HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #3A BLK 6 LT 3Thunderbird 'D Heights #3A Block 6 Lot 3 #051-582-48 S usuirrA Municipality of Anchorage Community Development Department Page 1 of 2 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141128 PID Number: 051-582-48 ❑ New ❑✓ Upgrade Name: BOTTORFF JEFFREY H & STACEY A ABSORPTION FIELD ❑ Deep Trench El Shallow Trench El Bed El Mound Address 24854 TEAL LOOP ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot THUNDERBIRD HEIGHTS #3A 6 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ftp Ft. Well N/A N/A N/A N/A N/A TANK O Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1.950 Gal. Surface Water N/A N/A N/A N/A Material Number of compartments Lot Line 51.6 10+ N/A N/A STEEL 2 NA Foundation 11.6 10+ N/A N/A LIFT STATION Manufacturer A mwh o(t "-6 T4" Capacity 056 Curtain Drain N/A N/A N/A N/A Gal. Remarks Pump on level at Pump off level at High water alarm at + 4 d t 3(, + 45 in. in. in. Pump make and model Q2005 Electrical Inspections performed by 5ONso �iECfatts PIPE MATERIAL House to tank Tankto 3034 drainfield Installer J R's Septic Pumping Drainfleld 3034 CO/MT 3034 Inspector PANNONE ENGINEERING SERVICES BENCH MARK (Assumed elevation) 100ft Inspdates: 1" 5/22/2014 Location and description 2�a BOTTOM OF TRIM e 4'" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp `4(�0!4'�jill Conditional Approval: Date ,; CL7 49 7H seven an me % CE 814 o AW Approved Date illftmu#,�"" Inspection Report_1-1 2.doc W—W_ W—\\ // WATER SERVICE f TEAL LO gP \9S�9 . FIRE HYDRANT ' WATER SERVICE /. 1250 AL S TIC /80.4 B 4 BEDROOM TAN R CED HOUSE wliyd' 100 GAL S.T.E.P A MT 500 GAL EEL TANK MT ABANDO ED PER CODE y��57 C1 T1 198 BED /198 BED T2 22' W X 43'L 22' W X 24' L MH C RRENTLY IN FAILURE DIV RTER VALVENSTALLED AN FLOW ITCHED TO 1983 BED sN / o on � z Qo 0 0 Cw w 100 U U t 90.51 / - IV/ � A A C 1 1 1 .90 48.00 T1 13.60 49.40 T2 19.60 53.70 MH 21.50 55.20 DCI 20.90 56.20 DC2 27.40 57.20 W—W_ W—\\ // WATER SERVICE f TEAL LO gP \9S�9 . FIRE HYDRANT ' WATER SERVICE /. 1250 AL S TIC /80.4 B 4 BEDROOM TAN R CED HOUSE wliyd' 100 GAL S.T.E.P A MT 500 GAL EEL TANK MT ABANDO ED PER CODE y��57 C1 T1 198 BED /198 BED T2 22' W X 43'L 22' W X 24' L MH C RRENTLY IN FAILURE DIV RTER VALVENSTALLED AN FLOW ITCHED TO 1983 BED sN / o on � z Qo 0 0 Cw w 100 U U t 90.51 / - IV/ � 1500 g S.T.E.P. TANK (P) NOTES: 7��7�77�7 �7� �7 ��n �� PP O1 BO O10NO2Ei17 ANCHORAGE, SAK 9951.0 PHONE (907) 272-8218 FAX (907) 272-8211 `��� ��G OF� `!�gslk' %g�P yr- #0 TH *? �...... .. .. I Steven R"Po'n'none' j I Pr,�; CE 8149 .. ��/ t�1`ll\\ oFES"= Date 8/27/2014 EMERGENCY TANK REPLACE RECORD DRAWINGS Scale 1'•-�0' P.I.D. NO -Ssz-4s THUNDERBIRD HEIGHTS #3A BLK 6 LOT BOTTORFF JEFFREY H & STACEY A 24854 AN CH OR AGE,AAKL 99567 PERMIT No. OSP141128 PLAN Sheet eQF 2 J ELECTRIC LLC 6732 E. 99th AVE. ANCHORAGE, -AK . 99507 June 15, 2014 Flintstone Enterprises 1300 Oren St, Anchorage,Ak. 99515 RE: Jeff Bottoroff 24854 Teal Loop May 22, 2014 This letter is to certify that J Electric LLC wired a septic at the above address in accordance to the NEC and MOA Codes . J ELECTRIC LLC Contr . Lie # 34469 On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141128 Tax Code Number: 05158248000 Work Type: SepticTank Upgrade Permit Effective Dates: May 20, 2014 to May 20, 2015 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: THUNDERBIRD HEIGHTS #3A Site Legal Address: THUNDERBIRD HEIGHTS #3A BLK 6 LT 3 GA865 Owner/Address: BOTTORFF JEFFREY H 24854 TEAL LOOP CHUGIAK AK 995675114 Site Mailing Address: 24854 TEAL LOOP, Chugiak This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 23873 Total Bedrooms: 4 N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received B Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 051-582-48-000 Property owner(s) Jeffrey & Stacey Bottorff Day phone 907.440.9890 Mailing address 24854 Teal Loop Chugiak, AK 99567 Site address 24854 Teal Loop Legal description (Sub's., Block & Lot) Thunderbird Heights #3A B6, L3 Legal description (Township, Range & Section) Lot Size 23,873 