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Home My WebLink AboutPROSPECT HEIGHTS #1 BLK 5 LT 11Onsite File #015-091-41 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191442 PID Number: 015-091-41 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name GAYLE BJORN-ROLI ABSORPTION FIELD -EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 9451 BUDDY WERNER DR., ANCH., AK 99516 __T� ❑ Other Phone Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot PROSPECT HEIGHTS #1 5 11 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area z Number of trenches Dist. between trenches From Tank Field Tank Line Ft Ft. Well 100'+ __ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface water 100'+ __ Material HDPE Number of compartments 2 Lot Line 10'+ -- I NA Foundation 10'+ __ [LIFT STATION Manufacturer Capacity Gal. Remarks Existing septic tank decommissioned per code. Tank installed 5'+ to existing field & deck supports. Alarm location Electrical installed by Installer NORTHERN EXCAVATION PIPE MATERIAL House to tank 3034 d a n Tankto 3034 ld Dranfield 3034 CO/MT 3034 Inspector FWCS/ MNA BENCH MARK (Assumed elevation) 100 ft Inspdection ist 10/23/19 11/13/19 Location and description 2nd 3'd 4`h BOTTOM OF TRIM ON-SITE WATER AND WASTEWATER SECTION APPROVAL OF rt r Conditional Approval: Date `4 4 9TH Septic System p Y Approved - MICHAEL N. ANDERSON.' 04 ( ( Date 511 y � 0�Q No. CE 9468 / 12/10/19•' Note: this approval does not include well permit requirements. ��'ESSI011�' trcev uo/uu iuf PROSPECT HEIGHTS #1 BLOCK 5, LOT 11 PID: 015-091-41 PERMIT: OSP191442 A -C=35.8' B -C=11.7' A -D=40.3' B -D=16.9' A -E=44,4' B -E=22.5' A -F=43.7' B -F=26.4' A -G=42.7' B -G=26.6' SCALE 1' = 30 12299MMIN MIN"G SEPTIC SECTION GAYLE BJORN-ROLI PROSPECT HEIGHTS #1 BLOCK 5, LOT 11 9451 BUDDY WERNER DR., ANCH., AK 199516 Michael N. Anderson, P.E. DATE: 4661 Natrona Ave. DRAWN: Anchorage, Alaska 99516 (907)727 8864/FAX: (907)345 1391 SCALE: SCALE: NTS SUPPORTgSERVICES: Im OF AZ4 ®. *� TH 49- 12/10/2019 MICHAEL N. ANDERSON No. CE 9469 FWCS ��o 12/10/19Af 1 = 30' LOT 11LOT 9ALOT 12ASHEDN58° 11' 58"W 372.73'N58° 11' 58"W 362.78'N31° 48' 02"E 280.00' N33° 50' 00"E 280.18'30'30'BU D DY W ER NER D RIVE 157.1'158.1'115.5' 110.2'17.6'23.2'LOT 4BLOT 10LOT 5LOT 4ALOT 8ASHEDSHED (3) SEPTICSTAND PIPESSEPTICMANHOLE LID66.2' 92.1'HOUSESEE DETAILBARNSEE DETAIL6%GARAGESEE DETAIL (4) SEPTICSTAND PIPES65.0'98.8'45.9'166.9'104.5'26.3'26.5'44.1'5.2'13.7'10.0'3.0'8.0'19.4'24.6'8.6'10.2'23.8'24.4'28.4'SUNROOMEXISTINGHOUSEGARAGE28.4'24.3'5.1'24.4'37.0'24.4'13.7'24.3'GREENHOUSEBARNNOTE:THIS DRAWING SHALL NOT BE MODIFIED FORUSE AS A PLOT PLAN WITHOUT THE EXPRESSEDWRITTEN CONSENT OF LCG LANTECH.LOT 11, BLOCK 5,PROSPECT HEIGHTS ADD NO. 1AS-BUILTDRAWN DATE:DRAWN BY:SCALE:CHECKED BY:5/12/2020SCADS/SC1" = 60'PLAT:WORK ORDER: 2001767-23FB/PG: 817/15-17GRID: SW2441REF: 86L66ORDERED BY: GAYLE BJORN-ROLISURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THEPROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTSSITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXISTOTHER THAN NOTED.EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE EXISTENCEOF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DONOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCESSHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERTYLINES, OR