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Home My WebLink AboutTALUS WEST BLK 2 LT 13 MUNICIPALITY OF ANCHORAGE Di~. ~RTMENT OF HEALTH AND HUMAN SER..~jJES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ?LJ~--~.~ ~--2~ 6/~/~ t~ DISTANCES Address SEPTIC ABSORPTION '~.~--'~, '~t.~ ~o~ ~, ~ TANK FIELD WELL Subdiwm ~ TANKS ~_.. SEPTIC [] HOLDING Capacity IR gallo~s NO. of Gompadmenls TYPE OF SYSTEM .~TRENCH [] BED [] W. DRAIN [] OTHER Depth to pipe bottom lrom Total depth from o[iglRal grade original grade ~-~'~. 0 FT Fill added above o/rgmnal grade Gravel depth beneath pmpe ~FT ~,0 WELLS '~ PRIVATE [] OTHER {Identifvl REMARKS: '.,.[~i~Jl~i ~s in effecl on Ibis dale: 17034 Eagle Ri~ver l~o,~ Ea;le River, AlasEa 9952'~ H/~allh Deparimenl Approval: 72 013 (3/'85) ENGINEER'S SEAL J. 70:/!;.4 E:,'.:'.i(.:il .E£ J:::~ Z M[i/J::L*. I_F:'. J~/¢:i[%.l: R :i: VEi}:~: :, A'lJ< Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~ I ~. . ~L~'~-- DATE PERFORI~ 1 3 4- 5 6 7 8 9 10 11 12- 13- 14 15- 16- 17 18 19 20 COMMENTS t ) ~"~ ~_ ENGINEERING SLOPE WASGROUND WATER ENCOUNTERED? SITE PLAN s IF YES. ATW T neplh t° Water A,~9 ,x/ ///~' /¢'"~ E Monitoring? / Gross Net Depth to Net Reading Date Time Time Water Drop 'Fl/ 3;~,s ~- ~?~" PERCOLATION RATE ~- ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND , ~ FT i ~1¢~1. Ea~Je [~Jve." L~ ~ea~ N~. ~/~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH~,~',&~ ,~GUlDELINES~CT ON THIS DATE. DATE: 72-008 (Rev. 4/85) "l SCALE ~v IEF:I:: E~E; i' :[ VIE !)lEI::' I' H [;i]VER i)EiF"I H FEi I ,q[. I..E"~NE[f I I N Z i3'FH St~! F"I' ,, I_E[:~AL DESf-]IqtlF:'YI[]N~: I..(]-I- 1:$ Bt_I< 2 'T¢:~LUS WEST SUBD,. ...._..,SEZC: '"'" "~ EOF ' ....... ,:~ J. ZI::. = :L '7::~;00 (]1:~ (:~CI::~iS) SEIZE I:~f:~T :[NG = S[IZL, 'I'IES;T DE:I::']I,]= 14 F"I' NIl W~YYER 'FH~S ):S F~N IJP(d~(M)E '1"0 'tHE EX]:SF:[N(~ SEF"FIC 5 5 270 SF:'E:[..: I At.. C[)N}) :[/' :[ (:)NS (:)F,t :[ NSi I:~L.IC I* I [iNS: E: L D (~ J 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 ~ ~ D~ .... ~~u~p~r~ ar~ PERMIT NO. ~ ~ Material No. of compartments ~ ~ J Liq. capacity in gallons [F HOMEMADE: Inside rength Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling MateriaJ Liquid capacity in gallons -- No. of ,ines Length~ ~,~ine TotaJ ' Distanc~ bet~y~es ~'~ / grade,~' + Mater/albeneathtile Totaleff~iv~rpt[onaree ~ Top of tge to finish ~ Length Width Depth ~O inches ~ ~ Type of crib Crib diameter ~ ~ Crib depth Total effective absorption area DISTANCE TO: Bugding foundation Nearest lot line ~ Class Depth Driger Distance to lot line ~ PERMIT NO. ~ DISTANCE TO: Building foundation Sewer Ene Septic tank Absorption area(si OTHER PiPE MAT RIALS , SOl L ~EST RATING INSTA LER - ~rOLT.~ DATE LEGAL PERMIT NO. B25 '"L~ STREET., ANCHORAGE, AK. 99501 264-4?20 mll[-~--'---~ I TE SEWE~: F'ERF1 I T ( 82~890 ) ~PPLICRNT -OCATION LEGAL DEARMOUN EXCAVATING LimB2 TALUS WEST SAR BOX ~4-B 99507 LOT SIZE ~45-i6i9 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MRXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 225 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C'EPTH= 10 LEI'-IGTH= 57 GRR'~-"EL [-~EF"TH = 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE 80TTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F-:E6!LI I ~-:EB SEPT I L--: TA~-~( S I ZE= ~-3£40 GRLL£m~4S 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. TW[I (2) I [-~SPE~Z:TI,DNS ARE RE~LIIRE~ 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 R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO 8 PRIMATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T I CERTIFY THAT 2.: I AM FRMILIBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS ,REMODELED~ TO INCLUDE MORE THAN ~ BEDROOMS. s ~ 6NE[.: ---;Z~--~___U__~ .............. APPLICANT DERRMOUN E~4CR'/RTING , SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264°4?20 SOILS LOG - PERCOLATION TEST PERCOLATION TEST /' DATE PERFORMED: SLOPE SiTE PLAN 11 WASGROUNDWATER ENCOUNTERED? 12 13 14- 15 16 17, 18- 19- 20 IF YES, AT WHAT DEPTcH? ~ ~ a,~,, :'/'~ /--~ Reading Date _~ 7t/ Gross Time ¢.'zo Net Depth to Time Water /o o. lo o,~-¥ Net Drop O ,Oq. 0,01 PERCOLATION RATE TEST RUN BETWEEN CERTIEIED BY; ~llUlltOJll'l'lSFil't-ll, COIiI'P~OL $~ftUIC~$, lilt. PERCOLATION TEST DATA SIIEET READING # ADDRESS ZIP CODE TOTAL DEPTH OF HOLE _~ ft. ZONE TESTED ~ ~ ~ ft TO ~ .......... ft CLOCK TIME NET TIME DEPTH TO NET DROP RATE (min/in DATUM :~']~?-~ ' / oo, ~. o,.o~ .................... ~;~ /o ~ Z~ ~ o~o7 - z .,' ~%~' ~ O,~'f -' ...... ~ _~&~ ...... ~ .~ ~ ~._ ~..:R :~ ................ FINAL PERCOLATION RATE PERFORMED BY .~t~ E/,'*/__. ................................... (min/in) GREiL,]R ANCHORAGE AREA · Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska ggE07 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~/¢~'¢J[~,'~ /~-/~'e ,~-/ MAILING ADDRESS LOCAT,ON LEGAL OESCR,PT,ON SEPTIC TAN~ DISTANCE ~' ,_ / ~ FROM WELL ~'~ 0 MANUFACTURER~'/c'ZP.~ ~_~/-~ ~2. MATERIAl INSIDE LENGTH ~ iNSIDE WIDTH__LIG~UID DEPTH NUMBER OF COMPARTMENTS ~ .LI(~UID CAPACITY /~<~-~ GALLONS. SEEPAGE PIT: NUMBER OF PITS / .. DIAMETER__ OR WIDTH LINING MATERIALC~,~g./'~'~ CRIB SIZE: DIAMETER BUILDING FOUNDATION ~_l, NEAREST LOT LINE ~'?~Z/ . ADDITIONAL ABSORPTION ? LENGTH ~ 7, DEPTH '2 ~/ DEPTH ~/ DISTANCE FROM: WELL /~) /~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~/(~ SQ. FT. TYPE BUILDING FOUNDATION CONSTRUCTION NEAREST J LOT LINE ~ ~,~//e ~/ ~1 /~m~-a-~ DEPTH /.~; I DISTANCE FROM: NEAREST / SEPTIC ~ SEEPAGE SEWER LINE /~ ~ TANK ~ SYSTEM /0~ ~ CESSPOOL OTHER SOURCES~)ygc~ ,~t~,-u~2 APPROVED / DISAPPROVED REMARKS DISTANCES: INSTALLED BY: ~('-~-- . PIPE MATERIAL: LOT SLOPE: REMARKS: Form PW-026 DIAGRAM OF SYSTEM APPROVED ~2'ZL)~O G.A.A.B. GRE~;,.,,,'~E:R ANCHORAGE AREA f30,~.d.,UGH SEWAGE DISPOSAL SYSTEA4 --- APPLICATION AHD PERMIT COMPLETION DATE ANTICIPATED ~LL TO SE~IC TANK _., R&M Civil Engineers ENGJt FERING & GEOLOGICAl: CONSULTANTS 22g EAST 51st AVE. - P.O. BOX 808? - ANCHORAGE, ALASKA ggs03 TELEPHONE 907-279-0483 TELEX 090-35419 Geologists Lend Surveyors JAMES W. ROONEY, P. E, MALCOLM A, MENZ[ES, P,E,, L,$, JAMES H. WELLMAN, October 1~, i972 R & A~ No. 26540-39 RALPH R. MIGLIACClO Engineering Geologist 1V[r. Howard Nugent Star Route A, Box 1591 N Anchorage, Alaska Re: Test Hole and Soil Log Report for Sanitary System Lot 13, Block 2, Tals-West Subdivision Dear Mr. Nugent: We are submitting herewith the test boring results and our comments regard- ing soil sondkions encountered at the subject site. This investigation was performeA in accordance with your request of October 12, 1972 and those pro- cedures outlined in a letter dated September 13, 1971 by Mr. Roll Strickland of ~he Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 13 area for the purpose of de- fJnin~ general subsurface so~l conditions for the proposed sanitary system. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extended to a total depth of 15 feet below ground surface. The ~Jnal log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being~ven this opportur~ty to be of service to you. Should you have any questions with regard to the above, please do not hesitate to con- tact us, Very truly yours, R & M ENGINEERING & GEOLOGICAL CONSULTANTS / mea W. Rooney JWR:wb Enclosure xc: GAAB ANCHORAGE FAIRBANKS JUNFA[! Note: Hole T.N.'-I )0-i 2 -72 ORGANIC SILT SILTY SANDY GRAVEL SILT~ SOME SAND GRAVEL (SM)- 1.51 TRACE SAND (SP) 14.0' SILT, TRACE TO SOME SAND (SM) 15,0' No Water Table excuvation with tr(]ctor mounted b(~ckhoe. Engineering ~ GaologJcal Consultante 10-13-72 SCAL. E 1" = 2' OWN 9¥ G.A.W. . CHKO Howard Nugent Property LOG OF TEST BORINGS Anchorage Alaska aY W.E.D JPROJ. ',10. 26540-39~DWe NO. A-01 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 13 Block 2 Talus West Subdivision Location (address or directions) (b) Property Owner Assoc. Relocationi-elephone: Home Business Mailing Address (c) Lending Institution Lomas & Nettleton Telephone Mailing Address 4300 B Street, Anchorage, % Rocky (d) Real Estate Company and Agent Jack White Company % Larry Clarke Address 3201 C Streetr Anchoraqe, Alaska 99503 Telephone 563-5500 (e) MailtheHAAtothefollowinoaddress:or:Checkhere~,ifholdforpickup. List contact person and day phone number below. S & S Engineering 17034 Eagle River Loop Road #204 Eagle River, Alaska 99577 TYPE OF RESIDENCE Single-Family []xx Number of Bedrooms four ( 4 ) WATER SUPPLY Individual Well;[~: Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [~x Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 IRev 8/861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As ceH:ified by my seeJ affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional aed 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 Js Jn compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S Enqineerinq Telephone Address Date Engineer's Seal This department has received written confirmation from the engineer (S & S Engineering) regarding the Conditional Approval of March 26, 1987. The upgrade and inspections of the on-site waste disposal system have been completed and reviewed by this department. This property now meets with Municipal codes and regulations. DHHS APPROVAL Approved for ..~t~,- ('~,~ bedrooms by Approved ~x~_ Disapproved · ~,/~,~/"~ ~D a t e Conditional Terms of Conditional Approval 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 DH HS does th is 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. Page 2 of 2 72-025 trey 8z861 Beck HEALTH AUTHORITY APPROVALS SEWER & WATER MAiN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN May 5, 1987 Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 13; Block 2; Talus West Subdivision You issued a conditional Health Authority Approval for the residence located on the referenced property on March 26, 1987. The terms of conditional approval have now been satisfied. Attached is a copy of the on-site inspection report for the upgrade of this system in accordance with your permit ~870049. Reques~sue a final HAA at this time. SRB 196X EAGLE RIVER, ALASKA 99577 ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) (c) Applicant Name ./~$~-, Applicant Address Telephone: Home Business Applicant is (check one): Lending Institution []; Owner/builder [~; Buyer []; Other [] (explain); (d) Lending Institution Lov,,.. ~4r '~ ~ E:~'L_d'-~-z.~ ~ Telephone Address L~.~ (-~O "-~," ~"r'~ (e) Real Estate Company end Agent ~--~ L~~''t ~-~- Address ~0) ~ ~, ~, ~, Telephone ~ ~% - ~O ~ (f) ¢a~ft the HAA to the following address: S & S ENG;NEE~.;NG 17034 Eagle River L~>op Road No, 2i:~4 Eacjle River, Alaska 99577 ' TYPE OF RESIDENCE Single-Family~ MultNFam2 [] Other Number of Bedrooms ~ WATER SUPPLY Individual Well ~]' Community [] Public [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) g Jo ~ ~ied NOI.I.R~O '9 · uo!padsu! slql Io aiep uo loajja ul suollelnBm pue 'saou~u[p]o 'sapo3 alBIS pub led!olun~ lie NIi~ eoUelld~O3 ul si ~e]sXs lesodsip Jale~a:se~ ]o/pue Xlddns Jale~ ells-uo a~l 'uolioedsui pue uo~ie6!isaAul X~ ~oJI pue SaliJ a6moqouv jo Xliledio!un~ 8ql pau!e~qo uo!le~]o~u! a~l uo paseq leq~ Xj!JaA Jaqpnl I 'uleJaN palco!pul e]n]on]~s Io adXl pue s~ooJpaq ~o Jaqmnu aql alenbape pue leUOipuni 'ales si LUaiSXS lesOdsip ~ale~aise~ ]o/pue Xldd ns ]ale~ alls-uo aql leal s~oqs leAoJddv Xi~JO~lnv ~lleaH slNl Io uolleBRsaAul X~ leql XIIJaA I '~olaq u~oqs alep uoliePlleA aq] lo se pue o]a]a~ paxil~e leas X~ Xq paulpa3 sV NOI&V~MOJNI aNV v&~a 'HOOVES ~qla 'S&S~& 'SNOI&O3dSNI UNlalAO~d ~lJ gNI~a~NIIgN~ .g · MUNICIPALITY OF ANCHORAGi~ i~j,~/i~,ONM~NTAL SERViCeS DiViSiON MAR 2 1987 RECEIVED WELL DATA MUNICIPALITY OF ANCHORAGE (M~) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Well Classification -.~. /~, If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y~ · - , Date Completed ./~./'~?/~c))~ /~):~_~ Yield ~. Total Depth / ~ r-¢./ Cased to L'//C~/-~' Static Water Level /o.'~ I Casing Height Above Ground /4///~ Electrical Wiring in Conduit (~) Separation Distances from Well: To Septic/Holding Tank on Lot -~ 9~'- ~ To Nearest Edge of Absorption Field on Lot /OC~" Depth of Grouting Pump Set At C~). ~ Sanitary Seal on Casing(~N) Depression Around Wellhead (Y~b ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments -~ x'uq/,~_ To Nearest Public Sewer To Nearest Sewer Service Line on Lot 4:~..,,'~U6~,~&c.,'l~_l,~'c~ ; Date ._2,~/~ ~- B. SEPTIC/HOLDING TANK DATA Date Installed Y? *~/- -~ ~-- Size /2_...51:> No. of Compartments Standpipes ~1) Air-tight Caps~:/N) Depression over Tank (Y(~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ ~(~' To Property Line ~--~ To Water Main/Service Line / Course Comments ~ ~.,,/A.~'~/'? OL~/~.~I'.4G,~ Foundation Cleanou(~N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) '~(/P'~ __ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72 026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~'~---~' ~/'/'~'/~ Date Installed c/_ ~ _ [~ ~_ Width of Field ~.~, t/ Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Test --~/ _~¢5 Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot /O/ ~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course Type of System Design Length of Field Depth of Field / Gravel Bed Thickness Standpipes Present ~N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ,,-~,/ To Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area --~"~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Sign~ $ ~-NGiNi~E.R.;NG- Date Receipt No. ~--OO / -d¢¢ / ) . ~. % Dateof Payment _ ,~ ~ ¢~ ~ ~ '. Amount: $ ~ ~ ~ Page 2 of 2 72-026 (11/84) CHEMICAL & GEOLOGICAL LABORATORIES OF LASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Whter Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER E~'PRIVATE WATER SYSTEM Mailing Address ~o. Day Year SAMPLE TYPE: L~Routine [] Check Sample (for routine sample with lab reft no. [] Special Purpose _) [] Treated Water [] Untreated Water SAMPLE NO. LOCATION READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Time Collected Collected By I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [~ Satisf;ctory [] Unsatisfactory [] Sampl~ too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sa[nple via special delivery mail. Date Received , Time Received l Analytical'Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* I J BACTERIOLOGICAL WATER AN~ALYSIS RECORD i Analyst .~o~. Membrane Filter: Direct Count i Coilform/100ml Verification: LTB_ BGB _ ~ Date o s//?/~7 Time: //~'~ a.m. TNTC - Too Numberous To Count OB = Other Bacteria ~"~MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (ad0res~ or directions) (b) App icant Naoae .9,~....~._-..~.¢.,-~,.,,..~.-~c,. ,Telephone: Home __ -- Applicant Address · (c) Applicant is (check one): Lending Institution ¢~'; O?~ner/builder []; Buyer []; Other 17'1 (explain); Business (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address ~'~ ~/~,' /~'~J¢ ~v~ Telephone ~ ~ ~ "~ ~ ~J (f) Mail the HAA to the following address; TYPE OF RESIDENCE Single-Family,J~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual WellJ~r' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4, SEWAGE DISPOSAL Onsite,J~ Public [] Community f-I Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-°2s nl/84) 5. I~NGINEERING FIRM PROVIDING~PECTIONS, TESTS, FILE SEARCH, DAT~.._,ND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with alt Municipal and State codes, ordinances~ and regulations in effect on the date of thisj,.~,~..~inspection..~*-~ .)~ ,~'~'"' ,~... ~/~ ~ ~ ~ ~.~ Name of Firm ~- ~~ ~ephone . _ Date Approved for Z~2bedrooms by Approved ~-,""~(~__ Disapproved Conditional Terms of Conditional Approval //I/ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Empioyees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions ia the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 WELL DATA Well Classification /¢~,¢.~ j z./-~? ,.~'~.~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ~ Date Completed ./.~¢7'~2~ Yield Total Depth / ',...'~ '.';2 Cased to .-)'_-~ ? ? Depth of Grouting Static Water Level ?~ ~--'¢~ ~?'~..4~,,~¢-~ Pump Set At Casing Height Above Ground /' .~/'/'~ Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) ~ Depression Around Wellhead (Y/N) ~'~ Separation Distances from Well: To Septic/Holding Tank on Lot /~'~"~-., ~ ~/~' ; On Adjoining Lots ./.~ To Nearest Edge of Absorption Field on Lot /./')~ ; On Adjoining Lots ~/~.2 ~- To Nearest Public Sewer Line ,,/~¢'.~'~ To Nearest Public Sewer Cleanout/Manhole ~b¢.~ To Nearest Sewer Service Line on Lot Water Sample Collected by .../¢.-'.~?~. ,,~'~. ~'.,4~.'.'.'.'.'.'.'.'.~ ; Date t'~/~/~ Water Sample Test Results Comments ~ ~-~*'~¢-'~'-'-:¢~'-:~-~ ~¢*~/ :""¢'"~" SEPTIC/HOLDING TANK DATA Date Installed /¢~ Size /~..~ ~-]z%'~¢~No. of Compartments Standpipes (Y/N) ~¢" Air-tight Caps (Y/N) )~' Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~ Date Last Pumped ~/Z~-~L-/-.¢¢~ Pumping/Maintenance Contract on File (Y/N) ?v'~'~ ; for Holding Tank High-Water Alarm (Y/N) -/¢-~.~/~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation 2~ ~¢~." To Disposal Field /Z)'~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(lf/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed .~,~r'~ ~, Width of Field ~,, ¢" Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot '~,.,.,.,.,.,.,.,.,.~ ~' To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ~¢'?,¢;"¢.~J Type of System Design Length of Field ~ ~ j Depth of Field ~'~'¢~ Gravel Bed Thickness Standpipes Present (Y/N) . ~" Date of Last Adequacy Test __~,~ To Property Line ~'~' To Existing or Abandoned System on ; On Adjoining Lots ~'2¢--~¢.-;' To Cutbank (if present¢ LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have check__or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Sign e ~ .¢"~. ~/~~~Date Receipt No. ~ Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) CHEMICAL & GEOLOGICAL LABORATORIES OF TELEPHONE (907) 562-2343 Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ,~ P.,VA*E WATE. SVSTm J~,-.~,.~ .z~..,'~, .¢.~,. ~.~. Name Phone No. Mailing Address Cily State Mo. Day Year Zip Code SAMPLE TYPE: ~ Routine : [] Check Sample (for routine sample with lab ref. no. [] Special Purpose _) [] Treated Water [] Untreated Water SAMPLE NO. Time Collected LOCATION Collected By 1 2 READ INSTRUCTIONS MemBrane Filter: Direct Count BEFORE Verification: LTB Final M embran~sults ~ COLLECTING SAMPLE Repealed By ~:~¢~ TO BE COMPLETED BY LABORATORY ~UNICIPALffy OF ANCb/O~A(}~ Analysis J~CJ~DA~I~li~)~Jff~A~MPLE to be: ~mvW.(3NMENTAL PROTECTION J~ Sa;tisfactory , [] Unsatisfac(~ 27 'tg86 [] Sample tja¢ J~ru:~ trsn_sit; sample should no:t be to/.indicate reliab~'e"r(;~su~sYPlease send new sample via special delivery mail. Date Received Time Received Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* I I :q I I FF1 TNTC = Too Numberous To Count OB = Other Bacteria BACTERIOLOGICAL WATER ANALYSIS RECORD BGB Analyst Coilformll00ml Coilform/100ml Date' '1~¢o Time: a.m. · HEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name SAMPLE DATE: ~-~ I.D. NO. Phone No, Day Year SAMPLE TYPE: ~(. Routine .'. [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose [3 Treated Water [] Untreated Water SAMPLE NO. LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY ~Analysis Shows this Water SAMPLE to be: [~.Unsatisfactory ~l,,Sample too long in transit; sample should not be over 30 hours old at examination to intimate rehable results. Please send new ,~ample via special delivery mail. Time Received /C-~ ~ ~ ,~nalytical Method: :[3 Fermentation Tube ~_.xMem bran e Filter Lab Ref. No. Result' i LJ CT-] LJ ~ I ~ Analyst BACTEF4 IO LOG ICAL WATER ANALYSIS RECORD READ INSTRUC liONS COLLECTING SAMPLE Membrane Filten Direct Count Final Membrane Filter Resu ts Reported By BGB Date Time: 'TNTC= Too Numerous To Count /%Sunicipality o¥ Anchorage P.O. BOX 6650 ANCHORAOE, ALASKA 99502-0650 (907) 264-411~ tONY KNOWLES September 3, 1985 James B. Roberts, P.E. 360 West Benson, Suite 207 Anchorage, Alaska 99503 Subject: Waiver Request(WR85-022), Lot 13 Block 2 Talus West Subdivision Dear Mr. Roberts: This department hereby grants a waiver to 96.7 feet between the existing well and septic tank on the subject lot. This waiver is valid for a three(3) bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw IVJUNIClPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT OF H~A1TH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT .... 825 L Street- Anchorage, Alaska 99501 ~IRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION JUL 6 1979 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~[;~ ~-'VJ ~SL~ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1, PROPERTY OWNER PHONE Equibable Relocation (Pinzone) MAILINGADDREES SRA Box 1583-M Anchoraqe, Ak 99507 PROPERTY RESIDENT (If different from above) 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS PHONE 344,9290 PHONE 4. REALTOR/AGENT PHONE 277~553 Jack White Company (Elliot Lawson) MAILING ADDRESS 3201 C Street Anchoraqe, Ak 99503 5. LEGAL DESCRIPTION Lot 13 Block 2 Talus West ;TREET LOCATION Talus Drive 6, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other__ :~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY ~ INDIVIDUAL* * ATTACH WELL LOG. A well Icg is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach Icg if available.) 8, SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** **If individual/on-site, give installation dat.e unknown If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) ~j '.~ ~,~_~_~¢,.' · / THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME CATE DATE CATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1; TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE CATE INSTALLED [~PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size:~[-O ,.I,f Tank is homem3de . SOILS RATING TYPE OF TANK ~ · MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Abserption Area Sewer Line I Nearest Lot Line WELL TO: _ Absorption Area to nearest Lot Line 5. COMMENTS [] CONDITIONAL APPROVAL (letter must accom)~ny~certificate) [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev. 3/78) July 13, 1979 Elliot Lawson % Jack White Company 3201 C Street 2~chorage~ Alaska 99503 Subject~ Lot 13 Dlock 2 Talus Wast Subdivision Al~prova! for the individual sewer and water faeiliite~ will not be granted until tho following items have been completed: ~ The wa~er analysis report be ~[elivered to this office from Chem Lab~ 5633 B Street, for our review. (2) ~A3) The s~p~ic tank be m~ped with a receipt submitted Co this office. A p~rcolation test be performed on the existing leao~ng area. This will determine if the system is adequate a~eording to National Standards° A list of private firms who perfo~ the test is enelose~. If there are any further questions~ please contact this office at 264-~4720, Sincerely~ RObert C. Pratt, Associate Specialist RCP/ljw ~.~IClPALITY OF ANCHORAGE ~-~" DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-22_21 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES June 29, 1979 1. Type of lnspectioni CMRO V~A FHA CONV XXX 2. Property Owner: Equitable Relocation (Pinzone) Malting Address: SRA BOX 1583-M, Aneh. 99507 3. Name of Buyer: Just listing...no buyer yet Mailing Address: 4. Name of Lending Institution: Just listing 6Z t 0 qnr' Mailing Address: Phone: 5. Name of Real{or or Agent: Jack White Company (Elliot Lawson) Mailing Address: 3201 C Street, Anch. 99503 Phone: 277-1553 Legal Description: Lot 13, Block 2, Talus West .............. Location.~~O~ ~aZ~ Drive....take~u~'man Rd. to Wilderness Dr. a~d'~-"~ [ left into Talus West Sub ..... go to Talus Drive and turn right) ~ .... home is on right hand side of street. / 7. Type of Facility to be Inspected: $ipgle-family residence No. Bdrms. 4 8. Water Supply Type of Supply: Public Utility .individual If Individual, number of dwellings presently served one If Individual, depth of well unknown 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) X.Xif If Individual, date of installation unknown NOTE: PLEASE CONTACT ELLIOT LAwsoN FOR ACCESS TO HOM~ AFTER JULY 8... ALSO PLEASE DIRECT ALL CORRESPONDENCE TO ELLIOT LAWSON AT JACK WHITE COMPANY. Many thanks .... 72-003(3/76) July 9, 1979 Jack %~ite Co. 3201 "C" Street Anchorage, Alaska Attention: Elliot Lawson MUN;CIPAUTY OF ANCHORAGE DEPT. OF U,~ALZ'd & ENVIRONMENTAL p~oTECT[Ob~ JUE 1 M g7g RECEIVED R&M No. 951224 Re: Adequacy Test on Existing Sanitary Sewer System; Lot 13, Block 2, Talus West Subdivision, Anchorage, Alaska Dear Mr. Lawson: Per your request of July 2, 1979, we conducted a test of the sanitary sewer system on the above described property. During the test the liquid level in the seepage pit was monitored as 750 gallons were removed and 600 gallons were pumped back into the seepage pit. All liquid levels were measured below the top of the standpipe and are shown in the following table: Initial 24 hour Total Reading Reading Drop 6.2' 11.6' 5.4' The average specific capacity is 11.7 gallons per inch based on two sets of readings showing 13.3 and 10.0 gallons per inch. After twenty four hours the liquid level was measured again at 11.6 feet. It had dropped 5.4 feet or 64.8 inches. This indicates an average effluent acceptance rate of 758 gallons per day for the surrounding soils. If the 4 bedroom residence on the property is to house 8 people, the average load on the system can be expected to be 600 gallons per day. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 4 bedroom residence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours, R&M O~NSULTANTS, INC. Pro jrt Manager NG, "')tELEPHoNE CHEMICAL & OEOLOOI0AL LABORATORIES OF Ai.A~KA~ I ~ i (0o7) 2794014 P.O. BOX 4-1276 ANCHORAGE. ALASKA 99509 4649 BUSINESS PARK RLYD. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER i.D. NO. Mailing Address ~ .: City State "'% Zip Code ! SAMPLE DATE: ~ ~ ~ MO. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose LOCATION / .... ~? ~' *~ [] Treated Water [] Untreated Water Time Collected Collected By TO BE COMPLETED BY LABORATORY SAMPLE NO. I 3 I 4 I 5 LABORATORY: NAME A RES CiTY Date Received "~ ~/-~ Time Received ,/~ Analytical Method: [] Fermentation Tube ~hT' Membrane Filter Lab Ref. No, Result* J ~ ?? ,06-1220 (b) Rev. 1978 Date Collected READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18-310 (3-78) Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD~' ' 10mi Tubes pos]tire/Total ~.Oml Portions July 9, 1979 R&M No. 951224 Jack White Co. 3201 "C" Street Anchorage, Alaska Attention: Elliot Lawson Re: Adequacy Test on Existing Sanitary Sewer System; Lot 13, Block 2, Talus West Subdivision, Anchorage, Alaska Dear Mr. Lawson: Per your request of July 2, 1979, we conducted a test of the sanitary sewer system on the above described property. During the test the liquid level in the seepage pit was monitored as 750 gallons were removed and 600 gallons were pumped back into the seepage pit. All liquid levels were measured below the top of the standpipe and are shown in the following table: Initial 24 hour Total Reading Reading Drop 6.2' 11.6' 5.4' The average specific capacity is 11.7 gallons per inch based on two sets of readings showing 13.3' and 10.0 gallons per inch. After twenty four hours the liquid level was measured again at 11.6 feet. It had dropped 5.4 feet or 64.8 inches. This indicates an average effluent acceptance rate of 758 gallons per day for the surrounding soils. If the 4 bedroom residence on the property is to house 8 people, the average load on the system can be expected to be 600 gallons per day. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 4 bedroom residence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours~ R&M ~NSULTANTS, INC. Proj~t Manager JACK BENNY'S AND ANCHORAGE CESSPOOL PUMPING STAR ROUTE A, BOX 144 ANCHORAGE, ALASKA 99502 PHONE 344-2632 OR 349-1131 ~r. Elliot Lawson e/o Jack White Company 3201 "C" Street Anchorage, AK 99503 6/25 Invoice #11565 ~ Mr. Pinzone paid on: 7/3 Received on account 51.00 7/10 Invoice #111~4 45.00 Lot 1> Block 2-- Summit Estates 51.O0 STATEMEb4T 51.00 45.00 JACK BENNY'S AND ANCHORAGE CESSPOOL PUMPING