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Home My WebLink AboutSUSITNA SUNSET LT 4 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. t~j 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 · [] UPGRADE LEG L DESCRIPTI LOCATfON NO~EDROOMS DISTANCE TO: Iwell /~ I Ab'°mti°~? ' ' "~ Man, facturer Liq, capT~llons IF HOME.DE; Inside length Widtb Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z < Manufacturer Z -- N Material Liquid capacity in gallons ; ~ ~ DISTANCE TO; We]]~ C ~ Foundat,o,~ Neare>~t~ine .PERMIT ?~ -- No. of lines~ Length of~lin Total 1o~t~of lines Trenc%~¢ Distance ~)w¢ lines inches Total effe~orption area ~ Top of tile tyinish grade~ Material beneath tile '~ inches Length ¢ Width Depth PERMIT ~ ~ Type of crib Crib diameter Crib deptb Total effective absorption area ~ Well Building foundation ~ Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PiPE MATERIAL~ ~ . , ¢~¢ SOiL ( ,¢ INSTAEL[R REMARKS / ?, ~ J, ,UIL. RRTIN_: THE SOIL ¢:iEE'£RP"*I'£N E'.¢STEM ]'HE LENGTH DIMENSION I:E; THE: LENGTH ,::Ii',! FEE'T) OF THE TRENCH OR DRf~!NFIEL[:,. %HE DEPTH OF' F! TRENCFI OR F'IT IE; ]"HE DIL:.,TFtNCE BETHEEN THE E;URFRCE OF' THE GROLIN[:, FIND THE E,'OTTOH OF' THE' E::.~CFIVFFI"_TOI,,! (iN FEE-F). THERE 15 NO E;E]' 14IDTH FOR TRENCHE:L-';. THE GRFI',,,'EL DEPTH IE; THE H. INII,,'!LIM DEF'TH OF GRFP/EL BE'I'HEEI,.,~ THE OLITFRLL. F'IF'E RND THE E~OTTOM OF THE E',=:CR',/RT.tON <IN FEET). F'ERhtZ 'T' RF'F'L i CFli,,IT HH_, THF-' RE'L: PC NE.. I E I_. i 'f"./ TO I NF-" E RH TH Z E; IN:'STALLFITICI,.,I Ii' ..... L-.I .t ..... '"IF Ri,'~.'.'r' !-'.fELL!5 R[:,,;FRCEI,.4T NUHE:ER - F' RFZ% :[/,EHF: E'5 THFYF 'THE !,.IELL. H [:,EF'FIRTI,,.E~-T E:,L!RING THE RF.:OPERT'-/ Fli,.&D THE MINIHUH DIE;TRHCE BETHEEN R HEL. L F~N[), RN'T' OI,.,?_.'.;;ZTE SEWRGE DISPO~;RL ~SYSTEH iS 19~ FEET FOR R PRIVRTE HELL OR 150 TO 20P.~ FEET FROH R PUBLIC HELL DEF'ENDZNG LtPON THE T?PE OF PUBLIC HELL MINZMLIh~ DIE;TRNCE FROM FI F'RZVRTE HELL TO F4 PRZ',/RTE SEHER LINE IS 25 FEET RND TO R COHMUNIT'¢ ~SEIqER LINE I9 75 FEET. OTHER REQUIREHEI',iT~; i'dR'.? F!PF'L.'¢. LSF'ECIFICF~TIONS RN[:, CONSTRUCTION [:,IFIGRRMS RRE R',/FiILiRBLE TO INSURE PROPER !N%T[~L. LRTION. I CER'T'IF'¢ THF!T i: I Ri',i FFti,,'K[L. IRR HtTH THE REQU!REI','!ENTf5 FOR ON-STTE :'SEHERS FIND HEL.L2~ RE; E;ET FORTH Bb.' THE I,]UI,.,I:[CZF'FILZT'¢ OF F!NCHORRGE. 2: I HILL iNSTRLL. THE S'T'~'J'f'E!"! Ii'.,! RC:CORDRNCE !.4~TH TFIE CODE~. ~:: Z UNDER~TRND THRT ]"HE ON-SITE L::;EHER S'¢.?rEi,,~ t"IFYT' REQUIRE ENL. iaRGEMENT IF THE 825 .... c .... L ,~FREEq AIXICHORAGE, ALASKA 99501 (90'/) 264-4111 GI~ORGE M, SULLIVAN, A,IA Y 0 R DE?A£~TMENTOF HEALTH AND ENVIRONMEN]ALPROTECTION December 31, 1980 Steve Agee Box 2468 Anchorage, Alaska 99510 Permit # 800459 Subject: Lot 4 Susitna Sunset Subdivision A permit issued by this department for well and/or sewer system has expired as of this date. 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 an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are an~ further questions please call this office at 264-4720. S inc er ely, --/ Les N. ~UC · , S./~/ Senior Environmental ,~p~cialist LNB/ljw enc: Copy of Permit SWP/057 RPPLICRNT STEVE RGEE BO~ 24~8 RNCH. RK. LOCRTION COTTONTRIL LEGRL LOT 4 SUSITN8 SUNSET SUB. LOT SIZE ~44-267± ~6430 SQURRE FEET TYPE OF SOIL RBSORPTION SVSTEM IS: TRENCH MR~IMUM NUMBER OF BEDROOMS SOIL RRTING (SQ FTZBR)= 258 THE REQUIRED SIZE OF THE SOIL 8BSORPTION SYSTEM IS: [:,EF"TH= 2~ LE~'-~GTH= S~24 6 P.. R'-.¢ E L EaEPTH= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTN OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE E~CRVBTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRBVEL BETWEEN THE OUTFRLL PIPE RND TNE BOTTOM OF TNE EXCRVRTION (IN FEET). ~:E~]-.~Li Z F;ED SEPT I ;]: TI~--~'-~--'. S,, T ZE= 1E~OE~ ,3RLLO~'-~S PERMIT BPPLICRNT HAS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RN9 WELLS BDJRCENT TO THIS PROPERTY' BND THE NUMBER OF RESIDENCES THBT THE WELL WILL SERVE. BRCKFILLING OF FINY SYSTEM WITHOUT FINRL INSPECTION FIND RPPROVRL 8'~' TNIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RN'T' ON-SITE SEWRGE DISPOSRL S'~'STEM IS ±00 FEET FOR B PRIVRTE WELL OR ~[50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE T'~PE OF PUBLIC WELL MINIMUM DISTRNCE FROM R PRIVRTE WELL TO IR PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPBRTMENT WITHIN Z..O DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MFI'~.' FIPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS FIRE R',?RILRBLE TO INSURE PROPER INSTRLLRTION. F:'EF:~'~ ir T E::-~P ][ t~ES [:,ECE~"~BER _~--~-1 .. I CERTIFY THRT ±: IRM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH B~r' THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL THE S'~"STEM IN 8CCORDRNCE WITH THE CODES. ]:: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY RE.qUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THFtN 7~: BEDROOMS. CON 1 I ]C'-i-tON TEST LAB PERFORMED FORL AGEE LEGAL DESCRIPTION: THIS FORM REPORTS: Lot 4 Block [] Visual Soils Examination 18OL..~W. 48TH AVE. STE 'C' ANCHORAGE, ALASKA 99503 248-i333 DATE PERFORMED: q/q/R0 ...... Subdivision_ Su,qi ~-na ,qun~t ~ Percolation Test DEPTH FEET I-- 2,5 t SOIL NOTES DESCRIPTION Topsoil GRV-SA DRY SA-GRV DRY SI-SA-GRV DRY GM BOTTOM OF HOLE WAS GROUND WATER ENCOUNTERED IF YES, WHAT DEPTH LEGEND ® -- Parc zone ~,S - Sample loken I~ -- Frozen zone ~' -- Water table READING ~ DATE _ 9/03/80 I I 9/05/80 I I ~ NO -- GROSS TIME t NET TIME SATURATIO~ PERIOD 5:30 / 0 Hrs. 6:30 6:45 7:00 PERCOLATION RATE: 30 Min./Inch DRAINAGE REQUIREMENTS: 250 Sq. Ft~B_~ PROPOSED INSTALLATION: [] SEEPAGE PIT ~D DRAIN FIELD [] OTHER COMMENTS: TEST PERFORMED BY: L.S~ DATA CERTIFIED BY: Kinney_ R. Baxter, P.E. DATE:~9/_0~5/80 _ 3 1/2_" 6 1/4" 6 _3~/_4 NET DRAINAGE 2 _1~4" 1./2_IL l_l1 Hr. 1/4 tIr. 2 Hrs. DEPT'H TO H20 \ WATER WELL RECORD ~'/ STATE Of ALASKA DEPARTMENT OF NATURAL RESOURES Division of GeOID§iCOI 8~ Geophysicol Surveys Drilling Permit No. A.D.L. No. 911a. Borou'ou~'"- Sub,division Lot Block~-~l I/4qtrs. Section No. TownshiPN[~ RanGe E~ Meridian OlS~ DIREC~.,~uM ~uA~RSECTION$ ~. OWNER Of WELL: Feet Below 4. W. f~ PT"' [final} 5.~JTE OF C.MPLETI~N. Material Type Top Bottom ' ' / 7.S 6. ~ c.~,, / 5?k O~V~C 'il0 f> diam. in. to ft. Depth S li~ ....... ft. I0. STATIC WATER LEVEL: MUNI~IPALI~ ~¢ ENVi~ONM~N'iAL PROTE~ION ~ ~ ~ ~!.~_ ~~ ms. PUMP: (if ovailoble) HP ~RAgistered/Business Na~ _ -- ~ / C°ntr~ct Li~fl)~J~ff~/ (907) 243-7893 F;EN JOP~NSON WATER WELL DRILLING PUMP SALES & SERVICE Steve AGEE Lot 4 Susitna Sunset AnE:ho r~g'.e ~ NIUNICIPALITY OF ANCHORAGE DEPT. OF HZALTFf & ENVIRONMENTAL ~ ZO'I'ECTION JAH 1 4 I981 RECEIVED 3~63 LINDEN DRIVE ANCHORAGE, ALASKA 99502 October 8~ 1.980 0 ftc 8 1~ fro 17 21 ft~ 27 ft~ 60 ft~ 110 ft. to 8 ft. Brown silt and ~ravel to 16 ft. Gravel with some light Brown silt to 17 ftc to 21 f~. silt to 27 2'I~. (drcve casing to Bculder Gravel with bro~ Decomposed bedrock to 60 f'~, Firm bedrock ( light grey ) to 110 ft. Same but weeps wate~~ refusal ) to 175 ftc Firm rock with occasional fractures ( dry ) Total depth 175 ft. Total casing 29 ft. Static water level 32 f't. 14~ ft coloumn of water in well Yeild I GP~ Drawdown 100% fai~ recovery ( 215 gals, ) 1940 POST ROAD ANCHORAGE, ALASKA 99501 July 3, 1974 W.O. #16756 279-2581 Alaska Land Development 8730 Lake Otis Parkway Anchorage, Alaska 99507 ATTENTION: Mr. Bill Tucker SUBJECT: Seepage Pit Test Hole~ LOCATION: Susitna Sunset Subdivision Gentlemen: Transmitted herewith are the results of the subsurface investigation performed on the above property on June 18, 1974. Exploration consisted of 2 - 15' test