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Home My WebLink AboutFOX HILL BLK 1 LT 3Fox Hill Block 1 Lot 3 #051-073-21 Municipality of Anchorage F ',;•. Development Services Department -_ Building Safety Division - On -Site Water and Wastewater Program. 4700 Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 Page of www.cl.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO090167 PID Number: 051.073.2.1 "• Wastewater System: E]New ❑ Upgrade 76"BOX 672096 CHILIGIAK. AK 99567 ABSORPTION FIELD Ptwna: NutWar of Bedrooms: Daap Tnneit t] Slsnaw TnnN ®Bed Q Mwrq D Om•f. LEGAL DESCRIPTION tial Rabp TOtal Depen ham orpitsw 9we EXISTING GPo�F� Ft. slocx. Lot. S.Wokiw: Npd, b PPe daaan ham OnaMaf arae.: Dra.N d•oNW *tt%P.Pe. 1 3 FOX HILL Ft. Ft To gyp: Pana•: sea t: FA added Wow wqa ars G,a Larpm' Ft. Ft. Well: ❑ New ❑ Upgrade Grant anM: Nu Mr of laNa: DnW caww..n fM..: Ft. Ft. GaaNhubon (Pn W.. A 9, C): TOW Dopm: cans W: Total absorV+on wea Pope Matenal: EXISTING PRIVATE Ft. Ft. Ftt 3034 PVC I Doles Date D W.. stout; water lMl: ksww: Date Inatalrod: Ft. JR PUMPING 1 9110109 Ywd. Pump set W C&"D.N•pid Adds Gtane TANK GPM FL FL SEPARATION DISTANCES p Septic ❑ Holding ® S.T.E.P. ❑ Other: To Septic Absorption lift Holding ubnc/Private'a"r•` un' From Tank Field Station Tank Sewer Ll Anchorage Tank 1000 Gans well 116' 116' 100+ 75+ Mat•rw Numwr of Cunp•nnwnr. 1 2 S:rfaos w.t.r 100+ 100+ . . LIFT STATION La LMs 55.6' 10+ - - •. 250 cw. YW M:IW er. ANCH. TANK/ ORENCO 10+ 10+ - - Pump a . «.t 'Pump or lov at Wan wasr W m u. FoundWan +40 In. +36 N +45 In. 100+ 101)+ P.mp Make a Mod•I Esanu !mpe ana po d.n by ' Cn Dram unu P2005 : SEPTIC TANK REPLACEMENT NEW 12508 S.T.E.P. INSTALLED; BENCH MARK l.oeauon.nd Dwcnpoan: EXISTING TANK AND LIFT STATION ABANDONED PER CODE GARAGE SLAB REUSED EXISTING ELECTRICAL. 100..00 Ft Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1" 911012009 2nd 911112009 ........ Development Services Department Approval . +i+ Date: a9T— 0� Conditional Approval �;•• uuuw Mu; �fk'sS:even R.••Pcr.none:� In. E 8149 Reviewed by: ✓ Date: - 0 ++1.�•� and approved 02 ••• � tV i I I I I 1 .1 \\ EXISTING 3 BR \ HOUSE \ PC 21 SEPTIC AREA —H 34.0 F� -4130.0 EXISTING T2 / ELEVATED �T14 S BED NOTE: THIS IS NOT A SURVEY AS UUILY. HOUSELOCATIOONNT�0 1-011, APPROXIMATE NOTES: PAMONOCLi ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FOX HILL BLOCK 1 LOT 3 JOHN PETERS PLAN PO BOX 672096 CHUGIAK, AK 99567 '—NEW 12509 S.T.E.P K INSTALLED - ING TANK AND LIFT STATION ABANDONED PER CODE SEPTIC 2 AREA 10/8/09 Scole ,t; TH •.kl� 1* -50• •'•• P.I.D. NO •• •• / 51-073-2 annone j PERMIT NO. 8149 - SWO90167 1 OF 2 SWING TIES CO A B C WELL Cl 45.5 50.3 T1 48.8 53.8 T2 52.5 59.8 LS 53.8 61.8 WELL 63.0 54.6 PC 64.5 21.0 \\ EXISTING 3 BR \ HOUSE \ PC 21 SEPTIC AREA —H 34.0 F� -4130.0 EXISTING T2 / ELEVATED �T14 S BED NOTE: THIS IS NOT A SURVEY AS UUILY. HOUSELOCATIOONNT�0 1-011, APPROXIMATE NOTES: PAMONOCLi ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FOX HILL BLOCK 1 LOT 3 JOHN PETERS PLAN PO BOX 672096 CHUGIAK, AK 99567 '—NEW 12509 S.T.E.P K INSTALLED - ING TANK AND LIFT STATION ABANDONED PER CODE SEPTIC 2 AREA 10/8/09 Scole ,t; TH •.kl� 1* -50• •'•• P.I.D. NO •• •• / 51-073-2 annone j PERMIT NO. 8149 - SWO90167 1 OF 2 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDIT:ON OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: SEPTID TANK REPLACEMENT, INSTALL NEW 1250 GALLON S.T.E.P. TANK. 4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION ABOVE 20 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. 