HomeMy WebLinkAboutHERITAGE HILLS BLK 4 LT 2Heritage H*11s Block 4 Lot 2 #015-221-26 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PermitNumber.. Q� tib PID Number: X15-'29f - 2& Nems J4r1 li•n Wastewater System: ❑ New ❑ Upgrade Paoass 1232.0 Hf~i a t ROILA ABSORPTION FIELD l;w to Phone Number a eaaroallle ` 3 O Deep Trarrll O SMlbw Trench O BeA O ManO O Opw LEGAL DESCRIPTION sod ReWq TOM Depen tom wginal praw GPD4r' FI. Biark� LO I /T [ /� H;115 31D a amia Pie Gravel cacti bxratn Pipe L 1/ U Q FI. FI 7pwmlap Rahe j sactm FDapinQo apnY grace CravN Fl. FI. Well: iFiS4;Numaw ❑New El Upgrade GravN w+aln a Ines Distance Meaaen Ines FI. FI Clasvnuun (Pmne A. S. C( TOM Deem Cassa to Taal absorpm n rear Pipe Marina FI. FI Fes Onter Data Dnlba Stals:Walw Levo Inoaller* Datam slalea FL o,-0t4 . ' u 9 e mala Panp psaln CamVh`A *c` 05 U> 05-ploy TANK GPM FL Ft SEPARATION DISTANCES [9 Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To From Septic Tank Absorption Field Lift Station Holding TanksewerL'me ubhUPmate 'Wer A horn, t T nk •peury Ga 1000 WMI 105' Melanie 51C.1A NunDw a Cdronmwai 1 2 sunaawn« N0. LIFT STATION • nu✓w LN Lma 7,1o, Gal FouMann 5 I Pump On'e,,ei a 'Poop air ie a at N pan wow aam a t 1 in n n Curran dam A / ^ Y i1 71 PunC Maur a MWel Ebdnca hspaclans WormW by R•ma,$ - BENCH MARK Locum ailDasd�ptwn . ,1 ,! t Y l i Nsumea MvaaOn. 100 Ft 44 4 Inspections performed by: L2175 SPuroan� Dates: 1a 9 OS F 2n° Development Services Department Approval 7 Tr a g rk"Y"p !�7 b. ta.rf `79r�y Reviewed and approved by: Date: r !' (Rev 12W) In I I I 3 I I I INSTALLED 1000 GAL TANK I I CONNECTED EXISTING DRAIN FIELD I I I I SFFnC AWA A I INc s I At 54 BC= 18 AD= 56' BD= 15.,5' Al= 58.,5' B£= 20 53' 6�= 18' IA[( I 1 L__ RI00.00_ _—__ I I Iam I I I CK I I I I to sr I 1 I I svw 8 I 44 ` 49th '•'} �� I I 13 if I I I ARV PN�• ; • No. CE - 9. ` I o so n tw tso SCALE, 1- = 50 FT. TOWN SPURKLAND P.E. HERITAGE HILLS BK 4 LT 2 SEPTICSYSTEM ASBU/LT 203 W 15TH. AVENUE JANfLLE FLEMING DATE: OCTOBER 13, 2005 (NCH. AK. 99501 907 179-3916 11 12320 HERITAGE RD. SH££T.• 213 GRID: 2737 PERMIT # SV050340 PID # 015-221-26 HRH04022.DVG Connected to Existing Drain Field OO -------O a 1000 gal Septic tank c a Q, U t O a 3 2 Feet Cover (Minimum) 1000 gat septic tank NO SCALE .497H ri, fit. b-= BENCH MARK BOTTOM OF SIDING ASSSUMED ELEVATION 100 FEET TUBELN SNUKKLANU Y.L. I I L 0 T 2 BLOCK 4 HERITAGE HILLS I I SEPTIC SYSTEM ASBUILT Anchorage Ave An JANELLE FLEMING DATE- October 13, 2005 Anchorage Ak 99501 12320 HMAG£ ROAD SHEETo 2/2 GRID, 2737 IPERMIT ,/ SW050J40 PARCEL I0 { 015-111-26 HRH0204J DWG/ SW050J40 PARCEL 1D { 015-111-16 HRH0204J DWG MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO50340 Legal Description: HERITAGE HILLS BLK 4 LT 2 Date Issued: Sep 09, 2005 Expiration Date: Sep 09, 2006 Parcel ID: 015.221-26 Design Engineer: 0007 Tobben Spurkland, PE Site Address: 012320 HERITAGE RD Owner Name: JANELLE FLEMING Lot Size: 15500 SQ. FT. Owner Address: 12320 HERITAGE ROAD Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516-2344 This permit is for the construction of. ❑ 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. 5. The following special provisions. THIS PERMIT IS ONLY VALID FOR A TEMPORARY HOLDING TANK AND CAN ONLY BE IN OPERATION FOR A PERIOD OF 90 DAYS OF INSTALLATION. AN AS -BUILT INSPECTION REPORT AND ELECTRICAL INSPECTION NEEDS TO BE SUBMITTED PRIOR TO BEING USED. PLEASE SEE ATTACHED A.D.E.C. LETTER DATED SEPTEMBER 12,2005: WITHIN 90 DAYS, AN ALTERNATE DESIGN FOR A NEW SEPTIC TANK (AND POSSIBILY A SEPTIC ABSORBTION FIELD) WILL NEED TO BE SUBMITTED BY A PROFESSIONAL ENGINEER TO A.D.E.C. AND THE ONSITE PROGRAM WITH WAIVER REQUEST. PLEASE BE AWARE THAT THE SEPARATION DISTANCE REQUIREMENTS WILL BE BASED IN PART ON THE CLASSIFICATION OF THE WELL BY A.D.E.C. Received By: S� sxtA�x Date: ill -2105 Issued By:p 41— Date: _ iZ /°f 09/12/05 -' 40:48 FAX 9072693108 .DEC/Ell/DWPP 1. . Q002 VE Or RUN& (RANK va St. KOWSK; GOVERNOR 555 Cordova St. Anchorage, AK 99501 DEPT. OF ENVIRONMENTAL CONSERVATION Phone: (907)269-3076 Fax: (907) 269-7650 DIVISION OF ENVIRONMENTAL HEALTH Sarah Rygh0,dcc.state.ak.us DRINKING WATER PROGRAM bttp://www.statc.ak.uVdeeldeh/ September 12, 2005 File: Heritage Hills SID Let 8 Block 4 PWSM. 216033 Tobben Spurkland Spurkland Engineering 203 West 151° Avenue, Suite 203 Anchorage, AK 99501 Re: Temporary Holding Tank Separation Distance Waiver Approval Heritage Hills S/D Lot 8 Block 4, Class C Public Water System Dear Mr. Spurkland: On September 7, 2005 this office received a submittal from you requesting a waiver of the required 150 -foot separation distance requirement between the above-mentioned Class C well and a septic tank located on Lot 2 of Block 4. The submittal and our files indicate this well serves lots 1, 2, 3, 6, 7, and 8 of Block 4 Heritage Hills. Our file also indicates Lot 1 of Block 5 may also be connected to this system. According to the Municipality of Anchorage records, the total number of bedrooms on the lots 1, 2, 3, 6, 7, and 8 of Block 4 is 16. The ADEC Drinking Water Program uses maximum design capacity for assessing water system classification. Residential homes have a maximum design capacity oft people per bedroom. Based on this, the system is designed to serve 32 people (16 bedrooms x 2 people). Drinking Water Regulations define a Class C water system as serving less than 25 people. Class A systems are defined as serving more than 25 residents. Based on these definitions, this public water system is a Class A public water system. The required separation distance between a septic tank and a Class A well is 200 feet A separation distance of 80 feet to the septic tank cannot be approved as submitted. Because the existing septic tank is currently in a state of failure, a distance of 80 feet is approved for a temporary holding tank on Lot 2. The holding tank will need to be approved by the Municipality of Anchorage and can only be in operation for a period of 90 days. Within 90 days, an alternate design for the new septic tank will need to be submitted by a Professional Engineer. Please be aware that the separation distance requirement will be based in part on the classification of this well. t* Prinled un Reeyclnl Paper 49/12/05;,,10:49 FAX 9072693108 DEC/Elt/DWPP .. . •.i :':. -!I cs . .... 11003 ; { Separation Distance Waiver, Heritage Hills Block 4 Lot 8 If you have any questions, please contact me at 269-3076.Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC IS.195- 18 AAC IS.340 or an informal review by the Division Director in accordance with 18 AAC 15.185. Informal review requests must be delivered to the Division Director, 555 Cordova St., Anchorage, Alaska 99501, within IS days of the permit decision. Adjudicatory hearing requests must be delivered to the Commissioner of the Department of Environmental Conservation, 410 Willoughby Avenue, Suite 303, Juneau, Alaska 99801, within 30 days of the permit decision. If a hearing is not requested within 30 days, the right to appeal is waived. Thank you, 2 L Sarah Rygh, Err Environmental Engineer Assistant cc: Jamie Stain, ADECtEHIDW Program Tobbin Spurkland, Spurkland Engineering Joe Goodall, Municipality or Anchorage On-site Program Carolyn Favorite, Heritage hills SID Block 4 Lot 8 well owner Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 615-'99 1- 26 Permit Number SW Property phone 563 -0702 - Mailing address 12320 YeAnjo PJ, Zip Code 495Ilo Site address Same. Zip Code Legal description (Lot, Block & Sub'd.) joT 444, a'11.5 Legal description (Section, Township & Range) Lot Size 15 ,5W Acr /Sq.F . THIS APPLICATION IS FOR: Number of Bedrooms 3 Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade [Vi THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I 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. Sim (Signature of property owner or authorized agent) Permit/Rush Fees: 70 - Lrb Waiver Fees: Date of Payment: 6?*7/06' Date of Payment: Receipt Number. 735V k, t Receipt Number. (Rev. 09/04) A� Environmental Consulting and Design September 8, 2005 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: TEMPORARY HOLDING TANK PERMIT HERITAGE HILLS LOT 2 BLOCK 4 The septic tank serving Lot 2 Block 4 Heritage Hills has collapsed and needs to be replaced. The septic tank was permitted and approved for installation by the Greater Anchorage Area Borough in 1972. A Class C well (ID # 216033) on Lot 8 Block 4 Heritage lulls serves lots 1,2,3,6,7 and 8 Block 4 Heritage Bills. The distance between this well and the septic tank is 80+ feet. There are no suitable sites on Lot 2 Block 4 Heritage Hills outside the required 150 foot well radius. We have applied to the ADEC for a separation distance waiver. The ADEC can take up to a week to review waiver requests. The residence at Lot 2 Block 4 is currently without septic service. To restore service we would like a emergency permit to install a temporary holding tank, to be used until the waiver review process is complete. Sarah Rygh at the ADEC has agreed to this measure (per phone conversation 9/8/05). If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely, Lz Sx 00-� Lars Spurkland 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net i ti l scpnr Z I AKA 00 It, 11 i_ _ _ _ _ _ _ _ _ _ J .•�P� •• "'� I 12 • ._n. 49th f,ai . I I I II ..cr.m �. �• WNoSYUfKLMIU I I '' 1� ' I I 0 25 50 75 00 s 1501 • •• �� SCALE! 1' = 50 TOWN STH. A TKP.E.20J HERITAGE HILLS BK 4 LT 2 SEPTIC SYSTEM DESIGN ANC W 15TH. AVENUE JAN£LL£ FLEMING DATE. AUGUST 31, 1005 (NCH. 7 9916 11310 H£RITAG£ RD. SHEET. 