HomeMy WebLinkAboutTIMBERLUX #2 BLK H LT 10Timberlux #2 Block H Lot 10 #018-271-45 UBMITTA Municipality of AnchorageNOV kr 3 Community Development Department Page 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: OSP131215 PID Number: 018-271-45 ❑ New ZU14 1 1 of 3 Upgrade Name: Francis & Joyce Bebey ABSORPTION FIELD ❑ Deep Trench i Other Shallow Trench Bed ❑Mound Address 4825 Hillandale Avenue Phone Number of Bedrooms 4 Soil Rating 4 GPD/SF Total depth from original grade 2.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade - 1.5 Ft. Gravel depth beneath pipe 0•5Ft. Subdivision Block Lot Timberlux #2 H 10 Fill added above original grade 1 Ft. Gravel length 30.0 Ft. Township Range ' Section Gravel width 5.0Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 150 Ft: Number of trenches 1 Dist. between trenches N/AFt. Well 113.7 129,1 113.7 N/A 93 TANK ■ Septic 0 S.T.E.P. • Holding • Other Manufacturer Anchorage Tank / Orenco Capacity 1500031. Surface Water 100+ 100+ 100+ N/A NA Material STEEL Number of compartments 2 Lot Line 44.2 26.1 41.3 N/A Foundation 15.5 47.8 27.0 N/A LIFT STATION Manufacturer Orenco Capacity 250 GaI. Curtain Drain N/A N/A N/A N/A Remarks Pump on level at 43 in. Pump off level at 40 in. High water alarm at 45 in. Pump make and model - P2005 Electrical Inspections performed by Installer Beeks Contracting to PIPE MATERIAL House to tank 3034 Tank drainfield3034 Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft Inspection, dates: 1 ' 12/16/13 2m 12/16/13 Location and description Corner of house trim 3'" 12/22/13 a" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date Engineer's Stamp �OF .�P N•ftp} #r p *: • • TH )1 *00/ •• 'teven •t#: P&nnorae �1 • . CE 8149 +/'r f x.J01(03. ' c'! �1�• 1` poiEss Y / ', / Approved / Gam° . Ad Date _�7 �S Inspection Report_1-1-1 T.doc M M DRAIN FIELD (6) 30LF x 5'W x 2.5'ED IN FAILURE RE -USE AS RESERVE WELL (6) I_ , 117.6 LOT VACANT NO WELLS OR SEPTICS REMOVED IB IOCYC LE LS2 • • 10'UUUTILITY EASEMENT TH-2 TOBBEN SPURKLAND NEW DRAIN FIELD / 30LF x 5'W x 0.5'ED x 2.0'TD NEW INSULATED 1500g S.T.E.P. TANK WITH HOLD DOWNS, AX20 POD, -SAND AUXILIARY PUMP VAULT — N � 1► ' 4" HOPE SERVICE LINE (P) 3=0.0030 MIN \ ,. \ / \ o. / c� A SEPTIC AREA (6) T� \\, 11 3 71 0 SEPTIC AREA (6) 74/ A AA NOTES: PLAN PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 TIMBERLUX #2, BLOCK H, LOT 10 FRANCIS & JOYCE BEBEY 4825 HILLANDALE AVENUE ANCHORAGE, AK 99516 ---7D-r,4"‘‘ ..�.Pig...y' • 7 ;*:49 A\ .* , /5*C�t, Steven R. Pannone j h -v.... CE 8149 .A2j ftl sr' •':,: PRoFEsso --- l\\\��.�--- Date 11/3/2014 Scale r'=50' P.I.D. NO '018-271-45 PERMIT NO. 0SP131215 Sheet 2 OF 3 A B C T1 17.4 26.3 - LS1 25.0 33.0 - LS2 28.2 36.0 - M1 61.6 - 103.7 M2 51.9 - 79.3 M M DRAIN FIELD (6) 30LF x 5'W x 2.5'ED IN FAILURE RE -USE AS RESERVE WELL (6) I_ , 117.6 LOT VACANT NO WELLS OR SEPTICS REMOVED IB IOCYC LE LS2 • • 10'UUUTILITY EASEMENT TH-2 TOBBEN SPURKLAND NEW DRAIN FIELD / 30LF x 5'W x 0.5'ED x 2.0'TD NEW INSULATED 1500g S.T.E.P. TANK WITH HOLD DOWNS, AX20 POD, -SAND AUXILIARY PUMP VAULT — N � 1► ' 4" HOPE SERVICE LINE (P) 3=0.0030 MIN \ ,. \ / \ o. / c� A SEPTIC AREA (6) T� \\, 11 3 71 0 SEPTIC AREA (6) 74/ A AA NOTES: PLAN PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 TIMBERLUX #2, BLOCK H, LOT 10 FRANCIS & JOYCE BEBEY 4825 HILLANDALE AVENUE ANCHORAGE, AK 99516 ---7D-r,4"‘‘ ..�.Pig...y' • 7 ;*:49 A\ .* , /5*C�t, Steven R. Pannone j h -v.... CE 8149 .A2j ftl sr' •':,: PRoFEsso --- l\\\��.�--- Date 11/3/2014 Scale r'=50' P.I.D. NO '018-271-45 PERMIT NO. 0SP131215 Sheet 2 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 3. SCOPE OF WORK: INSTALLED NEW 1500g S.T.E.P. TANK WITH AX20 POD AND AUX. PUMP VAULT. INSTALLED SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 7 FEET BELOW EXISTING GRADE A5 EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OE THE EXCAVATIONS LESS THAN 7 FEET BELOW EXISTING GRADE. TH SPUR KLAN D-1995 CLEAN OUT 15.0 0 0 a ML LIFT STATION a W 94.0 1 1500 g S.T.E.P. TANK (P) 98.2 /'-RIGID INSULATION —FILTER FABRIC �/ 134' 0 PERE PIPE W/ ROLES 18" O.C. I —DRAIN ROCK 6" ABOVE PIPE INV 9 2 50 91.2 9/11/95 SECTION X FUME VAULT INSULATED (SEE ADVANTEX DETAIL) LEGEND WATER LINE/ WELL RADIUS SS NEW SEPTIC r.5 1 —96.7 031 —96.2 DRAIN ROCK 09 0 z w 0 0 H 0w 0 a r RIGID INSULATION FILTER FABRIC j-1 34" m PERF PIPE W/ 34" e HOLES 18" 0.0. / ) FDRAIN�ROCK 6" ABOVE PIPE INV 99.2 98.2 PROFILE DESIGN PARAMETERS RESERVE SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500o S.T.E.P. W/ AX20 POD & AUX PUMP VAULT PERC RATE = 16-30 MPI SOIL RATING: 4 GPD/SF AREA ROD: 150 SF SYS. TYPE: WIDE TRENCH MIN LENGTH: 30 LF USED: 30 LF X 5' WIDE, 0.5' E.D., 2.0' TD TOTAL AREA: 150 SF -s 7 96.2 DRAIN ROCK ABBREVIATIONS CU COPPER DIP TH FC T# Cfi M# R.I. DCO DV FS BFG 00 FG TS&V DUCTILE IRON PIPE TEST HOLE FOUNDATION CLEAN OUT TANK CLEAN OUT NO. CLEAN OUT NO. MONITOR TUBE NO. RIGID INSULATION DOUBLE CLEAN OUT DIVERTER VALVE FLOW SPLITTER BELOW FINISH GRADE ORIGINAL GRADE FINISH GRADE TOPSOIL & VEGETATE NOTES RECORD DRAWING PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 DESIGN DETAILS TIMBERLUX #2, BLOCK H, LOT 10 FRANCIS & JOYCE BEBEY 4825 HILLANDALE AVENUE ANCHORAGE, AK 99516 *49TM � . • *• `li Steven R. Pannone ,I+11 T101 �OFEfec. CE Bs,ON: �/ \\p��� Dote 11/3/2014 Scale NTS P.I.D. NO 018-271-45 PERMIT NO. OSP131215 Sheet 3 OF 3 Engineer: _egal Description: Municipality of Anchorage P.O Box 196550 4700 Elmore Road Anchorage, Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997 htto://www.muntorgionsite Planning and Development Services Department On -Site Water and Wastewater Program On -Site Sewer/Well Submittal Comment Sheet PANNONE ENGINEERING SERVICE TIMBERLUX #2 Blka-I Lt 10 12/24/2014 'ermit: OSP131215 Septic Completed By: J.Poet 2eportType: As Built Review -he attached paperwork has been reviewed and is being returned for the following reasons: Electrical Inspections performed by? Q2 ra-t.,s&C trs�"4 5-tPc(2t cAc erg -cot -7 FF2aM--R)c&cYC(./3/ 7lO a-t&c'()-(cAC�SPUcZC4),--) On -Site Wastewater Disposal 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: OSP131215 Tax Code Number: 01827145000 Work Type: Septic Permit Effective Dates: August 15, 2013 to August 15, 2014 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: TIMBERLUX #2 Site Legal Address: TIMBERLUX #2 BLK H LT 10 G:3136 Owner/Address: BEBEY FRANCIS A & JOYCE 4825 HILLANDALE AVENUE ANCHORAGE AK 995164148 Site Mailing Address: 4825 HILLANDALE AVE, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 50470 Total Bedrooms: 4 N Privy 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 By: Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 018-271-45 Property owner(s) Francis & Joyce Bebey Day phone Mailing address 4825 Hillandale Avenue, Anchorage, AK 99516 Site address 4825 Hllandale Avenue Legal description (Sub'd., Block & Lot) Timberlux #2, Block H, Lot 10 Legal description (Township, Range & Section) Lot Size 50,470 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage Initial Upgrade Renewal TYPE OF DWELLING: Single Family (SF) ❑X (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Si nature of property owner or authorized agent) Permit/Rush Fees: 53D— Date of Payment: 1 Ji81/ Receipt Number: c 33 Ct Permit No. ns f 131 16 Permit App__- Waiver Fees: Date of Payment: Receipt Number: Waiver No. Pannone Engineering Services ac Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com July 17, 2013 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. 0. Box 196650 Anchorage, Alaska 99519 Subject: Timberlux #2, Block H, Lot 10 Septic System Upgrade Permit Request Ladies and Gentlemen: I am writing to request a permit to install a septic system be issued for this property. The proposed systems will serve an existing four (4) bedroom house. Currently the lot is developed, and the existing field will be re -used as a reserve. The existing Biocycle will be removed and a new 1500g S.T.E.P. tank with AX20 Pod and Auxiliary Pump Vault will be installed. This lot is served by a private well that is over 100 feet from the existing and proposed system. The surrounding developed lots are also served by private wells. There are no wells within 100 feet of this system. 1. Soils. One test hole was excavated in the area of this drain filed by Tobben Spurkland in September of 1995, and groundwater was monitored at 7.0 feet below the surface. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 4.0 gallons/day/square feet should be used for a CAT III wastewater system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography slopes from east to west at approximately 20%-25% in the area of the proposed drain field. There are no steep slopes in the vicinity of the drain field. 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, 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 or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, .15.17.1...4:: .Ay diP l '41 ...0‘...0‘p ��yyTH � •.m.:n.