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Home My WebLink AboutKNIK HEIGHTS BLK B LT 5-= I _h�f Municipality of Anchorag oe t {1 ' 'r CO. IAs 1!Mifiill •.lnchnrgtc, .11utiki: S)<Ail!L(ifiil) • 470I Elnurcc Itmd Office: (!N)7) 343.9401 • 1xx: (!XM 3t3.S$(N) hlgxffitim.nuwLnrg Mayor 71ark Begich Devcloprnent Services Dcptu-bncnt 3 Jul 08 Doug Longacre 12600 Ridgewood Road Anchorage, AK 99516 Re: Knik Heights Block `B" Lot 5 Dear Mr. Longacre: Ment Department Enclosed you will find the waiver paperwork that was given to the homeowners of Block "B" Lot 6 for the sale of their house. The enclosed paperwork consists of the engineer request letter, a letter from the Municipality of Anchorage granting the waiver, and two copies of as-builts. If you need any additional information or have any questions, please feel free to contact On -Site at 343-7904. Sincerely, /, }d4l/_ Deb Wockenfuss Civil Engineer On -Site Water & Wastewater Program Enc: Credit Card Receipt Community, Security, Prosperity _ Municipality of Anchorage P.O. Box 19(WZ0 • Anchorage, Ala%ka W519 -6)(N). 47W Elmorc Riau) \ Office: (907) aX -W I • Fv%: (007) 343-820M htil)://uuiv.mtuil.org Mayor Mark Begich Development Scr%iccs Dcpartntcnt min[ ,*-SP �. q�t�f Department 16 June 2008 Certified Mail #:70042510000198885480 Doug & Suzette Longacre 12600 Ridgewood Road Anchorage, AK 99516 Re: Separation Encroachment of Absorption Field to Water Well Located at Knik Heights Subdivision Block "B" Lot 6 Dear Doug & Suzette Longacre: The property described as Knik Heights, Block "B", Lot 6 recently had the on-site wastewater disposal system and water well evaluated to obtain a Certificate of On -Site Systems Approval. The engineer performing the evaluation discovered that the water well serving the home on this property is being encroached upon by the wastewater system serving the home on Knik Heights Block "B", Lot 5. According to our records, you are the owner of this property. The existing separation is 91 feet from your wastewater absorption field to the well on Lot 6. The required separation is 100 feet. This is a violation of Anchorage Municipal Code 15.55 Water Well Code. The water well on Lot 6 was constructed in 1972, and the wastewater system on your property is documented as being constructed in 1975. A waiver was requested for the separation distance from their well to your septic. You are responsible for the waiver fee as your system was installed atter the well on Lot 6 was drilled. Please contact this office either in person or by phone at 343-7904 when you receive this notice. Sincerely, Wv Deb Wockenfuss Engineer, On -Site Water & Wastewater C01111111111ity, Security, Prosperity C3 s0 . S OFFICIAL USE Ir postage f ri CerthW Fes C3 Poetnmk C3 Return Receipt Fee here C3 (En6orsamerrt Reeuke0) C3 Reetr=ae-YFes ri (EMawrrwe ReW W) L ru toter Doug S Suzette Longacre C3 12600 Ridgewood Road C3 Anchorage, AK 99516 aro Cry—a •--- - ■ Complete items 1, 2, and 3. Also complete A 5, ture • Rem 4 R Restricted Delivery Is desired. /d , ❑ A0�1 ■ Print your name and address on the reverse w O Addressee so that we can return the card to you. e.ed by ( nr d NaUr) C +a t Delle ■ Attach this card to the back of the mailplece, or on the front R space