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HOCKER BLK 1 LT 3A
Hocker Block 1 Lot 3A #042-081-10 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 Permit Number: OSP151334 Tax Code Number: 04208110000 Work Type: Septic Upgrade Permit Effective Dates: October 19, 2015 to October 18, 2016 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: HOCKER Site Legal Address: HOCKER BILK 1 LT 3A G:3043 Owner/Address: CARR MATTHEW O & LORI O 9981 FLAT TOP AVE ANCHORAGE AK 995166944 Site Mailing Address: 9981 FLAT TOP AVE, Anchorage This permit is for the construction of: Ip�q�S Ila � I IAS//' 31 aC) Lot Size in Sq Ft: 93067 Total Bedrooms: 5 Y Disposal Field Y Septic Tank 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. 11I/�l5 CO m! TA, kA� '�rvm y'be _t" k to ale ex � Fi'eIC� i s pt�prpV�"\ ''o Cn+e. at _' e_ _<0CAf't ienj. Received Issued By Municipality of Anchorage x"e Mepartment P.O. Box 196650 a 4700 Elmore Road Anchorage. Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 httn://vMw.muni.org/Onsite Development Services Division Onsite Water and Wastewater Proaram *** VARIANCE/WAIVER REVIEW *** Waiver#: OSVI61134 COSH#: Permit#:OSP141334 PID#: 042-081-10 Legal Description: Hocker. Block 1. Lot 3A Engineer: Gareass Endineerina Group Applicant: Matt Carr Your request for a waiver to allow the following separation distances is approved. 1. 60' drainfield to rsurface water, 2. 35drainfieldto 25% or greater slopes, 3. 30' maximum bed width, and 4. 1' septic tank to property line. This waiver approval applies to.the proposed septic system only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the`owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. Waiver is Granted: X - Waiver is not Orante Date: Approved by: Aame of Reviewer Omni iti.• • u 0-•......... �1Y •���f�rYi��������• --fir• u�����:Yu ���i i������-������ MUNICIPALITY OF ANCHORAGE Community Development Department"""""""""* Phone: 907-343-7904 � ei0prrteni Services Fax: 907- 343-7997 On -Site VVater & VVastewater Program Mayor Sian Sullivan On -Site SewerN Vell Permit ADDlication For A Single Family Dwelling Parcel I.D. 042-081-10 Property owner(s) MATT CARR Day phone 830-8483 Mailing address 9981 FLAT TOP AVENUE, ANCHORAGE, AK Site address 9981 FLAT TOP AVENUE, ANCHORAGE, AK Legal description (Sub'd, Block & Lot ) HOCKER; BLOCK 1, LOT 3A Legal description (Township, Section & Range) Lot Size IS AN: APPLICr.T:Cy !S FOR: ❑ ( `Qall that apply) Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Sq. Ft. Number of Bedrooms APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) SURFACE WATER TO DROINFI D• DRAINFI D TO SLOPES >2511.'- BED WIDTH- OT LINE Distance: W; 35'• 30'; 1' I certify that the above information is correct. I further certify that this is in accordance with applicab!e Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of prooertv owner or authorized agent) PermiJRush Fees: Waiver Fees: Date of Payment: -1 A (I Date Date of Payment: 01 s Number ©-3O n4—'mhcr:�X /y '01aiver No f=ev. 0'./11 GARNESS ENGINEERING GROUP, Ltd CIVIL &ENVIRONMENTAL ENGINEERS October 8, 2015 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System for Hocker; Block 1, Lot 3A To whom it may concern: The existing 5 bedroom house is served by a private well and septic system. The drainfield is in a state of failure and needs to be upgraded. We are proposing to install a 2000 gallon S.T.E.P. tank, and bed (mound) type drainfield. Two testholes were excavated on the property, the drainfield is designed around the 30' radius of testhole #1. Comments regarding the design are summarized as follows: 1. SOILS: See the attached 2015 logs which show the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There is an intermittent stream located approximately 35' north of TH#2. See attached 40 scale drawing showing the stream location. 4. TOPOGRAPHY: Per G.E.G. inspection, there is a flat portion of the lot that appears to be excavated out. It is our intent to design the drainfield near the east side of the bench (at toe of hill) to create the maximum separation distance to the steep slopes (greater than 25%) that are west of the bench. We are requesting a waiver of 35' to the slopes to the west. See topographic information on the site plan. 5. WAIVERS: We are requesting your department issue 4 waivers for the subject property. First, we are requesting a variance so as to place the new bed from an intermittent spring that is north of the bed. We are also requesting a waiver to slopes >25%. Additionally, we are requesting your department issue a waiver for bed width allowing for a bed width of 30 feet, and we are asking for a 1' lot line waiver for the septic tank. Justification for the waivers are as follows: -The stream is located uphill from the proposed drainfield. If effluent were to overflow, it would not travel towards the spring. -The drainfield is an in open area. If effluent were to overflow, it would be easily recognizable by the property owner. -See attached drawing page 3/3 showing that the effluent would not daylight until about 42 feet. -The contractor shall take extra care to ensure that equipment does not operate on the bottom of the bed. Furthermore, we need this waiver to maximize separation to surface water. We are unaware of aAy adverse impacts this installation and waivers would have on adjacent wells or septic systems. If you have any que ti ns, please contact us at 337-6179. Thank you for your assistance. M.