEIdENT9 OF FECORD. OTHER THAN THOSE SHOWN OY THE RECORDED PLAT ARE NOT SHOWN HEREON. X6wI.5 fj we I hely cenity that I have performed a Mortgagee's inspection of the blowing descnood property; 1- OT 21. SLaGk 5, TALtrS we57- A D D rrroAJ N.. 'Z - Anchorage Anchorage Recording Precinct, Masker and that the Improvements situated thereon ars within the property fines and' do nM ~op or wwmach on the properly Iy ft a I i 1 sysrel4 " no Improvements on property lying adjaeent Owsw encrodch on Ore prembes M ¢lestlon and that there aro no roadways. transmission fines or or w visihle asemerss on said property except as indleared hereon. Dated at Anchorega. Aleaks ' tNs/f/' dayof SEPTEMbfR • jg •9� FRED VYALATKA t ASSOCIATES 99M 246.16M Engineers end Surveyors MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Day phone ~9-~--- ~'/q ~ Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 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. 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. 72-025 (Rev. 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validatfon 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. J further verify that based on the information obtained from the Municipality of Anchorage flies 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~C'7'~A^~J~J~; ~.t.3q. ~. rj cL Address %:~::~, a .'~E~o y__ /~{'~?..~ Engineer's sign at u re ~__-----,~1~ ,~. DHHS SIGNATURE I,/'' Approved for T'/-/F,£E Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date 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. Legal Description: A. WELL DATA Municipality of Anchorage V DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343S¢_~4] 0 ]991 Municipality of Anchora e Health Authority Approval Checklist Dept. Health & Hun/ac Serlv~ces /'~t /'~.~"' TAL~t~ ~,J ~-,~'T Parcel I.D.: Well type~ al,AT Log present (WN) "~ Total depth _ Sanitary seal (Y/N) Date of test Static water level '~ O t Well production / ,5- WATER SAMPLE RESULTS: If A, B, or C, attach ADEC letter. ADEC water system number Date completed 8/3 ~ 5z -:~ Cased to .,~d:; ~- &." Casing height (above ground)_ '~ Wires properly protected (Y/N) AT INSPECTION /~¢ FROM WELL LOG g.p.m. Coliform ~'-' (~ '- Date of sample: 'T(/~ / ~ B. SEPTIC/HOLDING TANK DATA Nitrate ~', ~'7__~__ Other bacteria~"'~) '-- Collected by: ~ ~ ~ -~'~,~a/v ¢~./r_~ Date installed Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA Date i.nstalled Tank size /'~c, Number of Compartments '~ Cleanouts (Y/N)_ Depression (Y/N) Pumper. · Soil rating (g.p.d./fF or ft2/bdrm) ~- q % System type ~ -[-- Length. / O/--( ' Width .'~ ' Gravel thickness below pipe Effective abSo~'Pti0n area / ~l ,~._ Monitoring Tube present (Y/N) Date of adequacy test q'/~3/~ Results (Pass/Fail)'-~A,g_ Fluid depth in absorption field before test (in.); ,,~u~.~ Fluid depth ~--- (ins) Minutes later: ':~' ~-- Total depth . Depression over field (Y/N) For ,--% bedrooms Immediately after ~ gal. water added (in.): _---- -- Absorption rate = '-------~ g.p.d. If yes, give date ' - Peroxide treatment (past 12 months) (Y/N). 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level Size in gallons "Pump on" level at* N! *Datum "~c~"~, "~-A/J "Pump off" level at* _ ~f Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / [ ~./ Absorption field on lot _ / ~- ~ ~ On adjacent lots On adjacent lots _ Public sewer main _ '/~ [ ~A Public sewer manhole/cleanout Sewer/septic service line _ c~ '2 ~ Lift station / SEPARATION DISTANCES FROM SEPTIC/HOLDiNG TANK ON LOTTO: Foundation '~ 7_- Property line Absorption f etd_ Water main/service line ~.~-i Surface water/drainage _/cc, SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation _7'~-3 ~ Property ine _/R Surface water __ Curtain drain _ / C~c~ Wells on adjacent tots F. ENGINEER'S CERTIFICATION Water main/~ervice line _ Driveway, parking/vehicle storage area. Wells on adjacent lots _ /Cc~ '~ I certify that I have determined thru field inspections and reviet4 'ns are in conformance with MOA HAA guidelines in effect on this date. Signatu~ Engineer's Name ---~'-T-'~ Date _ . '4L m ,of Municipal ri~~ HAA Fee $ '?~(~'~ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ _ Date of Payment _ Receipt Number _ ' i Time ,~...~, Time ~Date Date Date Inspector Inspector Inspector Comments Conditional Approval roved [~.edl'oon~ ~ ) D's~cpproved '"~~ ' ( ) C,o'~o~t'ona Approval Date Sewer Installed Permit No, Septic Tank Size ¢ ¢ ? Holding Tank Size Soils Rating W ' ' ed To Absorpbon Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY PropertyOwner l~c_ ~,~ ~,~-~ ~A~ ~ ~ ~'~ Phone Mailing Address I~ ~ ~Jll~~ ~,/ ~ · ~ Lending Institut on ~Fh ,: ~ r¢:::o ~) ~: ' ~ ~ ' Address ~c~ ¢~Q ~)~ ~,~s,~ ~, Address ~O~ ~- ~b~-~ [1~4~ ~L)~ , ) k~C~' )~t4,/~ '~'1~ Street Location [~ ~ ~l ~ I ~'~¢~%% Typ~f Residence ~Single Family ~ Multiple Family No. of Bedrooms Wat~upply ~ Individua~ A~ACH WELL LOG. A well log is required for all wells drilled since June B Community 1975. For wells drilled prior to that date, give well depth (attach log if ~ Public Utility available.) Sew~ Disposal ~ndividual Year individual ~nstalled: --~ ~ ' ~ Holdin~ Tank HOME & COMMERCIAL SEWAGE TREATMENT PLANTS BOX 149~:~ WAS!LLA, AK. 99687 - PHONE 376-5919 JET Home Plant Service Policy This Agreement entitles: Owner {~ k-GM¢' ~/r4-~.t~A.~x-~ Street ..---' Address j ~ C~ ~ I ~ ~ ~-~ l[~:~q ~,.~ ~._ City ---~ ~4~"~' ~ f~ ~ ~~- ) ~' Phone ~O~ to the following service for / year(s) from the date of acceptance. ..~ Upon receipt of th s s gned a~reement and $ l~'O.~:~ ~ ~- ~'~, ~/ .... , -- , ,.-u,,,.re,~ ~',~,,J,,crs agrees to perform the following services dJJring the term of the agreement: ~ wdl ins act the JET lant at the above address twice a year. These inspections · , P P wtll include: PLANT SERVICE e Removal of aeration unit, inspection, adjustment, cleaning of aerator's shaft, field service of aeration unit, if needed, and re-installation. · Inspection, cleaning, and adjustment, if necessary of surface skimmer and/or tube setter· · Examination of final effluent for color and odor, if there is access at time of inspection. · Check of discharge point and wet weather overflow for blockage (if applicable). · Inspection and adjustment of control panel setting and overload protection, if there is access at time of inspection· e~L.~p~ectio9 for,~ludge accumulation with arrangements for removal when build-up warrants removal· ~.;;..,a: _.m'~r~.c. , ;,;~u:.~further agrees to the fei;owing: EMERGENCY SERVICE · ...... ' .... fo ' · There will be no service or labor charges for removal or re-installation of aerator, if required. e. If i'mproper operation cannot be corrected at time of service, homeowner will be notified immediately and given estimated date of correction. · If improper operation cannot be corrected at time of service, the Department of Environmental Quality, GAAB, will arso be notified. · If necessary, the entire mechanical unit or any parts will be replaced according to the manufacturer's warranty program. Freight charges fo the factory or fo an unauthorized repair station and aerator repair charges are not covered under this agreement. Owners Signature ~k~ Date ALASKA UIRO M TAL £O TROL I~n§inecrinq & I~nuironmental Studies S RUIC S, IRC. 4/13/82 RAINIER M ORTGAGE/ATTN: CATHY 4797 BUS]I~ESS PARK BLVD ANCHORAGE AK 99503 SELLER - RELOCATION COMPANY SUBDIVISION-TALUS WEST #2 BLOCK-5 BUYER-KEN PALMER LOT-21 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM ]~ A TRENCH WITH AN AREA OF 600 SQFT. THE SYSTEM ]~ CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM ]~ 665 GALLONS. BASED UPON THE TEST DATA THE SYSTEM ]~ ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 4/13/82 . SEPTIC TANK ADEQUACY T~ HOUSE HAS A PACKAGE PLANT IN LTE. U OF A SEPTIC TANK. ,cAs .o' ~ ,. 1220 U Jest 25th Auenue · AnchoraQe, Alaska 99503 ,, (907) 276-1361 Municipalityof Anchorage DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION April 7, 1982 Texas Commerce Ba~f/Steadman 11651 Wilderness Dr. Anchorage, AK POUCH 6-650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, ~~ MAYOR / F Subject: Lot 21 Block 5 Talus West Sub. ~2 Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The water sample could not be taken due to silt content (turbidity). The well should be flushed clear by turning on a garden hose until clear water is evident over an extended period of time. Please contact this department for a resampling appointment. o The top of the well casing sealed with a sanitary seal so that it is water tight. The depression or pit around the well casing needs to be filled with impervious type soil so that it slopes away from the well casing. The septic tank pumped with a receipt submitted to this department. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. A maintenance contract for the Jet unit serving the sewer system needs to be obtained from Consteel Company, 376-5919, and a copy submitted to this office for our review and our files. Please notify this department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincere , Robert C. Pratt Associate Environmental Specialist Enclosure MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street * Anchorage, Alaska 99501 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 I. PROPERTY OWNER ~.~ J MAILING ADDRESS C--~ ~ ,~ . PROPERTY RESIDENT (If different from above) DIRECTIONS: Complete ali parts o~page 1. Incomplete requests wgl not be processed. Please allow ten (10) days for processing. 2. BUYER t PHONE PHONE MAI LING AQDR ESS 3. LENDING INSTITUTION PHONE MAI LING ADDR ESS 4. REALTOR/AGENT PHONE MAILING ADDRESS STREET LOCATION 6. TYPE OF RESIDENCE NUMBEROFBEDROOMS [] One [] Four [] Other ~. SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER SUPPLY [] INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI L1TY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] IND[VI DUAL/ON-SITE** **If individual/on-site, give installation date If system is over two (2} years old an adequacy test is required [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) TI'IlS SIDE FOR OFFICIAL USE ONLY -DATE RECEIVED INSPECTION APPOINTMENTS TIME q TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1, TYPE OF RESIDENCE NUMBER OF BEPROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX · PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI I.I-EY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED EZiPUBI_IC UTILITY Connoction Verified INSTALLER []Septic Tank or ~_l Holding Tank Size:_ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES' Septic/Holding Tank ,~bsorption Area ~Sewer Line / Nearest Lot Line WELL TO:I J__ Absorption Area to nearest Lot Line 5, COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (10tter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev, 3/78) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchora§e, Alaska 99501 Telephone 264-4720 CERTIFICATE OF INSPECTION SEWER AND WATER FACILITIES '~,PROPERTY OWNER MAILING ADDRESS 2, LEGAL DESCRIPTION 3. TYPE DWELLING ~'¢-SINGLE FAMILY RESIDENCE MULTIPLE FAMILY RESIDENCE [23 OTHER (Describe) 4, WATER SUPPLY INDIvIDuAL COMMUNITY/PUBLIC 5. SEWAGE DISPOSAL ~ INDIVIDUAL/ON-SITE L-~ PUBLIC UTILITY [23 HOLDING TANK (Maintenance Required) APPROVED FOR -.~ BEDROOMS CONDITIONAL APPROVAL (See Attached) L~ DISAPPROVED DATE 72~)14 (3/78) DEPART~,.~IT OF HEALTH AND ENVIRONMENTAL ~-,.~,.TECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (addressoor directio, nsl ~ (b) Applicant Name ,/~J.e..~,~.. ~>o~,Jt, vL~,¢" Telephone:Home ~'-7/Z~ BusiJ~ess'~'C~C-Z,~Zgf Applicant Aaaress //~ -~'- / ' ':~fJ/~ '/J~'f""~ ~-~ ~'~ -Z~'~'~ ~ '(¢~' (c) Applicant is ¢;heck One): Lending Institutlon~l~ Owner/builder []; Buyer []; Other [] (explain); (d) Lending Institution Address ~j'~ .~, /dr' Telephone (e) Real Estate Company and Agent Adoress Telephone (f) HAA to me following address: Mail the ~,~.¢_/~//,, /~'//.44~¢"~--' TYPE OF RESIDENCE Single- FamJly,,~' Multi-Family Numoer of Bedrooms Other WATER 'SUPPLY Jndividual Well'~ Community [] Public [] Note: If community¢ well system, must have written confirmation from the State Depar[ment of Envlrol~ mental 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 legauw and status. 72-025 (11/84) Page '1 of 2 ENGINEERING FIRM PROVlb~ ~,~.j. INSPECTIONS,. .TESTS' FILE SEARCH,~.~A AND INFORMATION 'As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm ~E::)~ ~"."~'~'U~'~...L~ Te,ephone ~ ~--~/~ ~ Date . ~~ ~ , ~. .00~ .... DHEP APPROVAL Approved for ~./,~,e.¢-..- bedrooms by Ap~ed Disap~ed Terms of Conditional Approval .,4~. "'~/~'~ Date Conditional ~ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the . professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MO~ HEALTH AUTHORITY APPROVAL (HAA) MAR 0 ,~ t~' CHECKLIST - FEBRUARY 1984 264-4720 ~ Legal Description: A. WELL DATA Well Classification ~/L,t d~, V', C~-~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) .t~z.( ~'~ Date Completed Total Depth ~""O ¢ Cased to Static Water Level -~'~ ~' Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot / O ~ / ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~[~ ~"~" ; On Adjoining Lots To Nearest Public Sewer Line /~O~ To Nearest Public Sewer Cleanout/Manhole /['"0~= To Nearest Sewer Service Line on Water Sample Collected by ~ . .~//...~¢"' <:~/~'"'~. ~ ¢~" ;Date Water Sample Test Results ~ ¢'~'~., Date Installed ~¢~/,ZV 77S' e~~No, of Compartments Standpipes (Y/N) ~--~ Air-tight Caps (Y/N) ~---~, Foundation Cleanout ~;:'//'~,/77 Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) ~. ~ Depression Around Wellhead (Y/N) ~, Date Last Pumped ///.//~t- ; for Temporary Holding Tank Permit (Y/N) Depression over Tank (Y/N) ' /['/~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) . Separation Distances from Septic/Holding Tank: To Water-Supply Well ~, O~.~ f To Property Line 7~;~ ~ To Water Main/Service Line ~-~ Course To Building Foundation Z~ / To Disposal Field t~ ~ To Stream, Pond, Lake, or Major Drainage ! Page 1 of 2 72-026(11184) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Z~2, ~:~ '/,,,~ ~ Type of System Design "'Tt~ Date InStalled ~./~._~/"'2 ? Length of Field ' ~- ~" · Width of Field Depth of Field -~ · Gravel Bed Thickness "7 · Square Feet of Absorption Area ~ -~' O ~:7 ,~ Standpipes Present (Y/N) Depression over Field (Y/N) /V~, Date of Last Adequacy Test Results of Last Adequacy Test /~v'~O "~ ~.-J~z~ ~:) 0 ~ Separation Distance from Absorption Field: To Water-Supply Well /D.~ / ~ To Property Line ~) / To Building Foundation ~.~ "" To Existing or Abandoned System on Lot ,,/~'Ot¢,~' ; On Adjoining L~ots ~ To Water Main/Service Line ~:~ ';""~ To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course ~_O~ I To Driveway, Parking Area, or Vehicle Storage Area k~,'~ ! ~ Date Installed ~ Dimensions Size in Gallons ~ Manhole/Access (Y/N) "Pump On" Level at ~ "Pump Off" Level at High Water Alarm Level at ~"'"'""'---.V~t (Y/N) Tested for Pumping~uacy Test. Meets MOA Electrical Codes (Y/N Comments ~ ~"-~., ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I bav~' chec..~C~v~e.,,rifi.¢,~, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Engineer s Seal