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Home My WebLink AboutKNIK HEIGHTS BLK I LT 5On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSPI51086 Tax Code Number: 01737231000 Work Type: Septic Renewal Permit Effective Dates: April 29, 2015 to April 28, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: KNIK HEIGHTS Site Legal Address: KNIK HEIGHTS BLK I LT 5 G:2836 Owner/Address: NORRIS JOHN R & DONNA LEE 4631 SHELBURNE PLACE ANCHORAGE AK 995162930 Site Mailing Address: 4631 SHELBURNE PL, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 37366 Total Bedrooms: 4 N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: 1. The Engineer needs to do groundwater confirmation prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. 2. Per the note on the Section view: Confirm on the IR that the existing sand is on top of the GP layer. va Received y/a� /a.U, r Issued By: XILI�ewc'kZX9_—_ Date: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-372-31 Property owner(s) John & Donna Norris Mailing address 4631 Shelburne Place, Anchorage, AK 99516 Site address 4631 Shelburne Place, Anchorage, AK 99516 Day phone None Available Legal description (Sub'd., Block & Lot) Knik Heights, Block I LotX5 Legal description (Township, Range & Section) Lot Size 37366 Sa. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) 1Z (w/wo ADU) Septic Tank Q Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Munl4al Codes.f----) property owner or Permit/Rush Fees: 'r,/Yo 0 Waiver Fees: Date of Payment: Date of Payment: Receipt Number: ��fb�/ Receipt Number: Permit No. osp Waiver No. Permit App__ ::L:c. Pannone Engineering Services LLc Steven R. Pannone, Principal Registered Professional Engineer E-mail: stevePpanengak.com Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. O. Box 196650 Anchorage, Alaska 99519 Subject: KNIK HEIGHTS B1 L5 Septic System Permit Request Ladies and Gentlemen: I am writing to request to reissue 13 April 2015 SW050382 (issued October 05, 2005) to upgrade the existing septic system using t ached proposed system for this property. The proposed systems will serve a proposed fo edroom house. Currently the lot is developed. The proposed system will utilize a 12508 S.T. ank and drain field. The surrounding developed lots are served by private wells. There are n e Is or septic systems on surrounding lots within 100 feet of this system. Soils. Several test holes were performed by S&S Engineering in January of 1991. Groundwater and bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.8 gallons/day/square feet should be used for this wastewater system. 1. Soil Absorption System Design. a. See Sheet 2 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The existing topography slopes from the northeast to southwest at approximately 5% in the area of the proposed drain field. There are no steep slopes within 50' of the proposed drain field. The elevation of the existing drain field to be removed and replaced is located at the original grade of the property and has six feet of fill covering it resulting in an existing elevation of 95'± over the bed. 4. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 5. Waivers: Due to location and lot -line limitations request a waiver be provided for the dimensions of the proposed bed absorption system. The proposed dimensions are to be 30' by 25'. Since the drain field will be pressurized the prescribed dimensional width limitation should be waived. The proposed installation will not affect the future development of the surrounding or existing lots. There are no surrounding wells within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 o� 3M—M-M� 200'± TO PRIVATE WELLS TO THE NORTH AND EAST OF LOT 5 —M -- ------- LQL_ 5, 7i-- ---------- r --- /y Mnn M Ad S LY I\41,- /CC REMOVE 1250g S TANK (E; INSTALL 15008 ADVANTVANTEX W/AX2 %y POD AND DISCHARGE PUMP BAS' I /REMOVE & REPLACE ABSORPTION FIELD (E) 1 USE (E) NOTES: FOR CONSTRUCTION 1 �d W—W 3 I S� 1� W� W (P) PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 KNIK HEIGHTS, BLOCK 1, LOT 5 DRAWNSRL JOHN & DONNA NORRIS 4631 SHELBURNE PLACE PLAN ANCHORAGE, AK 99516 Cd -4--1 I Lo 00 U) L, Jo co ' J W I— W w Q o . >z Via_ EL = o F 0 +I oz o W o= N � RESERVE DRAIN FIELD (P) 20LF z 5.0 W, E.D. 0.5 , T. 1.25'0 PIPE W/ 0.125' DRILLED HOLES 18" O.C. (P), REMOVE BIOMATTED MATERIAL. ENSURE BOTTOM OF SAND IS ON TOP OF GP LAYER DRAW FIELD (P) - b,-79a� 20LF x 5.0'W. E.D. 0.5', T.D. 9!Y(P) 1.25"0 PIPE W/ 0.125" DRILLED _ HOLES 18" O.C. (P) REMOVE 20' U BIOMATTED MATERIAL. ENSURE BOTTOM OF SAND 15 ON TOP OF GP LAYER _ N LU a+ 7 CN N OFA�q ill 05/%15 P.i D 5NO V/T—.... �50 017-372-31 Steven R. Pannone PERMIT N0. +mac' CE 8149 OSPI51086 r aPRoFEssiQ9 Sheet h1 eOF 3 klkX44 � � 0 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK WILL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: REPLACE EXISTING 1250g S.T.E.P. TANK WITH 1500g ADVANTEX W/ AX20 POD, INSTALL NEW SOIL ABSORPTION SYSTEM AND RESERVE ABSORPTION SYSTEM. 4. GROUNDWATER WAS NOT OBSERVED TO A DEPTH OF 8.0' AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 8.0 FEET BELOW EXISTING GRADE. DRAIN ROCK 6' ABOVE PIPE INV FILTER FABRIC 1.25.0 PIPE W/ 0.125" DRILLED EXI5TING GRADE 95.7 HOLES 18" O.C. (P) V90.0'TH-.BOH SECTION )RAIN ROCK i- ` REMOVE ALL SIOMATTED MATERIAL & REPLACE W/ NEW. ENSURE BOTTOM OF SAND IS ON TOP OF THE GP LAYER. m 1.25"0 PIPE 5' O.C. TYPICAL W/ 0.125"m p GRILLED HOLES 18" O.C. (P) Z E rIORAN ROCK 6" ABOVE PIPE INV O II FILTER FABRIC a 1 Z ORIGINAL QqAQE— 1II �ORAIN ROCK 95.7 I II REMOVE ALL �REPIACE "VV/1'• W/ NEW. ENSURE BOTTOM 15009 93iY. 20 0—j OF SAND IS ON TOP OF THE GP LAYER. ANI (P) PROFILE ABBREVIATIONS LEGEND CU COPPER DESIGN PARAMETERS DIP DUCTILE IRON PIPE PRIMARY/E SEPTIC SYSTEM W WATER LINE/ TH TEST HOLE NO. BEDROOM: 4 (600 gpd) WELL RADIUS FC FOUNDATION CLEAN OUT TANK SIZE: 1500g (�9y T# TANK CLEAN OUT NO. PERC RATE = &° MPI 4� SS NEW SEPTIC C# CLEAN OUT N0. - SOIL RATING: 6.0 GPD/SF M# MONITOR TUBE NO. AREA ROD: 100 SF _ R. 1. RIGID INSULATION SYS. TYPE: WIDE TRENCH 0.50' E.D. . DCO DOUBLE CLEAN OUT MIN SIZE: 20LF - .. DV DIVERTER VALVE USED: FS FLOW SPLITTER (2 EA) 20.01F X 5.0' WIDE, 0.50' E.D.,g.7' TD BFG BELOW FINISH GRADE TOTAL AREA: 200.0 SF OG ORIGINAL GRADE FG FINISH GRADE - - - TS&V TOPSOIL AND VEGETATE NOTES: PANNONE P.O. PHONE ENG SVC, LLC BOX 100217 ANCHORAGE, AK 99510 (907) 272-8218 FAX (907) 272-8211 :'oFa ��i S'��"' ''qS l� /�trD'P f9+t 49 .... .. . .. ...... o5i26i,5 FOR CONSTRUCTION Scale P.I.D. NO KNIK HEIGHTS, BLOCK 1, LOT S 017-032-31 JOHN & DONNA NORRIS / Steven R. Pannone -p 8149 8149�� PERMIT N0: DRAWN JRL 4631 SHELBURNE PLACE OSP, 51086 DESIGN DETAILS ANCHORAGE, AK 99516lA70fES9� Sheet ��"„�� 2 OF 3 ADVANTEX TANK SYSTEM WITH AX20 POD sc� C,D -2"z 1 DESIGN PARAMETERS PRIMARY4€ SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g (Pj PERC RATE = S MPI SOIL RATING: 6.0 GPD/SF AREA ROD: 100 SF SYS. TYPE: WIDE TRENCH 0.50' E.D. MIN SIZE: 20LF LEGEND W WATER LINE/ WELL RADIUS USED: (2 EA) 20.OLF X 5.0' WIDE, 0.50' E.D., t7' TD TOTAL AREA: 200.0 -SP SS NEW SEPTIC ABBREVIATIONS Cu COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE ES FLOW SPLITTER BFG BELOW FINISH GRADE - OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NOTES: ��\� Date FOR CONSTRUCTION PANNONE ENG SVC, LLC ? OF AL `1 05/26/15 P.O. BOX 100217 ANCHORAGE, AK 99510 1) Scale PHONE (907) 272-8218 FAX (907) 272-8211 MO�A • 9 �NTS ...... / P.I.o. NO KNIK HEIGHTS, BLOCK 1, LOT 5017-032-31 JOHN & DONNA NORRIS Steven R. Pannone /PERMIT NO DRAWN JRL 4631 SHELBURNE PLACE �j+PFc,�. �C 14 \fir osRtstoas ANCHORAGE, AK 99516 .� Sheet 'NA DESIGN DETAILS Il\�\�� `0- 3 OF 3 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE ANDy D `,_ uA THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this a Day of I'JAV of 20J5, by and between J o - N` o herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as AAVan+t;X located at (legal description). 5 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or anal the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this hifonnation. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. O By: — signature) ��A tk �)0Na 2.__(print name) Date: 5 - a-- "L — I j STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregaiMg instrument was acknowledged before me this_ 20�5, l yS� . Ncxr s My MUNICIPALITY: IC FOR ALASKA expires:%7Vcc,.. 