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HIGHLAND TERRACE #4 LT 2B-2
Highland Terrace #4 Lot 2B-2 #050-311-37 Municipality of Anchorage Development Services Department - :< Building Safety Division ' - On -Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW020160 PID Number: 050-311-22 Name' FRED RIPP Wastewater System: ❑ New ■ Upgrade Y P9 Address: 10919 STEEPLE DRIVE * EAGLE RIVER, AK 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 694-3618 3 ❑ Deep Trench ■ Shallow Trench Dead []Mound LJ Other LEGAL DESCRIPTION Sol/ Rating: 0 8 Total Depth from arigim8.0-9.0 GPD/Sq. Ft FL Block: TRACT: Subdivision:- Depthto pipe bottom from original grade: Gavel depth beneath pipe: — 26 HIGHLAND TERRACE #4 3.85-4.85 Ft. 4.15 Ft Township: Range: Section: Rl added above original grade: Gravel length: — — — SEE DWG. Ft. 56.5 Ft. WELL: ❑ New ❑ Upgrade Gmvol width. 5 Number of HAM: 1 Distance between lines: — Ft Ft classification (Private, 0.&c): Total De -Cash To: Total absorption area: Pipe material: G Pt. Ft 565 so. Pt. D 3034/ F-810 Driller. �I`5�Date Drilled: 1� Static Water level: Installer. OWNER Date Instalb Ft 6%25-26/2002 Yield: Pump Set At -Casing Height Above Ground: TANK GPM R, Ft SEPARATION DISTANCES ■Septic ❑Holding 0S.T.E.P. 13 Other To Septic Absorption Lift Holding Public/Privata Manufacturer. GREER Capacity In gallons: 1000 From Tank Field Station Tank Sewer Lines well 100'+ 100'+ — — 25'+ Material. STEEL Number of compartments: 2 Surface water 100'+ loo'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — Size in gallom: Manufacturer. Foundation 5'+ 10 '+ — — — 'Pump on' level at: mp o ole High water alarm ab Curtain Drain NO KNOWN Pump Mole tlM: Electrical Inspections performed by: Remarks: EXISTING SEPTIC TANK WAS COMPLETELY BENCH MARK Location and Descriptbn: ABANDONED PER UPC. PATIO DOOR THRESHOLD CONFIRMATION TEST HOLE WAS DUG 6 FEET Assumed Elevation: 100.00 FL ENGINEER'S SEAL BELOW DRAINFIELD BOTTOM. ooaOF p0�0� AKWWC INC. Inspections performed by: Dates: 1st 6/25/2002 ... 9*.0 2nd 6/26/2002 D 3rd 6/26/2002 Q Ye r it Ga ess:' Development Services Department Approval p° E 9 aP"o�0 Reviewed and approved by: Date: /�'/ 6 4p rofeseon (Rev. 12/01) o0 �ODOOD�Op PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID :1 SW020160 050-311-221-22 \ EXISTING \ WELL EXISTING \ Boa %lj� p• \ 3 HOUSE OM A `/ �j(h \ FCO/ \ \�'•A \ B \\ I \ \ 33.4 27.9 ST2 39.6 NEW1000 L ON DBL1 41.8 34.2 SEPTIC TANK 43.5 35.5 C01 46.1 37.8 IVIT 148.3 41.2 CO2 95.8 1 89.3 MT2 97.3 1 91.2 CONFIRMATION TEST HOLE \\ \ ST1 33.4 27.9 ST2 39.6 32.9 DBL1 41.8 34.2 DBL2 43.5 35.5 C01 46.1 37.8 IVIT 148.3 41.2 CO2 95.8 1 89.3 MT2 97.3 1 91.2 7/25/2002 DRAWN BY: ALASKA WATER & WASTEWATER SCALE. C.J.G. CONSULTANTS, INC. 1" = 40 6901 DEBARR ROAD, SUITE 2B' ANCHORAGE, AK 99504' PHONE (907)337-6179 * FAX (907)338-3246 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: FRED RIPP (907) 694-3618 2 OF 3 HIGHLAND TERRACE SUBDIVISION #4: TRACT 2B AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE NEW DRAINFlELD ISTING CUTBNK (SEE ATTACHED LETTER) OF14Ad4n ... .... . .............. ffr Ga ss:: 79 m� 140 PERMIT NUMBER: AS—BUILT SW020160 DATE: DRAWING PARCEL ID NUMBER: 050-311-22 INSULATION FINAL GRADE _ DRAWN BY: 96.89-96.96 f TOP OF TANK AT TOP OF TANK AT INLET = 93.46 N.T.S. OUTLET — 93.46 NEW 1000 GALLON INVERT OF BUNG SEPTIC TANK AT INLET — 93.02 INVERT OF BUNG AT OUTLET = 92.66 ORIGINAL GRADE = 95.85-96.85 Lo 00 00 T 4.1 T 5 6'+ TO BEDROCK NO GROUNDWATER ALASKA WATER & WASTEWATE CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B ` ANCHORAGE, AK 99504 - PHONE (907)337-6179 • FAX (907)338 PREPARED FOR: PHONE NUMBER: FRED RIPP (907) 694-36 FINAL GRADE — 96.65-96.82 FABRIC INVERT OF PIPE = 92.00 (AVG.) BOTTOM OF TRENCH — B7.85 (AVG.) RELALTIVE ELEVATION = 81.85 LEGAL DESCRIPTION: HIGHLAND TERRACE SUBDIVISION #4; TRACT 2B TYPE OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE '.... Je a Garn ss.-' E-7 4pfa ........ ..... d'oro fes sio0\ ��400es DATE: 7/25/2002 DRAWN BY: R C.J.G. SCALE: N.T.S. -3241, PAGE NUMBER: 18 3 OF 3 LEGAL DESCRIPTION: HIGHLAND TERRACE SUBDIVISION #4; TRACT 2B TYPE OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE '.... Je a Garn ss.-' E-7 4pfa ........ ..... d'oro fes sio0\ ��400es ALASKA WATER & WASTEWATER - - - - CONSULTANTS, INC. July 26, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Cutbank Waiver for Tract 2B; Highland Terrace Subdivision. To whom it may concern: We request that you waive the 50 foot cutbank to drainfield setback to 20 feet. The new drainfield was installed in the same location as the existing drainfield. The existing drainfield was in a surcharged state with no indication of surfacing effluent and the encroachment from the existing cutbank has existed for 19 years. The cutbank is heavily vegetated. Additional fill was pushed over the cutbank to create more seperation. Fill was added as much as possible as not to start sluffing into the road. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your,assistance. .E., M.S. 6901 Debar Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 11, 2002 Expiration Date: Jun 11, 2003 Permit Number: SW020160 Parcel ID: 050-311-22 Legal Description: HIGHLAND TERRACE #4 TR 213 Design Engineer: 0024 Eagle River Engineering Services Site Address: 010919 STEEPLE DR Owner Name: Fred Ripp Lot Size: 158077 SQ. FT. Owner Address: 10919 STEEPLE DR Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER , AK 99577-8467 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: G elIZ61 MUNICIPALITY OFANCHORAGE Development Services Department V On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 11, 2002 Expiration Date: Jun 11, 2003 Permit Number: SW020160 Parcel ID: 050-311-22 Legal Description: HIGHLAND TERRACE #4 TR 213 Design Engineer: 0024 Eagle River Engineering Services Site Address: 010919 STEEPLE DR Owner Name: Fred Ripp Lot Size: 158077 SQ. FT. Owner Address: 10919 STEEPLE DR Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER , AK 99577-8467 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: G Municipality of Anchorage • �) Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel 1. D. Osd _3 1 1- a a Permit Number SWOZO/0 Prcn.e <vowner's) P7recQ lrCtg(J Day phone (99J/-36+� Mailing address (1) 10919 '+"pie, &Q5ie_ 2v'JiL Al olg577 Mailing address (2) Zip Code Legal description (Lot, Block&Sub'd.)