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Home My WebLink AboutVALLI VUE ESTATES #1 BLK 1 LT 17 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: ,~W c72. C) ,~ ~- ''L- PID Number: Name://J~lf~ ~ C ~ ~'~ ~r/~ Wastewater System: ~New ~ Upgrade Address: ~ ~ ~ C+, ABSORPTION FIELD Phone: lNo. of~drooms: ~DeepTrench BShailowTrench BRed BMound BOther LEGAL DESCRIPTION so,,..t,,,~: /~ GPD/Sq. Ft. Total Depth fro~r~inal grade: Lot: ~ Block: [, ~vis~ ~ Depth t° pipe b°tt°m fr°n~rjginal grade: Ft. Gravel depth b~~th pipe Ft. O,~- ~' ~. .~. ~~~ ~/~pgra~Gravelwidth: ~t¢ Ft. Number~flines: IOistar~eenlineFSt:. c~.i,io~tio. ~,~:% T~,~. C~s.d To: ~t. To~a~ ~b,orptio, ~rea:~ S~..~. ~ ~:r: ~ Stadc Water Lev~:. ng 'nstalle %~ E~. Date installed: /0//~ / ~~ SEPARATION DISTANCES ~Septic D Holding D S.T.E.P. From Tank Field Station Tank Sewer Lines I ~ Well ~ ~ ~ ~ ~ Material: ~ Number of ~partments: Surface ' ~ ~ LIFT STATION L~te ~ ~t~ "Pump on" level at:~ water alarm at: Foundation ~t~ C~;~n ~0~ ~ ~ ~ ] Electrical Inspections performed by: ~ Remarks: ¢/]~ ~/~ ~ F~ BENCH MARK Location and Desoription: Assumed Elevation: ~ /¢~ r~, Inspections performed by: Dates: lst~'~ Department of Health and Human Servi~s approval 72-013 (Rev. 9/91) MOA 25 Page '~ 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 LegalDescription: ~,~L/...~._ V~I~ E,~"/'. ~---~; ~-.~! ~.O? /:~' / 1~5OG~L 'A 72-013 A (Rev. 9/91) MOA 25 'Perrhit No...~W c~.,~O?.~.~'~_. Page .~ of 3 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 % 72-013 A (Rev. 9/9t) 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:SW920322 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:GUPTIL MARK C & RITA L OWNER ADDRESS:6816 DOUBLE TREE CT ANCHORAGE, ALASKA 99516 DATE ISSUED:10/01/92 EXPIRATION DATE:10/01/93 PARCEL ID:01531118 LEGAL DESCRIPTION: VALLI VUE ESTATES #1 BLK 1 L T 17 LOT SIZE: 20370 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~- ~- HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERTSHAFER, P.E. ROGERSHAFER, P.E. September 21, 1992 CIVIL ENGINEERS (907) 694-2979 FAX 694 1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Valli Vue Estates No. 1, Block 1, Lot 17 Request you issue a permit to upgrade the septic system serving the referenced property. An adequacy test was performed on the existing system and the absorption capacity of the system was found to be inadequate. A test hole was excavated and a percolation test was performed in the area of the proposed upgrade. Attached is the proposed upgrade design. This property is served by a Community water system. There are no protective well radii which encroach upon the property. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, ROGER J. RJS/JPW/lsu 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 I"=$0" SCALE UPGRADE DECK DOUBLE TREE COURT Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRI"TIO": ~r ~ME ~ ,. ~? /¢, ~r ¢ownship, Range, Section: SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 O RC,-~-ac s QNL ~ O~(.r Sic'r%- 13- 14- 15 16- 17- 18- 19- 20- WAS GROUND WATER ENCOUNTERED? A S IF YES, AT WHAT ~ ~) DEPTH? __ P E Depth to Waler A[terF-E2 I.- ~-22-?2.