HomeMy WebLinkAboutMOUNTAIN PARK ESTATES #2 BLK 3 LT 1Mountain Park
Estates #2
Lot 1
Block 3
#017-022-13
Municipality of Anchorage Page 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:. ,5 W 910 3 2O PID Number: 017022/.3
Name: Ceci( MCL.eop
Wastewater System: ❑ New ❑ Upgrade
Address:
128ao S«undcrs 8ot� r nCA 99y
ABSORPTION FIELD EKr-sriHG.
Phone:No.
3 Y$' — 6002
of Bedrooms:
3
❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
GPD/Sq. Ft.
Lot: ! Block: Subdivision:
3 Mfr,• Par k E44 #2
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
Ft.
Ft.
Township: t Z N
Range: 3 tu
Section:
2 6
Fill added above original grade:
Gravel length:
'Ft.
.�Ft.
WELL•�JgW ❑ Upgrade
E)4r S r -
Gravel depth:
Number of lines:
Distance between lines:
l
Ft.
Ft:
Classification (Private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe material: . .
Ft.
Ft.
SO. Ft.
Driller:
Date Drilled:
Static Water Level:
Installer:
Date installed:
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
MSeptic ❑ Holding ❑ S.T.E.P.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
Public/Private
Sewer Lines
Manufacturer:
t4nC%ora [ %atRk
Capacity in gallons:
IUGid
J�40
lO r r>
(00 ,
—
—
&S r
Material: S Lt e!
T
Number of Coryipartments:
Watere
> Gmr
> ruot
—
-
—
LIFT STATIONG Nr.4.
Lot
Line
2Sr
> for
-
—
r
—
25'r
Size in gallons:
Manufacturer:
Foundation •
2S '
1yG r
O
"Pump on" level at:
"Pump off" level at:
High water alarm at:
Curtain
Pump Make &Model
Electrical Inspections performed by:
Drain
—
-
-'
—
'-'
Remarks: _s Fio nbc inr lle� er
BENCH MARK
Q ro veck .er/++it. 2 rf ri I'o(
Location and Description:
CoAcrEiC Secy auf,5lct'e acyor on uuut
n ulotftan IacecC uu¢� 7rtn k cine(
;Side of 64Utt(0I17
wa1 tine . S f i c fun k a roX
Assumed Elevation:
100.00
8Sl from we I! an A& f• 2 Calk 3 us ro 4,.e,( h ruG f t/(r•
ENGINEER'S SEAL
A4 0�
Inspections performed byFlattop Technical Service Dates: 1st 10 /2//9/
rw
0* Z"
Echo Street
Anchorage, Alaska 995 2nd
0•°°•••°••°•,..•.......t•,•
J •,.e ••e •..• • •. e. ue6i•
Department of Health Hum a Ices approvals
s Vie; l� /s
�f�,THEODORE E. 5:100RE11
CE - 3539 q,` 0
�48��r '°•....•... •
Reviewed and approved b : y'
O�
4 itPmissst`>xtiv�
Permit No. S W 5'10 3 ZO
Page 2 of 2
Municipality of Anchorage
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
Legal Description:
Cs
4a.kar 14r2
PID No.: 01-70'2 "--7
e'+ 2"rt�rr(a xas' Z
Exrsr(NG
9S' s �p:n hre, 96s'
PrT Ave,9iSs' NEW '1000 rrA4
Flattop; Technical S
1430 Echo Street
Anchor e, Alaska
)xvices
99516
ENGINEER'S SEAL
WIT A[
4
0°�
�
___". . _..... ..._..._.
cross-S.EcT'ion!
�.•• 00.1 oo.J.. e......e0 e*ie
= S' -O
A
� •e..a • .. .eeeev.e.e.
No f}&R(2' ,Sc.44e
. �THEODO;�E F. RAOORE;e
••• CE - 3539 4
,� �4'
Ar
$0 �f•pmisass�tn .•���`�
AF
72-013
A (2/91) MOA 25
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:SW910320
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:MCLEOD CECIL F & LUCINDA M
OWNER ADDRESS:12800 SAUNDERS RD
ANCHORAGE, ALASKA 99516
PARCEL ID:01702213
LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES #2 BLK
3 LT 1
LOT SIZE: 20130 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED:10/07/91
EXPIRATION DATE:10/07/92
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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY:
� m
DATE: 01 �? l
DATE f P - / r /
j2 , Opp
Municipality of Anchorage
Department of Health and Human Services dhh5
825 "L" Street
Tom Fink,
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
October 7, 1991
Ted Moore, P. E.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99507
Subject: Waiver Request for Lot 1 Block 3 Mountain Park Estates #2
Waiver Request #WR9100461 PID #017-022-13, SW910330
Dear Mr. Moore:
Your request for waiver of the required 100 foot horizontal
separation of a septic system to a private well has been approved.
The approved separation distance is 75 feet from the private
well to the septic tank.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincerely, Concur:
-Rev
�-Daniel J. Roth Robert W. Robinson
Civil Engineer Acting Program Manager
On-site Services On-site Services
DJR/ljm
MUNICIPALITY OF ANCHORAC~
Depa,.tment of Health and Human Services
On-site Services Section
Waiver Review Worksheet n
WR# WR910046 PID# 017-022-13 HA# Permit # CW3 3 a c)
Date Received: September 19, 1991
Legal Description: Lot 1 Block 3 Mountain Park Estates #2
Engineer: TEd Moore, P. E., Flattop Technical Services
14530 Echo Street, Anchorage, Alaska 99516
Applicant: Cecil F Mc T.Pn(1
Waiver Requested: Well to Septic Tank - 75 feet
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: Waiver is NOT Granted:
List Conditions or Reasons for above: !�jg F 4 Zr A 0-16P
Date: /0-7-17/ BY (_,�
NName o
Rec #: 23090/8385 Amount: $ 410.00 Date Paid: 9-19-91
�11lN%1VER
I
REquEST FOR LOT / 8Lk 3 MOk.vtAiv pyA'k EST.vTEs z
'�IWAIVEIQ
/1'EQk�S7' NIrMBE/� W R �/00¢6
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PROPOjBO
jl
WAiyE R /QEQ k F_ ST ,FOR wELL oAy LOT 2 Bik 3 TO ^ SEPTic
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M.O.A. DHHS
P.O. Box 196650
Anchorage, AK 99519
Dear Sirs:
By means of this letter we are requesting a well -septic tank separation distance waiver down to 75' and
a sewer upgrade permit to replace a collapsing septic tank on Lot 1, Block 3, Mountain Park Estates #2,
located at 12800 Saunders Road. A site plan and copies of inspection reports and well logs from nearby
lots are enclosed for your review. It should be noted that portions of the existing seepage pit are also less
than 100 feet form nearby wells, however we are not requesting a waiver of these distances at this time,
since the immediate goal is only to upgrade a collapsing septic tank.
