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HomeMy WebLinkAboutT12N R3W SEC 27 LT 10 I � I I I I I i I I 5 00' 01 ' 3 E 329.42' / O ci ci 4 Q I e U r o f Q J 3 O � Q Q7 oq of _j N N Z l44 W O H PO N j W C> I- W W \ Z :E O m m aoLLJ \ a U Z O J � �a \ O l 1 V) \ QElf U Y w z 0 N 35.9' Q Ln [V ry x N x ? N � S H U 50' ROAD & a a OTILITY o � RESERVATION `" -- - - - - - - N 00'05'40"W 329.33' o I o O O— W — — — — — — — -� Q U I " I m I T v Q � I I [O K7 N a O J / U Z w w Y z o w x / I 110, / Z ¢ S N U DO U U N w 0- Q" UO�¢ w �z� N J ��hL1 [V 0 J M w 7 anon 113NoaOV4 0 I J I k�k I A : ao�,'e _ * O w z s Q N I% � -cc: • U. 2 I Y rn HI z � /a �� - Y IP o rfi --- U) m � D � p y y r_ m E D� Q a r " E D o m m I a E m U m m m o o 0 m— i�iu�im�7 t mn IQ�mrnZ ,� c ao I cp N C m 7 Q m N N C D L ? .- IpLoC®D +-GCS D D.0 II DS® mQ'y D a o 3 O O® I!' 4 r03 e° a� i^rn00 MUDvmQ-N c zm°cct°N �Qoam_ v1m I U N O D o 0 0 m m L MeN E+- I c p 'aM' Qmy_m I •— rn a.2Z t k c I � O' re� I n � 03 os m o+ rr1 4JL°o—D iI� Lm 1 Al 0N OLD y pi m a V! m r° t- V) t 3rn 6 N V O O 0 C � p •— - i-z�r�cQ I mo I U m N D >. O C) 3 F Q V m C X ° ° U J N ri O m m G m t �%} m N 2 1 > D a D _ } 0 N 1 DZv1 m m I OC y =Op mr mL p I 0), ��J\ C U C V .O L V) tCL oD I N I N m c ° L [n aEc o v a AAl1 m F 7--�1 (D U OJ m m j D N y L N �J��� �•C � N C L L.m m U _L - .E m m N m N J t Q C O_ m p U MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 995'9-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http:iiwww.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221314 Work Type: Septic Upgrade Tax Code Number: 01809211000 Site Legal Address: T12N R3W SEC 27 LT 10 G:2936 Site Mailing Address: 13641 MC DONELL RD, Anchorage Owner: PHILLIP KAREN C Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: gent Is off' r.. r' fi v (I[') i1Tr]Tlellr 1012112022 1012112023 108595 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 (2417). 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 Received 13) Issued By: Date: 10/21/2022 Date: 4A 1 Z If I 4 �1.1�UMCFP UTY OF A HCHOPRA' E Development Services Department r� Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I. D. 018-092-11 Property owner(s) KAREN PHILLIP Day phone_ Mailing address 13641 MCDONELL RD, ANCHORAGE, AK 99516 Site address 13641 MCDONELL RD, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 2N R3W SEC 27 LT 10 Lot Size 108,595 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade 0 (D) El Holding Tank ElRenewal ElDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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: 5G 5 Date of Payment: 0 ) 2 Receipt Number: 7050 C/� Permit No. OS P2 2 13 l Y Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13021 Montego Circle, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com October 12, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: T12N R3W SEC 27 LT 10 PHYSICAL: 13641 MCDONELL RD, ANCHORAGE, AK 99516 The septic field has been found failed and we request a septic permit to upgrade the system on the above referenced lot. We propose to install one deep trench with an Advantex system to serve the existing 4- bedroom residence. This property was originally proposed to be subdivided. Apparently, this action was not proceeded with and therefore the original design in conjunction with this proposed platting action and subsequent ROW authorization is no longer being perused. The design is also based on the recent test holes conducted on July 12, 2022. The slopes are basically flat at 0-5% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221314, Deb Wockenfuss, 10/21/22 FIRST WATER CONSULTING T12N R3W SEC 27 LT 10 DESIGN CALCS: NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. PRESSURIZED DIST. LINE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221314, Deb Wockenfuss, 10/21/22 FIRST WATER CONSULTING NO WELLS WITHIN 50' OF PROPOSED SEPTIC SYSTEM. DESIGN DETAILS: T12N R3W SEC 27 LT 10 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221314, Deb Wockenfuss, 10/21/22 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: T12N R3W SEC 27 LOT 10 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7/22/2022 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 5 6 7 8 GM/sm-ml tight 9 10 11 12 13 14 15 BOH 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 7/20/22 30 min 6” 11/16” 30 min 6” 11/16” 30 min 6” 11/16” PERCOLATION RATE 44 (MIN / INCH) TEST RUN BEWTWEEN 3 & 4 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 7/20/2022 TESTHOLE # 22-1 DATE PERFORMED: 7/12/22 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: KAREN C PHILLIP 7/22/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221314, Deb Wockenfuss, 10/21/22 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: T12N R3W SEC 27 LOT 10 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7/22/2022 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 5 6 7 8 GM/sm 9 10 11 12 13 14 15 BOH 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 7/20/22 30 min 6” 1 15/16” 30 min 6” 1 16/16” 30 min 6” 1 15/16” PERCOLATION RATE 16 (MIN / INCH) TEST RUN BEWTWEEN 3 & 4 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 7/20/2022 TESTHOLE # 22-2 DATE PERFORMED: 7/12/22 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: KAREN C PHILLIP 7/22/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221314, Deb Wockenfuss, 10/21/22 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this w30 Day of� `2"rein'the � of 20 � `` ' by and between , "OWNER,'' and the Municipality of 7-1 Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as AN ADVANTEX SYSTEM located at (legal description) T12N R3W SEC 27 LOT 10 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the terns of this Agreement, the Owner shall enter into a service agreement t with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in �0, accordance with the equipment's approval for operation in the Municipality. V-] It shall be the responsibility of the Owner during the term of this P Agreement to pay for all . repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This r includes an annual maintenance fee (typically $400 to $600). J Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 r v rs Owner acknowledges that the Municipality may request records of maintenance and °°`} repairs from the manufacturer's representative or maintenance provider. -:' Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be r' assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. 14\1� Owner agrees that any sale or transfer of title of the property will not occur without a new I) ) Certificate of On -Site Systems Approval. r4AI Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severabilitv. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: ., 11 � o By: ! (signature) Date: (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 'So day of PO405T 20zZ , by P N►t-tg- ' LN NOTARY PUBLIC FOR ALASKA My Commission expires: J u LY 13 -7,oCZOZ ,C6 Anr se.4&3 u0►ss!11o3 An Notary Pilb,, ^muo N .IN M. N. ANDRES ON -I'd fJ81ON State of Alaska ?i. '-ion Expkas July 13, 2023 Date: C-07- 1 ZZ int name) Title: (rev. 05/18/2018) Page 3 of 3 TRACT B-2 HILL — N — DALE SUED. TRACT A Lot 11 Lot 31 Lot 9B G S�J� J00 Lot 9A Lot 32 $ 114 8 2 HAY 0 3 2006 PLOT PLAN _ AS BUILT X SCALE 1 = 50' GRID 2936 Project No. 06-011 Lang & Associates, inc, 11500 Daryl Avenue, Anchorage. Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax —o`�OF q o�4 kglanglsOalasko.net / jclonglsOalasko.net ` ... I hereby certify that I have surveyed the following described property: BLM LOT 10, SEC 27, T12N, R3W t Anchorage Recording District, Alaska, and that the Improvements situated thereon aro :49TH ........ y*:... within the property tines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed promises and that there aro no roadways, transmission lines or other visible KENNETH .. easements on sold property except as indicated hereon. Dated this the I4t Day of . MbR .Ak 2c�lo, at Anchorage, Alaska OQ ''•'� 14-io�0• 0 � It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 0 CSEPTIC ARE�D • MULLBERRY S/D; TRACT 82, \ FA V1 L gG N r ,�QRo'�• �' I I T12N, R3W, SEC. 27, LOT 11/ / / r APPROX. LOCATION T12N, R3W, SEC. 27, LOT 30 ri I i I I I I ' I HILL—N—DALE S/D; TRACT A, NO ENCROACHMENT CONCERNS I .y I ' I 511482 MAY 0 22001 I NOTE: TEST HOLE LOCATIONS II ARE APPROXIMATE. !L--------------------- — ---- 50' ROAD AND IUTILITY EASEMENT (TO BE VACATED) I ---1--------- I- Z w � I — �o I w zi I / ?o o� Er I � 0 Ir I \ AR \ I \ I \ I SCHUMACHER S/D; LOT 9B, I i i T12N, R3W, SEC. 27, LOT 31 WELL T12N, R3W, SEC. 27, LOT 32 o GARNESS ENGINEERING, GROUP, Ltd p cl) : T .� r x v s�x�x CONSULTANTS & GENERAL CONTRACTORS c a _ w Q• • • • : • .f.. t ... ................ r 11 707 E. MOOR ROAD, SURE 101 •ANCHORAGE. AK 99507 •PHONE (907)337-6179 •EAI( (907)338-3246 ' WEBSRE: rwvr.gomeasengineering.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ? SUSAN MCCREADY 907-230-5758 1 OF 1 OO . Je Jr y G ess. LEGAL DESCRIPTION: DRAWN BY: Q4 s1 E-7953 T12N, R3W, SEC. 27, LOT 10, J. L. "'(a- �AoG TYPE OF WORK: DATE: DOa�'�ofessiono�o SITE PLAN FOR WELL AND SEPTIC RESERVE SITES 3/28/2006 (Rev. 01/05) GARNESS ENGII�TEERIN GR®1CTI' Ltd. CONSULTANTS & GENERAL CONTRACTORS�* 4 T— D 0 3701 E TUDOR ROAD, SUrtE 101 • ANCHORAGE, AK. 99507 •PHONE: (907)337-6779 • FAX:(907)338-3246 • WEBSRE: gamessengineering.com .......... . .... ............ .D D SOIL LOG - PERCOLATION TEST Q LEGAL DESCRIPTION: T12N, R3W, SEC 27, LOT 10, f ey . Garness:' CE -7953 4 p� PERFORMED FOR: SUSAN MCCREADY DATE: 3/16/2006 Q4'rc�O DEPTH — _� i z-t��a� <ov� (feet) ORGANICS TEST HOLE1 '1' mesfsi°�°��� 1 Owe s SOIL CLASSIFICATIONS 2GW ORG NOTE: TEST HOLE LOCATIONS 3 GP ML GM CL 50' ROAD AND UTILITY EASEMENT 4 GC OL N o SW MH 5°•;• SP CH �' ,,SEPTIC RESERVE SM .'; OH 6 Sc 7 DEPTH O GROUNDWATER DATE GM TO SM 8 MORE SILT AND DRY 3/16/2006 DENSER w/ DRY 3/23/2006NOY 9 DEPTH AND SOME LARGE SCALE: I BOULDERS 10 THROUGHOUT _ 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP 12 13 3 1:32 — 6" — 14 15 B.O.H. 7 1:36 — g" — 16 17 10 1:40 2 0" 6" 18 19 PERCOLATION RATE *<1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: [—]YES NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: BENJAMIN MAUS COMMENTS: *THE INSITU SANDY SOILS WILL ACT AS A SAND FILTER. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 3LZ , 06 _ ARE APPROXIMATE. -- -=-------------------------------------__T__ (MINUTES) READING � (TO BE VACATED) 1:30 — 6" — 2 1:32 2 0" 6" 4 1:34. 2 0" g" 5 1:34 — g" — 6 1:36 2 0" 6" 8 1:38 2 0" i goo' TIME (MINUTES) READING (INCHES) 3/17/2006 1 1:30 — 6" — 2 1:32 2 0" 6" 4 1:34. 2 0" g" 5 1:34 — g" — 6 1:36 2 0" 6" 8 1:38 2 0" g" 9 1:38 — g" — 0 GA.RNESS ENGINEERING GROUP, Ltd.. CONSULTANTS & GENERAL CONTRACTORS 101 E TUDOR ROAD. SUGE 101 • ANCHORAGE AK. 99507 • PROW! (9071-17-f,179 • FAT mn7111A_11— wca<nc. ..,,...rm_.......-_... LEGAL DESCRIPTION PERFORMED FOR:_ DEPTH SOIL LOG - PERCOLATION TEST T12N, R3W, SEC 27, LOT 10, SUSAN MCCREADY DA 4 6 7 8 9 10 11 12 13 14 15 16 17 18 GM TO SM MORE SILT AND DENSER w/ DEPTH AND SOME LARGE BOULDERS THROUGHOUT TEST HOSE #2 SOIL CLASSIFICATIONS DEPTH TO GROUNDWATER DATE DRY 3/16/2006 DRY 3/23/2006 (TO BE �s� ANN • 2 1:44 -- --------------- -[----------------------- -I-- 'i�.� • � 6" _ 4 1:46 2 DEPTH TO GROUNDWATER DATE DRY 3/16/2006 DRY 3/23/2006 (TO BE VACATED) 6" N Sgi482MY02 NOTE: TEST HOLE LOCATIONS ARE APPROXIMATE. -A----------------------------------------- 50' ROAD AND UTILITY EASEMENT 3/17/2006 1 (TO BE VACATED) 6" N 2 1:44 -- --------------- -[----------------------- -I-- 3 ''::'SEPTIC RESERVE AREA'S � 6" _ 4 1:46 2 0" 6" 5 1:46 — 6" — 6 1:48 2 0" 6" 7 1:48 — 6" — 8 1:50 2 0" I 9 1 OP0v0 �u5 6" — I SCALE: , 2 0" 100' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/17/2006 1 1:42 — 6" - 2 1:44 2 0" 6" 3 1:44 — 6" _ 4 1:46 2 0" 6" 5 1:46 — 6" — 6 1:48 2 0" 6" 7 1:48 — 6" — 8 1:50 2 0" 6" 9 1:50 — 6" — 10 1:52 2 0" 6" 19 PERCOLATION RATE *<1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: BENJAMIN MAUS COMMENTS: *THE INSITU SANDY SOILS WILL ACT AS A SAND FILTER. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAPE FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: .31 If, u · Gl'' 'I'ER ANCHORAGE AREA B'--DUGH Department of Quality Environmental 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ViAl LING ADDRESS ~¢~¢ ~ LEGAL DESCRIPTION ~[ /Z] SEPTIC TANK: DISTANCE ~ FROM WELL INSIDE LENGTH MAN U FACTU R E R~ MATERIAL NUMBER OF COMPARTMENTS. NSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /,~tO GALLONS. SEEPAGE PIT: ,/LENGTH NUMBER OF PITS / DIAMETER __ OR WIDTH //~ '//, / DEPTH /'~/ LINING MATERIAL ? /~ ~RIB SIZE: DIAMETER DEPTH ~' / DISTANCE FROM: WELL_ · BUILDING FOUNDATION NEAREST LOT LINE ~'~ '~/- TOTAL EFFECTIVE · ABSORPTION AREA (WALL AREA) / SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BUILDING FOUNDATION CESSPOOL. APPROVED CONSTRUCTION ~/ ~'''~' '5~'''[' '~ qEAREST NEA REST ~OT LINE ~ '''~''' SEWER LINE OTHER SOURCES / DEPTH. /'~'~/ DISTANCE FROM: SEPTIC ~ / SEEPAGE TANK "~ '~-, SYSTEM · DISAPPROVED REMARKS DISTANCES: INSTALLED BY: .Z)Z,/~'2'?' ,~,/~,,~2~" PIPE MATERIAL: LOT SLOPE: DIAGRAM OF SYSTEM TYPE :~.-?OUNDATION TO SEEPAGE PiT 20 fi;,~ DRAIN FIELD ].0 2'~?~EPTIC TAN K TO SEEPAGE PIT '~¥ALL -- DRAIN FI~L~ 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 1. GENERAL INFORMATION (a) Legal Description (include Iot~ block, Subdivision, section, township, range) _~ i - Location (address or direct 0nb)'} ' - --- (c) Applicant is (check on~): Lendi~ Institution ~; 0~nedbuilder Buyer ~; Other ~ (explain}; (d) (e) ' Lendin~ institution/-~'r'/~~-~ Real Estate Company and Age"t ' ~//A ' Address Telephone (f) Mail the HAA to the following aaaress: - Z.'7 -53 TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Well~ Community [] Public [] Individual Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite/~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation "attesting to the legality and status. 72-025 (11/84) Page 1 of 2 . .. '~IJOM S,J@eu!Bu@ I~UO!SSaJoJd aU~ U. ~UO!SSlU. JO JO sJOJJe JO~ alqisuodsaJ ou 9 a5~JOgOUV ~o XI led 0 un~ eq~ 'penss] Jo suo~loedsu ~OnDUOO ZOU op a~HQ ~o seOXold~ '9]UD~DJ~nD~J ~B]9 pUB leJepeJ IBUOJSBGJoJd ~uGpu~depuJ ue Xq 9AoqB ~ ~deJ~eJed u~ U~A[~ suoJlBlUeSGJd~J Gq1 uodn ~lelOS pe~eq seJeo~JueD eAoJddv NOIJ. nVO · leUO!l!puoo · uo!loedsu! ~!LJl JO oj~p ~LJj UO loeJJe u! BuojJ~lnB~J pue '~eoueu!pJo 's~po9 @~l~ pue i~d!o!un~ iiB LJl!M ~OUe!IdLUo0 U! ~! LU~I~/~S le~Od~!p JB:JeM@I~BM Jo/pue Aldd~B JBJeM Oj!B-UO BLJj 'uo!lo~d~u! pue uo]jeB!:J~^u! ~lJJ uJOJJ pue ~l!J @BeJoLIouV JO Al!led!o!un~ ~LI1 p@u!e)qo uoJleuJJOJU! ~LJJ UO p~Bq leLl:J ,~JJJeA JBLJ:pnJ J 'U!eJeLJ p~leo!pu! ~JnlonJ:lS JO edAj pue ~LUOOJp~q JO JequJnu eLll ~l~nbepe pue IBUO!jounJ 'ejes B! LUelS/~S leBOdB!p JBleMeiSeM JO/pU~/qddn~ J~:J~M el!B-UO eL~j leLJJ SMOL~8 leAoJdd¥/~]~!JOL~JnV qJleaH s!q], lo UO!ieB!lS@AU! ALU leqi AIpOA I 'MOlOq UMOqS ejep uop, ep!le^ @q], Jo se pue OjOJ@q pex!~e leOS ALU Aq pe!/!po0 sV .g MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) .MUNICIPALITY OF ANCHO~]~ LIST FEBRUARY 1984 WELL DATA AUG 1 0 1987 RECEIVED Legal Description: Well Classificatiorv/A//;~/V//~//~/-~/~/*'~--&E~//~JV'~,4~f A, B, C, D.E.C. Ap~oved (Y/N) Well Log Present (Y/N)~ Date Comple~ ~//~-/~ ~ Yield Total Depth / 7~ Cased to . 7~Depth of Grouting Static Water Level /~ ~ ~ Pump Set At Casing Height Above Ground /~// ~ Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: T0 Septic/Holdi'ng Tank on Lot /~ ~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /~/~ ; On Adjoining Lots To Nearest Public Sewer Line ~/~ ~ To Nearest Public Sewer CleanouVManhole ~/~' ~ To Nearest Sewer Service Line on Lot Water Sample Test Results ~'r/~ SEPTIC/HOLDING TANK DATA ~/~' ~r'~ / Date Installed ~'~../~:~7~, Size "7-.~4~:~,,~-4~. No. of ~mpa~ments / Standpipes (Y/N) Y ~ Air-tight' Caps (Y/N) ~ ~ Foundation Cleanout (Y/N) bepressio~ over Tank (Y/N) ~ ~ Date Last Pumped ~/~/~7 Pumping/Maintenance Contract on File (Y/N) ~¢ ;for /~ ~ Holding Tank High-Water Alarm (Y/N) ,/"Y//,~ (~ Separation Distances from Septic/Holding Tank: To Water-supply Well /2~ ~ ~'~' (~ TO Property Line ~ 2 ~ ~'T' ~ TO Water Main/Service Line /'V*//~ (~) Course /'~///~ (~ Temporary Holding Tank Permit (Y/N) /~//,/~ 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 ~/'~ ~ ,~/-~//~/¥¢ (~)Type of System Design Date installed ~"'7~ /~'~ (~ Length of Field //..~ F~'(~) Width of Field //,c~/~7- ~ Depth of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Gravel Bed Thickness ~ ~-'7-' ~ Standpipes Present (Y/N) ,,y/~J Date of Last Adequacy Test (4~/j~/(~.;.~ ~' 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 To Properly Line To Existing or Abandoned System on ; On Adjoining Lots /~)7~ To Cutbank (if present) //~//~ Comments D. LIFT STATION Date Installed __ Size in Gallons "Pump On" Level at __ High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Rating Against Request ** I certif Signed Date Company ~'~-~'/~ __ MOA No. __ Receipt No. / O O / <~ 0//,/42 Date of Payment C~//y ~'--~ Amount: $ Page 2 of 2 uidelines in effect on the date of this inspect on 72-026 (11/84) CHEMICAL & GEOLOGICAL LABORATORIES OF ALA~KA, INC. ~,\' ~m~s ~ STREET ^NC.ORA~E. ^'ASK^ 99~9 TELE.HONE ¢O71 ~m2-2m43 ~.~-,~e'o~;,~,',~sn'~% FEDERAL TAX ID # 92-0040440 ANALYSIS F;EFORI' BY E;~qMF'LE Cl!ent POe : VERBAL Client Sm, pi II): 1364] Sample Ree'd : AUO 14 D? Ordered By : DOD ~RIg[l? Reports To: 0.-HIUE ENOR i¢ock Order No, : 2254 Client Account :DBIGtIE~ Date Report Printed: A0G 14 87 9 14:44 Re]eased By,r% : 3 Report9 Add:em9 ~2 3605 ARCTIC $~ ~993 F~]CEO~AGB, AK. 99503 Special ROUTINE SA))PLK COLLKC~KO 8-14-87 BY Il-HIGH ENGIN~RRS. instruct: Chemlab Ref ~: 7324 Lab ~npl I0: I Matrix: ~ater AIIo~able P~rameter Tested Result/Units ~lethod Limits 1.1 mg/1 ~UNICIPALITY OF ANCHORA(~I~ DEPT. OF HEALTH & r=~IRONMENTAL PROTECTION ~AUG 1 4/987 RECEIVED Sallie ROUTINE SANPLE Remarks: ! Tests Performed ~ See Special Instructions Above Nl~ ~one Detected *~ See Sample Remarks Above NA: Not Analyzed L?=Les9 ?hah, O?=Greater ~)an · ftX .. B.o roR Es ~ .....~ Drinkin0 Water Analysis Beport for Total Coliform Bacteria TO BE OOMPLETEDiBY WATER SUPPLIER X"mV^TE~'^*E" SVS~rEM ~ Name ~ Phone No, ~o. Day ~ Year SAMPLE TYPE: Routine Check Sample (for routine sample with lab ref. no. [] Special Purpose .) [] Treated Water [] Untreated Water SAMPLE Time Collected NO. . . ! LOCATION Collected 21 3 I I 41 I ' READ INSTRUCTIONS BEFORE COLLECTING SAMPLE TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [~ Satisfactory [] Unsatisfactory [] Sample too Iorig in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received <~Ta~ '~ ~ ~ Time Received /"r~ ~ ~ ? Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref.~o- Result* BACTEFIIOLOGICAL V~AT£RtAMAL¥$1$ Rr=CORD Membrane Filter. Direct Count Verification: LTB !BGB Final Membrane F~r~sults . Reported By nato TNTC = Too Numberous T° Count OB = Other Bacteria line: Analyst CoilformllOOml O Collformll00ml INVOICE " EWER AND DRAIN ".'~W' ~o, '7,'u,.~r,~ CLEANING SERVICE P.O BOX 112688 PHONE 345-2513 ANCHORAGE, ALASKA 99511-2688 ROTO- ROOTER SERVICE CALL STEAM THAWING TRIP CHARGE OVERTIME CHARGE ADDITIONAL LABOR CHARGE PUMPING SERVICE "'~) (GAL) HRS HRS. (G, ~ "---"~. HRS. HRS.' HRS. ~ HRS ~ HYDRO-JET SERVICE MATERIALS PLEASE PAY FROM THIS INVOICE TOTAL FOOTAGE CLEANED OR THAWEd- BLADES USED LINE CLEANED [] JOB NOT GUARANTEED~C~R F~LOWING ~'~/SQ~~ ® N-° 021501 ~¢~¢~:~ ~¢~~SEWER AND DRAIN ",~,w-f ~a ~,u~_~ CLEANING SERVICE P.O. BOX 112688 PHONE 345-2513 ANCHORAGE, ALASKA 99511-2688 ROTC- ROO~ER SbHVlOb ~ Llb "R SI / ¢ STEAM THAWING HRS. ~ TRIP CHARGE HRS. ¢ OVERTIME CHARGE HRS. ~ ADDITIONAL LABOR CHARGE HRS. ~ HYDRO-JET SERVICE HRS ~ MATERIALS TOTAL PLEASE PA* FROM THIS INVOICE . TOTAL FOOTAGE CLEANED OR THAWED ~ BLADES/D PRDBABLE CAUSE O/: STOPPAGE J/~