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Home My WebLink AboutKASILOF HILLS BLK 4 LT 1 MAP OF SEPTIC SYSTEM PIPES AT 10920 KASILOF BLVD MADE ON SEPTEMBER 5, 1992 Northwest corner of house--right corner of house facing garage 4 feet above driveway to pipe #: 1.46' 6" 2.42' 9" 3.35' 10" 4. 35' 9" 5.39' 5" 6.38' 10" Northeast corner of house--left corner of house facing garage 4 , feet above driveway to pipe #: 1. 45' 3" 2. 46' 8" 3. 46' 3" 4. 49' 4" 5. 53' 6. 53' 4" Pipe number 7 to pipe 1. 22' 10" 2. 22' 4" 3. 30' 4" 4. 33' 10" 5. 31' 5" 6. 33' 4" 8. 2' 8" 9. 14' 6" 10. 14' 2" 6 3 8 9~ 10 o '7 22"10" 22'4" 30~ 4" 33"10" 46'6" 45~ 3" 42~9- 3a 3g~ 10" 4" 35'9" NORTHERN SIDE OF HOUSE. ALI. MEASUREMENTS WERE MADE FROM THE CONCRETE BLOCK HOUSE CORNERS 3.5 FEET ABOVE THE DRIVEWAY Municipality of Anchorage Page _ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~q,,&~2 SZ~.,~ PID Number:_ Name: Vo~) N~~ ~ wastewater system: ~ New ~Upgrade Address: I~o ~l[~ ~-[~ ABSORPTION FIELD Ho. of Bedrooms: ~eep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION so, Rating: Total Depth from original grade: Lot: ~ ~k: ~'1 ~Subdivisi°n:~l'[ Depth to pipe bottom from original grade:~ ~ Ft. Gravel dopth beneath pipe Township~ ~ ~ ~nge: ~ ~ Sectio~ ~ Fill added above original grade: Gravel length: WELL: D New D Upgrade Gravel ~ Number Classification (Private, A,B,C): T~tal Depth: Cased To; Total absorption area: Pipe material: Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: GPM Pump 8et at: ~t. Casing ~eight Above Ground:~l. To Septic Absorption [i[~ ~olding Public/~rivaleManufaclurer: CaPacity in~allons: Material: Number of Compartments: Well Surface ~ Water LIFT STATION Lot Size in gallons: Manufacturer: Line ~ O J ~ Foundation ~ ~ ~ ~ "Pump on" level at: "Pump olf" level at: J High water alarm at: Curtain ~ ¢~ Pu~p Mske & Model J Electrical Inspections performed by: Drain Remarks: BENCH MARK Inspections performed by: ~ DateS:2ndlSt_~/&/' ~/~1/' ~ ~ Department of Hea~ and Human Services approval Reviewed and approved by:~~ ~~ Date: ~-2 7 72-013 (1/91)MOA 25 I 70 I TOP 17F / / TDB]tEN SPURKLAND P,E, 803 X4 ISTH, AVENUE ANCH. AK, 99501 / // / S£~LD I' -- $8 FT, LOT I BL£CK 4 KA$IL£F HILLS SEC 24 T12N R3~/ HEf~B VOGEL NBTE! VERIFY LI]TLINE AN~9 B[$TANCE Tfl l/ELL fin LOT 2 1~o I~5 SEPTIC SYSTEM ASBU[LT DATE, AUG 83, 1998 SHEET, £/3 GRID, 2641 Stondord French: 56' LDNO TDTAL 10' DEEP 5' DF SEV££ ~[TCK 5-7 F$ oF Cover Exi% ~ 1000 9o! SepflE ~onk ND SCALE M/mo Pi i40 5' Feet o£ Septic Rock C{eonoufs Nonltom ~ ---~~ 88.5 ]000 GAL SEPTIC TANK BOTTOM TESTHDLE 88.5 T[]]~BEN SPURKLAND P,E, _5TH, AVENUE ANCH, AK, 99501 L/7 T] 3L [TCK 4 KAS.[L DF HILL S SEC ~4, FISH, R3~/ HER3 VDGEL i ooz SEPTIC SYSTEM DESIGN DA'I:E, AU~, ~, l~c~ PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920225 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNF. R NAME:VOGEL HERBERT S OWNF. R ADDRESS :10920 KASILOF BLVD ANCHORAGE, AK 99516 PARCEL ID:01516140 DATE ISSUED: 8/13/92 EXPIRATION DATE: 8/13/93 LEGAL DESCRIPTION: KASILOF HILLS BLK 4 LT 1 LOT SIZE: 38818 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS UPGRADE SYSTEM MUST BE INSTALLED IN ACCORDANCE WITH THE APPROVED ENGINEER'S DESIGN DATED 8/8/92. THE TOTAL LENGTH OF B L .SS MUNICIPALITY OF ANCHORAGE Department of Health &Hurnan Services On-Site Sewer/Well Permit Application ~-~} ~,.) -- NOTE: Application must be filled out completely SING LE FAMILY DWELLING Property Owner Name _ H-~,"~-~ ~/o ~ ~ Day Phone Mailing Address lO ~,O ~:~¢"-~'~ [~¢'~ ~'¢" ZipCode Legal Description 1 4 ~ tj LOl Block Section Township Lot Size ,,2~¢~.