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HomeMy WebLinkAboutALPINE WOODS BLK 5 LT 9 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~,~{/0~ (~) I.~ PID Number: Name: ~~ ~~ Wastewater System: ~New r~Upgrade Address:~1~ ~L~;~ '~;~ b~ ABSORPTION FIELD Phone: INo. of Be~ooms: ~DeepTrench ~ShallowTrench ~Bed ~Mound ~Other Total Depth from original grade: LEGAL DESCRIPTION ~oi, Rating: O,~ GPD/Sq. Ft. Lot: ~ BIock:~ /~ ~ Subdiv~ion:~ ~ ~ ~ ~ Depth to pipe bosom from~original_ ~grade: Ft. Gravel depth beneath pipe ~ Ft. Township: ~ Range: ~ Section: Fill added above original grade: Gravel length: Number of lines: ~istance be~een lines: WELL: ~ New ~ Upgrade Gravel width: ~ Ft. J [ '1' Ft. Classification (Private. A,B.C): Total Depth: Cased To: Total absorption area: Pipe material: / Ft. Ft. '~ SO. Ft. Driller: ~ ~ate Drilled: Static Water Level: Installer: ~ Ft. Date installed: ~ v,e,~: I~e,~,: ~ Casing Height Above Ground: TANK GP~ Ft. Ft. SEPARATION DISTANCES ~Septic D Holding D S.T.E.P. To Septic Absorption Lift Holding =ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~C~ t7 Number of Comments: Welh ~{ ~ ~1~ Material: ~T~ E Sudace Wat~ Nl ~ ~ ~ LIFT STATION LineL°t ~ ~ ~ Size in gallons:~ Manufacturer: Founder, on ~ ~ "Pu~P °""'e~e' at: 1"Pump °~"e~e' at: I Hig' wate~a'a~'t: Cu~ainDrain ~O~ ~-- Pump Make & Model [ Electrical Inspections pedormed by: Remarks: ~ ol / BENCH MARK ~ ~ ~ ~.~ ~ ~ ~ ~ ~ ~. Location and Description: ns e ions e ormeU Da eS:2nu S ~-. ,. Depa~ment of Health and Human Se~ices approval Reviewed and approved by~~~ ~ ~,/~~ Date: 72-013 (Rev. 9/91) MOA 25 ~ t~'~':~ STANDARD TRENCH / ,/ -- /~**,~,~\ TOTAL DEPTH 10 FT I / / /*~*~**%~ TOTAL LENGTH 75 FT J / / /.~.*.*.**.~ EFFECTIVE ROCK DEPTH 6 FT I I ~ ~ ~ ~ ~~ ~ REPLACED I000 GAL. J.T. , ,'~ ~ ~ ~ W/TH ,250 GAL s.r. 1~ ~ ~' . ~ ~ S.NG TIES: i ~ ~ ~ A~ 38.4 FT ~ ~.~. BC 25.3 I I j ,, BD 35. 5 ~ - ~m /k' Z', 7 ' *~ BE 35.2 ~ -- ,~ ~"-' -. ~ AF 97. 7 ~ ~ 49th ~x ~ · BF 95.8 j ~ ~ ..... ~_~ ..................... , li~.,~x:'"':'~'"t*~'~ ~ ~ I I ~.~.~.,.~.~...~.~.~ ~ ~$ TB~EN SPURKLAND ~ ~ J J j ............... BENCH ~ARK: BOTTO~ SIDING REVISED: ~ARCH 25, 1999 ASSU~EO ELEVATION: ~00.00 TO~ SPU~KLAND P.~. ~0~ 9 ~ 5 AZPi~ EOODZ SEPTIC S~ST~ ~S ~UiLT 20~ W 15TH. AVENUE EDMOND BASYE DATE: JUNE 22, ~999 ARCH. AK. 99501 6100 ALP/NE WOODS DRIVE SHEET: 2/5 GRID: 27~8 ~.,,~ .. · .....~ ~ DIVERTER VALVE Z' 75' L on9 lO' fleep NH 2QALE 3' qoven onl'O C/e~ nou ts 4 Cover 6,0 Pt oS Sep?ic Rock EffecHve /Z50 9o/, :ept/T tank INSULATED NH SCALE EJECTOR PU~P IN HOUSE REVISED: ~ARCH 25, T~BBEN SPURKLAND P,E, LO~ 9 ~LOOK 6 ALPINE ~OODS SEPTIC SYSTEN AS BUILT sOS Wl5th Ave Anchora9e Ak 99501 EBMOND BASYE SATE', JUNE 22, 1999 SiO0 ALPINE ~OODS DNIVE SHEET: 3~3 G~: 2728 PER~IT ~ SW980047 PARCEL ID ~ YYY APWO509&DWG MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Apr 01, 1999 Expiration Date: Mar 31,2000 Permit Number: SW990047 Legal Description: ALPINE WOODS BLK 5 LT 9 Design Engineer: 0007 Tobben Spurkland, PE Owner Name: Edmond Basye Owner Address: 6100 ALPINE WOODS DR ANCHORAGE , AK 99516-2467 Parcel ID: 015-234-39 Site Address: 006100 ALPINE WOODS DR Lot Size: 61148 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE PROPOSED ABSORPTION FIELD SHALL BE CONSTRUCTED A MAXIMUM OF 7 FEET DEEP FROM GROUND SURFACE UNLESS GROUND WATER IS MONITORED THROUGH MAY 20, 1999 AND IS NO SHALLOWER THAN 14 FEET THEN THE ABSORPTION FIELD MAY BE CONSTRUCTED AS DESIGNED BY THE ENGINEER. Issued By: 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 9 BLOCK 5 ALPINE WOODS EDMOND BASYE RESUBMITTAL RECEIVED 2. 