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Home My WebLink AboutSUN VALLEY HEIGHTS BLK 3 LT 5 Municipality of Anchorage Page I of 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: '~¢~'/~,O ~-~1' PID Number: 01~' O~.- ~ ~ame: ~D O ~ TO~ ~/ Wastewater System: ~ New ~Upgrade Address: I~o t ~oo~-~ ~c~ ABSORPTION FIELD Phone: ~ [~ ~.~ ~ IN°'°fB~r°°ms: ~DeepTrench ~ Shallow Trench ~Bed ~Mou~d ~Other Total Depth from original grade: LEGAL DESCRIPTION s°"""""~; · ~ ~/s~.~,. Lot: Block: Subdivision: Depth to pipe boaom bom original grade: Gravel depth beneath ~ 25 5[~N ~,~LL[Y ~IEI61I 3 Ft.~ Ft. Township:[~ NII Range:~ ~ Section: ~ Fill added above original~ grade: Ft. Gravel length: ~ ~ Ft. WELL: B New ~ Upgrade eravel~: ~'~ Numberoflines: I Distance between lines: ~ Ft. ~ I ~ Ft. ~lassification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe materiak Driller: Date Drilled: Static Wa~er Level: Installer: Date i stalled: Yield:GPM IPump SOt at: Ft. ICasing HCgh, AbOve GrOu"o:F`, TANK SEPARATION DISTANCES ~eptic B Holding ~ S.T.E.P. TO Septic Absorption Lift Holding Public/PHvate Manufacturer: Capacity in gallons: From Tank Ffeld S,ation Tank Sewer Lines ~C~ T~t~ Material: Number of Com~mepts: s.~f,o~ ..... LIFT STA'rlON Water Size in gallons: Manufacturer: Lot "Pump on" level ~t: "Pump off~level at: High water alarm at: Foundation ~ ~ ~0 ~ ~ ~ ~ ~ Ourtain PUre Make ~ Mo~el Drain ~ ~ ~ ~ ~ ~ Remarks: BENCH MARK ~~,~ ~ Location and Description: 1~~ Assumed Elevation: Inspections performed by: ~ DateS:2nd.lSt ' ~ ~ ealth~ Hu~ '~'" Department of H d ervices approval . ~:" -:'-'-- ~:, Reviewed and approved _ Date: . ~ ' ' 72-013 (1/91) MOA 25 t-iiiI £5 0 £$ ~0 7~ 100 1£$ I~'0 $£~LE: I' = ~0 FF, I I TOBBEN SPURKLAND P,E, 803 W 15TH, AVENUE ANCH, AK, 99501 IILOT ~ ~kOCK $ SUN VALL£Y H£IGHr$ I SEC ~6 [TONY HA~]}URE 13201 Moun fo t n P l o ce SEPTIC SYSTEH ASBUILT DATE, SEP?', £~ 199£ SHEETi 2?$ GRID, 2938 S¢;ondord Tren~ _1 42 0 Nonl~or I 1/8' Pr; l/~ HOLES(~ 4B' 3' ~'lde 42' Long 9' Deep 12 6' Sewer rock 3' Cover NonlgorO I 1/~' P~C ~ II N~ SCALE ~LL VAL~ ACREAGE SYSTEM LIFTSTATIDN ~ 1£50 SEPTIC TANK OUT TO C ~ F R U ~C~CREECI~ MIrQ Fi 140 6 £'b o£ Sep~¢/c Rock TBBBEN SPURKLAND P,E, 203 ~15th Ave · nchorcge Ak 99501 /-- Monitor /--- 4' Topsoil / / /--- 4' Cover/ /, / ll~.~ I1~ -i~4_~~~ - 4 II L[FF ~TA~[~N ~50 G~L SEPFIC LOP S 9[.DCK 3 SUN VALLEY HEIGItTS SEC, £6 17£N T~INY NAR~UR~ SEPTIC SYSTEM ASBUILT 9ATE, SEPT, 25, 1992 SHEET, 3/3 6RI~, £938 POST IN A CC)NSPICUOUS PLACE ELECTRICAL 3500 East Tudor Road Phone 786-8376 INSPECTION 563 34F~ i ~IT FEE~ NO. ~ i4-009 (Rev. 4/8B) POST Tiil9 COPY MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920294 DESIGN ENGINEER:TOBBEN SPURKLAND, OWNER NAME:HARDUAR A BARRINGTON OWNER ADDRESS:13201 MOUNTAIN PL ANCHORAGE AK 99516 DATE ISSUED: 9/18/92 P.E. EXPIRATION DATE: 9/18/93 PARCEL ID:01706235 LEGAL DESCRIPTION: SUN VALLEY HEIGHTS BLK 5 3 LT LOT SIZE: 42958 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. THE CONCRETE CRIB MUST BE ABANDONED. AREAS DISTURBED BY CONSTRUCTION MUST BE TOPSOILED AND RESEEDED PRIOR TO 'INAL APPR,OV L. 5 203 I} 15th, ¢~,enL~e~ SL~if.e 206 AI~CIt0RAGE, ALAS)(~t 99501 (907) 2794~'16 SEPTIC SYSTEH DESIGN TONY HARDURE .STANDARD TRENCH TOTAL LENGTH B4 FT. 