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Home My WebLink AboutRABBIT CREEK VIEW & HEIGHTS BLK 11H LT 16A Municipality of Anchorage page \ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: Phone: o. o cms: LEGAL DESCRIPTION Lot: Township: WEt. L: Cleon (Private, A,B,C): From Well Surface Water GPM Line Foundation Curtain Drain Range: ISect'o :' [] New [] Upgrade i Total Depth: FI. iCased To: Ft. Date Drilled: Static Water Level: I Ft. Pump Set at:Ft. Casing freight Above Ground:Ft. Remarks: Septic Absorption Ta/lk Field SEPARATION DISTANCES Sewer Lines PID Number: Wastewater System: [] New /~Upgrade ABSORPTION FIELD [] Deep"'f<,~nch [] Shallow Trench [] Bed [] Mound [] Other Soil Rating: ~ Total Depth from original grade: i~S_q. Ft. [ , . Depth to pipe botlom from original grade.~'~ Gravel depth beneath pipe Fill added above original grade: Gravel depth: Total absorption area: Ft. Ft. Ft. SQ. Ft. Gravel le n~.k~ Number of lines: Distanc~ween lines: Ft._ TANK [] Septic ..,~¢...~ oldi n g [] S.T.E.P. , ~ , ICapacity in gallons: LIFT STATION Size I n ~e.~.~....~ "Pump on" level at; Pump Make & Model J "Pump off" level at: ~ at: IEleclrical Inspections performed by: ...... BENCH MARK Location and Description: S & S ENelNEEP. ING ~ Inspections performed by: .-. u : Eagle River, Alaska 9957~ 2nd Department of Health e~d Human Servi~ approval Reviewed and approved by: ~~~~~~Date: 72-013 (1/91) MOA 25 Permit No. ~\~'~:~ ~ Page ~2_..~ 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 72-013 A (2/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920148 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:FEDERAL NATIONAL OWNER ADDRESS:17015 NICKLEEN ST ANCHORAGE, ALASKA 995116 DATE ISSUED: 6/23/92 EXPIRATION DATE: 6/23/93 PARCEL ID:02011162 LEGAL DESCRIPTION: RABBIT CREEK HEIGHTS BLK 11 L T 16 LOT SIZE: 25422 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE C CTION OF: HOLDING 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ( i ssu D D DATE: I"=$0' SCALE / ! JUPGRAD~ J June 12, 1992 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-121t HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Marlene G~ils VISTA REAl. ESTATE, INC. BETTER HOMES & GARDENS 621 W~t Dimond Blvd. Anchorage,, Alaska 99515 REFERENCE: Lot 16; Block 11; Rabbit Creek H~ight~; Dear Ms. G~ils, At your request we performed soils t~sting and a site assessment on the referenced property for purposes of upgrading the on-site septic system. AS can be seen from the attached site plan there are ,t~o protective we~l radii which l~its the space available on the property for a septic upgrade. A test hole was e~cavated in the only area available outside the we~ radii. Within this test hole we found a thick organic cover over fair soils with groundwater at approximately 6 ft. below the surface. (SEE LOG ATTACHED). A preliminary sizing design for a n¢~ l~achfield to serve, the 4 bedroom home on the property was developed. Due to high groundwater, shallow 5 ft. wide drainfields were, anticipated. Unfortunately, to fit the. required size of absorption area on the property, the neighbor's we~l wou~d need to be encroached by nearly 50 ft. Considering the, high groundwater levels and reasonably shallow wells in the area, this encroachment is considered to be too extreme to waive. Therefore,, we recommend the installation of holding tanks for wastewater disposal on this property. The required size of a wast~water holding tank is 2500 gallo~ for a 4 bedroom house. However, I believe you are aware of the poor accessibility of