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HAMPTON HILLS #1 BLK 2 LT 13A
Onsite File g <'. tr"k�s 12. # I s f 4 �& 1 c=134 95 33 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181047 PID Number: 015-134-95 Dwelling: 0 Single Family (SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: El New ❑■ Upgrade Name: Walter Quigley ABSORPTION FIELD Address El Deep Trench El Shallow Trench ❑ Bed Cl Mound 7900 Sitzmark Cir. Anchorage, AK 99507 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907) 229-2115 5 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Ft. Ft. Hampton Hills #1 2 13A Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. Tot Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line Ft2 Ft. Well >100' N/A N/A N/A >25' TANK g Septic ❑S.T.E.P. ❑Holding ❑Other Manufacturer Capacity Surface Water >100' N/A N/A N/A Anchorage Tank 1,500 Gal. Material Number of compartments Lot Line >5' N/A N/A N/A Steel 2 NA Foundation *7,0' N/A N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Pump on level at Pump off level at High water alarm at Remarks *Septic tank is above the 1:1 influence line from the foundation. in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034Tank to D3034 Installer drainfield Owner Install Drainfield CO/MT D3034 Inspector J.Millette BENCH MARK (Assumed elevation) 100 ft Inspection 15' 6/22/18 Location and description dates: 2'd 3'd 4th Bottom of siding on North corner COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp .tet\\\ ‘ ���OF ALgllll Conditional Approval: Date �,`Q. . • •I %*Co:49 TH /1k • • *+06 1 ett<1,-.,-t Ea:4 F Michael E.Anderson . � .� •1<is•, 4381-E •.`�oilf Approv j v•./1, ` Date 7-26- 1 11F,P....�O�,. Inspection Report_9-1-12.doc HAMPTON HILLS #1 , BLOCK 2 LOT 13A PERMIT # OSP181047 PID # 015-134-95 DEVELOPED LOT I \N BLOCK 6, LOT 9A \ 10'CEA EASEMENT N 1` NEW1500-GAL SEPTIC TANK_ __ ZERMATT AVE l,� 4") 1 1 ---)x-74- _ (\N...., ✓/ TH#2 l j • / ---7: -T I /� , II // % EXISTING 43.5'LONG 3'WIDE X 8' ;-'0� EFF.DEPTH ABSORPTION TRENCH // ///7 ,_ __ __ �S \ 2 I / / '4 \ � V2 /� I �,5, •F�• SV1 /� J f \/ O. O TH#1. / CO / ` � i 10'712----,- 4-1. `I BLOCK 1, LOT 1 r------- ._,.., TFCC\ EXISTING WELL \ - FNT LOT 13A LOT 14 N LOT 12 � - - - J ' '� A B _I SV1 41.1 13.0 _ _ _ - - - � SV2 44.1 20.8 T n 2C0 45.5 23.0 .-OFA 4'k NOTE: LEGEND l f •'• •..?�' ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH CO-CLEANOUT j*.49. \ *t06 WELLS OR SEPTIC SYSTEMS. 2C0-DOUBLE CLEANOUT ' n AElaFCO-FOUNDATION CLEANOUT r� FS-FLOW SPLITTER VALVE Michael E.Anderson: j MH-MANHOLE �f,<F`��•••»g381 i 0 50 100 lzq �•c„� EN m m mi FEET MT-MONITORING TUBE �* PROFEsso 4.71"=50' SV-SEPTIC VENT \NN���~ TH-TEST HOLE J` ' GE ENGINEERING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) July 13, 2018 Municipality of Anchorage Development Services Dept- On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage,AK 99507 Subject: Hampton Hills#1, Block 2, Lot 13A- 7740 Zermatt Avenue Existing Absorption Trench Dear On-Site Services Engineer: The existing absorption trench on the subject lot was constructed in 1975. The design of the trench was based on a visual analysis of the subsurface soils. The test hole log completed at the time indicated sandy soils full depth of the hole with a siltier lense from 4' to 10'. The assumption was made at the time that the siltier lense was visually rated at 190 square feet per bedroom while the remainder of the test hole was rated at 125 square feet per bedroom. No mention is made in the MOA file as to where the test hole was located. We placed two test holes on the lot to determine the consistency of the underlying soils. The location of the test holes is shown on the attached drawing. The second location is in the middle of the existing trench with the 30' radius covering the entire trench. In both cases clean sand was found full depth of the test holes. Percolation tests indicated theses soils absorbed water at a rate less than 5 minutes per inch. We are therefore requesting the application rate for the constructed trench be 1.2 gallons per day per square feet as filed verified rather than estimated through a visual analysis. The actual absorption area then becomes 835 square feet which is more than acceptable for a five bedroom home. Sincerely,71/1- -e, E A.T��°F 51, Michael E. Anderson, PE j*: 49 TH • *r/ � 1 •. Michael E.Anderson ���6* 4381-E ••�•`� me ik 6,9• . cc'•A i`F0. 7/13/18PROFESS,ON9'• HAMPTON HILLS #1 B2 L13A PERMIT # OSP181047 PID # 015-134-95 - 7.5 0 N 0 7- 100.0 0 > > 0 LL cn Cn CV — — f-- 99.2 — — — I 4.0 5.6 r 93.6 .- \\_ U L____ \ 93.0 92.8 1500 GAL SEPTIC TANK \ \ / ''''''-- 88.7 ...V.-7;9FA : k k i� �••001 i*49 n *r -B I LT � 8enja hiller j PROFILE AS U �r�e •. CE 12592 •��. �slF. Jui14 2712 •� i 1 4 ,il`A\\�� -'~~ MUNICIPALITY OF ANCHORAGE �P�cl........qC 41•x, DEVELOPMENT SERVICES DEPARTMENT /N(� * � �I# • 49 TH 0, 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 a*•• r�••• SOILS LOG AND PERCOLATION TEST / :MICHAEL E. ANDERSON ,I s:• CE-4381 •:,. ', LEGAL DESCRIPTION: HAMPTON HILLS #1, BLOCK 2, LOT 13A �I�f<`��•.7-9 •r� .•'��` PERFORMED FOR: WALTER QUIGLEY '1 rRriFESS W-.00� DATE: 6/8/18 PROJECT No.: ProMilltiklivi!� i9111P. PARCEL ID#: 0I5-I34-95 TECHNICIAN: N. SHAFER DEPT TEST HOLE 1 (Peet) 1' OB SLOPE SITE PLAN 1 2 !r4,rfl.,,_• ; J: :s• :• i^ 5 ..1'...=;V.:7;: SEE SITE PLAN 6 ..:A,r ,-:.; i._; 7 '`; 'l s: ' SAND w/GRAVEL ':q.:AV...- SW/SP 10 0 ?,i:..yi? WAS GROUND WATER ENCOUNTERED? NO r!:.:•,.4;...1!,',.;•:, IF YES @WHAT DEPTH'? - .4•':,:•:..i• DEPTH OF WATER AFTER MONITORING: NONE 1 1 WiAi::: DATE OF MONITORING: 6/15/18 12 r w- -; ~i GROSS TIME NET TIME DEPTH TO NET DROP • DATE READING (MINUTES) (MINUTES) (INCHES) (INCHES) . 14 •'1' ':::.z'••`' 6/08 TEST HOLE PRESOAKED PRIOR TO TESTING: ,J''" • '•" 1 13:17/13:27 10 9-6/16/4-12/16 15 •`:�'�;="'�� 4-10/16 4.` 2 13:30/13:40 10 8-12/16/4-8/16 4-4/16 16 + ,a :;4';,:•:4-.4';:* ; 3 13:42/13:52 10 8-13/16/4-8/16 4-5/16 4 13:54/14:04 10 8-11/16/4-8/16 4-3/16 18 5 14:06/14:16 10 8-11/16/4-8/16 4-3/16 19 6 14:18/14:28 10 8-10/16/4-8/16 4-2/16 20 PERCOLATION RATE:2.42 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 6 FT. and 7 FT. COMMENTS: MUNICIPALITY OF ANCHORAGE ��P. 41,16, ii� DEVELOPMENT SERVICES DEPARTMENT ...,42).• 4 ;9 �k 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 *' �TM �\ •.*�/ SOILS LOG AND PERCOLATION TEST r/ eenja. hiller" j #I BLOCK 2, LOT 13A ,+ii l% �CElui 24.M18 *` /7 LEGAL DESCRIPTION: HAMPTON H ILLSPROFESSION PERFORMED FOR: WALTER QUIGLEY i\AIX.Xw���` Professional Engineers Stamp: DATE: 6/19/18 PROJECT No.: PARCEL ID#: 015-134-95 TECHNICIAN: J. MILLETTE DEPTH TEST HOLE 2 (feet) 1' OB SLOPE SITE PLAN 2 ti'.-. .�2:1,.if.�j� ' ,y .'. 5 —'-"',f''--.- FINE SILTY SAND SEE SITE PLAN SM 6 —%`�`s,` 'ai 7A f ": 10 '7M11•;it?:'�:: WAS GROUND WATER ENCOUNTERED? NO S •`' ••��• IF YES L WHAT DEPTH? - t:•:r:si 1'.v�i L S. %':;_:i DEPTH OF WATER AFTER MONITORING: 0 1 1 DATE OF MONITORING: E 12 GROSS TIME NET TIME DEPTH To NET DROP 13 DATE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES) 14 6/19 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 1 4:50/4:53 3 4-8/16/10-8/16 6 2 4:54/4:57 3 4-8/16/10-8/16 6 16 3 4:58/5:01 3 4-8/16/10-8/16 6 17 4-8/16/10 8/16 4 5:02/5:05 3 6 18 5 5:06/5:09 3 4-8/16/10-8/16 6 19 6 5:10/5:13 3 4-8/16/10-8/16 6 20 PERCOLATION RATE: 0.5 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 10 FT. and 11 FT. COMMENTS: HOLE WAS DUG FOR PERK TEST ONLY. GROUNDWATER WAS NOT MONITORED MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP181047 Work Type: SepticTank Upgrade Tax Code Number: 01513495000 Site Legal Address: HAMPTON HILLS #1 BLK 2 LT 13A G:2540 Site Mailing Address: 7740 ZERMATT AVE, Anchorage Owner: WRIGLEY LINDA C 50% & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: Dt'I)artnnant 4/16/2018 4/16/2019 53715 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: r! Issued By: I`�� ��JUG�3'(J' Date: �� �G7 Irk F 3 MUNICIPALITY OF CW;: Community Development Department Development Services Division On -Site Water & Wastewater Program C i �a�'-\s ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-134-95 Property owner(s) Walter Quigley & Linda Wrigley Day phone 229-2115 Mailing address 7900 Sitzmark Cir, Anchorage, AK 99507 Site address 7740 Zermatt Ave Legal description (Sub'd., Block & Lot) Hampton Hills #1, Block 2 Lot 13A Legal description (Township, Range & Section) Lot Size 53,715 —S q. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo AD U) Septic Tank INUpgrade ❑X Duplex ❑ (D) Holding Tank ElRenewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Jib - Date ib - Date of Payment: I I I I ) � Receipt Number: Oq99 OD Permit No. OSV J1 $1 C`� -1 Permit App_-'-:- Waiver Fees: Date of Payment: Receipt Number: Waiver No. PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) April 16, 2018 Municipality of Anchorage Development Services Dept- On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Hampton Hills #1, Block 2 Lot 13A – 7740 Zermatt Ave Septic tank replacement application Dear On-Site Services Engineer: The owner of the above lot has a 3-bedroom home on the property, but the septic tank has failed. We are submitting this permit application for a replacement tank. The attached site plan identifies the location of the home, well, septic system, and existing tank. No conflicts exist between this new tank and any well, whether on this lot or adjacent lots. According to as-built documents on file, the existing trench is 8’ from the foundation, and the trench is 10’ further. Our measurements indicate the field is actually closer to 6’ away. Although the existing tank is already oversized at 1250-gallons, according to the as-built report, the owner wants us to install a new 1500-gallon tank. The new tank will be 2’ longer, and there is not enough room to install it 10’ away from the building without impacting the field. Therefore, we will be installing the tank 7’ from the foundation. The bottom of the tank will be approximately 8’ deep. We do not know how deep the footings are, but if they are assumed to be 42” below grade the line of influence from the footings will not intersect the septic tank. There is no danger from putting the tank this close to the building. Please refer to the attached plan for the septic tank location. If this plan is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE 4/16/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181047, Rebecca Carroll, 04/16/18 HAMPTON HILLS #1, BLOCK 2 LOT 13A J � 10, TFC EXISTING WELL C � \ FgSFMF�T LOT 12 \ \ v LOT 13A / i '2CO On-site Water and Wastewater REVIEWED FOR CODE COMPUA OSP181047, Rem Carroll, 04 BLOCK 6, LOT 9A ZERMATT AVE ------ �- / / / BLOCK 1, LOT 1 EXISTING 43.5 LF, T WIDE, 8' EFFECTIVE DEPTH ABSORPTION TRENCH NOTE: ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. 0 50 100 FEET 1"=50' INSTALL NEW 150 0 -GALSEPTIC TANK AND DOUBLE CLEANOUT LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTERVALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE u 1 - GREk ` -NNCHORA�-E AREA BORT- r'`.. J Q Department of Environmental Quality ��:.. 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMETEYeCK+1 VC &W fCS MAILING ADDRESS 4s 07 P_e� �- PHONE 333- SZ%7'% LOCATION LEGAL DESCRIPTION_Li'AiD 1-0_N Hil k I31IC 'Z SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH Tec rcxcl� NUMBER OF MANUFACTURER _' 1" CY/^ MATERIAL _ql2rc, t COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY L-LbGALLONS. _ ' c TOTAL LENGTH DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE_LJ OF LINES �j3 NUMBER OF LINES ( DISTANCE BETWEEN LINES — TRENCH WIDTH,�b IN. TOTAL EFFECTIVE ABSORPTION AREA (r)q (40 SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE i -SI MATERIAL BENEATH TILE0. ABOVE TILE IN. WELL: TYPE/'Si.�D CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL OTHER SOURCES APPROVED vv DISAPPROVED REMARKS DISTANCES: �L� Dlt �� l,[5 DIAGRAM OF SYSTEM I rE1 INSTALLED BY: 344--8313 24*r Il, �^-`I �o 9"`Idr �n TTT �o I SEWER LINE DEPTH: --t) 1/Z-1 -- 5., I C. Calf%� u�okse PIPE MATERIAL: 6154 ',roil clk_� nra� rinc���. LOT SLOPE: c:Uwl, Tn. _5J0 K) P'bP�ed 4'eu REMARKS: Anwe DATE s/r/__7SAPPROVEO G.A.A.B. Form EQ -032 � 7 f�GRE%�' ` ANCHORAOE EA BOF i �► 3/-�%� i• - +'✓ ~•4 DEPARTMENT OF ENVIRONMENTAL QUALITY P Ir j 3330"C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4581 �(ezd CC SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT EXEGU77l1L' pG!/tDF_QS 9-P7 YrtK HUE J33 %J 2� NAME OF APPLICANT MAILING ADDRESS PHONE INSTALLATION LOCATION A T�.L LEGAL DESCRIPTION L CT 1-'o I C FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PR SECUTION. SEPTIC TANK SIZE ` Y - TYPE MINIMUM DISTANCES. REQUIREMENTS 'e- / SEEPAGE AREA SIZE FOUNDATION TO SEPTIC TANK lroc e 77L/ X Dl'PJPA FOUNDATION TO SEEPAGE P+P INSTALLATION OF: SEPTIC TANK RLT- DRAIN FIELD OTHER I .�(SEEPAGE AOQ-. l SC) i VAIN SEPTIC TANK . SEEPAGE TYPE AND SIZE OF FACILITY TO BE SERV TO NEAREST LOT LINE. / / / �L MOON■■■■■■■■■ WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD FINANCED THROUGH TO BE INSTALLED BY DRAIN FIELD / SEPTIC TANK,0� SEEPAGE 14T^DRAIN FIELD TO RIVER. LAKE. STREAM, FOIL TEST RESULTS NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST ' S�'-/�/ a' COMPLETION DATE ANTICIPATED 11 FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PR SECUTION. SEPTIC TANK SIZE ` Y - TYPE MINIMUM DISTANCES. REQUIREMENTS 'e- / SEEPAGE AREA SIZE FOUNDATION TO SEPTIC TANK e 77L/ X Dl'PJPA FOUNDATION TO SEEPAGE P+P DRAIN FIELD / 1( DE�7PY SEPTIC TANK TO SEEPAGE RCL WALL I 5-1 i VAIN SEPTIC TANK . SEEPAGE PIT FIELD TO NEAREST LOT LINE. / / / �L MOON■■■■■■■■■ WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD / SEPTIC TANK,0� SEEPAGE 14T^DRAIN FIELD TO RIVER. LAKE. STREAM, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION B FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. w•�� SGL',,/�O GRAVEL BACKFILL X2__21 /;z L/c L B//P+CF/cL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. 