HomeMy WebLinkAboutTALUS WEST BLK 1 LT 3('a,, W�,,q
"ois-ao�-ate
72-013 (Rev. 9/91) MOA 25
Municipality of Anchorage Page t of 2
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW �2�5 PID Number: 0I!�,),0126
Name:
Wastewater System: ❑ New Upgrade
Address: 2 M&Z �UNI:/-}Ot
ia' � 7z, i�S.tl
ABSORPTION FIELD
Phone:
No. of Bedrooms:
Deep Trench O Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
D
Total Depth fromoriginal grade:
U
GPD/Sq. . FL
Lot:'7 Block: _n io
Depth to pipe bottom from original grade:
Gravel depth bern�eattp pipe
IS
rSubdiv'
J I ��fLUS �_7
9. S' Ft.
r Ft.
Township:
Range:
Section:
Fill added above original grade:
r
D
Gravel length: f
�� FL
Ft.
WELL: ^ ❑New ❑Upgrade
Gravel width:
Ft.
Number of lines: Dist e�twean lines.
1
Classific3tiap (Private, A, B,C): Total Depth: Cased To:
Total absorption area: / �
Pipe teal: �j,C. /}S7M
FL FL
?J(I SG. Ft.
3 ITLIf/(PVC). r810 AF
Driller:
Date Drilled:
Static Water Level:
Installer:Date
5i� _ G.
installed:
U-1 - 2
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
XSeptic ❑Holding ❑S.T.E.P.
To
Septic Absorption
Lift
Holding
Public/Private
Ma ufacturer: 7-, pdr
Capacity in gallons: //��
/VW
From
Tank Field
Station
Tank
Sewer Lines
IA
(j"t'(t_
Well
��I
_
S r
Material: �1
Number of Compartments:
`wo
`l- `'f
—
—
LIFT STATION
WateSurface r
00 IOU
Lot
f I
Size in gallons:
Ma surer:
Line
1�
Foundation
I [J r �0 �
_
"Pump on" level at:
"Pum lev
High water alarm at:
Curtain
Pump Make&
Electrical Inspections performed by:
Drain
O
BENCH MARK
Remarks: l U o oN ni=auiZ15a
LOISz
Location and Description: Te>P OF
s � N•w. HSK ccrw
IflILMSSw�CA--rte
7
�- 1 RL TREM0 W SLIC92UEP
Assumed Elevation: �
v 156' o GflAvu flFt
ENGINEER'S SEAL
-nLE was / o CLS, 01-Dqlb— Q+ AiI.Q
OF �®t�t�
IC i[ItA hZF_0 6 WIES? f=N 01
oGoae°naegpaOae�
�
5V*
S & 5 ENGINEERING
17034 Eagle River Loop Road 1`16,20tates: 1st 10
Inspections performed N9 f
84 ®°3G Ey a 3!Y 560
a
2nd
30�0 °r
dF� J. �
a Rotsswar-..R o �,
Department of Health and Human Services approval
b��Pa�,�e No.215
by:
Reviewed and approved
72-013 (Rev. 9/91) MOA 25
, Permit No. SV1('_(a0A55 Page of 2 -
Municipality
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
72-013 A (Rm 9191) MOA 25
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502 3 D �. vYl
ANCHORAGE, ALASKA 99519-6650 l i o�
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920255
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:CRYAN IAN D
OWNER ADDRESS:1822 MARKALAN DR.
JUNEAU, AK 99801
PARCEL ID:01520126
LEGAL DESCRIPTION: TALUS WEST BLK
LOT SIZE: 16757 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT
1 LT
3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 9/01/92
EXPIRATION DATE: 9/01/93
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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED B
ISSUED BY:
DATE: � 11 1 O�'
DATE: ��Z
ROBERT SHAFER, P.E.
ROGER SHAFER. RE.
lid August 19, 1992 CIVILENGINEERS
(907) 694-2979
FAX 6941211
HEALTH AUTHORITY
APPROVALS
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, AK 99519-6650
SEWER& WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
REFERENCE: Talus West Subdivision, Block 1, Lot 3
We request you issue a permit to upgrade the septic system
serving the referenced property.
ENGINEERING STUDIES An adequacy test was performed on the existing system and the
AND REPORTS absorption capacity of the system was found to be inadequate.
A test hole was excavated and a percolation test performed.
WELL INSPECTION The approximate location of the test hole is located on the
&FLOW TEST attached site plan.
We do not anticipate any adverse effects on neighboring
properties by the installation of the proposed septic system.
SITE PLANS
If you have any questions, or require additional information
for your review, please contact us.
ROAD DESIGN Sincerely,
Roger J. Sh fer, P.E.
SOIL TEST
RJS/LSU/lsu
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN 1 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
I
r
o
FJotwmS N
D /
a 3 2 ICo ~ o zo _ o
n C
-18-18
o y o
H mp
m mb -ry
kA F e m
r
p
o y
r
UPGRADE
/
SCALE
o y
0
I
r
o
FJotwmS N
D /
a 3 2 ICo ~ o zo _ o
n C
-18-18
o y o
H mp
m mb -ry
kA F e m
r
p
o y
r
o y
0
m
A
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Ul
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'Pi
V
7
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: 1 77FL S/Ji%IP, N L. DA
LEGAL DESCRIPTION:/f1T ELL I%Township, Range, Section:
r. I SLOPE SITE PLAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
6M
Y SA1-D1/ GW &r -
WAS GROUND WATER nla
ENCOUNTERED? Yy
S
L
IF YES, AT WHAT _ O
DEPTH? - P
E
Depth to Water A
Monitoring? —%E:x Dale:
Reading Date
Gross Net
Time Time
Depth to
Water
Net
Drop
v
r`
;/g
glitr r
5�a
VI/
20LPERCOLATION RATE Wt (minutes/inch)^�PERC HOLE DIAMETER 6
'',,�� TEST RUN BETWEEN 6 FT AND 7 FT
COMMENTS �01LS 112V
PERFORMED BY: S & S ENGINEERING ;� CERTIFY THAT THIS TEST WAS PERFORMED IN
17034 Eagloa;9 �j-
8S"
ACCORDANCE WITH �a�I�yawjV yjZiU1DEL11PE91N EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
- 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 Aft@t§#M=kL INSPECTION REPORT
NAME
PHONE
❑ NEW
G
'�� 31S'7
PGRADE
DESS
MAILING ADR
LEGAL DESCRIPTION
L LI o.G L, ...
LOCATION
NO. OF BEDROOMS
Well
Absorption area
Dwelling
20
PERMIT NO.
O Y
DISTANCE TO:
.f•%
F z
Manufacturer
Material
No. of co part ents
W<
c
Stee, /
�,
rn
Liq. capacity in gallonsHOMEMADE:
Inside length
Width
Liquid depth
D ANCE TO:
Well
Dwelling
PERMIT N
-ioz
Sz Q'Manufacturer
aterial
uid capacity in gallons
o
Well Foundation Nearest lot line
PERMIT NO.
1Uu
DISTANCE TO:
u zNo.
of lines
e�gtli` ch i Total length of lines Trench width
Distance between lines
Z w
F _
y�� inches
�
Top rile to finish Material beneath rile
Total effective absorption
� f.
of grade
area
p
inches
Length
Width ppth
PERMIT NO.
w
QP-
Type of ib
Crib diameter Crib depth
Xial effective absorption area
wa
w
Well Building found
Nearest lot line
DISTANCE TO:
-
J
Class
Depth Driller
Distance to lot line -
PERMIT NO.
J
w
i ding undation Sewer line
Septic tank
Absorption area(s)
DISTANCE TO:
OTHER
2
PIPE MATERIALS
gme
f841Ig)
SOILESTRATING
S
`p,
INSTALLER
'yN
C"Lr I t
REMARKS
1
'TLA
Q vt
O
`
i F f7 ' ✓>•1tT. -
U
G r
7
TOP a
r
ovse
-a•
APPROVED DATE LEGAL
72-513 (Rev. 3/78)
, . .
Department
MUNICIPALITY OF ANCHORAGE
Health and Environmenta
. 825 Street, Anchorage, AK.
264-4720
i # # HANDWRITTEN PERMIT # #
2I0% t� 1�2 \ '"`r'—""��"" ON-SITE SEWER PER
Applicant: . 1 6ti, �) Cf�r,, "L'� Mailing Addre
Location:`` //�� _ Phone Number:
Legal Description: LO -V �J eLr- I WOSW41&_�
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed:
1 /rotection } _
99501 1'�)CD(;UL��
M I T�
SS:
-�L-I3)s `(
Lot Size:
Holding Tank:
Maximum Number of Bedrooms: �`� Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH LENGTH 1) " . GRAVEL DEPTH y!d- WIDTH N _
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 surface of the ground and
the bottom of the 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).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = 1600 GALLONS # #
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve. '
* # * TWO(2) INSPECTIONS ARE REQUIRED # # #
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 u 1 # # #
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
residence is remodeled to include more that 3 bedrooms.
2"_
Signed: —0. �j Issued by:
Ap licant
,n�11 Date: / 6/
SWP/024 (1/81) �n2 VhOV n4 SQ�7lL�Uti d��i/ c�
T1 l^2 G(J vi v�iaPCl�vt lops . ' ' ��S i S S(p C,. e �3 I'
Via *,P- VVIDOC .
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 T
1. Q,✓�
r 0.i
PHONE L+�� //
2 f q b
ff❑� NEW
i`i' UPGRADE
MAI LING AD DR ESS I )
LEGAL DESCRIPTION ,n
(
LOCATION
NO. OF BEDROOMS
\",O
Uy
DISTANCE TO:
Well
Abs or - ion area -
Dwelling
PERMIT NO.
i Q
wF
Manufacturer
Material
No. of compartments
y
Liq. capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
�'
J � Z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
2 z F
Manufacturer
Material
Liquid capacity in gallons
O
m=
DISTANCETO:
Well t
.b
Foundation i
Nearest lot line t
L)
PERMITNO
Q 30
� u z
F zw
No. of lines
0 42j
Length of each line
Total length of lines
Q
Trench width
Distance be ween lines
FTop
p
of tile to finish grade r
Material beneath tile
Total effecftive,a SargAion area
0 UU
to
Length
Width
Depth
PERMIT NO.
QF
Luw
Type of crib
Crib diameter
Crib depth
Total effective absorption area
rn
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
w
3
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
it
ry
-G
PIPE MATERIALS
SOIL TEST RATING
leo
f
INSTALLER
REM RK5
( f�D42- 0 5
�
11nn Ilk
f�( �ITI, I nr
t�
ED
w
DATE LEGAL
72-013 ev. 3/78)
I F= Fl 1_ a T "T }-1'D
DEPARTMENT HEALTH AND ENVIRONMENTAL iOTECTION
025 STREET, ANCHORAGE, AK. gy-.di
264-4720
anl-rF= .li14 :F� F" c�G
� y � 3� �L u� a'y
PER111T NO. C 800430 > lLOxPPt- � �
SPA BOA, 15E4T � "S-��• 344•-6 c r'
- `� S C�
AP'P'LICANT IAPB D. �_RrHtd ��
LOCATIOtd TALUS URI51E
LUT SIZE 2Jb4-4_i SQUARE �E�T
LEGAL LOT < BLOCK i TAUS WEST
SYSTEM I': TRENCH
TYPE OF SOIL ABSORFTIOt
MAXIMUM NUMBER OF EEC}R..00OPTS =
SOIL RATIN
(SQ FT/BP•.'= 150 <<
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
C•F=F="TI-1=
we=e LF�ra�TF-1= ._ �F �'• E L CmF=F
IN FEET) OF THE
H OR
THE DEPTHHOFDMNSIONIAETRENC:HIORTPITHE LENGTH I5 THE{DISTANCE BETWEEN THECSURFACEAOFFTHECy
GROUND A14D THE BOTTOM OF THE EXCAVATION CIN FEET).
THERE IS NO SET LAIC}TH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL FIFE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
aaF=F=1 QEF=°Ta
®_ THt-AE - E5 a ZF -=
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RE=SIDENCES THAT THE WELL WILL SERVE.
_ ® � > a r-4 Fes' E r_ T a C-3 PA - F=1 F-� F= F_ F= w_ a N_! I FF C=a
T 1•a
EACI':FILLItdG OF ANY SYSTEM LdITHOIIT FIhdAL ItdSF'EO:TION AND HFFRO':+AL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM 15
i00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AtdD
TO A C014MUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENT_. MAY APPLY. SPECIFICATIONS APdC, CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F° F= F?'r•1 a T F. r-;. F° a F* F==• Ga F= a=- F= r•'1 F1 F* �' _': �- ^ �- :D =` 0_1
I CERTIFY THATi
1: I AM FAMILIAR WITH THE REQUIREMENT'S FOR ON-SITE SEWERS AND WELLS AS 'S
ET
FORTH BY THE Mi lNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERS -ND THAT THE ON-SITE SEWER SYSTEM MA4' P..E����IF:E ENLARGEMENT IF THE
RESIDENCE S REt•1ODELED TO INCLUDE MORE THAPd 3 BEDROOMS.
--------------
SIGNED:- __D ----
APF' ICANT TA D. ::F:',Atd
/ n 17n, r �,1V4.0
ISSUED BY
a' 9[rfk� JOCi CSL35ti .F? -?"5 ,.iE.!E,.Fti. Er tea: ffivimf
INSPECTION: RFFlQW ON.StIF. ,EW•%Ci&i Disp0SAL SVSIt'A-t
-
"AC.F
C`C r,?In�T EGAL DESCRIP;In?, __ __ _
SEPTIC TANK.
ilC;ii D CAPArn, _ - -. _._ .—_ GALLO;JS_ INSIDE
SEEPAGE -SYSTEM. SEEPAGE Pi':
WILJ!H_. _
DstANCc FROM WELL_.. __..
NUMBER OF
_CO/AFA RIMEIV?S
LIOUID
NSIDE WiDIH _.._ _DEPTH__
LENGTH DEPTH
FFFE' T.v5 A350RPn9N ARE1 v . Ak,A ___
.__
.! F DRAIN FIE"LIi:
"dNJA?ION _ -_, NEARESTICf LINE
E BEIWEEN LINFS__ ------TRENCH WIDTH
.;3 � ri AFi"-.._ _._ - 10. C. LE3dG(H OF EACH UNE
F WISH GRADE_
_.d ELL �_,..
-
NEARLSI SEPTIC
t.*',.Np ..CW Fd LINE ___-. ,TANK_
-.��iANCES.
— Q FT.
,IAL LENGTH
OF :wES
W_ TOTAL EFFECTIVE
DEPTH OF FILTER MAIERW BENEAIH 111 E._. --- I.^±. ABOVE TILE_�
DISTANCE FRC°M
BUILDING FOWd0AT,ON SAMPLE=_.___, NEAREST
SEEPAGE OTHER
SYSTEM-____ CESSPOOL___ SOURCES=
DIAGRAM OF SYSTEFA
A
.... ):' r x I/ h ��t § ptrv't�4 a 'S K ,�. � h �^'� t & �.�-, F r`�YJt '�ie•. Aus"�f���S'e�3�ad1'xaa+fr:T.
GAAB-HD 1 GR. TER ANCHORAGE AREA BORON 4
DEPARTMENT OF ENVIRONMENTAL QUALI'L-s✓
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279.8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
NAME, //,--/ J'///�PL�112r•
ADDRESS _L/I �Y�CJI✓/- L PHONE �ry� II�-
LOCATION //1' �iP-/�f �V/l�ir/i'l%�!/'.L�" LEGAL DESCRIPTION li / 3d-�,�
SEPTIC TANK:
Q iNUMBER
DISTANCE FROM WELL 7U MATERIAL f%tib'-� S�i/`1 //.L/� /�7��� OMPARTMOENTS �-
LIQUID CAPACITY ✓Olj(9 GALLONS. INSIDE LENGTH ` INSIDE WIDTH -- DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH 6 LENGTH / DEPTH
LINING MATERIAL
.DISTANCE FROM WELL � i� ,BUILDING FOUNDATION,
NEAREST LOT LINE'S TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) �.fr SQ. FT.
DISTANCE FROM WELL
-_-- TOTAL LENGTH
DATION , NEAREST LOT -LINE OF LINES ,
NUMBER OF LINES DISTANCE BLLTWEEN LINES
ABSORPTION AREA SQ. FT. LENGTH OF
1111gral ."" Dim
EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL 4"/w/&C DISTANCE FROM WATER
TYPE ���'// O DEPTH 1✓ 1 , BUILDING FOUNDATION. SAMPLE NEAREST
15 NEAREST i SEPTIC /( / SEEPAGE / / OTHER
LOT LINE / SEWER LINE/ , TANK J , SYSTEM O— CESSPOOLO✓SOURCES 40//<'
DIAGRAM OF SYSTEM
DATE
GRL.,,,rER ANCHORAGE AREA BG bUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
a' r 3500 TUDOR ROAD POUCH 6.650
' 1 ANCHORAGE. ALASKA 99502
TELEPHONE 279.8686
J
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
P2RMIr NO.
NAME OF APPLICANT - eN E"E V I 1T IgryGN �'"�G/�� /`MAILING ADDR�ESS/'�`�YI•�g-,�'y�a /�/jV/`O<�(�'pHONE
INSTALLATION LOCATION --- / AIV J (, I'�' ®�T" W 1 &DAP�1G _ PJ 9
LEGAL DESCRIPTION
INSTALLATION OF:
SEPTIC TANK. '" SEEPAGE PIT
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST.RESULTS
FIELD , OTHER ,
COMPLETION DATE ANTICIPATED
NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKPILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE _ TYPE `�, SEEPAGE AREA SIZE
TYPE
SEPTIC TANK, SEEPAGE PIT DRAIN FIELD
TO RIVER. LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
Wad
ALTH A HORITY
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE,
DESCRIBED SYSTjEEM] IS INACCORDANCE WITH SAID CODE.
