HomeMy WebLinkAboutTIMBERLINE LT 10Tom Fink,
Mayor
January 8,
Municipality Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
1990
W.F. Brattain
10900 Vosikof Place
Anchorage, Alaska 99516
Subject: Lot 10 Timberline Subdivision
Permit #890042, PID #015-164-11
The subject permit, issued by this office for a single family
well and/or on-site wastewster system has expired as of December
31, 1989.
Permits are issued on a calendar year basis by authority of the
Municipal Code of Regulations. A new permit must be obtained
from this office for an well and/or on-site wastewater system
not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this office for documentation of the installation and to close
the permit.
If a private engineer inspected the installation of the on-site
wastewater system, the original as-built inspection report
(three-part form) must be sent to this office for review,
approval and documentation.
When applying for a new permit, the fees are: $90.00 for an
on-site wastewater permit; $50.00 for a well permit; $140.00 for
a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
Sincerely,
John Smith, P.E.
Program Manager
On-site Services
JW/ljm:200
enc: Copy of Permit
"Kids Are Our Future"
.~ ~ ,., Anc:l-iol'a~¢!, Alaska 99,501 ..,4..> ~, ......
C)wr~e_eP Nam6!:
0 w n ~..~, r- Ad d r. e:,ss:
W ,, [::' ,, BRATTA I N Day I:::'hI:)ne
:1 "9: 0 VOS ]:KOP- F:'LACE 274-<)666
ANCHUI"u.~b[:., Al< 995:1.6
I..c)t. Lega].:
Subdivision': TIMBERLINE SUBD,, t.c~t: 10 Block: '-
Sec:kion: 24 Township: 12N Range: 3W
49500 (scl. {'t,,, of acres)
ThJ.~ Per, mit.: 0 Total Capacity: 2
be st..d:3l~it.t, ed to Iqunic:ipali'Ly o[ Ar'lchcH-.age Del:)artr~er~t
wit. hirJ 3()days o¢ ~ell c:l~mp].etian,,
FJ6:a J. Lh
COIq,~3TRUEY]' I::'EF4 ATr]'ACHED APPROVED S]:TE PLAN.
PI'Y. RMI]' E×F:'IFZES :1.2/31/89 AND VALID F'OR A SIN(i'}LE FAMILY HOME (]Nt...Y,~
,?~I.JBM]'.]' A COF:'Y OF' i"[qE WEL. L LOG UPON COMPL.ETION OF' THE
CONSTF~'.UC]~ l [!N.
CI };R 1' I I:;:'Y 1HAl':
I am ['amiliar' w:i.t.h 'Lhe Pequ~.pel?le)ir(.s J'clp on-.-sit, e ~(aw(~ps and we:Lis
~oP'Ll'l by the I"]Lmic:ipality !:)¢ Anchor'age (MOA) anti the State of Alaska.
I wJ].l inst. all the syst. em in acc:opdarJc:e ~git. h all MOA codes arid
and ir'i (:tgr(q~].J. aw/c:(~~ 14il'.h th(}~ CJ~,~J.(]l"i cr. iter':La of th:[s~ per'mit.,,
I w:i.].l ,a(::lhe)r'6.) ~.(::) a].] MC}J.~ ar'~cJ ~J'La~t.e~ o{' ala!~kE~ i,e})CjL.tiP(.}~nteY/t.% J'c:lp '~..h6) ~[~c~t. [)ack
d:Lst, ar'lces fr'om any exis't, ing well, wast. ewat. e~' disposal system or' pub:Lie
[~(.~)l.~(al"a(;JE' EFyst, E~I~I c]n 'l:.hJ.s c:)!" ar]y ~d.~acel'Jt, ()P !']6)aPL:ly ].cia,.
