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HomeMy WebLinkAboutMELINDA VIEW ESTATES LT 3AfAne�a (,ua� tOj&�6 * o n- 09 a%, q(v i 8 1 -5 Municipality of Anchorage Page of 3 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: Sk& 9LIb0 1 A PID Number. 01-7- n42— f4kb Name: SELL, SC -0 -TE Ii Wastewater System: YNew ❑ Upgrade Address: ABSORPTION FIELD Phone: c9-71— 7 No. of Bedrooms: Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: GPD/Sq. Ft. I ) Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe ^ 3 A H LLI 41DvtalV 14 Ft. 9 Ft. Township: Range: Section: Fill added above original rade: Gravel length: _ IdL� Ft.J Z— m Ft. WELL: New ❑ Upgrade Gravel width: Number of lines: Distance between lines: Ft. 12- Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: V 1 r—�D Ft. Ft. / SQ. Ft. e / O Driller: Date Drilled: Static Water Level: Installer: Date in Calle A L 1 - 7- - R� Ft. c - e .S,.,.ti 1 6 /a �- (� 1S 9 Yield: Pump Set at: Casing Height Above Ground: TANK GPM 13e O'1,r1 Ft. 021 Ft. SEPARATION DISTANCES ,,,,// L(Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Litt Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines 6 6 JE hF 12 1 t; G— -D WellMaterial: I too Number of Compartments: Surface IIIc, NoLve- LIFT STATION Water Lot Size in gallons: Manufacturer: Line tpD 5 Foundation 2 J D "Pump on" level at: "Pump off" level at: High water alarm at: Curtainn' " I ". Pump Make & Model Electrical Inspections performed by: Drain ff— tph ` 04 Remarks: BENCH MARK Location and Description: �_. _, �1 . !0 OVHaC.n oL14 - Assumed Elevation: I[90� ENGINEER%8-SEAL , �� d 5 Irl L1 Inspections performed by: , Dates: 1st fllY 2nd Department of Health anc�lHumata�S� ices approval Reviewed and approved by: 72-013 (Rev. 9/91) MOA 25 i it I it i F—+ — -- — -- —-I i i i feu I SWING TIES: G H FOUNDAT1 ?N AC 15 FT TOP OF B OCK BC 26 FT AE 46 FT BE 41 FT AD 46 FTRD J9 FT �o I AH 72 FT D BH 36 FT F ° E AF 62.5 BF 54 F7 AG 84 FT yI BG 51 FT BULL RUN DIVERTION VALVE PS 0 P5 50 75 100 125 150 SCALE: 1 " = 50 FT i TOBBEN SPURKLAND P.E. LOT 3A MELINDA VIEW ESTATES SID SEPTIC SYSTEM ASBUILT 203 W 15TH. AVENUE SEC. 35, T12N R3W DATE.- JUNE 24, 1994 gNCH� A,Ko_9 x501 14550 JOANNE CT. SHEET 2/3 GRID: 3038 5� Monitor Clean Out Standard Trenches Monitor Clean Out 3' Wide 52' L ong 10' Deep 6' Sewer rock 3' Cover NO SCALE 75.9, 79.4 Miro Fi 140 69.9, 72.2 6 Ft of Septic Rock 12 Clean Clean Cleanouts Monitor 4' Topsoil 4' Co ver 79+, 82+ NO SCALE 3 0 ti c O � o v -N � a s z � o q � 1,500 gal Septic tank DIVERTER VAL VE BULL RUN 96+ 5 1500 gal, septic tank TBM: TOP OF FOUINDATION ASSUMED ELEVATION: 100.00 FT ITOBBEN SPURIQAND P.E.LOT 3A MELINDA VIEW I I SEPTIC SYSTEM ASBUILT I 203 W151h Ave SECTION 35. T12N R3W DATE: JUNE 24, 1994 A�0-o Q�� I I Ak 99501 14550 JOANNE CIR. SHEET.- 3/3 GRID: 3038 (ENGINEER'S.SEAL) Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: S �o[T -�—{, DATE PERFORMED: LEGAL DESCRIPTION: 1--0431-�' Township, Range, Section: n-TFP� SLOPE SITE PLAN 1 2 3 4- 51 5 6 7 Fe, E 10 Gross Time WAS GROUND WATER Depth to Water Net Drop ENCOUNTERED? _ 11 IF YES, AT WHAT DEPTH? 