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TALUS WEST BLK 3 LT 2
Talus West. Block Lot 2 #015-201-53 Municipality of Anchorage e,,'' 6.11, Development Services Department 5r yam: Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 'Z www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: Sw O Yd yZq PID Number: 015 -Z01 -S'_1 Nam. Doncrld Re�cQ Wastewater System: y [I New ®Upgrade bb.a' 11991( &11ldernalr Drive 99S -1e ABSORPTION FIELD Ph" NumDM aB",xxne. 68 9 - 2 V 6� y 9 Daap Trench O 5"110 Twnch 0 Ba° o Moura o olfw LEGAL DESCRIPTION SW Raang G �• V GPDIFtt T" D"M hm or9ml prM 12.91 FI. lei c LN - Sec 'ws 3 2 Tom* I w z4l�.r t Daph W Fpm honam tram ongnal wa 5-.3 Growl gaph a MII ppe -7.1 Ft. Ft To.nMvp Rarpe Sw m. F11 agae° Mxhro or9nM boas G.av LMph� 1.0 Ft. If y Ft. • Welt [- Xrs f E3 New El Upgrade C faith h �' N,ah of 1Dl.lr <. »"w« In.. S Ft. I FI cwsL lg (P.Me. A a, c). Tdtl DlFft caws to TOWahWrPi w*&. P99 Mal" r^.StQ nE/f FI. Ft 766 F2 D-3034/ No.^ -e -e Dr,IM. OMe Dmlea SWM W01M l." MMallw.. A+ DMe hslM wt I Ft 10/2G/6y Yr P.mP SM M. caMrp Nag" nhuw G.Illxks. TANK TANK ?o GPM FI. FL S7- SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To I Septic Absorption Lit Holding uDIIHPnvate M.%dwww aPwty From Tank Field Station Tank Sewer Line Gr Wa 1030 1216 — — > 2s/ la. r Nulger of co.Wlwns. Sufao.WalM > 1CC' > tL,ar — — LIFT STATION n►, /� WLM 33t 1v — — se Gal aM FouMMpn 3 Z s ' SS — -. 'Poop ori Mvel M. •P,Rp WMv.l M Nigh valW rrm r. h h N. Dutrn Dren — — Pump Make 6 Mogul Ebaral hfpWwne ptnpmM W Rerlurk. / BENCH MARK r Lorilwn rho DeNrow. % un r },•-!nC /T li+G! JfG tm c do $ IG/a N C'V 1-01 (FQner i+un eri tdAnze 4&1r..'e As.ume0 Nw4on. fore) Gr 451C hcc,-rg IOG,4:�Fl. Irl 2i+ hon Engineer's Stamp OF ,pl000�a 1111,• ,�y� ���z�•,,, • ��0. Inspections performed by: TaCA Ct-c Dates: 1M 1G/ 26/ ay 'I b �y: r 11 TM 2n°_tG1).....0...0.0.0.0....... Development Services Department Approval s• Reviewed and approved by: Date:q��� it THEODORE F. YOOgE. =hoot -`1JT,� G< \1.� o..�CoVoa �3 or\y� �al it CE -3589 M� ••. /1� . Q' �a`'^ 6.1.4' '�d3sR J au�.W .•avlw•w \t� t/VJTvt7�V UAL s• ._�.. a.Y�..-a. PERMIT NO: SW040429 PAGE 2 OF 2 ' PID NO: 015-201-53 „H.. , SWING TIES: FROM: COR. "A" COR. "B" COR. "C" TO: NEW 54-FOOT LONG VALVE"E" 50' 47.5' r� SOIL ABS. TRENCH TR. C.O. "F" 72' 60' 65' G" • w. 7.1' EFF. GRAVEL TR. M.T. "G" 82' 55.5' TR. C.O. "H" 107.5' 60.5' ' ` T.H. «F.. #1 TBM 1 100' LOG CRIB SEEPAGE PIT 'BULL RUN" \ DIV. VALVE PLAN VIEW SCALE: 1" = 30' NEW 54 -FOOT LONG SOIL ABS. TRENCH w. 7.1' EFF. GRAVEL CROSS-SECTION SCALE: 1" = 5' EXISTING SEPTIC TANK 1 „q„ f:14, LOT 2 BLOCK 3 ELEV J 98.7- , 1, 1, „ „ „ „ INV. 91.4' i € 11 1 , iiEiii Ti� 11 { ,1 1, ELEV. 84.3' BOT. T.H. #1 ELEV.77.2' M.T. DRY 10/26/04 PLAN VIEW SCALE: 1" = 30' NEW 54 -FOOT LONG SOIL ABS. TRENCH w. 7.1' EFF. GRAVEL CROSS-SECTION SCALE: 1" = 5' EXISTING SEPTIC TANK 1 „q„ f:14, LOT 2 BLOCK 3 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Oct 12, 2004 Expiration Date: Oct 12, 2005 Permit Number: SW040429 Parcel ID: 015-201-53 Legal Description: TALUS WEST BLK 3 LT 2 .' Design Engineer: 0019 Flattop Technical Services Site Address: 011986 WILDERNESS DR Owner Name: DONALD REED Lot Size: 18230 SO. FT. Owner Address: 11986 WILDERNESS DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516-0000 This permit Is for the construction of: ❑; Disposal Field ❑Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. Date: Issued By. ala�� Date: %e//L /oy Municipality of Anchorage • Development Services Department Building Safety Division / On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. /1/5 - pig/ - 53 Permit Number SW Property owner(s) Don r3eeep( Day phone Mailing address (1) 119b6 &1,le:PPr1)err Derr -e ZD Mailing address (2) Anchc nn%po A Zip Code 99s�G— ZZ 3� Legal description (Lot, Block & Sub'd.) l of 2, 6/oc4 3,, 771 /Uf u -"--rt SIL) Legal description (Section, Township & Range) Lot Size /9, ;7_aq Acr q.F THIS APPLICATION IS FOR: Number of Bedrooms `/ Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade R THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: H60 '0 Waiver Fees: Date of Payment: 10/7/03( Date of Payment: Receipt Number: 5019 FA Receipt Number: (Rev. 12100) 421b ( 1 ,FLATOP`TEGHIGAL�_SER GES` CIVM & ENMONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345.1355 October 6, 2004 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: ANCHORAGE, ALASKA 99516 The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 2, Block 3, Talus West S/D. A soils log, pert test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil log, the native material between 5.75 and 13 feet below ground level is a somewhat silty sand with a measured pert rate of 7 minutes per inch. Using the soil application rate of 0.8 gpd/sq. t. specified in the wastewater ordinance, this 4 -bedroom residence requires a total absorption area of (4 x 150)/0.8 = 750 square feet. The proposed 54 -foot long trench design with an effective gravel depth of 7 feet has a total absorption area of 756 square feet. The topography of the lot in the area of proposed construction is level. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space -surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. LOT 29 , LOT 28 -� NEW SEPTIC SYSTEMIN / THIS AREA/ EXISTING SEEP. PIT SEPTIC LOT 30 SYSTEM j a LOT 3 CONSTRUCT NEW 54 -FOOT LONG SOIL ABS. TRENCH w. T EFF. GRAVEL T.H. - 100' 7#1 W�A' iii...0l SEPTIC TANK • SEPTIC SYSTEM o SEPTIC SYSTEM -WELL bl / TRAVERSE WAY Q � � i tee" LOx t a/ r 'BLOCK2 OUSE i' SEPTIC SYSTEM LOT 2, BLK. 3, TALUS WEST SID % SEPTIC SYSTEM UPGRADE 49 m i •: * SITE PLAN «/........................... / -------- -- }/�"�^�.;�;�.•,ry�; % FLATTOP TECHNICAL SERVICES 1INCH =50 FEET A :• THEODORE F. MOORE : ,ice 14530 EC110 STREET DRAWN BY TFM :, CE - 3589 ,J� �cAr ANCHORAGE, ALASKA 99516 ,SEPTEMBER, 2004 0^ �� 4VNOTE: THIS IS NOT A SURVEYED PLAT. ,lk � f s%O ALL LOCATIONS SHOWN ARE APPROXIMATE. 