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) Upgrade 0 (w/wo ADU) Renewal Duplex (D) F-1 Multiple Dwellings F and/or D) gBMI TA MAY 2 0 2014 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 0 i AI Distance: J I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ('' n e s of property owner or Permit/Rush Fees: Z-6 `I 1 , Date of Payment: J7/�/77 Receipt Number: i O-1 5__� G Permit No. C)5iolq Itis' Permit App_:. > :L_c: Waiver Fees: Date of Payment: Receipt Number: Waiver No. Pannone Engineering Services «c Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(d)panen¢ak.com May 20, 2014 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 Subject: Thunderbird Heights #3A, Blk 6, Lot 3 Emergency Septic Tank Replacement Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new 1500 gallon S.T.E.P tank be issued for this lot. The proposed system will serve an existing four-bedroom house. Currently the lot is developed. The existing septic system was designed and installed for four bedrooms. The existing 1250 gallon septic tank has collapsed and sewage is leaking out. The existing 1250 gallon tank and 500 gallon steel tank with Omeco lift station will be abandoned per code. This lot is served by a public water with a service connection that is 80' from the existing tank. 1. Upgrade Tank Design. a. See Sheet 1 of 1 of the plan set 2. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: Lot 3 slopes from southeast to northwest at approximately 4% in the area of the tank replacement. The proposed installation will be located in the southern portion of the lot, behind of the house, and next to the existing septic tank and absorption system. Mailing: P.O. Box 100217, Anchorage, AK 9951.0-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 100217, Anchorage, AK 9959-0-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (9077)272-8218 FAX: (907) 272-8211 NOTES: i TEAL LO 1 1250 OIL SERO (E) IN AILURE E RE CED 150 GAL S.T.E.P) IBM SERVICE g9 FIRE HYDRANT WATER SERVICE 4 BEDROOM HOUSE \ 5/X43'L L TANK (E) LIFT STATION (ONED PER CODE) 1 2FAILURE /' ED 22 V i 22' X 24'' L L FLOW ITCHED TO 1983 BED i a z 11- IA -c 1, PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ..... .. .... .... � P.I.D582-048 THUNDERBIRD HEIGHTS #3A BLK 6 LOT .I Steven R. Pannone BOTTORFF JEFFREY H & STACEY A � PERMIT N0. �.•, �� 24854 TEAL LOOP tt+ � CE 8149XXXX PLAN ANCHORAGE, AK 99567 il Pana n P� � Sheet 1 OF 1 MUNICIPALITY OF ANCHORAGE DE ATMENT OF HEALTH AND HUMAN SER. ES Flattop Technical Services Environmental Health Division 1,4530 Echo Street 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720Anchoro(Je, Alaska 09511 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name _ Don Jo (( 'k (� 1-53 a -' i DISTANCES TO FROM SEPTIC TANK ABSORPTION FIELD WELL Address God (U& 7ec[( iiAek, Peferr UT, $k 995'77 Phones) Permit No. No. of Bedrooms 6&� -3s3o eaos& 5' WELL NA. N.A. LOT LINE i + lot N.A. LEGAL DESCRIPTION Lot 3 Block ( Subdivision `'� Thanclr�biro( /ref hly FOUNDATION -' 4. .367' N.A. Township, Range, Section Z,S % /� N 1 Lv S /� / l AS -BUILT DIAGRAM (Show location of well. driveway, water bodies, etc.) septic system. properly lines, foundation,Stec TANKS i M SEPTI [I HOLDING Tun k /-' Manufacturer(;) "rp/. `2) An Cho e Tank Capacdy m gallons (.L f.O SUO Material Sfee( No. of Compartments Cu 2 ( TYPE OF SYSTEM ❑ TRENCH M BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from original grade �3O FT Total depth from original grade 3"5- FT rSot AAA (2 ep f "tee i 'G c n Cr I FT" T" 2' a R 10 Fo Q� 171 IP 51 %j � Hf FII added above original grade FT Gravel depth beneath pipe O.S I FT Gravel length Lf -3 FT Gravel width— 2 2 FT Total absorption area 91111 SQ FT I Distance between lines S.0 FT Number of lines i Sod rating SGAa(I es SQ FT Pipe material Prr-i F-FJ'�O N'Iprl S011a D -3o3 y v" an Installer Dean Consfrucfw� Date Installed G/3 /8B /� WELLS wn7/nurl[� ❑ PRIVATE ❑ OTHER (Identity) ClassAiceimn (AB,C) Total Depth FT Cased to FT Installer Dale Installed. r n2 REMARKS: 2' 52tJl-Nr Sanofi etatred he(oal hea CJ ren co W Slah&o Ins- /a(leoc iD szo u( Ian k P"me oJ4 ex , J4r I r( I' /i ut*c( r'emot"Onrn Soale:� Inspections Performed by: F&Hbiq 7-echnitnif Sw✓u'�v ENGINEER'S SEAL >.. O A/ � ° �� p`l ki rZ"--c Of o .a:oea.oe ° 0, 0df ., ` o THEC)i I°, 6i'JC)nG ?