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Home My WebLink AboutHIGHLAND HILLS #2 BLK 2 LT 1 Municipality of Anchorage Page I of 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: -~u')c~~ O'~c''~ PID Number: C..) ~7o,- .~ ~'Z_ - ~ ~: ~o~ ~ ~ ~O~T~ Wastewater System: D New ~Upgrade Address: ~.o. ~,,~ '~7'~q~ Ea~.~ ~=-% A~ ~ ABSORPTION FIELD Phone: /~ ~ ~ ~ ~ NO. of Bedrooms:~ ~ ~Z'-~H~ ~ ~ Deep Trench ~ Shallow Trench D Bed D Mound er LEGAL DESCRIPTION SoilRating: ~GPD/Sq. Ft. TotalDept~nalgrade: Subdiv~ion: Depth Io pipe bottom from orig~de: ~pth beneath pipe Lot: ~ Block: Z ~1~ I~I~E ~Z ~t.~ Ft. ~ownship: Range: .~ Sectien: ~ Fill added 8bore original grade: ~ ~vel length: '~ ~ Ft.~ Ft. WELL: ~,~.,,~New D Upgrade~ Gravelwidth: ~ Number~: 1Oistancebelweenlines: Ft. ~ Fi. -- ~ ~I~C ~ Ft. Ft. _ SQ. Ft. ~riller: ~/ Date Drilled: Stati~Water Level: Installer:~ ~ Ft. ~; ~O/,~i~ Date installed: --~ie~/~ GPM PumpSeta,: Ft.CasingHeigMAboveGrou~: TANK SEPARATION DISTANCES u Septic ~Holding D S.T.EP. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines A~¢~~ ~ ~ C~OO 8~ Number of Compa~ments: Well- . ..... ~¢ I ,Z ~,(~ Material: ~¢~6L Sudace Water .... IO~t~ ~ LIFT STATION Lot Size ,.~~rer: Line .... 6~ tL~ Foundation__ -- .... ~.~,. "Pump on" level at:~~~igh water alarm at: Drain ~ ~ ~¢ I'~ Pu ions pedormed by~ Remarks: BENCH MARK Location and Description: Assumed Elevation: Inspections performed by: ~As'r~'¢A~6~ ~cu~,~ Dates: 1st g/Z~_ '%~'~'~ ' ~ '~ ~ ~"''~'g r';'/ tnt. 2nd .? :, IJ~ 'rey~O.rnm, : ,~ Department of Health and Human Se~ices approval .a;,a, ~¢ %..,:. ........ .,~ Reviewed and approved by: ¢~ffi ~, ~' Date: ~-/~ ~& /Z/ ~ , 72-013 (Rev. 9/91) MOA 25 <.,,,rsw.8o3o3N,,.,[,,:.: AS - BUILT DRAWING ,, ~ y., ,,, x,, ~~ I xx ANEW 40o0 (AltOn'/ "~ ,, d~/ ', / ~ ,o~ T~a~-~, '-... ~( .~ ~ '?, X?., ',X / '%'7 ' X ~ , AND I~J ALONG, DITCIII3NE. FRENell DRAIN AND ~.. % ~ ' DII'CHL/NE FIILEI) ,'tlTH DRAINR(]CK; AND COVER WlfH 7~-~ ~X ~ FILLER FABRIC AND THAN BACKFILl ED.-rl41S WAS NOT ~ ~ .) . % ~ ' INSPECTED B'e OUR RaM, /,~ t, iNFOR~¢A'nON WAS / ~ -- X ~ ; PROVIDED BY THE EXO~VAI'OR (DF2¢I CONSIRUCIlON~ ~ (.~ ~ ' (NORTH TO NORTtlFAST SIDE OF HOUSE) ~ ~.~ ~ 2. INVERT AT TANK = ~2.81 ~'l'lJ/lO ~S~A WA~RTa2O A~ W~S~W~ CONa~TA~S, INC. E. CHEWER HEIGHTS CIRCLE, ~CHO~OE, AK 99504 PFPE OF WORK: AS-BUILT OF SEPTIC SYSTEM UPGRADE ,'REPARE(, FOR: PHONE NUMBER: JOHN AND LILLI SCHULTZ272-6442/696-6841 J,L.M. 1 = 40' 2 OF 2 )D1~£$$ ...................................................................................... ~-LL SITI: ...............................................................' .............. \T£--~TARTED ...... ~ ~/.,~., ~./7 ~'.~. ........................................ ..?_ ~.. .~,, .... / o / O.:~ /..~...~-... ...................................... :~D Or rORM. A. TION~ DRILLI:R'R NA ,,'~ ................ RECEIVED MUNICIPALITY OF ANCHORAGE Deparfment of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (9O7) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 13, 1998 Expiration Date: Aug 13, 1999 Permit Number: SW980303 Legal Description: HIGHLAND HILLS#2 BLK 2 LT 1 Design Engineer: 41 ,'~,~.~ t.~oS~-~ct~ Owner Name: John & Lilli Schultz Owner Address: PO Box 773456 Eagle River, AK 99577-3456 ParcellD: 050..382-32 Site Address: Lot Size: 61866 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: I~ Disposal Field [] Septic Tank [] Holding'rank ~]] Privy [] Private Well ~j 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (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. (:)pen and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. This permit is for a holding tank. Received By: Issued By: ~j"~~ ~ ¢,(?~f~ Date: Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle - Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers August 3, 1998 Municipality of Anchorage Department of Health and Human Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Sewer Upgrade for Lot 1, Block 2, Highland Hills S/D. HOLDING TANK To whom it may concern: The existing 3 bedroom house is served by a private well and a septic system that consists of a 1000 gallon septic tank, a lift station, and three trench type drainfields. The existing lift station is currently is not functioning and the drainfields are in groundwater. The system must be upgraded prior to the sale of the house. Because of the topography, and the location of the drainfield, installation of a curtain drain does not appear to be a viable option (see attached letter dated 7/13/98). Four test holes were excavated on the property and groundwater was found at 5', 6.8', 2.4, & 4.4' (see attached soil logs). It is probable that during the spring the groundwater levels will be much higher. The property has numerous springs daylighting on it, even during the sunm~er months (see the design drawing). Based upon our assessment of the site, it is unlikely that, in the spring, there will be suitable accepting soils (2 feet unsaturated), as required to