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HomeMy WebLinkAboutHERITAGE HEIGHTS LT 19Her'itag Height Lot 19 015.-$61 -4.1 Municipality of'Anchorage ,..~: , -.. Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bmgaw St. P.O. Box196650 .,~cflorage, AK 995196650 Page I of www. ci.anchorage.ak, us (907) 343-7904 - ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPEcTii3N REPORT . . ' ':'" N..~: ~. ~--. H~I[ WastewaterSystem: [] New J~ Upgrade Address: ~9 '2'0 ~,.ro~c~ (..¢,'o2,, ~^c.t, 9,~s'o'7 ABSORPTION FIELD Phone: Number o~ Bedn3(~ns: 7 S~' - t'7~'3 ¥ ~Deep?rond~ n~?re~ nBed aMound I'lOff~.: B~oc~k: Lot: ~JboWis~on: ~ Io ~ Ix~3m tram ~lginM g~de: C~ave~ C~ass~flca~on (Pnvate. A, S. C): Total Dep~: ' Cased to: I Term ~ area: Pipe Mate~al: ~" -~ ~' O ~;~ ~'~' Dnller: Oa~ D~ed: Static WarD' Lcd: . m,~.a':. Date SEPARATION DISTANCES [] sep~c [] m~:r, ng [] S.TZ.P. . []  Septic Absoq3tion Lift Holding ~ublicJPt~.-ale Manufaca-~* Tank Field Station Tank Sewer Une Curtain Dran ~ -- .. .-, ~ Make I Mod~ EiecmcM In~ec~ons pe~cnmd b~. ~eeeeeeeeeeeeeeleeee~eee~ e~. Development SeTjces Departn~nt ApproVal }'~ -,,.~,~ ....... PERMIT NO: SW040190 P.01 PAGE 2 OF 2 PID NO: 015-361-41 SWING TIES FROM: COR. 'A" COR. "B" TO: DBL C.O. 'C" 20' 25' VALVE "D" 21' 27' TR. C,O. "E" 35.5' 38' TR. M.T. 'F" 42' 39.5' TR. C.O. "G" 84,5. 70' WATER KEY BOX- --. LOT 19 r,.,'..~.r.,.-...-.;.-....-...-.~..-.. EXISTING ,qEXlSTING [~ 1500-GALLON :; :[!iSEEP. P~T NEW 61-FOOT LONG SOIL AB8. TRENCH w. 5.0' EFF. GRAVEL PLAN VIEW SCALE: t" = 30' MONITOR TUBE ~ FILTER FABRIC ~.r [ [~- ., J , r [~~. __4, DIA. F.810 PERF. PIPE- INV. 93.4' 51I~~~'1/2' - 2 1/2" SEWER GRAVEL OTrOM OF TRENCH ELEVATION 88.4' CROSS-SECTION SCALE: 1" = 5' LOT 19, HERITAGE HEIGHTS SEPTIC SYSTEM UPGRADE AS-BUILT INSPECTION REPORT I FLATTOP TECI[NICAL $ERV]CF-q { SCALE: AS NOTED ~'Sz'~~'~-~' i 14s3o r~CilO ~-r [ DRAWN BY TFM /o.~. ANCHORJtGE, ALASKA995,~ i JUNE, 2OQ4,. TOTRL P. 01 PERMIT NO: SW040190 PAGE 2 OF 2 PID NO: 015-361-41 SWING TIES FROM: COR."A" COR."B" TO: DBL C.O. "C" 20' 25' VALVE "D" 21' 27' TR. C.O. "E" 35.5' 38' TR. M.T. "F" 42' 39.5' TR. C.O. "G" 84.5. 70' WATER KEY BOX LOT 19 .~. :~ ;~: ~; .~.: ~: ~: .T. :~ EXISTING RINGS SEEP. PIT ,,£ EXISTING 1500-GALLON TANK "F NEW 61-FOOT LONG SOIL ABS. TRENCH w. 5.0' EFF. GRAVEL PLAN VIEW SCALE: 1" = 30' -/~__~ONITOR TUBE LEANOUT __~L GROUND ELEV. 98.2' ' IIIII-L ------<.5' SO~L COVER ILU_I__I ~ F,LTER FABRIC ~BOTTOM OF TRENCH EL~ATION 88.4' CROSS-SECTION SCALE: 1" = 5' LOT 19, HERITAGE HEIGHTS SlD SEPTIC SYSTEM UPGRADE AS-BUILT INSPECTION REPORT FLATTOP TECHNICAL SERVICES SCALE: AS NOTED 14530 ECtlO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 JUNE, 2004 MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 14, 2004 Expiration Date: Jun 14, 2005 Permit Number: SW040190 Legal Description:£HERITAGE3.-IEIGHTS :L,'I'--T9'77 Design Engineer: 0019 Flattop Technical Services Owner Name: P.J. Hill Owner Address: 5970 Chisana Way Anchorage, AK 99507- Parcel ID: 015-361-41 Site Address: Lot Size: 19213 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field r~ Septic Tank D Holding Tank [~ Privy Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: -~'--~ Issued By: ~)~ Date: Date: Municipality of Anchorage Development Services Department Building Safety Divbion On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us' (907) 343-7904 ' ON-SITE SEWEPJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLI'NG Parcel I.D. Permit Number SW Property owner(s) Mailing.addresS (1) Mailing address (2) Day phone ~J'~'l C~}o~'tad~~ ~ Zip Code ~) ~,CO 7 Legal description (Lot, Block & Sub'd.) ~-,o/' Legal description (Section, Township & Range) /'~C~---)~) Number of Bedrooms Well Only [] Water Storage [] Jacuzzi [] Water Softening Unit ['-I Lot SiZe \ q, '~\ '-~ Acres/~ THiS APPLICATION iS FOR: Sewer Only I-'1 Sewer and Well [] Sewer Upgrade I~ THIS PROPERTY C'ONTAINS: Hot Tub [--I Swimming Pool I-"] Therapy Pool r'-I I certify that the above information is correct. I fudher certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of properly owner or' authorized agent) Permit Fees: '¥~' Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 June 9,2004 14530 ECHO ST. ANCHORAGE, ALASKA 99516 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 19 of Heritage Heights S/D, located at 5970 Chisana Way. Soils logs, pere test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole #1. As can be seen from the soil log, the native material between 5 and 14 feet below ground level is a silty gravelly sand with a measured pert rate of less than lminute per inch. Scattered small seeps were encountered at the bottom of the SP/SM stratum; these were undoubtedly a residual effect of break-up and do not represent a groundwater table. The water level observed in the monitor tube after 7 days was at 15.3 feet below ground level. The primarily sandy nature of the proposed absorption stratum, in combination with the slowly permeable underlying silt, should eliminate the need for imported filter sand. Using a slightly conservative soil application rate of 1.0 gpd/sq, t~. (to compensate for lenses of less permeable material) this 4-bedroom residence requires a total absorption area of(4 x 150)/1 = 600 square feet. The proposed 60,foot long trench design with an effective gravel depth of 5 feet between 5.3 and 10.3 feet below ground level has a total absorption area of 600 square feet. The topography of the lot in the area of proposed construction slopes down towards the north at approximately 3 %. All lots in this subdivision are served by public water, so no well separation issues arise. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space-surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. LOT 12 LOT 11 CHISANA waY LOT 10 i/ ITM /~ WATER KEY BOX ............. ':~ ::":'" .........................9 ......%'~ ........................... ~ ~ , iCONOR~E~ 1 00 ::::::::::::::' ~ ~ o 8EPTIO, ~mNaS ,~ 5 -GALLON~ , ISEEP PIT I ~ ~l 8 AR~ ~ .... ~ ....... I ~8EPTIO TANK~ ', /~ ~ OONST~UOT ~O-FO~ LONG ,u.,, //~ BELOW HOR,Z. D,ST. P,PE ...... j .... ...................................... LOT 23 SEPTIC, ~' AR '~ i~i LOT 21 i~i LOT 22 I I ~w~m~ ~% ~ YUKON ROAD ~,~ ... -._,~'~, ~ ~ TH~ODO.~ ~. ~.E ~ ~ ~'.~ .... .,.. ~'~. LOT 19, HERITAGE HEIGHTS SID SEPTIC SYSTEM UPGRADE SITE PLAN FLATTOP TECHNICAL SERVICES 14530 ECttO STREET ANCHORAGE, ALASKA 99516 I INCH = 50 FEET DRAWN BY TFM JUNE, 2004 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. CONSTRUCT 60-FOOT LONG SOIL ABSORPTION TRENCH w. 5.0 FEET GRAVEL BELOW HORIZ. DIST. PIPE PLAN VIEW SCALE: 1" = t0' C.O. TO ORIG.  SEEP. PIT VALVE ; / FROM EXIST. SEPTIC TANK MONITOR TUBE  X~---ORIGINAL GROUND ' Fi, LTER FABRIC 1/2 - 2 1/2 SEWER GRAVEL BOTTOM OF EXCAVATION CROSS-SECTION "A" - "A" SCALE: 1" = 5' LOT 19, HERITAGE HEIGHTS S/D SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN 14530 ECHO STREET DRAWN BY: TFM ANCHORAGE, AK, 99516 JUNE, 2004 TEST HOLE FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION:__Lot 19_He_ritage Reig .hts_S!D DATE PERFORMED: May_28.2004 PERFORMED FOR: P.J._H_i!I DEPTH -- (feet) 1 Pt. SM Gravelly sandy loam GP Somewhat silty sandy gravel ML Gray silt SP/SM Brown silty gravelly sand Lenses of SP, SM & ML SLOPE 11 Depth to Groundwater Date Small seeps_@ 1__4' 5581_04 Water 15' - 3" b,g.I. 6/4/04 ~LOI Small seeps 17- ML Gray gravelly silt S.H. RINGS I t.".': ~ ~SEEP. PIT ~ I.H.~ Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) _55_8 12" Presoak 27-~-/2 12" Resoak 27 1/2 A~-d~t~-& start 10~ -9T3-5 23-3~8 ~1___ 10 F2-0~35 I 19-7i8 3_! 5/.2 Add water ~10!2~1- 2-3-378 ~2 1_0;-22 1 19~3/4 3-5/-8 Add_water 1_0:22:_25 23_3/_8 #_3 10;23 :_25 1 19_11~2 3-7~8 I i , PERCOLATION RATE <1 TEST RUN BETWEEN 6.5 (minutes/inch) PERC HOLE DIAMETER 5" FT AND 7.0 FT COMMENTS: Despite rapid~erc rate, in-situ sand and silt lenses should eliminate need for filter sand. Small water seeps encountered @ 14' are not grp_un_d_w_ate~b_ut_are residual snowmelt in process of being_a_bA0r_b~_d_b~_le_s.s_permeable underlyin_g._silt stratum.__ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~' f ~;~ / ~:~ ~ G~ttop Tec~n~alSerofi~es 14530 Bcho $treet, AncboroOe, AK 99516 Pl~one (907) 345-1355 Lot 19, Heritage Heights S/D 5970 Chisana Way Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of construction ora 60-foot long soil absorption trench with a total of 5.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tank may be retained in service, only if it's structural integrity has been verified by the inspecting engineer, and if it has functional cleanout pipes with airtight caps, allowing pumping access to each compartment. Any existing septic tank or seepage pit which is not retained in service must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. The double cleanout downstream of the septic tank shall be extended above ground and a "Bull Run" diversion valve installed to allow future reconnection to the original seepage pit as desired. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 60-foot long trench to a depth of 10.3 feet below original ground level in the approximate orientation shown on the site plan. The exact alignment shall be laid out to minimize disturbance to two large trees, one on either side of the trench. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 5.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 5.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the Soil cover thic 'kness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, !n addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A total of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. , , Municipality of Anchorage Page J of 7__ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: --~/ q~2~(~:)~c)/c~ PID Number: O1~ - ~ ~1 4~ Name: ~ ILL. ~~1~ ~ Wastewater System: ~ New ~ Upgrade Address: ABSORPTION FIELD Phone: No. of B~rooms: ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other LE GAL D ESCR I PTI O N so,~ Rating: Total Depth from original grade: GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe Range:~ ~ S~ction: Township: ~ ~ ~ 1 ~ Fill added above original grade: Gravel length: Ft. Ft. WELL: ~ New ~ U pg rede Gravel depth: Number of lines: Distance between lines: Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. SQ. Ft. Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. Yield: GPM Pump Set at: Ft. Casing Height Above Ground:Ft. TAN K SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field S,ation Tank S .... Lines ~H~H TA~ t 5~ Well ~/~ Materia':~ ~ Number of Compa.ments:~ Surface LIFT STATION Water %~O ~ ~ Lot Size in gallons: Manufacturer: "Pump on" level at: "Pump off" level at: High water alarm at: Foundation CuKainDrain Pump Make & Model Electrical Inspections pedormed by: Remarks: BENCH MARK , Location and Description: ~ ~ ~ Assumed Elevation: 2nd Department of Health~ Huma~vices approval Reviewed and approved 72-013 (1/91) MOA 25 New 1500 Gal Septic lank O0 Old Tank Crushed and Burrled FDUNI~A TI£N CLEAN I]UT 1500 STEEL SEPTIC TANK TNSBEN SPURKLAND P.E. 203 W 15TH. AVENUE ANCH, AK, 99501 LOT 19 HERRITAGE HEIGHTS Pi. HILL, 5970 CHISANA SFPTIC SYSTEM A$]3UILT DATE, MARCH lg 1993 SHEET, £/£ GRID, £438 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920296 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:HILL PERSHING J & OWNER ADDRESS:5970 CHISANA WAY~ y~&f/~5 ANCHORAGE, ALASKA 99516 DATE ISSUED: 9/18/92 EXPIRATION DATE: 9/18/93 PARCEL ID:01536141 LEGAL DESCRIPTION: HERITAGE HEIGHTS LT 19 LOT SIZE: 19213 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~--~. ~ DATE: DATE' 205 ~ i5~.h, b~i~l~ bit~ 206 ~'~ Aq'~ ~750! ANCHORAGE~ ~ ~o,,,~ ~0~) 2~9-59i6 SEPTIC SYSTEM DESIGN F'.J. HILL SEPTIC TANK ONLY 1250 GAL. MIN. 4 FEET CDVER CHECK C£NDIfIDN DF EXISTING LINE REPLACE IF NECESSARY 1£$0 STEEL SEPTIC TANK TBBBEN .PURKLAN9 P,E, 203 ~ 15TH, AVENUE ANCH, AK, 99501 SHEET, £/p GRID~ CHISANA WA Y N/A TE~ KEY JSZTX I I I I I I CONCeitq ~N~ I I REPLAC~ ]~150 GAL STEEL TANK O0 15 0 15 30 45 SCALE; I' = 30' LOT 19 HERRITAGE HEIGHTS SEC 14, lIEN, R3W P.J, HILL, ,5970 CHISANA 1 6O N 75 90 SEPTIC SYSTEM DESIGN DATE, SEPT, 15, 1998 ~EET, 1/3 GRID, 2458 ~,~.~]~ D p ' al Quality '~ 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE G~'~' FROM WELL INSIDE LENGTH MANUFACTURER ~--/'~'/~ ~[~- MATERIAL ~ /~ C& [ NUMBER OF / COMPARTMENTS INSIDE WIDTH LIQUID DEPTH ~ LIQUID CAPACITY / ~---'f'~ O GALLONS. SEEPAGE PIT: LINING MATERIAL ~ ~(-~1£~)~' CRIB SIZE: DIAMETER ~ / / ~/~'[ DEPTH (/~ DISTANCE FROM: WELL BUILDING FOUNDATION /~ ' )~ ' TOTAL EFFECTIVE ~,//4;C NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION TYPE _(~/'~//)~ CONSTRUCTION BU I LDI NG N EA REST FOUNDATION __ LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK __., SYSTEM REMARKS DISTANCES: INSTALLED BY; pi pE MAT E RiA L: d~. ~ f~..~.'',''-''? LOT SLOPE: REMARKS: Form No, FO-031 G.A.A.B. SEWAGE GREATE:R ANCHORAGE ARea BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99[[03 TELEPHONE 274-4561 DISPOSAL SYSTEM --- APPLICATION AND PEP. MIT PERMIT NO. INSTALLATION Of: SEPTIC TANK SEEPAGE PIT-- , DRAIN FIELD FINANCED THROUgh TO SE INSTALLED SY /L2~/-L? ~/~} I~ COMPLETION DATE ANTICIPATED ., OTHEr NOTE.- THIS PERMIT IS I~lOT VALID WITHOUT SOIL TEST 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 TAN SIZE MININIUI~ DISTANCES, REQUIREIViENT~ POUNDAT~ON TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT ~JL/ ., DRAIN FIELD SEPTIC TANK TO SEEPAge Pit WALL . /.7 SEPtiC TANK ~ ~i SEEPAGE PIt ~' , DRAIN FIELD . WELL TO SEPTIC TANK . ' SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK __ /~/ , SEEPAGE PIT DRAIN FIELD SEPTIC TANK, //~)~ ., SEEPAGE PIT /~)~ DRAIN PIELD TO RIVERi LAKE, STREAM. ~ IRON IN__TO AND OUT OF SEPTIC TANK AND INTO Crib CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURSED SOIL. 4 I~NCH.D[AMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH Airtight rEMOVABLE CAPS. GI'~AVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR With THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAiD CODE, 7 7 :'7/t.d.d,d ~ t DATE APPLICANT'S SIGNATURE R&M ENGI xiEERING & GEOLOGICAL CONSULTANTS 229 EAST 51st. AVE. - P.O. BOX 6087 - ANCHORAGE, ALASKA 99503 TELEPHONE 907--279-0483 TELEX 090-35419 Civil En§ineers Geologists Land Surveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P.E., L.S. JAMES H. WELLMAN, P.E. RALPH R. MIGLIACcIo' Engineering Geologist. September 10, 1973 Mr. Harry Foosness 1436 Matter Horn Place Anchorage, AK 99504 36662 RECEIVE]) SEP ?. 1973 (~I~A?~R ANCHOP. A~E A~ ~O~OuGH D~PT. OF ~NVIRONMENTAL QUALITy Re: TeSt Hole and Soil Log Report for Sanitary System, Lot 19, Heritage Heights Subdivision Dear Mr~ Foosness: We are submitting herewith the test boring'results and our' comments regarding soil conditions encountered at the subject site. This investigation was performed im accordance with your request of August 31, 1973, and those procedures outlined in a letter dated September 13, 1971 by Mr. Rolf Strickland of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 19 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extended to a total depth of 14 feet below ground sur- face. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered i~ the test hole~ We appreciate being given this opportunity to be of serviceto y°u. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M ENGINEERING & GEOLOGICAL CONSULTANTS James W. Rooney JWR:ph xc: GAAB~' ANCHORAGE FAIRBANKS JUNEAU NOTE: 1 9-4~73 Organics Silt, Trace Sand & Gravel (ML) Sand, Some Silt (SP) Silty sandy Gravel (GM) Sandy Gravel (SW) Silty Sand Trace Gravel (SM) No Water Table Test hole excavated with tractor-mounted backhoe. 3.0~ 5.0' 7.0' 13.0' 14.0 T.D. Engineering ~ Geological Consultants ANCHO~AGI~ FAIRffilANKS ALASKA UUNZAU f~RRY F00SNESS CONTRACTOR LOG OF TEST HOLE Anchorage Alaska m~rE: 9-4-73 IS°A'~ ~" =2' Iow. sY JS Ic'~o"Y W~ I.~o~. ~o. ~? Io~. "°.'A-01 MuniciPality of Anchorage Development Services'Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O..B0x 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ,; GENERAL INFORMATION Complete legal description Location (site address or directions) Expiration Date: 5'9 '70 C~,sct~ I.~.e, ~, Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent P,,.7. I-I;/I //1"~,~, Ho~,,~,.~ Dayphone M,,',r'/'~.~ ,~ ~ /vo,-v/~v'~up~' Day phone '~. 3'3'$3 l>enol; £l~ .Cc,,,% i~.p., ,4,,¢4., 4-~ ')ex-o? . ~'~ ~, Day phone Mailing Address Unless othervvise requested, HAA will be held by DSD for pickup. ..,, NUMBER OF BEDROOMS: TYPE OFWATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding tank [] [] Community On-site [] [] 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 sample results. (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. e o 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 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 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 Address I 5/.¢'.3'~ ~'c~o ..C~..,, Engineer's Prin[ed Name. -'/"'~ DSD SIGNATURE' . I/"'~.., App,rgved..for !~.. bedrooms. , Disapproved. . Conditional approval for. Phone 3' ~V,5"--; 3..~_~-- ...Date, 0%,,,¢ '~3':- Zoo~ 'bedrooms, with the following stipulations: Additional Cotnments Attachments: HAA Checklist Septic System AdvisOry ~ Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report, Other Original Certificate Date: ~ '-',~. (~ -/'~/../L (Rev. 01/02) Municipality of Anchorage 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 CHECKLI.,ST WELL'SATA'-- ~rU.~ ~4./~ ' f IfA, B,-or C provide PWSID # Sanitary seal (Y/N) Cased to ft. FROM WELL LOG g.p.m. o t~--'3o"7- W Well Log (,Y/N) Wires properly protected (Y/N) Casing height (a~ ye ground) AT INSPECTION ft. g.p.m. Well typ,e, I, '; Date co,m, pleted /oral depth t .. ft. Date of test. I,.., Static:~at~ ievel - .i!l . 'i: ' We,, WAIER SAMPLE RESULT. S: Coliform' ~.- colonies/lO0 mi. Arsenic:t: 1, ~ rog.II. SEPTIC/HOLDING TANK DATA Nitrate ', ~...mg./I... Date ofsample: · · :· · colonies/1 in. Date orpump!ng ~'/-~ y' .~/0.~ Pumper ,~q + ~le,~, ,('er, "' .- ~,,.~., . ~t ABSORPTION FIELD DATA " Date installed '~ l'~ ~ ~So rating (g.p.dJ~ °rft~/bdrm)'l,~ Systemtype -:~ Length~ t ~. Width :' ~, ~ -ft. Gravel below pipe. :~. Total debt~ ~,~ ft. Eft. absorption area ¢'0 fl2 Monitoring tube ~ ; D~'~e~si~n 6v~:r field Date of adequacy test ~ A. Results (Pass/Fail) I~ ';; ~ ' For' ~ bedrooms Fluid d;pik ~h absorption field before test ~ i~. ' Water added~gal. ' '" ' ':'t,:, New depth~ m. ~lapsed.Time:' ~ min. Final fluid dept~ ~ in. Absorption r~te~ ,= ' ~ oo ' g.p.d. Any rejO~'n~{ion~t ,} treatment (past .12 moo (YIN &type) ~ ~ Ii'y, .~,, give date Tank T~,~/l~'tei'ial Tank sing Foundatioh ~lsanout (YIN) Cleanouts (Y/N) ~ High water a arm (Y/N) Other bacteria' Collected by;!; .... '. Date installed ; lO / D0 mi. D. LIFT STATION Ee Fe Date installed "Pump on" level at ~ in. .Datum SEPARATION DISTANCES Size in gallons "Pump off" level at Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: S~'lStic tanl~lift'st~tion On lot Absorption field on lot Public sewer main . ~ Sewer/septic service line Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? >'." Oh ~ljacent lots ' ' ~' ~ " On adjacent lots Public sewer manhole/cleanoui Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main "~ Wells on adjacent lots. sEpARATION DISTANCE FROM ABSORPTION FIELD ON 'LOT TO: :: Property line Properly line ,,5'0' Water service line "~ to ' .' AbsorptiOn field Surface water Building foundation '3'.3' ' Water main Water Service line ~, (o ~ ' Surface water '~ ¢oo ' Driveway, parking/vehicle storage '~ Curtain drain ~Jo~ ,.~'~ i Wells On adjacent lots '~, Z. oo, i :.. !t,~: COMMENTS ...... ~ ' ' ' ' :~ ENGINEER'S CE~RTIFICATION I cerlffy thai;!'have determined through field it~pections and review o~ Municipal records that the above ~ystems are in conforman6e ~with MOA HAA giJid~lines in'effeCt 'oh th[~ d'ate. Engineer's ~srinted Name HAAFee, $ ,,,iii~i/2O o~,, Date of Payment Receipt Numb~i· ~"_L~7 ~. (Rev. 12/01) , {' :' !, Waiver..Fee $ Date of Payment Receipt Number 05/23/2004 15:86 2728738 HILDONEN P/~GE 01 ( , FK,G i,I E ~1 i/ , . -' . , ~) 0 · *~, Wo~, ~ ......... .. .... '" ~:1'~/ '""  ASE~6~NT$ OF :~CORD, OTH~ THAN ''.' THOSE $t~C~'/~J ON THE R;:.CO~DED "' F~T, ARE NO[ SHOWN HEREON. No ~ ~ ~h~ Der. .? ~, ' J MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # (~ / ~"- ,~/ ¢/ HAA# 1. GENERAL INFORMATION (Must be completed prior to submittal) ' (a) Legal Description (include lOt, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address Telephone: (home) Business (c) Lending Institution ~--L,b~ ~ Telephone Mailing Address ~ _oJ,.~_~ i (d) Real Estate Company and Agent ~L~~ ~ Address Telephone (e) Mail the HAA to the following address: (or check here}~r~f hold for pick up.) List contact person and day phone number below: Singie-Family/~, Number of bedrooms 3. WATER SUPPLY Individual Well ~ Community [] Public~" Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site~%. Public [] Community [] Holding Tank [] . Note:/ -/'f community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page I of 2 5. 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 w~3~stewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in,e'ff, ect on the date of this inspection. Name of Firm Address Date 6. DHHS APPROVAL Approved for Approved ~' Disapproved Terms of Conditional Approval · bedrooms by ~~ ~',~' ~ Date Conditional ~:11i Il[el [ The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 A. WELL DATA Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground ~ Electrical Wiring in 'Conduit (Y/N) :' SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments · Legal Description: Date Completed · Depth of Grouting ENVIRONMENTAL SERVICES DiViSION 0C? ,- 5 1988 IfA, B, C, D.E.C. Approved (Y/N) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression'Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots TO Nearest Public Sewer Cleanout/Manhole ; Date SEPTIC/HOLDING TANK DATA Installed~e.f~' J~?-~ Size Date Standpipes (Y/N) ~ Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) lP. 50 No. of Compartments O Air.tight Caps (Y/N) Foundati?leanout (Y/N) .Y' ~ Date Last Pumped e/z-E/o'~-~ ~/A ; f o r ~/A Temporary Holding Tank Permit (y/N) To Water-Supply Well To Property Line ' To Water Main/Service Line r To Stream. Pond, Lake 0r fl/lajor Drainage Course SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Bud ng Foundgti0n To Disposal Field Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in AbsorptiOn Strata Date Installed Width of Field Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: Type of System Design ~' ~--/~:, Length of Field ~ Depth of Field /( Gravel Bed Thickness ~' / Statndpipes Present (Y/N) "~- -~ Date of Last Adequacy Test ~//~-~/d To Water-Supply Well To Building Foundation ~ ~ Lot """//~ To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area .,~ 2.(,¢~0 To Property Line _~ To Existing or Abandoned System on ; On Adjoining Lots j~ ,~' 1) ~/['~ To Cutback (if present) Comments D. LIFT STATION ~J~ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) __ Pumping Cycles during Adequacy Test. **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 Signed CompanyDate MOA No. Receipt No. (~-¢ "g~,¢O'2/ ¢ Date of Payment Amount: $ /" ~)- ~)~.--~ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 Engineer's Seal DATE RECEIVED ; INSPECTION APPOINTMENTS ~IME TIME TIME~ DATE ~ ~.ATE DATE INSPECTOF~ , ,NSPECTOR SPECTOR ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 LStreet-Anchorage, Alaska99501 MAR 3 1981 ENVIRONMENTALSANITATIONDIVISION RECEIVED Telephone 264-4720 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 for processing, 1. PROPERTYOW~ER I PHONE MAILING ADDRESS PROPERTY RESIDENT'(If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. ~.ENDINGINSTITUTION I PHONE MAILING ADDRESS 4. REALTOR/AGENT ' - PHONE MAILING ADleR ESS ~ LEGAL DESCRIPTION ;TREET LOCATION ~. ~ ~~ TYPE OF RESmENCE ~ ~ One ~ Four 6LE FAMILY ~ Two ~ive ~ MULTIPLE FAMILY ~ Three ~ Six [] Other 7. WATER SUPPLY r~ INDIVIDUAL~ pOMMUNITY UBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [~i'N DIVI DUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY BI ONE EZ] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER E]Septic. Tap~k or [] Holding Tank Size: /'~} ~,~,) If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ~O Area ~ Lot Line 4. DISTANCESwELL TO: Septic/Holding Tank IAbsorption Sewer Line Nearest I Absorption Area to nearest Lot Line 5. COMMENTS [~/'~PPROV ED FOR ~I~., BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY z" 72-010 (Rev, 6/79)  825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION APR 9 '.c)79 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND ~A~I~ES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1, PROPERTY OWNER PHQNE MAI L~NG ADDRES~ 1 2. BUYER PHONE MAILING ADDRESS 3, ~ENDING INSTITUTION PHONE MAILING ADDRESS / V 4. REALTOR/AGENT ¢ m PHONE MAILING ADDRESS / - / '~ 5, LEGAL DESCRIPTION 6. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDRO~;;~S----~.~-~-~ [] One [] [] Two [] Three L%I Six Other 7, WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM .'?ff~ INDIVIDUAL/OS-SITE*~ [] PUBLIC UTILITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1, TYPE OF RESIDENCE NUMBER OF: BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER L~Septic.~Tank% ,')'~ or []Holding Tank Size: (' c--z~~'' __ If Tank is homemade SOILS RATING TYPE OF TANK MANUFACTURER /~.,., ~ 4. DISTANCES Septic/Holding Tank Absor0ti~'nrArea Sewer Line ~ I Nearest Lot Lina WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS [g~/CAPpROV ED FOR ,~.~ ¢-""- BEDROOMS [] CONDITIONAL APPROVAL (letter must ac¢4pany certificate) LEGAL DESCRIPTION 72-010 (Rev. 3/78) Tobben Spurkland P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 SEWER S YST[~4 ffDEQUACY T~$T Lot 19, Heritage Height Subdivision 5970 Chisana Way Anchorage, Alaska Performed for: Dale Hopkins Dynamic Realty 501W Northern Lights Anchorage, ~Qaska 99503 Building Bedrooms Baths Lot Size Sewer System Last Pumped Water System Two story, finished Five 19000 feet Septic tank and drainfield, installed 1974 May 7, 1979 CAU Date of test Performed by Result Methode used May 5 and May 6, 1979 ToSpurkla~d System is adequate Residence has been vacant since January 1979, therefor 1000 gsllons of water was introduced into the system on May 5. No backup or other dis~ess was observed. On May 6 an additional 1000 gallons was introduced with no sign of stress. The water level in the septic tank was static all through the test. '' uYG© /'~GREAT %~~ ~3~'C" Street. Anchorage, Alaska 99503 274-456] .. ,'-1 .... . . ~ 1. ; /].~ 1.-4,,.~.i' / REQUEST FOR APPROVAL OF ' ' ~ //. '¢ x,--~.~-~'~ INDIVIDUAL SEWER & WATER FACILITIES // ' ' " ~ x" ,/~' ~ ~ FOR 1.Approval requested by: Mailing Address: 2. Property Owner: o 4. 5. 6. Date Received Time of Inspection 0...~?.o , Date of Inspection (,~ ] h~ Phone: Mailing Address: Legal Description: No. of bedrooms Location: B. Depth D. Bacterial Analysis Type of facility to be inspected Well Data: A. Type O,4,(J. Od8¢¢x-~,-- C. Construction //~4~¢ o Sewage Disposal System: A. Installed ¢//~/~ C. Septic Tank: D. Seepage Pit: E. Disposal Field: B. Installer '7(; :, ~., .' /~ Size /2 ~: 5i~A{J~, 2. Manufacturer Absorption Area 6&o ~' ~ 2. Material iotal length of lines Distances: A. Well to: Septic tank , Absorption area , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page~2 of two pages - Req~est for Approval of Individual ~_.,~er & Water Facilities Legal Description Comments Approved ~/-~,~ ~,~c~-' Disapproved Date (~--m ~,~ .-?/ Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74)