'TOTAL NIDTH 5 FT. TOTAL DEPTH 9 FT~ ROCK DEPTIt 6 FT. COVER 5 FT. CHECK EXISTING TANK REPLACE IF necessary WITH SEPTIC TANK 1500 BAL. STEP LEAVE EXISTING CONCRETE PLACE PIT !::~ q. S:.' BL£CK ,I LD1- 5 LOT 4 LD? 3 \ LL #3 ~LL1CK 3 LDT 9 I I c,K3 -~ I00 1.50 £00 8.50 SCALE; 1' = 100 FT. LO? 4 300 TDBBEN SPURKLAND P,E, E03 ~/ 15TH. AVENUE ANCH, AK, 99501 II L . IJT 5 BLDCK 3 SUN VALLEY HEIGHTS SEC TOWN RANGE TONY HARDURE SEPTIC SYSTEM DESIGN DATD SEPT, 9, 199£ SHEET, IlS GRID~ £958 INSTALL , I TOE DF ~ANK 99~ ~'1 TRENCH SUMP ;;;;1;:;':'**' ~0~,~ GAL *C~NCRE~ ~KEY BDX CRIB 2,5 ,50 75 100 125 SCAL& 1' = 50 FT. T~/D TRENCHES REPLACE 1250 GAL SEPTIC TANK 'BBBEN SPURKLAND P,E, W iSTH, AVENUE ANCH, AK, 99501 LOT 5 .BLOCI¢ 3 SUN VALLEY H£TGHTS SEC 26 TI2N R3~/ TONY H~RDUNE 13201 Moun ~o l n P l o ce SEPTIC SYSTEM DESIGN 9ATEI SEP~ ~ 1998 SHEET~ 1/3 GRID 2938 0 Non/tom 4-1neb Clean f(nltorO Clean 3' Il/de 42' Long 9' Deep 6' Sewer mock $' Cover 4-tach ~er£ l£ 3 Clean Llut~ 3 NL1 SCALE J 1-l/8' P°l 1500 9al STEP tank Cleonouts 4' Topsoil 4' Co vet Moni~cor 4' Nin Cover' Tank PllroF/ 140 6 £t oF Sep'b/c Rock NO SCLmE 1500 S?EP Tonk TUBBEN SPURKLANB P,E, 203 W15-th Ave Anchorage Ak 99501 £Lfl£1{ 3 SUN VALLEY SEC, 26 T12N N3lF TONY HARDU~E SEPTIC SYSTEM DESIGN DATE, SEPt-, g 1992 SHEET, 3/3 GRID, 2~38 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3- 4- 5- 6- 7 8 9 10 12 ~3 ~4 ~7 ~9- 20.- COMMENTS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST , (~NGINEER's ~¢v~ ~/l~ll~c~ ~'¢,~l~rownship, Range, Section: SLOPE ENCOUNTERED? SITE PLAN IF YES, AT WHAT DEPTH? S Monitorin[17 _ ~.~.~m~t~ I::; L [ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~;) (mmutesnnch) PERC ROLE DIAMETER 72-008 (Rev, 4/85) GR~ 'ER ANCHORAGE AREA BOROL 1 D~:,,-~fll'MENT OF ENVIRONMENTAL QUALh 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 2'19-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~'"/) J.)]l~[.~l'~:'l.'~'l _._ MAILING ADDRESS ))~g(,/IO~.-~.~_ {'~.L' PHONE ~.-~' DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL_-C~-O nlln LIQUID CAPACITY__Z~-~(~ GALLONS. MATERiAL~.((~./~' ~ ~/ NUMBER GE · ~ ~_C-'~ .~ __COMPARTMENTS INSIDE LENGTH_ ' INSIDE WIDTH. LIQUID DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS J/ OUTSIDE DIAMETER NEAREST LOT LINE__~) / 'rILE DRAIN FIELD: D~STANCB EROM WELL .... OR W~DTH /'i ~ /~ DISTANCE FROM WELl .../_~. ~} ~ ~'~ LENGTH /(" , DEPTH ., , BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALl· AREA} /~c~ SQ. FT. , NEAREBT Lo, UNE: ......... t'o ., GE UNEB NUMBER OF LINES_ -~) DISIANCE BETWEEN LINEg ' ~- TRENCIIWIDIH ~ 1-~ IN. TOTAL EFFECTIVE ABSORPTION AREA~ ,~Q. FT. ~ffH~F~I~E .... . . DEPTH: TOP OF~ILE [O ~NISH GRADE DEPTH OF FILTER MATERIAL B~NEATII TILE IN. ABOVE TILE WELL: TYPE (~l?'~fil~t~lT'-~' , DEPTH_ / NEAREST / SEPTIC LOT LINE , SEWER LINE ., TANK DISTANCE FROM .~ WATER ~/~ BUILDING EOUNDATION._~ SAMPLE___ , NEAREST ~ SEEPAGE / ~}~)/L¥, , SOURCES? /~. ' , SYSTEM. , CESSPOOL. DISTANCES: ~11' I)~(~ JOoi~Osd' DATE /~(.?.