-fir •itliii, \h • • ■ E Steven R. Pannone F a G9 no oun et222a Steven R. Pannone, P.E. Owner/Civil Engineer Attachments -Soils Log -Septic System Design Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 � LOT VACANT NO WELLS OR SEPTICS i REMOVE BIOCYCLE (E) DRAINREL0(E) 3OLF x 5'W x 2.5'ED |N�A|LURERE-USE ASRESERVE ,WELL (E) /n_� -2 . x'\ ' T0DR[NSPURKU\ND 114.2 . • „.„ NEW DRAIN FIELD /J0LFx5'YYx0�5'[Dx28'TD ' � `s‘ 10' UTILITY EASEMENT INSULATED 1500g .[E.P TANK WITH HOLD DOWNS, AX2O POD, AND AUXILIARY FUMP VAULT / '-`' \ ! / -_-- ` , 4"HDPE SERVICE LINE (P) 5=0.0030 MIN • 4 BR HOUSE (E) SEPTIC AREA (E) ` \ \ \ \ � | \ ` SEPTC AREA (E) � NOTES: m _``� */` FOR CONSTRUCTION PANNONE ENG SVC, LLC P.0.BOX 1O0217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 PLAN TIMBERLUX #2, BLOCK H, LOT 10 FRANCIS Xc JOYCE BEBEY 4825 HILLANDALE AVENUE ANCH0RAGE, AK 99516 `��r``| ��� ..:7��^ m sk t:An.?0. F:s.‘.07.Litirtnna:e Date 8/9/2013 Scale l^=so' p/u.wo 018-271-45 PERMIT NO. osp13l11u SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 3. SCOPE OF WORK: INSTALL NEW 1500g S.T.E.P. TANK WITH AX20 POD AND AUX. PUMP VAULT. INSTALL SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 7 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE I5 OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 7 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. w zs ¢o z za 0W Li - OV TH SPURKLAND-1995 O 0 15.0 a X LIFT STATION 1500 g S.T.E.P. TANK (P) RIGID INSULATION FILTER FABRIC 1 Ya" 0 PERF PIPE W/ 14" 0 HOLES 15" 0.C. DRAIN ROCK 6" ABOVE PIPE IW alas 2AP.15 .r 2.0 ___ I-5 DRAIN ROCK 50 9- /11/95 SECTION PUMP VAULT INSULATED (SEE ADVANTEX DETAIL) LEGEND W WATER LINE/ WELL RADIUS SS NEW SEPTIC w CO r z w K O z6 0 RIGID INSULATION FILTER FABRIC 14"0 PERF PIPE W/ J4" 0 HOLES 18" 0.C. DRAIN ROCK 6" ABOVE PIPE INV PROFILE DESIGN PARAMETERS RESERVE SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. W/ AX20 POD & AUX PUMP VAULT PERC RATE = 16-30 MPI SOIL RATING: 4 GPD/SF AREA RQD: 150 SF SYS. TYPE: WIDE TRENCH MIN LENGTH: 30 LF USED: 30 LF X 5' WIDE, 0.5' E.D., 2.0' TD TOTAL AREA: 150 SF DRAIN ROCK ABBREVIATIONS CU DIP TH FC T# C# M# R.I. DCO DV FS BFG OG FG Ts&V COPPER DUCTILE IRON PIPE TEST HOLE FOUNDATION CLEAN OUT TANK CLEAN OUT NO. CLEAN OUT NO. MONITOR TUBE NO. RIGID INSULATION DOUBLE CLEAN OUT DIVERTER VALVE FLOW SPLITTER BELOW FINISH GRADE ORIGINAL GRADE FINISH GRADE TOPSOIL & VEGETATE NOTES: FOR CONSTRUCTION PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 DESIGN DETAILS TIMBERLUX #2, BLOCK H, LOT 10 FRANCIS & JOYCE BEBEY 4825 HILLANDALE AVENUE ANCHORAGE, AK 99516 7 -� of a�gskll 90 • Al 'steven R.'Rannone /Irt� CE 8149 w r Date 8/9/2013 Scale NTS P.I.D. NO 018-271-45 PERMIT NO. 05P131215 Sheet 2 OF 3 ADVANTEX 4" JIM CAPS x20 POD ADVANTEX DESIGN 24" INSULATED RISER AUXILIARY PUMP BASIN 4" PUMP -OUT/ 64" SLIDE SECTION OF 6" PIPE OVER THIS CONNECTION TO PROVIDE SHEER PROTECTION - EXTEND TO BRIDGE EXCAVATION x'e�"w"nnawx-m: 12' PASSIVE AIR VENT INSULATION INSULATION %" STAINLESS STEEL CABLE 6" 0 CHANCE ANCHOR TYP. OF 4. (GLAV.) NOTES FOR CONSTRUCTION PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SITE SECTION TIMBERLUX #2, BLOCK H, LOT 10 FRANCIS & JOYCE BEBEY 4825 HILLANDALE AVENUE ANCHORAGE, AK 99516 --ztThr. titArte• ' �1 2' �y *: 49 h1 /\ �, '.'k I P.I.D. NO 018-271-45 even R. Pan nsOr; e PERMIT N0. `� ‘A. =' ice Sheet 235 Date 8/9/2013 Scale NTS ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND RUM x 1 Joyce —:g_v THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Mr Day of SEPI of 2013 , by and between Thiptuic. 13Fv herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as AtwA E$ Sy gal located at (legal description). 11MBa'zw.uK2 a I-1 Lr IO 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: T'KR►n . f JDyceasy b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: 12/3/4.3r (5 A "Be L p STATE OF ALASKA THIRD JUDICIAL DISTRICT gnaturup Date: 09. P4, 2 0 1 3 AWN 40:1 fs �sTATE �F ticti 14,4:5 'pglll rn# before me this tl day of (s o The foregoing instrument was acknowledged triad/ ANL _ 1- Y Pr: LIC FOR ALASKA y Commission expires: (I' jj 20 1,6, by 4 5 MUNICIPALITY: Q CNC , (signature) (print name) Date: g>15-71%.3 Title: CC,7 MUNICIPALITY OF ANCHORAGE MEMORANDUM Q m ck� Z � m rn v 4i 144 <- h J O LI, --- 4---- ''‘ 4-v 0 2 d F LL O LST ID i •3 j/ocYCC £ /5 -4 ti t t V v z Q pe s c;erow( lt5 0n Am/, /EL 12 [RENc.V //f l OA'4 otic c[ i£, c, t4 T T Sour/( ENO.• A/o P70N,7-o,e TubeP/?as -r PRI9/,vHELD CLE/b'Nour ow PERF OPE 9/9"6"-' TG ei 9 ¢" iTAa-OP/oE l 1 _. ce-Efr 1 ParareATED /BI's %j/Oc%LSE 4/PERR5 iv fl Avi- lti /4- Peet SVan GOOLE). tiny ft: /u St'Q"6 alwaruP. R PRDDLCt1 �lltf �C -r,t4 (-(,as H> 3 b12 -7i1 aL Mark Begich Mayor Well Drilling Permit Number: SW Parcel Identification Number: Legal Description ieve.iaprnent Services (:)epartrnent Building Sc-Fety icn \ff.Avic.1-ter & Wastevu.c.Teer ProgrcM 4700 9ragaw Street P.O. gag 19C:Ce350 AricHzracle.„AK 99519-6650 muni.orciirmsire (9.07)243-7904 Pump installation Log Date of Issue: "7 - Property Owner Name & A.ddress: rIK- 0-0 lc fX_ 4825 A Pump Installation Date: 7 / 0 Pump Intake Depth Below Top of Well Casing: -•".7Z=. feet Pump Manufacturer's Name: Pump Model: C_AS- 5/ Pump Size hp PitiesAdapter Burial Depth: g- feet Pitless Adapter Manufacturer's Name: -Ef4--1.< Ptiess Adapter Installer (4 LAD <?. -7,/ ell Disinfected TJoa Corniethja?Ys iijNo i_Yiethod ()CD isinfectio n: (....ornmentS: Pump Installer Name: Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation_ AnchoragePage / of 3 Municipality of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 e Telephone: 343-4744 On -Site Wastewater�Disposal System and/or Well Inspection Report g 0 P--73 PID Number O/3 f7/— !s , Permit Number: �{{C.t-1/��L �j1i--1--� Wastewater System: 0 New Upgrade /f Address: Lig t4; i ABSORPTION FIELD rfL5 1LY:f✓1ln_L, Phone: No. of De +r oms: l D Deep Trench Sheikhs? Trench D Bed D Mound ❑ Other LEGAL DESCRIPTION soil Rating: GPD/Sg Ft. Total Depth from original grade: iS Lot: '^y Block: Subdivision: , Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: Range: Section: Fill added above original grade: _'/ FL Gravel length: .75 0 Fl. Gravel width: Number of lines: 'Distance between lines[ WELL: 0 New 0 Upgrade Ft_ / --- Ft. Classification (Private, A,B,C): Total Depth: FI Cased To: Ft. Total absorption area: /6-0 SG. Ft. Pipe material:' / t� CJ/ 7 o r V Driller: Dale Drilled: Static Water Level: Ft. Installer: + TT Date installed: �j ei 71 Yield: Pump Set at: Casing H ight Above Ground: TANK iLn [= '� A!, GPM Ft Ft. SEPAFIATION DISTANCES D Septic D Holding D S.T.E.P. To Septic Absorption Field Lin Station Holding Tank Public/Private Sewer Lines Manufacturer: Capacity in gallons: From Tank Number of Com ar ments: Well /..p -o 11 C >25 Material: // /—/h•er 9/w."„'- Surfacertl0 Water l Z7 LIFT STATION Lot//� Line 19O : 0" Size in gallons: Manufacturer: +�- /0C� C A G-+ Foundation i 0 ..Pump tove3/y PumP79vVi-/ (High water al�m�/� '7t Curtain Drain X10 X10 Pump Make & Model I Flee rical Inspections pertormedb NEYER- lr%i Vit r+ 4U SENCH MARK Remarks: Location and Description: Assumed Elevation: (L'Ci - - i l9 -r%----- FI : ENGINEER'S SEAL ,-a )r - Dates 1st 2 1 Inspections performed by: 2nd O'//`14 Department of Flea and F -I an Services approval �L— Date./044"-- b / Reviewed and approved . 2-013 (Rev. 9/91) MOA 25 BENCH MARK \10 FT. .•��P . . O q<..S • %\ \ \ \ ` a 49th ... \ \ \ •• TTO: i . SPURKLAN• : Li: • •��<j \ No. CE-• 25 ?.'Z♦ • ♦♦• ♦%1P ��PROFESS\CPC' . .h Well 1 25 25 50 / 75 100 -125 150 SCA IX: 11" = 50 FT. TOBBEN SPURKLAND P.E. 203 W 15TH. AVENUE ANCH. AK. 99501 (907) 279-3916 LOT 10, BLOCK 11, TIMBERLUX S/D 4825 HILLANDALE AVE. MICHAEL BILLS SEPTIC SYSTEM AS BUILT DATE: :SEPT. 26, 1995 SHEET: 2/3 GRID: 3136 1 30 I-1/4' PVC Schedule 50 98± 3/76" Holes ® 18" 5 -WIDE TRENCH 3 Fl. of Cover 4" Topsoil ' 000000oou 0 0 0°0°0°0° 1-1/4" Discharge 9000-�ogogogogogc D 94./ 6" Sewer Rock 1-1/4" Dis/ibulion Pipe Mirafi 140 94.7 95.2 49th •• 2 r TUBEN SPURKLAND •AC:col c No. CE -2225 ��ti"'� BACKFILL AND LEVEL WITH SAND 97.8 4 BIOCYCLE PLANT Myers Pump ME40 4/10 HP BENCH MARKT: BOTTOM SIDING TOBBEN SPURKLAND P.E. 203 W 15TH. AVENUE NCH. AK. —391699501 907) 279 BIOCYCLE AERATED TREATMENT PLANT LOT 10 BLOCK H TIMERLUX 5/0 4825 HILLA/JDALE AVE. SEPTIC SYSTEM AS BUILT DATE: SEPT 26, 1995 SHEET: 3/3 GRID: 3136 nOLHFIRE.,GE„ fmLLiiTNIA 1.r.)1),() TUUHH rjUnil UHOLE: r.!LOCk7, ',LLY111flirc:,'Cr.LUX - 10;;Yr:LIIHH; 6 :CI EE.SflNIT.(0, ( • (-1.; ()ft NY r 10::WITTION r DONT CONCE UNTN, 17, 009 6. ( , 11) r •(.-"( RECEIVED SEp 2 8 1995 municipality Qt Anclluta9e Dept. Health & Human Services / ,tic LC MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 q -A - a31S Cic24 1n -\b ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950273 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:BILLS MICHAEL & DIANE OWNER ADDRESS:4825 HILLANDALE AVE ANCHORAGE, AK 99516 PARCEL ID:01827145 LEGAL DESCRIPTION: TIMBERLUX #2 BLK H LT 10 LOT SIZE: 50470 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 9/12/95 EXPIRATION DATE: 9/12/96 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS SPECIAL PROVISIONS: THE WASTEWATER DISPOSAL SYSTEM INSTALLED UNDER THIS PERMIT IS AN ALTERNATIVE SYSTEM UNDERGOING EVALUATION WITHIN THE MUNICIPALITY OF ANCHOR GR. C' r. .. RECEIVED BY: ISSUED BY: DATE:f3LC DATE: // T.SPURKLAND P.E. 203 WEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Jim Cross Municipality of Anchorage Department of Health and Human Services On -Site Service Section 820 L Street Anchorage, Alaska 99501 Subject: Dear Mr. Cross; Lot 10, Block H Timberlux S/D PID # 018-271-45 Septic System Upgrade. August 30, 1995 Per our discussion I am submitting an application to install a " BioCycle" innovative system on this lot. The present ystem is surcharged.and will not s an cy test. les show w roundwater ,rg ,e2 Ln and/ or cl ey `''` v.. sense non percablt iltafeel) The to at on of the well elimits the limits arealableofor a surface mound, the only conventional system possible on/ this site. a/sem naeisWe11 intend to excavate an additional testhole in the North-West portion of the lot. If the soil is acceptable there the drainfield will be relocated to this location, thereby saving substantial disturbance to the property and also eliminating the long pressureline. This testhole is scheduled for Friday Sept. 1, 1995. The present testhole has been left open for your inspection. Yours Tobben Splrkland P.E. 4 /1 /-.•.,' i- 1 PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, bated a y,26— 19957 is made between the Municipality of Anchorage Department of Health and Human Services (DHHS) and the property owner(s) of: Loi l01 BLOCK 4 Tt►-13e2Lu)C sit) This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owners agree to the following: Allow the Municipality of Anchorage the perpetual right of entry to the property during normal working hours, to allow for effluent sampling or evaluating the general state of repair or function of the system. Submit to the Municipality of Anchorage, on an annual besis, an inspection and operation statement from a registered professional engineer. This irspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. 12_ Q Sl 47,s- (Signature) s (Si nature) (Signature) Mr e_e 3; ti_s (Printed Name) (Printed Name) (Notarize Here) Rick Mystrom, Mayor Municipality of Anchorage Al, fil Department of Health and Human Servicesth 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Dear Homeowner/Prospective Buyer: The on-site wastewater disposal you are interested in purchasing is an "altemative" wastewater disposal system. This system, known as a "Biocycle Aerated Wastewater Treatment System", is undergoing testing within the Municipality of Anchorage under the Alternative System section of the Wastewater Disposal Regulations (AMC 15.65). There are certain risks involved with the ownership of one of these systems: 1. This system has been shown to be effective in other areas. The system is currently undergoing a two year testing period in Anchorage under the guidance of the Department of Health and Human Services (DHHS) and the State of Alaska Department of Environmental Conservation (ADEC) to determine its effectiveness in a subarctic environment. Testing results on systems installed in 1994 have been very encouraging. Copies of initial test results are available from the DHHS. 2. The Biocycle system has not been tested and approved by the National Sanitation Foundation (NSF). Currently, Anchorage Municipal Code for Wastewater Disposal Regulations requires proprietary equipment to have NSF approval. This approval or changes to the Wastewater Disposal Regulations through Municipal Assembly action will be necessary prior to this system being approved as a standard system. 3. The "Biocycle" system for this property may have received vertical separation distance waivers from both State of Alaska and Anchorage Municipal Codes to both ground water and bedrock. These waivers were granted due to the system's expected performance within the site conditions on this property. If the test results do not support these waivers, modification or replacement of this system may be required. 4. If this system fails to meet the requirements set for it to become a standard, code approved wastewater disposal system, it may have to be removed and replaced by either a holding tank or (if possible) other wastewater disposal system that meets Municipality of Anchorage requirements. The cost of any conversions required to meet code requirements will be the responsibility of the homeowner at the time of conversion. I (we) certify that I (we) have read the above statements and am (are) aware of the risks outlined. I (we) also certify that I (we) am (are) in the process of purchasing (property legal description): it/LC 11cc_ ( N2N B : I t 5 (Purchaser Name) (Purchaser Name) (Purchaser Signature) Notarize Here (Purchaser Signature) _knit eke''res T.SPURKLAND P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Groundwater at 7 Ft. Use BioCycle Soil Rating. SEPTIC SYSTEM DESIGN LOT 10 BLOCK H TIMBERLUX S/D MICHAEL BILLS From test September 1, 1995 20 min/in = 4 gal / sq. ft. No. of Bedrooms 4 Required Area per Bedroom: 150/. 4 = 37.5 sq.ft.. Total area required: 4 x 37.5 = 150 sq. ft. Use 5 Wide Trench SYSTEM CONFIGURATION BIOCYCLE AEROBIC PACKAGE PLANT 5 -WIDE TRENCH TOTAL LENGTH 30 FT. TOTAL DEPTH 3 FT. ROCK DEPTH .5 FT. COVER 3 FT. ABANDON EXISTING SYSTEM The installation of this septic system will not prevent wells from be installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. pg.1 T.SPURKLAND P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 10 BLOCK H TIMBERLUX S/D MICHAEL BILLS Groundwater at 4 Ft. Hardpan at 8 Ft. Use BioCycle Soil Rating. From test August 29/1995 23 min/in = 4 gal / sq. ft. No. of Bedrooms 4 Required Area per Bedroom: 150/. 4 = 37.5 sq.ft.. Total area required: 4 x 37.5 = 150 sq. ft. Use 5 Wide Trench SYSTEM CONFIGURATION BIOCYCLE AEROBIC PACKAGE PLANT 5 -WIDE TRENCH TOTAL LENGTH 30 FT. TOTAL DEATH 3 FT. LAKE OTIS GRAVEL 3 FT ROCK DEPTH .5 FT. COVER 3 FT. ABANDON EXISTING SYSTEM The installation of this septic system will not prevent wells from be installed on the adjacent Lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. pg.1 3 5C 0 50 100 150 200 250 300 SCALE: 1' = 100 FT. 10 Ayr • TOBBEN SPURKLAND P.E. 203 W 15TH. AVENUE ANCH. AK. 99501 (9071 279-3916 aid TDBE91 SPURKLAND / 4j No, CE -2225 ,.afr' Ct 47 ♦e��.p. LJJI �l� LOT 'h ,,"PZOCK H, TIMBERLUX S/D 4825 HILLANDAL£ AVE MICHAEL BILLS 2 12 2 SEPTIC SYSTEM DESIGN DATE: AUGUST 28, 1995 SHEET: 1/3 GRID: 3/36 Install BloCyde Abandon Exist, Septic To 1 il 49th • •� TO: . SPURKLAND Li• 0. ,CI) ••• No. CE-• 25 •° _• fir i •1111****So*** Well e_vlsef q/lij'9f TOBBEN SPURKLAND P.E. 203 W 15TH, AVENUE ANCH. AK. 99501 (9071 279-3916 LOT 10, BLOCK 11, TIMBERLUX S/D 4825 HILLANDALE AVE. MICHAEL BILLS SEPTIC SYSTEM DESIGN DATE: AUGUST 28, 1995 SHEET: 2/3 GRID: 3136 1 30 1-1/4" PVC Schedule 50 7 J/l6" Holes 11 18" 5 -WIDE TRENCH SECTION A -A 4" Hollpipe 6" LONG 1-1/4 PVC Holes Pointing Up 3 Ft. of Cover / 4" Topsoil 1-1/4" Discharge •••�E oF. ,q..0 �GJ ��s • i {a 49th 0 % / 070 ti 0 vn 70B EN SPURKLAND 4 (oa: •ICf• No. CE -2225 . =,i T. •+',017tESstIsKte Ves.,;sa lots BACKFILL AND LEVEL WITH SAND On On o o oc0 on n n0ogon 6" Sewer Rock 1-1/4" Dis/ibulion Pipe Mirafi 140 ism BIOCYCLE PLANT Myers Pump M£40 4/10 HP BENCH IAARKL: 4 TOBBEN SPURKLAND P. E. 203 W 15TH, AVENUE NCH. AK. 99501 907) 279-3916 BIOCYCLE AERATED TREATMENT PLANT LOT 11 BLOCK 5 SOUTH HILLS 7501 EAST 140771. AVE SEPTIC SYSTEM DESIGN DATE: AUGUST 30, 1005 SHEET: 3/3 GRID: 3136 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST f r' I Ii 14c •ei I IIS LEGAL DESCRIPTION: L01— Io BK 1+ 45 /101 3 4 • 1 i W-i?9a i2 L u x ,26A-1,-11 Ls s 10 11 12 13 14 15 16 17 18 19 20 LL, roc Li CiCt:14t7 .ris, .....,c 4 ,� 11 B'e. . '°a,E'. 10 '9 Oe .0.•.. ..c -.u..,,, o el ® 0. T t ol• en Sporldnnd • 4 44, 'Q Th so ',1•. CE -7225 e •' 4 '2 ei .••...e..e•.��.'aisle /. / DATE PERFORMED®®�RQpre ® 'Z %, Township, Range, Section: eo4erv.ti of Rat -e Heti-a at SLOPE 4) WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Atter Li Monitoring? 7 • Date. ,/ S L 0 • p E SITE PLAN 1 N L `Z ti Reading Date Gross Time Ne Time Depth to Water Net Drop FILL s/4IVO a' I4 -e s 4, 4.- 6t- F/Zrlgf ?Az 5;',-l7 7'e, I; v 5 .ria /0 1-117.4 /o •34 /fl c2:0 s- / D A " s/g 7 /n' /ice 544. 