Loading...
HomeMy WebLinkAboutHERITAGE HILLS BLK 3 LT 11 Municipality of Anchorage Page 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: ~W' ~2,02-1¢'1 PIDNumber: ('~1~)~-!!, Name: ;I~'~."T~.. ~ ~2~ ~z~ Wastewater System: ~ New ~ Upgrade ABSORPTION FIELD Nc. of Bedrooms: ~DeepTrench ~ Shallow Trench ~Bed DMound ~Other LEGAL DESCRI PTI ON Soil Bating: ~, ~ GPD/Sq. Ft. Total Depth from~tForiginal grade: Lot: ~ Block: ~ ~[~1 t Subdivision: H~ ~ Depth 1o pipe bottom from~toriginalgrade:~ ~ Ft. Gravel depth be~a~h pipe Ft. Township: Range: Section: Fill added above original grade: Gravel length: WELL: ~&~&7l~ew D Upgrade Gravel width: Number of lines: Distance between lines: Pipe material: Classification (Private,~U~A,B,C): Total Depth: Ft. Cased To: Ft. Total absorption ar~ SQ. Ft. ~ Driller: Date Drilled: SlaticWater Level: Installer: / ~1~ Date installed: Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft.. SEPARATION DISTANCES ~s~.tic ~ Ho~di.~ TO Septic Absorption Lilt Holding ~ublic/Private Manufacturer: Capacity in gallons: From Tank Field Stalion Tank S .... Lines CH~T~ 7 wat~ 1Oo* f0o~ % LIF STATION Size in gallons: Man~r: ~ Line Lot ~" '0~ ' ,,Pump on,, level at: ~~water alarm at:~ - Foundation 8' Electrical lnspeclionspeffo~medby: ~ BENCH MARK Remarks: ~.~ ~S~s~ T~c~ Location and Description: ,ewtio.: Inspect,ons per,ormed by:17¢*,,,I,"1"r ~=~ ' '~ates: 1st -~ Department of Heal~ an~ Hpman Services approval '~¢'~ ' '"'~' Reviewed and approved by: Date: ~ -2d-72 ?' 72-013 (Rev. 9/91) MOA 25 Permit No. %~.,/u/~--(~,,'~l~ Page ~ of 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 LegalDescription: ~L~--~lq-fi~y-~- }-/l(x~ / ~.~'"r' ,//,, I~/.JC_7 PIDNo.: 3 72-013 A (2191) MOA 25 ~ Permit .o. ~ c~(~-I~ Page of 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 72-013 A (2/91) MOA 25 ~ 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 NUMBER:SW920214 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:MILAN ARTHUR & BRENDA D OWNER ADDRESS:12321 HERITAGE RD ANCHORAGE, AK 99516 PAGE 1 OF 1 PERMIT DATE ISSUED: 8/10/92 EXPIRATION DATE: 8/10/93 PARCEL ID:01522119 LEGAL DESCRIPTION: HERITAGE HILLS BLK 3 LT 11 LOT SIZE: 15000 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS~ PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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: VERIFY INTEGRITY OF EXISTING SEPTIC TANK. ABANDON SEEPAGEpIT PEP, AMC 15.65~.~ DATE: DATE: August 3, 1992 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Heritage Hills Subdivision, Block 3, Lot 11 Request you issue a permit to upgrade the septic system serving the referenced property. The existing system is in a state of failure. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, RJS/LSU/lsu 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 /"-- $0' SCALE UPGRADE ~, Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~:e~ NO, 8215 DATE PERFORMED: 1 2 3 4 5 6 7 8 9 10 11 12 13 14- 15- 16- 17- 18- 19- 20 CO M M ENTS '~_~4~'J~ Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? L IF YES, AT WHAT' O DEPTH? P E SITE PLAN A Depth t0 Waler Ai~ter . Monitorin,? ~'[::~;;~'~'"y Date: ~;::~-z~'-~"L" Gross Net Depth to Net Reading Date Time Time Water Drop ~ l~: ~ ., ~1~ '/~" ,. PERCOLATION RATE 7j'~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ '/~'- FT AND /~_~-.~FT PERFORMED BY: $ 8, S ENGINEERING I ~<.,_ \//__ ~'A /~ CERTIFY THAT THIS TEST WAS PERFORMED iN 17034 Eaele Rive. Loop Eoad No, 204 TH'~ A UIDELINES IN ACCORDANCE WITH ~[~a~j~F~e-~DAI~t~4C,~I~7~i EFFECT ON DATE. DATE: 72-008 (Rev. 4/85} "-,_~t MUNICIPALITY OF ANCHORAGE '~._~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchora9e, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS LEGAL DESCRIPTION Well Absorption area DISTANCE TO: Manufacturer Inside leng' DISTANCE Well Dwelling PHONE [] NEW Dwelling Material NO, ~EDROOMS PERMIT NO, I Liquid depth PERMIT NO. ~pac~ty_~rt~gallons J~-~ DISTANCE TO: Wel~. /" ~'~3 , Foundatio~,~ 20 ' PERMIT NO.oo~/¢ O0 ('¢ '7 Nearest lot lin~ Trench w, id~_,~'~ (~ inches Total length ;~li~0~s~ No. of lines Top of ti]e to finish grade Width Material beneath tile Length Depth Distance be~l~:~ lines Total effectiv~ absorption area PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Driller Depth Class Distance to lot line PERMIT NO, Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS SOl L TEST RATING INSTALLER REM APPROVED DATE LEGAL PERMIT NO. , r" " i'tUCC HPF L I ~,HH f' DAV I D Z ¢1C: LOCATION HEt.I FSGE TYPE OF SOIL ABSORPTION DEPARTMENT~.,.<r HEALTH AND EN~IRvNMENTAL~ ....... IE~,TI pit 02:5 'L,'" STREET, ~NUHORt~bE., ilK. ~:¢o0& ~ S45-2E94 LOT SIZE 20008 SQU~RE FEET MAXIMUM NUMBER OF :" ',RonM'- = 2;OIL. RATING (~;~ FT,,'BR>= 85 THE REQUIRED S~ZE OF THE SOIL RB~ORPTZON ~.