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FAIRMOUNT LT 2
Fairmount Lot 2 #017- 1 12-09 Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231160 PID Number: 017-112-09 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name CONOR HLAVINKA ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 5421 RABBIT CREEK ROAD *ANCHORAGE, AK El Other Phone Number of Bedrooms Soil Rating Total depth original grade 907-317-2191 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grad Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot FAIRMOUNT; LOT 2 Fill added above original gr Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES 0 Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 1 QQ'+ 25'+ TANK [:]Septic 9S.T.E.P. 171 Holding El Other Manufacturer Capacity ANCHORAGE TANK 1500 Gal. Surface Water 100'+ Material Number of compartments Lot Line 5'+ NA STEEL 2 Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR - OLD SEPTIC TANK DISPOSED OFFSITE ARI C H O RAGE TANK 500 Gal. Alarm location UNDER KITCHEN SINK Electrical installed by EXISTING/OWNER Installer PIPE MATERIAL House to tank D3034 Tankto D1785 A+ HOME SERVICES Drainfield D3034/EXISTING CO/MTD3034 Inspector GEG BENCH MARK (Assumed elevation) 99.88 ft Inspection 15` 7/25/2023 - Location and description 2nd r TOP OF M H 1 3_ 4'^ _ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Qo�oopp OF.q����d Conditional Approval: Date oo �� "' •'s4� Q O 9 TH .......................... . ... .D D ........... ....�. ...... Septic Syste G Approved �( • Je r � \A. Go ness� Q .- Q Q(jo 9 ' . � E— g 3 Date z ��fPre�.• ��,I 23�0� Note: this approv does not include well permit requirements. #aEccesa4���0Ooot�� kr%Uv uuluu Ion PERMIT NUMBER: PARCEL ID NUMBER: OSP231160 RECORD DRAWING 017-112-09 A B DBL1 110.2 114.1 DBL2 110.9 114.9 MH1 112.4 116.5 MH2 119.5 124.0 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE -GENERATED IN AUTOCAD. GENERAL LOCATION OF EXISTING BED FAIRMOUNT; LOT 1 - 100' WELL RADIUS DOES NOT ENCROACH UPON NEW 1500 GALLON SEPTIC TANK z z wl w w w H 0 Co O PARK HILLSRIDGE; LOT 3A PER OWNER JAMES ST. GEORGE - WELL IS LOCATED IN THE NORTHWEST CORNER OF LOT (OFFSET FROM THE CREEK); WHICH IS LOCTED 100'+ FROM THE NEW TANK —10' UTILITY EASEMENT CONTRACTOR INSTALLED CLEANOUTS ON EACH DISTRIBUTION LINE AND TWO MONITORING #WITHIANCHORAOGE TUBES. THE EXACT LAYOUT AND ORIENTATION OF THE BED IS UNKNOWN. ADDITIONALLY, THE CONTRACTOR HAD THE LINES JETTED EPDXY COATED STEEL STEP TANK TANK LIFT STATION COMPONENTS 3L1&22��-- — SHED EXISTING 3 BEDROOM HOUSE ARS Ek lG (31.T9 Ltd y -r E N G I N E E R I N G = S A L E S CONSULTING 3701 E. TUDOR ROAD. SUITE 101 'ANCHORAGE. AK 99507' PHONE (907) 3376179' FAX (907) 3963246' WEBSITE:-g-se0@ mg.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CONOR HLAVINKA 1 907-317-2191 1 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: FAIRMOUNT; LOT 2 D.J.G. TYPE OF WORK: DATE: � SEPTIC TANK RECORD DRAWINGS 8/2/2023 z 0 �IJJ z Sv~ v o0a \ W �zEDLU \ O 1- O -30� { Z Q ZO(9 000 � 0 w O Z Q ,q�®o P. Jr ey A Ga ness : W ���%' �� C -79 3 Zee AV Aw AW LICENSE® ®�'ROFESSI�� o O #AECC884 4a� / PERMIT NUMBER:C �+ © /� l �, PARCEL ID NUMBER: OSP231160 RECORD DRAWING 017-112-09 TOP OF MANHOLE = 99.88 TOP OF TANK AT INLET = 93.87 INVERT OF BUNG AT INLET = 93.26 FINAL GRADE = 99.71-99.76 NEW 1500 GALLON EPDXY COATED STEEL STEP TANK PER A+ HOME SERVICES, INTERIOR OF TANK WAS PLUMBED SO THAT FLOW COULD BE DIVERTED TO EITHER FIELD TOP OF MANHOLE = 99.81 — TOP OF TANK AT OUTLET = 93.88 W Tp ENGINEERING -SALES v CONSULTING 3701E TUDOR ROAD. SUITE 101 'ANCHORAGE. A<99507' PHONE (907) 337.6179' FAX (907) 3384248' WEBSITE: vrvw.gam.ssen¢n«nn0_com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CONOR HLAVINKA 907-317-2191 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: FAIRMOUNT; LOT 2 D.J.G. 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N •n aN O RS u W C N c Q) Q C U=O C L C CU —.'a Cf6 L N a) O N tN W e-1 C N > L a7 o m 2 3 y (a a !n rn N U -00 N t N M O 0 E ` o O O :E r-4 E o f •U) L A o Q U U` O ,C U N U O Q ++ M a/ N N N • >, i fu> J~ GN O C i i a� 0 5 2 N Z > O O=3 � O c u v C Y Q=C°� a) N m O .F-+ v) U QBE ._I W O O y a v J °'`-N CaJ o 16 E a) CL 0 �E��a` E` C 7•-` Q lD m LLh fu a) c 'c) a) :c A N to O O 41 3 N� y N roLn a� O 0 0 MUNICIPALITY OF ANCHORAGE iricnt 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 I. Department On -Site Wastewater Disposal System Permit Permit Number: OSP231160 Effective Date: 6/29/2023 Work Type: SepticTank Upgrade Expiration Date: 6/28/2024 Tax Code Number: 01711209000 Site Legal Address: FAIRMOUNT LT 2 G:3137 Site Mailing Address: 5421 RABBIT CREEK RD, Anchorage Owner: HLAVINKA CONOR L & Lot Size in Sq Ft: 75075 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 2 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: 15,5 `� r� T10 c7 r C" Date: Issued By: Date: 2 % 2-0 2 al _.._ Development Services Department ate' ` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-112-09 Property owner(s) CONOR HLAVINKA Mailing address 5421 RABBIT CREEK *ANCHORAGE, AK Site address 5421 RABBIT CREEK *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) FAIRMOUNT; LOT 2 Legal description (Township, Range & Section) Lot Size Sq. Ft. Day phone 907-317-2191 Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ initial ❑; Single Family (SF) 0 Septic Tank 0 Upgrade (w/wo ADU) Holding Tank E] Renewal❑ (D) ElRenewal Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (5lgnature of property owner or authorized agent) Permit/Rush Fees: k22 5 Waiver Fees: Date of Payment: �/�Z3 Date of Payment: Receipt Number: 0 3 g 3 G Receipt Number: Permit No. Waiver No. GADevelopment Services\Building Safetyl0n Site Water and Wastewater\Forms\Client FormsTermit Application.doc my Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231160, Curtis Townsend, 06/29/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231160, Curtis Townsend, 06/29/23 XXXXXXX X X X X X X X X XXX O H U O H U O H U OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU N80° 57' 00" E 8 1 . 3 6 N75° 21' 0 0 " E 4 9 . 9 5 S0 0 ° 0 6 ' 3 0 " E 5 8 7 . 2 8 S0 0 ° 0 5 ' 0 0 " E 5 6 1 . 6 5 X 1 S S S S SS S W E T MB 1 S 1 SHED N89° 54' 30"W 128.99 10 0 ' W E L L R A D I U S 10' U7ILI7< EASE0E17 10 ' U 7 I L I 7 < E A S E 0 E 1 7 10 ' U 7 I L I 7 < E A S E 0 E 1 7 DIR 7 D R I 9 E W A < ED*E O ) 3 A 9 E 0 E 1 7 LO7 LO7 LO7 LO7 1 DE7AIL A S&ALE 1 0' DE7AIL A ℄ RA%%I 7 & R E E . R O A D LRW )DLUPRXQW SXEGLYLVLRQ 0 ST )W 1 RDEELW &UHHN RRDG SWRU\ WRRG )UDPH HRXVH WLWK AWWDFKHG &DU *DUDJH E X X X X 0 0 S W G E PROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. May 12th, 2023. Legend: Scale 1" = 75' Gas Meter Electric Meter/Outside Power Deck Septic Fence Mailbox Overhead Utility Lot 2 Fairmount Subdivision General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. Connor Hlavinka 23-174 05/12/2023 P-567 N/A E Elec. Pedestal Water Well Tel. Pedestal MB G E S x T W Culvert 0D\ 1 0 R E GISTEREDPROFESSIO N A L L A N D S URVEYORPierre M. Stragier No. L.S. - 9812 SSSS SS Septic Cover 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 O DISTANCES P_ &1 a 4r -f-,2 TO FROM SEPTIC TANK ABSORPTION FIELD WELL Address f q 2/ f? -a` b,d ere 6k Re sef, '*A� f fra WELL r /DO i /.D — 3.f- FT .[ Phones () Tyr Permit No. X00 426 a No. of Bedrooms 1 3 LOT LINE added above original grade /D , LEGAL DESCRIPTION Lot 02 Block Subdivision /jtfo .L FOUNDATION Gravel length � q3 / FT Township, Range, Section Ti2/V 7 AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, etc.) TANKS D S4- „u t .1. ♦ _ Distance between lines 41 //00 16.FT j" FT ❑ SEPTIC ING -'_7 1 Manufacturer Capacity in gallons Material No. of Compartments TYPE OF SYSTEM , ❑ TRENCH BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade r original grade 0-&--,3 FT i /.D — 3.f- FT .[ Fill Gravel depth beneath added above original grade pipe /.s`— Z, a FT Q Cr FT Gravel length � Gravel width � FT ZO FT J Total absorption area Distance between lines 41 //00 16.FT j" FT Number of lines Soil rating Pipe material Al I 2C/L SQ FT S1C*V sbalr, Cr/g> Installer AV 70 — #/ Date Insta ed SM/ d t 90 -- Con � x-60 00. WELLS ❑ PRIVATE ❑ OTHER (Id Classification (A,B,C) Total Dept Cased to FT FT Installer Date Installed: 1- 02_ REMARKS: r*ePC !S 8-0 q'/n NB' .,4.f beel wl'4- was0IdSyfle.1. Renseved IOg4to¢1me Nr raZ• "ir Cov^" /,n p pe Inspections Performed by: tree At` /u M► corral- 0f 6ars lZP. W/" /00. 1. r 12e-//� Q Ge -/140 a 'f �Y'N L � 0� le;/'/ / r..t`�i► Ali '- Date: C L 0 Ob � a %,1i s sL.,Y- 9n V ree / x �. /0" o^1,, VQ� W ifs40--i- 8" -d, A,ir,m " #Wee AXed &,,-* elalc y . 