HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 1H LT 6ARabbit Creek View Heights Block 1 H Lot 6A #020-511-07 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP121354 PID Number: 020-511-01 Dwelling: M Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New Upgrade Name: CHRISTIAN DE SCHWEINITZ ABSORPTION FIELD ❑ Deep Trench El Shallow Trench ❑Bed ❑Mound Address 15801 ALTA CT ANCHORAGE AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft.Gravel depth beneath pipe Ft. Subdivision Block Lot RABBIT CREEK VIEW & HGHTS 1H 6A Fill added above original grade E.Gravel F length Ft. Township Range Section Gravel widthBeds: Ft. Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ftp Ft. well 100'+ - TANK ■ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 1001+ -- -- -- Material STEEL Number of compartments 2 Lot Line 10'+ — NA Foundation 51+ LIFT STATION Manufacturer Capacity Curtain Drain N.O. -- -- — -- __ Gal. Remarks EXISTING TANK ABANDONED Pump on level at in. Pump off level at in. High water alarm at — in. PER MOA REQUIREMENTS Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer OWNER Drainfield CO/MT F810 Inspector ANSON MOXNESS BENCHMARK (Assumed elevation) 100 R Inspection 1�' 10/21/13 Location and description 2m 3"' a"' i BOTTOM SIDING NE CORNER COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp �4,4 ll�r Conditional Approval: Date C_ • c'_ld`J.�'....... d � . 1 . SS LAE S 15 �� Approvedw4alDate S lS ( 1 aF0;151�J 0,lk Inspection Report 9=Y12.doc ----------------------------------- INSTALLED FOUNDATION C.0�a n BD c 0 E F � �\ ABANDONED EXISTING SEPTIC CARL ST A TANK PER MOA REQUIREMENTS PARK INSTALLED NEW 1250 GAL SEPTIC TANK SWING Tl£s A D CONNECTED TO EXISTING f/ELD F.C.O. C 27' 4' S T. C.O. D 30' 10.5' S.T. C.O. £ 35' 19' / / \ \ C.O. F 43' 29.5' / / Area! LOT \ \ C.O. G 47.5' 35' / , \ \ Lor sA ,/ ,� Lor sA HEIGHTS Lor 7A / EEK VIEW & `� RAggcK GRE \ NOTE.: THIS 1S NOT A SURVEYED PLAT. WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER 25 0 25 50 75 100 125 I50 DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. SCALE 1' = 50 FT DOUBLE 4 FEET COVER CL£ANDurs FOUNDATION CLEANOUT CONPIECTED TO EXIST BRAINFI£LB 1250 GALLON SEPTIC TANK BENCH MARK BOTTOM SIDING NE COR ASSUMED ELEVAOON 100 FEET .31-UKALANU L:NUINLLKINU RABBIT CREEK VIEy & HEIGHTS BLK IH LT 6A SEPTIC SYSTEM ASBUILT 203 W 15TH. AV£NU£ ANCH. AK. 99501 WILLIAM D£SCHW/NIlZ DATE.' OCT 21,201�j (907) 179-3916 15801 ALTA CT, ANCHORAGE AK SHEET.- 1/1 GRID: 3240 PERMIT # LISP 121354 PID # 020-571-07 RABBITCREEKVIEVHEIGHTSBIHL6AIPERMIT # 121354 PID # 020-571-07 RABBITCREEKVIEVHEIGHTSBIHL6A-ASB,DV6 On -Site Wastewater Disposal System Permit Permit Number: OSP121354 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 Tax Code Number: 02051107000 Work Type: Septic Upgrade Permit Effective Dates: October 21, 2013 to October 21, 2014 Design Engineer: SPURKLAND ENGINEERING Subdivision: RABBIT CREEK VIEW & HEIGHTS Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BILK 1H LT 6A G:3240 Owner/Address: DE SCHWEINITZ CHRISTIAN 1530 GAMBELL ST ANCHORAGE AK 995010000 Site Mailing Address: 15801 ALTA CT, Anchorage This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: Total Bedrooms: jo-2l-13 32592 3 N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The 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. Received B Issued By: / 2:49 y;� Date: k7 2-1113 //t/ Date: SparN almd Enuhmaaflimg Environmental Consulting and Design October 8, 2012 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION Rabbit Creek View and Heights Blk 1H Lot 6A Ladies and Gentlemen: We are submitting an application to upgrade the septic tank for this lot. The existing tank collapsed and the owner has placed a new tank in the ground. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely, Lars Spurkland, P.E. 203 West 15`a Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gcLnet -- ----------------------- INSTALL FOUNDATION C.0 N \ ABANDON EXISTING SEPTI PER MOA REQUIREMENTS \ INSTALL NEW 1150 GAL \ CONNECT TO EXISTING FI \ \ LOT 6A LOT 7A \ \ \ NOTE: THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. DOUBLE CLAM \ 9mm ANK PARK Sr / Septic \ \ r Area \ �3 LOT 5ANEIGHTS EEK VIEW 8( tABnu SRH 25 0 25 50 75 100 125 150 SCALE., 1' = 50 FT 4 FEET COVER CONNECT TO EXIST DRAINF7£LD 1250 GALLON SEPTIC TANK FOUNDATIDN CLEANOUT SPURKLAND ENGINEERING RABBIT CREEK REF & HEIGHTS BU 1H LT 6A SEPTIC SYSTEM 203 W 15TH. AV£N(IE D£SCHWINRZ DATE 203 AK. 99501 WILLIAM OCT 3 ,2012 (907) 279-3916 15801 ALTA CT, ANCHORAGE AK _ SHEET., 1/1 GRID: 3240 PERMIT # 3SP 111XXXX PID # 020-511-07 YABBIICMLLKVILVHLI&HI UIHLbA.LfWlj I �Ul(l$`I \a✓ CJS � clQ�l / of J��� r��d1 fl l l ^ `0" l , t A � I1e G Ct Ulm ltil�� SePI�L I��� 1D ; 2ipla� ct��G orle .. i Liks T,µ� 3 t� f �r rw �XLaVq'�r wcis v-,,evj-ec( � r� �a�eyg �af 2 Owr2f V,b(vej40 t� Co ��N �n u� ✓b'�c'I Cl-'�✓�J LI1li°� V jv, v — �s i YYY � r(.,,, e_,�cgv�i��> ved QQ Se� �� '�rtilc- a+�5'Ia11S �Ie�rL e MUNICIPALITY OF ANCIIUKAGli rVk�l r -It L1\-iJ Head and Environmental Protec in fourth Floor Pest 825 L Street Anchorage, Alaska 99501 204-4720 INS'rLCTION I:F:I'OR'l ON—uJf(l SMAC: [)ISl'OSAL SYSTEM :,F,r, i ej��y�crosFlNN IINc; nor) Ls5 _ Q. �bX _ ���----- �, PHC I -Aldi\: It_L liki-Al i`If_L1): NUMUE-11 or- CO N1�..-_LIQUIf)ULPIfI._NI�_-___1,10UI1)CAPACI-IYk-250 GALLONS. 7 I t FT (-t' TOTAL LUNGTH %T' _f-OU;iUn11oN _T7— _ .r�i.nRC`_,I l C -/f LINE .� 3U OFLINE - A b 1 1 N[ _ [w,i -f L:E. IiL.IV-rL.I_rl LIMES \_kt.� `•.� of Lines � D-rcu_NCN ,INTI -_G Irv- 10AL L1=FFCTIvI= Fi (10 T7,__ ._ JQ, f r. l LNG I If Of LACI' LIM- I iF FAIfI TILE __'�� �l1f.1. ABOVE. III-E._IN. L71.-'.lLif-P - __._Olt WILT{I_-.. 1f-NGl lI. r)'t_PItl___.___--,_____.�__....�. Loy Crib Rings- _ Crib Size: LIA6;1L-H P _-_uf lrfl.—I)ISTANCE I -PO I: WELL ICI ^-L I_I FFM 1\/P: U'f - ;If Altf ,I I -Or ii'5GRPTION AR A (VJAL_t_ AP.FA)_._ 1r.Iss : Depth: I 'ice' ..I (w- ell Distance To: Lot 7,ine ldy: Sewer Line: -----SCJ. FT. 0 jpe P1aLer_TaJs: _�� m -I I_ of L'edrooras: nstaller: SLr`F - i- -marks: -- t:; 0"TO-juhm 11: 13 1: Ow — 11- - x , I - y, 'C, 11 II- H -Il U;, ..11 4..A If H' jj DEA19,11RAW D MR -AM 141AD 101WARMAMEES1AL I'l F E u A I (D 11-11 IMITT, f PA(DWIRAGIT, fW, WD 5 is IL: :: I At EGIRM 1 -F is I: 1!'-.1 -1 1 IEI*T--,; flrfl) :1 jkl t111 'I::, cd 1- jotyt- L. 4LIA CIL) FY 1. F0 FQ T 1:1%1(:i ifl:,�!Ej) SIM OF �31 KEE N::. m - I - v 0 = TO 0 .. 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SOILS LOG 1AUNICIPALI [Y OF ANCHORAGE 6r'f' DEPARTMENT OF HEALTH ANC) ENVIRONMENTAL PROTECTION J PERCOLATION resr Pouch 6.050, Anchcrago, Alaslca 99502 276-2221 SOILS LOG -- PERCOLATION TEST PERFORMED FOR:._`/�il�% !