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Home My WebLink AboutSOUTHPARK #2 BLK 2 LT 7Address: Municipality of Anchorage Page I o! ~'' 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 Permit Number: ~>~/~q~O-¢ ¢) ~ PID Number: ~ 7.0- ~z~2. -- g I ~"~?'~"v ~"*"/~i __~-~' ~' "' ~-' Wastewater System: [] New [] Upgrade ~ ~ ~Zd,,~.4 L.~ I~ '~,.¢F ~x~.,~a,~lo,.~ ABSORPTION FIELD INc. of Bedrooms: LEGAL DESCRIPTION Lot: Block: Subdivksion: iBL ¢°' l 'secrio " Township: WELL: [] New [] Upgrade Classification (Private, A,B,C): Total Depth: Cased TO: Ft, Ft. Ft. Date Drilled: Static Waler Level: Driller: Yield: [ Pump Set at: ] Casing Height Above Ground: GPM[ Ft.[ Ft. SEPARATION DISTANCES TO Absorption Holding From Field Tank Well- ~ 1~4.~ t'/-~ ~'~ Surface Water Lot Line Foundation Curtain Drain Remarks: Inspections performed by: ~.DeepTrench [] Shallow Trench []Bed []Mound []Other Soil Rating: Total Depth from original grade: 0. ~ GPD/Sq. Ft. q 3epth to pipe boltom from original grade: Gravel depth beneath pipe Fill added above original grade: Gravel length: --- ,~7 q' Va= ~7 ~,. Number of lines: I Distance be[ween lines: Total absorption area: Pipe material: TANK ~Septic B Holding ~ S.T.E.P. Material: ~¢~ .umbero ~parments: LIFT STATION Size in gallons: [ Manufacturer: "Pump on" level at: ~ "Pump cfr' level at: ~ High water alarm at: Pump Make & Model [ Electrical Inspections performed by: BENCH MARK Location and Description: %1' ~'~¢ ~ 14 ¢~. Dates: 1st 2nd Department of Health.nd Human Services approval eviewed pp,o ed (- Date. 72 O13 (Rev 9/91 ) MOA 25 ~ / \ ~ DISCONNECTED SEPnC TANK gEVERSED PLU~BINQ CRAWL BENCH ~ 25 o 251~ 50 F~ TOBBEN SPURKLAND P.E. 203 W 15TN. AVENUE ANCN. AK. 9950! SOUTH PARK ~/2 BE 2, LOT /5721 SOU?H PARK LOOP JOHN FITZGERALD JSEPTIC SYSTEW AS BUILT DATE: WAY 18, 1998 SHEET: 2/5 GRID: 3256 PERMIT Il SV980D09 PIP Ii 0R0-058-8i SDPO2072,DVG Standard Trenches: 2' ~'de Cleon 18' Deep 9' Sewer rock 3' Cover Cleon Out~ 800 FLOW SPLITTEB 40' Long Monlt ~ ..................................... ~'""~ Cleon' '~u>~....~% No , CC-~ae5 ,.*~'"-~ N~ SCALE L T BARRIER ~ ............... 86,2 ~ SIN6LE CLEAN OUT 866 '' ]250 SEPTIC TANK NJ7 SCALE BEIVCN h]~£K, TOP FOUN~A TION ASSUWEP EL.EV, 1002Y0 TDBBEN SPURKLAND P,E, ~03 W15th Ave Anchorage Ak 99501 PA£K #£ ~L[7£K £ L~T ~S7~] SOUTH PAR/( LOOP SEPTIC SYSTEM SCHEMATIC 7 :'SEPTIC SYSTEM AS BUILT DATE: SHEET: 3/3 GRID: 3836 PE£MIKT # SW980009 PID # 0£0-052-8! SDPOCO73,DWb MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PAGE 1 OF tm_W o r PERMIT ~00~ PERMIT NUMBER:SW980009 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:FITZGERALD JOHN R OWNER ADDRESS:229 W ROBERT LEE BLVD NEW ORLEANS, LA 70124 DATE ISSUED: 1/22/98 EXPIRATION DATE: 1/22/99 PARCEL ID:02005281 LEGAL DESCRIPTION: SOUTHPARK ADDN 2 BLK 2 LT 7 LOT SIZE: 24060 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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 SHALL ASSURE THAT THE SLOPE BETWEEN THE TOP O9 THE DRAINF~ELDROCK >AND THE DRIVEWAY AND ROAD DO NOT EXCEED/ 25%-I~E'ITHER ~IREcTION~ ? 2. THE EXISTING SEPTIC~SYSTEM LOCATED IN THE BACK YARD MUS~ BE ABANDONED COMPLETELY./ ISSUED BY: ~-~~ C' ~/~/~ DATE: {'~ '~ T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 . ,/IRONMENTAL SERVICES OIVlSh. Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: HAA South Park #2 Block 2, Lot 7 January 14, 1998 Gentlemen; We are submitting a conditional HAA for this property. The existing drain field did not pass an adequacy test performed in November. The property is being transferred with the closing scheduled at the end of January. The design for a replacement system is enclosed. Funds will be escrowed to install the system after breakup. Yours T.S 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN SOUTH PARK #2 BLOCK 2 LOT 7 15721 SOUTH PARK LOOP RONMENT^L SERVICES DIVIS[~ JAM 1 1998 RECEIVED Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 January 14, 1998 We are submitting an application for the upgrade of the septic system for this lot. The existing drainfield did not pass an adequacy test and must be replaced. This submittal consists of three (3) drawings showing the present iraprovements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: The soil in the back of the residence is marginal based on the soil test performed in 1983. Locating a replacement system in the back would involve a lifr station and substantial disturbance of both front yard, side yard and back yard. Soil test performed in the front yard indicates substantially better soil conditions than in the back, and site disturbance is kept to a minimum. The proposed trenches are located 10 feet from the existing 6 feet high cutbank, which have an approximate 40% slope. No Ground Water or Impervious Layer to 15 fr. Use Standard Trench Soil Rating. 