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HomeMy WebLinkAboutHERITAGE HEIGHTS LT 8H *tage. eri Heights.�, #015-361-27 SuBNTTAL Municipality of Anchorage Community Development Department Page 1 of 3 Onsite Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www,muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP121165 PID Number: 015-361-27 ❑ New ❑✓ Upgrade Name: ARNOLD HINDIN ABSORPTION FIELD ✓❑ Deep Trench El Shallow Trench ❑Bed E] Mound Address 6060 YUKON RD, ANCHORAGE, AK 99507 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.6 GPD/SF 12 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3 Ft. Gravel depth beneath pipe 9Ft. Subdivision Block Lot HERITAGE HEIGHTS 8 Fill added above original grade 0-1 Ft. Gravel length 43 Ft Township Range Section Gravel width 2Ft. Beds: Number of Lines - Distance between lines --Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 774 Ft2 1 --Ft Well 200'+ 200'+ NA NA 25'+ TANK ❑ Septic ❑ S.T.E.P. [-]Holding ❑ Other Manufacturer Capacity Gal. Surface Water 100'+ 100'+ NA NA Material Number of compartments Lot Line 5'+ 10'+ NA NA NA Foundation 51+ 10'+ NA NA LIFT STATION Manufacturer Capacity Curtain Drain 50'+ 50'+ NA NA ANCHORAGE TANK 500 Gal. Remarks EXISTING FIELD ABONDONED Pump on level at 25 in. Pump off level at 44.5 in. High water alarm at 22.5 in. Pump make and model ORENCO Electrical Inspections performed by MOA PIPE MATERIAL House to tank Tank to SCH40 drainfield Installer A+ HOME SERVICES Drainfleld SCH40 C01MT F810 Inspector LARS SPURKLAND & ANSON MOXNESS BENCHMARK (Assumed elevation) 100ft Inspection � 8!6/12 8/7/12 Location and description dates: Zen a" 8/8/12 a BOTTOM SIDING NW CORNER GARAGE COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date 49T SPURKLANO Ir 1 5 0 � ±�,•FO Approved Date -z 2' /.2- mspecuon Kepen_1'1 T.9 ec �Areu Lot 9 I I Lot 254 Lot 10 LOT 21 'ER UPC REQUIREMENTS 5' ELEC. ESMT _ F .SLOPE > 25 x �— SLOPE - tax I I INSTALLED 3 -BEDROOM SEPTIC SYST, EXISTING 1000 GAL CONCRETE TANK 500 GAL STEP TANK TRENCH LENGHT 41 FEET MAXIMUM DEPTH 11 FEET W/DTH 2 FEET SEWER ROCK 9 FEET ��l I SWING TIES SLOPE) z;x A 8 / SLOPE _ taz E I C 12.5 36 0 D 18.5 31.0 A E 52.0 14.0 F 720 49.0 o BENCH MARK 0 "A" WL I `� n Ih } Lot 26A "W LOT 8 VACENT iI I � 10' fLEC. ESMT 5 5� LOT 7 �E RI F I Lot 27A NOTE: I EWAGE HEIGHTS SUBDIVISION SERVED BY PUBLIC WATER SYSTEM. NOT£.• THIS 15 NOT A SURVEYED PLAT. WELL h SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WAST£ WATER DEPARTMENT DOCUM£NUTIOIL ALL LOCATIONS SHOWN ARE APPROXIMATE. 25 0 R5 50 75 100 125 150 SCALE: I' = 50 FT. ISPURKIAND ENGINEERINGI I HERITAGE HEIGHTS LOT 8 I I SEPTIC SYSTEM AS -BUILT 203 V 15TH AVENUE RATE: AUGUST 9, 2012 ANCM AK. 99501 ARNOLD HINDIN (907) 279-3916 6060 YUKON RR, ANCHORAGE, AK 99516 SHEET, 213 GRID, 2438 I PERMIT If OSP121165 PID # 015-361-27 IIERIT4GEHEI6HTSL8SC50ASB.DV5 r. R. &T. ELEV=92.8' Installed 500 gat, STEP Tank Existing Concrete Tank Deep Trench: 2' Wide 43' Long 12' Max Depth 9 ' Sewer Rock Distribution Line (typJ 3/16' Hole 30' on Center Trench Elevation Monitor— Sil t 9 ft of Septic Rock BENCH MARK BOTTOM SIDING NW CORNER GARAGE ASSUMED ELEVATION 100 FEET 203 W15th Ave QnQhoQaBe Ak 99501 PERMIT # USPI21165 HERITAGE HEIGHTS LOT 8 ARNLBD HINDIN PARCEL 1W If 015-361-27 TH , ,O.G. ELEV=104.5' B.O.H. ELEV=86.5" a 3 SEPTIC SYSTEM AS -BUILT DATE, AUGUST 9, 2012 HERIT46EHE16HTSL8D3ASB.DW6 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121165 Tax Code Number: 01536127000 Work Type: Septic Upgrade Permit Effective Dates: July 17, 2012 to July 17, 2013 Design Engineer: SPURKLAND ENGINEERING Subdivision: HERITAGE HEIGHTS Site Legal Address: HERITAGE HEIGHTS LT 8 G:2438 Owner/Address: HINDIN ARNOLD L & APRIL L 6060 YUKON RD ANCHORAGE AK 995076664 Site Mailing Address: 6060 YUKON RD, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 21223 Total Bedrooms: 3 N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receivo Issued MUNICIPALITY OF ANCHORAGE Community Development Department t Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-361-2-4 Property owner(s) AROLO HINDU Day phone 2ZZ-3/65Z Mailing address OLD V00 N 0.) ANCa1DUa I AK 195q Site address — JA/V*_- Legal description (Sub'd., Block & Lot) HERITAGE NQGNT5 LoT S Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Initial ElAbsorption Field Septic Tank ® Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made fora Single Family Dwelling and is in accordance with applicable Municipal Codes. owner or Perm!VRush Fees: of Date of Payment: (a moi Receipt Number: t�lS/QEi Permit No. r�SP/� llCt��i Waiver Fees: Date of Payment: Receipt Number: Waiver No. GABuilding\On Site\Forms\Client FonnsTennit App_010411.doc (Rev. 1/11) sparM and En onsefing Environmental Consulting and Design SEPTIC SYSTEM DESIGN Heritage Heights Lot 8 Municipality of Anchorage June 26, 2012 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Septic System Installation Permit 6060 Yukon Rd. Ladies and Gentlemen: I am writing to request a septic system upgrade permit for the above referenced property. The existing septic system is no longer functioning adequately. The proposed system will serve a 3 - bedroom single-family residence. A soil log, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: No Groundwater observed to a depth of 18 feet below ground surface (6/19/2012). Soil Rating. From Testhole 6/12/12 16.5 min/in = 0.6 gal per sq.fl/day No. of Bedrooms 3 Required Area per Bedroom: 15010.6 =250 fie Total area required: 250 x 3 = 750 fie Use Deep Trench Absorption Field w/ 9 feet of sewer rock Minimum Trench Length: 750 ft/ 18 ft = 41.6 feet System: Existing 1000 gallon Concrete Tank (replace outlet baffle), a 500 gallon STEP tank, followed by a deep trench absorption field 2 feet wide, 42 feet long with 9 feet of sewer rock. Soils: A test hole was excavated on June 12ah, 2012. See the attached soil logs. Ground water was not observed during the excavation nor at the end of the 7 day ground water monitoring period. Surface Water: There are no surface waters within one hundred feet of the proposed septic system upgrade. 203 West 15t" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net spaftlmd C IMUORM 89TEMg Environmental Consulting and Design Topography: The ground level slopes down towards the west at an approximate grade of 10% grade. A slope greater than 25% exists along the west property line. The drain field will be located 50 from the start of the slope. Waivers: None The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, LCVOS4 Lars Spurkland, P.E. Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net ABBOTT ROAD I I f a l l I I I allr� I L I I Lot 10 rl�t ) CHISSANA WAY 19 - i1 Lot 20 I l' III 11� PG Lot 19 - �R-- - - --- - - - - -- - I I LOT 22 0 LOT 21 ! YUKON ROAD LOT 4 LOTS II I it 9 I Lot 25A II I I � I I Lot 26A LOT 8 I VACENT II II LOT 7 I � I I I LOT 6 I NOTE.• limmoE N£lom SURDIV/Sm SERVED DY PURUC WATER SYST£IL NOT£.• TNLS s NOT A SURVEYED PLAT. WELL d SEPTIC LOCATIONS TAKEN FROM ON -SIT£ WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 50 0 50 100 150 200 250 300 SCALE., 1' = 100 FT. ISPURKLAAfD ENGINEERINGI I HERITAGE IIEIGffYS LUT 6 (( SEPTIC SYSTEM DESIGN 203 W 15TH, AVENUE ANCH. AK. 99501 ARNULB HINDIN DATE, JUNE 21, 2012 (907) 279-3916 6060 YUKON ROAD, ANCHORAGE, AK 99516 SHEET., 1/3 GRID, 2438 PERMIT # OSPI12OXY PID # 015-361-27 HERITAGENEIGHTSLBSCIOO.BWG Lot 10 lz i Area Lot 9 I I Lot 25A II rcn vr„ new - "" EXISTING 1000 CAL CONC 5' £LEC. £SMT 500 GAL STEP TANK TRENCH LENGHT 42 FEET — MAXIMUM DEPTH 12 FEET WIDTH 2 FEET SLOPE n X SEWER ROCK 9 FEET SLOPE - mx COVER 3 FOOT MIN. TN SLIPE7 OKE - loz I I_ WL Ici } Lot 264 IN Lor 8 ; VACENT T — to, Ec£c. EsuT S S� — I �1G � T I I LOT 7 1� Lor 21 � RZ P I Lot 27A I I 1� I N07E.• HERITAGE HEIGHTS SURVIVISION SERVED BY PUBLIC WATER SYSTEM. NOTE- THIS IS NOT A SURVEYED PLAT. WELL d S£POC LOCATTDNS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIDNS SHOWN ARE APPROXHWTE. 25 0 25 50 75 100 125 150 SCALE, 1' = 50 FT SPURKLAND ENGINEERINGI I HERITAGE HEIGHTS LOT 8 I I SEPTIC SYSTEM DESIGN I 203 V 15TH. AVENUE DATE J(/N£ 21, 2012 ANCH. AK. 99501 ARNDLD HINDIN (907) 079-3916 6060 YUKON RQ, ANCHORAGE, AK 99516 SHEET, 2/3 GRID+ 2438 PERMIT # OSP/12XXX PID # 015-361-27 HERITA6EHEI6HTSL8SC50QDV6 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. ci.anchoraae. ak. u U*j s (907) 343-7904 Soils Log - Percolation Test Performed For: ARNOLD HINDIN Date Park Legal Description: HERITAGE HEIGHTS LOT 8 Township, Range, Section: Depth 9A/LoArn ' An 7- _8-9- .i p Gross Time 8- Depth to Water Net Drop 9- 6/12/12 W1 PoLke�s 10- oD a o QD SiN CTra�e� 11- 12- 6112/12 l (MUSH/ 30 MIN 13.0625" 2.375" 13- 6/12112 5:03 PM 14- 15- oe 1.8125" 16- 6/12112 5:33 PM 17- 1.8175" 1 19 - WAS GROUND WATER ENCOUNTERED? NO a IF YES, AT WHAT DEPTH? - L Depth to Water After o Monitoring? DRY P E Date: 6/19/2012 J[AR�PURKIAND:w� tttcT, 1 5 0 I '•..� ly, Iz•'��r rmed:JU Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 6/12/12 4:03 PM 0 MIN 13" 10.625" 6112/12 4:33 PM 30 MIN 13.0625" 2.375" 11.25" 6/12112 5:03 PM 30 MIN 13" 1.8125" 11.1875" 6/12112 5:33 PM 30 MIN 1.8175" PERCOLATION RATE 16.5 (minutearinch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 6 FT AND 7 FT COMMENTS PRE-SOAKED. PERFORMED BY: ANSON MOXNESS I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL�GUAWININES IN EFFECT ON THIS DATE. DATE: 6/19/2012 Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: Heritage Heights Lot 8 Date: June 25, 2012 General: 1. The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached MOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the project includes the procurement and installation of a 3 -bedroom on- site wastewater disposal system at the location depicted on the attached site plan drawings. The existing concrete septic tank will be exposed and the tank outlet baffle will be replaced. The scope of the work also includes the installation of a new 500 gallon STEP tank, a drain field comprised of an absorption trench 42 feet long, 2 feet wide with 9 feet of septic rock. The location of the drain field is shown on the attached site plan drawings. The maximum depth of the field will be 12 feet below the existing ground surface. A minimum of three feet of cover is required over the drain field. In addition to the required earthen cover, 2 -inch thick, 40 psi, direct bury board foam shall be installed directly over all piping beneath the driveway. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of backfill material. The property owner is also responsible for vegetation of all areas disturbed by septic system installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 7. The contractor shall ensure that ALL materials being used are in compliance with the most current guidelines established by the Municipality of Anchorage. Refer to "Standards and Specifications for Component Parts and Materials Used in the 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net Spuftkmd Rmgomew'mg Environmental Consulting and Design Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. Septic Tank Installation: 1. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 2. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval is obtained from the engineer. 3. The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be sufficiently compacted to prevent future settlement of the soil. 4. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings. S. A cleanout shall be installed 1 to 4 feet from the foundation. 6. Post tank cleanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 7. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. a. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. 9. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 10. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and inspections must be obtained where required by the MOA. 11. The contractor shall verify that the septictank/lift station is a minimum of 100 feet from any residential water well, 150' from any class `C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. 12. The contractor shall remove or abandon the existing tank in compliance with the Uniform Plumbing Code. Drain field Construction: 1. The drain field shall be excavated to the dimensions outlined in the design drawings. If any discrepancies are noted, contact the engineer immediately for clarification. 2. The drain field shall be installed parallel to slope contours. 3. The bottom of the drain field shall be within 2" of level. If the sidewalls or bottom of the excavation become smeared, they must be raked or scared prior to the placement of filter sand or drain rock. 4. The drain field must be a minimum of 5 feet from the test hole excavation. S. Distribution pipe is to be installed level with perforations facing downward, atop a level bed of drain field rock. Septic rock shall then be placed atop the distribution piping to provide a minimum of 2" of cover, level across the entire width and length of the trench, above the piping. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspuridand@gci.net P�& gpuwM aimd Eng'Emee rong Environmental Consulting and Design 6. A silt barrier must be installed at between the final drain rock and the native soil backfill. The silt barrier shall cover the entire drain rock surface. 7. Monitor tubes must be 4" in diameter, installed in the locations depicted on the design drawings, and extend a minimum of 12" above final grade. The portion of the monitoring tube below the distribution piping must be perforated and the portion above the drain rock shall be solid. 8. Backfill over the final gravel layer must not be less than 2 feet. Insulation must be installed when the backfill depth is less that 3 feet. 9. Drain field back fill shall be mounded to prevent depressions from forming due to subsequent settlement of backfill material. 30. The contractor shall verify that the drain field is a minimum of 100 feet from any residential water well, 150' from any class'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. Inspections: 1. A minimum of two inspections are required by the Municipality of Anchorage. These inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. 2. The first inspection must be conducted after the excavation of the drain field and before the placement of any gravel. The septic tank may be set in place, but may not be backfilled. 3. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any backfill 4. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use in preparing the mord drawings. S. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 West 15t" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net GREA"_..ANCHORAGE AREA BORO, ' Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMEy c V" Fav, V'i MAILING ADDRESS Q 14re_ l G PHONEaO7 _3b l LOCATION^���' ^ 5}` 04 NflrJQq e LEGAL DESCRIPTION fir' ���Y 1-1'e(' k'�5 (IC'f SEPTIC TANK: DISTANCE NUMBER OF FROM WELL tiV MANUFACTURER 0 �� MATERIAL CCV cwef-e COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 1000 GALLONS. FIELD: TOTAL LENGTH P DISTANCE FROM WELL WA FOUNDATION- '33 NEAREST LOT LINE P3 OF LINES �b , NUMBER OF LINES-�IDISTANCE BETWEEN LINES N TRENCH WIDTHS IN. TOTAL EFFECTIVE ABSORPTION AREA 4 �4 SQ. FT. LENGTH OF EACH LINE Lr DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE `+ MATERIAL BENEATH TILEIN. ABOVE TILE IN. WELL: L I_u w CL'k-, V— TYPE TRUCTION BUILDING NEAREST N FOUNDATION LOT LINE CESSPOOL HER SOURCES - APPROVE- //DISAPPROVED DISTANCES: 0 N\ INSTALLED BY: Dc*.v•e Wt` (3_w SEWER LINE DEPTH: PIPE MATERIAL: OLS - I rJ v Cl Vcd_ L� rgtnuY 41av,C LOT SLOPE: REMARKS: Form EQ -032 DEPTH DISTANCE FROM: SEPTIC SEEPAGE LINE—, SYSTEM_ REMARKS DIAGRAM OF SYSTEM lo} 1i'Ae 5 DATE APPROVED_ n' G.A.A.B. 2 GREATER ANCHORAGE AREA BOROUGH d� o DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 •'C•• STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 \\�VllMueo nx.iiiPe///. SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT 6LI MAILING ADDRESS ��Q� sx ALV yC� PHONE CllCJS " '? �' A1y71,— ./ INSTALLATION LOCATIO �x'�""' k' LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK 5E EPAGE PIT DRAIN FIELD OTHER , TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS s� +'z t'Kiti� 1? l tNOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE 1060 TYPE "� SEEPAGE AREA SIZE �` ^a" �� TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK 67/ FOUNDATION TO SEEPAGE PIT DRAIN FIELD r— l SEPTIC TANK TO SEEPAGE PIT WALL v% SEPTIC TANK SEEPAGE PITC? DRAIN FIELD TO NEAREST LOT LINE. 1 WELL TO SEPTIC TANK DRAIN FIELD SEEPAGE PIT /Vo' ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT / 6o DRAIN FIELD / f SEPTIC TANK, (005: SEEPAGE PIT U� DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO 130ROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE OUGH ORDIN NCE^ NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE �� ?'!'2� , 7r� APPLICANT'S SIGNATURE -�- i rnou w,n rn-nt c Fa 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE OUGH ORDIN NCE^ NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE �� ?'!'2� , 7r� APPLICANT'S SIGNATURE -�- i rnou w,n rn-nt c �­ --,/;REATER ANCHORAGL AREA BOROUG -----' Department of Environmental Quality 3330 "C" Street �. Anchorage, Alaska 99503 SOILS LOCI -- PEROLATION TliST Performed for- ✓ cz�G�--.--_._------ -- -Date Performed �i Legal Descrip - This form reports: Soils loge Percolation test___--_ Depth Feet 1- 2- 3- 4 - S�Ope L k) 14 r Was ground water encountered? If yes, at what depth? Reading Date Gross Time Net Time Depth to Water Net Drcp Percolation rate minute. T- a Drain Field -Proposed installation-: Seepage Pit Depth of Inlet — Depth to bottom of pit or trench _- COMMENTS: - ERZ-040 (6/74) 0 Parcel I.D. 015-361-27 G TGE @4'C Municipality of Anchorage On -Site Water and Wastewater Program < (907)343-7904 A E I Y Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: S - 9 — / ff Complete legal description HERITAGE HEIGHTS LOT 8 Location (site address) 6060 YUKON RD, ANCHORAGE AK 99507 Current Property owner(s) ARNOLD HINDIN Mailing address Real Estate Agent 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 222-3652 Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual n Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System I] Public Sewer ❑ WaiverNariancere request NONE ___ 9 _.. Distance, Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ o�J`b 'II `zXih, w upo�lc�g Waiver Fee $ Date of Payment Date of Payment Receipt Number OS Irl Gn Receipt Number COSA# as�i.� ly�?J Waiver# 5. 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, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm SPURKLAND ENGINEERING Phone 279-3916 Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND Date 10/23/2012 6. DSD SIGNATURE i Z System #1 Approved for bedrooms ��r j System #2 Approved for bedrooms l ctca n i � •,';gin;' Disapproved ���a0 •(G�Z 12r,w �� pRG�ES 10``1P, e,• Conditional approval for bedrooms, with the following stipulaal$PasRa�.��" By: (ii/. Original Certificate Date: The nici ty An orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet S , 0 If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist /-/{tg4fs Legal Description: HERITAGE t ,a'LOT 8 A. WELL DATA Well type PUBLIC If A, B, or C provide PWSID # Date completed Sanitary seal (Y/N) Total depth ft. Cased to ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform colonies/100 mL ft. 9.p -m. Nitrate mg/L Arsenic ug/L Date of sample: _ B. SEPTIC/HOLDING TANK DATA Tank Type/Material CONCRETE Tank size 1000 gal. Number of Compartments Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping 8/8/2012 Pumper A+ Home Services C. ABSORPTION FIELD DATA Parcel ID: 015-361-27 Well Log (Y/N) Wires properly protected (YIN) Casing height (above ground) in. AT INSPECTION ft. 9.p -m. Collected by: _ Date installed 5/1975 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 8/8/12 Soil rating (g.p.d./ftz or ft2/bdrm) 0.6 System type TRENCH Length 42 ft. Width 2 ft. Gravel below pipe 9 ft. Total depth 12 ft. Eff. absorption area 756 f? Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed 8/8/12 "Pump on" level at 25 Datum Manhole Rim Size in gallons 500 in. "Pump off' level at 45 Cycles tested NEW E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot _ Public sewer main Sewer /septic service line _ Manhole/Access (Y/N) Y in. High water alarm level at 22'5 Meets alarm & circuit requirements? Y On adjacent lots _ On adjacent lots _ Public sewer manhole/cleanout Holding tank _ Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO Building foundation >5 Property line >5 Absorption field >5 Water main >20 Water service line >10 Surface water >100' (N.O.) Wells on adjacent lots >100, ABSORPTION FIELD ON LOT TO: Property line >1D Building foundation >10, Water Service line >10 Surface water >100' (N.O.) Curtain drain >50' (N.O.) Wells on adjacent lots >100, F. COMMENTS PUBLIC WELL>200' FROM SEPTIC SYSTEM G. ENCfWEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name LARS SPURKAND Date 10/23/12 COSA brown sheet 10-10-12.doc Water main '20' Driveway, parking/vehicle Storage >10' in. •�,. •,�ua�LAraD:wi 1P l,�E J h F*E- � F �' i� LOT 9 N S9°57120DW 1 1 S.❑01 A �5� LITILITY EASEMENT W X Y A m2 � 1• I r i m i �Im I� N ASPHALT4U1 1 DECIC� I fPCA;yyE J7 JAMPI 3 � glT'1 P1,AE NO "I I�3 4 Q 0 SNE Y I_' 1 1 O' UTILITY EASEMENT X N S905712❑°W 140.001 -- LOT 7 C� OF q_Q%�u 6 q gT H� s ' a I'(S -SHANE A. HOLT t G LS -6914.' p?O THE INFORMATION HEREON 35 FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND I5 MOTTO BE USED FOR POSITIONING ADDITIONAL STRUCTURES,IMPROVEMEN75, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THATMAY APPEAR ON THI5 DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. AS -BUILT SURVEY 1" = 30' NO CORNERS SET THIS DATE 4 LOT 25A J Q IQ Z LW m ❑I LOT 26A v D W w R Q U1 W cq � F 3 o Z, LOT 9 N S9°57120DW 1 1 S.