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HomeMy WebLinkAboutMARYS LT 20 AR main to be addressed at time ot system upgrade. Municipality of Anchorage ® Development Services Department Building Safety Division 5 = T On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page / of -3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTIOii��N, REPORT Permit Number: l S U PID Number: t2/". Name: Wastewater System: El New >eUpgrade Address: P Oa 702Y2 ABSORPTION FIELD Phone: �^ — Y ^ 3 � ^, Number of Bedrooms: `, (J Shallow Trench Bed Mound ❑Other: (1�i Deep Trench ❑❑❑ LEGAL DESCRIPTION Soil Rating: l Z Total Depth from original grade: P GPD/Ft2 Ft. Block: Lot: Subdivision: G Depth to pipe bottom from original grade: S-5- Gravel depth beneath pipe: &41ZyS Ft. Ft. Township: Range: sectiont Fill added above original grade: Gravel Length: � Ft. Ft. . / V f%� C Well. /J ew Upgrade Gravel width: Number of 'nes: Distance between lines: t ill --Ft. Classification (Private, A, B, TotalDept Cased lo: Total absorption area: V Pipe Material: C 3O Ft. Ft. Ft' /f2/V Driller. Date rilled: Static ter Level: Installer: r� ♦ S �V 1Z Dale Installed: /) Ft. I Yom— (/S Yield: / G Pump Set at: Casing Hei t Above Ground: = 4. O G f ) j) 1 - TANK i54. l•/ v �P GPM FL Ft. SEPARATION DISTANCES septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption LiftHolding ublic/Private(Manufacturer. Capacity: 94 00 0. From Tank Field Station Tank Sewer Line G 0,ed 7 / PMaterial: Number of Compartments: We �r CISi Surface Water dM0�f — _ / LIFT STATIO Lot Line / D l � Size: Manufacturer Gal. Foundation T" "Pump on" level t: `Pump off" level at: High water al at: in. in. in. Curtain Drain , / /].. N / �` N � /� ` /] ' ^i Pump Ma & Model Electrical Insp ctions performed by: Remarks: U vv z1W (,dLocation BENCH MARK T% �r 5= k and Description: iec) (,)AJ4A�rv,J /3ZJT-4n Assumed Elevation: // /�� � hlq �...I� 7 /00 Ft. En mp negi;s.Sta. 6 G V/�J ,, ., - � 3l�GS Inspections performed by: U,, Dates: 1st /�% nd • -_ �:==5.r _-:: - �, ., 2 `,;`��;' Development Services Department Approval �+ ;���� Steven V• g <f PE C�1i. �o CL `� 1 `a' « �c ""� Reviewed and approved by: v� � 6k k Date: $ � U , :: �; ; ; �� • (Rev. 12/00)-- '- F.C.O. S.T. C.❑.1 S.T.C.❑.2 D.C.O. C.O. MT/CD A B 28 14.5 31 15 35 16 41 18 45 21 50.5 55 Bu« Run S ptic System Construction V a l V I D es Not Preclude Adjoining L is From Sanitation Im rovements. 3 Bdrm Old Septic Tank Water I House Decommissioned Line ew 1000 Gallon (Approxi a I` ° Septic Tank H DCO IQ CO TrencI0 IDESIGN N13TES, MT/C0 1, Total Depth of Trench Is 8' from surface. Terrain Is flat. 2. Sewer ServiceLine minimum 2% slope. 3. Trench Is Minimum 10' from Lot Line. 4, Lots Served by Public Water. Maintain 10' From Water Line. NOR THRI M ENGINEERING 17237 Bear Pow Circle Eagle River, Alaska 99577 907.694. 7026 MARYS S/D I AS -BUILT LOT 2 I L❑T LAYOUT 1 = 30Dat12/1/05 12 of 3 tn n i A m N Y- a W N S W S U L F o LO L M L O L c T O t'• 7 t i O a = A• : N s Q u + ; L I C z F- � I v 3 LU 1 z � $ a C C5 L o N II q W 11 d 'a 4} ° > L d + +t O L W to li > N +t p d 7 LLJ W F0• > W 1.1 Q d d > _ U N U :. Z C: WR Q j O CL a L �3 u rn PW W a C3 d d z 0 CL of o e ° u o>, _ > L L W0) Z N L L Q 0 Z p W O dWW• i J ~OUG ON C O . S d N +1 O L U • > Z W O .}a Y «-� > 'N a V) , d to c- L ZInJ L d > a ddLNN N W 0 X> � s�£ 0 C U ° 0 L d JWZ E0 .030 EU 3:p Cl • Y 3 O d j~� L M LCI U~ W d O W 0 O Z J 0 to d CL N a' F O L LI C mc Ni aa3 py L WO7 �.a� CD d Q Z U m _ ON = . O C C L� 00 S N OIC UN LJ 0 O 0 L £ d LO ��``U"d"41tA£ U OII N~� O i OIt` H W W O� 4'F- NNF- N W -Y L L _0 > ° LO CL (I+- aQ)= a 3 N d y Q N �tn3NQ Q f tn n i A m N Y- a W N +000sit r r .• „ a t § g —_wK_=_Z 1 1 1 I a�i"I i i- A anw• ..vo 1 __ _ __ — , I I I ` E/ ;� I I I 1 , 1 � 1 ' j I ait I `r.lAi Erg S STcM 5 K5, 1z,�l�l.F_ SLS �O EAG & RiV'c-_ H6`IGHTS gDOSd 1;,.IA1 K SYS .ri'i. 71.. rjJ�S GUS?AV Y. IG};NSCN -- EEGISTMED ENOINEEN ANCHCAAGE, ALASKA 5 wEE- w a T[ :I.+ly, �9 I•'� SNE[T 1 OF 3 I FJ�E �1�•3 r x ... -. 1 V 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: Oct 25, 2005 Expiration Date: Oct 25, 2006 Permit Number- SWO50402 Parcel ID: 050-282-51 Legal Description: MARYS LT 2 Design Engineer: 0838 North Rim Engineering Site Address: 018130 BARONOFF AVE Owner Name: BILL LESTER Lot Size: 11744 SO. FT. Owner Address: PO BOX 770253 Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER. AK 99577 - This permit is for the construction of: Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements 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, seated, and heated to prevent freezing. Received By. Date: e 2� Issued By:t�T"&t Date: l\Zunicipality of Anchorage ° Development Services Department Building Safety Division On -Site Water and Wastewater Program :. .. 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak. us (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. h5b – w 2 - Permit Number SW Property owner(s) �g Day phone nn ?YS'77 Mailing address ISD �X ��Q��3��C UJ[l� Zip Code Site address i J i30 73"nn0V VL Zip Code Legal description (Lot, Block & Sub'd.) /� �t2? f C� t;, / Z Legal description (Section, Township & Range) Lot Size ((� ��� Acre Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only L Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade r/ THIS PROPERTY CONTAINS: Hot Tub ' ElJacuzzi ❑ 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 15 Permit/Rush Fees -:—L4 ' Waiver Fees: Date of Payment: T /1-/01100 S Date of Payment: Receipt Number. 16691 I/ F 1 Receipt Number: (Rev. OWN) ITF ENGINEERING NorthRim Engineering 17237 Bear Paw circle Eagle River, AK 99577 907-694.7028 October 18, 2005 MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Marys S/D, Lot 2 The septic system has failed on the subject property. The owners wish to replace immediately. The soil test was excellent. The neighboring lots are developed. This site should not negatively impact any of the other area lots. The lot slope is relatively flat. Please review the wastewater system design for the single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Sincerely, a, PE, PH Design Enclosures TF' ENGINEERING Marys S/D, Lot 2 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing single family home @ 3 bedrooms. The existing system is in a failure mode and is 24 years old. The septic system will be replaced. This requires a new 1000 gallon septic tank. The lot is served by public water as are the neighboring lots. The public sewer system does not allow access to this lot. The neighborhood lots have been developed. A Homestead Elementary School is located to the north. No adverse impacts are expected from septic system replacement. The lot is relatively flat with a small slope to the southwest. No conflicts to any neighbor lots is anticipated. One soil test was conducted. A sandy soil with an good percolation rate. An application rate of 1.2 GPD/FT= is being utilized with reduction factor for using a 5' wide trench. The old septic tank will be properly abandoned. The old absorption trench will be connected via a "Bull Run" valve. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1000 gallon septic tank. • Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' to property lines. • 3' of cover or insulation is required for trench; an equivalent of I" insulation for each foot soil cover. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required V to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock. • Drain rock to be %: inch to 2'/2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • Backfill over drain rock must not be less than 36". • The finish grade must be mounded to promote drainage over the trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI or equal) • The existing septic tank will be abandoned; the septic tank will be pumped, crushed, and filled with sand/gravel or removed and properly disposed of. "Bull Run" valve to old absorption trench. DESIGN NOTES: 1, Total Depth of Trench is 8' from surface, Terrain is flat, 2, Sewer Service Line minimum 2% slope, 3, Trench is Minimum 10' from Lot Line. 4, Lots Served by Public Water, Maintain 10' From Water Line, L A Bull Run Valy I (Conn ct t 3 Bdrm Water I House Line 0101 Sep Tank Trenc H existing f ield) New 1000 Gallon Septic Tank X Septic System Construction Does Not Preclude Adjoining Lots From Sanitation Improvements. -•'t� °F.� MARYS S/D NORTHRIM y�P' . aem LOT 2 ENGINEERING I 17237 Bear Pow Circle Eagle River, Alaska 99577 at-ur j 902694.7028 1„ LOT —'LAYOUT 3 0'l0�.: - — _ 10/17/05 11 of 4 DESIGN NOTES, 1. Total Depth of Trench is 8' from surface. Terrain Is flat. 2. Sewer Service Line minimum 2% slope. 3. Trench is Minimum 10' from Lot Line. 4. Lots Served by Public Water. Maintain 10' From Water Line. NEIGHBORING LOTS SERVET , Y PUBLIC WATER & j : �:::::...........116.50..:.:::,..... z Y� (P I Ic: C W O W x',vnn Ln 00 3 0� 100 N w N83°24'35 E , 115.69 T00 n v 1,,SUght�lo e A �,k:a4o T�SW-"' ^� o ;/ Septic System Construction Does Not Preclude Adjoining Lots From Sanitation Improvements. 0 M �PNV� 33 "' N N6� a � 4, I /��� to CN 00 y N 0 0 0° ��y/ I n •o Z Ni e�0 ��00'1 1% o to o •/�' h�% Io 89.59'00"E 131.95 70-2 Z 1�aa�F % I� 131.95 P-419 /•O O/ w 5y• / �o Atn NOR THRIM. y�P'' ...asmik''... ...LOT 2 SUBDIVISI❑N ENGINEERING /�• :17237 Bear Pow Circle na. M•—`•t—LAYOUT Eagle River. Alaska 99577 a-vM 907.694.7028 .... 1 �i - 6 O Caw. 10/17/05 12 of 4 s W u U / 0/ a, W N L L Q N H J N 3 O W >_ O Z ow ° c O LY 75 {+ O L C d C O a L CD O •F, o t s d u F� a u u _N C C d ¢ � i O NO .}+ +, iH N W N a L O L N o c t d O) 4- CL N � W N ON U a s u c L i F- C O 4' O. 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L Zr L t s L L W i' (5 3 L 0 0 L L3 O uu L L N W O -P z0 E 3 lil A N, m 0 N we F— L a = W U F--4 Z LL- W E3 WLd H Z 3 Q J lf) CL ' \\ S❑ILS L❑ M11THSI'IM_ iNC9- INEERING 11 Performed For, Bill Lester — PERC❑LATI❑N TEST Date Performed: 10/10/05 Legal Description Marys S/D, Lot 2 DEPTH (FEET) organic Flat Slope 1_ " ' ' " SM See Location Drawing 2 :a> ; Silty Sand 3 :. w/Gravel 4 - w: 5 6 Groundwater? No 7 _ Depth -- '' Water Depth After Monitoring.-- Dates 10/17/05 9 - # Date Gross Time Net Time De th et Dro N10 ....... 1 10/13 0 -- 8' -- 11 - .. 'Y 2 10/13 1 1 min. 8.5' 1/2' 12 - :� -- 7' -- 13 - 3 10/13 3 1/2' 14 -4 10/13 4 1 min. 7.5' 15 - 5 10%13 6 '-8' -- 16 - 6 10/13 7 1 min. 8.5' 1/2' 17 - 18 - 19 - 20 - Percolation Rate 2 min/Inch Perc Hole Diameter 6_ 21 _ Test Run Between 3' & 4' Comments: CERTIFY THAT THIS TEST WAS Performed By Nr)rthRim Eng. I State/Municipal Guidelines in Effect Performed in Accordance with All ON THIS DATE. DATE, 10/17/05 �9... K ORTHRIM TESTH❑LE LOG Nh~P TH 1 * ENGINEERING ''" 77237 Bear Paw Circle •" C • •'• 'Eagle Rive, Alaska 99377 ..... �•''•� I GE❑TECHNICAL ___ Dot 10/17/05 I 1 907.694.7028 - MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME '—� ��•� f � IDLIONE EVV `l �©� UP RADE MAILING ADDpf!l!,Sn, ) LEGAL DESCRIPTION ! 