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Home My WebLink AboutSKY RANCH ESTATES #2 BLK 2 LT 24 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: ~,kJ c[ ~.0 ~.Z~),'>~ PID Number: ~ ~ ~ - ~ -- ~ -- Name: ~-~U~ ~J ~ Wastewater ~ystem: D'New ~Upgrade Add,.,:~51~ ~P~t~G 5~~ P~, ABSORPTION FIELD No. of Bedrooms: ~DeepTrench .D Sha owTrenoh D Bed ~ Mound D Other Phone: ~1 ~ "' ~41- ~o~ 8oll ~11~: ~_ ?~1 os~lb from odgln~l 9~d~: / -- Township: (~ IRangm ~ /~ 1Section: ~ /~ FHladdedsboveoriglnolgrad,: * Gravellsngth:~ Growl ~: ~1 Number of lines: DIs~nce ~l~n fines'. ~ ~ New ~ Upgra~ ~= '' ~Ft, ~ J ~/* Ft, Classglc~tlon (P~B,C): ~pth~ Cased TO', Torsi absorption are~:/ Pipe material: Yield: Pump Set et: C sing Height Above Ground: ~ SEPARATION,DISTANCES~ ~s~pt~o ~,Ho~n~ ~S.T.E.P. To Septic Absorption , Lie Holding '~H;'PHvate Manufacturer: ~. Cap~cltyln gallons: Surface ~/* NJ~ ~/~ '~' LIFT STATIO,,~ Water . , . Foundation. ~ ~1 ~ ~, "/~, 'Pump on' lev~,mp Of'.'rev;~~tera'arm at: Remarks: ~o~ ~ON-- ~~ ~ BENC'H. MARK . Location and Descriptlom J Assumed Elovatl n: , .. / ¢~%.' ~ "~ .~,. Inspections pedormed by:_ ~~ -- Dates: ls · of Health and Human Se~ices approval' , Department Reviewed and approved by: ~ Da~e: 72-013 (1/91) MOA 25 Permit No. ~'~q c~ ~O'Z.O..~ Page ~' of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES · ENVIRONMENTAL SERVICES DIVISION P.O. Box 1'96650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System~:~lnsp'ection'?R~port ' ID0, oo ~0.00 Permit No. Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES .ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System ~lllllll~nspecfion Repot[ Legal DescMption: ,~/o .... PID No.: bio PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920203 DESIGN ENGINEER:ALASKA WATER ~ WASTEWATER SERVICES OWNER NAME:CARTER AMY L OWNER ADDRESS:5316 WHISPERING SPRUCE DR ANCHORAGE, AK 99516 PARCEL ID:01530248 LEGAL DESCRIPTION: SKY RANCH ESTATES [~2 B 2 L 24~ DATE ISSUED: 7/30/92 EXPIRATION DATE: 7/30/93 LOT SIZE: 16125 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: IN ORDER TO MAINTAIN A MINIMUM 10' SEPARATION TO THE OLD SEPAGE PIT IT MAY BE NECESSARY TO ENCROACH ON THE SOUTH PROPERTY LINE. IF THIS IS DONE A LOT LINE WAIVER WILL BE REQUIRED PRIOR TO AS-BUILT APPROVAL. VERIFY NO IMPERVIOUS STRATA EXISTS TO -6' OF BOTTOM OF TRENCH. RECEIVED BY .~ ~,~-~ ~'~?- ~/~/~ ~%~ ~ :, ~ DATE: DATE: Alaska Water 8c Wastew'ater Services "Preserving the Last Frontier" ,July 21, 1992 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section P.O, Box 196650 Anchorage, Alaska 99519,-6650 RECEIVED JUL 2 3 1992 Municipality of Anchorage Dept. Health & Human Services Ref: Septic System Replacement 'flor Lot 24, Block 2, Sky Ranch [Estates ~f2. To Wries it may concern: Attached is the aDmlScation, site plan, are design drawings For one subject septic system reDlaoemen c. Comments regarding the oroposeo system are as follows: 1. SEPTIC SYSTEM: As can be seen frem reviewing the attachec 'percolation 'best ¢esulis, the sei] "perked" al: 20 ~&Ru%as/iRch at; t~8 looatiof] OroPosad fo~ the system - Fop ~ tr'enoh system, ~his oopresoonds go an application rate c)f _6 gpQ/ft2 . S'i. nce tile existing ,qemm has three Doorooms, the betel design flow is 450 gpd. Based upen this, the minimum 8moun~ of absorption area is 750 ft2. The proposao system orovides 750 ft2 of aosorptior area. 2. TOPOGRAPHY: l'he differentia] elevatien of the grounc was "shot" within 100 feet of the oroposed "~rencnes" there were no slooes in excess of 25~ within this area [hat would have and imDac~ on the subjec~ system. See the percolation tee~ -'esults for slcoe information. ;~ WAIVER OF SEPARATION DISTANCE TO WELL: ]'he size of the let, and the proximity of the Class "A" well looa~e~ on Lo'r, 11, Block 1, dictate that the 200 foot separation distance cannot De met. Attached is a WAiver TOt ~ 170 foot separation distance 9~'om the Alaska Depaptmen~ of Environmental ConservaEion_ '[ am going so insisE tshab the installer have a registered lane surveyor fla~ ~he proper%y ]~nes ara the 170 well radius so that the separation dist¢ ncr is 4. As can ce seen ir ~ne design drawings, she bottom of see trench will De a~ a relative elevatioo ef mS.0 ~eet. Since trm bottom of trim test hole was only at 78.6 feet the installer ~ill have to dig a ces~ hole co 77.0 feet to verify the 6 feet separation distance to oedrock. I will be oreeen5 to verify this. I don'5 think oedrock wilt De a problem since ~he nearby well (170 feet away) was driller to 216 'feet without encountering Telephone - Fax 338-3246 ® 8471 Brookridge Drive · Anchorage, Alaska 9950't .5. Because the boundary of the eax±sting c~'ib is~ unknown, and ~ne location o'~ the ~renon is restricted by the 170 ~oo~ separation distance waiver, it may not be possible to maintain the 10 :oct seoaration distance from ~ne -~ew stench to the old crib. I am unaware of any impacts that this installation would impose on adjacent wells, or smptio sys~ems~ If you hmvm any questions, [)lease cai]. me ag 557-6179. Sincerely. JAG/jag ~lu nson2 LOT I~-~ u o'-r' BK-. i uon- 15',, LOT 'znj Bi~ ~-- PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Aleska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~.L",¢ ~_.~ ~_&"~¢~Township, Range, Section: 8 9 10 11 13 14 15 ~!~'r"~ 16 17 18 DATE PERFORMED: 19 20 SLOPE SITE PLAN %OMMENTS S DEPTH? E Gross Net Depth to Net Reading Date Time Timo Water Drop ~ G/z~ ~o ~o IVz" PERCOLATION RATE .~0 (minu[es/inch) PERC HOLE DIAMETER,, -~;~ ~/ TEST RUN BETWEEN (~ FTAND C~. ~' FT I00. OC'a ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON T~IIS DATE, DATE: 72-008 (Rev. 4/85) WALTER J. HICKEL, GOVERNOR DEPT. OF ENVI]RONMENT,AL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 (907) 349-7755 July 20, 1992 RECEIVED Jeffrey A. Garness, P.E., M.S. Alaska Water & Wastewater Services 8471 Brookridge Drive Anchorage, Alaska 99504 JUL 2 1992 Municipahty of Aachorage r)ept. Health & Human Services Re: Separation Distance Waiver for a Private Septic System serving Lot 24, Block 2, Sky Ranch Estates No. 2 to a Public Class A Well on Lot 11, Block 1, Sky Ranch Estates No. 2. Dear Mr. Garness, The Department of Environmental Conservation has completed its review of the request for a separation distance waiver for the above referenced property. Based on the information on record in our offices and your July 1, 1992 and July 12, 1992 submittals, we are granting the requested waiver to 170 feet. It would appear from all the information available that the public well in question has not experienced any detectable impacts from several on-site systems within the 200 feet protective radii in nearly 18 years of operation. Should you have any questk)ns concerning this approval, do not hesitate to contact me. Sincerely, ill H. Lamoreaux, P.E. District Manager BHL/of cc: John Smith DHHS GRE, 'ER ANCHORAGE AREA BOF "UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /'/(-"'~',O C~'"'//'~'~ MAILING ADDRESS~ LOCATiON~'/,~OC.// /'~,&x) /¢./~t=.~ LEGAL DESCR PT ON SEPTIC TANK: DISTANCE ,---. NUMBER OF FROM WELL~¢4''4 ~T~'(~MANUFACTURER '~'7'~ <2 /~", . MATERIAL ~ / ~-4~L~'/'- COMPARTMENTS ~ INSIDE LENGTH ~ INSIDE WIDTH__ LIQUID DEPTH ~ LIQUID CAPACITY /~ GALLONS. SEEPAGE PIT: NUMBEROF PITS / . DIAMETER OR WIDTH/'~/,¢,~ LENGTH DEPTH LINING MATERIAL ~.//~/¢ -~ CRIB SIZE: DIAMETER DEPTHS. DISTANCE FROM: BUILDING FOUNDATION_~/ NEAREST LOT LINE6'~¢ ( TOTAL EFFECTIVE WELL ABSORPTION AREA (WALL AREA) (~ / ~ SQ. FT. ADDITIONAL ABSORPTION WELL: DEPTN . DISTANCE FROM: TYPE ('~'~o.~ /v~ ~,¢ ~F'£~CONSTRUCTION BUILDING NEAREST NEAREST/~ SEPTIC SEEPAGE FOUNDATION , LOT LINE ~O'2/--, .~L~I~./O~7~ -, TANK SYSTEM C ESSPOO, APPROVED DISAPPROVED . REMARKS DISTANCES: INSTALLED BY: ~/~O.L) PIPE MATERIAL: ~"~/~$~7- -/./(~a/b/ LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY INSTALLA'rlON LOCATION LEGAL DESCRIP'rlON ~ FINANCED 'rhrOUeH _ TO BE INSTALLED COMPLETION DATE ANTICIPATED ---- SEPTIC TANK SIZE YPE WATER MAIN TO SEPTIC TANK SEPTIC TANK,-~ CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO Crib CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL, GRAVEL I~AGKFI LL, OR Form RemrL. Soils Loq ~4(,~. PercolaVion Test ~,laS C, rot!lid Wa :er Iincouni:orl:d? /~,,' > what Depth? .......... ~6_~ /0 ,~ ~ __ . ..... ~d~ .;~, . ~ ~ /o' ~,~ ~,~.~ ~;-' ' ' %'P ,/~ ~/~¢o~ .... ~ .. . -... · · . ~ . ~ Top o~. ~oundadon, ~ re~adons~p to F~nish ~ ~ ~ Grade. Top o[ Fo~dado~ ; ' ~ ~ ~.o~'bl~.a~vo F~sh Grado. ,. .... .';.,..' ' .. . .-'. ~ ~ ),.¢ ~ /d,/~ ~. ~, ;' '%~ ,'49~ '~' . %'k ~-..;,'- ~ '~ ~ I/'~Y l/ ¢J¢ , . ~ ~ improvements situated thereon are w~tmn the proper~y ~ ~.~~~ , ~ lines and do not overla~ or encroach on the property ~ g~%. ~ . ' ~ 2~'' ~ lying adjacent thereto, that no improvements on prop- ¢J ~ ~ ': ~O.~25&S .b ~ ~ ~ erty lying adjacent thereto encroach on the premiums, m ~ ~y~i, Y"'(" - · ,~}~* k question and that there are no roadways, transm~smon ~ . ~o~2', '~ . "_¢[~ lines or othe~ visible earemont8 on said property except / T~ d/~" ,',*~ ~[q~ as indicated hereon, ~ED WALA~A & ASSOCIAteS Engineers and Surveyors MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAL'I H & 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 Parcel I.D. # O t_~'~'3OZ- '¢'~6 .... I,.iAA# ,~,,°~,(("')('-")L~l(~¢.. .:~ 1. GENERAl. INFORMATION ' - , . Complete legal description L~ '~- Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone. Agent Add ress Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPF- OF WA'rER SUPPLY: Individual well Community well Public water NOTE: 'TYPE OF WA'STEWATER DISPOSAL: Individual on-site Holding tank Community on-site If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. , NOTE: 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 7320 East Chester Heights Circle ~ Anchorage ~ Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consnlting Engineers March 9, 1998 ;NMfN'IAL $[:RVICES DIVISK,., Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 FCEIVFD Reft Health Certificate for Lot 24, Bk 2, Sky Ranch Estates #2. To whom it nmy concern: The existing 3 bedroom house is served by a private septic system and a conununity well. An adequacy was last performed on 3/30/96, and an HAA was issued in April of 1996, less than 2 years ago. At this time, we are requesting that a em'rent HAA be issued. When the system was inspected on 3/3/96 the liquid level in the MT was 35.25 inches. A visual inspection was performed on/around 2/27/98 and the liquid level in the MT was only 24.25 inches, 11 inches less than it was 2 years ago (the effective depth is 59 inches). The septic tank was pumped on 3/6/98, and the HAA processing fee was submitted with this letter. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. Sincerely, ~ .../ Jeffr~.y ~..[G~t~ness, P.E., M.S. Principhl ] 2216 Wilderness Road ,~qchorage, Alaska 99516 34.5 - ! 890 OUSTOMER Todd ~ot. Anchorage, AK 99516 INVOICE # .'[ 3 215 DATE DESCRIPTION AMOUNT 0341~-~8[- l>um~ Septic .... ~a~ Iryou have mw quesuo~ 9~ ~fe~ not ' Gallons t.~eptic ,____ Leach Area ~ Holding Tank Standpipes '~ '" ~.'~me [-] PROBLEM AREA -- CALL FOR MORE INFORMATION [--1 NEEDS TO BE DONE AGAIN IN 6 MONTHS l--~Good Shape [] sludge buildup on boffom I-] Jim cap missing or [] Cut standpipe to 1' above ground needs replacing I I Floater on top [] Needs Septlctrine DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Se~ices On-Site Se~ices Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Parcel I.D. # 1. GENERAL INFORMATION Complete legal description Location (site address or directions) ~':Z~Z.O L,,.~v-~.t£~F:~_..C._~,,~f..~- ~ ~ .~])¢..., Property owner Mailing address Day phone Lending agency Mailing address Day phone Agent ~;~ ~--~ Address Day phone ~/- "7~; ~)O Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 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. 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 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 WasWwater Se;vices Phone Address Engineer's signature __ DHHS SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date The Muni~ipality 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 D H HS 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 engineeCs work. Legal Descriptmu: Municipality of Anchorage /, ~¥? , DEPARTMENT OF HEALTH & HUMAN SERVICE¢$~¢, ?o , Environmental Services Division ~[ ~¢'~,,~ /~ 825"L.' Street, Room 502 ® Anchorage, Alaska 99501 · {907) 343-47a-~yt% a~, Health Authority Approval Checklist WELL DATA Well type _'~:~. lO B, or C. attach ADEC letter. ADEC water system number L~g,p~esent (Y/N) Tolal depth'~.~ Sanitury seal fY/N) Date of test Static water level Well production WATER SAMPLEJ?~LTS: Coli~ ,/,~tte of Salllple B, SEFFIC/HOLD1NG TANK DATA Datciestalled ~/,.g/¢~' Tankmze Foundation cleanout (Y/N) Date of Pumping, C. ABSORPTION FIELD DATA Date installed Length I~ '7_. Width Date completed Casing height (above grouud) _,,¢.,.-.-" Wires properly protect, qLe&(~) WELL 1. OG ' TA"~IINSPECTION / _ ~.~ ~. g.p.m Nitrate 0~~ Collected by: ~ Cased to I 0(.~ Nulnber of Compamnents 7~ Cleanouts (YRq) ¥ . Depressiou (Y/N) tO D lligh water alarm (Y/N) _ Soil rating (g.p d./fi2 or fl%drm) · (m Gravel thickmess below pipe 4 · q Monitoring Tube present(Y/N) xI' _ Depression over field (Y/N) Results (Pass/Fail) "~'~g~'~---(--~ For ~ bedromns System ~ype Total depth Q. Fluid depth 4-f ~/~ (ins.) Minutes later: -1~. L'"') Effective absorption area Date of adeqoacy test ~ Fluid depth m absorption field before test (iu I; $I~' ~ hmnefliately afierqOOgal, water added On.): Absorption rate = ~ 4 ~-D .g.p.d Peroxide treatment (past 12 lnonths) (Y/N) __ 'te installed ~ S' e ' gallons Mmfl~olc/Acecss (Y/N) ~' "Pump off level at* High w~ * Datum~ ~stcd E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorptiol~ field on lot Public sewer main Sewer/septic sm~ice line ~ {Pr'- ; On adjacent lots ; On adjacent lots /~1 Public sewer manhole/clcanout t'x,,J [~t~ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation '~r"xoI~ Property line ~"7-.~ Absorption field Water main/service line ~":' 173 t ~% Surface water/drainage i'Q Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Bailding foundation Surface water Curiail! drain Water main/service line Driveway, parking/vehicle storage area Wells ou adjacent lots { '-7 C3 Property line F. ENGINEER'S CERTIFICATION I ce,'ti~v ,hat I h~et~/nined thru fi~d tn*~ections / Engineer s N~ne~ ,~ ........................................................................................................ Waiver Fee $ Date of Payment Receipt Number Rev. 8/95 eSS: haa.wk.doc Facsimile Transmittal Alaska Water & Wastewater Consulting Engineers Phone: (907) 337-6179 Fa,w (907) 338-3246 8471 Brookridge Drive Anchorage, Alaska 99504 D ate: Attention: Front: Jeffrey A. Garness, P.E., M.S. Number of pages (including this cover): Comment(s): Reply requested: [~ Yes [] No 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 GENERAL INFORMATION Complete legal description Location (site address or directions) ~1~ \N ~r I ~ p ¢L~_~__L ~ ~-- % ~P ~t~.C~_. Property owner Mailing address Lending agency Mailing address Agent ~1U~4~gohJ Day phone ~'l~- ~-4- I - ~30~ Day phone Address 2. GOO Co¢~po'4,% Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: Day phone AT'T'i'4 '. N,A-NC'./ .~ ¢'7 - 0/~'0 TYPE OF WATER SUPPLY: Individual well Community well Public water X NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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. NameofFirm AL..cc~J~, V4~-I-E:~tV~'~--V,/Ad~'r,S¢~, ~vq;¢.Phone Address %~"-1 I 2 ¢¢'~'- ~ Engineer's signature Date ////~ DHHS SIGNATURE /__ Approved for Disapproved. bedrooms. 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 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. A. WELL DATA Well type d. oH~4 Log present (Y/N) Total depth Sanitary seal (Y/N) _ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~/h Z-~.¢ ~'~¢A ~'~Erz' '¢~_ __ Parcel I.D. ~/¢,--~ I~,B, ~_ ~ . ADEC water system number or C, ttach ADEC lett_e~. _ 2.//~'//~ _ /¥'/A' Date completed /'~/'/~ Driller /v'/,/~ /Y//'~ _Cased to /Y.~:~- Casing height_ /~'/,'~ ~"///~ Wires properly protected (Y/N) .ce AT ,.SPECT,O. Date of test f%//~'~- /~/'~) Static water level Well flow g.p.m, t ' Pump level SEPARATION DISTANCES FROM WELL TO: ~Septic/holding tank on lot / ~ ~ ~% ;On adjacent lots Absorption field on lot I ~ ~'~ ; On adjacent lots Public sewer main ~/~ Public sewer manhole/cleanout Sewer satire line ~/~ Petroleum tank ~./~ WATER SAMPLE RESULTS: Coliform /"4/,¢c Nitrate _ Date of sample: /"/~_/~r B. SEPTIC/HOLDING TANK DATA Date installed _ ~/l'~/c/2_., Tank size Cleanouts (Y/N) High water alarm (Y/N) Date of pumping A/ ///~- Other bacteria . Collected by: /x./r/fcJJ- I000 Compartments Foundation cleanout (Y/N) 'T'~¢% Depression (Y/N) Alarm tested (Y/N) /",///Cb ¢J/~u*J ~'V S 'T'~ Pumper SF-PARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: / Well(s) on lot__ /'/.//q- On adjacent lots ! "7 To property line / ~- / Absorption field Surface water/drainage _ /~5~ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE O, L4F~TIO N r9 Manufacturer Date i n s t a"fted....L~ //~ Size in gallons ~'~._ Manhole/Access Vent (Y/N) _ "Pu m"p--o~vel at~.~ / / "Pump off" level at High water alarm level ~ Cycles tested __ Meets MOA electrical codes~)_-~'~ ~~ '~.. SEPARAT~.T~CE FROM LIFT STATION TO: On adjacent lots Well .o. mi'dt Surface water. D. ABSORPTION FIELD DATA '--. Date installed ~//4~/<~ ~. Soil rating ' ~ (:~J)/P'3~:Z System type Length ~ '~-/ Width '"~ · 0 Gravel thickness '~' ~ ¢¢ / Total depth / Total absorption area ~:~ 0 ~. FT'. 2_ Cleanouts present (Y/N) "/-'~--~ % Depression over field (Y/N) /'JO Date of adequacy test /'¢//~ Results (pass/fail) ,,~//A- for ~%/,//¢jL. bedrooms Peroxide treatment (past 12 months)(Y/N) ~ ./¢'~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /"///~' To building foundation ~- ! On adjacent lots Surface water cC/A. Curtain drain / On adjacent lots /'7(~ Property line To existing or abandoned system on lot o ?po5 / 7-~ Cutbank ~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, orc~nformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature ~~ (~~ Engineer's Name '~J~'7' A' ~_~,o/Zcj,~E~g ate' ?' / ¢ HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev 3/91) B~ck MOA 21 NOV 02 '92 il:08AM ALASKA HOME MORTGA6E IHt P.2 DEPT. OU' ENVIRONMEN~UAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD,, SUITE 3-4'70 ANCHORAGE, ALASKA 99515 WALTER J, HIC, KEL, GOVERNOR (907) 349-7755 October 29, 1992 Ms. Mary Reardon Personal Service Realty SUBJI=CT: Sky Ranch Estates II Class "A" Public Water System, PWSID 212916 Dear Ms. Fallon: I have oompleted a review of this office's files ooncerning the monitoring status of the above-referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample resuits was submit[ed to this Department on September 29, 1992. T~jhi~_do_~s~mme_et~l.he provisions of 18 AAO 80.200(a), of the State Drinking Water Regulation,s, The last inorganic Chemioal Contaminants Sample results were submitted to this Department on October 19, 1992, This does meet t~he provisions of 18 AAO 80.200(a), of the State Drinking Wat~-R-~gulations. The last Radioactive Contaminants Sample results were submitted to the Department on August 20, 1992. This does~.m~e~et_~the provisions of 18 AAC 80.200(a), State Drinking Water Regul~tlo'~ns. The last Organic Chemical Contaminants/Volatile Organic Chemicals were subn~itted to this Department on August 20, 1992. ThisLd~_oe~s ~the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance o~' this letter does not imply that the above-referenced Class 'W' Publio Water System is in compliance with other provisions of the State Drinking Regulations. 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 M[INICIPALITY OF ANCHORAGE DIVISION OF ENVIRON~IENTAL HEALTII DEPARTMENT OF hIEJfLTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTit AUTItORITY APPROVAL CERTIFICATE I. Gen.~era~ I~_,n~forma_tio~n. Application Date (a) Legal Desel.~iption (include lot, block, subdivision, section, township, rm~ge) Location (address or direc~±ons) Buye~ [ ]; Ol:hac ~ (explain); ~ . U~..~ .~' (d) Lending Institution ~ Tele hone Address Real Estate Co. & Agent Address Telephone (f) Mail the HAA ~o the following address: Single-Family Multi-Family O~:her (desc ~ib~e)~ ........... Pul, lie No~e: If community well system, mnsg have ~rri~ten confirmation from the Department of Environmental Co~ation attesting to the l~galigy and status. DeparLment of Enviro~ental Con~e~atiom at~esgimg Lo Lh~ l~gality ax~ status. ~ [.Page I of 2] 5. E__n~ineerin~g Firm Providin~_I.n_~j~?,cti___..on__~o~Tests, File Search~. Data and Information As certified by my seal affixed hereto and as of the validation date showa below, verify that my investigation of this [lealth Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, function~ and ~dequ~te for ~he nnmber of bedrooms and type of structure indicaged herein.. I furgher verify that, based o~ the info.etlon obtaln~ from the l~nicipality of ~chorage files and fro~ my investigation and inspection, the on-site ~er supply and/or wasgewager dis~sal sysCem is in compliance ~th ~1 ~nicipal and Sta~e codes, ordinances, and regula~ tions in effect on ghe date of this inspection. Name ef Fir~ ............. }. ~5~__:21 .... Telephon~ Te~s of Co~dition~ Approval (DHEP) ISS~S ~TH AOTHORZTY ~PROV~ CERTIFICATES BAS~). ,SOkELY UPO~ ZHE ATIONS Glen IN PA~GR~[-I 5 ~0~E BY ~ INDEPE~ENT ~OF1sS~'~f ENGIneER. ~IS~RF~" -- IN,Tm] STATE 0F ALkSI~. ~m DHI~P DOES ~!S AS A CO~SY TO PmC~SERS OF H0:~S Tmf~R ~NDZNG I~TITUTIONS IN O~ER TO SA]{ISFY CS~TAZN }ZDEI~, AND S~m I~NrS. ~PLO~ES 0~DHEP D0 NOT CO~UCq. INSPECTIONS ~R ~wzg DAn~ ~EFO~a A CERT~FICA~ IS ISSUI~D. ~ bK~IC[P~I~ ,OF ,~CtI0~GE Ib NOT ~SPONSIBLE FOR (DHEF S~24L) RR4/ej/D18 [~age 2 of 2] MUNICIPALITY OF ANC~DRAGE (MOA) HEALI~{ AUTHORITY APPROVAL (HAA) CP~.CKLIST - FEBRUARY 1984 Legal Description: _~Y-- ~/ Well Log P~esent (Y/N) ~/~ U -- Date~z~pleted ~/'~{ Yie].d__~ Total Dapth A)/~ .. Ca.~d to ~J[~ Static Water Level /J/~- Pump Set At Casing Height Above Grcund ~J//~ To Nearest Public Sewer Line C leancut/Mar~ole Wate~ Sample Collected By Wate~ Sample Test Results Cc~ents Dapth of G~outing ~J/~ Sanitazy Seal on Casing (.Y/N)~/~- A~f/% ~ep~ession A~ound Wellhead (Y/N~A Electrical Wi~ing in Conduit .(Y/N) Separation Distances f~om Well.' ~1"~,'~),¢~'~''d''~ TO Septic/Holding Tank cn Lot. ~, 96 ~P ~ ; On Adjoining Lots To Nearest Edge of Absorption Field on ~ot_~&/'Y<,-~.; On Adjoining Lots To Nearest Public Sewer ~YlA~ To Nearest Sewe~ Service Line on LOt B® s mic/ o i raTA Date Installed /~)/~-~/~3_ Size Standpipes ~N) / ' Air-tight Caps No. of Compartments Foundation Cl~anout .(Y~ Depression ove~ Tank .(Y~_~ Date Last Pumped_ ~-l~'~;/~(~ Pumpi. ng/Mainte.nance ~n~a~ ~ File (Y~)~- ; fo~ / ,~/~ ~p~ation Distan~s ~ ~ptic/Holding Tank: To Building Foundation ~ / To Disposal Field ~/' ' TO Stream, Pond, Lake, c~ Major D~ainage [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field /~/ Square Feet of Absorption A~ea Depression ove~ Field (Y~ Results of Last Adequacy Test Separation Distance f~om Absc~ption Field: ¢~-To ~ate~-Supply Well /~/ /~ ~ To P~operty Line To Building Foundation ~/ To Existing or Abandoned System on Lot /~7~ ; On J~joining Lots ..~/~- TO Water Main/Service Line ~ ! To Cutbank(if p~esent) To Stream/Pond/Lake/c~ Major D~ainage Course ~ /~/ ~ To D~iveway, Parking A~ea, c~ Vehicle St/orage A~ea ~ ~ De LIFT STATION Date Installed / On" at Tested for /.~,,.-~ Pumping Cycles du~ing Adequacy Test, ~4~ets MOA Electrical Codes~ ** Check Permitted Bed~oc~ Rating Against HAA Request I certify that I have checked, verified, o~ confo~a~d to all MOA HAA Guid~ on the date~ this inc. pection. Company ~/-~ e. C ,~ ~,,m.c_ [Page 2 of 2] 2-15-84 ALASKA EIILIIROI]Pl]E TAL COI]I'ROL CATHY WELLS 5320 WHISPERING SPRUCE ANCHORAGE ALASKA 99516 SELLER-SAME JULY 19 1985 CATHY WELLS 5320 WHISPERING SPRUCE ANCHORAGE ALASKA 99516 50232 LEGAL:SKY RANCH ESTATES BLOCK 2 LOT 24 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-MAY 22 1985 THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 918 SQFT. THE SYSTEM IS GAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 690 GALLONS. BASED UPON THE TEST D~£A 'DHE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON MAY 23 1985 . 1200 ~Jcsl 33~'d J~ucnu¢. $ui1¢ ~, ~nchora% r~Jaska 99503 ,[907) 561-50/40 DEPT. OF ENVIRONMENTAL CONSERV/~TION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOYEI~NOR Telephone: (907) Address: 274-2533 To Whom it May Concern: According to records on file in this office the _~5'/~ ~"/~Z/~ Water System is in compliance witgthe State Drinking Water Regulations Sincerely, BILL SHEFFIELD, GOVERNOR D~PARTMENT OF ENVIRO~iENTAL C~NSERVATION ANCHORAGE/WEST~LRN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 July 18~ 1985 MS. Gwen Turner Alaska Environmental Control Services 1200 West 33rd Avenue Suite B Anchorage, Alaska 99503 SUBJECT: Lot 24, Block 2, Sky Ranch Estates # 2, Anchorage, Alaska 8621-WA-011 Dear ~. l~rner: Upon reevaluation of the subject request for waiver, it has been found that the septic syste~n was put in properly under 'the reglllations in effect in Sept~nber 1973. Therefore we will approve the system based on regulations in effect at the time of installation. If any part of the septic syston fails or needs upgrading or is changed, current separation requiren~nts of 200 feet must be met from the Class A well. Sincerely, ~teve Hng, P.E. District Engineer SE/dd