10 min/in - .8 gal per sq.fi/day No. of Bedrooms 4 Required Area per Bedroom: 150/.8 = 187.5 sq.fr.. Total area required: 187.5 x 4 = 750 sqfi Testhole depth 15 feet Bottom Rock At 9 feet Top Rock At 3 feet Rock Depth 6 feet Total Trench Length 750/12- 62.5 fi SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 62.5 FT TOTAL WIDTH 2 FT TOTAL DEPTH 9 FT ROCK DEPTH 6 FT COVER 3 FT SEPTIC TANK 1250 GAL. The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. 50 0 50 100 150 ~00 S£ALE; 1" = 100 FT, ~°50 300 TOBBEN SPURKLAND P.E, 205 W 15TN. AVENUE ANCH. AK. 99501 (907) 279-3916 SOUTH PARI( //2, BI( 2, LOT 7 SEPTIC SYST£~Z DES/ON 15721 SOUTH PARK LOOP DATE: DEC, 51, 1997 JOHN FITZGERALD SHEET: 1/5 GRID: 5256 PERMIT # PIP # 0£0-058-8I Sl]P0~071,D¥6 75 100 125 150 \ TOBBEN SPURKLAND P.E. Il 205 W 157H. AVENUE II ANCH. AK. 99501 (907) 279-$916 SOUTH PARK ,//2 BK 2, LOT 7 15721 SOUTH PARK LOOP JOHN FITZGERALD IIs£Prlc s~sr~ D£$;GN OAm JAN. 14, 1996 SHE£?: 2/3 GRID: 3256 PER'MIT # sw98oxxx PID fl 020 052 $i Standard Trenches: Monitor Clean Out 12' Deep 9" Se~/er rock 3' Cover 40' Lan9 Cleon Out 1250 9ol Septle tank · 200 FLDb/ SPLITTER' Out - ND SCALE 25' L on9 Z 200 Monitor Cleon [- ND SCALE 1250 SEPTIC TANK BENCH MAR'Id ASSUMED ELEK 100.00 TBBBEN SPURKLAND P,E, ~03 WlSth Ave Anchorage Ak 99501 SOUTH PARK #2 ?LZ}£/< 2 LOT 7 Y5721 SDUTN PA£K LDDP SEPTIC SYSTEM SCHEMATIC SEPTIC SYSTEH DESIGN DATE, JA~ 1~ 1998 SHEET: 3/3 GRID: 3236 PE£MIKT # S~/980XXX PIP # 0£0-05£-81 SDPO207331~G Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG --- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: 1 2 g;/.4- 4 ~.~ ~ .{, ~...... 5 7 10 12 13 14- 18- 19- 20- DISCLAIMFR: Grnundwater Past and future presence from these observations. DATE PERFORMED: Township, Range, Section; SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT SL DEPTH? pO E R ading Date Gross Net Depth to Net ~ei t.i.. Time Time Water Drop i PERCOLATION RATE ~, (~ (minutes/inch} PERC HOLE DIAMETER __ TEST RUN BETWEEN ~' FT AND ~' FT conditions indicatRd are for the dates and/or depth of groundwater can not be shown only. predicted PERFORMED BY: , _T- ~, I ~ ~ CERTIFY 'FHA'[ THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DA] ~' DATE: 72-008 (Rev. 4/85} ,~ ~ '"~ NIUNICIPALITY OF ANCHORAGE il,~J~ DEPAR! .:NT OF HEALTH & ENVIRONMENTAl.. PR(.; .CTION ', ,t,~:.,~lr_ m ENVIRONMENTAl.. ENGINEERING DIVISION ,,~ 825 L Street- Anchorage, Alaska 99.501 Telephone 264-47~0 ~ ON~ITE SEWAGE DISPOSAl. SYSTEM AND/OR WELl. INSPECTION REPORT PHONE ~ DPGRADE ~A~LING ADDRESS LEGAL DESCRIP~ON" ~ LOCATION NO. OF BEDR~MS ~ PERt T NO. eU Absorption area ~,~ DISTANCE TO: J ~ ~JJN,~ I ~0.~' Dwelling ~ ~ Manufacturer ~recr MaterJa3~ No. of compartmentsz Liq. c~ci~gallbns IF HOME--DE: inside ,zngth Widthr ~ Liquid depth -- ~ ~ DISTANCE TO: WelJ Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons ~ il Nearest Jot Jingojl ~ ~ No. of lines Length of ach, li~e Totam length of line Trench widt lines Q~ Topofti,etofinishgrade ~-- Materia, beneathti,e ?0 inches Totaleffectiveabsl~0~tionarea Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Weg Building foundation Nearest lot line ~ DISTANCE TO: ~ ;]ass Depth Driller ~ Distance~o lot line PERMIT ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS A6T o3q INSTALLER REMARKS : : ; ; ] ,, · - APPROVED DAT LEGAL 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 [~NEW [] UPGRADE LOCATION 0.~ ,,~¢0,~'0 ~-¢ ¢0-¢L --OK LiqD/STANCETO:-;"i I~bsorptionarea/o,~ Dwali.g 7.~' ~ ~<Z Manufacturer 0 Inside length wMateria~dth IF HOME,DE: DISTANCE TO: Well Dwelling No. oflines ~. Lengthof~:~,~e~(~, Top of tile to finish grade Length Width Foundation ~5 Total length l~s~ Material beneath tile Depth NO. OF BEDRO.~S IFERM& 'O0 No. of compar~ment~.~ Material Nearest lot line I Trenchwidt~_~ inches inches Liquid depth 'ERMIT NO. Liquid capacity in gallons PERM'TC %!OOq' Distance betwe~en lines Total effecti~.b~so6t~ area PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot llne DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Euilding foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS INSTALLER REMARKS MUNICIPALITY OF ENVIRONMENTAL P BAR ", RECEI APPROVED 3/78) DATE LEGAL DEPFIF.'.TMENT OF HEla'LTH AND ENVIRONMENTlaL PROTECTION - MNL. HURlabE., RI.::]9~502L ,:,.:.. '"L'"_,TF. EET., - -' - ' ..... FFL_L. HhlF: TODFIY L. UN=,T. PHONE: ~ ......... 