install an onsite septic system. Without spring groundwater monitoring, an innovative septic system (ISF or RUF) would be a risky installation at best. Installation of a curtain drain above the test holes may be feasible, however, there is no guarantee that it will work. The majority of the drain would have to be in the section line easement in order to leave enough room (given the 20 foot setback requirement) for the drainfield. If the well was relocated further to the north it may be possible to put in an extensive curtain drain and an innovative septic system, however, the problem of dealing with the curtain drain discharge (onto the neighbors property) would have to be addressed. Given the aforementioned site conditions, the costs associated with the upgrade, and the uncertainty of whether it will work, makes the installation of a holding tank a preferred alternative. It is our recommendation that your department allow us to install a 4000 gallon holding tank. The tank will be located adjacent to the driveway and 75 feet away from the well. A copy of the proposed design is/~tached. If you have any questions, please contact us at 337-6179. Presidenf ' ' ' '~ ~ % 5 ~r~M , , ,, '.~J ~ ~ >~ ~ ~ ~IICFtLAND Hills %ID ~/ ~¢Rf~b~,~ ' ~x-~ ~ I ~ WELl. A~D SEPHC ~- ,,-', , X xk~ . ,',,", /%¢'; / '. ~ '.. q / 'm~ ~..,,, ,.'., .' ~ ¢- J¢ ' ' ' 111 - / / ~ _ ~ ~ ~ , LO/ ~,, BLOCK i t~OUNTAJN VALLEY S/D I O'l 1 FiIO('K '5 ~' .... 7,,,-~.,t, %;, ,%,,',./¢. : ~ , ' LOI' 2, ~t.O(.I< '~ ~ SERVED I~'( PIRIVAT[' WIUUIN I/~IR VJ~L_I.I%? ¢~/t) ~ ' ' ~1 IM'I-AI~I ~/AI I L-V C' /r~ ~ WLI. L. AND %E~rlC S~RVE~ B( ~RVAFE ' , iv~ ~/upt v/u l/ ~/ ~ ' ~ O WA3 R AND WAS'rEWA R 7520 E. OHESfEB HEIgH~ OI~C~, ~OHO~SE, AK 9~504 HIGH.ND HILLS SUBDIVISION, LOT 1, BLOCK 2 r ~vf PI~FPARED FOR: PHONE; NUMBER: JOHN AND LILU SHULTZ ~h~o;'"" 272-6442/696-6841 /0~ ''/ I CE~7955 .,' ,~ I I I ......... J.L,M. 1 = 100' 1 OF 2 ~ ~!. .4~ ,4~ ,-~ ~,,¢ - EXISTIN6; TREN CItE-'-; ~ ' ::~ ~ '~: ~.~/ i'D BE ABANDONED COMPLLIEIY ~ ~ ~ ~ ~ ~// (ENCROACHING GROUNDWA'f ER) ~ '=. ~ :: g: ~ AND LIFF NTAFInN TO , ~ ~ ... X.k ~. [ ~R~)/_ ~/~INLS~II:~CtNG-' L. S AREA ~OPOSE} 4()O0~A OF ~ "~2- '% ~ , ~ IS TO BE [-ILLEED Will{ D~INROCK ] I'~1 )N'O I'AN~- ': ~x % ~ ~ .......... ~ ~. , ~ COVERED WITH FILTER FARRIC ~ [ %"~- 'x xx ~ '~'- ~ AND BACKFIIIED NO SUREACF 'l~ ~ ', X~-¢~. / ~.X~A / '% . ' ~OF- ~liE PROPOSED I101 DINE; TANK .~-" . I ~n ' X II WlIH I~LOWIN6 ~ ~ ....... , ~ ~ ~ V-EXSIFNG OUTFAL PiPE AND ERENC I D~A~N. / ', N . _ ~. N ~ A 4" INCH PIPE WIIICil IS NOr CONNECTED ~ /~ k ~ TO IHE QIJI'FALI: PIPE, I% LYING IN A OPEN / ~ f-.-y % ~ DITCH AND E~ENI)S TO Ar'PRQXIMA1ELY TIlE / ~ /_ ' X ~ ' EDGE OF IHE SITED. A SOLID PIPE IS TO BE / ~ /~-~ ~ N ~ . CONNECTED m 'rile OtlF~AIL. PIPE AND [_~FENDEI1 /- N ~-"~ ', N ~ ~ lO A POINT IlIAT IS GRATER IItAN A 100' EROM / N ~- L ~ ~ ~ 1Hr PROPOS[-:D ttOLDING rANI(, 1HE DI'fCHLINE N %N~N l'ltAT I~ WITlilN A 1DO' OF rile PROPOSED II()LDING ~ '.~ 'lANK ES FO FIE FII.LED WRH DRAINROGK, COVERED / , WA R AND WAS WATER LESAI. DESCRIP~ON: ~" ~ ~11~ '.-~ ...... ~-~' DESIGN OF SEPTIC SYSTEM UPORABE ,~...-'t'f~ ~) ,~'~.r~''~-'~~. u n~s] ~ PREPARED FOR: PHONE NUM[]ER: JOHN AND LILLI SHULTZ 272-6442/696-6481 ~. C~5~953 ...". F "¥: I'=: J.L.M. 1 = 40' 2 OF 2 ofes,~°~~ July 13, 1998 7320 East Chester Heights Circle ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers John Shultz P.O. Box 773456 Eagle River, Alaska 99577 Subject: Septic System at Lot 1, Bk 2, Highland Hills. Dear Mr. Shultz: Attached is the soils logs and site plan associated with the septic system upgrade for your property. Also attached is a bill for our services. Your prompt payment would be greatly appreciated. Prior to performing any upgrade it is recommended that groundwater conditions be monitored tttrough the spring. There shouldn't be any depressions around the test hole pipes which would collect surface runoff.. If it is determined that groundwater levels are not excessively high, and the drainage ditch which runs along the west/south sides of the house can be redirected (100 feet away fi.om the proposed septic system area), it should be possible to utilize the area in the vicinity of the test holes for the installation of an innovative septic system. It is inoperative that the redirected surface waters do not impact any of the properties onto which it is discharged. Another option to consider would be installing a curtain drain 20 feet to the west of the existing drainfield (20 foot separation required by code). In order to lower the groundwater to at least 4 feet below the drainfield, the curtain drain will have to be extremely deep. The water from the drain would have to be discharged to the east of the lot, and cannot adversely effect any neighboring lots. Further compounding the problem is the fact that there is not enough room to the north of the trenches to install a curtain drain, consequently, groundwater will still migrate from the lot to the north. If you have