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Home My WebLink AboutNORTH WOODS BLK 1 LT 14 , ' Municipality of Anchorage Page [ of 'z 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: ~0 '~O PID Number: O ~l ~ 7 ~| ~4~-~' Name: ~'l~'~,~, ~¢~ ~A ~ Wastewater System: ~ New ~' Upgrade Address: ~1 ~z~ ~oo~ 0~, ~'~c~ ~ ABSORPTION FIELD No. of B~roo~s: Phone: ~ ~ ,~ ~ ~ D Deep Trench ~ Shallow Trench ~ Bed ~ Mound D Other Total Depth from original grade: LEGAL DESCRIPTION so,,~.~:j.'z ~s~.~,. Block: Subdiv~ion: Depth to pipe bosom from original grade: Gravel depth bene{th pipe Township: ....I~ Range: Section: .. , Fill added above~ ~lqrlginal~ ~grade: Ft. Gravel length: 5~ j Ft. Number of lines: Dista~ lines: WELL: ~x~5*,~ New D Upgrade/ Gravel width: ~ Ft, i Ft, Classification (Private, A,B,C): Tota~ ~ased To: Total absorption area: Pipe material: ~A~ ~t~~t, ~ Ft. Ft. ~Oo SQ. Ft. ~ 03C'~ Driller: ~ Date Drilled: Static Water Level: Installer: Date installed: y~ Pump Set at: Casing Height Above Ground: ~u ~. ~t. TAN K SEPARATION DISTANCES ~s~ptic ~ Ho[din~ a S.T.~.P. To Septic Absorption Lift Holding =ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~C~ ~ ~[ We]~ ,~ol+ .~O~+ ~ ~ ~ Material: ~T~~ Number of Co~a~ments: Su dace ~e I ~ Water ~OO~ '~ -- ~ LIFT STATION LineL°t ~)i ~ j ~ ~ ~ Sizein gallons: Manufacturer:~ Foundation j ~ i ~.~ t ~ ~ ~ "Pump on" level at~~l at: High water alarm at: Cu~ain ~ - ~ ~10,~ , ~ JElectdcallnspectionspedormedby: Drain Remarks: ~,'r~ ~.~ c~,~,~ ~ BENCH MARK Location and Description: ~O/~T I)~)~ ~ A~umedElevation: ~00 *O ~C~ ~' /~ ',,.'~. inspections pedormed by: 17a34 ~,e~ mve~ L~ ~==a ~.~S: 1st 1-tZ-fl 4~,~.~~ Eagle River, Alaska995~ 2nd. W.-iz-~ ~ ' ~ ~ ~ RO3ERT C. CO'WAN Department of He~ Ith an ~,n Sewices approval ~,, ,~',,~ .., ..,."..-. Reviewed and approved b )(~. ] ~ Date: ~1 ~]ff~ 72-013 (Rev. 9/91) MOA 25 Perr~it No, SW950520 2 2 Page of 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 LOT 14, BLOCK 1, NORTH WOODS S/D 051-751-67 Legal Description: PID No.: 'lNG SEPTIC T,NK DBL1 DBL2 N EXISTING 1000 GAL SEPTI( TANK SCALE 1" = 40' / / / / / CO1 = ,~.0' / C02 = / NEW 1250 S.T. CO1 C02 MT1 66.4 ~,6: .4' WATER 57.4' ROBERT C. COWAN CE - 8801 72-013 A (Rev. 9/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PERMIT NUMBER:SW950320 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SWEEP CURTIS W & MARIA A OWNER ADDRESS:22744 NORTHWOODS DR CHUGIAK, AK 99567 PARCEL ID:05173167 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT DATE ISSUED:10/05/95 EXPIRATION DATE:10/05/96 LEGAL DESCRIPTION: NORTH WOODS ELK 1 LT 14 LOT SIZE: 28935 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DB : · ISSUED BY: DATE: DATE:/C~/~/,,~3~'- ROBERT C. COWAN, P.E. ROBERTA. SHAFER, RE. September 15, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of H~alth and Human P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 14; Block I; North Wood6 Subdivision .~ou~ bed.~om hou,6e, on ,the. re~e~eneed p~o~. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the tdme of excavation no water was encountered and after thirteen day ground water monitoring, water was found at ten fe~t. Attached is the proposed upgrade design. This property is served by a Community Water System. We do not anticipate any adverse effects on neighboring w~lls, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information please corcC_~o..X: u~. Sincerely, obert . RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 I~CALE H ~-~ o~. .°~ r~ H SITE PLAN UPGRADE ~ ~----~5 Z ~ ~ I Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST /' PERFORMED FOR: ~ LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 DATE PERFORME /¢~ X~ownship, Range, Section: 12 13 14 15- 16- 17 18 19 20 "~ ~"~ ,0 / "~ WAS GROUND WATER · ENCOUNTERED? IF YES, AT WHAT DEPTH? SLOPE SITE PLAN E Depth lo Waler After ~ Monitoring? \ c~. Dale: ~ ~"~c-1;~'~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ TEST RUN BETWEEN __ (minutes/inch) PERC HOLE DIAMETER FT AND z.~,.~__~ FT COMMENTS PERFORMED BY: 17034 Eagle River Loop ~,~.~ ~'{,,;,. 20~. "~"" ~ ¢' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH 72-008 (Rev. 4/85) ROBERT C. COWAN, RE. ROBERTA. SHAFER, P.E. HEALTH AUTHORI~ APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL iNSPECTION & FLOW TEST SITEPLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN ON-$ZTE OJASTE~JATEI~ P1$POSAL $¥STEU CO~ISTRUCTZON P~CTZCE$ UATERZAL SPECIFZCATIOHS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Lot 14; GE/~ERAL: I. The scope of this project in,lades the insta~ation of a 1250 gallon septic tank and a five foot wide drainfield to serve the existing .~o~/~ bedroom residence on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and MunicipaI WastewaterDisposalRegulations. 3. The contractor shall be r~sponsible for obtaining any necessary underground utility locates. U~ess specifically agreed otherwise, the property owner shat~ be r~sponsible for final grading areas subsequently depressed from soil s~ling. On all leachfi~ld mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded ~ea. Contractors installing wast~water disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal H~alth Department. ~EPrIc TA~K ZHSTAL~ATZO~: A Septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent s~tling or shifting of the tank. 3. All standpipes on thc septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tan~ installed with less than 4' of cover shall be insulated. 17034 NORTH EAGLE RIVER LOOP" SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 14; Block I; North Woods Subdivision J A foundation cleanout shall be instatled one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10' from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORFFION TRENCI'J/I~.~4~INFIEL~ INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed-up) before gravel (sewer rock) placement. Once the gravel is installed, the d~tribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inch~s of cover over the pipe. A silt barrier must be installed b~tween the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter and inst~ed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. UINIUUU MATERIAL SPECIFICATIONS.. I. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Lot 14; Block I; North Woods Subdivision 2. The following pipe materials are approved for use in septic system installations in the Munieipa~y of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe oth~ than listed above must be approved by the inspecting engineer. 3. Insulation shall be atl~ast 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted withwat~rtight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (s~wer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is b~ing used as a filter material, its gradation specifications must conform to current M.0.A. or D.E.C. requirements. INSPECTIONS= Typically there will be a minimum of three (3) inspections required during the installation of the wast,water disposal system. These inspections will occur a~ follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or bed~ and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after th, placement of the silt barrier, gravel, distribu~on lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. Page Four Lot 14; Block I; North Woods Subdivision 3. The final inspection is to occur upon final grading of thc property. Often there will be more than th~se 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of co~truction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.0.A. permit. There will be no contractual arrangement existing b~tween the contractor and S ~ S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.0.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this ~pro.ject or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering 'S inspecting engineer will not be responsible for the co~truction means, m~thods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER MAILING ADDRES~ LEGAL DESCRIPTION : ~ 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 HONE /~NEW DISTANCE TO: ~ ¢ Manufacturer~ LOCATIQCJ~ Liq, capac tV in gallons DISTANCE TO: We DISTANCE TO: No. of lines / Lengtil'~f each line Top of tile to finish grade Length Width Absorption area Inside length Dwelling Dwelling Material Width Material Foundation/ (~ ~ Neare~;~lin~ TM°:t:lr i ~1 b te~n ?:t I~ et; Se I Trench~t% Depth Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: Depth DISTANCE TO: Building foundation OTHER Class INSTALLE~ REMARKS inches inches APPRO D . DATE Driller Sewer line Total effective absorption Nearest lot line Distance to lot line Sept c tank NO. OF ROOMS No. o~..pa, r t me nts Liquid depth PERMIT NO. Liquid capacity in gallons Distance b e t ~,.~2~(~. Total e~L~2&sgrption area PERMIT NO. area PERMIT NO. Absorpt on area(si F'ERH :,.' T' _ O 3FFF I .- ~.. F'ETE:R '" S CF.:EEl.:' LE3RL L :14 E~ ± ~.J'Z~E'T.,-. NOOE:,:5 rE;,.."[::, LF.T F.;IZEE T~ FE !3F SO f FE~SOF::F'TION ':'-": ...... ,' ............ IEH IS' TF'E[.EH FEET HR.:.:.TH.H N "tE.F.::I;.: ,'::IF: E,'EF..',ROO.H':-:; = 2: '._:;OTI ~'FT'ir.~G ,.'.'!Sr::~ FT?'F~'",= ~- .............. - LL ¢ I~l THE F--.'F '3 11 RE[:, ''"' 1' '%.: ........ -, T ~. ~ ~ r,~ · ..... :,...~F.. C)F' TFIE F.,F' Tl FIE:SORF"TiFIr.~ Z' '"--','Z.~ IS TMF ............... L. FH"~7'h [:,It,?F:'Hq"-h! IS 'T'HtE LENGTH ,::II",! FE:ET> F~F' THE T..:'R'F~ ......... '"*'H OF? r-,-,' - . ~ ~.HINP iEL..E:,. THE DE:F'TH OF R TR/ENE:H OP .... PiT ,Tq .......... THE [:,T'BTEN-F' ~,,....~'~CT. ,,..,_=,~[:c'~.~ THF'. - ~;UF?F'Fi-E_. OF: THE',. GROUNE:, !qN[:, THE E F'FTT DH OF THE E~',:F'~R',,'RT T ON < ~ N FEET THERE :I:S NO :~E:T H!D'FH FOR TRENCHE:5. THE G~'F.',/EL [:'EF'TH !:E THE HIN!HUH DEF'TH OF' GR!~VEL. E:ETHE:EN THE OLITFF:I! i PTF'F FiND THE E:O'TI"OH OF 'T[-.E EXCR~,,'FI't*ION <!N FEET>. ' ....... F'EF:H Z T hF F _ Z CRNT HFd: TI-IF F.:[.:.:'SP_- ~-~'~: I £-:~ ! L I 'T'¢ T "_' ~ N.F "X F.'H TH I :~; E:'EF'F!F.':TH.EI'.,!T [>UF.: i NG THFJ i'NL:;TFfi_LF'T'TF'~N ZBSF'ECTT"N'~ OF FIN'¢ HELLS RD."FI,'-:F'NT TO THiS *:-_- . : '.' . .~. ......... - ..... "k' F'P~T,. FINE:, TFIF~ ?.!1 [,1RF'~;.' OF FE(S~F,Fh~'"F":T, 'rHRT T!qF I.,IF ! HILL ................................... :,EF: ,.. ..... F~RF~::'F-'T LING FF FINtr' ':"-":'Tm'l . . ................... H I THOLIT F I NFIL [ N'-:;F'E' I T ! ON RI",ID ~qF'P'~' "_" 'R ..... E~? TH t S E-"EF'RRTH_F';NT H ~ LL BE SUEL!E:i:"F TO F'RC SEF:.tT T ON. HiN!h'ILtH [:,IS;TFfi'.,!CE E:ETHEE:N Fl HE:LL..F~N[> F~N"r' ON'-SITE SEi.,.!RGE DI'.E;PO~F)t .......... '::".":'"r'F'l.. -, -,. tfi; · ~m¢:~ F*EET F'"F' R FR.. P I~:. HELL F "' .......... UP"tH 'THE I"'¢F'E OF' F'UEILIL-: HELL. - HIN. IH!.H D:!:STRNCE: FROH FI F'F'I'v'RTE HELL T- F! FKI,-' ....... t E SEHEF;'. ~ TNE '~'~ ';'~'~ F'EE"t .... '~- ' ' ' · ........... P,,.,~L. TO R COHHLIN!T'¢ SEHEF4: L.!NE I~; '75 FEET. OTHF'F'_. RE(;:¢JIREHE:NT~5 HFW ~F'FL'¢. 2;F'F'~TF'rCFiTf qN,:::;. , ~i.[ L. Hb,LE TO I N%LIRE PF"Z F'E~;: I NSTFtLLRT I ON. I CE,r';;:TIF'?' THF!T i: i RH F'I-~,HILI~F?. HITH THE F:E(;!IJIF:EhlENTS FOR ON-SITE SE.~,.IEF:S ~N[:, I.,.IELL$ RS SET FOF:TH B'./ 'THE P'!UNICIPF!L I"F'T' OF F!NC:HOF:RGE. 2: I HILL INSTF~L.L "FFIE S'¢STEH !N FiCC:ORE:,FINCE 1.4!TFt THE CO[:,ES. 2:: Z U[',![::,Ef~S"I"F!~.,IB, THFFF THE ON-SITE SE[,.!E~: S"/:~STEH HFI'¢ REQUZRE ENL. RRGEHENT IF' THE F.~.::,~D~:NL.E Z:, RE!'IUE.,ELE~? ]U ~NL:L. UDE HOfRE THRN :2: E:EDROI3HS. S; ~ Gh!E't'3 ' ~~~.~_. PERFORMED FOR: LEGAL DESCRIPTION: '.,~.,,VIUNICIPALITY OF ANCHORAGE ',..~./ DEPARTMENT OF HEALTH AND ENV[RONN~ENTAL PROTECTION Pouch 6-650, Anchorage, Al=ka 90.502 276-222~' SOILS LOG -- PERCOLATION TEST 1 2 3 ..~'~ 4 6- 7 8 9 PERCOLATION TEST SLOPE SITE P~N 10 11 _.---12. '13- 14- 15- . 16 17 18 19 20 COMMENTS PERFORMED BY.* WAS GROUND WATER NO ~ ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop 2 ' 248-~: PERCOLATION RArE / / ImI,u,e,n,~h! ~,~.g 5//2. TERT RUN ~I:T~A/EEI~I '~ FT AND ~ FT SIGNED ~~. '4S 472 SEND PARTS 1 AND 3 WITH CARBON INTACT - PART 3 WILL BE RETURNED WITH REPLY. DETACH AND FILE FOR FOLLOW-UP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES · DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 7/29/88 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 14 Block 1 Northwoods Sec. 4 T15N, R1W Location (address or directions) 17559 Northwoods Drive Peters Creek, AK (b) Property Owner .g¢.c. of: HUD Telephone: Home Mailing Address Attn: Single Family Property Dispo. (c) Lending Institution n/a Telephone Mailing Address Business 271-4665 64 An~h~o~ QQq~q-0001 (d) Real Estate Company and Agent Address Telephone Mail the HAA to the followin(~ address: or: Check here I~, if hold for pick up. List contact person and day phone number below. Engineer - 694-5195 (e) TYPE OF RESIDENCE Single-Family [~ Number of Bedrooms" WATER SUPPLY Individual Well [] CommunityJ~] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 fRev 8/861 Front 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 flies and from my investigation and inspect[on, 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 P~a¢]e, Riv~.r EngiJr~eer±n¢ Se~m,"ices Telephone 907/694-5195 Address P.O. Box 773294 Eaqle River, AK 99577 Date DHHS APPROVAL Approved for ~.'7~Z ~.) bedrooms by Approved ~/~.~.._ Disapproved Terms of Conditional Approval Conditional Date CAUTION The Municipality of Anchorage Department of Health and Human Services /DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-0251Rev 8/86) Back MUNICIPALITY ~F ANCHORAGE (MO~/ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Well Classification ~,/e ~'.r ~J~ Well Log Present (Y/N) Total Depth Cased to Static Water Level 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 Water Sample Collected by Water Sample Test Results ,y If A, B, C, D.E.C. Approved (Y/N) Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) Y Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well '/"'..2.,~ ~ To Property Line -y-~o ~ To Water Main/Service Line No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ~j~ ; for Temporary Holding Tank Permit (Y/N) To Building Foundation // z To Disposal Field ~" To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test ,..~',~/:,,~ ~ ~./'w,,-,~ Separation Distance from Absorption Field: To Water-Supply Well 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 '~ t Depth of Field /1, :~ / Gravel Bed Thickness ,~o / Standpipes Present (Y/N) Date of Last Adequacy Test Y / To Property Line /-~' To Existing or Abandoned System on ; On Adjoining Lots ¢- ~o "' To Cutbank (if present) ,,1///? 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 MOA and HAA guidelines in effect on the date of this inspection. Signed ~~4Servjc's. . Date Date of Payment Page 2 of 2 · J U L 2 8 1988 72-026 (11/84) RECEIVED 3801 C STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 STEVE COWPER, C;OVERNOR 5~3-6775 DATE: _'7__Z/'_~_/'/_~'~_ ......... To Whom It May Concern: Accordinq to the records on file in this office, the __¢---_~9~./~.L~ .... ~.~ _C/.~A/_6_/C._'~__~J~_O_~ ........ Uater System iS in compliance with the State of Alaska Drinking Water Regulations. Sincerely, Environm~nta~ Field Officer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) Leg.al Description (include lot, block, subdivis, ion, section, township, range) Location (address or directions) Applicant Nam~~ b ~ Telephone: Home ~, ~pplicant is ~check ~e): ken¢in~ Institution ~: Owner/buiMor ~; Bu~or (b) (c) (d) Lending Institution '_~/~,./'-" ., ?~-~'¢'~ .,. ~. ¢" ,/'-'~?',¢'~ /~ %'rd * Telephone Address C ~_~. .4~¢.~' / )~:-~/-~A ~' (e) Real Estate Company'and Agent -~ ~-~'~{'~ F'r~~ 4"~ --~ Address Telephone (f) ~-~'~/HAA to the following address: ~H. 694-2979 TYPE OF RESIDENCE Single-FamilyK Multi-Family I-1 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 OnsiteA 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. Page 1 of 2 72-025 (11/84) from the Municipality of Anchorage files and from Fr, y mvest~gat'.on and inspection, the o,msi~e V.,ator wastewater disposal system is in compliance ~ ~" M. unic~pal and Staid codes, ord~nancos, and regu!abons ~n effect on the date of this inspection. Name of Firm _ Address Date Telephone Approved for ~ [~'~( ~l bedrooms by~ Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues ltea!th Authority AppFovat certificates based Solely upon the representations given m paragraph 5 above by an independent pFo~essional engineer registered in the State of Alaska, The DHEP does this F~.s a courtesy to purchasers ol homes and their lending institutions in order tO Satisfy certain federal and state requirements, Employees ol DHEP do not coRduct inspections or analyze dat~ before a certificate is issued, The Municipality of Anchorage is not responsible for errors OF omlsSIOFIS in the professional engineer's work. Page 2 of 2 "'~'? 'MUNICIPALITY OF ANCHOP, AG~ MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH 8, HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST- FEBRUARY 1984 264-4720 I,;A'? 0 6 IOD~ LegalDescription: ~ ~ l~~/~ ~ WELL DATA Well GlassificatJon If A, B, G, D.E.G. ApprovedL~r~/4~ Well Log Present (Y/N) Date Oompleted Yield ,/x.)~epth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ~=~-~:;'"P To Nearest Edge of Absorption Field on Lot ~¢ To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~0/¢/' Stand pipes (~),N-)~ Depression over Tank-Cr~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~O/~ To Property Line ,~ To Water Main/Service Line Course Comments Size //'~'¢ ~'~ Nc. of Compartments Air-tight Caps ~/N-)-- Foundation CleanOut-(N~) Date Last Pumped k-.-~//~ ~-~ Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata / ?~ ¢///~/~ Type of System Design Date Installed / 9///-~///'~P'/' Length of Field Width of Field CJ~/-- Depth of Field ~/' Gravel Bed Thickness Square Feet of Absorption Area ~'-'/O Standpipes Present~N-~ Depression over Field (-~ Date of Last Adequacy Test ~'---~ - Results of Last Adequacy Test J'~¢¢ 'r r,~ t¢: ~,- ~ 'T'~ f2~" Separation Distance from Absorption Field: "~- 0>2~ / To Water-Supply Well ~ ~' To Property Line To Building Foundation ' To Existing or Abandoned System on Lot /'G/'///~' ; On Adjoining Lots ~'~ To Water Main/Service Line To Cutbank (if present) .'~-/'//~- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Man hole/,~ccess (Y/N) _ "Purr~ Off" Level at / 7~~/en` (Y/N) ./ t.. / ~' 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 MOA and HAA guidelines in effect on the date of this inspection. Receipt No. Date of Payment Amount: * MD(~tAe N 0 .~"~"~.% ¢~ Page 2 of 2 72-026 (11/84) ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: Address: 274-2533 To Whom it May Concern: ~_/~ ~]~,~ Water System is in compliance with the sta~e Drinking Water Regulations Time , Time Date Date Date Inspector Inspector Inspector Comments Conditional Approval 3.;Z Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner t]ethard construction, Inc. Phone SIVA Dot. 1698-K, Anchorage, Alaska 99507 345-1615 Mailing Address Buyer Delbert L. and Deloris Ao Crowder PO Box 2804, ~-almer, Alaska 99645 Address Lending Institution First l*'ederc~l SaviTtgs And Loan Phone Address ~' a~d Northern Ligb. ts Blvd. 274-6565 ',' '¢~ . Will Eason Phone Realty Co. & Agent }~,E/.[',_~-~- Properties, Inc Attn 2702 Gambell St. , ste. 101~,Anchorage, AK 99503 276-2761 Address Legal Description LOt 1~ D]_OCk t, North~ooods NL:-~ North Woods Drive Street Location Type~f Residence 'E~ Single Family 3 [] Multiple Family No. of Bedrooms [] Other Water Supply ~ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach log if [] Public Utility available.) Sewage Disposal E~ Individual Year Individual Installed: 198 1 [] Public Utility When Connected to Public Utility:_ [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ALASKA enulRonmenTAL CONTROL SeRUIC $, Inc. ~ngineerinq S ~nuironmenld Studies ,Mamch 8, 1982 Bethar d Construction SRA Box 1698-K Anchorage, Alaska 99507 Dear Mr. Bethard: On March 5, 1982 I inspected the standpipes on the sewer system on Lot 14 Block i Northwoods Subdivision. The sumo pipe was free of--'-~ter~sep~io tan~-~ ha~ a'pproxi'mately 4 f~et of water in it. The standpipe for the second compartment was broken and ice was noted in both compartments off the tank. This could cause some problems if the ice freezes over the outlet pipe. Since the house is now occupied, the additional heated water may melt the i~e~ .~-..~:,~ ..~o~.,~" ~,~,~]~. Sincerely; C. ed Jr, PhD, PE President '~ 1220 West 25th/~uenue · ~nchora§e, ~lasl~a 99503 · (907) 276-1361