4 laC'DRESS: .2)}0 F! ]:4TH SUITE 43:2: laNCHORRGE., iai'::: 9~50_3.: LEGAL DE_,L.k. IFTIuhl - _,UE,[ I I_,Ichl: -~u_ITHPARk ~Z E, LECI' .... 2 LOT: 7 '=' ~ SQ. SECTION: 0 L..Of _,.LE 0 FT. TO.WNSHIP: 0 RlaNGE: 0 PllaXII"ILIM NUII.EER OF BEDROOMS = 4 SOIL RATING = ?'~m -'::AT' ~'9, .... ,='a '.._,M. FT. ,."E:R.:' ~_ TLUF- _,EFTIL. L. iSTED BELOI4 ARE THE OPTIONS FiVIRILlaBLE TO yFdl IN [:'ESIGHING _,t..,Tbfi. E:HOOSE THE OF'TION THlaT E,E_,T FITS y-ItlR SITE. 14iDTH = "~' = = .....FT. E~NG]'H = ::[.45. TOTlaL [Et'TH = .~. GRAVEL DEPTH = 5. GRla',,,'EL VOLIJME = o'-'-M, TFINK _,I~-E = ±., ~..:._ld. WIDTH = '5::1.. 0 FT. LENGTH = .... ' b~. 0 FT. T. OTRL DEPTH = 5. 0 FT. GRlaVE[_ E:,EPTH = 0:5 FT. GRlaVEL VEL_ME = ~'1,_. :L F:I.. "~-[=,."- TFINK .=,taE = ::L., 250. 0 GALLONS B.q .Z lC:, E E:" ~: ~'--"~ ][ ["-,~ , F" .:E E L. JZ) · t.,.ItDTH = 5. 0 FT. LENGTH = t,-,~,. 0 TOTlaL E:,EF'TH = 7. 0 GRA'¢EL.. DEF'TH = 3. Et GRFIVEL 'v'OLIjME = ':L20. 5 0 FT. ! NOTE ~ - }'75 FT. REQUIRES THO TRENCHES 5 Fl'. 5 FT. 5 CLL YDS. 0 GALLONS (TWO COMPARTMENT TlaNK) ,::T1.40 COi-4F'RR'FMEN'T TFINK) FT. ! NOTE ' - }'75 FT. REQUIRES TWO TRENCHES FT. FT. CU. YDS. TFINK SIZE = t., ;258. 0 GALLONS '(THO COi'qPRRTPIENT TANK) i CERTIFV THla-F: 'i.. I FIM FRMtL. IlaF.'. WiTH THE REQUIREhi.ENTS FOR ON-SITE SE,L,.IERS laN[:, .WELLS las SET FORTH BY THE MUNICiPRI_ITY OF RNCHORlaGE FIND THE STFtTE OF RLlaSKA. 2. I P.IiLL INSTlaLL THE SYSTEM IN laCCORDlaNCE I.,JITH THE CO[:,ES laN[:, HAVE RECEIVED A COPY OF THE CODE SUP'II'"IlaRY laN[) [:'IlaGRlaM laTTACHI'IEN]'S P.IFIICH IS PART OF THIS PERM i T. Z'.:. .I UNDERSTAND THlaT ]'HE ON-SITE SEWER S?STEM MlaY REQUIRE ENLlaRGEf'/ENT IF ]'HE RESIDENCE IS REMODELED TO !NCLU[:,E MORE THAN 4 BEDROOMS. PERi4IT laF'PLIC'laNT PIRS THE; RESPONSIBILITY TO iNFORN PERSONNEL DIJRING THE INSTRLLlaTION INSPECTIONS OF ANY WELLS F)DJFICENT TO THIS PROPERTY laND THE i'4I..I!,IBER OF RESIDENCES THAT THE NELL. FIILL SERVE. ~ iF FI LIFT STFITiON IS INSTALLE[:,., AN ELEC:TRI.C:AL PERMIT .FIf.,ID INSPECTION MUST BE OBTlaINED. RS-BLIILTS CANNOT BE A.PPROVE[:, 1.4ITHOUT lan ELEOTRtClaL INSPECTION REPORT. ]"HE ELECTRICAL HORK MUST BE DONE BY ta LICENSED ELECTRICIlaN. ~ ..... L~__£_'__~ ......... ~'~.._ _ _ :: 2="~'~_ _ _~= j ~>'' - F F L I _.HNT TO[:,laY. COI';,I~T. ISSUED BY: ._~ ............... F~. ~-' [:'Fi'T'E: 10/26,-"'8]: ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- 0~c~¢~ tO_, COMMENTS ~L q¢o.~t, dry E,OO~NTE~ED? SLOPE BITE PLAN IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERC(~ATION RATE y~,' [~ ~minutes/inch~ O~ TEST RUN BETWEEN ~5'~ F~ND ff I FT 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# ~)~- ¢ ,~ ~ 1. GENERAL INFORMATION Complete legal description HAA# Location (site address or directions) Property owner ~),,~-~-~ ~-- F~"~-'k~-./',,~-~ Mailing address Day phone Lending agency Mailing address_ Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickupl 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. 4. TYPE OF WASTEWATER DISPOSAL: " Individual on-site t/// Holding tank - Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attestin9 to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 STATEIVIENT 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 I ,~bb-e~ J~.~K¢ ~- Phone 2--7'~-~/,~ Addressr ~.o"~ ~ 1~'-)--'~ ~ 2_¢'~ Engineer's signature ~--~_ ~¢~.~_ Date B-/~ E' ¢/~ ~ DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: 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 pu rchaeers 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. Legal Description: A. WELL DATA Well type ~A~ Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed ~I~-l~ ~ Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA Date installed '~//~-/'/~ Length ~-.'.'2 4- ~ O Width Effective absorption area Date of adequacy test ~/A* Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist LoT '~ ~v,,~, ~¢'L~w~¥-~ I~ z- ParcelI.D.: IfA, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG g.p.m. Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Nitrate Other bacteria g.p.m. Collected by: Tank size '*/~,.~O Number of Compartments ~-- Cleanouts (Y/N) Depressmn (Y/N) Pumper Soil rating (g.p.d./ff~ or fF/bdrm) ,',',',',',',',',',~- Gravel thickness below pipe Monitoring Tube present (Y/N) ~/ Results (Pass/Fail) c.