� •,U , q, CL""­'q�' 47 �:y l/7r�Ii;uj�1G+�°�` ' (arm P(ou{ &11abel Pumv on, Ali mounlee( Date'. 6�3/� I» QY Er. L IeC {'r'2C ct( IY�.1'%tllt�iTon h //a� y �Irn Thom /—(y0� cerlily that this inspection was pedormetl according to all c Municipal and Stale guidelines in effect o is dale: June I%8cd' Health Department Approval: ' ✓ Date: G —L 69 — r 8 »_niz i1,RS1 l 11 U N l: C1 :I: P A L.. 1 T Y 0 F A IW C H C) R A £:S ]iii: Departme-nrt.. of Health & Human Services 8.:::5 L.. Street, Anchorage, .1:La<..-;4,:a 99501 343:,..4720 Owner Names DON JOLLY Owner Address: 108 TEAL. LOOP PETERS CREEK, AK 99t77 Day Phones 688-3530 Parcel Ids 051-582--49 Lot Legal: Subdivisions THUNDERBIRD HTS 03A Lots 3 Block: E, Sections 25 Townships 16N Flanges 1W Lot Size 22000 (sq. ft. or acres) Max Bedrooms- This Permits 4 Total Capacity: r} SEPTIC TANKn Minimum t.ot.al septic tank c_;apac:itys 1,250 gallons. Each septic: tank: must have at least 2 compartments. Depth to top of septic: tank (s) < 4.0 feet requires insulation over tank (s). INSTALL BED 20' X :£3' PER ENGINEERS DESIGN. MAINTAIN 6' OF: NATIVE SOIL. BELOW ABSORPION BED. LIFT STATION TO BE INSTALLED PER CODE:. NOTIFY DHHS BEFORE ZEST & 'ND INSPECTIONS. ENSURE: A MI:N.T.f'fUM G' SAND FILTER BELOW GRAVEL. BED. THIS PERMIT EXPIRES 12/31./ET8. F CERTIFY THAT - 1. 1 am familiar with the requirements for on—mite sewers and wells as 5iell. forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I wi.l.l install the system in accordance with all MOA codes and regul.C:itionsg and in compliance with the design criteria of this permit. 3. I wi.l.l, adhere to all MOA and State of Alaska requirements for the set back distances from any existing well., wastewater disposal system or public sewerage system on this or any adjaccant or nearby lot. 4. I understand that this permit. is valid for a maximum of 14 bedrooms. I also understand that the capacity of the total system is 4 bedrooms and any enlargement will require an additional permit. Signed: J% ` DATE- S<-/ 2'�rl&8 ----.-_---_.-._._....---..... _ _.. KClwner) DON JOLLY Issued Dy- P DATE. O N -- S T T E: S E: W E R F E R M I l' Per•m:i.t. Numbers E380058 Upgrade Date Isssueds 05/26/88 Engineer Designed Owner Names DON JOLLY Owner Address: 108 TEAL. LOOP PETERS CREEK, AK 99t77 Day Phones 688-3530 Parcel Ids 051-582--49 Lot Legal: Subdivisions THUNDERBIRD HTS 03A Lots 3 Block: E, Sections 25 Townships 16N Flanges 1W Lot Size 22000 (sq. ft. or acres) Max Bedrooms- This Permits 4 Total Capacity: r} SEPTIC TANKn Minimum t.ot.al septic tank c_;apac:itys 1,250 gallons. Each septic: tank: must have at least 2 compartments. Depth to top of septic: tank (s) < 4.0 feet requires insulation over tank (s). INSTALL BED 20' X :£3' PER ENGINEERS DESIGN. MAINTAIN 6' OF: NATIVE SOIL. BELOW ABSORPION BED. LIFT STATION TO BE INSTALLED PER CODE:. NOTIFY DHHS BEFORE ZEST & 'ND INSPECTIONS. ENSURE: A MI:N.T.f'fUM G' SAND FILTER BELOW GRAVEL. BED. THIS PERMIT EXPIRES 12/31./ET8. F CERTIFY THAT - 1. 1 am familiar with the requirements for on—mite sewers and wells as 5iell. forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I wi.l.l install the system in accordance with all MOA codes and regul.C:itionsg and in compliance with the design criteria of this permit. 3. I wi.l.l, adhere to all MOA and State of Alaska requirements for the set back distances from any existing well., wastewater disposal system or public sewerage system on this or any adjaccant or nearby lot. 4. I understand that this permit. is valid for a maximum of 14 bedrooms. I also understand that the capacity of the total system is 4 bedrooms and any enlargement will require an additional permit. Signed: J% ` DATE- S<-/ 2'�rl&8 ----.-_---_.-._._....---..... _ _.. KClwner) DON JOLLY Issued Dy- P DATE. Lot 3, Block 6, Thunderbird Heights Septic System Upgrade Specifications 1. All materials and construction practices shall comply with current M.O.A. requirements. 