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HomeMy WebLinkAboutSILVER CREST BLK 1 LT 3ASilver Crest Block 1 Lot 3A #015-062-57 n �r�p15S00jdp�Q (OO/ZlAau) o7�j :�(q panoidde pue paMalAa21 ° V y •� esy lenwddy juawpedaa so3mjoS }uowdolanaa sna`ti� lauuo e.io s O ..aaoa 0.0 GOOD a PJ£ L L L puZ'8151, :sale(•oul DUPOOUPL13 :Aq pewaojjad suolloadsul dwe1S s,j99ui6u3 -6ullslxe Al}uailno jeAoo 00 L jo .Z ueyj ssal uollonilsuoo jo awll :uo!1en813 pewnssy Ills Jooa 1e .Z 411M paJanoo 12 pajelnsul P1913 :uogduosao pue uo!leool NUVW HON38 unnouj auou* :s ljewaa �a13uanead4Z/L-L LOVOSi7tZu1l)lueJj :(q pawjoyad suo!loadsul leoploal3 lN g a� IapoleN dwnd VN VN +.0 S * VN u!ejo u!epno u! 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S.T �.T T PRIMARY SYSTEM TH97-3 ;22000 7.0 ,onRaac BBc 96.9 FINSIHED GRADE ram rAr AL95.8 . SEWER ROCK C.— `..�/ ................... �esslo�� i 69' PREPARED FOR, PETE FEIGUM 9450 GROVER DRIVE ANCHORAGE, AK 99516 FIELD BOOKS CD To: BouNo Y.HOLT DRAW! KMD STARwc HOLT (`°`Eo- KMO AS T: HOT DAM 3/8 0W Fit GAO: 2439 ACM ME nma•awo "" : 97059 ANK 91 SCALER V = 50' 1 SCALER NTS ciEDEo. ZAV iLU ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)998-6111/FA% (907)698-8111 w.KNDEntfneertng.com/kadent*ek.net aven electric inc October 14, 1998 KND Engineering 696-6111 20441 Ptarmigan Blvd Fax: 696-8111 Eagle River, Alaska 99577 ATTY: To Whom It May Concern RE: Sewage Lift Station Wiring 9450 Grover Drive Anchorage, Alaska On 11-10-97, we completed the electrical wiring of a sewage lift station and high level alarm located at the above address. The installation was completed by our electrician, Mike Stevens, who holds a valid state of Alaska Certificate of Fitness N 19960124. All of the wiring was installed in accordance with the requirements of the latest adopted edition of the N.E.C.. if you have any questions, please feel free to call meat 349-9668. Thank Yo on Id D. Lederhos " e President 8015 Schoon Street Anchorage, Alaska 99518 Phone: 907-349-9668 Fax: 907.522-3995 ravenele^a_.,alaska-net TOTAL P.01 --------------------•------------------- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 ^L^ STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 El a PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970296 DESIGN ENGINEER: 1&\C� �_ \C�Lr\EtLLA OWNER NAME:FEIGUM PETER W & BECKY T OWNER ADDRESS:9450 GROVER DR ANCHORAGE, AK 99516 PARCEL ID:01506257 LEGAL DESCRIPTION: SILVER CREST BLK 1 LT 3A LOT SIZE: 48719 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 9/05/97 EXPIRATION DATE: 9/05/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: DATE: 52- Q �J DATE: V - 7 7 Som �� -q-cl\1 Mai MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 ^L^ STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 El a PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970296 DESIGN ENGINEER: 1&\C� �_ \C�Lr\EtLLA OWNER NAME:FEIGUM PETER W & BECKY T OWNER ADDRESS:9450 GROVER DR ANCHORAGE, AK 99516 PARCEL ID:01506257 LEGAL DESCRIPTION: SILVER CREST BLK 1 LT 3A LOT SIZE: 48719 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 9/05/97 EXPIRATION DATE: 9/05/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: DATE: 52- Q �J DATE: V - 7 7 Som �� -q-cl\1 KNID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 111FAX (907)696-8111 August 30,1997 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Silver Crest Subdivision Lot 3A, Block 1- Septic Upgrade Permit Gentlemen: Following a request from the owner, we conducted an investigation of the existing septic system for the subject property. The observations in the monitoring tube and verification with excavation showed the effluent above the lateral. The owner requested we proceed with an upgrade to five bedrooms of the septic system. On June 27, 1997 we dug three testholes for the proposed upgrade. The results of this test are attached. The lot is served by an individual well. The proposed upgrade system will be placed approximately 10' north of the south property line and south of the existing system. As indicated