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MOUNTAIN PARK ESTATES #2 BLK 3 LT 13
Mountain Park states lock 3 Lot I 017-022 -25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME.~ ,~...UPG RADE ~ Wel~ t Absorption area Dwelling Manufacturer ~ ~ ~~~ t i Materi~l ~ . No. of co~artments ~ ~ Liq. cap~gallons IF HOME.DE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. ~ z ~ Manufacturer Material Liquid capacity in gallons ~ W Foundation Nearest lot line ~ ~ ~ DISTANCEt TO: e~ ~. '~ Trench ~ Distance~z~lines No. of lines , Length o~i~ Total ~gth ~f lines -- ~ ~ inches - ~ ~ Top of tile to finishqde Materia] beneath tile ~0 inches Total effec,iveZ~~a Length -- Width Depth PERMIT NO. ~ N Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: j Class Depth Driller Distance to lot line PERMIT NO, Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS ' ~'~ ~ SOIL TEST RATING~ ~ 72-01 ~ lev. 3/78) PERMIT NO. I C: I ' :tLI T'T' C,F Ar'tC:H 'RAGE DEPRRTMENT Or HEBLTH ~ND ENVIRONMENTRL PROTECTION 825 '"L' STREET, 8NCHORBGE, BK. 99501 264-4~20 I TE SE&-IEE: IJPGRR[:,E F"ER~I I l" RPPL I CRNT LOC:RT1 ON LEGRL TONY SWRN Lt2 B~ MT Pi-:.'. EST SRR BOX ~??',/ RNCHORRGE 995E~? LOT SIZE 999999 _.QUHRE FEET TYF'E OF SOIL RE:SORF'TION SYSTEM IS: TRENCH blH,-.,IMLIM NLMBER OF BEDROOMS = 4 SOIL RRTING THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: [:,EPTH=_ ':-,~ L E ~'-.IG TH = .:_._ '-"- -':~ C-i F.' A %-' E L [:.FPTH= ._ 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFACE OF THE GROUND 8ND THE BOTTOM OF THE E~CBVBTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). RED SEF'T I C: TA~-~:~ S I ZF= 5 ~--l~-~ ,SRLL,-,~-tS PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFDRM THIS DEPRRTMENT DURING THE INSTRLLRTION INz, FE_.TION:, OF RNY WELLS RDJRCENT TO THIS PR. OPERTY RND THE- N_IMBER OF RESIDENCES THRT THE WELL WILL SERVE. T~q,:, ( '2 ) I ~SPEC:T I C,~S RRE REL~L! I RED. BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPRO',/RL BY THIS DEPRRTMENT WILL BE~UBJEL. T ~ ' --' TO PROSE-.TInN_ _ MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS i00 FEET FOR R PRIVRTE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. F"ERr-1 IT E:~=:F'I ~:F~] [:,FC:E~'IE:E~: ]:i.. 1L~:B2 I CERTIFY THRT 1: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND HELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. _.. c .... r'IRY REQUIRE ENLRRGEMEN~. IF THE ~' I UNDERSTBND THST THE ON-SITE SEWER _,~z, TEM RESIDENCE IS REb~ODELED TO INCLUDE MORE THRN 4 E:EDROOMS./z .~, //~, ,~ ,-- r, , - HPPL~ _.HNT T]F~ :.WHN . ...... GR~ .... ~ER ANCHORAGE AREA B('-~,,UGH Department ~3E0n~irs~e;ntal Quality Anchorage, Alaska99503 OS~A~i /~)~ ~ INSPECTION REPORT ON-SITE SEWAGE DISP SYSTEM NAME. ~(~"~'/~//-////~'~ ~,~5-/~'~'-'r, MAILING ADDRESS --J~'/~'/-/~/ --~"~'//? ~/,-J:'~f'~--~ C-~ PHONE LOCATION f~--~/'~.-~;--~??~.~/ /~/~:~ LEGAL DESCRIPTION ~/2 ~'/_~, _,.~/_~_~ SEPTIC TANK: DISTANCE FROM WELL ~-'~ INSIDE LENGTH ~'~'/~;'/~ ~/"~--- NUMBER OF MANUFACTURER ~'~' ~'?-'~./~, MATERIAL ,~-~Z.- COMPARTMENTS ~ ~ INSIDE WIDTH ~ LIQUID DEPTH ~-- LIQUID CAPACITY ~/~.~/2 GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER LINING MATERIAL ,.~J" CRIB SIZE: BUILDING FOUNDATION~'~;, /d~ lb ' ~' ' -. / / ~ OR W I DTI:I'~, LE N GT H---"~, DEPTH '/ ~? / DIAMETER ~>' DEPTH/ DISTANCE FROM: WELL NEAREST LOT LINE''~ :? ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE ,../~//"~-~ ~/~'/~'~-/~:'- CONSTRUCTION BUILDING FOUNDATION APPROVED NEAREST LOT LINE /~ OTHER SOURCES DISAPPROVED NEAREST SEWER LINE DEPTH DISTANCE FROM: SEPTIC ~' SEEPAGE //~.~.<_ / TANK SYSTEM REMARKS DISTANCES: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM DATE APPROVED ~ -'~'~'~ .~/~2 _ G.A.A.B. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C"STREET ANCHORAGE, ALASKA 99503 TELEPHONE 27/~-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. NAME OF APPL,CANT c/ INSTALLATION LOCATION PHONE 'EGALDESCR,PT,ON ~NSTALLAT~ON OF~ SEPTIC TANK SEEPAGE T'~PE AND S,.E OP PAC,' ,TY TO · DRAIN FIELD , OTHER FINANCED THROUGH CO.PLET.ON DATE ANT,C,PATE. TO BE INSTALLED BY NOTE.' THI~ PEL~MIT IS NOT VALID WITHOUT SOIL TES"I' FINAL INSPECTION: 24 FLOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAl_ INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPT,C TANK S,,E ,moo MINIMUM DISTANCE~, REQUIREI~IEI~IT~ FOUNDATION TO SEPTIC TANK .~ FOUNDATION TO SEEPAGE PIT ~/"--') . DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL ~ TO NEAREST LOT LINE. WELL TO SEPtiC TANK /~) ¢ / SEEPAGE PIT WATER MAIN TO SEPTIC TA~K ~ SEEPAGE PIT SEPTIC TANK, ,//~L)~ , sEePaGE PiT //~J}O TO RIVER. LAKE, STREAM. TYPE ~'~ SEEPAGE AREA S,~E t~/~'~C~'eTYPE ~ ~)IAGRAM OF SYSTEM , DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURSED SOIL, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPT[O TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT rEMOVABLE CAPS. GI~AVEL ~ACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUG~H OR~D. INANCE NO. 28-68 AND THAT THE ABOVE GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For (~ALF_ Legal Description: Lot This Form Reports Soils Log ~ ' ' Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics 14- Was Ground Water Encountered? If Yes, At What Depth? Dated Performed Reading Date Gross Time Depth to H20 Net Time Percolation Rate Minute Proposed Installation: Seepage Pit Depth of Inlet COMMENTS: Net Drop Drain Field Depth to Bottom o'~ 'Pit or Trench--~ Test Performed BY Date Certified BY: Date: O Municipality of Anchorage Development Services Depsrtment ~,,,t,~ng Safety Division On-Site Water & Wastewater Program 4700 E.more Road P.O. Box 196650 Anchorage, AK 99519-6650 ---~:?:" t.._~ (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 017-022-25 1. GENERAL INFORMATION Expiration Date: ff'-q -// Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MOUNTAIN PARK ESTATES S/D #2; BLOCK 5, LOT 15 15141 FOSTER ROAD * ANCHORAGE, AK * 99516 CANDACE WINKLER 15141 FOSTER ROAD Day phone * ANCHORAGE, AK * 99516 Day phone 884-2484 NATE BAER W/ KELLER WILLIAMS Day phone 727-1150 101 W. BENSON BLVD, #503 * ANCHORAGE, AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 5 3. TYPE 'OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · Individual On-site · Individual Water Storage [] Individual Holding tank [] Communi.ty Class Well [] Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems 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 samples. (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. STATE!,~ENT 'DF INSPECTION BY ENGINEER As certified by my seai affixed hereto and as of the validation date shown below, i verify .... my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this appfication, shows that the on-site water supply and/or wastewater disposal system, is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furt,fer verify that based on the infomTation obtained from the Municipality of Anchorage files and ~m my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Munic(Dal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 5701 Eo TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone 357-6179 Date Engineer's Comments: the sole benefit of the own~r listed above. Any ' P . , , ~ ~t~t-,(.