According to the as=built inspection report the existing wastewater disposal system serving this
residence was installed in October of 1972, at which time the required separation distance between a
private well and a septic tank was 50 feet. The well was subsequently noted on the report as having a
depth of 150 feet, although our measurements show it to be over 200' in depth. According to our
measurements, the actual distance between the well and the septic tank is approximately 90'. In 1975 Lot
2, Block 3, located just to the south of the subject lot was developed, and the well serving that lot was
drilled approximately 75 feet from the septic tank on the subject lot. Even though the required separation
distance was 100 feet by then, the Municipal inspector approved the well location being 75' from the septic
tank on Lot 2, however he made no mention of the fact that the well was also 75' from the septic tank on
the subject lot.
As can be seen from the site plan, there is no feasible location to install a replacement for this
collapsing tank that meets all current separation distances. It would not be a good idea to attempt to utilize
the small area south of the present seepage pit, since that is the best remaining site for a future replacement
of the seepage pit when it fails. The proposed septic tank replacement site is slightly further from both the
existing wells than the existing partially collapsed septic tank. The waiver is requested for 75' to allow for
a limited degree of flexibility in field positioning of the tank to compensate for unforeseeable constraints.
The topography in the vicinity of the proposed upgrade slopes towards the west at 10%, meaning that
surfacing effluent from a failing septic tank would tend to flow directly away from the wells in question.
The westward sloping trend of the bedrock surface would also tend to direct subsurface effluent away
from the wells. Both these factors support granting the requested waiver.
The following is a breakdown of a way waiver analysis points could be assigned in conformance with
DEC SCRO's guidelines. Note: there is no driller's log for the well on the subject lot, however on
9/18/91 we measured the static water level to be 76' below ground surface, and the total depth to be in
excess of 200 feet. In computing vertical separation waiver analysis points we assume the. origin of the
effluent is 10 feet below ground elevation at the well, yielding 66' total. We have enclosed the driller's log
for the well on Lot 2, however it begins at 93' in depth and we were unable to gain access to the well to
verify the static water level. In characterizing soil conditions we have used the log for Lot 24, Block 3.
/` / /W' -,(V - 91 ? X 31)t�
Category
Points
Distance to water table (66') 5.6
Soil sorption (generally silt, no value given for bedrock - assume same) 3.5
Permeability (assume perc rate > 50 minutes per inch) 3.0
Water table gradient (assume level, even though surface slopes down at 10%) 2.9
Horizontal separation (75') 2.0
Total 17.0
Based on this point analysis, it would appear that the waiver could be granted without concern as to
contamination of the affected wells.
In light of the fact that the existing septic tank is in the process of collapsing, we are requesting your
timely review of this waiver request and issuance of the permit to replace the septic tank. Thank you for
your assistance.
Sincerely,
f-.C,k /�"
Ted Moore, P.E.
cc: Cecil McLeod, D.C.
dor S, 61,k a
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Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
13l^YCtc 3
MouN7'F4rN PAC�� QST # 2
SGA 6.G-': log -410f
i%14ra: 7/9/
push: TFn
nc�rr�: Trt1S- u NoT
A Su1ZuEY@o Ni,4r
A1,4 G.oGArIONS Aaa
Av p go At"Are
f GRE ^:R ANCHORAGE AREA BO' JGH
Department of Environmental Quality
Yo 3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ICS ZLIZC MAILING ADDRESS �T ' l '� �� e?� Ch-PHONEn2� 911&
LOCATION l�ur r-t3�cT/IJ �L�i��SiDF LEGAL DESCRIPTION /b RV 3 In i`F��K i 72szS
SEPTIC TANK: t/V
DISTANCE` NUMBER OF
���
FROM WELL �� - MANUFACTURER'J�NC`cL 046. MATERIAL W � 1 �969'� COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH -=_QUID DEPTH LIQUID CAPACITY �C1DG GALLONS.
SEEPAGE PIT:
NUMBER OF PITS J DIAMETER _—OR WIDTH S , LENGTH _�!, DEPTH
LINING MATERIAL2(t"Yrr'�1"B SIZE: DIAMETER DEPTH`�'«<,DISTANCE FROM: WELL a"20)0,
TOTAL EFFECTIVE
BUILDING FOUNDATION SC , NEAREST LOT LINE 20 ABSORPTION AREA (WALL AREA) �� SQ. FT.
ADDITIONAL ABSORPTION
WELL:
C
TYPE I%6D/U, CONSTRUCTION rl pled DEPTH .1 ® DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMA
DISTANCES:
\ r
i
INSTALLED BY: 21fl+�C
PIPE MATERIAL:
LOT SLOPE:
REMARKS: q"LYL flD_('PeT(IU
(� +�c� i �'�ilhP t�P lI1sS,�kteTtDzJ
Form PW -026
DIAGRAM OF SYSTEM
26,
n1
20
/fy
i3ed ecew
A)its c
W�
DATE (Q(t, 31 1972- APPROVED
G.A.A.B.