any qt working with yot~y ~stions, please contact me at 337-6179, or 244-9612. future. I look forward to C'C. Fortune Properties, Hal Jackson WATER WASTEWATER PHONE (90'7) 337-6179 * FAX (907) 338-3246 ~SOIL LOG - PERCOLATION TEST · HIGH.ND HILLS, LOT 1, BLOCK 2 JOHN AND LILLI SHULTZ TEST HOLE ORG LEGAL DESCRIPTION: PERFORMED FOR: DATE PERFORMED: SOIL CLASSIFICATIONS ML sc COHMENTS: B.O.H. DEPTH TO DATE GROUNDWATER 5' 6/17/98 5'1" 6/18/98 5'1 0" 6~2~/g8 DATE READING CLOCK TIME 6/17/98. PERC. H£LE ABSORBE PERCOLATION RATE <1 TEST RUN BETWEEN 2.0 PERFOMED BY ALASKA WATER &: WASTEWATER I, THIS WAS PERFORMED~ IN ACCORDANCE WITH ALL DATE. DATE: '~ t,l{ [~,~t NET TIME WATER LEVEL NET DROP (MINUTES) READING (INCHES) D WATER AS F,~ ~T AS IT WAS AD )ED MUNICIPAE ~UIDELINES IN EFFECT ON THIS ([VIIN,/INCH) PERC, HOLE DIA. 6 (INCHES) FT. AND 2.5 FT. ALASKA WATER WASTEWATER ~ 7--~0 -~'. ~T~C~--~'-AN-~~gB-~'~'~ -- - PHONE (907) 337-6179 * FAX (90'7) 338-3246 · HIGHLAND HILLS, LOT 1, BLOCK 2 JOHN AND LILLI SHULTZ 0/17/98 --- TEST HOLE #2 ORG SM/GM ML B.O.H. LEGAL DESCRIPTION: PERFORMED FOR: DATE PERFORMED: SOIL CLASSIFICATIONS GW GP GM GC SW SP SM SC ORG NIL CL OL MH CH OH DEPTH TO DATE GROUNDWATER 8' 6/17/98 6'10" 6/18/98 T2" 6/23/98 DATE 6/17/98 READING CLOCK TIME BEGAN PIIESOAK @ 2 i:4i .3 i:4-1 4- 2:11 NET TIME WATER LEVEL NET DROP (HINUTES) READING (INCHES) O0 AM 30 3 i~4;' 3 - 6 ~/4." ' ,~o ~ 'l/4" ~ 1/2" PERCOLATION RATE 8.6 (HIN,/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 2.0 FT. AND 2.5 FT. PERFOMED BY ALASKA WATER & WASTEWATER I, , CERTIFY THAT THIS WAS PERFORMED/iN ACCORDANCE WITH ALL[S/FATE AND MUNIClP~AL GUID'~LiN'ES IN EFFECT ON THIS DATE. DATE: ?/~'/~¢ ALASKA WATER & WASTEWATER I SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: HIGHLAND HILLS, LOT 1, BLOCK 2 ~..~.: DATE PERFORMED: 6/17/99 ~'~ '.. NO. 9608 ." v~'.., cz. ...'~/~ /' ~ GC OL ~ SW HH ~ / ~ . 5-- ~ SP CH SUR 7--,, DEPTH TO DATE 11 -- DATE READING CLOCK NET TINE WATER LEVEL NET DROP ] TINE (HINUTES) READING (INCHES) 12-- 6/17/98 NO PERC,)~TION TES' PERFORMED I I 15~ , 16-- 17-- 18~ , 19-- PERCOLATION RATE N/A (HIN./INCH) PERC. HOLE DIA. N/A (INCHES) 20 TEST RUN BETWEEN FT. AND FT. COHHENTS: PERFOMED BY A~SKA WATER ~ WASTEWATER I, ~ L ~(~ , CERTI~ THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL S~A~E AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. ~ATE: DEPTH TO DATE GROUNDWATER 3'6" 6/17/9§ 2'5" 6/18/98 ALASKA WATER WASTEWATER - 7-"~0-~'. C"~'~'TE'-~'~-~-T~CL"~'--~-^~9~¥- --- PHONE (907) 337-6179 * FAX (907) 33B-3246 HIGH.ND HILLS, LOT 1, BLOCK 2 JOHN AND LILLI SHULTZ LEGAL DESCRIPTION: PERFORMED FOR: DATE PERFORMED: SM/ML ML SOIL CLASSIFICATIONS GW ':':':':; ORG GM ~ CL GC OL SW MH SP CH SM OH SC B.O.H. DEPTH TO DATE GROUNDWATER 5' 6/17/98 4'5" 6/18/98 5;i" 6/23/98 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 6/17/98 BEGAN PRESOAK I 2 1:29 9:00 PM 16 i/2 6~ 24 0" . 6" PERCOLATION RATE 4 (MIN./INCH) PERC. HOLE DIA, 6 (INCHES) TEST RUN BETWEEN 2.0 FT. AND 2.5 FT. COMMENTS: THIS WAS PERFORME~D I~1 ACCORDANCE WITH ALL ~,/~'AI'E AND MUNIC~AL GUIDELINES IN EFFECT ON THIS DATE. DATE: "l~,~,~Z~ J)l ENV RONMENI'AL ENG NEER NG DIVtSION ~~~ 825 L Street - Anchorage, Alaska 99501 Telephone264-4720 Z~. ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS ~ . , ~ ) ~f I[] NEW GRADE Dwelling / Material No. of compartments Inside length [Width __ Liquid depth Dwelling PERMIT NO. Liquid capacity in gallons [ Material Foundation ? /(~) tt INearest lot line /6 f Total length~o_~lines~ / Trench Material beneath tile Depth DISTANCE TO: 1 I ~ i% g~'sI~F HOMEMADE: L DISTANCE TO: /welt Manufacturer L ~ L~ ~ ' __~ . ~f all: f~i~ 9rade ~ inches PERMIT NO. PERMIT NOK~ ..,~ ~ ¢~.~ Distance be~.~e~ lines Total effe, ct.iv._e~a~)sorption area Crib depth 'rotal effective absorption area Building foundation Nearest lot line Driller Distance to lot tine I'PERMIT NO, Sewer line Septic tank -l~bs~rpti~n~n 8rea(s} L OTHER PIPE MATERIALS ( S01L TES:F R~ APPROVED LEGAL DATE · HF F' 1. ] ..I II',l F JOHN LEFIR'¢ DHEF' I....OCFIT I ON ER "1"" L..E~HL LT.: 2L UNiT 2 HI.~HLBND HILL=S, LOT ~):.ZE 4E~E~E~E~ SC!UFIRE FEET ,:F '""':,::,IL ..... '" . _ _ I1H,.,IHUH HUIIE, EF.. 0F DErDF.':CHS 'T'HE RE:L,]IJIRED =,I,~E OF: THE SOIL HE,=,.I~F] IUN =,~.~.TEfl I=,: ]"FIE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF TNE TF.:ENCH OR .[.',RRINFIEL[). ]"HE DEPTH OF R TRENC:FI OR PIT IS THE DISTRNCE BETt.,.IEEN THE SURFFICE OF THE GROUND RN[:, THE BOTTOM OF THE EXCFIVRTION (IN FEET.'.',. THERE IS NO SET HI[:,TH FOR TRENCHES. THE GRFIVEL. DEF'TH IS THE MINIMUM DEF'TH OF GR~MEL BETHEEN THE OUTFRLL PIPE RN[:, THE BOTTOM OF THE EXCRVRTION (IN FEET:). F'ERHIT RPI='LICRNT HR:E; THE RESPONSIE:ILIT'¢ TO INFORM THI2; DEPRRTMENT DURING THE INS]'RLLRTION INSPECTIONS OF RN'¢ NELL.E; RDJ~CENT TO THIS PROPERT'¢ RND THE NUHBER OF RESIDENCES THRT THE PJELL NIL. L 5;ERk,'E. ........... 1- l,q C, ,:' 2: ':, ! i'-.~ *- F' E C: T Z 0 I'-.l '-- F4 F.: E ix: E ~:-~ #J I F.. E E., E FI'KF'ILL1HL~!: 'L: =.- ' "OF RN'¢ c,=,Tz, iE. rl,,- ".:' HITHOUI" FINRL INz. FE'- ' '".TION RND ' ~'"'¢' FIFf-I.J,F]L B'¢ THI% E:,EPFIRTMENT [,JILL DE SUBJEC:T TO FRUz, EL. UT[ON. HINIMIJM [:,ISTRNCE BETklEEN Ft WELL RND RNY ON-SITE SEI4FIGE DISPOSRL E;'¢':?,TEH IS ZE'~ FEET FOR R PRIVRTE HELl.. OR :LSE~ TO 288 FEET FROM R PUBLIC HELL DEPENDING UPON THE T'¢F'E OF PUBLIC t.,.IELI .... HINIMUH DISTRNCE FROM R PRIVFITE klELL TO Ft PRIVRTE SEHER LINE ]::5 25 FEET RN[) TO R COI"IMUI'4IT'¢ SEHER LINE IS 75 FEET. OTHE'"R REQUIREMENTS; FIR~¢ FiPPL'T'. SF'ECIFICFITIONE; RND CONSTR/JCTION DIFiGRRI',IS RRE Fi',,,'FiZLFiB[.E TEl ZNZ;URE F'ROPEF..' [N~TRLLFiTZON. F E.E,,;.I 1 Z -'t- t=.,---,F ]: t~:E~Z E:~EE]:EI"IE,'E:Ft. _.:.>::L ...... k== I CERTIF'T' ]"HFiT fi.: I Fff'l FFIMILIFIR NITH THE REQUIREMENTS FOR ON-SITE SEI.,IERS RND I.,.IELLEX FIS LqET FORTFI B'¢ THE MUNZE:ZF'RLZT'¢ OF RNCHORRGE. 2: [ 1.4ZLL [NSTRI_L TNE S'¢STEH [N RCCORDRNCE 1.4[TH THE CODES. ~:: Z UNDEF%TRI'.4D THRT THE ON-S[TE SEklER S't'STEf'I HR'¢ REQUIRE ENLRRGEMENT ZF THE L.L. IDENE:E I_, REMODELED TO INCLUDE MORE THRN ~' BEDROOMS. ,~. S;I GNEB, : .................................................................. ¢¢¢~': ~,~.~: ;~. ~ RPPL Ir':FINT .fI3FIN I EFIR'¢ ,.' ................... ..... ~ ............................... V4. E~ COPV HUST i~l; OBTAINED FROH THE FIt. ES ~ DSTR NOT RVRILABLE IN THE COMPUTER Russell Oyster 694-2774 0 &E ENL,~NEERING & DEVELO~-MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOlE LOG 688-.2280 _/. Performed for: Name: ~'- ~'~ '-' ~'J'~ Tel. No. / Mailing Address:_ Legal Description: L ~ ~ '~% ~ ~/~~ ~/t~ Depth (feet) Soil Characterlsllcs 3____ ¢~_ ~,~ ~ ~.~ I 50' .L~_~'~° ~,. 6 ~ ~" ~'~J, [ '12 13__ 14 15___ 16_ .... ,,.. PLOT PLAN PERCi-T~EST Ground Water Encountered: Yes Proposed Installation: Seepage Pit Comments: /"~N0__ If yes, what depth__ Drain Field__ Performed by: "~~.~ O&E ENG,NEERING & DEVELOk~VIENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 SOIL LOG Performed for: Name'. ~,~/ MailingAddress:.~,/~, /~o~: ~'~z,z~., ~/~',4~ Legal Description: Z~'F- {~' (~'//t//7- ~.'~. /'-/'~/'/~.,/¢/,/Z~ Earl Ellis 688-2280 Tel. No. ~- Depth (feet) 0 Soil Characteristics 9__ 10__ 11 12__ 13__ 14____ 15____ PLOT PLAN PERC. TEST Ground Wate Proposed Installation: Seepage Pit Comments: __ No If yes, what depth Drain Field.___ /// Performed by: Date: ~,:~GRE/)-. -..~.,~R ANCHORAGE AREA BOR I~J "J, ~/~ ~, ,b ./~r Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 GH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM AME _ _ MA,LIN? ADD~S 26z/~L~'~J, LOCATION¢~'~~~v/__ ¢ ~AL DESCRIPTION COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACIT~ALLON5. TILE DRAIN FIELD: / ,.~ / TOTAL LENGTH DISTANCE FROM WELL ]6'~'~ FOUNDATION ~L'~'Z4-- _NEAREST LOT LINE '~ "~ _OF LINES / NUMBER OF LINES J DISTANCE BETWEEN LINES TRENCH WIDTH '~ __ IN. TOTAL EFFECTIVE ABSORPTION AREA .... /"~¢"' SQ. FT. LENGTH OF EACH LINEDEPTH OF FILTER c:~--',~ DEPTH: TOP OF TILE TO F:INISN GRADE MATERIAL_ BENEATH TILE __IN. ABOVE TILE IN. WELL: TYPE.__ fl/O,~ ' -CONSTRUCTION .DEPTH BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION____ LOT LINE . , SEWER LINE__ TANK --, SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: DIAGRAM OF: SYSTEM S ER LINE DEPTH: .... ' ~ ' _1 ~ ~ OU , GRE/-,.ER ANCHORAGE AREA BO)-. _'.UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 'C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4~61 PERMIT NO, SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT 'EGAL OESO.'PT,ON LO '1'-- INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED -- FINANCED THROUGH COmFLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE: DEPARTMENT OF ENVIRONMFNTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ' ?~.- P MINIMUM DISTANCES, REQUIREMENT~ ~.: FOUNDATION TO SEEPAGE PIT ., DRAIN FIELO SEEPAGE AREA SIZE ~--__~__ 'tYPE:-- _ ¢¢' DIAGRAM Of SYSTEM SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ,SEEPAGE PIT TO NEAREST LOT LINE. / , DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD _ , SEEPAGE PIT SEPTIC TANK, . SEEPAGE PIT TO RIVER, LAKE. STREAM. ., DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIBCROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTUrbED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC 'rANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. LICENSED DESIGNER I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORA/~E ARE~ DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ABOVE FORM NO, EQ-016 GREATF,R ANCIIOtd\G~ ?,l?,i A BOROUGi; iJepartment of [nv~ror.nc, I~La| (tua]iLy 3330 "C" Street Anchorage, Alaska 99503 S()II~S l,O(l PERO1,ATI()N 'l'l'2gT IhlS form reports: Soils log ....... ~ .............. Percolation ~es 8- ll - 12: - ' 13- 'Proposed installat]~}-(}--"~ge Pit Urain Field Depth of Inlet I)epth~"}¢~'-U:¢-pit or trenci, P~,rforied By' ~ Certified By' LO(.3 ~Ji' ORILLII'q~ by A ~ L OKILLIN~ LJOMPANY .:,)DRESS ................................................................................... ',fELL SITE ........................................................................................ DEPTH OF WELL ....... /.~./. .......................................... STATIC LEVEL OF WATER FT ...... /.~. ........................ DRAW DOWN FT. ~0 / :!ND OF FORMATION: TO ........................ FT ............................... TO ........................ FT ............................... TO ........................ FT ............................. FROM ........................ FT. FROM ........................ FT. TO ........................ FT ............................... TO ........................ FT. ............................. TO ........................ FT ............................... TO ........................ FT ............................... 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 050-382£32 1. GENERAL INFORMATION Complete'legal description Lot 1; Block 2; Highland Hills #2 Location (site address or directions) Mile 5.1 Hiland Road Eagle River, AK Property owner Mailing address Lending agency Mailin. g address John & Lilli Schultz Day phone 272-6442 P.O. Box 773456 Eagle River~ AK 99577 Day phone Agent Address Barbara Crittenden/ Jack White E.R. Day phone 694-5500 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well xx 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. XX 72*025 (Re¥. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my s~'al 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 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 ,/ll~as]r,.a Wat;er & ~wa~ Phone Cons~, ~c. Address 7320 ~_S~ ~h~f~r Hts. Circle Engineers signature ~chorage, Alaska 99504 Date Alaska Water & Wastewater Consultants, is to be paid $1420.00 at closing for services performed. DHHS SIGNATURE ~' Approved for -{"/L'//~'E'bedrooms. Disapproved. Conditional approval for Inc bedrooms, with th-e following stipulations: Additional Comments Date 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 courtesyto 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. 72-025(Rev. 1/91) BaCk MOA#21 Legal Description: A. WELL DATA Well type Log present ~N) Total depth Sanitary seal Date of test Static Water level Well production Municipality of Anchoraae ,,~,~-,,~,,~ DEPARTMENT OF HEALTH & HUM~&~N SERVIC~¢[~, ~:~ E D Environmental Services Division ,~...-,~.¥ .~,M,IC4.,,,~,Pc.~I(~f~ i'/¢JNICII~ALI f'¢ OF ,Ac, NCIfORAOE 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 3qSY47-4'4. Municipality of Anchorage Health Authority Approval Checklist Dept. Health & Human Se~ices I,~ I~,[..~,¢V-. ~-~ ~-~,~4~¢~ ~,41~.~'~'Z Parceli. D.: IfA, B, or C, attach ADEC letter. ADEC water system number YES Date completed Cased to I~ ~/'~ (/¢¢¢~¢c(F'~Casing height (above ground) Wires properly protected (~,N) FROM WELL LOG AT INSPECTION I O~ ,.¢.~' F'¢.~ WATER SAMPLE RESULTS: Colifoi'm .~4E~-' Nitrate Date of sample: '"f '18 Date,nsta,,ed Foundation cleanout~N) Date of Pumping /,.~J-~ Pumper C, ABSORPTION FIELD DATA ~ g.p.rn. /"/', O +' g.p.m. O. ~/~' Other bacteria Collected by:__ ~o,.~ &¢~.~r~'. Tank size /.-/-~o4:) Number of Compartments ~ Cleanoutst~) '1/,[~5' Depression (Y,~ ~¢ High water alarm ('~) Date installed ' Soil rating (g.p.d./ft2 or fF/bdrm) System type ~ Length.... Width Gravel thickness below pipe o~-~ Total depth Effectige absorption are~se~/..~l~ Depression over field (Y/N) Date of adequacy test Res~jJ/e'('P-ass/Fa~--...._ For bedrooms Fludde · ---~_..,..--~ ~_ - · pth in absorp~est (in.); Immediately after ~(in.): Fluid depth ~.~- (ins) Minutes later: AbsorPtion rate = . ~ PerOxide' e t'~reatment (past 12 months)(Y/N) If Yes, give dat~ "" ~ 72-026 (Rev. 3/96)* D. LIFT STATION Date ~ Size in gallons Manhole/Access (Y/N~-'-'------~ "Pump on" level at* High water ala~~ SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 8~l~e~tank on lot '""/,~ Absorption field on lot I Public sewer main Sewer/septic service line '~-~ I ,.f. Lift station SEPARATION DISTANCES FROM~:jE.E..T-~/~ANK ON LOT TO: Foundation H' J~l ~-~ Property line On adjacent lots On adjacent lots IO°kf" Public sewer manhole/cleanout I")//~ :.¢ Water main/service line llot~ Surface water/drainage leo Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Prope~ line Building foundation ~ne Cu~ain drain Wells on adjacent lots ENGINEER'S CERTIFICATION ,.~ in conforman e with ; ~ ide~ ,es in effect on this date. ~ up Date Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number T~?~? F ~$/0~ F-8~6 Date/Time 08/28/98 08:08 Collected DatoZTime 08/24/98 17:30 ~v~l ~te/T~le 08/25/98 Teeh~eal Director; Stephen C. Rde r, 0.319 cot/loOmt. 0,100 .~/k Application Date GENERAL INFORMATION (a) Legal Descriptio%nclude lot, block, subdivision, section, township, range) Location (address or directions) MUNICIPALITY OF ANCHORAGE OJ~ 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 / (b) Applicant Name ../~/--~J~d,~.4C/'~/q-,',J~ Telephone: Home Business (c) Applicant is (check one): Lending Institution []; Owner/builder [~'~uyer F-I; Other [] (explain); (d) Lending Institution /_.c,~/~,,_~ /k,/~7~4./~2-o,~./ Telephone Address (e) Real Estate Companyand Agent Telephone ~;~'?' ' (f) Mail the HAA to the following address: S & S ENGINI"ERIflG · 17034 Eagle River Loop Road Ne. 204 ~r.~g ....... r, Alack TYPE OF RESIDENCE Single-Family [~/'~ulti-Family Number of Bedrooms Other 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. Onsite [~ 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) '>IJOM s. Jeeu!bue leUOiSSe~oJd eq~ u! SUO!SS!LUO JO SJOJJe JO,L elq!suodseJ ~OU s! ebeJoqouv ,to ,~uled!o!unv~ aq/'penss! s! e~eo!,t!peo e eJo,teq e~ep eZ/~leUe JO suo!~eedsu! ~enpuoo leu op dqHQ ~o see/,oldLUq 's~ueLueJ!nbeJ e~e~s pue leJepe,t umlu@o/~,ts!~es oh ~epJo u! suoi~n~Rsu! 8u!puel J!eq~ pue SeLUOq ,to sJeSeqeJnd ol Xse:pno3 e se s!q~ seep al=lNG eq/'e~selV jo e~e~S eq~ u! peJels!6eJ jeeu!bue leUO!SSejoJd luepuedepu! ue ~q e^oqe S qde~§emd u! ua^ih suo!~e~ueseJd@J aql uodn ,~lelOS peseq salee!,t!~Jeo le^oJddv ,~!Joq~nv qlleeH senss! (deHQ) uo!~oaloJd le~ueLuuoJ!^U3 pue qUeeH ,to ~UeLUiJedec] ebeJoqouv ,to ,q!led!oun~ eq/ NOI/rl'¥O leUO!l!puoo / ejec] euoqdelel uo loe,t,te u! suo!~elnS@J pue 'seoueu!pJo 'sepoo ele1S pue led!o!un~ lie LJ~!M eoue!ldLUo3 u! s! uJe~s,~s lesods!p Je~BMeiSeM ~o/pue ,qddns Je~eM a1!s-uo eq~ 'uo!~oedsu! pue UO!lee!lseAu! XuJ uJoJj pue Sel!,t e6eJoqouv ,to /~uledp!un!AI eq~ uJoJ,t peu!e~qo UOi~eLUJO,tU! elenbape pub leUO!loun,t 'e~es qlleeH s!q~ ,to uo!le6!jSeAU! ,~UJ l-eLI1 ~J!JeA I 'MOleq UMOqS ejep uo!lep!le^ eq~ jo se pue oleJeq paxl,t,te lees ,~LU Xq pa!,t!!JeO sV NOIJ.¥1AII:IO-INI CIN~' YJ. va 'FION'¢:I$ :1-11:1 '$J.S=J.L '9NOIJ. O:IclSNI 9NlalAOl:ld INbll-I 9NIIJe=INIeN=j WELL DATA Well Classification % Well Log Present6/N) Total Depth /~/'/' Cased to _ Static Water Level Casing Height Above Ground /,~ Electrical Wiring in Conduit~yN) Separation Distances from Well: To Septic/Holdin'g Tank on Lot _ /~ To Nearest Edge of Absorption Field on Lot / To Nearest Public Sewer Line __ Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments MU.NICIPALITY OF ANCHORAGE (MOA) ,,-¢~Cli1~'¢~ AUTHORITY APPFIOVAL (HAA) O~ rkt'~'-'% O\~I\~"~ECKLIST - FEBRUARY 1984 .~xC? ~ 5~*~'C~ 264-4744 ¢~u .. 0%9~I Legal Description: If A, B, C, D.E.C. Approved (Y/N) Date Completed /o- k~' ~- . Depth of Grouting Pump Set At Sanitary Seal on Casing ~N) Depression Around Wellhead (Y/~ ; On Adjoining Lots /ob/¢ ; On Adjoining Lots /~/~ To Nearest Public Sewer To Nearest Sewer Service Line on Lot ~.~ ¢.% ~":,,'~IC->,A/j.~.'"P~t,'~,'(~ _ ;Date _ %~/(5/¢/~ '~ /°9? B. SEPTIC/HOLDING TANK DATA ~ ' / '~ -u~-~-~_ Size ,"¢,¢'¢ No. of Compartments Foundation Cleanout (Y~) Date Last Pumped -~.,~ z¢~ .,:/ ; for Temporary Holding Tank Permit (Y/N) Date Installed Standpipes~/N) Air-tight Caps (~) Depression over Tank (Yt~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~"~-~ Separation Distances from Septic/Holding Tank: /~ To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026 fRev 8'86/ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed .~c <:~ ' ~ b' -,:~ Width of Field Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ('o~ / --/ To Building Foundation "-¢- ~-/ Lot /'//~ Type of System Design Length of Field _,r,¢/~,~,~ _ Depth of Field Gravel Bed Thickness Standpipes Present ~N) Date of Last Adequacy Test To Property Line /~/''/ To Existing or Abandoned System on ;On Adjoining Lots To Cutbank (if present) To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area . Comments -')k/F LJ/> ~.~,~- ~'~ D. LIFT STATION Date Installed 'Ye Size in Gallons // "Pump On" Level at High Water Alarm Level at Tested lor Electrical Codes (Y/N) Dimensions '~. 5' X ,3 ' Manhole/Access ~N) "Pump Off" Level at / /4~,2v-g 5o 7-ro.-,-¢. Vent ~.~)/N ) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Sign(Si& ~ ENGINEERING ~jDate~//~///5t¢/~ '~" ;' 17034 Eagle Rlvel' Loop Road No. 2v"~' Corn Ban~/ ....... ~'"7 MOA No. _ Rec pt.o. Date of Payment Amount: $ Page 2 of 2 72-026 fRev 8/86~ Back CHEMICAL & GEOLOGICAL LABORATOI~ES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE(907) 562-2343 FEDERAL TAX ID # 92-0040440 irt :, if ~.!r. t: (:OF.'( K';!; HFi I'~ F('J~' ¢'! (.:i( ijF', 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 _ //' Z GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~1~...~ .'_'~(-¢..,~r~.,~c.~ ~/.,~\~Telephone: Home Business Applicant Address '~,O,lq.~,z ~,O~%~J_J.-o /Od.d.,.,, 15¢~',... ~t~,FlO ¢YIA~F...-~C'i t.J, (c) Applicant is (check one): Lending Institution J~; Owner/builder []; Buyer []; Other [] (explain); (d) Lending Institution .~~~ Address ' (e) Real Estate Company and Agent Address ~ L~---'.. ti~.k Telephone ("~ (1 t_~ (1) Mail the HAA to the following address: 5 & S SRB 196x . /~'J/~elephone E~gle River, Alaslca 99~7'7 TYPE OF RESIDENCE Single-Famil/¢l~ Multi-Family [] Number of Bedrooms ~ Other 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. SEWAGE DISPOSAL Onsit¢ 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. Pacte 1 of 2 72-025 (~1/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal 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 the date of this inspection. Name of Firm Telephone Address Date E~gle Rivet', Approved for ~ bedroomsrby Date Approved , ~ Disapproved Conditional . . Term.~ of Conditional Approval ~~~~" ~- ~.A~,'-"~-~'~ 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. MUNICIPALITY OF ANCHORAGE (MO~) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 ~',~rn~i~nAL PROTECTION 264.47,° RECEIVED. Legal Description: ~,¢'~ / ~l/( ~ WELL DATA Well Classification ~ ~"~[~J,~-c~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present ¢,,N-) Date Compl~.te'd /O - ~_..7--- '7'~%'- Yield Toial Depth __/WI Cased to./J~_~¢~//t'/~ / Depth of Grout ng /,~,/~ static Water Level /O' ~- * Pump Set At Sanitary Seal on Casing Depression Around Wellhead ; On Adjoining Lots Ca~ing Height Above Ground Electrical Wiring in Conduit SeParation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field o~ Lot /O4) ¢ ¢' _; On Adjoining Lots To Nearest Public Sewer Line ~41¢N- To Nearest Public Sewer Cleanout/Manhole ~,~/~' To Nearest Sewer Service Line on Lot W~ter Sample Collected by .~,L~ ~'r,f G~N'~/'J & · Date Water Sample Test Results ~,z~-"F t .~ ~-¢N.¢~.~l~ r-4. ~' comments "~ 0~"~ d,.~,',-4¥ ~i~'. S.r~A-~.~'t% B. SEPTIC/HOLDING TANK DATA Daie Installed rCD-I~'- Standpipes DePression over TankWY~) pumping/Maintenance Contract on File (Y/N) Holding Tank kligh-Water Alarrn (Y/N) /"/~'- Sel~aration Distances from Septic/Holding Tank: To Water-Supply Well /~ To;Property Line To Water Mc, m/Service Line ,5--,..~ Course Size /42~o No. of Compartments 2 Air-tight Caps~bf)~ Foundation Cleanout (,~ Date Last Pumped / ~-~-,!~ ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage comments Page 1 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 ¢¢?~ Length of Field ~-MO~ L~N¢_~. -= Depth of Field ~ Gravel Bed Thickness ~..i Standpipes Present (~4N~ Date of Last Adequacy Test ,z/Co ~ Type of System Design Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /bO ! ~'' To Building Foundation Lot To Water4~alMService Line To Property Line ; On Adjoining Lots To Existing or Abandoned System on .~'-O ~'~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ,~ [_,/P(~f6J~'f'~ ~ To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons \ [ Cb "Pump On" Level at High Water Alarm Level at Tested for Dimensions ~,~ Manhole/Access ¢/~3" "Pump Off" Level at / Vent Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments .-~ ~L.,~¢:* tz/~,.,,c-c~z~ ~.4~4~ ~ ~r ~,~¢ ~ ~[~ /~r~ ** Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ,~ 8; S t=,%q!n~'~rh~,~¢ Date Company P:aglo :~ivei', ~x'¢asi~a 9v~¢~ MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) ALASKA E!IIUIROiqBeF1TAL COIqTROL SE!RuICeS, IF1C. ~nqincerin~) 6 ~nviromcnlol Studies November 6, 198# Keith Bandt Department of Health and '-~. Environmental Protection 825 L Street/Fourth Floor Anchorage, Alaska 99503 Subject: Highland Hills #2 Subdivision - Block 2, Eot i Dear Keith: On October 19, 198#, our office checked the well wiring on the above mentioned Lot. It has been buried. Therefore, we reccmmnd removal of the conditional item on the Health Authority Approval for this property, dated October 5, 198#. Approved by: Operat Eons Manager '~LeroylC/ Reid, 3/./0 PhD, P.E. Presifl~nt t/ ' ~uN~C,~^Ur( OF ^NC~O~O~ ~. o~ ~^~" ENVIRONMENTAL pROTEC[JONt BEC '~ RECEIVED 1200 LUcsl 33rd Aucnu¢. Suile ~ · Anch0roqe, Alask0 99503 ,(907) 561-50/40 · IGIPA TY 0r A CHO A DIVISION OF ENVIRONMENTAL HEALTH APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Location (addresa or directions) (b) Applicants Name ~6f~ ~O~}~ Telephone - ttome '.' Applicants Address ,:~. (c).Applic4n~'is~ (check one) Lending Institution ~-~ ; Owner/builder ~ ; ".' .'B~u?e?~ .~,,,~.l~Other [-~'~ (explain)i ~P.¢.~/ F~,t~_~ ~?~ , (d) Lending Telephone ~ ~ Address, .~ Bus ines sS ~'//7~Z (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single-Family~ Number of Bedrooms 3, Water Supply Individual Well~ Multi-Family Other .(describe) Commu~nity ~--~ Public ~-~ Note: If community well system, must have w=itten confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. S__ewa~e Disposal 0nsite~ Public ~ Community ~ Holding Tank~ Note: If community well system, must have written confirmation from the Sta~e Department of Environmental Conservation attesting ~o the legality and status. [Page 1 Of 2] e DHEP Approval Approved for ~-~/o [~Jbedrooms Approved ~ Disapproved En~tneerin~ ~i~ Providin~ Inspec~ions~ Tests~ File Search~ Da~a and Information As certified by my seal affixed hereto and as of the validation date sho~ below~ verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or ~stewater disposal system ts safe, function~ and adequate for the number of bedrooms and type of structure indicated heroin. I further verify that, based on the info~ation ob~ain~ from the ~nicipality of ~chorage files and from my investigation and inspection, the on-site ~ter supply and/or ~stewater disposal system is in compliance ~th ~l Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name, of Fir~_ ~C 5 Telephone Conditional Te~s of Conditional Approval CAUTION THE ~INICIPALITY OF ANCHORAGE' DEPARTMENT OF HEALTH AND ENVIRONM_ENTA~L PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRA3H 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THai STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO P[/RCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTSo 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 ae WEI.~L DATA ~MUNICIPALITYOFANCHORAGE (MOA) HEALTH AUTHORITYAPPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: MUNICIPALI'[Y O[~ ANCHORAG5 DEP'[, OF HEAL'IH ENVIP, ONM~NTAL PROTEC'[ION OCT '!. 2 i.c? Well Classification '-~ND If A, B, or C, D.E.C. Approved(Y/N) Well Log P~esent (Y~) ~£5 Date Completed Y-/O-ZT.-~ F- Yield Total ~pth ~ ~'/~l' Card to . P/~' ~pth of G~outing Static Wate~ ~ml ~ ~/~,0/,' ..... ~mp ~-A~ .4 = Casing Height ~ve Grpun~d~ / ~ ' .~--~-~ ......... "Sanitary ~al on Casing ~)~ Se¢~ation Distan~s fr~ mil: v~~ To ~ptic/Holding Ta~ on Lot $~- II0,%~ ; ~ ~joining Lots ~71()oI To ~a~est Edge of ~so~ption Field on Lo~5',H ' ; On Adjoining Lots ~t0b / To Nearest Public Sewer Line C leanout/Manhole ~ ~ Water Sample Collected By f- Water Sample Test Results ~Pr? C~m~nts To Nearest Public Sewer To Nearest Sewer Service Lir~.~ on Lot ; Date %- Q~.~ ~/ SEPTIC/HOLDING TANK D~EA Date Installed~ ~-IYI~F Size~/L)OO ,~-~/ No. of C~nts~'~ standpi~s ~) (~ Air-tight Caps (YTN)~ Foundation Cleanout ~Pression ove~ Ta~ (Y~ Date ~st P~d~Z~-~-// P~ing/Maintenan~ Con~act on File (Y~)M~ ; for Holding Tank High-Wate~ Ala~ (Y~) ~ ~]~rary Holding Tank Permit (Y~) Separation Distan~s fr~ ~ptic~olding Tank: T°Wate~-SupplyWell To!Property Line_~ I~ Toi Water Main/Service Line To Building Foundation-~TZ ! To Disposal Field To Stream, Pond, Lake, o~ Major Drainage [Page ~ of 2] Date Paid: .t~..- Amount: [_%.~, ¢_)TC~, . 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~ Date Installed ~- ~ -- J \- - ~ CP Width of Field ~( '~ (~ ~ i ~3[/ I~ Type of System Design f~ngth of Field Depth of Field Gravel Bed Thickness Squaue Feet of Absorption A~ea ~- ~/~) [~a Standpipes_ P~esent ~p~ession ove~ Field (Y~ ~ ~ ~te of ~st A~qua~ Tes~.' Results of ~st Adequa~ ~st Separation Distan~ f~om ~sorption Field: To ~te~-Supply ~11 ~ ~$~' To ~o~rty Line To Building Foundation W /1 0 ~ To Existing or ~ndo~d System / Lot ~ ; ~ Adjoining Lots To Water Main/~vi~ Line ~ To Cutbank(if p~e~nt) To Stre~ond~ke/o~ Majo~ ~ainage Co, se To ~iveway, Pa~kin9 ~ea, or Vehicle Storage ~ea D. LIFT STATION Date Installed Si~ in Gallons "Pump On" Level Dimensions ~ ~g~ Map2qole/Access ~3~/N ) "Puff~p Off" Level at ~z'" High Water Alarm Level at ~0~u~ Vent (Y~ ~ //~/~-~"' ..... Tested fo~ ~0~ ..... ....... ~i---~Pumping Cycles during' Adequa~ 'I~st. Co~nts & ~o~ o~ 4-~- ~eets MOA ** Oreck Permitted P~droom Rating Against HAA Request I certify that I have checked, verified, o~ ccnformed to all NfOA HAA Guidelines in effect on the date of this inspection. Signed. _~-)d ~~ Date 2-15-84 ALASKA 6FiUIROFIITII FITAL COFITROL $1 RLIICE$, IFIC. Er,,lin¢~,'ir,~ 8- I~r,~i,'or, rr,~,,IM Stu,:li~s OCTOBER 11 1984 KEN ZONG 3900 ARCTZC BLVD ANCHORAGE' AK 99505 SELLER - KEN ZONG BUYER - 5UBDZVZSZON -. HZGHLAND HZLL5 #2 ADEQUACY TEST FOR SEWER SYSTEN BLOCK - 2 LOT - i THE TYPE OF ABSORPTZON SYSTEM £S A TRENCH WZH~ AN AREA OF 480 THE SYSTEM ZS CAPABLE OF ACCEPTZNG 500 GALLON5 OF WATER PER DAY, THE 5URGE CAPACZTY OF THE 5YSTEN £5 457 GALL. ONS, BASED UPON THE TEST DATA THE SYSTEN Z5 ACCEPTABLE FOR A 2 BEDROON HO~, THE SEPTZC TANK WAS PUIVpED ON SEPT 25 1984 FLOW TEST ON I/CELL THE I~ELL FLOW RATE We ~ 55 GPN FOR 3 HOURS,' 5EPTZC TANK ~DEqUACY ' THE EXIST.rNG SEPTIC TANK VOLUiV~ O~ 100 'z~& ~EOUATE FOR THZ5 2 BEDROOM HOUSE, 1200 LUcsl 33r~I Augnu¢, Suif6 [~, Anchoro§¢, Alos~<e 99503,(907) 561-5040 --- -- ML~Nic. iPALiJY oP >~CHL)RAL~L: MUNICIPALITY OF ANCIIORAGE DEPT.-qz)f~ ~ & REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES 1. P~OPERTYOWNER PRONE MAI LING ADDRESS PROPERTY RESIDENT (If dilierenl from above) PH~NE 2, BUYER PHONE MAI LInG A~DRESS 3, LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE , MAI LI~ADDR ESS } ./ 5, LEGAL DESCRIPTION STREET LOCATION 6, TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NUM'JBEI:~ OF BEDROOMS [] One ~ Four ~ Two ~ Five E~] Three F~ Six [] Other WATER SUPPLY [] INDIVIDUAL" COMMUNITY [] PUBLIC UTILITY ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells dlilled prior to that date, give well depth (attach log if available.) SEWAGE DISPOSAL SYSTEM ~[] INDIVIDUAL/ON-SITE'' [] PUBLIC UTILITY If system is o'., :r two (2) yea s old an aderluacyl~cCst is required by Ihi$ Df:l)arlmunt. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACFI F;EQUEST BEFORE PROCESSING CAN BE INITIATED, 6/.90001.LfJ o~o