54 -FOOT LONG SOIL ABS. TRENCH „A„ w.7.0' GRAVEL BELOW DIST. PIPE 4" DIA. F$10 PERF. M.T. 4" DIA. D-3034 NON -PERF PIPE FROM NEW "BULL RUN" VALVE AFTER EXISTING SEPTIC TANK 54 "All Lom. PLAN VIEW SCALE: 1" = 10' MONITOR TUBE MOUND BACKFILL 6" GROUND FABRIC 13 i:'i>:::::::. 4" DIA. F-810 PERF. PIPE 7.5 7 1/2.-210 SEWER GRAVEL ".i BOTTOM OF EXCAVATION CROSS-SECTION "A"= "A" SCALE: 1" = 5' C.O. .L�dC4k ^� OF AL�Oc THEODORE F. MOORED CE -3589 0 0 � FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 [EST HOLE # 1 SOILS LOG — PERCOLATION TEST LEGAL DESCRIPTION. _Lot 2 Block 3, Talus West S/D DATE PERFORMED: _September 24, 2004 PERFORMED FOR: Don Reed DEPTI (feet) Reading Clock Time PL t 12" Presoak Reddish sandy loam 2- 12" Resooak _ _— 22 12 - 27_314 3 Start_ 11:57:30 1 � #1 _ dk7water 12:27:30 12:28 GM Gravelly, very silty sand 4- water12:58:30 30 18 5/8 7/8Add 23 318_�-- 5- #3 1:28:30 7/8, � -_ 51/2— 30 2 6- -17 7 - T T 6 " SM/SP Gravelly somewhat silty sand " = Pockets of GP, ML Becomes cleaner and more uniform below 9.5' 10 Depth to Groundwater Date tt f�Goundwate� 924/04 Monitor tube dry 170/1/04. LC 12 13- . c ('�� OF A ......................� ....;.. is . THEODORE F. MOORE 5 " '• CE -3589 i f! C SITE PLAN 0% Date Reading Clock Time Net Time Percometer I Net Drop (minutes) Reading (inches) 924 12" Presoak 2712 12" Resooak _ _— 22 12 - 27_314 Start_ 11:57:30 1 � #1 _ dk7water 12:27:30 12:28 — _23318 30 _173/4 _ 55/8A .231/2__1258 #4 water12:58:30 30 18 5/8 7/8Add 23 318_�-- #3 1:28:30 7/8, � -_ 51/2— 30 2 -17 - T T 20 � I` PERCOLATION RATE —7 (minutesliinch) PERC HOLE DIAMETER -_ 6"__ - TEST RUN BETWEEN 7.5 FTAND 8.0 FT COMMENTS: -Design_upgrade ogbasis of 0.8 gpd/sq..fL_betw, 5.75' and 13' b.g.t. PERFORMED BY FLATTOP TECHNICAL SERVICES. I A� " "+±.t, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: to Tfattop 7echnicaCSen*,es 14530 Echo Street, Anchorage, Ax 99516 Thone (907)345-13S5 Lot 2, Block 3, Talus West SID 11986 Wilderness Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installing a "Bull Run"diverter valve downstream of an existing septic tank and constructing a 54 -foot long soil absorption trench with a total of 7.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 Unless agreed otherwise, the contractor shall be responsible for any tree clearing and grubbing necessary to complete the project. Prior to the start of excavation, the contractor shall cut down and remove the branches of all trees larger than 6 inches in diameter and neatly stack these trees outside the construction area. If requested by the property owner, the contractor shall then bury non -detrimental branches, brush and roots generated by the construction work at a suitable site on the property located no less than 10 feet away from all present and foreseeable construction areas. The contractor shall neatly stockpile any detrimental material which cannot be buried, for subsequent disposal by the property owner. 1.5 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.6 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tank may be retained in service since it is only 6 years old. A "Bull Run" diverter valve shall be installed downstream of the existing double cleanout after the tank and plumbed to allow future reconnection to the original log crib seepage pit. 2.2 The waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 54 -foot long trench to a depth of 13 feet below ground level. The long axis of the excavation shall parallel an existing contour 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 7.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 7.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. 3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A total of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. Municipality of Anchorage Page I of Z_ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S W 9 8 0 2 ZS PID Number: O/S - ZO/ -S 3 Name: Pafr,G I a_ .S�n e Wastewater System: ❑ New 19 Y Upgrade Address: 11986 W,lo<aroeCr 0r; Anc6 95-16 ABSORPTION FIELD F 4sr. Phone: No. of Bedrooms: Sys - 77),5"Y I Al O Trench ❑ Shallow Trench ❑ Bed ❑ Md ❑ Other LEGAL DESCRIPTION Soil Rating: Total Dept om original grade: GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from origd Rravel depth beneath pipe 3 Or t as lvef Ft. Township: Range: Section: Fill added above original gr el length: Ft. Ft. WELL: EXf,ST' ❑ New ❑ Upgrade Gravel width: Number of line. Distance between lines: FC Ft. Classification (Private, A,B,C): Total Depth: Cased T ota so: Torption area: Pipe material: FL Ft. gn Ft Driller: Date Drilled: Static Water Level: Installer: ^ * 4 Date installed: %�/6 �9C/ Ft. Yield: Pump Set at: I Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ® Septic ❑ Holding O S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer:Capacity in gallons: From Tank Field Station Tank Sewer Lines /`fnctior R a Tank I eso Welh Joe f Material: S�CC1 Number of Compartments: Surface >100, LIFT STATION rv.,4, LotSize ^ $O' in gallons: Manufacturer: Line Foundation30 1 n "Pump on" level at: "Pump off' level at: High water alarm at: Curtain Pump Make &Model Electrical Inspections performed by: Drain Remarks: pr, ,nal Sep& ar,nk �> {a BENCH MARK /7ea< g iccce, Location and Description: hack r ru et6analoncue ,n 7ftreShOle o,f rilao in P Ort/ u� a /)tw u.,b/¢ c.o Luq 62 Tr/ O Assumed Elevation: leo. 90 Ft /� / eel J2n%c '%,nk- lee / ENGINEER'S SEAL IA.Cit,/lcc -fkrfo n uc wr'�j / ,raj" 281 r rf'b1Lte- 07 Inspections performed by: 1=1aFZ&P Tec/' S'k-c Dates: 1st 7/10 /1 2nd— nd y 4 Department Department of Hea i and Human Services approval Reviewed and approved by: Date: 7-22 c 72-013 (Rev. 9/91) MOA 25 PERMIT NO: SW980225 PID NO: 015-201-53 PAGE 2OF2 SWING TIES:/48'PIT "'_- FROM: COR. "TO: "C"31.5'ISTING "D" 34'G CRIB "E" 42'EPAGE "F" 46' O INV - 93 6' NV93.6' FROM HOUSE DOUBLE C.O. NEW 1250 GAL. SEPTIC TANK PLAN VIEW SCALE: V'= 30' GROUND ELEV. 97.2' 2" RIGID INSULATION 1250 GALLON SEPTIC TANK PROFILE VIEW SCALE: 1" = 5' LOT 2 BLOCK 3 WELL '��•OF•A !44 49 TH r . .................... % THEODORE F. MOORE IN To �'i4io '•, CE - 3589 93.4' SEEPAGE 4 ill .. sees-, PIT ,1\ �,fesslDnN 1 tvPt C.wr/ MUNICIPALITY OF ANCHORAGE bnL - -01 Department of Health and Human Services On -Site Services Program f1o�l 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW980225 Legal Description: TALUS WEST BLK 3 LT 2 Date Issued: Jul 09, 1998 Expiration Date: Jul 09, 1999 Parcel ID: 015-201-53 Design Engineer: Flattop Technical Services Site Address: 011986 WILDERNESS DR Owner Name: Patricia Stone Lot Size: 18230 SQ. FT. Owner Address: 11986 WILDERNESS DR Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516-2238 This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ASI construction must be in accordance with: 2. The attached approved design. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska 3, Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling 4, (907) 343-4744 (24 hours ). ( Not required for a Water Supply Permit only ). From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. ReceivedBy: �J1��c>ra Ft�'�lon 1 C ci- c��cn� Date: 7 Tl Cl Issued By: Date: 7- 9- 18 CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 June 30, 1998 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: 14530 ECHO ST. ANCHORAGE, ALASKA 99516 By means of this wetter we are withdrawing our request dated June 3, 1998 for a waiver allowing the existing septic tank serving the 4 bedroom residence on Lot 2, Block 3 Talus West S/D to remain in its present location. The property owner now wishes to abandon that original septic tank and install a new 1250 gallon septic tank at a location outside the 100 -foot protective radius of her well. A site plan illustrating the proposed work and specifications are enclosed for your review. To simplify accounting on this project we have paid the $320 sewer upgrade permit fee, and are requesting that the $625 waiver fee be refunded. The $320 HAA fee that we paid should be applied to the HAA that is to be issued after the new tank is installed. The topography of the lot is generally level. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space -surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. LOT 29 NOTES: ABANDON EXISTING 1250 GAL. SEPTIC TANK. INSTALL NEW SEPTIC TANK OUTSIDE 100' WELL RADIUS. EXACT CONFIGURATION OF EXISTING LOG CRIB UNKNOWN. PLUMB SEPTIC TANK DISCHARGE LINE INTO TOP OF PIT. ALL MATERIALS AND WORK SHALL COMPLY W. M.O.A. CODE CALL TED MOORE @ 345-1355 FOR INSPECTION(S) \ I / I OT 78 SEPTIC " 0 SEPTIC SYSTEM LOT 30 TIE IN TO a EXISTING LOG CRIB INSTALL SEEPAGE PIT DBL. C.O. ABANDON" N,' EXISTING 1250'6ALLON S,EOTIC TANK I I 0 G 2% 0 WELL F "'A <u LOT 2 a/ BLOCK 3 w�/,---- WELL _ TRAVERSE WAY III OF A4.14� ' 49 T" ••'�•;9 �j ' ...........f........ / ------- THEODORE F. MOORE I� CE - 3589 .I �a'of¢ssio°�� 4 LOT 1 BLOCK I ` HOUSE I SEPTIC SYSTEM LOT 2, BILK. 3, TALUS WEST S/D SEPTIC TANK REPLACEMENT SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 JUNE, 1998 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIN Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345.1355 Lot 2, Block 3, Talus West S/D 11986 Wilderness Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of abandonment of an existing 1250 gallon septic tank and installation of a new 1250 gallon septic tank. 1.2 Construction shall be as depicted on the approved site plan. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tank must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1250 gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil at a location greater than 100 feet from all private wells. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 2.4 The exact configuration of the excavation for the existing seepage pit is unknown. The contractor shall excavate as necessary to ensure that the location of the new tank is at least 5 feet away from the existing seepage pit. The ASTM D-3034 discharge line from the septic tank shall be plumbed into the top of the log crib seepage pit. 3.0 Inspections: 3.1 A total of 3 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the new tank is set level and the piping connected, but prior to backfill, and (3) after rough backfill and grading is complete. 3.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. --- GREP CR ANCHORAGE AREA BOR' 'IGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME UrOP/f/ 3C-O/r-5 MAILING ADDRESS '!��A� 160 ' a30 PHONE LOCATION LEGAL DESCRIPTION /oi Z 15LU C./C .3 T�uS (Uaj SEPTIC TANK: DISTANCE . NUMBER OF FROM WELL MANUFACTURER S7 S7Z54?�Z- MATERIAL STCEL_ COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /.9 � 0 GALLONS. SEEPAGE PIT: / 9/ X 26 / NUMBER OF PITS / DIAMETER OR WIDTH_, LENGTH_, DEPTH LINING MATERIAL 4C°f A4tfCRIB SIZE: DIAMETER_DEPTH !CDISTANCE FROM: WELL BUILDING FOUNDATION_, NEAREST LOT LINE .J/ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 8/0 SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE XA,60/0- CONSTRUCTION / ! DEPTH DISTANCE FROM: BUILDING / FOUNDATION NEAREST / LOT LINE NEAREST SEWER LINE 0 / SEPTIC /f- TANK » SEEPAGE SYSTEM CESSPOOL OTHER SOURCES APPROVED ✓ DISAPPROVED REMAR DISTANCES: INSTALLED BY: �ZAPPr- EKG. PIPE MATERIAL: C'457_T20AJ LOT SLOPE: REMARKS: :nY,5't74i.� CLEiVnIOKT 0A/ P/T DIAGRAM OF SYSTEM DATE Zo-a3` Gp L APPROVED G.A.A.B. Form No. EQ.031 - � - '2- Z_ 5w1/y M -W DRILLING, Inc P. O. Box 4-144 • 1310C International Airport Road (907)274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner ?stc boar-rrr Use of Well "'- Location (address of: Township, Range, Section, if known; or distance main Size of casing Depth of Hole 11 F feet Cased to 11 feet r� Static water IeveL��t. (a'bobe) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforation Well pumping test at if gallons per (hour) (minute) for_ hours with 1`' ft• of drawdown from static level. Date of completion a 74 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness O TO�� Sandi F.raYel --!