hole drilled by Denali Drilling, Inc., employing Nodwell mounted, Mobile B-SO drill, fitted with an 8", solid core, continuous flight auger. Grab samples were taken at 5' intervals, by pulling the auger out of the test hole and re- moving the sample from the flights of the auger from near the bit. The soils were visually classified in the field in accordance with sheets 1 through 3, following the text. This field classification was verified by visual review of samples based on the same criteria, in the laboratory. The drilling was supervised and the test hole was logged by L.B. Johnson, senior technician of our staff. The test holes were logged as follows: Test Hole 1 Depth in Feet From To 0.0' 1.0' Soil Description Brown organic overburden 1.0' 4.0' F-4, brown gravelly sandy silt w/occasional cobbles, damp to wet, hard, Pi+, SM/ML 4.0' 1S.0' : F-2, brown silty~sand, damp, high density, SM > .Bottom of Test Hole: 15.0' Frost Line: None Observed Free Water Level: None Observed --- c ° n t i n u e d-~~3 1974 MEMBER Alaska Land Development Page 2 July 3, 1974 W.O. #16756 Sample ~epth 1 4.0'-5.0' 2 9.0'-I0.0' 3 IS.0' Remarks: Type of Sample GRAB GRAB GRAB 1. Test hole located 150' from Huffman along power line 2. Elevation: existing ground 3. Date of exploration: June 18, 1974 Test Hole 2 Depth in Feet From T~ 0.0' 0.3' 0.3' 1.S' 1.5' 13.0' 13.0' 15.0' Bottom of Test Hole: Frost Line: Free Water Level: Soil Description Brown organic overburden F-2, brown silty sand, damp, high density, SM F-2, brown silty gravelly sand, damp, high density, SM F-2/NFS, brown silty gravelly sand, damp, high density, sM/sp 15.0' O.S' - 1.0' None Observed Sample Depth 1 5.0' 2 10.0' 3 13.0' 4 15.0' Type of Sample GRAB GRAB GRAB GRAB ---continued--- Alaska Land Development Page 3 July 3, 1974 W.O. #16756 Remarks: 1. Test hole located 1S0' East of Test Hole 1 2. Elevation: existing ground 3. Date of exploration: June 18, 1974 The seepage area required per bedroom by soil type (per the Greater Anchorage Area Borough) is as follows: Soil Type (Unified Classification) Seepage Area Required ML 27S ft2/bedroom SM 250 ft2/bedroom SP 1S0 ft2/bedroom SW 125 ft2/bedroom GM 225 ft2/bedroom GW 85 ft2/bedroom Soils requiring greater than 2S0 ft2/bedroom are not allowed in seepage pit area calculations (per the Greater Anchorage Area Borough). The seepage area required at depth ca'n be expressed as follows: TEST HOLE 1 Unified Soils Depth Classification 0.0'-1.0' PT 1.0'-4.0' SM/~L 4.0'-15.0' SM TEST HOLE 2 ': :' Unified Soils pept~ Classification 0.0'-0.3' PT 0.3'-1.5' SM Seepage Area Required Not Allowable Not Recommended 250 ft2/bedroom Seepage Area Required Not Allowable 250 ft2/bedroom ---continued--- Alaska Land Development Page 4 July 3, 1974 W.O. #i6YS6 TEST HOLE 2 (continued) Unified Soils Depth Classification 1.5'-13.0' SM 13.0'-1S.0' SM/SP Seepage Area Required 250 ft2/bedroom 200 ft2/bedroom Enclosed are some excerpts from State and Borough ordinances which may be of value to you. For further restrictions, particularly with ref- erence to location of the seepage pit, we call your attention to the Greater Anchorage Area Borough Ordinance 28-68. Please call if we can be of further service. Very truly yours, ALASKA TESTLAB ~John ~1. Lambe Harry R} Lee~ P.E. JML/vms Enclosures Page 15 Ordinance No. (a) No seepage pit excavation shall extend into th~ water table. Where g~ound water is encountered, the bottom of the pit shall be backfilled with clean above the water table. (~) The top of all seepage pits shall be nq~ less than 18 inches below the fi'nished grade. (c.) ~e required absorption area of seepage pits shall be computed.on the basis of percolation tests made in each vertical stratum penetrated. The weighted average of the results shall be computed obtain a design figure. Soil strata in ~hich the to percolation rates inch shall not be absorption area. (d) Seepage pits are in excess'of 30 minu~es per included in computing the Shall not be installed in areas where the percolation ~ate is greater than 30 minutes per inch, i.e., in areas where more than 30 minutes is required .for the water in the test hole, after proper preparation,.to fall one inch .