`rra a =28. i -/,Rh lC od Z.ry-ane, Legal description (Section, Township & Range) Lot Size /S$) 077 Acres q.F THIS APPLICATION IS FOR: Number of Bedrooms -1 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade Jam'' THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Zia) , Waiver Fees: Date of Payment: 6 'Z Date of Payment: Receipt Number: /j ZQ 3'10141 Receipt Number: (Rev. 12!00) Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax June 7, 2002 Dan Roth On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Tract 2B, Highland Terrace # 4 Narrative & Permit Re -Application Dear Mr. Roth: We had originally applied for an upgrade permit on 5/28/02 for a new trench upgrade for the subject property. As the slope aspect was 35% your department questioned the separation distance to bedrock and water at the actual trench site as our test hole was located 10' horizontally downslope of the proposed upgrade location. In a telephone meeting we informed you that we could not excavate a test bole upslope of the proposed location and you would allow us to excavate the test hole in the actual trench location. Two test holes were excavated with bedrock at 6' for both holes versus 13' at the original test hole. This eliminates our proposed upgrade location and shows a steeply sloping bedrock plane in this area. In another telephone meeting we requested that the permit be issued allowing us to excavate out the old leachfield and replace it with a new field in the same location. This application is for that proposed scenario. The distance to a change in slope of>25% will be increased to a minimum of 35' to the new field in the existing location by building out and grading the slope. The proposed septic system upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. This upgrade will not affect the ability of neighbors to upgrade. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity, this is an upgrade. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Louis Butera, P.E. \2002\02-014 NAR2.DOC ANO CONFLICTING �.� / _ 175 4 ' N89'57'33°E 15 WELLS OR SEPTICS ry�"j' / — — — / I 10' SLOPE MAINTENANCE ESMT. / I � I \ /Ae \\R100.0 XryhA° \1 V X�TOE OF EXISTING SLOPE \ (OUSE / H 2 X \ ® H I 3' WIDE X 56' LONG Z TRENCH IN EXISTING O S \ LOCATION �d10 R6R\\ cn STF v \ �'\` SAO ry\ TOP OF SLOPE .O N TOP OF SLOPE \ \ ED AT 25% ryh Ip 18/14 X100' �N \ \ \\ I \ I \J z LJ w Q Lu w z J In fn 0 r` \ V O THIS IS NOT AN LAND SURVEY AND IS BASED OFF AN ASBUILT SURVEY AND GRID NWO155. NO SURFACE WATER _ NO KNOWN CURTAIN DRAINS o — MO ffL •W* TEST HOLE MONITOR TUBE SEWER CLEAN OUT WELL EASEMENT PROPOSED LEACH FIELD EXISTING LEACH FIELD DRIVEWAY WELL SEPTIC SITE PLAN LEGAL: HIGHLAND TERRACE 4, TRACT 28 .��� OF<1g11j+�I OWNER: FRED RIPP CONTRACTOR: N/A * :49TH I JOB# 02-014SWI DATE: 6/7/02 1 SCALE 1 " =100] EAGLE RIVER ENGINEERING P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) SERVICES WE •• LOUIS A. BUTERA CE 6736 = O Py LI ka��ES510N PL ��� Eagle River Engineering Services Louis Butera. P.E. P.O. Bos 773294 (907) 694-5195 tel Eagle River. AK 99577-3294 (907) 694-3297 fax WELL Sr SEPTIC ADEQUACY TEST REPORT TEST DATE: 5/3/02 LEGAL: Highland Terrace #4 Tract 2B LOCA -1101x: Eagle River RESIDENCE: 3 Bedrooms/ single family residence WELL YIELD: 2.2 Gallons per Minute WATER SYSTEM: Private Well WATER SAMPLES: Held pending septic upgrade Well has a history of satisfactory coliform and nitrate SEPTIC SYSTEM: From MOA Records Tank: 1000 Gallons Absorption System: Trench tNe INSTALLATION DATE: 1983 TEST PROCEDURE SEPTIC: The leachfield was found to have effluent levels that show the leachtield is entirely saturated and will not meet IVIOA code approval for adequacy testing. This was reconfirmed by level measurements taken one week after test period. The systam will accept a limited amount of effluent and is not considered an immediate health hazard but will have to be upgraded by installation of a new system. WELL: The well was pumped at a gradually decreasing flow rate of 6.0 - 2.2 GPM. Total drawdown from an initial static water level of 5 feet was 380 feet after 175 minutes of pumping. At this point the water surface level in the well was stabilized at 385 feet below the top of well casing. The well was then pumped for 96 minutes at the rate of 2.2 GPM maintaining a water level of 285 feet in the well. With the use of a sonar the flow rate of the well was monitored and calculated at maximum rate of 2.2 GPM. This Flow or yield rate is based upon the assumption that the well is being placed under normal usage prior to the test date. un -V Trtir Itl inRr.ugr Paye i of'- TEST RESULTS The well tloe rate meets the requirements of the Municipality of Anchorage for a 3 bedroom single family residence as of the day the system was tested. The septic system will require an upgrade and this is being processed by Eagle River Engineering Services. Water samples have a lifespan of 30 days and will be taken when the IeachNeld is being upgraded so that they will not have to be repeated for home closing. Assessment of esistin, subsurface conditions by the inspecting engineer is limited to information obtained from the available monitoring tubes and MOA record search. We do not guarantee the validity or quality of subsurface tests and inspections performed by the original inspecting engineer or authority. This report is limited to absorption rate testing and surface separation measurements as currently required by the ADEC and does not verify the integrity of the piping for the water supply or water quality other than the bacterial and nitrate content. There is no guarantee that the well water system tested will meet the requirements for approval in the future. The test data and investigation of existing conditions is provided to our client for submittal to the MOA for their tiles. Anv concerns with this test report should -be discussed with the testing engineer. If it is requested. we will submit this report directly to the ADEC. Louis a.9utera •" S ` CE -6736 m,Q Ti SrRLMIRr.DUC - - Page 2 of 2 Municipality of Anchorage Development Services Department Budding Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.5650 www.ci. anchorage. ak. us (907) 343.7904 Soils Log - Percolation Test Performed For. Fred R I nn I Date Performed: 7 I 2 Legal Description: Highland Te✓mce "t Township, Range, Section: T)'t 4 sec..] 1 1 1 1 1 1 1 COMMENTS TO P.5 oil Mik Or6A h 1C. Gm) 51 1f1Sn'jd1C-rgpel Brow>7 hied Oenae WAS GROUND WATER ENCOUNTERED? S IF YES, ATWHAT DEPTH? dej L 0 Depth to Water After P Monitoring? // E Date: Reading Date Gross Time Net Time Depth to Water Net Drop 'oaK Sl r2 L- 2 rr S: 31 0 /Omits '3 I`r 3 1 'r S: 51. 0 0 30 ,,,;,1 s =5 S It 6:10- 0 0 1 10 PERCOLATION RATE ._(mwUeYv ) PERC HOLE DIAMETER TEST RUN BETWEEN S FT AND FT PERFORMED BY: E, R , I ,.- CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE HATH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT CN THIS DATE. DATE. .S`7 -S -�i� Municipality of Anchorage DEPARTMENT OF HEALTH 3 HUMAN SERVICES 825 "L'• Street. Ancnorage, Alaska 99502-0650 SOILS LOG Z— PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: O � LEGAL DESCRIPTION:7r— f %j 7---A'= 4v y Township. Range. Section: DEPSH SLOPE SITE PLAN 6 7 8 9 10 11 12 13 14 15 16 17 18 19 eeAT, I Ll WAS GROUND '.VA TER EN000N7ERED2 nJ� S L IF YES. AT'•VHAT O DEPTH' > OeDm to Water Alter IHemtunngl Oale: Reaping Dare tR'EETI Net Tme Depth to Water 1 � — {r 3 I I I I 4 �= I 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 eeAT, I Ll WAS GROUND '.VA TER EN000N7ERED2 nJ� S L IF YES. AT'•VHAT O DEPTH' > OeDm to Water Alter IHemtunngl Oale: Reaping Dare l Gross ime Net Tme Depth to Water Net Drop i I I I I I I I i I I I � I I t I I I 20 I PERCCLr.TICN RATE N4 tmmw:es..ncn, PERC HOLE CIAMETER lu' TERUN BETWEEN FT bC S COMMENTS PERFORMED 3Y ���1•, ACCORCANCE '.VIPH CE... -1 'HA7 *HIS TEST WAS PERFCRMEC IN ':j N EP==''.7 ,N -HIS DA 7 EC A- 6- e-1/—GZ 0 • r Municipality of Anchorage OEPARTMENT OF HEALTH & HUMAN SERVICES ��`; Louts A.Buterap, 825 "L" Street, Anchorage. Alaska 99502-0650 s S CE 6138 �or SOILS LOG PERCOLATION TESTti� PERFORMED FOR:___ lel J4� GATE PERFORMED: 6�y�01 ��'' ii,SL i. . ( LEGAL OESCRIPTION:/r''s, fa/P 7e,�-'a Sr Township. Range. Section: OEPT)A I SLOPE- SITE PLAN 6 6 7 8 9 10 it i lz 13 14- is- 16 - 17 4151617 18- 19 20- L COMMENTS r to 0 WAS GROUND WATER ENCOUNTEREO'Ll SIIIIIii�!I IF YES, AT'.VHA7 Oi DEPTH? ?' Eillillii II Ge0th to Water alter i Monitoring? gats Reading I Date Gross —7T Time et Tlme Oeoth to Water 3 /. LfIV.r 4- r_s s�ia I I 6 6 7 8 9 10 it i lz 13 14- is- 16 - 17 4151617 18- 19 20- L COMMENTS r to 0 WAS GROUND WATER ENCOUNTEREO'Ll SIIIIIii�!I IF YES, AT'.VHA7 Oi DEPTH? ?' Eillillii II Ge0th to Water alter i Monitoring? gats Reading I Date Gross —7T Time et Tlme Oeoth to Water Net Orao /. LfIV.r r_s s�ia I I I I I I I I � I PERCGLATION RATE NQ %minu:es inc^, PERC HOLE DIAMETER TEST RUN BETWEEN �/l F7 AND • - PERFORMED By e T' . CE.... + THAT -riS 'ES T WAS PERFORMED tN __. A.GCORDANCE'.VIT" Al i,A-= t.,^. 111 'Ir Pa, . , C=:_ tei v _== -% —I-tS CA 7= CA 7-� �`i "'O L Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 Eagle River, AK 99577-3294 (907) 694-5195 tel (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM — MOA CERTIFIED INSTALLER LEGAL: Highland Terrace #4, Tract 211 June 7, 2002 A. GENERAL 1. The well and septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK 1. Septic tank shall be a 1000 -gallon tank capacity of MOA approved construction. Tank may be located closer to deck but outside of the 100' protective well radius. Existing tank is to be pumped and properly disposed of. C. DRAINFIELD TRENCH 1. The trench is to be located in the area shown on the site plan excavating out the old trench and placing the leachfield material in a burial pit onsite. Trench width is to be sufficient to show soil that is not contaminated by leach material on both sidewalls of the trench. 2. The bottom of the trench shall be level, plus or minus 1.5". 3. The total depth of the trench excavation is not to exceed 9' at any point. 4. The trench gravel is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of +3' or equivalent is to be placed over the leachfield. 6. The area over the trench is to be finish graded to prevent ponding of surface water runoff. 7. Soil must be placed and the slope downgradient of the leachfield be graded so that there is a distance of 35' minimum from the edge of leachfield to a change in slope of 25%. RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH= 9' GRAVEL DEPTH = 5' under pipe, 2" over pipe TRENCH LENGTH= 56' TRENCH WIDTH = as necessary see note #C 1 NEW SOIL RATING = 0.8 GPD/ft BEDROOM CAPACITY = 3 SEPTIC TANK = 1000 REQUIRED ABSORBTION AREA = 563 SF. minimum Twenty-four (24) hours notice required for all inspections. \2001\02-014Trench-spec2.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 02-014 Calculated By: LB Date: 6/7/2002 Legal: Highland Terrace #4 TEST HOLE 1 Single Family 3 Bedroom Dwelling Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 12 minutes per inch Wastewater application rate = 0.8 gallons per day per square foot Required absorption area = 563 square feet Trench width (W) = 3 feet Gravel depth (D) = 5 feet Required length = Required absorption area / 2 / D Required length = 563 / 2 / 5 Required length = 56 feet Total Excavation Depth = 9.0 feet 49TH °moi .................. ....... � •. LOUIS A. BUTERAO CE -6736 ,' �`"p") OOFESS 02-014cal drainfield 3br.xls 4:11 PM6/7/2002 EAGLE RI" -R ENGINEERING k,-AVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694.5195 JOB ) fli:i 4i+Ll TC'rloC`— #Y TR'`+CT1,& SHEET NO. _ �s OF CALCULATED BY L� DATE_ CHECKED BY DATE_ - v - \ � 0 n' � �\ EACRWTFO BFKY S ti y`• \/ \ � AtaeE EXcEfJ n+wrcit.�+f- Y W \ 90 QK `\ f 4 �e \ e 1 i � f497l3 ti � � Louis A Butera ®®' ti� CE 6736 : 'j# 00 _ Q=Z vxonnmu :.vim=ys; u<. ccn wa Dial. Fred Ripp 10919 Steeple Dr. Eagle River, AK 99577 907-694-3618 Municipality of Anchorage On -Site Water and Wastewater 4700 S. Bragaw Street PO Box 196650 Anchorage, AK 99519-6650 June 19, 2002 To whom it may concern: This letter is to notify your office that I plan to install the septic system upgrade on my property myself. The property is Tract 2-B Highland Terrace Subd. Add. No. 4 I am experienced in the operation of heavy equipment including excavators and bulldozers of the type to be used on this project. I am renting the equipment from Airport Equipment Rental. Engineering inspections and due notification of your office will be completed by Anchorage Wastewater Consultants. Please call immediately if any more information is needed as I plan to start work on June 24. Sincerely, Fred Ripp 46 MUNICIPALITY OF ANCHORAGE is DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 - ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE prNew - FN K tSi ©♦40mes Nt -ul B' SSBI EIUPGRADE MAILING ADDRESS _ Z L )t/ C 3 LEGAL DESCRIPTION 7 - /2 OCT 2-6 ib 2 ACE 5 � LOCATION NO. OF BEDROOMS s 2 3 O Y DISTANCE TO: Well / -� rea ' Absorption are_;,- Dwelling / t Zlg PERMIT NO. $3 -Z3 QF Manufacturer Material No. of compartments w w Liq. gapacity in gallons IF HOMEMADE: Inside length ` - WidtFi Liquid deg+t, - O�z DISTANCE TD: Well Dwelling PERMIT NO. = Z F Manufacturer IfT Material Liquid capacity in gallons D m= DISTANCE TO: Well Q f' Foundation Nearest lot line PERMIT N Z w No. of lines / Length of eac}I I / 4 Total length Ifpgs / Trench widttll /� Distance between lines F2 ¢ J inches p. Top of the to finish grade I, / 4 Material beneath the Total effective a¢so 'gn'p+a 4 O inches (50 Length Width De t PERMIT NO. w ED 41- Type of crib Crib diameter r' th Total effective absorption area wa y DISTANCE TO: Well Building foundation Nearest lot line J Class Dapth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: di g t nda on Sewer line Septic tank Absorption area(s) OTHER — PIPE MATERIALS SOIL TEST RATING Moe INSTALLER - R K. CL. REMARKS L- o �+ i dw ® fl00 0 j ® „ m 'j MRobert A. Shafer ;.,f ++� No. 1457-E m aF ,oA PROFE5S10�P� I 'ewaa APPROVE//DATE LEGAL - v6 72-013 (Rey,3/78) r�1�iN I r I t_ I T Z' 41F IFir-JC R9=iC;E DEPARTMENT HEALTH AND ENVIRONMENTAL OTECTION > 825 'L' STREET, ANCHORAGE: AK. 99501 264-4720 tit -4—!E75 I TE !SELJER F-EFZ" I T PERMIT NO. { 830629 ) APPLICANT AK RESID HOMES INC 2214 ROSEVELT 99502 2485587 LOCATION STEEPLE 'R LEGAL LOT SIZE 55555 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: EpaF='r S) L_ a N IC3-rH= 4!5 K3FZI=V %.-P E>EPTH= 15 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F<EG�4 o I REGI SEPTI C TF=ilr-aK S} I �E_ 3LID010 GRLLC04- 37 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. --- TL41D < �2I tib -F Ea. T I v�ta5= FtFRE REC-�U I Fg ECa -- 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. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERri Y T E>SP I RES~ LTE=C:EME3ER :3::L, -S� �_� __3: I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS 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 TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED 6d APPLICANT ISSUED BY_ AK RESID HOMES INC: V4. 0 ` • SOILS LOG r MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 0 PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: l //V/i r� 1�J�L�R{c�2C� DATEPERFORMED: LEGAL DESCRIPTION:li DEPTH ,/� �SLOPE SITE PLAN (FEET. ©je(o, Y/Y?C S'!L.%� ,S69lj//� 1 2 O. 3 Date Gross Time Net Time �e 4 Ll�,�-r s�LT 5 G l S .6 6 Date Gross Time Net Time �e Net Drop 7 9 O 10- 12 12 `� O 6,e%weL WAS GROUND WATER / �D ENCOUNTERED? IF YES, AT WHAT vo DEPTH? 13 Rof'-fvv— Of {'\Ole 14 15 16 17 18 i 2ohest A- Ehwjrr Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT PAIP FT PERFORMED �+ .0E'SGINEER-Ply CERTIFIED Lr°?tb7WRIVE ALA3SKP r� n PH- 604-207 72-008 (6/79) -- -_. DATE: v vV c- O / by/_AS 1217 DOC Co. dba SULLIVAN WATER WELLS / r c/ P.O. BOX 272, CHUGIAK, ALASKA 99567 • TELEPHONE 688.2759 AJ I 7 ' � OWNER OF LAND Z77,1 s4 •✓ O /_ l�� l cl L=/_ L DEPTH OF WELL 3 0 0 ADDRESS .7 R o D, ELl G't i 6 G ! ASTATIC LEVEL OF WATER ? LEGAL DESCRIPTION 74.2 c 7- W1 615V4 OOA 5 u 4 O DRAW DOWN FT. DATE -Started -Z -E-3 Ended /� . _? GALS. PER HR 4o Tidy PERMIT NUMBER KIND OF CASING d �✓ KIND OF FORMATION: From 0 Ft. to_=2_Ft.- From�Ft. From Ft. From Ft. From ! i 1 Ft. to SL-Ft.�c flrl n L ShL i /� From Ft. to Ft Ft. From k ! Ft. to h a Ft. Dig /=4',45-7_0<c0From lar' e-leO L'-- 5",,41 19 Ft. to . Ft Ft From Ft. to Ft. From FL to Ft. From S O Ft. to Ft !?f !JE J L C LTeo ! } From Ft. to Ft. From Ft tc Ft u 4,<4rom Ft. to Ft. From_ �'_ Ft.to�_Ft. 1.7c Ern%_ �C C a 4Lj From Ft. to Ft. From Ft to Ft. l 157 t- r= From Ft to Ft. From .2 1,1717t. to 3S Ft. -2 > n <_ Tom Ft. to Ft. From Ft. to Ft.