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HomeMy WebLinkAboutHOMESTEAD HILLS BLK 1 LT 7 ..-" Municipality of Anchorage Page 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 Permit Number: ~G_3 ¢{'~O0~i"~ PID Number: ~:)lz~ -/'7'~ ' ~ame: ~ ~ ~ Wastewater System: u New ~Upgrade Address: I No. of Bed~oms: Phone: ~- ~0~{ ~ Deep Trench ~ Shallow Trench ~ Bed ~Mound ~ Other Total Depth from original, rede: LEGAL DESCRIPTION so, Rating: j 'O GPD/Sq. Ft. Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: ~ ~ Range: Section: Fill added above original grade: Gravel length: ~ a~ Number of tines: Distance between lines: WELL: ~New ~ Upgr Gravel w~dth: ~ Ft. A 15' ~t. Classification (Private, A,B,C): ~ Cased To: Total absorption area~o~ Pipe material: 5~C~ / Ft. Ft. SQ. Ft. Driller: ~ Date Drilled: Static Water Level: Installer Y~ GPM Pump Set at: ~,. I c,,i.g Heio,t AUove Grou;t: TANK SEPARATION DISTANCES ~ Septic ~ Holding ~S.T.E.P. TO Septic Absorption Lift Holding ~ublic/Private Manuf~tur~F; ~ Capacity in gallons: From Tank ~ield Station Tank Sewer Lines ~H' I ~ J ~0 Well- ~'~ ~ ~ ~ ~5~ Material: 5~ Number of Co~a~ments: Sudace Water ~0'* lo0'~ ) ~ LIFT STATION Lot / size in gallons: Manufacturer: Foundation ~ I~ 10 I~ ~~ "Pump on" level at: "Pump off" level at: ~ High water alarm at: Cu~ain -- aS'~ ~, Pure, Make&Model IElectricallnspectionspedormedby: Drain 05/ OS~ Remarks: 9~-3' ~.0.4, ~,~4 BENCH MARK ~ ~ Location and Description: Assumed Elevation: ' /O Inspections performed by: s~s ~N~INEE~ING . ~.~S' 1st ~'~w Department of He~{h ~n~ Hum~/Servipes~p~ ~ ~x 72-013 (Rev. 9/91) MOA 25 PERMIT ,NO. SW970093 PAGE 2 OF 3 HunlcipaLit;y o¢' Anchomage DEPARTHENT OF HEALTH AND HUHAN SERVICES ENVlRONHENTAL SERVICES DBVJSION P.D, ;Box 196650 ~, Anchorage, Ato. sko 99519-6650®TeLephone~ 343-4744 ON-S~TE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 7, BLOCK 1, HOMESTEAD HILLS S/D P.LD. NO. 015--175--09 rco[ STlJ IMTI/ /MT2/ /MT3[ IMT4/ A B 57.0' 57.5' 58.0' 38.0' 61.5' 41.0' 64.0' 43.0' 8,5.0' 98.5' 102.0' 53.5' 99.0' 107.0' 115.0' 68.0' E~ S ST1 99.3 I 1/4" X 4" REDUCER MH NJ, S, TH//1 · k'--EXACTLOCATION OF MT MT MT1 = 102.2.~ MT3 = MT2 103.2'\ MT4 = 103. MT1 = 99.2' --MT3 = 99.2' MT2 = 100.2' MT4 = 100.3' SEE D~AIL ON ~E #3 NO WATER FOUND ,~.,~'-~* T H u ~ IMPERMEABLE LAYER 92.0' & 94.2' 58.0' & 93.2' B.O.H. MT2 ~ 2.5' SAND __ V PERM['r iNO. SW970093 PAGE 3 0F 3 HunlclpaLi~y oF Anchorage DEPARTHENT OF HEALTH AND HUHAN SERVICES ENVIRONHENTAL SERVICES DOViSION P.D, Box 196650~Ancho~ge, Maska 99519-6650 ®Te[ephone~ 343-4744 ON-SITE WASTEWATER DOSPOSAL SYSTEH AND/OR WELL ~NSPECTION REPORT LEGAL LOT 7, BLOCK 1, HOMESTEAD HILLS S/D P.I.D. NO. 015--173--09 MT3/102.2' FINAL GRADE MT4 98.9' EAST TRENCH /~~ FINAL GRADE "~ , /" --INSULATION-- ~~""~ ~o~/' / 99.8' T.0.P. ~ / ~ ./ 100,8' T.0,P. ~ t~i:'.':? ..' ':.::' ':.'":~:' :,,"¥:":" ~ ~':/'~ ? ] ::: ,':','? : ,'.'.' ~ :: :": ":'": '.' ','~. :t:::"::' '. ':': :':'": ':": ': . .".":' ':',' :":.": d'.:":; ".".' .":; ';' .,: S~D FILTER i%X cE.8~o~ · <,~-., PERFORMED FOR: LEGAL DESCRIPTION:LO`j- 7 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section: 5 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS ~,~ 01 C .,~ S & S ENGINEERING SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After ~ Monitoring? Date: Gross Net Depth to Net Reading Date Time Time Water Drop ,. ~.;~ ~.~--~ 1 PERFORMED BY: ~11~'~4 P-agJe River Loop Road No. 204 ~-r-~,-/ ~ ~,-;~ ~,, ~ ACCORDANCE WI3~.e I~ .&.~I~J~I~L GUIDELINES iN EFFECT ON THIS DATE. DATE; 72-008 (Rev. 4/85) PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P,O. Box 196650 Anchorage, Alaska 99519-6650 July 29, 1997 Robert C. Cowan, P.E. S & S Engineering 17034 Eagl~ River Lopp Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 7 Block 1 Homestead Hills Waiver Request #WR970024, PID #015-173-09 Dear Mr. Cowan: Subdivision Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 4 feet from the leachfield to the property line. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. j~eerely' J es Cross, P.E. Program Manager On-Site Services:Program Lee MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ WR970024 PID# 015-173-09 HA~ Date Received: June 5, 1997 Legal Description: Lot 7 Block 1 Homestead Hills Engineer: Applicant: Waiver Requested: Permit 9 SW970093 Robert C. Cowan, P.E., St& S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska 99577 3ames Lee Lot line waiver of leachfield to property line of 4 feet. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: / Waiver is NOT Granted: List Conditions or Reasons for above: ~ ~~ Date: N~~ of Reviewer Rec 9: 02910/9284 Aa~ount: $ 115.00 Date Paid: June 5, 1997 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUM_AN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970093 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:LEE JUNE B & OWNER ADDRESS:4401 TRAPLINE DR ANCHORAGE, AK. 99516 PARCEL ID:01517309 LEGAL DESCRIPTION: HOMESTEAD HILLS BLK 1 LT 7 LOT SIZE: 25063 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 5/15/97 EXPIRATION DATE: 5/15/98 /~0 oiC To 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 (18AACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIA£ PROVISIONS: THE SAND USED IN THE 2.5 FT. FILTER LAYER MUST BE FROM A MOA APPROVED SOURCE WITH LESS THAN 4% PASSING THE #100, AND LESS THAN 2% PASSING THE #200 SIEVE. DATE: DATE: ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. CIVIL ENGINEERS May 14, 1997 (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER D~SPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7, Block 1, Homestead Hills S/D Request you issue a permit to upgrade the septic system serving the four bedroom house on the referenced property, and issue a lot line waiver for the existing leachfield a~ 4 feet. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 m>m~Z z© 10' UTILITY EASEMENT Z o~0 z%~ Oo~Zo -- 0~o zz NiT.S. ,SOACE S J DESIGN D ETA I L Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: AO')- '7 /$L~ c ~ I LEGAL DESCRIPTION: ~/-~),~1~$ ~-E,~-~ K/ILC Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER ~ O ENCOUNTERED? S IF YES, AT WHAT -- ~ DEPTH? p E SLOPE SITE PLAN Depth to Water After /~./ Morfitoring? J)~¥ Dale: &/ I ~/ '7 Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE i~O '~' (minutes/inc PERC HOLE DIAMETER TEST RUN BETWEEN ~''~/:O~ FT AND ~ t/;~ FT 7 ACCORDANCE WIT~ A~L ~ATE AND MU~[~L G~L~ tN EFFECT ON THiS DATE. DATE; =agra Klyer~ AlaSKa 72-008 (Rev. 4/85) ROBERT C. COWAN, P.E. ROBERTA. SHAFER, RE. HEALTH AUT HORI'[Y APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON S~TE WASTEWATER DISPOSAL SYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and~ MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 7, Block 1, Homestead Hills S/D April 22, 1997 GENERAL: The scope of this project includes the installation of two pressurized five foot wide drainfields to serve the proposed four bedroom residence located on the referenced property. The existing 1250 gallon septic tank will be verified for integrity. If found with good integrity, install a 500 gallon lift station, and if found with poor integrity, the existing 1250 gallon septic tank will be excavated, pumped, crushed, abandoned, and replaced with a 1500 gallon S.T.E.P. tank. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. e The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. ~EPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. e Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 7, Block 1, Homestead Hills S/D April 22, 1997 ® Se Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: me Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the holes faced downward. The distribution piping is to be of PVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 7, Block 1, Homestead Hills S/D April 22, 1997 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: ~ constructed by a / nioipally