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Home My WebLink AboutMOUNTAIN PARK ESTATES BLK 5 LT 5 NAME /~AI LING ADDRESS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~-~NEW [~PG RAD E EGAL DESCRIPTION 8:5 _OCATION DISTANCE TO: J Absorption a.rea ,~-' NO. OF BEDROOMS PERMIT NO. 'v/'~ No. of compartments Manufacturer ~(~') / IF HOMEMADE: Inside length Liquid depth Well DwelHng PERMIT NO. DISTANCE TO: Manufacturer line Foundation Total length of lines Material beneath tile DISTANCE TO: Length of each NO. of lines / Top of tile to finish ~rade Length Width Depth Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: DISTANCE TO: Depth Driller Sewer line Dwelling Material Width IMaterial N ea rest I_oL line Trench width inches Building foundation Liquid capacity in gallons PERMIT NO.-,. ~ Distance between lines Total effectiv~ absorption area PERMIT NO. Nearest lot line Distance to lot line Septic tank PERMIT NO. Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING NSTALLER REMARKS APPROVED DATE LEGAL 'T'!...l(ii; i....El'.t]iTH [:, ' .,. r-,, i," . .... . ......... · - -. '! !'il'-; [h:.:'l:::'Tq [)F I:::l "."F;?=!',lr?l iq:;? t:::'ZT ;[lili; THE [:,l'c:T:=ff',l::} ::: :?"i,IE?:j:I'. 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' .... : :' : ": ", -:';:'7,: ,:,' '. · GRt:; ANCHORAGE AREA BOr'UGH O ~ ~epartment of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION / /~ ~~o~,,,-v LEGAL DESOR 'PTI ON / i2 T'' ''''~- ~~ SEPTIC TANK: g X'~ ¢/~4/¢- DISTANCE -- / FROM WELL JO~) ~ MANUFACTURER-- INSIDE LENGTH- INSIDE WIDTH MATERIAL - LIQUID DEPTH_ NUMBER OF cOMPARTMENTS--- .LIQUID CAPACITY- GALLONS, SEEPAGE PIT: / $ -~ ~ WIDTH/_~,'1/'' LENGTH ~ ¢ DEPTH NUMBER OF PITS -- [ .-- DIAMETER OR " LINING MATERIAL-Ir~/cck~'Rd~ CRIB SIZE: DIAMETER DEPTH ~''. DISTANCE FROM: WELLJ TOTAL EFFECTIVE BUILDING FOUNDATION~ ~ NEAREST LOT LINE~O/ ABSORPTION AREA (WALL AREA) ~ _SQ, FT, ADDITIONAL ABSORPTION - WELL: ¢ DISTANCE FROM: TYPE _ ~'//~',O CONSTRUCTION- O ~,/(", DEPTH ~ BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION -- LOT LINE , SEWER LINE_ -- TANK -- SYSTEM CESSPOOL OTHER SOURCES. APPROVED - DISAPPROVED -- REMARKS. DISTANCES: _ ~)' ~ INSTALLED BY: ~ PIPE MATERIAL: LOT SLOPE: REMARKS: '~q¢'~'~'/// /¥gT/~ .. DIAGRAM OF SYSTEM DATE ~/'~:::~ --/'~'/ -7//1( APPROVED OO~ flOAO. ANCHORAO[, ALAIKA . /~e ~ ~ ~ Leoal ~escrintion: Lot~Bl°ck ~,..Subdivis~on ')/AZ~ O~J~~p~J ~l~ti on TesE_ , This Form Renorts Soils Lo~ ~ nenth Feet Soil Characteristics Was Ground Water Encountered?/O I~ Yes, At what Denth? Readinq Date Gross Time Net Time Depth to H20 Net Dron ~ Hinute Percolation Rate Install tio~: Seenaae Pit W~m.. Drain Field Proposed ~ ~ ~/ --h~.~ · Trench ,eo, o o,o, cn~ENTS:~/" Test Performed Data Certified BY: Date: GP"~,TER ANCHORAGE AREA BOROIJ'~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N? 897~ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM b;// LOCATION SEPTIC TANK: DISTANCE FROM WELL GALLONS. COMPARTMENTS .~.1~.~ :~1~ .>'i~ ~1 ~-~L / 7:'~. '/L~OU,D INSIDE LENGTH iNSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: / NUMBER OF PITS LINING MATERIAl NEAREST LOT LINE OUTSIDE DIAMETER OR WIDTH LENGTH D~.~ DISTANCE FROM WELL / f-~"-.