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HomeMy WebLinkAboutNORTH WOODS BLK 3 LT 25Northwoods Block 3 Lot 25 #051-731-57 UBMITTA Municipality of Anchorage4 On -Site Water and Wastewater Program • (907) 343-7904 ;Fee")02f0 ON-SITE WASTEWATER INSPECTION REPORT Permit Number O S Ply / 222 PID Number: 0 5/7315 7 Dwelling: Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New p Upgrade Name: 4'II4HC sr ,44'f OCJtC ABSORPTION FIELD — FX/ST/i✓C Address 22 P S3 AVC/2THWaC4 s Q/e. ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other Phone/' Q �i / ''7 ? �j (J GI � (� / J f Number of Bedrooms 3 Soil Rating GPD/SF Total depth from original grade Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision / Block Lot Ft Ft. /1/0 & T 11 N v 0 0 0 'j 3 c2.5 Fill added above original grade Gravel length Township Range Section FL Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area Fe Number of trenches Dist. between trenches Ft. Well .) NQ TANK ',Septic • S.T.E.P. II Holding Other AM AM /V,Q Manuffa)cturerr�e Surface Water �1N/fa t if q n ,f UlCapacity 40V c.- " 0Z4 o 6 7744/,c1 /000 Gal. /W W fey Qty Material Number of compartmentsnt Lot Line /d -< is /..r- 1.F / .•-•0 NA �c S r C✓ii. G Foundation 5 14 lit LIFT STATION EK/s rVs/G �0 /0 Manufacturer Capacity Curtain Drain _ - _ -- Gal. Remarks / � uJ (.4/tll� i /s /s1LGE�4 Pump on level at Pump off level at High water alarm at /�1//✓ (m (moi in. in. in. Pump make and model Electrical Inspections performed by Installer Tank to PIPE MATERIAL House to tank �vc- drantl&d /�✓Y+ q� '1 /' p v�-r j) �✓T, a3A/,17h w/ iC/� ') !I 3U> Drainfield CO/MT Inspector ,f� , t y. � 1 -` BENCH MARK (Assumed elevation) /00 ft Inspection a dates: 13 (5/24%//S �J),-,13 ' 2.�//S' Location and description "54 i..< cooz SILL 4� COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date Engineer's Stamp niv,. •..m0 Er2 .t' •%? $s . r ; it' i'm Approved Date Z -2-1 >.'sdg gW a � ,s ; r.,tov. -v. L44.miaII:v;- Inspection Report_9-1-12.doc AS -BUILT MEASUREMENTS DCD1 ST1 ST2 DC❑2 A B 47 49 53.5 56 22 24 29 32 5X Slope 57. Slope Existing Lift Station New 1000 Gallon Septic Tank w/DCD's Decommissioned Old Septic Tank PER UPC Septic 0 5% Slope Septic 0 Key Box NORTHRIM ENGINEERING *(� PO Box 770724 Eagle River, Alaska 99577 907.694. 7028 NORTH WOODS S/D BLOCK 3 LOT 25 WASTEWATER RECORD REPLACE SEPTIC TANK 1" = 40' RECORD LAYOUT Dote: 9/1/15 2 of 3 % IN3H33V1d3d NNVl 33Id❑ad >INVI 3I1d3S rn 8 I/S SI❑❑M ❑NIMVK I?J033?I ,S6 a uoi}nna 3 9- 0 \\ 19'66 a uon ona -5 & gnouta13 uo fl tpuno3 \ & 186 B uoi}ona13 uoil nes 1-di3 • 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: OSP151282 Tax Code Number: 05173157000 Work Type: SepticTank Upgrade Permit Effective Dates: August 19, 2015 to August 18, 2016 Design Engineer: NORTH RIM ENGINEERING Subdivision: NORTH WOODS Site Legal Address. NORTH WOODS BLK 3 LT 25 G:1459 Owner/Address: ST AMOUR MARK A & RUTH R 22853 NORTHWOODS DRIVE CHUGIAK AK 995675461 Site Mailing Address: 22853 NORTHWOODS DR, Chugiak Lot Size in Sq Ft: 20046 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 By: Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 0 5/— 73/— 5 7 Property owner(s) mark ,c -t-, 4r�zo W - Mailing address 02 Psi N,.,,{ -k -00c t.t Site address A Jr: Day phone CeS"—‘73( Legal description (Sub'd., Block & Lot) A./a,r or,d t 8..? tC Z Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: (IE all that apply) Absorption Field ❑ Septic Tank Holding Tank Privy Private Well Water Storage teg APPLICATION IS AN: Initial Upgrade Renewal TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings (SF and/or D) 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 agent) Permit/Rush Fees: 21 G - Waiver Fees: Date of Payment: $11y1/S Receipt Number: ©511 b D Permit No. OP 151Z$2 Permit App_9-1-12.doc Date of Payment: Receipt Number: Waiver No. Th'IM ENGINEERING Date: 8/11/15 To: MOA On -Site Services MEMO Steve Eng, PE, PH (907) 694-7028 tel SteveEngPE@gmail.com Subject: North Woods