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 336-3246 * Website: www.gamessengineering.com t . OESI�,N RITERIA: NUMBER OF BEDROOMS:5 GALLONS PER DAY (GPD): 750 PERCOLATION RATEIS; <1 MINIINCH --------------- __ ,PROPOSED APPLICATION RATE: 0.7 .AINiMUM DRAiNFIELD SOFT.: 1071 Fr - GRAINFIELD DESIGM: MAXIMUM DEPTH OF EXCAVATION:2 FEET t'WC'71: 30 F_'— LENGTH: 36 FEU M.O.A. APPROVED SAND FILTER: 2 FEET E�FEvT :0.3 FEET REDUCTION FACTOR: WA F" .ACTUAL 80,17T.: 1080 FT= APPROX;MA i'c LCCAT;CN OF 1 SG% XISTING TRENCH. WILL SERVE AS ALTERNATE SITE �w.wmr�aus 'NSULATE EACH PRESSURE LINE / 2' THICK 4° WIDE CENTERED OVER PIPE WHEN NOT UNDER ^_:R:VEWAY; UNDER DRIVEWAY INSULATE MTHICK 4' WIDE CENTERED OVER EACH SACK TO TANK SO THAT LINE DRAINS THROUGH WEST+ HOLE AFTER EACH CYCLE AND INSURE NO BELLIES ARE IF: THE LINE THAT WOULD 3WWATErt T - .Pr aXMA7 L.',CA Gai �..5. ANG SEPTIC TANK; TO SE INSTALL FCO; ASSUMED LOCATION OF EXISTING SEWER LINE GIVEN 1''SnNG TANK LCOATIO1 PROPOSED 2000 CALLON S.T.E.P. TANK. PROVIDE DUAL OUTLETS AND ' fALVWG SO FLOW CAN BE DIVERTED TO EITHER DRAINFiELD. PROVIDE 1.25' PVC PRESSURE LINE TO EACH DRAINFIELD- 1 FOOT LOT LINE WAIVER REQUEST€ 6 EXISTING q SBEDROOM HOUSE 10' UTILITY EASEMENT ORIGIN OF INTERMITTEI FLOW A7 CLOSE FCIN M. TO BE EXCAVATED OUT AND FILLED WITH SAND - SIX 30' LATERALS 1.2F DIAMETER PROVIDE 3/15' DIAMETER ORIFICES OFFSET AT 5' ON CENTER WITH ONE OLE AT EACH END (7 HOLES PER LINE). TOTAL OF 42 ORIFICES. �W SETBACK OF SURFACE WATER 0 EXISTING SHOP; CURRENTLY HAS NO WATER OR SEWER SERVICE ! PER THE HOMEOWNER; WILL BE / CONNECTED AT A LATER DATE � r HAVE ALL WELL RADII, THE 60' 1 / STREAM SETBACK, AND THE 1 J It WEST LOT LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. BEG, Ltd. HAS A B PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. TO �& OBTAIN A COPY OF THE LETTER CONTACT y BEG. BY PROCEEDING FORWARD WITH THIS 2� INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED, INSTALL FOO AND .00 SEWER LINE SO THATa �3HOF MAY BE 0/ gsy / CON.N.,ECC%yD AT A_/ u.-SERVEDRBJNFiELI) � •' 'i r `ems FALL SE REEUILDING THEis PROPOSED DRAINFIEL _ �1.. FLAT TOTS AVENUE -_-- - - - - -\- - - - - - - - - - -- G ARNEss ENGINEERING GROUP, Ltd :.: 04'•i9L i5 ENVIR0 N%IE'NTAL ENGI N'igFE'S y ..•."-••^,.'�;^��.F'ef•n_:rv�^.�:c'-.,::cel°sv.=s_;2`7)�atTJ°FX'CI�IaA&'i?A8•WaBlfEwxwT+�L`�estrCwn �...... -n tirz ~HONE NUMBER: I PACE44UMBER: �1JU%j25JU-8481 I 2OF 1 -_st �E CRiPTION DRAWN BY: SIS S' -CK 1., LOT 3A 1 3,1.M. a : R VIS_Dr �PCFESS 0" AIA. a�a 25% SLOPE AT 2.5 FEET ABOVE INVERT INTERSECTS AT APTROX IAMY 42 FEET 35.00 1.23- DIAMETER FRESSURIZED LINES WFFH 3(]G^ DIAMETER ORIFICES (FACING DOWN) OFFSET AT S' ON CENTER WITH ONE HOLE AT EACH END (7 HOLES PER UNE. TOTAL OF 42 ORIFICES). 2. OF INSULATION' TOP OF SAND AT OMGINALGRADE — 3.1 SLOPES TO TOPSOILED AND VEGETATED INSPRING 2016 1 SCALE: 1" = 10' 2' OFMOA APPROVED SAND. 300C' s- --A� ..�P�� OF .q�l �'♦♦ ♦♦ 9 G'ARNESS EINI GINEERING GROUP, Ltd,': ,�9�' 1i �. .,9 n. ll A. � „fv. i f • •� im PHON£NUME£R, jPAGE\:iAiB£R (�'" ( �. .:..^1,.5., - 9 i 90' 830 4a3 3 GF 3 �£ mor nxawN BY. Z c �, OFt55'1 a .j,_/ _�-_•�=411a����=� nn�c l7nac 1 'ii'S�13�.1� _ GARNES_S ENGINEERING GROUP, Ltq aro aruooaaonn SUITE 101 u+cxoCIVIL & ENVIRONMENTAL E TAL ENGINEERSe+ SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: ROCKER; BLOCK 1, LOT 3A PERFORMED FOR: MATT CARR DATE: 8/612015 DEPT ORG teeU TEST HOLE #1 19 20 SOILS LOGGED DEPTH TO GROUNDWATER DATE 7' SOIL CLASSIFICATIONS 6.33' 8/10/2015 6.6' 8/13/2015 8 GW ORG 10 B.O.H. 11 12 _ GP 13 ML 3 ,,`:_H 15 16 17 18 GM CL 4 �;:., G P GC OL 0000 0 0 0 0 SW MH !.: SP CH 5- SM ; OH 6 SC a:": 19 20 SOILS LOGGED DEPTH TO GROUNDWATER DATE 7' 8/6/2015 6.33' 8/10/2015 6.6' 8/13/2015 8 10 B.O.H. 11 12 13 14 15 16 17 18 19 20 SOILS LOGGED DEPTH TO GROUNDWATER DATE 7' 8/6/2015 6.33' 8/10/2015 6.6' 8/13/2015 �e 51 �O G� SCALE: 1" = 100' DATE READING CLOCK I TIME NET TIME (MINUTES) I WATER LEVEL READING NET DROP (INCHES) 8/10/2015 ABSORBED 15 GALLONS IN <10 MIN PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3 FT. AND 4 FT. A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO By: DAVIDGARNESS PERCOLATION TEST PERFORMED BY: ERIKWIDGER PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RME p IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: s I % (Y GARNESS ENGINEERING GROUP ,, —aw :2 mCIVIL & ENVIRONMENTAL ENGINEERS-- ' � 3 l E. TV00RROAg3UITE 101ANCXO0. E.W995W-PXOK(BW) Wl4ilH. M7) 138-iAdlB.111uyn.9ameaenpinee"C= LEGAL DESCRIPTION: HOCKER; BLOCK 1, LOT 3A PERFORMED FOR: MATT CARR DATE: 8/6/2015 DEPTH (feel) ORG ;� TEST HOLF#2 SOIL CLASSIFICATIONS 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3 FT. AND 4 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: DAVIDGARNESS PERCOLATION TEST PERFORMED BY: ERIK WIDGER COMMENTS: PERCOLATION READINGS ARE WITHIN 1116 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 r " GW ORG . .. ,.; GP ML GM CIL GP GC OL 000.%, SW MH SP CH �Q 5 '`« 5 SM .: OH `.3 Sc 6 + QG 7 `. DEPTH TO DATE P =cas;1 GROUNDWATER 8 7' 8/6/2015 DRY 8/13/2015 s® 9 V=100' «=?, ..B.O.H, 10 .. DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 TIME (MINUTES) READING (INCHES) 8/10/2015 ABSORBED 10 GALLONS IN <10 MIN 12 13 14 15 16 17 18 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3 FT. AND 4 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: DAVIDGARNESS PERCOLATION TEST PERFORMED BY: ERIK WIDGER COMMENTS: PERCOLATION READINGS ARE WITHIN 1116 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 r " MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930416 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:FRITZEL MAX J & RUTH A OWNER ADDRESS:9981 FLAT TOP AVENUE ANCHORAGE, ALASKA 99516 PARCEL ID:04208110 LEGAL DESCRIPTION: HOCKER BLK 1 LT LOT SIZE: 93067 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 3A THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED:10/06/93 EXPIRATION DATE:10/06/94 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1. ENGINEER MUST CERTIFY ABANDONMENT OF EXISTING WELLS. 