400%
200%
100%
75%
50%
25%
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
PENNINGTON PARK BLK 2 LT 5
Pennington Park Block Lot 5 2 #020-181-42 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 9951M650 Page of www.d.anchorage.sk.us (907) 347-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWC7;50-VAq PID Number. 042 O - 16 1 - Y Z- H'm"Pau Plv..e Wastewater System: ❑ New NfUpgrade amara 5-10t KD 1-LA ND R AVE. ABSORPTION FIELD Pte» 345-4414 M.b. Ne 3 0 Do" Twxh0 slwnow TWch0 ew OMeww ouw sNl Raft TNN DepF,eem� grade: LEGAL DESCRIPTIONDoom? Worn. Lot:SVDaNN«e DepF, to Floe aon«e Rom orW^N pees: GravN bwwaF, PM' 2 5 Pe m n;., 40 P4� k Ft. F, Taw,anp: Raw svN Fa a60M 8 w Fnprw 911160: GIrM LangF[ Ft. F,. Well: �i`Fiifi [3 New Upgrade DmM widit 14 F Niw11: ohsl n Wrwenf F,. F, Ft Cwsuftal n (Pmele, K e. CT TNN D"F,: caw at, TNN We«FF6n w ' P"M wwr: Ft. FL Fr DNaq Data Dree6: sYeEWet«Lw+t bUIIK Date Meaed: Fl. DSA. o YM6 Pump 3N N: Cams H9911 MP's Gould TANK GPM FI, FL SEPARATION DISTANCES ❑ Septic %Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption LIR Holding Pubtk/PdvalMi1bd1i4 11 Ancv Tank cap« y From Tank Field Station Tank Saver Llna or Gat-4cw — — _ _ M«an11t S}eCL «uroerN t«roanmemel wen Ito r LIFT STATION ov San. MarWa4u« Lot Lew — '� D GN. lpwrip A «, N.al at •Pwv w M N: High w«« N«m 61 In N. Pump Me11a { EMcokal Yupeeuone pvlpnnW Fy. Cutty, DIN. — I — R'm'"` G SurWIr BENCH MARK laraw, w wrerra«e 0- lA/ OsO019 Corte witJ -.I r Mw Ew"SUV, Std u l00 FL sStaili�-E _wfn'gi11A. d9�asilsq�tgaLx��•a L Inspections performed by: Lon, SnurkIyA Dates: 1" 5 200 0r5 ;�a{ass:� 2n° Developm rat Services Department Approval Cif, Csc.:m. Reviewed and approved by: Date: S� F4rK1 m \ We 4A , \ \ 6 R75.00 � / VIe \ � 1 \ \ \ as /\\ \ t , Y.N ♦ \\ V OF 14 YP�E,........A.., .♦'0 AW w 4L \ t V►" 4 \ / 25 0 25 50 75 1 SCALD 1' = 50 FT. ftN SPURKLAND No. CE -2227 _ . SPURKLAiVD ENGINEERINGENNINGTON PARK. BLOCK. 5 SEPTIC SYSTEII.ASBU/LT 103 W 15TH. AVENUE DATE: MAY 4, 2005 ANCH. AK. 99501 5 PAUL MANEr SHEET 1 2 CR/D: 3937 W71 97o—rofR a7nf mtAmncv Avr7urrc IPERMIT N SWO50089 PID #0230-181-42 PEN02052.DWCN SWO500B9 PID #0230-181-42 PEN02052.DWC £LEY. 98.8 2' INSULATION £LEY. 95.8 18' 0 RAIN CAP 6' PUMP I' X 10' CONDUIT 1' GALVANIZED LB. DIRECT BURIAL VIRE TO ALARM PANEL 1' PVC HIGH VATER ALARM ELEV. 95.8 MERCURY SVITCH FL AT 755' r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r 17' STANDARD •4000.,G/,L..,,HOLDING TANKOF lot ••OPE.. , b�� ANCHORAGE TANK NO SCALE 49th `s A No. CE -222 /,; • ' 7,-"W• • :�Ssta:•-• A s 3 u ► �-� AEWH MURK: AZWEO ELN. 100.00 fT. ISPUKKLAND LNGINLLKINGI I pENNINGTON PARK BLOCK 2 LOT 5 I (HOLDING TANK REPLACEMENT 203 . 15TH. AVE SUITE 203 PAUL MANEY DATElAARCH 30, 2005 ANCHAK. 99501 ~71 970-'iQ1R 5701 KALLANDAR AVE. SHEETi 2/2 GRIDS UJ7 1 SW050XXX PID 010-181-42 P£N01053 S_Gf._os cp 3: n< MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Apr 19, 2005 Expiration Date: Apr 19, 2006 Permit Number: SWO50089 Parcel ID: 020-18142 Legal Description: PENNINGTON PARK BLK 2 LT 5 Design Engineer: 0007 Tobben Spurkland, PE Site Address: 005701 KALLANDER AVE Owner Name: PAUL MANEY Lot Size: 22583 SO. FT. Owner Address: 5701 KOLLANDER AVENUE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE, AK 99516 - This permit is for the construction of: N Disposal Field N Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ 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 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 closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. PERMIT IS ISSUED FOR 3 BEDROOM SINGLE-FAMILY RESIDENCE ONLY. THE HOLDING TANK NEEDS TO MEET ANCHORAGE MUNICIPAL CODE 15.65.070, HOLDING TANKS. Received By. Date: y10 5 V Issued By.Cft:�_Date: & 1 Of 0 \\ •� — / PA. Wix 19CAM • Anchoragc, Alaska �YJ519.6(ZO • Telephone ('907) M-9301 • I'm ('907) 33. -KOO N "- ii 470U Brapw Street - Anchorage, Alaska 90507 s • s r x•xx•.munl.Org Mayor Mark Begich Ilutlding Safcty Dit3sion April 19, 2005 Tobben Spurkland Tobben Spurkland Engineering 203 W 15th Ave, Suite 203 Anchorage, AK 99501 Subject: Waiver Request for Pennington Park Block 2 Lot 5 Waiver Request #WR 050019 Parcel ID # 020-181112 PERMIT SWO50089 Dear Tobben Spurkland: Your request for a waiver of the required 100 feet horizontal separation from the holding tank to surface water has been approved. The approved separation distance is 40.0 feet. The approved separation waiver applies to either water body. Please refer to waiver