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SUN VALLEY HEIGHTS BLK 5 LT 1
Sun Valley Heights Block 5 Lot 1 #017-062-40 MUNICIPALITY OF ANCHORAGE DEl-, ,iTMEN'T OF HEALTH AND HUMAN SER~, 017 825 %" Street, Anchorage, Alaska 99502, TelephoDe 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address ~(s) Permit No Bedrooms LEGAL OESCRIPTION ' TANKS TYPE OF SYSTEM '~TRENCH El BED [~ W. DRAIN [] OTHER WELLS PRIVATE [] OTHEFI {Identify) REMARKS: DISTANCES ~ SEPTIC ABSORPTION TANK FIELD WELL WELL LOT LINE FOUNDATION Municipal and Stale Duidelines in effect on this date: _ Heallh Department App,'oval: ,.~'/~'~'~'~ 72-013 (3/85) Scale: Inspections PeHormed b: Date: .... sedily Iltat Ihls inspection was pedormed according le all ,~'-It,- g 7 PERFORMED POR: LEGAL DESCRIPTION: 4 5 6 7 8 9 10 11 13- 14- 15 16 17 18 19 20. Municlpallly of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST NOL$ 1_ I 695 SUA/ VALLfY HT'.'.~'°wnship, Range, Section: PEAl'-- OL COMMENTS SLOPE SITE PLAN WASGROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Oeplh Io Waler AIterr~r,' v Meniloring? -- VI~ ' Dale: _~] / 7/¢7 Reading Date Gross Net Depth to Net Time Time Water Crop PERCOLATION RATE TEST RUN BETWEEN (minutes/tach} PERC HOLE DIAMETER ET AND ff~ _ FT .2 7 ? PERFORMED BY: ~'" ~ ~ ~ ~ , , t /', kl, c ~ ~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE CERTIFY TEIAT TEgS TEST WAS PERFORMED IN DATE: ALASKA ~"IIRO~m~nTAL CONTROL SCR'"~,eS, IBC. ADDRESS ZIP CODE. LEBAL LOCATION TOTAL DEl)TH OF HOLE___.. ~'~ . ft, ZONE TESTED ._- ~ ,/~ ..ft TO_ '-7 PERCOLATION TEST DATA SHEET ._ft i~E. ADING #CLOCK TIME NET TIME DEPTH TO NET DROP RATE (min/ln) DATUM ~.' /V- ~:~ IP ~,'~ ~,O~-I,~f ,IF 3 '~!. % ' ~'~ I0 ,.,~,~ l, ~?~1,~ , il FILIAL PERCOLATION RATE . · ~,,~ .... __(min/in) ~ERFORMED DY__ .. P, /~d?/~, /~F'd ALASKA E"IROFIm~I1TAL COI~1'ROL ~jinm'im~ CLIENT ADDRESS' ZIP CODEL P__.ERC..~__O,LATION TEST DATA SHEET . RAY ~k,,/~L~ DATE LEGAL LOCATION --: TOTA~ DEPTH OF HOLE ..... ~,,5 ft. ZONE TESTED. HZ5 ...... RE,ADING # CLOCK TIME NET TIME DEPTH l'O HET DROP RATE (min/in) DATUM " EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. RECERTIFICATION " DR\vE · ~ B~ASB CAP HONgMENT -- LOT SURVEY CERTI FI CATIO~--~ LOT 1 BLOCK ~__ SUN VALLE~ HEIGH~SU~DIV[S[ON r, · ANCHORAGE RECORDING DISTRICT .~ RE'WmONS PREPARED BY: DOWLING '~"ASSOCIATES ; .'i.me'sldence ~:. '804 EAST'; ANCHORAGE, ALASKA '9950 : ~ . ~ .' .': · , ' 0~:~:_.~_~S_~98~ I"~,~ I~'', u':4o' J'°'8~-oo2t q~'D~A~Y J GRID: 2938 ' i(~.~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME~ ]PHONE MAILING ADDRESS cS K x LOCATION ' ~ ~ / ' NO. OF BEDROOMS .... Well Absorption area Dwelling PERMI~ i: Z Manufacturer ~- No, of compartments ~ ............. Manufacturer . ............... q-~q~- ~ ..... ~ria¢ ......... liquid cap~in gallo n s ~ = DISTANCE TO: ~.11. 0'~] ItL .~/A" ~17.i/ri Foundation~<¢ ¢~:"X, Nearest lot line Z O/;? PERMIT NO. ~~_- ~ No. of lines / C~ngth of each line ,~, Total length of Ib~e~/~/~; ~J Trench~width,.. () ~incbes Distance betwee ; ~ E Top of tile to finish grade / Material beneath tile , .. OTHER 72-013 (Rev. 3/~ ) I::'EI:~:M I T NO. I::IF:'PI,. I CFINT I...OCf:I'T' I O1",t I..E GI:::IL. JOHN EivlE R E;Oi",t ']'FIHOE I)EF:'FIRTMEN-I' OF HEFILTH FIND EN'v'IRONMEr. Ef'FIL. F'RCrI'ECT]iCff.,I 8?5 "'L'" STf[:EET., FliqCHORFII3E., FII':::. CI~ Ib..~ -.- _"E~',; :f[ '"F EF. :~T, DE L.JI EC I[:-':: It ..1~ F:::" (]~:~i 11:;i~: FII IE::, EE F" E: F: I'"'11 ]E -'t~ ( ? SrEu~,r58 E',. R. FI, BOX ]:72-X I..O'F :t. BK 5 E;UN ',,,'FIL. LE'¢ I-ITE; L. OT SIZE ;:?SE~Eu;~ :E;qt.IFIF;~:F_': F'E:E:T "I"VF'E OF SOIl,. RE~2;OREKI"ION S'T'S'f'Ef4 ~:E;: TRENC:H MI::I',~',',IMLIH i'.,IIJHE~ER ElF' BEDROOMS = :']: SOIL RFITING ,::E;g! FT/BR),~:: :tS~i~ ]'FIE REE.:!UIRE[) SIZE OF '¥HE SOIL. f:IDSORF:'TZON S¥S'f'EM THE LENG'r,H [:,]: MEN% I ON I S 'ri-fiR LEI'.,IGTH ( I N [::'El:ET ::, OF THE TRENCFI OR [)RFI I I'.,1[::' I EL.D. '1]..1[~ DEPTH OF F:I TRENCI.I OR F::'IT IS THE L':,IE:TF:INC[~: ErETHFEN THE: E;I..li'~:I':rI.":!C:E lift:: TILE: GROUND FIN[:, THE E~o'r'roM OF THE E'?::CFI'v'FITION ,:: Z N f:'EET::,. THE:RE :['.5 NO LSET 14IDTH FOR TRENC:HE:T,. ]'HE GRf%,'EL DEPTH I'.S THE fdINIHUM DEPTH OF' GRFIVEL D,ETI"HF.:E:N TFIE OUTF'FIL.[. F'IPE I::'IN[) THE 80 TTOM Of:' THE E'?:;CFIVFIT ]: CIIq ( I N I::'EE T ). PE!:F?.MIT FIF:'F'LICFIi',IT FII::IS THE RE':SF'ONSIEC[I_.IT"r' TO INFOI~:M 'T'H:i::5 DEF:'FIRTMF]",IT DLIRING TI'IE IN:STF:IL.[...RT]ON I'N':.'SF'ECTIONS (:It:' FIN"r' I.qE!.J.'.5 PI[)JlaCEI"4T TO TI'"II:E; PROF'ERT'¢ FIi",I[)THE: NI...IME~ER OF: RES I [:'E},IC:EE; 'T'HFIT THE HELL [,.I I L.L :E;EF~'.VE. E:F:ICKF' I L.L I NG OF FINV S'¢'.STEH I,.lI THOLJT F' I NFIL.. I I",ISF'EC:T I CrN I:::[NE:, RF'PI:~:O'v'FII.. E:"~" "I"H I S DEI::'f::IRTMENT H]:t..l.. 8E '.~51JEL3ECT 'Fi::[ F'ROSECUTIOi'4. f'IUH [.' I E~TFINCE: E=E~THEEN FI HEI..L Bf.,ID I::IN'.¢ ON-S I TE L:;IEHI::IG[!~ [:, I E:;f:'OE;FII.. FEET F:'OR FI f:'RI'v'FITE HEL.[..~ OR TO :-2C1!-:') FEEE]" i::RCIr,'I FI F:'UE:L.]'C kiEL.l._ I}EF:'ENE)ING UPON ]'PIE: T'Tff:'E OF::' PIJE:I...IC I.qEI.I O]"HE:R [;?.D;!U I F'.E]'"I[.~:NTE; MR"r' FIF'F:'L'¢. E;PEC :[ F:' ): CFIT :[ ON% FIN[:' CON:i];TRUCT I ON D I F:IGF?.F:th15; FI'v'FIZI.FIBL. E: TO INSURE: PROF'ER Z[",IE;TFILLI:::ITION. I F:'CIRTH D~'r' 'tHE MIJNICIPFILZT'¢ OF FINCHORRGE:. 2.: I I,.!]: LL II",I:STFILL THE S'¢STEf"I I H FtCC:ORDFINC:E: ].,.I I TH Tt'II.:E CO[)E'i~;. ::~:: I L.IN[)ERSTFIND THFIT TH/E CIi'.,I-'.SITfE 2;EHER S"¢SJ;TI~:.:M MFI"¢ RE:g!UIR,:~: Rli]SIE:'D:F,!C:E I:~:'; RE:MO[:,ELEf) 'T'O ];I'.,IC'L.U[:,E MORE "FI-fi:IN :ii: 8EI)RO1]d',ltE;. I ~';E;IjED B'T'. .................................................................................. DFITE ,:~. ~ , ~ · "~/) ~ j "/ ~ ~ ' I 2~ ~/,,.,, . ~,.:,c.,..~ .... . /'] · '/'/:t'/ ' CERTIF'T' 'FHFrF i FIM FFiM I L I FIR H I TH THE: RIEQLI I REMEN'f'}.'; FOR ON.-..':'i; I T E SEP.IERE; Fff.,l[) I.,.I[!!LL.:S F!S rE;lET EIqL.FIRGEMEIqT :1:1::' TI.IE · GRE ,--R ANCHORAGE AREA BORr"GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM NAME, ~'~-~./.~.Z.:.. ~-:/~.'..~.f-~_r' MAILING ADDRESS /g~Y~ LOCATION .~.~Y~ ~:~ ~-~//~;- g~/~:~L DESCRIPTION SEPTIC TANK: DISTANCE .'.~;'~-~?ZC''~/ NUMBER OF FROM WELE~'~227' r* MANUFACTURER~'~'~Z~:/";~ /'~//'" MATERIAL -~'~'/~ COMPARTMENTS INSIDE LENGTH ....... INSIDE WIDTH --'- LIQUID DEPTH --- LIQUID CAPACITY //~'.-~3~'~ GALLONS, SEEPAGE PIT: NUMBER OF PIT5 --/ DIAMETER / OR WIDTH¢:~, LINING MATERIAL ~.Z-'-~:~' _ CRIB SIZE: DIAMETER BUILDING FOUNDATION~' NEAREST LOT ADDITIONAL ABSORPTION ~LENGTH~ / DEPTH /" ,/', / DEPTH ~ . DISTANCE FROM: WELL~'~/--~?~';-~]~-~'~/~'-¢'~~''~ TOTAL EFEE-CTIVE ABSORPTION AREA (WALL AREA) ~;.~-~,'2~ SQ, FT, WE L L: /Ix/~'~/~'~ Z~,,//? ~- T y p E ..c~. f ~;~u~] ~.~.~/-~- CONSTRUCTION ~,~/~~ BUILDING NEAREST NEAREST FOUNDATION LOT LINE SEWER LINE DEPTH ¢~.~?g;~2 ~L_ DISTANCE FROM: CESSPOOL OTHER SOURCES APPROVED DISAPPROVE[} REMARKS SEPTIC SEEPAGE TANK SYSTEM PIPE MATERIAL: ~'~ LOT SLOPE: REMARKS: ~¢-'~ -~-~'~ Form No, EQ-031 DIAGRAM OF SYSTEM DATE GREATER ANCHORAGF AREA BOROUGH P£RMIT NO, SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT LEGAL DESCRIPTION --. . INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT ~ , DRAIN FIELD ., OTHER FOUNDATION TO SEPtiC 'FANI~ ~ / SEPTIC TANK 5/ -. SEEPAGE PIT ~'~ , DRAIN FIELD DRAIN FIELD /~ DIAGRAM O1'~' 8YSTEfVl SEEPAGE P T ,/()t~ / ALSO CONSIDER AREA WELLS. , SEEPAGE P'T. /~ / /dd / /~¢__ / GRAVEL. BACKFILL, CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION, . ,.,/ ?erformed For · Legal 'Descrip't'"i0n: l'his Form Reports 3500 TUDOR ROAD '~'~ ANCIt0RAGE, ALASKA 99502 ri9,<- ./' ~-,' '? ..~ ~:4 :. ;.~, ' :- : . ~;"'2 ~:-~:9"'.'~';~ ~/ W/%'.'?" ~.:'~;:z~h/, '"~ . .... -~ Leo Sawyer Date Performed 4/1.8/73 · Lot.l Block___5 Subdivl-~-~sion Sun Valley Heights Soils Log ' XX Depth . Feet Soil Characteristics Brown Sandy Silt Gray by 3' w/occasional gravel from 4' w/silty sand seams from 8' Nas' Ground Water Encountered? No If Yes, At What Depth?, -LL,L J__J ' Reading Date Proposed Gross I n s t aTT~-{To n: Time Net Time Minute Seepage Pit Depth XX Drain Field Depth Of Inlet Depth TO Bottom Of,Pit,, ~-r' Trench COMMENTS: This ~o. gjJ_does e×¢ee~d the ma×imum o£ 250 sq .. f~. o£ drain~e area per bedrom~" . therefore I ~an not recommend at] on-site system. Alaska Mineral " ~ & Materials D, ab 3500 TUDOR ROAD AN ~RAGE, ALASKA 99502 Perfor~i~ed For ~_-~_o ~o,~J~,.e~~---~ Date Performed Legal D e s c r i p t ~ o r--~--'~ ~'-' L o--~-~ ~S u bdi v~-~-i o n Th~s Form Reports Soils'-Log - Depth Feet Soil Characteristics I£. /Cz '---I z'. . z ~/~ .~,. ~ ~: ..... ~ I ~ -~ .... 2 ' ...... ~as Ground Wa~er Encountered? If Yes, &t What Depth? ,,' , Reading Date Gross Time Proposed ,, Net Time Depth i ' ~'inute I to H20 J ~ Seepage Pit .__~_~:.-''~_ Drain Field .Depth Of .inlet Depth To Bottom Of Pit ~r l'ronci~ , I \ EASEMENTS OF RECORD, OTHER THAN TliOSE SHOWN ON THE RECORDED PLAT, ARE HOT SHOWN HEREON. RECERTIFICATION LOT SURVEY CER'FI FI CATION_.---- LOT ..1 BLOCK 5 ~ ,SUN VALLE~F ~IEIGHT$ SUB~D~ZON _ 1' ,,, ANCHORAGE RECORDING DISTRICT '" I REVISIONS =REPAR~D BY: DOWLiNG '5':;ASSG~IA?ES' ' : "I~e's dense of' " DATE: 6 Jan 1981 BY~Gn !scAL~: t"=4o' Iw'°'st-oo2 I ~B'DIARY ,.LEGEN:D: IRON PIPE SURVEY HUB ~ TACK. ,~/ ~ GRID: 2938 Parcel I.D, 017-062-40 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: /0— l " 13 Complete legal description Sun Valley Heights, Block 5, Lot 1 Location (site address) 13420 Tahoe Current Property owner(s) Kathleen E. Case Mailing address Real Estate Agent Same Circle Anchorage, AK 99516 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three Day phone 562-1234 Day phone 261-7505 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public .Nater System ❑ Public Se.. ❑ WaiverA/ariance request for: Distance: �w Received by - n L !