¢.~:~_2:)O,(2 Number of Bedrooms: ~ Parcet Identification Number Subdivision Range · ¢.rr~s/Sq F~ Inspections will be conducted by: . ~'-*'C]? . J Approved Engineering Firm '?~'/ < - L~ ',~.~- \ c~to~ ~'/ 2 %Cz'[,xor:~",\"D Municipality (permit fee included) Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, Jacuzzi, or Water Softener Unit? If yes, which one?-," .... ,; ~ ";' This application is for: Sewer Only Sewer and Well __ Sewer Upgrade ~Well Only I certify that the above information is correct. I further certify that this application is being made for a Si~.g~e Family Dwelling and in accordance with applicable Municipal codes. ~~ ~ ~(.~7 Prope¢~/Owner/Well Dr~ler ~'~ '~'~'~ Fees: ,,~.."~ ~ .O'~ Receipt# '"~ "~ ~...~2..~ d ) Per mit # '~---~k-~, (9c7) 279-39!6 SEPTIC SYSTEM DESIGN HERE~ VOGEL STANDARD TRENCH TOTAL LENGTH TOTAL ~IDTI~ TOTAL DEPTH ROCK DEPTH COVER ~_56FT. FT. FT. FT. FT. SEPTIC I'ANK 1000 GAL~ EXISTING INSTALL DIVERTER VALVE 24 24 $0 100 1`50 200 SCALE~ I" -- 100 8.50 $00 TDBBEN SPURKLAND P,E, 203 W 15TH. AVENUE ANCH, AK, 99501 LOT I BLOCK 4 K/ISILOF HILLS SEC £4 FI£N R3~/ HERR VOGEL SEPTIC SYSTEM DESIGN DATE: AUG 8 1998 SHEET, 1/3 GRID, 2641 I I / £5/ 0 NOTE/ VERIFY LDTLINE AND ,DISTANCE TO WELL ON LOT 2 TBB]~EN SPURKLAND P,E, 803 ~/ ISTH. AVENUE ANCH. AK, 99501 LDT 1 BL£CK 4 KASII. DF HILLS SEC 24 TI£N R3W HERz? VDGEL SEPTIC SYSTEM DESIGN DATE, AUG 8 1998 SHEET, 8/3 GRID, 2641 Exls t 1000 9ol £eptlc tonk £tondord [renEW 56' LONG TOTAL ]0' PEEP 5' UF SEVER ROCK 5-7 Ft of Cover NO SCALF 140 5' Peet oP Septic Rock -- Cleonouts /~ Mon,'tor 1000 GAL SEPTIC TANK Ex/st, 6round 4' N/n Cover ~'~over Toni< TDBBEN SPURI<LAN]] P,F, 203 V/15TH, AVENUE ANCH, AK, 9950i LZITI £LDCK 4 KASILi1F HILLS SEC 24, T12N, P3~ HER9 VOGEL SEPTIC SYSTEM DESIGN DATE, AUG ~ SHEET, 3/3 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 '-: (EN'GJ'NE~R's SEAL) , Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT b'r~ oL DEPTH? - p 9eplhto WaterAIler~t ~/O/q E ~onitoring? Oate:_ Z, Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUiN BF~TWEEN -- (minutes/tach) PERC HOLE DIAMETER FT AND L~ -- FT PERFORMED BY: ~ .~, '~-~'~ ,.1~ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEi ~TMENT OF HEALTH AND HUMAN SER~, ':S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address / ¢)q, P'-A ¢ ¢_/'-:' SEPTIC [] HOLDING TYPE OF SYSTEM [~ TRENCH L' BED ~ W. DRAIN [] OTHER 1 grade FT Fdl ad~e~at~o~ee DUg]hal grade SO FT FT FT WELLS ~j PRIVATE i~ OTHER fldentifv) '~l~a~s~'~;ah~n (A.B.CI lola~ Depth J Cased lo FT] FT REMARKS: DISTANCES ~"-- TO SEPTIC ABSORPTION ~RO M_..~ TANK FIELD WELL WELL /~ LOT LINE -.'.~ 5 FOUNDATION_ ~.~ AS-BUILT DIAGRAM tShow Iocat,on of wed seph¢ systenl property anes, Ioundatron. duveway, water bodies, etd ) Scale: inspections Pedormed by Municipal and State guidelines in ellecl on Ibis da[P4 .... ). 2225-E UNL 25, 1971 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM Name. ,//~,~ -_~ti'/7/.~2. ~Ma~llng Address Ph,~ SEPTIC TANK: Distance from well ",(.)