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HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 1 LT 68 , ,~ ,~.~, MUNICIPALITY OF ANCHORAGE ~ DE TMENT OF HEALTH AND HUMAN SER( S Environmental Health Division ~ 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT DISTANCES Address ~ ~ SEPTIC ABSORPTION PI, one(s} PermU NO. NO O' Bed ms WELL *~ TownsUip, Range, Section AS-BUILT DIAGRAM (Show IocaUon ol well, septic system, property hnes, foundation, ~ SEPTIC ,~e o[~k~ HOLDING TYPE OF SYSTEM ~TRENCH ~ BED ~ W. DRAIN ~OTHER ~ 0rig/hal grade ¢ ~' FT /~ ~ FT WELLS ~ PRIVATE ~ OTHER ~ldenlifv) ~E~A~KS: J Scale: / '~ ~0 ' ENGINEER'S SEAL I. L ~ ~' ~' ~, J~ OcflJly thai Ihis inspection was pedormed according lo ali Municipal and State guidelines in eUect on this date: /z:/t ~/~. -- , ~ ~ 72-013 (3/85) on the prope~ lying edjocenl ~ereto, Ihal ne Impr~emenl~ on p~ope~ lying ad~acen~ ~,ho,o.,^~.*. Y ~',~Y /¢77 - r;'N'.-(:'iC T iUI,u::. ~ (:}f% F~:Y W I NI<LE~K iZ'.:I. W,, [::' ]: I::UE:NE:E:D LANE:~E~UITE: .'_.208 2'. 76CK) 00 E L.C.)CJ-... :t. I c::~.~r'L:J, fy t. ha",:.: :I.,, i am fam:i.!iap !,,~:i.'Lh '[:.h~:<.) p~,qL~ip~.:!rnen't.!~ for' c)r'l'-~it.d~ ~[~ew~:.?~"~i; arid (c:.r"Nq by Ll'i0:~ NLu']:J.c::il:)a].ity of fw~chc)r'ag(,.~ (j',lOjZ~) and a.r'[d in ~:oml3].iaric:e t~5't.h the I:le~:~igr~ cr, i'l/_a%p:i.a of 'J:.h:is~ any eFil&~t'g~,'~ff~ei'vk t..oJ.].] i"e:::'i::jt..~J,i-'(c= i:?tr'1 addi'i:.ior~al Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: .~/3e / /-J~,~j~; [~, DATE PERFORMED: (ENG~S SEAL) LEGAL DESCRIPTION: L/z//,' C/~e~/~ ~/~,+ / ffo~' 0~ Township, Range, Section: ,~-/'~ 7-/?-M ~-3~'~ 1 2 3 4 5 6 7 8 9- 10- 11 13- 14- 15- 16- 17 18 19 2O COMMENTS -So,'/ '7~oP?- / '~ / ~' SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED7 S L IF YES, AT WHAT O DEPTH? p E Gross Net Depth to Net Reading Date Time Time Water Drop Ioo~ Io3g 3o ,6~ - -3-3 . )q Deplh l0 Water After ~ ! Monitoring? ~ Date: PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ~ FT AND__°? '~. FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT O~IS DATE. DATE: 2~' 72-008 (Rev. 4/85) / GREA ANCHORAGE AREA Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL ~ MANUFACTURER INSIDE LENGTH INSIDE WIDTH MATERIAL ~'~,A~ NUMBER OF COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY/I~'-~"'¢GALLONS. TILE DRAIN FIELD: / DISTANCE FROM WELL P'~g~' FOUNDATION ~'~OC~'~ _NEAREST / NUMBER OF LINES ' DISTANCE BETWEEN LINES ABSORPTION AREA '~'-"'~:~,~'~ SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH LOT LINE ~ OF LINES TRENCH WIDTH ~'~ fN. TOTAL EFFECTIVE MATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPE ~; /'~,::~ CONSTRUCTION DEPTH BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE__ TANK SYSTEM. CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATE RIAL~ LOT SLOPE: REMARKS: Form LQ-032 GrEA ~r ANCHORAGE Area BoR '!gh DEPARTMENT OF ENVIRONMENTAL QUALITY NAME OF APPLICANT SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS F O.NDAT'ON TO ,EPT, ^NK .------- SEPTIC TANK SEEPAGE PiT . TO NEAREST LOT LINE. WELL TO SEPTIC TANK DIAGRAM 0~/SYSTEM ' * SEEPAGE PIT ~ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK ~ ~ SEEPAGE PIT TO RIVER, LAKe. STREAM. C~ST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSINg GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. /: ' [ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER A CHORAGE AREA IR~E)INANCE NO. 28-68 AND THAT THE ABOVE DATE APPLICANT'S SIGNATURE GREATER ANCHORAGE AREA BOROUL. Oepartment of [nvironmen[al Quality 3330 "C" Street Anchorage, Alaska 99503 SOILS LO(; PEROI,ATION TEST Performed for '~-~_? ~c. _~_.~__-~-~ Legal Descri p~i-6,~'-~7'CT'=~s[<-L~c~J~< k~ ~ This form reports: Soils log )~ Depth Feet 1 2 - c T/ Da te Pe rfo nm.~d._j-~.-_~_~f~ 10- Percolation Cest ll ~ 13-~ ground water encountered? If yes, at wi)at depth? Reading Date Gross Time Net Time Depth to Wate~~ Net Drop Percolation rate minute. -Proposed insta]lat~=-~h~ Seepage Pit Drain Field Dept~t~6~-t~-~-i)it or trench Depth of Inlet ............. · COMMENTS: Date: EQ-040 (6/74) MUNICIPALITY OF ANCHORAGE Department of HeaLth & Human Services DiVISiON OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # {~)\~ - ~:~\\~',._.\,~j, HAA# ~\~'3~ L----~")~,~c~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner -~-vt ~'{-c ~ r~' .Telept~oge: (home) ~ ~_~c~, Business _ Mailing Address (c) Lending Institution Telephone (d) Mailing Address Real Estate Company and Agent -- Address cX~ ~ ('ye'~ (e) Telephone Mail the HAA to the following address: (or check here~, if hold for pick up.) List contact person and day phone number below: ~ 2. TYPE OF RESIDENCE Single-Family,~ Number of bedrooms 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. 72-025(Rev. 7/88) Page 1 of 2 '~JJOM 8,Jeeu!i~ue {euo!sse)oJd eqi u{ SUO!SS!LUO JO SJOJJ@ JOJ elq!suodseJ ~,ou s! ei~eJoqouv jo,q!led!olun~ eq/'penss! s! eleo!j!peo e eJoleq el~p ez,~ieue Jo suo!~oedsu!lonpuoo lou op SHHQ 6u!puel J{eq~ pub seLuoq ~o sjeseqoJnd ol ,~selJnoo Jeeu!l~ue IBUO!$Se~oJd luepuedepu! i~^mddv ~lpoqinv qlleeH senss! (SHHQ) sao!^JeS u~LunH pus qll~@H jo lUGLUlJBdgQ @I~BJoqou¥ jo,~!led!o!unpl eq.L / lees s,JeeulSuq le^o~ddv leUOlllpuoo jo suJJe/ /~----~,~O'~UNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 ~--~ 343-4744 Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit [Y/N) 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 If A, B, C, D.E.C. Approved (Y/N) ./ Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On AdJoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~Size Standpipes (Y/N) Depression Over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ./'~ No. of Compartments Air-tight Caps (Y/N) ~/' Foundation Cleanout (Y/N) /~/ Date Last Pumped ~ ~/q/ Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Water-Supply Well ~ ~ To Property Line ) / (~ To Water Main/Service Line ~ ~0 To Stream, Pond, Lake or Major Drainage Course Comments · 72-028 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION F~I.ELD DATA Soils Rating3[itPAbsorption Strata ~. ~/ /,~--,~' Type of System Design Date Ins'La~H'ed / ;2/G-,.~//~.¢ i Length of Field , Wid[~C~;~FieJ ~ -- -'-'-~,~fi "g; ~"-' ~'ax:~ ' "¢J/ ~--~sortion Area Depressi~i err Field (Y/N) Results~f~Last Adequacy Test Depth of Field Gravelled Thickness ~',~'t~///~/) ¢,'~,") Statndpi'pes Present (Y/N) /~' · '-~ Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot ~ -~ ~-' To Water Main/Service Line ~' ~0 To stream, Pond, Lake, or Major Drainage course TO Driveway, Parking Area, or Vehicle Storage Area Comments '~' ~'Kl..~'v,~ AS, 'P~-~ 1J¢ JZ ,~ "/,,.Z) / 'e T,~- To Property Line 10 To Existing or Abandoned System on ; On Adjoining Lots ! tgD To Cutback (if present) ~/,~. D. LIFT STATION J'¥//Cr- Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (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.~, q .... {). ('}....,F : ;'~' '~"" Rianed ~t.4A.,t.~.c.~r.e-.u.,-'--% .:..; .., . ..... .... ,. Date ,1~o- ~° [I, l ("~q / Engineer's Seal MOA No, Receipt NO, -c~c~ ~0 Date of Payment Amount: $ /y~ 72-026 (Rev, 7/88) Back Waiver Fee: $ Date of Payment Page 2 of 2 ~751 N, DIMOND BL~D. (907) 2~8-50~5 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC Lot 68 q Bk. 6808 Round Tree Dr*lye Dan McGrew Single Eamily~ Privateq On Site SYSTEM: TRENCH ONLY SOIL RATING: 125 INSTALL.AT I ON DATE: 1975 lq Valli Vue Estates DATE OF TEST: Fei:). 20~ 1991 T'his trench was abandoned in 1986 probably because o~ septic over~lewing at the lower' end. This was a -Feur bedroom system~ bctt one bedroom was converted in 1986~ and a three bedroom drain~ield was installed. Some time later the bedroom was reconverted, A ~eur bedroom drain~ield is r-equired now. On Feb. 1:3th. the trench was expesed at the beginning and at a point 25 ~eet down stream, At beth locations the rock was ~ound -l:eur ~eet deep~ clean~ ~:i. th no discoloration or sludge deposit. The invert o-F the per~orated pipe wad also clean. A cleanout was installed at both locations~ and a 2-:1./2" s~eel monitor tube was pushed thrmugh the rock at the d~wns'liream location, The remainder o~ the trench was disconnected by excavating a cross trench and back{illing this trench with the excavated material. Then approximately 1500 gallens o.