on the site plan we need to install a STEP system in order to provide install the upgrade. The existing tank and field will be abandoned in place, and replaced with a tank and lift station. There was no ground water observed during monitoring of the testholes. As indicated by the site plan drainage arrows, natural drainage is away from this site and will be maintained after construction. There is no surface water within 100' of the proposed installation. There are no known curtain drains within 50' of the proposed installation. No wells exist within 100' of the proposed installation and the class "C" community well is over 150' away from the proposed site. This upgrade should have no adverse effect on development of adjacent lots. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, IKIA,D Engineering enneth M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WASTEWATER I NO SEPTIC SYST PROPOSED WELL DISPOSAL SYSTEM DETAILS/SITE PLAN SILVER CREST Z' L❑T 3A, BL❑CK 1 G1RCL LOT 2A LOT 13B .WELL IN 97-1 \ P:aO T0.00, PR OSED SE E 5 IDR �. SFD CO WELL WELL r 1 7-2 EXISTI SYST H'197-3 \1 0 GAL.tP. AN( o / NI 0:000 PROPOSED PRIMARY SYST -CLASS 'C' WELL LOT 1B 7' MT MT 1 1/4' SYSTEM DETAILS 1 1/4' PVC FROM TANK TO FIELD 3/16' HOLES E 22' SPACING PRESSURIZED 1 1/4' LOT 17 LOT 2 SCALE: I'= 100' SCALE: 1'= 20' 1750 STEP TANK DISTRIBUTION SYSTEM HOLE SPACING DESIGN 1. RESIDUAL HEAD = 5' 2. HOLE SIZE = 3/16' = 1.00 GAL. PER HOLE P 30 PSI 47LLL(PUMP DL 3'LSGROLS . 6FLATERAL/30 HOLES =22'PACINPER HOE 5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS. 6. HOLES AT END OF LATERAL SHALL BE CONST. W/O CAPS AND PLACED DOWN. TANK TO ©. CONTRACTOR SHALL USE 1 1/4' PVC FORM MANIFOLD. FIELD AND IN LATERALS. DESIGN DETAILS 5 BDRM X 150 GPD = 750 GPD of ALq ��. KENNETH N. DUF CE -7316 �' F'ESSIONN= 750 GPD/0.8 GPD PER SO. FT. = 937.5 SO. FT 937.5/(7'X2') (7.0' EFFECTIVE GRAVEL) = 66.96 FT. TRENCH Total depthlGOFSsysten sR125H fron7orgnalxgrad WIDE x 9' DEEP Total depth of gravel below distrlbutro" pipe is 9.0' . NOTES: I. USE 1750 STEP SEPTIC TANK. INSULATE TANK IF U' COVER. �. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 1. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN, 3' COVER. 5. CONTRACTOR TO PUMP TANK. 6. ANY ASPHALT. CONCRETE OR APPURTENANCES DAMAGED OR DESTROYED BY THE CONTRACTOR DURING CONSTRUCTION SHALL BE REPLACED BY THE CONTRACTOR AT NO ADDITIONAL COST TD THE OWNER. ARED FUR: KND ENGINEERING 20441 PTARMIGAN BLVD PETE FEIGUM EAGLE RIVER, AK, 99577 9450 GROVER DRIVE (907)G9G-6111/Fax (907)696-8111 ANCHORAGE, AK 99516 AV Muntcipatily of Anchorage 64. �y OEF'AR rMEN r OF HEALTH 8 HUMAN SERVICES 825 *V SNect. Anchorage, Alaska 99502.0650 R tl ••Kenne.n M SOILS LOG —PERCOLATION TEST ice., cE 711 � � �pROFESr, D/ /� - —O `�» PERFORMED FOR DATE PEFJFOnME —jump —' /'4Townsht LEGAL DESCRIPTION ��l,�&w�Y�/�l�,p. ge. SectionZW . SLRanOPE SITE PLAN DEPTH (f EETI Q/6Q1�/GS 1 (� 2 3 GM sang yravcl 4 W/SI� t 5 Cao ✓st Jgrty ICgsLSJ 6-1- 181 Pd.-,::. 9 14 15 16 n 18 19 J WAS GROUND WATER 10 ENCOUNTERED? Gross Net Depth to Net S 11 Time Time Water L IF YES. AT WHAT O DEPTH? P 12 E 13 Depth to Water Attu/ QAOL 111011011119?— 0?Ic — 14 15 16 n 18 19 20 y I PERCOLATION f1AIE -{� D,. Im,ntdcvmGH P�kli(' HOLE DIAMk ILII - ,__ ��—.JI'�FI TEST RUNDLIWEE1N__.`�-'-�-II AND COMMENTS PERFORMED Vy IYD G/(�AJ eGr /��� CERION IHA Um k 51 wA5PERFORMEDIN ACCORDANCE WITH ALL 51ATE 1tNO MUNICIPA GUIDELINE$ IN EFFECT ON THIS DATE DATE �1(�--- J - Gross Net Depth to Net Read m 9 Date Time Time Water Drop .O :92 0wI 20 y I PERCOLATION f1AIE -{� D,. Im,ntdcvmGH P�kli(' HOLE DIAMk ILII - ,__ ��—.JI'�FI TEST RUNDLIWEE1N__.`�-'-�-II AND COMMENTS PERFORMED Vy IYD G/(�AJ eGr /��� CERION IHA Um k 51 wA5PERFORMEDIN ACCORDANCE WITH ALL 51ATE 1tNO MUNICIPA GUIDELINE$ IN EFFECT ON THIS DATE DATE �1(�--- 0 Municipality of Anchorage � /..,�,49. DEPArt rMEN I UE HEALTH & HUMAN SERVICES 025 *V Sueel. Anchorage. Alaska 99502.0650 WA y i""'• to Kenne.n At. O SOILS LOG — PERCOLATION TEST CE 7116 .sem•. . . PERFORMED FOR —/lr.F �r��um DA rE PET)FORMED \ _„�j_/__91L'-s'�-*'�TDWnshlp. Range. Section �y� / LEGAL DESCRIPTION SLOPE SITE PLAN Dtr m Tf EETI iil0-V..