- FG.n S From Ft. to Ft. From :� c i Ft. to 7_ZL Ft. a < '� t fi d! c / F 4t f Ft. to Ft. From Ft. to -Ft. l� x O From Ft. to Ft. From i42. Ft. W-2 __7 13Pey e -L' �o41a From Ft. to Ft. From ? J Ft. to Yo Ft !3FOfn L 4� L�'G"'From Ft. From Ft. to Ft. i?! P`/ ,� S '� (7 ii. *'> From Ft. to Ft. From iF Z Ft. Ft. lar' e-leO L'-- 5",,41 19 From Ft. to Ft MLSCL. INFORMATION: T)R11.1,FR'C NAMF _�!-C DGCS Municipality of Anchorage ata Development Services Department Building Safety Division s On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-311-22 HAA# HP 0 0- 0 7 f 1. GENERAL INFORMATION Expiration Date: 1—/(0 O Complete legal description HIGHLAND TERRACE SUBDIVISION #4: TRACT 2B Location (site address or directions) 10919 STEEPLE DRIVE * EAGLE RIVER, AK 99577 Current Property owner(s) FRED RIPP Day phone 694-3618 Mailing address 10919 STEEPLE DRIVE * EAGLE RIVER, AK 99577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site E Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, orprior to closing for the engineering services provided. 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 Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE V Approved for 3 bedrooms. Disapproved. Phone 337-6179 Date to 11( Conditional approval for bedrooms, with the flowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other ON-SITE . I'll "n HIVU • I WASTEWATER o-t-MUcRAM By: ��� (w, Original Certificate Date: (Rev. 12101) ALASKA WATER & WASTEWATER CCSNSULTANTS, INC. October 15, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Attn: Jinn Cross, P.E. Ref: Highland Terrace Subdivision 94, Tract B. Property Owner Fred Ripp. Waiver of Separation Distance Between the New Drainfield and a Slope Greater than 25%.. Dear Mr. Cross: Attached is a profile drawing which shows the separation distance from the new drainfield to where a 25% slope, two feet above the top of the drainpipe, would daylight at the existing slope. The separation distance is roughly between 26 feet and 28 feet. This is roughly 7-9 feet less that than routinely approved separation distance of 35 feet. Based upon the following facts, it is my opinion that this encroachment does not present a risk of daylighting: The separation distance provided is greater than what existed prior to the septic system upgrade. The old trench was surcharged and closer to the slope, however, no daylighting occurred. • The soil is GM material with a percolation rate of roughly 12 minutes per inch. The effluent that is migrating from the trench should move downward rather rapidly with minimal lateral migration, certainly not over 20 feet. The performance of the old drainfield is proof of this. • The slope is vegetated, which will help to inhibit surfacing of any laterally migrating effluent. luestions, please contact me at 337-6179 .E., M.S. 6901 Debarr Road, Suite 2B *Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com `--rak�~r . 2 9 , ,txxX 1< <I +1 a o J N O w vi ` I .V 11 U 11 4r� CD 1 Il N 3 N / 7550 SLOPE CJOLIL4 OAYL1CT i!(PROit- Zg'-ZR' FRtl.N� O— Municipality of Anchorage e Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 f, , www.ei.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-311-22 HAA#4� 7/ 1. GENERAL INFORMATION Expiration Date; /0 - /S - d Complete legal description HIGHLAND TERRACE SUBDIVISION #4; TRACT 2B, Location (site address or directions) 10919 STEEPLE DRIVE * EAGLE RIVER, AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address FRED RIPP Day phone 694-3618 10919 STEEPLE DRIVE * EAGLE RIVER, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 Day phone Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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. Note: Alaska Water and Wastewater Consultants, inc, shall be paid $ at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future perfonnance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. 337-6179 Date O XX Conditional approval for 3 bedrooms, with the fllowing stipulations: Money to be placed in escrow for the amount of 1-9 times rhe high hid from three contractors Work to be performed pursuant to pnginpers letter of August 21, 2002. Money in escrow shall not be released until this offioe r 5 K fPrilrcC has given final approval. Work to be completed by October 15 2M17_ /�. iJ--,0--L- }- Attachments: HAA Checklist Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other By:� Original Certificate Date: Z Z (Rev. 12101) Municipality of Anchorage .a Development Services Department Building Safety Division On -Site Water& Wastewater Program "v 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ok.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: HIGHLAND TERRACE S/D #4; TRACT 26, Parcel ID: 050-311-22 A. WELL DATA *CASED TO BEDROCK **WELL TEST DATA BY EAGLE RIVER ENGINEERING SERVICES Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 7/13/83 Sanitary seal (Y/N) YES Total depth 300 ft. Cased to *19.5 ft. FROM WELL LOG Date of test 7/13/83 Static water level 20 Well production 0.67 — 9 -p.m -WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: N/A mg./L. B. SEPTIC/HOLDING TANK DATA Nitrate 0.687 mg./L. Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION **5/3/2002 2.2 g.p.m. Other bacteria 0 colonies/100 ml. Date of sample: 7/1/2002 Collected by: E.R.E.S. Tank Type/Material STEEL Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (YIN) YES Depression over tank (Y/N) NO Date of pumping NEW Pumper C. ABSORPTION FIELD DATA BELOW FINAL GRADE Date installed 6/25-26/2002 Soil rating 02DJbr ft2lbdrm) 0_8 Length 56 ft. Width 5 ft. Date installed 6/25-26/2002 Cleanouts(Y/N) YES High water alarm (Y/N) N/A System type TRENCH Gravel below pipe 4.15 ft. Total depth *8.9 ft. Eff. absorption area 565 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) – Fluid depth in absorption field before test = in. Water added =gal. Elapsed Time: = min. Final fluid depth = in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) – Absorption rate >= For 3 bedrooms New depth =in. If yes, give D. LIFT STATION Date installed "Pump on" level at in. E. SEPARATION DISTANCES Size in gallons Cycles SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ High water alarm level at in. Meets alarm & circuit requirements?. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line t0'+ Surface water t 00'+ Driveway, parking/vehicle storage 25'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION :§�G I certify that I have determined through field inspections and��* 4 T � �O review of Municipal records that the above systems are in "" conformance with MOA HAA guidelines in effect on this date. Q QQ_Jet y Garness:' 15 Engineer's Printed N'e JEFFREY A. GARNESS Qo4� C 7953 .• .gyp Date o\ rofessio� o� �040oo�oa HAA Fee $ I Date of Payment QZ Waiver Fee $ Date of Payment Receipt Number n 10 Receipt Number (Rev. 12/01) M% AJ/ {a I hereby.certify that I have sur, eyed the following described property: r ta-.-F f . _• ,.�_Y_--- ,( A Ey S�G�ro 7 Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said propertyexceptas indicated hereon. Dated at Eagle River, Alaska this- II(} day of_ ZY� i ]* ROB C. JOHNSON SCALE: Registered Land Surveyor'No. 0 0 -LS 1" _ /00 Box 456, Eagle River, Alaska Phone (907) 694-2543 ALASKA WATER & WASTEWATER CONSULTANTS, INC. August 21, 2002 Subject: Contract requirements for fill on Tract 213, Highland Terrace To whom it man concern: The scope of work is summarized as follows: Regrade area downslope of the existing drainfield so as to provide an effective 35 foot distance from the edge of the leachfield to a change in slope of 25+ %. The area downslope of the leachfield will be filled/graded so that a the slope from a point 2 feet over the leach field pipe (and at the edge of the drainfield) to a slope greater than 25% is equal to or greater than 35 feet. If you have any questions, please contact me at 337-6179. P.E., M.S. 6901 Debarr Road, Suite 2-13 * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com MUNICIPALITY OF ANCHORAGE • ^� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services INAW On -Site Services Section Oxe P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ©fid - 31 -;2 \' HAA#11�CI�4�� 1. GENERAL INFORMATION Complete legal description _141 94 /ati/ _ 7errr .e- mad �6 19L Location (site address or directions) o �/l� & Ea9/r ,P,•„�r �k Property owner fth Z7 P.// ¢ Lxn, Ski i� /ey Day phone d�-/ `1' 2 3 Z3' Mailing address P 0der 7�r� S6q E��/l Q,° er Ak. p'?s-`17 Lending agency Mailing Day phone Agent `l Y n„ `/ L -e e- /el m �.r Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 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(11ev1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 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 furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signatyir�. B.773294, Eagle River, 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments LOS bedrooms. Phone Date I Z` 8 —`t $ bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(RW.1M1 Beck MOA#21 RECEIVED Municipality of Anchorage DEC 08 19 DEPARTMENT OF HEALTH & HUMAN SERVICES MUNICIPALITY OF AN Environmental Services Division ENVIRONMENTAL SERVI 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: 4lUHA 72, ce 't 7ZC-T 2/33 Parcel I.D.: Of O " 3/1—,2 Z A. WELL DATA Well type rlvn Te If A, B, or C, attach ADEC letter. ADEC water system number X410 Log present (Y/N) Xe Date completed ;�?-/ 3 - F 3 Total depth 300 ` Cased to % 9 b ' L-azacCasing height (above ground) 2 Sanitary seal (Y/N) Date of test Y� s FROM WELL LOG 7-13 -- $3 i Static water level _ rel Well production 0, 7 WATER SAMPLE RESULTS: Coliform Nitrate Wires properly protected (YM) ee Cs AT INSPECTION /2--z-ys Zy' g.p.m. 2' 7 g.p.m. /. _z 6 ...y // Other bacteria Date of sample: 2 _ 1 - `t Collected by: B. SEPTIWHOLDING TANK DATA Date installed '?- Y3 Tank size we �j y Number of Compartments 2- Cleanouts (Y/N) / e s Foundation cleanout (Y/N) If s _ Depression (YM) /1/) High water alarm (YM) /� ¢ Date of Pumping Pumper Th s F""'l ,2 C. ABSORPTION FIELD DATA Date installed - L r/ Soil rating (g.p.c1AV or ft2/bdrm) )j f13 4System type 7 rr-L14 Length yS Width 3 Gravel thickness below pipe S Total depth 'i Effective absorption area HSD /r z Monitoring Tube present (Y/N) 1 `j Depression over field (Y/N) _Arcs Date of adequacy test 124- 93' Results (Pass/Fail) PJf For 3 bedrooms Fluid depth in absorption field before test (in.); y Immediately after YO gal. water added (in.): 33 11 Fluid depth 9 (ins) Minutes later: Absorption rate f yg a.p.d. Peroxide treatment (past 12 months) (Y/N) IVO If yes, give date /C/q 72-026 (Rev. 3/96)' D. LIFT STATION Date installed Manhole/Access (Y/N) High w=tested es E. SEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Size in at* Septic/holding tank on lot J! �7 On adjacent lots Absorption field on lot 12,11-11 On adiacent lots Public sewer main _ Sewer /septic service line 42r "Pump off" level at* Public sewer manhole/cleanout Lift station xV,4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation -2- g Property line t f b Absorption field 1114 Water main/service line Surface water/drainage -1 /eti Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / O r Property line ��� Building foundation y0 Water main/servios line Surface water i /C)e' Driveway, parking/vehicle storage area, Curtain drain 11114 Wells on adjacent lots 4- /,�q" F. ENGINEER'S CERTIFICATION I cerW that I have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signature ®- Engineer's Name Goes �• P1, t Date /Z- HAA Fee $>>D Cod d Date of Payment !o`L� o �Ig Receipt Number �y��� 77,3 72-026 (Rev. 3/96)` Waiver Fee $ Date of Payment Receipt Number +-3d / CUTS are 0 A t,(�,-L v' O MUNICIPALITY !