Loading...
HomeMy WebLinkAboutTIMBERLUX #3 BLK J LT 10oil UM\tzm AJI. ile'k'a Rod 10 4- (:)kl -.4 W -I & NAME LOCATION .-., GREk. _R ANCHORAGE AREA BORG..GH GPS;; Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS %i i09 �Ii%Xita��dU • PHONE LEGAL DESCRIPTION SEPTIC TANK: DISTANCE In NUMBER OF FROM WELL So t MANUFACTURER a MATERIALy' COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH ^— LIQUID CAPACITY GALLONS. TILE DRAIN FIELD: If LINE—/O-it—OF f DISTANCE FROM WELL Ll�FOUNDATION _10"t- NEAREST LOT LINE—/O t OFTLINES LENGTH ,I/ NUMBER OF LINES_ DISTANCE BETWEEN LINES lY../ � TRENCH WIDTH_ IN. TOTAL EFFECTIVE ABSORPTION AREA Soo o SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER / DEPTH: TOP OF TILE TO FINISH GRADE a MATERIAL BENEATH TILE ABOVE TILE IN. WELL: TYPE.�J_" __ CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION , LOT LINE , SEWER LINE_ CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH: I PIPE MATERIAL:, � LOT SLOPE: �9 ' - . REMARKS: Form EQ -032 DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK , SYSTEM_ RAM OF SYSTEM DATE -3o-%6 APPROVED G.A.A.B. F•1 J_� tJ I C I r:—.—i 1. I T'r' �� F= A r -J r-1-1 �r:1-t ►� E DEPARTMENT C. HEALTH AND EN'•rIRONMENTAL I .-TECTION -'16 E. TUDOR PD.. ANCHORAGE, AK. 9--D' 276-^2221 —E• I TE I L•.1EF=: FBFE:V" •1 I T PERMIT N0, 76,741 ) Ai'F'LICANT F:7Lt_ LO'JELACE 2109 t•iCKINLEY AVE LOCATIOtd CI It-:'•.'tL r: LEGAL L10 BJ TIMBERLUX 03 LOT SIZE Q ��:s0 an2 9-7G 279-1738 ,-es. 49-00 SQUARE FEET TYPE OF ;OIL ABSORBTION SYSTEM IS: TRENCH tiR'>:ItiUt1 NUM, -EP OF BEDROOMS = 4 SOIL RATING (SO FTrER)= 150 THE F'EQUIPED SIZE OF THE SOIL ABSORPTION SYSTEM IS: F.•r=_F='T1-4= A_ • LEt-.l1.3TH= Z51-- f- F-�:r=f'% EL C•EF-'-r"= IE - THE 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 GF:OUND 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 CIN FEET). F=:F=�-!JJ I F<:[=C•=.F=F=•T I C THtJF� -• I .=E= 1 •� ►-i GHLL�-it-.J 1-I413 _ �• I rif3F'EC—r I ��tJ nF='E F:E� �_� I F:C[i r•,71CKFILLING OF ANY SYSTEtJ WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEF'ARTHFNT WILL BE SUBJECT TO PROSECUTION. tilNlHUH DISTANCE BETWEEN A 4JELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS li_IFI FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. SF,FCIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE P'ROP'ER ItGTALLHTION. I T %.-n L_ I C• F= 174 F --:C Cl t -J E •-' F- FJ F: F= F: ?D 1 •1 I I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND I -JELLS AS SET FORTH BY THE t'IUNICIPALITY OF ANCHORAGE. I t•JILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. _. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. =.IGNEG:---- - ------ ----------------- APPLiCANT BILL LOVELACE ---- PATE --A 11!��- MUt-J I C I�'AFL I TV OF' FItJ(--V FRF C3 EE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 E. TUDOR, RD., ANCHORAGE, AK. 99507 276-2221 �dtJ-5I TE SEWER PERM I T PERMIT 140. C 76330 T APPLICANT BILL LOVELACE 2109 MCKINLEY AVE 279-1752 LOCATION CURVELL DR LEGAL L10 BJ TIMBERLUX SUBD LOT SIZE 49300 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING CSO FT/BP.)