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Home My WebLink AboutT15N R1W SEC 9 LT 143T15N R1W Sec 9 Lot 143 #051-144-36 Permit Municipality of Anchorage ; Development Services Department :101114 Building Safety Division On-Site Water and Wastewater Program. 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page / www ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Number. S. W05-0 310 PID Number. O51 -r 144 satp :.ft, : of 3 Name DAg J/Ad EUS PAAl Wastewater System: jgNew ❑Upgrade Adpes. P r. Rix 670025 , eFIJCvtk- ABSORPTION FIELD Fhane 4_.3 Number d Bedrooms 9 3 L/ ❑ Deep Trends i! shallow Trends 0 Bed 0 0 Ot LeuTotal aw mor /' LEGAL DESCRIPTION Rating Sol / GPD/F9 Depth from penal p A Ft. Bloat LP /' Subdivision /'y Depth 10 ppe bottom from engmaI grade 1 O. an. Gravel depth beneath ppe 1. ? Ft Toonanp /s, N1 Range / . / Seor W amon Fill added original grade mon •d• ^ Fl. L Gravel Length. 1 O FI. Well: /9(�/uV �New Upgrade crave wenn el"°n 5 FI. Number d Ines / Distance between Imo Ft Classification (Poen* A . CL Tow Gapes Ft. Cased to. Fl TOW aowgion pM /y S0Oi F12 P n V Sl rf v SCE Dram Date Sul +emir Levelalakinkedr Ft %�1.:4d EXC. Date Md mi ofas Yew GPM Pam Sol al FI. Casing •ye Above Ground Ft TANK SEPARATION DISTANCES 0 Septic • Holding IS.T.E.P. 0 Other To From Septic Tank Absorption Field Lift Station Holding Tank 'ubbuPnvate Sewer Line Mar"p&G1fee 4.4fP �d 2AC6 rest k_ 1 C'papIs /2.53 Gw Well — — — — — len STF'CL Number d Cprpanmwsu Z Surface Water MO el- /LIO'f /do'}- — LIFT STATION LP Ln. /0'f /Q''r' /o'' _ 5.. Zsa Gai /trwlfo RffGE TANK Fo ndelan ST`Q'+ / S'f' — 'Pump on* e.«al �/� in 'Pump dr ave al 30 1,1yS„ H. wale alarm as a,wDrwn -- .-- — Pump Mahe & Mooed OSI OsMite Fearic.yy«AeevJa Al0 %C/m Remarks (SELL s 4,B44,60NEQ BENCH MARK OLQ d'cio fc. T✓t l(- en4nl4o,JE4 .'- Location awl Desaplas TaP aF Cod` Me Me C2 td 0ARCM-MO Assumed Eevation /Q0 FL Engineers Stamp ikIi of AC%) - .in- eeeeeee s``,IA (.K!9 ,3 1 .......... . .t s;e, rEaxsaEng :1Ts B• ',- +ilkCop:•,,, '. ,. i:„,r ilk r r ". Inspections performed by: r en, 1- Dates: 11/6/70/or 7. l/ 21.4/0/z o/cr Developme t Services Department Re and approved by: CA Approval . Q,.Pate: Ul aIAcY�� ince —%f� DESIGN NOTES: 1. Total Depth of' Trench is 1.5'. Terrain relatively flat. 2. Sewer Service Line minimum 2% slope. 3. Trench is Minimum 10' from Lot Line. 4. Lot Served by Public Water System. AS-BUIy MEASURFNTS A B F.C.O. 12 61 STEP/ C. O. 19 72 STEP C.0.2 / 15 73 STEP Manhole 17 73 M.T. 137 47 1 .T. 2 / 76 17 STEP STEP STE New F.C.❑ Old Seepage Pit Crushed 10' eparation Maintained Septic System Construction Does Not Preclude Adjoining ning Lots From Sanitation Improvements. BLM ROW Easemen Old Septic Tank Abandoned NOR THRI M ENGINEERING 17237 Boor Pow Circle Eagle Pivot; Alaska 99577 907.694.7028 41, 1' = 50' WASTEWATER DESIGN°a1l11i05 ram. 3 to L pat 3 O L E O L- U U • L +• to > 00 L N 0't EN p1G Cs� d Efn L O 0'au. d i Ise dU NS w aou +' EEU N E{L, y Oay U U O L d FAS Na NN 3 ES EN 3 0 3 c 0{+E .4 d IA to s N CS orS iO ocnct. U N J 2 LO N ob (DU VU U U L 1- L i s 4I-0 - • OY- 4 „0 I- ' NY atO s a L w X13 0. td�� Q0c.) (n¢ Municipality of Anchorage (AMC) Requirements & Specifications. IX w I- x C] U Zo oa aw ooa Z Z O O w CX IXw LJ LI Vl to > x x U Z Z D c F- zzZ 1° Z tri w /- .