GREATER ANCHORAGE AREA BOROUGH
f DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD F'OJCH C+-550
AtiCHORAGE. ALASKA 99.502
TELEPHONE 279-8566
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
PERMIT NO. --=
Ne a�) &,V-5
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
l-01 /. 151A .y
.__ MAILING ADDRESS
Wt. IIYZ�Ie�
INSTALLATION OF: SEPTIC TANK . 4�- SEEPAGE PIT
TYPE AND SIZE OF FACILITY TO BE SERVED
V�
4E3�1-r ,4,--s 7-� C®,
�7i-err%
PHONE
DRAIN FIELD- OTHER --•
TO BE INSTALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL ST
SOIL TEST RESULTS /� C
_� COMPLETION DATE ANTICIPATED a
PFRMTT VAI TD ONE YEAR
FINAL INSPECTIONI 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
t✓QN-LTYPEei'nnl
SEPTIC TANK SIZE - DY rOflrYPt.PSEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
5 ft.
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT 20 fte
DRAIN FIELD 10 ft,
SEPTIC TANK TO SEEPAGE PIT WALL a.' ` "
SEPTIC TANK 5 ft. , SEEPAGE PIT 20 ft,. DRAIN FIELD 10 ft.
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK �/ SEEPAGE PIT'
DRAIN FIELD /gyp ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK 10 fte . SEEPAGE PIT TO ft,
DRAIN FIELD 10 fte
SEPTIC TANK, 25 ft', SEEPAGE PIT 100 ft- , DRAIN FIELD 50 ft, ,
REAM
Wa:;—,C
DIAGRAM OF SYSTEM
4" LAST IRON SIPHON
SEPTIC PIPE WITH AIRTIGHT CRIB
LANK/ CAPS \
CAST IOC
level3
CAST IRON
INTO
�
/. UH_D_IISTORBED SOIL5,
�1MR HINT EIIIIMIIH
C 1 required ehenDver line crosses
under drivenay.
TO RIVER, LAKE, 5'
N.11:1.':JFi 1iELL
-_�I-ii'Gf_CFS—�
INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
-L
CAST IRON
IN 11 VIOLA
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
ID TICK- 50
10 PIT- 100'
1;0 SEVER. 11111- 1
CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
4 INCH DIAMETER
"PI POOL IC
FITTED WITH AIRTIGHT REMOVABLE CAPS.
10 TA.!::;- P,0'-
TO I'I-1- 120'
I:li SII:EP 1AN,- 4
GRAVEL BACKFILL
GO• -n9' ONL'r
CAST IRON SDIEP.
L for.
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I_IiI,LIC
TO TA::r,- 200-
00'10
10I'll - 200'
'
l(W-2-CO, ONLs.
Vd.i Ifg;l Srs:ER
10r.•.I1y SOIIPC[ 0i
nN'. Ar.';IAT 1011
' HEALTH AUTHORITY
OR
LICENSED DESIGNER
-'.NRAVEL RA`KFIIA
AROUND CRIB.
(CRIB 4' MININU4 ABOVEHATER=
TABLE)
I INCH SEHER LINE.
C0111IOER AREA WELLS. '
SEEPAGE Pit EXCAVATION BASED ON 'V. F.LL'a e
SOIL TEST.
Erar Senn, :1
IaNr .
u:rn err.
D ISTBP.CEO —�
SOIL ;
\:J I
Grade: E'.Per TCO:
or 1/4' Pr foo:
oxecPt 10' precf-Ain!
tank 8 tha, should I
not exceed 2:.
6- per 100 on flat
terrains.
4 INCH
CAST IRON SIPHON PIPE
SEEPAGE PIT
_-CRIB
GRAVEL BACKFILL
20' HINIMU14
GEAPEST LOT LINE
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.88 AND THAT THE ABOVE
"SCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. .-1
LICANT'S SIG
i
R&M ENG i-4EERING & GEOLOGICAL 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.
September 27, 1972 R & M No. 26540-31
Mr. Les Houle
243 East 15th Ave. Terrace
Anchorage, Alaska
Re: Test Hole and Soil Log Report for Sanitary System
Lot 1, Block 3, Mountain Park Estates No. 2, Anchorage
Dear Mr. Houle:
RALPH R. MIGLIACCIO
Engineering Geologist
We are submitting herewith the test boring results and our comments regard-
ing soil conditions encountered at the subject site. This investigation was per-
formed in accordance with your request of September 21, 1972 and those proce-
dures outlined in a letter dated September 13, 1971 by Mr: Rolf Strickland of
the Greater Anchorage Area Borough Department of Environmental Quality.
A single test hole was put down within the Lot 1 area for the purpose of defin-
ing general subsurface soil conditions for the proposed sanitary system. Ex-
cavation was accomplished with a tractor -mounted backhoe and the test hole
was extended to a total depth of 11. 0 feet below ground surface. The final
log prepared for the test hole has been included in Drawing A-01.
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
James W. Rooney
JWR:wb
Enclosure
xc: Greater Anchorage Area Borough
11 INF A LI
a
T.H. -1
9-21-72
0.0'
0.5'
2.0'
4.5' awl V
11.0'
No Water Table
Note: Hole excavated with tractor mounted backhoe.
Les Houle Property
Engin�ering%3rGeolct�ictll Co115ultants LOG OF TEST BORING
ANOR ORAD£ PAIR BANKH ALAR. 3CA JUNEAU
Anchorage Alaska
DATE 9-25-72 SCALE 1" c 2' OWN BY G.Q.W. CHKD BY W.ED. PROS. No. 25540-31 DWG NTT -01
N
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ORGANICS
N
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ORGANIC SILT
W/SOME GRAVEL
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r .plq
o�•
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SANDY GRAVEL
W/ TRACE SILT (GW)
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SILTY SANDY GRAVEL
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MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section CEM
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FORA SINGLE FAMILY DWELLING
Parcel 1. D. # 0 1 -7 - 0 2Z - 13 b
1. GENERAL INFORMATION
HAA# U(155()1)")L
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Complete legal description Lo> `1, i31ocU 3 /y o Lti Jp 1/) Park- 'Ex %/V A�'Z
Location (site address or- rec�tion�). �►2SGo
Sccuno(er1 Raac(
Property owner
1'coIle4
Day phone 3Ys-- bi 2G
Mailing address
/ Z£s0,c"4e�s Rte?
f}ncyarcrOe /�-� 99S ��
Lending agency
un' hv'rvnt np fti'u f/M-e
F
Day phone
Da p
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Mailing address"
Agent Larr�4
Suf-er, Prudenftul v6,
Day phone S6Z-6y�y
Address y 2y�
Q" S>t/+^CAG/Ci4P
A k 99soj
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 b
3. TYPE OF WATER SUPPLY:
Individual well L-'
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #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 in effect on the date of this inspection.