_~Material %/z~_~_, Number of compartments_~ ~ Liquid capacity /~'~,.. gallons. Inside length~,..~y .... Inside width_~Liquld depth ~/ SEEPAGE SYSTEM: Seepage Pit: Nu~er of plts~Ou~side dia~en.~ or width '-~ ~ length ,'~ , depth (~ , lining ma~erlal ~L~,~ . Dist~ce from well /C~(]/ _~ building foundation ~(~ ~ nearest lot line~.~~, Total effeotive absorption area (wall area).~ sq. ft. 'fI~.~ .D~6~.N ..[~L_pj Distance from well , foundation~ nearest lot line~ 'F~tal length of lines ..... Nu~er of lines Distance between lines Trench wid~h~.n. Total effectiv~ ~sorption area.~q, ft. Length of each line Depth: Top of tile to finish grade__ Depth of filter material beneath tile~ in. Above 'tile WELL: YP%~3 ,[~/~/~ depth /'~ - distance from building fo~dation~ nearest lot ' ~ ' . ,'" ~ ~,-~ ~ ,(~ lzne ~(/~ nearest sewer ll~e ~,~ , septic ta~k -~ ~ seepage system /..(' cesspool other sources DIAGRAM OF SYSTEM DATE :~, : ............ APPROVED Health Authori~'~ SEWAGE DISPOSAL SYSTEM - APPLICATION 6 PERMIT Alaska Natiw; Name of A plicant William Thomas Evans Mailing Address. /vIedical Center __Ph. # 277- Residence Address Kasilof Hills Location of Installation Kasilof Hills I~gal Description Block~ 4 - Lot 1 Application to Install: Septic tank, ~x , Seepage pit x~, Drain field_.~_, Other To Serve the Following Facility Private t{esidence National Bank---~: ..... '" .... ~- Financed Through of Alaska To be Installed by _3oh. n Lamb - Lamb Brothers Con- Percolation Test Results~ -%...--~ ...... Anticipated Date of Completion within next Z weel~-(SePt: lStn) BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT This A~(h/f ~ ,/-~ / ~s descmibed below, Size of unit to be served ~ /?/:/}~ . . //~ , Septic tank s~ze ype eepaBe ~ea ' ' ' ' ' ......... Type d ~: ....... ,' ?:A, /::/. /~//~ '/%(' ' 'J')DIAGRAM 0r SYSTEM DIST~CES: ~ I certify that I am familiar 'with the requirements of Greater Auchorage Area Borough Ordinance No. 28-68 end that the above described system is in accordance with said code. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 · 343-4744 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1, GENERAL INFORMATION Complete legal description Location (site address or directions) J O¢L2. o [Z./~&i I_o ¢ Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: .-~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev. 1/91) Front MOA #21 s~uewwoo leUO!~!PPV :suo!~elnd!~s 6U!MOIIO~ e41 UP,!M 'swooJpeq 'SLUOOJpeq JO~ le^oJdde leUOp,!puoo 'peAoJddesiQ Joj peAo~ddv -~--;. ~]IdnlYNIDIS SHHQ '9 (~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST L-II Legal Description: ~'~ ~,~,~ [¢~r- ~; t[~ Parcel I.D. A. WELL DATA Well type '~ Log present (Y/N) Total depth Sanitary seal (Y/N) If A. B, or C, attach ADEC letter. ~\ Date completed /~,~ Cased to -~ ~ ? ADEC water system number Driller Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot J~ Absorption field on lot ~ O i~, Public sewer main ~//~- Sewer service line ~ j~L~ g.p.m. AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE BESULTS: Coliform ¢ Date of sample: e/'~o/~7.- Nitrate F [ Otherbacteria ~' / Collected by: ~-~'- '-% B. SEPTIC/HOLDING TANK DATA Date installed ~/~'/~ (~ Cleanouts (Y/N) ~ High water alarm (Y/N) Date of pumping Tank size ! ~ Compartments Foundation cleanout (Y/N) Y . Depression (Y/N) I'4/,A Alarm tested (Y/N) ~"//A -- Pumper_ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Surface water/drainage On adjacent lots ! ~ ~) ~ Foundation .