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION E>EF'TH= 12 LEtJ(3TH= 3� GFQr=l%6-FEL oS7 THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE GROUND AND THE BOTTOM OF THE EXCAVR ON CIN FE THERE IS NO SET WIDTH FOR TRENCHES THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL AND THE BOTTOM OF THE EXCAVATION CIN FEET,). REQU I REO SSEPT I iC TRtJK Sa I BACKFILLING OF ANY SYSTEM WITHO'T DEPARTMENT WALL BE SUBJECT TO PP. MINIMUM DISTANCE'B€TWEEN A WELL AN 100 FEET FOR R PRIVATE WELL OR 200 SPECIFICATIONS AND CONSTRUCTION DI INSTALLATION. \ PERMIT %601=fL I E> FQR THE TREK .H OR DRAINFIELD. WEEN THE SURFACE OF THE FINAL INSPECTION AND SECUTION. THE OUTFALL PIPE :ILIOC31 ON-SITE SEWAGE D FOR APUBLIC WEL ARE VRILRBLE 7 OtJE YEF=l R I CERTIFY THAT 1: I AM FAMILIAR JJITH THE REQUIREMENTS FOR ON -SI FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL �THE SYSTEM IN ACCORDA ICE WITH 3: I UNDERSTAND TH}IT`fHE ON-SITE SEWER. YSTEM M RESIDENCE IS REMODELED TO INCLUDE MOPE T AN 3 6E S I GF1ED : _L�LLL`-C`_w✓Gi_tc G6s--_----------- APPLICANT BILL LOVELACE ISSUED GFJLLOtJS~ BY THIS ISPOSAL SYSTEM IS L. D INSURE PROPER i 0r-1 I SLUE AND I -JELLS AS SET IRE ENLARGEMENT IF THE ,MLrAICIrMNIL_ITY OF Fr4Ctl'40FirE DEPARTMENT Or HEALTH AND ENVIRONMENTAL PmOTECTION i 2510 E. TUDOR P.D.. ANCHORAGE. AK. 99507 276-2221 Ot-J—S I TE E}EWER PE=RM I T PERMIT NO. C 76330 ) APPLICANT BILL LOVELACE 2109 MCKINLEY AVE 279-1758 LOCATION C k E LEGAL L10 BJ TIMBERLUX SUBD LOT SIZE 49300 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSO FTIBR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E}EPTH= 1.2 L-Ermir = 3O GRFANfE=L E?EPTF-1= .= THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS-THE"DISTANCE ETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN F ET). THERE IS NO SET'WIDTH FOR TRENCH S. THE GRAVEL DEPTH IS THE MINIMUM D PTH OF GRA L BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATIOt \N FEET). F?E=CILJ I FRE© ESEyT -C T tJ\F� I KE= 1000 C3FlLL.0 >J<=. BACKFILLING OF ANY SYSTEM JITH UT F NAL INSPECTI14iF! AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJEC TO ROSECUTION. / MINIMUM DISTANCE BlYWEEN A WE L AND ANY ON ,5fTE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIV�TEIWELL R 200 FEET FOR A PUBLIC WELL SPECIFICATIONS AND ONk$TRUCTION DIAGRAMS zARE AVAILABLE,TO INSURE PROPER INSTALLATION. FsEFZty I T NAFiL_ FOR/Ot+IE-YRFFFc' F= ROM I 113LlE I CERTIFY THAT 1: I AM FAMILIAR WITH THE R MISS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY 0 CHORRGE. 2: I WILL INSTALL THE SYSTEM IH 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:_!l1'-'=-�t_LSCZ6s�4-------------- APPLICANT BILL LOVELACE c ISSUED n Mr. Bill Lovela" 2109 McKinley Avenue Anchorage, AI: 99503 n 4040 '•B" STREET, ANCHORAGE, ALASKA 99503 PHONE: 907.279-2581 March 1, 1976 W.O. 17613 Grid 3136 Subject: Subsurface Investigation - Lot 10, Block J Timberlux Subdivision Dear Mr. Lovelass: Transmitted herein in accordance with your instructions are the results of the above referenced investigation as performed by us on February 25 thru 27, 1976. The scope of this project is investigation for suitability of an on-site sewerage system. Included in this transmittal are: Vicinity flap Figure 1 Test Bole Location Sketch Figure 2 Test Hole Log Table A Explanatory Information Sheets 1-3 The exploration was conducted using a track. mounted Mobile Drill model B-50 drill rig with a continuous flight solid stem auger. The rig is owned and operated by Denali Drilling, Inc. Drilling was supervised and the test holes logged by Air. O.M. Ilatch, geologist with Alaska Testlab. The percola- tion test was run by fir. Wallace Oliver, staff technician With Alaska Testlab. The test hole was placed at the approximate location shown on Figure 2. The log of this test hole is included as Table A of this report. In interpreting the log it would be helpful to utilize the explanatory information contained in Sheets 1 to 3 of this report. 