~ clean water was dumped into the trench throu~]h the eirst cleanout. By dropping a rock inte the monitor a splash ~as hear'd~ but ne ~ater registered ena tape or on a stick. This section o.F trench was then connec:ted to the discharge ].ine ~rom the tank. stream c)~ At that time it was noted that a small but constant water discharged .From the tank,, On Feb. 20~ an adequacy test was run on this section o*F trench. At this time 5 inches o~: water was measured in the monitor. 360 gallons e~ ~,~ater' ~.~as then added~ causin~ the ~at. er level to rise to 15 inches. Two hours later' the level had dropped to 5 inches~ indicating that more than.the 360 gallons e~ water had been absoi"bed by the ~jround. Based en my observations and testing I can certiYy t. hat this sectic~n o-f the original drain.(:ieZd is adequate to me~.~t the re- quirement o'F the Health Department. 675! M. DIHOND BLVD, ~907) 248-5095 LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM ~DEQUACY TEST L. ot 68~ Bk. 1, Va].li Vue Estates 6806 Reund Tree Drive Dan McGrew S:i. rigle Family~ 4 Bedrooms Class A Community System SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: 3 Bedroom System TANK: Greet Steel 1250 Gal. One Compart. ABSORPTION SYSTEM: Trench ABSORPTION AREA: 760 Sq. Ft. SOIL RATING: 231 INSTALLATION DATE: ' Dec. 1986 DATE OF LAST PUMPING: Ai]c:h. Cess Pool Feb. 20~ 1991 DATE OF TEST: Feb. 11~ 1991 TEST PROCEDURE: System was :inspected and measured. Tank was {.ound with 3 'Feet o.~ cover and with a liquid level o.F 48 inches. Twe trench cleanouts and oee men:Ltor tube were lecated. The trench cleanouts were 4 and 6 ~eet deep and both dry. Monitor was 16 4:eet deep and contained 94 inches o~ liquid. 600 gal].ons e~ clean water was added to the trench ~hile the water levels in the tank and the monitor tube were menltored. This caused the water level '~o iecrease 11 inches in the tube~ hours the water level ie the moniter dropped 5 inches~indicating · khat '~he -Field absorbed water at a sat:i.s~actory rate. The tank was pumpecl on Feb,, 20. On Feb. 24 the system was checked~ aciain. Tank was ~und ~ull o~ liqe:i.d~ however the water level in the meniter was 64"~ These observations indicates that there is )' liquid be:i. ng d:isc:harged 'Ehrough a ]eakin~l .~auce'L er commode. TEST RESULT: Department e.l: This system meets the code requirements the Health and Soci al Services the Municipality e'E Anchorage. NOTE The operatiorlal life o~ all septic systems depends on the local sail conditic~ns~ groundwater levels that may ~tuctuate during the year~ and the water usage o~ the ~am;Lly being served by the system. These cond:i, tioes are outs:Lde the control o~: the evalua'Lor o-F th:i.s septic rays'kern. We can therefore no'k give any estimate (:)~ how long this system will ~unction saris.Factory ~or CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 yi ~o DEPT. OF ENVIRONMENTAL CONSERVATION 3601 o ,-GTqF.~m SUIT;C 392 WALTER J. HICKEL, GOVERNOR eDruary 20, 1~:,_, PT',TSiD ~3~,.0605_...5rai!i Vue .~,~v_,~, of ,.~co.,~.]., on o ~} .... .~ Va]:li Vue :;,/~ Cl,~o,~ ~ Public provisions of !8 .lAC R.