HomeMy WebLinkAboutSKY RANCH ESTATES #2 BLK 2 LT 111, L (d -.0 !ba -a5
Municipality of Anchorage Page of
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: SW 9 y0 3 /7 PID Number: O /S 3 O 225-'
Name:
Te.ffre � Wend Smith
Wastewater System: ❑ New IR Upgrade
Wastewater
Address'
$000 Whisperiltq, S race Drive, Aneh 99,06'
ABSORPTION FIELD
e
Phone: 3yS•o661
3 No. of Bedrooms:
❑ Deep Trench ❑ Shallow Trench weed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth V. SoAginal grade:
GPD/S Ft
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
I 2 ,S It (?an ch 04%Itr P_
0,9' Ft.
0.6 Ft.
Township:
Range:
3w
Section:
22
Fill added above original grade:
1.5'
Gravel length:
32'-P le' = "17' Ft.
12N
FL
WELL: ❑ New ❑ Upgrade
Gravel width: 1b t
Number of lines:
Distance bbetween linees1
Ft.
Classification (P'ri1vate, A,B,C):
•n"
Total Depth:
Cased To:
Total absorption area:
-70S-
Pipe material:
C/euS Con1M,
Ft.
Ft.
SD. Ft.
I.2S"D1N, LCNGD WUN✓
Driller:Date
Drilled:
Static Water Level:
Installer:
Carl's
Date installed:
6/31/19
FL
i5KGGtapA%v
Yield:
Pump SetaC
Casing Height Above Ground:
TANK
GPM'
Ft.
Ft.
SEPARATION DISTANCES
❑ Septic ❑ Holding 91 S.T.E.P.
To
Septic
Absorption
Lilt
Holding
Public/Private
Manufacturer:
A rca Tan h,
Capacity in gallons:
1 125"0
From
Tank
Field
Station
Tank
Sewer Lines
n cha e
well
>20a'
>20o'
>20e'
-
Material:
S/-eet
I Number of Compartments:
z
surfaceLIFT
Water
> too
> too
i too
STATION
Line
,
HS'
Size in gallons:
Manufacturer:
O rp�c o
`/S
S
Tn Aral
Foundation
S'
HO'
S"'
—
y
"Pump on" level et:
HH"
"Pump off" level at:
Ha"
High water alarm at:
H6"
Dra nn
/S'
3S •
1 J ,
-'
—
Pump Make &Model
1/3 0
Electrical Inspections performed by:
M. 0.A.
SI
Remarks: Aif, Skhan ham, 6 (ewe/ «/«t-.
BENCH MARK
ntounkr� to 4✓aC!¢ment u�r/, t ,^uom, lbt
Location and Description:
S'a"Acaesf corner of aeck• beceor
/rne uiawer rs.ruea ceMocv,r, Scr/ ub.r.
hah laL6
��—
Assumed Elevation:
act12 he 'r�.•� laf 1,ite %'1ou h
100. d Ft
ENGINEER'S SEAL
a,lea�e� way nwa� ntaF ram(«(. Win«/ p/rrrernenF aF ry;/
4 ` At
O
'
eeno( ¢N in bear 4ac/ uru/el byhomnocu�er•.
b+� •L+,•••••� T°
TH
Inspections performed by: Ele,M3,�! Tec% S'G'c Dates: 1st b/31/9Y
•••�•••'•""•0101"""-"
2nd 8/3119Y
�1...... ... Kc3:..M�;'K
THEODORE F. MOOPE
anti H
Department of Healt uma ervices approval
1,4� •,,, t
Date:
Reviewed and approved by:
72-013 (Rev. 9/91) MOA 25
PERMIT NO: SW940317 ji PAGE 2 OF 2
PID NO: 01530225 1 L V
;
PLAN VIEW
SCALE: 1" = 30'- 0"
i '
i
I
EXISTING
3 BDRM
GARAGE
HOUSE
NEW 705 SO. FT.
SWING TIES
„A„
B
SOIL ABS. BED
O
DECK
FROM: COR."A" COR "B" COR'
;
C.O. "D"
_ _
M.T. "G"
TO:
M.H."E"
TBM
15
C.O. "D" 18' 21'
M.H. "E" 20.5' 26'
NEW 1250 GAL.
23'
STEP TANK
J
M.T. "F" 67.5' 50'
_
M.T.
"F"
Cn
M.T. "G" 76' 44' 64'
- - - - - -
,�[s,^4AAv*Tl' I
.:A- .�.r n .11 l_
----------------------------
32
49TH G •��q,
THEODORE F. MOORE ;
%% CE - 3569
INSULATION & FILTER
tTBM = 100'
(SW COR. DECK)
CROSS-SECTION VIEW
VERTICAL SCALE: 1" = 5' -0"
INV. I I NEW 1250 GAL STEP TANK I L—INV.
0
1.25" DIA. SCHED 40 DIST PIPES
ELEV = 98.4'-J ELEV =• 99.4'— ORIG. GROUND
AT T.H. #?_ 100.9
NATIVE SILTY SAND
BOTTOM T.H. #2
90.9' (M.T. DRY)
LOT 1, BLK. 2, SKY RANCH EST. #2
SEPTIC SYSTEM UPGRADE
AS -BUILT INSPECTION REPORT
FLA'ITOPTECHNICAL SERVICES SCALE:AS•SHOWN
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 DATE: SEPT. 1994
DEPT. OF ENVIRONMENTAL CONsEnvATiON
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3.470
ANCHORAGE, ALASKA 99515
September 6, 1994
Ted Moore
Flattop Technical
14530 Echo St.
Anchorage, AK 99516
SUBJECT: Lot 1, Block 2 Sky Ranch Estates #2
Class "A" Public Water System, PWSID #212916
Dear Mr. Moore:
WALTER J, NICKEL, GOVERNOR
(907) 349-7755
I have completed a review of this office's files concerning the monitoring status of the
above -referenced Class "A" Public Water System and found the following:
1. The last satisfactory Total Coliform Bacteria Sample results was submitted
to this Department on July 29, 1994. This dna meet the provisions of 18
AAC 80.200(a), of the State Drinking Water Regulations,
2. The last inorganic Chemical Contaminants Sample results were submitted
to this Department on October 19, 1992. This ,d= meet the provisions of
18 AAC 80.200(a), of the State Drinking Water Regulations,
3. The last Radioactive Contaminants Sample results were submitted to the
Department on April 7, 1994, This �Lm meet the provisions of 18 AAC
80.200(a), State Drinking Water Regulations,
4. The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC)
were submitted to this Department on January 20, 1993. Based on analysis
of the previous VOC samples results have been satisfactory, This d_=
meet the provisions of 18 AAC 80.200(x), State Drinking Water Regulations.
Issuance of this letter does not imply that the above -referenced Class "A" Public Water
System Is in compliance with other provisions of the State Drinking Regulations. Unless
otherwise noted, this letter is valid for 30 days and is for the specified legal description
noted above only.
Ted Moore
September 6, 1994
If you have any questions on the above Information, please do not hesitate to contact this
Office at 349.7755.
Sincerely,
Michael Lu
Environmental Eng. Asst. II
ML/of
iin.; i:, ��--i,l Ifni �.I IIL''i'
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Municipality of Anehorage
U, Department of Health and Human Services
825 "L" Street
Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor August 25, 1994
Ted Moore, P.E.
Flattop Technical Services
14530 Echo Street
Anchorage Alaska 99516
Subject : Waiver Request for : Lot 1; Block 2; Sky Ranch Estates # 2
Waiver Request #WR940045
Dear Mr. Moore,
Your request for waiver of the required 10 foot separation between a septic system and
lot line has been approved. The waived distance is five feet.
This approval applies to the existing septic system lot line separation only. Any future
upgrade to the septic system will require all separations to be met or another approval
from this department.
erely,
a eses Cr s
Program Manager
On-site Services.
Ijm:#6
MUNICIPALITY OF ANCHORAGz
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR940045 PID# 015•-302-25_ HA# _ Permit #SW940317
Date Received: 08-09-94 —
Legal Description: Lot 1, Blk 2 Sky Ranch Estates # 2
Engineer: Flat_ top Technical Services —
Ted Moore, P.E. ---
Applicant: Smith, Jeffrey R. & Wend W.__ ----
Waiver
.— —Waiver Requested: Lot line waiver to five (5) feet.
Points:
Criteria: 1. Geology:
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: ----
No adverse conditions found --
Date: 08-25-94
Rec #: 00177
By, ----
Name of Reviewer
Amount: $115_00 Date Paid: 08-09-94
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE I `Sr )X�3� �� o�
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650 "t CZ
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW940317
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:SMITH JEFFREY R & WENDY W
OWNER ADDRESS:5000 WHISPERING SPRUCE DR
ANCHORAGE, AK 99516
PARCEL ID:01530225
LEGAL DESCRIPTION: SKY RANCH ESTATES #2 BLK
T 1
LOT SIZE: 20274 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
f►m!
DATE ISSUED: 8/25/94
EXPIRATION DATE: 8/25/95
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE SPATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 HOURS) .
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
S. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
LOT LINE WAIVER #WR940045 APPROVED 08/25/94.
RECEIVED B
ISSUED BY:
DATE
DATE : Z
CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS
THEODORE T. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345.1355 August 8, 1994 ANCHORAGE, ALASKA 99516
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for a
permit to upgrade the wastewater disposal facilities on Lot 1, Block 2, Sky Ranch Estates #2 S/D, located
at 5000 Whispering Spruce Drive. Soils logs, perc test results, a site plan, design drawings and
specifications are enclosed for your review. We are also requesting a lot line waiver allowing the mound
to be constructed within 5 feet of die common lot line with Lot 2, Block 2. Granting of the requested
waiver should not prevent the owners of Lot 2 from constructing a similarly configured system an equal
distance away from the lot line on the other side, at such time as this might be needed.
The proposed system will be constructed in the vicinity of test hole # 2 and perc test hole 44 . As can
be seen from the soil logs, the native material between 1.5' and 4.5' varies from silty sandy gravel to silty
sand and two perc tests indicate that it has a perc rate of less than 5 minutes per inch. No water table was
encountered at the time of test hole excavation, however, a one foot thick sand filter is incorporated in the
design to provide good initial filtration of the septic tank effluent as well as additional separation from
possible seasonal groundwater. Using the soil application rate of 0.7 gpd/sq. ft. specified in the
wastewater ordinance for filter sand, this 3 bedroom residence requires a total absorption area of (3 x
150)/0.7 = 643 square feet. The proposed design has a total absorption area of 645 square feet.
There is a footing drain around the east side of the residence (configured approximately as shown on
the site plan) which was installed to eliminate It previous daylight basement flooding problem which
occurred during breakup. The footing drain is located 35 feet away on the downhill side from the closest
edge of the proposed mound. This is closer than the 50 feet specified in the wastewater ordinance,
however in our opinion the proposed mound, which is located as far away from the foundation drain as
possible, should not result in inadequately treated effluent making its way into the footing drain.
The topography of the lot in the area of the proposed construction is a gently sloping bench which
slopes downwards towards the north and west at approximately 2%. Below this bench the topography
slopes down towards the house at approximately 20%.
Except as described above, the proposed project will have no known impact on present or future water
supply and wastewater disposal systems serving adjacent properties, nor will it have any known impact on
reserved space/surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any
questions on this submittal.
Sincerely,
Ted Moore, P.E.
D]
I
I
EXISTING SEPTIC TANK
(TO BE REPLACED WITH
1250 GAL. STEP TANK)
I o ---
i
LOTI,BLOCKI
WHISPERING SPRUCE DRIVE
-------- —
TRENCH
SEEP.
L_—
T.H.
SEPTIC SYST.
(THIS AREA)
LPIT ------ NEW 645 S0. FT.
TH.ik1� - = - ------ SOIL ABS. BED----------
IL P.H. 84—/ P.H. ik5---N
-------------------------------------------------------------------------
SOIL ABS. TRENCH o
0
LOT 4, BLOCK 2
ltiw;,......,;�-;",,I
>i Tim",r ..a
�. THEODORE K. MOORE;
t CE - 3589Alp
HOUSE
LOT 3, BLOCK 2
1.25" DIA. SCHED. 40 PVC DISCHARGE 1.25" DIA. SCHED 40 PVC MANIFOLD (TYP.)
LINE FROM 1250 GAL. STEP TANK V(LOCATED 1' FROM EDGE OF SOIL ABS. BED)
/ MONITOR TUBE
15
"An ;;
��— 2.5i; 5 5 ;i;2.5
N
MONITOR o N 1.25" DIA. SCHED 40 PVC DIST. LINE
W. 5/32" DIA. HOLES IN BOT. 3' O.C. "
TUBE
�T61 0
•..•rrrr. r.rurrrrrr•:•e,r �+.
' THEODORE F. MOORE
CE -3589 •` X14
MONITOR TUB
ORIGINAL GROUND
3
N W�.::..... �....,:
N '
35
OUTER LIMITS OF EXCAVATION,
FILTER SAND AND SEWER GRAVEL
PLAN VIEW
SCALE: 1"=10'-0"
15
SECTION "A - A"
SCALE: 1"=F-0"
1.25" DIA. SCHED 40 PVC DISTRIBUTION PIPES
WITH 5/16" DIA HOLES IN BOTTOMS 3' O.C.'
2" RIGID INSULATION
FILTER FABRIC
2' SOIL COVER
9" SEWER GRAVEL
(6" BELOW PIPE INV.)
Ftattop Technica(Services
14530 Echo Street, Anchorage, AK99516
Thione (90 7) 345-1355
Lot 1, Block 2, Sky Ranch Estates #2
5000 Whispering Spruce Drive
Wastewater disposal systern installation
Specifications
1.0 General:
1.1 The scope of the project consists of abandonment of an existing 1000 gallon septic tank and
seepage pit and installation of a new 1250 gallon STEP tank which pumps effluent up into a 645 square
foot soil absorption mound.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform with Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any
buried utilities.
1.4 The contractor shall provide neatly graded cover material and topsoil over all system components
to ensure that proper drainage is achieved after settlement and that there are no residual depressions.
Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for reseeding all areas
disturbed by the construction.
2.0 Septic Tank:
2.1 The existing 1000 gallon septic tank is to be properly abandoned by thoroughly pumping,
cruslung and burying in the old seepage pit, or properly disposed of off site.
2.2 The new 1250 gallon, 2 compartment STEP tank shall be Municipally approved and shall be set
level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4"
cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type,
rigid insulation.
2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot.
3.0 Lift station:
3.1 The lift station shall be installed either in the second compartment of the STEP tank which has an
additional 250 gallon capacity. The lift station package shall be an "Orenco" system as supplied by
Anchorage Tank.
3.2 The contractor shall be responsible to obtain the necessary Municipal electric permit and
inspection, and shall provide a copy of the electrical inspector's report to the engineer overseeing the
construction of the wastewater disposal system.
3.3 The lift station shall be equipped with a watertight, insulated manhole riser and cover extending a
minimum of 6" above final grade with positive surface drainage away from the manhole. The contractor
shall be responsible for determining the necessary length of the manhole riser.
3.4 The on, off, and alarm floats shall be set at the elevations specified by the lift station supplier, and
their proper operations shall be verified by the contractor.
3.5 The discharge line from the lift station to the soil absorption system shall be 1.25' dia. Sched 40
PVC. All pipe connections in the distribution system shall be glued, and the ends of all pipes capped.
4.0 Soil absorption system:
4.1 The soil absorption system shall be constructed by creating a 645 square foot excavation
configured as shown on the design drawings, with the bottom of the excavation 2.5 feet below original
ground level in the middle of the bed.
4.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to
allow proper infiltration. A minimum of 12 inches of approved filter sand shall be placed in the bottom of
the excavation. Sand serving as filter material shall comply with Municipal specifications, and come from
a Municipally approved source with less than 4% passing the #100 sieve. Sand currently being sold as
"Lake Otis Gravel" does meet these specifications.
4.3 A total of 0.75 feet of approved sewer gravel shall be placed on top of the filter sand with the
perforated distribution pipes laid level such that the pipe inverts are no less Ulan 0.5 feet above the bottom
of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" washed gravel as supplied by Anchorage Sand and
gravel, with a minimum of silt particles clinging to individual stones
4.4 Monitor tubes shall be, of 4" diameter and installed in the locations shown on the design drawings.
The portion of the monitor tube extending through the sewer gravel shall be perforated.
4.5 Two inches of rigid, burial type insulation as well as approved filter fabric shall be placed over the
entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter
fabric.
4.6 The top surface of the cover material shall be graded to smooth contours. Fill slopes shall be no
steeper than 3:1. The uppermost 3 inches of cover material shall be topsoil.
4.7 Unless specifically agreed otherwise, the homeowner shall be responsible for seeding all areas
disturbed by the construction.
5.0 Inspections:
5.1 A minimum of 5 engineering inspections will be required during the course of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test
information, (3) after the sand inter material has been placed, (4) after the sewer gravel is in place and the
distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or
filter fabric, and (5) after the backfill and grading is complete. The STEP tank requires one inspection
after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated
with any of the above inspections.
5.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
TEST HOLE # 2 SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: LOT 1. BLOCK 2. SKY RANCH ESTATES
DATE PERFORMED:
ReadingClock
,JULY 27. 1994
Net Time
(minutes)
Percometer
Reading
JEFF AND WENDY SMITH
7L27
Bottom of P.T. hole__
PERFORMED
FOR:
DRIVE
`•Pvy
q�P'\EP
T.H.
na
DEPTH
2:52 P.M.
�5.
SLOPE
EXISTING
(feet)
Pt
GARAGE
HOUSE
1
SM Reddish sandy loath"
"""
_
2
0
#1
o J
3
ENCH
GP/GM Silty sandy gravel
:.....
Add water
1 �I
. . . .
(variable consistency)
....:.
4
2:59:10
(much less gravelly @ north end of T.H.)
.....:....:.....:.....
nr�^
Add water
cU�
---
-----
T.H. nt
5
H3_
P.H. U4
P.H. U5
6
238
SM%ML, Gray silty sand
....
dry, non -cohesive
o
2�.
8
...... .......
B.H.
COMMENTS:
Depth to Groundwater Date
No roundwatcr 7/27/94
_
M.
W
Q-
q O
rn
4f9Tfii
ADORE F. AAOOR<
CE•3509
SITE PLAN
WHISPERING SPRUCE DRIVE
Fh
ReadingClock
Time
Net Time
(minutes)
Percometer
Reading
Net Dro
(inches
7L27
Bottom of P.T. hole__
�$o
DRIVE
`•Pvy
q�P'\EP
T.H.
na
12" Pre-soak
2:52 P.M.
�5.
5 1/8
EXISTING
q
36DRM
GARAGE
HOUSE
Add water
2:56:35
_
9 1/8
0
#1
o J
T.H.
ENCH
23/8
U2
Add water
1 �I
t
SE
#t2
2:59:10
IT
11 1/2
nr�^
Add water
cU�
---
-----
T.H. nt
---
H3_
P.H. U4
P.H. U5
...........................................................
2%
Date
ReadingClock
Time
Net Time
(minutes)
Percometer
Reading
Net Dro
(inches
7L27
Bottom of P.T. hole__
17 1/8
12" Pre-soak
2:52 P.M.
5 1/8
55
13 1/8
Add water
2:56:35
_
9 1/8
#1
2:57:35
1
11 1/2
23/8
Add water
2:58:10
9 1/8
#t2
2:59:10
1
11 1/2
2 3 8
Add water
3:00:04
9 1 8
H3_
3:01.04
1112
238
PERCOLATION RATE <1 (minutes/inch) PERC HOLE DIAMETER 8
TEST RUN BETWEEN 325 FTAND 375 FT
PERFORMED BY FLATTOP TECHNICAL SERVICES. 1 " / CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECTON THIS DATE. DATE:
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
TEST HOLE # PH SOILS LO(a -- PERCOLATION TEST
LEGAL DESCRIPTION:_ LOT 1 BLOCK 2 SKY RANCH ESTATES
DATE PERFORMED: Au2ust2 1994
PERFORMED FOR: ,JEFF AND WENDY SMITH
DEPTH _� SLOPE
(feet)
1-
4
5
6
7
8
9
10
11
17
Pt
SM Reddish sandy loam
SM 'ran Gravelly silty sand (dry)
B.H.
5%
Depth to Groundwater Date
ret n82
w
a
O
N
40
. THEODORE P. M,OORE ; 1
t CE - 3589 A
�p/AM •.......•• ccs40
SITE PLAN
WHISPERING SPRUCE DRIVE
ReadingClock
Time
Net Time
(minutes)
::
Net Dro
(inches
DRIVE.
Pv2
T.H.
273/8
y5.' 3
EXISTING
q
213/4
3BDRM
GARAGE
HOUSE
27 1 2
a�
Add water
0
233/8
o
T.H.
ENCH
42
2134
158
r�
SE
231/2
IT
#2
2:49:45
21718
1 5 8
—T.H.
41
2:50:20
P.H. d4
P,H. 45
....................................:.................
2%
Date
ReadingClock
Time
Net Time
(minutes)
Percometer
Reading
Net Dro
(inches
8/2
12" Presoak
2:21
273/8
2:30
213/4
Add water
2:30:45
27 1 2
Add water
2:39:15
233/8
#1
5
2134
158
Add water
2:44:45
231/2
#2
2:49:45
21718
1 5 8
Add water
2:50:20
23 112
#3
2:55:20
5
21718
1 5 8
Add water
2:55:45
237/16
#4
3:00:45
5
21718
1 9/16
I PERCOLATION RATE 4 (minutes/inch) PERC HOLE DIAMETER_ 7
����JJJ TEST RUN BETWEEN 2,25 FTAND 275 FT
COMMENTS: This Vere test hole was dug to assess continuity of gravel stratum encountered in test hole #2, and to determine vert rate of
PERFORMED BY FLATTOP TECHNICAL SERVICES. I </ %,� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: c.c "Z f E.( F%% y
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
TEST HOLE # P�5ANCHORAGE, ALASKA 99516
TEST HOLE # PH s SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: LOT 1, BLOCK 2 SKY RANCH ESTATES
DATE PERFORMED: AUGUST 2..1994
PERFORMED FOR: ,JEFF AND WENDY SMITH
DEPTH SLOPE
(feet).Pt
1 SM Reddish sandy loam
4611
i
12
13
14
15
17
18
19
SM Tan silty sand, dry, easy digging
(similar to material in P.H. 4)
B.H.
5%
Depth to Groundwater Date
No roundwater 8/2/94
W
Q-
9 O
U)
.THEODORE P. MOORE
CE-35II9 �"��
SITE PIAN
WHISPERING SPRUCE DRIVE
Reading
O
Not Time
(minutes)
Percometer
Reading
Net Drop
(inches)
P
, 20
3yP�E
DRIVE
T.H.
r
EXISTING
3 BDRM
GARAGE
HOUSE
o
o
T.H.
ENCH
42
�1 �t
SEE
N
IT
�b1
T.H. H1
P.H. 64
P.H. 45—
..........................................................
2%
...........
Date
Reading
Clock
Time
Not Time
(minutes)
Percometer
Reading
Net Drop
(inches)
I PERCOLATION RATE (minuteslnch) PERC HOLE DIAMETER
LLL�__�JI TEST RUN BETWEEN FTAND FT
COMMENTS: This post (role was dug to assess continuity of soils encountered in T.H. #2 and PH 4. No monitor tube was installed.
PERFORMED BY FLATTOP TECHNICAL SERVICES. I �}'jw,.CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �r e /?9y
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
TEST HOLE # 1 SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: LOT 1, BLOCK 2, SKY RANCH ESTATES
DATE PERFORMED: ,JULY 27. 1994
PERFORMED FOR: JEFF AND WENDY SMITH
DEPTH pt SLOPE
(feet) `t
SM Reddish silty loam
1'
T.
2
ML Gray gravelly silt
3 dense, cohesive
4
5
6-
7— ML Gray silt
dense, wet (ribbons when squeezed)
8
10
11
12
13
14
15
1
an
.,.,
'•�9rM 4 ''F4i
.z.. No
I. THEODORE A MOORS•,• i
I r
CE - 3539
. 0
SITE PLAN
Depth to Groundwater Date
No groundwater 7/27 _
W
a
O
.............
2%
Date Reading
Clock
Time
Net Time
(minutes)
Percometer
Reading
Net Drop
(inches)
JPERCOLATION RATE (minutoslnch) PERC HOLE DIAMETER
'FEST RUN BETWEEN FTAND FT
COMMENTS: Material not suitable for construction of a soil absorption system, No monitor tube set.
PERFORMED BY FLATTOP TECHNICAL SERVICES. I �i_ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: —Acur f 8 /99 y
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
TEST I10LE # 3 SOILS LOG -- I3ERCOLATION TEST
LEGAL DESCRIPTION: LOT 1, BLOCK 2 SKY RANCH ESTATES
DATE PERFORMED: JULY 27, 1994
PERFORMED FOR: ,JEFF AND WENDY SMITH
DEPTH SLOPE
(feet) Pt
. J <i. SM Reddish gravelly sandy loam
ML dense gray silt
15
16
17
18
19
20
Depth to Groundwater Date
Eo roundwater 7/27
M M,a B/9
W
Q_
O
N
��T� `.?t r •. �.yx��p
THEODORE r. MOJRE ,
I. CE • 35139
�•., •,: ,r 1rY
VM,w
SITE PLAN
WHISPERING SPRUCE DRIVE
Clock
Time
T
Percometer
Reading
Net Drop
(inches)
DIiIVE
9
`x`92
Y� 'r.H.
y5•' 43
EXISTING
of
3BDRM
GARAGE
HOUSE
a�
0
0 ' J
T.H.
ENCH
2
N
SE
IT
41�
9"
T.H. lt1 '—
P.H. 714
P.H. H5
2%
Date Reading
Clock
Time
Net Time
(minutes)
Percometer
Reading
Net Drop
(inches)
UPERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FTAND FT
COMMENTS: Soils not consistent between test holes. This area generally not suitable due to poorly permeable shallow soils coupled with (mown
previous drainage problems affecting the nearby foundation during breakup
PERFORMED BY FLATTOP TECHNICAL SERVICES. I _ �%'j�.�S, _ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: dw is IL ,8 X99
V
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 PHONE ONE
,ItC `, , I! �_��DE
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION/ NO. OF BEDROOMS
16/GC!/at -t G�-ck 3
Well Absorption area Dwelling PERMIT NO.
DISTANCE TO:
Uy
tiF Manufacturer �� 1/� / Material No. of compartments
Liq. capacity in gallonsIF HOMEMADE: [Inside length Width Liquid depth
�U Z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
02
FQ-
Manufacturer
_
Material
Liquid capacity in gallons
O
wx
w u Z
_
X F.
Well s
DISTANCE TO: �9WLG�—
No. of lines Length of each line
- Top of tilo to finish grade
Foundation Nearest lo S IinF
D {--
Total length Pf lilies Trench width
��/ _�7I incheSf
--
Material benea h file
9s-irmhes
PERMIT NO. ®�
f' UC7 ils
Distance between li r
Total effective absorp[t^ion area
J --- —
W
7
Length
Width
Depth
PERMIT NO.
Q f-
Type of crib
Crib diameter
Crib depth
Total effective absorption area
w
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Souder line
Septic tank
Absorption area(s)
OTHER
LEGAL
PIPE MATERIA
/7,
6- r
SOIL TEST RATING
2,5'0
INSTALLER
C
REMARKS
v
APPROVED / � GATE
72-013 (Rev. 3/78)
r l 0._1 VA 1: e_-- I
DEPARTMENT 6
25
C3 r'.1--- K .E. -F EE
PERMIT NO. ( 800454 )
APPLICANT ACHE:": ON ENT.
LOCATION WHISPERING SPRUCE
LEGAL•. L 1 B 2 SKY RANCH
HEALTH FINE.:, ENVIRONMENTAL r 0T'ECTION
::STREET: AE CHORAGE: AK 99521
264-4720
Zkkc
l;>
C:5IES.L4E=Ff 1-,1E=°o_aEZF11:7.°IEC & EE. F-,.'r°l:1: T' 1C):�)L)
S. R. H. E',UX 1628—C.- 3444650;1 .
EST. LOT SIZE 20274 :=ir..UARE FEE.T..
TYPE OF SOIL_ ABSORPTION SYSTEM I S : TRENCH
:H
MAXIMUM NUMBER OF
BEDROOMS =
_ SOIL RATING
(SQ FT&BR )m
250
THE REQUIRED SIZE
OF THE SOIL
ABSORPTION SYSTEM IS:
BE:
SUBJECT TO PROSECUTION.
i
w " t C3 Fl F 9 %0 B._ f:*'— F 87 • "IF' 1 9 ::: n
60 1 '
THE I._F_NGFH DIMENSION IS THE LENGTH ON FEET:' OF THE TRENCH OR DRAINFIELO.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOT'T'OM OF THE EXCAVATION CIN FEET?.
THERE 15 NO `_;E:T WIDTH FOR TRENCHES.
THE GRAVEL. DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
t'IY+1D THE BOTTOM OF THE EXCAVATION CIN FEEL"?,
PERMIT APPLICANT HAS THE RESPONSIBILiTY TO INFORM THIS DEPARTMENT DURING THE
IE'STAL.LATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF. RESIDENCES THAT THE WELL. WILL SERVE.
_......_...-.... g
51 1 w 3
N.: -,-.v: ° T 6' ,l = F 9,E: eti: lF I w i r -A :` FI Fm: EE
FS = a, � E 1_I :IC fes• I__ I--°
BACKFILLING OF
ANY
SYSTEM WITHOUT FINAL INSPECTION AND
APPROVAL BY THIS
DEPARTMENT WILL.
BE:
SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL.. SYSTEM Is
100 FEET FOR A PRIVATE WELL OR 15TO 200 FEET FROM A PUBLIC: WELL DEPENDING
UPON THE TYPE OF. PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL.. TO H PRIVATE SEWER LINE IS 25 FEET ANC.,
TO A COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS AF:':
AVAILABLE TO INSURE PROPER INSTALLATION.
F""Fa:F-^F'°F :6' -1` IE`,"r F` 3 FR EF I[>l_:k. kF-Arl V3 ELE F;' _-_:L ,
E CERTIFY THAT
1: I FIM FAMILIAR WITH THE
REQUIREMENTS
FOR ON-SITE:
SEWERS
FORTH BY THE MUNICIPALITY
OF ANCHORAGE.
._: 1 WILL INSTALL THE SYSTEM
IN ACCORDANCE WITH
THE CODES.
3: I UNDERSTAND THAT THE.
ON—SITE SEWER
SYSTEM
MAY REQUIRE
RESIDENCE IS REMODELED 1.O
INCLUDE MORE
THAN 3
BEDROOMS.
------------
APPLICANT r C lESON ENT.
II
Alla _ Q,twat �� /L'
FIND WELLS AS SET
ENLARGEMENT IF THE
GRE/ :R ANCHORAGE AREA BOR ;GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
c /-0no m
MAILING ADDRESS eq SOX -lo_ 7 PHONE -3z1z1 277%
NAME �7Forr-Z>
LOCATION �2� %�/�`-" 1-s �'�i9 �� LEGAL DESCRIPTION Z 07- 2 -
SEPTIC
SEPTIC TANK:
DISTANCE NUMBER OF
FROM WELL _MANUFACTURER MATERIAL=j7t-c-L- COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH _LIQUID DEPTH_ LIQUID CAPACITY I" -Y) GALLONS.
SEEPAGE PIT:
/8 K S-0
NUMBER OF PITS DIAMETER _OR WIDTH_, LENGTH_, DEPTH
LINING MATERIAIZ06-r WQ,2101 CRIB SIZE: (DIAMETER—DEPTH 7' DISTANCE FROM: WELL
/f TOTAL EFFECTIVE
BUILDING FOUNDATION 7NEAREST LOT LINE z0/ . ABSORPTION AREA (WALL AREA) SQ, FT.
ADDITIONAL ABSORPTION
WELL:
TYPE LeMM
BUILDING
FOUNDATION —
CESSPOOL
APPROVED !/
DISTANCES:
_CONSTRUCTION
NEAREST
LOT LINE
, OTHER SOURCES
DISAPPROVED
INSTALLED BY: t_7Z_»t./Z-72
PIPE MATERIAL: ee!s_ '
LOT SLOPE:
REMARKS: / 06S '611wlE-_p
/Zt EP
NEAREST
SEWER LINE
DEPTH
SEPTIC
TANK_
DIAGRAM OF SYSTEM
A-90ea
DATE 6-1
3 60'-_'q
271u�.=mac >,✓r
4-yO-i
,1
y
__ DISTANCE FROM:
SEEPAGE
SYSTEM
G.A.A.B,
Form No. EQ -031
GREATER ANCHORAGE AREA BOROUGH
� ,
idJ�l llll l�q DEPARTMENT ENVIRONMENTAL QUALITY PERMIT NO
f�\/\/II\/\/u�__IIIIII,IWWWW y 3330 "C" STREETT ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT MAILING ADDRESS -_40,? 7 _ PHONE�79 saq
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC SANK _ SEEPAGE PIT--, DRAIN FIELD OTHER
i7_ < /J / /- i /
TYPE AND SIZE OF FACILITY TO BE SERVED
FINA14CED THROUGH _ TO BE INSTALLED BY �<✓/�tl
SOIL TEST RESULTS<U �l-—_ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE: REQUIRED. BACKFILLING OF ANY SYSTEM WI'T'HOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE A2-0�� TYPE W0�IEEPAGE AREA SIZE TYPE
I'
`\f _ TYPE —
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK __ 6
FOUNDATION TO SEEPAGE PIT :P 0 DRAIN FIELD _
SEPTIC TANK TO SEEPAGE PIT WALL
/ q !
SEPTIC TANK , SEEPAGE PIT OZ A DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK 1^ _, SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK--, SEEPAGE PIT
DRAIN FIELD—
SEPTIC TANit. —, SEEPAGE PIT.yL DRAIN FIELD _
TO RIVER, LAKE, STREAM.
CASI'IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAI' I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 20-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE APPLICANT'S SIGNATURE_ ---
FORM NO. EQ -016
(20nabLu,eteon gears -Pat xtLGEiVEill
"Ono test is worth a thousand opinions" "' '' ' 101d AM
0024 TUDOR ROAD, ANCNORAW, AL,AQKA 94007 U TKLKFH9119 333.04ii pJER PNWIURA"t Arc-'\ dunUUGh
APT, BM 1NVIA0NM9NTAk QUAL11Y
Performed For Glacier ExcavatiaL _Date Performed 5-17-74
Lenal Oescrintion: Lot 1 -Block. -2 Sub divI's ion Sky_Lanch _
This Form Renorts Soils Loct_yes Percolation Test^
Oenth
Feet Soil Characteristics _
INLET TO SEEPAGE PIT
2 — Silty Sand with some cobbles
3 — Si1-250
4 —
5 —
6 —
7 Bottom of Seepage Pit
9 —
10 —
11'41— bottom of test hole
Was Ground Water Encountered? No
If Yes, At what Depth?
Readinq
Date
Gross Time
I
Depth to N20
Net Dron'
n
I
i
I
iI
�
11
Readinq
Date
Gross Time
Net Time
Depth to N20
Net Dron'
Percolation Rate Minute
Prnnosed Installation: Seenaae Pit Yes Drain Field
Depth of Inlet_ Depth To Bottom Of Pit Or Trenc
CnMMENTS: 250 so. ft. d.rainaa e__arPa r�nn;r A an hA nnnm
no bedrock or water table
Test Performed By Ji.m Mack Data Certified By:Const. TestLab
— —� —�
1,nh Mtanmxor Date: —1 e—(4
Municipality of Anchorage
• Development Services Department 0•'�� '
Building Safety Division
On -Site Water and Wastewater Program `
4700 South Bragaw St. S" `T'
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
--- FOR A SINGLE FAMILY DWELLING
Parcel I.D. 01530225 HAA#_
Expiration Date: iLJL)oY
1. GENERAL INFORMATION
Complete legal description Sky Ranch Estates #2, Block 2, Lot 1
Location (site address or directions) 5000 Whispering Spruce Drive, Anchorage, AK 99516
Current Property owner(s) Eric Knudsen
Day phone 345-5213
Mailing address 5000 Whispering Spruce Dr., Anchorage, AK 99516
Lending agency Day phone
Mailing address
Real Estate Agent FSBO - Stacy Werner Day phone
Mailing Address Dover Center
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well ❑
Individual Water Storage ❑
Community Class Well ❑
Public Water System 0
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank ❑
Community On-site ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified_by my seal affixed hereto and as of the validation date shown_below,.lverifythat-rny_Investtgation
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Watkins Engineering, Inc.
Phone 349-1851
Address P.O. Box 110443, Anchorage, AK 99511.0443
Engineer's Printed Name Cindy W. Ellis Date /f - 25' - 0 3
5. DSD SIGNATURE
V Approved for 3 bedrooms.
19wr w Ellis
CE -10577
Disapproved. �%%
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
`%'- OF,q�j��¢i
WATER AND >m
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: Original Certificate Date:_ 2Z 0
(Rev. o+,vz)
4
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
.(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: _Sky Ranch Estates #2, Block 2, Lot 1 Parcel ID: 01530225
A. WELL DATA
Well type A
Batt pleted
B.
C.
Total depth\
Date of test
If A, B, or C provide PWSID # 2 12 R I to
Sanitary seal (Y/N)_
Well Log (Y/N) NA
Wires properly protected (Y/N)
BAD
Cased to ft. Casing height (above ground) in.
ELL LOG AT INSPECTION
Static water level ft.
ft
Well production g.p.m.
g.p.m.
WATER SAMPLE RESULTS:
III
Coliform colonies/l00 ml. Nitrate mg./I.
Other bacteria lonies/100 ml.
Arsenic: mg./I. Date of sample:
Collected by:
SEPTIC/HOLDING TANK DATA
Tank Type/Material steel STEP tank
Date installed 8/31/94
Tank'size' 1250 gal. Number of Compartments 2
Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y— Depression over tank (Y/N) n
High water alarm (Y/N) Y
Date of pumping 12-23-02 Pumper Denali
ABSORPTION FIELD DATA
Date installed 8131/94' Soil rating (g.p.d./ft2 or ft2/bdrm) 0_7
System type bed
Length 47 ft. Width 15 ft.
Gravel below pipe 0.6 ft.
Total depth 2.8 ft. Eff. absorption area Z05 ft' Monitoring tube Y Depression over field n
Date of adequacy test 10-29-03 Results (Pass/Fail) Pass
For 3_ bedrooms
Fluid depth in absorption field before test 0 in. Water added 726 gal. New depth 0 in.
Elapsed Time: NA min. Final fluid depth NA in. Absorption rate >= 450 g p d
Any rejuvenation treatment (past 12 mo.) (Y/N & type) None known
I
If yes, give date
D. LIFT STATION
Date installed 6131194 Size in gallons integral Manhole/Access (Y/N) Y
"Pump on" level at 44.5 in. "Pump off" level at 43.5 in. High water alarm level at 50 in.
Datum bottom of tank Cycles tested 10 Meets alarm & circuit requirements? Yes
E. SEPARATION DISTANCES
TION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer m Fleanout
Sewer /septic service line Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5 Property line 45 Absorption field 30
Water main 100+ Water service line 30+ Surface water 100+
Wells on adjacent lots 200+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 5 (waiver) Building foundation 40 Water main 100+
Water Service line 30+ Surface water 100+ Driveway, parking/vehicle storage 50+
Curtain drain 35 Wells on adjacent lots 200+
F. COMMENTS
Lot line waiver approved for drainfield.••.� F'•••AC
G. ENGINEER'S CERTIFICATION E
*:° 49-
I certify that I have determined through field inspections and """"' f "'"l " `"""'""
review of Municipal records that the above systems are in "� `� ���- ---
conformance with MOA HAA guidelines in effect on this date. �,'; 'Cir>�y W. Ellis :�
Cindy W. Ellis "'`' CE=105n ;.
Engineer's Printed Name Y •..•
Date
11-28-03O ssiot o�
i
HAA Fee $ Waiver Fee $
Date of Payment Date of Payment
Receipt Number Receipt Number
(Rev. 12101)
_______WHISPERING SPRUCE DRIVE
4
N 89 59' 44" W 165.00
3�
t
upas ruw�.
•N A'[I
AfL 10.] A'B 4 O
❑
SPLIT LEVEL a N
OLID la 9 FRAME HOUSE Z'
QP
u,o• W
I ae.l 7f Lie I N
LIR Q�
D I STATION, ❑
° I N
A
A_
I
y ° Z
I
I
I
L---------------------8----
IO' UTILITY CASEMCNT
N 69 59' 44" W 1 45.00
AS -BUILT SURVEY (NO CORNERS SET THIS DATE)
Vr30'
I HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 1, BLOCK 2, SKY RANCH ESTATES NO. 2
I ML INPUHMAI WN HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
STRUCTURES OR FENCELINES. WITHIN THE PROPERTY LINES AND NO VISIBLE
ENCROACHMENTS EXIST OTHER THAN NOTED.
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON (UNLESS INDICATED) DATED AT ANCHORAGE, ALASKA THIS 21ST
NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES DAY OF NOVEMBER 2003 - —
OR LOCATE STRUCTURES. HOLT LAND SURVEYING 6123, FB48-15, 109-15
ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. TEL. 345.5513
DENALI EXCAVATION, PAVING
& PUMPING SERVICE
651 East 1001h Avenue Phone'(907) 346-3338
Anchorage, Alaska 99515 Fax (907) 346-1388
FAMILY OWNED AND OPER ll MASTERCARD ACCEPTED
Sold To Invoice
ERIC KNUDSEN
5000 WHISPERING SPRUCE
ANCA. AK 99516
Date
Invoice #
12/27/2002
38911
.-_Terms . _ _._ I _ Service Date . I ._._ Rep
12/23/2002 JS
Item I Description
Septic Pump I Septic Pump & Lift Station
Please pay from this invoice,Thank you for your buisness!
----Job -- Truck Ticket #
11921
city Rate Amount
1 112.00 112.00
Total
$112.00
MUNICIPALITY OF CRA
• �'
DEPARTMENT OF HEALTHTH & HUMAN SERVICES.
Division of Environmental Services 7
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY U
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # Vt S -3b'2- -2.5
1. GENERAL INFORMATION
HAA # {a L"q-S
Complete legal description Z -0h ( 6/0ctal- 2� RaocA est- #2
Location (site address or directions) 5000 Whu er)n -WWr -WWDr)ve
Property owner
Je.ffrler ti fvencfy
Sen;M
Day phone
Sys" -066h'
Mailing address
SOLID whuner,_�
Seruae
Dr(ve AAcA
¢ir 99,s -i6 -
SulFe yUU�
AA choLYge, A -k 99507
Lending agency
Mailing acid
Day phone
Agent
Ti m R1 Hu t�2Do_
f
13�
Day phone 276 - 2CIOr
Address
2600
Denali,
SulFe yUU�
AA choLYge, A -k 99507
J—
Unless otherwise requested, HAA will beeld for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well !�
Public water
NOTE:: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA#21
S. 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 Flal-lo,p Technrcal Sel-L;lco, Phone 3yS-13S'S'
Address l'lS3o Echo S .1, .4nchorag y f?k 99Sr6
—T
Engineer's signature I ` Date Sept 7 IFFY
U ITIC
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 orderto 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) Book MOA #21
�YI♦..•.♦•11.. Yff11Y•••. Yf♦
THEODORE F. MOORL' ; a
5 , CE - 3589 ,: 1 4
Y
6. DHHS SIGNATURE
Approved for
bedrooms.
Disapproved.
Conditional approval
for bedrooms, with the following
stipulations:
Additional Comments
U ITIC
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 orderto 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) Book MOA #21
® Municipality of Anchorage AiL
Department of Health and Human Services an
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: I / 2 S k IJ an cA EsF #Z Parcel l.D. ofs 30? ?S-
A. Well Data
Well type °A
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump levels
A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to
Casing height
Wires properly protected (Y/N)
FROM WELL LOG AT INSPECTION
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot _
Public sewer main
Sewer service line
WATER SAMPLE RESULTS:
Coliform Nitrate
Date of sample:
B. SEPTIC/HOLDING TANK DATA
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
g.p.m. g.�q U R 1994
; On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
tank
Collected by:
RECEIVED
Other bacteria
Date installed 8131 / 9 H Tank size 125-0lra/ STEP Compartments S
Cleanouts (Y/N) r Foundation cleanout (Y/N) Y Depression (Y/N)
High water alarm (Y/N) Y _Alarm tested (Y/N)
Date of pumping N.A. ( IV <w Pumper N.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Y
Well(s) on lot N. A. On adjacent lots > 200' Foundation S
To property line is Absorption field 3S' Water main/service line _
Surface water/drainage > 106'
72.026(3193)• Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date Installed d / 31 1241 Manufacturer R/I cA,raT e Tcar? k' Z 0✓'ew co
Size in gallons 2.?d Coro02F, of t Z5-4 q STC /- Manhole/Access (Y/N)
Vent (Y/N) Y "Pump on" level at HY " "Pump off" Level at
High water alarm level H 6"'
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Cycles tested _ N, A•• (ncw)
Well on lot N. A. _On adjacent lots > 'ZOO ' Surface water > too '
D. ABSORPTION FIELD DATA
Date installed 8131 / 9 y _Soil rating (GPD/Ftz) (7.7 System type /3eo( _
Length H7' Width /,!;. Gravel thickness o.6 Total depth 2,S'
Total absorption area 70S a' Cleanout present (Y/N) YY (r-n�.Depression over field (YIN) _N
Date of adequacy test N.A. (new-) —Results (pass/fail) —N.A. for 3 Bedrooms
Water level in absorption field before test __ O After test __ 0
Peroxide treatment (past 12 months) (Y/N) N If yes, give date N• A.
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot N. A On adjacent lots > 20o' _Property liner' S'
To building foundation _ YO' _To existing or abandoned system on lot 30'
On adjacent lots 20' __Cutbank N, A. _Water main/service line_ > r0
Surface water > (00' Driveway, parking/vehicle storage area
Curtain drain .3S __ x wai�e.r 'istuo�C
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect
Signature 'T�� w�.� `T
Engineer's Name 7-hetoc/0rti F /"tocol
Datet�farn ber Z 199Y _
HAA Fee $ 300
Date of Payment 9'
Receipt Number p[�� �W Jv�
72026 (3/93)' Back
Waiver Fee $
73 '
of this inspection.
Date of Payment
Receipt Number
'DORE F. MOORE ;
CE - 3589
Arrlt
Date of Payment
Receipt Number
'DORE F. MOORE ;
CE - 3589
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date _s%moi+117(,•
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
'j On(, i. 1.14 I' , P, i'„ nr6- ., r5 ,7 •.: Ci
(b) Applicants Name6•_.a_ w,tL ,+IL. Telephone Home ^� Business ')'6_'j�'' '
Applicants Address_t, , Ji I l'. � ii " ",(, I,> II �_� „i: w:a to -c
(c) Applicant is (check one) Lending Institution �l owner/builder
Buyer I ] ; Other (explain);
(d) Lending Institution '1'_'•_3r,�!';r...;,•;r,,. Telephone ^)G i• -z>
Address �('tk' ii r—�.�,!� 11 .k �n.cl�,,..-irr.__�Lh `irj'j1
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. e_Y1T ie of Residence
_s.._T_��
Single–Family
Number of Bedrooms
3. Water �9_p
Individual Well E-7
Multi–Family Other (describe
Community Public
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewqje Disposal
Onsite [_=7 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]
5
6
En ineerinp Pirra Frovldin�^Inspections, Tests, File Search, Data and Infonnat.ton
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 ill compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm .!, (,
Address/
Z i :( ,tl)
'.1) ), l
: licit=l4i �r'. lC.r.. � f�_ `,q
Date„/
/�
`� � -
-
(ENGINEER SEAL)
21111.11 Ayarroval
Approved for _ J bedrooms
Approved Disapproved
Terms of Conditional Approval
Telephone 'i6 / ')( II(
BY 'amu a ti. rn� �S1�t L(1 d '.� A Da
CAUTION
Conditional.
lio
o H/
a.b�B00.. snort 0 f'a
C. Rotel, Jr.'..*
r..
2251•C
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 13Y AN INDEPENDENT PROF Le SINAL
SOENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SA'T'ISFY 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
DEPT. OF HEALTH &
IVIRONMU ITAL PRCTLCI tOM
SEP 131984
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA) RECEIVED
CHECKLIST - FEBRUARY 1984
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK EATA
Date Installed /`J" J VA Size /d 00 cl_j No. of Compartments 2-
Standpipes ON) Air -tight Caps Y- ) Foundation Cleanout'Y
Depression over Tank (Y Date Last Pumped
Pumping/Maintenance Contract on File (Y/N)&J4 ; for
Holding Tank High -Water Alarm (Y/N) "A-- Temporary Holding Tank Permit (Y/N)
I f6 -
Separation Distances from Septic/Holding Tank:
To Water -Supply Fkll + 2Voi To Building Foundation ]
To Property Line y a Q c To'Disposal Field)e* /(v/ I;,' S/ p
To Water Main/Service Line +30 To Stream, Pond, Lake, or Major Drainage I1�
*�'Fao,yl 4-5-bujb 0 :iyS�swm vols LA,2 . t'uc(c'P /c'?0&U' & 61' IfXencm-1
V_R� kl Was
.A ry i -! 3-J'y
,Atc a X1 1Z �3 V
[Page 1 of 21
2-15-84
Legal Description: E T 1, 0k2 ,_SKS{ qZ c[4 IA -;?-
A. WELL DATA
Well Classification /}
If A, B, or C, D.E.C. Approved(Y/N)
Well Log Present (Y 1N) A/4
Date Completed A/q- Yield N4_
Total Depth A/ q: Cased to
N A- Depth of Grouting /(/A -
Static Water Level /V A._
.Pump Set At A)q-
Casing Height Above Ground A//-
Sanitary Seal on Casing (Y/N) V
Electrical Wiring in Conduit (Y/N)
/V A- Depression Around TAbllhead (Y/N) A14-
4Separation
SeparationDistances from Well:
To Septic/Holding Tank on Lot + AOO'
On Adjoining Lots .4 2,C) �
To Nearest Edge of Absorption Field
on Lot t L(oO( ; On Adjoining Lots J-Zoeo /
To Nearest Public Sewer Line n/4
To Nearest Public Sewer
Cleanout/Manhole /Vq_
To Nearest Sewer Service Line on Lot Ni}
Water Sample Collected By NA
; Date A14 -
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK EATA
Date Installed /`J" J VA Size /d 00 cl_j No. of Compartments 2-
Standpipes ON) Air -tight Caps Y- ) Foundation Cleanout'Y
Depression over Tank (Y Date Last Pumped
Pumping/Maintenance Contract on File (Y/N)&J4 ; for
Holding Tank High -Water Alarm (Y/N) "A-- Temporary Holding Tank Permit (Y/N)
I f6 -
Separation Distances from Septic/Holding Tank:
To Water -Supply Fkll + 2Voi To Building Foundation ]
To Property Line y a Q c To'Disposal Field)e* /(v/ I;,' S/ p
To Water Main/Service Line +30 To Stream, Pond, Lake, or Major Drainage I1�
*�'Fao,yl 4-5-bujb 0 :iyS�swm vols LA,2 . t'uc(c'P /c'?0&U' & 61' IfXencm-1
V_R� kl Was
.A ry i -! 3-J'y
,Atc a X1 1Z �3 V
[Page 1 of 21
2-15-84
2.7 115N2, 5r.`1 ill AS.A"(k4
C. ABSORPTION FIELD DATA
% G7
Soils Rating in Absorption Strata aSO N"/02- Type of System Design Q-vL6 7rzehcl�
Date Installed 13 -N y 9-y N Length of Field '� o'
Width of Field V IS1 30" Depth of Field
Gravel Bed Thickness
Square Feet of Absorption Area C(y�1Vy lls"2�2
Standpipes Present (YN)
Depression over Field (YA@�_— Date of Last Adequacy Test 23 lF
Results of Iast Adequacy Test SA-. --�
Separation Distance from Absorption Field:
To Water-Sdpply Well Comm AwtV To Property Lim -t-i Q(Lo
To Building Foundatiort i -,QC) L l y' To Existing or Abandoned System on
Lot ANA ; On Adjoining Lots
To Water Main/Service Line —� To Cutbank(if rresent) --�
To Stream/Pond/Lake/or Major Drainage Coursei
_—_► /pp—
To Driveway, Parking Area, or vehicle Storage Area +Ljo' --�
Comments 3 Feom gas hu,, I V-� G_ TAC Z crs re , U)11-5 CA 9 Ga -4 DEP lq,?(),
CV -1.1) AND weigc4l Aao ,Lq C(Sl�"�_—e-- Y
D. LIFT STATION
Date Installed N A —® Dimensions
Size in Gallons _�-- Manhole/Access
"Pump On" Level at —_'— "Pump Off" Level at
High Water Alarm Level at _ —Vent (Y/N) - --�
Tested for Pumping Cycles during Adequacy Tbst. Meets MOA
Electrical Codes(Y/N)—
Convents
** Check Permitted Bedrocm Ratting Against HAA Request **
I certify that I have checked, verified, or confcrned to all MOA HAA Guidelines in effect
on the date of this inspection.
Signed _ % , (�� -- Date
Company A6CS — _`__— MOA No. 94-I1J
KB1/d5/s
(Page 2 of. 21
2-15-84
ALASKA RUIROf1 nTAL COnTROL SCRUIUS, InC.
Engineerinq 6 Enuironmenlal Sludies
09112184
ASSOCIATED BROKERS
640 W 36TH SUITE 1
ANCHORAGE AK 99503
SELLER — GOODWYN BUYER --
SUBDIVISION — SKY RANCH ESTATES 112 BLOCK — 2 LOT — 1
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 1152 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE: SURGE CAPACITY OF THE SYSTEM .IS 708 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
THE: SEPTIC TANK WAS PUMPED ON 08/24/84 .
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME SIF 1000 I�) ADEQUATE FOR
THIS 3 BEDROOM HOUSE. \\ _f_-/
�seeooge voapo 4J�
a.. E
9 c a •P •�
H °
njY _e Q+nh+ano ¢ 9
ar C. Reid, Jr. _ �,F•A
r o.
2251-L
foo oo oo oocoo� %C^:..��•-,
1200 LUesl 33rd Auenue. Suile 6 9 Anchorage. Alaska 99503 • (907) 5665040
Ji
t ,BILL SHEFFIELD GOVERNOR
ro
i
DEPT. OF ENVIRONMENTAL. CONSERVATION Telephone: (907)
t
l Address:
t
SOUTHCENTRAL REGIONAL OFFICE
437 "E" STREET, SUITE 200
ANCHORAGE, ALASKA 99501 274-•2533
DATE:
PWS I.D.
To Whom It May Concern:
According to records on file in this office the 1k V ce-,tS, is
Water System is in compliance with the State Drinking
Water Regulations.
Sincerely,
� 4
APPLIC-AT FILLS OUT UPPER HAL ONLY
Properly Owner 4
-�� q t) Phone
c
�,.. '- JJ
K4I {ZIP Code r .;
—rte
Buyer
Address
Zip Code
Lending Institution
Phone
Address
Zip Code
Realty Co. & Agent
Phone
Address
Zip Code
Legal Description
Ho'(")e, <>�
Street Location l'acx)
Type of Residence
F�Igingle Family
❑ Multiple Family No. of Bedrooms .'2
❑ Other
Water Supply
❑ ��, \-
WELL LOG. A log Is for drilled since June 1975.
Individual
well required all wells
FF,
EVCommunity .�
��
r ,r
drilled prior to that date, give well depth (attach log if available).
❑ Public Utility
Sewer Disposal
Individual
Year Individual Installed:'-�.>!(l`+ r--"
Public Utility
Whon Connected to Public Utility: _
❑ Holding Tank
'CONDITIONS OF APPROVAL
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
C
Time
Time
Time
Time 1 1
Date
Dale
Date
Date [
Inspector
Inspector
Inspector
Inspector In/
Field Notes:
MUNICIPALITY OF ANCHORAGE
DEPT. OfI &
ENVIRONMENTALL PROTECTION
r ,r
a r" p 2 O I!�....
RECEMD
( ) APPROVED BEDROOMS
'CONDITIONS OF APPROVAL
DISAPPROVED
( ) CONDITIONAL APPROVAL'
� ' .Z ,. Li
DATE ri — I I — Lz
—_
BY i Orr ( - __�lJ l� Vie`
1
6'
/ \\
��
J VISI
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Well to Tank
Septic Tank Size (Y ej
72 023
31IIII-�
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY 07 ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
DEPT. Or =.`'!: ' &
_ 825 L Street - Anchorage, Alaska 99501
El !VIRONI,�LNITAL f :.0i ;.CfION
ENVIRONMENTAL ENGINEERING DIVISION MAY 2 J !')/J
Telephone 264-4726
❑ Two ❑ Five
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND
pp II --
SEVRi fMCILyI ED
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please
allow ten (10) days for processing.
1. PROPERTYOWNER
ELu9- ✓ -L-1g, �1
PHONE
—
MAILING ADDRESS
ST19 a'30_7- ,auc_N
-
PROPERTY RESIDENT of different from above)
PHONE
B. SEWAGE DISPOSAL SYSTEM
— —
2. FIUY'EEFFFI
GE
PO
IC i'aaAA e -e-
MAILING ADDRESS
--
3. LENDING INSTITUTION
PHONE
—� —
Lu� w s -A) 6 J
MAILING AD ESS
_. ��,�-
4. REALTOR/AGENT - - -
- PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
I.00AI'ION
STFIEE
6. 'fVPE OF RESIDEN E
NUMBER Of BEDROOMS
Ag
❑ One ❑ Four E) Other_
SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
❑ INDIVIDUAL*
*ATTACH WELL LOG. Awell log is required for all wells drilled
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
B. SEWAGE DISPOSAL SYSTEM
— —
J INDIVIDUAL/ON-SITE**
**If individual/on-site, give installation date.
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
i I�
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMITNUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
INSTALLER
❑Septi �T k or ❑ Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
a
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL ^ .1
4. DISTANCES
WELL TO:
Septic/Holding Tank -
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
LTJ- APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
6m ce r f-� Iwo
BY (Title)
LEGAL DESCRIPTION
72-010 1Rev. 3/78)
May 31, 1979
Edward A. Jensen
Star Route A Box 1630-T
Anchorage, Alaska 99507
.i.. i pn ., .i, I 1.
Subject: Lot .1 Block 2 Sky Ranch Estates Subdivision
Approval for your individual sewer and water facilities
will not be granted until the following items have been
completed:
(1.) The water alis report be werejs'Jffy�z"/
from Chem L2a�-r yu3�Y3� ,lSfr o o r �iYe"w.
(2) The septic tank be pumped with a receipt submitted to
this office.
If there are any further questions, please contact this
office at 269-9720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: Lomas and Nettleton
4449 Business Park Boulevard 99503
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 2.74-4561
Date Received /- /"Z- /5
Time .of Inspection 10 -'Ca 4L)l'
Date of Inspection /-' (2
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by:
Mailing Address:
c - �d"-Phone:
2. Property Owner:
�_yCa�c= Phone:
Mailing Address:zv
— — —
3. Legal Description:
4. Location:
5. Type of facility to be inspected No. of bedrooms L3
6. Well Data:
A. Type -- B. Depth —
n
C. Construction_'-i'.>�_-a-e moi_ D. Bacteria] AnalysisEt_<-C-:^.cJ
77-
7.
/.-7. Sewage Disposal System:
A. Installed /7� B. Installer —
C. Septic Tank: 1. Size --� 2. Manufacturer --�
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines ^---- —
8. Distances:
A. Well to: Septic tank _ Absorption area --_, Sewer Lines
Nearest lot line _, Other contamination --_
B. Foundation to septic tank _— Absorption area --,_—!
C. Absorption area to nearest lot line__—
EQ-034 (1/74)
Page 1 of two pages
Page 2 of two pages - Re� st for Approval
�� of Individual er & Water Facilities
Lcgal Description ; r�L� X),A5 �I AL-
Comments
T
L) .C,0_w /L -a-7—
Approved _ Disapprovedz -„,2. \2c!-chi-Uf2Date 71
Approval,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I .,ei,,iiy 1,1101, Wle 1111vimu61vn vviiou uieu ill Vnia I04uea,, ivi uVVI vv”' w vc u u. ma uiiu
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
GREATER ANCHORAGE ARL/% BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection
2. Property Owner:
Mailing Address
3. Name of Buyer:
CMRO VA FHA CONV ✓
Day Phone 0 79 - 6L.
Mailing Address: 39U Re (e A Day Phone. -7 --(-- 7
4. Name of Lending Institution:
F7
Mailing Address:
Name of Realtor or Agent:
Mailing Address:
Legal Description:
Location:
/_/ 9 ) �Sk
-7c,�7
SITSI l
. v
7. Type of Facility to be inspected: C%,,,�,' No. Bdrms. 3
8. Water Supply �, 0
Type of Supply:-Ptrb�e llti1ity �� Individual
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type -of System: Public Utility Individual (on-site) -
If Individual, date of installation lq-7L