2. The location and configuration shall be as shown on the site plan and design drawing, except that minor adjustments may be made to minimize tree cutting, provided the same net absorption area is achieved and the 10 foot separation from the property line is maintained. 3. Trees larger than 2 inch diameter which must be cleared shall be cut into stove lengths and stacked at a location designated by the owner. 4. The existing septic tank and drainfield shall be pumped as part of the work. 5. A package lift station (Orenco as supplied by Anchorage Tank or equal) shall be installed in a new 500 gallon septic tank located after the existing 1250 gallon septic tank. Float switches shall be set to provide a 50 gallon dosage, with 200 gallons remaining after the high level alarm is triggered. The visual and audible alarm shall be installed in the garage at a location specified by the owner. Effluent shall be pumped from the lift station to the soil absorption bed through a 1.5" Schedule 20 PVC pipe, or equivalent. 6. The 20'x 38' bed shall be constructed by excavating no deeper than 5 feet below existing grade. A 2' thick layer of medium sand shall be placed in the excavation to reduce the percolation rate to 125 sq. ft./bedroom. A total of l' of Municipally approved sewer rock shall be placed on the sand with the bottom of the 4" dia perforated distribution pipe situated 6" above the sand. Two inches of approved burial type rigid insulation shall be placed over the sewer rock, lift station and pressure distribution line, prior to backfill with a minimum of 2' of cover material. The surface shall be graded to drain away from the absorption bed. Two monitor tubes with perforated pipe extending through the sewer rock to the top of the sand, and two cleanout pipes shall be installed as shown. 7. If requested, the contractor shall provide an additional 6" of topsoil over the entire disturbed area, and plant it with an approved grass seed. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 1-.0? 3 81-OCK6' � / Exrsfrl, jq V / /foare �a / IP..,foCuFS:T. N9F Propore�C � ?E' / Extfi»9Wor T.ff.42 c.o7' 2 1:0TC;: 1.Ole ra -fA it S /D .zre sere eo( b y. an ap�rdve�o( Cam,qunify wafer S ysfem St.OPe• 6vAA64ATION: Tie Pr000rc+o( Sr/ -e -or fhe new soil 0tbr0r12A6n be 4 on a broad- beacA Jt%LbiNoC approwmal-e/y 6'.f'eef higher• -/ha* ire extr47 So'rl abrorpAv) SysFem wti.eh i1 at fhe law 17oinf o.i f'Ae rot ProporevC ea, x36 J 971 lze' Sor( Abdorpbon Sem FY-Vfir9 Noase %. tl • tl / Ar �J►[� Oi 0 m .....................: *. �: t...... � ."� ® • °. THEODORE F. MOORE 4®s .• CE - 3589 % Q�AF b a (eSS10l1a®mom 7-IfuNDER6IRA HC -167(47--r S (rte Pi -AN DATE: S/2o(8�,+ pwm 13Y: TF" SCA I E.' (= Yo NaTF: This i.t not a Svry er e&( Alai_ 111( roce< -rb" -?rE ' eX/y ro X;" al -e l fez° SGBC-D HO NEW oRElvcO wsT/NG pvt PIPE —'tea HI FT STAT/ON l ZSW GA4 C, 7. IN .�d0 GAS TANK 2s' I A" X Y" Z"EE CA. Sd'u FF Al P`FiF pipe �H,T. S,O f 2S EDGE of SC -SER Rohe q! SANO In c fol '�4 t -A Iq l/S tF fit/ NL I (O' Q GP ORADE 70 DRAW AwA VNCLASSIFIEO FfD4 or -E!" Rt6�e(D rNSeAAATION Nu V7PB tyuu.&R Reef• MLsDtufl SAND FArc(? 1 (AtlDfSTcc8C04) GP } ,C—,gEaROc IT ......... • ORE F, MOORE ; • // CE -3589 0� R @4,D p�vfessioh�l�®s' E o'no LOT 3, B1,OG Fr 6• TffGfNDE(V (3(RP 144-(6:i,l%S SOIL A13SORF7 f3ED � 1. I FT STATION VA -TEF: 512016,9 p wN r3 F;' T1C(`t SCALL: AS CNoe&N e y� Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST s�ti OP A4 is """49TH /-'�k .. *Toso. i.•o I e• THEODORE R MOORE CE • 3589 • C�+® s PERFORMED FOR: P0/1 .%O M/ DATE PERFORMED: 3-1/2/B8 LEGAL DESCRIPTION:t.43, Tllvna(crbird gjjTownship, Range, Section: DEPTH IPt SLOPE SITE PLAN 0•� 1 ML/Oti 15 2 N 3 4-1 5 6- 7 8- 9 FS.1 fo• ui o tt 12- 13- 14- 15- 16- 17- 18- 19- 20 21314151617181920 COMMENTS — P C(eon Sanofi C-ta-¢/ F4anr Lob b(el (iecome-r Sandier W, depfh dy I, WAS GROUND WATER Y �drock w• !L0 S�yt ENCOUNTERED? !1 IF YES, AT WHAT DEPTH? 