-- Moniloring? J ~'1%,~ Dale; Gross Net Depth to Net Reading Date Time Time Water Drop APO ~,, ~:~% -- ~" PERCOLATION RATE --~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND '¢- FT PEBFOBMED BY: $ & $ ENGiNEErING I ~/~ CERTIFY THAT THIS TE$1 WAS RERFORMED IN ACC OR DA N C E WiT H ,~L~T~{~_~i|~/~iL~¢~j i~D~L~N~N EF F ECT O N THiS DATE. DAT E; 72-008 (Rev. 4/85) ·~ ~) ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELl_ INSPECTION REPORT NAME PHONE [] NEW MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS DISTANCE TO: ~ t ~ ~ ~anufacturer ~ Matorial No. of compartm0nts , kiq. capacitg in ~allons Inside length ~Mth UquiO Oepth /&~O IF HOME--DE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons W II Foundation Nearest lot line PERMIT NO. ~ ~ No. of lines Length of each line Total length of lines Trench width Distance between lines Top of tile to finish grade Material beneath tile Total effective absorption area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS INSTALLER - - / ' ¢~I' I ~ ,. OCl 24, 1070 ,'~ ~ APPROVED DATE LEGAL 72-013 (Rev. 3/78) DEPHRTMENT ~E HEHLTH BNC' ENVIRONMENTRL PROTECTION :325 ! ~TF:EET.. RNCHORRGE, RK ~ ~ C~4--S ITE PERMIT N0. RPPLICRNT ~ ~ ~'~ ~' ~. - ~ LOCRTIOf,4 LEGRL SEL4ER F"ER~I I T LOT SIZE Z~O00 S,~I.IRRE FEET SQIL RATING (9,] ST/ER)= <~ ~ TYPE OF SOIL BB_~O;.PTIIJN SYSTEM IS: MR)<IMUM f.~UMBER QF EEDROOMS = ~ THE REQUIRED SIZE OF THE SOIL .RBSQRPTiON _.¢_-.TEM IS: [:,ES'TH= J / bi~JGTi= LC ~] F~" R '-.-' E b [)EP TH-- THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE OISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRYRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRBVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). REQIJ I REC, SEF"T I C TR ~-J~ SIZE= [2~0 ,3RL L E, f4S PERMIT RPPLICRNT HR-% THE RESPONSIBILIT'¢ TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION IN%SECTIONS OF 8NY WELLS RDJ8CENT TO THIS PROPERTY RNO THE NUMBER OF RESIDENCES THRT THE WELL ~'~ILL SERVE. T~40 ( 2 ) I [4SPECT I ~314S RRE ~:Et]L; I F;E[) BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND 8PPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTIQN. MINIMUM DISTRNCE BETWEE~ R WELL ~ND RNY ON-SITE SEWRISE DISPOSRL SYSTEM IS 18~ FEET FOR R PRIVRTE WELL OR &58 TO 28~ FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVATE WELL TO ~ PRI'./~TE SEWER LINE IS 25 FEET RN[:, TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS RRE REQUIRED RND MUST 8E RETURNED TO THE DEPRRTMENT WITHIN ]~k] DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICRTIONS ~ND CONSTRUCTION DIRGR~MS ~RE RVRILRHLE TO INSURE PROPER INSTALLATION. PERr4 I T E~';P I [:ES C, ECEPlBER 2±.- ::[ :=~- 80 I CERTIFY THRT 1: I RM FRMILIRR WITH THE REQUIREMENTS FOR O~-SITE SEWERS RND WELLS RS SET FORTH B',r' THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL-THE SYSTEM IN RCCORDRNCE WITH THE CODES. 3: I UNDERST8ND THRT THE ON-SITE SEWER SYSTEM WRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. .... I~=,UED B~_ C'RTE_~ '¢4. 8 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-2224 SOILS LOG - PERCOLATION TEST ~' SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9- DATE PERFORMED: ~.~ ? Z ~'~,/gO SLOPE SITE PLAN 10- 11 13- 14- 15- 16- 17- 18- 19 20 U CS- CW COMMENTS [..,"3 "F I-I- ,~-5 ~"~c~ ~ tn ~ "Ti4 .~A,-P~G ,G. 'T~,~, PERFORMED BY: '~.'e. R 72-008 (7/76) WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? L Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BE~EEN /~'~,,____; ,~ . ' { ~ MUNICIPALITY OF ANCHORAGE ~. , //~-'='~1 i~,~=~'~ ' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION II~, ~. ~lJ ENVIRONMENTAL ENGINEERING DIVISION ~ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ~ NEW Drew L O.y~r 337-6763 ~ UPGRADE MAILING ADDRESS 7899 ~ebarr___#206 ; ~chorage, AK 99504 LEGAL DESCRIPTION L17 B1 ValliVue ~ast LOCATION NO. OF BEDROOMS 6816 Double Tree 3 Well PERMIT NO. ~' DISTANCE TO: lC ommu~it? ~a t ~sor~tion area Dwelling ~ Z Manufacturer Material No. of compartments ~< Existing ~ ~ Liq. capacity in gallons Inside length Width Liquid depth IF HOME,DE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons D Well Foundation Nearest I t line PERMIT NO. ~ DISTANCE TO: 100'+ laP+ 780256 No. of lines Length ~f~h line Total length of lines Trench width Distance between lines m 5 ' 72 inches 168 S · F. OTHER P. v. c. 155 S.F./B.R. Drew G. Loyer REMARKS System existing except as shown. 