pproved septic tank 2. The following pipe ~t_e_rials~.acproved for use in septic system installations i~ t~e Municipality of Anchorage: De e Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with ].ess than 3% passing the %200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever specifications applies. Page Four Lot 7, Block 1, Homestead Hills S/D April 22, 1997 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: me o The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & $ Engineering. S & S Engineering shall be the owner' s representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 7, Block 1, Homestead Hills S/D April 22, 1997 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER M~Y-2@-~997 ~G~ CT&E ESI ~NCHOR~GE 90755Z5~0~ P.0~/0~ i TOTRL P.O~ ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. May 2, 1997 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN ~XTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DEStGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7, Block 1, Homestead Hills Subdivision Request you issue a permit to upgrade the septic system serving the four bedroom house on the referenced property, and issue lot line waivers for the existing leachf;eld at & feet, and the new drainfield at i foot. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If yoU require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure MUNICIPALITY OF ANCHORAGE ENVIRON~ENT^L SERVICES DIVISION MAY 05'1997 RECEIVED ~ = 60~' ~CALE SITE-PLAN TRAPLINE I DRIVE EASEMENT DESIGN I ~0 mO Z"O oo 'TOO mm ,SCALE DESIGN DETAIL Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~'-~/'~ ~,,-~ /'"'- ~' ~- /~OT ~ ~L~ c ~ I LEGAL DESCRIPTION: ~,[.~,~1~-$~--{~,4-~ H//..l- $ Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS Oa-O.~,,,', c 5' ~ $,'z.. 7- 5/,*,-o ,~ ~ ,/~ ,~ ¢ ~. L SLOPE SITE PLAN WASGROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~ ~ DEPTH? p E Oeplh to Water Alter Monitoring? l),e'/ flare: l,j ! ~ .-~ I Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE i~O "J- (minutes/inc PERC HOLE DIAMETER TEST RUN BETWEEN ,.~9/.~. FT AND ~ I/~ FT 17034 Eagle Rive. L...oad "o. =~ ACCORDANCE WIT~ ~ ~s~[-g~L~ IN EFFECT ON THIS DATE. gATE: 72-008 (Rev. 4/85)  ~ 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 . -- [] UPGRADE MAILING ADDRESS LEO^LDESOR,PT,ON L Absorption area Dwelling PERMIT NO, DISTA ~ ~ ~ ~ Man ufacturer ~~ Materi~ No. of compartments~ Liq. capa~in gallons ~-- Inside length Width Liquid depth /~.~ IF HOMEMADE: ~ ~ DISTANCE TO; Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons Q Well PERMIT NO. ~ DISTANCE TO: A~' , Foundation Nearestl~n, ~ ~~ ~ No. of linest Length ; ~ ~ Top of tile to finish grade~, Material beneat, tile ~ , ~[ ~s Total effective abso~i'~r~ Length 'Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ CI~/. Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) PIPE MATERIALS SOrL TEST RATING REMARKS Suite #3 99503 December 29, 1981 Mary Killgore NHN Trapline Drive Anchorage, Alaska RE: Sewer System Inspection Lot 7 Block 1 Homestead Hills Subdivision Dear Mrs. Killgore, This letter is to serve as a verification that I have visually in- spected the sewer system installed on the above property on December 29, 1981. The standpipes have been installed at the septic tank and at both ends of the trench in accordance with city standards. Since this home is on a community water system and there is no on-site well, there was no water test required. Sincerely, WH:zc-p PERMIT NO. ~PPL. ICRNT LOC~TION LEGAL DEF'RRTMENT ~ HERLTH RN[:, ENVIFONMENTRL~'.OTECTION '~'"=,:,~._, '" :,TREET.,'- ' 8NF:H~]RRGE, FIK g" ~t ' ~. --~'~/' . -- .... b 264-4 ~'2E~ LEE 8. KILLSDRE 5~34E1 VBNCE ~.~.-t~,~ TR8PL I NE LOT Z 8LK t HOMESTES[:, HILLS LOT SIZE ~=.~';'~'qaR-,.- SQUSRE FEET ""' "-- IS: '' R TYPE OF SOIL RESORF'TIDN -,'r_,TEP1 TF..EN~H MR;qIMI_IM NUMBER OF BEDROOMS = 4 SOIL '- P (SQ ..... 