5. EXISTING TANK SHALL BE ABANDONED IN ACCORDANCE WITH THE CODE BY PUMPING, CRUSHING, AND FILLING WITH COMPACTED CLEAN EARTH MATERIAL. DESIGN PARAMETERS SEPTIC TANK REPLACEMENT: INSTALLED 12509 S.T.E.P.TANK EXISTING TANK AND LIFT STATION ABANDONED PER CODE Ijjl Ijjl Ij�I � 11 99.3 II II NEW 1250 g 93.9 f— S.T.E.P. .2 TANK ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT TH TANK CLEAN OUT NO. C# CLEAN OUT NO. My MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DNERTER VALVE FS FLOW SPLITTER LEGEND w—w— WATER LINE/ WELL RADIUS — u — m — EXIST'G SEPTIC — u — NEW SEPTIC —0 CHAINLINK FENCE NOTES: PANNONE ENG SVC, LLC _ ��__At D10 RECORD DRAWING ,�QF A�.40, 14 10/8/09 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 it��p ' •;fy�� scale i*:49TH rr/� NTS FOX HILL j " "• P.I.D. NO BLOCK 1 LOT 3 / feve^'♦?. Panno+e -073-2 JOHN PETERS // CE 8149 % PERMIT NO. PO BOX 672096 ()4'•.� swo901e7 DESIGN NOTES CHLIGIAK, AK 99567 (�� v ` '� Sheet 2 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 9951M650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO90167 Legal Description: FOX HILL BLK 1 LT 3 Design Engineer: 0062 PANNONE ENGINEERING SERVI( Owner Name: JOHN PETERS Owner Address: PO BOX 672096 CHUGIAK , AK 99567-2096 Date Issued: Aug 28, 2009 Expiration Date: Aug 28, 2010 Parcel ID: 051-073-21 Site Address: 021645 WOODCLIFF DR Lot Size: 40787 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of. ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received BY -461L C F V I Date: Issued By: kyl— /,1/%T Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program ° 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051.073.21 Property owner(s) John Peters Day phone 688.5701 Mailing addressP.O.Box 672096. Chugiiak Zip Code 99567 Site address 21645 Woodcliff Drive Zip Code 99567 Legal description (Sub'd., Block & Lot) Fox Hill SID Block 1 Lot 3 Legal description (Township, Range & Section) Lot Size 40,787 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field Septic Tank Holding Tank 1:1 Privy ❑ Private Well E3 Water Storage F1 Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade Renewal A14 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. Pannone Engineering Services, LLC (Signature of property owner or authorized agent) Permit/Rush Fees: 5�(� Waiver Fees: Date of Payment: 0 l/ Date of Payment: Receipt Number: %)Jr l 7532 Receipt Number: (Rev. 11/05) Pannone Engineering Services uc Steven R. Pannone, Principal Registered Professional Engineer E-mail: Steve raoanengak com June 13, 2008 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: Fox Hill S/D Block 1 Lot 3 EMERGENCY Septic Tank Replacement Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new S.T.E.P. tank be issued for this lot. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The existing septic system was designed and installed for a three-bedroom house and is operating adequately for three bedrooms. The tank has collapsed and gravel is hindering the operation of the effluent pump. The Owner is pumping weekly to keep sewage off the ground. The surrounding lots are served by private water systems and are over 100 feet from the proposed septic tank. This lot is served by private water and the well is located greater than 100 feet from the proposed system. PES will verify all required separation distances at time of installation. Upgrade Tank