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Home My WebLink AboutBOREALIS LT 4 Municipality of Anchorage Page ~ of --~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report P,erm t Number: S~{../~ OO~ 3._,. PID Number: Name: ~¢-/P---~N~. ~ ~~ ~ Wastewater System: D New ~Upgrade Address: ~8~ /~~ ~,,~ ABSORPTION FIELD Phone: I No. of Bedrooms: ~ D Deep Trench ~Shallow Trench D Bed ~ Mound D Other I Total Depth from original grade: , LEGAL DESCRIPTION Soil Rating: ~ GPD/Sq. Ft. Lot: Block: Subdivision: Deplh to pipe bottom from original grade: Gravel depth beneath pipe Township: I Range: I Section: Fill added above original grade: Gravel length: I I ¢ - { Ft. bO Ft. WELL: Q New ~ Upgrade Gravel width: ~ Number of lines: Distance between lines: ~ .t. ~ ' - Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. ~O SQ, Ft. Driller: Date Drilled: Static Water Level: Installer: Date in~talled: Yield: GPM I Pump Set at: Ft. 'Casing Height Above Ground:Ft. TANK i SEPARATION DISTANCES ~septic u Holding ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~NC~ %~N Well i ~ 5 13O ¢ Material: ~ ~( Number of Compartments: Surface Water ~kC I~""< LIFT STATION LineL°t ~ ~ ¢ Size in gallons: I Manufacturer: I Remarks: BENCH MARK O/~/~ ~ ~ ~ Location and Description: ~ssumeO Bevatron: Inspections performed by: :: Dates: l st~. 2nde- ~'~ Department of Healthand Human Services approval 'Reviewed and approved by' Date. 7- 2 ~ - 72-01'3 (Rev. 9/91) MOA 25 12 FT ~ / o /~ 1000 GAL SEPTIC TA, IK AF $7 FT ~ / / ANCHORAGE TANK BF ! 1 FT ~ I/ ~¥'- ' ~ - Y~. ~ I ~ I BULL RUN DIVERTION [AL VE I ~., '~. ,," .'.: ~ 1~,5 O ~5 50 75 '~, ,,>. ~,, .... . ...... rOBBER SPU~KLAND P.E. LOT 4 BOREALIS SIP SEPT/C SYSTEU ASBUlLT 205 W ~5TH. AVENUE gNCHAK. 9950~ 4850 ALPHA CIRCLE DATE: JUNE 2L ~994 OZ)' 27~-~[~ JIM WARNER SHEET: 2/5 G~D, 2756 1000 gal Septic tank ANCHORAGE TANK ~ DIVERTER VALVE )! 5-WIDE TRENCH 5' Wide 60' Long 8.5' Deep $5' Sewer rock 5' Cover EXIS TIN6 TRENCH . ' / Cleo nou ts ' · ':C / 'UU ,;: .. ~4.~ ~ ................................... ,..,. ' 140 91 o ,~,5 Ct o£ Septic Rock Under P/pe SCALE 84,£5 5-17- g3 i O0~ lO00 9aL septic tonk TOBBEN SPURKLAND P.E. 203 Wl5lh Ave Anchoro~ Ak 9950! LOT 4 BOREA£I 4850 ALPHA CPCLE JAMES WARNER SEPTIC SYSTEM ASBUILT DATE: JUNE 21, 1994 SHEET: GRID: £?35 RECEIVED T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 JUL 1 9 1994 Municipality ot Anchorage Dept. Health & Human Services Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 July 18, 1994 Subject: HAA for Lot 4 Borealis Ground Water Separation to Existing System Gentlemen; The septic system installed in 1980 consist of a trench with 6 feet of drain rock. The tank outlet is approximately 5 feet below ground surface. The testhole used for the design of the system was drilled to 19 feet with no water table observed. The date of the testhole was 5-21-76. A testhole excavated on 5-8-93 showed water at 14 feet and at 12.75 feet after 11 days. 5-17-93. Using the bottom of the building siding as a reference the invert of the septic tank is at 94.9 feet. Assuming a level trench, the bottom of the rock of the 1980 trench is at elevation 88.9 feet. The elevation of the ground water observed on May 8, 1993 is 84.25. The vertical separation between the observed ground water and the bottom of the septic trench is approximately 4.6 feet. The lot surface has an uneven topography with a 3 feet drop in elevation between the beginning and the end of the trench in question. There is no information available that shows that the depth to groundwater is uniform over the lot. Without additional monitoring over several years an assessment of the actual separa- tion distance between the deepest part of the septic system and the seasonal high groundwater can not be made with any kind of confidence that the observed distance will not be encroached. Yours ~ ?obben Spurkl~.nd P.E. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940042 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:WERNER JAMES P JR & OWNER ADDRESS:4850 ALPHA CIR ANCHORAGE, ALASKA 99516 DATE ISSUED: 3/01/94 EXPIRATION DATE: 3/01/95 PARCEL ID:01520310 LEGAL DESCRIPTION: BOREALIS LT 4 LOT SIZE: 17375 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE 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 RECEIVED BY: 0- DATE: DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. Dimond Blvd., Ste. 3-470 Anchorage, AK 99515 February 25, 1994 WALTER J. HIOKEL, GOVERNOR (907) 349-7755 Mr. Tobben Spurkland 203 West 15th. Ave., Suite 206 Anchorage, AK 99501 RE: Lot 4 Borealis Subdivision, Request for Waiver of Separation Distance Outline Under Title 18, Alaska Administrative Code, Chapters 72.015, and 80.020 ADEC Project No. 9421-WV-046-026 Dear Mr. Spurkland: This letter is in response to the materials received in this office February 15, and February 24, 1994, regarding the above waiver request. The Department has reviewed the materials which included a system design, site plan, soils Icg and a letter of non-objection from the homeowner association responsible for the Class "A" public water system (PWSID No. 211708) for which the reduced separation distance waiver is requested. Based upon this review it would appear that the proposed location for the replacement on-site wastewater disposal system will not present any increased threat to the public water system than the existing system which already encroaches upon the 200 foot protective radius. Results from routine water sampling do not indicate contamination from the existing wastewater disposal systems which are within the protective radius of this well. Therefore, the requested separation distance waiver to the proposed septic system indicated on the submitted plans is approved for the concerns of this Department in accordance with State Drinking Water (18 AAC 80) and Wastewater Disposal (18 AAC 72) Regulations. Thank you for your cooperation with this Department, if there are any questions regarding any of the above please do not hesitate to call. Sincerely, MLU/cf CC: John Smith/MOA/DHHS Michael Lu, E.I.T. Environmental Engineering Asst. II l". SF"U~F:~_AtgD F'- E- 203 W 15th. AYenue, Suite 203 ANCHORAGE, ALASKA 99501 (90?) 279-5916 Fax (907)-276-6015 SEPTIC SYSTEH QESIGN LOT 4 BOREALIiS JAMES WERNER Ground Water at 12.75 Tank outlet at 5 Use Wide Trench Soil Rating. From test May 8, 1993 Sizemore 8 min/in =.8 gal/ft sq day Required Area per Bedroom: 150/.8 = 187 sq.ft.. Ground Surface at Absorption Field 97 -101 Elevation of tank outlet 95.5+- pti 'T F:oc k De ~ .... Number of Bedrooms 3 Length of Trench 3 x 187/5 x .54 = 60 SYS'TEM COl,IF IGURAT I ON WIDE TRENCH TOTAL LENGTH TOTAL WIDTH TOTAL DEPTH ROCK DEPTH COVER 60 FT. 5 FT. 8.5 FT. :5.5 FT. 5; FT. SEPTIC TANK 1OOO GAL. INSPECT EXISTING TANK REPLACE IF NECESSARY ABANDON EXISTING SYSTEM INSTALL BULL RUN DIVERSION VALVE The installation of this septic system will riot from be installed on the adjacent lots. prevent wei Is There are ~o developed or natural surface / sub surface courses on this or the adjacent lots. drainage The proposed septic system will not change the general slope of the area. F'onding and/or concentration of surface runo~:f will not result from this installation. t::) Cl ,, :i 205 WEST 15TH, AVENUE SUITE 20& ANCHORAGE, ALASKA 99501 (907) 279-591& S u b j e(::: t; Re(::luest I:::'or" Wa:i. vet" Si ng 1 e I='am:i. 1 ',/ S~.:.:.:pt :i. c' System i:::il, ass A Wel '.1. to I}ra:i n [::'~ ~.:.:~ d I....ot 4. Bc:~real i s S/I) l}ear Keven; We are sLd:::,mitt:i.n~l a r"aClUeSt. .t:or i.~aivers .fr"om the sepal'"a'k:i, on (::l:i. star~c;:es stat:ecl in 'l"it].e :1.8~ A].aska Admini. strative Code,~ Chapi:er 80. ()2(),, Dur:i.r'~g an Health Autl"~or:[ty Inspectic)r'~ ~(::)r 'kl"~is pr"c)per't'.y it was c:lisc:overed that. the dr'a:[r~ .field that ~,~as ir~stalle(::l 'i.n :t98() was surc::har(i~led and not. operation :i.n ac(:::(::)rdan(:::e with state and Muni(:::i .... pal co, des,, i)ue t(:~ the 'topc~grapt"~y o.F t. he :l.l~t and the separa'E:i, or'~ requi red between drai n.~: :i.(.:.:.:,].ds,~ the locat:i.i::~n (M: 'Elna new drai n.f :i. e] (::1 is i:)retty much restr:[ctecl t.c~ the 'locat:tc)r'~ shown, "l"he welt on Alpha c irc].e has been tested regularly ar'id does r"~(::rt haw.:.;.: a h:L si::ory o.i: h'i gh n:i, i'.'rates or presenc:e o~c IE. (]cl~ ;i. ,, We have requa, sta, d a letter' o.t: Ixlc)n [.)bjet::t:ic)n 4:rom 'the hcime associ at i.(:)n. We wi i 1 4:(:)r"war'cl 't':.hi. s 'b(:) you as soc:~r'l as i. t c e :L v e (::l. T (::)1:7 !::) ~~," E: i. s re ..... PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGA' ESOR,.T,ON: La+ q, x COMMENTS PERFORMED BY: Township, Range, Section: WAS GROUND WATER ENCOUNTERED? y S IF YES, AT WHAT ~ ~) E Depth to Water After MonitorinD? !, 12.'