DATE—a7 APPLICANT'S SIGNATURE u6eK 0J.
��� DIAGRAM OF SYSTEM
MINIMUM DISTANCES, REQUIREMENTS /
-
FOUNDATION TO SEPTIC TANK - 6
FOUNDATION
FOUNDATION TO 8EEPAGE PIT, DRAIN FIELD
,
SEPTIC TANK TO SEEPAGE PIT WALL
� e
SEPTIC TANK SEEPAGE PIT DRAIN
FIELD
TO NEAREST LOT LINE.
0
WELL TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
5
/ ®
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
,
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT DRAIN FIELD
TO RIVER. LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
Wad
ALTH A HORITY
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE,
DESCRIBED SYSTjEEM] IS INACCORDANCE WITH SAID CODE.
DATE—a7 APPLICANT'S SIGNATURE u6eK 0J.
��� DIAGRAM OF SYSTEM
. •�. M•W orcuuac; ins.: -'•
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Municipality of Anchorage
L' Ito. I6x Vkkp ) • :\n,$om 4 \1a,k+!tl1.91!1-66PW • !
.7 I,',. Rlq+hont(N171 :iYaK411 .11ix(!Mli)33:{R91M1
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JIu icor Jfark J3egich
Iluilding safch Division
May 31, 2007
Cindy Ellis
Watkins Engineering
P.O. Box 110443
Anchorage, Alaska 99511
Subject: Waiver Request for Talus West Block 1 Lot 3
Waiver Request WR#: 070025
Parcel ID # 015-201-26
Dear Cindy Ellis:
Your request for a waiver of the required 100 feet horizontal separation from the
septic tank to the private well has been approved. The approved separation distance is
96.0 feet. Add a 6 foot horizontal separation from septic absorption field to property line
waiver is approved.
This waiver approval applies to the existing septic tank to private well separation only.
Any future upgrade to the on-site wastewater disposal system will require all separation
distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
ot"",
Jo oodall
Civil Engineer
On -Site Water & Wastewater Program
Conunfill ity, Security, Prosperity
State of Alaska:
Separation Distance Waiver Guidelines for S.C.R.O.
(State of Alaska Memorandum to District Office Engineers dated January 3. 1985)
Waiver Request for: Talus Nest Block 1 Lot 3
Parcel I D#: 015-201-26
Waiver Request Number WR#: 070025
Waiver Requested: 96 foot horizontal separation from well to septic tank ondot and a 6 foot
horizontal separation from septic absorption field lot line waiver.
Engineer: Cindy Ellis
Septic Tank Data
The septic tank was installed in 1992 during an upgrade to the septic
system. The approximate depth of the bottom of the septic tank is 10
feet.
There was no well log available for this property however the
engineer supplied a number of well logs in the area. The well logs
show there is a soil strata that is impermeable which will provide for
an adequate barrier. The direction of the hidralic gradient is away
from the well, however points for a flat gradient was used. For
purpose of calculating points lot 4 was used. The depth between the
bottom of the septic tank and the static water level was 100 feet.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage. AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Waiver Review Worksheet
WR#:070025 PID#:015-201-26 HAIPermit#
Date Received: May 31, 2007
Legal Description: Talus West Block 1 Lot 3
Engineer.
Cindy Ellis
Watkins Engineering
P.O. Box 110443
Anchorage, Alaska 99511
Applicant: RONALD PACHACEK
Waiver Requested: 98 foot horizontal separation from well to septic tank on -lot and a B foot
horizontal separation from septic absorption field lot line waiver.
Criteria: Geology Points:
A. Water Table 7.00
B. Soil Sorption 4.21
C. Permeability 2.19
D. Water Table Gradient 2.90
E. Horizontal Separation 2.84
Total:_ 19.144
..........................................................................
Waiver is Granted: X Waiver is not Granted:
List Conditions or Reasons for above:
Date: 1107 By: Joe Goodall
Name of Reviewer
Rec#: 08949 Amount: E9g0_ Date Paid: 513112007
State of Alaska:
Separation Distance Waiver Guidelines for S.C.R.O.
(State of Alaska Memorandum to District Office Engineers dated January 3, 1985)
Waiver Request for: Talus Nest Block 1 Lot 3 — I
ParcelID#: 015-201-26 Ir I
Waiver Request Number WR#: 070025 ; , vee .x s
Waiver Requested: 96 foot horizontal separation from well to septic tank on -lot and a 6 foot
horizontal separation from septic absorption field lot line waiver.
Engineer: Cindy Ellis
Water Table
Points .,.
Depth of well: 110 7.00
Depth of septic system: 10
100'.
Distance from the bottom
Polnt
of the system to the highest
Value
..
water table In feet
0
0
8
1
17
2
24
3
30
4
40
5
85
6
100
7
290
8
1000
9
10
• Straight line Interpolation Is permitted between any two values
Soil Sorbtion
Points
..
4.21
Soil Type I
Point Value
( 2814.5 + r
5 13.5 +
r 4.5 23
+ r 1111.5
Clean Gravel
0
100 J
l 100
J
l 100
1100
Fractured Rock
1
Course Clean Sand
1.5
+( 14 1 0 +
r 35 14.5 +
r 2 1 0
+ r 0 1 0
Sand wl Small Amt of Clay
2.5
100 J
1001
l 100 J
100)
Silt
3.5
Clay and Sand Equal
4.5
1.3 +
0.2 +
1
+ 0.2
Clay
6
0 +
1.6 +
0
+ 0
*Use the predominant soil type but values can be averaged
for a mixture
Permeability
Soil Type
Point Valuo
Clay(wiil channel)
0
Silt and Sandy Clay
2
Clayey Sand
3
Fine Sand
1.5
Sandy Gravel
1
Fractured Rock
0.9
Course Sand (30 grit)
0.4
Clean Gravel
0
Points ,.,.
2.19
28
17100-1 3 + 100, 2 +( 100 i + l 1 11 00, .4
+ f 100 14 , 1 `f 100, 3 + 100) 1 + [ 100, 1
0.84 + 0.10 + 0.00 + 0.04
0.14 + 1.05 + 0.02 + 0.00
*Use the predominant soil type but values can be averaged for a mixture
Gradient
2.9
%Slope
Points Value
-60%
0
In Feet
-30%
0.3
0
-20%
0.7
50
-10%
1.2
2
-5%
2
150
0%
2.9)-
.9}5%
5%
4.5
10%
6
}
60%
7
slopes toward well
Oat
slopes away from well
*If the gradient is unknown, assume the worst case
Horizontal
Horizontal
Point
Separation
Value
In Feet
0
0
25
0.7
50
1
75
2
100
3
150
5
200
6
300
7
Points .„14
2.90
Points ,* .
2.84
*Linear interpolation between two point value Is acceptable. Horizontally means
straight line distance to the well not the contaminate travel distance to water table
which may be greater.
Conclusion: Grant Waiver Total Points: 19.1441
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1 4
Watkins Engineering, Inc.
P.O Box 110443, Anchorage, AK 99511
(907)349-1851 cwellis@gclnet
November 20, 2006
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
RE: Talus West Block 1 Lot 3 Septic System Repair and
Waiver Request for Septic Tank to Well and
Lot Line Waiver
To Whom It May Concern:
This letter will document repair work conducted in September 2006 on the septic system
serving the subject lot. We also request the following waivers:
1) 96 ft from the septic tank to the private well and
2) 6 ft from two drainfields to the north and west lot lines.
Lot 3 was initially developed in 1972 with a private well and a crib. In 1980, a drainfield
was added to the crib. It was 30 ft long with 8 ft effective depth, which provides
absorption area of 480 ft2. The soil was rated at 150 ft2/bedroom, so the trench alone is
sufficient for 3 bedrooms. This system was abandoned in 1992, when a new tank and
drainfield were installed. The 1992 trench is now surcharged.
In September 2006, A+ Home Services located the old trench and crib. A diverter valve
was installed after the tank and the old trench was reconnected. A steel monitoring
tube was driven, and a cleanout was installed at the east end of the trench. It was
determined that the distribution pipe was not level, and there is 3" reverse grade from
the point where the trench is tied into the tank and the east end of the trench. Since the
crib is at the end of the trench, it was not connected. A site plan is attached.
An asbuilt survey by a registered land surveyor showed that the septic tank is 96.8 ft
from the well, and the cleanout at the west end of the 1992 trench is less than 10 ft from
the lot line. Based upon data provided on the inspection reports from 1992 and from
1980, both trenches are too close to the lot lines. Therefore, we request a lot line
waiver of 6 ft to the north and west lot lines. I am not aware of any adverse effect that
this would have on any adjacent properties' water or wastewater treatment needs.
WAIVER FEE: e)-46
PAYMENT DATE:
RECEIPT #: -F 8 `q'?
Watkins Engineering, Inc.; Talus W Blk 1 Lot 3;
Waiver Request; November 20,2006; page 2
Encroachment permits have also been requested from the utilities and from the MOA
Right -of -Way Division to allow the drainfield encroachments into the utility easement.
