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Home My WebLink AboutASPEN HIGHLANDS #1 BLK 1 LT 12 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: '~ t,~¢''[ '¢"~ ,,~4::~ (.,,¢ PID Number: ~ ~ ~ Na~ ~ ~ ~ ~, ~l ~ ~~ Wastewater System: D New ~grade Address: i~1 ~ ~, ~ ~. ABSORPTION FIELD Phone: [No. of Bedr~ms: ~DeepTre~ch ~ShallowTreRch ~ Bed ~MouRd ~Other Total Depth from original grade: LEGAL DESCRIPTION S°il Rating: ~D/Sq. Ft. Lot: Block: Subdiv~ion: ~ Depth to pipe bottom from original grade: Gravel depth beneath pipe / Township: ~ Range: Section: ~ ~ Fill added above original grade:~ Ft. Gravel length: ~/ Ft. Number of lines: ~ Distance between lines: WELL: ~ New U Upgrade Gravel width: ~ i ~. I ~/~ ~. C[assification~~(Private, A,B,~):~.~I ~ Total Depth: Ft. Cased To: Ft. Total absorption area:/~ SQ. Ft. Pipe~material: ~/~~ ~a~ Date installed: -- Driller: Date Drilled: Static Water Level: IFt. ~ ~~. Yield: I Pump Set at: I Casing Height Above Ground: ~M ~. Ft.TANK SEPARATION DISTANCES ~SepticL~,~ ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Well ~ //~, ~ ~ '~ ,+ Mate~s~W~ Number of Compartments: Surface Water [~ ~ /~ ~ - ~ ~ LIFT STATION Lot [ Line ~1 ~f Size in gall°ns: Manufacturer: Foundation ~/ ~/ ~ ~ ~ "Pump on" I~mp off" level at: [ High water alarm at: CurtaiRDrain ~ ~ ~ ~ ~ ~_ ~ Pump ~ Model ~ Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: Assumed Elevation: /~ ~[. ENGINEER'S SEAL ,~,~ % ~ ~ ~, , Inspections performed by: 170~".l' ,i,r L~ ,,d. N~S: 1st ~~ Department of Healt d Hum ervices apprpva o Reviewed andapproved 1~i~[ ~;J Date: V h 72-013 (Rev. 9/91) MOA 25 / Permit No. 2 2 $W930306 Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report ASPEN HIGHLANDS SUBDIVISION, BLOCK 1, LOT 12 Legal Description: 01701 ;523 PID No.: FINAL GRADE MT COM A B CO1 20.9 [ 35.5 co2 I ~.8 I 4.?.o I C03 64.6 4-5.8 MT 58.8 4-1.6 78.4 N.T.S. NEW CO,3 MT TH · DRIVE · 72.4' NO WATER FOUND 10' UTIL. ESMT.---...~ HOUSE I I I I XIO' UTIL. ESMT. I I I SCALE t" = 40' LOT 12 ~EXIST. 2025 GAL CONC. TANK WELL, I:NGINE£R'$ SFAL 72-013 A (Rev. 9/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930306 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DRINKALL MERLYN D & OWNER ADDRESS:13021.HILLSIDE DR ANCHORAGE, AK 99516 DATE ISSUED: 8/16/93 EXPIRATION DATE: 8/16/94 PARCEL ID:01701323 LEGAL DESCRIPTION: ASPEN HIGHLANDS #1 BLK 12 1 LT LOT SIZE: 36634 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: / al ity of Anchorage HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSALSYSTEM DESIGN August 3, 1993 DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 REFERENCE: Aspen Highlands Subdivision, Block 1, Lot 12 Request you issue a Dermit to uDgrade the seDtic system serving the four bedroom house on the referenced proDerty. An adequacy test performed on the existing system on June 23, 1993, fori~Health Authority Approval purposes found the existing system to be in a state of failure. The existing system was designed for a three