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Home My WebLink AboutHIDEAWAY HILLS BLK 1 LT 8 NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE [] NEW [~UPGRADE MAI LING ADDRESS $ cLtg.gto N LEGAL DESCRIPTION LOT ~L~EK LOCATION ~ ~ Manufacturer Well ¢ ~ ~ Liq. capacity in gallons IF HOMEMADE: D~STANCa TO: ~ I / g Manufacturer D,STANCE TO: Well C A V~ ofeack line No. of linT Length Top of tile to finish grade ~. I.~ // Length Width Type of crib ;rib diameter Well DISTANCE TO: Absorption area Dwelling Material Width Inside length Dwelling F o u n d-~t i~-~. Total I?~ :f_~nes Material beneath tile Material Nearest lot line/ C Trench,~id~ inches Depth Crib depth Total effective absorption area Building foundation Nearest lot line NO. OF BEDROOM~ PERMIT NO. No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERM N . e~s Distance betwee in Total effecti~y~ion area PERMIT NO. Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s) OTHER PIPE MATERIALS CAST SOIL TEST RATING INSTALLER TAH REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78)~ F'EF:M'.r. T N(]. FiPPL l CF!I",!T LOCRTI ON LEGRL TRCk: I !. .T? ] I".~I[:L?,Ot"~ S FI H E L8 E',:I. HI[)EFtHFI'¢ HILLS ';29~1A S-' EE:LLi':: 'i C!i'.,! [:,R L.O T ': '[ Z E '!'."-?F'E EIF ':_'-;011.., RE~S(}F.:PT ,,T. C!l'..-! S'¢STEM I tS: TRENCH ,44.'_'~E, bE~ ?~'3 ,..'~R!E FEET i"IR::.:: I MUM N. HBER OF E~E'£:,RE (" i'"l':_'; = ]: :.:_ O '[ L F.':RT I I"~:G "'_: 7.! F'T,.-"BR ) = ~ ---~--'"'~? THE REg!IJIF::ED SIZE ElF THE: SOIL .RBSORF'TZON S'T'STEM IS: 'f.'HE LENGTH [.', I .HENS I ON IS TH.E LENGTH <!.N' FEET.':, OF' THE TRENCH OF:: DRRINFIELD. THE DEP'FH ('.'IF FI TRENCH OR PI'T' IS THE DIE;TRNCE BETi.4EEN THE SURFRCE OF THE GRI]IUNE) .FIN[:, THE BOTTOM OF THE E::-::CFIVRT!ON (IN FEET). TFIERE IS NO SET HIDTH FOR TRENCHES. THE GRR'.',,'EL [:,EPTH IS TFIE MINiHUM DEP"FFt OF GRRVEL E:ETI.,.iEEN THE OUTF~L.L PIPE F:!.I",i.[> THE BOTTO.r,'t OF' THE E',:.::CFiVRTION ,.'.iN FEET). F..,: ~..] £:.;~ ~._~ }.] IF~". E: E:> :-.-~; E~}-- F::" -'If."' ]:: ~2.~ PERi',FZT .FIPPLICRNT FIRS THE RESPONS!BIL. IT"r' %0 INFORM 'I"HZS DEPRRTHENT DURING THE ZN?t"R!._LRTION INSF'ECT]:ONS OF RN"r' HELLS .FI[:,j.FIC'ENT TO THIS F'ROPERT? .FIND THE. NUHBER OF RESI[."ENCES THR]." ]."HE HEL, L .[,.IIL. L SERVE. DRCKF'ILLiNG OF' RN"r' S'-r'S"I'Ei"I HITHOUT FINRL INSPECTION RND RPPROVRL. B"r' THIS [.'-'EPFIRTHENT HILL BE SUBJECT "f'O F'ROL:':;ECUTZON. H. INIMUH [:'ISTRNC:E BE'FHEEN .FI !.4ELL FIN[> R.t",I'¢ ON-SITE SENRGE DISPOSRL, S'¢STEH iEeE'; FEE:'T FOR la F'F.'I',,,'FFFE 1.4ELL OF.'. ±5C~ TO 2:E~.E~ FEE"F FRIDM Fi F"UE:L. ZC HELL DEPEN[:,!NE4 UPON ]"HE TYPE OF PUE:LIE: !.4EL. L MINIMUM DI:F..;TRNCE FROM F~ PRIVRTE I,.IELL. TO R PRIVRTE SEi.,.!ER LINE IS 25 FEET RND TO R E:OMI"IUNIT'T' SEHEF;.: LINE l'_:; 75 FEE:'['. OTHER REg!UtF.:EMENTS HFI'T' RF'F'L'T'. :E;PECiFIE:RTIONS RND CONSTRLICTION [:,IRGRRMS RRE R'.v'RILRBLE TO iNSURE PROPER INSTRLLRTION. F' [EE F--: IPl Z "IF' [E %¢. F::' Z ~;: E ..i:. CERTIF'¢ THFIT 2t: I RH FRMILIRR 14ITH THE F.:E:QUtREMENTL:; FOR ON-SITE SEHERS RND .~4ELL. S RS SET FORTF! BV THE r,!UNICIPRLtT'¢ OF RNCHORRGE. 2: I [,!ILL. INSTRLL THE S'.?S]."EM IN RE:CORDRNCE WZTH 'TH.E CODES. 