HomeMy WebLinkAboutPROSPECT HEIGHTS #1 BLK 6 LT 13 , MUNICIPALITY OF ANCHORAGE ~ · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION  825 L Street ~ Anchorage, Alaska ' 99501 Telephone 264-4720 REPORT ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTIOiNpHONE MAILING ADDR ESSFD LEGAL DESCrIPTiON DISTANCE TO: [Well / - Absorption area Dwelling ,. PERMIT NO, Manufacturer ~ ~ Materia~ No, of compar-tments Liq, capacit~in g~Jons IF HOMEMADE Inside Jength Width /~ O (~ : .~ ~ Liquid depth ~ ~ Well Dwelling ~ ~ ~ DISTANCE TO: PERMIT NO, O~ Manu~~ ~ ~ , Liq~ap. acity- riga Ions ~ Well Foun~tion~ . ~earest lot line . PERMIT NO. ~ DISTANCE TO: ,~/-~ ~ i '/ ~/~ ~. ~ /~ ~//' ~" ~ m ~ No. of lines Length of each line Total length of lines Trench width Distance be, tween lines ~ ~ Top of tile to finish grade Material beneath tile Total effective absorD~n area Length Width Depth ~ PERMIT NO. ~ T _ vpe of cri~ ~ib diam~ ~ C~ ~ Tota~erption area ~ ~ANCETO:~ ~ ~uildingfoundati~~restlotline~~~~ ~ j CI~ ~ ' Depth ~ ~,~/(~j.. Driller Distance to lot line PERMIT NO. ~ Buildjnq fom~atien Sewer line Septic ta~ Absorptio~ area(s) ~ DISTANCE TO: /~~j ~ ~. ~- . ~ ~ ~ ') PIPE MATERIALS OTHER ~ ~ SOIL TEST RATING / / / APPROVED ._~ DATE LEGAL DEF'FIF,.tTME:NT GF HEFILTH RN[:, Ell',:',, I']F.));.:2t',,,.~r~FFL~t .... PROTECI"ION "~ .'~'/~ c,,~.._ "L '" STREET., FiN "£HOF.'FIGE. FI.K. '_~.gSCtl. 26,4--472Et F'ERMIT NO. ,:1 F:'J. O50E; :.', RF'PL I C:FINT DENN 12; FI. MC '_' RRC KEN P. 0. LOC FIT I 3H L I'-IK ,-EbM,_ LO]' :t3: BLK 6 F'F-:OSF'ECT NTb] SUBB .... · -, _-< - Z.'::=: 3::1. LOT SIZE F' E; ~:;,:-: Ii"-1 3: 'T ,~, ', ~ ,',.':LZL'~ SE~LRF..'E FEET -F'¢PE CF_'~']IL. RBSORF'TIGH S'¢STEM IS: TREN_.H' '"' tIH,--,II1UM NUME:ER OF E:EDROOMS = 5 '_--;OIL RFITING ,:.'S6! FT/E:R)= :LEu3 THE REL.]U!RE[:, SI?E OF THE sO'rL ..... BBqr~RF'TTr~N :,'r=,TEM'-"'"' , _T':,'_. [:' E F' ]~ ~'"~== :1.,~. L E. ~-,~ L~-T H =:._::.' ..... ,=:' 13F: FI. %mEE L. E:. E F' T' H: ...... THE LENGTFI DIMENSION IS; THE LENGTH ,.'.'IN FEE'[') OF' 'THE TRENCH OR DRRINFIELD. THE DEPTH OF' R TRENCH OR PIT Itc, ]'HE DISTRNCE BETI.4EEN 'THE SURFRCE OF ]'HE GROLtND RN[:, ]'HE BOTTOM OF THE EXCR',,,'RTION (IN FEET.'). THERE IS NO SE]' klIDTH FOR TRENCHES. ]"HE GRR',,,'EL DEPTH IS THE MINIMUM DEPTH OF GRR',,,'EL BETWEEN 'I'HE~ OUTFRLL PIPE RND 'THE BOTTOM OF THE EXCR',,,'RTION (IN FEE]'). PERMI'F RPF'LICRN'r HRS TNE RE_,F_P,z_E, ILzl" -- ;-i '-~" "'~- TO INFORH. THIS DEF'RRTMENT E:,URING THE INSTRLLRTION INSPECTIONS GF RN'¢ WELLS R[:,JRCENT -to THIS F:'RCF'EF?T'?' RND THE NUMBER OF RESIDENCES THRT TFIE WELL I.,.IILL'-F:,_R,E.',',,, E:RC:FFtLLTNG OF RN'¢ S'-r'E;'CEM !.4ITHOUT F]'NRL INSPE-:TI'N RN[:," -r ,- ' · - - . - HFFF-.],HL B'~.' ~H__-:, ],EF'RRTMENT WILL E;E SUB..TE.-:T TO F'F:.'ZSECUTION. "ltNIMUM [."tSTRNCE BETWEEN Fl WELL RND RNY ON-SITE SE[,.!RGE DISPOSRL S'¢STEM IS; LP'tE~ FEET FOR R PRI',,,'RTE P.IELL OR '1_5El TO 2C~E~ FEET FROM R. PUBLIC 1.4ELL DEPENDING ..tPON THE T~'PE OF F'UE,'LIC P.tELL 'tINIML.IH DISTRNCE FROM R PRI',,,'RTE f4ELL TO R PRI',/R-FE SEI.4ER LINE IS.; 25 FEET FIN[.., FO R COMMUNIT'¢ SENER LINE IS; 75 FEET. 4EL.L LOGS RF.:E REf.]UIRED FIN[.., MUST BE RETLtRNED TO THE DEPRRTMENT !.,.IITHIN .'2:E~ DR'CS ]F THE NELL COMPLETION. ]THER REb]UIREMENTS MR'¢ RPF'L'¢. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS Fi, RE Y',"RILRBLE TO INL:;URE PROPER IN'---.,TRLLRTION. : CERTIF'¢ THRT .: I RM FRMILIRR WITH THE RE~2UIREMENTS FOR ON-SITE SEP.!ERS RND P.IELLS RS SET 'ORTH B'¢ THE MUNIC:IPRLIT'~.' OF' RNCHORRGE~ :: I NILL INSTRL.L TFIE S"r'STEM IN RCCORDRNCE I.'.IITH ]'FIE (::ODE'_:;. :: i U.NDERSTRND TFIFIT THE ON-SITE SEWER S'¢STEM MR? RE[.:!LIIRE ENLRRGEMENT IF THE ES I[:'ENCE IS REMODELED TG I NCLU[."E MORE THRN 5 BEDROOMS. ir ~ January 31, 1978. No. 851,102.~"~ Mr. James Arnesen Rea1 Estate Corne~ o,f AJaSka ~. ~:~ ....... :. _. 555 W. N.o~l~he rn~ L}-g ht-s:~ B 1 vd:. Su ite ;~202 '~.,: -~,~'.~:_~_ '- ~Anchorage Alaska~: 9~50~ - ~Subject:~ ~S~ I :~cw~stiga;-t'~on for San-~ita~-y..Sewer System,., Lot 13, -, P ropsec't:.'~He;i.ght s. Subd i wi s'F. On:,?A_nc.~5~rag~., .~A1 a s ka~ ~Dear Mr.. Arnesen~:~ . . ~t your ~equest. of_January 22, 1978,~'we corfduct.ed: a s,ubsurface .~nves.t|gation at ,~h~: pr~oposed locati,omof- the sanitary sewer ~the sublet lot'[ -:The ~nvestiga~ion comp~lded~:.w,L:~h_.those,~rocedures.. [~requJred:by the.~M~ni-cipality~of Anchorages-DePartment oF'Health and~: ~:Th~ I s l nv~.~. [~a talon r'~h~[c:h:. ~as accomp:ki:~e~z~,¢J~nuary. ~.. 25.,. 1978, cons i ~:~f a tes:~hoCe: d-~ ~ ,[~ed~ [b~:a dap th of .~ ..fie~t~beLow-. th~ exis t ing g round :~-~-sur ace.~:~-The tes~- hb-l~ was s i ted accocd:[ng .-.~.'zyou.mL ins'~cu.ct ions:and i =;~with a~.tary-~r[llF rig:~uslng continuous f. li~ght-solid-_stem auger?with.-an ~-outs ida--~ la~t~-o'f.-~-, l-nches. Samples we~e.:~aNem.'at the depths,..-_showmQn-.c the so. F1s: log~;in:~.Draw}ng A-O1. The'_ ~am¢'[~s,.~t.&,l :be held i.n storage a[ of the.-investFgat~i~ t-he site had-or3g.i~:l...-~g~ta;tion~-¢onsls, tjag~o[ ground surface~. - ' . at th~: test~'-:iO~'~':[on. However, subsurface .conditions.:~y var:y',i.'mother part~ Of t~e lo[<~i Lhout,any appa-ren~.~ sur[icial evlden~e~.:e[:.-:.tbe-change; ~ro~k was'-no,t~e0.c. Ougte~.;.~ At the were measu~d~_.f~m the top=~.~f the hole.. January 3~, 1978 Mr. dames Arnesen Page -2- ~4~.~infiltration_~.from the depths indicated: ~'o',t, he bottom of the h~le. The ~&~.measu red_. p'e:r, co. ation_ rate was- 2.24 m~-nu:t-es. D-er--inch. .~We appreciat~ [his~-~opportunity to;'be--of, se~v.i~c.e~ to., you.- Please~ c~ta~[ _~ - . .~; . ~ ~-us if you. ha_ye ,any .questions concern~i~g~t.h~Es,?,Jetter~.or if we can..:b~. OF : .~add it ional ~servi-ce. ~ - - ' .... - -.Very truly yours, ~R & M CO~SU[YAN~$¢..I~C. -~!~ynne Kos[kowski -'tK./§ld ~t t a ¢ hmen~s = - --D ra~ i - :.Ji, mt Hc6as |<~n~ B ~own, ph~,D -.;lte. a.d,. Eacth Sc_i'ences Oept~; ~:-,_ ~g~: A-OI ,- B-O] , B.O2r.;~ab~e~-; LOCATION SKETCH / / LOT 13 :-Dlstances~sho_wn nrc approxin~e : ': .~and have.::not-been meas-ured.by~--- -'- ant vexing me:thod s. ' - ' i '---- ' TEST IIOLE LOG Scale: 1"=3 ' ORGANICS 1.5~ 2OBBLES-, Browni Sh-red, .... .. 5. ' Sofn, .Few Cobbles ...... 1~' -Cobbles an 10' - :AND:- T,~C ~ :COBBLES, LOO s e -~. Grdh~kQ~a tOP .~as ;~no t encouq~ed This to~ depict, s subsurface soils observed -.within: ~ihe test hb{e at t ~e location' showB. S~e Dral~ings B-01 and '1 "d~.LE I PERCOi,A lqON q~EST da ~es Arnosen R&M NO. 851102 TI ~[E ~9:20 9:21 9:22 .9:23 9:24 9:25 9:26 · 9.: 27 9~:28 9:29 ;9:30 9:35 _ --9:45 9:50 10:00 10~10 10:20 ELd%PS ED T I ME ' :c,- .. DROP IN IHC}{BS Initial .. 11.0 0 1 2 3 4 5 6 7 8 9 10 15 20 25 30 40 50 60 13.0 15.0 16.5 1.5 18.0 1.5 19.0 1.0 20_25 1.25 21.25 1.0 22.5 1.25 23.5 1.0 24.5 1.0 27.75 3.25 30,0 2.25 31.5 32.5 1.0 34.5 2,,0 36.25'_._ 1.75, 37.75 1.5 26; 75 INCHES TOTAL -DROP; - 2..24 MINUTES BEPa*-IN6I{'. ~ -'~:AC.