5 199 ) Mumc~pality et Anchorage Oept, Health & Human Services Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 March 25, 1999 We are resubmitting this application for the upgrade of the septic system for this lot. Yesterday I was informed by the real estate agent that the residence contained four bedrooms. Consequently the design has been revised to reflect the addition of the forth bedroom. No Ground Water or Impervious Layer to 16 ft. Use Standard Trench Soil Rating. From Testholes Oct. 19,1998 15 min/in = use 0.8 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 150/0.8 = 187.5 sq.ft. Total area required: 187.5 x 4 = 750 sqft Testhole depth 16 feet Bottom Rock At 10 feet Top Rock At 4 feet Rock Depth 5 feet ( Silt layer is not used) Total Trench Length 750 / 10 = 75 ft. SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 75 FT TOTAL WIDTH 2 FT TOTAL DEPTH 10 FT ROCK DEPTH 6 FT COVER 4 FT REPLACE SEPTIC TANK 1250 GAL The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. \ x 4 HUFFM4 N ~ ~ PWSIB £73598 TOBBEN SPURt(LAND P.E. II 203 W 15TH. AVENUE II ANCH. AK. 99501 pOZ) 2Z~-391~ LO2' 9 BK 5 ALPINE WOODS EDMOND BASYE 6100 ALP/NE ~/OODS DRIVE SEPtiC SYSTEM DESIGN DATE: NOV. 2, 1998 SHEET: 1/3 GRID: 2738 PERMIT # SW980XXX PIJJ # 015-'~34-39 APWOSOgLDw6 STANDARD TRENCH TOTAL DEPTH 10 FT TOTAL LENGTH 75 FT EFFECTIVE ROCK DEPTH COVER 4 FT $ FT REPLACEMENT TRENCH I000 GAL. S. WITH 1250 GAL S.T. 25- -- ~SO-- --75- -- -tO0-- --iL~ -- ~30 -~ SCAL E: 1" = 50 F T, REVISED: MARCH 25, 1999 TOBBEN SPURKLAND P.E. 203 W 15TH. AVENUE ARCH. AK. 99501 (907) 279-J9~6 LOT 9 BK 5 ALPINE WOODS EDMOND BASYE 6100 ALP/NE WOODS DR/YE SEPTIC SYSTEM DES/ON DATE: NOK 2, 1998 SHEEh 2/5 GRID: 2758 PE~H/T # S~/985XXX PI? # 0Y5-234-39 AP~/05072,?~/6 : ~,,,,~ ..................... ,,,,~,~,,~ ~ 1~50 ~o~ Septic tonk 75~ L on~ 10' fleep 5,8' Se~e~ Nfl S6~LE 3' 6ove~ :~Moni~o~ 6,0 ~? o; Septic Rock ~ Effective I250 gal sepf/c tank NO ~SALE REVISED: ~ABCH 25, 1999 T~3~EN SPURKLAND P,E, ~0~ 9 ~0~ 5 ~LP]~ ~00~ gEPT~C gYgTE~ DEg~gN ~03 ~l~h Ave Anchorage Ak 99501 EDNOND BASYE ~ATE', ROE 9, 1998 6100 ALPINE WOODS DNIVE SHEET: PENWI~ ~ SW980XXX PARCEL ID ~ YYY APWOSOgS. DWO Munlcil:,ality of Anchorage DEPARTMENT OF -iEALTH & HUMAN sERVICES 825 "L" Street, A~u.:horage, Alaska 99502-0650 SOILS LOG- PERCOLATION TEST (ENGINEER'S SEAL) LEGAL DESCRIPTION: Lo+ 9.. ~.,_.~ /~r ~..~_J/~ J.~. Township, Range, Section: ~/00 D...~ SLOPE :' SITE PLAN , 3 5 6 8 9 10 WAS GROUND WATER ENCOUNTERED? 11 s L IF '"ES, AT WHAT 0 12 D :?tH? p E '.'--~.a d i n g Date GrOss Net Depth to Net __.~'J L~L~ Jo ' J~_~J ~, Time Time Water Drop .a - 14 15 16 17 18 , 19 2O P :tRCOLATION RATE , J,,,~ (mm,~les/inchJ PERC HOLE DIAMETER T ~,T RUN BETWEEN , 7 FTAND 7/7-., FT DISCLAIMER: Groundwater (.~nditions indica.ted are for the dates shown only. .. Past and future presence vnd/or depth of gro,'ndwater can not be predicted trom these c~s,~val;lons. PERFORMED BY: ' J/"~---'~ CERTIFY THAT THIS TEST WAS PERFORMED IN AOOORDANOE WITH ALL STATE AND MUNICIPAL GL;iE EUNES iN EFFECT ON THis DATE, DATE: N0 ¢ D ql 72-008 (Rev. 4/85) 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 IPHONE I -~NEW LEGAL DEScrIPTION .ocA ,o. .o. O ~ M ufact rer , v Materia~~ No. of compartments ~ ~ Di STA~: Well Dwelling PERMIT NO. ~Z ~ ~ell Foundation ~earest lot line PfiBMIT ~0. ~ ~ Distance between line) ~ No. of lines Length of eachl line Total length of lines Trench width /  Top of tile to finish grade - I Material beneath tile ~, ~,~ Total effectiv~a~orption area ~ ~. Length ~id~h Depth P~RMIT NO. ~ ~ Type ~ crib Crib diam*~*r Orib depth ~o~al ~ ~ell Buildin~ ~oundafion Near~s~ I~ line ~ DI~TANO~ TO: z Class Depth Driller Distance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS , . APPROVED DATE LEGAL 72-013 (Rev. 3/78) SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: ["511t LEGAL DESCR,PT,ON: DATE PERFORMED: 'S och 5, q SL(CPE SITE PLAN I 2 3 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 C)L ML brown aq ¢..Ob~ ¢5 Com~qob SP ,0 ENCOUNTERED? DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~zO ~,lzqjt'~ i~.,~'7 2/o ~ il: 2'7 lO rn,~. Z.O I . O~ 3 blzfl)~3 /,. ~' /P~m. z.oV . os- HzO 12'00 iOm,'t~ , Z.6'1 PERCOLATION RATE ¢/ (minutes/inch) TEST RUN.ETWE~N /-//~ FT AND ~ FT .ERFORMEDB,: ~Onf)Of/O~/~~ CERTIFIED B,: /~~~ DATE: t:;'i Lt ~-.~ 3: ,2:: .:~: ~ ... '~:: ..., :[. T "T" "----" F:' F~ IN "-: ¢'~ ~..-fl~l~Ct-._~t~a:t. a lift station Is Installed aR ""* DEPFIRTHENT O, HEALTH AND EN',,,'IF.:ONHENTFIL elt~.~i~l:_:'pt~13fJt and inspection must be R25 "L" STREET., ANCHORAGE.. AK. 9'_~l~irclned. As-builts cannot be approved un- '' 264-4?20 til the electrical Insprection is received in this L--, i"-.~ --- "_=;_. 3: T E S E 1.--I E F-." F' E FOIh~eZ l'~e elebtriCal work must be peP; PERMIT NO. ,:; R~:F~50 ) formed by a t~cens~d electrician," RF'F'LICRNT ..TIMHIE F. SERt"IRI'.,t 7.'3.':2.':'_-3. RF.'.TIF: BLV[:, ~502 ~:49-::L5~:'~ LOCRT 1 ON LE:GAL LL~. B5 RLPII'-,IE WO0[:,S'-~,..D"' LOT SIZE 60974 S..=.._' E~I 1=1''F..E F~ET T"r'PE OF SOIL RE=SF~F.:F'TION S"r'STEH IS: TRENCH [ I"IR,:'4IHIJH [',I'_'I"IE'EF.: OF BEE:'F.'.OFd"IS = .'2: SFiIL F-:FITII",t'.3 (':';Q FT,-"BR)~ THE F..E6.!UIREE: SIZE OF THE SOIL. RE, SQ~.:F'TION S"rSTEH IS: ~ ' THE LENGTH E:'IMEI",ISIOI",I IS THE LENGTH ::II",l FEET:: OF THE TREt",IF:H FiR E:F.:FIII",IFIELE:,.~ THE DEPTH OF R TF.:ENF:H OF.: PIT IS T,H,E E:'ISTFINC:E BETHEEN THE SURFACE OF TH~ GF.:OLIND RNE:, THE E:OTTOh't OF ,THE E::-::F:R,,,RTION ,::IN FEET::,. // I1'~ ' THEF.:E IS NO SET WI[:,TH FOF.. TRENCHES.,, / F,;~:b-Z #T.~ LIt I F-:E[:, SEF"T I C: TRI"-~I--::: E; I mE= .~ ~Z.a 0 L~ F'ERMIT AF'F'LIC:AI'.,IT HI-I_, THE F.'EqF'-N'=;tEILIT'¢ TEl INFi-~F.:r,'I THI.:, [:,EF'AF.:THENT [:,LIF.:II'.,tG 'THE iNSTFILLRTII3t"] II"]SPEC:TIONS L-IF AN'T: , '- HELL=, FIDJRr':ENT TO TH I'-- F'F.:OF'ERT¥ AN[:, THE iqUME:EF: OF' RESI[:,ENCE'=; THFIT THE WELL WILL SERVE. -f- [L-.i,;, ":"..=_--:" .':" I I'-.I '='; F' E ,.-_: l" T ~--I l'-.i'_.-q F-! F-' E F.: E i_.-::.-! LII "Ir BACKFILLING OF ANY =,T=,TEfl WITHOLtT FINFIL IN=,FEL. TILN AND HFFF._,HL THIS [:,EPAR"r'MENT WILL E:E SLIB._TECT TO F'F.:OSEC:UTION. HINIHUH DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS :DRO FEET FOR Ft PRIVATE HELL OR :.1..5~.-':"~ TO 200 FEET FROM FI PUBLIC HELL [:,EPENDIt',IG UPON THE T"r'PE OF PUBLIC 1.4ELL MIF,IIMUH DISTFINCE FROM Ft PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET TO Ft COMMUNIT'T: '-";EWER LINE IS 75 FEET. OTHER REQUIREMENTS I'"lFi"r' APPL"r'. SPECIFICATIONS AND CFINSTRUCTION DIAGRRi"IS FIRE AVFIILABLE TO INSURE PROF'ER INSTFILLFITION. t CEF,:TIF¥ THAT 2[: I Rh'l FAMILIAR WITH THE REQUtREFIENTS FOR ON-SITE SEWERS FIN[.', WELLS AS SET FORTH B"r: THE HUNICIPFILIT¥ OF ANCHORFIGE. 2: I WILL INSTRL. L THE F';"r'STEH IN ACCORDANCE WITH THE CODES. '2:: I UNDERSTAND THAT 'THE; ON-SITE SEWER S"r'STEr"I MA'-r' REL::!UIRE ENLFIRGEMENT IF THE RESIDENCE IS REFIO[:'EL. ED TO INCLUDE MORE THAN -": BEDRO01"IS. S I GNE[:, ' ~ % 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 GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent ~; ~1 Address Day phone Day phone Day phone = Unless otherwise requested, HAA will be held'for pickup. 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA#21 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 ~ J,,~o.~ ,~ ~,v .¢ ~/~ L,~ ~ ¢..{' "~. ~/. Address ~ ~ /~ ~ ~ ~ Engineer's signature ' ~ ~ Phone 6. DHHS SIGNATURE Date Approved for bedrooms. Disapproved. Conditional approval for '~' bedrooms, with the following stipulations: Money shall be put in escrow in the amount of 1.5 times the high bid from a minimum of three (3) bids to construct the wastewater disposal system pursuant to permit number SW990047 attached. The system, shall be constructed later than June 15, 1999. Money in escrow shall not be released until this Additional Comments Date 4-/- ~'~' -The MUniciPality of Anchorage Department of Health Juman Services (DHHS) issues Health Authority Approval certificates based only upon the represer;a'. ,.:~ given in p[,ragraph 5 above by an independent professional engineer i'egistered in the State of Alaska -Th~ f:",H HS does this asa courtesy to purchasers of homes an d their lending institutions in order to satisfy certain feueral 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 engir~eer's work. 72-025 (Rev, 1/91) Back MOA~21 Municipality of Anchorage R E C E I V E DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MAR 18 1999 (907 343-4744 825 L Street, Room 502 · Anchorage, Alaska 99501 ° 7~N~aPAUT¥ OF ANCHORAGE ENVIRONMENTAl. SERVICES DIVISION Health Authority Approval Checklist Legal Description: L~-~ ~ ~ t4 ~ /5~ L.~I ~ ~ 'd~,ou D.5 Parcel I.D.: A. WELL DATA Well type IfA, B, orC, attach ADEC letter. ADEC water system number ~--I Log present (Y/N) Date completed Total depth Cased to Casing height (above ground) Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed g ,--1'7- g ~ Tank size Foundation cleanout (Y/N) Date of Pumping I~//A C. ABSORPTION FIELD DATA Date installed ~"-/ Length ~',~. Width Effective absorption area / '~ -/ Soil rating (g.p.d./ft ~-- ~-' Gravel thickness below pipe l o-~c~ Number of Compartments ,,~ Cleanouts (Y/N) . Depression (Y/N) /~ High water alarm (Y/N) Pumper '~"~ System type /'~-c:~// Monitoring Tube present (Y/N) "// Date of adequacy test t o/~/~ ~ Results (Pass/Fail) Fluid depth in absorption field before test (in.); ~Y~- ~, ~ Total depth J~ / '/' · Depression over field (Y/N) I~-) For _~_ J'3/f T'''''~ bedrooms Immediately after l~ gal. water added (in.): Fluid depth (ins) Minutes later: Absorption rate = .g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Septic/holding tank on lot Absorption field on lot Public sewer main ,,Pump~e~all°ns /" *Datum On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM WELL ON LOT TO: Sewer/septic service line j SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~ I Property line (~) ~ Absorption field Water main/service line Surface water/drainage "Pump off" level at* ! Wells on adjacent lots ~',l//,~, SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain Building foundation .'22 ~ Water main/service line '> ~-..~ ! Driveway, parking/vehicle storage area ~. ~ C> Wells,on adjacent lots {"J/,'~ F. ENGINEER'S CERTIFICATION · I certify that I have determined thru field inspections and review of Municipal in conformance with MOA H~ gUidelines in effect on this date, -- Signature Date HAA Fee $ ,~Z.,(..')©~ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number 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 Parc.~ ,.D. # 0 ~6 '-~ ,~% .~q 1. GENERAL INFORMATION Complete legal description A,L'P~f4 E Location (site address or directions) Property owner . ;~' c~ 144 ~ ~, W¢ Mailing address Lending agency Mailin. g address. Day phone Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 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. NameofFirm lc~J~J~'~,~ ~t~',.-[~ ~' ~ Phone ~7~-~ ~ Address ~ ~ /~-~ ~ ~ '~ EngineeC, signature ~ ~~~ Date. ~/~ '~/9 ~ DHHS SIGNATURE ~ Approved for Disapproved. FO U/:~ bedrooms. Conditional approval for T /--/ I U/,/ ¢ bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of 'Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Legal Description: Municipality of Anchorage R E C E IV E D DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division JUN 2 2 1999 825 L Street, Room 502 · Anchorage, Alaska 99501 · (!~u7n~c,~rt~7o~t'~,~cnorage Dept. Health & Human Services Health Autherity Approval Checklist LOT q; A. WELL DATA ~, Well type If A, B, or C, attachADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth Cased to Casing height (above ground) Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m, g.p.m. WATER SAMPLE RESULTS: Coliform Date of. sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Foundation cleanout (Y/N) Date of Pumping ~_~_~~ Tank size .~tP-Ch Number of Compartments ~ Cleanouts (Y/N) . · ~M ~' O'e'~ression (Y/N) ~-~ High water alarm (Y/N) ~ Pumper J -/ C. ABSORPTION FIELD DATA Date installed ~' /'Tlq Length b5'~' Width Effective absorption area Date of adequacy test Soil rating (g.p.d./fff or fWbdrm) O, ~ I Gravel thickness below pipe ~ I Monitoring Tube present (Y/N),.__~__ Depression over field (Y/N) ~ Results (Pass/Fail) t,~ For ~ Fluid depth in absorption field before test (in.); Fluid depth '"'" (ins) Minutes later:. Peroxide treatment (past 12 months) (Y/N) Immediately after System type Total depth ~al. water added (in.): Absorption rate = ~ q.p.d. 72-026 (Rev. 3/96)* ~ If yes, give date bedrooms LIFT STATION Date installed ~ize in gallons Manhole/Access (Y/N) ~"~mp on" level at* High water alarm level at* ~,,,"' *Datum Cycles tested E. SEPARATION DISTANCES "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO:,,,/ Septic/holding tank on Ici ~~''~ On adjacent lots Absorption field on lot ~ On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic servic~e Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~....~ Water main/service line Property line ¢:~ O Surface water/drainage Absorption field Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~. E;) -I- Building foundation ~,~ Water main/service line Surface water )~ ~1~ Driveway, parkin~ehicle storage area Cu~ain drain ~ ) ~ Wells on adjacent lots ENGINEER'S CERTIFICATION , .~. : .-, ~ -. I ce~ that I have dete~ined th~ field inspections and review of Municipal re~s-'~a~' ~bove .sys~ms are in confo~ance with MOA H~ guidelines in effect on this date. Engineer's Name ~ ~ ~ b o ~ ~ [A ~ ~ ~ ~ Date HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Department of Health and Social Services 825 L Street Anchorage, Alaska 99501 Subject: Conditional HAA Alpine Woods Block 5, Lot 9 PID 015-234-39 June 22, 1999 RECEIVED JUN 2 2 Municipality ct Anchorag, o Dept. Health & Human Serwces Gentlemen; The septic system has been upgraded on this property in accordance with the attached As Built. Please issue an unconditional HAA. Yours 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 GENERAL INFORMATION Complete legal description ~-~--~ Location (site address or directions) - . ~-- ~ ~ ~roper[y owRer ~ ¢- Mailing address ~/~ ~~; Lending agency ~'.~ ,~ ~ ~~~ ~ ~ Day phone Mailing address Agent Day phone Address = Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply 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 DHHS SIGNATURE ~ Approved for . _/'~._.,,.~-~//~1~.~ bedrooms. Phone Date ~/~-~/q~-- Disapproved. Conditional approval for bedrooms, with the following stipulations: By: 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. 72~25 {Rev. 1/91) Back MOA #21 Legal Description: Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST QI~- A[~ivl-~_ ~,~OJ_..~, Parcel I.D. A. WELL DATA Well type A If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well flow Pump level g.p.m. MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION Z 1992 g.p.m. RECEIVED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot ; On adjacent lots ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~//7/~'~ Tank size Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Compartments Foundation cleanout (Y/N) ]%~ ~ ~ Depression (Y/N) Alarm tested (Y/N) -- Pumper Well(s) on lot 1~////~' To property line ~> / O Surface water/drainage SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: On adjacent lots Absorption field Foundation Water main/service line 72-026 (Rev, 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION /'"/',//~ Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed ~/'~r~/8 ~ Length ~,2.. Width ~"-~ Total absorption area / Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating Gravel thickness Cleanouts present (Y/N) Date of adequacy test for System type Total depth If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I'//',~N On adjacent lots 7"/,/',,'N, Property line ~ I ~.~ To building foundation 3 ~ To existing or abandoned system on lot f¥,/,,~ On adjacent lots ~ Z-. ~ Cutbank ~ ~/E) Water main/service line ~' ~-,-~ Surface water t"//O Driveway, parking/vehicle storage area ~> ,~ ~ Curtain drain t'Y'/1~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature ~ Engineer's Name Date '~/,~- ...%/~ HAA Fee $ // Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number SENT BY:ADEC ANCHORAGE ; 3-23-92 ; 2:52PM ;ANCHORAGE/WESTERN D0~ 2485095;~ 2 DEPT. OF ENVIRONMENTAL CONSER%"ATION WALTER J, HICKEL, GOVERNOR ANCHORAGE DiSTRiCT OFFICE 800 E. DIMOND BLVD,, SUITE 3-.,4-'0 ANCHORAGE, ALASKA. 99503 (907) 349-7755 My review of the records or1 file in this office revee!$ that the Alr}ir;a Woc~d~ S~?, :ii,.., ~don. Class "A" Public Water System, i$ in corrllatiance with the rOLtir~e coliform b~oteri~ sampling requirements listed in Table C, end with the inor;;:ar~i.c, s~mpiir~g reqL¢iroments listed ir'~ T~i::i,:; ~.:~ of !8 AAC 80,200 Byroi~ Roys E;~vlronrnental Engir}eering Assistafqt BR/cf MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Location (address or directions) ow.er-- Mailing Address ~/O~ Telephone · (home) Business (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check herf~, if hold for pick up.) List contact person and day phone number below: TYPE OF RESIDENCE Single-Family/~ Number of bedrooms WATER SUPPLY Individual Well [] Communitv~ Public Note: If community well sYstem, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. SEWAGE DISPOSAL On-site/~¢-- Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 leUO!l!puoo leAoJdd¥ leuo!~,!puo0 J.o swJ~/ pe^oJddes!c] pe^o.~ddv ~q swooJpeq~Jot peAoJdd¥ 'IVAOI:IddV SHHCI '9 · uoiloedsu! si41 ~o a~ep a41 uo loeJ~e u! suo!lelnB@J pue 'saoueu!p~o 'sepoo elelS puc lediolUnlAI lie q~pA eoueildwoo u! s! LUelS~S lesodsip Jele~Ae~seA~ Jo/pue Xlddns ~a~e~ elis-uo eql 'uoRoedsu! pue uoileBilse^u! /~LU LUOJJ pue Sel!J eSeJoqou¥ jo /~Iledio!unlAI eq~ LUO~t peule~qo uoilewJo¢u! aq~ uo peseq leql ~J!Je^ jeqlJnj I 'u!eJ@q P@leoipu! eJnlonJls jo edXl pue SLUOOJpeq JO j@qwnu eql ~o~ @lenbepe puc I~UO!~ount 'ejes s! LuelsXS lesods!p ~@leA~else~ ~o/pue Xlddns Jele~ el!s-uo eql ~eql s~Aoqs le^o~dd¥ ,~poqln¥ qlleeH siql ¢o uop, e6ilse^u!/~LU ~eql ~¢ye^ I '~Aoleq uA~oqs e~ep uoReP!le^ eql ~o se pue oleJeq pexyje lees ~LU/~q peiJil~eo s¥ NOI~.¥1NI:IO_-INI ONe' ~.L~ 'FIOI=I~I$ t'll.-I '$.L$~i.L 'SNOItO~idSNI 9Nl(31^Ol:ld INI=il.