this property for a septic pumping ~ruck during the winter. Therefore, we recommend the installation of two - 3000 gallon holding tanks to serve the property during p~ods when the property cannot be accessed by a pumping truck. Each tank would have an alarm alerting the property owner to when the tan~ is nearly fu~. Attached is a site plan for the proposed holding tank installation as required for a permit from the Municipality of Anchorage (MOA) Depar~ent of Health & Human Services (DHHS). Upon your request, we will apply for this permit. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 16; Block 11; Rabbit Creek Heights June 12, 1992 Another option for this property is to relocate the neighboring well to allow room for a septic upgrade. At this point we have not fully investigated this option nor consulted with the n~ighbor to determine feasibility. If you have any questions or if we may be of further s~rvice, please contact us. Sincerely, R3S/gm CIYII,& I.;NYI~ONM~NTAI, EN¢ilNF, i,;RIhG · I,:NlO:t(;¥ CON,'dI':IW^YION & IitEODORL; I,', MOORE, P,E, PIt: (90T) 345-1355 Apdt 1~3, 1992 14530 I i/llll liT, AN¢ItORAi] E, ALAS }{A 00516 Bet~r t-[ome:~ Md O~dqms Real Estate 621 Wes: Dimond Blvd. Anchorage. AK 99515 D~ar Ms Gcil$: Pet' your ~equeg wo have conducted an extensive laves[igc, rich of [M adequacy of ~o water supply and De.p~mn~ut files tadkat~ ea~ it wa~ probably drilled ~ 1977 md h~ ~ to~ del)fit, of I~ f~[ On March drinking wat~:r re,gulanon~, As you reque~te{ on A.pr~ '7 - 9 rye cWorlnated and flushed ~e well the top of d'~e c~smg, w~: meam~ tl~, well )'[~ld over ,~tee r~o~y ired drawdow~ c. ycle~. B~ed meet municip~ ¢ritefla for ~.pprov~ of a ~ingle ltmtly inst~le~ ~a 1975 consis~d 0f a i250 g~on ae,~l ~ep~c [ap~ to,owed by ~ seepage pi[~ith two 19'8'4 and was replacM wi~h a 5' wide x 67' long soil abs0~lon dt~.tu~ield {:oxltai~ng 2.5' of ~avel tepl~cemea d~'~.nfield, whloh would haw agowed us both t0 detenn~e t[~c locaion of ~c ~field with respect to d~e prope~y lln, and also to monitor actual fluid bvels in th~ ~ahfl.eld as we added wate~ system. To ~s[ d~e adequacy of fl~ system in ~2 absence of ~is monitor tu~, w, co~ld only add wat~t lug, me could tt~en measure Iff, amom~t of wat~ n~essary to mfig It aft~ n fixed p~lod qf absoeuon. g~ton, ct wate,,to fi~ ~e aystem, so wo ~ged, wifl~ ~, pump track. W bring 2000. gfllons of w~ter absorption rat~ 0,~oug~ ~ds cleanou~ p~ of only 6 ga~ons m 86 minute,, 'l~is ab~o~on rat~ ~ Sln¢~rely, T~d l¥Ioora, P,t3, 4 ~..,~jp(-.,~,4D{- MUN,C,.^L,T¥O~ ANC.O.ACE &i ~::: -~~ D ~" ~ ~v,.o~T~ ~O~CT,O~ ' g , asia 99501 Telephone 264-4720 ~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ' ~NEW MAILING ADDRESS iLEGAL DESCRIPTION ~ __ DISTANCE TO: Wall //~. I Absorption area~ ~Dwelling ~ I ~)~i~PERMITNO' ~ M~.u~,u,.~ M~.,~ No.~co~,.~tm.,t~ Liq.~al~ in gallons Inside length Width Liquid depth /~D~' IF HOME,DE: ~ ~,~=.,C. TO: =.,, W/j ~.,,i.g *,.~,T,O. %..~0 ~ ~ Manufacturer ~ Material Liquid capacity in gallons ~] Well -' 'Foundation , Neares~ne PERMIT NO. NO. of linesI Length o,.e~c,] ',~o Total leng~, o'.~ines Treno~d~ " Gp ~- ((~:[~ inches a~ption ~ ~ ~ ~/op of til~ finisl~ grade ~ / Materiel benegth tile Length ' g~, Width ~ Depth ~ ~ ' PERMIT NO, ~ ~/~ ~ ~ ~Fype of crib Crib diamet Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: .j Class Depth Driller Distance to lot line PERMIT NO, -~ ~: DISTANCE TO: Building f tion Sewer line Septic tank Absorption area(s) __ o%~' ~ REMARKS ~ -- , ~o~ 72-013 (Rev. 3/78) MUI~tUIFALI I Y Uh ANCHU~ABP Departmer of Hea[Lth and Environment Protection 825 L Street, Anchorage, AK. 99501 264-4720 Location: P:one' .Nu~er: ~¢$', ~ /~' : ~ot Size: ~ Type of Soil ~sorption System Zs: Trench: Drainfield: //~Seepage Bed: Holding Tank: Maximum N~ber of Bedrooms: L~ ... Soil Rating (sq. ft/br) ~~¢ The Required Size of the Soil Absorption System Is: ~ . GRAVEL DEPTH _~ W~DTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet) .