~"ASSIFICATION:- Identification and dassif-i~ation._ o~ the soft is accomplished ~C=..4accord~cewi~.h. elm Unified Soil Class:~ica eion-Syseem, . Normnlly,., tho.gra~ <~-distribution,ge.~er n~es class~icatioa oE bbc:soil. ~The:'sofl is defied accorded-tm '_:;;major-and m~or cons. tituents with the-mknor e, le. men ts sezv~g as mod~ie=.s of :~%major ele~e~.e~;. :~or cohesive soils, ~the.clay becomes the principalmoun wi~h the ~z.=.~..~ other maj0r.__~oil.~ eon sEiLuenes, used as m~d i-'f ie~+,i~_q~. ~sil ry..clay, M~en the 'clay .~:z~are such that. the clay domMa-tes sod p~operties~ M~or s~il consti~u.ents ~:~added to thaclasa~icabion breakdown ~,accordan~e with the particle size proportion ~s-'~'67tiseed belo~l i..e. ~,sandy. sH.t w/some gravel, trace ctay~ . ~, _no.c~l ....0-- .3%~ trace .-_ 3 . 12.% ' some - I3 - .30~ 5~Y n°rm~-~ietd.'a~fid%b'o'rakory methods appiiesSon~, to,mon-fr, ozen materMt', ~-~hese ma~,~iats,. ~he influence of such.' f~neto~-s as soa. s~uett~e, i.e. fissure · =~Ystemsi sh~-k~kage-o~aeks, Mickensides, -e~c. f~muse, be eaken ~ta eonsiderabion.,. (.~ mak~g ~y gotrela-tion4vieh klm eonsisceney ~atu~s-li~ted Below, In permafrost,, -~ones, the:.d.0n~iateney;,~d s~zeng~h of'~roz2n soil~.may_vaxy si~i~icantly ~d ~n~la~ah~=wieh. ige ~on~ent, thermai reg-ime~:ahd soD, e~pe. -;e. .'Cohesionless - Cohesive ~ --.N*tbtows/f~J Relative Density : T - (tsf) ~oose . :~ 0 - 19- 0 to 40% .. Ve~, Soft 0 --0. :~edium Dense 10:.-a0 40 to 70% -- Soft 0.25 - 0.-5 '~7Dense.~ 30.~. 60 70 co 90% Stiff 0.5 - 1.0 &~,Very Den.se -. 60:,, 9g ~o 100% , : Firm 1.0 -2, -~*Seand~"~bne b~ai. ion-- N".: Btows per foot of - M~ F2-m . 2.0 - 4. :t~a 140-pound-:hamm~r,f~l. Nng 30 inches-on..a _ .- ttard ~-~.2-inch ODt split~,spoon-exeept where noted 1)RI LLING ~M BOI, S WOi .Wash Ou~ WD: ~e WL.: Wa~er Level BCR: Before Cas~g Remov~ WCt: '~wet Cave In -ACR: 'After Cas~g Removal. DCI4,-Dry Cave ~ AD: Aft'er Boring ~; -:~S: While ~mplin~ ...... TD:_% Tot~ Depth Not=ez~-~_-Wa,ter te¢etSs hidicaked on_eheTborinKt~g~:.are thedevet:s measured in borin~ab the bimes :~dicated. In ~er~ious-un.f~ozen ~oi1% eke indicated elevaeion~ are considered:_. .. e~,mepre sen_ ~ a c tuat-:grom~&, wa.t e~ condit iens ,~; .qm:in~erxdous and -. frozg~ ~o~s,~,ageurate determinations-of grou.n&water, ~el~=va. tions ca.nnoe be withig:-a_l~4 ted period of observation and-odmt evi&ence:~,~ra~d wa Ce~. eleva~t ions:: and ~ndi~ions a-re required. ..... ~,.~ ~- . -8 - OI SAND GRAVEL ORGANIC MATERIAL CLAY SI LT . SI Ss , SI Sh Sp .~:. Hs STA'JD_[y, SANDSTONE MUDSTONE LIMESTONE COBBLES "OULZ'eRS-. CONG L~MERATE .' ~ .. METAMORPH~6 · ICE,'MASSIVE:  ICE - SILT - --ORGANIC., SILT ~; SA,htPL.ER TYPE SY;dBOLS · ¢~? , 1.4," SPLIT SPOON .W TH 47 ~ HAMMER .~. , 4"' SPLIT SPOON WITH t40// HAMMER · :.~... 25" SPLIT SPOQN WITH 140~ HAMMER 25" SPLI~ SPOON WIfH 3,10~ HAMMER 20" SPLIT SP~N WITH I40¢~ HAMMER 1.4" SPL.tT SPOON WITH 340~ HAMMER - _ 2.5'[. SP,LIT -~POON, RUStiED ~. ' 1.4' SPLIT SPOON DRIVEN WltH AIR HAMNtER %...-~ HI .-._-~!, 2.5" SPLIT sPOON DRIVEN WITH AIR HAM, MER ....... ],-- N O T E;;~, S A,',~ P LEB....TY-P E S SAMPL DEPTH. SANDY SILT 'r' .. S ILT GRADIhlG TO S A N DY.{: SI LT  r~'~''~ SANOY GRA~ ' ~' ' :. _/Et:.,. ~-.. INTERLAYEREO SAND ~.~ ' ~ 'SANDY.L~RAVEL4 ~' sILT~ 6EA~. w~r ~AND Ts .... SHELBY TU8E ;~ Trr .... MODIFIED~ SHELB)'~' TUB~ Pb .... PITCHER BARREL=~ . Cs ..... CORE. BARREL WI;TH~:.S.!NGLE. T,'MBE Cd .... CORE. BA'RRE-L WIT'H~BOuBI~E TU8t~ BS .... BULK SAMPLE:. ~. ~ A ..... AUGER. SAMP. EE:-, -.