17hen drilling was completed a 3/4" slotted PVC pipe was inserted in the hole to aid in determining the free water level. For the percolation test, the test hole was filled With water and left overnight to saturate. On returning the next day the hold was refilled with water and the drop in the water level carefully monitored over the next 90 minutes. n fir. Bill Lovelass March 1, 1976 ,]Page 2 This procedure is not a standardized percolation test, however, we understand that the.Anchoragc Department of Environmental Quality prefers tests performed in this manner to evaluate a site for a proposed on-site sewerage system. Using the above test, the observed minimum percolation rate was B minutes/inch. No water table war observed during drillingl but it should be noted that the free water level normally fluctuates seasonally and with precipitation. Wo .hope this report meets your present needs. if we can be of further service, please do not hesitate to contact US. Very truly yours ALASKA TESTLAB_O__1 11e1y n R. ?lichols,,C.E. Laboratory Supervisor MRN:rb Enclosures M U N I C I FURL I TY OF nMCHOF2RGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 E. TUDOR RD., ANCHORAGE, AK. 99507 276-2221 W E L L P E R M I 'T - PERMIT PERMIT NO. C 76108 > APPLICANT C H SELF 914 EAST 78TH AVE 344-9242 LOCATION OFF ELMORE RD LEGAL L10 BLITIMBERLUX SUBD LOT SIZE 40000 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='EFZM I T '✓f=IFL I F> F=OfZ OFVE YEF9F2 F= ROM I SLUE 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 ACCOR;f;FjCE WITH THE CODES. SIGNED: ----------- AP LICRN C H 5EL / ISSUED BY Self 9L. East 7Atb. AveAue lAnchorage, Alaska 99504 FROM P—alth & Environmental itection Sewer and Water Section 2518 East Tudor Road Anchorage, Alaska 99507 p. 1 i 14 SIGNED ,,,•,� DATE SEND PARTS 1 AND S WITH CARBON INTACT - PART S WILL BE RETURNED WRH REPLY. RRdiFyrme 4S 472 rar FY 40 M) ono DETACH AND FILE FOR FOLLOW-UP ` SUBJECT Lot 10 Block J Well Log DATE 5 14 76': MESSAGE we have no permit for Lot 10 Block J -well log, however, we K do have a permit for Lot 10 Block L Timberlux. Is this Ip well log for this permit? If so please make the correct notation on the reply part of this memo and.return to the above address. Thank, you. SIGNED Les N. Buchholz REPLY F oiar�prn,v,,,..f aGcx.Qa� tLui-d �/o a1� I p. 1 i 14 SIGNED ,,,•,� DATE SEND PARTS 1 AND S WITH CARBON INTACT - PART S WILL BE RETURNED WRH REPLY. RRdiFyrme 4S 472 rar FY 40 M) ono DETACH AND FILE FOR FOLLOW-UP ` TIME LOG CASING /^//(J,.{J �jDRILL 11 1 160 - START START COMPLETEe,7,- DATE 19 z 1 NAME No. . i ADDRESS J f r / "pPo CITY Ae 1-21 PHONE `,-o JOB LOCATION 91< '�iran �1�/� `Vi h h (n �. DEPTH WELL LOG DEPTH WELL LOG f%7G/ Q 3 t STATIC LEVEL GPM -YIELD FA MUNICIPALITY OF ANCHORAGE Department of Health &Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcell.D.# 018-271-78 HAA# HA900173 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 10 Block J Timberlux Subdivision #3 Location (address or directions) 15140 Curvell Drive (b)Propertyowner H.U.D. #027808 Telephone: (home) Business Mailing Address (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Sandy 8 Associated Brokers Address 630 West 36th Avenue, Suite 1, Anchorage, Alaska 0�9' 503 Telephone 563-3333 (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-FamilyZNx Number of bedrooms three (3 ) 3. WATER SUPPLY Individual Well Ex Community ❑ Public ❑ Note: If community well.system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Mcx Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 73-025(R". 