-/~ Date: ~' 17' ~ SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop 6,~.q3 II:qt, - 18 ~/,-/ PERCOLATION RATE 8 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWE~EN q, 5 FT AND j'~ '-----~ FT I X O--~,c,~,~ ,~,3~u~l~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH L STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: LEGAL, DESCR,PT,ON: ~ ~,~ ( /~~ Township, Range, Section: ~ '~ .~ ~[._'1 'T'~' f2~ O/! SLOPE SITE PLAN 5 6 7 8 9 10 11 12 13 14 16 17 18 19 2O WAS GROUND WATER ENCOUNTERED? IF 'YES, AT WHAT DEPTH? ~ pO ,\ E Depth to Water Alter -~ , ~ - Monitoring? 7 Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN minutes/inch) PERC HOLE DIAMETER FT AND ~' ~ FT 1/ COMMENTS PERFORMED BY: . ,~4F'~,,~ J~,~'}~'~) O 7~*~__GERTiFY THAT THIS TEST WAS PERFORMED IN ;/.,_ . ACCORDANCE WIV. ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ ~-~ / 7 '-- 72-008 (Rev. 4/85) LDT 9 LOT £ LOT $ OCK I~ I LDT ~ TALUS DRIVE N 50 0 50 I00 1~0 ~00 SCALE: 1' = IOO FT, TDBBEN SPURKLAND P,E, 203 W 15TH, AVENUE ANCH, AK, 99501 LOT 4 .~flREALIS 4850 ALPHA CI~ JIM WARNER SEPTIC SYSTEM DESIGN DATE, FE~, 7, 1~94 SHEET, I/3 GRID' ~736 + + '1- + + CHECK INTEGRITY ~TF TAN/( REPLACE IF REQUI~ED %es%ho~e 12, ~ 0 INSTALL IVERfION VALVE BULL RUN I SCALD I' = 2§ FT, TDBBEN SPURKLAND P,E, II 203 W 15TH, AVENUE ANCH, AK, 99501 ¢9~7~ ~79-~916 LOT 4 gDREALIS S/~ 4850 ALPHA CIRCLE JIM IVARNER DATE, FEB. 11, 19~4 SHEET, 2/3 GRID, 2736 CLEAN I000 ga! Sepflc tank VERIFY INTEGRITY DF TANK DIVERTER VALVE 3ULL RUN Standard Trench 5' Wide 60' Long 8.5' Deep 3.5' Se~er rock 5' Cover SCALE EXISTING TRENCH / Cle°n°u~cs ~ /~ MoniStat ~ // 4' Topsoil ~ /, 5'Cover ~ . . T 3,5 F"t o~~ Septic Rock I ' Under f lpe J ~ 84 25 ND SCALE ~ % ~7 93 lOOO gal. septic tank TDBBEN SPURKLAND P,E, 803 W15~h Ave Anchor:9e Ak 99501 LOT 4 3DREALIS S/D 4850 ALPHA CIRCLE JAMES WARNER SEPTIC SYSTEM ASJ]UILT :D,~TE, FE~, 14, 1994 SHEET, 3/3 GRIll, £736 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. Dimond Blvd., Ste. 3-470 Anchorage, AK 99515 MAR ~ 1994, H,~;3,th & :,~fl'~gn Services ¢07) 349-7755 February 25, 1994 GOVERNOR Mr. Tobben Spurkland 203 West 15th. Ave., Suite 206 Anchorage, AK 99501 RE: Lot 4 Borealis Subdivision, Request for Waiver of Separation Distance Outline Under Title 18, Alaska Administrative Code, Chapters 72.015, and 80.020 ADEC Project No. 9421-WV-046-026 Dear Mr. Spurkland: This letter is in response to the materials received in this office February 15, and February 24, 1994, regarding the above waiver request. The Department has reviewed the materials which included a system design, site plan, soils Icg and a letter of non-objection from the homeowner association responsible for the Class "A" public water system (PWSlD No. 211708) for which the reduced separation distance waiver is requested. Based upon this review it would appear that the proposed location for the replacement on-site wastewater disposal system will not present any increased threat to the public water system than the existing system which already encroaches upon the 200 foot protective radius. Results from routine water sampling do not indicate contamination from the existing wastewater disposal systems which are within the protective radius of this well. Therefore, the requested separation distance waiver to the proposed septic system indicated on the submitted plans is approved for the concerns of this Department in accordance with State Drinking Water (18 AAC 80) and Wastewater Disposal (18 AAC 72) Regulations. Thank you for your cooperation with this Department, if there are any questions regarding any of the above please do not hesitate to call. MLU/cf CC: John Smith/MOA/DHHS Sincerely, Michael Lu, E.I.T. Environmental Engineering Asst. II 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 - I I Well Absorption area Dwelling PERMIT ~_ DISTANCE TO: I Manufacturer Material No. of compartments Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. DISTANCE TO: M~t~r M.~.~ Li~i~ .~..itv in ~,o~s - Well ¢ ~ Foundation Nearest I n~ Distance between Tren~w~Jh '~~ No. oflines I Lengtho~e/ __ Totallengt~s/~f' inches I1~~ Top of tile to finish grade ~ t Material beneath tile ~ Total effe~ absor~ ar~a hength 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 li~e PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER ,, ,,,,, ,,,,, ,, 72-013 (Rd '8) PERMIT NO. r-ll_i~-~ IC:I F'Ftl_ IT*T* DEPBRTMENT C: RPF'LICRNT LOCRTION LEGRL 825 O~4---.SITE ( 800~06 ) LARRY MOSER RLPH8 CIRCLE HCiRt:-]GE HERLTH RND ENVIRONMENTRL r ]TECTION STREET., RNCH"IRRGE., RI':::. LOT ~]I '..'' / ;; /' ," .._,.. . ..... TYF'E OF SOIL RBSORPTION SYSTEM IS: TRENCH MF~,':<IMUM NUMBER OF BEDROOMS = ~.. SOIL RRTING ]"HE F:.E.i,).LIIRED =,I.. E OF THE SOIL RBSORPTION'-,~"q'"'-~"t_~,--,', IS' [:, F--F"-r H= -1 ;_~.