165 RHTINm FT,,BR)- THE F. EB. IJIRED :~,I~E OF THE SOIL RB_-,ORFTION SYSTEM I=,. THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCF! OR DRRINFIELD. TFIE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRL. L PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). .... - ' " THI: DEPRRTMENT DIIRIN3 THE F'EF.'MIT RPF'LICFtNT HR':-"; THE F,E_-,FON-,!E, ILITY TO INFORM ' '-q - INSTRLLRTION IN--',FECTIUN:., F~F RNY WELLS RDJRCENT TO 1HI:, FRLFERT~ RND THE NUMBER OF RESIDENCES THRT THE NELL WILL SERVE. T ~-..] C, c"..:_.'":' ":. I ~'-~:.F EL-T I ,3 ~'-.~ '--=. R~.'E F: E Q L" I E, RL.k. FILLINb OF RNY SYSTEM WITHOUT FINRL IN'qF'EF:TIGN RN[:, FIPPROVRL BY THIS ~EFRETMEN] WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS t00 FEET FOR R PRIVRTE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVR'TE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS PRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. I CERTIFY THRT 1: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL ]'HE SYSTEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. LEE R. K~LLI~DRE PERFORMED FoR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99~01 264-4720 SOILS LOG - PERCOLATION TEST DATE PERFORMED: jXSOILS LOG PERCOLATION TEST 10 12- 13 14 15 16 17 18 19 SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? ,..- L'~?.. ..... ..~,S"! ,*"" · 'V~.* A '.-.'/" If*:' 9 L.~ ~'"~ t :,. :~.;. J'UNE 25, 1971 ..'. , t ..., ..:.~_~COLAT~ON RATE ~l~/OJ~~ ~¢.~T~, TEST ~BETWEEN ' 4: 2225-E . 20 ~ ,~., 25. 1971 ,'. . ~-~ ~ t .' '~ ¥10N RATE .~ [-~ (m nutes/inch) · ~: ." >i x- ~ " ~ , .... · ~ ~ ~ , J~,~ klAt ~ . RUN BETWEEN ~ FT AND FT, ~ , ~ PERFORMED BY: CERTIFIED BY: DATE: ¢~ ~ Gross Net Depth tO Net Reading Date Time Time Water Dr op /o ~,,o /0 /o ,P-/ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 · ~UNICIPALITY OF ANCHORAGE ,~ON~ENTAL SERVICEs DIVISION 3UN 0 6 997 RECEIVED Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 7; Block 1; Homestead Hills Location (site address or directions) 4401Trapline Anchorage, AK Property ownei/ ~Hr. June Lee M.ailing addressC/O':lst, Inspection Network Lending agency- :,.Mailing address Agent Day phone 346-3091 512 Green Bay Rd. Highwood, Illinois 60040 Day phone Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: 4 Individual well Community well ××× Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: xxx Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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. S & S ENGINEERING ~'c-( Name of Firm . .............. ....... Phone Address Eagle River, Alaska 99577 Engineer's signature ~/'~~- ~ Date Se DHHS SIGNATURE ,f~pproved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based on,!y...gpon 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/~g1) Back MOA~21 MUNICIPALITY OF ANCHORAGE Municipality of Anchorage ENVIRONMENTAL SERVICES DIVISION/~'"~, DEPARTMENT OF HEALTH & HUMAN SERVIGJI~r~ 0 6 1997 Environmental Services Division 825 L Street, Room 502- Anchorage, Alaska 99501. (~ ~'z~.Jz~ D Health Authority Approval Checklist Legal Description: Lo T 7 13z-~c~ i /Vo,,~7~,~o /~-~-£ Parcel I.D.: A. WELL DATA Well type~' [-~,~ $ ~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Date completed / Cased to ~ C~dT~ ~.~.~ properly protected (Y/N). FROM WELLLOG ~ AT INSPECTION Static water level / Well production / WA'TER SAMPLE~~LTS: Coliform ~ Nitrate Dado[ sample: SEPTIC/HOLDING TANK DATA g.p.m, g.p.m. Collected by: Date installed 5/3~//ff 7 Tanksize I~ Other bacteria Number of Compartments. High water alarm ~.'~/N) ¥ ~ 5 Foundation clear'out (~/N)'. ¥ ~ $ Depression (Y/~ ,v o Date of Pumping,U/'~ - ~v~.~ Pumper ~ ABSORPTION FIELD DATA. Date installed &-'/~ q / q '7 . Length. I ~o Width Effective absorption area ~00 ~'~ Soil rating g~.p~c[~ft~or ft2/bdrm) 1' O / Gravel thickness below pipe System type ~- Total depth ,.~ Monitoring Tube present ~)'N) ¥~ J Depression over field (Y/~ ~'~ o Date of adequacy test ~v/,~ ~ ~ ~ w Results (Pass/Fail) For b~drooms Fluid depth in absorption field before test ('~1 water added (in.): _ :,:id dep~r: Abs: r~ii~ng::t:d:t; g.p.d. 