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HomeMy WebLinkAboutTIMBERLUX #2 BLK H LT 3Onsite File Timberlux #2 Block H Lot 3 #018-271-52 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number:. OSP201429 PID Number: 018-271-52 Dwelling: X Single Family (SF) R with ADU El Duplex (D) EJ Two Single Family Project: EJ New NO Upgrade Name STOUT FAMILY TRUST ABSORPTION FIELD Site Address 4840 MANYTELL AVENUE *ANCHORAGE, AK ❑ Deep Trench RE Wide Trench [:1 Bed El Mound PhoneNum7ber Number Bedrooms Soil Rating ..E1 Other Total depth from original grade 907-345-1038 3 0.6 GPD/SF SEE DWG. Ft LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot SEE DWG3.57 TIMBERLUX #2; BLOCK H, LOT 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section SEE DWG Ft. 83 Ft. Gravel width SEPARATION DISTANCES 5 Ft. Beds: Number of Lines Distance between lines To Ft. Septic Absorption Lift Station Holding Sewer Number of —trenches Dist. between trenches From — Tank Field — Tank Line 750+ Ft2 1 Ft. Well 100'+ 100'+ 100'+ - 25'+ TANK El Septic [9 S.T.E.P. El Holding El Other Manufacturer Capacity Surface Water 100,+ 100'+ 100'-x- — GREER TANK 250 Gal. Material umber of compartments Lot Line 10'+ *1'+ 51+ - NA HDPE 2 Lift Station 10 otion I!Jg 1 N Foundation + JU+ 10 '+ LIFT STATION 10' 10'+ 10'+ I Manufacturer Capacity Remarks OLD TANK DECOMMISSIONED PER UPC PER CONTRACTOR GREER TANK 412.5 Gal. *SEE ATTACHED WAIVER REQUEST Alarm locationElec trical installed by UPSTAIRS BEDROOM CAPSTONE Tank to Installer A+ HOME SERVICES PIPE MATERIAL House to tank D3034 drainfieldEXISTING/178,1. Drainfield D1785 CO/MT D3034 inspector GEG AND TIM ECKLUND BENCH MARK (Assumed elevation) 98.45 ft Inspection 2nd 15, 6/23/2021 6/23/2021 Location and description dates: 3rd _6/_24/21 41h TOP OF MW ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stqmp Conditional Approval: Date•0F .......... ao TH Septic System J ff A. or ess'­ 'P, Approved Date 4 10J) CE 7953 C, 2=7 Note: this approval does not include well permit requirements. p� r 0 f e S slo�' (Rev 05/02/18) #AECC884 PERMIT NUMBER: OSP201429 A I B 41.0 125.8 M�H2 44.7 128.8I [MH1 76.1 105.02 152.7 178.0 I TIMBERLUX #2; BLOCK H, LOT 4 VACANT PER MOA RECORDS TIMBERLUX #2; BLOCK H, LOT 10 AWWTS RECORD DRAWING • �_ .t+ : GARAGE N EXISTING DECK HOUSE J \ O O 1250 GALLON STEP TANK ----------------------- 10' UTILITY EASEMENT TIMBERLUX #2; BLOCK H, LOT 11 AWWTS ONLY THE SOUTHEAST LOT CORNER WAS STAKED DURING CONSTRUCTION. THE SURVEY BY WALATKA SHOWS THAT THE MONITORING TUBE IS OUTSIDE OF THE EASEMENT. HOWEVER, IT IS IMPORTANT TO NOTE THAT THE EAST LOT LINE AND THE SOUTH EASEMENT WERE NOT FLAGGED DURING CONSTRUCTION; SEE ATTACHED LETTER REQUESTING A WAIVER TO THE EAST LOT LINE u LI ENGINEERING SALES,- CONSULTING .., 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507 -PHONE (907) 3376179' FAX (907) 336-3246' WEBSITE:—.g.ne—gineering.c.. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MIKE AND SANDIE STOUT 907-345-1038 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: TIMBERLUX #2; BLOCK H, LOT 3 D.J.G. TYPE OF WORK: DATE: SEPTIC SYSTEM RECORD DRAWINGS 9/8/2021 PARCEL ID NUMBER: 018-271-52 100 WEL�RADjUS J TIMBERLUX #2; BLOCK H, LOT 2 / NEW DRAINFIELD ' 'WAIVER REQUEST TIMBERLUX #2; BLOCK H, LOT 12 1"=40' sms mw 4 ...... .. .... .... 0 0. '00f� �; ea ess ' C i y # CE -79 3 LIC ENSE1��;� `S` #A 88 / PERMIT NUMBER: PARCEL ID NUMBER: OSP201429 RECORD DRAWING 018-271-52 TOP OF TANK AT INTLET = 95.34 INVERT OF BUNG AT INLET = 94.68 NO STANDING GROUNDWATER IN TANK HOLE NOTED DURING EXCAVATION TOP OF MANHOLE = 98.45 MH1 MH2 TOP OF MANHOLE = 98.54 INAL GRADE = 98.0-98.2 2" INSULATION PER CONTRACTOR OF TANK AT OUTLET = 95.33 NEW 1250 GALLON GREER TANK WITH ORENCO COMPONENTS TO BE USED AS STEP TANK MT r FINAL GRADE= 115.0-115.9 FILTER FABRIC 2" INSULATION BOTTOM OF OLD TRENCH ELEVATION = 108.95 BOTTOM ELEVATIONOF - • • TRENCH = 112.25 DIAMETER PVC �WITH 0.25" HOLE 36" ON CENTER .;.; .;.;:::•5:.::a• ' - 5' -j __�--BOTTOM OF EXCAVATION = 107.7-108.7 7 ENGINEERING- SALES CONSULTING ) 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 • PHONE (907) 337-6179 -FAX (907) 338-3246 • VVESSITE: w.nw.9amessensDneannp com PREPARED FOR: MIKE AND SANDIE STOUT LEGAL DESCRIPTION: TIMBERLUX #2; BLOCK H, LOT 3 TYPE OF WORK: PROFILE OF NEW S.T.E.P. TANK PHONE NUMBER: 907-345-1038 PAGE NUMBER: 30F3 DRAWN BY: D.J.G. DATE: 8/26/2021 Municipality of Anchorage P.O. Box 196650 e 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV201071 COSA#: Permit#:OSP201429 PID#: 018-271-52 Legal Description: Timberlux #2 Block H Lot 3 Engineer: Garness Engineering Group Applicant: Mike & Sandra Stout Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 0.0 feet. See engineer's waiver request for justifications. Proposed field is a rebuild of the field installed in 1993. This field has been in operation for 27 years with no observed effluent surfacing. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ( 1 C� O LAA .) l_21i.,lA. V oma " 4V ego -� P ro ,pe.r � W a. ve, and a� O ""-L4 (l�J`i'?t1e r %a ro i ale a mo n i `i) �-i At i'le. btnw cn the //� cvAe. �d. SeloC,n�ineer'S le -fit -� SHf7*c-.c 'on. ■■■■.■■■■,[�y■■ ■■■■■■■■■■■ ■■■■■■■..■■■■■■■ ■■■■■.■■■■ ■■.■ ■.■ ■■...■.■■■..■■■1 Waiver is Granted: X Waiver is not Granted: Date: a Saab Approved by: Name of Reviewer .............. ■ ........................... ■ ■ ■ ■ ■ . ■ ■ ■ ■ .. ■ ■ ■ .... ■ ■ ■ ■ ...... ■ ■ ... ■ ■ t **** VARIAN C E/WAIVER REVIEW **** Y - „ November 12th, 2021 Municipality of Anchorage ,.�, • .,y j Development Service Department On -Site Water & Wastewater Program .... . S 4700 Elmore Road J • y A.�Gamass Anchorage, AK 99507 11;,F��. . • ���� `'i3O pROFESS40NP.o"'' Ref: Proposed Septic Tank Upgrade for Timberlux #2; Block H, Lot 23 To whom it may concern: The subject lot had a new STEP tank and drainfield installed in 6/23-25/21. Per the design, the contractor was to have the east lot line and south easement flagged by a PLS prior to construction. This did not take place. However, the southeast lot corner was staked, and we were rebuilding the existing drainfield, which was located outside of the easement (per the 1993 inspection report and as -built for the design). Per the attached updated survey by Walatkas, PLS, the drainfield is outside of the easement, but encroaches on the east lot line. We are requesting that your department issue a variance form drainfield to lot line from 10 feet down to 1 foot. In addition, it was noted on the permit that a monitoring tube was to be installed at the "bend" of the trench. This did not take place. We are requesting that your department allow for the trench to remain "as is" without the monitoring tube at the bend of the trench. Justification for granting this waiver is as follows: • This is a rebuild of an existing system. This encroachment has existed since the initial installation of 1993. • The new drainfield does not encroach upon adjacent wells and/or septic systems. • Both ends of the drainfield have a cleanout and monitoring tube. In addition, the trench heads northwest, away from the east lot line and adjacent wells. In short, while an additional MT the bend would be "ideal' it is not "critical' to ensure that public health and safety are maintained. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Website: www.garnessengineering.com 1PAL)T Municipality of Anchorage Address: Development Services Department . . . . . . . . . . . . . . . . . P.O. Box 196650 - 4700 Elmore Road Inspector: Anchorage, Alaska 99519-6650 Info and Help: (907) 343-8211 INSPECTIONS: Voice: (907) 343-8300 Fax: (907) 249-7777 6/29/2021 Inspection Report License/AP#: RETROE211286 Parent AP#: Inspection #: 668680 Type: DPRETRO Status: Closed Address: 4840 MANYTELL AVE Parcel: 01827152000 Inspector: N.Holland Project: Resp Party: Descr: Lift station Inspection Electrical (Electrical Inspection) Item: Evaluation: Approved Result Notes: Electrical Install Approved Ins,,nection item lt--ii Desc�-ipflion Evaluaiion MAWTELL AVErgUe Metal (date L� lso 59 O 7, ra k• w_i:� .. Van � Septic vent 107_64 ity Easement LOT 3 Lot 10 I N86655'04" W 150.0(} Lot 11 n .J L0 in 0 a 0 PIN Lot 2 8491Y SCALE; 1"= 50' rit 1 ■49th I� ■ 00 % �, ■.beth ow W: �rF • 8036 - LS ` AW FESSIatSAG � ■ ■�t�� 7-8 • zr RECERTIFIED 5-321 AS -BUILT NO-COTRNERS SET THIS DATE 11 I hereby certify that I have performed a Mortgagee's Inspection In accordance with ASPLS Standards of the following described property: LOT 3 BLOCK H TIMBERLUX SUBDIVISION ADDITION No. 2 Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises In question and that there are no roadways, transmission lanes or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 22nd day of September, 2020. THOSEE SHOWN ON THE RECORDED EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES, L.L.C. HO PLAT ARE NOT SHOWN HEREON FB 21"5• pg 25 Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 20-5, pg 33-35 BE 907-248-1666 This drawing Is a repm3ontatlon of conditions found at the time the mortgage location survey was performed. Th1s document does not constitute a boundary survey end is subject to any Inaccuracies that a subsequent boundary survey may disclose, The Information contained on this drawing shall not he used to establish any fence. structure or other improvements_ This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of Bees collected for services in preparation of this product. rT�, .• .Se ,� �. Li� Asphalt Lot 4 welt .._ 24.0 CIA w 1.8 OH q o OeQk � v N d Q [D 29.7 24LO to Go 0 0 CD z 03 Manhole Septic vent 107_64 ity Easement LOT 3 Lot 10 I N86655'04" W 150.0(} Lot 11 n .J L0 in 0 a 0 PIN Lot 2 8491Y SCALE; 1"= 50' rit 1 ■49th I� ■ 00 % �, ■.beth ow W: �rF • 8036 - LS ` AW FESSIatSAG � ■ ■�t�� 7-8 • zr RECERTIFIED 5-321 AS -BUILT NO-COTRNERS SET THIS DATE 11 I hereby certify that I have performed a Mortgagee's Inspection In accordance with ASPLS Standards of the following described property: LOT 3 BLOCK H TIMBERLUX SUBDIVISION ADDITION No. 2 Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises In question and that there are no roadways, transmission lanes or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 22nd day of September, 2020. THOSEE SHOWN ON THE RECORDED EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES, L.L.C. HO PLAT ARE NOT SHOWN HEREON FB 21"5• pg 25 Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 20-5, pg 33-35 BE 907-248-1666 This drawing Is a repm3ontatlon of conditions found at the time the mortgage location survey was performed. Th1s document does not constitute a boundary survey end is subject to any Inaccuracies that a subsequent boundary survey may disclose, The Information contained on this drawing shall not he used to establish any fence. structure or other improvements_ This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of Bees collected for services in preparation of this product. MUNICIPALITY OF ANCHORAGE [n -Site Water &Wastewater Program POBox 1966x50 47OnElmore Road Anchorage, Alaska g951S-6GS0 Phone: (907) 343-7904 Fax: (S07)o43.7g07 hUp:Vwmwwmvniorg/omaoa Permit Number: OGP201429 Work Type: Septic Upgrade Tax Code Number: 01827152000 Site Legal Address: TIMBERLUX #2 BLK H LT 3 G:3136 Site Mailing Address: 484OMANYTELLAVE, Anchorage Owner: STOUT FAMILY TRUST Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Lot Size in Sq Ft: Total Bedrooms: 1O/2O/2O2O 101 20/2021 ElDisposal Field 0Septic Tank 11 Holding Tank 0Privy 11 Private Well []Water Storage All construction shall beinaccordance with: 1. The attached approved design. 2. All requirements specified inAnchorage Municipal codChapters 1555 and1566 andm State ofAlaska Wastewater Disposal Regulations (1 8AAC72) and Drinking Water Regulations (1 8AAC80) _. The '.--'-.'-'-r -_-- r -q__- '_,_----_—...g the installation. The engineer shall notify ... ~~...~r..~..` Services Department per AMC 15.85.Provide notification bycalling (BO7)343-78O4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: a. Opened and Closed nnthe same day, o/ b. Covered, sealed, and heated hoprevent freezing CSp:ecial Provisions: \fitisdetermined that the field |sless than 10ftfrom the property line, awaiver shall ba requested prior (oinspection report approval. Received By: jL, Issued By: 3 On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 018-271-52 Property owner(s) MIKE AND SANDIE STOUT Mailing address 4840 MANYTELL *ANCHORAGE, AK 99516 Site address 4840 MANYTELL "ANCHORAGE, AK 99516 Legal description (Sub'd, Block & Lot) TIMBERLUX #2; BLOCK H, LOT 3 Legal description (Township, Section & Range) Lot Size APPLICATION IS FOR: ( ® all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Sq.Ft. Number of Bedrooms APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ Day phone 907-345-1038 3 TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: -WA- ��ie �e� EJ1C Ce1-\.b i V S Lo P Distance: - l certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: 10113 , / aog 0 Receipt Number: 0 ' ( G G Permit No. ose)oIgaq Receipt Number: 70 3 3 Waiver No. ©SN 0b 1 0`1 � (Rev. 01/11) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201429, Rebecca Carroll, 10/20/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201429, Rebecca Carroll, 10/20/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201429, Rebecca Carroll, 10/20/20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES y 825 "L" Street, Anchorage, Alaska 99502-0650 �a SOILS LOG -- PERCOLATION TEST C l Y PERFORMED FOR: JANID- RA DATE PERFORMED ?,�'x1`F •f-,`(;} �E>a ' RERLum S17-), L= �, &r 14, Township, Range, Section: LEGAL DESCRIPTION: tIM(rte, Lot 4 d' CID N 1�- N 14 L0 d 0 d d Lot 10 MANYTELAVENUE R=1270.00 _ Metal gate 50, 30.0 :c Asphalt :'w'= �v Garage a Wellj 30,0 N .o .axN- 1.8 OH o g 0 o deck cp�2N N � � co LOT 3 o Manhole Septic vent (typ) J 10' Utility Easement r` LO Lo d O CD d ko Lot 2 AS -BUILT SCALE: 1"= 50' OF , qL�s ®��•. ,. U,. 49th .�9 �I °" I 00 . ... .. % �,'. lizabeth L. Walotka ff so t� �IPA • • 8036 - LS • • Jeyes,;' ZO O1:'ESSIONP-•�-%:411— % %\v%l 7, d NO CORNERS SET THIS DATE N8655'04"V}/ 50.00 I hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: LOT 3 BLOCK H Lot 11 ' TIMBERLUX SUBDIVISION ADDITION No. 2 Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 22nd day of September, 2020. EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES, L.L.C. THOSE SHOWN ON THE RECORDED Engineers and Surveyors PLAT ARE NOT SHOWN HEREON FB 20-5. 33-35 BE 907-24&1666 UNLESS OTHERWISE NOTED. p9 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and Is subject to any Inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other Improvements. This drawing shalt only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka Is a violation of Federal Copyright law. Unless gross negligence Is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: '~u~, _~-~--'~ ~ ~ '~- PID Number: N~:~i~ ~ ~~ ~ Wastewater System: ~ New ~ Upgrade Address: ~D H~T~ A~. ~z~ ABSORPTION FIELD Phone: INo of~OOms: ~DeepTrench ~hallowTrench ~Bed ~Mound ~Other LEGAL DESCRI PTIO N so, Rating: ~. ~ GPD/Sq. Ft. Total Depth from original Lot: ~ Block: ~%~¢Subdivisi°n; ~ ~ Depth to pipe bottom lmm origina,~d~: Ft. Gravel depth beneath pipe ~*~ / Ft. Township: IRange: [Section: Filladdedaboveoriginalgrade:~.~t. Gravellength: ¢/ /Ft. WELL: D New Q Upgrade Gravel width: ~ /Ft. Number of lines:[ I Distance b¢~, tween lines:Ft, Classification (Private, A,B,C): ~ Total Depth: Cased TO: Total absorption area; Pipe material: Driller: Date Drilled: Static Water Level:F,. ~ ~~. Dateinstalled~/ Yield: GPM J pump Set at: Ft. Ic¢'~"e"""'h'Ab°v" ar°""':Fb TANK SEPARATION DISTANCES ~ s~.t~c u Ho~di.g M~~ ~ Capacity in gallo S: To Septic AbsoCption Lift No~ding Public/Private SurfaCewater Ilo' ~O~ I1¢¢ ~ -- LIFT STATION LOt SiZ~n gallons: I Manufacturer: CurtainDrain ~ ~ ~} ~ ~'P"¢P~a~ ~ Electrical Inspections performed by:/ ~ I ~'¢.~. Remarks: ~ ~~ ~~ ~ BENCH MARK * Location and Descrfption: ' S & S EHGINEERING , Inspections performed by: ~1~= ~577 Dates: lst~ q~ Department of Healt uma~vices approval Reviewed and approved by: ~~/~ Date: ~ 72 013 (Rev 9/91) MOA25 Permit No. 2 2 $W930137 r'ag of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description:TIMBERLUX SUBDIVISION #2, BLOCK H, LOT $ PID No.:01827152 I S.T.E.P.. ~"~, / / HOUSE / / \ / ~0 ~01 COg iMT1 MT2 MH COZ C02 ENGINEER~ SEAL /FIN~ GR~2 MT1 INSULATION ~ 9~,~ NEW 93 ' S.T.E.P. · sYSTEM ~105.5' N.T.S. 100.5' WATER FOUND 5/3~92 72-013 A (Rev. 9/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930137 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:STOUT MIKE & SANDRA K OWNER ADDRESS:4840 MANYTELL AVE ANCHORAGE, ALASKA 99516 DATE ISSUED: 6/02/93 EXPIRATION DATE: 6/02/94 PARCEL ID:01827152 LEGAL DESCRIPTION: TIMBERLUX #2 BLK H LT 3 LOT SIZE: 40567 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECeiVED ISSUED BY: ~-~ ' ~ / DATE: DATE: Tom Fink, Mayor Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 June 1, 1993 Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 3 Block H Timberlux Waiver Request ~WR930029, PID #018-271-52 Subdivision #2 Dear Mr. Shafer: Your request for a waiver(s) of the required 100 foot horizontal separation of a septic system to the surface water has been approved. The approved separation distance(s) are 50 feet from the absorption field to the surface water. This waiver approval applies to the existing septic system to surface water separation only. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. Should the operation of the subject wastewater disposal system cause any contamination or degradation of the subject surface water, this waiver will become void. Sincerely, Civil Engineer On-site Services DJR/ljm ~?MUNICIPALITY OF ANCHORAG~~/ Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# ~ PID~ 018-271-52 Date Received: May 28, 1993 Legal Description: Engineer: HA# Permit # Lot 3 Block H Timberlux 92 Applicant: Robert A. Shafer~ P.E., S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska Mike & Sandra Stout 99577 Waiver Requested: of 50 feet Proposed upgrade absorption trench & surface water Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ List Conditions or Reasons Waiver is NOT Granted: for above: ~-~ /~/~ Rec ~: 24735/8115 Amount: $ 590.00 Date Paid: 5-28-93 i! MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL $SRVICES DIVISION L AY 2 8 199, ROBERT SHAFER, P.E. ROGER SHAFER. P.E. May 2 ,RE CEIVED CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & PLOW TEST SITE PLANS ROAO DESIGN SOl'TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS MUNICIPALITY OF ANCHORAGE D~partmcnt of H~alth and Human Servic~ ATTN: DAN ROTH P.O. Box 196650 Anchorage, AK 99519 RECEIVED BAY 2 6 1993 Municipality of Anchorage Dept. Health & Human Services REFERENCE: Lot 3; Block H; Timb~rlux SubdiviSion #2 D~ar Mr. Roth, Th~ l~t~er is an addendum to our le~t~r dated May 2, 1993. R~qu~St you issu~ th~ attach6d p~rmit r~qu~st~d in our prcviou~ l~tter and grant a ~iver for th~ horizontal s~paration d~tanc~ b~tw~¢n th~ proposed absorption trench and a surfac~ water sourc~ at 50 f~¢t. When th~ t~st hol~ ~ ~x~avat~d on this property and th~ s~ptic system absorption trench d~sign~d snow conditions w~r~ s~ch that a stream lo~at~d on th~ vacant lot directly to th~ ~ast was not r~adily d~fin~abl~. Attached ar~ photographs which will show th~ approximat~ lo,at, on of th~ proposed absorption trench along th~ ridg~ which runs in an approximat~ north/south dir~e~on. As you ~an s~ by th~ photograhs th~ t~st hol~ is lo~at~d on th~ w~st fa~ng slop~ of th~ ridg~ whil~ th~ stream is located in th~ Iow ar~a on th~ ~a~t sid~ of th~ ridge. This stream is shown on thc sit~ plan and was confirmed during a sit~ vlsltwhich was p~rform~d in your pr~s~nc~.. Ther~ is no other lo~ation on thc property thnt is suitabl~ for on-sit~ wast~wat~r disposal. Th~ ~a directly to th~ w~t of th~ ~dg~ ~ Iow lying prop~y and subj~ to ~gh orga~ lay,s and poorl~ p~a6l~ so~s. Th~ o~y ~t~r~v~ to t~ proposed upgrad~ wo~d be th~ i~talla~on of a holing ~nk. It ~ b6~n our ~xp~n~ th~ holing tan~ ~n ~ a gr~er ~nviro~ ~zard t~n an 6n~oa~ to thc s~rfac~ wat~ sours6 in t~ It is virtu~ly ~mpossibl& for ~fflu~nt from th& proposed absorption trench to affect th~ s~am lo~at~d on th~ opposit~ sid~ of th~ ridge.. Any failur~ in th~ absorption trench will caus~ thc ~fflu~nt to proceed in a down gradient dir~e~ion to th~ w~st. It is predicted that any contaminatio~ of this small stream wou~d probably result from an overflow of ~ff£u~nt on Lot 11 and Lot 12 directly to th~ south of this property. ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot $; B£o~k Hi Tlm§¢~lux Subdivision May 25, 1993 If you requir~ any addO~onat infa~matlon p£~a~¢ eontuet ~S. y~OBERT ~ SHAFE~ ~/gk ENCLOSURES ROBERT SHAFER, P E ROGERSHAFER. P E May 2, 1993 CIVIL ENGINEERS (907) 694-2979 FAX 694-!211 H EALTR AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST StTE PLANS ROAO DESIGN SOIL TEST Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Timberlux Subdivision ~2, Block H, Lot 3 Request you issue a permit to upgrade the existing septic system on the referenced property. The current property owners experience problems with their existing system every spring. The existing system is currently working in a surcharged state with periodic effluent backing into the floor drains within the house. A test hole was excavated and a percolation test performed on April 9, 1993. The ground water monitoring tube showed water at 10.5 ft. on April 19th and on May 3rd. The proposed trench is designed to follow the contour of the ridge which runs along the east property line. The referenced property lies in between two vacant lots. We do not anticipate any adverse effects on the neighboring properties by the installation of the proposed septic upgrade. If you have any questions, or require any additional information for your review, please contact us. Sincerely, J .am~. i 11 i ams A. Shafer, 'P.E. DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 50" UPGRADE SCALE LOT lz YT~LL AVENUE -- ~> _6) m -o L=z'J <~- ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PI~qCTICES and MATERIAL SPECIFICATIONS REFERENCE: Timberlux S/D #2, Block H, Lot 3 4840 Manyte11 Avenue GENERAL: 1. The scope of work covers the installation of the proposed septic system to serve the referenced property. The septic system consists of an 81 ft long pressurized wide drainfield trench with a 1250 gallon S.T.E.P. system. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Page 2 Timberlux S/D ~2, Block H, Lot 3 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed- up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Timberlux S/D #2, Block H, Lot 3 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank constructed by a manufacturer. proposed for installation must be Municipally approved septic tank The following septic system Anchorage: pipe materials are approved for use in installations in the Municipality of Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4e Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, it's gradation specifications must conform to AMC 15.65.060D. Page 4 Timberlux S/D #2, Block H, Lot 3 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3 o The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: C___~,~,.~[.~.[~ ~---'~'~'-(,3~'-."~ DATE PERPORME LEGAL DESCRIPTION: ttM[-~Z=Y/Lu'~ /~/ ]~T ~: /'~ b'(', Township, Range, Section: 1 2. 3- 4- 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- SLOPE SITE PLAN I N WAS GROUND WATER ENCOUNTERED? Depth to Waler After Monitoring? / ~.z~ rDate Reading Date Gross Net Depth to Net Time Time Water Drop I):q~,~ -- ~ Y.z " _ :~ to 3 Y'/" i; o,~; ,o ~ ~/.e" ~,~,. I : ~ /o 5 yq " y~,, : ~o Io Y Ye" ~ ,, PERCOLATION RATE t2~C) (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~AND ~ FT // /' __--- ' 72-00B (Rev. 4185) ' GREM2R ANCHORAGE AREA BOR..,,..JGH DepBrtment of Environment@l Quality 3330 C Street Anchorage, Alaska gUS03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS LEGAL DESCRIPTION SEPTIC TANK: DISTANCE EROM WELL tO INSIDE LENGTH INSIDE WIDTH ~ LIQUID DEPTH NUMBER OF ~f.~,-o I~s COMPARTMENTS 'Z- LIQUID CAPACITY J ~00 GALLONS. ~ DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA FOUNDATION DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH~ .OF LINES IN. TOTAL EFFECTIVE NEAREST LOT LINE_--.'.~IC) ''~ DISTANCE BETWEEN LINES P/~di'- TRENCH WIDTH,_-~ I SQ. FT. LENGTH OF EACH LINE ~ ~ .~2[ DEPTH OF FILTER MATERIAL BENEATH TILE ~(¢" IN. ABOVE TILE ~--~ IN. WELL: BUILDING ,~. ~ NEAREST ( NEAREST ~j/j~ SEPTIC FOUNDATION ~O~-, LOT LINE JO~, SEWER LINE , TANK~-, CESSPOOl / OTHER SOURCES / DEPTH DISTANCE FROM: SEEPAGE SYSTEM APPROVED_ DISAPPROVED REMARKS INSTALLED BY: ",~ 'J~' SEWER LINE DEPTH: PIPE MATERIAL: b~~C'~- ~ LOT SLOPE: DIAGRAM OF SYSTEM DATE ~q~/~_ APPROVED Form £Q*032 W~L OW~R ;~kL WATER WELL LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 to to_____ __t 0 ____tO to to__ ___to to __to ___~o tO___ PUMP TO BE SET AT tO TYPE OF SOIL RBSORBTION SYSTEM IS: NR~IMUM NUMBER OF BEDROOMS = THE REQUIRED SIZE OF THE SOIL RBSORPTION SMSTEM IS: THE LENGTN DIMENSION IS THE L. ENGTH (]:lq FEE]') OF THE TRENCH OR: C, RRtNFIEL.D. ]"HE [:,EPTH OF R TRENCM OR'. PIT IL-T, THE DISTflNCE BETHEEN THE St..IRFRCE OF ]"HE GROUNC, fiND THE BOTTOM OF THE E,",OZRVRTION (IN FEET). -['HERE IS NO '"':;ET WIDTH FOR TRENCHES. ]-HE GF..'flVEL DEF'TH IS THE MINIMUM DEPTH OF GRRVEL 8ETNEEN 'THE OUTFRLL. PIPE RND THIS BOTTOM OF ]'HE EXCRVRTION (iN FEET). E:RCKFILLING OF RN'¢ :,-r_ FElt NITHOUT FINIAL IN=,FEL. TIuf, RNE:, RPPROVRL. E:"r' THIS DEF'RRTMENT NILL DE: ..,UE,.]E_.[ TO F R_:,EUUTI..N. t'"iiNiMUN DISTRNCE BETWEEN R 1.4EL. L RND RNY ON-SI]"E SEI.4RGE DISPOSRL SYSTEM i00 FEET FOR R PRIVRTE HELl_ OR 200 FEET POR R PUBLIC: WELL. WELL LOGS RRE REQUIRED RND MUST BE RETUR'.NED TO THE DEPRRTMENT WITNZN ]:8 OF THE NELL COMPLETION. SPECIF'ICRTIONS RND CONSTRUCTION DIFtGRRIdS RRE RVRILRBLE TO INSURE PR:I]PER I NSTRLLRT 1 ON. i CER]-IF'¢ ]"HFIT t: t lam FlaI',IILIRR WITH ]"HE REQUIREMENTS FOR Obi-SITE SEHERS RNL3 NE!...LS RtE; SET FORTH 8¥ THE MUNICIPRLIT'¢ OF RNCHORRGE. 2: i WILL INSTRL. L THE S'¢STEM IN RCCORDRNCE 1.4I]"H THE CODES. 3:: i UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLF!RGEf,'IENT IF THE RESI[:,ENCE l~ REMODELED TO INCLUDE MORE THRN 3: BEDROOMS. RPPLiCRNT MII<E STOUT "On~ t~st i~ ,~'~h a th~an~t o?i~io~" 2204 Cleveland Anchorage, Alaska 99503' Leoal ~escrintion: Lot 2 Block /1~ Subdivision ~/m4~/~JX- This Form Renorts Soils Lea Perth Feet ~"p~i' Soil Characteristics Percolation Test. 6 8-- 12-- 20-- Was Ground Water Encountered? I¢ Yes, At what Denth? I Readinq Date Gross Time Net Time Depth to H20 Net Dron I Percolation Rate ~tinute Prnposed Installation: Seenaoe Pit Drain Field Deoth of Inlet Denth To Botto~ Of.Pit Or Trench · - I t)~X.y~Q Data Certified B~: Test Performed By ~ Date: ~7~::~~/~ _ Lenal Oescri~tion: Lot ~ Blo~!~___. This Korm Renorts Soils Loq Penth Feet 2204 Cleveland Anchorage, Alaska 99503 ate Performed Subdivision Percolation Test 14--. 16-- 18-- 20m Was Ground Water Encountered? HO i~ yes, At what Denth? I ' Readinq Date Gross Time Net Time Depth to H20 Net Dron I I I ~ Percolation Rate Minute Prnoosed Installation: Seenaoe Pit Drain Field Deoth of_Inlet. Denth To Bottom Of ~it Or Trench ~1. /~s ~. P~'~m~ t~,~ -2' ~ ~' ~J /(o' ~ ~. g~~ Test Performed 8y ~3~~ Data Certified B~: ~ - Date: ~/~~ 2204 Cleveland Anchorage, Alaska 99503 U~'i~,~ ~fnllt Date Performed Performed For Leoal Qescrintion: Lot 3 Block H This Form Renorts Soils Loq yes 4/20/77 __Subdivision Timb~rlu~ S~B_ Percolation Test Penth Feet 2 8-- 10-- 12-- 14--, 16-- 18-- 20-- Soil Characteristics Bro~K Silt Slightly Silty Sandy Gravel with occasional cobbles (GM) BOH Was Ground Water Encountered?.No ~?o~ I¢ Yes, At what Denth? Readinq Date Gross Time Net Time Depth to H20 Net Dron' i I '' Percolation Rate Hinute Prnposed Installation: Seenaoe Pit Drain Field Deoth of Inlet Depth To Bottom Of Pit Or Trench CoUPENTS: 150 square feet drainaqe area required per bedroom Test Performed at 4ft to 13ft ~vid Paul Cert~ fied B~ Da te :-- %/~(~/~ _ Data MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 - -... CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # {'--)\O~ _ ,,~ \ _ ~,~_r~ HAA# 1, GENERAL INFORMATION Complete legal description Lot 3; B£0~i !'H!" Timb~J~ux #2 Location (site address or directions) 4840 Manyt~..~£ Rd. 'Anchorage, AK Property owner Mailing address Lending agency Mailing address Agent Address Mike and Sandie Stout Day phone 4840 Manyt~l Ave.. Anchorage, AK Day phone Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 5 NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status ~of system. 72-025(Rev. 1/91) F~ont MOAff21 · HJo~ s,~@@u!l~u@ i~uo!ssejoJd eql u! suo!ss!uao ~o sJoJJe Joj elq!suodseJ lou s! a6~Joqou¥ ~o ~41edp!unlA/ aq/ 'panss! si e~!~!He9 9 eJo~aq ~ep eZXleUe JO suo!loedsu! ~onpuoo ~ou op SHHQ ~o sea,~o]d~u=~ 's~ueLueJ!nbeJ ele3s puc leJape~ u!~ao/~s!3es o~JapJo u! suoBn3!3su! Du!pue[.Jpq] pue SeLUOq JO sJaseqoJnd o~, Xse~Jnoo e se s!q~ seop SHHQ eq/'e~isel'¢ jo m,m,S eq3 u! pe~e3slDeJ ,eeu!l~ue leUO!SSejoJd 3uepuadepu! ue ~q e^oqe ~ qdeJl~.md u! ue^]l~ suoRe~uaseJdeJ eq3 uodn Xluo paseq se~ea!j!HeO le^oJdd¥ ~,poq3n¥ q~leeH senss] (SHHQ) se~pues ueLunH pue q~leeH Jo ~ueuJpedeQ e6e~oqou¥ jo X~jled!o!un!AI aq.L , / S~UeLULUOO leUOp,!ppv :suoBelndp, s ~U!MOIIOJ eq~, q~,!M 'SLUOOJpeq 'SLUOOJpeq jo~,t le^oJdde leUO!l!puoo 'pe^oJddes!Q ~oj pe^o~dd¥ -~ ~ -:aan~YNelS SHHa · UO!lOedSu! s!q~ Jo elep eq~ uo loejje u! suoBelnOeJ pue 'seoueu!pJo 'sepoo ele~S pue led!o!unlAI lie qlF~ eoue!ldUJOO u! s! uJelsXs tesods!p Jm, et~elseM ~o/pue Xlddns Jele/~ ei!s-uo eq~ 'uoBoadsu! pue uop, e6Bse^u! XuJ tuoJj puc Selg e6eJoqouv jo Xl!ledp!unL/~ eql uuoJ¢ peu!e~,qo UOp, eLUJOJU! eq~ uo peseq leq~ XjHa^ ~eqMnj I 'upJeq pe~eo!pu! eJnlonJ),s jo edX~ pue SLUOOJpaq JO ~eqLunu eq~ ~oJ e3enbape pue leUOBOunJ 'abes si LUe)¢9/~S lesods!p Je~et,~e),se/~ Jo/pue Xiddns ~e~e~ el!s-uo eq3 ~eq~ S~OLIS uop, eo!ldde le^o~ddv X~,Hoq~nv qlleeH S!LI~ JO uop, eeBse^u! XLU ~eq3 XjHe^ I '/~oleq u~oqs e~,ep uop, ep!le^ eLl~ JO se pue o~,e~eq pex!jJe leas ~uJ Xq pe!J!~aea sV "9 a=I::INION~ Ag NOI.LO=IdSNI dO J.N=IIN=I.LV-LS (~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~/ Z z¢//,~'~ (H.) 7~-///4 ~C/'/L4 ,~:/¢L-~'~ Parcel I.D. '~- A. WELL DATA Welltype ,/~1~'~ IfA. B. orC, attach ADEC letter. ADEC water system number Log present N) Date completed ~" ./7'~ Dril Total depth /O ~ Cased to /¢ ~ Casing height Sanitary seal ~N) Wires properly protected~N) FROM WELL LOG AT INSPECTION Date of test . Static water level ~/ ~ ¢~ ~ flow ~ ¢.~ g.p.m. ~' / Well Pump level /~ / ~ ~ ~ SEPARATION DISTANCES FROM WELL TO: / Septic/I-~otdffi~J~ank on lot / Absorption field on lot / Public sewer main Sewer service line .~ ,~- ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: Collected by: Date installed Cleanouts(~N)~'~/'~/¢''~ High water alarr~N) Date of pumping Other bacteria $ & S ENGINEERING B. SEPTIC/I~q~I~IG~TANK DATA Tank size / ,¢~(-~ ~'~-~'/ Compartments ~ Foundation cleanou~N) Depression (Y(~ Alarm teste,(~N) ' ¢ ./~.~'~'L.) Pumper k_..c /~Z//~... 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 SEPARATION DISTANCES FROM SEPTIC/,t~;~[[;~S~TANK TO: Well(s) onlot //~ t Onadjacentlots //~:~ ~/- FounG~.:on '~"-J"'- Topropertyline ~/z¢~) f,-]~ Absorption field ~'Z~ ! .- Water main/servi -e line Surfacewater/drainage ,~'-'-C9 2~2~/ ..~'LCE' /-'O)~'/L~,C'~c~eOD 2, ¢ 72-026 (Rev. 7/9~) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y~ "Pump on" level at High water alarm level ~_/z./E t~ MOA electrical codes (~Y~N) /'P/'~P /'~ Meets SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot ,/O ~ t On adjacent lots Manhole/Access CN) "Pump off" level at jo: Cycles tested /Z~:~ ~'-/- Surface water D. ABSORPTION FIELD DATA Date installed .~/'/.%~_'~'J~ Length ~,/ Width ~-~ Total absorption area Depression over field (Y/~.,~/ Results (pass/fail) Peroxide treatment (past 12 months) Soil rating Gravel thickness -~' Clear'outs present(~) Date of adequacy test for .~.~ d'/...O~-sYst e m type Total depth ~' ~'- If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots ./~ Well on lot /2~ ~- To building foundation / Property line /~;) ~z~Z ! To existing or abandoned system on lot On adjacent lots ~'~:2 ~- Cutbank /"J//~ Watermain/serviceiine Surface water ~-~-'~) ~J'~lc~'E--/~-J~-~ Driveway, parking/vehicle storage area O"-z} t-J,L Curtain drain /~/<2 f~d' ~ E. ENGINEER'S cERTIFICATION~' I certify th~irmed .... to all MOA and HAA guidelines in effect on the date of thi~.,!: inspection.,, ,~i Signatu~/~-/ ~ & s ENGINEERING No. 204 ......... : Date / :.:, HAAFee$ /2D Date of Payment Receipt Number 72~26 (Rev. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number VIRONMENTAL LABORATORY SERVICES Chemlab Ref.# :93.2069-3 Client Sample ID :L3 B (H) TIMBEELUX S/D #2 Matrix :WATER Client Name ':S & S ENGINEERING Ordered By :R. SHAFER Project Name : Project# : PWSID : UA REPORT of ANALYSIS Sample Remarks: ROUTINE SAMPLE COLLECTED BY: J.W. 5633 B STREET ANCHORAGE, AK99518 TEL:(907) 562-2343 FAX:(90~ 561-5301 WORK Order :65859 Report Completed :05/11/93 Collected :05/07/93 @ 13:15 hrs. Received :05/07/93 @ 18:30 hrs, TecbJnical Director Released By QC Allowable Ext. Anal Parameter Results Qual. Units Method Limits Date Date Init NITRATE-N 0.i0 U mg/1 EPA 353.2/300.0 10 05/10 LLH * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. ST = Greater Than Member of the SGS Group (Soci~t~ G~n~rale de Surveillance) ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA /~'~ ' , MUNICIPALITY OF ANCHORAOE- ,, ~ ~/~/~ /[~ ' · ~EPARTME~C.OF HEALTH'ND ENVIRONMENT, '~PROTECTION C~cJ~ [(~2)~ ~ ' %~ 825 ~ Str~e%,~cl~/rage, Alas~' 99501 ~ ~-;%~ ~ L ~[~'~ /Date Received: June 24, 1977 ~,Date ~ ~ ~ / _~ate ~1.~ Cr~5 Date ____ REQUES' FOR A~PROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES / 1. Lending Institution Request: Peoples bank and Trust Mailing Address: Pouch 7-007 99510 Phone: 279-7511 2. Property Owner: Mike/ Sandra K. Stout Phone: Mailing Address: 55510 Old Seward Highway 99502 3. Legal Description: Lot 3 Block H Timberlux Subdivision 278-1531 4: Single Family Residence: (x) Number of Bedrooms: two Multiple Family Residence: ( ) Number of Bedrooms: Well System: Individual well (x) Community/Public System ( ) Permit # ~0'~-- Depth of Well f(~.Q~' Well Log on File Construction Bacterial Analysis e Sewage Disposal System: Permit # Septic Tank Size Absorption Area On-site System (x) Public Utility Installed .~-~-'___~ Installer [,, /O~ Manufacturer ~;.~_3t~z~; Soils Rate /~ Material Distances: Well to Septic Tank ~O0 to Sewer Line Nearest Lot ( ) to Absorption Area ~/4~ line Absorption Area to Nearest Lot Line Page Two'' Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 3 Block H Timberlux Subdivision Coimments: Affadavit Attached: )// Approved: Disapproved: Letter Attached: ( ) Date: Department worksheet: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: VA 2. Property Owner~_4IKE & SANDRA K. STOUT FHA CONV. ~ Mailing Address: 55510 OLD SEWARD HI('~IWAY Name of Buyer: MIKE & SANDRA K. STOUT Day Phone: 278-1531 Mailing Address: SAME 4. Name of Lending Institution: PEOPLES BANK & TRUST Mailing Address: POUCH ?007 5. Name of Realtor or Agent: J.A. MODULAR REALTY Mailing Address: 6. Legal Description: Location: ~ ~4A~Z'l'~;I ,T, AVJ~UE Day Phone: Phone:. 279-7511 3400 Mr. VIEW DRIVE Phone: LOT 3~ BLK. H. TI)~BERLUX SUBDIVISION 279-2589 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: SFR Public Utility No. Bdrms. & SEPTIC Individual 2 If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation WEI,T, & SEPTIC Individual (on-site) 72-OO3(3/76)