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HomeMy WebLinkAboutFAIRMOUNT LT 3Fairmont Lot 3 #017-112-08 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES 0/7- / 7 // z �8 Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name ` DISTANCES / Z ery TO SEPTIC ABSORPTION Address FROMWELL TANK FIELD Po x /8^02 oa/e/,!/I 98a3t� Phones Permit No. No. of Bedrooms -- 74o/s8 Iy WELL TANKS LOT LINE /,7 z / Manufacturer LEGAL DESCRIPTION Lot 3 Block - Subdivision ai r A/aurr FOUNDATION 701 /Sy Township, Range, Section AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, %l /04 N LC 31.,9 SCS y O /7-- // z - ©B TANKS LX SEPTIC ❑ HOLDING Manufacturer Capacity in galloons 45100 Matena c J ee lit" No. of Compartments G. TYPE OF SYSTEM ❑ TRENCH BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom Irom Total depth from original grade original grade D FT 0's- FT Fill added above original grade Gravel depth beneath pipe Z 3t� FT 0"s- FT Gravel length Gravel width FT zO FT Total absorption area Distance between lines r 7J-0 SO FT S FT Number of lines Soil rating Pipe material / ZS SO FT F8/D 5De3J- SC -4 80 Installer k-,oc 90 X0,6 Date Insisted N/e(so,n �fos F Z/ -22 -fro WELLS ❑ PRIVATE ❑ OTHER llde Classification (A,B,C) Total Depth Cased to FT FT REMARKS: Lrne-4ff�&' �d /etv 0 sfn4tyO driveway, water A WI n E21 no! C/N 7it cl erl b d /iia -f I 0 e S Scale: Ce-- 90.-0/2 /S U(2 ice` e C �E �a/2- rLn� Inspections Performed by: kvv t c4 a 5 3 /-/- o- >c u Co vr // n e "hvy 4 oure � 2e t cl fe'v C f�t> v L .� ✓(/2 >nl�.'� Date: 9///� C 0 I Ir&_rw Municipal and State guidelines in effect o date: Health Department Approval: _._ _,__, cattily that this inspection was performed according to all G d Date: �—_2.37— ENGINEER'S SEAL FIF-i-P cl-�4ewtcv vy v.R.�ne 1PALIlY UF ANCHORAGE 0epartment o/ Health & Human Servzces 825 L tit rend. , Anchorage, A1aska 99501 343-4720 uN-S1TE SEWEH PEKMl[ nor mit Number: 110) 1511 Upgrade I LOCI, /-)0\,,� (owner Name: MOUSSA AZllEH Day Phone:� Uwner Address: J. U. BOX 182 279 5553 MAPLE VALLEY, WA 98038 Parce1 ld: 017~112�08 Loi .1 ;i Subdivision: FAIRMONT SUBUIVlSION Lot: 3 81ac: k: � Section: 34 T(-jwnship: 12N Range: 3W Lt Sire 70525 (sq"ft" or acres) Max Bedrooms: [his Pew mzt: 4 1ota1 CapaciLy: 4 SEPTIC TANK: Minzmum total septic tank capacity: 1,250 gallons, Each septic tank musL hav, at least 2 compartments" Depth to top oA septic tank(s) {eet requires 7nsulat. ion over tank(s). lNFU1 TM H.H.S PRilib: TO INSPECTIONS BY ENGINEER. 12,Vi11,111 |`ER ENG1NE[R'S ATTACHE)) DES1GN. [HS PERM]T EXPIRES 12/31/90 AND VALiD FUR A SINGLE FAMlLY HOME. ENGlNEER SHALL PROVlDE AN ADDlTIONAL SOILS LOG/Wal [ER MLOW ]TOR FOH THE UPSLOPE SIDE OF THE 8ED 13Y61 EM TU A MINIMUM DL MH UF FOUR(4) FEElBENEAlH 1 E 8O[/OM OF T||E BED. ] C1:RTIFY THAT: 1. i am iamiiiar with the requirements for on -site sewers and wells as set I orth the Municipalzty c, i, Anchorage (MOA) and the State o[ A]aska. 2. ] will insta]l the system in accordance wzih a11 MOA codes and regulations� and in compliance wiLh the design criteria A this permit" 3" l will adhere to all MOA and State oF Alaska requirements <or the in back distances from any existinq well, wastewater disposal system or public sewerage system on thzs or any adjacent or nearby lot, 4^ 1 unde,stand thaL this permit is va]id for a maximum of 4 bedrooms. I a1so understand that the capaciof the total system is 4 bedrooms and any enlargement wil�� req�ire an additional permiL^ Gigned: ~ issued 8y: OF DATE A `C5 ALASKA enU1R011� nTRL COnTROL SRICCS, InC. a Engineerinq & Enuironmental Studies SPECTFICATIONS FOR BED WAS'rEWA'1'1:R TREATMENT SYSTEM LEGAL DESCRIPTION: LOT 3, 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 arc 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. 