S/D, Block 3 Lot 25 Septic Tank Failure Number of Pages: 4 The subject septic tank has failed, the owner thinks may be in danger of collapse. Please expedite a permit so the tank can be replaced. The tank baffles appear broken along with general tank failure. Please review as soon as possible. If there is need for additional information or clarification please give me a call. Thanks -Steve I\ERTIHRIM ENGINEERING North Woods S/D, Block 3 Lot 25 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. Most of the neighboring lots are developed. The current septic tank has failed- the Bed/Lift Station is still useable. These lots are large and are served by public water system. No adverse impacts are expected from tank replacement. Easement is present on the lot. The septic tank is almost collapsing- recommend expediting. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • New 2- compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' to property lines. • 4' of cover or insulation is required for tank; an equivalent of 1" insulation for 1' foot soil cover. Minimum of 2' soil with insulation. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) DESIGN NOTES: 1. Existing Bed/Lift Station Remains In Place. 2. Sewer Service Line minimum 2% slope. 3. Replace Septic Tank/Decommission Old Tank Per UPC. 4. Lots Served by Public Water System. 5. No Conflicts Within 200'. 5% Slope 5% Slope Existing Lift Station New 1000 Gallon Septic Tank w/DC❑'s Decommission Old Septic Tank PER UPC Septic 0 57. Slope Septic 0 Key Box 00 3 4 NOR THRIM =4 ENGINEERING $tt PO Box 770724 Eagle River, Alaska 99577 907.694.7028 NORTH WOODS S/D BLOCK 3 LOT 25 WASTEWATER DESIGN REPLACE SEPTIC TANK = 40' PLAN LAYOUT Dote: ET: 8/11/15 2 of' 3 .5 cs ,§ 0) / Foundation Cleanout g Cleanouts Between Septic Tank & Trench / J 3 0C CU /\ j } 2 \ 0 d 0 Cr of *K on Compacted, 3' Cover, F SEPTIC TANK so 2 � c 2 r 3 i .]d TANK REPLACEMENT 72-013 (1/91) MOA 25 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: _✓W 01-7- (Co j PID Number. ' 11 ISS Name it tzv t� Wastewater System: ❑New iJpgrade q��� Address: 2 �• -�• --t-� t-lP� 2-7-63 ABSORPTION FIELD Phone:643s nf^ ,., . No. of rooms: 0 Deep Trench 0 Shallow Trenched 0 Mound 0 Other LEGAL DESCRIPTION Soil Rating: 4%)."4" GPD/Sq. Ft. Total Depth from original grade/ '/'1!` Lot: Block: Subdivision: l'• -t 4:V=1 -V -ice' Depth to pipe bottom from originalgrade: Ft. Gravel depth beneath pipe r eAG Ft. Township: Range: Section: Fill added above original grade: r l 1 'S Ft. Gravel length: / , Ft. WELL: ❑ New ❑ Upgrade Gravel4apth:10,1 ft.i t}} t .Z Ft. Number Hines: I Distance bet ren lines: Ft. Classificationic���(Private, A,B,C): iYt l- 1 ti. t4 l Total Depth: Ft. Date Drilled: Cased To: Ft. Static Water Level: Ft. Total absorption area: I (-J 7i` SQ. Ft. IInns�taalllller�:a /a /,..,.yam C2CC, C.�- 44 l fZ' . Pipe mateTial:- ,C �e 16.1*r1'1 -T.:/SQ.34 v Date installed: /_ �1 �7 +/�l'-d !ice .+1q/q-7--- Driller: Yield: Yield: GPM Pump Set at: Ft. Casing H ight Above Ground: Ft. ��„ f 1 i� % ^ C TANK SEPARATION DISTANCES 0 -optic 0 Holding 0 S.T.E.P. To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Lines Manufacturer: Capacity in gallons: �� 1 Cll/�--2./ Well 1-}- 1 Alter ,,.(. t+ Material: Number of Compartments: Surfac Water I6b1-t' 12:;-4-- 1(00' -1- — — LIFT STATION Lot Line �/ � !O/ �/ l2' t i �- Size in gallons: �) Manufacturer: IG{-i-cr -ere T'i1-l-1 lL' Foundation .02._.C..//� �/ - ` t cip, 'Pump on" level at: Z8 a 'Pump off level at: le" High water alarm at: Zit_n �'-T� Curtain Drain -" 1‘40 -Y•40( ----i\-1 �l� ti Pump Make &Model Elec rical Inspections performed by: flp i --47-P'-G ,.‘-t,FG-re-1 C ----- 'Pump Remarks: jC1�j'r11.}(q 1L 1ts1i--rlf BENCH MARK I om. \`--4-11-6 -11— -�� Location and Description: —2 -X ISTt r�� c- /)I4% 1-- . t4te-- Assumed Elevation: I SDo r Ft. EN tdir ar rli�e• eaee•e•e.q 0i, 7 ea f* i �y �. •. 8 / oeoefiaa•es` see .ed.6•® % S 1 S ENGINEERING 17034 Eagle River LoopRoad, No. 204 Inspections performed by: Eagle River, Alaska 99577 Dates: 1st 17-- . 