71881 Page 1 of 2 5. ENGINEERING FIRM PROVIDING 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. 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Telephone 694-2979 Address 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska 99577 Date May 12, 1990 Engineer's Seal 6. DHHS APPROVAL 3 Approved for rPe tedrooms by Date Approved Disapproved Conditional Terms of Conditional Approval 17, 1990 This is a re—type of the original from DHIIS files. Apparently the original is lost or being held by another party. Any questions, please call our office at 343-4744. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors oromissions in the professional engineer's work. 72-025 (Rev. 7/88) BACk Page 2 of 2 MUNICIPALITY OF ANCHORAGE !\r/ Department of Health &Human Services DIVISION OF ENVIRONMENTAL SERVICES 343.4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # ��is-a`l l - 7g HAA# 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) - . . .- . ,_ I Tf_LDe (6 0.4;„; A;AM*r'i4/ 114 JQM— Location (address or directions) (b) Property owner N n n #Oo7R01 Telephone: (home) Business Mailing Address (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent AAAnritjtpd R, f,°bA Attn• Sandy Address 640 Wat 36th Avenue Suite 01, Anchouge Alaska 99503 Telephone 563-3333 (e) Mail the HAA to the following address: (or check here aAf hold for pick up.) List contact person and day phone number below: 5 8 S ENGINEERING »nx� c,..la-Rivee�.00p-Road�lo��4 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-FamilyXX Number of bedrooms 3 3, WATER SUPPLY Individual Well 5D( Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site XX Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 7VUS IFt". 7188) Page 1 of 2 5. ENGINEERING FIRM PROVIDING 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 inspection. Name of Firm 5 8 5 ENGINEERING Telephone e"7 Cl Address 17034 Eagle River Loop Road N on Eagle River, A as a 99577 Date C cy�•• xy'�Te b.n A. 3%.icr Na. W7 -E 6. DHHS APPROVAL _ Approved forbedrooms by Date a Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 oranalyze 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 (ew. 7/88) Back Page 2 of 2 lnJ�\G\ 0; A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description:�)o(e �TT i nnti-Lr/vx Well Classification ��AL�Ie JL4 Mt t- If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed 0--,- 1 b Yield < 6 :� r M Total Depth�1 Cased to Depth of Grouting — Static Water Level f O fl Pump Set At L) 7• Casing Height Above Ground 3a Sanitary Seal on Casing (Y/N) N Electrical Wiring in Conduit (Y/N) 4 Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: , d To Septic/Holding Tank on Lot x `l + ; On Adjoining Lots DO t To Nearest Edge of Absorption Field on Lot / 3 ; On Adjoining Lots 1004 To Nearest Public Sewer Line A)& To Nearest Public Sewer Cleanout/Manhole Al 14 To Nearest Sewer Service Line on Lot -Z '( Water Sample Collected by S 6111Q i;/nDate -s Water Sample Test Results �Sfq I f f (R,r �nd 4 A rIC'J}-P,! (►4 -f Comments 'k' JNr r- I JA (Ve.ic 20 - SS B. SEPTIC/HOLDING TANK DATA Date Installed 11-30- Size of Compartments 2 Standpipes (Y/N) 4—Air-tight Caps (Y/N) _Foundation Cleanout (Y/N) Depression over Tank (Y/N) �J Date Last Pumped S _7 - lip Pumping/Maintenance Contact on File (Y/N) A) 1A ; for N �✓) Holding Tank High -Water Alarm (Y/N) 4 Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well To Building Foundation To Property Line ) + To Disposal Field .2 To Water Main/Service Line t 0 t if To Stream, Pond, Lake