-~ ~ Absorption field ~ -~ Water main/service line ,.N ~ O 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION /"V/,~ Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Date installed Length ,.~' '~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) On adjacent lots Soil rating Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water Gravel thickness ~ Cleanouts present (Y/N) Date of adequacy test for -~ Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I To building foundation On adjacent lots Surface water Curtain drain If yes, give date System type Total depth /O On adjacent lots ! ~ Property line ~ O To existing or abandoned system on lot Cutbank ~"~/,~,, Water main/service line Driveway, parking/vehicle storage area bedrooms E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. HAA Fee $ / 70 Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO, 5633 B STRF_ET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ~) Member of the SGS Group (Soci6D G~n~rale de Surveillance) 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 !NFORMATtON (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 1 Block 4 Kasilof Hills Subdivision Location (address-or directions) (b) Applicant Name Jack W]~ite Company Telephone: Home Business Applicant Address 3201 C Street, Suite 100, Anchorage 99503 (c) Applicant is (check one): Lending Institution []; Owner/builder []:~'./3uyer []; 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 [~xMulti-Family [] Number of Bedrooms _~th]:a~ (~) __ Other WATER SUPPLY Individual Well [~XXCommunity [] 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 F~xx Public [] Community [] Holding Tank [] 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 2 72-025 (11/84) ENGINEERING FIRM PROVIDINGI,,oPECTIONS, TESTS, FILE SEARCH, DATP, .',ID INFORMATION AS certified by my seal affixed hereto and as of the validation date shown below, I verify tha~ my ~nvestigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is saie, 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 lrom 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 A.E.C. S, LrLC~ Telephone Address Date Engineer's Seal This department has received written confirmation from the engineer regarding the Conditional Approval of January 7, 1986. The corrections have been accomplished and an inspection has b~en completed by the engineer. The subject property meets with Municipal standards and is now approved. DHEP APPROVAL Approved for three(3) bedrooms~b~ Approved XXXXXXXXXXXXX~isapproto/d ConditiO~c~l Date June i6, 1986 Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Autholity Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DFIEP 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 cmissions in the professional engineer's work, Page 2 of 2 72 025 {11/04) 203 W. 15th AVE! "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 5UNE 9,1986 Re: Conditional Health Authority Approval, Lot 1, Block 4, Kasilof Hills Gentlemen; On January 7, 1986 a conditional approval was given for subject lot. The conditions for the approval have been met. The septic tank has been reinstalled with a 100 feet separation distance from the well. The old septic tank was removed. Please furnish this office with an unconditioned