2 . 3 'rhe septic, tank shall be it 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./B 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 Tank and Welding, Inc. design. Specifications and design drawings are on file with the municipality and the engineer. 3.0 SEEPAGE BED 3.1 The gravel for screened rock No. 200 sieve. DHHS approval. 3.2 The bottom of raked with the bottom has not the bed shall be 0.5 to 2.5 inch, with less than 3 percent passing the All substitutes must have prior the excavation shall be level and backhoe blade to ensure that the 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 DHIIS for use as dr.ai.nfield pipe. 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 Filter fabric is required. 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. 4.5 The lift station will electrical inspection licensed electrician building code applies require either an MOA or certification by a depending on whether the to this part. of the city. ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 Toe �j//HOUR 5a� SHEET NO. / Z OF - CALCULATED BY— E2! d DATE 42 CHECKED BY— SCALE V_ DATE /71^e� c�V2/�Pble DH /11, /,6./s /ao r+� �� 7; �efline PAODUC1701.1 a Ina, Go., Mea 01171. ALASKA ENVIRONMENTAL JOB 3 Sulo CONTROL SERVICES, INC. SHEET NO. OF 1200 West 33rd Avenue, Suite B A ANCHORAGE, ALASKA 99503 CALCULATED BY— (907) V (907) 561.5040 CHECKED BY / DATE SCALE Z // -5— PROW PROWCT 2061ens Inc, Gwon, Mas 01471. 14 Y4 ��.•••.( yfiAH'SSEAL) . ::!! Municipality of Anchorage 0 • +.e O•• . •• •�• • •••� DEPARTMENT OF HEALTH & HUMAN SERVICES 0 ,. 825 "L" Street, Anchorage, Alaska 99502-0650 .• • • ••••� SOILS LOG — PERCOLATION TEST v c, ata t 1+ 5• CE - 2251 ' ��`'A* f r� �,,�\ •R ,r SL R t� 1profaol1�'''� PERFORMED FOR: �"� DU CA A. z / Z e/S DATE PER FQ:-�� f J LEGAL DESCRIPTION: !� �a/ /f-/0 L) SvG Township, Range, Section: //a/U /2�]r`.J S ,?y I --T1 SLOPE SITE PLAN 1 Sr�� Saf,7 2 G rase/ 3 4 ENCOUNTERED? s' Ine !( G / �d 5 L IF YES, AT WHAT / DEPTH? %O p 6 E �— 7 Cyra�•( H� 8 9 10 11 12 13 14 15 16 17 18 19 WAS GROUND WATER ENCOUNTERED? s' S L IF YES, AT WHAT / DEPTH? %O p E Depth to Water After U e _ Monitoring? Date: S�To 7 20 -{ / G uPERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER // TEST RUN BETWEEN FT AND Z FT COMMENTS �aW 50"/f (T- /",z /I'd? PERFORMED BY: / " I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ao%?ZQ0 72-008 (Rev. 4/85) we Net �— 20 -{ / G uPERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER // TEST RUN BETWEEN FT AND Z FT COMMENTS �aW 50"/f (T- /",z /I'd? PERFORMED BY: / " I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ao%?ZQ0 72-008 (Rev. 4/85) we ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. JOB /0 / / SHEET NO. / OF CALCULATED BY �Q - DATE Q a CHECKED BY DATE_ f nr.el a / f �Q • 1w 1-. 1-- .— nail .............. ............ ............... ...._......... .......L...,,_.... �.......... _I ............ ... ; ... ... . ........ I l ........ i_ ........... .... . ceff .... we, .. fl 6 ....,....,. .......�, . �.�. A 2 /2 ....... ..... .. .. .... ...... b. Z .... ...,.. . ..... ,. e� - _. ... o ..., <: ...., D . ..... W.I. - I . .,... ..,... ...2 .,,.., .. 1 N ..,.. L ............... / . 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I} 133 a' 1 �.Ar. •i� ''•...•• .... �,�`�.. ,� Pro 10 . .......... ....... ................. .A.. mo ........... .... ....... • 1w 1-. 1-- .— nail A E°s ALASKA EnUIROWnTAL COnTROL SERUM, InC. a Enelineerinq & Enuironmental Studies 1'. 0. Box 21066£; Anchorage, AK 99524 0668 (907) 279-5553 * * * FAY ( 907 ) 2761;706 September 5. 1990 Municipality of Anchorage Department of health & ItuIna n Services 825 L Street, 5th Floor MUNICIPALITY OF ANCHORAGE A n c 1) o r a g e, AK 9 9 5 0 1 DEPT. OF HEALTH & nTTnBan RothENVIRONMENTAL PROTECTION : SEP E 1990 RF: Lots 2 Fairmont. Sub(Ii.visior) RECEIVED Dear Dan: In July .1930 i:l)e curtain drain that was designed for i,ol. 2 was inadvertently placed too close; to the lot line, In Some cases, the drain is onto Lot: 3. 'Fhe Iocat..ion of the lot. line waS nilsundersl:ood When the bed was hnilt on Lot 3 :it was found that there was IeSS than 100 feet to the curtain drai-n. The closest point is E39 feet- and the farthest point. is 92 foet. It: was when the east lot .Line was checked by a sul,veyor that the locations of the lot line was determined The two owners of t:he properties have agreed ill prim-cpal to leave the drain where it is ]ocatod if a waiver is obtainable. They are going to prepare an agreement to this effect 141,) west -33R- a -d The existing ordinance requires a 100 foot r,eparati011 distance beIween a curtai.n drain and the itpsIope septic system. The ,,oils log shows that, between 4 and 6 feet t -litre is a weII graded sand which had a percolation rate of 125 ft`/bedroom. The water level is at. X1.9 feet. The curtain drain does encounter this sand seam. The slope of the lot is to the southwest. Probably the sand seam slopes in the same direction. In this caro, flow would not intercept the curtain drain. Also, surface flow will not. he toward the curtain drain, as the around slope is such that water would not enter the curt -mitt drain. Alsothere is a berm alon<, the lot line which would prevent surface flow from reaching t}t(, curtain drain. The worst possible case is for the flow to be duo west through the sand seam and into the curtain drai.n. The ground surface slope. ignoring berms, et.c., is .1.5"4. Based on these premises, it is virtually impossil_)le for - , the bacteria to survlvo ttte passage t:hroagh tho ground water into the curt%n drain. The time of passage would be in the order of 1.9 years. See the attached calculation slieeIs. In my professional. opinion the waiver of t_he dist,auce from the field to the curtain drain from 100 feel: to 89 feet will IIV)t, C1'Q11 (, i) I1gil1tI1 1!i!7. ii Y'(3. I'lease iil)prove the IN' iIipe!• reduesl.. LCR/ sr OF A4 'h. 49 C. REID�' p II•. CE -225i 40 "'ilu.eI ,Iy yunrs, 1p, (I,r1,(az,JI'h1) ALASKA ENVIRONMENTAL JOB /' z-3 CONTROL SERVICES, INC. SHEET NO. / OF 1200 West 33rd Avenue, Suite B/r/9c ANCHORAGE, ALASKA 99503 CALCULATED BV ,/ DATE (907) 561.5040 CHECKED BY DATE SCALE 7�5 f-__ wGs _ i• r'�z. 5 so,/s z%��e, Y?°c �•� MtA w4er, nali 74c,__ deo<L p/ !1( 74. f P� e- p-oa , _. Tht s uv !d be �!o Y . ry •! > 7` ..u� s /rf� � �1 d/ &f s�N/�......... >�o ate/ sz rz d / ICS AIM l0les 740 -YT.•ne �✓ //zjo A7 , L9 .13 ......... h ............. f !3 H/off?7 _ — 75e 5`1 5'rAce 'fie Sd��s ?rQ _ Sa.�d �% r',r Sri cel/e�f I a/•4. ✓.41 ke cll^� !s Y , d2 f < 3►kc� C. / .� 3_^. �?•I'r�2u�Y�i ,r .1/lorsi b/ee A4. .bzc�i2 r� � - ►4. �e _�-AI�'. r 4� .,. 4� CoY— gin.* ',�1 alr`a#A `�aTT,44t'. � SO � PA0011C7241 �IM.. G,.tm. Men 01111. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. Oi%— IM -08 HAA # 0 r0 -15 g 3 Expiration Date: a - % 1. GENERAL INFORMATION Complete legal description Lo -r 3 F{Eli? mrr Location (site address or directions) 5;01 F 1 o rtr Gook.. ?-z7 Current Property owner(s) ji3Wt1 iE -rl;ky Day phone• 2-30-VOQZ Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3: TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site X Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a ,public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection,, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. 1 ,,'/may Name of Firm :E 1�Y iT' P• �TBN 1 P �• Phone ?;4 - ?U7 7 Address %670 _Fxco s -f6* LF A -"CA . , AV- q S l5 Engineer's Printed Name 5. DSD SIGNATURE _J,,� Approved for I-/—_ bedrooms. Disapproved. Date Conditional approval for bedrooms, with the following stipulations: tiuu, U � • r Additional Comments ZN • BPS S)TE-�-6►= WATERAND : in Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By. nz//Zy/ �, P� Original Certificate Date: — 7 — 0 � (Rev 01/03( Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: wT J Parcel ID: Or7— LM --09 A. WELL DATA Well type ,fKN kI`15 If A, B, or C provide PWSID # 4 Well Log (Y/N) Dateh ted ) ,� Sa i� tory seal (Y/N),�✓ Wires properly protected (YIN) �E Total depth,o_ft. Cased to 24d—ft— Casing height (above ground) in. FROM WELL LOG Date of test nIi;p►.IG Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0- 1 mg./l. AT INSPECTION IZ n. e" C..-1% g.p.m. reGo�/E1e-Y Other bacteria 0 colonies/1 DO ml. Arsenic: = mg./l. Date of sample: 10-0-05 Collected by: OZCI-►T IFA-ro4-1 B. SEPTICIWOtDM TANK DATA Tank Type/Material ev� Date installed IQg� Tank size L6r! gal. Number of Compartments ;7— Cleanouts (Y/N) `tom Foundation cleanout (YIN) 110r Depression over tank (Y/N) Oa High water alarm (Y/N) qCS•s Date of pumping Pumper R1-' VB"*L-D-5 Z.Ilvl.; y'ymr `5myt tE C. ABSORPTION ,FIELD � DATA Dale installed Soil rating wlii- ft2 or ft2/bdrm) .L;L-'20 System type W V• 45' I,Rr�gth 7• ft. Width .ZO ft. Gravel below pipe 5 ft. Total depth ft. Eff. absorption area 2152 ft' Monitoring tube \161�7 Depression over field 00 Date of adequacy test (�� -O� Results (Pass/Fail) 'PAIS6 For ±L bedrooms Fluid depth in absorption field before lest C in. Water added62 gal. New depth in. Elapsed Time: min- Final fluid depth Q in. Absorption rate >_ 607 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) A(6"E y4inw If yes, give date D. LIFT STATION Date installed "Pump on" level at If- in. Datum :`OP CF L• s• E. SEPARATION DISTANCES Size in gallons AJ5)0 "Pump off"evel as=in. Cycles tested -1;>- SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic tank/lift station on lot 22 - Absorption field on lot elo Public sewer main M#t Sewer /septic service line �Zr Manhole/Access (Y/N) High water alarm level at N70 in. Meets alarm & circuit requirements? —)k On adjacent lots On adjacent lots loll Public sewer manhole/cleanout N Holding lank tjA. SEPARATION DISTANCES FROM SEPTIC/lfAt:15iINO TANK ON LOT TO: t / n/ I Building foundation Q_ Property line Absorption field 60 Water main Water service line 101 Surface water PJa{r BP I Wells on adjacent lots 12 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: l/ Property line N �t7 Building foundation( �O Water main t �Mr Water Service line Hoo Surface water gcLICQJ Driveway, parking/vehicle storage N Curtain drain gQ P10040JAr Wells on adjacent lots_ F. COMMENTS R5 G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in ON conformance with MOA HAA guidelines in effect on this date. . ' ��.rr P F 13RF11T ... Engineer's Printed Name ^/ �hT�►,I �c' '• CE 9126 . . Date 10— :31— 0157 HAA Fee $ 4 �c / Date of Payment Receipt Number U �� (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number 10-26-05;14:10 S ry S SGS Ref.# Client Name Projact Npmo/# Client Sample ID htntrix Sample Remarks: 1056834001 Eaton. Brent 5441 Rabbitt Cr Rd 5441 Rabbilt Cr Rd Drinking Water ;907 561 5301 # 2i 4 All Dates/Pimes are Alwka Standard Time Printed Duterrme 10242005 9:23 Collected Datcmmc 10/132005 13:00 Racelved DnteMcno 10/132005 13:45 Technical Director Stephen C. Ede Microbiology Laboratory Total Coliform 0 coV100mL SM20 92223 A (<Ol) 10/13/05 TLS Allowable Prep Analysis Parameter Results PQL Units Mothod Container ID Limits Date Due Init Iditratc-N 0.100 U 0.100 mWL EPA 3533 B (<-10) 10/13/03 AZS Microbiology Laboratory Total Coliform 0 coV100mL SM20 92223 A (<Ol) 10/13/05 TLS Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Brent Eaton Legal description: Hidden Hills Block 1 Lot 20 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. _ ® Incomplete; missing Total depth of field ® Incomplete; missing Survey scales less than 100 feet well to tank. ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils information submitted. ❑ Well log required. _ ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ❑ Other. Name of reviewer: Jeff Date: 111/3/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MAQr Spua WWWOu3 S31VI00M V VN1VlVM 03111 FIsAsOtL MA WVWW aeW,ouza P paha „aa,w paaaapu* as dame Apadad pwa W vuauo..a GRIIA saw m aril uaawu.wa'aA*mpm W as GA41 Vaal pua udpab u1 aaauwrd a�a W V�•mWa clvaW VwaalW &A h admd W W SWUSAGAUl W FtA C1Waip POORIpa IwA N+admd as W rpmmw n dalaaw Mu pp pua asury Ayadod Kq u&pm we uowma palargm a}wwawrdul aL PnOI lma MulpaL Bum,d mlcvjm � i lyadnad paquaaap W V.W W uWWadarl aaaegNM api mind awV I pta pnraa A 31V0SIH1133Sd3J8000N nnl3SV I-V a d 'a 8a cz—.I'C:1 a9�^ "A M i v t z r4 ,Ob =. L :31VOS 4101 �o SL bmd'BS00.i at 00.�vcj O O O 0 v 0 I I I I I I I I i I I I dl I ml (v 13. I I I I r - 4S I I I I I I I I I I I I I l o c Ssf:; r *lkN) err I 'kbp g r ww I I Yo 0 7 0 £ 10l ivawa3se3 Aron At MUS 66'8ZL M.0£aVSa68N 'NO3V3H NMOHS ION 3HV 1Vld 030a003N 3H1 N0 NMOHs 3sOHl NVHI 113H10'0H003H j0 S1N3VOSY3 O O O O 0 J u Z101 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received April 21, 1976 �yv cs Time of Inspection q;Ar aln, J ti Date of Inspection-Zo-9/0 C/1htaI if REQUEST FOR APPROVAL OF JQ. INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Spokane Mortgage Company Mailing Address: 3201 C Street, Suite 250 Phone: 277-0543 2. Property Owner: Ernie Martinez Phone: 265-4260 Mailing Address: Box 473-F Star Route A 3. Legal Description: Lot 3 Fairmont Subdivision 4. Location: NHN Rabbit Creek Road 5. Type of facility to be inspected Single Family No. of bedrooms 6. Well Data: Individual - serving one , A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: / 9 p y On=site system ��"]l A. Installed B. Installer �! C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages APRIL 20, 1976 MUNI II'nU I Y UI AN(W) AUL GREATEN ANCHORAGE ARC.). BOROUGH [)wr of Department of Environme,-..tal Qualf��Y���`Ir�ural�,i 3'19 -'LC." -.s -t. , A n c h o r age, Al askaG 2J&=-4-rL51 2510 E. Tudor Road 99507 2M4,i�-21:1, A1V (Lora) REQUEST FOR APPROVAL OF R r C E I V 6_ A. INDIVIDUAL SEWER f, WATER FACILII'iES 1. Type of Inspection: CiiR0 VA FHA COtdV x 2. Property Owner: Ernie Martinez Bailing Address: Box 473-F, Star Route A Da.y Phone 2654260 ` Anchorage, Ak. 99507 .3. ;lame of Buyer: Moussa A. Azizeh Bailing Address: 3701 Eureka Sp 5-C, Anchorage Day Phone 277-2414 4. ;name of Lending Institution: Spokane Mortgage Co. Mailing Address: 3201 'V" Street, Suite 250 Phone 277-0543 tl 5. Name of Realtor or Agent: Direct Sale Mailing Address: Phone 6. Legal Description Lot 3, Fairmont Subdivision Location: NHN Rabbit Creek Road Anchorage, Alaska 7. Type of Facility to be inspected: single family No. Bdrms. 2 8. Water Supply Type of Supply: Public Utility _ I-ndividual x If Individual, number of d1wellings presently .served i If Ind i vi dual , depi.i: of weI I unknown 9. SeHrage Disposal -System Type .of System: Public Utility Individual (on-site) If Individual, date of installation _ unknown Page 2 of two pages - Rei ;t for Approval of Individual : it & Water Facilities Legal Description Lot 3 Fairmont Subdivision Comments Approved Disapproved Date Approval,Valid for one year from date signed Greater Anchor a ea Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date 1. 2. 3. 4, 5. 6. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 i Date Received //- i'- %�- Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & 'MATER FACILITIES FOR Anproval Requested By: ��c ,lam�i_tez-�r- Address: 1'{c�e /d - e;L-4j Phone: Prooerty Owner: f �f,u �� T�d/�4 Phone:., -2 77_.SG lv / ,71 Legal Description: Location: Type of Facility to be Inspected: _ 2. Numher of Bedrooms: Z' Well Data: A. Tyne B. Depth C. Construction D. Bacterial Analysis I�Tiiiti¢aV✓may 7, Sewage Disposal Svstem: A. Installed %' B. Installer C. Septic Tank: l., Size-; rw • 2, Manufacturer D. Seepage Pit: 1. 2. Material E. Disposal Field: Total Length of Lines 8. Distances: A. We]1 To: Septic Tank- >'N , Absorption Area , Sewer Lines Nearest Lot Line o Other Contamination B. Foundation to Septic Tank Absorption Area C. Absorption Area to Nearest Lot Line -� Red.:est for Approval of Individual Sewer & Water Facilities Page Two 9. Comments: -� c . .Annroved 20 Disapproved Date // -/3 —% Ap-r-oval :valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities located at: Signed Date 327 1 : A C j L 1: S' C, F- T MCHORACE , ALASKA 99501 279-2511 DAIT PECE"IVIT INSPECT: TINE : REQUEST ['011 APPROVAL OF 1NDIVTMIA1, Si;'IVAGF- AiNM WATER FACILITfUIS FOR Pv(jlicsLc,,d By vj�, 8,. A Phone J) L !oil 41 iyp�: of ii£icIi ty