72-013 (Rev. 3/78) TIiE t.FEN(3TH [:,ZML:NS)iE~N '_f.:~l; 'i-!4E LENGTH ,::ihl F'EE'f'::, OF' THE 'fP. ENCH OR DI;:RiHF!ELD. THE DEPTH OF Fi TRENCH OF: PIT ~2; THE DiS'TRNCE E:E'f'HEEN THE :~;UF:FRC:E (]F THE Fi.',EF;'.~E :1;::; !'4() SET !4]:13, TH FOR TRENCHES. THE GF;'.F!VEL DEPTH ):S THE Mirt'4!I'dUi'd DE!::q"H OF:' GRFIVE!.. BEETMELEN THE OLr!"i:'RI..L. F'ZPE RND THE BO'TTOFi i3F THE EXCR',/RTZOi'q ( Z~.4 FEET). :i_: FDF::TH E:'.~.' TI41~._' f,ILIN;(C;!:F'RL.!"F¥ O1::' F:iNCF.IOF?.RGE. 2: ): HZLI. ];,NS-FRL].. TFi!E ?¢S'i"E~'I :[f4 F:iCOOFi:DRI'4C:E i,.iITH THE CODES. :~:: I U!'.,!E:,E[;:!~;Ti'-'ii'.,iI3, THFiT THE ON-~'~;):T£:: F~'.E:Sii)Eh!CE )::~; FtEf,iO[;,EL. ED "['O INE;i..UDF:': ~ :-:,>:,,..,~::..~:, ~ .................. c,!:::n"E._ ..._~_. ~. .................... O--~.~T~nNCHOn;¢¢~ A~A ]~oRoG~ATER ANChOrAGE AREA BOROU--~H · ~n?oz'age,~,as~a ~Bi~PECTIoN REp°~T C)N~siTE's~W~GF-iDispO~i~ SYS'TEM N? 933 SEPTIC TANK: DISTANCE FROM WELL / LIQUID CAPACITY /~o-~d) gALLONS. ADDRESS PHONE LEGAL Dt~SCRIPTION .,~/'~' MATERIAL ~'~'~/~' ~'~ ~ /.~,~x~ .~-~/~.~.~ NUMBER OF COMPARTMENTS INSIDE LENGTH ~NSIDE WIDTH LIQUID DEPTH __ SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL / NEAREST LOT LINE SEEPAGE PIT: ~ / OUTSIDE DIAMETER OR WIDTH__~ ~&~ ~'~/~'~ 'J~/~' :)~,/~'~ . DISTANCE FROM WELL ~f~/~/'~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ., LENGTH /*~.~'~'/z , DEPTH BUILDING FOUNDATION/f~'? , ,/~e / SQ. FT. ~TI -~E~R~A. LN FIELD: DISIANCE FROM WEU NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE FOUNDATION . NEAREST LOT LINE DISTANCE I~bl~ TRENCH WIDTH OF SQ. FT. LENGTH EACH LINE ~ -~_~ DEPTH OF FILTER MA~ TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE IN, ABOVE TILE NEAREST LOT LINE SEWER LINE. DISTANCE FROM WATER ~ · BUILDING FOUNDATION SAMPLE_ , NEAREST SEPTIC SEEPAGE OTHER _, TANK. ., SYSTEM , CESSPOOl. , SOURCES DISTANCES: DATE DIAGRAM OF SYSTEM HEALIH AUIHORtlY ' GRE.,..C'R ANCHORAGE AREA BOROUGH SEWAGE DISPOSAL SYSTE~ -- APPLICATION AND PER~IT PHONE NAME OF APPLICANT JJ~.~' ~:~, .~_~'...C.~..,,,~ MAILING ADDRESS -~-'~ INSTALLATION LOCATION ~ ~~ INSTALLATION OF~ SEPTIC TANK / $~EPAGE PiT ~ DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED ~ ~~~/~~ ~~. .~~ r TO e~ ~NSTAbL~O ~Y SOIL TEST RESULTS ~ /~,- ~0~/ u~ ~ NOTE: THIS PERMIT IS NOT VA'LID WITHOUT ~IL FINAL IN~ECTION~ ;~4 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYS~r~M WITHOUT FINAL INSPECTION BY 'THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION, SEEPAGE ArEA SizE- .-~~ I TYRE DIAGRAM OF SYSTEM FOUNDATION TO SEEPAGE PIT ~EPTIC TANK TO SEEPAGE PiT WALL SEPTIC TANK, '~'~/ , SEEPAGE PIT DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF H E A L~"H AU'~Hb R ITY OR LICENSED DESIGNER CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26-68 AND THAT THE ABOVE ' DEPARIHEHF OF EHii!RON~!~-~,~.,~,,~,-'!L QdALiF¢ 350D TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed For Bill Wisdom Legal Descrintion: Lot~Biock__ This Form Reoorts Soils Loft XX 1 Date Performed_24 July, 197~2_ Subdivision Unit 1~ Valll Vue Percolation Test ~eoth Feet 2 Gm 3 to Gw 5-- 6-- 7-- 8 Gm to 9 Gw Was Ground If Yes , At Soil Characteristics The sediments were very erratlq with respeot to sarld, cls, y ~dl-~"-ll- sllt oon~ent, The sedi~r~nts were fairly loose wlth some erratio M1, Ch ~.~d Gw lenses. ~he bottom hole sediments 10 xeet plus)were Gm. Water Encountered? Yes what Depth? 12 feet Slope-- west '._._J._ __,.___J_ i t__i Readinq Date Gross Time Net Time Denth to H20 Net PercOlation Rate r!inute Peoth of Inlet neath - _ __]_~_.._~¢~ ..... ~, To Bottom Of Pit F)r Trench%2 feet ¢~ _ er bedroom-- t Gm to Gw) Test Performed By Pe~o .................. Data Certified g',:~;~¢¢ 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1, GENERAL INFORMATION Complete legal description Lot 17; Block 1; Yalli rue Estates Subdivision Location (site address or directions) 6816 Doubletree, Anchorage, Alaska Property owner Mailing address Mark and Rita Guptil Day phone (206) 235-4125 17805 Southeast 192nd Drive, Renton, Washington 98058· Lending agency Mailing address Day phone Agent Bonnie Hochstein/JACK WHITE COMPANY Address 3201 C Street, Anchoraqe, Alaska 99501 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ~ ' TYPE OF WATER SUPPLY: NOTE: Day phone 762-3135 Individual well Community well ~rJC4 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) Front MOA 1~21 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 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. S & S ENGINEERING Phone Name of Firm i 70~4 F..g;~ R;¥~r L~,~, F.~,~ N~; ~_~ Eagle River, Alaska 99577 'Address Engineer's signature DHHS SIGNATURE ,~-- Approved for ~/'-,~'~-~) bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 1/91) 8ack MOA~21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: /,~ ~//,~F ~ .~/&?//~ ~/_./C/Parceli. D' ADEC water system number ~ ] ~:~'~ Log present (Y/N) J~J//'3r Date completed /1//~ . Driller Total depth ]t)~Jr' Cased to .~v/lC,/,4 Casing height Sanitary seal (Y/N) /~'-)- Wires properly protected (Y/N) /7.~',//~ A. WELL DATA Well typeL~V./-.vtb~rvl7? If,~B, or C, attach ADEC letter. Date of test Static water level Well flow Pump level FROM ~/ELL LOG SEPARATION DISTANCES FROM WELL TO: AT INSPECTION g.p.m. ; On adjacent lots ; on adjacent i~tsn Public sewer manhole/c ea out //' Petroleum tank Septic/holding tank on lot ~,-O0 ~ ~ Absorption field on lot ~0 '~ Public sewer main ~///~ Sewer service line ¢~'/,~ WATER SAMPLE RESULTS:~/~ Coliform / Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/.~I~II~ TANK DATA Date installed /O/l~/~ Tank size /~c'~ ~'~c- Compartments Cleanouts f~N) T'l/,/o Foundation cleanout ((~N) ~o. /,d~_c, Depression (Y/I~ High water alarm (Y/~) }'~//4m Alarr~ te~te~ (y/l~ ,~//~- Date of pumping /~//~ -- //~-44/ .~l( Pumper ,,rV'~ SEPARATION DISTANCES FROM SEPTIC/EI~tli~I~I~ TANK TO: Well(s) on lot /'J//~ On adjacent lots To propertyline ~ ¢- Absorption field Surface water/drainage /O~ ' Foundation ~'-~ Water main/service line 72-026 (Rev. 7/91)Front CONTINUED ON BACK PAGE C. LIFT STATION~¢[,~/ Date installed /////~T' Manufacturer Size in gallons ~-, Manhole/Access (Y/N) J SEPARATION DISTAN~TION TO: ~~ Well on lot ~- On adjacent Iota Surface water D. ABSORPTION FIELD DATA Date installed ,//,~/C~/~ ~..~, Length /"/' ~J Width Soil rating /, ~ Gravel thickness System type . Total depth Total absorption area Depression over field (Y~ Results (pass/fail) ,A.)/~ Peroxide treatment (past 12 months) Cleanouts present ~N) Date of adequacy test for .~ /'~ If yea, give date /~//'~' bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent Jots Surface water /0~.) Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENGINEERING Signature 17034 Eagle River Loop Read Ne %gle River, Alaska 99577 Engineer's Name Date ~ C.~ ~-"~ '~ HAA Fees /~ Date of Payment Receipt Number 72-026 (Rev, 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 WALTER J. HICKEL, GOVERNOR (907) 349-7755 September 17, 1992 Mr. Roger Shafer S & S Engineering SUBJECT: Valli Vue Subdivision Class "A" Public Water System, PWSID 210605 Dear Mr. Shafer: I have compfeted a review of this office's files concerning the monitoring status of the above-referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on August 10, 1992. This does meet the provisions of 18 AAC 80.200(a) of the State Drinking Water Regulations. The last inorganic Chemical Contaminants Sample results were submitted to this Department on August 13, 1992. This does meet the provisions of 18 AAC 80.200(a). The last Radioactive Contaminants Sample results were submitted to the Department on October 12, 1988. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. The last Organio Chemical Contaminants/Volatile Organic Chemicals were submitted to this Department on November 12, 1991. Tbjs does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above-referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, Michael Lu Enviornmental Eng. Asst. II MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address'" ~(~ (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent ~"'c~ c~- Address Telephone (e) Mail the HAA to the following address: (or check here E~, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Number of bedrooms Single-Family ~ 3. WATER SUPPLY Individual Well [] Community [~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72q)25 IRev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS~ FILE SEARCH, DATA AND INFORMATION AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of th is Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, funct dna 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 end 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. NameofFirm Ic~/~/~p 7-~ch/~c~x( ~¢'~r'~'~'c~ Telephone Address /~-~0 ~cAO ~ ~c~or~¢ ~ ~/~ Date ~o~ 7/ 6. DHHS APPROVAL Approved for_~ '.'.~'~..~ bedrooms by Approved ~../'~ Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of Health and Hu man Services (DHHS) issues Health Authority Approval cerificated 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 M u nicipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7~-o25 (R.,. 7/8B) e.c~ Page 2 of 2 A. ~ Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: L. Date Completed Depth of Grouting SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ~-C',P,),' o'Tm /.)._~'~__~ ~.,,~/-~ r IfA, B, C, D.E.C. Approved (Y/N) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Y ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA Date Installed 715'/ ~O Size StandpiPes (Y/N) Y (' ~.~ Depression over Tank (Y/N) Air-tight Caps (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) N, No. of Compartments ~-.~ - J~ucH- ~,"~,e£ //o'/ ~YJ Foundation Cleanout (Y/N) DateLastPumped II /l~ I' ~) lp~ ,..~-J~r. ccc_./' ; for Temporary Holding Tank Permit (Y/N) N. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line ;~' f ¢ ' To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field 72-026 (Rev. 7~88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 7/5' / ~C2 Width of Field ~' Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field 3'~' ' Depth of Field f ~ ' Gravel Bed Thickness O' ' Statndpipes Present (Y/N) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well -:~ '8oo ' To Property Line To Building Foundation ¥~f' ~G-o., ¢.0. To Existing or Abandoned System on Lot ~ 5'o~ ; On Adjoining Lots '~. To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Cutback (if present) D. LIFT STATION ¢,h~. Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Cedes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date No MOA No. 72-026 (Rev. 7/88) Back %¢g~Engmeer's Seal Waiver Fee: $ Date of Payment Page 2 of 2 ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ~CHORAGE, ALASKA 99503 563-6775 DATE: 11/1/89 PWSID: 210605 Requested By: Flattop Technical Services According to the records on file in this office, the Vue S/D Water System is in compliance State of Alaska Drinking Water Regulations. Valli with the Sincerely, Cindy Thomas Environmental Engineer ~"' :)ATE RECEIVED ~" INSPECTION APPOINTMENTS )ATE DATE DATE NSPECTOR MUNICIPALITY OF ANCHORAGE DEPT. OF I:ZALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTi~V]RO~MENTAL 825 L Street - Anchorage, Alaska 99501 MAR 8 3980 ~ ENVIRONMENTAL SANITATION DIVISION REC E IV E REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES )1RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (1 O) days for processing, PHONE 1, PROPERTY OWNER MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER MAILING ADDRESS 3, LENDING INSTITUTION 4. ~ALTOR/AGENT · MAI~ING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPEOF RESIDENCE NUMBER OF~BEDROOMS [] One ~ Four [] Other~ '"'~ SINGLE FAMILY [] Two [] Five 7. WATER SUPPLY ~ * ATTACH WELL LOG. A well log is required for all wells drilled [] INDIVIDUAL* "'~ COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if a~ailable.)~[~,~ 8. SEWAGE DISPOSAL SYSTEM '~ INDIVIDUAL/ON-SITE** ~ IL-'~'~ ~' YEAR ~)N-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBEROFBEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTI LITY Connection Verified 3, SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: _1 ~-~..G' 0 If Tank is homemade give dimensions: PE~MITNUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holdin§ Tank Absorption Area Sewer Line Absorption Area to nearest Lot Li~e JNearest Lot Line 5. COMMENTS [/~'~ APPROV ED FOR ~ BEDROOMS -~ [] CONDITIONAL APPROVAL (letter must ~cg~npany certificate) ~'~ DISAPPROVED D Y fl 72-010 ( Rev.. 6/79) 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION April 7, 1980 Rhodi Karella % Totem Realty 724 East 15th Avenue Anchorage, Alaska 99501 Subject: Lot 17 Block 1 Valli Vue Estates Subdivision #1 Mike/Sandra Mosely Property ~ Approval for your individual sewer and.water facilities can not be granted until the following items have been completed: (1) The septic tank pumped with a receipt submitted to this office. (2) Expose the standpipes to the seepage area for our inspection. Please contact this office for a re-inspection when they are exposed. If there are any further questions, please~contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw ~xMUNiCIPALITY OF ANCHORAG%~., DEPARTME OF HEALTH AND ENVIRONMENi ~ 825~· street, Anchora~e, Alaska 264-4720 PROTECTION 99501 Date Received: November 21~ 1977 #1: Time l~- #2: Date Insp Time Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES .1. Lending Institution Request: Dynamic Realty % Mike Messick or Esther Bunn Mailing Address: 501 West Northern Lights Blvd. Phone 279-7611 Property Owner: .Gil/Mickey Meyers Mailing Address: _% D n~L~mic Realt~ Phone 3. Legal Description: Lot 17 Block 1 Valli Vue Estates Subdivision 4: Single Family Residence: (~ Number of Bedrooms: Four '~ Multiple Family Residence: ( ) Number of Bedrooms: 5. Well System: P ~mit # Construction Sewage Disposal System: On-site Permit # Insgalled individual Well ( ) Community/Public System (x) Depth of Well Well Log on File Soils Rate Septic Tank Size Absorption Area Nearest Bacterial Analysis System (~ Public Utility ( ) 1972 Installer Manufacturer ~ ~D Material to Absorption Area Lot line Absorption Area Distances: Well -to Septic Tank to Sewer Line to Nearest Lot Line Page Two Depar tH~[ent of ' Request for Approval ~tealth and Enviroumental Protection of Individual Sewer and Water Facilities Legal Description: Lot 17 Block 1 Valli Vue Estates Subdivision_~. ( ) Letter Attached: ( ) .t Attached: Approved: Disapproved: Date: Date: Department Worksheet: 1. PROPERTY OWNER MAILING ADDRESS MUNICIPALITY OF ANCHORAGE ," DEPARTMENT OF HE~ALTH & ENVIRONMENTAL PROTECTION }; ENVIRONMENTAL ENGINEERING DIVISION ,'~ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720'," CERTIFICATE OF INSPECTION SEWER AND WATER FACILITIES 2, LEGAL DESCR?TION 3. TYPE DWELLING SINGLE FAMILY RESIDENCE MULTIPLE FAMILY RESIDENCE E~ OTHER (Describe 4. WATER SUPPLY [~] INDIVIDUAL '~'~ COMMUNITY/PUBLIC SEWAGE DISPOSAL INDIVIDUAL/ON-SITE PUBLIC UTILITY E3 HOLDING TANK (Maintenance Required) APPROVED FOR 3 BEDROOMS CONDITIONAL APPROVAL (See Attached) DISAPPROVED DATE 72~014 (3/78) BY (TITLE) ~.,- /~.-'::.~/'-~MUNICIPALITY OF ANCHORAG~:~ ' -'De~a.r~tmen~tc~of'.'Hea'l.th .and Environmental Protection 82~ L' Street, ~chorage, Alaska 99501 e.7~-~-~, ~xt.~ - ~7~ quest for Approval of Individual Sewer and Water Facilities Phone: Name of Buyer: Mailing Address: Phone: Lending Institution: Mailing Address: Phone: Single Family Residence: (/~' Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well ( ) Public/Community System If Individual Well, well depth If Community System, name of system ~z,_,,~r~) Sewage Disposal System: On-site System (~)/ Public System If On-site System, date of installation: /~ *NOTE: 3/77 A well log is required on ALL wells drilled since 6/75. ~UNICIPALITY OF ANCHORAG2 DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION NOV 2 J. 1977 RECEIVED December 2, 1977 Gil Meyers % Dynamic Realty Mike Messick 501 West Northern Lights Boulevard Anchorage, Alaska 99503 SubJect~ Lot 17 Block 1 Valli Vue Estates $1 Subdivision Before this department may approve the request for sewer and water~ a percolation test must be run to determine the adequacy of the seepage pit. Before this test Can be run the ~$~dpipe must be expo4ed. If ther percolation test fails to meet the minimm~ requirement of 150 gallons per day per bedroom, an upgrade will be require~. If the u~3aade is necessary a permit must be issued prior to constr~ot~on from this office. If there are any further questlons~ please contact this office at 264-4720. Sincerely, Robert C. Pratt, Sanitarian RcP/lJn lo Approval Requested By: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SE~ER & WATER FACILITIES FOR People's Dank Address: 807 G Street 9950l Property O~ner: Mr. Richard W. Metz Legal Description:..~.17~ B1, Unit l~ Valli Location: Double Tree Court Type of Facility to be Insoectqd:, ___Single famil.¥ Number of Bedrooms:__Tbree 'Hell Data: Commullity A. Type C. Construction 7. Sewage Dts,~osal System: A. Installed ~?/3t/72 W~e S/D Phone: 279 - 7~11 Phone: 344-1567 B. Depth ., D, Bacterial Analysis B. Installer B. Wi S ~o~]l C. -~eptic Tank: 1. D. Seepage Pit: 1. E. Disposal Field: Distances: A. Size]250 gal.2. ~anufacturer~ Stack Steel Size2OxlSx6 2. Material ]OOS Totel Length of Lines Well To: Septic Tank , Nearest Lot Line Foundation to Septic Tenk 40'+ Absorption Area to Nearest Lot Line · Absorption Area , Sewer Lines · Other Contamination AbSorption Area 20'+ 20'+ sequent for ^~pro~ai of { ~i~idua~ Sawer & ~ater ~aoiiiti~ Page Two 9. Comments: Approved sewer and water system. Ao~roved .~-~_/~ffff~-~X~j__Disapproved Date Approval Valid for One Year From Date Signed ~ · Greater Anchorage Area Borough, Department of _nvironmentsl Quality DIAGRAM OF SYST~ I certify that the information contained in this request for approval to be a true and accurate representation of the sub.ie~t sewer and water facilities located at: .. Signed Date