5 A LOCATION/ 9R 4® 2t f NO. OF BEDROOMS Uy DISTANCE TO: Well Absorption area Dwelling ` PER NQ F Z LU F Manufacturer(/^�� V No. of co artments ti Liq. c p it Nin,5llons IF HOMEMADE: Inside length Width Liquid epth y DISTANCE TO: Well Dwelling PERMIT NO. 0C = Zz F Manufacturer Material Liquid capacity in gallons 0 w= DISTANCE TO:6 Well Foundation/ Nearest I in % PERMIT NO. J LL z 1= z w No. of lines Length ea Pne C�� Total I th f II' es Trench with/ 6 C3 b inches Distance between lines o F Top of tile to finish grade Material beneath tile �� inches Tota e ctive absorption area ©Q LU C7 Length Width Depth PERMIT NO. a I_- wa Type of crib Crib diameter Crib depth Total effective absorption area w w DISTANCE TO: Well Building foundation Nearest lot line J LU Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERI S Ap, ) , U l.� C SOIL TEST RATING 1p INSTAL R REMARKS r APP D DATE EGAL THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISN THN�E BE�WE�THE^5URFHCE OF TH� � GROU,,-!D AND THE BOTT011 OF THE EXCHVHTIQN (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRHYEL BETWEEN THE OUTFHLL PIPE AND THE BOTTOM OF THE EXCHYHTION (IN FEET). ���.4-9 1 E> F: --,'T' 1 C.' ��ir-.1. ��, -4 ��EE� PERMIT APPLICANT HRS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE INSTRLLHTION INSPECTIONS OF AN'.,' WELLS ADJACENT TO THIS PROPERTY AND THE BACKFILLING; OF HNY S9STEM WITHOUT FINAL INSPECTION HND HPPROYHL BY THIS DEPARTMENT NILL BE SUBJECT TQ PROSECUTIO1N. MINIMUM DISTANCE BETWEEN H WELL HND ANI -e' ON—SITE SEWAGE DISP85HL IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPEND�N� UPON THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM 1A PfRIYHTE WELL TO H pRIYHTE SEWER LINE IS 25 FEET HM TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MHY HPPLY� SPECIFICF�TIONS AND CONSTRUCTION DIHGRHMS HRE HVHILHBLE TO INSURE PROPER INSTALLATION. F""WORM 1 -7- E"WWW" 1: FRIFEW ED, EE. ���W W, F -r-" 7,.- -1- ���- I CERTIFY THAT 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR ON --SITE SEWERS AND WELLS HS FORTH BY THE MUNICIPHLITY OF H�CHORHGE 2: I WILL INSTALL THE SYSTEM IN HCCORDHN�.:E WITH THE CODES. ]: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MHY REQUIRE ENLARGEMENT RESIDENCE IS REMODELED TO INCLUDE IMORE THAN ] BEDROOMS. 01 SIGK�Z�� 205 FV CUMENTS ISSUED BY /] 4-1\���|Q�� SET IF THE � , ~ ' ` ~ D�PF�TMENT OF HEHLTH HND ENVIRONMENTHL PROTECTION E 825 'L' STREET/ ANCHORAGE, HK, 99501 Ls Ln hat 264-4720 � 1 �� � CT�� � fix " 2- .� PERMIT NO. ( 810967 ) �� �. ��U���M ��=�=o HPPLICANT FRED F. [1LEMENTS GENERAL DEL 694—]09� LOCHTION BHRHNOF ST./ EAGLE RIVER LEGAL L2 MARY/5, S;, -'D LOT SIZE 11800 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MHXIrel UM NUMBER OF BEDROOMS ] (SQ FT/BR)= 1.00 THE REQUIRED SIZE OF THE SOIL ABSORPTION IS: F^I �`-4- U K: P44 C -i V oil Q FM V KK.. Flo E=1 V WF`1= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISN THN�E BE�WE�THE^5URFHCE OF TH� � GROU,,-!D AND THE BOTT011 OF THE EXCHVHTIQN (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRHYEL BETWEEN THE OUTFHLL PIPE AND THE BOTTOM OF THE EXCHYHTION (IN FEET). ���.4-9 1 E> F: --,'T' 1 C.' ��ir-.1. ��, -4 ��EE� PERMIT APPLICANT HRS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE INSTRLLHTION INSPECTIONS OF AN'.,' WELLS ADJACENT TO THIS PROPERTY AND THE BACKFILLING; OF HNY S9STEM WITHOUT FINAL INSPECTION HND HPPROYHL BY THIS DEPARTMENT NILL BE SUBJECT TQ PROSECUTIO1N. MINIMUM DISTANCE BETWEEN H WELL HND ANI -e' ON—SITE SEWAGE DISP85HL IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPEND�N� UPON THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM 1A PfRIYHTE WELL TO H pRIYHTE SEWER LINE IS 25 FEET HM TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MHY HPPLY� SPECIFICF�TIONS AND CONSTRUCTION DIHGRHMS HRE HVHILHBLE TO INSURE PROPER INSTALLATION. F""WORM 1 -7- E"WWW" 1: FRIFEW ED, EE. ���W W, F -r-" 7,.- -1- ���- I CERTIFY THAT 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR ON --SITE SEWERS AND WELLS HS FORTH BY THE MUNICIPHLITY OF H�CHORHGE 2: I WILL INSTALL THE SYSTEM IN HCCORDHN�.:E WITH THE CODES. ]: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MHY REQUIRE ENLARGEMENT RESIDENCE IS REMODELED TO INCLUDE IMORE THAN ] BEDROOMS. 01 SIGK�Z�� 205 FV CUMENTS ISSUED BY /] 4-1\���|Q�� SET IF THE SOILS LOG \` MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION O PERCOLATION `.� TEST � 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Ft2E Q C L E M E /l) ( -5 DATE PERFORMED: 5e je� cl LEGAL DESCRIPTION: �_ DEPTH SLOPE (FEET) (FEET) A—jj 0'?G%ANjG I 1 ' 1 COMMENTS_� PERFORMED BY 72-008 (6/79) WASGROUNDWATER /Jv S SANy� ENCOUNTERED? C 4� P C r[ l— v & / IF YES, AT WHAT E DEPTH? ' OF A 'kh C®®aoe®99ogao��� e d 0 i 1®OHD OODBOBO ®009008 90 NO. 1732-E , June 22„1968 e;® N) i_) T 11_ u't')5'T Reading Date Gross Time Net Time Depth to - Water Net Drop t PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT 7/ c CERTIFIED BY �` DATE: i MUNICIPALITY OF ANCHORAGE JY DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL�7YL) ^� OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L2. MAP\V Svc) 7WIV R,2-461 sF�c l2 Location (address or directions) 19/30 pp 4 K ©x'60 r -E M/E. (b) Applicant Name `ri t/0U51A(G ar`//VRI&CFTelephone:Hrotme Business 2—yB-2q?O'l ApplicantAddress��� (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ; Buyer ❑ ; Other ❑ (explain); (dj Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. -TYPE OF RESIDENCE Single -Family p Multi -Fa '1 ✓ ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well ❑ Community ❑ Public, Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank El i 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 2 72-025 (11i84) 5. ENGINEERING FIRM PROVIDIh.a INSPECTIONS, TESTS, FILE SEARCH, DA iA 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 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 /VG- Telephone Address !2(,)Q �f h wc(_% /IA/ Date_ Ilat V6 OF A4 1000, ®" V.O°0a 060 0 �® o 9TH D, ,0 O000000000000°0000,0009'$0• �o Engineer's Seal a sea 0c9 aa00oo 000000000 Goo big o tEROY C. REID, JR. oa �d % CE - 2251 9° a.�� V V a0 99r6 a0 ��^V ��G�A.N •aaa0 as V4� 6 6. DHEP APPROVAL Approved for bedrooms by to /4 Approved - Disapprov Conditional Terms of Con ditional.Approval i 0 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) - ' - A�HDNICIPALITY OF ANCHORAGE (MOA) kUNt OHE p O VON CHECKLIST - FEBRUARY 1984(HAA) TY APPROVAL api. O E�tRpNS� GG 264-4720 Legal Description: T/ (& R U) S Ec Iz A. WELL DATA Well Classification Pu BUG If A. B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary >Aro Ca 'ng (Y/N) — Electrical Wiring in Conduit (Y/N) Depressiod Wellhead (Y/N) Separation Distances from Well: A A To Septic/Holding Tank on Lot fit / /-1 On Adjoining Lots — To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots To Nearest Public Sewer Lineeo Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ; Date B. SEPTIC/HOLDING TANK DATA Q, r / _ u 40 Date Installed / Size No. of Compart ents Standpipes (9N) Air -tight Caps @N) Foundation Clean ut (Y.® Depression over Tank (Y,9 Date Last Pumped I .31n Pumping/Maintenance Contract on File (Y/N) N ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) —-- Separation Distances from Septic/Holding Tank: To Water -Supply Well 2Q() To Building Foundation To Property Line To Disposal Field To Water Main/Service Line L Z� To Stream, Pond, Lake, or Major Drainage Course�� Comments Page 1 of 2 72-026(11/84) L 2 AAVR' 5114 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / VV Type of System Design I�5EIVG/7 Date Installed e/ Length of Field .30 / Width of Field X8 3 Depth of Field ` 7YAW �T Square Feet of Absorption Area Depression over Field (Ye Results of Last Adequacy Test Gravel Bed Thickness 300 Standpipes Present (WN) Date of Last Adequacy Test �� 8 SAr(S F4CWRY Separation Distance from Absorption Field: To Water -Supply Well 20n To Property Line 10 / I" / To Building Foundation Lot To Water Main/Service Line 2C 4 - To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments To Existing or Abandoned System on On Adjoining Lots 1,517 To Cutbank (if present)�Lt Dimensions Manhole/Access "Pu ff' Level at Vent(Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA I certify that I ha cked ierifi d, or conformed to all M A and HAA guidelines in effect on the date of this inspection. Signed �f Date p G Company MOA No.A4 '44e Receipt No. 7 V 0 o o l( �,�Qa °°°° �•.��,�®� Date of Payment lo— G e ir: TH a�*�® G�00° ee s ....•.°. .¢ Amount: $ / Prr("6CHMF,vtOY C. REID, JR. s ' l SIr6 Pc AAI '° $ i AT Page 2 of 2 72-026 (11/84) ° CE -2251 O sq 9+®> Proiesslooa�tiP�s' ALASKA ENVIRONMENTAL CONTROL SERVIC"INC. 1200 West 33rd Avenues, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB L2 MRRY SOB, SHEET NO. OF CALCULATED BY T K DATE /%- CHECKED BY- SCALE _)_- 60502 ALASKA HUIROf1 nTAL COnTROL SNOUS, InC. engineerinq & 6nuironmental Studies KIM WILMOTH SELLER - 2804 WEST NORTHERN LIGHTS BLVD ANCHORAGE ALASKA 99517 LEGAL:MARY SUBDIVISION LOT 2 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE -9/17/86 9/29/86 KIM WILMOTH 2804 WEST NORTHERN LIGHTS BLVD ANCHOA-&ZiA�ASKA 99517Ep.,vf„°`ar p OF A( C?N NC & ^Cti7 FN7-'e,& GZ Oct 0*p R(DrFCT'GA1 ` ,2$6 � D THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 300 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 450 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 9/22/86 . THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. .r� 0��e q� o,,a ps 0* . 49TH :g �+ �• OY C. REID, JR. A CE -2251 1200 lAest 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) 561-5040 Time APPLIC-VT FILLS OUT UPPERHAL"--''ONLY Property Owner Q /� 61 1 �¢ %�/ 5 f - _'o - Date ® Mailing Address y,`-y—� �jC( -, L(S� Zip Code /Phone t t Buyer [� C t �! 'v L. Inspector Address �/{� �- �, I _ e Inspector Lending Institution Phone Address N 5. P ` (ti�X �/�(Z� 5( Zip Code Realty Co. & Agent !-AD + C \ k<:\. 'S `J � V A C--1 OR � one � fir✓ Address �D. & ✓ �] Zip Code - 'CONDITIONS OF APPROVAL Legal Description I1 ; ( ) CONDITIONAL APPROVAL' Street Location I " Li DATE- DATE 1---••j Type of Residence _ Soils Rating K Single Family ? Well Log Received ❑ Multiple Family No. of Bedrooms••? - - ❑ Other Water Supply ❑ Individual - - ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log if available). - Public Utility Sewer Dis osal / b5-15dividual Year Individual Installed: ❑ Public Utility Holding Tank - When Connected to Public Utility: I ro o GAL NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date ® Date - Date Date Inspector Inspector Inspector Inspector Field Notes: - �( C. . (3) APPROVED BEDROOMS - 'CONDITIONS OF APPROVAL ( ) DISAPPROVED - ( ) CONDITIONAL APPROVAL' I " Li DATE- DATE 1---••j '9' BY: PCA Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank ".'3 t".'