166 a- 5' /0 6 /`i ti //4, 3 1U 6 3/{k, r1bb t/L 46' ry 3 VS/ //j6, 5.:; 0 6/ 'Gg /k P.3 3:u e; /V y �/� P PERCOLATION RATE .3 (m'nutes?inch) PERC HOLE DIAMETER q / TEST RUN BETWEEN 7 FT AND �3 Z FT 6 t7//L COMMENTS PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) �1�)1 /9% PERFORMED FOR: i �z Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST LEGAL DESCRIPTION Lp•- to I - 1144,10-er Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN N S L IF YES, AT WHAT 5 o DEPTH?0 L -e L P E Depth to Water Al c�///� er / Monitoring? ( Date Reading Date Gross Time Ne Time Depth o Water Net Drop r—;// 4V,/ 9:30 taVy p:zs- sprig- :38 :3E, /0 mi h 't 1 3/6 -"T/g 'I LS 10 l/° 34 // 37A 3 0 3: 00 / 0 I I° 5/4 h o3 rr 3i„ /0 / fi3/�i r/Z PERCOLATION RATE 020 1((2� Id -'/v (a-Is/inch) u3tes/inch) PEHtO HOLE DIAIJE&P€R TEST RUN BETWEEN 624, FT AND 3 FT COMMENTS I/L PERFORMED BY' /e ? CERTIFY THAT HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Kd>.71� 72-013 (Rev. 3/78) cjJ MUNICIPALITY OF ANCHORAGE 1 J NAME (I DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION a ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE T fl`1 ` �}} 11EW V, !VE!��.F-. IS'/J'/R?C` I mi UPGRADE MAILING ADDRESS j P D. 8d$ /O- 7-77 Ari - ei96 o/ LEGAL DESCRIPTION 140 2 H •/7s'y1,Liek u 9.2_ LOCATION NO. OF BEDROOMS U DISTANCE TO: Well ) /G1 , Absorption area Dwellin 9 .-10 PERMIT N0--'— ' "Steil F Z m Q NH Manufacturer _ ttiw.$`G-:1� Liq. in jj Materi 5 Ie%7k.c No. of compartments c pacify nylons �/JUrJ IF HOMEMADE: Inside length g Width -2 Liquid depth X DISTANCE TO: Manufacturer Well Dwelling PERMIT NO. _ F 0 Material Liquid capacity in gallons DISTANCE TO: Well ,,.Foundation / Nearest lot line PERMIT NO. LI W l— ~ Q F No. of lines Top finish Length of each line / / Total length of lines 1f ` r Trench width - 3�' inches Distance between lines .___— of rile to grade/ , J�7' / Material beneath tile i inches Total effective absorption area VV dt w Length Width Depth ff55 PERMIT NO. Q F- w a Crib w Type of crib Crib diameter depth Total effective absorption area w DISTANCE TO: Well Building foundation Nearest lot line J Clasa�/�£ / Depth _ Driller `_ _ Distance to lot line PERMIT NO. V DISTANCE TO: Building foundation Sewer line Septic tank _ Absorption area(s) OTHER PIPE MATERIALS 01-- (/ 1) ,?0C3` - P Lf� SOIL TEST RATING ,ll 9"-C N ) - yctzf INSTALLER - 201/P- LIKE f�'�� REMARKSl. Cc; / act /eS.nL;:L'.. '7/ES /44- Sit.) cc -.-K S zzvV_ . 144j -t tt, 71 ,_ry t'r; Jc' SEllG. 644 It ih] it1 ttra,0-#-isn^— `4tdn& 9 109 0 toke..s is b. -ski 4, A use M.ACL f si: W0 -- APPROVED nn-rr '',.,,, Kd>.71� 72-013 (Rev. 3/78) r4 r ir (-.) Fr EN-P0 ;��� PEPARTMENT /` HEALTH ANENYIRONMENTRL ` E . YOTECTION B25 /\ /ST�FET HNCHORH�E F� ���� � ^/ / ' '�� 9+".�4 264-4720 PERMIT /~�m�»�����C I��� ��EE��fl ����M I r - ��~. ` `^-`^�' / L. 0 y)p/ ^^,' APPLICANT J. ucu." ��^~`�. .�cncn FO BOX 1@`77� ANCHORAGE 99511 ATInN LEGAL 110 BLOCK H TIMBERLUX #2 TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH LOT SIZE 999999 // LI`t • (ll_gc,wa9-°' u"mnXrunu NUMBER OF .-DRUOMS = ~3T SOIL RATING (S4 FT/BR)- /195 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: PDEIF,MH= LAENT3C-FS= ��4-r.,2PEEd... THE LENGTHDIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH DR DRHINFIFLD THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE uxxUMP nND THE BOTTOM OF THE EXCAVATION (IN FEET) THERE Is NO SET WIDTH FOR TRENCHES � THE nRHVELDEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFHLL PIPE AND THF BOTTOM OF THE EXCAVATION IN FEET). ]45-1229 ��P.-.:4:1! Li "r�� 17S rA "St: ET_ = fiL CD CE-11L.A. Cs INS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE TmsTALLA|1UN INSPECTIONS OF ANY WED ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE ��� ��������� ��� ���� ---�� ���������FR' � ��> BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS ^--^-- DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN WELL AND ANY DN`SITE SEWAGE DISPOSAL SYSTEM IS : 100 FEEFOR HPRIVATE WELL OR 150.TO 200 FEET FROM H PUBLIC NEL. DEPENDING UPON THE TTYPE ':fl> PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO 9 PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY !SEWER LINE IS 75 FEET. AND CONSTRUCTION DIAGRAMS ARE AVAILBLE O INSURE PROPER Ir�ALIA.Ium. 0;7'.' I U "7'4:: F." 11.4:" �Cr.= M Lr;';'��11D:CE7 I CERTIFY THAT I HM FHMI| IHR WITH THE REQUIREMENTS FOR ON-SITE SEW£RS AND WELLS AS FORTH EY !HE MUNICIPALITY OF RNCHDRRGE 2: I NIL) L INSTRLL THE SYSTEM IN HCCORD�NCE WITH THE CODES • EN_ -- REMODELED TO HDP ,/ORE THAN 3 BEDROOMS. SIGNED. ISsUED HPPLICHNTJNEHER u � -/ . , _ ,��� ��j ���� 6-77���)F� ��'�' ][�� ���!) /^ Lc 82 -7 1 / ����� ~ THE ��1����C776�ame ak T911 i< 1-7/ / /tv � / h /() ` L'i t•,L �-s= rc-%=.*9Rrpt,:,r C }t,OP._. I9 4lit'' s i'fri:;vl?-'s'?;i`t e a. PRO TEC it�i3# "'3 ;r <I , i t'Ir jt 3t Sr. ;`" '3t I PO .. cx -771 : 11,-10 sli 9fl t <45-t223'.- .-.F,y11 I I t•S,S. t.717:-5-4 r fen I- I,ae _ H T SttFoicLt t;, � reF 1"{t- -30 L _ 2:71c0R.Pt I 01.4 'j'rSr r4 ('�, mirmc-t`: ?tix 041.Et4 Ng.1 = -x. crs. C,;•o.+ i t, _ SO II Lor r?r - ; ,,a•99 S' 1M .; `ie Stir; i `_ s3 : €.-`e ? _ •v- c THE RF1'rit .L Lc oF atsou_ :iia l,iCy-•CIOn 5'r"ji.:J4 Is: I-3 is t-4 a r ! - `S.+ C3 Friss € " _ a i= r 2-- a_ t -IE ' t1ii1 i? 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OR 1'6+3 TO 2C9 Fr r i=R'llt H rl.Ya_I #43 $ 1 ✓13jd iia S t`P;i" it' 7%h?3_ Es: Lk --1 JiJ4svflii4 C, I'; €m141.7;ROI, %3. PPIb"-tar' i.ki_!_ FI) i4 PRS . FE `,.Tt')1 R LSPC 1 rCl H t:.Ctl'•!1it4iC-' -- }, R r ut- i5 75 .- F. 4PH: p m iti;' .'#''t'r t`t_,.L:=I,_.Al LQ» -t I3rin i srtt_.iRix:r f C. Ii4:'al r;r ua 72.v.E.2 ! F;7'i Cr'H.t_..0 EOM i CtRI IF Ii:'ir - t iii Film rt1?417: uip-•,:I FE iiN" .'kFt_i_SFrA _ Ft -44 f:'1 Sy ri-i+_ j'tt gl1C1 Y:16 r; -u sic t i-33)'c:-N.'t.T f .i Fi ' 1 ._ r.s (Zt { x:Tr. r"-. {-H. 's s T nF' t•4 T FH 11-*: " t-`71iit t� z< ir, '$ Ira Yl. -'?, >! - s_aJs tc „,- 7' /HAT rr-le Ofl _: r7 - :Z? T v w ---71”-4-19f t'rfy ' Cfl � _ of?L?tF Pr Ecc_rit„ L _ he/0005:0 Ct+ 1j%=4? t1! -s- tit7r�f^ T: -{.-.U± s frfc15t•t0314a. LffiE "ri €t'.kl',1 T LUS ' 1i 1C 3-3l= t a;:i : J' Pr :-iN& €: '=','ti Ts t4 j %. `Ftdttt!-tia =5 F5>Er '. I r.-14FO • ei M7C I - . I Ari T 1 (gip} 4/cj' -/'7sc.)toc Ch -r! eJ r4nK 1_-:3_6_ S L :: /_ - J 2,- % it a /CJI �L LQ 0 GRE�4.riev 21t ANCHORAGE AREA BOR\ GH �/ 76, Department of Environmental Quality )J'13 7� 3330 C Street '/ Anchorage, Alaska 99503 :K vt!�C: ✓- INSPECTION REPORT ON-SITE SEWAGE DISPOS�AlL�SYS EM '4 /Grp .et MAILING ADDRESS r4/4 Ptt ;: PHONEc24/.-- LOCATION/? aagi iltI LEGAL DESCRIPTION I /Q te4V'. //)7� �C/2) SEPTIC TANK: DISTANCE 'I �/ pp FROM WELI UA/ „2-425/MANUFACTURER Y/,vser MATERIAL INSIDE LENGTH INSIDE WIDTH TQC' GG, D: DISTANCE FROM WELL FOUNDATION /© /0/;96//C— NUMBER OF COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY/QC) GALLONS. �.- TOTAL LENGT NEAREST LOT LINE -e� OF LINES NUMBER OF LINES / DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA SQ FT LENGTH OF EACH LINE �} DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE 7/4%MATERIAL BENEATH TILE �+ IN ABOVE TILE IN. WELL: 'y�;J'/ TYPE a01�` .f/�dONSTRUCTION DEPTH BUILDING NEAREST NEAREST FOUNDATION LOT LINE SEWER LINE TANK SEPTIC f/ SEEPAGE SYSTEM CESSPOOL APPROVED OTHER SOURCES DISAPPROVED DISTANCES• A C - AZ.1/6 INSTALLED BY. coez,s e -r> • SEWER LINE DEPTH - PIPE MATERIAL LOT SLOPE: 2&6/C / DISTANCE FROM: REMARKS DIAGRAM OF SYSTEM REMARKS• Form E4-032 DATVt 24 7CAPPROVED G.A.A.B. WATER WELL LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 MUNICIPALITY OF ANCHORAGE HEALTHDEPT. OF ENVIRONMENTAL PROTECTION DEC 91976 WELL OWNER t Chin N��-J�}n / rrUSE OFHomo omo LOCATION iQt JD R)06.4Ii 1in,bt/t.✓y 5j1) -c1 GIw sL:4Dn //.; RECEIVED SIZE OF CASING I "DEPTH OF HOLE/QbFT. CASED TO / 0 STATIC WATER LEVEL 98 FT. YIELD GAL.PER.MIN. WITH ci-it FEET OF DRAWDOWN. REMARKS FT. DATE COMPLETED II/0/7 /n fit £toD (2t oa '5 r� t oSe /itoLD4 1.Qto22,6 to to to to to to to to to, to. t 0, to t0_ PUMP TO BE SET AT nes Ftejt (►Try, San d Gra.✓, I ('Vey, 5a»d Gra3/4 (1la, y Siad Ji Gntiv✓/ (IA% Sar d a) Growei 6/cvyl, 5wn 6ru.✓4./ Sam I� (ravt/ J3rn Gre )/ 6 rt y A1tAie t Gr.� y 641 fhurd Ji to/ 14 . 1'Itd (A)Ait t>✓r i4;ZJg Cluj El P-4 ®_ I1�, RL I re e`®F eRt-•de_ F 1 ^o- eate;E f/ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION - 2516 E. TUDOR RD.. ANCHORAGE: AK 9951:17 6-2221 bJ L L a= -e PA C.--• 01%4 -- s; 1L `E F E_ R2 r i PERMIT NC'. ( 76766 4: a '- APPLICANT .JIM NEHR 801. AIRPORT HTS LOCATION HILI_HP�dCHLE AVELEGAL L± -i. 0 E TIME:ERLU(:; _,L 27 SUE: LOT SIZE 54455 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ THE SOIL.ABS0RPTION SYSTEM IS: LENC31Y' F -R = 4 C3F°E °"e°F- L 1 274-9452 THE REQUIRED SIZE OF 1'95 L>EEF" T R -R _= ' ^ THE LENGTH DIMENSION 1S THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. 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 EXCAVATION (IN FEET). F.:E-® eLe I Rte'E'c-. SEF•1F I ®_. "Te---et--0C -E_ -u eO "TWO •_:.` :s I t-J_"F"Ec:—r I u3tJ E,ACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN FI'WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 1400 FEET FOR A PRIVFITE WELL. OR 200 FEET FOR A PUE:LIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. • FOR: met --0E °-e-°Eh=eRu_ FR _c®R^R ISSUE". I CERTIFY THAT 1: I FIM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELL=, AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. =: I UNDERSTAND THAT THE ON-SITE ::EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE: RESIDENCE IS REte DELED TO INCLUD'E9 MORE THAN 3 BEDROOM=. SIGNED: r-�3 APPLLCANT JIt9 NEHR ISSUED BY._ C _DATE _/ Y /7- ? , 047 •31VDS aihnssv wnlva SNO11VA313 ON115113 PO 135 NJVI 0 any .21..i 0 A3G1:1n5 51141 135 UV1/3H 0/5 0 0383A0338 8V0311 0/5 • ON3`J31 1-1 - of tl 01 j.v -I :NO11d183530 1V931 Nis NOSN30 0 NVO 'B aOA3AHn5 ONV1 038 '81" 11VONVel 01V2139 IAB 03avdJtM '30V2:10 HSINU 01 NOI1V138 NI NOIIVONl1O3 AO dOl NO3H0 01 A1f11011SNOdS3N SHOIOVNINOO 31-11 SI 11 ^ — �t Oc\ • *.:'L \\ego '1SIX3 S1N3WHOVOLIHON3 ON ONV S3NI1 AL83d08d 3H1 NIHIIM 38V NO383H1 031Vl11S S1N3113A08dWI 3H1 1VH1 ONV No3213H 030ILJOS30 CNV NMOHS A1U3dOi1d l 3H1 03A3AL111S 3AVH 11VH1 A111833 A0383H 1 : NOIIVOLi11213Q A3ANf1S 101 d I Itt 714M1 ,v� \ 29 \ 270.1)(11 \,'1>r, 5.10,409 hi C Jorzsetu tton EJ .t .1 1,) "Ona testis worth a thousand opinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For Jim Nehr 8/3/76 Leval Descrintion: Lot 10 Block H Subdivisionte TimberluxPerfoed Subdivision This Form Renorts Soils LOO yes Percolation Test yes Depth Feet Soil Characteristics fop`sozl ?ere 4 — Brown Gravelly Silt (ML) :est Gravelly Sandy Silt 8--:..e.—� -Y, :one 10-- 12- – 0 12- Silty Sandy Gravel 14__ 16 -- 20_ Bottom of Test Hole Was Ground Water Encountered? If ves, At what Depth? No bedrock encountered. Reading Date I — No' Gross Time Net Time 8/27/76 saturate •eriod 8L30/76 L 8/30/76 8/30/76 8 30 76 8 30 76 Percolation Rate 1"/15 Minute Proposed Installation: Seeoaae Pit Drain Field Depth of Inlet Den—ft—To Bottom Of Pit Or Trench CnmMENTS: 195 square feet drainage area required_p_er bedroom. 72 hrs Depth to H2O inches 20.00 Net Dron inches Test Hole Empty 0 � 19.75 0 3.0 hrs I37.75j 18 3.5 hrs 4.0 hrs 40:25 1 2.5 42.25 1 2.0 Test Performed By j 4,2!x , /, 144, g/ T Data Certified By: CONSTRUCTION:TEST aures D Mack Date: 8/376 LAB ALASKA CflUIROflrpcflTAL COIITROL SSRUICCS, Inc. engineering & €nuironmental Studies 6/17/82 SUSAN NEHER P.O. BOX 10-771 ANCHORAGE AK 99511 MUNICIPALITY OF ANCHORAGE Cyr., T.7.1 ^. 18 1952 RECEIVED SELLER - SUSAN NEHER BUYER- SUBDIVISION-TIMBERLUX #2 BLOCK -H LOT -10 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRECH WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 150 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 6 GALLONS. THE SYSTEM IS UNACCEPTABLE BECAUSE THE SURGE CAPACITY IS LESS THAN 75 GALLONS. THE SYSTEM IS NOT CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SEPTIC TANK WAS PUMPED ON 4/16/81 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. n"t'e OF 44 Mil ,,........a .,c^. •• osa_ of e 60,11 goi, re to sone •J? In e 1„ for y C. Reid, Jr. • 4 /00 :0 % No. 2251•E* Vg's+ @4%®9OFESS P49. 1220 West 25th Avenue • Anchorage, Alaska 99503 • (907) 276-1361 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES (t,e `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 l-7,5 HAA# W CC .®4-iAtik omplete legal description ocation. fess otherwvisejr guested HA; MBEROFBEDROOM 'S ,r::� ✓ « '3 t req TYPE OF WATEF;i'.SUPPLY�xy�� 4bindividual well .u�nCa'+Sq s'-bra--:•.by,.�sr�-ia'2s�3.�ks�a-r,=' y & n SCom_mumtywel ' h?'s�z Sa 2 �'j ublic water -jtii c4.a t•d'y a._t,� t i"'S�^� s4�.i,-o-`S�j DOTE If community weltsystem,' provide written confirmation from St41YADEC attetstl ung to the legality and status otsystein * $ %C SVC! i. YPE OF WASTEWATER DISPOSAL _ ; 1Ci fiy`aJi��'�avatirrgs.-. oldlng`tank j' ' ` , c Communityon.site i a �Fe ' i t t S 3"l' L riF✓«i i 3:c�,"is rx> 3Publtc`sewer lfcommunitywastewatersystem, provide written confirmation from StateADEC-$ attesting to the legality and statues ofsystem 7-025 (Rev: int} ;Front ;MOA 221 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is sate, 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 (0hLr pu'rLCLek k / 1 E. Phone Address -90LliO ' Engineer's signature „Lt<�2'LG Date 1/9‘/% 3 6. DHHS SIC . TURE Approved for 4_ bedrooms. Disapproved. Conditional approval for bedrooms, with the :wing stipulations: By Additional Comments CAUTION jai The Municipality of Anchorage Department of Health and Human Services (DHHS) is.:ues Health Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (aev. 1/91) Back MOA 421 D. LIFT STATION B l 0 C'-/ C L IE Date installed 14-3/93' Size in gallons Manhole/Access (Y/N) "Pump on" level at* ie // "Pump off' level at* ( High water alarm level at* 2 7 i! . *Datum I 0 I cs-c- 1 a..ii. Ire Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: I Septic/holding tank on lot //2.0 : On adjacent lots Absorption field on lot 1 15 ; On adjacent lots i /0-0 Public sewer main 1 z/,4, - Sewer /septic service line 90' Public sewer manhole/cleanout NSA Lift station 1 Z 0 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: i I Building foundation cat, Property line is0 Absorption field 69- `a Water main/service line >oab Surface water/drainage 1\1 0 Wells on adjacent lots > / 0-0 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Surface water yo N10 Curtain drain HID F. ENGINEER'S CERTIFICATION Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots > 70'0 1 certify that 1 have determined thru field inspections and review of Municipal in conformance with MOA /IAA guidelines in effect on this date. Signature /% Engineer's Name { p .e. ✓i Cr U '� %rte lat t2 -PX I Date 240. Alp Lei 95- HAA Fee $ Date of Payment 9-2 Receipt Number /331J 3 a p Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Property line /2-0i recordsahatthe above systems are, o g Seat•Fiaee CF: 2225 9 Date of Payment Receipt Number Legal Description A. WELL DATA Well type Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist 10f/010kI •77144hert ,e Log present (YM) N1 Total depth lift Parcel I.D.: 018 - If A, B, or C, attach ADEC letter. ADEC water system number NIA Sanitary seal (YIN) Date completed 1 � 7 2- Cased to > y (% Casing height (above ground) FROM WELL LOG Date or lest Static water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK/DATA Date installed c/3(y Tank size Nitrate Wires properly protected (Y/N) AT INSPECTION 9/L Z/e/ rn rn 1 -n 0 W.? I SYri N/, I CW -11'141 414A -e -a l CW -11141 Collected by: Other bacteria 0 Cr) CO CD 01 1' x t'? Z <n o0 •c: T r;1 G v, G` fl rt, 7: g.p.m. 10 50OW. /07.-W 0 13LDcYct_t Number of Compartments / Clcanouls (Y/N) Foundation cleanout (Y/N) Depression (YIN) /2%-1 Date of Pumping N/A C. ABSORPTION FIELD DATA Date installed e1/43A Pumper High water alarm (Y/N) Soil rating (g.p.d./ft` or ft'Ybdrm) 4" Length , 0 Width Gravel thickness below pipe Effective absorption area / J 0 Monitoring Tube present(Y/N) \l Depression over field (Y/N) rI System type 6-- tie, c -A // / ry Total depth Date of adequacy test N/A 1 fJ Results(Pass/Faiq � For -/ W Immediately after gal. water added Fluid depth in absorption field before test (in.); Fluid depth ✓ (ins.) Minutes later: Peroxide treatment (past 12 months) (YIN) (in.): Absorption rate r/ g.p.d. bedrooms v If yes, give date CT&E Ref.# Matrix Client Sample Client Name Ordered By Project Name Projectq PWSID CT&E Environmental Services Inc. La boratory DivisionEx®®®®Basssrsriasszrmdr®a®®®,�®s®®sms�®®®®®®®gym 95.3983-1 Laboratory Analysis Report WATER ID LOT 10 BK H TIMBERLUX TOBBEN SPURKLAND, P.E. TOBBEN SPURKLAND UA WORK Order Printed Date Collected Date Received Date 17997 09/18/95 09/13/95 09/13/95 Q 14:58 15:30 17:05 Technical Director STEPHEN C. EDE Released Bys—` Sample Remarks: SAMPLE COLLECTED BY: T.S. Parameter QC Results Qual Units Method Allowable Limits Ext. Date hrs. hrs. hrs. Anal Date Init Nitrate -N * See Special Instructions Above 0.10 U mg/L EPA 353.2 10. 09/15/95 CMR ** See Sample Remarks Above U:= Undetected, Reported value is the practical quantification limit. IY = Secondary dilution. UA = Unavailable NA = Not Analyzed LT = Less Than GT = Greater Than 200 W. Potter Drive, Anchorage, AK 99518-1605 — Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 47s/97 -c 11 Application Date /f<G al/94-7 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lar/0 114.4-1 Location (address or directions) t/gst�-�& #a cep._ 3 VTh!N,&'3ifi/ (b) Property Owner patNn*-+S Ple1.4 `J Telephone:7�Home .1"/S-- /4/Business 7s-6- 3`y 3/ Mailing Address «Rif l/%t/ o( fl- 99 yL (c) Lending Institution 6,W4C Telephone Mailing Address/1 L (d) Real Estate Company and Agent {- �i 109 t '^ps% A �` "" SiPruD_ Address .3a�A 1 C Telephone 6(v 3 -55 0-0 (e) Mail the HAA to the following address: or: Check here List contact person and day phone number below. 7— if hold for pick up. ,22q- s 9f'b 2. TYPE OF RESIDENCE Single -Family O. Number of Bedrooms 9 3. WATER SUPPLY Individual Well Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (Rev 8/861 Front Nue (99/9 AO ) GM -LC Z 10 Z abed ')IJOM %Jaaw6ue leuo!sseJoad agl u! suolss!wo JO S/0119 ,10; alq!suodsaJ lou s! a6eJogouy;o Auledlo!unIN ag1 'penss! s! aleo!ppao a eJo;aq elep ez<,leue Jo suolloadsu! lonpuoo lou op SHHO to saeAoldw3 'sluaweJ!nbaJ aims pue impel u!e4Jao Als!les 01 Japao ul suopnlpsul 6u!puel maw pue sawoq to saasegoand of /sa1JnoO e se slgl scop SHHO ag1'9)!sely;o ale1S aql u! paJels!6aJ Jaaul6ua leuo!ssa;oad luapuadapu! ue Aq anoge g gdeabeaed u! uan!6 suo!leluesaadei eql uodn Apo paseq saleo!;!1Jao IenoJddy Aluoglny UlleaH sanss! (SHHO) saolnJas uewnH pue g11eeH to luaw29da0 obeaogouy;o Rl!led!oium aql NOI1nVO CIOVor 19uolllpuo0 ,L 8— arZ�.S' ale0 'r nispht . �. leas s,ieeu!6u3 • lenoaddy leuo!1!Pu0O to SWJa1 panoJddes!0 panoaddy Aq swoapeq 7`p2 ✓+.1L Jo; panoaddy IV✓AOHddV SHHO '9 Tt6T 'St 3Nnr �'.' 3-9ZZZ ..it P,.644p G�i2V (7/6C/b1-75 auogdalal / O V Sea 'uopoadsu! s!ql 10 a19p aUl u0 10311a u! suopeln6aJ pue'seoueulpJo'sawn owls pue led!o!un4 119111!M eoue!ldwoo u! s! wals%s lesodslp Ja19Ma3seM Jo/pue llddns JOIBM ops-uo eql 'uo!loadsu! pug uo!196!lsanu! Aw woi; pue sell; e6wogouy to A1!led!a!unW aql wag paulelgo uonewao;u! aql uo paseq lwUl Awed\ Jagpn; ! 'want' paleo!pu! aanlonais 10 edAi pue swooapaq 10 Jegwnu aql Jo; ewnbape pue leuo!lOun;'a;es s1 wals/s lesods!p Ja39MalseM Jo/pue Alddns Jawm e11s-uo ag11eg1 smogs lenoaddy Aluoglny Ul19aH s!Ul10 uope6psanu! Aw 1947 Anion 1'Malaq uMogs alep uo!lepllen 014110 se pue oTeJeq pax!;;e leas, w Aq pa!;!1JOO sy NOIIVW!IOJNI ONV VIV0'HO8V3S 3111 131931'SNOISO3dSNI DNIOIAOHd INHId ONItl33N10N3 '9 0190 ssaappy WJld 10 aw9N U MUNICIPALITY OF ANCHI IANECIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL SERVICES/REALMAUTHORAUTHORITY APPRO L (HAA) CHECKLIST 4 MAY 2 71987 264-4720 Legal Description Lor 1 f, l a V_ f4 I I 1--1BEILLI7x SLC- sti i/2N, RECEIVED A. WELL DATA Well Classification 12 e -s. If A, B, C, D.E.C. Approved (Y/N) ryr Well Log Present (Y/N) Date Completed W/7%=4'/ Yieldr4„2# Total Depth 10P, Cased to (0 & Depth of Grouting I'4 O HJ Static Water Level Pump Set At //o Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) 1 Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot (Let ; On Adjoining Lots >I UU To Nearest Edge of Absorption Field on Lot 1 .6 0 a- " ' On Adjoining Lots J r U n To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results / % /1 Comments JXi Y �ayq Te/f [sii tF .� . u`t` Lr a,"1.4�.d < lcal Ela C4-JaLL.� B. SEPTIC/HOLDING TANK DATA Date Installed i / Size /P-sv No of Compartments "7"1✓io Standpipes (Y/N) / &it-) Depression over Tank (Y/N) Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) Date Last Pumped 3/4c-../8, 7 Pumping/Maintenance Contract on File (Y/N) N/�1 ; for WA r Holding Tank High -Water Alarm (Y/N) W/A Temporary Holding Tank Permit (Y/N) TVA- Separation VA Separation Distances from Septic/Holding Tank: ILC To Water -Supply Well To Property Line To Water Main/Service Line To Building Foundation To Disposal Field elelo> 5 / To Stream, Pond, Lake, or Major Drainage Course "? r {�> '7 % +0 tutu Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ;2,2:5` Type of System Design Date Installed 10 ('1 E 1 2181 Length of Field 9 *S Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test 1 ty2 (1 1./ Standpipes Present (Y/N) Date of Last Adequacy Test frv' 2itlecielrmejvt:r�> 0 n!/L� Separation Distance from Absorption Field: /'5c.t. To Water -Supply Well To Building Foundation Lot NI o v1 To Property Line To Existing or Abandoned System on • On Adjoining Lots > °-C> To Water Main/Service Line ) /01 To Cutbank (if present) /VU/1/i To Stream/Pond/Lake/or Major Drainage Course //0 i p. nor volt- /n 0/ra ' a_.ay clic-4 To Driveway, Parking Area, or Vehicle Storage Area //.7 Comments 4 (Jen1//n i{+ h&vv./ w-aZA.�y..-... eJ1 / 1.446 4qs/....„ tit "44 .!, & y D. LIFT STATION W / EFT Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments "" Check Permitted Bedroom Rating Against HAA Request "" I certify that I have checked, verified,rconformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed % " �'/�t L`L`au Date /A /12d / Company MOA No Receipt No ca - 0007 Date of Payment S- a 2- C-1 Amount: $ /0 0 AL V--00/-007 Page 2 of 2 72-026 (11,84) , 9111 t .a 0 2225-E I1' JUNE 25, 19 1 Engineer's Seal Municipblity of Anchorage May 26, 1987 P.O. P 7 196650 ANC RAGE, ALASKA 99519-6650 (907) 343-4200 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Dennis Money 4835 Hillandale Avenue Anchorage, Alaska 99516 Subject: Waiver for Lot 11 Block H Timberlux Subdivision Waiver Number WR87-031 Dear Mr. Money: After visiting the above mentioned lot to verify land contours between your drainfield and surface water, your waiver request has been approved. The required 100 foot separation from surface water to drainfield has been waived to 42 feet. This approval was granted because your drainfield is on the opposite side of a knoll from the subject surface water. In the event your drainfield were to fail and begin to overflow, effluent would be directed away from the surface water in question. This waiver applies to this existing drainfield only and any future upgrade may require another waiver request from D.H.H.S. ncerely, Daniel J. Roth Civil Engineer On -Site Services cc: Gus Andress, P.E. Water Quality/On-Site Services Project Manager TOTING ENCONSULUUL tNLWJV D)203 W. 15th AVE "C" SUITE 203 9 o�o MOND;ntaY ANCHORAGE, ALASKA 907)2799501 RONENr.HEACTHE t oorEcION MAY 2 7987 RECEI QED MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 6-6650 ANCHORAGE, ALASKA 99501 MAY 26, 1987 SUBJECT: REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR PRIVATE WELL, AND SURFACE WATERS. LOT 11, BLOCK H, TIMBERLUX SUBDIVISION DENNIS MONEY. Gentlemen; We are submitting a request for waivers from the separation distances stated in Title 18, Alaska Administrative Code Chapter 80.020 The closest standpipe on the septic tank on Lot 11 is 97 feet distance from the well on lot 12, which was installed at a later date than the septic system on lot 11. Also, the developer of lot 12 improved the surface drainage of that lot by ditching and thereby created or changed the drainage pattern of that lot, which resulted in a small pond 40 feet distant from the end of the drainfield on 11. Representatives from your department inspected this drainage situation to -day and indicated to Mr. Money that a waiver would be granted. Yours Tobb-n Spurklan. P.E. cc. tennis Money • U O o V1 GFJP1a7AADD9 Pulta CONSULTING ENGINEER 1203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 11, BLOCK H. TIMBERLUX SUBDIVISION LOCATION: 4835 HILLANDALE OWNER: DENNIS MONEY TYPE OF WELL: SINGLE FAMILY WELL LOG AVAILABLE: YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: PUMP YIELD: DATE OF INSPECTION: 4 GALLONS PER MINUTE 4.5 GALLONS PER MINUTE MAY 14, 1987 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 4.5 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. AT THE BEGINNING OF THE TEST WATER LEVEL WAS FOUND AT 72 FEET BELOW TOP OF CASING. AFTER 38 MINUTES OF PUMPING AND DELIVERY OF A TOTAL OF 215 GALLONS THE WELL WAS AT 100% DRAWDOWN AND THE PUMP SHUT OFF. RECOVERY WAS MONITORED FOR 70 MINUTES. 50% RECOVERY WAS OBTAINED IN 13 MINUTES, 75% IN 25 MINUTES AND 97% IN 70 MINUTES. BASED ON RECOVERY RATE WELL YIELD IS 3 GALLONS PER MINUTE. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA AND NITRATES ON MAY 18, 1987. BOTH TEST WERE NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. rJ CONSULTING ENGINEER . ada�a9 P L 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: 19071 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOT 11, BLOCK H, TIMBERLUX SUBDIVISION LOCATION: 4835 HILLANDALE OWNER: DENNIS MONEY RESIDENCE: SINGLE FAMILY, FOUR BEDROOMS WELL: PRIVATE, ON SITE SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1250 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 900 SQ. FT. FROM MUNICIPAL INSPECTION FORM. 744 SQ.FT. FROM FIELD MEASUREMENTS. SOIL RATING: 225 INSTALLATION DATE: JUNE 1981. DATE OF PUMPING: MAY 18, 1987. ISAACS PUMPING SERVICE. DATE OF TEST: MAY 22, 1987. TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED TANK WAS FOUND WITH 3.5 FEET OF COVER. TRENCH SUMP WAS 7 FEET DEEP AND THREE FEET TO TEE. TRENCH WAS FILLED WITH WATER TILL WATER ENTERED THE TANK. A TOTAL OF 2200 GALLONS WERE USED, WHICH CAUSED A 38 INCH RISE IN WATER LEVEL. INFILTRATION RATE WAS MONITORED FOR 18 HOURS. DURING THAT PERIOD WATER LEVEL IN TRENCH DROPPED 10 INCHES INDICATING AN INFILTRATION RATE OF 580 GALLONS PER 18 HOURS. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. ,_1 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID #92-0040440.. Client P0# : VERBAL Req #: Client Smpl ID: LII, B4 TJMBERLLV Sample Recd : MAY 14 87 Ordered By REPORTS ADDRESS #1 TOBBEN SPURKLANUPE 203 IW 15TH AVE, #C-203 ANCHORAGE, AK. 99501 ANALYSIS REPORT BY SrwIPLE Spec ia.i COPIES HELD FOR. PI OK UP. Instruc t: ROUTINE SAMPLE TAKEN BY TOBBEN SPURKLAND, 5-14-87, 1200 HRS Chemiab Ref #: 6258 Lab Smpl ID: 1 Matrix: Nater Parameter Tested ts N 1 T RA T E -N Sample Remarks: 1 Tests Performed ND= None Detected NA= Not Analyzed ND (0.100 mo/1 Mork Order No. . 574 Client Account : TOBBENP Date Report Pr inted: MAY i8 8? ? 18.3- Rel eased BY REPORTS ADDRESS 142 ADEC Al towable Method Limits * See Special InstructlonsAbo've ** See Sample Remarks Above LT=Less Than, GT=Greater Than CHEMICAL; & tEOLOGICAL LABORATORIES OF ALASKA, INC. LABORATORIES 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 , f1t4-1TYSIS REPORT BY SAKIP1 E 01 it PO4 : ARPFIL Reg #1 CI int STrip ICI: LI I , P4 TIPIBERTUX Samp 1 e Ref:" d MAT 14 87 Ordered BY ! REPORTS ADDRESS #1 T088E41 SPURKTAND 203 IT I 5TH 0416, 14C-103 PITCHOKAGE, AK. 99501 ci al COPIES HELD FOR PICK OF . ins ta t KOUTINC SAMPLE TAKEN aT TOLIBEN SPURKLAND, 5-14-37., 1200 HRS Ch Ref 14: 8,258 Tale 84'01 10: 2 Nab' i (4ater Par erria ter. Tas t ed Re P.1 I Ugh i tS TOTAL COL I FORPI 0 roi/100m1 Work Order. NO. ; 524 CI enthccount ; 1:000209 Date Repor t Pr! ted 37 Released 44y REPORTS ADDREaS 142 :4E0 1 eEtE ESHOPITI9d See 9eca} inatructcirbov!? None Lscts :nrr,!, !.57.5ii!!! Ken:ark KKdeDeddd . . • Le,dd Hat fTh !C. St! !_i=!.!!SS tRif 4T1-rter 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 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) ',, / A 69 tea Location (address or directions) 4:gge /////, wp, e Ave %/Uc/J cia ', 4e 99S/G (b) Applicant Name L 13/1--e-6 Telephone: Home � � J� .94226-g627, Business ��, �/9,� Applicant Address 4676 /�// tiM/PP( T/V2 /4jj�al® Wee 4c 9937 (c) Applicant is (check one): Lending Institution 0 ; Owner/builder Buyer 0 ; Other 0 (explain)• (d) Lending Institution_f7Gf/ Address (e) Real Estate Company and Agent A/o/y._ Address Telephone Mail the HAA to the following address: 17- /hay/ ,ci✓a//(6-2/1 7 % /th6,0 ?�D.S Aec77e 8oilz, s//7.- 99' A/a/D at, %;C 996.0 aro/52- Telephone lib ` 769° _1_�� /il/i✓�os� �G//� A�/o���-9903 (f) 1/P 2. 2. TYPE OF RESIDENCE Single -Family Multi -Family 0 Other Number of Bedr��`ooms 3. WATER SUPPLY Individual Well Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) `` 5.' ENGINEERING FIRM PROVIDII (INSPECTIONS, TESTS, FILE SEARCH, DLA 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.ns�// //r Name of Firm !% /k C/✓ai/V�irie'/V Telephone 7b Address Date JAI 8•C' 6. DHEP APPROVA Approved for bedrooms by Approved 41%6000p 0 ao. ra%P°49111 o'*I ° j�Qinaert;®& el!Oa 1�0000eoe ro 00 00000aoou0000��CyyOE90�foo Li pannla efl8 ^VF e CE 5909 °e X0000000 °Ind ppA �p wag elle Disapproved Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a 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) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /25 OM/1° DFr Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design %.�iGgeh //3Frl) g, 5 r & o<r Length of Field Depth of Field Gravel Bed Thickness No SAVA PAcra X.i Separation Distance from Absorption Field: To Water -Supply Well /24r7- 29Fr() To Building Foundation Lot To Water Main/Service Line Standpipes Present (Y/N) Date of Last Adequacy Test }lc 7/8//86C) To Property Line /2Fr'C2 To Existing or Abandoned System on /oofrr • On Adjoining Lots /y'lA0 To Cutbank (if present) A✓/,4 To Stream/Pond/Lake/or Major Drainage Course Z To Driveway, Parking Area, or Vehicle Storage Area /0 / rT Comments a) /&2// Doer ,9ECO.epS (V crew c d --&r6 ,wEA retem W,,r 7/sY/O6 D. LIFT STATION (A//4) Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at \\ Tested for Electrical Codes (Y/N) Comments Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** 1 certify that I have check dtv ified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Ma— �� Date ff,it no Company -1 .f11644 CfJCP6OCEl'{�ll MOA No Receipt No \ O \ ®`o a- 3 Date of Payment Amount. $ \O S .b Page 2 of 2 72-026 (11/84) • 141/47 74-1 • Dennis . D CE - 5 P'1iii.lZt' f e A. WELL DATA MUNICIPALITY OF ANCF Y CIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTALP----IO,tHECKLIST - FEBRUARY 1984 1986 264-4720 RECEIVED /-/ij /52 Legal Description: (97-4 C /� T/ev cs-032 A/9- 4825 ///G P14t6 1o'e Well Classification �2/U4re If A, B, C, D.E.C. Approved (Y/N) u/A Well Log Present (Y/N) Date Completed ////�/7l% Yield 4 7�7PA' Total Depth /06FT O Cased t /06fr 1 Depth of Grouting /VO/Vo Static Water Level 11- arr. 0 Pump Set At /(9,gfT Casing Height Above Ground , �U e) Sanitary Seal on Casing (Y/N) ' / ��/� Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) /Y Separation Distances from Well: � T 6� FT To Septic/Holding Tank on Lot /ASF" ; On Adjoining Lots / z,cr. To Nearest Edge of Absorption Field/ on Lot ./2 t7 • On Adjoining Lots ____//0/>71- To Nearest Public Sewer Line N/A To Nearest Public Sewer / / Cleanout/Manhole N/A �/� //Too Nearest/stSewer Service LineonLot .—_/ //4 Water Sample Collected by s er !iV/ 1 7 % Date // Vg Water Sample Test Results SAY1S toil timi Comments e -O$ 17//6P ,2ECoePS , 0 A&OA1 4A.,-S/r€ M,,ASU.lMENrS 7/6//86 B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) 62 Depression over Tank (Y/N) Size /�001/A/ No oLCompartments Air-tigtbt,Caps (Y/N) ,, /CCyJJ /Y Date Last Pumped 2 - Foundation Cleanout (Y/N) Pumping/Maintenance Contract on File (Y/N) • for Holding Tank High -Water Alarm (Y/N) /' Y' Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well /5/7-6) To Building Foundation To Property Line / 7.tFT r0 /V >t To Disposal Field // rCT v To Water Main/Service Line t/A•• To Stream, Pond, Lake, or Major Drainage Course Comments Flo/ ae/ep ,eeco,eos ® F,eo,w av-wre Aleds,ee,ce/Ts Page 1 of 2 72-026(11/84) A+Home Services 15900 Francesca Drive Anchorage, Alaska 99516 345-1890 • 345-2444 DATE 8'-i -0 6 fif /l iAsq,�7/s/ diga.� J // k n1 -Da /e- cla-_31,7 - /96/S2 DATE DESCRIPTION CHARGES CREDITS BALANCE PREVIOU CE 62 44 4, I , . / 4 0 - - i 40 _ 4 O szetze;tt l %0 �0 G B /" 7mi/ �t,oc. )25-0_2700 Cq( y s"Se ye_ 6e/Qo/ .;-/wK BALANCE DUE I> 0 If this statement does not agree with your records please notify us at once. STATEMENT PI PFMm' 111 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE ) � 1. General Information Application Date c_ii `. ) HO (a) Legal Description (include lot, block, subdivision, Section, township, range) Ttrrnb6K�Ltx * a Lot I t i31 oc. A fy Location (address or directions) (b) Applicants Name U%i`%.f"�rC,y3 0n001)E- C,DO.�>4_� Thlephore:5q -31"7'J "n Applicants Address l(] `1 I r I D\ d 5E L1)a a (c) Applicant is (checkore) Lending Institution n ;[Owrrer�/builder ; Buyer r ; Other Ii k(explain); (d) Lending Institution Telephone Address I C (e) Deal Estate Co. & Agent (( AnnLe 60.1-1-s4 -�.I R; p 1�.', nn �.Lt n Address ' -�I l P i 0 t d SEC- UDC (ZC^ Telephone 131-119- u? (`l I 2. Type of Residence Single -Family Number of Bedrooms 3. Water Supply Individual 4 11 Multi -Family 1 Other (describe) Communityi Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting<to the legality and status. Is the well adequate for the number of bedrooms specified in this'HAA ] I) 4. Sewage Disposal Onsite Paq Public $j Community $1 Holding Tank Is the wastewater disposal system adequate for the nunier of tedrocros ON) (Page 1 of 21 2-15-84 5.. Engineering Firm Providing Inspections, Tests, Data and Information I certify that I have checked, verified, or conformed to all MDA HAA Guidelines in effect on the date of this inspection. Signed C. /°� / /ui 24Le747 Date n' /f i R1aal Name of Firm '1E C;.S , Address X20,0 4).. 33 :16: 6 Signed by Date 3/1/ ti (ENGINEER SEAL) 6.DHEP Approval Approved for / bedrooms Approved rsaDisapproved Terms of Conditional Approval Telephone .5-6 SZ1 7O ti .c- S- • •.�.1S ®0 4' •°°4.9 9D • figict 6 o•c acc.V '• Lero 0C2251�E ,r?4� ® • BY% VcZ-- Date:41.±._;1_:: Conditional L. 1 The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater' disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedrooms and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 2] 2-15-84 A. WELL DATA Well Classification Zialwaduki If A, B, or C, D.E.C. Approved(Y/N) Well Log Present (Y/N) YE -5 Date Completed y//7/gy Yield y 9 po Total Depth /013" Cased to dth.4N00 a Depth of Grouting 1"'14,16tet,u Static Water Level Iv1/44 V o'h. Pump Set At itiw►tttoWh� Casing Height Above Ground /.i/' Sanitary Seal on Casing (Y/N) Ves Electrical Wiring in Conduit (Y/N) Yes Depression Around Wellhead (Y/N)/04 Separation Distances from Well: To Septic/Holding Tank on Lot /IV' ; On Adjoining Lots /00 '4- To tTo Nearest Edge of Absorption Field on Lot /3O' ; On Adjoining Lots /400.04_ MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Lot 11 Block AlTimberlux Subdivision #2' To Nearest Public Sewer Line Cleanout/Manhole N/4 Water Sample Collected By Water Sample Test Results Convents N/A- To Nearest Public Sewer To Nearest Sewer Service Line on Lot �. %urn er' ; Date 2/204 N/A - B. SEPTIC/HOLDING TANK DATA Date Installed /,l$/ Size /2-5RD No. of Compartments Standpipes (Y/N) CIES Air -tight Caps (Y/N) yts Depression over Tank (Y/N) ftJp Date Last Pumped Pumping/Maintenance Contract on File (Y/N) /4,4 ; for Ain Holding Tank High -Water Alarm (Y/N) N14 Temporary Holding Tank Permit (Y/N) A!/,* 2- Foundation Cleanout (Y/N) Yes Separation Distances frcm Septic/Holding Tank: To Water -Supply Dell IAD/ To Building Foundation 20 To Property Line s_ yD' To Disposal Field 5� To Water Main/Service Line tsjfr To Stream, Pond, Lake, or Major Drainage Course N I /} Col nts [Page 1 of 2] 2-15-84 48 -ST -Z goa33a uT 9euTTepTnJ ywH (� LS •oN 1/09411,4d (Opv'AV0441/1i11143 VON Tie ege0 [Z Jo Z 05ed) 9/SP/TEM •uoTgoadsuT si.g 3o egep egg uo og pemaojuoo ao 'pe gTaw 'pepa4o ene4 i Begg A3Tgaeo I * gsenbeg yfH gsuTeby 6uigflp ee wooapeg patuued eu3 VON sgaaw •gsay Aoenbepy 6uTanp SeToAO 6uTdwnd (N/A) gueA sgua uop (N/X)90po0 TeoTagoaTO 42 TeAe7 030 dwna„ (N/A) ssaooy/eToquew suoTsueaTO ao3 pegsey ge Tanal waeTV aageM 46TH ge :canal ,,u0 dmndu suoITeo uT ezTs PeTTegsul 0420 s2zi d 3NaN Noiyyys Ian •u sgua:wroO eeay e5eaogg eToTq0A ao 'eeay 6uTjaed 'icemen -a0 oy it Is esanoO OSeuTea0 aocew ao/axevpuod/weeaas oy -41iy (guesead 3T)NueggnO oy //N i+IN s4o7 buTuToCpy uo uo wagsAg peuopuegy'ao buTgsTxg oy ,6 sun e Tnaes/uTew aegeM oy aura Zgaadoad oy - ,orf :pTeTa uoTgdaosgy prl6 0(2°) SQT, 3o egeO ()iv (N/A) pTeTa aano uoTsseadec eaay uoTgdaosgy 3o geeg eaenbs /,Role 49q, I,aenbapy gse'I 5?,6 (N/A) guesead sedTdpuegg a ry o tv goy uoTgepuno3 6uTpTTng'oy TTeM ATddns-zeieh oy woa3 aDuegs10 uoTgeaedeg ioenbepy gsel 3o sgTnseu sseupoTgy pee Teneao PTaT4 3o 4gdec uroo1l wV1 PTeTA Jo 41PTM i 06 PT°Ta 30 41bue71 W9 peTTegsul 9420 #fl'19ar/ u5TseO megsAg 3o edAy Sz?' egeagg uoTidaosgy uT buTgeg STTOS VIVG O'IOIa NOISdaOSSV • 0 ALASKA dIT If10I1f11Cf1TRL COf1TROL SCI CIiCCs, inc. engineering & environmental Studies FEB 29 1984 WAYNE AND ANNE COOPER 6917 OLD SEWARD HIGHWAY ANCHORAGE AK 99511 SELLER — WAYNE AND ANNE COOPER BUYER — SUBDIVISION — TIMBERLUX #2 BLOCK — H LOT — 11 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 900 SOFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 600 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 2/29/84 . FLOW TEST ON WELL THE WELL FLOW RATE WAS 1.9 GPM FOR 4.25 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. '41 .d P e F✓u es 2o e -' d®� L- a C. Reid, J . <• %o -J 4 u o. 2251-E a fcSo/ .4tY AAWtHe 1200 West 33rd Auenue. Suite B • Anchorage, Alaska 99503 • (907) 561-5040 ALASKA dTOIROf11116f1TAL COf1TROL sSU(CeS, inc. Engineering & enuironmental Studies March 1, 1984 Mr. Keith Bandt MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 Ref: Timberlux #2 Lot 11 Block,2' y Dear Keith, This letter addresses the discrepancies in the septic system on this lot as per our phone conversation of February 29, 1984. As I pointed out, the total effective absorption area recorded on the inspection form of June 10, 1981, does not match the other recorded data. With a trench length of 93' and a gravel depth of 4', the absorption area should be 744 square feet, not 900 square feet as recorded on the inspection form. I can confirm a trench length of 93 feet, the gravel depth cannot be confirmed without excavation or drilling. The problem arises in that this is a 4 bedroom house and 744 square feet is not adequate. The original design was for a 3 bedroom house, as was the approval. The design called for an 85' trench with 4' of gravel. Apparently this was adjusted in the field to a 93' long trench. The inspection form does comment to "Hold for 2nd soil", so it could be that an additional percolation test was performed and the design adjusted. But only the original 225 soils test rating is listed. In Mr. Spurkland's report, the soils are rated as having a highly variable percolation rate and 225 was recommended as a safe rating. It might have been adjusted if they discovered better soils while excavating. I performed an adequacy test on this system on February 28, 1984. The system tested out as adequate for a 4 bedroom home. We cannot tell whether or not the error on the inspection form is due to an error in calculation or a change in soils rating, but the variable percolation rates reported by Mr. Spurkland tend to indicate that the soils could be better than the 225 rating. The fact that the system tested out as adequate for a 4 bedroom house tends to support this. I recommend that this system be termed adequate for a 4 bedroom house. Sincerely, SAwAr 'wen Turner nvironmental Scientist 1200 West 33rd Auenue, Suite B • Anchorage. Alaska 99503 • (907) 561-5040 Time APPLII ,,NT FILLS OUT UPPER HAS ONLY Property Owner o.-rn-c s Mailing Address » n R (4 'P- S (AAS A Yl) K Altive 1 to • 2--/) I r C.„n. Pk Zip Code �'99S) - V- (11Ctc-I\\in1'h t-. CUO.ber p t ? --. G t 1 Ar 4,Ai -Code cO J.Z� + F rklc�,��l � , 9 Phone j(15i aa.9 . Buyer Qo,1C.1cl /\. WL.he..r Address7✓ SSU C � iJ.� Lending Institution Address - I- l p-A,t_0 J1q6Af•,rc 6nr Phoneele-,LL, P7Ki-& U° 11i{ [!l 41. SA-Trq-"le-.-P,h--(ik-,;—. t-- Zip Code 99570 Realty Co. & Agent. p ) I A O L -7 Address - w MI �— ✓ (e`f\-\-- - Lac{ \ E-6-1-0 Y\ t o-ra. Pr -'27.155-2- rZip Code Phone en,- 7 66 S LegalDescriptionL Street Location c _J l /4 1 11(.x! D e, �it`.-} t, 1�,\;N- & c R- Q (i1 Type of. Residence gSingle Family Multiple Family ❑ Other No. p of Bedrooms 'S _ Water Supply . Individual Community ❑ Public Utility (j ) APPROVED BEDROOMS ( 3) DISAPPROVED ( ) CONDITIONAL APPROVAL ..y ATTACH WELL LOG. A well log is required for all wells drilled since June 1975: For wells drilled prior to that date, give well depth (attach log if available). Sewer Disposal gIndividual Public Utility ❑ Holding Tank G // Year Individual Installed: / / 7 W _ When Connected to Public Utility: ..-� 1 `t' � J�-`'V Ml91 { 6,-,6) NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time -4 UJ V Time Cc. 7• „'h "% atet,nun Date Date - Date 1(l-'�1-1-qa 1 kmLA Date to - VA .a .a&), -- Inspector Inspector Inspector Parr{ O. Inspector P, & Field Notes: �� — InAl'po4 t+N- I - Li. Aip or (--,- � v- oo Pi of � 0e- 11s IE:!" (j ) APPROVED BEDROOMS ( 3) DISAPPROVED ( ) CONDITIONAL APPROVAL ..y 'B6 " OF APP OVAL �/"l/0 �, ''" _� / ^-y 'C't j �- ..W -t t (/W '--2Lw-1 WCl BY. C7 -(-,GYM. / ..-� 1 `t' � J�-`'V Ml91 { 6,-,6) Soils Rating 461 Date Sewer Installed tb -At Well To Absorption Area Well to Tank Well Log Received \I Septic Tank Size /.0ave) 7242313/82) / INSPECTION APPOINTMENTS DATE RECEIVED .erruSi; TIME TIME ,_ KA A$, AcP TIME PL , 0 hOJAufd h!i DATE DATE 1- 11)-q\ (kJ_I_f5. DATE -2-- E1Qobbb INSPECTOR • COMMUNITY since June 1975. For wells drilled prior to that date, give well c_)-)INSPECTO , � 14 MINSPECTO Qj) UNICIPALITY OF A/4 LP DEPARTMENT DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 Jul 2 9 1981 SANITATION DIVISION Telephone 264-4720 RECEIVED OF INDIVIDUAL WATER AND SEWER FACILITIES •. -J.( 4 i _ ENVIRONMENTAL REQUEST FOR APPROVAL DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days fo processing. 1. PROPERTYOWNER .774A-SC4- 6e -w p PHONE 37, 37/'7 MAILING ADDRESS ',CA ' &)( 9/� - J. A iC PROPERTY RESIDENT (If different from above) 1-/`( A-426,3,-4 (('/C PHONE 2. BUYER �7 COil'ely�e/ 4 Cha 7 e--1--"- f�MAILING PHONE MAI LING ADDF(ESS 3. LENDING INSTITUTION ae.m • PHONE 0276 //3z � %74I MAI LING ADDRESS V /V i�-z-cL 1.e 4. REALT R/AGENT LZ PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION /— /a 7L 7/ 8/e (4 ( 6w /0 y s�-,6/. STREET LOCATION %/ 7/! GYL.-t f(In--, 1 cl—' ' 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS 0 One • Four 111 Other fel SINGLE FAMILY 0 Two • Five ■ MULTIPLE FAMILY - en Three ■ Six 7. WATER SUPPLY lT INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled • COMMUNITY since June 1975. For wells drilled prior to that date, give well • PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM EN INDIVIDUAL/ON-SITE** (/1%pc YEAR ON-SITE SYSTEM WAS INSTALLED. 0 PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) f2t THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE • SINGLE FAMILY IN MULTIPLE FAMILY NUMBER OF BEDROOMS O ONE O THREE D FIVE O OTHER O TWO ■ FOUR O SIX 2. WATER SUPPLY O INDIVIDUAL ■ COMMUNITY O PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM EINDIVIDUAL/ON -SITE •PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER OSeptic Tank or IN Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANKMANUFACTURER ) 2- S(m Cy4-9.j.` s-m5 TOTAL ABSORPTION AREA MATERIAL - � € \ OCYh M \ L s, Li{-C9.1. c� o k civ g ( \) 4. DISTANCES WELL TO: Septic/Holding Tank Absorption ea A Sewer Line Nearest C5)Line Absorption Area to nearest Lot Line 5. COMMENTS Ile. APPROVED FOR - BEDROOMS • CONDITIONAL APPROVAL (letter must accompany certificate) O DISAPPROVED DATE 1 — 25 \ --' 8 \ BY \c„....5.---- mbe 72-010 (Rev. 6/79)