4 r Pe -e I certify that this inspection was performed according to all Municipal and State guidelines in effect on this dale,4 /D Health Department 72-013 (3/85) Date: V;,AVf ENGINEER'S SEAL �N-SlTL SEWER PERMIT Permit Number': 900260 Upgrade ~�u-u_� C� r��c�u/�� 8ate Issued: 08/29/90 Engineer Designed Owner Name: ROBERT HAAKINSON Day Phone: Owner �)ddress: 5421 RABBIT CREEK RD. 345-0348 ANCHORAGE, AK 9951b Parcel Id: 017-112-09 Lot Legal: Subdivision: FA1RHONT Lot: 2 Block: - Section: 34 Township: 12N Range: 34 Lot Size 75075 (sq.ft. or acres) Max Bedrooms: !his Permit: 3 Total Capacity: 3 %PTJC TANK: Minimum total septic tank capacity: 1,000 gallons. Each septic tank must have at least 2 compartments. Depth to top of septic tank(s) leek requi/es insulation over tank(s). INSlFALL PEF< ENG1NEER8 APPNOVED DESIGN. MAXIMUM DEPTH NOT TO EXCEED -I.5'. NOTIFY DHHS PRIOR TO EACH lNSPECTION. [HiS PERMl| 19 lSSUED FOR !HE EX1STIN8 3 BEUROUM SlNGLK FAMILY VWB-L[NG AN� E�P[RLS UN 1. ] am iamziiar wzLh the requiremenLs for on-site sewers and wells as seL forth by the Municipa1ity o; Anchorage (NOW and the State o/ Alaska. 2. | will install the system in .zcordance with all MOA codes and regulations,, and in co/opliance with the design criteria of this permit.,, wzl} adhere to all MOA and SLate of Alaska requirements for the set hack dis|anc`,s from any existing well, wastewater disposal system or publzc sewerage system on this or any adjacent or nearby lot,, A. l understand that this permit is valid for a maximum of 3 bedrooms. ! also understand that the capacity of the total system is 3bedrooms and any enlargement will 0equire an additional permit. Signed: _.... ..... __-_______--___��_______-______ .Owner) ROBERT HAAKENSDN Issued Byx DATE: A c #" FCS ALASKA RUIR0MPTAL C0nTROL SCRUICCS, InC. o Engineerinq & Enuironmental Studies SPECIFICATIONS FOR BED WASTEWATER TREATMENT SYSTEM LEGAL DESCRIPTION: LOT 2, FAIRMOUNT SUBDIVISION. 1.0 GENERAL 1.1 The Drawings, sheets 1 through 4, shall be part of this specification. 1.2 All materials and workmanship shall meet the requirements of the Municipality of Anchorage, Department of Health & Human Services (DHHS), the conditions of the permit, and all applicable rules and regulations currently in effect. 1.3 All excavations and depths are advisory, and are to be verified or modified in the field by the Engineer or inspecting agency. 1.4 It is the responsibility of the property owner or installer to adhere to approved design for the installation, to maintain the specified separation distances and to have the appropriate inspections. 1.5 It is the responsibility of the property owner or installer to report to the engineer any observed conditions which would put the system in violation of state or Municipal regulations. 1.6 If the installation is not inspected by an AECS engineer, AECS will not be responsible for the installed system. An engineer at AECS should be consulted prior to construction, to determine the number of inspections that will be required and to explain what these inspections will involve. 2.0 SEPTIC TANK 2.1 If there is an existing septic tank it may be used if it meets the capacity requirement for the residence. The structural integrity of the tank must be verified. 2.2 The septic tank shall be a UPC -approved two-compartment tank, constructed of 12 gauge steel with bitumastic coating and set level on undisturbed soil. If the tank is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. (907)279-5553 �� 2.3 The septic tank shall be a minimum of 5 feet from the house foundation, and a minimum of 5 feet from the absorption area. 2.4 The septic tank and bed shall be a minimum of 100 feet from any private well or body of water, 150 feet from Class "C" wells, and 200 feet from Class "A" or "B" wells, unless otherwise specified. Less than the required separation distance must have prior approval or waiver by DHHS or Alaska Department of Environmental Conservation (ADEC). 2.5 Piping shall be fitted with a mechanical watertight calder coupling on the outlet and inlet of the septic tank. Piping shall be 4 inch solid PVC ASTM D-3034 or cast iron, sloped a minimum of 1/4 inch per lineal foot on the inlet side and 1/8 inch per foot on the outlet side. If the piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. 2.6 Cleanouts shall be installed as designated and capped with air -tight rain caps (Jim Caps or equivalent), and extend a minimum of 1 foot above ground level. 2.7 If a lift station is required it shall be a combination lift station septic tank per Anchorage Tapk and Welding, Inc. using an ORENCO lift station design. Specifications and design drawings are on file at the Municipality and with the engineer. 3.0 SEEPAGE BED 3.1 The gravel for the bed shall be 0.5 to 2.5 inch, screened rock with less than 3 percent passing the No. 200 sieve. All substitutes must have prior DHHS approval. 3.2 The bottom of the excavation shall be level and raked with the backhoe blade to ensure that the bottom has not been compacted during excavation. 3.3 Sand, for leveling, shall have a size distribution which meets the requirements of MOA code 15.65.077. 3.4 The distribution pipe shall be perforated 4 inch rigid PVC with a minimum crush strength of 1500 pounds and shall meet the approval of DHHS for use as drainfield pipe. If the system is a pressure distribution system, see Section 5.0. All pipes shall be laid level, and spaced according to the drawings. 3.5 Monitor standpipes shall be placed as shown in the drawings. They shall be 4 inch rigid PVC ASTM D-3034, or cast iron. The section shown with holes may be either drilled 0.5 inch holes on 6 inch centers on opposing sides of the pipe, or a section of regular perforated sewer pipe may be clamped to the solid section with a no -hub coupling or solvent joint. The perforated section of the monitor tube shall be located in gravel only. The portion of pipe above the sewer rock shall be solid. A rubber raincap (Jim Cap or equivalent) shall be placed over the top of the pipe. 3.6 The gravel shall be covered with a layer of nonwoven engineering fabric. 3.7 The side slope of the mound shall be slope 1 foot vertical to 3 feet horizontal. 3.8 The bed shall be planted with a white clover and red fescue mix, or with Kentucky bluegrass. 4.0 INSPECTIONS 4.1 This bed will require a minimum of three inspections. The first inspection will be of the open excavation, to assure that the system is installed in the proper soil strata, correct depth and meet minimum specified design parameters. 4.2 The second inspection will be after placement of gravel, monitor standpipes, and distribution pipe, to verify proper installation and position of pipes prior to backfill. 4.3 The third inspection will be after final backfill grading and seeding to ensure that adequate soil cover has been provided over the bed. 4.4 The inspection of the septic tank or lift station installation can be incorporated with any one of the above listed inspections. ZA 4.5 The lift station will require either an MOA electrical inspection or certification by a licensed electrician depending on whether the building code applies to this part of the city. 5.0 PRESSURE DISTRIBUTION SYSTEMS 5.1 The lateral and header pipes are to be Schedule 40 PVC or ABS in the sizes indicated on the drawings. 5.2 The laterals are to be level within plus or minus one inch. 5.3 All joints are to be solvent welded. 5.4 There shall be 2.5 inches of rock over the top of the headers and laterals. 5.5 The holes in the pipe are to be properly sized and spaced. 5.6 The holes shall be clean with no cuttings still attached to the pipe or left free inside the pipe. 5.7 Holes may be reverse beveled if it does not increase the outside hole size. d ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB /- Z rte+ i,, S� z c'{/ SHEET NO. OF CALCULATED BY �et� DATE ��o23/QD CHECKED BY DATE SCALE ..used... s... ..�o Ibe;..p���sed ;i��a �%..�lc�l Taw ._7`esf ..... C/I PROW 201.1® Inc, Omtm, Mm 01171. ,40AT& 14 2. 0.FA.... ...................................................i....../ ........:....... .... ..... r)N . R Q ALASKA ENVIRONMENTAL ,gap_ CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 JOB t!4�al� fl0ue I SHEET NO. G OF CALCULATED BY CHECKED BY SCALE ZP DATE DATE PROOI1Cf 7041 ® Inc.. Orolon, Mea 01471. IA C W H LL TO LL I 4 seYeE. Its Ito tog• too, aa• TH so 60 • LEROY C. NEt J 225 % CE - ,�\r►a a M a I � i 1 a a M F O. a 1 O p 4 O 4 0 O O-�.... ........ ............... ................. .......... SLOPE I o � u hIto k O a 3 o a a 1a o � ° w � lvy liytijy� Q W M f a I OR )UNO SURFACE! TRE CH ■O OM ORAWXNO ALASKA ENVIRONMENTAL CONTROL SER.. INC IOP, DATE: 06-08-90 CALC: REID DRAWN: REID 4 seYeE. Its Ito tog• too, aa• e Municipality of Anchorage y •;' t 00 .� DEPARTMENT OF HEALTH & HUMAN SERVICES 4 .e. 825 "L" Street, Anchorage, Alaska 99502-0650 ""' ' '• 00000• SOILS LOG — PERCOLATION TEST 6009 % IJeRC. REID, JR. AT PERFORMED FOR: E� O � 22 �>1Dr� SOS DATE PERFORM �• •�•`�... I / 11 �11 LEGAL DESCRIPTION: !