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Home My WebLink AboutDEVONSHIRE #1 TR A Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221433 PID Number: 015-283-62 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name SISTER OF THE EUCHARISTIC HEART OF JESUS ABSORPTION FIELD ❑Deep Trench El Trench El ound Site Address 2843 Huffman Rd ❑ Other Phone Phone Number of Bedrooms 3 Soil Rating Total depth fr original grade Existing GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Devonshire #1 Tract A Block Lot Fill added above original gra Gravel length Township Range Section Ft. Ft. Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total ab rption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well >100' > 100' N/A N/A >25 TANK Q Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Infiltrator Capacity 1060 Gal. Surface Water >100' >100' NIA N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield HILAND EXCAVATION Drainfield D3034 c0/MT D3034 Inspector L. Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection 15t 11/9/22 Location and description dates: 3 2 m th Bottom of siding @ deck stairs 4 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date Septic System ZI Ben)arryrSchiller FFG' •.. CE 12592 Approve Date 2t�}— 'sr 11/28!22 .•'•Cz pROFi Note: this approval does not include well permit requirements. � DEVONSHIRE #1, TRACT A PERMIT # OSP221433 PID # 015-283-62 I� i I Li L6 L� �" I - ; (? D BY PU P- A r1) i ul Nm lem m 10' T&E EASEh1ENT z SHEDS EXISTING 50' uj TRENCH W -- w o / � I , \ / \ 2CO l CORRAL \ H2 2C0 H1 CORRAL !! \ j ASTABLE '� f f A NEW 1,060 GAL B { INFILTRATOR 3-BDRM HOME i SEPTIC TANK I CAR PORT f \ f � J ENG IN EE RING 0 �I• ®Y Benja i Schiller (��Fc •. CE 259211128122 \®�PROFESSIONP .� HUFFMAN ROAD PLAN AS -BUILT 0 50 100 -mm om FEET 111=50' A B 2CO 62.3 30.0 MH1 64.4 32.0 MI -12 69.2 36.9 2CO 73.7 40.7 �z Z U, Lu Lu �w w 0 EL , \ Cm p LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PERMIT # OSP221433 ENGINEERING PID # 015-283-62 lWallola (NO SCALE) M. . • ' • • • • • Benja ' Schiller ' ®�'F� •. CE 12592 •��`�i 11/28122 o`��jw�PROfESS10NP�'4 AW Lot 7 / Lot 6 \Lot5 N89°57'38"W 329.98 Wood fence (typ TRACT A Hi#hed etal fence ®Septic vent (typL~ 0Manholes Chimney a. 11/2 StoryFrame11_HOuse T -----------e ----- S89°57'07"E 329.99 HUFFMAN ROAD RECERTIFIED 12-05-22 AS-BUILT NO CORNERS SET THIS DATE I hereby certif}/ that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: __ _TRACT A, _ ______ DEVONSHIRE ADDITION No. 1 lizabeth L. Wdlatka SCALE: 1"= 60' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED FLAT ARE NOT SHOWN HEREON UNLESS OTHERWISE NOTED, :;€f##\:ftyis. 8036 -LS I Z. 3 I . 2.E}.a:I FB 224, pg 31-32 FB 16-13, pg 34-36 Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines ahd do not overiap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 21st day of December , 2016. 907-248-1666 FRED WALATKA & ASSOCIATES, L.L.C. Engineers and Surveyors This drawing is a representation of conditions found at the time the mortgage location survey was perfomed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use Of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. ` MUNICIPALITY OF ANCHORAGE 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 Circ -Site Wastewater Disposal System Permit Permit Number: OSP221433 Work Type: SepticTank Upgrade Tax Code Number: 01528362000 Site Legal Address: DEVONSHIRE#1 TR A G:2734 Site Mailing Address: 2843 HUFFMAN RD, Anchorage Owner: SISTER OF THE EUCHARISTIC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: oar S. _ v Del,>ar�rme.iat 10/28/2022 10/28/2023 92602 ❑ 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 theSt ate 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, seated, and heated to prevent freezing Received By: 1, INtce t-�a �(� �—p r-- Issued By: Date: Date: 3 UNICP UTY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-2 83-62 Property owner(s) Sister of the Eucharistic Heart of JesusDay phone 907-360-3722 Mailing address 13900 Specking Avenue, Anchorage AK 99515 Site address 2843 Huffman Rd Legal description (Sub'd., Block & Lot) Devonshire #1 Tract A Legal description (Township, Range & Section) Lot Size 92,602 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: (® all that apply) Upgrade Absorption Field ❑ Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: Initial ❑ Upgrade ❑X Renewal ❑ TYPE OF DWELLING: Single Family (SF) ❑X (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. L Signature of property owner or authorized agent) Permit/Rush Fees: ai 4" S Date of Payment:Zo J l: f'�? Receipt Number: Permit No. Permit App_::- ::.,:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. October 12, 2022 Municipality of Anchorage On-site Water and Waste nater REVIEWED FOR CODE COMpUAN, OSP221433, Tim Eddund, la'28"22 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FORGECIVIL.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Devonshire #1 Tract A - 2843 Huffman Rd Septic system design Dear On -Site Services Engineer: The owner of the above lot has a septic tank that has reached its end of useful life, so we are submitting this permit application for its replacement. The attached site plan identifies the location of the 3 -bedroom home as well as the wells and septic location. No conflicts exist between this proposed system and any other wells or septic system, whether on this lot or adjacent lots. We are replacing the septic tank with the same size. The new septic tank will be a minimum of 100' from all wells and surface water, and more than 5' away from the absorption field. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE i Lis L17 L1$ L7 F— DEVONSHIRE #1 TRACT A - On-site Water and 1Nastewater REVIEWED FOR CODE COMPLIF OSP221433, TimEcklund, 10128V, L611 L5 1� I (y,96FIVE® BY AWWU PUI31 IC WATEM 200' WELL RADIUS I� I •I 10' T&E EASEMENT Ali I SHEDS EXISTING 50' TRENCH wl � DECOMMISSION i EXISTING SEPTIC \ I / TANK \ \ CORRAL � CORRAL ° � --2c1 / \R STABLE t � )`R.GE ENGINEERING OF:-, • *7 -49 7H Benja i Schiller �•• CE 2592 ••� ' `cO• ®,�P 10,15122 ROFESSIONP,o, HUFFMAN ROAD NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. 0 50 100 kW FEET 11.=50' NEW 1,000 GAL SEPTIC TANK II � o u 1 Ute \: LIJ w � \ (w Z7m \ w U co N I LEGEND CO - CLEANOUT 2CO-DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE 0 J 0 J :3 CCD O V O CO CV P ti W m oLO .t CY7 0 S �C) Lot 7 Lot 6 , Lot 5 / N89°57'38"W 329.98 ' f- — — — — — — — — — — — — 1D' — Telecomm. & elec. Easement ----------------------- I Wood fent& -/ i i I t 1 .I I hed i ( I clot fornc;;:,, I 1 1 I _ Corral 1 c( m EI w _ 0 ua Corral rhad LO C) Well, Car Po •`�"�- SCALE: 1"` NTS 60r EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED TRACT A �aptie vents--+ Wre fen v 64.0 1 V2 story Fnmo House Cone, bfoek rat. wall (typ) 589'57'07"E 329.99 HUFFMAN ROAD Municipality of Anchorage tOtArlgi On-site Water and WasteAster OMPL1ANi la2&22 I I I 1 I 1 I i 1� IE 12 cc IUj d CD led 0 z m { E a c 0 IF co to O (- O S 82. o Z E I � m ( .d I w "- to I I 1 ( I 1 ( I I 0 U) OF , A�� P 49thX00 00 0 � red Wc1otk C ��'+� a 3255+- 5•�0� AS -BUILT NO CORNERS SET THIS DATE i "erovy eentry that 1 have performed a agee'a h specticn of the fottouing descnlwd propony. �^ DEVpNSHIR_E ADb(f10N No 1 Anchonpe Recordfng Dtstrlq, Alaska, and that the Paproyaments situafod themon aro whhln the pmperry Gnu and do net overlap of encroach on the pmpany t tV adjacent thereto, mat no improvements on the property lying afllaceM thereto encroach on the premlms in question and mai mem aro no roadways, tfansmhslon ltrm Or other vhlbh easements on aakl property espppt as haliUted hereon. Dated at Anchorage, Ala t. thb __21st day Of Dccembly 2018. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME lPHONE [] NEW Richard Henry c/o GEOLAB I 344-8042 ~UPGRADE MAILING ADDRESS 1131 E. 76th Ave. ~101 Anchoraqer Alaska LEGAL DESCRIPTION Devonshire Subd. Add ~1 Tract A Sec 21 T12N R3W LOCATION NO. OF BEDROOMS Huffman west of Gander 3 lWell [ Absorption area Dwelling PERMIT NO. DISTANCE TO: 100 ' 25 ' 26 ' 850472 I- Z Manufacturer Material ,~ No. of compartments ~ < Unknown-existing tank Liq. capacity i n ga, lo,~ IF HOMEMADE: Inside length ~//~ Width Liquid depth ~ ~ ~ DISTANCE TO: Well N/A Dwelling PERMIT NO. ~ -- ~ Manufacturer Material Liquid capacity in gallons ~ Well Foundation Nearest lot line 52 ' 850472 ~= DISTANCE TO: ~2~ ' 29' PERMIT NO. ~Z~ ND. of lines Lengthofeachline50 Total lengthoflines 50~ Trench width_~ ~ Distance between lines ~ ~ Top of tile to finish grade Material , ~eneath tile Tot~Le~fective ab~qrption ar~ ~ ~fter grading 4'-5' Qramn rOCk ~8"inches ~00 sq.z~. Length Width Depth PERMIT NO. ~ N/A ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ Indiv. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER P~ERIALS Septic Tank to new trench f i~ }.~ ~it~ pipe. ASTM D2729 in trench,t.. -- SO,LTESTRATING Carlon Z46 standpipes* ~ %~ ~ / 125 sqft/BR%, x %~'~,. / INSTALLER Pyramid Excavatinq REMARKS *See attached certificates ~.(/ F. d '"'"'" "' / APPROVED DATE LEGAL 72-013 (Rev. 3/78) PEI."RM I T NO: DATE ISSUED: APFLIL, ANT: ADDRESS: CONTACT PHONE: DI.:.:~:'ARTME:N:T OF HIEAI_TH AND ENVIRONMENTAL PROTECTION 825 L.. STREET, ANCHGRAGE, AK 995()1 ~C~'"'"~ /~ . C:.;t N ........ Ell I: T' tX S E: ~"~ EE ~:~ 8.~. 4. 7..~:. 08/06/85 C/O GEOLAB RICHARD HENRY 1131 E 76'T'H ~101 ~ ANCHORAGE, AK 9951G 344-804~ L..EGAI_ DESCR I I::'", I...0 T !:31 Z E: MAX BEEDF~GGMS: SLJBDIVISIGN: DEVONSHIRE ADD SE:C'T'ION: 21 TOWNSHIP: 12N 2. :I.A (SQ. FT. OR ACRES;) 3 L. OT: TR A RANGE: ..:,W BLOCK: NA I_is'Led I~eZI. ow are 'Lhe options available to you in designing your' sep't'..ic system C. hmose the option that best. fits your site.. DEP'T'H TO PIPE BOTTOM (FT.) GI::~AVE:I.- DEF'TI"] (F'T.) TOTAl .... DEPI'H (FT.) GRAVEL WIDTH (FT,,) GRAVEl.., LENG'TH (FT.) GF~AVEI..,. VOLUME (CU. YDS. ) T'ANI< SIZE (GALS) SOIL. RATING (SD.FT./BR) 'TREI~I[.]I-! BE][) W . ,I,)F~(~ ::[ ~ 5.0 4.0 4.0 4.0 0.5 5.5 9.0 4.5 '7'.5 2.5 17.0 5.0 47.0 34.0 41.0 19.6 21.5 30.4 1,000.0 ** 1,000.0 ** 1,000.0 *~ 1~25 1-35 125 · ~. 'T'ANI< MUST HAVE AT LEAST "FWO COMPARTMENTS t certify that: 1.. I am Fami].iar with the requirements for on-site sewers, and wells as set Forth by the Municipality o~ Anchorage (MOA) and the State oF Alaska. 2. I will install the system in accordance with all MOA codes and eegulations, and in compliance with the design c~iteeia o~ this permit. 3. I wi:.,1 adhere to all 'MOA and State of Alaska requirements for t. he set back distances From any existing well~ wast. ewateP disposal system or public sewerage system on this or any adjacent, or nearby lot. 4. ~ understand that this permit is valid for a maximum o~ 3 bedrooms and any enlargement will require an additional permit. IF: A L. IFT S"FA'T'ION I!.S IN~TAI...LED IN AN AREA COVERED BY MOA BUILDING CODES, 'T'HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUS'T' BE OBTAINED; (2) At0 BUII_I,.~ WILL. NOT BE APPRGVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE E:.LE.L,, 1 t ,, I CAI .... WORI< MI..I.~ BE DONE: BY A L. I (,.,E.N,,.~ED ELEC] R I [. I AN. S I G~ED _.~ APF:'I_ICANT: C/O GE:OL. AB RICHARD HENRY r.-:,Y DnTE: I 131 E. 7§th Ave.: ~ i0 ! '::ii~.i;i :i'i:' '~.'ii.-.. SOILS LOG · PERCOLATION TEST z'l SOIL TYF~ _DEPTH DESCRIPTION ~ o'~,.l,o' ~.~*.',:' ~-'i ~"','.(:~"~',; /.o'~ ~.~' ~)~'~,,,~ .~,,~. ~'1+ ~1 SLOPE • • O . a, O.� Municipality of Anchorage On-Site Water and Wastewater Program Q �:i I� 111 (907) 343-7904 SAFETY Certificate of On-Site Systems Approval r Parcel I.D. 015-283-62 Expiration Date: l --zq-( 0 1. GENERAL INFORMATION: Complete legal description DEVONSHIRE#1;TRACT Location (site address) 2843 Huffman Road *Anchorage 99516 Current Property owner(s) Estate of Richard Henry Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: l Z ' ` L Date: / 2 / I `' COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 52A-0-tO Waiver Fee $ Date of Payment Or/ [g Date of Payment Receipt Number 0n52�-{8� Receipt Number COSA# OKI '\3D ) Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 6/Zl=�/`3 oQ ,400 � In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system oOF Ar z.. \ accordance with the guidelines and regulations established by the Municipality of Anchorage and ,57/\c„.„ " -,'/LA industry practices. The reported results describe the condition of the system/s on the date/s of the L P •• a0 evaluation. Separation distances were measured to readily identifiable features. Hidden defects or Q� encroachments may exist that were not identified during the evaluation. The operational life of all wells �* 9TH, \ �*v and septic systems depend upon a variety of variables, including but not limited to, soil conditions, r f• ` Q groundwater levels (that may fluctuate during the year), quality of construction (materials andII VA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and � are outside the control of GEG. Satisfactory test results do not guarantee future performance of the V '.u, fr Game s; system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of P the well or septic system. GEG makes no representation whether an alternative well or septic system QO9.s '•f CEI ZL •• cOQQ can be installed on the property in the event either of the current systems fail to perform adequately in l,l �?`......•• the future. The content of this report is for the sole benefit of the person/party that retained GEG to 4� °' rofesso°o0 perform the evaluation. Reliance upon the information provided in this report by any other person or \\‘.\ � �0 0000' party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE / System #1 Approved for ,3 bedrooms System #2 Approved for bedrooms �\. Disapproved �S V l�E G�� Conditional approval for bedrooms, with the folloytimg stow icogt W klc,\NIPEER o vT PFZOG By f I, `' -^ =syC�`-�' Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist ___ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: DEVONSHIRE#1;TRACT A Parcel ID: 015-283-62 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Q Date completed 6/11/58 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES ly- Total depth 180 ft. Cased to UNK ft. Casing height(above ground) 12+ in. CFROM WELL LOG AT INSPECTION %, Date of test 6/11/58 12/19/16 d 4 58.2 ft. Static water level 40 ft. 6 Well production 10 g.p.m. 5.2+ g.p.m. u I WATER SAMPLE RESULTS: 4 kColiform 146-6- colonies/100 ml. Nitrate N mg./L. Collected by: GEG,Ltd. s Arsenic: Ly' ug./L. Date of sample: 6/18/18 e) 4 CONDITION OF 1958 SEPTIC TANK IS UNKNOWN E B. SEPTIC/HOLDING TANK DATA •PER 1985 HAA **1991 HAA APPROVED ***TANK C/O APPEARS TO BE WITHOUT FCO NEAR OUTLET OF TANK T Tank Type/Material UNKNOWN Date installed *1958 Tank size *1200 gal. Number of Compartments UNK Cleanouts (Y/N) "'YES Foundation cleanout(Y/N) "NO Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumping 11/10/16 Pumper AROUND THE CLOCK PUMPING C. ABSORPTION FIEL D TA. 'BELOW EXISTING GRADE AT MONITORING TUBE 4219Q.?i,. Fw Date installed 1 - Soil rating (g.p.d./ftzo<e/bdrrr) 125 System type DEEP TRENCH Length 50 ft. Width 3 ft. Gravel below pipe 4 ft. Total depth *10+ ft. Eff. absorption area 400 ft2 Monitoring tube**YES Depression over field NO Date of adequacy test 1/9/17 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 15 in. Water added 556 gal. New depth 20 in. Elapsed Time: 120 min. Final fluid depth 16 in. Absorption rate>= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date - **MONITORING TUBE EXTENDS 3.91 FEET BELOW THE INVERT SEE ATTACHED STATEMENT FROM EXECUTOR OF THE ESTATE REGARDING HOME BEING LIVED IN UNTIL 12/28/16 D. LIFT STATION Date installed Size in gallons Manhole/Access(Y/N) "Pump on"level at in. "Pump off'level at '• a er alarm level at in. - - Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *50+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 1004 Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas"'100'+ (WITH CAVEAT) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation **5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+PVT&200'+COM SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 104 Water main 10'+ Water service line 10'+ Surface water 1004 Driveway, parking/vehicle storage 1O'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+PVT&200'+COM F. COMMENTS 'TANK AND WELL BELIEVED TO BE INSTALLED IN 1958 "APPROVED BY HAA 8/5/85 **APPROXIMATLY 67 FEET AWAY FROM STABLE G. ENGINEER'S CERTIFICATION :,,,P "'• A ♦♦j I certify that I have determined through field inspections and : *i '9 I• i *#, review of Municipal records that the above systems are in • is conformance with MOA COSA guidelines in effect on this • . ••.. . • •! • date. �^'s, J= • ,y Gorness i •►= Engineer's Printed Name JEFFREY A.GARNESS •♦�d'�� . G I. • Date / ♦t PROFESS\ - 4 LICENSE IIiii,"`lk *AECC884 (Rev.10/12/12) 84491 Lot 7 / Lot 6 ' Lot 5 I / N89°57'38"W 329.98 ♦ s l♦ r r s r r 10' Telecomm. & elec. Easement in r T _ Wood fen.: (D hed o 6 J m E .6 — — etal fern•- co rA (00. to Ln O d) °8 co TRACT A 08 coo E N a I— N• IP eptic vents E E g o E -1 — — Wrefen•: a5i lA w o Corral F in c = o m`Y o o —CO 82.8_ 0l,,l a E Shed 1'4 1 1/2 Story Frame House co N 0/Shed y 22.0 W E o We10 0 0 �, .,; �,; co r '`" !f. 42.0 V7 W ''-'11tt 4. tr- 83.6 1CX co r .y;X+1;:t.\s ls? Car P•73 g h ''e " + ryy'' dT�y��,�u.�� 1C E inter;-' -- ,�•a�i'L ri d8i /0.1/ enc.onc.block `., y,r.�;` n \ / Y! rot.wall(tYP) /:-..'S • -.•,.....-4. ., CS S89°57'07"E 329.99 o in U) HUFFMAN ROAD iI < _....... („f::, 0 .• • ```+"\1 AS-BUILT NO CORNERS SET THIS DATE • ... ,.. ..,..., OF q I hereby certify that I have performed a Mortgagee's Irapedior .,F,• C,q , of the following described property:TRACT A. icy' S,�,, DEVONSHIRE ADDITION No. 1 -* 49th *�0 Anchorage Recording District,Alaska,and that the ��J'• improvemenla situated thereon are within the property gars &LW�C:41.LR,• and do not overlap or encroach on the property tying y ••`_••' '"7 adjacent thereto,that no Improvements on the property lying �,.Fred Wal a tic a. / adjacent thereto encroach on the premises in Question and ,0 m`•• 3255-S ...4":' . that Nero aro no roadways,transmission foes Or dMr �. visible easements on said property except as Indicated o • o SCALE: 1"=NTS 6t�r 1',ssidw•,�� hereon. Dated at Anchorage,Alaska EASEMENTS OF RECORD,OTHER THAN 4‘%%%NS. this 21st day of December 2016. THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES PLAT ARE NOT SHOWN HEREON. F8 18-13, pg 3436 BE tom Ila iepnr Engineers and Surveyors MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-47'44 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description 'T I~-~J (~ 3cO $p'1 Location (site add'ress or directions) Property owner /~ ;c~,a,,~ Mailing address Z ~ ~/'3 ~, Day phone .3//5- 71~/ Lending_agency_. .Day phone Mailing address Agent Day phone Address 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well ~ Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site ~ Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 a. nd/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 Engineer's signature Phone 95",5 / 8 - Date ................................................................. 6. DHHS SIGNATURE ~ Approved for ~~ ~bodrooms. Disapproved. 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. 72-025 (Rev. 1/91) Back MOA t¢21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. A. WELL DATA Well type Log present (~N) Total depth Sanitary seal If A, B, or C, attach ADEC letter. Date completed Cased to Wires properly protected (Y/N) ADEC water system number .... ¢,, [ l~15 ~ Driller Casing height FROM WELL LOG Date of test Static water level Well flow ~o Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot fi5 ' ¢¢ Absorption field on lot I~ / ' Public sewer main Sewer service line g.p.m. AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout g'p'r~ 0 g ~ Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: ~ Z [z.O Nitrate O.IK. Other bacteria O k, Collected by: ,/z/TY1- B. SEPTIC/HOLDING TANK DATA Date installed / ? ,5 ~ Cleanouts (~N) High water alarm (Y~]~) AJ ¢ Date of pumping Tank size IZOo 0,~[ Compartments Foundation cleanout (y{-/~') /Ja Depression (YX~ Alarm tested (Y/N) ~ o/-o5- ~( Pumper A ~ ~'~o,~c¢ ~e~;ce.c X_Jo SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: f Well(s) on lot ~ .5 To property line 5 Surface water/drainage 72-026 (Rev. 7/91) Front Onadjacentlots ~o~ Absorption field_ .~-~ ¥ Foundation Z. Water main/service line i0o~' CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D; ABSORPTION FIELD DATA Date installed b/~, /8 5 Length ~5 o ~',L Width Total absorption area Depression over field (Y/(~ Results (pass/fail) Peroxide treatment (past 12 months) (Y~,~ Soilrating /z5 c~'//8/)R/~[ Systemtype ~-~'~,~ Gravel thickness "/~- Total depth Cleanouts present (~/N) Date of adequacy test for -,~ bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent jots ~oo Surface water too Curtain drain I od ~ ~C~- On adjacent lots ¢ o ~ ~ ~-[-- Property line To existing or abandoned system on lot Cutbank too t- ~_~_ Water main/service line Driveway, parking/vehicle storage area ioo ~-~Jr 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 Na Date HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 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) Application Date Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) ' Telephone: Home Applicant Address ~_~. ~-~ /--_~_.~J--/~./J~/6.~ ~ (c) Applicant is (check one): Lending Institution [] · Owner/builder [~; Buyer [] ' Other [] {exCain); (d) Lending Institution Address _~ (e) Real Estate Company and Agent Address (f) Telephone Mail the HAA to the followin§ address: TYPE OF RESIDENCE Single-Family [] Multi-Family [] Number of Bedrooms .3 Other WATER SUPPLY Individual Well,~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmer~tal 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-(rz5 p'~,~ 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~,is Health Authority Approval shows that the on-site water supply and/or wastewater disposal system ts safe. functional and adequate for the number of bedrooms and type of structure indicated herein. I further, verily that ba~-~Cl on the informa"~or~ obtained from the Municipality of Anchorage files and from my investigation and inspection, the o~-s~te water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, or¢inances, and reguiati._ons in effect on thedateofthisinspection.-..f;~' ~ff'~'~ c;l~.[~'h.¢~- tJ.,'~d c~?tr,,~ ~,~.~.~'~ ~ ?~' ~ ~ . Name of Firm ~J~ '~c~dr~/ ~'~c~ ~ Telephone O,EP APPROVAL Approved [Disapproved Conditional Terms of Conditional Approval CAUTION Date .... The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP} issues I-~a]lh Aul:hodty 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 tt~r 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 responsib{e for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 {I 1/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-472O Legal.Description: "'7"~C~ ,~' ~ ,~r~ pRofOundN .RECEIVED If A, B, C, D.E.C. Approved (Y/N) Well Classification Well Log Present (Y/N) ~' Date Completed ~'/l( /~-,~ Yield Total Depth 180' Cased to ~ I~'O' Depth of Grouting Static Water Level ~"O' Pump Set At Sanitary Seal on Casing (Y/N) Y' Depression Around Wellhead (Y/N) Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Casing Height Above Ground To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line · On Adjoining LotS ~' ; On Adjoining Lots ~' To Nearest Public Sewer Cleanout/Manhole ~v ~'~'0 ' To Nearest Sewer Service Line on Lot Water Sample Collected by "rP=P/' · Date '7/~ Water Sample Test Results .~--t~,,~t~c,y' - //g B. SEPTIC/HOLDING ~o°~lJ No. of ComPartments '~h~.e~/-~ Foundation Cleanout (Y/N) Date Last Pumped ,~/ 'for Temporary Holding Tank Permit (Y/N) N0/J, Date Installed ~ If,.~ Standpipes (Y/N) ~' Air-tight Caps (Y/N) Depression over Tank (Y/N) I~' 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 ~ (¢O' To Building Foundation P---,¢' ¢ To Disposal Field -'~' ~ 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 ~¢'/~'/~5"' Width of Field ~'~"'" //~R/-r Type of System Design Length of Field ~:~ ~ Depth of Field ~ ~'' 5' Gravel Bed Thickness ~'~ # Standpipes Present (Y/N) Date of Last Adequacy Test Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~ 2_0 To Building.. ?OUF~a~on To Water MaFn/Service Line ~ 500' To Stream/Pond/Lake/or Major Drainage Course To Cutbank (if present) ~' (~0' To Property Line ~' /'~ ~ To Existing or Abandoned System on ; On Adjoining Lots ~' ~,?,O ~ To Driveway, Parking Area, or Vehicle Storage Area Comments ~e~.~ /~_~o ~',~ ,~zd,~ '/?'~,~¢~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/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 checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ ~. ~ Date Company /~('~'/'~:~¢-~( .C~/c~ MOA No. Receipt No. ;.,, Date of Payment ~'~/ ~J~ ~ /./, Amount: $ /~,_ '~ - .~,?~. ~¢,, , . . . Page 2 of 2 72-026 (11/84)