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PARADISE VALLEY BLK 5 LT 6
Paradise Valley Block 5 Lot 6 #020-412-13 • MUNICIPALITY OF ANCHORAGE ` ,..— , r �ti„ nt / • \ On-Site Water & Wastewater Program �, '} Soh PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http:/Iwww.muni.org/onsite 3 er„rtrnynt 4 ' 0KAVE On-Site Wastewater Disposal System Permit Permit Number: OSP191164 Effective Date: 8/1/2019 Work Type: SepticTank Upgrade Expiration Date: 7/31/2020 Tax Code Number: 02041213000 Site Legal Address: PARADISE VALLEY BLK 5 LT 6 G:3538 Site Mailing Address: 6510 SWITZERLAND DR, Anchorage Owner: REISHUS ANTHONY M & DAWN K Lot Size in Sq Ft: 25582 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: eV 2- 1 Issued By: /�(�'rir_A. "Lc& r!� Date: a �1 7 • MUNICIPALITY OF ANCHORAGE ( • L) Development Services Department `_ _�� Phone: 907-343-7904 On-Site Water & Wastewater Section \ Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 02041213 Property owner(s) ANTHONY & DAWN REISHUS Day phone Mailing address 6510 SWITZERLAND DR Site address SAME Legal description (Sub'd., Block & Lot) PARADISE VALLEY BLK 5 LT 6 Legal description (Township, Range & Section) Lot Size 25,582 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank El Upgrade C Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple D . - • ❑ Privy CI (SF _- ,,r 6 7 9 if 9 Private Well CI Q.* ., o Water Storage II) Q qp,p •- N OZ0/9 2 THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: o�6 • a isr .f , . ti I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 0/4- (Signature of property owner or authorized agent) Permit/Rush Fees: .g5 Waiver Fees: Date of Payment: 571/i9 Date of Payment: Receipt Number: 11-10225. Receipt Number: Permit No. 05Pfimpy Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc April 29,2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage,Alaska 99519-6650 Fax 249-7847 Re: New Septic tank permit Legal: PARADISE VALLEY BLK 5 LT 6 To Whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. Sincerely mw Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 4 S - ITZERLAN �- 1 !53 3 Z - b_f___ , Ant -/ f----- --- ti r /r 5° 1i ,..:7 ,,,,,, OC f . s1 po .. �f , ' 1 r ` 1 , i \` m \ I \, I . \ ‘----......„.____I Z Co G wh^tr, r vet o it cc co o , H a, - . „ w .1 s 4 � 44, Lai / J n ��'‘43S" fr � 1 'ew h •v t-ds 6 v IR I ,co.�4� N p c< fr -: i-(`toMvA 4(I 0••C4, `�7,e\off 41,4 YoPtoy �S , PtO .. A( .l -____J i*.:49TH r 41 0 "1 .* it/ /p a A(. y �-� r -ek,4)/0 0 4 i 0 {,on(tii oto 9 a)1nh MICHAEL N. ANDERSON 3 �' /e��•. C -219149? �1iPRQFESSIO`�a�= �� w ` �l _t+�+-i- ctiOP o �000pp�G --- 1 17 "A p 11 r} `/0" LIIll , 5EN�N o. E ��Z 62 -4.- 1 -- N 76 31, 2 IhilLti - Q � AS-BUILT SURVEY 1° =20' VII5% 'SHA• NE A. HOLT.1rvg No coRNERS SET THIS DATE �nt" '•.La{'-6914.•'• n�� . - ,...,,>42-2.,:/ I HEREBY CERTIFY THAT I HAVE PERFORMED A SURV( V �A • PrQ� OF THE FOLLOWING DESCRIBED PROPERTY ���ROFessror>I�•►-�c LOT 6, BLOCK S, PARADISE VALLEY ( PLAT 87-16) ��•- . 7' ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAI VISIBLE IMPROVEMENTS SITUATED THEREON ARE WTI- . THE PROPERTY LINES AND NO VISIBLE ENCROACHMEN1 THE INFORMATION HEREON IS FOR THE USE OF LENbTNGINSTITUTIONS SPECIFICALLY TO SNOW ANY EXIST OTHER THAN NOTED. CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS:ANI>IS RAT GO 4T ANC4.1 IMG64L.ALIC . THEA 3&TH I NOT TO BE USED FOR P05111 ONING ADDITAL LONSTRUCTURES,IMPROVEMENTS,OR FENCELINES. _ EASEMENTS OF RECORD,OTHER THAN THOSE APPEARING ON THE RECORD PLAT,ARE NOT SHOWN _JUNE ,, 2013. HEREON(UNLESS INDICATED) NOTE: FENCELINE5 THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERAhNE HOLT LAN PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. 600 HIGH' ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO OCCESSIVE SNOW AND/OR ICE. ANCHORA 345-55L MUNICIPALITY -OP ANCHORAGE p DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet -Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME / // / c, 0 L&-` L0. ' 'A04-'7 J AJ^So PHONE E:1 NEW UPGRADE MAILING ADDRESS 'r� i til G 76/�J _.6 1c'A' f y�tso� V $P. LEGAL DESCRIPTION J� 7 f"scs-+_drs2 Vnlfe lot- 6 LOCATION iU I 42ie NO. OF BEDROOMS p '4v 3 6Y Uyi DISTANCE TO: Well Absorption area Dwelling PERMIT NO. F- Z n. Q wF Manufacturer Material No. of compartments W Liq. capacity in gallons IF HOMEMADE: In ide length Width Liquid depth Y J C7Z DISTANCE TO: Well Dwelling PERMIT N0. 2 Z F Manufacturer - - Material Liquid capacity in gallons w=vim DISTANCE T0: Well O�'t, Foundation Nearest I18ef PERMIT �®6 J Z w F _ No. of lines ` Length of each ine '� Total length f lines 6 Trench widtj `j inches Distance between lines ¢ f p Top of tile to finish grade A Material beneath tile inches Total effective absorptiopyaiea '� '6 1IJJ , w Length Width Depth PERMIT NO. 0 Q F w° Type of crib Crib diameter Crib depth Total effective absorption area WWell DISTANCE TO: Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE T0: Building foundation Sewer line Septic tank Absorption areas) OTHER a PIPE MATERIALS Pec- SOIL TEST RATING r i Z,5- 0 /h INSTALLER (� REMARKS aaari- ST 8 02 2 n ,ilrvl«�i:,� w+ss ,/* aver e *- r_ APPROVED DATE LEGAL jV/7 5 ?,Y)9,tr>cmt7�e Vthe% '`f- e 410 72-01'3 (Rev. 3/78) I�ILJN I l=: I R_ L� I _r ke (3 V F-1 t-4 y-lj�Z F-1 17A F7 bEPARTMENT 017,1EALTH, AND ENYIRONMENTAL ECTION 825 ANCHORAGE, AK 995EDl 264-4720 PERMIT NO: 840506 -HAND WRITTEN tr DATE ISSUED: 05/205/84 APPLICANT: C/O LARRY EATON JOHN SA S' ADDRESS: 1101 E 76TH - B ANCHORAGE, AK 99502 LEGAL DESCRIP: SUBDIVISION: PARADISE VALLEY LOT: 6. SECTION: li TOWNSHIP: ilN RANGE: 3W LOT SIZE: 20C100 (SO. FT. OR ACRES) BLOCK: 5 I CERTIFY THAT: 1. 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS As SET FORTH BY THE MUNICIPALITY'OF ANCHORAGE 4MOA) AND THE STATE OF ALASKA. 2. 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOR CODES AND REGULATIONS, AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. I WILL ADHERE TO ALL MOR AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY EXISTING WELL, WASTEWATER D15POSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES. - THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; ".*2) AS-BUILTS .WILL,NOT EE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT: ANDS (3) THE ELECTRICALWOPIK" ST BqE BY A LICENSED ELECTRICIAN. SIGNED E DO DATE: -------- ------------ -- APO'L I CANT �,/�AR ISSUED BY: &/a 6 ----------------- DATE ------- - /f 17-o 49W 2,91 27 re -p4 • �' SOI LS LOG MUNICIPALITY OF ANCHORAGE yr DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATIION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 14L" -/-q DATE PERFORMED: LEGAL DESCRIPTION: / G°l F li2k��-fes57O�741p ���if' �—, SLOPE SITE PLAN 2 1 Gross Time Net Time 3 Net Drop 4- 5- 5 6- 67 7 ' 8- 9- 910 10- 11 11 12 13 14--��[ 00 15 n#1 16- 17 18 19 va-Al pt 1,ce a%a7 i rax ✓@ l Some smad S"14 ,se.,Lms Ae v ",14 `herr- 1ooS✓erl�� 1'a'1t'G.�i 57 pe,-Acf p-nve-1 WAS GROUND WATER y L ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? .&�- s0le Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS 2 1 v..:. S1ij4 r j' -cg, ) f 17 11,4 7�v `iC �'s yrs .� 1� t-aI ecl A PERFORMED BY: lz:>A�C- Jy Yi CERTIFIED BY: DATE: 72-008 (6/79) / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME Tadda Associates Inc. PHONE 344-8261 ®NEW ❑UPGRADE MAILING ADDRESS SRA Box 440X LEGAL DESCRIPTION Lot 6 Blk 5 Paradise Valley LOCATION Golden View Switzerland NO. OF BEDROOMS 3 DISTANCE TO: Well - 128' Absorption area 8' Dwelling 10.5 PERMIT NO. 780704 Y EZ Q W F Manufacturer Greer Tank Material Steel No. of compartments 2 y Liq. capacity in gallons 1 000 IF HOMEMADE: Inside length Width Liquid depth OJ a Z DISTANCE TO: Well Dwelling PERMIT NO, O Z F Manufacturer Material Liquid capacity in gallons O = DISTANCE TO: Well 149' Foundation 12' Nearest lot line 25' PERMIT NO. 780704 w WLL V Fz w No. of lines 1 Length of c line 4 r Total le Ih of lines wr� t Trench width 36 inches Distance between lines ----- p Top of tile to finish grade 31 Material beneath tile 48 inches - Total effective absorption area 32 W Length 'Width - Depth PERMIT NO. IL H Lu Type of crib Crib diameter Crib depth Total effective absorption area W CO) DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller - Distance tc lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS Cast iron and plastic SOIL TEST RATING 100 sq. ft./per bedroom INSTALLER Tadda & Associates Inc. D S REMARKS G ANCHORAGE 4 DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION UG 2'7 RECEIVED Q hV 60 APPROVED DATE LEGAL . Pc, —eh 6-T* Seo c &- 5, / a,401SI VAUXX 72-013 (Rev. 3/78) December 29, 1978 #780704 Tadda Associates, Inc. Star Route A Box 440K Anchorage, Alaska 99502 Subject: Lot 6 Block 5 Paradise Valley Subdivision A permit issued by this department for well and/or sewer system has expired. 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 should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/ljw enc: copy of permit | � � ' U r -J 1: (::� l f--1 L_ 1~F F::.." C.3 IfE-, DEPHRTMENT f�LTH^AND �NVJRONMENTHL / xTECTION ��[�8/6> , 825 'L ��TREET, ANCHORAGE'., �K� ���... �/bP_t4~ ' ~' 264~4720 t-4 E`-.. F-1 CH ("D r-4 ....... �i T' E_ 1,4 1E.". �1 "T 7�0704 ) ]44 TH0}H ASSOCIATES INC SRH BOX 440 X 8261 LOCATION GOLDEN VIEW HND LEGHL L 6 E) 5 PRRH[4.jISE VALLEY S.D LOT SQUARE FEET TYPE QF SOIL HBSORBTION SYSTEM IS: TRENCH MAXIMUM MUMBER OF BEDRQOMS = � SOIL RHTINQ THE REQUIRED SIZE OF THE ABSORPTION SYSTEM ��0-A ��r-j "'o-, I -A L_ U�'> JE -Er"' 1- 0- A= � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS. THE DISTANCE BETWEEN THE SU�FACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IW FEET). THERE IS NO SET WIDTH FQR TRENCHES, THE �����EL DEPTH IS TH� MINIMi/� �EPTH OF GRHV�L BETWEEN THE �UTFHLL PIPE HND THE BOTTOM OF THE EXCAVATION (IW FEET). ���C_o l[`.H'. F'� "T" T. (Z7 �F-4 P -A �����1?...o� PERMIT APPLICHNT HAS THE RESP�NSIGILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY HND THE NUMB,ER OF RESIDENCE, THAT THE WELL WILL SERVE. IF������� ��I—'. �F: ICA U.9 F:�: LE� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION HND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTHNCE BETWED4 H WELL AND ANY ON—SITE SEWAGE DISPOSHL SYSTEM I� 100 FEET FOR H PRIVATE WELL/ OR 15Q.1 TO 200 FEET FROM H PUBLIC WELL UPON THE TYPE OF PUBLIC WELL WELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION. OTHER �EQUIREMENTS MAY SPEC IFICATI ONS HNL) CONsTr;,UCTJ.ON DIHGRHMS HRE AVAILABLE TO INSURE PROPER INSTALLATION. ���Irl 1 7" ������F.'.- 1-7:,p I CERTIFYTHRT 1: I HM FAMILIAR 14ITH THE RE-.QUIREMENTS FOR, ON SITE SEWERS AND WELLS HS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALLT1 tri, S STEM IN ACCORDANCE WITH THE CODES, ]� I DE EWER SYSTEM MW? REQUIRE ENLHRGE�ENT 'IF:' THE RESIDENCE��� �M1321-1-El> �� I�MORE THAN ] BEDROOMS. SI8NED: TES INC Iii li C11-7,ittuCtior' "Ont test it U. -'A a then+and r i:r.h.MS - 2204 Cleveland Anchorage, Alaska 99503 Performed For Tadda & Assoc. Inc. Date Performed 8/3/7s Legal Oescrintion: Lot h_Block 5 Subdivision Percolation Test This Form Reports Soils Logyes - - tenth Feet Soil Characteristics Peat / Reddish Silt - 2 — 4 Brown Sandy Gravel 12 — BOH 14- 16- 18- 20— Was 4-16- 18- 20— Was C -round Water Encountered?_4j,_ If Yes, At what Depth? Readinq I Date I Gross Time 00, \-04 bo I Ica MFO Net Time Depth to H2O Net Dronj Percolation Rate _Minute Proposed Installation: Seenaae Pit_ Drain Field_ — Depth To Bottom Of Pit Or Trench Deoth of Inlet.—_ cf)mVENTS: loo sq. Fr drainage Test Performed By Data Certified 8y:roz sr..TTp,;t- lab Date: — MUNICIPALITY O ANCHORAGE WELL CONSTRUCTION LOG DEPT E . <:; NVI RO Nn f t t (' I, , , 'CTION Drilling Co. USGS no, q J Driller Type off rig C( le, IIJU� Date well co p�e�ed 1 )� — ( '] R Well owner C )l} Nearest cRm�hyPt m Well location: (address & legal description)_ -04 ( / o Alk --�7 ]� ` a i tch or remarks _P0.r0'd1f_-�.e Ira.'Ae_u Depth of wellbi Casing: d J h It. diam. ' it i_n�, p Static water level It. (ice below) land surface. Dated O Finish of well: (open-end, screen, perforated, open -hole, other) Describe intervals and size: Well yield tested by (pumping, bailing, air) at gal/min. for hours with ft. of drawdown from static level. DRILLER'S MATERIAL LOG `$cu led duan & reeOueX Depth below surface in land feet Give description of strata penetrated (size of material, color, hardness of drilling, and water content) �to ' NA C C anto 150 —to- 15mmae- -to- dam to to to to to to to tc to to to to to to to to to to to Parcel I.D. 020-412-13 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: Complete legal description PARADISE VALLEY BLK 5 LOT 6 Location (site address) 6510 SWITZERLAND DR., ANCHORAGE, AK 99516 Current Property owner(s) JOHN MCDANIEL Mailing address Real Estate Agent :� 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 345-3736 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Fx I Individual I -XI Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: NONE Distance: --- Received by: :y I ' .+ Date: COSA to be released to the eng Leer, unless otherwise requested by the engineer. COSA Fee $ —` 01 C> f 2JWaiver Fee $ Date of Payment � / � 13 /� �� Date of Payment Receipt Number (D l I (P � Receipt Number COSA # G S C_ 4 313 0) Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, f verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems 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 SPURKLAND ENGINEERING Phone 279-3916 Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND Date 6/20/13 AC�1S� ro 9 6. DSD SIGNATURE � � 4 T � . • _ • •�;/ _LZ System #1 Approved for bedrooms 0 J/r� i System #2 Approved for bedrooms �I s E. SPURKtAND_4 ' Y Pp %tom'• it 0 ;C i Disapproved �� rd.�'• P� 1\OFESS10C1` Conditional approval for bedrooms, with the following stipp�tfaus��� By: G Original Certificate Date: Th uni ipalit�of orichorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r - � - If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: PARADISE VALLEY BLK 5 LOT 6 A. WELL DATA Well type PRI If A, B, or C provide PWSID # Date completed 11/16/78 Sanitary seal (Y/N) Y Total depth 150 ft Cased to 28 ft. FROM WELL LOG Date of test 11/16/78 Static water level 45 Well production 1.5 WATER SAMPLE RESULTS ft. Coliform NEG colonies/100 mL Nitrate 5.68 mg/L Arsenic ND ug/L Date of sample: 6/3/13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Parcel ID: 020-412-13 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) +12 in. AT INSPECTION 5/7/13 <24 t 2a7 L• � ft. 1.5 g.p.m. Collected by: ANSON MOXNESS Date installed 8/25/81 Tank size 1000 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 Date of pumping 5/15/13 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA Date installed 8/25/81 Soil rating (g.p.d./ft2 or ft2/bdrm) 100 System type DEEP TRENCI Length 41 +26 ft. Width 3 ft. Gravel below pipe 4 & 5.5 ft Total depth 10 ft. Eff. absorption area 614 fe Monitoring tube Y_ Depression over field N Date of adequacy test 5/7113 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 19 in. Water added 450 gal. New depth 48 in. Elapsed Time: 70 min. Final fluid depth 15 in. Absorption rate >= 450 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO If yes, give date D. LIFT STATION Date installed Size in gallons - "Pump on" level at in. "Pump off' level at - Datum E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot >100, Absorption field on lot >100' Public sewer main NA Sewer /septic service line >1W 25 r Manhole/Access(Y/N) -- in. in. High water alarm level at -- Meets Meets alarm & circuit requirements? On adjacent lots >100, On adjacent lots >100' Public sewer manhole/cleanout NA Holding tank NA Animal containment areas >50Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >51Property line >5 Absorption field >5 Water main >10 Water service line >10 Surface water >100- (N.O.) Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: >10' >10, >10, Property line Building foundation Water main Water Service line >10' Curtain drain >50' (N.O.) F. COMMENTS G. ENGINEER'S CERTIFICATION >100' (N.O.) >10' Surface water Driveway, parking/vehicle storage _ Wells on adjacent lots >100, l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name LARS SPURKLAND Date �IzI 1 j COSA brown sheet 10-10-12.doc E.O.A9st11 A,! 1 r .. 10 . .. X L S. SP1pUnKLAND15kk: 1 CD •h��r in. Municipality of Anchorage ' Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 131301 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 5, Lot 6 of Paradise Valley subdivision. This inspection revealed a nitrate concentration of 5.68 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH &HUMAN SERVICES Division of Environmental Services co 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 l.D.# y1a - 13 V HAA# UQ9IU)) 9c1 1. GENERAL INFORMATION L Complete legal description Lo Location (site address or directions) -r> aw-1 Property owner F:_avtKe� 14 aQ Day phone Mailing address Lending agency Day phone Mailing address Agent 50 rfnC11 �pD4-4 JA4,^t-'L Day phone c2 -y9— 9�1D Address Hca I ►�/ �n.ri�•� _ �'wi Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well 1z Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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. p Name of Firm �"( �p r Phone Address Engineer's signature 6. DH S SIGNATURE Approved for Z�) bedrooms. By: Date Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date /?Z' .,7 9—.73 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 order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �.� � �X �� PawParcel I.D. Y / z A. WELL DATA Well type 1R If A, B, or C, attach ADEC letter. ADEC water system number / N/A - Log present (Y/N) \ Date completed ft" 1 ` 7ze? Driller V-wh Total depth I S O Cased to 02 AS Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION MUNIC'?A!.ITY ^F ANCHORAGE Date of test it . 1 b ' i aR j* - I `4 - 4 -14VIRONMENTAL SER\ K -ES DIVISION Static water level 145 Well flow 9•10•m Pump level SEPARATION DISTANCES FROM WELL TO: 1 1993 o MIVED 1 W� Septic/holding tank on lot I ; On adjacent lots > 15-0 Absorption field on lot i I a ; On adjacent lots 7 I Public sewer main NSA Public sewer manhole/cleanout nZA Sewer service line z' � Petroleum tank N1 WATER SAMPLE RESULTS: Coliform Nitrate 3.2"?" 'I`ila3 Collected b Date of sample: Y: B. SEPTIC/HOLDING TANK DATA Date installed (95r4 / Tank size 1 Other bacteria Compartments °Z Cleanouts (Y/N) X Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) N�A Alarm( tested (Y/N) Date of pumping �/b(93 Pumper r!�d�srS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I a On adjacent lots > /,17c) Foundation 1 `j To property line -Absorption field Water main/service line 4-0 Surface water/drainage N 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) NnNc High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water _ Date installed g/�/b'/ L -72s/B�% Soil rating System type cA Length off -(e 4 y j Width 3 Gravel thickness Al.'?- ✓ ,!F Total depth fD Total absorption area - �-�j Cleanouts present (Y/N)%/ Depression over field (Y/N) Date of adequacy test L11l 1 9 3 Results (pass/fail) for 5 bedrooms Peroxide treatment (past 12 months) (Y/N) N. If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot a y On adjacent lots ? / J D Property line 10 + To building foundation �2 To existing or abandoned system on lot ' `I /A On adjacent lots % sy Cutbank N 0 11-L Water main/service line D Surface water N �IC7 Driveway, parking/vehicle storage area Curtain drain l E. ENGINEER'S CERTIFICATION l certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature _ p i Engineer's Name H Jp u f V,La.1,t� 7� Date A,9jtA C �, 3 O HAA Fee $ Waiver Fee: $ Date of Payment �-�` Date of Payment Receipt Number �%� 7 0� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 13 STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343 FAX: (907) 561-5301 Chemlab Ref .# :93.1567-1 REPORT of ANALYSIS Client Sample ID :6/5 PARADISE VALLEY Matrix : WATER Client Name :TOBBEN SPURELAND, P.E. Ordered By Project Name Project# PWSID :UA Sample ROUTINE SAMPLE COLLECTED BY: STUART. Remarks: QC Parameter Results Qual. Units NITRATE -N C-7/1 mg/1 Collected :04/14/93 @ 14:00 hxs. Received :04/14/93 @ 16:20 his. WORE Order :64943 Report Completed :04/19/93 Technical Director :STEPHEN Released By Allowable Method Limits --------------------------- EPA 353.2/300.0 10 Extract Analysis Date Date Init ------------------------ 04/16/93 LLH --------------------------------------------------------------------------------------------------------------------- ' See Special Instructions Above UA - Unavailable See Sample Remarks Above NA - Not Analyzed U - Undetected, Reported value is the practical quantification limit. LT - Less Than D - Secondary dilution. GT - Greater Than r22� SE3S Member of the SGS Group (Soci(5te Generale de Surveillance) MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M y Division of Environmental Services N= 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. # U—qzz _/ 2 1. GENERAL INFORMATION HAA # A--_',]�f �Z DS Complete legal description La.t G; Block 5: Panad ize VaUe.y Subdivision, Location (site address or directions) 6570 Switzen2and Property owner John & Cano.te Qaen Day phone Mailing address Lending agency Day phone Mailing address Agent Manu Minden MARSTUN REAL ESTATE Day phone 248-2804 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX 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 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. Name of FirmPhone ........,:.__.,.,. Address River Loop Road No. 204 �_aaia izver, as Engineer's signature 6. DHHS SIGNATURE _X_ Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Date bedrooms, with the following stipulations: By: _30k- SM ice+ Date 7 =LITlr 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 order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: gadtSP 041Iey Parcel I.D. ©Z16-eIZZ--15 A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number —J8_ Log present (Y/N) 1i Date completed,! 1�1 �_ Driller t Total depth Cased to Z rN o asing height / Sanitary seal (Y/N) I • Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level I Well flow g•p•m• Pump level V n AT INSPECTION s-�31-`fl z SEPARATION DISTANCES FROM WELL TO: r Septic/holding tank on lot y ; On adjacent lots f n _M M U Absorption field on lot / `� ; On adjacent lots Public sewer main Ai�<q Public sewer manhole/cleanout /J/A Public sewer service line L4 Petroleum tank r1 oA)C "owN r_ C r f r-� co WATER SAMPLE RESULTS: Coliform Nitrate sTArt4 Otherbacteria Zd;r0 Date of sample: _ - r1 Collected by: —� 'd `� EtJ0J e&e11 5 B. SEPTIC/HOLDING TANK DATA Date installed / e I Tank size 100C I Compartments Cleanouts (Y/N) 9 Foundation cleanout (Y/N) Depression (Y/N) 1J High water alarm (Y/N) �C,� /1 Alarm tested (Y/N) t Date of pumping �� `Z�l — I ' r -I + Me, �SetrJIc(3-S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 114 c) On adjacent lots!! n 0 1 Foundation 19 To property line Z Z Absorption field >-Water main/service line n Surface water/drainage /00 fi -X— fgecA sured -�row� C. O• 72-026 (Rev. 3/91)Front MOA 21. CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level Manufacturer Manhole/Access (Y/N) "Pum"n" level at "Pump off' level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STA Well on lot D. ABSORPTION FIELD DATA On adjacent lots Cycles tested Surface water Date installed B L A Soil rating 100 System type 1&QCrJc.he S Length 4 l r � 2 (o Width ?,)(a Gravel thickness 4 + (a fo Total depth 7 o'z Total absorption area (.0 144, �Qt41 Cleanouts present (Y/N) Depression over field (Y/N) IJ Date of adequacy test Results (pass/fail) D A S5 for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) t4 A If yes, give date /i/A SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot f � D On adjacent lots / On f Property line To building foundation Z To existing or abandoned system on lot f On adjacent lots 3 0 f Cutbank &211 A Water main/service line (O + i r Surface water / bO f Driveway, parking/vehicle storage area I t7 Curtain drain A) [A McrA!SJ 'ed fV oi4A t�tentpCt�r(�`a E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. :Ed.�wa'aw� Signature ' i ASN... V"'[ (9 Engineer's Iqt&HJb River, Alaska 99577 Date ;=m� � `S!;ectcn s r,= HAA Fee $—� 7 Q Waiver Fee: $ Date of Payment y Date of Payment Receipt Number "� �o �v �23 Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING LABORATORY 9C 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS REPORT BY SAMPLE for WOREorder# 34677 Date Report Printed: NAY 31 91 A 16:15 Client Sample ID:L6 B5 PARADISE VALLEY Client Name :S Sc S ENGIRMINU PWSID :UA Client Acct :SNSENGP Collected MAY 29 91 4 14:10 bra. BPO # PO # NONE RECEIVED Received MAY 30 91 E 14:45 hre. Req # Preserved with :AS REQUIRED Ordered By :R. SHAFER Analysis Completed :MAY 31 91 Send Reports to: Laboratory Supexv�s r HEN C. EDE 1)S & S ENGINEERING Released By Y7 2) .................................................................................................................................... Chemlab Ref #: 912342 Lab Smpl ID: 3 Parameter Tested ------------------- NITRATE-N Sample ROUTINE SAMPLE COLLECTED BY: R.D.J. Remarks: Matrix: WATER Result Units Method ------------------------------- 3.5 mg/l EPA 353.2 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 O MUNICIPALITY OF ANCHORAGE DIVISION OF OMRM004TAL HEALTH DEPARMW OF.i]AL.TH AND ENVIRONMENTAL PROTECTION APPLICATIC FOR HEALTH AUTHORITY APPROVAL CERTIFICKTE i. General Information Application Date (a) Legal rascriptian (in��luop lot, blt�c, Subdivision, section, township, range) r�nrl /-f/ -pro 1//9 1/to(/ P e t /_ Location (address or directions) (b) Applicants Name Applicants Address IJ Te (c) Applicant is (check Lending Institution ; Owrer/buildgr ; Buyer ; Other (explain) (d) Lending Institution Telephone Address (e) Real Estate Cc. s Agent zefrpn'y Address Telephone ` 76 TI 2. Type of Residence Single -Family Multi -Family r:j Other (describe) Number of Bedrooms 3 3. Water Suppl Individual Well Community r_:j Public Note: If ocamnity well system, mast have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedroc m specified in this HAA (Y ) 4. Sewage Disposal Onsite Public Community Holding Tank Is the wastewater disposal system adequate for the number of bedrooms ( ) [Page 1 of 21 2-15-84 5. Engineering Firm Providing Inspections, 'Tests, Data and Information I certify that I have checked, verified, or conformed to all NDA HAA Guideli effect on the date of this inspection. Signed Name of Date Address A;ADD Z] � sew T ee77 d r `cwez -' frig/zuF Signed byOF Al `c Date� `� w� p p.p.0a ppb c v fyf p �® os �jb.a eF,!1� •�e�mp,a Gy :a (ENGINEER SEAL) 6.DHEP Approval Approved for bedroca s Approved Disapproved Terms of Conditional Approval .a e V, Lero .Reid, 1r. "gyp Op ®� ,?orr:ss�m>f B*onditional �.. Date The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that/ as of the validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedroca o and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s (Page 2 of 21 2-15-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST — FEBRUARY 1984 A. WELL DATA Legal Description: Q f, e A Well Classificationf6I If A, B, cr C, D.E.C. Approved(YM) Well Log Present Y N) Date Completed /1� Yield d_ t n,rZ> el Total Depth Cased to 0`28 f Depth of Grouting N�A Static Water Level Pump Set At_jjz � Casing Height Above Ground,�;y,,�� )_ ,176-1 Sanitary Seal on Casing OYNi Electrical Wiring in Conduit Depression Around Wellhead (YAV Separation Distances frau Well: To Septic/Holding Tank on Lot T[S/0 ; On Adjoining Lots �►/OD To Nearest Edge of Absorption Field on Lot On Adjoining Lots x-1 To Nearest Public Sewer Line AJ A-- To Nearest Public Sewer Cleanout/Manhole ATo Nearest Sewer Service Line on Lot Water Sample Collected By Date eI25�,��5 Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed _ `a b/ _ Size No. of Ccapartments Standpipes 6Air-tight Caps Y ) Foundation Cleanout Depression over Tank (Y Date Last Pumped Pumping/Maintenance Contract on File (Y ) for Holding Tank High -Water Alarm (YM) NTemporary Holding Tank Permit (XM) Separation Distances from Septic/Holding Tank: i To Water -Supply M11 1 �(— To Building Foundation To Property Line 2-7- s*. To Disposal Field To Water Main/Service Line JJ O To Stream, Pond, Lake, or Major Drainage Course Comment [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata `400 f/ Type of System Design 786XV52Y Date Installed Length of Field Width of Field _�� Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present ON) Depression over Field (Y ) Date -of Last Adequacy Test Results of Last Adequacy Test.Q -'Ailecl� Separation Distance fran Absorption Yield: To Water -Supply Well AIV To Property Line To Building Foundation /911� To Existing or Abandoned System on Lot n, ),A= ; On Adjoining Lots --t- (o© "iF - To Water Main/Service Line _zT� To Cutbank(if present) A,1.1, 1— To Stream/Pond/take/Cr Major Drainage Course N ZA- To Driveway, Parking Areas or Vehicle Storage Area /h(Q D. LIFT STATION Date Installed Dimensions Site in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (YIN) Tested for Pumping Cycles during Adequacy Test. Meets MDA Electrical Codes(Y/N) Convents Check Permitted Bedroan Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed—Date JJr" / Company MOA No. STff3-Qa� KB1/d5/s (Page 2 of 21 OF AC ®o® Aw I� ee bL� b a � C. Reid,Jr.%`�� 2251-E n �� NX • oar bred• ��'� J .tB 2-15-84 I e ALASKA e%IRMSTAL COnTROL SCC OUS, InC. Engineering & Enuironmental Studies MAY 15 1984 LARRY EATVN 674 ALBION DENVER to 80220 SELLER — JOHN SASSO BUYER — SUBDIVISION — PARADISE VALLEY BLOCK — 5 LOT — 6 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TR..,CH WITH AN AREA OF 328 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTIN 190,LLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 210 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 3 BEDROOMS. THE SEPTIC TANK WAS PUMPED ON 5/3/84 FLOW TEST ON WELL THE WELL FLOW RATE WAS 0.5 GPM FOR 4 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. OF Be p068We®9000 09 ed.�+4q r?? Ler Reid, Jr. ;I6 r 2251E 1200 West 33rd Auenue. Suite 6 • Anchorage, Alaska 99503 9 (907) 561-5040 oZr 5. LEGAL DESCRIPTION Db ECEIVED' le INSPECTION APPOINTMENTS TIME TIME TIME - DATE DATE DATE ❑ One ❑ Four ❑ Other -N INSPECTOR INSPECTOR INSPECTO ❑ MULTIPLE FAMILY MUNICIPALITY OF ANCHORAGE t DEPT. OF HEALTH & DEPARTMENT OF HEALTH &. ENVIRONMENTAL PROT€CWIISNMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 • AUG 1 8 1.981 .ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERT ERe PHONE C-3) & /✓� SYSTEM WAS INSTALLED. MAI LIW ADDRESS - oc 3 ek' %S` .0e w PROPERTY RESIDENT (If different fr m ab ve) PHONE NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 2. BUYE� PHONE .MAILING ADDRESS 3. LENDIN INS ITUTION PHONE AA. MAILING ADDRESS. - 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION _� ,4--z4 .� STREET LOCATION 16-C.// -_ 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other SINGLE FAMILY LK Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three" ❑ Six 7. WATER SLY EW INDIVIDUAL* ATTACH WELL LOG. A well log is required fgr all wells drilled ' ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE D%I�POSAL SYSTEM SYSTEM WAS INSTALLED. L�3 INDfVIDUAL/ON-SITE** YEAR ON-SITE PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-070 (Rev: 6/79) h� c QJ,(l/ -q V — THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF-BEDROOMS ' SINGLE FAMILY [:1 ONE ❑ THREE ❑ FIVE ❑ OTHER [:].,.MULTIPLE FAMILY ❑ TWO ❑- FOUR ❑ SIX i PERMIT NUMBER 2. WATER SUPPLY C) INDIVIDUAL DEPTH OF WELL El COMMUNITY DATED I.LLED ED PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER - 0INDIVIDUAL70N`-SITE DATEINSTALLED C3 PUBLIC UTILITY _ J Connection-Verified- INSTALLER ❑Septic Tank or ❑Voiding Tank Size_[ If Tank is homemade -sOILS RATING give dimensions: i TYPE OF TANK MANUFACTURER 7 _ T&ALABSORPTIONAREA MATERIAL Nearest Lot Line i 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line WELL:TO: Absorption Area to nearest Lot Line 5. COMMENTS i j i I 00* 20000 POOO APPROVED FOR BEDROOMS CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY t� I i - i i ,1 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENTOF- HEALTH AND ENVIRONMENTAL PROTECTION August 21, 1981 John A. Sasso Star Route Box 475-Y Anchorage, Alaska 99507 Subject: Lot 6 Block 5 Paradise Valley Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. (2) A well log submitted to this office for our files J, U "- Q and review. c%sn Q� � (3) The permit for the installation of the on-site sewer system has expired as of December 31, 1978. We have not received the as-builts of the installation in this office. If a private engineer inspected the system, please send us the report for our files and review. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist cc: Alaska USA Federal Credit Union Pouch 6613 99502 5. LEGAL DESCRIPTION LOT 1. MUNICIPALITY OF ANCHORAGE DEPT OF 'ALT ! & OF HEALTH &;ENVIRONMENTAL PR&ty6W&-`NTAL t;:C, L-CTION DEPARTMENT .825 L Street - Anchorage, Alaska 99501 ' • €AlAY 2 0 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests not be processed. Please allow ten (10) days for processing.- //will 1. PROPERTY OWNE ,.S SII .�J.. I PHO i.J`i/ E�3 MAILING 'ADDRESSo'� a S .. PROPERTY RESIDENT (If different from above) U PHONE - 2. BUYER Arlo PHONE MAILING ADDRESS 3. LENDING INSTITUTION fj0rnti 4Ldx'k�c 2 - PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE NIAILINGADDRESS 5. LEGAL DESCRIPTION LOT I D ck 0.ra-&' S �- { /' v STREET LOCATION p 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One E] Four ED Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATESUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled - ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If �� ^ ? p INDIVIDUAL/ON-SITE** individual/oh-site, give installation date If system is over two (2) years old an adequacy testis required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-01013/78) J THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE,OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE, ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑, COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA. MATERIAL .4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS c ❑ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) UD— DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78)