2. SUBMIT NEW WELL LOG WITHIN THIRTY (30) DAYS OF WELL COMPLETION. RECEIVED BY: W _ DATE: b I 13 ISSUED BY: DATE: 4 ( It dv a X06 MAR1 1,1 \ September 25, 1993 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 SEWER &WATER Anchorage, Alaska 99519-6650 MAIN EXTENSIONS SEWER & WATER REFERENCE: Hocker Subdivision, Block 1, Lot 3A INSPECTION ENGINEERING STUDIES Request you issue a permit to drill a well to serve the three bedroom house AND REPORTS on the referenced property. Two wells currently exist in the Southwest corner of the lot. One well is located WELL INSPECTION in the right-of-way along Flat Top Avenue and the second well is located in the &FLOW TEST driveway. We propose to abandon both existing wells once the new well is drilled. SITE PLANS There are no points of contamination within the proposedwellradius which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the drilling of this well. ROAD DESIGN If you have any questions, or require additional information for your review, please contac Sinc% ely, SOIL TEST PERCOLATION TEST o rt A. Shafer, P.E. / n/i0/L0V//0U STRUCTURAL& ✓ MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 D fn TI D ami � 3�£�m �OyZ1 N �N32 i OZN� sig$ 7"'g< r�oo� N Tim Z 1'= = 50' SCALE A P p�amo0 O m -1Z Z .Z�] D O a Dry Z � M r— n 0 m 111;u V)V) M 0 0 z 0 O O O I I I d .ice r'�� 1 1 I I I I I g / Vol � I I np ON0 DNN ZOM I I � 3 tDi)Z l) Z� I I . a ODDm z —ri�tn I Z Z N N omo H � Z -om n ro ro AZA �O V) ao X0 V) a O ro m- Mp'O -I p�amo0 O m -1Z Z .Z�] D O a Dry Z � M r— n 0 m 111;u V)V) M 0 0 z 0 O O O I I I F � .ice r'�� 1 1 I I I I I g / Vol � I I np ON0 DNN ZOM I I AZMI �= tDi)Z l) Z� I I _ 2 n N{ m 2 CO Z m ODDm z —ri�tn I Z Z N N omo S m N(n � Z -om rA N tnm AZA �O V) ao X0 V) Zm =1� —I{mZ I m- Mp'O -I �m{ =D�N z o c� rp11 DZ � I t� V)0= o m <r"z I x m D (') t j imp NO � 1 MTJA OS -i�D 00-0a zZ z O-1 N I I I I I 1 I I X z F � .ice r'�� ir'4 4pF 1i`. h Vol � &5 P } Frorn . ALPINE DRILL L -Me _4- UC:L.cr. i ��1-1 U10.�� I II I �� STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF WATER WATER WELL RECORD 14'/Yi Yt/1{I /1! SAWA I LV%. {I9Wn WF VVU{ . BOROUGH SUBDIVISION LOT BLOCK "CT1ON UTfA$ SECTION TOWNSHIP RANOE MERIDIAN [IN CIE i34 , _ IIs OW I.00ATIONISKETCH: WELL OWNER: DEPTHS MEASURED FROM:Clcasing top Ogrcund surface WELL DEPTH: DATE OF COMPLETION --- ho+e:, -V It -- Depth of p BOREHOLE DATA: Depth Depth of casino:_ -_Jt Material Type and Color From To DEPTH f O STATIC WATER LEVEL: 0 surface _� �It below �i top o! casing ground Pate: METHOD OF DRILLING: fi4,air rotary © cable tool 'A2ALI] other USE OF WELL% ii� oome0C C] irrigation O monitor - o❑ public Supply 0 rrt.Mt>r �4._...__......-.....---•-•._..._...-. _ -- CASING STICY.•UP: _ ti, LTiam: �in. t0 ft Casing type: in. to St WELL INTAKE OPENING TYPE: 0 open and II Screened ❑ perforated open hole Depths of opfmings: qV E t4pV 121933 SCREEN TYPE: _ _ Diarn'-- — __� in. — slot/Mash 1 p4unicipality of gnCh Health & Human aces GRAVEL PACK TYPE: Volume used:____ Depth to top: Dept. VOlume: GROUT TYPE �. _ Depth:from _ ft to it DEVELOPMENT METHOD!^— buration: PUMPING LEVEL AND YIELD: G-> it after f=LL hrS pumpin® gpm PUMP INTAKE DEPTH: _ It Horsepower: WELL DISINFECTED UPON COMPLETION? YES © NO CONTRACTOR INFORM TION; i4egister d Business Name 41ciru .ure of AulhnnaCd es p Onti+ C Date RFMARKS: PLEASE MAIL. WHITE COPY OF LOG TO: DNRIDIVISION OF WATER PO BOX 772116 EAGLE RIVER AK 99577.2116 ^ Dry O' HEALTH AND ENYI��omm ° ~ 825 'L' STREET., ANCHORAGE, A[.-::. ( 264-4720. '11 BE OBTHINED FROM THE FILES OT HVH R ������T T —0 2-0 C# F= ����F... F i ci IF. DEPARTMENT OF' HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, HK. 99501 264~4720 ` PERMIT NO. ( 8�0979 ) APPLICANT RICHARD PARRY E 72 99507 I497030 1 OCHTI8N L] H B1 HOCKER SD LEGAL L ] H B J-HOCKER LOT SIZE 400000 SQUARE FEET MINIMUM DISTANCE BETWEEN H WELL AND ANY Ohl -SITE SEWAGE DIS�OSHL SYSTEM IS i00 FEET FOR H'PRIVHTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FRQM A PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H cOMMUNITY SEWER LINE IS 75 FEET. � �ELL LQG� ��� �EQUI��� HND ���T ��� RETUR�ED T� T�E DEPHRTMENT WITHIN �0 DAYS O� THE ^ELL COMPLETION. ' OTHER REQUIREMENTS MHY APPLY. SPECIFICATIONS AND CONSTRUCTIQN DIAGRAMS FIRE HVHILHBLE TO INSURE PROPER INSTALLATION. ���M I -T ���I lF4;*."F�'.-..#.-".-.- 2CA OF3� I CERTIFY THAT J.: 1.1-91,1 FHMILIHRWITH THE REQUlREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2: 'J.ACCORDANCE WITH THE CODES. ` SIG . ..... ...--�~-- � ` ISSUED B DATE -c7 /7 ` WELL LOG Date Drilled Static Hater Level—feet Drax Down feet Tyne Material Drilled- �t Gallons Per Minute -7/ Total Feet of Casing ` O .feet to /S C— Z12 to�J 7 to G �,tL� / 61- LCAs���`� v � � to �- to 3 8Ile l /i o c k c e -50 60 Hefty Drilling; S.R.A. Box 1553 H 41, Anchorage ,Alaska a 99507 APPLI? NT FILLS OUT UPPER HAI` , ONLY F` @: 0w er Date Phone D dl Da ' te IF Inspector Mai..„,, AddressC, 'a x) Zip Code c) Inspector i Buyer /;�l Address Zip Code 0 PEPT. OF ENVIRONM'INTAL PROTECTION Lending Institution 7' Phone VW APP DVED BEDROOMS *CONDITIONS OF APPROVAL X) PROVED >Q CONDITIONAL APPROVAL' DATE B Address Zip Code Realty Co,& Agent j7- Date Sewer Installed Well To Absorption Area Well Log Received Phone Well to Tank Septic Tank Size Address c-' 7/-"- -S V Zip Code > 3 Legal Description V, Street Location Z Type of Residence )K Single Family 0 Multiple Family No. of Bedrooms E Other Water Supply X Individual ATTACH WELL LOG. A well log Is required for all wells drilled since June 1975. 1-1 Community For wells drilled prior to that date, give well depth (attach log if available). El Public Utility Sewer Disposal Individual Year Individual Installed: `El Public Utility When Connected to Public Utility: L1 Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE "4�CABE INITIAt&U - A 0 /Z 014 Time Time I Time iz= mad Date Date D dl Da ' te IF Inspector In spec to r Q f. Inspector i Field Notes: 4 MUNICIPALITY OF ANCHORAGE 0 PEPT. OF ENVIRONM'INTAL PROTECTION RECEIVED VW APP DVED BEDROOMS *CONDITIONS OF APPROVAL X) PROVED >Q CONDITIONAL APPROVAL' DATE B ev Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size %A, 'I m vieptember 12, 1933 Richard and Kathleen Parry sr'j� 0 380-1 Anchorage, Al 99507 subj ect'. 1,(.)t 3A, clock 1, 'Mockerc,;ubdiv*Lcion s Ap-,.)rC)val for the individual sower and water facilities cannot be granted until tile following itelas have been c0l"Pletcd: well :Locj submitted to t,,hia office for our fj).es and v -L e v�j for the neW well. 0 top of tile well casing should be seale(.-I so that -it '-ss water tight. 'The septic tank pumped With a receipt sub.glitted to this eqartjaejlt. Tile total number of gallons pultiped needs to be verified by a registered engineer as to on the receipt and f gallons pullIped. This is to verify the the actual number o size of the septic tank. Epose the septic tank manhole to verify its existence:. x the cleanout to the seepage pit and/or Locate and expose ti :01lis is to insure the leaching area for our inspection. I-Animun, distance requirements are met between the well and sewer systel1l. A four (4) inch cleanout needs to be installed to the sep- tic tank. inch cleanout needs to be installed to the 7 A four (4) leaching area. acy te.st needs to be performed on the existiflq An adequ leaching area. This test will deter"JIle if the systc-111 is to National Standards. 1�i listing of dequate accordil',J TIC is rePOrt the test is enclosed. 11 \\J-) private firms performing K needs to be submitted to this office for our review - %04' 'The standjAPe to the sewer systell need caps oil thOM- Richard and Kathleen Parry September 12e 1983 Page 2 A permit will also be required for the well drilled in Spring of 182. Have your engineer provide an as built of the sewer system. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any turther questions, please call this office at. 264-4720. Sincerely, Jim Roberts Associate Environmental Specialist JR21/ej/E2 Enclosure b. •. ',� � ���, rte'. PENINSULA ENGINEERING 440 W. Benson Suite 200 October 7, 1983 Mr. Perry NHN Canyon Road Anchorage, AK RE: Inspection and Adequacy Test Sewage Disposal System Lot 3A, Block 1 Hocker Subdivision Dear Mr. Perry: Anchorage, Alaska 99503 907-276-4855 As per your request I have witnessed the excavation of the septic tank as performed by your contractor Mr. Monte Acheson on 9/28/83 and herein verify that the previously unknown system consists of a 1000 gallon septic tank located approximately 30' from the north side of the building and further consists of two separate drain pipes (perforated) extended northward out of the tank an undetermined dis- tance. After verification of the tank and drainfield system by myself and the Municipality of Anchorage inspector it was agreed upon by all parties involved that the system would be acceptable if an adequacy test was performed and was acceptable in accordance with municipal standards. The system was then backfilled and an adequacy test per- formed on 10/5/83. Water was added to the septic tank at 5 gpm until 500 gallons had been added.and the levels monitored for two days in accordance with Municipality of Anchorage standard adequacy test procedures for drain - fields. Although the configuration of the drainfield is unknown the system did accept the required daily loading for two consecutive days with adequate recovery within 24 hours. See attached table of test results. In conclusion, the test results indicate that the system is function- ing adequately, however, it does not have standpipe cleanouts at the end of the drainfield lines. Therefore, it would have to be con- sidered not up to current Municipal standards until such time as these standpipes were installed. Since the location of the drainfield is unknown it would not be practically possible`to install these standpipes in accordance with Municipal standards. I would recommend that this requirement by the Municipality be waived under the circum- stances. Mr. Perry (Letter/ Page Two , A copy of this letter and test results should be given to the Munici- pality for their concurrence and approval of the system. Sincerely, Wayne Henderson, P.E. WH -mks Y / 1 b PENINSULA ENGINEERING ADEQUACY Tsar Client: Mr. and Mrs. Perry Address: NHN Canyon Road _ Legal: Lot 3A, Block 1 Hocker Subdivision System: 1000 Gallon Septic Tank with Drainfield OI:P'1'II DI?1''1'11 WA'I'I;R ADDI?D TOTAL WATER DATE TLMG(min) SI -ATTIC 'TANK SPJ:PAG E PLT (k;pm) RA'Z'E ADDL) al) 10/5/83 0 0 After pmpg 0 Start test 47 5 0 10 min 49 5 50 20 min 51 5 100 30 min 52 5 150 40 min 53 5 200 50 min 53 5 250 60 min 53.5 5 300 70 min 53.5 5 350 85- min 53.5 5 425 100 min 53.5 5 500 min 10/6/83 0 min 46 5 0 10 min 47 5 50 20 min 50 5 100 30 min 51 5 150 40 min 52 5 200 50 min 53.5 ® OF A< 4 5 250 60 53.5 °.�-®© 5 300 min ��.••° 70 min 54.5 o�*�,� 350 .�9T�... .. ..�ir�� 425 85 min 55 100 55 ENDER �° ON e �j 500 min ® •WAYNE '�r •. CE -4488 • a s ��a"- AV • Ev AV min _ /����°°••..°.