- G ..... GRAB SAM-PLE .= .~- . A;~E'_ E. ITH ER NOTED ABOVE'. ~J-tl~'. B'OR'tN.6": ¢:'OG' OR ~ADJA gENT TO: IT AT..-THE R £SPECTtVE W~ TE,~2t TAB L'~S WHIZ E D;CtLZi~'~' --- .:,7 .'r. YPICAL BORING LOG ~ "'~-'[H 30-15 Elev 8746 ""~"EZEVATIOA/ IN FEE[' . ORGANIC. MAT~R~AL O' ICE ~ SfLT shmote 65°/0 90, X-,-M L~ ?'. .~ 72, 57. LR/o,~85~Bp~t,..28~ OP~ / (COR~S, OF EflG/%'EERS't~ETttO0) SAND~GRAVEL Cd 26 ADDITIONAL OAI~A- AFAiLAB~ ON SUPP&~4~/T~4L LAB. SH£~TS F~XPb. A~j~T.J~0N..0F SEL:E-C'TEB: S'YMBTC~LS Real Estate C .rner of 'Alaska ~O~. 555 W. NorH~.cro |.l?" t.Hlvd. A c ~,e. Alaska 99503 January ~1., 1978 RE: Soils test per£ormed As per discussion .with. the director_o£ Environmental health-,_.. Mr. Joe B~ta-ir, ~ was told tha~t~ the soils reset perform~ the results' therein are good a~d~ that the ~' - · septic system,; The parbicula-r.pe~k rating determined~by.Mr ~lalr was.:135//, q'his '~s a lower than most; g-igures ' indicates very 4~ood soiJs. --~I have enc]o:;ed a-phot:ocopy, oD Mr. }~lairs _c- of this' leL,te.[~ fo;r you~- Futune reference. and hence.-. the bottom~ portion JA/ja ,.,./~__,~;t- ~'~ '' ' - Municipa[iw of.,Anchol'a§e · ~'lt ' - ' "-'- 825 "1." Street I ' ¢ Anchorage. A~sAa ~9.~01 ~,. ,~:~ '.[: . Telepho,,e. 9 7', .... ._- {OI .... t~.. I'italt h.& Enw[onmenta JOSEPH,~. BLAIR, R.S. 0 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.# ~__~\~-~- \~ 1. GENERAL INFORMATION Complete legal description Locatio. n (si.te address or directions) Property owner ~rry ~:/~'~ i Day phone Mailing address ~ o~ ~ox ~ooot~, ~c~o~. ~ Cq~-~o Lending agency Noem~ ~o~a~ Day phone Agent No~, Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 5'- 'v TYPE OF WATER SUPPLY: Individual well ~-' Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site 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, 1/91) 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 inspection. (~Z.,,F /,~ e NameofFirm ~'/~/'/'~/' 7-~c/*~¢,~/ C~¢¢~,[re,, Phone Address /~/5-~0 ~--¢cAo _C/:, ~ncl~or~,¢ ~ Engineer's signature ~-~~ ~. '"/2'Z¢.~,~ Date DHHS SIGNATURE _ Approved for Disapproved. bedrooms. 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~)25 (Rev. 1/91) Back MOA #21  Municipality of Anchorage Department of Health & Human S.erv cas HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoT t3. ~L~ ~,, P~os~cr UTS ¢~ Parcel I.D. A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed 1/2,~/$¢ Driller t Cased to 12fo Casing height Wires properly protected (Y/N) T' Date of test Static water level Well flow Pump level FROM WELL LOG AT INSPECTION 205- SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Io2' Absorption field on lot Public sewer main ;~ ,'oo Sewer serviCe line ~ ; On adjacent lots ~/o0 ' ; On adjacent lots '~/oo ' Public sewer manhole/cleanout Petroleum tank Ho~E WATER SAMPLE RESULTS: Coliform O co f /~o0 ,'~ Date of sample: 7/7/c/2 Nitrate ,5-;.-~ ~,~¢./-4~ Other bacteria Collected by: F'I.A TTOP TECl'/ $~'c$. B. SEPTIC/HOLDIN G TANK DATA Date installed c/ Cleanouts (Y/,N) High. water alarm (Y/N) .1~ Date of pumping '7 / I o / ¢ ~ Pumper SEPARATION DISTANCES FROM SEPTI C/HOLDING TANK TO: Well(~)-.on lot' I'O;z' On adjacent lots ~'/00 ' To property lin~ ~/'~'~5¢ Absorption field ~' ' Tank size I¢oO ~,~; Compartments :2_, Foundation cleanout [Y/N) N Depression (Y/N) Alarm tested (Y/N) /~,AI Surface water/drainage Foundation /5" Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed c~/IH/8/ Length $2' Width Total absorption area ,.