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Home My WebLink AboutMOUNTAIN PARK ESTATES #2 BLK 2 LT 11Mountain PaPk Estates Block Lot 11 #017-022-11 " Municipality of Anchorage Page J of 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: ~'ta~:~7 O5//! PIDNumber: Name: ~c.~r,~ }}~rc~ Wastewater System: ~ New ~ Upgrade Address: }Zl~ HII~I~ P~ , ~ ~J~ ~ ABSORPTION FIELD Phone: ~ ~-- 7 ~ ~ ~ ~ Deep Shallow Trench ~ Bed ~ Other LEGAL DESCRIPTION SOil Rating: ~ Tota~m original grade: GP~Ft. Lot: Block: Subdiv~ion: Depth to pipe boEom from original grade:~ ~el depth beneath pipe Township: I Range: I Section: Fill added a bo v eo r,'g',nal, al~ ra Grav~: ~ Ft. % Ft. WELL: ~ ~ ~ New ~ U pg rade Gra~e~ width:~ Number of lines:~ce be~een lines: / Ft. I ~ Ft. Ft. Ft. ~ Ft Driller: Date Drilled: Static Water Level: Inetaller: Date installed: Yield: GPM I Pump Set at: Ft. I ca,,., Height Above Ground:Ft. ~ TANK SEPARATION DISTANCES ~ s.pt~c ..o~in~ ~ From Tank Field Station Tank Sewer Lines ~ ~O ~e ~ ~ ~ OO ~ Material: Number of Compa~ments: WeW lot ' S~e I Su~ace w~t~ >~, LIFT STATION N. Lot I Line I ~ I Size in gallons: Manufacturer: Foundation ~ ~ "Pump on" level at: "Pump off" level at: High water alarm at: CuMainDrain -- Pump Make & Model Electrical Inspections pedormed by: BENCH ~ARK ~ Location and Boscdption: I Assumed Elevation: ENGINEER'S SEAL Inspections pe~ormed by: F[af 7¢c~ ~r Dates: 1si 7/~/)~ ..............., ,; ~ ~ · 2nd Reviewed and 72-013 (Rev. 9/91) MOA 25 PERMIT NO: SW970411 PAGE 2 OF 2 PID NO:01702211 ~'--PROPERTY LINE// -,~R 100' ,~ALARM FLOAT / TBM" '~ ~ NEW 4000 GALLON / ~ ~'.V ~HOLDING TANK / A~RM~ ~ ~ ~ ' FROM: COR."A" COR.,,B,, ~ ~ ,, TO: ~ ' C.C. "C" 17.5' 29' ~ ,, 6" C.C. "D" ~7.5' 37' ELL PLAN VIEW SCALE: 1" = 30' ~C.O. ~6" C.C.~ A~RMFLoAT C.C. GROUND~ ELEV. 100.1' 94. o' ' NEW 4000 GALLON HOLDING TANK L11, BLK. 2, MTN. PARK EST. ~2 HOLDING TANK INSTAL~TION PROFILE VIEW AS-BUILT INSPECTION REPORT SCALE: 1" = 5' FLA~OP THC~[C~ SER~CgS SCALE: AS NOTED ~4530 ECHO ST~HT DRAWN BY TFM ANCHO~Og, ALAS~ 995 ~6 JULY, 1998 JUL-11-199B 16:}91 CT&E ESI ANCHORAGE ~II'K'. CT&E Envlronment.! Services Inc. 90?5615501 P.02×05 CT&E Ref.# 982087008 Clien~ Name Flattop Technical Sty. Project Name/# n/a Client Sample ID L 11 Blk 12 Mm Park F~t//2 Matrix Drinking Water Ordered By PW$ID 0 ~amplc Remarks: Client PO// Printed Date/Time 07/11/98 16:11 Collected DateFl"hne 07/08/98 09:45 Received Date/Time 07/08/98 15:50 Technical Director:. Steplien C. Ede ~arame:er Results PQL fo:at Cotifo~ 0 cot/lOO~L litrate-N 1.28 0.100 Attouabte Prep ~ethod Limft$ Date Date Init S~18 9Z228 07/08/98 EPA 300.0 10 max 07/08/98 07/08/98 RHV 7-8- 3 PAGE 1 OF 1 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 (UPGRADE) PERMIT PERMIT NUMBER:SW970411 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:HARRIS RICHARD D OWNER ADDRESS:13120 RABBIT CREEK RD ANCHORAGE, ALASKA 99516-3262 PARCEL ID:01702211 DATE ISSUED:12/09/97 EXPIRATION DATE:12/09/98 LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES #2 BLK 2 LT 11 LOT SIZE: 23760 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 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 PROVISIONS: 1. AT THE TIME OF CONSTRUCTION, ENGINER SHALL PERFORM A SOILS TEST TO A MINIMUM DEPTH OF 23 FEET. A PERCOLATION TEST SHALL BE RUN AT A MINIMUM DEPTH OF 17 FEET. RECEIVED BY: ~~C~< ISSUED BY ~// : ~~ DATE: DATE: T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Daniel J. Roth Municipality of Anchorage Department of Health and SOcial Services 820 1 Street Anchorage, Alaska 99501 Subject: SW970411 Mountain Park Estates #2 BK. 2, Lot 11 Richard D. Harris May26,1998 Gentlemen; Per your instruction we drilled a testhole on this property on May 20, 1998. The testhole extended to 28 feet. The soil encountered was a sandy silt for the first 5 feet, probably imported material, and a moist, plastic, dense silt to the bottom of the hole. No free water was observed during drilling. On May 22 the hole was full of groundwater to an elevation 4.5 feet below ground surface. Please revise the permit to reflect the installation of a 4000 gallon holding tank as originally proposed. Yours ~gth SPURKLAND No, CE-2225 VACANT I AmNOON. SCALE; 1' = SO FT~ EXIST, T~ENCH ~ INSTALL 4000 OAZ. HOLDING TANK I I EXISL ~000 GAL S.Z ABANDON. I 125 ZgEA/?MI?UN /?DAD TOBBEN SPURKLAND P.E. 203 14/ 15TN. AVENUE ANCH. AK. 9950! (907) 279-39~6 II LOT 11 BLOCK 2 MOUNTAIN PARK EST. i3f20 HILLSIDE RICHARD HARRIS J J SEPTIC SYSTEId DES/ON DATE: NOV. 21, 1997 SHEET: 2/$ O£1D: 2859 PERMIT # S~/970XXX PlO # 017 022 11 MPEO2111.~9~/G f?A]N CAP 6 ~ PUMP 1' X 10' £ONEU[? 