- '~- other person or party is not authorized nor will it confer any legal righ~ wna~soever, k.~,"" ;,"~ ~' ~1~' ~11 DSO SIGNATURE .,,.~L~'~o · ~.,~ . / -o ~. ON-SITE .~.- ~ Approved for ~ bedrooms. ~: WATERAND _. , = 1. WASTEWATER · : u~sapprovea. ~ ; PROGRAM Conditional approval for bedrooms, with the follow, ng stipulations. ~_,,~2". .° '"'~,~ Attachments: Septic System Advisory Well Flow Advisory (Rev. 11105) Arsenic Advisow Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 wWW.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Legal Description: MOUNTAIN WELL DATA *PER Well type PRIVATE Date completed ~ 1974 Total depth *222 ft. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Arsenic: ND ug./L. SEPTIC/HOLDING TANK DATA PARK ESTATES S/D #2; AARow PUMP AND WELL If A, B, or C provide PWSlD# N/A Sanitary seal (Y/N)YES Cased to *40'+ .ft. FROM WELL LOG g.p.m. CHECKLIST BLOCK 3, LOT 15 Parcel ID: 017-022-25 INSPECTION. SEE ATTACHED REPORT. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 5/17/2011 195 ff. 5.46 g.p.m. Nitrate 1.71 mg./L. Date of sample: 5/17/2011 Tank Type/Material SEPTIC,STEEL/SEPTIC,STEEL Tank size 1000/500 gal. Number of Compartments 2/1 Foundation cleanout (Y/N) YES Date of pumping 5/19/2011 ABSORPTION FIELD DATA 5/23/74 Date installed 9/13/'82 Length 16/27 ft. Depression over tank (Y/N) NO Pumper. ~*BELOW EXISTING GRADE] 125 Soil rating (g.p.d./ft20~ 125 Width 1 6/5 ft. NO YES 12+ in. Collected by: GEG, Ltd. 11974 TANK/1982 TANKI Date installed 5/25/74 / 9/15/82 Cleanouts (Y/N) YES/YES High water alarm (Y/N) N/A ONE STOP SERVICES **UNKNOWN 384 Total depth .11.3 ft. Eft. absorption area **270 ft2 Monitoring tube YES Date of adequacy test **'5/17/2011 Results (Pass/Fail) PASS Fluid depth in absorption field before test 15 in. Elapsed Time: 120 min. Final fluid depth 16 Any rejuvenation treatment (past 12 mo.) (Y/N & type) **654 TOTAL SQUARE FEET ***CRIB PIPE COULD 11974 CRIB/1982 TRENCHI System type CRIB/TRENCH Gravel below pipe 6/5 ft. Depression over field NO For 5 bedrooms New depth 20.5 in. Water added 600 gal. in. Absorption rate >= 450+ g.p.d. NONE KNOWN If yes, give date - NOT BE LOCATED. TESTED 1982 TRENCH ONLY. D. LIFT STATION Date installed "Pump on" level at in. Size in gallons Manhole/Access (Y/N~ ~ "Pump off'~ High water alarm level at Cycles tested. Meets alarm & circuit requirements~ SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: *96 Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas. 50'+ in, I 'PER On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas EXISTING WAIVER #WR9600411 100'+ 100'+ N/A 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+/5'+ Property line 5'+/5'+ Water main N/A Water service line 10'+/10'+ Wells on adjacent lots 100'+/100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+/10'+ Water service line 10'+/10'+ Curtain drain NONE KNOWN COMMENTS NOTE: DISTANCES FOR CRIB J1974 TANK/1982 TANK] Absorption field 5'+/5'+ Surface water 100'+/100'+ J1974 Crib/1982 TRENCHI Building foundation 10'+/10'+ Water main N/A Surface water 100'+/100'+ Driveway, parking/vehicle storage10'+/10'+ Wells on adjacent lots 100'+/100'+ 1974 CRIB PIPE COULD NOT BE FOUND DURING INSPECTION. SEPARATION BASED UPON 1982 SURVEY SHOWING CRIB PIPE AND 1996 AKWWC INSPECTIONS. 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 COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date [,,/~/ll COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Lot /_~ ,Btock ~ Anchorage Recordng ~is~ric~, A~aska LOT SURVEY C~RTIF~GAT~ON ROAD tho plat of r~oor~ oro not s~wn ~r~n unie~ LEGEND // / ~, ~ D~t~ i© Of ,_Ol./ / F.B. Nc. .- / ! i Prap~r< by: ! Pr,cp~fi~ cf: Aarow Pump & Well Service LLC (907)346-9355 Inspection Report 13141 Foster Rd. Well was inspected by camera to 45'. No perforations were found above 45'. Well was measured at 222' with a SWL of 150'. Brian R. Wille Aarow Pump & Well Service 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. 01 7-022-25 GENERAL INFORMATION Complete legal description Location (site address or directions) HAA# 0 ur o.t g 7 Expiration Date: MOUNTAIN PARK ESTATEg.. BLOCK 3: LOT 13 13141 FOgTER RD.; ANCHORAGE; AK 99S16 Current Property owner(s): DAN FLYNN Day phone 348-8727 Mailing address Lending agency Day phone Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: __3_ Day phone TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site [~] Individual Water Storage [] Individual Holding tank E~] cOmmunity class Well [] Community On-site [--] Public Water System [] Public Sewer [~ The MuniciJ~alit~ of Anchorage Development Services Depadment (DSD) Issues Cedificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent profession.al Civil engineer registered in the State of Alaska. Cedificates 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 andlo~ 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 pdvate or Class C well and may be reissued with new water sample results. (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. S'i:ATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto' and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this appl.ication, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and ~ adequate for the number of bedrooms and type Of structure ~ indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm KND ENGINEERING= Inc. Phone (.907) 696-6111 Address 20441 Ptarmigan Blvd., Eagle River, AK 99577 . Engineer's Printed Name Kenneth M. Duffus Date '5/12/04 Engineer'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 the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the 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 characteristics and are outside the control of the evaluator of the well and septic system. Therefore, KND can not give any estimate of how long a system will function satisfactory for current or'futd'~e occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. DSD SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: ~: W~,TERAND : m~ By: Attachments: HAA checklist Septic System Advisory Well Flow Advisory ' ~ : WASTE'WATER .~ ",."PROGRAM · ~ ~ .. .. Maintenance Agreements ~'_'~/..'. · .... · Supplemental Engineer's Report . ~'.4~S~..~,~ Other - "~')¢) J ~ ~ t~'' Original Certificate Date: ~"~- ! ,,~ - ~) L~ ~,i :DeveloPment Services' Department ;~,.i~ , .. ~ Building Safety. Division [~:': , On-Site :Water&'WasteWater Program .: .. : 4700 South Bragaw St. ! P O -'Box 196650 Anchorage, AK '99519-6650 ~: i :~ , www.cl.anchorage.ak.us .. · : .~ - ; f9071 343-790 · ,: · ~'. '~ ," - " l~' ?' ~ ' HEALTH AUTHORITY'APPROVAL'CHECKEIST :Leg~l',~ Desc~'iption;' ' -MOUNTAIN: iPARK ,''EST"' B3. L1 3 '." Parcel ID:, 0,17-022-25[: ' WELL DAT ' '-** '. , , Well ype Private . If A, B~ or C prOvide PWSID #. Well Log (YIN N - ' 'l~r°tected (Y/N) Y Dat(J :ompleted NA , Sanitary seal · (Y/N) Y · ~.Wires proper ~ Casing heigh [(above ground) :1 Total depth~ 245 ' ft. casedlto 40+: ft." ... !~ ' 'FROM'WELL LOG i AT INSPECTION s'-t ' ' NA ...... ' Dare'of te · : '. '~ : 5/6/04 I I Static wat(~' I(Jvel NA:: ft.!.~.'' . t 9 3 , , ft. ~'~ : '~ ~'-..5,27 I!l Well production*' '*" NA' ***g'.i~.m ** * ~ - g.p.m. WATER SAMPLE RESULTS:' ': ~,: ~ .... 1 ~,,lu'"o':;'2rm 0" colomes/100' ' 't ~ 1;14';' mg./I.Other'ba~t~ria .0 col6nies/100 mi. mI.N~rateI , , . Arsenic: NA mg./I; Date ofsample:~5/6/04: i ' ~Collected by: KND'I !Engineerina ' SEP~ICIHOLDING- ,i TANKrDATA;... i _!:' '::i,:: ' ' '~, ;;i r Tan~k~Tvne/Matel-iai ':::~SEPTIC/S'F_,~ ~ in§tailed".5/74 & 9/82'Tank size .1000 & 500 gal. -:, - i:'.~ ' : :,": ~ :".: : I: .:' , 'i.[~r,~ ''' . : " . ~ ': Num~erofi';.Compartments~~lea~°ut!r(yi,N)Y' i :", · . i' ' ' ":" "'"'" ' ! ·' !;': ' ' '" " " t}!t Foundatioplcleanout (Y/N) Y . *Depression over[ tank (Y/N) N H~gh water alhi'm~ (Y/N) N Date of pumping' ,5/5/04 ?: "~' ~ 2~ [ '~ iI' ABSORPTION ~IELD DATA ,.~ '.,~ - iI' *!'- · . "' *: *..: ~i i~ · ':"" ':"" I ' !"' ! .... ' Date~ instal'led 5/74 &9/82 S~il rating (g ,p:.d:/ft' orft!/bdrm) 1 25_ Sy~st~ type'CRIB &.'TRENCH [ i - . ' , ~ ; . ' ' · ' * , . Length ' 1~,,', ~'c3'_.. & ~7.m ft.:.:Width'.. ~ , ~6',. ¢c~&,3'cn .... ft..Gravel, below, p~pe :u -R~B & 5' TRENCH ft. Total depth!0.8' (¢} & '11.5 {T) ft.,~lf, l[i" I I ' ' ' tub~!¥' :Depression over'field N area ~54 '¢crr~ ft~ Monitoring ~ . _ Dar{/: of adequacy test 5/6/04 ~'1 Pa'§siFail) :: PASS . For $~ I b~lro6ms ,: ! :: . ll'i'i':~ ~. Fluid depth'~in absorption field' be[ore test__ in. ~i~ Water added ~0 CT)IgaL '' New dept~in. ElapSed Time: ~0 min. :~inal fluid di~pth in. Absorption ~' "'~u.:~.~. " ,'i ': ~ If'yes, give date Any rejuvehation treatment (past1'2'mi°') (Y/? &'type)' N D. LIFT STATION Date installed NA Size in gallons ~ ' "Pump on" level at in'. "Pump ofF' levei at Datum . Cycles tested" E. SEPARATION DISTANCES ~": in. Manhole/Access (Y/N). ,High water alarm level at Meets alarm & circuit requirements? in. SEPARATION DISTANCES FROM WELL,ON LOT. TO: Septic tank/lift station on lot 96.5' Absorption field on lot 100'+ Public sewer main 75'+ "' -'On.adjacent lots 1 0 0' + On adjacent lots I 00'+ 'r;.. Public sewer manhole/cleanout 100'+ Sewer/septic service line. 25'+ Ho!ding tank , 1 0 0' + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5 ' + Absorption field Water main 1 0'+ Water service line 1 0 ' + Wells on adjacent lots 100'+ SEPARATION. DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I~/'t- Building foundation I 0 ' + Water Service line 10'+ Surface water 1 0 0'+ Curtain drain 50'+ .. Wells on adjacent lots 1 00'+ F. COMMENTS Surface water I 0 0 ' + Water main 10'+ DrivewaY, parking/vehicle storage The wall adjoining ?_ ·small bedrooms was removed for a total of 3 existing bedrooms. All 460 gallons were injected into the trench. 'The· crib's monitoring tube is blocked or is non-existent.. ENGINEER'S CERTIFICATION ": ' ' ,' r :: I- ' : ' ' :* . Ice. rtifY that ! 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 Kenneth M. Duffus Date 5/12/04 HAA Fee $430.00 Date of Payment Receipt Number (Rev. 12/01) : · -_.~_ OF ,4/,. - t~ Waiver Fee $ Date of Payment ReCeipt Number ~ E ~ ~ ~'I 0~ ~O~D THE INFORMATION HEREON IS FOR THE USE OF - LENDING INSTIT~IONS SPECIFICALLY TO SHOW A~ CONFLICTS BE~EEN EXISTING STRUC~RES EASEMENTS OF RECORD, OTHER THAN AND P~ED LOT LINES OR EASEMENTS AND IS THOSE SHOWN ON THE RECORDED NOT TO BE USED FOR POSITIONING ADDITIONAL P~T, ARE NOT SHOWN HEREON, STRUCTURES OR FENCELINES, "ASBUILT" No corners set .Book I hereby' ce~l~ that I have su~ey~d the following described prope~, Lot /~.'BIock '~ ~N~I/J ~A'~ EST, ~2 Anchorage recording district Alaska, and lh~t the Improvements situated thereon are within the prope~ lines eno do not overlap or encroach on on prope~y lying adjacent thereto Ihe prope~y lying adjacent thereto, that no Improvements encro~ch on the premises In ~uestion and t~at,here ere ftc roadways, transmission lifles or other ~sible easements on said property except as Indicated hereon. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section Parcel I.D. # O ~-7 - O '~-~.-- Z~-" P,O, Box 196650 Anchorage,343.4744 Alaska 99519-6650 u/-4/~o '~'~/~/~'~?'/o~ ' CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner 1'~3J-~_M__ ~? C~,~t~_.L~--~-----~ Mailing address ~-- ~ ~:~'~--' Day phone Lending agency Mailing address Day phone Agent ~-O~ ~..~,~---t.-%-"~ --I~.~0~ ~ Day phone ,,'~'7~1_~0~-"7J Address"]~Z-4 ~-- , 1~- ~"'+-{-' Z~,3~-4'J~ - -1~. ' c~~ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: ~ TYPE O F WATER SUPPLY: ndividual well Community well Public water NOTE: tf community well sYStem, provide written confirmation from State ADEC attest- ing to the legality and status of system. ;.~ :, ~ " ',, . . - ~,~:~' _,..,.~- ~. TYPE OF WASTEWATER DISPOSAL: -~' ' Individual on-site . "' ~,,' - G ni-ommu 'ty on--'-e - '"''-' ' '"-~ · ',?/;:_., . Public sewer )~ ~, from State NOTE: If community WasteW~ter system, provide written confirmation attesting to the legality and status of system..~ . . 72-025 (Rev. 1/91 ) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authori.ty 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 d; Name of Firm Address Engineer's signature 6. DHHS SIGNATURE ~' Approved for ¢ Disapproved. Conditional approval for AlaskaWater& [e of this nspection.' Phone Date r A. Garness CE~7953 bedrooms. bedrooms, with the following stipulations: Additional Comments By" "~; · Date ~-- ¢ - ' ""3'hb I~ality of~.A.?dhOrage Department of Health and Human services (DHHS) issues Health Authority -.:. up°n C'Srtificat~e~'~a~ed only the given m paragraph 5 above by an independent ;-- i~r0f~ssi0n, al eng ~'"~'r re'gistered in the stateof Alaska. Th~ DHHS does this as a courtesy t~ purchasers of homes and their, lendiPg institutions in order to satisfy certain federal and state requirements. Employees Of DHHS do not ...... conduct i'nspections or analYZe data'JSefore a certificate iS issued. The Municipality of Anchorage is 'not ;' - responsible f~r errors or omissions in the professional engineer's work~ -'.:, . '. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 ,. (907) 343-'4744 Legal Description: Lz3";-' t,'~j A. WELL DATA Well type "~ 'J~-"' Log present (Y/N) · / Total depth Sanitary seal (Y/N) Health Authority APprOvaI Checklist ~_ ~ ,) J,40o~-c~-~ Parcel I.D.: If A, B, or C, attach ADEC letter. ADEC water system number I,~c~ Date completed I,~/;~ Cased to ~/'+' Casing he'igl~i (above ground) Wires properly protected (Y/N) Date of test Static water level Well production ' FROM WELL LOG AT INSPECTION ' 'g.p.m. 4 g.p.m. 'WATER SAMPLE RESULTS: Coliform ¢ Nitrate Date of saml~le: B. SEPTICiHOLDING TANK DATA Date installed ~/~ 'Z Tank size Foundation c eanout (Y/N). ~/~____ c,, , ~,'~ ~ w,Jj~ Other bacteria ~Z~ Collected by: ~-'1)O Number of Compartments ! Cleanouts (Y/N)__ Depression (Y/N) t',~lb High water alarm (Y/N) C. ABSORPTION FIELD DATA Date installed ,=//e z 'T'~--,-~oil rating (~or fF/bdrm) Length ~-'~'~--J4~ Width ~'~ Gravel thickness below pipe Effective absorption area gfl~ ~0 Monitoring Tube present (Y/N) Y Date of adequacy test ~/~/~4 Results (Pass/Fail) ~ For ~"~ Fluid depth in absorption field before test (in.); ~ I~mediately after GO Ogal' water added (in.): Fluid depth ~'~ (ins) Minutes later: ~0 Absorption rate = .g.p.d. Peroxide treatment (past 12 months) ~/N) ~ ~ ~ If yes, give date /2~-' System~ type ~2 ~_, E ~, ',~,~ ~ '~/o" c~-,~ ~'-~.Jc~l'otal depth ~/- . Depression over field (Y/N) bedrooms 72-026 (Rev. 3/96)* Manhole/Access (Y/N) ~__ "Pump off" level at* __ E. SEPARATION DISTANCES Absorption field on lot Public sewer main Sewer/septic service line SEPARATION DISTANCES FROM WELL ON LOT TO: / Septic/holding tank on lot c~,. ~' ~ ! On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station ! SEPARATION DISTANCES FROM SEPTIC/HOLDINGTANK ON LOTTO: ! ! Foundation /q~ +' Propertyline ~ ~ Absorption fiel'd UtO/.~,~o corJ Water main/service line ~' t O Surface water/drainage ~ ~ Od Wells on adjacent lots ;:~ [ 00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~ - ~ (~ Building foundation ~'~/% ¢/c~ V~ater main/service line /' Surface water ~ lDO Driveway, parking/vehicle storage area Curtain drain IOc~.~-~ ,l~ov,,JM Wells on adjacent lots ~' leo/ / ENO,.E.R'S C..T,.,C^T,O. ,/ I certify that l ha?p~tcC/ned~,ietCinspections( in conformancywi~h/¥f;~ H~A ~ide#~ ~n e~ec~ on ~h~ da~e. Signature ~~~/- ~ Engineer's Nam[ [~ ~ ~ ~ ~' ~~ Date; ~%~' Date of Payment 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 343-4744 Parcel I,D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description JUL .2 6 ]996 RECE,IYED Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone _ I''3 I~-'~ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72*025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the 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 Address ~,~c'1 Engineer's signature DHHS SIGNATURE · ,~ Approved for ¢ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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~'25 (Rev. 1/91) Back MOA fY21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVl~FxEc~paun, oF,~:~o~ Environmental Services Division ENVIRONM~.i~A[. SERVICEs DJ 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343~4744 Legal Description: I...o"~' ~.~ A. WELL DATA Well type ~,,r'r". Log present (Y/N) I,,30 ~-- Total depth ~_z:~' Cased to Sanitary seal (Y/N) Date of test Static water level Well production Health Authority ApProval Checklist ~ ~--~ /MO O~q'~r~'~ Parcel I.D.: ~ RECEIVED If A, B, or C, attach ADEC letter. ADEC water system number Date completed IQ ~ Casing height (above ground) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION / g.p.m. ~ g.p.m. WATER SAMPLE RESULTS: Coliform ~ Nitrate B. SEPTIC/HOLDING T32qK DATA Date installed e-//0 'Z Tank size Foundation cleanout (Y/N) Date of Pumping 'O/~ ~A~'--Pumper t14 ~/~- Other bacteria Collected by: ~'~--~'~---~ ex Depression (Y/N) ~ Number of Compartments High water alarm (y/N) Co Fluid depth ~' (ins.) Minutes later: Peroxide treatment (past 12 months) (Y/N) ABSORPTION FIELD DATA Date installed ~-)/Oz ~t'P'tS°il r.ating ~or fi%dmO [ 2~ System ~e ~g Len~h g7 t ~¢~ Wid~ g ~R Gravel tNc~ess below pipe 5t~t~To~ dep~ Effective aoso~tzon ~ea Mo~todng Tube present~ ¥ Depression over field ~ For - ~ b~ooms Fled depth in abso~fion field before test (in.); ~ "~c~I~ediately ~er~ ~i~ ~atcr added (in.): ~O Abso~tion rate = > ~OO g.p.d. ~ ~yes, give date LIFT STATION /x,J D Size in gallons Manhole/Access (Y/N) ~1" level at* High water alarm level at* ~ *Datmn E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer lnain Sewer/septic service line I : On adjacent lots .; On adjacent lots Public sewer manhole/cleanout Lift station gQ SEPARATION DISTANCES FROM SEPTIC/HOLDINGTANK ON LOT TO: Building foundation Water main/service line Property line '~/4- Surface water/drainage ~' I DO t Absorption field Dca Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation .~'~ Surface water ~ Cu~ain drain [~o Driveway, parking/vehicle storage area ~' ~ Wells on adjacent tots >' I C:~ Property line F. ENGINEER'S CERTIFICATION in conformaJ,~e with g~O//J//f[/A[4 gui[telines in effect on this date. ........................................................................... HAAFee $ ~ ~ W~verFee$ Date of Payment ~/~ Date of Payment Rev. 8/95 OSS: haa.wk.doc g.Y--. 3,) ~-- TANK C/O 4-5.2 A TO WELL = 59.8 B TO WELL = 58 C TO TANK C/O = 22.6 D TO TANK C/O = ,36,2 EDGE OF TANK TO EDGE OF WELL = 96.5 FEET (APPROX.) WELL I , . . .,~ . ~ . I .. ' ~.-. ~ ..... ~- ; · . .... ~ . ' ~ · ~ --I .... ., .." .. ~' ~ '.. ~' ~ -~=~, f : ~-~ ..... : . . : .... ,_ . ~r,:ll · i . ~. .. ~. / .... ~s~ t~ ~ '' :_: ' ;,~ .... . "''' ' c' ' : , ''" '" ~" ~. :l '~'. '/~' .... .'1;,' ...... :' '" 'i .l*'- I~ ' I. : "' r~ .... ~ ..... ~r'". ....... ~ ....... ~-' i .... ~": i ~ .... :'7" ~ ..... I .... .i:::l" " "' ~ I . i ..... ~l. ...... I .... '~' i t 'l ..... ..... :~ , .... i:. , , i * .. " '1 '; .... ': ....... * ...... I · "~ ..... ,1' '' '' ~' · ' ~ ..... ~. · i . . i · · , · · I ' : : : '"I ' ' ....... :-~..~ : :. .:Ii ;'l: ...... :~';'!~' ':: : : -' · I: ........ ' ' · . ' ' : ' ' ; : : ~ ; I ' : ': ; · : : ........ ;-' I i - : ~ : · · ~ ~ · - - :.:-. ~-:-I i , I . . · ;.. , · . ~ .... , .:[. ~O~O~' i · ".ii. .:: '.l- · I. : ! · ..~ .. . . ~.~ ..,.~ A TO WELL - 59.8 B TO WELL = 5B C TO TANK C/O = 22.6 O TO TANK C/O = 36.2 EDGE OF TANK TO EDGE OF WELL = 96.5 FEET (APPROX.) .ELL Rick Mystrors, Mayor Mmncip ty of Anchorage Department of Health and Human Services 825 "L" Street P.O, Box 196650 Anchorage, Alaska 99519-6650 September 5, 1996 Jeff Graness, P.E. Alaska Water and Wastewater 8471 Brookridge Drive Anchorage, Alaska 99504 Subject: Waiver Request for Lot 13 Block 3 Mountain Park Estates Subdivision #2 Waiver Request #WR960041, PID #017-022-25, HA960311 Dear Mr. Garness: Your request for a waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance is a private well to the on-site septic tank of 96 feet. 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 form this department. If there are any questions or further concerns regarding this waiver, please call our office at 32~3-4744. Sincerely, Daniel J. Roth Civil Engineer On-site Services DIR/ljm:Parmelee MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# ' .~O~lr~/ PID# 017-022-25 HA# ~i~'~ Permit Date Received: August 8, 1996 Legal Description: Lot 13 Block 3 Mountain Park Estates Subdivision #2 Engineer: Jeff Garness, P.E., Alaska Water and Wastewater 8471Brookridge Drive ANchorage, Alaska 99508 Applicant: Mark Parmelee Waiver Requested: Private well to on-site septic tank of 96 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: Y Waiver is NOT Granted: List Conditions or Reasons for above: $~ ~fv~ Date: ~-- ~-~ By: Rec ~: 02143/1526 _~rtount: $ 625.00 Name of Reviewer Date Paid: August 8, 1996 ~lq3 __f D IA/TI /.7 ~v E T~R_ T-tF~z £ 6 ~OIE~V r Al[a ]ka Waaer & Wa ewal er 8471 Brookridge Drive ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers July 25, 1996 Municipality of Anchorage Dept. Health & Human Services Division of Environmental Services On-Site Services Section P.O Box 196650 Anchorage, Alaska 99519-6650 Ref.' HAA for Lot 13, Bk 3, Mountain Park Estates #2. To whom it may concern: The subject lot is served by a private well and septic system. I tested the well and the septic system on 6/22/96. The results are summarized as follows: WELL TEST: The static water level in the well was determined to be 190 feet below the top of the casing. Water was pumped at a rate of 4 gpm for a total of 150 minutes (600 gallons). During that period, the water level fluctuated between 205 feet and 215 feet. The well recovered completely in less than 30 minutes. Based upon this data, it was determined that the well is adequate for a 4 bedroom house (600 gpd). WATER ANAYLYIS: The water results showed no bacteria, and .995 mg/l of nitrates (10 rog/1 is the allowable limit). In short, the water quality is acceptable in regards to these parameters. SEPTIC SYSTEM TEST: Prior to introducing water, the liquid level in the crib was 45 inches, and the trench was dry. Water was introduced into the crib at a rate of 4 gpm for a total of 150 minutes (600 gallons). The liquid level rose 8 inches in the crib, and 1.625 inches in the trench. The trench remained dry, until the liquid level in the crib reached 53 inches (approximately 350-450 gallons added to crib), and then spilled over into it. Before the crib filled, and spilled over into the trench, it was noted that it took approximately 43.6 gallons to raise the crib level one inch. The recovery of the system was monitored for 1 hour, during which time the water in the trench completely dissipated, and the level in the crib dropped 3.875 inches (169 gallons). Based upon this data the system was deemed to be adequate for a 4 (four) bedroom house (600 gpd). NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of septic tank pumping, usage of biological additives), condition of drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age), type of substances deposited in septic system (cigarette butts, sanitary napkins, misc. objects), and the amount of water being introduced on a continual basis. Consequently, the results of this adequacy test are only yah'd for the specific day of the test. Furthermore, because of the limited nature of this investigation, it is possible that there are hidden defects which may not have been detected. No warrantee is made regarding the future performance of this well or septic system SEPTIC TANK: The existing 1000 gallon septic tank was installed in 1974. The condition of it is unknown, however, given the age, it is reasonable to assume that it is near the end of its useful life. The existing 500 gallon septic tank was installed in 1982, making it approximately 14 years old. The condition of this tank is unknown. No warrantee is made regarding the future life of the septic tanks. LOG CRIB: The log crib was installed in 1974. Given the age, its structural integrity is questionable. Should it cave in, the next homeowner will have to repair it, or install a new drainfield. No warrantee is made regarding the structural integrity of the crib. SEPTIC TANK APPROXIMATELY 96 FEET FROM WELL: The 1000 gallon septic tank is only about 96 feet from the well on this lot. This was noted on the 1982 HAA application, which was approved by DHHS. The 1985 HAA noted this separation distance as 100 feet. I assume there is a "grandfathered" waiver for this separation distance. SEPTIC SYSTEM PARTIALLY IN UTILITY EASEMENT: Based upon the as-built survey, the trench sump is inside the easement. Attached are letters of non-objection from the utility companies. If you have any questions, please contact me at 337-6179, or on my pager at 1-800-481-1162. Sincerely, OwnerlCong~ultant c.c. Bob Baer, Totem Realty Mark Parmelee · 8471 Brookridge Drive - Anchorage ~ Alaska 9951~4 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers August 7,1996 Municipality of Anchorage Dept. Health & Human Serwces Division of Environmental Services On-Site Services Section ~;?~r~_[ I ~,,~v P.O Box 196650 ~;~ ca-?~sa Anchorage, Alaska 99519-6650 o/?_ Attn: Dan Roth Subject: Waiver of separation distance from existing septic tank to existing private well. Lot 13, Bk3, Mountain Park Estates #2. Dear Dan: The subject property has a 4 bedroom house, served by a private well and septic system. The septic tank was installed in 1974. There is no log on file for the well. The distance from the tank to the well is approximately 96.5 feet. This distance was noted as 97 feet on the original inspection report(5/23/74) and the 1974 Health Certificate. At this time, we are requesting a waiver of the required separation distance to 96 feet. Justification for this waiver is summarized as follows: GENERAL: Given the fact that the house has a daylight basement, it is highly unlikely that the septic tank will ever overflow onto the ground surface, since in order for this to occur, the basement would have to flood with sewage. However, if it did occur, the topography is such that the wastewater would not flow towards the well. Attached is a diagram showing several elevation shots, and photographs showing the topography. The other potential path of contamination would be leakage through the tank sidewalls (rusted tank). Analysis of this contamination potential will he evaluated based upon the ADEC point system. ADEC WAIVER, POINT SYSTEM EVALUATION: Geological: As mentioned previously, there is no well log for the subject lot. The static water level was determined to be at 190 feet on 6/22/96. I was able to locate well logs for lots 12, and 14 (Block 3, Mountain Park Estates #2). Neither of the wells are in bedrock, and the shallowest' depth that water was encountered was 173 feet. I researched DHHS records on the adjacent septic systems, and noted that no groundwater was encountered in any of the test holes. In short, the bedrock profile does not appear to be a consideration, and the groundwater supply is quite deep. a. Distance from the bottom of the tank to groundwater (190 foot static level in well): The bottom of the tank is approximately 9 feet below grade. The separation distance from the bottom of the tank to the static water in the well for this lot is approximately 180 feet. This corresponds to 7.4 points. b. Soil sorption below the septic tank According to the well log for Lot 14, the geological profile is as follows: 0-15 feet is clay/sand/gravel (equal parts?), 15-65 feet is sand & gravel, 65-190 feet is clay/sand/gravel. In short, 74% of the profile is clay/sand/gravel, and 26% is sand/gravel. I am going to assume a point value of 2.0 for the clay/sand/gravel & .75 for the sand/gravel. This corresponds to a point value of 1.7, calculated as follows: (.74(2.0) + .26 (. 75)) = 1.7. c. Soilpermeability below the tank: I assumed 1.0 for the sand/gravel (.5(0) + .5(1.5)), and 2.5 for the clay/sand/gravel (.33(6) + .33(1.5) + .33(0)). I believe this is a conservative assumption. This corresponds to 2.1 points calculated as follows: (. 74(2.5) +. 26(1.0))= 2.1. d. Water table gradient: When performing the well adequacy test (pumping at a rate of 4 gpm for 150 minutes) the drawdown was only 10 feet. The hydraulic gradient, due to drawdown, from the septic system to the well, is negligible (approximately 10%). This corresponds to 1.2 points. e. Horizontal separation from well to septic tank: Given a 96 foot separation distance, the point value is 2.8. Total Points: 15.2 According to the ADEC waiver guidelines, a point value 12-16 indicates no bacterial contamination is possible, and that chemical pollution (from household sources) is unlikely. Recent water sampling/analysis (6/27/96) found no bacteria, and nitrate levels of .995 mg/1. Copies of the lab results were submitted with the Health Certificate package. Given these facts, it is my recommendation that the requested waiver be approved. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank you for your assistance. Sincerely, /,~ Jefl~ Garne~, P.E., M.S. Prin'~ c.c. Mark Parmelee ENCROACHMENT PERMIT 1203-26A G-2839 EN96039 This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach'), whose address is P. O. Box 196300, Anchorage, Alaska 99§19-6300 and Mark Parmelee and Katherine Nitzberg (herein 'Permittee") whose address is 13141 Foster Road, Anchorage, Alaska 99516. 1. F,~i~. Chugach is the grantee'or user of an easement/s for. the construction and maintenance of electrical facilities, described as follows: That certain written instrument recorded on the 20th day of January, 1953, at Book 84, Page 298, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, Dedicated by the plat of the subdivision known as Mountain Park Estates No. 2, according to Plat Number P561, recorded on the 31st day of October 1960, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The East Ten Feet (E 10') of Lot 13, Block 3, Mountain Park Estates Subdivision No. 2, according to Plat Number P561, recorded on the 31st day of OCtober 1960, on file in the office of the .District Recorder, Anchorage Recording District, Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot 13, Block 3, Mountain Park Estates Subdivision No. 2, according to Plat Number P561, recorded on the 31st day of January 1960, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Parcel"). 2. ~lg~. Permittee proposes to continue the existence of the following improvement(s) on or within the real property subject to the Easement: A septic system clean out pipe located approximately Five Feet (5') into the above referenced Easement, (herein "Encroachment") · Encroachment Permit - Page 1 of 4 3. Pe~it. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its current location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the construction or continuation of the Encroachment. 5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. ~odification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. 8. Covenants ~unninq with the Land. The obligations of the Pe~mittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. 9. ~. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if: a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. c. Permittee fails to make the payment described in paragraph 7, above. Encroachment Permit - Page 2 of 4 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Aqreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. General Manager STATE OF A~S~ THIRD JUDICIAL DISTRICT PEP~-~ITTEE Mark Parmelee By: Katherine Nitzb~g / J Date:v . t$) lqqd, The foregoing i~strument was acknowledged before me this Z~day of '~'~'(~... , 1996, by ~ug~ N. Bjorn~ad,(?the General Manager of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. Noea~y Public in and for the~tate My commission expires Encroachment Permit - Page 3 of 4 of Alaska .'-"-~i'.~ ,, · :~ ........ </" STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before me this /r'~day of ~----~c/,.,L_ . , , 1996, by Nota.~FPubl~c in and for the State of Alaska My commission expires F/~// ~ After Recording, Return To: Chugach Electric Association, P.O. Box 196300 Anchorage, Alaska 99519-6300 ~_ 03G0~3 ANCHORAGE f~EC. OlSTRIOT JUL 2'l P~ 3 03 Encroachment Permit - Page 4 of 4 ENSTAR Natural Gas Company A DIVISION OF SEAGULL ENERGY CORPORATION 3000 Spenard Road P.O. Box 190288 Anchorage, Alaska 99519-0288 (907) 277-5551 July 9, 1996 Mr. Mark Parmelee 13141 Foster Dr. Anchorage, Alaska 99516 Dear Mr. Parmelee: ENSTAR Natural Gas Company has no objection to the Septic System that encroaches into the utility easement on Lot 13 Block 3 of Mountain Park Estates #2 Subdivision. This easement is not needed by "ENSTAR". If you have any questions please call me at 264-3743. V~ly yours, Dan Westervelt Right-of-Way Agent aw PRIME July 9, 1996 Mark Parmelee 1314i Foster Road Anchorage, Alaska 99516 Dear Mr. Parmelee: Subject to your agreement to indemnify the company as set forth below, Prime Cable of Alaska has no objection to the existing septic clean out that encroaches into the 10 foot utility easement on Lot 13, Block 3, Mountain Park Estates Subdivision No. 2, City Grid 2839. This letter of non-objection in no way precludes Prime Cable from full use and enjoyment of any rights it may have within any portion of the right-of-way, including unlimited access for servicing its facilities. By signing below, you agree to indemnify and hold Prime Cable harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property, occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to myself at the address below. Sincerely, Dale Greinke Design Department DO:jb cc: Jim Topolski, CEA Greg Schmidt, ATU -;1-~1 FAIRBaNKc-, fi, TRFFT" aNCHORAGE. Al ASKA '4q'503 * (qr}7~ 5~-,2-2400 600 Telephone Avenue · Anchorage, Alaska · 99503-6091 · 907 564-1000 July 9, 1996 Mark Parmelee 13141 Foster Road Anchorage, AK. 99516 ATU Telecommunications has no objection to the encroachment of the septic clean out into a platted easement located on Lot 13, Block 3, Mountain Park Estates # 2, as depicted on the as-built drawing submitted. Acceptance and use of this letter of non-objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 5 o ATU will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. Any ATU facility damaged or destroyed as a result of this encroachment will be repaired at no cost to ATU. Any costs incurred by ATU for special construction necessitated by this encroachment will be borne by the property owner. Ail applicable safety code regulations will be observed and maintained. This letter of non-objection will in no way preclude ATU from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, ATU ~ELECO~NICATIONS Outside Plant Engineering' DATE: AC&P # 474 GS\ml\g: mswd\cor\ nonob\mt ri_pk, doc ,,"* N° INVOICE 1578_~.'; M-W DRILLING INC. P.O. BOX ANCHORAGE, ALASKA ggsH 'Gl'y,~ . ':;' MAYS'RIALS, Pnt¢lU~l'r AMOUNT. PHON£ 344.0526 . :,. ,, .,,.,,,,/.,.,.,,Ax.., (..:/,: x' -......'. '-.'"i' .i- ..'i .... ;:, ' '. ' _'~,~ ~-~ ,-.Z.?d- .... : ...:' .,.' '"~/~// A t: '"" '" :.'"'...;~::'~" ":' '- '~;: ?' · LEGAL DESCRIPTION '."" ' ' ~2~ ' ~-,, ~ . ~ ~ . ...,: '_:~.:~. days unlo$$ othot arran! Smount not paid ~thin ten MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHOP, AGE D~PT. OF H~ALTH & DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIg~ViRON!/,EN?AL FROTFCTIOI~ DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL JU[~ 2 ~ J0~q OF ON-SITE SEWER AND WATER FACILITY ,6,.,720 R E C E IV E D_ Application Date ~ ~; I ~'~ GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name ~ Di~ [ Telephone: Home ~- /~/ Applicant Address /~/~/ ~e ~ ~ ~ Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain); (d) Lending Institution ~f~[,E, ~'~,i,~a~? ' Telephone Address ~. ~ ~ ~~T ~~ (e) Real Estate Company and Agent ~ ~~ Address ~ ] 0~i~ ~~ ~ Telephone ~ ~ - ~ (f) Mail the HAA to the folJowing address: 2. '"'TYPE OF RESIDENCE Single-FamilyJ~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~JJ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11~84) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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. Nameof Firm T~BI~IE~ c.~'I>~!~1~,1~::~ ~,1~ Telephone ~-'7~'~/'~ Address DHEP APPROVAL Approved for ~' c//~- ~'/bedroopn~ by ~ Approved X Disa~~'~ ¢~'¥~)') Conditional Terms of Conditional Approval Engineer's Seal -. ~' 49'~ ~-~"~, .,.'." Date Y¢~-- CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 ,MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOI~ J U N 2 284..72o EIVED Legal Description: Well Classification ~'~,¢-- -' If A, B, C. D.E.C. Approved (Y/N) Well Log Present (Y/N) N Date Completed !~ ~ Yield Total Depth .~.,2,'0 Cased to ~.¢,O Depth of Grouting t4~ O~ Static Water Level / 8(~ Pump Set At ~ IO Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots Water Sample Collected by Water Sample Test Results Comments ~ ~ ~ ; On Adjoining Lots NON. ~-- To Nearest Public Sewer To Nearest Sewer Service Line on ,Lot ~ -~' . ;Date ~- 7,~ N B. ~ SEPTIC/HOLDING TANK DATA ' Date Installed .Standpipes (Y/N) ~' Depression over Tank (Y/N) ~ I~o. Of Co~flp~rtments Air-tight Caps (Y/N) ~'~ Foundation Cleanout (Y/N) J~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) t4/~, ; for Holding Tank High-Water Alarm (Y/N) ~/A Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well J¢~ -' To Property Line To Water Main/Service Line Course N ~h, ll~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~'~'"'¢/,~ l¢7¥'¢ '~,,'~-~.~ Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well I'~ To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field I Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all .[VIO.~ and HAA guidelines in effect on the date of this inspection. Signed '"~ ~ Date Company "~/¢.~-,~ ~'~vr[cl~./P¢, MOA No~'r'86 Receipt No. Date of Payment Amount: $ I~,~ Page 2 of 2 72-026 (11/84) Seal CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 13, BLOCK 3, MOUNTAIN PARK ESTATE, #2 LOCATION: OWNER: 13141 FOSTER JOHN DIEHL TYPE OF WELL: RESIDENTIAL WELL LOG AVAILABLE: NO INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LoG: UNKNOWN PUMP YIELD: 4 GALLONS PER MINUTE DATE OF INSPECTION: JUNE 27, 1985 TEST PROCEDURE: WELL WAS PUMPED AT A STEADY RATE OF 4 GALLONS PER MINUTE. THE DRAWDOWN WAS MONITORED FOR 90 MINUTES. THIS WELL IS 220 FEET DEEP WITH A STATIC WATER LEVEL OF 180 FEET.AFTER 60 MINUTES OF PUMPING AT 4 GALLONS PER MINUTE THE DRAWDOWN HAD STABILIZED AT 205 FEET. TEST FOR COLIFORMS: WELL WAS TESTED FOR COLIFORMS ON JUNE 26. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPAL CODE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours. This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: TEST PROCEDURE: TEST RESULT: LOT 13, BLOCK 3, MQUNTAIN PARK ESTATE NO. 2 13141 FOSTER JOHN DIEHL SINGLE FAMILy, FOUR BEDROOMS ON SITE WELL FROM MUNICIPAL RECORDS: TANK: 1000 GAL + 500 GAL. BOTH STEEL ABSORPTION SYSTEM: LOG CRIB + TRENCH ABSORPTION AREA: 384 + 270 SQ. FT. SOIL RATING: 125 INSTALLATION DATE: 1974 AND 1982 JUNE 27, 1985 JUNE 27, 1985 SYSTEM WAS INSPECTED ON JUNE 26, 1985. NO WATER WAS OBSERVED IN THE TRENCH. BOTH TANKS AND LOG CRIB WERE FULL. WATER COULD BE HEARD ENTERING THE TANKS. ON JUNE 27 WATER WAS ADDED TO THE CRIB AT A CONSTANT RATE OF 4 GALLONS PER MINUTE. THE WATER LEVELS IN THE CRIB AND IN THE TRENCH WERE MONITORED. AFTER ADDING 450 GALLONS THE LEVEL IN THE CRIB HAD RISEN 1 INCH. THE WATER LEVEL IN THE TRENCH DID NOT CHANGE. THIS SYSTEM MEETS THE OPERATIONAL REQUIREMENTS OF THE MUNICIPAL CODE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. APPLIC :' "-'NT FILLS OUT UPPER HAt ":ONLY Property O~,ner J.,'"'~,,~,.