~l 2 3¢ Soil rating Ioo Gravel thickness Cleanouts present (Y/N) Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) System type Total depth Y Date of adequacy test for ~ ~ow~ oF If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I I '7 To building foundation On adjacent lots ~ Eo Surface water ~'too~ f Curtain drain ~o~, On adjacent lots ~fO0' Property line '~6" To existing or abandoned system on lot N,/~, Cutbank '~ /~' Water main/service line Driveway, parking/vehicle storage area ~'0 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. Engineer's Name -f'b~:3,-~ ~ ~'~oo,-~_ HAA FeeS /~ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 7 14-?Z,, Tom Fink, Mayor unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 20, 1992 Ted Moore, P. E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 13 Block 6 Prospect Heights #1 Waiver Request ~WR920036, PID #015-092-18, HA920440 Dear Mr. Moore: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 5 feet from the common lot line with Lot 14. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. /~rely, / ...~. Robert W. Robinson Civil Engineer On-site Services ~ ~ -~ ~ -' ,~ ,, - ~ ~ =~ ~,,~.~ ,~ ~×~ , .. , ,.. ~ .......... ~ OP TECHNIC!AL CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 July 15, 1992 14530 ECHO ST. ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 196650 Anchorage, AK 99519 Dear Sirs: By means of this letter we are requesting a waiver of the normally required 10 fOot separation distance between a soil absorption system and the property line common with Lot 14 for the existing soil absorption trench on Lot 13, Block 6, Prospect Heights S/D, Addition #1, located at 9850 Buddy Werner Drive. A copy of the as-built survey of the lot is enclosed. Although the distance on the survey scales to 6 feet, we are requesting a waiver down to 5' to allow for possible underground projection of the soil · absorption trench and/or survey plotting error. Since all components of the existing well and septic system on Lot 14 are greater than 100 feet from the soil absorption trench on Lot 13 and both lots are larger than 2 acres, the existence of this trench will not affect the ability to perform future upgrades to the septic system serving Lot 14, when needed. For this mason believe the requested waiver should be granted. As noted on the HAA checklist, the well serving this residence is located under the paved driveway. I discussed the configuration with Robbie Robinson at DHHS, and he indicated your office could approve it since the well has a proper seal and is under a sealed manhole and the driveway pavement is sloped such that water does not pond over the manhole cover. · Pleas~ feel free to give me a call if you have any questions. Sincerely, Ted Moore, P.E. · It is. the respons,ibtlity, of~'the ? ~e~ e~.~ s ~er~cet o ~ a~y-- e~s ~en tsp. co v en~nts~';' o ~ re-- * " ;-. :~1C.:lons uh i ch'~:'do:. ~0~ appea~ on· the:'recorded:~ sub ..... .'l~sh~ng bdund~,~'OF fence lines, qbe surveyor,.t~es " ' ' ':' 'i" ~'~'~" ' ~ " X4'' '' ='~ ~~ffo. ~ r ,. . ~¢ ...... , · . . · ....... · .... · ~'1;. -~ .... -~ '-;-'~ ~ ~$~C .... ~' ' '~ ~ , ' ~~.',.. ,..= .... ,,,.~.~,~,~.-~ .,,.,... ,,"~ ,".~,':~.."~ .... ~4 , _ ~ ..... .,~.~... t, .% .... ,,. · . CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGI'NEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 :~TELEPHONE (907) 562-2343 FAX: (907) 561.5301 ~NALYSIS RESULTS for INVOICE g 55627 Chemlab Re£.~ -92.3302 Sample ~ 3 14atri×: WATER Client Sample ID PWSID Collected Rece~?sd PreserYed with 13/6 PROSPECT HTS ADDN F1 EAST HOSE BIB Clienz Name :FLATTOP TECHNICAL SRV UA Client Acct :FLATTOT JUL ? 92 ~ 09:45 h~s. BPO$ : PO~ :NOtIE RECEIVED JUL ? 92 @ 15:30 hrs. Req~t : AS REQUIRED Ordered By Analysis Completed : JUL 8 92 Ssnd Reports Laboratory Superwso~ : STEPHEN C. EDE iJELATTOP TECH)IICAL Parame~e~ Results Units I,~et hod Allowable Limit~ NITRATE-N 5.3 mg/1 EPA 353.2 J.O Sample ROUTINE SAI4PLE COLLECTED BY': C~A%IS. 1 Tests Pe~fo~med * Soo Special Instructions Above UA-Unavailable ND= None Detected '* See Sample Remarks Aboye NA= Not Analyzed LT~Less Than, GT~G~eater Than ~SGS Member of the SGS Group (Soci~t~ G6n~ale de Surveillance) MUNICIPALITY OFANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or dir~.c, ti(~r~s)'i ' ;' (b) Property owh~r."'D ~ ,~-n ,* "D)~'i~-rhc~ Telephone: (home) (c) Lending Institution Telephone Business Mailing Address (d) Real Estate Company and Agent Address Telephone . (e) Mail the HAA to the following address: (or check her.~, if hold fei' pick List contact person and day phone number below: ' ' ? 2. TYPE OF RESIDENCE Single-Family~ Number of bedrooms 3. WATER SUPPLY Well/~ Community [] Public [] Individual 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/[~ Public [] Community [] Holding Tank [] Not~.- I¢ Community well system, mu~t have' written Confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) 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 t. his' Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional end adequate for the number of bedrooms and type of structure indicated hereim 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. Telephone Name of Firm Address Date 6. DHHS APPROVAL Approved for ~' bedrooms by Approved ~. Disapproved Date Conditional TermsofConditionalApproval Note: The well for this property mee~s '~xisting State and Municipal Codes. There are nitrates present, however, it is suggested that periodic testing be performed to insure the wells continued suitability. Nitrate concentration is 5.7 mg/1. EPA maximum concentration is 10.0 mg/1. 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 A. WELL DATA Well Classification Well Log Present~) Total Depth 7_~Z-,.~ Cased to .. Static Water Level Casing Height Above Ground Electrical Wiring in Conduit~N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot 1 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) · CHECkliST- FE.RUAR¥ 19. ,ALtTY OF ANCI-TO~ ' *43-4744 ENVIRONMENTAL SERVICES DiVISIOR /AUG 9 1990 If A, B, C, D.E.C. Approved (Y/N) Date Completed //¢P-~ Depth of Grouting Pump Set At c~ Sanitary Seal on Casing Depression Around Wellhead (Y/~ Water Sample Collected by .~, ~"~¢~r t/, ; Date Water Sample Test Results Comments ; On Adjoining Lots /o~O / ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole B. SEPTIC/HOLDING TANK DATA Date Installed ¢//~//~'/ Size Standpipes~N) Air-tight Caps t~/N) Depression over Tank (YI~ Pumping/Maintenance Contact on File (Y/N) No. of Compartments Foundation Oleanout ~)N) Date Last Pumped .,~ ;for Holding Tank.High-Water Alarm (Y/N) ,.,~/,,¢- Temporary Holding Tank Permit (Y/N) SEPARATIQN DI§~A~NCES FROM SEPTIC/HOLDING TANK: To Water-SulSpl~¢ll., - .,,/~'¢ I To Building Foundation J'-~ ~ .~ ~ .,~ .~,~,.~¢r, ~ ~ . To ProlSer/~y',E~rle ,~ ',"- ?~/0 'f t To Water:',.M, Si¢~/~i~dEi~e~ ~ /% ~-.~'~/ To Stream, P6r~d,'b~ake~dr, 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 Date Installed Width of Field Square Feet of Absortion Area ~'-'/~-- Type of System Design Length of Field .72- / Depth of Field /~' ! Gravel Bed Thickness ~- / Statndpipes Present'N) Depression over Field (Y~ Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well //! To Building Foundation ~-0 -¢ / Lot To Water Main/Service Line ,/% gJ~/ To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Date of Last Adequacy Test To prOperty Line ~/o To Existing or Abandoned System on ; On Adjoining Lots ,,> ~ · To Cutback (if present) LIFT STATION Date Installed Dimensions / Size in Gallons Manhole/Access (Y/~?~ ~ "Pump On" Level at "Pump~.f~-'~evel at High Water Alarm Level at /'~~/ Vent (Y/N) Tested for -~ ,~¢ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y Comments / **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date ~-/~/ MOA No. Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 Seal CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 Dr, ts ,~oport Pzin'cafi: A(iO 2 ,90 @ .I. 3:[I4 ~acexvod JUE 26 90 ~ !E:O0 P~se~:¥~d wiih :AS Client Acer : O~do~ed ~y : L. Sa~pls .~ Tssts v .- -. . · , . ... : }ID~ ~one Detected ~' ~J~a Sample k~a:ks 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 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or direction,~ / , (b) Applicant Name /f~'fl~o¢~'a~ Telephone: Home '~'~-;~ ~Z. t/ Business Applicant Address P~(~ ~>~ ,,~ ~-,¢O ~',--~ it /q 'c(~. k g k (c) .Applicani'i~..(ct~eck.~ne): Lending Institution I-I; Owner/builder,~; Buyer [] ;Other [] (explain); (d) (e) Lending Institution Address ,.~O/ ' ~ ~ of ~ Real Estate Company and Agent Address Telephone Telephone (f) Mail the HAA to the following address: Lo;Il p &_/: TYPE OF RESIDENCE Single-Family)~]~ 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. · 4. SEWAGE DISPOSAL Onsite~l/ Public [] Community [] Holding Tank [] '" Note: If community well system, must have written confirmation from the State Department of Environmental Conservation ' attesting to the legality and status. " ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by myseal 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 ,,4~c~'~ ~"44~" , Telephone --,~'~'('- ~-0~/4~) Date ~ - 7- ~ DHEP APPROVAL Approved /~ Disapproved Condit~.~ 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 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 a ,nalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions,in tl~e professional engineer's work. DEPT. OF HEALTH & "" ",! ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA/ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: L./::~ / MAR I 'L 1986 RECEIVED / ~x/. '~ %. ~-~, ~-:~ WELL DATA Well Classification Well Log Present Total Depth ~'¢~' Cased to J~ Static Water Level I Casing Height Above Ground Electrical Wiring in Conduit ~yN) Separation Distances from Well: To Septic/Holding Tank on Lot If A, B, C, D.E.C. Approved (Y/N) Date Completed ~7-¢2¢- ~ / Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (~.~) Depression Around Wellhead ; On Adjoining Lots /~O (¥ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ; On Adjoining Lots /()~ To Nearest Public Sewer /(.M.