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HomeMy WebLinkAboutBARNHILL TR A LT 1 krICV V:J/VL/ 10) Municipality of Anchorage On-Site Water and Wastewater Section < (907) 343-7904 Page 1 of 2 Ohl-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221268 PID Number: 011-262-30 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name GREGORY L PHELPS ABSORPTION FIELD ❑ El Dee p Trench ® Wide Trench ❑ Bed El Mound ❑ Other Site Address 8501 SKYHILLS DRIVE Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 8.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.0 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision BARNHILL TRACT A Block Lot 1 Fill added above original grade 0 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines NA Distance between lines NA Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 500 Ft2 Number of trenches 1 Dist. between trenches NA Ft. Well 100'+ 100'+ NA NA 25'+ TANK A Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ 100'+ NA NA Material Number of compartments Lot Line 5'+ 10'+ NA NA NA HDPE 2 Foundation 101+ 10'+ NA NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer GLW Enterprises PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield 3034 CO/MT3034 Inspector PES BENCH MARK (Assumed elevation) 100.0 ft Inspdection im 06/06/22 28/18/22 Location and description 3rd 8/22/22 4118/23/22 South Side Garage Finished Floor ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date�,. OF ACS a�......,qs .. � . ;.:. . `j .. r. vee R Fan norae �s 1 '. r�149 OcgFE�,i�,a Septic System Approved Date(� Note: s approval does not include well permit requirem nts.��®��+` krICV V:J/VL/ 10) z Jo z�b '�Ot12�OHONd 133HS mp' Nb'�d �11S 89ZlZzdSO N',, 3nl�a SITH)\AS 1058 'ON AN83d a oaie-� u ;...:......d:d uwa,g '.. Sd1�Hd J.�J003�10 03NO3HO OE-z9z- L LO , ON '0'I'd 5 L 101 'd lOd(�il '-RHN�JV9 Orl NMVHO ,09 fzoz/80/co sb�V �o'3ydy�-- LOZB-993 C>)iV a3plVd ZL08I X08060 d3NOHd SONIMVdO 02100321 31V0 sNoisin3a " ...,..��(8806 lilt) �l'1 _,AS ON3 3NONNdd :S31ON :\ \ ..:.:: ' w 10' til Esmt o wDf \ .tee _ : w I�\��II m�w :Q 0 o0 . w / N c CO L'i LLJ -i I W o Iw Qo. 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Z W J I— z (n Z a_ — W (n Z W J I— 01 a OQw0Q'rL� (n000 W0<w (if >- (n-0 QFacooC)(nF� a z i- a_ (n Q (n a 5i � � f- a_ z t- a v7 Q (n N C) � N .--- M 17 CC) � �- Ln Lr) o of d• Lo Lo d- d- 00 h - co o h 00 h 10 Q N (D O N d- � dt h h a0 (6 0 0 0 O F F- � U U N W � U Z p 1- �¢ a - w � N O z o z 33 z o Z�Wm Zw FZF: F O J W BOJ~ "> o oa � y 1-2 pz QV10Q § QZ� V) 0 X J D o z d E W 00 3 y � LLJ — Z a_ — W cn .. Z W J I— z (n Z a_ — W (n Z W J I— 01 a OQw0Q'rL� (n000 W0<w (if >- (n-0 QFacooC)(nF� a z i- a_ (n Q (n a 5i � � f- a_ z t- a v7 Q (n / | ~` Lot | SkvhUks Subd. 61 = i . 20'Driveway Easement | / / m'Utility aDriveway Easement 10'U0i� o��-- / /---7--- -----� | Lot I —| am c L - | | --�= |— Av»x xManhole | Septic vent/ | ~ (tvp)/ | | | Tree \ |uCO 4 LU/ i ' | Tract A/— —~ m ~ ' ~� /-------------------- -- J ~ - 4�th30' Easement Granted to Lot 2, Tract A ' 8036 - LS AS -BUILT NO CORNERS SET THIS DATE Encroaches � Chain link fence -77------' N89058'00"W 193.15 CO ~~CJ Driveway encroaches 0<9 EASEMENTS OFRECORD, OTHER THAN FB 22-3 pg59&81 THOSE SHOWN owTHE RECORDED ' PLAT ARE NOT SHOWN HEREON FB 21'8, 54-59 UNLESS OTHERWISE NOTED. Lang |oereuy �— ection in accordance with ASPLS Standards of the following described property:-. LOT 1, TRACT A, Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvernents on the property lying adjacent thereto encroach an the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated Dated at Anchorage, Alaska this aym_feh[uayry_umw. FRED mmLATua&ASSOCIATES, LL.n. BE ! Engineers and Surveyors � This drawing is a representation of conditions found at the time the mortgage location sur,,ey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose, The information contained en this drawina shall not be used to establish any fence. structure or other improvements. This drawing shall only be used far a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite Permit Number: OSP221268 Work Type: Septic Upgrade Tax Code Number: 01126230000 Site Legal Address: BARNHILL TR A LT 1 G:2322 Site Mailing Address: 8501 SKYHILLS DR, Anchorage Owner: PHELPS GREGORY L & Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: 04 Z . Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: 8/16/2022 8/16/2023 50700 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. It appears that when installing the tank, the extent of rock around the concrete rings will be determined. The new trench is required to be 12' from the edge of the seepage pit's sewer rock. 2. Show the extent of the seepage pit on the Record Drawing. Received By: Date rd hANUNUPAU71'Y OF ANCH(C) RAGE I -A .-`e-"'.�"r•_`�s^.y_. :._-.�---n--'-".."^:_^.���:� ,.--�-�, :a-acF-i-n�--�,-.. Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I. D. 011-262-30 Property owner(s) Gragory Phelps Mailing address 8501 Skyhills Drive, Anchorage, AK 99502 Day phone Site address Same Date of Payment: Legal description (Sub'd., Block & Lot) Barnhill, Tract A, Lot 1 Receipt Number: Legal description (Township, Range & Section) Waiver No. Lot Size 50,700 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field X❑ Initial ❑ Single Family (SF)X❑ (w/wo ADU) Septic Tank X❑. Upgrade ❑X (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner -or authorized agent) Permit/Rush Fees: 1J / Waiver Fees: Date of Payment: 15' �_0 'a 2 Date of Payment: Receipt Number: 01 Y a (o G Receipt Number: Permit No. OS P '� 2 A )_ Gl�_ Waiver No. Permit App_-'- :- :-.,:c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221268, Deb Wockenfuss, 08/16/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221268, Deb Wockenfuss, 08/16/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221268, Deb Wockenfuss, 08/16/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221268, Deb Wockenfuss, 08/16/22 040.002 Client: Pannone Engineering Services Project: Barnhill Tract A, Lot I Date: June 11, 2022 Sample Source Water Content Sieve Size 3 inch 1-1/2 inch 1/4 inch #4 #10 #40 #100 #200 0.02 mm Particle Size Distribution Table (percent passing sieve size) Zn Lot I 2.4 Percent Finer 100 100 100 100 99 59 Classification Fine grained � Sand (SP) Invoice 170 Crowther Associates Percent Finer Percent Finer Percent Finer 1632 Bellevue Circle /Anchorage, Alaska 99515 Telephone (907) 349-2198 /E mail: crowther@,alaska.net p- —& to c , yl, ISI auwawa p- —& I c , yl, ISI auwawa ,v"4 . M, a � : mgPm tpmmv 4As:,worw Pwew QLVUKWWMAr �s w. ' F>" =.d# �.4—P44-041 IMI - Ozer ¥sc irsrIr --Ir 3I. x M w s vis 1L° 1 � � 5-0 r a a � : x M w s vis 1L° 1 � � 5-0 r a Municipality of Anchorage, Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P,O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 01 1-262-30 1. GENERAL INFORMATION Expiration Date: ,~:~ - ,~r--_ O L[, Complete legal description LOT Location (site address or directions) Current Property owner(s) JOHN & Mailing address PO BOX Lending agency Mailing address Real Estate Agent Mailing address 1, TRACT A ; BARNHILL SUBDIVISION 8501 'SKYHILL~DRIVE * ANCHORAGE, AK. 99502 SARA DOYLE Day phone 245-6964 2445~4 * ANCHORAGE, AK. 99524 Day phone Day phone Unlessotherwise mqueste~ HAA wfllbeheldbyDSD ~rpickup. 