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THUNDERBIRD HEIGHTS BLK 3 LT 2
Thunderbird Heights Block 3 Lot 2 #051-711-06 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore Sl. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5WOS003S PID Number: 05 1 - Ill —Oto Na" (C m66a1 F nc�c Wastewater System: ❑ New ❑ Upgrade Address 2-4331 Gotha £a Ie- Pircle ABSORPTION FIELD Jx) ;., p"rn NumWr of aWroan. IDea - 5s�s O Deep Tent. O Shoo. Trehch 0e.d 0MOund aodror Sal Ramp Tar Depth from onginel ands LEGAL DESCRIPTION Gpoire Ft. aura Lot 1 Suo YWW T Depth W ppe WUM can ongnel Weds Gravel depth D.r"ath ppe 3 2 1 h 4t, 6, r4 e tt/ill Ft. FI To hshlp Rarge S 'on Fa added Wave W91" alba Gravel Largth. Ft. FI. Well: [:]New ❑ Upgrade I M V I K. I ILO Gravel Wdth. Ft. Number Of IMS Dratahta baM whet FI Cuwnc.o0n(Pnvate. A 9. Cr Taal Depth COW TOW abb0co0n Brea P,pe Malta Ft. I FI Fe Druur Dau DnIW SIWOwatw Lavel Inatalw, �,1 Airilk/t'104A� brut Dm InaW"d Jr S O FI Yield Pump Set at Gang H.pve ht AOoGround TANK GPM FI. FL SEPARATION DISTANCES %septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding ubtcrinvate n""1ufer TzIlk apaatr Gel 1250 From Tank Field Station Tank Sewer Line Of e 2s rt INtsnY Steel Numbw el GompMm.hta Z Wait 2vo,1+ t+ LIFT STATION Surfacewat" loo 1+ ,aa, u aqunr Lot uh. 5 G.. 1 'Pump ai Nuel at 'Pump otr .l tngh welH alwm at FouededM �j th in Pump IMk. 1 Eticl l Napes Ows pedormed br Cwtrn Orrn /J. o, Romis an BENCH MARK Location ehd Daamptim r 1 1.6. ti lug V �en VtTG un poor Ter.-^ med I.VabM, ICO FL II„ 5 5 og br6 SpuA 1 L1_ EngZeeCm p X11 Inspections performed by: aw.d Dates: OF q� 2 nd Development Services Department Approval Co 49TII Conditional Approval.4 Date: i jj -- �^ �"� � L /..✓r4^v^� /0 1 �OFESStJ` Reviewed and approved b : Date: P Y: a ► (Rw 0405) ' I / _--- ER&W-HEATS / THUND k Lot 3 } ,� I l INSTALLED F.C.O. XSZ� I nx ALTERNATE DRAIN FIELD SITE ABANDONED EXISTING �Testhole EXISTING LLL INSTALLED NEW 1150 GALLON STEEL SEPTIC SEPTIC TANK ST i TANK 100+ FEET FROM EXISTING WELLS WITH CONCRETE) NOTE. NO PRIVATE OR PUBLIC WELLS WITHIN 100 FEET OF PROPOSED SEPTIC TANK LOCATION DOUBLE CLEANUI CONNECT EXIST DRAII.r .«. -- /— 4 FEET COVER 1250 gal, septic tank FOUNDATION CLEANOUT • �.; ,.y ��49th ) •'.sl} ..................... _ $PURKLAND ; 25 o 25 50 n 100 125 150 ' SCALE, 1' = 50 FT. sneh d d D BoNom Door Jam Artumorolion = 100' 00 !00' SPURKLAND ENGINEERING THUNDER BIRD HEIGHTS B3 L2 SEPTIC SYSTEM DESIGN 103 W 157H. AVENUE DATE.• APRIL 10. 1008 ANCH. AK. 99501 KYMBERLY FERNANDu IAATI �»_:n.& 11 97770 cnlnru rlr/C rniror SHE£T.'111 GRID. NW 1865 PERMIT # SV070XX PID # 111HUJLeUl.VVU Municipality of Anchorage Development Services Department Buldkq Safety Division Onsite Water rind Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 89519-6650 www ci anchoraee.ek us (907) 9437904 49TH* Soils Log - Percolation Test r Performed For: �'1K Y M BK LY FE RNA N 0 E Date Pertonned:_�' Legal Description: 1 LlAj m— R. B I QO H EIGWTS 03 U -Township. Range, Section: i 1 1 7 1 Depth 2- Date Gross Time 1. . . 0 . Net Drop 4- '•:' 1:52 iom O 133/1(." 5064 It ;�of t. ado WAS GROUND WATER ENCOUNTERED? 5 IF YES. AT WHAT DEPTH? "" L Dpthto WaWARW _ D Monhorkp? E Data: $ 8 OB ARS E. p-'; TTS:, Plan Reading Date Gross Time Net Tune Depth to Water Net Drop 5/5/08 1:52 iom O 133/1(." It ;�of t. G rlB It t1 Z: 13 20 ..;. 13 r/ it 7Y4 'I it 2 3 n 30 . r: 133/6" 7116" (� 1JZ.t 1r Zt33.. 40 M^ 11,318 rr G-+/Brt 3/Btt `t Z: 4i 50 .n: 13'Ar' VOu C. 3/8 t tt 2: 53 (.O n:.% 11B It PERCOLATIONRATE 1r`/ ImWa) FERC HOLE DIAMETER �D y� 11 TEST RUN BETWEEN 5.FT AND ( -FT COMMENTS ITC Soiktd PERFORMED BY: LABS $urk1Q.,rt I JJ#(r� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE H ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 549N MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Apr 28, 2008 Expiration Date: Apr 28, 2009 Permit Number: SW080035 Parcel ID: 051-711-06 Legal Description: THUNDERBIRD HEIGHTS BLK 3 LT 2 Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: 027339 GOLDEN EAGLE CT Owner Name: KYMBERLY FERNANDEZ Lot Size: 26802 SO. FT. Owner Address: 27339 GOLDEN EAGLE Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - 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. 5. The following special provisions. A TEST HOLE IS TO BE DONE TO VERIFY EXISTING TRENCH AND TO PROVIDE'<ERNATE SITE FOR THE'4 BEDROOM HOME. IF THE PERC RATE DOES NOT VERIFY THE EXISTING TRENCH PLEASE CONTACT THE ONSITE OFFICE. PLEASE SUBMIT THE SOILS TEST AND ALTERNATE DESIGN WITH THE ASBUILT. Received By: Date: I I e /0 P) Issued By: l(��r 1�/ //f Grill Date: q7 g Municipality of Anchorage -� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519.6650 www.muni.org/onsfte (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0�5-/ - 7-/ 1 ' oto Properp Mailing 1e 088.5335 Site address .54m 6 Zip Code Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) �i Lot Size d , d Q o Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank ,, Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage Number of Bedrooms I/ 9950 THIS APPLICATION IS AN: Initial ❑ Upgrade ,, Renewal ❑ 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 pfoperty owner or authorized agent) Date of Payment: Receipt Number. Receipt Number. (Rev. 11105) ��\ 0 0 Environmental Consulting and Design April 28, 2008 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION ThunderBird Heights Block 3 Lot 2 As a condition of the permit to install a 1250 gallon septic tank at the above referenced property we will conduct a soil analysis, ground water monitoring and a percolation test for a reserve drainage field. Based upon a review of the soil tests on the neighboring properties and a soils test done in conjunction with the installation of the existing septic system, we anticipate that the reserve drain field with be sized based upon a wastewater application rate on 1.2 gpd/sq.ft. At this application rate a 4 -bedroom residence would require 500 sq.ft. of absorption area. The soil analysis will be conducted in conjunction with the upgrade of the existing septic tank. Ground water monitoring will be conducted over a seven day period. We are requesting conditional approval to replace the septic tank at Thunderbird Heights Block 3 Lot 2. If you have any questions or are in need of additional information please contact me at 279-3916. Lce,ely,�� Sp Lars Spurkland, P.E. 203 West 15t° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEngaa..gci.net O & E ENGINEERING & DEVELOt VIENT CO. Box 90. Davis St, Eagle River, Alaska 99577 694-2774 or 688-2280 huswtl Oyster Earl Ellis 694.2774 SOIL LOG 688-2280 Performed for. Name, d lers-rZE N lel. NO 6 0-3 4—n� Mailing Address: r n <- 2b s/0 44e 9q�47 Legal Description:-�—Or' Z�� j—�/N,rYlr_r�-Qii�1� ��'�� ;L>NLIP Depth (feel) 0 1 T. 2 3 �^4 5 6 7 8 9 10- 11 12 — 13— ,V:4�4-14 — 15— Soil charecterls6cs ;S&J- G zap«y saw - �nn w�rroti7d` �S o F �-i erg - f�1lcrRQ� 16 — 6a-rranl o F Ground Water Encountered: YesNoIf yes, what depth Proposed Installation: Seepage Pit_ Drain Field—t::: Performed 7d . Lcrr Z, LOT/ a N 137 r PLOT PLAN PERC.TEST n L 0"Ier . W iP .� 4236-E '40FESSIUN.�� Date, BOMHOFF & ASSOCIATES,INC. Engtneertng-P1anning-surveying • . ;Tti���ubt�� N-gM5 n Lj • . 1030 N%XISt lntcrnattonal Alrport •Road Anchorage.Alaska 99502 TClephone(007) 279$52 LOCATION: TNtJNA�fL�ult2b HEIGHTS - CORING NO. Ifl•T' 1—r . ; BORING NO. p►� 1 a �• / STATION I' STATION .,. tae 4 o EL v 1.1,s ••2 ox 07 -, lit s 0 t P 6� •�T 4�D SILTY SAu9 ;°�a GP �' GPAVc(- �••' �E'D2x1_ lb v. o e UP • 0 6 •' .. e •o, • �eo 1 WAY E4 YAbl O 0 1 2 R 6 T 8 9 P 6� ;°�a GP SANG c,¢ovs �E'D2x1_ • 0 l .. .• '" • .t, • •`t s • gevaocK .- EORINIG 140. BORING NO. STATION ' STATION A EAGLE RIVER ENGINEERING 10421 VFW RD, SUITE 201 ACIE RIVER. AK. 99577 907) 694-5195 FAX: (907) 694-3297 SOILS LOG - PERCOLATION TEST PERFORMED FOR: RON RICKMAN DATE PERFORMED 8/24/200 LEGAL DESCRIPTION: THUNDERSM HEICHTS LOT 3 BLOCK 3 TEST HOLE ) 1 ^ LOPE 1 15• 16 17 to 19 20 21 22 COMMENTS* WATER TABLE DATA DATE WATER LEVEL 0 812412007 DRY 08191/2007 DRY R1W, SEC -25 TOWNSHIP RANGE SECTION T16N, PERC TEST RESULTS READING GATE GROSS TIME NET TIME DEPTH 10 WATER NET DROP(IN 1 0812412007 12:42 0:00 6' 5 0 2 08/24/2007 1:04 0:10 6 7 314 2 314 3 6812412007 114 0:00 5' S 0 4 oen4noor las o:+o s 7 112 2 172 s 6812412007 1725 700 5' s 0 6 09124/2007 1:38 010 6' 7 318 2 316 7 0812412007 139 0:00 6' S 0 6 08/2412007 149 —W. 10 1 6' 7 114 r2 114 PERCOLATION RATE- 4 Im"llo6 P1Nc ncnc w�.c�u.-° PERCOLATION TEST BY: CHARLES BALZARINI I �� _CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �c Environmental Consulting and Design April 20, 2008 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION Thunder Bird Heights Block 3 Lot 2 During the COSA review process it was discovered that the septic system serving the above referenced property was not sized correctly for the number of existing bedrooms. The septic system was installed in July of 1980 for a 3 -bedroom house. At some subsequent time an additional bedroom was added. The soils were rated at 125 sq.ftJbr. A 29 foot long, 4 -foot wide, and 8 -foot deep trench was installed. This provides 464 sq. ft. of absorption area. Five hundred square feet are required for a 4 -bedroom house. A standard trench is 2 feet wide. An additional 58 square feet of absorption area is provided by the additional width, for a total of 522 sq.ft. An adequacy test was performed on the drain field on April 11, 2008. Before the start of the test the drain field was dry. Six hundred and tcn gallons of clean water was added to the drain field. A corresponding rise of 25" was observed in the drain field monitor tube. The water level dropped 22 inches in 10 minutes, indicating that the existing drain field is capable of serving a 4- bedroom house. We are submitting an application to upgrade the septic tank for this lot. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. There are no wells within two hundred feet of the proposed replacement site. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely, L� 5 Lars Spurkand, P.E. 203 West 15'" Avenue Suite 203, Anchorage, Ali 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEngCa gci.net i i f THUNDERBIRD HEIGHTS 9 1 / INSTALL F.C.O. I ABANDON EXISTING os' SEPTIC TANK PER MOA - -L O t - - MIN CODE REOUIREMENTS INSTALL NEW 1250 GALLON STEEL SEPTIC TANK 200+ FEET FROM EXISTING WELLS NOTE. NO PRIVATE OR PUBLIC WELLS WITHIN 200 FEET OF PROPOSED SEPTIC TANK LOCATION L a. !�Ck Cf: i'i r•7'C.9 f5, B'�5'C ;r<'i5 . rOe:r!✓_�' Cui'.'M_Y','1 !i°N, dpi A:.J lI9.V:: .`.i`C NM1' f4( 1 �l DOUBLE CLEANOI /-- 5+ FEET COVER CONNECTED TO EXIST DRAINFIELD 1250 gal. septic tank 25 0 25 50 75 100 125 150 SCALE, 1' = 50 FT. 7 FOUNDATION CLEANOUT L9' th SPURKLAND SPURKLAND ENGINEERING SEPTIC SYSTEM DESIGN 103 W 157H. AVENUE THUNDER BIRD HEIGHTS B3 L2 APRIL 20. 2008 ANCH. AK. 99501 KYMBERLY FERNANDEZ DATE. /DA71 1770_rofa 11 977ro rnincu rArir rnuaT SHEET.•1/1 GRID. NW 1865 PERMIT # SV070XX_ PID # TBHB3L2DI.DVG Y t A& SPHTNand ER&SMORP _ Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: Thunder Bird Heights Block 3 Lot 2 Date: April 20, 2008 General: 1. The owner shall contract with a contractor to perforin the work outlined in these specifications and plans in accordance with the attached MOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the work includes the installation of a new 1250 gallon septic tank. The location of the drainfield is shown on the attached site plan drawings. All components of the proposed septic system must be constructed a minimum of 100 feet from any surface water or water wells in the area. A minimum of 4 feet of earthen cover is required over the septic tank. If less than 4 feet of cover is available, 2 -inch thick, 40 psi, direct bury board foam shalt be installed directly over the septic tank and all installed piping. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of backfill material. The property owner is also responsible for vegetation of all areas disturbed by septic system installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 7. The contractor shall ensure that ALL materials being used are in compliance with the most current guidelines established by the Municipality of Anchorage. Refer to "Standards and Specifications for Component Parts and Materials Used in the Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. 203 West 151° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 'Fax: (866) 354-1597, LspurklandCagci.net Environmental Consulting and Design Septic Tank Installation: 1. A new septic tank, of the size specified in the design drawings, shall be procured from a qualified manufacture/supplier if the existing septic tank is found to be defective. Construction shall Include two 4" diameter deanouts for pumping access. 2. The burial rating of the tank shall be adequate for the actual burial depth encountered. 3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 4. All standpipes on the tank shall extend a minimum of 12inches above the final grade. S. Tanks installed with less than 4 feet of cover shall be insulated. 6. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval Is obtained from the engineer. 7. The inlet and outlet lines from the tank shall be bedded in drainrock or the soil shall be sufficiently compacted to prevent future settlement of the soil. S. Septic tank inlets, outlets and deanouts shall be fitted with water tight couplings. 9. A cleanout shall be installed 1 to 4 feet from the foundation. 10. Post tank deanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. 12. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. 13. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and inspections must be obtained where required by the MOA. 15. The contractor shall verify that the septictank/lift station is a minimum of 100 feet from any residential water well, 150' from any class *C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. 16. The contractor shall remove or abandon the existing tank in compliance with the Unform Plumbing Code. Insped3ons: 1. A minimum of one inspections are required by the Municipality of Anchorage. These inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. 2. The septic tank may be set in place, but may not be backfilled. 3. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use in preparing the record drawings. 4. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 West 15'" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCagci.net f ' MUNICIPALITY OF ANCHORAGE -f'" t� pct le t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION \ 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 Q R40, -r- !O t ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE Ery O UPGRADE MAILING ADDRESS Qac, ec3a.c/v,� c t�s�d 9757 LEGAL DESCRIPTION � ` ' Lor 44574 r'£� uQ.O LOCATION NO.OF BEDROOMS UY Well rea DISTANCE TO: Absorption CcyN.H(trl 4 Dwellin g / PEFjMIT NO. f(33 1-2 W 2 Manufacturer ^ ��� /) �C.. Material 00(( 40 No. of compartments fA V' Lip.caracit�yi�allons ( CJCJC� IF HOMEMADE: Insitle len tb 9 W'dlh Liquid depth 6D J02 welling TO: Well Dwelling PERMIT NO. 02� Manufacturer Material Liquid capacity in gallons W = DISTANCE TO: W[A/N� Foundation, Nearest lot —Jin PEHI� T NO. abet u. ¢No. of lines ' Lengtholy yi line Total leenn_oth lines Trench,w th ``77 Distan'c en lines K H Top of rile to finish rade g /� (I LT/. inches Material beneath rile Total efl tive absorption area D UPLength D Width Depth inches j=-7— PERMIT NO. L7 WType of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line —1 J Class Depth Driller Distance to lot Ilne PERMIT NO. W 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIS MATERIAL �3 1 IML SOI L TEST RATING, r INSTALLER.4^rj 04 a. gyp: ,S;<• 8 a/ 303 >c �] x : �.cyT!-t tr=y •. z` d: LA y ti iJ yd JT : No. 4:Su: �� • V@ s •.0. v APPROVED DATE LEGAL Ls» 0,11 TC -j Lit )Z.. 14 ea L CT - 72 -013 IR.V -1 MUtl4I <-- F�.t,F_ I TV C3F= w&jN<-_h-iLjRl-yGE DEPARTMENT^'-' HEALTH AND EPJ'JIRONRiEPJTA -" f'OTECTION 825 i' STREET, ANCHORAGE, AK. 264-4720 C)" -5I _r a W R F=1F=RIY:I -- PERMIT NO. ( SOOIIC. ) a APPLICANT FORESTEDGE HOME GEN•RAL DEL., CHJUGIAK,AK 688-3004 LOCATION THUNDERBIRD DR. LEGAL ""�J c�F3L< 3`7H�JNDERGIRD'hITS. LOT SIZE 25802 SQUARE FEET Type of soil absorption system is: TRENCH Maximum number of bedrooms = 3 Soil rating (SQ FT/BR)= 12S The required size of the soil absorption system is: FDc-p1-F,-= 1Z Lerrg-LV,= I'3 Grrave?1 oC- p-tVe :L C) 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= E qui r - c - <S .^sC-_p-ti c TaT-1t< Si Z E= 1{]0{7 Gal 1 aTrrs 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. --- TWO CZ3 RRF= RF=CD1UXREFD ---- 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. F> 4z-, r -m 1 -t E- x R 1 r- a sa. a ea c em b e r- _-31, 1 'D8C) 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: 1 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,,�delyyd to include more than 3 bedrooms. SIGNED: ISSUED BY ___!7l-_s1_P__ 0 PLA husselt Oyster 694-2774 Performed for. n O & E ENGINEERING & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG srd Mailing Address: lr'CJ Y—Q:!>r— -51Q Legal Description: L -Z- Depth Depth (fest) Soil Characteristics 0 2 Qct7rs ,Q� d J ��i 2 7.5 3 57 4 5 /nJ 6 QsJ RA1)4=-4-4-41t�z.,dX10 - 0"-A 2:'i to n14 c_ —L�C= 8 6>1jc_2A— 9 10 12- 13 — �14 — 15 E- 16 — tJ�a rTt7M o F LfiT /—� Ground Water Encountered: Yes No If yes, what depth Proposed Installation: Seepage Pit_ Drain Field 9--� Earl Ellis 688-2280 137 PLOT PLAN PERC.TEST OF Russell L. Performed by: h n QU�t^� L i 1 Date: 2 —6%9 fi L, 50 Municipality of Anchorage Development Services Department_ Building Safety Division , On -Site Water and Wastewater Program 4_5 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING QQ Parcel I.D. 051 --+Il- 06 COSA # OU 139 Expiration Date: T_ 9-09, 1. GENERAL INFORMATION Complete legal description Th mAerbir� H614ll,ts BLK 3 LT 2 - Location(siteaddress) V+335 Gelle Location (site address) Fa,le r LViak AK `i9967 Current Property owners) KyM 6v�y Fprnan�ez Day phone W-533-5 Mailing address 74331 Golden Lade M1 ak AK IMI Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held bydDSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Q 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 On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Spurk6J Erif"n Ec¢, Ny Address 203 t1. SMAve. Sip.20.Amory AK 995or Engineer's Printed Name LwQt Suurkl a. a 5. DSD SIGNATURE Approved for Disapproved. _ bedrooms. Phone 279-3916 Date Me /06 lit Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: C / ,,., ILX J52::Vet�;r Original Certificate Date: (Her. 11105) - -- Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: %4je, Dir 14401,. OIk3 Lt 2- Parcel ID: esl-? II -oG A. WELL DATA Pahl;� �1atErL Well type = If A. B, or C provide PWSID # = Well Log (Y/N) '— Date completed = Sanitary seal (Y/N) = Wires property protected (Y/N) Total depth — ft. Cased to ft.: Casing height (above ground) — in. FROM WELL LOG AT INSPECTION aeo es Static water level Well production 9 -p -m WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate -- mg1L Other bacteria Arsenic: _-- ug/L date of sample: — Collected by: K DATA — colonies1100 mL B. SEPTIC/HOLDING TAN Tank