_ ❑AfE PERFORMED: LEGAL DESCRIPTION: u• (-- - . r`) ---- _� _ J� L��3 �____E_�_�% I�b[PTH SLOPE SITE PLAN — 4 ., r r z f 6 -�l�� 10- 1 1 —{ 12 13 - 14 15 '16 17 18- 19- 2.0 - COMMENTS___ 1 ZVI PLHFORMED BY: 72-008 (7!76) WAS GROUND WATER�, S ENCOUNTERED? �-�.� L P IF YES, AT WHAT% E DEPTH? PERCOLATION RATE _ _ __ _,Iminutes/inchi TE_Sl RUN BETWEEN FT AND --- FT ,le -_, CERTIFIFDRr: ae� �� r P �• : ��—� t l G 1 C, MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 020-511-07 ANCHORAGE Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 7 ` z -1 —?/ Complete legal description RABBIT CREEK VIEW & HEIGHTS BLK 1 H LT 6A Location (site address) 15801 ALTA CT ANCH AK Current property owner(s) CHRISTIANDE SCHWEINITZ Day phone Mailing address 2107 W 44TH COURT #A ANCH AK Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55 Date of Payment y 27 02 i Receipt Number 02 7 % COSA # 05c.?, 1 1 2 01 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 4-25-21 49rNf"'`E 6. DSD SIGNATURE /••... •.•�:.`• •s'r f System #1 Approved for 3 bedrooms 9 MICHAEL N. ANDERSCN % System #2 Approved for bedrooms �� < =�•.• CE 94 ••; av;; Disapproved �@ `yt� .y�t2 pp��PSai�l�r`�-m �e Conditional approval for bedrooms, with the following stipulaiflPorprfff�s--vim"' ��V rtSERNJ\`-,4 By: Original Certificate Date: 2 q – Z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet OF�i�i ON-S1TF WATER AND m �_ WAST _v O— —PR,rLrk Anfi ��V rtSERNJ\`-,4 By: Original Certificate Date: 2 q – Z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet • Legal Description: RABBIT CREEK VIEW & HEIGHTS BLK 1H LT 6A Parcel ID: 020-511-07 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled *UN Total depth 127 ft Cased to UN ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12°+ in. Date of flow test for COSA 4/7121 Static water level at beginning of test 19 ft. Comments * HOUSE BUILT 1970'S B. TANK DATA Age of tank(s) $ years Tank type/material 5EPTIL:5TEE Measured operating fluid level in septic tank 48 FOR Standpipes/foundation cleanout per record drawing Date of pumping NOT USED SINCE TANK REPLACED D. ABSORPTION FIELD DATA Which system tested (date installed) 12/2177 ❑ ALL standpipes present per record drawing Total measured depth from grade 4.5 ft (max) Measured depth to pipe invert from grade 0.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 2000+ gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ON Coliform bacteria is Negative Nitrate 2.86 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L FOR Arsenic less than MRL (ND) Collected by MNA Date of Sample 4/7/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 4/7/21 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 600+ gal New depth 0 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 7 Yes if No ft Absorption Field on Lot > 100'✓Q Yes if No ft Holding Tank > 100' El Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment? 50' F/I Yes if No ft ✓/ Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ED Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' QQ Yes if No ft Water Service Line > 10' M✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' M Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' ❑✓ Yes if No Water Service Line > 10' M✓ Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ®�`�: 4971 =?