2FQ U/2E 2 /.JSPrer/cA/S OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.66 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. 7 7 -r - DATE APPLICANT'S SIGNATURE FORM NO. CO -014 / `J ,94-O. .5Ll/L/'n/j1-Ep P/c4A^assn puQUWfj I ■ MOON■■■■■■■■■ ■MM■MM■■■■M ■MM■MM■MM■■ ■ MMEMM■M■MM 0 MINIMUM= uM uu■■■u■MM El ■■MM■■■MMM I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.66 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. 7 7 -r - DATE APPLICANT'S SIGNATURE FORM NO. CO -014 / `J ,94-O. .5Ll/L/'n/j1-Ep P/c4A^assn puQUWfj Performed for Legal Descript on: This form reports: r. ►LSREATER ANCHORAGE, AREA DOROLe"'.!`1 --partment of 'Envirsnmental Qu,.i _ 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - PEROLATION TEST Date Performed Depth LoTi3 Feet 2- 3 4 _ / ✓ 42 5- 6_ , 41 8- / 9 10 14 - �Was ground water encountered? 5el If yes, at what depth? A) Reading Date Gross Time Net Time Depth to Water Net Drop Percolation rate minute. Proposed installation: S6'e age Pit Drain Field Depth of Inlet Depth to Bottom of pit or trench COFVIENTS: Performed G'yc_,Iy. J' 7 I�e-�.Certified EQ -040 (6/74) ,);1-70 0 '3!"700 y3 276 2 s -s �3 t?r M -W DRILLING, Inc. P.O. Box 4.1224 • 1310C International Airport Road (907) 274AGII ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner Executive Builders Use of Well Dom Location (address of: Township, Range, Section, if known; or distance main road— Lot 13, Block 2 Hampton Hills Size of casing 6" nepth of Hole 300 feet Cased to 162.2 feet Static water level 140 ft. (llbWA) (below) land surface. Finish of well (check one) open end ( x ) ; Screen ( ); Perforated ( x ). Describe screen or perforation 4" PVC Liner set from 3001 to 1401 with bottom 40' perforated. Well pumping test at 315gallons per (}siw) (minute) for—1 hours with 100/5 st, of drawdown from static level. Date of completion 25 Sept 1975 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness O TO 10 Silty, med.gravel 10 TO 13 Sand & Large gravel 13 TO 21 Silty, coed. gravel —21_TO3_ Silty gravel no TO 35 Med. gravel caving in- .i_TO 36 Boulder 16 TO 92 small C;rayPl 79 59 TO RA Siltg, mod—gravel 79 TO 90 Shale 99 TO 105 Silty, small gravel 105 TO 125 Sand, fine 125 Tp 134 Silty, med. gravel 134 TO 135 Gravel, med. 135 TO 147 Silty, med. gravel 1 —CUSTOMER M -W DRILLING, Inc. P.O. Box 4.1224 • 1310C International Airport Road (907)274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner Use of Well Location (address of: Township, Range, Section, if known; or distance main road_ Size of casing nepth of Hole feet Cased to feet Static water levet I. (above) . (below) land surface. Finish of well (check one) open end ( ); Screen ( ); Perforated ( ). Describe screen or perforation Well pumping test at gallons per (hour) (minute) for hours with ft. of drawdown from static level. Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO 147 TO 148 148 rn 160 Clean Gravel: dry watercourse Siltv Small Gravel 160 TO 175 Medium Gravel 175 TO 180 AIA: silty, dirty 180 TO 200 Bedrock: gray siltstone argillite, soft 290 TO 300 A/A: black, hardier TO Note: Small water seaps in sporadic fractures in last TO 50 feet of bedrock/ TO TO TO TO 1 —CUSTOMER nc&41 Munir 1pality of Ancl :gage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 29, 1993 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 13 Block 2 Hampton Hills #1 Waiver Request #WR930038, PID #015-134-64, HA930378 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 0 feet. 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. Sincere Daniel J. Roth Civil Engineer On-site Services DJR/ljm r ^ MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR930038 PID# 015-134-64 Date Received: July 7, 1993 HA# HA930378 Permit # Legal Description: Lot 13 Block 2 Hampton HIlls #1 Engineer: Ted Moore, P.E. Flattop Technical Services 14530 Echo Street, Anchorage, Alaska 99516 Applicant: paul/Beverly Proffett Waiver Requested: Lot line - trench to lot line - 0 feet Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: _X Waiver is NOT Granted: List Conditions or Reasons for above: SEE Eti6bvetRS AIT'9-CKf. o LrTTF►? Date: /--LV— By: ewer Rec #: 'a4S:)S Amount: $ '10.00 Date Paid: 1 -i -CIS FLATTOP TECHNICAL SERV CES u e ;�.-'..��+Wa�%.L.rti-. r..- ^�. ::b :.'1 �.a:I4l$�•i'1+~+.�r�iV:�::KP'�i. CIVn.6 ENMONMENTAL ENGNEERLVG • ENERGY CONSERVATION 6 A.WALYSS THEODORE. F. MOORE, P.E. July 6, 1993 PH: (907) 345.1355 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: 14530 ECHO ST. ANCHORAGE, ALASKA 99516 By means of this letter we are requesting issuance of a lot line waiver allowing the existing wastewater disposal trench serving the residence on Lot 13, Block 2, Hampton Hills SID, Addn. #1 to be as close as 0 feet from the property line abutting Zermatt Avenue. Copies of the septic system as -built inspection report and a new as -built lot survey which I have marked up to illustrate this waiver request are enclosed. The 1975 inspection report for the on-site sewage disposal system indicates that the sump at the end of the trench is 15 feet from the property line; it appears that the inspector was not aware that a 50 foot radius circle for a turnaround bulb at the west end of Zermatt Avenue had been carved out of the lot at the time it was originally platted. The 1993 as -built lot survey indicates that the sump at the end of the trench is actually located in the platted R.O.W., approximately 14.9 feet beyond the lot line. The property owner, Paul Proffett, has obtained the enclosed encroachment permit allowing the system to remain in the R.O.W., and is in the process of vacating a portion of the R.O.W. circle, which will ultimately result in the septic system being on his lot. The lot line waiver is needed because the trench presently does cross the property line, and even after the vacation is complete, will be within approximately 2 - 3 feet of the property line. Issuance of the lot line waiver should not be controversial, because M.O.A. Dept. of Public Works has already indicated their non -objection to the location of the system, and it will have no impact on the ability of adjacent property owners to construct future water supply and wastewater disposal systems. Please give me a call if you have any questions on this waiver request. Sincerely, T-4 C- Ted Moore, P.E. cc: Paul Proffett 3 yL�k 00 ?2 NOTC-: T#IS OAAWING ffAl 171a OF .44'j411 i *•,'r�9 �1 i '49IH� '' Shone A. Hall •�g� Sr,, •., IS 6911 �' a e MA-Ate60 UP 7'1-.P SNoW THEE i-&chrlON OF THE pF10 POSEo F•urUAE F.c•r LING, AFTMR A PORTION OF ZC-R"xrr A-OGNUIF R.o.tu. N -AS CiEE,v VAcA.rr-D. �T THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS EASEMENTS OF RECORD, OTHER RETWEN EXISTING STRUCTURES AND PLATTED LOT LINES THAN THOSE SHOWN ON THE OR EASEMENTS AND IS NOT TO RE USED