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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 4 LT 10 MuNICIPALI1Y ur ¢',, ........... MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH DL RTMENT OF HEALTH AND HUMAN SER. ES ENVIRONMENTAL pROTECTtON Environmental Health Division 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~d~ Y ~'~ ~ ~ TO SEPTIC ABSORPTION WELL FIELD Ph~n~[s~ ........ P~rm,t No ~ o~drooms WELL jog Lot Block Subd~wslon , To~nsbip,~ang~, Sect,~ ~AS-BUILT DIAGRAM tShow [ocatlof, of well, septtc system, p,opeHy hnes, foundation, %~¢ Z ¢ 71~ lU ~ /d wway water bodies, etc} --T - TYPE OF SYSTEM ........... s'-','~ =--% - ~3 PRIVATE ~ OTHER {,de.titv~ ~ ~ RE~ARK5: Mun~guidelines in ellect on this Health gepadm~n pp ; L? --~' ] L.o-r ..j ANCHOP-A(~ 'L~Di~. ~ Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Ataska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: (ENGINEER'S SEAL) Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13: 14- 15 16 17 18 19 2O SLOPE WAS GROUND WATER ENCOUNTERED? S L iF YES, AT WHAT O DEPTH? P E Depth to Water ADer SITE PLAN Monitoring? Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RA'fE -- (m~nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND F7 COMMENTS ~"(~" ~ I'~,' ",/~/¢ .~' ~,~-_ ~.~ ;"~1 '~ ~'f 40/e ] ~ .~ '~ .~ 'T~ ~ *' ~'~) ~ ¢Cc i/~~ '- CERT FY THA~ THIS TES~ WAS PERFORMED IN PERFORMED BY: _ ~1 ~ ~/' / ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELiNES IN EFFE¢ ON THIS DATE. DATE: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: (ENGI~SEAL) DATE PERFORMED: / O ~;_~ o ~er ,/d/Oe d Township, Range, Section: SLOPE SITE PLAN 10 11 12 13 14 15 16 17- 18- 19 2O COMMENTS WAS GROUND WATER F0o ~, <~"~ ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? P E' Depth to Waler All.er Gross Net Depth to Net Reading Date Time Time Water Drop 3 4 z ~o 3 -f- PERCOLATION RATE /O (minutes/inch) PERC HOLE DIAMETER -- TEST RUN BETWEEN ~'2-. FTAND.-- /:~' ?,~ ,.. ~. -h 'o , ~ <- ., ~' / ~ ~- L~ ' I ,¢ . ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT~/N/NN THIS DATE. DATE: GREi :R ANCHORAGE AREA BOR Department of Environmental Quality 3330 C Street ~¢ Anchorage, Alaska 99503 (~ //6) INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAM E ~.~,,~,~_~F~.:..~-~.CF~/~_--,~F-:~'~/ MAI LING ADDRESS LOCATION ,.,~/'~ ,~,,~//~_~r2~) ~,.,~-. _ LEGAL DESCRIPTIO SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH_ MANUFACTURER INSIDE WIDTH_ NUMBER OF MATERIAL . ~<'E2'~'x-C'/2E~ COMPARTMENTS LIQUID DEPTH ~ LIQUID CAPACITY~/~)GALLONs. TILE DRAIN FIELD: TOTAL LENGTH / DISTANCE FROM WELL~~''~' '" FOUNDATION-'?'~-?'d~ NEAREST LOT LINE ./~F' : __._OF LINES NUMBER OF LINES '-J'~ DISTANCE BETWEEN LINES ? ' TRENCH WIDTH/~2%/IN. TOTAL EFFECTIVE ABSORPTION AREA --~/~ ~/'/=,-~/ SQ. FT. LENGTH OF EACH LINE - /' ~_/~2 / · ~'~"~_',,~ '/ DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE ~ / MATERIAL BENEATH TILE ,.,~ -";) __IN. ABOVE TILE ,~?~ __IN. W E L L: z..,.. -,./.,~_.F',."Z. ~ TYPE ~/t./.~/-/~/~.~//~/~_ CONSTRUCT ION ~'"/ /~,~-'//~'P/~'~ ~/"//L_z~__--Y-;' DEPTH c'z2/~/-t~'7 DISTANCE F ROM: BUILDING , / FOUNDATION .~,'2/ , C E SS POD L//u/.~/[/2¢ APPROVED NEAREST .