FOR PLOT-PLAN PURPOSES.250 H StreetAnchorage, Alaska 99501Survey DepartmentPhone: 562-5291MainlinePhone: 243-8985AECC 668LEGALDESCRIPTION:BARN DETAIL1" = 20'HOUSE ANDGARAGE DETAIL1" = 20'PARCEL#: 0105-091-41-000 ADDRESS: 9451 BUDDY WERNER DRIVESEPTIC STANDPIPEWATER WELLFENCEAsphaltConcreteOverhangWood DeckLEGEND:GRAVELBOUNDARY LINE,LOT 13ROAD CENTERLINEADJACENT LOT 10/4/19 EPI RAIS MUNICIPALITY OF ANCHORAGE Development Services Department F" I Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-091-41 Property owner(s) GAYLE BJORN-ROLI Day phone 9073461512 Mailing address 9451 BUDDY WERNER DRIVE, ANCHORAGE, AK 99516 Site address 9451 BUDDY WERNER DRIVE, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) PROSPECT HEIGHTS #1 BLOCK 5, LOT 11 Legal description (Township, Range & Section) Lot Size 104,000 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo AD U) Septic Tank ® Upgrade ® Duplex (D) ElHolding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 01025 Waiver Fees: Date of Payment: 101910 Receipt Number:nn NAM 1) Permit No. (Jsp1 q NgP1 Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 / Fax 345 -1391 Support Services Brent M. Western 907-440-4601 September 28, 2019 On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: PROSPECT HEIGHTS #1 BLOCK 5, LOT 11 The owner has requested we proceed forward to obtain a septic permit to upgrade the aged septic tank on the subject lot. The proposed upgrade will serve the existing 4- bedroom house. The lot and area are served by private water. The proposed design will not impact any of the neighboring properties due to the lot layout. Please contact Brent M. Western or me if you have any questions. Sincerely, Michael N. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191442, Rebecca Carroll, 10/04/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191442, Rebecca Carroll, 10/04/19 7207 ~.All~Orlfl $,~. 99515 A~,'CHORAGE, ALASKA 844'??1,~_ SIX INCH WATER WELL DRILLED ........... -OUT TO THE DEPTH OF 415 ~r~te DRILLED AT THE RATE OF ~99_ 00 PER POOT. Chx~ ~o~ 380 ft or~. 9451 ~ ~ " - PROPERTY OWNER ~' & ~' (~ ~ ~) B~-~o~ S~ Box 2115C ~o~ LOCATION OF WELL SITE DRILLER Bc.q, tt,Le. ~ WELL LOG: 0 .... 17~ 17---43 ' 43---87~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION s,c~.~ ,~en~ ~zve, L. 407~ c,La~ ~~ Lttlt ~ 198g 87--108' ~ ~ 35~ ~e ~. 3ee~ ~ bo~. 108-415' B~ocL. fl ~~ ~o~ ~ ~ ~ ~ o~ w~ b~ ~. 345 ~o 369 ~ ohowo ~ ~~e ~ o~ 2 1/2 ~. ~. ~ 400 ft. Sulr~e2~,tb. te. pm~p muj. he .0'~~ aru~h.e,~e ~bzor~ 350 ft .to 380 fA...gl lump ~co 400 fto tao..~e~. 250 ,ge. et a,~ lred~oc.~. 108 ft. and m. oh.i_.bL3a.~ot wate.,z p.o..~ u.o . ~a~e2, ble. ZL pagd .0~ ~uAZ ,O¢ ~o ~ B~o~-ko~ 6/6/86 ~L 2~ ~ COST INCLUDES ALL LABOR AND MATERIAL FOR COMPL~ION OF SAID DRILLINg, WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF THANK YOU VERY MUCH. ~ ~ ~ ~.O1% BERNIE CLAUS OF RAMPART DRIL~LIhG WORKS =ERVIC£ CHARGEOF 1~% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNT=. L.E}"F ~ 1 J. IEd,_DCK ~ NF~NGE7 ~ :51/J :1. :l: atun {i:un:i. t J.~'aP ,,~ ¢. .I](4=. 'i'~C:l'...~:~. P~)m,'..:en't.E~ fc)r (:)rt.....~6:i.t.(::.) E~(,~v.~6m~ and ~z.~E-):L ]. ~ a~ ~Ee'~'.. f(:)r'Lh t3v 'i. hE~ l'fiLu"l :i.c:: J. pa]. :[t.v c){' ~lq (:: J'l c:) r, at~]¢.~ (vi[Ih) 27:, :l: 4J ] ] :" ) .,.] ......... and J n c:c)mp ! J. anc(:. ~4:l't.h ht'"e,~ 4 .... ~ .... :5, ]: ~,~:i.].]