2:: I UNDERSTRN[:, THRT 'THE ON-SITE SEHER S"r'STEM MR'¢ REL.]UIRE ENLRRGEMENT :i;F' THE RESI['.,ENC'E IS REMO[:,E:LED ]"0 INCLUDE !dORE THRN 2: BEDROOMS. PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9- 10- 11 12 13 14 15 16 17 19 20 COMMENTS PERFORMED BY: 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST DAT PERFORMED: SLOPE SITE PLAN ~.*: Ho. 22~-E WAS GROUND WATER ~] ~ ENCOUNTERED? l\l 0 0 P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ ~q (minutes/inch) 25,, 13,1 ,' I 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.# 1. GENERAL INFORMATION Complete legal description LoT Location (site address or directions) Property owner AL INc0~q'l~o Mailing address 6~× .2,1oo'12 , /ciNCH, Lending agency Mailing address ~ECLLi$/oN bR. Day phone 1%8o Day phone Agent Address I~IcK J~R[/15 , RE t'l/~lf Day phone · Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water v/"" NOTE: 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 ~'~ H(~lding 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~f21 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 FLA'f-TO? Address 1~$3o EcHo Engineer's signature ~'~ DHHS SIGNATURE ~, % THEODORE- F. ,V, OORE Approved for ~M/{~(~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ..~t.¢~ ~,.4.¢-,~¢r Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze .data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data N./-}-, Well type Log present (Y/N) Total depth Sanitary seal (Y/N) LoT ~'., '~tK J) HJbE~IZ,/Ad ~l/~lSParcel I.D. if A. B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to FROM WELL LOG Date of test Static water level Well flow Pump level1 DISTANCES FROM WELL TO/ SEPARATION Septic/holding tank on lot Absorption field on lot / Public sewer main Sewer service line WATER SAMP~ULTS: Coliform.,/" ' Nitrate D.~at~of sample: Casing hei~'" Wires properly protected (Y/~. AT ,~/~,.,, ~N MUNICIPALITY OF ANCHORAGE g.p~~''xx ~.NVIRONMENTAL SERVICES DIVISION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA I'3,~ uate installed O~o~j ~Fo~ I~/~l Tank size Iooo ~,~L Compartments u~o~' Cleanouts (Y/N) ¥ Foundation cleanout (Y/N) N Depression (Y/N) N High water alarm (Y/N) N,/~. Alarm tested (Y/N) N ,/~, Date of pumping ll/~/~l Pumper E'OTO - ROOT£~' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot kl,/~, To property line :>-/0 Surface water/drainage On adjacent lots N,/~. Absorption field $5' {o0 ' Foundation -,co Water main/service line g.p.m.' ;:: 0 1993 RECEIVED Feo~ C,o. 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION r'q. ,4. Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Sudace water D. ABSORPTION FIELD DATA Date installed /O/81 Length &'2.5" 2.5' Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) Width Gravel thickness 87,5- ' Cleanout present (Y/N) 7/~-//q 3 Results (pass/fail) NONE /<N 0 ~,'t,,I System type 'l-ge,~ cH Total depth Depression over field (Y/N) for Aftertest ~ Iqon~ J,~ If yes, give date N, ~, Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I~ t To building foundation 5' 2. On adjacent lots Sudace water Curtain drain On adjacent lots N. h · Properly line To existing or abandoned system on lot Cutbank ~, ~. Water mai~se~ice line Driveway, parking/vehicle storage area > ~o E. ENGINEER'S CERTIFICATION aec~/~l~aa~ Io~ ~' ~,a/ t/~o ~,/~ ¢,,,/ -~/,~;~ .~,,/~,¢ ;,o .~,~?. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date ,.7'~ HAA Fee $ / 70 ,9 ~ Date of Payment Receipt Number ~ ~'~ Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE ~)~) ~ DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date ~.:/~? _~7 GENERAL INFORMATION /MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) ~ / ,~.. ~ .... / . (~.~aaahen~(addc.ess' or d~re~lons) ~ (b)' .~-Property Owner ~i,f,,C,) "Lending Instiiut~i'od '., -.Mailing,Add(e~s Telephone: Home ~-~--¢~(~ Business Telephone (d) Real E~tate Company and Agent Address Telephone (e) Mail the HAA to the followin~ address: or: Check here ltd, if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Si ngle-Family'~J~ Number of Bedrooms 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. SEWAGE DISPOSAL Onsite~E~ 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 status. Page 1 of 2 72-025 fRev 8/861 Fronl ENGINEERING FIRM PROVIDI SPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /'~'~'~ Telephone Address /~ /d .~¢-~ Date DHHS APPROVAL Approved for '~"/~r~'~bedrooms by ~ '~' '~'~~ Approved /'~ Disapproved Conditional Terms of Conditional Approval CAUTION 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. Page 2 of 2 72-025/Rev 8/861 Back WELL DATA \'~' MUNICIPALITY OF ANCHORAGE (MOA~ MUNIQP^LITY OF ^[x~lkL~_Ai~l~ AUTHORITY APPROVAL (HAA) ENVIRONMENTAL SERVICES DI~KLiST . FEBRUARY 1984 264-4720 JUl. 1 0 1987 Legal Description: RECEIVED '~,~ssification Casing Height Above Ground'~'%~ Electrical Wiring in Conduit (Y/N) Distances from Well: Separation To Septic/Holding Tank on Lot ~- ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~oining Lots To Nearest Public Sewer Line To Nearest Pu~-lfc~S_..e~_er Cleanout/Manhole To Nearest Sewer Service ~Lot Water Sample Collected by ; Date Water Sample Test Results Comments If A, B, C, D.E.C. Approved (Y/N) Date Completed Yield Cased to Depth of Grouting Pump Set At Sanitary Seat on Casing (Y/N) Depression Around Wetlhead (Y/N). - B. SEPTIC/HOLDING TANK DATA Date Installed Stand pipes~/(~N) Depression over Tank (Y/~)~ Size Air-t~ht Caps Pumping/Maintenance Contract on File (Y/N) / Holding Tank High-Water Alarm (Y/N) /¢//Y- Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To water.k,f'~ih/$ervice Line Course ,, "~ No. of Compartments Foundation Cleanout (Y~?~ Date Last Pumped Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage · _ .Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area ~¢~/ Depression over Field (Y~ Results of Last Adequacy Test /¢7~'~¢/~ Separation Distance from Absorption Field: To Water-Supply Well ~"~/.~ To Building Foundation ~-'g" / Lot ,/d) To Water Main/Service Line ,ID '~' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field ¢ ?'''' ¢' Depth of Field ~ / / Gravel Bed Thickness ~7 Standpipes Present~,)N) Date of Last Adequacy Test To Property Line //~' To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) /6 / -/-- D. LIFT STATION Size in Gallons % "Pump On" Level at High Water Alarm Level at ~ Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Tested for ~Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) 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 ~/¢~2/~. /.. t~/z~~ Date Company /;~-:-L-fi MOA No. Z'Y-~Z / R ce pt No. --¢ O / Date of Payment ~ -- ~d-- &~ Amount: $ ~ ¢ Page 2 of 2 72-026 (11/84) MUNICIPALITY OF ANCHORAGE DMSION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRDNMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE Inforn~tion Application Date ~'_~~ ( i- General (a) Legal Description (include lot~ block, subdivision, section, township, rap. ge) Location (add~ess,' 6~:directions ) Applicants Add~e.