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RABBIT CREEK BLK 2 LT 5A
Rabbit Creek Block 2 Lot 5A #017-063-52 oave[a,,p,-nent Services Oepertmel 8uilcing Sef_T•f 'j n-SItz Year C `,4 ast?iplciai '..700 9r^_aow 5rreet p.0: Sax L9b650 ar'�t 8egicn - Ancharage, K 99719-1650 w_yar woi ;nuni.arnr�n=ire 1?07j?4_•75Ai Pump Installation Log DrMbg Permit Number: S-,N— Date of Issue: el Identification Number:_ L Dzscr ptiaa / �� Property Owner Name & Address: R a Ila �' G �G� .SAN e Al z L _ . �a Z,,7-YO � III,gtaJ.(anon y are: �/�'� � Z p J,ntrke Depth Beiow Top of WeE Casing: Ila feet p Dq_qMnfactarer's Name: xey lr+ Lo Model.: �oG3Il e-5 /2- P Zp Size Y2—hp Ss Adapter Bural Death: Jp feet ss ;�dnpter Nlannfacturer's Name: A01f . tmeat;: 1p instaLer i i 1Rle: ., nrio n Vae pump iustaLier ahaL provide a pump instaila ton log to the DSD w tiva 30 days of pump instaLlat io= 0 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 Page j of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 0S P I PID Number: 7 Name: TO A 0 N It Wastewater System: ❑D New rade J= Address: 6 7,11a O"r CCUe) ke4no W /41c-4 99,5-1d' ABSORPTION FIELD Phone: Number of Bedrooms: YS --O 2--7S– I - 3 0 Deep Trench [I Shallow Trench [I Bed 0 Mound 0 Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: GPD/Ft' Ft. Block, Lot: Subdivision- 2 S'A rLI66;f C# -,e, -4C Depth to pipe bottom from original grade: Gravel depth beneath pipe: Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel Length: Ft. Ft. Well: r=-Ai&� E] New ❑ Upgrade Gravel Width: Number of lines � n lines: = Ft. Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Ft. Ft. Ftz Al 3 ZS ",P VC Driller: Date Drilled: Static Water Level: Installer: Date Installed: Ft. Af- M-o^e S -e Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft.7 Ft. SEPARATION DISTANCES El Septic El Holding 0 S.T.E.P. El Other: To Septic Absorption Lift Holding aublic/Private Manufacturer: Capacity: From Tank Field Station Tank Sewer Line ��.17 IT I 5_�atJ Gal. Well 41 Material: Number of Compartments: Surface Water > LIFT STATION Size: Manufacturer: Lot Line 4 ,10 , -e r Gal. _Tj �j j:5, re-) e;!�� Foundation "Pump on" level at: If q in. "Pump off' level at: Iya in.1 'High water alarm at: JV 7 in, Curtain Drain — Pump Make & Model Electrical Inspections performed by: Remarks: A T BENCH MARK Location and Description: 11:! (r, ^cr (ni-e g,01 C,:)- le,<nexlta, s�eze,^ o,* Assumed Elevation: e Ft. V Inspections performed by: Dates: is' Engineer's Stamp 2nd Development Services Department Approval Conditional Approval —Date: Reviewed and approved by: ldj!2�fDate: 2 (Rev, 04/06) ------------ _- PERMIT NO: OSP101213 -- PAGE 2 OF 2 EXISTING 21'x 34.5' SOIL ABSORPTION BED o PID NO: 017-063-52 UNE TO BED asTING 2- DISCHARGE „G„ „F„ NEW 1500-GALLO „E„ STEP TANK TBM "D"I „B„ WELL R =100' EXISTING 4-BDRM RESIDENCE LOT 5A SWING TIES -FROM: COR. A COR. "B" WELL "C".- 'TO: DBL. C.O. "D" 30' 6' ♦ C.O. "E" 64' 82'------� 41. T. C.O. "F" 90.5' ��t..Q ® ®® ®•�•j�1�� 106' % 4,-V• PLAN VIEW S.T. . ' 100.5' 114.5' % .407' 49 LTH SCALE: 1" = 40' eoeeee.....e®-.%roj..ee.....e /® •oeeaeoe eoe ee e®eo eeo•oe. io ,0 1.THEODORE F.MOORE o . �•fSA,®'e'•si®••• O / Pre re 3218 ®�® 4ZkW; ® ELEV. 92.4' 4' SOIL COVER 1.25" DISCHARGE LINE TO EXISTING 2" DIA. INV. NEW 1500-GALLONN INV. 88 4, FORCE MAIN 87.8' STEP TANK LOT 5A, BLOCK 2, RABBIT CREEK S/D STEP TANK UPGRADE AS-BUILT INSPECTION REPORT PROFILE VIEW FLATTOP TECHNICAL SERVICES SCALE: AS NOTED 1 " = 5' 14530 ECHO CANYON ROAD DRAWN BY TFM ANCHORAGE, ALASKA 99516 OCTOBER, 2010 Inspection Report Municipality of Anchorage, Building Safety Division 4700 Elmore Road INFO & HELP (907) 343-8211 INSPECTION: VOICE (907) 343-8300 • FAX (907)249-7777 • www.muni.org Name KENNY Permit # 10-9505 Company ED'S ELECTRIC Inspection Date 19 -Oct -2010 AM Address 6740 OUR OWN LN Phone 2724591 Grid SW2939 Subdivision RABBIT CREEK LOT 5A BK 2 TR n/a Work Description install septic lift station Insp. performed/prepaid 1 / 1 Permit Technician MORISA, MARIAMENE G. Comments or Directions ANY QUESTIONS FEEL FREE TO CALL ME AT 272-4591 THANK YOU KENNY Inspection Type Electrical: Retro Electrical Comments (for inspector use only) Inspector Date On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP101213 Tax Code Number: 01706352000 Work Type: Septic Upgrade Permit Effective Dates: September 30, 2010 to September 30, 2011 Design Engineer: FLATTOP TECHNICAL SERVICES Subdivision: RABBIT CREEK Site Legal Address: RABBIT CREEK BILK 2 LT 5A G:2939 Owner/Address: REESE JOHN E & STEPHENS SANDRA A 6740 OUR OWN LANE ANCHORAGE AK 995163727 Site Mailing Address: 6740 OUR OWN LN, Anchorage Lot Size in Sq Ft: 64005 Total Bedrooms: 4 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with.