Name of Firm F/aF P T«tin 'c«/ S�w�c� Phone 3vs_ - 13s s -
Address /`/S'3o Cc�10 5,�, /��cAa/crc�o A
Engineer's signature I Date J -f !r s / 999
•.... N..O��.�pN0�.91k
A _
C6 0 3 1�0
0
6. DHHS SIGNATURE
L,'� Approved for TM?E bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Note: The well for this property meets existing State and Municipal Codes.
There are nitrates present. Itis su25�ested that periodic testine be
performed to insure the wells continued suitability. Current nitrate
More information on nitrates is available from the On-site Services Program,
Additional Comments
0
Date 7 -,2- L 9 q
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.
72-025 (Rev. 1/91) Back 140A 021
KECEIVEV
Municipality of Anchorage
JUL 09 1999
DEPARTMENT OF HEALTH & HUMAN SERViGESPALITYOFANCHORAc
Environmental Services Division ENVIRONMENTAL SERVICESDIVISI
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
Health Authority Approval Checklist
Legal Description: Got 1 B/ kr 3 / !fn Park Fs)' ? Parcel I.D.: Of 7 - D Z 2 - 13
A. WELL DATA
Well type lor w a f e If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) N Date completed z r 9-7 2
Total depth 36 7' Cased to Sec-tfr,c Ic Casing height (above ground) 1,9 1,
Sanitary seal (Y/N)
FROM WELL LOG
Date of test
Static water level
Well production
Wires properly protected (Y/N)
AT INSPECTION
g.p.m. 0.5,5 g.p.m.
Node: The well pump ''i, SQf Ce'f- ce��rtiK.inafe y
WATER SAMPLE RESULTS: 3 S' 2 h etc, w f -+c yv to oe-
Coliform D co /o n i y // o a m -e Nitrate R. Y� /-e Other bacteria none ,^ego c tea(
Date of. sample: 6 / 2.9 t 99 Collected by: Fluth:'.e Tec"l -Ce"c
B. SEPTIC/HOLDING TANK DATA
Date installed 10 / 2 l / 9 f Tank sizeI o� Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) N • 14.
Date of Pumping 9 9 Pumper P o Ra o f c'
7unLc 0 F;/-- eeAmpeo( ayct'��, in ton�uncizv� u�. 5/l�/9% %t,liu-4iiP
C. ABSORPTION FIELD DATA
Date installed /o/.3/72- Soil rating (g.p.d./ft2 or ft2/bdrm) 2 UOCIf System type
Length .2d, Width 2S ' Gravel thickness below pipe 61, Total depth 161
Effective absorption area Monitoring Tube present (Y/N)--Y-- Depression over field (Y/N) Al
Date of adequacy test . 6i' /99 Results (Pass/Fail) For 3 bedrooms
Fluid depth in absorption field before test (in.); 15 Immediately after 6/ gal. water added (in.):
Fluid depth 31,5 It (ins) Minutes later: / I S Absorption rate = '> y111 g.p.d.
Peroxide treatment (past 12 months) (Y/N) "i errat -1-1R If yes, give date. S// 6 /y9
fit, '+G[
72-026 (Rev. 3/96)`
D. LIFT STATION N.
Date installed _
Manhole/Access (Y/N)
High water alarm level at* _
Cycles tested _
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at*
*Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
"Pump off" level at*
Septic/holding tank on lot t o / ' On adjacent lots > !Uo '
Absorption field on lot > 100' On adjacent lots > too'
Public sewer main N. 4, _ Public sewer manhole/cleanout
Sewer /septic service line -0� > Z 5 T�Al Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation 2 5-' Property line
2s'
Absorption field — S
Water main/service line > 1U' Surface water/drainage > too' Wells on adjacent lots % 90'
lee wR9/0oy?'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Z0' Building foundation Y0' Water main/service line > fa '
Surface water > ( ao' Driveway, parking/vehicle storage area > 2o'
Curtain drain N on c S *n Wells on adjacent lots OS ' 7'v we/! d9 ti Z y
see w? SG-oz8
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal records�p�e systems are
in conformance with MOA HAA guidelines in effect on this date. OF
A*f VN
Signature ® •,(,q{ 9
V000Oa•o0a••a.a••aa0••tl ep;rpp�
Engineer's Name Th eo a -c 'c �
•ea•e•r yeas a'o.•"a"vaasai
Date J :THEODORE F. MOORS a ( 1
s '• CE - 3589 nX
HAA Fee $ U UU
Date of Payment _' G} �T
Receipt Number � �� f zD
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
6 V4 / Receipt Number
aPo
MUNICIPALITY" OF ANCHORAGE
M E M 0 R A N D U •i
WATER WELL ADVISORY
HEALT'r_ AUTHORITY APPROVAL NO. 01 Q 3 3�
Durinq - recent A Health 1' Authority Approval on-site
and test of tie potable water supply well on Lot
Block 3 0f /I?nv � tn� P t�z
—�/T ARk es7.Subdivis40n, the __ s
productivity was determined to be
0-#S--S-gallons per m_-•��e.
The mi~'_mum well _productivity required by this Depart -e-=
(AMC 15.55) for a 3 bedroom residence is
per min_ n t
;tee. _�nou 1'i ie subject well currently e:YCeeCa _ 1S
minimum- requirement, all parties concerned are advised the
Product -'on Capacity of the well i::ay fluctuate. Rest__, __=
of nen-crit--ca= ;•rater uses such as washing cars and wa e__r_c
lawns d gardens may be recuired.
This cf."'i Zs0r" ;•ilio be at r c .
1 a.C_i2.., t0 all COp1eS C= the SL'�-ec
Health -ut ority Apprc%,al.
May 16 99 11:58a
To: DHHS
JERRY LEACH
(907) 694-8501
Date: 16 May 1999
We hereby notify DHHS as required by permit of the intent to terrace the
following property.
Lot: 1
Block: 3
Subdivision: Mountain Park Estates
Address: 12800 Saunders Rd. Anch. AK.
Engineer Consulted: Yes X
No
Jerry Leach
Alaska Drainfield Restoration
President
RECEIVED
p.3
MAY 2 6 1999
Nunjc;aal;ty.yl ri,,Lnoiage
Dept. Health & Human Services
Parcel I.D. #
MUNICIPALITY OF ANCHORAGE
e� 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
J, p GZ _ HAA#
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions) 1�cP9V Sc?uy,'c CY J Or,'✓o
Property owner 9/r (-,fcr%' Pr_ Day phone ' ^ `000
Mailing address �.���U SG�y;/�r' ✓Y' �''�� °fc �!�-rhea
Lending agency
Mailing address-
Agent'tr
Address
Unless otherwise requested, HAA will be held for pickup.
3
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
Day phone
27�;
Day phone
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site t'
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
IZe VOW soee 464 A@H) 9Zo-ZL
-ilaorn s,aaaul6ua leuolssa;oid all ul suolsslwo ao saoaaa aoj epsuodsaa
jou sl a6eaogouV jo Al!ledlolunw aql 'panssl sl a]eolblljao e aaojaq LJep az(leue ao suolloodsul jonpuoo
lou op SHHO to saa (oldw3 -sluawaalnbei alels pue leaapa} ulejao Ajsljesoiaapao ul suollnllisul 6ulpual alag4 pue
sawoq jo siasegoand of Asalinoo e se slgl saop SHHO aul'e�selV;o ale1S aql ul paaalsl6aa.)aaulbua leuolssajoad
juapuadepul ue Aq anoge g gdea6eaed ul uanl6 Suoljejuasaidaa aql uodn lluo paseq saleol}13jao lenoaddV
lluoglnV gllueH sanssi (SHHO) soopueS uewnH pue glleaH }o luawueda0 a6eaogouV p Allledlolunyj eql
sluawwoo leuolllppV
suoijelndils 6ulMollod aqj ql!m 'swooapaq ao} lenoidde leuoilipuo0
panoiddesia
•swooapaq JOI pano,iddV
3af11VNJIS SHHO
6 s l TF I A—I 3 t��� / �, ssaaPP`d
V
auo
qd air: wili 10 awe
•uolloadsul siq;10 alep eql uo 109;Ia ui suollelnbej pue 'saoueulpao
'sapoo a}ejS pue lediolunw lie ql!m aouelldwoo ul sl wa}sAs lesodslp aalemaisern ao/pue Alddns
aalem ails-uo aql 'uoi}oadsul pue u01je6ljsanul I\w woaJ pue Sall; 96eaogouV 10 AjIledlolunW aq1
woa; paulelgo uol}ewjolul aql uo paseq jUq} /\;laanaaq}jn} l •ulaaaq paleolpui ain}onils to ads(} pue
swooapaq jo aagwnu aqj aol alenbepe pue leuollounj'ejus sl wa}sl\s lesodslp aajennajsBM ao/pue
Alddns aalem a;ls-uo oqj jegi smogs uoileolldde lenoaddV /\IuoglnV g31eaH slgl jo uolle6IjSanul
Aw 1egj ApJOA I 'Molaq unnogs alep uolieplleA aqj }o se pue ojaaaq paxl}je leas /\w f\q paipliao sV
w
9
H33NION3 AS N01103dSNl d0 1N3W31t11S 'S
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
G1 33 V Iouh�q H Farr jq�Z 017— 022—/3
Legal Description: Parcel LD.
A. WELL DATA
Well type ri"' f'_ If A, B, or C, attach ADEC letter. ADEC water system number -
Log present (Y/N) �VP `II 6 � e"` P'L- Date completed L Driller—
Total %� �%® 4-
Total depth Cased to Casing height
very Jrt� �yy /nS/94aniow(v;,gd) Y4s
Sanitary seal (Y/N) Yes Wires properly protected (Y/N)
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot /01 /
Absorption field on lot
Public sewer main
Sewer service line
WATER SAMPLE RESULTS:
Coliform `e9�
Date of sample:
UJ I
�— 8 —92
AT INSPECTION
32�
y
A/,
WaiVw q
On adjacent lots 21" W q__ C(I000 (o
; On adjacent lots
M
Public sewer manhole/cleanout N�
Petroleum tank lvao z
Nitrate 61 y
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed 10-21- q1 Tank size
/000 (5g/
Other bacteria
60t?e1ae Mallye,
Compartments
/Vail e
2
Cleanouts (Y/N) Y Foundation cleanout (Y/N) � Depression (Y/N)
High water alarm (Y/N) /)Ik Alarm tested (Y/N)
a
Date of pumping l -s-1?, Pumper & Arm oy
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
r
Wells) on lot lot On adjacent lots S Foundation
r 3 0l'
,�S t
To property line 6-3 Absorption field Water main/service line
r
OJ
Surface water/drainage
72-026 (Rev. 7191) Front - CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons —_
Vent (Y/N)
High water alarm level
Manufacturer
Manho!plA-6cess (Y/N)
"Pump on" level at ��' "Pump off' level at
Meets MOA electrical codes
SEPARATION DJ.SrTANCE FROM LIFT STATION TO:
Well o
D. ABSORPTION FIELD DATA
Date installed
a Ole? -
On
le?
On adjacent lots
Cycles tested
Surface water
Soil rating �00� Ybaitvn System type
I i 1 �—
Length Width a Gravel thickness 3 Total depth
Total absorption area _ & 2 T Cleanouts present (Y/N) /V
Depression over field (YIN) Date of adequacy test
Results (pass/fail) 3q �5 for bedrooms
Peroxide treatment (past 12 months) (Y/N) 14hIl �R1i�lP14Wc,+- If es, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
1
Well on lot�0 I On adjacent lots a � Property line
1
To building foundation 2�� ! To existing or abandoned system on lot t\)L'
On adjacent lots-Cutbank Vv Water main/service line � �f
!
Surface water - zoo Driveway, parking/vehicle storage area e7/
Curtain drain
E. ENGINEER'S CERTIFICATION
I certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature
Engineer's
Date G`7/ K`!_ 5 ,` oF!ra n.. P zP�R
°s.
HAA Fee $ ) _� L1 L)C) Waiver Fee: $ —
Date of Payment i - 1 ��- °I Date of Payment
Receipt Number Receipt Number
72-026 (Rev. 3/91) Back MOA 21
J
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. # a !72 z I HAA #�i
1. GENERAL INFORMATION I
175plete legal de cri tion
a�I -e ' S ,#
Location (site address or directions)
\2200 A+ktl"v0
q 5l�a
Property owner
Le L1 `
f ` �- L 20 J
Day phone
3 y s-- (a O O Z
Mailing address
/G X00
SG (�1 CI 2 r"+
�✓�41C /t
�����
Lending agency
Day phone
Mailing address
Agent l hhy (�tJAa0/ Day phone -7(a
Address '=' 1�evtA k 4- 44 t W?ggS'0'
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY: /
Individual well r/
Community well
Public water
- 200
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL.
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA n21
A
6.
0
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm mrd 1"L� JGin 2iN[r Phone ( ts
Address
b -
Engineer's signature Date
L/
JOIHN
C.l'..L'.?iq.
DHHS SIGNATURE°
Approved for bedrooms.
-- Disapproved.
Conditional approval for 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.
72-025 (Rev. 1/91) Back MOA H21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST 44
Z133 3 r1oUIT;4! a orLTsl (0 17
Legal Description: Parcel I.D.
A. WELL DATA t
Well type Iva If A, B, or C, attach ADEC letter. ADEC water system number V /
Log present(Y/N) /y
Total depth 501 4 -
Sanitary seal(Y/N)
Date of test
Static water level
Well flow
Pump level
— Date completed
Cased to Y � 0 0
Driller
Casing height 21J
Wires properly protected (Y/N)
FROM WELL LOG AT INSPECTION
q -7-9Z
SEPARATION DISTANCES FROM WELL TO:
I
Septic/holding tank on lot / 01
Absorption field on lot
Public sewer main
Sewer service line
/J
05'1
WATER SAMPLE RESULTS:
Coliform Nitrate
Date of sample:
B. SEPTIC/HOLDING TANK DATA
—OltJ L '
Date installed
3Z°
g. p. m.
4/�- �e--
Owh-e (5 54k'~-+
NJ WG /% �n✓
g.p.m. \ ��
Collected by: 1
Tank size 100 0 C4 � Compartments
L
Cleanouts (Y/N) Foundation cleanout (Y/N) y Depression (Y/N)
ti
�-
High water alarm (Y/N) �' Alarm tested (Y/N)
Date of pumping Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Wells) on lot G' `I On adjacent Into 9
S
To property line 2 J Absorption field
Surface water/drainage
Foundation
30,
Water main/service line
2 S I
72-026 (Rev. 7/91) Front CONTINUED ON SACK PAGE
On adjacent lots
3
�)
On adjacent lots
'
cry
Z r
n
0A
M
m v
Public sewer manhole/cleanout
�►
r
Petroleum tank Pom L
CZ P 4 e1^1 "/0
c"
m O
<z
Z
rri
N
U) S
Q
o 0
Other bacteria
o m
Z
Collected by: 1
Tank size 100 0 C4 � Compartments
L
Cleanouts (Y/N) Foundation cleanout (Y/N) y Depression (Y/N)
ti
�-
High water alarm (Y/N) �' Alarm tested (Y/N)
Date of pumping Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Wells) on lot G' `I On adjacent Into 9
S
To property line 2 J Absorption field
Surface water/drainage
Foundation
30,
Water main/service line
2 S I
72-026 (Rev. 7/91) Front CONTINUED ON SACK PAGE
C. LIFT STATION p � fA
Date installed / Manufacturer
Size in gallons
Vent(Y/N)
High water alarm level
"Pump on" level at
Meets MOA electrical codes (Y/N)
Manhole/Access (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
D. ABSORPTION FIELD DATA
On adjacent lots
"Pump off" level at
Cycles tested
Surface water
Date installed Soil rating o System type
Length Z Width 2 Gravel thickness Total depth E
Total absorption area Cleanouts present (Y/N) /f2S
Depression over field (Y/N) O Date of adequacy test _ 7 ^ 9
Results (pass/fail) �' for bedrooms
Peroxide treatment (past 12 months) (Y/N) l� �;i� Q, Ft vTIf yes, give dateyv
SEPARATION DISTANCE FROM ABSORPTION FIELD TO: /
Well on lot ' ` On adjacent lots tr Property line
To building foundation % Ile"To existing or abandoned system on lot
�t
��_`�
On adjacent lots
Surface water�-
Curtain drain N
Cutbank Water main/service line
eL
Driveway, parking/vehicle storage area % 1
E. ENGINEER'S CERTIFICATION
1 certify that f have checked, verified, or conformed to all MOA and HAA guidelines in pfeEf4te of this'inspection.
�J •'.- A; ``,
,n '•` j 1
1 � Y c;ti•f
Signature
Engineer's Narrie �� :7 ' ••• �; ...
Engineer's
io'Date CI:' --,/32
HAA Fee $ l 70 ` cfz)
Date of Payment `i�15-_Aj 7 __�
Receipt Number Aj,/d b l 373
72-026 (Rev. 3/911 Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number
p -i L
MUNICIPALITY OF ANCHO
{, W IOUNICI ALl r .ANCHORAGE
^ � �
DEPT. OF HEALTH &
�= ,1 DEPARTMENT OF HEl' S E(d .IROrdMEr�'TAL PRGTEC€�j(1FRONMENTAL PROTECTI N
C,
s` S25 L aet - "& Alaska 99501
\
Q- H
6. TYPE OF RESIDENCE
NOV 16 1979
ENVIRONMENTAL ENGINEERING DIViSlON
jo a
Tele hone 264-4720
p
UN Three C Six i
7. K,'ATER SUPPLY
RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AMD SEi',IEfi FACILITIES j
f DIDI R ECTIOI.S: Com^lete all parts on page 1. incomplete requests %vili not be processed. Please ailr:a
ten ('10) days for orocessl ng.
1. P+' ;OPERTYOlYNER
PHON°
Thomas Hartman
344-2080
MAILING ADDRESS
EXI INDIVIDUAL/ON-SITE"
S.R.A. Box 2386-P
PROPERTY RESIDENT (It different from above)
0000 Saunders Drive
PHOhJE
344-2080
2. BUYER
I PHONE
RiAl Llit'G ADDRESS
I
—^�1
3. LENDING INSTITUTION
PHONE
none
MIAILING ADDRESS
4. REALTOR/AGENT
PHU7 -� {
-. Clair J. Ramsey at Jack White Co.
277-1553_
MAILING ADDRESS
3201 C St. Anchorage, 99503
_
5. LEGAL DESCRIPTION
Lot 1, Block 3, Mountain
Park Estates #2
STREET LOCATION
Saunders Drive
A
6. TYPE OF RESIDENCE
NUMBER OE BEDROOMSIR
❑ O Four ID Other
SINGLE FAMILY
One _
E) Two !E_+ Five
i=; IAULTIPLE FAMILY
UN Three C Six i
7. K,'ATER SUPPLY
IN INDIVIDUAL*
"ATTACH kYELL LOG. A well log is required for all wells drilled
i
LJ COMMUNITY
snce June 1975. For wells drilled prior to that date, give well
(:1 PUBLIC UTILITY
depth (attach log if available.) —}
S. SEWAGE DISPOSAL SYSTEM
EXI INDIVIDUAL/ON-SITE"
"If individual/on-site, give installation date_
If system is over two (2) ,ears old an adequacy test is required
J PUBLIC UTILITY
by this Department. t
i
NOTE: THE !NSPECTION FEE (BUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
rzr;lcian�a y (
��; cd 70-x- �`
THIS SIDE FOR OFFICIAL USE Ot
iv
INSPECTION APPOII t:^ENTS
-----
.-
❑ATE RECEIVED
I
1-1 E
_
T -MIE
I
_
T 1 ".1 E -
DATE
DATE
i DATE,
i
INSFECTOR ... !INSPECTOR.
I
IPSP ECTOR
1. TYPE OF RESIDENCE
❑ SINGLE FAVILY
iJ MULTIPLE FAMILY-
NUMBER OF BEDROOMS
❑ ONE ❑ THREE `I FIVE ❑ OTHER
❑ T1VO ❑ FOUR O SIX
2. t'dATER SUPPLY
U INDIVIDUAL
ED COMMUNITY
❑ PUBLIC UTILITY
Connection Verified_
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
�INDIVIDUAUON-SITE
'PUBLIC UTILITY
Connection Verified _
PERMIT NUMBER
DATEINSTALLED
INSTALLER -
,--Septic Tank or ❑ Holding Tank
Size: If Tank is homemade
give dimensions: _
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area ISewer Line
Nearest Lot Line
Attic: prion Area to nearest Lot Line
5. MOMENTS
41aAPPROVED FOR BEDROOMS
CONDITIONAL APPROVAL (letter must acc m any certificate)
DISAPPROVED
BY
LEGAL DESCRIPTION 1
72."1) IR;v-3,70)
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
December 17, 1979
Clair J. Ramsey
% Jack White Company
3201 C Street
Anchorage, Alaska 99503
Subject: Lot 1 B untain Park Estates Subdivision #2
Tho s Hartman Prop ty
Approval for the individual sewer and water facilities can
not be granted until the following items have been
completed:
(1) The septic tank pumped with a receipt submitted to this
department.
(2) An adequacy test be performed on the existing leaching
area. This test will determine if the system is adequate
according to National Standards. A listing of private
firms performing the test is enclosed.
(3) The cleanout on the septic tank and the seepage pit needs
to be raised twelve(12) inches above ground level and
inspected by this department.
If there are any further questions, please contact this office
at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
` MUNICIPALITY OF ANC �NGE
DEPT. OF 1; =ALTH
ENVIRONMENTAL POTECTION
011
IF
R6M CONSULTANTS, INC. 5024 CORDOVA ■ BOX 6087 ■ ANCHORAGE, ALASKA 99502 ■ PH. 901-279-0483 • TLX. 090-25360
ENGINEERS
GEOLOGISTS
PLANNERS
SURVEYORS
February 11, 1980 R&M No. 051001
Charlene Hartman
SRA Box 2080
Anchorage, AK
Re: Adequacy Test on Existing Sanitary, Sewer System; Lot 1, Block 3,
Mountain Park Estates Subdivision, Anchorage, Alaska
Dear Ms. Hartman:
Per your request of January 31, 1980 we conducted a test of the sanitary
sewer system on the above described property.
The septic tank was pumped prior to the performance of the test on the
seepage pit. During the test the liquid level in the seepage pit was
measured before and after the addition of 1000 gallons of water. All liquid
levels were measured below the top of the standpipe and are shown in the
following table:
Initial Liquid Second Water Third 24 -Hour Total
Reading Removed Reading Added Reading Reading Drop
(gallons) (gallons)
90.5" 400 117" 1000 48.5 841' 35.5"
The indicated capacity of the seepage pit is 15 gallons per inch. After
twenty-four hours the liquid level was again measured and found to be 84
inches. It had dropped 35.5 inches. This indicates an average effluent
acceptance rate of 532 gallons per day for the surrounding soils. 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. 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 regarding this letter or if we can be of additional
service to you.
Very truly yours,
R&MC NSULTANTS, INC.kz
ary A mi h
Proje t Manager
GAS/dj/AT&SI-Q
ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA
t=
n
1\j_
RSM CONSULTANTS. INC.
5024 CORDOVA • BOX 6087 0 ANCHORAGE. ALASKA 99502 ■
PH. 907-279-0983 t TLX. 090-25360
ENGINEERS
GEOLOGISTS
PLANNERS
SURVEYORS
February 11,
1980
R&M No.
051001
Charlene Hartman
SRA Box 2080
Anchorage, AK
Re: Adequacy Test on Existing Sanitary Sewer System; Lot 1, Block 3,
Mountain Park Estates Subdivision, Anchorage, Alaska. For Services
Rendered.
Dear Ms. Hartman:
The following is our invoice for professional services rendered on the above
referenced project.
Professional Services
Fixed Fee
Invoice No. 051001-3
Total Invoice No. 3
$155.00
$155.00
Please note our invoice number on your remittance. Should you have any
questions concerning this invoice, please contact me or the Project Manager,
Mr. Gary Smith.
Thank you,
R&M CONSULTANTS, INC.
✓�un C. J. Parisena
C1 Anchorage Office Manager
CJP/dj/Il-D
ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA
VW4 TQC%09AGL app -
d0
a
G
Y
R a GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
�6�/YEO JATUTOy `9b` 3330 "C" Street, Anchorage, Alaska 99503 274-4561 .
Date Received January 8, 1976
Time of Inspection Q13n Ant,
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.
1. Approval requested by: National Bank of Alaska
Mailing Address: Phone:
2. Property Owner: I.B.M. Phone: 272-6551
Mailing Address: 1689 C Street
3. Legal Description: Lot 1 Block 3 Mountain Park Estates qVI,
4. Location: Saunders .Road off Hillside Drive
5. Type of facility to be inspected Single FAmily No. of bedroom 4
6. Well Data: Individual
A. Type B. Depth 42'
C. Construction D. Bacterial Analysis
7. Sewage Disposal System: on-site system.
A. Installed 1973 B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
r,
A. Well to: Septic tank Absorption area Sewer Lines ,
Nearest lot line Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
Page 2 of two pages - Re' 'st for Approval of Individual er & Water Facilities
Legalo-Description Lot 1 Block 3 Mountain Park Estates
Approved Disapproved _ Date i4
Approval;Valid for one year from date gned
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I
certifv
that
the
information
contained.in
this
request
for
approval
to
be
a true
and
-accurate Irepresentation of the subject sewer and water facilities and these facilities
are 'operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
i WUNICIi ALITY OF AGE
MUNICIPALITY OF ANCHORAGE �eI viN'e -eFp� &
EN IRONAA iL�''TAL P,:C'� ECTION
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 JAN 1.j 1976
REQUEST FOR APPROVAL OF RECEIVED
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: n CMRO VA FHA CONV
2. Property Owner:_/� /
Mailing Address: C Day Phone, 2— 6 5-
3. Name of Buyer:
Mailing Address: Day Phone
4. Name of Lending Institution: -2 l
Mailing Address: Phone
v Name of Ito: or Agent: %�iz��� 5l 1'�iJo:fn/� �7 /IJ
Mailing Address: ��� e a2 Phone 25
6. Legal Descripti
Location:
7. Type of Facility to be inspected: 2- G� No. Bdrms. _z
8. Water Supply
Type of Supply: Public Utility Individual
If Individual, number of dwellings presently served
If Individual, depth of well L-1
9. Sewage Disposal System
Type of System: Public Utility Individual (on-site) ,k'
If Individual, date of installation / 2�z _�
EQ -037 (1/74)
REALTORS®
MUi\iGPALITY OF ANCHORAGE
DEP;'.„T<4, "':F OF HFAL,H &
ENVIRON A--",i„',L P'�C! TION
J AN 11Q ,1
RECEIVED
January 21, 1976
Department of Health and Prevention
3330 "C” Street
Anchorage, Alaska 99503
Attention: Les Buchholz
Subject: Lot 1, Block 3, Mountain Park Estates #2
Dear Mr. Buchholz:
Regarding the above described property, this should be a three bedroom,
single family residence instead of four berooms as I indicated on my
request for approval of individual sewer and water facilities. If you
could make this change for me, I would greatly appreciate it.
Thank you for your cooperation.
Sincerely,
Avalon R. Rickerson
AREA, Inc., Realtors
119
AREA, INC. REALTORS 3300 "C" Street Star Route A, Box 74 E] Parkgate Building
Anchorage, Alaska 99503 Palmer, Alaska 99645 Eagle River, Alaska 99577
REALTOR (907) 278-2525 (907) 745-4334 (907) 694-9555
N pT�(%OiAbf aPt�
v �
�c��teto lAt�uTGY
I J�
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received -/l' l' `
r
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES C��� �9�7�y ?�� ` A/
FOR jfk` i� 1n n C v« L�i.K�cr�n
1.
2.
3.
4.
Approval requested by: Jiy</T-� 1�)ly,�2 �c)
Mailing Address: Phone:
Property Owner: LeSlelz e4r/k_ -�4b1� Phone:
Mailing Address: /%
Legal Description: CD f �Gc,� _3 /J%T Q �
Location: -
77-
&,5-1,,4te
5.
bedroomsc5—
Type of facility to be inspected No. of
6.
Well Data:
el -
A. Type B. Depth /5
A.
C. Construction D. Bacterial Analysis
1-2
7.
Sewage Disposal System:
C -*X
A. Installed 3.. B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8.
Distances:
A. Well to: Septic tank Absorption area
Sewer Lines ,
Nearest lot line Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74)
Page 1 of two pages
f
S-A �7<
GREATER ANCHORAGE AREA BOROUGH_...
Department of Environmental Quality
3330 11C11St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO
2
3
4
5
Property Owner: / e—S
Mailing Address:
Name of Buyer: y
Mailing Address: ' N z
Name of Lending Institution:
Mailing Address:
Name of Realtor or Agent:
Mailing Address : -0
Legal Description:
Location:'S
VA FHA
Day Phone.
l c"u
c� Day Phone -
CONY �z
Phone
�• ��- Phone
O
J) _'R_e_e4
7. Type of Facility to be inspected:
8. Water Supply
No. Bdrms.
Type of Supply: Public Utility Individual /
If Individual, number of dwellings presently served /
If Individual, depth of well /G
9. Sewage Disposal System
Type of System: Public Utility Individual (on-site) `
If Individual, date of installation -
Jp
EQ -037 (1/74) 'a/Z ty��'/�✓�%t��^ .2-717„l S
PagP 2 of two pages - Ree or Approval of Individual Water Facilities
Legal � Descri`ption
Comments
Approved e—Z 9 Disapproved Date S
Approval,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)