—To 68— �/4I1�4y 6rati-1 To 72 Df., w�. r— ,• = 96 SPOLII GrAval T0��5 Aed,i.u_a Cro,vall sand, mal fa sa4 TO TO L. 2 —STATE ` GREAT R ANCHORAGE AREA BOROUGH I�^1O++oe 4 DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 1\,\Vlgl TELEPHONE 274-4561 �4¢e •� SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT ✓ ���/� //r�� / J�//�/Fi�-C MAILING ADDRESS V�• �L/.c F�d _ INSTALLATION LOCAT LEGAL DESCRIPTION PHONE INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FA FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED - TO BE INSTALLED BY ( (� X' NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZET TYPE ��- ` 6w" SEEPAGE AREA SIZE W TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK S / FOUNDATION TO SEEPAGE PIT � DRAIN FI SEPTIC TANK TO SEEPAGE PIT WALL 115- / SEPTIC TANK -9-, . SEEPAGE PIT C:5�0 / DR. TO NEAREST LOT LINE. / WELL TO SEPTIC TANK /OO SEEPAGE PIT. DRAIN FIELD A00 ALSO CONSIE WATER MAIN TO SEPTIC TANK A) / SEEPAGE DRAIN FIELD SEPTIC TANK, L , SEEPAGE PIT ,�DRP TO RIVER, LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC T, FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALL G.A.A O LICENSED DESIGNER 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE] APPLICANT'S SIGNATURE DIAGRAM OF SYSTEM TH-1 5-24-74 I--] ORGANICS V�/N SILTY SAND (SM) 11 1 GRAVELLY SAND SOME SILT, (SP -SM) ✓ Note: Test hole excavated with tractor -mounted backhoe PETE SPURGERS PROPERTY LOG OF TEST HOLE R Engineering & Geological Consultants Inc. ANCHORAGE ALASKA ANCHORAGE FAIRBANKS ALASKA JUNEAuFAIRBANKS ALASKA JUNEAU GATES -2 —74 ISCALE IDWN BY M_M_ ICHKD BY WFn I PROJ. NO. Lim n II InWG NO. A-nl e Q.. i 5.0 \ UUU�w SAND,.TRACE SILT (SP) SJ f 8.0' p., SAND, SOME GRAVE (SV) ti2� •'G : 9.5' o.% SAND, TRACE GRAVEL & SILT (SP) 12.5.'TD NO WATER TABLE Note: Test hole excavated with tractor -mounted backhoe PETE SPURGERS PROPERTY LOG OF TEST HOLE R Engineering & Geological Consultants Inc. ANCHORAGE ALASKA ANCHORAGE FAIRBANKS ALASKA JUNEAuFAIRBANKS ALASKA JUNEAU GATES -2 —74 ISCALE IDWN BY M_M_ ICHKD BY WFn I PROJ. NO. Lim n II InWG NO. A-nl ViW JR&M tN(�NttKINU & UtULUUK ,\L I.VIVJULIAN IJ k _ 229 EAST 51st. AVE. — P.O. BOX 6087 — ANCHORAGE, ALASKA 99503 N TELEPHONE 907-279-0483 TELEX 090-35419 "Civil Engineers Geologists Land Surveyors JAMES W. ROONEY, P. E. RALPH R. MIGLIACCIO MALCOLM A. MENZIES, P.E., L.S. Engineering Geologist JAMES H. WELLPAAN, P.E. R),,6F1VF:1) May 28, 1974 Mr. Pete Spurges SRA Box 230 Anchorage, Alaska Nvim GREATER ANCHORAGE AREA BOROUGR DEPT, OF ENVIRONMENTAL QUALITY R & M NO. 462033 Re: Test Hole and Soil Log Report for Sanitary System Lot 2 Block 3 Talus West Subdivision Dear Mr. Spurges: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of May 24, 1974, and those procedures outlined in a letter dated September 13, 1971 by Mr. Rolf Strickland of the Greater Anchorage Area Borough Depatt- ment of Environmental Quality. A single test hole was put down within the Lot 2 area for the purpose of defining general subsurface soil 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 12.5 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M ENGINEEERRIINNG & GEOLOGICAL CONSULTANTS, INC. James JWR:kd xc: GAAB ANCHORAGE FAIRBANKS JUNEAU Municipality of Anchorage • Development Services Department Building Safety Division Y +. On -Site Water and Wastewater Program ` 4700 Bragaw Street SA `T' P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. OrS'- tot - S-.3 COSA# o I % 1. GENERAL INFORMATION Expiration Date: 9 - I I - © R Complete legal description _1-vf 2 d3iec% 3 - To./ccr Cy4f Si Location (site address) 119bf* Uljleee�l)arxu D. - Current Property owner(s) _Drtn R red Day phone _ 2 - Z91 ? Mailing address Lending agency Mailing address Real Estate Agent Mailing Address logo d encA Gfy y3� vfVe /► k 99s"oy Day phone Woner'. S. 8. Ge r'. S. 8. G. Day phone Unless otherwise requested, COSA will be held by DSD for pickup. Pis C� r• own «@ & 6 t -29 �2 2. NUMBER OF BEDROOMS: _A� `"y"' Corp ^¢"``y 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site X❑ Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. 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, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Fac. Ho Te c4 A( cu/ S V" Phone 3 •+s- �3ss' Address tYs340 F'c6o 6Q-_yo� Ray. f-ncyi _92S2 Engineer's Printed Name 'Th vo c�o-t° E. n to -,e Date Tine S, 200 5. DSD SIGNATURE Approved for Disapproved. 4 bedrooms. s n ct 1— i A'S s . THEODORE F. SOC "�' cc•3se� Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory NKUUKAM "111111111111 Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. ell� Original Certificate Date: Co - I ( - 0,2 (Rw. TIAS) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program , 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: l-ut 2. Q fack3 'Tc=/W Luvf CKD Parcel ID: 0 IS'- Z01 - A. WELL DATA Well type PV t If A, B, or C provide PWSID # _ Well Log (Y/N) N Date completed -0-7 y Sanitary seal (Y/N) _Y Wires properly protected (Y/N) Total depth 1/ 6 ft. Cased to 7 ft. Casing height (above ground) - V e in. FROM WELL LOG AT INSPECTION Date'of test �'/ Zb / a& Static water level ft. 69' ft. Well production g.p.m. 7.a •t- ' g.p.m. WATER SAMPLE RESULTS: 40.! Coliform _12_colonies/100 ml- -Nitrate AW mg/L Other bacteria O colonies/100 mL le: 5126/4+6 - Arsenic: «_�Smy/I Date of sample: ,Collected by: _ Flal`/�o i euG' Sc'c B. SEPTIC/HOLDING TANK DATA Tank Type/Material S%ep Rc / Sfai/ Date installed 7/ 16 19,S Tank size I Zs'o gal, Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) Al. Date of pumping 61f /06 Pumper A t C. ABSORPTION FIELD DATA Date installed Ie,/ 26/oy Soil rating (g.p.d./f? or fe/bdrm) O.b .4POr/ System type 7-re"c4 L Length XY ft. Width Z•S' ft. Gravel below pipe 7. / ft. Total depth 82. Y ft. Eff. absorption area 766 ft? Monitoring tube Y Depression over field _l0 Date of adequacy test S-/ 109 Results(Pass/Fail) Pc-cr For 451 Fluid depth In absorption field before lest _0 in. Water addedL.!gal. New depthZ& in. Elapsed Time: 20 min. Final fluid depth 13 Vk In. Absorption rate >= 600 g,p.d, Any rejuvenation treatment (past 12 mo.) (Y/N &type) Al If yes, give date N. of., D. LIFT STATION Date Installed Size in gallons Manhole/Access (YIN) "Pump on' level at _ in. Datum E. SEPARATION DISTANCES "Pump off" level at _in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot _-Le) Absorption field on lot 12-J" Public sewer main N. A. Sewer /septic service line" Animal containment areas N• A. On adjacent lots 100 On adjacent lots ? I00 Public sewer manhole/cleanout N• A . Holding tank N• h . Manure/animal excrete storage areas N• A. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 3 Z r Property line 33' Absorption field 30 Water main N. A. Water service line > 16' Surface water > two Wells on adjacent lots > 100 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I2' Building foundation r XX; Water main N• /�. Waley Service line 7 ra Surface water r 61 Driveway, parkingtvehicle storage >SO Curtain drain Wells on adjacent lots y tom' F. COMMENTS �ti' f rw G. ENGINEER'S CERTIFICATION 4 ` .. `�•"' -'� n I certify that I have determined through field inspections and r ,;; „ .....e..�.....:...pt review of Municipal records that the above systems are In / t conformance with MOA COSA guidelines in effect on this date. ✓ R/�`:,.......�... Engineers Printed Name Date til.cnc COSA Fee $ `A�� o� Waiver Fee $ Date of Payment t'; 16 106 Date of Payment Receipt Number 10 q n t? q F)m Receipt Number (Rev. 11/05) E; v A% �S \ 9R M 99 � k�) q \t§ is' .§<! ,. § PM /\ \) /{ F; / � E; SCS Rete 1082287001 Client Name Flattop Technical Srv. Project.Namem Lott Blk3 Talus West S/D Client Sample ID Lott DIk3 Talus West S/D Matrix Drinking Water PN'SID 0 Sample Remarks: Parameter Results PQL Metals by ICP/MS Arsenic ND 5,00 Waters Department Total Nitratc/Nitritc_N Microbiolow Laboratory Colony Count Total Coliform Fecal Coliform All Detes/1'imes are Alaska Standard Time Printed Date/rime 06/04/2008 13:38 Collected Daterrime 05/282008 12:10 Receired Date/rime 05282008 14:20 Technical Director Stephen C. He AOo%ahle Prep Analytic Units Method Container ID Limits Date Dau• Init usti EP200.8 C (<IO) 06/02/08 06/03/08 NRB 0.137 0.100 11181 SM204500NO3.r B<I0) ( 0529/O8 LCP 0 col/IOOmL SM209222B A 0 (<200)052W08 DLC col/IOOmL SM209222B A (<0 052WO8 DLC 0 col1100ml. SM20922211 A (<I) O52WO8 ULC Property owner Pafr)e(ef Sone Day phone 355'-7954/ Mailing address 11986' Dp-i e A'?C6, A(<- 99s-/45- Lending agency Day phone Mailing address Agent PcOd::414'ell IlLr?'t )T. E. Day phone 2 70 -7 2 23 Address H2y1 °I3 1 S� /}�charctge, ,11e 99�®3 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well >r 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: In on-site V 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.1191) Front MOAN21 - - 5 STATEMENT OF INSPECTION 13Y 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 ttie 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 Fle, AA- p %PcA ;ea/ S _ery i c ar phone T `yS - /3S'S Address / "/S 3 D Echa S�, fin CG orct .4 k .995 /,f Engineer's signature Date _fly 7 /99,�-- s 6. DHHS SIGNATURE --X_ Approved for Disapproved. 0 4 bedrooms. Conditional approval for Additional Comments bedrooms, with the following stipulations: Date %-22-?F 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 (flay. 191) Dnck MOA N 1 Municipality of Anchorage C C DEPARTMENT OF HEALTH & HUMAN SERVICE E C E I V E D Environmental Services Division rl 11'15 825 L Street, Room 502 a Anchorage, Alaska 99501 e (907) 3#tl,BL4ta 1998 Municipality of Anchorage Health Authority Approval Checklist Dept. Health & Human Services Legal Description: L 0 f 13locIr 2, Tc+/cv 14, r/' Parcel I.D.: 67 /.5-- 20/ — S 3 A. WELL DATA Well type PrI v o f e If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N) N Date completed ^ /9 7 Y Total depth Sanitary seal (Y/N) Date of test Static water level Well production 6' Cased to > Y0' Casing height (above ground) 32 " f: FROM WELL LOG WATER SAMPLE RESULTS: Wires properly protected (YIN) AT INSPECTION N G9, g.p.m. 57 7 FA Coliform 0 co/ I(oo MIL Nitrate G 0, / !77 1--e Other bacteria None ream &e ( Date of sample: S / 2"r, ( 9E Collected by: B. SEPTIC/HOLDING TANK DATA At Date installed 7/ 16/98 Tank size / 2_5-0 9Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) i Depression (Y/N) N High water alarm (Y/N) N• A, Date of Pumping N. A, ( Now) Pumper N. /t. C. ABSORPTION FIELD DATA r Date installed /D /23 /71/ Soil rating (g.p.d./ft2 or ftz/bdrm) 16 1 System type /,of 6rr3 Length 2 ri ' Width 19' Gravel thickness below pipe 9 j Total depth 11 ' Effective absorption area 810 Q' Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test I I / V / 941 Results (Pass/Fail) Pa-rf For Al bedrooms Fluid depth in absorption field before test (in.); 3s Immediately after7?9 gal. water added (in.): (1,S Fluid depth 59 i/,F (ins) Minutes later: /I I Absorption rate = > G00 g.p.d. Peroxide treatment (past 12 months) (Y/N) None Icnow n If yes, give date IN. A 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) _ High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / O c Absorption field on lot ^ 113 Public sewer main V-4, Sewer /septic service line "Pump off" level at* On adjacent lots > loo' On adjacent lots Public sewer manhole/cleanout Lift station A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation � 3 0 ' Property line — 30' Absorption field = S' Water main/service line >!O� surface water/drainage > /Oa 1 Wells on adjacent lots > / Go SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line i::= IG ' Building foundation = YO ' Water main/service line > la ' Surface water > IUo' Driveway, parking/vehicle storage area > s01 Curtain drain None SeP-) Wells on adjacent lots lGo' F. ENGINEER'S CERTIFICATION 1 certify that i have determined thru field inspections and review of Municipal records that the abdvessystems are in conformance with MOA HAA guidelines in effect on this date. Signature l a e*•t e.. ue>e�f cre •. Engineer's Name 7%¢oo�O�L F• i toGre V1 '� 0�4d 04e0— gb �pyy [ Date 76-1y7 1998c ,J VS �xcdc• .