HomeMy WebLinkAboutHYLEN CREST #1 BLK 3 LT 11Onsite File
Hylen Crest
#1
Block 3
Lot 11
#050-474-07
sul*ml
1n�1AL �n
Municipality of Anchorage
On-Site Water and Wastewater Section ^ (907) 343-7904 Page 1 of 4
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201317 PID Number: 050-474-07
Dwelling: ❑® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade
Name
Kathy and Daniel Bonney
ABSORPTION FIELD
❑ Deep Trench X Wide Trench El Bed El Mound
Site Address
21323 Lowland Ave Eagle River
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
1.2 GPD/SF
8.3-9.3 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.8-5.8 Ft.
Gravel depth beneath pipe
3.5 Ft.
Subdivision Block Lot
Hylen Crest #1 3 11
Fill added above original grade
0-0.6 Ft.
Gravel length
54 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
0 Ftz
2
7 Ft.
Well
> 100
> 100'
NA
NA
TANK ❑® Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Greer
Capacity
1250 Gal.
Surface Water
> 100
> 100
NA
NA
Material
plastic
Number of compartments
2
Lot Line
> 10
> 10
NA
NA
NA
Foundation
>10
> 10
NA
NA
LIFTS.TATION
Manufacturer
Capacity
Gal.
Remarks
Alarm location
Electra stalled by
PIPE MATERIAL House to tank 3034Tank to 3034
drainfield
Installer
ARM Services
Drainfield 3034 co/MT3034
Inspector Curtis Townsend
BENCH MARK (Assumed elevation) 100 ft
Inspdection 1m 10/2/2020 10/7/2020
Location and description
2�d
3b 10/9/20 4'h 10/26/2
bottom siding at point A
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
®"
Or
Conditional Approval: Date
��Q'�. �1�qS����
.... ............o...
!
..
'Curtis L. o send.off..
��+ • �' Date t�• `D; �0
Septic System
Approved t a��
�C�`nc'jri No. CE 119;4 • G� �w
rc'�Q�OPROFFSsio�,�y
/iii%Itzli Date
Note: this approval does not include well permit requirements.
(Rev 05/02/18)
Lot 9
BED : 4 (600 gpd)
OIL RATING: 125 SF/BR
AREA REQUIRED: 500 S.F.
SYSTEM TYPE: WIDE TRENCH
54' x 60" x 42" EFFECTIVE
DEPTH YIELDS 500 SF
EXISTING TRENCH WAS EXCAVATE 7' 1984
OUT FROM NEW TRENCHES AND
BACKFILLED WITH INSITU MATERIAL.
AREA BETWEEN NEW TRENCHES WA
BACKFILLED. IN AREAS WHERE NEW
TRENCHES INTERSECTED OLD TRENCH
ALL BIOMAT WAS REMOVED. MOA FILTER
SAND WAS USED TO BRING BOTTOM OF
NEW TRENCHES UP TO CORRECT
ELEVATION. TEST HOLE ON THIS LOT 2
APPROXIMATELY 150' FROM RA
PROPERTY LINE
Iz-
SEPTIC LOCATED > 10' o
FROM PROPERTY LINE
0
SCOPE OF WORK
1. REMOVED EXISTING SEPTIC
TANKS.
2. PLACED NEW 1,250 GALLON
SEPTIC TANK. THE TANK WAS
PROVIDED WITH A MINIMUM 20"
0 MANWAY RISER SERVING THE
FIRST COMPARTMENT.
CONSTRUCTED TRENCHES IN
TWO EQUAL LENGTHS OF 27'.
MAX DEPTH OF EXCAVATION
WAS 9.3'.
3. ALL CONSTRUCTION WAS IN
ACCORDANCE WITH ALL
REQUIREMENTS SPECIFIED IN
ANCHORAGE MUNICIPAL CODE
CHAPTERS 15.55 AND 15.65.
THISLOT AND MOST NEIGHBORING
LOTS ARE SERVED BY A COMMUNITY
WATER SYSTEM AND THERE ARE NO
® WELLS WITHIN 100' OF THE SEPTIC
HYLEN CREST #1 SYSTEM
133 L12 TH
REMOVED TWO SEPTIC TANKS,
REPLACED WITH 1250 GALLON
Lot 12 SEPTIC TANK. DOUBLE CLEANOUTS 1 SEPTIC LOCATED > 10'
PROVIDED DOWNSTREAM OF TANK I FROM PROPERTY LINE
H® uu
C01MT1DC0 0 10
10 I--7 \ ITTER
CO3 CA2�•
TH �\ MT2B
S \
/8% SLOPE° �• C 4
' T4
4 BR HOME
APPR XIMATE
LOCA ION OF UTILITIES
15' UTILITY
NEIGHBORING WE�Z
'PROTECTIVE R ADf
CONTRACTOR DUG TESTHOLE PRIOR
TO CONSTRUCTION IN LOCATION AS
SHOWN. SEE SOIL LOG ON PAGE 4
—
EASE�E-NT
Septic Record Drawings Prepared for
LOWLAND AVE
KATHY AND DANIEL BONNEY
21323 Lowland Ave Eagle River, Alaska 99577
HYLEN CREST #1 BLOCK 3 LOT 11
EKLUTNA ENGINEERING,
19162 MOUNTAIN ROAD
CHUGIAK, ALASKA 99567
(907) 355-9820
OSP201317
LLC
DATE: 1/13/2021
DRAWN: CLT
SCALE: 1" = 30'
PID: 050-474-07 SHEET 2 OF 4
0.
U)
W
U
LLJ
Q
n
Aff '' .. 4,9 TH �. ♦.
.....:.................................
♦ 80. CURTIS TOWNSEND ��
♦♦�i� ; No. CE 11904 '� i
4 VA visa
.10
27' x 5' x 42" EFFECTIVE 27' x 5' x 42" EFFECTIVE
DEPTH TRENCH DEPTH TRENCH
MARK
A
B
SI/1
17'-0"
29'-2"
SV2
21'-3"
30'-11"
DCO
23'-6"
31'-2"
C01/MT1
36'-5"
39'-11 "
CO2/M T2
33'-11 "
13'-11 "
CO3/M T3
44'-7"
28'-9"
C04/M T4
51'-4"
15'-4"
SILTY GRAVEL
SAND AND GRAVEL WITH SILT
SILTY GRAVEL
COARSE SAND & GRAVEL
Septic Record Drawings Prepared for
KATHY AND DANIEL BONNEY
21323 Lowland Ave Eagle River, Alaska 99577
HYLEN CREST #1 BLOCK 3 LOT 11
EKLUTNA ENGINEERING, LLC
19162 MOUNTAIN ROAD
CHUGIAK, ALASKA 99567
(907) 355-9820
DATE:
DRAWN:
SCALE:
PID: 050-474-07
SAND & GRAVEL
OSP201317
1/13/2021
CLT
1 1/2" = 1'
SHEET 3 OF 4
97.2
-4
PEGRC TEST 4.4 mpi
-7
_9
-10 MAX DEPTH OF EXCAVATION
81 .2
P.. q� �s��♦i
.
AV
49TH ..•�%
0 ............. . ......................::
oi�—:�CURTIS TOWNSEND: 7i
00.
No. CE 11904 _Al
11 4/; h"��•• ••
ORGANICS
1
DATE
CLOCK TIME
2
GM
GP
NET
DROP
GM
9/21/2020
3
30
6"
4
5
6
7
8
9
DATE
CLOCK TIME
GC
GM
GP
NET
DROP
SOILS LOG — PERCOLATION TEST
N0.
10
DATE
CLOCK TIME
NET
TIME
(MIN)
WATER
LEVEL
READING
NET
DROP
1
9/21/2020
17:14/17: 44
30
6"
— 0"
6"
2
9/21/2020
17:45/17:55
10
6"
— 3"
3"
3
9/21/2020
17:56/18:06
10
6"
— 3 3/4"
2 1/4"
4
921 2020
18: 06 18:16
10
6—
3 3/4"
2 112r-
45
5
9/21 /2020
18:19 /18: 29
10
6"
— 3 3/4"
2 1/4"
6
9/21/2020
18:30/18:40
10
6"
— 3 3/4"
2 1/4"
7
9/21/2020
18: 41/18: 51
10
6"
— 3 3/4"
2 1/4"-
/4"
10
11
12 SM
13
14
15
16
DATE PERFORMED: 9/16/2020
WAS GROUND WATER
ENCOUNTERED? NO
DEPTH TO WATER AFTER
MONITORING? NO WATER
DATE: 9/23/2020
DEPTH TO WATER AFTER
MONITORING? NO WATER
DATE: 10/2/2020
Lot 12
1984 H® m
O
I Ts\
ss
CD
0
J
4 BR HOMEI
15'
PERCOLATION RATE: 4.4 MIN / INCH
PERC HOLE DIAMETER: 6"
TEST RUN BETWEEN 5 AND 6 FEET AS THIS STRATA WAS
THE LEAST PERMEABLE STRATUM PROPOSED FOR USE.