2. NUMBEROFBEDROOMS: 3 o TYPE OF WATER SUPPLY: Individual Well I Individual Water Storage r-'] Community class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site I Individual Holding tank r'-] Community On-site r'"] Public Sewer [-'] The'Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certifidates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued'with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of AnchOrage Development Serwces Department · ': 'i Building Safety Division ; ! :: ~' On-Site Water& Wastewater P~°g'ram .' ' i :: :: : i 4700South'BragawSt.! i::~ i~ i.; "P.O. Box i::'196650WWW;ci.anchorage.ak.us'. ~Anch°rage' AK 99519-6650 ':t ';) ;'!' i, · . ." ... . b, uTROF~iTY , ~ , r ,' . ~, , ,II' ~;: · Legal'DeScriP{io :,,;' '.'..,LOT: ,' TRACT, A; BARNHILL SUBDIVISION ;~fcel ID: O~ 1~'262-30 'WELLDATA~' ";' :'~ :: " ': i ~:' ; : . .. ~ . ~ . . Well type i:PRIVATE ;"' '~.;' If of;C ~qogide PWSID¢. ',':. ~weil Eog (y/N) . NO Date'~ompleted ~,~ ,!~.1968 ,Sanita~ seal fy/N) YES ~. ' ~'; i: Wires proFerly protected (Y/N) YES Totafdenth 242~!ft.:,:~. ' . . Cased to ~:' 40+ ft ;~ / . L,{: Casing he~ght (above ground) 12+ I ,' :'" Hi ' ' "' ' .: [ ":,. . ',' ~ ' . : , I i ', :' ;, : ~' ' ,~ I;: ', ; , ' ': : ' ' ...... , ............... 242, ~ .Statlcwater.le~~'; ft. ;,:- .: ~,,,:~..j:-.~ . ' prodUstiSn~f'~!~~ :~. % ' ~ ' ' ~'~::,~:.g.p.m.L i ::,:~::i'~:~':ti : ,,,~.3 :r. g.p.m. ,., WATER SAMPLE RESULTS: '..:;:~' ' ; ~;' :? , :, : :,; . r';: ;';.?' ' . :- ; :' ' . ?' :' , · H' ' : ,'. ' ' ' . : ' : . ; ~ - : : ; i' ~,' ;' Coliform : :'~,l~{colomes/100.m...N~trate O. lO mg;/L:';'~' . .OtherSactena ~ colomes/100ml. i .... ~i ..... J ' ~ Arsenic: ~i mg.'(L;.;'; .:~ .::..- .:.Data,of sample: 1/20/04 Collected by: AKWWC, 'INC. ' ~ .... ' ' '' · ~ I 't " , ' :' ..... SEPTIC/HOLDING ~ANK DATA ..... , .L,'¢~, ,,,~ m~,. Cu~.~n~ ~ '~k~ ,m~.~. oPACE ' , ;, ; , I~ , I"' ' ~ ''''" ' , · " ' . ' ' : "' '.~ ' ' TankiT~-e/Matbriali':"" ,UNKNOWN,~',:' - .: ,-'.;'14~ ~;~. Datemstalled ' lg68 , , ~ , : [ ;~ , , . , . : ' .~: j :~::'.i':. ::':.'~'". :[' : ' : '.' ~ :;' ".' ; ';' ; ' ' "' ' ~':" ; ' ' '' '" ...... "' ...... ' ....... ;' ' ........ ' YES Tank size' ;1.200~1aa1.::,~:. ' Number of Compa~ments , ..-1 :./. :::.. Cleanouts(Y/N) ' ,~ ..... % : ~ '~ ; · . ~ , r ~ , , ;~ , , , ':, ~~J I .... Foundat on.c eanout (Y/N) ' NO ...... Depression over tank (y/N) J ,NO. . High water alarm (Y/N) / , . .j ; , , , · I , .. : I~,,, :,, t 1 ~0 2004 ~ ~ ~ ~ CHUGACH PUMPING ABSORPTION FIELD DATA : ' .,:,", , ~:~[,BELOW,EXISTING,,GRADE , : ~, ,,, ', ' , ' i ~¢~s~~~t:.:,~ . ']:.! ': ;';~,:t :4; ;";.,~:"~?l:r~t~%~~~~.p.: ,.,.,~l,.;..... .,., . ~ ""' .": pi~M~D' ' ft. Total de t~r~;; ~4.,~';~ f~':~¢iff. a6;:0;mii~ A~8~:: UNK ~ff~ ii~;~ tube ~ES':;' ::.a~pression overfield NO Date ofadeauacv, test : ;.,1/30/'2004 -.. 'i,i,~: Results (Pass/Fail)]'i'PASS h; '.: ; ~ For ' 3 bedrooms , .... , , ~ .... ~1; , ,. : .... , , , ,,, .~ ,1 .... ~ . , , ,,.~ , , ,, .... ,; . . , .... :,,. .... . ,:....,...... ...l, .. .............. .... .. ., . . . . Fluiddepth nabsorptonfledbeforetest;19;5 m.-:r::~.: . ::Water added1059 gal: . .:.. ,, Newdepth 51 .... ,,......, ... ...... . .... ,.,.: ..,, . ..... .. ElapsedTime:;!120~mm. ~..Fmalflul~ depth .,~2 ~n:[]; .~, ~.~ Absorption rate>=__ 450+ ._g.p.d. ,i ~ . ,' ~:i~,~ I~ II,I ',,"~... , ," ' '"~, ' ; :' ""-~ !'l,~'~ ..... ' ~, i4' ' a · ' An~ rejuvenat on ~reatment (past 12 mo.) (YIN &' type) 2~ ~NONE. KN~2 ',, 'i'. If,yes, give date - 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~ \ ~ - ,~r,I ~ '~),- ..~('~ haa # '~ ~-.,~C~ Oe, t~~ .~ ~ GENERAL INFORMATION Complete lecjal description Location (site address or directions) ~-~ Property owner Mailing address Lending agency Mailing address. Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site 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 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 .~/'?7~_~¢ ~Z~ ~/'2~0/-(% ~/2;~:~__ Phone ~W~7~ Address ..~[~ ~~¢~¢~ ~. ~~./~, ~/~' EngineeCs signature ~~~~ ~ ~. '/D~ ~ -~ ~ DHH8 SIGNATURE .~/ Approved for %~¢L~--- 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 1¢21 Municipality of Anchorage R E { E IV ~ DEPARTMENT OF HEALTH & HUMAN SERVICES DEC :;5 0 19 Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 3~LW~"/P4~TM oF AN ENVIRONMENTAl- SERVICES DIVISION Health Authority Approval Checklist Legal Description: L~).'7" 1 T~~J-~ ~;~..~,A/~t'/_~.-,~· Parcel I.D.: A. WELL DATA Log present (Y/N) Total depth ~,I~..~ ~ Sanitary seal (Y/N) y If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to -~ ~ / Casing height (above ground) Wires properly protected (Y/N) ~ Date of test Static water level Well production FROM WELL LOG g.p.m. AT INSPECTION g.p.m. WATER SAMPLE RESULTS: Coliform ~ Nitrate. Date of sample: Z/~/~, £~' / Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Foundation cleanout Date of Pumping Tank size J Z....~'~ Number of Compartments / Cleanouts (Y/N)~ Depression(Y/N) >~'*'~Pumper /~_ ,~_r~.['?~/~ C. ABSORPTION FIELD DATA ~/~* ,>~,/ Date installed I ~ ~ ~ ~ Soil rating (g.p.d./ft2 or fF/bdrm) ,I Length i~d~/~l,~/f~ Width ~~ Gravel thickness below pipe ~ Effe~ive ~sorpfion area ~d~~ Monitoring Tube present ~) ~ Depm~ion over field ~) . . Date of adequacy test ~ J?~. Resul~(P~,il) ~~ For ~ Fluid depth in abso~tion field before t~t (in.); ~ Immediately a~er ~.~al. water added (in.): mFluid depth ~ (ins)Minutes later: ;~ ~: ~o~io~r~= g.p.d. Peroxide treatmeni (past 12 months) (Y/N) y Total depth ./ ~'~, ,~ "~'/ bedrooms If yes, give date /~ ~ 0"/~') ~'(~ 72-026 (Rev. 3/96)* Dm E= LIFT STATION Date installed ~ ! Size in gallons Manhole/Access (Y/N'~at* High wet, er ala~ ~ Cycles tested ' SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holdingtank onlot ~'Ot ~' f/~.- [ 4::~ ~) On adjacent lots Absorption field on Ici i: (~ ~-~'-/' ( F/~c ? ~'67 ) Public sewer main : ~) Sewer/septic service line /~/t~}- Lift station On adjacent lots Public sewer manhole/cleanout "Pump off" level at* r SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: ! ~' Absorption field ,4~f~/~. /~? Foundation /:~")-! !~ Property line (~o c'~ % , ._ Water main/service line ~ Surface water/drainage"/~0~(~-- Wells on adjacent lots ~ .J _L")~/? / SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Propertyline ,~,(,,~1 i' Building foundation ~--~[ C~!Watermain/serviceline ",,_~"'~/~?-) Surface water .~/,~, Driveway, parking/vehicle storage area ~ )d~' Curtain drain '~ ~ ~'" ~/~ ~'d~ ~///~. Wells on adjacent lots }(~ ~/ ENGINEER'S CERTII;ICATION I certify that I have determined thru field inspections and review of Municipal records in conformance with MOA HAA guidelines in effect on this date. Signature Engineer's Name Date HAAFee $ ~-'~- Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALIi'Y OF ANCHORAGE DEPARt'MENT OF HEALI-H & 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 ~ //- 2 /o'~. -- 54::) HAA# ~ 1. GENERAL INFORMATION Complete legal desCription Ba~nhill Subd±vision. Lot 1 ?ract A Location (site address or directions) 6741 w. Dimond Blvd., Anchorage: AK Property owner Gre9 Braud Day phone Mailing address 6741 w. D~-nond Blvd., Anchorage, AK 99502 Lending agency N/A Day phon(~ Mailing address 248-9156 Agent Address N/A Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well × Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. X 72-025 (Rev. 1/91) Front MOA #21 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 _ZagZ.e_E:i..v_az:_DuC~~rvtce_s Phone 694-51._95 Address P.O. Box 773294, Eagle River, AK 99577 Engineer's signature Well to septic distances approved under pre-1969 grandfather rights. DHHS SIGNATURE Approved for '-~'~4¢~- (3_> Disapproved. Conditional approval for bedrooms. Date 04/22/91 ~ ~n .. CE-6736 · ~ bedrooms, with the. following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 ( Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~-~'~' I ~3"~/~"~ Z~k,-~,4,'//Parcel I.D. A. WELL DATA Well type /"r~,,~+¢-. If A, B, or C, attach ADEC letter. Log present (Y/N) "~ Total depth .2¥.¢ Sanitary seal (Y/N) ADE~C~yTter system nu~m~be~r~_~.~,~~, Date completed ,Z..~,~ Driller ~'.' ~--~-,~'~'- Cased to ~ e',~ · Casing height ~-~(' Wires properly protected (Y/N) ~ FROM WELL LOG Date of test "~',/'~ Static water level ,.,,-/~. Well flow Pump level g.p.m. AT INSPECTION ~ g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot '~"~" / Absorption field on lot "~ ; On adjacent lots ~"/~'~" ; On adjacent Iot,i` . Public sewer manhole/clea Public sewer main Public sewer service line Petroleum tank ~. _,'~ _ ~4/,~ /U' WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate ~"~" ~') Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed / ~'~"~ Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size Foundation cleanout (Y/N) Compartments / Depression (Y/N) ~'/"~ Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~'~ ~ On adjacent lots ~.,,,,~,~ · Topropertyline /'/'~ Absorption field -"J,r','.',- Foundation Water main/service line Surface water/drainage 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Ve,,n.,t (,Y/N) - ,-~ "Pump on" level at High wat~'~l~m level~ ~"~ Meets M bodes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Manhole/Access (Y/N) "Pump off" level at Cycles tested Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ~"~',~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) ""'"~"" Gravel thickness ~' "~'~'. System type ,~' Cleanouts present (Y/N) Date of adequacy test for /-z'~'> ¢,,~,~ Total depth 7' If yes. give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot '-" ~) To building foundation On adjacent lots Surface water Onadjacentlots ~"/,~ / Propertyline · -q.c'/e~-. To existing or abandoned system on lot Cutbank /~/,~ Water main/service line Driveway, parking/vehicle storage area Curtain drain -,,,,-.-~- ,~,,,~,,4 ~-e..~'/- E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S ig at U re Engineer's Name HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 ii ii I1' III/ I~1 ........... Eagle River Engineering Services " 11940 Business. Blvd, Suite #205 ~ P.O. Box 773294 694-51 Eagle River. Ak. 99577 Fax Legal: ,ia~.-../ 7-.~ .J Owner: ,,Z~-,,~,v~ Date: ~/~ ~/,'~,, Type of test: r-1 Well Flow Test [] Septic Test Only '!~ Well & Septic lest [] Other: Meter Monitor Well Tank GPM PSI' Remarks' Time Reoding Level Level Level Louis Butera, P.E. Registered Civil Engineer April 23, 1991 Susan Oswaldt Department of Health and Human Services 825 L Street Anchorage, AK 99502 Re: Barnhill Subdivision, Lot 1 Tract A Dear Ms. Oswaldt, We are responding to your concerns for Health Approval on the above referenced lot. Thank you for your prompt review in our attempt to allow an April 24, 1991 closing. The main concern is laCk of a soil log on file at MOA. After discussions with Dan Bowles, it was determined that evidence of consistent soils and lack of water table in local area would be sufficient to allow approval based on the following: ;m~ W~ The system was installed in 1968. At that time the ~ ~.~4~ Municipality did not keep consistent records. There may 9~~ v have been a test hole accomplished with the. lo~ not ~ ~.~T~placed in record or not recorded due to lack o~ MOA ~'~ ..... files. 2. There is no suspected problem with ground water or soil type. The pit is performing very adequately and was dryc~~ at time of test. This is consistent with SW - GW type soils as expected per local soil logs· We had excavated~"~ to do a line repair and found SW - GP type soils in ~,~_~-excavation to 6 feet. This was inspected by Tobben 1,2~.~. Spurkland, P.E.. Soil logs attached for Lot 2 Tract A ' ~ Barnhill and Lots 7 and 8 Block 2 Seaview which are at a lower elevation show consistent soil data. The Sand Lake area is known to contain sand and gravel ~7~ subsurface soil with absence of water table. This home ~, is located on top of a hill with good drainage· The system was previously approved by the Municipality under a request for approval in 1972 .... ~'~. P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297 Page 2, Barnhill Subd., Lot 1 Tract A Se There was a proposed Subdivision called "Crest Ridge" which involved our Lot 1. The soils information should be on file at MOA for preliminary plat. We ask that the MOA waive any soil log requirements due to the above justifications. I do not feel that there is a danger in allowing this waiver under the described circumstances. The home is occupied. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. cc: Greg Braund MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAL1tt AND ENVIRONMENTAL PROTEC11ON SOILS LOC; .... PERCOLATION TEST PERCOLATION TEST PERFORMED FOR' LEGAL DESCRIPTION 1 2 ' ' ~;I. OPE SI1 E PLAN lO 11 12 13 14 15 16 17 18 19 20 L ENC©UNT F RE [)~ 0 P I1 ¥[$, Ar wHAT E N~t T ~rne' Depth to Water Net tU~ ~.LTH 777 __ . . r~,, [/~ 3 ~ "\ (~ I 4~ ..... .~- bate pmrforme~ '"~' - Ee ort$ 4; S<)-'~-~ Lo~ .... _F l~s Form P I)~pth Feet {~cat lo. Sketch ~as Gt-~nd Water £ncountered? /~.'.~ _ If Y-.s, At What ~eFth ........... ___ P. eadlni( D~te O~o~s Time Net Time Depth ....... To H20 Net,.Drop _ F-cposed Installation: '$eeuape }'it ~ 'Of' l)rain Field ........ Depth Of Inlet ,,,]t~' ..... l)eptn io ~o(tom' 'Pit Or Trench- //'{ ..... ......... ~ ~1~ .... (/ ~,~,~,/t lX~.'/'./~dr~ - . - Test ~erfor~d B):. _ i¥,:.cc_~' . .: ..... led i~7 .'___~..!/Z:._~_?/~.~!..Z~/ Date: ' - --... ---'-':..','i/',:'~"' l¢~_ , o- ~ O, LAN(i, r..S, 1731 I~Ct~i BF.J~ CIRCLE, AIEB0~GE, ALAS~ 99515 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Recetve ..-- Time of Inspection ~,"-~ 0 Date of Inspection ~ ~ .~ ,~ 1. Approval Requested By: REQUEST FOR APPROVAL' OF INDIVIDUAL SEWER & WATER FACILITIES Address ~. Legal Description: ~ /. '~"'~.~'~ FOR Phone: Type of Facility.to be Inspected.'_~ Number of Bedrooms: ~ 6.. Well Data.' e C. Construction D. Bacteria] Analysis ) C. Septic Tank: 1. Size /ooo 2. ~anufacturer ,,, ,, , D. Seepage Pits 1. Size 2. Materiel ................. , ..... E. Disposal Field: Total Length of Lines Be Distances: A. Well To: Be ! Septic Tank ~-$" , Absorption Area /00 , Sewer Lines , Nearest Lot Line-~'5-~3 , Other Contamination · Foundation to Septic Tank "~ AbsorPtion Area -~,~,'~ ..... · C. Absorption Area to Nearest Lot Line ,, ........ · Reguest for Approval of Individual Sewer & Water Facilities Page Two 9. Comments: Approved ~ Disapproved Date Approval Valid for One Year From Date Signed Greater Anchorage Area Borouqh, DeFartment of Environmental Quality DIAGRAM OF SYSTEM,. I certify that the information contained in this request for appreval to be a true and accurate reprnsentation of the subject sewer and water facilities located at: Signed Date FNA Form Rev. Jury 19S8 FEDERAL HOd,CmO ~,6M,NIST~a,T;CN Budget Bureau No. 63-R0296 HEALTH AUTHORITY APPROVe- INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM INSURING OFFICE Anchorage, Alaska MORTGAGOR OII SPONSOR John g. Laird PART I.mTO BE COMPLETED BY FHA MO,TOAOEE SEmALNO. First National Bank of Anchorage JPROPERTY ADD"ESS NHNDimond Blvd. Anchorage,Alaska SUKIVISION NAME Barnhill TOTAL NUMBER: ! 1 2 1/5 ~ WATER SUPPLY BY: J]Public system BASEMENT [] New installation Yes 1~ No El Community system S~WAGE OISPOSAL ElPublic system '-]Community system rt6/NO, ~o. f LOT tact A 1 Can crttJc ~r other ~rta bo made Into addl~onel b~om~? (If Y&s, how manyf) Individual ' ~o. o~ ~o,~s. Individual I j~ Yes ~ Ho PART fl.--tO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the E] State E] County [] Local Department of. Health that this individual water-supply system E~] is El is not ~tisfactory as a domestic water supply for the subject property. It is the opinion of the ['--] State El County tern with proper maintenance: [~Can be expected to function satisfactorily, and · is not likely to create an insanitary condition SIGNATURE 10-20-72 Robert C. Pratt [~] Local Department of Health that this individual sewage-disposal sys- El Cannot be expected to function satisfactorily ! ', Environmental Control Office4 DATE J TITLE NOTE: The health authority should complete the appropriate opinion statement above and affix date, signature end title in the Ipoce~ provided. Use of tho above gr~d for Health Department Inspector's sketch as well as use of the back of this form it at the option of th~ heal~ au~ority, "-: i,~;'~~:] ''~ ! I ACR£$ 7',.'-.,~ :! .'" '.:~ ..... :.(~]'. ..... 1 NOTE ....... :i:: ::: ..... All lot purchasers take and all lot owners hold their lots subject to the requirement that ali building units presently existing and those constructed hereafter be connected to public sewer facilities within one year after such facilities become available within 200 feet of the hearest lot line. ._N ~ose,w J_ J E TRACT "A" 74,400 SQ FT 1.708 ACRES (Basis of Bearing GLO Record ) LEGEND GLO or BLM BC Monument BC Monument 5/8" Rebar Existing §/8" Rebar set this s~rvey SURVEYOR'S CERTIFICATE~ ], The undersigned registered surveyor, hereby certify that a land survey has been completeO by me or unaer my direct supervision and that corners and monuments have been located and established and that the dimensions shown hereon ore true and correct. Date- z,/~'/A=..~: : ~: ...... ' t970 .......... ~. ~ , V- CERTIFICATE OF OWNERSHIP 5 DEDICATION, We hereby certify thai we ore the owners of the property shown and described hereo~. We hereby request approval of this plat, showing such easements for public utilities, roadways and alleys dedicated by us for public use. Dote .... "~' - - F370 :~, ~;,~ "~ ~,, HARVEY W. BARNHILL MARY K.' BARNHILL BOX 650'~ A~chorage, Alaska NOTARY'S ACKNOWLEDGEMENT, Subscribed ~nd sworn to-before me this ..... *~' 'i ,~.~-.¢_.J~. , 1970 ~ . ''- day of __ My commission expires PLAT APPROVAL Plat approved by the Borough Planning Commission PLAT OF TRACTS R~, ond "B" Bt~IHILL SUBD. SW I/4 Section 9. TI2N, R. 4W., S.M..Alaska DICKINSON-OSWALD 8 ASSOCIATES ENGINEERS - SURVEYOR $ CHECKED I DATE t ~_-16-70J 2322 I 3666 j 44-65 '