Design. a. Number of Bedrooms: 3 b. Septic Tank Size: 1,250 gallon S.T.E.P. 2. Surface Nater: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: Lot 3 slopes to the west at approximately 1-5 percent based on existing contour information. The proposed installation will be located in the central portion of the lot adjacent to the property line. Mailing: P.O. Box 102954, Anchorage, AK 99510-2954 Physical: 11301 Olive Lane, Anchorage, AK 99515 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. if you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Perrone CE $149 i Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: maning: P.o. Box 100217, Anchorage, AK 99510-0217 Physical: 11301 Olive Lane, Anchorage, AK 99515 Telephone: (907) 272-8218 FAX: (907) 272-8211 a O � r f 1= � (n p j N F2� �LL intr uF iC p►C.3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES .—DAtAuc f L-"Vd1 Sta rm TO SEPTIC ABSORPTION WELL Address FROM TANK FIELD O �.� l� Phone(s) Permit No. No. of Bedrooms WELL 00 �-J-- Do X71 b 88011 8 LOT LINE _/ '-1 T/� (D t r QO J LEGAL DESCRIPTION Lot Block Subdivision P_'qx 41,11FOUNDATION / O s C � Township, Range, Section �L�njlAS•BUILT � DIAGRAM (Show location of well, septic system, property - lines, foundation, �e ec-. driveway, water bodies, etc.) TANKS , 5r SEPTIC ❑ HOLDING -ft - Manufacturer Capaaty In gallons G I W14 .cx t.sfitr 125-0 I Material No. of Compartments TYPE OF SYSTEM ❑ TRENCH f$1 9ED ❑ W. DRAIN ❑ OTHER �r D%j(l f� r. o L Depth to pipe bottom from Total depth from original grade j original grade FT FT •, ,o Fill added above original grade Gravel depth beneath pipe :5 FT as- FT li � I GO Q � bt+,r y(� Gravel length Gravel width -7. 3 FT a i FT Total absorption area Distance between lines GO S (o 3Z SQ FT ' f FT Number of lines Soil rating Pipe material SQ FT _S3Q3 Installer_� X gq _ l.)t Y.ale Installed e iNt o co 0 ELLS °" Q 14ops G N PRIVATE ElOTHER (Identify) Classification (.A, Total Depth Cased to • h , f -B -C) I)( I SIL t lel FT FT Installer Date Installed. G j a oN fu • REMARKS: udE� �j�ry CYJ,►121• ) e N rJ N U� �S �; i Lo Scale: - p II N Inspecti( dormed by: • e '; -J C C n A)11I 12M 'C. ft 4�A1/D 14 ADate: /r1 —2,� �� 7-21 r � ,�} r ;�� r�' `fi 'rf 1 i�J ('SCI i�f,�,$,A f•i J �r•r; D' i - •u •srr • •a^mvea as . i ERIN g 8 S ENGINE li R9014 No. 204 cenil that this pection was perlorrned according to all �,'• s�h� + A• aha rc 9 ;' Municipal '1n�l�F h� l � �— - and�{g1�Igyilidll �3 �%al'O P e,s Health Department Approval: Date: MUNlC[PALIT� OF ANCHORAGE Department o� Hea1th & Human Services 825 L Street� Anchorage; Alaska 99501 343^4720 ON'SITE SEWER PERMIT Oh\8�� Permit Number: 890118 Upgrade ��LL~�7\l��///l Date Issued: 07/11/89 Engineer Designed Owner Name: SAMUEL & EVA STAMPER Day Phone: Owner Address: BOX 2274 552�2618 EAGLE RIVER. AK 99577 Parcel Id: 051�073~21 Lot Legal: Subdivision: FOX HILL Lot: 3 Block: 1 Section: 4 Township: 15N Range: 1W Lot Size 40787 (sq.�t. or acres) Max �edrooms: This Permit: 3 Total Capacity: 3 SEPTIC TANK: Minimum total septic tank capacity: 1,000 ga1lons. Each s'I. C: tank must have at least 2 compartments, Depth to top o� septic Lank(s) ( 4"0 �eet requires insulation over tank(s)" THE TAL DEPTH OF THIS MOUND MUSl NOT EXCEED 1.0 FEET" THIS PERMIT EXPIRES 12/31/89 AND VALID FOR A SINGLE FAMILY HOME. THIS MOUND SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH THE ENGINEERED DESIGN. DHHS MUST BE ADVISED PRIOR TO ALL INSPECTIONS l CERTIFY THA7: 1, I am �amiliar with the requirements [or on-site sewers and wells as set [orth by the Municipality o[ Anchorage (MOA> and the State o[ Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria his permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distanisting well, wastewater dispm or public sewerage system on this or any adjacent or nearby lot" 4" I understand that this permit is valid or a maximum rooms" I also understand that the capacity of the total system is 3 bedrooms and Aly enlargement will require an additional permit^ Signed: ~ DATE: ��C� —��^�-��8'��----- (Owner) SAMUEL~AI « Issued By DATE: ~71-~--�^��'-- / o Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST i�:vn+ea as as♦o e.,,�L, tr_ PERFORMED FOR: �l-�� G^1'— 7 DATE PERFORM ra- 'An LEGAL DESCRIPTION:.I 1 1y4 L—L� Township, Range, Section:.-�jc�,t,� 1 Q� 2 3 _ r 4 ' 5 t` 6 2, p` L 8 9 _ 10- 11 12- 13-- 14-- 15- 16-- 17 14151617 18-- 19 20 COMMENTS 111 7%7SLOPE �"o, VV - - SITE WAS GROUND WATER � / iA ENCOUNTERED? _iyj��`"` S IF YES, AT WHAT t L DEPTH? O — P E Depth to Water Aller' A Monitoring? Dale: Reading Date Gross Time Net Time Depth to Water Net Drop K +a °7 �✓ 'a �•O ��% ti � V i '7✓ N PERCOLATION RATE _ZQ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 1 _ FT PERFORMED BY: 17034 Eagle River Loop Road No, Eagle River, Alaska 99 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDE 72-008 (Rev. 4/85) CERTIFY THAT TH STE T WAS PERFORMED IN ON THIS DATE. DATE: �-� C^ MUNICIPALITY OF ANCHORAGE /e 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 e PHONEI KNEW T• `.�%'� F S ��iE.-,j 6% %j ❑UPGRADE MAILINGADDRESS LEGAL DESCRIPTION �/ ��•--��'' UTP? �31_R�-� •f /Za.i /!%1- - LOCATION /,{ % —A [/l! A NO. OF BEDROOMS •7 _5 [ U X DISTANCE TO: Well Absor tion area l Lj t , / Dwelling � / PERMIT NO. - 6 (/o (" �t,�•, 1- Q Manufacturer Material - No, of compartments Lu rn Liq. capacity in gallons JSP;, IF HOMEMADE: Inside length Width Liquid depth_ DISTANCE TO: Well Dwellin PERMIT NO. JOE = N Manufacturer Material Liquid capacity in gallons O DISTANCE T0: Well Foundation Nearest lot line PERMIT NO. w a Z uj No. of lines Length of each line To I t o lines Trench width Distance between lines z Fw ccinches Top of tile to finish Material beneath grade tile Total effective absorption area O inches Length 3o, Width / Depth _ , IS PERMIT NO. {y///�l�r. (./ 0 '/ !JF < I- CL o Type of crib �— - Crib diameter �- Crib depth -- /� r Total effective absorption area lo, 7 U / i) DISTANCE TO: Well / '� Building foundation ��• Nearest lot line ••y v Class De th r�nrc Driller Distance to lot line PERMIT NO. ' W � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOILTEST RATING tf '•5)t INSTALLER,(�% ( REMARKS Y AP4, r1hmtwl A. vtV y _ P _ 1 AW I A)PROmY- k�Aa lt9 IVER, ALASKA t MUNICIPALITY OF HNCH `98E , DEPARTMENT O. 825 L HEALTH AND ENVIRONMENTAL F ]TECTION STREET/ ANCHORAGE, HK 99501 J»~-/ 264-4720 l" -TIE ��.— L- t'-1 1 -1... PERMIT NO: 840495 DATE ISSUED: 0�/21/84 APPLICANT: C/O S & S ENG'G. ART SALES ADDRESS SRB 196X EAGLE RIVER, AK 99577 CONTACT PHONE: 684-2979 LEGAL DESCRIP: SUBDIVISION: F8XHILL LOT BLOCK: 1 SECTION: 4 TOWNSHIP: 15N RANGE: IN LOT SIZE: 40787 (S8. FT. OR ACRES,', MAX BEDROOMS: ] LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM, CHOOSE THE OPTION THAT' BEST FITS YOUR SITE. -IF t ---o I—E I'AK---H NE: E: E> K�.��I�� b��b DEPTH TO PIPE BOTTOM (FT. ) 2. 0 ** / 2. 0 **\ 2. 0 GRAVEL DEPTH (FT. } 2. 0 � ,/ 0 5 1. 0 'TOTAL DEPTH (FT. ) 4. 0 I 0 �I 8 GRAVEL WIDTH (FT. ) 2. 5 5. 0 ��o GRAVEL LENGTH (FT. ) 64. 0 � 45. 0 *m0 GRAVEL VOLUME (CU. YD 8 ' -14. 5 29. 1 -- TANK. SIZE (GALS) 1/ 000. 0000. 0* 1, 000. 0 ** /om0 SOIL RATING FT. /BR) 85 85 8�^ ** DEPTH TO PIPE BOTTOM { I 5 FT. REQUIRES INSULHTIQN ** DEPTH TO PIPE BOTTOM { 4. 0 FT. MAY REQUIRE A LIFT STATION ** TANK MUST HAVE AT LEAST - - - - - - - - - - - -- - - TWO COMPARTMENTS -- -- - - - - - - - -�� I CERTIFY THAT: 1. I AMFAMILIAR WITH THE REQUIREMENTS FOR ON-�SITE SEWERS HND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOH) AND THE STATE OF ALASKA. 2 I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOH CODES AND REGULATION -,:3.' AND IN COMPLIANCE WITH THE DESIGN CRITERIA QF THIS PERMIT. 3I.WILL ADHERE TO ALL. MOA AND -STATE OF HLHSKA 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 H MAXIMUM OF � BEDROOMS AND AMY -ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT. ^` IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOH BUILDING CODES, THEN (1) FIN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED/ (2) HS-BUILTS WILL NOT BE APPROVED WITHOUT HN ELECTRICAL INSPECTION REPORT; AND (]) THE ELECTRICAL WORK' MUST BE DONE BY H LICENSED ELECTRICIAN. SIGNE� DATE: / 7 " HRT S��zHPPLICHNT: C/G SCa S �nG/8. ISSUED BY DATE: u' SOI LS LOG /L MUNICIPALITY OF ANCHORAGE C f • +ut J DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 1:1 PERCOLATIONTEST 825 L. Street, Anchorage, Alaska 99501 264-4720 -�� SOILS LOG — PERCOLATION TEST PERFORMED FOR: ✓ /-�'> "-� DATE PERFORMED: ! jA�C/-, LEGAL DESCRIPTION: t--- / - Cr _ SLOPE SITE PLAN 10- 11 ISE P r H _LFE /i C, f +-� /-/ " i / Net Time 14 ENCOUNTERED? O 2 P 12 E IF YES, AT WHAT i: DEPTH? 13 f L� + 17 e "' 4� is hto 19— 4- 5 7 (« 8 9 10- 11 Date WASGROUND WATER L Net Time 14 ENCOUNTERED? O P 12 E IF YES, AT WHAT i: DEPTH? 13 'Reading Reading Date Gross Time Net Time 14 Net Drop i: 16 f 17 e "' is hto 19— 'Reading Reading Date Gross Time Net Time Depth to Water Net Drop i: f 20 v..;.. PERCOLATION RATE i..-(�, (minutes/inch) TEST RUN BETWEEN _. FT AND FT COMMENTS ,iJ, A u23,'K� _n„ -y. riJ / DATE: (7 /, +��f PERFORMED BY: ! Y-'r.t ;I�Jtiv �la.,�+a•� `"� CERTIFIED B i 7 q 72-008 (6/79) 11tria UnIfing lwq bv DOC Co. dba SIULLI"N WATERLLS P. 0. BOX 272, CHUGIAK, ALASKA 99567 a TELEPHONE 688-2759 OWNER OF LAND-- ADDRESS�,— LEGAL DESCRIPTIO J DATE - Started .— Ended— PERMIT NUMBER KIND OF FORMATION: From•—Ft.to �.-L —Ft._fi ,--- u' "<. _ From From __a___Ft. to ��Ft._ From. --Ft. '`_,4 '' - c :•f ` 'r �;• From � From t_Ft.co`i to r Ft._%r� From__—Ft. From _ Fromji�Lh.to>*t�_.Ft._ to Ft. Froin—Ft. From From' r t + ii (a Ft. to_J_—Ft. 5 s t+.� E,'I ( = a, From -- Front_? Ft. to,( L _Ft._. <.. �v r3'C, �i �f t:: ;a jrrom From_—,__Ft. to -----Ft._.— wi ( .i From From,�__Ft. tot! -. From From__Ft. to_ Ft.------ •'.-C.a,4 %--`.nr:;>._ From From___Ft. to Ft.__— From From Ft. to Ft. Frmn—_—Ft. to ---Ft. From. --Ft. to Ft. From,_Ft. to Ft. From__—Ft. to Ft. From._—_Ft. to Ft. Froin—Ft. to Ft. MISCL. INFORMATION: DEPTH OF WELL. STATIC LEVEL. OF WATER FT. JJ DRAW DOWN FT GALS. PER 1 -IR - ,F . KIND OF CASING'-.'�---- G�% 00 Ft. to— Ft. o Ft, tQ� to—wcla\A�. - e�---- — -- Ft. to-----Ft--- Ft. to-----Ft,.f V " Ft. to-----Ft---- Ft. o— -.Ft-.-- Ft. to_ Ft Ft. ro Pc. Ft. to,___Ft Ft. to____Ft. Ft. to__ Ft. From __Ft. to ---Ft. From Ft. to Ft From _Ft. to ----Ft. From— _Ft. to ----Ft. From to__Ft. --_—__F(. From Ft. to Ft. Front _Ft. to ---Ft. MUNICIPALITY OF ANCHORAGE I�A • Department of Health & Human Services}1 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 l.D.# n�) 1-01I'll)-a L HAA#C:� ,a'5\ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3; Btoch l; FOX HILL Subdi.v.i4ion T15N; RIW; Sec. 4 Location (address or directions) WoodePUi D.inve, Pe.tens Cxeek, Ata,6ka (b) Property owner caMuL-29 .9 Fun et„mpek Telephone: (home) Business..'` -2618 Mailing Address Box 2274 Eagte R.ive%, Ataelza 99577 (c) Lending Institution n Mailing Address Telephone (d) Real Estate Company and Agent REIMAX o4 Faqte Riven ATTN. Ray Hehpnon Address 10160 Cp.mtvn/q"e1r' 27n,.yp_ #901 Fagep R,rveh, AK 99577 Telephone (e) Mail the HAA to the following address: (or check here 3X if hold for pick up.) List contact person and day phone number below: 17034 gagia Rim Lues goad Na 904 Eagle River, A alkill 949Y? 2. TYPE OF RESIDENCE Single -Family g Number of bedrooms 3 3. WATER SUPPLY Individual Well INX 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-site M< 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. vae) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ' As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of 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. G� Name of Firm Telephone //Z�%7% S&S ENUINEIMING Address 17034 Eagle River Loop Road No. 204 Eagle Rivev, Date Alaske 99577 6. DHHS APPROVAL Approved for _bedrooms by // / Date / `! Approved --Disapproved Conditional Terms of Conditional Approval 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 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 fRev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • �� Health Authority Approval (MAA) I1Y or ANc6it8kI ST - FEBRUARY 1984 ENVIR i ENTAL SERVICES DIVISION343-4744 Legal Description: oe. ' :s 0. nI A. WELL DATA Well Classification {li ..2 5 1989 RECEIVED If A, B, C, D.E.C. Approved (Y/N) - Well Log Present (Y/N) r_ Date Completed �t— SA Yield la, 0 Q Total Depth Cased to ND � Depth of Grouting _ Static Water Level 7/ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) 7 i To Septic/Holding Tank on Lot I o1) f ; On Adjoining Lots �� r To Nearest Edge of Absorption Field on Lot /Uo ; On Adjoining Lots — O� To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole✓"� To Nearest Sewer Service Line on Lot t Water Sample Collected by — .5 d 4fN4 NeeYli; Date U Water Sample Test Results` bkC��_r �� I iri'm ta 6A N� k A Icy Comments B. SEPTIC/HOLDING TANK DATA Date Installed— B4Size No. of Compartments Standpipes (Y/N) --Air-tight Caps (Y/N) _Foundation Cleanout (Y/N) L Depression over Tank (Y/N) — N Date Last Pumped c_2 0�� I R Pumping/Maintenance Contact on File (Y/N) & ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well / FAD -F To Building Foundation i To Property Line o_ To Disposal Field ([� To Water Main/Service Line 3 O nn To Stream, Pond, Lake or Major Drainage Course Comments5��« --t) P L)�<�55�oopod 'lDurmi 72-026 (Rev. 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA J Soils Rating in Absorption Strata a� (3_ �� Type of System Design &ONdej �c d Date Installed U Length of Field 3 Width of Field d_-7" Depth of Field Z Gravel Bed Thickness __c Square Feet of Absortion Area �1 £� 3 Statndpipes Present (Y/N) Y Depression over Field (Y/N) /J Date of Last Adequacy Test e- VJ Results of Last Adequacy Test NCw SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well / no fi � To Property Line n � t To Building Foundation To Existing or Abandoned System on Lot t o rt ; On Adjoining Lots 30 /f - To t To Water Main/Service Line 3 fi To Cutback (if present) N VA To Stream, Pond, Lake, or Major Drainage Course ,NbV To Driveway, Parking Area, or Vehicle Storage Area 3o Comments D. LIFT STATION Date Installed S,6 lU _� Dimensions 5 Crr�9onNtN/ �6N Size in Gallons S �� l Manhole/Access (Y/N) "Pump On" Level at 3 "Pump Off' Level at High Water Alarm Level at 3 Vent (Y/N) 1 Tested for � /A jVeW Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) _ 1 Comments Atjc_hny-V�-4G� 1 (� l` Wald ( NC-� **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 5 th a ENGINEERINCa Company 17034 Eagle River Loop Road No. 204 Engle Mar, _ Z,SI Date z MOA No. /�d� Receipt No. 7 Receipt No. _ Date of Payment Z J / Waiver Fee: $ Amount: $ / zu 0-o Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 ;�s O*Shia q•YV Y4lV nq ]° oY Y '91Yq• �/ 70aJ• 4Y .�•YSJ. On M fit: 4 hire? R. Shc A ,y'•, Yw No, JA574 Y x �Y"•ne YeN• ,�. nix a CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 0.2 R TELEPHONE (907) 562-2343 5633 B Street^ - Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER �_ ❑ PUBLIC WATER SYSTEM I.D.# I C;CPRIVATE WATER SYSTEM Name Pbone No. S & S ENGINEERIt4fj .'V. ?_34 F_g Mailing Adtpbge River, Alaska 99577 City }}ff�� State Zip Code SAMPLE DATE: 1 Mo. Day Year SAMPLE TYPE: ,�- Routine ❑ Check Sample (for routine sample with lab ref. no. ) ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE Time Collected NO. LOCATION Collected �z.By 3 L 4 TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: JF�y Satisfactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received 7 - Time Time Received Ii�30 Analytical Method: Membrane Filter ' No. of colonies/100 ml. Lab fief. No. Result" (o% -PJ ED I m U [I] -� m Analyst 5'�/-' BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter. Direct Count BEFORE verification: L COLLECTING SAMPLE Coliform/100mi GB Final Membrane Filter Res is Colifo(r'mT/1 omi Reported By Date7— /6'— d Time: ��Z� a.m. p.m. TNTC = Too Numberous To Count OB = Other Bacteria CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 S STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 \ FEDERAL TAX ID It 92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order # 12253 Date Report Printed: MAR 23 89 @ 13:37 Client Sample ID:L3, B1, FOX HILL S/D Client Name S & S ENGR PWSID :UA Client Acct SNSENGP Collected MAR 20 89 @ 15:30 his. P.OA NONE REC D Received MAP, 20 89 @ his. P 1. Preserved with :COOL Ordered By Analysis Completed :1,M 22 99 Send Reports to: Laboratory Supervr o :STEPHEN �JCEDE 1)S & S ENGR Released 1 2) --------------------------------------------------------------------------------------- Special Instruct: Chemlab Ref 4: 4593 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result/Units Method Limits ------------------------------------------------------------------------------------------------------------------ NITRATE-11 0.29 mg/l EPA 353.2 10 Sample ROUTINE SAMPLE. Remarks: 1 Tests Performed See Special Instructions Above UA=Unavailable ND= None Detected See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Greater Than MUNICIPALITY OF ANCHC,RAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-472.0 Application Date lune 23, 1986 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3; Block 1; FoxhiU Subdivi6ion Location (address or directions) Obeng Road .to Gtac%en Road; twtn 2e6t .to Woodc 64; sign on pnopenty Lunn Light - 3rd houae on )tight; Reatty Centers (b) Applicant Name Ata6ka Mutual Banf Telephone: Home Business Applicant Address , EaAte Rivex Branch/ATTENTION: Cindy 2. (c) Applicant is (check one): Lending Institution M ; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution nnmo nS ,app iP_ant Telephone _ Address / (e) Real Estate Company and Agent Ron A.tr 0n,t01tn�t1Q �if4t?11A Address AvahaXaaeAPaAha Tel phone 344=a5f!t (f) YM the HAA to the following address: TYPE OF RESIDENCE Single -Family C Multi -Family ❑ Number of Bedrooms -3 Other 3. WATER SUPPLY Individual Well ® Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite R1 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 72-029 (11184) F. ENGINEERING FIRM PROVII)h INSPECTIONS, TESTS, FILE SFARCH, D. a 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 FirmS R S ENGINEERING _ Telephone Address ZKDr v Date EAGLE RIVER, AK 99577 ! �v 6. DHEP APPROVAL Approved for bedrooms by �G i Date Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 DFIEP 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 professioi al engineer's work. Page 2 of 2. 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUiJICIPALITY OF CHECKLIST - FEBRUARY 1984 DEPT. OF HEAL TI &RAG'= 264-4720 ENVIRONMENTAL PROTECTION Legal Description: JUN 3 01986 A. WELL DATA CEIVED rt_ Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present Y ) — Date Completed _ �� Yield +- �6P 1' I u I •N .� Total Depth I t'� �r Cased to 1 O Depth of Grouting Static Water Level _ 96 1 Pump Set At — 461K G/4-- Casing Height Above Ground — 17 Sanitary Seal on CasingrLY k Electrical Wiring in Conduit&4- Depression Around Wellhead (Xa Separation Distances from Well: To Septic/Holding Tank on Lot �'O t Y ; On Adjoining Lots %a D z To Nearest Edge of Absorption Field on�ot9 �� ; On Adjoining Lots To Nearest Public Sewer Line . �� To Nearest Public Sewer _ Cleanout/Manhole To Nearest Sewer Service Line/on Lot Z� t Water Sample Collected by S`S �if� �^��E� ��6 Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed �Z'Size �� No. of Compartments Z Stand pipes6y* — Depression over Tank N'* Air -tight Caps Foundation Cleanoutomy Date Last Pumped 4,-TZs`� 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 ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field 36 0 To Water44airr/Service Line - To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 70 nORIil RU1 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �s�'C Type of System Design r7 Date Installed /— ?Z Length of Field ZZ) Width of Field Square Feet of Absorption Area Depression over Field �— Results of Last Adequacy Test Depth of Field Gravel Bed Thickness Sym P G' Standpipes Preserc/•Pd7 Separation Distance from Absorption Field: To Water -Supply Well /6= f /- Date of Last,,Adequacy Test To Property Line i It To Building Foundation / �/% To Existing or Abandoned System on Lot �/� On Adjoining Lots �� f To Water Mah-tService Line �>7 F To Cutbank (if presenty fir° To Stream/Pond/Lake/or Major Drainage Course( To Driveway, Parking Area, or Vehicle Storage Area /F Comments D. LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments " Check Permitted Bedroom Rating Against HAA Request .. I certify that I have checked, verified, or conformed to all MjA a d. uidelines in effect on the date of this inspection. 9 Si ne§ & S ENGINEERING Date y Compa�6 196X MOA No. �� s EAGLE RIVER, AK 9957,7 Receipt No. 0 � , ' Date of Payment ��4 O OJIW1' Amount: $ fes, 00 Page 2 of 2 72-026 (11/84)