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Home My WebLink AboutMOUNTAIN VALLEY ESTATES #1 BLK 3 LT 19 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 -- -q[PFION E ~"~V~ MAILING ADDRESS ~ LEGAL DESCRIPTION " iLOCATION DISTANCE TO: Well 6:/ '.~ ' Manufacturer ~ -'*~ -~ ~_ [Liq. capacity in gallons IF HOME~DE: DISTANCE TO: Well Manufacturer DISTANCE TO: Well / / '7 / No, of ines Length of each line Top of tile to finish grade ~ ~/ I Length Width ¢ Type of cri~ ~7-- DISTANCE TO: Class Depth DISTANCE TO; Building foundation I Abs~rption area Dwelling Inside length. Width- Dwelling Foundation /...~ ./? *' Total len,~l ~_~ lines Material beneath tile Depth Nearest lot ling : Trench w~ BEDROOMS PERMIT NO. PERMIT NO, inches inches No. of compartments Liquid depth Liquid capacity in gallons PERMIT NO. Distance between lines Total effective absorption area PERMIT NO, Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line Sewer line Septic tank PERMIT NO, Absorption area(s) OTHER PIP~/TERIA LS (~ SOIL TEST RATING INSTALLER REMARKS APPROVED ,r ~ _ 72-013 (Rev. 3/78) DATE LEGAL )" ~ ' R]TEC'rION [ [~.FHRTr~ENT - HEALTH AND ENVIRONf,IENTFIL 8R5 ",~ STREET., ANCHORAGE, AK. 9~,..01 PERMIT NO. ( Z80~<6:: ) APPL ~ CANT LOCAT I ON LEGAL JOHN L HOPKINS JOHNNY DRIVE LtV B 3 MT VALLEY ESTATES BO>~ ~02d. ANCH LOT SIZE t:~645 SQUARE FEET TYPE OF SOIL, RB$ORBI'ION SYSTEM IS: 'TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT?BR)= 125 THE RE6;.UIRE~, SIZE OF THE SOIL ABSORPTION SYSTEM IS: IC:,E:P ]'H= S-=~ L.F.: f-,tr.:'~ T Ft = :~:2 13 ~'~ Fi",,," E b. [) bT: P ~r Fl:= ¢.~; THE LENGTH DIMENSION IS THE LENBTW (IN FEET) OF THE TRENCH OF.: [:,RRINFIELD. THE DEPTH OF R TRENCH OR PIT ~S THE DISTANCE E:ETWEEN THE SURFACE OF THE GROUND AND ]'HE BOTTOM OF THE E>4CRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. TWE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GAR'eEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEEl'). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING ]'HE INSTAI.L. ATION INSPECTIONS OF ANY WELLS ADJRC:ENT l'O THIS PROPERTY AND THE NUMBER OF' RESIDENCES THAT THE WELL WILL SERVE. ........ 'TI4u] ( ~.2~ ) X !"",! ;~'.;F"E ti.': T I 01"-12; tIRE Ii':. EL-;!tJ I; F-':E[: BACKFILLING OF ANY SYSTEM HITHOUT FINAL INSPECI'ION AND APPROVAL BY THIS [:'EPARTMENT WIL. L BE SUB.SECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS ~.00 FEET FOR A PRIVATE 14ELL; OR '1.50 TO 200 FEET FROM A PUBL. IC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER RE(~.UIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS FIRE AVAILABLE 'TO INSURE PROPER INSTALLATION. I CERTIFY THAT t: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SEI' FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I PilL[. INSTALL.. THE SYSTEM IN FICCORDRNCE WITH THE CODES. 3:: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE %5 REMODELED TO INCLUDE ~ORE THAN ; BEDROOMS. SIC~NED: RPPL ~ CRNT JOHN L HOPK ~ NS December 29, 1978 John IIopkin s Star Route 2 Box 9354 ~]aqle River, Alaska 99577 ,.,u~)j..ct: 80351 Lot 19 Block 3 Mountain Valley Estates t~7S0971 Lot 13 Block 5 I¢lounta~n Valley Estates ~780936 Lot 12 Block 5 Mounts%in Valley ES'bates ~1 978093'7 Lot 13 Block 5 Mo~u~tain Valley Estates A permit issue6~ by 'this department for well and/or sawer system has expirect. P~rmits are issue¢~, on a ~alend. ar y~ar basis, as stated on 'the permit, by autherity of ~4unieipal or£1inance. If yon have drilled the well, a well ~Lo~ should be sent to this department to document the installation da~;e. %f 'the.re are any further q~lestions, please contact this office a.t 264-4720. S~lcere].y, Les N. }~'uchho!z, R.£3. Senior Environmental Specialist enc: copy of permit J~ I .L I NO. .... t.:~ ~,,.:.~di:.F~i LII ItL;I'IL1H dj"4[.. ENVIrJ. L:II'~r,I[~I'.CFI'~IL. [I,...JILCI ION c.,.-~,r= ...[ , ....., ::: ...... · . '- ;,~ ; ~',r- ...... = ....- I kJ..E I. "'" t. [;IJ'~L.J IL]l; .f ILM ......, h,. FIt:::'f':'L I CFINt .......... , I I i ON ,.:lOHIq HOPK 11'4'2; JOHr.,tN't' DF:: I, ,:. 264-4720 LA_gL:J2.' MOUNTFIlN ',/IqL.LI;'¢ [ZG'FFtTES ",~"Fc- OF: ':'"iii,._ . F:IF2;OF:t3TIOI'4 =,,..;.IEM- '"""'- IS: TRIZNCI'I 2;OIL RFll'ING (2;C.4 F:'T,/BR)=':t~.o · FIE..:;,,.. s~ ION Gh'STt.~M :[2;: lt'IE REf:~UIRE[) '.i]z¢.E. fiji:' TI'If£ ..:,..ILL THI2 LEI'.tGTH DIME:tqSIOIq INS THE LENGTI'I (IIq FEET) OF' "H.IE TREIqC:II OF..' DRFIIIqFILZL, D. 'HI~Z DEPTli OF Ft TRENCH OR PIT :[2; THE DISTFINCE BE'I'IqEEN THIE 2;URFfIC:E 01: TIlE GROUND FiND THE BOTTOM OF 'FI.'IE EXCIflVflTIOI'.,I (IN FEET). TI.IERE IS NO SE]' HIDTH FOR TF..'L']'ICI.IES. TIlE :::if,]P¢,,'[]L DEPTH IS THE 1"I:I'.I'4IMUI'I DEf"'Tll Of: GRf:IVEL BEI'HIEEN THL'-. OtJ]'FFtL!.... r::,Ipli; FiND THE BOTTOM OF THE E',:.'::CFIVfrITIC~I",I (IN FI:EIZT). [,Ed;.l'll RFFI ..... N] HFtS TI. lIE RE.::,Ft,.i'&x, IE,;fLIT~ TO II'4F'ORM THIS DEPfIRTMENT [.~U,.,.I.l',lb I 4_ ~ d..._, ].(..,I'4 IN;'..,[ E'.L. ,IL,,L, OF fIN'.? !4EI..LS FID..If:IC:ENTTO TI r',,.., ,=m~ FIND TIlE 't. JM[~E[,.. OF I,[;.z.,.[,~.~",~L.[..;. TI,,,T 'H'tE HEL,L,, HILL. MINIMUM DIS'I'RNCE BETWEEN FI WELL. FIND fiN',' :1..00 F:EET FOr.". R PRIVRTE HELL.~ WE;.LI.. LOGS FII:,'.E REr.:!UIRtZD FiND I'1LIST DE RETURNIED TO O'T'IIET.,' IT..'Ef2UIREMENT2; MIT,' I;JJ'"[:'L'i'. ~:F'EOIF'ICFITION~; f'IND CONSTRUC'TION D]t"IGRI-1MS FIRE .. F Jl'. ;.,E. HE,' ..... F'II',ID HEL. L2; :!: I Fit'1 }.FIi'lll_I Ilk .LtlTH THE I,.Eg..IIRE.MF. NT.> ON..-.SITE SET ,"FF",'.,...,,, Er,' 'rill.; MUNICIPf:iLIT'.r' (:;if FINE:IIORRGE I HILL INSTFILL THE .: ~,TE, II IN RCC:ORDRNCE IdV'H.I TIlE CODIES. '":' ' I ,-,,~'m,":'~' ~*~ '. '" "" UN' 2; I'I"E JE.WER '- "-" -' ~" - 3 ' ' ..... ,..,NJ.,,..., ...... ,I,,ID TIIFIT ~. -, ,:,:r =, :.i'EM MFl'r' ,...EL..uIr...E ENLIqF:'.GEMENT IF "rilE; I,.E.:;,I[.ENL. E. I2; }~EI'Iu.:LE.[. TO INCLUDE MORE THFIN .~. BEDRuOfl.:. ~ h , [. I ... IIqT ,IOFIN I IOI Ix I t..,=,t., :1[~ ............ DI-1TE . _ V 7:i:. unicipalitYof Anchorage POUCH 6-650 ANCHORAGE, ALASKA 99502 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (825 "L" Street) May 16, 1978 ~77379 John Hopkins 4417 San Roberto ~2 Anchorage, Alaska 99504 Subject: Permit Expiration A permit issued by this department for well and/or on-site sewer installation on Lot 19 Block 3 Mountain Valley Estates Subdivision has expired since the issue date exceexs one(l) year. In the event you still plan to install the well and/or on- site sewer system, a new permit is required. The original soil test may be used to obtain a current permit. If the well has been drilled, a well log should be sent to this department to document the installation date. If you have any questions regarding the above matter, please contact this office immediately at 264-4720. Sincerely, ~ ~ Les~lz, R.~.~ Senior Environmental S~cJ. alist LNB/ljh GREA.ZR ANCHORAGE AREA BOA dGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456! SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT 'NST."'.LAT,ON LOCA'"',ON INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO SE SERVED FINANCED THROUGH SOIL TEST RESULTS SEEPAGE PIT ., DRAIN FIELD NOTE= ~EIRMIT IS NOT VALID WITHOUT E~OIL TE~' FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL 13E SU MINIMUM DI.~TANCES, REQUIREMENT~ FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT . DRAIN FIELD SEPTIC TANK TO SEEPAGE P~T WALL SEPTIC TANK SEEPAGE PIT ., RAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK __ __ __ SEEPAGE Fl~ GEAVEL BACKFILL A~REA TEM WITHOUT FINAL INSPECTION BY THE PROSECUTION. ZE TYPE '~¢ ,~ C~ ~i DIAGRAM OF .~Y~TEM I CERTIFY Tl4AT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS; IN ACCORDANCE WITH SAID CODE. DATE f~ /'~/'-- APPLICANT'S SIGNATURE "~ - EQ-016(3-75) ':i "::"i::'i~ii:'i::'ilil~ i:' E:d:::?Ft!il (ilft:: ilili!i;'.!i;I..I!iiil HFiR:!:I'"tI.JI"1 I'.,!t...ll"i!iii:liii:!:;i: EJI:':' lii:li::t)l:ilX::*Efi'"l:iii; :::i: 't'l'llli: I..liiZi",tG TH E:, :1: I','IE:I'.,I:i::; ]: ON 1 :ii:; "i'I.-IIF !..!i~:l'.,l(:!iTt. I 'iFil!ii: Dli!i:l:::'"l'H Oi::: t:i:1 "I'I:;i:IiiZNE:I.I QI:;;: I:::':[T ]::iii; "l'l'llii: Gi;;i:EE.tI'.,iI::, FIND 'i'l-"lli: lii',~9'l'TOH ~:::~1::' "I'I'IE: 't'hlii!!:l:;i:l!:!: :1: :ii; I",]~:J :ii;li'::'l' H :1: D'I't'I I:::T I:;i: 'Tl:;i:llii:l'.,1Cl-Iliii::ii;. '"N 'l'l..ltiii: Gl:;iff::l',,,'tliJ. E:fli:F'TI.i :1: :ii; "i"l.l!i: H :[ I",1 :[ HI.IH t:::,111:1:::'"1'I..I I:;:I['-,ID "i'I.IE: I!i',O'I"'IEIH Eli::: I I-~I t:,..,.,. I ION 'I'I.IE: 'i.l:;i:hd'.,IE::ll I:::IF'. 'l.,.Ihi:l!ii:H 't'l..!lii: liii;I. Jl:;i:l:::'l:::lI::::lli!: OF' 'Fl.iii!: lii!:li!il T I,.ilii2 li51 I"~1 "I'1 '1 Ii[il Iiill I I 'i' I:::' I:::li. !... !:::' i!i ? !:::11",11) I:::!l:::'l:::'!:;i:l:)'v'l:::ll. I!!:"," TI'i :11 :ili; O 8- E GEOT CHNICAL F:~ DEVELC MENT CO. Russell Oyster 694-2774 Soils 8 Foundations Performed for: Legal Description: o 2 6 7~ Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Name: MMling Address: Earl Ellis _SOIL LOG 688-2280 , Land Development ~,,~', ,_"5~.,a \\,,~,,_,~., ,el. ,o. %~7- S~ll Characteristic~ Ground Water Encountered: Yes No If yes, whet depth Proposed Installation: Seepage Pit Drain Field Comments: ~-[~,~ ~,._~-'~.,,.~-:, t-'r~>~, :',~'-,. Performed Date: I::IF::'F'L. i£ CI::~N*T* L 0 C FI *'1" ,'11CI N I.. E:~:~i FI I t"1 :l:t'q :1.' I"t1...11'"1 I:::,:[ :5"1~1:;:t1'.,IC1~:: E:E"I"I.,.IIEEI'-,I R t.,.Ili~:L.L. FIN[::, FIN'.? O1'.,I...-'.15 :'I..~;!'.~O t::'E:lii:T I:::'Oi';i: I::1 I::'l;i::l.",,,'l:::lTl!i: I.,.IIELI... CII~: ;;~6~12) F'IEET' I::'()1:;i: I::t F:'IjE:I._.:I:C F.fl!!~:l....I ..... l,.ll~ii:l....I..., t....OG:i~; I:::II:;;:E F~:IE~:.:.!U):I;.:'.EI)FIN[::, I','ll..l~i:;']' BE ¢'.IiL'TLII:;;:I'.4E:t)'T'C~ ('.'Il:::' 'l"Hl!i!: I.,.IIi~:L.I.... (::OI"'IF'L.ET .'1: O1'.,I. ':'~;I:::'I'_:::C 'l: F: T ::: I:::IT :1: OI'.,t:E; 1::11'.41:::, i'": '" t'-I':::;"FF'.I;:: ~1" :1: OH [::, :1: I::ll:~il:;,':l:::ll','lli:~; I::11:;i:[~ :1: I'.,l:i~; "t" F:I L.. I,,,, I:::1 'T' ]: ON. by A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588 OWNER OF LAND j ::..'."~" LEGAL DESCRIPTION DATE - Started ~ ,,' PERMIT NUMBER DEPTH OF WELL / ,%: STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KIND OF CASING C KIND OF FORMATION: From ': ' Ft. to ~ Ft. From ,~ Ft. to ' ' Ft From i :~ Ft. to F'5 ' Ft. From" Ft. to "i' Ft.. From Ft. to : ~ Ft. From ' From , Ft. to ' :: Ft Frmn · , Ft. to r":' Ft. From__Ft. to__Ft From Ft. to__Ft. From Ft. to.__Ft. Fl'om Ft. to__Ft. From Ft. to__Ft From Ft. to Ft, From Ft. to Ft. From____Ft. to.__Ft Front From From From ~n r .Z From __ From From From From From From From From From From Ft. to__Ft. __Ft. to.___Ft Ft. to Ft. Ft. to Ft Ft. to___FL Ft. to Ft. Ft, to Ft Ft. to Ft, Ft, to Ft Ft. to Ft, Ft. to Ft. Ft. to_ Ft. Ft. to_ Ft. Ft. to _Ft. Ft. to Ft. Ft. to Ft. Ft. to Ft MISCL. INFORMATION: :,:: ,,. ? ~ ,:,. DRILLER'S NAME ' 1. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEAl_TH AUTF{ORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Descriptien (include lot, block, subdivision, section, township, range) Lot 19 Block 3~ Mountain Valley Estates T14N Location (address or directions) J o h n_n~y_ Drive RiW SEc. ,~3 (b) Applicant Name Jim --York Telephone: Home694-_4_309 __ Business N/A Applicant Address Star Route 9253 Eagle River AK._~_~_7_ (c) Applicant is (check one): Lending Institution []; Owner/builder~_"~-; Buyer []; Other ~ (explain); (d) Lending Institution __N/A _ . Telephone Address (e) Real Estate Company and Agent Address (f) Telephone Mail the HAA to the following address: ___.P_~,_ck_u_p b~_ eng~in_eer TYPE OF RESIDENCE Single-Family L~ Multi-Family Nurnber of Bedrooms Other WATER SIJPPLY Individual Well ~ Community E] Public ['"J Note:'lf community well system, must have written confirmation from the State Department of Environmental Conservation attestin9 to the legality and status, SEWAGE DISPOSAL Onsite [] Public [3 Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 /2 025n1,84) ENGINEERING FIRM PROVIDING INSPECTIONS, "rESTS, 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 Flealth 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 compliancP~ with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. ~-';'f~' ~-"":"~¢'~ ° ~'~-~'~ ~-/~'/''~' ~- ~ ~,~,~ Y~,-/-~ ~ ..... ~' . Name of Firm ~6LE Rt-VE~ ENC:rlNEER~RVf~ES Telephone Address EAGLE RIVER, Al( 99577 Date P, 0. BOX 773294 694=51'g5 Engineer's Seal DHEP APPROVAL ~ Approved for ~"~(.-~-~bedrooms by Approved ___ _'~ Disapproved Terms of Conditional Approval l Conditional Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requiroments. 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. Page 2 of 2 WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORrrY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: ,~- o If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) / Date Completed ,.