PERFORMED BY: CURTIS TOWNSEND. I CURTIS TOWNSEND CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9/21/2020
Septic Record Drawings Prepared for
KATHY AND DANIEL BONNEY
21323 Lowland Ave Eagle River, Alaska 99577
HYLEN CREST #1 BLOCK 3 LOT 11
EKLUTNA ENGINEERING, LLC
19162 MOUNTAIN ROAD
CHUGIAK, ALASKA 99567
(907) 355-9820
DATE:
DRAWN:
SCALE:
PID: 050-474-07
OSP201317
11/7/2020
CLT
1"=30'
SHEET 4 OF 4
W
LOT 10 0
0
O
0
O
z
a�0000p��
OF A X44
�* 49 TH �*
................................
~, STEVEN CALLAHAN
LS -12034
144 nf
4veSsion6 _�01_
250 H Street
Anchorage, Alaska 99501
Survey Department
Phone 562-5291
® Inc Mainline
A� Phone 243-8985
AECC 668
ORDERED BY: CURTIS TOWNSEND, EKLUTNA ENGINEERING, LLC
MANHOLE -\
so
0
Ck.EPN 00101 NO
00
SVP . h3
C
47.7'
••
0
m
LOT 12
S88° 51'53"E
10.7'
205.00'
::::::::::::::...� 15' ELECTRIC & TELEPHONE EASEMENT v
........
00
N89° 59'00"W 185-00' P
LOWLAND AVENUE
LEGAL DESCRIPTION:
LOT 11, BLOCK 3,
HYLEN CREST UNIT NO. 1
DRAWN DATE:
DRAWN BY:
O
6.2' ~
SC
WLU
to
ti
L
NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES
SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERI
LINES, OR FOR PLOT -PLAN PURPOSES.
Ln
cow
LOT 11
0
G o
�
O
a
WLU
°
�n W
o
CD
U)
I
::::::::::::::...� 15' ELECTRIC & TELEPHONE EASEMENT v
........
00
N89° 59'00"W 185-00' P
LOWLAND AVENUE
LEGAL DESCRIPTION:
LOT 11, BLOCK 3,
HYLEN CREST UNIT NO. 1
DRAWN DATE:
DRAWN BY:
10/16/2020
ADS
CHECKED BY:
SC
SCALE:
1 11 = 30'
WORK ORDER: 20090
PLAT: 83-91
GRID: NW0057
FB/PG: 818/72
AS -BUILT
LEGEND:
CLEAN OUT
WATER WELL
FENCE —
0
m
25'
ILL]
J
U
('
U
U)
ILL]
U
25' LU
Of
NOTE:
THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN
WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH.
��]�]:1�.Y.��i[c�ic��iPi�l�1►1�7\�/�►111�11 Zil��E31<i1.7ibfLQ�yQiI�I�I
SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THE
PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS
SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST
OTHER THAN NOTED.
Asphalt ;.......
Brick
EXCLUSIONARY NOTE: IT ISTHE OWNERS' RESPONSI BI LITY TO DETERMINETHE EXISTENCE
O
OFANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DO
Overhang
NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES
SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERI
LINES, OR FOR PLOT -PLAN PURPOSES.
X
Wood Deck
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP201317
Work Type: Septic Upgrade
Tax Code Number: 05047407000
Site Legal Address: HYLEN CREST #1 BILK 3 LT 11 G:0057
Site Mailing Address: 21323 LOWLAND AVE, Eagle River
Owner: BONNEY KATHY ALLEN & DANIEL
Design Engineer: EKLUTNA ENGINEERING, LLC*
This permit is for the construction of:
Effective Date
Expiration Date
ry
�1 r
V ��U
Departinent
Lot Size in Sq Ft
Total Bedrooms:
8/24/2020
8/24/2021
20003
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
The Engineer is to do a minimum 15.5 foot deep test hole, including percolation testing, prior to the construction
of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete.
Please submit stamped and signed results with the As -built Inspection Report. If the results require a design
change, construction of the system will stop pending On -Site review and approval.
Received By:
Issued By:
Date:
Date: 0
( Z4/�_'f )
12
MUNICIPALITY OF ANCHORAGE
Development Services Department s Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 050-474-07
Property owner(s) BONNEY KATHY & DANIEL Day phone
Mailing address 21323 Lowland Avenue Eagle River AK 99577
S'lt 14A 21323 Lowland Avenue Eagle River AK 99577
ea ress
Legal description (Sub'd., Block & Lot) HYLEN CREST #1 BLK
Legal description (Township, Range & Section)
3 LT 11
Lot Size 20,003 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
F
Initial ❑
Single F F)
(w/*2_ ADU
0
Septic Tank
El
Upgrade FE
❑
(D)
Holding Tank
❑
Renewal ElDuplex
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above informatio s correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Q 50-VI1)-19) Waiver Fees:
Date of Payment: g i 0020 Date of Payment:
Receipt Number: 0 S'O L -lb Receipt Number:
Permit No. OSP20 j`�1r( Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\FormsUient FormsTermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201317, Deb Wockenfuss, 08/24/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201317, Deb Wockenfuss, 08/24/20
MUNICIPALITY OF ANCHORAGE
Dr RI'MENT OF HEALTH AND HUMAN SER ES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name
Phone(s) Permit No. No of Bedrooms
LEGAL DESCRIPTION
Township, Range, Seclion
TANKS
~ SEPTIC
[] HOLDING
Material -- No.-~l Cor~l~ts
TYPE OF SYSTEM
(~,'FRENCH Er BED [] W. DRAIN [] OTHER
$1) FT
iravel width
WELLS
FT
[~ PRIVATE
Installe~
~OTHER (Identify)
REMARKS:
DISTANCES
TANK FIELD WELL
WELL ~oo ~'~- ~oat4'-
LOT LINE ~_.o
FOUNDATION
AS~BUILT DIAGRAM (Show location ol well, septic system, property I,nes, foundahon,
dfp/eway, wator bodies, etc.)
,~ ri.i:'- / ?6×
U-.'fi;: Wv,":v,.~"~"~'J..,~,.,'t 995/'7'
Municipal arid State guidelines in ellecl on this date: __.
Health Department Approval: -'"
72-013 (3/85)
Scale:
Inspections Pedornred by:
: cedily IhaI this inspection was perfornled acoording Io ail
MUNICIPALITY OF ANCHORAGE ~
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- A~choraga, Alaska 99501 Tel0phone 264-4720 ~
ON.SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
IPHONfi
[] UPGRADE
DISTANCE TO: IWell
Manufacturer
' DISTANCE TO: / ~OO ~
NO. 0%EORO0 ,
i.,mgth Width
tgi), of c~r~partmanls
Inside length Liquid depth
Dwelling PERMIT NO,
Liqu!d capacity in gallons
Material
Tote, le,~fof lines J Trench?~,~th inches
Materiel beneath tile
inches
Depth
Distance between lines
Total effe~ive ~.bsorptior~..~ea
vERMIT NO. u
Type of crib
DtSTANCE TO:
i"C!ass J
DIE'I'ANCE TO:
Crib diameter
Well
Oepth~.~t
Build~]g foundation
Crib depth
Building foundation
Driller
Total effective absorption ere0
Nearest lot line
Oistanco to lot line I PERMIT NO.
Septic tank Absorption area(s)
OTHER
~N~TALLB~
REMARKS
...................
................
......................... E~ ~'~i-~da--. :~,. ......
APPROVED OA'TE
I. FGAL
DFZPAF~TMENT OF HEAl_TH AND ENVIROi',IMEEIqTAL F:'ROTECT]:OIq
G25 I_ S'TREF~T, AI',ICHDRAGE, Al'::: 9950 t
C]: ~ ..... ~E:~ ][ "T- IL: :E~, IE~Z ~,,JI
F'ISRMIT NO:
DATE ISSUED:
APPLICANT:
ADDRESS:
COl ITA[.¥ F'HONE:
84069:Z.;
08 / 13/84
WALKER CONSTRACTING
F'.O. BOX 1974
EAGLE RIVER, Al.'.:: 99577
694-4858
LEGAL DESCRIP:
L[)T SIZE:
LDT LOCATION:
PlAX BEDROOMS:
SUBDIVISION: HYI_EN CREST
SECTION: 8 TOWNSHIP: 14N
(SQ.I=T. OFt ACRES)
.5A
:]..i
LOT: 11 BLOCK:
RANGE.' 1W
Listed below are the options available 'Lo you in d~-~signing your septic
system. Clnoose the option that. best fits'your site.
.................................... ................................
DEPTH "FO F'IPE BDTTOM (FT.) 4.0 z~,o 4.0 4.0
GRAVEL DEPTH (FT.) ~1 ----~ 3,,5 ~.3' 0,,5 2.5
T(]TAL DEF'TH (FT.) ~ 7,~5 . '7,3 4.5 6.5
GRAVEL WIDTH (FT.) 2.5 2,b~ 15.0 5.0
GRAVEl_ LENGTH (FT.) 42.0 ~5- ~?..0 37.0
GRAVEl_ VOLUME (CU.YDS. 15.5 16. 1 ~')
TANK SIZE (GALS) 1,000.0 ~-~ 1,000.0 .~.~ 1,000.0 ~.~
96 96 96
SI]IL. RATING (SQ.FT./BF4) ~ ~g ~ ~
~e TANK MUST 14AVE AT LEAST TWO COMF'ARTMENTS
I c~..~rtify that:
1. I am familiar with the requirements fop on-site sewers and wel].s as set
fortln by the Municipality of Anchorage (MOA) and tine State of Alaska.