%C. s 1 3iA I SM 4 5 6 GM/mL 8 Motsw/Sail 9 10 11 12 13 14 15 16 n 19 19 Pre-. Loc. WAS GROUNDWATER ENCOUNTERED? / IF YES. AT WHAT DEPTH? Otpth W Water Are Monir _ 1 Monitorings �jl�� Urtt B .*e Reading Date Gross Net Depth to T.me Time Water 3zj 30 e+Cl �b_ 4Net7 , ., �o -!T/ e .._iiia - - - - - .......... _.. 20 PERCOLATION RATE . GD 1.•"mQD1AME 11 TEST RUN DL(WEEN —7- 11 ANU COMMENTS f /r- YERFORMEDDY fND G/(iAJ G1jBCC'—'M—//717--- - I /+��hGln_ / 1� CERNi, IMA) Imsp51 WAS YERT ORAIED IN ACCORDANCE WIIl1ALL SIATE AND MUNICIPA GUIOELWESINEFFECIONDIISOAIE DATE �e—/ -- 7 Municipality of Anchorage DEPAFITMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502.0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR"Z— LEGAL DESCRIPTION DEPTH (FEE Qrapijr/G •5 1 / 2 3 4 5 Govt e- Sa x1' j e4 ua 114 % 5XI �er..aai./ /oast 8 10 t1 I F//!UHO Se>•na si/� 12 13 DATE PE13FORMED pwrc WASGROUNDWATER ENCOUNTERED? IF VES, AT WHAT DEPTH? - Depth to Waterer -�""� G p Monitoring? �.r1._ Date: 14 15 1 I P�RfG 1s B.o. N , 1?I s1zLke, Sven 1s no bed/oc., 19 20 Readmg Date Gross TYme Net Time Depth to Water Net Drop /a y5 /'q winS ' p-510 9'' ZOAtiz;1 7—//:07 _ 3 I A - --- - /Z: 9�ivfo t✓/'xlCiut PEHCVLA11UNKAIC r ---o•-..--__._??,.__- `• TESL RUN DE TWEEN I AND COMMENTS —dole—f PERFORMEDDY R&y_.G04fln. !' __ I JI�%1I1e-.ai`t A;S"— CERIIFY 1HA//)) hn5 Etii WASPERFORNIEDIN ACCORDANCE WIIFa ALL STATEIND MUMCIPA GUIDELINES IN EFFECT ON THIS DATE DATE __$ �U.— ;f^ Municipality of Anchorage ...,, UEPAFI rMEN f Of HEALTH & HUMAN SERVICES 825'L "!reel. Anchorage. Alaska 99502.0650 SOILS LOG — PERCOLATION TEST Q t''i DATE PEgfOn PERFORMED FOR _Jli—L—���u __ _—_MED LEGAL DESCRIPTION S I 2 3 4 PcrG,� 5 Gows a Saxi�9 ra ��� s 7 $91A15�, is ants/4 1`00A"11 ie4,41 s 9 10 A /G -17 WAS GROUND WATER ENCOUNTERED? Range. Section 11 i I Fii/ a &CUT I Sona si/� 12 13 IF YES. AT WHAT DEPTH? S L —AIA P E Depth to Wrier Anti �q MDndorine? fix— OaIL 161AIV 14 15 ?kree' -Vpz 1s 17 s+�lkr, �i✓�.� IS Ile, beleoe,- 19 Kenne.n At..9�;iuv CE 7115 ��;FESt�P� B.�f197 PLAN Reading Date Gross Time Net Depth to Time Water Net Drop 2 1/:35 �D sC6 !F//6 71 h „ zo; VERCUTAIIUN RAIL _'c'�//1 1rr^..ulra,mUa VEIIC HOLE UTAMl.I 111 __ _.__ IESI fIl1NUEIWEEN _._.( -- 11 ANU _-/0._. It COAIMEN I$ PERFORMED L1v 7�IyD Gn �jf1e�. •._..—__ _ I �� �— CERIpv IIHA ?H= tSI WAS VER1 Uf1AtED IN ACCORDANCE WIIH ALL SIATETND MUNICIPA GUiDELINLS IN EFFECT ON THIS DATE DATE O G!J -27-- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH R ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage. Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME '.5— SOL PHONE• NEW ❑ UPGRADE MAILING ADDRESS /y LEGAL DESCRIPTION LOCATIONI Gro re-"-+ Cu of z cc NO. OF BEDROOMS 3 DISTANCE TO: Well pp Absorpbon area Dwelling PERM T oe93 O Y ;:z Manufacturer Material No. of compartrpC(tis L N ~ Liq. capacity in gallons 000 IF HOMEMADE: Inside length Width Liquid depth 6 Vz DISTANCE TO: Well Dwelling PERMIT NO. S? hQ- Manufacturer Material Liquid capacity in gallons p = DISTANCE TO: Well Foundation Nearest lot)i a PERMIT NO. W J LL Z No. of lines / Length of eacn line Total leng� f lines SS Trench width inches Distance between lines ~ ¢h¢.. O W Top of tile to finish grade Length Width Material beneath the inches Depth Total effect�vE absorption area PERMIT NO. U a F Type of crib Crib diameter Crib depth Total effective absorption area W� W in DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot boil PERMIT NO: W DISTANCE TO: Building foundation Sewer line Septic tank Absorption Steals) OTHER PIPE MATERIALS /? s 1 SOIL TEST RATING Q. INSTALLER Ne...,A... REMARKS Z S) 67 APPROVED DATE LEGAL // J %—Z—B� 72-013 (Rev. 3176) - G^L I TY OiF Flt�ti�14F�FiGE DEPARTMENT �. HEAFFiLTH AND ENVIRONMENTAL rROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 Pair ���=E1 II:IY� WELL FIND Ut�l—S I TE SEWER PERMIT �{ PERMIT NO. C 810093 ) KA m & A�npv. APPLICANT ROBERT MILBY P.O. BOX 3114 PALMEP..,AK. 745-05230 LOCATION GROVER LEGAL LOT 3A BLK 1 SILVERCREST LSUB LOT SIZE 46260 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING <50 FT/BP.)