- OT �aiY r.e��.T Township, Range, Section: / 1,,2A) /Z 3W z35/ DEPTHSLOPE (FEET) ' // 2 3- 4- 5 4 5 6 S / 312, c%' f f 2� 7 c6M; 8- 9 9 10 WAS GROUND WATER .. ENCOUNTERED?� 11 S IF YES, AT WHAT L O 12 DEPTH? P E 13 Depth to Water After Monitoring?� Date:X40 14 15 16 17 18 19 ®®®®Depth to Water .. 20 PERCOLATION RATE 124" (minutes/in,.,c�h)rPERC HOLE DIAMETER tl �/ TEST RUN BETWEEN ZL5 FT AND 1.L FT / COMMENTS .9-2 4Q a yoZ A %64 3.5� - 5 � lis r (ltd Se f (3 —o� � d �7� /Yom• N vn/ e z yz �r%6n Arer d"Ib' PERFORMED BY: it l(ei d I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: F�Z�/�� 72-008 (Rev. 4/85) A EC s UALASKA RUIROWnTRL COnTROL SCUM, InC. Q Engineerinq 6 Enuironmental Studies P. 0. Box 240668 Anchorage, AK 99524-0668 (907) 279-5553 *** FAX (907) 276--8706 ,June 8, 1990 MUNICIPALITY OF ANCHORAGE Municipality of Anchorage DEPT. OF HEALTH & Department of Health & Human Services ENVIRONMENTAL PROTECTION 825 I, Street, Fifth Floor Anchorage, AK 99501 'JUN 14 10,90 ATTN: John Smith RECEIVED RE: Lot 2, Fairmount Subdivision Dear John: Here is a design for a curtain drain for this lot. The water table is getting too close to the sewer system bottom. Also, there are water problems in the back yard (north side) of the house. The curtain drain should drop the water table to more than 4 feet below the bed. Quickly, let me know if you have any objections Haakenson wants to start construction. LCR/sr Mr. Sincerely yours, Ler C. Rei Jr. Ph , PE, DEE H Q a Its %to ion• too, oa• 13a W l h a h 2 O 0 . I = M ¢ a D a Z r O� J, I0 p D O O ° q M 0 f ° t1��..... ........� ................�........ ........... I --' 40 BLOFE I N4 7 u R T x i L vi a °0 a J �I s° 1 ¢ a M r n J 7 . i• O GROUND BURFACE TRC CH a0 OM DRAWING ALASKA ENVIRONMENTAL CONTROL SER.. INC IOF, DATE: 06-08-90 1 CALC: REID DRAWN: REID Its %to ion• too, oa• O Z H \3 Q E WATER W J \ H LU� W L 0 H O H E E U) 0- >I W GROUND LEVEL SAND � TRENCH BACKFILL MIIRAORAIN OR EQUALI SB -2 PIPE :4 '--NEW WATER LEVE CURTAIN DRAIN DETAI�- E�F 4 GROUND SAND W J H W R FLOW: -TRENCH O Q aw �H ZQ QQ J> a MIIRAFI OR EQUAL W W N ROCK Aa - 4" PERF PIPE °I 1 NEW WATER LEVEL 3 OF !F SB2 PIPE 5 PIPE --_--- S B 2 PIPE CLEAN OUT DETAIL DTRFr..T RI IATAI %---f %.-./ v - � FBIO 4" PERF PIPE OUTFALL DETAILS 4 OF 4 J _'7- - 4V 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 t' ❑ UPGRADE MAILING ADDRESS -11 ® �d^ y, ' LEGAL DESCRIPTION / 7 I I ► I � L—, LOCATION I � I1 kaMj /� fWWellll NO. OF BEDROOMS U Y DISTANCE TO: : Absorption area , o ' I ®� � Dwelling+ / PERMIT NO. u j%0(Q H N F- Z CL Q Manufacturer Material ,,I e No, of compartments Cn rn —Li, q. ca acity in gallons ©®� Inside length IF HOMEMADE: g Width r_ Liquid depth Y Jaz DISTANCE TO: Well Dwelling PERMIT NO. = Z F Manufacturer Material Liquid capacity in gallons W = DISTANCE TO: Well q i OI + Foundation + Nearest lot line / OD /Q PERMIT N9 AI�DYyRCTTEN FQ ¢ No. of lines Length of each line �+ Total length of lines/ Trench widtiv�/ Distance between lines i � H O Top of tile to finish grade � Material beneath the �•f� ([j Total effective absorption_ area inches 70'7' W Length Width Depth PERMIT NO. Qa F Wa W Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALL R )_ C,c A3— f O REMARKS 0 VIV APPROVED DATE LEGAL �042 7Wr()1jon1 ��_nazrao,, znQ� _'7- - 4V ��Jr-4 I C_ Ih.��1 -T 11 -r -ft #::# F- 1:::::l Ir -4 C� VA �__4;."F--1 1:3 EZ ^ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION | ' 825 'L' STREET, ANCHORAGE, HK 99501 264-4720 ANCHORAGE 694-2131 : EAGLE RIVER CCH r -4-- 'u n E� "a E7 AJ rE�K--- F- F= rz-- vi][—K- PERMIT NO. 831106 APPLICANT: WILLIAM C HIGOINS PHONE: ADDRESS: PO BOX 11146 ANCHORAGE, HK 99511 LEGAL DESCRIPTION — SUBDIVISION: FHIRMONT BLOCK: NH LOT: 2 LOT SIZE 71000 SQ.FT. TOWNSHIP: — RANGE: — SECTION: — MAXIMUM NUMBER OF BEDROOMS = 0 SOIL RATING = ### ### ### (SQ.FT./BR) LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR SITE. ^ ———`-——————————————————————————————————— I CERTIFY THAT: 0 I HM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE AND THE STATE OF ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES AND HAVE RECEIVED H COPY OF THE CODE SUMMARY AND DIAGRAM HTYHCHMENTS WHICH IS PART OF THIS PERMIT� � ]. I UNDFRSTHND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 0 BEDROOMS. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM PERSONNEL DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. IF H LIFT STATION IS INSTALLED/ AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED. HS—BUILTS CANNOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT. THE ELECTRICAL WORK MUST BE DONE BY H LICENSED ELECTRICIAN. SIGNED: � _..... _... ..... ..... ..... ..... .... ..... ... .... ..... .... .... _..... __.... ..... .... ..... .... ..... .... ..... ..... ..... ..... _..... _ APPLICANT: WILLIAM C HIGGINS� ^ -ISSUED BY: ` DATE: 12/1]/8] ----------------------------------------- �� MUNICIPALITY OF ANCHORAGE Department Health and Environmenta' rotection 825 Street, Anchorage, AK. :113501 N ) 0 F-C_..�_ 264-4720 Permit # ( # # # HANDWRITTEN PERMIT # # # R ON-SITE SEWER PERMIT Applicant: W II A%A C � ca, h S Mailing Address: 0. llaa I I I `-F(o zqq!! � Location: 'Cj c��� �.(L � • Phone Number: TT Legal Description: ftcocLot Size : / C)CD0- Type of Soil Absorption System Is: Aj Trench: Drainfield: fcw Bed: '� Holding Tank: Maximum Number of Bedrooms: 3 Soil Rating(sq.ft/br) 9 _� The Required Size of the Soil Absorption System Is: 22a s - DEPTH 10' 15-6 ENGTH q _ GRAVEL DEPTH DI -I The length dimension is the length(in feet) of the trench or drainfield. The depth of a 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). # # REQUIRED SEPTIC(HOLDING) TANK SIZE = f o o e GALLONS # # 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. * # * TWO(2) INSPECTIONS ARE REQUIRED # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. # # # PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is emodeled to include more that 3 bedrooms. S igned : Issued by: Applicant Date: 10 3 t- C 3 SWP/024 (1/81) Nln the event that a lift station is installed an electrical pe:rrr;it and inspection must be obtained. As-builts ca11not be approved un- til the electrical ini',pection is received in this office. The elcctrical work must be. per_, formed by a licenced electrician." . - xSOILS LOG MUNICIPALITY OF ANCHORAGE / • +.E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION fd PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: C.�-�,Y I C. ICIQ DATE PERFORMED: IO' I5_ S3 LEGAL DESCRIPTION: FA i R MO11/r '�Ub. Z P 5/1(-f I �� SLOPE SITE PLAN ( 5' T I 1 2 3 GRE 4 5 6 7 Iolaa 8 9 10 0 LD 5 ySTE>`1 11 12 13- 14- 15- 16- A% 3141516 17 ecn' •' •r �i ••'4tk 9, 18 �•• ° .•. .•y•.•% 19 . ....,.. _...... ..:... '. Leroy C. Reid, Jr.� `° Q.� No. -^-51 E r 20 �`• ,.• �C\� ar ,• a COMMENTS •.P . z / PERFORMED BY: 72-008 (6%79) k3 1��AsT g3-oa y WAS GROUND WATER S ENCOUNTERED? J O P IF YES, AT WHAT I O1 E DEPTH? (11" til A. 111lc Reading Date Gross Time Net Time Depth to Water Net Drop 41)D 44-0 10 /7 1:.3 160 I I .50 , /o ace RAp riz o 1,55 1 b l Z '0= •5 Io ob Szo 210 1 s I 2' 15 Jo Abb Pio 2' )5 , bo 2 PIN ab AD>; Azo 2-25 SQ 2:,38 I --- 'Z� RR PERCOLATION RATE 2-V (minutes/inch) Lf TEST RUN BETWEEN ._J_- FT AND / FT '7#171 nw°� 1Il 1p. • �1• PtK •41a CERTIFIED BY: DATE: 146'OW83 0 D MUNICIPALITY OF ANCHORAGE ' DEeARTNENTOFHEALTH & ENVIRONMENTAL ,,loTECT|DN ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE kDE MAILING ADDRESS LEGAL DESCRIPTION OCIATION NO. OF BEDROOMS DIS CE TO: e (�Iya Dwelling PERMIT NO. z Manufacturer Material No. of compartments Liq. ca pacity in gallons Inside 1.!��th Width Liquid depth ) IF HOMEMADE: 6 DISTANCE TO: Wall Dwelling PERMIT NO. 0 3: ant,.facturer Material Liquid capacity in gallons i We" DISTANCE TO: r16 Lu u- Z No. of lines TL.n��tht- V Total lenjLth of lines Trench widtf-j.,, Distance between lines Total effectiveabsorption area Top of tile to finish grade erial b6neath tile 5 Length Width ry IL Depth PERMIT NO. vpe of crib Crib diameter Crib depth I otal effuctive absorption area 10 DISTANCE TO: Well Building foundation Nearest lot line 'Juss Depth Drillor Distancp to lot line PERMIT NO. Septic tank DISTANCE TO: Building ioundaTtio_n�__ Sewer line Absorption area(s) OTHER PIPF MATERIALS rFs-r RATING 14 so see a see 0 see TYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 195 � THE REQUIRM SIZE OF THE SOIL ABSORPTION SYSTEM IS: KA FF F" -r VA IR L. ET r4 C3 -r vi C:'l FT Fs N? Ez L. THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINF]ELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCAVATION (IN FEET) THERE 15 NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE HND THEOF THE EXCAVATION (IN FEET) ��������� ���T�� �F1 PA cc ���K = ���CA �����54 � 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. (3 PA SN F4 Fo FE FQ IEE CA tj 7F Fy K CA 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 WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DHYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. �K lot oil 1 -1 , F::::,, 1: r:::::- CT EE 91 E3 EE FK it AL , K to I" w;;11 I CERTIFY THAI'' 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICJPHLITY OF ANCHORAGE. 