~ REeUIRED SEPTIC~PANK S~ZE = /~ GALLONS Pe~it applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. ~ ~ ~ T~O(2) INSPECTIONS ARE:.'REQU~RED '~' * ~ Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a cot~aunity sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other~requiremenbs may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9F* * * Z certify that: (1) i am f~Lmiliar with the requirements for on-site sewers and wells as se-(-, forth by the Municipality of Anchorage. (2) I will instal], the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence ~s remodeled to //Applicant include more t~at/3%bed,ro/oms. ENGINEERS, INC. 7125 OLD SEWARD HIGHWAY ANCHORAGE, ALASKA 99592 (907) 349.6591 SOIL LOG PERCOLATION TEST JOB NUMBER SOIL LOG ~PERCQLATION BEDROOMS PERFORMED FOR: P~. U U ])¢~.'~ ~"~ DATE PERFORMED _IS ~'~T~. ~4 SLOPE SITE PLAN 2 8 9 13-- 17 20l_ DEPTH (FEET) WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? W E ~I i/ ,%i I I I /I 1,/ 1 Gross Net Depth to ! Net Reading Date Time Time Water / Drop PERCOLATION RATE VIed~6 L (minutesliRch GREI .:R ANCHORAGE AREA BOR JGH ) Department of Environmental Quality ~ 3330 C Street Anchorage, Alaska 99503 INSPECTION REPOR'i' ON-SIIE SEWAGE DISPOSAL SYSTEM / SEPTIC TANK: DISTANCE NUMBER OF FROM WELL //,5 / MANUFACTURER ~'7/2 ('~ MATERIAL ~7 Z~ Z-Z COMPARTMENTS INSIDE LENGTH INSIDE WIDTH TILE DRAIN LIQUID DEPTH LIQUID CAPACITY_/¢'~t ~ GALLONS, DISTANCE FROM WELL /Cd' /¢' FOUNDATiON__L¢_i iv. NEAREST LOT LINE /(~ I~1 TOTAL LENGTH / _OF LINES ./~ NUMBER OF LINES ,2 DISTANCE BETWEEN LINES ABSORPTION AREA ~/ ~ Zt / /_~.~ ~'~_~" , SQ. FT. LENGTH OF EACH LINE ~2i::~'2~! ~,'/: 7/2~-¥~,1~/-t i /'2. ~ DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE '~/~ / MATERIAL BENEATH TILE TRENCH WIDTH '-~' IN. TOTAL EFFECTIVE ABOVE TILE /'/-' IN. WELL: TYPE :_ DEPTH _ . */_0~ /_ DISTANCE FROM: BUILDING L~ , / NEAREST FOUNDATION ~)~' LOT LINE NEAREST SEPTIC SEEPAGE SEWER LINE ~/¢ / ]} A~ ! , TANK SYSTEM /4¢t /'/' CESSPOOL APPROVED OTI4ER SOURCES DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: (¢/]&~ '~4.,/ /~.<. ~'~/2'~ , '7'2~¢/]*./~ ~ ~L~' LOT SLOPE: REMARKS: DATE APPROVED G.A.A.B. Form EQ-032 SEWAGE GRE, ER ANCHORAGE AREA BO; UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3;330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! IT NO.~ ' DISPOSAL SYSTEM ~ APPLICATION AND PERMIT /;)/i '/ NAME OF APPLICANT ~/¢~'~ f~'/ INSTALLATION LOCATION A/~/ ~,/~/:' <~/:~. LEGAL DESCRIPTION ~0 'F- / ~ INSTALLATION O~: SEPTIC TANK TYPe AND SIZE OF FACILITY TO BE SERVED ~INANCED THROUGH SOIL TEST RESULTS 2 2'~g/ SEEPAGE , DRAIN FIELD . TO BE INSTALLED BY · OTHER NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TI'-ST COMPLETION DATE ANTICIPATED ,_-~L¢'~'I 7']'" /~-:~Z"~S ~ / %LV/ ~_, FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF E~VIRONMENTAL QUALITY AUTHORIT~ WILL BE SUBJECT TO PROSECUTION, SEPTIC TANK SIZE ~ ~ ~ TYPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS POUNDAT[ON TO SEPTIC TANK FOUNDATION TO SEEPAGE ~ ., DRAIN FIELD SEPTIC TANK tO SEEPAGE PIT WALl SEPTIC TANK .,SEEPAGE ~ , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SERTIC