•l. HAA Fee $ 300 ao Waiver Fee $ Date of Payment 6'1' / 98 Date of Payment Receipt Number 0 3 e 77 / 2 Si Receipt Number 72-026 (Rev. 3/96)* •e Municipality of Anchorage REQUEST FOR VOUCHER CHECK FROM: Health & Human Services (DEPARTMENT) TO: MUNICIPAL CONTROLLER DATE: July 21, 1998 R 82275 I nw ar u I JUN run A"uuN I s HAYAULE USE ONLY 1099 VOUCHER REFERENCE N0, NO. INVOICE DATE PAYtAENT DT. V VENDOR N0. INVOICE N0. DESC CHECK NO. CHECK DATE PREP APPR REQUEST THAT A MUNICIPALITY OF ANCHORAGE CHECK BE ISSUED TO: Name Flattop Technical Services Address 14530 Echo Street Anchorage, Alaska 99516 2. THIS PAYMENT IS FOR THE Waiver Refund for Lot 2 Block 3 Talus West: a waiver of the on-site septic tank to the private well was applied for on June 4, 1998. However, the applicant choose to install a new on-site septic tank in place this outside the 100' protective radiuscof the private well. Therefore a refund of the waiver fee is required. No work has been performed on this property for the waiver portion. 3. DISPOSITION OF CHECK: (1) 3�NX MAIL TO PAYEE (2) ❑ MAIL TO PAYEE WITH ATTACHMENT (3) ❑ NOTIFY PAYEE TO PICKUP IN TREASURY Name: Phone #: 4. ACCOUNTS TO BE CHARGED: AUTHORIZED USE ONLY (6) ❑ NOTIFY DEPARTMENT EMPLOYEE WHEN CHECK IS READY IN FINANCE Org. H: Phone#: 5. TOTAL AMOUNT OF CHECK $ 625.00 6. SIGNATURES Employee - Phone No. Approving Authority - 7. INSTRUCTIONS 343-4744 a. To be used only when payment cannot be made by purchase order, travel expense report, travel authorization or petty cash. b. Must be approved by department head unless approval authority is delegated in accordance with Policy and Procedure 24-7. - c. Retain carbon copy for your file. 40-001 (Rev. 11/94) . e o « « $ - ® CD E # } \ CD \ 2 CD °90\ - § } / k � 2 � \\\ %L Ay \} ]} / ƒ 2 m m 2 = a \ ). ,� \\/ 2 k k \ CD (} \ - } , ! # ] ` } \ j. } � ) \ § 0 f f / \ 2 = \ c a \ c § ƒ 0 FL f } } \ \ x s 9 § \ /2 CD 9; -0 /C \ e z CD ! : 0 0CD / 2 � ± / . � \ m mm . m 222 \ (D =1 0 2 e= E m� m= m0 >& m:3 L q\\ �a {>» OW&z, 0f 020=/ ca— =. to m /> , 2 ,z m \ z w s » z m ( CD 2 � 0 f m� w w ,,,'MUNICIPALITY OF ANCHORAGE' Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# UILA01bOc24ID# 015-201-53 HA# Permit # h,__�PL Date Received: Juen 4, 1998 Legal Description: Lot 2 Block 3 Talus West S/D Engineer: Ted Moore P E Flattop Technical Services 14530 Echo Street Anchorage Alaska 99516 Applicant: Patricia Stone Waiver Requested: Well to on-site septic tank on property of 93 feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: i 2. Special Conditions: 3. Other: .�n a I A Waiver is Granted: �Q Weer ig NOT Grant d AU, n List Conditions or Reasor\vpo above: It `� A. e Imo+ Date: By: Name o Rec #: 03877/1259 Amount: $ 625.00 Date Paid: June 4, 1998 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. # 01.5 - ZO 1 ' S 3 " HAA #� 1. GENERAL INFORMATION Complete legal description I -Of 2 P/ocic 3 Ta fur Wer)- SID Location (site address or directions) Property owner Cc- fr c I c ,S /-W" e Day phone 3YS- �9Sy Mailing address 1196E Dr'/ve Lending agency tAll tC"C'`'"" Day phone Mailing address Agent ITevin Tc loe - Prc denhl t I/tl%zc Rea/ FrP Day phone 27-7 - 7 2 23 Address `'f 2y/ "13" Ef '+/)cA0/_q P ¢or 99503 Unless otherwise requested, HAA will be held for pickup. Lq , "-)-L) )-L 2. NUMBER OF BEDROOMS: y 3. TYPE OF WATER SUPPLY: Individual well Community well - Public water - NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site >r 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. See well-s'e/ih"c o- awer Name of Firm Ela NdP 7'echn era/ Serer; « Phone 3 Vs-- 13 Ss Address l wSZO Ec4o S�. /4�chv�ccgpy ,4 -cc Engineer's signature -T Date Ze".e 3. 1998 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments 0 bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/81) Back MOA 021 Municipality of Anchorage JUN 0 f9A98 • DEPARTMENT OF HEALTH &HUMAN SERVICE&,BNICIPAUTroFANcr1 Environmental Services Division ENVIRONMENTALSERVICES D 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: /_af 21 (jiGc �c 3 Tu/clWerf Parcell.D.: O/S 20/ 6-3 A. WELL DATA Well type Pr, oaf N If A, B, or C, attach ADEC letter. ADEC water system number N• A. Log present (Y/N) N Date completed 197V Total depth 116 Cased to 7 Yo' Casing height (above ground) 3 2 ' Sanitary seal (Y/N) Y Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test 1I /.( / 9 Static water level 69 Well production g.p.m. S• 7Y t g.p.m. WATER SAMPLE RESULTS: Coliform O Cc, (o�,er //oo m,F Nitrate 4 0. I m q / Q Other bacteria Mone Date of sample: S/ 26 / 99 Collected by: Flafkv Techn i ca / f� �1 B. SEPTIC/HOLDING TANK DATA Date installed ) 0 / z3/ -?Y Tank sizei �� Number of Compartments 2 Cleanouts (Y/N) Y Q) Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) N• A Date of Pumping 10 / 7 ( 2:7 Pumper C. ABSORPTION FIELD DATA Date installed /0/ Z3 /7H Soil rating (g.p.d./ftz or ftz/bdrm) 161 �r System type _ Cr b Seep. P;l Length 2 G' Width 19, Gravel thickness below pipe 9 ' Total depth 11' Effective absorption area 810 0' Monitoring Tube present (Y/N)'r Depression over field (Y/N) N Date of adequacy test 11 / N / 9 o� Results (Pass/Fail) Pe�_cr For `/ bedrooms Fluid depth in absorption field before test (in.); 3S Immediately after 729 gal. water added (in.): 6/. S Fluid depth 59 '/8 (ins) Minutes later: // / Absorption rate = > 600 g.p.d. Peroxide treatment (past 12 months) (Y/N) Al,, e Irnow If yes, give date N• A 72-026 (Rev. 3/96)` D. LIFT STATION V- A. Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: "Pump off" level at* Septic/holding tank on lot 2.3' CSee u aiver reo� On adjacent lots > tao ' Absorption field on lot n 113' On adjacent lots > /06 ' Public sewer main Sewer /septic service line _> ZS Public sewer manhole/cleanout Lift station N. A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 123 Property line x yS' Absorption Water main/service line 71v' Surface water/drainage > 10o' Wells on adjacent lots > r GO' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line w (0' Building foundation 5:�- KO' Water main/service line > 1 a ' Surface water > (C'o' Driveway, parking/vehicle storage area Curtain drain IV on e Seems Wells on adjacent lots '> rua F. ENGINEER'S CERTIFICATION l certify that I have determined thru field inspections and review of Municipal records thatthe above systems are in conformance with MOA HAA guidelines in effect on this date. See nett-se/5,hs;"war�ri..._reyu`f Signature %llwo- Engineer's Name T4 eo MoC re Date June 3 l 9 g f l� HAA Fee $ 3cr)/Gv Waiver 4s- 6 t/ Date of Payment / �Y Date of Payment Receipt Number 12 Receipt Number ,3 '7 7 ( / 2-s / 72-026 (Rev. 3/96)* �OP TCHNiCAL SER.: CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 June 3, 1998 M. O. A. DHHS P.O. Box 196650 Anchorage, AK 99519 Dear Sirs: By means of this letter I am requesting issuance of a waiver allowing the existing septic tank serving the 4 bedroom residence on Lot 2, Block 3, Talus West S/D to be approved in its present location, 93 feet from the private well serving the same lot. A site plan, water sample test results, HAA application, logs of nearby wells, and other supplementary information from your files is attached to assist you in your review. I was unable to locate a driller's log for the well, however the septic system as -built inspection report indicates that the well was drilled prior to October of 1974 and has a total depth of 116 feet. On November 4, 1996 the static water level in the well stood at 69 feet below the top of the casing. During the course of a well yield test on that date I pumped a total of 729 gallons of water from the well at the maximum pump output of 5.74 gpm. This caused the water level inside the casing to be drawn down to 97 feet, but no further. Based on the test data I concluded that the total yield of the well is in excess of 5.74 gpm. Water samples collected on May 26, 1998 were satisfactory, showing 0 colonies of coliform or other bacteria per 100 ml., and non-detectable nitrates. According to the as -built inspection report, the wastewater disposal system was installed in October of 1974 and consists of a 1250 -gallon steel septic tank that discharges into a 9 -foot deep log crib seepage pit with a total effective absorption area of 810 square feet. The inspection report signed by the Municipal inspector states that the well is located 100+ feet from the septic tank, however my field measurements indicate that the septic tank cleanout is actually 94 feet from the well. The waiver request is for 93 feet to allow for a probable underground projection of the tank slightly closer to the well. The overall topography of the lot slopes down towards the west at approximately 1-2%, which means that, were effluent to daylight from a failing septic tank, it would flow away from the well, rather than towards it. Furthermore, the house is located between the well and the septic tank, making any surface flow path be greater than 100 feet. While the land surface in the area of the septic tank is uneven, no depression was observed over the tank indicative of imminent collapse. Since no driller's log is available for the subject well, I am enclosing logs for the wells on Lots 1, 4, and 5, Block 3. Since the well on Lot 1 is only approximately 100 feet away, and has a comparable depth, it is probably the most representative of the subsurface soil conditions relevant to the subject well. This driller's log reports seemingly impermeable strata of clay and gravelly hardpan between 12 and 63 feet, and 85 feet and the waterbearing aquifer, with a 22 -foot thick sand and gravel stratum in between. The following is a breakdown of how waiver analysis points could be awarded in conformance with D.E.C.'s 1985 "Separation distance Waiver Guidelines for SCRO". Analysis Category Points Distance to water table, assumed to be at well intake: (116' — 12' = 104') 7.0 Soil sorbtion (sic) ((22' x 1.5) + (82' x 4.5))/104' 3.86 Permeability ((22' x 1.0) + (82' x 3))/104' 2.57 Water table gradient (assume +2% - parallel to land surface) 2.9 Horizontal separation (93') 2.72 Total 19.05 Based on this point assignment it appears that the waiver can be granted without concern as to contamination of the well on the subject lot being located less than 100 feet away from the septic tank. The fact that the recent water samples indicated no bacterial or nitrate contamination lends further support to this finding. Because of the age of the septic tank, it will probably need to be replaced before many more years have elapsed, and at that time the replacement tank can be installed 100 feet away from the tank. Please feel free to give me a call if you have any questions on this submittal. Sincerely, Ted Moore, P.E. cc: Pat Stone, c/o Kevin Taylor, Prudential Vista Real Estate LOT 29 LOT 30 LOT 28 100, —� o EXISTING SEPTIC LOG CRIB SYSTEM SEEPAGE PIT WELL , WELL �0 R7 ` EXISTING O 1250 GALLON r / SEPTIC TANK LOT 2 ; co�/ BLOCK 3 LOT 1 LOT 1 BLOCK 2 2% \ / SEPTIC �,' HOUSE SYSTEM HOUSE ^� WELL , 0 SEPTIC TRAVERSE WAY SYSTEM \ A�s --�-L— — -- 49 T" A ;y*' .................... THEODORER MOORE i t CE -3589 .' C� -*,., see* ..v.`��II 1�\\ l" LOT 2, BILK. 3, TALUS WEST SID WELLAND SEPTIC SYSTEM SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 JUNE, 1998 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. APPLI(- NT FILLS OUT UPPER HAI, ONLY Time `Property Owner J,-'�� (�Q,(��/ C��� c oui>&� -t- < /� Phone n��ySys-�ys- Mailing Addres'5 _ (� N /fit/ -T �C ' ip Code - J� Date Buyer 1C1'11rl 'z) q no / W Address �s ,�� C><r-� Zip Code 99'!�Cfc;� Date Lending Institution J jy /ylQ Q.