. a'~dt"i6:,r~, !'..c~ ~tJ.]. I"tQ~:>~ ~F~(::} ~BIL.;:cL.E:, c~f rq:[a~d.cat r~qL,~J, rEm~nt, s c3 ' "4 - ~:'v' ~':'"'":~':::'"'~'""' ~:":'::~ ~~:~2 -'- ' ........... ~'::~'""'""~':'~ ......... ..... ~* ' .0/.YTE7 0 ASO' 'j'V 1* I ` 5 116 lltl� Me rAIA11AAS MALL 2sm'$='r r—RAME NOLJS.E M N *B OZ o.ua.un nu, n m° urtnc G G sponslblllty to determine existence of any easements, covenants, or vrestrictions which do not apnder on Iha record:d sebdiel.!en plat. Under no clrcumstenccs shatA any data • Wean he used for : rmsto:pCon or I" establishing boundary of fence lines. ' MUNICIPALITY OF ANCHORAGE ~, ~) ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECt'ION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE .J~N EW MAII~G ADDRESS LEGAL DESCRIPTION LOCATION ~ NO. OF BEDROOMS Well Absorption area Dwelling PERMIT NO. ~ ~ Manufacturer Material No, of compartments Liq.~_~capacity in gallons IF HOME.DE: Inside length ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer ~--~ Material Liquid capacity in gallons ~ Well~ Foundation Nearest lot line PERMIT NO. --~Zm No. 0flines ~ Length of each line~ ~ Top of tile to finish ~rada ~ ~ Material beneath tile Tota, effect}ve absorption area Length ' Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ DISTANCE TO: Well Building foundation Nearest lot line ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER SOl L TEST RATING REMARKS , ,. I~ tion (address k'ILSON · WEll_ DRILI. h' G ANCHORAGE, ALASKA 99503 PHONE ~3 DRIM. INO LO0 ' Use of Well of: Town. ship, Range, Section, if known; or distance main road Size of casingt~_Ot~ Depth of Hole Static water le4el I~~ ft. (above) Screen ( ); Perforated ( fJet cased to ~ feet - land surface. Finish of well (cheek one) open end ( ~ ); Describe screen or perforation Well pumping test at !.~ gallons per (hour) (~ for Io hours with of drawdown from static level. - k~.O~.'-'. Date of completiov ~~I ~ t~ ~l~ C~ · ~ ~so ~, ~-~, ~~. WELL Depth in feet from ground surface TO_~ .TO TO TO TO .TO. .TO. .TO. .TO TO. Give details of formations penetrated, size of material, color and hardness '"',. '.': : ,. / ' ~ TO TO TO TO THE/ LENGTH L'.',:[ i"tEi',IS :1: ON 1' S THE LE/I',IGTI-! ( I N F'EET> OF:' THE TI;t.r.:[NC:H OR [:,1:;~:1:::1 ]: NF'.'[ EL.D. THE DEPTH Eft.:: I::i ':['RE'!',tE':H OR P t"i' :[S THE C, ISTFIi'-,!C[-~: E!~,~:'T'I.,.IEiEI'.,I TI..ilZ '.:.-:;I...It:~:i:::'F:i(:i:E ElF: THE: GF..'OLIt'.~!D I:::IND THE BO'I"TEq',t OF:' 1¥-I?_:: E',:.::CFt',,,~FfT"I20N (]:N FEET::,. 'I-t...II~:RE .IS .t,,tEl SET I4IDTI.-! FL-iF: TF~'.EI',ICHI~:S. THE L-iF;:Fr,,,'EL t::,EP"I"I.-I :[. :'5 THE: I"1.1:t,.,t :[ I"1L11',I DEPTH CIF:' Gt:~:FI'v'EL F3L::T!.,.IEIEt'.,I THE C)Lr'FFFiLL. F:':I: PE i::tND THE E:O"I"T'OFI OF' THE F::':;CFt!,,'I:::!'F.!:L')N ':::]:N FEET). ~F.:.: ~('_'-'::.~ .~._.~ :7[ F~:: E~. [_~:, :5-:; IE:.'{: !!:::" -'l?' ::~_" i~Z:: '"11" F:l! ~'"-~ F::: ::~}':.; '.rF_ ;:J'.-'i?.' ~:7 .... £JL. ;;~:_.?. ~i~!;; ~i;~-.'ii~ (]!ii F:~ L.. L.. ~Z:)~ ~'-,~ ::'1~1:;i~1"1.1: T FIF'F'L. I L-:!::INT t"tt::~'.:E; TFIE F.:ESF'IZII'.,tS .1: E: ~ L 12 T'?' TO :I: I'.,IF'OF;:H ':['H :[ S DE::F'F:IF::'i"HEI',IT I.':,I...11:~: ): NG THE: ~!",I'-:.?I'I:::iLL. I:::ITXON :['.,!SF:'t:£"T:r-H,:;: FF FIN? h F_:': '::; :'D--I'FtF':,~z1",tT '!"O .... ~"'-_. ................. I ri ! z, F'F::I3F'E:Fi:'I"'.r' F::Ii",IE:, 1-1.