•• MICHAEL N. ANDLRSCN :-�z -7r ft ft N Lot 7A �(5 N89°26'06"E 227.53 — — — — — — — — 10' T & E Easement (Book 670, pg 742) \ 10' Utility Easement teck l Septic vent (typ) / 40p Co P1, `Story ° ° ° ° / 00,87e ry / 8 0 Window well Lot 6A / dk 4- � Note: Driveway location is approximate due to snow and ice. SCALE: V= 40' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON UNLESS OTHERWISE NOTED. L=44.99 R=50.00 FB 20-7, pg 35-36 8493M N� c9 cbh Lot 5A Aftr AM 49th00, 0� JO Z 00 0 izabeth L. Walatka ; 1:00 // �srF • 8036 - LS �p AW amp o—RoFZsslor4N-•0® AS -BUILT NO CORNERS SET THIS DATE I hereby certify that 1 have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: LOT 6A, BLOCK 1 H, RABBIT CREEK VIEW & RABBIT CREEK HEIGHTS SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 10th day of December , 2020. FRED WALATKA & ASSOCIATES, L.L.C. BE 1 907-248-1666 Engineers and Surveyors This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICE $_ Division of Environmental Services On -Site Services Section P.O. Sox 196650 Anchorage, Alaska 99519-6650 r h 343-4744 d CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING l �q Parcel I.D. # ✓� / J HAA # — 1. GENERAL INFORMATION Complete legal description Lot 6; Stock 1; Rabbit Cn.eek Hei.gha Subdivision Location (site address or directions) 15801 At& Count Anchonage, AK Property owner -JM,(ko Laclzaxt Day phone 345-9581 Mailing address 15801 Atta. Count Anchonage, AK 99516 Lending agency — Mailing address— Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water Day phone Day phone NOTE: if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank . _- Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. - 72-025 (Rev. 1/81) Front MOA #21 - - - 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this ' pection. Name of Firm Phone ' 9 Z1?79 Address 5 & 5 ENGINEERING Ea;�ie driver Loop Ra Engineer's sigr�lu•vur Date 6. DHHS SIGNATURE Approved for Disapproved. — bedrooms. S: VJrp .� V.O.♦ Y !o(lort A. 5hmfvv • aj" + No. 1467.2 .,• c Conditional approval for 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-M (Rev. 1/81) Back MOA 021 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo BLOc. l 6 1E�l< Parcel I.D. A. Well Data Well type IZ (A 2 ,If A, B, or C, attach ADEC letter. ADEC water system number 4A — Log (Y No �LO Date completed UK Driller L1K present �i? -y — to � Casing height Total depth - —1 P --Cased __ protected A) --- Sanitary seal&N) J _Wires properly * M6 UYCDW 1T-Jq FROM WELL LOG AT INSPECTION Fn : z` 106, AU141LI�td6e n Date of test _ �Uv y. Static water level-- rn C) Well flow m. 4,Z —_g.p.m" —g.p.�� cd Pump levels _— —_� it r9 �� irk > C SEPARATION DISTANCES FROM WELL TO: Fn c: o M Septic/helding-tank on lot ; On adjacent lots `LID �L— Absorption field on lot ---L�� ; On adjacent lots — (2) -) �f Public sewer main 2� Public sewer manhole/cleanout/ Cw l-- Sewer service line -2 f Petroleum tank WATER SAMPLE RESULTS: Coliform qz � � Nitrate U , ['0 n�-�� , _Other bacteria Date of sample: (o I 14--. Collected by-- B. y— B. SEPTICIRGEDFNC TANK DATA Date installed 1 �Zf/ Tank size �Z�i G4 �- Compartments -- Cleanouts ((YJ,t�I)(L� --Foundation cleanout (YL6)) Z� _Depression (Yf)�_—_ High water alarm (Y,- �U Alarm tested (Y/N) �� Date of pumping/U Lzj 1-3 Pumper." Noiwe- SclulcL5 _ SEPARATION DISTANCES I -ROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots / 00 �� Foundation f To property line —_Absorption field S'� Water main/service line l 0 C) Surface water/drainage v — CONTINUED ON BACK PAGE 72-026 (3/93)' Front C. LIFT STATION NO6 S Date installed Size in gallons Vent(Y/N) High water alarm level Meets MOA electrical "Pump on" SEPARATION,D STANCE FROM LIFT STATION TO: On adjacent lots D. ABSORPTION FIELD DATA Manufacturer (Y/N) "Pump off" Level at Cycles tested Surface water Date installed Z Soil rating (GPD/Ft2) 1 System type _ T9LZ_ GR Length (d 7 Width Gravel thickness O, S Total depth Total absorption area 3 2 Cleanout presen6N) Depression over field (Y/ lM _u Date of adequacy test Result pass/ il)- for Bedrooms Water level in absorption field before test —e After test C) Peroxide treatment (past 12 months) (Y/N) A h, IJ (f Q6­31�j If yes, give date �/ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 10D /�,. On adjacent lots To building foundation Property line Z(� To existing or abandoned system on lot_ A)ot--jL On adjacent lots Cutbank_M9 , K )f1L—rE1J % Water main/service line- /U Ir -- Surface water �Ol> 17'�- Driveway, parking/vehicle storage area Curtain drain KN�cJ,J E. ENGINEER'S CERTIFICATION I certify that/ have checked, verified, or Signature _-,0. =[Eagle ho N;204 Na1EagDate e D O HAA Fee $ o.! DD Date of Payment .9-e9_7717-- 9 - e9 -7`— Receipt Number C) 72-026 (3/93)' Back Waiver Fee $ Date of Payment _ Receipt Number— pf this inspection. i swcE �eoa CT&E Ref.# Client Sample ID Matrix CI ient Name Ordered By Project Name Project# PWSID Commercial Testing & Engineering Co. Environmental Laboratory Services LABORATORY ANALYSIS REPORT 94.4193-3 LOT 6 BLOCK 1 RABBI"C CIu:EK I iEIGI iPS S/D WATER S & S ENGINEERING R. SIIAFER UA WORK Order 81415 Printed Date 08/18/94 @ 15:32 firs. Collected Date 08/16/94 @09:40 firs. Received Date 08/16/94 @ 12:00 hrs. Technical Director STEPHEN C. EDE Released By.�,,;_� �� L Sample Remarks: iwur NF, SAMPLE COLLECTED BY: SS. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init Nitrate -N 0.10 U mg/L EPA 353.2/300.0 10 * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA=Not Analyzed U = Undetected, Reported value is the practical quantification limit. I'F= Less'Ihan D = Secondary dilution. GT= Greater Than 5633 B Street, Anchorage, AK 99518-1600 — Tel: (907) 562-2343 Fax: (907) 561-5301 08/17/94 DJS ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA MUNICIPALITY OF ANCHORAGE • Y Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES M},i 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING OHO Oil— U� HAA# r,0J��L-0.. n; Parcel I.D. # eN\7iF.k_NanENTALSCRVK;6:3'JIVISION 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 6; Btock 1; Rabbit Cneek He%gh,t,� Subdivi6ion; Location (address or directions) 15801 Atta Count enn Quinn/Judith Hant Tele 345-2357 Business 552-2024 (b) Property owner Ky 2 phone : (home) — Mailing Address (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent PPH/HUMQUITy Attn: Lorena Oeonnio Address 1855 Gatewau Blvd Suite #950 Concord Ca2i�. 