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HomeMy WebLinkAboutT12N R3W SEC 33 LT 37A Municipality of Anchorage Page of_ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 o Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW930218 PI~) Nurnber: 0]_8-]_82-]_8 U.S. Marshals Service Wastewater System: E] New E~ Upgrade 3700 ~ast 142nd Avenue, Anchorage, A~ LEGAL DESCRIPTION Lot Block: Subdivision: 37A T12N WELL: N/A Range: ' Secti(~'n Lq New [] Upgrade Classification (Private, A.B,C) Ft Cased TO: FtFl Stalic Water Level: Driller: Dale Drilled: SEPARATION DISTANCES Waler Lol Line Drain ABSORPTION 'FIELD [] Deep Trench E] Shallow Trench []Bed L~Mound [3Other Soil Rating: 0 · 7 GPD/Sq Ft Depth Io pipe boltom from oPginal grade 0,5 ' ~ove Ft Fill added above original grade: 4/.5' ~ Gravel width: ]_5 i Ft Gravel deptb beneath pipe 6" Ft. 29' Ft Number of lines: [Oislance bel',,¢oenlines 3 I 5 Ft. 435 SQ Ft Sch 40 PVC WhJ. tters'~ J~Kcc~a~in _~Z1Z93_ N/A TAN Kupgrade field onl, El Septic LI Holding [] S.T.E P. Pubhc~Pnvate Manufacturer: Capacity in gallons: Maleriah Number o[ Compartments N/A LIFT STATION "Pump off" level at: [ High water alarm at: BENCH MARK Location and Description: B~2~%~0-- ~L~Qr-~er~ar-age entra4~ce Inspections performed by: "'~-~-~0,,'~ .~- ~o"~s?~' Dates: lst__--):_l'~'~ 2nd :~31 ~q~3 Department of Healt~nd Hum~ervices apprCv¢l~ ~. Reviewed and approved by: ~/-~~~ D at e ::'- / ¢~: 72 013 (Rev 9/91 ) MOA 25 Assumed Elevation: 100.0 ~ ',~ The~80re A. Johnson 3 1 7 1993 Municipality ol Anchorage Permit No. ~U~ ¢~ '~:)':~ ' ~ ~ ~-~." (~ ~ ?':~ Page ~ of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650. Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Repot[ RECEIVED AUG li '( t9~:b Municipality ~t Anc ?rage H2ep~. Health & j-luman Service~ Permit No. ~L~ ~'~©7_/~.;~ .page ~ of :::~ Municipality of Anchorage' DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: /-..~ 7',H ~ '~c. %5. 3ipality of A /~ ;~VV~ PID No.: o/Ge .- /¢, Z .- G5 Permit No. Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVlRONI~IEN'rAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 o Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: L-~'¥.ff, :.'~ ~"5 , ~-/ZA,(, ~qSW PID No.: ENGIN[ Permit No. . Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650, Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription: .Z-~,4'~ ~"Zc.%5~ 7~./p~xk,~,, /:~ SV'V' PIDNo.: ~/~- t PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW930218 ]DESIGN ENGINEER:TED JOHNSON, P.E., L.S. OWNER NAME:UNITED STATES OF AMERICA OWNER ADDRESS:3700 E 142ND AVE ANCHORAGE AK 99516 (UPGRADE) PERMIT DATE ISSUED: 7/14/93 EXPIRATION DATE: PARCEL ID:01818218 LEGAL DESCRIPTION: T12N R3W SEC 33 LT 37A 1 OF 7/14/94 LOT SIZE: 44976 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. PROVISIONS RECEIVED ISSUED BY: DATE: DATE: ALASK £NGi V ERS TO: FROM: SUBJECT: DATE: MEMORANDUM Municipality of Anchorage, On-Site Sma, ices, Attention: John Smith Ted Johnson, P.E., Criterimn Alaska Engineers 3799 East 142nd Street, CAE Job. No. 92264 July 8, 1993 P O. BOX 111790 ANCHORAGE AK 99511-1790 TEL 907 349-1003 ~N AK 800 478 1003 FAX 907 344 9936 On 4/21/93, TH#4 ,,vas excavated with a Depth to Water (DTW) of 3'6". Fro'thor monitoring has shown this level to be decreasing as follows: 5/18/93 DTW 5'0" 6/21/93 DTW 6'3". On 6/i 1/93 TH #6 was excavated with a DTW of 5'10". Further monitoring on 6/21/93 indicated a DTW of 5'3". Since tile two test holes are separated by less than 60' and have the same geologic features, it is apparent that oneaquifer interconnects both holes. It is noticed from the67/21/93 readings that the DTW in TH #6 is 1' lower than in TH #4. This would tend to indicate that the maximum amuml water table would be 1' closer to the sm~'ace itl TH #6 than in TH #4. This woold correspond to a DTW of 2'6" in TH #6 at the annnal high point in the water table. DATE TH 4 TH 6 4/21/93 3'6" 5/18/93 5'0" 6/11/93 5' 10" 6/21/93 6'3" 5'3" Difference 2'9" (6/21-4/21) HIGH WATER Seasonal high water in TH 6 from above is 2'6" (2'9" above 6/21/93 reading) RECEIVED JUl.. 9 MUnicipalil o Dept. HoalJh . ' ' ,'{ENGINEER~SS~-- Munlclpallly of Anchorage .... ' DEPARTMENT OF HEALTH· ~ HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR:_ -% LEGAL DESCRIPTION:_~ 2 3 4 5 6- 7 8 9, 10- 11 12 14. 15- Township, Range, Section; SLOPE WASGROUNDWATER ENCOUNTERED? /V"[~,~ COMMENTS SITE PLAN DEPTH Depth to Water Alter ,' ., · Ms.J~orJ.o? _, ~. ~ Dale: .~"-~/-9~ ~ Time PERCOLATION RATE TEST RUN BETWEEN . Depth to Net Water Drop Net (minutes/inch) PERC HOLE DIAMETER FTAND _ --FT PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFy THAT THiS TEST WAS PERFORMED IN DATE: Munlclpallly of Anchorage .' '~ DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Ancho'ra~te, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST 3 4 5, 7 9 10- 11 12 13 15 16 17 19- 20- COMMENTS PERFORMED FOR: LEGAL DESCRiPTiON:_~,¢ 7 __Township, Range, Section: _~'/Z d,,// ,,~_,~__~ /x/, SLOPE SITE P~AN WAS GROUND WATER ENCOUN'¥ER ED7 Date Reading Gross Time '5 '. Net Depth to Time Water PERCOLATION RATE¢~ ,~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN _.~, '~t FTAND . /-)/, _(Z)Z FT Net Drop /d/ PERFORMED BY; ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: Municipality o! Anchorage ":-' DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 2 3~ ~, 4 5 7 8, 9 to 11 12. 13- 14 15 18 - 19 20 COMMENTS DATE PERFORM Township, Range, Section: '~/2./{¢"/ SLOPE srrE' PLAN WAS GROUND WATER ENCOUNTER ED? ~X(/~'¢ ~ Jill Reading Date Gross PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN _'~. ~ ~' FT AND .~., (~ ¢ -- FT Net Depth to Net Time Water Drop PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATBANDMUNiCiPALGUiDELiNESiNEFFECTONTHiSDATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage ...... ' DEPARTMENT OF HEALTI~ & HUMAN SERVICES 825 %" Street, Anchorai~e, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL D ESCR I PTION:.. ~'~Z~' ~o ~ Township, Range, Section: 10 12 15 16 17 18 20- COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT Deplh lo Water After MenlterlnD? "~" Dale: Reading Date Gross Time SITE PLAN !~LII/I fi I I I I 1 Net Time Dep[h to Net Water Drop PERCOLATION RATE __ TEST RUN BETWEEN -- (minuIes/inch) PERC HOLE DIAMETER FT AND __ FT PERFORMED eY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 {Rev. 4/85) Municipality ol Anchorage .-: ' DEPARTMENT OF HEALTH & HUMAN SERvicEs 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: 7 8 9 11 12 13 14 15. 16- 17 18 19 20, COMMENTS ENGINEER'S S~Ij') ' DATE PERFORMEI Township, Range, Section: SLOPE SiTE PLAN WAS GROUND WATER ENCOUNTER ED? ~ ~.~ 0 Oepth to Waler A,(ler Monl(orinD? ~ DaLe:_ Reading Date Gross N ~ Time PERCOLATION RATE TEST RUN BETWEEN . (minutes/inch) PERC HOLE DIAMETER Depth to Net Water Drop FT AND .... FT PERFORMED BY: CERTIFY THAT THiS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage ,~:,' DEPARTMENT OF HEALTH & HUMAN SERVICES 825 %" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION:~ ~" 6 7 8 10 12 15 16 20 COMMENT8 __ DATE PERFORMEC ~ .~ Township, Range, Section: ~ ~/~,//'~ SLOPE SITE PLAN WAS GROUND WATER Beptfl to Waler M0nil0rJn0? ~ DaLe:. Not Time Depth to Water Drop PERCOLATION RATE -- TEST RUN BETWEEN (minutes/inch} PERC HOLE DIAMETER FT AND FT PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev, 4/85) CERIIFy THAT THiS TEST WAS PERFORMED IN DATE: 825 "L" Street, Anch0'rage, Alaska gg502-0850 SOILS LOG -- PERCOLATION T£ST PERFORMED FOR: '~r~/~'~ ~-~ LEGAL DESCRIPTION: /'~7~/ 3 4. § ? 8 9. 10 ~2 '13 '14- 16 ~7 ~8 19- 20- COMMENT8 Township, Range, Section: _.~_/_~/(.// , ,~./~ ..~.~. ~,~ d~)¢4~ &~- "~ SLOPE SITE P~AN ' ~ WAS GROUND WATER ~/' ENCOUNTERED? ~ - DEPTH;) Deplh Io Water AIIBr ~°ait°rlflg? ' Dale - Reading Date Gross Time --?~__ .E-//-qB ,~ ',z. ? ~Jet Depth to Not 'ime Water ¢.',', . .~,~ :~,'~ ~ ~ PERCOLATION RATE¢~ -- (minutes/JnchJ PERC HOLE DIAMETER TEST RUN ~ETWEEN , % 2, FT AND .. q, _.¢ FT PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON fidis DATE, DATE: 72-008 (Rev, 4/85) RECEIVED JUN 2 5 199; Munlclpallly of Anchorage .... ::' . DEPAR,,T,,MENT OF HEALT. T.H~FijgkQA~Si~FR~ii~iq~rage 825 L Street, Anchora~f~,P/~l~4C~f~j~3~2[li~r~[¢ Services SOILS LOG -- PERCOLATION TEST DATE PERFORME[ Township, Range, Section: ~//,2,/(('/! SLOPE SITe PLAN 7 8 9 10. 11 12 13 14 15. 18- 17 18 19 20- COMMENTS. WAS GROUND WATER ENCOUNTERED? S ¢ §eplhlo Water Alter. ,~, Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~ PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE; 72-008 (Rev. 4/85) t ./V Municipality o~ Anchorage Dept. Health & Human Servioes Permit No. Page ~,LD°C: EIYEIJ Municipality of Anchorage JUN 2. 5 1995 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. BOX 196650 ° Anchorage, Alaska 99519-6650 · Telephone: ~43-474'4 ' On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PID No.: Permit No. . P~g~R E£ E I V .F_ D Municipality of Anchorage JUN 2 5 199;3 DEPARTMENT OF HEALTH AND HUMAN SERViO~l§nicipality of Anchorage ENVIRONMENTAL SERVICES DIVISION Dept. Health & Human Servict¢, P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 OmSite Wastewater Disposal System and/or Well Inspection Report ALASKA 'NGI VE£RS June 4, 1993 P.O. BOX 111790 ANCHORAGE AK 99511 1790 TEL 907 349-1003 IN Al( 800 478-1003 FAX 907 344 9936 Ms. Susan Oswalt Municipality of Anchorage Department of Health and Haman Stax,ices Ou-Site Program, P.O. Box 196650 Auchorage, AK 99519-6650a Reference: 3700 East 142nd, Job # 9226,1 Dear Susan; Enclosed is a design for modifications to the on-site sewage disposal system of the referenced property. These modificatious were deenled necessary after performing an adequacy test on the subject site. We excavated around the septic ta~tk aud fouad it to be intact. On excavation of the seepage pit, we found that it was overflowing at the top and determined that a uew disposal system would be appropriate. We iuvestigated the site iu the vicinity of the existing seepage pit and found a water table at approximateb, six feet below the ground surfilce. The site itself is iu two plateaus; an upper level to the uorth on which the resideuce and the existiug on-site system is located, and approximately 15 feet below and to the south is a pastare area with a shed type structare, that appareutly has beeu used to house horses. The upper plateau appears to be mixed materials and, iu our opinion, has been used as a fill site. We performed a soils test on the lower field near the toe of the slope and found il be sandy and gravely material. The water table was located approxhnately leer Feet below the surface. We determined the most economical system would be to install a bed system near the surface and to protect that system widl foul' feet of fill. This determination was based ou the uniformity of the soils encouutered iu that location (Test Hole #4) and the reduced mamtenaucc costs, because ora lack ora need for a pumping system. We believe lhJs is tile most desirable location fei' a disposal system ou this parcel where it will operate most effectively aud eQSciently. The system as desigaed complies with all Municipal and State regalations in effect at this time. If you have any qnestions about this report or inspectiou, please feel free to call We are available for fllrther phone consultations. Should an additioual visit to the ,, e that visit to meet your needs TAJ/jbj~l~nclosl~.reosoo %' 3~, Permit No.. Page of Municipa!it¥ of Anchorage BEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report .3 Cove,r- 72-013 A (2J91) MOA 25 Permit No. Page .. of Munic'pa ity of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PLAN 72-013 A (2/91) MOA 25 t ./V '¢ l'heodor9 'A. CE 5191 Municipality of Anchorage --~.' DEPARTMENT OF HEALTH ~. HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ,~': EN G[NEER'S,SEA[;) PERFORMED FOR: DATE PERFORMED: Township, Range, Section: 1 2 4 5 6 7 8 9 10- 11 IZ, V- 13- 14- 15- 16- 17 18 19 20 COMMENTS SLOPE SITE PLAN WAS GROUND WATER ~/ ENCOUNTERED? /~' ~ IF YES, AT WHAT DEPTH? Oeplh 10 Weltr .~ller ' I~0nlterln0? , Date:. Time Net Depth to Time Water Not Drop PERCOLATION RATE TEST RUN BETWEEN __ (minutes/inch) PERC HOLE DIAMETER __ FT AND ..... FT PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFEC'r ON THIS DATE. DATE: 72~008 IRev. 4/851 r'l~ RAP~AR REAL ESTATE SENT BY:Xerox Telec0Pier 9020 ', 5-10-93 ; 8',38At, I ~ Cpnditional Oommitment O reet Endorsement Statement of Appraised Value General Commltmor~t CondlUona f. M~lmu~ Me,gage ~ount ~nd (~) ~eupant Me.agora: Mo~t~e ~mount and tarm~a~umO depending upon the rating of borrower, h/e/her lnoo~e &~d otedlt, the law h~t[~ the mo~eOe amount; lot ')Dropoeed" eond(u~lon, A~hoHof period may be Imposed by 90q 349 ~08I# 2 ~I WHITLOC~ ^ ,,H. UO for p~,opoeed oonstruotlon, AJI ce, oeo are classified as 'exl~ilng" or ax a nO hOu~ If It w~e hot ~pproved by HUD, VmS, et e DE Le~der priorio beginning of eonetruotion, tower Io~n-io.vaIuw/~{Io~ will be applied unle~ l~ye~t ptoteotlon ~rr~niy) 4, Canoellatlom Thl~ document may ha o~t,~ll~d after 50 daY~ ftom the dare Of lasuanoa U oon~tfUotlon hag not ~, Prope~ Bt~Rdard&~ ~l non,fruition, rep~lre, et ~ltefs~lons proposed equal or ex~eed appIIoable Codes and HUD requ r~m~r~t, InformatIO~f The esth~etea nl fire In~urarroe and taxes nra fumlsh.d for motlgagoe'o end mortg~ger'a Information, They bluet be used tO prlpi1~ Form HUD gP..~, ApplIoatlon for Commitment ~nd Ineurena,~ when a firm ~ommltment le desired, E~t, Velum~fProp,,~ ~ 18, BO0, 00 ~TR~T,ANCHO~A~E,AK §9 Commitment Terma [~ 'Oondlfional Commltmanttor mortgege ~ ~ 3 b I~iutin~ under the N~UoBal Houatng ~ eeo, LendefID i5220-0011-~ Action Date 04 8poneor/A¢lent N / A FHA ~t No. l IN~T C:nee Roi, Mod~oO~e R~O WH1TLOCK S~ATTL~ NORTGAB~ CONPANY ~80 ~. 34TH AVE, , SUJT~ 100 ANCHORAge, AK BgS03 Property Addraes: (~ee gen. ooad. ~) 703 Commitment ~plroe Improved LIvino Monthly Expense Flre Ins ............ Taxon ............. 06/OB/g8 ~6/24/9~ Condo. Oeo, ~p,, Total .............. Speeliia Commitment OOn(fltlone (Appll~ble wlmn oheoked) HUO'~ enroll mini to In~ure a modo~Oe on thio propo~ I~ ~ependent on the Oo~pleilon ~f the ~ondmtlon~ ii,ted below· HUD Dona Not Guarantee the work ~on~to oompJywlth thJ ~ndt~lon~, Comply with P, equirementa No, from Repor~ dated 8ubdlvloI~ 'mu m In~ureble mortgage for a medg~.gor other lh~n a displaced family ptal6htIng ~ Ce~lfJoate of EllgibIll~. Form · ...?,~d repdre 0&n~0t be oomplated prior to iubmJmllen ~f noosing paper, Form NU~2~ in the ~mount of 45, 40, AT, 48 the Kitchen Apprslsel Asaool~tes of Alaska NO, ~ INDIOATED VALUE BY ~ALE~ COM~ARI~0N APPBOACH ~-- U.8. I)I~PARTMI]NT OF HOUSING AND URBAN DFVBI.OPMItN¥ HOUSING - FEDERAL HOUIIING CnMMII~IONIjR APPflAISA REPORT ADDENDUM a, Cost oF R~ Proposed & . · R~ulred $ I~, IMPROVED LIVING ARI~A ...... j oqsT DATA f'"12O14d Numbs, ~/A ~ Smgrmomtcd N/A Cost ~ ~Squiro Foot Co~t S ~93B~3 for ~/~ ~W N~r ............ JMarkit Prlcl , . NEI~HBOflHOOD CHARAOTERI~TI08 E, ~ND ~XCLUDBD FROM VALUATION F, ITEM~ ~OLUDED FROM RE~OEMINf CO~T 349 V~08;# ~ V08~ ~ vc,~ [] DEPA~T[~ T ADD"NO,U~M TO HUI31FflA COMMITMENT #~~,.~%~lfln u~e[ ~ ~welllno _~_ 18) ...... Replace mil ~eterlormt,~ w~ mid,itl, i~mled &l ............... er course ~n~ rapll~e with rt~l~ o~menl ~r~ o~ metal i~te~ ~t JnJtall ~ foundation venti aM/or ~ ~Itlg vents l~ provide cr~ ventilation. (C) ~ Remove ~ebrle, w~ I~flpl, fgrm ~irdm, Ite.i f~ under vC~ ~ 8ubmlt FHA Form ~&3 aat~litld by I Ilcens~ pent eon re ol~ramr, Any ~orfeallons or re~l~ r~ulr~ ~y by the momgagor, Remove all ol~ r~flng whmn more tM~ two Imyerm exist. Submit final IMM~ttOn by VC 35 ~ Initall new heating ayatem mUequmlm lo Met m flnllMd ~ to 70 ~r~m, aubmll acceptable evlde~ new system complies with existing O~ll, ~Plumblng ~Hliti~g ~El~tH~l~Othm . ~(elde or to an Imlder drm n or to w~lhJn 6~ Of n ~tl f~, VO~ ~ IflStall UL,app~d 8~e deteotor I~lplabli la fO~l JurlldlotlO~ off el~trl~l ~ll ~rO~ file I~l authoHly ~viflg jurl~l~lon, VC40 ~ Furnish evident t~t pr~y Ii oonfl~Ied Ia public ~) WiIiL~_ (a) hwmr VO 41 ~ Submit ~vldenae that the ~ubJeat ~re~ fronts cfi a It~)t d~laat~ to and aaoepl~ ~ I~ I~al Ju~tlo~ for continuoul malnte~neeI or, submit aeaePtable evidin~ el a reoord~l eMe~nt for the private drl~I ~I~g tho aubJe~ pro~Hy. Provide le~pt~lt ~o~ mJlntehanai agr~I f~ ronda not ~ub~J01y maintainS. ~ Submit ~t legal ~e~gllon and lot dimeMI~. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650 343-4744 Parcel I.D. # CERTII:ICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING NAA # ~'~ ~ 1. GENERAL INFORMATION Complete legal description L37A T12N R3W Sec 33 Location,(site address or directions) 37~N ~'m~f 14Qn/t_~=, A~ehorage, ~< Property owr~er. _.T1~ I~rtr'~h~q Rc, wv~r:~ . Mbili6g'adSress '..'Lehding agbncy Mailing address Day phone~L%=.~-.54 222'W&st 7th Avenue, Anchorae, AK 99513 Day phone Agent Angelito Corre, Miramar Day phone 344-2565 Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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(Rev. 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 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 Criterium Alaska Engineers P.O. Box 111790, Anc~horage,/AK Address -- Engineer's signature/~<~~~ _ Theodoro A.//dohnson 99511-1790 Phone 349-1003 Date 8/16/93 DHHS SIGNATURE [/'""~,pp roved for ~" Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduot inspections or analyze data before a certifioate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: f,37A 'Tq 2N R3W g~ 33 Parcel I.D. 018-182-18 A. Well Data Welltype Private Log present(Y/N) N Totaldepth 102' Sanitary seal(Y/N) Y FROM WELL LOG ~/A If A, B, or C, attach ADEC letter. ADEC water system number N/A Date completed 1969 Driller Cased to 100 ' Casing height 2 Wires properly protected (Y/N) y Date of test Static water level Well flow Pump level1 g.p.m. AT INSPECTION 3/12/93 MUNICIPALITY OF AN( HOkAG~ ENVIRONMENTAL SERVICES DIVISION 63 242 g.¢.L,~ 1 7 1993 RECEIVED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 90 ' Absorption field on lot 157 ' Public sewer main N/A Sewer service line N/A ; On adjacent lots 126 ' ; On adjacent lots 140 ' Public sewer manhole/cleanout Petroleum tank ~/A N/A WATER SAMPLE RESULTS: Coliform O rog/1 Nitrate 0.1 ~j/1 Other bacteria 0 Date of sample: 8/1/93 E'~'o(, (o~,... ~. O. ~3 ,'~ Collected by: Jim Rid.9~ay, AnchorageZell & Pump Servic B. SEPTIC/HOLDING TANK DATA Date instalied 1963 Tank size 1,250 qal ._Compartments 1 Cleanouts (Y/N) Y - Foundation cleanout (Y/N) ¥ Depression (Y/N) Righ water alarm (Y/N) ~ 1~!~. Alarm tested (Y/N) Data of pumping ?/9~3 Pumper ~cBonalds SEPARATION DISTANGES:FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 90 ~':,': On adjacent lots 200+ Foundation 26' To property line 57 ' Absorption field __~Z9' Water main/service line 5-1' Surface water/drainage ] 22 ' 72-028 (3/9o}-Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) N/A High water alarm level N/A N/A "Pump on" level at N/A Meets MOA electrical codes (Y/N) N,/A SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Date installed 7/31/93 Length 29' Width 15 ' Total absorption area 435 Date of adequacy test New sy~l-.eJm Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) On adjacent lots Manufacturer N/A Manhole/Access (Y/N) N/A N/A "Pump off" Level at Cycles tested N/A N./A N/A Surface water N/A Soil rating (GPD/Ft2) 0.7 GPD/ft2 System type Mound Gravel thickness 1.1 ' Total depth [, 5 ' Cleanout present (Y/N) ¥ Depression over field (Y/N) Results (pass/fail) for 2 After test /k,.//,~ If yes, give date ,M Bedrooms Well on lot 157 ' To building foundation On adjacent lots 100 ' Surface water 121 Curtain drain N/A E. ENGINEER'S CERTIFICATION SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots 10R' Property line 11. % ' 108 ' To existing or abandoned system on lot ] 27 ' Cutbank N/A Water main/service line 1 0(3+ Driveway, parking/vehicle storage area ~ 004- I certify that I have checked, verified, or conformed to ali MOA and HAA gu/defines in effect on ~ ~ this inspect/on. TM OF, Signature ,~/.~~ Engineer's Name The~ore A. Johnson, P.B. HAA Fee $ ~O a~ Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Date of Payment Receipt Number WA? GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Time of Inspectzon~.{),¢/4,'-U REQUEST FOR APPROVAL OF INDIVIDUAl. SE~ER & WATER FACILITIES FOR /? 2. Prooertv Owner: .4.~/5~~ ~ ~ ~p~ ~ Phone 4. Location 5. Type of Facility to be Inspected: ~ : _ Bacterial Analysis Insta 1 ler__L~'~ '/ ii:: Manufacturer Number of Bedrooms: ..~3~ A. Type ~,:'.~ / <, . B. Sewage Disposal Sys~ern~ ~?'~: ~¢~ Septic Tank: 1. Size~ D. Seepage Pit~ 1. Size Disposal Field: Total Length of Lines_~___ Distances: A. Well To: Septic Tank ~/ , Absorption Area /~f / , Sewer Lines ~f<~ , Nearest Lot Line ~ ~, Other Contamination~,,,2f . Foundation to Septic Tank ~ / "~ Absorption Area ~0(~ Absorption Area to Nearest Lot Line ~0"/ ~~. Reque£t for Approval of.,' ,.vfdual Sewer & Water Pac~]],t~e,' ' ' Page Two 9. Comments: ~-~ _~ =~~ ~~'-~.z~x-~v-~.~.~_~¢~_~~~ A ~ r o v e d._~2~f/c"~.~,~f~..~ Disae~roveO Date Ap,.~rova] '/al. id for One Year From Date Signed Greater Anchorage Area Borough, Department of Environs. entel quality Di'AGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subiect se~er and water facilities located at: -.d.. ~/- 3 ~/7. ?-~c, 3 ~ /--/~/ ~ :,/~ ....