-I 9NII:I~INIIDN~i 'S ~ MUNICIPALITY OF ANCHORAGE (MOA) MUNiCJp~,~,/~NCHORAGIElealth Authority Approval (HAA) ENVJRONM~iCEs DlVls~ECKLIST - FEBRUARY 1984 A. WELL DATA J U L 1 2 1990 RECEIVED Well Classification Well Log Present (Y/N) __ Total Depth "----- Cased to __ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~ ZO~ / To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results 343-4744 Legal Description: Date Completed -'-'-- Depth of Grouting ICB, C, D.E:C. Approvedl~N) Yield Pump Set At '---- Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots .~ ~--o 0 ~' ; On Adjoining Lots r., ~ To Nearest Public Sewer Cleanout/Manhole ~¢/f"~ ; Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~"//?/~"~ Size Standpipes ~) Depression over Tank (Y~.,~ V Pumping/Maintenance Contact on File (Y/N) ~/~ ;for ~~ ~~~~~~ ~~~~' i''~r' ~IC/H ~G ~~~~~ ~~~YF~ ~ ~~~~ ~~ P~r~ '~ ~~:nk To Property Line ~ ~ To Disposal Field To Water Main/~rvic~ffe'~ ~ ~ ~ To Stream P~a~ or Uajo¢~ge Course ~ / ¢ ¢ / O~D No. of Compartments ~-' Air-tight Caps~N) Foundation Cleanout (Y~j) Date Last Pumped ~///~/PO 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed _~//~/~ .,3 Width of Field Square Feet of Absortion Area Depression over Field (Y~) Results of Last Adequacy Test Type of System Design Length of Field Depth of Field ~7/' · Gravel Bed Thickness Statndpipes Present ~N) Date of Last Adequacy Test ~,-..¢'~o SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot /~/'/,,¢- To Water Main/Service Line / ?/4'-/~ o To Property Line /g) ~-/- To Existing or Abandoned System on ; On Adjoining Lots ~ ~-o / ,,~,/,,,~ To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for ~ Meets MOA EJect'~a~ Codes (Y/N) Comments 7~-,~¢ /~' ~ ~ r,,~ol~ ~y)u~,-p Dimensions ~  _.,--~ump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelL~P..%/Q effect on the date of this inspection. ~., / · Company -- ~~ mer's Receipt No. L'~ Receipt No. Date of Payment '~ -- f ~- ~0 Waiver Fee: $ Amount: $ I ~'~ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 STEVE COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 563-6775 For: Lee Reed DATE: June 28, 1990 PWSID: 213598 According to the records on file in this office, the Alpine Woods S/D water system is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, Richard Sundet Environmental Field officer cc Vera Craig MUNICIPALITY OF ANCHORAGE DMSION OF ~Wv-i~AL HEALTH 1o General InfGrmation Application Date (a) Legal D~sc~iption (include lot, block, subdivision, section, township, range) Location (add,ess o~ directions) (b) Applicants Na~ 3 ] m~ .~' ~.~- ~ ' Applicants Add~oss ~ ! OO ~ I F' ~ '~' ~ ,3o (c) Applicant is (check one Lending Institution ~; Owner/builder ~; Buyer ~--~; Of. he= ,~--~)(explain); Address ~ O / [.4.) 5-'r ~ (e) Real Estate Co. & AGent . ~ /~ Telephone ~ ~ s- ! 4:3 ~ H, Address Te le phone 2. Type of Residence Single-Family ~ Number of Bed~ocms 3. Water Supply Individual Well [~ Multi-Family Other (dearie) Community ~ Public Note: If czm~unity well system, must have w~itten confirmation f~cm 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 4. _Sewage Disposal_ Onsite ~ Public ~-~ ~nity ~-~ Holding Tank ~-~ Is the wastewater disposal system adequate fc~ the rnmbe~ of bedrooms (Y/N) y [Page 1 of 2] 2-15-84 5. En~ineerin~_Fi~(l_ .. Providing Inspections ~ ........ Tests , Data and Information I certify that I have checked, verified, or ooDforn~d to all MOA HAA Guidelines in effect on t~ dat~ o.~ this inspection. ~'~,'-/~l"y ~'K~ ,,~.l"o~,~..~,~.