bedroom capacity in December 1972. The property Owner's have requested an upgraded to four bedrooms. Therefore an alternate site has been depicted on the attached site plan. The existing well was drilled prior to the ordinance change in October 1973, which required a 100' separation distance between a well and a septic tank. Therefore, the existing septic tanks separation distance is grandfathered. The alternate site encroaches upon the old seepage pit. The crib will be crushed and filled with a sandy gravel from Lake Otis Pit. By the time the alternate site is required the pit will have been dormant for a number of years, therefore, will have no adverse affects on the alternate site. A test hole was excavated and percolation test performed in the area of the proposed upgrade. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information for your rTiew, Please contact us. t A. Shafe~s/LSU/lsu r, P.E. 17034 NORTH EAGLE RIVER LOOP . SUITE 204 . EAGLE RIVER, ALASKA 99577 SCALE IPGRADE HILLSIDE Z'-qm m ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Aspen Highlands Subdivision, Block 1, Lot 12 ~ENERAL= The scope of this project includes the installation of a leachfield trench to serve the four bedroom residence located on the referenced property and excavation of the existing 2025 gal septic tank to verify its integrity. If the integrity of the existing septic tank is poor the existing septic tank is to be excavated, pumped, crushed, and abandoned in place and a new 1250 gal septic tank installed. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. o Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. Page Two Aspen Highlands Subdivision, Block 1, Lot 12 August 2, 1993 A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. o Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. Page Three Aspen Highlands Subdivision, Block 1, Lot 12 August 2, 1993 o When sand is being used as a filter material, it's gradation specifications must conform to AMC 15.65.060D. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed- up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Four Aspen Highlands Subdivision, Block 1, Lot 12 August 2, 1993 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCR,PT,ON: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 (ENGINEER'S SEAL) Township, Range, Section: ~.~O~:~q~Et~ ,, SLOPE SITE WAS GROUND WATER ~[ ENCOUNTERED?~JO S L IF YES, AT WHAT ~ 0 DEPTH? p E Depth to Water A.er ~ "~']~l / ~.~ Monitoring? ~ ~.~' Date: , Gross Net Depth to Net Reading Date Time Time Water Drop : ~ IO ~ ~1~" ~1~" : ~ !o ~t~l/~" ~1~ PERCOLATION RATE ~,~ (minutes/inch) PERC HOLE DIAMETER TEST R~N BETW~E~N ~ ..~ AND ~ FT '/ S~S~N~.~N~ // ~ / PERFORMED BY' . , . I ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ...... j ~O,~ ,ag,e ~lver L~p .oa..o. 2. /~ 72-~8 (Rev, 4~85) ' / I I I MATFIIX CONS TRUC TION August 9, 1993 Municipality of Anchorage Environmental Services On-Site Services 825 L Street, Room 502 Anchorage, Alaska Re: L~t ].