FOR POSITIONING RECORDED PLAT, ARE NOT ADDITIONAL STRUCTURES OR FENCELIMES SHOWN HEREON N V PX9,, Q � r •� ms's.. 0 `� tet• 3 N U eu \ I 1" 40• AS•RUILT SURVEY (NO CORNERS SET THIS DATE) 1 hereby certify that I have performed • Mortgagea•s Inspection of the following described property) LOT 11, BLOCK 2, HAMPTON HILLS SUR., ADDITION NO. 1 Anchorage Recording District, Alaska and that the Improvements situated thereon its within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no leprovwwts on property lying adjacent thereto encroach on the premlass In question and that there are no roadways, transmission lines, or other visible easeawnts on sold property except as Indicated hereoVv Dated at Anchorage, Alaska this 2_ day of U14me 19'L3 . f0/7-/ HOLT AND ASSOCIATES LAND SURVEYORS /yo 240 2,5-11'0 � tltlr ti J a�a`r. ti s o��c to d u ■i 3 N U eu \ I 1" 40• AS•RUILT SURVEY (NO CORNERS SET THIS DATE) 1 hereby certify that I have performed • Mortgagea•s Inspection of the following described property) LOT 11, BLOCK 2, HAMPTON HILLS SUR., ADDITION NO. 1 Anchorage Recording District, Alaska and that the Improvements situated thereon its within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no leprovwwts on property lying adjacent thereto encroach on the premlass In question and that there are no roadways, transmission lines, or other visible easeawnts on sold property except as Indicated hereoVv Dated at Anchorage, Alaska this 2_ day of U14me 19'L3 . f0/7-/ HOLT AND ASSOCIATES LAND SURVEYORS /yo 240 2,5-11'0 MUNICIPALITY OF ANCHORAGE ENCROACHMENT PERMIT THIS AGREEMENT, made this day of J , 19, by and between Paul G. Proffe n Beverly M. Be Proffett, and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". W I T N E S S E T H: WHEREAS, "PERMITTEE" is the owner of the following described property: LOT 13, BLOCK 2, HAMPTON HILLS SUBDIVISION ADDITION NO. 1, according to the official plat thereof, on file in the office of District Recorder, S.M. Alaska, and; WHEREAS, "PERMITTER" owns and maintains the 50 foot street right—of—way this street right—of—way is more particularly described as follow: The 50 foot right-of-way at the southwest corner of the intersection of Olympic Street and Zermatt Avenue, and; WHEREAS, "PERMITTEE" has constructed a septic drain field which encroaches upon "PERMITTER'S" right—of—way; NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The "PERMITTER", acting through the Director of Public Works, hereby grants to the "PERMITTEE" the privilege of allowing its presently constructed septic drain field to encroach upon the "PERMITTER'S" street right-of-way a distance of 14.9 feet as shown on Attachment "A", included herein. 2. The "PERMITTEE" agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought by any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal',-Cc�co:istruction7,060etat�6ns_„ use of removal of the encroaching septic drain field situated upon "PERMITTEE'S" property and encroaching upon "PERMITTER'S" street right-of-way as described herein. 3. The "PERMITTEE" shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Public Works. 4. This Agreement and Permit grants "PERMITTEE" no interest in "PERMITTER'S" real property whatsoever, except only the encroachment rights described herein. 5. The "PERMITTER" reserves the right to revoke this permit upon twenty days (20) written notice to the "PERMITTEE" The "PERMITTEE", agrees upon said notice of revocation, to immediately move said encroachment from the street right-of-way. Should the "PERMITTEE" refuse or fail to comply with said written notice, the "PERMITTER", may without further notice to the "PERMITTEE", remove or cause to be removed the encroachments, and the "PERMITTEE" hereby agrees to reimburse the "PERMITTER" for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the "PERMITTEE" hereby promises to pay the "PERMITTER" a one-time permit fee of one hundred dollars ($100.00). IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day and year first hereinabove written. Grantee: Grantor: MUNICIPALITY OF ANCHORAGE 2 At -of -=way En orcemen Supervisor 07-06-93 ' 702.85 *100.00'U' STATE OF ALASKA ) )ss THIRD JUDICIAL DISTRICT ) HIS IS TO CERTIFY that on this day of 30 19 5 before me, the unders gne a Notary Pu n an for }Tie Stade —of/� Alaska, duly commissioned and sworn as such, personally appeared .fian 6J. // For' , know to me to be the Right—of—Way Enforcement Supervisor for the Mun cipality of Anchorage, Alaska, who executed the foregoing instrument, and he/she/they acknowledged to me that he/she/they executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he/she/they was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. My Commission Expires: My CommUYonExpirh: 1pr114,1994 STATE OF ALASKA ) )ss THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this day of 19g�3 , before me, the undersigned, a Notary Pub in an or a Sta eAlaska, duly commissioned and sworn as such, personally appeared t / �_ know to me to be the individual name a ein w o cu the foregoing instrument, and he/she/they acknowledged that he/she/they did so freely and voluntarily for the uses and purposes therein mentioned, and on oath stated that he/she/they was authorized to execute said instrument. WITNESS my hand and official seal on the day and year in this certificate first above written. PUBLIC in an or A as a My Commission Expires: MYCommlutres --ApN11,19941994 3 07-06-93 702.0 *100.006 JUN -02-93 WED 13:21 MOLT LAND SURVEY 9073433713 P.01 _ e BYu, 'Jan. Of 00 �•`�� Shona A. Halt �� si,.�•,• IS 6911 •� •Oe,� ,,SEG .6.0 ........ ry0yi ,, QOifSSICHAII ` �l�toc`imen�` �`�l • THE INFORMATION HERECN IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS EASEMENTS OF RECORD, OTHER 11MEEN EXISTING STRUCTURES AND PLATTED LOT LINES THAN THOSE SHOWN ON THE OR EASEMENTS AND IS NOT TO RE USED FOR POSITIONING RECORDED PUT, ARE NOT ADDITIONAL STRUCTURES OR FENCELINES SHCWN HERECN C AS•SUILT SURVEY (No CORNERS SET THIS DATE) I horsey certify that 1 have performen a Mortgagoe•s Inspection of the fottoring described prapertyt LOT 13, BLOCS 2, HAMPTCN MILS SUB., ADDITION NO. 1 Anchorage Recording District, Alun am that the Improvements situated thereon ire within the property tines and do not overlap or encroach on the property tying adjacent thereto, that no Ittpreveaewtts on property lying adjacent thereto encroach on the preetua In question and that there are no roed.ays, transmission tines, or other visible easeernts on *aid property except as Indicated hereon. Dated at Anchorage, Alaska this 2AJ day of a^d 19n. FB/7•/ HOLT AND ASSOCIATES LAND SURVEYORS ."'IZL A .00.00.00 N Ln s ? 3.I ti Q •wui.a a Nor II � _ n vi 12 1 4t 1142 CA t T�� o$oY� ♦ t gg$r-•7op J"8 o• -map Q d�ME t t t t t m �Y N�p�1i5S+•N�y �.tl y � �fl 4� •YYt� • �•� IIS I +u+'�y"1�•l•G� •l �N �N �8 b u+ � s r� Ct s � i• 1 inn urun oiao3n it 3NOH.UM .01 !