- p ! Date:U" COSA to be rele4,d to }fie engineer, unless otherwise requested by the engineer. COSA Fee $ tTj 0 Waiver Fee $ Date of Payment �" t Q) L1 EiL Date of Payment Receipt Number} �1�{n� Receipt Number COSA # n)t-- 1 b \ Waiver # 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, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE Phone 522-7773 Date 6/23/2013 / 3�0 a 49TH f1 o1 System 41 Approved for bedrooms A : ,_ °a =• �_ ==a ANDM.?SOM System #2 Approved for �oMICNAEL�E,• a err bedrooms d mss° CE - 4381 Disapproved ®�6� 'ORO FES510�a Conditional approval for bedrooms, with the following stipt lio, t/ v/ f✓ %� u G r ON-SITE By: G" Original Certificate Date:�� The' um alit B nchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage isnot responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet ( S c If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Sun Valley Heights, Block 5, Lot 1 Parcel ID: 017-062-40 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) N Date completed 1974 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth >210 ft. Cased to >40 ft. Casing height (above ground) >18 in. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS ft. AT INSPECTION 6/21/13 183 ft. 1.7 g.p.m. Coliform 0 colonies/100 mL Nitrate 9. 17 mg/L Arsenic ug/L Date ofsample: 6/20/13 Collected by: Anderson Engrg. B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 1/2/1974 Tank size 1,000 gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Date of pumping 10/9/2012 Depression over tank (YIN) N High water alarm (Y/N) Pumper A Plus Home Services 1 C. ABSORPTION FIELD DATA Date installed 8/11187 Soil rating (g.p.d./ftz or ftz/bdrm) 156 SF/BDRM System type Deep Trench Length 59 ft. Width 2.5 ft. Gravel below pipe 4 ft. Total depth 8 ft. Eff. absorption area 472 ftz Monitoring tube Y Depression over field N Date of adequacy test 6/21/13 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 11 in. Elapsed Time: 1,440 min. Final fluid depth 0 in. Absorption rate >= 450 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFTSTATION Date installed "Pump on" level at Datum Size in gallons _ in. "Pump off' level at Cycles tested _ Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100 On adjacent lots >100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line > Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >51 Water main > 0, Water service line >10 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10, Water Service line >10' Surface water > 100' Curtain drain None Noted Wells on adjacent lots >100' Absorption field >5' Surface water >100' Water main N/A , Driveway, parking/vehicle storage > 10 F. COMMENTS Files Indicate the Absorption Trench Constructed in 1974 May is Accessible With a Diverter Valve On Site. Absorption Trench was recently switched. G. ENGINEER'S CERTIFICATION t certify that f have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 6/24/2013 COSA brown sheet 10-10-12.doc ®FoA4 a in. 0 p, -MICHAEL EEANDER` N j% . CE - 4381 ��t���ROfESSIOMa®�� Municipality of Anchorage +` Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 131282 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 5, Lot 1 of Sun Valley Heights subdivision. This inspection revealed a nitrate concentration of 7.17 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. AAROW Pump & WER SERVICE, LLC �4v'PWCOW(C n P.O. Box 110496 No. 9847 Anchorage, AK 99511 Office: (907) 346-9355 • Fax (907) 345.0202 Eagle River: (907) 622-9335 /j CUSTOMER JOB SITE J INVOICE VnIE WELL DEPTH I CHLOHINATEV V'VMV VEPTH SALESPERSON J QUANTITY DESCRIPTION PRICE AMOUNT __._. ___.—_ fl �Lr'_f-Fr•rt�TLF''S._.._�G,c?S .'.-_L;�1C�C _.—._ ... 1-x' 'S_ n LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR 1 WORK ORDERED RY DATE COMP. TOTAL LABOR PAY THIS AMOUNT ? �c Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above De6Ctlbed Work and agree that If above work is not paid for In 90 days I agree to allow Aarow Punlp & Woll Sorvlcu, L.L.C. Ino TIgM to ramove unpaid for o,Ll mont grid I;hargs for labor Weedy performed & tab.T to .,,. unpod for eguipmenl.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. f - arA I h is do nvmmky grow oww to dow,mins ft "W� Graw commath mmma cr*m*� ASBUILT WW* do an "M on ft famm $"Vi" PlL U"w 10AMMMOM 311011M =y da hmm be "W ft COBMVWM a fw ClIliftft bwAWW ar FA ftm Ram. Tba ww.4m mw rapa w* &r ft EASEMENTS 0PR=W.MMTHAN . . Wks I mouica wo. TWSS SHOWN ON THE RECORDED PLAT, ARE N0rSWWNHEREON. LKCRN Lal� BLOck' (3) BRASS CUMONUMV0 (PIATNO.: 0 IRON PIPE FCHOR.AG A14C rm Rn Dmmcr 0 ===F0&HD DAM fCRiZ1FD`N0:.: SCAM. f*dp&ji 110E1191:1 MD Boole. Y If B. — 40 .,6e .9 40, 707, rZ HD BY. DOWLING& ASSOCIATW P.Q. BOX 110029 AMHORAGEAK 995114029 J 'I UATB BY DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 v~ONMEN 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUI:HORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) /,~' ,'~.,~" '/~,'~l~*e~- "~ ' Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 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. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: 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. 72-025(Re¥ 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 inves!kgation 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. NameofFirm /~/~4'~ldr'~ /' /~.), .//)~ll~,-.,'":~.,qff~Phone Engineer's signature ~l/~ ~~ Date DHHS SIGNATURE ~ Approved for -/'H/:~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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. IVI OCT Municipality of Anchorage ~l,~ DEPARTMENT OF HEALTH & H LJMAN SERVICES,,~;~A~ Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: c/'"c~*~// ~/~ C-,{2- ,~'-~ ~-~4/'~ ~/£¢~ Parcel I.D.: A. WI=-LL DATA Well type ~Z~z¢( · Log present (Y/N) Total depth Sanitary seal (Y/N) If A. B, or C, attach ADEC letter. ADEC wa[er system number Date completed Cased to ¢-/-~'/¢ Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION FROM WFLL LOG Date of test ./ ~'~ / ¢ - ¢ 7 Static water level ..~ / ~/_ t Well production ~.~-~ g.p.rn. /, ~'/ g.o.m. WATER SAMPLE R.~ULTS: C~,iform __ ~(~... _Nitrate D~lte of sample: /~ El. SEPTIC/HOLDING TANK DATA Date installed -/-~ ~/- --//_,L Tank size //~2~,~ Foundation cleanout (Y/N) '~'P Depre~ssion (Y/N) Dateof Pumping' 7/Z~J/¢{~ Pumper -~-¢~,~ ~- ~'~ Collected by: Other bacteria Number of Comeartments ./ Cleanouts (Y/N) /k/~ High water alarm (Y/N) C. ABSORPTION FIELD DATA Date installec ~//-¢'~ Soil rating (g.p.d./ft~ or fF/bdrm) /'~--f~ System type '~'~'/.,~' Length ,~'c// Width ¢~' '~ / Gravel thickness below pipe "/ ' _ Total depth Effective absorption area '¢~L?'%-r/~' ~onitoring Tube present (Y/N) .~//_ Depress,on over field (Y/N} /V/ Date of adequacy test ~, ~-/~ ~ 0o Results (Pass/Fail) /~U .~ For ,~ bedrooms Fluid depth in absorption field before test [in,); ~ Immediately affer///dPgal, water added (in,):. -~'~" Fluiddepth ¢'// (ins) Minutes later: ~'//~* ,~I~ Absorption rate = ~/~:-¥'-~ g.p.d, Peroxide treatment (past 12 months) (Y/N) /'v'/ If yes, give date 72-026 (Rev, 3/96)* D. LIFT STATION Date installed Manhole/Access Hig~eveY~at* ¢.~ybles tested ~ Size in gallo~ ~ "Pump on~ "Pump off" leve. C.at*'''''~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ?E:~ E~/.4- Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~--/r ~ ~.., (¢. Property line //2 I-A- Absorption field Water main/service line 2-¢/'f'¢ Surface water/drainage/0 ¢2/;¢ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line J¢-/ Building foundation /-/'- ~'¢ '-./o ¢~Water main/service line Surface water / ¢ ¢~ "' '¢'- Driveway, parking/vehicle storage area /,~ '~' ~'. C- Curtain drain /~¢)¢'1c ///"¢';'~ ~",~l Wells on adjacent lots / ¢]¢/w F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections ~ in conformance with M.OA HAA guidelines in effect on this date. Engineer's Name Ml~'~o,P'r/k~. /~q ~r,aod HAA Fee $ Date of Payment Receipt Number Waiver ?ee $. Date of Payment Receipt Number 72-026 (Rev. 3/96)* September 7, 1998 Municipality of Anchorage Dept. of Health and Human Services On-Site Services Section 825 L Street Anchorage, Alaska 99501 Subject: Lot 1, Block 5, Sun Valley Heights Adequacy test Gentlemen: Recently I was. requested to perform an adequacy test on a sewer system serving the above residence. The system to be tested was the most recent of the two upgrades which have been installed on this property. In May, 1997 this system was found to be full to the bottom of the lateral pipe and therefore was not tested. The suggestion was made to the owner that a reconnection be made to the original seepage pit and adjacent short trench to provide absorption and allow the newest trench to dry out. In August, 1997, a post tank cleanout, diverter valve and two line cleanouts were installed, and the effluent disposal switched to the older systems. At my inspection on August 29, 1998, I found no water in the monitoring tubes on either the original trench or the upgrade trench. At this time we felt it was appropriate to test the newest trench. On August 31, 1998, the trench was presoaked with the addition of 2,100 gallons of fresh water. This injection of water caused a total rise of 53" in the monitoring tube and 4" in the lateral. Eighteen hours later, on September 1, the monitoring tube was again dry. Later that same afternoon a total of 1,450 gallons of water were injected into the system, for a total rise of 50". No water was observed in the lateral pipe. Twenty-one and one half hours later there remained only 8" of water in the monitoring tube. At this point the newest system has been able to accept more than the required 450 gallons per day for a three bedroom residence. There is, however, no guarantee that the system will continue to function at this level. I would recommend that the use of the older systems be continued, possibly for another two years, before effluent is again switched. The old systems have been dormant for over 11 years and should be able to handle current loading for some time to come. Page 2 Municipality Well flow information from May of i997 has been provided, along with current water samples. Based on the above testing, it is my recomlnendation that a Health Authority Approval be issued. Sincerely, /] Michael N. Anderson, P.E. cc: Dr. & Mrs. Peter Schaab $EP-2~-98 1!