2nd'IP e 906906.0 G9 . as ♦ F ; ROG R . SHAFER :-6 B I® �"J(�ee No.8215 64® ®Lea s*. es•41• �eis�®® Leaps*.-®_ Department of He and HumanServices approval Reviewed and approved by: Date %- 24 -92 72-013 (1/91) MOA 25 Permit No 1‘1 Page Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: O 4u1oe 1-4 - PID No• (%11-1--1-. fir1 )oo- GoZ t-tk) (A— IDZ�Co3NTZ • A 1 "- 10 to/Iq��iZ Gol OUST: (oc,c, S.T. Ft s i7 lnri:�Gi. VE' r-l64r4 soa Q" - L -r r Sr ftaJ t 'f1or.1 72-013 A (2/91) MOA 25 011111 PAC ELECTRIC LICENSED BONDED INSURED Industrial - Commercial - Residential July 13, 1992 S & S Engineering 1704 Eagle River Loop, No, 204 Eagle River, A1217.5ka 99577 3655 Ruth Drive 99687-9201 (07) 373,4767 FAX 373.7035 This letter i8 Veilify that Harry Myr • NORTH PAC ELECTRIC, perforwed electrical wiring services (wircithE :!.(itt station at Lot 25, Bleck 3, Northwor,d Sub -Divi ion Eag1.2. River, Alaka If lufther infornvation is nest7,d, contact iixy at 373-4767. Sincerely, „elfw ylve',....- MaL-ilyn E. whalsn office Manager PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE lS`tc 3'cc 4,l DEPARTMENT OF HEALTH AND HUMAN SERVICES -7/� P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT '7/8 PERMIT NUMBER:SW920163 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HARVITT CHARLES L & OWNER ADDRESS:22853 NORTHWOODS DR CHUGIAK, ALASKA 99567 PARCEL ID:05173157 LEGAL DESCRIPTION: NORTH WOODS BLK 3 LT 25 LOT SIZE: 20046 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 6/30/92 EXPIRATION DATE: 6/30/93 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS BED SYSTEM MUST BE INSTALLED IN ACCORDANCE WITH THE APPROVED REVISED ENGINEER'S DESIGN DATED 6/23/92. RECEIVED BY: DATE: ?(/ 1/7Z DATE (/z DATE : 7/ 1 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. June 23, 1992 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Northwoods Subdivision, Block 3, Lot 25 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Request you issue a permit to upgrade the septic system serving the referenced property. Two test holes were excavated and percolation tests were performed in the area of the proposed upgrade. Attached is the proposed upgrade design. This property is served by a Community water system. There are no protective well radii which encroach upon the property. As can be seen from the site plan this lot is large enough for another future upgrade. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, ROGER J. SIAFER, P.E. RJS/LSU/lsu 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 v0409L Sandal -IS 3/V I" ; 40' SCALE UPGRADE Y SEPTIC AREA NORTHWOODS DRIVE } PREVIOUSLY ABANDONED TRENCH V1831180 NO1S30 0 O s 0 m m w Co N xr m r O (r) (J) O W r N CI -71 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST �Vi -rr -N o-rii c' �-�.t . LEGAL DESCRIPTIOrE-A?LO(4•Township, Range, Section: SLOPE DA "0.R pp ryry- TE PERFORMED: �4`a \ `Z G -- — 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 .9 H (FEE -11--- 0. 0. . 0 c n 1' COMMENTS GM o. N WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? J6 DepthManic to W?ter-{iNer�� 4/161' Monitoring? 1��1t�G Date. S L 0 P E SITE PLAN -r I 1/4N to/ 2 , c -z - Reading Date • Gross Time Net Time Depth to Water Net Drop ,�, ^^�A, �,, 'moi -CC: Y & iti - 10:WAt1. r' co Y-4-" ID cot -I i•J CiW si ' g /2• {0 :2t> (•�y 1/�•rU% ?1l4: t %3I " 1/,,r I D:40 I. 6,P 1¢.. Y2 n PERCOLATION RATF(/v (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 4 F PERFORMED BY- S R S F±N.GtNEF_RlNG CERTIFY THAT THIS TEST WAS PERFORMED IN 70 4 Eagle River Lo�oi Road t�e,4 } ACCORDANCE WITH agrTAIver/NA18SUrNir UID LI N EFFECT ON THIS DATE. DATE - 72 -008 (Rev. 4/85) (--24 GIS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �4I u C I� ' ' - O I 1 , LEGAL DESCRIPTIONLGY'�IG L--� Township, Range, Section: SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 D EPTI1 (FEET) `s •14 • 1‘. 11/ • • • r • ct t. • WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? SITE PLAN N S L 0 P E Date ta 61' ! !