~=,TEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRtNFIELD, THE DEF'TH OF R TRENCH OR PIT IS THE DISTFtNCE BETWEEN THE SURFACE OF THE GROUND AN[) THE BOTTOH OF THE ENCAVATION (IN FEET). THERE IS NO SET HIDTH FOR TRENCHES. TNE ORRVEI_ DEPTH IS THE MINIMUM DEPTH OF GRRVEL 8ETHEEN THE OUTFRLL PIPE RN[:, THE 80TTOM OF THE E~.:CSVRTION (IN FEET), PERMIT RPPLIC:ANT HAS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTSLLRTION INSPECTION2; OF RNY HELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THAT THE HEL, L HILL SERVE. BRCKF~LL~N6 OF RNY SMSTEH H~THOUT F~NRt. ZNSPECTZON AND APPROVAL BY TH~S DEPARTHENT H~LL BE SUBJECT TO PROSECUTION. HINIMUM DISTANCE BETHEEN ~ HELL FIND FtNY ON-SITE SEI,.IRGE DISPOSAL S'y'E;I'EH IS ~88 FEET FOR R PRIVATE HELL OR Z58 TO 288 FEET FROM R PUBLIC HELL. DEPENDING UPON THE I'YPE OF PUBLIC HELL MINIMUM DISTANCE FROM R PRIVATE HELL TO ~ PRIVATE SEI4ER LINE tS 25 FEET AND TO R COMrtUNITY CEi4ER LiNE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. ~PECIFtCRTIONS AND CONSTRUCTION ~',/RILABLE TO INSURE PROPER INST~LLFITION. I CERTIFY THAT t: I AM FAMILIAR HITH THE RE6~UIREMENT.S FOR ON-S~ITE SEHERS AND HELLS RS SET FORTH BY THE MUNICIPRt. ITY OF ANCHORAGE. 2: t HILL INSTRLL THE SYSTEM IN ACCORDANCE HITH THE CODES. 24: I UNDERSTAND THAT THE ON-SITE SEI,.IER SYSTEH HAY REgtUIRE ENLARGEMENT IF THE R~$IDENCE IS REMODELED TO INCL. UDE MORE THAN ~ BEDROOMS. GRE" ' ¥cR ANCHORAGE AREA BOR' -c; H Department of Environmental Quality 3330 C Street Anchorage, Alaska ggs03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM W E LL~__..~,~"./,'~'"'C-~/'~N U FACTU R E R INSIDE LENGTH INSIDE WIDTH_ MATERIAl LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY GALLONS. DISTANCE FROM WELL"-~ FOUNDATION NUMBER OF LINES / DISTANCE BETWEEN LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE SQ. FT. LENGTH OF EACH LINE /.?.~DEPTH OF FILTER __. ~" /MATERIAL BENEATH TILE ~ ~-~ TOTAL LENGTH NEAREST LOT LINE OF LINES ,~..~ TRENCH WIDTH F~tN. TOTAL EFFECTIVE / IN. ABOVE TILE ~ "-/ IN. WELL: TYPE BUILDING FOUNDATION-- CONSTRUCTION NEAREST NEAREST LOT LINE__ SEWER LINE__ DEPTH SEPTIC SEEPAGE TANK.__ SYSTEM DISTANCE FROM: CESSPOOL APPROVED OTHER SOURCES __ DISAPPROVED INSTALLED BY: SEWER LINE DEPTH: REMARKS DIAGRAM OF SYSTEM DATE/L/~-- /~¢~'7&PPROVED ~ ~,,~ ,~// '"--' G.A.A.B. ~ Form EQ-032 GP~I~ATER ANCHORAge AREA Borough DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMit NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT TYPe AND SIZE OF FAC L TY TG-B.~.~.ERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED TO BE iNSTALLED BY · -- --~'~--"/~ ~/ NOTE, THIS PERMIY IS NOT 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. SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM SEPTIC TANK SIZE ---*~"~'~K TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ., SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK.. , SEEPAGE Pit TO RIVER, LAKE, STREAM. j DRAIN FIELD , DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. , SEEPAGE PIT DRAIN FIELD 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 SEPTIG TANK AND SEEPAGE Pit FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. [ CERTIFY THAT [ 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 SIGNAT'URE '~...,. t HEALTH DEPARTMENT " , * ' 327 EAGLE ST. ANCHORAGE, ALASKA 9950] 279-:25] INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ,.~ ~'~/--~.~7_~ ~f'~/_./'~/,._,/'~_ PHONE ADDRESS LOCATION~/~/~ ~- ~/~:~GAL DESCRIPTION~)~~ * /~/~ SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY ,.//g9 ~,' £? GALLONS. NUMBER OF MATERIAL t/'?~';?/~/~-5"Z'~ COMPARTMENTS / ,~5' c~-~''-L ~,'~-.-.-.-.-.-.-.-.-./~"~'~-r/-~ /.~" LIQUID ~ INSIDE LENGTH g/ INSIDE WIDTH z~-~ DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER LINING MATERIAL ~'?,4~1:/'~ NEAREST LOT LINE ~ OR WIDTH , LENGTH , DEPTH DISTANCE FROM WELL J/~'/]~'] 'J ~ , BUILDING FOUNDATION. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~r SO' FT. TILE DRAIN FIELD: DISTANCE FROM WELl ,/~'""'~, FOUNdeD TION , NEARESI LOI LINE../'''"~~ L/ , OF LII~E~NGTH ABSORSOR/~ONAREAION AREA SQ. FT. LENGTH OF~EA,C~ LINE~_ ~ ~ DE/H: TOPOF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE N. ABO E LEV TI , WELL: TYPE .~',x?-/~/~'4-~:''~ , DEPTH ~.:~¢~' x NEAREST ~_/ SEPTIC LOT LINE / , SEWER LINE ., TANK DISTANCE FROM WATER BUILDING FOUNDATION. '--~'"-'~'~ '" · SAMPLE ~ ., NEAREST 12,4. SEEPAGE ,,~ ~-~ OTHER ~_~. _,.~z~ , SYSTEM .