~...--~-. NEAREST / SEPTIC . ./ SEEPAGE ~ .-' LOT LINE /~'./~':', SEWER LINE ~'~/? ~z_ TANK i/''/~/', SYST , OTHER SOURCES D I S A P P R O V E D R E M A R K S --//f..~.~ ~F.~--' ,_,_,_,_,_,_,_,_,c~" DISTANCES .... ~J'?/~'¢~/",l'//'~/- - -- SEWER LINE DEPTH: REMARKS: DIAGRAM OF SYSTEM G.A.A.B. Form EQ-O32 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT pERMIT NO. -- MAiling PHON E~ ~ SEEPAGE PIT D~A~N FIELD inSTALLaTION Of: SEPTIC TANK TO ~[ iNSTALLED ~Y FINAL INSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAl.. iNSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WAL[ TO NEAREST LOT LINE. v/2'~/~/ SEEPAGE P[T. DRAIN FIELD ._~'~,~ ~¢t ~ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK J~ SEEPAGE PIT . DRAin FIELD-/~' / / / /' CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OP EXCAVATION S FEET INTO UNDISTURSED SOIL. 4 INCH DIAMETER CAS]' IRON SIPHON PIPES ON SEPTIC TANK aND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. TYPE GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GRE/tER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE R&M ENC..4EERING & GEOLOGIL.. ,L CONSULTANTS 229 EAST 51st. AVE. - P.O. BOX 6087 - ANCHORAGE, ALASKA 99503 TELEPHONE 907-279-0483 TELEX 090--35419 Civil Engineers Geologists Land Surveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P.E., L.S. JAMES H. WELLMAN, P.E. RALPH R. MIGLIACCIO Engineering Geologist. September 5, 1973 Mr. Don Shermm~ Abbott Realty 601 East Northe[~ Lights Blvd. Anchorage, AK Re: Test Hole and Soil Log Report for Sanitary System, Lot 10, Block 4, Mountain. Park Estates Dear Mr. Sherman: 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 August 27, 1973, and those procedures outlined in a letter dated September 13, 1971 by Mr. Roll Strickland of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 10 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 15 feet below ground sur- face.. The final log prepared for the test hole has been included in Drawing A-O1. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M ENGINEERING & GEOLOGICAL CONSULTANTS JWR:ph xc: G/~tlBF/ ANCHORAGE FAIRBANKS JUNEAU NOTE: T.H. 1 8-31-73 Organics w/some Silt Silty Sandy Gravel (GM) Silty Sands Trace Gravel Dense to Medium Dense (SM) No Water Table Test Hole Extended with Auger Drilling Unit. 0.0t 1.0' 6.0! 15.0" T.D. Engineering ~, Geologico I Consul tonts AN(~HORAeI~ ~rAII~aANK~ AL.A~3KA JUNEAU I ...... ,, ~, ~mw~l mY ~ ICHKD BY L7;'1~ ABBOTT REALTY LOG OF TEST BORING IPEOJ'NO' 36658 I'owe NO'A-O1 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastev~ater Program 4700 South Bragaw St. P.O; Box 196650 Anchorage, AK '99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITYAPPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O ¢ '7 _ Od' ! - '~.~7 GENERAL INFORMATION Complete legal description /..= ~L Location (site address or directions) ! Current Property owner(s) /-lo,~ ~ Mailing address Lending agency Expiration Pate: - I R - O Z-/.. Pe ~ v ~..~,p~ f ,~"cf' Day phone Day phone e Mailing address Real Estate Agent .13~ ~_~,~c_~o~ I'Ve/~,~ p/'o? Day phone Mailing Address ~'0~, ~:3, rz~O,,'~ -~) /Y/'r-~Or'::~'~.