2: I WILL NSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDER THND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOM& ` u9 /~ SIGNED�_ '.... ... -__-_-_-_ MPLICHNT DIBB ISSUED BY_�__���jl' ~DHTE -�7- // /'/ Y] 2 � // -7-7------- --- ' --��-�-~- ❑ SOI LS LOG MUNICIPALITY OF ANCHORAGE � `R ENVIRONMENTAL PROTECTION COLATION � DEPARTMENT OF HEALTH AND TEST Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR: " I ✓ 1 + F3 B� DATE PERFORMED: 1 LEGAL DESCRIPTION: I- I— F4 i 1 �VP / D DEPTH / SLOPE SITE PLAN (FEET) 2 v6 3 '-4 5 Z- 5 O- Ise, 6 7 Date S��_ r l� _=__ 8 Depth to Water / j1117-1- G,(_1 9- 10- 10'JS-es 7 ':S -es 12- 13 �-� L4h �� 14 r4" i 15 16 17 18 19 /0/166/i %Z U WAS GROUND WATER I/C .5 S i ENCOUNTERED? L' P - V IF YES, DEPTH?AT WHAT ! O E T- , 12 i7— i Reading Date Gross Time Net Time Depth to Water Net Drop 7 �-� L4h �� err► r4" �L" 20 PERCOLATION RATE ,//.I (minutes/inch) ,, �j �/r TEST RUN BETWEEN � nFT AND , FT / COMMENTS (�.�e �/S �r'r' �tr bldrUU�� . �Di�OyH a`f 7�✓.e•�� /� �S'fJev�G! At r bt t o w c r -J -er PERFORMED BY: (,42-Y.51, i7q CERTIFIED BY: DATE 72-008 (7/76) Municipality Of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 017-112-09 COSA# 1. GENERAL INFORMATION Expiration Date: Complete legal description FAIRMOUNT LOT 2 Location (site address) 5421 RABBIT CREEK ROAD *ANCHORAGE AK 99516 Current Property owner(s) ROISIN KENNEDY Day phone 345-6131 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 5421 RABBIT CREEK ROAD *ANCHORAGE, AK 99516 Day phone DAR WALDEN W/ KELLER WILLIAMS Day phone 865-6406 101 W. BENSON BLVD. SUITE 503 *ANCHORAGE AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 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 On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 mixed hereto and as of the validation date shown below, f verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that `he on-site tvater 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 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. Approved for bedrooms. Disapproved. Phone 337-6179 Date 4A3 ZG9 I .....s../F.. ... ....... r 1A.V6aess.�JVVCE-7. c°G Conditional approval for bedrooms, with the following stipulations COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory O'er vu �c� By: (Rev.11l0 �r fesst��i,r 0000 4`�`t V��L�r � .' • .moi ON-SITE X WATER AND WASTEWATER PROGRAM ; �, NT . Original Certificate Date: � — j/ `T Municipality of Anchorage �E......Q� . ... • Development Services Department " ` ' 2.:::::::::.:Y . u::Y::� Y:..: .. _ Building Safety Division • S A • E TV On -Site Water & Wastewater Program 4700 Bragaw Street_ P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: FAIRMOUNT LOT 2 A. WELL DATA *WELL CERTIFICATION PERFORMED BY ALPINE DRILLING ON 1/30/84 Parcel ID: 017-1'32-09 Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) *NO Date completed PRIOR -1975 Sanitary seal (Y/N) YES Wires properly protected '(Y/N) YES Total depth 63 ft. Cased to 63 ft. Casing height (above ground 12+ in. A Date of test Static water level FROM WELL LOG AT INSPECTION 1/30/84 2/11/11 13 ft, 30 ft, Well production 15 g.p.m. 4.0 g,p,m, WATER SAMPLE RESULTS: An'�,,�-� Coliform C) colonies/100 ml. Nitrate yr �� mg./L. Other bacteria colonies/100 ml. Arsenic: 1JQ ug./L. Date of sample: 2/11/11 Collected by: GEG, Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 12/26/83 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date4 pumping 9/24/10 Pumper A+ HOME SERVICES C. ABSO PTION FIELD DATA *BELOW EXISTING GRADE 12/26/83 239 BED Date installed 10/12/90 Soil rating (g.p.d./ft2o 2/bdr 242 System type BED 43 2 0.5 Length 59 ft. Width 20 ft. Gravel below pipe 0.5 ft. 1075 � Total depth *3.75 ft. Eff. absorption area 1100 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **2/11 /11 Resylts (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 480 gal. New depth DRY in. Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 450+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — **1990 BED TESTED ONLY. MT FOR 1983 BED WAS DRY. ti D. LIFT STATION *ELECTRICAL APPROVED AT THE TIME OF INSTALLATION. ,. Date installed 12/26/83 Size in gallons UNK Manhole/Access (Y/N) YES "Pump on" level at 21 in. "Pump off' level at 21 in. High water alarm level at 36 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/lift station on lot 100'+ A66orptiign field on lot 100'+ W Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building fountq;ion 5'+ Property line 5'+ Absorption field 5'+ Water main# N/A Water service line 10'+ Surface water Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water Y'ii Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS SEE ATTACHED LETTER REGARDING DIVERTR VALVE. G. ENGINEER'S CERTIFICATION OF 1 certify that I have determined through held inspections and 0 6?., 4 �� 0 review of Municipal records that the above systems are in �' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' conformance with MOA COSA guidelines in effect on this date. f A Garne s:'id, Engineer's Printed Te JEFFREY A. GARNESS �o� CE -7 �6 Date —-_�''Z� 4OeaF1 ofessior`aa LM COSA Fee Waiver Fee $ Date of PaymentDate of Payment Receipt Number 0i a"55 -Y Receipt Number (Rev. 11/05) r 4# GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS February 18, 2011 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road, P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Fairmount S/D: Lot 2, To whom it may concern: The septic system consists of a septic tank, lift station and two bed type drainfields. Flow to the drainfields is controlled by a valve box, shown on the 1990 inspection report. During our inspection, the valve box was opened and inspected. We found that the box extended approximately 7' below grade and the valves were covered in loose fitting pieces of rigid insulation. A key for the valves was not present, so we were not able to determine the functionality of the switching valves. If you have any questions, please contact us at 337-6179. Thank you for your assistance. ,,,,.-ixlcerely,f, °e �`—"Jeff ey A Game .E., M.S. Prtdett 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com I a I u LOT 1 I 7 a L SURI/EYORDEREDBY� DAR WALD, KELLER WLLLLAMSREAL ESTAT OF A,(-9%��p �p) �0 49 TH Y S` '-4111 f% N 89 54' 30" W. 128.99 10'UTILITYE4YEMEIVT i I I I I I I I I I I i I I I I I I I I I I II I I I I I I I I I I i I I I I I I I I I i I I I I II I I SINGLE FAMILY FRAME HOUSE N 89 57' 00" E. 81.36 RABBI. CREEK LOT 3 AS -BUILT SURVEY 1" =401 NO CORNERS SET THIS DATE �oY►D I HEREBY ESHAVE YMED A SURVEY OFTHEFOLLOWING DCRIB DPROPERT LOT 2, FAIRMOUNT SUB. '._ THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY SHANE A. HOLT .'®DO CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS LS -6914 0` O NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN �4toHEREON Sas slona% (UNLESS INDICATED) NOTE: FENCELINE THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _9TH DAY OF _FEBRUARY , 2011. 11489, FB 144-31 HOLT LAND SURVEYING 600 HIGHVIEW DRIVE ANCHORAGEAK 99515 345-5513 E SGS Ref.# 1110491001 Client Name Gayness Engineering Group, Ltd Pr(&ct Name/# Fairmount Lot 2 Client Sample ID Fairmount Lot 2 Matrix Drinking Water Sample Remarks: Printed Date/Time 02/17/2011 16:52 Collected Date/Time 02/11/2011 11:30 Received Date/Time 02/11/2011 12:05 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Hardness as CaCO3 35.3 5.00 mg/L SM20 2340B C 02/14/11 02/16/11 NRB Waters Department Total Nitrate/Nitrite-N ND 0.100 mg/L SM204500NO3-F B 02/11/11 AYC Microbiology Laboratory E. Coli Negative 1 IOOmL SM20 9223B A 02/11/11 DLC Total Coliform Negative 1 IOOmL SM20 9223B A 02/11/11 DLC Private Individual Analysis Alkalinity 181 10.0 mg/L SM20 2320B D 02/11/11 ACF Aluminum ND 20.0 ug/L EP200.8 C 02/14/11 02/16/11 NRB Antimony ND 1.00 ug/L EP200.8 C (<6) 02/14/11 02/16/11 NRB Arsenic ND 5.00 ug/L EP200.8 C (<10) 02/14/11 02/16/11 NRB Barium ND 3.00 ug/L EP200 8 C (<2000) 02/14/11 02/16/11 NRB Cadmium ND 0.500 ug/L EP200.8 C (<5) 02/14/11 02/16/11 NRB Calcium 11500 500 ug/1- EP200.8 C 02/14/11 02/16/11 NRB Chloride 45.4 0.500 mg/L EPA 300.0 D (<250) 02/16/11 02/17/11 KDC Chromium ND 2.00 ug/L EP200.8 C (<100) 02/14/11 02/16/11 NRB CO3 Alkalinity ND 10.0 mg/L SM20 2320B D 02/11/11 ACF Conductivity 515 1.00 umhos/cm SM20 2510B D 02/11/11 ACF Copper 89.8 1.00 ug/L EP200.8 C (<1300) 02/14/11 02/16/11 NRB Fluoride ND 0.100 mg/L EPA 300.0 D (<2) 02/16/11 02/17/11 KDC HCO3 Alkalinity 181 10.0 mg/L SM20 2320B D 02/11/11 ACF Iron 672 * 250 ug/L EP200.8 C (<300) 02/14/11 02/16/11 NRB FINL A, 707 IHT SERVC, IIIES, I 7501 E. 140th Avonw Arichmage,-A-Wka 99516 345-18,90 OUSTOMER 5421, RMAI it 1*6' 0-4 S"A Lot - INVOICE# 5.441444 DfirlE OEWFOPTION. AMOuttr 0.9 -10 ,14 ' hmz-p LSWg.- 11; & lift' 95 c Ta-,Wdiade tau Iffte W L,Iip 632-40.,66 Qvi.o go g gloss. 2 gn. kipe": Tauk 11ouged 12T fiato be(I aflawn -AM 9' , Zf REf ReS k 7 Gallons—Septic —Leach -Ar -ea- —HoldingTOnk -,SOindpipos: .1r1M*_'4p 0 PROULem ARiEA — GALL FQR MOFIE INFORNATION. 0AIWIN TA.,$rM.Offa� AO I...-MMMS . .0 Qwd,.,gh no vpp ED s16jgq-bWildOppn1�Ot-fem- %E] ---F' o Ate. liD ar . Ao n _P Jim cap Missingp.r -Owt-Ognd :pAp f-'qj3,0v_j�.gfqun# 00s plictc ne needs -replacing Parcel I.D. # 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 017-112=09 HAA # 1. GENERAL INFORMATION Complete legal description Lot 2; Fairmount Subdivision Location (site,address or directions) 5421 Rabbit Creek Road Property owner John & Kbmberly Stricklan Day phone 345-5771 Mailing address 5421 Rabbit Creek Road Anchorage, AK 99516 Lending agency uay pnone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: Three _(3) 3. TYPE OF WATER SUPPLY: Individual well XXX 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 X)OC Holding tank Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's signature Date 4/21/99 6. DHHS SIGNATURE Approved for Disapproved. By: bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date 4 -.30-72 CAUTION 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 W i Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES R E C E I VC E Environmental Services Division 1999 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 34A�4442 Municipality of Anchorage Health Authority Approval Checklist Dept. Health & Human Services Legal Description: Lot 2, Fairmount Subdivision Parcel I.D.: 017-112-09 A. WELL DATA Well type Private Log present (Y/N) . Total depth 63' Sanitary seal (Y/N) Date of test Static water level If A, B, or C, attach ADEC letter. ADEC water system number Date completed Prior to 1975 Cased to 63' Y FROM WELL LOG Well production WATER SAMPLE RESULTS: Coliform 0 Date of sample: 4/19/99 B. SEPTIC/HOLDING TANK DATA Date installed 1975 Tank size Foundation cleanout (Y/N) Date of Pumping 10/7/98 C. ABSORPTION FIELD DATA V Casing height (above ground) Wires properly protected (Y/N) _ AT INSPECTION 3/27/99 9 - p.m -Nitrate • 5 m5/L Collected by: +4' VA 23.3' Below Top of Casing 3.6 Other bacteria 1 IMA 1,000 Number of Compartments 2 Cleanouts (Y/N) Y Depression (Y/N) N High water alarm (Y/N) Y Ve-%4-vi R(Y1+'GY Pumper Date installed 1.975/1990 Soil rating (g.p.d./ft2 or ft2/bdrm) 242 SF System type Shallow Bed Length 43' and 44hidth 25' ,Both Gravel thickness below pipe • 51 Total depth 4' -5.5' Effective absorption area 1100 SF Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test 3/27-3/29/99 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test (in.); 0 Immediately after 511gal. water added (in.): 0 Fluid depth 0 (ins) Minutes later: 10 Absorption rate = GT 450 g p d Peroxide treatment (past 12 months) (Y/N) N If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed 1990 Size in gallons 500 Manhole/Access (Y/N) Y "Pump on" level at* 43" "Pump off" level at* 43" High water alarm level at* 45" *Datum Bottom of Tank Cycles tested 5 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot GT 100On adjacent lots GT 100' Absorption field on lot GT 100' On adjacent lots GT 100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line GT 25' Lift station GT 100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation GT 5' Property line GT 5' Absorption field GT 5' Water main/service line GT 10' Surface water/drainage GT 100' Wells on adjacent lots GT 100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line GT 10' Building foundation GT 10' Water main/service line GT 10' Surface water GT 100' Driveway, parking/vehicle storage area GT 10' Curtain drain GT 40' Wells on adjacent lots GT 100' F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal reco � gems are in conformance with MOA HAA guidelines in effect on this date. ow ' " ° ° " ° fg,g Signature �' J Engineer's Name Michael E. Anderson, P.E. 00 �"a • R . f e° i s ,f Date 4/20/99 ^, ot► �1. E JB i { i W.� %k,k "+rl� Y's' HAA Fee $ �Cnn .n) Waiver Fee $ Date of Payment C2 l Date of Payment Receipt Number CtA Receipt Number 72-026 (Rev. 3/96)* April 19, 1999 Prudential Vista Real Estate 4241 B Street Anchorage, AK 99503 Attention: Cheryl Ponder Subject: Lot 2, Fairmount Subdivision Septic System Inspection and Testing Dear Cheryl: RECEIVED APR 22 1999 Municipality of Anchorage Dept. Health & Human Services We recently completed the testing and inspection of the septic system on Lot 2, Fairmount Subdivision to determine whether it was operating in conformance with requirements established by the Municipality of Anchorage. The septic system as currently configured consists of a a 1,000 gallon septic tank, a 500 gallon lift station, a valve box and two absorption beds. The first bed (25' x 43') was constructed in the 1970s. The second bed was constructed in 1990 when the first bed apparently failed. At that time a diverter valve was installed allowing the use of the first bed at a later date if needed. Unfortunately, that time has come and the first bed has been put back in to service. We originally inspected the system in early March and found the newer absorption bed flooded. The older bed, however, was dry. We therefore soaked the old bed with more than 2,000 gallons of water. The following day we performed an adequacy test on the bed by introducing more than 500 gallons of water directly into the bed. The water level in the monitor tube was undetectable during the entire test indicating the bed is capable of absorbing a minimum of 450 gallons of water per day and therefore incompliance with Municipal requirements. The new homeowner should be informed of the two bed system. The system will operate at maximum performance if the newer bed is allowed to dry out which may take up to two years. At that time the valve should be again turned and the newer bed put back in to service. The beds should then be alternated every two years for the most effective results. Sincerely, -WWt-Q'L E: dt-'-� Michael E. Anderson, P.E. APR -21-99 16:32 LTE. FROM -CTE ENVIRONMENTAL 5615301 CT&E Environmental Services Inc. Laboratory Division ►�va� T-188 P.02/02 F-990 200 W Potter Drive Drinking Water Analysis Report for Total Coliform Bacteria Te horage. AK (9071 562 2343 1s�1605 READ GYSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE Fax: 1907)561-5301 MUST BE COMPLETED BY WA FER SUPPLIER TO DF COMPLETED BY LABORATORY ❑ PuBLIC WATER SYSTEM I.D. q ❑ PRIVATE WATER SYSTEM q Srnd Resalra ❑ Send Invoice omw rwnM .ta a..�mi n.mr wop+nr +m• wnc »m r r int � cw v coo q S a4 Reratrx O Sen4 lero-:e IJ '77 Aa -)N" SAMPLE DATE. F a r -- f� l Month Day Year SAMPLE TYPE. 9 Routine ❑ Repeat Sample (for routine s+mple with lan rt:f. no. 1 0 special Purpose SAMPLE LOCATION 1(0 Y' I =;L11.AZ)Uh) r Comments. ❑ Treated Water ❑ Untreated Water Time Collected Collected By 7iioo'4#7 /1lCq_ PICW Nan Analysis showy this W,ster SAMPLE to be. Satisfactory ❑ Unsatisfactory C3 Sample o-er 30 hours old, results may be unrcbable ❑ Sample too long in transit: sample should not be over 48 hours old at examination to Indicate reliable results Please send new sample via specfal qclivery mail. Date Received Time Received Analysis Began 3D Analytical Method: �3C Membrane Filter ❑ MMO-MUG • Number of c0ontes1100 ml SS 1 623 result• Analyst ! °$ tQM V 40col; El Jun Faxed Data: runt Client notified of unsatisfactory results: Cl P"oned Spoke wit" Date. Time. BACTERIOLOGICAL WATER ANALYSIS RECORD NiMO-MUG Result: Total Coliform E. Cali Niembrane Filter Direct Coult _ _I Cel t, Colonies/100 ml Verification: LTSsGti COLIFIRM Fecal Coliform Confirmation Final Mqnprane Filter Result Coliforr.%•Ito mi to `�' Time _15 .— hrs 13 Faked Member of the SGS Group iSouote Gdnerals do Surveillance) ENvIRONMENTAI- FACILITIES LIN A1n5�2.^60 3,: - — OROA. ILLINOIS. MARYLAND, MICHIGAN. MISS,]URI. NEW JERSIEY. OHIO. WEST VIRGINI w m 7 m 4 CO 07 U C r C\l ek,KV Vo L1.1 CL ro �r � L a Member of the SGS Group iSouote Gdnerals do Surveillance) ENvIRONMENTAI- FACILITIES LIN A1n5�2.^60 3,: - — OROA. ILLINOIS. MARYLAND, MICHIGAN. MISS,]URI. NEW JERSIEY. OHIO. WEST VIRGINI APR -21-99 16:32 FROM -CTE ENVIRONMENTAL ME Environmental Services Inc. CT&E Ret'.# Client Name Project Name/# Client Sample ID Matrix Ordered By FWSID 991623001 Anderson Engineering Lot 2 Fairmount Lot 2 Fairmount Drinking Water 4-1141111 T-188 P-01/02 F-990 Client POA Printed Date/Time 04/21/99 16:29 Collected Date/Tithe 04/19/99 14:00 Received Date/Time 04/19/99 14:55 Technical Director: Stephen C. Ede 0 Released By AllawaDle Prep Analysis Parameter Resulcs PGS '^ units Method Limits � Date Date � /nit Nicrate-N 0.500 u 0.500 mp/t. EPA 300.0 10 max 04/19/99 04/19/99 SCL Received Time Apr -21. 3:33PM SENT BY: 4- 1-99 ; 8:06AM ; DAMES & MOORE - ANC- 5226779;# 2/ 2 8070M No 93422 ROO�-��'e P. O. Boz 112888 � ANCHORAGE, AK 99E SEWER -DRAIN (907) 345-2513 Phon S E R V I C E 345.8284 Fax ,Np SWAM Oo o`MM THE p�A/Ne noouncs ° Jots Address 7 ' • ! r DATE 17- �V' 18ALFSM - TER 1$ YS I U [nM ROTO -ROOTER SERVICE CALL HRS. ® '` STEAM THAWING TRIP CHARGE OVERTIME CHARGE HRS. HRS. HRS. ® ,_ ADDITIONAL LABOR CHARGE HRS. PLUMBING PUMPING SERVICE) HRS. MRS. HYDRO -JET SERVICE HRS. a TV CAMERA INSPECTION HRS. MATERIALS s00, PLEASE PAY FROM THIS INVOICE TOTAL ' PROBABLE LINE CLEANED ❑ JOB NOT GUARANI EED FOR FOLLOWING REASON, WORK ACCEPTED BY El See additional job intormadon form attached. to naader 00 NFR', Ctl%Y 4,,0'l lnnng tervlct yvu rra e 1 •nr�rane a f;•% NC1ig, ur.., frrrcrD ouyh, rd I o:.•u+r. Bei. rhe G ih;ti RECE�v ED APR 2 2 1999 t Munc'pd►rtY H`umanserces Dept Health & Received Time Apr, I. 8:09AM D�7 - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services low On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 :qd:q-d7dd CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 1. GENERAL INFORMATION Complete legal description Lot 2; Fai mount Subdivision Location (site address or directions) 5421 Rabbit Cneek Road Anchokiz e., AK - Property owner Robent 9 Linda Hazken.6on Day phone 345-9587 Mailing address P.0. 112615 Anchona e AK 99511 Lending agency' ,. .... Day phone Mailing address Agent r Pete. FeA,%i5/ DYNAMIC PROPERTIES ; Day phone.., , 261 7600 Address! -- ;:'3111 "C" Sre.et Suite;100 Anchohaq e, AK 99503"`°h . r,..M.. VF €K Fi.ie.� _. ,. ♦ --=. v+ x r 1 'w :. +.,.> 1 '£ Aa # Clnle3$ 6h se requested, HAA will be held for NUMBER OF BEDROOMS:' .ye jl* iG 9 i .y .: 1 _.... 3, TYPE OF WATER SUPPLY: _.. : Individual well XXX ' Community well •t Public water NOTE If community stem r� e ' tY wells system, prov�de.written confirmation froln;State'AGEttest�� ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: ` t- _ Individual on-site XXX A f t•.t 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-M (Rev. 1/91) From MOA #21 !•; 5. i STATEMENTLiOF: INSPECTION:': BY:.ENGINEER ::- _... As certified;b my ysea ffixed hereto and<asoithe validation date shown below; l;yerify that my ' investigation of this Health Authority Approval application shows that the on-site watersupply ::ala.Y Y.r._ Un: and/orvv tewaterdisposal system is safe, functional and adequate for the number of. bedrooms and type of structure indicated he l further verity that based on the information obtained from the Municipalityof`Anchorage files and from my investigation and inspection' the on=site water supply and/or wastewaterdisposai system is in compliance with all Municipal and State codes, ordinances,'and regulations in:effectonthe date of this inspection. � A t S&S.ENGINEERING r:- _.- .`. �:'69��' Name of Firm&swamswwwOOP Phone .r O. 2U4 .., t ,.,,:.. ...•. .1L Eels Riwr,• �f1�5�'. - ...; �..' - .'. .: i:i 6 a..~s�iy CCS a a.G. rL 'M Engineer's signature r Date U 74, j1- svRM I Y n r+iy. iI P'4i• 1.«i Ui`t "'^ yt f`iiy 1 `vY"°"'MY"" - ,•� 7 .. - a � r. r ; i 15� i rrPY � � .,✓t°/� YAPtPS �1 . it +"i faw-k-ra''a x �v.�� Qe�. r :�J r Ic+r1..1uj�+bar'�asitritIrmd` .r��'d.�m��Ul�r " f '-FfiYt elf�i•e+.Tt Musir Y s Wy,tst,�rew1(l W,'1+inr4a�: '' rx iw�`s sY1 tlIrr .2�`r�1�rRuzjnt6�r 041 i '� 3r a" b p�f� iTifr;�rt f, .� 4A:?+rA. c a. auv c:fiw �y 4r1.i- v!t�P.il-l}41 �.✓:' a�1..9]#hid9F4'YrEV+�uS!< F+#:r: 'r IkWLNr�'.�.WWJ.•Q,1�74laiiJ'ii�e�M.'.r.+W�'3RsPl-AI•.Mutle"-M+ . &v �'N4:LMa.1s.w 4iEY. � $'xx .1: . • i�9TxrN••3,�'L��'^ LyL+(Mu�I�•ea�t•-,, 1y'nnYT:.... x Na /rw� tj`�. G. `a'a� p�M#a.a�q�"•a"{/�'/i� �i4 .J�il�V'dMi?rNt..vA'Xl 1,(n9RFyA4!s2y1r,{�M/[I;IR�aIr".Iau�1p1i4}8��rht6'4i!1 / � ,+w v taa : a y��1' w nw�.rvn .ww• rvmry J Y / A . •, d 'v {,X a•� �'`v"�'°'S`�LA �; s - biry '-"`3r1'a d d � � t��rf r - �n ae qj�, 4 k. 'aa �. 'z. -c �.sa �.. z "dyrr'x r %C.JS�L, k� x ��� A . f ip..-1 : J ` '� 4kl • - r.. 1'l./RMI CMM1]HIM1A. tl f:I!'tr M1 aR44':�M94-!i{ 9f- YI • 5I .•ri .�r :(! .•• - � M :u r W'+YAkiNy�Ab •r.•••r r! 'P[dF#'fia4AF. _ ' k`ii�ilk�%:` w'UTa .Cy< xkr +, ROPERTr 'PCSoilwai'i n .v $. .w 7 d{�y �'SS l .. .rl+ •2 iso "Q0.1:.w r � "" i i : � ftt �� 5Y � �`. . r' if' rfr> �• is u.. �, sro- aR-. �. CE�� � f `�" °� HHSL SIGNATOR' �'r' ,.LrhYt r>}" '7ti x l.: . N! ki� r r#�''�.Ytk-S>l4. Wt -e . � Fj1 ♦ "� !!1 irw - �� m pp�o fo11-1 t>Bdr00ms �. fir.'r _ta3✓g{�11__'' M t _ D ro �'�:Conditiona o :room wi the. .olfovr ri st pu a ons t'tJ 2 y�� 3. > �. 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'. a1, � Y kk a a� •s j+ �;✓ 'j,. ,yfy i p d.0 r4gY d�pray !+� n w N In 3'r�yu �.p �yn I;'. �Lil.�y: a'-l��il�`._s-S 'vcl \'�`�'�^. xM��,.t.ra �.Lc `�}pFa'•tlVYW:Y .{n''�4R�'+'iJF' -ve i�'�I�R.ai;� �J"R''"I4 .. rM 7+� . i;1 . `fl'f ry}a9A'f•IE''Ri4��'-T•N'44r1. ., n ] MY" na+S1. .1@41! 79y5'+. `pl riN�ar9na:G rF #"^�v Y4,:;7 B[�tY".�-4{it'iYNR'1 : r. �S♦" fyi w '}'- 1 ai 4EN F+ J..-. ,r, -:r. 1�'. ,r Y CAUTION :Y t QW N The Municipality of AnchorageDepartment of Health and Human Services (DHHS) issues.;Health Authority 'S* ,i -rr.t n r Y•.e e' };n Approval Certificates based opon tie representation`s given- in pgregrephF5 above by aniindependent A, '�' �� �„ professional engineer registe�redin the S •tate of Alaska The DHHS does this as a courtesyto purchasers of homes,n� MI �Y i'�s�lr'-c';1��+'din`tt���andtheirlendinginstitut(onstnordertosatisfycertaintederalandstaterequirements EmployeesotDHHSdoanot ' b:«e..P'..k..'ieT.. .;,v;- :�srt•.s•^.•.`-_. .�.•.•xr_::-^_�a�_cs��•_�_..�^�^.....�itl:.e�e-iulaettaaa�.'.:Thn 'M.rnin{n>71ity.-of r0nCf1[1fAd9 I3 RIF. respon-sibCe for errorsomissions ln�trof§ssronaFengmeers wont -1d• �dF-ryry,,.r+.A:.w,K A -1..51^a ���§ a:.Ft y�#. ids:�.k+-..5 >-• 7Z-0261FN. 1/Gl) Beck MOA Mt1 v` Municipality of Anchorage rn Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST { Legal Description: L-OT�, Flgl w"T ,SSD Parcel I.D. (9 / i i � I � – 09 —_ A. Well Data co rn cn 0 0 52 Well typeA-7 If A, B, or C, attach ADEC letter. ADEC water system number /J/A z Log present (Y/Lq) Ivo Date completedDriller �NX Total depth 03 � Cased to Casing height %oZ Sanitary seal &V N) rzs Wires properly protected (Y/N) S Date of test Static water level Well flow Pump levell FRO I WELL LOG I o 8�1 13 S 6 SEPARATION DISTANCES FROM WELL TO: AT INSPECTION 31asj�ti g.p.m. 43 g.p.m. ^�r Septic/*eHiog tank on lot fGa f ; On adjacent lots Absorption field on lot On adjacent lots _ Public sewer main �S J- Public sewer manhole/cleanout Sewer service line aQ S ,-�- Petroleum tank 1 SNE. K►,�OwN WATER SAMPLE RESULTS: Coliform Nitrate e /0 m J/L Other bacteria a Date of sample: .3 �d �� S Collected by: C S Iy�t Nr �2 t KG B. SEPTIC/HeLBFNG TANK DATA Date installed 68'3 Tank size r666 6>4L Compartments 2 Cleanouts (?/N) /t 5' Foundation cleanout (63/N) YE -C Depression (Y/N) -A) C) High water alarm (Y/I)' pa P/� Alarm tested (Y/N) \ A Date of pumping 4 �9 S Pumper R --_,7b J w -t Q(L - SEPARATION DISTANCES FROM SEPTIC/Hft-DWG TANK TO: Well(s) on lot l 60'4- On adjacent lots 100 k Foundation 10'4 - To property line (b%a- Absorption field 10 Water main/service line l.d Surface water/drainage 4- 72-026 72-026 (3193)• Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed 1a 1 a c 183 Manufacturer Size in gallons (sht c.oN. Manhole/Access ON) YVS _ Top or- Vent f _ Vent (61N) yw1� Ff "Pump on" level at 8 Iec.o ,ti, "Pump off" Level at 8,5 13c-cuw /.-P eF 114, N, ,, � � High water alarm level E3� Cycles tested -7 Meets MOA electrical codes (Y/N) yf� SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot 166'f On adjacent lots 100,4 Surface water 160 ilt D. ABSORPTION FIELD DATA Date installed tob-2J96 Soil rating (GPD/F?) �`"�2 SF/&Z System type EE9 Length 19 r Width ay Gravel thickness ors" Total depth a .S . Total absorption area 1160 SF Cleanout present Or/N) YFS Depression over field (Y/to _ 8 Date of adequacy test 3'2 S � I `f Results (pass/fail) �%tSS for 3 Bedrooms Water level in absorption field before test II 10 After test 0 Peroxide treatment (past 12 months) (Y/� NO *T Ow ri If yes, give date &f4 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / 06 ,4 On adjacent lots Property line /d To building foundation 16 Ir To existing or abandoned system on lot oda On adjacent lots �� k Cutbank WZ/h Water main/service line �0 Surface water I U� Driveway, parking/vehicle storage area s / Curtain drain E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effeq.�T-o 19 is inspection. P` •,v�e...v.... �` `1 �A.•N r.a . eN 1a aNU aN Nv., a.�' Signature _ , .aa......apl Engineer's Name 0 /3 l / C . Co �''� ``�°CE 880 WAN fE`� Date L/ Z pr.......