Loading...
HomeMy WebLinkAboutAUDUBON HILLS #1 BLK 3 LT 5Audubon Hills #1 Block 3 Lot 5 #015-231-72 Municipality of Anchorage - ® .� Development Services Department Building Safety Division — �• On -Site Water 8 Wastewater Program, 4700 Bragaw St. -~ P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO90113 PID Number. 015-231-72 Name: DAN AND BIRGITTA TULIP Wastewater System: O New ■ Upgrade Address: 6746 DOWNY FINCH * ANCHORAGE, AK ABSORPTION FIELD Phone: No. of Bedrooms: (907) 562-2944 4 O Deep Trench D Shallow Trench N Bed D Mound pother LEGAL DESCRIPTION $od Rcd g: 3.0 Total Depth from orVriol grvde: SEE DWG. OM,sa. Ft FL Block: Lot: Subdivision: Depth to plPe bottom from orlgtnd grade: Gravel depth bwmcth pipe: 3 5 AUDUBON HILLS #1 SEE DWG. rL 0.50 n Township: Range: Section: ra added oboe originot Voo.: Grawel Wvth: ` — — SEE DWG. FL 30 WELL: 0 New p Upgrade GrwN width: 10 Number of Mea: 2 obtonp between Mea: 5 FL Ft Close•fkabon Nate. A.B.0 : Total Cooed To:cecDftocx) Total of �^ area: pipe male": 300 D 3034/ F-810/SCH 40 R F. DrlWr, Dote DrW d: Stock Water Levet hwtofier: BEEK CONSTRUCTION Dole Mrtolted: 10/9-10/09 Ft. rea: pt.np Set AL Caere H qht Above Gro -r TANK (DEEP BURIAL) Gp„ M FL SEPARATION DISTANCES Oseptic DHolding aS.T.E.P. ®Other• To Z Septic Absorption LNt Holding bric/Prtvate 4orwfocLxer GREER Gopapty N palwe. 1500 from Tank Field Station Tank sewer tkwa Well 100'+ ••ss'+ 100'+ — 25'+ wt.rla: STEEL Numbw of compartrr,.,,t. 2 Surface Water 100'+ 100'+ 100'+ — — LIFT STATION lot Line 5'+ 10'+ 5'+ — — Stte In "lone: 1500 Wonufocturer: 1 QUANICS GREER Foundation 5'+ 10'+ 5'+ — — Oa &veil at unp off &vd at: H gh water dorm ot: TIMER TIMER 44" Curtain Drain NONE KNOWN wmp uaFs a Nod.l P—TE-30—PLUS t k Elecrp•ctions pertom»d bre M.O.A. Remarks: *THIS IS AN QUANICS AEROCELL UNIT BENCH MARK Laaat;,arr and o..a.ipban: **WR 090038 FRONT DOOR THRESHOLD OLD TANK AND DRAINFIELDS WERE ABANDONED PER UPC. Aeeu<n.o Elovataa. 100.00 Inspections performed by: GEG Ltd. Dates: 1st _ 10/8/2009 EHGlHEER'S AL 400 2nd 10/9/2009 4 �F q� D 3rd 10/9/2009 Services Department Approval p�p Development p....... ........ Conditional approval: Date: 4� :j. A. E-79 3 e p p C9�Qr. to izZ�O�'••r�`p�Q n A� �u04dp�ofesslo�°` �� Reviewed by: �� 6�� Date- I I 1 and approved (Rev. 4/06) dQ Q4pQQ�dd� t � rY) cl� CH T 40 0` CAT ZL qqanics GARNESS ENGRNEERING GROUP, Lid AeroCell _ — ENGINEERING - SALES CONSULTING =- - Alaska Authorized Dealer January 24, 2020 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 Ref: Audubon Hills S/D #1; Block 3, Lot 5 (3746 Downey Finch Drive, Anchorage, AI) Memo concerning converting CAT III AWWTS to CAT II AWWTS septic system To whom it may concern: The permitted septic system was installed on the referenced property on 10/8-9/2009 and started up shortly after the installation. ARM Septic Services, LLC has checked the monitoring tubes in the drainfield in July of 2019 and found them to be dry. In order to simplify the operation and maintenance of the system, we are proposing that this unit be permanently configured as a CAT II system. Our justifications are as follows: The receiving soil has a percolation rate of 10 minutes per inch. Given this percolation rate, a 3.0 gpd/sq.ft. application rate is required for a Cat II system. The residence has 4 bedrooms, so 300 sq./ft. of absorption area is required for CAT II effluent (600 gpd / 3.0). The existing 2009 drainfield has 300 sq./ft. of absorption area. The approved On-site Wastewater Inspection Report stamped and signed on 9/9/2008 already shows the soil rating to be 3.0 gpd/sq.ft., so it does not need to be amended. At this time, we request that your department approve a CAT II configuration to be used at the referenced property. Upon your concurrence, we will have ARM Septic Service, LLC., go to the property relevel the Jandy valve basin, remove the actuator from the ball valve, leave the valve in the opera position, and have them place a CAT II sticker on the control panel. P. E., M.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179' Fax: (907) 338-3246 * Website: www.garnessengineering.com Jody Maus From: ARM Septic Services LLC <armservicesak@outlook.com> Sent: Monday, August 19, 2019 10:54 AM To: Jeff Garness Cc: Jody Maus Subject: 6746 Downey Finch Dr (CAT II Conversion) Happy Monday GEG, I'm checking if the Quanics unit located on 6746 Downey Finch Drive (Audubon Hills #1; Block 3, Lot 5) qualifies for CAT III to CAT II conversion. The drainfield was dry on 7/25/19 and the homeowner (Birgitta Tulip) approved CAT II conversion on 8/19/19. Let me know if there's anything else I can do to help. Thanks! Landon Bruce Septic Technician/Consultant ARM Septic Services, LLC Ph: (907) 688-9433 Cell: (907) 230-2383 Email: ARMServicesAK(@outlook.com Website: www.ARMServicesAK.com Facebook: www.facebook.com/ARMServicesAK/ PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SWO90113 015-231-72 RESERVED SITE NEW 1500- GALLON 500GALLON \STEP TANK / EXISTING 4 BEDROOM HOUSE 001 DOWN), N), Fl Ncy tAN E RDCELL `NEW 30' X 10' UNIT BED '•�• a,. Ewa ilii .\L, GARNESS ENGINEERING GROUP, Ltd. p; 9 CONSULTANTS 6 GENERAL CONTRACTORS '••••••• ••• • ani L e ■ IA w 101 • wt:wr�s. r� »eor • na[ 007)W- '" • rM fb -uw . °ovm .••.w•�rt+•M�. PREPARED FOR: PHONE NUMBER: PACE NUMBER: •• • DAN do BIRGITTA TULIP 562-2944 2 OF 3 OQ v ' .Je e LEGAL DESCRIPTION: DRAWN PNB oV . • • J.I� AUDUBON HILLS ;y1. LOT 5. BLOCK 3 TYPE OF WORK: AS—BUILT DRAWING 10/22/09 (R. O1N5) A 1 6 ST1 66.05 128.75 MH 66.72 36.01 C01 55.06 40.28 MT1 51.14 38.19 MT2 63.18 66.02 CO2 61.94 65.76 CO3 56.97 163.98 JV 53.84 42.58 POD 1 54.37 47.46 POD 2 54.60 49.63 Ewa ilii .\L, GARNESS ENGINEERING GROUP, Ltd. p; 9 CONSULTANTS 6 GENERAL CONTRACTORS '••••••• ••• • ani L e ■ IA w 101 • wt:wr�s. r� »eor • na[ 007)W- '" • rM fb -uw . °ovm .••.w•�rt+•M�. PREPARED FOR: PHONE NUMBER: PACE NUMBER: •• • DAN do BIRGITTA TULIP 562-2944 2 OF 3 OQ v ' .Je e LEGAL DESCRIPTION: DRAWN PNB oV . • • J.I� AUDUBON HILLS ;y1. LOT 5. BLOCK 3 TYPE OF WORK: AS—BUILT DRAWING 10/22/09 (R. O1N5) fet 20 2009 8:45nM ■M■ ■ ■� October 20, 2009 HP LnSERJET FRXG 907 -G22 -G777 Rising son -E—lectric, Inc. /A � 14916 \\//oodland rive f j `ogle River, AK 99577 1.; (907) 622.6777 Gamess Englneering Group Jeff Gamess 3701 E. Tudor Road, Suite #101 Anchorage, AK 99507 Re: Lot 5 Block 3 Audubon Hills #1 - 6746 Downey Finch Dr. - Anchorage, AK Dear Jeff: pace 1 The lift station at the above referenced property has been wired in accordance with NEC and State/Local codes. Thank you. Sincerely, Kevi� Hombuckle, owner Administrator License Number 1284 Specialty Contractor License Number 27285 cc: file MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 15, 2009 Expiration Date: Jul 15, 2010 Permit Number: SWO90113 Parcel ID: 015-231-72 Legal Description: AUDUBON HILLS #1 BLK 3 LT 5 Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 006746 WAXWING CIR Owner Name: DAN & BIRGITTA TULIP Lot Size: 0 SO. FT. Owner Address: 6746 DOWNEY FINCH Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516-0000 This permit is for the construction of: Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. A. Permit includes waiver WRO90038 allowing an 85' replacement drainfield to well separation distance. Received Issued By: Date: y /� B ,% 2 Date: t Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program menr e Department **** VARIANCE/WAIVER REVIEW **** WR#: 090038 HA#:_ Permit#:SW090113 PID#: 015-231.72 Legal Description: Audubon Hills #1. Block 3. Lot 5 Engineer. GEG Applicant: Dan & Birgitta Tulip Your request for a waiver of the required 100 feet horizontal separation from the replacement absorption field to the private well has been approved. The approved separation distance is 85 feet. This waiver approval applies to the replacement absorption field to private well separation only. Any future upgade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Ones..6.660 .... 266.6060..666, Waiver is Granted: X Waiver Is not Gran Date: 7/15/2009 Approved b l Name o R viewer ............................................ ...mass.......................... Rec#: 995247 Amount: 1050 Date Paid: 7/9/09 **** VARIANCE/WAIVER REVIEW **** Municipality of Anchorage •°, l Development Services Department Building Safety Division �— On -Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cf.enchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D.y�7 _ �`� I— ?�2 Property owner(s) DAN & BIRGITTA TULIP Day phone 562-2944 Mailing address 6746 DOWN FINQN LANE * A CHORAGF. AK Site address Zip Code 99516 Legal description (Sub'd, Block & Lot) AUDUBON HILLS fl. BLOCK 3. LOT 5 Legal description (Township, Section & Range) Lot Size Sq.Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 4 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (GignSluffl of property owner of aullieFized agent) Permit/Rush Fees: A $ Date of Payment: 20 1 G Receipt Number. (Rev. 11/03) Waiver Fees: GSo• c d Date of Payment: 7 7 Receipt Number. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS July 9, 2009 Municipality of Anchorage Development Service Department On -Site Water R. Wastewater Program 4700 Bragaw, Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ret: Proposed Septic System Upgrade for Audubon Hills H1; Lot 5, Block 3, To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be upgraded. We arc proposing to install a 1500 gallon S.T.E.P. tank with Quanics controls/floats, a 650 Aerocell unit, and a bed type drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography within 50 feet of the proposed septic system is relatively flat. 5. WELL WAIVER REQUEST: We are requesting an 85 foot waiver from the proposed reserve drainfield site to the existing well on property. Mitigating factors for the waiver is summarized as follows: • We are proposing to use a MOA category 111 Nitrogen reducing Quanics Aerocell unit that will produce an effluent meeting State of Alaska DEC secondary standards in regards to BOD/TSS. Consequently, if effluent were to daylight, there is less potential for environmental impact. • The system is an advanced treatment system which requires regular maintenance inspections and is monitored 24/7. • The proposed drainfield is in a prominent location; therefore daylighting effluent would be immediately noticed. • Attached is the well log for the referenced property. The well depth is 78 feet. Also attached are four well logs from adjacent properties. The soil above the bedrock appears to be confining layers of silt, clay and clay/gravel mixtures. Bedrock was encountered at a similar depth in all of the surrounding wells (70-80 feet below grade). • The topography of the lot is such, that if the tank were to overflow, the effluent would travel down the slopes in the complete opposite direction of the well head. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamesscngineering.com Recent water samples results indicated no bacteria and nitrate levels to be present. In short, the water quality is within MOA, state, and EPA requirements. Based upon the aforementioned facts, it appears that there is minimal risk associated with granting the requested 85 foot waiver between the existing well and the proposed reserve drainfield site. We are unaware laity adverse impacts this installation would have on adjacent wells or septic systems. If you have any q esti ns, please contact us at 337-6179. Thank you for your assistance. M.S. NOk. Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for this septic system. (Contact G. E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road. Suite 101 *Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamessengineering.com / / / 1 AUDUBON BLOCK 1, IOWW FINCH LAN -------- LLI JI i UI / 1 / Z !inn' WEI I RADIUS/ �::I I xl 1 Q AVDUBON HILLS? \\\BUl3. LOT 6 I SEPTIC I I I/ 1/ / AUDUBON HILLS19 BLOCK 1, LOT 5 ARUC I 1 os&D — rl L- 1, AUDUB I, \I 1 ' BLOCK O1, LOT 4 I , � I , � 1 , I I, 1 I , / L I AUDUBON HILLS) BLOCK 3. LOT 7 7 AUDUBON HILLS: BLOCK 3. LOT 3 � Phi I \—SEPTIG i / I ARE r � / AUDUBON HILLS: BLOCK 3. LOT 4 / GARNESS ENGINEERING GROUP, Ltd. .. _......., .....—..,... CONSULTANTS 6 GENERAL CONTRACTORS �►���•��-•- Al C TA'Oe 00.0. PLIC 101. MLIMK.0 Nf Oe101 � AOI 00 1-11T � IM e0 J]H . O[091C ew. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DAN do BIRGITTA TULIP 562-2944 1 OF 4 LEGAL DESCRIPTION: DKAWN BY: AUDUBON HILLS #1: BLOCK 3, LOT 5 1 K.D.M. TYPE OF WORK: SITE PLAN 7 ®ffmrA�� (Rev.4(n>sl IQr 6 L) \ LETTER THAT PERTAINS TO THIS DESIGN. yLalvly aay.�,•i�. NOTE: THE CONTRACTOR SHALL HAVE TO OBTAIN A COPY OF THE LETTER NUMBER OF BEDROOMS: 4 THE NORTH LOT LINE, AND ALL WELL CONTACT CEG. BY PROCEEDING FORWARD GALLONS PER DAY (CPD): 600 WITH THIS INSTALLATION, THE ENGINEER, PERCOLATION RATE/S: 10 MIN./INCH ZADII FLAGGED BY A REGISTERED LAND WELL DRILLER. CONTRACTOR AND PROPOSED APPLICATION RATE: 3.0 SURVEYOR PRIOR TO CONSTRUCTION. PROPERTY OWNER AGREE THAT THEY MINIMUM DRAINFIELD SO.FT.: 200 HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND nn. ulrl rl n nrolnl.l. (J"2 Cal (ISDNG DRAINFIELDS \ TO BE COMPLETLY ABANDONED (92 74 K EC 1250 GALLON SEPTI / SEPTIC TANK IS TO BE COMPLETELY / ABANDONED PER UPC III I /I SIDE SLOPES ��\NYE/n/C 'ed �A^ Ic TERNATE SITE `�' ' V` I 1 1 INSTALL JANDY VALVE '•'� 1 INSTALL CLEANOUT AFTER JANDY VALVE ••q ,-' /}�` \ / ROPOSED 1500 GALLON i,•,•I.',.:•; S.T.E.P. TANK WITH OUANICS� • . <. \ CONTROLS/FLOATS 612 / :.4, • ;•i; • / / EXISTING • • , • ,• : a A• 4 BEDROOM .....�: / HOUSE •/ :.. " / GARNESS ENGINEERING GROUP, Ltd. -....-.....,....,._.-.......... CONSULTANTS R GENERAL CONTRACTORS ••"' .. "" ' '••""" IAl C T10011 VOID. !1!I[ 101 • M ICHOPML Mf (0041]0142" •X091[ •w.p•wriernbgm.. PREPARED FOR: IPHONE NUMBER: PAGE NUMBER: ^• ••• ••••••• •••••^•• DAN & BIRGITTA TULIP 562-2944 2 OF 40o e t rey amess: LEGAL DESCRIPTION: DRAWN BY: O . CE.1— ��9 3 ��' . �F< AUDUUBON HILLS #1. BLOCK 3. LOT 5 K.D.M. �4�e. ' ••.1(Ad TYPE OF WORK: DATE: 40QO4Op�oOoo`� PROPOSED SPETIC SYSTEM DESIGN UPGRADE 1 7/6/2009 (Pe .o1A5) MAXIMUM DEPTH: REMOVE ALL ORGANICS WIDTH: 10 FEET f LENGTH: 30 FEET M.OA. APPROVED SAND FILTER: 2.3 FEET IROPOSED EFFECTIVE: 0.50 FEET 10 % 30 REDUCTION FACTOR: N/A BED MOUND IS ACTUAL SOSTA 300 SIDE SLOPES ��\NYE/n/C 'ed �A^ Ic TERNATE SITE `�' ' V` I 1 1 INSTALL JANDY VALVE '•'� 1 INSTALL CLEANOUT AFTER JANDY VALVE ••q ,-' /}�` \ / ROPOSED 1500 GALLON i,•,•I.',.:•; S.T.E.P. TANK WITH OUANICS� • . <. \ CONTROLS/FLOATS 612 / :.4, • ;•i; • / / EXISTING • • , • ,• : a A• 4 BEDROOM .....�: / HOUSE •/ :.. " / GARNESS ENGINEERING GROUP, Ltd. -....-.....,....,._.-.......... CONSULTANTS R GENERAL CONTRACTORS ••"' .. "" ' '••""" IAl C T10011 VOID. !1!I[ 101 • M ICHOPML Mf (0041]0142" •X091[ •w.p•wriernbgm.. PREPARED FOR: IPHONE NUMBER: PAGE NUMBER: ^• ••• ••••••• •••••^•• DAN & BIRGITTA TULIP 562-2944 2 OF 40o e t rey amess: LEGAL DESCRIPTION: DRAWN BY: O . CE.1— ��9 3 ��' . �F< AUDUUBON HILLS #1. BLOCK 3. LOT 5 K.D.M. �4�e. ' ••.1(Ad TYPE OF WORK: DATE: 40QO4Op�oOoo`� PROPOSED SPETIC SYSTEM DESIGN UPGRADE 1 7/6/2009 (Pe .o1A5) PROPOSED DANDY VALVE PROPOSED 630 AEROCELL UNIT •-1 — — — — — — — — — — — — AR i 'UNE FROM r Qf I z' � S.T.E.P. CO CO CO 00 ' RECIRCULATION UNE I CO CO O --------4 O I NOTE: MOUND IS TO BE TOPSOILED AND HYDRO—SEEDED FINAL INSULATION —FILTER FABRIC CO ,APPROVED $AND FI GRADE GARNESS ENGINEERING GROUP, Ltd. p°�• .'.�* ,....._.—.•„,»�._.....�, CONSULTANTS & GENERAL CONTRACTORS •T�tl�^.. �'••” •' • ......•• JAI L T Mow. curt /01 . AMOOIUtf. nM n (OolllPl %" • F" No la " • M ' ....�s y.•rn a PREPARED FOR: PHONE NUMBER: PACE NUMBER: ............... DAN & BIRGITTA TULIP 562-2944 3 OF 4 Q p ey a33rness; LEGAL DESCRIPTION: DRAWN BY; Oa ° '° 10 AUDUBON HILLS #1• BLOCK 3, LOT 5 DATE: �Q O�O000���� TYPE OF WORK: 6 2 PROFILE DRAWING 7 009 0 0 U DATE READING _.qs��0 ENGINEERING GROUP, Ltd. �� °00 oo �••••.... '. GARNESS ...... ......,,......_...,..., m AMCI CONSULTANTS 3 GENERAL CONTRACTORS �+•-�•�+-»•��r^-+ l AN. /abF • A' !° )-l1Jl • FAIL W 3244 etB51fL ymw�wgwrYp.own ri foo • • • • • • • • • • • • • • • • • • •/I iVo1 J701 E ^JDpI aw. J 6' — SOIL LOG — PERCOLATION TEST A ............ LEGAL DESCRIPTION: 2:45 AUDUBON HILLS 1; BLOCK 3, LOT 5 •, f ey GO nesse a CE eQQ CE PERFORMED FOR: DAN k BIRGITTA TULIP DATE: 6/26/09 -79 •' -7 � •' ' e •, DEPTH 6' — ^Q�oQ ��°°d PFo lea si°^°oma (feet) 3:15 30 3" ORGANICS ITEST HOLE #1 3:15 1 ILII 6' — 6 3:45 SOIL CLASSIFICATIONS i ASEPTIC I 2GM GW __ _ ORG�J;GP ML 3 GM CL �d) 4 SM GC OLSW I MH 5 SP CH SM OH EXISTING 4 6 SC \ BEDROOM �r ` HOUSE i ,j • / 7DEPTH ML TO DATE GROUNDWATER 00• WELL RADIUS 8 SEEPS O 4' 6/26/09 I 1Y �pN t I f I 4' � g \� 10 B O.II. 11 12 13 14 15 16 17 18 PERCOLATION RATE 10 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 1.5 FT. AND 2.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: KYLE MAUS PERCOLATION TEST PERFORMED BY: ANDREW GRAY COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PER ORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING 7/6/2009 6 26 09 1 2:15 — DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 6 26 09 1 2:15 — 6' — 2 2:45 30 3' 3' 3 2:45 — 6' — 4 3:15 30 3' 3" 5 3:15 — 6' — 6 3:45 30 3" 3' ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND_Qan r 13ir0; i�A Tu�i�J THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this _VL Day of of 2009, by and betweenlpaA r Gf 0', 1 to Tu 1;P herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Or" n,*c 5 Ae/Oeel/located at AA du (A i l 5 :0-) ✓S 3 L 5 Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AW WTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AW WTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of ($ m .00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AW WTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWwTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Remnval of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such parry thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. 3urisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: By: Date: a / 1 « 1 n STATE OF ALASKA THIRD JUDICIAL DISTRICT MUNICIPALITY: By: Title: Date: ) ss. The forego�rlg instrumwas � v dged before me this day oC���L -, 20T3 . by }� , r VOTARY PUBLIC FOR ALASKA My Commission expires: :�2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION A 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 r( - Z -,k) r4 %? P /Z15 _--s. 3Ys5-- ArUPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS Well Absorption area Dwelling PERMIT NO. DISTANCE TO: �� v Y F z Manufacturer Material No. of compartments aQ wI.- y Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth 0 Y DISTANCE TO: Well Dwelling PERMIT NO. JUZ O z Q 2 F Manufacturer Material Liquid capacity in gallons D �= wV DISTANCE TO: Well / /� Foundation Nearest lot lie� PERMIT NO. !F3 No. of line Length of each line Total length of lines Trench width Distance between lines — w Z -- inches QTop of tile to finish grade / Material beneath tile 1% Total effective absorption area p C3 inches 603' Length Width Depth PER MIT NO. LU C7 Q F- Type of crib Crib diameter Crib depth Total effective absorption area as w N Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J LU 3: DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS Ph, th, 27dy SOIL TEST RATING / Zs - INSTALLER 7-C /f CO REMARKS % fly,, • Ic } r 4 APPROVED DATE LEGAL & el o � c 72-013 (Rev. 3/78) `-- MUNICIPALITY OF ANCHORAGE is \l DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR VVELL INSPECTION REPORT NAME �,�, PHONE E W ` JCcv►1F ✓1'11 ]'L `� - n?.�' y/i ❑ UPGRADE ----- -—— MAILING ADDRESS H u 3 LEGAL DESCRIPTION A3 4)s LOCATIO 4"') J/- �,�C L/L.) NO. OF BEDROOMS n DISTANCE TO: Well SCJ Absorption area Dwelling �� PERMIT O. U x n I Ci hManufacturer n S£� Materia,],, � L No. of compartments , f✓�- Liq. capacity in gallon ^U Inside length IF HOMEMADE: Width ��-- Liquid depth __---- Y DISTAN Well D elling PERMIT NO. J z 2 Z M facturer Material uid capacity in gallons M DISTANCE TO: Well �� Foundation v Nearest lot line aY PERM % O. 339 W ,f- LL No. of lines Length of eac line Total length of li es Trench�i h Distance between lines Z_ p e eek@ Q Top of tile to finish grade �. Material beneat ile Total effective absorption a O �5 0?- inches S Length Width .Depth PERMIT NO. 01 w c� -- Qa H Type of c ' Crib diameter Crib depth Total effective absorpti rea wa Uj En DISTANCE TO: Well Building fo dation Nearest lot line Class Depth Driller Distance to lot line PERMIT. NO. ,7 LU DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) O , OTHER PIPE MATERIALSZ2, SOIL TEST RATING 45 aL INSTALLER � A 4-1 �v/j REMARKS I i APPROVED DATE LEGAL 0 72-013 (Rev. 3/78) �����������"W" 11P 1=7 dol t%J C0 01 t3 F": fob tEv 1EE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 PERMIT NO: 85O483u ENGINEERED DESIGN ^ '^p// �/� �/ -'' - DATE ISSUED: 08/08/85 APPLICANT: ATC ENTERPRISES TOM LIPPS DBA ADDRESS: 12761 OLD SEWARD HWY ANCHORGAE, AK 99515 CONTACT PHONE: 345-4427 LEGAL DESCR[P: SUBDIVISION: AUDUBON HILLS 01 LOT: 5 BLOCK: 3 SECTION: 23 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 48104 (SQ.FT. OR ACRES) LOT LOCATlON:� DOWNEY FINCH LN I certify that: ^- 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances From any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED: (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK Mum BE DONE BY A LICENSED ELECTRICIAN. SIGNED L- DATE: _____________ _______________ APPLICANT: ATC ENTERPRISES TOM LIPPS DBA / ISSUED BY �L^/��~,`� /� .L��// DATE: \).��- �_ -- _____________________________________ _______________ JNICIPALITY OF ANCHORAGE?,, Department u- Health and Environmental _rotection 825 L Street, Anchorage, AK. 99501 !-'1 �• ���� �'�� 264-4720 HANDWRITTEN PERMIT # # # ►i c,�J��t�._,� WELL AND/- 49 ON-SITE SEWER PERMIT Applicant: �%�»l�'� i�/«%)Mailing Address: /qC 3 P71<((O-Sc Location: 'z r) C i -t Phone Number : l Legal Description: L- rJ 8 3 E��'1 Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: _ Soil Rating(sq.ft/br) /<s C` The Required Size of the Soil Absorption System Is: f�_LENGTH GRAVEL DEPTH = �� FT WIDTH DEPTH - 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 = ICC 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 1 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 remodeled to include more that 3 bedrooms. �? Issued by: Signed: ,Applicant Date: ( ;L SWP/024(1/81) ALASKA Ci01ROC1f nTAL COnTROL BRUINS, Inc. engineerinq & Enuironmental Studies MUNICIPALITY OF ANCHORAGE SPECIFICATIONS FOR ELEVATED BED ALTERNATIVE WASTEWATER TREATURTC&-DMHi& AUDOBON HILLS #1 BLOCK 3 LOT 5 ENVIRONMENTAL PROTECTION 1.0 GENERAL AUG 1� 1 1.1 THE DRAWINGS, SHEETS 1 THRU 4, SHALL BE PART OF THIS SPECIFICATION. RECEIVED' 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES. 1.3 ALL EXCAVATIONS AND DEPTHS ARE ADVISORY AND ARE TO BE VERIFIED IN THE FIELD BY THE CONTRACTOR. 2.0 SEEPAGE BED 2.1 THE GRAVEL FOR THE BED SHALL BE SCREENED TO THE SIZES INDICATED; 0.5 TO 2.5 INCHES. 2.2 THE BOTTOM OF THE EXCAVATION SHALL BE RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. 2.3 TWO OBSERVATION PIPES SHALL BE PLACED AS SHOWN IN THE DRAWINGS. THEY SHALL BE RIGID PVC, ASTM 3003 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 SECTION OF REGULAR PERFORATED SEWER PIPE 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. 2.4 INSULATION,IF ANY SHALL BE DOW EXTRUDED BLUE STYROFOAM BOARD OR EQUIVALENT. 2.5 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MIX OR BLUE GRASS. 2.6 THE SEPTIC TANK OF BED MUST NOT BE CLOSER THAN 100 FT. TO ANY EXISTING PRIVATE WELL OR BODY OF WATER AND SHALL BE NOT CLOSER THAN 150 FEET FROM EXISTING CLASS C WELLS OR 200 FT FROM ANY CLASS A OR B WELL. 2.7 THE DISTRIBUTION PIPE SHALL BE 4 INCH RIGID PVC OR POLYETHYLENE. THE PIPES SHALL BE LAID LEVEL. 2.9 THE SAND SHALL HAVE AN EFFECTIVE SIZE OF 0.4 TO 0.6 MM AND A UNIFORMITY COEFFICIENT OR NOT MORE THAN 4. 2.10 THE BERM AROUND THE SEEPAGE BED SHALL BE CONSTRUCTED OF IMPERMEABLE MATERIAL, AND ON A SLOPE OF 1 FOOT VERTICAL TO 3.0 FEET HORIZONAL. 3.0 INSPECTIONS 3.1 INSPECTIONS WILL BE REQUIRED = 1 OF THE EXCAVATION, AND A FINAL OF THE SEWER ROCKS/PIPES/INSULATION AND TANK IN PLACE. IF AECS DOES NOT PERFORM THE INSPECTIONS AECS WILL NOT BE RESPONSIBLE FOR THE BED. 1200 West 33rd Auenue, Suite B • AnAorage. Alaska 99503 • (907) 561-5040 (ENGI Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: T--,,?) 4. DATE PERFORMED: 7- �c \?" P LEGAL DESCRIPTION: 4.tJ. / a/ 4—, A41/S L.J i /� ) 3TownshiP' Range, Section:� � '; j / ziv A jC".: 7lE SLOPE SITE PLAN _ 1 N 2 4 �� `-12.�i1.-. /ova.; j -Z 1 �. •lc` 5 •- � i iS � ' 6 -1 as 12 Net Time Depth to Water Net Drop 71Z- t mss 13 14 `• ° L 15 L :=r f� rl5e� �ff en 16 'i cJ i 1 J -3L777 t 18 [me WAS GROUND WATER ENCOUNTERED? l`r� S IF YES, AT WHAT L DEPTH? O E Depth to Water After Monitoring? ' ` Date: Reading Date Gross Time Net Time Depth to Water Net Drop 71Z- t mss `• ° L .._. 'i cJ i 1 J -3L777 t 20 -{ I�JI PERCOLATION RATE If � (minu;es,inch) PERC HOLE DIAMETER r TEST RUN BETWEEN J FT AND —13, 2 ---PT COMMENTS - S." t` '6"77 L( /,4— Ci cz; PERFORMED BY, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFE' T ON THIS DATE DATE: /5��� 72-008 (Rev. 4.85) Q SOI LS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION IITEST Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �% �� r J� � � /% ?_��7 DATE PERFORMED: "" �� lzf LEGAL DESCRIPTION: (FEET) 1 / pp / 3 _ 4 5 -- 7 8 A 9 10 yY 11 12 13 14 15 16 17 18 19 WAS GROUND WATER S ENCOUNTERED? � • O P IF YES, AT WHAT E DEPTH? / Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE (minutes/inch) l / TEST RUN BETWEEN FT AND FT COMMENTS �� 1 ) -� f� •') � G � G`i i C� F,` r.?'. � TI�'� � G_ y: '.ice '�-- � - •^a PERFORMED BY: C i>�'� s'► C: ►`% J�"K -. CERTIFIED BY:Aj'1!`qf, '� "�� '`-� DATE: 72-008 (7/76) Coll ALASKA ENVIRON`"ENTAL CONTROL SERVIG_ ,, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907)561 .5040 AE lori w kie RmlE65. fin_ ^."o' M. Ciel. 6.3 JOB L S SHEET NO. — OF CALCULATED BY A &�J DATE CHECKED BY DATE — — SCALE , : 3C% D A,fTro�/ 14 � 7t d- ri I JOB-- Iiva'ob�il M�(�' +f ( 1- 5- ALASKA ALASKA ENVIRONMENTAL SHEET NO OF CONTROL SERVI( , INC. 1200 West 33rd Avenue, Suite ti CALCULATED BY DATE ANCHORAGE, ALASKA 9950$ / CHECKED BY DATE (907) 561-5040 M,3h '= �„r!I 11 SCALE / _ S O PRODUCT M! des Inc Goran Mass 0101 JOB h u ALASKA ENVIRONMENTAL SHEET NO. 2 OF 4 CONTROL SERVIC' , INC. CALCULATED BY �R'• DATE 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 CHECKED BY DATE (907) 561-5040 PLAN VIEM of _l3Er7 PROOT 2Wes 5 Inc Gmtm Mas 01471. ALASKA ENVIRONMENTAL CONTROL SERVIC INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB SHEET NO. 3 OF y CALCULATED BY �`I`' { DATE CHECKED BY cr.nl F DATE PRMV 204.1 'VEWW� 1,. Groton. Mm 01471. JOB 6k lT •7 17, 1& r i f � ALASKA ENVIRONMENTAL SHEET NO. OF 9 CONTROL SERVIC , INC. /2'T/Eis- 1200 West 33rd Avenue, Suite B CALCULATED BY DATE l ANCHORAGE, ALASKA 99503 CHECKED BY DATE (907) 561-5040 SCALE PRODJCT 0dl /7 a 1n GM.. Mass 01471 Wei I Log Y 4-714 41 '_ For... . ............J .17-6 4 .......... 14� ......................................................................... L )Itc) Location.... ... ......... 4). ...... /�k ........ TO ...... 411'/eas ..................... Datecompleted....—/.. -..J/ ....... ................................................................................. Depthof well ..... 7�� ....................... ................ I ......................................................... Sizeof casing........}........................................................ . I ..................................... Distanceto water ......... 7 ..................................................................................... Distance to water while pumping........ ............... at rate of ................ ............................. gallons per hour. ..................... ..... ... . . ...... .. Drille DELTA DRILLING COMPANY SRA BOX 394 B ANCHORAGE, ALASKA 99507 Formation I from J to 45511,7 1 4-L AL as 44 14 ..................... ..... ... . . ...... .. Drille DELTA DRILLING COMPANY SRA BOX 394 B ANCHORAGE, ALASKA 99507 a MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION ,xr: (a) Legal Description (include lot, block, subdivision, section, township, range) f}u�alx�v► {;Ils Lo�-s (floc 1� � , 23 T IZ W R3 Location (address or directions) `D owre•� �i hc.l'•.. (b) Applicant Name L L5 Kcy Telephone: Home _ Business ? -2- -4 3Q Applicant Address dem° 1 OU O U 15- ve— (c) Applicant is (check one): Lending Institution ❑ Owner/builder ❑ Buyer ❑ ; Other (explain); Ren(- (d) Lending Institution -' Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the followaddress: Pi TYPE OF RESIDENCE Single -Family Multi -Family ❑ Number of Bedrooms 3 Other 3. WATER SUPPLY Individual Well PV' Community El Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite 1� Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDINU .ASPECTIONS, TESTS, FILE SEARCH, DA -i.- AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm AE CS Telephone :S;Z Address t Z-oo W 33r` Al -i, Kc- QK S23 Date -7-8-06 OF A4 .• .r, '*= 4 T - Nr•oo .. 009 • IFR C. REID, JR. j r4 •.009 E - 2251 k t jr tl I .•�r.rr.• �. b 6. DHEP APPROVAL Approved for �.ct+ee� bedrooms by 4W G� Date Approved Disapproved Conditional Terms of Conditional Approval dhep CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 j11/84) MUNICIPALITY OF ANCHORAGE (MOP.j Gr-.._, HEALTH AUTHORITY APPROVAL (HAA) DEPT, OF HEALTH r"K ,57 ENViRp;�;�^` H`ALTH & CHECKLIST - FEBRUARY 1984 NTFL FROTECTICN 264-4720 1,9%Legal Description: A u, 06 ort I fi IlS se, z 3 it � rV A. WELL DATA RECEI VED Well Classification /?" V11 Well Log Present,�l, Total Depth �' Cased to Static Water Level 3- O If A, B, C, D.E.C. Approved (Y/N) — Date Completed `� - 9 Yield y Depth of Grouting Pump Set At Casing Height Above Ground — l Sanitary Seal on Casiny7/�N) Electrical Wiring in Conduit (1� ) Depression Around Wellhead (Y/1 Separation Distances from Well: To Septic/Holding Tank on Lot %' '� On Adjoining Lots ti !SE r�,, 4b � 7Fiit u To Nearest Edge of Absorption Field on Lot % Z7r ; On Adjoining Lots elder > /vi- it, _ .4 r¢. To Nearest Public Sewer Line IVA To Nearest Public Sewer Cleanout/Manhole '�A To Nearest Sewer Service Line on Lot Mia Water Sample Collected by Z�L��y ; Date 6 t -86 Water Sample Test Results ✓a G - N Comments B. SEPTIC/HOLDING TANK DATA Date Installed ` l��o j` Size �` '-'I Standpipes (�i�l) Air -tight Caps 6)N) Depression over Tank (Y/N) iti C% Pumping/Maintenance Contract on File (Y/N) r� Holding Tank High -Water Alarm (Y/N) N Separation Distances from Septic/Holding Tank: To Water -Supply Well �' S �-p To Property Line, To Water Main/9erv" Line T 15 s Course -7 T t" Comments Page 1 of 2 72-026(11/84) N No. of Compartments y Foundation Cleanout/ .�^ h 1 Date Last Pumped ��— for ti+ A Temporary Holding Tank Permit (Y/N) ti A - To Building Foundation l 3 "J Cx d To Disposal Field"v To Stream, Pond, Lake, or Ma' `bra age f' illL :rA`�. f C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area t Depression over Field (Y/ ) Results of Last Adequacy Test ryr+ Separation Distance from Absorption Field: To Water -Supply Well Z Y_ To Building Foundation 3_1 I nt z -� To Water Main/Service Line G% 25 To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Installed Size in Galls_,"� "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments— Type of System Design Length of Field 3 q Depth of Field Gravel Bed Thickness Standpipes Present �) Date of Last Adequacy Test _ wdva x tf) i is LS BS P,e1c_ r4 To Property Line "'X To Existing or Abandoned System on On Adjoining Lots T 3 To Cutbank (if present) Gr foo 80 Al /q Dimensions Manhole/Access (Y/N) "Pump Off" Level at /N) ping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify thattII hive checked, ferified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed C f '� Date Company SGS MOA No. ? ' ��' z�L .►�� OF At� 1+ Receipt No. 4� 1i?J�1 v% 4111 _ a or Co 4 1.* ♦ Date of Payment 1 I A, ••. • •... ••_ a III Amount: $ � �%C� 0000 O LF Q REID, JR �� t % -225 1 Page 2 of 2 72-026 t11,84) LAMWORAiORI[* CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM I.D.# ❑ PRIVATE WATER SYSTEM Name Phone No. Mailing Address ,2c:b tc) 33r`t #f3 ct9�y3 City State Zip Code SAMPLE DATE: I` L J FFF-6-1 Mo. Day Year SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sample with lab ref. no. ) ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE Time Collected NO. LOCATION Collected By 1 I /' LU(i()UN 11 ( /I IIS I •2 13 2 3 4 5 TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory ❑ sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received r-) Time Received Analytical Method: Membrane Filter * No. of colonies/100 ml. Lab Ref. No. Result* Analyst y� �W m ED ED BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter. Direct Count Coilform/100ml BEFORE COLLECTING SAMPLE Verification: LTB BGB Final Membrane Filter Results/ Coilform1100ml Reported By Date Time: a.m. P.M. TNTC = Too Numberous To Count OB = Other Bacteria ?CU,GE DLV t; Id ak 'r:WIRO'=..°E. AL HEALTH DEPART.xE..T oF RZALTt$ "d.0 EN-VIROINYENTAL PROTECTION �VPLICATION FOR a A' T 3 .' L:T'iORIrY APPROVAL CERTIFICATE r 1. General Information Application Date"�3 (a) Legal Description (include lot, block, subdivision, section, township, range) /;4 L W ,e .... .,.......�.....,.....,.e.....,.........««......�.�.....A.....A..sew. '� N '�. .sd IN S•'+ f Location (address or directions) (b) Applicants Name '�. p r��`y ,� =u `' Telephone - Home5�sCSusiness Applicants Address �.�'` �.p..� �„_� '�. /r� (c) Applicant is (check one) Lending Institution Owner/builder Buyer ; Other ;explain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. ape of Residence Single -Family Number of Bedrooms 3. Water Supply Multi -Family =1 M Other (describe) Individual :dell Community [.--7 Public = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite Public 1= Community = Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 21 1,5r 3 5° Engineering Firm Providing Inspections, Tests, File Search, Data and Informai-µ-_- As certified by my seal affixed hereto and as of the validation date shown below, verify that my investigation of this Health Authority Approval shows that the on-s;--:-- water n-s.-::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 t at, based on the information obtained from the Municipaiity of Anchorage files and from ^•► investigation and inspection, the on. --site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regtila- tions in effect on the date of this inspection. Name of Firm /�X &Ah','r:e�iL "".-vTihz `�'-.�I:` 'g� �F. ?s ;t� >" > �' Telephone Address 7,i' -r G�� ,sir a'i,'t' ij ;�l�^1,✓. `' % " Date ./��x �� II ��+ `` �� � � .:"`v" Gt �, ^-1t �' Z nom-..,-�.