16, Joig , By: (signature) Date: name) Title: 09/12/2007 03:29 5 Mark Begich Mayor 9072430742 AWPS, INC. Development Services Department Building Safety Division -Site Water & Wastewater Program 4700 Brogaw Street P,O. Box 196650 Anchorage, Ar 99519-6650 WWW Mkmi oro/oa<Re 1907)343.7904 Pump Installation Log Well Drilling Permit Number: r t Parcel Identification Number: Date of Issue: rrLegal Description Pro Oa�u N�n/e & Addre� �4et�vlr,,�<u_ lG.w Pump Iastauation Date: q1 1 _f t t Pump Intake Depth Below Top of Well Cacint: `a�nfeet Pump Manufacturer's Name: Pump Model: 0_4,3%j( -,%J6 Pump Size Jj4 hp Pitless Adapter Burial Depth: I feet PitlessAdapter Manufacturer's Nlme: Nl^ PitlessAdapterinstaller: V 1A Well Disinfected Upon Completion': Pg Yes ❑ No Method of Minfection: Comments: i I . l[IORAGE WELL & PUMP SERVICE, INC Pump Installer Name: —30 II�EAST 76TH AVE. ANCHORAGE, ALASKA 99518 (9E7 -MAIL' pumpm43-0740 - a jim@at 413-0742 PAGE 05/07 Attention: The pump installer shalllprovide a pump installation log to the DSD within 30 days of pump installation. 1 I CW municipality of Anchorage P.O. &I.x 1grm • ,lttchoragc, Alaska 9'J519 -fill-() • Telephone (907) &158'101 • r,« ('.x17) 343.6.(X) 47011 Braga( Strca • Anchorage, Alaska 99707 ouu•.munl.ory( Mayor Nark Begich Building Safety Dixislon 19 September 06 Donna Norris 4631 Shelburne Place Anchorage, AK 99516 Subject: Expired On -Site Water and/or Wastewater Permit Permit Number: SW050382 Legal Description: Knik Heights Block I Lot 5 Dear Ms. Norris: An On -Site Water/Wastewater Permit, number SW050382 issued by this office for a single-family system, will expire on 05 October 06. Permits are valid for 365 calendar days from date of issue. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A one-time renewal fee for a second year may be issued for a $115.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are $460.00 for a wastewater permit and $175.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, 5 2 p Daniel J. R Program Manager On -Site Water and Wastewater Program Enc: Copy of permit Community, Security, Prosperity 9 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 Renewal Permit Number: SWO50382 Legal Description: KNIK HEIGHTS BLK I LT 5 Date Issued: Oct 05, 2005 Expiration Date: Oct 05, 2006 Parcel ID: 017-372-31 Design Engineer: 0003 S & S Engineering Site Address: 004631 SHELBURNE PL Owner Name: DONNA NORRIS Lot Size: 37366 SQ. FT. Owner Address: 4631 SHELBURNE PLACE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516-2930 This permit Is for the construction of: ❑✓ Disposal Field ❑✓ 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. 5. The following special provisions. THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. ALL CONTAMINATED MATERIAL NEEDS TO BE EXCAVATED AND PROPERLY DISPOSED UP TO SIX FEET DEEP AT THE DIRECTION OF THE LICENSED PROFESSIONAL ENGINEER. Received By: Date: Issued By. QL= Date: /d /S-�os— Municipality of Anchorage Development Services Department 4 Building Safety Division On -Site Water and Wastewater Program 4700 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. 617 -3w - B,/ Permit Number SW Property owner(s) t_"rIr tta 1110# Mailing address Li�3i 51,46 Site address qp 3/ SGrld a*ie Legal description (Lot, Block & Sub'd.) r15c Day phone 3`7—:> J 7�C vio pjn /io Aj_11v)1a!ja, iLZip Code % /�`9/�> �/7 Legal description (Section, Township & Range) Lot Size 3q-3co(A Acr q.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi 13 Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above)nformation ' correct. I further certify that this application is being made for a Single Family Dwel�nd is in cordance with applicable Municipal Codes. S & S ENGINEERING 17034 Eaple River Loop Rad No. 404 (Signature of authorized agent) 00 Permit/Rush Fees: y 6 D Date of Payment: `1 t a 7 / o 5— Waiver Fees: Date of Payment: Receipt Number. o -7 w q Y O Receipt Number: (Rev. 0904) NEALTHAUTHORITY APPROVALS $EWER & WATER AMINE%TENSIOTS SEWERLWATER 24PECTION ENGINEERINOSTUMES ANDREPOTRs WELL INSPECTION S FLOW TEST SITEPWJS SOILTEST PERCOLATION TEST STRLICT RAL& AECIAMrM. INSPECTIONS ONSITE WASTEWATER DtSPOSALSYSTEIA DESIGN ROBERT C. COWAN, P.E. FIOBERT A. SHAFER PE. CMLENGINEEPS (907)694.2979 September 21, 2005 FAX(907) 694.1211 MUNICIPALTfY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 5, Block I, Knik Heights Subdivision It is requested that you issue a permit to install an I.D.S.F. septic system upgrade to serve the existing four bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 1/26/91, water was not found. After monitoring, ground water was not found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you Enclosure information, please contact us. P.E. 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 " = 40' I DESIGN I SITE -PLAN r O 0 am`�= ---J 10' lf - - - - - - - - - - - - - - - - - - - - I I I I I I � I I I r0 inoo I I m I I Dor I I I I y'ut I I i tnoo* Km I I �/ GZ I II I I o (� C-) v � � � CC O y �x �x z ro ", PN wi' A UI O r O yj . 'R .ao Z y0 y r" f ro '- (A �o I i O F o� .... yf o i Z •-1 ,. -1r '%..?5 Xo 1 N C.1) KZ .,sl•WDNC SmX I N ,>• BOZO i'i xZ o CO m I ;'. o> < m r, o -N•1 o- InoZ m F I o OC) I _ 1 sl ---J 10' lf - - - - - - - - - - - - - - - - - - - - I I I I I I � I I I r0 inoo I I m I I Dor I I I I y'ut I I i tnoo* Km I I �/ GZ I II I I o (� C-) v � � � CC O y �x �x z UTILITY EASEMENTLIM --------------- I I W :� N. T. DESIGN I PROFILE 1 rM O� ►� —CA \\ cn a y i i C/i �rnrn5 C�7 0 t4m N O 7 "D 5;; d m -0Ai..� CJ o OO Darn OWiA mnN D� C70o �r rn C7 r7E mp ZpDmOr. EnCA2 D > c7m0�,�-ti 0D r a A 11 20' � I h I q M tz O �C/) I b Y N �6 �f`rt3 CJ o r -O =JDO mnN pv p 0D �D 9 a• -0 A 0 m p w y D us Z O Y N �6 �f`rt3 e .e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FORM OHtN 1 - �T� -.7 LEGAL 1 �Y 2- 3- 4- 5- 6 345 6 p 7 .d a 8 9- 10itto - 11 12- 13- 14- 15- 16- 17- 18- '91 213141516171919 20 OTZ' M►- �Paus- A-. WASGROUNDWAT ENCOUNTERED? IF YES. AT WHAT DEPTH? Depth to Water After Monitoring? e, Section: C1ENG R'S 6EA1) �. Nc. 1457E ..... Reading Data Gross Time Net Time Depth to Water Net Drop �O t Z Lrao 13 d -w LJ N PERCOLATION RATE (mmutevmcshh))�PERC HOLE DIAMETER Lcl TEST RUN BETWEEN AND / FT COMMENTS S & 5 ENGINEERING 17JEap ,vxr o. 04 PERFORMED W Eagla34 t'3 ac Alastra 99577 1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELIN .S EFF CT ON THIS DATE. DATE: 72-DOEI (nev 4 05) / MUNICIPALITY OF ANCHORA( O PERCOLATION !� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST SOILS LOG — PERCOLATION TEST PIRP011MED FOR: HNO _ — DATE PERFORMED: )0110 ice-) llOAIO[itiIIPT10N: SLOPE + { 13IcIrk 111777=1 f TE PLAN 11 12 12 14 .,• .� 492!! # Oro /.bt Wow .:S 4 • • e •' 0 to t, ��`.•..-___••�'��" • 7 —a w► V14 • . 4 I►r,% '� 7 : f i /. .O '• 7 �;'i• / Pyr . IOL. 11 12 12 14 10 WAS GROUND WATIR •NCOUNTIRIO/ G P IF VlS, AT WHAT /Pr..•.h•�.F ! DS►TH1 .a/i•//f I. If/** "oodw4 i* 492!! # Tliw. Wow Not O.a11 ^ •`.. I Iwl• A. S+w• t, /��• CE•6?34 r.�• to t, ��`.•..-___••�'��" 10 WAS GROUND WATIR •NCOUNTIRIO/ G P IF VlS, AT WHAT /Pr..•.h•�.F ! DS►TH1 .a/i•//f I. If/** "oodw4 0•I•T•iw Tliw. Wow Not O.a11 ^ •`.. '� 7 : f i /. .O '• 7 �;'i• / Pyr . . 1 Iei. (iw1w•.wllwAl _ . U MROOLATgN RAT! TOOT RUN SlTW!!N FT AND PT co w sm NIt /lr so"Atrf_ PtR►ORrlO WI !•/• Mosta Lvosseo" bvbm _Ct11T1P1lDtV• ��'�'�+' LATI: bob Fhw, AS INR► X11" 7th E•/fFl Municipality of Anchorage page t of [DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ® Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: = PID Number: Name: \A. � ;� Wastewater System: ❑ New pgrade Address: ABSORPTION FIELD Phone: No. of Be rooms: ❑ Deep Trench ❑ Shallow Trench *ed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grad: —> — IE�) GPD/Sq. Ft. Lo ZBlock: Subd ivisio �45 1✓�. �. E ILr�+ L r9 � � Depth to pipe botto /froomoriginal grade: r�l`e-t Ft. Gravel depth beneath pipe r �? r`� Ft. Township, Range: II 1W Section: Fill added above original grader -- '5 Gravel length: o Ft. •5E6 2 FL WELL: El New El U rade p9 Gravel 9eptiT-. "i 2 / ?_ Number of lines: Gi Distance between lines: Ft. Ft ClassifiiVionn (Private, A,B, ): Total Depth: Ft. Cased To: Ft. Total absorption area: t �� SQ. Fl. Pi e material:p ( L:�, ' Driller: _ Date Drilled: Static Water Level: Ft. Installer: G Date instIalled—: ' Q, �— II Yield: Pump Set at: Casing Height Above Ground: TAN GPM Ft. Ft. SEPARATION DISTANCES _ Septic o Holding o S.T.E.P. To From Septic Tank Absorption Field Or Station Holding Tank Public/Private Sewer Lines M nut eturer: '/ [��- . I h� Capacity In gall .�--Cri2ro c_D Well _ f \ 010 �/ t `V7 �r o Material: Nuin bar of Compartments : Surface`� Water k �� / ! LIFT STATION Lot Line 1 \k t Size in gallons: Manufacturer: Foundation /�l�15 t / / "Pump on" level at: "Pump off' level at: High water alarm at Curtain % I Pump Make &Model Electrical Inspections performed by: Drain J+1 Remarks: BENCH MARK _ Location and Description: Assumed Elevation: --1�?� ` ENGINEER'S SEAL ri A S ENGINEERING 17 Eagle River Loop Road N0. Inspections perform i Dates: I-st A1�fi7Ce ;�,�j .. JC�1Id �, Department ofHe nd Hu Services approval Reviewed and approved _ —Date: 72-013 (1/91) MOA 25 Permit No. 15'11 Page _ 2 of -2— Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PID No.: t� `� � J✓ moo, � �3 T a .o 0 t" V r—lh•t� �i(T—� r�T 1 c�ri [NQS 72-013 A (2/91) MOA] 25 l'% •� ✓f `' G.1 Crrf�Ni 04"�5 ENGINEER'S SEAL P1I1NICIPAL.ITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUNAN SERVICES P.O. BOX 196650, 825 "L" `=STREET. ROOM 502 ANCHORAGE. ALASKA 99519-6650 CIN -SITE (JELL. AND WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT NILIMBER:c;b.191002.5 DESIGN ENGLNEER:S & S ENGINEERS OIJNER NAME -SECRETARY OF HUD OWNER ADDRESS:605 W. FOURTH AVE. ANCHORAGE. AK 99501 PARCEL. ID:01737231. LEGAL DE'tiCRIP_IION,' KNIK HEIGHTS BLK I LT 5 LOT ';ICE: 37366 (SO, FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 PAGE t OF I I ;CX:) Co -a1-91 4-' a ✓o PERMIT DATE ISSUED: 2/25/91. EXPIRATION DATE: 2/25/92 THIS PERMIT I`:3 FOR THE CONTRLICTION OF; DISPO`_�AL_ FIELD / IJELI_ SYSTEM AL.L CONSTRUCTION MUST BE IN ACCORDANCE IJITH: I. THE ATTACHED APPROVED DESIGN. - ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL. CODE_ CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA I.JASTEWATER DISPOSAL_ REGULATIONS (18AAC72) AND DRINKING MATER REGULATIONS (18AAC:80). 3. THE FOL_LpIJ.ING SPECIAL PROVISIONS. SPEC.I.AL PROVISIONS: RECEIVED By: �DG� _-_ DATE:�S//__ ISSUED BY. _-� G _ /�% ` __� __ _ ---- DATE: � � rtp� 6 0 ROBERTS HAFER, P.E. ROGER SHAFER IA -4 CIVIL ENGINEERS 1 A, (907)694-2979 Febkuahy 18, 1991 FAX 694-1211 PqC E RIVER. A ASA HEALTH AUTHORITY APPROVALS Muwicipat,ity o6 Anchmage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 SEWER &WATER MAIN EXTENSIONS Anchona ge, Ata.ska 99519-6650 REFERENCE: Lot 5; Bfock I; Kn.ik Heights Subd.ivi,sion; As discussed with Dan Botfes o4 your, o46ice on January 31, 1991 we SEWER &WATER INSPECTION request you issue an on-site wett and septic permit and a conditionat Health Authon.ity Appkova2 bon the kebeneneed pnopenty. The pkopenty is eunrentty owned by H.U.D. In June, 1989, Louis Butera, P.E. o6 Eagte Riven Engtneen.ing Seu ices pen6onmed a weft and septic asse66ment on the pnopenty. As pant o6 the assessment so.it, test hates were excavated and a weft 4tow test was per.bonmed. The ,4t% ng wett was _bound_ to have_a_62ow_4ate ob 0.61 GPM -and_ the existing system was bound to be encroaching guundwa.ten. Due to the United area avaitabfe and topography o6 the afteknate septic site, and due to the tow p7oduetivity o6 the existing wett, Mx. Butera keeommended a new wett be diLitted on the property. This new wet? toeation woued atso provide a move desi,%abte area bon a septic upgrade. SITE PLANS A permit was obtained and _ -,a new _weU dh_,i-tted_ .in January un6o4tunatety, the new wets' 6tow nate was bound to be onty appnox,imatety 0.25 GPM. This is uuat.i64aetory bon, the 4 bedroom house toeated on the property. ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN A6ter having spent oven $19,000.00 on this property without obtaining neither an approved water system non an approved septic system, H.U.D. wishes to "wash thein hands" o6 the property and sett .it "as is . A potentiat buyers o6 the property, John Norris, has retained our. services to assess the property and ob6er a sotution to the weft 9 septic ditemma. Using the extnemety tow production o6 the new wett a6 hindsight in6ormation unavaitabte to Mr. Butera, we have re -evacuated the atternate septic site outside both on property wett radii. Att monitoring tubes instatted within WL. Butera'6 test hotel axe dry at this time. This suggut6 a dramatic 6easonat 6tuctuation o6 groundwater tevets in the area 06 the existing teaehbietd. The existing teaeh6.ietd appears to have been instatted within a poo i.on o6 the Furrow Creek drainage area that neve4 receives btowing sur6ace water. However., sub6u&6ace water, tevet6 4tuctuate seasonatty and po66ibty with precipitation events. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 5; BCock 1; Kn.ik Heights Subdivision; Febhuany 18, 1991 We have pen.4okmed additional so.i2 testing in the atLea near ,the existing Leach4.ietd. Prom this so.itz .in4o)Lmat.ion we have designed a new septic system with the 2eaeh4.ietd elevated above high gnoundwateh teve.2s. The e2evatt.on o4 the gn.oundwaten wa! detelunined 44om Butena's data coLQected lune 22, 1989. Gnoundwaten 2eveU ane genera ty near, theilL peak at that time o4 year. The con4.igunation o4 the proposed teaeh4.ietd is such that ,it does not encroach upon any went +radii, and it blends into the peeutian .topography o4 the area. The location o4 the proposed system w.i2t also nequ,ine a panti.at netocati.on o4 ,the existing daiveway as shown on our attached site plan. As pant o4 ,the design we propose nedkitting .the okiginat weft. (Un4oktunatety, this well was abandoned below glade fust pn.ioh to d&iUing the new well.) The pn.oduett.on o4 this weU should nema.in as good as it was pnton to abandonment. The4e4o4e, this wells' pn.oduct.ion o4 0.61 GPM combined with the new wells production o4 0.25 GPM should give .the pnope)Lty a su64,ic.ient quantity o4 watex 4on the existing 4 bedroom home. With the issuance o4 the conditional Health Authontty Approval Mn.. NovLts has agreed to contract with oulL 4tiw to pnov.ide weekly gnoundwaten mon.iton.ing on the pnopenty. 14, at anytime, we 4.ind the existing leaeh4.ield to be enenoaehing .the 4' requited separation distance to gnoundwaten, the septic tank wilt be pumped weekly by a Municipally approved pumping contractor.. 14 you have any questions, on n.equi Le additional .in4oiLmat.ion 4on your, review, please contact us. E. V < dl I lit ori" g OT-�'-��.�• -- �i � t��'P �D MI lq \-4,�,) SCALE *v./(,/w Zov' ,1- T V.%1-5 '(SDR-lL� gip, f'� 114 �I TI .A 5; o Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOO — PERCOLATION TEST Io PERFORMED FOR: \1�C�' oS-_'� S DAT LEGAL DESCRIPTION: Lam/ —F-'• \h.- 01f,'. Township, Range, Section: QEPTH SLOPE 14 15 16- 17 18 19 oo I N PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN F I/AND _FT SITE SITE PLAN Reading Date ((PE P T`F t Depth to Wate! Net Drop 2 �z —� 3 f 4 - D -2- 2-Z,' 5 Z,'/E3 •fit/(% ~ ! 2— 7 9 10 - WAS GROUND WATER ENCOUNTERED? 11 - s L IF YES, AT WHAT O 12 - DEPTH? p E 13 Depth to Water Aller Monitoring? Dale: 14 15 16- 17 18 19 oo I N PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN F I/AND _FT SITE SITE PLAN Reading Date Gross Time Net Time Depth to Wate! Net Drop �z —� �� '�-N W3 -2- 2-Z,' Z,'/E3 •fit/(% ~ ! 2— COMMENTS _ F 47"ij i'.;e j)f f:l`Jti !` 49�1d i l 16t3� (0c PERFORMED BYI_: ..! ky. , • AIwka 29W/ 4W7 1 ACCORDANCE WITH ALL STATE: AND MUNICIPAL GUIDELIN� 72-008 (Rev. 4/85) / ^0 CERTIFY THAT THIS TEST WAS PERFORMED IN F ON THIS DATE. DATE: — o Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: L'� ,-�" �Lt�j IL- Township, Range, Section: DEPTH SLOPE SITE PLAN COMMENTS WAS GROUND WAT ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? S L O P E Dale: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE _ (mnutesimch) PERC HOLE DIAMETER TEST RUN BETWEEN --Z�T AND FT 170314 ',"0o I=O ro12'006 Vi;, `•. F,rllci I?.t�,'(3 Y� r`•.I F3`-yii5 f�a:;t%? PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDE 72-008 (Rev. 4/85) 1 CERTIFY THAT THIS TEST WAS PERFORMED IN �lYCTON THIS DATE. DATE: 2 �L 3 4 5 6 -moo 7 t3ol �C 8 9 10- 11 12- 13 14 15 16 17- 18- 19- 20 COMMENTS WAS GROUND WAT ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? S L O P E Dale: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE _ (mnutesimch) PERC HOLE DIAMETER TEST RUN BETWEEN --Z�T AND FT 170314 ',"0o I=O ro12'006 Vi;, `•. F,rllci I?.t�,'(3 Y� r`•.I F3`-yii5 f�a:;t%? PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDE 72-008 (Rev. 4/85) 1 CERTIFY THAT THIS TEST WAS PERFORMED IN �lYCTON THIS DATE. DATE: TH 1 SOILS LOG MUNICIPALITY OF ANCHORAGE p *E-J�01 ■ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: Hurt LEGAL DESCRIPTION: La e; - It 1= T �— �(f E@tl 1 j "-T"oPSor L- Date Gross Net Depth to Net Time Time Water Drop y 4 1 n ] o 5 Wol 1r) WATER, 6 7 9 9 s 10 tl: I2 11 12 13 14 15 16 17 16 19 20 COMMENTS PERFORMED BY: 72 008 (6/79) DATE PERFORMED: 'e' � /ter S /Tn17 K fiF� SLOPE WAS GROUND WATER S ENCOUNTERED? L 0 P IF YES, AT WHAT E DEPTH? j T /-1 'v SITE PLAN I I Se ,. S r I Reading Date Gross Net Depth to Net Time Time Water Drop y /23�h'7 Cr10 1 n ] o Wol 1r) s tl: I2 /oIt, PERCOLATION RATE_ (minutesPrtch) TEST RUN BETWEEN FT AND — . FT CERTIFIED BY: DATE: t TH 43 O� SOILS LOG MUNICIPALITY OF ANCHORAGE • +..e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION • 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR:_ LEGAL DESCRIPTION: yup DATE PERFORMED: 6��y /5 � r,t 1y- SLOPE SITE PLAN ToP�srr_ 2 O ' 3 v GM 4 \ p / 14y,'�,,.,,1.� 1 5 6 7 g o O. Gp- C w �, ;" p � / t�•1-�4n uel( 1 lo - 12 0 12 13 14 15 16 17 18- 19- 20- WAS 81920 WAS GROUND WATER S ENCOUNTERED? Ny L O P IF YES, AT WHAT E DEPTH? _ Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE "�1d TEST RUN BETWEEN COMMENTS PERFORMED BY: CERTIFIED BY: 72008 (6/79) 4�. —(minutes/inch) FT AND e^_ FT DAT ..n T T T T T T (wj O O O O O O 1 0 0 f Lco w o 'co w 1 T T -n 0 0 0 L j, w co r. � I� r- ol W 1/ � I T N H M N .-r / \ N �y] ICA I W • L7 I C/� 1-3O IW 0 KD IR r. ,G (D ~ In CD Ic� °Poo- !y CD 1 J IC / 1✓ ^ -n T T O O O O O O O co ^ IW W I7V TJ � iw ° o --2 n r• -n T T mT .•Ti .� O O O O O O O w I� to O o o •+ T IT T . r T r i+ � •'z] ' � ly i� W I(D CD C I� (D 0 r+ G c G N � � 1�3 U'� A i IO 10 � w Z �CD(D I Io r D o O z o 0 0 r w m I w N cn W m to m > O D r O Z V) n D -1 ® � m Z O r m Ip IpI� IO co O X co co rr r r N C � � G rn v, w Li r rn N O A L o 0 0 \ v. I� o co m r• C+ i j a (D n O n N � A� Oq (D a x I i � to m > O D r O Z V) n D -1 ® � m Z O r m Ip IpI� IO co O X co co rr r r N C � � G rn v, w Li r rn N O A L Scee 1 0f 1 Pump Service Date: 2-12-90 WATERWELL - TEST PUMP REPORT ` "'du eo�ed by: Anchorage Well & Pump Service w-ner¢ H.U.D. Address: 'ell Location:4631Shelbourne Place -- Lot 5 Block 1 Knik Hats `e'-1 information: Ttl. Depth 400 Depth of Casing 180 Screen From n/a To Casing Size 6" Screen Dia Screen Slot n/a Remarks 'umn_ information: Intake Depth 3T8- Pump Size 1 hp Air Line Depth Electronic Static Water Level 176 Av.Discharge __ GPM, Max,Drawdow-n umU on: Time 3:40 DateZ-5 Pump Off: Time 4;i6 Date _ 11:00 2-8 11:40 3:40 2-8 _3:52 WATER PIEZO- FLOW WATER PIEZ FLOW CJ1IE LF'VF.L TUBE GPM REMARKS TIME I LEVEL TUBE GPM I _ REMARKS ?-5 176 Meter 113413 -- 3:4 176 9.81 Star -�-- -4-E ---2 rl9 . 21 113460 _ 4:uu 311 4i tl� 4:0 337 6.0 113638 1 4:i 360 5.5 113668 1 4: 1 379 5.0 113694 I 4:1a 388 5.5 113707 Suction B eak I I 375 5.0 Gallons 294 Pumped 388 REcovery Check I I _ �4:1 285 Gallons n . Irl Zai 4 Hour Reco c' -o 11:01 11:0' 11:1 11:1 11:2 11:3 11:3 114 2=8 3 4 3 4 3 5 3:5 1T 213 246 10.01 113746 9.51113792 278 8 .9 1 113836 306 7.7 113875 332 6.6 1 13910 358 5.5 113942 375 5.0 113968 388 113992 Suct 285 Gallons 4 Hour Reco 3 on Break ec -114048 I 1 1 1 - I11 56 Gallons Pumpedl:- 240 Min l=.2333 gpmiIndicated Yi6ld ® Municipality ol Anchorage, Department of Health and Human Services 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 January 8, 1990 Housing and Urban Development 701 C Street Box 64 Anchorage, Alaska 99513 Subject: Lot 5 Block`" Knik Heights Subdivision Permit #890262, PID #017-372-31 The subject permit, issued by this office for a single family well and/or on-site wastewater system has expired as of December 31, 1989. Permits are issued on a calendar year basis by authority of the Municipal Code of Regulations. A new permit must be obtained from this office for an well and/or on-site wastewater system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as -built inspection report (three-part form) must be sent to this office for review, approval and documentation. when applying for a new permit, the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincerely, John Smith, P.E. Program Manager On-site Services JW/ Ijm:200 enc: Copy of Permit "Kids Are Our Future" H(}N1ClPALlTY OF ANCHORAGE Department of Health & Human Services 825 L Street, Anchorago� Alaska 99501 343-4720 ON~SIlE SEWER & WELL PERMlT ^� Permit Number; 890262 Upgrade <] !<��u/ Date 1ss1.1ed: 11/17/89 Engineer Designed Owner Name: H U D Day Phone: Uwner, Address: 222 W 8TH AVENUE 27i-4342 ANCHD9AGE� 0K 99513 Parce1 [d: (/17`372�J1 J| �v Lot Lega1: SubdivjEli on: KNlK HE1GH|S Lot: 5 Hlock: SecLiCori : 7 |ownship: 14N Range: 1 Lot Sjze 37366 (sq.nr acres) Max 8edrooms: This Permit: 4 [otal Capacity: 4 SEPTIC [ANK: Minimum LoLal septic tank capaciLy: 1,250 gallons. Each septic tank must have at ieast 2 compartments" Depth to top of septic Lank(s) ( 4.O �eet requires Insu]at- ion over tank(s>. �ELL: Log must be submitted Lo Municipality of Anchorage Department olz Health and Human Services within 30 days o| we1l comp!eLion. PERMlT EXPIRES DECEMDER 31, 1989. ADSORB. AREA MUST 8E OPENED AND CLOSED IN SINGLE DAY, OR H�AlED. PROPERLY ABANDON OLD SEEPAGE PIT AND OLD SEPTIC TANKS' l CERT|FY THAT: |. I am amiliar wiLh the requirements 1or on-site sewers and we1ls as seL forth by the Municipality o1 Anchorage (MO)) and the State of Alaska. wi|i ivast al1 the system in accordance with all MOA codes and regulations, and jn com! 1 1iance wiih the design criteria of this permit. J. I w111 adhere to all MOA and State CA Alaska requirements {or L1e set back �istances |ron� any existinq well, wastewater disposal sysLem or public sewerage system on �his or any adjacen� or nearby lot" understand that f Kjs p'rm1t is valid f1 a maximum Co[ 4 bPCI 'ooms. l a�so 'mderstand thai the capacity of the tota1 system is 4 bedooms and any en1argement wili require an additionai permiL' SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: /—/" V DATE PERFORMED: In./ )o%SCS, - LEGAL DESCRIPTION: IJ Yl k j et �h t ! ,ubc� V • I �, �� i31n 1� ^� 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 1E 1E 2C PERTH �— (fEJET1 T0960-17L Depth to Water Net Drop 0 v. ,.. -2 3 : 2 7 i 0 -a o - d {, 0f 4 1.4 4� �7 �9 rad .,��, �•,� .n � �g -gaOenSf p nv:.zece vsnecB'?auseon 41 u° !.cu . A. Butera e' Q 0 !.cu'-. € <� x.`_57'6 E{(ti4' (9VgFa o, on oo�EO `P��rx-=� COMMENTS I 2 re WAS GROUND WATER �O L ENCOUNTERED? 0 P IF YES, AT WHAT E DEPTH? /x/,, Af Reading Date Gross Time Net Time Depth to Water Net Drop -2 3 : 2 7 i PERCOLATION RATE S—, 3 (minutes/inch) TEST RUN BETWEEN D FT AND 3 - FT Eagle River Engineering Services PERFORMED BY: P 0 Rax 77:29A CERTIFIED BY: /��y 27 DATE: Eagle River, AK 99577 6945195 7 2-00 8 (6/79) 1 SOILS LOG MUNICIPALITY OF ANCHORAGE yt DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: /-/'w d DATE PERFORMED: LEGAL DESCRIPTION: �+'" k N�' -�+-} S �a h I-.. ��' 1 -310c -k SLOPE SITE PLAN m -n m v-= z 3 — — o O. 4 0 0 5 0 • J 6 6 7 (3 8 L . 0 6 9 0 0 10 — 11 12 13 14 9113 15 17 b..era 18 „ 19 20 COMMENTS 14S'e /T,, 0 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? � O P {Jiir'ilsr!' � E /o/i-/g 9 /i /7/a9 MOMISMOM 1111 I. �i1NNl.:I011 lEEmNIN: PERCOLATION RATE b;-(minutes/inch) TEST RUN BETWEEN ._ a FT AND FT Caglo River Engineering Services PERFORMED BY: P- n Rnv 770294— CERTIFIED BY: Eagle River, AI( 99577 694-5195 72-008 (6/79) DATE: /*// f/8 9 Gross Net Depth to Net Reading Date Time Time Water Drop AD H'j —2 7 lys x,•30 7 b 2 1311, PERCOLATION RATE b;-(minutes/inch) TEST RUN BETWEEN ._ a FT AND FT Caglo River Engineering Services PERFORMED BY: P- n Rnv 770294— CERTIFIED BY: Eagle River, AI( 99577 694-5195 72-008 (6/79) DATE: /*// f/8 9 APPROX. NEIGH NEIGH WELL LOCATJON\ WFLL1 LOT` 6 kN°02'W L 100' JJPA3 I I W 0 W TEST HOLE— Fo o SEWER CLEANOUT N 00004'W •Q• - WELL NO STREAMS 10' 7 NO KNOWN CURTAIN DRAINS c: SEPTIC SITE PLAN _ LEGAL: LOT 5 BLOCK I KNIK HEIGHTS APPROX. NEIGH I r co WELL LOCATION n 5' WIDE ZlD"i Lq r Fri co II F'1EXIST W Fri01 LOT 4 D z o LOT 13 m NEIGH WEL L W 0 W TEST HOLE— • - MONITOR TUBE o SEWER CLEANOUT N 00004'W •Q• - WELL NO STREAMS 10' UTIL, EASEMENT NO KNOWN CURTAIN DRAINS I'D SEPTIC SITE PLAN _ LEGAL: LOT 5 BLOCK I KNIK HEIGHTS OWNER: H,U,LI, PROPERTIES CONTRACTOR: N/A �z FU TH 8 J II I'D �N DRAINFIELD 5' WIDE 2' GRAVEL r 84' LONG II NEIGH SEPTIC TN A +30' NEIGH WEL L +100' NCIGH WLI L «1001 SUBDV J06 # 8_( DATE: 07/06/89FSCALE 1" = 40' EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-•5195 FAX. (907) 694-3297 SPECIFICATIONS FOR ON—SITE SEPTIC SYSTEM LEGAL. L01 5 BLOCK I. KNIK HEI('r11':3 A. GcNERAL 1 The weil and septic, pian arc: -f=or, a s male farm iv residence only. 2. The drawinq and or site plan shall be a part of- this specification. !!11 materia i s and vmr,krnanship s'ha l'l mcot the Anchorage Department of SIea'Ith and State Department of Enwir,onmental Conservation redui r,ernonts . r -.All coil tests are advisory tc.) tllo de;siyn and arc.>,to be verified r_ -)r mod IFicd in tFle iie-Id by the (--ngir)o,_Wr'. Li Al 1 excavat'Iam'; depths are ad1 isot'v and af-o to be vCr-i-f-l"A or rnodif-led in the 'Field by the contractor' to me -1: Munk ipalit:v of Anchorage. Depa,trnent of Environmental Conscar,vatlor7 r"rquirements. 6. It is the responsibil ity of the owner to obtain all nece-,sary perrnits or, casements and to locate any adjacent mkill It farn-1Iy we11s, 7, The ox(,avation is to be exactly it the area shovin on the site plan. any deviation roquir'es engineer apps -oval. 8- It is a lWay> ieocomrncnded that a surveyor 10ccaue tho rleareSt: lot: line position and the loc.;nt ion of any e0 soment:s. F31 , DRAINf:IE:L1) I. The draa-infleld is to follow the natural ]and contour to maintain uniform total der)th of the bed bot:toin. 2. The bottom of the dr'ninf ie'ld ;hal l be leve] . N lus> or, minus 1 . "ti" 3. The total depth of the drainfie-ld excavation is not to excood 3.5' at anv point:. i. The sewer line it to roplace the ex,istinq s;cwor line that 1czade to the <s;,istin<a tank. 5. T1)e bed arave'l is to be coverod with tvpar fabric mater,—Tal, 6. roil or combination of soy l and oxtr,udcad board insu lation to a d%pth of 4' or, equ-iva lent is to be placed over, the le>.achf-ield. 'l. Thea area over' thr bed i s to bo finish graded to proven<. pondiltca of <;urface water r^unof-F. o. The septic tank and -1eachf Ield must: not be closer than 100' to a n v exis;ttnq pr-iva1:e well, I50' to any Class "G" w(a or' 201") feet: tea any comrnunit V we I 1 . RECOMMENDED LEA.Clli'IFI.1_D DIMENSIO1\I5 TOTAL DEPThI 3. 5 ` GRAVEL- DEPT11 =, 2' `r3ED L.EiNGIII Ew,/`3EC) WIC)T1] = 5' t.>oi i ` ,nca — 50 Bedroom Ga pa n, Septic Tank S z ea 1:500 includ Inca lift cstation ***MOTE: EXISTING WELL ABANDONED TO MOA &� AWWA. 5PEC11-ICATION5 Al"TI_I `.IiGii`U�E�1 INSPE=CTION. HELI-. TO CAPPED AND WELDED AT PiILESS LEVEL. ^; *NOTE: LIFT 5TAT101\1 R1,0UII2ED WIRE:D TO MCA C 0 D I `3Y LIGE:ill E0 LI_LCTRIC1..Ai�1. �"*N0TE EXISTING LINE, FROM i'1OU;'13E FO TANK 10 13E SNAKED 11_WSHI:D. i'X1STIN1(a TANKS ('1.) TO BLI>UMPt-D AND PROPERLY A(3ANDOiit._C_ _ ;->r EEiSURf: !..Iil` 1 Ci A1' MUS BLJRIE_;D +5` ;f lld)]LATU) !All .11 i'O'iIT:iVE;. DRADVIACli TO '.T'r"1 5T AT 101'1 , MUNICIPALITY OF ANCHORAGE ' ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION \ 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME�TIP`H�ONE ❑ NEW . �'f 5 L1 9 L— 'UPGRADE MAILING ADDRESS /� sP fA (boy ISf? ? 3 Ar,(hvr�+le /l ftsktt ati s / G LEGAL DESCRIPTION vcLN 0-3 LOCATION NO. OF BEDROOMS TO: Well / D U Ced9e) Absorption area Z Dwelling G� O� Cc.:) PERMIT NO. �/ OctDISTANCE a -ES c�1 y' CLa Manufacturer 61ree e- Material No. of compartments / w Liq. capacity in gallons IF HOMEMADE: Inside length ;5'-Ot� Width Liquid depth 8 Y DISTANCE TO: '�-� Dwelling PERMIT NO. JOZ ®=FManufacturer aterial --- _ " uid_capacity in gallons DISTANCE TO: Well i' S' Foundation 6 -5 Nearest lot line /0 PERMIT NO. �'' r/ )" a u. z No. of lines / Length of each line Total length of IJnes Trench widthDistance "+ between lines 3C) inches Top the to finish Material beneath E. of grade tile Total effective absorption area fy "J '2- inches Y "` .length Width Depth PERMIT NO. ua 0 - I -- p.LuN Type of crib11 ter Crib depth Total effective absorption area DISTANCE T0: Well Bui i -g o n tion Nearest lot line Class Depth Driller Distance to tnt-"a- PERMIT NO. w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area I -`e OTHER We t _ - PIPE MATERIALS 1'�t; --• - ,J� to cy SOILTESTRATING A4iJc1 �t 3 '. � - 'O w " /c y v( INSTALLER ./�LrF atrx / (? S' �- Sr `1 — t ,r b, t. C' .5 (.o REMARKS e ly t o (td ,"n y t tits t2i) tf (o'i- (, Yt e.y (= erg nc(c t 7')7') � " s //° rvc,E/ 5'hv.icl- •>�-,.t.h ,c -TSP• �� ,-t c 1W, S f7 �'GIr �nrt �� /Z/O/f 1' �yUZ ive I a�� 1wc:�lc�•'<� pJw at>iy�-•t �-pn L' Ile,) ;ar, St ale / t APPROVED DATE LEGAL 7-/.;,A/ /J -3 •4 �-�, q n 72-013 (Rev. 3/78) ^ V�1.1111411 X 10 A7 HOWIE. X -1-Y" ED F7, ��fit 1 - 1171170 OR Eq 1AU. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264~4720 PERMIT NO: 84O950 /�� DATE ISSUED: 11/27/84 "/ APPLICANT: MARSHA PRICE ADDRESS: SRA BOX 1588 -B ANCHORAGE� AK 99516 C'01\1 PHONE: 345~4396 LEGAL DESCRIP: SUBDIVISION: I&A IK HEIGHTS SECTION: 27 TOWNSHIP: LOT SIZE: (S0. 1-:1 OR ACRES) MAX (3 ��n0 `�z '/- 43 Listed below are the options available to system. Choose the option that best fits ... ... ..... T|F-1;:!|E8�U�� DEPTH TO PIPE BOOM (FT`) 4^0 GRAVEL DEPTH (FT.) 1O.O TOTAL DEPTH (F 14"0 GRAVEL WIDTH (FT.) 2.5 GRAVEL LENGTH (FT.) 56.0 ' GRAVEL VOLUME (CU TANK SIZE (GALS) �2��} �~«m ** �rlE- /J�O /�r7.J� P7r &d�t-/ ' LOT: 5 8LOCK: I 12N RANGE: 3W you in designi:g your septic vour site. ** TANK MUST HAVE ATLEAST TWO COMPARTMENTs; �..... ..... ^`��..^�� I certi�y that: 1" I am �amiliar with the requirements �or on~site sewers and well� as set [orth by the Municipality of Anchorage (MOA) and the State of Alaska. ' 2. I will install with all MOA codes and regulations:z and in compliance with the design criterick o" this permit, 3. I will adhere to all MOA and State o", Alaska requirements [or the set back dis�ances {rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nqarby lot, 4. I understand that this permit is valid fol, a maximum of 3 bedrooms and any enlargement will require an additional perwit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS~BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUS A LICENSED ELECTRICIAN^ SIGNED DATE� ... .... ..... ~~~~~`~~^�-~-~~ APPLICANT: MARSHA PRICE � � ISSUED BY DATE: ----------�-----------^-�`--��----~~_ ~~-r~�~-~7.---' l;' SOILS LOG _---- MUNICIPALITY .MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION • TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: IGY ('IGS. DATE PERFORMED:_ LEGAL DESCRIPTION:- L'� BIOCL _. 7 f u/ b�e/o1�c `> S ---1, SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS PE DKGANI( PA r /SAua'r s/ res Irk, ✓.a;.��r So�L 5Ak _r PAVcC._ II F (OV- N1 wto�,51 / "i -f-rcrcIfct'f /� i'' - n 1 f c.tof [aS 1��i81f "aAk (( ,- Ljrt^/ utpi5l/ %�'1't'S' 13, 116e LIKEN Date Gross Time Net Time 11 �r► Net Drop No If67 115Ir (C ii ■■ ME ■■►a Mks v.(�s� MM + WAS GROUND WATER S ENCOUNTERED? PAO O p P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 4k,10 If67 115Ir (C v.(�s� 0,oq + D +u a 0-26 ;s r / C PERCOLATION RATE -(minutes/inch) t BY:/'I Wt UI-4get� CERTIFIED BY: �. GRf 'R ANCHORAGE AREA B0'._ )GH y Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 _ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME �L'l %`rl MAILING ADDRESS PHONE 1 LOCATION LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL MANUFACTURER MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH _ INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 7Civ'o L, SEEPAGE PIT: NUMBER OF PITS DIAMETER .__ OR WIDTH,1j , LENGTH/ _, DEPTH - Ci LINING fVATERIAL Z CRIB SIZE: DIAMETER �DEPTHL_ DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION%, NEAREST LOT LINE u G ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION WELL: TYPE _ BUILDING FOUNDATION CESSPOOL APPROVED DISTANCES: _CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED INSTALLED BY: �- 4) A/ � L IF PIPE MATERIAL: ilA LOT SLOPE: REMARKS: 6 m No. EQ -031 NEAREST SEWER LINE REMA DEPTH SEPTIC TANK_ DIAGRAM OF SYSTEM GALLONS. SQ. FT. DISTANCE FROM: SEEPAGE SYSTEM _. GAAB-"'-I OP'" ATER ANCHORAGE AREA BORO1 `-IH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 _ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ,MAILINGog �,;_ r �i�l %� .ADDRESS -:ilO L'%k!�M%6»7rV' _PHONE___ SEPTIC TANK: % NUMBER OF DISTANCE FROM WELL .V _MATERIAL _: COMPART ENTS ( � -J• �(.°s', r /C LIQUID LIQUID CAPACITY �� SLG GALLONS. INSIDE LENGTH_ _INSIDE WIDTH DEPTH_ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PIT—OUTSIDE DIAMETER_ OR WIDTHPTH !), LENGTH ,'K�, DE S , LINING MATERIAL 1�, . DISTANCE FROM WELL BUILDING FOUNDATIONOL NEAREST LOT LINE �L—� TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)_,Lsr•SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OW LINES ABSORPTI DEPTH: TOP OF TILE TO FINISH GRADE FOUNDAT STANCE BETWEEN L NGTH OF EACH LINE WELL: f" &, TYPE , ✓', � / / _ NEAREST SEPTIC LOT LINE / SEWER LINE >✓ , TANK DISTANCES: f� 1 S r REST LOT LINE TOTAL LENGTH OF LINES_ _.. L EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROM / WATER BUILDING FOUNDATION. 0 • SAMPLE�" NEAREST i SEEPAGE / OTHER SYSTEM /4 .� "fT CESSPOOL t_)A,/-, SOURCES! DIAGRAM OF SYSTEM DATE � =� � APPROVED GARB-xn-2 GRE. A Er kNCHORAGE AREA ')RO JGH Case No. g�D_2 HEALTH DEPAR'rMENT /y a 327 Eagle St. Anchorage, Alaaka 99501 279-251j/ • SEWAGE DISPOSAL SYSTEM a APPLICATION & PERMIT NAME OF APPLICANT t� -L s MAILING ADDRESS PH NQ. RESIDENCE ADDRESS _ LOCATION OF INSTALLATION // UC�.to LEGAL DESCRIPTION x<zj, APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH PERCOLATION TEST RESULTS THIS IS TO SERVE AS DISTANCES: C_ RPFPArF PIT L nRAIN FIR n TO BE INSTALLED BY ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT , PERMIT TO INSTALL A OTHER 9 - I AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED SEPTIC TANK SIZE 65590 TYPE iU4 LSEEPAGE AREATYPEw`-� (22,CY, !lam r HEALTH AUTHORITY OR LICENSED DESIGNER I certify that I am familiar with the r _ above described system is in accordance with said code. DATE APPLICANTS SIGNATURE Y \ REATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT CASE id 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed iorionP; ,), / �,�,: Date Performedi�;. c Legal Descript: Lot t Block- .:.. J—c7�r 2L1S� This form Reports a: Soils Log �-/� Percoolation Test" Depth Feet Soil Characte7,isti(,s 7'he soil shows C, Icc 1 5iure L.o,;bw4 ti C.Gvp} 13 r, d ��ense. The re is c.. reIc,4i elf k«Ih sila F, play Cortivv� Gui f k e oUerlcll C11:*c,ssl�iccr�icn w LkT-r- some svv,all ICL Y1 CO n LC N i r" I co g 3 I m Pvr4ctn Cu Was Ground Water Encountered? N�} If Yes, At y.?