~"-///4~//~? Yield Total Depth /~b ¢ Casedto Mc w Depth of Grouting ~ ]~ Static Water Level ~'/ / Pump Set At / ~5-- Casing Height Above Ground ~ ~ Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) ~ D~pression Around Wellhead (Y/N) Separation Distances from Well: ~) ~'¢ 0 ¢ To Septic/Holding Tank on Lot ~ ~ ~ .~ gf~ On Adjoining Lots To Nearest Edge of Absorption Field on Lot /O~ ~ ; On Adjoining Lots To Nearest Public Sewer Line ~ To, Nearest Public Sewer Cleanout/Manhole ~ To Nearest Sewer Service Line on Lot Water Sample Collected by _ ~2 '~e~ ; Date ¢// Water Sample Test Results ~ ~ ~ ~ ~ Comments ~Y~= ~c SEPTIC/HOLDING TANK DATA ) Date Installed //¢' / ~._~j~.,:~ize /.2- Standpipes (Y/N) _ .,~ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~. No. of Compartments . ,Y Foundation Cleanout (Y/N) Date Last Pumped .S.~ ; for Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line ~ To Water Main/Service Line .... ~/¢'~ Co m me~lts -.~ To Building Foundation To Disposal Field ~' Page 1 of 2 To Stream, Pond, Lake, or Major Drainage 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /¢ '"~'Y' Width of Field ~v¢ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation /'~'¢ · Lot To Water Main/Service Line /'~ c- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness '~' / Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line ~-"'/¢ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company '~'¢'/~ Receipt No. Date of Payment Amount: $ ~' Page ~ of 2 Date ~,~'- / ~//f~"3" MOA NO. ~-¢7'" ~ ,,,%-~' ,J- 72-026 (11/84) Susan Oswalt Municipality of Anchorage Health Department 825 L Street Anchorage, Alaska 99501 Ref:Lot 19, Block 3, Mountain Valley Estates Dear Susan; ii/ /85 On behalf of my client, Mr. Jim York, I have inspected the drainage on the above referenced lot on 11/11/85. The inspection shows that the drainage path was dry and nonexistant at time of inspection. Enclosed is photo for your inspection. There is no definitive drainage basin associated with this area and the major drainage path exists 100' to the north of the septic system. At the time of my adequacy test it had been raining heavily. Enclosed is a statement from the owner regarding the status of the drainage as he has observed over 4 years time. Based on current evidence and the absence of any current drainage I would concure that no health hazard exists. It must be realized that the engineer cannot observe drainage channels or ground water levels through every season of the year and therefore cannot be responsible for anything other than current observation. It is evident that in some areas of Alaska 'the surface and ground water patterns may change based on the severity or combinations of weather patterns and manmade alterations of surface/ground water flows. If there are any questions or concerns please call me at my office 694-5195. Sincerely, Lou Butera P.E. STATEMENT REGARDING HEALTH AUTHORITY APPROVAL LOT 19, BLOCK 3, MOUNTAIN V~kLLEY ESTATES # 1 MUNICIPALITY OF ANCliORAGE, STATE OF ALASKA A~ owner of the above mentioned real estate, I have observed for over four years the small drainage located approximately sixty feet to the south of the well. I declare that this drainage is ephe~-~'al, that