94520 Telephone ( 415) 246-"6563 (e) Mail the HAA to the following address: (or check here if hold for pick up.) List contact person and day phone number below: 5 & S ENGINEERING o. anio River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family ax Number of bedrooms 3. WATER SUPPLY Individual Well Kk. Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site TR Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 7M25 (Rev. 7788) Page 1 of 2 5. 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. Name of Firm P J -N {�jlit Ll'.:J!" U/ Address, >R,„r; Nn ntm ,iJ sGi� Date Eagle River, Alaska 99577 6. DHHS APPROVAL Telephone /- " 4,�' ? - t (J �3 , 4 eer's'Seal" Approved for 5 bedrooms by JQ 4NJ T} -r Date Approved __—Disapproved Conditional Terms of Conditional Approval I'- • I I CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 LNVIK; . NMLNI AL ;)LRVII,n tAVIJtUIN MUNICIPALITY OF ANCHORAGE (MOA)� �L`' ,D -IJ i �1 1990 Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1954 t I? t' i r 343-4744 ``� L Legal Description: �-�� IOC'// �Ja/* Ats A. WELL DATA Well Classification 1NCt _t!e / (A nn1/ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) —6—Date Completed U(�1 Yield N\ Total Depth U_Cased to 40't Depth of Grouting — � -q d Static Water Level II / Pump Set At Casing Height Above Ground i f _ Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) /J SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot — ( r ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot / Do 7 ; On Adjoining Lots / 0 o To Nearest Public Sewer Line — To Nearest Public Sewer Cleanout/Manhole k) Y+ r To Nearest Sewer Service Line on Lot 2-_s— - — Water Sample Collected by A) Date -Z' Water Sample Test Results _ <:3i4 I /S 16C- I Of t4 — Comments B. SEPTIC/HOLDING TANK DATA Date Installed 2-2- 7 Size �,>_ 50 No. of Compartments Standpipes (Y/N) __ Ll Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) fIVI) Date Last Pumped ? - / Z - "( D Pumping/Maintenance Contact on File (Y/N) ti/IA ; for Holding Tank High -Water Alarm (Y/N)—Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTI HOLDING TANK: To Water -Supply Well 9� �=� To Building Foundation To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata O O �� r� Type of System Design TzcNC, Date Installed ( — — Length of Field ( O -7 a /-ro rra� Width of Field (n Depth of Field Gravel Bed Thickness O Square Feet of Absortion Area D 7. Statndpipes Present (Y/N) Depression over Field (Y/N) A/ Date of Last Adequacy Test Results of Last Adequacy Test k� eiroo SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well c / f To Property Line (� f To Building Foundation ( CD t To Existing or Abandoned System on r Lot N It1 ; On Adjoining Lots a O 4 To Water Main/Service Line10 utbk (if present) /t/ To Stream, Pond, Lake, or Major Drainage Course r To Driveway, P rking Area, or Vehicle Storage Area O f Comments* i V� (� pq� tr � �� a (�� 1���✓�t r� L4� CSD Nl --ti -h-s D. LIFT STATION M'T I p�lY�b1� � f*ff(�X, 7�c� �—g LSF is n, Date Installed W� Dimensions �. Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) 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 checked, verified, or conformed to all MOA and HAA guidelines in effect gr da ate of this inspection. !!U i fie �M� t, Signed r{ ; aJEaNt?tiF<Ei',C> 77034 «j(� Lots "I'd No. 2614. p y Com an Eagle u U1, Engine Seal; Date 12— MOA LMOA No, k Receipt No. �19 Receipt No. Date of Payment Amount: $ Waiver Fee: $ Date of Payment 72-026 (Bev. 7/88) Back Page 2 of 2 ALANDRAYOR198 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order It 30722 Date Report Printed: DEC 13 90 @ 09:54 Client Sample ID:L6 B1 RABBIT CREEK HTS Client Name S & S ENGINEERING PWSID :UA Client Acct SNSENGP Collected DEC 10 90 @ 12.:30 hrs. P.O.It NONE RECEIVED Received DEC 11 90 @ 14:35 hrs. Req It Preserved with :AS REQUIRED Ordered By : R. SHAFER Analysis Completed :DEC 12 90 Send Reports to: Laboratory Supervisor :STEP E C. EDEA 1)S & S ENGINEERING Released By —�e� /�j�� lI� Special Instruct: Chemlab Ref It: 905194 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Units Method Limits ---------------------------------------------------------------------------------------- IIITRATE-N ND(0.10) mg/l EPA 353.2 10 Sample ROUTINE SAMPLE. Remarks: 1 TestsPerformed= See Special Instructions Above UA=Unavailable ND= None Detected See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Greater Than it PROJECT: 17034 Eagle River Loop Road ROBERT A. SHAFER Eagle River, Alaska 99577 CIVIL ENGINEER 694-2979 DATE OF TEST: / Z - / _2'D LOCATION OF WELL (Legal Description): n ,, k -- WELL DEPTH:. --WELLDEPTH:.FT. CASING:_ !!!S(D i •FT. SCREEN: DATE DRILLING COMPLETED:., V DRILLER: STATIC WATER LEVEL (Top of Casing): / FT. DATE: CLOCK ELAPSED TIME SINCE TIME PUMPINGSTARTED/MIN. STOPPED, MIN. DEPTH TO WATER, FT. DRAWDOWN/ RECOVERY PUMPING RATE,GPM REMARKS 0 Owl) p 0 Start 1 _ Lo 5 .2-5-10 - `� 15 —�-- 20 — D 25 — —� --- 30 0 35 — _ 40-- - pO -- --45 �� v a� 50 j 55 r 60(1 hour) ,- --- go —� 120 (2 hours) _q 150--- 14 I 180 (3 hours) r 45 210 - -- 240 (4 hours) -- RECOVERY �v t 0 0 5 — _ 10 — 15 20 �- o� 25 _r — 30 -- 35 --- Comments:mel ` I IVry I• "ww V�/YI YIIIt�tlM �r o d uc e s g IN t fJ I m L)Pv� Of � �¢ � �� Subsequent Variations aver L4 KDL-)V- P(fCjOG( Can Occur. A./ a9fyz /E. ZDE. // Ke6r-)(-22,6.i/ T© v �ec�• rn 1F A1.1('1.1(1PA v �J(e�A, DEPT. OF H' ALTH & IN 4 ENVIRONMENTAL Fi;OTECTION - MUNICIPALITY OF AN �.� DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTECTION Alaska 99501 825 L Street • Anchorago, n f I �� 03 6 O�AU ff< ` ENVLRONM80 � ENTAL ENGINEERING DIVISION RECEIVED Telephone 264.4720 R E. C E I V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. �� ----'--)E"E� "'--"— B. TYPE OF RESIpENCE -PHONE 1. PROPERTY OWNER 276--5100 AK USA FEDERAL CREDIT UNION In SINGLE FAMILY _ MAILING ADDRESS POUCH 6613, Anchorage, Alaska , PROPERTY RESIDENT (If different from above) PHONE 7. WATER SUPPLY 0 INDIVIDUAL* PHONE :.BUYER _ 694-4099 Kerry Quinn Hart and ]daisy S. Tang depth (attach log if available.) MAILING ADDRESS -- SRA Box 196H _ --- - PHONE 3. LENDING INSTITUTION AK USA FEDERAL CREDIT UNION 264-2840 MAILING ADDRESS Pouch 6613, Anchorage, Alaska 99502_ PHONE 4. REALTOR/AGENT NONE MAILING ADDRESS -- 5. LEGAL DESCRIPTIO11 Lot 6, Block 1 RABBIT CREEK HEIGHTS STREET LOCATION ^SUB. NHN Alta Court, Anchorage, Ak 99507 ----'--)E"E� "'--"— B. TYPE OF RESIpENCE — NUMBER OF BEDR00MS ❑ One ❑ Four ❑ Other— In SINGLE FAMILY ® Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY 0 