~ To Nearest Sewer Service Line on Lot ,~'~ -'~' ;Date B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes al)N) .~, Air-tight Caps CN) Depression over Tank (YN~ Pumping/Maintenance Contract on File (Y/N) /d/~ Holding Tank High-Water Alarm (Y/N) /~"/~ Separation Distances from Septic/Holding Tank: ~'-/L1L~. J Size /.~OO No. of Compartments Foundation Cleanout Date Last Pumped ."~ 7- ~' ; for Temporary Holding Tank Permit (Y/N) t(~/A To Water-Supply Well To Property Line To Water Main/Service Line Course TO Building Foundation ~'. /'~/ ~ / To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed c7--/ Width of Field '~ Square Feet of Absorption Area Depression over Field (Y~)~) Results of bast Adequacy Test / Separation Distance from Absorption Field: To Water-Supply Well /0© "/- To Building Foundation ,¢;2¢2 Lot (-~ ~L / To Water Main/Service Line ~'- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field / Gravel Bed Thickness Standpipes Present (Y~q) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots :;2dD r_/ To Cutbank (if present) /~'-/~ D. LIFT STATION Date installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments ,~ M a ~pm ~f ,e, S~e(vYe/i Na)t ' Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedred~m Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed~& ~ ,~,--~-~ Date ~¥- 7-~'~ Company . A~-~'-~ ~'-~7 MOA No. '~' S~-~).~'/' Receipt No. -~-~ Amount: $ Page 2 of 2 72-026 (11,84) ALASKA ,ldll OFlmdlTAL COF1TF OL Sd lCeS. IFIC. MARCH 10 1986 GREG MCNEIL 3333 DENALI STREET ANCHORAGE ALASKA 99503 SELLER-SAME 60107 LEGAL:PROSPECT HEIGHTS #1/BLOCK 6/LOT 13 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-MARCH 7 1986 WILL PICK UP FROM OUR OFFICE THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 512 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 750 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1200 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 5 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1500 IS ADEQUATE FOR THIS 5 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON MARCH 7 1986 . THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. FLOW TEST ON WELL WELL FLOW DATE-MARCH 7 1986 A FLOW TEST WAS PERFORMED ON THE WELL. 1200 GALLONS OF WATER WAS PUMPED AT A RATE OF 2 GPM OVER A DURATION OF 2 HOURS. THE DRAWDOWN WAS 111 ' WITH A RECOVERY TIME OF 60 MINUTES AND THE STATIC WATER LEVEL WAS 112 FEET. THE WELL IS ADEQUATE FOR THIS 5 BEDROOM HOME. 1200 LUcsl 33r(I Aucnu6, SuiI¢ B · Ancl~oreq¢, Aloske 99503 ,(907) 561-5040 Time .e Date 'Date ~-- Date ~ Inspector Inspector inspector Conditional Approval Comments i ( ) ;i~;approved i ()CondiiJonal Appr~.,~,~ Date Sewer installed ~~ Permit No. Septic Tank Size Holding Tank Size ~ Well Log Received Well To Absorption Area Soils Rating Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY : ~ ~ Phone Buyer ¢~ (~ Address Phone Realty Co. & Agent Address .- . Type~f Residence ~' Single Family D Multiple Family No. of Bedrooms Q Other Wat~Supply WELL LOG A well og is required for,ail wells drilled since June A~ACH .... . ........ that date, give well depth (attach Icg if /~ Individual 1975, For we s dr eu ~ Community available.) , ~ Public Utilit~ Sew~e Disposal Year ~ndividual InstatJed:_ ~ Individual When Connected to Public Utility:~ ~ Public Utility ~ Holding Tank ................ ~,~ ~ ~H~T ACCOMPANY EACH REQUEST ~EFOBE p~OCESSIN6 CAN BE INITIATED.