is, water flows in it for only short periods of time during and inm~ediately following rainfall and snowmelt events. Date ~James E. York P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-41 '11 TONY KNOWI_ES. MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES October 22, 1985 Lou Butera Eagle River Engineering Services PO Box 773294 Eagle River, Alaska 99577 Subject: Lot 19 Block 3 Mountain Valley Estates Subdivision Dear Mr. Butera, Based on information submitted with your application, this Department hereby grants a waiver to 93 feet of the separation distance from the well and septic tank on the subject lot. This waiver is valid for a four(4) bedroom single family dwelling. Sincerely, Susan E. Oswalt Acting Program Manager On-site Services SEO/ljw DA'~'E RECEIVED I NSPFCTI ON APPOINTS ENTS (~.~f.~-~_( TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~EPT' OF l iEALTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION ENVIRONMENTAL SANITATION DIVISION j[.~N 9 t981 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1, PROPERTY OWNER PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3, LB~BI~61~STITUTION [ PHONE I MAILING ADDRESS 4, RE~AG~ ¢~ ~ / PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION ;TREET LOCATION 5. TYPE OF RESIDENCE NUMBER OF~BEDROOMS '~ SINGLE FAMILY ~ One [] Four Two [] Five [] MULTIPLE FAMILY Three [] Six [] Other WATER SUPPLY 7. '~ INDIVIDUAL* LI COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled · since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available,) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS E~,,-'~GLE FAMILY [] ONE [~ THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2, WATER SUPPLY PERMIT NUMBER ~"'~-~NDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED Connection Verified. LOG RECEIVED PERMIT NUMBER '7 ~. ~DiAGE DISPOSAL SYSTEM VI DUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER ~pticTank or []Holding Tank Size:give dimensions: ! 2.~ If Tank is homemade SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line Absorption Area to nearest Lot Line d~, ~,~/' 5, COMMENTS APP OVED FOR .EDROOMS [] CONDITIONAL APPROVAL {letter must accompany certificatel [] DISAPPROVED DATE BY ~~, 72-010 (Rev, 6/79) D[JPAHTMENI OF IIEAITIt AND EItVII~ONMI~NFAI.. PftO1EC[ION June 11, 1981 John L. Hopkins 431 Mellow Place ~chorage, A].aska 99504 Subject: Lot 19 Block 3 Mountain Va!].ay. East Subdivision #1 Approval for the individual sewer and water facilities canno~ be granted until the following items have been completed: (1) The water ana].ysis report: needs to be submitted to ~ this office from ~he Chem Lab.. 5633 B Street, fo]: our review. Effective June l, 1981, the ].ab fee is $2O.OO. ) The septic tank pumped with a receipt submitted -to this office. ,~/~(~ (3) Exposed electrical wires to the well head are in violation of the Munic.i. pality of Anchora.le codes and ' C ' must be encased in conduit and buried. ThJ. s will need to be reinspected when it is completed. g-/~/ If there are any further questions, please call. this office at 264-.4720. Sincerely, James S. Roberts E~vironmental c, ' opec~alist JSR/ljw cc: Alaska Bank of Con~erce Post Office Box 1185 99577