approval. Yours MUNICIPALITY OF ANCHORAGE DEPARI't'~IENT OF HEALTH AND ENVIRONMENTAl. PRO'I ~,CTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF iNSPECTION FOR FIEALTH AUTFIORtTY 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) Applic~rlt Naroe'~f~---'~ ~"~/~ ~' Telephone: Home BtJsiness . Applicant Address' ~-¢ (c) Applicant is (check one): Lending Institution 12; Owner/builder; Buyer [2; Other ~ (explain); (d) Lending Institution ~ Telephone Address "' · (e) Real Estate Company and Agent Address Telephone (f) Mail the FIAA to the following address: TYPE OF RESIDENCE Single-Family'~ Multi-.Family b-"] Number of Bedrooms -.~,'~ Other WATER SUPPLY Individual Well.'~ Cornrnunity I~ Public I~ Note: If community well system, must have written confirmation from the State Department of Environmental Conserwttion attesting to the legality and status. SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conserw~tion attesting to the legality and status. Page 1 of 2 t2 025 (11,84) Address . [)ate ENGINEERING FIRM PROVIDII'. ,~SPECTIONS, TESTS, FILE SEARCH, D~ .~ND INFORIVIATiON As cartifiod by my seal affixed hereto and as of the validation date shown below, I verity that my investigation of this l-'-Iealth 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 fudher 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 /¢~;-~¢~"-'~-"'"{ Telephone Approved for It,,~t~,9.~_ bedrooms Approved : '- Disappro¢~ Terms of Conditional Approval _~¢~ CAUTION ']-he 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. '[he Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. -~f 2 MUNICIPALITY OF ANCHORAGE (MO,.-,~ NIUNic~.~J~.T~AUTHORITY APPROVAL (HAA) JA~ G 198~Legal Description: RECEIVED WELL DATA Well Classification P'&¢/¢//']"~ · If A, B, C, D.E.C. Approved (Y/N) ~4~/,/¢- Total Dept~ ~O Cased q:~2 //1/¢/ Depth of Grouting /J'//¢ , ,,, ~ ' / Static Water Level ~'~ ..,...4"¢~. ~ Pump Set At ~ --~'J¢' Sanitary Seal on Casing~q) Depression Around Wellhead (Y~) Casing Height Above Ground Electrical Wiring in ConduiQN) Separation Distances from Well: To SepticS'Holding Tank on Lot f ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line. 4/¢ Cleanout/Man hole ! //'/' ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ~¢~ ;Date .,/'-~"~ B. SEPTIC/HOLDING I'ANK DA'T'A Date Installed ,,/O Standpipes~N) Air-tight Caps~N) Depression over Tank Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Wat~r~S...u,pply Well ~ 7 Size /~:~ ~'/~ No. of Compartments ~¢ Foundation Cleanout (Y~ Date Last Pumped ~'~ ~/""~"~*¢"' ,'~/,~ ;for *//¢' Temporary Holding Tank Permit (Y/N) To Building Foundation ,, T6 Proper~:y I~ine . To Disposal Field 'i 1~ .T° water MainiSe~;(ce Line ~_///'¢' To Stream, Pond, Lake, or Major Drainage Page I Of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field ,,/~" Square Feet of Absorption Area ~'~¢;~ Depression over Field (Y/N)~') Results of Last Adequacy~Test ,/~V/¢'%~r'' Separation Distance from Absorption Field: To Water-Supply Well //~ To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field _ Gravel Bed Thickness Standpipes Present) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~0 To Cutbank (if present) Comments Size in Gallons ~ "Pump On" Level at % High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) es during Adequacy Test, Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I ha~che~ked,,0erified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed~'/'/~/-'~'-~ Date /~' 'Company //~'~'% MOA No. Receipt No. 3 Lo ~ -~ Date of Payment ~ ~Lo'~ Amount: $ Page 2 of 2 72-026 (11/84) INVOICE N° ~, 3 I 13 IVI-W DRILLING INC. DATE /f,/? P.O. BOX 110378 UNIT ANCHORAGE, ALASKA 99511 QTY. MATERIALS PRICE AMOUNT PHONE 349-8535 CITY LEGAL DESCRIPTION WELL NUMBER DIAMETER ~PT~ STATIC LEVE~ GPM DRAWDOWN DESCRIPTION OF WORK MATERIALS {FROM ABOVE) OTHER CHARGES / All charges shall be paid in full within ten days un/ess other arrangA~ents are made prior to drilling. The customer shall pay in- terest at the rate of 1 ~ % per month on any amount not paid within ten days. Failure to pay may result in a lien against the properly. ,' ALASKA"% u ROIq E IqTAL COIqTROL IFIC. I~nqin¢¢vin,:l ~ ~nuironm~nl(]l $ludi~s HOME EQUITY 2600 CAMPUS DRIVE SANA MANTO CALIFORNIA 94403 JULY 22 1985 SELLER-CAMILLE FRINK-HILL HOME EQUITY 2600 CAMPUS DRIVE SANA MANTO CALIFORNIA 94403 50385 LEGAL:KASILOF HILLS BLOCK 4 LOT 1 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-JULY 9 1985 THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 288 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 438 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 MAY 21 1985-. FLOW TEST ON WELL WELL FLOW DATE-JULY 9 1985 A FLOW TEST WAS PERFORMED ON THE WELL. 438 GALLONS OF WATER WAS PUMPED AT A RATE OF 4.5 GPM OVER A DURATION OF 2 HOURS. THE DRAWDOWN WAS 41 ' WITH A RECOVERY TIME OF 60 MINUTES AND THE STATIC WATER LEVEL WAS 38 FEET. ~mE WELL IS ADEQUATE ~OR THIS 3 BEDROOM ~o~. 99503,[907) 561-5040 APPLI Property Owner Mailing Address NT FILLS OUT UPPER HAr 'ONLY ,,~ - ( ~. Phone Zip Code Buyer ~ Address Zip Code I_ending Institution // ~- ,,. ,; Phone Address Zip Code Bealty Co. & Agent Address " Phone Legal Description Street Location Type of Residence ~ Single Family [] Multiple Family No. of Bedrooms '~ [] Other Water Supply ~ Individual ATTACH WELL LOG, A well log is required for aH wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach log if available). [~ Public Utility Sewer Disposal J~ Individual Year Individual Installed: [] Public Utility When Connected to Public Ulility: ~ Holding] Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH BEQUEST BEFORE PROCESSING CAN BE INITIATED. Time [)ale Inspector Time Date Inspector [)ate Inspector Time Date Inspec,,~r Field Notes: ( ) APPROVED BEDROOMS ( "- )- iilSAPPROVED ) CONDITIONAL APPROVAL' [)ATE ] ( "( ,' -"~' '~ MUNiCiPALITY OF ANCHORAGE DF_PT. OF I~,~I',LT~1 ~ ~NVIRON;v~NI'AL pRoTECTION RECEIVED 'CONDITIONS OF APPROVAL Date Sewer Installed Well To Absorption Area Well to Tank Well Log Received Septic Tank_____Size {.ubject~ .Bt)t; 1 iS].<x:.k 4 Kas±loff Hilln App,?oval fou the il~dJ, vidual ,'~ o- ..,C~?.~L ~/I](~ w/Ii]o]? '~i.~Ci].J. tJ.(2L; CglD~]()L ._ .. ..:..lo have )c n COml)lcte(t ~ of. the Plunicii)a].j. ty of Anchorage corle:; and '.n o,,he· s(;ptic haiqk })umpe<l with a l:<~ceJ.}')t F;ulmqihted t.o this leaching aroa. 'i?}~is Lest will dei:c~rtuine :i.f the svntem :[.s adeC!Lla'he a<]col:d:hl]g ho NatJ. ollal Stan(la~:ds, h .l_J. sl;J. rh} Of l)l'ivate Eitrmf; }HeiyEormJ. nq the itc}St J.S er{cl, os<~<], '.il}ill.:.; 17epoFt needs to be submitted to this office for our lreviow, ,%incer'ely, "" DATE RECEIVED INSPECTION APPOINTMENTS TIME TIMEi /~ TIME DATE INSPECTOR INSPECTO~ , MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL P::OTECTION ENVIRONMENTALSANITATION DIVISION ['~/~Y O 1981 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1, PROPERTY OWNER PHONE MAILING ADDRESS ~ROP~R~RESIDENT(Ifdifferent from above) , ~ / w PHONE 2. BUYER / PHONE MAI LInG A~RES~ 96-1 3. LEND~N~iN~T~TUTION / / · ~ / / PHONE MAILING ADORE88~ 4. ~EALTOR/A~ENT /' ' ] PHONE MA~UN~ ~DB~ES~ 5, LEGAL DESCRIPTION STREET LOCATION 6, TYPE OF R'ESIDENCE /D~ SINGLE FAMILY [] MULTIPLE FAMILY 7, WATER SUPPLY INDIVIDUAL~ COMMUNITY [] PUBLIC UTILITY NUMBER OFtBEDROOMS [] One [] Four ~] Two []Five Three [] Six [] Other *ATTACH WELL LOG. A welt log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** //~;'(~ YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79)~/~ ~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY /,~ TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY '[~ DEPTH OF WELL INDIVIDUAL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: ~ (~O ~ If Tank is homemade SOl LS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ,~,-~ ~ 4, DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS FOR ~ BEDROOMS [~I~-"~APPROV ED [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY Hotchkiss Co. ilealtors 2601 Blueberry Anchorage, M~o 99503 Tobben Spurkland P.F_. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 flay 22, 1981 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALT!-I & ENVIRONMENIAL FV:C [EC'flON RECEIVED Le gal Location~ Owner Res:i. dence Wab er Date of Test;: .us Procedure: JUNE 25. 1971 Test Result; Lot I Block 4, ~ ' -" kasz].o f.6 ifi[l, ls On Ka:~Jlo£f Drive, off Tz~a:Lls [',.]nd K ~ ] Log house with full basement, trree bedrooNs On site well From Nuni. cii)al Records: Tank~-- ~;teel~ two compartment, '1,000 gal. Absorption iJystem-.~ 8'xS'x6' log crib Absorption Area--- 288 Da'be of instal].ation~,- Oct° 1968 liay 20~21 ~ [L981 System was inspected on May l~Stho Crib is 10 feet below ground with 29 inches of liquid, l'ank is qq~ feet below ljround. Conj.(mrs very hoavy. T~mk was pumped on Nay 20th, aud approximately 'I,000 gal. of liquid was chaz'gcd to the crib. The following readings were taken~ Water Volu!t]e (gal ,, ) Depth(inches) o 31 ~00 1 ~000 May 21 1,000 gal. of wa~er was cht~'ged to the c:cJb~ The 1~000 gal. had been aN~orbed by bhe ground within the next 2l~ hours. '2his system exceeds the mun-- icipal requiz,cment for a 3 bed~,oom house. S'.fi:)~ec{:: ],<~t: .i !31o<:h ,) ~:as i]of NJ s Su}xk~v is~on c om p 1. e ~: ed: t:c) I:r ~s Of f: J.::,~ from khe Chem Lab, 5633 [3 Street (2 'Phc ,%opkJ c t:o this is adequaLe ~-~cr:ordJng Lo Nat;iona]. Standards, o:E p]'.'[ va [: e f'ir'l'qr.~ perEo]:m:~ng Lhe LesL is (inclosed ]-eport: needs Lo be submiln~:ed i:o Lh]9, o:[[JT~ce RC P,/] j w cc:: Na?~onc,] Bank of .i]aska Pouch '7'-F, 25 99510 Cai. Hotchk{ss 260] f)h)(.b(.'Rry Road 99503 December 29, 1975 MUNICi?ALIIY OF ANCHORAGE DEF,~RiMEN[ OF HEALTH & MUNICIPALITY OF: ANCHORAGE ENVIRONMENTAL PROTECTION I::)EPARTMENT OF E~VIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 - 274-4561 ~EC ~] 9 lgTF~ REQUEST FOR APPROVAL OF RECEIVED INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO 2. Property Owner: Bernice A. Brown VA FFIA CONV ×X Mailing Address: 3. Name of Buyer: Edward J. Kiml Day Phone 344 5123 Mailing Address: P.O. Box 10141~ Klatt Station Buyer is occupying the property Name of Lending Institution: National Bank of Alaska Day Phone 344 5123 Mailing Address: P.O. Box 33859 Name of Realtor or Agent: None Phone 279 2506 X2]. Shirley Jones Mailing Address: Phone 6. Legal Description: Lot 1, Block 4, KASILOF HILLS SUBDIVISION Location: NHN Stroganoff Drive~ Borough Parcel #015-161-40 7. Type of Facility to be inspected: __Single Family Residence 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation 1969 No. Bdrms. 2 I nd iv id ual xxx Individual (on-site) EQ-037 (1/74) GREATER ANCHORAGE AREA BOROUGH -J~n/_)>?c Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 ~.~ ~/m/~ ~{:~( Date Received Deoember 29, 1975 Time of Inspection - -_~~ ~ Date of Inspection eg~] REQUEST FOR APPROVAL OF ~-'~. INDIVIDUAL SEWER & WATER FACILITIES FOR CO nv. 1. Approval requested by: National Bank o~ AZaska Mailing Address: Post O£fice Box 3-3859~ 99509 Phone: 279=2506 x 21 2. Property Owner: Bernice A. Brown Phone: 344-5123 Mailing Address: 3. Legal Description: Lot 1 Block 4 Kasilof Hills Subdivision Location: NHN Stroganoff Drive Type of facility to be inspected Single Family Wel 1 Data: Individual NO. of bedroo~ss~-'-~ ~ A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On-site system. A. Installed 1969 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: l, Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - R( ~st for Approval of Individual Jer & Water Facilities Legal Description Lot 1 Block 4 Kasilof }{ills Subdivision Comments Approved .... ~,,,r,~"~ Disapproved Date Appr~vval~ Valid for one year from date signed Greater Anchora9e Area Borough, Department of Environmental qual'ity DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) I DI IDUAL SE~'AGE AND WATER FACILITIES (Fill out in Triplicate).~ · of person requesting approval ~ a, Bant ~¥,-~ a] b. Detergent "' Well data: a. Type__~. b. Depth /~-~ ~" c. Casing Size Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank 3, Seepage Area__~O 4, Cesspool' 5, Property Line houses, barn, drainage ditch, etc. SewaEe disposal system. a. Age of system~ ,2~_~ , · b. Other sources of possible contamlnation~ i,e., creeks, lakes, Septic tank capacity in gallons~ 1. If "home made" show diagram on reverse side of this form. Disposal field om seepage pit size and type 1, Distance to property line, ._ to house foundation e, Pereo]~tj(m Te~t r.esu]ts f. Percolation Test performed by ~. Use the revemse side of this f'orm to show diagram. Diagram should include ~:he fo_]'lowing information: p?operty lines~ .well location, house location, ~¥.-I-~c tank location, disposal aeea location, location of percolation test, a~d direction of ground slope. The h~[~,rma*ion on this form is 'true and correct to the best of my knowledge. '~'i ~ ~S t u~e 'o ~-/~¢p z ~i~ ~ate Signed ~0~ BE Fl'bLED OUT BY HEALTH DEPARTqENT PEP, SO~NEL The above described sanitary facilities are hereby approved, subject to the ........ ~6'llowing cond~:'~ons: ' Conditions: The above described sanitary facilities are disapproved rom the followim~ re aso~s I ~ Approval .is valid for one yea~, following the date of approval, CPJ: cw ANCHORAGE, ALASKA 99503 (907) 561-5040 c.~c~o .~ o^r~ 8C^LE / · = 5'0 · . -,/_0'0~ 3-,,0[.,~0.00 N ~ ,09'Ag ~ 3 ,,0 !.,~0.00