- 1. ith:1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The existing drainfield is sized for 3 bedrooms. Received Rxl- Issued By T"a 111', Date: Date: TIL A unicipatity Gf Anchorage Deve[opme t Services Depart nt Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 knnnnN.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING pSPlUlZt3 Parcel I.D. Cal `7 ^ 06 .S Z Property owner(s) -TL, R -?&,ie Day phone ,3 yS - 0 E 2 ;- Mailing Mailing address e 7Y0 Or -.t,- Zip Code 9 `"7.,s I C Site address Zip Code Legal description (Sub'd., Block & Lot) ", I ,j-& )3 iGr G; `Z, pct -4 h : /` � /) Legal description (Township, Range & Section) Lot Size 00 S Sq. Ft THIS APPLICATION IS FOR (® all that apply) Absorption Field ❑ Septic Tank 51 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms y /0 If 0-1 THIS APPLICATION IS AN: Initial ❑ Upgrade so Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 2 00 C'6' Waiver Fees: Date of Payment: 9 % Z '7 Date of Payment: Receipt Number: L( ��G Receipt Number: (Rev. 11/05) FLATTOP TECHNICAL SERVICES CIVIL & ENVIRONMENTAL ENGINEERING " ENERGY CONSERVATION & ANALYSIS TED MOORE, P.E. 14530 ECHO CANYON ROAD PH./FAX: (907)345-1355 ANCHORAGE, AK 99516 E -Mail: tgmoore@gci.net September 26, 2010 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to replace the combination of an old septic tank on the verge of collapse and separate lift tank with a new 1500 -gallon STEP tank on Lot 5A, Block 2, Rabbit Creek S/D, located at 6740 Our Own Lane. A site plan and specifications are enclosed for your review. There are no known deviations from prescriptive wastewater code requirements, nor any known adverse impact of the project on adjoining properties. Please feel free to give me a call if you have any questions on this submittal. Sincerely, Ted Moore, P.E. I NO WELLS WITHIN 100' OF PROPOSED STEP TANK ---------------- ---------------------------------------------------------------------=------------------------ INSTALL NEW 1500 -GALLON STEP TANK w.4` MANHOLE RISER Y W Z m � J d ?J W J U) J w O u- 100 OFESE� EK o o "3,aa CREE: a A DECOMMISSION EXISTING SEPTI( AND LIFT TANKS Q Aw-itap Ted Maoo q,30/►0 OUR OWN LANE _CONNECT NEW TANK DISCHARGE INTO EXISTING 2" PRESSURE LINE NEW 4" 3 BRA INSTALL EXISTING^21' x 34.5' D-3034 SOIL ABSORPTION BED DBL. C.O. WELL —._ R = 100' EXISTINGX-BDRM RESIDENCE LOT 5A �------------ 25' CREEK MAINTENENCE ESMT. NOTE: SOUTH PROPERTY LINES ARE APPROXIMATE THREAD OF RABBIT CREEK �► *G;° 49 TH `:®® rast••am •a•®e •a®as2a•as s• .®aw aas s.i•sas •s•a•••� THEODORE F. MOORE �e CE - 3589 s/�•�i �e� • ... �® V4 0feSsio�+'► TRACT "A" LOT 4A (VACANT) Flattop 7echnicafServices 14530 Echo Canyon Wpad, Anchorage, AX 99516 ('hone (907) 345-1355 Lot 5A, Block 2, Rabbit Creek S/D 6740 Our Own Lane STEP Tank Upgrade Specifications 1.0 General: 1.1 The scope of the project consists of properly decommissioning an old, presumably concrete, 1000 -gallon septic tank and a separate 500 -gallon lift tank, and replacing them with a new 1500 -gallon STEP tank located as shown on the site plan. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. 1.3 The installer shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The installer shall provide adequate cover material and rough grading over the tank to ensure that proper drainage is achieved after settlement and that there are no residual depressions. 1.5 The homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Tank Decommissioning: 2.1 The existing 1000 -gallon septic tank and 500 -gallon lift tank must be properly decommissioned by thoroughly pumping, removing the tops and backfilling with soil, or other approved method. 3.0 STEP Tank 3.1 The new 1500 -gallon, 2 compartment STEP tank shall be Municipally approved and set level on undisturbed soil. If the tank is buried less than 4 feet it shall be insulated with 2 inches of rigid insulation plus 2 feet of soil cover. 3.2 The contractor shall be responsible to obtain the necessary Municipal electric permit and inspection, and shall provide a copy of the electrical inspector's report to the engineer overseeing the construction of the wastewater disposal system. 