10.0 Depth to Water After Monitoring? (o•O Date: 51&19'f Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: F iCc ffoP Trcl, 3,e j I r%itrr.k CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: s1001SW 72-008 (Rev. 4/85) PERFORMED FOR: 76/1 TO IIy/ DATE PERFORMED: 5-/12/88 LEGAL DESCRIPTION: 0 fiG 7-hunoPerb rrot. Township, Range, Section: DEPTH P{- SLOPE SITE PLAN 0'S (-1 c. R�lo(uA Grr��enr st /t 2 3 4 6P Gj�n Scrnd� 6yratvef 5 Many co6hlel 8S Ct! /Cs�rm 6 7 7.S (3pyfrock 0�. Fi20 seey�l' 8 9 10 11 12 13 14 15 16 17 18 19 WAS GROUND WATER Y ENCOUNTERED? IF YES, AT WHAT DEPTH? Depthto Water Aller Monil Monilerinp? 7 OBale. 11 I Reading Ur ry4q ►® • Gross Time Net Time Depth to Water � fJi.1QENGIN EALl.9 *, 49LH ,* of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 143e q ••• •, •�,��, OTHEODORE F. MOORE ice'Municipality / 825 "L" Street, Anchorage, Alaska 99502-0650 ��•. CE - 3589 Qj�4 ®a®�f�°in SOILS LOG — PERCOLATION TEST ;••••••••;•FS�ci9 PERFORMED FOR: 76/1 TO IIy/ DATE PERFORMED: 5-/12/88 LEGAL DESCRIPTION: 0 fiG 7-hunoPerb rrot. Township, Range, Section: DEPTH P{- SLOPE SITE PLAN 0'S (-1 c. R�lo(uA Grr��enr st /t 2 3 4 6P Gj�n Scrnd� 6yratvef 5 Many co6hlel 8S Ct! /Cs�rm 6 7 7.S (3pyfrock 0�. Fi20 seey�l' 8 9 10 11 12 13 14 15 16 17 18 19 WAS GROUND WATER Y ENCOUNTERED? IF YES, AT WHAT DEPTH? Depthto Water Aller Monil Monilerinp? 7 OBale. 11 I Reading Date Gross Time Net Time Depth to Water Net Drop 20 ��..11.. PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS 13,etre, c --k su/' e ti !!tl,J ��u�c.��r11O/ 7'1G/` eC+dl�' PERFORMED BY: I��u7Tc;.ii Tecti Ser-v�c•,- I :T: ' - VERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �/� /a8 72-008 (Rev. 4/85) vin ryr��usv �APPROVAL -FOR ;A!.'81NGLE.`FAMIL"(',DWELLING ""' zLv - -HAA� tzevow a-.a ue�t•�°urszo-zc -�joms,Jeeui6us leuo!ssa;oid eqj ui suoiss!wo'Jo sione Jol alq!suodsaJ lou si obujogouV to �4!ied!oiunV4 oqi panssi s! eleojlj>Jao a eJoleq elep ez(jeue Jo suoµoadsui lonpuoo louop,SHH0losaaAo!dwg sluewaJ!nbeJalejspueleiapej61elJeo%811esolJapJouisuoilnl!isui6u!puGIJIaglpue sawoylosJasegoandoi (seVnooesesiylsaopSHHOeg 'eNselylo'elelgeglu(p9Jelsi6aJJ99ui6uajeuoisseloJd ?uapuadopui ue (q enoge g gdeJ6eJed ui u0A!6 suoileluasoJdej agl uodn Aluo poseq saleoililJap !enoJddy Al!joglny glIeaH sanssi (SHHO) saoiAJaS uewnH pue UeaH l0 3uawpLdaa abuJogouy to Al!lediotun!nl agl S p a}eQ -!-LU 1145— 1 -1-10`' :�(g sluawwoa Ieu011!PPb :suo!lejnd!is 6uimoj!oj ayl ,qi!m 'swooapaq Jol !enoadde jeuoil!puop ` penoJddesia l swooJpeq aol�panoJddy 15 3-mf11VNDik !§Mtp HO' �� .6 SYS ��(♦ .I, -. �'.�� ,tJ �e •�•�ii l fir, -.I �a L Ell aJnleu6!ssJesu!6u3 17 V SUIV JDAIS 8 0.3 '' 1 or-,- N,p oa do• ie !b e!ss3 t EOGL SseJPPt1 o. . •, wJ!j 10 eweN auoyd i2N Wi- G °8 t; •uogoedsu! syyi i el yl uoyae u! su61le!n6ai.pue1990ueu!pJ0 'sapoo elelg pue Ied!oiun!nl !!e,gl!M eoueijdwoo u! si weleAt iesodelp ieleMelseM Jo/pue A!ddns. JejeM al!s-uo`egl 'uoljogdeui pUe{uo!le51jsenuj AW woJJ pue' 9111 e6e]ogouy to Al!jedi5!un!nl eyl ! ; woJ;pouiejgo uojlewjolu!"egl uo peseq le43 A1!Jen ieyljn; i u eJey pe3eo!pu! eJnjonJis;o ediQ pue swooapaq lo;Jogwnu aul Jol olenbepe pue !euoilour l'a;es s! walsAs•!esods!p JajeMelseMao/pue ` h!ddns JaieM alis-uo egl legl snnoys,uoileo!!dde ienoJddV Aj!Joglny:gljeej { s!yj;o uo!;e6!isanu! Awleyl /4!JaA ) 'Mo!eq uMoys alep uo!lep!jen ayl lose pue oleJey paxja fees lw �(q pe!j!jaeo sy ! t+ s 833NISN3,!AE N01103dSNl d0 1N3W31V1S Municipality of Anchorage A&r s Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST �� Legal Description: L < S 3 � (o [ a��� eo � Parcel I.D. A. Well Data Well type k- If A, B, or C, attach ADEC letter. ADEC water system number 2l I ISLa Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires properly protected FROM WELL LOG QSYCCTION Date of test �C: o m Static water level s w Well flow 9•p -m. 9•p•rn; o _ 04 Pump,le t o `� c.0 3 w✓ SEPARATION DISTANCES FROM WELL TO: R '.D t c3 m Septic/holding tank on lot C ; On adjacent lots Absorption field on lot a oa k ; On adjacent lots Public sewer main Public sewer manhole/cleano Sewer service line WATER SAMPLE RESULTS: Coliform Date B. SEPTIC/HOLDING TANK DATA Collected by: Other bacteria Date installed Tank