~f] Na~ of Fi~m_ t,J /4a v~ '~" ~ o ~ ~ .... Telephone 6. DHEP A~roval Approve d for Approved ~ (ENGINEER SEAL) Disapproved ~ Conditional Terms of Conditional Approval %he Municipality of Anc~o~age Department of Health and Environmental P~otection does not guarantee the continued satisfactory perfc~manoe of the water supply and/or the wastewate~ disposal system. This approval indicates tJaat, as of t3~e validation date shown above, based on tb~ data and information furnished by an engineer ~gistered in the State of Alaska, tJ~e water supply and wastewater disposal system is safe and func- tional for t.he numbe~ of bedrooT~ and type of structure indicated. (D~EP SEm~) KB2/d5/s 7. Mail the HAA to the following add~ess: / [Page 2 of 2] 2-15-84 As MUNICIPALITY OF ANCHORAGE (MOA) HEALT~ armO~TY APP~AL (H AA) CHECKLIST - FEBRUARY 1984 Legal Description: Well Classification Well (Y/m Total Depth A///] Cased to ! Static Water ~evei ~/~ 03A!3S)3 G~/c~und Casing Height Above ///,~ , , Elect=ical Wiring in Conduit ,{~/N)' ' /~./~ Sepa=ation Distancss f~cm Wall: To Septic/Holding Tank on Lot To Nea=est Edge of Abso=ption Field on Lot~' To Nearest Public Sewer Line .,?~ C leancut/Manhole /9' Water Sample Collected By Wate~ Sample Test Results Ccam~nts .. ~anita~y Seal on Casing (Y/N~///~; Depression A=OUnd Wellhead (y/N~.4/~ Adjoining Lots ; ~ On AdjOining Lots To Nearest Public Sewer To Nea=est Se~r Service Line on Lot ~'~- ~I/~ B. S,EPTIC/HOLDING TANK DATA To Water-Supply Well ~69z9 To P~operty Line ~ To Water Main/Service Line Date Installed F-/7 - ~ Size ,/69~9~,, ?~ NO. cf Ccmpa=tments Statics (Y~) ~ Aid-tight ~ps (Y~)~/~$ F~n~tion Clean~t ~ession o~ Ta~ (Y~)~ ~te ~st P~d ~ P~ing~inte~n. ~n~a~ ~ File (Y~)~; f~ Holding Ta~ High'ate= ~a~ (Y~)~/~ ~=a~ Holdi~ Tank ~t (Y~) ~p~ation Distan~s ~ ~ptic~olding Ta~: / ~ TO ~ildi~ F~ndati~ ~ To Dis~al Field , ,, /~ ~~ ~ ....... [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ ~/7 ' ~3 Width of Field ~- / Square Feet of Absorption A~ea /3o0 ± of System Design Length of Field .... ~-~./ . Depth of Field . ~, 5-- ' . Gravel. Bed Thickness _~ ).. ~/ Standpipes P~esent .(.Y/N) Depression over Field (Y/N) ./~/~... . Date of Last Adequacy Test Results of Last Adequacy Test ,4//~ Separation Distanoe f~cm Absc~ptio~/ Field: To Water-Supply W~ll ~' ~ To P~operty Line ./d~' ~ To Building Foundation ~' To Existing or Abandoned System cn , / To Water MairJService Line /~-~ ~ Cutbark ( if p~esent) To To Stream/Pond/Lake/or Majo~ D~ainage Course ~///~ To D~iveway, Parking A~ea, or Vehicle Storage A~ea ~.5 Cc~ents Date Installed ~D~ nsions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Manhole/Access (Y/N) "Pump Off" Level at Vent (Y,4~) .... Pumping Cycles du~ing Adequacy Test. ~ets MDA Comments on the da ** Check Permitted Bed~ocm Rating Against HAA Request certify that I have checked, verified, c~ conforn~d to all MOA HAA Guidelines in effect [Pa~ 2 of 2] 2-15-84 BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: SOUTHCENTRAL REGIONAL OFF ICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 274-2533 DATE: ~ - PWS I.D. # ~,,I To Whom It May Concern: According to Cecords on fi, le in this office the G]~]c~-~ '~~ Water System is in compliance with~the State Drinking Water Regulations. Sincerely, June 17,1983 DISTRICT RECORDER'S OFFICE 941 WEST FOURTH AVE ANCHORAGE, ~LASKA 99502 ~IUNICIPALITY OF ANCHORAGE POUCH 6-650- ANCHOP~GE, ALASKA 99502 ATTENTI©N: PLANNI~G DEPARTMENT ACCOUNT NO. 1543-3E04 FILING OF PLATS strawberry Meadows Subd., Lots 1A-lB ~_~ thru 9A-9B, Blk 4 & tracts F1 & F2 FILE NO. S-6668 Huffman Hills North Add. #2 Blk 1, Lots 1-30; Blk 2, Lots 1-26; Blk 4, Lot 1; and Tract A,B,&c S-6622 ~._~',~Dale Briggs Subd., Lots 1A-i,IA-2,1A-3 S-6759 & 1A-4,Blk 2 GRID NO. 2228 2833 NW 152 ~4OUNT 10.00 10.00 10.00 Alpine Woods Subd., Lots 1-6,Blkl; 1-6,Blk4; Lots 1-10, Blk 5; Lots 1-11 Blk 6; & tracts A,B,C,&D S-6420 3183 10.00 P.O. No. 10S14 W.O. No. 01-65-020