~/ /.~., ./gP APPROVED DIAGRAM OF SYSTEM G.A.A.B. FIPPL. I CRNT LO(.':A T ! ON LEGAL LINC C:ONSTR. UCT I ON DEFtRMOUN RD L.5 Bi: SUN VRLLEY NTS I'YPE OF SOIL RB'.E;ORBTION SYSTEM IS: 2L60~i SRNYR CIRCLE LOT SIZE TRE:NCH 40000 SOURRE FEET MFtXIrlUH NLINBER OF' BEDROC, HS = ~ SO~L RR'rZNc~ <S~ FT/BR;,= THE REQUIRED S~ZE OF I'HE SOIL FIBSORPTION SYSTEH IS: Tt4E LENSTH DIMENSION IS I'HE LENGTH (]N FEET) OF THE TRENCH OR DRFIINFIEL. E%'IJ TWE DEPTW OF R TRENCH OR P]T Z% Tt4E [:,ISTFINCE BEI'WEEN Tt4E SIJR. F'FICE OF Tt..IE~ GROUND FIND THE E:OTI'OM OF THE EXcFIVRTION ,::IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. TWE 6RRVEL DEPTH IS THE HINIHUM DEPTH OF GRRVEL.. BETHEEN TWE OtJTFRLL PIPE FIND THE BOTTOM OF THE EXCRVRflON (IN FEET). PERHIT RPPLICRNT HRS THE RESPONSIBILITY TO IHFORM THIS DEPRRTMEI'4T DURING THE INSTRLLFF['ION INSPECTIONS OF' RNY HELLS RDJFICEN-[' l'O Tt4IS PROPERTY FIN[) 1TIE NUMBER OF' RESIDENCES THRT THE WEIJ_ WILl~ SERVE. BFII-I. KFILLTN(3 OF ANY SYSTEM WI'FHOUT EINFIL INSPECTION RND RF'F'ROVRL BY TH.I'.5 DEF'FIRTMENT HILL BE SUBJECT '1'O PROSECUI"ION. MINIHLIM D]STIqNCE BETWEEN R NELL RND RN'¢ ON'-'SITE SEI'.IROE DISF'OSRL. SYSTEM IS ±00 FEET FOR R PRIVRTE HELL.; OR ±50 l'O 200 FEEl' FROM R PUBLIC HELL [:,EPENDINO UPON THE TYPE OF pLIBL..IC WEL..I .... OI'HER REOIL.IIREMENTS MRY FIPPLY. SPECIFICRTIONS RND CONSTRUCTION [.',IRGRRMS FIRE RVRILBBtZ TO INSURE PROPER INSTRL. L. RTION. I CER. TIF'Y THRT :t.; I Afl F:RMILIF~R WITH TJ'IE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS FI5 SE;3' FORTN BY 'T'HE: MUNICIPRLITY OF RNCHORROE. 2: I WILL INSTRLL THE SYSTEH IN RCCORDRNCE WITW THE CODES. ~: ~ UNDERSTRND TI4FIT THE ON-SITE SEHER SYSTEM MRY REC;!tJIRE ENL.RRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THFlN 5~ EJEDROOtdS. SII]NE[): ................................. RPPLICRNT' LINC CONSTRUCTION [] SOILS LOG iVI[JNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222'[ SOILS LOG -- PERCOLATION TEST PERFORMED FOR: )gte PERCOLATION TEST '~ ~SITE PLAN lO 11 12 13.- 14- 15- 16- 17- 18- 19- 20- WAS GROUND WATER ENCOUNTERED? IF YFS, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~2 0 ,(minutes/inch) TESTRUN BETWEEN __~-I ,,_ FTAND ¢-7' FT COMMENTS ,..,2-- u / / 72-008 (7/76) 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 GENERAl. INFORMATION Complete legal description I~ o-T ~ ~, ~ ~ \/f~.L.L_~_. '.-/ Location (site address or directions) Property owner _ ' l ,~vt.',,! ~4r~ u.~'z_ Mailing address '~.0. ~),~ bt ~,-¢-It Day phone Lending agency Day phone Mailin. g address Address Day phone 56 ~ "G~-'~ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-O25 (Rev, 1t91) Front MOA ~1 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature DTS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Date 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 DH HS 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. Legal Description: A, WELL DATA Well type ~/'~ Log present (Y/N) Municipality of Anchorage DE[PARTMFNT OF HEALTH & HUMAN SERVICES Environmental Se~ices Division 825 L Street, Room 502. Anchorage, Alaska 99501. (907) ~ Health Authority Approval