//~,~ , CESSPOOL , SOURCES ' -- DISTANCES: DIAGRAM OF SYSTEM DME ,~ /~,~ APPROVED GAA~D~Z ~ .... HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case No. / SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT RESIDENCE ADDRESS APPLICATION TO INSTALL: SEPTIC TANK ., DRAIN FIELD TO BE INSTALLED BY ~ ,~_~/V ANTICIPATED DATE OF COMPLETION TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH ~-/ PERCOLATION TEST RESULTS THIS IS TO SERVE AS BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF~UNIT TO BE SERVED DIAGRAM OF SYSTEM DISTANCES: / ~'~ rH AUTHORITY I certify that I am familiar with the requirements of Greater Anc~h~9~'age Are~,~Bor ~j~gh~O,rCi~a~n~e~o. 28-~$ above describedsi/stem is in.accordance with said code. ~~ ~?~z~' ~TE APPLICANTS SIGNATURE De~ t,, Soii Ch~,;cte;'is%ics Feet ~ ~ / q~ Was Ground Water Reading Date G-¢oss TJ me Net Time r, .'h To HoO Net Drop MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot I I; Block 3; Heritage Hills Subdivision Location (site address or directions) 12321 Heritage Hills Property owner Arthur & Brenda Milan Day phone-' 345-1882 Mailing address Lending agency Mailing address Day phone Agent June Brandt VISTA BETTER HOMES & GARDENS RE~a~e.562-6464 Address Anchorage, Alaska 99503 Unless otherwise requested~ HAA willbe held forpickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 o STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of thevaiidation 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 ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S :,%'GhN~P, ING 17034 Eagle River Loop Road No. 204 Eagle [~iver, ,&.iasJ<a 9~77 Phone Name of Firm Address Engineer's signature bedrooms. DHHS SIGNATURE /~/ Approved for -,~ Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date - - -1 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations' given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~025 (Rev 1/91) Back MOA ~21 ( Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /-/~IT(~-~-~ /-//cut; ~o7//; ~/_./5 ~ Parcel I.D. A. WELL DATA Well type ~tU/~7~ Log present (Y/~ Total depth Sanitary seal (~_.~N) If A, B, or C, attach ADEC letter. ADEC water system number J~'~ (~ Date completed [ ~ "~0 Driller (--'~ ~ ~ .'~ ' Cased to /~0 '-/' .Casing height ~---- ~'~ Wires properly protected (~/N) Date of test Static water level Well flow Pump level FROM WELL LOG AT INSPECTION MUNICIPALITY OF ANCHORAGE g-- L/-c~ "~VIRONMENTAL SERVICES DIVISION g.p.m. ~,S I E"CEIVED SEPARATION DISTANCES FROM WELL TO: Septic/h~ tank on lot Absorption field on lot Public sewer main Sewer service line ~F.~ ~. ; On adjacent lots ;: On adjacent lots Public sewer manhole/cleanout WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ~-~-~-- I, ~ m~'/~' ,Other bacteria Collected by:' (~ ~ ~---~3C~I~F-~c. B. SEPTIC,q"H~"~ TANK DATA Date install, ed '~'~-,~t- or-(~ Tank size [ 00~ 6P~L- Compartments Cleanouts ~_~N) 0~(=- Foundation cleanout ((~N) ~'r~ Depression (Y/I~ High water alarm (Y/~ ~/~t Ala~'m tested (Y/~.)~ Date of pumjSing Pumper SEPARATION DISTANCES FROM SEPTIC/He~-TANK TO: Well(s) on lOt ~ ~ On adjacent lots J O0 '~ Foundation To property line ~q,O ~ ~ Absorption field ~ 4- wate~ main/service line Surface water/drainage IOC~ ~7- 72-026 (Rev. ,'/91) Front CONTINUED ON BACK PAGE C. LIFT STATION D~~J//'~ Manufacturer Size in gallons '"""~'"'~_ Manhole/Access (Y~ Vent (Y/N)_ --"P~~ .~'~:~"Pur~p off" level at .~.~e14~ lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length c~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) hJ/~ lf~u,v. Peroxide treatment (past 12 months) (Y/~ Soil rating 0,6 GPP/s? System type ~=~r Gravel thickness 4./ Total depth ~,~ ' '~ Cleanouts present ((~)'N) Date of adequacy test /~/,4 ~Y~?~ for ~ bedrooms ~/~3~ If yes, give date _ /,///~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /00 ~ On adjacent lots /~O ~+ Propertyline '+ To existing or abandoned system on lot Cutbank ~CIA Water main/service line Driveway, parking/vehicle storage area To building foundation On adjacent lots Surface water Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in S & S ENGINEERING Signature ~7034 Eagle River Loop Road Nn ~4 Eagle Eivm', Alaska 99577 Engineer's Name Date ~1-~ ~ ~ HAA Fee $ / ~ ~-¢' Date of Payment (~ ~ / '/- ¢ ~-~ effect.cj~ttC~tYEt~c,~fEhis inspection. Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev, 3/91) Back MOA 21 MUNICIPALITY OF A~CHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) :. , ~'.' ..... Location (add.r, ess'or~d~recbons) (b) Property °~n~. ~:~ ~:' ~. ~ ~ Maihng Add~es~. '/, . ,,..,' ,..;~" - (c) Lending Institutio6'~'~:';:~::~ '" :" Telephone Telephone: (home)J~..C'- 5"~5'?-Busihess,,~?/- Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here [], if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-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 J~' 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 ofthi~ 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. [ 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 ~Z--d ~' . ._~.