~$8 ~O~-CTE ENVIRONkI~NTAL 56]§301 T-552 P 02/0~ Inc. CT&E RcL,'/ Cli~! Name Mike .~d~'~on Proj~ Name/~ L~ 1 Blk 5 Sun Client ~ampl~ ~ 13420 T~o~ Circle Matrix D~:~ug Ordered By PW~ Clicn! PO# Printed Da~e/Tlme o9~8/98 10:57 Collected l)atc/Tlme 09/22/98 10;13 Received Date/Time 09122/98 10:q0 T~teal Dlr~or: Stephen C. E& MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CE_,RTIFICATE OF INSPECTION FOR HEALTH ALJTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLP FAMILY DWELLING Parcel I.D. 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner 7-ecx' /Z'orn¢ r~,~ Mailing Address /-~/8¢ ?'~,~ae (c) Lending Institution ~, A-. Telephone: (home) 7¥~,--..~0"~o Business Telephone Mailing Address (d) Real Estate Company and Agent ~'-~' ~1'~¢ P,'~-~r~.~/ - ~"~o/ Z:~//b,'f (e) Address Telephone Mail the HAAto the following address: (or check here [], if hold for pick up.) List contact persoe and day phone number below: -T'ev, L o,~ E/~',.~ 2. TYPE OF RESIDENCE Single-Family [] Number of bedrooms 3, WATER SUPPLY Individual Well [] Comrnunity [] =ublic [] -,: Note: I! community,well Sys.ter~,,must h.ave written confirmation from the State Department, of Environmental ' ConsbJ'vat[o'n atte~t[ng't~ th legality"and'$tatus. "' "' ........ DISPOSAl' ' ' On-site [] Public [], .), Community O.'," :~ Holding Tank [] _:.,, - ......~.. ~r ,.:.. ,: ..... N~te,' If corem,unity well sys!em, mu, st have'wr!tten confirmation, from the St~t C6r:i 'e~va 6~ti'b~(i~' t th 'and' partme f Environmental, 72-825 [Rev. 7/88) Page 1 of 2 ~ ~o B ebed 'HJo~ 9,Jeeu]bue leUO!99e~o~d eq] u! 9uo!se!t~o Jo 9JOJ~e Joj elq!suodseJ ~ou 9! ebeJoqouV jo Xl!led!o[unVW @q/'penes! 9! eleo!j!]Jeo e eJo~eq elep eZXleUe JO suo!loedsu! lenpuoe leu op SHHQ ~o seaXold~U3 'slueu~eJ!nbeJ me]s pue leJepe~ u!e~Jee A~s!]es o] Jap Jo u! bu!puel J!eql pue 9euJoq jo 9JeseqeJnd ol ~seIJnoo e 9e 9!ql, seep SHHQ eqi 'e~iSelV Jo elelS eql u! peJeleiSeJ Jeeu!bue leUO!SSejOJd luepuedepu] ue/~q e^oqe c qdeJSeJed u! ue^!8 suoge~ueseJdeJ eq~ uodn ,{lUO peseq le^oJddv/~ipoq~nv qlleeH 9enss! 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WELL DATA Well Classification _ MUNI_OII~,LITY OF ANCHORAGE (MOA) ~*'["*~--J~' ,;'" ' ~e~.t,l~Authorlty Approval (HAA) ~v~ ':' 343-4744 Legal Description: ~ Well Log Present (Y/N) N _ Date Completed Total Depth~,~fo Cased to.~ qo'~ Depth of Grouting f Static Water Level I 85 Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Y SEPARATION DISTANCES FROM WELL: To Septic/Holdiag Tank on Lot To Nearest Edge of Absorption Field on L. ot If A, B, C, D.E.C. Approved (Y/N) Yield PumpSet At ~ ~0 Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) N ; On Adjoining Lots ~' ¢oo ' c,o, ; On Adjoining Lots >, (co ' To Nearest Public Sewer Line ~,/f. To Nearest Public Sewer Cleanout/Manhole '1'o Nearest Sewer Service Line on Lot _;;, Water Sample Collected by Water Sample Test Results Comments f,z/ett ,,y/.~tc.( ~.r B. SEPTIC/HOLDING TANK DATA Date Installed 1/2J(7 y Size Standpipes (Y/N) ?' _Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) No. of Compartments ~' Foundation Cleanout (Y/N) Date Last Pumped .7/',¢/~'P ; for Temporary Holding Tank Permit (Y/N) N, 4, SFPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ToWater-SupplyWell IS'Y' ~-~'"~ c .o, To Property Line ~O' To Water Main/Service Line -w 8&' To Stream, Pond, Lake or Major Drainage Course ':> ~'¢ Comments To Building Foundation ~'~' To Disposal Field ?" g¢(-~,, c,o,'g 72-028 (Rev. 7/88)Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed g/(I /' ~ 7 Width of Field Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test led ¢='[ ,¢c~t,,,, Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~ 7 ;~ Statndpipes Present (Y/N) h' Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ! To Building Foundation To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area c, ¢/. To Property Line 18 ' ¢. ¢'. To Existing or Abandoned System on ; On Adjoining Lots ~> ~'o ' To Cutback (if present) N, ~. Comments D. LIFT STATION N,A. Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA gu!delines in effect on the date of this inspection. Date of Payment ~' ~ ~'~ - ~'~ Waiver Fee: $ Amount: $ / ~. d~ Date of Payment 72 026(Rev. 7/88) Back Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INCo 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907)562-2343 FEDERAL. TAX I,D. #92-0040440 ~N^[,Y$~S ~['0gT [~ S~.!['[,~ for ~'lo~l: 0x'(ior ~, 2J.7~6 Collected ~] ~oce~vod I~ J5 90 Sample 3hl.llq,~ C,.I, LEJlr. D gY T.h. !,!OORP;, ,JJUD; ,hJ[[,{,. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application [)ate 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal~.z~,/Descripti°n '~ ./'~'¢'~ ~"'(include~'"~l°t' block,i/.~q..Ke,_y,,subdivision,,,~,r~ section, township,.7..) $~/ range),,~/¢"J ¢ Locat 9n (addre,ss, or, cd rect~ons) -];.,, · , ~,,,, ,~a,l!n~g A,d?ress_//r,''~'. ,(c, 'Lending Instituti'o,~ '4. ,: 'M~ilin. g Addres~ (d) Real Es(a{e COJ'C~p~ny and Agent Address Telephone: Home ;-'~¢~'"- O~¢i Business Telephone Telephone ~"?G '~'~'~ (e) Mail the HAA to the followine address: or: Check here [], if hold f. pr pick up, List contact~per~on and day phgne numl),er below. TYPE OF RESIDENCE Single-Family~ Number of Bedrooms WATER SUPPLY Individual Well~ Community El Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~. Publicl'-I Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 fRev 8/861 Fronl 'ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~-'5 Telephone DHHS APPROVAL Approved for -/--A Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based (~nly'up0rt the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska, The DH HS does th is as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-o25 troy 8/86) Back MUNICIPALITY OF ANCHORAGE (MO,-,r A~cHO~AG~c · .~/,,uT~ OF ...... iOi,,I[-IEALTH AUTHORITY APPROVAL (HAA) i¢~4t¢£N~hL $~v. VtCE$ O~W'~ CHECKLIST - FEBRUARY 1984 ~t4'4 264-4720 AUG ?- 7 19ffl WELL DATAREC£/V ED Well Classification Well Log Present (Y~). Total Depth ~ If A. B. C. D.E.C. Approved (Y/N) ,'~/"~ Static Water Level ~ ,/¢,.rf Casin~c He~gi~t Above Ground __ Electrical Wiring m Conduit ON Seoarauon Distances from Well: To Septic/Holding Tank on Lol Date Completed _/.¢ff~,x/'c~J/./ Yield Cased ,o (~'~ Depth of Grouting _ ,'~/~' =ump Set At __ Sanitary Seal on Casing~"~N) Depression Around Wellheac To Nearest Eoge of Absorption Field on Lot To Nearest Public Sewer Line Gleanout/Manhole Water Sam pie Collected Dy Water Sam ule Test Results ; On Adjoining Lots ,./.- ,/--'~': On Adjoining Lots £'¢q') "''/'- TO Nearest Public Sewer / To Nearest Sewer Service Line on Lot ,,~, /~E'Z~ Date SEPTIC/HOLDING TANK DATA Date Instal ec ].",Z-../-'~/ . Size //.-/7./O No of Compartments Standelees(~N) _ Air-tight Caps~N)_ _ Foundation Clean~ou, u,u~rN) Depression over Tank (YLJ~ - Date Last Pumped _/~_,~¢_~.._~"¢~ -~'-~--~'~'$ Pumping/Maintenance Contract on File (Y/N) /~]'/'~ ;for / / ~//~" - Holding Tank High-Water Alarm (Y/N) .'~' Temporary Holding Tank Permit (Y/N) To Pfc 3erty Line To Water Main/Service Line Course Separation Distances from Seetic/Holdir]g Tank: To Water-Supply Wel /,$)" ' /(2 "'~' /,o To Building Foundation To Disposal Field To Stream, Pond, LaKe, or Major Drainage Comments Page 1 of 2 72-026 11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed S~?/~°~ ~ Width of Field '~" ~''~ Square Feet of Absorption Area Depression over Field (Y{~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot /O ' ¢- To Water Main/Service Line /O /"/' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field 5"'¢ / Depth of Field ~" / Gravel Bed Thickness ¢ ~' Standpipes Present ~N) Date of Last Adequacy Test To Property Line /~-- To Existing or Abandoned System on ; On Adjoining Lots /O/~- To Cutbank (if present) Comments LIFT STATION D a t e"~T~e d /' Dimensions ,,S, Jze in Gal,~ /d/~74-' Manhole/Access(Y/N) Pump On Level at ~ "Pump Off" Level at High Water Alarm Level at ~ Vent (Y/N) Tested for ~....~Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I h~/~h,~edj, ve~i~ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection, . Signed ~'~¢;'-"'--~ · ~/~'~'~---~ Date Company ,~-~-'"¢~...5 MOA No. Receipt No. / ¢ O/ 0~¢~ Date of Payment ~'/2 Amount: $ ~Or_) ~ Page 2 of 2 72-026 (11/84) MUNICIPALITY OF ANCHORAGE MUNICIPAl'lTv O~NCHORAOE DEPT OF II-~LT; & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI ' " ENVIRONMENTAL ENGINEERING DIVISION JAN Telephone 264-4720 REQUESI' FOR APPROVAL OF INDIVIDUAL WATER AND DIRECTIONS: Complete all Darts on page 1, Incomplete requests will not I)e processed, Please allow [er (10) days for processmg. 1. PROPERTY OWNER Deborah J. Whitethorn sa~d William D. Chadwlck PHONE 345-1696 MAILING ADDRESS SRA BOx 372-X, Anchoraqe, ]~Laska 99502 PROPERTY RESIDENT fdlfferentfromabove 2, BUYER _l~.ymond V. and 2~h Nold PHONE MAILING ADDRESS _c/o Schlumberger/500 West International AJ_z'~o.