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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 m Ul r.- y A o. C ° v7 ®a. m . a S pc �jNe �!O '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.: -'• • � !,^•Dea 4177a , IIIOC InrrrNlMNI /W awl l^a ': •7 •'ti': •.1' • •ANclronnc C•AtARA l7 $ol. Ir .0 DRILlINO IOC �•'�� \Yell Owrer:+7 r; ern d 1 S.i•• a • . • • � � • • ' Dae of Well '•^' . Lecmbn (1d:':ess at; Tawnshlp, )tante, Stenon• If known; or distance Melo rw•r L!,1rL1n\,6t1.x1•:i:"-''�0T1- 'R�:•3• TUBI Sae et a: np L Dep;h It Ifola IL} feet't•Cucdl •'e—.•`..feet y1.. : S:a:le water level -RA -It. (•Uerr).& .claw) land auriser. Finishatwell (check one) cyto and S:tten' , 1 ' 417 ".r i;t.'.:¢• Da:rl.a e:recn Cr perfora;tew 7Selt pampfnp eat at.. 24 ra;:one per (h'ohr) ' (minuta) for -J, --hours with fl �•(L of drawdawn Isom snt:e level. n Za:e of rm;.letic^ :{ /.• • •�\ : f.,! •,(,� . • ... •)•. a�•,• a: '�' •♦ Dep:h In feet horn WILL IOC .t•^ e;rocnd urfato '.• Cive details of tormalleno penetrated• /11r of material, tolor and hudaess ��TO, •+..'1n 1 ;u.�.ea 0,�.o-.rr� `�r::'!; i;;.. •( ... .5' alttl •Fn �.TD ''"i'L Ellie •erne•\ ':a .. vt .. -- ,;L __7.0L� e::,r • r CLAD .►Z�_T0 _ l•rnrnllr •.I,�u � Kf,IyCLc y LI y,r,,\ r 5LT0�'� ' dr,•r+1 •�� r<c�ra LI� Y.! .TO_._l.� :r •,1 • 54n0A SrAJti 74ro s.� ' P. ea2j �a To___liD _•.•..•,. :. J_ JLi�s�c.11�1'an)k._ �nr'1ht�,•� ♦ w9 -0 ' • ... ' I—COW11nC144 1 . Municipality of Anchorage L' Ito. I6x Vkkp ) • :\n,$om 4 \1a,k+!tl1.91!1-66PW • ! .7 I,',. Rlq+hont(N171 :iYaK411 .11ix(!Mli)33:{R91M1 " 471N1 ISmI;aTc Si nYt •.\nchuml;q .11a.k+cdAiOi eIM.nu dart 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 ,,, �- :: t •. '`.rte \I: ,„t���LG,. ` •t i ��a.r.. {p7 .t.y. Ih. .bY �lt�. .'. '� :1•ii a � � I. j• 1•w - r}I' •• iM �i - %'v - r. �ilv� . r�il!`I, 1lr .tr .. `1A` 1 / - it w`41 r i1 r 1 Qf i�}r }1r11 !` •w r 1 ♦ a.'l �. .J - i.a _ � ,�.3 � \l CI�i•I t:7.[v9f rr �'... .. � e n L '9r lc.' ri ... r _ `1 • r , ElI I Ile { -:r 1 t . �li��'11' r: ii �__}.t}I ��12:'i' Ii. Vii•\iia 1r`. '.I �I t• r' � 1 � r i .' 'li I �.. .l � t '�.. - 1. 1�• \� tr; � � �.� /�,I � L.y •Pr"`�.`+.0 •r:+= i._ rvt � 'at" r t•r C \ "r ,. w •' f r • �,f•v to, Y`.`Y -i }zz r >4 •.^� 7 l !. •�.ti 1 t- !'`' w If"• • ti ^} w. r,. tom. i>� ''Y ! t�� ^' ; t '•" sr 1. • r T ti .♦ •< r`��.Y Y � ,j.. :.v • _ _r � ,w1.� /,� �I rte• � ".I N �, !,: 1 .:. • - 1 .''N .�A .. • '.. ! Io, i. �•. .. ..'♦'1 �...•. •. vl.., ..�t.. .. 1 '.. 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. — I I r I I I I r i I E I DECK r �I I I I I \) I SINGLE FAMILY I I I I FRAME HOUSE36.4 I I I DECK f ATRIUM i I I +'ALL° I I r I e I Z I I 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 I Y: \ CU. lk.x VxxLitl • tin honlge. Ala,k, !1!Ai 1!) fxiMl •;7 W 13m..a�c titircl `�.. ()"'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