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Home My WebLink AboutSKYWAY PARK ESTATES BLK 6 LT 3Skyway Park Block Lot 3 I� u #019-151-10 Municipality of Anchorage Department of Health and Human Services Building Safety Division Onsite Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Pagel of 3 www.cLanchorage.ak.us (907) 343.7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number SWSWO50034 PID Number. 019-151-10 Names Wastewater System: ❑ New ® Upgrade Mereer 1340 Won I'llurf. Anch. AK Q951-9 ABSORPTION FIELD Pharr or 0 Dery Trwch O Snaeo- Tw -d ® Bed ® Ma"d O Omar LEGAL DESCRIPTION s°'"" Total DOM Dom GnVWa,.d` Block. Lal Subdivislom Depel to pipe bosom tan ongwt trade: Gravel depth beneath p" To- ww Rrge: Sect=: FA added above w0nal "do 3.0 FL Graval Leryth: 20 Well: ❑ New ❑ Upgrade10 G'"wide[ Ft- Number"Ims: Dietena botw Ines: Clasracatrn lPnW *. A B. Cl: Total Depen: Cased to Total absapeon area Ppe MatriarExist. e Doer I Data DrIoed State: Wetr Lev": ImMear Data Wteped A+ Home Services 512412005 Yrld: Paras"" awHw+Ab" 434 , d TANK GPM Ft, fl SEPARATION DISTANCES ❑ septic ❑ Holding ® S.T.E.P. ❑ Other. To Septic Absorption Lift Holding ubnemrivate tat-jarn capocay From Tank Field Station Tank Sewert.lne AnchTank 1500" wall 200+ 200+ 200+ Malmo! Steel lhl n aCarptv~te 2 a.e"w"a 100+ 100+ LIFT STATION Lot Lkw 51.8 12.1 Srse 250 c" Menuhtgrer Orenco 8.1 69.9 -Poop On. lev"at_ -Pump clr level at Hqh walr rrm": Foundation 44 n 40 n 46 n C-1— Dr— 50+ 50+ Pump Melee a Mad" Elecldte nape perlamad by A QSb Remrba 2" ri Id insulation over field andpost-tank line. TH BENCH MARK was field located off building. x Location and Dawigx n Front Porch south east comer near house Msunwd Elevation 100.0 FL 'tf L L �rC1rT�Wr�l�l'i? Tp'� Engineer's Stamp orlL�(� Se6DE S�Qt.v4 �.• P\ ...�.. C. �• • �i . ,. , Inspections performed by: Pannone Eng. Svc Dates: 1"2/23/2005 %, C �` ' �e r�•• • 0"02/2312005 �..... i..... :s..... • i Department of Health and Human Services approval • -. ' "" " ' ..................� R. P,,nnone n Ifo ;Steven :'�i. •j Reviewed and approved by: r/i� /Ij. P� Date: 2 J '%• No. CE 81 as �4a (Rev. 711891 •♦ 7-27. 41, .. .� PERMIT NO: SW050034 fEXIST'G SEPTIC AREA RECORD DRAWING WASTEWATER DISPOSAL SYSTEM LOT 3 BLOCK 6 SKY WAY PARK S/D NO WELLS W/IN 200' LOTS SERVED BY AWWU WATER SYSTEM EXIST'G 4 WATER LINE EXIST'G 4 BR u HOUSE J 3 NOTES: 1) All work was performed in accordance with AMC 15.65. 2) Materials used was in accordance with those specified in AMC15.65, Wastewater Disposal. 3) Maintained 10' separation to oil lot lines and proposed water lines. 4) Lots served by AWWU water system. No wells within 200' of proposed system. W \ W / W _ W'00 8.1 P.I.D. NO: 019-151-10 3 W PROPOSE6 W / RESERVE 20' x 10'-x --, 0.5' ED BED 12 fEXIST'G AREA —12.1 PROPOSED PRIMARY 20' x 10' x 0.5' ED BED ABANDONEDEXIST'G / TANK PL4CE J � / � NEW 1500 GAL. ADVANTEX-TTANK W/AX20 / POD & AUX. PUMP VAULT NO WELLS W/IN 200' NO WELLS W/IN 200' LOTS SERVED BY AWWU LOTS SERVED BY AWWU WATER SYSTEM WATER SYSTEM CO A B Tt 8.7 43.8 LS 16.3 49.7 EXIST'G SEPTIC /oL PV 20.5 52.4 / /� 01;/ Mt 75.6 104.5 f AREA /--M2n186.5 111.0 / / EXIST'G SEPTIC ••�P v.. . / / AREA en R. P CE 81 Mr. Cary Schafer 1340 Woo Blvd Anchorage, AK 99515 244-7836 PANNONE ENG. SVC, P. 0. BOX 102954 ANCHORAGE, ALASKA 227-3522 P. 272— LLC 99510 8218 Fa) PLAN PERMIT NO: SW050034 RECORD DRAWING DETAILS P.I.D. NO: 019-151-10 WASTEWATER DISPOSAL SYSTEM LOT 3 BLOCK 6 SKY WAY PARK S/D \`y un win :a ]WII YJIINO„ ''` z �I•aru wu.aw a Z O J y F la i W O VI a- a n �± n i p a d un.rm � e e � • Q M N 0 Y�O M/lU S x n a •' . • (� .1� r � .......... .. ... ........ .....� r c PREPARED FOR: ...................... ...............: • • PANNONE ENG. SVC, LLC ��`'•Steven R. Pannone .0 Mr. Gary Schafer P. 0. BOX 102954 ♦G�i 1340 woo Blvd ANCHORAGE, ALASKA 99510 ............ Anchorage, AK 99515 227-3522 P, 272-8216 Fax •••• 244-7836 DATE: 2/2? SCALE: NTS DETAILS ,a. FEB -20-2005 04:46P FROM:ji+ NOME SERVICES,. INr 860-6770 70:2720210 From +141079)01107 Non Fs I 05IM20 1005 Page 1 of 1 Itjspsatlon Report Munlalpalty all A" tail Building Safety Division . 410q uth Bregaw INBPECT1ON: YOtCG 343-0300 ; g .. Insp.otor .yh �. •.! : Nome CIPS dLECT r Addrass Itt:. 