ic o he hispocted r i j,r: D mic L1011 Ail"d ysis 'C 1111, (If hoilicradc, show �Iiacfranl Oil back, li J 11:1,nmf*.,Ic1jlrcr r-rotc onc cr l DISAPPROVED: DATE VAJAD FOR ONI�i YEAR FROM DATE- SIGNED. GREATER ANCHORAGE ARCA L'OROUCd-i HEALTH DEPARIMENT 13. Scupage Pit I. Sizo 16TxI t 2. Lining_ry horlie, C. Disposal Field 1 . Number of Lines ec" 2,,. Total Length 7n� 7. Required Measuromonts A. (Voll to Septic Tank 1331 o. doll to Socpago Pit C. i7cll to Sower Line U. hul I to Property Line 9') E. l'lcll to Other Possible Contamination Pouridation to Septic Tank r" fi G. I-oundation to Seepage Pit !r; Ii. ;;eopaga Pit to Property Line qr)r °. CMT'I.]NTS: l DISAPPROVED: DATE VAJAD FOR ONI�i YEAR FROM DATE- SIGNED. GREATER ANCHORAGE ARCA L'OROUCd-i HEALTH DEPARIMENT 1. Appro Addre Phone EATER ANCHORAGE AREA BOROUGH I'EALT11 DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 279-2511 DATE RECEIVED INSPECT: TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES ' } FOR 2. Property Owner -J'447Phone 3. Legal Description �L,� 4. Type of Facility to be Inspected STR4ET:)ILJLI l Number of Bedrooms eg "P S. Well Data: fj /f 64- A. Type f (�� B. Depth C. Size �� a D. Construction E. Bacterial Analysis 6. Sewage Disposal System: A. Septic Tank (If homemade, show diagram on back) 1. Size Z,l o 2. Age f 3. Manufacturer — et L.� .2.[ � 4. Installer Approval Request for Six $ Water Facilities Page Two B. Seepage Pit 1. Size 2. Lining C... Disposal Field 6rIA 1. Number of Lines 2. Total LengthO co ys 7. Required Measurements 00 A. Well to Septic Tank ✓�� �r /v B. Well to Seepage Pit C. Well to Sewer Line XL D. Well to Property Line E. Welt to Other Possible Contamination i F. Foundation to Septic Tank x i G. Foundation to Seepage Pit 30 i H. Seepage Pit to Property Line---�0 8. COMMENTS: SAPPROVED: XE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT ED1170 �o , '00 vi A,W,e/T ac X-ol/lF' 1.91171(o P- q-v'D 0C ()C) INI,. eIIAJAL FA(:lI,T-I.L-,, (Ti.11 out in Triplicate), Name of .person rlaquesti approval Clam- r)li property �owne -2.ge Lt. Nlimbex �of be4rnoms, in house WAter, A'wilv Ris - a. APATJ b. Deterp4rit 6. we'd- I a' -at a: d. Casln. S'ze , I ��NA VC tri Distance from well to clbsest existing or proposed: 1. 8ewex lino 2. Septic *A)l1e. Other loupns.of potw%'je ttk&'tA in m ation, 7. Zewape di sr uca.i. System, i.e., crocks, lAk e. s I b. opacity" in gal 6i.q ca N'atne: of shit t4nk McO),Afaratuvor 446), chow diaram on 4vtveof this,foYT 0 allo pitsite :arjd!r'�t I e , Percol.ar iott Test rpsu i_ 's f. Percolation Test performed by Use the reverse ,side of this form to show diaF>rar . Diac-ram should include -the following information: ppoperty limes;-we:11 location, nousc;! location, %eptic tank ].oration, disposal area location, 1:)c,ttion of percolation test, ar� direction of Around slope. The Info-rination on thls> form is true and correct to the best o{ my knowledge. Sa.t.-nature of Applicant Date SiF<ned TO BE PILLED OUT BY HEALTIi. MPARVIENT PERSONNEL 'The above described sanitary facillti are hereby approved, subject to the •Tollowing conditions: Conditions: r The above described sanitary facilities are disapproved for the followin3-. reasons: J ure Approval is valN for one year following; the date of approval., CPJ:cw f 4w j'. �--� AAr- JG-7oo�IE Pr $ y O/ S� -2 Z:. $ y O/