= 200 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C?EFTH= 14 LENGTH= 3C3 GRRkrEL. OEFTH= 1lCo THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REGeU I REO SEPT I C -rnr4K SIZE= 1 E�4 C;FLLOr4E; PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T44Q C 2 ] I NSFECT I UtJS RRFEE REQU I RELY --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. P E R M I T E X P I R E S D E C E M B E R 3 1 s AL n3E31 I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TP INCLUDt,PPRE THAN 3 BEDROOMS. SIGNED:/_/_1 L_"�'-mcm-L�ly ISSUED B' V4. 0 PERFORMED LEGAL (FEETI 1 4p�t 2- 3- - 3 4 5 s h�3FY, 7- 8 9- 10- 11 10 11 V 12- 13- 14- 15- 16 213 14 15 15 17- 18-- 19- MUNICIPALITY 7181s MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 8650. Anchorage. Alaska 99502 2782221 SOILS LOG - PERCOLATION TEST -A 0 SOILS LOG PERCOLATION t TEST ' B DATE PERFORMED: - LS SLOPE SITE PLAN WASGROUNO WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Data Gross Time Net Time Depth to. Water- Net Drop 9:Zo 3aa ZO io 2T t :30 :3 z8 30 '1 r � yyz 20 k •• �2r3.� : c' minutes/inch) H!G /%.� 2L27� .�hr'•..,,,,,.•' �• PERCOLATION RATE �� —1 � TEST RUN BETWEEN /b FT AND „c.r� FT PERFORMED 72008 17/76) CERTIFIED X > m cQ0 rm amc c n c c r 0 0 r -c c z E ca o-3 � t' :6 GIN bT. Municipality of Anchorage .r Development Services Department Building Safety Division ; Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsfte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. COSA# n ExpirationDate: lo -.21 -0 1. GENERAL INFORMATION Complete legal description Silver Crest Block 1 Lot 3A Location (site address) 9450 Grover Street, Anchorage, AK, 99516 Current Property owner(s) Peter M. & Becky T. Feigum Day phone Mailing address 9450 Grover street, Anchorage, AK, 99516 Lending agency Day phone Mailing address Real Estate Agent Dan Wolf/ Re Max Day phone 907-257-0114 Mailing Address 110 W. 38th Ave., Anchorage, AK 99503 Unless otherwise requested, COSA 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 0 Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of titre (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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 andfor 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 Finn Watkins Engineering, Inc. Phone 907.349-1651 Address P.O. BOX 110443, Anchorage,'AK 99511.0443 Engineer's Printed Name CINDY W. ELLIS Date 7/17/2006 0 5. DSD SIGNATURE Approved for r bedrooms. Disapproved. Conditional approval for bedrooms, with the following tdy W. Ellis CE • tos77 COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Gy. � Original Certificate Date: 7 Z ' 0.g; (RN. *1W) Municipality of Anchorage • Development Services Department Sutlding Safety Division ` On -Site Water & Wastewater Program `• 4700 Brogaw Street P.O. Boa 196650 Anchorage, AK 995198850 www.muni.orylonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Silver Crest Block 1 Lot 3A Parcel ID: 018.082-57 A. WELL DATA Well type PRI If A, S. or C provide PWSID S _ Wet LOU (Y/N) Y Date completed 8/6181 Sanitary seal (YIN) )L— Wires properly protected (Y1N) Yea Total depth 171 R. Cased to 170 R. Casing height (above ground) 14 in. FROM WELL LOO AT INSPECTION Date of test 6W981 411212006 Static water level 70 R. 63 R. Well productlon 3 O.P.M. 1.0 9 -P.M. WATER SAMPLE RESULTS: Cditorm 0 colonies/100 mL Nitrate 2.85 mglL Other bacteria 0 colonies/100 mL Arsenic: < 0.005 mgA Date of sample: 6122/2008 Collected by: Cindy W. Ellis B. SEP ICIHOLDINO TANK DATA Tank TypelMaterlal Steel STEP Tank Data installed 11I08f97 Tank size 2000 gal. Number of Compartments 2 Cieanot is (YIN) Yes Foundatlon deanout (YIN) Yes Depression over tank (YIN) No High water alarm (YIN) Y Daft of pumping 41171W Pumper Northland C. ABSORPTION FIELD DATA Date installed 11/09/97 Sol rating (g.p.dJe or fe/bdrm) 0.8 System type Deep Trench Length 69 R. Width 2.0 R. Gravel below pipe 8.8 ft. TotaldepthjO�.OJIL ER. absorption area 1214 R' Monitoring tube YES Depression over told NO Date of adequacy test 4112/2008 Results (PtsslFao Pass For 5 bedrooms Fluid depth in absorption field before teat -11h. Water adds 7d 8 gal. New depth 102 in. Elapsed Time: 220 min. Final fluid depth 90 in. Absorption rate >• 760 ".d - Any rejuvenation treatment (past 12 mo.) (YIN & type) NO If yes, give date D. UFT STATION Date installed 11/09/97 Size in gallons 2000 STEP Manhole/Access (Y/f) Y 'Pump on' level at 115 in. 'Pump offevel st 117 in. High water alar level at 111 in. Datum Top of Manhole Cycles tested 3+ Meats alarm d Bradt MCO amerrls9 Yes E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAiR station on lot 10S Absorption field on lot 194' Public sewer main 100'+ Sewer /septic service line 51' Animal containment areas 100'+ On adjacent lots 100'+ On adjacent lots 100'* Public sewer manholeideenout 1001+ Holding lank 76+ Manureiantmal excrete storage areas 1001+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 61' Property One 2T Absorption field 1b'+ Water main 100'+ Water service One 56+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One 13' Building foundation 91' Water main 10d+ Water Service line 65+ Surface water 1011'+ Driveway, prkingNehide storage 15'+ Curtain drain WA Wells an adjacent Iola tar+ F. COMMENTS: 525 gallons of water put into septic system from a truck. Remainder from the well Additional fill was put over Geld, to provide 2 R of Boll cover. It was topsolled and seeded. 0. ENGINEER'S CERTIFICATION I cerhljr that I have determined througA field inspections and (*-+ 491 minview of Munk pal records that the above systems are in+ ' `i conformance with MOA COSA guidelines in effect on this date. Engineers Printed Name CINDY W. ELLIS CTtf �jy Ellis Date 7N 7f2006 CE -loan ; COSA Fee S ii 70 Date of Payment 7�55✓Or i Receipt Number. (Rev. ffrce) Welver Fee S Date of Payment Receipt Number SCS ReO 1063341001 Client Name Watkins Engineering Project Name/U Silver Crest Blkl Lot 3A Client Sample ID Silver Crest BlkI Lot3A Malls Drinking Water Sample Remarks: All Dates/rimes are Alaska Standard Time Printed Date/time 07/0712006 15:24 Collected Date/rime 06/22/2006 11:45 Received Dste/nme 06/2212006 12:45 Technical Director Stephen C. Ede Allowable Prep Analysts peameta Results ML Units Method Containerm Limits Date Date Init Nitrate -N 2.85 0.100 mgIL EPA 353.2 B OVM06 ALR Nitrite -N ND 0.100 mg/L EPA 3532 B 06/22/06 ALR Metals Department ltardnessssCaCO3 155 5.00 mg/L SM202340B C 06/27/06 06/30/06 "1 Private Individual Analysis Aluminum ND 20.0 ug(L EP200.8 C 0627/06 06/30/06 bill pntimon ND 1.00 ug/L EP200.8 C (<6) 0627/06 06/30/06 Mil Arsenic ND 5.00 ug/L EP200.8 C (<10) 0627/06 06/30/06 "1 Barium 31.7 3.00 ug/L EP200.8 C (0000) 0627/06 06130/06 Mot Cadmium ND 0.500 ug/L EP200.8 C (<5) 0627/06 06/30/06 Mli Calcium 45000 500 ug/L EP200.8 C 0627/06 06/30/06 M11 Chromium ND 1.00 ug/L EP200.8 C (<I00) 0627/06 06/30106 Mll Copper 42.1 1.00 ug/L EP200.8 C (<1300) 0627/06 06/30/06 MDI Iron ND 250 ug/L EP200.8 C (400) 0627/06 06/30/06 "1 bead 1.70 0.200 ug/L EP200.8 C (<15) 0627/06 06/30/06 Mil Magnesium 10400 50.0 ug/L EP200.8 C 06127/06 06/30/06 MI[ Manganese 4.71 1.00 ug/L EP200.8 C (<50) 0627/06 06/30/06 M01 Phosphorus ND 200 ug/L EP200.8 C 0627/06 06/30/06 Mil Chloride 12.8 0.100 mg/L EPA 300.0 B (Q50) 0626/06 0626/06 DSI I Fluoride ND 0.100 mg/L EPA 300.0 B (Q) 0626/06 06/26/06 DSII Potassium 1010 500 ug/L EP200.8 C 0627/06 06/30/06 Mll Scl nium ND 5.00 ug/L EP200.8 C (<50) 0627/06 06/30/06 Mil Sodium 3670 500 ug/L EP200.8 C (Q50000) 0627/06 06/30/06 "1 Silicon 5520 200 ug/L EP200.8 C 0627/06 06/30/06 Mill Silver ND 1.00 ug/L EP200.8 C (<100) 0627/06 06/30/06 Mil Sulfate 16.4 0.100 mg/L EPA 300.0 B (Q50) 0626/06 06/26/06 DSII Thallium ND 1.00 ug/L EP200.8 C (Q) 0627/06 06/30/06 MDI F' egos 12• .g WtQyg �W j~%.t ^1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION Application Date /0 7/ ge- 1. /ge- (a) Legal Description (include lot, block, subdivision, section, township, range) .