(e~) Table No. 4 shall be used to compute the required seepage area for seepage pits. (f) The effective seepage area of a seepage pit Shall be the vertical wall area, based on dug diameter, of the pervious strata below the inlet. (g) The lqcation of seepage pits shall be such as ~o provide not less than the stated distances from the followi, ng: ' Page 16 ~ Ordinance No. 28-68 TABLE NO. 6 1. Any Source of Domestic Water Supply 100 feet ~ 3. River~ Lake, or Stream lO0 4. Watermai~ or Service Line l0 5. Other Seepage Pits (3 times the diameter of seepage pits.) 6. Septic Tanks (h) The seepage pit shall building tile, perforated or other material feet feet the be lined with brick, Drecast concrete rings, approved by the health authority. The.space between the outside of the li.ning and :he soil shall be backfilled with clean coarse gravel or similar material. The lining shall be rrounded on all sides by at least 2 feel of clean coarse gravel or similar material. (i) The sewer line draining the septic tank effluent to the seepage pit shall be of cast iron from the seepage pit lining to a point not less than 5 feet beyond tl~e nearest undisturbed soil unless suitable bedding material properly compacted is used to support the line. (j) The top of the seepage pit shall be 'covered with a reinforced concrete, top or other material approved by t~e health authority. Page 17 Ordinance No. 2~ (k) A!.I seepage pits shall be provi.ded with a cast iron siphon Pipe of 4" diameter or larger. All siphon pipes shall be fitted with an air- Cesspools shall not be used for disposal of ~,ouse- hold wastes unless specifically authorized by .the health authority. (al' Cesspools where ground water supplies domestic purposes. (b) The construction of cesspools sh~)l follow the same standards as those given for seepage pits. (C) Exemptions. 1. All septic tanks, drainfields, and seepage pits in use on September, 1968, are exempt from subsections (B) (5), (B) (6), {D) (7), (B) (8) (b), (B) (2) (c), (B) (8) (d), (B) (el, and (B) (8) (fl of this section° Sec. 9-72 IJO__~N__bI_ATER-CARRIED SEF!AGE ~TSPOSAL SYSTEIq. So (Al The construction and maintenance of earth pit privies shall comply with the following requirements. 1. Earth pit privies from any spring, well water supply; lO0 feet shall not be used in areas are used for feet shall be located at least lO0 or other source of domestic from any stream, river, or lake; and lO feet from any watermain, water service line or property line. 2; Earth pit privies shal? in the Alaska Department of be constructed as recommended Health D~cument HSE 762, ~.~, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) (b) (c) Legal Description (include Iot,J~ock, subdivision, sectiop,~township/~ran,~. Location (address or directionsJ / ~//~ ~_ '7// Applicant N~me~~ ~ ~-~ - Te,ephone: Home Applicant Address ~ Applicant is (check one): Lending Institution ~; Owner/builder~Buyer ~ ; Other [] (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the follo~wir~g addrsss: /. 3. .WATER SUPPLY' TYPE OF RES.~ENCE. Single-Family [~_i Multi-Family [] Other Number of Bedrooms ~' ~ Individual Wel Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL · · Onsite [] Public [] Community [] Holding Ta~e'~~''~ · Note: If community weJJ system, must have~n confirmation from the State Department of Environmental Conservation attesting to the legality and~ Page 1 of 2 ..~ . 72-025 (11;84) NGINEERING FIRM PROVIDIN~G~NSPECTIONS, TESTS, FILE SEARCH, DAit--~/,~,ND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance.with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~ ~-~.-~,~ o--~. /'~/~ Telephone Address r.j Date Engineer's Seal DHEP APPROVAL Approved for 'f~'~ ~'~","~ bedrooms by Approved ~ Disa p~..ved Condi~nal Terms of Conditional Approval Date "2.. ~l t' - ~, 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 engineer's work. Page 2 of 2 72-025 (1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name .~'l~x~,.~ /:~,,~' Telephone: Home ,~ ¥,5°°O'¢'&~ Business Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder' []; Buyer []; Other [] (explain); (d) Lending institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family FA 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 Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank [] Note: If community weli system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (1~/84) ENGINEERING FIRM PROVIDING~'dlNSPEcTIONS, TESTS, FILE SEARCH, DAT~A~AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the o n-site water supply and/or wastewater disposal system is safe, fu nctional 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 Flczf"/-~fl ' ~C~J ~ Telephone ~E~- l~6-- Date I/~ ~ DHEP APPROVAL Approved for '~ Approved . bedrooms by Disa"~:)ved . Con(~nal Terms of Conditional Approval Engineer's Seal ~fft, g.x .'.. ....... ~ * THEODORE F MOORE Date 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 professionel engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (1u84) WELL DATA ,~ ,,,~ ~IMUNICIPALITY OF ANCHORAGE (MOA) CHECKLIST- FEBRUARY 1984 264-4720 ~,AN~ Legal Description: ~o~ Date Completed Depth of Grouting Well Classification Y if A. B, C, D.E.c. Approved (Y/N) Yield Pump Set At ~ l Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Well Log Present (Y/N) _ Total Depth I '"~.~' Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit Separation Distances from Well: To Septic/Holding Tank on Lot ~ ii" To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole ; On Adjoining Lots I O'~" ; On Adjoining Lots To Nearest Public Sewer TO Nearest Sewer Service Line on Water Sample Collected by Water Sample Test Results Comments ~4,,'~ ~-~ I ~c]~/~ SEPTIC/HOLDING TANK DATA Daie Installed ? / 2~ ,/aa size Standpipes (Y/N) ~ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank, High-Water Alarm (Y/N) - Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ ~ ~ To Property Line To Water Main/Service Line Course ,~' ~'OO ' No/of Compartments ¥ Foundation Cleanout (Y/N) Date Last Pumped ; for .T~mporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 / 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 7/~ ~-~ /~ ~, Width of Field $6"' Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well I0~° To Building Foundation Lot N. ,~. To Water Main/Service Line Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design To Property Linde ~, ~0 ' To Existing or Abandoned System on ; On Adjoining Lots ~' $~ ' To Cutbank (if present) pi.R, ~' tO0' D. LIFT STATION 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, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date MOA No. Signed ,o'r~ Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal Municipal ty of Anchorage P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLE$. MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 28, 1986 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Lot 4 Susitna Sunset Subdivision Waiver REqust, WR86-012 Dear Mr. Moore: Your rstuest for a waiver of the i00 foot separation required between a septic tank and well has been approved for the subject lot. The required distance has been waived to 95 feet. This waiver is valid for the existing septic system serving a three bedroom single family dwelling. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw C~ & EN~ON~NT~ ENG~EER~G · ENERGY CONSERVA~ON & ~YS~ T~ODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 3anuary 20, 1986 ~CHO~GE, ~KA 99516 Steven Morris M.O.A. Dept. of Health and Human P.O. Box 6-650 Anchorage, AK 99502 Services Dear Mr. Morris: By means of this letter I wish to request a waiver of State well-septic tank separation criteria down from 100 feet to 95 feet on Lot 4 of Suisitna Sunset S/D. While conducting an adequacy test on the wastewater system serving this property I found the nearest corner of the septic tank to be approximately 97 feet from the well. Several factors support the granting of this minor waiver. Please refer to the enclosed well log and septic system inspection report. When inspected by a municipal inspector at the time of construction, the separation distance was reported as 100 feet. It is not considered likely that the ground has shifted sufficiently in the intervening years to cause the noted discrepency. The ground surface at the septic tank is approximately 20 feet lower than at the well casing, which in the event of a failure of the septic tank would tend to direct effluent away from the well. No water table was encountered in the test hole. The well log shows firm bedrock starting at 27 feet in depth, with the water bearing stratum between 60 and 110 feet in depth. This solid bedrock should effectively prevent any stray coliform bacteria from making their way into the deep aquifer. Please feel free to call me if you have any questions on this request. Thank you for your assistance. cc. Steve Agee Sincerely, Ted Moore, PoE. m 0 o > < ',n OD <o _--" ~' GO Z j'~.i_ I'Yy'"'°l'/°.2 tO2Zl 9ISG6 n~sn[¥ 'eSn.~oqou~ ~.ee.qS oqo~ OCS~I saol.i.[aS [oo!uqoe.l. dollnL4' ENCROACHMENT PERMIT j · His. A REF E T, made this day of , , between ANCHO~GE, Grantor, an~ S~ve or ~rri Aq~/ , Grantee, WITHNESSETHz- ~e Grantor does hereby grant an Encroachment Permit in the following described Public Right-of-Way or Easement Area to wit~ susf~ S~set S~ivision, ~t-4, l~ted ~ ~e ~1/4~ · ' Gr~d~ 2740 _[ 12301 Cottontail Trail ) The encroachment hereby author zi-~d is described as and limited to the followtng'__~klg_~ of a sewer stand pipe for clean, out that encroaches appro~nately 10.4' (~ into Cottontail .Trail Right-Of-Way ~s shown on attachment "A" In consid~raEi~n for this permit, th~ Grantee agrees that he will indemnify and hold harmless the Grantor against any and all claims which may arise or be caused b~ ~he .construction, alteration or maintenance and existence of the above described encroachment or for any damages whatsoever arising out of the granting of this permit. The Grantor reserves the right to revoke this permit upon twenty (20). days written notice to the Grantee. The Grantee, agrees upon said notice of revocation, to immediately remove said encroachment from the easement, street or public right-of-way. Should the Grantee refuse or fail to comply with said written notice, the Grantor, may without further notice to the Grantee, remove or'cause to be removed the encroachment, and the Grantee hereby agrees to reimburse the Grantor for all cost incidental to the removal thereof. The Grantee hereby agrees to pay an annual fee of $ 1~.~0 · IN W/TNESS wHEREo~, the parties hereto have hereunto set their hand~ and s~als t~day and year first above written. Gr an~e~/~ ~~ Grantor ~ ANCHORAGE ~ D--~rec~o~,'P~b-~c~Works Dept. STAT ALAs THIRD JUDICIAL DISTRICT) · 19~, before me, the un~ersigned, State of ~l~a, ~ly~workanO eo~issioned as such, ~onally BPpeare0 ~. ~. //~ , k~own to me to be %he Municipal En~neer of the Municipality of Anchorage, who executed %he foregoing instrumenk said ins%r~ent as ~he free and voluntary a~ and deed of sald corporation for the uses and purposes therein mentioned, and %hat he/she wam. authorizeO ko execute sai~ instrument. WITNESS my hand and official seal the day and year in this certificate first above written. STATE OF ALASKA ) THIRD JUDICIAL DISTRICT ) "y Conuuission Expires: BEFORE ME, the undersigned, a Notary Public in and for Alaska, duly ~ommi~sio~d ~d sworn as such, this day personally executed the above instrument and ~. acknowledged to me that and sealed the same freely and voluntarily for the uses and purposes therein mentioned. ITNESS hand and notarial seal this /~ day of NOTARY PUBLIC IN AND FOR My co.,issio. E×pires,, Y ¥/f7 5' I.)flL, I T~/ I:-5t~'T';, t-- LoT '~' ~ 5c, LE 1"=.40 Z'/,, / E~SEMENT~ OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PI.AT ARE NOT SHOWN HEREON. SET THIS o^TM hereb~ ce~d~ that I: have ~ormed a M~tgagee's in- k.don ~ ~e f~o~g d~ ~ L~ ~ m~ ai~at~ th~n ~ ~ the p~ ~ ~d ~ that no ~v~en~ on p~ ~g ~a~t ~ ROBERT T. KEAN & ASSOCIATES FLATTOP TECHNICAL SERVICES CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS TItEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 January 20, 1986 ANCHORAGE, ALASKA 99516 Steven and Terri Agee 12301 Cottontail Trail Anchorage, AK 99516 Dear Mr. and Mrs. Agee: Per your request, on January 16 I tested the well and septic systems serving your residence on Lot 4 of Suisitna Sunset S/D for adequacy to qualify for Municipal Health Authority approval. The septic system is capable of absorbing effluent at a rate in excess of 80 gallons per hour which is more than adequate for the 3 bedroom home it was built to serve. At the time of the test the well produced a total yield of of 7.57 gallons per hoar or 182 gallons per day. This yield is only slightly greater than the 150 gallon per day design requirement for a one bedroom residence. Thus your home can only technically qualify for formal Health Authority Approval as a one bedroom residence. However, the following factors support the conclusion that the water supply is fnnctionally adequate for at least a two bedroom residence. The total depth of the well is 175 feet, and the static water level at the beginning of my test was 66 feet below the top of the casing. This means that there is a reservoir of 160 gallons of water in the well which can be drawn upou at any time. Thus there is ample water availab]e for any short-ter~ surge demands such as for showering or washing clothes. The 150 gallon per bedroom per day design standard is conservatively based on the assumption that every bedroom is occupied by two people who each use 75 gallons per day. Nationally, the average p.er capita usage is approximately 45 gallons per person per day. Thus the measured rate is adequate for 4 average people. Water couserving measures or devices can easily reduce actual consumption well below the national average. At the time the well was drilled in October of 1980, the driller measured a yield of 1 gallon per minute, which is more than adequate for a three bedroom residence. Bedrock wells in the Hillside area often show a marked decrease in yield during the coldest winter months when the aquifers are no longer being recharged, and the higher yield then returns during the summer months when demand is often greater. I would expect the yield of your well to be greater if measured in the summer. I noted that the pump is equipped with a device to protect it from running dry and overheating, should an unusually large water demand cause the 160 gallon reservoir to be expended. This is a good safety precaution to take in the case of a low yield well. The water sample taken on January 6 was satisfactory with no evidence of coliform bacteria. For the above reasons, I believe that this well should continue to provide an adequate water supply for you and your family. Please feel free to call me if you have any questions. Sincerely, Theodore F. Moore, P.E.