or Major Drainage Course too Comments 72-M (Aft. 7/88) Font Page 1 of 2 'i C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata _LEO Type of System Design Date Installed O — b Length of Field 1 Width of Field D Depth of Field o Gravel Bed Thickness (n Square Feet of Absortion Area iC2 12 `/' Statndpipes Present (Y/N) Depression over Field (Y/N) � �y Date of Last Adequacy Test � Results of Last Adequacy Test 'ZFi 1�S to !u r na>m _ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well ( O 3 To Property Line 2 O To Building Foundation Lot To Existing or Abandoned System on On Adjoining Lots 100 + i To Water Main/Service Line 1 F To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course ( 00 14 - To Driveway, Parking Area, or Vehicle Storage Area '.2,T �f Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions - Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. Signed —6 8. S 6NGINFFRING Company 17034 Eagle River Loop Road No. 204 Eagle River, ca Date �Z MOA N �`C7hy .- o. - — 4..�r:— •r Receipt No. a� /_� \ /� " 7 /_ Date of Payment Amount: $ 1%K) • do �' Iltr-[ fire Receipt No. - BlaFoc� sr,a0" Waiver Fee: $ Date of Payment 72-M (R". seal Back Page 2 of 2 r •' o CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. a` c 5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343 a FEDERAL TAX I.D. X192-0040440 1NALTSIS REPORT EI SIC -LE for Wotk Order 121521 Data Report Ptlnted: MAI 8 90 / 14:25 Client Sample ID.LIO R'J' 1101ERLUE S/D Client Name 3 & S INUR MID :UA Client Acet S"DE9GP Collected YII 4 99 1 11:20 Are. ?.OJ NONE RECEIVED leceivel NAI 4 90 ! 16:CO hrs. Req 1 Preserved with :13 R%UIRED Ordered Ey : R. SHARER Analysis Coepleted :NAI 8 90 Send Reports to: Laboratory Supervisor/STEPHEN C. EDE 1)3 5 S ENGR Releases Ey : e"e'- 2) .................................................................................................................................... Special Instruct: Cbe:alab Ref 8: 901226 Lab Smpl ID: 3 1Gtri:: NATER Paiaaetsr Iested NIIP,ATE-N Semple ROUTINE SICLE. Remarks: SWLE COLLECTED RI IN. Allowable Result Unita Y.ethod Limits ND(0.10) mq/1 EPA 151.2 10 ................................................................................................ 1 Teets Performed See Special Instructions Above 111 -Unavailable ND- None Detected " See :ample Remarks Above IU• Not Analyzed LT-Lese Than. 6T -Greater Than 6'�z CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.5&SENBIAEERMtii90n 5622343 5639 B StreetAnchorage, Alaska 9951817034 Ea91e River Loop RaZ Ndt �YEagle Rarer, Alaska 99577, . �•�-•• Drinking Water Analysis Report for Tota i Coliform Bacteria • TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY ❑ PUBLIC WAT?A�STEfd V4"' Anal sis shows this Water SAMPLE to be: • .:a rslrer Loop Roll No, 211 PRIVATE WA90 SY.ST4Otlaeka 99577 Satisfactory ❑ Unsatisfactory Name phone No. ❑ Sample too long in transit; sample should :$4&"INEERING not be over 30 hours old at examination Mailing Address 1 a9 a rver «p RadNd,K to Indicate reliable results. Please send :• River, Alaska 99577, new sample via special delivery mail. City State Zip Code 'rn Date Received SAMPLE DATE: O `v l E—) l R �_ 1 Time Received � V Mo. Day Year Analytical Method: Membrane Filter SAMPLE TYPE: " Routine ST Check Sample (for routine sample , ❑Treated Water No. of coionies1100 ml. with lab ref. no. [I Untreated Water ❑ Special Purpose SAMPLE Time Collected Lab Ret. No. Result* Analyst NO. LOCATION Collected t I�.tQ;BlK�-� t kl�,r �� I f 320 0.126' 2� I U m 3I I U 4 I I I m fs l I �----I m BACTERIOLOGICAL WATER ANALYSIS RECORDC' READ INSTRUCTIONS Membrane Filter. Direct Count d Collform/100ml BEFORE Verification: LTB BOB Final Membrane Filter Results Collform/100ml COLLECTING SAMPLE S--S—qo • Reported Date Time: ��� a.m. p.m. TNTC = Too Numberous To Count OB = Other Bacteria MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION . DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 2644720 Application Date L-126-81, 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L-0+1DQI{L T mLCAJux *3 Location (address or directions) 15146 cur &ll 'i)arua (b) Applicant Name 1111 L-utlaGG Telephone: Home$? Business Applicant Address39+2LF— (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other EL (explain); (d) Lending Institution Address (e) Real Estate Company and Agent -- Address Telephone (f) Mail the HAA to the following address: _t.riL11 P' � 2. TYPE OF RESIDENCE Single -Family'& Multi -Family❑ Other Number of Bedrooms 4- (4,0 3. WATER SUPPLY Individual Well 5( Community ❑ Public ❑ Telephone 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: It community well system, must have written confirmation from the State Department of Environmental Conservation L ring to the legality and status. Z Page 1 o1 2 ..... _ 72-025 (11,84) ('m� r` 5. ENGINEERING FIRM PROVIDING 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 Inspection. NameofFirm-Ro..ie.R- oA+A A&saea:6-k Telephone Address Date f. -25-A5 6. DHEP APPROVAL �a Approved for r/' bedrooms by/ v Approved Disapproved Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (OHEP) 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 engineers work. Page 2 of 2 . __ ..., ". -. _ .' " MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & I ^ ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 RECEIVED 264-4720 Legal Description: 1-&4 y0 ,84ck T Tre1�Clux So6dlA1dise1 *A A. WELL DATA Well Classification _PrAIIA If A. B, C. D.E.C. Approved (Y/N) Well Log Present (Y/N) — Date Completed S- I& Yield &.63pyr Total Depth 1410, Cased to 40 + - - Depth of Grouting Static Water Level (01,* `* Pump Set At —Ah+ Casing Height Above Ground Sanitary Seal on Casing (Y/N) y. Electrical Wiring in Conduit (Y/N) —x Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot � ; On Adjoining Lots �OOi To Nearest Edge of Absorption Field on Lot X0.3 ; On Adjoining Lots /OOi To Nearest Public Sewer Line To Nearest Public Sewer CleanouVManhole To Nearest Sewer Service Line on Lot Water Sample Collected by _%sm ; Date L-5ne5 Water Sample Test Results '�// Comments >� .%m --w yeR 0.7T.AeJ B. SEPTIC/HOLDING TANK DATA Date Installed _11-;16-7 o_ Size — U-0 No. of Compartments 2 - Standpipes Standpipes (Y/N) Y Air -tight Caps (Y/N) V Foundation Cleanout (Y/N) _AL Depression over Tank (Y/N) Date Last Pumped `'6'&S 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: To Water -Supply Well 97tt To Building Foundation 14:4 1 - To Property Line Is+ To Disposal Field -_�U 4' To Water Main/Service Line ' To Stream, Pond, Lake, or Major Drainage Course t6� 40 QG�far�t1T�ts�.nnr�a 44.�8r�wt�- Comments Page 1 of 2 72-026(l L841 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata isn SF IW LM Type o1 System Design ( r* incl Date Installed 1 (-3t)-7L Length of Field 'SI Width o1 Field Ante Depth of Field ( O Gravel Bed Thickness _((V Square Feet of Absorption Area %o O Standpipes Present (Y/N) Depression over Field (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well log -it To Property Line v -r,+ To Building Foundation -N5 To Existing or Abandoned System on Lot — ; On Adjoining Lots 10-64 To Water Main/Service Line '— ,f�T'o Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course ( b, e 44ft . a .fen+ -d } Ck s -e T To Driveway, Parking Area, or Vehicle Storage Area 1'S.. Comments D. LIFT STATION Date Insta 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' at Check Permitted Bedroom Rating Against HAA Request •• Vent(Y/N) Cycles during Adequacy Test. Meets MOA Icertifythat havec ked verified,orconformedtoallMOAantlHAAguidelinesineffectonthedateofthisinspection. Signed _ Date 1.-a4-85 1 r Company ' MOA No.�� Receipt No. S4�/DC Date of Payment "rp,5' �S Amount: $ - 1115� Page 2 of 2 72-026(11,84) STATE UU F ALASKA ^ BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 MHORAGE, ALASKA 99501 Jame 20, 1985 Mr. Tony D. Barter, P.E. Barter & Associates 10461 11ampton Drive Anchorage, Alaska 99516 274-2533 SUBJECT: Horizontal Separation Waiver Between Well and Septic Tank, Lot 10, Block J, Timberlux Subdivision, Anchorage, Alaska 8521 -WA -187 Dear Mr. Barter: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic systems to 97 feet on the subject property for a single family residence only. Sincerely, Steve Eng, P.E. District Engineer SE/dd NORTHERN TESTING LABORATORIES, INC. 800 UNIVERSITY PLAZA WEST, SUITE A FAIRRANKS, ALASKA 99701 907479-3115 8957 OLD SEWARD HIGHWAY, SUITE 101 ANCHORAGE, ALASKA 99502 90&349-9623 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT ❑ PUBLIC WATER SYSTEM I.D. # PRIVATE WATER SYSTEM Ch1, Stno Zip con. SAMPLE DATE: -iD-L 1L2- .L Phone Mo. D•Y You Purchase Order No SAMPLE TYPE: Routine ❑ Treated Water ❑ Special Purpose ❑ Untreated Water ❑ Check Sample (for original contaminated sample with lab reference no. 1 TLno lae•tbn CdMnW Coa«v4M 1 ale .8LK5 T,l gay 2PNl �iA_ 2 3 4 5 3 7 a 9 10 Signature of Representative FOR LABORATORY USE ONLY P,(JMOTia/J No. TO BE COMPLBY LABORATORY Received at: Anch. ❑ Fbks. Date Received b / O J Time Received /O Next Sample Due COMMENTS: SATISFACTORY 0 UNSATISFACTORY U RESAMPLE R OTHER BACTERIA OB TOO NUMEROUS TNTC TO COUNT Dha V.,mneuo nn•I Count Lsa BGS Rwfuh• Cemm•nb } ; r _•1(\ • o of Total 11f r C nies per 1 00 mis. Rep ned by Date 7 Time �, n June 19, 1985 To: Mr. Bill Lovelace 15140 Curvell Drive Anchorage, Alaska 99516 Ref: Lot 10, Block J Timberlux Subdivision s3 MUNICIPALITY OF ANCIaORAGE D,P1. ci Hi ALIY 8 ENVIRONW NTAL PROTECTION JUN 2 P'0°` RECEIVE Dear Sir: At your request, I performed an adequacy test on the existing septic system for the fcur bedroom residence at the above referenced location. According to the Greater Anchorage Area Borough's Inspection report for installation of On -Site Sewage Disposal system at this location (11-30-76 permit 76641) your system consists of a 1250 gallon steel tank, and 51 lineal feet of trench. Upon arriving at the property on June 169 1985, I observed the septic system and recorded the static water levels. hater was then introduced to the system at approximately 6.5 gallons per minute. The water levels wezb periodically measured and recorded with respect to time during the filling and subsequent absorbing period. The absorption rate was extrapolated according to Dr. Leroy Reids paper, "In Site Testing of On -Site Sewer Systems," September 1982. Cn the date tested, this system would accept approximately 900 gallons for a 24 hour period and exceeds the NIGA requirements for a four bedroom residence. Sincerely, Tony D. ",-,arter, cc: Municipality of Anchorage TDB/kb Civil Engineer