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (~YN) ¥ ~ -~' High water alarm level at* /¥ 5- Cycles tested '~ Size in gallons I~'-o0 "Pump on" level at* *Datum "Pump off" level at* '3 3 '~ SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: - - ~.......~- Public sewer main ~ Public sewer manhole/cleanout Seine Lift station SEPARATION DISTANCES FROM~HOLDING TANK ON LOT TO: Foundation 'J" -~' Property line 30 -)-- Absorption field Water main/service line ~"~'/+ Surface water/drainage /0 o '/- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /o t./_ Building foundation ~- ~'/~ Water main/service line Surface water ! O O Driveway, parking/vehicle storage area 5- ~J Curtain drain ~ ~ ~ ~ ~</v~ ~ ,J Wells on adjacent lots /o0 ENGINEER'S CE RTIFIC AT I ON ~~ I certify that I have determined thru field inspections and review of Municipal re s are in c°nf°rmanc,~[it~ ~ HAA/~ide_llne~ in effect °n this date' Signature f'~,¢"/ (.~ L.~ ~ Engineer's Name ~¢0~,~A T' ~ - ~'~) ~4 Date (o [ 5" / ~1 '7 ~.,.. HAAFee $ ~" ~ Date of Payment ~.//~//~',~- .eceiptNumber c~/~-~---~/'/ ~~) Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Municipality of Anchorage Department of Health and Human Services 825 "L" Street Rick Mystrom, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 July 18, 1997 Robert C. Cowan, P.E. S & S Engineering 17034 Eagt~ River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for.iLot 7 Block 1 Homestead Hills Subdivision Waiver Request #WR970024, pID #015-173-09 Dear Mr. Cowan; Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 4 feet from the leachfield to the property line. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. J~mes Cross, P.E. ~ogram Manager On-Site Services Lee Property Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 7; Block 1; Homestead Hills Subdivision 4401Trapline, Anchorage, Alaska Location (site address ordirections) Property owner Mailing address June B. Lee 4401 Trapline, Anchorage, Alaska Day phone 99516 564-5867 wk 346-3091 hm Lending agency Mailing address Day phone Agent Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 4 NOTE: Individual well Community well x×x Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: xxx Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address ~agJe River, Alaska ~$7~' Engineer's signature Phone Date \-'~ -'~'~" Approved for /~-c~/,~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does th is as a cou r[esy 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 #21 (~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~0'r "¢'f ~ I/ ~-~t¢_.~?,~, -¢///::) Parcel I.D. ~ / ~---- A. WELL DATA Well type 0~NF,~V~3'~ Log present (Y/N) ~' Total depth Sanitary seal (Y/N) If~~' B, or C, attach ADEC letter. ADEC water system number Date completed Driller. Cased to Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level g.p m. AT INSPECTION ,~- ~- , g.P.m?l'l r-or'° >~ O Z SEPARATION DISTANC ES FROM WELL TO: Septic/holding tank on lot ~,.~O r ~L Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform ~J,/~r'A ; On adjacent lots On adjacent lots Public sewer manhole/c leanout Petroleum tank ~ ou~r~ Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts Y~N) High water alarm (Y/¢ Date of pumping Tank size ),'~ ,T..~ ¢-J:'d~ Compartments Foundation cleanout I~YN) Y~J;~ Depression (Y/~/)- Alarm tested (Y/N) (~' ~"~ [ Pumper SEPARATION DISTANCES FROM SEPTIC~I~ TO: Well(s) on lot A///~ On adjacent lots To property line -~ Absorption field Surface water/drainage 103 ~,¢ o~ Foundation ~ ~'-~ /' ~.~-~ Water main/service line /(~. ~- 72-026tRey. 7/91 Front CONTINUED ON BACK PAGE C. LIFT STATION / ~'"----....~ate installed ' /~/A . Manufacturer .~ S~~ __ ' _ Manhole/Access(Y/N) ~ Vent(Y/N) ~'"--~.._o n" level at j ~level at Fligh water alarm level ~..