-fl::' ',IUHF El'T:: C F RES .i DE1",!F' .F'E'Z~ 'f'HFtT "t"t'~11:~ t4E_L 14 ' :: CI-:: :' .T ....... 'ri'.l':-L-iF FIN'./ .'5 //;TEH I.,.ItTH(:EjT. FIi'.,IFiL 'I:q:~;F'tEL'::Tt:'/1',! FINE:, PI'-Ft~. ,'' IL. E:'.r' 'T'H:[S I::,EF'F:It:;i:THF2.,!'F I.,.I]:LL. E:E:: SIJE:'EL'Y'I" TEt I:::'I:;.:EtS'&:CLITZL-~N. t"1i:1'.,!I1',11..Ii','!_ [:'):'-:;'I"I::II'.,ICI~: E':E"I"HEE1'.,f Fi I.,.fE.I":" ....... ' FtI'.,![) F!N"r' CIi'-,I--'::;TTE 'JS¢~HF:I(:iE:: .F_:, ]: '.:!~;F'EF_'-~;FIL '""" ...... ,' ......... =,~ ::, I.:.1-1 :[:ii; · t_.~:~ F"ELqT FOI:;: Ft F'R.I:',,,'I:::ITE: I.,.!ELL..~ Eft;;: ::L!5~;2 TC ;;2F.j.c!I F:EET F:'F:OH FI F'UE~L. :[ C HELl.. DEF'E!",!D I I"4L'3 1_ F-:'Z I",1 THE: ':['"r'F't'2 L-iF I::'L.II'~i:L.. :1: C I.,.!!~.:L.[ .... b. IE[ .... LF_'_-i'.E; Ffl:;:E' ,q:E(;:!!J:[I~EDI::ll",![::, I"IUST E:',EF-:L(TUF~:NE::I)TF3 THE: [:'EF'F!I'~:THENT bJ:['TT'i:[1",I ::i:~:J [.ff .:5 C:li::' '1"~ ~E: I.,.iEJ._.L CLqt"IF'L.E'-.T :t: IZff..t. ' ' - TI'"IF'I:;' i;~EX;:!t..I 1 F.EI [~t, . .:, 1"1F:t? F~t::'I::'L'T'. SPEC :[ i::' :t: CF:t'!" :[ ~2 I",IS FIND ::!',,'!::1 '.r I :t~::_ :_:' "F('_'t .! I'.,!:SLII:.7:E F'F.':OF'EI:;~: :[ '., S'i"F:ILLFtT I. r- I'.1 February 2, 1978 R&M No. 851104 Mr. Gordon Reese Alaska Recreational Cabins Box 535 Girdwood, Alaska subject: Soil Investigation for Sanitary Sewer System, Lot 11, Block 5, Prospect Heights Subdivision, Anchorage, Alaska Dear Mr. Reese: At your request of February 1, 1978, we conducted a subsurface soils investigation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage, Department of Health and Environmental Protection. This investigation, which was accomplished on February 2, 1978, consisted of a test hole drilled to a depth of 20 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. Drilling was accomplished with a rotary drill rig using continuous flight solid-stem auger with an outside diameter of 6 inches. Samples were taken at the depths shown on the soils log in Drawing A-01. The samples will be held in storage at our lab for approximately six months. In addition, all material brought to the surface by the augers was continuously monitored by an experienced engineering geologist. The topography at the drilling site is generally gently-sloping. At the ~ime of the investigation the site had original vegetation consisting of spruce and birch. The top of the test hole was located at original ground surface. The soils encountered in the borehole are shown in the test hole log in Drawing A-01. The symbols used in Drawing A-0i are explained in Drawings B-01 and B-02. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surficial evidence of the change. Groundwater was not encountered. Bedrock was not encountered. At the time the hole was drilled seasonal frost was present from the .surface to a depth of 6 inches. Permafrost was not encountered. Based on the visual classification of the so~l and the requirements set forth by the Municipality of Anchorage, a percolation test was not necessary within the test hole on the subject lot. February 2, 1978 Mr. Gordon Reese Page -2- We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or if we can be of additional service. Very truly yours, R & M CONSULTANTS, INC. Lynne Kosikowski Staff Geologist Jim McCaslin Brown, Ph.D. Head, Earth Sciences Dept. LK/JMB/gld Attachments: Drawings A-01, B-01, B-02, LOCATI~O[~ SICETCH J Distances shown are approximate and have not been measured by surveying methods. .