~s ...... O tF6 P? f:J/~ 1) [~ __ _ (d) Lending' Institution Telephone Address (e) F~al Estate Co. & Agent Address Te le phone 2. Type of Residence Single-Family Number of Bedrooms Multi-Family Other (describe) 3 · Water Supply Individual Well ~ Comnllnity ~--~ Public ~/ Note: If coca,unity ~11 system, must have w~itten confirmation frcm the State Depa~tr~nt of Environmental Conservation attesting to th~ legality and status. Is the ~11 adequate for the number of bedrccn~ specified in this HAA (Y/N)~J/~ 4. Sewage Disposal Onsite I~ Public ~ Cor~nunity ~ Holding Tank Is the wastewater disposal system adequate f~r' ~e filmier of [Page 1 of 2] 2-15-84 5. Engineering Firm P~oviding Inspections, Tests, Data and Information effect on the date of this inspection° I certify that I have checked, verified, or confo~-.~d to all MOA HAA Guidelines in Telephone 5r~ / '- q'~t~p ~, Si~ned by Date ( ENGINEER SEAL) bedrooms Disapproved ~ 6. DHEP Approval Approved for Approved~ , ~. ~, . .,~..~ Conditional ~ Terms of Conditional Approval .The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date sho~n above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional fo~ the number of bedrooms and type of structure indicated. ( [tHEP SEAL) 7. Mail the H~ to the following address: 2-15-84 ae MUNICIPALITY OF ANCHORAGE (MOA) HFALTM AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification Well Log P~esent (Y/N) Total Depth z¢~,//~ caSed /./iUNICIPALITY OF ANCHOP, A~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION jhll! I. lg84 RECEIVED Legal Description: LO'T ~ ~LK If A, B, or C, D.E.C. ~pro~d(Y~) ~/~ / ~te ~le~d ~/~ Yield to ~/~ Depth of/Grouting Static Water Level x4~//q-- Pump ~t At ~/~ Casing ~ight ~ G~nd ~ ~ Sanit~ ~al on ~sin~ (Y~)~/~ Elec~i~l Wi~ing in ~nduit (Y~) ~/~ ~p~essi~ ~ound ~l~ead (Y~ / ~p~ation Distan~s ~ ~11: To ~ptic~olding Ta~ ~ ~t ~ ~/~ ; ~ ~joining ~ts To ~a~s-t ~ge of ~so~tion Field on ~t ~/~ ; ~ Adjoining ~ts To Newest Public ~ Line ~//~ To ~est ~blic Clean~t/Ma~ole ~,/~ To ~est ~r ~rvi~ Li~ on ~t Wate~ S~le Colle~ed By ~/~ ; ~te Wate~ S~le Test ~sults B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (~/N) Depression over Tank (Y~) Date Last Pumped ~,-/~,//~ ~- Pumping/Maintenance Contract on File (Y/N) AJ[~.; for ~(,.~f Holding Tank High-Wate~ Alarm (Y/N) /~//~ Temporary-Holding Tank Permit (Y/N) ~/~ Separation Distances f~om Septic/Holding Tank: To Water-Supply Well ~//~ To Building Foundation ~, ,5'~ To Property Line [~ ~ $' ' To Disposal Field ~ ' /O -- ~ I . Size IOOO ,~,':~/-- No. of Cc~partn~nts I Air-tight Caps (Y~ .~.~. Foundation Cleanout (Y~..~_ /b.,),;z¥ ~ TO Stream, Pond, L~ke, or Major Drainage TO, ~z?~in/Service Line 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /6>- ~; Width of Field ~ O~ Squ~e Feet of Absorption Amea Depression over Field ~N) .