~: Road 3, LENDING INSTITUTION _Alaska Skate Bank/Ak~C Conventional VIAl LING ADDRESS 310 F~st Northern Lights Blvd., Anchorage, Alaska 99503 4. REALTOR/AGENT Patti Zantek/Transalaska Realty, Inc. PHONE 276-450~ MAI LIN G ADDR ESS 1577 C Street, Suite 103, ~cho:rage, Alaska 99501 ~, LEGAL DESCRIPTION ~t ~L, Block 5, Sum Valley Heiqhts STREET LOCATION _37eArmoun and Tahoe Circle 6. TYPEOF RI:'SIDENCE [] SINGLE FAMILY ~ MULTIPLE FAMILY NUMBER OF BEDROOMS [] One I~] Four [] Two E] Five [] -hree EZ] Six [] Other 7, WATER SUPPLY INDIVIDUAL* COMMUN TY PUBLIC UTI LITY *ATTACH WELL I_OG. A well log is required for all wel s drilled since June 1975. For wells drilled prior to that date, give wel depth (attach log if available, 8. SEWAGE DISPOSAL SYSTEIV [~] INDIVIDUAL/ON-SITE'* roved 5 2~/79 ;~op PUBLIC D/T21LITY "If individual/on-site, give installation date If system ~s over two (2) Fears old en adequacy test is required by this Department. NOTE: THE INSPECTI ON FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. '~-01013/78) il ,~, -~.~ THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS; 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX ~ERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] iNDiViDUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER []Septic Tank or []HoldingTank Size: /Oc~b If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS E~'"~PROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (/T~tle) / / LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE DI.:PT. ©i '~ 'ALTH & ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT OI~NVJRON ;4ENI,,~L .ETLON 825 L Street - Anchorage, Aleska 99501 FEB 2 6 1,979. ENVIRONMENTAL ENGINEERING DIVISION J~ Telephone 264-4720 j,,, ~ .... A' L~O. . NI:LEIVED----c REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW'~:R FACILITIES DIRECTIONS: Complete all Darts on page 1, Incomplete requests will not be processed. Please allow ten (10) davs for processing. PHONE 1. PROPERTYOWNER J PHONE John M./Nancy G, Emerson MAILING ADDRESS Star Route A Box 372X ~ROPERTY RESIDENT qf different from above) 99507 2. BUYER PHONE PHONE MAILING ADDRESS 3. LENDING INSTITUTION MAILING ADDRESS PHONE · 277--155~3 REALTOR/AGENT Elliot Lawson % Jack White Company MAiLING ADDRESS .3201 C Street 99503 LEGAL DESCRIPTION Lot 1 Block 5 S%m Valley Heights Subdivision STREET LOCATION See attached map for directions. ~. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One r-] =our :1~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAM LY X~X Three I--] Six [] Other 7. WATER SUPPLY X~: NDiViDUALo [] COMMUNITY [] PUBLIC UTILITY ~.."SEWAGE DISPOSAL SYSTEM ~X NDIVIDUAL/ON-SrTE** [~ PUBLIC UTILITY ATTACH WELL LOG. A well og is reauired for all wells drilled since June 1975. For walls dril ed prior to that date, give well depth (attach log if available. J Indlvldual/on-slt~, give installation date Ap~r-o~x--~3- If system is over two (21 years old an aaeauac¥ test is required by this Department NOTE: THE INSPECTION FEE MIJST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/7g; THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVFD INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ SINGLE FAMILY [] ONE ~ THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY ~ INDIVIDUAL )EPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER '~i] IN DIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ,._~ ~, ~.~\ \ O~'~ L~ Connection Verified iNSTALLER -~]Septic Tank or []HoldingTank ~,"-,_~ ~.~t~, . Size: ~ (:~'~((~ If Tank is homemade ' SOILS RATING give dimensions: I~(~ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~--'APPROVED FOR _~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title} LEGAL DESCRIPTION 72-010 (Rev. 3/78) CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. / ~,~;;¢;ak;~ll;x;:;:~%,. \ FEDERAL TAX ID # 92-0040440 ,~ February 21, 1979 MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HE:ALTH AND ENVIRONMENTAL PROTECTION ENVJRONMEN1; ! 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAl. SEWER and WATER FACILITIES RECEIVED Type of Inspection: CMRO Property Owner: Mailing Address; 3, Name of Buyer: Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address: 6, Legal Description: VA_ FHA CONV. xxxx John M. and Nancy G. Emerson contact Elliot Lawson J k Wlte Company SRA Box 372X, Anchorage, 99507 Day Phone: 2~-15~3 No buyer yet .... ~ust listinq home for sale Day Phone: NO 'lending institution yet .... just listing home for sale Elliot Lawson .... Jack White Company 3201 C Street, Anchorage 99503 Phone: Lot l, Block 5, Sun Valley Heights 277-1553 Location: Go up Dearmoun Road to Tahoe Circle (on South/right side of Dearmoun) House is modified chalet style with attached 2-car garage on in~ediate right when you enter Tahoe Circle 'Type of Facility to be Inspected:_ Single-Fa~ly No. Bdrm$. 3 Water Supply Type of Supply: Public Utility. Individual xxxx If Individual, number of dwellings presently served one If Individual, depth of well Sewage Disposal System Type of System: If Individual, date of installation 200' plus Public Utility approx. 1973 Individual (on-site). XXXX NOTE: PLEASE CONTACT ELLIOT LAWSON AT JACK hHITE COMPANY FOR ACCESS TO HOME Thanks .... 72-003(3/"6) March 12, 1979 R&~i No. 951059 Jack ~lite Co. 3201 "C" Street Anchorage, Alaska 99501 Attention: Elliot Lawson Re: Adequacy Test on Existing Sanitary Sewer System; Lot 1, Block 5, Sun Valley Heights, Subdivision, Anchorage, Alaska Dear Mr. Lawson: Per your request of March 2, 1979, we conducted a test of the sanitary sewer system on the above described property. The septic tank was pumped prior to the performance of the test on the seepage pit. During the test the liquid level in the seepage pit was measured before and after the addition of 1000 gallons of water. All liquid levels were measured below the top of the standpipe and are shown iH the following table: Initial Water Second 24 hour Total Reading Added Reading Reading Drop (gallons) 12.1 1000 10.8 ~ 11.25 .44 The water level rose 16 inches with the addition of 1000 gallons of water, indicating a capacity of 62 gallons per inch. Twenty-four hours later the liquid level was again measured and found to be 11.25 feet. It had dropped .44 feet or 5.2 inches. This indicates an average effluent acceptance rate of 325 gallons per day for the surrounding soils. If the 3 bedroom residence on the property is to house 6 people, the average load on the syste~n can be expected to be 450 gallons per day. We can therefore conclude that the system is not disposing of effluent at an adequate rate for a 3 bedroom residence. We appreciate this opportunity to be of service to you. you have any questions concerning this test or if we service. Please contact us if can be of additional Very truly yours, G ry ~/ mith Proje~t Manager GAS/djb/12-J GREATER ANCHORAGE AREA BOROUGH 2' Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274--4561 ~'~'~ :.d.~/] .- Date Received -~y//'~-~//7~' Time of Inspection~ r Date of Inspection \ REQUEST FOR APPROVAL OF . ~ ~O ~, ~ ~ .... (~.~, Phone: ;...? / 'Z,.-:-,x~..~/b- Mailing Address' 2. Property Owner: ~m~c~--~ ~.~>~T Phene: .~ Mailing Address.' /_3~ ~. s-~'. -~ ~. ~'~(/ 3. Legal Description: .~0~- ~ ,~-~'~/~-~.-]' '~/~~"~ 4. Location: ~/~o~-~~.~:~--' :' 5. Type of facility to be inspected r~xd-==~:=~ No. of bedrooms 6. Well Data: 7. Sewage Disposal System: A. Installed z~/-~t/~j $-,© ~_/ B. Installer ~.._x/ C, Septic Tank: 1, Size 2. Manufacturer .~'~'~ D, Seepage Pit: 1, Absorption Area ~v' 2, Material E, Disposal Field: Total length of lines Distances: A. Well to: Septic tank.<~ ~-~_~_, Absorption area ~ ~ , Sewer L~nes Nearest lot line //~ , Other contamination ~<>J~':'- B. Foundation to septic tank '~]~ ~ , Absorption area /_~ C. Absorption area to nearest lot line ~~;_..'~.~_~___~-S~,.,~ ~ -" .... v--~ · EQ-034 (1/74) Page 1 of 'two pages Page 2 of two pages - Req..~st for Approval of Individual S, .~r & Water Facilities Legal Description ~ ~ ~-~-- ~z~/ /~' Comments Approved ~c~ ApO~Pro~~one year from (late signed ?/// Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 'I 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. EQ-034 (1/74) Joly l?, 1!)74 Linde Martin First National Bank P. O. Box 720 Anchorage, Alaske 99~10 SUBJECT: Existing on-site sewer system on Lot 1, Bl~.JCk !3, Sun Valley Hetghts Subdivision Deer Mrs. Motrin: On July 16, 1974 this Department inspected the on-site sewer systen serving a 3-bSdroom, single family dwelling at the above location. 'The following dlscrepenctes were noted: 1) The ground had settled considerably since the installation in the area of tim aeptlc tenk, seepage pit and sewer line~ There is insufficient cover {earth) in these areas. 2) The septic tank appeers to hove settled lower than the sewer line entertn~ the ~nk. 3) The septic t~nk does not appea~ to be sitting level, as it should be. 4) The sewer line ts broken f~ the house foundation to tim septic t~nk. This bas caused sewage to back up into the down- stairs of the dwelling and to fl~ onto the ground surface. 5) The standpipe (Cleanout) has been re~ved frmn the septic tank. 6) Tbe cleanout on the outside of the dwelling ts loose and stable. The cleanout ts blocked by an outside staircase and unable to be utilized, if necessary. The occupants of the dwelltng were advised not te us() the sewer system due to items #2 and #6, above, Once the above repairs are made, no problem is anticipated in the system functioning satisfactorily, If you have any questions, please do not hesitate to contact Sincerely, C. S. McKachnte, R.S,~ Environmental Control Officer III CSH/ko cc: Mr. and Mrs. Rtlaer, tluff Realty, Robert Gtvtns Ap~I 11, lg73 Hr. Jerry (,flare Farm iiome AdministraCion P.O. ~ox 8 5o1 dotna, Alaska 99669 .,ubject: Lot 1, i)lock !5. Sun Valley liei(hts S/~ i.~ear Hr, Glore~' I'ne subjecC pr'operCy t~ served by a co),m)uniCy ~-¢ell sylt~ which ¥~,:tu ~pp¥'ow~d by this departl~e~vC ~ovember 9, 1972, li)e gull cunditions In ~:ne ~rea ~ru such that. ~r( on-site se~/erage system s;iould ~.e quite successful, Sincerely, Susa~ E, Oickerson Sant L~r'lan CC: ~,Ir.s. Oudy Iiul~ae 2640 Eas[ 84 St., #2 Anctlorage, Alaska 99507