�-j G Phone (� Address Ifo F/JoK, U / ,\ / U Gi7`� _�' Zip Code Realty Co. & Agent leca Phone Address �o f>� - -' ( Zip Code Legal Description / /J �-1�- / GT/W V ✓ .0/Y /-7?, ?/ %�' ` ?f � .. U.j % /517 _ ��"T 1 r/✓A/j Insp epG.., � Street Location �%J e Type of Residence _ LLSttrfgle Family ENVIRONMENTAL PROTECTION �_G• C��� JUN 31001 ❑ Multiple Family No. of Bedrooms RECEIVED ❑ Other 'CONDITIONS OF APPROVAL Water Supply ( ) CON D, ION APPROVAL' rvidual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community O For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Well To Absorption Area Well Log Received Sewer Disposal / ITY91 /Q �-`-) `f Q-tudi7t8ual Year Individual Installed: Septic Tank Size ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. U AO, Time Time Time Time. Date Date Date Date Inspector Inspector Inspector Insp epG.., Field Notes: f D 'IR�VY TALTN I. Y O FANCHORAGE ` 0 v ENVIRONMENTAL PROTECTION �_G• C��� JUN 31001 RECEIVED ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CON D, ION APPROVAL' DATE z BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received /Q �-`-) `f Well to Tank � Uc�) Septic Tank Size 72023131821 CHEMICAL & GE.OGICAL LABORATORIES ALASKA, INC TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIALCENTER & - 5633 B Street -eO^•°^°e Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER J WATER SYSTEM: I� I.D. NO. 7 a - 0,0 '—VY\ A,.h, Water System Name Phone No. Mailing Address fZ City mm State Zip Code C�SAMPLE DATE: I I YYJ 5-951 Mo. Day - Year SAMPLE TYPE ❑ Routine ❑ Check Sample (for routine sample with lab rel no. t ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE NO. t 2 3 4 5 LOCATION I 3 jj ' 4 �n �/rt,�, �A iO.l1N l Time Collected Collected By Data Collected Source TO+BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: lx/S. atisfactory ❑ Unsatisfactory ❑ Sample too long in transit: sample should rjPit be over 48 hours old at examination to indicate reliable results. Please send new sample. . / Date Received C� !J � Time Received , Analytical Method: ❑ Fermentation Tube Membrane Filter Lab Ref. No. Result- Analyst FT -1 a m m FT -1 No. of colonies/ 100 ml. or No. of Positive portions. 08.1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1978 Data Collected Source READ INSTRUCTIONS a.m. Date Recalved Time Received p.m. Lab. Hours BEFORE loml I 1.0ml I 0.1ml EMB Broth 24 hours: Broth 48 hours: COLLECTING SAMPLE Multiple Tube Report: 10ml Tubes Positive/Total 10ml Portions Membrana Filter: Direct Count Collform/100ml Verification: LTB BGB Final Membrane Filter Resu Coliform/100ml Reported By e=%'�s- _ Dale li Time. S('?2'] A.M. p.m. June 14, 1383 Ronald & warilvn _iodafteri SIL. Box 1584 ') anchorage, AK 99507 Subject; Lot 2, Block 3, Talus West Subdivision Approval For the individual sewer and water facilities cannot be granted until tate following items have been completed: ° The septic tank pumped with a receipt submitted to this department. G\ et four (s#) inch cleanout needs to be i.iistrali0Ci to the (J leaching area. An adequacy test needs to be performed on the existing leaching area. `i'tii_s c.c:st will determine if the System is= adequate according to National Standards. A listing of 041 �W private firms performing the test is enclosed. This report t9` u needs to be submitted to this office for our. review. �NOY Tease notify thi 3 Department for a reinspection when the noted discrepancies have Leen corrected. if there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt .associate Environmental Specialist Enclosure Rpl8/ej/E2 ALASKA CWROWnTAL COnTROL SCRUIUS, InC. Cngineerinq & enuironmental Studies JUNE 9 1983 RONALD MODAFFERI SRA BOX 1584 Q ANCHORAGE AK 99507 SELLER — RONALD MODAFFERI BUYER—RICHARD STONE SUBDIVISION—TALUS WEST BLOCK -3 LOT -2 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT/CRIB WITH AN AREA OF 810 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 390 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 495 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 3 BEDROOMS. THE SEPTIC TANK WAS PUMPED ON 7/1/83 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. SYSTEM TREATED WITH HYDROGEN PEROXIDE ON JULY 1 1983. RECOMMEND APPROVAL AS ADEQUATE. 1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 • 907) 276-1361 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 L/ Date Received / D x-9 Time of Inspection //•`moo A./a_ Date of Inspection id si Y - REQUEST FOR APPROVAL OF INDIVIDUAL SEWER_& WATER FACILITIES 1. Approval requested by: ?a-:t��Llc u h �i.P/-1 01A. Type c eX �C_ B. Depth 116 C. Construction . Bacterial Analysis 7. Sewage Disposal System: A. Installed/b z 3:�7 B. Installer ^ �2 C. Septic Tank: 1. Size /2--7 2. Manufacturer D. Seepage Pit: 1. Absorption Area 1/11 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank /®o/# , Absorption area /®O�� Sewer Lines S0; Nearest lot line fp f , Other contamination B. Foundation to septic tank J. ' Absorption area 1-,5- C. -.5 C. Absorption area to nearest lot line "I'- EQ -034 (1/74) Page 1 of two pages Mailing Address: �`/(G�• '/ a�� Phone: 9 79 2. Property Owner: Phone: Mailing Address: 3. Legal Description: 4. Location: 5. Type of facility to be inspected ^ No. of bedrooms_ 6. Well Data: 01A. Type c eX �C_ B. Depth 116 C. Construction . Bacterial Analysis 7. Sewage Disposal System: A. Installed/b z 3:�7 B. Installer ^ �2 C. Septic Tank: 1. Size /2--7 2. Manufacturer D. Seepage Pit: 1. Absorption Area 1/11 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank /®o/# , Absorption area /®O�� Sewer Lines S0; Nearest lot line fp f , Other contamination B. Foundation to septic tank J. ' Absorption area 1-,5- C. -.5 C. Absorption area to nearest lot line "I'- EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Re`t for Approval of Individual it & Water Facilities Legal Description Approved c -mac -Y. kJ.4U-I�0-1>-Di sapproved Date / b - -6 6 -7f� Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify 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)