~ ?,.. Date ~of Last Adequacy Test Results of Last Adequacy Test /%nE~o~.r-e~ Separation Distanoe from Absorption Field: To Water-Supply Well ~,//~ To P=operty Line To Building Foundation ~,~-' To Existing or Abandoned System cn Lot ,A2/W% ;,.On Adjoining Lots To Water Main/Service Line~ To Cutbank(if pre~nt) To Stream/Pond/Lake/c= Major D~ainage Coup.se To D~iveway, Pa~kinc3 A~ea, or Vehicle Stc=age A~ea Type of System Design 7t'~;~k°/%lC ~-~ Length of Field -~ ?_~ ~' Depth of Field ~ ' Gravel ~d ThiCk,ss ~ ' Stan~i~s ~esent ~) D. LIFT STATION Date Installed in allons "Pump On" Level at High ~ter Alarm Level at Tested fo~ Electrical Codes(Y/N) ' Comments Dimensions _/~2/ a hole/ ss , "Pump Off" Level at Vent (Y~) ~in~ Cycles ~ing Adequa~ ~s~. ~ets ~A ** Check Permitted Becl~oom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed ~ ~! ~ ~-'~r,'~ Date 5 .~A&~ D~P~'~';o~ O~ [Pa~ 2 of 2] 2-15-84 ALASKA B/qVIRO /meI1TAL COI1TROL $6/B'dlC S, II1C. (~n~incePincI ~ ~nuirc, nme'nlal Studies June 20, 1984 Department of Health & Environmental Protection 825 L. Street Anchorage, Alaska 99501 Attn: Keith Brandt Re: Hideaway Hills Lot 8 Block 1 Dear Keith: On June 19, 1984 this office att~pted to located the keybox on the subject lot. Using a metal detector, we were unable to locate it. The Municipality of Anchorage Water and Waste Water, which maintains the water system in this subdivision, were also unable to locate the keybox. According to their records, the keybox is located: 104 feet frc~ the SE corner of the residence 87 feet fr6mtheNWcorner of the residence These coordinates are somewhat confusing. The neighboring lots have keyboxes located approximately 15 feet from Seclusion Drive. The subject lot has heavy overburden in this area. Although not a precise 'locate', the septic system is in the opposite side of the lot. The building itself is in an excess of 100 feet from Seclusion Drive. If you have any questions please feel free to contact our office. 1200 ~¢sl 33r~ Auenu¢. $uiI¢ B · Anchoracl¢. Alaska 99503 ,(907) 561-50/10 ALASKA B FiCIIROFlmI FITAL COFITROL SI IBdlCI $, IFIC. June 20, 1984 Department of Health & Environmental Protection 825 L. Street Anchorage, Alaska 99501 Attn: Keith Brandt Re: Hideaway Hills Lot 8 Block 1 Dear Keith: On June 19, 1984 visited the site and observed: 1. All caps were on standpipes and were tight. 2. All standpipes were tight. 3. The depression over the drainfield had been repaired. Recc~a~end the conditional on the Health Authority issued 13, June 1984 be ramoved. If you have any questions please feel free to contact our office. Sincerely, Engineer 1200 Lgesl 33rd Aucnue. Suite 13 ,, Anchoraq¢. /~lask,~ 99503,,(907) 561-50z10 ALASKA B=FfOIRO[lmEI1TAL COI1TROL SEI ICES, I[1C. [~nclJneer'JncI 6 ~nuironmental Studies JUNE 8 1984 RICK LUTTMANN/CHUNA MCINTYRE 7956 SECLUSION ANCHORAGE AK 99504 SELLER - RICK LUTTMANN/CHUNA MCINTRYE BUYER - JAMES D CARTER/YANO A INTONT~ SUBDIVISION - HIDEAWAY HILLS BLOCK - 1 LOT - 8 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 875 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 300 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 450 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 2 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED 0N6/8/84 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 2 BEDROOM HOUSE. 1200 UJesl 33rd Auenue. Suil¢ [~, Anchoro% /~l~ske 99503,(907) 561-5040 APPLli~ANT FILLS OUT UPPER HAt., ,:~ Ui~ILY Buyer Address ,.~[ Zip Code ' Phone Phone Realty Co. & Agent ¢'~ Zip Code Address Type of Residence ~-'S}ngle Family ; ~ Multiple Family No. of Bedroo~ ~ Other Water Supply ~ '¢ ~ A~ACH WELL LOG. A w¢l Icg is required for all wells drilled since June 1975. ~ Community ~2. ~; .¢~, / ~ ~/~ For wells drilled prior to that date, give well depth (attach Icg if available}. ~ublic Utility Sewer Disposal Year Individual Installed: ¢-lhdividual When Connected to Public Utility: ~ Public Utility ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Insp6ctor MUNICIPALITY OF ANCHORAGE :ield Notes: DEPT. OF HEALTH _.~_~ ENVIRONMENTAL PROTECTION ~' ~..,¢4-. OCT ~ Iq83 RECEIVED ( ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ""~L~APPROVED I I COND~T~ONALAPPROVAL' ~v: _ ~'X ~ ~ ~ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received ~._ ~ Well to Tank Septic Tank Size 72-023 (3182) 20, 1983 Rich Luttmann ~1956 Seclusion Drive Ancb. orage, AK 99504 Subject: Lot 8~ Block 1, k{ideaway !iilis Approval for tk~e individual sewer and 'water ~acilities cannot be granted until the JJollowin<j items have been completed: o 'Phc septic tank pumped with a receipt submitted to this depart.ment. A four (4) inch cleanout n(~eds to be installed to the sep- tic tank. [~lease notify this Depart~'c{ent for a reinspectko~% when the noted discrepancies have been corrected. If ti~ere are any further <~uestions, please call this office at 264-4720. Sincerely, Ji]~ t{ober ts Associate Euvironmental f~pcciaiist ~-' D~,TE RECEIVED ~ ~ '~ INSPECTION APPOINTMEN'TS "' TIME TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC~ 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MA~LING ~D~R ESS PROPERTY aESIDENT {If dffferanl from above) PHONE :MAILING ADDRESS :3, LENDING INSTITUTION I PHONE MAI LING ~DDRESS 5. LEGAL DESCRIPTION 6. TYPE OF R~S~E~CE NUMBER ~ One ~ Four ~ Other ~ SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7. WATER SUPPLY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach' log if available.) SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6179) . (~::~z~t/." THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE 'NUMBER OF BEDROOMS [~] SINGLE FAMILY [~ ONE I~] THREE [~] FIVE E~] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified. INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS > APPROVEO FOR,_ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~ DATE BS~ 72-010 (Rev. 6/79) 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4] 11 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AN[} E'NVI[~,ONMENTAL PROTEC'rlON October 12, 1981 Jack/Ruth Jacobson 7956 Seclusion Drive Anchorage, Alaska 99504 Subje-t: Lot 8 Block 1 Hideaway Hills Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The septic tank pumped with a receipt submitted to this office. The number of gallons pumped need to be on the recaipt and verified by a registered engineer. This is to verify the size of the septic tank. (2) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this o~fice for our review. If there any further questions, please call this office at 264-4720. Sincerely, Robert C. pratt, R.S. Associate Specialist RCP/ljw ~M~~ ~icipaJity of A~ncho~ ~g~ MEMORANDUM NAME iSAACS PUMPING SERVICE (Norm Tibbetts, Owner) 6215 Quinhagak Street ANCHORAGE, ALASKA 99507 Phone 563-3300 RECEIVED BY 4684