/ Reading Date Gross Time Net Time Depth to Water Net Drop PcV.-----P12( �- 10tospz� 1 (to -a -KZ -z ,I ID: i . IU1-li1-S lo: 26 „ 4- fa l l (O 10'.YII PERCOLATION RATE I `, (minutes/inch) PERC HOLE DIAMETER • ' TAND + TEST RUN BETWEEN COMMENT T2"' V--161---) • T PERFORMED BY - S & S ENGINEERING I p17I0R34, pE7aFgqleN River�7I,�(,� Loopn�R��orad NEP ACCORDANCE WITH t6Viiita lilaS 14 51/7 UID N EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE' NIUIVIl..I1 / LI 1 Y Ur AINUhON/Mat Dr ATMENT OF HEALTH AND HUMAN SER` ' S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES Address 5tz- 3 g22)e 2 - Phone(s) Permit No. oei3- 41-3 sty n L4-4 No. of Bedrooms FROM TO SEPTIC TANK ABSORPTION FIELD WELL WELL 1^c7* LEGAL DESCRIPTION Lot 2S Block Subdivis n LOT LINE S Township, Range. Section -1-1s FOUNDATION 2 S TANKS SEPTIC ❑ HOLDING Manulacturer Material ❑ TRENCH Depth to pipe bottom from original grade Capacity in gallons I f0 -r2 No. of Compartments 2 TYPE OF SYSTEM ❑ BEDW. DRAIN ❑ OTHER Fill added above original grade Gravel length Total absorption area Number of lines 1 installer 3,5FT CI OFT 1D, p FT la L(.9) SQ FT Soil rating 2) 2 SQ FT Total depth from original grade Gravel depth beneath pipe Gravel width Distance between lines Pipe material ?nrrMT7)2034- Date Installed WELLS WELLS C✓r�j FT Z,0 FT 610 FT ti/jA FT ❑ PRIVATE 'OTHER (Identify) Classification (A,B.C) \\ Total Depth Cased to 12iA-oa1)5 FT FT Installer Date Installed: REMARKS: 2t » S & 5 ENGINEERING CRR 196)C Municipal anEAelitEiRisM kytAKs99577 AS -BUILT DIAGRAM (Show location of well, septic system. property lines, foundation, driveway, water bodies, etc.) Scale: t" zLS(c) Inspections Perfor ed by:cl— Date: (p. certify that This inspection was performed according to all r Inter' J I AUL.) Health Department Approval: i� ff 2 72-013 (3/85) Date .6 '1 ENGINE RS SEAL r PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: LEGAL DESCRIP: LOT SIZE: _LJIIF ff������� DEPARTMEOF HEALTH AND ENVIRONMENT -PROTECTION �� 825 L STREET, ANCHORAGE, AK 99501 /rAt^ 264~4720 ~' 860144 UPGRADE 05/29/86 CHARLES HARVITT SR 3 BOX 7526 NORTHWOODS DR CHUGICK, AK 99567 688-9423 SUBDIVISION;: NQRTHWOODS SECTION: 4 TOWNSHIP: 15N 20046 (S.FT" OR ACRES) LOT: 25 RANGE: 1W I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth 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 adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. IF A LIFT STATION IS INSTALLED •IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRI ,RivIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVEtYWITHOL[ AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK ML3T BE DO CENSED ELECTRICIAN, SIGNED 411111!���� 5� DATE: ^/�^�_ APPLICANT: C-F- �� �� ��_�� RVITT SIGNED ISSUED BY ^� u��mo /�'�_542.nz Ze15 r DATE: _ HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT A. SHAFER May 21, 1986 Mun.LcLpat.L y o4 Anchonage Depantnen. o4 Heath and Human Senv.Lees 825 L Stneet Anchorage, Atasfza 99501 ATTENTION: Robby Robinson REFERENCE: Lot 25; Btacfz 3; Nonthwoods Subdivision Mn. Chuck Hanv,Ltt, S -tan. Route 3, Bax 7526, Nan.hwoods Dkive, ChugLalz, Atasfza 99567, made app! anon thnaugh u3 4on. a Health Authontity Appnavat on May 9, 1986. Dun.Lng pen4anmanee o4 the adequacy test a satunaved condition existed within the trench. A6 a result we had a monitoking tube Lvsta ted appnox.Lmatety 15 4ee-t penpend cutan 4nam the -trench and gnaund wa-ten was monJtoned ate a pezJod o4 one week at 92 4eet. The on.Lg.Lna2 so.L,2 tog dated June 16, 1981 neeonded a waters tenet at 10 fleet. A penm.Lt was .issued attow.Lng a total depth o4 tkeneh o4 6 fleet. However, at the time we per4onmed this test the total depth o4 the tneneh measured at appnax-i-matety 7 fleet. We ane unable to detenm,Lne whether add-Ltlanat 4itt had been added on t-4 the trench was oven excavated. The results would Indicate a waters levet at appnox.Lmatety 21/2 fleet below the bottem o4 the existing Trench. Since this condition .i.s in non-comptiance a penm.it appt.Leatt.on is attached 4on an upgnade a4 this system. As soon as the upgnade wonfz has been completed the appticattan 4on a Health Authan.ity Appnaval wiet be processed. CIVIL ENGINEER 694-2979 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAY 231986 RECEIVED 14 we may be a4 4unthen assistance please contact us. S.Lncen:ety, T A. SHAFER, P.E. S/ss cc: Chuck Hanvitt .J 4-5 1 s` SRB 196X EAGLE RIVER, ALASKA 99577 `-( 1-t?\X.? K1`�1r-�Gt d1 c1 J. use A 5 I \nl k . c R --An t•J 1/Z ' _'t g L-G,t,J61 ( /i9') 1 S & S ENGINEERING SR B 196X EAGLE RIVER, AK 99577 MAY 2 11986 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST shsiv, w Y 1457 ° r 00.tg- Y� 61 Y [�`W. S•Q/'lq t n���P.nr DATE PERFORMED:` -'14,4. -' 8� LEGAL DESCRIPTION: I. 25 , 3 NI,uR.,-Tt,l-v.kx,p5 Township, Range, Section: SLOPE oh.t-.t 1 2 3 4 5 7 8 9 10� 11 12 13 14 15 16 17 18 19 20 121E PL -t. (F E'E T4 COMMENTS 5 CAM —2—c (iL ) C1�ri(7F-� WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? lb Depth to Water After Monitoring? Date. S L O P E T 1st- �,,\4 sem. LJ' SITE PLAN \v N 110 7.1,7 \// N' fi Reading Date Gross Time Net Time Depth to Water Net Drop 1 5-37- 810 '3', &S P S 9//6 — 2 -31/SP /P mho. `7 -'-AL` / r �/Jb ., 3 3;ZSP r/ 011UJ5jt; / 9L." 5 'r 7" r'/,6 " Y3,SsP 4t,' r' 9 7/)&,/9.5% 5/I/o " 1 4 1'`'oS10 i/5-/7 ii: /J-/' 11 (p /6„ 9//," i/ PERCOLATION RATE _It_ (minutes/inch) PERC HOLE DIAMETER ta TEST RUN BETWEEN T FT AND 5- FT PERFORMED BY' led ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELI 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN EFFECT ON THIS DATE. DATE JUN 5 1986 MUNICIPA 72-013.(Rev. 3/78) .Tr. ' DEPARTMENT OF HEALTH & ENVIRONMENTAL. PROTECTION - ►(, �ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/I'LL INSPECTION REPORT NAME n "F') iv i BEr 14 ! i PHONE 3(16 ----ibis ----t—NEW ❑ UPGRADE MAILING ADDRESS — STK 120x 1/oc($1{ gr50'7 LEGAL DESCRIPTION ,, / L. ,..5-- /3 -5 Alok 71}&) 0 cD-2,--S S/Z_ LOCATION,NO. O r LspinC1-& .� R . + S Com_ )<_ OF BEDROOMS DISTANCE TO: Well Absorption area Dwelling PERMIT NO. I- 2 w Q m � Manufacturer (/� lei Material No, of compartments rteto Liq.Jcapacity in g V r IF HOMEMADE: Inside length Width Liquid q depth �,.q z D , CE TO: Well Welling PERMIT NO. / a 2 fact nufacturer � Material Li �--apacity in gallons ii DISTANCE TO: Well / / �`{imfi�hi/� /,. ,o4t.. Foundation ,,) Nlij - /A Nearest lot line /`j PERMIT NO. '7 6-/Z),57,5- 2 w No. of lines I Length f a h I ne Total len th of lines ,�/=/� Trench w th inches Distance between lines jnes FMaterial O Topof tile to finishgrade (a )s , the inches Total effective parea , r�/lee//1` in Length \,- Width !1,[_1 Depth PERMIT NO.CSi a F Q- Lu °- Type of crib Crib diameter Crib depth Total/effective absorptio ea ui w TANCE TO: Well Building undation Nearest Io;J.i e W Class � /�j7/7Jb�dn.,Y//" 7gr)LQT Depth Driller Distance to lot line PERMIT NO. — DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALSIA/ �L/ J ct/ �5 �(Gr _wi)z- SOIL TEST RATING / Lc-- -C/. -74/Z;eir 11,1 o INSTALLER L kee C____ o v e a REMARKS /14,1 /MONO& 7 - r� o (.L>Rs -772/ a 7 G'�/-�i�� Fes,- .,i), ---/z. sai ,�A- ��'� �' G APPROV D LEGAL VL.L -1 C? Ifi<-'('. 7 DATE VG�� �l Gcc/ 72-013.(Rev. 3/78) 9 " ,11 , y M.-- Ar.. o zr �/^ DEPARTMENT i �HEHLTH AND ENYIRONMENTHL� .OTECTION `r' 825 'L STREET/ ANCHORAGE, HE 99501 264~4720 PERMIT NQ ( 810557 ) P_O (� APPLICANT FRANK BETHHRD STR BOX 1698K LOCATION PETERS CREEK LEGAL L 25 B 3 NORTH WOODS S/D TYPF OF SOIL ABSORPTION SYSTEM IS: TRENCH q9507 345-1615 LOT SIZE 200r0 SQUARE FEET MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 195' THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: � ��F���1� � � ����3��= �� ����vEEAL 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). ����17.7: EEC. 7E -3E: 1: g2'; 1FF-7u rA 6-‹ a'. ��C.En PI�������� ` PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THISDEPHRTMENT DURING THE INSTALLATION INSPECTIONS OF ANY-NELLS.HDJHCENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES' THAT THE WELL WILL SERVE. ~_— "TWO IPAS:F="F=FIRDPA:S FIR:1E FZEDIDUIF2E:CH BACKFILLING OF ANY SYSTEM WITHOUT^FINHL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTIOU MINIMUM DISTANCE BETWEEN H 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 INSTHLLHTIQR �E2 ri 1- I ��: 117.