+ TEST HOLE LOG ' - Scale: 1"=3' Ail Samples A 0! PEAT Dark Brown, Wood Chips.to 1.0' 1;0[. GRAVELLY SAND{~ Q Brown, Dryt ... Medium Dense G GRAVEL W/SO~ COBBLES AND TRACE SAND Brown, Slightly Moist Medium Dense Q SANDY GRAVEL Brown, Dry, Loose __12.5' G SAND W/SOME GRAVEL Brown, Dry, Loose 20'T.D. Groundwater was not encountered. This log depicts subsurface soils observed within the test hole at the location shown. See Drawings B-01 and B-02 for explanation of symbols. LOCATION SKETCH AND TEST tlOLE LOG GRIO. PROJ. NO. 851104 DWG. NQ A-01 "one test is worth a ~hca~sand opin'ons ' Performed For Arthur. Sill Date Performed Legal Oescrivtion: Lot .12 Block ~ This form Reports Soils Loq,., ,yes Subdivision Prospect Heights Percolation Test Oeoth Feet Soil Characteristics 2\.',/! Tan Sandy Silt, ML sandy Gravel, GW-GM (12~) Bottom of Test P-it Was Ground Water Encountered? If Yes, At what Depth? · Reading Date Gross Time Net Time Depth to H20 Net Drop '/L Percolation Rate tlinute ./M1 ~ Proposed Installa~'ion: Seenaoe Pit yes [)rain Field Depth of Inlet Denth To Bottom Of .Pit Or Trench CoH~'ENTS' Sample delivered to our Lab' by Hank Wilson and is represena ~-~ of the soil type 'from min~s 3 ft. to 10 ft.--125 sq. ft. drainage area- required per bedroom. No bedrock or watexTM table to bottom of test~i-~ Test Performed B.y Jame:~ D. Mack Data Certified By: Construction Testlab 4 < 0 121 J, HOI~A~' /.g 1::/3NId J,.N33 E~3cl S..,A~61 MAY ? 1974 I~1~® 4S 472 SIGNED SEND PARTS 1 AND 3 INTACT - PART 3 WILL BE RETURNED WITH REPLY. DATE / POLY PAK (50 SETS) 4P472 DETACH AND FILE FOR FOLLOW-UP GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. // :/_/' I)' ,5 !' ./ / I CERTIFY THAT DESCRIBED SYSTEM IS IN ACCORDANCE ~.¥1TH SAID CO1/E. DATE APPLI¢ANT'S SIGNATURE AM FAMILIAR WITH THE REQU1REMEF" S OF GREATER ANCHORAGE AJ~EA BOPtOUGH ORDINANCE NO. 28-§8 AND TH,AT THE ABOVE MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) (b) (c) Application Date Legal Description (include lot, block, subdivision, section,~ownship~ range)., ~ Location (address or directions) Applicant Name P~ ,;¢¢~ -~O1; Telephone: Home ~'t~~ Business %7¢' Applicant Address ¢~/ 8~ ¢~.~ ~. Applicant is (check one): Lending Institution ~ Owner/builder ~; Buyer ~; Other ~ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the followin~g address: -- . TYPE OF RESIDENCE Single-Family~t~' Multi-Family [] Number of Bedrooms ~ Other. WATER SUPPLY Individual Well~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status.' ' ," SEWAGE DISPOSAL ' , Onsite,¢[~ Public [] Community [] ~ Holding Tank [] Note: If community well system, must have written Confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVIDh~G INSPECTIONS, TESTS, FILE SEARCH, D~rA 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. '~'~~~ ~-~,,~ TelePhone // Engineer's Seal DHEP APPROVAL Appr°vedf°r 'l~°°~"~)bedroomsby ~/~' "~~ Date Approved ~ Disapproved Conditional ~ Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations gwen m paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does thi's as a courtb~y't0 purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ', Page 2 of 2 ?2-025 (~ MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 ,.~ ~4-4720 WELL DATA g ' ' Well Log Present (Y/N) Yield Total Depth ~l~¢ Cased to /~ ~ Static Water Level Casing Height Above Ground Electrical Wiring in Cor~'duit (Y/N) Separation Distances from Well: Depth of Grouting /L,/~, ~., ~. Pump Set At .~) t Sanitary Seal on Casing (Y/N) ~ Depression Around Wellhead (Y/N) ~("'/ To Septic/Holding Tank on Lot ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot / ; On Adjoining Lots To Nearest Public Sewer Line ,~,,/ /t~ To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments /'¢~,/J~¢' To Nearest Sewer Service Line on Lot ~.~,]. _ _~.~;~.4~,~.~ ;Date B. SEPTIC/HOLDING TANK DATA LJ./.--,..,~/-~'~ Size J"~-'~) No. of Compartments Date Installed Standpipes (Y/N)· t',/~L¢/ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course /V~l~/~'~ ,"¢5' Foundation Cleanout (Y/N) ~ Date Last Pumped ~~'~ ; for Temporary Holding Tank Permit (Y/N) ./I,//./,'~' To Building Foundation ~ // To Disposal Field ~" ~' To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Instal led .¢::~/~, Width of Field '~ Type of System Design '"7 Length of Field '~ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well / ~..~IL / To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Depth of Field i.?Giravel Bed Thickness ~'~' "~ ~-' Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~' To Cutbank (if present) /tM'lC) ,~,~'~ Comments D. LIFT STATION Date Installed ~ 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 hav/e check~d,/ve~ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ,,,'~_~//~ Date Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84} Engineer's Seal 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 .~/~z, ~-/'~' ~, GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Locati~Oress or diroc,2~ (b) Applicant Name~ '%~;f~ -- ~ l~ Telephone: Home ~-/~/~ Business Applicant Address (c) Applicant is (check one): Lending Institution~; Owner/builder []; Buyer []; Other [] (explain); (d) Lendinglnstitution : _~u'~"'Ce.c~ ,Ir~o..~.~...~.~,Telephone Address (e) Real Estate Company and Agent IV// Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Well~" Community [] Public [] individual Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL " Onsite'.~ Public [] Community [] Holding Tank [] . .Note: If community weJl system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, Page I of 2 ' 72-025 (11/84) 5. ENG,!NEERING FIRM PROVID' / iNSPECTiONS, TESTS, FILE SEARCH, £ 'A AND INFORMATION As cerhfled by my sea 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 ~f 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 ~ A.~,~v, ~, [~. ~'~;~e,~,,,v.~ Telephone ,~6 ~/-- ~'/"~) '~ Address ..c~_~. 0 (JJ~ ~i~ ~-'~'%-~"~"'/ ,~"~'~. ~ ~/~'.. ~.-'¢ ~'"4) ~ 6. DHEP APPROVAL Engineer's Seal Approved for o~I¢-~/') bedroomsby ~ ~"~)' "~'~,-~'-"~' Date Approved / Disapproved Conditional Terms of Conditional Approval ~ ~(I Ve~(~ /~ ~&~c~tl.- ~e~.~~ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a cedificate 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) WELL DATA MUNICIPALITY OF ANCHORAGE (MO~-v HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: ~lUNICIPALiTy OF ANCHORAG,,: DEPT. OF HEALTH 8, ENVIRONMENTAL. PROTECTION Well Classification '~'~'~ I dAq-~' if A, B, C, D.E.C. Approved (Y/N) y Well Log Present (Y/N) .. y Date Completed .4 i 2~ i i "7 8 Yield Total Depth ~q 0 Cased to Static Water Level [ C~O Casing Height Above Ground ~ ~ ~1 Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Depth of Grouting .x,~/'~ Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) I O(:)J-Y- ; On Adjoining Lots L,O¢ '~"~ ; On Adjoining Lots To Nearest Public Sewer I00 Cleanout/Manhole Water Sample Collected by Water Sample Test Results SEPTIC/HOLDING TANK DATA J~j A To Nearest Sewer Service Line on Lot Date Installed '~ ~-~Y/'T¢ Size i~. ~-~, No. of Compartments Standpipes (Y/N) \/ Air-tight Caps (Y/N) / Foundation Cleanout (Y/N) Depression ove[ Tank (Y/N) ¢'-J Date Last Pumped '~ I i~" Pumping/Maintenance Contract on File (Y/N) ~,~ ; for Holding Tank High-Water Alarm (Y/N) J~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line ,. i/_+ i ' '. Course Comments To Building Foundation To Disposal Field 5 To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed n Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation 2 ~" Lot AJ 0/O To Water Main/Service Line '~'O ~' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design ! Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line ¢..~ I To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) AJO?O~''~ Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at .~- ~ ' Tested for Electrical Codes (Y/~) ...... Dimensions _Mafihole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments --'""" ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checke~d, venf' i~d,~r conformed to all MOA apd HAA guidelines Signed/~~~ Date ""-~::~~~'; /I, ~,~_ ' / ' / Company ~,~-~, MOA No. -~* ~ ~ -- / Receipt No. ~'~1 Date of Payment Amount: $ /_¢ Page 2 of 2 72-026 (11/84) in effect on the date of this inspection. Engineer's Seal ~9 W. Benson Blvd. Suite ~06 PENINSULA ENG G Anehor~e, Alaska 90~03 (oo?) April 22, 1986 Per Bjorn-Roli 9451 Buddy Werner Drive Anchorage, Alaska RE: Lot 11 Block 5 Prospect Heights Health Authority Approval Dear Mr. Bjorn-Roli As per your request we have performed the adequacy test on your septic absorption system and a flow test on your well on the above referenced property. The septic system was tested by adding 600 gallons of water to absorption field on two consecutive days and monitoring the levels the field and septic tank. The test results are tabulated below: the in Quantity Date Time Tank Cleanout Rate Added 4/16/86 0 13" 81~' 0 gpm 0 gals. 10 13 84.5 6 60 30 13 90 6 180 75 13 97 6 450 100 13 97 6 600 Well Stpd 4/17/86 0 16~' 77" 0 10 16 79 5 30 16 84 5 35 16 84 0 0 16 83 5 16 97 10 16 106 4/18/86 0 ~-- 74 50 gpm 5O 5O 0 5O 150 155 Well Stpd 155 By 405 Truck 655 The test results indicate that the absorption system is functioning adequately for a four bedroom home. The well flow test was performed on two consecutive days and the data indicated that the well has a daily recovery rate of 150 to 200 gallons per day. This is substantially below the daily requirements of 600 gpd for a 4 bedroom home. Due to the excessively deep well with approximately 500 gallons of storage available within the well casing, the well was found to supply 600 gallons the first day of testing, but was only able to recover thereafter at 150-200 gpd. Although this well may very well function