~ / BUILDING FOUNDATION (",.11 ']')( -~XJJ~,I ~,1'O)1 '- '~'J)(' ,~-~Z.(;/ SQ. FT. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: DISTANCE FROM WELL DEPTH: TOP OF TILE TO FINISH GRADE FOUNDATION WELL: TYPE ;lied ~( NEAREST LOT LINE /C~} ~ TOTAL LENGTH NEAREST LOT LINE , OF LINES ~"'T~NCH WIDTH IN. TOTAL EFFEC~ SQ. FT. LENGTH OF EACH L!NE · ' . z:~.,: ~',~" . ~' '~/:~! ?~ .[~EP~H OF FILTER MATERIAL BENEATH TILE ~' ,'~ FROM .~_,./~/ ,<~.~%/ WATER 7 ~ (~w~/~ DISTANCE DEPTH ~' ~ , BUILDING FOUNDATION'/ ~ SAMPLE -~ SEPTIC / SEEPAGE ] ~:~i SEWER LINE TANK / [~ ~/ SYSTEM CESSPOOL IN. ABOVE TILE.~ NEAREST OTHER SO URC ES~-:'~ DISTANCES: DATE DIAGRAM OF SYSTEM APPROVE . TH AUTHORITY Gre^~eR ANCHORAge AREA BON~UgH ,~ , DEp~I~RTMENT OF ENVIRONMENTAL DUALITY F/~.~ d , ~.~.>: ?-~,L~?' ~oo ~o~ ~o~ ~O~OH ~-~o ANCHORAGE, ALASKA 99502 PERMIT NO. 2204 TELL: HONE 279-80B6 SEWAGE DI.~ sYsTEM '~/ APPLICATION AND,,PERMIT NAME OF APPLICANT fa~f MAILING ADDRESS PHONE LEGAl DESCRIPTION ~/~' /~/~ ~ ~/7~~ ~' I~~ J / SEEPAGE PIT ~~A , DRAIN FIELD ~- OTHER INSTALLATION Of: SEPTIC TANK TYPg AND SIZE OF FACILITY TO Be / TO B~ iNSTALLED BY . F,NANC~n THrOUgh /~/~ NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST SOIL TEST RESULTS COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY S¥=ii~.l~ WITHOUT FINAL INSPECTION BY THi HEALTH DEPARTMENT AUTHORITY WILL 13E SUBJECT TO PROSECUTION. TYPE "~-~ ~:~ ff"~' SEEPAGE Area SiZE SEPTIC TANK SIZE MINIMUM DISTANCES, REQUIREMENTS fOUNDATION TO SEPTIC TANK fOUNDATION TO SEEPAGe pit SEPTIC TANK TO SEEPAGE Pit WALL SEPTIC TANK SEEPAGE PIT TO NEARESt LOT LINE. DRAIN FIELD DRAIN FIELD DRAIN FIELD SEEPAGE PIT AlSO CONSIDER AREA WELLS. SEEPAGE PIT WATER MAIN TO SEPTIC TANK DRAIN FIELD-- sePtIC TANK, J~ SEEPAGE PIT DRAIN field TO RIVer, LAKe, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO Crib CROSSING GAP Of EXCAVATION 5 PEET INTO UNDISTUrbED SOIL, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT ReMOVABLe CAPS. GRAVEL SACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH A ~'H (~1 T'~z OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE DATE MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Lot 5~ Bloc~ 5; Mountain Parr Estate #I CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING (~"/\.'"~- ~L~\- \~-~. HAA#__ Location (address or directions) 1 3 1 1 0 Alpine Drive (b) Property owner Mailing Address HUD #024-663 Telephone: (home) Business (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent _ ASSOCIATED BROKERS/Sandy Address- 640 West $6th Avenue Anchorage. AK 99503 Telephone _ 563-3333 (e) Mail the HAA to the following address: (or check here lq, if hold for pick up.) List contact person and day phone number below: $ & S ENGINEERING/694-2979 '' ~ ~,1'7034 Eagge. Rx'u¢~ Loop Road _qux'~o 204 _ Eag2. o Ri~2o~: A£aAba 99577 2. TYPE OF RESIDENCE Single-Family~ Number of bedrooms 3. WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Enwronmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-siteJ~ PubUc [] Community [] Holding Tank [] Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88] Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S ENGINEERING 17034 Eagle Rib/er Loop Road No. Eagle River, Alaska 99577 Name of Firm Address Date Telephone / // 6. OHHs APPROVAL Approved for ,,~ _bedrooms by Approved ,.~ Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHSdonotconductinspections or analyze data before a certificate is issued. TheMunicipalityofAnchorageisnot responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 ~ MUNICIPALITY OF ANCHORAGE (MOA) MUNICIP,~I'~CHORAGr/-lealth Authority Approval (HAA) ENVIRONME~.__~ICES DlVlSI(;i~I-IECKLIST - FEBRUARY 1984 1989 RECEIVED A. WELL DATA Well Classification ~ ~'~'(~ \ J~ ~ ~ Well Log Present (Y~j::) I~ Date Completed ~ Total Depth'~~-'~'Jr' Cased to ,'~'~"J~ Depth of Grouting Static Water Level 1"7'i~ Pump Set At 343-4744 Legal Description: ~ ~' ~L~,c=~.~d.-- \ If A, B, C, D.E.C. Approved (Y/N) r..~/._./~. Yield "~, Casing Height Above Ground Electrical Wiring in Conduit~gN) '7' SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot \ Sanitary Seal on Casing (~:N) Depression Around Wellhead (Y~;I~ t ; On Adjoining Lots To Nearest Edge of Absorption Field an Lot \ ~\.J~ ; On Adjoining Lots To Nearest Public Sewer Line I~/~ To Nearest Public Sewer Cleanout/Manhole TO Nearest Sewer Service Line on Lot "2.~ I~ Water Sample Collected by ~ ~c ~ ~ ~¢':::~---'¢"~J'~"~l ; Date Water Sample Test Results G'cC~t~[~~ "~~ Comments B. SEPTIC/HOLDING TANK DATA Date Installed V~'~'Z-- Size Standpipes ¢~N) Depression over Tank Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) Air-tight Caps ¢~'N) No. of Compartments ',/ Foundation Cleanout (Y¢~;]~ r'J Date Last Pumped ~7 ; for Temporary Holding Tank Permit (Y/N) ~/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line To Building Foundation To Stream, Pond, Lake or Major Drainage Course Comments To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata '7~7..~'~ ~///¢5,,'L~ Type of System Design ~;;~'- --~--~c__.¢~ Date Installed \ "'~/"~' ~ Lc'/'6:)"/-- Length of Field '"%,¢¢ ~ - Width of Field I ~ ,~/~., -" '"~' ' Depth of Field ~/.-- -- Gravel Bed Thickness -- Square Feet of Absortion Area \ c;~'"~¢¢'~"~'~-'~"I~ Statndpipes Present ¢¢~1) Depression over Field (Y/~ ~ Date of Last Adequacy Test Results of Last Adequacy Test _~~--~'/¢f~--~J~'--/ ~ ~ ~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ~,,c;;~~''F To Property Line \ ~ t To Building Foundation I~ To Existing or Abandoned System on ' -b~ , On Adjoining Lots Lot I ~'~ ' TO Water Main/Service Line \ ~ To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course \ ~;:=~-' To Driveway, Parking Area, or Vehicle Storage Area ~ b'''~ Comments ,~-c~ ¢"~'T- ~ ¢---~.__O~ ~ ~=4:> ~ ¢ c_~.. Date Installed Size in G~ "Pump On" Level High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) -"'"-'""'""~__ Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in inspection. S & S ENGINEERING Sig ed , Company Eagle River~ Alaska 99577 Date MOANo. Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 -% CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 ~~, Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM I.D.# d~.PRIVATE WATER SYSTEM Name ~ & S ENGINEERING Phone No. 170a4 I=a~le RiYer L~e[~ll~aad Ne_= ~ Mailing Ac~[~j~a River, Alaska ~577 City State Day Year ,.SAMPLE TYPE: 'Routine Check Sample (for routine sample with lab ref. no. [] Special Purpose SAMPLE NO. LOCATION Zip Code Treated Water Untreated Water Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ~ Satisfactory [] Unsatisfactory [] Sampletoo long in transit;sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter: Direct Count Verification: LTB_ Final M em b ran~F~~ · Reported By _ ~.~ C/I r~GB_ Collform/lOOml Collform/lOOml Date Time: ~'/~ a.m. p.m. TNTC = Too Numberous To Coun OB = Other Bacteria PART 1 O~ Z REMAI£~DEr TO FOLLO¥t CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAIdPLE for Work Order ~ 13929 Date Report Printed: JUN 13 89 @ 12:$6 Client Sample ID:L5 B5 MOUNTAIN PARK EST {1 PWSID :UA Collected JUN 8 89 @ 17:00 hrs. Received JUN 9 89 @ 15:55 hrs. Preserved with :AS REQUIRED Client Name : Client Acct : SNSENGP P.O.$ NONE REC'D Req # Ordered By Analysis Completed :JUN 12 89 Send Reports to: Laboratory Supervisor :STE/~N C. EDE_ 1)S E S ENGR Special Instruct: Chemlab Ref #: 5672 Lab Smpl ID: 1 }~atrix: WATER Allowable Parameter Tested Result/Units ~ethod Limits NITRATE-N 1.1 n~/1 EPA 353.2 10 Sample ROUTINE SANPLE Remarks: SANPLE COLLECTED BY RJS. Tests Performed ' See Special Instructions Above UA-Unavailable None Detected "See Sample Remarks Above Not Analyzed LT-Less Than, GT-Greater Than MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL I~G OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date July 21, 1988 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 5; Block 5; Mountain Park Estate 4~ ~ Location (address or directions) 13110 Alpine Drive (b) Property Owner Mailing Address [-/LTD Telephone: Home 9111.024663-203 Business (c) Lendihg Institution Mai'ling Address .... Telephone (d) Real Estate Company and Agent MARSTON PROPERTIES/Ed Tolley Address · 4t05 Tu~nagain, Anchoraqe, Alaska 248-1717 Telephone (e) Mail the HAA to the followina address: or: Check here:J~, if hold for pick up. List contact person and day phone number below. S & S ENGINEERING/694-2979 17034 Eagle River Loop Road~ Suite 204 Eagle River, Alaska 99577 ordered by Ed Tolley TYPE OF RESIDENCE Single-Family [] Number of Bedrooms WATER SUPPLY ' Individual Well~ Community[] Public[] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite::[~ 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. 72-025fRev 8/861 Front Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. ~ 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 Telephone the date of this inspection. Name of Firm A ~. s ;NGINEERING Address 170~4 Eagle Rim, er Loop ROad No. 204 I~agie i~iver, Aiaska Date DHHS APPROVAL Approved for ~ bedrooms by Approved ~/~ Disapproved Terms of Conditional Approval Conditional CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 7~-025 (Bev 8/86) Back MUNICIPALITY OF ANCHORAGE ~ HEALTH AUTHORITY APPROVAL (HAA) 0 AUG 1988 CHECKLIST-FEBRUARY 984 264-4744 RECEIVED Legal Description: ~"f'' ~'~ ~'~ WELL DATA Well Classification ~f,~\~ t ¢'~,~/~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/~ /~ Date Completed ~:~¢-~_~ .~ \~ 2-- Yield Total Depth _"-/~-'~&- Cased to ,~C2'A- Depth of Grouting Static Water Level \"~ ~ ~ Pump Set At L~, Casing Height Above Ground Electrical Wiring in Conduit ~/N) Separation Distances from Well: Sanitary Seal on Casing ~/N) To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot _ \ Depression Around Wellhead (Y~ ~ I \ ~ ..1¢ ; On Adjoining Lots ; On Adjoining Lots I,J //~ To Nearest Public Sewer ~.~ To Nearest Public Sewer Line _ r4 / Cleanout/Manhole r~ To Nearest Sewer Service Line on Lot Water Sample Collected by ~ ~ ¢'~ ~..~ 1.1~'¢~--/6;¢~1''-3('' ; Date Water Sample Test Results ~\ ~ ¢-/~"~¢c,.~n.~ ,"- ~ t'~'"~ "~ Comments L.~q..~ ~ ,~:;r-~.'~ ~ - "~6.-- ~ B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes~/N) \/ Air-tight Caps ~/N) _ Depression over Tank (Y~)) - Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ Separation Distances from SepticAbr01~ Tank: To Water-Supply Well _ ~, '-~ ~ To Property Line To Water Main/Service Line No. of Compartments t,],~--. '~ Foundation Cleanout (Y/4:!:~-) rJ j Date Last Pumped '~ ~ '~ ~ f¢*'~ ~/b'~ ;for ~ Temporary Holding Tank Permit (Y/N) /o/~ Course Comments To Building Foundation ~:~ ! _ To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026 (Rev 8/86/ Fronl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~.~/'"~ ~ -"" Width of Field Square Feet of Absorption Area Depression over Field (y/~2 Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well I ~ I~r To Building Foundation ~ ~ Lot I ~ I ~ ':*'/r5¢/_._ Type of System Design Length of Field .~/ .- Depth of Field _ ~ ~ Gravel Bed Thickness ¢'~ Standpipes Present ~/N) Date of Last Adequacy Test To Property Line ; On Adjoining Lots To Existing or Abandoned System on To Water Main/Service Line ~ ~ 4'4- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Cutbank (if present) D. LIFT STATION Date I~ Size in Gallons% "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Bating Against HAA Request ** I certify that I have checked, verified, or conformed to all M/CA a/~d HAA guidelines in effect on the date of this inspection. Signed .......... Co m pa~7/034 Ea~lle River Leop Road No. ~A No. Eagle River, Alaska 99577 Receipt No. Date of Payment Page 2 of 2 72-026 IRev 8/86/ ~ack CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ~.i~.;;~)'~',~['% FEDERAL TAX ID # 92-0040440 ACHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PRIVATE WATER SYSTEM Name S & S ENGINEERING 17034 Eagle Rh, er Leep Read Mailln~E~(~¥el', Alaska 99577 Phone No. City State Day Year SAMPLE TYPE: 1~ Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose SAMPLE NO. LOCATION Zip Code Treated Water Untreated Water Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: E~Satisfactory Unsatisfactory Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time{ Received Analytical Method: Membrane Filter * No; of colonies/100 mi. Lab;,Ref. No. Analyst Result* READ INSTRUCTIONS BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filter: Direct Count Verification: LTB_ Final Membrane t I Reported By ~~ BGB Coilformlt00ml Coilformll00ml Date 7/z:~ ¢~ Time: _ //'~_.~ ~.,x a.m. TNTC -- Too Numberous To Count OB = Other Bacteria PART 1 OF Z REMAINDER TO FOLLOW MUNICIPALITY OF ANCHORAGE . DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF I~iALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR ~ALTH AUTHORITY APPROVAL CERTIFICATE 1, Genera]_ Information Application Date (a) Legal Description (include lot, block, subdivi,~]ion, section, township, range) l.. z:~ r'~. ~ t~,~,~, .~ ~v~..'-~ ~',~. ~..,~.._ .-- ,,:..t, /~i~W .~ '~' ~ ~<-. Location (address or directions) (b) Applicants Name ~ t '~'~ Tele. phone - ttome z,ousiness ~ '~. Applicants Address (c) Applicant is (check one) Lending Institution ~-~. ; Owner/builder ~ ; Buyer ~--~ ; Other ~ (explain); ~.C~.i~I (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone ~o.._. ~7, 1..~ .- 'z. ~, i (f) Mail the HAA to the following address: 2. T~e of Residence Single-Family ~--] Number of Bedrooms Multi-Family~ Other describe) 3. Water Supply~ ~ndividnal Well ~--q ~omm~nlty f--q ~l~ f--] Note: If community well system, must have written confimnation from the State Department of Environmental Conservation attesting to the legality and status. 4. S_ew,!~.~e D_isposal Note: If community well system, must have written confirmation from the State Department of Environmental Cc. nservation attesting to the legality and status. [Page 1 of 2] E_~ineering FiTM Providin~ Inspections~ Tests, File Search~ Data and Info~lation 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 ~mll Municipal and State codes, ordinances, and regula- tions in effect on the date of this &~&~>~R~¥~ installation. Name of Firm /~ ~,z~ ~/ b ~ /~'2~ S __ Telephone J Date .. , ~ .... (ENGI~ER SEAL) ~_7,.,-~6', DHEP A~or oval Approved for __.i~> _ bedrooms Approved ...¢~ Disapproved Terms of Conditional Approval Co nd i t io hal CAIn'ION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH ~]D ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIOMAL ENGINEER REGISTERED IN THE STATE OF ALASKA. T}LE ])HEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE RE~!UIRE- MENTS. ~PLOYEES OF DHEP DO Nfff CONDUCT INSPECTIONS OR ~NALYZE DATA BEFORE A CERTIFICATE IS ISSUED~ TIlE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE, PROFESSIO~kL ENGINEER'S WORK. (DHEP SEAL) RR41eJ/D1.8 [Page 2 of 2] MUNI~PALITY OF ANCHORAQE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOI~ MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 OCT 1 ? RECEIVED A. WELL DATA Date Completed Pump Set At Legal Description: Z~.$, ~::~/C.~ ~U~/~' If A, B, c~ C, D.E.C. Approved(Y/N) -- ~ ~ Yield ~.~c~ ~pth of G=outi~ ~ Sanit~y ~al on ~sing (Y~} ~ . ~ ~ession ~ound ~l~ead (Y~) ~ well Classification Well LoG P~esent (Y/N) /pc Total Depth ~- Cased to Static Water Level --- Casing Height Above Ground Elect=ical Wiring in Conduit (Y/N) Separation Distances f~cm Well: To Septic/Holding Tank on Lot ; On Adjoining Lots To Nearest Edge of Absoz-ption Field on Lot /oo~- ; On Adjoining Lots ~.//~. To Nearest Public Sewer Line ~//~ To Nearest Public Sewer Cleanout/Manhole . ~///~ To Nearest Sewer Service Line on LOt Water Sample Collected By ~.~. ~j. ; Date Water San~le Test Results ~'ATiSw,%~'~k,¥ Be. Standpipes (Y/N) y Air-tight Caps (Y/N) ~ Depression over Tank (Y/N) . A/ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ~/ ; for ~ Holding Tank High-Water Alarm (Y/N) A///$ Temporary Holding. Tank Permit (Y/N) Separation Distances f~om Septic/Holdin~ Tank: ' To Water-Supply Well To P~operty Line To Water Main/Service Line Course ~/~ Coh~nts No. of Cu~a~tments ~ Foundation Cleanout (Y/N) AZ' To Building Foundation ~9-x To Disposal Field ~ ' To Stream, Pond, Lake, c~ Major D~ainage [Pa~e 1 of 2] 2-15-84 C. ABSORPTION FIELD [1%TA SOilS Rating in Absorption Strata Date Installed Width of Field Squa=e Feet of Absc~ption A=ea Depression over Field (Y/N) Results of Last Adequacy Test ~=~o. Type of System Design / Length of Field g--~ / of Field Depth Gravel Bed Thickness- 7 ~2z~~ ~ Stanc%pipes p=esent (Y/N) A/ Date of Last Adequacy Test ! Separation DistanCe f~c~ Absc~ption Field.' ~,/ To Water-Supply Wall /OQ~- .... To P=operty Line TO Building Foundation .~/~ To Existing ~ 4~ System cn Lot Il ' ; O~ Adjoining Lots N/~ To Water Main/ServiCe Line m,/~ To Cutbank(if; present) ' To St=eam/Pond/Lake/c~ Major D~ainage Course . ~/~ To D=iveway, Parking A~ea, c~ Vehicle Stc~age A~ea Date Installed Size in Gallons "Pump O~" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Ccmlrents Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles ~,~ing Adequacy Test. Meets ~DA ** Check Per~mitted Bedroom Rating Against HAA Raquest I ce=tify that I have checked, verified, c= aonfo~r;~d to all MOA HAA Signed ~ Date /~ . q' , ~ / Company ~~~ ?~ ~7~ MOA No. KB1/d5/s [Page 2 of 2] effe~ct 2-15-84 BESSE, *PS & POTTS October 8~ 1984 Municipality of Anchorage Dep~rt~nent of Health and Environmental Protection 825 "L" Street Anchorage, AK 99501 Attn: Keith Bandt Re: Lot 5, Block 5 Mountain Park Estates - Adequacy Test Dear Mr. Bandt, On October 5, 1984, the referenced on-site lot septic tank was pumped out and approximately 1000 gallons were recovered. Shortly thereafter over 500 gallons of water were pumped into the on-site leach field and the field was found to be adequate at that time. Sincerely, Engineer RPW/lbs ENGINEERING, PLANNING, SURVEYING 2220 E. 88th Ave./Anchorage, Alaska 99507/Telephone 907-349-6451/344-1352 "Providing a quality personalized service to those building Alaska's future" BESSF.~ EPP$ & P~I~S 2220 F~T 88 AV~UF. ANCHO~AGE~ AK 99507 (9O?) 349-6451 ~ATF~{ ~-LL Subdivision: Lot: ~ Block: ,c, Add~ess: 1 i% I10 AL.'P~,V,~. Tester: "~.. d, Initial Reading on Meter: TI~ GPS A ¥OLUSE TOTAL ~LU~ NOT~S: 'r-or, iL a4z. F'O-°bo~-~b :glX .R~.b/~41. Production Rate: ~;3 GPM 24-Hour Capacity -- Gallons .I-~ ~me Time Date Date Date Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed Permit No. Septic Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~l KE ~ MalllngAddress % ~0¢1 ~E~T7 ~.~u~}~U~ ~ ~4 ~ ~0 Address ~ /~ ~ ~e Z~ 7 Lendln~qnstltutlon /4~/~f~ '[''~/' ~'' S~/~ ~ ~/o Phone Address 3~0 E. 2~ ~o t~' ~ .......... ~g~ ~ E Legal Description ~1 ~ ~c~ ~ y~ . I'~f~ ~. ~, ~ ,~: ~ Street Location ~ ~/~C~ ~ I~ ~ Type~f Residence ~ Single Family D Multiple Family No. of B~drooms ~ Other , " /~ , Wat~Supply~ ~ ' ' . ~ Individual ACH W~L LOG. A well log Is required for all wells drilled since June ~ Community , / 1975. For wells drilled prior to that date, give well depth (attach log If ~ Public Utlllt~ ~/ available.) Sewage Disposal ~ Individual YearJndividual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ALASKA [1UI[ OllmdlTAL CO[1TI OL Sd UIC $, linC. ~nqineeeinq 15 ~nuieonmentoJ Studies MUNICIPALITY OF ANCHORAGE DEPT. OF : ' ENVIRONMENTAL ~ ~.i[.C[iON 12/22/81 MIKE ARCHER SRA BOX 368-A ANCHORAGE AK 99507 SRr,r,~,R - MIKE ARCHER BUYER- SUBDIVISION-MT. PARK ESTATES BLOCK-5 LOT-5 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYST~bl IS A PIT WITH AN AREA OF 712 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 320 GA;ZONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 50 GA~ONS. THE SYSTEM IS UNACCEPTABLE BECAUSE THE SURGE CAPACITY IS LESS THAN 75 GAr.tONS. THE SYSTEM IS NOT CAPABLE OF ACCEPTING 450 GAY;[ONS OF WATER PER DAY. THE SE?TIC TANK WAS PUMPED ON 12/22/81 . SEPTIC TANK ADEQU/~L'Y THE EXISTING SEPTIC TANK VOLUME OF THIS 3 BEDROOM HOUSE. 1000 IS ADEQUATE FOR 1220 U Jest 25th Auenue · Anchoroqe, Alesb 99503 · (907) 276-1351 GRBATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received Time of Inspection, Date of Inspection Number of Bedrooms: 6. Well Data= A. Type ~Zc~)- B. Depth.. C. Construction ~/Z,g/ ' D. Bacteria] Analysis 7. Sewage Disoosal System:~~~-~ ,/Jc~.~ A. Installed B. Installer C. Septic Tank: 3., Size 2. Manufacturer D. Seepage Pit: 1. Size 2. Material E. Disposal Field: Total Length of Lines A. Well To: Septic Tagk~, Absorption Area , Nearest Lot Line Foundation to Septic Tank , Sewer Lines , Other Contamination . Absorption Area . C. Absorption Area to Nearest Lot Line 2ecp~est for Approval of I Page Two tdual Sewer & Water Faeflitfe, Approval Valid for One Year From Da~e Signed Greater Anchorage Area Borough, ge~rtment of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representat~.on of the subject sewer and water facilities located at: Signed Date March 1.5, 1973. WILLIAM A. EGAN, GOVERNOR SOUTHCENTRAL REGIONAL OFFICE MACKAY BLDG, 338 DENALI STREET ANCHORAGE 99501 Mr. William M. Bm~kston P. O. Box 1713 Anchorage, Alaska 99510 SUBJECY: Lot 5, Block 5 --Mountain Park Estates Dear Mr. Bankston: As long as the existing water and waste disposal systems met 6AAB-DEQ standards m~d were existing pr:lot to February 5, 1973, we have no objections 5n regard to the emergency waste water regulations with regard to transfer of o~mership. AAS-DZSQ / Gk...,TER ANCHORAGE AREA BOROUGh DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDDR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR APPROVAL REQUESTED BY: ADDRESS: PHONE: PROPERTY OWNER: 0/'// TYPE FACILITY TO BE INSPECTED: .~?/>?~'~4 //2~,~/' STREET: /"~'~/~//7~' ...~,'~'~i.¥ NUMBER OF BEDROOMS: ~'~ ~'~ ~ :/ ' WELL DATA: A. TYPE ~'//r B. DEPTH C. SIZE D. CONSTRUCTION E. BACTERIAL ANALYSIS SEWAGE DISPDSAL SYSTEM: AJ 2 AGE 3. MANUFACTURER 4. INSTALLER 7~ APPROVAL REQUE. PAGE TWO FOR SEWER & WATER FACILIi B. SEEPAGE PIT 1. SIZE 2. LINING C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT WELL TO SEWER LINE WELL TO PROPERTY LINE '- WELL TO OTHER POSSIBLE CONTAMINATION FOUNDATION TO SEPTIC TANK -- ! G. FOUNDATION TO SEEPAGE PIT. /~ H. SEEPAGE PIT TO PROPERTY LINE -~ COMMENTS: APPROVED: ~,,:, "~ DISAPPROVED: DATE: ':' ,~:' ' ' ii ~-.--: DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SI.GNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALIt SuF~iec~: Sewur ,~nd !~ater Facilities Servine ku~] 5 ~$1r)c~ . I ~ul vi 0~ . Sir. u:,, Se~!F.~,mher 1 1f)77 Also hr:sitate ~n cm~,l;ac~, thi,~ office,, Timothy L. [Tumf;'~l [; Sa~itaria~