3.3 The second compartment of the tank containing the lift pump mechanism shall be equipped with a watertight, insulated manhole riser and cover extending a minimum of 6" above final grade with positive surface drainage away from the manhole. The contractor shall be responsible for determining the necessary length of the manhole riser. 3.4 The on, off, and alarm floats shall be set at the elevations specified by the lift station supplier, and their proper operations shall be verified by the contractor. 3.5 The discharge line from the new lift station to the existing 2" pressure line leading to the soil absorption system shall be 1.25" dia. Schedule 40 PVC or HDPE. An appropriate fitting will be needed to transition to the existing 2" pressure line. 3.6 A double cleanout shall be installed in the new ASTM D-3034 waste line upstream of the tank at the point of its connection to the existing waste line exiting the house. 4.0 Inspections: 4.1 A total of 3 engineering inspections will be required during the course of the project: (1) initial discussion with the contractor to finalize the location of the tank and construction procedures, (2) after the tank is set level and piping connected but prior to backfill, and (3) after rough backfill and grading is complete. The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. MUNICIPALITY OF ANCHORAGE DE ITME:NT OF HEALTH AND HUMAN SER', Z'S Environmental Health Division 0/ 825 " L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON -SITS: SEWAGE DISPOSAL. SYSTEM AND/OR WELL INSPROTION REPORT Name DISTANCES —� FROM TO SEPTIC TANK ABSORPTION FIELD WELL Address - ---- �('++ /- 1iO3 Utes. rTudoe- llaoicii �.L ;4 "l WELL /„ o I t+ i 6-0 -+ Phone(s� Permit No. ,661460 ��— No of Bedrooms ?%tree � LOT LINE I -J- W _LEGAL DEscruPTION__ _ Lot ,rY�} ©lock SuU isaon — t:L 6 FOUNDATION _ Township, Range, section I . I ( Rd UJ y-�C ---� AS -BUILT DIAGRAM (show location of wen. septic system. property lines, foondeupn, Or veway, water bodies, etc., On TANKS c� ^C __ _ -- _ __ — — SEPTIC" HOLDING -- Nlanulactw er � Gapacny In gallons Material J No of Compartments TYPE OF SYSTEM _❑ TRENCH I 1 BED —a W. DRAIN ❑ OTHER 'Fe—Pim, pipe bottom Iron original grace z� FT 'I oral cepth from original grade -i - C FT -� -- — — - Fill added above original grace ,S,o FI --- - Gravel depth beneath Tape (��FT Gravca Icny;h--_--- -- .�.3 - -- FT Gmvei width J FT — - - — — - - Total absorption area /� ✓r. SO FT Distance between noes (Oal F -T — - hs Nhmber aoe Soil rating SO FT Pipe material 1 A,t'&LeP �-v�A,iA-k,,,. Date Date Installed— 1 -P119h - — - t T — K PRIVATE L7 0.1 -HER (Identity) I A. 671 1 Total Depth Cased to kIs0141 �!_ FT -V- FT Instanai Date Instaneo- (I�11 s — Ad— REMARKS: Scale: p cu 1s Performed by Date certify that this inspection was performed according to all Municipal and jW e guidelines in effect on this date:-Qd-7— Health Department Approval: _ (._._-- J �.- Date. (l-. OL::1 72-013 (3,85) aYF I �c� 3SiYl r1 r1.1 r S 2- WTV him: ilk W "F Daj Phorm 5h 1-40.) Lui Ln W; Subdivision! RABBIT CREEK Ent: 5A Block: 2 SwAlov; 20 foxiship; AN Range; A, I is Pa 0 total Capacity: em KER DER ON h 1 Ot,'f o' rE - .4" -'. I � z '- ' BEH; t'1 0 A A1.. � A f P 5 1 V .. P V i� Ti E u ", u 111 t C E;, , -, C L [" 1" 1 H E -E. R� 50 1 W PLACK W W 1-... ! !dN ill- 1� 4L A A UFf SIM 1M Q, WWWA A HIGH NI ER ALARN ELL BL CORFOU 10 ME WDE0- HO &REF 1 Vii:f:!N ':A' LL -L 1 J� �, 1 T v- ti �iz 6ith up rapipvEnts for hi -mita lowers ad Vis m Q Qv UMPAT Of AnChI'm om and the State of Wwya; Al wRAP Ja insw in sunrlel n aith W how rodwo and raquintionn � n V 1 hP dan yr c V A 07 a M P 10 Psm 1 t a 1 ; �"U -�n�j '-.to to Q A 1 at v r vV i P mea s Np t hy se t dw i i-6 1 wn, any P Ki log top . waynnater dignsal systan of P&Q.- nowe'aqu mW m oil up anj 10imut of newh, W -ii , i jadymm W! Ilii`_'- parm isvalid for a roxinm of 1 Norm 1 Av,; wdPrOand that the capacity of the total syster is I berooms aw ovy AINSWOM ; A! [Pqmrp an WAWA pwit, —DATE: Q "in 4111 iH. ,° F 4. s Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES °`• °" • ° BeO ° ES R 825 "L" Street, Anchorage, Alaska 99502-0650 Y�° B ue <)Y C°REID,, JR. a a SOILS LOG ® PERCOLATION TEST �� CF - 2251 a �� PERFORMED FOR:IP 114-2 7 [D DATE PERFORMED g�9 0 LEGAL DESCRIPTION: 407-5/'[ xz0e'VZ ��C�Bjl� Me S"I ownship, Range, Section: DEPTH SLOPE SITE PLAN FEET) 1 f%LL. f �rt�E�IAL 2 3 4 — I''•1` 5 ( C�L�ty%I ,$/�/YLL srtiall� 3�liN'i 6 -- 7 s 9 10- 11 12 13 14- 15 16 17 18 19- WAS GROUND WATER ENCOUNTERED? L=S S IF