HomeMy WebLinkAboutPENNINGTON PARK BLK 2 LT 3AP nnington Park lock 2 Lot 3A 020- ! 8 ! -52  Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 EImore Road P.O. Box 196650 Anchorage, AK 99507 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSPlO[~' 93 PID Number: 020-181-52 Name: Eballar Revocable Trust Wastewater System: [] New [] Upgrade Address: 107 N. 90th Street Seattle, WA 98103 ABSORPTION FIELD Phone: Number of Bedrooms: 3 [] DeepTrench I~1 Shallow Trench [] Bed [] Mound [] Other: Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 1.2 GPD/Ft2 8 Ft. Block: Lot: Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe: 2 3A Pennington Park 4 Ft. 4 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0-1 Ft. 38 Ft. Well: [] New [] Upgrade Gravel width: 5 Ft. Numberofl lines: I Distance between lines:Ft, Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Existing Ft. Ft. 380 Ft2 ASTM D3034 PVC Ddller: Date Drilled: Static Water Level: Installer: Date Installed: Ft. Phillips Construction North 9/3-4/2010 Yield: GPM Pump Set at: Ft. Casing Height Above Ground:Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~ To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity: From% Tank Field Station Tank Sewer Line Anchorage Tank 1,000 Gal, Material: Number of Compartments: we, >100' >100' N/A N/A >25' Steel Two (2) SurfaceWeter >100' >100' N/A N/A % / LIFT STATION Size: Manufacturer: Lot Line >5' > 10' N/A N/A Gal. "Pump on" level at: "Pump off" level at: in, High water alarm at: Foundation >5' >10' N/A N/A in. in. Pump Make & Model Electrical Inspections performed by: Curtain Drain None Noted Remarks: Existing Septic Tank Pumped, Crushed and Backfllled. BENCH MARK Location and Description: Existing Trench Tied In For Future Use. Garage Slab Assumed Elevation: 100.0 Ft. Inspections performed by: M. Anderson Dates: 1st 9/3/2010 2nd 9/4/2010 ;.:' 49-T.U ~% '..'.~ Development Services Department Approval Conditional Approval Date: ~ .... ..e.*...*,.*',~*,o*~*.o*o*o**'~ .. Reviewed and approved by: i'/"~~ Date: c~-//2.-~--/ 7' I I rq Z © --t 0 Z Permit Number: OSP10 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Page 3 of 3 PID No. 015-221-46 / 90.8 03 / 03 oO r~ 88.8 1,250 Gallon [ ~'7 ! Septic Tank ~ // 85.3 Finished Grade Existing Grade Geotextile Fabric Drainfield Rock 80.9 --/ J 72.6 38' (Trench Length) J No Groundwater x~ · 85.2 PROFILE AS-BUILT No Scale Permit Number: Tax Code Number: Work Type: On-Site Wastewater Disposal System Permit OSP101183 02018152000 Septic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 EImore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade Permit Effective Dates: September 02, 2010 to September 02, 2011 Design Engineer: ANDERSON ENGINEERING Subdivision: PENNINGTON PARK Site Legal Address: PENNINGTON PARK BLK 2 LT 3A G:3437 Owner/Address: EBALLAR REVOCABLE LIVING TRUST 107 N 90TH STREET SEATTLE WA 981033625 Site Mailing Address: 17301 MARl JANE ST, Anchorage Lot Size in Sq Ft: 36514 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Minimum 7 day water monitoring must be provided. Construction may proceed at your own risk before the 7 day monitoring is complete. Please submit stamped and signed results with the as-built inspection report. If the results require a design change, construction of the system will stop pending on-site review and approval. AMC 15.65.060.B.4 Issued By: .... ~.~/_ Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 vvww. muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-181-52 Property owner(s). Eballar Revocable Trust Mailing address 107 N 90th Street Seattle, WA Site address 17301 Marijane Street Anchorage, AK Legal description (Sub'd., Block & Lot) Pennington Park, Block 2, Lot 3A Legal description (Township, Range & Section) Lot Size 36,514 Sq. Ft. Day phone Zip Code 98103 Zip Code 99516 Number of Bedrooms Three THIS APPLICATION IS FOR ([~ all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] 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: ,~-- 30 -~ 3 / O Waiver Fees: Date of Payment: '~_- '?~ / O Date of Payment: Receipt Number:~-~Oq ~ '7 ~' Receipt Number: (Rev. 11/05) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) September 2, 2010 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 3A, Block 2, Pennington Park Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption system on the subject lot has failed and must be upgraded prior to the issuance of a COSA. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing 1,000 gallon fiberglass septic tank will be replaced with a new 1,000 gallon steel tank. The existing absorption trench system will be left intact and tied to the new system with a flow diverter valve. Also identified on the plans are the locations of the existing well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Protective radii are shown to the adjacent wells. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole recently placed on the lot indicated clean gravel with some silt (GMIGP). The percolation rate was determined to be 5 minutes per inch. A previous test hole placed several years ago resulted in a visual rating of 110 square feet per bedroom. We have designed the new trench with an application rate of 1.2 gallons per date per square foot. We are proposing to place a 38' long trench, 5' wide with a 4' effective depth. The total depth of the system will be 7'. The test hole was placed to a depth of 18' and has remained dry since construction. No groundwater is anticipated in the area of the new trench. The ground surface on the lot slopes from the west to the east at a steep grade from the back of the house and then flattens in the area of the absorption trench. The trench Lot 3A, Block 2, Pennington Park September 2, 2010 Page Two will be placed parallel to the contours of the gro.und as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the existing well and from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: o The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed'as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments .~Z_.AST_. 172nd AVENUE 8A ?C 7A 6A ! t ! ! I 9 7A 5A \ .~-~ AREA MAP ~ SCALE 1' = 100' 5 i'~/ 49-1;h MICHAEL E. ANDERSON No, CE-4381 2 Z 0 7 LOT 3A, BLOCK 2, PENNINGTON PARK SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom System 5' Wide Trench System Perc. Rate: 5 MinJInch 1,000 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 3 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 375 SF,Absorption Area 375 SF/5 SF/LF* .5 (Red. Factor) = 37.5 LF Trench Length THEREFORE: Construct a New 38' Long x 5' Wide x 4' Effective Depth Absorption Trench Flow Line Elevation in Trench to be 3.0' Below Original Ground Surface. Total Depth to be 7.0' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Place Flow Diverter Valve and Connect to Existing Trench. Natural I Back~.~ ~ o '-~ PVC (Holes Down) -- Drainfield Rock Geotextile Fabric 4" Perforated TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) ,~,~,~.~,,~ ............. Minimum 6 Separation From Bedrock. ~...j~ ...... .~....,~ ........ ~..:~..~.~ Minimum 4' Separation From Groundwater. ~ ~.~~~~ Minimum 100' Separation From Wells in the Area. ~'"~A~'~.~"'?~ Minimum 100' Separation From Su~ace Water or Streams.-~z No. 5 5 6 7 8 9 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM L~700 SOUTH BRAGAW STREET, ANCHORAGE, AK g9519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: Eba~lar Revocable Livinq Trusf DATE PERFORMED: 9/1/2010 LEGAL DESCRIPTION: Lot 3A, Block 2, Penninqfon Park Subdivision TEST HOLE # 1 SLOPE SITE PLAN Organic Material OG Silty 6rave~ 6W/GM See Site Plan WAS GROUNDWATER ENCOUNTERED? NO IF YES, WHAT DEPTH? DEPTH OF WATER None AFTER MONITORING: DATE: 9/2/2010 S L 0 P E 0% 18 COMMENTS: READING DATE GROSS NET DEPTH TO NET TIME TIME WATER DROP Sfacf 911 11:35 1.25" 1 12:05 30 8,00" 6.'/5" Recharge 12:05 1.13' 2 12:35 30 7.50" 6.37" Recharge 12:35 1.25" 3 13:05 30 7.69" 6.4/+" PERC RATE: 4.6 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN. /~.5 .FT. AND 5.5 FT. Tesf Hote Pre Soaked Prior To Percotafion Tesf. TEST PERFORMED BY: ALAN HARALA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 9/2/2010 GRE, ER ANCHORAGE AREA BOR' IGH Depsrtment of EnvironmentsI Quslity 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTUREI~/_~'~r/ ' MATERIAL /~i~2~7/~-~ COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY//~-~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL// NUMBER OF LINES / ABSORPTION AREA DEPTH: FOUNDATION '~ ~ DISTANCE BETWEEN LINES TOTAL LENGTP~ / NEAREST LOT LINE__~E/~ ~ OF LINES ¢/ TRENCH WIDTH~~'L~,~ IN. TOTAL EFFECTIVE TOP OF TILE TO FINISH GRADE SQ. FT. LENGTH OF EACH LINE / DEPTH OF FILTER ~ MATERIAL BENEATH TILE__~r .IN. ABOVE TILE /~ IN. TYPE BUILDING FOUNDATION __ CESSPOOL APPROVED ..CONSTRUCTION NEAREST LOT LINE OTHER SOURCES __ DISAPPROVED NEAREST SEWER LINE__ DEPTH SEPTIC SEEPAGE TANK__ SYSTEM REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: ~'~¢/''/~:~¢¢~/L/ SEWER LINE DEPTH: PIPE MATERIAL:--~"~/~"~"'/'7 ~/~'~¢' LOT SLOPE: ~¢ fr'/ '¢~ REMARKS: Form EQ-032 DIAGRAM OF SYSTEM d GReater ANCHOrAGe Area Borough DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE Z74-456 ! LEGAL DESCRIPTION SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION Of: SEPTIC TANK / -'"~ SEEPAGE PIT /--~'"'""'""-"~-- DRAIN F OTHER ........,..o....,.,...o.....v.. FINAL INSPECTION: 24 HOUR NOTICE REQUIR OF ANY RY~'' ..... WiTi:--UT~ Fi;;AL TION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REOUIR;MENT~ /,~ FOUNDATION TO SEPTIC TANK . DRAIN FIELD SEPTIC TaNK TO SEEPAge PITWaLL SEPTIC TANK ~- / TO ~EA~EST LOT LINE. W~ TO S~P~IC ~ANK DRAIN FIELD /~ ~ . , A~SO CONS,De~ A~eA W~L~S. WATER MAIN TO SEPTIC Tank SEEPAGE PIT DRAIN FIELD SEPT,C TANK, ../"~ ~ .'SEEPAGE P,T/~O" TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED WITH AIRTIGHT REMOVABLE CAPS. G"AVE:L BACKI='ILL /'~C/,"~- /C'~'x't2' CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION, LICENSED DESIGNER I CERTIFY THAT I Am FAMILiar WITH THE REQUIREMENTS OF GREATER ANCHORAGE A,~REa BOROUGH ORDINANCE ~) 28-68 AND THAT DESCRIBED SYSTEM I$ IN ACCORDANCE WITH SAID CODE, ~_~ .-'} / / THE ABOVE DATE' ~' ! / &' / I //~AZ~:NT'$ SIGNATURE/ /'/~2, ..__~/~/~/./~.(:~.~/ [ ~," '/~/,~.-6/~,~x~ ' / TIER ANCHORAGe AREA Borough SEWAGE DISPOSAL SYSTEM APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK TYPE AND SiZE OF FACILITY TO BE SERVED FINANCED THROUGH COMPLETION DATE ANTICIPATED MA'L'NG ADDRESS SEEPAGE PIT ~ DRAin Field OTHER TO BE 1NSTALL2bY ~~' ~q~.~O~ NOTE: THIS PERMIT IS NOT VALID_WITHOUT SO_IL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK fOUNDAtION TO SEEPAGE Pit ~(-~ SEPTIC TANKTO SEEPAGe PIT WALL /~-- / SEPTIC TANK 5~' , SEEPAGE Pit TO NEAREST LOT LINE. ! WELL TO SEPTIC TANK '/~ DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD /~)- / SEPTIC TANK SEEPAGE PiT DRAIN FIELD ! ~ / ,DRAIN FIELD SEEPAGe PiT ALSO CONSIDer AREA WELLS. ~ SEEPAGE PIT /00/ DRA,N F,ELD ., /'bo TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRib CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DiaMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH or/~,,NANC40. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, '~ /, j //~': ~OR~ N~. ~-01 6 ' Performed Legal This DEPA"~MENT OF EtlVIROu'~r'~' 3500 TUDOR ROAD .,NCHORAGE, ALASKA 99502 CASE # 25 RECE., V.~D' , PM For Bruce LaRosa Date Performeo~J~l~!~t?~t~l;p~.. Descrip't'ion: Lot 3-)Block ~. Subdivision. Penmn. gtonpar_k '"°~""~q~X?~?~ff~ Form Reports Soils Log ~ Percolati6n Test Depth Feet ]. ---- 2~ 3~ 8'-' 10"-' Soil Characteristics '~Organics, surface cover Gravel, Sandy - 3" layer silt at 1' dark brown GW ........ ? ........... W~s If Silty sand, brown, medium fine - coars{' -- Sandy Gravel GW Sandy Silt - fine SM Sandy Gravel - dark brown, med. GW Silty Sandy Gravel -GM Ground Water Encountered? Yes, At What Depth? No 1 r t :' i I I Reading Date Gross Time Net Time ! Depth to H20 I Net Drop ate Minute Proposed Insta)']ation: Seepage Pit .... x~. Drain Field Depth Of Inlet Depth To Bottom Of Pit i)¢' Trenchl3' COMMENTS: Soil characteristics require at least 110 sq. ft. p?r bedroom. yes't performed By W. F. AIL-wood [ '? Data" Certified By: ALASKA MINERAL & MATERIALS LAB,' INC. '~_.-7 7~.--.'Z' 7l ~ Da t e: May 31, 1973.' 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 1. GENERAL INFORMA'I"itON Application Date ___ (a)Legal Description (include lot, block, subdivision, section, township, range) ......... ..... ..__Tz/¢¢ ......... Location (address or directions) (b) App,icant Name __~,__~~ Telephone: Home ,~"1~ .... Business A p p li c ant A d dr ess _J~_~_¢~__.~~~ ................... ~¢~.._ ~ (c) Applicant is (check one): Lending Institution ~ ' Owner/builder ~ ' Buyer D ' Other D (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"~" Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well'l~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite'l~ Public [] Community [] Holding Tank [] Note: tf community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72~025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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 on-site water supply and/or wastewater disposal systern 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~,C~-c.~.Z3~t~~~~~Telephone _~.~,/'~ Address ~,2(:2¢,~_~_~.~. ,S'~_~ .~~____~,C_~~l .,~_~,¢~_~-¢~. ............... Date ~/l?//~&'-' "' Engineer's Seal DHEP APPROVAls. Approved for. _~_%:_7~__~._b e d r o o i'rr~by .... ~'_' ..... Disapprove~ _ Approved Terms of Conditional Approval ¢'onditional 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 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: _/-~)- MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION WELL DATA Well Classification /~//,/'t'//~' t.,,-' If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/~.~ D~e~n~etedD ~~/ Yield Total Depth ~ Lf .... /Cased to ept Static Water Level /_/L/f Pump Set At Sanitary Seal on Casing~j~N) Casing Height Above Ground Wiring in Conduit (Y~j) Electrical Separation Distances from Well: To Septic/Holding Tank on Lot Depression Around Wellhead (Y/I(~ I0~ I ;~- ¢'/" 'OnAdjoiningLots To Nearest Edge of Absorption Field on Lot / 1~--/ ; On Adjoining Lots To Nearest Public Sewer Line ~ To Nearest Public Sewer Cleanout/Manhole c.~~To Nearest Sewer Service Line on Lot Water Sample Collected by ~ ;Date B. SEPTIC/HOLDING TANK DATA Date lnstalled /~//(/::~Y'~'/ Size / Standpipes~N) Air-tight Cap,~. ) Depression over Tank ~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 /~_~O / To Property Line '/7/~/ To Water Main/Service Line ~z.. .....---- Course _/~/~/C~ No. of Compartments Foundation Cleanout~N) Date Last Pumped ~//?/"~ ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) ABSORPTION FIELD DATA Width of Field Soils Rating in AbsorptlonStr/ata / ///~:~ /--'~'~" Type of System Design Date Installed //~'////~* ~- Length of Field Square Feet of Absorption Area /'// Depression over Field (Y~) Date of Last Adequacy Test Results of Last Adequacy Test ~/'¢-~~ Separation Distance from Absorption I~eld: /' TO Water-Supply Well //"~ / TO Building Foundation To Water Main/Service Line ¢' ~'/ Depth of Field Gravel Bed Thickness ~..~'- / ~~r~- ~ Standpipes Present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~v-~~t'e~'~4~'- ~t~ /~ To Property Line To Existing or Abandoned System on ; On Adjoining Lots ../_, w./~::~ To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons , le/Ac~) i "Pump On" Level at ~! ...... ~Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for '/~' Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes ~Y/~ Comm~ ** 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. Sig e~ i~,L.~.i~I~'~ ~' Date ~::~//~/~'~-'~/~ " Company ~' ~' (% ~ MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) ALASKA llLIIROFImI FITAL COFITROL $1 RUICI $, IFIC. BILL WELCH 17301 MARY JANE STREET ANCHORAGE ALASKA 99516 SELLER-SAME AUGUST 13 1985 BILL WELCH 17301 MARY JANE STREET ANCHORAGE ALASKA 99516 50438 LEGAL:PENNINGTON PARK BLOCK 2 LOT 3A ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-JULY 16 1985 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 410 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 607 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON JULY 17 1985 . FLOW TEST ON WELL WELL FLOW DATE-JULY 16 1985 THE WELL FLOW RATE WAS 3 GPM FOR 3 HOURS. THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME. 1200 LU6sl 33rc~ Augnu¢. $uiI¢ ~ · Anchoro§¢, Alosko 99503 .[907} 561-5040 INVOICE N° ~ i 2 8 9 7 M-W DRILLING INC. I-'.U. ~U,~ llU~ /1~ UNIT ANCHORAGE. ALASKA 99511 QTY. MATERIALS PRICE AMOUNT PHONE 349-8535 ADDRI~S - c~TY LEGAL DESCRIPTION LEGAL OWN E'R5 BANK OR LENDING INSTITUTION5 CURRENTLY HOLDING DEED OF TRUST HOME PHONE WORK PHONE WELL NUMBER DIAMETER~ ~/DEPTH STATIC~ ~LEV L GPM1[ DRAWDOWN PUmP MAKE hP SETTING VOLTS PHASE AMP RATE SERIAL NUMBER MODEL SCREEN LENGTH SLOT SiZE LINER/SCREEN DESCRIPTION Of WORK DATES LABOR Ail ch.arges shall be paid in full within ten 7 days unless °'her arrangements are made /~-['~1~ ' prior to dr/fling. The customer shall pay in- terest at the rate of 1~ % per month on any _&__ii,J(-- ~ MATERIALS {FROM ABOVE~ OTHER CHARGES amount not paid within ten days. Failure to pay may result in a fien against the property. _ · CUSTOMER SIGNATURE pAy-~..s AMO,,NT Time ©i'.~~ #2: Time ~3: Time MUNICIPALITY OF ANCHORAGr DEPARTME~,, OF HEALTH AND ENVIRONMEN, - PROTECTION 8259 L Street, Anchorage, Alaska 99501 b~,~ fYd~a~' 264-4720 ~x~,~ ,=~ a~ Date Received: September 1, 197'7 Date Ol-~-"]~[ (~L.L¢~, Date Date Insp 12~ ~ ~ta~t~ Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Pouch 7-010 Mailing Address:~ Alaska National Bank of the North 99510 Phone: 278-4581 Property Owner: Mailing Address: James L./Ronilee Lynch Phone: Terrie Piza, 276-8100 or 349-4723 3. Legal Description: Lot 3A Block 2 Pennington Park Subdivision 4: Single Family Residence: ( ~ Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Well System: Permit # Individual well ( ~ Community/Public System ( ) Depth of Well Well Log on File ( ) Construction Bacterial Analysis Sewage Disposal System: On-site System ( ~ Public Utility ( ) Permit ~ Installed ~'/// /'~---Installer Septic Tank Size Absorption Area~~/~ stances: Well to Septic Tank /~ to Sewer Line /'~/ to Nearest Lot Line Manufacturer =~z~_w~/ Soils Rate //~ ~ Material to Absorption Area Nearest Lot line Absorption Area . < ..... ~ ]'~,~', MUNICIPALI. TY OF-ANCHORAG[ - L~,._~ - ~~-'~ ~1' Depar~tmen%' ~f'~ ~eat~th~ ~and~ Envir°nmen'tal Protection ' ~~~/u- ' '825 L street, Anch°rage, Alaska 99501 ~.;; 279-2511, ext. 224, 225 .... ' est for Approval of Individual Sewer and Water Facilities 1. Proporty Owner: .~ ~ ~ Phone: Mailing Address: l~ ~~ .... ~ 2 Name of Buyer: ~A~ C, ~ ~ , ~~ ~~~ Mailin9 Address: ~ ~ &~' Phone Se Lending institution: ~ ~ Mailing Address: ~~ 70[0 ~~ ~/o Phone: ~7~-~/ Realtor/Agent: A~ ~ . ~~ /q~--~ ~~ Mailing Address: ~O'~.'~~~, Phone: Legal Description: ~~ ~_ ~~ ~ ~~ Street Location: ~N N ~~ Single Family Residence: (~ Number of Bedrooms: _ .~" Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well (~ If Individual Well, well depth If Community System, name of system Public/Community System ( ) Sewage Disposal System: On-site System If On-site System, date of installation: Public System ( ) *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 Page Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 3A Block 2 Pennington Park Subdivision Af fadavit Attached Approved Disapproved: Letter Attached: ( ) Date: Date: 5).- /,9- "77 Department Worksheet: