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Home My WebLink AboutAUDUBON HILLS #1 BLK 1 LT 8 --' MUNICIPALITY OF ANCHORAGE ifvto/~ i~ 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 1PHONE [ [] NEW MAILING ADDRESS LEGAL DESCRIPTION .o. D.OO=S DISTANCE TO: [ OO "~ -- ' Material No. of compartments Manufacturer Liq. capacity in gallons Inside length Width Liquid depth ~ IF HOME,DE: ~ ~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. ~OZ O Z < Manufacturer Material Liquid capacity in gallons PERMIT NO. O DISTANCE TO: Well ~OO ~ Foundation ~ Nearestlotline ~ ~~D'~ ~m ~ Ne. of lines , Lengthofeac~i~i Total lengthofl~' Trenchwid~inches Distance between__ lines ~ ~ Top of tile to finish grade Material beneath tile . Total effective absorptioGarea Een~th ~idth De~th ~E~MIT ~0. ~ ~ Tgpe of crib Crib diameter Crib d~th Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING ~ 15o INSTALLER , ~ ~ I,~ ~11~ -' REMARKS '~ . ; / APPROVED DATE LEGAL MUNICIPALITY OF ANCHORAGE Department ~f Health and Environmenta'~rotection 825 ~- Street, Anchorage, AK. .3501 ~ 264-4720 * * * HANDWRITTEN PERMIT * * * Permit ~ ~'~,_~k W~/OR ON-SITE SEWER PERMIT Applicant: Location:~! Phone Number: ~ ~--~ Legal Description: ~ ~ ~/ ~ ~t~t Size: Type of Soil Absorption System Is: Trench: Drainfield: ~ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ~ ~ Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is:' DEPTH LENGTH . GRAVEL DEPTH WIDTH r 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). ~ /~ * *-1~~ SEPTIC(HOLDING) TANK SIZE : 5%0 GALLONS Permit applicant has the responsibility to inform this department du~ng 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 departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee 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 51, 1 9 8 3 * * * i certify that: (1) I am familiar 'with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may ~equire enlargement if the residence is remodeled to include more that~-/8/bedrooms. S igne~ :~~ .~ ~/u~~/ Issued by: ~pp~ican~ / Date: ~-- ~~ SWP/024 (1/81) 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 1 AD~'-D~S~'' -- (~'1~. / ~ ~ UPGRADE MAI LING LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS DISTANOETO: ]Well//~ i I Absorption area Dwelling PERMITNO. ~ Manu~ Mater~ No. ofcompart~ts ~ ~ Liq. cap~cit~gall~ns I Inside length Wid~ Liquid de~" /~ IF HOME'DE: Well Dwelling PERMIT NO. ~ ~ ~ DISTANCE TO: O ~ Manufacturer Material Liquid capacity in gallons ~ DISTANCE TO: ~1~ :c~n Foundation Nearest lotline~t PERMIT NO. 7~ ~_,o.o,,in.s ~ ~O~ , ,o,a,,.n,,,o,,,ne.x¢Z, ~r. nc,~,~t,~ O ,n~. ~,~,.n~.~t~.,,n~/~. Too of tile to finish ~rade ~ Materia} beneath tilo Total effective absor a Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line m DISTANCE TO: ~ ~ Class ~ , Depth ~l Driller Distance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS~ ~ SOl · /~O~ ._~ ~, ~-, - REMARKS ~ - - ~ ~ ~ 1~ DATE LEGAL 71 )13 (Rev. 3/78) F' t::-: F: r,! Il "f' NO ".r'HIE DE:F'TI-4 OF i:q "r'F;t[::ZI'.,IC:H C!l:;i: F'I f' !::.?; -l"i..-!l:.i:i [:,I:L.:"f'FINIi;:E i:!:E'f'HEEN THE ::::;!iF:'t:::.::~F:F i.[:~ ~: (3 U i'.,I [:, l::l t'..~ I::, T H I:!: B O 'F 'T' !.-.~ hl O F' 'T' HIE [:: ':. :C .---~', ,' ~:k 'f '[ O N ,:i ]1 i'.,! F:' [:: E: "!" "r F.. EL I:,;r F! J:::!!; !'-,!O :~i;r.:',r HIf?f'H F:'¢;ff;'. 'i'!:;;:[:_:NC:H_F_".-:!;. 'l'hllE L:iF. rF:!',,,'F:t.., r",F'F'-f'!-..I Ti!.:: THt:::' f,l:lt'.,l'[r,lltH i.'.:,EF'I"H OF ..... rzn',, I:"1 F' ..................... :,..,-, v ..: .... E:~.E'I"!,.iEE:N "H'"fliii: .:::It't.? "f'Hl:-il E~Eq""t"E!H Eft::' THE: El?l:.'?:!' '!::,T .1.: C I'.,t ,: !' ~'-,! FEET MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION Pouch 6,650, Anchorage, Alaska 99602 276-222I SOILS LOG - PERCOLATION TEST SOILS LOG PERFORMED FOR: LEGAL OESCR,PT,O.; DATE PERFORMED: [] PERCOLATION TEST ~_ =~r_77 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN s ..... , ,_~~.__~_..~.___ ~ ~ o Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch COMMENTS '"~ TEST RUN BETWEEN FT AND FT CERTIFIED BY: 72-008 (7/76) !'"i !' !'.4 ]: t, IL.It'", [Z:, ]; :!B'T'f:~I'.,IC:E: E:E"f'I.,.!EEN R I,!E!..L FIN[:, 1 i:::tt::i ..... f:::'l~:[~:"!" ~::r'l¢;',..,. [::l c:":'¥....~ ,., P ,'"' "" .:'! [. t.,.iEL. 1 .: EiB: ::L~;G 'T":'i :2:Ei(?~ i:"'EE:T F'F:Ohl f:l F'I...IE',!..iE: I,.!EL.L. I:]:, t~; F:' E: f'-4 [:, t h, (;)i !..JF:'ON P.iE'i ........ t.._O(T~i:~]]; F'II::;:E F~: E: [;fi.,I :I. ?;: E] [> FIN[:' !"II...I:E;T' E',E: F;:E:TL.iRNIE[> '."O THE' r:)l:::' THE: !,.!tFi..k ![;: []: !'"ff::'k.[~;]" ]' OTHEF;: ......... t;;'[:'Ot .I I ?E:HE;r,I'T':~: ~"~','"-'" i:lf::'F'b 'T' ':: ......................... ::'1:::1"" T Drilling Co,. WELL COHSTRUCTIOH LOG Vern' s Drilling & Enterprises Vernon ~'Nowell Dr i I ler Gene Kro tke We I I owner Type of rig. cable tool Well location: (address & legal description) Audubon ~lls Sub. Lot 8, Blk 1 USGS no.. Date well completed Nearest community 84' 848 6" Depth of well __ - ft. Casin~:,depth ft. diam. in. I~owlng over $o~1~ Static water level ft. (above, land surface. Date5-79__26-__ Finish of well: ~,-~,. Oescribe intervals and size: Well yield tested by ~p?~'"~"~, bailing, ~'~'~"at 1~ gal/min. for. I hours with---- ~LI't ft. of drawdown from static level. 5-26-79 A~¢horage Location sketch or remarks MUNICIPALITY O? ANCHORAGE DEPT. C,: ;: '.-:! & EhiVIROb~M ~ is [,\L i;:; .L; i' ECTI ON J JN 1 8 Ifi79 RECEIVED DRILLER'S MATERIAL LOG Depth below land surface in feet 18 0 to /Y to to to __to ~to --to __¸to to __to __¸to __to __to to --to __to --to¸ __to __to. ito Give description of strata penetrated (size of material, color, hardness of drilling, and water content) brown silty till with cobbles silty gray-browm clay & gravel silty sand & gravel gray silty gravel-tight brown silt & clay hard pan sand &gravel - H20 A 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 1. GENERAL INFORMATION Complete legal description Lot 8; Block 1; Audubon Hills Subdivision Location (site address or directions) 6701 Downey Finch Lane, Anchorage, Alaska Property owner Mailing address ~m Wnr~ll Day phone 345-4534 6701 Downey Finch Lane, Anchorage, Alaska 99516 Lending agency Mailing address Day phone Agent Day phone Address e m Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 6 TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 Se Sm 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 $ & S ENGINEERING Phone 17034 Eagle ~iver Loop Road NO. 204 Address Eagle River. Ai~ska ~)577 Engineer's signature DHHS SIGNATURE Approved for Disapproved. Conditional approval for Date i"Z..- [ ~ - ~ '7.- bedrooms. 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~K21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST _ r-arcel I.D. Legal Description: LoT ~ t3LOC~ I AUDU~O~ HILLS A. WELL DATA Well type P~ Log present ~_.~/N) Total depth ~;~' ' Sanitary seal (~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ,.~/~6/~'lq Driller Cased to ~"~' ' Casing height Wires properly protected ([~'N) Date of test Static water level Well flow Pump level FROM WELL LOG O /dOT SEPARATION DISTANCES FROM WELL TO: Septic/~.if~ tank on lot //O / Absorption field on lot l~ / Public sewer main ~/A _ Sewer service line ~,~' / .. g.p.m. AT INSPECTION C) ENVIRONMENTAL SERVICES DIVISION RECEIVED ; On adjacent lots ; On adjacent lots /00 ¢-t- Public sewer manho e/c!eanout Petroleum tank _~ O,¢~__~' _ WATER SAMPLE RESULTS: Coliform ~' Nitrate . Date of sample: 1,'~_ ,_ ~--2~_ '~'~ Other bacteria Collected by: ~ ~ ~::~ B. SEPTIC~TANK DATA Date installed (~ Tank size Cleanouts (~)N) High water alarm (Y~J Date of pumping / ~ Z'O 'P 5'00"~ Compartments Foundation cleanout ~.