12 l l: b 3 _ c� r� Depth to Water After 13 7o Monitoring? Date: 14 15 16 17 18 19 MIMMEMEMIMMIN NNEENEENIME MENNEN Reading Date Gross Time Net Time Depth to Water Net Drop F-; t .5• o l l: b 3 c� r� -5/r,t1.5 7o G'/ z3 l l •. Y J Z O 1 7-5 s 534 3111 IIA colr 20 { I r' IL_�I PERCOLATION RATE __A_s(minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN Ile FT AND 6 • `� FT COMMENTS PERFORMED BY: U - 5 I Y- S CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �<�- Z q 1 q 4 LZ 72-008 (Rev. 4/85) T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: Lot 3A Melinda View Inspection Report. October 14,1994 A recheck of the installation confirmed that then soil cover in the vicinity of stand pipe "H" was indeed 2.4 feet. Sufficient cover (minimum 3 feet) will be provided at final grading and placement of top soil. The absorption field consists of two equally long trenches. Each trench being 50% of the total required absorption area. The design is based on sequential use of the two trenches. The installed diversion valve will direct the effluent from the septic tank to one of the two trenches. Periodically the owner will switch the flow from one trench to the other. That way one trench may have the opportunity to dry out and allow air to access to maintain aerobic conditions, a condition that may substantially increase the useful life of the system. cc Scott Sells 9 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 PERMIT PERMIT NUMBER:SW940018 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:SELL SCOTT 0 & BARBARA E OWNER ADDRESS:7140 LINDEN DRIVE ANCHORAGE, AK 99502 PARCEL ID:01709246 LEGAL DESCRIPTION: MELINDA VIEW ESTATES LT 3A LOT SIZE: 49000 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1 �ox_� Lo - -'l �A DATE ISSUED: 2/01/94 EXPIRATION DATE: 2/01/95 I. 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE DRAINFIELD MUST BE DESIGNED ON THE BASIS OF A PERC.RATE OF.31-60 MIN/IN WHI GIVES A"TRENCH _LENGHT OF 139 FT. 36 RECEIVED BY: DATE:_ \ ISSUED BY: DATE: -:?/Z- /15vz- CC- `V �`� 40 -0C\L�� C\iiis E=- 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN SCOTT SELL No Ground (Mater or Ia per-v_i ous Laver to 16 t. Use Standard Trench Soil Rating. From test December =:, 1993 i-16 min in = .6 gall iman Required Area per Bedroom: 150/.6 = 50 sq.ft.. Finished Floor Elevation Lowest Floor 503. (=round E -Jur -face at Absorption Field 496 Testhole Total Depth 16 Less 6 feet 10 Less 4 Cover- 6 Rock Depth 6 Number of Bedrooms Length of Trench 250 .. 5 . 12 - 1k-;4 ft. STANDARD TRENCH �:;.; TOTAL LENGTH 2 x 52 = 104 Ft. �/- TOTAL DEPTH 10 FT- ROCK T. /G' f �/ I3J 7� / SFJ€ K DEPTH 6 FT. / C j% SEPTIC TANK 1500 GAL. The installation of this septic system will not prevent wells from be installed on the adjacent lots. There are no developed or natural surface i sub surface drainage courses on this or the adiacent lots. The proposed septic system will not change the general slope of the area. Ponding andior concentration of surface runoff will not resu:t 4rom this installation. .., ciir C'J r:. a t::: . '� \,•� !:f:'l:. F.::'� i'fl .l)!S Sii J. C;) Il '`:ic::S-.i II 11 II I II I II II IL -_--- __--- __� I Ir — — — — — —— — — — — -� I