I urider'st, ar~c! t. hat th:i,s pepfl~J, tL is v&~],id ['c]l' ~ ~aN:LmL,L~I C)J' 0 bedl*ooms. I
a~[s(] LU']CI(."~P~F~.,F¢d']C:I t.J"lat. 'J:.h~f capac::Lty o¢ the t.c)'['.~l E~ys'l:.,(:~lfI :J,!~i ~=J b6-)dpoaifis~ arid
S :i g ri e d:
( 0 w n e l" )
I ssu(,~d
W }:IRA -I'TA i N
~.._,i ............... OATE:
A.~ Built
.90.0
~ ,
No. O~ Page No.
~' ,'~'~ MUNiCiPALiTY OF ANCHORAGE )~;%
) DEPARTMENT OF HEALTH & ENVIRONNiENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchota§e, Alaska 99501 TeJephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
AbsorPtion area Dwelling i PERMIT
Manufacturer~C~. IIMat ' ]~.~ No, ofcompartmo~
Liq. ca~ ~,ons IF HOME.DE: Inside length Width Liquid deptk
Manufacturer Material Liquid capacity in gallons
OTHER
PIPE MATERIALS ~
~13 (Rev. 3/78)
PERHIT NEt < E:::LE~543: ]'
.I-IF:._ E. LUCHSINGER
',,,' D'5; I k'OF F'L.
· ' ' ,' =,UB
L~O ¥IME, EF. LINE '- '
· iFF L I _.HN F
L 0 C: F! T I 0 N
LEGAL
T'¢PE OF SOIL HE,_,LIRFFILN --~--TEM I=.. TRENC:N
,- I, SOIL RRTING
[1H,'.,Ii'lLi'l N_Ii"IBE~' OF BE[:,RO01'4S = /,~. ·
]'PIE REQUIRE[:, _,I~.E OF THE SOIL RBSORPTIE)~,f S"tSTEH IS:
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF TNE TRENCH OR DR~INFIELD.
THE DEPTH OF B TRENCH OR PIT IS THE DISTh]NCE BETWEEN THE SURFBCE OF 'THE
GROUND BND THE BOTTOM OF THE EXCFIVFIT~ON (IN FEET').
THERE IS NO SET WIDTN FOR TRENCHES.
THE GRBVEL DEPTH t:5, THE MINIMLIM DEF'TH OF GRR',/EL BETWEEN THE OUTFRLL PIPE
BND THE BOTTOM OF THE EXE:RVRTION (IN FEET).
PERMIT HPFLI_.HNT Htl_ THE RESF'CNSIBILIT'-t TO INF]F."M THI_'=; DEPRRTHENT £,IIRING 'rile
INSTRLL. RTIGN IN=,FEuTIuN_, OF RN'¢ WELLS R['.'JRC:ENT TO THI=, F~_PEF. T'~ FIND THE
NUHEEK OF RESIDENF:ES THRT TNE NELL WILL _,EF:.,E.
E, RL.k. FILLINI.~ OF RN¥_,'="c"'F~_,._,, WITHOUT FINRL IN_FECIIL[t RND RF'F'ROVRL B'¢ 1HI_,
[:,EPRRTMENT WILL BE .:UEJEuT TO PF,'OSFZF:LITICIN.
M]:NIMUM DISTRNCE BEI'WEEN R HELL RND RN'¢ ON-SITE SEWRGE DISPOSFIL S'¢STEM IS
t00 FEET FOR R PRIVRTE WELL OR t50 TO 200 FEEl' FROM R PUBLIC WELL DEPENDING
IJPON THE T'T'PE OF PUBLIC WELL
MINIMUM DISTFINCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND
TO R COMMUNIT'¢ SEWER L. INE IS 75 FEET.
WELL LOGS; RRE REQUIRED RND MUST BE RETURNED "FO 'rilE DEPRRTMENT 14ITHIN 3:0 DR'CS
OF THE WELL COMPLETION.
OTWER REQUIREMENTS MR¥ RPPL'¢. SPECIFICRTION~ RND CONSTRUCTION DIFIGRRMS FIRE
RMRILRBLE TO INSURE PROPER INSTRt_LRTION.