•�! HAA Fee $�� �� Waiver Fee $ Date of Payment e/__�Z_ 7 Date of Payment Receipt Number ?Xp c cn o Receipt Number, 72-026 (3/93)' Back 04/03/95 12:54 COMMERCIAL TESTING - 9076941211 Ak CT&E Environmental Services Inc- CT&E Ref.4 95.1196-3 Matrlx WATER Client Sample ID L2 FAIRMOUNT S/D Client Name 8 h S ENGtNEERINO ordered By R.J.S. Project Name Project# PWSID UA Sample Remarks: SAMPLE COLLECTED BY: J.W. NO. 123 907 WORK Order 13544 Printed Pate 04/03/95 (V 13:51 hre. Collected Date 03/30/95 ® 13:45 lire. Received Date 03/30/95 co 15:45 lire. Technical Director STEP11$N c. EDE Released By �G 4� QC Allowable Ext, Anal Parameter Results Qual -------------------------- vnitD Method Limits Date Data Init Nitrate-N 0.10 U — ---------------------------- ing/L EPA 353.2 10. ------------------- 03/31/95 CMR o.ccccc::�czzzzzz=zsssssszzzzzzzzerw------n-�.ezzzzz_zz_zssczzzzsasss-ww w wry---zr.szsszezzzzzzzzzzzzz z------------..__ See Special Instructions Above UA Unavailable ?w �" See Sample Remarks Above NA - Not Analyzed f, U- Undetected, Reported value is the practical quantification lltnit. LT - Lees Than P. .D - Secondary dilution. GT - Greater Than r : Location (site address or directions) 5421 Rabb.c t Ckeek 'RoadJ. Anchonaae AK Property owner Linda''. Haaken6o'n Day phone 345-0348(h) ; 345-8110(h) Mailing address 5421 Rabbit Cneek Rd. Anchotaae. AK 99516 , Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. y 2. NUMBER OF BEDROOMS:3 ,3.: TYPE OF WATER SUPPLY: Individual well XXX 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 XXX stiff 3 f:, Holding tank Community on-site " Public sewer 1 NOTE: If community wastewater system,. provide written confirmation' from State ADEC i4 attesting to the legality and status of system., #, s 72-025 (Rev, 1191) Front MOA #21 Name of Firm Address — Engineer's signature S & S ENGINEERING Eagle River, Alaska Phone 'Date c -f W r� >. w .5r of yye M \O\ •\PPw ............ Robort A. Shafw ; C. No. 145741 ,• .; with the following tr rt ltC b22R\Y', � t I e4 I1 ;; 5. STATEMENT OF INSPECTION BY ENGINEER 4? 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 By' and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms 15; and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address — Engineer's signature S & S ENGINEERING Eagle River, Alaska Phone 'Date c -f W r� >. w .5r of yye M \O\ •\PPw ............ Robort A. Shafw ; C. No. 145741 ,• .; with the following tr rt ltC b22R\Y', � �v S; rl. 4? By' Date J. 0=6 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. ®Municipality of Anchorage • Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoT• Z FAI✓CMOUOT- S/t> Parcel I.D. A. Well Data Well type PYLIVA-16- If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/Q NO Date completed i ? 7 _ Driller UK, Total depth 1111.3 Cased to d t Casing height S 1 Sanitary seal (Y. q) YkS Wires roperly protected ON) WELL CEYLT/FIQ� !3Y A[p/N prLlL(./NCS i• 61J7 i PReISES �tid WILLi�In C. /-/I AJ / Twv FROM WELL LOGS AT INSPECTION 4-E77E4S OMTED/ 84 o� IN {MUg.F/LLS.I Z Date of test �30 / 3%ZSR 1�T7 D Static water level 13 / n t' �I T1 v, M o Well flow S 9.13-m.43 g•p• C Pump levels .fro N45 / tT o C v y� SEPARATION DISTANCES FROM WELL TO: m Septicthekft tank on lot 1 CAD 14- ; On adjacent lots _f 00 (-t Absorption field on lot / C)n i� ; On adjacent lots &(,) I -f- Public Public sewer main I_J(_ Public sewer manhole/cleanout /DU (-t Sewer service line ZS Petroleum tank "NE KAJ 06JIJ WATER SAMPLE RESULTS: Coliform C) 1/0U Nitrate () ,10 ' ZA Other bacteria O//Ot7rwe� Date of sample: 3 % 2 �1 �1¢ Collected by: SSS o_)61>•�7 x)G B. SEPTIC/TANK DATA Date installed /Z/Z6 Y_? Tank size 000 &K1L Compartments Z, CleanoutsON) Foundation cleanout6N) Yes Depression (Yg k)o High water alarm (YAV ,JJ,> Alarm tested (Y/ l@ N� Date of pumping 3 I Z // 94-- Pumper A—t- H6m 4r S6t2v/cES SEPARATION DISTANCES FROM SEPTIC/149EBIN6ANK TO: r � Well(s) on lot /00 /7(— On adjacent lots CSO Foundation SO f To property line /U / Absorption field 0 �f Water main/service line O /� Surface water/drainage too (-r- 72-026 (3W)' Front -r- 72-026(3W)•Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed I2 / Z (, / p 3 Manufacturer U Size in gallons 614(.0" S Manhole/Access &N) �(CS Vent�l) ��S "Pump on" level at O '&L,,w 7b#vorMANltr�mp off" Level at High water alarm level �Z Cycles tested 3 Meets MOA electrical codes UY N) rFS SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot /00 �t__. On adjacent lots /O(::) (-/-- Surface water ZU C:) (4- D. ABSORPTION FIELD DATA Date installed / U / Z ( qQ Soil rating (GPD/Ft2) Z 42- 1�ZrZ System type 6626 ) Length '5� Width 2 U r Gravel thickness 0,51 Total depth ?, - Z, 5 Total absorption area /(�� Cleanout present 6N) �S _Depression over field (YAO &A_� Date of adequacy test 12- % 5 4 Resufts as fail) /'�4LS for �C 3 Bedrooms Water level in absorption field before test U Aftertest C7 Peroxide treatment (past 12 months) (Y/N) Allo Ndc,,j4 j If yes, give date /VZ& SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot On adjacent lots 0 �� Property line / h To building foundation 1014 - To existing or abandoned system on lot ZO fir` On adjacent lots 2-0 (-1- Cutbank /U6/-)6 Water main/service line Surface water Driveway, parking/vehicle storage area S fi Curtain drain E. ENGINEER'S CERTIFICATION l certify that / have checked, verified, or conformed to all Signature Engineer's Name Date S & S ENGINEERIP 17034 Eagle River Lo�cad f/b. 204 v HAA Fee $ 100 Date of Payment �L- Receipt Number S ' 72.026 (3W)' Back HAA guidelines in effect on the date of this inspection. r, Waiver Fee $ Date of Payment Receipt Number 04/04/54 08:23 CT&E ENVIP.ONMENTAL LAB SEPVICES NO. 212 P02 Commercial Testing & Engineering Co. Environmental Laboratory Services,��rii�•��risw�wsriirr.rwiisi►�+�►iriw� anec ,�e LABORATORY ANALYSIS nEPORT CT&ERef.N 94.1323-1 Client Somple ID 1,2 F'AIRMOLTN'1' S/1) Matrix WATER ClientNmie S & S LNONF.ERINC, Ordered By R, SHAPUR Project Nance Projci0 PWSID UA Sr�npleRemarhs: ItbUTINE SAMPLldCULLEC•TLll 19Y: S.S. WORK Order 6982 I'rin+cdDute 03/31194 'Ck)10:32 lis. Collectedlhrte 03/28/94 Vii; l 8:00 lis, Received Date 03/29/94 (r!; 07:401 li,3, Technical Director rr 811PHLN C,1A)F: Released B) ~BMJ QC Allowable I'.Nt. Anal Parameter Results Qwal Units Method Limits Date Date Tnit ---------- ...------------- ---- ------ -----------mg1L I -...-- ----'A--353.-- 2•_i30J-3,00-,0--------0 0.-- ----------i1.:--/30 4 ------ Nitrate -N 0.10 I1 L;1I.LFl See Special InArwtions Above '• Soo AamplcRcmarksAbovc U= undetected, Reported valve is ti epractical quantification limit. 1)- Secondary dilution. i1A=Unavailable --, NA = Not Analyzed 11'-1_ess Than C;1'= 0 -cater Tl(an 5633 B Street, Anchorage, AK 99518-1600 — Tel: (907) 562-2343 Fax: (907) 601-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application DateZ/d & (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name Applicants Addr (c.) Applicant is (check one) Lending Institution Owner/builder; Buyer r_T ; Other r::J (explain); (d) Lending Institution Telephone Address (e) Ictal Estate Co. & Agent Address Telephone 2. Type of Pesilence Single -Family Wf Number of Bedrooms 3. Water Supply Multi -Family ;_3 Other (describe) Individual Db ll Community Public Note: If comffunity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA YON) 4. Sewage Disposal Onsite Z Public Cbvmurity Holding Tank Is the wastewater disposal system adequate for the number of bedrooms (DN) _ (Page 1 of 21 2-15-84 5. Engineering Firm Providing Inspections, Tests, Data and Information I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed Name of Firm fsEGS Telephone Address Vii Signed by Date (ENGINEER SEAL) 6.DHEP Approval Approved for bedrooms By Date Approved Disapproved Conditional Te of�onditional Approval The Municipality of Anchorage Department of Health and Environmental Protection dies not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished by an engineer registered in. the State of Alaska, the water supply and wastewater disposal system is safe and funs. ticnal for the number of bedrooms and type of structure indicated. 1�6 (DHEP SEAL) 7. Mail the HAA to the following address: KB2% d5,/s (Page 2 of 21 2-15-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 /�ovz arKs�"`'�'`� RECEIVED A. WELL DATA MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 21i Pod Well Classification i()r� If A, B. cr C. D.E.C. Approved(Y/N) NSA Well Log Present D Date Completed Yield'>oenm Total Depth (p 3 _ Cased to Depth of Grouting Static Water Level 0" 13' Pump Set At —'* st Casing Height Above Ground 51 Sanitary Seal on -Casing N) Electrical'Wiring in Conduit _ ) Depression Around Wellhead (YAD Separation Distances from Well: To Septic/Holding Tank on Lot On Adjoining Lots le(n To Nearest Edge of Absorption Field on Lot 12PI on Adjoining Lots To Nearest Public Sewer Line NL To Nearest Public Sewer Cleanout/Manhole 011 _ To Nearest Sewer Service Line on Lot IVI,.q Water Sample Collected By �ti��ev _; Date , A, Water Sample Test Results AaA 1 �� c+rLI Comments ik ppp_ , caul( Ina - "&yL4EA4ZQI=q Ea eA-4F-. At3+ d we If (nS —r B. SEPTIC/HOLDING TANK DATA Date Installed U $_3 Size No. of Ccnpartments 7 Standpipes (Y/N) Qe Air -tight Caps ) _ej Foundation Cleanout Y ) yc Depression over Tank (Y ) /� Date Last Pumped Pumping/Maintenance Contract on File (Y ) ti' ; for Holding Tank High -Water Alarm (YM) Temporary Holding Tank Permit (Y )' Separation Distances from Septic/Holding Tank: To Water -Supply Well /0() / To Building Foundation • /!o To Property Line 4Z To Disposal Field '24? To Water Main/Service Line ' To Stream, Pond, Lake, or Major Drainage Course N/A Comments [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA o AL- -,/ � Q r ` � epi._ Soils Rating in Absorption Strata 2 Type of System Design Date Installed Length of Field Width of Field ,S Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present (Y/N) Xc) Depression over Field (Y Date of Last Adequacy Test Results of last Adequacy lost A'/43) Separation Distance from Absorption. Field: To Water -Supply Well /,X11 To Property Line /P To Building Foundation X39 To Existing or. Abandoned System cn Lot A) JA On Adjoining Lots To Water Main/Service Line To Cutbank(if present) 't To Stream/Pond/Lake/cr Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed �� G��3 Dimensionsc� AeT Size in Gallons oZ�a.: Manhole/Access "Pump On" Level at w 7f3 "Pump Off" Level at r4 X7,0 OF High Water Alarm Level at t'7 i)' Vent t N) Tested for ^ 3 Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes Comments ** Check Permitted Bedrocm Rating Against HAA Request I certify that I have checked, verified, or, conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed_ Date 52tJ v Company MOA No. -0.2 KB1/d5/s (Page 2 of 21 4!r ^ F .RS " L C. Reid, Jr. j 4 No. 2261-E 2-15-84 M WELL CERTIF'ICAT10N A.rump, test was conducted for Northridge Construction, at Lot 2, Block O, Fairmont Subdivision in Anchorage, Alaska. The results are as ioliows: Casing diameter: 61, Well Depth: 63' Static ,Level: 1.3' 1. Well was Lumped at 1.5 gallons per minute for 15 minutes. 2. Reduced rate to 6 gallons per minute for 30 minutes at a pumping level of 551. 3. Reduced rate to 5 gallons per minute for 2.5 hours at a pumping level of 561. ALIINE DRILLING & ENTERPRISES 1.0. Box 1.1.U496 Anchorage, AK 9951.1 �..�CAd t .mak G 30 ��. INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 3500 EAST TUDOR ROAD INcPF[.TInNS 14071 563-3464 ADMINISTRATION (907) 786-8211 NAME � � STREET ADDRESS LOT /'!"7_ BLOCK / � •' �`rT $UBDIV. / �"� /PERMIT NO. J -3� / PHONES ��%y�✓ " / DATE������� FOOTING FOUNDATION BOND BEAM FRAMING FINAL OTHER ❑ ❑ ❑ ❑ E]O ❑ El ❑ ELEC. TEMP. ❑ PLBG. UNDGR. _ ❑ ELEC. SERVICE— ❑ PLBG. ROUGH ❑ ELEC. ROUGH ❑ GAS TEMP. ❑ ELEC. FINAL ❑ GAS—11 ER _' I MECHANICAL — ElSHEETROCK T�C'MECH. FINAL ElSTRUCT. FIRE MNAL ❑ PLBG. FINAL ❑ ZONING ❑ OTHER ❑ ❑ NO NONCOMPLIANCE OBSERVED ❑ WILL REEXAMINE AT NEXT INSPECTION CI CORRECTIONS ESSENTIAL AS EXPLAINED BELOW ❑ DO NOT CONCEAL UNTIL REINSPECTED COMM NTS u �i —J yrm Ake IV /4 S o if Ki S OR DATE WHEN COkRR CTIONS ARE MAD , PLEASE CALL FOR INSPECTION DO NOT REM E THIS NOTICE woo¢ la« an31 `°tea z ro wr i' Q +� N iC C(i �n S 3, KI . NO 2 7t# J�� c�� e ��� s 4� c fr o �C� 41 vti�l 0 G vt � W a 5 Cl r i 1 I -e d FY' iOk, 4--n 1976-- , 976-- APPLK NT FILLS OUT UPPER HAI ' ONLY Time Property Owner -TET F Time Phone/ Time Date Date Mailing Address) / L% - �2 Zip Code C U ) 5 8 Boyer Address Zip Code Lending Institution Inspector Inspector Phone Address Zip Code Inspector Realty Co. R Agent C. i A) _11 I j? t / _�jJ / �1�C 1(� / / / - %<<%% L /Il/ Phone Address AA f'J / )1 c P 4 / , _/ -"s Zip Code Field Notes: '\ Legal Description Fta/2i? /0--tO ".)ilq /6I(ji). l✓,UNICIPALITY OF ANICHORAGI. Street Location %J e/% Type of Residence ,/n,/ '! Ot-4 - OD /� Q 71�LA,G11 yln� E) Single Family OL_j LJOf ❑ Multiple Family No. of Bedrooms Other / a)/v �.� 1 /��I ��/�� JOA. LLXW - CUL.( Loi. F L uL. .A Dly_. Water Supply RECEIVED `U 4_L 0L!LU_ /Ltic/ 4U I.,UL's ffl Individual ( Lam -DISAPPROVED ATTACH WELL LOG. A well log Is required for all wells drilled since June 1975. ❑ Community ( ) CONDITIONAL APPROVAL' For wells drilled prior to that date, give well depth (attach I if a ailable). ❑ Public Utility DATE % Sewer Disposal !� %0 Individual Year Individual Installed: 7 % / ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank Well to Tank -ki 00 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date 1 rte-- to z), Inspector Inspector Inspector Inspector Field Notes: l✓,UNICIPALITY OF ANICHORAGI. RECEIVED ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( Lam -DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE % Y BY: C Solis Rating Date Sewer Installed Well To Absorption Area 'Aloo Well Log Recelved "V Iq ? q Well to Tank -ki 00 Septic Tank Size / Q e5v 72023 (3/92) ALASKA 6I0ROWnTAL COnTROL SCnUICCS, InC. Engineering 6 Enuironmental Studies SPECIFICATIONS FOR ELEVATED BED ALTERNATIVE WASTEWATER TREATMENT SYSTEM— LOT 2, FAIRMONT SUBDIVISION 1.0 GENERAL 1.1 THE DRAWINGS, SHEETS 1 THRU 2, SHALL BE A PART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERMIT AND REGULATIONS. 2.0 THE LIFT STATION 2.1 THE STOCK MATERIAL FOR THE LIFT STATION SHALL BE EITHER GALVANIZED STEEL (ASTM A-4444-76), OR ALUMINUM CULVERT, CAPABLE OF BURIAL TO 10 FT. 2.2 THE 24" PIPE FOR THE LIFT STATION SHALL HAVE A WELDED WATER TIGHT BOTTOM OF THE SAME THICKNESS AND COMPOSITION AS THE CULVERT. 2.3 ALL PENETRATIONS OF THE LIFT STATION SHALL BE WELDED AND WATER TIGHT. ALL WELDS SHALL BE CLEANED OF SLAG. WELDS ON GALVANIZED STEEL WILL BE SPRAYED WITH ZINC RICH PAINT OR COATED WITH BITUMASTIC. 2.4 THE TOP CAP SHALL BE RAIN TIGHT AND SECURELY FASTENED WITH SCREWS. 2.5 ALL ELECTRICAL FITTINGS AND CONNECTIONS IN THE LIFT STATION SHALL MEET THE REQUIREMENTS FOR A WATER TIGHT SERVICE. 2.6 THERE SHALL BE A HIGH LEVEL ALARM SET AT THE LEVEL OF THE SOIL PIPE FROM THE SEPTIC TANK. THE BUZZER SHALL BE LOCATED NEAR THE ELECTRICAL CONTROL PANEL OR IN A LOCATION DESIGNATED BY THE HOMEOWNER. 2.7 THE SUMP PUMP SHALL BE CAPABLE OF DELIVERING 10 GPM AT A HEAD OF 20 FEET. 2.8 THE SUMP PUMP SHALL BE SUSPENDED NOT LESS THAN 6 INCHES OFF THE BOTTOM OF THE LIFT STATION WITH A CHAIN OR NYLON LINE. 3.0 SEEPAGE BED 3.1 THE GRAVEL FOR THE BED SHALL BE SCREENED TO 0.5 TO 2.5 INCHES PER CODE. 3.2 THE SAND SHALL HAVE AN EFFECTIVE SIZE OF 0.4 TO 0.6 MM AND A UNIFORMITY COEFFICIENT OF NOT MORE THAN 4. 3.3 THE BERM AROUND THE SEEPAGE BED SHALL BE CONSTRUCTED OF IMPERMEABLE MATERIAL, AND ON A SLOPE OF 1 FOOT VERTICAL PER 3.0 FOOT HORIZONTAL. 3.4 THE BOTTOM OF THE EXCAVATION SHALL BE RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. THE BOTTOM ELEVATION SHALL BE PLUS OR MINUS 2". 3.5 AN OBSERVATION PIPE SHALL BE PLACED AS SHOWN IN THE DRAWINGS. IT SHALL BE RIGID PVC, ASTM 3033 D-3034. THE SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED 0.5" HOLES @ 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE OR A REGULAR SECTION OF REGULAR PERFORATED SEWER MAY BE CLAMPED TO THE SOLID SECTION WITH A NO HUB COUPLING OR SOLVENT JOINT. A RUBBER RAIN—CAP (JIMCAP OR EQUAL) SHALL BE PLACED ON THE TOP OF THE PIPE. 1200 West 33rd Auenue, Suite B 9 Anchorage, Alaska 99503 • (907) 276-1361 7.4 8 fil 4 �� 0 taor^ �►/� R h /1. 4a = 4 Pv` eTk 3.6 IF INSULATION IS REQUIRED THE INSULATION SHALL BE DOW EXTRUDED BLUE STYROFOAM BOARD OR WESTERN INSULFOAM OF THE THICKNESS SHOWN ON THE DRAWINGS. 3.7 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MIX OR BLUEGRASS. 4.0 PRESSURE SEWER 4.1 THE PRESSURE SEWER SHALL BE 2 INCH POLYETHYLENE OR PVC PIPE BURIED TO THE DEPTH OF 4 FEET FROM THE LIFT STATION TO THE CENTER OF THE BED. ALASKA ENVIRONMFNTAL CONTROL SERVIC" NC. 1220 West 25th Avenue Suite B ANCHORAGE, ALASKA 99503 276.1361 279.2917 jDB_FA_l-R.M_o-(7-4 Loo L SHEET NO OF 2 - CALCULATED CALCULATED BV CHECKED BY L OG A 2 DATE DATE SCALE J Qa^� Li p t * 1- U . J O Q W O O — cl K ul _Ln 0. ku NO m Q y LL 0 to 8 [7 )K 9 lCl to x ' Lit yr o M � ZZ- -N ' LCl ALASKA ENVIRONMENTAL jCo FAIR M6�T_6A) L'i 2 - CONTROL CONTROL SERVICE NC. SHEET NO OF 1220 West 25th Avenue Suite B ANCHORAGE, ALASKA 99503 CALCULATED BY L 0�� — DATE 276-1361 279-2917 CHECKED BY DATE L_ i FT 5fAt IWJ . -- OF Ak �1� '�P•�E••.....••.•4 t� ...... _..... L y C. Reid, _Jr- ; w, j �fJJ" JD. 2251•E��I �.•��Aw CONTROL SERVICES, INC. 1200 WEST 33RD AVE., `-TE B SHEET NO. - OF , ALASKA l 3 CALCULATED BV -- DATE PHONE 276-1361 ( CHECKED BV DATE SCALE NOTES 1, URETHANE FOAM SHOULD BE APPLIED TO A. DEPTH CF 4 FEET BELOW GROUNL, SURFACE AT A THICKNESS OF 1 INCH, 2, COAT $OTTOMi 2 FEET INSIDE WITH EITUI"ASTIC FAINT, 3, USE 11/4/ OF, 1 �� FLEX IBi-E HOSE TO FIT PUMP. 4, SEE SPEC IFICAT10f S FOR MATERIALS,