►'roN DRIVE - r CA I � o -1 ■ L s , I �s�� I � �Ly1 •.g� I �W I e itl) co .00zz�Q CCmit r Q N .00.00.00 N L ONNY70 JO SG"In 7 �pL Yj Dm~ W 0 OA N eix� s Ale D on • S GE B` Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 SAF ETY Certificate of On-Site Systems Approval Parcel I.D. 015-134-95 Expiration Date: [ (9 `3 1. GENERAL INFORMATION Complete legal description Hampton Hills #1 , Block 2, Lot 13 Location (site address) 7740 Zermatt Ave. Current Property owner(s) Linda Wrigley & Walter Quigley Day phone Mailing address Real Estate Agent Kevin Taylor Day phone (907) 244-7437 2. TYPE OF DWELLING: E Single Family (w/wo ADU) 111 Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: L4f d-ite ttl fl trCe Date: -1/3-0 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ a U21-5° Waiver Fee $ Date of Payment 1(l i 1 Date of Payment Receipt Number 0 HO MO Receipt Number COSA# 0)CA.8 (327 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 Forge Engineering Phone (907) 522-7773 Address PO Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, PE Date 6/06/18 p F \v�\ • * 49 TH �� * 6. DSD SIGNATURE <� E System #1 Approved for J bedrooms . Michael E.Anderson ."'/�-1 System #2 Approved for bedrooms r�+#�Fcsr. Y 4`81;E .�.:.c' Disapproved �ill��\F`�IO,`' Conditional approval for bedrooms, with the following stipulations: \Q i,\V 1' OF 444 J` O ON_8171 - WATER AND m. WASTEWATER PROGRAM p aN •�. nrc- 1 By: J 1��--. Original Certificate Date:-7 E - 1 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_f c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Hampton Hills #1 , Block 2, Lot 13 Parcel ID: 015-134-95 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 9/25/75 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 300 ft. Cased to 162.2 ft. Casing height (above ground) 38 in. FROM WELL LOG AT INSPECTION Date of test 9/25/75 3/27/18 Static water level 140 ft 127 ft. Well production 3.5 gpm 4.0 g p m WATER SAMPLE RESULTS: Coliform N- colonies/100 mL Nitrate li) mg/L Arsenic kl D ug/L Date of sample: ( � L I , I, Collected by: Poi'(�� t n(I���/l J B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/22/18 Tank size 1 ,500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping New Const. Pumper C. ABSORPTION FIELD DATA Date installed 8/05/75 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF' System type Deep Trench Length 43.5 ft. Width 3.0 ft. Gravel below pipe 8.0 ft. Total depth 12 ft. Eff. absorption area 835* ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/22/18 Results (Pass/Fail) Pass For 5 bedrooms Fluid depth in absorption field before test 51 in. Water added 868 gal. New depth 59 in. Elapsed Time: 1440 min. Final fluid depth 3 in. Absorption rate >= 750 g p d None Any rejuvenation treatment (past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout X100' Sewer/septic service line >25' Holding tank X75' Animal containment areas >50' Manure/animal excrete storage areas X100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation **7.5� Property line >5' Absorption field >5' Water main >10Water service line Surface water Wells on adjacent lots X100' ABSORPTION FIELD ON LOT TO: Property line 10 Building foundation Water main Water Service line >10 Surface water 100 Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS *Recent Test Holes and Percolation Tests indicate sand (SW) with absorption rates <5 Min./Inch. **Bottom of tank is above 1 :1 influence line from footing. G. ENGINEER'S CERTIFICATION �-��0F AC��`i I certify that I have determined through field inspections and P��O. ''9S ��+ review of Municipal records that the above systems are in /rC0.. �4A •:7y +j conformance with MOA COSA guidelines in effect on this date. *; 49 TFI /\ ••* Engineer's Printed Name Michael E. Anderson, PE Od 111(A-ti v1 �C';_ tl Date 7/09/18 • Michael E.Anderson/ r+ ?'es•• 4381-E •••(� 1� se,�..-..7-i.3.-(.6\.• vm 'k\F°PROFESS�oN .. COSA brown sheet 10-10-12.doc w N Unsubdivided 8298W c 0 /Found r rebar Found 5/8"rebar U / N89°42'31"E 267.52 ---30. q Zermatt Ave. - - © ITo 10'T& E Easement 3,;(1 1p ..�c'oo�: �s0 00 co o 9 co cO. a mac• [- — ound 2i•Aluminum 11'• • :., J Monument ra) coQ'Q;`�G _ e Lot 1 ~ W °',. Prospect Heights 0 - ,�°° .0 c`y Addition No. 5 :_ f s�Op F.>,. py Je, is G o 0.5 LOT 13A so °° q)c. 122 SCALE: 1 "= 30' ~o 66 1-x• ,O shed o LOT 14 • \, s° s� 1:)�0 " �%:%.11.X '° 39.6 d- a4. rn ,� ,� of • •A�gS11 _, O WELL /cfi . .. a) :1- / F izabeth L. Walatka. P \ E Co /$ %• 8036 - LS •"• ,I.q- : "Fo •. • . • •• o _" \ \ \ Y, O w Co 1' ';orEssiot4``�� N ° z 7- 2- k 67°ss, \ \ 0 Staked &flagged East and North property limes 5-2418 41"IA t— RECERTIFIED 5-21-18, 6 25 1./WO AS-BUILT NO CORNERS SETT! RATE 32,' �6' 'oI��' i. I hereby certify that I have performed a Mortgagee's inspection ase ,, of the following described property: LOT 13A, BLOCK 2, yF -e,1 HAMPTON HILLS SUBDIVISION, UNIT No. 1 LOT 12 ` , — anchorage Recording Precinct,Alaska, ana mat the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying -, adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other J visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 28th day of April ,2006 EASEMENTS OF RECORD, OTHER THAN Found 2 2/2"Aluminum 4w Monument FRED WALATKA&ASSOCIATES, L.L.C. THOSE SHOWN ON THE RECORDEDI Engineers and Surveyors PLAT ARE NOT SHOWN HEREON. Fb 06-3, pg 25-26 Fb 18-3, pg 30-31 907-248-1666 Municipality of An Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-134Ag5I COSA #_ 0(p D Efl Expiration Date: — - O Co 1. GENERAL INFORMATION Complete legal description Let 13A, Biocc 2, Hampton Hils SubdMsion#( Location (site address) 7740 Zermatt Drive Anchorage, AK 99516 Current Property owner(s) Ricardo Felix Day phone Mailing address 7740 Zermatt Drive Anchorage, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Jody Moses Day phone 242-3137 Mailing Address Unless otherwise requeslod, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three (3) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El 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 Onsite Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent. professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal'and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be. reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineers work. 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 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 Anderson Englnisering Address - P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 Date X006 ! 49th` 6. DSD SIGNATURE jtmp!Am r- mmsom 1/ 1�f No. a-4 Disapproved. 