size I zsa Compartments z Cleanouts(9/N) _T Foundation cleanout (2f N) _ 4 Depression (Y/0) r� High water alarm (Y& Alarm tested (Y/N) n Date of pumping a lti-5 Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 10 o `+ On adjacent lots ''(A Foundation To property line I o k Absorption field 2 S Surface water/drainage IOD I k _Water main/service line /J 72-026(3W)•Frmt CONTINUED ON BACK PAGE C. LIFT STATION Date installed (-v- 3 - S `a Manufacturer A-)� a, -r6,y - Size in gallons r,0o Manhole/Access (DN) Vent (ON) "Pump on" level at 3 2� "Pump off' Level at -39, High water alarm level `11 Cycles tested Meets MOA electrical codes (ON) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot 200' On adjacent lots D. ABSORPTION FIELD DATA Date installed ('' 31438 Soil rating (GPD/Ft') g,5 ' 9- System type t3A-D Length +'3 Width y2 Gravel thickness O,s' Total depth k 3,S' Total absorption area A, k.0, Cleanout present &)N) _ Depression over field ()CW) Date of adequacy test `r- Results fail) Proms for Bedrooms Water level in absorption field before test N After testy eroxide treatment (past 12 months) (Y/M If yes, give date a SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot v" � k �- On adjacent lots 'A P Property line �0' To building foundation To existing or abandoned system on lot 2-5 On adjacent lots 3 k Cutbank �'I A Water main/service line 1 o k Surface water 1 0 Driveway, parking/vehicle storage area Curtain drain y A E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed Engineers Name 17034 Eagle er Lop oad No. 204 Date e7 _ I-?. / T HAA Fee $ Date of Payment V `/ �3- ?_// Receipt Number 625 h"/)Y ( J-zDl 72-026(3/93)' Back and HAA guidelines in effect oft t Waiver Fee $ Date of Payment Receipt Number B®t`f m 0 f c'I -0 o c Surface water t c 0 z Date installed ('' 31438 Soil rating (GPD/Ft') g,5 ' 9- System type t3A-D Length +'3 Width y2 Gravel thickness O,s' Total depth k 3,S' Total absorption area A, k.0, Cleanout present &)N) _ Depression over field ()CW) Date of adequacy test `r- Results fail) Proms for Bedrooms Water level in absorption field before test N After testy eroxide treatment (past 12 months) (Y/M If yes, give date a SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot v" � k �- On adjacent lots 'A P Property line �0' To building foundation To existing or abandoned system on lot 2-5 On adjacent lots 3 k Cutbank �'I A Water main/service line 1 o k Surface water 1 0 Driveway, parking/vehicle storage area Curtain drain y A E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed Engineers Name 17034 Eagle er Lop oad No. 204 Date e7 _ I-?. / T HAA Fee $ Date of Payment V `/ �3- ?_// Receipt Number 625 h"/)Y ( J-zDl 72-026(3/93)' Back and HAA guidelines in effect oft t Waiver Fee $ Date of Payment Receipt Number 4161-ma2a-J-t01 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES I rY _LA IQ, DIVISION OF ENVIRONMENTAL SERVICES i'1 L`ri CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date Tune r, /9B9 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) r rif3�f3(ack 6 Thunderhir_ a� Ikryti/o' Location (address or directions) (oB Tyr( I.oW Rd. pel-ert 0-eet A -/•C 99s"-77 (b) Property Owner Don Telephone: Home 666 Business Mailing Address Mme (c) Lending Institution Telephone J-6'2 2re/ Mailing Address "'- (d) Real Estate Company and Agent J ac(� ClJ/ r/e (pm�an�/leen hcrm Jq Address 3E01 Telephone 3'63 - 5300 (e) Mail the HAA to the following address: or: Check here 19, if hold for pick up. List contact person and day phone number below. 7n'd ticc-e :3 IVs' —r3s-s' �o/%en %taeniAq 363—SSO0 __ 2. TYPE OF RESIDENCE Single -Family IR Number of Bedrooms 3. WATER SUPPLY I/ 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. 4. 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 rRe� aiasi Fmm 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 FW46'e Technics/ Servic.v Telephone 3HS- )35-5- Address JYS30 E'c1W Sf. RnchcrayP, */r 99S4f Date Jun[ 6 /969 �aaF A4 am,a,O o' .................::... aa.• ...••. •• •.