HomeMy WebLinkAboutMOUNTAIN AIR ESTATES #1 BLK 6 LT 3, U " 'w�✓ folk{A :ga o NEI Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191013 PID Number: 017-211-05 Dwelling: ❑■ Single Family (SF) ❑with ADU ❑ Duplex(D) ❑Two Single Family Project: ❑ New It Upgrade Name William & Jamie Kattness ABSORPTION FIELD Site Address ❑ Deep Trench ❑Wide Trench ❑ Bed ❑ Mound 6736 Cloudcroft Lane *Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-230-3787 3 GPD/SF Ft. ttt���... LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Ft. Ft. .•1 Mountain Air Estates#1 6 3 Fill added above original grade Gravel length S Township Range Section Ft. Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. 'T To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches ��� From Tank Field Lift Station Tank Line FP Ft. Well 100'+ - - - - TANK ❑Septic ❑� S.T.E.P. ❑Holding 0 Other 'f-, Manufacturer Capacity T Surface Water 1004 - - - Anchorage Tank 1250 Gal. —F- Material Number of compartments q Lot Line 5'+ _ _ - NA Steel 2 0 Foundation 10'+ - - - LIFT STATION Manufacturer Capacity Remarks Old tank decommissioned per UPC per contractor Anchorage Tank 416 (STEP) Gal. C Alarm location Electrical installed by 3c Ola;'I4c✓'°`t P„,'I” GA 95 To A-) - PIPE MATERIAL House to tank Existin Tank to Eit;g drainfeldxsInstaller A+ Home Services Drainfield Existing cc/MT D3034 Inspector BENCH MARK (Assumed elevation) 100.00 ft Inspection 1s' 1/21/2018 2b - Location and description d3'l - 4th - Bottom of Trim at Northwest Corner of Home ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 4p6p\`.1/4 Conditional Approval: Date oo�� 0F I ��Si4d o )1,- ..- --00 i :• •• • •••. •••• .......0 Septic to e OO -73 •• f r ,A. Gar mss. Approved j .... 414 Date 1—D-2-17 009• . -795 .it Note: this approval does not include well permit requirements. #AEcces%pDOO000\ (Rev 05/02/18) PERMIT OSP191013 RECORD DRAWING PARCEL ID NUMBER: 017-211-05 / A B C \ —'' ST1 37,1 10.3 25.6 \ ST2 43.7 16.5 26.0 I MH 456 18.3 25.8 I WELL RADAII AND LOT LINE WERE NOT \ — 'I o �PNE PROFESSIONALLY SURVEYED PRIOR TO ..------- �` G�OvDC CONSTRUCTION AS STATED ON THE DESIGN. -' WELL RADAII WERE PHYSICALLY MEASURED BY THE CONTRACTOR A+HOME SERVICES 100 --- •1*.'‘.ELECSR1G�S Ni ---- .-- \Q,'" MOUNTAIN AIR ESTATES#1;BLOCK 6,LOT 4 • s'. I �e, I LINED IDSF - - / i"•. NEW 1,0 GALLON STEEL STEP TANK MOUNTAIN AIR ESTATES#1;I •: BLOCK 6,LOT 2 ll ', ••. 4/ EXISTING FCO I 7.':::;..:.**;44 / i N • \ .. DRIVEWAY EXISTING i F ???• •` .. .• BEDROOM H0 SE I100' ELL RADIUS • il CLEANOUT IS NON-FUNCTIONAL FOR ITS PURPOSE;PER DISCUSSIONS \ / WITH MOA ONSITE EMPLOYEE TIM ECKLUND ON 1/22/2018,REPAIRING THE - / CLEANOUT IS NOT REQUIRED AS THERE IS A CLEANOUT ON THE NORTH ..•••"" \SI'N S END OF THE FIELD AND EXCAVATION WOULD REQUIRE THE REMOVAL OF / Gs N THE RETAINING WALL AND REPAIRS TO THE ASPHALT DRIVEWAY / SNP / -•J'c' ' \ SCALE: / ..---- \ 1"=.40 N. • GARNESS ENGINEERING GROUP, Ltd y . 4/21 " '' *�'• ENGINEERING ,SALES CONSULTING - C • 3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE,AK 99507•PHONE(907)337-6170•FAX(907)335-32,6• .AB SITE w.'w.pamcsseipv+eeri+p corn / / PREPARED FOR: � {{{ tt. � PHONE NUMBER: PAGE NUMBER: �• J ey Garne ./ = WILLIAM&JAMIE KATTNESS 907-230-3787 LEGAL DESCRIPTION: DRAWN BY: •.♦ �'I �i MOUNTAIN AIR ESTATES#1; BLOCK 6, LOT 3 D.J.G. CP• N •••�• Z�j Je.� F, TYPE OF WORK: • e.Jl SEPTIC TANK RECORD DRAWINGS DAT 1/28/2018 #LICENSE ECC86f,1,���„wl,P+���� • PERMIT NUMBER: RECORD DRAWING Y V I N G PARCEL ID NUMBER: OSP 191013 017-211-05 • FINAL GRADE=99.83-100.23 TOP OF MANHOLE ELEVATION=99.74 TOP OF TANKSTl MH AT INLET=94.87 C c TOP OF TANK AT OUTLET=94.87 1 INVERT OF BUNG NEW 1250 GALLON AT INLET=94.27 STEEL STEP TANK 10'MAX BURIAL `i I •° # ..vi\t•\\\141 oafirve 4. . .. .0.- '7,4 ' ':„., • .. GARNESS ENGINEERING GROUP, Ltdff4i1 1 �ENGINEERING SALES CONSULTING / ` 1✓ i 7701 E.TUDOR ROAD.SUITE 101•ANCHORAGE.AK 99507•PHOT (907)1374179•FM(007)176.3146•Y.EESITE:wen.gar.1I ngh..m0.ccm 0 �; / ' 0 PREPARED FOR: f PHONE NUMBER: PAGE NUMBER: ' WILLIAM AND JAMIE KATTNESS I 0 y^ /Jeffrey A. mess .' i 907-230-3787 3 OF 3 11•0 f '/ 9E-79q3 m LEGAL DESCRIPTION: DRAWN BY: �%J`I'• �� MOUNTAIN AIR ESTATES#1; BLOCK 6, LOT 3 D.J.G. ..F�••••• IiZ.3/1 1...‹C jr . TYPE OF WORK: DATE: its co p••••••• •• P� •• SEPTIC TANK PROFILE 1/21/2018 LICENSE �4� ;;SS\T�• #AECC884 / MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO BOX 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http:1Avww.munj.org1ons1te • `- Permit Number: OSP191013 Work Type: SepticTank Upgrade Tax Code Number: 01721105000 Site Legal Address: MOUNTAIN AIR ESTATES #1 BLK 6 LT 3 G:3139 Site Mailing Address: 6736 CLOUDCROFT LN, Anchorage Owner: KATTNESS WILLIAM A & JAMIE J Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of. 2MR-m- IA73,��. Lot Size in Sq Ft: Total Bedrooms: 1/1712019 1/17/2020 0 Disposal Field P1 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15-65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 017-211-05 Property owner(s) WILLIAM AND JAMES KATTNESS Day phone 907-230-3787 Mailing address 6736 CLOUDCROFT LANE *ANCHORAGE, AK 99516 Site address 6736 CLOUDCROFT LANE `ANCHORAGE, AK 99516 Date of Payment: Legal description (Sub'd, Block & Lot) MOUNTAIN AIR ESTATES #1; BLOCK 6, LOT 3 Date of Payment: Legal description (Township, Section & Range) �.fa �� Lot Size Sq.Ft. Number of Bedrooms 3 Permit No. APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (13 all that apply) Initial ❑ Single Family (SF) Absorption Field ❑ Upgrade ® (w/wo AD U) Septic Tank ® Duplex (D) ❑ ElRenewal Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: N/A Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: d I II �`I -! Date of Payment: Receipt Number: �.fa �� Receipt Number: Permit No. Waiver No. (Rev. 01/11) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191013, Rebecca Carroll, 01/17/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191013, Rebecca Carroll, 01/17/19 M LQ --j LLJ > UJ < Z Q 0 < - 10 z , x x 00 w z Ltj C', Lu < 0 CL a ul U-0 (x dc Lo T Yb - b (1) a_ 0 w 0 z > t E> L,U 0 Y5 co z: cr- 5 tz E d z uj < P < UJ Z Z (1) 0 z >, Z Z 0 �E z Q tj- — ::) (-) uj p 0 ui > Z 0 w o ui W- cl: V < 7- Q� T �- ac UL 0 Ct 0 €- < LL, cowm C) MQ 0 Lli 0 UJ m U-0 Z 5.4, < � E a IL FM L, LU L w rl%� 0 C4 LU ijM: uj < .'a Ul UJ a- Lu x m 2 vi ir tn W > a V) LA X LIJ Ln wn z f- k -j LU :) 7 Lu nc f� uj:z) +- or > t A 00 = uj -j a. 1- 0 LU vi LU V) U., LA =90 m L" reel �- I '(III, � en C) Ln F- uj 7- vi 0 0 0 " C) �d 'i Lrl w W. uj X (-I C4 , 2, m w T 7-1 0 0ul w U,I-Q W0�i wv1z = W-jw= -j w z Ln M:D 0 z I-) =1 z Ce- kA LU LA w u z > < uj EL t� ti) W LU m uj Ln Ci p- 0 > Municipality of Anchorage Page / ,,, of "~t',,, 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: '~J c~~°O ~-~ ~"' PID Number: ~/~- ~1~ -~ Name: ~1~ ~&~~ ' Wastewater System: DNew ~ ~pgrade ~'": G~ ~ C~o~ ~ ABSORPTION FIELD ..... Phc'ne: 3~ ~9~/ ~ NO. of Bedrooms: -- ~ ~ Deep Trench ~ Shallow Trench B Bed ~ Mound,, ~,, Other, ' Tots Depth from ~flglnal LEGAL DESCRIPTION ~o~, ~... ~ ~,~/s,. ~. ~' ~ Lot: ~ Block: ~ Subdiv~lon: Depth to pipe bottom from original grade: Gr~vel depth beneath pipe Township: ~ Range: Sect,o ~ / Fill added ably} or~ina, grade: Gravel ,ength:~, ' Gravel w~dth: ~ I Number of lines: D;iia~ ~F~lin--; ~, a New ~ Upgrade / ~'~ Ft. I I ~,~ Ft,, Classification (Pri~ Tota~ ~d To: Total absorption area: Pipe materlal:~ ~ . . . Yield:~/ GPM IPump Set at: Ft. c.~,., n.~;:. TANK SEPARATION DISTANCES a s.p~ic ~ Ho~di.