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SKY RANCH ESTATES #1 BLK 4 LT 6
MUNICIPALITY OF /ANCHORAGE 0 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 015-301-06 Certificate of On -Site Systems Approval Expiration Date: 2 2.a 23 Legal description SKY RANCH ESTATES #1 BK 4 LOT 6 Site address 5601 Whispering Spruce Dr Anchorage Current property owner(s) Baines X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: L_ Original Certificate Date: 2/27/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE A, Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-301-06 Complete legal description SKY RANCH ESTATES #1 BILK 4, LOT 6 Location (site address) 5601 WHISPERING SPRUCE DR ANCH AK Current property owner(s) BAINES 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: N Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 2016 -See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑■ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: _0 Distance:_ Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ /SJ Date of Payment �/ '-Ll / Pz -3 COSA # �M�o e as Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: SKY RANCH ESTATES #1 BLK 4, LOT 6 ParcellD: 015-301-06 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled *1973 Total depth 223 ft Cased to 40'+ ft ❑ Sanitary seal is functioning correctly ❑� Wires are properly protected Casing height (above ground) 12 in. Date of flow test for COSA 2/1/23 Static water level at beginning of test ft. Comments ` FROM MOA RECORDS B. TANK DATA Measured operating Fluid level in septic tank 48 Date of pumping 2/1/23 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/26/16 0 ALL standpipes present per record drawing Total measured depth from grade 8.3 ft (max) Measured depth to pipe invert from grade 4.3 ft (min) ❑ N/A —pressurized field. ❑ Per record drawings, field is insulated. ❑� Monitor tubes go to bottom of effective. If not, state depth into effective _ ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date COSA Checklist June 2022 Well production at time of test 4+ gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No X Coliform bacteria is Negative Nitrate 0.286 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L X Arsenic less than MRL (ND) Collected by Date 2/1/23 M NA C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 2/1/23 Results QPass Fluid depth prior to test 3 in Water added 450 gal New fluid depth 8 in Elapsed time 1440 min Final fluid depth 3 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 8 in Effective depth remaining 48 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Yes if No ft Community Sewer Manhole/Cleanout > 100' []i Yes if No ft E Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Q Yes if No ft Holding Tank > 100' DYes if No ft Neighboring Absorption Fields > 100' Water Service Line > 10' Q Yes Animal Containment > 50' © Yes if No ft [i Yes if No ft COSA Checklist June 2022 Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft Q Yes if No ft ❑ N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' Yes if No ft Surface Water > 100' ❑■ Yes if No ft Tank to Property Line > 5' Yes if No ft Wells on Adjacent Lots: ete Field to Property Line > 10' [_] Yes if No __7_ ft Private Wells > 100' Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' Q Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS Vv X A ( W, p— I SS�l 17 G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Ml h t-Ag � tJ A o h Pt Phone 727-8864 Engineer's Printed Name «V^.:� Date 2- 'L( L ete �-• MICHARN. - < `�,;o,. Cr -94¢9 • � .`yam...., L COSA Checklist June 2022 Feb. 27, 2023 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: lot line waiver Legal: SKY RANCH ESTATES #1 BLK 4, LOT 6 To whom it may concern: This is a request for a lot line waiver on the above referenced lot. From the asbuilt survey the NE corner of the field encroaches 3feet into the 10 foot setback from the property line, see the new survey asbuilt. Reviewing the MOA file for lot 7 shows their system is over 15 feet from the property line and will not be impacted by the granting of this waiver. The effective depth of the gravel for lot 6 is only 4 feet therefore using a 2:1 ratio we would not impact the neighboring system. The granting of this waiver will not impact any of the surrounding neighbors. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage "� S n P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV231008 PID#: 015-301-06 COSA#: OSC231038 Legal Description: Sky Ranch Estates #1 Block 4 Lot 6 Engineer: Mike Anderson Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 7.0 feet. This waiver approval applies to the proposed absorption field. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. .............................................................................. 1 Waiver is Granted: X Waiver is not Granted: Date: Z 2 2 Approved pp ed by: Name of Reviewer .......................................................... 0 E x N K N .............. 1 **** VARIANCE/WAIVER REVIEW **** BASIS OF BEARING S89"59'33"F 81-64' (81 - LOT 5 (,36 n 9"00, ! 1%33."* 4 S6 C�- ANCHORAGE RECORDING DISTRICT, ALASKX AS -BUILT OF: SKY RANCH ESTATES Nol LOT 6 BLOCK 4 PLAT 71-166 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shou.14 any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER:D_A_7_E_: SCALE: E—MAIL SEPT 3, 2022 1 =30 schullerOok.net 22- 1 0 2 DRAWN BY. JCHECKED BY. GRID NUMBER: ' Book AGE JLS SW2737 220332 LOT 7 * == FND 5/8" REBAR stj'�v OF 4 L A Aw N 4or . . 4 A07 .' 49TH •.' •..... ...... YA c" L 1)0 - ........... I ............i -.A0 %JOHN L. SCHULLER,-* 0 IX LS -10408 IS?, Ofessjon& Aow' 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 f ax On -Site Wastewater Disposal 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: OSP161239 Tax Code Number: 01530106000 Work Type: Septic Upgrade Permit Effective Dates: August 26, 2016 to August 26, 2017 j'3d Design Engineer: ANDERSON ENGINEERING Subdivision: SKY RANCH ESTATES #1 Site Legal Address: SKY RANCH ESTATES #1 BLK 4 LT 6 G:2737 Owner/Address: BAINES BRIAN M & BARBARA A 5601 WHISPERING SPRUCE DRIVE ANCHORAGE AK 995162314 Site Mailing Address: 5601 WHISPERING SPRUCE DR, Anchorage Lot Size in Sq Ft: 16994 Total Bedrooms: 3 This permit is for the construction of: Y 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. Provisions: Prior to construction, please confirm that the proposed field will be 16' from the existing field. Received Issued By: MUNICIPALITY OF ANCHORAQLRUSH! Community Development Department 4y6 V 7 7 Phone: 907-343-7904 Development Services DivisionRUSH! y Fax: 907-343-7997 On -Site Water & Wastewater Program AUG 2 3 2016 ON-SITE SEWER/WELL PE T APPLICATIO ' 015-301-06 t �� oe Parcel I.D. Property owner(s) Brian and Barbara Baines Day phone 229-1104 Mailing address 5601 Whispering Spruce Drive Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Sky Ranch Estates #1, Block 4, Lot 6 Legal description (Township, Range & Section) Lot Size 16,994 Sq. Ft. Number of Bedrooms Three APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: Waiver Fees: (® all that apply) Date of Payment: Receipt Number: Receipt Receipt Number: Permit No.�`JP/(Qla� Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank 1ZUpgrade FX]Duplex F-1Holding (D) Tank ElRenewal 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 agent) Permit App_-'-: 1C.A, Permit/Rush Fees: Waiver Fees: Date of Payment: �!//Lo Date of Payment: Receipt Number: Receipt Receipt Number: Permit No.�`JP/(Qla� Waiver No. Permit App_-'-: 1C.A, ANDERSON ENGINEERING P.O.BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX August 23, 2016 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Sky Ranch Estates No. 1, Block 4, Lot 6 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The absorption system on the subject lot has failed must be upgraded to prevent damage to the property. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic systems. The existing septic tanks will be replaced with a new 1,000 gallon steel septic tank. The existing tanks will be decommissioned in accordance with Municipal Code. Also identified on the plans are the locations of the existing well on this lot and adjacent lots. No conflicts exist between the proposed septic system and the wells on adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The ground surface in the area of the proposed trench is virtually flat. The drainage patterns will be maintained after construction. The test hole placed on the lot indicated Silty Sand with Gravel (SM) in the absorption zone of the trench. The percolation rate was determined to be between 4. 5 minutes per inch. No groundwater was encountered during the placement of the test hole and none has developed to date. We have designed the new trench with an application rate of 1.2 gallons per day per square foot. We are proposing to replace the existing 1,000 gallon and 500 gallon septic tanks and construct a new 38' long trench by 5' wide by 4' effective depth absorption trench. The total depth of the trench will be 8' with the distribution line at 4' below the existing surface. The existing absorption trench will be connected to the new system with a flow diverter valve for future use. The ground surface on the lot in the area of the new trench is flat. The trench will be placed parallel to the contours of the ground as much as possible and in conformance Sky Ranch Estates, Block 4, Lot 6 August 23, 2016 Page Two with design criteria. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments �0.••••49th �„�� MICHAEL E. ANDERSON SKY RANCH ESTATES SUBDIVISION NO. 1 Community Water LOT 6, BLOCK 4 LOT 4 BLOCK 3 No Well on this tract O is within 200' of the property line. VACANT TRACT SCOPE OF WORK: Decommission Existing Septic Tanks in Accordance with Municipal Code. Place New 1,000 Gallon Septic Tank and New 38' Long x 5' Wide x 4' Effective Depth Absorption Trench. Connect Existing Absorption System with Flow Diverter Valve. SITE PLAN SCALE 1" = 40' 10' UTILITY EASEMENT x a_____________ _____________________ _____________ Connect Lines From r —.Ry. to Existing Absorption Pit i 38' Long x 5' wide x and Trench Together i1 4' Effective Depth Prior to Connection to i i Absorption Trench Flow Diverter Valve. FDV DCO SV 1,00'a,Gallon T —' NOTE: Septic `F(?nk SV CO Decommission Existing ------- -''---- ! CHAIN—LINK 1,000 Gallon and 500,-' ! FENCE Gallon Septic TanksAn i U)! Accordance with ,''� Co ,,, � 4 Well on this lot is Municipal Code/ >100' from the oThree11LBedroo ' property line. Lot 5 Horne m M rn Lot 7 W N ` i•— .."� i T ... 01 Ut ` EXISTING WELL o In z Q o. Lot LEGEND " 16,994 4.f. MT - Monitor Tube MH —Man Hole FCO — Foundation Clean Out EXISTING / TH — Test Hole WELL / ; CO — Clean Out FDV — Flow Diverter Valve Mme• _ N 6g•0po .. " 2CO — Double Clean N�S r Out NOTE:SA R�;46. ; R��'R24p 401 Verify 16' separation from 00' ; existing absorption trench to D RIVE new absorption trench during construction. SCOPE OF WORK: Decommission Existing Septic Tanks in Accordance with Municipal Code. Place New 1,000 Gallon Septic Tank and New 38' Long x 5' Wide x 4' Effective Depth Absorption Trench. Connect Existing Absorption System with Flow Diverter Valve. SITE PLAN SCALE 1" = 40' LOT 6, BLOCK 4, SKY RANCH ESTATES SUBDIVISION NO. 1 DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5' Wide Trench System Perc. Rate: 4 Min./Inch 1,000 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 3 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 375 SF Absorption Area 375 SF/5 SF/LF".5 (Red. Factor) = 37.5 LF Trench Length THEREFORE: Construct a 38' Long x 5' Wide x 4' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 8' Below Original Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Provide Flow Diverter Valve and Tie Existing Trench in to System for Continued Use. Natural Backfill Geotextile 3'6" Fabric 6" O 4' Perforated PVC (Holes Down) 4'0" 5' i i Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2 3 4 6- 7- 8- 9- 10- 11 12- 13- 14- 15- 16- 17- 18- 19 - SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 6, BLOCK 4, SKY RANCH ESTATES SUB. # PERFORMED FOR: BRIAN AND BARBARA BAINES DATE: 8/11/16 PROJECT No.: PARCEL ID#: TECHNICIAN: J. MILLETTE TEST HOLE A mmr-nmr nR//1r m SAND W/SILT AND GRAVEL a d SM d 4 0 BOH @ 15' SLOPE SITE PLAN SEE SITE PLAN K WAS GROUND WATER ENCOUNTERED? No READING IF YES a WHAT DEPTH'S NET TIME (MINUTES) DEPTH To WATER (INCHES) DEPTH OF WATER AFTER MONITORING: NONE TEST HOLE PRESOAKED PRIOR TO TESTING: 8/11 0 4:18/4:28 DATE OF MONITORING: 8?21/16 0.50/2.75 2.25" DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 8/11 1 4:18/4:28 10 0.50/2.75 2.25" 2 4:29/4:39 10 0.38/2.63 2.25" 3 4:40/4:50 10 0.50/2.75 2.25" 4 4:51/5:01 10 0.25/2.50 2.25" 5 5:02/5:12 10 0.50/2.75 2.25" 6 5:13/5:23 10 0.25/2.50 2.25" PERCOLATION RATE: 4.5 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 8/23/16 MUNICIPALI Ty OF ANCHORAGE DFPAR I MF.NT OF FIEAI_'f li & E NVIRONME.N IAL. PROTFO I ION ENVIRONMENTAL ENGINSFRING DIVISION 825 L Stre.Ct - Anchorage, Alaska 99501 Telophonp. 264-4.720 \= ON-SITE SEWAGE DISPOSAL SYSTEM ANWOR WFI_1_- 1NISPF-cTION REPORT NAME//"V DC> ' - - - PHON/L' / k'Il7L]NM _.C� `7 `I�C�`J-c[ _ )PC;RAr)E MAI LING AD iESS D-) „ LEGAL DESCRIPTION Lip Q1 LOCATION/� nW ` /^ �-X. .. VC! NO. O BEDROOMS �(/ V N1el��� Absorption area E t DISTANCE TO: U (00 Dwelling PERMIT NO. Y���„1 j C) Y 2 Manufacturer p� Mater' ___ No. of copartinents rn Liu. capacit in allons Inside length r` �� IF HOMEMADE: Width Liquid depth � DISTANC �O-� -WeltDwelling PERft41T NO. ----”--.___ C7 0a:—<l- Ligwd capacity mgallons"---`-"-`-"-� Ma4ruf3cturer _ _ _�-- - `__--�-- Material ® wz " - Well t DISTANCE TO: No. lines Length each line Foundation , Total length of li ies Nearest lot line t -------- Trench width PERMIT N Distance betwe u_ 2Lcc of of inches- Ines b. Material beneath the .__ © I'- ._., O c eS - __� Total effective absorp ion area Top of file to finish grade E n_ _ Length Width Depth PERMIT NO. LU 4 f- CL K W 0. Lu Type of crib ---_ _– -.— Crib depth Building foundation Total effective absorption area - — — Nearest lot line Crib diameter to DISTANCE TO: .j CI'�- DISTANCE TO: ---^-_ Depth Building foundation —�-- Driller Sewer line - --` Distance to lot line Septic tank ------^�- -- N . PERMIT NO. Absorption area(s) OTHER — - -- - 0 _ �a -- PIPE MATERIALS SOIL TEST RATING �- v o 0 5 Nk INSTAL-LER�"`�A REMARKS ���p�0-- I��CJ�� C (ItiL Q2 d tcj 0- C_ -�/ APPR ED DATE LE/GAL 72-01I S4 iev. 3/78) U MUN X K0 X VOW. X T"W" vy 11 1 lot N KS 1-0 CA Hot NoGd 71 TM, OTVCTT _4 L.CIC41T1. OIA LF:011- LOT fS I. LOT I 1,114-`F: Of�, 1RADRA-1 Nl,ltflf;CF! C:W` 5011. MAMA QQ OF' TFIE Pi,;: 1.011::: 11 F: I F.TiGiTI-I CU -4 01- OF., 'ME OF., A OF'.., Pyr, IS JTIF-�". [.",I ITI(-: 1.1sf:" crr-j F'P.J.,.J). 1IPATI.IU11 C-t,.-,.P,ITI OF, 13Rr,,IVf-,J... [.AfT In j . wME FAFT*,.' "I'llik: IDIP, ITIE". ',TN t Sij G.... 117 Gs IL -A X, II U:: -11— all PA 11-A "c:...1(: PF"FITT'l, Fi F, F., L.1 C: r) I'l 1' I IIi iiS ITIF': TC) INFORM MIS DEPARTPIENT DMIN6 fl -W OF, ANY f•IIJI91;1 F: OF. TFIAT 1.f IC WILL. IL.1,, ::on 1, X X 1-INY f -WA.", 1411.1. BF,' MINIMUN A FIND Arly I f-,,PJVFI,P,,.K OR 12JO P.1 ei:kicl ITIAT RZOM A PI -04 -AC". llif.- T'r'PFr:: Oloo' PLILA.A.C: I -IF -A-1 i-I.IJ11111"JUM F-RCIM TO FI FIJKA, 1-0 f ,_,, Sl,.- I -RER. !- T. PAE: FIT - MAG, L.Q FIRf:: W Fka vs! I w I X -v , I lot all Pat lw I lot FEE FYI VAIA... A SW *51s a I UNT11710 MAT :.L 1: Fill F'Fil-1:111FIR WITI-I 111.,'. i- C" ,A:J is Pr' 11 E fARAIMPAUTY OF' ANG110RAGE!, NIE'.: IJA ITITI-I TI -If". f�ll_ FT Tt !I I 'I 1-IF11, Ohl— ST'l F: , G IE IS REPUNNUND TO INCURAT NEARE: MAN 4 SEDROON".3, DR 1 r.. . . ..... ...... 0GREI �R ANCHORAGE AREA BOP _'1GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME 2ou/n% MAILING ADDRESS /24• /JO' °1i PHONE_<</�— LOCATION LEGAL DESCRIPTION SjG� SEPTIC TANK: DISTANCE P—f70-'O NUMBER OF FROM WELL /4--0/ MANUFACTURER E-SPi NOZA MATERIAL �/�� 2 E77_&COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS �. DIAMETER -AOR WIDTH �,/ LENGTH /7, DEPTH 12 / � LINING MATERIAL/C/^�GS��2A CR B SIZE: DIAMETER _DEPTH /DISTANCE FROM: WELL /o`G/ TOTAL BUILDING FOUNDATION ��� NEAREST LOT LINE -7—U ABSORPTIONCA AREA (WALL AREA) .Z SQ. FT. ADDITIONAL ABSORPTION WELL: pl�o Pa st« TYPE ZVOItl CONSTRUCTION BUILDING NEAREST FOUNDATION—,LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: ,EZ_c. PIPE MATERIAL: NY7"' _27"oo/V LOT SLOPE: REMARKS: SF -21/ 1V1jAW-91_e (�o11�72J O A) 7/fnl/C, NEAREST SEWER LINE , REMAR DEPTH DISTANCE FROM: SEPTIC SEEPAGE /Cc�Fit!'2C-O TANK ld'D SYSTEM IdV I ��50IL' Y1 /.. a/. DIAGRAM OF SYSTEM IN I61+�'ryls \_� I261 (E z' PCoi�sE - Pilo � �4-z ..7�uJC-zcii✓E/-� DATE 77 % %3 APPROVE G.A.A.B. Form No. EQ -031 K'o,w i D .' 3 0 / /V GRFA*rER ANCHORAGE ARRA BOROUGH DEPARTMENT OF ENVIRONMENTAL_ QUALITY 3330 "C" STREET ANCHORAGE, ALASI<A 99503 TELEPHONE: 274-4561 SEWAGE DISP®SAI,. SYSTEM - APPLICATION AND PERMIT PERMIT NO. NAME OF APPLICANT •��%% f� //7 p�'/JJ MAILINGGAA/DDRES5 `= �/` — —� — PHO NAME 1% 4 INSTALLATION LOCATION LEGAL DESCRIPTION G� INSTALLATION OF: SEPTIC TANK —_— -- SEEPAGE PIT _ _--.—, DRAIN FIELD _—_—_, OTHER , TYPE AND SIZE OF FACILITY TO BE SERVF_D�.��=L�L.G` FINANCED THROUGH ._-------.-- TO BE INSTALLED BY — //.G `/ �i�J✓%� SOIL TEST RF_SUI_T5 � r1 NOTE: Thlly PEF2PA17' IS NOT VALID WIT'HOU'T SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BSACI<FILLING OF ANY SYSTEM WITHOUT FINAL, INSPECTION BY THE DEPARTMFNT OF ENVIRONMENTAL QUALITY AUTHORITY WILL, BE SUL4JECI' TO I'ROSE:CU'TION. SEPTIC TANK SIZ.E TYPE-_f�A_-5SEEPAGE ARI MINIMUM DISTANCES, REQUIREMENTS T / FOUNDATION 'TO SEPTIC TANK __J__ FOUNDATION TO SEEPAGE PIT DRAIN FIELD --_J SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK_ J —. SEEPAGE PIT cell DRAIN FIELD — TO NEAREST LOT LINE. WELL TO SEPTIC TANK _L— � / —. SEEPAGE PIT _, L/ C —.—. DRAIN FIELD —J ALSO CONSIDER AREA WELLS. �Q WATER MAIN TO SEPTIC TANK--� � —. SEEPAGE PIT --, DRAIN FIELD SEPTIC TANK, LLIIL/_, SEEPAGE PIT,-.----, DRAIN FIELD — 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 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL. BAC KPIL,L. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. C ��r G.A.A.B. OR LICENSED DESIGNER I CER'T'IFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF 1{EATE ANCH9 AGE AREA BOROUGH ORDINANCE_ NO. 26-6B AND THAI' THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. �// DATE/ APPLICANT'S SIGNATURE, _ �-—.----- - -- ---- FORM NO. EO -01 6 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For MR. JAMES BROWN Dated Performed OCT 16,1973 Legal Description: LOt- 6,B10Ck—__4 __Subdivision SKYRANCH ESTATES :al This Form Reports Soils Log__ X - - -- Percolation Test - Soil Test Must Be Logged To 4Be1ovr Proposed Soepage System - Depth Feet Soil Characteristic, 2- 3- 4- 5 — SW WELL -GRADED SANDS AND GRA 7- 9 -------------- 10- 1 I- SP POORLY GRADED SANDS 12 ------------------ 13- 14--//--^ - SM - S ILTY SANDS 171- --------------------- -Was Ground Water Encountered? No If Yes, At What Depth? Reading Date i Gross Time Net Time ---- ---.-A--------L Depth to H2O I Net Drop l -- --- --- �__- 1 PerCnlAtinn -- --- -� Pate I--IJ Reading Date i Gross Time Net Time ---- ---.-A--------L Depth to H2O I Net Drop l -- --- --- �__- 1 PerCnlAtinn -- --- -� Pate Proposed Installation Se iagr; Pit x Drain Field -- Depth of Ir,�let too -_- D;:r,th l; --o B-o--tto-m---of P•it or 1-rench----�-3-'---_ COMMENTS: - - -- - - -- -- ----------- ----------- -EQM-M.END._-A80UT,166 _sq. FT. OF PIT SURFACE PER BEDROOM* Test Performed BYE1DF _Uk._GEOLOGIST Date Cert ;Fd By • r �� H. -- -- -s - ---- ---- - -- ` Da.tn• Orr 16 1973 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 4lRONMENTAL UNICIPALITyOp ANCHORAGE SERVICES DIVISION OCT 21 1997 CERTIFICATE AP ROVALFOR A 3 SINGLE HEALTH FAMILY DWELLING RECEIVED Parcel I.D. # O I S 30 f o HAA # LD C� L -I R'S 1. GENERAL INFORMATION Complete legal description u G f; iso r- ke Location (site address or directions) g- 6 0 f l,✓ H r S /°=",t C S .'/1 u c Property owner D 01-t I Z- ' > f� Day phone Mailing address S C" L. cl si'<-,"��- Lending agency Mailing address Agent 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 Day phone Day phone 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 N21 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage T 2 1 1997 DEPARTMENT OF HEALTH & HUMAN SERVICMES Environmental Services Division �/ 825 L Street, Room 502 • Anchorage, Alaska 99501 • (9R7f4i Wf D Health Authority Approval Checklist Legal Description: i-0 i C� L K y S K y 24� L -H t Si . Parcel I.D.: A. WELL DATA Well type PA I V T IL If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/6) tv 0 Date completed v I 7 _ O rA JM N1 -C,.4 "S Total depth a 3 Cased to Lr 0 Casing height (above ground) Sanitary seal (ON) Y j 5 Wires properly protected (lit) Yrt j FROM WELL LOG AT INSPECTION / Date of test � / o r/ / s" f ti 7 Static water level .k Well production g.p,m. /-� • ? f g,p.m. `A A�' eas`RrcTed 13Y n�M� � /�i.✓r .lr. L WATER SAMPLE RESULTS: Coliform Nitrate U' 3 "% Other bacteria S & S ENGINEERING Date of sample: / %0.s' cy 7 Collected by: 17034 Ear=.le River Loop Road No. 204 Eagle River, Alaska 99577 B. SEPTIC/HOLDING TANK DATA ( i it `,'D S c I Date installed tI 1 *7 h 3 Tank size 10 Number of Compartments I Cleanouts &N) Y� Foundation cleanout (Y/0) Depression (Y/61' "` High water alarm (Y/LSI) �" a Date of.Pumping s_ I "17 Pumper Ns a r (1L' 4^' 0 C. ABSORPTION FIELD DATA 7/„-f/ k0 Date installed It /-+ / 3 _ Soil rating (g.p.d./ftz or ftz/bdrm) I Iv b System type-r� Length 1 Width I z Gravel thickness below pipe Total depth G '7 X. Effective absorption area _S- �- �- ZMonitoring Tube present (YIN) "4 f Depression over field (YIQ N Date of adequacy test ( 0 / 15- It q 7 Results (Pass/Fail) %)1) 5f For `f bedrooms !, - Fluid depth in absorption field before test (in.); nR y Immediately after 6/oar gal. water added (in.): 3 Fluid depth (ins) Minutes later: I $ Absorption rate = ° ti g.p.d. Peroxide treatment (past 12 months) (Y/N) tj u N 2 K. o w ,�) If yes, give date 72-026 (Rev. 3/96)* CT&E Environmental Services Inc. ztL Laboratory Division DrinkingWater Analysis Report for Total Coliform Bacteria 200 W. Potter Orive y p Anchorage, AK 99518.1605 lE,4D INSTRUCTIONS ON REYERSE SIDE BEFORE COLLECTING SAMPLE Tel: (907) 562.2343 Fax: (907)561.5301 MUST BE CON(PLETED BY WA �7 PUBLIC WATER SYSTEM I.D. M f6 PRIVATE WATER SYSTEM ER SUPPLIER to Send Results 0Y Send Invoice Collected "" NR gre River Loop Road No. 204 one. umVal, u,'Now :.Was n ic6 C. GrY )we Zp Ca ❑ Send Results ❑ Send Invoice iongam. rir - � araw't^ uu MW Mr w .(Y Zip Code SAMPLE DATE: lel 1=11 lJ 1J1 Montle Day Year SAMPLE TYPE: lg Routine O Repeat Sample (for routine sampler with lab ref. no..) ❑ Special Purpose SAMPLE LOCATION ; LJi jLK I SKY )Zd,"Co/ 657 Comments: ❑ Treated Water cir Untreated Water TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory ❑ Sample over 30 hours old, results may be unreliable ❑ Sample too long in transit; sample should - - not -be -over 43 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received (( Oo Analysis Began I ! 'i ` Analytical Method: Membrane Filter a N1b10-iVtUG ° Number of colonies/ 100 ml. Result* 97G395 Time Collected Collectaati I;y .10:6/iA'A ic6 C. rleew true 10,941 Analyst 14L— ich Fbks Jun Cl Faxed Due: Time: Client notified of unsatisfactory results: ❑ ❑ Phoned Spoke with Foxed Data Time: BAC'T'ERIOLOGICAL WATER ANALYSIS RECORD ,1fIb10-NIUG Result: Total Coliform E. Coli Membrane Filter- Direct Count(; ' % Colonies/100 mi Verification: LTR BGIF _ COLIFIR�IW rvrco ree,vmmvm a re Cmm Fetal Coliform Confirmatiow Final Memb n FI 1 0 Coliform/100 mi Reported 8 ■ts _ 1 (o'Cj Time hrs Member of the SGS Group (Societl Gdnlrale de Surveillance) ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNtA. FLORIOA, ILLINOIS. MARYLAND, MICHIGAN. MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA F A Rick Mystrom, Mayor v ie.fpalt r of .. r_c ora e Department of Health and Human Services 825 " L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 November 7, 1997 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 6 Block 4 Sky Ranch Estates #1 Waiver Request #WR970068, PID 4015-301-06, IIA970485 Dear Mr. Cowan: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 5 feet from the leachfield to the we5fi property line. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, T2.". � Donna C. Mears Civil Engineer On-site Services ljw #7 MUNICIPALITY OF ANCHORAGh Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR970068 PTD # 015-301-06 HA# HA970485 Permit # Date Received: October 22, 1997 Legal Description: Lot 6 Block 4 Sky Ranch Estates Subdivision_,A1 Engineer: Robert C. Cowan, P.E., S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska 99577 Applicant: Dori Linse weSfi Waiver Requested: Lot line waiver from the leachfield and the n2Lt%V property _ line of 5 feet. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: Date: lr g l By: Nanfe of Reviewer Rec #: 10-21-97 Amount: $_115.00 Date Paid: Oct 21, 1997 S&Sl ,ineentng October 21, 1997 ROBERT C. COWAN. P.E CIVIL ENGINEERS (907)694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 SEWER&WATER Anchorage, AK 99519 MAIN EXTENSIONS REFERENCE: Lot 6; Blaock 4; Sky Ranch Estates SEWER&WATER INSPECTION Request you issue a Health Authority Approval on the referenced property and grant a waiver for the horizontal separation distance between the leachfield and the property line at five (5) feet. ENGINEERING STUDIES AND REPORTS We do not anticipate any adverse effect on the adjacent properties (see attached asbuilt survey). WELL INSPECTION If you require additional information, contact us. & FLOW TEST please Sincerely, SITE PLANS Robert C. Cowan, P.E. RCC/gk ROADDESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 /v g� a 59.3- I,/ vng0 iZrvf,� --' 4 VJ ''r'ONYE' o'.L InE a'.��'I,.T ' � Y�y, •,r �? p ir) �P_.-�,.-�.-.•.'..:�.I...... ..... ,O } <<�•,.. IIIOMAS N. OrtCYF /( }; LS _ 7625 C) ..� 9, Lh-.aVa• i) oI• tl� . ......... }� 43vuld V.•Ro-JoIr '1- 101 NO. 4053.5 ro 0 A_/'O/FSSI011A6 `Pt�� tiv, n ra - c SVRVEY CERTIFICATION: I h.,eby taRry t S.y. '� N� that tenntd hell„ end Ih., the ImPrawm.nU IIlu.dd th.,av" !o U ' .nt,O.thm.nll vh111 other Ih.o noted. I vrpah nib 11l ly la dolermino the t/ o)i=6ccp nt +..ay rrst"Ir.la, coyvwts, LEGEND: SET ur rc'!rio!i+': wMdl do nol appal wo../a on III: I:'[PC.`;1 r.,'jTM;I?n plat. Un00r •ot'r rerPoni blifty to check top ny v!:<W1;tInmif, sll;ldd Cny. data p borcmi I:a uscd 41r concbuctlon or to, 0 WEST 0ENSON BLVD. ba6tUG5:;ui� bouuuary of Icuce Ilbn, HUD h TACK p 0 ovrr6p /v g� a 59.3- I,/ vng0 iZrvf,� --' 4 VJ ''r'ONYE' o'.L InE a'.��'I,.T ' � Y�y, •,r �? p ir) �P_.-�,.-�.-.•.'..:�.I...... ..... ,O } <<�•,.. IIIOMAS N. OrtCYF /( }; LS _ 7625 C) ..� 9, Lh-.aVa• i) oI• tl� . ......... }� 43vuld V.•Ro-JoIr '1- 101 NO. 4053.5 ro 0 A_/'O/FSSI011A6 `Pt�� tiv, n ra - c SVRVEY CERTIFICATION: I h.,eby taRry t S.y. '� mr that tenntd hell„ end Ih., the ImPrawm.nU IIlu.dd th.,av" rvrvvyad 1h. ",ap.,Iy rho.." "Id E, .,a wlthl" /t the 0,aa.y I, n., and "v .nt,O.thm.nll vh111 other Ih.o noted. NQtNG4ER�,P4ANNQRB URV�Y(7 PLEASE NOTE, It1, the aumhet LEGEND: SET FOVNO wo../a •ot'r rerPoni blifty to check top 5/0" ReVAR O p Il� -� - _S✓ 0 WEST 0ENSON BLVD. on In rrlot[on td HUD h TACK p 0 on,, a.• JCHOIIAGE• ALASKA 09503 562.5291 IrhoundHlon I pled. Md W11,11,.o tot- betkr oI I.l 1]*' to lot 'In" MONUMENT y AL,CAP rl) lL/ t • v and oid III V C, 1 <�,•,,, GAL OESCRIPT :'7- 11 QF AN /Y S01.1'r l:T i.)rlp L- q (l�.t•r f� /�• "I •r mr._ I Z) P. m* '(.11 I= S'I /1'17T W/ NAZI >t IRON PIPE t" ELEVS.• DATUM ASSVMEO �•'% M MUNICIPALITY OF ANCHORAGE Department of Health & Human Services r DIVISION OF ENVIRONMENTAL SERVICES M}i 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # HAA #�ry(,�Q/��% 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) I � , 8 4 1 SKY RANCH L- ST-. #I SEC 22, T 12 N, R3 W Location (address or directions) 5(D01 WHISPERING SPRUCE (b) Property owner DAVID 4- ?I NA HERMAN SON Telephone: (home)345-M2 Business Mailing Address 5(a01 WHISPERING SPRUCE (c) Lending Institution N. RA, Telephone ___2_7__G=1I Mailing Address NORTHERN LTS +"C" ST, (d) Real Estate Company and Agent ERA PROFE SSIQNFh LARRY ROSS Address 2702 GRMSELL Telephone 278 - 2 _7710 (e) Mail the HAA to the following address: (or check here A if hold for pick up.) List contact person and day phone number below: C.ALLARD � T. MooRE 3�S- (3SS 2. TYPE OF RESIDENCE Single -Family( Number of bedrooms 4 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 MUNICIPALITY OF ANCHORAGE (MOA) fiA C*)_ Health Authority Approval (HAA) C�I 1 KLIST - FEBRUARY 1984 j C1!1Au rY OF ,N1�I O AC3t843-4744 ENVIRONMENTAL SERVICES DIVISION Legal Description: L 6, 4 S'kN RAnIC9 E5 IVI I'Y 2-1- ]S)( Q A. WELL DATA k) I" C V I] I F rf Well Classification PR) VAT[ V L If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) _ NO _ Date Completed 1`173 _ Yield S+GPM M A.5 5117/90 Total Depth 2�3 Cased to .-->�D'_ Depth of Grouting Nr A Static Water Level Pump Set At Casing Height Above Ground 37 Sanitary Seal on Casing (Y/N) YE5 Electrical Wiring in Conduit (Y/N) YES Depression Around Wellhead (Y/N) NO SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 107 ' TO C.D. On Adjoining Lots 5 /Dp To Nearest Edge of Absorption Field on Lot �? 11c) ; On Adjoining Lots > 100 To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole �� •� To Nearest Sewer Service Line on Lot % 25 Water Sample Collected by T• F. ; Date 5/19 /10 Water Sample Test Results 0rolt�rs�.n /iac>�n E?_ o• l8 t -e n/frfe _�� Comments urin ct,,e!l (ow f 0e1'e over _raGG crallo�+s cr/ IAC mAx oeu."lle `44uF ad S q;pm Cczce,1e�< Me- c/ete ✓e l % !o ( 4::;(MCV0P C&cc.it /0 /9 / I 6 u / A Acf-f4 .v^ B. SEPTIC/HOLDING TANK DATA o0 Iq IIs S G Date Installed 11 7/73 Size 1000 G. No. of Compartments Standpipes (Y/N) YEs Air -tight Caps (Y/N) YES Foundation Cleanout (Y/N) N Depression over Tank (Y/N) 1 0 Date Last Pumped 12,bil81 VY Roro _ROoTbR Pumping/Maintenance Contact on File (Y/N) N -V • for N. R . Holding Tank High -Water Alarm (Y/N) H.A. Temporary Holding Tank Permit (Y/N) t' I• /} SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 107 FRoM C.O. To Building Foundation 28 To Property Line 30 ` To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments To Disposal Field W0 72-026 (Rev. 7/88) Front Page 1 of 2 J INVOICE QOY�C;aooy a ",,4ata y qo '7""&ea CLEANING SERVICE Douce Me Z)"t ", P.O. BOX 112688 / �PHONE 345-2613 ANCHORAGE, ALASKA 99511.2688 Job Address 7 jl L/ ATE SALESMA TERMS— DAY CUSTOMER OROERq ROTO -ROOTER SERVICE CALL HRS. STEAM THAWING HRS. TRIPCHARGE HRS. OVERTIMECHARGE HRS. ADDITIONAL LABOR CHARGE HRS. PUMPING SERVICE/ �n GALJ HRS. HYDRO-JETSERVICE HR -S. MATERIAL ® - PLEASE PAY FROM THIS INVOICE TOTAL TOTAL FOOTAGE CLEANED OR THAWED PROBABLE CAUSE OF STOPPAGE LINE CLEANED _ ❑ JOBNOTGUA. WORK ACCEPTED F t-LOWINGh BLADESUSED C e."z 315 Time APPLIG IT FILLS OUT UPPER HAL INLY Property Owner /GLS., .; �' ". Time AddressZip Date Code [PhoneMailing Buyer Date Inspector Inspector Inspector Address r Zip Codo✓�"- Lending Institution Institution 4"/ ' r -`� -_ Phone `"t - -�- /' Address Zip Code 'CONDITIONS OF APPROVAL Realty Co. & Agent ,'; , . � : '�.; .. - 1, J ` - -.., -f ... / % . ,; -,<_,' -. Phone Address _-'}E / ��r=! ( �i,'.' .,� / ., ,� ,�-`. Zip Code BY: Legal Description Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Street Location -6,- Well to Tank Type of Residence Type Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply ,, Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that dale, give well depth (attach log if available). ❑ Public Utility Sewer Disposal Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. C e."z 315 Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: MUNICIPALITY OF ANCHORAGE , -T C^ FNVI; � d I - t.. .O F ) RECEIVED ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE o �� BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72023 (31821 ALASKA RIROn HTAL COnTnOL SRICCS, Inc. engineerinq & 6nuironmental Studies MUNICIPALITY OF ANCHORAGE ENVh' -I! RECEIVED July 1, 1982 Department of Health and Environmental Protection 825 L Street Anchorage, Ak. 99501 Dear Les: On July 1, 1982 1 inspected the well and tools a water sample for the house on lot 6 block 4 Sky Ranch Estates. This house is located on Whispering Spruce. The well has a seal and the casing stands approximately one foot above the ground. The electrial wires are not enclosed in metal conduit. The sewer system has all caps on the standpipes. The results of the bacterial test for the water is attached. It was satisfactory. Sincerely, L r.oy Reid Jr., PhD, PE President \a9p 1220 West 25th Auenue 9 Anchorage, Alaska 99503 • (907) 276-1361 CHEMICAL & . G TELEPI � R I �OGICAL LABORATORIES ANCHORAGE INDUSTRIAL `,' 5633 B Street f ALASKA, INC. 1 �^'°^^ro^•• Drinking Wa er Analysis Report for Total Coliform Bacteria TO BE COMPLETED BT WATER SUPPLIER TO BE -COMPLETED BY LABORATORY i I WATER SYSTEM: Analysis shows this Water SAMPLE to be: / 'I.D. NO. ;,Satisfactory ��"i` J ❑ Water System Name : Phone No. Unsatisfactory /220 2 �1j r A I I '� fJ� Sample too long in transit; sample should not be over 48 hours ,old at examination Mailing Address f� —� `� V (�77, to indicate reliable results. Please send ��1()1-a e/ / I Id� � � �/ 7�� new sample. ! state SAMPLE DATE: 1= I t I =i Z Mo. DayI Year SAMPLE TYPE: Routine Check Sample (for routine with lab ref. no. _ ❑ Special Purpose SAMPLE NO. 1 2 3 4 5 I "Cl Treated Watery" Untreated Vftter LOCATION i" C Tl e , READ INSTRUCTIONS 1 BEFORE COLLECTING SAMPLE Collected By tr n' Date JRecelved Time!Received . 1700 Analytical Method: i ❑ Fermentation Tube Membrane Filter L.ab Ref. No. Result' Analyst li r ® .D S L I m .. 9 L —_j .No. of colonies/ 100 ml or No of Posnwe portions 06.1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Ray. 1978 Data Data Received / Source--- 2. ource___■. M. Time Received —...,. .... ..— Presumptive 10ml SOmI lOml loml 10_ml 1.0ml 0.1ml 24 Hours — 48 Hours Confirmatory 24 Hours ' 48 Hours LM 11— Multiple Tube Report: Membrana Filter: Direct Count Verification: LTB Final Membrane Filter Results_ Reported By Broth 24 hours: Broth 48 hours: e 20ml Tubes Posltiva/Total,10MI Portions • Coliform/100m1 1 a Coliform/100ml a.mP.m. INSPECTION APPOINTMENTS DATERECEIVED — - ' TIME TIME TIME DATE DATE DATE INSPE OR INSPECTOR INS -Z PECTOR C' COMMUNITY ICIPAL MUNICIPALITY OF ANCHORAGE DEPT.I OFOF ALN i O RAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECOOMONMENTAL.. PkOTECTION 825 L Street - Anchorage, Alaska 99501 - ENVIRONMENTAL SANITATION DIVISION 0-C 71979 0* Telephone 264.4720 RECEIVED 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. PROPE/R/7TTYOWNER H(O�NrE MAINGADDRES 6r PROPER Y ESIDEIVT (lf ferePnt from ab/o�ve) ] n �` /� yPHONE (� 2. BUYER PHONE 0-0>)e MAI LI NG ADDRESS 3. LENDING INSTITUTI IN ;� PHONE CT�S�Cz 4.501y,�p( MAILING ADDRESS 4. REALTOR/AGENT � PHONE MAILING ADDRESS EGAL 0-/ & 6zon ET o. 1 YPE OF RESIDENCE l SINGLE FAMILY ❑ MULTIPLE FAMILY 7. WATER SUPPLY INDIVIDUAL* ❑ COMMUNITY ❑ PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM Xl INDIVIDUAL/ON-SITE** ❑ PUBLIC UTILITY NUMBER OF,BEDROOMS ❑ One Four ❑ Other ❑ Two O Five ❑ Three ❑ Six *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) /!i 2,8—YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 00c:e1W)er ll., 1979 Hary La Rose Star Route A Box 1029,'. Analrorage, Alaska 99507 Subject: Lot 6 'lock 4 Sky Ranch EstatOS, Subdivision 1#1 �p*roval for Yolxr :i.rzeUvidUal sower rand water fcrc;.ilx.ties can not lae granted until the fc,llowing itol-as 11,�ve r.)een completed (1) The water analysis report tie deliverecl 1.o t:hise oEfic;e± froM ChOm 1,41?, 5G,33 'i Strce3t, for our review. (2) The: septic tank puzripecl with a receipt sa b-mitte e to tilis Office. (3) M adequacy test be% Parforaaed on the exi'stinq leaching area. This test will determine if they eystem is adequate according to _,, ational Standards. A, listing of: private firms performing the t=est is encloser't. (4) Your application shows the number of bedrooms excc,?e ds the number the: sewer syste=m Wats oa: iginzlly Olosigned for. A 500 gallon Septic tank will need to be addled to the exist:ing 1.000 gallon septic tank to meet the requirements of a four(4) bedroom sin(lef3I_gily dYyelling. If there are any furthear questions, ?�1eaSe contact this office at 264-•4720. f 1inc.erely, Robert C. Pratt, R.S. Associate Specialist RCP/J. jw Cc: Alaska frank of Conrierce Pouch 7-012 99510 rANCHORAGE AREA BOROUGH of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: "I to -t0 fe. J Mailing Address: Phone: 3 3zo 2. Property Owner: ; _ Phone: �( Mailing Address: 3. Legal Description: 4. Location: 5. Type of facility to be inspected No. of bedrooms 6. Well Data: i A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: A. Installed iB. 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 -A Absorption area /00 jrt Sewer Lines i 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 Page 2 of two pages - Re�__:st for Approval of Individual '- ,er & Water Facilities Legal Description Comments A Date Approval Valid for one year from date signed Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* E. SEPARATION DISTANCES Size in "Pumu.en�T—evel at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /00 `4 Absorption field on lot c f Public sewer main Sewer /septic service line N/4 S 1 / "Pump off" level at* On adjacent lots I U On adjacent lots / f Public sewer manhole/cleanout N 1,q Lift station ,V /.4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation J I+ Absorption field Property line ''� S r� Water main/service line /� r i Surface water/drainage NJ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation to Water main/service line Surface water / 04D Driveway, parking/vehicle storage area �v0Nf �cNc1"o /--J ioa `-t Curtain drain Wells on adjacent lots F. ENGINEER'S CERTIFICATIONoF I certify that i have determined thru field inspections and review of Municipal recorc#,I "tJltk-1we -abov s are in conformance withpyA gui lines in effect on this date. c9 'r '" Sign Engineer's Name ��� z' a�' if i ROBERT C, COWAN f,r� E-8801 Date / �.�1 / 7 7 B�c',••C�``�M�° HAA Fee $ �v , !/0 Date of Payment r� Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number 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 (7 `) y - } Cl 7 / 17034 Eagle River Loop Road No. 204 Address uacile River, Alaska 94677 Engineer's signature 6. 7ZHHSIGNATURE Approved for Disapproved. �oy2- bedrooms. Conditional approval for Additional Comments C Date / o/ a ( /2 7 bedrooms, with the following stipulations: Date J . �- 9 7 - 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 courtesyto purchasers of homes and their lending institutions in orderto satisfycertain 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 engineers work. 72-M (Rev. 1/91) Back MOA #21 C. ABSORPTION FIELD DATA -r Remcli Soils Rating in Absorption Strata (/13 DR Type of System Design SEEPg6e' F r Date Installed FIT', 11/7/73 TRuµctl V14lgo Length of Field PIT - II ' TR6u(tt 7C Width of Field Fir -, (z^ TRLv),-cc�+'' 3 r Depth of Field P)T', )2, RAnccN Ll Gravel Bed Thickness p)r' R I Pe-�-( Square Feet of Absortion Area FIT; 5s2 ❑r -rReu+:67Z Statndpipes Present (Y/N) qE5 Depression over Field (Y/N) No Date of Last Adequacy Test S /17 /go Results of Last Adequacy Test Adeoua fe or y btdt-por r SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well To Building Foundation Lot 114 -M To Water Main/Service Line 25 To Property Line ID To Existing or Abandoned System on r On Adjoining Lots 7 3 0 To Stream, Pond, Lake, or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION N, Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments To Cutback (if present) 'OD Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) r4 -A, Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA�g 11V%fk�n effect on the date of this inspection. 4C oF° A4 -v Signed—u- �f 7'� «� , • r��� Company F(c—cA o Tedin',c�� f �' Ser�<<ar °��, L a "•�,t h °° •° °°••°°•°•°••°•°• °t� Engineer's Seal Date S/ r / 9 9 i3 MOA No. i O _ �� t' Ti Lo,o:::aE F. 'dore° • �I Cl-- 3539 Receipt No. Date of Payment Amount: $ 120.0-0 eceip o. Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 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 FLAT70P TECH, SVCS Telephone 34S- 1356 - Address 14530 c-ci4o s -r, ANCN- Ak ggsl& Date q 0 Fr IA, ........................ °° pI// F� °Y e. l° o . • 6666. , t} • 'f�iEO.Gi:E F. ,pp2'e ,' Engineers Seal 6. DHHS APPROVAL X p, Approved for .-bedrooms b �'��'�� �—� Date Approved Disapproved�—Conditional Terms of Conditional Approval ' " 61 " CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS _ ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified - PERMIT NUMBER DATE INSTALLED INSTALLER ❑ Septic Tank or ❑ Holding Tank Size: 1000 If Tank is homemade give dimensions: SOILS RATING t TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: 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 72-010 (Rev. 6/79)