°°°_,�AV ����®�' 10/7/83 0 min 47 0 0 1 PENINSULA ENGINEERING 2820 'C' Street, Suite #3 Anchorage, Alaska 99503 276-4855 September 4, 19$1 Becky and Daniel Crow NHN Canyon Road Anchorage, Alaska RE: Adequacy Sewer 'fest Lot 3A Block I (locker Subdivision ^ NHN Canyon Road r Dear Mr. and Mrs. Crow: \�As per your request, I have performed an adequacy tes� on the above property in accordance with the Municipality of Anchorage recommended procedures. The configuration of the existing system is unknown. There is only 1-4" C.I. standpipe located approximately 30 feet from the home on the north side. This was assumed to be the septic tank and the test was run in accordance to the procedure of a septic tank/drainfield system. Water was added to the septic tank at 6 gpm until 500 gallons had been added and the level monitored at regular intervals for two days in a row. Although the configuration of the system is unknown, it did accept the required daily load for two days without any indication of back up into the home. This, however, cannot be guaranteed to continue on a continual use basis without means of measuring the actual drainfield water levels. On the third day of the test after the level was taken, the tank was pumped and found to contain 1000 gallons of effluent. In conclusion, the test results indicate that the system appears to be functioning adequately, however, it does not have the required cleanout standpipes for the drainfield. Therefore, it would have to be considered not up to Municipal requirements' until such time as they were installed in accordance with Municipal Standards. Sincerely, Wayne H ndr dcrson, P.E. i MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel ►.D. 042-081-10 1. GENERAL INFORMATION Expiration Date: 6�' r2 2 Complete legal description Hocker Sub Block 1 Lot 3A Location (site address) 9981 Flat Top Ave Current property owner(s) Mailing address Real estate agent Matthew & Lori Carr Day phone (907) 830-8483 9981 Flat Top Ave, Anchorage, AK 99516 Carla Nice 2. TYPE OF DWELLING: ❑m Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone (907) 242-2427 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑° Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 15-50 Date of Payment Receipt Number 002 7 5b COSA # OS G Z 1 10 61 Waiver Fee $ Date of Payment Receipt Number Waiver # 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, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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 (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller Date 2/17/2021 ofq�ll Aw i TH.49 6. DSD SIGNATURE .+ f System #1 Approved for bedrooms BenjamtrLSchiller System #2 Approved for bedrooms �� ��`�,s • CE 12592 .`��`i/ � �il�F9F�.....•P`�� p Disapproved �` ROFESSION Conditional approval for bedrooms, with the following stipulations: V1 Gi t vt 2�✓ V C V��`k11 �l � S lS 2S OJ t^2 :�2 r\e4 Vey, cct<<i \\\\``OFP(Y q��,� ON-SITE r m� WATER AND _ t ,„ G PROGNAM /o%C`� , rG � �'/J,i �u� SER�i• • ,, Original Certificate Date: 2- 2-"2 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Hocker Sub Block 1 Lot 3A If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ON Well log is filed with Onsite (or attached) Date drilled 10/22/93 Total depth 106 ft Cased to 38 ft OR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 2/16/21 Static water level at beginning of test 38 ft. Comments B. TANK DATA Age of tank(s) 6 years Tank type/material S.T.E.P. STEEL Measured operating fluid level in septic tank 43 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 6/18/20 D. ABSORPTION FIELD DATA MOUND Which system tested (date installed) 11/05/15 ❑ ALL standpipes present per record drawing Total measured depth from grade 4.7 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: .,COSA Checklist yellow sheet Parcel ID: 042-081-10 Structure served by this system Well production at time of test 6.2+ gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ N ❑ Coliform bacteria is Negative Nitrate 3.16 mg/L ❑ Nitrate less than MRL (ND) Arsenic 5.00 ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 2/5/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station 5 years Lift station material Steel Comments: Adequacy test date 2/16/21 Results [D Pass For 5 bedrooms Fluid depth prior to test 0 in Water added 813 gal New depth 0 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate >750 gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' ✓❑ Yes if No ft ❑✓ Yes if No Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' F71 Yes if No Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' ✓❑ Yes if No ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' 1* ft ft ft ft ft ❑✓ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' 0 Yes if No Water Main > 10'✓❑ Yes if No ft Community Wells > 200' ✓❑ Yes if No. Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' ❑ Yes if No 60* ft F. ENGINEER'S COMMENTS *Waiver#: OSV151134 G. ENGINEER'S CERTIFICATION 1 certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet Aw TH �•. Benjarr*}r."Schiller E 1259 p /17/21 NP�������'' �� ROFESS10 .® ft ft ft ft Lot 2 c+M 00 N U rn N 0 0 Z Septic vent (typ) Chain link gate A „--Wood fence 30N.0 5.3r o 3/Manhole,' 7"' g o . 6 eo -----Grave L, r) ym drivewa 28.0 31. ' 24.0 (i Ue\ vs 1 v ti U� N O L rn O i ri z2 % 32.0 N v UNSUBDIVIDED N88°57'36"E 330.11 10' UTILITY EASEMENT Stream 1 Story Frame House with daylight basement o Well \2.4OH FLAT t # Access to Canyon Road CA) I 1 on Lot 2, Block 2. I # 11 ! IN I c 1 I Q) I CU l i(t 1 1C Lot 1 f N Block I 0 IY 1 0 100 I Q Im SCALE: V= 50' Lot 4 CY) M 0 00 (N W LOT 3A N88°24'31 "E 330.32 TOP AVENUE (Not built) " RECERTIFIED 2-11-21( Wo AS -BUILT NO CORNERS SET THIS DATE OF � ®P �0 2 ` •'49th • ;� 0 2 00 * ® ®� If i abeth L. Walatka `Th ATF • • 8036 - LS . • Jew® 5 I hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: LOT 3A, BLOCK 1, HOCKER SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska EASEMENTS OF RECORD, OTHER THAN pFo • • • • , a . ® this 15th day of JULY 2015. THOSE SHOWN ON THE RECORDED 0 plaw R01FESSIatJPL �.'