permits.' D. deMery address dnfereM from awn 1? O Yes 1. Article Addressed m: R YES, enter denvery address below: O No Doug & Suzette Longacre 12600 Ridgewood Road Anchorage, AK 99516 a Service Type 0 Certified Mall 0 Express Man --- 0 Registered 0 Return Receipt for Merchardlse _ ❑ Insured Man O C.O.D. '-2. A n PS Eorn 001 1. reurumy 102 5 95-02-41510 �wb GRE, ` ANCHORAGE AREA BOF Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL. SYSTEM / C i�cli� l (� �G%if�C (ZC MAILING ADDRESS I\ n he(oC� �� a1/PHONE �� /l�' NAME U� � ^y LOCATION LEGAL DESCRIPTION fJ k SEPTIC TANK: �dc ` NUMBER OF DISTANCE � �� ,;� FROM WELL �r 0 MANUFACTURER '" �-�Y'�J MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /Ocio GALLONS. SEEPAGE Rff':I ,tc;w� NUMBER OF PITS DIAMETER OR WIDTH —, LENGTH—, DEPTH rU LINING MATERIAL CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL �L U TOTAL EFFECTIVE //jj�� BUILDING FOUNDATION F3 NEAREST LOT LINE JAr) ABSORPTION AREA (WALL AREA) T`�� SQ. FT. ADDITIONAL ABSORPTION WELL: \\ c TYPE , C6�J%J4ci. CONSTRUCTION } 1 �` DEPTH BUILDING NEAREST NEAREST SEPTIC FOUNDATION LOT LINE SEWER LINE TANK_ CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES:��e1� INSTALLED BY:�'� d PIPE MATERIAL: ft'v y (�' ' L LOT SLOPE: REMARKS: 1hi`( j W -dam - Form No. EQ -031 REMARKS DATE DISTANCE FROM: SEEPAGE SYSTEM DIAGRAM OF SYSTEM - av -.i-b APPROVED n �A G.A.A.B. V I(C 3, Uj C11.1,41 (0 if 013114(tt"i v� v ( h" _ l DATE DISTANCE FROM: SEEPAGE SYSTEM DIAGRAM OF SYSTEM - av -.i-b APPROVED n �A G.A.A.B. V I(C 3, Uj C11.1,41 (0 if 013114(tt"i Jaax V1 .660, Sp raILZ 110UWE A yy '' BB ry�4.+yz�•�Yxrvy�e 14 SIX INCH WATER WI~L.L. DRILLED AND CASED OUT TO THE DEPTH OF 169 f. o e"t tiO'ro DRILLED AT THE RATE OF PER FOOT. PROPERTY OWNERA'x. Dou;;l.nr lonp_acre 2']?. `;1.691 '313' R?j-r norry n(J. iil r)iIJol) LOCATION OF WELL SITE--- 6 Sub, AV? 1k/ ��( L( DRILLER Leri f.n Malls of RTT1Part Dril.la.ng ldork; WELL LOG: Brc•N- cl ,y with 209, sznd; .18---65t L'1 -3'. SFv�t r.7. »obbles. 65---133' Gravel .with 3.0 ( clay hird.e". 133 �16�+ $t.nd.y "avol. 00;b blue clay, -- - — 1f,3---173' 14atc • bcarlm, grivol. Cased to 1.69 fe.r!t,. silty from 16, to 3.6n + Very ron(i water bearing gravel Proc?ucin,*• Etmht C,+ e% 167 foot hnzid ;•cath a $ minute .full r-..<t9v( ry 01-1 f'ull dl aa.w dot"n. - MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & ENVIRONMENTAL PROTECTION �V MAR 1989 RECEIVED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM F l 22M.50 1 YHAINIK YOU VERY MUCH. Pari 3.vl. F�111 An o£ July iFt.'J75 BER LADS OF RAMPART DRILLING WORKS DATE -'killed: 6rERVICE CHARGE 0 F 1 ye% PER MONTH WILL_ BE ASSESSED ON PAST DUE ACCOUNTS. N O V- 1 ;F_-9 1 TUE 1 1 ".40 1ST Nr�t T I 4NAL BRANCH J�L-E H33 P- 00 AOCKE EXCAVATING Phone 344.2625 BOX 1721-L, STAR ROUTE A ANCHORAGE, ALASKA 99502 Ar. Doiaerla s I,on� fi cre 3137 Nosbcrry Ad., { I Anchompa, Alaska �9502 June 10, 07 S`PA'I' 4�1 i�`WT June 5,6,7, 1975 Inntalllny gcwc;r syetem 1Qc,0 ral gPptir. t.snit inc]uded 4a-l_Bnos Dus ;t 1 ,GUO, co Jiang 9, 197P, A00MIP MAID IN VOLL (1,900.00) r �C- J ('5RLO ITT ARI,.A AIvCHU (AGR. Ii0R0UGH I^:wkb:C'PTUD! 63/'7/75 PIp!;.ig0vWD NAME OF APPLICANT L GREA : ANCHORAGE AREA BOF q DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL. SYSTEM - APPLICATION AND PERMIT PERMIT NO. �/ y I%y PHONE MAILING ADDRESS-> > INSTALLATION LOCATION IT LEGAL DESCRIPTION /ldI DRAIN FIELD - OTHER INSTALLATION OF: SEPTIC TANK SEEPAGE PIT ,rt 2-. TYPE AND SIZE OF FACILITY TO BE SERVED._—` - TO BE INSTALLED BY _ r FINANCED THROUGH NOTE: THIS PERMIT l5 NOT VALID WITHOUT SOIL TEST SOIL TEST RESULTS / COMPLETION DATE ANTICIPATED 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. 'f�C. c%�/'��/�� ✓T SEEPAGE AREA SIZE ! J� TYPE SEPTIC TANK SIZE —� TYPE j J DIAGRAM OF SYSTEM MINIMUM DISTANCES, REQUIREMENTS / 1 FOUNDATION TO SEPTIC TANK . FOUNDATION TO SEEPAGE PIT DRAIN FIELD Ck ZZI SEPTIC TANK TO SEEPAGE PIT WALL/ r l 't Y �fl / SEPTIC TANK y�, SEEPAGE PIT^- DRAIN FIELD .fG--- TO NEAREST LOT LINE. f WELL TO SEPTIC TA/NK DRAIN FIELD �= WATER MAIN TO SEPTIC TANK CI"jl SEEPAGE PIT / —f ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD SEEPAGE PIT _ l' DRAIN FIELD 1 cl SEPTIC TANK. �• - TO RIVER. LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PI" FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL. BACKFILL j— CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH/ ORDINANCE NO. 28.66 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. - I _ DATE .) -% APPLICANT'S SIGNATURE ` FORM NO. EQ -61 6 ^REATER ANCHORAGL AREA BOROUC" L artment of Environmental Qui. t� 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - I EROLA t ION PLS 1 Performed for Legal Doscriptio-n—F � This form reports: Soils log Depth Feet 2 ._ 3- 5 7 F3 _ 10 1? f 13 14 Was ground water encountered? Date Performed Percolation test S/0 :00 If yes, at what depth? Reading Date Gross Time Net Time Depth to Water Net U --- Perco1at�on_ Drain Field Proposed installation: Secpaye Pit - --- - - - - -- - ii2pt1i of Inlet Depth to bOt.tOm of pit or Lrenc -- - Date: MIT U 11 S Perforrned _ y (cPxL_ ` �� Ceri;nfte Y B� __ -_-___ ._- EQ -040 (6/74) MUNICIPALITY OF ANCHORAGE • 'tea DEPARTMENT OF HEALTH & HUMAN SERVICES A Division of Environmental Service;; On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 MUNICIPALITY ANCHORAGE SE 343-4744 ENVIRONMENTAL SERVICES DIVISION CERTIFICATE OF HEALTH AUTHORITY DCl. 0 2 1991 APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0t 7— 03?7 -�'� 1. GENERAL INFORMATION 2. 3 4 KLUIVED HAA # : Oa 7b Complete legal description 4-61 5 8)oVk 8 Xo k /I �-c, Location (site address or directions) 12 600 %Q'A@L-e_4.uoor.� Rel Property owner rJong i- c.re, _ Day phone 26 5- -15�9(o Mailing address % I s 1y&� jet a,119 , 1k op A/IeAo^44 ic <oHGw N"� Ave- AQ. 13o -e 1=7W Lending agency _ Day phone Mailing add Agent _ Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water M4BIMS✓ NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site --- 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 921 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Af }•'r- SfOpy-o CoAso A'pa &, adq Phone Address Engineer's signature 6. DHHS SIGNATURE X Approved for Disapproved. so,, Conditional approval for Additional Comments bedrooms. Il1Tlr Date —'I 2-1 q ,,+ .'•�^' r'� a ,q "J�4•i'+��JdB'J �IunJY�•' OObL•ODUO� ee E'. •Y n•y �� 7. �eee as O • Y •. n,°• Care' . Meyers 53 �� nt�C •�e�o. on oa�n�`T��`� . "POF[SSO'�-a:�' - bedrooms, with the following stipulations: Date 12 - Z8 -91 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. 1/91) Back MOA tt21 Legal Description: A. WELL DATA S Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST B Kh Parcel I.D. Well type-YL�I V IC�uGt If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) �� Date completed /J /- J Driller k�(WI ✓ � DY t 1 yuti VdOtS Total depth Cased to I �' Casing height Sanitary seal (Y/N) Date of test Static water level Well flow Pump level ye> FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ! UO h Absorption field on lot I U() .- Public sewer main Sewer service line N.A N .A- Wires properly protected (Y/N) YcL1, ; On adjacent lots 160 r On adjacent lots loo 4 - Public sewer manhole/cleanout N • A Petroleum tank o. A WATER SAMPLE RESULTS: Coliform it S Q�� SII V Nitrate �� Ytt� Other bacteria Date of sample: I IY I Collected by: K NI A SEPTIC/HOLDING TANK DATA Date installed �' I I r' Tank size I , Cleanouts (Y/N) Foundation cleanout (Y/N) . I Yes Compartments sto-1 (*)Vt. Depression (Y/N) W High water alarm (Y/N) // N O Alarm tested (Y/N) �. Date of pumping �I b/ I I Pumper G✓+ l ai�� t1 V1-1 1VlG _ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wei I(s) on lot ! On adjacent lots .f Foundation p To property line ` Absorption field Water main/service line ,U. A Surface water/drainage �,{ �. al��ic! Iecl sc�5�i �. f ��tk II�Ska� ( 72-026 (Rev. (Rev. 7/91) Front CONTINUED ON BACK PAGE= C� AT INSPECTION a 70 II�aI�I �ro CD � rr-I 90Z rri g.p.m. g.p.m.ro oCO !`i`i U tIL VI O UY 1 _1 .n 0m m ; On adjacent lots 160 r On adjacent lots loo 4 - Public sewer manhole/cleanout N • A Petroleum tank o. A WATER SAMPLE RESULTS: Coliform it S Q�� SII V Nitrate �� Ytt� Other bacteria Date of sample: I IY I Collected by: K NI A SEPTIC/HOLDING TANK DATA Date installed �' I I r' Tank size I , Cleanouts (Y/N) Foundation cleanout (Y/N) . I Yes Compartments sto-1 (*)Vt. Depression (Y/N) W High water alarm (Y/N) // N O Alarm tested (Y/N) �. Date of pumping �I b/ I I Pumper G✓+ l ai�� t1 V1-1 1VlG _ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wei I(s) on lot ! On adjacent lots .f Foundation p To property line ` Absorption field Water main/service line ,U. A Surface water/drainage �,{ �. al��ic! Iecl sc�5�i �. f ��tk II�Ska� ( 72-026 (Rev. (Rev. 7/91) Front CONTINUED ON BACK PAGE= C. LIFT STATION .� Date installed Size in gallons Vent(Y/N) High water alarm level _ "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off' level at Cycles tested Surface water _ r 4.. Date installed Soil rating System type Len th J g Width 3 Gravel thickness Total depth Total absorption area =3 �� F Cleanouts present (Y/N) Depression over field (7Y/N) Date of adequacy test Results (pass/fail) Y�G�� ` for bedrooms Peroxide treatment (past 12 months) (Y/N) �J If yes, give date T SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 10 C� -V On adjacent lots ICD Property line To building foundation On adjacent lots Surface water N 0 I 3 "_/ To existing or abandoned system on lot /SIV Cutbank_ ty A Water main/service line �1`t n Driveway, parking/vehicle storage area ' Curtain drain __& 1T E. ENGINEER'S CERTIFICATION See JAM' as -bt i 1-1- I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature n 1 Engineer's Name Date HAA Fee $ I V I Waiver Fee: $ Date of Payment Date of Payment Receipt Number G� Receipt Number 72-026 (Rev. 3/91) Rack MOA 21 NORTHERN TESTING LABORATUMES, W. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 ^ FAX 4563125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 o FAX 2749645 Arctic Slope Consulting Engineers 301 Danner Avenue, Suite 200 Anchorage AK 99518-3035 Attn: - Our Lab #: A115130 Location/Project: - Your Sample ID: Knik Heights L5B3 Sample Matrix: Water Comments: Method Parameter ----------------------------------------- EPA 300.0 Nitrate -N Reported By: William E. Buchan Anchorage operations Manager Report Date: 11/18/91 Date Arrived: 11/04/91 Date Sampled: 11/04/91 Time Sampled: 0820 Collected By: KMA Definitions MDL = Method Detection Limit B = Below Regulatory Min. H = Above Regulatory Max. E = Below Detection Limit Estimated Value Date Units Result Flag MDL Analyzed ---------------------------------------•----- mg/l 0.6 0.5 11/15/91 All>rz0VALS PM ------ .----- r�nn — — GM December 18, 1991 Mr. Dan Roth Municipality of Anchorage 825 L Street Anchorage, Alaska 99501 Re: HAA Knik Heights Subdivision Lot 5, Block B Dear Mr. Roth: Based on field measurements and the septic tank installation receipt, I certify that the existing tank on the above referenced lot has a 1250 gallon capacity. Very truly yours, 4(4Rn a Carey er, Senior Mined ry arae s: voce, :,o ,rAr 7}.. u n < yea oo `a oae2 cUre� 5 Meyer CM:MLT:1110-0026.004 ;. p .'6'53 W i PartnU /\4eI LIP, Suite )00 :iii I It _`__ARCTIC SLOPE CONSULTING GROUP IN e C�.'G IOIS civil [I1gII ", 3G1 8 I I rr Acenl �. .rtc )^0 Date' 0 / Z- /c// 907) 319514Q '� ' -5 s_.GiS I 9v: i49 -!Z•, LOCATION: Subdivision: Lot: 5 Block: A Client's Name:- Address:- ame:Address: e�a I sF /jc(;0 r, X_.,�,o,:. e ` Ca 'YeO W'7 piAoe PC5. /fitly /no1,7 TESTER: Initial Reading on Meter: `/P -/S DRAW DOWN TIME GPM GALLONS VOLUME GALLONS TOTAL FIELD MONITOR LEVEL METER READING 'C)Ci.c t "L- y , ,7 YZ, 3 7 35 72 ii r (p'.G Z- 7_,Z62,In,5 �37 � 1Zo7 %y" <175a U'.3Z 2•'1' 57 37 3/ ZFl 12/ 0 1 ,Soo" s/ZG 0.(07 !O Z9/ IZo !" 5 /3 1 6 7--7 316 ;zo' o" 516;3 " 11-47 Z,Z 3.3 2 .zo' 5l l6 x/:07 Z.0 D % /Zo, -0 5e5; Z NGS 20''� S3/o _ NOTES Production Rate: Z.Z/ GPM 24 -Hour capacity 3182 Gallons MUNICIPALITY OF ANCHORAGE I�J • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # HAA # CYL-) LI 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, townsh 0 Location (address or directions) / Gad I_ ,,oGDU range) Pf6� (b) Property ownee 45' ,ZoV15,ao/Pr Telephone : (home) 6A Business -- 763 Mailing Address l�G� "bGE tvomp (c) Lending Institution Telephone 1(-2A - Mailing Address (d) Real Estate Company and Agent 7 Address A)) A Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: �� — 'I _3"i 2. TYPE OF RESIDENCE Single -Family Z* Number of bedrooms -� 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND 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 all Municipal and State codes, ordinances, and regylations in effect on the date of this inspection. Name of Firfn ��wi^� �y ssG�ii�Telephone J Address Date 2- :ngineer's Seal 6. DHHS APPROVAL Approved for �—bedrooms by Date v Approved (�, Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7/88) Back Page 2 of 2 F ANffBP� PLITY OF ANCHORAGE (MOA) MUNI*CHECKLIST ERvt�E5 Uihlealth Authority Approval (HAA) EWmo - FEBRUARY 1984 0 'J g 1ggg 343-4744r V_ / __� " Legal Description— A. WELL DATA Well Classification % If A, B, C, D.E.C. Approved (Y/N) Well Log Present t�/ ) Date Completed % — Yield Total Depth %69 Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground �h / Sanitary Seal on Casin (Y/ _ Electrical Wiring in Condui (Y/N) — Depression Around Wellhead /N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot fwd /�— ; On Adjoining Lots To Nearest Edge of Absorption Field an Lot /��i / � ; On Adjoining Lots DG' . ' To Nearest Public Sewer Line / To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Ling on Lot ��— Water Sample Collected by ��"<G 'F G ; Date Z Water Sample Test Results Comments / B. SEPTIC/HOLDING TANK DATA Date Installed "ZL Size No. of Compartments Standpipe NX Air -ti t Cap (Y'/�) Foundation Cleanou Y/ Depression over Tank (J j4,J / Date Last Pumped Pumping/Maintenance Contact on File;for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: / To Water -Supply Well 465'O / - To Building Foundation /0 To Property Line To Disposal Field D / To Water Main/Service Line — 6 To Stream, Pond, Lake or Major Drainage Course - /2P Comments `>�Q �i r��z" /� �� sa<iv'S /`r i � I) A14, 1 72-026 (Rev. 7i8e) Front Page 1 of 2 C. ABSORPTION FIELD DATA / Soils Rating in Absorption Strata Zz5 Type of System Design�`�'�F� �a Date Installed 7-, Length of Field Z Width of Field 13, / Depth of Field Grave. ed Thickness Square Feet of Absortion Area Statndpipes Presen6y r-� Depression over Field 1 �, Date of Last Adequacy Test Results of Last Adequacy Test r �i�Sfrfc'r+2}l SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well z4y -/I-- To Property Line To Building Foundation ��O /� To Existing or Abandoned System on Lot /� �� L-2is�- ; On Adjoining Lots 7 U "�— To Water Main/Service Line --� / To utbackyf To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area 14/C� Comments s tir�� Cc°k-/3r�i /x- cfr% D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at — High Water Alarm Level Tested for Meets MOA Electrical C Comments i *`Check Permitted Bedroom I certify that I ,Iia � h ckec inspection. Signed Company Date MOA No. G �� Manhole/Access (Y/N) "Pump Off" Level at ng Against HAA Request** or conformed to all MOA and c 2 �0 J Receipt No. � - Date of Payment z= Z4, ii Amount: $ Receipt No. Pumping Cycles during Adequacy Test. effect on the date of this Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 Engineer's Seal CHEMICAL & GEOLOGICAL LABORATORIES OF ALASK4, INC 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 5622343 FEDERAL TAX ID # 92-0040440 AHA('LSiS REPORT M SAIAllt?, £or Work 01 du 4 11.8( Dato Report Prinod : 7 1. 22. 99 0 1'1,0; ('I)Gnt S, alliplo so:VD, I Bj� Klifil, 11'rs C310fli 11 & PlMll) Wk Chani U)MIllip I'MI, 20 89 ", if, (10 'fly s' P 0. 11011F Kl,'c D @ Rorl hons yCd ir%.h :AS RQlJT'LkED Oydo"V'el By colephf'od /.2 P") Sofia R;ports co: ki)ouitofy UU)" k?l �'�isea By WMIUR 0.2G I AJol, Alillyzc(li IA -h-- jh:in, "�Y Gcp.atc,,: lhpii EPA 2 ,d] owal)l ur ISAACS PUMPING SERVICE (Norm Tibbetts, Owner) 6218 Quinhagak Street ANCHORAGE, ALASKA 99507 Phone 563.3300 accorn panled by this bill. 'Thank`You 5323 pgpwm Meos Irc Gdm uaa 01+11 �_rqW� ...., yU4 ... u. r r-.. �_r....w._......r.........ww ...........-..r......rr-w...w.- 10 vric./7'Y E�el, /1117~ ®9 (P e. • N r a ,1500 Cz, C', �4 4U I n,.e It is the responsibility of the owner to'deterhiine J+aen[KanA� 7 the existence of any easements) covenants,'or he- 0'•. ��"��„ . I I strictions which do not appear on the recoMed sub (I�`�*•.., .�'. ,4, division plat. Under no circumstances should any NOTE data hereon be used for constructsgn or for estab- 'lNrB OF RECORD, OYIf£1 THost lishinq boundary or fence lines. The surveyor takes SHOWN HEREONN ON T144 RECOROE0 ALAI, ARE -NOT— r. ,jJl ty foC the initial transaction only. LOT y BLOCK � /gAOt CAO NONUMIHT `� c u IRON �1P1 A --I 14� /y ii I � /+ r� - --(PLAY NO. I ' RISAR PROP, COR.Mb - - ANCHORAGE RECORDING DISTRICT tI Nu/ A TACK ,CPARtM eY: OOWUNG & ASSOCIAT'CS _ • 1426 NYDEfT STREET ANCHORAGE ALASKA 99501 i ITE: W 8 SCALE:/ u: 6Q 0 D; +vC.) 7 tIJ 7 p� /_ . 4TiK%0SAuf a3fd GREATER ANCHORAGE AREA BOROUGH De artment of Environmental Quality 'Pfo,,,sy 3330 '11C � eet, Anchorage, Alaska 99503 274.4561 Las m,2• �} Date Received April 21, 1976 ('0' �a y. Time of Inspection 7 lr Date of Inspection n �`9 REQUEST FOR APPROVAL OF �Q INDIVIDUAL SEWER & WATER FACILITIES FOR �v�r��Y�. Conv. 1. Approval requested by: First National Bank of Anchorage -&/ Lz Mailing Address: Post Office Box 4--2090, 99509 Phone: 274-1521 2. Property Owner: Douglas & Suzette Longacre Phone: 272-5491 a �*�-�_ Post office Box 1591—H mss. truae2o -� - Mailing Address: _P{��m_+iy .�N./r 3. Legal Description: Lot 5 Block B Knik Heights Subdivision 4. Location: NHN Ridewood Road 5. 6. Type of facility to be inspected Single Family Well Data: Individual A. Type z� e� B. Depth C. Construction ��, ti�� _ D. Bacterial Analysis 7. Sewage Disposal System: on—site system No. of bedrooms 3 A. Installed C. Septic Tank: 1. Size B. Installer D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: 2. Manufacturer 2. Material A. Well to: Septic tank , Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages iv1111�(I<�IYivli ll' 6i' :1�'CrlOfi/�G; MUNICIPALHY uf- ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 REQUEST FOR APPROVAL OF_ -9 INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONY X 2. Property Owner: Douglas and Suzette Longacre Mailing Address: P.O. Box 1591-H Day Phone 272-5491 3. Name of Buyer: Douglas and Suzette Longacre Mailing Address: P.O. Box 1591-H Day Phone 4. Name of Lending Institution: First National Bank of Anchorage Mailing Address: P.O. Box 4-2090 Phone 274-1521 5. Name of Realtor or Agent: Mailing Address: _ Phone 6. Legal Description: Lot 5, Block B. KniK Heights Subdivision 7. Type of Facility to be inspected: SED No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation EQ -037 (1/74) Individual Individual (on-site) Page 2 of two pages - Re( st for Approval of Individual ` er & Water Facilities Legal Description Lot 5 Block B Knik Heights Subdivision Comments Approved Disapproved Date 5-- /�—i " ;?6 App Wal Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM i certiry tnat the inrormation containea in this request for approval to be a true ana accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date