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HomeMy WebLinkAboutT12N R3W SEC 20 PARCEL 31 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES O)~' ~ //2 Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264~4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Address Permit No. LEGAL DESCRIPTION TANKS ~] SEPTIC [] HOLDING DISTANCES WELL LOT LINE FOUNDATION SEPTIC ABSORPTION TANK FIELD WELL AS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, etc.) Manufacturer Material No. of Compartm~.~s TYPE OF SYSTEM [] TRENCH J~ BED [] W. DRAIN [] OTHER Depth to pipe bottom from Total depth from original grade original grade ~'~' ~ FT '7. ~ FT Fill added above original grade Gravel depth beneath pipe ~. ~ FT O, 5 FT Gravel length ~rave] width '-70.0 FT I 0. o '700 SQFT /6 ~ ~. 0 FT Pipe material Number of lines Soil rating 15~ SOFT ~..STr-'% .30 3q" Date Installed WELLS ~ PRIVATE./~,r~,.,7 Classification (A,B,C) Installer [] OTHER (Identify) Total Depth FT Cased to Date Installed: FT REMARKS: I ,~ "~'¢'~"'-~' cerlily that lhis insl~ection was podormed according to all Municipal and State guidelines in effect on this data: Health Deparlmen, Approval: >~'9~ 72-013 (3/85) ,.. E ...,.. :i. ].00 · · S59'57'00" E 258.2'/ Abandon existing ayetem -" -'~. ~ NO~ ~lstlng tank muat be allow 8' total depth of leachbed _ /~ 3' ~ ~ ~ ~ / ~ as measu.d at ~4 ground ~/~/ ~~/  ~u~aae. S89'57'0~ E 258.2' Septic I ~ - ~ HO~ Tank · - MONITOR o - S~ER C~O~ + - WE~ - PROPOSED ~EME~ CONTRACTOR: JOB ~ 9o'o941 DATE: 09/15790 SCALE 1" = 40' ".o. P.O. : (907) 894-5195 r~: (907) 694-3297 SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM T12N, R3N. ~e~. 20 The septic plan is for a single family residence only. The drawing and or site plan shall be a part of this specification. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. All soil tests are advisory to the design and are to be verified or r~tff~d in the field by the engineer. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to rr~et Municipality of Anchorage, Department of Environmental Conservation requirements. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. The excavation is to be exactly in the area sho~q~ on the site plan, any. deviation requires engineer approval. It is always recommended that a surveyor locate the nearest lot line position and the location of any easen~ts. The bed is to follow thenatural land contour to maintain uniform total depth of the bed bottom. The bottom of the bed shall be level, plus or minus 1.5". The total depth of the bed excavation is not to exceed 8' at any point. In relation to ground surface of test hole ~4. Contractor is to reference a suitable benchmark. ' . The sewer line is to replace the existing sewer line that leads to existing trench. The bed gravel is to be covered with typar fabric m~terial. Soil or combination of soil and extruded board insulation to a depth of 4' or equivalent is to be placed over the leachffeld. The area over the bed is to be finish graded to prevent pending of surface . water runoff. The septic tank and leachfield must not be closer than 100' to any e~tstfng private well, 150' to any Class "C" well, or 200 feet to any coT~F, unity well. RECOF~ENDED LEACHFIELD DIMENSIONS TOTAL DEPTH -- 8' GRAVEL DEPTH = 6" ":,!i;BED LENGTH = ?0' BED WIDTH = 10' ::::'~!i~:i!?~OTE;. 