�at Depth r s0 M Reading e,te ,s ..,.., Gross Time Net Time Depth To H2O Net Drop R^�'�+sn�u.<•.uxs..•.ra!r>c-,�e.n.,�_++.�� F m e.rs,u�.w+aw+/.w� n.aqun.taan>ra-.e- x»'emmmsen.se:w �l(-. �•�t�wa�mryn 9] wMvn'ein «['.ate-.mmmamww>w�ew+xSVawm nem euu�tn'e->msa�„wy� - >e.w.+ev,w w. n`w•rwewa oe�..r>+e,ar.w nmu-��nei'uv+v w.xelyYb� _ ge+'�eglsnw+r xr.w�+azwy�ysa<e n,.raxrram J'((�m nom.». �an•�,..�.r.Mx _ kw .air .mm�+,>amnrv-.x. e�i �¢m++c'M-e.zurva., e.r .'n+-rT.+ee¢as�.wzM�> awl, ie>Mfa,Wn�euer„�cd � uOlnrCWaw.v�c>ee.>i:y¢Tu1..�+nuRe.,��anemy.pd�p� - !O<9e+n. �. a.veyn.eomis�.Y�AfuiY�,<'.p erre a l= i_ Frog -)sod. Installai.io�n Seepage Pit Drain Field Depth Of _ n.' e : y r Depth T B tto� pf Yit Or Trench-- -, — COMMENTS: : e � Test Performed By: -1 Data Certified By: Date- .,�i,2L�...�.,...,,a....�. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M}�1 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. # e�)l 7— 37Z-3/ HAA # 19?1610_'6 1. GENERAL INFORMATION Complete legal description Lot 5; P,2ocn "I"; Kvak Heighta Subdi.v,Lstion; Location (site address or directions) 4631 SheX.buhne. Place. Property owner H.U.D. #111-094531:-203 Day phone 271-4608 Mailing address 605 we.a-t 4th Avenue, Anchorage., Ak. 90501 Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well xx Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL. Individual on-site XX 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 Phone C/( / �Z?� Piver Loop Road No. 204 Address - - p Engineer's signature Date D 61 The conditions o� .the pne.vious Health Au-tho)Lity Appn.ovaE? ,i,shued Heb,cuany 25, 1991 have been met. See- septic inspection 9 watea samptes attached. y u yr 6. DHHS SIGNATURE Approved for —Z— bedrooms. 9, Disapproved. Conditional approval for Additional Comments -•s ala. ..`i •4 bedrooms, with the following stipulations: ii mr 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 u21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL_ TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS REPORT BY SAMPLE for WORKorder# 35760 Date Report Printed: JUL 2 91 @ 10:27 Client Sample ID:LS B I KNIK HEIGHTS PWSID :UA Collected JUN 28 91 @ 13:30 his. Received JUN 28 91 @ 15:20 hrs. Preserved with :AS REQUIRED Client Name :S & S ENGINEERING Client Acct :SIISEHGP BPO # PO # NONE RECEIVED Req # Ordered By Analysis Completed :JUL 1 91 Send Reports to: Laboratory Supezvi or STEPHEN C. EDE 1)S & S ENGINEERING Released By ��' �_ 2) ................................,.,,.............................................. ,....e.,,...... ..._.... ... Chemlab Ref #: 913100 Lab Smpl ID: 2 Matrix: WATER Parameter Tested Result Unite --------------------------------------------------------------------------- NITRATE -N 0.30 mg/l Sample ROUTINE SAMPLE COLLECTED BY: R.D.J. Remarks: Allowable Method Limits -------------------------- EPA 353.2 10 ........................................................................,.............................. 1 Tests Performed See Special Instructions Above UA -Unavailable NDA None Detected See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than 110 IGS Member of the SGS Group (Societe Generale de Surveillance) ar �� MUNICIPALITY OF ANCHORAGE ,Department of Health& Human Services j DIVISION OF. ENVIRONMENTAL SERVICES , 343-4744 a`: c• j ill' ho CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF, ON-SITE SEWER AND WATER FACILITY.FOR SINGLE FAMILY DWELLING .Parcel 1. D. # \`l - �`l�. i HAA # _ a 1, GENERAL INFORMATION (Must be completed prior to submittal) F 1= w> 4 ov fv (a) Legal Description (include lot, block, subdivision, section, township, range);;W f Lot 5; BQoch T; Knih Heights Subdivi4ion; Location (address or directions) 4631 SheCbunne Place (b) Property owner H.U.D. # 111-024538-203 Telephone : (home) Business 271-4608 _Mailing Address 605 Wat 4th Avenue, Anehonage, Alaska 99501 (c) Lending Institution Telephone — - Mailing Address (d) Real Estate Company and Agent Address Telephone VJ J (e) Mail the HAA to the following address: (or check here Rk if hold for pick up) r List contact person and day phone number below -.....i rr�! S & S ENGINEERING 19034 Eagle River Loo_Ip-lLoad Ne. 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE - Single -Family MC Number of bedrooms 3. WATER SUPPLY Individual Well INN Community ❑ Public ❑ Note Iflcommunity well systemj.m,ust have written confirmation from ;the State Department of. Environmentak Conservation attesting to th1egeility and status: 4 SEWAGE DISPOSAL ! .., t: I,:.l i4i' ♦.i fire%lj, , •�. h .t •T.4 1. .Ill On-site IXM Public ❑ Community ❑ °:'• Holding Tank ❑ -,Note', community well system, must have'Wr, itten c'ohfirmation from the Sfate Department'of Env)ronm®ntal Conservation attesting to the legailty and status. 7M2e (Rev. vee) 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 regulations in effect on the date of this inspection` j 7 Name of Firm Telephone v ` `/ 7 S &S.ENGINr1=R Address 17034 Eagle River loop Road No. 204 Eagle River, Ala$Ka 77�i 11 Dat! r . -'RECOMMEND CONDITIONAL APPROVAL AS PER LETTER ATTACHED! 6. DHHS APPROVAL Approved for bedrooms by Date p Appreved Bisapproved Conditional Terms of Conditional Approval Escrow funds to upgrade septic system -and drill new well per terms outlined in letter from S & S Engineering, dated 2-18-91. System upgrade and well installation must be completed and new water samples submitted with the as—built to DHHS no later than June 15, 1991. 0 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors oromissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) QN, Health Authority Approval (MAA) e ECKLIST - FE13RUARY 1984 L,I V ET 343-4744 FEB 2 0 1991 Legal Description: Municipality of Anchorage A. WELL DATA Dept. Health &uma� Services / Well Classification_ 11%U>l� If A, B, C, D.E.C. Approved (Y/N) /v A Well Log Present ©/N) Date Completed�' (� �� Yield 0.2-6 A -D� I'ZLFD OG D tVF'G L ©„%9 Total Depth Cased to A� Depth of Grouting Static Water Level �� Pump Set At 44 Casing Height Above Ground 1Z k Sanitary Seal on Casing (M) % Electrical Wiring in ConduitON) y Depression Around Wellhead (Y/, SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot (L__"=, `y ; On Adjoining Lots _, odI-i' To Nearest Edge of Absorption Fieldf7,6 Lot i ('~ ; On Adjoining Lots (I' To Nearest Public Sewer Line r To Nearest Public Sewer Cleanout/Manhole 4 To Nearest Sewer Service Line on Lot Water Sample Collected by 12 ; Date Water Sample Test Results ISti✓2—�f —��- _dd� B. SEPTIC/HOLDING TANK DATA ?: / r Date Installed 1°1.10 Size o. of Compartments Standpipes (69/N) _�sfAiitight Caps(O/N) _ Foundation Cleanout (� Depression over Tank (Yo Date Last Pumped Pumping/Maintenance Contact on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) e Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well To Building Foundation I ( To Property Line ti k To Disposal Field �✓ + ( To Water Main/Service Line j O To Stream, Ponc�Laake or Major Drainage Course Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA r– Soils Rating in Absorption Strata �� —Type of System Design—1 � Date Installed Length of Field u � Width of Field X70 Depth of Field 1� i Gravel Bed Thickness Square Feet of Absortion Area Ly Statndpipes Present C/N) Depression over Field (YcT Date of Last Adequacy Test 4r Results of Last Adequacy Teo SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well �OdI`( To Property Line f r� To Building Foundation To Existing or Abandoned System on Lot �. o i On Adjoining Lots a -f I L1 To Water Main/Service Line To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course 10o I To Driveway, Parking Area, or Vehicle Storage Area 5 Comments D. LIF STATION IV / /X Date Ins 17 j Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent (Y/N) Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed c € Sf:iVr-1h'` s-F� nu Company 11034. ca I•le i;iver Im �t, .':E•t??f I; Facile Rlw� W),i Date � --� " �� Z MOA No. D , o p Receipt No. 2, r-_5() — I f' �� LI Date of Payment i 1 n)0 Amount: $ 1 Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. 7188) Back Page 2 of 2 at`j -- 444 L/�OOILA101LI li CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 Client Sample ID:L5 BI KNIK HIS. PWSID :UA Collected FEB 4 91 d 15:00 hrs. Received FEB 5 91 C 14:00 hrs. Preserved with :AS REQUIRED ANALYSIS REPORT BY SAMPLE for Work Order R 31797 Date Report Printed: FEB B 91 N 08:56 Of.�NDfVFHOF 5 f O E Client Name S & S ENGINEERING Client Acct SNSENGP BPO B PO 4 NONE RECEIVED Req B Ordered By R. SHAFER Analysis Completed :FEB 6 91 Send Reports to: Laboratory Superv.tsor. S EPNEN C. EDE 1)3 & S ENGINEERING Released By ax --e" 2) Chemlab Ref B: 910394 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Units Method Limits NITRATE -N ND(0.10) mg/l EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: RJS. Remarks: 1 Tests Performed See Special Instructions Above UA=Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT -Loss Than, GT -Greater Than MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date 12/26/84 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 5 Block I, Knik Heights S/D Location (address or directions) 4661 Shelburne Place _ 3454396 337.9474 (b) Applicants Name Marsha Price Telephone v Home � Business Applicants Address�LA Box 1588Ba Anchor pe AK 99516 (c) Applicant is (check one) Lending Institution ; Owner/buildeXX r; Buyer ; Other (explain); (d) Lending Institution ® Telephone_ �a Address - (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single -Family � Multi -Family Number of Bedrooms 4 3. Water supply Individual Well Community Other (describe) Public = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal OnsitelE-L Public �7_ Community E7— Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1. of 2] 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 om-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 regula- tions in effect on the date of this inspection. Name of Firm — Telephone Address Date ORIGTNAL ENGINEER'S STAMP AND SIG14ATJRE ON FILE WITH DHEP. The upgrade of existing (ENGINEER SEAL) system has been met and the full approval is granted. 6. DHEP Approval Approved for 4 (fOur)bedrooms By Date ,�7 Approved Disapproved Conditional Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY. UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY. OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date 11-15--84 (a) Legal Description (include lot, block, subdivision, section, township, range) .,Tat r; Block I, Knik Heights S/D Location (address or directions) 4631 Shelburne Place (b) Applicants Name Marsha PriceTelephone - Home345-43%fisiness 337-9474 Applicants Address SRA Box 1588B, Anchorage, Alska 99516 (c) Applicant is (check one) Lending Institution ; Owner/builder Buyer F__j ; Other � (explain); (d) Lending Institution _ Telephone (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. jUe of Residence Single -Family r-:4 Multi -Family Number of Bedrooms 4 3:. Water Sunply Individual Well MR Community = Other Lq ribe) Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal. Onsite 1 -777 Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. (Page 1 of 21 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 regula- tions in effect on the date of this inspection. Name of Firm Address Date 6. DHEP Approval Conditional approval A,V11V Xfor four 4 bedrooms Telephone ORIGINAL ENGINEER'S STAMP -� AND SIGNATURE ON FILE WITI3 DFIEP. Additional information (ENGINEER SEAL) has been submitted on well yield. Date_ _1)15/84 _e Approved Disapproved Conditional XX Terms of Conditional Approval;canwill upg.rade existinc sewer. system nger than June 15. 185. This Conditional approval will expire on ,Tune 15, 1985. This Conditional approval is valid only for the addition of a garage and does not a221X to a chance of ownership._ CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH S ABOVE BY AN INDEPENDENT.' PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/DI8 [Page 2 of 2] 7-19-84 M -W DRILLING INC. P.O. BOX 110378 ANCHORAGE, ALASKA 99511 PHONE 349-8535 67q SI LEGAL DESCRIPTION LEGAL O 5 BANK OR L ING INSTITUTIONS CURRENTLY HOLDING DEED OF TRUST ,3zF� 7 Ire L33 7- 74- 7'k HOME PHONE WORKPHONE INVOICE No 2447 DATE_ 11VI2 UNIT QTY. MATERIALS PRICE AMOUNT W RK AN DATE IN All charges shall be paid in full within ten _( 0 r D9 O days unless other arrangements are made prior to drilling. The customer she# pay in- terest at the rate of 1/a % per month on any amount not paid within ten days. Failure to pay may result in alien against the property. CUSTOMER SIGNATUR y �_ lb ti PA/A, 1, 1 iP� UT HOUR5 I RATE LABOR / ` L'G TOTAL MATERIALS MATERIALS (FROM ABOVE) WELL NUMBER DIAM�ER DEPTR 0 STATIC LEVEL GPfd WDOW % _ �T VMP MAKE HP SETTING'21J - VOLTS PHASE AMP RATE: SERIAL NUMBER MODEL SCREEN LENGTH - SLOT SIZE LINER/SCREEN W RK AN DATE IN All charges shall be paid in full within ten _( 0 r D9 O days unless other arrangements are made prior to drilling. The customer she# pay in- terest at the rate of 1/a % per month on any amount not paid within ten days. Failure to pay may result in alien against the property. CUSTOMER SIGNATUR y �_ lb ti PA/A, 1, 1 iP� UT HOUR5 I RATE LABOR / ` L'G MATERIALS (FROM ABOVE) OTHER CHARGES PAY THIS AMOUNT 4� I 3 G'� ALASKA C1(OIROOBTAL COnTROL Sekuff S, InC. Engineerinq & 6nuironmenlal Studies 27 November 1.984 Marcia Price 40a1 Shellburne Place Anchorage, Alaska 99516 Lot 5, Block 1, Knik Heights Subdivision Adequacy test for sewer system The type of absorption system is a pit: with an area o1:396 Sq Yt. The system is capable of accepting; 160 Gallons of water per day. The surge capicity of the system is 76 gallons. Based upon the test data, the system is not acceptable for a home of 4 bedrooms. The septic tank was pumped. on July 25 1984 Septic Tank Adequacy The existing septic tants volume of 1000 gallons anti installed September 15, 1970 is adequate for this 4 bedroom house, 1200 West 33rd Auenue. Suite a • Anchorage. Alaska 99503 •(907) 561-500 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CER.TIFICATIi 1. General Information (a) Legal Description (include lot, -f s- (24 J_ Ab tL fie iict Location ad(dre. s or direc-. ons Appl.icati.on Date , subdivision, section, township, range) (b) Applicants Name 'l:el�hone Home Business _ Applicants Address ___Al_�o�trlf> r- _ �f!✓ 5 ._. _ (c) Applicant is (check one) Lending Institution Buyer F-7-1 s Other [-"I (explain);,_,---, (d) Lending Institution Address (e) Real. Estate Co. & Agent Address Telephone (£) Mail the HAA to the following address: 2. ape of Residence Single -Family ART Multi-yamily Number of Bedrooms 3. Water} SuRplY Individual Well ll Community I �� Owner/<bu:feet' y�{ Other (describe 1'u.bJ_i_c Telephone Note: If community well system, must have written confirmation from the State Department of Envi.ronmenta.l. Conservation attesting to the legality and status: 4. Sewage Disposal Onsite Public~^� Community Holding Tank _ Note: If community well system, must have written confirmation from the State Department of Environmental. Conservation attesting to the legality and status. [Page I of: 2] S. Enjineering Firm Providing Inspections� Tests File Search, Data and Tnformittion As certified by my seal affixed hereto and as of the validation date show7.1 below, T verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, f.uncttonal and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained Prow the Municipality of Anchorage files and from my investigation and inspection, the on --site wager supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of. Firm Address % 1. 0 Date 6. DHEP Approval Approved for Approved z � _ heclrooms Terms of Conditional A n. ..n_.., _, ... _J _ / Telephone ' iv�`-)G)`{C� of f g B8P:1-CBV V El "A 3 1 �1 au -PA tm fVE`l: '� �� EAr l �� c. P,•�:�I J� a z��, f, :� 61 as uc�f`s fJ By s ` `sit JI c . 1£ z Date^ M Disapproved Conditional )roval CAUTION THE 14UNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENIAh PROTECTION (DIIEP) ISSUES HEALTH AUTHORITY APPROVAL, C1?R'.L-IF1C;ATJ-`,S BASED SOLL_LY UPON THE' F+EPRFSIENT-- AT[.ONS GIVEN IN PARAGRAPH `i ABOVE BY AN INDEPEN01iN7' PROE'ESS:COh1AL ENGINEER REGIST3RED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF tlO,MEES AND THEIR LEND:I:NG INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE. IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT I:E:SPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.. INIEP SEAL) tr RR4/e j/DI8 [Page 2 of 21 7._7.9-•£3�f MUNICIPALITY OF ANCHORAGP IDKPT. OF FII:ALM &, UNVIFON.V:NT/l FR0FLCTIOM( MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) 0 G CHECKLIST - FEBRUARY 1984 fit; 67 "Y Legal Description: L7 %k_ht k Oat'w4 Ls- A. sA. MLL DATA B. Well Classification Xtao If A, B. or C, D.E.C. Approved(Y/N_ )_ &4- Well Log Present (Y/N) Np Date Completed _ Ll $A 1C__ Yields ?"