~-,~-. Telephone ~7 ~'- ~-J-J- ~ 6. DHHS APPROVAL Approved for/~-~/¢-r~'5,C::)edrooms by Approved ~"* Disapproved Terms of Conditions, I Approval Conditional The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph S 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 DHHSdo not conduct inspections or analyze data before a certificate is issued. TheMunicipalityofAnch°rageisn°t responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88)Back Page 2 of 2 Well Classification PO Well Log Present (Y/~ Date Completed Total Depth ~ Cased to MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: ,/i///1 3~ /¢e~,~/~?~, ,.~,///~ / Depth of Grouting If A, B, C, D.E.C. Approved (Y/N) Yield .1¢. ~ p'£'v Static Water Level ,¢- G ~/' Casing Height Above Ground Electrical Wiring in Conduit CN) 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 /, f~e-~ Water Sample Test Results Comments To Nearest Public Sewer Cleanout/Manhole Pump Set At (,c,~. Sanitary Seal on Casing ~N) Depression Around Wellhead (Y/L-~ ; On Adjoining Lots ; On Adjoining Lots./p¢¢ / B. SEPTIC/HOLDING TANK DATA Datelnstalled ~',//~1/?~ Size /~o~ No, of Compartments / Standpi. pes ~;}'N) Air-tight Caps ~.}N) Foundation. Cleanout DepresSi,on over Tank (Y/~ Date Last Pun~ pumping/Maintenance Contact on File (y/N) ,/.J/'/;L Holdi~i{~;.'~nj(iH]g~l/~a. ter Alarm (Y/N) /~2',,~ Temporary Holding Tank Permit SE[P'A'~I~,TI©~ DI'~T~A'IN*CJES FROM SEPTIC/HOLDING TANK: · ~_.... ~,,~ p..~ .~ , . . -- /O/ .:~0 Water~.p, pl~Jl, :: - ?~ To Building Foundation _17~ [ To Disposal Field /l~- / iTc Property Lin,_.e,. ~. -,- .. ,~ i~ ,',';.~. ~',~. ~o,Wa{er Ma[n/S,erv?~ ~me ,. !~ '%.. .,,~' ,,~.~, , . / To' St[ea~,-P. ondt'Lal(e Or Major Drainage Course Comments 72-028 (Re'/. 7/88) Front ra~e ;. C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field/S¢?¢-/ Square Feet of Absortion Area///¢/ Depression over Field (Y/~-~ Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot /¢ ,//~ To Water Main/Service Line ,.?¢./ / Type of System Design Length of Field ~,J//'r,¢;,~/,v. ,(/.~-~'/~/ Depth of Field¢/// 5-;/~' Gravel Bed Thickness ~,~/¢ ¢ ~ Statndpipes Present ~N) Date of Last Adequacy Test To Property Line ~-¢'' "///~ ~ "~,~i7/J* ~/~' '~L~/' ' &~ To Existing or Abandone~l System on ; On Adjoining Lots .;~ z ¢ To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course ~/'~ /' To Driveway, Parking Area, or Vehicle Storage Area ~¢2¢ Comments¢ ~/zo/~-/ /,,~?~F,~.~, ~? l?~, D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Dimensions Manhole/Acces~~ / ~u~p Off" Levelat ?~//~¢~ Vent(Y/N) Tested for Meets MOA Electrical Codcsl'~¢~)¢~ Comment~./~Y 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 efh inspection. Signed ~ Company ~: ,f~'~d -f " Date MOA No. 72-026 {Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 - o DATE RECEIVED ·, APPOINTMENTS . TIME DATE DATE DATE I SPEOTOR INSPEOTOR INSPECTOR G DEPT OF H~AL/H & MUNICIPALITY OF ANCHORAGE ' RONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC ~'[~ FEB 9 7 1981 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomp[ete requests will not be processed. Please allow ten (10) days for processing. %PERTY OWNER PHONE PROPERTY ~NT (If different from above) PHONE PHONE 2. BUY~ MAI LiNG ADDRESS 3. LEN~ING INSTITUTION PHONE MAILING ADDRESS 4, REALTOR/AGEnT I PHONE I MAI LING ADDRESS 5. LEGAL~DESCRIPTION STREET LQCAT~ ON 6. TYPE OF RESIDENCI~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~B EDROOMS [] One [] Four [] Other__ [] Two [] Five ~ Three [] Six 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. Awell 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~ INDIVI 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 [~ ONE [] THREE [] FIVE F~ 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 EZ]INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified iNSTALLER []Septic Tank or [] Holding Tank Size: ~'~)~C) IfTank is homemade SOILS RATING ,~:,~:~, ~;~;~,~, give dimensions: % ~ ~ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL '~ 4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~'APPROVED FOR BEDROOMS ~CO~DITIO~Ak AP~BOVAk (letter must accom~an~ certificate) ~,SAPPROVED ~ ,~ DA~E 72-010 (Rev. 6/79) ADC NO 81014 Mr. & Hrs. David Muceiaeito SRA Box 1599-R Anchorage, Alaska 99507 Re: Adequacy Test for Existing Septic System on Lot 11, Block 3, Heritag? Hills. Dear Mr. & Mrs. Mucciacito: This letter supplements the report prepared March 6, 1981, regarding the above referenced adequacy test. You initiall, y reported that your septic system consists of a lO00-gallon septic tank, a con- crete septic tank and a 37-foot seepage trench. This was confirmed with Mr. John Kennedy of the Municipality's Department of Health and Environmental Protection (D.H.E.P.). He stated that the initial system, consisting of the septic tank and 13' x 15' x 17' x 24' x 6' effective depth concrete crib was installed in 1970. The drain field was upgraded in October 1976, with the addition of the 37-foot seepage trench. The adequacy test was performed by adding 450 gallons of water to the seepage pit standpipe for 2 consecubive days. A stand- pipe for the seepage trench was not found. "" The seepage pit was measured to be 10.3 feet deep with an ini[i~al liquid depth of 8.1 feet. The elevation of seepage trench outlet is not known. However, since the effective depth of the seepage pit was reported by D.H.E.P. to be 6 feet, it would appear that the absorptive capacity of the 3?