~ ~--.. ~ y~ Phone Maiii?~g Address~ ~ ~ F~ "~"~ ~ 'V' ~.[/.U (~3r.~ ~ zip Code q ~ ~ 0-'~ ~,:~.'.~-- I,,,~ Address Zip Code Address Legal Descripfion.~ /~ ~,=~ ~ ~,,,,~./..~_,~.~..~..~./..¢~.¢...~__.. ~,-'~¢?~.~:~.,~"r~ (.~-/'"'~/~,.' Type of Residence ~' ' ~;;~'Sin gle Family [] Multiple Family No, of Bedrooms [] Other Water Supply ~'lndividuat ATTACH WELL LOG. A well Icg is required for all wells drillec~ since June 1975. [] Community For wells drilled prior to that date,¥give well depth (a, ttach Icg if available). [] Public Utility . ~ ,o~, . - , Sewer Disposal ?' ~ Individual Year Individual Installed: / F 7'~' ' ~-- [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time ~D to- ' · 7' ~ ~ Date Date Date ,nspec~~ Inspector Inspector Inspect?,,) OF APPROVAL Soils Rating Date ~wer Installed Well To Absorption Area I ~ * ' Well Log Received 72.023 (3/82) August 10, 1982 Tony L. Swan SRA 377V Anchorage, AK 99507 Subject: Lot 13 ~lock 3 ~-~ountain Park Estates Approval for the individual se~er and water facilities cannot be grante~], until the ~ollowln~ items have been completed: The to.~ of 'the well casing sealed with a sanitary seal so that it is water tight. E×posed electrical wires to the well head are in violation of the ~unicipality of Anchorage codes and must be encased in conduit. )o The water analysis report needs to be submitte~ to this ~%~Ot~/l office from -the Chem Lab, 5633 B Street, for our review° ~.~ The septic tank pumped with a receipt submitted %o this ~'~ d~Dart~ent · \t An adecuacy test needs to be performed on the existing ] ~eachinc area. This test will d~termine zf the system,zs ~%~dequat~ accordinc to National Suandards. A listinc or ~'vat~ firr.~s er~orming the .test is enclosed. This report permit needs to be issued from -this d. epartment. Please notify this Department for a reinspection when the noted discrepancies have been corrected.. If there are any further questions, please call this office at 264-4720. Sincerely, Cory Willis, R.S. Enclosure August 19, 1982 Tony L. Swan S~ 377V Anchorage, ~ 99507 Subject: Lot 13 Block 3 Mountain Park Estates Approval for ~e individual sewer and water facilities cannot be granted until the following items have been completed: Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. ~ The septic tank pumped with a receipt submitted to ~is department. ~]e application shows the number of bedrooms exceeds the number the on-site sewer system was originally!designed for. An upgrade will be required. Prior to any upgrade, a permit needs to be issued from this department. An additional 250 gallon septic tank must be installed to give enough septic tank capacity for a 4 bedroom home. Since the adequacy test results showed the seepage pit to be adequate for two (2) bedroom, an additional drainfield must be installed. A permit for this upgrade needs to be issued from this department. The additional drainfield to be nine (9) feet deep, twenty-five (25) feet long with five (5) feet of gravel backfill depth according to Municipal Codes. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Cory ~illis, R.S. '".. ALASKA UIBO m TAL COnTrOL S BUIC S, InC. I~n§i~eerin~ 8 I~nuironmenta] Studies 8/9/82 MUNICIPALITY OF ANCHORAOE · ~ ~' ~1 ,',US ~. 9 Ig$2 RECEIVED TONY SWANN SRA BOX 377-V ANCHORAGE AK 99507 SELLER - BUYER- SUBDIVISION-MOUNTAIN PARK ESTATES #2 BLOCK-3 LOT-13 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION sYSTEM IS A PIT WITH AN AREA OF 384 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 300 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 140 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A ~OM~ OP 4 BEDROOMS. A1~ ~ ~ THE SEPTIC TANK WAS PUMPED ON 8/9/82 o SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 GALLONS IS INADEQUATE BY 250 GALLONS FOR THIS HOUSE OF 4 BEDROOMS. 1220 LUest 251h Auenue · Anchor~qe, J~lctska 99503 ,,, (907) 276-1361 ~ . Data Received _~ ..~_.~ .... .[~l~.~/~~j~~ - Time of Inspection Date of Znspection REQUEST. FOR APPROVAL OF ~ ~ T ~i' o~-~X & WATER~XukzT.~.~-~* FOR i Appreval~, *+¢~. . re,~ue ..... by: Mailing Address: __~ /-~-~,4z-~ d~ ~-~r~--~,~ Phone: Property Ow,,er: /~2~/-"~~f- Phone: Mailing Address: 5. Type of facility to be inspected~_zf__,t.//~P-/---~__z~. ~_ No. of bedrooms 6 .... 11 Data: A. Type C. Construction Sewage Disposal. System: A Installed ~'--~__~_~_~_ g. Insta C, Septic Tank: O. S~p~,R:~ Pit: t. B~ Depth _ ,~_ 5./~'~/-~/--; D. BacterialA,~ I, ',-a ,,s]~ ~X~ -2~/-4~s$ E. Disposal Field: Total long'ch of lines 8, Distances: · ~,'i to: Septic / ~ Absorpbion area.~/~_~.'~__/__.., Sewer Lines Other .on~.d. / g FoundatioF~ to ~on"~c tarlk~ ~ ,,k .... ,~- area to noarr-'-q,~ 'lot , AbsorFtion area ~':~ 0o~ (1,'~'~ ~ ~- '."~, Page ] of two pages 'GREATE,~ ANCHORAGE ARh,q BOROUGH . . . ~ , . . · Departmen~ OT Env]ron~e.~tal Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Ty~e of Inspection: CRRO VA FHA CONV Property Owner: Lawrence J. Sebring Mailing Address: Day Phone 3. Name of Buyer: Edward S. Lewis III & Bdob y Dea'n-Smith ~.Iailing Address: St. Rte. A., Box377V. Day Phone 344-96-61 (Lewis), 4. Na~]e of Lending Institution: Mailing Address: Box 4-2090 5. Name of Realtor or Agent: Nielsen Real Estate Mailing Address: 606 No. Lights Blvd. The First National Bank of Anchorage South Center Branch one 274- 1521 Phone 277-243T/ Legal Description: Lot 13, Blk. 3, Mountain Park Estates S/D Locati on: NHN DeArmou'n Rd. ~ Anchorage Type of Facility to be inspected: Water Supp'ly Type of Supply: If Individual, Dwelji'ng Single Family 1~0. Bdrms, Public Utility Individual xx number of dwellings presently served 1 Individual, depth of well,~/J...;f~--~''- If Sewage Disposal System Type.of S~stem: Public Utility If Individual, date of installation Individual (on-site) xx Comments Approved : Disaooroved Date al Valid for one ,,ear ~rom date signed Greater Anchorage Area Borcugh> Deo~rtment of Environmental Quality ~YS~ cM DIAGRAM CF ~' ~' I certi'F?' tn. at ~-i:e inff ]L'-q C(F,'C~]i,,~ ~i] ~.,~,:=and watew c=ccurace ,.f..]rc,=~ _.:tic" := '-~ sub~]ecc sewer S.(GNED