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Home My WebLink AboutHERITAGE HILLS BLK 3 LT 4Heritage Hills Block 3 Lot 4 #015-221-14 / Municipality of Anchorage ° Development Services Department 5: Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 9951 M650 Page / of 1^ www ci.anchorage.ak.us (907) 3417904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5 t•+ 07 O vS' 3 PID Number: V_IT%Ci ia Wastewater System: ❑ New liq Upgrade G ikf T L4 Aaaasa t 2 2 N0 FF Y� ! f2 ABSORPTION FIELD Prang LJ i^ D lil W aBedpans L'D.ap Tnaxil t] $1WIow Tranrll O eea O Ma,w on,a LEGAL DESCRIPTION SW Raonp D• �o Tvai c"M Dan 1 ;�F� GPDIFt• Ft. 81p LaBWEmvan DWh b ppe Donau hen agmai Ptge C." apth D Mh ppe ,, /I dr., C M /. 5- Ft. 50 FI Tovmsmp Rage Seapn Fu aooeE above a9" 7aoa GravN Lrpih FI. Well: El New El Upgfa Gr" wain 2 Nvnxrardtnes Dnlara:e Mt~tii,iea .0 Ft. Ft Gasvhwtwn (Prnae. A B. C)iaN Deph Daseo to Tay ik,10 tmn arae Pipe Mrrnl Ft. FL 000 Fh 1 '•/vP) DnUW Dale DnliaG SWWale Laval anoint Dretnstrl ct N S /k o Ynio Pump Sat M Cunp "apm Above GraAq TANK GPM FI. Fl SEPARATION DISTANCES %septic []Holding ❑ S.T E.P. ❑ Other. To Septic Absorption Lrft Holding ubadPrivate dd1•r 'Y From Tank Field Station Tank Sewer Line v f� iv !0oa Gr Weil 1 06'4- wuI/- t44 SD IA M.larw 5 i--ce l Na a co-wments z swn wmw tod,I- re!%1F LIFT STATION La Uro ras Z S {-. / (%1 4. Gal KI,Xw fpuMYOn lot{- $Olf 'Pump an Wv r 'Pump oD' Iwa r High glia ram al n N n Cunrn prn r Perp Masa 6 Moo Enantsi InapaaxMa psnanro DY Remans BENCH MARK Locauon ano Deacnpem Pal.. cve's6ilt� cameo N atWi 00 Ft Inspections performed by: AI M7 n�/i. clnn. Dates: 1" S1'6f07 -('n. Eng Ca�St,��e ��`OF AN XI ,0.A�gs1! ••.•Ill Development Services Department Approval icy,•' + 49TH Conditional Approval Date: • . �• .... . .... MICHAEL N. ANDIRSON if��••••CE-9469 •• Ji Reviewed and approved by:o-4I Date: 0 �k\\PRCIfSS�1 = ass Permit No. SWO7O053 Page 2 of 2 Municipality of Anchorage 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 Legal Description: LOT 4, BLK 3 HERITAGE HILLS S/D PID No.: 015-221-14 MARK A 1 B GRND ELEV. PIPE ELEV. CO1 26 28 100.1 98.1 CO2 36 59I 102 98 TC01 39 63 102 TCO2 44 67.5 102 CO3 48 72 I 102.2 97.8 C04 49 72 102.2 97.8 C05 56 82 I 102.7 97.6 MT 57 81 102.7 CO6 71 57 1100.1 1 97.6 / I/ / i HOUSE C05 MT / MT� CO3 ° e Cil l A ICO � I /�—iC6T,J I I` HOUSE / GARAGE— — ®— — — I I C01471 — I I I I ' ��w lP`►I � � �' I 1U06 o TANK nLLED k ABANDO ED IN PLACE TEST HOLE RAD�US / CONCRETE S BENCH MARK \\ Imo' I ASBCIILT S/ I SCALE: 1"1:30' °, CO, <W .<°l r<.> <� „ w, ........ LH ru¢. rrxt • .nu ran to .J.. s_.._/ `0 •�tMICHAEL N. ANDER V�I -.o `" #No. CE 9469 #�♦ •., .+ SEPTIC seeraN MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 A ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 08, 2007 Expiration Date: May 07, 2008 Permit Number: SW070053 Parcel ID: 015-221-14 Legal Description: HERITAGE HILLS BLK 3 LT 4 Design Engineer: 0088 ANDERSON CONSTRUCTION & E Site Address: 012240 FREEDOM RD Owner Name: RICK JANDREAU Lot Size: 15000 SO. FT. Owner Address: 12240 FREEDOM ROAD Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516-2346 This permit is for the construction of: ❑V Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: / / �L Date: n Issued By. ("T Date: 5—/9/0-7 Municipality of Anchorage Development Services Department Building Safety Division j On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTICMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. l5 ' o"t I' I y Property owner(s) • 4ti "Iv n (i V -ea q Day phone Mailing address ZipCode Site address 1 �' 14D FI'rt.fAQ0r\ RD ____Zip Code CM 5 ((P Legal description (Sub'd, Block & Lot) Luh q Q I P- 3 It., 4,r 9, /If s /D Legal description (Township, Section & Range) Lot Size Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field 0 Septic Tank 91 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ W certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: zfg! o • iv Waiver Fees: Date of Payment: 26 /b 7 Date of Payment: Receipt Number: q riot! 12; Receipt Number: (Rev. 11/05) Michael N. Anderson, P.E. Civil/Structural Engineering 4640 Shoshoni Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 May 6, 2007 Municipality of Anchorage Department of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: Lot 4 Block 3 Heritage Hills Subd. To Whom it may concern: This is a request for an emergency septic replacement. The existing steel tank has collapsed and needs to be replaced quickly. The existing tank and leach field were within the 100 well radius, therefore the new system will be moved outside the well radius per current design standards. A test hole was excavated near the property line, the soils consisted of silty gravel for the full depth with no water, but after the 7 day monitoring the water had risen to 11 feet. The perc rate was 10 minutes. The new three bedroom system will be a 5 wide trench, with 4 feet of gravel for a total length of 56 feet. If the water raises more than 11 feet then the system will be revised to maintain the 4 foot separation. The slopes are all very flat 1 to 2 percent, sloping from the front of the lot to the back, east to west. No slopes greater than 25 percent exist within 200 feet of the site. This new system will not impact the neighboring properties due to the layout of the existing systems. If you have any question please call me at 345-3377 Sincerel Michael N. Anderson, P.E. -DESIGN CRITERIA: MOUND OVER (TH11) o GRADE 3 BDRM X 150 = 450 GPD ORGFILTER FABRIC SOILS = 450/0.8 = 563 GPD 4'P PIPE 563 GA/5 * 1/2 = 56' —30 SEWER ROCK H CM 7.0' DEEP WATER 0-11' —7.0- 7 O 4' EFFECTIVE s.o' 5.0' WIDE 56' LONG 16.01 1 LOT 7 I I LOT 6 FELL \ � \ I I •WELL I / LOT 8 ; \\ I I LOT 5 i VACANT LOT r � E A S T 1 3 1 S T AV E- �` EXISTINGOUSE PROPERTY LINE / c__ _LOT 9 VACANT LOT I 1 L _ ELI � , o o PROPOSED SEPTIC i SEMC TO EXISTING BE ABAN09NED I a EXISTINGW[LL/ • 100' RAg1US� ) : WELL ` LOT 10 / I I \` LOT 3 ' I LOT 11 i II i LOT 2- LOT 12 I I I I LOT 1 I I Septic Design Prepared For .�� ,,♦♦ RICHARD JANDREAU & HALEY ELLEN HERITAGE HILLS BLOCK 3 LOT 4 ,!�j. • ♦j� Anchorage, Alaska '�4. 9 TH ....�%. ..... .. ....... .....� Prepared By MICHAEL N. ANDERSON, P.E. �• .. •• ••••• • 'MICHAEL 4640 SHOSHONI DRIVE �� N. ANDERSON; '� (907) 345-3377 / FAX (907) 345-1391♦� No.0 69 ♦♦♦Z� ••• SCALE: 1"=100' MAY 2 2007 I I , EXISTING HOUSE I I , LOT 8 - i ----------------'- LOT 5 i i -� I ----�_______-_--"-- �� i EXISTING WELL I 100' RADIUS LOT 4 XEPTIC OPOSED NEW OTANCALK � 1-27. _ GARAGE LOT 9 I 1-2 r D 0 C.O. r. 0 1 r' \ 1 \ 1 \ 1 THp1 \\\\ I I I I I I I PROPOSED I C.O. EXISTING ABANDONED o DOUBLE C.0 EXISTING EPTIC TANK AND CRIB TO BE ABAND NED r \ __- G.O. 1 � 1-2z EXISTING 3 i BEDROOM HOUSE LOT 10 I I EXISTING WELL I aDGa&eDIUS�f� Septic Design Prepared For RICHARD JANDREAU & HALEY ELLEN HERITAGE HILLS BLOCK 3 LOT 4 Anchorage, Alaska Prepared By MICHAEL N. ANDERSON, P.E. 4640 SHOSHONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=20' MAY 2, 2007 DRNEWAY WELL I LOT 3 LINE 7 {� r 49 n, .rS IAEL N. No. CE Municipality of Anchorage Development Services Department Building Safety Division y,t On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 www cl anchoraae.ak.us (907)343-7904 Soils Log - Percolation Test Performed For: ��<� �on cL •ToL4 __CatePork Legal Description: 1_0+ Li (51k 3 �/•• {>rr ��5 Township, Range, Section: ygofs rZ 3- 5'C7 /Vf 6- 7- �r1TvC\ WAS GROUND WATER D ENCOUNTERED? Af 10- 1 IF YES, AT WHAT DEPTH! Depth to Water After e 1 11- Monitoring? 1 12- Dalc •� 7 /0 15- 16 17- rran C Reading * • 49TH Gross Time Net Tune Depth )o Water Y • MICHAEL N. ANDERSON ; 4 •• CE -9469 9f OT �w• •��ia •.•• 11 F�Prn...:��N1.�.�'�-.� rran C Reading Date Gross Time Net Tune Depth )o Water Net Drop 9f OT Try OTh g,r �+rS lr/ • o �.. 5-4 r•{ f G PERCOLATION RATE 10 Irwr<s5rca1 PERC HOLE DtAhIETER t10 1 TEST RUNBETWEEN A4 FT AND_FT COMMENTS Wn�Tr M^Uw 'itv rti • Lo 4- T to �. rf. — PERFORMED BY: 1`41 F ( am 1 r, •un I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: dyr t/ /e a Elea" h and Environmental Proter ion Fourth Floor Vilest -, 825 L Street Anchorage, Alaska. 99501 279--2511, x 2.24, 225 INSPECTION REPORT Ori -SIVE SEWAGE DISPOSAL SY-5-TKi --- NAME__ _ � /—K ----- MAILING ADURLS. _ �_ i'_l2 _. j.(�9 �_%__ PHONE LOCATIONFtZ P -A te ----- LEGA(_ 1)ESC11IPT10N SEPTIC TANK: DISTANCE e(9 ; ! ) NUMBER OF FROM WELLJ%JS.L6V` Py�-�"I��ANUF ACIURER _�L� +f"00 If i21A1_ NUMBER OF ® '160e) INSIDE ______. INSIDE WIDTI-1 sem- t_10011) DEPTH LIOUID CAPACITY .-_------ GALLONS. Y �P_ TQ •e� TOTAL LENGTH /__NIEAREST LOT LINE _ _. _--__OF LINE / DISTANCE FROM WELL ._L��_-FOUNDATION_-'�'�__---------- # of Lines ____1_ -__-DISTANCE BETWEEN LINES ___ V __-TRENCH WIDTH -at -0-61N. TOTAL EFFECTIVE:-: ABSORPTION AREA -- �SO. FT. LENGTH OF EACH LINE _. _---�--------------- e DEPTH OfFILTER / DEPTH: TOP OF TILE TO FINISH GRADE -_� _- MATERIAL BENEATH TILE ----IN. ABOVE TILE SEEPAGE PIT: DIAMETER ---OR WIDTH----., LENG i -H____, DEPTH Log Crib _Rings_ Crib Size: DIAMEFER__._DEPTFi__�_DISTANCE FROM: - TOTAL EFFECTIVE BUILDING FOUNDATION__, NEAREST LO LINE ABSORPTION AREA (WALL AREA; _ \Lx well `) Class: Depth: (well Distance To: Lot Line Bldg: Sewer Line: 1 I Pipe Materials: 30 # of Bedrooms: Installer: Remarks:, 0 � I I . I I 1 1 1 1 I I I I DATL-:C�tc/�'ZZAPPROVED WELL FT. TYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER 8F BEDROOMS SOIL RATING (SQ FT/BR)= 0 THE REQUIRED f)25 '\ STREET/ ANCHORAGE, HK. SYSTEM IS: FT-_ I=. "r -_11_ A 279-2511 �� P.-� �� ~— 1: Nit PERMIT NO. �P�LICHNT SRH BX. 1599~p ]44-9802 J. "/ u�/L� LOCATION FREEDOM RD. HILLS LOT SIZE 1]00 SQUHRE FEET LEGAL LT. 4BK.] HERITAGE TYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER 8F BEDROOMS SOIL RATING (SQ FT/BR)= 0 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS: FT-_ I=. "r -_11_ A ��p-.B j-3 �� E.UEU�h-U-9 =" «S THE LENGTH DIMENSION IS THE LFEET'.)TH (IN FEET'.) OF THE TRENCH OR DRHlNFIELD. THE DEPTH QF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). �K�� I�PA � H PACKBEAGE PLANT MAY BINSTALLED 'AT THE PERMITTEE -"S OPTION SUBJECT TO THE ' FOLLOWING CONDITIONS: ` 1. EITHER H CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. | 2. H CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE � AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL � ABSORPTION SYSTEM HND/OR YOU MAY BE SUBJECT TO PROSECUTION. �� ' BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. DISPOSHL SYSTEM MINIMUM DISTANCE BETWEEN WELL AND ANY ON-SITE SEWAGE IS 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL OTHER REQUIREMENTS MAY HPPLY� SPECIFICHTIONS AND CONSTRUCTION DIHGRHMS HRE AVAILABLE TO INSURE PROPER INSTALLATION. ��I 'T- FEE." F- Fe F__ �� I CERTIFY THAT I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WB -LS HS FORTH BY THE MUNICIPALITY OF ANCHORAGE. ' 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]` I UNDERSTAND THAT THE 8N -SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT RESIDENCE UDE MORE 'THAN ] BEDROOMS. IS SIQNED: 2� � ISSUED BY - ,& SEI IF THE i�ATER .ANCHORAGE AREA. BOROU,� / DEPAP,TMENT OF ENVIRONMENTAL QUALIT`! .-; 3500 TUDOR ROAD ,a ANCHORAGE, ALASKA 99502 CASE # Performed For Ila f'g/C [,)oe— Date Performed Legal 0escrintion: Lot _B1ockSubdivision �r This Form Renorts Soils Log X Percol tion Test_ _ Denth Gross Time I Net Time Depth to H2O Net Dron I Feet Soil Characteristics I T i I _ Percolation Rate Minute IS- ,M ., S „ 5 VA. (, E I 1 7 i I 9 — ' I I 10 i i I jjf i Was Ground Water Encountered?A _ If Yes, At what Depth? � Reading Date Gross Time I Net Time Depth to H2O Net Dron I I T i I _ Percolation Rate Minute Proposed Installation: Depth of Inlet _ CnN!MENTS :�eep_T — E1al — z14D it -f> 0 �L 5: S O.f Test Performed By jp 'rP7 ' 1>Itsr7�; S-Zoa l -Sawe, Seepage Pit Drain Field Deoth-To Bottom Of Pit Or Trench rack— iX�( Taal > se G�l7KiP4 s<T• �„� >Ua�ioc��4" /eir� 7�t o f %r`Pu �. jwyup� Data Certified By: J Date: .�-�. GREX ,R ANCHORAGE ARA IJUK(. UH Department of Environmental Quality 1IVV�� 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME f%C" MAILING ADDRESS PO, l_'e)X PHONE LOCATION 1 Ree;/h » k i1 f1f=!' 1 i(,U(-/i113// LEGAL DESCRIPTION t'! heti j i��r`i7ltr /� 1._I_ti SEPTIC TANK: DISTANCE/� NUMBER OF FROM WELL Of MANUFACTURER SILLC.IC .Siee'l MATERIAL -S 10C-k,C1��j /(c'I/�>-COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER --OR WIDTH —15, LENGTH'; 1 DEPTH Ci LINING MATERIAL �� gT/' ti�CRIB SIZE: DIAMETER _DEPTH DISTANCE FROM: WELL 1hr�Y/� TOTAL EFFECTIVE BUILDING FOUNDATION 0_�, NEAREST LOT LINE 1% ABSORPTION AREA (WALL AREA) L �_3 SQ. FT. ADDITIONAL ABSORPTION WELL: pkctbs=D TYPE BUILDING FOUNDATION _CONSTRUCTION NEAREST LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: PIPE MATERIAL: au �lG1TfJI✓ LOT SLOPE: REMARKS:g1z�an Form PW -026 NEAREST SEWER LINE REMARKS ! 6 DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM DIAGRAM OF SYSTEM 1A/ 32 16 A PLY z, ,.;, r ,I �;� 15 P , it I �Pla,hti�a 3 Yk'cl�czvn DATE APPROVED &�• 1 ' G.A.A.�B\ NAME OF APPLICANT GRE` --'..!ER ANCHORAGE AREA Bo1,,�,jUGH DEPARTMENT OF ENVIRONMENTAL QUALITY f 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE. ALASKA 99502 TELEPHONE 279.8686 INSTALLATION LOCATION SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT Na MAILING ADDRESS ! 'U'' ZZI LEGAL DESCRIPTION E- �j "" �/ `-� PERMIT NO. ---- t1f -5 5i - ONE /� INSTALLATION OF: SEPTIC TANK ` ` SEEE/y{Pp(fAGE PIT A DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE S RVED 5 IC,C `lr iull FINANCED THROUGH '� `� TO BE INSTALLED BY SOIL TEST TEST RESULTS� fob i `I NOTE: 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 HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT, �T`O PROSECUTION. SEPTIC TANK SIZE "` Q W TYPE SiYid- d- 0L0-(lIL(yfLSEEPAGE AREA SIZE - �' TYPE MINIMUM DISTANCES, REQUIREMENTS - .�I DIAGRAM OF SYSTEM CAST IRON I -G--AND OUT OF SEPTIC TANK AND INTO CRIB C EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATIO FOUNDATION TO SEPTIC TANK ORI7Y LICENSE SIGNER FOUNDATION TO SEEPAGE PIT DRAIN FIELD . 4 / SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PITO DRAIN F TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER A - WATER MAIN TO SEPTIC TANK "" SEEPAGE PIT _ DRAIN FIELD `�� / SEPTIC TANK, SEEPAGE PIT DRAIN F TO RIVER, LAKE, STREAM. CAST IRON I -G--AND OUT OF SEPTIC TANK AND INTO CRIB C EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATIO I CERTIFY THAT 1 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. DATE APPLICANT'S SIGNATURE v ,I HEALTH AU ORI7Y LICENSE SIGNER I CERTIFY THAT 1 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. DATE APPLICANT'S SIGNATURE v ,I 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 l.D. # tri t �- -1'-� HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) 6:of `l (3(ock 3 R -oro E fi4l(1 SID Location (address or directions) 12 Z y0 Jcr ceo'n !'� ,fro(. � (b) Property owner � FC /0 13�a(1( Cfr Telephone: (home) � Business () p Mailing Address (c) Lending Institution N Telephone Mailing Address (d) Real Estate Company and Agent (�X Ctnkl. I76ccuf u�lron Address a °(00 f}ar A?- 13o(.0/}nGharoq{ d 9%SG7 Telephone 3 iyi1— oSD / (e) Mail the HAA to the following address: (or check here 64, if hold for pick up.) List contact person and day phone number below: eoC mevore 3 ys- - CrT - 2. TYPE OF RESIDENCE Single -Family 9 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 9 Public ❑ Community ❑ Holding Tank ❑ Note: If 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 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm F'112* Techntca/ SQrvert& Telephone 3yS' 13SS' Address I yS30 �ctia S>� AncAon% Date Feb 28 1989 aE- tda��u•' tiie�ooC -4; s�are�{�o� ^ w{!/ on G. 3, I3.3 f�e�laJt /fil�f dF A4®Q®� ; 40 ® ..........................Engineer's Seal v �T�2O��RE MOORE j 0 _. cj CE - 3569 ��*.gam .....•• � �� 6. DHHS APPROVAL Approved for bedrooms by Date a✓" Approved - Disapproved Conditional /� � Terms of Conditional Approval � "a10 CAUTION 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) MUNI F ANCHORAMECKLIST - FEBRUARY 1984 - ENVIRONME N*MEL DIVISION 343-4744 Legal Description: 4ee/ FEB 2 8.1989 Oer,lowe- *1(i s /D A. WELL DATA RECEIVED Well Classification PrivotA4 If A, B, C, D.E.C. Approved (Y/N) ►��/� / Well LPresent (Y/N) `1 Date Completed 1 2 1e" sgrmc at -Sit. Total Depth ly' -A Cased to -_�, y0' Depth of Grouting Static Water Level Casing Height Above Ground I if Yield > 5•8 5yM r+�eas 2/9/89 Pump Set At > 200 ' Sanitary Seal on Casing (Y/N) ti Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) N SEPARATION DISTANCES FROM WELL To Septic/Holding Tank on Lot 82, ; On Adjoining Lots > too' r To Nearest Edge of Absorption Field on Lot (1& a' �� —;On Adjoining Lots To Nearest Public Sewer Line No A. To Nearest Public Sewer Cleanout/Manhole N•A To Nearest Sewer Service Line on Lot *> 25'' Water Sample Collected by% • r Ptv°re ; Date Water Sample Test Results 5a_ u�der'y 0 co /titm Itoo m-C�. a.466 any14 ndr4k - N Comments well - s4ei►e Prink separ4f•an d0gn<< of hme a -f 04%, Nxr� Duv-;ne well y„e/d � on 2/9/t37, SftudZaunit i y of lnax .WWW 094112"y 014 9'. B 7a,9 ir, naw tct' spa {i c cua ki heto1 / v6 Se amw� prawn 4 zeo' bvf no JQr It er B. SEPTIC/HOLDLNIG '7N1-- ZDATA `- Date Installed`e//x/77 Sizea1141 No. of Compartments 2 Standpipes (Y/N) 'r Air -tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) — Foundation Cleanout (Y/N) N 2 /9/999 6 Date Last Pumped � ; for /Y. A• Holding Tank High -Water Alarm (Y/N) AA Temporary Holding Tank Permit (Y/N) J* A. SEPARATION DISTANCES F , SEPTIC/HOLDING TANK: To Water -Supply Well b 2' To Building Foundation 17t To Property Line r0' To Disposal Field 171 To Water Main/Service Line > 2s To Stream, Pond, Lake or Major Drainage Course > f 00' Comments Well-seJ°f'0 14.nk rewaraf►o., .lct�an�e/19��e+f 0- V riginar-rr�S�i'�lGtl�'on� 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 2527 +7'1800"�n Type of System Design S0,0047A At w, 7'reoc6 Date Installed P14 81161> Zy ?ee VA B/ZY 77 Length of Field Pi+ l,, ' x'!B' x 6' ryrPc1,1/ Width of Field Depth of Field _P?1' h 60 ` 1& x 6" grov-e/ Gravel Bed Thickness 6 ' Square Feet of Absortion Area 73 (r I5'00 Statndpipes Present (Y/N) Y Depression over Field (Y/N) N Date of Last Adequacy Test Results of Last Adequacy Test AdeouaFe .%r 3 �PGt!ropdn! SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well 1001 To Building Foundation �6 Lot 1q, A. To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Property Line To Existing or Abandoned System on On Adjoining Lots 36 ' To Cutback (if present) N .4, To Driveway, Parking Area, or Vehicle Storage Area foe �p GaF3 drlv4 CommentsMyA+ am_rj? ,ecf6r's naFer 'MoNct, e -Y-rencA 99' 4�,yo+ lnsf 3 use// D. LIFT STATION N, h, 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) **Check Permitted Bedroom Rating Against HAA Request** "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. '�O A "1 -,-1� / w CM At 4 Signed Company Flafly® Te44A11;Ca ( Servteiy -Yt7 a e e ,k engineer's Seal Date Ftb 26 X989 � ,°°�°°°e°ceeo°°°°ae°ee ° K MOA No. 69eeeo�oe�6 a o° a.. ° IHEODORE F. ,;nooae e L 3 55 f. C 1 Receipt No. US __ �' ( c� Receipt No.tJ��^� �� Date of Payment cq- r Waiver Fee: $ Amount: $ V� t Date of Payment 72-026 (Rev. 7/68) Back Page 2 Of 2 Flattop TechnicaI Services 14530 Echo Street Anchorage, Alaska 99516 so) VACANT aT I PIT f , Z I W I 'ri D(3rviff ' TRE11 I LGT �l .11, 1� ®r R�s A*I �0 i�9TH Q09 9;.F.%..0090,0� b > 0.••.°. : L 0000400 .. THEODORE F. MOORE o a :S CE -3589 • ¢.4 so 4tkllProlesswo i\;0* 0 O t10T i 6�K 2 + 3 1sr AVE p srpnc l o W IXi L 07- JA 04k 1 i' HSE s 3W o f 0 LoT_3. 1 T31. k 3� _RrTelF� --s r N _- ScA� DA7-15 ; 2/23 189 pWN Q Y.' T�r-r IV OTE', Thu uti,lp Ct Survey Pot plat ct I i lova frons a �e aP�ro X�m a%e Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 March 6, 1989 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 4 Block 3 Heritage Hills S/D Waiver Request #WR890008, #HA890068 Dear Mr. Moore: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 99 feet from sewer system (trench) on Lot 4 Block 3 to the well on Lot 3 Block 3. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Robert W. Robinson Civil Engineer On-site Services RWR/ljw#6 It L 100 F �' in1=tee;-"(x�Fi tai„C!%f blots A ) �7 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION THEODORE F. MOORE, P.E. PH: (907) 345-1355 February 27, 1989 M.O.A. Dept. of Health and Human Services A.O. Bog 6-650 Anchorage, AK 99519 14530 ECHO ST. ANCHORAGE, ALASKA 99516 RE: Lot 4, Block 3, Heritage hills S/D - Separation distance waiver Dear Sirs: By means of this letter we wish to request a waiver down to 99 feet from the required 100 foot separation between the soil absorption trench on Lot 4, Block 3, Heritage Hills S/D and the well on Lot 3, Block 3. A site plan and copies of other relevant documents are enclosed to assist you in your review. The original septic system was installed in August, 1972, and consisted of a 1000 gallon, two compartment septic septic tank, followed by a 15 foot by 48 foot seepage pit with 6 feet of gravel dgp#..(i. This soil absorption system was upgraded in August, 1977 by the addition o a oot long soil absorption trench containing 6 feet of gravel. The well was also drilled in 1972, but after the septic system went in, so no separation distance was reported on the original as -built. At the time of the 1977 upgrade, the municipal inspector reported that the septic tank was located 99 feet from -the well however my measurements'in_February=of this year_indicate the separation to be approximately 82 feet. This distance was entirely legal at the time of installation, so I do not believe any waiver is necessary, but I did wish to set the record straight. The 1977 upgrade Municipal inspection report also notes that the trench is 100 feet from the well on the lot, which appears to be correct. However the ,inspector's notes made at the -time -of installation; indicate that °a portion- of -the trench comes within 99 feet of the well on Lot 3, Block 3.. This information does not appear on his approved inspection report, and there is no ready way to confirm it, as the standpipes are all more than 100 feet from that well. On my site plan I have drawn what appears to be the most logical configuration of the trench. No well log exists for the well on either Lot 3 or Lot 4, but other references in both files indicate identical de s -of. 2'14_f_ee). I was unable to contact the owner of Lot 3, regarding sampling his water, however I believe that the data I obtained from testing the well on Lot 4, located just 102 feet to the north, is representative of the well on Lot 3 also. Considering the extremely small deviation from standards being requested, I do not believe extensive efforts to contact the owner of Lot 3 are warrented. On February 9, I conducted a flow test of the well on Lot 4. The, initial- ._static water level was 197 feet below the top of the casing and steady pumping of over 500 gallons of water at the maximum pump output of 5.9 gpm caused the water level to be drawn_ down to 200 feet and no further. This level returned to it's original position within 10 minutes of cessation of pumping. These measurements demonstrate that there is approximately 185 vertical feet of -separation between the bottom of the wastewater disposal -system and the drinking water aquifer:: Water samples taken on February 9 were satisfactory, showing , -O coliform bacteria/ 100 ml., and 0,86 mg/_1 of''nitrate-N. Research in DHHS files reveals only one well log for a nearby lot - Lot 1, Block 2, Heritage Hills located a couple of hundred feet to the northeast. That well has a total depth of 220 feet, a static water level at 200 feet and a yield of 10 gpm, so I believe the log for this well is also representative of the wells on Lots 3 and 4, Block 3. The. log indicates two strata of grey clay, between ,65=feet and 132 feet, and between 195 -and -209 -feet in depth. These strata should; provide-exceliant protection from surface contamination. The soil log apparently for Lot 4, Block 3, Heritage Hills (although labeled Lot 3, Block 4 in your files) indicates the material in the soil absorption stratum to be silty sand with a rating of 250 square feet per bedroom, and no groundwater table was encountered. The silty sand material should provide excellant filtration of the septic tank effluent, as well as a slow downwards percolation rate. The topographyof-both lots is -generally level with no noticable slope towards or away from the well. Thus, there would be no reason to expect effluent from the trench would percolate, or flow on the surface, towards the well. Based on surficial evidence, I would expect the underlying aquifer to also, be reasonably level, and the direction of flow is presumably towards the west. Based on the foregoing evidence, it is my professional opinion that this extremely small waiver can be granted without concern as to public health. Please give me a call if you have any questions on this analysis. cc: AHFC c/o Paul Wilson, Realty Center Sincerely, Ted Moore, P.B. G. Rte ®� s;6�9 air G. r@ E ¢ TH a �mamm emm aememeaaee �sm0e eimee� ��aoea lse eom mV Smoeommee "S o0 HEOQQRE F. MOORE e`e 00 a° A; a+ APPLI( VT FILLS QUT UPPER HAS ONLY Time Properly Owner -G t7 /'\ �O�7N��S IS /� Phone Lf _ Mailing Address j -, 9Gf tb Zip Code 9( Date Date t9-7 --rlrJ- Buyer PC( 6CP Date /'' Address ' Rr--I- 0' Zip Code q'f�y, -07 Inspector Lending Institution - CZ, _ C,_-3 � Phone A�Idress L`/ ��C-[-o '".o__�C-4 14 o "Z& 4� Zip Code Field Notes: 1�0�""'"/_. R Ity Co. & Agent >�,/Ti%r� 1 ---�FjLV! (7i"ry / f oy-y-lf s Phone "7.ul,- -7 2 �J,,Z Zip Code 9 Address 0 1 e, Ivu, m F/Vr'� - �.. 'rS . �\/l �/ - l Legal Description Z o 4 61occ,k 3 �iy� � ��'f %�,S S1-bd, (J1 ( ) DISAPPROVED Street Location �j-{ r (Jw Type of Residence Single Family - ❑ Multiple Family No. of Bedrooms �`'�'�•�• I ❑ Other Water Supply XI Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available) f ❑ Public Utility Soils Rating Date Sewer Installed Sewer Disposal - / Individual Year Individual Installed: �+rr(- 29 7 ❑ Public Utility When Connected to Public Utility: - ❑ Holding Tank Well to Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE :PROCESSING CAN BE INITIATED. - - - Time Time Time Time Date Date t9-7 Date Date Inspector Inspector - Inspector Inspector Field Notes: ( '3) APPROVED BEDROOMS - 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' �`'�'�•�• I DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72023 (3182( ALASKA RUIROWnTAL COnTROL SCR US, InC. Engineering 6 6nuironmental Studies 7/22/82 JOE KURTAK SRA BOX 1699—P ACHORAGE AK 99507 SELLER — JOE KURTAK BUYER— SUBDIVISION—HERITAGE HILLS BLOCK -3 LOT -4 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH CRIB WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 700 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 11/14/81 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. 1220 West 25th Auenue • Anchorage, Alaska 99503 • (907) 276-1361 Ingrid Donnerstag SRP, Box 1699P Anchorage, AK 99507 :subject: Lot 4 Block 3 July 15, 1981- Heritage ?8? heritage bills Subd. Approval for the individual sewer and water facilities cannot be granteri until the following items have been completed: Expose -_d electrical wires to the well head are in violation or the Municipality of Anchorage codes and must, be encased in conduit. 1� The water analysis report needs to be submitted to this Office from the Chem Lab, 5633 R Street, for our review. ° An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A. listing of private firms performing the test is enclosed. This report need: to be submitted to this office for our. reaview. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, plea<3e call tp�is office at 264-4720. sincerely, Robert C. Pratt Associate Environmental Specialist RP167/p/EF? 's Enclosure 1 INSPECTION APPOINTMENTS DATE RECEIVED C v TIME TIME TIME DATE - ATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF 1T -ALT[ I & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT ONMENT;L -� :.AECTION 825 L Street - Anchorage, Alaska 99501 21• 80 ENVIRONMENTAL SANITATION DIVISION �'' 19 Telephone 264.4720 RR !! vv REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE9��I1NI DIRECTIONS: Complete all parts on page 1. Incomplete requests will not he processed. Please allow ten (10) days for processing. 1. PROPERT OWN R - IONE -•G� MAILING ADDRESS I I5 0 7 PROPERTY RESIDENT (If differen% from above) / PHONE ��- /V /V FI- P' d 6 �° 2. BUYER , l W G {- i J fio/V/v Pt Sf ce 10 (e PHONE MAILING ADDRESS - 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT n PHONE MAI LI NGADDRESS 5. LEGAL LEGAL DESCRIPTIONS mar STREETV N /v /r1 P d %i�j 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other Jam. 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 - C- INDIVIDUAL/ON-SITE** / ! f 7 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),1 THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE LJ SINGLE FAMILY ❑ MULTIPLE FAMILY NU BER OF BEDROOMS ❑ ONE THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEW GE DISPOSAL SYSTEM L�'TNDIVIDUAL/ON -SITE ❑PUBLIC UTILITY V-erified PERMIT NUMBER DATE INSTALLED INSTALLER —Connection SeptC� is Tank or ❑ Holding Tank Size: 00-0 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 6. COMMENTS APPROVED FOR_ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE l-7 1 BY /, � 4"� _q v 72-010 (Rev. 6/79) June 5, 1980 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR !1LPAR TPdENT OF HF,ALTH AND ENVIRONMENTAL PROTECTION Charles Teague Star Route A Box 1699P Anchorage, Alaska 99507 Subject: Lot 4 Block 3 heritage Hills Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: V // (1) The water analysis report be delivered to this department from Chem Lab, 5633 B Street, for our review. (2) The septic tank pumped with a receipt submitted to is department. (3) n adequacy test be performed on the )listing le h'ng area. This t t will deter /-!'"s s . adequateQef di g to io tandare� lis ing of privarm erfor,i the test is11 e closed. This repeeds to submitted to this department for our review. If there are any further questions, please call this office at 264-472 . Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/ljw _ L 1EPARTMEN-1 F HEALTH AND ENVIRONMENTAI, ,,DR0_rEC_(I0N z 825 Al e Aka reef, -)Cho- las99501 279-21711, ext, or 225 Da-&,' Relceivcd: August 8, 1977 --- --------- 41: T _Jm e 9:30 a.m. #2-. Time_3 T J', n ie _4 Date 8-10-77 Wednesday Date - Date tLL Insp Insp Insp , 142 R11, -QUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACIL" 1. Lending Institution Request: Alaska Mutual Savings Bank % Sheryl Mailing Address. Post Office Box 1120 99510 Phone: 274-3561 2. Property Owner: Raymond and Dona Pinex Phone: 344-9802 Mailing Address: Star Route A Box 1599-P 99507 3, ',',egal Description: Lot -4 Block 3 Heritage Hills Subdivision 4: Single Family Res-idence: (x) Number of BedroomsThree - Itiple Family Residence: Number of Bedrooms: Well System: Individual Well (x) community/Publi-c System Permit II Depth of Well Well Log on -File I Construction Bacterial Analysis 6. Sewage Disposal System: On-site System (x) Public Utility --�Crmit Installer IL j1w_' installed Septic Tank Size _jCZjj-urer _&)DJ�L Manuf act Absorption Area Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Neare-t Lot Line MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV� 2. Property Owner: " Mailing Address: o Day Phone:�- 3. Name of Buyer: Mailing Address: _'�Z, x z g�/ —�/ Day Phone:— dyn `SJ 4. Name of Lending Institution: Mailing Address 5. Name of Realtor or Agent: Phone: Mailing Address'Z Zd W,,,, Phone: �'79 6. Legal Descriptions Location: 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply No. Bdrms. Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Util If Individual, date of installation 72-003(3/76) Individual (on-site),--' Pa o Department of Health and Environmental Protection Request for, Approval of Individual Sew --r and Water Facilities Legal Descri-ption'. Lot 4 Block 3 Heritage Hills Subdivision Comments: Affadavit Attached, ( 'I Approved. Disapproved: LT -ched: Letter At,' - a Date. Date Department Worksheet: �T j6 dff 1/0 d' -j 10 C C' 7-j j ot% = P I �� '4Y � a 1 60 1- c CLM Ll P Rc JA CD , C413 C c� -T aco �.J �L, �1- �. �,.d � August 23, 1977 Alaska Mutual Savings Bank s Sher** post office Box 1120 Anchorage, Alaska 99510 Subject: Lot 4 Block 3 heritage dills subdivision According to the recent pore test conducted by this department on August 18, 1977, the existing sewer disgsosal system serving the subject property is inadequate for a three(3) bedroom residence and must be upgraded before final approval can be granted. However, this department will grant a temporary approval if funds are escs:owed for the upgrade and additional funds set aside for interim pumping if needed.. A completion date of the 1977 construction season is required. Specifications for the: upgrade are as follows; Total depth 11 feet Total length €2 feet Gravel depth 6 feet A'permit to upgrade is required prior to construction - en August 23, 1977, a permit was applied for for the above property and scheduled for inspection on August. 24, 1977. if there are any further questions, please contact this office at 279--2511, extenkion 224 or 225. ,Sinceirely, Jahn Kennedy Pri4pipa1 Code L nforcement officer i I �AEc 7 -11w 2370 I �.� Form Approved ., �.� U_ S. UE PARiNENT OF H.OJSIM^, AI:, URBAN OE�'E L.CPMEKT o.___.. IJ.. A7_R 099A �¢:. •� r .. FEDERAL H'._„iSIN•", AD�lWJISTP.AT�0:4- ' HEALTH AUTHORITY APPROVAL INDIVIDUAL `NATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.—TO BE COMPLETED BY!W" — -\J. P INSURING OFFICE MORTGAGEE SERIAL NO. f— MORTGAGOR OR SPONSOR PROPERTY ADDRESS i✓ n c>�_._ � � l �M ,� l SUIDIVI ION NAME - I ILOCK NO. j LOY NO. TOTAL NUMBER: tan attic al o01+ar arca ae madQ Into —{ SASEMENT I ,yl New installation i additional bedevomii? i VINO UNITS St02O0_1 t1I LATHS I /if YCS, haw many?) ElYes No ❑ Yes No WATER SUPPLY BY: SY:,Y2F.t Public system Community system ®Individual No OF SC2M5. DES4GNED 70_ B GASSAGF Ot5IO5A4 SWAG! DISPOSAL By, �—i Public system U Community system Individual ®Yes No I PART II. --TO RE COMPLETED BY H7ALTH DEPAPTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH it I e -44 -41 1 I _r t — 1 I Til Y I I I TT�.�.y� �! 1 I 1 1 1 j 1r fT I 1 It is the opinion of the❑State ❑ Counry ® Local Department of Health that this individual carer-supph system E3 is F-1 is not Satisfactory as a domestic water supply for the subi-ct property I It is the opinion of the El state ❑ County ® Local Department of Health that this individual sewage -disposal sys- tem with proper maintenance: M Can be expected to function satisfactorily, and Cannot be be ex,.eaed to function satisfactorily 1 is not likety to create an insanitary condition J —~ DATE SIGNATURE TITLE \ Environmental Control Offia 12-26-72 i �2�r✓wr �. - -� �_1 I GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279--685 Date Received/,-;) -"/',-) 7.1 Time of Insnection Date of Inspection REQUEST FOR APPROVAL OF INDIviDUAL SEINER & 'NATER FACILITIES �FJOR 1. Approval Requested By:�^� Address: 2. Property Owne > 3. Legal Description: /--� ._ , 4 Tocation: c��• cs �( Phone: Phone: � -ei 2. n 5. Type of Facility to be Inspect.ed:��t�v�2a Number of'Bedrooms: 6. dJell Data: A. Types (/j iCQLt} B. Depth_ C Construction it J- D. Bacterial Analysis / C r2 fiIe 7. Sewage Disoosal System: v A. Installed � II -J e — 7.2, B. C. Septic Tank: 1.. Size Q 0 CJ , 2 D. Seepage Pit: 1. SizeSLII, y 4, 2• Installer #. /= . d1) A ;--o Manufacturer Materials is .•J E. Disposal qField: Tota,�_Length of Lines X14 (-�Gio� 9, Distances: 2 j -Tb A. Well To: septic Tank G i Absorption Area /C+`%� Sewer Lines Nearest Lot Line Other Contamination B. Foundation to Septic Tank /0 Absorotion Area i C. Absorption Area to Nearest Lot Line 2 Cc zjuect:fgr'-Approval of individual Sewer & Water Facilities Page Two' , 9. Comments: Anoroved FJc,+/ '�Disa^proved gate Approval Valid for One Year From Date Slaned Greater Anchorage Area Borough, Department of Environffental Quality D?AGPAVI OF SYSTEM 2 certify that the information contained in this request for approval to be a true and accurate representation of the subiect sewer and water facilities located at: Signed Date