- ����� I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CQDEa 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS SIGNED: APPLICANT FRANK BETHARD ISSUED BY �^'�� g� �DHTE_��_�a-Y4.0 Applicant: UNICIPALITY OF ANCHORAGE Department Health and Environmental\-2rotection 825 L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND/OR ON-SITE SEWER PERMIT Mailing Address: 54/g /6 94:,t ;'42 Location: Legal Description: cS/r Type of Soil Absorption System Is: Trench: Drainfield:Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) Phone Number: of Size: 0, ©o The Required Size of the Soil Absorption System Is: DEPTH LENGTH 7C101., GRAVEL DEPTH WIDTH 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). Al\ * REQUIRED SEPTIC(HOLDING) TANK SIZE = Gn U GALLONS * * 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(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence ism emoed,9to include more that jbedrooms. Signed: Ap2icant swP/024(1/81) Issued by: Date: PERFORMED FOR: _,JIUNICIPALITY OF ANCHORAGE \-.-' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6550, Anchorage, Alaska 99502 2762221 SOILS LOG — PERCOLATION TEST F rain k l3ea laA LEGAL DESCRIPTION: PERCOLATION TEST DATE PERFORMED: k -16 _91 1—of 2 5 131 k 3 North woods Ei : LovutA 4k64 SLOPE WAS GROUND WATER S ENCOUNTERED? P.5 1 O IF YES, AT WHAT DEPTH? P E tO SITE PLAN L ati 1 1 Reading Date Gross Time Net Time Depth to Water Net Drop 3 314 19//6 o 0 33,4 o 4 `/2 6//6 to to 41k 3/4 5 A 646 Zo 10 5A 3/4 6 646 30 10 6 3/9 7 `/2 64 b 0 30 7 I/2 1 Y2 PERCOLATION RATE q //� TEST RUN PETWEEN COMMENTS t 5- IJ 7 ft . __AA _AA 06-7,4 PERFORMED BY: /6 4 1FT AN,utes/inch) FT 1 • *Ad 3 3j CER T:FIED BY: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I D # 1. GENERAL INFORMATION HAA # OiZc\ 1-0)1 Complete legal description Lot 25; Block 3; Northwoods Subdivision Location (site address or directions) 22853 Northwoods Drive Property owner Harvitt Day phone 688-9+-23 Mailing address Lending agency Day phone Mailing address Agent Sharon Minsch — RE/MAX OF EAGLE RIVER Day phone 694T4200 Address 16600 Centerfield Drive, Suite 200, Eagle River, Alaska 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 XXX 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 xxx 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 7121 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 S & S -ENGINEERING Phone 17034 Eagle River Loop Road No. 204 Address Eagl Engineer's signature Date I ����Z 6. DHHS SIGNATURE X Approved for 3 bedrooms. Disapproved. tea.474.1.4hv .; �E OF. 4 4'11vs „ / '• s7 •4. a9 of* / 491►t ,� b� * 0 ••°g NN stn S ROGEIR J. No.8S5AFER ...4:10" �": w? " 14"ildPRO FESSt°N;e7 e/11Pts.1:100"v Conditional approval for bedrooms, with the following stipulations: Additional Comments By• ��%1.s.{�Q. Date 7 - 2 ¢ - '2 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 921 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 4vg1-1-11A-I•cc5 Parcel I D I��I�� A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number -19.�1IT7 21-06 / Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG gpm AT INSPECTION r zTs t")Z D co 0 9Pm• • <a F-3 z O Zn 0 m SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 200' On adjacent lots Absorption field on lot 'j ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by B. SEPTIC/HOLDING TANK DATA Date installed - l46 Tank size !Ooo Cleanout N) 7 Foundation cleanout (Y N) LI Depression ( Y High water alarm (Y/N) IJ'•P Date of pumping %Jq1„--- Compartments Alarm tested (Y/N) Pumper 1 i�r✓t (I,jGI SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots 2 Foundation To property line 20 Absorption field 42 Water main/service line I b (4- Surface water/drainage bb 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Ven -4-)9 1 Manufacturer Manhole/Acces N) High water alarm level "Pump on" level at o- "Pump off" level at le ��" Cycles tested Meets MOA electrical code (Y N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots /r Surface water (dd + Date installed �l2 Soil rating O. System type • Length -2(p Width Gravel thickness b•S Total depth 2 Total absorption area 2--.11=1 Cleanouts prese Depression over field (Y Results (pass/fail) Peroxide treatment (past 12 months) (Y Date of adequacy test for k•1 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation bedrooms If yes, give date On adjacent lots �d -I- Property line 2. - To To existing or abandoned system on lot 1D` -1 - On adjacent lots2Jb � Cutbank ' Water main/service line (D / gib' Surface water j66 � Driveway, parking/vehicle storage area Curtain drain lL-- C'1/-ir • E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect Qra�clate of this inspection. ig470 vVvAW e °9OOfA000R 40 / u 0 t3" e9 oo m 0 tiz 493 °Y as{ d 00%,X0000000000 00000 aB00 p 0 0 s0 a 000000 8ba a$®B 0�\ ft©GE J.. HAFER / &9' 4 e No,8 15 r 0114;.... °(N6.411'.:1' g�t�'8�00 eo11% PROF °°04.°''c'w e000°° s & 5 ENGINEERING Signature 17t5�q Cay'ver l.00l) Road No.20d Engineer's Name yie River, Alaskal99577 Date —1 � \ —1 -92-- 1 76.4` HAA Fee $ / Date of Payment 7/4?2 ,/ Receipt Number ata p `J-4-4/4> 72-02fi (Ray. 3/011 Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number r� �..`.�i 7 i ��::�. :i I, rj (6.1 ` �' 1M' , 1 ' i` (� �ti;� �� i' 1 I OJ J Lr a i LL.::, U( IF !.r I .: t' K`)ti DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99503 FOR: Roger Shafer S & S Engineering April 6, 1992 PWSID # 213001 WALTER J. NICKEL, GOVERNOR (907) 349-7755 My review of the records on file in this office reveals that the Northwood Subdivision Class "A" Public Water System, is in compliance with the routine coliform bacteria sampling requirements listed in Table C, and with the inorganic sampling requirements listed in Table B of 18 AAC 80.200. Sincerely, Sc-( Byron Roys Project Engineer BR/cf b y C.D. A I• 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 May 9, 1986 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 25; Block 3; Northwoods Subdivision Unit #1 Location (address or directions) 7526 Northwoods Drive (b) Applicant Name Chuck Harvitt Telephone: Home 688-9423 Business same Applicant Address SR 3, Box 7526, Northwoods Drive, Chuaiak, Alaska 99567 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ®; Buyer 0 ; Other 0 (explain); (d) Lending Institution Alaska -Mutual Bank Telephone Address Anchorage, Alaska (e) Real Estate Company and Agent none/refinancing Address Telephone (f) • 1412. the HAA to the following address: S S P.ngi nperi ng SRP 196X Eagle Rivpr, Alaska 99577 2. TYPE OF RESIDENCE Single -Family ® Multi -Family 0 ' Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well 0 Community IC] Public 0 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 i Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Telephone 6'- 2-?? 9 SR B 196X Address Date EAGLE RIVER, AK 99577 6. DHEP APPROVAL Approved for Approved Terms of Conditional (4) /2--4bd'drooms by Disapproved Approval Rol cA R. Shag .a ka. 1474 40--or- 0,,,<%,°,..., * •< PS - To se...eee0'je �.144,,, _Pita FEBS‘C314r Conditional 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) A. WELL DATA Well Classification A MUNICIPALITY OF ANCHORAGE (MOA HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 ��� Legal Descrip ion. 25 r912-er Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot u[ri. 'Jr f7CNLlr1 64 ENVIRONMENTAL PROTECTION N G 6 1986 If A, B, C, D.E.C. Approved 7N) Date Completed Yield h of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Zara Ik To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments ire, 21363v1 B. SEPTIC/.14-etatNG TANK DATA Date Installed 1 —1\—g) Size No. of Compartments -2— Standpipes StandpipesN) Air -tight CapsON) N) Depression over Tank (Y/TP Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) rI� Ix Separation Distances from Septicg Tank: To Water -Supply Well To Property Line 2e�( 4- 12-0 - I To Water Main/Service Line Course Comments l� Foundation Cleanout (Y/N Date Last Pumped \—' for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field )i4 1,0 I To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 0I6/L Date Installed (0 —6-- ` lo Width of Field Type of System Design t):7 -,A, Length of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area � Standpipes Present 4DN) Depression over Field (Y/f Jp Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well To Property Line To Building Foundation rLCo To Existing or Abandoned System on Lot \ ; On Adjoining Lots 'tan 1-{- To Water Main/Service Line r> ` To Cut ank (if present) I P To Stream/Pond/Lake/or Major Drainage Course N A To Driveway, Parking Area, or Vehicle Storage Area X01 Comments A. 121,--4 Wl -rev .),). Pt.) i f? -1 A -ME Sx 1S�trJG 1� �� Capt w�5 •t-taJ r.0 --ro N - S• f G ,M WP -5 \ D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify tgat Ihae check�eEklNfiied, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed sitsttt C' DateJUN 51986 ComparApLE_R[V I(99577 MOA No Xr--3 Receipt No '72)9 eltoa. Date of Payment G--(.0-6 UC Amount $ Page 2 of 2 72-026 (11/84) • h.ri ,r I •Y C - - L LL/L DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE: May 16, 1986 PWS I.D.# 213001 BILL SHEFFIELD, GOVERNOR Telephone: 1907) Address: 274-2533 To Whom it May Concern: According to records on file in this office the NORTHWOODS Water System is in compliance with the State Drinking Water Regulations Sincerely, Steven ,- ng, PE District Engineer Time' Timei_. ;e Date Date Date Inspector Inspector Inspector Comments eV 3 .110 -44 -44N- 9 -c 2-- ---16r-1)'2 6.420 Conditional Approval Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well to Tank Well Log Received APPLICANT FILLS OUT LOWER .HALF ONLY Property Owner Uethard Construction, inc. SPA Pox 1698-K, Anchorage, AK 09507 Mailing Address Phone 345-1615 Buyer Charles L.- and Evelyn L. Harvitt 7432 SW Miles Place, Portland, OR 07219 Address Lending Institution Alas ka. Mutual Denson and Minnesota Address Phone Realty Co. & Agent PE%`M2-Y Properties, Inc. attn: Will Eason , 2702 Gamhell St., suite 101, Anchorage, AK 9950/ Address Phone T76--2.761 Legal Description Lot 25, Block 3, Tlorthwoods NIIN North Woods Drive Street Location Type,gf Residence C? Single Family ❑ Multiple Family No. ❑ Other 3 of Bedrooms Water Supply lcIndividual ATTACH WELL LOG. A well log is required for all wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach log if ❑ Public Utility available. Sewage Disposal ti Individual Year Individual ❑ Public Utility When ❑ Holding Tank - 1981 Installed: Connected to Public Utility NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ALASKA CfUIROn1n6nTAL COfTROL sCnUICCs, inc. engineering & 6nuironmental Studies MUNICIPALITY OF ANCHORAGE CP HE,';='i ENVIE is+'-1JfA. iO E TDC` E 1=S tt 1982 RECEIVED January 29,1892 Mr. Les Bucholz Department of Health and Environmental Protection Pouch 6-650 Anchorage, Alaska 99502 Attn: Les Bucholz Dear Les: On the 29th day of January 1982, Alaska Environmental Control Services Inc. inspected the on-site sewage system for 5 homes located at Northwoods Subdivision.••Lolock 3 Lott 100 Block 3 Lot 13 Block 1 Lot 16 Block 4 Lot 12 Block 1 In my inspection I found a cap missing, and final grade, needed for Lot 12 Block 1. All construction of the sewage systems, except for Lot 12 meets Municipality of Anchorage code. All had dry sump pipes. If you have any gue§:ti ase contact me. �opp <Qa aQoc�Qc"�7. Sincerely; .V1 4Jw. O i'� � �a� I g000 00 opt) o ,s �,, C. Rid, dr. ; �, �; eroy C. Reid Jr., PhD, PE lvt,QaQ nZ:f ice. 22 1. . t�`f President • 6 C0 `- RUFESSl3 1 1220 UJest 25th Auenue • Anchorage, Alaska 99503 0 (907) 276-1361