❑01 A �5� LITILITY EASEMENT W X Y A m2 � 1• I r i m i �Im I� N ASPHALT4U1 1 DECIC� I fPCA;yyE J7 JAMPI 3 � glT'1 P1,AE NO "I I�3 4 Q 0 SNE Y I_' 1 1 O' UTILITY EASEMENT X N S905712❑°W 140.001 -- LOT 7 C� OF q_Q%�u 6 q gT H� s ' a I'(S -SHANE A. HOLT t G LS -6914.' p?O THE INFORMATION HEREON 35 FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND I5 MOTTO BE USED FOR POSITIONING ADDITIONAL STRUCTURES,IMPROVEMEN75, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THATMAY APPEAR ON THI5 DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. AS -BUILT SURVEY 1" = 30' NO CORNERS SET THIS DATE 4 LOT 25A LOT 27A I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLORING DESCRIBED PROPERTY LOT 9, HERITAGE HEIGHTS ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEIIENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _GTH DAY OF _OCTOBER , 2012. HOLT LAND SURVEYING 600 HIGHVIEW DRIVE 5093. 49-18 117-3.155-30 ANCHORAGE,AK 99515 345-5513 J IQ LW p LOT 26A II0 W Ln2w R Q U1 W � F 3 o --E 0— EtF N o-0 ❑ uP D LOT 27A I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLORING DESCRIBED PROPERTY LOT 9, HERITAGE HEIGHTS ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEIIENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _GTH DAY OF _OCTOBER , 2012. HOLT LAND SURVEYING 600 HIGHVIEW DRIVE 5093. 49-18 117-3.155-30 ANCHORAGE,AK 99515 345-5513 hlCunicipility bf �i�ichi age t? bevelolpment Sdirvicbs adpartmdnt Building Safety Division Onsite Water 6 Wastewater Program 4700 South pragaw SL P.O. Box 196650 Anchorage, AK 996j§.b650 www.cl.anchonageak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR .A SINGLE FAMILY DWELLING Parcel I.D. 015-361-27 HAA# 1. GENERAL INFORMATION Expiration Date: ! , " 0 �A Complete legal description HERITAGE HEIGHTS SUBDIVISION: LOT 8 Location (site address or directions) 6060 YUKON ROAD ANCHORAGE, AK. 99516 Current Property owner(s) Mailing address Lending agency Mailing address DON do SAGA VERBLE° Day phone 346-8012/229-3984 6060 YUKON ROAD * ANCHORAGE. AK. 99516 Day phone Real Estate Agent TERRIE PISA W/ PRUDENTIAL JACK WHITE Day phone 762-3157 Mailing address 3801 CENTERPOINT DRIVE SURE 200 ANCHORAGE, AK 99507 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System Public Sewer ❑ The Municipality of Anchorage Development Services Department.(DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or,Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my Investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. 1 further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and inspection, the onsite water supply and/or wastewater disposal system Is(are) incompliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, ltd. Address 3701 E. TUDOR ROAD, SUITE 101 + ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines d Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational Its of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the fami7y being served by the system. These conditions are outside the control of the evaluator of the system. SaUsfactory test results do not guarantee future perfommance of the system, nor do they guarantee that there are no hidden defects or enaoachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet fire operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIG ATURE Approved for 3 bedrooms. Disapproved. Phone 337-6179 Date 112'atF _ Conditional approval for bedrooms, with the following stipulations: Attachments: L/ HAA Checklist Septic System Advisory Well Flow Advisory UP M (Rev. 12101) Maintenance Agreements Supplemental Engineer's Report Other �D .••��. WASTEWATER --PR96RAW Original Certificate Date: 1 t 1 - © s Municipality of Anchorage n°r reg Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci:anchorage.ak.us (907)343-7904 I HEALTH AUTHORITY APPROVAL CHECKLIST - Legal Description: HERITAGE HEIGHTS SUBDIVISION; LOT 8 Parcel ID: 015-361-27 A. WELL DATA PUBLIC WATER ,a Well type If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N ves properly protected (Y/N) Total Cased to - ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION is Date of test Static water level ft. ft. Well production 9 -p.m. g.p.m. p WATER SAMPLE RESULTS: _ ( Coliform colonies/100mi. Nitrate - mg./L. Other ba i, Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA € Tank Type/Material CONCRETE Date installed - 5/7/1975 ` Tank size 1000 gal. Number of Compartments 1 Cieanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A t y Date of pumping 1-11-2005 Pumper Ai- Anp Coe ii C. ABSORPTION FIELD DATA ITELOW ExisnNG GRADE ( Date installed 5/27/75 Soil rating 6P -0 .45x ftlbdrm) 150 System type DEEP TRENCH Length 28 ft. Width 2.5 ft. Gravel below pipe 9 ft. Total depth "13 ft. Eff. absorption area 468 ft2 Monitoring tube YES Depression over field NO Date of adequacy test "'7/9/2003 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 86.5 In. Water added 540 gal. New depth87 in. Elapsed Time: 115 min. Final fluid depth 86.5 In. Absorption rate >= 450+ g.p•d• Any rejuvenation treatment (past 12 mo.) (YIN &type)NONE KNOWN If yes, give date ... i ""TEST DATA IS LESS THEN TWO YEARS OLD, LIQUID LEVEL WAS 82" 12/27/2004 ` Date installed Size in gallons ManholelAc�ess{— Pump on" level at _in. "Pump off" _in. High water alarm level at in. Cycles tested Meets alarm & circuit tequiremants7. E. SEPARATION DISTANCES `SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main _ ,val—c service line PUBLIC WATER On adjacent On adjacent sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 1o'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 0' Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. 