¢ LEI'4GTH= _--at. 2 ~.~ R R'.z" E L IZ:.E P TF.J= ~-._-; THE LENGTH DIMENSION IS THE LENGTH (IN FEET]) OF THE TRENCH OR [:,RRINFIEL[:,. THE DEPTH OF R TRENCH OR PIT IS THE D ISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE E>:',CRVRTION ,.'.IN FEET.".,. 'THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET]:'. PFRMIT RPPL I CRNT HRS THE RESPON'-."ilBILI TY TO INFORM THIS [:'EPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERT'T' RND THE NUMBER OF RESIDENCES THRT THE NELL WILL SERVE. TI-4C, (2) 8RCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL 8~ THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVRTE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UF'ON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET 8ND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS M~Y RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS 8RE RVRILRBLE TO INSURE PROPER INSTRLLRTION. F"EF-:I".I I T EXP I RES DEC:EMBER _--~.-1 .. I CERTIFY THRT i: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH B'T' THE MUNICIPRLIT'T' OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. _-<: I LINDERSTRND THRT THE ON-SITE SEWER SYSTEM WRY REQUIRE ENLRRGEMENT IF TFIE RES I[:'ENCE~LE[) TO INCLUDE MORE THRN --': BEDROOMS. ' ....... '-F~PPL I,::;'~- ~,~R',' r.~c, seR ,..._ , .,, _ q -/7- ~ko GREA,cR ANCHORAGE AREA BORouGH Department of Environmental (~ualJty 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ,~,~ ~{~t'"~ t""~L/I{~I"Z~ MAILING ADDRESS -~iR.i~t, {"~'k f.~-Vo LOCATION ~LPi,4'A Cftc 1~ LEGAL DESCRIPTION /"- O'P ~ PHONE SEPTIC TANK: DISTANCE ~ FROM WELL(~-~t MANUFACTURER MATERIAL '~"~"¢--'~¢ f NUMBER OF COMPARTMENTS_ INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH .LIQUID CAPACITY//Or~,~; GALLONS. SEEPAGE P3il~-T'~- ~t ~ (jr NUMBER OF PITS __ LINING MATERIAL BUILDING FOUNDATION__. ADDITIONAL ABSORPTION DIAMETER __ CRIB SIZE: OR WIDTH , LENGTH.__, DEPTH DIAMETER___DEPTH DISTANCE FROM: WELL TOTAl_ EFFECTIVE , NEAREST LOT LINE__ ABSORPTION AREA (WALL AREA) , SQ. FT. WELL: ~ ' BUILDING NEAREST FOUNDATION __, LOT LINE CESSPOOL , OTHER SOURCES_ APPROVED DISAPPROVED DEPTH DISTANCE FROM: NEA REST SEPT lC SEEPAGE SEWER LINE , TANK __, SYSTEM REMARKS DISTANCES: INSTALLED BY: ~'-,-~"~I~'(C.R..~ PIPE MATE RIAL: -~{)~ .~ LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM DATE '7// ~/?(~ APPROVED G.A.A.B. PERMIT NO. ( ?~,~_~5 ) APF'LICANT LuL. HTI~N LEGRL Pll_l~ I C I ~L. I T~' OF A~-IC:P' DEPARTMENT b, HEALTH AND ENYIRONMENTAL , OTECTION 25i0 E. TUDOR RD... ANCHORAGE.. AK. 99507 27ei-2221 S;ENEE: F'ERt4 · T SEBRING BUILDERS L' I. _. ~,/ #1 SAME SAR BOX 1540 C LOT SIZE i000~:~ S~!I_IRRE FEET TYPE OF SOIL AB$ORBTION SYSTEM IS' TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING <SQ FT/BR)= THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS' E, EPTH= 12 LENGTH= ~5 GRAVEL DEPTH= 5. 5 THE LENGTH DIMENSION IS THE LENGTH <IN FEET> OF THE TRENCH OR DRRINFIELD. THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND 8ND THE BOTTOM OF THE EXCAVATION (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. RE['(LI I RED SEPT I C: TF~NK S I ZE= i000 f3HLLEIt'IS BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE ~UB. EE.T TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVRTE WELL OR 200 FEET FOR 8 PUBLIC WELL. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE FR_FER INSTALLATION. F'ERF1 I T VRL I [:. FOR Ot~E YERR FRF~M I I CERTIFY THAT i: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. Z;: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE R:ESI[:,ENCE ~c. ~EM~B~TO INCLUDE MORE THAN 3 BEDROOMS. ALPHA Log Represents Location of Test Hole Lot 4 Borealis Subdivision Addition No. 1 DWN: CKO: pJ DATE: 5-21-76 SCALE: 1"=3' R & M CONllUL.TANTB, INC. SANDY SILT (ML) SILTY SAND W/TRACE GRAVEL (SM) SANDY S ILT- SILTY SAND (ML SM) (260) SAND W/SOME GRAVEL AND SILT (sp SM) (2O0) sAN~ SIL~:Y GRAVEL (G~) SILTY SAND W/ SOME GRAVEL (SM ML) (260) SP~NDY SILT (ML) No Water Table Log of Test Hole Sebring Builders Anchorage, Alaska 0.0' 2.5' 6.5t 12.0, 14.0~/ 16.0' 19.0' T.D. I°w~."o. A-o1 CONSULTANTS, INC. ANCHORAGE FAIRBANKS JUNEAU 2A9 r'AST 515T AV£NU~' * P.O, BOX 6087 ' ANC:HORAG£. ALASKA 99503 May 21, 1976 R & M No. 656231 Mr. Larry Sebring Sebring Builders Box 1540 C SRA Anchorage, Alaska 99507 RE: Test Hole and Soil Log Report for Sanitary System Lot 4 Borealis Subdivision Addition No. 1 Dear Mr. Sebring: We are submitting herewith the boring logs, percolation results and our comments regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of May 12, 1976, and th~se procedures outlined in a letter dated July 15, 1976 by Mr. Rolf Stribkland of the Municipality of Anchorage, Department of Environmental Quality. A single test hole was put down within the Lot 4 area for the purpose of defining general subsurface soil conditions and conducting percolation tests for the proposed sanitary system. Excavation was accomplished with a tractor-mounted auger type drilling rig and the test hole was extended to a total depth of 19 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this Opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M CONSULTANTS, INC. JWR/PJ/pe xc: Municipalilty of Anchorage PERCOLATION TEST SEBRING BUILDERS R & M NO. 656231 TIME 3:30 3:31 3:32 3:33 3': 34 3:35 3:40. 3:45 3:50 3:55 4:00 '4:05 4:10 4:15 4:20 4:25 4:30 ELAPSED DROP TIME INCH~s 0 0 1 1 1 1 1/4 1 1 5 4 5 3 1/2 5 3 5 2 3/4 5 2 1/2 5 2 1/4 5 2 5 2 5 1 3/4 5 ~ 1 3/4 5 2 60 Minutes 33 1/4 Total Drop unicip lity of Anchorage MEMORANDUM DATE: 'FO: FROM: SUBJECT: July 30, 1980 File Senior Environmental Specialist Telephone Conservation: July 30, 1980, 11:15 a.m. with Larry Moser, Lot 4 Borealis Subdivision Mr. Moser called to complain of this department's inspections. I explained the following points: (1) Mr. Spendlove, Spendlove Excavating, is not licensed per Municipal ordinance, and has been given notice or the matter will be referred to the Municipal Legal Department. (2) Mr. Spendlove has now had four(4) inspections on less than a days notice. Normally, twenty-four(24) hours notice is requested. (3) Currently the installation is still not ready or approved. (4) The matter of traditionally two to three inspections per installation was being exceeded, in this: instance and in all fairness to other excavators, inspections were first come first serve. Mr. Spendlove had obtained more service then most excavators, who were licensed and their work was ready for inspection. (5) I explained the next available time slot was tomorrow morning. Spendlove had an appointment for this morning; our inspector was on the site, as requested, and found no work completed and the excavator not on the site. Essentionally, the excavator will be referred to the Municipal Legal Department if he does not become licensed. This department is aware of Spendlove doing business, this year, and in past years. In fact, Spendlove has had excavators permit from this department in the paslt years. Inspection requests by the property owner/excavator have been accomplished in a most reasonable manner and the service abused, in this instance. Since another inspection is scheduled for tomorrow, this brings the total of inspections to five. Les N. Buchholz, R.S. Senior Environmental Specialist nNS/ljw cc: Lynn Lindquist John Kennedy Maggie De Stefano 91-010 (5/78) 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. HAA # 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone .~G ~-3 1 / '~ ~q~-I / - o 72 ~_~ Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 system. 72-025 (Rev. 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance .with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm 1--~/o~/ .~¢<~_Lc~ c~ ~ ~__ . bedrooms. bedrooms, with Address ¢¢--¢ Engineer's signature DHHS SIGNATURE Z Approved for -~ Disapproved. Conditional approval for Date ~/'~-//~'~ the following stipulations: Additional Comments Date 7"' 2 2-- ,~'~ 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 i¢21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type A Log present (Y/N) LoTH ~,,-*_o._(i~ ParcelI.D. OJ.'~- ~_C~-JO If A, B, or C, attach ADEC letter, ADEC water system number Date completed Driller Total depth Sanitary seal (Y/N) Cased to Casing height FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Wires properly protected (Y/N) AT INSPECTION .g.p.m. Septic/holding tank on lot ; On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed (~/1"/ Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size / ¢~--,"E~ Compartments Foundation cleanout (Y/N) ~'//' Depression (Y/N) / ~h////--~ Alarm tested (Y/N) ~'Y'//A Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: W~ Well(s) on lot ' ~/,/---~ To property line ' Surface water/drainage On adjacent lots Absorption field Foundation Water main/service line 72-026 (3/93)* Front 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) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D, ABSORPTION FIELD DATA Date installed ~//~ Length ~ Width Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water Soil rating (GPD/Ft2) o ~ System type Gravel thickness '~. ~ Total depth ~', Cleanout present (Y/N) ~// Depression over field (Y/N) /~/ Results (pass/fail) -~ for .-~ Bedrooms After test If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~////~- On adjacent lots ~///-~, Property line To building foundation J ~) To existing or abandoned system on lot On adjacent lots ~ ~ Cutbank J~ ~ ~ -~ Water main/service line Surface water ~ ~ ~-1 ~- Driveway, parking/vehicle storage area ~> Curtain drain J~-I / ~ E, ENGINEER'S CERTIFICATION I certi~ that I have checked, verified, or conformed to afl MOA and HAA guidelines in effect oil the date of this inspection. Engineer's Name Date '~. HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back 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 CompleteJegal description Location (site address or directions) Property, owner Mailing address Lending agency Day phone Day phone Mailing address Address a~.~, c'~::~ C'~o Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Day phone Individual well Community well Public water NOTE: lng to the legality and status of system. If community well system, provide written confirmation from State ADEC attest- 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 system. 72-025 (Rev. 1/91) Front MOA#21 S~ STATEMENT OF INSPECTION BY'ENGINEER ~ As certified bymy seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health AUthbrityAPPr0Val aPPlication shows that the on-site watersu and/or wastewater diSp0sal system~' is safeI ~functibnal and adequatefor the number of bedr°oms~ 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 d!sposal system is in compliance .with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm -7-""~,~¢ ~ ~>~ ~'J~._l~ Phone I Address ¢Q4::) ~ ~¢~ ! ~ ~ /¢ ~ '~ Engineer's signature ~" ~ ~~ DHHS SIGNATURE Approved for bedrooms. ,' ' Disapproved. : ~ Conditional approval for bedrooms, with the following stipulations: .,<~¢40042 BY /~o Z~?'r~R T'H6/v ,TcfLY' I., Additional Comments T'H/r DEP/~RT/YE~Ul- HJ~$ $1~1u£0 0~ MuniciPality of A'~Ch°rage 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 pr°f~ssional 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 Well type /~ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: .g.p.m. Septic/holding tank on lot Absorption field on lot Public sewer main ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Sewer serVice line WATER SAMPLE RESULTS: Petroleum tank Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed -//~? Cleanouts (Y/N) ~/' Foundation cleanout (Y/N) High water alarm (Y/N) ~"~//~- Date of pumping SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: To property line Surface water/drainage Alarm tested (Y/N) Pumper. "~a ./w3_ On adjacent lots Absorption field Compartments Depression (Y/N) · Foundation '~ Water main/service line 72-026 (3/93)° Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Manhole/Access (Y/N) "Pump off', Level at .Cycles tested Well on lot On adjacent lots Sudace water D. ABSORPTION FIELD DATA DateJnstalled 7~'~,/,~, ~ ~,,/~ Total absorption area,5/~' .j. Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/Ft2) Gravel thickness ~_) Cleanout present (Y/N) 7 Results (pass/fail) F System type Total depth Depression over field (Y/N) for ~ Bedrooms After test If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water /'~ Curtain drain ~'"~ / ['~ On adjacent lots 't'V'//,,~. Property line To existing or abandoned system on lot Cutbank ~"~ u v~ -.~ Water main/service line ~> / ~_") Driveway, parking/vehicle storage area ~, ,~'O E. ENGINEER'S CERTIFICATION 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 'T'~ ~.~ '~- L~ I Date ~//C)//q W'' HAA Fee $ ~' ~ ~ ~:~"~ Date of Payment ,.~ Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment' Receipt Number S PL~I~L_~-iiN[) F~ _ E- 203 W. 15th. AVE. SUITE 205 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6015 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage~ Alaska 99501 Subject: HAA for Lot 4 Borealis S/D March 10~ i994 Gentlemen; The septic system serving this lot failed an adequacy test in May of 1994. A replacement system has been designed and a permit issued, SW940042. The ownership of the residence is being transferred and a conditional HAA is requested. Bids to perform the required upgrade have been obtained, and the seller is pre- pared 'Lo escrow the necessary funds to have the work completed after breakup. Please issue a conditional HAA, ~ith the condition that the work be completed before Dune i5, 1994. .,_ APPLIC,i-'IT FILLS OUT UPPER HALknaDNLY , / Buyer Address Zip Code Lending Institution ~.~ ~: ~~/ ~//~ ~ ~ho~o Address ~: Zip Code Realty Co. & Agent ~ Phone Address Zip Code LegalDescription ~ ~ ~?~//~ ~~/~/~/0~ Street Locati~ ~--~ ~f~ ~/~ ~_ ~ ~ Type of Resi~nce / SingleFamily Multiple Family No. of Bedrooms ~ Other Water Supply ~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ' ~ommunity For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ndividual Year Individual Installed: ~ Public ~ility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: /"'/- '2-- C.~ ~ MUNICIPALITY OF ANCHORAGE z o,. .RECEIVED I~l APPROVED BE°ROOMS 'COND,T,ONS OF APPROVAL I / COND,T,ONAL APP~VAL' Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received 72-023 (3182) ROBERT A, SHAFER ADEQUACY TEST WATER AND SEWER INSPECTION WELL INSPECTIONS AND FLOW TEST SITE PLANS ROAD DESIGN SOILTEST ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN EXCAVATION WORK January 3, CIVIL ENGINEER 694-2979 Mr. Mitchell 4850 Alpha Circle Anchorage, Alaska REFERENCE: Lot 4: Borealis Subdivision A sewer system adequacy test was performed on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of approximately 1338 gallons of water through the system over a period of 48 hours. The average flow for a 24 hour period was approximately 669 gallons without any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the three bedroom home located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. If we may be of further service, please do not hesitate to contact us. Sincer~lY, ~ ..,, ,, / /' ..!~ / /..'~ /- // .~ //R~O~ERT A. SHA~ER~, P. E. S/ss ~c: Municipality of A~,,,chorage Department of Health and Env±ronment Protection SRB 196X EAGLE RIVER, ALASKA 99577 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 GENERALINFORMATION (a) Application Date Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name /~,~z-//" Appli'cant Address 4~-~''~' ' Telephone: Home ~'4¢- '~ ~ ~O Business ,,Af ,4z,' (c) A~)pli'cant is ('check one): L~nding Institution [] · Owner/builder~,' Buyer [] ' Other [] (explain); (d) Lending InstitUtion ,~.c-~7-,~l/$ 7" ~¢~'£1-~-z/~'" Telephone Address (e) Real Estate Company and Agent ~'~-'-/¢ Address ~ ~'/ ~" ~1~/~ ~ ~ ' ~ ~/~ TelephOne ~- ~o~ (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. 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 status. Page 1 of 2 72-025 (11,~4) 5. ENGINEERING FIRM PROVIDII"'~ INSPECTIONS, TESTS, FILE SEARCH, D.,' 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 :'~:?i-~. 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 ~s in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /z~¢ .~ Tele phone ':~-~,/-.S"~ ¢/~ 'i'~;~",;.. Address /z~'~:~ /d 55''~ /¢~"'~. .~"¢r/F'-~:'~ z~' /¢~'/'. ~ ./ DHEP APPROVAL Approved for Z--, _..¢ edroomsby Approved L/~ Disapproved Terms of Conditional Approval Conditional 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 Page 2 of 2 72-025 f11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Ins.tailed 7 Width of Field Type of System Design Length of Field Depth of Field /-~ Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /~,- t ~ Gravel Bed Thickness .~ ~'"/~-./' Standpipes ~resent~) Date of Last Adequacy Test To Building Foundation Lot ~A~,,¢_~ /~J)~ ~3 To Water Main/Service Line /4) ~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ~¢.e7¢~"/" To Property Line /dP To Existing or Abandoned System on / ; On Adjoining Lots To Cutbank (if present) / Comments D. LIFT STATION Date I1,~~ // Size in Gallons ~ "Pump On" Level at High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at lng Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I ~:~h~ezd,~er, ified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~----~:.~L: /1./~ Date 4//-/?"-~'7 Company Receipt No. Date of Payment Amount: $ ~ 43/40 MOA No. ,c~'~, -o ~/ Page 2 of 2 72-026 (11/84) . Mm,. O\~i\cJ~INIClPALITY OF ANCHORAGE (MOA) .~\.~ O~¢i\C%% HEALTH AUTHORITY APPROVAL (HAA) .~\C\~l''~'5 ,4 CHECKLIST - FEBRUARY 1984 ~0~ %~i 264-4720 ~ . IC~ Legal Description: ~~, Well Classification ~';~,,~'w,~J'/;r/ If A, B, C, D.E.C. Approved(~) /~ ~'~ / ~ 7~ g Present (Y/N) Date Completed Yield Total ~__ ~ Cased to __~ Depth of Grouting ~ ~t~ Wat~~ ..... Pump Set At __ ~ing H~i.g. ht Abo~~ / Sanitary Seal on Casing (Y/N) EI~ Wi_ ri~~d~t ~ ~/~ Depression Around Wellhead (Y/N) ~ep~rati.on. Di.s~ances from Well: ~ ~O ~.eptic/H~lding ~ank on Lot ~ ; On Adjoining Lots __ ~ N~mst ....... Ed~ of A~p '_ b~ F~ld ~ L~ ~On Adjoining Lots ~ To N~ewer Line ~ To Ne~ublic Sewer ~ ~ N~ms~~~ Line on Lot __ ~ ~H~~ ,. ~at~ ~t~rj~ple Test Results ' ~ Co m .t . %.. B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes~) Depression over Tank (Y~_~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well /~--~' / / /c~ ---/-- Size /¢r-z~D No. of Compartments Air-tight Caps(~l) Foundation .Cleanout(~N) Date Last Pumped ~'-,Z.-? ~?'~ ,,(,///4- 'for /-//~- ,~)//~ Temporary Holding Tank Permit (Y/N) To Property Line To Water Main/Service Line Course To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) STEVE COWPER, GOVERNOR 274-2533 April 15, 1957 Alaska Environmental Control Services ATTN: Alan C. Wien 1200 West 33rd Avenue, Suite 8 Anchorage, Alaska 99503 SUBJECT: Waiver Horizontal Separation Between Well and Septic System, Lot 4, 80REALIS SUBDIVISION, Anchorage 8721-WA-062 Dear Mr. Wien: The Department has reviewed the subject waiver request. The subject residence falls under the former semi-public regulation which required 120' of separation distance between the subject well and septic system, ~_m_~_~Jl]~_ the_existiD$_~P~r~__t_~.~O.. ~~¢~.=1_1~5~ 1~. s~.p!~&c~_~aok, and _145, .... ~ ..... tren.¢.h_.acg ~pprove¢.. This approval is valid for a 3-bedroom single family home only. Sincerely, SWE:pkk ~ ~.~ DEPT. OF ENVIRONMENTAL CONSERVATION / / ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 09501 STEVE COI4/PER, GOVERNOR Telephone: (907) Address: 274-~_533 DATE: 4-2- 87 PWS I.f).# 210786~¢' To Whom it May Concern: According to records on file in this office the Water Regulations 50R£ALIS OMEGA Water System is in compliance with the State Drinking Sincerely, ~rvisor ALASKA ENVIRONMENTAL CONTROL SERVICES INC. 1200 West 33rd Avenu~ uite B ANCHORAGE. ALASKA ~9503 (907) 561-5040 SHEET NO, CHECKED BY OF DATE DATE / / / / / / /- / / / \ [ ~=.~== ,~ MUNICIPALITY OF ANCHORAGE ~~,~,' 825 L Street, Anchorage, Alaska 99501 264-4720 . uest for Approval of Individual Sewer and Water Facilities Property Owner: Mailing Address: Phone Se Name of Buyer: Mailing Address: Lending Institution: Mailing Address: Realtor/Agent: Mailing Address: Phone: 5. Legal Description: Phone: Phone: ,Street Location: Single Family Residence: Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply:.~ *Individual Well ( ) If Individual Well, well depth If Community System, name of system 8. Sewage Disposal System: *~n-site System (~/ Public System ( ) If On-site System, date of installation: /0 -- ~-- ~ Public/Community System (~'~ *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 MUNICIPALITY OF ANCHORAG[ D'~'PARTMEN, OF HEALTH AND ENVIRONMEN}~ PROTECTION 825 L Street, Anchorage, Alaska 99501 264-4720 Date Received: April 14, 1978 #1: Time 9:30 a.m. #2: Time #3: Time Date 4-14-78 Friday Date Date 'Insp Pratt Insp ..... Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER Ai~ID WATER FACILITIES 1. Lending Institution Request: Amfac Mort..gage Corporation ~-}~0~. Mailing Address: Post Office Box 1420 Portland, Phone: Oregon 97207 2. Property Owner: Patrick ~. Rgdri~uez Phone: 344-8204 Mailing Address: Star Route A Box 1681-P 99507 3. Legal Description: Lot 4 Borealis Subdivision 4: Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Three Number of Bedrooms: Se Well System: Individual Well (~:c) Community/Public System (x) Permit # Depth of Well Well Log on File ( ) Construction Bacterial Analysis e Sewage Disposal System: Permit # ~.(~, Septic Tank Szze Absorption Area On-site System (x) Public Utility ( ) Installed 1976 Installer Manufacturer Soils Rate Material e Distances: Well to Septic Tank to Sewer Line Nearest Lot-line to Nearest Lot Line to Absorption Area Absorption Area Page ~TWo : Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal' Description: Lot 4 Borea~is Subdivision Comments: Affadavit ~tt~c,hed:/~ (') Approved: _ . Disapproved: Letter Attached: ( ) Date: Date: ~partment Worksheet: