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HomeMy WebLinkAboutPARADISE VALLEY BLK 4 LT 1Paradise Valley Block 4 Lot 1 #020-411-09 Stoz 9 o qnn EA Municipality of Anchorage Community Development Department NumOn-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141312 PID Number: 020-411-09 ElNew 0 Upgrade Name: Shawna Thomas ABSORPTION FIELD ❑ Deep Trench ElShallow Trench ElBed ElMound Address 18041 Spain Drive Anchorage, AK 99516 ElOther Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Paradise Valley 4 1 Fill added above original grade - Ft. Gravel length Ft. Township Range Section Gravel width Ft. I Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ftp Fl. Well >100' >100' >100' >75' >25, TANK El Septic ElS.T.E.P. [jHolding E] Other Manufacturer Anchorage Tank Capacity I 1,000Gal. Surface water >100' >100' N/A N/A Material Steel Number of compartments Two Lot Line >5' >10' N/A N/A NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain None Noted Remarks Tank Only Replaced Under This Permit . Pump on level at in. Pump off level at in. High water alarm at in. Existing Tank Decommissioned in Accordance With Municipal Code. Pump make and model ElecUical Inspections performed by PIPE MATERIAL Housetotank D3034 Tank to drainfield D3034 Installer John's Excavating Drainfield CO/MT Inspector A. Harala BENCH MARK (Assumed elevation) 100.Oft Inspection 1" 8/12/14 8/15/14 Location and description 2w Garage Slab s" a'" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL OF Q 11� 4<gs1� PSE... Conditional Approval: Date ��: ��• ,/�-�� Ste: 49T�1- 60'*..• .. ..., .......... rA„ -MICHAEL E. ANIIERSON CE -4381 Approved Date - r-�� lo �� rls Inspection Re06rt_1f=lfd� Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 PID No.: 020-411-09 Page 2 of 3 Permit Number: OSP141312 ®Existing Well PARADISE VALLEY LOT 1, BLOCK 19,055 S.F. Three Bedroom Home I UPPer v� \� Deck S A I B R S1 46 a' 22 5' NOTE: 19. O' As Built Not CompletedGG;y �\ S2 49.7' 28.6' from Surveyor As Built. 2 Locations are not °' FasP \� Excat. F hP �! OF Im E /s) Rr�,F Existing Septic Tank Decommisioned in Accordance with Municipal Code. ��SS SCALE I" = 30' LEGEND f ': �1 49th S1 — Septic Vent ....i :.....�. CO — Clean Out �:............ %l M1 — Monitor Tube ............................................ MICHAEL E. ANDERSON TH — FCO Test Hole — Foundation Cleanout s.: NO. LE -4361 •`moi PLAN AS BUILT ��SS SCALE I" = 30' Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP141312 PID No. 020-411-09 99.8 U U y UU /'nished Existing Grountl Grountl Gallon c Tank Y490.390.1 Tank Only Replaced Under This Permit. Existing Tank Decommissioned in Accordance with Municipal Code. •�gaaaaa� ......... 4. 49th � .°.�.. ♦1 00}'✓F�-�-�-�..... ... ...... �. ..................L E..................... . PROFILE AS-BUILT ,� MICHAEL LEA43BRSON.: ♦s 4� No Scale ♦♦t 0'•,¢' .......... �` �� On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141312 Tax Code Number: 02041109000 Work Type: Septic Upgrade Permit Effective Dates: August 07, 2014 to August 07, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: PARADISE VALLEY Site Legal Address: PARADISE VALLEY BLK 4 LT 1 G:3538 Owner/Address: THOMAS SHAWNA J 18041 SPAIN DR ANCHORAGE AK 995166023 Site Mailing Address: 18041 SPAIN DR, Anchorage This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 19055 Total Bedrooms: 3 N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receiv< Issued MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343 f58Q 2velopment Services Division Fax: 907-343-7997 n -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-411-09 Property owner(s) Shawna J. Thomas Day phone Mailing address 18041 Spain Drive Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Paradise Valley, Block 4, Lot 1 Legal description (Township, Range & Section) Lot Size 19,055 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) Q Upgrade (w/`No ADU) Renewal Duplex (D) ❑ ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. r, Qt4' property owner or authorized agent) Permit/Rush Fees: y l 4r. = $3yy Waiver Fees: _ Date of Payment: / Date of Payment: Receipt Number. . '6 6— Receipt Number: Permit No. aspigala Waiver No. Permit App_ .:- :L,:c3 August 7, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1, Block 4, Paradise Valley Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The septic tank on Lot 1, Block 4, Paradise Valley Subdivision has failed and must be replaced immediately. We are therefore requesting a permit be issued for the construction of a new 1,000 gallon steel septic tank to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the existing septic system and the location of the new tank. Also identified on the plans is the existing well on the lot and those on the adjacent properties. No conflicts existing between the well separation distance and the septic system on this or the adjacent lots. The existing tank on the lot will be properly disposed in accordance with Municipal Code. The existing absorption system will remain in place for continued service. The ground surface on the lot slopes at a grade of 7% to the southwest in the area of the septic tank. The tank will be constructed near the location of the old tank and in conformance with Municipal requirements. If the tank is constructed in accordance with our design the following statements apply: The tank, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The tank, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The tank, if constructed as designed, will have no adverse impact on reserve Lot 1, Block 4, Paradise Valley August 7, 2014 Page 2 of 2 space, either surface or subsurface, on any lots located in the area. 4. The tank, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, j - Michael E. Anderson, P.E. Attachments PARADISE VALLEY LOT 1 , BLOCK 4 IIA Tank in ode. tic Tank )uts. Tie h. Cleanout 7 MUNICIPALITY OF ANCHORAGE DEPAR�.._,:NT 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 NEW _ 4�- •. �%� �I ❑ UPGRADE �, dU MAILING DRESS 1� 9PTIO LEGAL DESCRIPTION Lv-T r &xjc: U L LOCATION Vic) L-I.S Or -r- rzAm I T Gzmzv, -to GCxDCN V iaw NO. OF BEDROOMS ,3 Uy DISTANCE TO: WellM IfV Absorption area Zif Dwelling p y PERMIT NO. FZ %A'/1�� wF Manuf ct r r xog6r Material Si L - No. ofmpartments ti U c�pin gallons q%LJ5_0 g IF HOMEMADE: Insideacit lent orQ Width A Liquid depth q p ^.j1Si Well DISTANCE T : Dwelling PERMIT NO. 4 _ H Manufacture i Material Liquid capacity in gallons DISTANCE TO: Well Ma C� Foundation / Z9 Nearest lot line A PERMIT NO. �O. w= j LU LL v J w No. of lines Length of each in� g Total le th of)ines Trench Distance between lines z �—x 3 inches A_ a finish Material beneath the Total of ec "ve abs on area Cr F- Top of the to grade �� / / Z fe✓+'i�Eit i �l/� (� •iwekes `T Length Width Depth PERMIT NO. LU a <F 01C Type of crib rib diameter Crib depth - Total effective absorption area LU Lu Well Building foundation Nearest lot line DISTANCE TO: Class D pth Driller Distance to lot line PERMIT NO. J24W (ding foundation Sewer line Septic tank Absorption areas) DISTANCE TO: OTHER � PIPE MATERIALS ry �9 ryry p ^ 4c G- I H 4 %nV a® 'g A�j SOIL TEST RATING INSTALLE,,Rrr^^ lJ REMARKS 1 t—ovkbo I/)QWL L ar Y 4005C-1 AT CACA -0 09 SOOne OR O Uze ;5ew-aq '41or e -AJ Z"i2mib 9� c� �►FAF Icy 'r 4 'r 0 / APPROVED DAT ,.gWpNSON:-e ®W 01, •••• 1834E \ ®•; All 72-013 (Rev. 3/78)®,®°pROFESSIONP®/', 11� TYPE OF SOIL ABSORPTION SYSTEM IS MAXIMUM NUMBER OF BEDROOMS = �� TRENCH THE REQUIRED SIZE OF THE SOIL HBSORPTIQi ' SOIL -RATING (5Q FT/8R)= 150 SYSTEM IS: x�Fic"FA'vPUEUL r-.-- F_- F-' --"== -7^ !ffn THE LENGTH DIMENSIONIS THE LENGTH (I' FEET) OF THE TRENCH OR DRHINFIELCi � THE DEPTH OF TRE OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCHVHTION (IN FEET). ` THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH' OF GRAVEL BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCAVATION IN FEET). ��� ����� ������� |' �������� ����K�!��][��K�.U�v �����»�-` , -»- --�� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTH[~LHTION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL'WILL SERVE. �� -17-1��� �����1--- 7- � � �� � ��U ' ���C� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. ` MINIMUM DISTANCE BETWEEN HWELL HND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM, DISTANCE FROM H PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. c WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ��0 0HY~ OF THE WELL COMPLETION ' OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ` �'��H. =< I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPHLITY OF 8NCHORHGE 2:' I WILL INSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ' 2` I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MHY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. ` SIGWED:~_---- d-4- HPPLICH�� DWIGHT CLOUTIER ` /y -^r- / � � y4'0 ISSUED BY~�L_���~��� _.��_u���_�_�_ � �EpA. TM' OF._�� PROTECTION { -NT 825 ' STREET.- K HGE/ 8. qq ' / 264~4720 «� IL_ `��a ' ~�3- "T- r=- E -Z L -.l E Fm- EF_ F­-:� 11"-1 1� PERMIT N8. 8]09]0 ` APPLICANT DWIGHT CLOUTIER 5210CHENH #2 99508 ' 2]7 � 71�5 � � LOCATION i TYPE OF SOIL ABSORPTION SYSTEM IS MAXIMUM NUMBER OF BEDROOMS = �� TRENCH THE REQUIRED SIZE OF THE SOIL HBSORPTIQi ' SOIL -RATING (5Q FT/8R)= 150 SYSTEM IS: x�Fic"FA'vPUEUL r-.-- F_- F-' --"== -7^ !ffn THE LENGTH DIMENSIONIS THE LENGTH (I' FEET) OF THE TRENCH OR DRHINFIELCi � THE DEPTH OF TRE OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCHVHTION (IN FEET). ` THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH' OF GRAVEL BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCAVATION IN FEET). ��� ����� ������� |' �������� ����K�!��][��K�.U�v �����»�-` , -»- --�� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTH[~LHTION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL'WILL SERVE. �� -17-1��� �����1--- 7- � � �� � ��U ' ���C� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. ` MINIMUM DISTANCE BETWEEN HWELL HND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM, DISTANCE FROM H PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. c WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ��0 0HY~ OF THE WELL COMPLETION ' OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ` �'��H. =< I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPHLITY OF 8NCHORHGE 2:' I WILL INSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ' 2` I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MHY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. ` SIGWED:~_---- d-4- HPPLICH�� DWIGHT CLOUTIER ` /y -^r- / � � y4'0 ISSUED BY~�L_���~��� _.��_u���_�_�_ � 9 el U V-1 I tlz- I f 1 C L_ I —F °-r r✓F"• 9--1 C-4 tl-I I— F" 9 tl arHE DEPARTNENdT i.. L�EFILTH FIND ENVIRONMENTAL :OTE'�_TIONd -,5 `L' STREET, ANCHORAGE, I lk'.' ' x_=,501 264 4720 : ANCHORAGE GE r__94 21.2 i EAGLE F: IVER -T- PERMIT NO. 8.-,d0@4 ADPLICANT: S S ENGINEERS PHONE: ADDRESS: : 7 -125 CELE:' SWD I IWY ANCHORAGE, At". 99502' LEGAL_ DESCRIPTION LtBDIVISIONd: PARADISE VALLEY BLOCK: 4 LOT: 1 LOT SIZE 0 SO. F'T. TOWNSHIP: RANGE: =.E C:T I ON•d : •-- f li=t ; T N U_INi NUMBER + =F' BEDROOMS SOIL RATING = 1.25 125 1.25 (SO. FT. e --'BR? ,LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOQ IN DESIGNING YOUR SEPTIC SYSTEM CHOOSE THE COPT T-ONd THAT BEST FIT' YOUR IFS: I TF_'.' i 'T" F-__4 E7 P -A e__:: C -K ✓1 : I RD rJ WIDTH 2. 5 FT. LENGTH I 0 FT. TOTAL DEPTH = 10. tip, F -T. GF":IiVEL_. DEPTH _ 6. 0 1!7T. GRAVEL VOLUME — :19. 2 CLI. 1.1"DS. TANK T :1, EE Jco. 0 GALLONS dS (TI. O COMPARTMENT TANdF--::::l WIDTH = l 0 FT. LENGTH i = 34. F 'TOTAL DEPTH = C. 0 FT. GCi::N=tVEL DEPTH = Ci..__, FT. .GRAVEL VOLUME 21.4 CU.YDS., TANK 'SIZE = 1,000. 0. 0 GALLONS TWO COMPARTMENT TANK) L -J I E -ft E. E -n F--, I P-4 i— I EE 9___ r -a C -a UES ; I C3 ✓N`""j W I DTI...I = 5 0 FT. LENGTH = 44. 0 FT. TOTAL DEPTH 7. 0 FT. GRAVEL DEPTH -:. Nva FT. GRAVEL VOLUME UME — ,_ rt C:t_t. YDS. TANK `._IEE _ 1, 000. 0 GALLONd`._, ( TWO CONPARTMENdT TANK) I C:EF:TIF%l THAT: J. T ntel Ft INTI L I t` R WITH THE f:E'_-:U I REl'IENdTS FOF:: ON --SITE '_EWEF::'_. AND WELLS AS SET FORTH BY 'THE NTL UNd I C: I PAL I T',' OF FiNdCF•Ior,:. GE FIND THE 'STATE OF ALASKA. 2. I WILL TNkSTALL THE SYSTEM IN ACCORDANCE WITH 'THE CODE`er; AND HAVE RECEIVED A COPY OF THE CODE Sd_II''ll'fF{RY FIND DIAGRAM ATTACHMENTS WHICH IS PART OF T'I'••LIS PERM I. T. �^� _. I UNDERSTAND D THAT THE ONd••SITEEWER SYSTEM NAY,REQUIRE ENLARGEMENT* IF THE RESIDENCE IS • REN'IODELED -10 INCLUDE DE MORE THAN BEDROOMS. Y. PERMIT APPLICANT FIFIS 'THE RESPONSIBILITY To INJFORII PERSONNEL DURING THE INSTALLATION I NdSPEC:T T C,N•d'._, OF ANY WELLS t DJD IC:ENdT TO THIS PROPERTY AND 'THE NUMBER OF RESIDENCES THAI* THE WELL WILL SERVE. IF A LIFT STATION IS INSTALLED, AN ELECTRICAL PERMIT AND INd`SPECTIONS MUST BE OE,TAIN E -D. A-BUILTS CANNOT BE F=IF'F'F:OVED WITHOUT AN ELECTRICAL INSPECTION REPORT. THE ELECTRICAL WORK N1i..t'._,T BE DONE E'r'r' A LICENSED ELEC:TRIC:IANd. SIGNED APDL I Ci—AN dT : _ _ ENdi i I NdEEF ISSUED BY: DATE: ;L2.-.-'12/83 ............... ........ ......... ... ....... .... .__..... ..... ..... ..... ..... ..... ......._..... ......._._._..__..._...._...... _.__......___.»_..__._•-- � 1O -MUNICIPALITY OF ANCHORAGE w.00 Department; Health and Environmenta'' trotection 825 L Street, Anchorage, AK. v9501 264-4720 Permit # HANDWRITTEN PERMIT # # WELL AND/OR ON-SITE SEWER PERMIT Applicant: 3 iL S "et�s�g^� Mailing Address: -)S S� Location: Phone Number: Legal Description: UG{.X.�Lot Size: Type of Soil Absorption System Is: Trench: k Drainfield: _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms; Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: rr�3 H3 DEPTH ��� LENGTH GRAVEL DEPTH— WIDTH T� The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOt-Di-NG) TANK SIZE GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # # # TWO(Z) INSPECTIONS ARE REQUIRED # # # 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 150 to 200 feet from a public well depending upon the type 11 of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper.installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) L understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signed: .tee Issued by:C plicant Date: ( O SWP/024(1/81) r ` SOILS LOG S & S ENGINEERS. INC 7125 Old Seward Hwy. Anchorage, Alaska 99502 D, PERCOLATION 3449=6561 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR:—S t�/1 t V 14, �Py DATE PERFORMED: LEGAL DESCRIPTION: L© -r1 �(�t"14'' �' Q,F`l '•A�t�C" VAGLL.'� SLOPE SITE PLAN IME MNIEM MIN E O—O,S OL Depth to Net Water Drop 1 O y� I �O 5 tt/ -- 64Ave-1-Lq 2-.0 ,mains MEIN! 3 0.0 1JSE CA"b A) ti.. E a � 5 6 7 j = O=i 8 �•la" 9 IME MNIEM MIN Date Gross Time MM E Depth to Net Water Drop A 01 ,mains MEIN! O. o WAS GROUND WATER 11 1 ^ �� it COMve-4 ENCOUNTERED? t2 SA Wr7r SoAlr:. st`r IF YES, AT WHAT - �. SCAVI DEPTH? 13 • e:/. �/ 14 %Q T��A.L 15 v1-rmi 16 r'r'.. 00 F AAL 17 t 9 9R, % IONN E SWANSONe w e W 20 Jtj •••• • 1834-E •• i 01 W E s -f P? MENQEEtMENEHIMEMEEMME Reading Date Gross Time Net Time Depth to Net Water Drop A 01 No MEN W E s -f P? MENQEEtMENEHIMEMEEMME Reading Date Gross Time Net Time Depth to Net Water Drop A 01 PERCOLATION RATE Immures/inch) TEST RUN BETWEEN FT AND FT 1 e PERFORMED BY: rCERTIFIEDBY: DATE: 71 7 4:.i•llt ANCHIi 50 (907) 264_[1111 TONY ItNi V!_I MAYOR DEPARTMENT Of HEALTH AND ENV IHONMEN i AL PHOTEC, ION Permit #: 820583 ;January 31, 1983 TO: Permit Applicant Subject: Lot 1 Block 4 Paradise Valley Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerely • �d� Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 9 4� M U Phi :1. C-1 31"Iff Q X "T F"" F,-1 VA C.": =-3 K:3 Mw F.-',EF`F!RTJlEN T HEAL'TH AY -JD O]-EC:TIOhJ &.25 -`L, STREEM FINCHOR'FIGE':.- 26',4 14 IFEE 1_..1._- 1=1 FYI Q M AM ---- -'-'5 1 "T FEE :001 FEE WJ ::1::..T F'EFIIIT NO. ( 82058:-,.: ) APFIMANT ROMAN F, f"FRANK 3006 EUREKA 5 UDD-TTI ON LEGAL LAB4 PRRADISE VALLEY LOT SIZE 999999 SQUARE FEET TYPE: OF' SOIL. A,6SOF.F`TU)N 'E;Y'.E:TEM IS: TREINIC.'F1 NFIXIi"ILRel NUIE31ER OF' = 2' SOIL. RATIENK"i (50 FT/6R)= 1.50 THE REQUIRED SIZE OF: THE -5011- FiBSORFFION SY.STEM IS: EEE 9-1-,= fl- L-- El T` -A -*ff- 0-1;z= 9.21 lFs rt Fl 0-o" T L- 111 -Al =-- 'TF -IE !.,.ENG -D-1 DIMEN`E,-'ION IS THE LENGTH is IN FEET) OF THE TREN(.*H OR DRAIWIEL-D. 1111E DlEFID-1 Of."' A TR'ENcH OR Pu !.E: T11 -AE": DISIFAPICE 13-El-WEEPA THE OF THE (A-EOUt-Xj APAID '11"HE BOTTOM OF` THE EXf.`.AVATI0P--! (IN F,'EET). THEE.F.,'T: IS iNIO EET WIDTH F`OFE 'TRENf";HE,=-;. TIAE GHIT-:F!,%'EL. DEF"J"PI I'<<THE IIINIMUM DEF,TH OF (3RAVE1._ BET1,1EEN THE F'IF'E FINE) THE BOTTON OF' THE EXDTvATI('.,Nl FEET: -'l. F,".",E-DGZ,M,j 1: MEH"IT), I Y-".- -1-F-1 01�4 -,,::E`-, 1: E E.*.-.-,--=: J- C'N C'Em ff.E:� Cl F'EF'-`A',1IT AF-l"LWAN!" HAS THE TO INFORM THIS DEFIARTIlEr-ff EjUR11,1C, THE IP-ISPECAlovic, OF' ANY WELLS FIDiFICENT 'TO "I"F-!I S FROFERTY AND THE WJf,lE-.:ER Cll-"* RESIDENCES THAT 'THE WELL WILL SER'v'E. ... ....... .. Ca X& 12, :1 3: 1WAVEHAT-1- 1: WhIsT 1=1 Fit K Fit FEE Gh U X F;-.. E--EE*-n OF Flhl'i` SYSTEI''! IAITFKXJT FFIII-ML. INSPECTION. AND APF,F,,OVF;L BY "THIS )EF"IFIF: TMENIF HILL BE 'EUBJECT TO M):H3E(:LITIf,.iN. Il DA I 01UM I:-*�i.c--;T,w-JC[--': Bl.'TWEEN 1A 1-4ELL. FINE) ANY Off -SITE SMAGE :E;Y:--';TEj,,l IS .]LOE3 FEET FOR, A F'RIVATE WEEK OF 150 TO 200 FLET FAROM R FALUBLIC !`JELL. [jEF--'r.-.:NDIP-,113 WDON THE TYF`E (:.*IF F`LJfF.,LIL': WELL MINMUN D.lc.:;*TFiM(":E F'ROJI F., FRTVATE WEL.L. 713 A MID.4-ITE SEWER LIP -JE IS 2`,-.i FEET Ar -J!) TO A COMMUP-417"i' SEINER LIP -JE IS 7`5 FEE -F. t --!ELL LOGS FIRE 1--t!EQUI FREE) FIND MUST BE RETURNED 1-0 'FHE DEFDAMMENT WITUIN TO DAYS OF THE !,.!E[ -L- (-'-'OMFl.E'TI0N. OTHER FREGWIREIIENT'S MAY AMA.Y. SFlEC:IFIC:A*FI0NS ANE'., i1ONSTRLJC,TD)N DIAGRAM.C• ARE.-- AVAILABLE TO INISURE F.-TOFIER INSTALLATION. F----4[- X 7' :1 CA W V 10, 1-1 V 1=7 1__.A,._ szoal., I C:EF'--"TIFY 'I"FH9'f U I FUl FAP111 IF!FE WITH TFIE REQUIREMENTS FAIR ON -MITE SEWERS AND WE! -AS FIS SET FIORTH BY THE l"lUND.-.-,IPFA-Ir-, OF 2: 1 WILL INSTALL THE SYSI-Ell Il, -4 WITH THE K 1 UNDERSTAND 'rHAT THEE ON-SITE SEldER' SYSTEIel r-lffi` IT.,!EQUIRE ENLAF;-'.,GEj",LJEN'f' IF:' THE FEE's 1 DEN(DEE E[) R) INCLAJ)E tIORE 'i"HiFiN -'.: BEDROOMS. GNED: FIFIFTMANT F" lFT::All-JK BY—ALIV) M SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 0 PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: R. "Butch" Frank DATE PERFORMED: 5/27/82 LEGAL DESCRIPTION: Lot 1 Block 4 Paradise Valley Subdivision r-1 SLOPE SITE PLAN 10 (FEET) Gross Time 1 V V V D VIV Overburden 2 / ENCOUNTERED? 3- P 12 4- 45 E �'• • IF YES, AT WHAT 5- 13 6 6- 7- 7 '(}•', Gravelly Sand w/ 8 / trace silt /,Q•' (SP) 150 sf/br 9 10 Gravelly Sand 14 (SW) 125 sf/br 15 Q`•;', Q . 16 Bottom 17 18- 19 Reading Date Gross Time WATER S 11 D WAS GROUND No L t, ENCOUNTERED? P 12 E �'• • IF YES, AT WHAT DEPTH? 13 Gravelly Sand 14 (SW) 125 sf/br 15 Q`•;', Q . 16 Bottom 17 18- 19 Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE :,(minutes/inch) r fe 3 TEST RUN BETWEEN ®�4 COMMENTS The test it was located at a high location o wa�ot, end' Tonal depth of test may be required for gravity flows stem. I PERFORMED BY: Kinney R. Baxter, P.E. CERTIFIED BA . TE: 2 8Z `r,� Kinney 11. Pater V� 3656 E 72-008 (6/79) �<�� "',6Q?® %l 1�EVIk/ -01coM Municipality of Anchorage -� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ok.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 ZO - yl / - 09 HAA # 05-0337 Expiration Date: I 1 - i - D 5' 1. GENERAL INFORMATION Complete legal description Lof-1, Stock H, Para-�IycyQllfy S //� Location (site address or directions) l0 e; 'y/ SAetrn brrc�< Current Propertyowner(s) fin; 171c'm4r0n Dayphone '317-0/39 Mailing address Lending agency Mailing address P.o.J3ox 110'770, Rn g, Irl< 99S Day phone Real Estate Agent Kau.n Tuyfo y Piuvfinhal tit/..Dayphone 2-73-7223 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. Please crx 11 6ci,.a, Tziyto. 273--7Z23 cuRcn H?h r1 2. NUMBER OF BEDROOMS: 3 ready ,Z,r p1ck' -kP 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site 10 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 5 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 less than 30 days old. (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, I verify that my investigation, 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. NameofFirm_ F(u1-hnP Tect of;;ead Se.v.ce_r Phone 'SYS--13r&— Address ! y.S3o Crc ticyP- Ak 99S - /Z Engineer's Printed Name Date 3'24 fy 30 2r -10-r �F6 49L 1N 5. DSD SIGNATURE Approved for 3 bedrooms. = ?MOD' tE F. AlOORE ; s Disapproved. �r 4� .....• '"s Conditional approval for bedrooms, with the following stip ulatio'n�.��'w� Additional Comments ZfX ; WATER AND ; r^= Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By:� _ / Original Certificate Date: g (P.. 12m) Municipality of Anchorage ,.• •• ' Development Services Department Building Safety Division • r On -Site Water & Wastewater Program 47W South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST LegaiDescription: l.04" 14 Sd/ock If,r.rrwdve llbtl g -S/A ParcellD: 020-Y/1-09 A. WELL DATA Well type --EV t it A, B, or C provide PWSID # Date completed =1963 . Sanitary seal (YIN) Y Total depth X 290 ft. Cased to 7 Yo ft. or bedrock FROM WELL LOO Date of test Static water level Well production ft. Well Log (YM) N Wires property protected (YIN) Y Casing height (above ground) 2 8 in. AT INSPECTION 6/z9los- 60 ft. g.p.m. WATER SAMPLE RESULTS: Coliform D colonies/100 mi. Nitrate 1.69 mg./I. Other bacteria O oolonies/100 mi. Date of sample: f / 7-9 / os Collected by: F [aFAPA T&cbn is 0J 7 /r+,/or B. SEPTICIHOLDINO-TANK DATA Tank Type/Material S we He- / S fvt / Date installed I o / /'i / 6-2 Tank size 12so gal. Number of Compartments 2 Cleanouts (YM) Y Foundation cleanout (YM) *r Depression over tank (Y/N) N High water alarm (Y/N) Date of pumping Pumper S110t"-c 16"U L� o., C. ABSORPTION FIELD DATA Date installed 1E_1 (-&/ Bj Soil rating (g.p.d./ft' or ft'/bdrm) ! 5P 1 System type "T'nr chi Length 38 ft. Width It ft. Gravel below pipe C ft. Total depth 10 ft. Eft. absorption area 1&".6_W Monitoring tube Y Depression over field /v Date of adequacy test 7 / 29 /OS Results (Pass/Fail) Pat4f For _3 _bedrooms Fluid depth in absorption field before test 0 in. Water added 177Lga1. New depth 17sin. Elapsed Time: *Z£ min. Final fluid depth _sem in. Absorption rate >= `ASG g.p.d. Any rejuvenation treatment (past V mo.) (YM & type) NavA t kn 0 ewn Ifyes, give date N• h• D. LIFT STATION N A. Date installed 'Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off" level at _ In. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: +k Septic tank/INt station on lot % 10 t' i.• c.a �pe-Rr1f SO;;Oy) tit Absorption field on lot 9s' Public sewer main Al • A. Sewer /septic service line 7 2S' Manhole/Access (YM) High water alarm level at Meets alarm 8 circuit requirements? On adjacent kris > IUo On adjacent lots 7 10y Public sewer manhole/deanout ".4, Holding tank N • 14, in. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 20Propertyline OZO' Absorption field 2' _91f�i lyl Water main N• A• Water service line >10f Surface water > 10o I Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 12' Building foundation 3Z' Water main A/. A Water Service line >10' Surface water > 1e -la' Driveway, paftv&eWe storage S. S' Curtain drain A/sne Sere Wells on adjacent lots > 14' F. COMMENTS Altru H,r tn,66fle&C 7/7-7/0j- ew4nali Sr dele-q-, e(vf Pr¢• Y warver tttueat Z /t y 7 Offlour wolf -Sep ffc Syrk�t e4la-cc of 97' G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. E • . • ea 0� Engineer's Printed Name '1—i+eodcrr F• Naomi 'd�TH Date Tiu l y 3a ZOO � ••••: HAA Fee $ N• A. 84eis j A aWaiver Fee $ •' C` 35 p Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 12/Do) Cn'a.&ENVIRONMENTALENGLNEERLNG • ENERGY CONS ERVAnoN&A.NALYSis THEODORE F. MOORE, P.E. 14530 ECHO ST. P11: (907) 345.1355 July 30, 2005 AONCHORAGE, ALASKA 99516 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 RE: Septic adequacy test — Lot 1, Block 4, Paradise Valley S/D Dear Sirs: In issuing HAA certificate 4 050337 for the subject property you attached a "Septic System Advisory" which asserted that the 92% of the absorption area is inundated and that the remaining life expectancy might be limited. This attachment unfortunately caused buyer concern which led to the sale of the property falling through. Based on my own test data I did not share the Department's concern that the absorption area was mostly inundated. In order to test this hypothesis I arranged to have a new independent monitor tube installed near the south end of the absorption trench on July 27`". This new monitor tube extends approximately 5 feet below the level of the horizontal distribution pipe and did not encounter any standing fluid in the sewer gravel. On July 29, 2005 I retested the septic system adequacy by having a pump truck add 1500 gallons of water directly into the trench through the original cleanout/monitor tube at the north end of the trench. This rapid infusion of over three times the design daily water demand caused a maximum buildup of 14.5 inches of fluid in the new monitor tube (achieving a maximum level approximately 4 feet below the horizontal distribution pipe). This temporary buildup had completely dissipated within 25 minutes, and the subsequent addition of another 270 gallons of well water at the maximum pump rate of 6.4 gpm was absorbed faster than it was being added, resulting in no net fluid buildup. Based on this test data performance I feel that it has now been demonstrated that the absorption rate is more than adequate for a 3 -bedroom residence and also that the absorption area is nowhere near inundated. Accordingly, we are requesting that you reissue IIAA 050337 as a clear approval without the previously attached "Septic System Advisory". Thank you and please give me a call if you have any questions on my test procedure. Sincerely, Ted Moore, P.E. Cc: Coni Thompson (FAX 746-1195) Kevin Taylor, Prudential Vista (FAX 273-7350) r .FLA 'TOP TEC"HNIGAL SERV,ICES�_ Cn'a.&ENVIRONMENTALENGLNEERLNG • ENERGY CONS ERVAnoN&A.NALYSis THEODORE F. MOORE, P.E. 14530 ECHO ST. P11: (907) 345.1355 July 30, 2005 AONCHORAGE, ALASKA 99516 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 RE: Septic adequacy test — Lot 1, Block 4, Paradise Valley S/D Dear Sirs: In issuing HAA certificate 4 050337 for the subject property you attached a "Septic System Advisory" which asserted that the 92% of the absorption area is inundated and that the remaining life expectancy might be limited. This attachment unfortunately caused buyer concern which led to the sale of the property falling through. Based on my own test data I did not share the Department's concern that the absorption area was mostly inundated. In order to test this hypothesis I arranged to have a new independent monitor tube installed near the south end of the absorption trench on July 27`". This new monitor tube extends approximately 5 feet below the level of the horizontal distribution pipe and did not encounter any standing fluid in the sewer gravel. On July 29, 2005 I retested the septic system adequacy by having a pump truck add 1500 gallons of water directly into the trench through the original cleanout/monitor tube at the north end of the trench. This rapid infusion of over three times the design daily water demand caused a maximum buildup of 14.5 inches of fluid in the new monitor tube (achieving a maximum level approximately 4 feet below the horizontal distribution pipe). This temporary buildup had completely dissipated within 25 minutes, and the subsequent addition of another 270 gallons of well water at the maximum pump rate of 6.4 gpm was absorbed faster than it was being added, resulting in no net fluid buildup. Based on this test data performance I feel that it has now been demonstrated that the absorption rate is more than adequate for a 3 -bedroom residence and also that the absorption area is nowhere near inundated. Accordingly, we are requesting that you reissue IIAA 050337 as a clear approval without the previously attached "Septic System Advisory". Thank you and please give me a call if you have any questions on my test procedure. Sincerely, Ted Moore, P.E. Cc: Coni Thompson (FAX 746-1195) Kevin Taylor, Prudential Vista (FAX 273-7350) \ Municipality of Anchorage • �- Development Services Department �• Building Safety Division ;. On -Site Water and Wastewater Program ` 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ek.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 20 - N// -09 HAA# ATP03?- Expiration Date: / O — '�:?_ D - OS 1. GENERAL INFORMATION Complete legal description t-, f- f. 13 /oc ec IV, Para d,r, t/a / l a� S //) Location (site address or directions) IFo y/ Spet"A Orad," Current Property owner(s) Con; 7 -ho. a_ro., Day phone _3/? - 3 /39 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P,o.630 1/07701 /}nc%oe!Mjt /}i< 99S// Day phone Lc?. ' ,..�kr� fe., *,feFr vvin Dayphone 273 -7zz3 Unless otherwise requested, HAA will be held by DSD for pickup. FU curl wti'n U44- 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site IR Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ '7s-7223 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 less than 30 days old. (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, I verify that my investigation, 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 Pfcr ffa ✓r Tec-AA;cal Se'-".« Phone 3 YS-13ss- Address rNSza Ecce _f/T ACCIIOC!a /}cc WS'// Engineer's Printed Name Tbeadcl7 F'• 1-100 a DateT�!S, oaf 5. DSD SIGNATURE ✓ Approved for 3 bedrooms. Disapproved. 211 MEEt;'S' V- 4 . 4 00RE F. YOORE CE -3589 _ Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ��/� (t/ Original Certificate Date: )Rev. WOO) Municipality of Anchorage .: Development Services Department Building Safety Division < Onsite Water & Wastewater Program : • e 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6850 www.ci.anchorage.ak.us (907) 343.79W HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L • t tf . Q l k Y PgrWW(v'- //a ll ew S /p Parcel ID: O z v - hl / l -49 A. WELL DATA Well type _E wk If A, B. or C provide PWSID 1f N. A Well Log (Y/N) N Date completed 4-- 1983 Sanitary seal (Y/N) Total depthZ? 90 R. Cased to > YO R •r S wek FROM WELL LOG Date of test , Static water level Well production WATER SAMPLE RESULTS: fl Wires properly protected (Y/N) Y Casing height (above ground) 28 in. AT INSPECTION —: 60 ft. g.p.m. f . I— g P.m. Coliform O cobnies/100 mi. Nitrate 1. �71IZ1400 �P mg.A... Other bacteria O colonies/100 ml. Arsenic: _ mg.A. Date of sample: 6lW lot Collected by: F'(af/en Trt6 rc,, B. SEPTIC/NOLDING TANK DATA 71 l; los Tank Type/Material _,Sen +;t- / S hi/ Date installed Io / 1-4 /B Tank size t 2 SO 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) N. A. Date of pumping 6 130 10 S Pumper Ss -watt him"W k C. ABSORPTION FIELD DATA Date installed o r 3 Soil rating (g.p.d.te or fe/bdrm) 160$'. System type TiYn c y dd�+. Length 3'& R Width i ft. Gravel below pipe air— ft. Total depth 10_ ft. Etf. absorption area Yt6 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6 ! 29 o s s e ey . q cy S Results (Pass/Fail) _�,S t.e nyro-/For ? bedrooms Fluid depth in absorption field before test 0_ in. Water added.7� gal. New depthA.S in. Elapsed Time: UL7 min. Final fluid depth ?..f in. Absorption rate >= _ NST1 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Mont btno wn If yes, give date N. A, Ste tupnleinenlwl e,! on 4el09w.rcr f+rt D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons 'Pump ofr level at —in. Cycles bested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ,y, Septic tanknift station on lot ^ 1oL' 10 c•o, p e•- - w1t' taF^^•r Absorption field on lot 95 ' Public sewer'main N• A Manhole/Access (YIN) High water alarm level at Meets alar & circuit requirements? in. On adjacent lots > too On adjacent lots Public sewer manhole/cleanout IV. k Sewer /septic service line 7 AS" Holding tank N• As SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 2o' Property line ZO' Absorption field 'a ' (P.•wrow v I Water main N• A. Water service line > to ' Surface water�C.v r Wells on adjacent lots 7 140 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 121 Building foundation 3V Water main N • A. Water Service line > 4Surface water > 100 ' Driveway, parkinglvetdde storage B• f /n �n»v /Y Curtain drain None SfIn Wells on adjacent lots > F. COMMENTS Y WGrvee, Fs.r, f* 4 'X/7 -Y/97 42/4-ta-1rn� Wt/['Seph'c 'SYlfc•�" cict/gnrr �f9s' G. ENGINEER'S CERTIFICATION cs:e 1 certily that I have determined through field inspections and C"Yo�N........ review of Municipal records that the above systems are in r. :•.n :„,, conformance with MOA HAA guidelines in effect on this date. E; n;i w •: [7 _ - }; 7 <E Engineer's Printed Name —Th[Uc%Zr .••••••••••• ••••j•••a Dated 200C -- r+ %. Tricow re F 44210RB C rc - • HAA Fee $ H 30 Date of Payment 7/ r 0 / of Receipt Number ILL/2. _. (Rev. 12101) Vi - Waiver Fee $ 4,,•C �;a` Date of Payment Receipt Number FLATTOP TECHNICAL SERVICES. CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. Pit: (907) 345.1355 July 5, 2005 A.ICHORAGE, ALASKA 99516 MOA DSD P.O. Box 19-6650 Anchorage, AK 99509-6650 RE: Septic adequacy test — Lot 1, Block 4, Paradise Valley S/D Dear Sirs: On June 29, 2005 I conducted an adequay test of the referenced septic system and discussed the test data with Jeff Poet and Dan Roth on June 30 . Prior to the start of the test the cleanout at the south end of the trench as well as the monitor tube at the north end of the trench were both dry. The cleanout at the south end extends 62 inches below ground level and the monitor tube at the north end extends 104 inches below ground level. Despite the apparent elevation difference, due to topographic variation of the lot the bottom of the monitor tube actually extends only approximately 6 inches lower than the invert of the distribution pipe as measured in the cleanout. The house had been occupied prior to the start of the test. During the course of the test I added 796 gallons of water to the system through the second compartment of the septic tank. After 53 -gallons had been added to the system I observed a fluid depth of 6.5 inches in the monitor tube with none in the distribution pipe invert visible through the south cleanout; this level remained unchanged as I added the remaining 743 gallons, indicating that the trench was not full. After letting the system sit overnight I measured a fluid depth in the monitor tube of 2.5 inches. Based on these observations which demonstrated a large surge capacity, I believe the system continues to function adequately for a 3 -bedroom residence. As I discussed with Jeff Poet and Dan Roth this system (in apparently the same configuration) has been tested and approved several times over its life. Mr. Roth indicated that DSD would probably be able to reapprove the system based on this test data. Please feel free to give me a call at 345-1355 if you have any questions on this test procedure. Thank you, 0...,Q lb1..,, Ted Moore, P.E. cc: Coni Thompson Municipality of Anchorage ., •G'S c St Development Services Department Building Safety Division ' On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Septic System Advisory Health Authority Approval # 050337 During a recent adequacy test on the septic system for Block 4, Lot I of Paradise Valley subdivision, 65 inches of standing water was observed in the absorption field. This indicates that approximately 92% of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Health Authority Approval. O.M. D(DK S � 4S P 4� hr � WCLLO 40 ,o \F s'' \ 0 THE INFORMATION HEREON IS FOR THE USE OF LENNNO INSTITUTIONS SPECFX'NLY TO BMOW ANY CONFLICTS BETVIEEN EXISTING STRUCTURES AND RATTED LOT LINES OR EASEMENTS AMD IS NDT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELNES. EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ME NOT SHDINN MEREON.(1114ESS INDICATED( NOTE. ANY FENCELNES SHOWN ME LOCATED APPROXI TELY AND ARE HOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRUCTURES. ANY PAVING SHOWN WY BE APPROXIMATE DUE TO SNOW CONDITIONS, A Ao .�1 O 0000pp �P.•• •.s Opt O11 49— Y SHANE A. HOLT: 0 O !. LO.691 4 iG AS -BUILT SURVEY (NO CORNERS SET TMIS DATE ) 1'.10 1 HERESY CERTIFY THAT 1 HAVE PERFCRMED A MORTGAGEES INSPECTION OF THE FOLLCWW4 DESCRIBED PROPERTY. LOT 1. MOCK 4. PARADISE VALLEY SUB, ANCHORAGE RECORDING DISTRICT. ALIVSAA AND THAT THE VISIBLE MPROIEMENTS WTUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED, DATED AT ANCHORAGE. AAS" THIS BTM_ DAYOF_ ANE =5 HOLT LARD SURVEYRZ Sf D1.FB 119.14 TEL 74585:1 07-15-05 05:08P9 FR011-CT(E ESI, SCS ERV SERVICES 9075615301 SOS7CT8.E ENVIRONMENTAL SERVICES Drinking Water Analysis Report for Total Coliform Bacteria K" eia7RUcum oN REVERee arae affoae CMLECT1MC SAMPLE MUST BE COMPLETED BY WATER SUPPLIER 13 PUBLIC WATER SYSTEM IDS [PRIVATE WATER SYSTEM Sana A.." ❑ Sand btroka SAMPLE COLLECTION: Date: =7 rz ups Mw, 0" Yw 13 Sana Raaotq SAMPLE TYPE: T-433 P-01/01 F-152 200 W. POTTER DR= ANCHORAGE, ALASKA 99518 Tel: 907-562-2343 Fax: 9075815301 tab RM No. 11054217 4�-- t p Sana ttNote @ Routine O Treated Water Two: daPM Pr ww ❑ Repeat Sample ® Untreated Water Location: 0 1 L'/k H Pared. /i. S/ (refer to lab no. 1 Cotlecmr. Tim/ Ho a K _ .�.� 'Jyr.-• - _ ❑ Special Purpose emr n.n. Tnnepwta0 y m Lab err. (5 Same as collector Other. •' . �• TO BE COMPLETED BY LABORATORY Sample RecetvinD: Date: 7 q Samoa p 10 h&n ow: L Raavft cut be tnvakeWe Time: 6Q Temp: ❑ as Novy r tr Renata lion. Delivery Method: G Received BY: Co raa' ❑ RUSH SAMPLE Phone 0: Fax #-- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F: .......................................................................................................................... I . . . . . . . . . . . . . . . . . . . pacteriotooical Water Analvels Record: anew.+... .M.e. 1N5 SO �A✓ ff• w f%thora t M..� 99sr SAMPLE COLLECTION: Date: =7 rz ups Mw, 0" Yw 13 Sana Raaotq SAMPLE TYPE: T-433 P-01/01 F-152 200 W. POTTER DR= ANCHORAGE, ALASKA 99518 Tel: 907-562-2343 Fax: 9075815301 tab RM No. 11054217 4�-- t p Sana ttNote @ Routine O Treated Water Two: daPM Pr ww ❑ Repeat Sample ® Untreated Water Location: 0 1 L'/k H Pared. /i. S/ (refer to lab no. 1 Cotlecmr. Tim/ Ho a K _ .�.� 'Jyr.-• - _ ❑ Special Purpose emr n.n. Tnnepwta0 y m Lab err. (5 Same as collector Other. •' . �• TO BE COMPLETED BY LABORATORY Sample RecetvinD: Date: 7 q Samoa p 10 h&n ow: L Raavft cut be tnvakeWe Time: 6Q Temp: ❑ as Novy r tr Renata lion. Delivery Method: G Received BY: Co raa' ❑ RUSH SAMPLE Phone 0: Fax #-- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F: .......................................................................................................................... I . . . . . . . . . . . . . . . . . . . pacteriotooical Water Analvels Record: ewxtpAOEC: UM04WG (PIA) RESULTS: ANC FSK JUN Analrale Basan: 7�L� f" /7%/� Total Coeomt oatarTl"'a' Aatlyat ii E. CSE: Sam b Chant , Anatrtical Matbod: MEMBRANE FILTER RESULTS:��//'' oaed Count Cdaniw/toamL Phoned Q Faxed Q Darolrarw. Membrane Finer verFKa'twc spot. Mft! MMO•MUG (PIA) trrr.. �L1B: eca-Satisfactory { EC: Unsatisfactory 7NTC•T.• M•.r••. p C.yN Date/Tlme: /--nx— /O=Jo a•o.+a..... Reported By: a v. Form s FW. 0053 12117N3 �G9 SCS Re1.N 1053863001 Client Name Flattop Technical Srv. Project Name/a Lt 1,Dk 4, Paradise Valicy S/D Client Sample ID Lt I,Dk 4, Paradise Valley S/D hlatrix Drinking Water Sample Remarks: All Dates/Times are Alaska Standard Time Printed Datelrime 07/07/2005 11.47 Collected Datelrime 06/29/2005 14:35 Received Date/Time 06/29/2005 15:38 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results POL Units hlctlad Container ID Limits Date Date Init Waters Department Nitmic•N 1.59 0.100 Microbiology Laboratory Total Coliform 17 00, No Coli mg/L EPA 300.0 D (<.10) 06/30/05 JJI) col/100mL SM209222D A (<-I) 0629/05 TU MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES i Division of Environmental Services On -Site Services Section P.O. Sox 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 1. GENERAL INFORMATION 2. 3. 4. HAA # '2'CA n 2-) 39 .* Complete legal description Tot 1 Block 4 Paradise Valley Location (site address or directions) 18041 Spain Dr. Anchorage, AK 99516 Property owner Mary M sassara Day phone 243-7775 Mailing address 1964 Loussac Dr., Anchorage, AK 99517 Lending agency Day phone Mailing address Agent Address Day phone Individual on-site X 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 <.y Unless otherwise requested, HAA will be held for pickup. 71 NUMBER OF BEDROOMS: 3 " G G-) TYPE OF WATER SUPPLY: '' c Individual well X ? 1 Community well (D w Public water 5 CD N NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. I TYPE OF WASTEWATER DISPOSAL: Individual on-site X 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. 6. By 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 furtherverify 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. 6. Name of Firm Address 206 E. Fireweed Ln Engineer's signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Phone 272-9336 AK 99503 J / _ Date bedrooms, with the following stipulations: %tJTl(1 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. 1/91) BaCk MOA #21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist G, Legal Description: Lott Block 4 Paradise Valley Parcel I.D.: -Yj 0" A. WELL DATA iY+ Well type Private If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) N Total depth 134 + ft. Sanitary seal (Y/N) Y Date of test Static water level Date completed APPX- 1983 Cased to = 40 + ft FROM WELL LOG _ Casing height (above ground) 24 inches Wires properly protected (Y/N) Y AT INSPECTION 8-5-95 41.5 ft. Well production g.p.m. 2.5 g.p.m. a WATER SAMPLE. RESULTS: Coliform 0 Colonies/ml Nitrate ND(<0.10mg/L) Other bacteria 0 Date of sample: 8-3-95 Collected by: Environmental Management Inc. B SEPTIC/HOLDING TANK DATA Date installed 10-12-83 Tank size 1000 gal Number of Compartments 2 Cleanouts (Y/1) Y Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) N Date of Pumping 8-3-95 Pumper Isaacs PURPing C. ABSORPTION FIELD DATA Date installed 10-12-83 Soil rating (g.p.d.41:2 or ft2/bdrm) 150 System type tXench Length 38 ft. Width 4 ft. Gravel thickness below pipe 6 ft. Total depth 10 ft. Effective absorption area 456 sq ft Monitoring Tube present(Y/N) Y Depression over field (Y/N) N Date of adequacy test 8-5-95 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test (in.); 0 Immediately after 600 gal. water added (in.): 3 Fluid depth 1140 Minutes later: 0 Peroxide treatment (past 12 months) (Y/N) . (in.) Absorption rate = 760 g•p.d. N If yes, give date D. LIFT STATION N/A Date installed Manhole/Access (Y/N) High water alarm level at* C,ycles,tested Size in gallons "Pump on" level at* *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 108 ft. ; On adjacent lots "Pump off' level at* 120 + ft. Absorption field on lot 95 ft.* ; On adjacent lots 120 + ft Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 106 ft. Lift station N/A * Waiver approved in 1987 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 22 ft. Property line 20 + ft. Absorption fief" 2 ft,,� Water main/service line 20 +ft Surface water/drainage N/A Wells on adjacent lots 120 . SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: p Building foundation 32 ft. Water main/service line 20 + Surface water None observed Driveway, parking/vehicle storage ar f i :' 8.5 ft.,; ` Curtain drain N A Wells on adjacent lots 120 + �+ iO�"i Simpson F. ENGINEER'S CERTIFICATIONy fRO..... certify that 1 ha e dete fined t field ' pections and review of Municipal records that the above systems are in conforman e, vi - A H uidel' e in effect on this date.�IE Il/U(G �lwo ae Rr?f i S% �dG Signature r'�p%✓ 73 Engitfeer's Name :.. // �' te.fe 71,E �sTC��s M�Cp�r��cx7�re.La Date D,vo�R zw,,p (-t as�e�V'a,-J To !ate HAA Fee $_ -� 06 Waiver Fee $ Date of Payment /�f ��' S Date of Payment Receipt Number L U� �•—�/ Receipt Number Rev. 8/95 OSS: haa.wk.doc 08/10/95 08:47 COMMERCIAL TEST I I• G � 9072724159 1,10. 104 902 m .- -rs ME Environmental Services Inc. laboratory Division ►.r+.r•►+sii+w CT&E Ref.# 95.3275-1 Laboratory Analysis Report Matrix WATER Client Sample ID Ll ELK4 PARADISE VALLEY oUTSIDZ FAUCET Client Name ENVIp.ONMENTAL M>MT INC tEMI) Ordered .By SIMON Project Name Projsct# 6384 PWSID UA Sample Ramarkr: SAMPLE COLLECTED BY: E.M.I WORK Ozder Printed Date collected Date P.eeei+/rd Date C S N �. rn rn o "' C 5 rn o "' Q U) (DCo m CD1681�p8 08/Nr/95 G 19:58 hrs. 08/03/95 +1' 11:20 hrs. 08/03/95 « 12:00 hra. Technical Director STEPHEN C. ED£ keleased Ey QC Allowable Ext. Anal Parameter Result- Quaff. Un- - - Method Limits; Date Date Init --"----------------'- 08/04/95 CMR Nitrate--fi 0.10 U me `L EPA 353.2 10. .. �.: p.,�--.,........ � �.' _ __-...-- o-.- _ -----�....,........ �............... .... --------------..---- UA . Unavailable See Special Instruction& Above NA . Not Analyzed �• 560 Sample Remarks Above LT - Leas Than LT. Undetected, Reported value is the practical ctuanCiE kation limit. GT - Greater Than p:- Secondary dilutlo.n. 20D W. PottBr Drive, Anchorage, AK 99518-1605 - Tel: (9017) 562.2343 Fax: (907) 561-5301 WEST VIRGINIA ENVIRONMENTAL FACILITIES IN ALASKA, CALIFGRNIA, FLORIDA. ILLINOIS, MARYLAND. MICHIGAN, MIS` OLID NEW JERSEY. UHlil. MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services M� R DIVISION OF ENVIRONMENTAL SERVICES M}.�.�' 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel 1. D. # L Q- 1--11 1 - (Y) HAA # k- ti'�iC)C_-� 1 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mary Sassara Telephone : (home) ';4S -1;()9R Business _97R-g??ca Mailing Address 18041 Rp4in privi=0 .. .c (c) Lending Institution COMMOMVEALTH, MORTGAGE Telephone 278-5229 Mailing Address 3333 Denali, #130, Anchorage, Alaska 99503 (d) Real Estate Company and Agent N/A Address Telephone (e) Mail the HAA to the following address: (or check here IN, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eagle River Loop Road, Suite 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family [N Number of bedrooms 3 3. WATER SUPPLY Individual Well IN Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site 13 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 Z to Z abed NOVO (89/L'Aga)9Z0-ZL -ijoM s,aaeuibua leuoissaload ayl ui suoissiwo ao saoaaa aol alglsuodsaa lou si 96eaoyouy to Allledlolunlnl ayl •penssl sl aleollllaao a aaolaq elep azAleue ao suolloadsui;on puoo lou op SHHG to seeAoldw3 •sluawaalnbaa alels pue lejapal ulelaaoAjsllesolaapao ui suollnlllsul 6ulpual alayl pue sawoy to siaseyoind of Aselinoo a se slyl saop SHHO ayl TNsely 10 alelS ayl ul paa0191691 aaeuibue leuolssaloid luepuedepui ue Aq anoge g ydea6eied ul uaAlb suoileluesaidaa ayl uodn Aluo paseq paleollpeo lenoaddV Allaoylny ylleaH senssi (SHH4) SMAaaS uewnH pue ylleaH to luawlaedap 96eaoyouy to Ailledlolunyi ayl ?zl — h/ lenoaddy leuolllpuoC) to swaal leuolllpuoC)panoaddeslp panoiddy alep Aq swooapaq �E aol panoaddy ,ey'�' \piSS3�OJr'�L� vi 3 v lN.yy Jf;,l1 too y�V�yd y bl0yy`V:Y'+' �y.u� •SVS 'Y 1�®9� � i` a°i1°ys o y �`p�H �e}y!°o-weye � °s° •heyx o nr 0 euoydalal -IVAObddV SHHa '9 ,.�„ e�selV'aanla a16e3 algid _,°tlMNIDNI ;7; ssaippy wall to aweN uolloadsul siyl to alep ayl uo loal{a ui suoileln6ei pue 'seoueulpio 'sapoo alelS pue ledioiunVq lie yllM eouelldwoo ui si welsAs lesodslp aalemelseM ao/pue Alddns aaleM alis-uo ayl 'uolloedsui pue uolle6lls9nul Aw woal pue said a6eaoyouy to Allledlolun" ayl woal pauielgo uoilewao;ui ayl uo paseq leyl LcllaaA aatyl.(nl 1 -ulaaay paleolpui ainlonals to adAl pup swooapaq to aagwnu ayl jol elenbape pug leuollounj 'ales sl welsAs lesodslp aaleMalseM ao/pue Alddns aaleM ails-uo ayl leyl sMotys lenoaddy Allaoylny ylleaH slyl to uolle61lsanul L(w leyl Al!JaA 1 'Molaq uMoys alep uo!lep!IeA ayl }o se pue olaaay pail;le leas Aw Aq pallllaao sy NOIIVWdO:INI ONV VIVO `HOHM 311d `S.LS31 `SN01.L03dSN1 ONIOlAMId WHW ONIH33NION3 '9 MUNICIPALITY OF ANCHORAGE (MOA) • p AsctA09Qth.Authority Approval (HAA) mu SERVICES 00AW KLIST - FEBRUARY 1984 (0 :2-0 - Et•MRo 343-4744 APS 16 19S Legal Description: ISA J'iJ3� i �C L) � i e ti A. WELL DATA 'ir ov Well Classification (i\)q /a FA_ AA1 114 If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) A_ Date Completed Yield Total Depth303t Cased to q� Depth of Grouting Static Water Level 47, Pump Set Aty < �r Casing Height Above Ground Sanitary Seal on Casing (Y/N)_ Electrical Wiring in Conduit (Y/N) y' Depression Around Wellhead (Y/N) A) SEPARATION DISTANCES FROM WELL: y i To Septic/Holding Tank on Lot / Oo' ; On Adjoining Lots l 00 f To Nearest Edge of Absorption Field on Lot On Adjoining Lots / 00 t To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole A)IA r To Nearest Sewer Service Line on Lot Water Sample Collected by Z:� I' ZZ) Water Samole Test Results ALL ; Date !H _ & - I c' r_ , l_ 4__ B. SEPTIC/HOLDING TANK DATA Date Installed / 0 -'/2 -IR Size 10"' No. of Compartments Standpipes (Y/N) 4—Air-tight Caps (Y/N) 4 Foundation Cleanout (Y/N) (— Depression over Tank (Y/N) AI Date Last Pumped 4 " f'( - q() '" Pumping/Maintenance Contact on File (Y/N) rglA ; for AJ/A Holding Tank High -Water Alarm (Y/N) _ Alf/ Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: r / To Water -Supply Well / 00 f To Building Foundation r r To Property Line to f To Disposal Field To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course N rl Comments ri��Dl(G 1'/��JMIp�CI bci A f lgOMC, !Jc:V'UlCeS 72-026 (Rev. 7/88) Front Page.1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �5 �� �� Type of System Design / E'ftoGUI Date Installed J �l 2 >� 3 Length of Field 3 S Width of Field 4 a Depth of Field I �_ Gravel Bed Thickness e Square Feet of Absortion Area q ` 6 0 Statndpipes Present (Y/N) 111 Depression over Field (Y/N) t\% Date of Last Adequacy Test 14 — e9 D Results of Last Adequacy Test !�,18L s f cj_o Jq — 3 ►3 eco ✓OOAA SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well *- q s/ To Property Line To Building Foundation :��9 To Existing or Abandoned System on Lot A)/A ; On Adjoining Lots 30 op + To Water Main/Service Line / O 1" To Cutback (if present) — 6v! To Stream, Pond, Lake, or Major Drainage Course A)/[A To Driveway, Parking Area, or Vehicle Storage Area / 5 Comments -it WALVer gy'ftNlc=a 11f — r I 45e_-lWeeN WC,fl (i4Nd d6 soPm f (oPJ f -�(d. v D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed 5 & F ElUCs1 aax GRiNG Company 17034 Eagle River Loop Road No. 204 Eagle River, aS a Date i4fa 7?D MOA No. C- � =196,n Receipt No. C z/ ��U7 Receipt No. _ Date of Payment Waiver Fee: $ — Amount: $ %Il ULA Date of Payment 72-026 (Rev. 7/68) Back Page 2 of 2 "3 nv.'9�°� n„aaao„w v °i Sl ,ti 6y s a'1n.. S ane v c 11:I b.tiMAop; • s .P�^v a^a.�.�ex 0®p .� Ebert A. She{ve o >_ No. 1457@ a CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 \ FEDERAL TAX ID # 92.0040440 ANALYSIS REPORT BY SAMPLE for Work Order. # 20928 Date Report Printed: APR 10 90 @ 11:35 Client Sample ID:L1, B4 PARADISE VALLEY Client Name S & S ENGR PWSID :UA Client Acct SNSENGP Collected APR 6 90 @ 15:00 his. P.O.# NONE RECEIVED Received APR 6 90 @ 16:20 his. Req # Preserved with :AS REQUIRED Ordered By : R. SHAFER Analysis Completed :APR 9 90 Send Reports to: Laboratory Supervisor :STEPHEN C. EDE - 1)S & S ENGR Released By �' , �C/ 2) ............................................................................................................................... Special Instruct: Chemlab Ref #: 900789 Lab Smpl ID: 1 Matrix: WATER Parameter Tested Re Units Method ------------------------------------------------------ --------------------- NITRATE -N 2.6 mg/1 EPA 353.2 Sample ROUTINE SAMPLE Remarks: SAMPLE COLLECTED BY RDJ. Allowable Limits --------------- 10 1 Tests Performed See Special Instructions Above UA -Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than - r1 � p MUNICIPALITY OF ANCHORAGE " DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ` DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL 4g7_ nn89 r- OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application"Date Jana"y 22, 1987 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) " Lot 1; B.eock 4; Panadi.ae Vattey Subd.iv.l.6.ion Location (address or directions) (b) Applicant Name Ed Fad.nham Telephone: Home , Business 376-4147 Applicant Address United Bank ob A&6ka, 851 Ea6t West Point fti.ve, Suite 101, Wa6iUa. (c) Applicant is (check one): Lending Institution 6; Owner/builder ❑ ; Buyer 0 Other ❑ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) he HAA to the following address: S 9 S ENGINEERING 17034 Eagte R.i.veK Loop Road, Suite ie 204 -Eagte R.iyPl[, AZa6ka 99577 2. - TYPE OF RESIDENCE Single-Familya Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well Community ❑ Public O ., F ' Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status 4. SEWAGE DISPOSAL �. OnsiteU Public O Community 0 ' Molding Tank 17 Note: If community well system, Must have Wnttan confirmation from the State Department of Environmental Conservation attesting to the legality and status F ;=Y u, 7225 (11/84) u Page 1, of 2 5. ENGINEERING FIRM PROVIC ; INSPECTIONS, TESTS, FILE SEARCH, t 'A AND INFORMATION As certified by my seal affixed hereto and as of the validation dateshown below, I verify that my investigation o. its Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 5 a s ENGINEERING Telephone Address 17034 Eagle Rtvw Loop Road No. 204 nim RIYwj Masks 990" Date � — /3 —9,7 AF Or t AW \, fad 6. DHEP APPROVAL Approved for A'1"e'r C3 bedrooms by Ate++ �' e'•n.•� Date Approved Ao-� Disapproved Conditional Terms of Conditional Approval 2- —Irl- CAUTION S$ - CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based wkly upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84). +. J?,Y: i a. ..,r ....., a a..,,: .:.., «, wrw,taJaidV,.r.iu++s:tti(-�:*a'..oSai/k e.n .�.i w. haF. x.,.. ee. A.. gird#'S E,_t:v.au .isa, e,��:� .., 'a;�9ti...•�e"��wx.a ,... r� MUNICIPALITY OF ANCHORAGE (MOA/ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 (� Legal Descriptior� a ...iS. 1/�s�crvM/ A. WELL DATA c Well Classification J F 1f A, B, C, D.E.C. Approved (Y/N)�� Well Log Present (Y&_Date Completed A PA¢.oY• /983 Yield GAM Total Depth Cased to Yc)'-F Depth of Grouting Static Water Level s 3 f Pump Set At L;) , Casing Height Above Ground ZYSanitary Seal on Casing (9?N) Electrical Wiring in Conduit/N) Depression Around Wellhead (Y/P Separation Distances from Well: To Septic/Holding Tank on Lot /ooi� On Adjoining Lots (��Y To Nearest Edge of Absorption Field on Lot 95 ;On Adjoining Lots To Nearest Public Sewer Line Nf To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lott 'S a- 5 C4A4&11`Jd Lti Ll& ; Date Water Sample Collected by �e Water Sample Test Results 5 A -"> )(Z�*� Comments \t1JA!c,L- GokL,D 0,10T 6 gA-r#16Lkj HcPQ. 25 N0 4cCWG�K Lha f5 .-Sli tiCE s5 iNe k-ep. Caq L40 - -e B. SEPTIC/HOLDING TANK DATA Date Installed /O Tz Size /ooD No. of Compartments Standpipes&N) Air -tight Caps (9N) Foundation Cleanout (Y�I Depression over Tank (Y& Date Last Pumped Pumping/Maintenance Contract on File (Y/N) A- ; for Holding Tank High -Water Alarm (Y/N) N Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well 1-4 To Property Line /c f To Water Main/Ser vi a Line (af f Course Comments Page 1 of 2 72-026(11/84) To Building Foundation To Disposal Field Z To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA „� r Soils Rating in Ahenrntinn Strata SO 4�1 b)e Date Installed lellzz83 Length of Field 3e' Width of Field `�$ r' Depth of Field /U� Gravel Bed Thickness v' Square Feet of Absorption Area Standpipes Present C1 I) Depression over Field (Y& Results of Last Adequacy Test Date of Last Adequacy Test Z Z f3% SA i/5oc7Ac-t-oz-% 3 6312 Separation Distance from Absorption Field: ✓ 1'C 5 � Ualvw To Water -Supply Well % To Property Line To Building Foundation LS �i- Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Store Area Comments u2JL f't.,,� G D. LIFT STATION Date Installed On Adjoining Lots i To Existing or Abandoned System on 'U `4 To Cutbank (if present) l S' Dimensions N/14 Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. SiAhS ENGINEERING Read No. 204 Date 2 ^ 3- 17034 Eagle Fdyw LOOP Coff6%" I"r,Alasks99'S77 MOA No. R'0— Oo3 Receipt No. /OU �^ (:51do Date of Payment �I Amount: $ A)6` 00 d aA cc)3r`,1I� �8&i 1, 1133 4 Page 2 of 2 NOISIAIp SDIA 3OV4ONJS 1V1N3"91AN2 72-026 (11/84) NV 3O,t1I)VdIDINtlW !__\1 Municipality of Anchorage February 24, 1987 P.O. BOX 196650 ANCHORAGE, ALASKA 99519-6650 (907)264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Robert A. Shafer, P.E. S&S Engineering 17034 Eagle River Loop Road, No.204 Eagle River, Alaska 99577 Subject: Lot 1 Block 4 Paradise Valley Subdivision Waiver Request WR87-019 Dear Mr. Shafer: Your request for a waiver of the 100 foot separation required between the absorption field and well on the subject lot has been granted. This distance has been waived to 95 feet. This waiver is based on your assessment that there is no possibility of well contamination resulting from the absorption field's proximity to the well. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services 0 HEALTH AUTHORITY APPROVALS S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577, Febnuany 13, 1987 Munic.i,patity ob Anchorage Depax.tment of Hea.tth and Human Se vices 825 L StAee# SEWER &WATER Anchorage, Alaska 99501 MAIN EXTENSIONS TTENTION: Steve Morr.Ls ROBERT A.SHAFER CIVIL ENGINEER 694-2979 PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN EAGLE RIVER, ALASKA 99577 REFERENCE: Lot 1; B.tock 4; Paradise Va,ttey SEWER &WATER INSPECTION pi[../.� Request you approve the attached Heatth Authortity Appnova,t app�(cati on and grant a waiver to .the hor.izontat sepanatiwon distance between the pnLvdte:wett and `.thC a63anj tibh atea. a. 9 < ee A weft .dog eoutd not be obtained 4or the weft on this property. The weft dndt.ten has gone ENGINEERING STUDIES out ob business and cou.td not be .toeated. For purposes o4 obtaining AND REPORTS a %i,6k ana,tysis we used the we.tt .tog on the adjoining .tot. In accordance with our anatysiz there .is no poss.ib.itity o4 contamination ob this we.tt 4rom the on-site wastewater disposa.t system. WELLINSPECTION &FLOW TEST Attached bon your nev,iew .is a copy os our risk ana,tysiz wokk sheet and a p.tot plan showing the utative .tocation o$ the Saciti.ties constructed on this property. SITE PLANS It .is aur opinion that the hor.izontat separation distances presc,%ibed .in 18AAC72.021 ane not necessary .in this case. IJ we may be ob 4urther senv.iee, p.tease contact us. ROAD DESIGN Sine.ty, SOILTEST A. SHAFER, P.E. PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN EAGLE RIVER, ALASKA 99577 F x m N 3 Ir J laz Z, ?.a a NJ 0 r r �\JU u , a A. ILL j 31yos. 1 Inh Y 4 f ® N X x U n,., 5 ppi� S i V ;IAF F x m N 3 Ir J laz Z, ?.a a NJ 0 r r �\JU u , a A. ILL j 31yos. 1 Inh S & S ENGINEERING 17034 Eagle River Loop Rood MCINUTATION SHEET Eagle River, Alaska 99677 SUBJECT - Lq k , i , �L i _ DATE: SHEET OF BY CKD I MUNICIPALIIF G AVCtiOh.. li DEPARTMENT OF HEALTH AXD HUXAN SE.RVICGS WAIVER REV".W 'ACRP:SHEEI' ����� ' ii�d II DATE RECEMD: ENGINEER: I GAG ERiVU,AK 99W I APPLICANT.s.,,, �7L1•IT' f.-o. .L2L`__L�.�L_�Y.._ __ TJ WAIVER REQUESTED: I'�bNl_�� �,✓�ct_ (I��' �' ..II ' k CRITHRIAs I I) Geology: f' A. Water Table S. Soil Sorption /.o C. Permeability" � 5 D. Water table-Gradient E. Horizontal Separation 2 TOTAL: /(o. 2) Special Conditions: 3) Otbart h WAIVER'IS: granted, with conditic;vs iiated below: not granted for reasons lisred 'below: i' , DAM `:AME'- - p. } n v