I CERTIFY THRT
1: I RH FRMILIRR WIl'N ]'HE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH B'¢ THE MUNICIPRLIT'¢ OF RNCHORRGE.
2: I WILL INSTRLL THE S'¢STEM IN RCCORDRNCE WITH THE CO[:,ES.
3:: I UN[:,ERSTRND THFIT THE ON-.SITE '=;EWER S"r'$TEM MR'¢ REQUIRE ENLFIRGEMENT, IF' THE
REHO[:,EL.E[:, TO INC:L..L~__ I',10F,'E'" THRN 4 E, EDROOMS.' --~X/O?~~:---
RESIDENC:E
IS
.............
/ . :~ ~ . :::';' / &)() I'~:. , ::- TM '"" *'P::>" :'" ' ,,,,~L.,,:; ' " o¢: 1'7
DOUG~.~.S A. STARK and ASSOCIATES, CONSU~,TANTS
957 Westbury Drive · Anchorage, Alaska 99503 · Phone: 277-4300
MUNICIPALI3'Y OF ANCHORAGE
DEPT. OF HSALTH &
ENVIRONMENTAL pF¢O [ECTION
AUG !'i
RECEIVED
Dxx-~re ~ ~-
pA~9_ c C.~
UC'%T LoCA4-~0,o :
1-£-~, T ~ e~rq-i~b '.
7,0
i~.o -- F~¢~
Organization · Management · Engineering · Surveying · Planning · Human Resource Development
L.
ItlII~IHIIIIi!II!Ii
~. Iii/~11! 4//I~]IHI!IIIIIIIIIIH
R.B.C PUHP & ~JELL~UFPL¢ '' ' '
WRSILLR,RL~LR
JOB INVOICE
ZZ274,,~ V<?.: I ,/<,~ /)4
PHONE
9-15-83 FRANK, This is to act as a well log showing quanity of flow for Ms. Brattian
on the purchase of Steven Johnson's home at 10900 Vosikof Drive. This is all we can get,
as the ~unicipality has miss placed the original well log done at time of construction.
It is our understanding that this report is reporting;better than good for water flow for
that area. If you have any questions or concerns, please feel free to contact our office.
Pam Schlegel w/Connie Yosimura
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
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Loca~t~on,(addres.~rect o s) .
(b),~,~p[ca~t:,~me ~]~¢ ~F,~ Telephone:Home ~-¢¢~ Business
c)',. ,Apphcant'lS'(Che~cP, one): L~d~ng Instttutron [];
';r~
(d) Lending Institutiop~:~';eTM
Address *¢ ~¢¢¢
(e) Real Estate Company and Agent
Owner/builderJ~; Buyer []; Other [] (explain);
Address
Telephone
~ address
Mail the HAA to th~ follow'ng, :
(f)
TYPE OF RESIDENCE
Single-Family{~ Multi-Family []
Number of Bedrooms 3
Other
WATER SUPPLY
Individual Well~ Community[] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status. ,. \', ~
SEWAGE DISPOSAL
Onsite [~ Public [] Community [] Holding Tank r-I~
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)
ENGINEERING FIRM PROVIDING ~NSPECTIONS, TESTS, FILE SEARCH, DA'I~ 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 an d/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 /~J ECS //~(~- Telephone
Date ~/~¢~ -
DHEP APPROVA~ ~-?~
Approved for
Approved
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 th~s as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUA.¥ 984
Well Classification i ND](/I~)0/~'/-- l~ A, B, C, D.E.C. Approved (Y/N)
Well Log Present ~N) ~ Date Completed /~ / Yield
Total Depth C/~z Case? ~i) '~ Depth of Grouting
Static Water Level ~,2 Pump Set At
Casing Height Above Ground
Electrical Wiring in Conduit CN)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
Sanitary Seal on Casing ~)/N)
Depression Around Wellhead (Y,~
I00 '
I10'
;on Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Line A!//~ To Nearest Public Sewer
Cleanout/Manhole ~//,/~ ' To Nearest Sewer Service Li~:~ on Lot N//Pf
