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Home My WebLink AboutHERITAGE PARK BLK 1 LT 8Heritage Por'k lock I Lot 8 050- 211 -36 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 1 of 3 www.ci.anchorage.ak, us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: -SW101123 PID Number: 050-211-36 Name: David McMullen Wastewater System: [] New [] Upgrade Address: 10537 Tradition Avenue, Eagle River ABSORPTION FIELD Phone: Number of Bedrooms: ; [] Deep Trench [] Shallow Trench [] Bed [] Mound [] Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: .6 GPD/Ft2 10 Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 1 8 Heritage Park 2 Ft. 8 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 1.5 Ft. 47 Ft. Well: [] New [] Upgrade Orave~ width: Number of lines: I Distance between lines: 2.5 Ft. 1 Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: I Existing Public Ft. Ft. 752 Ft' 3034 PVC Driller: Date Ddlled: Static Water Level: Installer: Date Installed: Ft. Flinstone Excavatin~l 812612010 Yield: I Pump Set at: Casing Height Above Ground: GPMI Ft. Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity: From~ Tank Field Station Tank Sewer Line Anchorage Tank 1000 Gal. We,, NIA NIA Material: Number of Compartments: Steel 2 Surface Water 100+ 100+ X / LIFT STATION · o~ L~ne 10+ 10~ Size: Manufacturer: 250 Ga,~ Orenco/Anchorage Tank Foundation , 6.2 (E) 10~- "Pump on" level at: "Pump o~' level at: I High water alarm at: +40 ~n +36 ~n. +45 ~n. I Pump Make & Model Electrical Inspections performed by: Curtain Drain P2005.1 Risin~l Son Electric Remarks: New lift station and absorption field only. BENCH MARK Location and Description: Door Assumed Elevation: 100.0 Ft. Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1st 8/26/2010 ~.~c OF- 4 2n~ 8/2612010 --- ~e. ........... ,,,;~..,;, ... o22 Development Services Department Approval ~.." ~ '..' Conditional Approval Date: ~ .. . -- . . nnone&,~ /9. Reviewed and approved by: ' - 11 .... ..... ?-..---..... 31.7 19.0 I~ / "' '~ --- ~N "<'-'-~ 35.1 21.2 ~ / ""-.. 36.2 22.2 v ~ --.. ~..~ 38.8 28.4 i ~ ""/'-' .~...~-_~ 71.7 64.6 ~ ~ "' ~...~. ~ 62.9 35.0 ! / ~ ~ '~ '~- ...."' ~--... 88.8 72.4 i / ~ ~ '~' "' '--- ~"~"'~-. UPCRADED DRAIN'FIELD SEPTIC AREA ]FC T1 T2 LS I ECl F- i EM1 FM1 CO A B FO 30.7 18.6 T1 31.7 19.0 T2 35.1 21.2 LS 36.2 22.2 ECl 38.8 28.4 ~- EM1 71.7 64.6 M1 62.9 35.0 M2 88.8 72.4 / 47LF X 2'W X 8'ED, I O'TD ....... , / / / PESTH~ ~ ~~IVERTER VALVE (P) r/ NO SCOPES /~~~. / ~DOUBLE C.O. (P) :%x W/IN 50' / //,.,~ ¢/ / ,~LLED NEW 1250 S.T.E.P. TANK,.//11 ~~. D a t e ,oxs: ENO 9P. RECORD DRAWING P.O. BOX ~00217 ANCHORAGE, AK 99510 ~"' ~.,.~i~a lO/5/lo PHONE (907) 272-8218 FAX (907) 272-8211 ~ .. ~..~ fa Scde - ~*."49~ ~ '.*~ q"=5o' HERITAGE PARK S/D BLK I LT 8 ~ ..... ~P.L~. No DAVID McMULLEN '~~E~ ;~d~&'~ 050- 211-3( b 10557 TRADITION AVE r¢~.:. ,CE 81E9 ..~-;~ ~EE-~ ~ EAGLE RIVER, AK 99577 ~ii~.[}¢~¢¢~..¢~~ 0SP101125 PLAN (907) 529-9~00 i ~ pS~{S{~S~ Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE /N ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 5. SCOPE OF WORK: 5 BR HOUSE SEPTIC UPGRADE, VERIFY INTEGRITY OF TANK 5009 STEP TANK, DEEP TRENCHES 47 LF X 8' ED X 10' T.D. REUSE EXIST'G DRAIN FIELD. 4. GROUNDWATER iS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOiL TEST IHOLE INFORMATION ABOVE 16 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 16 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. 5. INSTALLED NEW 12509 STEP TANK. EXISTING 10009 SEPTIC TANK ABANDONED PER CODE. 100.2 .~F~F~.~-GRAVEL ABOVE PIPE 1.5' FILL 2' ~ __ .~O~__ . 8.0 ~¢~ -- GRAVEL ~ --88.7 6P/6~ i -- 2'-5'-- BBTH I 4" ¢ PERFORATED PiPE NEW 1250g S.T.E.P. TANK -88.7 %GRAVEL BELOW PiPE DESIGN PARAMETERS ABBREVIATIONS LEGEND UPGRADESEPTIC SYSTEM CU COPPER ....... w- w WATER LINE/ NO. BEDROOM: 3 (450 gpd) DiP DUCTILE IRON PIPE WEN RADIUS TANK SIZE: 1,000 gellon TH TEST HOLE PERC RATE: 21 MPI 0.6 OPD/SF FCO FOUNDATION CLEAN OUT ~ss ~ss ~ EXIST'G SEPTIC AREA RQD: 750 SF T¢ TANK CLEAN OUT NO. SYS. TYPE: DEEP TRENCH, 8' ED C~ CLEAN OUT NO. ss ss NEW SEPTIC MiN LENGTH 46.5 LF M~ MONITOR TUBE NO. USE: 47 LF X 8'E.D. X 23' WIDE, 10' T.D. R.I. RIGID INSULATION 0 CHAINLINK FENCE INSTALL DIVERTER VALVE. DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 ~.. ..... ~¢~,~ 10/5/~0__ PHONE (907) 272-8218 FAX (9O7) 272-8211 '~9~ NTS HERITAGE PARK S/D BLK 1 LT 8 ~-'~-~'"'-'~ -- PERMIT NO. 0SP101125 EAGLE RIVER, AK 99577 ~ *~ '. ..... ~-~ Sheet DESIGN NOTES (907) 529-9400 Oct OS 2010 8:54RM RISING SOH ELECTRIC 90?