3 bedrooms. �i�•/,,a, �� Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checidist _X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. C7417U90r Original Certificate Date: _'6--j-06 (n«.,,os) Municipality of Anchorage Development Services Department Building Safety Division OnSRe Water & Wastewater Program • 4700 Bragaw Street P.O. Bar 198850 Anchorage, AK 99519-850 www.muni.orp/onaRe (907) 343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Let tali Brock 2, Hwn mo Has &bdrvwm Parcel ID: 015.1aA_9 r A. WELL DATA Wen type Pdvete H A, S. or C provide PWSID C _ Well Log (YIN) Y Data completed arms Sanitary seal (YIN) Y Wires property protected (YIN) v Total depth soo R. Cased to L52 R Casing height (above ground) >24 in. FROM WELL. LOO AT INSPECTION Data of test 9=75 4r25noos Static water level 140 It. t22A fL Wen production 35 g.p.m. 7.0 g,p.rn. WATER SAMPLE RESULTS: Coliform o coloniesh00 mL Nitrate No mgA. Other bacteria 0 colonies/100 mL Arsenic: RD mg/I Date of sample: 4/17= Collected by: L Hwnwdm B. SEPTICIHOLDING TANK DATA Tank Type/Material aeoadsred Date installed 8WO75 Tank size 1250 gal. Number of Compartments Orw Cleanouts (YM) v Foundation cleanout (YM) Y Depression over tank (YM) N High water alemr (YIN) N Date of pumping 4116!2008 Pumper Ord MacD~s Pmft C. ABSORPTION FIELD DATA Date installed SM975 Son rating (g.p.dA? or ft2/bdrm)225 aFBDRM System type Deep Tmech Length 4&5 R Width arewm 3 ft. Gravel below pipe 8 R Total depth 11t13 2 Elf. absorption area A' Monitoring tube Y Depression over field N Date of adequacy test 4MAN Results (Pasa/Fam Pan For 7N" bedrooms Fluid depth in absorption field before test 41.2 in. Water added 80.2 gal. New depth in. Elapsed Time:1.440 min. Final fluid depth 41.5 in. Absorption rate >c 450 g.p.d. Any re)uvenatbn troab hent (peat 12 mo.) (YM & type) H yes, give date D. LIFT STATION Date installed 'Pump on' level at _ In., Datum E. SEPARATION DISTANCES Size in gallons 'Pump off" level at _ In. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot >tar Absorption field on let Public sewer main WA Sewer /septic service One >25' Animal containment areas WA Manhole/Access (YIN) _ High water mann level at Meeh alertn & dr pdt requaemems? On adjacent Iota >tca On adjacent Iota >10a Public sewer menhoWdeanout WA Holding tank WA Manureh]nmal exrete storage areas WA SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation >s Property One>S Water main WA Absorption field >s Water service One >19 Surface water >tae' Wells on adjacent lots >tar SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One a Building foundation >ta' Water mein NfA Water Service One >tQ Surface water >tar Driveway. pandrilksNele storage >s Curtain drain None Noted Wells on adjacent lots >toa' F. COMMENTS: SftLot Lim Wal artarAbserpamTrento G. ENGINEER'S CERTIFICATION I cer* that I have defemdned Mtmgh field krspecf = and review Of MunibW re00nfs that the above systems are in coNormance wJfh MOA COSA guldellnes a► effect on olds date. Engineer's Printed Name Mwrsel E• Anderson. P.E. Date srsnsoe COSH Fee 8 30 Waiver Fee $ _ Date of Payment Date of Payment Receipt Number S Receipt Number. (nev. tiros) e in. m m 5-2 D 00 >mm m=Z z0-' 1 0 =zm M;0 =;uO .Z1 0 0 z;um v m� v= z Z �T w I o 0 V A r O .i A NORTH 121.83 I a T& E Utility Easement / /------------------1 I / It L / I / I / I / I / I / r I r 0 / I O ) / —I Y i V N �_ /It I Q / I / Iw / Im Ile I It qel' y T It / I F $ I I It I / I v':;•«fir.;,j . V. It It It OIt�O 1;, •1. It %.It m / L------------- T-- — 10' T & E Utility Easement q 0 0 0 z m ca 2 Cl) a m N00002'04"W 213.94 >CL a O N v = 0 Z = 0 CD al t5 cn r- 0 co to .P. N C3 M N rn V N C CD C 0 c Cr CL* : CD CL mifer St. Nmm�—,yna�3 ' av =mr(OD $ . OCL .m+ • m m ; (D (D M'ID 7 p O O ^ N v� m O 01 m o� 0cr c m vID r : m m 04 CD CD 0 =1 �$��� Rcn c IbiiO�m O CO N O iR .0 g 0 0 8;�� 3 M N 10' T & E Utility Easement q 0 0 0 z m ca 2 Cl) a m N00002'04"W 213.94 >CL a O N v = 0 Z = 0 CD al t5 cn r- 0 co to .P. N C3 M N rn V N C CD C 0 c Cr CL* : CD CL mifer St. MUNICIPALANCHORAGE • �' DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On Site Services Section to P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # I - in Ll HAA # 11 GENERAL INFORMATION Complete legal description Loa 13, SLK 2 9AMPTON HILLS it Location (site address or directions) _77'40 ZERMATT AV -_ ANLHoRA E 1 AK 89516 Property owner PAUL iBEVERLY PROFFETT' Dayphone 20-95gS' Mailing address 774o ZERMATT ANru Ak g9,5/L Lending agency Nnrtaeyk Har-I-oay& Day phone 27G- YZro Mailing address—_ 2SSV Oe+al; SA.,Cu Fe_ IYOd 4AMoi� Ak 99t oT Agent KEN Mc KEAN REMAx Day phone 276' -2-767 Address 2600 Cordae -C-1. f}AcAororoe Ak 9gSa3 Unless otherwise requested, HAA will be held for pickup 2. NUMBER OF BEDROOMS: 3 V 3. TYPE OF WATER SUPPLY: Individual well _y1*1 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. 72-025 (Rm. 1,91) pool MOA D21 5. 6. M 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 Sfate codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm F laJLI oe T-ecti n t ecIf Se. -vita Phone ? ys--I3ss Address /HS30 6ctio Sfftr nc� P A -h 99Sre Engineer's signature Z4�'t� -f wle� Date 7u ty DHHS SIGNATURE 49TH ................ THEODORE F. 400RE CE -35£1 4 p ac P RfA�'.a�'�• X_ Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments S 611 Pa ay bedrooms, with the following stipulations: Date Z -9f—.P_3 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 thei r tending 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. rros Mw. iAn Back MOA m Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lor 13 Bk 2. HAMPTON lirccs u' parcel I.D. A. WELL DATA Weil type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) y Date completed 1121hr Driller_ -M -W PRILLIA16 Total depth 300 P Cased to 162 Casing height 33" Sanitary seal (Y/N) y Wires properly protected (Y/N)y FROM WELL LOG AT INSPECTION Date of test 9 12575 12q MUNICIPALITY OF ANCHORAGE ..,,enNNsF_NIALSERVICES DIVISION Static water level Well flow Pump level IYD' 3.5' g.p.m. SEPARATION DISTANCES FROM WELL TO: 12 1Y 1; 071993 civE� > ZyN' Septic/holding tank on lot Ito` -ro C.o . -;On adjacent lots > /oo Absorption field on lot -- /20, to GO. : On adjacent lots > roo Public sewer main > too, Public sewer manhole/cleanout loo' Sewer service line loot Petroleum tank NONE OBSER✓Eb WATER SAMPLE RESULTS: Coliform O cot 1100Me Nitrate 0.1 ale /.0 Other bacteria -004d rysorhrd( Date of sample: _411,193 Collected by: - ELAT7aP TEcp Svcs B. SEPTIC/HOLDING TANK DATA Date installed 2151/75 Tanksize 1260 6AL Compartments Cleanouts (Y/N) - Y Foundation cleanout (Y/N) % Depression (Y/N) N High watei alarm (Y/N) N.A. Alarm tested (Y/N) - N.A . Date of pumping Tutt, 7� 1993 Pumper_jrLaacr SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot - 110' FRon CO. On adjacent lots > 100' Foundation Io Fk,n C.O. To property line 30' Absorptionfieid 10 Water main/service line Soy Surface wate r/drainage >/001 72-026 (Rev. 7191) Front CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) —Manufacturer— Manhole/Access Manufacturer_Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water Date Installed ' SJ'S� 7S Soil rating 215 91 /BDRM System type TRENCN Length 4 3 Yt Width 3 7 Gravel thickness 8 Total depth It .S - 13 Total absorption area 9to O Cleanouts present (Y/N) y Depression over field (Y/N) N Date of adequacy test 5/26l93 Results (pass/fail) Po,sd -for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) NONE KNOWN If yes, give date N .A . SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 122 On adjacent lots >100' Property line To building foundation 19' FRon Go . To existing or abandoned system on lot N.A• Onadjacentlots > 50' Cutbank N, A. Water main/service line 50 Surface water > 1001 Driveway, parking/vehicle storage area S Curtain drain 'NONE 085ER✓ED E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. A•w,.......',so � � `. i/ ' Signature l' TH Engineer's Name Th",:eOrr /-tcx7.r �••••••••••••••••••••••• ..Q t......... .....�... Date ✓" ()C_6� N9 3 �� THEODORE F. MOORE ••� CE -3589 �•p +14 lgly fpf1,,•�•kwta�E®�� HAA Fee $ 0 '0170 Waiver Fee: $ 7d ter' I'^ e Date of Payment 1. 1.9-5 Receipt Number 2A 2/7-1683( 72-M (A". 3191)Beck MOA 21 Date of Payment -1 '1 -93 Receipt Number ;;LL)fi1S MUNICIPALITY OF ANCHORAGE • Department of Health 6 Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel l.D. # (1l'�n- j 2,L`-LLj HAA It 0 Qqa 1Q'Zn 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) .41362- /////.r -1/ Location (address or directions) ... ....; ' P. (b) Property owneJ•^i 0 Telephone: (home) Business Mailing•Address ' ' (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family;f Number of bedrooms_ 3. WATER SUPPLY Individual WeIl1iZ( Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. ' 4. SEWAGE DISPOSAL On-site)4 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025(A..mee) Page 1 of 2 Z 10 Z abed %'we (Mc•Mal smU •NJom s,Jaau!6ua !euo!ssa;oJd 941 u! suo!ss!wo Jo sJoJJa Jo; olq!suodsaJ jou s! 96eJoyouy;o Aj!led!o!unVj 9y1 •ponss! sl also!plJao a aJolaq elep azAleue Jo suo!loadsui lonpuoo lou op SHHC;o s9aAo!dw3 •sluewaJ!nbaJ Owns Pug!eJapa; u1e3Jao A;s!3es 0318pJo u! suo!3ni!jsu! 6u!pua! J!ayl pug sawo4;o sJaseyoJnd o3 AsolJnoo a se S!y3 saop SHHO 041'e%se!y10 91eIS 841u i paJOIS168J Jaaul6ua!euo!ssa;ad juapuadapu! us Aq anoge S ydeJ6eJed ul uaA!6 suoi3ejuasaJdaJ 9yl uodn A!uo paseq paled!;!Jao !en0JddyAj!Jo4jnV 4jleaH sanss! (SHHO) saO!AJaS uewnH pug y31eaH;o luawjJedaC a6eJoyouy;oAl!!ed!o!unIN 941 1,�-7L,i -4 !gnoJddV !euo13!pu0010 swJa1 !euogjpuo0 panoJddes!C k PaAaddV Aq swooJpaq J 0.IJo; panoJddV A IVAOHddV SHHO '9 f yr OIL(] rssj auoyda!al '�S7 wJ!d;o aweN •uo!joadsut s!yl;o alep a43 uo loa;;a ul suo!le!nbaJ pug 'saoueu!pJO'sapoo OMS pug !ed!o!un!N pe yj!m aOue!!dwoo ut Si! wa3sAs !esods!p Jalemajsem Jo/pue A!ddns Ja3eM a3!s-u0 a43'uoiloodsu! Pug uo!le61ls9nu! Aw woJ; Pug Sal!; a6eJoyouy ;o Apled!o!un!ry a43 woJ; pau!gjgo uogewJolu! a43 uo paseq jeyl A;!Jan JayUn; I 'u!aJay pa3eo!pu! aJnjonJls;o edAj pug swooJpaq;o Jagwnu ayl Jo; alenbape pug !euo!loun; 'a;es s! wa3SAS lvsoislp JaleMajSEm Jo/pue A!ddns Jalem allS-uo ayl jgy3 SMO4S !eAolddy A3!Jo4lnV gIleaH s!yi;o u011e611sanu! Aw1ey3 A;!Jan I Imo!aq uMoys ajep uo!jep!!eA ay3;o se pug o3aJay pax!;;e!gas Aw Aq pa!;!3Jao sy NOIIVWHOdNI CNV V1VC'HOUV3S 3lid'S1S31'SN01103dSNl ON wOIdd WHIJ ONIU33NIJN3 S 01 PNGNOR N\G�vp,� �SE0.v\`E5 E��RO�ENW', i9a9 A. WELL DVJC�'`v�o ,0r, ✓,4e Well Classification MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Well Log Present �91N!) Legal Description: L / 3 Q2 Na -.?i,. /,-///S- Well /s If A. B, C. D.E.C. Approved (Y/N) A* Date Completed Zr5l+PY /9'71' Yield Cc Qrfai f! tiG F.srd/�,L Total Depth 3 00 Cased to lkZ'F Depth of Grouting uN,e4U0un Static Water Level /1f -5- Yy! B •"^S Pump Set At -y�, ��,� N• r Casing Height Above Ground `3 Sanita S I C ' Electrical Wiring In Conduit�N) . SEPARATION DISTANCES FROM WELL: ry ea on asmg&IN) Depression Around Wellhead (YO To Septic/Holding Tank on Lot _ALL);? 1 ; On Adjoining Lots > /ao / To Nearest Edge of Absorption Field on Lot -- /,7n, ; On Adjoining Lots ->/0o r To Nearest Public Sewer Line A�llf To Nearest Public Sewer Cleanout/Manhole 'y/'R To Nearest Sewer Service Line on Lot ? SZ' Water Sample Collected by / • 124;j , Date iZ6ZS9 Water Sample Test Results kve4',4- Comments At.4 1-144 V,tVCL„V B. SEPTIC/HOLDING TANK DATA Date Installed g' > 7 Size / Z J�D No. of Compartments Standpipes (5N) Air -tight Caps &N) Foundation Cleanout ( Depression over Tank (Yo Date Last Pumped 7 SDI" 1 Pumping/Maintenance Contact on File (Y/N) X12 • for _- AJ/ -4 Holding Tank High-'Waferj�far5fY/N) Temporary Holding Tank Permit (Y/N) 41 SEPARATIOt4 DISI -KNEES FRCtM,�VTIC/HOLDING TANK: To Water -Supply Weil "N~ ?CO+ To Building Foundation To Property Line To Disposal Field /L t ` ...........,..•....•,. To Water Mlio/gAi eliner'9' >c3b/ • �•++'.iJ • F To Stream, Porld,.Lake or, MaWr Drainage Course Comments - 72 -026 (A". omments 72-026(A". 7/88) F, nl Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata o7a Type of System Design Tr e e 4 Date Installed Length of Field 7`•? • S Width of Field 76 Depth of Field / Gravel Bed Thickness Square Feet of Absortion Area 6 V Statndpipes Present&VN) Depression over Field (Y& Date of Last Adequacy Test ?L7Z�Z Results of Last Adequacy Test �L✓' SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well /30 To Property Line 5 To Building Foundation 7s To Existing or Abandoned System on Lot NIA : On Adjoining Lots > 30/ To Water Main/Service Line 720 To Cutback (if present) N/A To Stream, Pond, Lake, or Major Drainage Course >/oo To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed . Size in Gallons "Pump On" Level at — High Water Alarm Level at Tested for Meets MOA Electrical Comments Dimensions Manhole/Access Level at Vent(Y/N) Pumping Cycles during Adequacy Test. "Check Permitted Bedroom Rating Against HAA Request' certify that I have checked, verified, or conformed to all MOA and HAA inspection. / , Signed i 59 , Company * Date 7 162/��F d MOA No. Receipt No. �2-1,�-6 �Z- r73,`3 Date of Payment Amount: $ Receipt No. _ Waiver Fee: $ Date of Payment 72-026 (8.,,.7/88) Back Page 2 of 2 on the date of this •• • C. ofto, ]IC.f; 1 • •• CE -2251 ••* "A Seal n _ W. • INSPECTION APPOINTMENTS DATE RECEIVE TIME TIME TIME / DATE DATE DATE —71c?