-. I-. c X f a d in U I1') d L 11 Ls. • c 0 U > d a o>, in W LN N Foundation Cleanout Tank Cleanout Cu E +' O d d L 01 1311 > — U N vatlon = 95' Mounded. Cover To Match Terr in ('7 c co vi It 11 C c O O V • CS;; > > d > 0.1 W W z b � 0 U W c) 0 .C1 1n END VIEW TANK PROFILE ik WASTEWATER DESIGN Oct 20 2005 4:17PM HP LASERJET FAX October 28, 2005 622-6777 Rising Son E Lectric. Inc. 14916 Woodland Drive Cagle River. A1C 99571 (907) 622-6/1/ Dean Construction Development 22222 Elkhorn Orcle Eagle River, AK 99577 Re: T15N R1W Section 9 Lot 143 - 21752 Taffies p.2 Dear Mr. Dean: The lift station at the above referenced property has been wired In accordance with NEC and State/Local codes. Thank you. Sincerely, • -A��,ts— Kevin`t. Hornbudde, Owner Administrator Lic ense u Numb4 er 27285 Speciatty Permit Number: Legal Description: Design Engineer: Owner Name: Owner Address: MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Oct 11, 2005 Expiration Date: Oct 11, 2006 SW050390 Parcel ID: 051-144-36 T15N R1 W SEC 9 LT 143 0838 North Rim Engineering Site Address: 021752 TARIKA AVE DARWIN ZUSPAN Lot Size: 108900 SQ. FT. PO BOX 670025 Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK . AK 99567-0025 This permit Is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank 0 Privy ❑ Private Well 0 Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: �l f / Date* /00 I Issued By.� Date: in I if [of Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. /)S7_ /L/LJ Property owner(s)_ ,para..[., a) tp c� Mailing address /a .30)c C 700 ZS. Site address Z /7S2 —nee Cc AV6 Legal description (Lot, Block & Sub'd.) % Permit Number SW Day phone ?9y-J'q '( c Zip Code 79-5-e7 Zip Code 1 QST Legal description (Section, Township & Range) %/SA/ R710 SEefe,u 7' car icf3 Lot Size 10$'906 Acres Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only �7 Well Only Sewer and Well /❑ Water Storage Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool 0 Water Softening Unit 0 Therapy Pool 0 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or a horized agent) Permit/Rush Fees: 010 Waiver Fees: Date of Payment: 10/7 /0 1 Date of Payment: Receipt Number: ) OZ Receipt Number: (Rev. 09/04) NCTHIM ENQINEERING NorthRim Engineering 17237 Bear Paw Circle [cote River, AK 99577 907-694-7028 October 7, 2005 MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Septic System Design, TISN MW, Section 9, Lot 143 An undocumented system was investigated. Due to bedrock & groundwater a new system is required. The two wells were properly abandoned. The residence is served by public water. This is a large 2.5 acre lot. Most of the neighboring lots are developed. This site should not negatively impact any of the other area lots. The slope is relatively flat. Please review the wastewater system design for the single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Sincerely, Steve Eng, PE, P Design Enclosures N/CRTHRIM ENGINEERING TISN RI W Section 9, Lot 143 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. The septic system was undocumented. Upon investigation it was found that bedrock was too high. A replacement system is being designed. This is an old subdivision with large 2.5 acre Tots. Groundwater was monitored at 6.5' below the surface; this will require a S.T.E.P system to maintain separation, manufactured by Anchorage Tank & Welding per Orenco Systems specifications. No adverse impacts are expected from septic system replacement. The two on -lot wells have now been properly abandoned; cut-off two feet below ground, filled with concrete and a plate welded to the casing top. This lot is served by a public water system. Neighboring lots have on-site systems but the large lots produce no conflicts. The easements are located on the drawing and are not encroached upon. Soil tests revealed sandy soil with silt. An application rate of 1.0 GPD/FT= with 0.87 reduction factor for utilizing a 5' wide trench. Trench Length = 450 FT'/5 x .87 reduction factor = 79'. Excavation refusal was at 8'. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1250 gallon S.T.E.P. tank, conforming to Anchorage Tank & Welding/Orenco Systems Specifications, allowing gravity -flow from outlet. • Watertight couplings on inlet & outlet • 5' minimum between the tank and bed. 10' to property lines. • 2' of cover is required for trench + 1 inch insulation board. • Tank & solid pipe must be set on well compacted, stable soil • 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line. • All cleanouts must extend to at least ground level • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock • Drain rock to be % inch to 2 % inch screened. Drain rock to be distributed uniformly throughout the trench. • Distribution pipe shall be 1.25" Schedule 40 PVC w/ 1/8" orifices ® 27" on center. • Force main shall be 1.25" Schedule 40 PVC, conforming to Anchorage Tank & Welding/Orenco Systems specifications. Force main burial to be 4' minimum. • Silt barrier (filter fabric) to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required • insulation board shall be extruded direct burial polystyrene (Dow Styrofoam 111 or equal) • Maintain minimum 10' separation between water line & wastewater system. • The existing septic tank will be abandoned; the septic tank will be pumped, crushed, and filled with sand/gravel or removed and properly disposed of. DESIGN NOTES: 1. Total Depth of' Trench Is 1.5'. Terrain relatively flat. 2. Sewer Service Line minimum 2% slope. 3. Trench Is Minimum 10' from Lot Line. 4. Lot Served by Public Water System. / New F.C.O. Crush Old Seepage Pit Minimum 10' eparation Septic System Construction Does Not Preclu&F Adjoining Lots From Sanitation Improvements. Abandon BLM ROW Easemen Old eptic Tank NOR THRIM ENGINEERING 77237 Bear Pow Clrc/e Eagle River. Alaska 99577 907.694.7078 `ttCf .'ti"'' T15N R1W SECTION 9 Jett ` ATM -j.\' LOT 143 LOT PLAN WASTEWATER DESIGN 1'=50' Dote: ___.._... ISHEET: 10/6/05 1 of 4 Well DESIGN NOTES' 1. Total Depth of Trench Is 1.5'. Terrain relatively flat. 2. Sewer Service Lint minimum 2X slope. 3. Trench Is Minimum 10' from Lot Line. 4. Lot Served by Public Voter System. / Septic Area / e 1 /3 / / 1 L- /310723 -J0 / / Septic System Construction Don Not Preclude Adjoining Lots from Sanitation Improvements. �/ Air— / 1 / //C' 240 / A 4 _1 / 5 Replace/Wastewat System NORTHRIM ENGINEERING 17237 Bear Pow Circle Eagle River, Alaska 99577 907.694.7028 or Lo Level Lot Served By Public Water .. 51' 4.3 • Hein 01 213 21 235 zesttz.iril2 %% • .aonl • i Vacant T1SN R1W SECTION 9 LOT 143 50 50 1320.33 BtV N 30 0 n ShM35S C'O w 1.3; 0 Vacant SUBDIVISION LAYOUT 111 = 10 0 i Dots — 10/6/05 22of 4 • soAsV ZZ N ol iED 0 2 1 r9 TT 0 0 • ° y Co e n Z� V • u 0�to cn$ NOIS3G a31VM31SVt1 F 11 C1 rn 0 Z 3 3 O 3 n e+ S 0 ID Z t•-•1.0 c UI o a.nouoam >{uol ;nouoam uowopuno j mcn.PWNt- DypyNd �N AD f1O'3 A O fj et— Z f 4 (Q Q03 ,-z- 4..• rcnn 'h3-0 3 O S ON;rp QN 3 (0 to r 4+^) • 1� UI c.$5- p O 3. V13 3 n c 0a $ ANS N A e+' "D O e} O Vl E < 3 0 n n 0 Oto Q0 .3 3z w 1.71 z 0c 10O el - 30 3 N n<Q-5 �; f0 710 n 34+ ✓ '0 < a o°o o ; x r1 v n e+ CO O O (0A 3 ti p(0O (0 I 3 3 Vl O A 3 • -1 D D ' 3 3 Z z ' nMO 0--I_{i 0Z0 n2 Z Z n 2 O. .A 1p T1 0 Z < O '0 30 '2 'Z' N 3:S C Z Z , .. to do c l fl c f733 A h Q o < N 0 -, N mrnin Aaa N D D D li -4 r--4 m O O Azz r 0 --I O O w Ll n A O C A £ D i rn 73 Minimum 6' to Bedrock, 4' to Groundwater V^ W w:rsro:-•ri . ri UI 1 3 '-� - Z o 0 ip 3 3n E. Z 3 SN —10 Q. 1 3 O n3 N 3< r tto c -"ro • -5 < 0 D ^tip 3S y h_. O f 01 I^ V13 t f Q3 T N Z Vy '0C7 o —13 Qi b 1-5 r X3 3'•1 co O c 1rP i .+ � O n N3 4+ 0 N N 1., .1.1 1!/: P.:, ,:.; ,•,, '•`;? P,,, Alegi t,, 4,, a:.,,;:".V, 1',, •140 •,• •,,.• 'tit 1•,1• ••1On ,1•, •.• 1 •,1•n •1•,, •,., :. •S, ' •%.: 1•.,•.' •1 \,1 ••', ••.\• ' • .1.' II I , I , . I I I I y ...i :fin y . .."4't .•,4iftie• --,----____1.25' PVC FORCE MAIN HEADER Plan Moni oring Tube PIPING TO CONFORM TO ANCHORAGE TANK & WELDING ORENCO SYSTEMS SPECIFICATIONS 1Insulation .1 1.25' PVC SCHED. 40 w/ 1/8' ORIFICE @ 27' 1.25' PVC SCHED. 40 w/ 1/8' ORIFICE @ 27' rU V V U U U U V U U V V V V V V U Ci:A:. • r . •_•... • + a• :• ::. : .;u ',..!a;. •.o:. . . •. 44.1i .% •• .i. 1 4•.r ,;' .e:r., . Y.,. S• ,. it..% L"2 :i i ' '•. I •:'; • !.•. '•: f.� .3.,:: :'• ,.• .`' 'y ,:�1:•,: . .4'.'• 11.40 .1.4,1441111 •4.[•1.'• V^ W w:rsro:-•ri . ri UI 1 3 '-� - Z o 0 ip 3 3n E. Z 3 SN —10 Q. 1 3 O n3 N 3< r tto c -"ro • -5 < 0 D ^tip 3S y h_. O f 01 I^ V13 t f Q3 T N Z Vy '0C7 o —13 Qi b 1-5 r X3 3'•1 co O c 1rP i .+ � O n N3 4+ 0 N N THRIM ENGINEERING Performed For: Darwin Zuspan Legal Description: T15N R1W Section 9, Lot 143 S❑ILS LOG - PERC❑LATI❑N TEST Date Performed: 9/27/05 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 DEPTH (FEET) 0' 0 O' O 040, Organic SP Sand w/ Gravel 10/6/05 Monitor Refusal Comments:Presoaked Performed By NorthRim Fng. I a CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE: 10/6/05 Location: See Drawing Groundwater? Yes Depth' Water Depth After Monitoring. 8' Date' 6/15/05 it Date Gross Time Net Time Depth Net Drop 1 9/27 0 -- 7' -- 2 9/27 2 2 Min. 7 3/8' 3/8' 3 9/27 5 -- 7' -- 4 9/27 7 2 Min. 7 3/8' 2' 5 9/27 10 -- 7' -- 6 9/27 12 2 Min. 7 3/8' 2' Percolation Rate 5.33 Min./InchPerc Hole Diameter 6' Test Run Between 2' and 3' NORTHRIM ENGINEERING 17237 Bear Pow Circle i Eagle River. Alaska 99577 907.694.7028 TESTH❑LE LOG GE❑TECHNICAL IT. H. 1 10/6/05 1 Parcel I.D. 1. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 !l/z//°S CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 05t -i 4taa_ GENERAL INFORMATION Complete legal description 7'/SN /ZIW SECT7OAr 9' HAA# b5n44i9 .awdI-►mss• Expiration Date: Ii /r4 f ares D Location (site address or directions) Z / 752 'r19/2//e44 Lor /c/3 Current Property owner(s) l%4Rrtil/n/ ZUSPifij Day phone. 3V.-3e/3t/ Mailing address PO. $6X c‘ 7e oeS Lending agency Mailing address Real Estate Agent Mailing Address Day phone Cigo y cJ/LSdiC/ Day phone l `tCf -ciao 0 %2E/4441e Cr t4 GCF Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3 TYPE OF WASTEWATER DISPOSAL: 0 0 0 Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or .a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm iVn milt Address / 70237 ,Sear r w /1 V^ ter re Engineer's Printed Name StrevG_ Ski 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for By: Phone 6 7y— 702d Date _ q /Z./OS OF .A (0000 ,45111 .r C2 • , 44 �•, '9 0 ft Y., �j,: 5'e.en W. En s t+••• FE 6256 � bedrooms, with the following stipulations: :31 (f:lltlr, Additional Comments : a - ON SITE WATER AND •• 'rns WASTEWATER . PROGRAM o. •1 J'Sr r�tlEM SFf\ al)) rrrJJ» »»)111 Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory (Rev 01/07) Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 1f/ajl 5 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: '7(s -1.l /ZIg.0 c_C-/;C.