-622-6??? pa~e 1 (~07) 67'2-6777 October 5, 2010 3R'S Septic Pumping Attn: Dave Mero P.O. Box 773415 Eagle River, AK 99577 Re: 10537 Tradition Ave. - Eagle River, AK 99577 Dear Dave: The lift station at the above referenced property has been wired in accordance with NEC and State/Local codes. Thank you. Sincerely, Administrator License Number 1284 Specialty Contractor License Number 27285 cc: file Pannone Engineering FAX#272-8211 Permit Number: OSP101123 Tax Code Number: 05021136000 Work Type: Septic Permit Effective Dates: July 28, 2010 Design Engineer: Subdivision: On-Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade to July 28, 2011 PANNONE ENGINEERING SERVICE HERITAGE PARK Site Legal Address: Owner/Address: HERITAGE PARK BLK 1 LT 8 G:0055 MCMULLEN DAVID E & JANICE 10537 TRADITION AVE EAGLE RIVER AK 995778413 Site Mailing Address: 10537 TRADITION AVE, Eagle River Lot Size in Sq Ft: 21310 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y SepticTank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www. muni.org/onsite (907) 343:7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-211-36 Property owner(s) David McMullen Mailing address10537 Tradition Ave Site address 10537 Tradition Ave, Eagle River Day phone 529-9400 Zip Code 99577 Zip Code 99577 Legal description (Sub'd., Block & Lot) Heritage Park S/D Block 1 Lot 8 Legal description (Township, Range & Section) Lot Size 21,310 Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR ([~ all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] I certify that the above information is correct, t further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. Pannone Engineering Services, LLC~ (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve~panengak.com July 19, 2010 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Heritage Park S/D, Block 1 Lot 8 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The lot is served by a private water supply. The existing septic tank will be verified and the drain field shall be reused.. A new drain field will be installed west of the existing field. A five hundred gallon list station will be installed. The surrounding developed lots are served by private water systems. The private wells are located over 100 feet from the proposed soil absorption system. 1. Soils. A single test hole was excavated by PES on June 24, 2010. See the attached soil log. Ground water was monitored for over seven days. No ground water was monitored to a depth of 14 feet below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.6 gallons/day/square feet should be used, using a conventional wastewater treatment system. Soil Absorption System Design. See Design Drawings sheet 2 of 3 for the design calculations. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surhce water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately three to five percent based on the survey inforrnation north of the area of the septic system. The area the septic system will be installed is relatively ilar, graded to approximately two percent. There are no steep slopes within 50 feet of the proposed septic system. Mailing: P~O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82~d Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and there are no further comments received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, I....~....~...~.....~.....~ [~ 8tovon R Paanone ~ Steven R. Pannone, P.E. OwneffCivil Engineer Attachments: Mailing: P,O, Box i00217~ Anchorage, AK 99510-0217 Physical: 615 East g2nd Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 6 6 ~OSED DRAINF! 4-7LF X 8' SEPTiC AREA (E) ADD ON PE S~, TA. (P) OT REQ~UIRED '.F (E) ANK N~_EDS TO BE EPLACED 7 NO SCOPES EXCEEDING 25% W/IN 50' UPGRADE O'TD SEPTIC AREA (E) 3% 7 SEPTIC AREA (E) EXISTI ]LD IN TO REVISED VALVE (P) C.O. (P) O00g SEPTIC TANK (E) RIFY INTEGRITY LACE W/1250 STEP RRODED NOTES: ISSUED FOR CONSTRUCTION PLAN PANNONE ENG SVC, LLC P.O~ BOX 100217 ANCHORAGE, AK 99510 FHONE (907) 272-82!8 FAX (907) 272-8211 HERITAGE PARK S/D BLK 1 LT 8 DAVID McMULLEN 10537 TRADITION AVE EAGLE RIVER, AK 99577 (907) s2e-9z~oo HOUSE (E) 1" CU WATER SERVICE (E) 9 11 D~te 7/28/10 Scale 1 "= 50' P.I.D. NO ~-50- 211 - 36 PERMIT NO. 84-0265 Sheet I OF3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE /N ACCORDANCE WITH THE Al-I-ACHED SPECIFICATIONS. 3. SCOPE OF WORK: 3 BR HOUSE SEPTIC UPGRADE, VERIFY INTEGRITY OF TANK 500g STEP TANK, DEEP TRENCHES `47 LF X 8' ED X 10' T.D. REUSE EXIST'G DRAIN FIELD. `4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION ABOVE 16 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 16 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. 5. IF EXIST'G TANK IS CORRODED, REPLACE W/NEW 1250g STEP TANK & REMOVE 500g STEP. · '~'FF~.<~BRAVEL ABOVE PiPE °~i 2.0 ~ 2' ML ~ 4" ¢ PERF PIPE ~.0 ~ -- GRAVEL GF/GM -- -- 2'-3'-- 14,/. I NO GROUNDWATER TO 16' BASED ON BBTH DESION PARAMETERS ABBREVIATIONS LEGEND UPGRADESEPTIC SYSTEM CU COPPER --w--w WATER LINE/ NO. BEDROOM: 5 (`450 gpd) DIP DUCTILE IRON PIPE WELL RADIUS TANK SIZE: 1,000 gallon TH TEST HOLE PERC RATE: 21 MPI 0.6 GPD/SF FCO FOUNDATION CLEAN OUT ss --ss -- EXIST'G SEPTIC AREA RQD: 750 SF T# TANK CLEAN OUT NO. SYS. TYPE: DEEP TRENCH, 8' ED C# CLEAN OUT NO. ss ss NEW SEPTIC MIN LENGTH 46.5 LF MC/ MONITOR TUBE NO. USE: 47 LF X 8'E.D. X 2.3' WIDE, 10' T.D. R.I. RIGID INSULATION 0 CHAINLINK FENCE INSTALL DIVERTER VALVE. DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLI%FER NOTES: PANNONE ENG SVC, LLC ~.~OF A.L._~.~), Date PHONE (907) 272-8218 FAX (gO7) 272-8211 ~'~'."~0 ll"l~.~.. ~_./~'n..~'~,~ '".~ scale NTS HERITAGE PARK S/D ELK ! LT 8 ~". '?*_...~~';'--"-'~ P.I.D. NO DAVID McMULLEN~~.~, onnor~e ~ 350-211-.36 ' 10557 TRADITION AVE '¢~' 'ffc;""i.:~ PERMIT NO. ¢~, ~,~-. CE 81,49 .'x,%,~ EAGLE RIVER, AK 99577 fl~ccX.... ..[¢%.-.-.-.-.-.-.-.~ 840265 DESIGN NOTES (907) 529-9400 'l~f;/~S.S/-o~'~%~ Sheet SOILS LOG - PERCOLATION TEST TEST HOLE 1 1--2 ML BROWNSILTS SEPTtCAREA(E) __ I J 500g ADD ON / : ] /TAN~ NEEDS TO BE ~DIVERTER VALVEI(P) i NO SCOPES I REK~CE W/1250 STEP W/SAND & / W/IN 50' 7-- GP/GM ;SILTS'POORLY ~ ~DON GRADE KERS 8" ~ L /' /~ 8 -- MSA I TEST 9 -- I HOLE ~ 12 J WAS GROUND WATER SLOPE 14 ENCOUNTERED? N BOH IF YES, AT WHAT TH 1 DEPTH? -0-' X DEPTH TO WATER A~ER MONITORING? DRY - DAT E: 7/6/10 I R~DING ~ DATE CLOCK WATER TIME NET TIME LEVEL NET DROP , ~ READING I 1 i 8-24-10 10:11 5.50 ~ 2 ~ 10:21 , 10 LIN 5.97 0.47 3 ~ 10:21 ~ -- 5.50 ~ j 10:31 5,50 I ,o:,, ,O ,N PERO~TION ~TE 21 (min~nch) PERC HOLE DIAMETER 6 inches TEST RUN BE~EEN 6 ~AND 7 COMMBNTS: Test ~o~e excavated by ~SSACS CONSTrUCTiON. Test Hole was p~eso~ed before pe~c test. PB~O~MBD BY: Ste~e~ R. P~o~e, P.~. ~ CB~T~Y THA~ ~S TEST WAS PERfOrMED IN ACCO~DANCB W~TH A~ STATB AND MUN~C~PA~ GU~DMNSS ~N ~BCT ON T~ DAT~ O~ T~S TBST. ~g~ .... ¢~}I[, 7/28/10 ISSUED FOR CONSTRUCTION P.0. BOX 102954 ANCHORAGE, AK 99510 =__~.. ~¢~..~ u ~..~ ( Scale I PHONE (907) 272-8218 FAX (907) 272-8211 ~...'~ ~'::..,~ NTS . ~50~211-36 ~ D A VI D M cM U LLEN '~ ~E ~L~P~h'~d~ ~'~ I 10537 TRADITION AVE ~ ~,....... · ~ iPERMIT NO. SO~LS EGO IEAGLE RIVER, AK 99577 ,~,~.. .~ 840265 ' (907) 529- 9400 'l~~s{~ Sheet CLOCK WATER READING i DATE TIME NETTIME LEVEL NET DROP i READING 1 i 8-24-10 10:11 5.50 2 I 10:21 10 LIN 5.97 0.47 3 ! 10:21 5.50 4 I 10:31 10 LIN 5.98 0.48 5 j 10:31 5,50 6 I 10:41 10 MIN 5.90 0.45 O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONE/IENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE MAI LING ADDRESS - LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS I ~ ~ DISTANCE TO: ~ ' ~ ~ Material No. of compartments ~ ~ Liq. capacity in gallons Inside length Width Liquid depth /~ IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ( Manufacturer Material Liquid capacity in gallons Well :~ DISTANCE TO: ~/~ Foundation Nearest ,ot line PERMIT ~O. ~ ~ ~ TopN°' °f li~es6/e(til to finish gradeLength °f ea~ line~ Total length of Ijnes~. Trench width~,, inches Distanc~ines. Material beneath tile Total effe~ve absorption area Length Width Depth PERMIT NO. ( ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS ~ ~ ~ ,~ INSTALLER i .~ ~_~ RE~ARKS / / /r~r .. ~ -.,~. / ~--' ~ _ __ ~~ ~. / APPROVED DATE LEGAL~0" .i ~.~/~/~~"~'''-- 72-013 (Rev. 3/78] PERM I T NO: [:,RTE I SSLIED RF'PL I C:~NT: F~£:,C,F:.E SS: COI4TRCT PHONE: LEGRL DESCF.:IP: LOT S I ZE: HR?:; E',EE:,ROCd'IS: 26 .:~ - 4 ,:' 20 '_--; E I--~ E F-: F' E F-:P1 t 'T .LOT ' ':' F:RNGE 1l,-I [:,EVCON ENT INC 54±i OL[:, SEI,.IFIRC' HFY-," RNCHORRGE., AK 99562 561iEeE',;-2 SUE:E:,I',/ISION: HERITAGE PRRK 3]EC:TION: ? TOHNSHIF': ±4N 7_.'1]:±E~ <SQ. FT. OF: FtCRES> ]: E:LOCKi "LISTE[.' E:ELOH FIRE THE FIF'TtONS FI',,,'RILRE:LE TO 'T'OU I~".~ [:,ESIGNIN. G '¢OUR SEPTIC T~~ FIT'~ yFdlR SITE. ' '?¥"~TEH CHOOSE THE OF'TION .... SOIL RRTING ,::SQ. FT. ,."BR) ** DEPTH TO PIPE E:OTTOH < 4. 8 FT. HR'¢ REQUIRE R LIFT STRTION :+:* TRNK f'IUST t4R',,,'E RT LERST THO COHF'RRTHENTS I CERTIFY THRT' $. I R['I FRI"IILIRR HITH THE RE;,JIF'EHENTS FOR ON-SITE SEI4ERS RN[:' HELES R~ SET FORTH E:'T' THE 1,1UHIE:IF'RLITk' OF RHCH3RRGE ,::HOR> RND THE STRTE OF RLRSKR. 2. I HILL INSTRLL THE b%¢STEH IN RE:CORE)RNCE HITH RLL MOR CODES aND REGULRTIONS., RN[:, IN COMF'LIRNCE HITH THE DESIGN CRtTERIR OF THIS F'ERHIT. 3. ~ HILL RDHERE TO ALL HOR RNC, STFtTE OF RL. RSKR REQUIREHENTS FOR THE SET ERCK DZSTRNCES FROH RN'¢ E,NtSTING NELL, HRSTEHRTER DISF'OSRL 5'¢STEM OR F'LIE',LIC ,-,,~ ~HI~ OR RN'T' R[:,ZRCENT F~F' NERRE:'¢ LOT. SEHEF:FIGE :,~_,TEH ON - ' -s ' 4. I UNDER~;TRN[:' THRT THI~ PERHIT IS VRLID FOR R HH,,IMUH OF 2: BE[:,ROOHS RND RNY ENLRRGEHENT [,JILL .F'EQLI~FE RN RE:,DITIONRL PERHIT. IF R LIFT 5TRTION IS INSTRLLE[:' IN aN RRER COVERED E:'¢ MOR BUILDING CODES., THEN ,::i::, FIN ELECTF:ICFIL F'ERHIT RN[:, ~NSF'ECTION t,IU~T E:E OE~TRINEE:,.~ ':2', RS~E:Lt~LTS F.IIi_IL f-~OT E:E f:¢:'F'RO',,,'ED F.IiTHOLIT IRN ELECTRICRL INSPECTION REPORT.; RND <~", THE KLECT R I '5 t 3NEE:, _ ............. C:ONTRC:T PI-lONE: L.EGF!L. [;',E:SE:I:;;: I I:::': L 0 T ' F c'¢ p'--~:" · ::LI.,:! E: L, 0 C K ' DE?TH "FO F:'iF:'E E:O'T'TOH (I:~:'T. ], ]!i:. 5 :.l.::~.: 'GRAVEL. 1]:,EF'TH ,:: i:::"T'. ]' ',?,'1 5 TOTAL. [:'EP"i'H ,::F:.'T. ;:' 1.2:. 0 GF?.FF,IEL H I D'FH ,::F::'T. ;:' ;2. 5 GRFI':,,'EI.... LfEHG"FH ,:] F'T. ) ,~t~:.~. El G~:i::?vT]... ',,,'OLLt!"iE ,::C:LI. ¥[:,S. ;:, 2:]~L 2:: TAb,if( S I ZE: ,:: GFii....S ::, :i.., !2~t2~(~i. i;~[i :+::.1-: E;O i L Fi:AT Z I'.,iG ,:: S(;L F"T'. ,.."E',F;: ::, ;2;25 ~..-~ _ E::', FA: ~:::!i % ~:. 5 :4.::.1-: :%5 5. I-'_,"t 7':..~:. 0 5,::1.. 0 1, E10~-3. ~3:4.::+: 225 CER T ! F:".r' 'TH!:::FF: t !:::IM FFIMIL. ZA.¢;?. Hi'T'!-I THE !::;:E:~]!!...i:!:RiEMENT:E; FOR 0N-.SiT'E 9..';.-EI,,IEFi::.5 F:llql:::, I,.!ELL. E; I::IS '.:~';E'T I::'Oi~'.TH E',"¢ TI.iE MLlhi ! C.]: F'FIL. ]; 'T'? OF' i:::Ii-4C:FEd:;;:I:::iEiE; ,:: ?II)Fl;:, Ftt-,iD THIE S'f'I:YTE OF ;2. I !,.!I!....L I i'.,I:E;'T'F'iLL. THE S'.,.':i?."!EH !'I'.,! F:p::::[X],q:[:,I::!h!E:E: !.,.l:rTl.-! FtL. L h'!OFi E:O[.':,!iES; FIN[::, t:-.;-:EGIJLF:iT!ONS, Al",![:, I h! E:[}MF'L. ]: l::iiqE:E] H i "FH 'THE [:,E:~;; I' [:_d'.,! C:R Z 'TE]:~: ! FI OF' ']'H ! :E; F'ERM t % 3:. i HIL. L. !:::!C,HE!:~::i!~; 'T'Et F:IL.L i,IOFi FiH[:, :!?f'FFi"E] C,'F' i:::ii...F:E.~.:;KA RE(;:!UZ,q:E?iENTL::; F'OF?. THE: E;ET. !.'], i :E;TI::i,"'.,K]:ES FF:E!.h'! F:li'.,!'.¢ Iii[::.:; Z :E;T I P.,!G l.,.l!i![l...! .... HFIE;Ti!.:.'HFiTE:i:-']: D I E;i:::'CE:2;RL SYSTEM OF?. F'UBL. Z E: '.;':..';I..'~:!.,.iE;I:;i:I:::I,'.'3E; :E;?:!i;TEI"! Cd'-,l 'I"H];E; OF?. f:l~',i~.,-' FiD3F~E:E!'.,!T OR ?.,ilE!:::fi:;:IF.?¢ LCIT. 4.. I UH[:,E:r?.'_:ii;-I'Fih!E:, 'THF:FF "I"I...I ;£ :!;i; F'Ei~:M i' T Z '_.]~; ',,,'F!L. Z [:, FE!E: .F'~ MR::-:: I MUM. (;IF 2: E=EDR(]OM% FIND F:!h!"r' IEh!LF:!f:;~:GEi"]E:i",!T !.4 ~ !...!.... ~;;::I:~i;!~;!1...! :[ [:;:E~ i::i!",i !:::I[:,[:, Z T ]: Ed'~h:::iL PiiEi:;;:hi I T. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST LEGAL DESCRIPTION: 5 6 7 8 9 10 11 12 13 14 15 16-- 17 18 19 20 COMMENTS DATE PERFORMED: SLOPE WAS GROUND WATER S ENCOUNTERED? J~ O ki O P E AT WHAT ~'/~SOI LS LOG [] PERCOLATION TEST SITE PLAN ~ ~ ~ '*" ~'~ Gross Net Depth to Net · '~ - Date .,~_.~ Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ~ FT 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVI RONE4ENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST LEGAL DESCRIPTION: ~-,O'T" ~; j~-' I 1 2 3 4 5 6 7 8 9 DATE PERFORMED: SLOPE 10 SOILS LOG [~'~PERCO LATION TEST SITE PLAN 11 12 13 14 15 16-- 17 18 19- 20- WASGROUNDWATER /~(~ ~ ENCOUNTERED? O P E Gross Net Depth to Net Date Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) TEST RUN BETWEEN - / , FT AND ~ FT Av_e~ of ,last three readin§s 6" alia ho]e;~s~b-~eurs,~ ~e]~ co~pacted,lo~ p E R F O R M E D B y :~_~ L .~_ ~.~.) i~ ~.~ ~___...~ CERTiFiED B~~ DATE 72-008 (6/79) MUNICIPALITY OF ANCHORAGE ~ · DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Se[vices 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 .D.# C.~-~JI-'~'~/"' ' ' . HAA#//~-~/~-~-c~'/ 1. GENERAL INFORMATION '" ' ' : ' '"' Lot 8; Block 'ii Heritage Park Subdivision Complete legal description Location (site add tess o r directions) 10537 Tradition Eagle River, AK PropertyOwner: .Maurzce 5ehouillier ,,~aii.i'6g... address ',,~.'0. Box 4745 Incline Village ~ · , ...... ~Cit~y Mortgage ~.kendmg agency ....... ' .... 1196'~1 BuSiness".Blvd. Btdg "B" ~ "%,~fl~ng address -' ~ ~.~ Address Unless otherwise requested, HAA will be held for pickup. Day phone (702) 832-3043 Nevada 89450 Day phone 696-0701 Eagle River, AK Day phone NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 3J RECEIVED APR 24 1997 Municipality of Anchorage Dept. Heai[h & HumanServices If community wel; 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 Public sewer ' NOTE: If Community wasteWater system, provide written confirmation from State ADEC atteSting to'the legality and'status of Systeml 72-025(Rev. 1/91) Front MOA~21 r ' STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigatipn 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 verifythat 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. S & S ENGINEEP. ING Name of Firm !70_~4 _,~!e ~_~,.,~? L~-~2- .".-~---~ .~:c. 204 Phone ~; r4 "/~-¢/ 7 ¢/ Eagle River~ Alaska 99577 Address Engineer's signature ")~'f~,~/'/'~ ~'/~'~---- Date ~//-~q / ¢/7 DHHS SIGNATURE · ~' Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments '.The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval tort ftc,ares'based only upon the representabons g yen n paragraph 5 above by an ndependent profess~or~.al eng n~rreg stored n the State of A asks The DHHS does th s as a courtesy to purchasers of homes and their lending institutions in order to ~atis~ certain federal and state requirements. Em ~loyoos of ~HH$ 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 engincmr's work. 72-025 (Re,,. 1/91) Back MOAit21 ~v I~uINMI:NTA~ Municipality of Anchorage APR DEPARTMENT OF HEALTH & HUMAN SERVICES_ Environmental Services Division J~ E C L~l V 825 L Street, Room 502 · Anchorage, Alaska 99501 (907) 343-4744 Health Authority Approval Checklist LegalDescription: L~-r ~., (~,ocv,, J., ~t~'~c~E. ~.Y- Parcel I.D.: 0 ~:~ --~//'-,~(~ A. WELL DATA L-//~Cfl~dJt't-'Y Well type /"'~,~ "A" If A, B, or C, attach ADEC letter. ADEC water system number ...--- Log present (Y/N) __ Date completed~~ Total depth ~ Casing height (above ground) Date of test Static water level Well production WATER sAMpLE RESULTS: FROM WELL LOG Wires properly protected (Y/N) AT INSPECTION g.p.m. ..~/ g.p.m. Coliform Nitrate Other bacteria Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed E, - 8- 8~ Tank size IOOC3 Collected by: Number of Compartments Foundation cleanout (~XI) Date of Pumping I"l'/'ZZl/~t"l Pumper ,.~R. C. ABSORPTION FIELD DATA Date idstalled -~' ~-~ Soil rating (g.p.d./fF or Length ' ~ ?- Width H' Effective absorption area -TE,?. ~ . Date of adequacy test ~r/'z."5/W'/ Depression (Y/<I~D t,~e High water alarm (Y~ /'~ ~ System type 'TRe~I ~_ H 8. :~ ~ Total depth __ Depression over field (Y/~ For Gravel thickness below pipe Monitoring Tube present ~/N)'~'~.~ Results (~/Fail) {3~$ Fluid depth in absorption field before test (in.); ~/z" Immediately after ~ gal. water added (in.): Fluid depth ~,l u (ins) Minutes later: lO ~,,I. Absorption rate = z-J~O~r .g.p.d. Peroxide treatment (past 12 months) (Y/N) ~o~ J4,~¢~ If yes, give date ~ bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "~ High water alarm leve..~J~.-~'~'-~- *Datum C~'l~sted "Pump off" level at* SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot '7-'~'°t'~ On adjacent lots Absorption field on lot Public sewer main ~Public sewer manhole/cieanout S~-'-~- Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation E~ 'P Property line I ot -F Absorption field Water main/service line loll' Surface water/drainage toeI'P Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ~,o~ ~' Building foundation 3o ~-I- Water main/service line / ¢l~- Surface water I oo ~ ~' Driveway, parking/vehicle storage area _~o ~ + Curtain drain ~o¢~ ~o~J~/ Wells on adjacent lots 'Zoo ~ + ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal reco[~.~f ,,~.a.~ ~y~tems are wi~ in conformance MOA HAA guidelines in effect on this date. ~, ~ / ~ .,,~ r ~ ~: 4 ~ :~ g' 'ers Name HAA Fee $ ~ Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number 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 GENERAL INFORMATION Complete legal description Lot 8; Block 1; Heritage Park Subdivision Location (site address or directions) Property owner Mailing address Lending agency Mailing address 10537 Tradition Ave. Ecgle River Mike and Cindy Grant 10537 Tradition Ave. t Day phone 694-0655 Eaqle River, Alaska 99577 Day phone Agent Address Day phone Unless.otherwise requested HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual welt Community well NOTE: Three (3) Public water xxx If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: XXX 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 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/orwastewaterdisposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, l 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 't~/~ ENGINEEP'ING oa~'~ ~O / . Address 17034 Eagle River Looper ~104 EngineeCs signature 6. DHHS SIGNATURE Approved for .'~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: 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. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~--o-~ ~5 ~>w- \ ~e,c-~-c~e, 17A~~ Parcel I.D. A. Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow~ Purn~p level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~"~ ~ P Absorption field on lot ~.~oo ~ ~ Public sewer main Sewer service line If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height Wires pro~ L~~~ AT INSPECTION FROM WE g.p.m, g.p.m. ~__~ WATER SAMPLE RESULTS: Coliform ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank........ /-4 Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~"~'~ ~ ~ ~ Cleanouts (~/N) ~/ High water alarm (Y/~ Date of pumping Tank size I o o o Compartments 7.--- Foundation cleanout ~N) ,// Depression. ('~L.~) Alarm tested (Y/N) ~/~ Pumper ~--_~----,. ~_.~ ~ f oo ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: / Well(s) .on lot '2--~,z~ ~ 'P On adjacent lots To property line /-0 / 7~ Absorption field Lo / Sur/ace water/drainage /oo / ¢' Foundation Water main/service line /00 72.026 (3/93)OFr~nt CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested ~- Surface water D. ABSORPTION FIELD DATA Date installed G"%9, -- ~ Length /W7---~ Width Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y~ Soil rating (GPD/Ft2) z~, ~ Gravel thickness Cleanout present,IN) ~/ b, ~ ~ ~ 4' Results ~;~fail) ~ System type Total depth Depression over field (Y~) for "~ After test If yes, give date Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot "-/"t~:~ ~ On adjacent lots To building foundation '¢---~ ~ On adjacent lots ~ ~ Sudace water \ oo Curtain drain ,_k/,~ Property line To ~xisting or abandoned system on lot Cutbank ~/~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I ce~'fy that I have checke conformed to all MOA and HAA guidelines in effecroh~ i Signature / ~~Jr~::,,",~ ~ ~i~ ~i::=;.,'.'~:~. .~' - ' -s Narr~e~zu~"'ag'er~iverb°°P Eoa, No,, 2,04 , ~ "~'~"':' . .. bng~neer .... , .......... . .. '~ ":;'"'~*'":~:' :r~: ?~' "' Date HAA Fee $ ~ 7~ Date of Payment Receipt Numar 72-026 (~)* ~ck Waiver Fee $ Date of Payment Receipt Number k..~~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~.,.Z~,,..J.~-J,~_-- ¢.~c~c, ~ Telephone: Home /~f~/z_~/'~.~/ Business Applicant Address ~:~':~t::~)(. I~.(~ ~../~-~P--~- ~'~(~--,¢-- ~..~'¢~- (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other I~i (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent ~ ,~--.tl'"/~(_~'~.. '~O rX/t ~..~, Address Telephone (f) Mail the HAA to the following address: S & S ENGINr:I~R!NG SRB ]96X F.~GLE RIVER, AK 99577 TYPE OF RESIDENCE Single-Family ~] Multi-Family Number of Bedrooms Other WATER SUPPLY Individual Well [] Community~" Public Note: If community well system; must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL / Onsite I~ Public [] Community [] Holding Tank [] rvat Note: If community well system, must have written confirmation from the State Department of Environmental Conse attesting to the legality and status, 72-025 (11~84) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND II'FORMATION ' As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verity 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 ~[ & $ ENGINEERING Telephone S~B, 196X Address Date F~G[E RIVER, AK 99577 J~AY I 5 1986 D HEP AP PR OVAI'/ /'~'~'~) bv~'~ "-~ ~/~-/~)'"' bedrooms Approved for - Approved ;,~ DisapprTe/d" Cond~'iJal Terms of Conditional Approval Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Pgn~ ? nf 2 ~--~ MUNICIPALITY OF ANCHORAGE (M0~T~ MUNICIPALITY OF ANq~Li~-c~,, | AUTHORITY APPROVAL (HAA) DEPT OF HEALTH & ' ...... ;~,,~^, oROTECTK:~-IECKLIST- FEBRUARY 1984 =l~viK~l'~m~,'-,~- · 264-4720 MAY '~ 0`9 1986 Legal Description: ,~ ~¢' ~ I WELL DATA RECEIVED Well Classification ""-~L~I ~ If A, B, C, D.E.C. Approved ,~/N~ Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot '~f~ ~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date B. SEPTIC/HOLDING TANK DATA Date Installed ~-' Standpipes ~//N) Air-tight Caps (~/N) Depression over Tank Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course Size IOc:>~'~ No. of Compartments Foundation Cleanout (~,N')~ Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation ~!. ' To Disposal Field Lo ¢ To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026[11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~'-~ ~ ¢0 Width of Field q Square Feet of Absorption Area Depression over Field ~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~ ~ t,~ To Building Foundation Z-?'¢ Lot ~ \/'* To Water Main/Ser,,4ce4_ine / O o ~ ~- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~ ~'~5 I'4E:yl" '~¢_-~, I~"-~ Type of System Design Length of Field ~/ Depth of Field J 7--~ Gravel Bed Thickness ~)' Standpipes Present ,~'/,N'~ ~)ate of Last Adequacy Test ~ To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~" c::~ To Cutbank (if presept) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) t"Pump Off" Level at ~ [,~ Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S & $ENGINEERING Date MAY t 5 1986 SRB 196X Company ___ MOA No. EAGLE RIVER.AK 9,9577 Receipt No. Date of Payment Amount: $ ('-0 ~'~' ~¥'~-") Page 2 of 2 72-026 (11184) DEPT. OF E~VIRON~iENT~kL ~ON~SE~V.~TION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA q9501 BILL .SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 DATE: May 13, 1986 PWS I.D.~ 212291 To Whom it May Concern: According to records on file in this office the EAGLECREST S/D, HERITAGE PARK Water System is in compliance with the State Drinking Water Regulations Sincerely, Michael P. Lewis Environmental Engineer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ¢~/~ ./ ~'~'~ GENERAL INFORMATION (a) Legal'-~/'¢'"~- Despription (include t~ Iot,.¢4?~-''-~'' ~-~' -'¢?'/block,..~ --~ subdivision,.~,j!..,,/, section,7J''~ ¢'¢ township,.cC.~__~,range)/ Location (address or directions) ~' Cz/'- Name ~..~'.¢<7~ ( ~,¢-~.Telephone: Home ~ ...Bu§iness ~,~,X 47,',,¢ ~ (b)ApplicantApplicantAddress ~-~'~-~~l ¢~¢ ~~4~'~ (c) Applicant is (check one): L~nding Ins~i;tion ~; Owner/builder ~; Buyer ~; Othe~ (explain)~ *~ (d) Lending Institution Telephone Address (e) Real Estate Company and A~ent ~4~.~/~_~-~_~-~.. Address /~ ~;' C~/~/~A~ Telephone ~ ¢¢- ¢¢¢¢ (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family/[~' Multi-Family Number of Bedrooms Other WATER SUPPLY Individual Well [] Community/[~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite,~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and statusl 72-025 (11/84) Page 1 of 2 Terms of Conditional Approval ;onditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 MUNICIPALITY OF ANCHORAGE DIVISION OF ~,KrIRONMENTAL HEAL~iH DEPAUfl%IENT OF P~LLI~ AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALI/~ AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township~ range) (b) Location (add~ess or directiom~) Applicants Name ~C~ ~ \~%~ ~ Telephone~o I ~ Applicants Address~q-%~ ~) ~-~ ~;~( ~~ $ ~[-~rS~_~, (c) Applic~ant~is (che~ck~_~) Lending Institution .~; Owner/builder.~-~; Buyer ~ ; Othe~ ~ I (explain); (d) Lending' Institution Telephone. Address (e) Real Estate Co. a Agent Address Te le phone 2o Type of Residence Single-Family ~--~ Number of Bedrooms 3 o Water SuDply Individual ~ell ~ Multi-Family Other (describe) Public ~_~ Note: If c~,,~nity ~11 system, must have w~itten.confirmation f~c~ the State Department of Environmental Conservation attesting to the legality and status° Is the ~11 adequate for the number of bedrooms specified in this ~ (Y/N) ~_____ Sewage Disposa_~l Onsite ~ Public ~ ~nity ~' Holding Tank ~ Is the wastewater disposal system adequate f~r the number of bedrooms (Y/N)'-~ [Page 1 of 2] 2-15-84 ~ /5.~ E_n~ineerin~ Firm Providing I.n_spections__z, Tests____m, E~ta and Information ~/ eI'f~ify~atgteha~f c~i~nd~fo~e.d~ or conforn~d to all MOA HAA Guidelines in Name of Firm ~F~[.~-l(. ~.~o~.T~ Telephone ~-~-- \q~ Address Signed by Date 6. DHEP Approval Approved for Approved ~ ( ENGINEER SEAL) ~sap~o~d~ Conditional ate Terms of Conditional Approval The Municipality of Anchorage D~pa~tment of Health and Environmental Protection dces not 'guarantee tl~ continued satisfactory performance of the wate= supply and/or the wastewater disposal system. ~nis approval indicates that, as of the ~lidation date shcwn above, based on the data and infc~mation furnished by an engir~er registered in the State of Alaska, the wate~ supply and wastewater disposal system is safe and func- tional for the number of bedrooms and type of structure indicated° (DHEP SEAL) 7o Mail the HAA to the following address: KB2/d5/s [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORA~NiCIPALiTY OF ANCHORAGE (MOA) DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIC~TH AUTHORITY APPROVAL (HAA) APR lg85 DATARECEIVED Well Log P~esent (Y/N) Total Depth Cased to Static Water Level Casing Height Abo~e Ground Electrical Wiring in Conduit (Y/N) Separation Distances f~om Well: To Septic/Holding Tapk on Lot To Nearest Edge of Abso=ption Field on Lot To Nearest Public Sewer Line C leancut/Manhole Water Sample Collected By Water S~ple Test Results CHECKLIST ~ FEBRUARY 1984 Zf A, B, ~ C, DoE.Co Approved(Y/N) Date Cu~tpleted Yield Depth of G~outing. Pump Set At Sanitary Seal on Casing (~Y/N) Depression A~ound Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Weakest Sewer Servi~ Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA [Page 1 of 2] Date Installed ~'lh'~ ~5, %QSq- Size _~A~ c~o Q~ _ No. of C~nts T%qo Stan~ims (y~) ~ Air-tight ~ps ~Y~ Foundation Clean~t (Y~) ~' ~ession o~ Ta~ (Y~) ~ Date ~st P~d ~~C-~ Qu~ ~T · P~ing~intenan~ ~n~a~ ~ File (Y~) ~ ; for Holding Ta~ High-Wate~ ~a~ (Y~) k~l~ .~ ~~ Holdi~ Tank ~t (Y~) ~.~ ~p~ation Distan~s ~ ~ptic~olding Tark: TO Water-Supply ~11 ~ ~~ To~ildi~g F~ndati~ q ' To ~o~=ty Li~ ~ ~ ~' To Dis~sal Field ~ To ~ter ~i~=vi~ Li~ ~ %~' To S'~e~, ~nd, ~e, ~ ~jo= ~aina~ ; C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~' Width of Field Square Feet of Absorption A~ea Depression ove~ Field (Y/N) Results of Last Adequacy Test ~3f/~-. Type of System ~sign ~t-~ ~ng~ of Field ~ ~ ~p~ of Field ' %~ ' Gravel ~d ~ick~ss ~.~ ~ ~. Stan~i~s ~esent (Y~) ~ ~te of ~st A~a~ Test ~-~ ~ Separation Distance f~om Absorption Field: '". ~.'' To Water-Supply k~ll ~l/~ ~' To P~operty Line "L5 ! To Building Foundation ~-~-~ To Existing or Abandoned System Lot ~lo~ ~_~o~l ; On .Adjoining-Lots ~. ~to~l To Wate~ Main/~vi~ Line > ~o' To ~t~k! if preent) ' To St~e~ond~ke/~ Majo~ ~ai~ ~se ~ %~<~ ~% To ~iveway, P~ki~ ~ea, ~ Vehicle St~a~ ~ea . k ~ Do LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Wate~ Alarm Level at Tested fo~ Electrical Codes(Y/N) Dimensions , Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles ~ing Adequacy Test. Meets MOA Check Permitted Bed~oc~ Rating Against HAA Request in effect ce~tify__that I ha~e-~ecked, verified, c~ confo~rfed to all MOA H~ KB1/dS/s [Page 2 of 23 2-15-84 DEPT. OF ENVIRONMENTAL CONSERVATION / ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 DATE: ~,~s I.~.~ cP_Y,,2,~ 9'/ To Whom it May Concern: , According to records on file in this off ice the ~-~2 ~/~//~ ._~ Water System is in compliance with the St~e Drinking Water Regulations Sincerely, MUNICIPALITY OF ANCHORAGE DIVISION OF ~IRONMENTAL HEALTH DEPARTMEBFf OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) legal I~sc~iption (include lot, block, subdivision, section, township~ range) (b) .Location (adchzess or directions) ' Applicants Nam~ ~of5 I-~ ~-~ Telephone'~o I -- %~[~[~ Applicants Adctress~A~ t~ zp~xz~.O ~.~_~ ~C~~ ~t~t~o~_~ (c) Applicant is (check one) Lending Institution ~; Owner/build~r.~-~; Buyer ~--~ ~ Othe= ~--] (explain) ~ (d) lending Institution Telephone. Address (e) Rmal Estate COo & Agent Address Telephone 2. Type of ~sidence Single-Family ~[ Number of Bedrooms 3. Water Suppls! Individual Well ~,. M~lti-Family~ Other (describe) Cc~nity~ Public~ Note: If con, unity well system, must have w~itten.confirmation from the State Department of Envirorm~ntal Conservation attesting to the legality and status~ Is the well adequate for the number of beclroc~s specified in this H_AA (Y/N) ~____ 4. Sewage D_isposal. Onsite ~ Public [---] Conmnnity ~ Holding Tank Is the wastewater disposal system adequate for the numbe~ of kedrocms (Y/N) [Page 1 of 2] 2-15-84 5. Engineering Firm Providing Inspections, Tests, Data and Information I ~ertify that I have checked, verified, or conformed to all MOA HAA Guidelines in signed Nam~ of Add~ess kot.7t Telepho Signed by Date 6.DHEPApproval Ap~oved for Approved ~ ( ENGINEER SEAL) ~ ~edrocms Disapproved ~-~ Conditional Date Te~ms of Conditional Approval The Municipality of Anchorage Department of Health and Environmental P~otection dces not guarantee the continued satisfactory pe~fo~n~ance of tke water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished by an engireer ~egistered in the State of Alaska, the wate~ supply and wastewate~ disposal system is safe and func- tional for the numbe~ of bedrooms and type of structure indicated° (~PS~) 7. ~il the HAA to the foll~{ing ad'ess: KB2/d5/s [Page 2 of 2] 2-15-84 Well Classification kl/~ --~__ Well Log lh/esent (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distanoes f~om Well: To Septic/Holding Ta~k on Lot To Nearest Edge of Abso210tion Field on Lot To Nearest Public Sewe~ Line C leanout/Manhole Water Sample Collected By Water Sample Test Results C~fents ~x7~13~ ~%~ ~UN%C1PAUT? MUNICIPALITY OF ANCHORAGE (MOA) MEALTH AIYi~ORITY APPROVAL (BAA) ENViRONW~gN~/"L pRoTECT%ON CHECKLIST - FEBRUARY 1984 If A, B, o~ C, D.E.C. Approved(Y/N) Date Cca~leted Yield Depth of Grouting. Pump Set At Sanitary Seal. on Casing (.Y/N) Depression Around Wellhead (Y/N) ; On' Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Se~r Servi~ Line on Lot ~ Date B. SEPTIC/HOLDING TANK DATA Date Installed %'1/~'~ ~5. %CLS~c Size ~ ~]~ ~ No. of C~nts Stan~i~s (Y~) ~ Ai~-tight ~ps ~Y>~)'~ Foundation Cleanout (Y~) ~pression o~ Ta~ (Y~) ~ ~te ~st P~d ~~-~~ P~ing~intenan~ ~n~a~ ~ File (Y~) ~ ; for Holding Ta~ High-Wate~ Ala~/Y,~) k~ ~r~y Holdi~ Tank ~t (Y~) ~p~ation Distan~s ~ ~ptic~olding Ta~: To Water-Supply ~11 ~ To~ilding F~ndation To ~o~rty Li~ ~ ~ ~ ~ To Dis~sal Field To ~ter Main/~rvi~ Li~ ~ '~ To S~e~ ~nd, ~e, ~ ~jor ~aina~ / [Page 1 of 2] 2-15~84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~;~f ~5) ~ Width of Field ~ ! Square Feet of Absorption A~ea Depression ove~ Field (Y/N) Results of Last Adequacy Test Length of Field ~7~ t Dapth of Field ' %g ' Gravel Bed Thickness ~.~ ! ~.~. Standpipes P~esent (Y/N) Type of System Design T~_~%-~ Date of Last Adequacy Test ~o~-a---~,_%=~.s.~ ~%-~, Separation Distance fromAbsorption Field: To Water-SupplyW~ll To Building Foundation Lot ~o~ Y-~ko~ To opert ' TO Existing or Abandoned System ; On .Adjoining .Lots ~Ao~.e. ~o~ To Water Main/Service Line > ~o' To Cutbank(if present) ' To Stream/Pond/~ake/c~ Ma3o~ D~ainage Co~se ~- %C~<~ ~\ Storage A~ea k~ ~ To D~iveway, Parking Area, o~ :e~icle , z ~,_~\ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water AlarmLevel at Tested for Electrical Codes(Y/N) Din~nsions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Co~%~rlts ** Check Permitted Bedgown Rating Against HAA Request I certif~at I h~ecked, verified, o~ conforn~d to all MOA HAA G/~~ in effect on t~a~f th~ction. ~ ~ %3r b%, '~ · 2~15-84 DEPT. OF ENVIRONMENTAL CONSERVATION SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (907) ,~ddress: 274-2533 To Whom It May Concern': According to records on 'file in th~s office the .Water System is in compliance with Che Water Regulations. ' Sincerely, State Drinking