213 GRID: ?737 907 ?79-3916 � PERMIT # SV05OXXX plD # 016 -141 -XX HRH04022DVG N 3 0 1000 gal Septic tank t e d m � o a a § t° 4 Feet Cover (Minlnun) Connect to £x/st/ng DralnFleld 1000 gat. septic tank Qk� NO SCALE 44Lt /� , y TOBBEN SPURKLAND P.E. LOT Z BLOCK 4 HERMCE HILLS SEPTIC SYSTEM DESIGN 203WAnchorage Ak 99501 Ave Anc ong JANELL£ nrmING DATEo S£PTEMB£R 8, 1005 P79-WA 12.W I EWAGE ROAD SHEET, 212 GRID, 2737 PERMIT f SWO40OXX PARCEL 1D / HRH01042.DWC nr o -r I n N SEPTIC TANK: @111A7 iNCHORAGE ARA bUKV Department of Environment Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS %el)62 PHONE LEGAL DESCRIPTION OF DISTANCE r y FKC. NUMBER M FROM WELL �� h MANUFACTURER ui- �=MATERIAL ��E%�' COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY L62 GALLONS. TILE DRAIN FIELD:i TOTAL LENGTH DISTANCE FROM WELL 1e43r FOUNDATION ---471&) , NEAREST LOT LINE 17 -OF LINES 1g� NUMBER OF LINES DISTANCE BETWEEN LINES 112 vZ TRENCH WIDTH Wr TOTAL EFFECTIVE '7(oSQ. FT. LENGTH OF EACH LINE ABSORPTION AREA �3 + DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE & 7 MATERIAL BENEATH TILE IN. ABOVE TILE 69 IN. WELL: TYPE, -PiL �C�6`��7&ICONSTRUCTION ld IS ➢ti' DEPTH DISTANCE FROM: BUILDING , NEAREST r NEAREST SEPTIC r SEEPAGE FOUNDATION /L LOT LINE /d SEWER LINE (� TANK �, SYSTEM- CESSPOOL YSTEM CESSPOOL /UOAIC Y APPROVED DISTANCES: OTHER SOURCES IULINC� K'UC)t'eA) DISAPPROVED REMARKS INSTALLED BY: „''��i�D &dA SEWER LINE DEPTH: .7 / PIPE MATERIAL: (A'17 -alar Fr LOT SLOPE: REMARKS: tlkCPA/ (2(r'­L-Q- C--Fsr zk c' %r' qz Form PW -027 DIAGRAM OF SYSTEM wau. M , I /•Ivcur� e ,i ILL DATE S �� APPROVED �Q'�� (-' beU14z�,tij- G.A.A.B. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. i. 3500 TUDOR ROAD POUCH 6.550 ANCHORAGE. ALASKA 99502 TELEPHONE 2798686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT MAILING ADDRESS L � PHONE INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK SEEPAGE PIT� . DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED /`_ FINANCED THROUGH TO BE INSTALLED BY -�v /� - J SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTIONt 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE SEEPAGE AREA SIZE, TYPE MINIMUM • • rDIAGRAM OF _ ■...�■...i.u./... ■ L mommommum�O=i No No m IN FIE p .--7 ....�.1' ER AREA WELLS. ■■.� �I"�■■■.■..■MM PIT M _ ��J ■■.■� ,����■.■.■ ....�� ..� ........ IN FIELD .,L —_. ...�.�1�....�■...■■■_ ... Mum..no .... IB CROSSING GAP OF ....■■.�■.. NK AND SEEPAGE PIT . ..■�.��,■. .� ...■■.■mo ATI ON. :C ,x.61 Oau -Por GREATER ANC RALE "• • •- • - • c• FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIE SEPTIC TANK TO SEEPAGE PIT WALL /J SEPTIC TANK �. SEEPAGE PIT DRA TO NEAREST LOT LINE r `-"`/-'� SEEPAGE PIT WELL TO SEPTIC TANK--) DRAIN FIELD ALSO CONSID WATER MAIN TO SEPTIC A) SEEPAGE YANK DRAIN FIELD 1/0 2 S SEPTIC TANK, SEEPAGE PIT DRA TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CR EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TA FITYED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS NG INSTALL HEALTH AUTHORIT OR LICyq SED DESIGN I CERTIFY THAT I AM FAMILIAR WITH T14E REQUIREMENTS OF DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE q '/� APPLICANT'S SIGNATURE MUNICIPALITY OF ANCHORAGE AAL • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services N9 On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0 ( S_ — I -A" — I (a 1. GENERAL INFORMATION HAA # t -,' C"vtnL 2)_,� k Complete legal description Lot 2; Btock. 4; HekitaGe HiUz Subdixi6 Lon Location (site address or directions) 12320 Heai.tage D4ive Anchonaae'l, AK Jennotd Bea.g 9 Lynn Andehzon 345-2127 Property owner Day phone Mailing address 12320 Hekitage Dkive Ancho4.age, AK 'Lending agency Mailing address Agent _ Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S& S ENGINEERING (2 2 y � Z 7 17034 Eagle )ver Loop Roado. 204 Phone Address Eagle River, Alaska 99577. Engineer's signature 6. DHHS SIGNATURE Approved for �Z� bedrooms. By: Disapproved. Date �//9C ,!Sop per, ROBERT C. COWAN I *, CE -8801 j Conditional approval for bedrooms, with the following stipulations: Additional Comments 71717 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (Rev. 1/91) Back MOA 7121 ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage AUG 02 1996 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division ) f4� YE®825 L Street, Room 502 • Anchorage, Alaska 99501 • (90)- 4 Health Authority Approval Checklist Legal Description: /0/� 94 06/- 'Yr ����xr��� fe u/S Parcel I.D.: d%S� ` 2 I m 2 S✓J Ql v�3Lan� A. WELL DATA Well type 4f If A, B, orO, attach ADEC letter. ADEC water system number Log sent (Y/N) Date completed " �.n Total depth Cased to Casing height above ground) Sanitary seal (Y/N) Wir operly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level \ Wellp uction g.p.m. \ g.p.m. WATER SAMPLE RESULTS: i Coliform Nitrate 0,971 r` % Other bacteria Date of sample: — l61` / Collected by: SANS S f✓✓GLi✓4/ .r/6 B. EPT /HOLDING TANK DATA Date installed Zs� Tank size 1ee0(1'14i Number of Compartments U�,e � -­Cleanou)wcf*) %S Foundation cleanout (Y N� N O Depression (Yu Date..of Pumping •� � Pumper C. ABSORPTION FIELD DATA .. Date installed z Sr �'. Soil rating 1.4.6.d./ft- or t2/bdrm High water alarm (Y1W GV1? ,G ZOO System type 6 "4jzDZ7 f . 6, 6„ , Length 2e Width Gravel thickness below pipe Total depth SF'4�L'La I/31/IC" Effective absorption area Monitoring Tube presentoN)A Depression over field (YO f A'n Date of adequacy test Result (, /Fail) 10,1'95S For -� bedrooms Fluid depth in absorption field before test (in.); Immediately after gal. water added (in.): Fluid depth _ j (ins) Minutes later: Absorption rate = ��� /'� g.p.d. Peroxide treatment (past 12 months) (YQ /VG' If yes, give date /V- '_/ 72-026 (Rev. 3/96)* D. LIFT Date installed Manhole/Access (Y/N) High water E. SEPARATION DISTANCES F. Size in gallons level at* *Datum SEPAR•ATI NQ DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lo`tt�--�n-1- Absorption field on lot Public sewer main Sewer /sepfic-service line OnAdjacoftf lots On adjacent lots "Pump off" level at* Public -s-ewer-manhole/cleanout Lift station SEPARATION DISTANCES FROM IC HOLDING TANK ON LOTTO: Foundation Property line Absorption field Water main/service lineX�,A; Surface water/drainage /J0 ' Wells on adjacent lots atAl SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: o F r,a N zyvsTRaLnrGc� Property line es Building foundation Water main/service line _ of Surface water /6� 0 r � Driveway, parking/vehicle storage area /,7-Ze-,O �'•vpr�' ���v^Y Curtain drain Wells on adjacent lots j-Dv� r� //•JAOG ,e+CNU �`�GHa Ar ENGINEER'S CERTIFICATION �j/tz6+Gf QriNG 4�z< r 'r.+; Fz l` A r, S r/+t r !_= pi's I certify that I have determined thru field inspections and review of Municipal records tha¢'1 t9�e Q.Nare �p P ......... inconformanceWMQguidelis in effect on this date. .rrA, + hSSi nature.- � 41MC .�.�.. M1YWIfLN1 Engineer's Name JC O,3ro.L r - L a("(4ni ti 70 � ROBERT C, COWAN �"k- Date k- Date `� t fl �! �`��'is •% CE - 8801 / � HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY E DEPARTMENT OF HEALTH& HUMAN SER , '.- >- �: '®,: Division of EnvlroArnenial Services. .�;On-Slte Services Section L P.O. Box 198850 .Anchorage, Alaska'':`99619 8650 CERTIFICATE OF HEALTH AUTHORITY % APPROVAL FOR A SINGLE FAMILY DWELLING re .11.!'" -.GENERAL INFORMATION. \ .. . .. ..... ' , , I-. - - - . I ;;Comple4IegaI descriptloh. Lot 2, Heni tagefi" 12320 ffoivltan "ID, e xivi (site address or dire ons) faa'nh kiith4 owner. and Da.y. phone"*'.:345-5360 ..Property :a !Malling 'Box 113074 AK. 99511-3074 adore' P.Q. . .Anchorage., ;Lending a ency Day phone'. ling address " Jan a0 Pay,phona,461 7b00 Agent Ir q %'tan if '?j...... . he held for pckul NUMBER OF. BEDROOMS:', I. IT)EOF WATER riz: -Individual well H', -0_m'm'i"1jnIty well 'L . ..... attest= S I. ;iI r '1* -:11: '' i7 m F .1i41- a VM0544' 77-r777=.A - Public sewer "If &ommunfly Wastematersystem, provide wrl ....,attesting to; the legality and status of Sys am. 72.M(RW.1/91) Fro t 140AM S. STATEMENT.OF INSPECTION BY ENGINEER . As certified by my seal affixed hereto and as of the validation date shown below. I verity 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 forthe number of bedrooms and type of structure Indicated herein.1 further verity that based on the information obtained•from the Municipality of Anchorage files and from my invest!gation 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. S 8 S ENGINEERING + ` "Name of Firm Phone Of I �.A 7 q.e• ' 17034 U916 KIWLAM Address I* Rtwr, Al sks 99577 ' ) •-Engineer's signature Date• :d, `Qq .........�!�S;Qi'`' ..125 1�� •LAOO��L 801 �N ,a',,:' ~ . • • ... f By) Date C r "The fv(!lAlcfpallty of,, ;;h orage Department of Health and Human Services (DHHS) Issues Health Authority ,- '. Approval Gtsrtiflcateg based only upon the representations given in paragraph 5 above by an Independent.:" �;.• ''•"protosslanalen$irteerregisteredIntheStateofAlaska.TheDHHSdoesthisasacourtesytopurchasersofhomes '•e: end tlA04ndinglnstltutionsinerdertosatisfycertainfederalandstaterequlrements.EmployeesofDHHSdonot con46conspectlons or analyze data before a certificate Is Issued. The Municipality of Anchorage is not - _. respon`s`ible for errors or omissions in the professions! engineers work: "'+: •: <,, r;; •.']'/;: ' T7Ctl(11w.-M) 6 k MOA hI 6. • DHHS•SIGNATURE :a'Approved''for bedrooms.'.' ...........:..... .. ,' r'1.•fY .�Ar FII .. ..�., �.�.. ..�i•: ..M - /�4A: �1•.H�. -.� i'1. ..1• - - •Diss �rOved..�� "t Conditional approval for t " bedroomsrwith.the fotiowing`atipulationsi Y. _ ''Additional Comments By) Date C r "The fv(!lAlcfpallty of,, ;;h orage Department of Health and Human Services (DHHS) Issues Health Authority ,- '. Approval Gtsrtiflcateg based only upon the representations given in paragraph 5 above by an Independent.:" �;.• ''•"protosslanalen$irteerregisteredIntheStateofAlaska.TheDHHSdoesthisasacourtesytopurchasersofhomes '•e: end tlA04ndinglnstltutionsinerdertosatisfycertainfederalandstaterequlrements.EmployeesofDHHSdonot con46conspectlons or analyze data before a certificate Is Issued. The Municipality of Anchorage is not - _. respon`s`ible for errors or omissions in the professions! engineers work: "'+: •: <,, r;; •.']'/;: ' T7Ctl(11w.-M) 6 k MOA hI ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LT gL/L 14 1`{F T96:6 H,uParcel I.D. n/5 ,221 -.26 A. Well Data CC� Well type (,SS If A, B. or© attach ADEC letter. ADEC water system numberlLr7ACf1�- (Y/N) Date completed Driller Total depth Sanitary seat (YIP Date of test Static water level Well flow Pump levelf to Casing WELL LOG SEPARATION DISTANCES FROKWELLTO: Wires properly protected AT 9.p -m. SeptiGtiolding tank on 'Y- 00'+ : On adjacent lots Absorption fiel nlot x 3/ ; On adjacent lots Public er main &11,4 Public sewer manhol ewer service tine J!�A Petroleum tank _ REWT 111;0sl'�12­ WATER SAMPLE RESULTS: * ��?_ ZNipECr(oN x Otherbacteria Date of sample: -Collected by: iNGIiVEERING 17674 Eagla __ River Loop Needo. B. SEPTIC4WG9=G TANK DATA Eagle River, Alaska 99577. Date installedl� �- Tank size �DO� Cmc Compartments U/• Cteanouts (�i1 J) !C -S Foundation cleanout (Y/6) P'�6 Depression (Y/gD /Vo N /A Alarm tested (Y/* IJIP Highwateratann(Y/d) n 1 Date of pumping a 1 �L 5 Pumper A * Pomy SEwtoce SEPARATION DISTANCES FROM SEPTICS TANK TO: Well(s) on lot OJIA On adjacent lots f Foundation 6 r To properly line /0 Absorption field S Water main/service line /0 � 4 - Surface water/drainage 1w i fi 72-0zar-W;•From �k lzbpc G Timm CONTINUED ON BACK PAGE fit= •�NS7ntck'+roM• /`L7 T n M C r'f'1 co Cn C7 v i SEPARATION DISTANCES FROM SEPTICS TANK TO: Well(s) on lot OJIA On adjacent lots f Foundation 6 r To properly line /0 Absorption field S Water main/service line /0 � 4 - Surface water/drainage 1w i fi 72-0zar-W;•From �k lzbpc G Timm CONTINUED ON BACK PAGE fit= •�NS7ntck'+roM• C. LI TION MIA Date installed Size In gallons Vent (Y/N) "Pump on" leve High water alarm level Meets MOA electrical codes (Y/N SEPARATION CE FROM LIFT STATION TO: _"Pump off" Level at tested lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date Installed '9 J 02G) 72 Soil rating (GPD/Ft) 2,4�O Si A/Z System type I WIDE C59_AIM. Length W I d / idth r Gravel thickness � � Total depth _ 4 r Total absorption area SF Cleanout present ON � i'6 $ Depression over field (YVJ Date of adequacy test 13193 Results (pass/fall) ASS for 3 Etedrooms Water level in absorption field before test -Y4 A)6N = After test NonrF_ Peroxide treatment (past 12 months) (Y/ J@ A, e"xi " If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: T6cT Fn�,pMrxo by RATTOP Taft SRRocar Well on lot W2 On adjacent lots / 13 Property line ?/ To building foundation LLrxti 4m#cE To existing or abandoned system on lot _ AIIA On adjacent lots 5 1 Cutbank .44 Water maintservice line Surface water n Io6"t Driveway, parking/Vehicle storage areaTEic 14 P -UFS (,=ell Curtain drain Nr» tiiv0VZ) L E. ENGINEER'S CERTIFICATION AaL, To LccAz*= 1K.7. 147' InAS (NS7AUc0 ?EZ PZEWuxu N.A.A. CIG c.it-T BY F? -477w TF_ cls Suc , I cefVfy that I have checked, verified, or conformed to all MOA and HAA guidelines In effper_�JW-a(,jhis Inspection. Signature 'l� ��"� r'�tr�� Engineer's Name Cn w 4,U gid ; CE • 8801 Date �L /7 HAA Fee $ .J bQ ' Cq Date of Payment —7/— 9S Receipt Number 7/ r '5-X6 ) 72025 rM)' Back Waiver Fee $ Date of Payment Receipt Number OF ENVIIIONMI':N'1'A1, CONSF11VA110N ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 Flattop Technical Services + Mr. Theodore Moore, P.E. 14530 Echo St. Anchorage, AK 99516 WALTER J. HICKEL, GOVERN:; +• ;r (907) 349-7755 December 20, 1993 SUBJECT: Lot 2, Block 4; Heritage Hills Subdivision, Anchorage, Alaska Class C Public Water System ID No. 216033 ADEC Project No. 9421 -DW -354-093 Dear Mr. Moore: This letter is in response to the submittal received in this office December 20, 1993, regarding the above public water system, which included wecent water sample analyses for total coliform bacteria and Inorganics for nitrate. Since this drinking water system has been previously approved by the Department, verification that the water supply has been recently tested will be required to maintain compliance with State Drinking Water Regulations. Results from the recent water samples submitted were satisfactory for both total coliform bacteria and inorganics for nitrate, and satisfy this concern. Therefore, for the concerns of this Department, this system is in compliance with State of Alaska Drinking Water Regulations (18 AAC 80). Attached is an "Approval of On -Site Residential Water and Sewer Systems" certificate verifying this system's status as an approved water system that is in compliance with 18 AAC 80. Thank you for your cooperation with this Department, if there are any questions regarding the above please do not hesitate to call. Sincerely, Michael Lu, E.I.T. Environmental Engineering Assistant II ML/cf Attachments STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPROVAL OF ON-SITE RESIDENTIAL WATER AND SEWER SYSTEMS PROPERTY DESCRIPTION Lot 2, Block 4 Heritage Hills Subdivision 12320 Heritage Rd. Class 'C' PWSID no. 216033 C.rtifk.b b.wd b Anoue.t'" Na: 9421—DW-354-093 This approval does not constitute a guarantee of any kind, explicit or implied, as to the performance of the water supply and wastewater disposal systems. WATER SUPPLY A recent water sample was tested and found to meet Department of Environmental Conservation drink - Ing water standards for total coliform bacteria. and nitrates. N.m. Tit,-ZnV3.ronMenta1 081. Engineer Dec. 20,193 WASTEWATER DISPOSAL The domestic wastewater system was: ❑ Inspecte y the Department of Environmental Conservation and found t In compliance with applicable uiir is of 18 AAC 72; ❑ Inspected by a Pr ssional Engineer who certifies that t ystem complies with applicable re quirements of 18 AA 2: ❑ Installed by a Certified Insta of 18 AAC 72; or ❑ tested by a Professional Engin who i and that the system compUel with the the system compiles with applicable requirements that the performance of the system Is satisfactory m separation distances specified In 18 AAC 72. This approval Is vali or a ❑ single family ❑ mut mily unit with a total of bedrooms. Nem. Title Cate 1&0404 JR". M51 DISTRIBUTION: WHITE—eANKILENOING INSTITUTIOII; CANARY—APPLICANT, PINK—DEPARTMENT U -49 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I. D. # n 15,--\'�(n 1. GENERAL INFORMATION Complete legal description 6 lock- � Her, / urs e Hi ll r S /1D Location (site address or directions) 12320 Iferr k4a e Rood Property owner I%, I8- i 6ll�4 Oro 6",, Day phone 3Yy - 6v3/ Mailing address i'• G. 130 III 65 fMch or-gye (+1C 9951/ Lending agency Mailing address Day phone Agent Atnrlee Phill,Af (lulu Rea/ )mss/-ake_ Day phone 562-6`/6 Address 3 o o o °?" Sfi r AAd1 9es-03 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 V 3. TYPE OF WATER SUPPLY: Individual well Community well ✓ Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater sys'O n, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Front MOA N21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm i=1ar-14c4 7"echnicca/ Phone 3S's Address / ys 3 U _Echd .96, An e -A ar-ay e A k 995 V Engineer's signature 07�. - 1-� i'7� - Date Dec Z7 �99� 6. DHHS SIGNATURE x Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: �,y / 1� Date — S ^ %4 7IITIF 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 a21 Municipality of Anchorage s Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L.vt ? 6(UckK*,tn ie lbwf Parcel I.D, A. Well Data Well type °c 11 If A, B, or C, attach ADEC letter. ADEC water system number 216o 33 Log present (Y/N) Date completed Total depth Cased to Sanitary seal (YIN) FROM WELL LOG Date of test Static water level Well flow Pump levels SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Driller Casing height Wires properly protected (Y/N) AT INSPECTION %rc'o vn __Nitrate z Other bacteria nbhf Date of sample: I a / 3 / 93 Collected by: Flu/W4 Tec% Sve, Z az Z 3.p -m. g.p.m. �_ m o z M L6 m p C < Y ti c o R, On adjacent lots z ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform o rol %rc'o vn __Nitrate o.GY my e Other bacteria nbhf Date of sample: I a / 3 / 93 Collected by: Flu/W4 Tec% Sve, B. SEPTIC/HOLDING TANK DATA Date installed 9 / ZY / 73 _Tank size /coo al Compartments Nal Cleanouts (Y/N) Y f=oundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) I. A. Alarm tested (Y/N) N , A. Date of pumping 12/ Is-/ 9-3 Pumper A -+* &, Serge 1 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot NOn e- On adjacent lots lis' Foundation 6' To property line 7 S' Absorption field 371 Water main/service line gbraf*&^ Kn 1v,o«.,; Surface water/drainage > 10 _ 7z-026(3193)• Front /��l @ hme of CONTINUED ON BACK PAGE C. LIFT STATION �►,,¢. Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed 9 / 2S/ 7 2 Soil rating (GPD/Ft) 25-0 0'16ar» System type 6'w• �(ti�n �e2/� Length 125'_ Width 6 Gravel thickness 1' Total depth 6' - ' Total absorption area 768 c1' Cleanout present (Y/N) r Depression over field (Y/N) N Date of adequacy test 12 / 13/9 Results (pass/fail)Y, Po -U for 3 Bedrooms Water level in absorption field before test Aeon e %n M T After test O Peroxide treatment (past 12 months) (Y/N) N If yes, give date Al2w rnvn%. �' iT-eSe �h SIS /l teC 7h cercwrnf+e/ ( le ca Feae n_rrr m,edc i, afjf;-0.7f `� c l -ea a wFer ever- hu lE u in W"A,16��uyo No� SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 2c oc V90 at• /F,a ctiuPcltr�r io ytk� Well on lot None On adjacent lots* I H3 ' Property line 7' To building foundation Pau es un seer prq g To existing or abandoned system on lot N, A. On adjacent lots > ?v' Cutbank Ai A. Water main/service line io' Surface water > 100' Driveway, parking/vehicle storage area lasses un Beer e_-er«e wGy Curtain drain 1\ione Seen iE Sed ra free ' c!(r /trn c e w at rt�ur Q f �'"II'+ie or rrit�ll C2�n E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and NAA guidelines in effept•.Rq t4date of this inspection. .�Ja''¥.�id�c0aaa av(� ae � " � a s __ �°y'Y ppqv -a• s qct a +�'<: 4 Signature 0OV#99890 FgA 4N �9ecA9a#4 k.t9t'Vwx Engineer's Name %heoe:Pore E Lfc vry— 99 ea>�.�'eaa•a ea®xr'ce'ertioitagx ® T.HEODOaE r. ,'ACORE,' CE - Date Der•em hem 27, /993 * � tr`,�°9 Q993a 39i�o v� HAA Fee $ 3 Oa Date of Payment 7117-3 Receipt Number J �30 70 -MA /71191• Rark Waiver Fee $ Date of Payment Receipt Number WALTER J. HICKEL, GOVERN. iDEP11. OF ENVIItONNIEN7'A1, CONSE11"11ION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 December 20, 1993 Flattop Technical Services Mr. Theodore Moore, P.E. 14530 Echo St. Anchorage, AK 99516 (907) 349-7755 SUBJECT: Lot 2, Block 4; Heritage Hills Subdivision, Anchorage, Alaska Class C Public Water System ID No. 216033 ADEC Project No. 9421 -DW -354-093 Dear Mr. Moore: This letter is in response to the submittal received in this office December 20, 1993, regarding the above public water system, which included recent water sample analyses for total coliform bacteria and inorganics for nitrate. Since this drinking water system has been previously approved by the Department, verification that the water supply has been recently tested will be required to maintain compliance with State Drinking Water Regulations. Results from the recent water samples submitted were satisfactory for both total coliform bacteria and inorganics for nitrate, and satisfy this concern. Therefore, for the concerns of this Department, this system is in compliance with State of Alaska Drinking Water Regulations (18 AAC 80). Attached is an "Approval of On -Site Residential Water and Sewer Systems" certificate verifying this system's status as an approved water system that is in compliance with 18 AAC 80. Thank you for your cooperation with this Department, if there are any questions regarding the above please do not hesitate to call. Sincerely, Michael Lu, E.I.T. Environmental Engineering Assistant II ML/cf Attachments . Ar Of' T, STATE OF ALASKA E c•-,:����, +�, DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPROVAL OF ON-SITE RESIDENTIAL WATER AND SEWER SYSTEMS -A1,A PROPERTY DESCRIPTION , Block & Subdivision or U.S. Survey Lot 2, Block 4 Heritage Hills Subdivision 12320 Heritage Rd. Class 'C' PWSID no. 216033 Certificate Issued for Application No.: 9421 -DW -354-093 This approval does not constitute a guarantee of any kind, explicit or implied, as to the performance of the water supply and wastewater disposal systems. WATER SUPPLY A recent water sample was tested and found to meet Department of Environmental Conservation drink- ing water standards for total coliform bacteria. and nitrates. dame a�- nue nv1ronmen a Dale EngineergineerDec. 20,'93 WASTEWATER DISPOSAL The domestic wastewater system was: ❑ inspected by the Department of Environmental Conservation and found to in compliance with applicable quirements of 18 AAC 72; ❑ inspected by a Pr essional Engineer who certifies that t system complies with applicable re- quirements of 18 AA 2; ❑ installed by a Certified Instal who cthe system complies with applicable requirements of 18 AAC 72; or ❑ tested by a Professional Engin><t that the performance of the system is satisfactory and that the system compI' with tm separation distances specified in 18 AAC 72. This approval is vali or a ❑ single family ❑ multi -family unit with a total of bedrooms Name 18-7404 (Rev. 8185) DISTRIBUTION: WHITE-BANKILENDING INSTITUTION; CANARY -APPLICANT; PINK -DEPARTMENT r `4 `IUNICIPALITY OF ANCHORAGE" DEPARTMENtT�,— HEALTH AND ENV IRONMENTAL�sr-AOTECTION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 I Date Received: March 14, 1977 1st Inspection: Time 0',�M _ 2nd Inspection: Time _ Date Date Inspector Inspector REQUEST FOR APPROVAL OF INDIVIDUAh SEWER ARID WATER FACILITIES 1. Lending Institution Request: First National Bank of Anchorage Mailing Address: Post Office Box 4-2090 Phone: 274-1521 fl4 3Llg-7�2T 2. Property Owner: Donald 1/Lynn E. Burns Phone: 276-2233 Lynn Mailing Address: 3. Legal Description: Lot 2 Block 4. Single Family Residence: (X) Heritage Hills Subdivision Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms: d 5. Well Data: Type Individual Depth Construction Bacterial Analysis Well Log Filed ( ) 6. Sewage Disposal System: On-site sy_te (X) Public Utility ( ) Permit # Installed L' Installer Septic Tank Size/001) Manutactureer Absorption Area Soils Rate's _/ Mat rial. 7. Distances: Well to Septic Tank —ILIA to Absorption Area to Sewer Lines Nearest Lot Line L Absorption Area to Nearest Lot Line J �,__ ,. WNICIPALITY OF ANCHOUGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION'' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 MAR I i 1977 1. Type of Inspection 2. Property Owner: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES RECEIVED CMRO VA FHA CONY x Donald L. & Lynn E. Burns Mailing Address:. Day Phone: Lynn -276-2233 (T &-C. Realty) 3. Name of Buyer: Clarence E & Barbara J. Young Mailing Address: SRA Box 1301 P (99502) Day Phone: 349-4994 4. Name of Lending Institution: First National Bank of Anchorage Mailing Address: P. 0. Box 4-2090 99509 Phone: 274-1521 5. Name of Realtor or Agent: Towne & Country Realty -Lynn Burns Mailing Address: 115 W. Northern Lights (99503] hone: 276-2233 6. Legal Description: Lot 2 Block 4, Heritage Hills S/D Location: NHN Heritage Road (Contact Lynn Burns for directions) 7. Type of Facility to be Inspected: SFD No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility Individual XX If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation 72-003(3/76) Individual (on-site) xx MUNICIPAUrr OF AN(tIO1tA DEPT. or- I r Arc i r; �NVIRONMFyTA(. Pi1U'I'@CTION MAP 14 1.9,17 RECEIVED, 1 Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: _ Lot 2 Block 4 Heritage Hills Subdivision comments: Affadavit Attached: A ) Approved: Disapprove&V: Department Worksheet: Letter Attached: ( ) Date: — L' -- -71 Date: i 1 alb R&M CONSULTANTS, INC, 5024 CORDOVA ■ BOX 6087 ■ ANCHORAGE, ALASKA 99502 B PH. 90)-2]9-0483 O TLX. 090-25360 ENGINEERS GEOLOGISTS PLANNERS SURVEYORS March 18, 1977 R & M No. 751506 First National Bank of Anchorage P.O. Box 4-2090 Anchorage, Alaska 99509 Attention: Florence Wegner, Real Estate Department Re: Percolation Test on Existing Disposal System; Lot 2, Block 4, Heritage Hills Subdivision, Anchorage, Alaska. Gentlemen: On March 18, 1977, at the request of Ms. Lynn Burns, our office conducted a percolation test on the existing sewage disposal system located on the above described lot. The following table represents the level of the liquid in the tank. The depth of liquid in the tank was initially 6.1 feet below the top of the stand pipe. The tank was assumed to be full or at the outlet level. For the test, the liquid level was measured from the top of the stand pipe. Summary of Measurements The meter used during the test was a Rockwell 5/8" standard water meter. The meter had previously been calibrated by R & M Consultants, Inc. The septic tank had not been pumped prior to the percolation test. Since the house on the lot concerned was occupied, it can be assumed that the leach field in question was at its normal degree of saturation. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA Level of Liquid Meter Reading Time In Septic Tank In Gallons Remarks 0:00 6.10' 3,488 (Initial) Arrived 0:21 5.76' 3,613 1:00 6.08' 3,638 (Final) 150 gallons in 60 minutes (2.50 gpm) The meter used during the test was a Rockwell 5/8" standard water meter. The meter had previously been calibrated by R & M Consultants, Inc. The septic tank had not been pumped prior to the percolation test. Since the house on the lot concerned was occupied, it can be assumed that the leach field in question was at its normal degree of saturation. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA First National Ban -V of Anchorage March 18, 1977 Page 2 If it is assumed that the existing three bedroom house will house six people, the average daily load on the disposal system can be expected to be 450 gallons per day, or 0.31 gpm. Since the existing disposal system accepted 2.50 gpm, we would conclude that the leach field is presently performing in a satisfactory manner for the attached private residence. If you have any questions concerning this test or this letter, please do not hesitate to call. Very truly yours, R & M CONSULTANTS, INC. Edward Yarmak, Jr. Geotechnical Engineer EY:mh