LOT 3A 1 I W I I o II A I II I II I II II I II I I� I II I LOT 5 LOT�4�efl I I Y II I I I I i _ _ _ _ _ II i 50 0 50 100 150 200 250 300 SCALE 1" = 100 FT. 6 �6 e F♦ 6� �� ° UNDEVELOPED �;�e• '� a°`°`` �'°°`' I TOBBEN SPURKLAND P.E. I LOT 3A MELINDA VIEW ESTATES SIBI I SEPTIC SYSTEM DESIGN I 203 W 15TH. AVENUE SEC. 35, T12N R3W DATE: JAN. 4, 1994 ANCH. AK. 99501 ��e_�s,� 14550 JOANNE CT. SHEET, 113 GRIDi 3038 I I I I I i I I I i I I TBM- TOP OF ALUM ON I 490.8 ASSUMED ELEV. 5 .00 FT. IL — — — — — — — — — — — — — — — — — — — — — — — —— -I -I-- -- -- -- -- -- Ir — — — — — — — — — — — — — I I TESTHOL #1 O 497 REPLACEMENT tREWCHES i I I .. I I I I TESTHOL #2 p 1 PRImigY� TRENCHE 496 1 I I I I SLOPE C 10/. i I 1 492.4 1500 AL I I 503 I I 1 I I I I I I I I I I I I I I I i l I I 25 le 25 50 75 100 125 150 I SCALE.• 1' = 50 FT I � I --———— — — — — - I SEPTIC TANK 502 \ TOBBEN SPUKKLANll P.L. I I LpT 3A MELINDA VIEW ESTATES S/D I I SEPTIC SYSTEM DESIGN I 203 W 15TH. AVENUE DATE, JAN, 4, 1994 ANCH. AK. 99501 SEC. 35, T12N R3W 14550 JOANNE CT. SHEET, 2/3 GRID, 3038 well �< i , TOBBEN SPUKKLANll P.L. I I LpT 3A MELINDA VIEW ESTATES S/D I I SEPTIC SYSTEM DESIGN I 203 W 15TH. AVENUE DATE, JAN, 4, 1994 ANCH. AK. 99501 SEC. 35, T12N R3W 14550 JOANNE CT. SHEET, 2/3 GRID, 3038 SP Monitor Clean Out Standard Trenches - 3' Wide I 52' L ong 10' Deep 12 6' Sewer rock 3' Cover Monitor Clean Out Clean Clean NO SCALE /�I�JC 7-z? c vE' J'�d v✓� c�1�� Mira F; 140 . -- 6 Ft of Septic Rock ClPanouts Monitor 4' Topsoil 4' Co ver NO SCALE 1500 gal Septic tank DIVERTER VA BUL L RUN 4' Min Co ver over Tank Exist, Ground 1500 gat. septic tank TDBBEN SPURKLAND P.E.SEPTIC SYSTEM DESIGN 203 W15th Ave LOT 3A MEL INDA VIEW Anchorage Ak 99501 SECTION 35, T12N R3W DATE- JAN, 5, 1994 —. 14550 JOANNE CIR 11 SHEET- .?/.? GRID: 30.?R w 3 O 41 C o _m U c C5 c v m a I 3 3 0 ql 1 L2 1500 gal Septic tank DIVERTER VA BUL L RUN 4' Min Co ver over Tank Exist, Ground 1500 gat. septic tank TDBBEN SPURKLAND P.E.SEPTIC SYSTEM DESIGN 203 W15th Ave LOT 3A MEL INDA VIEW Anchorage Ak 99501 SECTION 35, T12N R3W DATE- JAN, 5, 1994 —. 14550 JOANNE CIR 11 SHEET- .?/.? GRID: 30.?R Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �Cdif SF""- DATE PERFORMED: 13�d1� LEGAL DESCRIPTION: LeL SA Lt c:, Township, Range, Section: T 1\1;. � C- r DWPTH Vt,-"tr JES4,4e- SLOPE - -- - 1 // T Ure A,NtLS 2-061 pl 1 C, f J-- M L wII; LL- �bbI-C', 3 I I �L<.kse-- 7 G` 8 9 10, 11 12 13- 14- 15- 16 3141516 17 18- 19 20 COMMENTS V-41' [-� J�-� A cwu C cl{NSC 77'D WAS GROUND WATER ENCOUNTERED? O S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? Date: Reading Date Gross Time Net Time Depth to Water Net Drop 17-3 - 3 40:50 Te crci 0 ta, SB 75 S'/,1 1 ;0 ' 70 7 s/q Ll VY 1b PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER T ST RUN BETWEEN FT AND Z FT -p- i i I �% "< 1 n 12.17 PERFORMED BY: f% I �'s CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) municipality of Anchorage i Department of Health and Human Services CjhhS Tom Fink, 825 "U Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 January 8, 1991 Gary and Zandy Russell 4821 Loretta Lane Anchorage, Alaska 99516 