INDIVIDUAL* * ATTACIVAVEL L LOG. A well lou is required for all walls drillud ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) � B. SEWAGE DISPOSAL SYSTEM � . **If individual/on-site, give installation date_Jq-VZ C� INDIVIDUAL/ON-SITE" If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department, NOTE: THE INSPECTION EEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DAl'E RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER of BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY ❑ PUBLIC UTILITY DATE DRILLED ' Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUALJON -SITE ❑PUBLIC UTILITY Connection Verified DATE INSTALLED l'�^ INSTALLER --- ❑Septic Tank or ❑Holding Tank Size: _ \� ��— If Tank is homemade- give dimensions: -- SOILS RATING TYPE OFTANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL (\�) 4. DISTANCES _WELL_T_O: AUsorption Area to nearest Lot Line Septic%Holding Tank AGsorp on Area Sewer Line Nearest Lot Line cs���z� - - — — G. COMMENTS L-'2' APPROVED FOR �--_ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED LEGAL DESCRIPTION- -------- ----------------------- — 72.010 (Rev- 37781���-������"— JSP FF hP: r7'- OF4 ;. ALASKA U (C((r bERAL CREDIT UNION Q 'rr f/UNICOF ( Alto TION DEPT. p„3iEC _ ONIJ�EI`(TA 777 JUNEAU STREET CN\j(R (� POUCH 661 3 N C H O R A G E ALASKA 9 9 5 0 2 � V 9 0 7) 2 7 6- 5 1 0 0 (' 2 O H iT v� August 4, 1980 RE: Lot 6, BLk 1 Rabbitt Creek Hgts. Gentlemen: Attached please find a request for approval of individual Water and Sewer Facility located on the above listed property. Please be advised that unsuccessful attempts have been tried in locating the Original Well Driller and that I have been advised to send it through without the Well Log. Sincerely, Barbara Basham Mortgage Loan Specialist Telephone# 264-2840 LAO.'. S I E t 826 „L„ SI HL [I ANCHOliAGE, ALASKA 99�A01 (907) 264 4111 C (li61- M. SULLIVAN, iM A'r OR W P,J I,AI N i (:r sir -AI ru AN1) FNVIiiON I F N I A L P1�OTecn0N August 8, 1980 _r"r`O co\" Alaska U.S.A. Federal Credit Union — Pouch 6-613 Anchorage, Alaska 9951-0 Subject: Lot 6 Block 1 Rabbit Creek Heights Subdivision Buyer: Kerry Quin Bart/Daisy S. Tang Approval for the individual sewer and water facilities can not be granted until the following items have been completed: (1.) The water analysis report be delivered to this A department from Chem Lab, 5633 B Street, for j our review. (2) The septic tank pumped with a receipt submitted to this department. \( (3) Expose the well for our inspection to determine proper construction, also to insure the minimum distance requirements are met between your well and sewer system. If there are any further questions, please call this department at 2644720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw August 11, 1980 ALASKA USA FEDERAL CREDIT UNION Department of Health and Environmental Protection 825 L St. Anchorage, Alaska 99501 Atten: Bob Pratt Dear Mr.. Pratt: 7 7 J U N E A U STREET P O U C H 6 6 1 3 ANCHORAGE, ALASKA 9 9 5 0 2 9 0 7) 2 7 6- 5 1 0 0 ppUNICIPAIIiY CF i+NCHCRAGE vEPi. OF CiION EN\1120Ni..gLNiAi. r> RE: Lot 6, BLk 1 Rabbit Creek heights Please be advised that the above listed property was built in 1977, however no one has occupied this structure. Sincerely, Barbara Basham Mortgage Loan Specialist