YES, AT WHAT l L { PDEPTH? E Deplh to Waler Alter Monitoring? _ Dale: Reading Date Gross Net Depth to Net Time Time Water Drop 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN �FT AND FT COMMENTS SO/L Il,7%lllt4l F/f`Te� k7 /7d �'Q,%'/- /l��iZi1 1%,q PERFORMED BY: ff�C S /I-- /J/," I --L.' h''//— CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) ing ■ ■�iC■ no No P WAS GROUND WATER ENCOUNTERED? L=S S IF YES, AT WHAT l L { PDEPTH? E Deplh to Waler Alter Monitoring? _ Dale: Reading Date Gross Net Depth to Net Time Time Water Drop 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN �FT AND FT COMMENTS SO/L Il,7%lllt4l F/f`Te� k7 /7d �'Q,%'/- /l��iZi1 1%,q PERFORMED BY: ff�C S /I-- /J/," I --L.' h''//— CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES' ' 825 "L" Street, Anchorage, A laska 99502-0650 4 �� SOILS L.OGm PERCOLATION TEST lY D• )'urt r '' %,`r PERFORMED FOR:(I h _ DATE PERFORMED:����'1`"r�--• LEGAL DESCRIPTION: Township, Range, Section: tt P'\Q�7U 1�-CPC'.e1� SLOPE - T 2 O 3 �p ,50 4 5 - -- J 8 9 6 jj 10 WAS GROUND WATER ENCOUNTERED? 11 IF YES, AT WHAT 12 DEPTH? 13 gepth to Water Alter Monitoring? 14 15 16 17 18 19 20 COMMENTS SITE PLAN V S c 02`]b I p E gate: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (mmutesimch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: - I < CE IFY HAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TH/IS DATE. DATE: 72-006 (Rev. 4185) /"Jt �c c?1_t; 7� �` -(—�t� 0. 0 X ! �}CC� ��2i-L�}2Q,E� —4 `( Ce e D>( L JIF Municipality of Anchorage �� • • • •• ° DEPARTMENT OF HEALTH & HUMAN SERVICES ••' " ' °°° 825 "L" Street, Anchorage, Alaska 99502-0650 44 00 SOILS LOG — PERCOLATION TEST OY C. REID, JR. ; 11 �IG'• CE' 2251 A PERFORMED FOR: �J�'f�J�� DATE PERFORMEID�CV V� LEGAL DESCRIPTION:_"7-Sn /�LdeOz- ?,OA7' eeQe S'Iownship, Range, Section: DEPTH SLOPE SITE PLAN (FEET) --1 F--F---F—T- 1 fi[.` ilk R/AL 2 3 4 77 nL 51111 1 Shhct sAa�d SeAftS 6- 7-s%ti, 8- 9 - /L// k��f rJo[KGfs 10- 11 / �K 12 �{. 13 14 15- 16 17 18 19 - WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Atter Monitoring? El ES S / L -5�EPS s o 3 E Dale: Reading Date Gross Net Depth to Net Time Time Water Drop � I 20 PERCOLATION RATE tminules?inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS .SO/G �I%H/�"LLj� 04 0 Af /76 j'Q,`T PERFORMED BY: /�-�,'CS �' iJ�Fal� I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: L —LD Y7 _ ES S / L -5�EPS s o 3 E Dale: Reading Date Gross Net Depth to Net Time Time Water Drop � I 20 PERCOLATION RATE tminules?inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS .SO/G �I%H/�"LLj� 04 0 Af /76 j'Q,`T PERFORMED BY: /�-�,'CS �' iJ�Fal� I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: L —LD Y7 _ 0*Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: J 2 m e.3 hC r }4 DATE PERF( LEGAL DESCRIPTION: °%S/a �ll�r,E L e.2 J,l (°r� e:e Jcwnship, Range, Section: %/z/U JZ 3� s47ry Z DEPTH SLOPE SITE PLAN 10` 11 --- 12 13- 14 15 16 '17 18 19 20 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? _ °,P f S q r L 0 P E Date: Reading Date Gross Net Depth to Net Time Time Water Drop I PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER vvvJJJ TEST RUN BETWEEN FT AND FT / COMMENTS ��r"� Ste' 11 is 5�� n A)goJ S.s- t✓ ��cY- o %j0 °jC ��,��[�� gPr�/�ca 2c_ PERFORMED BY:�� r`"? O' -d J� I C_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFEC ON THIS D TE. DATE: (FEET) 1 7.^ 2 �s 3 t 4 - 6 ` 7 10` 11 --- 12 13- 14 15 16 '17 18 19 20 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? _ °,P f S q r L 0 P E Date: Reading Date Gross Net Depth to Net Time Time Water Drop I PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER vvvJJJ TEST RUN BETWEEN FT AND FT / COMMENTS ��r"� Ste' 11 is 5�� n A)goJ S.s- t✓ ��cY- o %j0 °jC ��,��[�� gPr�/�ca 2c_ PERFORMED BY:�� r`"? O' -d J� I C_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFEC ON THIS D TE. DATE: ALAMA �"I IIRUIIIKI1I AL CUM RUL KR' "1;E5, IN Enqineerinq & Enulronmenlal Studies TEST HOLE NO. Z: Date.? i /C,;� Legal Description L ffj G 2 P,d Sample Depth_ 5— D 10?0 D• NM D 3040 D 6040 Comments 6%/e -//z l r? — e./,,j Reported to�J?"c s 41-4 1 vc Plotted L Pu,W Checked by_ Approved by 1209 West 33-d Auenue. Suite B • Anehorage Alaska 99503 • (9071 2761361 SIEVE ANALYSIS •. �� M1 rl ��O '�MP�M ■ -IMMII MMMK-MMIMM ■ ■ �It1 IN �t ■ ■ �■ IllllllMI �IN IN t� I MI 1 T■�y■■■MM ■�_ �� ■ ■ ■■■— . m� �� � is mt ��� ■ —���■ ■ � • • �� : =���I• NMI IN —� 0 ■=—I� ■ � . �.■ E MEN . ■Itlllllll�-'--_:E- -- • - ,.._� -- .■-■� - - IN I_ -- -- m. m- .__---.--- __■ ■ �1��■�i. Moo .�.��1�.■�.�.��i�... ■ l llllt� MM ---mn --- - - IN - ---- . --�--- - - - -m-m -_--- - - . --- --r— - - _ .ININNI ■I I NIM1111lllllll■ttllll■ ■ ■ I� kXMIMM ■ ■■ Estwo ■ • NINON I— ■■■ MM In �■ E IN ■ma■I�ltlll� ■t --t —I—=■■ �■■ ■■■ IIIA ■� m— ■■■ M RUM ■■ ■MMM1I.■t t ��■■■ t . • ■■ M I• li•M� 10111 ■I•011MIN ■■■ MMMME . Mn N IN M10 ON tllllo 1101 ■�I—��=■■■■ t ' on WE ME r�\ M■� I�01111001 �M• I■�-! I ■■■ ■MMME—MMIM■■■MW . • MM 0001101 ME i t MIN �M�� � ■I■■�■ w ■���� ■■■ � ■ ■�■ MI�n ier�� m. m ■■ • IME IN ■■�■fY 10=1■�—•■�� ■■■No In 0111 ON ��M■I■ Ilt ■ Ili � � 11111 - t� _ ■�—�� no ��M A —Irk ■■ 01111 No M1 mem 011111O■UMM01110SME ■■ MINNIE MIN ME 0����• ■oonsi— �m ■■ � � MM IN MINE �i�■� It— ■■ IIIA 1110 ME 0 tea■■ ■■ Illllllllllltllll OM11 =1111 ME In 1— 11=1 M111■- m�glm ■■ IMMUNS01111 . . No 10000111001 IEM MM IMMISIMS INS on IN IMUMMIUM =01=1111=00110M No MM MOM WINMENI MOM11 NEI �Nullwtwww M min • • 1209 West 33-d Auenue. Suite B • Anehorage Alaska 99503 • (9071 2761361 ::-.'.-r" Sj'S'il,v, ASTv I)-248)7 21 FEB 87 RABBTT CREEK SUB B2 I.5A S4ua-_E 'DENT -TY "'H2-4.5 PASS t200 S1FVE: 0.68 RETAINFID: 7.87 PASSING # 40 SIEVE: 8.55% RETAINED: 14.07% PASSI\G� '0 ST1'.VE: 22.620. RETAINED: 9.9,5 PASSI\G t: 4 SIEVE: 32.57% RETAINED 18.21 PASS'SG ii2 IN' SIEVE: 50.78% RETAINED: 9.673., PASS',S(=. 3,4 IK SIEVr: 60.450a RETAINED: 31.25°;, PASSING .l I\CH SIEVE: 9i .70%. RE.T.AIM): 8.3000 PASSING 2 INCii SIEVE: 100.00° REMAIN'"I 0.0000. PASSI\ 3 INCH SIEVE: 100.00% RETAINED: 0.000x, Din IS 0.50 MM,. Dan -5 3.90 mm. D60 IS 20.00 YM. THE LIQI'ID LIMIT IS UNKNOW,\, THE. PLASTIC LIh`:IT IS UNKNOWN THE PLAST'CTTY INDEX IS UNKNOWN CL = 40.00 CC 1.521 TH= Sr'-- S ARF COAI'SE GRAB\ED THE Sr) ".S ARE GRAVF.i. THE SC';.S ARE WELL GRADED GRAVEL.(GIO ALASKA el uInOWRIAL COnTROL SeRuOS, InC. engineerinq & Enuironmenlal studies March 25, 1987 Municipality of Anchorage Department of Health & Duman Services 825 L Street Anchorage, Alaska 99501 Re: Lot 5A, Block 2., Rabbit Creek Subdivision As required by your office, monitoring of groundwater has been done once a week for four weeks on the above referenced lot. Water levels are listed below at a depth from ground surface. TH #1 TH #2 When Testhole dug - 8' 9.5' 2/27/87 8' 8.6' 3/6/87 8' 8,8 3/13/37 8' 8.4' 3/20/87 6.3'* 81* * Melting snow water running into both backhoe testholes. This is the cause of the high levels. We recommend that TH #2 be used for the upgrade with a bed design. Using 8 foot as the groundwater level, we recommend 4 feet total depth with 2 feet of sand fill for filtering. A lift station will be required. The integrity of the existing septic tank needs to be verified. Upon completion of this, the type and size of lift station will be determined. If you have any questions, please feel free to call. Sincerely, Alan C. Wien Engineering Technician Approved by: '.y Awa : •/� a 'ee 0 �eeeoe• e•�� ieeee eio .� i sea s° eeepw°ge00e° °�°� C. REID, JR. o a o �� �-•= - 2251 Oo :ftii Ffa 1200 Wesl 33rd Auenue, Jwte B a Anchoraqe. Alaska 99503 a (907) 561-5040 ALASKA &UIRo Mm n -[AL COnTROL SNUIRS, MC. �figineermq & @nuironmeiwd SWO nnl; it Rni'-_;nit 1907 1200 WN 33rd Nenue. Jwle • Anchorage. �las�.a °9503 • 561-50U0 r. Koo I` :oc 1 .. 1)C, r 1 i{ ) r ,Co a l)nr�r o it ", l <_ ! 'r Nei n C f tr 1� ) It S( 1 I r) f nr ned O. L - �' _ - __ I. I:i LrCi - C � 11 r1H -. 1_;ni, 11 n'_ p nt` a c g n Nllr 1 . _ . r l I l t e �1 is ;I•<_FOOT 1QU 14.t11 U was insla Lunt the "c.. An '.0 )1'e t; nPll.i t) L J � he clil_ llr il; _i "clienwitsin as to CAP[4 t _On 1 Lli l litil 1A �' -ILCI _ I -), u._li 3 t I 11. L ' IILI WPiL. L -{) turn and conclinup to Lae 1- { -1 �s ion- V (: rlc 1 lint lel A I i jl.)f )f' U r _'!, II n. _ __ I I ._E'c_IC"ec" -u iii, OX 1 Mo ON is MUL 7T"n KP K ,,r -; _ 1 ,,r 1 L ti �r t. (, _r .- _ - < f? rPa E�"Il �l lr n MY vo �I ,eep OL _,� ]ill. 1CC c711 )bC t rCICO�II�P1'2U TPYPZ( •, p 7p inle ter lllf' 1_ .P �� 1 n i1 1 U.c- - 1tq Ic�it�__ 1l chit,, �_Lc - Ae - r UI_ , 11 _o. la Ir u�'L „ 1li11 .. '.]c n f-' , des i r Omm-Ao a:nn( go r t iL ALI�1 �:. Ven nor �sr Ul':FI �'•y.�� Wit'-' ' onn I: f)f'i from IS Go !ter foon Me 11' Rant' C "1 Iwboy was- pumpla )1 lritC Oak Ii_@g � in (,r . t'i- Ir. _ me of le upgrade V e t 8 on :^u-- -to an extreme rush in MW Cie ._ _ e c rl l-. r)n 1 L_ CI 1 _ P JI - _ t_i p -A jai ( 1 loan re peqvus.hal _et .. lf�; 1907 1200 WN 33rd Nenue. Jwle • Anchorage. �las�.a °9503 • 561-50U0 L•Lor 7A /a7F rla vos/bl c weLr EXUWrh�i. 7d ✓eArF/ SEI}ll� Lrtil STF'n C bo>/. 30' I Lor 514 ;? Creek - M4in> en ce Ured A3ndt• �E I 'sh d \ r. n. L .- i /06 7 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: L"� 6 -Al +8)."k a &u4 C"e A. WELL DATA Well Classification iOP–IV 4&. If A, B, C, D.E.C. Approved (Y/N) _ Well Log Present (YO) Date Completed Ae /968 Yield8�,org Total Depth sZ(Ikn.lLkanL Cased to * !VO* — Depth of Grouting Static Water Level /OSS Pump Set At — n Casing Height Above Ground Electrical Wiring in Conduit ©N) Separation Distances from Well: Sanitary Seal on Casing ®N) — Depression Around Wellhead (Y,© To Septic/Holding Tank on Lot ; On Adjoining Lots a 4 To Nearest Edge of Absorption Field on Lot j6b+ ; On Adjoining Lots 1�f To Nearest Public Sewer Line Cleanout/Manhole --- Water Sample Collected by Water Sampl Comments Ecs — To Nearest Public Sewer To Nearest Sewer Service Line on Lot -- ; Date '43 -1d-97 B. SEPTIC/HOLDING TANK DATA Date Installed— Size —_16?f No. of Compartments T'W O Standpipes 6)N) Air -tight Caps6N) Foundation Cleanout (Y® Depression over Tank (Y J % — — Date Last Pumped i eoggi" Pumping/Maintenance Contract on File (Y/N) ; for -- Holding Tank High -Water Alarm YI ) *-- Temporary Holding Tank Permit (Y/N) — Separation Distances from Septic/Holding Tank: 1� .1 To Water -Supply Well To Property Line L� To Water Main/Service Line i .- Course 'iv 7C1- Comments*4_.t��_� tiAnrJr)0Ah lJw. ra To Building Foundation To Disposal Field — )a. 1f' — To Stream, Pond, Lake, or Major Drainage 51�, �teu� .-I�n.a,4 � �-�. �Lt�►,.e uu•.4 ustn. err�,e.La.�' o,-i.�r� L4A.� . Card "_r L� C , Pk "' �-�Z1W4,. Page 'I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Sf' 6d AM Type of System Design Date Installed /98'7 Length of Field Width of Field Depth of Field 44W 3S Gravel Bed Thickness Square Feet of Absorption Area 4F Standpipes Present ©N) Depression over Field (Y/N) Date of Last Adequacy Test Wet,-) ftp rdp k Results of Last Adequacy Test 5Arl.SF-A01ZRy Separation Distance from Absorption Field: To Water -Supply Well I 16-0-1- / To Property Line To Building Foundation Lot /'?0� To Water Main/Service Line — To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course 166, To Driveway, Parking Area, or Vehicle Storage Area /64 - Comments 0f Comments D. LIFT STATION Date Installed AU41AIJ8 1487 Dimensions Ardce+' e T+MIK Size in Gallons �'Slla dt�XG k�0 Manhole/Access®N) j 'Pump On" Level at ( X�O)C.(1 yy•.s "Pump Off' Level at q6 -S-11 / 0Q0 e/ High Water Alarm Level at °'�►Vent/) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have c ked, erified, or conformed t all MOA and HAA guidelines in effect on the date of this inspection Signed Date 1+7 ! 8� Company MOA No. !'c�� Receipt No. .h �� OF Date Payment of or�.. a,, •"r �a �� *..,. Amount: $ �, °f Engineer's Seal e: Farm Page 2 of 2 6� �F�°.CI: 5730 ` e�'�4�O•C►�:�`Rb 72-026 (11/84) ^F „NCNOMGE MUNICIPALITY OF ANCHORAGE C,r & LNVIRONMENTAL SERVICES DIVISION MUNICIPALITY OF ANCHORAGE (MOA) pC- N MENTAL PROTECTION WEALTH AUTHORITY APPROVAL (HAA) J U L. 2 1988 CHECKLIST -FEBRUARY 1.984 ,���• 264-4744 E l WD Legal Description: / co& `YNy S'fF � �f/ - �3/ac Gr e flab bi C°"Ok. S/,o A. WELL DATA Well Classification rlJer>L¢ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) _ N Date Completed U -A knc vf) - nre 4667 Yield 1, 7@71;- meat 7/!D/49 Total Depth I t 6 --Jr Cased to _> `!a' Depth of Grouting N, A. Static Water Level 7K.5, Pump Set At t IS ' Casing Height Above Ground 20 ° Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot 60, 40 S,f.J ("1)'6 1,S, On Adjoining Lots �' 16v' To Nearest Edge of Absorption Field on Lot 1014 ; On Adjoining Lots > (UB' To Nearest Public Sewer Line Cleanout/Manhole To Nearest Public Sewer To Nearest Sewer Service Line on Lot a/i•• Water Sample Collected by �r/'r=_ lctu tech, Svcs, Date 7/—!-9 166 7 / 26/ gc9 Water Sample Test Results - r6( rt iack-Ov- - �, 11,,y/� ntl+afe - N r a li iarr F;tV an �rrrf._a�rryrle Comments _Water syr_ tro _Conlorhtna/ �urye c(aw,n/tri �mr S'eca samx!< o,Ft-e<•- G�(orina0van aA'•% F(WAI'Ay ,chacuav( 0 co&Alrn, � loon, Q, (vet/�sejofic frn(r Sef�ura�� �t oi4 aft repo r k dakA o04 tiv/ty!/afion fr/21! yleCoC d 8• �( /'"' r��or %ec! -,Ptv,» 2 tt"7 f(acw '-Of/ E /L4'C.f war in cvrr6'C 9 B. SEPTIC/HOLDING TANK DATA That Co rlt�r %Crf prnbab/ H�eove ,-o,C ou%,t/- ,�roa, rGO qua( S/btafrC fan/r indde vt%tii9(onc Date Installed 196 Size 100 No. of Compartments 2 Standpipes (Y/N) _ 1' _ Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) N Depression over Tank (Y/N) N Date Last Pumped e /7/87 w Pumping/Maintenance Contract on File (Y/N) ;for Holding Tank High -Water Alarm (Y/N) N. Temporary Holding Tank Permit (Y/N) N•/h Separation Distances from Septic/Holding Tank: To Water -Supply Well bo To Building Foundation — (I' To Property Line 7 10To Disposal Field 160 To Water Main/Service Line Ns t4. To Stream, Pond, Lake, or Major Drainage Course _ 704 �v Rabb;/ Creek Comments 5eeearati ,ton otcf1.e4ncer / c.( crf oCale pF'1nrf6//a1r6.> )6 market( IrtAormaAon :-4'roo? 8/!u/67 clheckItirf y, �4o(eeuacy Tifhny 446eear 06uce unocctVted oto muff cr-�' IParf year Page 1 of 2 72-026 (Rnv P M Front �I February 23, 1987 Robert W. Robinson Municipality of Anchorage Department of Health & Human Services 825 "L" Street Anchorage, Alaska 99502-0650 MUNICIPALITY Of' ANC:I-I0hA(3P DEPT. OF HEALFH & ENVIP.ONMENTAL PRO"rECfION r Re: Lot 5A, Block 2, Rabbit Creek Subdivision Health Authority Approval, Additional Soils Log, Sieve Analysis, Site Plan Showing Alternate Upgrade Area Per your request on Friday, February 20th, 1987 we obtained another soils test and delineated an alternate upgrade area at the new test hole on the site plan. Our engineer, Leroy C. Reid, Jr. accomplished this over the weekend as time is of the essence in this particular situation. Please contact me if you forsee any delay in processing this approval. Sincerely, William M. Geil Vice President/J.: attachments 703 W. Tudor Rd., Suite 201 • Anchorage 0 Alaska 0 99503 u (907] 561-4007 MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIV'WOARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES J U L 2 $M&ICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ��� C OF ON-SITE SEWER AND WATER FACILITY k sq- S b��_-t-� RECEIVED 264-4744 Application Date—sLwry 27. /g68 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) l.oFr �!'•�� S A rr' 6A� Qlk 2 %'i xb btf C're¢kS /D Location (address or directions) S'7YO Our O.un l czn (b) Property Owner C -"AC IKor01/e- Telephone: Home Business Mailing Address (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Re /-taut Pmeer) n Srdse / 6e7~ v Address 2(5�Do <or��« S A++cAo Lrcagc, Ak 99s -7 Telephone 2 766-- 2 (e) Mail the HAA to the following address: or: Check here 19, if hold for pick up. List contact person and day phone number below. Ted I-Coore 3 VS-- 13'S -,r 2. TYPE OF RESIDENCE Single -Family R Number of Bedrooms 3 3. 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 R 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 72-625 (Rev 8/86) Front MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL qJ —C OF ON-SITE SEWER AND WATER FACILITY 264-4744 __. Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) L64 ,�A &� a ";4 a' ee•k 7/aA/ P-4LOsee ,neo Location (address or directions) (b) Property Owner J-4-reES /nTelephone: Home /n� Business &(/ 4Z60-7Mailing Address `2 W <¢ / ae Algz Sur -c. Xiz/ #Ae6� 4A? 99 a (c) Lending Institution / Telephone 4641 4161 Mailing Address 701 F 'FL)d rl- /o? (d) Real Estate Company and Agent—D_cs��rA'L Address Telephone (e) Mail the HAA to the following address: or: Check here E7, if hold for pick up. List contact person and day phone number below. 11-1 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms T%P_ee- 3. WATER SUPPLY Individual Well , Community E7 Public El 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 [� Public E7 Community E7 Holding Tank E7 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 (Rev 81M From 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 Application Date �� d 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) "A) Location (address or directions) Oci 67L)� LA7✓E (b) Applicant NameTelephone: Home Business S!v 1- 6,v'7 Applicant Address 703 tJ Tu�jr Soii7Zs a 1171el< 45e 995_03 (c) Applicant is (check one): Ldnding Institution ❑ ; Owner/builder ❑ ; Buyer; Other ❑ (explain); (d) Lending lnstitution.67 //I_C Ak1,e76At,E ed_ Telephone7-' Z18/ Address 761 C'- T,,W f#/7r /67 1971 r , /11�� 9 95 _03 (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE' Single -Family Multi -Family ❑ Other Number of Bedrooms e 3. WATER SUPPLY Individual Well 10 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 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 (11184) 5. ENrINEERING FIRM PROVIDINu ,NSPECTIONS, 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 at,,; 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. �J Name of Firm— GS �— Telephone T Address /fry �,f f�3r frvt'' SliiTt %f i4rlCi✓' %i�j Date 7 L'uo /71-evIx-t - /, �iF6F.rhr• /}�%P.Piira/ /3%'trA sF,F�,JE y 98 % L: 5`Fr�c-Tf}i✓il itl'Tz'b�ii�� ✓er,iG/ cvt-Yi�� /�/h fur/ar,✓�j sP,ey�/4 iY57, 6. DHEP APPROVAL Approved for bedrooms by _ Approved Disapproved �__T//err/ms of Conditional Approval �`�` � r �s 6 WW/_P Conditional �l LL, o r/ 0)-/ dt'1ep CAUTION Date 0; 6_g 3 Get i.�7t70'1� /hfQt��G (� 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 DFIEP 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 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Z_07�A )3zoo Z- - A. WELL DATA Well Classification 7/z/ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y(9 Date Completed G/.t/rhla`J�/ /76s Yield 6T°•36 6P/V Total Depth 366'_ Iftkr5 Cased to Sc� `"�'/'r A/Tf Depth of Grouting Static Water level a lO 3 Pump Set At Casing Height Above Ground Sanitary Seal on Casing Y/ ) - Electrical Wiring in Conduit Y/ ) Separation Distances from Well: To Septic/Holding Tank on Lot 06 Depression Around Wellhead (YN On Adjoining Lots — '7a To Nearest Edge of Absorption Field on Lot /n /K�// /� ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer , Cleanout/Manhole /� To Nearest Sewer Service line on Lot Z �" Water Sample Collected by _ C/i9/U�K /; Date Water Sample Test Results -MI-If%i�rC���, _ Comments l�l��itTJ 'j37 Z /3-8�. GJCLe s�=�'t/�r°v� P� Sacudr9J r✓/I�c@ /��cc�, c�//��9cc-' yo e),67 II ?A -7e l0le,1- 2G ✓^7n,F/ ,f IJec 3�/ihy/ - B. SEPTIC/HOLDING TANK DATA Date Installed — L9_6 Size Gf.✓kcjnsJn1 — No. of Compartments 41X/41� - Standpipes�N) — Air -tight Caps(Y/ ) Foundation Cleanout (Y&j - Depression over Tank (Y1 Date Last Pumped 365 iuSlt/�r�%i7 _ Pumping/Maintenance Contract on File (Y/N)—/ SLA ; for Holding Tank High -Water Alarm (Y/N) _—_X,117 Temporary Holding Tank Permit (Y/N)— Separation Distances from Septic/Holding Tank: i To Water -Supply Well . To Building Foundation i To Property Line %©f 'y To Disposal Field To Water Main/Service Line /d i To Stream, Pond, Lake, or Major Drainage Course -76— Comments ,�/a.,/3uirv"3�c i?rr��f�� tip'. 7iJJk % pE i'i,Hr'e1 R}/ i/�eiJlr — /�S7 aJlfeAl �itJK /d>�r�'7r� ✓�relr,E . Pagel of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �1 `�K^/Oi1 r Type of System Design ,,/,eJ,'J 1/ Date Installed /96,z— Length of Field - sIAJRA) WWJ Width of Field q JkAJ"AJ Depth of Field U, dJl�1��n1 Gravel Bed Thickness ,11,4/k.A)M,%� Square Feet of Absorption Area <r�1k Jcw✓ Standpipes Present (Y6 Depression over Field (YO) Date of Last Adequacy Test 47- %�L'R/aA'HiL�d Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well 4(AbeIJAI)A/ To Property Line To Building Foundation J tf�11L�✓��c/ Lot �!%F) ; On Adjoining Lots / To Cutbank (if present) %✓%/4 i To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Existing or Abandoned System on elb 4i To Driveway, Parking Area, or Vehicle Storage Area /0 , ,y, Comments A10 fiR zy&7' 1-uti9-yid uA/,eAJA J 1, j -CW /4-7r,+edc--� 7a 06� )i e /AI sF.eu✓t, ar 199'7. .3 8bVI D. LIFT STATION Date Instal e Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) — "Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA °" Check Permitted Bedroom Rating Against HAA Request .• I certify thatI hav ec d, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed � �_ Date 7--X7- y' Company MOA No. Receipt No.-.-�(Zi [ / U ✓ �� OF A4� Q Date of Payment 2L2-' ! s Amount: $ 4 U Z) P-5� �°� ��° TF*8e, ala � &I V&A G677V/\ d •Y Oi.° .R° Y tl 0, OY C. REID, JR. e° Pa e 2 of 2 2. A-6 Pci kc-,�ozrf Cr -2251 `AV g 72-026 (wea) i{, sir I'LsPx/ ®B��Proiesslona� a'� 7A ,V J/ zazlel 010 a YI371AII, e,eM hN Qj WV9 -lic A L,6 1 m Lor 5A A MAAl 3a David A. Garrison LS A9.11 /Y 00a //I l91, sie42, gyp .1 if /rte• IMIZOY C..REID;, JR. 0 CE -2251 sg; jt+�e W,//, 1A do7l' : 4 v)516ci w" IIKI hod, 30' 19 OF A4 h 4A 30/ .st~ jv.//, -);Mob , v ;wJ "�-j 4 "F u4Ye IPA: ec( . ..- ---- 10f, v x - I / �" � � 1. �� e9olro 4ywg// Lor 5�1 106 ily w 2.42, Lor 4A fr 7A16 C4,A-LOd'jq k6-5 &C" Vvtoc)dlfd4-Le. y E471hcele 46 AC;4toit's 6 tot 01. 6-161-7 L)I)gf'6.de. Filial /,?�SbecAd� e nY D. Bartor Davld A. Garrison LS 6931 )QJA"& ot)e 1-1 A C r J �j Creek Ii red 106 ily w 2.42, Lor 4A fr 7A16 C4,A-LOd'jq k6-5 &C" Vvtoc)dlfd4-Le. y E471hcele 46 AC;4toit's 6 tot 01. 6-161-7 L)I)gf'6.de. Filial /,?�SbecAd� e nY D. Bartor Davld A. Garrison LS 6931 30' )QJA"& ot)e 1-1 A C �j 30'