~ Block ~i Aspm~ Migh.!an~s ! I, Russell Cary, am requesting approval to install the proposed drain field at the above noted location. My wife, Debra Cary, and myself are in the process of purchasing said property, however the seller in accepting our offer excluded any necessary repairs. Therefore we are responsible for septic system upgrades. I have been employed full time in the general construction industry for over 13 years and am currently working as Project Superintendent for Matrix Construction. I am well qualified as an equipment operator, carpenter, and cement mason. I also have access to all necessary heavy equipment, trucks, survey equipment and suppliers to perform this work quickly and professionally. S ' ncerely, ~6perintendent 7720 KING STREET ANCHORAGE, ALASKA 99518 AK//17189 (907) 349-4942 FAX 349-7226 F'ERMIT NO. FtPI:::'L. tCFINT RLLEN F:'H"r'RLR F'O BOX 5:1.4 1.4RSSIL. R RI".'.' LOCFITION H~I....LS I DE LEGRL ~ FISPEN HTGHLFINDS SUBD LOT SIZE .,~/,::¢._. ~ / 'T'"r'I::'E OF SO I L. R,DSORBT I ON S'"r'STEI"I I S: -I"RENCH .'2: 7' 6- 2 ::L 42 ~:2670 S6!LIRI:;;:E FEE]" I"'IFI:,.::IMUH NI...IMBER OF EEE,F.'O3MS = 2: =.UIL RRTING ,::SQ FT,..BF. ..... ;I.,:~.. TFIE RE6~LIIRE[:, SIZE OF' THE SOIL HE,_,OF..F FIUN SYSTEM D' EE F" ~]- FI==,=. '--" "--' .=.. L. Ei"-,16T H= ~:.?: .._ E-i F-_' R '-..' E L ID, .rE F' '"IF ~4 == (E; THE LENGTH DIMENSION IE; THE LENGTH (IN FEET::, OF THE TRENCH CR DRRINFIEL[:,. THE: [:,EF'TH OF R TREN...H' F' FR. . PIT IS THE [:,ISTRNCE BETHEEN THE _'qlIRF'RCE.. . OF TFIE GR[:UN[:, RN[:, THE E:OTTOM OF THE EXCRVRTION ,:: IN FEET). THERE IS NO SET WI[:,TH FUR TREN_.HE=, .THE P '-',' ...... ' ..~RH,,EL [EFTH ZS THE MZNZMLIM DEPTH OF GRRVEL BETWEEN THE C~I...I]'F'FIL. L F ZF"E FIND THE B]TTOM OF THE E:,.,:CR',,,'RT~ON (IN FEET). .................. '? ' I-' I ...... E, HL.k. FlI.J...Ihlb OF RN'T' SYSTEM WITHOUT FINRL IN=,FE_.TIJN RN[:, HFF~E,NL ]"HI_, [:,EF'RRTMENT WILL. BE =,JE, JEL. T TE PRA~ERIITION. MtNIMLIM [:,IS'rFiNCE E, ETWEEN R WELL RN[:, ANY ON-SI"rE:,EHH~E'-, -F' [:, I ,=; F, A ,=; Fi i S'.,.'STEM IS :t. 00 FEET FOR FI FRI,,H'fE WELL OR 2E'~O FEET FOR R PUBLIC HELL .... : SF'EC I F I CFIT IONS RN[:, C:ON'$TRL CT I ON [.',I R-P'-~F..NM=,"' RRE R',,,'R I LRBL. E TO I N'=, .... F.'E F'RAF'ER I N S T FI L L FI T I 0 N. I CE:RTIF¥ THRT ±: I RM FRMILIBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND NELLS FIS SET' FORTH B'¢ THE MUNICIPRLIT¥ OF RNCHORRGE. 2: I WILL INSTRLL THE S'¢STEM IN RCCORDRNCE WITH THE CODES. 2:: I LtNDERSTRND THRT THE ON-SITE SEWER S'¢STEM MR'¢ REQUIRE ENLRRGEMENT IF' THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. RF'F'L I C:flNT ~LEN F'H T RL~ ~ ;ER ANCHORA6E AREA E Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 ~UGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME .~"/--/0m,,¢~' /_.~,,¢'),~-,4~g~,- MAILING ADDRE~SS LOCATION ,~¢/~.g..:~'-/g3~' ~V'.z~ ~",,'~---,¢¢2'gc~,'f// LEGAL DESCRIPTION PHONE ~ ,. SEPTIC TANK: 'DISTANCE '~/v/~?""'