~ c~ System type '"~',cc,~ ~' ' Total depth Depression over field (Y/N) For Immediately after ¢" gal. water added (in.): Fluid depth in absorption field before test (in.); Fluid depth ~" (ins) Minutes later:'~' Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Absorption rate = '"" .g,p,d. If yes, give date bedrooms D. LIFT STATION //~ Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at* "Pump off" level at* High water alarm level at* *Datum Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 1 ~) J Property line ~'7 ! Absorption field -~ Water main/service line JC~ Surface.water/drainage ~1~ o Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: I Property line J ~ Surface water ~t"~/~ Curtain drain /'¢'/~ Building foundation Water main/service line Driveway, parking/vehicle Storage area Wells on adjacent lots F. ENGINEER~S CERTIFICATION I certify that I have determined thr~ in conformance with MOA HAA guidelines in effect on this date.· Signature ~ ~ En~ine~r'sName Ir ~ ~.~-[~'. HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $. Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # Or~-(~ ~ ~:) _~--~ -" <~ I HAA # RECEIVED ,qAqffoooe 1. GENERAL INFORMATION Completelegaldescription 5~OoT'~ '~:>~T~.~,.~,2; 1~ ?_, Ed';- ~ Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent I_~ L~al,~ , 'i~-e ~(¢¢/.- Address ¢'~ ~;:~ ('o ~'¢.~ ¢ ~, Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: L'(/ TYPE OF WATER SUPPLY: NOTE: Day phone Individual well Community well v' Public water 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 If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 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 alt Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm r¢¢~ ~"~¢'~¢~'"~Z,~ Phone ,¢-'7 q -'~¢/I 6, Address ' ~ ~ Engineer's signature ~ ~ Date '//'-//~1~ 6. DHHS SIGNATURE __ Approved for bedrooms. Disapproved. __ Conditional approval for Four bedrooms, with the following stipulations: Money shall be put in escrow to constructia new wastewater disposal system in accordance with the attached permit #SW980009. The above work shall be completed by no later than June 15, 1998. Money in escrow shall not be released until this office has given final approval. Additional Comments The MunicipalRy of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given Jn paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS 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. 72-02~(Rev. 1/91) Back MOA~2$ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: ~o~ ~ "~ou-J'2-'l'l~ ~t~ ¢., LOT '7 Parcel I.D.: A. WELL DATA Well type /~ Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Dateinstalled 11/1'7 /,~' 3 Tanksize Foundation cleanout (Y/N) ~/ Date of Pumping lllt~'l~"7 C, ABSORPTION FIELD DATA Date installed I I/~ lg'~ Length J 0 ~, Width Effective absorption area ! 5~O Date of adequacy test 11/1~ /q'7 If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG g,p.m. Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Nitrate Collected by: Other bacteria g.p.m. ~2.. --~ D Number of Compartments __ Cleanouts (Y/N)___ Depression (Y/N) ~ High water alarm (Y/N) Pumper ~'~¢ ~O Soil rating (g.p.d./fF or fF/bdrm) Gravel thickness below pipe Monitoring Tube present (Y/N) 7 Results (Pass/Fail) ~ Fluid depth in absorption field before test (in.); Fluid depth 4 ~ (ins) Minutes later: ~ Peroxide treatment (past 12 months) (Y/N) ~'~ System type '7, ~, Total depth I'/ 4- Depression over field (Y/N) For ~ bedrooms Immediately after_~_~ gal. water added (in.): Absorption rate = ~, ~,4.1~ g.p,d. If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) Size in gallons "Pump on" level at* "Pump off" level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot On adjacent lots On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: , Foundation Property line '~ ,~O Absorption field Water main/service line ;> /O' Surface water/drainage ~.t Jo Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain Building foundation ~1.'7 Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots )"'t///c~ F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records that the above systems are Engineer's Name Date in conformance with MOA HAA guidelines in effect on this date. Signature HAA Fee $. J~)~; ~ / Date of Payment ' L~ ~-'-/ ~~' Receipt Number z~ ~',~ ~O--~ ~(/~__~'~ ~;> ~,~12-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: HAA South Park #2 Block 2, Lot 7 January 14, 1998 Gentlemen; We are submitting a conditional HAA for this property. The existing drain field did not pass an adequacy test performed in November. The property is being transferred with the closing scheduled at the end of January. The design for a replacement system is enclosed. Funds will be escrowed to install the system after breakup. Yours T. Spurkland P.E. May 27, 1998 As Builts for the new system are enclosed. Please review and issue an unconditional HAA. T.S. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~-~/-~ -- ~)v4~,~ ,~ [ NAA# //,Z~/'-~ ~/~/ 1. GENERAL INFORMATION Complete legal description Location (site address or directions) ~_~-7 2- 1 Property owner Mailing address Lending agency Mailing address Agent Address Dayphone ~q~ 7/g Day phone 7¢¢- ~;7/- ¢o~'t Day phone NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water Unless otherwise requested, HAA will be held for pickup. NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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. Phone ¢-] ~ ~ l~ Name of Firm 'i Address Engineer's signature DHHS SIGNATURE ~/~'~ Approved for Disapproved. Conditional approval for Date bedrooms. bedrooms, with the following stipulations: Additional Comments By: /m 7 . /1/ Date ,~",-'"~'/'~,¢ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued, The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~25 (Rev. 1/91 ) Back MOA ~21 Legal Description: Municipality of Anchorage .,~._~ Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. A, WELL DATA Well typeCf~ ¢- ~ A Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. Date completed Cased to FROM WELL I, OG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ADEC water system number Driller Casing height Wires properly protected (Y/N) AT INSPECTION g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed II/I/l~ % Tank size 12~t-~ Compartments Cleanouts (Y/N) ~/ '~' Foundation cleanout (Y/N) y ~ Depression (Y/N) High water alarm (Y/N) \~/A Alarm/tested (Y/N) I~ J,z~ Date of pumping ,Z~r~.~..~ [ ) [ o~ ~ ~'~ Pumper /~ -~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To propertyline Surface water/drainage On adjacent lots Absorption field '~'~,/',~- Foundation ~,, --~ Water main/serviceline ~ I D 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION 7'~/,/~ Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed tl/~7 l~ ~ Length I0~" Width Total absorption area Depression over field (Y/N) Results (pass/fail) ~ Peroxide treatment (past 12 months) (Y/N) Soil rating ~9"~ ~' System type Gravel thickness '7, ~; ' "' Total depth Cleanouts present (Y/N) Date of adequacy test ~'/~//~.~ for ~7/ ' If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1~/,~ On adjacent lots ~/JA Property line To building foundation ~ "~ To existing or abandoned system on lot Onadjacentlots .~ 50 Cutbank '-¢ ~,o +-- Watermain/serviceline Surface water F"//c;, Driveway, parking/vehicle storage area Curtain drain .~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. HAA Fee $ // Date of Payment Receipt Number Waiyer Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91} B8ck MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. Chemlab Ref.# i~.~.~o Client Sample ND. D~AIN Matrix LHATER Client Name :TOBEEN SPb~KLAND, P.E. Ordexed By :TOBBEN 3PU~KLAND Project Name : Projects : PWSID :UA 5633 B STREET ANCHORAGE, ALASKA99518 TELEPHONE (g07) 562-2343 FAX:(907) 561-5301 REPORT of ANALYSIS SOUTH PARK #2 ¢ollooted :03/31/03 ~ 13:00 hrs. Neeeivod :03/3L/93 6 15:30 hrs. WORN Order :644?2 Nepozt Conpleted :04/02/93 Te¢lmioal Director :STEPHEN C. EDE Released By : /~..T~~ Sample ROt~CINE SAMFLE COLLECTED BY: QC Allowable Extract Analysis Parameter Results Qual. Units Method Llr~ts Date Date Init HITRATE-N ("~'18)-- mg/l EPA 353.2/300.0 lO 04/02/93 LLH See Special Instructions Above See Sample Rer~arks Above Undetected, Reported value is the practical quantification lint. Secondary dilution. UA: Unavailable NA - Not Analyzed LT · Less Th~n GT - Greater Than ~SSS Uembe~ of the SGS Group (Soci6,¢ G~n~rale do Surveillance) '~~ COMMERCIAL TESTING & ENGINEERING CO. AK DIV CHEMICAL & GEOLOGICAL LABO_..___~TORY TELEPHONE (907) 562-2343 5633 B street Anchorage, Alaska 99518. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [] PRIYATE WATt~R SYSTEM Name I Phc~e No. Mai~ing Address C~(y State Zip Code Mo. Day Year SAMPLE TYPE: ~/~Routine [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose SAMPLE No. LOCATION [] Treatdd Water [] Untreated Water 'nme Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ~/~atisf acto ry [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received ~ I Time Received ~ ,~'~'~ ~ Analytical Meth~d: Membrane Filter * No. of colonies)100 mL A .D,E.C. READ INSTRUCTIONS ~mbra.e Filter: Direct Count Lab Ref. No. 93.1320 ~ ~ I Result* BACTERIOLOGICAL WATER ANALYSIS RECORD A~t Coliforr~JlO0 mi BEFORE Verification: LSB Fecal Coliform Confirmation COLLECTING SAMPLE 'Final M .... ' embrane Filter Results TNTC = TOO Numerous To Count ~' BGB Coliform/lO0 mi OB = Other Bacteria PART ONE OF TWO ~,~,~-~G-~ Member of the SGS Group (So REMAINDER TO FOLLOW [ WALTER J. HICKEL, GOVERNOR ~DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 (907) 349-7755 March 22, 1993 Mr. Tobben Spurkland SUBJECT: South Park Terrace Subdivision Class "A" Public Water System, PWSID 213475 Dear Mr. Spurkland: I have completed a review of this office's files concerning the monitoring status of the above-referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on February 4, 1993. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Wat~gulatio-ns. The last inorganic Chemical Contaminants Sample results were submitted to this Department on November 5, 1992. T~es me_ejjhe provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last Radioactive Contaminants Sample results were submitted to the Department on December 10, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC) were submitted to this Department on November 6, 1991. Based on analysis of the previous VOC samples results have been satisfactory. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water R~gulati~-~. Issuance of this letter does not imply that the above-referenced Class "A" Public water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, Michael Lu Environmental Eng. Asst. II ]):J. Vi ~,:i (::)[I C]'F J:~il'lV:J i"cH'Hfieri'l:a]. J'.JE, a] '~'J'] 820 DL~r ing a -fic.?Id :i. nspec:t:i, on .fc~r' a I'IAA is ~as c:,bser'ved that a 4 inc:h pipe was discharging ~ater onto the drive~,~ay o-F th:i.s pr"c~perty. 'Fhi:~) poi nt c~'i: d:i. scharqe was api::moximat:el y 3() lin my -i: :i. rs'i: v;i. ~;ii;i. t; tl::i t. hc,? prl::ipi:~,r"l;.y ,~ I:)t"l I*J,:;~r'c:h :l '7 ~ 1993 ,; charg(e was ob~:¢(~rvecl,, (]n Ilarch 3:l a s~bstantial 'f:].o~ cfi [~'F NJ.'L:rat~es. March 5J wa.s a ~,~al'-'m clay ~z~Z'L'.h substant:~at snc~w me].'L,, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES , /,,--.)~ 264-4744 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner ? .ea~. ~_(,~4..~t44 ~. Telephone: Home Application Date Business Mailing Address (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the followina address: or: Cheek here/~ if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family ~ Number of Bedrooms' WATER SUPPLY individual Well ~ Community~% Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite]~ 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 trey 8/861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date sh own below, I verify that my investigation of this Health Authority ApprovaJ shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. _./,/,~. ,~ Name of Firm '~ ~ Address ,~C' ~.~ Date ~ Telephone /e '8 Engineer's Seal Approved for ,'~/~ ~'~//-) bedrooms by . Date Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health AuthoritY/Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev 8186) Back Page 2 of 2 ~0%~~0 MUNICIPALI'rY OF ANCHORAGE (MOA) v~.~%~g HEALTH AUTHORITY APPROVAL (HAA) .~,O~'~.~x'~ CHECKLIST - FEBRUARY 1984 y.x,x~ L~r~~ ~o,3~3 264-4744 WELL DAT 4~ Well Classification C(&~o-,E. ,~ If A, B, C, D.E.C. Approved (Y/N) ~ Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots 'To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date SEPTIC/HOLDING TANK DATA Date Installed rJlT~_ Size Standpipes (Y/N) Tt~,o Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line .> ~ O To Water Main/Service Line ,.~r O Course No. of Compartments T'~ y Foundation Cleanout (Y/N) Date Last Pumped ,~' ; for Temporary Holding Tank Permit (Y/N) X To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed I I/i../ Width of Field ~O Square Feet of Absorption Area I S' ~ Depression over Field (Y/N) NI Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation ~ '7 Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness '7. Standpipes Present (Y/N) '-~ Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA g uidelines in effect on the date of this inspection. Signed ~ .~t.~¢¢.4~ Date Company Receipt No. Date of Payment Amount: $ I MOA No. Page 2 of 2 72-026 (Rev 8186) Back Engineer's Seal DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3501 C STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 5~3-6775 DATE: Auqust 30, 1988 PWSIB: 213475 To Whom It May Concern: According to the records on ¢ile in this o¢¢ice, the SOUTH PARK TERRACE SUBBIVISION Water System is in compliance with the State o? Alaska Drinking Water Regulations. Sincerely, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION IMUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner ~/~s~-~'w ~occ~k°~! Telephone: Home Business Mailing Address (c) Lending Institution · Telephone Mailing Address (d) Real Estate Company and Agent ~-~ /~ Address Telephone (e) Mail the HAA to the followino address: or: Check here~if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family ~ Number of Bedrooms WATER SUPPLY Individual Well [] Community~ Public [] Note: If community well system, must have written confirmation from the State Department of Environ mental 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 Environ mental Conservation attesting to the legality and status. Page 1 of 2 72*025 fRev 8/861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, r verity that my investigation of this Health Authority Approval shows that the on-site water su ppJy an d/or wastewater disposal system is safe, functional and adequate for the nu tuber 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 in~on~ ,,, Name of Firm 4", ~x'~'*~'~''~'~t/'/~" ' ~' Telephone Address Date DHHS APPROVAL Approved for c4) bedrooms by Approved ~ Disapproved Conditional Date Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72~025 fRev 8/86) Back \O~ MUNICIPALITY OF ANCHORAGE (MOA) .EALT. AUT.OR,TY APP.OVAL(.AA) .~ ~ ~ X~~' 264-4720 ~ ,,>? %~ Legal Description: ~' ~/ ~]~ WELL DATA ~%~ Woll ~lassification ~ ¢' ~ -~L~ ~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Size ICL 90 No. of Compartments Air-tight Caps (Y/N) %¢/' Foundation Cleanout (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ 2, To Property Line ~ To Water Main/Service Line Course Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) To Building Foundation '~. ~ To Disposal Field / -~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 11 )t~ / ~ Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~' To Building Foundation LOt To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field I Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line / ~ To Existing or Abandoned System on ; O~ Adjoining Lots ~ ..~ E) To Cutbank (if present) ~ ~ O Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Oft" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I~.~y e ~c~hecked, verified, o~conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed /¢- ~' Date Company MOA No. Receipt No. / ('~ 0 '/ 0 ~¢~'0 Date of Payment V ~"~¢~ ~ -, Amount: $ ~/"~ ¢ ~ Page 2 of 2 72-026 (11t84} Engineer's Seal CONSULTING ENG NEER °-03 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: 1907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: ,.,;,,~...-~. .., ,~ 15721 SOUTH PARK LOOP ~ ;' "r,;:~% '~-~'~;, ~W. 49~_-~~ ~""~ ~-.'/j: ~,..~4~ ..... ~-'~' T;' ~ WESTERN RELOCATION ~ ~_~Jz~ o~ SINGLE FAMILY, FOUR BEDROOMS ~2~ t0~t .' .~;: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP.1000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 1590 SQ. FT. SOIL RATING: 397 INSTALLATION DATE: NOVEMBER 1983 DATE OF PUMPING: JANUARY 22, 1987 DATE OF TEST: JANUARY 21. 1987 ROTO-ROOTER INSPECTION REPORT: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH FOUR FEET OF COVER AND 51 INCHES OF LIQUID. TRENCH CLEAN-OUT WAS FOUR FEET DEEP AND DRY. SUMP WAS 10.5 FEET DEEP AND DRY. 1000 GALLONS OF WATER WAS ADDED TO THE TRENCH WHILE THE LIQUID LEVEL IN THE SUMP AND TANK WERE MONITORED. TANK LEVEL DID NOT CHANGE. NO WATER SHOWED UP AT THE SUMP. THIS SYSTEM MEETS THE REQUIREMENTS OF THE ANCHORAGE MUNICIPALITY. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. DEPT. OF I~NVIRONMI~NTAL CONSERVATION BILL SHEFFIELD, GOVERNOR Telephone: (~07) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 DATE: January 15, 1987 PWS I.D.# 213475 To Whom it May Concern: According to records on file in this office the ADDITION ~2 Water Regulations SOUTH PARK TERRACE Water System is in compliance with the State Drinking UNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) LoT 7, Location (address or directions) (b) Applicant Name ~,~ed¢~ t~.c.,~u~ Telephone: Home Business Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer F1; Other [] (explain); (d) Lending Institution ~¢'~--~,¢~¢-~.' ~¢_./~£~.~%,~4 Address Telephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ¢ Multi-Family [] Number of Bedrooms ~/ Other WATER SUPPLY Individual Well [] Community~ Public [] Note: if corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite/J~ Public [] Community [] Holding Tank [] Note:/If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. 72-025 ( 11 Page I of 2 ENGINEERING FIRM~PROVI~ING ,,,ISPECTIONS, TESTS, FILE SEARCH, DA'~ ,~ AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of.t~s Health Authority Approval shows that the on-site water supply and/er 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/er wastewater disposal system is in compliance with all Municipal and State codes, ordinances~ and regulations in effect on the date of t.his i~sp.~ecti6n. Name of Firm '~'~~-~/~~/ Telephone ,~'~j~',. 2~ ~'~,~ Address Date Engineer's Seal Approved for _,? ,.~-- bedrooms by Approv~ DisapproveY~ Cond't' n~ll Terms of Conditional Approval 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 cedificate 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 (I 1/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 ~uNIcIPAUTY OF ANCHOP. AG~' DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION NOV , .RECEIVED Legal Description: LoT "~ ~ ~] WELL DATA Well Classification ~..~.~.¢.~ A If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Complete~d Yield Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date SEPTIC/HOLDING TANK DATA Date Installed J7 ~¢'.~1~ Size t~;) No. of Compartments Standpipes (Y/N) ~ Air-tight Caps (Y/N) Depression over Tank (Y/N) .~. Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~.fA Separation Distances from Septic/Holding Tank: To Water-Supply Well ~' ~ Y ¥ Foundation Cleanout (Y/N) y Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Property Line *~,'l~ To Water Main/Service Line ~'¢¢O Course ~0 N ~" Comments _~ ~'~- ~ *"-~' ° ~'- ~J ~' J~'~ TO Disposal Field ~) To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026(11/84) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 11[17/ Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test No '~,.~'~ . separation Distance from Absorption Field: To Water-Supply Well To Building Foundation ' Lot N o To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area,' or Vehicle Storage Area Type of System Design "~/~.~ Length of Field Depth of Field Gravel Bed Thickness '7. Standpipes Present (Y/N) Date of Last Adequacy Test N ; On Adjoining Lots To Cutbank (if present) To Property Line / (:3 I To Existing or Abandoned System on Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at 'rested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified or conformed to all MOA and .HAA guidelines in effect on the date of this inspection. Signed ~~ . Date Company L'~,~ MOA No / Receipt No. "~L- q 113 Date of Payment ~ ~ - ~0 --~ Amount: $ ~ ~ ~ ~'~,' ~'~' ','Z :~ Engineer's Seal Page 2 of 2 t~ ~ '. 72-026 (11/84) DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR ~'elephone: (907) Address: 274-2533 According to records on file in this office the Water System is in compliance with the State Drinking Water Regulations Sincerely, ~203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: LOT 7, BLOCK 2, SOUTH PARK NO.2 15721 SOUTH PARK LOOP OWNER: RESIDENCE: WATER SYSTEM: JIM VANDERVEEN SINGLE FAMILY, FOUR BEDROOMS COMMUNITY, CLASS A SYSTEM SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP.1000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 1590 SQ. FT. SOIL RATING: 397 INSTALLATION DATE: NOVEMBER 1983 DATE OF PUMPING: OCTOBER 29, 1985, ANCHORAGE CESSPOOL PUMPING DATE OF TEST: NO TEST, SYSTEM LESS THAN TWO YEARS OLD DATE OF INSPECTION: OCTOBER 28 & 29, 1985 INSPECTION REPORT: THE SYSTEM WAS INSPECTED ON OCTOBER 28, 1985. THE TRENCH MONITORING TUBE WAS FOUND WITHOUT CAPS AND THE SUMP BLOCKED BY A ROCKS SO NO MEASUREMENT OF THE LIQUID LEVEL COULD BE MADE. THE CLEAN OUT AT THE WEST END OF THE TRENCH WAS DRY. THE FOUNDATION CLEAN OUT WAS LOCATED UNDER THE PORCH. ACCESS TO THE CLEANOUT HAD BEEN MADE BY CUTTING ONE OF THE BOARDS OF THE PORCH. THE INLET CLEANOUT TO THE TANK WAS ALSO UNDER THE PORCH. ACCESS TO THE STAND PIPE CAN BE MADE BY REMOVING ONE OF THE ~,~BOARDS~,THE OUTLET END OF THE TANK IS ACCESSIBLE. ~.-o.O --,~O~HBER 19 THE MONITORING TUBE WAS REPLACED AND ALL PIPES C6.pE~..THE TRENCH WAS FOUND TO BE DRY. ~,~49~.~ SYSi~M MEETS THE CODE REOUIREMENTS O~ THE MUNICIPALITY OF (~~The operational life of all septic systems depends on the local 7~'~'~"_'~.~s~'~[~[~ions, groundwater levels t~at may f~uctuate during the JUN~/! .~ the water usage of the family being served by the system,-,-~hese condmt~ons are outszde the control of the evaluator ~[,~'-.Qf.~hls"sept~c system. We can therefore not give any estimate of '~,ho~Ong the system will continue to meet the operational requi- rements of the Municipality and State. ALASKA B dlROFImenTAL CORTROL SI~[4uICI~$, ~nqineerinq 6 ~nuironmental Studies InC. Department of Health and Environmental Protection 825 L Street Anchorage, AK 99501 Dear Robbie, 15 April, 1984 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED This is the as-built of the sewage disposal system in South Park Subdivision #2, block 2, lot 7. The original as-built you were sent was based on early field notes and should be disregarded. Please excuse any inconvenience this may have caused you. Sincerely, Laura Ogar Environmental Specialist 1200 LU¢sl 33rd Aucnue. SuiIc J~ ,AncJ~req¢. ^l~ska 99503,(907) 561-5040