~ TO Septic Absorption Lift Holding Public/Prlvst~ Manufacturer: Capacltyln gallons: From Tank Field Station Tank SewerLines ~C~ ' ~1~ / / Material: Number o~mpaA~ents: Su,'.ce ~ ' od ~ ' .... Water >lO >1OO >J >1~ Air I gl~llv,~ , , Lot /~ . Foundation ~ i, i~1 ~1~ ~ ~ "Pump on" level at: [~ t-~ [ "Pump off" level at: ~$t~ High wa:ar alarm at:.~lt Pump Make & Model ~ Electrical Inspections pedormed by: Drain. "' Remarks: ~ ~w~ ~~ ~~ BENCH MARK A~um~ E e~tlon= ENGiN~;S SEAl. Inspectionspefformedby:~ ~~$ ,Dates:lst ¢ '~ _. Depadment of Health ana'~ ~e~iuman ces approva~ '~,'~:'.Z -." Reviewed and approved by:~~ ~ y~ Date: V-~-?7 72-013 (Rev. 9/91) MOA 25 SW960~7~ PID~ 017-211-05 AS-BUILT EDGE OF ISF IS 1'+ FROM WELL NEW 1250 GALLON STEP TANK EQUIPPED WITH PROGRAMMABLE DOSING AC BC AE BE FH GH FI G] FK GK THE AIR LINE FROM THE HOUSE TO ;iTHE TRENCH IS 1/2 INCH \ ~plA., SCM 40, PVC, INSULATE)] WITH I72 INCH FOAM PIPE WRAP (R3> I~SIDE A 2 INCH, SCH 40, PVC JACKET. THE LINE IS BUt~IED AT LEAST 2 FEET DEEP. -'~ GENERAL LOCATION DF ~ RERDUTE~ WATER 16.5 30 18,2 ~ ' 8,9 25,5 10 25 IB 43,8 46,8 4 INCH PVC (D3034) ~;EWER LINE TO DRAINFIELD, NO JOINTS WITHIN 10 FT,-~. OF WATER LINE PER EXCAV^TOR.~ / / / / ~NEW DRAINFIELD. 7'x14' + 5'X2'X6'X~' ~ 9'X3'Xg'XS'. SURFACE AREA = 145 SQ FT. EFFECTIVE ROCK DEPTH = 1.25 FEET. -MT 'J' ISF BED -MT NH 'I'- '--C/O 'E'~ HOUSE GARAGE = 100.00 1.25' L 'H' AIR COMPRESSDF IN BASEMENT SEPTIC UPGRADEI PREPARED FOR: PREPARED BY~ DATE: LOT 3, BK 6, MOUNTAIN AIR #1, JIM ARMSTRONG ALASKA WATER & WASTEWATER SERVICES 6/22/97 DRAWN: GARNESS SCALE~ 1' = 20' -7953 ..' I8' x ~0' ISF INSULATED BOX 1 INCH PVC ~ V/ITH ORENCO PVC LINER, HEADER.// PRESSURE PIPING DESIGNED ~ BY ~RENCO, AND SUPPLIED : I : i , ~ I ~ ~ 4 INCH DIA, MONITORING t,e5 INCH PVC ~ % LINE FROM THE '~ STEP TANK, , \ · TUBE AT EACH CORNER, AIR LINE COIL i i ! i i ! ·/ FLUSHING VALVE , i i ~ ~ (TYP), BURIED W'~TH SPACED AT APPPRDX ~ J ' REBAR MARKER, P FEET, ORENCO--/ I ~' it ! "~'ASTEFLOW" TYPE x,,~/ ANCHORAGE TANK, ~ r----3/4' PVC LATERALS /INVERT ~ 102,55+ 2' OF INSULATION BOARD /8' COVER OVER TOP~-ON TOP & SIDE§, / r-FILTER FABRIC / AIR LINE 6' ABOVE / ! F]VFD PFA / X / / / / /--GROUND OVER ISF: 105,85 -.~ MIN, COVER = 2,0+ 6" LAYER OF 3/8' PEA GRAVEL~\ / / / ~ FEET OF FILTER SAND, WITH THE PVC LATERALS BURIED \ / / / QUALITY SAND & GRAVEL, SIEVE ATTACHED, TBP OF SAND AT 1083 BEDDED IN DRAINROCK, P' OVER /---8,4 INCHES OF PEA GRAVEL BELOW SAND FILTER, TOP OF THE PIPE, INV, = 99,8 BOTTOM OF PEA GRAVEL AT 99,6 SEPTIC SYSTEM UPGRADE : LOT 3~ BK 6~ MOUNTAIN AIR EST, DATE: ~/ee/a7 DRA~N~ GARNE$S ~CALE: NTS GROUND ELEV, : lOS (APPRBX,) /--TOP OF LID 103,06 ~DVER OVER TANK = 4.3 FEET, ~PPROX. ~ NEW 1~50 GALLON STEP TANK. L85 INCH PRE~SURE ANCHORAGE TANK. PVC LINE FROM HOUSE LINE TD ISF INLET ELEVATION = TANK SET LEVEL~ WITHIN .D3 FT, FOR LOCATION DF M.T SEE PLAN DRAWING DVER GRDUN~ ELEV. TRENCH ~ 99.1+ ~ ~ FILTER FABRIC OVER ~RAINRDCK - m E. TOTAL EFFECTIVE ABSORPTION AREA = 145 SO, FT,+ :~ , , BENCHMARK I~ GARAGE FLOOR, ASSUMED ELEVATION = 100,00 3' TD 7' PREPARED FOR: JIM ARMSTRONG ~~." PREPARED BY: ALASKA WATER & WASTEWATER ~.~..~ DATE: 7/82/97 DWN' GARNESS SCALE: NTS 010 P~i _T LIIq-- ~ ~,-- 9 ? T H U lk4ARK HANSEN P.1Z. May 15, 1997 Project 9717 f~mmer, AK 99~,~5 Gentlemen Group A. Group Goeffio, ier~t of G~Jrvauare~ G,: ','.~ 8 85-100 0-5 4 f,,A axirv~u m 45 Maximum -13,¢~j_~.-~CI:IqlC.->ENL.-JSe,&J. IqMi-li3 91:: ~.0 AH./. Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 July 9, 1997 Jeff Garness, P.E. Alaska Water & Wastewater 8741Brookridge Drive Anchorage, Alaska 99504 Subject: Waiver Request for Lot 3 Block 6 Mountain Air Estaets #1 Waiver Request #WR970036. , PID #017-211-05, HA970260 Dear Mr. Garness: 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 t foot from the property line to u the absorption trench to the east. 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, Daniel J. Rot~ On-site Services ljw #7 Armstrong MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ ~ PID~ 017-211-05 HA~ HA970260 Date Received: June 30, 1997 Legal Description: Lot 3 BLock 6 Mountain Air Estates #1 Engineer: Jeff Garness, P.E., Alaska Water & Wastewater Permit 8741Brookridge Drive, Anchorage, Alaska 99504 Applicant: Jim Armstrong Waiver Requested: Lot line waiver of 1 foot from the propertyiline to the absorption trench east 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: 5~ ~ E~L.!~ ~; Date: 7- -77 By: ~/ Name of Reviewer Rec =: 02787/0367 Amount: $ 115.00 Date Paid: June 30~ 1997 Alaska Water & Wastewater 8471 Brookridge Drive - Anchorage ~ Alaska 99504 Phone (907) 337-6179 - Fax (907) 338-3246 Consulting Engineers June 22, 1997 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Septic System Lot Line Waiver for Lot 3, Bk 6, Mountain Air Estates To whom it may concern: During construction of the septic system upgrade for the subject property, it became clear (after the lot lines were flagged by a land surveyor) that, in order to stay 100 feet from the well (and ensure a slight factor of safety), it would be necessary to push the ISF box as close as possible to the lot line. Jim Cross was contacted on 6/11/97, and after discussing the situation, granted us verbal approval to place the ISF approximately 1 foot from the lot line. As can be seen from the original design submittal 100 scale plan, the property line in question borders an undeveloped lot. There are no existing wells or septic systems that will be affected by this encroachment. I am unaware of any adverse impacts associated with this waiver. It is my recommendation that the subject separation distance (ISF box to lot line) be waived from 5 feet to 1 foot. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank you for your assistance. ~~Sincerely,~ ~ ess, P.E Prindfp~tl U ~DXL ~?ELL LOT 5 AN~) ~Y~TEM, RATED AT AREA VACANT EPTIC AREA-7 LOT '7, ~)K 6 S£PTZC PRIVATE WELL AMA ~ ~EPTIC NO BROUND TM 1~ FEET. ;/ELL L~T 4, ~K VACANT SEPTIC UPGRADE~ PREPARED PREPARED DATE' LOT 3, BK 6, MOUNTAIN AIR JIM ARMSTRONG ALASKA WATER & WASTEWATER SERVICES 12/I5/96 DRAWN, GARNESS SCALE' 1' = 100' PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW960375 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NAME:ARMSTRONG JAMES K & OWNER ADDRESS:6736 CLOUDCROFT LN ANCHORAGE, ALASKA 99516 PARCEL ID:01721105 (UPGRADE) PERMIT DATE ISSUED:12/16/96 EXPIRATION DATE:12/16/97 LEGAL DESCRIPTION: MOUNTAIN AIR ESTATES #1 BLK 6 LT 3 LOT SIZE: 24852 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISO, · ~ RECEIVED BY: ISSUED BY:f~(j~_~' ~f ~~ Alaska Water & Wastewater December 15, 1996 8471 Brookridge Drive ~ Anchorage ~ Alaska 99504 (907) 337-6179 - Fax (907) 338-3246 Consulting Engineers Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Seclion P.O. Box 196650 Anchorage, Alaska 99519-6650 Attn: Dan Roth Ref: Revised Design. Sewer Upgrade for Lot 3, Bk 6, Mountain Air Estates. Dear Mr. Roth: As directed by your department I am modifying the previous design to utilize a lined Intermittent Sand Filter with a secondary drainfield, rather than a Bottomless ISF. The design is summarized as follows: 1. INTERMITTENT SAND FILTER DESIGN: a. Allowable Application Rate for ISF: 2 gallons/day/fi2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 225 fi2 f. Dimensions: 18' X 20' (standard M.O.A approved configuration) g. Effective absorption area = 360 fi2 (>225 fi2 OK) j. Air Supply: Thomas Industries, Model 5070, Supplied by Anchorage Tank. k. Air Supply Line: "Wasteflow' emitterline, 1/2 inch I.D, 120 feet total length. Supplied by Anchorage Tank. Same type used in intermittent sand filters. To be placed 1.5 feet below the top of the sand layer. 1. Sand Material: Central Paving Products "Winter Road Sand" The design & construction will be per the standards outlined in the "Intermittent Sand Filter Design, Installation, & Maintenance Manual", M.O.A. Please specify if there are any design or component changes your department has implemented since this manual was published. We are proposing to use a conventional 1250 gallon lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed. 2. DRAINFIELD DESIGN: a. Percolation Rate: 11.7 minutes/inch b. Application rate: 4 gpd/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 112.5 ft2 f. Effective Depth: .5 feet g. Width: 5 feet minimum h. Length: 30 feet. i. Effective absorption area = 150 ft2 (>112.5 ft2 OK) For the revised design, the old trench will be abandoned in place, rather than be used as drainfield area. The new trench will be constructed by excavating into the insitu soil, to an elevation of 94.5 (3.4 feet above the water in TH #2), and constructing a shallow, five foot wide trench. The trench will be 30 feet long. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system components. 4. TOPOGRAPHY: See the 1' = 30' site plan for topography information. There are slopes in excess of 25% within about 25 feet of the new trench. The existing trench has been approximately 15 feet from this cutbank since 1983 and it has yet to daylight (based upon my observation of the site). The homeowner has not mentioned any daylighting problems either. In short, the potential for future problems appears to be minimal. 5. SEPARATION DISTANCE FROM NEW TRENCH TO FOUNDATION: The new trench will only be about 5 feet from the slab-on-grade foundation. The existing trench (at the east end) is against the foundation and has been there for approximately 15 years without causing any problems, per the homeowner. There is no foundation drain which could collect wastewater and allow it to daylight~ Based upon these facts it is reasonable to assume that the 5 foot separation distance to the foundation will not cause any problems. 6. RELOCATION OF WATER LINE: The existing water line runs directly through the area in which the new trench will run. We are proposing to reroute the line (copper) around the north side of the deck and into the basement. The ISF gravity discharge line will run directly over the new water line. It is anticipated that the vertical separation distance between the sewer line and the water line will be approximately 5 feet. In order to minimize the potential for cross contamination, there will be no sewer line joints within 9 feet where the sewer line crosses over the water line. 7. CLASS "B" WELL ON LOT 2, BK 6, MOUNTAIN AIR ESTATES?: Per a previous septic upgrade design, submitted to DHHS, for Lot 2, Bk 6, the well is a Class "B" system, with a protective radius of 150 feet (should be 200 feet per ADEC regulations?). I contacted ADEC and asked them to verify the status of the well. They indicated they have documentation showing it to be a public water system. Furthermore, if it was a public water system, the septic system would also be under ADEC jurisdiction. Since the recent septic upgrade was approved by DHHS I am assuming that the well is classified as private. 8. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (5th floor, 9th & L St.). 9. SEPARATION DISTANCE FROM ISF BOX TO LOT LINE: I am unsure of what the required separation distance is from the IFS box to the property line. Is it classified like a tank, or a drainfield? Please specify the requirement under the special provisions section of the permit. There is room to provide 10 foot separation if necessary, however, a 5 foot separation would be preferred. 10. CLOSING: Given the site restriction, and the soil/groundwater conditions, 1 think the ISF is the most viable option for this lot. I am open to any suggestions from your department which would be an improvement to the proposed design. Clearly, this is a case in which we are trying to do the best we can with a marginal site. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank you for your assistance. Sincerely, Jeffrt~/)[. Games,, P.E~.,M.S Owher/Consultant Jim Armstrong Revised Design Package.wps LOT ~ AND ~Y~TEM, ~OIL ~ATE~ AT ~6 LOT 1, BK VACANT -- LOT 8, OK,5 PV~ WELL & '~PTIC, ~DIL RATED AT 850, SEPTIC ARE~ AREA LOT 3, PVT, WELL SEPTIC, RATED AT WELL mWELL ,~PRGPD~E9 EPTIC AREA~ LOT 4, BK 6 VACANT LOT 9, DK 6 PRIVATE WELL & ~EPTIC NO GROUND LOT 10, ~K 6 TO 1~ FEET, ~EPTIC AREA LOT 7, 3K 6 VACANT WELL WELLm LOT 5~ VACANT LOT 6, VACANT SEPTIC UPGRADE' PREPARED FURl PREPARED BY' DATE' LOT 3, BK 6, MDUNTAIN AIR #1, JIM ARMSTRDNG ALASKA WATER & WASTEWATER SERVICES 12/15/96 DRAWN' GARNESS SCALEI 1' = 100' ' A. Gorness CE-7953 SLOPE POOR SnILS GRDUNI~ = 103,4 ~ 4' PVC GRAVITY LINE. NEW DDX GENERAL LOCATION OF EXISTING WATER LINE, LINE TO lie RERGUTED AROUND THE NORTH SIDE OF THE HOUSE SD THAT IT IS AT LEAST 10 FEET AWAY FROM THE NEW I]RAINFIELD, ISF, AN9 STEP TANK. NO SEWER LINE JOINTS 10 WHERE SEWER LINE THE WATER LIN. 101,~ ~ TH #~. NEW TRENCH- AIR AIR LINE PERK TEST DN LOT. WATER B 1E.~5 FT t0/30//95. PERKED AT 80 MIN/INCH, 93.9 SEPTIC UPGRADEI PREPARED FDR~ PREPARED ByI DATE~ SITE PLAN IS DASE]) UPON AS-DUILT SURVEY PREPARED BY JAMES DOWLING, L.S. 9/29/92, LOT 3, 9K 6, MDUNTAIN AIR ~1, JIM ARMSTRDNG ALASKA WATER & WASTEWATER SERVICES THE CONTRACTOR SHALL BE RESPDNSIDLE FOR HAVING THE PROPERTY LINE LOCATE]) BY A REGISTERE]) LAND SURVEYOR, IN AD])ITION, THE CONTRACTOR SHALL RE RESPONSIDLE FOR UTILITY LOCATES, THE HOMEOWNER SHALL ])E RESPONSIDLE FOR REGRADING, AFTER SETTLEMENT, AND TOPSOIL/RESEEdING, INCH, SCH 40, PVC PRESSURE LINE. SEPTIC TANK TD BE ADADNDDNE9 PER UNIFORM PLUMDING CD])E, /--NEW 1~50 GALLON STEP TANK EQUIPPEB WITH PRDGRAMHADLE DOSING TIMER. SUPPLIER SHALL DE 'ANCHORAGE TANK', BURIAL RATING DF TANK SHALL ])E CON- PATI])LE WITH THE ACTUAL ])URIAL DEPTH. . .~/103.9 C/D (EXISTING) THE AIR LINE FROM THE HOUSE TO THE TRENCH SHALL BE 1/~ INCH DIA., SCH 40, PVC, INSULATE]) WITH 1/~ INCH FOAM PIPE WRAP INSIDE A 2 INCH, SCH 40, PVC JACKET. THE LINE SHALL SE ])URIE]] AT LEAST ~ FEET ])REP & COVERED WITH 4 INCHES DF BOARD INSULATION, PROVIDE PRESSURE 50~+~ ~ STEEP SLOPES FROM ])RIVEWAY AND HOUSE TD SOUTH THE TRENCH SHALL HAVE A NININUN LENGTH OF 30 FEET, AND A TOTAL EFFECTIVE ABSORPTION AREA OF 150 SglJARE FEET. ~?ITH NATIVE SE/IL ANB MDLINB. MONITORING TUBE (TYP~ PERFE~ATEB ZN DRAINROCK, NOTE~ BOTTOH DF TRENCH, EXCAVATION, SHALL BE LEVEL, MAX, VARZATT,~I DF ~ INCHES · ET~EEN HIGH & LD~ ~PDTS, 4 ~[NCHES DF 2J:TARB INSULATION, INSULATION SHALL COVER THE ENTIRE THE TRENCH, FABRIC SILT BARRIER ~RAINRDCK SHALL ~IE SCREENED PER N.O,A ~ECIFICA TIONS, m 95.0 94,5 BENCHMARK IS GARAGE FLOOR (NORTH BAY, RIGHT SINE), ASSUMED ELEV, = 100,00 FEET I 4 INCH DIA. PERFORATED PIPE, A~TM FBIO. LEVEL WITHIN .01 FEET. NOTE~ 1. TRENCH SHALL RUN PARALLEL TO THE SLOPE CONTOURS. E. FOR LOCATION OF CLEAN-OUTS AND HE1NITDRING TUBES SEE THE SITE PLAN, CDNSTUCTZDN PRACTICES~ AND MATERIAL SPECIFICATIONS SHALL C/~PL Y IVITH ANCHORAGE HUNICIPAL CODE 13.65, 'WASTEWATER DISPOSAL REGULATIONS°, 4, INSTALLATION SHALL C[THPLY ~/ITH SPECIAL PROVISIONS NOTED ON THE SEWER PERMIT. ~, SHEARED BGTTDM ~ND SIDEWALLS ~HALL BE RAKED, DETAIL FLIR 5 FDI~T ~IIDE BDTTDMLESS SAND FILTER PREPARED FDR~ JIM ARMSTRDN~ PREPARED .~Y, ALASKA 6/ATER & 6/ASTE~/ATER DATD l£/15/96 I DVN, G~RNESS I SCALE' NTS 1I L~ 3 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: t,~lO~Jl~"T"~ " / SLOPE DATE PERFORM~I~: Township, Range, Section: hd/,~ ~ 2 3 4~ 5 6 7 10 11 12 WAS GROUND WATER ENCOUNTERED? ~'l ~----.- ..~ s IF YES, AT WHAT ~_.~ , ~_~ /?_~ ~ DEPTH? p E 13 Depth to Waler Alter ~. k ~ Monitoring? - Date: SITE PLAN 14 15 16 17 18 19 2O Reading Date Gross Net Depth to Net Time Time Water Drop 30 " g. " ~o 3~~ ~ ~" PERCOLATION RATE ,ti, '7 (mpnutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN "Z)C FT AND ~¢ '~ FT CERTIFY THAT THIS TES/T~WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /~)/"~"7/~'~ 72-008 (Rev. 4/85) LEGAL DESCRIPTION= ~'~3~'"Ai~,J ~1~ :m I 1 3 4 5 6 8 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 10- 11 12 13 14 15 17 18 19 DATE PEIRFORMED: ~' Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN Depth to Waler AIl~ r/,.., Gross Net Depth to Reading Date Time Time Water Drop ~ ~ __"- ~~/~"-'--- .~. ,~ ~o ~0 20 PERCOLATION RATE ~:l (m~nutes/Inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ t;T AND'''~' ~' ~'- FY 72-~8 (Rev. 4/85)  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO .CTION ~ I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE / i~] MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS Well Absorption area DwelHng PERMIT NO. DISTANCE TO: ~ Manufacturer ,~? ~ ' Nd. of compartments ~ ~ Liq, capacity in gallons IF HOMEMADE: Inside length /; ' Width Liquid depth ~ ~ DISTANCE TO; Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material LiqUid capacity in gallons ~ DISTANCE TO: Well IO~ ' Foundation t~' Noarest~tgne~__ PERMITNO, ~ __ len~ 5lines T ..... ~w~ inches Distance between lines ~ ~o. o' lines ~ ~en~t~ I,ne Total ~ To~ of ~ p Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth ~ Driller Distance to lot line PERMIT NO, Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE~MATERIALS SOIL TEST RATING INSTAELER REMARKS II till ,T [:,EF'RRTi"IEF~T OP:' HEFILTH RI'.,IE:, ' ............. EN :.P25 "L'" STREET., RNCHORRGE, FtK. ,~ ~.':, ~ -- '!', ,~ I::.1 ,' 'B'.I, Fi5 87' RPPL I CRNT L L")F-: F:l T T O N L..EGRL GERFILD, J'. RITTEF! L. LLIJ[.,L.F. IJF1 LRNE LZ.': BE; MT. R I R E'E TRTES L.O'F SIZE 'TYPE OF SF'IIL FIE:SOF.:PTION -'"- "' · --,~ =,TErl ]:'=3 TF::ENE:H '1.. ,:,; ~. S Cd..IFI F:::E FEET MR>:; ]: I'"IUM NUME:ER ClF E:E[:,ROOMS ~-"' 2.': SO I L RFIT I NG < SC! F'T,.."E~R ) = ',,A,,4,'~'"'~ TF.IE RE(;:!UIRED, SIZE OF THE SOIL. FIE:$ORF'TTON. S,~'=-;TEM E: F' 'T IH ==; =1_ ,~ L. E' 1"-4,3 T' g-Il == 'TF.IE L. ENGTH [:, I MENS I ON IS THE LENGTH ,::IN FEET::, OF THE 'FRENCH OR DRRINFIELE:,. THE DEr'TH OF R TRENCH OR PIT IS THE DTSTRNCE BETL,,IEEN THE SURFRC:E OF 1"HE GE'.OUND FIND 'THE E~OTTL"d'"I OF' THE EXCR',,,'RTION ,::ZN FEET::,. THERE ZS NO SET I.,.IIDTH FOF.'. TRENCHES. THE GRR',/E:L DEPTH ]:S THE P1TNTMLIM DEPTH OF GRR'v'EL E',ETb. IEEN THE OUTFFILL. PZPE RND THE E=OTTOM L]F THE EXCI.-q'v'ATZON ,.'.'ZN FEET::,. Pr..EF~:M I 'T' FIPF'L I CRNT HFIS THE F.E.E;F Of,IS.[ E: I L I "rY TO I NFCiF.:M TH I S E:,EPRRTMENT [',. R I I'.,!G THE II'.4S!;I'RLI_RTZON TI'.,I'.:SF'EC]'IL]I'.,IS OF RI'.,IY b-!EL. LS ¢:I[:,.]RCENT TL-I THIS .... - .... F, .... r"r~..,rr:r~.~ FIND 'THE I",IUME',I~ER OF RESIE:,ENCES TFtFIT ]'HE [,.IEl_[.. [4ILL SER'v'E. .................. '-IF t1..~11 ~: FI: I<F ILL I NG r')F F-INY S"r'S;TEM I.,4 ~ THOUT F I NRL I NSPEL-:T I L-d'.,I FIN. I::, FIF'F:'F-'pD',,,'FIL E:Y TH ]: S C, EF'FIF~:TMEN]' L4ILL E:E =,JE,.3EL. [ 'rL'l F'ROSECUTIOI'4. M].'NIMUr,t DiS"f'RhlCE BETI.qEEI'.,I R P.IEL. L RNE:, Ri'.4Y IDN-SITE SEb. IRGE .r.:,]:SPOSRL SYSTEM IS :~J2~(~ FE£ET FOR R PF.:I'v'FITE P.IEL. L OR ±SL'-'~ Tf'l 2EIEI FEET FROM R F'UE',LIC 14ELL [:,EPEN[:,ING LIF'ON THE TYF'E OF PUE~LIC I.,.IELL MINIMUM DISTFINCE FROM FI PRIS,'RTE 14ELL. TO Ft PF.:I',,,'FITE SEb~EF4'. LINE IS 25 FEET RN[:, 'TO F:~ COI"IMUNIT'T' SEb. IER LINE IS 7'5 FEET. OTHER REC!UIREMEi'.,ITS i"IRY RPF'LY. SPECIFICRTIONS RN[:, COI",ISTRUCTIOI'.,I DIRGRRMS ARE RVF~ILFIE:LE T'O INSURE PROPER IN:~;TRL. LFI'TION. I CERTIFY TF'IFIT :1.: I rIM F'FIMILIF]R I.,.IITH THE F.'.EQLIIREMENTS; FOl..: ON-SITE SE!4ERS RND HELLS R.'L:; SET F='OF:'.TH BY THE MUI",IZCIF'RLITY OF RNCHORRGE. 2: ! 14It...L ZI",ISTRLL THE SYSTEM ZI",I FICCORDRNCE F.IITH THE CODES. ]:: ~ UN[:'i:ERSTRN[:, THFIT THE ON-'SITE '.:SEI.4ER SYSTEM MRY F.'.EQLIIRE ENLRRGEMEt",!T IF THE " .,- --,;;2.,2_ "I- E~ ISSUED E'r. ~ ........ [.H1E ............ . GRE)- ,:R ANCHORAGE AREA BOR,, JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL S¥STE/~ SEPTIC TANK: DISTANCE FROM WELL MANUFACTURER ...... MA]ERIAL_ NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH __ LIQUID DEPTH LIQUID CAPACITY__ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL TOTAL LENGTH .FOUNDATION . _NEAREST LOT LINE OF LINES NUMBER OF LINES / . DISTANCE BETWEEN LINES TRENCH WIDTH__ IN. TOTAL EFFECTIVE ABSORPTION AREA ~ C~"~-- SQ, F:T. LENGTH OF EACH LINE DEPTH OF EILTEB DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE __IN. ABOVE. TILE IN, WELL: TYPE _CONSTRUCTION _ _ DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST FOUNDATION .... LOT LINE .... SEWER LINE SEPTIC SEEPAGE TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED ___ _REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTt4: .......... PIPE MATERIAL: C~;~,~- _ ....... LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM G.A.A.B. ,.., ,,' 4-1224 AN£H~ ALASKA gg§0g ?hone 274-451 ! START G ADDRESS · COMPLETE DATE JOB LOCATION DEPTH LOG DEPTH , STATIC LEVEL ~UNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL pROTECTION gEg Co ECEWED 19 PHONE - WELL LOG GPM - YIELD I}EF'RRTMENT UF" HERL. TH RND, EN'v'IRCd'.~ME.I'.,t"F'FIL..=~:OTE:CTIOi'.,I_,..., ,~ I(~, ~-'")~ 25:t. 6 E. TUDOR RD.., FINCHORRGE, RK. 9..'.=.'.5E'7 ~,'z.t)pu'~ . 14E:LL I-Il%iL~" Ibll"-.i--~:. 1 TE2 PEF.'I"II7 N'" ':' 7~"]7"79 ':' i~ I ,I ! .... :;'. "' - ...... V FIF'F'L I CFINI" !"~FIR'¢ LEH I S SF..FI' BOX 3:3:0 ]i:44-,~v~t:l. LOF:FI].' I ON c~Cii.~~' LflNE LEGFlL L]i: B6 MOUNTRIN FIlR ESTRTES LOT SIZE L:".'48.::,]~ '.=.";~]:¢JFIRE FEET T"r'PE OF SOIL RBSORBTION S"r'STEM IS: 'rRENCH MFt',;-.',IMUM NUMBER OF BEDROOMS SOIL RFITING (SQ FT,."BR)=. ±,:I.E"~ THE REI'.]UIRE[:, SIZE OF 'THE SOIL RBSORPTION SYSTEM IS: E:, [:J F' 'T H = :1. ;~:.; L E [-.t ,.3 T H = --_-:: ~; ,.3 t~"_ F-~ ",,..' E{ i ..... E::, E] F" 'T F! == ~; THE LENGTH DIMENSION IS THE LENGTH ,::IN FEET:." OF 'THE TREI'4C:H OR [:,RRIi',II=IEI...E:,. THE [)EP'f'H OF FI TRENCH OR PIT IS 'THE DI. STFlNCE BETWEEN THE SLIRFFICE OF THE: GROUN[:, FIND THE BOT'I'OM OF' THE EXCFIVFITION '.'.'IN FEET). ]''HERE IS NO SE]'' HIDTH FOR 'TRENCHES. THE GRFlVEL DEPTH IS 'THE MINIMUM DEPTH GF' GRR',,,'EL BETHEEN THE OLITFFII...L. F'IPE RND THE BO]"TOM OF THE EXCFIVFI]''ION (IN FEET::'. 'l' i-..I 0 ,:'. 2 ) ]: I'-.I S F" E: C: T I C) i%1 S FI E.', E:: E'.' E: Ii::! LI ][. IF;-': EiE E::. BRCKFILLING OF' FIN'¢ S'¢STEbl WITHOUT FTNFtL INSPEC]''IOI'4 FIN[:, FIPPROVRL E:'¢ THIS DEPFIR].'MENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTFINCE BETWEEN FI WELL FIN[:, RNY ON-SITE SEWFIGE: DISF'O:i];FIL SYSTEM IS 2L¢.~O FEET' FOR Ft PRIVFlTE HELL. OR 2E~E~ FEET FOR R PUBL~IC NEI~.L.. NELL_ LOGS RRE REQUIRE[:` RND MUST BE RETURNED TO THE [:,EPFIRTME:N~F WITHIN ]i:O DFF?S OF THE: HELL E:OHPLETION. SPECIFICR].'IONS RND CONSTRUCTION DIRGRRMS FIRE FI'v'RII_FIBLE TO II'.4SURE PRGF'EF.': I NSTFILLA]'' I ON. F" F' R I1"1 ][ 'l "..." l=l L_ I E::, F El F.." C, I'-.11E ",r" E; If'Il Ii'.:: It:' R i.=n l'.ll Z :i~; S; IU EE I CERTIF'¥ THFlT i.: I ill"1 F'FIMI[.IFIR WI'TH 'THE REQUIREMENTS FOR ON-SI'T'E SE:HERS FIND WELLS FIS SET FORTH B"¢ THE MIJNICIF'FILIT9 OF FiNCHORRGE. 2-':: I WILL INSTRLL ]'HE S"r'STEM IN RCCORDFiNCE WITH THE CODES. :l.::: I UNDERSTFIND THRT THE ON-SITE SEWER S'¢s"r'EM Mfl"r' REQUIRE ENL..F~F;:'.GEMEI",I].' IF:' TFIE: RES I [:,ENCE I S/F~MODELE[:' TO I NC:L.U[:'% ~'.~F.'.E THFlN ~: IDE[:,ROOM'S. FIPPL I'~]FINT,¢;¢' GFlR~r' LEH I S ,, , ..," .. ,_ ¢ ISSUED B'r ' __ z ..... ~/¢_.A~_-z-~_ ....... [:H]'E ...................................... September 20, 1976 R & M No. 656297 Gary Lewis St. Rt. A, 330 T Anchorage, Alaska 99507 Test Hole and Soil Log Report for Sanitary System Mountain Air Estates, Block 6, Lot 3, Section 35, T12N, R3W, Anchorage, Alaska Dear Mr. Lewis: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This in- vestigation was performed in accordance with your request of September 7, 1976, and those procedures outlined in a letter dated July 15, 1975, by Mr. Roll Strickland of the Municipality of Anchorage Department of Environmental Quality. A single test hole was put down within the subject site area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 19 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Groundwater was not encountered in the test hole while drilling. A percolation test was performed from a depth indicated and reflects average infiltration from that depth to the bottom of the hole. We appreciate being given this opportunity to be of service to you. you have any questions with regard to the above, please do not hesitate to contact us. Should Very truly yours, R & M CONSULTANTS, INC. James W. Rooney Vice-President JWR/ddp xc: Municipality of Anchorage T.H. 1 9/8/76 ORGANIC MATERIAL 0.0' Dark Brown 1,0' GRAVELLY SAND W/$O_~,~ SILT Occasional Cobbles t~rown Boulder at 5' 6.0' Boulder at 8' SD~NDY GRAVEL W/SOME SILT Occasional Cobbles Brown 14.5" SILTY SAND W/SOME GRAVEL Occasional Cobbles Brown Test Hole locationa are approximate and have not been located by survey methods. ~ '~ NO WATER TABLE This g represents subsurface Sol. conditions within Mountain Air Estates, Block 6, Lot 3, T12N, R3W, Anchorage, Alaska :' Gary Lewis Log of Test Holes Anchorage, Alaska GRID: PROJ. NO 65629/ j I, DwG. NO. A-OI TIME 3:52 3:53 3:54 3:55 3:56 3:57 3:58 3:59 4:00 4:01 4:02 4:07 4:12 4:17 4:22 4:32 4:42 4:52 ELAPSED TIME 1 2 3 4 5 6 7 8 9 10 15 20 25 30 4O 5O 60 PERCOLATION TEST Gary Le%~is 656297 INCHES 11.5 11.5 11.5 12.0 12.0 12.5 12.5 13.0 13.0 13.5 13.5 14.0 15.0 15.75 16.25 18.5 i9.5 21.0 T.H. 1 9/9/76 DROP IN INC~{ES 0 0 0.5 0 0.5 0 0.5 0 0.5 0 0.5 1.0 0.75 0.5 1.75 1.5 1.5 9.5 inches total depth = 6.32 min/inch © Municipality of Anchorage - On -Site Water and Wastewater Programfiz (907) 343-7904 s v e T v Certificate of On -Site Systems Approval Parcel I.D. 017-211-05 1. GENERAL INFORMATION: Expiration Date: — 11 " zo Complete legal description MOUNTAIN AIR ESTATES #1 • BLOCK 6, LOT 3 Location (site address) 6736 Cloudcroft *Anchora-ge 99516 Current Property owner(s) Kelly Snodgrass Day phone 907-242-5061 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ❑X Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 100,76 V f D_ Date of Payment I .7 Receipt Number COSA# 0SGz016714 Waiver Fee $ Date of Payment Receipt Number Waiver # 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, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s: therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. QSQ SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, ll q TH� � '—V �I i ,Joe fpf/re 'cirness* f�• 0�CE-79.53 9• .� (�lo r7�.�. •' .per/ `14 �• • �' • �t��'O Proi ession°�a #AECC884 .4. 'ill with the following stipuliio)s: dN_S7 yp w� rE rE M � Original Certificate Date: I -Z_"1 l -Zy The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: MOUNTAIN AIR ESTATES #1; BLOCK 6, LOT 3 Parcel ID: 017-211-05 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA 9 Well log is filed with Onsite (or attached) Date drilled 1976(?) Total depth 133 ft Cased to UNK ft A-1 Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 1 2`20/0 Static water level at beginning of test 101.3 ft. Comments B. TANK DATA Age of tank(s) 2 years Tank type/material 0 Standpipes/foundation cleanout per record drawing Date of pumping SEE ATTACHED MAINTENANCE Well production at time of test 4.4+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes W No W Coliform bacteria is Negative Nitrate mg/L Q Nitrate less than MRL (ND) Arsenic ug/L On Arsenic less than MRL (ND) Collected by GEG, Ltd. Date of Sample ""72°2" C. LIFT STATION [®I Required maintenance completed Age of lift station 2 years Lift station material STEEL Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 6/13/97 Adequacy test date 12'za ns 0 ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 5'+ ft (max) Fluid depth prior to test �5 in Measured depth to pipe invert from grade ft (min) Water added "543 gal lJ NIA — pressurized field New depth X5.5 in ❑ Monitor tubes go to bottom of drainfield. If not, state "35 depth into effective Elapsed time min p 0 Code -required soil cover over field Final fluid depth *5 in ❑ System presoaked Absorption rate "450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO date of test) Gallons introduced gallons If yes, enter date N/A Comments/Deficiencies: 'TESTING DATA FROM 12/28/18 - ALL MONITORING TUBES IN THE IDSF AND DRAINFIELD WERE DRY ON 1213120 COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 7 Yes Community Sewer Manhole/Cleanout > 100' F✓ Yes if No ft .Yes if No ft Neighboring Tank > 100' Z Yes if No ft Private Sewer/Septic Line > 25' ,/0 Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment >_ 50' Yes if No ft Q Yes if No ft `JC YC if No ft Community Wells > 200' Q Yes if No ft ✓� Yes Manure/Animal Excreta Storage > 100' ft Community Sewer Main > 75' 0 Yes if No ft � Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Buildino Foundations > 10' 7 Yes if No ft Surface Water > 100' 7 Yes if No ft Property Line > 5' 0 Yes if No ft Driveway/Parking ?10' 0 Yes if No, comment Absorption Field > 5' [71 Yes, if No ft Wells on Adjacent Lots: if No Water Main > 10' 7 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' F� Yes `JC YC if No ft Community Wells > 200' Q Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q,/ Yes if No ft Driveway/Parking > 0' F� Yes if No, comment Property Line > 10' F-1 Yes if No *� ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' FV� Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' ✓� Yes if No ft F. ENGINEER'S COMMENTS *WR970036 (IDSF to lot line) **ASSUMED 10'-r- per 1997 record drawing. Edge of drainfield is under driveway. G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet Or %'✓.7 cit TI—}� � ' � ; } " s� 11_, CE 7c.;.3 #AECC884 MIN UCIPAI Me OF A Comm, I ILI it r' Doxlopmei I I>_-,7zirtT.i=-, - On, Sit r Warzr& 9,)11_345 -79r -P.0- Um 19&650A,tcbmZt; AV, W519-6650 - Intermftterit Dosing Sand Filter1� 0 e L3 V -7-O' - Maintenance Log Caner_ Kel I,/ Street Len- S-0130. PID Plione Cal I- esc. SP-�Vtq T8trjk. -8lDdqn level inches -(Pumping: rcquiee yps no -Pumping completed rRs no Ab -sorption Field: -Liquid level -Flushing VatVaS Per 3DPTOVed deS'Ql v�e:s, no -All flushing valves di'stributlon lines flushed, and Pushing valves closed re2, no Lift station: -Fume basket clearic.-Il no -Biotubeeffluent:rit,,rcicaied — Q_Q -Timer float setting2,in ches -High level Boat sett rig L_21 inches -Rcfcre11C.'L'1 point -1:1P : r 4V..- -Pump 011 `7f 'J seconds -Pump off l D Minutes -Gumulauve lifetime cycles -Cumulative• run time z? / 7, 2 Z— hour, < -Operation satisfactory, es no Air System: -Air pump filter cleaned 'Ali- pre sure -Date of latest install oric.,L Air sy-stem opeiration�d!fhct.� Y nqj�atisfactoiy Alarm S stem: no -Dedicated electrical circuit \ -Audible and vL,,u.al alarm inside dwelling Coe, -Floatsetting YS'nch('s -Alarm system opera" ort � satisfartoni' tinot satMfaot TM Comments: .................................... ................................................................................... I .............. ...... Maintenance Frovider: C I Technician `j'j,,W Company IDSF Date of maintenance—)A- Date. tl", - A described as located at (legal description)( i 0 li 2. t4lnintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throw=bout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The ANWAITS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the N'Iunicipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to S600). /(}�� Owner a��rees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, j repairs or permitted alterations to the system. U Owner acknowledges that regular maintenance of an AWINTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Palle I of 3 jurisdiction shall not invalidate the remaining provisions of the Agreement (rev. 05/18/2019) Page 2 of 3 Owner acknowledges that the \Mtinicipality may request records of nlaintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the Eine for failing to maintain and repair an AWWTS may lie yy assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the /ANNI"ITS. The Municipality will give at least 24-hour notice. not occur without a new Owner agrees that any sale or transfer of title of the property will Certificate of On-Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the constriction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the r ANVWTS approval. 3. Terni. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nomvaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement (rev. 05/18/2019) Page 2 of 3 OW 13y: ( (;' V "�/Vl/l (signature) t. (print name) �— Date: —00-0do STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) \p{11TM11111", The foregoing instninient was acknowledged before me this ! ��1�; 1. I 'H73r0- L 2020, by Jk-mil S -00A. \OT. R ' PL LIC FOR ALASICt = ry' Illy Commission expires: U NfUNICIPAUTY: (signature) Date: (print name) Title: (rev. 0511 S/20 IS) Paac 3 of 3 epioN3 4°,j. Municipality of Anchorage On-Site Water and Wastewater Program ad I II (907) 343-7904 s:FET Y Certificate of On-Site Systems Approval Parcel I.D. 017-211-05 Expiration Date: 4^-9-''_.' q 1. GENERAL INFORMATION: Complete legal description MOUNTAIN AIR ESTATES#1; BLOCK 6, LOT 3 Location (site address) 6736 Cloudcroft Lane*Anchorage,AK 99516 Current Property owner(s) William&Jamie Katness Day phone 907-230-3787 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ $BD Waiver Fee $ Date of Payment I/2 I/q Date of Payment Receipt Number 00'317-6 Receipt Number COSA# JXClq 10gi Waiver# 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, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: t i '6 !1g o000,, 4 ooCj In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system 1 •Np in accordance with the guidelines and regulations established by the Municipality of Anchorage and a.`C'..••••• -' industry practices. The reported results describe the condition of the system/s on the date/s of the 0 `. V evaluation. Separation distances were measured to readily identifiable features. Hidden defects or O� •• �' '. 1 encroachments may exist that were not identified during the evaluation. The operational life of all wells �� • 41, T H .yh$.. and septic systems depend upon a variety of variables, including but not limited to, soil conditions, Q groundwater levels (that may fluctuate during the year), quality of construction (materials and / VA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and 4.. are outside the control of GEG. Satisfactory test results do not guarantee future performance of the i -f r•, A. Gare s; system/s; therefore, GEG makes no warranty (express or implied)regarding the future performance of V0 9 CE 7953 •• �Q1O the well or septic system. GEG makes no representation whether an alternative well or septic system Ori • .c,-O can be installed on the property in the event either of the current systems fail to perform adequately in Vm11;'0,/, c,. ''•• •• �c(3)so the future. The content of this report is for the sole benefit of the person/party that retained GEG to 1� °'profess;on°ez perform the evaluation. Reliance upon the information provided in this report by any other person or ��DOOpooG party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE XSystem #1 Approved for bedrooms System #2 Approved for bedrooms 0.t ur bytt Disapproved ,c- 7"4 Conditional approval for bedrooms, with the followir> stipt.OIN:OTE ill WATER AND L WASTEWATER oz `* PROGRAM S SER g By: t....„ %-- Original Certificate Date: f —ZtV —/ The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist — Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheer 10-10-12.ccc COSA Checklist Legal Description: MOUNTAIN AIR ESTATES#1; BLOCK 6, LOT 3 Parcel ID: 017-211-05 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA ❑Well log is filed with Onsite (or attached) Well production at time of test 4.4+ gpm Date drilled 1976(?) Water storage tank volume N/A gallons Total depth 138 ft Well disinfected for coliform test? ❑Yes ❑■ No Cased to UNK ft Q Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate J() mg/L ■❑ Nitrate less than MRL (ND) ■❑Wires are properly protected Arsenic A)10 ug/L ■❑Arsenic less than MRL(ND) Casing height(above ground) 12+ in. Collected by GEG, Ltd. Date of flow test for COSA 12/28118 Date of Sample * Static water level at beginning of test 101.3 ft Comments *12/28/18 & 1/2/19 B. TANK DATA C. LIFT STATION Age of tank(s) 0 years ❑ Required maintenance completed Tank type/material S TE P 'S EE` Age of lift station 0 years Standpipes/foundation cleanout per record drawing Lift station material STEEL Date of pumping NEW Comments: NEW D. ABSORPTION FIELD DATA Which system tested (date installed) 6113/97 Adequacy test date 12/28/18 0 ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 5'+ ft(max) Fluid depth prior to test 5 in Measured depth to pipe invert from grade ft(min) Water added 543 gal ❑■ N/A—pressurized field New depth 5.5 in ❑ Monitor tubes go to bottom of drainfield. If not, state depth into effective Elapsed time 35 min 0Code-required soil cover over field Final fluid depth 5 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies:WATER INTRODUCED THROUGH LINED IDSF WHICH WAS DRY UPON ARRIVAL AND REMAINED DRY THROUGHOUT TEST COSA Checklist yellow sheet 1 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' 0 Yes if No ft 0 Yes if No ft Neighboring Tank> 100' Q Yes if No ft Private Sewer/Septic Line>25' 0 Yes if No ft Absorption Field on Lot> 100' OYes if No ft Holding Tank> 100' OYes if No ft Neighboring Absorption Fields> 100' Animal Containment> 50' 0 Yes if No ft EYes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 2Yes if No ft 2Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft Property Line> 5' f Yes if No ft Driveway/Parking > 0' 0 Yes if No, comment Absorption Field > 5' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells> 100' 0 Yes if No ft ** Water Service Line > 10' LI Yes if No ft Community Wells>200' 0 Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft Driveway/Parking > 0' El Yes if No, comment Property Line> 10' ❑ Yes if No *1 ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells> 100' 0 Yes if No ft ** Water Service Line > 10' El Yes if No ft Community Wells >200' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *WR970036 **unknown, but ASSUMED 10'+ per 1997 record drawing. Edge of drainfield is under driveway. 000�oOp� G. ENGINEER'S CERTIFICATION oP,�c �F A��s�� 1 certify that 1 have determined through field inspections and review Qf'`P .4\— .-QUO of Municipal records that the above systems are in conformance with Q 9 MOA COSA guidelines in effect on this date. O1 r O vO •.Je e/ A. Game s. vcf —79 Q 's • P • c$.O V ° 1`.i2 i1,00ma ���professi ^°OoCOSA Checklist yellow sheet #AECC884 OOpp04 r • CROFT----- LANE J- c�p�D --��• - EASEMENT IN FAVOR OF CHUGACH ELECTRIC; U -���J RECORDED AT BOOK 203.PAGE 523 • N--D��F 1 f SEMENT —� — 10•ELECTRIL .. ,, ...,..\,..., .0.. Yv .£ 0 0 0 0 \ , • • • 2 Co ;, a • \ , .o 0._ \aa, I, • Fi' 1 'a I Q RAN 8' ° / S 4 iC k.t 1 , •r F , o+ • A • \ 4. \ . of p'' •• oQT �i oa a�Goa/ SeT�E''``Pss� �� ..49mrr0 `900 ' / o .SAF si fig 1 O.O, „Q ••.'li- AS-BUILT SURVEY 1" =20' OQO�� SHANE A.HOLT .• �O� ar: t ` L1 ^N@ .•,LS-6914 -••• 9JQ4 IHEREBY CERTIFY THAI I HAVE PERFORMED A SURVEY Opp1peo Tassional\-4� OF THE FOLLOWING DESCRIBED PROPERTY ���000p00 LOT 3,BLOCK 6,MOUNTAIN AIRF SUB.NO.1(PIAT 71.61) ANCHORAGE RECORDING DISTRICT,ALASKA,AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SNOW ANY EXIST OTHER THAN NOTED. CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; ANP T5 DATED AT ANCHORAGE.ALASKA THIS 43,d DAY OF NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN JANUARY ,2019 HEREON (UNLESS INDICATED) NOTE' FENCELINES THAT NAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERNNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. I1C;LI LAND SURVEYING ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. BOU9 GHUVER DRIVF. ANCHOR14121,FB 194.41,58 34S-551JAGE.AH 99507 MUNICLt'AL.T/Qr ANCI6O AGtt-Community Development D patuacat•On-Site Water&Wastewater Progemn P:907-343-7904•F:907-34S-7997•P.O.fox 194650 Mohr:cage.AK 99519-6650•imp:iierwty.firms•orgtbuilding Intermittent Dosing Sand Fitter Maintenance Log Owner .ii)i .: T • I' r 5j Street Address /0'1310 t.16uQ�'r-j$ + Pr/e'lu Phone Legal Dose. PID Septic Tank: • -Sludge level Y' inches Pumping:required cs o -Pumping completed yes no Absoption Field: •Liquid level incl:•as -Flushing valves per approved design ' yes.no -All flushing valves oper_J,distribution lines flushed,and flushing valves closed ;;,« a I yes fia Lift station: �Jlv -Pump basket cleaned yres no" -Biotube effluent filter cleaned yes no •Timer float setting'?1 incises -High level float setting ;v.a inches -Reference pointer-or,c4 r moo. -Pump on 0.7 __..seam* '^ -Pump off (1 3 -rte ffma� -Cumulative lifetime cycles 4.05117..7- -Cumulative run time Zy;1.. hours -Operation satisfactor r ve\ no Air System: -Air pump filter cleaned (les no -Air pressure `1-7 psi •Date of latest install or rebuild ' •Air system operation ugatt`siact t sans- tactor Alarm System: -Dedicated electrical circuit yes �' -Audible and visual alarm inside dwelling'i no -Float setting "c inches -Alarm system operation"saSsE ctar�not satisfactory Comments: -�—-- ttt rVvw `Ca-r•Y— rup 44• Nd,sT e rn i Maintenance Provider: Technician /L.•b Y(rL Date of maintenance /--21( 1 Company r? 1),L.--) Signature �.rt ,< A-- .- Date...!"z/ /l iDSF Mar tcnance Lcg_0403l:.doc you! 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O.' Box196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# (~t~ --'2.. I I--C)_~ 1, GENERAL INFORMATION Complete legal description ICIPALITy OF ANCHORAGE NMENTAL SERVICEs DIVISION dUN 3 0 1997 RECEIVED Location (site address or directions) ~(~ ~o~ f3~z~r-~F" t_zm-a ~: . Property owner k..~u"'~ .,~.'~1,,,'1%~~;'~'" Mailing address Day phone ~z~,~' _ (=c/,~. j Lending agency /'J Mailing address Agent ~---~ P~---~ Address ~g..o t Day phone ~ ~ Day phone. "7~- '.~ I ~* O Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well )(, Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holdingtan k Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system, 72-025 (Rev. 1/91) Front MOA#21 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 n umber 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~f this inspection. Name of Firm ~,n~ 'qou¥ L ~ ,~,~+ ................ Address e~ ,,,..,,~?/ &nth., AK 99~0~ Engin..ssignature ~~ ~7¢ ~ Date ' ~ Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date The Municipality of Afichorage 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. Th~ DHHS does this as a courtesy to purchasers of homes andtheir lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before 'a certificate is issued. The Municipality of Anchorage'is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev. 1/91) Back MOAil~l Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ~S~l~) Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501'° (907) 43-47~4 Health Authority Approval Checklist VED A. WELL DATA Well type ~(~"~/~-- If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) '"/~---- ~ Date completed "~ Total depth /-.~ ~ / Cased to / ~ ~ ! Sanitary seal (Y/N) ~'t~-~ Casi'ng height (above ground) Wires properly protected (Y/N) ~ ~.-~ FROM WELL LOG AT INSPECTIOI~ Date of test - O ~-' Static water level '~, ~ ~c'/ Well production ~' ¥' g.p.m: WATER SAMPLE RESULTS: Coliform (~ Nitrate t,i/'l:~ Date of sample: ~/D'~/c=~- Collected by: B. 'sEpTIC/HOLDINGTANK DATA N~-~-'~-J ~.T', F::~, P Date installed Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA Date installed ~/~/~ ! Length :~ ~" Width Depression (Y/N) Pumper /'J & Number of Compartments /,JO High water alarm (Y/N) ~---'~'~ Soil rating (g.p.d./fF or.freedom) ' ~ System type '~ / ~'~ u ~ Gravel thickness below pipe I-~/ Total depth Monitoring Tube present (WN) ~ Depression over field (WN) Effective absorption area -~ Results (Pass/Fail) For bedrooms Fluid depth in absorption fiel~m~mediately after, gal. water added (in.): Fluid depth (ins) Minutes later: ~ ~, ~ g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* Dm LIFT STATION Date installed Manhole/Access (Y/N) High water alarmlevel at* Cycles tested Size in gallons I "Pump on" level at* /'J/~ "Pump off" level at* *Datum ~° ''/'~j'-4:v'7. O~ '~3MJ~' E. SEPARATION DISTANCES Absorption field on lot Public sewer main SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/hol,ding tank on lot ~ ;~ /~-' · On adjacent lots On adjacent lots Sewer/septic service line ! Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROMSEPTIC/HOLDING TANK ON LOT TO: ~t~ IO r~ Foundation r , ' Propertyline Absorption field Water main/service line '~O/' 'SurfaCe water/drainage tO0/~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: I /+ ~ Building foundation 10 / Property line Surface water [ O0 / 4- ~ Curtain drain I'JO~,/l~_- [,~-.,,..~3~ ~J ENGINEER'S CERTIFICATION Wells on adjacent lots Driveway, park ng/vehicle storage area Wells on adjacent lots I Water main/service line I certify that I have determined thru field inspe[~!ions a~ HAAFee $ ~5~-). ~ Date of Payment Receipt Number ~;~/7~_ _'~ C~,~ ~ 72-026 (Rev. 3/96)* Waiver Fee $ //~'~-~ r-/D) 'Receipt Number ~::~-~'- _~ ~'~ Facsimile Transmittal Alaska Water & Wastewater Consulting Eng/neers Attention: '~ ~ t-~ S From: Jeffrey A. Garness, P.E., M.S. Comment(s): Reply requested: ~ Yes I7] No 8471 Brookridge Drive * Anchorage, Alaska 99504 * Phone: (907) 337-6179 * Fax: (907) 338-3246 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF I{EALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date /~/t~/~/~/r)Q ~('~.,~//~ (a) Legal DescriptiQn (include lot, block, subdivision, section, township, range) Location (address or. directions) (b) Applicants Name ?oAr~.~C~h ~J~)/~ Telephone - Home Business Applicants Address ~ ~ C~~[~+ - ~YS~ ~-~, ~q~ (c) Applicant is (chec% ong) Lending Institution ~ ; ~/builder~; Buyer ~ ; Other ~ (explain); (d) Lending Institution Telephone Address (e) (f) Real Estate Co. & Agent Telephone ~ I~- Mail the It&A to the following address: 2. Type of Residence Single-Family ~ Number of Bedrooms 3. Water Supply Individual Well',~j~,. Multi-Family~-~ Other (describe) Community~ Public~-~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Sewase Disposal 0nsite ~ Public ~-~ Community ~--~ Holding Tank Note: If community well system,' must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] .Ensineerin~ Firm Providin~ 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 regula- tions in effect on the date of this inspection. Name of Firm ~lk' ~'~'"~tj'l~D~ll"ll~'~-~O,/ '~)l'~l ~-~O~6Telephone~l~)~O Date DHEP Approval Approved for ~,~ ~_~; bedrooms Approved /{ Disapproved (ENGINEER SEAL) Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF [~ALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOI~LY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HFALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 OEO 6 198, RECEIVED Well Classification Well Log P~esent~) Total Depth ,. /~/ Cased to Legal Description: If A, B, o~ C, D.~.~. App.~oved(Y/N) A~ ?t~. ~uc,~..~c>~y - - Date Completed ~/<./7~.2/~ Yield /~/ Depth of Grouting .~- Static Water Level . ~.~.~/~ /~) Pump Set At Casing Height Above Ground ¢~. 9// Electrical Wi~ing in Conduit ~/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot ~ ~ ~ t~ Sanitary Seal on Casing ~/N) Depression Around Wellhead (Y~ ; On Adjoining Lots ~- ! 0 0 /~'-- To Nearest Edge of Absorption Field on Lot ( 0~'~6 ; On Adjoining Lots .4-f~O/4~ To Nearest Public Sewe~ Line /t//~ To ~est Public ~ ~ Wate~ S~le Test ~sults ~T~~~K / ' ' B. SE~IC/HOLDING T~ ~TA ~ ~te Installed ~/~/~ Si, /~ NO. of C~,,=~nts Z. StandpipeS')~ Ai~-tight Caps ~)aF°undati°n-- Cleanou~ ~) ~p~ession o~ Ta~ (Y~ .Date ~st--P~d ... ~, % P~ing~aintenan~ Con~a~ on File (Y~) ~ ; fo~ Holding Ta~ High-Wate~ Ala~ (Y~) ~ ~e~ya~y Holding Tank Pe~it (Y~) ~ Separation Distance ~ ~ptic~olding Tank: To Water-Supply Well TO P~:'operty Line TO ~ter Main/Se~vi~ Line Cour~ ~ Counts To Building Foundation ~/~V'~ To Disposal Field /~ / ~ To Stream, Pond, Lake, or Major Drainage Receipt Date Paid: ]~'~( Amount: [Page 1 of 2] 2-15-84 ~ C. ABSORPTION FIELD DATA Soils Pating in Absorption Strata Date Installed &/j2~ Width of Fie ld ' ~ k '/ Length of Field ~ Depth of Field /3 / _/~/ Gravel Bed Thickness /~/ Standpipes Present~/N~< Square Feet of Absorption A~ea . ~ . Depression over Field (Y ~te ~ ~st A~quac7 Test ~ Results of ~st Adequa~ ~st ~~ ~ Separation Distan~ fr~ ~sorption Field: To Building Foundation /~ / To Existing or ~ndo~d System Lot ~ '~ ; ~ ~joining ~ts '~t~ To Wate~ Main/~rvi~ Line ~/~' To Cut~!if pre~nt) To St~e~ond~ke/~ Majo~ ~aina~ C~se &~ To ~iveway, Pa~king ~ea, ~ Vehicle Stora~ ~ea LI~ ST~TZO~ Date Installed & Dimnsi ns "~ ~,' I~l at ~ / / /~~" I~vel at High water ~ ~1 at/~~ - Vent (Y~) Tested fo~ ~~inG Cycles ~ing Adequa~ ~st. ~ets ~A Electrical Co~s (Y/ C~nts ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified~ o~ confor~d to all MOA HAA G~es in effect on the date ~¢ ~, ~.~.~ signed Date / , / , Company [Page 2 of 2] 2-15-84 ALASKA eiiUII OFImgI1TAL COI TI OL S{!I uIC S, IF1C. ~n§in¢¢rin~ $ ~nuironmcnldl $1u~i~s NOVEMBER 30 1984 STEPHEN WOLFE 6736 CLOUDCROFT ANCHORAGE AK 99516 SELLER - STEPHEN WOLFE BUYER - SUBDIVISION - MOUNTAIN AIRE ESTATES #1 BLOCK - 6 LOT - 3 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 720 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 476 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. A FLOW TEST WAS PREFORMED ON THE WELL. 476 GALLONS OF WATER WAS PUMPED AT A RATE OF 6.1 GPM OVER A DURATION OF 2 HOURS. THE DRAWDOWN WAS 29.15' WITH A RECOVERY TIME OF 90 MINUTES AND THE STATIC WATER LEVEL WAS 77.42 FEET. THE WELL IS ADEQUATE FOR THIS /3 BEDROOM HOME. SEPTIC TANK ADEQUACY THIS 3 BEDROOM HOUSE. THE EXISTING SEPTIC TANK VOLUME OF 1000/IS ADEQUATE FOR 1200 LUest 33r¢1 Aucnu¢. Suile [~. ~nchoroqe, Alasko 99503.{907) 561-5040 APPLI¢ .T FILLS OUT UPPER HAl.' )NLY Property Owner t--, i_.L~ Mailing Address Zip Code :;'~ 15 )~C;i' (,; Address Zip Code Lending Institution ~ L ~ ~J( A ~q A '~'~ ~ ~ ~1(- ( ~; ,~,~ ) Phone Address .~ ~. ~(~ ~: . ~ ~.~[~% ZipCode .;~ r~,~ ~;~L ~ Street Locatl~ E) I'{ ~,~ C~ [L)~ ~:' (}~- T Type of Resl~nce ~ Single Family ~ Multiple Family No. of Bedroo~ ~ ~ Other Water Supply ~ Individual A~ACH WELL LOG. A wall Icg is required for all wells drilled since June 1975. ~ Community For wells drltled prior to that date, give well depth (attach Icg if available). ~ Public Utility Sewer Disposal ~ Individual Year IndtvMual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Ti r Time Time Time D,~. ~ ~' Date Date Inspector Insp~tor Inspirer Insp~tor ( ~PROVED BEDROOMS ~ *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( } CONDITIONAL APPROVAL* DATE ~-- ~-- ~ Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ¢--~ [ WelltoTank Septic T~k Size 72.023 (31~2) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Approval requested by: Mailing Address: Property Owner: Mailing Address: Date Received Janua'ry 13, li977) Time of Inspection ~:~o Date of Inspection 1-13~7 Thurs / \ REQUEST FOR APPROVAL OF LNB INDIVIDUAL SEWER & WATER FACILITIES FOR Cony. o Alaska Mutual Savinqs/ % ~r. Post Office Box 1120 Phone: Gary Lewis Phone: Star Route A Box 330T % Jerry Ritter Legal Description: Lot 3 Block 6 Mountain Air Estates Loca ti on: See directions Type of facility to be inspected Single Family No. of bedrooms 2 Well Data: e A. Type Individual B. Depth 138' C. Construction <~//~, D. Bacterial Analysis ~ Sewage Disposal Syst~m:~"t On-site system, permit #76779 / A. Installed 1976 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation ~o septic~tank , Absorption area , Other contamination , Absorption area , Sewer Lines ...... 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 S ~r & Water Facilities legal Description Lot 3 Block 6 Mountian Air Estai~e$ Comments Approkv. a~ Valid for one year from date signed Greater 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 ~f the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED ~Date EQ-034 (1/74) ~./NICIPALITy OF ANCHOI~(3E MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECT~ENTAL PROTECrI~ 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 JAN t3 1977 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA 2. Property Owner: ~-'(~ ~'~-,1 '~]~y- Mailing Address: _~'-/~_/)~ ~ ._~.:~'O 'T' A~/, ~/qS~y Phone: 3. Name of Buyer:. .co v Mailing Address: Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Day Phone:, Phone: Mailing Address: Legal Description: Location: Phone: 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utility. No. Bdrms. .Individual If Individual, depth of well. Sewage Disposal System Type of System: If Individual, date of installation If Individual, number of dwellings presently served .. Public Utility Individual (on-site) 72-003(3/76)