1' dAL VANIZED LB, HIOH F/ATE£ ALARM MERCU£K SF/ITCH FL S ?AA/PA£P 4000 ANCHD£AdE TANK NO S£ALE _1 -I ~?]RECT BUP,[AL F/IRE TO ALA£M PANEL 75,5~ , 1~ PV£ CDAIDUII BENCH I~ARK: ASSUMED ELEK 100.00 Ell. T[3BBEN SPURKLAND P.E. I IL[TT 675~ ~/, ]D~NE]ND ~BLVD. II ANCH. AK. 99508-3904 (907) P4~-509~ 131~0 H[LLSIOE O££VE II £ICHA£~ HA£f~IS SEPTIC SYSTEM DESIGN SHEET, 3/3 GRID: Z~ SW970XXX PID ff 017-022-1i WPEO2113. DWG 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN MOUNTAIN PARK ESTATE #2 BLOCK 2, LOT 11 RICHARD HARRIS 13120 HILLSIDE DRIVE Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 December 17, 1997 Per your verbal insistence we are resubmitting an application for a septic system upgrade for this property. The design is based on a single testhole excavated on April 30, 1980 which shows a very dense silt to 15 feet and moist, clean well graded gravel from 15 feet to 21 feet, which was the bottom of the test hole. No ground water monitoring was performed, neither was the presence of the gravel verified in a second testhole. Per your instructions I am assuming that at least two feet of the gravel strata can be utilized. This assumption will be verified by groundwater monitoring during break up. A soil rating of 1.2 has been assumed based on the description of the gravel material.. No Ground Water or Impervious Layer to 23 ft. Use 5 Wide Standard Trench Soil Rating. 1.2 gal per sq.ft/day No. of Bedrooms 4 Required Areaper Bedroom: 150/1.2 - 125 sq.ft.. Reduction factor for 24 inches of rock: 0.70 Total area required: 125 x 4 x .7/5 - 70 ft Outlet Existing Tank 5 feet below ground Backfill with sewer rock to 6 feet. SYSTEM CONFIGURATION STANDARD 5-WIDE TRENCH TOTAL LENGTH 70 FT TOTAL WIDTH 5 FT TOTAL DEPTH 17 FT ROCK DEPTH 11 FT COVER 6 FT SEPTIC TANK i250 GAL The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. N 100 150 -- ~.00 FT, LOT LOT ]~ PEA £ PI I~ U N 300 ¥ % % VA£AN? LOT 10 II II TOBBEN SPURKLAND P.E. 205 W 15TH. AVENUE ANCH. AK. 99501 (907~ 279--~ 1 ~ LOT 11 BLOCK 2 MOUNTAIN PARK EST. 15120 HILLSIDE R/CHARD HARRIS I I SEPTIC SYSTEM DESIGN DATE: NOV. 21, 1997 SHEET: /'/5 GRID: 2859 PERMIT II S~/970XXX PIP # 0]7 022 11 PIPEO2ill, BIF5 SPURKLAND NO, CE 222S V~NT EXIST, T£ENCH SCALD /~ SO FT~ PRDPOSE~ 5-7~EI TRENCH I DEA~MDUN ~DAD TOBBEfl SPURKI_AND P.E. 205 W ISTH. AVENUE ANCH. AK. 99501 ('907) 279-J916 II LOT 11 BLOCE 2 MOUNTAIN PARK EST. 15120 HILLSIDE RICHARD HARRIS SEPTIC SYSTEM DES/ON DATE: NOV. 21, 1997 SHEET; 2/5 GRID: 2839 PEP, NIT # S~/970XXX PI]9 # 017 0£2 l/ MPEO2111,D~/5 EXISTING TRENCH 5' Wide ~Y2-.5' L on9 17' ~eep 1LO' Sewer rock 6' Cover 10+ FI-. REPLACEMENT TRENCH Cleon /]ut Cleon LluI SILT 11,0 Pt o£ Septic Rock NO SCALE Cleonouts Non/tom 6' Cover NO SCALE DIVE£TE£ VALVE Septic tank Foundo f~ion Cleon out 4Exist, 5roun ' Nih Cover ~ ~er septic tank BENCH TEIBBEN SPURKLAND P.E. ~03 W15th Ave II Anchorage Ak 99501 P77 MOUNTAIN PARK ESTATE //2 BLOCK 2, LOT I1 SEPTIC SYSTEM DESIGN DATE, DEC, 8, 1997 SHEET, ~/~GRID, ?839 PERMIT NO. SW960XXX PIP NO. 017-022-I1 MPE02114. DW$ PERFORMED FOR: LEGAL DESCRIPTION: 8 9 10 11 12 13 14 19 20 COMMENTS PERFORMED BY: 72-008 (7/76) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch ~-650, Anchorage, Alaska 99502 276-2~.1' SOILS LOG- PERCOLATION TEST SOILS LOG [] PERCOLATION TEST Ok)iq' t:::L ~1 HL/6 H SLOPE DATE PERFORMED: Z/'4 6;2/~ SITE PLAN IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop : /.49m 'x~/] _. 25-E _.;¢r~ AND PERCOLATION R A~, t<~ ~"~' ~" (minutes/inch) CERTIFIED BY: -- FT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-472.0 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl. INSPECTION REPORT NA~'~ = . IMAI LING ABD'RESS ~ I LEGAL DESCRiRTiON LOCATION, ~ . -- ' -, ' ' Well Ab o p ~ Manufacturer m lUq. cauacitg M ~alh ,,~ I Inside length I~idth / D~ IF .uMEMADE; DISTANCE TO: We Dwe ling PERMIT NO. Manufacturer ~ Material Liquid capacity in gallons Well DISTANCE TO: //,~<~ / No. of lines / Length o?~ach licqe Top of tile to finish grade Length Width Foundation Total le.~gth o~lines Material beneath tile Depth Nearestlpt li~e Trenchw~ inches inches NO. OF~EDROOMS ~ PERMIT N O.~4~) ~_ No. of compartmen~_~_ Liquid depth PERMIT NO. ¢,~0(~ D ista ,ce bet~,2~ Total effectige absorpl~n area PERMIT NO. Type of 8?lb Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Depth ! Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER REMARKS APPP~ DATE LEGAL " . ELL oN .... S :'T'E ' .............. .... , ........... TYPE OF :,OIL RBSORF'TION SYSTEM IS: TRENCH HHXIMJH NLIMBER OF BEDROOMS SOIL RBTING (ST! FT/BR)= 85 THE REL~.UIRED _,IZE OF THE SOIL 8BSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DR~INFIEL. D. THE DEPTH OF 8 TRENCH OR PIT IS THE DISTBNCE BETWEEN THE SURFBCE OF THE GROUND 8ND THE BOTTOM OF THE EXCBVBTION (IN FEET), THERE IS NO SET WIDTH FOR TRENCHES. THE GROVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRL.L PIPE 8ND THE BOTTOM OF THE EXCRVRTtON <IN FEET). PERMI"r RPPLICRNT HBS THE RE:,FuNSIBILITq TO INFORM THIS DEPFtRTMENT [URING THE INSTRLLRTtON INSPECTIONS OF 8NY WELLS 8DJRr:ENT TO THIS PROPERTY RND THE NUMBER OF RE:IDENLiE_ THF~.T THE WELL HILL SERVE. BSCKFILLING OF RNY SYSTEM WITHOUT FINAL INSPEC:TION ~ND F~PPROVF~L'BY THIS DEF'SRTMENT HILL BE SUE:JECT TO PROi~EUUTILN. MINIMUM DISTBNCE BETWEEN 8 WELL. 8ND 8NY ON-SITE SEWRGE DISPOSAL SYSTEM IS t00 FEET FOR 8 PRIVBTE HELL OR i50 TO ~00 FEET FROM RIPUBLIC WELL. DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTBNCE FROM 8 PRIVHTE WEE. L TO 8 PRIVBTE SEWER LINE IS 25 FEET' 8ND TO 8 COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS 8RE REQUIRED 8ND MUST BE RETURNED TO THE DEP~RTMENT WITHIN ~0 DBYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MHY 8PPL. Y. SPECIFtCBTiONS 8ND CONSTRUCTION DIBGRBMS 8RE HVBIL8BLE TO INSURE PROPER INSTHLLBTION. I CERTIFY THBT l: I 8M FRMILIBR HITH THE REQUIREMENTS FOR ON-SITE SEWERS 8ND HELL, S 8S SET FORTH BY THE MUNICIPBLITY OF 8NCH[RMGE. 