'CQMMENTS G. ENGINEER'S CERTIFICATION 4 I certify that 1 have determined through field inspections and 0 : ............ review of Municipal records that the above systems are in 0 conformance with MOA HAA guidelines in effect on this date. VA Je r nessrEngineers Prnt NameJEFFREY A. GARNESS Q� ` E-7 5 0� jOQ�%a �..��.���cAvoa Date f /(toS 040 Foress;o^nom v HAA Fee $ �2U� Date of Payment i I I 106 — Receipt NumbeFsd?Q% LJllt" (Rev. 12/01) UIVI� Waiver Fee $ Date of Payment Receipt Number ¢, e, u li vejo a / 11 � s o� N rock 's J Rl I h h I ,h r E• 0 , 5l° _ ss ' I N. B9°s� zo �✓. iya.00 T• . 30s /f'ec�rf�j{, d7-Z3-oj AS-KJILT MMM (NO CCRYERS SET TYIS MATE) OF����' �ha�r s,/�.c� I I hereby eareity n,at t luw panor4sa •. r fp,•••r••••k4G '�iA1� �AGi+I7A/� T I deaerlbdMortgagee•ap1'gliel'tya ion o the wtoeln4 `>�. • 7• '! g �f I LOT ,Y, RERITAGE IRiIWITt �"� t •«N. •No I Anchorage Recording Mtatrict• Ataka and c l drone A. Fioh I that the I ti S aprovenxata atbgted !lstrecn a •• LS6Fle r �• I or* within the fir' G Pr M�rttr 31aaN MMId Ila IiDt E Y• .d'' Cqg�:...—► 4.e✓ VCS g �` ,fjJ�•••«N..•_,�O � w // I overlap or *IGroach en R)IR jMl^ty .: �'•. °,- ,`,FSSIOIAL��.r ✓vote Fences F/�e7 C6v.//s I tying adlaant ehereto, that tso I Na �a VM etre /i�°rox %mih. thereto oo wwr�oeck �ti �pYMlio w question and that there ar*'p* f TME ]YFOWATtOI HEREON IS FOR TMEROE OF LENDING I transmtealan Rima, arK Myatt,*- IYSTITIRICNS SPECIPMUT TO 9NOW AMT CONFLICTS I easements an geld ; EASEMENTS OF RECORD,.DINER indicated her!cn� �y c ' *'" SETIEEY MRIifIYOSTRIICTIgES AMO PLATTED LOT LIVES TNRW T I meq""" *t' • '1°` ti OR USMNTS AND IS NOT TO BE IMIED NOSE SNOW ON tRE Alaska thie'+g'. ADDIifOYALL CtME;E;YMES at WXMLSf� ITIOMIMB RECORDED FLAT, ARE NOT SNOLN NEREON I BOLT AND ASSOCIATES "'Vp rt r E• 0 , 5l° _ ss ' I N. B9°s� zo �✓. iya.00 T• . 30s /f'ec�rf�j{, d7-Z3-oj AS-KJILT MMM (NO CCRYERS SET TYIS MATE) OF����' �ha�r s,/�.c� I I hereby eareity n,at t luw panor4sa •. r fp,•••r••••k4G '�iA1� �AGi+I7A/� T I deaerlbdMortgagee•ap1'gliel'tya ion o the wtoeln4 `>�. • 7• '! g �f I LOT ,Y, RERITAGE IRiIWITt �"� t •«N. •No I Anchorage Recording Mtatrict• Ataka and c l drone A. Fioh I that the I ti S aprovenxata atbgted !lstrecn a •• LS6Fle r �• I or* within the fir' G Pr M�rttr 31aaN MMId Ila IiDt E Y• .d'' Cqg�:...—► 4.e✓ VCS g �` ,fjJ�•••«N..•_,�O � w // I overlap or *IGroach en R)IR jMl^ty .: �'•. °,- ,`,FSSIOIAL��.r ✓vote Fences F/�e7 C6v.//s I tying adlaant ehereto, that tso I Na �a VM etre /i�°rox %mih. thereto oo wwr�oeck �ti �pYMlio w question and that there ar*'p* f TME ]YFOWATtOI HEREON IS FOR TMEROE OF LENDING I transmtealan Rima, arK Myatt,*- IYSTITIRICNS SPECIPMUT TO 9NOW AMT CONFLICTS I easements an geld ; EASEMENTS OF RECORD,.DINER indicated her!cn� �y c ' *'" SETIEEY MRIifIYOSTRIICTIgES AMO PLATTED LOT LIVES TNRW T I meq""" *t' • '1°` ti OR USMNTS AND IS NOT TO BE IMIED NOSE SNOW ON tRE Alaska thie'+g'. ADDIifOYALL CtME;E;YMES at WXMLSf� ITIOMIMB RECORDED FLAT, ARE NOT SNOLN NEREON I BOLT AND ASSOCIATES "'Vp rt Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A .SINGLE FAMILY DWELLING Parcel I.D. 015-361-27 1. GENERAL INFORMATION Expiration Date: 3 - " D Y_ Complete legal description HERITAGE HEIGHTS SUBDIVISION; LOT 8 Location (site address or directions) - 6060 YUKON ROAD* ANCHORAGE AK* 99516 Current Property owner(s) DON & VERBLE SAGJAr Day phone 346-8012/229-3984 Mailing address 6060 YUKON ROAD* ANCHORAGE AK* 99516 Lending agency Day phone Mailing address Real Estate Agent TERRY PISA W/ PRUDENTIAL JACK WHITE Day phone 762-3157 Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 0 Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 7 Z8 /0 3 - Engineer's Comments: in conducting this evaluation, AKWWC, Inc. attempted to provide a thorough. QQd��O conscientious engineering analysis of the system in accordance with ADEC and MOA o� OF , �Q DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation p distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local s0i7s condition, groundwater levels that may Q• Q fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test ... of re . Ga S. �P results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, inc. can therefore not provide OQ�°e C 7953 e any warranty or future estimate ofhowlong the system will continue to meet the �4eyP�ofeesto�°o operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any �DOOOoo�a other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ✓ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: A i-v( Oi AAy,.% J • ON-SITE (nIATER entre_ WASTEWATER _ nonron�� Attachments: ��ilp • • • • • •• 9 HAA Checklist ✓ Manitenance Agreements ii�� j Supplemental En y��»>Illtj1 Septic System Advisory PP Engineer's Reort 9 Well Flow Advisory Other By: Original Certificate Date: — R 0 3 (Rev. 12101) Municipality of Anchorage ^t b Development Services Department Building Safety Division On -Site Water 8 Wastewater Program ' ^' r 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: HERITAGE HEIGHTS SUBDIVISION: LOT 8 Parcel ID: 015-361-27 A. WELL DATA PUBLIC WATER Well type If A. B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected Total depth Cased to ft. Casin (above ground) in. FROM WELL LOG AT INSPECTION Date of test I Static water level ft. ft. i roduction g.p.m. g.p.m. WATER SAMPLE RESULTS; j Coliform colonies/100 ml. Nitrate mg./L. Other b j Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank ;Type/Material CONCRETE Date Installed __ 5/7/1975 Tank siie 1000 