-foot seepage trench was tesUed during all of the adequacy test. If you have any.further questions, please do not hesitate to cgntact this office. Very truly yours, ALASKA DEVELOPMENT CONSULTANTS Project Manager SDS/mf 'I March 6, 1981 624 W. ~T'L, A/~FrOR~J~OAD, SUITE ':% ~ ;~ -~ ~ ANC~AGE. ALAS~& ~9502 ~' ADC NO 81014 Mr. & Mrs. David Mucciaeito SRA Box 1599-R Anchorage, Alaska 99507 Re: Adequacy Test for Existing Septic System on Lot 11, Block 3, Heritage Hills, Dea'r Mr. & Mrs. Mucciacito: At your request our office conducted a percolation adequacy test on your existing septic system at the above-refereneed location during the period March 3 ko 5, 1981. You reported that your septic system consists of a lO00-gallon septic tank, a seepage pit and a 37-foot seepage trench. The septic tank had been pumped approximately 2 months prior to the percolation test. Since the 3-bedroom house had been occupied up to the time of the test, a normal degree of sat- uration within the leach field is assumed. In accordance with the Anchorage Municipal Code, Chapter 15.65, Waste water Disposal Regulations, any on-site sewage disposal system "shall have adequate capacity to properly dispose of the maximum daily sewage flow." The maximum daily flow is computed at 75 gallons per capita-day (gepd). Since "the population of dwellings shall be estimated at two persons per sleeping room," the maximum daily sewage flow for your 3-bedroom house is 450 gallons per day (gpd). To test the soil absorption capacity as well as the surge capability of your system, 100 percent of the maximum daily flow or 450 gallons of clear water was added in 50-gallon increments to the seepage pit. The water was obtained from your on-site private well at its maximum sustained rate of about 3 gallons per minute (gpm). .The liquid levels were monitored closely to detect any backup in the septic system. Mr. & Hrs. Huceiacito Hareh 6, 1981 Page -2- The attached Table of Test Data represents the depths of liquid in the septic tank and seepage pit, and the quan- tities of water added. The septic tank was determined to be 9.5 feet deep (bottom of tank to ground surface) with an initial depth of 6.6 feet in the tank. The seepage pit was measured to be 10.3 feet deep with an initial liquid depth of 8.1 feet. Ground elevation at the septic tank standpipe is approximately level with that at seepage pit standpipe. The attached Summary of Test Results indicates that the liquid level in the seepage pit at the beginning of testing on Day 2 fell to its initial static level on Day 1, during a recovery period of 24 hours. On Day 3, the level had fallen to 0.3 feet above its statie level on Day 2, during a recovery period of 24 hours. Based upon two days of testing, an average percolation rate for your existing septic system of approximately 425 gpd is indicated. Since an on-site sewage disposal system for a 3-bedroom dwelling must be capable of disposing.of 450 gallons of sewage per day, the soil absorption capability of your septic system appears to be marginal at this time. Many factors affect the operation of a soil absorption type of sewage disposal system. Soil type, groundwater depth, age and history of maintenance of the system, and types of waste are a few. This test has been performed in an attempt to determine actual soil absorption capabilities of your septic system under normal useage by considering the degree off saturation of the leach field and surge loads that might be imposed on the system. This test can' only evaluate appar- ent performance at a given point in time, and cannot deter- mine either the condition of the leach field, seepage pit or other components of the septic system, or the.depth of the water table. We appreciate the opportunity given to perform this adequacy test. If you have any questions regarding this test, please contact this office. Very truly yours, ALASKA DEVELOPMENT CONSULTANTS Stephen D. Shrader, P.E. Project Manager SDS/mr Mr, & Hfs, Hucciaeito March 6, 1981 Page -3- ADC NO 8101~ Wtr Added, Seepage PiE Rise in Seepage Pi[ Rise in Septic Tank Recovery Time between Test (Hours) Drop in Rit during Recovery Average Absorption Rate (gal/day) SUMMARY OF TEST RESULTS Day I Day 2 450 450 1.9' 2.2' 1.6' 2.1' 24 hrs 450 gpd Day 3 24 hfs 1.95' 399 gpd Adequacy Test for Existing Septic System Owner: Mr. & Mrs. Mueciacito Address: SRA Box 1599-R~ Anchoraqe, Alaska 99507 Legal Description: Lot 11, Block 3, Heritaqe Hills Components of Septic Sy~tem:lOO0-qal Septic Yamk, comc. crib; 37-ft. tremcb Number of Bedrooms: 3 Occupied prior to test: Yes X No Project No. 81014 How long vacant: Test performed by: CRA Initial Static Levels: Septic Tank 6.5 Last pumped: 0an. 1981 Water meter/S.N. ; Seepage Pit 8.1 TEST DATA i- :;-' · .':.Liquid Deoth, ft* - "Water Meter 'lime Septic Tank Seepage Pit Added, gal Reading, gal Remarks 9:04 5.4 3.4 -0- 29,487 3/3/81 9:13 5.2 - 3.1 50 29,537 9:27 4.9 2.85 50 29,587 9:41 4.5 2.55 50 29,637 9:53 4.3 2.20 50 29,687 10:07 4.1 2.00 50 29,737 10:20 4.0 1.80 50 29,787 ' 2:37 5.0 3.0 0 29,787 2:52 4.5 2.5 50. 29,837 3:07 3.8 1.6 50 29,887 3:40 4.5 2.4 0 29,887 3:53 3.8 1.5 30 29,917 4:05 4.3 2.2 0 29,937 4:13 3.8 1.65 20 29,937 Stop Test 9:00 5.3 3.4 '-0- 29,937 3/4/81 9:22 5.0 3.0 50 29,987 9:37 4.6 2.6 50 30,037 *Measured from top of Standpipe Ow~ier.-' Mr. & Mrs Mucciacito Project ~o. 81014 Legal Description: [6t 11, Block 3, HeritaqelHills TEST DATA (Cont'd) Liquid Depth, ft * Water Meter Time Septic Tank Seepage Pit ~ded, gal Reading, gal R~marks 9:52 4.1 2.0 50 30,087 10:07 3.7 1.4 30 30,117 Stop 10:36 4.3 ~.3 -0-' 30,117 Start 10:37 3.7 1.6 20 30,137 Stop 2:00 4.8 2.8 -0- 30,137 Start 2:20 3.7 1.5 50 30,187 Stop 2:45 4.4 2.4 -0- 30,187 Start 3:03 3.7 1.4 30 30,217 Stop 3:30 4.3 2.3 -0- 30,217 Start 3:37 3.3 1.55 20 30,237 4:05 4.3 2.2 · -0- 30,237 4:19 3.2 1.15 30 30,267 4:45 4.2 2.2 -0- 30,267 7:00 3.5 1.6 80 30~347 7:18 3.25 1.2 40 30,387 Stop Test 450 gal 9:23 5.1 3.1 -0- 3/5/81 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4'1 '11 GEORGEN SULLIVAN, DEFAU, Tt, 4EN¥ OF HE,~LTH !',~,/) ENVIRONMENTAL PROTECTION March 2, 1981 Star Route A Box 1599R Anchorage, Alaska 99507 Subject; Lot 11 Block 3 Heritage Hills Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be delivered to this office from the Chem Lab, 5633 B Street, for our ~ review.  (2) The depression or pit around the well. casing needs to ' be filled with impervious type soil so that it slopes away from the well casing° pL T he septic -hank pumped with a receipt submitted to this office. (4) 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 needs to be submitted to this office for-our review. Please notify this department for a reinspection when the noted descrepancy has been completed. If there are any questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Assodiate Specialist RCP/ljw GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561  Date Received Apri____~l 12__/, 1__976 Time of Inspection Date of Inspection ~/~/~-~/~- Lb' REQUEST FOR APPROVAL OF ' U~NDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 4. 5. 6. Approval'requested by: Mailing Address: Property Owner: Mailing Address: Legal Description: Location: United Bank of Alaska 645 G Street Bruce & Nancy Silverthorn Phone: 278-1541 Phone: 277-056~ Lot 11 Block 3 Heritage Hills Subdivision Huffman & Heritage Road Type of facility to be inspected Well Data: Individual - serving 1 A. Type C. Construction Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: 1. Size 1. Absorption Area Single Family No. of bedrooms 3 B. Depth D. Bacterial Analysis B. Installer 2. Manufacturer , Absorption area , Other contamination E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank 235' 2. Material , Sewer Lines , Absorption area C. Absorption area to nearest lot line LQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHOP, AGD 'GREATER ANCHORAGE ARE/:, BOROUGH P~PT, OF HE,.',Li!-I & t ~ENVIRONI~qE N1 AL ;' ~,.k-, I.~T ION Department of Environmental Quali y 3330 "C" St., Anchorage, Alaska 99503 - 274=~11/~,n ~ ' ~ ~g'~'~ REQUEST FOR APPROVAL OF t'~,~;~... ~ ...... ~ INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owner: - Mailing Address: FHA CONV/~ Day Phone .~ ~.~- d~]'-~? 3. Name of Buyer: Mailing Address: 4. Name of Lending Institution: Mailing Address: ~_ ~/'~_~ 5. Name of Realtor or Agent: Mailing Address: Day Phone~ Phone Phone 7. Type of Facility to be inspected: ~~Z.,~",~.~,U~O. Bdrms. ~ 8. Water Supply Type of Supply: Public Utility Individual ~ If Individual, number of dwellings presently served ~ If Individual, depth of well.~-~ 9, Sewage Disposal'System Type ,of S~stem: Public Utility Individual (on-site) If Individual, date of installation Cage 2 of two pages - Re~ st for Approval of Individual .~ er & Water Facilities Legal Description Lot 11 Block 3 Heritage Hills subdivision Comments Approved~~Disapproved Date ~"~/' al~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) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality "C" Street, Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAL OE INDIVIDUAL SEWER & WATER FACILITIES FOR Date Received \[~-jE~>-q~ Time of Inspection Date of Inspection~~ 1. Approval requested by: Mailing Address: ~(])LD ~_ ..~~ 2. Property Owner: ~ /~ ~L~JF~ Mailing Address: Phone: Phone: 3. Legal Description: ~ ~/ []~[o~cJO_ ~ ~F~_~Ob& ~.~. 4. Location: ~ ~r~ q~ ~~ ~r~,~~ ~4-~t~,q~b~. 5. Type of facility to be inspected J~,~(Jo (~k~ No. of bedrooms(~¼~o, 6. Well Data: A. Type C. Construction Sewage Disposal System: B. Depth ,~' D. Bacterial Analysis ./}//"~//Y~"'-.,'~J~'~-- A. Installed B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. 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 GREATER ANCHORAGE ARE~ BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Type of Inspection: CMRO Property Owner: Mailing Address: VA FHA CONV~ Day Phone -" 3. ila~ie of Buyer: Mailing Address: Day Phone 4. Name of Lending Institution: Mailing Address: Phone Name of Realtor or Agent: . .. Mailing Address: Legal Description: ,o ation: --. U (J U 7. .Type of Facility to be inspected:- 8. Water Supply Type Of Supply: Public Utility No. Bdrms. ~ Individual 'x/~' If Individual, number of dwellings presently served I.f Individual, depth of well ~~ Sewage Disposal'System Type,of S~st'em: Public Utility Individual (on-site) ~ If Individual, date of i.nstallation ,~ ~ ~ ~ge 2 of two pages - Re~,~est for Approval of Individual. ler & Water Facilities Legal Description F~vmJFl\ ~q~Lo~Jr~_ ~.~ J~L~F~t~ ~ J~L~Y~J~L~q~F~ Comments Approved sapproved Date 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 sati~torily~ ~ SI G~~-~ Date ~/~_~///~ EQ-034 (1/74) · Febzuaw~ll, 1975 425 "D" Street SUPJECh Lot 11, Block 3, l{eritage ~is off~ h~ ~iv~ a ~tisfacto~ wa~r ~ ~je~ ~11~ Susan E. Dic~, cc: Jo~ Shep~rd GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C", Street, Anchorage, Alaska 99503 274-4561 - ~'* Date Received / , · ~ ~ Date of Inspection ~'~ INDIVIDUAL SEWER & WATER FACILITIES FOR ~equeseed b~: C .... ~<e {~ . - . ....~-~" Phone: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. Location: Type of facility to be inspected We 11 Da ta: .... ~-~--'"7~=~Z~-~~/~~'· A. Type , ,~,c..~.x._--~ 7 C. Construction B. Depth D. Bacterial Sewage Disposal System: A. Installed /?7o B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. 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 AA~ BOngO UGr, GREATER ANCHORAGE .... ' ....' Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99§03 - 274-6561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type o~ Inspection: CMRO VA 2. Property Owner: Nels A. Anderson Mailing Address: Dilllngham, Alaska 3. Name of Buyer: Bruce Silverthorn Mailing A~dress: SRA Box 1548M ~nchorage, Ak. 99507 CONV DaZ Phone Day Phone 274-1654 x 121 4. Name of Lending Institution: Home Federal Savings & Loan Association Mailing Address: 5'35 D Street Phone 272-1451 Anchorage, A±as}~a 99501 5. Name of Realtor or Agent: Saylor Riem or Joan Sheppard Mailing Address: 3300 c Street Phone 278-2525 Anchorage, Alaska 99503 Legal Description: Lot 11, Blk. 3, Heritage Hills S/D Location: Heritage Road off Huffman 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well __2~35' 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation Single family No~ Bdrms. 3 XX one Individual (on-site) 1970 xx Page 2 of two pages - Rei, st for Approval of Individual S ~.r & Water Facilities Le§a,l' Description // /~. ~ Comments ~~~/ '~ '~ ~ ~* ~ /_./ ~ d/ II .~7~.~.. ~. ~_]z_~m~-_m/~i sa ppro ved Date 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) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-.9686 Time of Inspection Date of Inspection //; o cY REQUEST FOR APPROVAL OF I~IVIDUAI, SEWER & WATER FACILITIES FOR AddresS; , e: ~7~¢~/ LocatSon: , Number of Bedrooms: D. Bacteria] Analysis. Sewage Disgosal .System: /~ Installed/_~_ B. Instal. er Total Length of Lines__ Seepage Pit: 1. Disposal Field: Distances: A. ~1~ To: C. Septic Tank~ , Nearest Lot Line /f~/Y , Other Contamination ~oundation to Septic Tank 7 ~ "~ Absorption Area ~/ Absorption Area to Nearest Lot Line ~(~ / ~ __ Absorption Area /~ /~ , Sewer Lines R. equas~t for Aporoval Page Tv~o 9, i Comments: Approval Valid for One Year From Date Signed G~ater Anchorage Area Borough, Department of ~nvironmenta] QUality DIAGRAM OF SYSTEM I certtf'/ that the information contained in this request for appreval to be a true and accurate representation of the subject sewer and water 'faci!it~es located at: Ft~A For~'~573 J Re~. Ju~y 1958 ~" U. S, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT ~ Form Approved FEDERAl_ HOUSING ADMINISTRATION Budget Bureau No, 63.R0296 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.~TO BE COMPLETED BY FHA INSURINGOFFICE Anchorage MORTGAGOR OR SPONSOR Joseph & Phyllis MORTGAGEE First Nat'l. Bnk. of Anch. PROPERTY ADDRESS Marzucco NHN Heritage Road SUBDIVISION NAME SERIAL NO. BLOCK NO. LOT NO. ls Subdivision 3 11 Heritage Hi TOTAL NUMBER: WATER SUPPLY BY: ~] Public system BASEMENT [] Yes [~'~'J. No -]New installation Can attic or other area be made Into addl~onal bedrooms? (If Yes, how manyf~) SYSTEM DESIGNED FOR ]Community system [] Individual .o. oF SDSMS. G^.^OE msros^t SEWAGE DISPOSAL BY: [] Public system [] Community system [] Individual [] Yes r-] No PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT 4EALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the N State ["-] County __ Local Department of Health that this individual water-supply system [~]/is F-t is not satisfactory as a domestic water supply for the subject property. It is the opinion of the [-']1 State ~l County rem/~ith proper maintenance: [~Can be expected to function satisfactorily, and is not likely to create an insanitary condition [~ocal Department of Health that this individual sewage-disposal sys- [~ Cannot be expected to function satisfactorily NOTE: The health authority shouldcomplete the appropriate opinion statement above and affix date, signature and title in the spaces provided. Uso of the above grid 'for Health Department Inspector's sketch as well as use of the back of this form is at the option of the health authority. PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compli~mce Inspection Report, and recommend that the Individual water-supply system be considered [] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. DATE SIGNATURE ] CHIEF ARCHITECT r-~ DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 R~Y. July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMAfiY TREATMENT consists of [] Septic tank. SJptlc Tank: Distance from well, feet. Material Total liquid capacity. Inside length, feet. Inside width, CJsspooh Distance from: Well, feet; foundation, Inside diameter, f~t. Depth, [] Cesspool. gallons. Capacity inlet compartment, feet. Liquid depth, feet. Number of compartments gallons. feet; nearest lot line at [] front, [] side, [] rear, feet. Liquid capacity, gallons. Lining material SECONI)ARY TREATMENT consists of [] Tile disposal field. [] Seepage pits. Other TIl~'Dla~3osal Field: Distance from: Well, Total length of tile lines,. Trench width Length of each line feet. feet. square feet. inches. feet; foundation, feet; nearest lot line at [] front, [] side, [] rear, feet. Number of lines, Distance between lines, inches. Total effective absorption area in bottom of trenches, feet. Depth, top of tile to finish grade, Type of filter material: [] Gravel. [] Broken stone. Other Depth of filter material beneath tile. inches. Depth of filter material over tile, Seepage Pits: Number of pits ...... Outside diameter, feet. Depth, Distance from: Well, feet; building foundation, Ins~,~l'lon made by: [] State. feet. Lining material feet; nearest lot line at [] front, [] side, [] rear, [] County. [] Local Health Authority. Inspected by 19.__ (TITLE) Date of inspettion .__ REPORT OF INSPECTION~INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main, __feet. Size of main, inches. lmlividual wells [] ar(. [] are not customary in neighbgrhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood [] are [] are not being developed with both individual water-supply and sewage-disposal systems. Lot size: feet wide, feet deep. Dwelling set back from front property line, feet. Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. D~stance o~ well from: Bnilding flmndation cast iron sewer, feet; tile sewer, seepage pit, feet; cesspool, Well construction: Diameter,~ .inches. Total depth, .feet; nearest lot line at [] front, [] side, [] rear, feet; septic tank,, feet; disposal field,. feet; other sources of possible pollution, (eel Approximate depth to pumping level of water in well, Sealed watertight to depth of feet. Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No. Pumpt [] Shallow well. [] Deep well. Length of drop pipe, _feet. Pump capacity, la)cared in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit. Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No, Type of storage: [] Pressure. [] Gravity. Capacity, .gallons. Has bacteriological examination of water been made? [] Yes. [] No. If answer is "yes," give date. Quality of water [] is [] is not satisfactory for human consumption. Installation [-3 does [] does not comply with approved exhibits, if any. Inspection made by: [] State. [] County. [] L(x'al Health Authority. Inspected by Date of inspection 19__ feet. Type of casing, Depth of casing, feet. Approximate yield, gallons per minute. .gallons per minute. {TITL£) feet; .feet. GPO 889 -0 88