/'~/ NUMBER OF FROM WELL ~-,Z~ MANUFACTURER INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH ~:~ / · LIQUID CAPACITY.c'~¢~ GALLONS. SEEPAGE PIT: NUMBEROF PITS ...... / DIAMETER OR WIDTH,/.~,! LENGTH~'~-T/ DEPTH ~ / LINING MATERIAL / ,¢g~4¢ ~/~,'~/'g~:RIB SIZE: DIAMETER DEPTH ~¢"/ DISTANCE FROM: WELL BUILDING FOUNDATION NEAREST LOT LINE ~/'''~- TOTAL EFFECTIVE ~, ABSORPTION AREA (WALL AREA) .._,~.,.¢~¢J2 / .. . .SQ. FT. ' ADDITIONAL ABSORPTION WELL: TYPE p/~_j/./'/~_,?.--~--r- BUILDING ~=~,~/ NEAREST FOUNDATION ,,LOT UNE CESSPOOL /v'~,, OTHER souacEs APPROVED__ . DISAPPROVED CONSTRUCTION DEPTH ~/~ / 'SEEPAGE / NEAREST SEPTIC ~ , SEWER LINE , TANK .__,'~/~" SYSTEM REMARKS, DISTANCE FROM: / DISTANCES: INSTALLED BY: ~ C~Y~E~' PIPE MATERIAL: L,OT SLOPE: REMARKS: Form PW.026 DIAGRAM OF SYSTEM GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 350(') TL) L')O~ Ii'DAD F'OUC~ SEWAGE DISPOSAL SYSTE~ -- APPLICATION AND PER~IT PERMIT NO. PHONE INSTALLATION LOCATION SEEPAGE PIT-- ~DRAIN FIELD OTHER . TYPE AND SIZE OF FACILITY TO BE SERVED - r ~ ~~ ~ :7~ SO,L TEST .,SULTS ;y ~ ~ ( -- NOTE, THiS PERMIT~ NOT VALID WITHOUT ~'L COMPLETION DATE ANTICIPATED ~ '~ ~)' ' ~/ praTT~VAI fD ~NE YFAR FINAL IN~E~TIONI ~4 HOUR NOTI~ REQUIRED. BACKFILLING OF A~Y SYBTEM WITHOUT FINAL IN~E:TION BY THE HEALTH DEPARTMENT AUTHORI~ WILL BE lUBJEGT TO PROSECUTION. ~EPTIC TANK SiZE TypES[eel O~ ~B~SEEPAGE AREA SIZE TYPE DIAGRAM OF BYS~M MINIMUM DIBTANCE$. N[QUIRrMENT$ FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT 20 ~Cte DRAIN FIELD ~L0 ~:t, SEPTIC TANK TO SEEPAGE PIT WALL ~ f~ e TO NEAREST LOT LINE. WELL TO SEPTIC TANK e SEEPAGE PIT ORA,. ,,~LD * ALSO CONS,DER ARE~ WE~S. WATER MAIN TO $EPTIC TANK [0 fEI ,,, SEEPAGE PIT [0 fee , DRAIN FIELD [0 fee ~EPTIC TANK, 2~ fEI. SEEPAGE PIT [00 f~., DRAIN FIELD ~0 fi* , O RIVER, LAKE. STREAM. ./ CAS~'IRON INTO AND OUT OF SEPTIC TANK AND iNTO CRIB CROSSING GAP OF EXCA~ION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON ~IPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER I, lkl~*!:U.! t,!£I.L 1 I~!t I V ! I1UAL 1 (F 't?~;i:,-' ".;0 ' lO PiT- 100' ~0 T~;K- B0" TO FIT- ~0" 40'-{~0' 0liLY I. l'O TANK- 200' I() hit - ~OO' lflg'-2qO' 0ULY CA)T iPOH q~l: AI.I~ ~{A T I OH 4" CAST IRON SIPIION $i'PTIC PiP[ k'llH AIRTIGHT CRIB · 1A!~I: ~,~'~ CAPS .-~ .... .,,.: .._. [/~::,:;; ,. .............. ~,~~j~,~--- ' '~ ....J ~ · '~:.:.,. ,:' - -- .... .D~";' CAS~ ~ no~ ~.'~';~:':~ ..... I:'::'?.'{ I I I %,,~L ,*;~¢,.L . . ~o~: o c~.. ' C I required ~d~oncver line crosses (CRIB 4' HI~I~UM ABOVE' WATER.: undcr drt ve','~y, lADLE) 4 It~CH S~t~ER COIiS 1 (Jr R ARCA t~ELt S. St[PAGE Pi1 EXCAVATIOIi BASE~ SOIL lEbT, i Grade: ~'.per IGC' Or 1/4" p.r foot except 10~ pr~cfL, dJl~ "^"5' ' ta~k Jtha. s~ould nuu c eot eXCeed 6~ per 100 on fiat CAST ]~Otl~ ~'SEPTIC ~ fllSTUflB[~ ~ [ CAST IRON SIPIION PIPE SO~L ,~ / SEEPAGE PiT I;E~PC~T L0f Lille , ',~ DE~TCRIB ED .~YSTEM~~//~/¢7LIS IN ACCORDANCE WITH SAID CODE. .~~/./) / J(-/~//~/.L_Z~.."- t ~ . DA E APPLICANT'B SIGNATURE DEPARTMENT OF ENViRONf~Ei'iiAL 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE # Performed For TNm~.~s Lemal Descrintion: Lot This ~orm Re~orts Soils ~. ~'o---.~ , _Date Performed /2_Block / Subdivision__~j~.e.~ Log ~ Percolation Test ~eoth Feet Soil Characteristics Was Ground Water Encountered? m~ ~?o~ I~ Yes, At what Depth? Readin.q Date Gross Time Net Time Denth to H20 Net Drop Percolation Rate ~ili nute Proposed Installation' Seenaqe Pit Prain Field Pa t e ' MUNICIPALITY 0f ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 017-01-323 HAA # ('~'<~/~ GENERAL INFORMATION Complete legal description Lot 12, Block 1, Aspen Highlands #1 Location (site address or directions) 13001 Hillside Drive, Anchorage, AK 99516 Property owner Mailing address Lending agency Mailin. g address Russ Cary Day phone Day phone 345-3795 Agent Address George McCain Day phone 333-3332 e Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 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: xxx If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm s & s ENGINEERING 17034 Eagle River Loop Road No. 204 Address _~_g!e R!Ye.-, ?.]-__~k= °°=.77 . Engineer's signature .~-~Y Z /~----~ Phone Date DHHS SIGNATURE J Approved for F (~ ()~ Disapproved. Conditional approval for 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 ~ Municipality of Anchorage OC'[ 0 DEPARTMENT OF HEALTH & HUMAN Environmental Services Division. 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: Health Authority Approval Checklist (917 -Ol-3,3 A. WELL DATA Well type t° ~' / v/~ ;' ~ Log present (Y~ /v O Total depth "5 '7 5' Sanitary seal (~N) '7 ~- $ If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to ~ 0 ~ Casing height (above ground) I r _)_ Wires properly protected ~/N) ¥ ~ $ Date of test Static water level Well production FROM WELL LOG AT INSPECTION WATER SAMPLE RESULTS: g.p.m. :?' + g.p.m. Coliform 0 Nitrate Dateof sample: ?o / ~/.W~' B. SEPTIC/HOLDING TANK DATA Date installed ~ ~.. / '7 3. Tank size ~ o 3. 5'- l./. -/,// Other bacteria o S &$ ENGINEERING Collected by: 17034 Eaale River Loop Road No. 204 Eagle River, Alaska 99577 Number of Compartments I Cleanouts (~N) ~ 0 High water alarm (Y~j~. "' 0 Foundation cleaneut,{~N)(:~ ~.r, c T~,.~ Depression (Y/~) Oateofp~d~Plflg ~"/">G~.[*~,t. Pumper .~ '/' /./o~f._. C. ABsoRpTION FIELD DATA "- ;" "':' Date installed` ¢~/~' ./ ~/ ....... ~So,I rating ~r fff/bdrm) -:. - - ! Length'~, ,,-,~ / ' Width. ,,- O ."/~' System type ~ ~*' c// Gravel thickness below pipe / ~ Total depth / 'y '/~ Effective absorption area 13~/:). ~rZMonitoringTubepresent(~) Y~.~ Depression over field (Y~)) ~,, 0 Date of ,dequaw test. G 1, w / , Resu ts{ )F,,) ~'/~ $ ~ For ../7/ bedrooms Fluid depth in absorption field before test (in.); .3 .3 ~, Immediately affer~~'G gal. water added (in.): 6 o Fluid depth '~ ' ~o ~' (ins) Minutes later: 3 5 Absorption rate = (~ 0.0."/'. g.p.d. Peroxide treatment (past 12 months) (Y/N) ~,~,v~.. ~.,~0~/ If yes, give date -- 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* cycles Size in gallons "Pump on" level at* evel at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~ ~ f(t,,~ ~ ~*~,~.~ To ~73~) On adjacent lots ! Absorption field on lot ! 0 ~ 4~ On adjacent lots Public sewer main /v //~ Sewer/septic service line ! /00 '/' 1oo Public sewer manhole/cleanout Lift station /') /// SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~ -F Property line 5"" f-/'- Absorption field. Water main/service line I o '-F Surface water/drainage I o 0 '+ Wells on adjacent lots I_/_ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain Building foundation / o -/'- Water main/service line Driveway. parking/vehicle storage area Wells on adjacent lots I o F. ENGINEER'S CERTIFICATION ..~?~... , I certify that l have determined thru field insp,,ion, and review of Municipal =~~=~.~ ~,m, are in confo~ance ct on ~is date. - Date ~l 0 [ S- / ~ g . HAA Fee $ Date of Payment /~/~.~../Y~ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number OCT-08-08 16:50 FROM-CTE EN¥ I RONMENT^L CT&E Envlronmenlel Se~vlce~ Inc. 56t~301 T-BS1 P.01/02 F-g2B CT&E Ref.# Client Name Project Name/# Client S#mple ID Matrix Ordered By PWSID Sample"R~ema~ks: 985738001 S & S Fngm¢cr~ng L~ 12 Bik I Aspen Highlands L~ 12 Blk 1 A~peu Highlands Drinking Wa~r Clien~ PO# Prin~ed Date/Time 10/08/98 16:32 Collected Date/Time 10/02/98 09-- Received Date/Time 10/02/98 10:50 Technical Director: Stephen C. Released By~~__~ Parameter Total CoLiform o 4.7~ 0,100 5MI& 9ZZ26 70/02/98 ~,ap EPA 500,0 10 mas 10/05/98 10/05/98 GCP 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 Parcel I.D.# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) 13001 Hi~l~id~ 'Driv~ PropertY owner Mailing address Lending agency Mailing address Anchoraq~, AK M~rri Ann~ Drinkal£ 13001Hill~id~ Driv~ Anchorage. Agent' Art Clark/ 2001 Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well ~' Public water Day phone 345-2334 AK 99516~, Day phone Day phone 276-2001 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 e 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. qV 'ae^RI el§"3 Name of Firm Phone Address Engineer's signature DHHS SIGNATURE -'/'/Approved -for bedrooms. Date Disapproved. Conditional approval for 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 ,,dependent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. (~ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well Log present (~ Total depth Sanitary se~--~/N) If A, B, or C, attach ADEC letter. ADEC water system number ~L.)/~ Date completed /~::~ "~'~.- Driller L~ t~-- Cased to '~"D '-'~ Ca~ng height Wires properly protect~,)N) AT INSPECTION g.p.m. ['~ g.p.m. FROM WELTOG Date of test / Static water level / / Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/hetdfng tank on lot ~/--~-~ Absorption field on lot I I ~) / Public sewer main 1~ ~__~ Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: -Z~ ~~-~ "~(-- t.~J~--~-F:P~I-'~--~'~:::) Coliform ~ Nitrate ~,~~v~/ ~ Other bacteria Date of sample: ~//~/~ Collected by: ~ ~ ~ ~ B. SEPTIC/HO~D~q~ TANK DATA Date installed /'~--I ~ ~ Tank size ~ ~"" Compartments Cleanout N) Foundation cleanout (Y/~I),)~ ~ ~ Depression (Y~ High water alarm (Y~) . . Alarm tested (~J'~ _ __ __ Date of pumping ~12~ ~ :~'' PUmPer ~ ~.~ SEPARATION DISTANCES FROM SEPTIC/Et~t~N~I~ TO: Well(s) on lotC~, ,,~ ~,,,_ To property line Surface water/drainage On adjacent lots Absorption field [ ~ ~ --~ Foundation '~-- ~t- ! /~t Water main/service line I~) '-~ 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical~,~N) SEPARATION D~ANCE FROM LIFT STATION TO: Well orj4dt On adjacent lots _ .~an h Die/Access (Y/N) "Pump on" lev~'~'~ "Pump off" Level at J Cycles tested D. ABSORPTION FIELD DATA Date installed Length ~(' Total absorption area Date of adequacy test ~/~-~/~-? Soil rating (GPD/Ft2) Width "~/ Gravel thickness I'~::~ ~ Cleanout present~/N) I-~ [,~. Results (pass/fail) ~_.~ Water level in absorption field before test Peroxide treatment (past 12 months) (/~ Surface water System type "~ Total depth Depression over field (Y~.~ ~-~'./~ for ~ Bedrooms After test f.-) If yes, give date ~--)/--~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1 To building foundation /--~_ ~,/ On adjacent lots Surface water Curtain drain On adjacent lots I ~ '4-- Property line To existing or abandoned system on lot Cutbank ~-~ C>~-~ Water main/service line Driveway, parking/vehicle storage area ~ E, ENGINEER'S CERTIFICATION ENG;NEERING Signature /~/ ~/ 17o3~ River L~ Read, HAA Fee $ Date of Payment ~'-/Z) - ~-~..~ Date of payment Receipt Number ~ ~-'-~/~,~.? L~(b/-j)O ~2 Receipt Number 72-026 (3/93) Back NTAL LABORATORY SERVICES S,NOE .... REPORT of ANALYSIS Chemlab Ref.~ :93.2880-9 Client. Sample ID :L12 Bi ASPEN HIGH~ANDS S/D Matrix :WATER 5633 B STREET ANCHORAGE, AK 99518 TEL: (907) 562-2343 FAX: (907) 561-5301 Client Name :S & S ENGINEERING Ordered By :RAY SHAFER Project Name Projects : PWSID :UA Sample Remarks: SAMPLE COLLECTED BY: S.S. WORK Order :67364 Report Completed :06/22/93 Collected :06/18/93 @ 08:57 hrs. Received :06/[8/93 @ 15:00 hrs. Technical Director:STEP.HE~N_./C. EDE Released By :/'? 7~---- Qc Parameter Results Qual Units Allowable Ext. Anal Method Limits Date Date Init Nitrate-N 4.49 mg/L EPA 353.2/300.0 10 06/21 LLH * See Special Instructions Above UA = Unavailable ~* See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than Member of the SGS Group (Soci~t~ G~n~rale de Surveillance) ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA -INSPECTOR INSPECTOR INSPECTOR ~ " ~ ~V]RONMENT~ REQUEST FOR A~PROVALOF INdiVIdUAL wATeR AND sEWER FACILITIES DIRECTIONS: Complete all part~ on page 1, Inc0mplet~ r~qu~ will not ~ pro{~d, Please allow ten (10) days for processing,' 1.' pROpERTY O~R ~ ' - ;" ' ' I PHONE PROPER~Y RESIDENT (1~ diffe~nt from above) ~ PHONE , , y ..... pHON~ 2, BU ER MAI LING ADDR ESS ' ' 3~ LENDING INSTITUTION ' - ' ' ~ ' ' ' I PHONE 'MAILING ADDRESS .... 4." REALTOR/AGENT ~ ' I pHoNE' ......o...,.,o. ., ........ Lot- 10. ~t. oer. I ,~t~ /1'/~ S~'R EET LOCA~TI ON 5 - ~,. ,r , ..... .- 6. TYPE OF RESIDENCE ' NUMBER OF~BEDROOMS · ~ SINGLE FAMILY [] One [] Four [] Other ~' Two [] Five [] MULTIPLE FAMILY . [~.Three [] Si~ - 7,' WATER~UPPLY r , -.-.. [~ INDIVIDUAL* * ATTACH WELL LOG, Awell Icg is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach Icg if available.) _B. SEWAGE DISPOSAL SYSTEM. ' - ' ' ' o ~ ~' ~, t ~&,~ ' ~ ,,,,v,o~,~,o,.s,,~- / ~ z& ~,,,~;.;,~ s~s,~ ~,s ,,s,,,~,~. I NOTE: THE INSPECTION FEE MUST ACCO MPA N YEA C{~ ~'tBfF;R E~O~S ~INGC A NB E IN ITl ATE . , THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] NDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] t N DIVI DUAL/ON ~SlTE []PUBLIC UTILITY Connection Verified []Septic Tank.~o[ [] Holding Tank Size: ~ O~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Li~e ' ~" NUMBER OF BEDROOMS [] ONE [] TWO [] THREE [] FIVE [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DAT.EI NSTA L LED INSTALLER SOILS RATING MANUFACTURER MATERIAL Septic/Holding Tank IAbsorption Area I Sewer Line [] OTHER Nearest Lot Line 5. COMMENTS DATE [~APPROV ED FOR -~ BEDROOMS [] CONDITIONAL APPROVAL (letter must~mpany certificate) 72-010 (Rev. 6/79) 1. Approval requested by: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received June 21. 1976 Time of Inspection 9:30 a.m. Date of Inspection 6-24-76 T.eS REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Polar Realty % Charlie Banister Mailing Address: 101 East International Airport Phone: 272-1541 2. Property Owner: Mailing Address: Allen & Patricia Pyhala Phone: 3. Legal Description: Lot 12 Block 1 Aspen Highland Subdivision 4. Location: 5. TyPe of facility to be inspected 6, Well Data: Individual A. Type C. Construction 7. Sewage Disposal System: A. Installed 1972 C. Septic Tank: 1. Size D. Seepage Pit: E. Disposal Field: 8. Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank Single Family No. of bedrooms 3 1. Absorption Area Total length of lines B. Depth 375' D. Bacterial Analysis On-site system B. Installer 2. Manufacturer 2. Material , Absorption area , Other contamination , Absorption area , Sewer Lines C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page'2 of two pages - Re. st for Approval of Individual '. er & Water Facilities Legal Description Lot 12 Block 1 Aspen Highland Subdivision /~pProved ~_ ,~j.,,% Disapproved Date ~2/ '-~ App~q~al Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 ENVIRONMENTAL PROTECTIO~ REQUEST FOR APPROVAL OF JUN 3 1 1976 ,.~,v,~u~. s~w~..n. ~. ~c,..,~s ~ I:~ !::: ! V_ If ~ -'--." '-- 1. Type of Inspection: 2. Property CMRO VA .... FHA ,CONV . . Owner: Mailing Address:. Day Phone: 3.Name of Buyer: Mailing Address: .... 4. Name of Lending Institution: Day Phone: Mailing Address: ...... Phone:_ 5. Name of Realtor or Mailing Ad dress: ~~L a~~ ~j~T~ 6. Legal Description: Location: 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: NO. Bdrms. , '~ Public Utility ,Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) 72-003(3/76)