'P' I WILL INSTBLL THE ,_b~TEM IN 8CCORDBNCE WITH THE CODES. :~: I~ UNDERSTBND THRT THE ON-SITE SEHER SYSTEM N~Y REQ_IRE ENLARGEMENT IF T~E PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5- 7 8 9 SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99602 276-2224 [] PERCOLATION TEST SOILS LOG- PERCOLATION TEST L%L II, SLOPE HL/cH SITE PLAN , 10 11 12 13 14 19 20 COMMENTS WAS GROUND WATER RI ENCOUNTERED? ~;~ IF YES, AT WHAT DEPTH? PERFORMED BY: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION R A~'~ ~-"~ '~'"'~' (minutes/inch) TEST RUN BET, WEE. FT AND -- FT CERTIFIED BY: 72-008 (7/76) . RETURN TO: Division of Geological and ' /slcal Surveys (DGGS) STATE OF ALASKA . ~ 3001 Porcupine DrJve (Tel% ..ne: 277-6615) DEPARTHENT OF NATURAL RESOURCES Anchorage, AJaska 99501 WATER WELL RECORD Drilling Company Name ~) ir1 ~ i~['$(~ U.S.G.S' Local NO. / Orllllng Permit No. .OCATION OF WELL~1 Please complete either la, lb, or lc. A.g.L. Borough Subdivision Lot Block lb. Fraction Section No. Township Range Meridian Street Address and Area of Well Location Feet Bel~ 4. WELL DEPTH: (completed) Surface Elevation Date of WELL LOG Surface C~pl et ion Materlal Type Top Bottom ~ ~ f:. ~'F; Il ~,':~ *~l, le~ 0 I 'S' 5. ~CabJe t~J ~,otaFy ~Driven ~y/ ~J ~ 0 ~ ~lrrigation ~Recharge ~Co~rcia' lbs/ft. [~-Zl/~ ~j~,~/ ~[f-~ ~ ~ ~J 0 ~ in. to ~' ft. Depth Weight ~ t ft. Depth AVl Set bet~en ft. and ft. Fittings: 9. STATIC WATER LEVEL: /~ ft. ~A~vm ~Below land surface ' ' Type Of Measur~nt: '~ ~ ~, I0. PU~PI]6 LEVEL below land surfaCe ~/:~ ft. after / hrs. pumping ~ g.p.m. ft. after hrs. pumping g.p.m. ll. WELL H~O COMPLETION: ~ in Approved Pit Pitless Adapter inches above grade 12, GROUTING: Well Grouted: ~ Yes Material: ~Neat Ce~nt ~ Other: 13. PUMP: (If avallab]e) HP Length of Drop Pipe~:~O ft. ca~clty ~ g.p.r Type: ~Sub~rslble ~Reciprocat lng l~. REMARKS: 15. WATER WELL CONTRACTOR'S CERTIFICATION: This well was drilled under my jurisdiction and thls report ls true to the best of my knowledge and be) left Registered Bus~n~5~ ~iame Contract License Number J~ ~ ~ ~ Oate: Authorized Representative Form 02-WWR Copy-Distribution: WHITE - State DGGS, PINK - Driller, CAHARY - Customer Eplarts -A- Pq-Per7 Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7e04 CTNTITIcATE oF ON-SIIE SysrrMS APPRoVAL Parcel l.D. 017-022-11 1. GENERAL INFORMATION Complete legal description Mountain Park Eslates SZElock 2 Lot 11 Location (site address) 131 20 Hillside Dr^ Current Property owner(s) Rogan & Sandra S.cottt Mailing address Real Estate Agent TYPE OF DWELLING: X Single Family (w/wo ADU) n Duplex n Multiple Dwellings (Single Family and/or Duplex) 2, X Tux ,X 4-f'InL TYPE OF WASTEWATER DISPOSAL: lndividuat f Holding Tank X Community tl Public Sewer n WaiverA/ariance request for: Distance: Expiration Date: -J".\ t-U, a OfO_-?- Day phone 13'120 Hillside Dr. Anchoragq AK Day phone 3. NUMBER OF BEDROOMS: 4, TYPE OF WATER SUPPLY: lndividual Well lndividual Water Storage Cornmunity Class _ Well Public Water System Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $,fffo Date of Payment Receipt Number qltlaoaD Waiver Fee $ Date of Payment Receipt Number Waiver #cosA# 0o ceoile" 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affxed hereto and as of the validation date shown below, I verify that my investigation, based on proceduGs outlined in the Ceftificate of On€ite Systems Apprcval Guidelines for this application, shows that the on€ite water supply and/or waste\ /ater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of struc'ture indicated herein. I further verify that based on the informition obtained from the Municipality of Anchorage files and from my investigation and inspec.tion, the orFsite water supply and/or wastet ater disposal system is(arc) in compliance wilh all applicable Municipal and State codes, ordinances, and regulalions in eftct at the time of installation. NAmE of Firrn AECTERRA CONSULTING. INC.Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99527 Engineer's Printed Name KENNETH M. DUFFUS _ Date Enginee/s Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of lhe day tested. The flow and absorption rates may change due to subsurface conditions that may not be obserued from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during lhe year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characleristics and are outside the control of the evaluator of the well and seplic syslem. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. 6. DSD SIGNATURE J System #1 Approved for -{-- bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms, bedrooms, with the following stipulations: ttu!(llgtl(rr Ttn: z) D S s WATE ?,- W-7€s i*$ :\\. Nitrate Advisory Arsenic Advisory ',ffi u'/x / 4+* / '+* l o**"llll,i[,T}.;l. The Munioipallty of Ancho€go Dsv€lopmant Ssfllc68 Divislon (DSD) i$ues CedificaGs of Onsite ql3tcms Appro/sl (COSA) bas€d only upon ths rlpr8lntations giv€n in paragEph 5 by an independentprcfosrional civil ongineer .€gi6lrrld in thG State ofAlesks. The Munklpality of Androrage is not responsible for €r0r3 or onlsglons in thg protsssional 6flginee/8 work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory cosA blu€ sheet_1 0-1 0-1 2.ds X MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Holding Tank Advisory Certificate of On‐Site Systems Approval # OSC201137 Subdivision: Mountain Park Estates #2 Block:2, Lot: 11 The holding tank for this property is 22 years old. The average life for a steel tank is 20 years. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. NORTHLAND PUMPING SERVICE, INC. Yow NWJR."Mrinl Sir tic Ramping Service CoiyiWny- 7fAll E. 14(ilh A%mnue AnOwzge, AK 99516 (9W)344-71116 Fax W7)8GA-E1,rIQ 3-W PIM Northland Pumping S Inc. W3021) Custwner QuIckReport March 1, 201:9 thimugh March 13, 2020 TYPD SCOL I&MOND 1"(fte I rw Droe :132FMln Irm-nice Pqrnom I Rwolce Imcci:ce paymkv I rW %GrE IWDIC:E IrN Die@ Palrrtert I rr(olce P a yrrie rrt lnYC4:@ Pjym--ft lrw nice 334Mgrl 13010 tFMNNW CLr split Amooffl - o_MfrADl.9 2W52 Pe-,eftatH'@ I a410.w1:g 23EUD -SPOT- 170M o4nwms V A=urls Rec... sx.00 DrA 1 rM Sj 29750 Ecelya-Die -SPUT- 170.0 TNDV"9 V K.- 'UMapOsit-ed Fundb X A,-c-yjr.FS Rec... 170.10 0529MM9 2EaW AtonLrrtz Reccrhi ab!u -SPUT- 170.17 06r,!=l 9 213925 Aco'nurrrs R-2Ce* oir- : •Spur- 170.00 T171 Bmi 9 V ol... 'Ufl(*PffhN FjnC Ax�courrW 34DJBG 07fr19 2990 AtCoulff Rwql�fjL, -SPUT- 170 BYMMI� 2!3~3W AscQUntj Recg(2-- -SPUT- -OD Com 09wrW19 FC 1 D- finance Char.. ALtokjfftf, H Ec---, -- -SPUT- a.AD IMIM9 V U.- 'lJrXleRGd F--:- ft . 0 10. 4.0 1 lfqMI9 MID AmLints Rece ._,-R SPJi 170.00 114=19 V 03... 'tJ ndepogll,;-j Ac:cDufftis 1713JDO 0111 D2WD 2M3 ACC-DLtM� F :;- . it;e -sFUT- 17DM 0MD2= V Url--- LjFld%GSIEl FunaE X AftOLwrts Rec... 1171) ou EqW= 2MJS ACcCWfft5.R EcErfabjB -SPUT- MAO &MQWM V 01- 'Ljna"=Ea fLqds ACCOUNFr Rec.-. 17G.00 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ~/7~ 0 ~--~ - 1..'GENERAL INFORMATION Complete legal description Location (site address or directions) I1 Property owner Mailing address Lending agency Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. ~-2.~ NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: TYPE OF WASTEWATER DISPOSAL: Individual On-site : ~ ' i HOlding tank ~ : Community on-site · pUblic sewer If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 5. STATEMENT OF INSPECTION BY ENGINEER. As. certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations n effect on the date of this inspection. Address 20.~ 1,¢' ],3~,J"¢1 '¢-¢",,¢~-¢) ~ rO / Phone Date ,'' '~.¥' "' . _' - 7. 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Four (4) bedrooms, with the following stipulations: Money shall be put in escrow to construct a new wastewater disposal system in, accordance with the attached permit number ~W9704ii. The above work shall be completed by no later than June 15, 1998. Money in escrow shall not.be released until this Office has given final Additional Comments By: Date December 17, 1997 The Munioipality of Anchorage Department of Health and Human 8eh/ices (DHH$) issues Health Authority Approval Oertifioates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the 8tare of Alaska. The DH H$ does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHI-18 do not oonduot 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. 7'~025(R~w. lJ~1) J~ok MOA~4~I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Divis~on of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 017 -d:~ ~-tl HAA# H/~ ~7d:~5-3~ GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address /~, c/~ ~,"M' /~t r~}~ Day phone Day phone Day phone 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: NOTE: 'Individual on-site Holding tank ~ Community on-site Public sewer If community wastewater system, provide written co~firmatio'n from state ADEC attesting to the legality and status of system. 72-025 {Rev. 1/91) Front MOA #21 Engineers s~gnature ~ ~~ STATEMENT OF INSPECTION BY ENGINEER ,7 As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this ins ' /~e ~.r.r~,~,~ cE 6. DHHS SIGNATURE ~ Approved for 4 Disapproved. --. Conditional approval for bedrooms. Phone _ '~ ,cc'- LT.~..? Date _ ~/Z~ {/~ ~¢ bedrooms, with the following stipulations: Additional Comments Date. 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. 724)25 (Rev. 1/91) Back MOA ~1 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist ~/-n. ~-~< E.c/~/-~r ~ ParcelI.D.: Legal Description: II/~- A. WELL DATA Well type ? ~'/~ Log present (Y/N) Total depth ~ ?_.,z'- Sanitary seal (Y/N) Date of test Static water level Well production If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~ ~-$ ' Casing height (above ground) Wires properly ~rotected (WN) AT INSPECTION I~ /~ /?7 I ,~5' ' I~' ~' g.p.m. I, _3 ' Cased to T FROM WELL LOG ~-i"~, / ~o WATER SAMPLE RESULTS: Coliform ~ ~olo~,e[ /!(.,o' ~.~ Nitrate Date of sample: '7 / ~/' ) ~' B. S~aq~I~/HOLDING TANK DATA Date installed 7/~{ Foundation cleanout (Y/N) Date of Pumping /V'. g.p.m. /, ~-~ ~-/*~ Other bacteria Collected by: Tank size ¥~./d~./ Number of Compartments / Cleanouts (Y/N) Depression (Y/N) fv~ High water alarm (Y/N) Pumper ~ ~, C. ABSORPTION FIELD DATA /J. ~. Date installed Length Width Effective absorption area Date of adequacy test Fluid depth in absorption field before test (in.); Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Soil rating (g.p.d./fF or fF/bdrm) Gravel thickness below pipe Monitoring Tube present (Y/N).__ Results (Pass/Fail) Immediately after Absorption rate = System type Total depth Depression over field (Y/N) __ For __ gal. water added (in.): .g.p.d. If yes, give date bedrooms D. LIFT STATION Date installed Manhole/Access (Y/N) Size in gallons "Pump on" level at* "Pump off" level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 8~,~t~c/ho!ding tank on lot I Absorption field on lot Public sewer main ~. At. Sewer/septic service line On adjacent lots '~ f c,,¢,' On adjacent lots I I .~ Public sewer manhole/cleanout Lift station /,/. ,4. SEPARATION DISTANCES FROM S~/HOLDING TANK ON LOTTO: Foundation '7 ' Property line I .3' Water main/service line ~. ?-5" Surface water/drainage '~ I ¢'o ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field Wells on adjacent lots "~ I Property line Surface water Curtain drain Building foundation -- Water main/service line Driveway. parking/vehicle storage area Wells on adjacent lots ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal ~'ecords'~hat the ~bOve systems are in conformance with MOA HAA guidelines in effect on this date. Signature ,~ ~. ~ Engineer's Name "7-,~e~, r.../o~'~ F, /-~oc,~'~_ Date ,,.T'~ I,y /.~,, /)~-E HAA Fee $ Date of Payment I Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-47'44 CERTIFI CATE OF HEALTH AUTHORITY Parcel I.D. # 1. -'GENERAL INFORMATION Complete legal description ]997 APPROVAL FOR A SINGLE FAMILY DWELLING ~.,2.-- 1/ - " HAA# '~ ~c['-~t'~-'""-~'~ Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone 0'7 ~ - ?~' 7._ Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: -~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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) Fronl MOA #21 STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structu re 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 Munici pal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~" .i~~ Phone. Address -- Z.~ _% Engineer's signature ~~ Date Z. Tq- fl 6. DHHS SIGNATURE XXX than June 15, 1998. Additional Comments Approved for bedrooms. Disapproved. Conditional approval for 3 bedrooms, with the following stipulations: Money shall be put in escrow to construct a new wastewater d~sposal system in accordance with the attached permit number SW970411. Money shall also be put in escrow to apply for a waiver of the existing septic tank to the well separation distance if the integrity of the tank is de~m~ ~ ~ g~n~ Th~ n~va w~rk ~hall be dompleted bv no later · Money in escrow shall not be released until this office has given final approval. Date · , - · The Municipality of AnChorage Department of Health and Human Services (DHHS) issues Health AuthOrity Approval Certificates' ~esed only upon the representations given in paragraph 5 above by an independent profeSSional engineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in 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. : ~2-025(Rev, 1/91) Back MOAfYZ1 Legal Description: A. WELL DATA Well type ~, Log present (Y/N) Total depth Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division · 1 · 7 343 825 L Street, Room 502 Anchorage, Alaska 9950 (90) Health Authority Approval Checklist H ~ e ,,1 ~',,,, "-~.,--'~ ~'s [.,~l-e._:~Z-- Parcel I.D.: -/ If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to Casing height (above ground) i! Sanitary seal (Y/N) FROM WELL LOG Wires properly protected (Y/N) AT INSPECTION Date of test ~" ~O- 8 D II- 2- I- q '7 Static water level ' l ~ ~ / J q ~:~' Well production ~ g.p.m. I..~ g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed ~" ~'~ Foundation cleanout (Y/N) Date of Pumping Tank size t ~ Number of Compartments ~.- Cleanouts (Y/N) ~ ~/ Depression (Y/N) ~ High water alarm (Y/N) ~ Pumper C. ABSORPTION FIELD DATA Date installed Length ~ ~ Width ~ Effective absorption area ~.-.~ ~, Date of adequacy test I I I I ~ I ~ ~ Fluid depth in absorption field before test (in.); Soil rating (g.p.d./fF or fF/bdrm) ~-.~ Gravel thickness below pipe ID System type 'T'P-,E'NLI-I- Total depth I '"7 Monitoring Tube present (Y/N)~Z__ Depression over field (Y/N). ~ Results (Pass/Fail) ~ For _ ~ bedrooms Immediately after gal. water added (in.): Fluid depth (ins) Minutes later: Absorption rate = .g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3~96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* *Datum "Pump off" level at* Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~ 7 ~ Absorption field on lot I C) ~ -'~ Public sewer main I",///,~ Sewer/septic service line On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation .-~ Property line ~ Absorption field Water main/service line ~,~ ~ Surface water/drainage r,-/I,c:) Wells on adjacent lots 1,¢o t SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtg. in drain Building foundation I L~ ~ Water main/service line Driveway, parking/vehicle storage area ~'.~ Wells on adjacent lots / ~¢~LO I F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records that the;above systems are in conformance with MOA HAA guidelines in effect on this date. Signature ~~~..t.~ Engineer's Name I o [~.~ ~1 -.-~F ~ ~- V-,.L~ v,. ~,~ Date jk~ ~/, ~ HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* 97'* 197001 l'c~bben 5pur}:.land P.E. MPE BK 2, Ltl MPABK2, LI! Drinking Water Client PO# Printed Date/Time l l/26/97 12:55 Collected Date/Time ; 1/21/97 14:00 Received Date/Time 11 t21/97 16:45 Technical Director: Stephen C. Ede 1.i5 0.190 ,m,g/L EPA ~00.0 10 max 1~/22/97 G£P :~:.,: Coiiform ; fiB/ ~OO gL,; NO COL: $glg 722~[~ 11/~1/97 i","-'~" ·'- ' i ora! Colifbrm Bacteria _J, m. Etng Wa:er Analys~s Report for' ~ ~- ~.~ o ~;,~smvcrw,~$ OJ.~C~ Sme s£eomc COLLECTING $,~tPL£ ,%PJST BE COMPLETED BY WATER SUPPLIng TO BE COMPLETED BY L,M3OIt. ATORY Analysis shows this Wate~ SAMPLE to ~: Uns~fi~facm, ry Sampl~ over ,30 hour~ old, re,mlt~ m~y 0 S~pie ~ I~g in ~i~ s~ple ,hould not be ov~ 48 horn old ~ ex~inafion to in,em mli~ie ~ulm. Pl~gsund n~ ~ple via s~i~ deliv~ m~L d MMO-MUG U~J.n: ............ Time: ........... ~WERIOLOGI~AL WATIgR ANALYSIS i~ECORI~ 203 W 15th. Avenue, Suite 203 Anchorage, Alaska 99501 (907) 279-3916 Fax (907)-276-6013 Sid Glascock 13120 Hillside Drive Anchorage Alaska 99516 December 2, 1994 Subject: Lot 11, Block 2, Mountain Park Estate Soil Investigation For Septic System Dear Mr. Glascock; On December 1, 1994 I witnessed D.L.W. Contractors excavate two testholes on your property for the purpose of assessing the suitability of the soil to support an onsite wastewater system ( Septic System). I regret to inform you that based on my observation I concluded that a standard septic system, can not be installed on your lot. The two testholes were located in the north-east section of the lot. Both showed from four to five feet of imported fill over a very dense silt. The silt extended to 15 feet. We attempted to perc the silt at the 6 foot level by excavating a percolation hole with the use of a 6 inch posthole digger. These two holes were filled with approximately 8 inches of warm water. Afler two hours the water level had dropped 1 inch in one of the holes and .5 inches in the other. The minimum requirement is that the water level will drop more than 1 inch per 60 minutes. My observation yesterday conforms to the observation made in 1980 and also to testholes excavated on lot 10 by Flattop Technical Services in 1986. Both Flattop and my report from 1980 shows gravel and sand at 10 feet and 15 feet respectively. The present system was installed in this sandy material. Under todays regulations this material can not be used, because it is too deep, and probably flooded with water during breakup. The only "standard" solution at this time is a holding tank. The Municipality presently is testing and evaluating two alternative systems. One is a sandfilter that still requires percable soil, the other is a self contained biological system that may have effluent that can be safely discharged to the surface. None of these systems have proven themselves under our climatic conditions, and the regulatory apparatus for their use is not in place. However, the fact that they are being tested may indicate that there are viable options to a holding tank sometime in the next 5 years. Yours Tobben Spurkland P.E. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O OOMMENTS :o;l "O Township, Range, Section: SLOPE WAS GROUND WATER r~[ ENCOUNTER ED? ~ S IF '~E$, AT WHAT ~) DEF 7 H? P E Deplh ,'; Water AFter Monit,~,'in§? Date: SITE PLAN Gross Net Depth to Net C'eading Date Time Time Water Drop PEVGOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER TES' RUNBETWEEN ~FTAND ~--FT ,,,.~ I CERTIFY THhT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUN[CIPAL GUID~LINES IN EFFECT ON THiS DATE. DATE: 72~008 (Rev. 4/85) N 100 150 = ~00 FL LOT ~ 300 ¥ % % % VACANT LOT 10 TOBBEN SPURKLAND P.E. 20.3 W 15TH. AVENUE ANCH. AK. 99501 (907) 279-5916 LOT 11 BLOCK 2 MOUNTAIN PARE EST. 15~20 HILLSIDE RICHARD HARRIS J J SEPTIC SYSTEM DESIGN DATE: NOV. 21, 1997 SHEET: 1/$ GRID: 2859 PERMIT # SV970XXX PID # Ol_7-O~V£-iJ HPEO£1_H.P~/5 49th BEN ~PWRKL~ND No. CE 2225 gell V~C~NT TRENCH SCALE: 1~ = 50 Fi-I I ~ 4000 GAL, HL1LDING TANK I EXISL 1000 6AL S,L I CHECK INTEGRIT~ REPLACEIIF 125 15~0 I C~]£RIT~ED ~ ?OBBEN SPURt(LAND P.E. II 203 W 15TH. AVENUE II ANCH. AK. 99501 (907) 279-5916 LOT 11 BLOCK 2 MOUNTAIN PARK EST. 15120 HILLSIDE R/CHARD HARRIS II s~,,c SYSTEM DESIGN DATE: NOV. Zl, 1997 SHEET: 2/5 GRID: 28J9 PERMIT # SW970XXX PID # 017 022-11 MPEO2111,DW6 j DIVE£TE£ VALVE £AIN CAP PUMP HI6H WA TE£ MERCU£Y SWITCH ANCHLT£A6E TANK ND SCALE CONDUIT l" dALVANIZED L~ ~IBECT ~URIAL WIRE TO ALARUM PANEL 75.5~ BENCH ~i/RK: ASSUIffED ELEK I00.00 FL TI]IBBKN SPUF~I<LAN]D P,E, I ILiTT II 6751 ANCH, AK, 9950~ 3904 (907) 248-5095 /£ SK ~ PllYUIVTAIIV ?A~K 13120 HILLSIDE DRIVE RICHARD HARP, IS ISEPTIC SYSTEM ]DESIGN DATE, NOV, ~1_~ 1797 SHEET, 3/~ GRIll: 2559 SYK970XXX PID ~/ 017-022-11 IdPEO211J. DWO ? DATE RECE~ INSPECTION APPOINTMENTS -' INSPECTOR INSPECTOR ~ INSPECT MUNICIPAU~ OF ANCHO~ MUNICIPALITY OF ANCHORAGE DEPT. OF H~ALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL PXOTECTI( 825 L Street - Anchorage, Alaska 99501 ENVIRON~ENTALSANITATION DIVISION JUL 2 1980 Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed. Please allow ten H0) days for processing. 