[—i4 B I J 1 �vFrL ii�FSi Srlij Location (address or directions) 7� SC7 e7�',eo✓ciL ,J/Z (b) ApplicantNamej--MVSTelephone: Home ¢9'3�rc�! Business 7493-511 Applicant Address (c) Applicant is (check one): Lending Institution ❑ : Owner/builder; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: Telephone ENVIRONMENTAL PROTECTION OCT 91986 2. TYPE OF RESIDENCE { Single -F milyMulti-FPh'ly ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Weds Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. \`1 Il.11i / f 4. SEWAGE DISPOSAL Onsite y) Public ❑ Community ❑ Holding Tank ❑ Note: If community welt system, must have written confirmation from the Slate Department of Environmental Conservation attesting to the legality and status. 72-025 (11,84) Page 1 of 2 5. ENGINEERING FIRM PROVIDIn%91NSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as o1 thevalidation date shown below, I verify that rry investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is saf e, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verity that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date Telephone 5m -&q -s-7 6. DHEPAPPROV� Approved for bedrooms byate Approved Disapprove Conditional Terms of Conditional Approval ..CAUTION1 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 o12 72-025 (11/814) AMMIICIPALITY OF ANCHORAGE DEPT. OF HEALTH 6 MUNICIPALITY OF ANCHORAGE (MO^) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) OCT 0 g CHECKLIST - FEBRUARY 1984 flffi 264-4720 Legal Description: ��'F% F3 DECEIVED '-,5 cvEz 'rt-. A. WELL DATA `-� Well Classification-f`K--,✓.ARTS If A. B. C, D.E.C. Approved (Y/N) _�Ja Well Log Present (Y/N) Date Completed YW& Total Depth ✓ Cased to ' / �ffZ— Depth of Grouting .J 1A Static Water Level A' ,✓ Pump Set At L ik-')O. J Casing Height Above Ground '1--r Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) lJ Separation Distances from Well: To Septic/Holding Tank on Lot ( -A70- ; On Adjoining Lots /07> w To Nearest Edge of Absorption Field on Lolt /,Lj*—; On Adjoining Lots To Nearest Public Sewer Line A -)//I To Nearest Public Sewer Cleanout/Manhole A1111f To Nearest Sewer Service Line on Lot-� Water Sample Collected by �� ,� �- rT ^>,t KrDate Water Sample Test Results �"Sr=Tcsc 4t -TD PL4 'T Comments B. SEPTIC/HOLDING TANK DATA Date Installed_ Size r No. of Compartments L� Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) Date Last Pumpeds Pumping/Maintenance Contract on File (Y/N) ) ; for Holding Tank High -Water Alarm (Y/N) IL -A Temporary Holding Tank Permit (Y/N) N� Separation Distances from Septic/Holding Tank: To Water -Supply Well f(gZ 0- To Building Foundation 15;-/ �C7- To Property Line To Disposal Field _ "f!:;- g, To Water Main/Service Line 5 rrT To Stream, Pond, Lake, or Major Drainage Course AJ/A_ Comments p ,A )/,-- p -,(2T - ECL, 2T - Page 1 of 2 72-026(11,851 to C. ABSORPTION FIELD DATA 601 P �7 o� 3' Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Dimensions Manhole/Access (Y/N) "Pump Off' _ Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA •• Check Permitted Bedroom Rating Against HAA Request •• Icertify thatIttaveche ed e i d, conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company SSr .1 MOA No. Receipt No. qe e e S^ Date of Payment �[" Amount: $ Jp S xl� Page 2 of 2 72.026 01,811 Soils Rating in Absorption Strata 74x�>-`P7/—R—r-- Type of System Design 1x`�. �`I Date Installed 7xg, / Length of Field �3 Field �� " Depth of Field Width of Gravel Bed Thickness' Square Feet of Absorption Area /A' 5F Standpipes Present (Y/N) Depression over Field (Y/N) /� Date of Last Adequacy Test Results of Last Adequacy Test 'ns o Separation Distance from Absorption Field: To Water -Supply Well t.117 To Property Line /(n Fr To Building Foundation Co Z or To Existing or Abandoned System on Lot ^�1_4 ; On Adjoining Lots Line "S TLT To Cutbank (if present) LI/I To Water Main/Service To Stream/Pond/Lake/or Major Drainage Course 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 Electrical Codes (Y/N) _ Comments Dimensions Manhole/Access (Y/N) "Pump Off' _ Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA •• Check Permitted Bedroom Rating Against HAA Request •• Icertify thatIttaveche ed e i d, conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company SSr .1 MOA No. Receipt No. qe e e S^ Date of Payment �[" Amount: $ Jp S xl� Page 2 of 2 72.026 01,811 2220 m= CO AVLPJL• ANQ10( A=i AK 99507 (907) 319-6451 WATER WML T= Location: n Date: 9 Z� Subdivision: Lot: 3A 1310c1:- I Clients Harm: Addrem= Tenter: /IiirF /SeIF�E� Initial Rcadin7 m Meter: Z13Zp 4' TIM CFM A VOLUME RC7TAL VOUIMZ 9. s� ?_r3z,v 1Z J 17n� 3- /Z 3z c uo Marc.;: FY-040ct,*.Oti Pa4C: A410 GPw1 F' .._.. �:.� :! S'; Zolz r:::.... MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION r DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION . (a) Legal Description (include lot, block, subdivision, section, township. range) Lof 3A l�Mo A i/% /vele, 74 ✓`o6cY/✓/�iO/l Location (address or directions) Giri dr - (b) Applicant Name,-/ 5-11 Telephone- Home .341, .2023 Business Z12' Applicant Address (c) Applicant is (check one): Lending Institution D ; Owner/builde01 Buyer O ; Other D (explain); Ci T Telephone MOWie rtc C C611`0 Telephone �3— Qr%UV (d) Lending Institution � --� �--r— Address-0S wtST 3ln'YL. Ff���erac� Ff�QSky 99ri0 (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following Laddress: el 1 M N 0 ,(`Jrq Q CI Q 4 &.5 wesA a & J-6 YT VtL' e rgcr f s—i'rq 99 0�3 r , 2. TYPE OF RESIDENCE Single -Family Multi -Family D Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well v Community[3 Public D Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public D Community[3 Holding Tank D Note:/If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11,84) Page 1 of 2 5. ENGINEERING FIRM PROVIDINU INSPECTIONS, TESTS, FILE SEARCH, DATA 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 �n,�o{ection. Name of Firm 'J���E 1 Telephone Address '77%0 L�Asi fp �� /`/�F ✓H��r6E is ric DatelrS�— Q DHEP APPR� Approved for 4 bedrooms b ate Approved _"k ..Disapproved Conditional Terms of Conditional Approval CAUTION Engineer's Seal .:S OF AC�gsp�, t�QT►1 % R The Muncipatity 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 72-0254111841 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 ocly y OF AGE OV►, OF MEKI:i a ° NrAL PWTECTpf,I NOV 2 7 IM 284-4720 "O rt e K ETV E D Le Description: A. WELL DATA Well Classification J"i e<B �. �cY If A. B. C, D.E.C. Approved (Y/N) Well Log Preser Y 1) Date Completed '� — G Yield Total Depth �71 Cased to /7o Depth of Grouting ' Static Water Level 70Pump Set At Casing Height Above Ground ��� / Sanitary Seal on Casing99N) Electrical Wiring in Condui4 1) Depression Around Wellhead (Y& Separation Distances from Well: To Septic/Holding Tank on Lot /D ' ; On Adjoining Lots To Nearest Edge of Absorption Field on t �/z / ; On Adjoining Lots To Nearest Public Sewer Linex To Nearest Public Sewer / Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments ATTAfNW WELL T8 -T PE5ULT-�- 1 WELL. WA j ANO WATM 6h ?PLE- 16-2;;T I7eSULr5 B. SEPTIC/HOLDING TANK DATA Date Installed 7-- Size 10*z b No. of Compartments StandpipekJqN) Depression over Tank (Y& Air -tight CapsON) Foundation Cleanout4("PIN) Date Last Pumped /"' -!7Z Pumping/Maintenance Contract on File (Y/N) ;for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: /O To Building To Water -Supply Well 9 Foundation� To Property Line S I F' Id S To Water Main/Service Line A To Disposa ie To Stream, Pond, Lake, or Major Drainage Course - Comments t5,,`E­ A1TW_1ftro 1AJeY1c77oA! YZ-POPT /120 PU1NPrNGI P�Gt�T Page 1 of 2 - 72-026(11/81( C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Z60c1 --` Type of System Design /tee,✓'/% Dale Installed Length of Field ; Width of Field Depth o1 Field �J � i Gravel Bed Thickness �7 3 Square Feet of Absorption Area el Standpipes Presen6N) Depression over Field (Y® Date of Last Adequacy Test -�1- Results of Last Adequacy Test - C� - 1 < ,eye - y Separation Distance from Absorption Fie d: To Water -Supply Well To Property Line 'le- To lTo Building Lot _ To Water Main/Service Line — To Stream/Pond/Lake/or Major Drainage Course To Existing or Abandoned System on On Adjoining Lots e "o'Cutbank if resent) �Y/o,liF �rP.c� To Driveway, Parking Area, or Vehicle Storage Area " Comments��w Inf�N O�PG✓� D. LIFT STATION Date Installed Size in Gallons _ "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at " Check Permitted Bedroom Rating Against HAA Request " Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certifythat /II have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Gf/�l /r m ,� Date ,'G -r- Companyi?41Zt R --> MOA No. Receipt No. :� it I 1 0 Date of Payment I 1 f Amount: $ to rim= Page 2 of 2 72.026 (11,84) Lo©tion: Client's Name: Address: BESSE, EPPS S PC71TS 2220 EAST 88 AVENUE At4010RAGE, AK 99507 (907) 349-6451 WATER WELL TEST n Date:,//- Location: ate:,//- Subdivision:«�T �r•xT Lot: Block: i / MukrCtvqUry Tester: pr OF NQq ENVr O OF # PaC� cwkAGE NOV 2 % � Initial Reading on Meter: < / yWf CEI V ED TIME GPM T1s G VOLUME- cjj� mIS TOTAL YOLUt= loy•1V 7- 'A N c ! 42 ?U / 91 ez �. fv Z' I F- O , t}OTES• . Pr.*lnrtion Pato: /,,7, PK 24-11our Capacity/cGillms n. n. 5. LEGAL DESCRIPTION DATE RECEIVED — INSPECTION APPOINTMENTS TIME TIME TIME 6. TYPE OF RESIDENCE NUMBER OFsBEDHOOMS ❑ One ❑ Four ❑ Other DATE DATE GATE Three ❑ Six 7. WATER SUPPLY INDIVIDUAL' 'ATTACH WELL LOG. A well log is required for all wells drilled INSPECTOR INSPEC INSPECTO �L-V depth (attach log if available.) r n WN;�ir^o i i Or AIN=77= MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH E DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIC WVIRONMENTAL PROTECT ION \ 825 L Street • Anchorage, Alaska 89501 • \I JUL 16 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page t. Incomplete requests will not be processed. Please allow ten (101 days for processing. PHONE 1. PROPERTY OW7 77 MAILING ADDRESS i=fir./; PROPER Y RESIDEN (lf dillerent from above) PHONE —PHONE 2 BUYER r cue v5/ to S MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS PHONE 6. REALTOR/AGENT MAILING ADDRESS 5. LEGAL DESCRIPTION s STREET LOCATION GAoae 6. TYPE OF RESIDENCE NUMBER OFsBEDHOOMS ❑ 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 ,SP ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM c� INDIVIDUAL/ON-SITE" Gv YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72oto (Rev. 6/79) 1 }}.� � t. U ��_ C7r�l-e-tiw.s.0 72010 111*, 6/79) 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 LOGRECEI VED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line 5. COMMENTS LL7 APPROVED FOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) 10DISAPP ROVED DATE BY 72010 111*, 6/79) Municipality Anchorage n l -W] �gI 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 2644111 n1G11 . '7 -a`) -2I P/n t � GEORGE M. SULLIVAN, MAYOR on m RLL co DEPARTMENT OF HEALTH ANO ENVIRONMENTAL PROTECTION L"I Lfr WCIY c�L�� Sd'2.c.IcK1r6Y1 July 21, 1981 Robert Milby Post Office Box 3114 Palmer, Alaska 99645 Subject: Lot 3A Block 1 Silver Crest Subdivision Approval for the individual sewer and water faciliites cannot be granted until the following items have been jc mpleted: ) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. n (2)wA well log submitted to this office for our files and review. Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit and buried. t(4) The depression around the well casing needs to be filled with impervious type soil so that it slopes away from the well casing. (5))A permit for the on-site sewer system has been issued, however, we have not received the as-builts of the sewer system in this office. If a private engineer has inspected the system, please have the as-builts of the installation forwarded to this office for our files and review. Please notify this office for a reinspection when the noted descrepancies have been corrected. If there are any further questions, please call this office at 264-4270. Sincerely, a h:4 A)I3D 4X__ Robert C. Pratt, R.S. Associate Specialist