Type/Material nAofa C S n % Date installed 5zs_LO. S Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) �_ High water alarm (Y/N) /V Date of pumping Aftz Pumper Ale C. ABSORPTION FIELD DATA Date Insta ! lled' 71140SSoil rating ( .d./f r fe/bdrm) LZ Length 2q ft. Width Total depth 1 l ft. Eff. absorption area `6 ftx Monitoring tube Dat© of adequacy test Results (Pass/Fail) as Fluid depth in absorption field before test O in. Water added (010 gal. New depth35 in. Elapsed Time: to min. Final fluid depth 3 in. Absorption rate >= 60b g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) AfMp i noir% If yes, give date System type 066P 711Mh Gravel below pipe i_ ft. y Depression over field For 4 bedrooms D. LIFT STATION Date installed Size In gallons Manhole/Access (Y/N) 'Pump on" le at _ in. 'Pump off" level a in. High water alarm le at In. Dat Cycle ed Meets ala circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: P" 61'c 411 TE 2 Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas —' On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 r+ Property line 5 1+ Absorption field .5 r+ Water main 10 + Water service line 10 �+ Surface water 100 '4 - Wells on adjacent lots 2006 + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 6 0 Building foundation 10' Water main 10 r+ Water Service line 101 + Surface water 100 r+ Driveway. parking/vehicle storage _1 Curtain drain X.O. Wells on adjacent lots 100'+ F. COMMENTS * Fro.. M.. J: G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and� �?• � i ; i lipreview of Municipal records that the above systems are in i , , , ...T--.... . , . I/ conformance with MOA COSA guidelines in Leffect on this date. N��`' Engineer's Printed Name ARS-Srlr(l aj 1J5 0 Date 518'00 111�i�PfO�FES� �a��r� COSA Fee $ Waiver Fee $ Date of Payment 4�08 Date of Payment Receipt Number_ �5.�`�(i Receipt Number (Rev. 11/05) �\ r . 1 0 1 i N o n ' 0 c y NV41 2 O c m0 0 O = OX 02 zz �0 y gN gymy M 2 Hsi N mm�m K ROm�1 •e T .i O�yif s F, 0 C � m �O 9 D Z D O m A 41 z of AD D n r n �m A pe r0 M MM M 1n r Z O iA O i mU n y N( �S mO OO N io 0, \ j Q \ \ As. „„r C n n N U 0 N D 1 00 Ln yX_Z \\ rDm iy m ct^m \\ yZz \\ N m[< m y A401p \\ A tit M oc-1 \ \\Oz mN p m>N>m NV41 2 O c m0 0 O = OX 02 zz �0 y gN gymy M 2 Hsi N mm�m K ROm�1 •e T .i O�yif s F, 0 C � m �O N 03 IR TyVNDERB'R 9 D Z D O m A z of AD D n r n �m A pe r0 M MM M 1n r Z O iA O i mU n y N( �S mO OO N io 0, j Q a n n N U 0 N N 03 IR TyVNDERB'R 5 O"08'49"r 139.60' 0 z r n pe r0 M O i 3 R N < n 0, n r N 0 N D 1 N n A 5 O"08'49"r 139.60' 0 Municipality of Anchorage C(1.Iklx1!M54)-.\nchonkgc"\I nska!V.A19-fiGN)-471X1 Enorc 16mi,1 I lllicc: 1!X17 1:NRlti111 - Pax: (!X171 ai:Sti�INl bnp://x��xc.numLar� ,t/ayar Mark Begich Development Senices Department 5/9/2008 Lars Spurkland Spurkland Engineering 203 W. 15i' Ste.203, Anchorage Ak. 99501 Subject: Waiver Request for Thunderbird Ileights Block 3 Lot 2 Waiver Request #WR080023 Parcel ID #051-711-06 HAA# 080134 Permit # 080035 Dear Engineer, ru• n t Department Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 6.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there arc any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department • Building Safay Division _ On -Site Water and Wastewater Program i 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 WR#:80 0023 PID#:051-711-06 Date Received:15 9108 Waiver Review Worksheet HAM 080134 Permit#: 080035 Legal Description: Thunderbird Heights Block 3 Lot 2 Engineer: Lars Sourkland Spurkland Engineering 203 W.15'° Ave. Ste. 203, Anchorage Ak. 99501 Applicant: Kimberly Fernandez Waiver Requested: 6 feet separation distance absorption field to property line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ....a.......................................................................a.. Waiver Is Granted: Waiver is not Granted: List Conditions or Reasons for above: Date: 5--9-08 By: a f Reviewer ........ aa11111.... messages, ...... .11111111. ..... ....1... .... savages .... .1..... Rec#:195 108 Amount: — Date Paid: 519108 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bmgaw St. . _ P.O. Box 196650 Amborage, AK 99519.66% www.d.anchorage.ekus (907)343-79N ;.CERTIFICATE OF HEALTHrAUTHORITYrAPPROVAL FOR A SiNGLE FAMILY DWELLING_.% -: Parcel I.D.-nS 1-11 11=0 fn Expiration Date: _ �2' D GENERAL INFORMATION ' Complete legal desc iption r Tn iv b i v Location (site address or directions) Z2=6— Cuff ent Property owned.) 2 6— CurrentPropertyowned.) r^'I r. �...,� , %311tt, nAj. Dayphone, p���� r l IQJCi _4% Mailing address Lending Day phone _ ..._ Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested. HAA w7/be held Dy DSO forpichup. } 3 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ IrKrividual On-site 12 ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System IN Public Sewer The hlunicipality of Anchorage Development SenRces Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by en independent professional civil engineer registered in the Stale 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. DSO 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 wen and may be reissued with neve water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water r for water ystemmThe Municipality of CertficoteS re valid for Anchorage isenotaresponsible ic �for errors cr om ss3onsClass A r B wells or a in the professional tat engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, ) verify that My invesUdation, based on procedures outlined In the Health Authority Approval Gulderumes for this application, shows that the on-sito water supply andfor wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. i further verity that based on the information obtained from the Municipality of Anchorage files and from my Investigation and Inspection, the on-site water supply andlor wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the Erne of Installation. Name of Firm Eagle River Eneineerinsf Services Phone LAL1. S IRS Address - F.U. Box 773 ' w"99Ta32gs Engineer's Printed Name (bft_ &A .feyo . Date__ 14-44-0:3 • .. . p\R'S'V •. + f ,Z1 5. DSD SIGNATURE _ff Approved.for bedrooms. Disapproved. - Conditional approval for** U'Yz A.9•Jk 3 CE -6735 bedrooms, with the following stipulations: �t M Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: — �'� Original Certificate Date: I - Municipality of Anchorage Development Services Department Building Safety Division On -Site Water b Wastewater Program 4700 South Bragaw SL P.O. Box 196550 Anchorage, AK 99519-66650 www.danchorage.akus (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDeseption: /.'1' "Z el* .7 ;W eie,;4'b Parcel IM -05I -7/1-D& A. WELL DATA pub/.; w. ttr - A *✓.w"' Wen type _ If A. B. or C provide PWSID S _ Date completed _ Total depth fL Date of test Static water level Well production WATER SAMPL Coliform col sanitary sea? (YM— Cased to ft.. FROM WELL LOG It. g.p.m. 1LTS: ies1100 ml. Nitrate mgr• Date of sample: Collected by: e. SEPTICIHOLDING TANK DATA Tank TypeMiatertal S'r'e G / Wen Lo_%M protected (YIN) height (above ground) in. AT INSPECTION fL 9•PJM Other bacteria eolonles/100 ml. Dale instaned IMM Tank size oio pal. Number of Compartments Cteancuts®N) yrr es,a, Foundation cleancut,(YIN) Depression over tank (YIN) N High water alarm (YIN) L.c.'e/...t.. w.r.hrr Datoofpumping 'i -3✓ -tea Pumper OA /'.:.�+P•^�J C. ABSORPTION FIELD DATA Date installed 1 fr° Son rating (g.p--xr or tt°lbdrm) Lir System type jre.." Length a-2 i 11 WiCth '/ ft. Gravel be!ow pipe d tL Total depth 122 ft' Eff. absorpton area //d.. ft' Monitoring tke _Y Depression over field i✓ Date of adequacy test N-/-0 7 Results(PasslFal) sr For bedrooms Fluid depth in absorption field before test O In. Water added New depth/a in. Elapsed Tune:I0_ min. Final Ituid dept D in. Abscrpt:cn rate >_ * W,S- g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN E type) ✓ It yes, give date — D. LIFTSTATION Neve :Dumpate installed SizeIngallons Manhole/Access(YM) eve! at _ In. 'Pump afr level at _ In. High water alarm level at in. tum Cycles tested Meets alar E circuit repuirementV E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/.t On adjacent lots owl Absorption field on lot �/Ir- On adjacent lots N /A Public sewer main /-'/A' Public sewer manholelcleancut ^''// Sewer/septic service line ~�'' Holding tank /tet SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Ir'H , euild:ng foundation I' W Property line_'`!" , Absorption Feld .s r Water maln eto r Wzter service line Surface water t/.04 Wells on adjacent lots aor' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line f/o " Building foundation // ' Water main ri0Jf Water Service line 4rk Surface water */od 0 Driveway, parking/vehide storage I, Curtain drain N'"�— Wells on adjacent lots 't -2•-7 F. COMMENTS G. ENGINEER'S CERTIFICATION �. %,.-+-•� .;, *-?: I certify that I have determined through field inspections and ,� ; , ( • . review of Municipal records that the Stove systems ere in ;; = s •r S ...:.• conformance with RtOA HAA gulde!ines lo effect on this date. sntq Engineer's Printed Name �o.r•f ��•^� +-' JT.�yy?y� = w .> � •• ,•,, ;,:i.5 ��-�Y�J_ c/ -rte? Date HAA Fee S S 75 Waiver Fee S Date of Payment 7 /L' Date of Payment Re;eiFt Number Rece:p: Nun�ti er (Rev. 12r3) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH d HUMAN SERVICES Division of Environmental Services On -Site Services Section P•O• Bax 196650 Anchorage. Alaska 99519-6650 343.4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY OWELLING Parcell.D.051-711-06 HAA R �°► In pp�� Y. GENERAL INFORMATION _Complete legal description -Ttarrderbird Heights Lot 2, Block 3 +<• Location' (site address or directions) 27339 Golden Fagle !'^Propertyowner,^•F=ncine Pznd==o Day phone - Mailing address-_P.O. IQXi _870489, wasflla AK 99687 _.' Tending agency Z ALeska I=/ L. Blew Day phone 786-2813 Mailing address 19-6613 Agent „•,�fl Day phone Address . .. _ .. - _ Unless ather_wlserequested ` ' `' '' '_ "; " �- HAA will b© held for pickup. `= ' » •i '. .1.. C`L'ir1"%.•t�1=�N' ♦r i[•ei:-.' • i • , .-• ,t+! f. �_.' ...• A ..•. Y� �N1�1►/. �- ' '•+•L'L•f:3NUMBER OFBEDROOMS• ,,...,s::,3,...:,.. .(:•�.''•:. .•.. f• tLOwyY•1vq fTf. N.Y:w:. •T :��I�.7J ���....ij•.�:•1•��•}^•I.��i'�1:•��•'ai—I w..- •. ,.: •,M__ 'zr.=3.1 =TYPE =. OF,WATERSUPPLY:-''�-�'ririr' 1,. `. -14;I..V�'.. •'•:1�•.���•\�J..,�ri .. \T'.•• �"? • :: •:..�... .r.i.�\..i•�1'---r���.�-n +r' -= .. _'_': _.—..• ._—A�.—.._••._N•r_•�.�-�_�r_� r}'• -.l'l�w. v..•rM-. .-1.• _M•Y•. •. •-i�� :r:i •.. J.. w.•l../{'. Y.•:-, .I .\R'y,i.:�i.l��1'.iJ.':.r • Individuai viell�. w..• . "" = Y=• • • _ -• Communitywell '.Pubilcwater Y NOTE. • if community well system, provide written confirmation from State ADEC attest:: Ing to the legality and status of system. " �•• +a4 -TYPE OF WASTEWATER D_I_SPO1"' SAL•._....-._..... '•° \1 +�'� ""�' �...: �.a.� .-.Indlvidualon-site xo'' 'a= .. Holding tank"•.:: ....._ -:...•......,. t r ..{ r a i .•.�%s+::vi.t,a� .r.�riirt�etnZ..ti-„eer.--.... ..:-. s=: r:.• ' • :. xa;•;;•�:�;:.:�::;:...Communityon-site .. •...... =. � . ,. .. Public sewer' ::--NOTE:*'-- . .. .. .. .. •.. .. L..• .q•.....•....1�1.i�\1•�w '.. =NOTE ' = ll eorrrmunity wastewater system, provide written confirmation from State ADEC .`•''`.' 'ettesting to the legality and status of system. _ fld27 f�.+.1Ay rio.w ro�n� S. 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. t 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 Eagle River Engineering Services phone 694-5195..... Address P.O. Box 773294, Eagle River, AK 99577 Engineer's signature Date .t '• t' n •. E+, tis `� � ,c �4g•ru jr� 6. DH�VHS SIGNATURE _. _Q._ Approved for bedrooms. Additional Comments .'rI til .•' g`,. , ,� .,, •.� _ . • O -.yam . tE3y; -u,t iha^MunicrpalityoT� nctiorage Department of Health and Human Services (DHHS) Issues Health Authority Apprgval,Certitioites based only upon the representations given to paragraph 5 above by an Independent pnilessiorial engineer registered in the State otAlaska The DHHS does this as a courtesy to purchasers of homes andtheirlendinginstitutionsinorderWsaustyeenainfedemlandstaterequimments EmployeesofDHHSdonot conduct Inspections or analyze data before a certificate H Issued. Tho Municipatlry of Anchorage is not responsible for errors or omissions in the professional englneefs work. TIAZ F ..IA+) Oak Mei R7 Disapproved. _. �,: •_:.:_.,.: i•d, 4'�.:,'•.,.,t�••=••�. •;; to r :. . C., `--Canditlonai approval for �bedroorns: with tholtoliowing.stipulations: t = :•• Additional Comments .'rI til .•' g`,. , ,� .,, •.� _ . • O -.yam . tE3y; -u,t iha^MunicrpalityoT� nctiorage Department of Health and Human Services (DHHS) Issues Health Authority Apprgval,Certitioites based only upon the representations given to paragraph 5 above by an Independent pnilessiorial engineer registered in the State otAlaska The DHHS does this as a courtesy to purchasers of homes andtheirlendinginstitutionsinorderWsaustyeenainfedemlandstaterequimments EmployeesofDHHSdonot conduct Inspections or analyze data before a certificate H Issued. Tho Municipatlry of Anchorage is not responsible for errors or omissions in the professional englneefs work. TIAZ F ..IA+) Oak Mei R7 Municipality.of Anchorage / • ...`1 DEPARTMENT OF HEALTH & HUMAN SERVICEfi Environmental Services Division E C E (V E D 825V Street. Room 502 • Anchorage, Alaska 99501 • (907) 341-4744 FEB 161996 Municll)—ail of Anchorage Health Authority Approval Checklist :Dept Health d Human Sorvicos Legal Description: i ✓ . Parcel I.D.:- iv A. WELL DATA L07 7— Well Well type punt./P If A, B, or C, attach ADEC letter. ADEC watersys[em number Log present (YfN) Date completed Toed depth Cascd to Casing height Wbove nd) Sanitary seal (YIN) Wires proper rotcctcd (YM) FROM WELL LOG ATINSPEC170N Date of test Static water level Well production. WATERSAMPLE Coliform Nitrate Other bacteria Datc�t mple: Collected by: B. SEI'fIC/11OLDINGTANK DATA Date installed /9do Tank size ae'a ./NumberofCompartntcnts Clcanouu(Y/N)_y Foundation cleanout (Y/M Scpresston (Y/t) _ V _ high arm (YIN water al) _ N_4 Date of Pumping 1 / Pumper !. C. ABSORPTION FIELD DATA Datc installed Soil rating(gild M! -or R 'Urm ' /7. / . )�Systcntlypc TcEvc<1 Length Z 9 _Width �4 Gravel thickness below pipe 961 Total depth �? / Effective abiorption area br/ e Monitoring Tube prescnt(Y/I� Dcpression mer field (1'/N� N Dare of adequacy test Results (PassrFainP19� For bedrooms Fluid depth In absorption Ccld before test (In.); Immediately alter oo gal. water added (hi): AV. S'` Fluid depth _ (ins.) Minutes tater: / aro Absorption rate's ry p e.p;d, Peroxide treatment (past 12 months) (YIN) I' If yes. give dale v ., t D. LItTSTATION Date installed hlanholc/Acccss (Y/N) -Pump oit- 1 ligh surer alarm level at;, E. SEPARATION DISTANCES Size In gallons *Datum SEPARATION DISTANCES FROM WELL ON LOT TO. 414 Septiclholding tank on lot :On adjacent lots Absorption field on lot Public scuer vain "Pump off' level it* Public smccr vanholckleanout line Lill station SEPARATION DISTANCES FROM SEPfICMOLDING TANK ON LOT TO: t Building foundation i' n �»•r-:. •+ Propcny line 7i'/D Absorption field 5 Watcrtimin/serviceline rro' Surfacenater/drainage t f -fit Wcllsonadjacentkts iZz-O SEPARATION DISTANCE FROM ABSORP71ON FIELD ON LOTTO: Building foundation I // r Water main/senice line t1,00 Surface %%iter 71 /00 r Driveway. parking/cchicle storage arca 71-/t r MY& 11� Curtain drain All -W i NT Wells on adjacent lots 7'17140 Propcny line ' /Z F. ENGINEER'SCERTIFICATION I ecrtifv that l have determined thru field Intpeetionr and review of tlunieipal in conformance with A 10 Met guidelines In effect on this date. Signturv- Engineer's Namc C-01�i5 t�i/f<yrl �F Date :1- /f-76 IIAAFcc $ .Ir'Q.C� WaiccrFee S Date of Payment Receipt Numbcr Rev. 9/95 OSS: haa.rk.doc Date of Payment Receipt Numbcr toeh A.:.Imo ' CIMS +. r, �` lJrrOr.�9�rr1tJ c llricrs, lo- la •�q MUNICIPALITIYOF ANCHORAGE h413 DEPARTMENTOF HEALTH& ENVIRONMENTAL PROTECTIPd.%VOPALftt OF ANCHORAGE ti 925L11tt"t.Anchorage,Alaska 99501 DEPT. OF ICALTH & ' • ENVIRONMENTAL ENGINEERING DIVISION ENVIRONMENTAL F«OTELTION, Telephone 264-4120 ,lU14 61930. • :.• REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW EllI DIRECTIONS: Complete dt pang on page 1, incempleto "Quests wlil Not be proca.ad, Plusa plow len 1101 days for processing, I 1 I. /RO►ERTY OWNER I►NONE Stuart V1. 6 Margaret A. Gustafson work 263-3716 hone 688-3004 MAILING ADDRESS P:O. Box 310<'. G2ttlgililc, Ak. 99567 PROPERTY RESIDENT UImUorant Item e""I HUNL ' L BUYER sarne as above t. - MAILING ADDRESS c �sT4• Alaska Pacific Bank rNUNt. MAILINGADDRESS 274-9662 P.O. Box 420 Anch, Ak. 99510 4. REALTOR/AGENT H N T1/a MAILINGADDRESS , Ioots 1&2,c Blsock 3, 7hundcrbiici Heights' STREET LOCA ION MIN Thtaxlarbird Drive Chugiake , Ak. 0. TY►E OF RESIDENCEUMd . ,�;••.. r R O BEDROOMS SINGLE FAMILY One 13 Four E3 ,Other O MULTIPLE FAMILY E3 Two C3 Five Z3 Three O Six 7. WATER SUP►LY - ` O :•'. ' ATTACH WELL LOG. A well lop is requimc! for all wells drilled iDJ : COhIMUNITY COMM COMMUNITY • • • since June 1975. For wells drilled prior to that data, give well ; ' • - E3 PUBLIC UTILITY depth (attach log it available.) a. SEWAGE OISPOSALSYSTEM EZ INDIVIDUAL/ON•SITE" -**If Individual/on-sits. give(nstallationdate- lclq7N,� CJ If system is over two (2) years old inadequacy test h required g PUBLIC UTILITY by this Department NOTE: THE INSPECTION FEE MUSTACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, nolownel _ ,•. • `r ( UJ t�r/a��G.r�s 3 " C. G •�C w1- w y a t o - I THIS SIDE FOR OFFICIAL USE ONLY • INSPECTION APPOINTMENTS v DATE HECEIVED TIME tIMF DATE DATE INSPECTOR IN4rL6IUR DIRECTIONS: s ems. T. TYPE OF RESIDENCE NUMBER OF BEDROOMS C3 ONE CO THREE E3 FIVE 7. Or OTHER - SINGLE FAMILY C3 MULTIPLE FAMILY C3 Two M FOUR 0 SIX 2. WATER SUPPLY PERMITNUMBER P .-INDIVIOUAL DEPTH OF WELL -a , COMMUNITY E3 .' PUBLICUTILITY- DATE ORI LLED • Connection Verified. LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER M INDIVIDUAL/ON SITE DATE INSTALLED OPUBLIC UTILITY Connection Verified Ic1 Urn - INSIALE�Fft OSeptIcTankor C3Hold;ngT&nk .L Size:_ If Tank Is homemade SOILS RATING giv* dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES 54PUCIM0101"STank ADsorpdon Ane aewer Line "west "I Line WELLTO: Absorption Argo to pearl"t Lot Une 5. COMMENTS b -APPROVED FOR BEDROOMS E3 CONDITIONAL APPROVAL (letter must a Y, certificate) t='DISAPPROVED DATE 'Municipality of Anchorage June 12, 1900 825 "L" STREET ANCHORAGE. ALASKA 09501 (907) 264.4111 GEOnrE M. SULLIVAN. AIAYOII hfPAIMIt NT Of POFALTH ANO ENVIRONMENTAL PnOTECTION Stuart W./Margaret A. Gustafson Post Office Box 310 Chugink, Alaska 99567 Subject: Lots 1 and 2 Block 3 Thunderbird Heights Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: (1) Replace the three(3) inch cleanout to the trench with a four(4) inch cleanout. This will need to be re -inspected by this department. (2) We have not received the as-builts of the installation in this office. If a private engineer inspected the system, please send us the report for our files and review. If there are any further office at 264-4720. Sincerely, Robert c. Pratt, R.S. Associate Specialist RCP/ljw questions, please call this cc: Alaska Pacific Bank Mortgage Loan Department Post Office Dox 420 99510