'Existing tank to be uncovered at both manholes for inspection. If existin . · ;~i:ii:i~::.:.~a~k.is used the 2nd compartment is to be provided with pumpout pipe. ' . ---;!. .... i?~OTE, The bed in area of TH3 may have to be over excavated & beck-filled with sand_ ?i~at~'rial to reach SP layer. PERFORMED FOR: LEGAL DESCRIPTION: 2 4- §- 7- 8 10- '14 16 ~7 '11t - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 826 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST COMMENTS SLOPE WAS GROUND WATER /~E.~' S ENCOUNTERED? OL ~*, / P E DEPTH?IF YES, ATWHAT ~,~,v,t~re,~ ~. DATE PERFORMED: SOl LS LOG PERCOLATION TEST SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop : :: · PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ~ FT Eagle River Engineering Servlces -.-~~~ P, O, ~( 7732gj, CERTI FlED BY: ~~~- Eagle River, AK 6~5195 PERFORMED BY: 72-008 (6/79) PERFORMED FOR: LEGAL DESCRIPTION: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264~,720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST DATE PERFORMED: ~A4'//~O SLOPE SITE PLAN Gross Net Depth to -i Net Reading Date Time Time Water Drop ': : ~::'::~':. 3eLATION RATE :..:, ': :~;': TEST RUN BE'rWEEN ~, COMMENT~ ::::=i PE~i~0RMED BY: Eagle River Engineering $orvloos P. 0. Box 77~4 ' Eagle River, AK 9957'/' · 8~4,-51g$ CERTIFIED BY: --~ , FT AND (minutes/inch) ~>, .C'- FT PERFORMED FOR: · LEGAL DESCRIPTION: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264~,720 SOILS LOG - PERCOLATION TEST p 4Rc '/- g t SOILS LOG [] PERCOLATION TEST SLOPE DATE PERFORMED: SITE PLAN 1¥7 ; 10- ;GROUNDWATER 11- COUNTERED? IF YES, AT WHAT Gross Net Depth to Net Reading Date Time Time Water Drop . .20 COMMENTS 2OLATION RATE ~,/f,~',,',~¢' /~ ~ TEST RUN BETWEEN . FT AND (minutes/inch) FT Eagle River Engineering BY: P. 0. Box 77~1294 CERTIFIED BY: Eagle River, AK 99577 6~4.5165 · PERFORMED FOR: 'LEGAL DESCRIPTION: SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264~,720 SOILS LOG - PERCOLATION TEST [] PERCOLATION : TEST SLOPE SITE PLAN (~EP.'EH. PEer) ~ · ,O /~'1/ .'-,_ , * : ~.~..~,: .. ':'i ~: ~ 'r WA · ~., .'~'~ · EN( ~ '*~,.. / IF~ · . . DEl . ~ ~;.~.~ ...... CE~730 . .~ ~ : PEI 14 17 · ;:.,18 ' GROUNDWATER ',OUNTER ED? YES, AT WHAT DEPTH? Gross Net Depth to Net " Reading Date Time Time Water Drop · PERCOLATION RATE TEST RUN BETWEEN ,~::~/zf (minutes/inch) , FT AND ~"°"~. FT , CERTIFIED BY: Eagle River Engineering 8ervloe$ QGREA,iR ANCHORAGE AREA BOR~,uGH Department3330°f EnvironmentaIc Street Quality Anchorage, Alaska 99503 INSPE/C~]'IO~/REPORT ON-SITE SEWAGE DISPOSAL SYSTEM DISTANCE FROM WELL /O~/~rT~MANUFACTURER NUMBER OF COMPARTMENTS INSIDE LENGTH ~ INSIDE WIDTH LIQUID DEPT1T LIQUID CAPACITY /~d!,--~) GALLONS. SEEPAGE I~J~: NUMBER OF ~ LINING MATERIAL TOTAL EFFECTIVE BUILDING FOUNDATION: EAREST LOT LINE__6 · ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION DIAMETER J'/ OR WIDTH 7g, '/ LENGTH ¢4 DEPTH //~"~- CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL / ~'gO SQ. ft. WELL: BUILDING NEAREST ~ NEAREST FOUNDATION / LOT LINE SEWER LINE CESSPOOL APPROVED DISAPPROVED REMARKS //~_~ © DEPTH DISTANCE FROM: SEPTIC . SEEPAGE TAN K .,/~"~ ,~,,"7'~ SYSTEM ¢~'~._.1 ~'~'-- D,STANCES: ~ INSTALLED BY:_ PIPE MATERIAL:9.m- ':~ p-'¢-'¢ DIAGRAM Of SYSTEM DATE PERMIT NO. AF'F'L I CAI'IT LOCFIT I ON LEGAL 2_'940 YALE DR 279-L:.':6G4 4.'_. ...... b ~,QURRE FEET LOT _,I~.E - · STEVE RUDD REEDER R[:' _,E_..-4_4 T~L2N R2:W PARCEL .?,-1 c- c: ¢'- TYF'E OF SOIL ABz, ORBTION SYSTEM IS: TRENCH MA::--':'rNUf'I NUMBER OF BEDROOMS = 4 SOIL RATING (SC., FT.-.'BR)= 140 THE REQUIRED SIZE OF' THE SOIL~'TION SYSTEM IS: E:,E£PTH= ~--~ I ..Ei"-.llS"l~ .g ,3RR .. EL_ THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFAE:E OF' THE GROUND AND THE BOTTOM OF ]'HE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF' GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ~:Egll!L#IREB" SEF'TI C: TRF~:] S;IZE=: 125~Z1 BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR R PUBLIC WELL. WELL LOGS ARE REQUIRED RND MUST 8E RETURNED 'fO THE DEPARTMENT WITHIN ~0 DAYS OF: THE WELL. COMPLETION. SPECIF'ICRTIONS AND CONSTRUCTION DIAGRAMS ARE RVRILRBLE TO INSURE PROF'ER INSTALLATION. I CER'¥IFY THRT UN--',I .=,EWER=, AND HEL_LS RS SET ±: I FIM FAMILIAR WITH THE REQUIREMENTS FOR - '- TE ~"' FORTH E:Y THE MUNICIPALITY OF ANCHORAGE. '2: I WILL INSTRLL TNE SYSTEM IN RC:CORDRNCE WITH THE CODES. ~.' I UNDERSTAND THAT THE ON-SITE SE. WEF.' SYSTEM MAY REQUIRE ENLARGEMENT IF 'THE ~:~..c]i[)ENCE~IS REMODELED TO,~I,[4E:LU~'~E r,~RE THAN 4. E:E.[:,ROOMS. APPLICANT STEVE RUD[:' ISSUED E CONSULTANTS, INC. ANCIIORAGE FAIRBANKS JUNEAU May 24, 1976 R & M No. 656240 Mr. Steve Rudd 2940 Yale Drive Anchorage, Alaska RE: Test Hole and Soil Log Report for Sanitary SYstem Parcial 31 Section 20 T12N, R3W, S.M. Dear.Mr. Rudd: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject iste. This investigation was performed inaCcordance with your request of May 12, 1976 and those procedures outlined in a letter dated July 15, 1975, by Mr. Roll Strickland of the Municipality ~f Anchorage, Department of Environmental Quality. A single test hole was put down within the Parcial 31 area for the Purpose of defining 'general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 20.0 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity tO be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M CONSULTANTS, INCo JWR/WED/pe xc: Municipaltiy of Anchorage TH 1 0o0' STH 1 SILTY SAND TRACE GRAVEL [SM) SANDY GRAVEL W/SOME SILT (GW-GM) 150 sq ft/bedroom SILTY SAND TRACE GRAVEL GRAVELLY SAND TRACE SILT (SP) SAND, SOME SILT SOME GRAVEL (SM) SILT, SOME SAND (ML) No Water Table 3.0' 6.5' 8.0~ 14.0' 18.0' 20.0' T.D. Log Represents Location of Test Hole Parcial 31, Section 20 T12N, R3W, S.M. DWN: VRZ CKD: WED DATE: 5-26-76 SCALE: 1'=3' Log of Test Hole Steve Rudd. Anchorage, Alaska PIROJ. NO. 656240 PERCOLATION TEST STEVE RUDD R & M NO. 656240 TIME 4:00 4:01 4:02 4:03 4:04 4:05 4:10 4 :~15 4:20 4:25 4:30 4:35 4:40 4:45 4:50 4:55 5:00 ELAPSED TIME 0 1 1 1 1 1 5 5 5 5 5 5 5 5 5 5 5 60 Minutes DROP INCHES 0 2 2 1.5 0.5 0.25 2.50 2.25 2.5 2.0 2.25 2.25 2.25 2.25 2.0 2.0 2.25 30.75 Total Drop ,/J l/) .~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# f~'j \L~- \\~,-~\ HAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address '"~_ ~,~ ~.~ v'ct ¢~'~'/ Day phone ~ .o,~/~/,~- ~'L"~,X '~'-~'~'~1' Dayphone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Individual well ~( Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date Shown belsw, 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. NameofFirm '-~'~'/ g~u~-~-L~.,.c~ ~- ~ Phone Address ~¢ % ~ l ~ ~ Engineer's signature ~ ~~ Date Approved for ~ Disapproved. Conditional approval for bedrooms. DHHS SIGNATURE bedrooms, with the following stipulations: Additional Comments II~:~,lJ / Ia] ~ 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. Em ployees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Parcel I.D. Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed '7//~ 71~ Driller Cased to ~ t_/C) Casing height ~.~ xl Wires properly protected (Y/N) Y FROM WELL LOG Date of test "~ [ ~' "Z b Static water level -7 ~ Well flow t.~ Pump level "~{3 '~o,-,,,~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line g.p.m. ; On adjacent lots ; On adjacent lots ~/~ Public sewer manhole/cleanout /'///,~ petroleum tank I~ / t:::) WATER SAMPLE RESULTS: Coliform ¢ Date of sample: ~ I ..__J Nitrate N r~ Other bacteria ID l [~-- Collected by: B. SEPTIC/HOLDING TANK DATA Date installed I o/.{j~/q O Tank size [ u...¢~o Compartments Cleanouts (Y/N) ~ Foundation cleanout (Y/N) y Depression (Y/N) High water alarm (Y/N) I~///_&, , Alarm tested (Y/N) Date of pumping: ?/~ 7_. Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot [ ~ -;z_ On adjacent lots .~ l ~ Foundation To propertyline J20 ~ Absorption field ~¢' Water main/service line Surface water/drainage /~/E~ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested __ Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on tot On adjacent lots Surface water D, ABSORPTION FIELD DATA Date installed I 0 / ~lt,l ~, L~ Length '~'O Width Total absorption area '7f---°~¢ Depression over field (Y/N) ~ Results (pass/fail) ,"~' Peroxide treatment (past 12 months) (Y/N) Soil rating I~ System type Gravel thickness ~, ~! Total depth Cleanouts present (Y/N) / Date of adequacy test _ for ~=' If yes, give date 7 bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I ?-- ~ To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ,~" '~o _Propertyline To existing or abandoned system on lot Cutbank I"~ t~ ~ ~_ 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 effect on the date of this inspection, Engineer's Name Date ~ HAA Fee $ / Date of Payment "7~/'~L- ~' ~ Receipt Number ~-~ ~'~ ~('/%~/~? ) 72-026 (Rev. 3/91) Back MOA2~ Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS for INVOICE ~ 55716 Chemlab Ref.~ 92.3392 Sample ~ 1 Matrix: WATER FAX: (907) 561-5301 Client Sample ID PWSID Collected Received PzeserYed with PARCEL 31 SEC 20 T12N RSW UA JUL t0 92 @ 14:20 hrs. JUL 10 92 ~ 14:40 his. AS REQUIRED Client Name :TOBBEN SPURKLAND, P.E. Client Acct :TOBBEN$ BPO$ : PO~ :NONE RECEIVED Req~ : Ozdered By : Analysis Completed : JUL 13 92 Send Reports to: Laboratory Supervisor~STEPHEN C. EDE IOTOBBEN SPURKLAND, P.E. Released By : ~/~ 2) Parameter Results Units Method Allowable Limits NITRATZ-N ND(O.IO) m~/1 EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: T.S. Remarks: 1 Tests Performed ' See Special Instructions Above UA=Unavailable ND= None Detected '* See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Greate~ Than ~SG-~ Member of the SGS Group (Soci~t~ G~n~rale de Surveillance) Parcel I.D. #  MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) P~r~l ~l S~t~on 20 T12N R3W Location (address or directions) ll?~ ~f Drive; Anchorage': Alaska (b) Property owner Mailing Address~' (c) Lending Institution N/A Mailing Address C) l 9R7. Telephone: (home) ~ Business~ Annhn~-a ~np. A1 nSk~ Telephone (d) Real Estate Company and Agent N/A Address Telephone (e) Mail the HAA to the following address: (or check here El, if hold for pick up.) List contact person and day phone number below: Enqineer " TYPE OF RESIDENCE Single-Family I~ Number of bedrooms 3. WATER SUPPLY Individual Well ~3 Community [] Public [] Note: If community well system must have written confirmation from the State Department of Environmental Conservation attesting to th legalitY and stat~sl'''~ ' ~' ~'" ":: ' :" 4. SEWAGE DISPOSAL ." On-site:~] 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 (Rev. 7/88) Page 1 of 2 ')iJOM s,Jeeu!6ue I~UO!SSetoJd eq~, u! suo!ss!uuo Jo sJoJJe Jot elq!SuodseJ lou s! S6BJOqOU¥ IO ~l!led!o!un ~I eq.L 'penes! s! m, eON!lJeO ~ eJo~eq sisP eZ~l~U~ Jo suo!joedsu! lonpuoo lou op SHHO ~o see~oldtU~] 'sjuetueJ!nbeJ m, ejs pue leJepet u!el~eo ~s!lss ol JepJo u! suo!jnlp, su! 6u!puel J!eql pue SeuJoq ~o sJas~qoJnd ol ~sm, Jnoo e se s!q~, seop SHHO eq.L '~>lSel¥ to ele~S eql u! peJels!6eJ Jeeu!6ue leUO!SS~toJd juepuedepu! ue ~q eAoqe S qdeJBeJsd u! UeA!6 suop, eiueseJdeJ eql uodn,ilUO pessq pel~o!tpeo I~AoJddv/,lpoqln¥ qll~eH senss! (SHHO) seo!AJeS ue,,,nH pue qileeH ~o lueLulJedeo e6eJoqou¥ to,f1!led!o!unpl eq.L PI F ql¥ ' leAoJdd¥ leUOp, Ipuoo ,to s,,ue.L leUO!jlpuoo pe^o,Jdd'~s!O -,,,>~' peAoJdd¥ lVAOaddV SHHa '9 / / 'uo!loedsu! s!ql 1o elep eql uo loette u! suo!leln§e~ pub 'seouBu!pJo 'sepoo elelS pue ledlolun~ I1~ q31~ eoUelld~oo ul s! mels~s I~sods!p ~ele~e~sea ~o/pue llddns ~ele~ ells-uo eql 'uolloedsu! pu~ uolleD~lseAul l~ ~O~ pu~ Sel!l e6e~oqouv ~o lllledlolun~ eql mo~l peu!e~qo uo!~olul eql uo peseq leql ~lpeA ~eq~nt I 'ule~eq peleolpul e~nlon~ls ~o edll pue s~oo~peq ~o ~eq~nu eql ~ot elenbep~ pu~ leUOllounl 'e~es si ~els~s leSOds!p JeleMelSeM Jo/pue Alddns Je~eM elis-uo eql leql SMOqS leaoJddv ~lpoqlnv qlleeH s!ql lo uo!leBIlseAu! ~ leql ~tlJeA I 'MOleq UMOqS olep uo!leP!leA chi to s~ pue oleJeq pex!lje lees ~ ~q poy!~eo sV NOIZV~UOdNI QNV vzva 'HDBV3S ]lld 'S~S~ 'SNOIIO~dSNI DNIOIAOUd ~UI,J DNIU~NIDN~ '9 ,,xo~'_,&¢"~ MUNICIPALITY OF ANCHORAGE (MOA) .-~O~, ~9'~ /;'J'J~,~\ Health Authority Approval (HAA) ~ ~ ~ . 343-4744 ~ ~' ~O~ .~ Legal Description: ~c~f ~ / Well Classification ~ ~ ~ If A, B, C, D.E.O. Approved (Y/N) Well Log Present (Y/N) f Date Completed ~ ~ /~ Yield Total Depth /~ z Cased to /~' Depth of Grouting ~/~ Static Water Level ~, '2 ! Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots /'"'~'~' / ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments To NeareSt Public Sewer Cleanout/Manhole ../-..~ ~- / ; Date '¢/'~ ~/¢"' B. SEPTIC/HOLDING TANK DATA Date Installed //~ Cz.., Size /"~'~-..,~. No. of Compartments Standpipes (Y/N) ~' Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) Depression over Tank (Y/N) /1// Date Last Pumped "~"~-~"~/ ,'~'~"~' Pumping/Maintenance Contact on File (Y/N) '"?/'J"~ ; for Holding Tank High-Water Alarm (Y/N) '4/"/""F Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ,/'¢ :~ t To Property Line ~¢',,2 / To Water Main/Service Line ¢'/~' / To Stream, Pond, Lake or Major Drainage Course Comments To Building Foundation To Disposal Field ~/ 72-026 (Rev. 7188) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field ,,/'/~ / /¢,--..¢-- Square Feet of Absortion Area ~,¢¢ Depression over Field (Y/N) /v' Results of Last Adequacy Test ,¢v"~_¢,/~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot :3¢ / To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line -~--~ / To Existing or Abandoned System on ; On Adjoining Lots /".¢-~ ' To Cutback (if present) ~/''~ /,-"/..4- D. LIFT STATION '"f"/I,~¢ 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 guidelines in effect on the date of this inspection. Signed Company Date MOA No. Eagle River Engineer!ng Ssrvices P, 0. 8ox 773294 Eagle I~iver, Al( 99577 694~-5195 Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) Back ?? o,-oO Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 NORTHERN 2~05 FAIR.~AN~ ~$~0 INDUSTRIAL WAY TESTING LABORATORIES, INC. ANCHORAGE. ALASKA 09503 907-977.8~78 * ~AX 274.9845 FAIRBANKS, ALASKA 99701 907.4~.~116 · ~AX 456-3125 Eagle River Engineering PO. BOx 773294 Eagle River AK 99577 Attn: Louis Butera Report Da~e: Date Arrived: Date Sampled: Time Sampled; o~/27/9o o8/2~/9o 1600 our Lab ~: A104394 Location/Project: - Your Sample ID: Parcel 31 Sample Matrix: Water comments: Flag Definitions Below Detection Limit DL Stated in Result Below Regulatory Min. Above Regulatory Max. ~elow De=ection Limit ~s=imated Value Da~e Method Parameter Units Result Flag Analyzed EPA 300.0 Ni:rate-N mg/1 0,1 U 08/28/90 Re o ~ - ' Anchorage Operations Manager A Ea~le River Engineering Service: 11940 Business Blvd, Suite #205 P.O. Box 773294 Eagle River, Ak. 99577 694-5195 Fax 694-3297 Dote: ~/;~/~ Type of test: [] Well Flow Test [] Septic Test Only '~Well ~' Septic Test 1:3 Other: Meter Monitor Well Tank GPM PSI Remarks Time Reading Level Level Lev.el ~./~- //4 ' ~. c. S89'§7'00" E 258.2'/ 4' e sep, . 10~ .25~ ,. 5~ ~ Pl~y h S89'57'0~E 258.2' X I ~ end 11.~' Tank · - MONITOR ~BE o - S~ C~O~ Septic System Asbuilt ...... LEGAL: Percel J1 T12N, R3W, SEC. 20 OWNER: Charles Hunziker CONTRACTOR: N/A Jo~ ~ ~o-o~4 a~r[: o~s/~ol sc~[ ~"= ~AGLE RIVER ENGINEERING ~ERVIC~ P.O. Box 773~94 (907) 694-5195 FAX: (907) 694-3297 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' GENERAL INFORMATION (a) (b) (c) (d) Legal Description (include lot, block, subdivision, section, township, range) .PftR Et Z,I 5ECT O I zo '7'lZ Location (address or directions) Applicant Name'~/'tUCK [¢I./IV'Zl ~EiV Telephone: Home ~ ~¢'3750 Business Applicant Address //~-¢'0 /~¢7"" ~,~. ,,,~'~., ~ Applicant is (check one): Lending Institution []; Owner/builder ~i~'; Buyer []; Other [] (explain); Lending I nstitut;oh Address (e) Real Estate'Company and Agent .Telephone Address Telephone (f) M ail t h e %,t~,°..~i°ll°~d ~ , 2. TYPE OF RESIDENCE Single-Family[~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well BI' Community [] Public [] 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 sys['em, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) '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 flies 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 I ~OO Date DHEP APPROVA~_I..~ / Approved for --//'-~'~ Approved Disapprov'ed' Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based s'olely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy .certain federal and state requirements. 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: Ti2N WELL DATA Well Classification f IV J~l IJ l i~U~/.., IfA, B, C, D.E.C. Approved (Y/N) Well Log Present ~'N) Date Completed' ',,) d/-, ~ Is/7fo Total Depth J~0' Cased to ~_/"f- Depth of Grouting /V//~ Static Water Level Q 6/, ~ / Casing Height Above Ground 2-" Electrical Wiring in Conduit (¢N) Separation Distances from Well: To Septic/Holding Tank on Lot /O,~ / ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot / "~O / ; On Adjoining Lots To Nearest Public Sewer Line /~//~ To Nearest Public Sewer Cleanout/Manhole N/fir' To Nearest Sewer Service Line on Lot Water Sample Collected by ~1. ~U/~;-./V ; Date Water Samp e Test Results~ --,~1~/'~5~-"/~'~.~//~ COmments (~ ,¢¢.,/~¢._J-- /~¢-.~/~' ~d~ Yiel~ Pump Set At Sanitary Seal on Casing CN) Depression Around Wellhead (Y~ B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes ((~)'N) Air-tight Caps (~N) Depression over Tank (Y/~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: Size J 2-~'~0 No. of Compartments Foundation Cleanout (~N) Date Last Pumped c//,-~/~¢~; ~,//~1~ ;for ,~/~t~ Temporary Holding Tank Permit (Y/N) To Water-Supply Well To Property Line To Water Main/Service Line Course ")" /00 To Building Foundation '~'~- ! To Disposal Field L/(../ / 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 7/[ Width of Field ~I~ / / Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test Separation Distance from Absorption_,<,~ld: To Water-Supply Well / To Building Foundation Lot N/~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field <~1~ / Depth of Field / [ Gravel Bed Thickness ~'/~ Standpipes Present ((~'N) Date of Last Adequacy Test To Property Line -k gO' To Existing or Abandoned System on ; On Adjoining Lots '/" ~.'O .I To Cutbank (if present) + I00/ +10/ 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 ~ Manhol~N) / "..~ump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that l/.,cz.- ,, - J- / ha~/~ec~d, ,veri]ie~d, or conformed to all.~OA, and~J--IAA guidelines in effect on the date of this inspection. ¢'""¢"-"'--'U ~"L/Z.-.--~' Date '¢"~ -///'""~("' Signed Company Receipt No. Date of Payment Amount: $ MOA No. Page 2 of 2 72-026 {11/84) ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB . , : ~ -, SHEET NO OF ALASKA CiUlmonmenTAL CONTROL sehdices, ~n,:lin~:¢rin,:I $ ~n,.,Jronm~:ntal $ludJcs ir'lc. APRIL 11 1986 CHUCK HUNZIKER 11200 FOREST DRIVE ANCHORAGE ALASKA 99516 Sk~ ,T .~R-SAME WILL PICK UP FROM OUR OFFICE 60147 LEGAL:T12NR3W SECTION 20/PARCEL 31 ADEQUACY TESTFOR S~NER SYSTEM ADEQUACY TEST DATE-APRIL 9 1986 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 560 SQFT. THE SYST~4 IS CAPABLE OF ACCEPTING 600 GAT,T~)NS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 G~T,TONS. BASED UPON THE TEST DATA THE SYST~4 IS ACCEPTABLE FOR A 4 BEDROOM HCk~4E. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON APRIL 5 1986 . THIS REPORT DOES NOT VERIFY THE ~ITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. FLOW TEST ON WRY.T, WELL FLOW DATE-APRIL 9 1986 A FLOW TEST WAS PERFORMED ON THE WELL. 900 PUMPED AT A RATE OF 5.8 GPM OVER A DURATION OF THE DRAWDOWN WAS 60.2 ' WITH A RECOVERY TIME OF AND THE STATIC WATER LEVEL WAS 61.9 FEET. THE W~/.I'. IS ADEQUATE FOR THIS 4 BEDROOM HC~V~E. GALLONS OF WATER WAS 3 HOURS. 50 MINUTES 1200 ~Ucst 33rd Aucntl¢, Suite B · Anchora§¢, Alaska 99503"(907) 561-5040 , MUNICIPALITY OF ANCHORAGE ' /.~.,.~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchorage, Alaska 99501 A4UNIClPA£i~y REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (l~o~i~'g; 1. PROPERTY OWNER PHON~ MAI LING A ~R ESS PRdPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION ~ PHONE MAILING AgD~ESS 4, REALTOr/AGENT PHONE MAI kl~ XDDR ESS'' ( ~. LEGAL DESCRIPTION TREET LOCATION ,. TYPE O~ R~:SIDENCE  S INGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDF~MS [] One ~ Four [] Two [] Five [] Three [] Six [] Other WATER SUPPLY .~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM '1~ INDIVIDUAL/ON-SITE~ [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth {attach log if available.) ~~,~/~.~ **If individual/on-site, give installation date~ ~ If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME I DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS LIE]~'' SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [~I~""~N DIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER I~NNDIvI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: I~:~.~Q~ If Tank is homemade SOILS RATING give dimensions', TYPE OF TANK MANUFACTURER /~ . ~ . TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS {Z~'"'APPROV ED FOR Z~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate} [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev. 3/78) . "X .'~ ..~ ,' -" 2 /-~MUNICIPALITY OF ANCHORAGE~-x . : ': '~,%~'",~':..':'!- ';" .'!'-~DEPAR'FMENt*: UF'~ ~EALT~I :'AND- ENVI:RONMENTAE ,,'ROT'ECT-~ON -~",:"~":':~;; '.' .'-. ,~/'~';~'~ ' '1 ~ 825 % Street, Anchorage, Alaska ~,~~;~ ~/U ;:- 279-2511, ext. 224, 225 . let Inspection: Time ~:~ D~. 2nd Inspection: Time ~a~e ~-77- ~¢ Date Inspector /~ ~Do~ ~ Inspector ; ~QUEST FOR APPROVAL OF INDIVIDUAL SEWER ~D WATER FACILITIES 1. Lending Institution Request: Alaska Mutual SaviRgs Bank Mailing Address: Post Office Box 1120 99510 Phone: 274-3561 x 216 2. Property Owner: Steven C. Rudd Phone: 349-1258/279-3664 Mailing Address; Legal Description: o 2940 Yale T12N R3W Section 20 Parcel Multiple Family Residence: ( ) I Number of Bedrooms: Well Log Filed Well Data: Type Individual,.. . Depth /~ / Construction .~~cterial Sewage Disposal System: On-site system ~x) Public Utility ( ) Permit # ~- ~] Installed _. Instatle septic Tank Size Man _act rer so. Distances: Well to Septic Tank ~ I to Absorption Area /~ to Sewer Lines ~ Nearest Lot Line Absorption Area to Nearest Lot Line Page T~o ' ' . ' . .... ?._ :.'~'~-;~ ~_:"~'--' '~ Departmen't~6f"He~lth--and Envir0nmenta. t' Pro~oction - ....... Request for Approval of Individual Sewer and Water Facilities Legal Description: T12N R3W Section 20 Parcel 30 Comraents: Affadavit Attached: ) Letter Attached: ( ) Approved: ~ Disapproved: Date: Date: Department Worksheet: March 16~ 1977 ATTN; Debbie Johnso{ NIUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONIVlENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF ANCHOP~,GE DEPT. O,: ~CN¥1RONMENI'/% 19/'7 1. Type of Inspection: CMRO VA FHA CONV X 2. Property Owner:. Steven C, Rudd Mailing Address: Name of Buyer: 2940 Yale Steven C? Rudd Day Phone: 349-1258 or 279-3664 Mailing Address: 4. Name of Lending Institution: 2940 Yale Day Phone: Alaska Mutual Savings Bank Mailing Address: 5. Name of Realtor or Agent: Mailing Address: Legal Description: O, Box 1120 Same Parcel Phone: 274~3561 ext, 216 S20 T12N R3W SM Location: Reader Drive~ off O~Malley Road 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: SF No. Bdrms. 2 Public Utility. ,Individual X If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site). X 72-003(3/76)