We request a waiver for a separation distance of 96 ft from the existing septic tank to
the well. The tank was exposed and determined to be in good condition in September
2006. 1 believe that the reduced distance will not lead to contamination of the well or
the aquifer for the following reasons:
1) Satisfactory water analysis from the well (even after 14 years),
2) Direction of hydraulic gradient from the septic tank is away from the well,
3) Soil strata between the aquifer and the surface in wells in the area provide an
adequate barrier, and
4) Well depths of nearby wells of 137 ft to 175 ft provide substantial vertical
separation,
The water analysis from a sample taken on 9/27/06 reported 0.723 mg/I nitrate, and no
coliform bacteria. The lab report is attached.
The topography of the area prevents migration of fluids from the septic tank towards the
well. Relative elevations are shown on the attached site plan.
There is no well log for the subject well. Several logs from wells in the area are
attached. They range in depth from 124 ft to 175 ft, with layers of "hardpan" noted.
This impermeable layer provides a barrier to vertical migration of septic effluent.
Based upon these facts, I believe that the potential for contamination of the subject well
and the aquifer is minimal. Therefore, I request that the required distance from the well
to the septic tank be waived to the existing 96 ft.
Thank you for consideration of this request. If you need any further information, please
call me at 349-1851.
Sincerely,
1 i4'fe'i
Cindy Ellis, P.E.
President
ILot
Lot 9/
I1 Lot 8
M
�G
Lot6�
Lot 15—III —L\4 � Lot 13
----fir--- \O�
II
Lot 6 I I Lot 7 J�qt 8
Lot 12
Lot 9
Lot 11
v ALPHA CIRCLE
WELL —---- ---------
CLASS A�g
I
Lot 5
Lot 5 1
Lot 4
RSC , WELL
00
Lot 8 Lot 9 �00 Lot 10
Talus West Block 1 Lot 3
Proposed Septic Upgrade -Site Plan
Ronald F. & Kelley Pechacek
Parcel ID: 015-201-26
Cindy W. Ellis, P.E
October 30, 2006
Scale: l' - 100'
Lot 11
I
�
I
�
Lot 3
lot 2
Lot 1
/ Lot Line
giver Request
I
,
'tel-_
---
-_-_-�
Lot3
Septic �
Area/
� I
\
I
/ Lot 2
1
\
/
\Lot
,
,E
WELL
X00'
TALUS DRIVE
2
II
Lot 11
Lot 12
Lot 13
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, AK 99511-0443
Phone: (907) 349-1851 Fax (907) 349-1934
ate' 49 THW
.... ................
CINtrW. ELLIS
-10577
10' UTILITY EASEMENT
l• DCOO2
i — —
FC
/ / W
Q I DECK
L u}}l A
coJ
/ 1980 Trench 30'4' eH.
Note: Reverse grade
between MT2 and CC
ST2
S1
\ o
B \
3 BEDROOM \
HOUSE
s�
CD i DECK TRIO I I
Z
WELL
I
¢o
S 89°59'00" W 124.00'
—_ TALUS DRIVE
---
1972 Concrete Crib -
not Connected
N_
U)
_M
O
O
CD
0
0
Note: Based upon a survey by
\ / Shane A. Holt LS -6914
dated October 2, 2006
Talus West Block 1 Lot 3 oowo
OF Al
Septic System Site PlanWatkins Engineering Inco
.
Ronald F. & Kelley Pechacek oa A
Parcel ID: 015-201-26 49 T-
-.-
Cindy W. Ellis, P.E. C Y W. Alii
P.O. Box 110443 C •; •. e . iosn
Scale 1 Inch 230 ft Phoner(907) 349-1851, 1Fax (907) 349-1934 aoo4�. .000�..
A
B
FCO
35.4
9.3
STI
48.0
16.7
ST2
53.0
22.2
DC01
54.8
23.8
DCO2
56.6
25.0
DV
57.71,26.5C01
58.2CO2
68.1CO3
67.9MT1
57.4MT2
69.9
Note: Based upon a survey by
\ / Shane A. Holt LS -6914
dated October 2, 2006
Talus West Block 1 Lot 3 oowo
OF Al
Septic System Site PlanWatkins Engineering Inco
.
Ronald F. & Kelley Pechacek oa A
Parcel ID: 015-201-26 49 T-
-.-
Cindy W. Ellis, P.E. C Y W. Alii
P.O. Box 110443 C •; •. e . iosn
Scale 1 Inch 230 ft Phoner(907) 349-1851, 1Fax (907) 349-1934 aoo4�. .000�..
Relative Elevation at Ground Level
S 89059'28" E 124.00'
10' UTILITY EASEMENT
dire�i 9I
On of Cope
05236.71
wI I
-ROUND LEVEL I
:.y
Nell
3 BEDROOM
HOUSE
DECK
IN�
S 89059'00" W 124.00' %
96 __ TALUS DRIVE
Note: Benchmark=Top of Well Cap=100.00
Talus West Block 1 Lot 3
Waiver Justification
Ronald F. & Kelley Pechacek
Parcel ID: 015-201-26
Cindy W. Ellis, P.E.
November 1, 2006
Scale 1 Inch = 30 It
Watkins Engineering, Inc
49 IH
P.O. Box 110443 uQG,: cir + w0EWS
577
Anchorage, Alaska 99511-0443 �p0.,� •..,, ,,..:
Phone: (907) 349-1851, Fax: (907) 349-1934 4�44p0000���
SCS Ref.M
Client Name
Project Name/q
Client Sample ID
Matrix
Samplc Remarks:
1065833001
Watkins Engineering
Talus W B I Lot 3
Talus W Blk I Lot 3
Drinking Water
All Dates2'hnes are Alaska Standard Time
Printed DatefTtme
10/052006 15:35
Collected Date/time
09272006 17.30
ReceivedDaterlime
09282006 8:50
Technical Director
Stephen C. Ede
Allowable Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date
Init
Waters Department
Nitnuc-N 0.723 0.100
Microbiology Laboratory
Total Coliform 0
mg/L EPA 353.2 B (<10) 0929/06 ALR
coV100mL SM209222D A (<I) 0928106 TLF
SGS
Please inform the client if OB hank Y/Ou -
count exceeds 10. 200 W POTTER DRWE
i ANCHORAGE. ALASKA w516
Tek.. 907.WZM3 :`-
F=W7-567S3Ut
.Drinking Water Analysis Report for Total Coliform Bacteria'
READ wsiRUcrroNS ON REVERU AM SUM.TMUCTrlc UMM2
MUST BE COMPLETED BY
❑ PUBLIC WATER 3YBTEM 00
PRIVATE WATER aYBTEM
'ffiA B.nd Rekb
-0 +'dam•
t�verr
1065833 1�
MEMO
i
p a.nd R.:wu. ! ptl.,a aneioa
'4 •
aAATYLt GC7IA& T1OH:
Dat" Dev7 J
. Veer
TMM : ?j AM PM
Lesatbm 10 fill
eoYio°°"rwa..
to tau Dr. )it Same as eosedor Other.
SAMPLE TYPE
.coy;
3
Routtna 1 ❑ Tmtad.Water
13 R""tSam�le ❑ Untreated Wa1K .
(refer to lab no.
17 Speekl Purpose `
TO BE COMPLETED BY LABORATORY '
• l.e /1—
'Sample Receiving:
t�verr
1065833 1�
MEMO
i
p a.nd R.:wu. ! ptl.,a aneioa
'4 •
aAATYLt GC7IA& T1OH:
Dat" Dev7 J
. Veer
TMM : ?j AM PM
Lesatbm 10 fill
eoYio°°"rwa..
to tau Dr. )it Same as eosedor Other.
SAMPLE TYPE
.coy;
3
Routtna 1 ❑ Tmtad.Water
13 R""tSam�le ❑ Untreated Wa1K .
(refer to lab no.
17 Speekl Purpose `
TO BE COMPLETED BY LABORATORY '
'Sample Receiving:
.• ti ,
.Date: %� Ob
Osw'w«wr as hoes alq
❑ RUSH SAMPLE.
Time:
Rse,/h mq be arxeae6N
Temp:
❑ ss ltuver ww
Phone /:
�a
Delvery Mettwd: ii{ t2t .A
rot Remaa' Lo"10,16
Received By Cfiln n� e
. Cannwrxr hereNwe�7
, r�c-S
..-
...............»...................................:..............._..................................... .......I......
Bacterloloalcal WaterAnatvsle Record:
saetoAOEa
VA4044M (PIA) REaIATS:
ANC FBK JUN
Analyalseesan: 'T.21 MG fJ ce
TOW CoRome
D.w rxnr
.
'
Sent to Clont
Analytical Method: MEMBRANE fATER REBULTS.
Phoned Cl Faxed 0 .
'
Membrane Fi ter
Dked Covert pt-�
vwslrallo c
ColrnwW oomL De an o.`_
Spoke wlllc
MMO•MUG (P/A)
won.. LTR,
{txTe • $atlsfacttiry
❑ . Uns*atisfactory
Reported By: '
DateJTitrre:
de •0e
D!
3
c
0
iA
ry Oa Ott ZO"' t TZ4.UU
10• UTILITY EASEMENT
sr---------------a—
1 HEREBY CERTIFY TINT I NAVE PERFORAFDA
I
s
Lm>. uooc /. TALA18 WEBT aua
I
ANO110RAOE RE00M*4 M$7R CT•'W� AND THAT
THE VI& S.IPROVEMENTB MTINTED THEREON ME
MTTWN THE FgpERTY NNEI µpNp ylyu!
s
ENOROAOH.FNTBEAeTOTNER TINN NOTED.
EA8EMENT801 RECORD• OTHER THAN TNOBE SHMN ON THE REODRDEO PLAT, ARE NOT*H N HEREON.M4 SOICATEOI
DATED ATANUIORADE, AlABNA TM8 �ND�
DAY OF OCTOBER
NOTE ANY PENCElI SSHOWN ARE LOCATED APPRoxwATELY AND ME NOT To USED TO DETERMBIE
OR LOCATE BTRUCRIRE& PROPERTY UNEB
sAAiO
ANY PAW SHMN MAY BE APPRO TE OUR TO SNOW CONDrrKM.
—
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I
DECK
r
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SINGLE FAMILY
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f
ATRIUM
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e
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a Oy as UV W lZ4.UU
TALUSDRIVE
i
`pisLH**'
...............................
SHANEA HOLT
LS -6914 �•
4�ria_ � ...... ••A9G
A&SUILT SURVEY (NO CORNERS SET THIS DATE)
V- Sr
1 HEREBY CERTIFY TINT I NAVE PERFORAFDA
MORTOAOEE'S Ma4PECTION OP THE FDLLQYINO
OEe UD PROPERTY.
Lm>. uooc /. TALA18 WEBT aua
THE NFORWTKM/ HEREON 18 FOR THE LIGE OF L[Nglq MBTRVTIONS SPE/i rI VTO BROW ANY
EM180NO 8TRUCRIRES ANOPLATTED LDT UNEB OR RABEAFNTR AND RI NOT
ANO110RAOE RE00M*4 M$7R CT•'W� AND THAT
THE VI& S.IPROVEMENTB MTINTED THEREON ME
MTTWN THE FgpERTY NNEI µpNp ylyu!
TO RE Y° ED FOR FO°RgNN°EETWEEN
BTRUORgRE ORFENDEIRFR. KRNL
ENOROAOH.FNTBEAeTOTNER TINN NOTED.
EA8EMENT801 RECORD• OTHER THAN TNOBE SHMN ON THE REODRDEO PLAT, ARE NOT*H N HEREON.M4 SOICATEOI
DATED ATANUIORADE, AlABNA TM8 �ND�
DAY OF OCTOBER
NOTE ANY PENCElI SSHOWN ARE LOCATED APPRoxwATELY AND ME NOT To USED TO DETERMBIE
OR LOCATE BTRUCRIRE& PROPERTY UNEB
Sp�S
HOLT LOC-SNVEY�NO TWI.F813S-r1
TEL 3 S 13
ANY PAW SHMN MAY BE APPRO TE OUR TO SNOW CONDrrKM.
..� M:U1:1::!::C:::T:a1::!:tY of Anchorage
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()"'cc: "r7) fax: 1107)343.8!(x) hup://,ex w.munLon:
Mayor Mark- Begicll Dcvclolnrtcrtl Scrt•iccs Dt i).trtmcrtt
March 8, 2007
Ronald and Kelley Pechacek
4841 Talus Drive
Anchoirage, Alaska 99516-2257
Dear Property Owners:
RE: Application for Letter of Non -Objection to Encroachment
Septic System Drainfield and Vents in 10' Utility Easement
Talus West Subdivision, Block 1, Lot 3, Grid 2736, 4841 Talus Drive
mrnt
4�t
Department
The Right of Way Division has reviewed a request for a letter of nonobjection to existing septic system
drainfield and vents, which encroach approximately 3.5 feet into the 10400t utility easement at each the
northern property and western property boundary. On the as -built survey dated October 2, 2006,
submitted with the request, the petitioner has shown the existing septic trenches and vents.
This letter of nonobjection is issued with stipulations, and by using it the petitioner is agreeing to the
following:
1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or
injury to any person as a result of the encroachments.
2. All applicable codes and regulations will be observed and maintained within the easement.
3. This letter of non -objection will in no way preclude MOA from full use and enjoyment of its
rights within any portion of the easement.
4. Additional and extraordinary costs incurred during any future required construction, repair or
reconstruction of MOA improvements to accommodate any or all of the encroachments shall be
paid by the property owner.
5. Obtain letters of nonobjection from the following utilities:
®
®
Anchorage Water & Wastewater Utility
Chugach Electric Association, Inc.
®
❑
Alaska Communications Systems
Matanuska
❑
Matanuska Electric Association, Inc.
®
Telephone Association
Enstar Natural Gas Company
❑
❑
Municipal Light & Power
Eyecom (Girdwood Cable TV)
®
GCI Cable of Alaska
p
No letters required
All letters of nonobjection should be retained in your permanent fides. If you have any questions, please
call me at 343-8033.
Sincerely,
/',s+—Jack L. Frost, Jr.
Right of Way Supervisor
Concur
P operty Owr cr(s)
Community, Security, Prosperity
G:IDe.r/aanmtSmice�ROWLVw,-obierrlon Irttmlralar Prat BI4 1. Ld J. Pech"ekd"
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 1.D. # f91 S aLo / Da (- ,' HAA #
1. GENERAL INFORMATION
Complete legal description
Lot 3; Block 1; Talus West 1
Location (site address or directions) 4841 Talus Drive
Anchorage, AK 99516
"Cary & Debbie Brown - 345-7642
Property owner Day phone
Mailing address '" 4841 Talus Drive Anchorage, AK 99516
Lending agency Day phone
Mailing address,
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 v
3. TYPE OF WATER SUPPLY:
Individual well XXX
Community well
Public water
Day phone
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:
Individual on-site XXX
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev.1/91) Front MOAY21
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 5 & 5 ENGINEERING Phone
17034 Eagle River Loop Road No. 204
Address Eagle River, Alaska 99577
Engineer's signature
6. DHHS�SIGNATURE
Approved for bedrooms.
M
Disapproved.
Conditional approval for
Additional Comments
C `( 1- - )- C17
Date 61 -�-I q i
bedrooms, with the following stipulations:
CAUTION
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 orderto 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 engineers work.
72-025(8ev.1/91) Back MOA#21
Municipality of Anchorage E C E I V E D a
4
DEPARTMENT OF HEALTH & HUMAN SERVICE
Environmental Services Division 1997
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 3 A
Municipality of Anchorage
Health Authority Approval Checklist Dept. Health & Human Services
Legal Description: Ld r 3 0 L K 1 JAL u I I.,)I✓5 , Parcel I.D.:
A. WELL DATA
Well type PAA ' \ri t f If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/e1 N 0 Date completed I L ro i 1
t �
Total depth ) d t Cased to y C Casing height (above ground)
Sanitary seal yftq) y �s
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE
RESULTS:
Coliform
0
Nitrate
MEW
7
Wires properly protected (ON) Y6 S
AT INSPECTION
G/a7 A 7
Other bacteria
v
l
Date of sample: 6 d 3 I c) 7Collected by: S& S ENGINEERING
17034 Eagle Rive, Loop Road No. 204
B. SEPTIC HOLDING TANK DATA Eagle River, Alaska 99577
Date installed 10 13 19 L Tank size 160 0 Number of Compartments 2 Cleanouts ON) r/ES
Foundation cleanout (ON) Y64 Depression (YS) J High water alarm (Y/& d✓
Date of Pumping'Gll a 6) 7 Pumper t lfd r jE/ r cE S
C. ABSORPTION FIELD DATA
Date installed 10 /13 A Soil rating g..d./ft or ft2/bdrm) (9 - System type l 2�•v H
Length - S J Width 3 / Gravel thickness below pipe G �� Total depth I I
Effective'absorption area S y FY Monitoring Tube present &)N) YES Depression over field (Yo w o
Date of adequacy test G l �9 1 Results (Pass/Fail) PA -5 S For % bedrooms
1 .. .. I L, *
Fluid depth in absorption field before test (in.); -' 'z Immediately after'J' gal. water added (in.):
Fluid depth 7 (ins) Minutes later: ) 311 Absorption rate = �0 o g.p.d.
W�r£2 >jrn�EAiLiv Js 9n -s7 7"2i.,.oN Co �'. Gisr Co AzM.r"�a n/tY
Peroxide treatment (past 12 months) (Y/N) k16 N 't- tc.,.ow a/ If yes, give date r
72-026 (Rev. 3/96)*
G 9
7-tlAd vc-ur 0 r
r4S'T
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level
*Datum
SEPARATION DISTANCES FROM WELL ON LOT TO
�tic holding tank on lot /00 On adjacent lots
Absorption field on lot I o 0 1 On adjacent lots
Public sewer main N / Q
Sewer /septic service line 7 14
"Pump off" level at*
/ DO /4
Public sewer manhole/cleanout "k/ /4 _
Lift station
SEPARATION DISTANCES FROMEPTI HOLDING TANK ON LOT TO:
Foundation / D 14- Property line / D ! -f- Absorption field
Water main/service line c) -S h Surface water/drainage 106 ' - Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line / 0 Building foundation
i
Surface water
Water main/service line
/ 0 D - Driveway, parking/vehicle storage area
Curtain drain /v u N'r- K vo wk/ Wells on adjacent lots
F. ENGINEER'S CERTIFICATION
1 certify that / have determined thru field inspections and review of Municipal
in conformance �� {No)Auideli sin effecton this date.
Signature
Engineer's Name`d'P/f�' C �A ✓�N
Date / `d 9 7
HAA Fee $ J Di
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
3
Waiver Fee $
Date of Payment
Receipt Number
1 0 G r --)-
W c. COV
CE -8801
are
CT&E Environmental Services Inc.
Laboratory Division rdddd�/siddrtoor����dd�/��A��Ors®l�Gw '
Drin'
❑ '�s
';;Tater Analysis Report for Total Colifor
Fee D 1:':'.
',1 1 LO.'�'S ON REVERSE SIDE BEFORE COLLECTLNG SeIJVPLZ
�ij357 -BE COMPLETED BY `NATER SUPPLIER
'..tCWATiRSYSTEjvfJ,D.4
,TE SvATER SYSTEM
C' _..
-��sulu � Sendlmoiee
5 S. 5 ENGINEERING
[;
Lg O Sendln.oke
Month Day Year
e-%
O Treated NVater
in Pic (for routine sample
❑ :'!i�pose
S"
Comrn
c?C`ATION
r rtjt.Vs W�'T F!• J
>r Untreated Water
Time
Collected
9�tjo lam
Collected
By
rlus Pnrl
n Bacteria 200 W. Potte:
Anchorage. AK S"
Tel: (907) 562-23
Fax: (907) 361-511iT
TO BE COMPLETED BY L-PZt')�
Analysis snows this «14tcr S.'k:MPL
$atia(ativN
O Unsatisfactory
O Sample over 30 hours old.
be unreliable
O Sample too long in transit, s; ..
not be over 48 hours old 9c:, ..
to indicate reliable results.
new sample via special delve
Date Received
C
Time Received �
Analysis Began Q 7, i-, -.
Analytical Method:en-o
O MMO .
• Number or colon ies/t00ml.
Lab RvE No. Re511W
Mol S
�'.
I
sen -973301_ inth
Dale: Timc!
Client notified of unsatisraclory -
Q
Phon<d spoke >ilk
Dao:
BACTERIOLOGICAL WATER ANALYSIS RECORD
:4':'t1O.MUG Result: TOUT Coliform E. Cali
„-,brave Filter Direct Count 1 W bCOLQA.Lcolonies/100 mt
'.:.'ikation: LTB l BGB C?)VIRNI
.. sl CJtI (Jrm Confirmation O VV
�/
:� In al htcmboJ'rt� Firgcrjigsu;[s Coliform/100 mi
Dotted
Tint':
Time (rt�J hrs
L Environmental Services Inc.
CT&E''K,- _
973301001
Client 1 h', -
S & S 13ngineering
Project N;
U)t 3 Blk t Talus West 1
Client Srr.:
hot 3 Blk 1 Talus West #1
Matrix
7hinlang Water
Ordered
PWStll
0
Sample Re..
Client PO#
Printed Date/Time 06/26/97 10:1
Collected DateMme 06/23/97 14:CC
Received Date/Time 06/23/97 16: 5
Technical Director: Stephen C. E&
Released By
_ RLtowobte Prep
Parameter Results PQL Units _ Method Limits Dote 10 :e
m trate •P. 0.767 0.100 mg/L SM18 4500-g03F 10 MX ac;
Total Coir' 1 08 U/0 COLI COL/100 M. SM19 92228 0..,>
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. # 015-201-26-000
1. GENERAL INFORMATION
2.
3.
4.
HAA # IA 11"-11 • (':
Complete legal description Lot 3, Block 1 Talus west SID
Location (site address or directions)
4841 Talus
Property owner Brett Launsberry>> Day phone 34s -709s
Mailing address 4841 Talus Anchorage Ak. 99516
Lending agency city Mortgage (Al Shawl Day phone
Mailing address 121 West Fireweed, Suite 120 , Archoraae 99503
Agent Sale by owner Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual well X
Community well
Public water
263-0777
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site X
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) From 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 furtherverify 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 Anderson Engineeri
Address P.O. Dox 240773
Engineer's signature 7 �1 (� , r
6. DHHS SIGNATURE
X Approved for
Disapproved.
Conditional approval for
Additional Comments
M
"y Phone
Anchorage, AK 99524
Date
563 7155
1/22/96
.o
7 ,G
bedrooms.
411Th
bedrooms, with the following stipulations:
Date 2 - � - %
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (R.v- 1/91) Beck MOA n1
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
� c
Total depth 157'
Sanitary seal (YIN) Y
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Cased to GT 40'
FROM WELL LOG
Coliform 0 Nitrate
g.p.m.
Casing height (above ground) 1-5,5"
Wires properly protected (Y/N)
,44mg/L
AT INSPECTION
11 January 1996
0
Other bacteria 0
Date of sample:12 January 1996 Collectedby: Stuart Gilbert
B. SEPTIC/HOLDtNG TANK DATA
Y
g.p.m.
Date installed 10-13-92 Tank size 1000 Number of Compartments 2 Cleanouts (Y/N) Y
Z *** N N
Foundation cleanout (Y/N) Depression (Y/I� High water alarm (Y/N)
Date of Pumping 7-10-95 Pumper
TSAACX
C. ABSORPTION FIELD DATA *** More than 5' from foundation.
Date installed
Health Authority Approval Checklist
Soil rating (g.p.d.M2 or ft2/bdrm) . 6
o
Length 58
Width
3 Gravel thickness below pipe 6.
_Z
Y I u.._Z1
Legal Description:Lot 3,
Block 1 TALUS WEST Parcel I.D.015-201-26-000
�y
N
A. WELL DATA
co
:5o
Q
m r
Well type private
If A, B, or C. attach ADEC letter. ADEC water system number
o C
Log present (Y/N)
N Date completed August 1972
Total depth 157'
Sanitary seal (YIN) Y
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Cased to GT 40'
FROM WELL LOG
Coliform 0 Nitrate
g.p.m.
Casing height (above ground) 1-5,5"
Wires properly protected (Y/N)
,44mg/L
AT INSPECTION
11 January 1996
0
Other bacteria 0
Date of sample:12 January 1996 Collectedby: Stuart Gilbert
B. SEPTIC/HOLDtNG TANK DATA
Y
g.p.m.
Date installed 10-13-92 Tank size 1000 Number of Compartments 2 Cleanouts (Y/N) Y
Z *** N N
Foundation cleanout (Y/N) Depression (Y/I� High water alarm (Y/N)
Date of Pumping 7-10-95 Pumper
TSAACX
C. ABSORPTION FIELD DATA *** More than 5' from foundation.
Date installed
10-13-92
Soil rating (g.p.d.M2 or ft2/bdrm) . 6
System type trench
Length 58
Width
3 Gravel thickness below pipe 6.
5 Total depth 10,
Effective absorption area 754 SF Monitoring Tube present(Y/N) Y Depression over field (Y/N) N
Date of adequacy test 11 Jan 96 Results (Pass/Fail) pass For 3 bedrooms
Fluid depth in absorption field before test (in.); 5 7 " Immediately after5 3 0 gal, water added (in.): 7 8 "
Fluid depth 64 " (ins.) Minutes later: 2 4 x o r s Absorption rate = 450+ g P d
Peroxide treatment (past 12 months) (Y/N) N If yes, give date
D. LIFT STATION
Date installed None Size in gallons
Manhole/Access (Y/N) "Pump on" level at* •'Pump oft' level at*
High water alarm level at* *Datum
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot GT 100' ; On adjacent lots GT 100'
Absorption field on lot GT 100' ; On adjacent lots GT 100'
Public sewer main none Public sewer manhole/cleanout none
Sewer /septic service line GT 50 Lift station None
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation GT 25' Properly line GT 20' Absorption field GT10'
Water main/service line GT 50 ' Surface water/drainage GT100 ' Wells on adjacent lots GT 100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation GT 25Water main/service line GT 50'
Surface water None Driveway, parking/vehicle storage area _ GT 85 '
Curtain drain No evidence Wells on adjacent lots GT 100' Properly line 10 '
F. ENGINEER'S CERTIFICATION ** From S & S Engineering Certified As—Built
Dated 11/23/92..
E .,
/certify that /hove determined thru field inspections and review ofrLlroiicipnl records._I�rp`t thj?tztbt�ve sV,:t`tGtns are
in conformance with MOA HAA ,Guidelines at effect on this date.
Signature
Engittcer'sName Michael B. Anderson L (_
`.l ngmeerrit SeiYf dr�X
r
�. r icha�l F ..aron e
Date 1/22/96 - e,e�t
.LL;
HAA Fee $ d U z 21 Waiver Fee $ _
Date of Paymcnt Date of Payment _
Receipt Number G C.S G{o Receipt Number _
Rev. 8/95 OSS: haa.wk.doc
January 22, 1996
Municipality of Anchorage
Department of Health and Human Services
Onsite Services Section
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Lot 3, Block 1, Talus West Subdivision
Septic System Adequacy Test
Dear Onsite Engineer:
On January 11, 1996, an adequacy test was completed on the
trench serving the three bedroom home at 4841 Talus West.
was installed in October of 1992 and is 58' in length with
depth of 6.5' beneath the distribution piping. The as -built of
indicates an absorption rate of .6 GPD/square foot. The
therefore a little more than three years old.
absorption
The trench
gravel to a
the system
system i s
Our initial inspection indicated standing water to a depth of 57" in the
absorption trench. 530 gallons of water was added at a rate of 8 gallons
per minute. The water level rose to 78". At no time did the water level
back up into the post tank cleanouts or into the tank itself. 24 hours later
the water level was measured at 64". Simple interpolation indicates 365
gallons was absorbed.
Water was again added to the trench until the 78" level was reached. A
total of 380 gallons was added. During the first two hours a total of 64
gallons was absorbed. It appears, therefore, the upper reaches of the
trench are capable of absorbing more than 450 gallons per day and the
system is in compliance with Municipal regulations. It should be noted,
however, the system is only 3 years old and is already 73% under water.
This may or may not be attributable to the extremely cold temperatures
and deep frost conditions encountered this winter.
Sincerely,
Michael E. Anderson, P.E.
YMMILCT&E Environmental Services Inc.
Laboratory Division.�i•►�i�r�rrirriiiirrrrrrrrrrrrrr��rrrrrrrr����1
CT&E Ref..". 95.:3:45-1 Laboratory Analysis Report
Matrix .WATEP
Client Sample ID 3'i 7ALUS WEST
Client Name 50 TECHNICAL WORK Order 20656
Ordered Ely STUART Printed Date 01/15/96 m 15:42 hrs.
Collected Data 01/12/96 0 13:46 hre.
Project Name Received Date 01/12/96 ® 15:10 hra_
Proj ECC♦♦
PWSTD UA
Technical Director STEPHEN C. •HDE
Released
Sample Remarks; SAMPLE COLLBCTRD BY: STUART-
QC Allowable F.xt. Anal
Parameter Results Qual Units Method Limits Date Dare Ini[
Nierate-N 0.44 mD/L EPA 151.2 10. 01/15/96 BMW
T
._..:...._:........................................»._:....................................................__._....
See 5pecral ;nscrac;lons Above UA - Unavailable
•• See Sample Remarkm Above NA - Not Analyzed
U = Undetected. Reporcczl value i9 the practical quantification limit. UT - Lase Than
D - Secondary dilution GT . Greater Than
200 W Potter Drive. Anehorase, AK 99516-1605 —Tel: (907( 562-2343 Fa K: (907) 661-5301
ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA. FLORIDA. ILLINOIS. MARYLAND, MICHIGAN. MISSOURI. NEW JERSEY. OHIO. WEST VIRGINIA
Ahk CT&E Environmental Services Inc.
Laboratory Division
200 W. Potter Drive
DIinking Water Analysis Report for Total Coliform Bacteria Anchorage. AK 99518-1605
READ INSTRUCTIONS O,PREP'ERSESIDEBEFORE COLLECTING SAhTel:(907)562.2343lPLE Fax: (907)661.5301
MUST 13
SUPPLIER
fa PUBLIC WATER SYSTEM I.D, 0
JKPRIVATE WATER SYSTEM
❑ Send Results ❑ Send invoice
umra.•. ,m. o�iw,wna
\Iriiny Lu.V.ft
pN ]Pm �O Lade
SAMPLE DATE: l'ls_L' l Fl m
iVlonth Day Year
SAMPLE TYPE:
Lo- Routine 0 Treated Water
❑ Repent Sample (for routine sample 11K Untreated Water
with lab ref, no. J )
❑ Spccinl Purpose
SAMPLE LOC.ATION
.f
Comments:
Time
Collected
Collected
By
Jm
Analysis Began
Flaw Print
TO BE COMPLETED BY LA13UKA I Ute t
Analysis shows this Water SAMPLE to be:
,g-" Satisfactory
❑ Unsatisfactory
❑ Sample over 30 hours old, results may
be unreliable
Cl Sample too long in transit: sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received
Time Received
Analysis Began
Analytical Method: ,0`�hlembran s Filter
❑ N1MO•MUO
I Number of colonieS/100 tal
I ..L. n_e .,, Result* Anal st
96.0145,
—�
Sent to A.D.E.C. W tL4t� Fbw Jun
/
�l I Time:
FuscJ
Date:
Client notified of unsatisfactory results:
Q
Phoned Spoke with
Fated
Date: Time:
BACTERIOLOGICAL WATVR ANALYSIS RECORD
Result Total Coliform
Membrane Filter: Direct Count _
Verification: I.T8
Fecal Coliform Con RrmatRut
BCH
Final Membrane IFilter Results
Reported R.', r'"'7- Date
/. 13. 54
E. Colt
0 Colonies/100 ml
COLIFIR}t
Coliform/1100 ml
Time �L u u I hrs
LYTC `Tiro }'xmgoui Tx Cuen/
Oil • Illher HuaWid
/���—i• Laa-7. Member of the SGS Group (Soci4tIl GiInerale do Surveillance)
ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA. FLORIDA. ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA
MUNICIPALITY OF ANCHORAGE
` DEPARTMENT OF HEALTH & HUMAN SERVICES wee
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.# L1�- - 2c 1- a -- HAA# 1zC1-� rr"D
1. GENERAL INFORMATION
Complete legal description Lot 3; Bkock 1; Ta&,s West Subdivi.6ion;
Location (site address or directions)
4841 TaCus D4. ve
Property owner Cruan Day phone
Mailing address 1822 Marka2an Dive. Juneau, A2aaka 99801
Lending agency
Mailing
Day phone
Agent_ Beth Simpson SIMPSON COMPANY REALTORS Day phone
345-6644
Address 12350 Indu3.try Way Hu46man Plaza #203 Anchorage, AK 99515
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:y
3. TYPE OF WATER SUPPLY:
Individual well XXX
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:
Individual on-site xxx
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (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 5 & S ENGINEERING Phone
17034 Engle River LOOP KUdU INV.
Address Eaale River, Alaska 99577
Engineers signature
Rertueat a Condition,(' Heatth Authority
Appn.ovae under. the condition that aU
depne64.io" an.e 6iUed and b.inat gnarling
oven. the existing system .ih compteted
.in .the Spring o4 1993.
6. DHHS SIGNATURE
x_ Approved for bedrooms.
Disapproved.
Conditional approval for
Additional Comments
0
Date -2- " t e —13
bedrooms, with the following stipulations:
Date 2 - 2S - 93
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 ao 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 engineers work.
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: LoT34 F_K .4 T4W_S lAA%Z S4D Parcel I.D.
A. WELL DATA
Well type tOAZE If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/9 MO Date completed (>F—F-0 'IN -1 Driller—
Totaldepth Oct 'F Casedto y0r�_ —Casing height
—
Sanitary seal O/N) yGS Wires properly protected ON) y
Date of test
Static water level
Well flow
Pump level
FROM WELL LOG
rUAUAIL
9—
p.m-
SEPARATION DISTANCES FROM WELL TO:
N/1,
S"
AT INSPECTION
MUNIOPA'.IP' nF ANCHORAGE
tNVIKU MENTAL SERVICES [)1VISION
y,5 FCD 1 g 1993
9.p -m.
!Q9`� RECEIVED
Septic/holding tank on lot IOU ; On adjacent lots Ivo fi
Absorption field on lot ill ; On adjacent lots 166,f
Public sewer main /�%/A Public sewer manhole/cleanout INIA
Sewer service line SU Petroleum tank /VdNe kAoWN
WATER SAMPLE RESULTS: n
Coliform Nitrate r) 6 �Q Other bacteria 0
Date of sample: )`�3 Collected by: S * S EN&tNEERINlr
B. SEPTIC/HOLDING TANK DATA
Date installed ��'� 3-9� Tank size /000 6-4� Compartments 12 t
A I
Cleanouts (9N) 7WO Foundation cleanout (&N) IVES Depression (Y/�fJ� — o
High water alarm (Y/Q NIA Alarm tested (Y/N//4
Date of pumping NSA " AJEW Fglvlc Pumper AiA — /UEW 7 -Aly,(
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Wei I(s)onlot loon On adjacent lots X00 r11 Foundation /5r
To property line a% r Absorption field
Surface water/drainage jUy r
72-026 (Rev. 7191) Front
-'D f56Z.
Water main/service line a5.f
SEprIC T6FruK LocsatioN
CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed Y
Size in gallons
Vent(Y/N)
High water alarm level
"Pump o
Manufacturer
Manhole/Access (Y/N)
at "Pump off' level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DIST FROM LIFT STATION TO:
Well o
D. ABSORPTION FIELD DATA
On adjacent lots
Surface water
Date installed �� �3 — �� Soil rating &PL SP System type )Ear �RBNcrd
r /
Length SS Width Gravel thickness �, S Total depth
Total absorption area F Cleanouts present ON) %yam
Depression over field (Y/N) Ne Date of adequacy test W14 Syr
Results (pass/fail) PJ,/4 — /Vee flys. for 3 bedrooms
Peroxide treatment (past 12 months) (Y/O
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
On adjacent lots 106 f Property line
If yes, give date
Well on lot
i
To building foundation 3(3 '- To existing or abandoned system on lot
/
On adjacent lots as 4- Cutbank NIA Water main/serviceline
-
Surface water 1 /KJot) I Driveway, parking/vehicle storage area
Curtain drain ANE NOWN
E. ENGINEER'S CERTIFICATION
1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect
S A S E'NGINrE RIN6
11034 F!a,4o fiver Loop Rond No, 20{
Signature uc,;ilo Rivor, .: a.. as 99577
Engineer's Name
Date
-2—_10)"-1--�)
of this inspection.
"R J.311AFER
Nu. il'.15 _
)GIB
HAA Fee $ _ 7 Waiver Fee: $
Date of Payment _ — 61 7' Date of Payment
Receiot Number fg020 CiReceipt Number
72-026 (Rev. 3/91)Back MOA 21
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
Chemlab Ref J :93.0354-1 REPORT of ANALYSIS
Client Sample ID :L3 B1 TALUS WEST S/D
Matrix : WATER
Client Name :S & S ENGINEERING
Ordered By :RAY
Project Name
Project@
PWSID :UA
Sample ROUTINE SAMPLE COLLECTED BY: J.W.
Remarks:
Parameter
NITRATE -N
QC
Results Qual. Units Method
Collected :01/26/93 @ 13:30 hrs.
Received :01/26/93 @ 16:00 hrs.
WORE Order :62642
Report Completed :01/27/93
Technical Director :STEPUEN P. EDE
Released By : '?G�
Allowable Extract Analysis
Limits Date Date
----------------------------------------------------------------------------------------
0.46 mg/l EPA 353.2/300.0 10 01/27/93 01/27/93
See Special Instructions Above UA - Unavailable
See Sample Remarks Above NA = Not Analyzed
U - Undetected, Reported value is the practical quantification limit. IT - Less Than
D - Secondary dilution.��±±��++ GT = Greater Than
WN 567.7 Member of the SGS Group (Societe Generale de Surveillance)
COMMERCIAL TESTING & ENGIN
CAMICAL & GEOLOGICAL
TELEPHONE (907) 562-2343
Drinking ,Water Analysis Repoli for Total Coliform
TO BE COMPLETED
❑ PUBLIC WATER SYSTEM I.D. #
PRIVATE WATER SYSTEM
3Y WATER SUPPLIER
t " Acny sive
zro codw
SAMPLE DATE: 0 ai < < 3
Mo. Day Year
SAMPLE TYPE:
loutine
❑ Check Sample (for routine sample
with lab ref. no. ) ❑ Treated Water
❑ Special Purpose ❑ Untreated Water
SAMPLE Time Collected
No. LOCATION Collected By
1 1 o� 3 , &Lr f -
2 i TAt, Uw�s7 Sim ,�s 1>N.
3
4
5
CO. AK DIV
IRATORY
B Street
. Alaska 99518.
ria
TO BE"OOMPLETED BY LABORATORY
Analysis sows this Water SAMPLE to be:
❑ Unsatijfactory
❑ Sample too long in transit; sample should
not be over 30 hours old at examination
to indipate reliable results. Please send
new sgmple via special delivery mail.
Date Received 2
r
Time Received
Analytical Method: Membrane Fitter
'i
i
No. of colonies/100 ml.
Lab Ref. No. Result` Analyst
F
93.0566 m
m
I I I I
II I mm
� I LJJ
DEO -j-f5-9 BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS Membrane Filter: Direct Count
ColiforM100 ml
BEFORE
COLLECTING SAMPLE
Verification:
Fecal Coliform Confirmation
BGB
Final Membrane Filter R ults / Coliform/100 ml
Reported By Date Z- 1 �/ Z L 3
TNTC = Too Numerous To Count Time: t �7 --�o a.m
OB = Other Bacteria
PART ONE OF TWO
lVaNS'GS Memt REMAINDER TO FOLLOW
p.m.
Tpc%OQ.14I SPI i
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received February 7, 1977
�J Time of Inspection 9: 0 a.m.
Date of Inspection 2- 77 Tuesday
REQUEST FOR APPROVAL OF P a t
INDIVIDUAL SEWER & WATER FACILITIES
l FOR
c� Conv. .
1. Approval requested by: First Federal Savinc(s and Loan Association
Mailing Address: post Office Box 4-2200 Phone: 274-6561 x 216
2. Property Owner: _Allen R/Lois J Smith Phone: 344-2463
Mailing Address:
3. Legal Description: Lot 3 Block 1 Talus West
4. Location: NHN Talus Road, see attached map
5. Type of facility to be inspected Single Family No. of bedrooms 3
6. Well Data:
A. Type Individual B. Depth
C. Construction D. Bacterial Analysis
7
Sewage Disposal System: On-site system
A. Installed B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank , Absorption area Sewer Lines ,
Nearest lot line Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
Page 2. of two pages - Re, ,.st for Approval of Individual ter & Water Facilities
Legal Description Lot 3 Block 1 Talus West
Comments
Approved
Disapproved
Date
Approval,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
i certity 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.
SIGNED Date
EQ -034 (1/74)
MUNICIPALITY OF ANCHORAGE UNICIPALITY OF ANCHORAOF.
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION)1ADEPT. Or- HEALTH &
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 ENVIRONMENTAL PROTECTION
REQUEST FOR APPROVAL OF FEB 7 1977
INDIVIDUAL SEWER and WATER FACILITIES
RECEIVED
1. Type of Inspection: CMRO VA FHA CONY xxxxxxx
2. Property Owner: Allen R. and Lois J. Smith
Mailing Address: Day Phone: 344-2463
3. Name of Buyer: Ian D. Cryan and Lynda M. Cryan
Mailing Address: Day Phone:
4. Name of Lending Institution: FIRST FEDERAL SAVINGS & LOAN ASSOCIATION OF ANCHORAGE
Candy
Mailing Address: F.O. Box 4-2200 Phone: 274-6561 extension 216
Anchorage, Alaska 99509
5. Name of Realtor or Agent: N/A
Mailing
N/A
6. Legal Description: Lot 3, Block 1 Talus West
Location: NHN Talus Road Anchorage, Alaska
7. Type of Facility to be Inspected: Well & Septic Tank
8. Water Supply
Phone: N/A
No. Bdrms. 3
Type of Supply: Public Utility Individual xxxxxxxxxxxxxx
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility Individual (on-site) xxxxxxxxx
If Individual, date of installation
02/07/77
FIRST FEDERAL SAVINGS & LOAN ASSOCIATION
Candice A. Easley
72-003(3/76)
(� 0)artment of Environmental Qualit'
`Water and Sewer Questionnaire
Date � -.5 , Time
Subdivision 74 US
jyj 6-j T
Block
Lot
Owner's Name:
449
j
02 71/L
Mailing Address:
Questions:
1. How many bedrooms are now in your house? 5
2. How many bedrooms were in the house at the time of purchase? 3
3. Were the basement bedroom walls "roughed in" at the time of purchase? �
4. Was the basement athroom plumbing "roughed in" at the time of
purchase?
5. Did the realtor or builder inform you that you would have to enlarge the/
existing sewer system if you finished the basement bedroom (a)?
6. If on a public a r supply, do you always have an adequate supply of
water? t11
7. Is the pressure always adequate?��
8. Who was the builder?
Ne/
C
9. Who was the home purchased from?—K///de-1—
OTHER COMMENTS:
I /l Chi 61L-) .s.
February lo, 1377
Mr. Allen R. Smith
Star Inute A BOX l5a4- T
Anchoxuge, Alaska 99507
Subject: Lot 3 Block 1 Talus east
Dear far. Smiths
on upgrade of the sever system on the su§ject property
will be needed. An additional twenty (20) Fast of treach
with eight (6) feet of gravel below the drain will be
needed to complete the upgrade,
A permit swat he obtained before any construction begins.
anxa crewed for the completion of the upgrade
une1, 1377,
If there are any further questions, plOaSO oantaUt this
office at 273-2511, extension 224.
sincerely,
Robert C. Prattr R.S.
Sa n°it Flail a
m°y3.y
cc: First Federal Savings and Loan ASSOViatioll