~ /-J-~ Unless otherwise requested, HAA will be held by DSD for pickup. ' p I~'~,.r~ ~c~ I/ l),~ ,,.¢ ~..,,~,,4rc~,- ~ 7 Z ;' -3.~ NUMBER OF BEDROOMS: .~ ~en Pr,4-4 ce~'A ,~ reac~xv ~>r /~,¢~-~ TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community ClaSs ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the* representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Cedificates of Health Authority Approval are valid for 90 days from. the date of issue for properties served'by a private or Class C well and may be reissued with new'Water sample results. (Certificates may be reissued for a period 6f up to one year with v-~;d water samples.) Cedificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. e STATEMENT OF INSPECTION BY ENGINEER " .~ ~ As certified by my seal affixed hereto ~nd as of the validation date shown below,' I verify that my investigation, based on 'prOcedures outlined in the Health Authority 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. Engineer's Printed Name. bedrooms. DSD SIGNATURE ~ 'APprOved for DisapProved. Conditional approval 'for bedrooms, with the fbllowing stipulations: Additional Comments Attachments: · HAA Checklist Septic System Advisory Well Fiow Advisory X Maintenance Agreements Supplemental Engineer's Report Other ' ' ~ By: Original Certificate Date: (Rev. 01/02) Legal Description: A. WELL DATA Well type ?~' f Date completed to/-/3 Total depth'~-7~ ft. ' MuniCipality of Anchorage. Development services DePartment i Building Safety Division ~ on-site Water & Wastew~ter Program : ~4700 South~ Bragawist. : P.O. BOX 196650 Anchorage', AK 99519T6650 'www.ci.anchorage.ak.us : :(907) 343-7904 1 HEALTH AUTHORITY API ROVAL CHECKLIST ?,~,-,~- '~.~ Parcel ID: IfA, B, or C provide PWSID # ~ Sanitary seal (Y/N) ¥' Cased to ~ 5'~ ft. FROM WELL LOG Date of test Static water level ft. Well production WATER SAMPLE RESULTS: Coliform O colonies/100 mi. Arsenic: -- mg./I. B. sEpTIC/HOLDING TANK DATA Tank Type/Material ~'¢f, t-lc g.p.m. Nitrate (3,. ~,'?¥. mg.ll. Date of sample: t,/./k Well Log (Y/N) Wires properly protected Casing height (above : AT INSPECTION l'.t lo . ~.p.m. Other bacteria · 'i'ank size l¢'a~' gal. Number of Compartments I Foundation cleanout (Y/N) 'r' Depression over tank (Y/N) N' High water alarm (Y/N) Date of pumping '3 {~:,C'/0~ Pumper Nor t¢~1¢.,,~,,/ C. ABSORPTION FIELD DATA Date installed .t~/~ ~'/~,~,' Soil rating (g.p.d./ft2 or ft2/bdrm) !~'5" ~--~,,., System type Length '~ ~ ft. Width 3' ft. Total depth I ~ . ft. Eft. absorption area ,,~'~'~ ft~ Monitoring tube' Date of adequacy test ~/ / / d' / ~' Results (Pass/Fail). f~.~..r Fluid depth in absorption field before test ~'/ in. Water added7"/I gal. Elapsed Time: :31~'. min. Final fluid depth 7,5';5' in. - Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) /V'~,,~,~ h:,~ ,~ ~.-,-, Daie installed . I. Cleanouts (Y/N) ..... ~,,' Gravel below pipe I0: ' ~ ~t.': Depression Over field ' ~:', For '5', .... ~ bedrooms If yes, give date :New depthlJ)c'.~'i.n~."! i Vs-~ ! g.p.ld. :, ! '!EIF. TSTATION ~J. 4. i iL)ale instal,led ~"Pump on". level at in. E. SEPARATioN DISTANCES SEPARATION DISTANCES FROM WELL ON LOT Size in gallons "Pump off" level at ~ Cycles tested SeptiC tanl~/lift station on lot Absorption field on lot I ? 