� FRED WALATKA & ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON FB 21-1, pg 17 ' \ ��® Engineers and Surveyors UNLESS OTHERWISE NOTED. Lantech ���® 2�ti/ BE 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence, structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. MUNICIPALITY OF ANCHORAGE Phone: 90T -3,1'2,7e 9q4 cas Department Fax-, Servi F, On -Site Wu titer Wastev.,P'Ker Se(AZIOn L. ft, Stationipump Vault Maintenance Log PID__ Legal Desc, required -SlUdgiE-t level -v nch,e-s -Purnping. -Rump basket cleaned §'i ng -Effluent filter clear": --d -,n Proper float �iettingsconi;�ed C4Q-,5) no -Cn.ntrol floats cleaned -Operation satisfactory P5LM warm- �5�� circuit GL -D -Q -Audible and vi!5-3; alarm CYQ -Dedic,atedelectricalalarM -Alarm system operation notsaiLs-faLdQry ion -Z� Ground water intrusion at riser to iank connecf Y9 -AAk-,ep hole funct. o n a I 11.ision d arGLinpipo —ves 0� <1,roujid; wato;r ini, —91, (y ropperly Secured _QaInsulatied (g1 -DP - P -ManWe lid: Functowll d maintenance completed .Al; rnanwact�u(Pr required insc)ections an ........................ ........ ............ ............. ...... . - ...... ... .............. .................... ......... ....... .......... ........ ............ ....................... ............ -------- 1--.- ........ --- ........... Technician c721e of mninter%anceliA-1,,�Zl Company r- Signature 4 (-;. f MUNICIPALITY OF ANCHORAGE • T DEPARTMENT OF HEALTH & HUMAN SERVICESRECEIVED Division of Environmental Services M� i On -Site Services Section NOV 12 19A P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 (furl;Cjpality of Anchorage Dept. Health & Human Service CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# Q`1:-a-QSA1- 1C) HAA# 1. GENERAL INFORMATION Complete legal description Lot 3A; B2ock 1; :Hocket SubCiivi.6.i.on Location (site address or directions) 9981 Flat Top Avenue, Anchorage, Property owner Max F4i.tze2 - HaP2i.button Reeoca.ti-onDay phone W261-7700 CIO Donna GunnIVISIA- Mailing address 3000 "C" St)Leet, Suite 101 Anchorage, AK 99503 Lending agency Day phone Mailing add Agent Donna Gunn/VISTA REAL ESTATE Address 3000 "C" Sheet Suite 101 Anchanage, AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water Day phone 562-6464 NOTE: If community well system, provide written confirmation from State ADEC attest- lr. g 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. 1191) Front MOA #21 5. STATEMENT OF INSPL.,TION 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 furtherverify 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 5 & S ENGINEERING Address Engineer's signkvgPiver, Alaska 99577 Phone Date 1IITIr,, 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 N21 Al r 6. DHHS SIGNATURE M• ;, ';';,u —L Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: f� 1/ Date /Z 1IITIr,, 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 N21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 2314 _91 / 7L I r( t*'- Parcel I.D. A- Well Data Well type/UGGT6e If A, B, or C, attach ADEC letter. ADEC water system number �1 Log presen (Y ) Date completed /V 12 2 /� 3 Driller /vim !/� iGGl6✓G � � n Total depth /(SG/ Cased to Casing heightZD Sanitary seal(Y/) Wires properly protecte (Y/) FROM WELL LOG AT INSPECTION ? lid m > Date of test �y�Z z �/� �' ) a y Static water level r'r 110 rn c D Well flow `� 9•P•m• g'p'm' r°t'I c c 3 Pump levell //JD m z SEPARATION DISTANCES FROM WELL TO: Septic/tank on lot LOO r ; On adjacent lots Uo Absorption field on lot /O L) ¢ ; On adjacent lots `O&) f Public sewer main /y 1 Z/4 Public sewer manhole/cleanout /-)//qr Sewer service line 25- i74 Petroleum tank 14�0 f 2- OL D w r i=7 '`� T��ls T��rE WATER SAMPLE RESULTS: Coliform Nitrate 2 i Other bacteria S & S ENGINEERING Date of sample: Collected by: 1702A Paeale River Lawn Road No 204 Eagle River, Alaska 99,577 B. SEPTIC/rTANK DATA Date installed �i OC. 33 Tank size Gy��/ Compartments 1 Cleanout (Y/) Foundation cleanout ( N) Depression`( /N) /`� High water alarm (Y/N) / A //0- Alarm tested (Y/N) Date of pumping /D / Z Z /C/ 3 Pumper avow (,/j C� / .1c CO(, 42-'f 0YL 7tCt n SEPARATION DISTANCES FROM SEPTICIRPEOMIQ TANK TO: Well(s) on lot `L7d f On adjacent lots X00 �-- Foundation l � To property line l0 /- - Absorption field c5- Water main/service line �U Surface water/drainage '�)D 72-026 (3t 3)* Front �.��� �t�i=CQ S' CONTINUED ON BACK PAGE 0 Ye C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA lots anutacturer anhole/Access (Y/N) " off" Level at _ Cycles tested vv Surface water Date installed(W) DOG • 120 3 Soil rating (GPD/Ft2) b< System type 111?14614 Length 6'y D Width u Gravel thickness c3 Total depth Total absorption area fil.f.(f. Cleanout presen (Y/ ) Depression over field (/N Date of adequacy test �/ 3 Results (pass/fail) S for Bedrooms Water level in absorption field before test 0 After test X2 �r Peroxide treatment (past 12 months) (lf/N)) A-, D If yes, give date /LJ 6 - SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /�_ On adjacent lots l00 7e- Property line l O To building foundation �/o 111L To existing or abandoned system on lot Nr On adjacent lotsy`O ��` Cutbank Water main/service line 1:5-29 „C c Surface water !1,D Driveway, parking/vehicle storage area5:2�1�,Sb C-thW,1 ✓ii✓e Curtain drain T AC A -)O /�• /- Z- �D/-92'7- DF S'�r 7F9--� E. ENGINEER'S CERTIFICATION D 2l '(-) & 6,_J -r / I- A -T /DI �? s I certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 00-7- L GC $ 01 5 idty��lee/% y Signature S & S ENGINE Engineers Name 17034 Paola River I-c+s+rS Road Na 004 �M Date Eagle River, HAA Fee $ 9 OD , cr`Z Date of Payment awl Z -2 3/ 1 Receipt Number w D / ( /07/ / 72-026 (3/93)` Back Waiver Fee $ Date of Payment Receipt Number n,. 11/09/93 18:14 CTzE ENVIRONMENTAL LAB SERVICES COMMERCIAL TESTING & ENGINEERING CO - ENVIRONMENTAL LADONArCRY SERVICES NO. 655 DO" S-Ncd .VGd Drinking Water Analysis Report for Total Coliform Bacteria ANCHORAGE. AKf 9618 RFAD LVSTRLVT10,'VS ON REPTArsM SIDE B.f,,F SRF- CC7LL CTLV1O S.4.iizPLE TEL: Iv07) 562.2343 FAX: (907) 561-$301 MUST BE CQMYLETED BY iVIc ER. SUPPLIER p PUBLIC WATER SYSTEM I.D. P � ,bQ PRIVATE B'A'SER SYSTEM ❑ Send RjuAr Send Invoice _/- 1 k'P�tt bystem-ema'Cem PiJ�Y 1`�yilt ent0�t nan —._ ❑ Send Resails ❑ St�r,d in NOV 1 2 19� k4unicipality of Anchorage —------- ---- -' - 15ept. f4d- h &-HaMan 33 , lees! Ca rSAMPLEDATE: 1� Month Day Year SA"APLE TYPE; Routine Ij Repeat Sample ?for routine Satnpie `vith lab ref. no. i ❑ special Purk,ase SAM-PLE LOCATION Tre-med'4x',atel C. llilCYCat�i1 VJartr Time Cillle¢tCd Collected B) less' �i-a TO BE. CO viPLETED BY LABURA'i URY I3A.C,f'ERI•)i,CJC,TC'AL .'FAI'ERA. ,4L,l`SlS PXC0T4-D Analysis shows this W'atcr SAMPLE to be: Satisfactory % ❑ UnsatiSfutory �. C) Sample over 30 hours old, fesults mtly Membrane Filter: Direct Count be unreliable O Sample too long itl transit; 531[:ple should - not be oder 413 hours old 3t examination yeeal Coliform Confirmation to in•?icate reliable results, Please sand nt,�, sa;nplo, via special delivery mail. . _— ___._ �— — Colifarm/100 ml Date Receited d�UateTimc Tiive Rec3ived Reported By.0 y _;. Comments; C An2lNflcai'1i shod: ;- I\XembrarteFilter • , IlumbL: ort colonies/IO(i n':. ,abRol. No. Result" Analyst Sant to:1.'). .(;. Mich Fbks Jun Faxed C'Ient notified of unsatisfactory results: i'ylgncd Spo&ct*ith Fazed Ualc: — Time; '1:'v70 = Tnn .Vumarous To C4un, o.ti c 0tho Baderiu PART ONE OF TWO: �� SGS r:emre, of Ire SGS Gr, -,;;p (Snclal OEM A i ung; ► Til rm 1 nw I3A.C,f'ERI•)i,CJC,TC'AL .'FAI'ERA. ,4L,l`SlS PXC0T4-D KU INM0-Mi?ID Result; Tc,::l: Coiifonn _,,, —.,.____._Y.._.—.— — k'• Cc,ll _ _— f Membrane Filter: Direct Count Verification: VfB _, _ BGB a yeeal Coliform Confirmation Final Alembrane Filter Resu� . _— ___._ �— — Colifarm/100 ml d�UateTimc �Y� hrs Reported By.0 y _;. Comments; C '1:'v70 = Tnn .Vumarous To C4un, o.ti c 0tho Baderiu PART ONE OF TWO: �� SGS r:emre, of Ire SGS Gr, -,;;p (Snclal OEM A i ung; ► Til rm 1 nw 11/0y/93 18:13 CT&E ENOIRONMENTAL LAB SEROICES N0.655 D[ COMMERCIAL. TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVIC IES %,Ntc Yuu REPORT of ANALYSTS 5633 6 STREET Chemlab Ref.# :93.5943-1 ANCHORAGI!, AK 9951E Client Sample ID ;L3A B1 HOCMR S/D TrL: (907) 552.2043 Matrix :WATER FAX: (907) 561-530! Client Name :S & S ENGINEERING WORK Order :72875 Ordered By :R. SHAFER Report Completed :11./09/93 Project Name Collected :11/04/93 @ 09:16 hi Pzoject# Received :11/04/93 @ 10:15 hi PWSID :UA Technical Dlrector:SPH EDE Released By � f Sample Remarks: ROUTINE SAMPLE COLLECTED BY: S.S. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Ini Nitrate -N 2.1 mg/L EFA 353.2/300.4 i0 11/05 C!, RECEIVED NOV 1 2 19x3 Municipality of Anchorage Dept. Health & Human Services W*===See Special Instructions WAbove ---- UA = Unavailable ** See Sample Remarks Above NA ; Not. Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT R Greater Than 00MIR UAmhar or the SG9 Grouu (xaete 061`1erk)le 0 SurVOIIla ncel y, DA i cRECEIVED INSPECTION APPOINTMENTS rr__ TIME TIME TIME DATE --PATE DATE INSPECTOR INSPECT - INSPECTOR DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL f,:OTEC ION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE Wf INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. MAILING ADDRESS VPROPERTY 13,711 R- SI NT (If different from above) PHONE PHONE 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE " efflax MAILING ADDRESS 5. LEGAL DESCRIPTION rr__ STREET LOCATION 6jklNUMBER 6. TYPE OF RESIDENCE OF�BEDROOMS ❑ One EJ Four F-1Other❑ Lf SINGLE FAMILY Two ❑ Five ❑ MULTIPLE FAMILY E!T" Three ❑ Six 7. WATER SUPPLY E?T INDIVIDUAL* *ATTACH WELL LOG. Awell log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM Wf INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ TWO ❑ FOUR ❑ FIVE ❑ OTHER ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: ) 00Q If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area tdnearest Lot Line 5. COMMENTS C`YAPPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter mus ompany certificate) �DISAPPROVED G DATE — BY July 1, 1981 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Daniel Crow 3711 Casper Court, #4 Anchorage, Alaska 99502 Subject: Lot 3 Block 1 Hocker Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. (2) The top of the well casing needs to be sealed with a sanitary seal so that it is water tight. If there is a seal there, it needs to be tightened. This will need to be reinspected by this office. (3); The septic tank pumped with a receipt submitted to - this office, (4) An adequacy test needs to be performed on the existing F; leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms is enclosed. This report needs to be submitted to this office for our review. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Judy Lamb % Re/Max Properties 2702 Gambell Street, Suite 201 a NG iT Client: Becky and Daniel Crow Address: NHN Canyon Road Legal: Lot 3A Block 1 Hocker Subdivision System: Septic tank with unknown absorption system. iggq. VmOV®Vm 8 J �i✓ m°R A .� mm (+ �.>• o• e m � ✓ y T" mom�Ym4mOOUBOOOmOO °Olm1 imsommm .a< omnia o O. !0:^ tl�h oE t396N o gj ®AKm CE -4438 <ym a DEPTH I WATER ADDED I TOTAL WATER T DATE ITIME(min) I SEPTIC TANK I ( m) RATE I ADDED (gal) (inches) 9/2/81 1 0 min 1 0 Start Test ( 46 6 0 10 min 48 6 60 20 min 48 6 120 30 min 48 6 180 40 min 48 6 240 50 min 48 6 300 1'60 min 1 48 6 360 70 min 48 6 420 85 min 48 6 510 9/3/81 0 min 46 6 0 10 min 48 6 60 20 min 48 6 120 30 min 48 6 180 40 min 48 6 240 50 min 48 6 300 60 min 48 6 360 70 min ( 48 6 420 85 min 48 6 510 9/4/81 lBeforePmpg 1 46 0 0 After Pmpg 1 6 0 0 iggq. VmOV®Vm 8 J �i✓ m°R A .� mm (+ �.>• o• e m � ✓ y T" mom�Ym4mOOUBOOOmOO °Olm1 imsommm .a< omnia o O. !0:^ tl�h oE t396N o gj ®AKm CE -4438 <ym a MUNICIPALITY OF ANCHORAGE Azi 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Y61 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION NUMBER OF BEDROOMS Telephone 264.4720 ❑ One ❑ Four ❑ Other REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. InI6omplete requests will not be processed. Please allow ten (10) days for processing. 'HO 1. PROPERTY OWNER PNE Hocker, Robert E_. and Muriel E. _ 344-7551 MAILING ADDRESS ❑ COMMUNITY 2.2 Mile Upper DeArmoun Road, Anchorage, Alaska ❑ PUBLIC UTILITY PROPERTY RESIDENT (If different from above) PHONE Same Same 2. BUYER PHONE Henry,Vernon E. and Shires C 344-9964 MAILING ADDRESS NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 2 ens , Anchorage, Alaska 99502 3. LENDING INSTITUTION PHONE PP us Co_ _. 279-7511 MAILING ADDRESS 4. REALTOR/AGENT %i—CoIi� �.� G✓ HUNE Skyway Realt Ralph W. Stewart d7 274-8561 MAILING ADDRESS (/60( 3202 d R ad, Anchorage Alaska 99503 5. LEGAL DESCRIPTION — B1 k. 1, and Lot 2 lk- LoET 9, Hock r 4uhdivision _ LOCATION STRE_ 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other ® SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE. FAMILY ® Three ❑ Six 7. WATER SUPPLY - [0 INDIVIDUAL- ° ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE"' **If individual/on-site, give installation date . If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) RSM CONSULTANTS. INC. 5024 CORDOVA ■ BOX 6087 ■ ANCHORAGE, ALASKA 99502 ■ PH. 90]-2]9-0463 ■ TLX. 090-25360 ENGINEERS GEOLOGISTS PLANNERS SURVEYORS March 10, 1978 MUNICIPALITY Of ANCHCENo. 851507 DEPT. Of HEALTH & QNIRONMENTAL PROTECTION Mr. Bob Hocker Box 400 SRA ' S� 1 9 1978 Anchorage, Alaska 99807 Dj� Attention: Bob Hocker .�' RECE'_Y_EV' Subject: Adequacy Test on Existing Sanitary Sewer System; Nk, NE4, Sec. 31, T12N, R2W SM, Anchorage, Alaska Dear Mr. Hocker: At your request of February 15, 1978, we conducted a test of the septic system on the above described property. During this test the liquid level in the septic tank was monitored as water was added to the system. The measurements are summarized in the following table: The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. Liquid Level Below Top Total Gallons Time of Standpipe Added 9:17 6.0' 25 9:27 5.5' 50 9:35 5.4' 67 9:42 5.4' 67 9:52 5.7' 67 10:02 6.0' 67 The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. �I March 10, 1978 Mr. Bob Hocker Page -2- If the 3 bedroom residence on the property is to house 6 people, the average load on the system can be expected to be 450 gallons per day or 0.31 gallons per minute. During the test, the system accepted 67 gallons in 48 minutes. This indicates an average effluent acceptance rate of approximately 1.32 gallons per minute at the time of the test. Because the house on the lot is occupied, we assume that the leach field was at its normal degree of saturation. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 3 bedroom resi- dence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours, R&M CONSULTANTS, INC. Lynne Kosikowski Staff Geologist JMB/kah Jim McCaslin Brown Ph.D. Head, Earth Science Department . 1. - <: ':ate` S�v: ,. ;. y, t '.' 7 'f1 ,'F { r'v �`. :•'�&uw 4 a _ sty kW _.4..<f��. ':... o _ .. Kz .K. _; r`4�' . ' `fi .iii& w3 "",7 ,,...g.e�* +� _,t. Y <. MUNICIPALITY OF ANCHORAGP--•,, DEPARTML...`OF HEALTH AND ENVIRONMEN. PROTECTION 825 L Street, Anchoraap.. Alaska 99501 264-4720 Date Received: December 29, 1977 #1: Time 9:30 a.m. #2: Time #3: Time Date 1-13-77 Friday Date Date Insp Pratt Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Mailing Address: Phone: 2. Property Owner• Robert E./Muriel Hocker Phone: 344-7551 Mailing Address• Star Route A Box 400 99507 264-4516/her w 3. Legal Description• Lot 3 Block 1 Lot 2 Block 2 Hocker Subdivision 4: Single Family Residence: (x) Multiple Family Residence: ( ) 5. Well System: Permit # Construction Number of Bedrooms: Number of Bedrooms: Three individual Well (x) Community/Public System ( ) Depth of Well 55' Well Log on File ( ) Bacterial Analysis 6. Sewage Disposal System Permit # Septic Tank Size Absorption Area . On-site System (x) Public Utility ( ) Installed 1975 Installer Manufacturer Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line 1UNICIPALITY OF ANCHORAGE % IDE artment of Health and Environmental Protection'0( 825 L Street, Anchorage, Alaska 99501 CC 264-4720 '�) ;'3/ �3 equest for Approval of Individual Sewer and Water, -',6 l t' 1. Property Owner: Mailing Address: _&_K_4o_n45;i2 A 7 7�07_ Phone: -�- -7S_5/ 2,. Name of Buyer: �/{tJiz, � M. � LLS E Mailing Address: �1� c t72 T Phone: 333 .- 2 7 1 3. Lending Institution: Mailing Address: Phone: 4 . Realtor/Agent : "'( iA%�AaJ 2 A L i Mailing Address: Phone: Z7�1)J�l 5. Legal Description: ►�L 4 i-0� k?L .�Su�1�• Street Location: Z 6. Single Family Residence: ( Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: _ 7. Water Supply: *Indivi.dual Well �Q Public/Community System ( ) If Individual Well, well depth _T If Community System, name of system 8. Sewage Disposal System: "On-site System ( ( Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. **If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 ,PSI L Z i pC VR- Page„ Two • Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 3 Block 1 Lot 2 Block 2 Hocker Subdivision Affadavit Attached: ( ) Letter Attached: ( ) Approved: C.. _ Date: ! - ,�V , �-/Y Disapproved: - Date: J Department Worksheet: