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HomeMy WebLinkAboutPRATOR BLK 5 LT 2BPrator Block 5 Lot 2B #017-091-59 Development Services Department Property Owner Name & Address: Pump Installation Date: 3 �� Building Safety Division Pump, Man ufacturer'sName: /i, 1V1,&1,ezi46 Pump Model: 'I L y[ On -Site Water &Wastewater Pro gram�_� G£ B 4700 Elmore Rood Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: P.O. Box 196650 <' Method of Disinfecti n: �eG�e� MarkBegich Anchorage, AK 99507 s A E T * Mayor wwwmuni.oro/onsite PHONE: 907-243-0740 " (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW_ Date of Issue: Parcel Identification Number:: ell I S q Legal Description ',rOL46-0 Property Owner Name & Address: Pump Installation Date: 3 �� Pump Intake Depth "Below Top of Well Casing: feet Pump, Man ufacturer'sName: /i, 1V1,&1,ezi46 Pump Model: 'I L Pump Size Ttl hp Pitless Adapter Burial Depth: 5 " feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? Yes ❑ No Method of Disinfecti n: �eG�e� Comments: ANCHORAGE WELL & PUMP SERV. Pump Installer Name: 330 EAST 76TH AVENUE - " ANCHORAGE, AK 99515 " AWPS.COM• PHONE: 907-243-0740 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. ,. MUNICIPALITY OF ANCHORAGE J -'' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �. PHONE 1�7�—, 7(, I E]NEW I KUPGRADE MAILING ADDRESS x702 ec.S 9 LEGAL DESCRIPTION 1,o¢ nn // Y�fo a( 5s- LOCATION /� y iC.Ct.. 1. n _ r NO. OF BEDROOMS Uy DISTANCE TO: Well Absorption area Dwelling PERMIT NO. P Z a Q wF Manufacturer ' _ Material No. of compartments rn Liq. ca acity in gallons �y ) E E: Inside length Width Liquid depth O 0 z DISTANCE Ty��Dwelling DISTANCE TO PERMIT NO. Oz H Manufacturer Material Liquid capacity in gallons in w= DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. J LL z P Z w No. of lines Length of each line I Total length of lines Trench width inches Distance between lines < Fes- Top of the to finish grade Material beneath tile inches Total effective absorption area w Length / Width�( Depth �® PER0.3 w Type of crili�/ LL Crib diameter �% Crib depth �/� l Total effective absorption area , `�„ Cl LU DISTANCE TO: Well s( Building foundato) Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. Lu Z� DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER At IV a'r PIPE MATERIALS fl �, SOIL TEST RATIN�Gj INSTALLERVia - ids REMARKS 1 ° s S APPROVED DATE LEGAL 72-013 (Rev. 3/78) DEPARTMEN � HEALTH AND ENV IRONMENTAi~^^`R8TECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 9_3 No 1' "ff"'� ;=a, V_ W F� PERMIT NQ: 850376 ENGIN ERED DESIGN DATE ISSUED: 07/01y85 APPLICANT: GERALD E. DEWHURST ADDRESS: 2702 GAMBEL ST ANCHORAGE, AK 99503 CONTACT PHONE : 276-2761 LEGAL DESCRIP: SUBDIVISION: RRAT0R LOTx 2B BLOCK: 5 SECTION: 35 TOWNSHIP: 12N RANGE- 3W LOT SIZE: 71.047 (SQ.FT. OR A(..'RES) certify that: 1. I am familiar with the requirements for on --site sewers and wells a 's 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 ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE AP PECTION REPORT; AND (3) THE ELECTRICAL CTRICIAN. SIGNED DATE - APPLICANT. GjERAI E. DEW)--1URST ATE:APPLICA ^ ISSUED DATE: MUST BE INSTALLED PER ENGINEER DESIGN AND ENGINEER INSP, SOILS LOG - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST 1111 Iu/JI PERFORMED FOR: Emit c %/icrn 'fo") DATE PERFORMED: LEGAL DESCRIPTION: Pra:-16 Lc t .Z 6 13 /b S` / " 93w SAID 3a SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 (7L 6t'34. '% C'm .5,1+1 sk. ,'1 14.c 1 if C' &W5 50.hC( S+T,-o Fs all gC::?a5 ell � o c e 3En �Za,t WAS GROUND WATER ENCOUNTERED? 176 IF YES, AT WHAT DEPTH? 2Y Lo to°to 24°/a x'•-776 S L _ O P E Reading Date Gross Net Depth to Net neon 5 T- Y L. v 2y CERTIFIED BY: Time Time Water Drop 25*) — .67 — ' 3430 q It -Z �?_3 z 3va -63 311 3 311 3 21 — IG 1 Kz 112 zt — Gy •- 4 331 10 YL 22 33/ 63 — s` j to , 41 3 20 20t__] 3v1 -0z PERCOLATION RATE art �'� 10 (minutes%inch) 3 'r z, TEST RUN BETWEEN 3 FT AND FT COMMENTS SG- )j )'w-Ir.Q !S "'"t 01 i ane oma, ola/[ (moi /0-0/0 oie^cf, •Zi 72-008 (6/79) ' r PERFORMED BY: / a...N - neon 5 T- Y L. v 2y CERTIFIED BY: DATE: 72-008 (6/79) ALASKA el�11f�01101C11TAL COnTROL SeRIJI �, Inc. 6ngineerinq & 6nuironmental Studies SPECIFICATIONS FOR BED WASTEWATER TREATMENT SYSTEM — LOT 5, BLOCK 2B, PRATOR SUBDIVISION 1.0 GENERAL 1.1 THE DRAWINGS, SHEETS 1 THRU 4, SHALL BE PART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE, DEPARTMENT OF HEALTH & HUMAN SERVICES (DHHS), THE CONDITIONS OF THE PERMIT, AND ALL APPLICABLE RULES AND REGULATIONS CURRENTLY IN EFFECT. 1.3 ALL EXCAVATIONS AND DEPTHS ARE ADVISORY, AND ARE TO BE VERIFIED OR MODIFIED IN THE FIELD BY A DHEP APPROVED INSPECTOR. 1.4 IT IS THE RESPONSIBILITY OF THE INSTALLER TO ADHERE TO APPROVED DESIGNS FOR INSTALLATION, TO MAIN— TAIN THE SPECIFIED SEPARATION DISTANCES, AND TO HAVE THE APPROPRIATE INSPECTIONS. 1.5 IF THE INSTALLATION IS NOT INSPECTED BY AN AECS ENGINEER, AECS WILL NOT BE RESPONSIBLE FOR THE DESIGN. AN ENGINEER AT AECS SHOULD BE CONSULTED PRIOR TO CONSTRUCTION, TO DETERMINE THE NUMBER OF INSPECTIONS THAT WILL BE REQUIRED AND TO EXPLAIN WHAT THESE INSPECTIONS WILL INVOLVE. 2.0 SEPTIC SYSTEM 2.1 THE EXISTING SEPTIC TANK MAY BE USED, IF IT MEETS THE CAPACITY REQUIREMENTS FOR THE RESIDENCE AND THE APPROVAL OF DHHS. IF NOT, THEN SPECIFICATIONS 2.2 THROUGH 2.6 APPLY. 2.2 THE SEPTIC TANK SHALL BE A UPC—APPROVED TWO—COMPARTMENT TANK, CONSTRUCTED OF 12—GAUGE STEEL WITH BITUMASTIC COATING, SET LEVEL ON UNDISTURBED SOIL, AND INSULATED WITH AN OVERLYING LAYER OF 2 INCH BURIAL TYPE POLYSTYRENE. 2.3 THE SEPTIC TANK SHALL BE A MINIMUM OF 5 FEET FROM THE HOUSE FOUNDATION, AND A MINIMUM OF 5 FEET FROM THE ABSORPTION AREA. 2.4 THE SEPTIC TANK AND BED SHALL BE A MINIMUM OF 100 FT. Y t 1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) '561-5040 FROM ANY PRIVATE WELL OR BODY OF WATER, 150 FEET FROM CLASS C WELLS, AND 200 FEET FROM CLASS A OR B WELLS, UNLESS OTHERWISE SPECIFIED. LESS THAN THE REQUIRED SEPARATION DISTANCE MUST HAVE PRIOR APPROVAL OR WAIVER BY ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION (ADEC). 2.5 PIPING SHALL BE FITTED WITH A MECHANICAL WATERTIGHT CALDER COUPLING ON THE OUTLET AND INLET OF THE SEPTIC TANK. PIPING SHALL BE 4 -INCH SOLID PVC ASTM D3034 OR CAST IRON, SLOPED A MINIMUM OF 1/4" PER FOOT WITH A MINIMUM OF 4 FEET OF COVER. 2.6 CLEANOUTS SHALL BE INSTALLED AS DESIGNATED AND CAPPED WITH AIR -TIGHT RAIN CAPS (JIM CAPS OR EQUIVALENT), AND EXTEND A MINIMUM OF 2 FEET ABOVE GROUND LEVEL. 3.0 SEEPAGE BED 3.1 THE GRAVEL FOR THE BED SHALL BE 0.5 TO 2.5 INCH,i SCREENED ROCK WITH LESS THAN 3% PASSING #200 SIEVE RESIDUAL. ALL SUBSTITUTES MUST HAVE PRIOR DHEP APPROVAL. 3.2 THE BOTTOM OF THE EXCAVATION SHALL BE LEVEL AND RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. 3.3 THE DISTRIBUTION PIPE SHALL BE 4 -INCH RIGID PVC WITH A MINIMUM CRUSH STRENGTH OF 1500 LBS. ALL PIPES SHALL BE LAID LEVEL, AND SPACED ACCORDING TO THE DRAWINGS. 3.4 TWO MONITOR STANDPIPES SHALL BE PLACED AS SHOWN IN THE DRAWINGS. THEY SHALL BE RIGID PVC ASTM D-3034, OR 4" bIAMETER CAST IRON. THE SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED 0.5" HOLES ON THE 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE, OR A SECTION OF REGULAR PERFORATED SEWER PIPE MAY BE CLAMPED TO THE SOLID SECTION WITH A NO -HUB COUPLING OR SOLVENT JOINT. A RUBBER RAINCAP (JIM CAP OR EQUIVALENT) SHALL BE PLACED OVER THE TOP OF THE PIPE. 3.5 IF THE FINAL GRADE OVER THE BED IS LESS THAN 4 FEET ABOVE THE GRAVEL, INSULATION IS REQUIRED, USING DOW EXTRUDED BLUE STYROFOAM BOARD. THERE SHALL BE 1" OF INSULATION FOR EVERY FOOT OF SOIL LESS THAN THE REQUIRED 4 FEET OF COVER, BUT THERE MUST BE AT LEAST 18" OF SOIL EVEN THOUGH INSULATION IS USED. THE SOLID PIPE EXTENDING FROM THE SEPTIC TANK TO THE DRAINFIELD SHALL ALSO HAVE 4 FEET OF COVER OR AN EQUIVALENT LAYER OF INSULATION COMBINED WITH SOIL TO PREVENT FREEZING OF THE LINE. 3.6 IF INSULATION IS NOT NECESSARY, THEN THE GRAVEL MUST BE COVERED WITH A LAYER OF A NONWOVEN FABRIC (SUCH AS MIRAFAI, FIBRETEX 200 GRADE, POLY -FILTER X, OR EQUIVALENT). 3.7 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MIX OR BLUE GRASS. ALASKA ENVIRON; -.NTAL CONTROL SERVICl3`, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907)561.5040 1 SHEET NO. OF 3 CALCULATED BY --2>-`) DATE CHECKED BY DATE �,, o i SCALE 3 0 Pmcrmices IM.. C,qm, Mm 01411 nLM0F%M Civvlrtvwr wince CONTROL SERVICL-;1, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 SHEET NO. OF -5 CALCULATED BY 72A, DATE CHECKED BY DATE SCALE / Io ' M-1-V241/Ae.e SIM.. Grt. Nffi M71 .....,a, _ .. -. r' TR ........ _To lay ..... ........... ___ .._ -... -.. ...... .... T .t ... �" solid r.P�.. .............. .....:.... ru ......... '.... , ee l.mi<< k .. h z ...... , _ ... -- .. .. M-1-V241/Ae.e SIM.. Grt. Nffi M71 ALASKA ENVIRON`NTAL P r CONTROL SERVit:�:�, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO. OF CALCULATED BY 'Pa DATE 6 21 �gS^ CHECKED BY DATE SCALE A'K un e PRGCaa Mln a �l�.Gdm. Mas (W w GRE: 'R ANCHORAGE AREA BOR ',GH a��l'Uua Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ��/��ULf�G��//1/f/J%✓ MAILING ADDRESS PHONE LOCATION%!��/T 61�e_ LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL ��>� MANUFACTURER MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/�Le9GALLONS. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL��C,_FOUNDATION✓,4 NEAREST LOT LINE OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH✓�� IN. TOTAL EFFECTIVE ABSORPTION AREz 63 SQ. FT. LENGTH OF EACH LINE J� DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE,2•.S MATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPE 1_41 /DLJ/C CONSTRUCTION ���/«Grp DEPTH /�� � DISTANCE FROM: BUILDING NEAREST NEAREST / SEPTIC /SEEPAGE / FOUNDATION1X' LOT LINE �� SEWER LINE TANK /�� SYSTEM CESSPOOL ©�E OTHER SOURCES /`�/��r ✓���a/�� APPROVED DISAPPROVED REMARKS DISTANCES:9i��� INSTALLED BY:�����c�� SEWER LINE DEPTH: PI PE MATE R I AL: LOT SLOPE: REMARKS; Form EQ -032 DIAGRAM OF SYSTEM'�'�� DATED' % APPROVED.-'C- G.A.A.B. „,tea=.,[ y \VI l gOVVV'h'E[0 ,\M1l b�, \_ .. GREATER ANCHORAGE AREA E30ROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C” STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 /j PERMIT NO. S Vic: j7 SEWAGE DISPOSAL SYSTEM ® APPLICATION AND PERMIT NAME OF APPLICANT ! A)ko INSTALLATION LOCATION LEGAL DESCRIPTION -Z_ INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED IN ILING ADDRESS Sq- r4 r) E PIT , DRAIN FIELD S/'0C'`45 f'-qm %�(I PHON3��-9�147 OTHER , FINANCED THROUGH TO BE INSTALLED BY P/ SOIL TEST RESULTS S 1 NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL '7 COMPLETION DATE ANTICIPATED ✓�� d/[/�" TEST -- FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. z�;_O _ cl L 1 _ SEPTIC TANK SIZE �� S'/qL TYPE `��c"'m coyuueE PAGE AREA SIZE � TYPE rQs I MINIMUM DISTANCES, REQUIREMENTS/ c FOUNDATION TO SEPTIC TANK >✓ //v �a(0 / FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK � SEEPAGE PIT CDC) TO NEAREST LOT LINE. / WELL TO SEPTIC TANK SD DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD DRAIN FIELD /0 / SEEPAGE PIT /0 —. ALSO CONSIDER AREA WELLS. //0 . SEEPAGE PIT /O DRAIN FIELD e / SEPTIC TANK, ��"5 / SEEPAGE PIT 9DD DRAIN FIELD O TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 ON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A .B. R LICENSE ESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ` DATE _ / �=— APPLICANT'S SIGNATURE FORM NO. EQ -016 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For rnnncaeyPo LC *,S Dated Performed Legal Description: Lot �Block �Subdivision N This Form Reports Soils Log X'` r "�`� Percolation Test z- - Soil Test Must Be Logged To 4' NBelow Proposed Seepage System - .� Depth FPPt Soil Characteristics 1 V- 147 Date - 2- 3- 3- 7 -a- 7- 8- 11'- 127 13— O r. Was Ground Water Encountered? tie) s!O . If Yes, At What Depth? AF 4 .t Reading Date Gross Time Net Time Depth to H2O Net Drop Fercoiation Kate minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom o Pit or Trend COMMENTS: FS Flt / L 5, r ,,,._ - ;-(�' ius�/1P :I c%f ,-\ tom" a 4 Test. Performed BY c G` Date Certified BY: Date:_ w�� J da GJd A :a GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Stregt ANCHORAGE, ALASKA 99503 Performed For };(o« < \�� ��; � s�14 Dated Legal Description: Lot `Z Block _Subdiv'sio This Form Reports Soils Log (5'`'L;. ��� x - Soil Test Must Be Logged To 4' Belo 10 Depth Feet Soil Characteristics 1— 2— Gross Time Net Time 3— Net Drop 4— 5— 7- 8— 10— ° !— 11— 12— 13— 14— Was Ground Water Encountered? 1-0- If Yes, At What Depth? Perf ormed 7-•� �� (Percolation Test Seepage System s- Reading Date Gross Time Net Time Depth to H2O Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to.Bottom of --Pit or Trencfi— COMMENTS: c�ra,�.f lid Test Performed BY /77 S' �. , _� Date Certified BY: Date: 60 8 APR -✓� GREATER ANCHORAGE AREA BOROUGH4 DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For co `' 01�,<< �� Dated Performed Legal Description: Lot L) BlockSubdivisionl�;«��� Su�� This Form Reports Soils Log "�` Percolation Test_ - Soil Test Must Be Logged To 4' elow Proposed Seepage System Depth rapt Snil Characteristics , S Y1l `O L10 o Was Ground Water Encountered? rl() If Yes, At What Depth? I shop - F Reading Date Gross Time Net Time Depth to H2O Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet D/ept_h tfo Bottom of Pit or /TrencF — COMMENTS: Test Performed BY c S. G` Date Certified BY: Date: s :o c 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 rays 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) a-zCL 12 (b) Applicant Name ��C T, elephone: Home � `O�i Business� Applicant Address ��'Jocz?i : /ly y� G• �51��' (c) Applicant is (check one): Lending Institution ®; Owner/buildef/6 ; Buyer D ; Other D (explain); Es E (e) Lending Institution Address Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-FamilyAl Multi -Family ® Other Number of Bedrooms Telephone 3. WATER SUPPLY Individual Well,A Community D Public[D 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 D Community D 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 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 `v `� S �" Telephone Address a` Zoe, SJf-d �&,e Sf4 � � � c ��.;- ate Vte 9s JO Date �C✓i CLC` rG:9 ,? Pte.. t"itc �'2C1 �/I61 Z(' (.(t ea_ x1Z 4 6A/ feta os"ec' / �� 6J���- t­� Jr+� r 6. DHEP APPROVAL 0 PRGrr Approved for bedrooms by())> X -t rc Date ' _ .r�l ci ?S ' Approved Disapproved Conditi I r Terms of Conditiohal Approval — 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 17 117E /11/0.11 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 11715-57: 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) T2o2t)Location (address (addreessmss or/directions) (b) Applicant Name&ke�' �d�Lc-fA6z2!LTelephone: Home Business Applicant Address C10 7-0-a- (c) py(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder's , Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Familyt Multi -Family ❑ Other Number of Bedrooms —2- 3. WATER SUPPLY Individual Well V Community ❑ Public ❑ Telephone Note: If community well system, must have written confirmation from the State Departmentof Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite V Public ❑ Community ❑ Holding Tank ❑ Note: if community well system, must have written confirmation from the State Departmentof Environmental Conservation attesting to the legality and status. Page 1 of 2 724-123 t es' 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 Address Date 0 ZA� !a teo 6� e n °eeoe eeee®e�e.°O •°g�/�/e ° reee w oy C. Reid, J . ; kw °e No. 2251-60 Engine ��p J6 cc0910 6. DHEP APPROVAL /� -oNDirioncaL 0 Date ,Aeved.for T'''�b�L bedrooms by Approved Disapproved Conditional A PC Terms of Conditional Approval G%t� CAUTION .r i°dLQ, oc� s � A_ G4 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) �1 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata// /6� Type of System Design Date Installed �il7LJ�S� Length of Field '301 Width of Field.7 fCID Depth of Field Gravel Bed Thickness ®rS� Square Feet of Absorption Area Standpipes Present ON) Depression over Field (Y16 Date of Last Adequacy Test " 4) 174 Results of Last Adequacy Test Separation Distance from Absorption Field: ,t To Water -Supply Well 7 % S f To Property Line 10 1 To Building Foundation To Existing or Abandoned System on Lot 121�- 0 ; On Adjoining Lots 36 f To Water Main/Service Line To Cutbank (if present) w/,4 To Stream/Pond/Lake/or Major Drainage Course /06 To Driveway, Parking Area, or Vehicle Storage Area I D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions Manhole/Access (Y/N) Pump Off' Level at Vent(Y/N) Pumpcles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** ®�®�®��� I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect gcQoA�js�&tion. peee°eeeea cP U Signed Date/�� �I<Q : • °O° ®�� Company MOA No. Ca o 21 POP �� e6•e . Receipt No. r � 24 a•• Date of Payment ►" �® Le y C. Reid, Jr Amount: $ LV7)CO �T �• Er inee sit al !�h<�iY'i�u•G� ; C!u-�z eZ:c> Pi�t,.a•a3 ES Page 2 of 2�,v 72-026 (1 1184) IMAM CUSTO,M�ER'S ORDER NO - ,j DEPT. DATE 'p- 113 (zFe-rc . I MPLFM" KEEP THIS SLIP sH 320 FOR REFERENCE i V� ALASKA MUInOnMenTAL COnTROL SMUS, IX 6ngineerinq & 6nuironmental Studies July 8, 1985 Department of Health & Human Services 825 L. Street Anchorage, Alaska 99501 RE: Lot 2B, Block 5, Prator Subdivision Well Flow Test for Single Family Residence On July 2, 1985, we performed a flow test on the well at the above property. The flow rate was 3.4 gpm for 2 hours, a total of 410 gallons was pumped. The static water level was 8.8', maximum draw down was 21.2 feet and recovery time was 1 hour. I consider this well adequate to meet the requirements for this 2 bedroom house. Sincerely, wen Turner nvironmental Scientist Approved by: p4Ufrf3 ori. c.p3UC5. 6o0' 000U n n066 ue �'- �� L r y C. 1-f e.j f9 \ 1200 West 33rd Auenue, Suite B 9 Anchoraqe, Alaska 99503 • (907) 561-5040 � AA . W%4l/ 1'd MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE a. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OP f'cALTH & 825 L Street - Anchorage, Alaska 99501 g ENVIRONMENTAL N,O i ECTION ENVIRONMENTAL ENGINEERING DIVISION DEC J 1978 Telephone 264-4720 NUMBER OF BEDROOMS pp ae ,,'' nn AND SEINUCGLI REQUEST FOR APPROVAL OF INDIVIDUAL WATER IVSD DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (1 O) days for processing. 1. PROPERTYOWNER ❑ Three ❑ Six PHONE rn. 2 il'gw H A/9- A/o (5r MAILING ADDRESS since June 1975. For wells drilled prior to that date, give well SIZFI lox 7 o �Go.q�� 9so7 v 17�/-9SAIb PROPERTY RESIDENT Of different from above) PHONE 2. BUYER j II P'06gv+ PHONE MAILING ADDRE `` by this Department. V CAl 3. LENDING INSTITUTIO PHONE LA MAILING ADDRESS 4. REALTOR/AGENT PHONE In I, r' L i E tart LVA yy -oso MAILING ADDRESS �� L f� 5. LEGAL DESCRIPTION .i P � -4 '-Ds $ vs STREETLOCA ION mir 2. 6- Ir 12c-� Gre-ck wa 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other IOC SINGLE FAMILY �K Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY 121 INDIVIDUAL* ' ATTACH WELL LOG. A well 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 INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date 76 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) 'GyF a�(%OiAGf AFtBOo �. u' H GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received February 5, 1976 ()Io' lop a iq f)[0, n / Time of Inspection �+ Date of Inspection-/3/n?�.. �� �� M REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1 �' FOR LVL 1. Approval requested by: Mailing Address: Phone: 2. Property Owner: Monroe & Milissa Robinson. Phone: 344-9947 Mailing Address: Star Route A Box 94-C 99507 3. Legal Description: Lot 2B Block 5 Prater Subdivision 4. Location: Rabbit Creek Road 5. Type of facility to be inspected Single Family No. of bedrooms 2 6. Well Data: Indy' A. Type B. Depth 200' C. Construction D. Bacterial Analysis 7. Sewage Disposal System: on-site system. A. Installed 1974 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages GREATER ANCHORAGE ARLA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VAy `_ FHA_ CONY }( 2. Property Owner: 0,4 wt Mailing Address: Day Phone 3. Name of Buyer: Mailing Address: Day Phone 4. Name of Lending Institution: Mailing Address: Phone 5. Name of Realtor or Agent: jA_t«'z.mb Zc Mailing Address: Phoneri'�J.�y 6.. Legal Description: • • 1`i�l ����i ii� i it S c- .,L�, .��ic �u Lit 7. Type of Facility to be inspected: a��29c :, No. Bdrms. 8. Water Supply Type of Supply: Public Utility Individual x If Individual, number of dwellings presently served If Individual, depth of well r 9. Sewage Disposal System Type.of System: Public Utility Individual (on-site) Y If Individual, date of installation / q Page 2 of two pages - Re ;t for Approval of Individual it & Water Facilities 1 Boal Dnscrintion Lot 2B Block 5 Prater Subdivision Comments 4 Approved G _ Disapproved Date Appro Valid for one year from date signed Greater Anchorage rea Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request Tor approvai to ou o LIrua acid accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74) March 2sr 1016 vynarla Realty 3300 C StrOOt Anohcar agO-r Alagka 90503 Attention.- Vivian xito StIbject- y�ot 2n, Block , 5 Prator SWL-divisicia I -.;1 - 2221 4,1 The 5k'+Jf'%r Syste'a on the subject vproperty bag a Septic tank miss unto for a ttjrea (3) bedroom aingle family residence. vie absorption area JO adequate for a two (2) bodroom single family residence, gnIarginq the absorption system by adding 55* additional length witlih, a widt-A of throo (3) feet and a gravel depth- of one (1) foot, Vie woll is of Sat"Laraotary Construction for any size of single favtily VesidOnCO* Sinceralyr Los t'%BuChI1017, sanitarian XON-u/l j h cc% Monroe r-.0binson Box 394-C Sia.- rWut'(-:* it Anc-laorage, Alaaka qqS02