gal. Number of Compartments 1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 7/9/2003 Pumper McDONALDS'S PUMPING C. ABSORPTION FIELD DATA BELOW EXISTING cw,oe Date installed 5/27/75 Soil rating p.d./ r ft2/bdrm) 150 System type DEEP TRENCH Length 26 ft. Width 2.5 ft. Gravel below pipe 9 ft. i Total depth "13 ft. Eff. absorption area 468 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 7/9/2003 Results (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test '� in. Water added 540 gal. New depth'�Sin. Elapsed Time: 115 min. Final fluid depth '5* in. Absorption rate >= 300+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — I Ii, D. LIFT STATION Date installed Size in gallons "Pump on" level at in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main line On adjacent lots On adjacent Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 109+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 0' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed e JEFFREY A. GARNESS Date I &S NaT-, HAA Fee $ 3-1 Date of Payment I ?,I Receipt Number (Rev. 12101) Waiver Fee $ o� ./ ......... y C r ess.: 7953 '\�G pro f e $ slot% Date of Payment Receipt Number Ne9'S71k_ a'w //Soo ti �p1 �• o v�.o D1 iI M s I IV 05' ch tK ,C.0 � rti a 1J0 0° Ur•i0G/1" 22.E 7 1 98Ito 2Y.o i ' , I N.89•S7 Zo IN ■ sof AS-BUILT SURVEY (MO QORIIERf RET THIS DATE) OF 44 Al p�p, �..••w,.,• ,4 , I 1 Mreby certify that I have . •. ..�sNortf.f«oos inspection of tt» rotf taming tt %• y �j I described property: •...'448 * �� K� g 1 I LOT 8, HERITAGE ME(SNTR fUR. too Shone A. I Anchorage Recording Olatrlet Al Wolf , esim and ,.•'"' I that the imW'owmrnts altuttad -4 FO„9 •�•NNN•� �� Lej�^`�: —i =o.' Ve fl I are Mlthln the property in" and lot ' i, OFfBSIowAoy I ovsrlap or encroach on tae ���►►V►��P' /Yo Tc fences F�ef Cvnl/s I lying adjacent thereto, tlut no -Q re /1P 1Pr° k %n,t7•r . 4•rr•tovaer rnts on propty., tyles pdilant thereto I reach on the Pr�taas .Ib ;� TIE INFORMATIONI question and that therere aFie MERE011 IS FOR THE USE OF LENDING I transmission tlrrs, e► etber,W140t& INSTITUTIONS PIC USE TO SIM ANY CONFLICTS ( sessmsnts on tald t1 ! Y IETIEEN tI1RTllq EAtE11ENTR OF RECORD, OTHER Indicated herson` G DR WERN EXIS AND 12 My AM MATTED LOT LINES THAN IN= SNOW ON THE�.F'�,� MOT TF RE UfED FOR POSITIONING RECORDED PLAT, ARE NOT Alaska119�this �3 �, 400Ii1O11A1 RTRUCTtRtEi OR PEMCEIIMEf 'r"'+++eni+++. SHOW HEREON I HOLT AND ASSOCIATES LAW NORIfIrM +' V • 1 I I Ri A i ZS, S ti = a ry () 0 OF.q`�s� � r•• t NeNsu e r t •.N...}.N� Shane A. dolt %90ffSS1GWAL %Ymoi; S N. B9°s� zo"w. /vo.00 /C'ecc f.ec/7-23-03 J /Lung. C/ tl Ge,„q/: --► =a r. Veli /yore: /�ences F�ef Cf/R//S Q Ile TME INFORMATION KUM IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SM ANY CONFLICTS EASEMENTS OF RECORD, OTHER SEIIEEN EXISTING STRUCTURES AND PLATTED LOT LINES THAN THOSE SHOWN ON TME OR EASEMENTS AM IS NOT TO a USED FOR POSITIONING RECOROEO PLAT, ARE NOT ADDITIONAL STRUCTURES OR FENCELINES SNOW NEREON IN a 301 AS -BUILT SURVEY (NO CORNERS SET THIS OATE) r 4• .; 1 hereby certify that I have performed a; I Mortes@ee's inspection of thi following I described property: I LOT 6, RERITAW REISNTS S1N.' �fi 1 ti ti I Anchor&@. Recordine District, Alaeka and 1 that the iaprovsamm a oltu"W tlwa&n _ I overlap or ansroaeh en the Or'sP�'tY h I IYIn@ adjacent tharato; 'um to I Improvements an pe ups, Lytle.+dwii tt ''� "' I thereto &ncraach an tilalllESlFrdS' F ' mIm 4. I Indicated her&enPatladr r, � Alaska this •23 day'af N j� �r 1 1922•PG/9 /a ;."',' i ! ! OL I NT AND ASSOCIATES LASD' iii % .B 2s!0 \ !� I,4 E✓je of r pt</c �� - I -- _j i N. B9°s� zo"w. /vo.00 /C'ecc f.ec/7-23-03 J /Lung. C/ tl Ge,„q/: --► =a r. Veli /yore: /�ences F�ef Cf/R//S Q Ile TME INFORMATION KUM IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SM ANY CONFLICTS EASEMENTS OF RECORD, OTHER SEIIEEN EXISTING STRUCTURES AND PLATTED LOT LINES THAN THOSE SHOWN ON TME OR EASEMENTS AM IS NOT TO a USED FOR POSITIONING RECOROEO PLAT, ARE NOT ADDITIONAL STRUCTURES OR FENCELINES SNOW NEREON IN a 301 AS -BUILT SURVEY (NO CORNERS SET THIS OATE) r 4• .; 1 hereby certify that I have performed a; I Mortes@ee's inspection of thi following I described property: I LOT 6, RERITAW REISNTS S1N.' 1 �+ wi I Anchor&@. Recordine District, Alaeka and 1 that the iaprovsamm a oltu"W tlwa&n I are within the property Ilan aid ds nst , I overlap or ansroaeh en the Or'sP�'tY I IYIn@ adjacent tharato; 'um to I Improvements an pe ups, Lytle.+dwii tt ''� "' I thereto &ncraach an tilalllESlFrdS' Wast and that ares � arf fp ' transmission ling• ar ea I easements encaid'proplpsy I Indicated her&enPatladr r, � Alaska this •23 day'af N j� �r 1 1922•PG/9 /a ;."',' i ! ! OL I NT AND ASSOCIATES LASD' r MUNICIPALITY OF ANCHORAGE ARL • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services 41111111111151 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. # �� (� � SID -;a-) HAA # 1. GENERAL INFORMATION Complete legal description Lot 8• Heritage Heights Location (site address or directions) 6060 Yukon Road Jana �rN,� Da hone 279-7611 Property owner. Y P Mailing address 1200 N Nash Street #228 Arlington, VA 22209 Lending agency Day phone Mailing address Agent AAA.— n I 4 4 vvv Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 N 3. TYPE OF WATER SUPPLY: Individual well Community well Public water XXX Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72.025(Rev.1/91) Front MOAU21 6. In 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 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 17034 Address Engineer's signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments No. 204 Phone 2�7� Date :a•J auu aA i', per. s� eUi1¢1'f f;. °J.ifJ.` p 7/ .3 sig 'YS ryCqq,/`4.�i U U�r a�sts't L`C`4 Sl3' bedrooms, with the following stipulations: Date � � / 93 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 orderto 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 B21 Municipality of Anchorage Department of Health and Human Services 44 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lea- $ H6,�rtAc,6 HOGITrs Slej Parcel I.D. A. Well Data Pvi_11L/C WA12FI2- 40/5-_�_b/--_17-7 Well type Fb43L/C If A, B, or C, attach ADEC letter. ADEC water system number �J/A Log present (Y/N) Date completed Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell Driller Cased to Casing height FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliforgv, Nitrate of sample: B. SEPTICf#QGTANK DATA Wires properly protected (Y/N) M. AT INSPECTION On adjacent lots ; On adjacent lots Public sewer manhole/cleanout tank Collected by: _MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION Other bacteria SEP 13 1993 .m. RECEIVED Date installed S%Z2/ r Tank size /a2U i'AC— Compartments I Cleanouts6N) Foundation cleanoutY/) Yes Depression High water alarm (YAdQ /Lf6 Alarm tested (Y/N) 'If/ Date of pumping Pumper A+ 1*�mC SepvICFs SEPARATION DISTANCES FROM SEPTICS -TANK TO: P0au C QAr62 Well(s) on lot A,,WJ6 PKETE1' i On adjacent lots X00 r- Foundation 5 '7 - To To property line 10 (-�– Absorption field s Water main/service line /0 t Surface water/drainage .160 72-026(9r9s)•Front CONTINUED ON BACK PAGE C. LIFT STATION /U o r--�E Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FRO Well on D. ABSORPTION FIELD DATA ATION TO: On adjacent lots ufacturer Manhole/Access (Y/N) "Pump off" Level Cycles tested Surface water Date installed S�Z �%� Soil rating (GPD/Ft2) ULIc�f� System type T /tG&JCk Length 33 Width 2 ,S Gravel thickness Total depth /S" Total absorption area �6 �� Cleanout present) _Depression over field (Y® "Jy Date of adequacy test Z� ?3 Results as ail) P�}SS for H� � 3 _Bedrooms VZ Water level in absorption field before test 93 After test Peroxide treatment (past 12 months) (Y/N) N3tiG KNoc-J I -J If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: �v3Lf C Gvr}�YL Well on lot itla c>� /'n �S��T On adjacent lots 1 Y- Property line 2C--) r"d- To building foundation _/D r14- To existing or abandoned system on lotP2C-s�AJ7-" r r On adjacent lots z `� Cutbank /Jo/E P LL C, rJ7 Water main/service line ZS a- / c�NDc,✓Z Surface water ZL(-) rf Driveway, parking/vehicle storage area �j� Curtain drain N01 -J KA Jo W /J E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effecton the e of, s inspection. Signature o >< 34 ale r2i r Loo Road Engineer's Name 770 5 _a a Rive ,, laska 99977 ' Date HAA Fee $ ,20 o, o Date of Payment 9-13-23 / Receipt Number 7 /'� / fry o��ti� 11 nnc rorom• Mme. Waiver Fee $ Date of Payment Receipt Number 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS C�,o TIME TIME TIME DATE DATE DATE SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY INSPEC R INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE p�� DEPT. OF HEALTH & IRONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTfDN 825 L Street - Anchorage, Alaska 99501 • NOV 91979 ENVIRONMENTAL SANITATION DIVISION Telephone 264.4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days f r-ocessg 1. PROPERTY91NNER NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MAILING ADDRESS c j6Cd9 <' gam e PROPERTY RESIDENT (If different from above) PHONE U060 �L&Qlj 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION ��✓`r�'� � /' a: MAILING ADDRESS/� _ / ��t15d lUd CJ/f �� nl 4. REALTOR/AGENT PHONE IL MAI LING ADDRESS - 5. LEGAL DESCRIPTION /' X2 �Ja STREET LOCATION DO&o /�o.v ��• C�,o ( 6. TYPE OF RESIDENC NUM8FFVUF,bEDRO0M5 4 One ❑ Four E__1 Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM 7 INDIVIDUAL/ON-SITE** ZZ 26� YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE -91 SINGLE FAMILY O MULTIPLE FAMILY NUMBER OF BEDROOMS ED ONE "SO THREE ED FIVE O OTHER ED TWO O FOUR O SIX 2. WATER SUPPLY O INDIVIDUAL `91 COMMUNITY O C, . 0 PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED C INSTALLER Septic Tank or O Holding Tank Size: 101)C) If Tank is homemade give dimensions: SOILS RATING I -)C TYPE OF TANK C(2S CAA—A-e, MANUFACTURER P \ Ln a , {a, TOTAL ABSORPTION AREA MATERIAL � c" L7J\ 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR -3 BEDROOMS L) CONDITIONAL APPROVAL (letter must accompany certificate) El DISAPPROVED / DATE I BY 72-010 ( Rev. 6/79) E_p e BC SYSTEM G L ADEQUACY REPORT MATERIALS TESTING a QUALITY CONTROL JOB NO. CTL 79-267 SOILS ENGINEERING 2204 Cleveland Ave. 710 Third Ave. DATE OF REPORT 11/7/79 P.O. Box 10- 1 12 6 P.O. Box 2540 DATE OF TEST 11/5/79 Anchorage, AK. 99511 Fairbanks, AK. 99707 277-0231 452-1267. 456-5155 LEGAL DESCRIPTION LOT 8 ,BLOCK Heritage Heights SUBDIVISION OR SECTION , T—N, R_W, S.M. , ALASKA PERFORMED FOR: REQUESTED BY: Western Enterprises Phil Powelson 4101 Arctic Boulevard 99503 Anchorage-,, Alaska PHONE NO. PHONE NO. TYPE OF SYSTEM 0 SEPTIC TANK - SIZE 1250 GALLONS ❑ CRIB OR SEEPAGE PIT 99 LEACH FIELD NUMBER OF BEDROOMS 1 SEPTIC TANK WAS PUMPED M YES ❑ NO ABSORPTION RATE: AVERAGE 24 HOURS 600 GALLONS. SURGE RATE: 500 GALLONS IN 20 MINUTES. NOTES a OBSERVATIONS: d TEST PERFORMED BY: D•P- REPORT PREPARED BY: T) P APPROVED BY: R.P