~N) ~ Depression (Y/~) Alarm tested (Y/N) ./4.//A Pumper ~/~/ / ,/,JO SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) onlot //O/ Onadjacentlots /00/+' Foundation ~/ To property line <~0 ~ Absorption field i~' Water main/service line Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE Manhole/A~ VentSize in(y/N)gallons -'"--.~~~. _._,, "iP ~'r~ ~vel at High water alarm level ~...--'~ ~ Cycles tested ~_ Meets MOA e~es (Y/N) ----- ~ yon lot On adjacent lots ~Surface water D. ABSORPTION FIELD DATA ~' Date installed ~//Z/77/~/t5_/~'__~___ LengthlOl'/ZtO/ Width '~ "/30" Total absorption area GOO Depression over field (Y/~_~ J-JO Results (pass/fail) P/~.~ Peroxide treatment (past 12 months) (Y/N) Soil rating Gravel thickness Cleanouts present (~N) Date of adequacy test for ,~OT' /,~/J~:)L. fl~ If yes, give date System type Total depth 5',5-'/ bedrooms Wellon lot / To building foundation '-~' / ~'~ On adjacent lots Surface water Curtain drain /uO.~' SEPARATION DISTANCE FROM ABSORPTION FIELD TO: / ~,~ On adjacent lots / To existing or abandoned system on lot /LJA Cutbank ,~Jc,~E f',~c-.~ Water main/service line_~ Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I cedify that I have checked, verified, or conformed to all MOA and HAA guidelines in of'this insertion. Signature Engineer's Name Date S & $ ENGINEERING 17034 Eagle River Loop Road NO. 204. Eagle River, Alaska 99577 HAA Fee $ /70 Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 effect oz~ JAe date A__.: % k ...-,,'. ,. ~.*~.: .... ....' .' ~;-' Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL L~IBORATORY A D'VISION OF COMMERCIAt. TESTINO & ENGINEE~IN~ CO. PW$ID : UA Client ~cct Collt¢:~d ~ 12/t3/g2 e 2~.15 h~, BPOI : ?Of :~01~ hgCglVlO i Ieet, PB~ormed ' See Special In~txuctlon~ Ahoy, Uk-On~Y.ll,bl~ IfD- ~ne Peteete~ *' See Sampl~ ~e~lk! lbove ~k- h~t ~r~lyzm~ LT-L~ss Th~n, ~?-~eatet Than Member of t~e SOS Group (,goci~h5 O~n,~rale de $,~rveH~ance) 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 (~:)/,5"~ ,,z ~/- ~, ~ HAA # ~'~ ("'~Ol('''¢'h\-'~ '[ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Location (address or directions) ~7ol 'Dow N r:: ~ F,~4cH (b) Property owner Mailing Address (c) Lending Institution Mailing Address (d) Real Estate Company and Agent ~, Address ~0/ Downey Telephone ~ ~- Telephone · (home) Telephone . (e) Mail the HAA to the following address: (or check here ~, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family [~ Number of bedrooms ~ '// 3. WATER SUPPLY Individual Well l~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of th is 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 FLA'1ToP "7ECH. $£~VICE~ Telephone 3~t-g- t~ ~' Address 14530 EC /¢ s-r Al< ,, Date 6. DHHS APPROVAL Approved for ~ bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in 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. 7/88) Back Page 2 of 2 gj~y MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 OF ANCHORAGE 343-4744 r~J~ClJL~NI~NTAL SERVICES DIVISION legal Desoription: MAY 1 i ]990 A. WELL DATA R D Well Classification Well Log Present (Y/N) Y' Date Completed ,.4-/~6"/ Total Depth ~¥' Casedto ~¥' Depth of Grouting N,~. Static Water Level 'T~/~ o~c Cojl~, - /Jr-J-~ico,, Pump Set At Casing Height Above Ground I?-" Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) If A, B, C, D.E.C. Approved (Y/N) /V. ,~. Yield _'~ ~./ q,/,m /~,oj &-//o/po I-' Depression Around Wellhead (Y/N) N I1~ ' SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot I0¥ ' To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line N. To Nearest Sewer Service Line on Lot Water Sample Collected by ~'(~,zJ°p' Water Sample Test Results ; On Adjoining Lots ;> ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ~, ?_.F~ 7~r~nt cc.,/ ~'¢r,,;c,,./ ; Date .J"/,E/?O Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~Size Standpipes (Y/N) Y' Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ~,~/ No. of Compartments Air-tight Caps (Y/N) Y' Foundation Cleanout (Y/N) H Date Last Pumped ..C/l/ /~ /~7' .Z'~,~,~c..r IV, ti. ; for N,,~. N.& Temporary Holding Tank Permit (Y/N) N.~. To Building Foundation To Disposal Field To Water-Supply Well ( ~ ,f ' ~r~,,., ¢. c,,, To Property Line '-> 4o To Water Main/Service Line :> To Stream, Pond, Lake or Major Drainage Course IV' :~,'~.,~ e', ~ no/ ~4~,~ Comments 72-026 (Rev. 7/'88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ¢~ ~'~' Width of Field ~.~-' Square Feet of Absortion Area 9 Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ~ ( To Building Foundation ~ ' Lot lq' be~e~ /,~ To Water Main/Service Line ~ To Stream, Pond, Lake, or Major Drainage Course ~ To Driveway, Parking Area, or Vehicle Storage Area ~ Comments ~ ~r~ ~o~ LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for t¢~r~ Type of System Design 5-//'~6_3' Length of Field O~'~' Depth of Field Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line ~-? ~ To Existing or Abandoned System on ; On Adjoining Lots ;> .7¢, ' To Cutback (if present) ~0~¢. / / Meets MOA Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Comments Date of Payment Amount: $ 72-026 (Rev. 7/88) Back **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA gu'l~[l~_~n~l~l~.on the date of this inspection, ~.,.~..~..y...."';~:~ ~J~ "'~ *'',... ~.~ ~,. Signed ~~ ¢ ~ Company F[~p ~eeeeeeeeeeeeeleeeeeeeee~ ee~ ~ ~ ~ ~ ~ ~ee¢~ Sea~ Receipt No. ~' /~ / Receipt NO. '~'''~' Waiver Fee: $ / ~' ~ Date of Payment Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 :UA P.C.$ NOgE RECEIVED ~eq ~ t I~,~t~act Ci,emiab .~.af ~' .~0L265 L~.b Stop! 15: i NiTRL~E- !I ,! 2~ n~/'i ~?~ 553.2 Re=ark~: SilLS COiLtC?~D BY C. ALLAED. }~z~e ~,et ~cte .... Not M'~oiyzed [T~L'~se ~n~n. 3T-Gz~tet Tna~. unic pality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 May 15, 1990 Alliance Bank c/o F.D.I.C. 4009-351-198 P. O. Box 196639 Anchorage, Alaska 99519 Subject: Lot 18, Blk 8, Paradise Valley Gentlemen: In July, 1988, the sewer system on the subject lot was brought into compliance with AMC 15.65 (On-Site Wastewater Disposal ordinance) through the installation of a holding tank. This ' action was necessitated due to the inadequate separation distances between the holding tank and a stream in the ditch on Romania, and between the tank and a surface flow along the east side of the property. At that time the engineer applied for and received waivers from the required 75 foot horizontal setback to surface waters. Certain conditions were noted as justification for granting the waivers. This office subsequently granted a Health Authority Approval certificate on the property. During a routine field check on an adjacent property, I noticed that conditions on Lot 18 have changed substantially. The small surface flow is still present. It is not possible to know if the small surface stream actually disappears into the ground as was the case during the earlier waiver application. However, at a point immediately east of the cleanouts for the holding tanks there is an eruption of water from the ground. This flow is estimated to exceed 5 g.p.m., and has eroded the bank as it drops into the road ditch. It appears that a previously installed underground drain pipe has ruptured or separated. As measured, this flow is 21 feet from the cleanouts on the holding tank. This letter will serve as your official Notice of Violation for the sewer system on Lot 18. As the owner of record, F.D.I.C. is responsible to see that this system is brought into compliance within fourteen (14) days. In addition, the previously signed Health Authority Approval is hereby revoked. Page 2 Lot 18, Blk 8, Paradise Valley Please note that any persons who occupy this dwelling are also subject to enforcement provisions of the wastewater ordinance, and may be issued a citation should the violation continue. I am enclosing copies of pertinent file documents for your information. If you have any questions about this enforcement order, please contact me at 343-4718. Sincerely, Susan Oswalt, Acting Manager On-Site Services Encl. cc: Robert Sharer, P. Eo S & S Engineering so/300 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) (b Legal Description (include lot, block, subdivision, section, township, range) :ions) Telephone: Home '~¢~"-'~¢)~'? Business e,e. one (d) Address ~nd Agent (e) Telephone // Mail the HAA to the followina address: or: Check here~, if hold for pick up. List contact pers an d y phone n ber bel . TYPE OF RESIDENCE Single-Family ~. Number of Bedrooms WATER SUPPLY Well%l~ Community [] Public [] Individual Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsit~[. 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 trey 8/86) Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm '/~'~'<~ Telephone Address /,7--¢'f) /,J .,J'.~'c'J /~,~,'" .~'",/,v,~T,E"' ,~ ,/~,~/ Date 7"'/ Approved for ~' bedrooms by Date Approved ,~X '-Disapproyed Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 fRev 8/861 Back WELL DATA MUNICIP~,ITY OF ANCHORAGE (MO,.,~ O .,~ ~ORITY APPROVAL (HAA) ~HECKLIST- FEBRUARY 1984 264-4720 Legal Description: Well Classification Well Log Present6N), Total Depth Static Water Level ~ -/~? o-~ Casing Height Above Ground Electrical Wiring in Conduit ON) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line CleanouVManhole Water Sample Collected by / Water Sample Test Results ~,,~'~-- '7-- '~,~'/t,/,"~)"~'" If A, B, C, D.E.C. Approved (Y/N) Date Completed :~'"- Z.~,-~' Yield Cased to Depth of Grouting Pump Set At Sanitary Seal on Casing&N) Depression Around Wellhead (Y~ · On Adjoining Lots /O"0 ~7~ ' On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Comments B. SEPTIC/HOLDING TANK DATA Date Installed 5'-- / ~' -~'~ Standpipes CN) Depression over Tank (Y~]) Size Air-tight Caps Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ///,,4 Separation Distances from Septic/Holding Tank: ! /o~ ~- / No. of Compartments ~-~ Foundation Cleanout ~1) Date Last Pumped 'for Temporary Holding Tank Permit (Y/N) To Building Foundation /m To Disposal Field To Stream, Pond, Lake, or Major Drainage To Water-Supply Well ~...~.,.'~_~a~~~,,e~,~ Line Page i of 2 ' ' 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Square Feet of Absorption Area Depression over Field (Yi~I Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /~r.) To Building Foundation Lot / ~ ~ ~e~T-~-~'J ! To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field ~,e~4, Depth of Field ~'~'"~' ~ ~'' Gravel Bed Thickness c,,~/~ ~..~" Standpipes Present GN) Date of Last Adequacy Test '~" ut~ ~ To Property Line To Existing or Abandoned System on · On Adjoining Lots /~2 To Cutbank (if present) Comments D. LIFT STATION ~stalled Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pum ~uring Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that ~e~~ or conformed to all ~ . MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company /~C~' MOA No. Receipt No. Date of Payment 7 --c:,~--~-Y Amount: $ // 2 (.,) ~ Page 2 of 2 72-026 (11/84) CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. /~-\ 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907)562-2343 FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE £or Work Order ~ 7668 Date Report Printed: JUL 11 88 @ 12:10 Client Sample ID:LT 8 BLK I AUDUBON HILLS Client Name : AECS PWSID : Client Acct : AKECSRP Collected JUL 5 88 ~ i5:00 hrs, P.O.~ VERBAL Received JUL 6 88 @ 09:00 ks. Req # P~esezved with :4 DEGREES C Orde=ed By : A WIEN Analysis Completed :JUL 8 88 Send Reports to: Laboratory Supervisor :STEPHEN C. EDE 1)AECS Released By : ~ ~'~-~' 2)ADEC Special Instruct: Chemlab Ref ~: 1664 Lab Smpl ID: 1 Matrix: Water Allowable Parameter Tested Result/Units Method Limits NITRATE-N 0.21 mg/1 EPA 353.2 lO Sample ROUTINE SAMPLE Remarks: SAMPLE COLLECTED BY A WIEN 1 Tests Performed ' See Special Instructions Above UA=Unavailable ND~ None Detected "See Sample Remarks Above NA= Not Analyzed LT=ness Than, GT=Greater Than ~ APPLIC ,NT FILLS OUT UPPER HAl. ONLY Property Owner/..,~ (.. / / , . ,, / / ,r / . Mailing Address / . , ': ' -/ ,' .. Zip Code /' / Buyer , /~ ) ' 'J Zip Code Address ,, "' ' Lending Institution ,/~_ / / ,~ ~ ; , · , . ,i~ ', ~, ,, / ,/~. ,. , Phone Address / :'- :, :,: ~, . /~ .' Zip Code Realty Co. & A~nt Phone Address Zip Code / ~ , . ~:'~ .~, ~ Legal Description .~ ~ L ~ "~ ('' [ : ...... Street Locati~ (~ /~ / .... ,,,, / , Type of Resi~nce ~ Single Family / ~ Multiple Family No. of Bedroo~ (-. ;, ~ Other Water Supply ~ Individual A~ACH ~LL LOG. A w~l log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ndividual Year Indiv~ual Installed: ublic Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: MUNICIPALITY OF ANCHORAGE DEPT. OF H_CALTH & /~/~ ENVIRONMENTAL PROTECi'ION SE P 1 6 Ig&3 .RECE! ED (,~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE ~ I ~ 2 -- ~ ~ Soils Rating Date Sewer Installed Well To Absorption Area ,/' ~ ~ '~ Well Log Received ~ /~.~ / ,.~ ~) ' Well to Tank /g~ Septic Tank Size / 2... 72-023 (3r82) DATE RECEIVED · ~ INSPECTION APPOINTM ENTS TIME I TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE ,' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchorage, Alaska 99501 .j ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requ~ will not be processed. Please allow ten (10) days for processing. MAI LING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHON~ MAILING ADDRESS 3. LENDING INSTITUTION ~ , PHONE MAILING ADDRESS '~ ~ ~ C ~n 4. REALTOr/AGENT PHONE MAILING ADDBESS 5. LEGAL DESCRIPTION t ,/?o, STREET LOCATION' ..... NUMBER OF ~B EDROO.~r' [] One !3~ Four I[~"~NG LE FAMILY 1--I Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY li~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM /~.~..2 ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY q'qfl YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] I NDI VI DUAL/ON -sI-r E I--I PUBLIC UTILITY Connection Verified i--ISeptic, Ta~n.k or []Holding Tank Size: ~'-.~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line NUMBER OF BEDROOMS [] ONE [] THREE [] TWO [] FOUR PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOl LS RATING lSewer Line [] OTHER MANUFACTURER MATERIAL I Septic/Holding Tank IAbsorption Area [] FIVE [] SlX iNearest Lot Line 5. COMMENTS [~' APPROVED FOR z~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE I BY 72-010 (Rev. 6/79)