5"' in. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirementS'~ in. ~TO: '. -On adjacent lots. On adjacent lots Public sewer manhole/cleanout ' 'Holding tank · Public sewer main fit. A. .- .. Sewer/septic service line "> z.~-' SEPA. RATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO' Buildripg fo?n(atio, ~ Y' Propertyline 70' Absorption field Waterma~n.=~ h/. 4-, .' Waterse~ce ina '>. to, Surface water Wells on adjacent lots ';> t o o, '. '. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO' P.r°~p!rty lin'.~ ! ~' o' '~ Building foundation c)O' · Water main. Wate.[' Serv~e' hne ">. t~" Surface water '>. /co, ' Driveway. parking/vehicle storage Curtaindrain'~Mc,,,~ $~,,,-, Welsonadiacent ors '>- COMMENTrS= . ..7'4e ~qe~,4,,,C,{..car:~¢e ~" /~,e ~e,~,~ ~e /4,. ..ce~/-~ ,-/-¢_,,,~- b, e-e~e,,'vo ',ENGINEER'S CERTIFICATION -~. ,,~,,-,,,~¢,,- ,~ I' ,,~e 6' ,.~.z,-~' --,,~ ----';-"--~----- '.: : ~ i 'I ' .~.~"~ ~.,~..-'~""",~L I certify that'l have determined throu h field t~[;pections and ;.,.?~.,'"'~_ ~" z~,~ . .. ~ , ....... g _ . ~, :.'~_...oo...~,,~.~ re, v~ew of M~n,tc/pal records that the above systems are tn . .~.~.~.~"g .* CO..r~formanc.~ wtth MOA HAA guidelines'in effect on this date ' Engi~&er's ~ri~ted Name-T'fi ~ ~,~,~, ~-~' /=. ~.-~o o--~. ' Date t:/~A'¢ I: 17 "2.o~, ¥ , , , - ,-., .-~, · OOR~ .... ,-,.% CE.358~ !HAA Fee' $' II;~/..?~ ;'Date of Payment Ji ,ReceiPt Number ::(Rev. 1~01) ~; Waiver Fee $ Date of Payment Receipt Number RIDGEVEI~ DRIVE :::::: :::::::::::::::::::::: · ..:::::::::::. X X ~ : N03'41'00 W MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEAL'I~H DEPA~I~EN~F. OF HEALTH AND ENVIRONMENTAl. PROTECTION APPLICATION FOR HEALTH DirI~HORITY APPROVAL CEt~FIFICATE 1. General Information Application Date (b) (c) Legal Description (include lot! block, subdivision,~ ~;ecticn, township, range) Location (address ~r directions Applicants Applicants Address App].icant is (check one) Lending Institution Buyer ~. ; Other ~ (explain); (d) Lending Institution Te le phone Address (e) t~.al Estate Co. & Agent Address ,' ? Te le phone 2. ~ of residence Single?Family ~_-~ Numl~r of Bedr~m Multi-Family L----~.' Other (describe) 3. Wate~ Suppj.ji Individual ,{ell ~ Community ~ Public [~ Note: If cc~n~nity ~11 system, must have written confirmation from the State Department of Envirorm~ntal Conservation attesting to the legality and status° Is the w~ll adequate fo~ the number of bedroor~ s~.cified in this ~AA (Y/N) 4. ,Sewa~osa 1 Is the wastewater disposal system adequate for the nt~ber of t~droc~m~ (Y/N)__ [Page 1 of 2] 2-15-84 5. Engineerin_~ Firm Providing Inspections, Tests, Data and Information I certify 'that I have checked, verified, c~ conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed Name of Firm Add~ess .... '~.;., ( ENGINEER SEAL) Terms of Conditional Approval The Municipality of Anchom-age Dep~3~tm~nt of Health and Enviroc~rental Protection dces not guarantee tY~ continued satisfactory perfomnance of the water supply and/or the wastewate~ disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished bi an engineer ~egistered in the State of Alaska, the ~ate~ supply and wastewater disposal system is safe and func- tional for the numbe~ of bedrocks and type, of structure indicated. ( DHEP SEAL) 7. Mail the HAA to the following address: !- ~"'~ ~: ~ ' ' 7'/': ''~'~'Y /:: .... ./'- / ~' KB2/d5/s [Page 2 of 2] 2-15--84 BRUST & ASSOCIATES Engineers - Planners - Surveyors 1610 Dimond Drive Anchorage, Alaska 99507 (907) 562-7878 Ron & Terri Jones P.O. Box 670882 Chugiak~ AK 99567 April 26~ 1984 Re: Lot 10~ Block 4 ~ountain Park Estates MUNICIPALITY OF ANCHORAGF. DEPT. OF HEALTH & ENVIRONMENTAl. PROTEcTIoN I~A¥ © ~ ~984 RECEIVED Dear Ron & Terri~ A reinspection of the referenced lot was made on April 26~ 198~, at the request of Andy Zywot. The inspection disclosed that all applicable municipal requirements are met. Enclosed is a filled-out application for your submittal to the DHEP. We appreciate this opportunity to be of service. Sincerely, Stanley Brust cc Andy Zywot P.O. Box 264 Chugiak~ AN 99567 h/ unic pa ty Anchor-age P() ~,.Jl~ 6-650 ANCHORAGE, AI_ASKA 99502-0650 (90 ~') 786-8211 TONY KNOWl F,~r MA Y Ot? April 30, 1984 Ron Jones & Teri Graybill 13340 Ridgeview Anchorage, Alaska 99516 Re: PUBLIC WORKS DEPARTMENT Building Safety Division ~' HJ'lV:lH ~0 'ld:~ Inspection for Code Compliance with Reference to Property Located at Lot 10, Blk 4, Mt. Park Estates Dear Mr. Jones: The above-referenced premises were inspected for Code Compliance. Ail members visible and able to be observed appear to be in com- pliance with all applicable co'des. Sincerely yours, Lou Ellis Code Enforcement Officer Building Safety Division Department of Public Works LE;mp MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ~IRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. Gene~a! Information Application Date (a) (b) Legal Description (include lot, block, subdivision, sect.ion, township, range) Location (add~ess or directions) Applicants Name ?.Z~rz.' ~ ,,-.~-~Y~ ~ Applicants Address (c) Applicant is (check one.) Lending Institution ~--~; Owner/builder ~-~; Buyer ~ ; Other ~-~ (explain); (d) Lending Institution /~//~,-~,F :'" ~ '~:' ~,:,-.~,','~,:. F /'~ .'~ ~lepho~ Ad, ess (e) I%~al Estate Co. & Agent Address Telephone 2. T~ of ~si~n~ Single-F~mily ~ N~ of ~dr~ Multi-Family~-~ Other (describe) 3. Water Suppl~ Individual Well ~-~ Community ~-~ Public ~ Note: If coca,unity well system, must have written confirmation from the State Depart~nt of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA (Y/N) z~z 4. Sewage Disposal. Onsite ~ Public ~ Con~t~nity ~ Holding Ta~k ~ Is the wastewater disposal system adequate for ~he number of kedro~us (Y/N) :'~3 [Page 1 of 2] 2-15-~4 5. Engineering Firm Providing Inspections, Tests, Dsta and Information I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the. /~'>~/ ~4~/~X/ date ~/z~is inspection. Signed Date Namm of Firm ~ ?/~._~'~<.'I -~J /~/.~3~.,~.~-/?.'3 Telephone · /"~'/ ~ Address Signed by Date ( ENGINEER SEAL) 6. DHEP Approval Approved for Approved ~ .