� ANCHORAGE DEPARTMENT OF HEALTH &HUMAN SERVICES M �A Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 050-311-22 HAA # 1A �" 1. GENERAL INFORMATION Complete legal description Terrace #4, Tract 2B Location (site address or directions) 10919 Steeple Drive, Eagle River Property owner Laurie Jarvela Day phone 694-2325 Mailing address 10919 Steeple Drive Eagle River, AK 99577 __ Lending agency NSA — Day phone Mailing address--------- Agent ddress — Agent —_ ReMax Q Anct�age /Mike Messick Day phone Address 2600 Cordova Street, Anchorage, AK 99503 Unless otherwise requested, NAA will be held for pickup. 2. NUMBER OF BEDROOMS: ___3_ \,__. 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water 276-2761 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 X Holding tank Community on-site _— Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91 Front MOA 021 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Eagle River Engineering Services Address P.O. Box 773294 Engineer's signature 6. DHHS SIGNATURE M River, AK 99577 X Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments 0 Phone 694-5195 Date 7//3/,i bedrooms, with the following stipulations: Date 9 ^ f — %4 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 120_)SIIluv I/911 !fuck MOAIIJI ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:_ r6ez!A'[, �j Parcel I.D. 050-3i/ -ZZ >2,1er Z/3 A. Well Data Well type P%jd47E If A, B, or C, attach ADEC letter. ADEC water system number /J/A Log present (Y/N) Y65 Date completed 01//319 3 Driller Sol-&I✓A1,1 Total depth 3U0 Cased to /91("" Casing height Sanitary seal (Y/N) V65 Wires properly protected (Y/N) yE� FROM WELL LOG Date of test o 7 h 3 83 Static water level 84 Well flow g.p.m. Pump IeveH Z 90 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot //7 ) AT INSPECTION bl�lZi�9t o z rT-, c._ n r 3. 0 g.p.m. y r _rn C < n rn co Z 00 00 ; On adjacent lots /"/0o Z Absorption field on lot ; On adjacent lots f /00 J Public sewer main n//✓I Public sewer manhole/cleanout /1)q i Sewer service line t 25 Petroleum tank A/olye 4)0P14)2CN r WATER SAMPLE RESULTS: Coliform $ Nitrate 0. V(.0 Md,IL- Other bacteria -0- Date of sample: 06,13019�j Collected by: "6&N Ek B. SEPTIC/I TANK DATA Date installed 0 93 Tank size /,000 Compartments Cleanouts (Y/N) _T Foundation cleanout (Y/N) Y Depression (Y/N) /V High water alarm (Y/N) N/Iq Alarm tested (Y/N) HIA Date of pumping /0/03/93 Pumper SEPARATION DISTANCES FROM SEPTIC/ISG TANK TO: Well(s) on lot //?' On adjacent lots / UD Foundation To property line f /0, Absorption field S Water win/service line /D Surface water/drainage 72-026(3M)•Front CONTINUED ON BACK PAGE C. LIFT STATION IYI #) Date installed Manufacturer Size in Vent (Y/N) High water alarm level Meets MOA electrical codes "Pump on" level at SEPARATION DISTANCE FROM LIFT STATION TO: D. ABSORPTION FIELD DATA (Y/N) "Pump off" Level at tested On adjacent lots Surface water Date installed / M3 Soil rating (GPD/Ft2) / S 0 System type �eENG 14 Length 45 Width 3 Gravel thickness S Total depth 9 Total absorption area #50 Cleanout present (Y/N) Y65 Depression over field (Y/N) NO Date of adequacy test ob/2l Results (pass/fail) P1355 for 3 Bedrooms Water level in absorption field before test After test — i Peroxide treatment (past 12 months) (Y/N) H/ t4 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 17,q On adjacent lots t/010 Property line /DS To building foundation ZID To existing or abandoned system on lot 141lq On adjacent lots f 3o i Cutbank &M Water weie/service line _ff D Surface water 4g Driveway, parking/vehicle storage area Curtain drain N//9 E. ENGINEER'S CERTIFICATION -)"/D I certify that t have checked, verified, or conformed to all MOA and NAA guidelines in effect on "`4 l�e _cute of this inspection. tfi a Z w � 8 Signature Engineer's Name LOvi5 Pzu%e_kl-4 .. }> Date 3✓r y HAAFee$ 01�0 r(,O Date of Payment cz�;a Receipt Number ��1,f C 72026 (3/93)° Back Waiver Fee $ Date of Payment Receipt Number �MUNICIPALITY OFANCHORAGE 6 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 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) cRecc < 2 --S; -rFa.V-(�C-t_ inn r\�� Flo, )+ T/yam lOrw Se<- 7 Location (address or directions) 1 O G\ of ) ) A\5,. 995-7-7 (b) Applicant NameLQvtzE 6Telephone: Home Business a_1 -3011 - Applicant Address S<) -s, �jlA � , t="AG L� YL. Lf-lamAF i 41GA-E C2.A\) V.Y�._) fllc `l`19W7 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builderO ;Buyer ❑ ;Other ❑ (explain); (d) Lending Institution FLAS c Telephone 2'7 L, Address :57.j A N c raang G$ (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: '>=E.O t>LASkti FEi7P�fl1..._ LD �O �'C UN\tea '13\ .-t s'T. \ SINN . _ STTN: MS . \_ 4F% Gu L29-WTN 2. TYPE OF RESIDENCE Single -Family JK Multi -Family ❑ Other Number of Bedrooms -� �� ✓� 3. WATER SUPPLY Individual Well q Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite M Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-02e (11/84) 5. ENGINEERING FIRM PROVIDINv INSPECTIONS, TESTS, FILE SEARCH, DO AND INFORMATION IA 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 (egulations in effect on the date of this inspection. Name of Firm Telephone EAGLE RIVER ENGINEEKIRG SERVIC€S� Address GAM 1: AIVFR AK 99577 Date P. 0. BOX 773294 DHEP APPROVAL, Approved forbedrooms Approved Disappr Terms of Conditional Approval e i Engineer's Seal 311�v-c r. c by Date e�_ oved Condition _ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11184) • . MUNICIPALITY H ANCiiORAG< DEPT. DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) 'j 06 CHECKLIST - FEBRUARY 1984 284-4720 E j1 Legal Description: L/ fel. a`4, f ice/ 1 / �✓ 1e A. WELL DATA Well Classification 1f' I Udr T/ If A, B, C, D.E.C. Approved (Y/N) Al Well Log Present (Y/N) �— Date Completed 7 / 3_ &" 3 ield 3 G P Total Depth 