adequately for your use it does not meet the minimum requirements of the Municipality of Anchorage for a 4 bedroom home. If I can be of further assistance please call. Sincerely, y e Henderson, P.E. WH:js ONLY OUT UPPER HAt' Zip Code JPhone // Realty Co. & Agent Address Legal Description Street Location Type of Residence [~'"~in g le Family Z/ [] Multiple Family No. of Bedroon~s [] Other Water Supply ~, Individual [] Community [] Public Utility Sewer Disposal ~ Individual [] Public Utility [] Holding Tank Zip Code Phone Phone ATTACH WELL LOG. A we~l Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available). Year Individual Installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ~,,~ { ~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE BY: . . Soils Rating Date ~wer Inslalled Well To Absorption Area ~ e ~ Well Log Received ALASKA P iUIROFImeF1TAL COF1TROL Se dlCe$, IRC. ~n§ineerinq 8 {~nuJponmenl~l $1ud[es MARCH 31 1983 GORDON REESE SRA BOX 2051-G ANCHORAGE AK 99507 SELLER - GORDON REESE BUYER- SUBDIVISION-PROSPECT HEIGHTS BLOCK-5 LOT-ii ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 462 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 3/31/83 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 4 BEDROOM HOUSE. ~_ nUFE~ 1250 IS ADEQUATE FOR 1200 ~Uest 33rd Aucnu¢, Suite ~ ,, Anchoraqe. Alaska 99503 * (907) 276 1361 ~.., ~ ..J A 3 ,qNC!'[ORAGE DEPT. OF HEALTH & .:.;: ~;~- :. Dq~>AR¥;t,!E;~: I' OF }~F,c,L'~'i', & EigVtF;OF~MENTA[ PRO F:CTIO;ENVIRONMENTAL i~;~:Oi-ECTION 825 ~ -' " JAN 3 0 1979 Dt[-~SCq iO',qS; ~.o .,e,e ~ t parts on pr, ge ~. Incomplete eauests will not ba processed. Please allow ten (10) days for processing. I MAiLIr~G ADQ~ESS U. "f YPE O;- R :,;1[.,~. CE NUIv]BER OF 8EDROOi¢,S [_-] One E:J Four ',~_3 ();her '" SiNGI E FAi,,~LY [~i Two [~_~ Five _~ MUt_'I"IPI. E FA[viiL\'" '~J~' q'hi-ee _1~ Six ?. ~',.~A'¢EF', SUPPLY · IND!\,, [ D.,,L',u'~' * ATTACH WELL LOG. A well log is reqdirec! for al! wells drilJed ~J CC:'MM, UF!ITY since Jurie 1975. For wells chilled prior to that date, ~. ~W~AGE DId:POS:ti. SYS'I EM "~ ~N: iV~DL AL. ION-Sr~:~" '"qf individu~!omsite, ~ive ins~,h~tion If system is over two (2) ymsrs old an adequacy tcst is required _~ PUBLIC UZII_ITY by this Dep~,rtment. ,-,,C , L. '¢1 .: INSF'ECTIOi'~ FEI:: MUST ACuOM¢/'~f~i' EAOtl REQUEST DEPQRE PF;OCESSING CAN BE tN!-i'II~TED. TIIK'-; ~IDE FOi~ OFFICI/\L USE ONLY INEPEC'F!ON APPO!N YMEN-FS / '~o;<V~ ...................................... I'5~TF .......................... -~ ................................. ~ s : IHSPRCTOR liN, PECTOR DIRECTIONS: TYPE OF RESIDENCE SINGLE FAMILY MULTIPLE FAMILY i2. WA'¥ER SUP?LY ~-J INDIVIDUAL ~] COMMUN!TY J ~ PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAl. SYSTEM ~INDIVIDUAL/ON -SITE [~PUBLIO UTILITY Connection Verified l~]~Sel)tic 'l'auk or [] ltolding ?ank Size; 3_ ~.~__~) If Tank is hornemacle give '-55F TOTAL ABSORPTION AREA 4. DIS'FANCES J L]O ONE TWO PERMIT NUMBER 'n .q DEPTH OF WELL DATE DRILLED NUMBER OF BEDROOMS L~] THREE F_~J FIVE ~g] FOUR EEl SIX LOG RECEIVED PEIqK4IT NUMBER DATE INSTALLED [] OTHER '-i-NSTA LI_ER SOl L.S ,qATI NG MANUFACTURER MATERIAL Septic/Roi(~,'ng T~{ion. Area [S'.'wer Line INealest l.o'( l.i~e 5, COMMEN ¥8 CONDI'FIONAL APPRON/AL (h~ttet must accompany certificate) [TJ DISAPPRO\!ED DA I E ' I~Y (f~tla)