— 7 LCT- /yS ParcelID:-(e1-I(44-.31Q A. WELL DATA — Z t,J &LS ft8/WO oN6P - PugL/C L. ,4r it C- -"+CJ Well type _ If A, : , or C provide PWSID # Well Log (Y/N) Date completed _ Sanitary seal (Y/N) _ Wires properly prot ed (Y/N) Total depth ft. Cased to ft. Casing height (a•-,ve ground) OM WELL LOG Date of test Static water lev Well produc •n g.p.m. WATER MPLE RESULTS: Colifor colonies/100 ml. Nitrate mg./I. Ars = ic: _ mg./I. Date of sample: _ Collected B. SEPTIC/HOLDING TANK DATA -�- Tank Type/Material A/UeffOfZ4CE Ta/- Date installed /0720/05 AT INSPECTI ft. P. in Other bacteri colonies/100 ml. Tank size /2S0 gal. Number of Compartments ? Cleanouts (Y/N) / Foundation cleanout (Y/N) // Depression over tank (Y/N) 4/ High water alarm (Y/N) / Y Date of pumping ALE (�1 Pumper C. ABSORPTION FIELD DATA Date installed /6/22105 Soil rating (g.p.d.lft2 orcein)-/ System type S&ft ao a' %:2 C49 Length 8 0 ft. Width Jr ft. Gravel below pipe / 7 ft. Total depth3.5 ft. Eff.absorptionS area�!- ft2 Monitoring tube y Depression over field ,i/ Date of adequacy test /lF il Results (Pass/Fail) Fluid depth in absorption field b re test _ in. Water ad • -d gal. ' New d - h_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. If yes, •'sedate For -r bedrooms Any rejuvenation treatment (past 12 mo.) (Y/N & type) D. LIFT STATION Date installed 7/012O/Cls Size in gallons /230 "Pump on" level at L// in. 'Pump off" level at 30 in. Datum %Bsno. Cycles tested 2 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: PC) BUC w,4 ra C/%44,40) Manhole/Access (Y/N) High water alarm level at Yasin. Meets alarm & circuit requirements? Septic tank/lift station •n lot Absorption field • lot Public sewe ain Sewer / - ptic service line On adjacent lots On adjacent lots AllMr Public sewer manh. - Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S'"r Property line / O t � Water main / 0 r # Water service line / a t Surface water / S14 - Absorption field Wells on adjacent lots /00 'f" SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 /itBuilding foundation /0 �t" Water main ' r Water Service line /0 '� Surface water /00 1 II- F. drain Wells on adjacent Tots /00 'f F. COMMENTS 01-13 ri ABC MeAti elm .6.41 G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name S'7""tde E,U 6 Date ///2/US /a 00'•f• r Driveway, parking/vehicle storage /4 HAA Fee $ C 'CC) Waiver Fee $ Date of Payment 9/425 Date of Payment Receipt Number -HMS Receipt Number (Rev 12101) > -.5, /)> 's, 4' / 10' N 0 j c= i f .. V Robert C. Job risco . ' �+� NO. tsu•5 t•: I.,,($ ire:* ',-. ....aiti. / f 4 250.1 AS -BUILT Trc F- 1 hereby certify that 1 have surveyed the following described property. Ler 1 r?, :c.c. "�/,•,x 1 . i 1 ti i•; I W'i; MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 4-1 0-86 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 143 SEC 9 T 15 N RIW SM Location (address or directions) 100 YDS South along Eklutna Power Line from Tayhawk Dr (b) Applicant Name Darwin Zupan Telephone: Home 688-7335 Business Applicant Address P.O. Box 25_ C1_! gal ajL, Al a ,ka 99567 (c) Applicant is (check one): Lending Institutionia; Owner/builder ❑ ; Buyer 0 ; Other 0 (explain); . (d) Lending Institution L/4 Telephone Address (e) Real Estate Company and Agent N/A Address Telephone (f) Mail the HAA to the following address: CTS Associates PO. Box 671473 Chugiak, Alaska 99567 2. TYPE OF RESIDENCE Single -Family 5 Multi-FamilyC Other Number of Bedrooms Three 3. WATER SUPPLY Individual Well CR Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public 0 Community 0 Holding Tank 0 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;84) 5. 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, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm CTS Associates Telephone 688-4442 Address Date P.O. Box 671473 Chugiak, Alaska 99567 ri1 10., 1986 ,, CO ; Zr1J:=7' °. $''110 ft e t� t:: John R. Chambers j441:71; ® Jr % CE 6922411 tiliPtti..0:Pe: OOOOOOOO Se .\ v� Engineer's Seal 6. DHEP APPROVAL /yc� Approved fore &bedrooms by am `�� Date 2 %— Approved X Disapproved Conditional Terms of Conditional Approval syrif dh CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description' 5.M. Lot 143 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION APR 101986 secR E'CE15v/ E D i -w. A. WELL DATA Well Classification Single Family Res. If A, 8, C, D.E.C. App�pved (Y/N) NAA- 5 GPH A - 30 Nov. Well Log PresRnt (YM Yes Date Completed B - 18 Aug. 83 Yield B - 4 GPH A - 22 Total Depth B - 260 Cased to B - 16 Depth of Grouting N/14 Static Water Level A - 11 5, R - 7S Pump Set At A - 220, B - 250 Casing Height Above Ground A - 14" B 22" Sanitary Seal on Casing (Y/N) Yes - Both Electrical Wiring in Conduit (Y/N) .pepressionAround Wellhead (Y/N) No Separation Distances from Well: To Septic/Holding Tank on Lot A - 77' . B A - 104' To Nearest Edge of Absorption Field on Lot B - 150' ; On Adjoining Lots - 123' ; On Adjoining Lots To Nearest Public Sewer Line N/A Cleanout/Manhole N/A Water Sample Collected by G. Skyles Water Sample Test Results Sati sfactory To Nearest Public Sewer 100'+ 100'+ To Nearest Sewer Service Line on Lot ; Date 4/9/86 N/A Comments Water system (wells) plus 500-qallon storage tank in lower level of house provided acceptable/satisfactory quantity of water quality. 8. SEPTIC/HOLDING TANK DATA Date Installed 1971 Size 1,000 gal. No of Compartments single Standpipes (Y/N) Yes (1) Air -tight Caps (Y/N) Yes Depression over Tank (Y/N) No Pumping/Maintenance Contract on File (Y/N) N/A Holding Tank High -Water Alarm (Y/N) N/A Separation Distances from Septic/Holding Tank: To Water -Supply Well A X77' ,✓ B - 123' To Property Line 100'+ To Water Main/Service Line N/A Course N/A Foundation Cleanout (Y/N) No Date Last Pumped March 28, 1986 ;for Temporary Holding Tank Permit (Y/N) N/A To Building Foundation 13' To Disposal Field 27' To Stream, Pond, Lake, or Major Drainage Comments System satisfantorily meets 3 -bedroom home. MOA criteria for existing system and )4 JMa gerif—$_ Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Leach Pit Date Installed 1971 Width of Field Unknown - Approximately 15' Length of Field Unknow - Approximately 30 ft. Depth of Field Approximately 12' Gravel Bed Thickness 8' Square Feet of Absorption Area Unk - 450' Standpipes Present (Y/N) Yes (one) l t0 Date of Last Adequacy test _ rY 1-9$0 tg (494 Results of Last Adequacy Test Satisfactory for 3 -bedroom house surge capacity was 1,000 gallons. Depression over Field (Y/N) No Separation Distance from Absorption Field: To Water -Supply Well A - 104' . R - 150' To Building Foundation Lot N/A 40' To Water Main/Service Line N/A To Property Line 100'+ To Existing or Abandoned System on 100'+ • On Adjoining Lots To Stream/Pond/Lake/or Major Drainage Course 11/A To Cutbank (if present) N/A To Driveway, Parking Area, or Vehicle Storage Area 10' Driveway Comments Surge capacity 1,000 gallons in 8 minutes 3 -bedroom house system is satisfactory for D. LIFT STATION NOT APPLICABLE Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certiftthaTI Signed—, Company CTS Associates ave checkedyerified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date April 10, 1986 MOA No P.O. Box 671473, Chugiak, AK 99567 688-4442 Receipt No of a Sq 7 Date of Payment Amount $ Page 2 of 2 72-026 (11/84) 14- 0-€4° LD c oo' / .� L *� � .- tPr.. . i 9 , sr /49 z ; :*I $1.. H0. a Engineer's Seal APPLIC�:NT FILLS OUT UPPER HAL ONLY -cl") /ii...Sr°/%scl07i ( —./,7'2: Zip Code Phone - Prop .. r iij,�2-,/7,'a�-V/ vc../ Mailing Adu,ess /- r,: ,; L) ,�.. )17 Buyer Address Zip Code Lending Institution/ /r_. / / Address /: '..-- -, �4..- ._ f ,%r . ,. �.; . Zip Code ' Phone Realty Co. & Agent Address Zip Code Phone Legal Description J / ✓-0 ._.-t Street Location /V//// ,)//< %:" ,/ 7 /.;J /7 (i._/ /'' ,S ,.,/ �,..- /.._ / •�/,,...,.. , CI.. Type of Residence Wigle Family ❑ Multiple Family No. of Bedrooms ( APPROVED BEDROOMS ( )DISAPPROVED ( ) CO�NDITIONAL APPROVAL' gL[ a`P-- �1. LJ ❑ Other DATE - ''_t v.' Water Supply Q4dividual ❑ Community ❑ Public Utility ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For welly drilled prior to that date, give well depth (attach log if available). Sewer Disposal V't7 dIvidual ❑ Public Utility ❑ Holding Tank Date Sewer Installed Year Individual Installed- '�' When Connected to Public Utility: Septic Tank Size NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time.... Time `' —� G-ig irtrlar Date Date Date Dat �4 4/ Inspector d i) -...., Inspector l.h ,-v� 7- I l CI ,/,,,, Q (. ki (Ne H' C ',NA. / n K t - U ti (i (X (_��lA-,-, ' (i.r F ( r'lA A1, )° v,co Ir,-, Inspector ,,„r (nJ,n. 0.. �Y J r AL t c <,j,, Inspector Field Notes:f.,.Li E . ( APPROVED BEDROOMS ( )DISAPPROVED ( ) CO�NDITIONAL APPROVAL' gL[ a`P-- �1. (-) (1 .7 . /4 D D - a. c� / 'CONDITIONS OF APPROVAL --- DATE - ''_t v.' et BY (17 r..ei (r�-i R0 a?nnl I( Soils Rating Date Sewer Installed Well To Absorption Area / (' ` -) Well to Tank 7 . y Well Log Received Septic Tank Size 72 023 January 27, 1984 Darwin L. Zuspan P. 0. Box 25 Chugiak, AK 99567 Subject: Lot 143, Sect. 9, T15N, R1W, SO Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: ° The septic tank pumped with a receipt submitted to this department. ° An adequacy test needs to be performed on the existing leaching area. This test will determine it the system is adequate according to .National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Please notify this Department tor a reinspection when the noted discrepancies have been corrected. if there are any further questions, please call this office at 264-4728. ncerely, Cory Willis, R.S. Acting Sewer. & Water, Program Manager CW109/e j/i1 ALASKA CfUIROf DARWIN ZUSPAN POST OFFICE BOX 25 CHUGACH AK 99567 T EnTAL COfTROL sCRUICCs, Inc. engineering 6 Environmental Studies FEBRUARY 2 1984 SELLER — DARWIN ZUSPAN BUYER — SAME SUBDIVISION — T15N R1W SEC 9 BLOCK — LOT — 143 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS,ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPBD ON FEBRUARY 1 1984 SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. 7e.eOF SI .4aih e17,4 om o .70.4.44titled* oes..i.YOlen4444 it q. y C. Reid, Jr. No. 2251-E a' .w st P0r[SS\'-' err %%COAX el 1200 West 33rd Auenue, Suite 6 • Anchorage, Alaska 99503 • (907) 276-1361