1040 woo 0 Legal BK 6 LT 3 Bubdlvlston ." SKYWAYPA ESTATES • tf Comments or Directions. .i PM CALL B4 ! Rnpsallen Rat•0 Efeotils.1 EB NO NONCOMPLIANCt:OSBERVEOjj L] CORRECTIONS ESSENTIAL AS EXFSLAINED [] WILL RE-EXAMINE AT NEXT INSPECTION COMMRNTB: (`o: 4wpnc:or use only) ' tl J i� FAX (907)9441_7777 INFO: 949-7104 Perm" 05-7421 Phan 272-4011 Inspeatlon Data 2/262005 ?NSITE MTG Relnapeetlon N i' OW U 00 NOT CONCEAL UNTIL REINSPECTION J i Doter -2 • .;2 U • (9-5 PRGE:1 .. Insp.otor .yh �. •.! I•EB-29-2305 MCN 01:!8F•M I0:A* N]ME SERVICE'_. Itt:. i Doter -2 • .;2 U • (9-5 PRGE:1 MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 .2,27-0-5' / /: O v d— /'3a ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Feb 17, 2005 Expiration Date: Feb 17, 2006 Permit Number: SWO50034 Parcel ID: 019-151-10 Legal Description: SKYWAY.PARK ESTATES BLK-- LT 3' Design Engineer: 0062 Pannone Engineering Services Site Address: Owner Name: GARY SCHAFER Lot Size: 60000 SO. FT. Owner Address: 1340 WOO BLVD Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99515-3211 This permit Is for the construction of: ❑,/ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and dosed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. Received By. X" Date: / OL Issued By/44,f= Date: Z I 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.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 014— L51— !a Permit Number SW Property owner(s) IN IlLk s CPAP Day phone2fl Lt "_'�5 Mailing address (3 c1 b worms --lial C YD Zip Code Y 45t.g Site address S&^A [2 Zip Code Legal description (Lot, Block & Sub'd.) L 3 I L S `; W A : A0 It- (y Sr Legal description (Section, Township & Range) Lot Size � ety Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms q Sewer Only Well Only ❑ Sewer and Well Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 4it6 d0 f 1,;15 bb aiver Fees: Date of Payment: 'PLI %'q 105 Date of Payment: Receipt Number. 16-'5$EJa— .6.. Receipt Number. (Rev. 09104) Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax February 16, 2005 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 3 Block 6 Sky Way Park S/D Septic System upgrade Permit Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing four-bedroom house. The lot is approximately 60,000 square feet (1.38 acres) in size. The lot is served by AWWU water system. 1. Soils. See the attached soils log. Ground water was monitored for 10 days. Ground water was measured in the monitor at a depth of six feet below ground surface. Bedrock was not encountered in the test hole. It is my opinion that the overall soils appearance of the soils, an application rate of 5.0 gallons/day/square feet should be used using a class III advanced treatment system. 2. Trench Design. a. Percolation Rate: b. Application Rate: c. Number of Bedrooms: d. Design Flow: e. Min. Absorption Area: f. Total depth: g. Effective Depth: h. Width: i. Reduction Factor: j. Minimum Length: k. Design Length: 1. Effective Absorption Area: m. Septic Tank Size: Cont'd on page 2 C:\Work\Letters\3-6 Skyway Park.001.doc 5-15 Min Per Inch 5.0 gpdpsf 4 600 gallons per day 120 sf 0.0 feet (above ground level) 0.5 feet 10 feet 0.0 12 feet 20 feet 200 sf 1500 gallon Advantex W/AX20 Pod. Page 2 3. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately one percent in the area of the SAS. 5. Future Upgrade Area: I am proposing that the primary field be installed at this time. A new 1500 gallon Advantex advance treatment system will be installed. I have shown the proposed location on the site plan. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed well location or of the proposed septic location. If you have any questions or concerns, please contact me at 227-3522 or 272-8218. Sincerely, Steven R. Pannone, P.E. Civil Engineer Attachments: C:\WORK\LETTERS\3-6 SKYWAY PARK.001.DOC PERMIT NO: DESIGN DRAWING P.I.D. NO: 019-151-10 WASTEWATER DISPOSAL SYSTEM LOT 3 BLOCK 6 SKY WAY PARK S/D EXIST'G SEPTIC —AREA NO WELLS W/IN 200' LOTS SERVED BY AWWU WATER SYSTEM EXIST'G 4 WATER LINE NOTES: 1) All work shall be performed in accordance with AMC15.65. EXIST'G 4 BR HOUSE 2) Materials used sholl be in accordance with those specified in AMC15.65, Wastewater Disposal. 3) Maintain 10' separation to oil lot lines and proposed water lines. 4) Lots served by AWWU water system. No wells within 200' of proposed system. {s p' 49 TH t �} ..... j '*Steven R. Pannon,! � '\ L � w W'00 1%-i A.7 5.1 fEXIST'G AREA PROPOSED RESERVE 20' 9 x 10' x 0.5' ED BED PROPOSED PRIMARY 20' \/ /y x 10' x 0.5' ED BED ABANDONE EXIST'G TANK & FIELD PROPOSED 1500 GAL 2 IN—PLACE / ADVANTEX TANK W/AX20 / POD & AUX. PUMP VAULT NO WELLS W/IN 200' / i NO WELLS W/IN 200' LOTS SERVED BY AWWU LOTS SERVED BY AWWU WATER SYSTEM WATER SYSTEM AREA EXIST'G SEPTIC\'OZUI'l�f` nt / EXIST'G SEPTIC ` / / f AREA trAKtU rUK: PANNONE ENG. SVC, LLC Mr. Gary Schafer P. 0. BOX 102954 1340 Woo Blvd ANCHORAGE, ALASKA 99510 Anchorage, AK 99515 244-7836 227-3522 P, 272-8218 Fa) DATE: 2 16 OS PLAN crei c. i•_an• 0 PERMIT N0: DESIGN DRAWING WASTEWATER DISPOSAL LOT 3 BLOCK 6 SKY WAY DETAILS SYSTEM PARK S/D P.I.D. N0: 019-151-10 —IeF y A Z su rowan ..Li. - O < F- W yy l W wrvm O � N o_ 3 `+ D to dE w rqu i � ; ; ^• un rvra �� ua rito Q s uro rrTu rou.annm OF J� • PREPARED FOR: PANNONE ENG. SVC, LLC ;Steven R. Pannonei # tY� 2i Mr. Gary Schafer P. 0. BOX 102954 j CE 8149/ ♦1Q�!Z!.K''rii•� 1340 Woo Blvd Anchorage, ANCHORAGE, ALASKA 99510 ♦ • ♦ AK 99515 244-7836 227-3522 P. 272-8218 Fax ♦ ; t�1•• �� DATE: 2 16 OS DESIGN SCALE: NTS 0 PERMIT NO: SW04 DESIGN DETAILS P.I.D. NO: 019-151-10 WASTEWATER ABSORPTION SYSTEM LOT 3 Block 6 SKY WAY PARK S/D AX -20 FILTER WITH INSULATED LID. ROTATED 90 FOR pp CLARITY.I . . 1500g STEEL rrA$ S.T.E.P. TANK INLET CLEAN-OUT L TO � II DK NW EL S RNH nELD 3' PVC PIPE TO AMBIENT AIR INSTALL 4' RIGID INSULATION OVER TANK & DRAINFIELD. EXTEND R.I 2' BEYOND SIDE OF TANK. INSTALL R.I. AROUND AX -20 FILTER. DESIGN CALCULATIONS Number of Bedrooms — 4 Total Bedrooms —4 Design flow — 150 gal/br/day Total flow — 600g/day '.6 . R. ACCESS MANHOLE TANK SIZE: 1500 gallon Advantex tank SOIL ABSORPTION SIZE: Advcntex Sewer System AX20 Pod — Class III System Perc Rate= 5-15 min/inch Application Rate= 5 GPD/SF Size Required= 600 GPD/5 GPD/SF = 120 SF Use bed, 0.5' effective 20' Long by 10' Wide 20 LF x 10' x 0.5' = 200 SF Total Mr. Gary Schafer 1340 Woo Blvd Anchorage. AK 99515 244-7836 PANNONE ENG. SVC. P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 PHONE & FAX DESIGN 'i` SOILS LOG — PERCOLATION TEST ��• READING NET DROP 1 .�� ♦ 1:52 PANNONE ENGINEERING SERVICES 5• ............. Gj"�,.• 2 2:22 = �. 7/e' P.O. BOX 102954 3 ? TH 2:22 ANCHORAGE, AK 99510 6' ::..... 0""4 4 (907) 272-8218 2:52 _ •• ....... • .............•• • • 2' 4' S ven R. P}onnonee PERFORMED FOR: Mr. Gory Schofer DATE PERFORMED: 2/7/05 E 81 ��j��A C 021 '022i LEGAL DESCRIPTION: LOT 3 BLOCK 6 SKY WAY PARK SUBDIVISION 6 J:22 }0 MIN 2• 4' TEST HOLE 1 SLOPE SIT LAN 1 / OR Organics EXIST'G / WATER LINE 2 / 3 OP Poorly groded / 4 GRAVEL 5 6 / / Poorly graded 7 SAND to Silly SP/SM Sond — Damp 8 Seepage 0 8.5' 10 Poorly groded HEST GRAVEL / /J 11 OP W/Cobble. Hord / digging 12 BOH / 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? Y (2005) 15 IF YES. AT WHAT TEST HOLE 16 DEPTH) — 8.5' 17 DEPTH TO WATER AFTER MONITORING? — 6' 16 DATE: 2-16-2005 19 READING DATE CLOCK TIME WATER NET TIME LEVEL 20 PEROLATION RATE 7.5 (min/inch) PFR G HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by A+ Home Services. Test Hole was presoaked before pert test PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. 'i` READING NET DROP 1 2/7/05 1:52 5• p• 2 2:22 30 MIN 7/e' 6-1/B' 3 2:22 6' 0' 4 2:52 30 MIN 2' 4' S 2:52 6• p• 6 J:22 }0 MIN 2• 4' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl- PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ~/~ - / ~'/-- / LP ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer NO. OF BEDROOMS Absorption area - Mated~ ...... IF HOMEMADE: Inside lengtt] jWichh Liquid deptg Well DWelling PERMIT NO, DISTANCE TO: []UPGRADE Material PERMIT NO. / o '7 c/7_ No. of compartme.,~[,~ ~ Manufacturer Liquid capacity in gallons DISTANCE TO: ]Well Material beneath tile PERMIT N~/ ~) 71¢~ Z-- Distance betwe0n lines Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption are~) Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line Total e f fective a~o~i~:~area DISTANCE TO: Building foundation Sewer line OTHER P]PE MATERIALS SOIL TEST RATING INSTALLER REMARKS Septic tank LEGAL FIF'P[_ I C:FINT IJ:)CR T I ON LEGRL TRR[)E HFIRK FIOME:S HO0 STf' F'.EEE"f L]: B6 E;Kh.'I.,.IFI"F F'FIRK EST. S;RR ±7']i:Cl (;!., FINCH. 975Eq:? S ,-" E:, LCd' '.S :[ ZIE 6Ev98,::1. SQUF:IRE I:::EET "F'¢F'E OF: SOIL F~BSORF:'T:[ON '.".:;'.r'S;TE:M :[:'!!;: 'FRENCH MFI::.:',IM. IJM F,IL.IME:ER OF:' E:[:~]]:,ROOf"IE; 3 SOIL P::FITZN(.~ (SE:! FT,-."E$~:>= 2::[.E~ THE REQUIRED SIZE OF' FHE SOIL. FIBSOF,'PTION S'.,'STEM 'THE LENEFf'H DII'dENSION I6 'T'HE LENG]"H (IN FrEET) OF THE: TRENCH OR DRFIII'.,!F'IELE:,. THE DEPTH OF'F! TREF.!C:H OR F'ZT ZE; '1"HE E:,Z'JE;TFIi'qCE BETHE:EN THE .".SURFF:ICE OF THE C:iFi:OIJI'.,ID FIN[:, THE: Eu]TTOi"I OF THE E:XCFI',,,'FITION (IN FEET). THERE: :I:E; NO E;E'F HI E:,TH FOR TREI',~CHE'S. THE GRFI'v'EL DEF'TH I fii; THE M ZNII','IUr,'I [:,EPTH OF GRF:I'v'EL E[I:.~:'I"I,.If:~E:F,I 'TH[.$ CiLITFFiLL. F'!F:'E F:IND THE E.',O"F'r'OH OF TI--IE LE::.:;CFI',/FIT!ON (IN FEET). F'ERH ! T FII:::'PL t CFINT hlFr:7, THE RESF'C)NS I B I L. ~ T"r' TO l NF:'Cff4tH 'I"H I S, INSTF:ILLf:I]'II3N INSF'EC-rIONS OF FIN'.¢ HEL. L.E; FID..!FIC:E]'.,IT '1"O TI.lIS I'.,IUMBEf~r OF RESIE:,ENCES THFI]" TFIE I.,.IEI....L .WILL SER',,,'E. DEF'FIRTMENT I)l.,.ll~:]ih,II::~ TFIE F'ROf::'ER"f'T' FINE:, TFIE E~RCKF I I..L I NG OF FII',Fr' S"r':STEM I.,.I I THOm' F'~ NFIL I NSI::'EI2T I Obi f::[ND I::IPF'RO',,,'f:IL E:"r' TH Z E; E:,EF'F]RTMENT HIL.[. BE '.SUBJECT TO r:'ROSECUTION. MIN:[MUM [:, I; E;'TFINCE BE'T'HEEh! FI klELL FIN[:, FIN'¢ CIN-Si'F!E SEI,IFIGE [', ;.1..EBE) FEET FOR FI PRI',?FFf'E: 14ELI.... OR J_SC~ TO 21:3E[ F;'EET FROM F:I F'IJE:I..IC PJ.E:L.L. UPON 'THE T"¢PE OF' F'UBL. IC HELL. MZI",IIfqlJM DZ'.ii;"['f:INCE FROM FI F',q'.IVFI'fE I.,.IELL TO FI F'RI",,'FtTE SL::HER LINE IS ;25 FEET F:II",![:, -!-0 F:I COMMUNI[T"r' E',EHER L..INE IS 7'3 FEE"I'. I.'.IELL LOC'iS FIRE REE:!UIRE:D F:Ii",ID MIJE;-I' BE RE-f'URF,IEL':' "t"0 THE E:,EPFIFi:TMEd",IT I,.IITHZN ]:::El I}l::l"r'S OF' 'FHE HE]J... COMF'LETION. OTHER f',~:E:E,flJ I REME[",ITS HF:I"r' FIF'F'L..'¢. ~E;F'E'C I F I CFIT I ON'}_:; FIN[) CONfE;T[;;!IJCT :[ 01",f I} Z I::IGRFIMS RRE 19,,,'FttL. FIE[I..E' -I-0 IF,12;UiqrE: F'ROPER II",IE;TFIL..L..FIT'fON. IFTM E6: It;F: ,~"t ]: ""F fi!L:: :="=: IF::" 9.1 E:;.'F:: EE :L:'5; El>' EEC;: EE 'f"l E,', E:: IF;: i]~:: ::il ..... :_t,... :D~' ~E~ :::L C:ERT I F'"¢ THFFI' I RH FRI','IILIFIF.: P!I]'I-I THE REQUIREMENTS; FOR ON-..S;:I:TE SE!.,.IERS ]:aND 1.4EL.LS; Fl'ii; SET I ::L: FOR]'FI Bb.' THE MUNIC:IF'I::]t_iT"r' OF' FINC:HOF..'FII.SE. ;iF.:': I P.! I I._L. Z NS-fFILL THE :5"??FEM I N RC:C:OF,.':C, FII",ICE 141 TH THE: CODEE;. 2:: I I..IhlI}EF,~STFIND THFFF THE OI",I-"SI]"E 'SEI,.IER Sh"STEI'd HFI"¢ [',?.E(;!IJIt;:E ENL. FIf;~:EiEMENT IF THE RES I[:,EZNC:E IrS RE:H(]E:,EL_E[:, TO I f.,IIZ:I._.I_.IE:,[E MO~.E THFllq ]: E~EiI}ROCIH:S. FIF'F'L. ICFIN]'j/J '[RFI[:,IE i',IFIF[:I<. HOI'IE~ ]":?~ ~E[.' Eff'r'. . /=rz'/..,~.~ .........[ I::IT[:-.~('- ....................... 'v'4, 121 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST I~PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION:__k6"~ 2 3 5 6 7 8 --.10 11 13- 15- 16- 17- 18- 20- COMMENTS WASGROUNDWATER ENCOUNTERED? P (~ ~ ' O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~-Z ~, /1: ¢n Io ,~o ,off PERCOLATION RATE CERTIFIED BY: 72-008 (6/79) STATE OF ALASK~ DEPART/~ENT OF NATUNAL RESOURCES N/S OWNER OF WELL:/y/a~O.J /l'~l/e~ J~] Auger C] Jotted C] Bored C] Other :___ ~]Test Well [~]Other: 7. CASIDG: ~ Threaded [~jj~W~4~ed .in. to ~ / ft. Depth Weight ___lbs/Ft. In. to ft. Depth 8, FINISH OF WELl.: ~ In,d surface 12, GROUTING: Well Grouted: ~.]Yes ~ F'~Other: 14. REMARKS: ~ater Temperature: 15. WATER WELL CONTRACTORIS CERTIFICATION: This well was drilled under my jurisdiction and ~his report Is ~rue to the best of my knowledge and belief: : ' ~Br ized 'gepre~ Copy Distribution: WIIITE - State DGGS, PINK - Driller, CANARY - Customer MDrjlk LJ0-jm_Nd Municipality of Anchorage Development Services Department c . Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 019-151-10 HAA # O.r d O -7 Expiration Date: '7 — R - G 1. GENERAL INFORMATION Complete legal description Lot 3 Block 6 Skyway Park SID Location (site address or directions) 1340 Woo Bivd Current Property owner(s) GarySchafer Day phone 244-7836 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 1340 Woo Blvd, Anch AK 99515 Day phone Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 4 L 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ED TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Department of Health and Human Services (DHHS) 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also Issues HAAs upon request to home owners. 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 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. (Rm +uvs) 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 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm _Pannone Eng. Svc. Phone 272-8218 Address P.O. Box 102954, Anch. AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 6/27/2005 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DIIIIS Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PFS can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DIIIIS. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or parry is not authorized nor will it confer any legal right whatsoever. 5. DHHS SIGNATURE Approved for _ LL bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments M6V l-�A,J �ro—Psc7 -L zzb Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: �<%�� 4 Y ( Original Certificate Date: :7 " g — 0-6— Expiration Date: Reissue Date: (Rev. rIM) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 3. Block 6 Skyway Park SID Parcel I.D.: 019-151-10 A. WELL DATA Well type AWMI U Date completed _ Total depth n Date of test Static water level If A, B. or C provide PWSID # Sanitary seal _ Cased to n FROM WELL LOG Well production WATER SAMPLE RESULTS: Cofdorm colonies/100 ml Date of sample: B. SEPTICIHOLDING TANK DATA n Well Log _ Wires properly protected Casing height (above ground) in. AT INSPECTION It 9 -p.m g.p.m Nitrate Collected by: mg/I Other bacteria colonies/100 mi Arsenic mgll Tank Type/Material Steel Date Installed 212312005 Tank size 1500 gat Number of Compartments 2 Cleanouts Y Foundation cleanout Y Depression over tank N High water alarm Y Date of pumping 2123/2005 Pumper NEW C. ABSORPTION FIELD DATA Date installed 23/2005 Soil rating (g.p.d.1W or ftz/bdrm) §�O— System type BED Length 20 ft Width 10 ft Gravel below pipe 0.5 It 3 Total depth $ It Effective absorption area "Lfe Ivbnitodng tube Y Depression over field N_ Date of adequacy test 2/23/2005 Results (Pass/Fail) NEW For 4 bedrooms Fluid depth in absorption field before test _ In Water added gal. New depth_ in. Elapsed Time: _ min Final fluid depth _ in Absorption rate >= _ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date (Rev. 11/99) D. LIFT STATION Date Installed 212312005 Size in gallons 250 "Pump on" level at 44 in"Pump ofr level at 40 in Datum Bolton of Basin Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAitt station on lot NIA On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manholetcleanout Sewer /septic service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 8.1 Property line 51.8 Absorption field 50 Water main 137 Water service line 37 Surface water 100+ Drainage 100+ Wells on adjacent lots 00+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 12.1 Building foundation 69.9 Water main 72 Water Service line 75.2 Surface water 100+ Driveway, parking/vehidie storage 75 Curtain drain 100+ Wells on adjacent lots 200+ F. COMMENTS Manhole/Access Y High water alarm level at 46 in Meets alarm & circuit requirements? Y G. ENGINEER'S CERTIFICATION.•� Pit.•• ••• • V,. 1 certify that 1 have determined through Bea Inspections and : u�i :y review of Municipal records that the above systems are In .0 ° ., conformance with MOA HAA guidelines /n effect on this date. i VA\steven P. i'onnonr.{)� Engineer's Printed Name Steven R. Pannone. P.E. ++o No CC 8149 Date 2-27-05 ��Girr ct3'��• HAA Fee $ �3O Date of Payment :51111)50 Receipt Number G Ua4E (Rev. 11/99) r. Date of Payment Receipt Number, Municipality of Anchorages&-> Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907) 343-7904 . CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 019-151-10 HAA# n�5OO'13 Expiration Date: to — = o.5 1. GENERAL INFORMATION Complete legal description _Lot 3. Block 6 Skyway Park SID Location (site address or directions) 1340 Woo Blvd gg515 Current Property owner(s) _Gary Schafer Day phone 244-7836 Mailing address 1340 Woo Blvd, Anch AK 99515 Lending agency Day phone Mailing address e Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ® Public Sewer ❑ The Municipality of Anchorage Department of Health and Human Services (DHHS) 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also Issues HAAs upon request to home owners. 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 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. m.11w) 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 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn Pannone Eng. Svc. Phone 272.8218 Address P.O. Box 102954, Anch, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 2/27/2005 Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DHHS Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system These conditions are outside the control of the evaluator of this system All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DIIHS. 7be content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DHHS SIGNATURE Approved for - Disapproved. % Conditional approval for bedrooms. U �t`Slevem R. annone S No. CE 81<9 bedrooms, with the following stipulations: $1,000 to be placed in escrow for topsoil and veaetntine mn,rnd_ Work to be Performed p urcnani to nn lr c130.50031, The work—shall—be completed no later than 6-15-05. Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other ,--w �. Original Certificate Date: .3- �" Expiration Date: Reissue Date: (Ray. I IM) ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND N1AQK- w�or�t THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this 1,+� day of 1�£3m+nc1 20� by and between m1h[ WCV^,.r✓ , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: I. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as L3,'E bsk-<WA-eP�l c�ed at 13 N o ty cy �R t -V D Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to t performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65 B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time.of property sale and title transfer in accordance with AMC Page I of 5 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction). An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. ' Permit (Operating). An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all requirements of this agreement, the conditions of the Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65. I Fee. Owner shall pay to Municipality an annual fee of —"' 611 —($ '—.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. Page 2 of 5 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of on site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, owner agrees to comply with all applicable ordinances, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: Page 3 of 5 C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the systems. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way affect the validity of this Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality as this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. Page 4 of 5 B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: MARK�,tiA,J Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. F /I1 t MUNICIPALITY: By: By: Title: Date: a/1-745 Date: STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) arns The foregoing instrument was acknowledged before me this j7 day of Ei4A� , 260,1, by , the of , on behalf of Municipality of Anchorage. NOTARY PUBLIC FOR ALASKA Page 5 of 5 I�rA�� Judicial District ) 9SY1 a of A�iskci ss. On this day personally appeared before me 14akk WOalh1n h , to me known to be the individual, or individuals described in and who executed the within and foregoing Instrument, and acknowledge that #r signed the same as o� free and voluntary act and deed, for the uses and purposes therein mentioned. Given under my hand and official seal this /-7 day of hrugrl/ ZSrjnature of Notary) LOA) QP55'I/1!� (Printed Name of Notary) Notary Public in aqd for the Stalje of AlaSk9 Resident at-PMd16/1f r/e , fyg SK I My Commission Expires Wry Commission November 1.2008 AKUSA 0010 R O&WISS My Commission expires: Richard\ASSIGNMENNUACode Addendum AMC 15.65 [No0-0257]kMc=mnudm of Understanding Version VI.doc Page 6 of 5 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATF OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAl. INFORMATION Complete legal description Lot 3; Block 6; Skyway Park Estates Anchorace, AK Location (site address or directions) 1340 Woo Blvd. Anchorage~ AK Property owner Mailing address Lending agency Mailing address La~&y Klawunder ¢/0 Polar Realt~ 1101 E. Day phone 76th Ave. AnchoraRe¢ Day phone AK Agent Nanc~ Lathrop - POLAR REALITY Address 1101 E. 76th Ave.. Anchorag&, AK Day phone 349-7681 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ',4 TYPE OF WATER SUPPLY: Individual well Community well Public water X×X NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on--site Holding tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. ?2-025(Rev 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEFR As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature 17034 Eagle River Loop Road No. 20~ E egle-RNe rFC4-1 ,-rslca~ ~5'~/'7 Phone Date_ ~'-I~ -~''~ DHHS SIGNATURE /'~__ Approved for'~-'4,~-~z~' Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: /¢~-~-~c~-,_. ~'~¢-¢¢/-~¢ Date ~_¢,°J~- 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~)25 (Rev. 1/91) Back MOA#21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /-aT ~ ~-Oc~ ~, 5'K'yc~/~Y' p/ar4E, Parcel I.D A, WELL DATA Well type ~. If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Wires properly protected (Y/N) AT INSPECTION Septic/holding tank on lot ; On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed/--~//~'/ Cleanouts (~)'N) High water alarm (Y/~ _ Tank size /Z ~'~) Compartments ~--~. Foundation cleanout (~__)N) ~/"E.t- _ Depression (Y/(~i) /o~o Alarm tested (Y/N) ,/(//~ Date of pumping ~- /( 2- [ ~.~ Pumper 4 ~' floraE' ~c~.~lCES' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /20¢d6 ?~E'.¢ETd?- On adjace,,. ,ots ,.,¢o/Jd- /¢~E.r¢'7...¢- Foundation_ _ TO property line_ /Of ' Absorption field ~ Water main/service line Surface water/drainage ~/o~' /~,~£$£~/~' 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE Manufacturer Size in gallons Manhole/Access (Y/N) (Y/N) "Pump on"~e 14tJ~.~~ ~ ~f" level at Vent High water alarm level -- ~ - Cycles tested ____ Meets MOA electrica~ SEPARAT~NOE FROM LIFT STATION TO: .~,J~iot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Soil rating Gravel thickness ~" Cleanouts present (~N) Date of adequacy test for '-~ System type Total depth If yes, give date Length ~':~/ Width Total absorption area ~'~¢ ~ Depression over field (Y(~) Results ~fail) Peroxide treatment (past 12 months) (Y/N) bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ,z.J¢,v,E To building foundation On adjacent lots Surface water Onadjacentlots ~.z~-~- ~',-z~=£~:~¢-Propertyline /0/ To existing or abandoned system on lot /co/cE Cutbank /¢OfJE ?/'zE~¢/,Jl" Watermain/serviceline Driveway, parking/vehicle storage area ~'0 Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect date of this inspection. S & $ ENGINEERING 17034 Eagle RlYer Loop Signature Engineer's Name Date HAA Fee $ ,f/'~"~. ~ Dute of Payment ¢~-/-t I~'~ /~ *ece,ptN.mber / I 72 026 (Re',' 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPOR rS WELL INSPECTION & FLOW TEST SITE PLANS ROAO DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ADEQUACY TEST FORM LEGAL DESCRIPTION: A~[~L ICANT :. ~JAUc W NUMB~ OF BEDR~MS: SEPTIC T~K SIZE: TYPE OF ~SORPTION SYST~: TIME S.To 3:00 o~%.o Y% E~ ~ 3;00 p ~,,/5-4 RESULTS: ROBERT SHAFER, P.E. ROGER SHAFER, P,E. CIVIL ENGINEERS (907) 694-2970 FAX 694-1211 METER TOTAL VOL. READING (Gal.) C~MMENTS HEALTH Au'r HORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHAN]CAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. ADEQUACY TEST FORM CIVIL ENGINI:ERS (907) 694-2979 FAX 694-1211 5EGAL DESCRIPTION: APPLICANT: /~A/Jd f L/~7'HifQ/~ ,/~o~ NU~ OF BEDR~MS: 3 SEPTIC T~K SIZE: ~f~ TYPE OF ~SORPTION SYST~: ~'~67Uc t-I METER TOTAL VOL. TIME READIN( (Gal.) -~ M.T. COMMENTS .515' z;zlo ' ~'~0 130o '7~ IR ZOa 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 APPLI( 'NT FILLS OUT UPPER HA; ONLY Phons Address Zip Code Address Zip Code Realty Co. & A~nt3~ ~ g- /Y~)~ ~/ ;j~/ ~0 Phone Address Zip Code ~ MuLtiple Family No. of Bedrooms~ Water Supply '~ Individual A~AOH WELL LOG. A well Icg Is required Ior all wells drilled since June 1975. ~ Community For wells drilled prior ID that date, give well depth (allach Icg if available). ~ Individual Year Indlv~ual Instafled: ~ Public Utility When Connected to Public Ulllity: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST ~EFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Dale Date Date Date Inspector Inspector Inspector Inspector Field Notes: (~..{(_ . , 0 ~) C ~ t~,~'--, (--~. MUN)CIPALITy OF ANCHORAGE Soils Rating Date ~wer Installed Well To Absorption Area / (3 ~ Well Log Received &~A -~;~-< ~ { (':~ ~ J ~' ')~: ?'?, ~ Well Io Tank [ ~ ~; Septic Ta~k Size / 'J- ~; 'C') 72.023 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTI:CTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTFI AUTHORITY APPROVAL OF ON-SITE sEWER AND WATER FACILITY 264-4720 App,,oat,on Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Address Telephone: Home _~/~o !~"?~'_ Business (c) Applicant is (check one): Lending Institution E]; Owner/.l~4Nf4~',,l~; Buyer []; Other [] (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address (f) Telephone Telephone Mail the HAA to the following address: TYPE OF RESIDENCE Single-Famiiy,~ Multi-Family [] Number of Bedrooms _ "'~[~ Other WATER SUPPLY Individual Well,~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite/(~ Public [] Community [] Holding Tank [] Note: If corn munity well system, must have written confirmation Irom the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72 025 (1184) ENGINEERING FIRM PROVIDING . _,.4PECTIONS, TESTS, FILE SEARCH, DA'f, ND INFORMATION As certified by my seal affixed hereto and as of the validation data shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is sate, 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 Municipatity of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is i~ cornpliar~ce with all Municipal aRd State codes, ordinances, and regulations in effect on the date of this inspechoa, ~ Name of Firm ~ ~N~~ Telephono ~7 ~ ~ ~ ~/~ Engineer's Seal DHEP APPROVAL ~Approved for '~'~2~-~,)bedroorns by_ Approved ' ~ Disapproved Conditional. Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional ongineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 /¢.JJNICIPALITY OF ANC'HOP, AGr. DEPT. OF HEALTH & ENVIRONMENTAL, PROt'£CTION NOV 1 21! 1 Legal Descrp on ,LO~- ~'~':~. WELL DATA Static Water Level ~ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding 'rank on Lot Well Classification "~ ~'--~-.-~' If A. B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) _~/' Date Completed lC) - _'~o-,, ,?~1 Yield Total Depth _~ Cased to Z,~ //' Depth of Grouting Pump Set At .~'"~ · "~/-¢ 'f Sanitary Seal on Casing (Y/N) Y Deeression Around Wellhead (Y/N) To Nearest Edge of Absorption Field on Lot _ J ~ ~ To Nearest Public Sewer Line _ Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments : On Adjoining LOtS N __; On Adjoining Lots ~'~ ON ~ ot~L~. To Nearest Public Sewer N O i'~ ~ To Nearest Sewer Service Line on Lot '"'~, ~', Date J¢/:~f/,~,,.~ B. SEPTIC/HOLDING TANK DATA Date Installed //%,~, ~ I Standpipes (Y/N) _ '~' ~ ~ Depression over Tank (Y/N) ~'~ Pumping/Maintenance Contract on Rle (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding 'Tank: To Water-Supply Well / O To Property Line Size /,,,~,~ O No. of Compartments '-T' b~_ Air-tight Caps (Y/N) _ ~ Foundation Cleanout (Y/N) Date Last Pumped / o/-~o J8 ,.~ Temporary Holding Tank Permit (Y/N) _ To Building Foundation To Disposa Field _ To Water Main/Service Line Course Comments To Strearr Pond. Lake. or Major Drainage Page 1 of 2 72-026(11184) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area ~ ~"~ ~ Depression over Field (Y/N) N~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well / ~ ~:~ To Building Foundation .~. Lot To Water Main/Service Line ,-~ / ~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area / Type of System Design ..,' Length of Field ,~ Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lois /N/O/,/~" TO Cutbank (if present) ~J O ~ ~' Comments D. LIFT STATION /"~/(~)/'N/ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified/."~r conformed to all MOA and HAA guidelines in effect on the date of this inspection, fo . Signed ~ ~--~_.uC'f--~X~-d(~ Date Company Receipt No. Date o~ PaymenI I ~- 1~ Amount: $ [~ [nCneer's Soal Page 2 of 2 72-026 (11/84) CONSULTING ENGINEER ~ ~ ~ ANCHORAGE ALASKA 99501 TELEPHONE: 1907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: LOT 3, BLOCK 6, 1340 WOO BLVD DAVID JENKINS SINGLE YES SKYWAY PARK ESTATEoF ~ONICIPA%lrf ANCHORAG5 B~PT, OF HEA~TH & iiNViRONi~J~NTAL FROIECTION FAM:[LY REcEIvED INSTALLATION REQUIREMENTS MET: NON SANITARY CAP ON WELL. CAP REPLACED WITH SANITARY SEAL. WELL YIELD FROM WELL LOG: 6 GPM. PUMP YIELD: 6.5 GPM. DATE OF INSPECTION: OCTOBER 30, 1985 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6.5 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED. THE WELL WAS PUMPED TILL THE DRAW- DOWN STABILIZED. STATIC WATER LEVEL WAS FOUNF TO BE 86 FEET BELOW TOP OF CASING. AFTER 90 MINUTE OF PUMPING THE WATERLEVEL HAD STABILIZED AT 88 FEET. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON OCTOBER 31, 1985. TEST WAS POSITIVE. WELL WAS CLORINATED ON NOVEMBER 9 AND RETESTED. RETEST WAS NEGATIVE. TEST RESULT %',-,,. ..... ~'"~, .'*'lL'~ ;.'.:' :?'" THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow ms 150 gallons of wa~er per bedroom per 24 hours.This well surpasses this requirement. The assessmenn of the condition of this well applies only no the conditions as of this date. The flow rate of the well may change due ~o subsurface conditions that may not be observed from the surface, and changes mn land use and other factors thaz may impact the conditions of the aquifer feeding the well. ~~ ~ a~~ ~ ~ 203W. 1§th AVE "C" SUITE 203 CONSULTING ENGINEER ~ ~ ~ ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST ]LEGAL: ]LOCATION: OWNER: LOT 3, BLOCK 6, 1340 WOO BLVD. DAVID JENKINS SKYWAR PARK ]}~Jr~l]Y OF ANCEIORAgE DEPT, OF HEALTH 8,, ENVIRONMENTAL PROTECTION NOV 2, RESIDENCE: WATER SYSTEM: SINGLE FAMILY, THREE BEDROOMS RECEIVED ON SITE WELL SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, 1000 GAL. TWO COMP. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 636 SQ. FT. SOIL RATING: 21~ INSTALLATION DATE: 11.2.8]. DATE OF PUMPING: OCTOBER 30, 1985, ANCHORAGE CESSPOOL PUMPING DATE OF TEST: NOVEMBER 1, :L985 .-TE,S.~~:' pROCEDURE: ',~,~'.~ , JUq% ~,o ~/~ ' 'aTESrJ~2. 't,~E~ULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on t~e local soil conditions, groundwater levels that may fluctuate during the year, and the wa~er usage of the Family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore no~ gzve any estimate of how long the system will continue to mee~ the operational requi-- rements of the Municipality and State. WATER WAS ADDED TO THE TRENCH AT A CONSTANT RATE OF 6.5 GPM WHILE THE WATER LEVEL IN THE TRENCH WAS MONITORED. A TOTAL OF 730 GALLONS WERE ADDED, CAUSING THE WATER LEVEL TO RISE FROM 22 INCHES TO 41 3/8 INCHES. AFTER 60 MINUTES THE WATER LEVEL HAD DROPPED 1.5 INCHES, INDICATING AN ABSORPTION RATE OF 56.4 GALLONS PER HOUR. THE APPARANT SURGE CAPASITY OF THE SYSTEM IS MORE THAN 1500 GALLONS.