1. PROPE~Y OWNER PHONE MAI LI N~ ADDRESS PROPERTY ~ ESl D~T (If ~ifferent from above) f PHONE 2, BUYER PHONE MAILING ADDRESS MAILING ADDRESS 5. LEGAL DESCRIPTION 6. TYPE OF RESIDENCE SINGL~FAMILY 'E~ MULTIPLE FAMILY 7. WATER,, S~UPPLY ~ INDIVIDUAL* ( [] COMMUNITY [] PUBLIC UTI LITY NUMBER OF~BEDROOMS E~] One [] Four [] Other ,/ Two [] Five Three [] Six *ATTACH WELL LOG. A well log is required for all wells drilled ' since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM /~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY 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 PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED [~PUBLIC UTILITY Connection Verified INSTALLER []septic Tank or []Holding Tank Size: [ ~J If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Septic/Holding Tank Absorption Area ISewor Line Nearest Lot Line 4, DISTANCES WELL TO: ~ ~ Absorption Area to nearest Lot Line 5. COMMENTS ~APPRoVED FOR ~. BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) ~ DISAPPROVED~ DATE BY~ o _ 72-010 (Rev. 6/79) CHEMICAL & GL_LOGICAL LABORATORIES ~ £ ALASKA, INC.~. " TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER' /~ _~.~ 274-3364 5633 B St re et ~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: i.D. NO. Phone No. Water System Name ' ' !'"? · ?L: r-~-,r,~- Mailing Address ~ - i City State Mo. Day Year Zip Code SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref, no. [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. 1 2 3 4 5 LOCATION Time Collected Collected By TO BE CO MPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Samole too long in transit; sample should no[ be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received Analytical Method: [] Fermentation Tube []'Membrane Filter Lab Ref. No. Result* Analyst I ICl READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 [b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collected Source ~(esumPtlve 10mi 10mi Z0ml ].0mi 10mi 1,0mi 0.Zml 24 Hours 48 Hours ~onflrmatory 24 Hours 48 Hours EMB Broth 24 hours: Broth 48 hours: : 10mi Tubes Positive/Total 10mi Portions Multiple Tube Report: Membrane Filter: Direct Count Collform/100ml VerJflcatlon~ LTB BGB Final Membrane FI tar Results ~ Collform/lO0ml Reportici By ' .'· : ' ": · Date' '" Time= ', ',': ' a.m. July 11, t980 Roger Fielder · Box 71, Marcus Street Eagle River, Alaska 99577 Sup]eot. Lot 11, Bloek 2, Mt. Park Estates ~2 Subdivision Approval for your individu~ sewer and water facili.~ies can not be granted until the following items have been completed: from the Chem Lab, 5633 B Street, for our review. \~1) The water analysis report be delivered ~o this office ~~~h~ell log s~bmltted to this department for our review. If there are any fur,%er questions~ please contact this office at 264-4720~ Sincerely, Robert C. Pratt, Associate .Specialist RCP/kas Peeples Bank & Trust ~ortgage Loan Section Pouch 7-007 99510 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. OI '7 -0~.~ 1." GENERAL INFb~MATION C ' .'.' . omplete legal deSc'ription t, ot 1 1 · Expiration Date: / -.~.- '~- 0 / Mountain-Park Eastates LocaQon(siteadd(ess~ordirections) 13120 Hillside Dr. AnchoraF. e · Current Propertyow~ner(s) Troy Franklin '.~.~aiHngaddres$ C/'O Scott ~ 3120 Denali St, I_endin~ agency #2 Day phone 345-6486 Anchorage, AK 99503 Day phone Mailing address Real Estate Agent Mailing Address Unless othenvise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site ~olding tan] Individual Holding tank Community On-site [] Public Sewer The Municipality of Anchorage Deve!opment Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations 9iven in paragraph 5 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· Certificates 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates 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. 4. STATEMENT OF INSPECTION BY ENGINEER and regulations in effect at the time of installation. $ & $ ENGINEERING Address Ea. cjle River, Alaska Engineer's Printed Name ~9 As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation, based on procedures outlined in the HeaIth Authority Approval Guidelines for this application, shows that the on-sita 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 verity that based on the information obtained from the Municipality of Anchorage flies and from my investigation and inspection, the on-sita water supply and/or wastewater disposal system is(are) in cornpliance with all applicable Municipal and State codes, ordinances, 5. DSD SIGNATURE ~ Approved for Disapproved. /'3/--' bedrooms. Conditional approval for Phone. ~c~"2- q '7? Date bed ooms, w th the fo,owing stlpulabons: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~-7 - -~- 0 ) Municipality of Anchorage Development Services Department Building Safety Divisioo On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchemge.ak.us (907) a43-7904 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescripUon:LOT' ti ~).oc,c ;3- ~u~T'e'~,~, /~,4 £$7. a'Z ParcellD: If A, B, or C provide PWSID # Sanitary seal (~)/N) Cased te ;}~.F' ft. FROM WELL LOG g.p.m. A. WELL DATA Well type p~,~74. Date completed 5'/,r/a'o Total depth .~ ;) 5-- ft. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform O colonies/100 mi. Date of sample: Nitrate J, ,}"/. mg./L Collected by: El. SEPTIC/HOLDING TANK DATA .T. Bnk.Type/Matedal t/o~.0,~(,- /S~-¢ t_ ~",Tank?ize .~ 00. ga~. number of Compartrnents I 'Foundation cleanout~t) y'4~' Depression overtenk (Y~) ~e Well Log~l~) Wires properly protected~l) Casing height (above ground) AT INSPECTION ] 3 ft. 3, ~' g.p.m. t~,q- in Other bacteria. O colonies/100 mi. $ & $ 17034 EIglo River Loop Road No. ~ :~gle Ri~er, AIIII[I Data installed ~/S/¢~ ~ Cleanoute (~N). High water alarm~rN) Y~ J' · Date of pumping '"//, ~ / O, Pumper 'C. ABSORPTION REID ~ATA Data installed . Soil rating (g.p.d./ft~ or f~Fodrm) ~ Length ft. Width ~Gravel below pipe fl. Total depth ft. Eft. absorption area ,~onitoring tube Depression over field Date of adequacy test ~/,./'l~ts (Pas~Fail). For bedrooms Fluid depth in ab~m test in. Water added gal. New depth in. ~~ min. Finalfluid depth in. Absocption rate >=~ gpd A~juvenafion treatment (past 12 mo.) (Y/N & type) if yes, give date D. LIFT STATION Date instelted . Size in gallons . Manhole/Access (Y/N) 'Pump on" level at _ in. 'Pump off' level et ' Datum _ _.~i~13.-~-''''''-~ .. Meets alarm & ~rcult requirements? _ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tan~ift station on lot _ N / ~ Absorption field on lot _ /J/~ Public sewer main On adjacent lots On adjacent lots loo "t' /00 x'J' Publlo sewer rnanhole/cleanout Sewer/septic service line ~ 5' ~"/' Holding tank SEPARATION DISTANCES FROM eL~m?tC~ANK :ON LOT TO: c-- '-./- - ~ ' ne ~'' '/'' Absorption field /~ ,/A Building J=oundation _ o . I-,ropeny ~ _ ~ , Water main ~J / ,4 Water service line _ /O ¥ . Surface water Wefts on adjacent lots ~/OO 'J-. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water Service line ~ Driveway. parking/vehicle storage _ C~~ We~s on adjacent lots F. cOMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name /~30~R'7' C. ~'"O~.,~d~'~ Date HAA Fee $ Date of Payment Receipt Number (Rev. 12~00) Waiver Fee $ Date of Payment Receipt Number SEP-05-OI 1~:4~ FROU-CTIE ENVIRONUENTAL SRV 9075615301 T-854 P.01/01 F-8?O CT&E Environmental Services Inc. Laboratory Division ~'~,~.~,~:m,~,.~,~mrw.~.~,~,~.m~,~:w,~:~ff~f~fm 200 W. Po~er Drive Drinking Water Analysis Report for Total Coliform Bacteria ^,~ho,.*., Az ..s~..~.os · Tel: (907) 562-2343 READ INSTRUCTIONS ON REFER. gE SIDE BEFORE COLLECTING SAMPLE Fan: ~907~ 561-5301 TO BE C~MPLETED BY LABORATORY MUST BE COMPLETED BY WATER SUPPLIER El PUBLIC WATER SYSTEM I.D.# ~ ~t~' PRIVATE WATER SYSTEM Month Day Year SAMPLE TYPE: ,,~ Routine O Treated Water Q Repent Sample (for routine sum'pie I~' Untreated Water with lab ref. no. :) El Special Purpose Time Colletted Collected By SAMPL£ LOCATION Analysis shows this Water SAMPLE to be: Satisfactory Unsatisfactory ~ Sample over 30 ho.rs old, ~sults may be unreliable Sample too long in transit; sample should not be oveu"~ D~ours old at examinnnon to indicate t~liahle r~sults. Please s~d new sample via ~ial delive~ mail. Date ~eived ' ~/~1/~ / Time R~eiv~ ~ ~/~ Analytical Method: ~l~Me~,brane Filter 'El M~O-MUG * Number of colonies/100 mi. Result* Analyst ch F'Dk! Jun ti Fixed Dote; Time: Client notified of unsatisfactory results: Phoned Spoke with Dote: · Time: C3 Commenls: BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MUG Rt~nlt: ToL~I Coliform Membrane Filler:. Dirtct Count , VeriflcaUou: LTB . RGB Ftcal Coliform Confirmation Final Membrsne Reported By ~("l'"---I-~"~Dste , ~ Co~ Colouies/100 mi COLIFIRM. dl~~ Member of the SOS Group ISociMd~ G6n*rnln ,~n Surveillance) ENVIRONMENTAL FACILfflES IN ALASKA. CALIFORNIA, FLORIDA, ILLINOIS. MARYLAND. MICHIGAN, MISSOURI. NEW JERSEY. OHIO. WEST VIRGINI,~ SEP-OS-O1 09:05 FROM-CT&E ENVJRONI~NTAL ,~T~__ CT& E Envimnmen,a, Service, Inc. 9075515301 T-798 P.02/02 F-797 CT&£ Ref,~ CUent Name ~roject I~ame/~ Client S~mple ID Me,rix Ordered By PWSID 1015838001 S ,,e, S Engineering Lt 11 Blk 2 Mountain Paring2 Lt 11 Blk 2 Mountain Parce ~2 Dr~g Wawr 0 Sample Remarks: Client PO# Printed Date/lime 09/04/2001 16:02 Collet~ed Date/Time 08/30/2001 10:30 Received Date/Time 08/30/2001 12:55 Tt~hnical Dlre.~tql~ . dStephen C..Ed~, w PQL Unit~ M~ 1.24 0.500 mg/L EPA 3000 AIlowabk: P~ A~alysis L;mi~ D~te Date I<lO) OS~0~t SCL