�, �7 r.. 5 fi �� !' �:' � .:'lI� � � ° '�` ' � S •, (ENGINEER SEAL) fti w` Ler C. Peidl Jr. No. 2251 -E 6. DHEP Approval -eo-..ce-- bedrooms By ,�� '�°;I, --•°-v `ila`t ;u� JK / Approved for � Approved �e �^ Disavp�oved Condinal Terms of Conditional. Approval -- CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL. PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESEN-f- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTER IN THE STATE OF ALASKA. THE DEEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES Aam THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQU R'-- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS N0T RESPONSIBLE FOR ERRORS OR OMISSIONS III THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 7-19-8+ (Page 2 of 21 c . t OF E,NCH &aP r � A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: 7-/;?- R3wi sit z j Well Classification VA 72r If A, B, C, D.E.C. Approved (Y/N) J�fn Well Log Present /- ) Date Completed 7" �`b�/ Yield` Total Depth %` Cased t �T Depth of Grouting Static Water Level Pump Set At i Casing Height Above Ground ✓ Sanitary Seal on Casing 6,N) Electrical Wiring in ConduitEY)N) Depression Around Wellhead (Y(N)) Separation Distances from Well: > To Septic/Holding Tank on Lot /C On Adjoining Lots l��' To Nearest Edge of Absorption Field on Lot /Z? ; On Adjoining Lots To Nearest Public Sewer Line^✓ To Nearest Public Sewer Cleanout/Manhole JU To Nearest Sewer Service Line on Lot N/ Water Sample Collected by — ATr-s ""; Date Water Sample Test Results _:;�isi & 7 'y )( Comments Pak rJL714 FL—NJ 'tsi`p'Sin�d h�i'�, T� rrriG iG�K. 7� jjr1S sv�ELL, B. SEPTIC/HOLDING TANK DATA Date Installed 7- Size 141P:) &4il- No. of Compartments 7— Standpipes tfV) Air -tight Caps�N) Foundation Cleanout�N) Depression over Tank (YUN� _ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) for Holding Tank High -Water Alarm (Y/N) �� Temporary Holding Tank Permit (Y/N) �) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line I� To Building Foundation To Disposal Field Yja2>7 JT l r To Water Main/Service Line W114 To Stream, Pond, Lake, or Major Drainage Course V )4 Comments /a k 9/ 4" {aQf �,, n�l�h�i� its fr'. L��.vti;� alS�tc��E✓ Page 1 of 2 72-026( i v84) 1-5- 1,.fi7�lJe,l'c� hzz.> C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata % Z S t%('t1 Type of System Design Ac r i Date Installed' Z�'� Length of Field -3 a i a Width of Field Depth of Field d Gravel Bed Thickness Square Feet of Absorption Area Depression over Field (Y& Results of Last Adequacy Test CSV Separation Distance from Absorption Field: To Water -Supply Well "7 3r / Al FA — Standpipes Presen Y/ ) Date of Last Adequacy Test To Property Line i To Building Foundation / To Existing or Abandoned System on Lot /d ; On Adjoining Lots ' f" To Water Main/Service Line /� To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course 14 To Driveway, Parking Area, or Vehicle Storage Area 5-01.0, Comments D. LIFT STATION / Da ailed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Manhole/Access (Y/N) _ "Pump Off' Level at Vent(Y/N) umping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I hUVhked, ' erified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signe��� Date Company MOA No. � ��` .,-OF .4` data Receipt No. Date of Payment Amount: $ - C- u Page 2 of 2 72-026 (11;84) q �v je••s•aofs'1T�1 bC Foe °a•aaC • inF ea a• ae° ®� Ler C. Reid, Jr. Aa( h w enf 7�r f -i i Nh AAD rf�) 4wn" Sufan OF ANC4 MUN,C,P N. p1TA� PROT G(10t�1 pEPT. v1,0 m ED (N, _m T4bWts, Otrnso) ISAAC'S PMIP1NG SERVICE 6; .� (UUIrtF1�;�k Street (N Zr Tit:bOts, Ownor) �a 5f ^-3 ; 'O 6219 hh galk !,trect P.NCli0PAG.. ALASr, £\ 9JJ J/CUSTOMER'S ORDER NO PHONE DATE Phone 1-33,'.0 NAME 1� 17 STOMER'S ORDER NO. PHONE DATE �,.1.. 19, �._.. ADD 1 �-- , -\ CASH C OA. CHARGE ;ON ACCT, MD3E.RET'D. PAq OUT iE>i s i I CHARCa6' ON ACCT. AWSEAETD. P •.. _...... _ _..._.. _._._.. - _. y I l _. . 1._...... _ l t, `l - _. TAX A. SOLD B�.i HECEIYED BY TOTAL i TAX I 7.✓ All claims and returned goods MUST be •B RECEIVED BY \\ 2665 accompanied by this bill. TOTAL PROS- 6n1��€est Mm ONTI. All cl ims and returned goods MUST be ecc mpanied by this bill. 23` 8 `�ilciFllf��vl1 � Cj PSOUIC1 En13, ; '� Gmron Mm 01171 �(o 50363 ALASKA CiOROnMenTAL COnTROL SNUS, InC. 6ngineerinq & 6ironmental Studies JULY 15 1985 CHARLES & JOAN DAVIS SELLER—SAME CHARLES & JOAN DAVIS 6746 DOWNEY FINCH 6746 DOWNEY FINCH ANCHORAGE ALASKA ANCHORAGE ALASKA 99516 99516 LEGAL:AUDUBON HILLS BLOCK 3 LOT 5 FLOW TEST ON WELL WELL FLOW DATE—JUNE 27 1985 A FLOW TEST WAS PERFORMED ON THE WELL. 295 GALLONS OF WATER WAS PUMPED AT A RATE OF 2.5 GPM OVER A DURATION OF 2.4 HOURS. THE DRAWDOWN WAS 20.6 ' WITH A RECOVERY TIME OF 60 MINUTES AND THE STATIC WATER LEVEL WAS 4.86 FEET. THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME. t.. 1200 fest 33rd Auenue, Suite B • Anehoroge. Alaska 99503 •;907 561-5040 ,NR—,,rNo AL CAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER II TO BE COMPLETED BY LABORATORY WATER SYSTEM:(') see h on back I.D. No. �c5 SG I-54 Water System NamePhone No. UJ 33 Y 13 Mailing Address City State zip code SAMPLE DATE: F -T J Z , Mo. Day Year SAMPLE TYPE: Routine ❑ Check Sample (for routine samplet ❑ Treated Water with lab ref. no. Untreated Water ❑ Special Purpose SAMPLE Time Collected NO. LOCATION Collected �By G S B 3 kAoSwJ 4W j 1436 P ( o s SA 2 3 L 4 I 5 I READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Analysis shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory ❑ Sample too tong in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received i 7 T Time Received S.' U 0-12 Analytical Method: ❑ Fermentation Tube Membrane Filter Lab Ref. No. Result' Analyst 0,-2- I I � I I m i m •No. of colonies/ 100 ml or No. of Positive portions 08.1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1993 Membrane Filter. Direct Count Coilform1100ml Verification: LTB BGB Final Membrane Filter esuits CoilformM00ml Reported By L r Date j M Time: a.m. P.M. TNTC = Too Numerous To Count ALASKA bUIROnMOnTAL C011TROL SIBUICOS, Inc. 6ngineerinq & Enuironmental Studies 14 August 1985 Department of Health & Human Services 825 L. Street Anchorage, Alaska 99501 RE: Lot 5, Block 3, Audubon Hills Subdivision The above referenced lot consists of a 3 -bedroom home with a private well and on-site sewage disposal system. The sewage disposal system was installed on June 20, 1981. The well was drilled on July 7, 1981. On June 27, 1985, we performed an adequacy test, well flow test and Health Authority. The Well Flow Test results are attached. The adequacy test proved the disposal system to be inadequate. A new soils test was done on July 26, 1985 and showed the soil from 4 to 8 feet to be SW rated at 125 square feet per bedroom. A new upgraded system was installed on August 5, 1985. It is a shallow bed design with a total depth of 4 feet. The existing 1000 gallon steel septic tank was left in place. The terrain in this area is level and heavily covered with trees. From the Health Authority, the separation distance from the existing septic tank to the neighbors well is 94.8 feet. A log of the neighbors well was obtained and shows it to be an artesian well with a total depth of 57 feet. The soil formation indicates gray clay from 4 feet to 55 feet. Due to the heavy clay content in the soil and the fact that the tank is water -tight steel, we request a waiver of the required separation distance be reduced to 94 feet so the existing septic tank can continue to be utilized. If you have any questions regarding this, please feel free to contact our office at 561-5040. Sincerely, _Ae Alan C. Wien Engineering Technician Approved by: Le C. eid Jr., P ., PE President 1200 West 33rd Auenue. Suite B • Anchoroge, Alaska 99503 • (907) 561-5040 Municipality of Anchorage August 28, 1985 P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES. MAYOR DEPARTMENT Of HEALTH & HUMAN SERVICES Alan C. Wein Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 5 Block 3 Audubon Hills Subdivision Dear Mr. Wein: This Department has examined your request for a waiver of the required 100 foot separation distance between the septic tank on the subject lot and the well on adjacent Lot 6. A waiver cannot be granted until proof is provided that the septic tank is equipped with watertight couplings. If you have any questions regarding this matter please give me a call at 264-4720. Sincerely, Steph(Q/en S. Morris Civil Engineer On—site Services SSM/ljw ALASKA PUIROWnTAL COnTROL SMUIRS, IN. engineering 6 Enuironmental Studies November 13, 1985 MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & Municipality of Anchorage ENVIRONMENTAL PROTECTION Department of Health and Human Services 825 L. Street NOV 1 Anchorage, Alaska 99501 Attn: Steve Morris RECEIVED Re: Lot 5, Block 3, Audubon Hills Subdivision Dear Steve: On 11/7/85, I inspected the septic tank inlet and outlet for the above referenced lot. Both inlet and outlet are equipped with water tight calder couplings and showed no sign of leakage. Per your letter dated 8/28/85, the subject lot now meets your requirements for issuing a waiver of the required separation distance between the septic tank and the neighbors well. We request the waiver be granted to reduce this distance to 94 feet. If you have any further questions, please feel free to contact me at 561-5040. Sincerely, Alan Wien Engineer Technician Approved by: J• ,i L�r C. Reid, % No. 2251-E Q PRCPESSiv• may.. 1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503-(907) 561-5040 Municipality ®1 Anchorage November 21, 1985 O P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 7ONY KNOWLE-S, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Alan Wien Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 5 Block 3 Audubon Hills Subdivision Waiver Request WR85-019 Dear Mr. Wien: This Department has approved your request for waiver of the required 100 foot separation distance to 94 feet for the distance between the septic tank on the subject lot and the well on the adjacent lot(Lot 6). This waiver is valid for the existing septic system only. Any upgrade of the system will invalidate this waiver. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw 17- D _ RECEIVED INSPECTION APPOINTMENTS STREET LOCATION TIME TIME TIME NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other DATE DATE ❑ MULTIPLE FAMILY DATE 7. WATER SUPPLY ®"— INDIVIDUAL* " ATTACH WELL LOG. A well log is required for all wells drilled INSPECTOR INSPECTOR INSPECTOR' l depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM L?'SPINDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY MUNICIPALITY OF ANCHORAGE MUNICIPALITY CF DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWR CFCCjqycS DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MAILING ADDRESS PROPERTY RESIDT NT (If different from above) PHONE 2. BUYER -- -- PHONE MAILINO ADDRESS 3. LENDING INSTITUTION PHONE MA+NG ADDRESS 4. REALTOR/AGENT PHONE Syr= e 5 '-F -- MAILING ADDRESS 5. LEGAL DESCRIPTION , > STREET LOCATION en G 6. TYPE OF RoLESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other .oi�' SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY [`Three ❑ Six 7. WATER SUPPLY ®"— INDIVIDUAL* " ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM L?'SPINDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY /� -.` (_�-' ( ,1iCj ! -•Jf NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY i 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size:_J.0 d If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding TanT Absorption Area O J Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY r 72-010 (Rev. 6/79) VO I August 27, i981 James K. Armstrong Star Route A Box 3163 Anchorage, Alaska 99507 u2`3 i90 <(3 f 1 1 Subject: Lot 5 Block 3 Audobon Hill Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) A well log submitted to this office for our files and review. (2) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: First National Bank of Anchorage Post office Box 4-2090 99509 Esther Bumgardner_ 'totem Realty 724 East 15th Avenue 99501