2. I will install the system in accordance with all MOA codes and regulat, ions,
and in compliance with tine design criteria oF this permit.
3. I will adhere to all MOA and State o{ Alasl<a Pequirements fo~' the set bacl<
distances From any existing well, wastewat, eP disposal system or:public
sewerage system on this or any adjacent Dp nearby lot.
4. I understand that this per'mit is valid for a maximum of 3 bedro6ms and
any enlargement will ~'equire an addition~i permit..
IF A LIFT STATION IS INSTAl_LED IN AN AREA COVERED BY MOA BUILDING []ODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPEC, TION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN EI_ECTRICAL INSF'EC]'IOIq REI='ORT; AND .(3) THIE
ELEC]RICAL WORI~LJS~ EE DONE B~ A LICEN~ED ELEC,]I~ICIAN.
c* - ~~ DATIE:
u) I GNED
AF~PLICANT: ~_KEF~ ~TRACTING
ISSUED BY ~/ DATE:
N
NAME
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Ancl~orago, Alaska 99501 Telephone 264-4720 · ~-
ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
__ ]PHONE
C
[] UPGRADE
I OCA [ ION
T' 4 d {::.!IV,./
........ ] Well
, DISTANCE TO:I ~ ~ /
..... 'i~, 7.
¢ Liq capacity in gallons~ ...... ~MA~E
QOz I DISTANCE TO:
0~ }M~nuf~cturer
Absorption area D~llin~ I
Inside ~ength '/~;~i~
Dwelling
F ounda,.~ ~
Tot¢l le~¢.~ tof lines
'Fop of tile to¢~sh/grade Material beneatXi~
t.ungth Width Depth
T~/l~,'~'f~ril~- ........ Crib diameter Crib depth
Well ~ Bui,ding four, darien
DISTANCE TO: /
/'O as~' '~ Depth / Driller
..... --J Bt Iding loundution /Sewer lin~
DINTANCE TO: ~'~' /,
........
Material
N,mrest Jot line
I ,%' 'b
Trencl~vidth
,~-{::~ inches
inches
NO, OF BEDROOMS
NO.
Liquid depth
PERMIT NO,
Liquid capacity in gallons
Distance betwoan lines
Total e f f e~iS~,~ s o rpt i o,rl.~ea
PERNIIT NO.
Nearest lot line
Distance to lot line
Septic tank
LPERMIT NO.
DATE
POu,.,H 6-650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES.
MA YOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Permit ~: 840693
January 31, 1985
TO: Permit Applicant
SUBJECT: Lot 11 Block 3 Hylen Crest Subdivision
A permit issued by this Department for an individual well
and/or on-site sewer system has expired as of December 31,
1984.
Permits are issued on a calendar year basis by authority
of Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system not
installed by the expiration date.
If you have drilled the well, a well log needs to be sent
to this Department for documentation of the installation
and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, the original as-built inspection report
and the yellow copy must be sent to this office for review
and approval, and for documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Keith E. Bandt, SupeYvisor
Environmental Engineering Program
KEB/ljw
enc: Copy of Permit
SWP/057
F"IERM I 'T' NO:
DATE!: ISSLJED:
APPLICANT:
ADDRESS:
COpI"FAC'T' I:::'HONE:
L..EE)AL~ DIESCRIP:
LOT F.'J I ZE:
I_OT LOCATION:
MAX BEDRDOMS:
P'"', ILJ ~,,,~ ][ C:]: :]: f" J¢~ IL.... ::[ '"~- '"¢' C]l IF::" ~lc'.~l~ IP, ll C]: I1"'-, Cji
DEF:'ARTHENT OF FIIEAI_TH AND ENVIRONMENTAL FF~D'TECTIOI'q
825 L S'T'RIEET, AItL, HDI-.,AGI::., AK 9950
E.} ~ q .... '~, ][ 'T E:.: SS~ EE: b,dl EE: f;~ IF" E'S_"] F~." P"I
840693
08/13/84.
WALKER CONSTRACTIPIG
F'.O. BOX 1974
E.']A[')LI~ RIVER, Al'::: 99577
694-4858
SUBDIVISION: HYLEN (]RES]"
SECTION: 8 TOWNSHIP:
(SQ.FT. OR A[]RES)
.5A
3
L.OT: 11 BLOCI<." 3
14N RANGE: 1W
List. ed be].c~ are the optic~ns available 'Lo you in design:i, ng your sept:Lc
system. Choose t. he op'L:i, on that. best fits'youe site,,
DEF:'TI"] TO F:'IF'I!"] BO]'T'OM (FI".) /:~,, 0 4.0
['}RAVEl_ DEP]'t4 (F"T'.) 3,, 5 0,, 5
]"OTAL DIEF']'H (ET'.) '7 ,~ 5 _ 4 ,, 5
GRAVEL. W.I:DTt4 (F:'T,,) 2.5 15,, 0
GRAVEl_ LENGTH (F:'T ,, ) 4.::..?. 0 29 ,, C'
GRAVE~L.. VOLUMIE (CU.YDS.) 15,, 5 16. 1
TANI< S I ZE (GALS) 1 .,, 000.0 ~",~' .t., 000.0 '~"~'
SOIl.... RATII'4G (SC,!.FT. /BR) 96 96
'~'~- "FANK MLIST HAVE AT I_IEAST TWO (3OMPART'MENTS
4. ,, 0
6,, 5
5 ,, 0
37.0
20 ,, 5
000 ,, 0 .~..~.
96
I c:ertify t. hat:
1. I am familiar with the requir'ements for c)n-sit, e sew~r's and wells as set
for'th by the Municipality ~t' Anchor, age (MOA) and 'Llae State o¢ Alaska.
2. I will install tine system in accc)r'dance with all MC}A codes and regula'L:Lor~s,
ar'id in cc~mpl:i, ance witl"l t. he design cri'Leria c:)f 'Llnis per'mit.
3. I w:i.].l adher'e 'Lc) a].]. M[]A alqd St. at:e DJ' ¢~lasJ.:'.a peqt,.t:i.l-em(;erlts~ fop t. he set bacJ<
dist,¢:U'lC:es ¢l"om ar'iy 8>{istil'lg we].l~, was'LePta'[.(:al" d:Lsposal system or'publ:i.c
sewer'age system on 'Lhis~ e:n- any adjacerH:, of near'by la'L.
4, I underst, and that, 'Llais permit is valid for a max:i, mum of' :3 bedroc~ms and
any enlar'gement w:i.].], r'equire an ad(:liti(~n~:~l per'm:i.t..
IF A LIFT STATION IS INSTAL. LED IN AN AIRE:.A " ' .....'~ BY ..... '"'
bI]dI:J~ED MOA BLJII_DIIxlG [.[]bt'.::.~,
THEN (1) APl ELECTF~ICAI_ I~ERM:[T AND INSF'IECTION MUS't" BE OBTAIIqED; (2) AS'-BUIL.TS
WILL ND'I" BE AF'F'ROVED WITHOLJT AN ELECTIRICAL iPlSF:'ECTIDIq REF:'[]RT; APID (:];) TI'lIE
.... ,'] C"'" (- ~ ' qV ..... ~ ~ ............
ELECTRICAL WC.IIR~d..J~:~I EE. DDI.fE B~ A L..I. CEII~ED [:LI::.C]RJ.C.I. AI I.
S I GPlED DA ]"J2~ _.:
ISSUED BY ~ ....... DATE:: '~_ '--
PERFORMED FOR:
LEGAL DESCRIPTION:
[] SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
PERCOLATION
TEST
1
2
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
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WAS GROUND WATER ~Xl~ S
ENCOUNTERED? L
O
~ ~'~ I~.~ . p
E
IF YES, AT WHAT
DEPTH?
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water' Drop
3 .~. ,'~., !~ ,~, ..,.. ~,, ~
TEST RUN BETWEEN
' ' \d
COMMENTS J~ S C~ Y" '/'"L)'~¢~ (.'lf~ ~""~'~ e ~ ~ ~
'
72-008 (6/79)
DATE:
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COSA Checklist.docx
COSA Checklist
Legal Description: HYLEN CREST #1 BLOCK 3 LOT 11 Parcel ID: 050-474-07
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA - PUBLIC &/OR CLASS “A” WATER
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 58”
Date of pumping 8/7/24
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 10/26/20
ALL standpipes present per record drawing
Total measured depth from grade 9.3 ft (max)
Measured depth to pipe invert from grade 5.8 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective (ED).