••• 9( : h9c F. MOORS B Engineer's Seal 6. DHHS APPROVAL ;� Approved for � bedrooms by !Y�-y—� Date 6 - Approved n Disapproved Terms of Conditional Approval Conditional dhh5 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 72-625 Rev 8/861 Back .:MUNtCtPP�t�P�s R.f1GEo� GS ON EN�tRONMEN tv tt tN ? 1966 A. WELL DATA v It Well Classification — MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 - 264-4744 Legal Description: 6'of 3 $tock 7-h under brrd ffer k( If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At 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 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 Water Sample Test Results Comments DEC Cer/-4(cz k- of C01"0?fra1)C'e enc(v{e�Q B. SEPTIC/HOLDING TANK DATA Date Installed 3/22/83 Size(2SO!?&t No. of Compartments *2 Standpipes (Y/N) r Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) N Date. Last Pumped 2/86 tk JR S Pumping/Maintenance Contract on File (Y/N) NA. ; for NrA. Holding Tank High -Water Alarm (Y/N)' Nr A. Temporary Holding Tank Permit (Y/N) N, A Separation Distances from Septic/Holding Tank: To Water -Supply Well 2-:20, To Building Foundation Stf HO r To Dis osal Field 2S t To Property Line P To Water Main/Service Line _!> eS'r To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026 (Rev. 8/86) Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 8S Type of System Design Date Installed 6 /3 / 8B Length of Field 113 Width of Field Square Feet of Absorption Area Y Y6 Depression over Field (Y/N) N Results of Last Adequacy Test 1q, A. Separation Distance from Absorption Field: To Water -Supply Well > 200 ' To Building Foundation 30' Lot 2S' To Water Main/Service Line > 2X' To Stream/Pond/Lake/or Major Drainage Course Depth of Field 3 ,5 Gravel Bed Thickness 0.157' Standpipes Present(Y/N) . 6eo< Date of Last Adequacy Test N,A, (new 6wul,) Cann) To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area > -5U Comments ae u sys fan vis /a(led /0 n;&late 0F*frtac/ bea rn.c/srll<d u 1n ,al-er F* 4 Ale D. LIFT STATION Date Installed 613 MF Dimensions ,5y11 Dwa A H8" ICA� Size in Gallons 5 -co Manhole/Access (Y/N) Y "Pump On" Level at 2'r" ..Pump Off' Level at ty" High Water Alarm Level at .324, Vent (Y/N) Y Tested for NIA. Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Y Comments X'nsia11a;6A bi Dean Cav>`rchcn of 0,-enco l �F S rFrc� s moo/ �d �v flnCho�atl! Talk. — Sir cu�r�r���. on �uM�, Fle[iy'eta/ ins/lahon hj. /�xl ltatfl�n of //almar 6/ec{rrc ** 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 !T 9- 2nV`0'r- Date 6�1dY86 Company F=lu-reehA"6tt Suy MOA No. S -F -Z2 Receipt No. 1-26 '� Date of Payment (� / '— a.......... " , OF .4 pR� �% a'l " r7 Amount: $ � ©�r,� � ` °°.°P,�, A� Engineer's Seal OSc�2_0_39,4 Page 2 of 2 72-0261Rev 81861 Peck I � rill -rj � � � �i� � � STEVE COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3601 "C" STREET. SUITE 1334 ANCHORAGE. ALASKA 99503 DATE: --_L-20-88 PWSIO #: 211156 To Whom It May Concern: 563-6775 According to the records on file in this office. the EKLUTNA -THUNDERBIRD-HEIGHTS ----- Water System is in compliance With the State of Alaska Drinking Water Regulations. Sincerely, Ronald Klein ^'Environmental Field Officer MUNICIPALITY OF ANCHORAGE '1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 Ot ENVIRONMENTAL ENGINEERING DIVISION ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAM+ &/� k) r PHONE O RADE MAILING ADDRES LEGAL DESCRIPTION 607_ G c .Uc�� � _ l T.s , LOCATION NO. OF BEDROOMS •N-`OYZ. O Y DISTANCE TO: Well Gm Absorpti n area ,� Dwelling Dp'5-/ PER R` NO PZ w F- Manufacturer /�� Li Metal No. of c7rtments w Liin Ilons _ IF HOMEMADE: Inside length Width Liquid depth ❑ Y DISTANCE TO: Well Dwelling PERMIT NO. Z =O z< Manufacturer Material Liquid capacity in gallons ❑ w= DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. J LL z F ? w No. of lines Length of each line Total length of lines Trench width inches Distance between lines H ❑ Top of tile to finish grade Material beneath tile inches Total effective absorption area w Lengths ( �( Width f Depth ,y r / PERMIT r*3 00 7- iType of crib `-- Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well/A� l n Building foundation / Nearest lot line -7L_. Class Depth Driller Distance to lot line PERMIT NO. w w � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS tt Q 2j - SOIL TE RATI V- 15 f7/I (� INSTAL`^LE R ty�IARKS �P -r- ` s OVED ^ DATE LEG L 72-013( e-.3/78) 1" 11 1 P 8 ®_= I F=" 1=1 L I T'r (0 F=r X01°-.11= 1—VQ F! F-1 C31= DEPARTMENT 'HEALTH AND ENVIRONMENTAL' 10TECTIONd =25 'L STREET.. ANCHORAGE, AK. 99•`_0l 264-4720 1.11`.1—" = ITE On 1=141=1*~• F= 1=F;P-Fel I _F PERMIT NO. ==4=072 ) APPLICAN•dT LOCATION :ATION•d LEGAL STEVEN L. SKAGG'_ P.O. BOX D. C:HUGIAK AK.. LCAT ' BLK 6 THUNDERBIRD HTS. LOT SIZE 23000 _QUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = _ _OIL RATING (SQ FT!BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINdFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND 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 OUTFALL PIPE AND THE BOTTOM OF THE EXC:AVATION•a (IN FEET). FZ E C_ a 1_1 I FT = E> _• f= F "T I CD T FA FA 1 O I ."1= = _L CDCA e_m PERMIT APPLIC:AN•dT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE IN•ISTALLATION INSPEC:TIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TINA C3 It I PA"T F°EC=-T I 13 VA 05 FAFTE F='ECAL1 I Fes"EE> --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTfANC:E BETWEEN H WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENdDING UPON THE TYPE OF PUBLIC: WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRI'•rATE SEWER LINE IS 25 FEET AND TO A COMMUN'dITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPE_IFICATIONS AND C:ONSTRUCTION DIAGRAMS ARE A•iAILABLE TO INSURE PROPER INSTALLATION. F"EFZP 1 I "F I=:tF" I Fes_E - E>EFEDEEP1EDEFQ A "_ jL03ED_: I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIR'EMENTS FOR ON•d—SITE SEWERS AND WELL_, AS _,ET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM INd ACCORDANCE WITH THE CODES. : I UNDEROND THAT THEAN�d—SITE _EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE N REMODEU6 TWINCLUDE MORE THAN 3 BEDROOMS. SIGNED ISSUED BY V4. 0 O & E ENG +JEERING & DEVELO' MENT CO. „ Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 686-2280 Performed for: Name: ST�[i�i! �• --5/,/ACC,S C S7, Tel. No. 689-2��! Mailing Address: P'69, 13 d x D (3/-/ 1-4/--. 29f� 7 Legal Description: L,7-3, 13 z" c_ /< 6,,, 710AI 0 1i3 /12- 77 7-S Depth (feet) Soil Characteristics 0 1 AllL 5/L7- '7-0a 7� 2 �3 4 �7%� JAA10y �/LpvE�, c DFJ/�se- ❑30i 5 Z- 6 vo5� _ j � I� 6 �S i/ iS.2. ki? 7 9 PLOT PLAN 10 R/o SL/iLF 11 12 P1 7- 13 — PERC. TEST 14 — 15 — •�® �a�i 16 Ground Water Encountered: Yes No If yes, what depth ® �Ez„ P j e �® Proposed Installation: Seepage Pit Drain Field 9d�l�b ..... �® Q e Earl P. EIIis W y� NO. Performed by: _ APPLIC—VT FILLS OUT UPPER HALF ONLY Time Property Owner T & D Construction Phone Mailing Address Box. 2524, Palmer, AIC Zip Code 99645 745-2731 Date _. 3 Inspector Buyer Don and Susan Jolly 6431 Reed Lane Anchorage, zip code Field Notes:Gp� TL) d% p ! .Address v-4 Gly" Y 5 ENVIRONMENTAL PROTECTION Lending Institution Rainer Mortgage Co. Phone 4797 Bisiness Park Blve. zip Code 99503 561-1744 Address ( ) Realty Co. & Agent Commonwealth Totem Realty, Inc. Phone William Schlegil 724 E. 15th Avenue Zip Code 99501 272-0571 Address Date Sewer Installed Well To Absorption Area Legal Description Lot 3, Blk 6 Thunderbird Heights Septic Tank Size 1`00 CJ Street Location Raven View Loo - Well to Tank Type of Residence -. 4C Single Family 4 _ ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply ❑ Individual - ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. IX Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal .r R Individual Year Individual Installed: 1953 ❑ Public Utility When Connected to Public Utility: - ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date _. 3 Inspector Inspector Inspector Inspector Field Notes:Gp� TL) d% p ! -0� MUNICIPALITY OF ANCHORAGE DEPT. OF HEARTH P. v-4 Gly" Y 5 ENVIRONMENTAL PROTECTION /ty�Q fir$ a MAY 2 0 98".. �� RECEIVED 'CONDITIONS OF APPROVAL ( �Eil ( ) DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size 1`00 CJ Well to Tank 72 D23(3182)