letter issued by Keith Brandt from Dept. of health and Environmental Protection, dated July 12', 1984. This waiver approval applies to the existing holding tank to surface water separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jo Goodall Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity 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.ek.us (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O20— l A 1 — 4;- Permit Number SW Property Mailing address (1) 13 Y 3 & ' 5 *Vle ►' address (2) X011 lQfY1_Eh Legal description (Lot, Block & Sub'd.) Dayphone .2711—a.0 ;l. kk 49h01 Zip Code Legal description (Section, Township & Range) Lot Size AQ+• 5S3 Acr /Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: 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 authori jed agent) Waiver Fees: Leh! cl __._ qh-165 Racnip( Numhm: 65550- _.__.. e, Permit Fees: I-ufni_it. ' (Rev. 1b00) �— Waiver Fees: Leh! cl __._ qh-165 Racnip( Numhm: 65550- _.__.. S PU PPTLAND ENGn IlE]EPJNG 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 5 BLOCK 2 PENNINGTON PARK S/D PAUL MANEY Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street Anchorage, Alaska 99519-6650 April 13, 2002 We are submitting an application for the replacement of the 3000 gallon holding tank on this lot. The present tank was installed in 1984 and at that time waivers were granted to a pond on Lot 5 and a road ditch with running water on the east side ofKallanderAvenue (Wavier Letter 7-12-1984, KeithBandt). These water bodies still exist and the new tank needs the same waivers (50 +- feet). A well separation waiver is not required The justification for the waiver is the same as it was in 1984 (wavier request, 7/9/1984, Theodore More). The proposed holding tank is made of 3/16 inch stee4 coated on the inside and out with coal tar pitch. Leakage into the ground caused by corrosion damage to the tank is highly unlikely. Special Construction Techniques Use of water tight flexible couplings will be required to ensure a water tight seal and the tank inlet and outlet. All pipe joints will be provided with shrink wrap seals. A 4000 gal tank will be installed for a 3 -bedroom residence, to minimize the frequency of pumping and maximize reserve capacity. A high water alarm with a mercury switch float will be installed to indicate when the tank is 2/3'3 Poll, providing several days reserve capacity after alarm is triggered Mitigating Factors A holding tank is a closed system with no sewage discharge to the surrounding environment. We request that a permit to replace this holding tank be issued. Yours truly, Tobbenurkland P.E. i 'T\ SErl- 3A \A ---7 _ - OM eIR 4A 6 06A \ ¢\ Me» \ 5A CiL de \ \\ 3A 000 4 40 i j 5 o... 50 0 \\\50 fan 150 aro SCALD 1'= 100 FT. 49th !^►,! Ijt'UMKL9NV LNG/NUMING(�PENNINGTON PARK BLOCK 2 LOT 51 I SEPTIC SYST£Al DESIGN I 203 W 15TH. AVENUE II DA M. APRIL 4, 2005 ANCH. AK. 99501 PAUL MANEY (907) 279-3916 5701 XAILANDFR AVENUE SNffT 1/3 GRID: 3437 I PERMIT # SW050XXX PID # 0130-181-41 PEN01051.DWG 5EP% \ \ \ / We 4A \ \ \ \-¢-\ VIe \ �St , 5 \0000.�' 4 i Zs o 25 so 75 SCALE+ P = 50 rT. i TAT. 5 11 PAUL MANEY I I DATE. MARCH 30, 2005 snm ,renewnra evrurnr SHEET.• 112 GRID. 3437 P£RNIT # SW050XXX PID / 0230-181-42 PEN02052.DWC �__ RAIN CAP 6' PUMP o 1' X 10' CONDUIT I' GALVANIZED LB. LBIRECT BURIAL VIRE ARM PANEL 1' PVC CON NIGH VA TER ALARM MERCURY SVITCN FL 14T 18' 75.5' r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r 17' STANDARD 4000 GAL, HOLDING TANK ANCNORAX TANK `9 .` 49th )Bfp SPLPKLAND No. CE -2225 .: NO SCALE BEACH MARK.• ASSWtD [ILI: 100.00 !T 1203 VQ,rUKNLANlJ 5TH AVE SUITE 2 I I PENNINGTON PARK BLOCK 2 LOT 5 I (HOLDING TANK REPLACEMENT I 203 V 15TH. AVE SUITE 203 PAUL MANLY DATE -MARCH 30, 2005 rgn7i P7Q—"tg 501 5701 KALLANDAR AVE. SHEETt 2/2 GRID, 3437 SW050XXX PID 020-181-42 PEN02053 MUNICIPALITY OF ANCHORAGE 0 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑ NEW les /70 3 /1— Ids y ® UPGRADE MAILING ADDRESS 4"7?— r- r A o rrwd 9 9S'/ LEGAL DESCRIPTION Lot S II 10C ke paw r LOCATION Ka!