~ ~s tested ~ Meets MOA electrical codes (Y/N) ~ S EPARA. T.I ~ST .A.T'O N TO: ~ D :;~~ D~TA On adjacent lots Surface ~ Date installed ~-'~:3r-~ \ Soil rating 16C~ ¢¢:/~L -~FJ'4C_.JA System type Length C~'"~ ~ Width '~ Gravelthickness '~,~ ~ P~ Total depth "~/-~/ Total absorption area Depression over field (Y,~ Results (pass/fail) Peroxide treatment (past 12 months)(Y/~ Cleanouts present (~N) ~-'--~' Date of adequacy test for bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /X~'/~ On adjacent lots / ~ [ ' ~ Property line ! 0 t '~ ~ To existing or abandoned system on lot Cutbank ~-~ ~J~- Water main/service line Surface water Driveway, parking/vehicle storage area Curtain drain ~' I~ '~ ~f~J~tU~-~ ~y' i~l~(~ E. ENGINEER'S CERTIFICATION L8~ - W/3r - I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. To building foundation On adjacent lots Signature Engineer's Name Date $ & S ENGINEERING 17034 Eaflle River Loop Road No. 204 Eaclle River, Alaska 99577 HAA Fee $ J' '~ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number SH&FER ~ NO, DEPT. OF ENVIRONMENTAL CONSERVATION WALTER J. HICKEL, GOVERNOR ANCHORAGE DISTRICT OFFICE 3601 "C" STREET, SUITE 322 ANCHORAGE, ALASKA 99503 563-6775 Janua~ 21,1992 FOR: S & S Engineering PWSID 211669 My review of the records on file in this office reveals that the Homestead Hills Subdivision Class "A" Public Water System, is in compliance with the routine coliform bacteria samples requirements listed in Table C, and with the inorganic sampling listed in Table B of 18 AAC 80.200. Sincerely, Keven K. Kleweno Lead Engineer 177 O? MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or direbtions) (b), Properly Owner 1~ k//~ ~ Mailing Address ~[~/~ (c) Lending Institution~-~4d (d) Real Estate c~mpany and Agent g~g Telephone ~ ~¢-P~ (e) Mail the HAA to the followin~ address: or: Check here ~, if hold for pick up. List contact person and Cay pho~ number belo~ TYPE OF RESIDENCE Single-Family.J~ Number of Bedrooms WATER SUPPLY Individual Well [] Community/.~ Public [] Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite,l~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 fRev 8/86~ Front '~pOM s,Jaeu!Sue leUO!SSejoJd 9ql u! suo!ss!uJo Jo sJOJJ~ Joj @lq!suodseJ 3ou s! abeJoqouV jo ,~l!led!o!unl/~ all/'panss! s! @Jeo!~!JJ@3 ~ aJojaq ejep @Z/,leU~ Jo suo!jo@dsu! jonpuo3 jou op SHHa jo see/~olduJq 'siueuJeJ!nbaJ elels pue leJepeJ u!elJe3 /~JsJ~es OJ Jap JO U! SUO!im,!lSU! 5u!pual J!eqj pub SaLUOq JO sJ@sBqoJnd ol/~s@pno3 e se s!ql saop SHHQ eq/'8HsEIV jo aleiS alii U! paJa~,s!SaJ Jeeu!Su@ IBUO!$SejoJd juepuedepu! uB ,~q ~AOqB ~ qde~l~eJed u! ue^!O suo!leluesaJdaJ eql dodn/~lUO peseq saieo!j!iJeo le^oJdd¥ i~poqjnv qllBaH sanss! (SHHO) SaO!AJeS UeLUnH pu~ qJleeH 1o luauJ~edao aOeJoqouv ~o /q!l~d!o!unlAI aqJ. NoI/rIvc) leUOtl!puoo leAoJddv IeUO!l!puoo ~.o SLuJei pe^oJddes!C] ~' pa^oJddV ./~,,~ Aq SLUOOJpOq ,~ JOJ poAoJdd¥ 1VAOBddV SHHa o ~o~-j~ auoqdele~ ~ 5~ wJ~oeweN 'uo!~oedsu! siM] ~o e~ep uo ~oe~¢e u~ suo!~elnDeJ pue 'saoueu!pJo 'sepoo e~e~9 pue led!o~unR lle ql!~ eouefld~o3 u! s! ~e~s~s lesOds!p JO/pue ~lddns Ja]e~ elm-uo aql 'uo!~oedsu! pue uoi]eS!~seAu! ~ ~oJ~ pue Selg eDeJoqouv ~o ~!led!mun~ emi ~oJl peu!e)qo uo!le~Jo~u! emi uo peseq ~eM1 ~peA Jeq~ni I 'u!eJeM pa~eo!pu! eJn~3n~s ~o ed~l pue s~ooJpeq ¢o Jeq~nu emi e~enbepe pue leUO!~3un~ 'e~es s! ~e~s~s lesods!p Je~e~e~se~ Jo/pue ~lddns Je~e~ el!s-uo eql ~eq~ s~oMs leAoJddv q~l~eH s!q~ ~o uo!~e6!lse~u! ~ ~q~ ~;!Jen I 'MOleq UMOqS elep uo!lep!len eql ~o s~ pue o~eJeq pexg~e leas ~ ~q pe!~eo sv NOliV~OdNI aNY viva 'HOUriS ]lid 'SiSii 'SNOIIOidSNI ONIQIAO~d ~ld .g MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) .~,c~o~CICLIST_., - FEBRUARY 1984 _ ~,~.\-¢ O~ ~'~'*_.$ O'N~(J~ 264-4744 WELL DATA Well Classification Well Log Present (Y/N) ~Cased to Date Completed Total Depth Static Water Level ,/ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot '~--~ / ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /~',] / ; On Adjoining Lots To Nearest Public Sewer Line ,,'//'To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results IfA, B,C,D.E.C. Approved~N) /:)/ ~ //~G ? Yield Ded~°f Grouting . .//' Pump Set At / Sanitary Seal on Casing (Y/N) / ./ Depression Around Wellhead (Y/N)/ / To Nearest Sewer Service Line on Lot / Y ;Date Comments B. SEPTIC/HOLDING TANK DATA Size Date Installed Standpipes ~¢N) Air-tight Caps~N) Depression over Tank (Y/~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well 2L Z-/ / TO Property r-'ine '" ~-~ To WaterMain/ServiCe Line ~ /~ C0qrse ~ / ~ ~ '( "' No. of Compartments Foundation Cleanout ~N) Date Last Pumped ;~/7/~? Temporary Holding Tank Permit (Y/N} To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comm(~nts Pagelof2 ,' ",' ; : 72-026 fRev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ./~',/ To Building Foundation ,_"~ '/ Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field ¢.?'/ Depth of Field /~' J¢ "' Gravel Bed Thickness '-3 Standpipes Present'~N) Date of Last Adequacy Test To Property Line ~0 To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) /Ob ,v / D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested 'for Electrical Codes (Y/N) Comments Dimensions M a n h ole/Ac ces_s (...~)~ _ __ ! "Pum. pOff'~'~evel at ___ ," / "I/~-.-; ~J~~''',' Vent (Y/N) ......... '/~/ Pumping Cyc es dur ng Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify t~ck_ed, ~verified, or conformed to al lM CA and HAA guidelines in effect on the date of this inspection. ~iogr~a~~--'--'~~" ~_..,~.. Date p ny . ~ MOA No. Receipt No. ~'~ Date of Payment _~/'~' /~"~' // / Amount: $ //'-~O .._.--~-'~' Page 2 of 2 72-026 fRev 8/86/ Back / DEPT. OF ENVIRONMENTAL CONSERVATION / / ANCHORAOE/UESTERN DISTRICT OFFICE , 3601 "C" STREET. SUITE 1334 ANCHORAGE. ALASKA 99503 STEVE COWPER, GOVERNOR _~_~63-6775 3-7-88 DATE: Zli669 PWSID #: To Whom It Way Concern: HOMBSTBAD Accordin~ to the records on File in this o~tice, the HILLS SUBDIVISION Water System is in compliance with the State o¢ Alaska Drinking Water Regulations. Sincerely, Ronald S. Klein Environmental Field OfFicer MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL ,SERVICEs DIVISION ~AR 9 ~988 RECEIVED MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include'i0t, block, subdivision, section, township, range) Location (adcJress or directions) ; (b) Applicant Name ~ ~0~ Telephone: Home ~-~5~ Business ~ (c) Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone Mail the HAA to the following address: (f) 2. TYPE OF RESIDENCE Single-Family ~ Multi-F~ily [] Other Number of Bedrooms ~:iii!~'4 WATER SUPPLY Individual Well [] Communit~:J~.: Public [] Note: If community well system, mbst have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [~' Public [] Community [] Holding Tank'[] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, DA'lA 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. Name of Firm /~F~ ~---~ Address Date Approved for '~'(~ ~ bedrooms b . Approved ~ Disapprove~[J Terms of Conditional Approval  '-'~ _~ate Conditional CAUTION The Muncipality of Anchorage Departr~ent of Health,and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The ~unicipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 IJ :l li l :l J ::l MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: gl L NOIJ.3~lOad IVJ. N~3~I,~q~ gO~OI-DNV :10 XfrlVdl3iNnW A. WELL DATA Well ClassificationEOM/ U/t/I If A, B, C, D.E;C. Approved (Y/N) Well Log Present (Y/N) ~'//~ Date Completed /~/~' Yield Total Depth ./V?~. Cased t9 /~/4 Depth of Grouting /V/~f~,,~/,,~. Static Water Level /~//3r Pump Set At Casing Height Above Ground /V//~ Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) ~N/~ Depression Around Wetlhead (Y/N) Separation Dist~nbes from Well: TO Septic/Holdi~ng Tank on Lot Water Sample Collected by Water Sample Test Results Comments To Nearest Edge of Absorption Field on Lot /. To Nearest Public Sewer Line Cleanout/Manhole FRO/VI ; On Adjoining Lots I On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~'"/2-7/~?/' Size (2-,,5--0 NO. of Compartments Standpipes CN) Air-tight Caps ~/N) Foundation Cleanout ~N) Depression over Tank (Y~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) h'/'//l~' ; for Holding Tank High-Water Alarm (Y/N) /V/~ Temporary Holding Tank Permit (Y/N) /V//~} -- Separation Distances from Septic/Holding Tank: . /...~ To Water-Supply Well ~_. Z J /~' To Building Foundation ~,-~- ' To Property Line ~'~ /''~ To Disposal Field /,Z. '-~ To Water Main/Service Line '/O/¥' ~i~ To Stream, Pond, Lake, or Major Drainage Course I O0 i ../. :~ Page I of 2 ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field To Water-Supply Well To Building Foundation Lot To Water Main/Service Line Square Feet of Absorption Area Depression over Field (Y/~) Results of Last Adequacy Test Separation Distance from Absorption Field: To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~ /'¢ype of System Design /Length of Field g Z // ~(xGravel Bed Thickness _~, ~ Date of Last Adequacy Test To Property Line / 0 / To Existing or Abandoned System on ; On Adjoining Lots ~,~(~)/'~' ;~ To Cutbank (if present) JV//~t D. LIFT STATION Date Installed Dimensions Size in Cations Manhole/Access (Y/N) ~ "Pump On" Level at j /j~ "pu m p Off" ~""~at High Water Alarm Level at ~//?~ ~-'"~'~Ve nt (Y/N) Tested for /,,~/ Pu-m-Pi~'~le-~during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~/ Comments ~ ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I ha~/e~c, bccke.d,#erifiild, or conformed to all MOA. and HAA guidelines in effect on the date of this inspection. Signed qJ//J~/~~ Date J//~'/~ Company ! ~--~:,.~ //~fC, MOA NO. ~4~ Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) ALASKA ENVIRONU~NTAL CONTROL SERVI£ ., INC. 1200 West 33rd Avenue Suite B ANCHORAGE ALASKA 99503 (907) 561-5040 JOB ' ~-/ ~ · SHEET NO CALCULATED BY CHECKED BY ~' SCALE DATE BI~-L SHEFFIELD, GOVERNOR DEPT. OF EN%IRONMENTAL CONSER%~TION 437 "E" STREE,~, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 July 18, 1985 Alaska Environmental Control Services 1200 West 33rd Avenue Suite B Anchorage, Alaska 99503 Horizontal Separation Waiver Between Well and Absorption Trench, Lot 7, Block 1, Homestead Hills Subdivision, Anchorage, Alaska 8521-WA-O18 Dear Sir: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and absorption trench to 181 feet on the subject property for a single f.mily residence only. Sincerely, Steve Eng, P.E. District Engineer SE/dd 50242 LEE KILLIGORE 4401 TRAP LINE DRIVE ANCHORAGE ALASKA 99516 SELLER-SA/~E JULy 22 1985 LEE KILLIGORE 4401 TRAPLINE DRIVE ANCHORAGE ALASKA 995~6 LEGAL:HOMESTEAD HILLS BLOCK I LOT 7 ADEQUACY TEST FOR SEWER SYSTEM ADEQuAcY TEST DATE-MAy 29 1985 T~E TYPE OF ABSORPTION SYSTEM IS A TRENCH WITR AN AREA OF 679 SQFT. TRE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 938 GALLONS. BASED UPON Tf{E TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. THE SEPTIc TANK/PACKAGE PLANT WAS PUMPED ON JUNE 5 1985 . ~t:.,-,~.e~ C. P,,r~i~, Jr..' .':%"? DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 DATE: November 5. 1986 PWS I.D.# 211669 To Whom it May Concern: According to records on file in this office the HOMESTEAD HILLS Water System is in compliance with the State Drinking Water Regulations Sincerely, ~//Regional Sanitarian Supervisor Time Time Date Date Date Inspector Inspector Inspector Comments Conditional Approval Dat~ S~wer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~ ~ ~ /~, k~ //~,v.- ~, Phone Mailing Address ~ fi ~ / ~ ~/~ ~?~ Buyer .¢/~)/2~ ~. Address Lendinglnstitution ~/~5/(~' ~¢ ~ ~ / Phone Realty Co. & Agent Phone Address /~j /~ ....... Street Location ~ D/ [~ /~ Type,gf Residence '~ Single Family ~ ~ Multiple Family No. of Bedrooms . ~ Other Water Supply ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach lo.if ~ Public Utilit~ available.) Sew~e Disposal ~ Individual Year Individual Installed: ~/ ~ Public Utility When Connected to Public Utility:__ ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.