� Total Depths 21N 1 Cased to U ru kP _ Depth of Grouting___ fVi�i iC_ Static Water Level _ �55 Pump Set At L1 DUk-v� Casing Height Above Ground /«3 ____ Sanitary Seal on Casing[V]( )P� Electrical Wiring in Conduit 61/N) y-ec;- Depression Around Wellhead (Y /Lo Separation Distances from We11: -- -- To Septic/Holding Tank on Lots I Z � ... / On Adjoining Lots 6-7 /(do I _ To Nearest Edge of Absorption Fibld onJLbt*/021 ; On Adjoining Lots 6,7Iou _ To Nearest Public Sewer Linel 4 -go' To Nearest Public Sewer Cleancut/Manhole___2ViTo Nearest Sewer Service Line on Lot - -_ Water Sample Collected By Q_ 6vto-7i)e"1 Date Water Sample Test Results Cawents 1 44 FjVO"i 4s --10 u N SEPTIC/HOLDING TANK DATA Date Installed q -1 Size C) ' c No. of Capartments � Standpipes &_/N) LP.. Air -tight Caps (M) *E _ Foundation Cleanout (Y eV6 Depression over Tank (Yt (,Up Date Last Pumped `%- Pumping/Maintenance Contract on File (Y/N) JU_; for &,4- Holding Tank High -Water Alarm (Y/N) w-,Ik-_Temporary Holding.Tank Permit (Y/N) Separation Distances from-Septic/Holding Tank: To Water -Supply wall �2( , To Building Foundation?!.( To Property Line _—VA10 _- To Disposal Field' To Water Main/Service Line lUa- To Stream, Pond, Lake, or Major Drainage Course it l to U Comnents _ (Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption trata a�212�P-- Type of System Design _L1J-> Date Installed �l"% S- 2]- Length of Field //r Width of Field / 7 / / } Depth of Field 4 f',S- t / IV Gravel Bed Thickness uAjK- Square Feet of Absorption Area* loy(o Standpipes Present (Y6 Vb Depression over Field (YA,) N o Date of Last Adequacy Test)'*WOwt Results of Last Adequacy 'lest & len Separation Distance from Absorption Field: To Water -Supply Wall _ (6-L( 1",A I- To Property Line *1-!o t &1a / To Building Foundation A- -7v1 1tin fc To Existing or Abandoned System cn Lot /V4- On Adjoining Lots 6-7 /OUB To Water Main/Service Line ±:- -f-)ot To Cutbank(if present) N,?, To Stream/Pond/Lake/or Major Drainage Course G -TC Gu / To Driveway, Parking Area, or Vehicle Storage Area LAodg L. Da%, fe (,Vcc ('nmrrentc {n.�.,c A A. ^_ II -.. cir .,.,I .. •. / ., 1- ?n,...b., .,..,•a Ian dc. iA, I i,)a I.06A.ri'P" A61A IAP e,Ntje a .!L I-vaWA A- S--hcaclll D. LIFT STATION Date Ins d Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(YM) Comments Dimensions Manhole/Access (YIN) "Pump Off" Level at Pumping Cycles Vent (YIN) during uacv 'lest. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all on the date of this inspection. Signed - __, Date /!7 ® 43 Company d e c S MOA No. If/ - uz Sf C ]v(YAqvLA KB1/d5/s ,Jell ji�ka ,jv4ar (Page 2 of 21 effect e .Aa a c ; roy C. 81KIJr. w: in 4 �nNo.225?.EE�°.°� s,�r HOFESStiOa"tl 2-15-84 ALASKA bUIRMETAL COnTROL SRUS, InC. Engineerinq & Enuironmenial Studies October 12, 1984 Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99502 Attention: Keith Bandt Subject: Knik Heights Subdivision, Block I - Lot 5 Dear Keith: On October 10, 1984, our office office performed an adequacy on the subject lot, the adequacy failed. The system is covered by the driveway. Our recommendation is that a new absorption field be installed. The well flow was performed on October 1.1, .1984, the static water level was 256 feet. The gpm of the well flow was 0.15 gpm over a period of 3 hours. If you have any questions, please feel free to contact me. Sincerel , Ronald Go a�- Environmental Engineer REG/caj 1200 West 33rd Auenue, Suite B 9 AnAorage, Alaska 99503 • (907) 561-5040 44 TTC%OSAEL A44 t GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 2744561 Date Received Time of Inspection Date of Inspection/ REQUEST FOR APPROVAL OF _ INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval rbquested by: � %/ .� _ !/'1 141,Q ' Mailing AddresPhone:.;=�i�_ 2. Property Owner:Phone: Mailing Address: Af. z 7l11"re? 4&C IexleAl 'i/7 3. Legal Description: of 5 ,(.seek -Z A -A111 4. Location: 5. Type of favi 1 i ty to be inspected �;G';Y/fes /fC.Utft6!f bedrooms - 6. Well Data: A. TypeB. Depth C. Construction�/1-,1,6 ' D. Bacterial Analysis S,�716' 7. Sewage Disposal System: A. Installed %L7 — B. Installer C. Septic 'Tank: 1. Size 2. Manufacturer ,'iV S�,v r D. Seepage Pit: 1. Absorption Area 4)z/ 2. Material E. Disposal Field: Total length of lines 8. Distances: , ��s /�N,!✓^ �jF_f�uz4 rs?rvJ, i5�o: !/�"!J /k.G L�.tE'llli/lCr i t, a GSf?c�4��/Cs� A. Well to: Septic tank %� ,f _, Absorption area e�je f , Sewer Lines Nearest lot line _Z.0 I , Other contamination @ �� B. Foundation to septic tank "-2,1./ , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages -• Rei, -st for Approval of Individual er & Water Facilities Legal DescriptionX/✓/1 //-/S, a Comments Z Approved Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM ' I�r �-ysT�t ass dfi/ lw'.C•/✓ ,mac✓./!" ell- ,/ (.. /. /y :�11( O !�li��fl 'LLQ/(/O;i/ .��Gr Gt% i/l%✓G>`/i%. C1-C>c../. �il //�tt�/_/i li._ //C(/!. �9 il'�`.. �.,'�! /�s(('.//.0<��l/•'%1/f.'.�f G�Jf.,�1t.'�.,!-Le'-ii�>'.�� //AN 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 EQ -034 (1/74) Date /,0/T FHA Form 2573 � Form Approved Re.. July 1958 FEDERAL HOUSING ADMIN15TRATION Budget Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER. SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.—TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. Anchorage Matanuska Valley Bank MORTGAGOR 0X:t fflVXX PROPERTY ADDRESS Arthur L. Parker Shelburn. Place, Anchorage, Alaska Lot 5, Block 1 Knik Heights Sub. SUBDIVISION NAME BLOCK NO. LOT NO. Knik Heights Subdivision 1 5� ® �� TOTAL NUMBER:Can attic or other area be made Into BASEMENT lx I New installation additional bedrooms? LIVING UNITS BEDROOMS BATHS I -J (lf Yes, how many?) 3 2 Yes No Yes E1No IcWATER SUPPLY BY: I I Public system Community system � Individual SYSTEM DESIGNED FOR NO. OF BDRMS. GARBAGE DISPOSAL — SEWAGE DISPOSAL BY: Public system Community system Individual Yes ❑ No PART II.—TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH ---------------------- 11444 It is the opinion of the State County i`^I Local Department of Health that this individual water -supply system EAis ❑ is not satisfactory as a domestic water supply for the subject property. It is the opinion of the ❑ State E] County [jj Local Department of Health that this individual sewage -disposal sys- tem with proper maintenance: qCan be expected to function satisfactorily, and ❑ Cannot be expected to function satisfactorily is not likely to create an insanitary condition DATE Feb. 12, 1971 SIPNAT ----- E �) TITLE �� Sanitarian � „ NOTE: The healuthority should complete the appropriate opinion statement above and affix date, signature and title in the spaces provided. Use of the a ave grid for Health Department Inspector's sketch as well as use of the back of this form Is at the option of the health autho fit PART III.—FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent PHA Compliance Inspection Report, and recommend that the Individual water -supply system be considered E] Acceptable C] Not Acceptable Sewage disposal be considered ❑ Acceptable 1:1 Not Acceptable. DATE SIGNATURE ElCHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL FHA Form 2573 INDIVIDUAL WATFR SIID9LY AND RFWAGF DICDnCAI CYGTFAA Rov. July 1958 J j REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES (fill out in Triplicate) „ Name of person requesting approval ed /lip 2. Name of nropertvTowner Sbe6t e. 3. Legal_ 4. Number,of bedrooms in house — 5. Water,-Analyais: a. b, //� F Bacterial 0f: t`[ �" G3 �B� Detergent' {/tC 6. Well data: a, b. C. Type Depth Casing Size_ N ;�. MA , t'v H-It4o, d, Distance from well to closest existing or proposed: 1. Sewer line Wil/ 2. Septic tank-7"-- 3. ank73. Seepage Area 1r, Cesspool' ' 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. 7. Sewage disposal system. a. Age of system � Mn+h'g �+ b. Septic tank rapacity in gallons LJ J i c. Name of septic tank manufacturer 1. If "home made" show diagram on reverse side of this form. d; Disposal. field or seepage pit size and type.% 1. Distance to property line _ ?�� to house foundation=- >a U e. Percol.atioA Test results , f. Percolation Test performed by Use the reverse .side of this foram to show diagram. Diagram should include _ he following information: pxoperty li.nes;•well location, house Location, peptic tank location, disposal area location, location of percolation test, a,� direction of ground slope. ` 9. TheInformation on this form is true and correct to the best of my knowledge. 9 1 S gnature of Applicant Date Signed iQ BE PILLED OUT BY HEALTH DP,PARVIENT PERSONNEL the above described sanitary facilities are hereby approved, subject to the Tollowing conditions: Conditions: E] The above described sanitary facilities are disapproved for the following reasons: Approval is valid for one year following the date of approval, CPJ:cw