3 D t' Cased to /9 �z Depth of Grouting / VV Static Water Level .sr le- e pump Set At '5 Casing Height Above Ground /.Q Sanitary Seal on Casinq (Y/N) Electrical Wiring in Conduit (Y/N) Separation Distances from Well: y Depression Around Wellhead (Y/N) i To Septic/Holding Tank on Lot //7 ; On Adjoining Lots / To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots — To Nearest Public Sewer Line I' X14 To Nearest Public Sewer Cleanout/Manhole 121 F To Nearest Sewer Service Line on Lot Water Sample Collected by ;Date S %s.:'E Water Sample Test Results air Y r I Comments B. SEPTIC/HOLDING TANK DATA Date Installed '7A3 Size /acw Gam, No. of Compartments Standpipes (Y/N) y Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) f J Date Last Pumped Pumping/Maintenance Contract on File (Y/N) for f��9 Holding Tank High -Water Alarm (Y/N) �y Temporary Holding Tank Permit (Y/N)/W-0 Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line yyo To Water Main/Service Line Course Comments Page 1 of 2 72-026(11/84) To Building Foundation To Disposal Field 5 To Stream, Pond, Lake, or Major Drainage 0 9 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /5 3 Width of Field 3 Type of System Design Length of Field Depth of Field y Gravel Bed Thickness .S / Square Feet of Absorption Area �'Ile S Standpipes Present (Y/N) Depression over Field (Y/N) Results of Last Adequacy Test ,L Date of Last Adequacy Test ,5/i�/ s-6 7- c7�2'r g Separation Distance from Absorption Field: To Water -Supply Well / Q 4, 1 To Property Line /�, Y To Building Foundation /716To Existing or Abandoned System on Lot On Adjoining Lots3v r To Water Main/Service Line To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course 11-1l-4 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" Level at " Check Permitted Bedroom Rating Against HAA Request " Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. .._ Signed � -��' Date < 1&kC Company MOA No. Receipt No. 3gblo qr-� Date of Payment 11—Ve Amount: $ (42sak Eagle River Engineering Services Page 2 of 2 P. 0. Box 773294 Eagle River, AK 99577 694-5195 72-026 (11/84) 6MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, toxmship,/range) Location (address or (b) Applicants Name Applicants Address (c) Applicant is (check �Vone) Lending I 6�:®i Buyer ; Other (explain); s!0/ -O y: % /v�15/- 5-�' -u0 - home Business Owner/builder ; (d) Lending Institution Ahc (e) Real Est Address Telephone 6. C � � �"� � (f) Mail the HAA to the following address: 2. Type of Residence Single -Family Multi -Family Other (describe Number of Bedrooms 3. Water Supply Individual SdellCommunity Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] S. Engineering Firm Providing Inspections, Tests, File Search Data and Information r, 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 file's 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 regula- tions in effect on the date of this inspection. Name of Firm Telephone Date ;EN�x�E$ b. DHEP Approval Approved for bedrooms By Approved c Disapproved Terms of Conditional CAUTION itional Date THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DEEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DEEP 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. (DEEP SEAL) RR4/ej/D1S [Page 2 of 21 7-19-84 UNICIPALIT! OF ANCHORAGE DEPT. OF HEALTH & • MUNICIPALITY OF ANCHORAGE (MCA VIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) MA? 'I I� CHECKLIST - FEBRUARY 1984 R EI V F D A. MEL DATA Legal Description: ewdr Well Classification�If A, B, or C, D.E.C. Appro (Y ) Well Log Present �{`_ Date Colleted %�f� Yi1d ` <; Total Depth 300 '6-- / Cased to / q �6 � Depth of Groutin ` ' 9? + Static Water Level Z E' i t At CC Casing Height Above Ground + Sanitary Seal on Casing' Electrical Wiring in Conduit/R/W Depression Around Wellhead Separation Distances from Wall: To Septic/Holding Tank on Lot On Adjoining Lots /&X) r< To Nearest Edge of Absorption Field on Lot /�40 L On Adjoining Lots /o0 To Nearest Public Sewer Line To Nearest Public Sewer Cleancu t/Manhole ��� To Nearest Sewer Service Line on Lot 2,>�- Water Sample Collected By --:5o 6�/ /� q ; Date Water Sample Test Results .�_T/S, Cca>nlents /-)c-, 'k_� C ' B. SEPTIC/HOLDING TANK DATA Date Installed T'1 Size Odd No. of Ccmpartments Standpipes ( /N°) Air -tight Caps (Y Foundation Cleanout (Y Depression over Tank ( ) Date Last Pumped Pumping/Maintenance Contract on File (Y/NY" /a ; for If -1111 - Holding Tank High -Water Alarm (Y/N Temporary Holding Tank Permit (Y g Separation Distances from Septic/Holding Tank: To Water -Supply Tull � To Building Foundation To Property Line /D `* To Disposal Field To Water Main/Service Line /7 To Stream, Pond, Lake, cr Major Drainage Course Comments Receipt # Date Paid: Amount: [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption S ata ��1W Type of System Design U - Date Installed 8 3 Length of Field Width of Field 50 <r Depth of Field 9 � �.,( Gravel Bed Thickness Square Feet of Absorption Area Y�5-6 i Standpipes Present (YM) Depression over Field CfA) Date of Last Adequacy Test o eke Results of Last Adequacy Mast Separation Distance from Absorption Field: To Water -Supply Will To Property Line Q� To Building Foundation To Existing or Abandoned System on r Lot N o n F On Adjoining Lots .3--) To Water Main/Service Line /tD ( L To Cutbank(if present) ti 0 o -J To Stream/Pond/Lake/or Major Drainage Course /J 0 I -,J To Driveway, Parking Area, or Vehicle Storage Area go c4 Camients // L9 "J /_� D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Comments Dimensions Manhole/Access (YM) "Pump oft Level at (YM) Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed S r gyi lFiEBlmn Date 2-ZB—�S •o .....:�cA`�, ALAvv Company a ESO 4 a}=-qn MOA No RB1/d5/s .y. rw 11 A. She w No. 1437-E [Page 2 of 21 2-15-84