Subject: Lot 3A Melinda View Estates Subdivision Permit #900034, PID #017-092-46 The subject permit, issued by this office for a single family well and/or on-site wastewater system has expired as of December 31, 1990. A new permit must be obtained from this office for a well and/or on-site wastewater system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as -built inspection report (three-part form) must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit. If you have any questio s, Sin re y, Jo Smit , E. Pr gram Manager On-site Services JW/1jm:200 enc: Copy of Permit please call this office at 343-4744. "Kids Are Our Future" » + MUNICIPALITY OF ANCHURA6� Department o{ Health & Human Services 825 L Street, Anchorageska 99501 343~4720 ON~SITE SEWER PERMIT 7 // Date Issued: O2/13/90 Engineer Designed Owner Name: GARY & ZANDY RUSSELL Day Phone: [}wner Address: 4821 LORETTA LANE 345�2122 ANCHORAGE� AK 69507 Parcel Id: 017^092�46 Lot Lega1: Subdivision: MELINDA VIEW ESTATES Lot: 3A Block: ~ Section: 35 Township: 12N Range: 3W Lot Size 49000 (sq,�t" or acres) Max Bedrooms: This Permit: 3 Total Capacity: 3 SEPTIC TANK: Minimum total septic tank capacity: 1�000 gallons" Each septic tank must have at least 2 compartments" Depth to top o� septic tank(s) {eet requires insulation over tank(s>. INFORM D.H.H.S. PRIOR TO INSPECTIONS BY ENGINEER; IF AFTER OFFICE HOURSv CALL 343�4681 AND LEAVE A MESSAGE. CONS7RUC[ PER ENGINEERS ATTACHED DESIGN" THIS PERMIT EXPIRES 12/31/90 AND VALID FOR A SIN8LE FAMlLY HOME, ^ I CERTIFY THAT: 1. I am {amiliar with the reOU, iremenor on-site sewers and wells as set �orth by the Municipality o� Anchorage (MOA> and the State o Alaska, 2" I will install the system in accordance with all MOA codes and regulations� and in comp1iance with the design criteria o� this permit" 3, I wiIl adhere to all MOA and State j Alaska requirements �or the set back disL ances {rom any existing well� wastewater disposal system or public sewerage on thisI I AIy adjacent or nearby lot" 4, I underst t this t is valid [or a maximum o� 3 bedrooms. I a}so unde that t pacity o� the total system is 3 bedrooms and USSELL DATE:�� _.-~������_ DATE: ��~.... ..... ..... ....- �~^��-��r�~�...~- INFORM D,H.H.S, PRIOR NS BY GIN IF AFTER OFFICE HOURS, CALL 343 4 8 AND AVE A SSAGE CONSTRUCT PER ENGINEER ESIGN" THlS PERMIT EXPIRES 12/31/90��0\VALID F�R A C, L, FAMILY HOME, I CERTlFY AT 1. I am � J. t. sewers and wells as set �orth and the State o� Alaska, 2. I will with all MOA codes and regulations, and in ria of this permit. 3. I will Alaska requiremeI set back distanJ. tewater disposal system or public sew�ra ent or nearby lot^ 4. l undelid for a maximum o� 3 bedrooms. I a1so u � the total system is 3 bedrooms and an� enitional permit, S�gned: ..... ..... ..... .... _~~~~ (Owner) GARY & ZAN 1ssued Sy: DATE: 27171.1-1. _���w�' ��.1�'�� ���� U. ' ~ In ! 1� w | ^��� ' \ �� � �. 0�F\`` \ � ~°o _W 4 uo Q ��" 0 o ]`~ \\,�� � MUNICIPALITY OF ANCHORAGE Department o� Health & Human Seryces 825 L Street, An�horage� Alaska 99501 343^4720 ON~SITE SEWER PERMIT Permit Number; 900034 Date Issued: 02/13/9O Engineer Designed OwnerName: SARY & ��NDY RUSSELL Day Phone: Owner Address:4821 mJ. C:. LANE 345-2122 ANCHORAGE� AK 99507 Parcel Id: 017�092�46 ���"^ Lot Lo- ga1:Subdiv1sion: MELINDA VIEW Section: 35 Township: 12N Ran 3W Lot Size 49000 (sq,�t, or acres) Max Bedroo�s: This Permit: 3 l ty:\ 3 SEPTlC TANK: Minimum total septic tank caty: 1 00 gallons, Each septic tank must have at least 2 in. D h to t o� septic tank(s) < 4^0 �eet requires k( insu1a�zon over \ INFORM D,H.H.S, PRIOR NS BY GIN IF AFTER OFFICE HOURS, CALL 343 4 8 AND AVE A SSAGE CONSTRUCT PER ENGINEER ESIGN" THlS PERMIT EXPIRES 12/31/90��0\VALID F�R A C, L, FAMILY HOME, I CERTlFY AT 1. I am � J. t. sewers and wells as set �orth and the State o� Alaska, 2. I will with all MOA codes and regulations, and in ria of this permit. 3. I will Alaska requiremeI set back distanJ. tewater disposal system or public sew�ra ent or nearby lot^ 4. l undelid for a maximum o� 3 bedrooms. I a1so u � the total system is 3 bedrooms and an� enitional permit, S�gned: ..... ..... ..... .... _~~~~ (Owner) GARY & ZAN 1ssued Sy: DATE: 27171.1-1. _���w�' ��.1�'�� ���� U. ' ~ In ! 1� w | ^��� ' \ �� � �. 0�F\`` \ � ~°o _W 4 uo Q ��" 0 o ]`~ \\,�� � W 0 PPOPOSED BED I /WEL( x 18' 38 PeoP, 1,000 64L TAIJK- _ U 300' + C/o z yo 4-1 I I j $, � TEST HOLE m 1 lEt L l P_E ERVE AEFA \ 1lELL �i I NELL Ut\tDEVELOPED II PROPOSED SYSTEM: BED I �— rN) 4 ( :-3 Bdrm) ( 150 soils) (1.5)=:675 sq. ft. 6' °: D -o Geo• Fage�c 3 4" PEEF PIPE Construct Bed: "18' wide x :38' long �' 6-5 Install Ror tc - Install 1,000 Septic Tank M.O.A. Approved I6' Mou.P1PE Insulate Tank if cover is less than 4' ° I Install Clean -outs between house and tank, + between tank and bed, two in bed, and FPOM °, -rAUK one at proposed house foundation. Install Monitor Pipe in Bed Cover bed with 3 feet minimum of nativeB' 1 fill and/or import fill. ALL CONSTRUCTION TO MEE M.O.A. SPECIFICATIONS. NOTE: All Dimensions And Locations Must Be Field Verified Prior To Construction SEWER SYSTEM LOCATION PLAN SUDIVISION 3 e - MELI NIDA -VIEW_ ESTATES - 4j(7 31 NORTH 5 Tl?W-E3W NOTE, 1 .. I"— 106 The Accuracy OC Location OC Exisiting And Proposed Property Corners, Wells, and Septic % (' Systems Indicated Is Not Exact. Dimensions y _ KEE�SS Indicated Nave Been Determined By Use Or Cloth MR, Tape and/or Municipal Records, And Not ey SurveyingTechniques FOR ACEEA6E S STEMS 5Y STEMS 2.15/ ya I SHEET I OF 1 fdunicipalily. of Aachora� DEPARTMENT OF HEALTH & HUM. 825 "U' Street, Anchorage, Alaska SOILS LOG — PERCOLATI PERFORMED FOR: 7"1(_P%A % F J Y S E MS � LEGAL OESCR(PTtON:I HELI W n i�! O L I ES -Township, Range, Section_ T1,7 N1 SLOPE - SITE PLAN oePrR pL 6 a o ad SP :14F rcbr I y 5 raced SA 2 a o n WD N 00 3 4 c A T ( I It 5 s sdv Si�uo s s 70 WAS GROUND WATER - ENCOUNTERED? -C) S Al to i - IF YES, AT WHAT p { DEPTH? P 12 E Depth 4o Ylz(er fitter 13 Asan tx nq? Gate 74 Reading Date Gross Net Depth to Net Time Time Water crop is- 16- 5to END �1° WATER 17- 18 's 1 1 20 PERCOLATION RATE (minuteVirkh7 PERC HOLE DIAMETER TEST RUN BE N FT AND FT COMMENTS n6 I � r f . PERFORMED 8Y: J�t-= ACCORDANCE WITH ALL STATE AND MUNICIPAL l 72-008 (Rev. 41851 _ 1 �CERT(FY THAT (S EST WAS PERFORMED IN -IN EFF CT N THIS DATE DATE: C—) . Thi e 1 wow drilled n er ris'l`clion pnd this /a port is true to the„best oVy knowledge and belief; fr a �R�Jpistered BussiinnQ-''54 Nome Contract License Number Address: Signed: ^-r v'?.tet.-.r,Y�='Z_ Date: Authorized Representative Form 02-WWR (11/81) Copy Distribution: WHITE -State OGGS, PINK -Driller, CANARY -Customer WATER WELL RECORD STATE OF ALASKA i DEPARTMENT OF NATURAL RESOURES Division of Geological & Geophysical Surveys n - Drilling Permit No. - LOCATION OF WELL (Please complete either la, Ib or Ic.) A.D.L. No. la. Borough bC��iwai n� r Block Ib. 1/4 citta. Section No. Township NC] Range EE Meridian - ';- J�/�/,�u V,p f.t.L;) ILot yn J,4 & _ot of_°f _ gE) ..W(J :1 c] DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS - _ 3. OWNER OF WELL:w�.-/-nww�w�q...�-` _ Address: Street Address and Area of Well Location 2. WELL LOG '.- Feet Below Surface - 4. WE L DEPTH: ((Incl) 5. DATE OF CQ PLETIO . .Material Type —Top --Bottom- — '-;.. "'�- S. ❑Coble fool :._ Rotary :Ej Driven _.Q Dug I a 1:. Aagar _-`Q Jetted Bored Other: ' 7. USE:/'Eg'Domestic .` D Public Supply :Q Industry - .1:1 irrigatlon'`' Recharge .; 0 Commericali ,�. : _ - ;- --.. �i Toot Well :. Other. - `y4+y B. CAS NG: .�. Thr a ed ,Welded J / diam: •{y' In.: to f1. Depth Watght - 'lbs./ft aAAfYle1i- - .,��-•% . +Q - diam, - In, fo 1f. Depth 'Silckup ' ' ft. 9. FINISH OF WELL: Ty De: Diameter• -:Slot/Mesh Size; Length:' - - bet wean !t. cud `lt. .Grovel Backfllllnq pack' rr -7� yy'7 10. STATIC- WATER LEV ''Ls Jd-. ft., / 7'� Above or Xeelow nd surfoc- Dote %1 . ; 1 z 1 , II . P MPINGLEVEL below a d surtaca andYlED ti atter hrs; 'pumping "}t. after : hrs. pumping�T_q.p m 1 _ IAI 12'GROUTING : Well Grouted: ,-�Q Yes _E] No . -•Moterlaeat Cement Q Other: 13. Pump: '(if available) HP N_ :Length of Orop Pipe`-. `'ft. -capacity :.-.;g:p:m. - y u E �Q Subm. Jet Centriticol -. Other r o° Munlcipaflty n . , t - ' _- . -14. REMARKS:- -. 16. WATER WELL CONTRACTORS CERTIFICATION: 15. Water Temperature _° E) F 1:1 C Thi e 1 wow drilled n er ris'l`clion pnd this /a port is true to the„best oVy knowledge and belief; fr a �R�Jpistered BussiinnQ-''54 Nome Contract License Number Address: Signed: ^-r v'?.tet.-.r,Y�='Z_ Date: Authorized Representative Form 02-WWR (11/81) Copy Distribution: WHITE -State OGGS, PINK -Driller, CANARY -Customer MUN1[1KALl|Y UP ANLHOHA6E Uepartme! it. o Health & Human Services 8�5 L Street, Anchorage, A1aska 99501 J43 ON~SITE WELL PERill Il ' Permit �umber: 900191 Date Issued: 07/0b/90 C`vn \(D \ Ownor Name: ALEXANDRlA RUSSELL on. -site sewers and Day Phone: Owner Address: 4821 LORETTA LN" and the State 562-3074 2. I will install the ANCHORAGE, AK 995i6 all MOA codes and re�ulaLions; Parcel ld: O17~O92~4� off this permit` Lot Legal Subdivi0on: MELINDA VIEW ESTATES Lot: 3A Block: ~ distances from any Seciion: 35 Township: 1201 Range: 3W disposal systrm or public Lot Size 49000 (sq"ft. or acres> nearby lot, Max bond rrums; : This Permit: 3 Total Capacity: 3 a maximum of 3 k3edrooms. l WELL: Log must be submitted to Municipality of Anchorage Department o{ HWow ith and Human Services within 04) days of well completion" lNSTALL PER SURVEYED LOCATION" NOlIFY DHHS PRIOR TO ANY CHANGE permit. VERIFY LOCATIDN HAS ADDEQUATE SEPARATION TO SEPTIC OF LOCATION. RESERVE AREA, THIS PERMIT IS ISSUED FOR THE PLANNED 3 BDRM" SlNGLE FAMILY DWELLING ONLY AND EXPIRES ON 12/31/90, [ CERTIFY 1Hl 1. l am familiar, with the requirements for on. -site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State C3 Alaska" 2. I will install the system in accordance with all MOA codes and re�ulaLions; and in compliance with the design criteria off this permit` 3. I will adhere to all MOA and State oi Alaska requirements for the set back distances from any existing well, wastewater disposal systrm or public sewerage system on this Co- any adjacent or nearby lot, 4. l understand that this permit is valid for a maximum of 3 k3edrooms. l that the capacity o§ the total system is 3 bedrooms and also understand anY enlargement will require an additional permit. Signed:DATE: �� �~^~_'����-~_ ~-~~.�6.^~~~~_~ V T5M; Tam a of MoN x zour- 18`•caP culwILr EL. Soo 00 In ASUmLjV 45.0 :.:: • $ 2, Pzc�PoscSo , I- I Wu'� - a • s. �? o.pp p �l/`�\`o r 3Z•�$ _sfb''sboa. 0`CPlca� — lo TELc4cINA LLCG, _ I r �• RQ 0 N . L�ASCMISN-r •. q , ��ruS N 490 Z GE(xEND B.e 4 I.o 85 � - -. u., 'L• }} Y. NcciNtbG15 _ i.o S.° is u k i'SZ 7 SOZ.(o am5nwg azo5b3 -Q FF.UL. Sa{.o i; So3.2 PRoPobl�gLLty 4 40 5.1 ¢A Cp T I 4-0 rpt 2_ LoT__4_A__ � I N ul Y aas Lor SA, 4910005.r. 0 N C7�ST P1; Q ip N 1 I 19 _tq�.C3L�cyT�LLcob1. U'nury �A�eµtsN-� I_ —_ 7A' ?ICT1iT•oF. WAY �A$liGu4YNT _ Z�ola Noo 7 49 SZ b UNSU$pi y/ pED PLOT PLAN X AS "BUILT SCALE 111- d 01 GRID 309, 7nl] 'Kr ou 2 0 SOILS LOG • MUNICIPALITY OF ANCHORAGE �•}�--1 DEPARTMENT OF HEALTH AND ENVIRONMEN"6'lOL4jWB>ff0fO#NCHOI�C,E PERCOLATION ! •.UO�.� N OF HEALTH & TEST "\\C `��S�:�J///J' 825 L. Street, Anchorage, Alaska 99501 2r��NMENTAL PROTECTION SOILS LOG — PERCOLATION TEST � APR 1 1 1Qk,. PERFORMED FOR: I ` ye ✓ `` E � LEGAL DESCRIPTION: ' W1EL11JDA �T 1^� �yA�D SLOPE SITE PLAN I T COMM oPwl-1t4 IGS LT I SL• Ch �Y Cs -Wa Y S\ L77 a84- Se�r��m SLIcrlrnY 501-" 15o 0 /Bmm Cj-rft\)et- 9ocx.S CssRA*3- WAS GROUND WATEF ENCOUNTERED? S ll..l (M`\ IF YES, AT WHAT J DEPTH? • THOtA A. H' -Hi b rrY CE -6793 if, �rtAis Reading A1,5 Date Gross Time Net Time Depth to Water Net Drop 3�Z1 I z ' 3o Yr. 3 z: oz> 15v,IN PERCOLATION RATE 4040,f (minutes/inch) TEST RUN BETWEEN 4 FT AND r FT PERFORMED BY:��sc-we SL CERTIFIED MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services it On -Site Services Section 019 P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 017 - b q.Z- 4b HAA # JA P(99-0557 1. GENERAL INFORMATION Complete legal description t b i 3 Ac \,/ t = uli Location (site address or directions) _ t t- 5 5D l oANNe 1 Property owner Sc -0 W ells Day phone 627 J Mailing address I I c p L L N D 1=. tom x121 V L::. Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: _ 5 3. TYPE OF WATER SUPPLY: Day phone Day phone Individual well (� Community well Public water NOTE: If community well system, provide written confirmation from State AbEC attest ing to the legality and status of system. 4. 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.1/81) Front MOAA21 6. STATEMENT OF INSPECTION BY ENGINEER 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 application 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 furtherverify 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 !n 66 S p Y V'-�''�O�-y Phone Address Engineer's signature Date r f •}, A DHHS SIGNATURE _ Approved for �� bedrooms. Disapproved. Conditional approval for -e %nuFES'C bedrooms, with the following stipulations: AL -0 CY/Ilei- i / X/e`V s.nciS��c Additional/Comments Date 'BT CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. 72-=(Rev.1/81) Back MOAM Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: i +tea. V i ZLo- L4 3 Parcel I.D. 0 1-7 — U 9 Z " qjL A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed '-p"-qy Driller &PI N l= Total deptha9-0 % Cased to 3 Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION m z Date of test %'la • g 4 v l 9 N O Z Static water level d U - f Z D Well flow Z7 g.p.m.W g.p > { m 0 Pump levell A& -o < �n < c r.n"' s SEPARATION DISTANCES FROM WELL TO: t C F�c M. Septic/holding tank on lot 1(0_0 ; On adjacent lotsz Absorption field on lot I. g y ; On adjacent lots Public sewer main o t4 e- Public sewer manhole/cleanout N/% Sewer service line 7 / v -c Petroleum tank © K e - WATER SAMPLE RESULTS: Coliform Nitrate < Oo 1 Other bacteria Date of sample: f �I13 I RSI Collected by: 1:7� B. SEPTIC/HOLDING TANKDATADATA Date installed 0! /V / 4 y Tank size j Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) � Depression (Y/N) High water alarm (Y/N) � ��/�4 A Alarm tested (Y/N) P 7 Date of pumping + � Pumper rVA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I &V On adjacent lots /9-0 Foundation Iv To property line 60 AAbs/orption fielder Water main/service line /no Surface water/drainage !V n He - 72 -026(3/93) -Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed _ Size in gallons_ Vent (Y/N) NbNf' High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Manufacturer Manhole/Access (YIN) "Pump off" Level at Cycles tested Surface water Date installed 6/t o ��` Soil rating (GPD/Ftz) System type t Length l v Width P- Gravel thickness _Total depth ( D Total absorption area 1250 Cleanout present (Y/N) _Depression over field (Y/N) ► 7 Date of adequacy test Y/�- Results (pass/fail) for`---> Bedrooms Water level in absorption field before test N After test jili4 Peroxide treatment (past 92 months) (Y/N) N -0 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ! q C2 On adjacent lots 11?0 Property line Z r�1J� To building foundation 30 To existing or abandoned system on lot G � /i4 On adjacent lots 3 0 Cutbank t44 14 L' Water main/service line Surface water E d K - Driveway, parking/Vehicle storage area Curtain drain I�y 11 -e_ E. ENGINEER'S CERTIFICATION l certify that I have checked, verified, or conformed to all MOA and HAA guidelines in Signature I �/ Engineer's Name l or6n4-+�t l0- I& �- Date t 01'. ) q L11/ HAA Fee $ 3 0 / Waiver Fee $ Date of Payment d -- y Date of Payment 7 C Receipt Number / Receipt Number - 72 -026 (3/93)' Back I LV -C> a o�rthe date��of.this{Z?. s� �' C,E-Z7.i5