water sample cOllected by '~ ~ld~ /'~l~[f(~l['l(~'/~ ;Date ~/~
Water Sample Test Results ~ ~ 'F/.5 F~ ~O~
Comments ~ ~N~ ~J~ R~T- ~ NgY ~r~ ~I~G ~
B. SEPTIC/HOLDING TANK DATA
~'////~:~ / Size
Date Installed
Standpipes {~N) Air-tight Caps (~N)
Depression over Tank (Y~,)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
No. of Compartments
Foundation Cleanout (Y/~
Date Last Pumped
~/~ : for l~/~
Temporary Holding Tank Permit (Y/N) /V///'I
To Property' Line,
)-6 Water Main/S~rvice Line
' Codrse - Il00
100
TO Building Foundation .'~,~
To Disposal Field '7
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2 .:
72 026(11/84) /
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata /,_~"'O ,~,/'~_~J'~
Date Installed
Width of Field ~//¢/¢¢.4/~(ff/'V'
square Feet of Absorption Area
Depression over Field (Y(~
Results of Last Adequacy Test
Type of System Design
Length of Field ,':~O /
Depth of Field // /
Gravel Bed Thickness ¢"
~t~'''IL Standpipes Present (Y/N)
Date of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation ~,.~
Lot
To Water Main/Service Line /V'/.~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area ,
To Properly Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present) /'kC/,/':)
lO0
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dimensions
,, Manhole/Acc~
,,/~ "Pump.Off Level at __
~¢'//~ /Vent(Y/N,__
' / Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N) ~
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 Q-~,~.~]~ Date
Company I I/~ ~::CJ~,
Receipt No.
Date of Payment
Amount: $ .~ % '%~
Page 2 of 2
72-026 0 1/84)
ALASKA eI dlROFImeFITAL COIqTROL
~n§i~mn§ $ ~,ui,'onmcnlol $ludks
WILLIAM BRATTON
10900 VOSIKOF PLACE
ANCHORAGE ALASKA
99516
SELLER-WILLIAM BRATTON
08/22/86
WILLIAM BRATTON
10900 VOSIKOF PLACE
ANCHORAGE ALASKA
99516
60449
LEGAL:TIMBERLINE SUBDIVISION BLOCK 0 LOT 10
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-08/18/86
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 450 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 700 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT HAS NOT BEEN PUMPED WITHIN THE PAST YEAR.
THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
FLOW TEST ON WELL
WELL FLOW DATE--08/18/86
A FLOW TEST WAS PERFORMED ON THE WELL. 450 GALLONS OF WATER WAS
PUMPED AT A RATE OF 1.1 GPM OVER A DURATION OF 2.5 HOURS.
THE DRAWDOWN WAS 111.5 ' WITH A RECOVERY TIME OF 60 MINUTES
AND THE STATIC WATER LEVEL WAS 8.2 FEET.
THE WELL IS ADEQUATE FOR THIS 3 BEDROOM IlOME.
i200 ~Jcsl 33rr~ Auenu¢, Suit~; [~*,~nchora§¢, Al,si, 99503.(907) 561-5040
ALASKA b,dIROrlml [1TAL COF1TROL
~n§ineerinq $ ~nuironmenlol Studies
WILLIAM BRATTON
10900 VOSIKOF PLACE
ANCHORAGE ALASKA
99516
SELLER-
8122186
WILLIAM BRATTON
10900 VOSIKOF PLACE
ANCHORAGE ALASKA
99516
60449
LEGAL:TIMBERLINE SUBDIVISION BLOCK 0 LOT lO
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-8/18/86
THE TYPE OF ABSORPTION SYSTEM IS A TRENCII WITH AN AREA OF 450 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 700 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
2 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR
THIS 2 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT HAS NOT BEEN PUMPED WITHIN THE PAST YEAR.
THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
FLOW TEST ON WELL
WELL FLOW DATE-8/18/86
A FLOW TEST WAS PERFORMED ON THE WELL. 450 GALLONS OF WATER WAS
PUMPED AT A RATE OF 1.1 GPM OVER A DURATION OF 2.5 HOURS.
THE DRAWDOWN WAS 111.5 ' WITH A RECOVERY TIME OF 60 MINUTES
AND THE STATIC WATER LEVEL WAS 8.2 FEET.
THE WELL IS ADEQUATE FOR THIS 2 BEDROOM HOME.
ut,p, ,,II~ ~/, ·
561-5040
.S WA,m ·
~:' BACT~IOLOGICAL MATER ANALYSIS
TO BE COflPLETED BY MATER SUPPLIER
D~TE COLLECTED TINE COLLECTED
TYPE OF ~.YSTEH
Iml PUBLIC/I~INDIVIOUAL
I.D. NO. (PUBLIC'SYSTEMS) CIRCLE CLASS
{ I m t I I I A B C
~ OF SYSTEM TELEPHONE NUMBER
SYSTEM ADDRESS
CITY STATE ZiP CODE
LOCATION WHERE SAMPLE WAS COLLECTE
BY:(SI
TYPE OF SAMPLE
(CHECK ONLY ONE THIS COLUMN)
~ORINKING WATER
r~-' ~CHECK TREATMENT
[] NAW SOURCE WATER
[] NEW CONSTRUCTION OR REPAIRS
I'1 OTHER(Specify)
IS THIS SAMPLE A CHECK SAMPLE TO A PREVIOUS NON-CONFORMING SAMPLE?
[] YES ~NO PREVIOUS COLLECTION DATE
ANALYSISREQOESTED (IF OTHER THAN TOTAL COLIFORM)
SEND REPORT TO:(PRINT FU~L NAME,ADDRESS AND ZIP CODE
NAME
ADDRESS !zno
[:]CHLORINATED
[]FILTERED
TREATED OR OTHER
~OR
D RESUBMIT SAMPLE
Sarmple rejected because:
CHECK ONE OR MORE
I-I Sample too long in transit.
Sa~q)le should not be over 30 hours.
[] Sample received too late in week
FI Not in proper container
I-1Leaked out
m-1 Ir~uffictent information provided.
Please read instructions on form.
I-) Other (Specify)
RECEIVED FROM
RECEIVED BY
DATE ~-/-5~-,q~ TIME
ANALYTICAL METHOD:
~BRANE FILTER
F1FERMEflTATION TUBE
Date & Time Started
Date & Time Completed~/le]B~;
LABORATORY RESULTS
~ Other Bacteria
[] Test unsuitable because:
{-1 Confluent Growth
[] T~TC
SATISFRCIDRY [~UMSATISFRCTORY
BACTERIOLOGICAL MATER ANALYSIS RECORD
FOR LAB USE ONLY
F-~ TOTAL COLIFORNS
~ FECAL COLIFORNS
[] OTHER
Membrane Filter: Direct Count
Verification: LTB
Final Membrane Filter Results
Reported By
Coliform/lODml
BGB
Coliform/lOOml
Date
Time
READ SANPLE COLLECTION INSTRUCTIONS ON BACK OF FORIN
ISAACS PUMPING SERVICE
(Norm Tibbetts Owner)
62~.8 Quinhagak Street
ANCHORAGE, ALASKA 99507
Phone 563-3300
ALASKA ENVIRONS'rENTAL
CONTROL SERVIC: ; INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEET NO* OF
CALCULATED BY ~'~ ~/*K D AT E ~~-
CHECKED BY DATE-
, APPLI(Y NT FILLS OUT UPPER HAI"' -TDNLY
'Prop6?yOwngr JOHNSON, Steven & Nancy Phone
..- " C/O SECURITY NATIONAL BANK 276-6800
Maging Addre~ 880 H Street, Anchoraqe, Alaska mp Code 99501 Steve Johnso
Buyer BRATTAIN, Georgianna
c/o FOSTER & MARSAHLL AMERICAN EXPRESS
Address 544 West 5th Avenue, Anchoraqe, Alaska rap Code 99501
Lending Inslilulio. NATIBNAL BANK OF ALASKA Phone
Main Branch: Att: Ruth LeBarr 276-1132
Address Pouch 7-025 Anchoraqe, Alaska mp Code 99510
RealtyCo.&A~nl DYNAMIC REALTY, INC. Att: Connie Yoshimura Phone
279-7611
Address 501 West Northern Liqhts Blvd, ANchoraee. AK mpcode 99503
L,gal D,soription LOT 10, TIMERLINE SUBDIVISION
Slreel Loc.t)~ 10900 Vosikof Drive
Ty~ of Residence
Single Family
[~ Multiple Family No. of Bedrooms 3:
Individual ATTACH WEEL LOG. A wcfll Icg is required for all wells drilled since June 1975.
[}~ Community For wells drilled prior to that date, give well depth (attach Icg if available).
Se er Disposal
~ Individual Year Individual installed: /'-t
[] 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 P~
Field Notes:
~,~?,.~ ~ _ t.~,_.~c.,_~ L..[~,.~C~O~ ~ ~~ NtUNICIPALITY OF ANCHORAGE
DEPT. OF HEALI'tl
(.~__.n ~.~._ ~(~ .~.,~ ,,-~ ¢-4' ~ ~,~-~'~ ENVIRONMENTAL PROTEC HON
· RE£EIVED
( -~ ) APPROVED BEDROOMS *COND TONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL*
Soils Rating Dale Sewer Installed Well To Absorption Area /~.~!'~ '~ Well Log Received
~ / WelltoTank / ~" Septic Tank Size //,
. ' CHEMICAL & GI~ LOGICAL LABORATORIES ,,./ ALASKA, INC.~
,i~ ~ TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER
/~_~ 5633 B Stre et
Z,-- .... ~,,~'-~ Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
t;Vat~r System Name~,/
I.D. NO.
Phone No.
Hailing Address
City ..~.r . .. .. ' ~¢'~ ~"' Stat~ ' Zip Code
MO. Day Year
SAMPLE TYPE:
fl~outine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO.
2
3
4
5 I
LOCATION
Time Collected
Collected By
I/~--~
I
I
TO BE COMPLETED BY LABORATORY
Aha ysm snows this Water SAMPLE to be:
/
~, Satisfactory
[] Unsatisfactory-
[] Samele too ong in transit; samole should
not be over>48 r~ours old at examination
to qo ca[e r¢.~iaol¢ resplts, Please send
·" /~ew ~§m~le%'!~ ....
Time Received "~ f~ ~'0
Analytical Method:
[] Fermentation Tube
'~Membrane Filter
Lab Ref. No. Result* Analyst
I r-FI
I m
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
pt-esum pt lye 10mi 10mi ],0mi 10mi 10mi 1,0mi 0.1mi
24 Hours
Final Membrane Filter ReSults (~
, .,. CHEMICAL & G, LOGICAL LABORATORIES . ALASK , INC.