/cr.nder s -k NO. OF BEDROOMS 3 Well Absorption area Dwelling PERMIT NO. UY DISTANCE TO: aQ Manufacturer Material No. of compartments wF N Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth Z DISTANCE TO: Well /DO Dwelling yO PERMIT NO.. 0: Manuf cturej k- Matrial e Vat/ Liquid capacity in gallons ra GN 4 000 w DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. = J u. z No. of lines Length of each line Total length of lines Trench width Distance between lines P Z W inches FTop of tile to finish grade Material beneath tile Total effective absorption area p inches Length Width Depth PERMIT NO. W 0 Q F as W Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J W � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS f ldtjAc D 303 SOIL TEST RATING N INSTALLER De ArMovrl OxCa vw �r► REMARKS � ah kA lee �► (, L, v.d 6,amt/ Cao ilio1 y'rglv/leo � In wed s /un of a V ^ Ct /a drM LAJAar► fVAAtr 2/3 fl/. o $T N s fo All ect O'er f+t01 (Tlei r t o PrP ` 13 f I CSF A 6 i x n ,►'"'w.fo l� r .•••....... ll01 I�:' •'. 14rM OX 9CIV r•.....•......•s.......i 4 ~ m� /, r ..............:........ : rHr000PE F. APPROVED V �` `. C g9 FOAL 72-013 (Rev. 3/78) 9411 6pi ^ MUP4 I C I F::*AL- I -1rV OF= DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ^ � 825 L STREET, ANCHORAGE, AK 99501 264-4720 ' x - PERMIT I -F E� E3 FEE ��F�F� F�F�F�P1][ -� / ` PERMIT NO: 840571 HOLDING TANK DATE ISSUED: 07/13/84 APPLICANT: ELIDA A. MEYER ADDRESS: SRA BOX 472-E ,. ANCHORAGE, AK 99516 CONTACT PHONE: 345-1814 LEGAL'DESCRIP: SUBDIVISION: PENNINGTONPARK S/D LOT: 2 BLOCK: 5 SECTION: 10 TOWNSHIP: 11N RANGE: 3W LOT SIZE: 0.5A (SQ.FT. OR ACRES) I certify that: I. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MQA codes and regulations, and in compliance with the design criteria of this permit. 3. 7 will adhere to all. MOA and State of Alaska requirements far distances from any existing well, wastewater disposal system seweragesystem on this or any adjacent or nearby lot. �*,/.�^�/'f LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING THEN`/k1)04AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTR%CIAN.�,~� SIGNED APPLICANT: ELID A. MEYER ISSUED BY ' DATE: - DATE: the set back or public COQES, AS-BU%LJS- (3) THE , ' w^ -^�------ ~^ ~-n--�--'---~ ~L lu. Ri�i, I T 0 J D r Box 0.1 11.-: 1-1 C', r P richore?g(! T., "I r r i 1 t,c)r v ,Aj 1 o) c, gre o ci Lwc,,--_' ri �' -1 1 0 I I I r r r t h t t.Iie ho11 r i n c r li 7)C d !- Ill" c, :1 1 1 in t p '! n (I I I C, tr I T h rll �l nm sy:�, c, ri, to o r m 4- c r,, p o n, of rtv • Ila to, M,unlcip&..ity . of Anchorage PO. � 6-650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 ]ONY KNOWLES, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION July 12, 1984 Mr. Theodore F. Moore, P.E. Flattop Technical Services SRB 7380N Anchorage, Alaska 99516 RE: Lot 5, Block 2, Pennington Park S/D Waiver Request Dear Ted: In consideration of your letter dated 9 July 1984, the only acceptable solution to the on-site waste water disposal system problem on Lot 5, Block 2, Pennington Park Subdivision, is to replace the existing failed system with a holding tank. Minimum tank size will depend upon the rated number of bedrooms it will serve, but a 3,000 gallon size desired by the current owner would likely be adequate. Your request for a waiver of separation distance down to 40 feet to either, water body, and 85 feet to the private well is approved. The existing failed septic system must be properly abandoned by: 1) pumping the septic tank and either filling it with soil or removing it; and 2) capping off pipe leading to the absorption field. The holding tank installation will require a permit from this Department, and will have an electrical high-water alarm system installed as a condition of the permit. A pumping/maintenance contract between the owner and a pumping contrac- tor will also be required before final approval to the system and to the as - built diagram is given. Sincerely, Keith E. Bandt Environmental Engineering Manager KB/ej/D18 cc: Mrs. Elida Tessaro SRA Box 472 E Anchorage, Alaska 99516 FLATTOP TECHNICAL SERVICES CIVIL & ENVIRONMENTAL ENGINEERING • ALTERNATIVE ENERGY DESIGN • TRANSPORTATION PLANNING THEODORE F. MOORE, P.E. PH: (907) 345-1355 July 9, 1984 Subj: Lot 5, Blk 2, Pennington Park Sub. Approval of Holding Tank/ Waiver of Separation Criteria Keith Bandt M.O.A. Dept. of Health and Env. Protection 825 L Street Anchorage, Alaska 99501 Dear Mr. Bandt: STAR ROUTE, BOX 738ON ANCHORAGE, ALASKA 99516 QTAI I f N011011OU IV -1-N-11. ?IIRNa 18 H1lVV 40 id](l 30'aOHDNV A0 kLI1VdIDINnA During June of this year I have made several inspections of the subject property in conjunction with determining the adequacy of the existing water and wastewater disposal systems, prior to sale of the property. Unfortunately, the existing wastewater disposal system had failed to the extent that septic tank effluent was leaching out onto the ground surface. I performed a soils test on June 18 as part of the procedure to secure a permit to upgrade the disposal system. (See the attached M.O.A. Soils Log - Percolation Test report form for applicable data.) At that time I also noted serious problems with separation criteria, notably the fact that the existing system was installed approximately midway between a man-made pond and a small stream situated 100 feet apart. I accompanied you on an inspection of this situation on June 19. The original septic tank and seepage pit system on this half acre lot was approved by the Borough and constructed in 1971. It was subsequently reapproved by Les Bucholz of the Borough in 1975 at the time of resale to the present owner. No mention of: either the stream or the pond being in violation of Borough and State separation criteria appears on either of these documents. Sometime after 1975, (in approximately 1977), the seepage pit failed and the owner had a replacement disposal system installed. This work was done without a Municipal permit, and no records are available regarding the nature of the system. Based on my discussions with you and with Bill Lamoreaux at the Dept. of Environmental Conservation, it appears that the most acceptable solution to this problem will be the installation of a holding tank, and both the owner and the prospective buyer have expressed willingness to go along with this if it is the only acceptable course of action. They will install a holding tank of 3000 gallon capacity in order to minimize frequency of pumping and to maximize reserve capacity. M.O.A. Regulations 15.65.090 and 15.65.050 require that a holding tank be installed a minimum of 100 feet from wells, lakes and streams. In order to permit this installation it will be necessary to waive the lake and stream separation distance down to 40 feet, and the well separation distance down to 85 feet, which is in compliance with existing D.E.C. criteria. D.E.C. has no criteria for minimum separation distance between a Bolding tank and lakes and streams. The septic tank will be installed equidistant from pond and stream. I believe that the 40 feet separation from lakes and streams can be justified in light of the closed nature of the system and the relatively large reserve capacity. As we discussed, there is also a partially blocked culvert connecting the stream and the pond which passes very close to the existing disposal system. I had a water sample from this culvert tested for fecal coliform, and it tested out as 1 colony per 100 ml. This is a very low incidence for natural runoff indicating contamination from the disposal system is not presently entering the culvert. Installation of a holding tank should minimize the potential for contamination here also. The reason for requesting a waiver of the M.O.A. holding tank - well separation criteria down to 85 feet is to permit a greater separation between the holding tank and this culvert. It is my professional opinion that installation of this holding tank within the constraints of these modified separation criteria is the best solution to the obviously unacceptable situation which presently exists. I believe this holding tank, when operated properly, will adequately protect the public health. Please advise me as soon as this waiver request, with a copy come in and pick up the permit. cc. Mrs Elida Tessaro SRA Box 472 E Anchorage, Ak. 99516 2 possible of your decision on to Mrs Tessaro, so that she may Sincerely, Theodore F. Moore A-et�, OF• AliAr •. �► 0INEODORE F. /,IOORE • :.z .�. CG - 3589 i ' Ar a7(i FLATTOP TECHNICAL SERVICES CIVIL & ENVIRONMENTAL ENGINEERING • ALTERNATIVE ENERGY DESIGN • TRANSPORTATION PLANNING THEODORE F. MOORE, P.E. PH.- (907) 345-1355 July 3, 1984 Subj: L,ot 5, Blk 2, Perin.i.ngton Park Sub. Approval of Holding 'Tank Bruce Erickson Alaska Department of Environmental Conservation 437 E Street Anchorage, Alaska 99501 Dear P1r. . Erickson: STAR ROUTE, BOX 7380N ANCHORAGE, ALASKA 99516 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOti 'JUL 91984 RECEIVED I have been requested by Keith L'andt at the M.O.A. Dept. of Health and Environmental Protection to obtain D.E.C. review and guidance on the following wastewater disposal problem and proposed solution. The subject system, as illustrated on the attached M.O.A. Soils Lot; — Percolation 'Test report form, Is Located in the Goldenview Drive area of Sough Anchoral;e. The original septic tank and seepage pit- system on thiti half acre Lot: was approved by I lie Borough and const ructed i n 1 x)71 . 1 t. was subsequent: Ly reapproved by L,es Bucholz ot. the Borough in 1975 at: the t i.me of resale to the present family. Pao mention of any pond, stream, or problem with separation criteria appears on any of these documents. Sometime after 1975, in approximately 1977, the seepage pit failed and the owner had a replacement system installed. This work was done without a Municipal permit, and no records are available regarding the nature of the present absorption system. In June of. Lhis year I was requested by the owner's widow to perform an adequacy test of this system as ;-I condition of sale of: the property. When I inspected the system, [ Found that the absorption system had failed and some of the septic tank effluent was leaching out onto the ground surface. I also noted that the the disposal. system was located approximately midway between a manmade pond and a small stream situated 100 feet apart. A partially blocked culvert connecting the stream to the pond passes very close to the existing disposal area. I had a water sample Erorn this culvert: tested Cor Fecal. coliform, and it tested out as 1 colony per 100 mi . This is a very low Incidence for natural runoff indiC;rt.in}; LIINt. Cont;rIII in.1t.iou from the disposal system i s noL 1)resellI I y c,ntvI- i n} I I(. cu 1 v'There i s no other. site availahl.e on this Lot. On .lune l9 Kei.l.h I;andt- i.nspect.ed this system with me at my requerst. X SOILS LOG /--- MUNICIPALITY OF ANCHORAGE ® PERCOLATION 1 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: E ba&v- ressary DATE PERFORMED: 6110 AfY LEGAL DESCRIPTION: Lof'.S Bfr 2 Pef eIA AA prezrk 4k 6 DEPTHdo# An*At t„�Y&(� SLOPE SITE PLAN (> o.s 1 $ANvrAve�. C6w� (S v116'AMIt LA rGfi Rao>? 2 3 S ILT �" SAH p Y lrHAu�t Caw/6�+� FS -f .01 4- 5 IVAT SR SOSOPING out or Soft 6 Fl. Z 7 S f t. T r 6;dh& $ L L6rt 12 -I Gf^Arl6YGR/�L��C) 13 14 1 � eOT 1'* f4 ole 06 it -6 15 �,��•4F A `q` wft 16 'r .•' '••.�! • •�*♦� ; /� 17 t" 9TH ON AV .........................' 18 0 • •.••r...• ...., •' :THEODORE F. MOORE ; 1 19 �� CE - 3589 � WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? res O P E s.o ;if Reading Date Gross Time Net Time Depth to Water Net Drop 6/18 N:37 PM en 30 N 2" gVs" 3 6 s d 7 Pry 3V N 2 y8 a 6;07 Piy 30 20 profession • ,�*�`p��• .�!„RCOLATION RATE 13 (minutes/inch) •TEST RUN BETWEEN FT AND y %r FT COMMENTS too' %>rAI- pts TANG l6 A?ar&ow PoMQ ITOA05fo e De7cm PART1.46•161- e49644$0 Cad.VffdT PANS .TEST 645,UVAtTO 0#41*00VA0 7V OWOR 00000 �M PERFORMED BY: �O^ o0 ee CERTIFIED BY: C.� T DATE: 4r1lolo!y civitf # 8r-o5Z 72-008 (6/79) ?104 NN GRr'"TER ANCHORAGE AREA BOROV"H HEALTH DEPARTMENT 515 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM /I- �C C2� � MAILING .�J ��9� '7'� [L PRUNE NAME � / A,DODRESS� /� } LOCATION /� C( �iE'7�C'/U�r GA L dAK SeRIPTION SEPTIC TANK: DISTANCE FROM WELL 4/ MATERIAL 1 e LIQUID CAPACITY 0 GALLONS. INSIDE LENGTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF l COMPARTMENTS LIQUID NSIDE WIDTH DEPTH. NUMBER OF PITS OUTSIDE DIAMETER OR WIDTHLENGTH, DEPTH LINING MATERIAL ©� DISTANCE FROM WELL / C� BUILDING FOUNDATION �! NEAREST LOT LINE �" TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 3 .;6 SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER ABSORPTION AREA DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE , NEAREST LOT LINE TRENCH WIDTH TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL:� S fll! DISTANCE FROM /WATER TYPE DEPTH , BUILDING FOUNDATION. SAMPLE NEAREST NEAREST SEPTIC �/ / / SEEPAGE C' L / OTHER LOT LINE SEWER LINE TANK 1.2 d SYSTEM CESSPOOL - , SOURCES DISTANCES: DIAGRAM OF SYSTEM DATE Z_ APPROVED HEALTH UTHORITY GREA I ER ANCHORAGE AREA BOFtvUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 14111 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT �r/��`'� l�i� MAILING`' ADDRESS } `^ %J""'" 1PHONE-'7`�< INSTALLATION LOCATION�y/�v/��/j��/���'��/ LEGAL DESCRIPTION z-G��J INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAINFFII,ELD f OTHER , TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS COMPLETION DATE ANTICIPATED NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE �L'TYPE -STL SEEPAGE AREA SIZE l� TYPE MINIMUM DISTANCES, REQUIREMENTS i FOUNDATION TO SEEPAGE PIT i DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT •�DRAIN FIELD TO NEAREST LOT LINE. l � WELL TO SEPTIC TANK SEEPAGE PIT /y L DRAIN FIELD �1? ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT / DRAIN FIELD ,/ Q /� / / SEPTIC TANK, -:--5 , SEEPAGE PIT /y`G� DRAIN FIELD '� 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. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE -3,7/�/ APPLICANT'S SIGNATU Municipality of Anchorage s On -Site Water & Wastewater Program (907) 343-7904 ¢ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-181-42 Expiration Date: 1. GENERAL INFORMATION Complete legal description PENNINGTON PARK; BLOCK 2, LOT 5 Location (site address) 5701 KALLANDER AVENUE *ANCHORAGE, AK 99516 Current Property owner(s) JOHNATHON & JAUNITA STRAM Day phone C/O AGENT Mailing address 5701 KALLANDER AVENUE *ANCHORAGE, AK 99516 Real Estate Agent DETTE OWEN W/ KELLER WILLIAMS Day phone 268-9948 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: 72/ I- — Date: 1011t/1")_ COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ g010' Date of Payment Receipt Number 0-1 1 G% COSA # OSC ;W4 (i O k Waiver Fee $ dbp Date of Payment 10 �- I is Receipt Number 013\ q � Waiver # D5 F Y a ) 75rs-D 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the onsite water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. /further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. 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 party is not authorized, nor will it confer any legal right whatsoever. Phone 337-6179 Date r2 6. DSD SIGNATURE \\\\S\�\i(OF A(j 6jf, L,""' , System #1 Approved for bedrooms. J ON-SITE Vi System #2 Approved for bedrooms. g WATER AND Disapproved. SWASTEWATER 1 PROGRAM �cn� Conditional approval for bedrooms, with the following stipulations: �^Sv,dSQ�,� ER The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: </ COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other By Original Certificate Date: (Rsc_ 11M5) If more than 7 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: PENNINGTON PARK; BLOCK 2, LOT 5 Parcel ID: 020-181-42 A. WELL DATA Well type PRIVATE *PER GEG INSPECTION **PER SURROUNDING WELL LOGS If A, B, or C provide PWSID# N/A Date completed 1971? Sanitary seal (Y/N) YES Total depth *38+ ft. Cased to **40+ ft. FROM WELL LOG Date of test NO WELL LOG Static water level ft. Well production g.p.m. Well Log (Y/N) NO Wires properly protected (Y/N) YES Casing height (above ground) 18+ in. AT INSPECTION 9/14/12 1.79 g.p.m. WATER SAMPLE RESULTS: �l� Coliform 0 colonies/100 ml. Nitrate / 0L mg./L. Collected by: GEG. Ltd. Arsenic: NO ug./L. Date of sample: 9/14/12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material HOLDING/STEEL Date installed 5/4/05 Tank size 4000 gal. Number of Compartments 1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO i High water )alarm (YIN) Date of pumping _qha Pumper AV 0%wLj 4i e. L t L C k C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2or ft'/bdrm)_ System type Length ft. Width ft. Gravel below Total depth ft. Eff. absorption area ft2 Monitoring tubeepres Date of adequacy test Results ft. over field For bedrooms Fluid depth in absorption field before test In. Water added _gal. New depth _in. Elapsed Time: _ mi Final fluid depth _ in. Absorption rate >= g.p.d. Any re ation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level ami . High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot N/A On adjacent lots 100'+ Absorption field on lot N/A On adjacent lots 100'+ Public sewer main Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: i Building foundation 5'+ Property lined Absorption field 5'+ Water main N/A Water service line 10'+ Surface water *40'+ Wells on adjacent lots 75'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line Building foundation Water Water service line Curtain F. COMMENTS G. ENGINEER'S CERTIFICATION Surface water on adjacent lots I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineers Printed Name JEFFREY A. GARNESS Date /D/jr/l2. (Rev. 11/05) storage 09/26/2012 05:16 8686770 APL115 PAGE 01 gSBNIQKT Rtes aCQT8 A FOtI A+ HOME SERVICES z INC. 7501 E. 140th Avenue ** Anchorage, Alaska 99516 345-1890 CUSTOMER Attn: Shari Morelli Win 9' 5701 Miander Avenue Anchorage, AK X9516 Rlnr-k Lot INVOICE # 4 3 2 21 DATE DESCRIPTION AMOUNT 09-25- �m $ .00 Fax: 565 r1.. i TOTAL RERKS 1$ "'` r Gailons _Septic Leach Area _ Holding Tank _ Standpipoc ,.,_Time D PROBLEM AREA — CALL FOR MORE INFORMATION ❑ NEEDS TO BE DONE AGAIN IN 6 MONTHS ❑ Good Shape ❑ Sludge buildup an bottom ❑ Floater on top ❑ Jim cap missing or ❑ Cut standpipe to 1' above ground ❑ Needs Septictrine needs replacing �. RAVAmI �,. Ae4r—r lYwla 00III1NT nwnr RAawe semAal LOT 4A me wnaew sterx \\ , LOTS \ $ (v N6D UVgLL\ \ 3d ryp. R `o+ \ 0 EXISTING HOU '\ ,420 X �hNO Th �s ` v �Oo UNDER NO CIRCUMSTANCES SHOULD AN AS-BWLT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE DOST OF THE SURVEY. USTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT SIRwY SURVEY TYPE SYMBOLS FOlHDA1Km AS -BUILT C3FTNAL STRUCTURE AS-BIW.T SET REBAR 3ARREF7 mW DRAINAGE ASPHALT ❑ PLOT RAM ... A9-B9IL7... LOT Vim... Top9Rf,wNY O FOUND WDOD FENCE CONCRETE ® ASSUMED ELEV. IN AS- - LT... No CMgM SET .S--R-1F METAL FENCE ® WOOD DECK PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE SHOWN. FENCES, WEU -S, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, ETC.. ARE SHOWN IN THEIR APPROXIMATE. LOCATOR, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION•••,,�`���, Prepared by PLOT PLAN .•.�E•OF,•• Robert E. Johns, Jr. & Assoc. M. N• �..ra aysaa n..a..a Ma l •v., ?•gip.° °' �p� Professional Land Surveyors ♦#. in W as Y tlw W! d.n 1700 BrIAk SM. KA ANCHORAGE ALASKA 99504 Scale., „ , = 1 O 4 Ree. Lot S.F. R". Plat Ill. Na. FOUNDATION AS-SULT -....... eawtlmanmeabaM, HAY0MA1 V-70 .. ... ....` .•.... .,.. ...`•• Dat<BVra: 09/19/12 Drb . REJ d bS ..m.�akau..tl a,,, ��,�y aW a+aa• ww.a an.w.. , . ROBERT 0 U .P 6• •S e` - WL Date Drawn: 09/21/12 Grid: W.O. �°%'••. t s ; SW3437 12-398 RNAL STRUCTURE AS -BUILT n.J-sAlvwjaMil ,<j� ��•............... ..•••�J<•1 Legal Description: aNa�.MNwwew1r er �PosLamb PENNINGTON PARK �����.�.• BLOCK 2 LOT 5 October 5, 2012 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Lot Line Waiver Request for Pennington Park; Block 2, Lot 5, To whom it may concern: We request that your department issue a 0 -foot lot line waiver from the southeast property line to the existing holding tank. The holding tank on Lot 5 has a separation distance of approximately 0 feet to the southeast property line, which borders Kallander Avenue. In short, there are no drainfields on adjacent properties for at least 60 feet. We are unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. .S. 3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 s (907) 343-7904 • Fax f907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program mellt �° s� E Department **** VARIANCE/WAIVER REVIEW **** Waiver#: osp121350 COSA#: osc121461 Permit# PID#:020-181-42 Legal Description: Pennington Park B-2 L-5 Engineer: Garness Engineering Group Applicant: Johnathon & Junita Stram Your request for a waiver of the required 10 feet horizontal separation from the holding tank to the property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing holding tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ........................................................................... Waiver is Granted: X Waiver is not Granted: Date: �D-� /— l,� Approved by: . Narrj ......................... ............................................. d�' Rec#: 07319G Amount: $200.00 Date Paid: 1018112 **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date % .?v /Isy! (a) Legal Description (include lot, block, subdivision, section, township, range) L r1f S Q loC-- Location (address or directions) orl ire mm der' aif 6DOell 0 ei v ��,5" f j fat <2 <l �rwc.. �l S � i A 57'e le�F� �`�`,' .- //A1 (b) Applicants Name �/�e�Gt lessctew Telephone - Home Business Applicants Address (c) Applicant is (check one) Lending Institution ; Owner%bui1der-r__1 Buyer [—_j ; Other [:::I (explain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single -Family Multi -Family Number of Bedrooms 3 3. Water Supply - Individual Well 5;�l Community El Other (describe) 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 I•� Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 21 5. 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 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 acrd/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm F/_cr��oT_7-e-a kN,'ca i t�t�'►rte Telephone YS` Address SR 1366 77390-1Y . AncAcr'o91� /+-/ 99.r/e' Date 3 / AV /F"� ,••... n 491 H ............. M ........ (ENGINEER SEAL) 0 G7-tlev at^� 6. DHEP Ap rp oval y��,'. , °•.o„ .••"4 Approved for bedrooms By ��'�1%Lx2Eir Datc Approved; Disapproved Conditional Terms of Conditional Approval CAUTION TPE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2 ] 7-19-84 .. n.r._.,...,,, MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION' HEALTH AUTHORITY APPROVAL ( HAA) SEP 4 1984 CHECKLIST - FEBRUARY 1984 RECEIVED A. WELL DATA Legal Description: I-es" tj/ k 2 Pe•�n���.n Parlr Sib Well Classification t'-1(4uke If A, B. cr C, D.E.C. Approved(Y/N) Well Log Present (Y/N) N Date Ccnpleted 19?i Yield 4 Total Depth S3, y Cased to ank Depth of Grouting Un/.r Static Water Level 2 e, S _f; Pump Set At Unh Casing Height Above Ground 2.,r A# Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) j' Depression Around Wellhead (YIN) Separation Distances from Wall: To Septic7'Holding Tank on Lot 100 On Adjoining Lots > 1 6o To Nearest Edge of Absorption Field on Lot n•a• ; On Adjoining Lots 7 (00' To Nearest Public Sewer Line A.a. To Nearest Public Sewer Cleaneut/Manhole 010. To Nearest Sewer Service Line on Lot n.a. Water Sample Collected By --f'o-17 Date 6 /19 /aY Water Sample Test Results G ca% A•M Catments Well 60 -ring q well Aac. o #rwvfONC toM '-ab/e- B. SEPTIC/HOLDING TANK DATA Date Installed 7 / 3o /pV Size 3000 :3a / No. of Carpartments / Standpipes (Y/N) r Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) Depression over Tank (Y/N) /1( Date Last Pumped '11•u, Pumping/Maintenance Contract on File C ) or Holding Tank High -Water Alarm (YM) Y ary Holding Tank Permit (Y/N) Y Separation Distances frau Septic/Hol To Water -Supply hiell leo p X To Property Line O' To Water Main/Service Line .A, Course 8'O' 40 s icer. M .5V I *-, Comments '7 / 1-4 ver of sePtro P*n '�i Arrncw- -v Tank: To Building Foundation `1►4 To Disposal Field n.A, To Stream, Pond, Lake, cr Major Drainage not fAd aAo( [ Page 1 of 2 ed 9 yl8y K /A aLApori -H ;), 9 <� 0-1 I Qd _ n -I - 4S`C)C) 2-15-84 C. ABSORPTION FIELD DATA 0- OL Soils Rating in Absorption Strata Type of System Design Date Installed Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present (YM) Depression over Field. (Y/N) Date of Last Adequacy Test _ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well To Property Line To Building Foundation To Existing or Lot ; on Adjoining Lots To Water Main/Service Line To Cutbank(if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, cr Vehicle Storage Area Abandoned System cn Com menti D. LIFT STATION t7• a Date Installed Size in Gallons "Pump On" Level at Dimensions Manhole/Access (Y/N) "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(Y ) Comments ** Check Permitted Bedroan Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. / o /may i p A4�,' Signed ��-�•• ° % Date 7130 i�.�.� .• .•s,� Company FIA -0'° ? e���� MOA No. �N � q S •�'y*• KB1/d5/s j•�.`....'"":T.:.�; THEODORE F. MOORE ; if I �. `fes••. CE -3589 mot All (Page 2 of 21 2-15-84 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received i- / a - /5 - Time of Inspection C . C (-) Date of Inspection '-� -- � S --1 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: _/VS/'�'Ztx i�c�,tdea.L4 �czhj,�hone: 2. Property Owner: Ufa-yx��� ���,�_ Phone: ,2 �-�Z — Mailing Address: 3. Legal Description 4. Location: 5. Type of facility to be inspected No. of bedrooms 6. Well Data: A. Type B. Depth C. Construction �_,��. D. Bacterial Analysis 7. Sewage Disposal System: A. Installed B. Installer -T C. Septic Tank: 1. Size " OCA r/a'L 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area q Sewer Lines , Nearest lot line D '�- Other contamination B. Foundation to septic tank Absorption area G ASC. C. Absorption area to nearest lot line .5"/ EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Rf st for Approval' of Individual er & Water Facilities Legal Description Comments ApprovedL Disapproved Date .-: ! 3 4roval,,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM - - _..J .. ..., .....M ... ..,........ ��.... .,. �rr..,.�. ., .,. - accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74) h GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA _ az FICA CONY 2. Property Owner: James C. Prichard Mailing Address: 6361 Neilsen Way Day Phone 274-3442 3. Name of Buyer: Gerald R. Meyer Mailing Address: 4105 Northstar Ave. Day Phone 278-3826 4. Name of Lending Institution: The Lomas & Nettleton Co. r Mailing Address: 4449 Business Park Blvd Phone 274-7661 5. Name of Realtor or Agent: NONE Mailing Address: -------- Phone --------- 6. Legal Description: Lot5 Block Pennington Park Subd Location: Pennington Park Subd. 7. Type of Facility to be inspected: water/well No. Bdrms. 8. Mater Supply Type of Supply: Public Utility x Individual If Individ-Ual, number of dwellings presently served unknown If Individual, depth of well 9. Sewage Disposal System Type,of System: Public Utility If Individual, date of installation Individual (on-site) ____
