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CHRISTOPHER HEIGHTS LT 6
Christopher Heights Lot 6 #015-233-06 SUBMITTAL . , Municipality of Anchorage AUG 16 201 Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131032 PID Number: 015-233-06 ❑ New ®Upgrade Name: CHRISTOPHER MYERS ABSORPTION FIELD ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound Address: 6740 SAMUEL COURT, ANCHORAGE, AK ❑ Other Phone: (907) 301-8263 No. of Bedrooms: 4 Soil Rating: 4.0 (ADVANTEX) GPD/Sq. Ft. Total Depth from original grade: SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: SEE DWG. Ft. Cmvel depth beneath pipe: 0.56 Ft. Subdivision: CHRISTOPHER HEIGHTS Block: Lot: — 6 Fill added above original grade: SEE DWG. Ft. Gravel length: 2 ® 45' (90 TOTAL) Ft. Township: Range: Section: Gravel width: 3eds Number of lines: Distance between linea: Ft `t SEPARATION DISTANCES Total absorprwn area: area: 450 sa. n. umbar of Wnohea: 2 Dist. between trenches: 10+ Fl TO From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Linea Well 1004 100'+ 100'+ — 25'+ TANK ❑ Septic ■ S.T.E.P. C]Holding El Other Manufacturer: capacity: Surface water 100'+ 100'+ 100'+ — ANCHORAGE TANK 1500 cal. Lot Line 5'+ 10'+ 5'+ — N/A Material: Number of compartments: STEEL 2 LIFT STATION Foundation 5'+ 10'+ 5'+ — Curtain Drain NONE KNOWN Manufacturer. Capacity: ANCHORAGE TANK 160+ Cal. Remarks: 'Pump on' level at: 32" 'Pump off Well at: 22" High water alarm at: 36" Pump Make & Model: ORENCO PF -20 Electrical Inspections performed by: M.O.A. PIPE MATERIAL SCH 40 House to tank D3034 Tank to PVC SCH 40 drainfield Drainfield PVC CO/MT D3034 Installer A+ HOME SERVICES Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Dates: 1st 6/28/13 2nd 7/1/13 Location and Description' 3rd 7 2 13 4th DOOR THRESHOLD @ SE CORNER OF HOUSE Community Development Department Approval ENGINEER'S SEAL 06000 0 Conditional approval: Date: �F..A..V%, Qa�ai�Q 49 ..... ... .............� D 0� •, f • • •A. arness.: • • Q� Qo9s '. E— 3 .'' ok 40od Prof es si°n°oma �40000�� Approved: - Date: �/3 PERMIT NUMBER: OSP131032 AS -BUILT DRAWING / r A R� FCO 20.75 44.20 ST1 32.63 44.11 MH1 40.59 46.82 MH2 44.25 49.34 MT1 37.38 68.95 MT2 47.04 86.11 MT3 77.70 92.66 MT4 82.17 102.02 EXISTING 3 BEDROOM - HOUSE / l 1990 TH L410 -t 3 PARCEL ID NUMBER: 015-233-06 SAMUEL COURT / NEW ORENCO PUMP ORENCO AX -20 TRICK NEW 1500 GALLON S.T.E.P. TANK i NOTE: 1004 SEPARATION TO SURFACE WATERS CONFIRMED DURING CONSTRUCTION 30' DRAINAGE ESMNT NEW DRAINFIELDS / SERT�/ /� —TEDD OORE TH Ir LT I FILTER GARNESS ENGINEERING GROUP, Ltd. ppT CONSULTANTS & GENERAL CONTRACTORS Q' ......... ..... ........... 3701 E. WWR ROAD. SUNS 101 • MMOW0E, M 99507 • PHONE (901),337-8119 • FM (90'nWS-3348 • W M- www.9amaeae�pinseNn9. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: j CHRIS MEYERS 301-8263 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: CHRISTOPHER HEIGHTS, LOT 6 A.J.G. TYPE OF WORK: DATE: AS BUILT DRAWING OF SEPTIC UPGRADE 8/1/2013 y arness: CE -7953 I- bERMIT NUMBER: PARCEL ID NUMBER: OSP131032 AS -BUILT DRAWING 015-233-06 FINAL GRADE = 98.25-98.62 - 2" INSULATION - TOP OF TANK = 93.02 - INVERT OF PIPE = 92.27 - INVERT OF PIPE = 101.08 - (1 1/4- PVC W/ 1/4" HOLES 0 36" ON CENTER) 1500 GALLON STEEL S.T.E.P. TANK NORTH TRENCH FINAL GRADE 103.39-103.59 -INSULATION rFILTER FABRIC IIf -TOP OF ORIGINAL SAND = 99.52 L TOP OF NEW SAND = 100.52 `- BOTTOM OF EXCAVATION = 98.92 I INVERT OF PIPE = 101.08 - (1 1/4" PVC W/ 1/4" HOLES 0 36" ON CENTER) P OF TANK = 93.01 SOUTH TRENCH GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 57.01 E. TUDOR ROAD, SURE 101 • MCHOMGE, M NW7 • PHONE (907)337-8119 • FM (M)MB-3248 • WEBSRE: rwrgomexwpineMnq.cwn FLOAT FIELD ORENCO PUMP VAULT FINAL GRADE = 103.50-103.60 r -INSULATION rFILTER FABRIC I TOP OF ORIGINAL SAND = 99.52 "TOP OF NEW SAND = 100.52 `- BOTTOM OF EXCAVATION = 98.92 PREPARED FOR: PHONENUMBER: PAGE NUMBER: CHRIS MEYERS 301-8263 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: CHRISTOPHER HEIGHTS, LOT 6 A.J.G. TYPE OF WORK: DATE: PROFILE AS BUILT OF SEPTIC UPGRADE 8/1/2013 08/07/2013 e �.r i M '�4f NO G.44 09:27 8686770 APLUS PAGE 01 Municipality of Anchorage Community Development Department - Development Services Division P.O. Box 198650 - 'Anchorage, Alaska 99519-6650 - 4700 Elmore Road Info and Help: (907) 343.8211 INSPECTION: Voice: (907) 343-8300 Fax (907) 249-7777 Inspection Report - Electrical APPLICATION NO. RETROE131245 Master/Standalone Permit Permit Type: Electrical Res Notes: Please call Devin 5 W.602.8893 prior to inspection. Requested by: Devin Rafeedie schedule Date:O /1 13 907.602.8893 capstoneelectdcllc@gmail.com Preference:Any Inspection 9: 250540' Wets MYERS CHRISTOPHER & MELINDA Contraotor (907)602.8893 CAPSTONE ELECTRIC, LLC- 19243 ADAK CIR. Comments: 1 rL 1 F7 tz > P le. V ANS e�IsTAL~Lr/4 0rJC-b ��-�',� : �orUT��.�c�-rr®rZ- f R,.�!.-r✓4cL (a�.�C, Csv,A,2%� is ��r�='-D /1 Z' G...��a ��- L.� l./�. �. ""i o r''lZti "L"� r✓! 5c ,-a t< (7 cl p Fr2opu9 p14 , C A t.- 7>4'vt �! C Inspector: ZLIJ Z 4 A 1 Date: `� — :20125 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131032 Tax Code Number: 01523306000 Work Type: Septic Upgrade Permit Effective Dates: March 27, 2013 to March 27, 2014 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: CHRISTOPHER HEIGHTS Site Legal Address: CHRISTOPHER HEIGHTS LT 6 G:2739 Owner/Address: MYERS CHRISTOPHER & MELINDA 6740 SAMUEL COURT ANCHORAGE AK 995162412 Site Mailing Address: 6740 SAMUEL CT, Anchorage Lot Size in Sq Ft: 49484 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. i---- .Spgefal Provisions: TfFe- installed drainfield-shNI be vim' ' d�Ieast 4 feet above ground using new 7 -Day groundwater monitsect moults. The test results shall be submitted with the final inspection re n ractor may proceed at his own risk prior to completion of the Received Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcell.D. DIr�^a33'OG� Property owner(s) CHRIS MEYERS Day phone 301-8263 Mailing address 6740 SAMUEL COURT *ANCHORAGE, AK Site address 6740 SAMUEL COURT *ANCHORAGE, AK Legal description (Sub'd, Block & Lot) CHRISTOPHER HEIGHTS, LOT 6 Legal description (Township. Section & Range) Lot Size Sq.Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (Rall that apply) Absorption Field ® Initial ❑ Single Family (SF) Upgrade ® (w/wo ADU) Septic Tank ® Renewal ❑ Duplex (D) ❑ Holding Tank F-1 MultipleDwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ 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. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: S �5V Date of Payment: Receipt Number: Waiver Fees: Date of Payment: 1 Receipt Number: Permit No. 05i7 1 J 1 0 3� Waiver No. (Rev. 01/11) January 22, 2013 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Christopher Heights, Lot 6; To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The drainfield is in a state of failure and needs to be upgraded. The homeowner has requested we design a 4 bedroom septic system for future expansion. We are proposing to install a Quanics Aerocell CAT III treatment system on this property which includes the installation of a new 1500 gallon S.T.E.P. tank. Due to site constraints we are proposing to rebuild the existing drainfield (bed) as dual 5- wide trench type drainfields (primary & reserve) within the footprint of the existing bed. We are proposing to excavate all contaminated material and import MOA approved sand to where as the top of the proposed sand filter will be 1 foot or higher than the existing elevation of the top of sand. 1. SOILS & GROUNDWATER LEVELS: See the 1990 soil log (attached) which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: The proposed re -built drainfield will be installed greater then 100' from any surface waters. The proposed S.T.E.P tank is located just beyond the 100 foot setback, if for any reason the proposed S.T.E.P tank can not meet this requirement a waiver will be requested before installation. 4. TOPOGRAPHY: The average topography around the drainfield is relatively flat. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. .E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com CHRISTOPHER / HEIGHTS LOT 3A i j00' 39 l\ rJ P4 I II ISI 1noJdELLnis _RAnIf I I I I\ CHRISTOPHHEIGHTS 4 \ / IY \ AREA r I I I \ CHRISTQPHER I \ HEIGHTS LOT 5 / L --- \-----/ ---- TELEMARK HILLS LOT 1 TELEMARK HILLS LOT 2 CHRISTOPHER \ X00 HEIGHTS LOT 2 / CHRISTOPHER / HEIGHTS LOT 1 _ _ 30' DRAIrygGE ESM(,11. N 0 TELEMARK HILLS LOT 3 c- '/" MD —LTED MOORE, P.E. TH / /X K CHRISTOPHER HEIGHTS LOT 7 / / I / / / I � / TELEMARK HILLS LOT 4 GARNESS ENGINEERING GROUP, Ltd -... CONSULTANTS & GENERAL CONTRACTORS I E MOOR ROPO. SOME 101 ANCHORIOE, M 99507 - PHONE (907)337-61]8 • FAC (90]1330 -Mm • wmmE:.ww.eemeu,,,,mn..rt„n., PREPARED FOR: PI CHRIS MEYERS LEGAL DESCRIPTION: CHRISTOPHER HEIGHTS LOT 6 TYPE OF WORK: SITE PLAN 301-8263 Nm 1/7/13 r- - t OF BEDROOMS: 4 S PER DAY (GPD): 600 ATION RATE/S: •27 min/inch IED APPLICATION RATE: 4.0 A DRAINRELD SQ.FT.: 150 UPON BOB SHAFER,, P.E. TH (1990) MAXIMUM DEPTH OF