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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 5 LT 6Municipality of Anchorage Community Development Department Page 1 of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:/Avww.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161102 PID Number: 017-061-16 ❑ New ❑✓ Upgrade Name: ANDREW DAOUST & BARBARA YAWIT ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address PO BOX 110750, ANCHORAGE, AK ❑ Other Phone Number of Bedrooms Soil Rating -- fatal depth from original grade - 3 - GPDISF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade - Ft. Gravel depth beneath pipe - Subdivision - Block Lot MOUNTAIN PARK ESTATES 5 6 Ft: Fill added above original grade Gravel length Township Range Section - Ft,.: Ft. Gravel width Ft, Beds: Number of Lines Distance between lines ra. SEPARATION DISTANCES - TLSeptic Absorption Liff Station Holding Sewer Total absorption area Number of trenches Dist. between trenchesFrom Field Tank Line Ft2- Ft. well N/A NA N/A 50+ TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Tank Capacity 15000al. Surface water 100+ NIA NA N/A Material Number of compartments Lot Line 51.3 N/A NA N/A STEEL 2 NA Foundation 8.3 N/A NA N/A LIFT STATION Manufacturer - - Capacity Curtain Drain 50+ N/A N/A N/A Gal. - - Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make, and model Electrical Inspections performed by Installer PIPE MATERIAL Housetotank 3034 drainfield Tankto _ 3034 Isaac's Excavating Drainfiield . 3034 COIMT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 1006 Inspection 1" 06/10/16 dates: zm 06/23/16 Location and description - - - V 0 Bottom trim NE Corner of House COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Mt Conditional Approval: Date Vteven W'l5aniroae Approve Date Inspection R tox -1-12.doc 1 1 � � 1 � 5 1 1 1 1 1 1 1 1 1 WELL E \ WELLE i 4A\ W — \N / — — 1 1 DCO2 _ _ _ 1�--1 51.3 Til- 44 il-M � I 1500 g SEPTIC TANK (N) PROFILE NOTES: RECORD DRAWING I DRAWN I JRL - I SITE PLAN 3BR SFD PANNONE ENG P.O. BOX 102954 ANCHOR, PHONE (907) 272-8218 FAX ELL E 1 bN �c 1 \ �1 1 1 00 B DC01 o Ow w w maww DU U U oc� o> nn 102.23 D DV 28.2 n n n n 1500 g SEPTIC TANK (N) PROFILE NOTES: RECORD DRAWING I DRAWN I JRL - I SITE PLAN 3BR SFD PANNONE ENG P.O. BOX 102954 ANCHOR, PHONE (907) 272-8218 FAX ELL E 1 bN �c 1 \ �1 1 1 \N S SEPTIC TANK PER CODE. INSTALLED DCO BEFORE & AFTER TANK AND DV NEW VC, 9 9510 LLC AK 907) 272-8211 A MOUNTAIN PARK ESTATES B5 L6 ANDREW DAOUST & BARBARA YAWIT PO BOX 110750 ANCHORAGE, AK 99511 A B DC01 17.5 11.5 T1 - 18.8 15.3 T2 24.1 . 25.6 DCQ2 26.9 29.5 DV 28.2 30.6 \N S SEPTIC TANK PER CODE. INSTALLED DCO BEFORE & AFTER TANK AND DV NEW VC, 9 9510 LLC AK 907) 272-8211 A MOUNTAIN PARK ESTATES B5 L6 ANDREW DAOUST & BARBARA YAWIT PO BOX 110750 ANCHORAGE, AK 99511 07/25/16 Scale 1"=50' P.I.D. NO 017-061-16 OSP161102 2 OF 1 1 LOT: 1 BY 1 1 1 1 1 1 'o 2 � o u 1 w \ � U 07/25/16 Scale 1"=50' P.I.D. NO 017-061-16 OSP161102 2 OF On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161102 Tax Code Number: 01706116000 Work Type: SepticTank Upgrade Permit Effective Dates: May 23, 2016 to May 23, 2017 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: MOUNTAIN PARK ESTATES Site Legal Address: MOUNTAIN PARK ESTATES BLK 5 LT 6 G:2938 Owner/Address: DAOUST ANDREW & YAWIT BARBARA LIVING TRUST DAOUST A M & PO BOX 110750 ANCHORAGE AK 995110750 Site Mailing Address: 13200 ALPINE DR, Anchorage Lot Size in Sq Ft: 33600 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By 10 MUNICIPALITY OF ANCHORAG Community Development Department Development Services Division On -Site Water & Wastewater Program �8 9' kg al MAY 1 1 2015 3 Phone: 907-34SW_cMA Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-061-16 Property owner(s) Andrew Daoust & Barbara Yawit Mailing address PO BOX 110750 Day phone Site address 13200 Alpine Drive Legal description (Sub'd., Block & Lot) Mountain Park Estates Block 5, Lot 6 Legal description (Township, Range & Section) Lot Size 33,600 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Q (w/wo ADU) Septic Tank Q Upgrade 0 Duplex (D) ElHolding Tank F-1Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further_certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized Permit/Rush Fees: l Waiver Fees: Date of Payment: CJ �II S° Date of Payment: Receipt Number: Receipt Number: Permit No. P) (P I 102 Waiver No. Permit App_:- : :'_.:c, Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(coanengak.com 19 May 2016 Subject: MOUNTAIN PARK ESTATES B5 L6 Tank Replacement Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic tank to be issued for this property. The proposed system will serve an existing three-bedroom (3) house. Currently the lot is developed. This lot and the surrounding lots are served by private wells and the lots to the east are served by a Class A well. The well on this lot and the surrounding wells are over 100' from the septic system. 1. System Design. a. See Sheet 1 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank. The proposed tank upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The existing topography generally slopes from the west to the east in the area surrounding the septic system at approximately 2-5%. There are no steep slopes within 50' of the proposed tank. The proposed tank will maintain 50' separation all steep slopes. 4. Drawing Markings: The Drawings are marked "For MoA Review Only'. When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 1 1 , 5 _ 1 , 1 \ WELL E 1 � , WELL -E 1 1 1 / _ _ — _� — — _ - 49.960.4 C, I I I I I I I �MI I I M � I I 100.0 1500 g SEPTIC TANK (P) 11 ` EL�Ey' \N ya W REMOVE AND REPLACE 1500 SEPTIC TANK. INSTALL DCO AFTER TANK (P) 1 3BR SFD / PROFILE NOTES: PANNONE ENG CONSTRUCTION P.O. BOX 102954 ANCHORi PHONE (907) 272-8218 FAX \ I \ 11 1 1 \ M \ \ LOTS 1, BY COM 1 1 35.0 1 20.0 1 1 1 1 1 \ 1 7 99510 272-82111. 1) MOUNTAIN PARK ESTATES B5 L6 DRAWN JRL ANDREW DAOUST &BARBARA YAWIT PO BOX 110750 SITE PLAN ANCHORAGE, AK 99511 Date b5/18/16 mz••• P.I.D. NO 017-061-16 taile PERMIT NO. � 8749 OSP761102 Sheet `�tt�•� 1 OF 2 0 0 5 w w V U wo o p U 1500 g SEPTIC TANK (P) 11 ` EL�Ey' \N ya W REMOVE AND REPLACE 1500 SEPTIC TANK. INSTALL DCO AFTER TANK (P) 1 3BR SFD / PROFILE NOTES: PANNONE ENG CONSTRUCTION P.O. BOX 102954 ANCHORi PHONE (907) 272-8218 FAX \ I \ 11 1 1 \ M \ \ LOTS 1, BY COM 1 1 35.0 1 20.0 1 1 1 1 1 \ 1 7 99510 272-82111. 1) MOUNTAIN PARK ESTATES B5 L6 DRAWN JRL ANDREW DAOUST &BARBARA YAWIT PO BOX 110750 SITE PLAN ANCHORAGE, AK 99511 Date b5/18/16 mz••• P.I.D. NO 017-061-16 taile PERMIT NO. � 8749 OSP761102 Sheet `�tt�•� 1 OF 2 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 2. SCOPE OF WORK: INSTALL NEW 1500g SEPTIC TANK. 3. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 4. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 5. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. - 6. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. - 7. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 8. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 9. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 10. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 11. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: m DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 3(450 gpd) TANK SIZE: 1500g NOTES: FOR CONSTRUCTION I DRAWN I JRL I SITE PLAN TITLE: PANNONE ENG P.O. BOX 102954 ANCHORI PHONE (907) 272-8218 FAX WATER LINE / WELL RADIUS NEW SEPTIC 1 99510 272-8211 MOUNTAIN PARK ESTATES 85 Lfi_ ANDREW DAOUST & BARBARA YAWIT PO BOX 110750 ANCHORAGE, AK 99511 ABBREVIATIONS TH TEST HOLE - (P) _PROPOSED (E) EXISTING CO CLEAN OUT NO. AT MONITOR TUBE NO. TYP TYPICAL - 05/16/16 2 OF Scale NTS P.I.D. NO fli149 017-061-16 PERMIT N0.OSP161102 2 OF MUNICIPALITY OF ANCHORAGE DI ATMENT OF HEALTH AND HUMAN SER\ a'sS " Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES FROM SEPTIC TANK ABSORPTION FIELD WELL AddressTO 13 7-00 14 WELL / o 3 Phones) Permit No. No. of Bedrooms LOT LINE - LEGAL DESCRIPTION Lot Block s- Subdivision /rl ,, ro.r: _ Township, Range, Section f 2 G .r f 1- f" R L'r AS-BUILT DIAGRAM driveway, water bodies, (Show location of well, etc.) septic system, property lines, foundation, TANKS ❑ SEPTIC ❑ HOLDING Manufacturer Capacity in gallons Material No. of compartments TYPE OF SYSTEM :r a ® TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from original grade 40 FT Total depth from original grade / a FT ' ' fr � '-;•, C -- O I yN 4:. t � N T _ :.1 Foy[ _zs FIII added above original grade S� FT Gravel depth beneath pipe FT Gravel length FT Gravel width J FT n / !; t Total absorption area T J 2- SQ FT Distance between lines FT Number of lines ! Soil rating v36 L SQ FT Pipe material /=8fv 8034 Installer V / Dale Installed WELLS ❑ PRIVATE ❑ OTHER (Identify) WQ it Q P Classification (A,B,C) Total Depth FT cased to FT - Ilk Lr Installer Date Installed: REMARKS: �j:eAVll l'lr G'/Kq '..%(J /G1' Si jcWj 'la "l- i-. dp ')iu Ae could Y.ilcllp /Zt /'Y•ic�1..L dlt/e £"- ui vrr�rl'`Ir�-'%Y'�, _5"O'145 Scale: Inspections Date: 11+ Performed by: CS S'7— '!Date: - - ENGINEER'S SEAL e " /0 — 2 S.- _ 6+ certify that this inspection was perlormed according to all Municipal and Statauidelines in ellecl on this date: / O _ 7 7 J­ Health Department Approval; ace: 72-013 (3/85) r Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES F(rf"/,< TO SEPTIC ABSORPTION WELL Aomess FROM TANK FIELD Pnonets) Perm,[ No. No. of Bedrooms WELL / 03 Z7z 8Y27- Sro6} + 1:2- LOT LINE _ Zo _ LEGAL DESCRIPTION Lot Block Subdivision �� C I FOUNDATION 8> I Township, Pange. Section I AS -BUILT DIAGRAM (Show location of well, septic system, property lines, louncaiion. S t L Z TIL f -' R 3 r"r driveway, water bodies. etc.) TANKS E) SEPTIC El Manulactwer Gapacnty in cartons dAalerial I No. of companments TYPE OF SYSTEM VJTRENCH ❑ BED ❑ W. DRAIN ❑ OTHER ' Depin to pice oollom born original grace 4 FT Total depth from original grade y a- Fiu acdec acove original grade FT Gravel depm beneath pipe 8 IGravei leng:n FT Gravel w'om 3 Total aoso,�:wn area 7- SQ FT I Distance between ones Numoer a .nes ( Soil rating 36Z SQ FT Pipe material F8r0 D 3034 lns:aeer 6668�— Date Installed WELLS PRIVATE ❑ OTHER (Identifv) CJassiocat�cr. (.�, B.CI Total Depth FT Cased to Ins;alle Date Installed: REMARKS: IXC n,/a�r d::y 'tv /6 �`'c S/t cr.✓ SIU r.,�<'K -r ,fn u¢ *7"k4 ize -�rdpe e— Municipal and Slalau delines in ellecl an this dale: Health Department Approval: L2-013 (3:851 I I I Scale: Inspections Performed 6y: .. Ii CCS ST F57C)L4 Date - y0 —2)--8r certify that this inspection was performed according to all 0—ZI-S)— ENGINEER'S SEAL Pal 1"ll X ET :E P" on; L. 3. Y W C13 W �W ET 1-1 j� .11 R: P% E-._]i� DEPAR�MENT OF HEALTH AND EN. IRONMENTAL PROTECTION 825 1 ANCHORAGE, AK 99501 264 .720 ` PERMIT NO:850671 DATE ISSUED: 10/11/85 APPLICANT: DEAN FLETCHER ADDRESS: 13200 ALPINE DRIVE ANCHORAGE, AK 99508 CONTACT PHONE: 272.8827 LEGAL DESCRIP: SUBDIVISION: MOUNTAIN PARK ESTATE LOT: 6 SECTION: 26 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 1"0A (SQ"FT" OR ACRES) MAX BEDROOMS: 2 BLOCK� 5 Listed below are the options to ��^� .���. you in designing your septic system, Choose the option that best fits you ite" (1) __-__�__~�_�~_ PERMIT AND INSPECTION MUST BE OBTAINED; (2) ASPBUILTS WILL NOT BE APPROVED Es EEE T�: T. P-4 DEPTH TO PIPE BOTT8M (FT. ) 4 0 � . 4.0 4,0 GRAVEL DEPTH (FT.) � 'J��' �� _���"�0.5 3.0 TOTAL DEPTH (FT.) ��� ���^ ��� 4.5 7.0 GRAVEL WIDTH (FT") 2"5 21^0 5"0 GRAVEL LENGTH (FT.) 4� 42.O 85.0 ** GRAVEL VOLUME (CU.YDS^) 39^3 32"7 55.1 TANK SIZE (GALS) 1,000"O ** 1�000"0 ** 1,000,0 ** �OT| R�TTNG (qQ.�T./BR) 362 290 362 � ~ ** GRAVEL LENGTH > 75 FT" 'EQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) ** TANK MUST HAVE AT LE`ST TWO COMPARTMENTS ..... ..... ����������.. I certify that: 1. I am f*amiliar with the requirements for on~site sewers and wells as set Hrth by the Municipality of Anchorage <MOA> and the State of' Alaska. 2" I will install the system in accordance with all MOA codes and regulations� and in compliance with the design criteria of this permit. 3" I will to sill MOA and State of Alaska requirements for the set back distances from any existing tie ll1, wastewater disposal system or public sewerage system on thiss or, any adjacent or nearby lot. , 4. I understand that this permit is valid for a maximum of, 2 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES' THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) ASPBUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL EON REPORT; AND (3> THE INSP�TI ELECTRICAL WORK MUST BEE DONE: 13Y A LICENSED ELECTRICIAN. ' SIGNED - _ �_-______. DATE: ~~--- APPLICANT: DEAN FLETCHER ISSUED BY DATE: .... ..... ...`~~.~_�_~-~_ p (ENGINWR's SEAL) w Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: C'Pr%S Zxca.r2+o+y DATE PERFORMED: LEGAL DESCRIPTION: Township, Range, Section: SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 MUNICIPALITY OF ANCRo�'O'� i DEPT. Of HEALTH & EWIRONMENTAL PROTECTION 00v 2 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? Date: ■■■■■■■RE■ ■■■■■■■"1I■ Net - Time Depth to Water Net Drop ■■■■■mM■ 2 2- - IN ■■■I■.■ 2 3i 233 ZbU011 -■I■ tg ■DEMO=N■1® -03 K10 — Zs -� /o gob .p ■INESIME■I11■I■ l0 3 [J 7t- 10 4A oke ■mmmmi i 01■I■ ■■■NOMEN,■W ■■■ 020511MI■ NEEMENEAME ■■■■MMMEEM1 ■■MENS■■■I■ 5 - rc) c, to Reading Date Gross Time Net - Time Depth to Water Net Drop 2 2- - 2 3i 233 ZbU011 J\ tg -03 K10 — Zs -� /o gob .p l0 3 [J 7t- 10 4A oke 20 PERCOLATION RATE 41-7 (minutes/inch) PERC HOLE DIAMETER � +rJ_ TEST RUN BETWEEN FT AND FT COMMENTS So l l/ la -W 286 r7' /� Fay fo 1[ E %1(/676 Sol'/ W'LS lSSVP61 -fti� Oro 7,J9!' Il' cfe��.j �X Ca V¢:t+- diuq '/�-` lE ' Ire S�oii.% ,�� Z^��-� � so ys 'j!3 yn PERFORMED BY: A C� !nc 3' 7 cFj `� �_/ I yl ��`�•�� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: - 72 -008 (Rev. 4/85) d e p'fic J'�r; rCrrr cieePp,_ olnGi ,JGiu�tey e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST (ENGI _. ESEAL) `J 1 PERFORMED FOR: L/r4i zs EXc/iy/+T t7✓ C7 DATE PERFORMED: /0 7 LEGAL DESCRIPTION:. Me, i4lv7-A-IM t'it/LA FSi• 135 L{ Township, Range, Section: 5. 26 'T 1z-1\je'3L'r p P SLOPE SITE PLAN 1 iF IT MUL UrI(.`nit Sc:. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: l'� U S L O _ P E ■■NEEM■N=10 Date Gross Time Net Time Depth to Water ■ENMMEE■��■ E■ENNE::iG�® -7 2-- _ �y z.7 /o MEN■EMEE��■ i.7' E■NEMEME■I■ lL� — NEENEE■E■I■ S' - t� Tc� Reading Date Gross Time Net Time Depth to Water Net Drop -7 2-- _ �y z.7 /o i.7' lL� — �3'3 ro 3 yV -t D e4. 2 5 its y. UG 011 ) tf U - G �( 20 PERCOLATION RATE 4Z' (minutes/inch) PERC HOLE DIAMETER � r TEST RUN BE -3 BETWEEN ` FT AND FT COMMENTS ?—eo P '/4 4)v -t Z / PERFORMED BY: h GLS / hC At ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN 72-008 (Rev. 4/85) �ri CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: ACREAGE SYSTEMS, INC. ��` ___---�°�`�,•_ _----- __ _�/'' P.O. BOX 11284E "�.•k (907) ANCHORAGES ALASKA =�` y - 345-2122 -__ 99511-2848 276-6552 INVOICE NAME: CENTURY 21 ALLIANCE/ McKENZT_E INVOICE: 8081058 ADDRESS: 3401 DENALI #130 DATE: 88/08/29 CITY: ANCHORAGE STATE: ALAKSA ZIP: 99503 WORK: 561-0491 HOME: ACCT: CEN ALL P 2938 INF: JOB: 85B DESCRIPTION: ADEQUACY TEST ENG: CORWIN 1: ENGINEERS TEST & REPORT FOR WELL AND SEPTIC SYSTEM. .: 520.00 2: NO MUNICIPALITY FEES PAID .. 3- 4- 6- JOB :4:6:JOB RDD: 13200 ALPINE DRIVE � TOTAL 5: 520.00 LG: SWI/4 526 T12N R3W SM AK L:� B:� SUB: MT. PARK ESTATES lD � C I rL S i/U 9A y 3f6-- Y- 6 r 450^ x 105 = 675- MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 37.0 } 0- c,� SEP 12 1988 RECEIVED 150- x 30 _ 450- 450^ x 105 = 675- 601 E. NORTHERN LIGHTS BLVD. ANCHORAGE, ALASKA 99503 345-2122 276-6552 HEALTH AUTHORITY SEPTIC SYSTEM UPGRADE ADEQUACY TEST & TEST HOLES SUBDIVISIONS AND LOT SPLITS PAPERWORK HAND DELIVERED TO CLOSING HEALTH AUTHORITY PACKAGE $690.00 ADEQUACY TEST INVESTIGATING MUNICIPALITY PAPERWORK ENGINEERS TEST AND REPORT FOR WELL AND SEPTIC SYSTEM CHECK WELL OUTPUT WELL INSPECTION FOR WIRES & LID CONDITION CHECK WATER FOR BACTERIA & NITRATED FIND AND.UNCOVER SEPTIC SYSTEM 2 HRS HAND DIGGING INCLUDED SYSTEM ADEQUACY_ TEST TO PROVE ABSORPTION RATE PUMP SEPTIC SYSTEM MUNICIPALITY OF ANCHORAGE DHHS FILING FEE ($170.00) SUBMIT AND RETRIEVE ALL PAPERWORK TO DHHS 3-5 TRIPS. TEST HOLES AS REQUIRED FOR SEPTIC PERMIT $650.00 INVESTIGATE MUNICIPALITY PAPERWORK LOCATE ALL WELLS AND SEPTIC SYSTEMS OF ALL ADJOINING LOTS LOCATE LOT CORNERS 2 HRS INCLUDED EXCAVATION WITH BACKHOE SOILS TEST WITH ENGINEERS REPORT PERK TEST FOR SOIL ABSORPTION RATE WATER MONITORING FOR ONE WEEK PLOT PLAN AS REQUIRED LY DHHS SHOWING ALL ADJOINING LOT AND WELLSr SEPTIC, HOUSES ALSO INCLUDING TEST LOT'S WELL, SEPTI.0 FUTURE SEPTIC SYSTEM SIGHTS, HOUSE AND DRIVEWAY. HEALTH AUTHORITY APPROVAL RESULTS AND ANALYSIS Legal Description: Lot 1% Block 0/� Subdivision At)r)iAIIJ PAPt_ EST4T,S Results of Water Testing: Results of Septic SysteX/m� Adequacy Test: ✓/� T/ ( �'" %� ` �A if i rA� �iir� /i/L -C�-'SCJ i+ ./ =✓�/ / Y Approved and Certffied: .v. kr ,' ,l .) V 1, I .— /I /n.. l l ✓i .,�1. I' / ✓/i�l. TIME /Z;4/ OU I ;e � 00, , METER, READING 7c�' -7s7z GALLONS .THIS' .. PERIOD .. TOTAL' GALLONS GALLONS PER MINUTE / . SEPTIC TANK; DEPTH INCIIE S 3 _ LEACH FIELD DEPTH INCHES_ Fo l0' -7,r .l ^ham G U • y ---------------- --_- OATA SHEET ;} i GATE OF TEST: PioiECT: / —� -LOCATION OF 41ELL (Legal Description): -- I� 1 CASI<G: DEPTH:/Z FT ---- FT SCREEN: it bIELL DR[LLER: 1i DATE ORILI,IIIG COMPLETED: STATIC ,, IATER LEVEL (Top of Casing): FT ,�. �. Zj I? apses ime.Sincel Oravidn��rn/ Pupping Renarks Ia Clock I Depth to pumping-Started/ P ft. Recovery Rare, GP. 14 ' U Tine Stopped, 11in. water, 0 p Start 0 g, �' swl G p a� 1 R V G ri SC' 9� 35 los, 0 5 i os 1 hour 19 4 / 90 0, i I. 120 2 hours i a I 1 0 hour$ 21U I 4 14 hours RECO';ERY I j 0 I i I 1�s L 3 6 15 I 20 /q/J i I 25 _ ,o !' ! a0 �0 1 r I � i 60 1 hour t0 1 T7 noufs i MUNICIPALITY OF ANCHORAGE He h and Environmental. Prot( I -on Fourth Floor West 825 L Street Anchorage, Alaska 99501 279-253.1, x 224, 22514 I INSPECTION REPORT ON-_S_ITF_CSE /AGE DISPOSAL _ SYSTEM NF4�nE aL _FTI- �_(A�e- MAILING ADDRESS _ `-� Ppf LEGAL DESCRIPTIO(! ___,_.. l----- - --- --------ANNA-- --- ;i SEPTIC T'ANK- DI$TANCE/ a NUMBER OF FROM WEt,_L ra� MANl1FAC'TURER -Q K MATFRI-_-COMPARTMENTS_ INSIDE LENGTH ----INSIDE WIDTH _----_-_. LIQUID DEPTH LIQUID CAPACITY �6U�ALLONS. -- ANNA -- --- - --- -- -ANNA-- -�. jp TOTAL LENGTH (PEEN_NEAREST LOT LINE__ -.--OF LINE DISTANCE FROM WEI.t_ _ 4� FOUNDATION_! _-_ __TRENCH WIDTH-- IN. TOTAL EFFECTIVE • #''Of L�ne,5-�._.-;-_ DISTANCE BETWEEN LINES .� • AB$ORPYIS]N AREA -,2 _-- - SQ. FT. LENGTH CP EACH LINE --- --- DEPTH OF FILTER DEPTH: TOP OF. TILE TO FINISHGRADE -_---�`-J-_-_.-._- NEAT-^ r�� IN. ABOVE TILE _�_.e.IN, - ---� A—INISH -_�--. MATERIAL BENEATH TILL ----R ya � SEEPAGE PIT: DIAMETER OR WIDTH_ LENGTH—,. DEPTH __ _. ­ 4 DIAMETER DISTANCE FROM: WELL I;oc� Crib s� Crib Size • DIAMET —_ Ring TOTAL EFFECTIVE BUILDING', FOUNDATIONS . NEAREST LOT LINE AL PTION AREA (WALL AREA) SQ. FT. ,Well 'Class:_ ) Depth: _ Well Distance To: Lot Line :Bldg:' sewer Line: Pipe, Materials: # of , Bedrdoms • Installer) ,/"4 3 Remarks: fK %r- DATE'/_r._.--( AFP I VED _ Q Q��1�.�-�-- I _ I I �Jf 111 I I DATE'/_r._.--( AFP I VED _ Q Vt--:�SON WELL DRILLIiJ1 l TIC ,: 1305 W. 45TH STREET ANCHORAGE, ALASKA 99503 PHONE 272-9343 .JL-`, DRILLING LOG Well Owner edv Use of Well-- Location ell—Location (address of: Township, Range, Section, if known; or distance main road Size of casing Depth of Hole feet Cased to feet Static water level ft. (above) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforation Well pumping test at gallons per (hour) ('minute;) for hours with ft. of drawdown' from static level. Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO at TO TO TO r� k TO f. TO TO 1 ; ; TO Toez_ 'r TO — TO — TO — TO TO TO THE REQUIRED S12E OF THE: SOIL ABSORPTION SYSTEI,-1 IS: ��F` -T, ":=m � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H 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). I FZEEC-a ��EE.F`r 1 c_- "_::E- I��� -T- L-A co < ;2 1 F"F� 9--- -F 1 co Ir Lj 1 1�� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION HND HPPROVHL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. � MINIMUM DISTANCE BETWEEN 8 WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS � � 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION. SPECIFICATIONS HND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ��f-`Ir-ll­F F:COF;? 1011`41li—E ��IP'lFR� �='FP!Corl I KJ F -H. I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS HS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL 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 ] BEDROOMS. IMA ISSUED BY prI cI r e cF Fl A CJ FE ' =^ 00 DEPARTMENT DF HEALTH HND ENVIRONMENTHL PROTECTION ^~. , 825 ' STREET, ANCHORAGE, H[. 9 | / | 1 / /�,` 04 EFE 9 . L_ F.:o HA E.-- \/ � � 279~2511 P-A-~��-IF F -E. #�-Il�� PERMIT NO. ( 77141 ) ` APPLICANT SRH BOX ]421-1 ]44~]246 LOCATION HLPINE/DEHRMOUN LEGAL L6 B5 MT PARK EST LOT SIZE ]".'7000 SQUARE FEET / ` TYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS -'C,! ] SOILRHTING (FT/BR)� 85 THE REQUIRED S12E OF THE: SOIL ABSORPTION SYSTEI,-1 IS: ��F` -T, ":=m � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H 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). I FZEEC-a ��EE.F`r 1 c_- "_::E- I��� -T- L-A co < ;2 1 F"F� 9--- -F 1 co Ir Lj 1 1�� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION HND HPPROVHL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. � MINIMUM DISTANCE BETWEEN 8 WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS � � 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION. SPECIFICATIONS HND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ��f-`Ir-ll­F F:COF;? 1011`41li—E ��IP'lFR� �='FP!Corl I KJ F -H. I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS HS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL 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 ] BEDROOMS. IMA ISSUED BY f R&M CONSULTANTS, INC. 5024 CORDOVA 0 BOX 6087 B ANCHORAGE, ALASKA 99502 • PH- 90]-2]9-0483 B TLX. 090-25360 ENGINEERS GEOLOGISTS PLANNERS SURVEYORS April 8, 1977 Mr. Dean Fletcher SRA Box 342-A Anchorage, Alaska 99507 R & M No. 751134 RE: Test Hole and Soil Log Report for Sanitary System Lot 6, Block 5, Mountain Park Estates Subdivision, Anchorage, Ak Dear Mr. Fletcher: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This in- vestigation was performed in accordance with your request of April 4, 1977, and those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Municipality of Anchorage, Department of Environmental Quality. A single test hole was drilled within the subject site area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Drilling was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 19 feet below ground surface. The final log of the test hole has been included on Drawing A-01. Groundwater was not encountered in the test hole while drilling. A percolation test was performed from a depth indicated on the attached table and reflects average infiltration from that depth to the bottom of the hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. very truly yours, R & M CONSULTANTS, INC. 4ii�q�x Edward Yarmak, Jr. Geotechnical Engineer EY/pe ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA A TH-1 Lot 6, Block 5 Mountain Park Estates Subdivision Not To Scale The test hole location is approximate and has not been located by survey methods. TH-1 4-5-77 All Samples A 0.01 - - ' 2M1 ORGANIC MATERIAL Moist, Soft, Brown ti — — — — — — — 2.0' aQ' p SANDY GRAVEL L'I/SOPiE SILT �e.. •°.ate— — — — — — —2.5' e 0, 64 .6 - gib SANDY SILT WISOME GRAVEL �/'.4• Moist, medium Dense, . P•o -6.e•e: Brown to Grey - - oio�• - Occasional Cobble _ - - �p-7.0' oa. � a•ao W1 VA O d. pGe bees. SANDY GRAVEL W/SOME SILT - e.a po 0°0A Moist, Medium Dense ..ebb . o' Boulder at 8' 11.0' SAND WSOME SILT AND GRAVEL ".b. Moist, Medium Dense 15.0' DWN: V 2 0 0�1%�_ _ CKD R&M CGNSUiY1i7�I'iSoiNC ENOiNYtPf 0E0000•IITII a�PNNEiY IIU vII DATE= 4-5-77 SCALE: -1m-3 GRAVELLY SAND W/SOME SILT :a•::' Moist Medium Dense 19.0' TD s Groundwater table not encountered D F. B. SANITARY SEWER TEST HOLE GRID 2938 DEAN FLETCHER ANCHORAGE, ALASKA PROJ.NO 751134 DWG. NO. A-01 TIME 10:55 10:56 10:57 10:58 10:59 11:00 11:01 11:02 11:03 11:04 11:05 11:10 11:15 11:20 11:25 11:35 11:45 11:55 PERCOLATION TEST DEAN FLETCHER Let 6, Block 5 MOUNTAIN PARK ESTATES R & M NO. 751134 ELAPSED DROP IN TIME INCHES INCHES 0 20.00 0.00 1 31.00 11.00 2 39.00 19.00 3 43.50 23.50 4 49.00 29.00 5 53.50 33.50 6 57.00 37.00 7 60.50 40.50 8 63.25 43.25 9 66.00 46.00 10 68.50 48.50 15 77.00 57.00 20 85.50 65.60 25 93.00 73.00 30 100.50 80.50 40 113.75 93.75 50 124.25 104.25 60 134.50 114.50 114.5 INCHES TOTAL DROP OR 0.52 MINUTES PER INCH <3-5 n MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 kQ343-4744 . t-�Og GI✓ CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # Q/? — 06P/-- / 6 HAA # 0 () GI0:3�1 1. GENERAL INFORMATION /� n Complete legal description �"� b B k �00V.� aur �a" cS'- Location (site address or directions) 1 ?2A 4 yn�a e- Drive— Property owner () S, Pta"I_t Day phone Mailing address Lending agency Day phone Mailing address Agent _�Ivu k Avyt-� Day phone 3 `/q— 77b 7 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 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 (Rev. 1/91) 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 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 1—s216 b. -e-1-1 SPv1(-teL0_Lt0k Phone LII " 3 9 _lJo Address�3 65 r it Engineer's signature Date 6. DHHS SIGNATURE 2 b<�_ Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments M Date IS li _ yWi a.i-`u',k .HiJ. 1 ® A•.y ...�G .4. ,..-af(. J{'ffwtn_il:i'n1Y hi {, n,y'����I..w�:�(A> � 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 orderto 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 (Rev. 1/91) Back MOA Q1 Municipality of Anchorage A Department of Health & Human Services _ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L44,eK'+ Parcel 1. D. 0/7•'D61— 110 A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed ('/�7/77 Driller Total depth ototI Cased to otZ 1 Casing height 1.3 Sanitary seal (Y/N) Wires properly protected (Y/N) Public sewer main M Sewer service line Public sewer manhole/cleanout N Petroleum tank N b WATER SAMPLE RESULTS: Coliform Nitrate 0 q3 Other bacteria 1)6 Date of sample: I'I� 9� Collected by: IS+ B. SEPTIC/HOLDING TANK DATA Date installed 9 J1' LI Tank size 1 5On Compartments Cleanouts (Y/N) — Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) "/A Alarm tested (Y/N) U SOA Date of pumping II�SI�I3 Pumper ' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 10-7 On adjacent lots > laS Foundation A To property line i -Absorptionfield1P� Water main/service line > 74�:> Surface water/drainage N { b 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION M < x//7/77 1 13 �4� Z n Date of test > Static water level 191 182 rr7 `r r { rT`i Well flow S g.p.m. g.p.m. < C) m O < z /3"��K4 M `4 n Pump level o p _ R D V;0 SEPARATION DISTANCES FROM WELL TO: p M _ z Septic/holding tank on lot J07 ; On adjacent lots > Absorption field on lot 1 /b!o ; On adjacent lots % Public sewer main M Sewer service line Public sewer manhole/cleanout N Petroleum tank N b WATER SAMPLE RESULTS: Coliform Nitrate 0 q3 Other bacteria 1)6 Date of sample: I'I� 9� Collected by: IS+ B. SEPTIC/HOLDING TANK DATA Date installed 9 J1' LI Tank size 1 5On Compartments Cleanouts (Y/N) — Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) "/A Alarm tested (Y/N) U SOA Date of pumping II�SI�I3 Pumper ' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 10-7 On adjacent lots > laS Foundation A To property line i -Absorptionfield1P� Water main/service line > 74�:> Surface water/drainage N { b 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION N/A Date installed Size in gallons Vent (Y/N) High water alarm level _ "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off' level at Cycles tested Surface water _ Date installed VX/`%i E 161,2545 Soil rating Zy System type i Length 3I+ Y7 Width 3 Gravel thickness E b Total depth e 1� Total absorption area AS -f 78yZ (yf Ud,2) Cleanouts present (Y/N) Y Depression over field (Y/N) hi Date of adequacy test I / 13 143 Results (pass/fail) for 3 Peroxide treatment (past 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot i �nt� On adjacent lots > /*.s Property line 1 t] To building foundation :25 To existing or abandoned system on lot 8(0 On adjacent lots iso Cutbank Water main/service line 7v Surface water t`f 10 Driveway, parking/vehicle storage area % 1 Curtain drain ll!�-X E. ENGINEER'S CERTIFICATION bedrooms I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name SDu ektct +tel Dateo�.vt n) HAA Fee $ �7 Waiver Fee: $ G^ � Date of Payment, U / y/� Date of Payment Receipt Number -:;P4/ I/ �� O Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Chemlab Ref.# :93.0182-1 REPORT of ANALYSIS Client Sample ID :6/5 MPE #1 Matrix : WATER Client Name :TOBBEN SPURRLAND, P.E. Collected :01/13/93 @ 17:00 hrs. Ordered By :TOBBEN Received :01/14/93 @ 10:00 hrs. Project Name WORK Order :62340 Project# Report Completed :01/15/93 PWSID :UA Technical Director Released By :S EPHE 6 Sample ROUTINE SAMPLE COLLECTED BY: STUART. Remarks: QC Allowable Extract Analysis Parameter. Results Qual. Units Method Limits Date Date Init --------------------------------------------------------------------------------------------------------------------------------------- NITRATE-N 0.93 mq/l EPA 353.2/300.0 10 01/15/93 01/15/93 LLH ' See Special Instructions Above UA = Unavailable " See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than �+ %SSC Member of the SGS Group (Societe Generale de Surveillance) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date �— g 1. GENERAL INFORMATION (a) Legal Description (include lot, b)ock, supbdivision, section, township, range) ;7'iLlouc 7�r /c1U lCs7a Location (address or directions) fes' Oce /�P�r-�e (b) Applicant Name 4�wacL Telephone: Home 922=OCP7 Business Applicant Address ���/tee (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ®r; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: �1'�IM 2. TYPE OF RESIDENCE Single-FamilY'Al- Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Telephone Individual Wel.1v 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 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 72-025 (11/84) - L-�65��GL%u� iacc-fro L Ls%irs 5. ENGINEERING FIRM PROVIDIN`G INSPECTIONS, TESTS, FILE SEARCH, DA�I�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 watersupply 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 CCS Zcac tt Telephone Address /Gn Cc.�- �iJ�V fccc�c��'n�t JI So�� Date 18'O ®� i �• l� b 1� `h _. e.,bae.. °s( No. 2257-F F 6060e °ROFESS\��h 6. DHEP APPROV Approved for bedrooms byf� , > . '"bate Approved Disapproved Conditional Terms of Conditional Approval 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 (11/84) 'nv ( N OEpr NAF ANC HO EIYVIR N HEACT RApa MUNICIPALITY OF ANCHORAGE M6d� AL PRO CTION HEALTH AUTHORITY APPROVAL (HAA) tjL U CHECKLIST - FEBRUARY 1984 Ro' 264-4720 I iWI / Legal Description: u • a f�2�' _13A Sir. ,ate A. WELL DATA A.,,. � ,�, ., d"V`rUc�I� If A. B. C. D.E.C. Approved (Y/N) 164 Well Log Present©/N) Date Completed G-�`� - 71 Yield AV- u — Total Depth ` — ased to O + Depth of Grouting u/ lCyo` Static Water Level /9f Pump Set At &evfkhcu 4w Casing Height Above Ground Sanitary Seal on Casing ON) Electrical Wiring in Conduit (Y N) Depression Around Wellhead (Y(N)/ Separation Distances from Well: I n i To Septic/Holding Tank on Lot !O� �' L ; On Adjoining Lots ��_ To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line — �k.IA To Nearest Public Sewer Cleanout/Manhole _k1A To Nearest Sewer Service Line on Lot Water Sample Collected by n rP ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date InstalledT'- / f - 7 7 Size x_500 No. of Compartments dL Standpipes O/N) Air -tight Caps/N) Foundation Cleanout/N) Depression over Tank (Y/ 1! �j Date Last Pumped �' q -55, 40 Pumping/Maintenance Contract on File (Y/N);for Holding Tank High -Water Alarm (Y/N) AM I Temporary Holding Tank Permit (Y/N) X(/4 Separation Distances from Septic/Holding Tank: / To Water -Supply Well 107 4 -�P To Building Foundation /O t To Property Line !/ 62 -f I To Disposal Field .' To Water Main/Service Line �0 To Stream, Pond, Lake, or Major Drainage Course G7- �� l Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA j'"7 4jk /177 Soils Rating ibsor tion Strata ���� X8°5 T G n Ap ta� Type of System Design Tr/'eoa �' � r , Date Installed �`T- 1/-77 Gry�o�lE /©�S 53 S Length of Field � y/ �/I Width of Field O'i 2i r T>] Depth of Field � Gravel Bed Thickness rP C' Square Feet of Absorption Are, -2_ C2� Standpipes Present(Y N) Depression over Field (Y6j Date o Last Adequacy Test Results of Last Adequacy Test traGc sc�S %F�l Separation Distance from Absorption Field: To Water -Supply Well /0 _; r To Building Foundation 37 Lot �;o -� r To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments r To Property Line To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) r f :imensions ole cess (YIN) 'ump Off' Level at Vent(Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA I certify that I ave chec d, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date /4) S CompanyMOA No. ReceiptNo. c� 4 ��P�Q4 _73 PP` ®v Al, � Date of PaymentA.. i� a `G O >�* m °., w r✓ Engineer's Seal Amount: $ � . gt� sr:; �Oeee6oasu.§a�5••�e• mcee.oa../7 (a def• �ew.�a�'1��,b! s�`�°�'y �".. g L Page toy C. Reid, Jr. ti e Pa e2of2 A�'e r F' SJ,Xs No. 72-026(1lr84( mB�pxRpOEEs`,td� '- �M4�VTV� To: December 5, 1955 Chuck Fletcher_ or. Alaska, Environmental Services Casing depth of 13200 Alpine, hot G Block 5- Mountain Park Estates, Anchorage, Alaska. Wells in this area, typically are 200 feet plus to bedrock. On the Southside of the subdivision, it is deeper to bedrock, Thiis particular well is most likely to be cased the full depth to 221 feet, certainly well past 40 feet. Alpine Drilling &Ent David. I,. gar�;er MUN191PAUTY Of ANCFIORAOff €NYI PNM9N AL PROTC�TION ULU U RECEIVED 50614 ALASKA �' NUIROV TAS COUROL 6ngineerinq & Cnuironmental Studies DEAN FLETCHER 13200 ALPINE DRIVE ANCHORAGE ALASKA 99516 SELLER—SAME se'l 'Ices, Inc. LEGAL:MT PARK ESTATES BLOCK 5 LOT 6 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE -9/17/85 10/10/85 DEAN FLETCHER 13200 ALPINE DRIVE ANCHORAGE ALASKA 99516 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 255 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 150 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 165 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 3 BEDROOMS. . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1500 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 6/14/85 . FLOW TEST ON WELL WELL FLOW DATE -9/17/85 A FLOW TEST WAS PERFORMED ON THE WELL. 739 GALLONS OF WATER WAS PUMPED AT A RATE OF 4.7 GPM OVER A DURATION OF 2.75 HOURS. THE DRAWDOWN WAS 10.2 ' WITH A RECOVERY TIME OF 10 MINUTES AND THE STATIC WATER LEVEL WAS 203 FEET. THE WELI,.0'b'0aFOR THIS 3 BEDROOM HOME. 0000000 0 00o I O GoseoY000voo *so C. Reid, Jr.e�; .2251-2 .......aoa % 4w 1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 9 (907) 561-5040 <- MUNICIPALITY OF ANCHORAGE DEPT. Or (:^,1. I u ENVIRONMENTAL PFO ECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchorage, Alaska 99501 • civ 2 7 ia1r 9 E] One E] Four ❑ Other ENVIRONMENTAL ENGINEERING DIVISION ❑ Two ❑ Five Telephone 264-4720 R E C E I E D _V_ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROP 06)E/9 OWNER �, 4" s " i C-� Q✓ *ATTACH WELL LOG. Awell log is required for all wells drilled _PHONE MAILING ADDRESS 4, ,Q Imo.'%A B 61% ❑ PUBLIC UTILITY PROPERTY RESIDE (if different from abo e) 8. SEWAGE DISPOSAL SYSTEM PHONE 2. BUYER PHONE � ❑ PUBLIC UTILITY by this Department. MAILING ADDRESS 3. LENDING INSTITUTION 1,4 PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION / O 7 �_ L ��, � STREET LOCATIO LL) 6. TYPE OF RESIDENCE 6. - _. - -NUMBER OF BEDROOMS E] One E] Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY [N INDIVIDUAL* *ATTACH WELL LOG. Awell log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation dateEA INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE THREE '❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY R INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM CN4NDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED �— (j — C' INSTALLER I PR:septJ�ic¢ �Tank or ED Holding Tank Size: IL5VO If Tank is homemade- give dimensions: -SOILS RATING L� TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL c� -e— 42-(�- 4. DISTANCES WELL T0: -Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (Title) R, C_. LEGAL DESCRIPTION 72-010 (Rev. 3/78)