TANK SEEPAGE ~ - DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK . SEEPAGE PIT DRAIN FIELD ~.' /~ / SEPTIC TANK, , SEEPAGE ~ , DRAIN FIELD TO RIVER. LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TaNK aND SEEPAGE PIt FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORm TO BOROUGH REGULATIONS RUGARDING INSTALLATION, DIAGRAM OF SYSTEM I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OP GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE ? ) ,?.. h DATE --- APPLICANT'S SIGNATURE /~ · R~bit O~g. Hts. with a very high wa~er con- 'tent. 'tim:re. w~-~s a moderate coarse sand co,tent with top- soil 2 G'IS NO Gm at 22~ sqft/bdrm Po~cco Aug 75 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAl. QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT 2/> '~ { /'.;//:X~..,,~.~ MA,LING ADDRESS':/:': /./ :;';:/ NAME Of A PPL'CANT 7 :;// c¢;],,~¢ :: ¢./ PERMIT NO, 2 I 7 1 PHONE,~'7 :) ' ?2:,;: [NSTALLATION LOCATION LEGAL DESCRIPTION ~C'¢ /~'¢' INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH ____ 7 COMPLETION DATE ANTICIPATED SEEPAGE PIT VALID WITHOUT FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOtJT FINAL INSPECTION BY THE: HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. ;?t;; ..... -,'. SEPTIC TANK SIZE /:({* BEEPAGE AREA S''E ~(:'/" /)~'/ TY'E *''-7'~:*:{-~ . DIAGRAM OF ~YS~M MINIMUM DISTANCE~., REQUIREMENTS FOUNDATION TO SEPTIC TANK ',~..~ SEPTIC TANK {'~ / TO NEAREST LOT LINE, WELL TO SEPTIC TANK DRAIN FIELD . DRAIN FIELD ,SEEPAGE PIT ~/- ') DRAIN FIELD :-2:' ' /: SEEPAGE PIT E/I/ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK -, SEEPAGE PIT DRAIN FIELD 5~;*' /::" SEPTIC TANK, . SEEPAGE PIT , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC 'rANI( AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SO.IL, ~4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM 'ro BORO//U~H ~EGULATIONS REGARDINg INSTALLATION. :.-;// /~- :/., HEALTH AUTHORITY or LICENSED DESIGNER I CERTIFY THAT I Am FAMiliar WITH THE REQUIREMENTS Of GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. . /,/ ./., .~ '" ~. ., , · . .. ~.,.t }~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# ~----J,"~ (~ 1. GENERAL. INFORMATION Complete legal description Lot 16; Block 11; Rabbit Creek Heights Subdivision Location (site address or directions) 1701~ N,/.e./~Q.~,n-q,t-~QJ'; AnchrJ~,~g~.; Property owner Fannie Mae Mailing address Day phone Lending agency Mailing address Day phone Agent Marlene Giels/VISTA REAL ESTATE Address Day phone 562-6464 Unless otherwise requested, HAA will be held for pickup. 4 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: XXX Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4, TYPE OI= WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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/orwastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverifythat 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 ail Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm $ & S ENGINEERING Address 17034 Ea.qle River Loop Road No. 204 Eagle River, Alaska 99577 Engineer's signature DHHS SIGNATURE ,.~"~,~ Approved for ~'~/-~?,"~?.) Disapproved. bedrooms. Phone Date Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ~,~///~_~ ~~'~////~' ~ _///'~ Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEAL'rH AUTHORITY APPROVAL CHECKLIST Legal Description: ~ tlc '¢~L..tZ . I / A. WELL DATA Well t yp e ~--~/A'I~· Log present (Y¢4~ h-J Total depth Sanitary seal. N) Date of test Static water level Well flow Parcel I.D. IfA, B, orC, attach ADEC letter. ADEC water system number Date completed t..)~_..- Driller Cased to ~c;:>~ J~ Casing height /'~ Wires properly protected~) Pump level FROM WELL LOG AT INSPECTION g.p.m. ~' ¢~ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank SEPARATION DISTANCES FROM WELL TO: ~ng t~n~)on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ~7 - / ~'~ .t ~ ~ Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed -7-"~- '¢1 '~. Cleanouts CC/N) High water alarm(J~N) Date of pumping Tank size Foundation cleanout~N) Compartments Depression (Y/~ Alarm tested ~:~N) y Pumper ~ SEPARATION DISTANCES FRO/vI~-~'EP-T-I:6/HOLDING TANK TO: Well(s) on lot '::~'¢f(t On adjacent lots_ To property line \ C;~ Absorption field Surface water/drainage r'~¢ I~ Foundation Water main/service line 72-026 (Rev. 7/91) From CONTINUED ON BACK PAGE C. LIFT STATION Date i~led Size in gal~ Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Manufacturer Manhole/Access (Y/N) ~el at "Pump off" level at C_.~ycles tested Surface water D. ABSORPTION FIELD DATA Date inst~ Length '"--..~ Width Total absorption area~'~ Depression over field (Y/N) Results (pass/fail) Soil rating Gravel thickness__ Cleanouts present (Y/N) Date of adequacy test Peroxide treatment (past 12 months) (Y/N) System type Total depth ~"'f'~ive date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot On adjacent lots To building foundation To existing or abandoned system on lot bedrooms On adjacent lots Cutbank Water main/service line Surface water Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature 17034 Ea~le River Loop Road No. ~04 Eagle Eiver, Alaska 99577 Engineer's Name HAA Fee $ / Z~) Date of Payment 72-026 (Rev. 3/91) aack MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL L4BORATORY 5633 BSTi~EET ANCHC)iiAGE AL &SKA 99618 TELE~'HONE(¢07~582234~ FAX:tg071861-5301 PWSID : UA Cull~ot~d JU~ iT ~2 { 13:00 hr~, R~cBlvsd · J~, 17 92 ( t4<tO BPO{ : PO{ :HONE RECEIVED HA- Not Analyzed tT~L~ss ~n, GT-G~atvr T~n ~ MUNICIPALITY OF ANCHORAGE } DIVISION OF ENVIRONMENTAL HEALTH DEPAR'ISIENT OF ~ALTH ~'~D E~IRONMENTAL PROTECTION APPLICATION FOR ~ALTH AUTHORITY APPROVAL CERTIFICATE 1. ~J}e_~_~t~gJ~_t~9~ Application Date ~_~2~i (a) Legal Description (include lot~ block, subdivision, section, to~ship, range) Ao~1. ~t~ ~oc~ ~/ ~.~'~:'~.~/:. /~o,~a~~ Location (address or directions) ~ ~? ~.- 9 .~'V (b) Applicants Name ~)~:~_:~L2t..,:~ ...... Telephone --' Home Business e) Applicants Applicant :is (check one) Lending Institution d) Lending Institution Telephone Address e) Real Estate Coo & Agent Address Telephone blaJ.1 the HAA to the following address: 2 Ty e of Residence Single-Family 1,~ Number of Bedrooms 3. Water Sup_p:lz~ Individual Well 0 t lmr ,(:!£5!r I~b e__)~ ................................. Note: If community r~m].l system, must have written confirmation from the State Department of Environmental Conse~ation attesting to the legaiity and status. 4o ~e~w~j}e_, Disposal Note: If community ~*e].l system, must have written confirraation from the State Department of Envirotm~enta]. Conservation attesting to the legality and status. [?age I of 2] _5. 6o Engineering Firm Providing Inspectionsz 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 obtaim~ from the ~nicipality of ~chorage files and from my investigation and inspection, the on-site water supply and/or waste~ater disposal system is in compliance ~W. th all Municipal and State codes, ordinances, and regula-- tions in effect on the date of this inspection. Name of Firr~_~.(~(l DHLt Approval ~'- Terms of gond;ttLonal Approval CAOTION 'THE MUNICIPALITY OF ANCHORAGE 1)EPARTMENT OF ItEALTtl AMD ENTIROb~dENTAb PROTECTION (t)HEP) ISSUES H~kI..TI! AUTHORITY ~PPROVAL CERTIFICATES BASED SOLELY UPON TIiE REPRESENT~ ATIONS GIVEN iN PARAGt~iPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN 'HiE STATE OF AI,ASKAo TbiE DHEP DOES Tills AS A COURTESY TO PURCHASERS OF HOMES AND THEIR IZNDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS~ E%IPLOYEES OF i')tIEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUE]). THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7M~ 9.-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AU%~ORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification Well Log P~esent Total Depth3[-~-- (~-... Cased to MUNICIPALITY OF ANCHORAGI~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION .RECEIVED Legal Description: .d~'/~/d II If A, B, or C, D.E.C. Approved(Y/N) Date Completed f~ Yield ~pth of Grouting ~i~ Static Water Level ~, ~ Pump Set At Casing Height Above Ground 2, ~' Sanitary Seal on Casing ~N) Electrical Wiring in Conduit ~) ~p~ession ~ound ~l~ead ~_~ Sep~aticn Distan~s fr~ ~11: (~. / TO ~ptic/H~l~g~ on ~t ~ .J ( ~ ~ ~ ~joining Lots~r/~d/ To ~a~est ~ge of ~sorption Field on Lot U~,~ ; To Nearest Public Sewer Line ~-J C leancut/Manhole_ Water Sample Collected By ~ (~o~% ~ a',O Water Sample Test Resuits To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date ! I ~e_K) -F B. SEPTIC/HOLDING TANK DATA Date Installed ,~L~-/,jQ,,~ Size _~6~ NO. of C~a~.tmsnts Standpipes ~) cj~> Air-tight Caps (Y~) Foundation Cleanout (Y~) ~p~ession o~ Ta~ ~ Date ~st Pu~d O~-, ~/. /~ Pu~ing~aintenan~ Con,act on File (Y~) ~- ; for Holding Tank High-Wat~ Ala~ ~Y~) ~J Te~ra~y Holdi~ Tank Permit (Y~) Separation Distends fr~ ~ptic~olding Tank: ( To Water-Supply Well ~ Jig To Property Line ~-q' To Water~ Main/Service Line ~.)~ COurse C~]' / c~ o ~ f To Building Foundation ~. ~ To Disposal Field k o ( To Stream, Pond, Lake, or Major Drainag~ Comments.: Receipt $ Date Paid: Amount: [Pag~ 1 of 2] 2-15-84 Co ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ ~l~t_ Width of Field ~ ~M{L Square Feet of Absorption A~ea Depression over Field~/N) ~ Da~e of ~st A~quao/ Test Results of ~st Ade~a~ ~st .... Separation Distan~ from ~sorption Field: To Water-Supply ~11 [~' To ~o~rty Li~ ~I To Building Foundation __. ll.~ Lot A/~ . ; On Adjoining ~ts To Water Main/~rvi~ Line To Stre~ond~ke/o~ Majo~ ~ainage Co~se To ~iveway, Parking ~ea, or Vehicle Stora~ ~ea Co~nts.,..~- , 15~9~v~ ~-~Le~D __ Type of System Design ___~_~, -[ __ Length of Field ~ D~.pth of Field ~ Gravel Bed Thickness __ Standpipes L~,esent D. LIFT STATION Date Installed Size .in Gallons "Pump O~." Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dime ns ions ~ Manhole/Access (Y/N) "Pump Off" Level at ~u,~r Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Conments ** Check Permitted Bedroom Rating Against HAA Request' ** I certify that I have checked, verified, or ~nfor~ved to all MOA HAA Guidelines in effect on the date of this inspection. Signed ,~ ~~. Date Company .. ~-~C.~ MOA No. KB1/d5/s [Page 2 of 2] 2-15-84 ENG INC. 7125 OLD SEWARD HIGHWAY · ANCHORAGE, ALASKA 99502 October 5, i9g# Mr. Bandt Department of Health and Environmental Protection 825 L Street, #th Floor Anchorage, AK 99~01 RE: Lot 16 Block 11 Rabbit Creek Heights Subdivision Dear Mr. Bandt: 3ob ##0512 MUNICIPALi,i¥ OF ANCHORAQ~ DEPT. OF HEAL ENVIRoNMr:,,.' TH & ~:~'~IAL PROTECTION RECEIVED This letter is in regards to a septic system upgrade completed September 28, 198# on the property referenced above. The two required inspections were performed during a rainy period, September 20-28, 198#. There was no apparent excess surface water flow at this si'te. No groundwater was encountered. Proper surface grading.L~be in_~pected .... - ' '-'-~ '- - after completzon, wall d~vert any s~r--face drainage from tMs sy_st~e m - - ~ - If you have any questions, please do not hesitate to contact me at 3~9-6561. Sincerely, Mary B. Bannister Engineering Geologist MBB#//djh WASILLA ANCHORAGE SOLDOTNA (907) 376-3770 (907) 349.6561 (907) 262-9534 ALASKA enulRonmenTAL CONTROL $ RUICeS, Inc. ~nqin¢~rin§ $ ~nuironmenlal Studies PAUL AND RUTH DAVIS 17015 NICKLEEN STREET ANCHORAGE Al( SELLER - LEE CARLSON/REIV~X BUYER - 5UBDIVISZON - RABB.'[T CREEK HEIGHTS BLOCK - 11 LOT - 16 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTZON SYSTEM ZS A PZT WZTH AN UNKNOWN AREA. THE SYSTEM TZS CAPABLE OF ACCEPT£NG 100 GALLONS OF WATER PER DAY, THE SURGE CAPACZTY OF THE SYSTEM ZS 24 GALLONS, BASED UPON THE TEST DATA THE SYSTEiVl .[S NOT ACCEPTABLE [:OR A HOt',tE OF 4 BEDROONS, THE SEPTZC TANK WAS PUivPED ON OCTOBER 4 1984 , FLOW TEST ON WELL THE WELL FLOW RATE WAS J.58 GPIvi FOR J HOURS. SEPT.'lC TANK ADEI~UACY THE EXZSTZNG 5EPTZC TANK VOLUIvE OF 1500 ZS ADEQUATE FOR THZ~., 4 BEDR001vl t-tOUSE. · 1200 I,U6sl 33rd Auenue, ~uil¢ [~, ~r~chora§e, Aloska 99503 ,(907) 561-5040 1. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-456k1..._ : . Date Received _ Time of Inspection Date of Inspection REQUEST FOR APPROVAl_ OF INDIVIDUAL SEWER & WATER FACILITIES FOR Approval requested by: Mailing Address: Property Owner: Phone: Phone: Type of facility to be 'inspected~-~__~-~x~:2, Well Data: A. Type No. of bedrooms C. Construction Sewage Disposal System: A. Installed B. Depth C. Septic Tank: 1. Size D. Bacterial Analysis B. Installer D Seepage Pit: 1. Absorption Area 2. Manufacturer E. Disposal Field: Total length of lines 2. Material 8. Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , Absorption area , Other contamination , Absorption area , Sewer Lines C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re ~st for Approval of Individual er & Water Facilities Legal Description ~/'~27zXJ ~/~/'/ ..x~/~/~×~z ~<~/~: /~,~_~/~//~-. Approved/~,.,~_ ~, /'<~-~.~,× IL- Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM : '/q~ ~t/~~ ,a/~¥~ I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) GREATER ANCttORAGE AREA BORO~Gtl. Department of Environlnental Quality 3330 "C" St., Anchorage, Alaska 99503 -. 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA FHA Mai.ling Address: Mai I ~ n9 Address: 4. Name of Lending Institution: Mailing Address: --./~ ~'~r3 ~ e~ ~- 5. Name. of Realtor or Agent: CONV ~2~ _ Day Phone Phone Phone 6. Legal Description: _~j-/- /g /~/~ // Location: %,'ce /~,97 ~e~/O N) 7. Type of Facility to be inspected: 8. Water Supply bio, Bdrms. Type of Supply: Public Utility ~ __ Individual If Individual, number of dwellings presently served If Individual, del)th of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) EQ-O37 (]/74) horeby certify Ihat I ho¥o ~urveyod the following do*crlbed properly, Lo~ "c<~ ~Lock._~l Jmprov~rn~nfl *l~alud lh~roon are within the propurl7 llno~ and do nor OvorJop or Oncro~ch on the prop~r~ lying adjacent Iheroto, ~hot no improvumonts on proper~ lying adjac~n? thor~to encr~ch on lh~ prumlto, In qu~Olon and that ~ero oro no roedwoy~, Iran~mi~ion lin~ or othor vl*ibb Oa~mon~ on ~id prop~r~ ~xcop~ a~ indica?od heroon, Anchoroge, AIo,ko