Checklist ~~'s~a~eN ~ ~ NOV 85 1998 If A, B, or C, a~ach ADE~ le~er. ADEO water system Date completed Total depth Cased to Casing height (above ground; Sanitary seal (Y/N) Wires properly protected (Y/NJ. FROM WELL LOG ,~1' INSPECTION Date of tesl Static water level Well production g.p,m g.p.m. WATER SAMPLE RESULTS:. Coliform Nitrate Other bacteria Date of sample; Collected by: B. SEPTIC/HOLr)ING TANK DATA Date installed ~/2-~,/q,~. Tank size/_~. ~ Foundation cleanout (Y/N) "2/ Date of Pumping I ~/,2, YJ~ _ Depression (Y/N) /~ . High water alarm (Y/N) .Pumper /~,4¢,~/, C-~.,3 P~,~_// -/ C, AB,~ORPTION FIELD DATA Date Instalted ~/~-,r'/~ ~ Length_ ¢'~'/ Width Effective absorption area Date of adequacy test_ ~ Fluid depth in absorption field before test (in.); Fluid depth P--c/~'-/ (Ins) Minutes later:· Peroxide treatment (past 12 months) (Y/N) _ Number of Compartments ~- Cleanouts (Y/N) ."7/_ Soil rating (g.p.d./fF or=ft~4bd~m)~_.. ~), ~ _ System type. Gravel thickness below pipe ~ ~ · _Totat depth _ C~ ~ Mon tor ng Tube present (Y/N) /_ Depress on over f eld (Y/N) _ ~ Results (Pass/Fail) _ '~ For Z-Z/ .bedrooms __ Immediately afte[ ~,/,¢;' gal. water added (in.): ~ i ?-- Absorption rate = .'2 ~'-~-~ .g.p.d. / If yes, give date L~ 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) / ~ ~ High water alarm level at* ~'~ Cycles tested Size in gallons // "Pump on" level at* *Datum "Pump off" level at* ~o ,I E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~ On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation .-~ Property line L~ O i Absorption field Water mair~service line ~'~-~'- Surfacewater/drainage l~Jl¢ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Surface wa{er I'd lo Curtain drain r'J I c~ Building foundation Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recordS.that the above"syste~ms in conformance with MOA HAA guidelines in effect on this date' ':f ''~ ' ~ ,~ ~ ['L : ~', Signature %~~ Engineer's Name I;~H ~:~ur~--t~ ¢'~-~'~ are HAA Fee $ Date of Payment .ece,p, Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number Parcel I.D. 1. GENERAL INFORMATION ~UNICIF£ALITY 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 Complete legal description Location (Si~'e address or directions) Property owner ['"'~ w ',./ J~o.¢c'~ ~ ¢'~'- Day phone Mailing address t ~, ~-CO I ~'-~, O~J ~ ~-~. ~ ~ Lending agency _ ~://a~.,~/~'~- L,)~ ~ K',,/,~/'J~'~5~'~r Day phone ~Mailing address Agent Day phone Add tess 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- : lng to the legality and status of system. : 4. TYPE OF WASTEWA'rER DISPOSAL: Individual on-site . /// Holding tank Community on-site : ' Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72-025 (Rev. 1191) Front MOA ¢i21 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 regulation~ in effect on the date of this inspection. NameofFirm ' ~ ~,,,-l~i~,~ ~,,~" Phone Address ~.O Engineer's signature 6. DHHS SIGNATURE ~ for bedrooms. Approved / .... Disapproved. Date Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date 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 Department of Health & Human Services HEALTH AUTHORITY APPROVAL. CHECKLIST LegalDescription: tt¢ .~ ~t L//~/,~,I /'/-~t'~ 4 ~. Parcell.D. A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELl. LOG Date of test Static water level Well flow Pump level SFPARATION DISTANCES FROM WELL TO; Septic/holding tank on lot g.p.m. AT INSPECTION ; On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE! RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ¢¢"//¢ Z- Tank size /~ ~O Cleanouts (Y/N) 7 Foundation cleanout (Y/N) High water alarm (Y/N) Date of pumping ~ Compartments Depression (Y/N) Alarm tested (Y/N) Pumper ~_/ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~"¢'/,~-% On adjacent lots To property line ~/~ Absorption field Surface water/drainage _Foundation _Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C, LIFT STATION Date installed Size in gallons Vent (Y/N) N High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) / SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot '[*¢/,'%-- On adjacent lots Manufacturer A ¢/t~¢-~.¢-- 0 Manhole/Access (Y/N) ¢~. I "Pump off" lei'el at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed ~/,¢-,,,-%/~ ~- Length ~' ¢ Width Total absorption area /6~ Depression over field (Y/N) Results (pass/fail) ~ Peroxide treatment (past 12 months) (Y/N) d Soil rating ~, ~:2 System type Gravel thickness ~o / ¢ / Total depth Cleanouts present (Y/N) Date of adequacy test '~t~/,~.. for ~ bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot ~'¢~.//--~- On adjacent lots ,]~ ~/~ Property line To building foundation ~'~, To existing or abandoned system on lot On adjacent lots Surface water Curtain drain Cutbank ?'~/,/"/~ _Water main/service line Driveway, parking/vehicle storage area E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe, ct on,the da, te of this inspection. Signature Engineer's Name HAA Fees '/7 Date of Payment Receipt Number 72 026 (Rev. 3/91} Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number WALTER J. HICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERV~kTION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 (907) 349-7755 October 1, 1992 Mr. Tobben Spurkland SUBJECT: Sun Valley Heights, South Class "A" Public Water System, PWSID 213962 Dear Mr. Spurkland: I have completed a review of this office's files concerning the monitoring status of the above-referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on August 31, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last inorganic Chemical Contaminants Sample results were submitted to this Department on July 8, 1991. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last Radioactive Contaminants._,~l:lple resu_~lts were submitted to the Department on January 31, 1992. (.T. his does not~eet t, he provisions of 18 AAC 80.200(a), State Drinking Water R~gu--~l'~ons. The last Organic Chemical Contaminants/Volatile Organic Chemicals were submitted to this Department on July 31, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above-referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do riot hesitate to contact this office at 349-7755. Sincerely, Michael Lu Environmental Eng. Asst. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date Or..-.-~ '~/,, /O/e~-5 GENFRAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address. or directions) (b) Applicant'Name ~. ___ Telephone: Home L~-~/¢'%'/~'~ ~) Business (c) Applicant is (check one): Lending Institution []; Owner/b'.:ckCe~j~; Buyer D; Other ['] (explain); (d) Lending ,nstit,ution /~/.~,~C.~'~/.- Address - /~0 ( ~-~9~ Real Estate Company and Agent ~ (e) Address ~ 70 ~ Telephone ...... ~ ¢0 (f) Mail the HAA to the following address: 'tYPE OF RESIDENCE si-ngle-Family~¢. Multi-Family [] Number of Bedrooms ____'¢¢¢ Other WATER SUPPLY Individual Well r Communit Public [] Note: If community well system, must bare written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite,~ Public [] Community f'] 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 72025(11/84} ENGINEERING FIRM PFIOVIDING INSPECTIONS, 'rESTS, FILE SEARCH, DATA AND INFORMATION ~ · As certified by my seal affixed I~ereto and as of the validatioe 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. Firm ' /'~"'~'~ c'~ vl ~ ~ --~.~Z~-(~] '~" ~' ~'7 ~ '~ ~ ~ ~ ~ Name of ~ -~- . . Telephone Address ~.OT~ t,~ / ~ ~ '~Z~'~ ~ ~{~' ~-~ ~ Date - ' [ ~ ~ ~ Engineer's Seal DHEP APPROVAL ~-- Approved for ~/~ ___ b e d r o o m s b y~J~ '- ~--~""~'""'z'~'~ Approved Disapprove~'~ Condition~-~) Terms of Conditional Approval Date CAUTION The Muncipal[ty of Anchorage Department of Health and Environmental Protection (DFIEP) issues Health Authority Approval certificatss based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of ^laaka. The DHF_P does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requiremeets. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description MUNICIPALITY 0;~ ANCHORAL ' DEPT. OF HEALT,~I EbJVIRON,~/~ENT,',L I',:O [£C~']0~ 1 WELL DATA Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Leve Casing I-teight Above Ground Electrical Wiring m Conduit (Y/N} Separauon Distances from Well: To SePtic/Holding Tank on Lot C If A. B, C. D.E.C. Approved (Y/N) Date Completed f¢/'/~ Yield Depth of Grouting Pump Set At . Sanitary Seal on Casing (Y/N) Depression Around Wellhea(~ [Y/N) ~'~ ¢-0-.~ On Adjoining Lots TO Nearest Edge of Absorption Field on Lot _ '~ ",~or_.)~_: On Adjoining Lots To Nearest Public Sewe~ To Nearest Sewer Service Line on Lot Date To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLI::)ING TANK DATA Date Installed Standpipes (Y Depression over Tank [Y/N) Pumping/Maintenance Contract on File [Y/N) Holding Tank High-Water Alarm (Y/N) Senarauon Distances from Septic/Holding Tank To Water-Supply We '7 To Property Line To Water Malt/Service Line ~ Course I'~ O ~/~. Air-tight Caps (Y/N) _ Size I ~.~ O %1o. of Compartments T I'¢¢/~ ~ Foundation Cleanout (Y/N) Date Last Pumped q/~-~ : for Temporary tdota~ng Tank Permit (Y/N) To Building Foundation ~ To [)isposa~ Field To Stream. Pond LaKe, or Major Drainage Comments Page 1 of 2 C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date installed Width of Field ~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~'/ Square Feet of Absorption Area ~'"r'/rZ /:' 77,~" Depression over Field (Y/N) Results of Last Adequacy Test ""'"~ Separation Distance from Absorption Field; To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) UFT ST*'r,o. NoNI Date installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ny Receipt No, ~v .'~O--/(O I~ ~¢' "' ~'~ Date of Payment /O '~ '~: "" * ..... ; ' ~' Amount: $ G~-O~ ~t~.4~TiI ~,:~ ...~ Engineer's Seal ' Page 2 of 2 f¢ '~;.. /JUN'~ 25, 1.971 ..... ~ ~ ~ ~ ANCHORAGE ALASKA 99501 CONSULTING ENGINEER TELEPHONE 1907) 279-3916 S E P T I C S Y S TEM AD E Q U A LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: LOT 5, 13201 BLOCK 3, SUN VALLEY HEIGHTS MOUNTAIN PLACE K. BEHYMAR SINGLE FAMILY, FOUR BEDROOMS ¥o. 'Z'225-[:: ,'.',,~ FROM MUNICIPAL RECORDS: " ~ ..... --:-~ TANK: STACK STEEL, STEEL, TWO COMP. 1200 GAL. ABSORPTION SYSTEM: CONCRETE CRIB AND TRENCH ABSORPTION AREA: 549 FOR CRIB, 798 FOR TRENCH SOIL RATING: 330 PER BEDROOM INSTALLATION DATE: 1972 AND 1979 CLASS C COMMUNITY WELL DATE OF PUMPING: 9/25./85 NORTHLAND PUMPING DATE OF TEST: 10/3/85 TEST PROCEDURE WATER WAS ADDED TO FHE CRIB AT A STAEDY RATE OF 6 GALLONS PER MINUTE. THE LIQUID DEPTHS IN THE TANK AND SUMP WERE MONITORED. THE ADDITION OF 600 GALLONS CAUSED THE WATER LEVEL IN THE SUMP TO RISE FROM 36 INCHES TO 45.5 INCHES. ONE HOUR AFTER THE WATER HAD BEEN ADDED THE WATER LEVEL WAS ]DOWN 3.5 INCHES. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the wa~er usage of the family being served by the system. These conditions are outside the control of the evaluasor of this septic system. We can therefore not: give any estimate of how long the system will confinue to meet the operation~i requi- rements of the Municipality and State. DE]PT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 / / / / BILL SHEFFIELD, GOVERNOR Telephone: (.907} Addross: 274-2533 DATE: PWS I.D.# ~/~_. od2 S To Whom it May Concern: According to records on file in this office the_ ~ Water System is in compliance with the Stale Drinking Water Regulations Sincerely, Depsrtment of Bnv!ronmentsl Qusltty , 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 r~ ~)~/,~', ' Date Received t ,,, .... ~_ ~// Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Address: Phone ,,' a . ' 5. Type of Fecilit7 to be Inspectsd:__.~'~. i~~ Number Of Bedrooms: ~ ,,, ' Ye Well Data: C. Construct~ n~ ~__~.~__~___.D' Sewage Disoosal System: C. Septic Tank: 1. D. Seepage Pit: 1. Disposal Field: Dept~ ,-Q'/~/ , Bacterial Analysis~ Total Length of Linee__7/~-- ,, 8. Distances: A. Well To, Septic Tenk,,,,,~/~- , Absorption Area 7~/[~ ,,, Sewer L~nes _~,~/~ ., Nearest Lot Lin __._, Other Contamination .... . B. Foundation to Septic Tank ~/ "~ AbsorPtion Area ~ / C. Absorption Area to Nearest Lot I, ine__,~!/-. . , .. Request for Approval of ~,,dividual Sewer & Water Faoilitieg Page TwO Approved ~ Disapproved Date__,/~.-~ -~ Approval Valid for One Year From Date Signed Greater Anchorage Ares Borough, DeFartment of ~nvfronmenta] Quality DIAGRAM OF SYSTE!M I certify that the information contained in this request for appreval to be a true and accurste representation of the subject sewer and water facilities located at: Signed Date