�.Q INSPECTOR INSPECTOR INSPECTOR ro /� MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & -\ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL F: OTECTION 825 L Street - Anchorage, Alaska 88501 1 JUL 2 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264.4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPS RTYOWNER t� ANA L . C( �S �� PHONE ll i,- 34{I -(cl to MAILING ADDRESS 53Z k -- f3o X zo ,+S • A)c--, cq -I- PROPERTY RESIDENT (If different from above? PHONE T. BUYER PHONE 32—.V MAILING ADDRESSUn���^ 3. LENDING INSTIT/•IT.IIOON ZINAT'[. PHONE -13 Ste$ SL MAILING ADDRESS STCG�T 4. REALTOR/AGENT c' Sk—GL t! 0E NS PHONE Z7U-27( 1 MAILING ADDRESS c.C- vl G ►a i 5. LEGAL DESCRIPTION GUT 3, Bt,OCtc z, �AAwiPTOA► HILLS - STREET LOCATION co2tjc� �I7 p MATT co I -F 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS B -'SINGLE FAMILY ❑ One &r ---Four ❑ Other ❑ MULTIPLE FAMILY ❑ Two ❑ Five ❑ Three ❑ Six 7. WATER SU LY L INDIVIDUAL' a ATTACH WELL LOG. A well tog is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM G�--'INDIVIDUAVON.SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUSTACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or 01-folding Tank Size: I If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS OY 3 ' V APPROVED FOR' BEDROOMS ❑ CONDITIONAL APPROVAL (letter mustac pany certificate) ElDISAPPROVED DATE 1I BY\^/ 72010 (Rev. 6/79) moi' • n -Municipality d" Anchorage July 9, 1981 r"N, \ 825 "L" STREET ^-R+� ANCHORAGE, ALASKA 99501 (907) 264-4111 GE GR GE M.SULLIVAN. MAYOR DEPARTMENT OF HCALTH AND ENVIRONMENTAL PROTECTION Diana L. Orren Star Route A Box 2048Q Anchorage, Alaska 99507 Subject: Lot 13 Block 2 Hampton Hills Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for �II our review. ct(2) The septic tank pumped with a receipt submitted to this office. (3) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system 4' is adequate according to National Standards. A listing � qf rivate firms performing the test is enclosed. This L},e rt needs to be submitted to this office for our r4e7are any further questions, please call this office \\ at r �3utT�� \Sincerely, 5> Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: First National Bank of Anchorage 8 Debbie Post Office Box 4-2090 99509 Skell Goens % Re/Max Properties . • (0�*\ r'` ALASKA Cf 1110f1MRAL COIITROL SCRUICCS, Inc. Enqinetrinq 6 Enuironmental Studies MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION JUL 171981 6/15/81 RECEIVED. i•Tr} b •.• • s • • •••t•Ia t THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 696 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SOUS RATING OF THE SYSTEM AT CONSTRUCTION WAS 225 AND NOP1 IS 232 SOFT/ BEDROOM. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK'WA4`PLMPED ON 6/15/81 . ��'�Q:•• A ••..salt.:' .. ►�• 221.4 4 +R 1220 West 25th Auenue 9 Anchorage, Alaska 99503 0 (901) 276-1361 Time APPLI^MT FILLS OUT UPPER HAI -''-ONLY Time Time Property Owner J4 M f r d /iyC, o f ,ti • K kf. Phone i Mailing Address 5/7A Olt zip Code '719'60? 4'r to Buyer / Dale Date Address - Inspector Zip Code Lending Institution �1ZsCf�.h ��� ��m Mpr�,L �T Phone Address Zip Code 4 Realty Co. 6 Agent .nGn�-c Phone Address ( ) APPROVED BEDROOMS Zip Code ( ) DISAPPROVED Legal Description ZOt f 3 /3 /oC Z <'%+n//i /�l /1n 1./ Street Location Type of Residence Date Sewer Installed Well To Absorption Area ;Single Family Septic Tank Size O Multiple Family No. 01 Bedrooms ❑ Other Water Supply /�� )4 -Individual = .1 ATTACH WELL LOG. A well log Is required for all wells drilled since June 1975. O Community For wells trilled prior to that date. give well depth (attach log If available). O Public Utility Sewer Disposal P�Jndlvldual L Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time 4'r to Date Date Dale Date Inspector Inspector Inspector Inspector Field es: ( MUNIC1PALITY CF ANCHORAGE 4 CE?I CF Y4!t'rl ., ENVI.(CA:;KNrAl. P93fiCTION APR ;& 7 EZI-, RECEIVED ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE Ll' --7"Q) BY: Solis Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72 W3 iA 0 .,tATER ANCHORAGE. ARCA BOROU,.,1 Department of Environmental Quality ' 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER E WATER FACILITIES ' Type of Inspection: CMRO VA FILA CONV (/ . 2. Property Owner: 4 6. 7. 9. Mailing Address: n„_ &P 7219 Day Phone2yVAI, r Name of Buyer: Mailing .Address: r'i/;< 41.. p, &1zy Day Phone Name of Lending Institution: Mailing Address: Phone , Name of Realtor or.Agent: Mailing Address: Legal Description: Location: 151r Phone Type of Facility to be inspected Water Supply I `�� 3' iJo. Bdrms Type of Supply: Public Utility Individual k If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual,date of installation A 7f r 1:30 - rr 7-5 MUNICIPALITY MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner:1-,-.•.= Mailing Address: j A Az -g:- Day Phone � S 3:6.7,,�Y 3. Name of Buyer: �JFl7rrF.t� Mailing Address: &T /.T T!X 2��7%,t• Day Phone 4. Name of Lending Institution: F Ls1* oa:a„zt Mailing Address: 5a dy& l -0/ Phone ,Q 21V —yZPSl 5. Name of Realtor or Agent: ASSse, Mailing Address: Phone 6. Legal Description: Ln% /�T 4 !� /•t' Zf��¢�yr Location: 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Z5042 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation / 577S EQ -037 (Incl No. Bdrms. v Individual (on-site) r� F i Y f' V7' f e- % 4 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality "C" Street, Anchorage, Alaska 99503 274-4561 Date Received / 0— -A /- 7S Time of Inspection 74-o 4-,n2 Date 'of Inspection 1--7.- REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: �- /,dl nA7. Mailing Address: ,- n1&1C 7 � 7 c Phone: a 9- c/c/S1 hn�" PR 2. Property Oe ,ac_! U,(- � Phone: Mailing Address: D 3. Legal Description: ,Bk -2 X4 -11t, 4. Location: 14-1 E. 5. Type of facility to be inspected S is D No. of bedrooms 3 6. Well Data: o-...� (n� . A. Type Y� 1�-�� B. Depth C. Constructiona4A&xnA D. Bacterial Analysis 81/3 7. Sewage Disposal System: 19 7.r A. Installed Y 7,i /� B. Installer l -cu C. Septic Tank: 1. Size / 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material rc E. Disposal Field: Total length of lines (04 G Ai 3 ria 8. Distances: r r A. Well to: Septic tank %/ S Absorption area 00 -f- , Sewer Lines Nearest lot line 10 f- Other contamination B. Foundation to septic tank 8 / , Absorption area n r C. Absorption area to nearest lot line r-5 EQ -034 (1/74) Page 1 of two pages 1? GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 330 "C" Street, Anchorage, Alaska 99503 274-4561 Y�\ Date Received (1r,�. 'Q0. lgrL6 (� Time of Inspection �0 Date of Inspection �r �r�. ig06 REQUEST FOR APPROVAL OF Us— a'.00 M INDIVIDUAL SEWER & WATER FACILITIES FOR tie-6a.m P Lll 1. Approval requested by: Mailing Address: �n1 Phone: 2. Property Owner: PxrrI I% Phone: X33_Q� AL1 Mailing Address: _o ri Pr Q 3. Legal Description: _ k4 y -q 'Ont M o�c`,yL 'dale 4. Location:, - 5. Type of facility to be inspected r; No. of bedrooms a:v in 6. Well Data: A. Type B. C. Construction D. 7. Sewage Disposal System: pyr�Y A. Installed 1 rlr3 B. Installer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: Depth Bacterial Analysis 2. Manufacturer 2. Material A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Re m^Jor Approval of Individual �,8 Water Facilities Legal, Description �.zf3 g� .2 Comments Approved rr. zl-d-e�44!74Disapproved Date _ Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify -that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilitfis. are operating satisfactorily. SIGNED Date EQ -034 (1/74) Page'2 of two pages - Rec^'for Approval of Individual S & Water Facilities Legal Description Comments Approved Disapproved Date 41-.x -7J' Apoibval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. Fi1CMz7 EQ -034 (1/74) Date