EXCAVATION: LIMITED TO REMOVAL CONTAMINATED MATERIAL. WIDTH: 5 FEET LENGTH: 2 0 45 FEET = 90 FEET M.O.A. APPROVED SAND FILTER: AS REQUIRED FOR PROPOSED TOP OF SAND TO BE 1 FOOT OR HIGHER HAN EXISTING TOP OF SAND. EFFECTIVE: 0.5 FEET ACTUAL SQ.FT.: 225 SQ. FEET EACH GEG, Ltd. HAS A'7 PAGE SPECIFICKnOff— LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND i Cl WELL RADIUS ' ..i;;: �:: INSTALL FCO F f,Ct NOT PRESEN �1 EXISTING 3 / BEDROOM / HOUSE / NOTE: THE CONTRACTOR SHALL HAVE THE NORTH & EAST LOT LINES, THE 100 FOOT SETBACK FROM THE CREEK, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. SAMUEL Et 650� SEPI TH""MT FD 00 CO r H MT",, RIMARY LpROPOSE RAINFI�E-LYD GALLON SI �, / TH Q( WITH Q( F / Tf )MMISSION ING TANKS / -- -� 30' DRAINAGE ESMNT - - PROPOS DRAINFI / / TED 06RE, P.E. TH ID AK 1\. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS Q" "' 3701 E. IUQ BOLD, SURE 101 r MlCHORAOE, M 98507 • % (907)33)-8178 r FIJI (907)118-32 9 r'ME9511E: ,nnAW^^r^^^YlmeMp.can PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CHRIS MEYERS 301-8263 2 OF 3 If LEGAL DESCRIPTION: DRAWN BY. oOO �f CHRISTOPHER HEIGHTS, LOT 6 TYPE OF WORK: DATE: Q�oO SEPTIC DESIGN UPGRADE 1/7/13 � ) I § %§ I \ I § n _ - _ - , , §:2t&..��.00 Mm i 7§ �(2 n 111111 1 \, I / �� Wn ])m\mom /P )¥� R Q - m ( // U2 ® - 2 . - ))§ 0 ) I °(n\j} m I § §`\ *00 I � m/a) \ f - - (�` / k�® /- j \ \ \ \ �8 0 \ , m \ \\\ \ \ /�\ k § Zcr- \ . 1 % 3 _: p ® g \�§ __ r 3/26/13 wLw » .... ...... « rDESCRIPTION: . ^< .z .... ..../ a�� : Esq s c �G&R&k ENGINEERING GROUP, Ltd. sJSNOF o QgesA@C±Sem �.�` - CONTRACTORS PRE _.R _ CHI_rNUMBER: �C%'Prof /o 0\ #,-33 E: '�. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES 0/5- —:2 3 7 — 0� Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES OJ Tp SEPTIC ABSORPTION WELL Address FROM TANK FIELD - No. Booms c% t �. .t INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 3500 EAST TUDOR ROAD INSPECTIONS (907) 563-3464 INFORMATION (907) 786-8211 NAME )tC �n /PERMIT NO. STREET ADDRESS PHONE LOT/ 1— BLOCK/ SUBDIV.?� / DATE FOOTING ❑ ELEC. TEMP. ❑ PLBG. UNDGR. ❑ FOUNDATION ❑ ELEC. SERVICE ❑ PLBG. ROUGH ❑ BOND BEAM ❑ ELEC. ROUGH X GAS TEMP. ❑ FRAMING ❑ ELEC. FINAL ❑ GAS ❑ INSULATION ❑ OTHER ❑ MECHANICAL ❑ SHEETROCK ❑ MECH. FINAL ❑ STRUCT. FINAL ❑ FIRE FINAL ❑ PLBG. FINAL ❑ OTHER ❑ ZONING ❑ OTHER ❑ Njo NONCOMPLIANCE OBSERVED ❑ CORRECTIONS ESSENTIAL AS EXPLAINED BELOW ❑ WILL REEXAMINE A.T NEXT I PE TION ❑DON CO EAL-UNTIL REINSPECTED COMMENTS INSPECTOR DATE 4I/HEN CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION W o DO NOT REMOVE TM3 NOTICE a a a ea ooz (Rev. tt W W_ O o W d I.L1 Qaz �. U LU O, �o w Owner Name: DOUG 8OTO Owner Address: 6740 SAMUEL CRT. ANCHORAGE, AK 99516 Day Phone: 345-2031 Parce1 Id: 015-233-06 Lot Legal: Subdivision: CHRISTOPHER HTS. Lots 6 Block: - Section: 23 Township: 12N Range: 3W Lot Size 49484 (sq.ft. or acres) Max Bedrooms: This Permit: 3 Tota1 Capacity: 3 SEP[IC TANK: Minimum total septic tank capacity: 1`000 gallons. Each septic tanp must have at least 2 compartments. Depth to top of septic tank(s) < 4.0 feeL requires insulation over tankls). lNSTALL PER ENGINEERS APPRQVED DESIGN. NOTIFY DHHS PRIOR TO EACH [NSPECTIL}N. lHlS PERMIT IS ISSUED FOR !HE EXISTING 3 BDRM. S[NGLE FAM1L'� DWELLING ONLy AND EXPIRES ON 12/31/90. THE LlFl 5[ATION WILL REQUIRE AN ELEC[RlC�L PERMll AND lNSPEcTl()N BY F'UBLIC WORKS. ! CER[l|Y |HAT: 1. i am /amiliar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage {MOA) and the State of Alaska. 2. I will insta1l the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 3 bedrooms. I also understand that the capacity of the total system is 3 bedrooms and any enlargement will require an additional permit. Signed: ���nY 'Owner) DOUG GOTO ° zssved By, DATE: SCALE ;w6t,L.- Mu m P2� Sc2L=. CUA4 1�f►��i 1'azo Calf too �4k7v 6-rr � �y ,�-trL.� 1 •5 Ff' Ste+,-�o � l� Lo G�CLp J rSri.�-� oJl�� S � s .Sr - L� �- F�t,aJ y s1 0 X v 1-1 10 v - 't ` b4.� 4;%::7 WAS GROUND WATER ENCOUNTERED? 11 IF YES, AT WHAT DEPTH? 12 Depth to Water After 13 1 AA Monitoring? —� 14- 15- 16- 4 15 1 17 18 r ■■■■■■■■■■ Reading Date Gross Time Net Time Depth to Water Net Drop ur Municipality Anchorage ,#a e of by DEPARTMENT OF HEALTH & HUMAN SERVICES ' '°' "'°•• p9y 825 "L" Street, Anchorage, Alaska 99502-0650 �. ......«••••••••••r"" 3°'�'" �' shofew R SOILS LOG — PERCOLATION TEST V ♦ � V O .� PERFORMED FOR: •«.oe•••� �. Aw f"� F�PROf V�Oog' �Tz> DATE PERFO�AR� LEGAL DESCRIPTION: LC>f kGf�0,6,a--Township, Range, Section: DEPTH ,� SLOPE 7 r'L�`"-I pis SITE PLAN '(FE/�.Elrt 1 JtN 0 � • 2 •• VAI, /4M 3 1 4 � ! 5 6 IrW i�. 7—le. . � 1 � 8 ., 9 10 v - 't ` b4.� 4;%::7 WAS GROUND WATER ENCOUNTERED? 11 IF YES, AT WHAT DEPTH? 12 Depth to Water After 13 1 AA Monitoring? —� 14- 15- 16- 4 15 1 17 18 r ■■■■■■■■■■ Reading Date Gross Time Net Time Depth to Water Net Drop ZD Z a 1 by V ♦ � V O .� 1� � N l �N 20 � N PERCOLATION RATE 13 (minutes/inch) PERC HOLE DIAMETER _4 TEST RUN BETWEEN ` — FT AND FT COMMENTS S & S ENGINEERING PERFORMED ftig RhW, AIRAIKa 99577 ACCORDANCE WITH ALL STATE AND MUNICIPAL GU 72-008 (Rev. 4/85) r CERTIFY THAT);HIST ST WAS PERFORMED IN T ON THIS DATE. DATE: d 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 PHONE NEW ❑UPGRADE MAI LI NG ADDRESS `C I z�td e�." LEGAL //DESCRIPTION L l X C_!' \' i s �c 2 f.�\eY K 1 i A e k i 9. 1� iV ri l LOCATION 'A NO. OF BEDROOMS UY DISTANCE TO: Well Absorption area Dwelling LL PERMIT NO. H Z W Manufacturer , Material �te No. of compartments Cn Liq. capacity in gallons ._ + ��� IF HOMEMADE: Inside length Width Liquid depth D Y DISTANCE TO: Well Dwelling PERMIT NO. O Z Q 2 F - Manufacturer Material Liquid capacity in gallons p J DISTANCE TO: Well ;�G� i+� Foundation 4 Nearest lot lin , PERMI7,NO. �'• t w= J LL Z Z w No. of linest 1 Length of each line +„3 Total length of Ilnes Trench width 5 inches Distance between lines <H o Top of the to finish grade i b Material beneath tile _ � Z inches Total effective absorptiop area 4 5 6 W Length Width Depth PERMIT NO. C7 Q F- wa Type of crib Crib diameter Crib depth Total effective absorption area LU Cn DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. W � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER Lit L PIPE MATERIALS SOIL TEST RATING Inc; n��4�r�• INSTALLER I n c �� �:� Xe✓ �t®a tir1L Ne REMARKS S �l G' APPROVED DATE LEGAL 72-013 (Rev. 3/78) pi i -i r4 I c- I'F:1 I I -r V ID F= ��t-- F --h � R_"n Cj FE o - DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE.- HK. 99501 264-4720 WE= -1 I_ ""C --v PERMIT NO ( 821157 ) APPLICANT FEJES DEVELOPMENT INC 6917 OLD SEWHRD HIGHWAY 99502 344-6691 LOCATION LEGAL L6BI CHRISTOPHER HTS LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (5Q FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: El E: F:� -IF "= :JL 21 L_ FE" C3 _r "= ��" %.-* E' I ���-F "= � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIEL[> THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). 1= r����� ������ -""K S17E= 1��� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. �22 "!E. F=* F= F; -'-'F= �������UK BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='F=F;;-*Ml-r �XF=�lF;;_'F=!E- �-1 ^ ���� I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED: ---------------------------------------- APPLICANT FEJES DEVELOPMENT INC ��>__ ISSUED B. 41_� - -------- f DATE ---- & VJ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION O PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: (-1 (1�t � I �---) J - DATE PERFORMED: "/--30 C LEGAL DESCRIPTION: C��� (S t z G��� f` "� � �`( ( I— J — SLOPE ) SI PL 3 4 nnr�t3 / C 5 /vk L 6- 7 g 1•v nr l.Wv�.l' f �� 9- 10- A 10 WAS GROUND WATER j / S 11 ENCOUNTERED? ��� L O P 12 IF YES, AT WHAT E DEPTH? 13 14 `� / 1 15 16 17 18 19 H Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE � ' (minutes/inch) TEST RUN BETWEEN FT AND FT p r � COMMENTS 'j t l' ✓ t // ' / 0 PERFORMED BY: /4 AC Pl Pt~AhFx CERTIFIED BY: 72-008 (6/79) DATE: WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological Sk Geophysical Surveys Drilling Permit No. LOCATION OF WELL (Please complete either la, lb or Ic.) A.D. L. No. Borough Subd�-isiy Lot Block lb 1/4qtrs. Section No. Township R Meridian N E) angle EE] j -of-of-of- S C] W E] DISTANCE AND61RECTIOI� FROMJOAD�NT ERSECT IONS 3. OWNER OF WELL: jrt4 Address: Street Address and Area of Well Location Feet Below 2. WELL LOG Surface 4. WELL DEPTH: (final) 5. ATE OF =ETION Material TtT ype Top Bottom ft Cable tool ❑Rotary ❑Driven Dug Ej Jetted ❑Bored 0 Other: -4 ZE]Auger 7. USE: Ej Domestic E] Public Supply E) Industry C1 Irrigation Cj Recharge ❑ commerical C] Test Well E] Other: c-, 8. CASING: Ej Threaded Welded diem. ,!in. tor" ftDepth Weight I bs./ ft. � ' diam.ft. -in. to ft. Depth Stickup 9. FINISH OF WELL: fi Type: Dlometerl,!` Slot/lAosh Size: Length Set between ft. and ft. Backfilling Gravel pack 10. STATIC WATER LEVEL: a ft. Date ❑ Above or .0 Below, land surface Equipment used: 11 . PUMPING LEVEL below land surface and YIELD 2j7 ft. after hrs. pumping 9•13•m - ft. after --hrs. pumping 9 -P.M. 12.GROUTING Well Grouted: ❑ Yes,.•ff] No Material: F] Neat Cement ❑ Other: 13, Pump: (if available) HP in, Length of Drop Pipe ft. capacity 9 -P.M. Subm. ❑ Jet C] Centrifical E] Other 14. REMARKS: 16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature E) F ❑ C This well was drilled ,'under m . isdIcilon and this report is .pur true to the bey of my knowledge and belief; Registered �psiness N me Contro9t License ' Number Address: p,.. .... Y'l Signed pp Date: Authorized Rfit3piresentative Form 02-WWR (11/81) Copy Distribution: WHITE-Stote DGGS, PINK -Driller, CANARY Customer 19Tti o rn rnrn M M d' d' C? C? ti ti O O CA CA N X Oil L a O a a H ®❑❑❑ a� N S O o W F- U U1 Q c L (D 'E LL (� U =) U) E U W O O O a s z U a d d a. 0 ® � U Cll � E � N 0 C E U co W co L +r � E Q o m 76 0 Q 'Q. CD C 'N VJ U) O 4- 0 W cu U A` c0 0 C O M .Q x LU co CDM M N 0 0 L c0 d O N W CZ z W o O U r N .0 0 CD C_ 0 a U 0 J (D C: O C1 c0 0 X CU Q. O i_ (a LL O � Q � O U? a� :1 5 O �3 Z m p J U- N W O Q LL uj a®❑❑ F- N in O W CD LL w W m Z M J Q O a a H ®❑❑❑ a� N S O o W F- U U1 Q c L (D 'E U)~ LL � � U =) U) E U W O O O a s z U a o U) m m a (Q aEi W O — O > , (n L Q O LL Q U) L L U m W Z E U d d 3. 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(Z 7�5N O vi 'o O z 0 C V) C 3 c o—'o lN tL J (n O N U N O •? OD 0 N 'S N bA Ql U a) 0 ct' G 0 [6 M Q 0. 0 J E U `0 V) N N E to m +T m�Z(c Uo 3 4� a' QO C Y O) LL Q �E In Q- Uw .E T U ..{� 0) O U O) d d N N O U a •� U a 0 C E Woo O a m Dw. �Z�0a� -� Q a J .amu ~ w a� CU 70 3omEa O v CL vi > ? 71 J J U C N E N N N v) C �-+ 0 I X 'c Ca Q fl �° E E a1 N T D v '% "0 u Ia p Q �o O O O me o Oi6 w N O Z5 (,, op 0 N -c LDY co'Ic ..0'6"a Ln u L �ma x Q 20�aw N= a m v + �v p T -0 al .Q O 0 9 v N U N i-� N O 70 L LnO 3 u Q a c 'o L O OX t h U C O N R J lL C = LL �rn 3 a) ,'n a)r 0) 404 057, Q 2L, < �,•f, Y 0 a) N N ura c m �^ W O1 J j N GJ % Z 3 �� O O\®\� o /LL =I d o 0o�o v U rn0m a)0 ,, dl vZ LDo� LL /�'. O �� Q� u u a)NELO Q u Q o���r6'. tea` U C N a)�- Q v z- E t t Lu L7 In N- y `�' t REG\S�•~ 1 {� Municipality of Anchorage Development Services Department4111� _ Building Safety Division On -Site Water &Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. X15- 0233 ge HAA# ✓-' Z 1. GENERAL INFORMATION Expiration Date: 0 Complete legal description CHRISTOPHER HEIGHTS SUBDIVISION* LOT 6 261-7546 Individual Water Storage ❑ Individual Holding tank Location (site address or directions) 6740 SAMUEL COURT * ANCHORAGE AK 1't J�lp ❑ Public Water System ❑ Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MICHAEL MCCARTER & GAIL-TUTT --Day phone 261-7546 6740 SAMUEL COURT* ANCHORAGE AK Day phone BECKY BROCIES W/ DYNAMIC PROPERTIESDay phone 261-7546 Individual Water Storage ❑ Individual Holding tank 3111 "C" STREET SURE 100 * ANCHORAGE AK. 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: 3 TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(ars) 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the . operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE L/�" Approved for—3 bedrooms. Disapproved. Phone 337-6179 Date /Ol Zf o _ WA IRMWAA Conditional approval for bedrooms, with the fllowing stipulations: ON-SITE Gy WASTEWATER PROGRAM Attachments: L/ Manitenance Agreements HAA Checklist g Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other By: Original Certificate Date: BID - D L — 0 (Rev. 12/01) cragm iartment _. r. SA BTY - 1 ' Gra Property line on ve systems are in in effect on this d. .... ....... A. G —7953 Waiver Fee $ r t Date of Payment Receipt Number OCT -05-2004 TUE 03;42 PM DYNAMIC PROPERTIES 5AM u E L I I I N 890 5739 ;SCALE s FAX N0. 2835019077775681 G ;J'f7JfhY CLF `lg.6 N 0 i ul th I' Al A4 r a 0 N 2ece�t /0-2-04pr P. 02 141 scr TI[ V6u'r•S r 0 ° r � :,EPT/C ycMr� N 0 i ul th I' Al A4 r a 0 N 2ece�t /0-2-04pr P. 02 141 lo' uriLirY evo'r N d') ` 1S'7'!5-4 10,C /G 4, V3 EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON.61/8./ ri,50 [2] AS -BUILT NO CORNERS SET THI 1 hereby certify that I have performed a Morl4ageo's inspection of the following described property:----.:,- /— roperty: _._ Susd/V/S/oN Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on properly 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 / � _._,..._._ day of % PF?IL 19 'r6 FRED WALATKA & ASSOCIATES (907) 246.1666 Engineers and Surveyors Municipality of Anchorage Development Services Department Building Safety Division � I31 On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL ; FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-233-06 HAAtf_ /IA OW/'U� 1. GENERAL INFORMATION Expiration Date: S_/'03 — //5 ' 0 3 Complete legal description CHRISTOPHER HEIGHTS SUBDIVISION: LOT 6 Location (site address or directions) 6740 SAMUEL COURT * ANCHORAGE. AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address CHRIS BORST Day phone 348-8840 P.O. BOX 111966 * ANCHORAGE, AK 99511 Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ■ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchcrage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid S at, or prior to closing for the engineering services provided. 4. 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 Health Authority 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. 1 further verify that based on the information obtained from the Municipality of Anchorage riles 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 213 * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWVVC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSO Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for -3 bedrooms. Disapproved. 337-6179 Date A' Z3 C3 Conditional approval for bedrooms, with the tllowing stipulations: A.Garness: ) —7 3 ' `.p4 �l`•ttt{tttOFV?1 \F��r�rr ON-SITE G) MATCO A\Ir1 M-. WASTEWATER Attachments: / %� '•. , .. , �: (/ r C HAA Checklist ManitenanceAgreements�S;: Septic System Advisory Supplemental Engineer's Reort li'i', Well Flow Advisory Other By: r / / /'" 7 Original Certificate Date: J i (Rev. 17,'01) ....___......... ......_.r...,.....�.......+«.. I--, •,..r....w.Y-._..m....n....w................ Municipality of Anchorage • Development Services Department t' Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: CHRISTOPHER HEIGHTS SUBDIVISION: LOT 6 Parcel ID: 015-233-06 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# NIA Date completed 2/1 Z1 983 Sanitary seal (YM) YES Total depth 114 ft. Cased to 114 ft. FROM WELL LOG Date of test 2/1/1983 Static water level 35 ft. Well production 3.5 9•p•m- WATER SAMPLE RESULTS: Well Log (YM) YES Wires properly protected (Y/N) YES Casing height (above ground) 24+ in. AT INSPECTION 4/7/2003 35 ft. 2.37 g.p.m. Coliform 0 colonies/100 mL Nitrate 0.2 mg.1L. Other bacteria 0 colonies/100 ml. Arsenic: N/A mgJL. i' , ' Date of sample: 4/7/200-3 Collected by: AKWWC. INC. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 11/22/1982 Tank size .1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YM)YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping 3/18/2003 Pumper NORTHLAND PUMPING ABSORPTION FIELD DATA BELOW B t-sy-N GRID '. Date installed 4/29/1990 Soil rating (g,p.d./ftbr bdnn 239 System type BED Length 45 ft. Width 24 ft. Gravel below pipe 0.5 ft. Total depth 02.79 ft. Eff. absorption area 1080 fe Monitoring tube YES Depression over field NO Date of adequacy test 4/7/2003 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 1128gal. New depth -2-in. Elapsed Time: _.0._ min. Final fluid depth U in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed 4/29/1990 Size in gallons 500 Manhole/Access (YM) YES "Pump on" level at 32 in. "Pump ofP level at 32 in. High water alarm level at 46 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/ltft station on lot "100.295' Absorption field on lot 1000+ Public sewer main N/A Sewer /septic service line 25'+ *FROM CENTER OF WELL TO CENTER OF ST1 0 TOP OF PIPE. PIPE LEANING 4 TO 6 INCHES TOWARDS WELL. MEASURED WITH TOPCON TOTAL STATION. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A 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'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and �a review of Municipal records that the above systems are in ""'" .. . .. """"""" conformance with MOA HAA guidelines in effect on this date. oA e r A ess.: Engineer's Printed Na a JEFFREY A. GARNESS VO o E-7953 Date HAA Fee $ 3�5' Waiver Fee $ _ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 12101) L 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. # HAA # O �C�S% L � " .-S 1. GENERAL INFORMATION LT Complete legal description ts76Pt% Aj1 Location (site address or directions) 6� -;' �a�y'l�t�L CC_'`7 Property owner fZG- I���� Day phone Mailing address � u [� &VV"{ ii7 L COt.u2-T A)-'' o- - lSl Lending agency Day phone Mailing address �� Kt�� ����. t C [Vct"j7'z?t�-Zay Agent phone Address t m �1 = i T tz IOL C1}. C 6-t/4 K �Gl �J✓ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 - 3. TYPE OF WATER SUPPLY: Individual well K Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. 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 4 6. By: 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. Name of Firm --Aim 7320 Address An Engineer's signature 4- DHHS SIGNATURE Approved for o bedrooms. Disapproved. Conditional approval for Additional Comments Phone Date S/�►-/L G bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 RECEIVtU MAY 0 4 1998 Municipality of Anchorage A'IIY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SEg=Nra.sERvicEs olvlsl Environmental Services Division 825 L Street, Room 502 * Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: oZ 6. C— IS76 P - PA _ l/O Parcel I.D.: of S -x,33 � A. WELL DATA Well type IRIUPF FE If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Es Date completed ';c -1-83 Total depth �l ! Cased to Casing height (above ground) Sanitary seal (Y/N)S Wires properly protected (Y/N) YES FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: 3S` 3S AT INSPECTION y/078 Coliform 5U Nitrate 01/ Date of sample: �i�rs! g� Collected by: B. SEPTIC/HOLDING TANK DATA 35 %'s. Other bacteria . R vj, Date installed �% a1a'82 Tank size 16W 64'L Number of Compartments"at— Cleanouttttfs (ON) Foundation cleanout C)�N) S Depression (Y/6 No High water alarm (Y/N) / S Date of Pumping 1d'19 Pumper %1f �y c l !?Er o y fig $Y A+ Nava C. ABSORPTION FIELD DATA A n Date installed L"9/70 Soil rating (g.p.d./ft2 o ft2/bdrm 219 System type MGUNiD Length 5 Width d� y Gravel thickness below pipe �� 5 Total depth � �Eww 1=xic7E 9 ( CsrzRv� Effective absorption area d Sf Monitoring Tube present I) ✓� Depression over field (Y/(o 00 Date of adequacy test Results (Pass/Fail) For 7 -WEE bedrooms Fluid depth in absorption field before test (in.);_ Immediately after gal. water added (in.): DRY Fluid depth AJ 19- (ins) Minutes later: N Absorption rate L/Sd .+ g p d Peroxide treatment (past 12 months) (YEN& N°Tf"01n'N If yes, give date tj/,4 Lt rr-ly 72-026 (Rev. 3/96)* D. LIFT STATION Date installed -q0 Size in gallons SW Manhole/Access ( N) Y�-S "Pump on" level at* "Pum off" level at* High water alarm level at _f *Datum Cycles tested I U w E E. SEPARATION DISTANCES SEE A -k P A-T7Rcaf'O SEPARATION DISTANCES FROM WELL ON LOT TO i % 1 f IfA Ump Septic/holding tank on lot `Qd r 'to GA oy On adjacent lots /V© I � /s .r fji..iC (70 GttRSzc� Jl&. Absorption field on lot /06 On adjacent lots�� Public sewer main to Public sewer manhole/cleanout Sewer /septic service line a 5 Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: c� Foundation 5 t Property line ZS rI Absorption field Water main/service line _Surface water/drainage 106 e4 Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10 Building foundation to f Water main/service line r Surface water /00 { Driveway, parking/vehicle storage area 5 4 - Curtain Curtain drain N 002 K-NC'w Wells on adjacent lots too I F. ENGINEER'S CERTIFICATION , certify that i have determined thru field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. s`�OF 4114 ������� Signature y't.• ��'.�++i Engineer's Name li M LUt LL Ig'-fS Date !,-;( +-/(3 P. HAA Fee $ Date of Payment Receipt Number d ` ` _-� 7 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number r• . ..A . . ::v:: JAMES P. WIWAMS : cc , �►;.� N0.9608 .: , ,10 t``ZS101 �sr 04/15/1998 15:25 169072517597 DYNAMIC PROPER -IES 5A U,5 L. COUil�-r'Ell � 6r N 69` S?f39 9&_� R.. O PAGE 02 0 � W 0 rySEtYK r'q�.flC y£FT/C YF�' S NLd I AS.BUILT NO COAIVERS SET THIS �P E 1 hereby certify that I have performed a Mart agse's inspection N � � • S i � � 'J= /� �, y3 0f the following described property:._...,'_.- Lo T' C 14R / S 7ZPJ•� �F•' ,tel 9 9 7-5 Anchorage Recordinq Precinct, Alaska, and that iha FFA '.( .5€.Pf7C VENT E Vii%! 7� •t. POCK 2 t f roa `L4�g � to , �Zn n a 41� AM Fd,uG6 Zo 1# GU'a o .� t N' i t 9. DeckGA . �--� •'. Wood �Er, t. r.c R� R.. O PAGE 02 0 � W 0 rySEtYK r'q�.flC y£FT/C YF�' S NLd I AS.BUILT NO COAIVERS SET THIS �P E 1 hereby certify that I have performed a Mart agse's inspection N � � • S i � � 'J= /� �, y3 0f the following described property:._...,'_.- Lo T' C 14R / S 7ZPJ•� �F•' ,tel 9 9 7-5 Anchorage Recordinq Precinct, Alaska, and that iha MUNICIPALITY OF ANCHORAGE • -� Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # - �" \ r' - HAA # i � 1DI� \ D q 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) 6740 Samuet Caunl (b) Property owner Qoug.PaL & Te-xesa Jato Telephone: (home) 345-2031 Business Mailing Address 6740 Sari?ue.E? Count Anchoh.a e Ata6ka 99516 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Rainbow Reatty Lunn Bunnb Address Telephone 545- (e) Mail the HAA to the following address: (or check here)p, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 a le Rinner Loop Road No. 204 Eagle River, Alaska 99571, 2. TYPE OF RESIDENCE Single-Famiiy)R Number of bedrooms / 3. WATER SUPPLY Individual Well .®C Community ❑ Public ❑ 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-siteXX Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 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. Names of Firm Address Date 5 & Telephone �ej �—Z > 2 17034 Eagle River Loop Road No. 204 Eagle River, AIaSKa �7GGI A 9 bawl A• Sh*42' ? `i 6. DHHS APPROVAL =� Approved for bedrooms by "�'Lf Date Approved Disapproved Conditional Terms of Conditional Approval CAUTION . 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 JICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 - u 1- Q 343-4744 Legal D- — A. WELL DATA Well Classification ISy' NIf A, B, C, D.E.C. Approved (Y/N) rJp Well Log Presentd'N) �:( Date Completed 2-' 1 Total DepthI I ACased to X1Ar' Depth of Grouting Static Water Level Casing Height Above Ground K� C3 Yield 4•� Pump Set At40� Sanitary Seal on Casing(:P'N) Electrical Wiring in Conduit4Y/N) 4 Depression Around Wellhead (Y(2ED +J SEPARATION DISTANCES FROM WELL: ( To Septic/Holding Tank on Lot ��— ; On Adjoining Lots I� '(C To Nearest Edge of Absorption Fieldn Lot �c�Z� ; On Adjoining Lotst'1' To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole N A To Nearest Sewer Service Line on Lot Water Sample Collected by S S ��� t r"�' ;Date 12_� Water Sample Test Results`�� Comments B. SEPTIC/HOLDING TANK DATA Date Installed `gZ Size 1 CR'� No. of Compartments StandpipesO>/N) �!f Air -tight Caps CRN) `, Foundation Cleanout(YbN) — Depression over Tank (Y/Or-1 Date Last Pumped Pumping/Maintenance Contact on File (Y/N) N o ; for Holding Tank High -Water Alarm (Y/N) �EA_ Temporary Holding Tank Permit (Y/N) A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 1 no To Building Foundation �4 To Property Line l o `�' To Disposal Field o To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course 11 Comments 'k 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA 4 Soils Rating in Absorption Strata Z�l !fes Type of System Design EI 7 Date Installed A—SOL — 41n Length of Field Width of Field Depth of Field I rl SJ Gravel Bed Thickness ops Square Feet of Absortion Area Statndpipes Present4VN) Depression over Field (Y/NP Results of Last Adequacy Test Date of Last Adequacy Test rv6_13 SEPARATION DISTANCE FROM ABSORPTION FIELD: t i To Water -Supply Well To Property Line To Building Foundation To Existing or Abandoned System on Lot I e: ; On Adjoining Lots ,c>t 4-- N p To Water Main/Service Line el"�" To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course I ,; 4— t To Driveway, Parking Area, or Vehicle Storage Area -Z.C=l4.. Comments D. LIFT STATION Date Installed ��2�— �'o Dimensions 'q % K 41 Size in Gallons �� Manhole/Access CWN) V% "Pump On" Level at �3 "Pump Off" Level at 7_1:E> High Water Alarm Level at u Vent PN) `a Tested for & Pumping Cycles during Adequacy Test. Meets MOA Electrical CodesdRN) Comments "Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA gu inspection. Signed Company 17034 Eagle River Loop Road No. 204 Eagle RJy4rJ AIUSIKa/7721 Date l�21 MOA No. C --,-o _:3? Receipt No. 2L r e t/ Date of Payment l Amount: $ Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 this Seal APPLK( NT FILLS OUT UPPER HAI — ONLY Time rroperty Owner F._ _, : ; Phone Zip Code Mailing Address /% f..�.:_ 'F-//I!.:✓r /1F - f Date Buyer ' / Date Address - xk r Zip Code Date Lending Institution / % i; Phone Address JJ ��a - % Zip Code Realty Co. & Agent f / � off 't'`/yi�' k- -4 �f�/ �f'`�.�" � " /�i .�%'r' J c''�.4 .i/ Phone Phone / `L / Code` Address Zip Legal Description�d�/ Street Location LIE, Type of Residence //J� 'CONDITIONS OF APPROVAL (4 ) APPROVED BEDROOMS-- ,�� // lacAeec ~4 lw"-' X Single Family +. El Multiple Family No. of Bedrooms_ D! e� ❑ Other Water Supply g Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community '}- - For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Septic Tank Size Sewer Disposal Well to Tank Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Ins7r Field Notes: 'S MUNICIPALITY OF ANCHORAGE `L DEPT. OF HE/1 H ENVIRONMENTAL PROTECTION 1 —,1 MAY 2 %, Res LIE, RECEIVED //J� 'CONDITIONS OF APPROVAL (4 ) APPROVED BEDROOMS-- ,�� // lacAeec ~4 lw"-' ( ) DISAPPROVED /A �L ( ) COND NAL APPRO � Q/� D! e� /mss ` DATE G BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72-023 (3182)