'~' , TELEPHONE (907)-279,4014 ANCHORAGE INDUSTRIALCENTER
/274-3364 5633 B Street ,
/-'" ....... ~ Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
,~ I.D. NO.,
Water Sysmm Name Phone No
Mailing Address
City State Zi¢ C~:~e
Mo. Day Yea3
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE Time Collected
NO. LOCATION ~_../ ~:",/~: ~ 'l Collected ~ B~.~)
I I
, I
TO BE COMPLETED BY LABORATORY
Ana yms snows this Water SAMPLE to De:
~ Satisfactory
[] UnSatisfactory
[] Sample too long in transit: sample should
no[' De over 48 3ours old at examination
to indicate reliable results Please send
new sample
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
~]~ Membrane Filter
Lab Ref. No. Result* Analyst
I I
I :-~
I r-~
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collected _ Source
24 Hours
Conflrmetory
24 HOURS
Date
January 13~ 1982
Gary Bliss
c/o Steven & Nancy Johnson
Pouch 7-777
Anchorage, Ak 99510
Slbjact~ Lot 10, Timberline Subdivision
Dear Mr. Bliss~
Approval for the individual sewer and water facile, ties cannot
be granted until the following items have been completed~
Exposed e]ectr~ca! wires to the well head are in violation
of the Municipality of Anchorage codes and must be encased
in conduit.
The water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B Street, for our review.
° The standpipe to the sewer system need caps on them.
Please notify this department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincere].y,
Robert C. Pratt
Associate Environmental Specialist
unicip' it¥
Anchora/ e
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES.
MA YOI~
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
March 12, 1984
Janna Brattain
10900 Vosikof
P.O. Box 104491
Anchorage, AK 99510
Subject: Well Waiver Request - Lot 10,
Timberline S/D
Dear Ms. Brattain:
Upon receiving your written request for a waiver from the 100 foot
separation distance between your present well and onsite sewer
system, and upon meeting with Mr. Mike Davidsavor and Ms. Ronda
Carmen of Frontier Drilling, I personally made an onsite inspection
to determine the feasibility of the request ~or waiver° This
inspection was made on Friday, March 9, 1984, the same day in which
your request was received and the meeting occurred with Frontier
Drilling° On Monday, March 12th, I also received additional
information, including an accurate surveyed plot plan which will
serve as an engineered as-built diagram of the present system.
I've determined that a waiver should not be qranted, that a new well
location can easily be found 15 to 20 feet south of the present well
location, in a direction opposite to that initially requested.
This proposed location would not require a waiver of separation
distance.
I should point out that a permit from this Department would be
required for any new well or re-drilling of the existing well, and
an inspection must then be conducted by this Department or by one of
our certified registered engineers from the private sector.
Additional requirements and notes of caution are:
o Well installation must be made in accordance with MOA Chapter
15.55 Water Well Standards.
A well log will be required by this Department for our files and
showing:
- a well yield of at least 0.104 gallons per minute per bedroom
on a sustained basis, as determined from a 4-hour Dump test
whereby discharge, drawdown, and recovery are recorded;
- an installation depth of at least 40 feet, according to ~OA
Chapter 15.55;
Janna Brattain
March 12, 1984
Page 2
- well location (plot plan) with respect to the original well and
onsite sewer system;
- soil/rock formations;
- depth to which casing was installed (must not be less than 40
feet);
- depth of grouting;
- static water level;
- depth of pump intake;
There should be no depression (ground surface) around the well
casing, a sanitary seal must be provided, and all wiring encased
in conduit according to municipal electrical/building codes.
Location of the well should be adjacent to but not within the
road right-of-way easement. This easement boundary can be dif-
ficult to accurately locate without a proper survey.
Storage/reservoir facilities will likely be necessary if a low-
volume well yield is encountered (e.g. pressure tank system). A
pump design incorporating a device allowing the pump to shutdown
in the event total drawdown to the pump intake is frequently
reached may also be required. Several such devices are readily
available. This would protect the pump from sucking sand or from
burnout.
If I can assist you further, please contact me at 264-4720.
Sincerely,
Keith E. Bandt
Environmental Engineering Manager
Department of ~{ealth and
Environmental Protection
KB2/p/D9
cc: Files
Janna Brattain
10900 Vosikof, Lot 10, Timberline
Subdivision
P.O. Box 104491
Anchorage, AK 99510
March 8, 1984
Mr. Keith Brett
Department of Health
Municipality of Anchorage
Hillside Water and Sewer Division
825 L Street
Anchorage, AK 99501
Dear Mr. Brett:
RE: Request for Variance
I am requesting a variance on the requirement for 100-foot separation
between my septic system and domestic water well. My existing water
well is dry. A new one must be drilled as soon as possible. The
existing site cannot be used because the casing is fractured, and
will collapse if re-drilled. It is also likely to be a low or non-
producing site. The best sites, which would comply with the 100-foot
setback from the septic system, would be in conflict with the right-
of-way for Vosikof Place and with the property line for the adjacent
lots.
Due to the steepness of grade, appropriate sites are limited as most
are inaccessable. The well drillers recon~end placing the new well at
a distance of 80 feet uphill from the septic system, which gives suf-
ficient setback to the road right-of-way. The drainage field extends
downhill, approximately twelve feet lower on the grade than the proposed
well site.
Enclosed is a copy of the plot plan for the lot with the proposed site
noted. I would appreciate your prompt attention as I am presently
without water. Thank you for your assistance.
Very T~.lf~o~r s,
DESCRIPTION N
,i
'SURVEYOR'S CERTIFICATE
FOR TITLE INSURANCE PURPOSES ONLY:
I, Clint Finstad, a registered Land Surveyor ~n the State of Alaska, hereby
certify that I am familiar with the improvements locate~ within the above
described tract, and that thebe improvements l'ie wholly within the property
lines, and do not overlap onto adjacent property, that no improvements on
the mroperty lying adjacent thereto encroach upon the premises in question
except as shown, and that there are no roadways, transmission lines, or any
'other visible eaaements, ~xcept as indicated hereon ....
p R~E P AILED FOR:
PILEPARED BY:
ALASKA ARCHITECTURAL &
ENGINEERING CO., INC.
P.O.BOX 10-1126
ANCHORAGE, ALASKA 99511
248-1212
CLINTON FINSTAD, LAND SURVEYOR
DATE: SCALE
30B NO.
CHE,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing,
1. PROPERTY OWNER
GARY BLISS
PHONE
MAILING ADDRESS
ANCHORAGE, AK
PROPERTY RESIDENT (If different from above)
NEW CONSTRUCTION - NOT OCCUPIED AT THIS TIME
2. BUYER
STEVEN J. & NANCY L. JOHNSON
MAI LING ADDR ESS
C/o Pouch 7-777, Anchorage, Ak 99510
PHONE
PHONE
276-6800Ext210
3. LENDING INSTITUTION
SECURITY NATIONAL BANK
MAILING ADDRESS
Pouch 7-777, Anchorage, Ak 99510
4. REALTOR/AGENT
None
PHONE
MAILING ADDRESS
§. LEGAL DESCRIPTION
Lot 10 Timberline Subdivision
TREET LOCATION
NHN Vosikof Place
S
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
[~( SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~( Three [] Six
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY'
[] PUBLIC UTI LITY
[] Other
* ATTACH WELL LOG. A well log is requ'ired for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
s. S WAGE G,SPOSA'SYSTEM /
I~ INDIVIDUAL/ON-SITE** ndividual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
[] PUBLIC UTI LITY by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
0{3/7B)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
I. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY ~/
Connection Verified INSTALLER
E~Septic Tank ~r [] Holding Tank
Size:~ If Tank is homemade SOILS RATING
give dimensions:
TYPEOETANK MANUFACTURER-- ,~ -
TOTAL ABSORPTION AREA MATERIAL
"~"'~A''~'~¥~'~'~- Sewer Nearest Lot
4, DISTANCES Septic/Holding Tank bsorption Area Line Line
/
WELL TO:
Absorntion Area to nearest Lot Line
5, COMMENTS
EZ~APP ROV ED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY (Title) / ) ,
/
LEGAL DESCRIPTION
72-010 (Rev, 3/78)