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced 2000 gallons 8/7/2024 date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 8/8/24
Results Pass
Fluid depth prior to test 0 in
Water added 600 gal
New fluid depth 7 in
Elapsed time 1440 min
Final fluid depth 0 in
Absorption rate 600 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 42 in (MOA 3.5’ ED)
Effective depth used 0 in (Final Fluid Depth)
Effective depth remaining 42 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots &
appears approximate.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 9/4/2024
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
9/4/24
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
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b)
(c)
Applicant Name ¢--~,~ ~.o~,.g~'~. Telephone:Home ~_C~r'~%-- Business
Applicant Address '~,O, "~,? f-'~t-~'~-Oq ~ F..,~ .
Applicant is (check one): Lending Institution []; Owner/builder ~"'; Buyer []; Other [] (explain);
(d) Lending Institution ~ O ~ ~ Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f)
Mail the HAA to the following address:
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.
SEWAGE DISPOSAL
Onsite/~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 [11/84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm
Address 5RB
Date Ea~Je River,
Telephone
/
DHEP APPROVAL
Approved for '~'~'~' ~-~bedrooms by ~ '~'' '~~ Date
Approved ~ Disap~,.ed Co~nal
· -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
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MO,,.,,~,
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
,MUNICIPALITY OF ANCHoP-,AGE,
DEPT, OF HEALTH &
ENVIRONMENTAL PROTECTION
3 u 1986'
WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth Cased to
Static Water Level
Casing Height Above Ground
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
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
'l~llJf~LI(~.~ If A, B, C, D.E.C. Approved ~,,N~
Date Completed Yield
Dept)'~/~/~ routing
//~.~ump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
,~Oo i ¢- ; On Adjoining Lots 2z~"o' '~
bo / ~ ; On Adjoining Lots ~.~,~c~ ¢ ¢'
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed Size /g20(2 No. of Compartments
/
Standpipes ~:rj~..)- Air-tight Caps(C~//N) Foundation Cleanout(~/N)'
Depression over Tank,.Cf~) Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) /,¢~/A-"'~.. T ;for
Holding Tank High-Water Alarm (Y/N) //.~ emporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Su'pply Well ~,~c~o J +'' /~u4CZ-~ To Building Foundation
To Property Line /o i*"" To Disposal Field ,-%'-/
To Water Main/aef. vic. e Line ¢.~O
Course
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026{11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed //"~- g J~;
// ,' // ' /
Width of Field ,~' '/
Square Feet of Absorption Area
Depression over Field
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot
To Water Main/-Se~-iee Line
of System Design
Type
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present ~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments /,~'! ,,/---¢~'/~:~-/' ~--¢-.'~ Z/'~,¢~¢
Date Q~ Last Adequacy Test
To Property Line )'o/'~
To Existing or Abandoned System on
; On Adjoining Lots ,.~O ' ~
To Cutbank (if present)
D. LIFT STATION
Date Installed Dimensions
Size in Gallons
Manhole/Access (Y/N)
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (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 checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
$ & S Engineer|tV,
Signed $i~,
Company Eaele
Receipt No.
Date of Payment
Amount: $
Date /'/2-'/~/
MOA No.
Page 2 of 2
72-026 (11/84)
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BILl. SHEFFIELD, GOVERNOR
Telephone: (.907)
Address:
274-~533
To Whom it May Concern:
,cco ding
to records on file in this office the ~..i~/:,,(~/~j /..c~./ --
, ~],:_.~JJ'(__.-<..../] ~ ~] ~]7~ Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
I,
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL
DEPARTMENT OF HEALTH AND ENVIRONMENTAL IEt0TF. CTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
io General Information
Application Date
(a) Legalt. II Description~ ~5 I~'~/C~'~j(include~/~CLi~l°t']~ blocl~, subdivision,~ ~ ~ .~ 63 section,f~ { u.3 township,_ _ range)
Location (address.or directions)
(c) Applican~ ts (check one) Lending Institution ~ ¢ ~er/bullder~
Buyer ~ ; Other ~ (~plain);
Mail ~he t~ ~o the follo~ng ~dress:
~dence
Single-Family~--~
Number of Bedrooms
Multi-Family~
Other (describe)
Water Supply
Individual Well
Community ~
Public
Note: If community well system, must have written confi~ation from the State
Department of Environmental Conservation attesting to the legality and status.
Sewage
Note: If community well system, must have written confirmation from the Sta~e
Department of F, nvironmental Conservation attesting to the legality and status.
[Page 1 of 2]
5. Ensineerin8 Firm Prowtdin~ Inspections~3 Tests2 File Searc~ Data and Information
Approved fo~'~.ek~-_.~ 'l~edrooms
Approved~
As certified by my seal affixed hereto and as of the validation date shown below,
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 ~pe of s~ructure indicated herein.. I further verify that,
based om the info~atiou obtain~ from the ~nicipality of ~chorage files and from my
investigation ~d inspection, the o~si~e ~ter supply aud/or ~stewa~er dispos~
system is in compliance ~th ~1 ~nicipal and S~ate codes, ordinances, a~ regula-
tions tn effec~ on ~he date of ~his in~pec~ion.
Di~approved
Terms of Conditiouad. Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARA~H 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASI~A. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. 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 ~IOFESSIONAL ENGINEER'S WORK.
Ra4/eJ/D~8
[Page 2 of 2]
(OHEP ss>&)
7-19-84
A. WELL DATA
MUNICIPALITY OF /~C~Cj~AT.--- OF ANCHORAGE (MOA)
DEPT. OF HEA'L'"JT{'8~ ..... J"J":~
ENVIRONMENTAL PL~NAUTHORiTY APPROVAL (["]AA)
J]£O 2 0 lgl~''~EcKL'rsT - F~RUARY 1984
RECEIVED
Well Classification
Well Log P~esent (Y/N)
Total Depth Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances f~cm Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Se~ Line
C leancut/Manhole
Wate~ Sample Collected By
Water Sample Test t%~sults
C~'t~nts DL3 ~-~ ~
Legal Description: ~- ! f '~'~.~
$ '7' I R,
If~B, ~ C, D.E.C. ~p~o~d(Y~) ~
~te ~leted Yield
~pth of Groutinq
Pump Set At
Sanitaz~ Seal on Casing (Y/N)
Depression A~ound Wellhead (_Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Se~r
To Weakest Se~r Service Line on Lot
; Date
B. SEPTIC/HOLDING TANK DATA
Date Installed ~-/7-g~ si~
Standpipes (Y/N) ,~ Air-tight Caps (Y/N) y
Depression ove~ Tank ,(Y/N) AJ Date Last Pumped
Pumping/Maintenance Contract on File (Y/N)/t/~ ; for
Holding Tank High-Water Alarm (Y/N) ~-//~ Temporary Holding Tank Permit (Y/N)
Separation Distances f~am Septic/Holding Tank:
To Water-Supply Well + ?~00' To Building Foundation ~ ~
TO P~operty Line + /.~''
To Water Main/Service Line
Cou~ /U .A ,
No. of Cc~a~tm~nts '~
Foundation Cleanout (Y/N)
To Disposal Field ]Z.I
TO Stream, Pond, Lake, c~ Major D~ainage
Comments
Receipt 9
Date Paid:
Amount:
[Page 1 of 2]
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date .Installed ~-/
Width of Field
Square Feet of Absorption A~ea
Depression over Field (Y/N)
Type of System Design '~-/~/d/~H'
Length Field
Depth of Field 7 L ~ ./
Grail ~d Thick.ss J f ~ w
Stan~i~s ~e~nt (Y~)
~ of ~st A~a~ ~st ~~
Results of Least Adequacy Test
Separation Distance from AbSorption Field:
To Water-Supply Well ~ ?_O~9 TO P~operty Line
To Building Foundation 30 ! To Existing or Abandoned System cn
Lot ~k/ ~ ; On Adjoining Lots '~ '3 O'
To Water Main/Service Line + q~O / To Cutbank(if present)
To Stream/Pond/Lake/or Major D~ainage Course
To D~iveway, Parking Area, c~ Vehicle Storage Area ~
Cc~ments
Date Installed
Size in Gallons
"P~'~p On" Level at
High Water Alarm Level at
Tested fo=
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"P~ Off" Level at
Vent (Y/N)
Pumping Cycles c~ing Adequacy Test.
Meets MOA
Comments
** Check Permitted Bedrc~m Rating Against HAA Request
I certify that I have checked, verified, or conforn~d to all MOA HAA Guidelines in effect
on the date of th~s inspection. .~=~ .--d'~ ~'~7~!~h~
Signed
KB1/dL/s
[Page 2 of 2]
2-15-84
HENRY WILSON
960[ BUDDY WERNER DR.:
ANCHORAGE, AK 99516
(907) 346.2000
Construc neers, Inc.
CHARLES A. LANDERS
SR BOX 192-A, MYRTLE DR.
EAGLE RIVER, AK 9957'/
(907) 694.9098
December 26, 1985
MUNICIPALITY OF ANCHOP, A(3E
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
1985
RECEIVED
~unicipality of Anchorage
Div. of Environmental Health
825 L Street Re Lot 11 Block 3
Anc~torage, AK I{ylen Crest
Gentlemen:
The water supply and sewage disposal systems for
this property were not placed in use until Decem-
ber, 198~.
Very truly yours,
CONSTRUCTING ENGINEERS, INC.
Itenry H. Wilson