~ ~ocms ~sappro~df-q Terms of Conditional Approval Tne Municipality of Anchorage DeparLm~nt of Health and Environmental Protection dces not guarantee the continued satisfactory performance of the water supply and/or the wast~water disposal system. This approval indicates that, as of t~ validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the n~nber of bedrocks and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the follcwing address: KB2/d5/s [Page 2 of 2] 2-15-84 If A~ B, ~ C, D.E.C, ~o~d(Y~) Well ~ ~esent (Y~,) /~ ~te ~,~le~6~~ /~/~/~Yield Total ~p~ > ~m~ Card ~ ~//~w ~pth of G~outing ~ F/~$/~ Static Water ~1 _~--/ (~.~-~ ~ ~t At.. ~/~ Casing ~ight ~ Ground /~//- Sanit~y ~al on ~sing (Y~) Elee~eal Wi~in~ in ~nduit (Y ~essi~ ~ound ~l~ead (Y~) ~p~at~on Dis%an~s ~ ~11: ~ -~'~'Ta To ~ptlc~oldlng Tark ~ ~ ~ ~6 ~,um ; ~ ~joining Lots ~/~ / To ~a~st Edge of ~)so~tion Field on ~.~ .; ~ ~joining ~ts > /m~ To Nearest Public ~v~r Line ~ To Newest Public ~vi~ Li~ on ~t Clean~t/Ma~ole ~ TO ~est ~r ~/~ Wate~ S~le ~st ~sults / C~,~nts .~ m ~ ~'~// ~z/~: /~/~z/~/~ S_EPTIC/HOLDING TANK II~TA Date Installed /~//~. ~/~ m Si~ F/~ D ~ Standpims (Y~) / Air-tight Caps (Y~)~/~ Foun~tion Cl~anout (Y~) ~ession o~ Ta~ (.Y~).~ ~te ~st P~% P~ing~intenan~ Con~a~ on File (Y~) ~F ; for ...~ Holding Ta~ High-Wate~ Ala~ (Y~) .~ ~ra=y Holdi~ Tank ~m~t (y~.).. ~p~ation Distance ~ ~ptic~olding Tank: To Water-Supply .~l~& ' To ~ilding Foundation To ~o~rty Li~ ~..jl . .~~ To Dis~sal. Field To ~ter Main/~=vi~ Li~ ~ ~,~ TO S~e~,~nd, ~e, ~ ~jor ~aina~ 2-15-84 ABSORPTION FIELD DATA Soils Pating in Absorption Stoat ~j~'~¢//~.-_ Type of System Design Date Install~ /JA ~/73 Length of Fiel~ 2~; / Width of Field ~' /Od .,z ~ ~ Depth of Field-~y .?z zfz~ /~,,~ Grail ~d Thickness .~ S~e ~et of ~sorption ~e~ ~ ~ ~ Stan~i~s ~esent (Y~) Results of ~st Ade~a~ ~st ~ ~5 ~ '~ ' {~' ,,,. ' ' Separation Distan~ f~ ~s~ption Field: / To Building Foundation ~ ~ To Existing or ~ndo~d System Lot /~ ; On Adjoining Lot~s ~/OD ~ TO Water Main/Serviu~ Line ~ ~-~Jz4~ ~'~z L~Cu/t~(if pre~nt) TO Stre~ond~ke/~ Majo= ~aina~ Co~se ~ ~ To ~iveway, Parking ~ea, ~ Vehicle Stora~ ~ea ~ ~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Covenants Dimensions MaD_hole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. ~..ets MDA ** / ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, o~ conformed to all MOA on the date of this inspection. ~/~ ~%~.~zya ~ S igne d~////~ ~ Date ~/~ ~/~/, Company _~/-~m~ /~3'~'~/ MOA No. ~7~-' o> ~ KB1/d5/s [Page 2 of 2] HAA Guidelines in effect ENGINEEP~S 5633 B Street . ~ _ _ . MUI',J[CIPALITY. OF ANCHORAGE ~I Drinking Water Analysis Report for Total Cohform t:~L~,e~tEALTH & ENVIRONMEN1-AL PROTECTION ,. TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D. NO. · / Phone No, Water System Name Mailing Address City / State MO. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample, with lab ref. no. i~Speclal Purpose Zip Code SAMPLE NO. LOCATION I 4 I [] Treated Water [] Untreated Water Time Collected Collected By //_ ~, _~/~,~ I TO BE COMI~ED aY LABORATORY _Analysis s~E~{~iE~/~S~'IPLE to be: ~_Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new s. ample via special delivery mail. Date Received - Time Received / ,~-_7 (~? Analytical Method:- ... [] Fermentation Tube .x~ Membrane Filter Lab Ref. No. Result* Analyst I I I-'1-1 I 06-1220 Rev. 1983 BACTERIOLOGICAL WATER ANALY51S RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filte~ Direct Count Verification: LTB.__ Final Membrane Filter Results BGB Date _. Time: TNTC= Too Numerous To Count Coilformll00ml ' ' ' ' DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PRI~?'I~'ITY OF ANCHORAGE  825 L Street - Anchorage, Alaska 99501 DEPT. OF I-~ LTH & ENVIRONMEi',~I AL rkO)~[CTION ENWRONMENTAL SANITATION D VlS ON Telephone 264-4720 APR 2 1980 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND ~I.I.I~ff~VI~DES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER I PHONE Robert Alb±etzI 274-8638 MAILING ADDRESS 1013 W 16th Ave. HOHE LOCATTON ii! Ridgeview Dr. PROPERTY RESIDENT (if different from above) PHONE 2. BUYER PHONE P, onnie Jones 272-7054 MAI LING ADDRESS 1310 W 56th Ave. 99502 3.' LENDING INSTITUTION I PHONE Alaska 1st Mortgage[ 276-0117 MAILING ADDRESS 207 E. Northern Lights 4. REALTOR/AGENT I PHONE Clair Ramsey Jack White Co.I 277-1553 MAI LING ADDRESS 3201 C St. Anchorage 5. LEGAL DESCRIPTION Lot 10, Blk 4, Mountain Park Estates STREET LOCATION Ridgeview Dr. 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [-- Four [] Other E~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM E~ INDIVIDUAL/ON-SITE** [] PUBLIC UT LITY 1973 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) ~ THIS SIDE FOR OFFICIAL USE ONLY . 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX ~ERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED ~ERMIT NUMBER 3. SEWAGE DISPOSAL SYSTEM ~INDIVIDUAL/ON -SITE DATE INSTALLED [~]PUBLIC UTILITY Connection Verified NSTALLER []Septic Tank or [] Holding Tank " Size: ~ If Tank is homemade SOILS RATING give dimensions: TVPEO. TAN. MANUFACTU.ER 4. DISTANCES Septic/Holding Tank IA er Line Nearest Lot Line WELLTO: Absorption Area to nearest Lot Line 5. COMMENTS ~A~PROVED FOR ~'~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED April 3, 1980 R&M N~4U~F~-~ANClqORAGE DEPT. OF i',:i ,L'i;I & ENVIRONMEJ~I,:,.L i, ,_'i.-CT[ON Jack White Co. 3201C. Street Anchorage, Alaska 99503 APR 8 1980 RECEIVED Attention: Clair Ramsey Re: Adequacy Test on Existing Sanitary Sewer System; Lot 10, Block 4, Mountain View Estates, Anchorage, Alaska Dear Mr. Ramsey: Per your request of March 31, 1980, we conducted a test of the sanitary sewer system on the above described property. During this test the liquid level in the septic tank was monitored as water was added to the system. The measurements are summarized in the following table: Time Liquid Level Below Top of Standpipe Total Gallons Added 1:20 5.5' 0 1:26 5.4' 50 1:36 5.4' 90 1:48 5.4' ]40 1:59 5.4' 180 2:07 5.45' 180 The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. April 3, 19.B0 Jack ~ite Co. Page -2- If the 3 bedroom residence on the property is to house 6 people, the average load on the system can be expected to be 450 gallons per day or .31 gallons per minute. During the test, the system accepted 180 gallons in 47 minutes. This indicates an average effluent acceptance rate of approximately 3.8 gallons per minute at the time of the test. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 3 bedroom residence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours, R&M CONSULTANTS, INC. Ernest R. Rahaim Staff Geologist qa~ice Cecere P~6ject Manager ERR/JC/dj/AT&SI-J ISAACS PUMPING SERVICE (Norm Tibbetts, Owner) 6218 Quinhagak Street ANCHORAGE, ALASKA 99507 STATEMENT DATE Phone 344-0114 - .TE I ,.vo,c..UM.£B.D.ecBI.T,O. BALANCE FORWARD ¢ LABORATORY )ter SAMPLE to be: ~nsit; sample should old at examination .~sults. Please send ) of Positive portions ISAACS PUMPING SERVICE ,,.,,~ ~_^~- ^~ou., THIS COLUMN BEFORE COLLECTING SAMPLE Presumptive 10mi 10mi 10mi ,10mi 10mi 1.0mi 0.1mi 24 Hours Confirmatory ~4 Hours 48 Hours EMB Broth 24 hours: Broth 48 hours: Multiple Tuba Report: Membrane Filter: Direct Count Final Membrane Filter Results. Reported By 1Omi Tubas Positive/Total 10mi portions Collform/100ml _BGB Date Colltorm/100ml GREATER ANCHORAGE AREA BOROUGH Department of Environmental ~Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection e 4. 5. 6. REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Mailing Address: Property Owner: '~z~~-~,/~} Phone:~-~~ Mailing Address: ~- ~~~--~,, Legal Descrip~-~~ Location: to Wel 1 Data C. Construction ~~ B. Depth D. Bacterial Analysis 7. Sewage Disposal Syste~:i.;,? , .~ A. Installed ~;~,~ B. Installer ~'~/ C. Septic D. Seepage?pit: 1. Absorption Area ~ 2. Materia~ E./D,i~posal~ Field: Total length of lines /~ ~. Distances: A.Well to: Septic tank ~× , Absorption area Nearest lot line .m~-/~ , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line ,. o Sewer Lines /~cD; EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Rt )st for Approval of Individual Legal Description ~/~/&~ ~'~/ ~ ,er & Water Facilities Approved ,,,~ ~, ~v,.[~- Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I 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. Date SIGNED EQ-034 (1/74) GREAI'ER ANCHORAGE AREA BOROUGH. Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 276-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACIt. ITIES 1. Type of Inspection: CMRO 2. Property Owner: Mai.ling Address: VA FHA CONV ~ Da_~y Phone Mailing Address: Day Phone 4. Name of Lending Institution: ~)'~T i'~-,L,CC?C~ Mailing Address: Phone 5. Name of Realtor or Agent: ~/~-~L~ Mai dress: ~.~ ~(,~ 6. Legal Description: . ._~ Location: x,L~f ;~,,' 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well ?~9~,.: ,.. Sewage Disposal System Type of System: Public Utility Individual If Individual, date of installation (on-site) Eq-037 (!/74) GREATER ANCHORAGE AREA ~OUGH THE UNDERSIGNED STATES THAT HE HAS JUST AND REA- SONABLE GROUNDS TO BELIEVE AND DOES BELIEVe THAT THE PERSON NAMED ASOVE COMMITTED THe OFFENSE HEREIN SET FORTH, CONTRARY TO LAW. z 2';, 1.975 ~ack Whl~e Co. 3201 "C" stzeet 99503 ATI~ON: William Swain SUBJECT= Lo= 10, ~1oC~ 4, Mt. Park B~tates SRA Bo~; 374~B Aneho~a~, Ala~) 9950? St7B~I~CT~ ~ 10, ~lo~k 4, ~{~ntaln Park f~om ~ack White Compm~y, A wate~ samplo w~ t~en at that time, Th~ followln~ ~t~m~ we~ not~d~ 3, S~a~e was pondin~ In a ]~w' ~pot ~ the ~9~ of the two field lines, aro~, Fu~her, ~is office will ~s~pp~ove the s~er ~tem until {uch t~ as tt is determined to be f~t~g p~ope~ly, Th~o ts ~ ltkelih~d t~t you will n~d to u~ade the enti~e I~le~se ~ntaet this office within ~ve (5) d~9 to df~$ tI~i~ prObl(~,