-TJ .u ,.. t .ono. Sincerely, .i"' -- 7 Ka~nowsk. ~ I "J-' ', 'ii. Environmental Engineer 'TAK/S k'o 9 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 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 68 Block 1 Valli Vue Estates Subdivision - T12N R3W Section 14 Location (address or directions) 6806 Round Tree Drive (b) Property Owner Better Homes Reloq~l~ne:Home Business 276-0000 Mailing Address 121 West Fireweed Lane, Suite 208, Anchorage 99503 (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the followina address: or; Check here I-I, if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family r--Ix Number of Bedrooms three(3) WATER SUPPLY Individual Well [] Community F~x Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite:~X Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State [Department of Environ mental Conservation attesting to the legality and status, Page 1 of 2 72-025 trey 81861Fro~t ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage flies 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. NameofFirm A.E.C.S., Inc. Telephone 561-5040 Address 1200 West 33 Avenue, Suite B Anchoraqer Alaska 99503 Date This department has received written confirmation from the engineer regarding the Conditional Approval of December 23E~g~9~¢eal The corrections have been accomplished and an inspection has been completed by the engineer. The subject property meets with Municipal standards and is now approved. DHHS APPROVAL Approved for J~0~_)bedrooms by o ~ ~ ate Approved XXX××XXX Disapprov~¢'~7~ ~2 Conditional Terms of Conditional Approval January 7, 1987 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Emptoyees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 IRev 8/86) Back 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 ~ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) .t~! L ~ y'hZ-Z/ gb!£ ~2 ?!zM Location (address or directions) Business' (c) ApplicantAddress 1¢1 IbC f~IR~[/P~_,~_~"~ su/?'~ ~o~ Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain); Le~ding Institution ' / Telephone Address ,' //~- ~ealr ~:tate company and Agent dd e s Telephone ~ Mail the HAA to the following a~ss: ~ .~ .~ ~ (d) (e) (f) TYPE OF RESIDENCE Single-FamilyJ~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well [] Community'S' Public [] Note: If community well system, must have written confirmation from the State Department of Environrn~ntal Conservation attesting to the legality and status. ., , , SEWAGE DISPOSAL Onsite J~ 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. 72-025 (11/84) Page 1 of 2 : ENGINEERING FIRM PROVIDIN~ ,NSPECTIONS, TESTS, FILE SEARCH, DA', ~ AND INFORMATION AS ce~ified by my seal affixed hereto a nd 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 fu~her 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, end regulations in effect the date of this inspection. Date J(d. /~/ . '/ Approved for _-/2(~,'~C ~bedrooms by Date Approved Disapprgved , ~,onditional ,/X'_ Terms of ond,t,o.a, Approva,, 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) WELL DATA %%C%\'' Well Classification MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: I~A, B, C, D.E.C. ApprovedCN) 'f?~/..~.,i./)?t~ Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Lev~.l~ .... Pump Set At Casing Height ,Abo~' Ground ~, Sanitary Seal on Electrical Wiring in Conduit (Y/N) A/ ///7 Depression ~lheed (Y/N) __ Separation Distances from Well: / ~/ //~ TO Septic/Holding Tank on Lot / To Nearest Edge of Absorption Field on Lot ; j ' ' g - -- 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~.~'~ Co m~.,,...~ B. SEPTIC/HOLDING TANK DATA Date Installed [ O//~-~/¢~" Size Standpipes ~)'N) Air-tight Caps Depression over Tank (Y,~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: TO Water-Supply Well ,~OO To Property Line Z ,.'~'/'-/-- To Water Main/Service Line Course ~/OO/-Jr-- Comments No. of Compartments / Foundation Cleanout ~N) Date Last Pumped J~- · empo , Ho,d n To Building Foundation /-~ / To Disposal Field Z ~ / TO Stream, Pond, Lake, or Major Drainage Page 1 of 2 72 026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~,~ ~ Date Installed / Z/! "~/~ Width of Field ~.~f"~ 2 Square Feet of Absorption Area Depression over Field (y/~i Results of Last Adequacy Test 7 -0 Separation Distance from Absorption Field: TO Water-Supply Well To Building Foundation Lot ~-, 0 , 'dC'- To Water Main/Service Line ~..} t .¢..~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field /-..~'-,'.~" / Gravel Bed Thickness /0 Standpipes Present Date of Last Adequacy Test ./~//t~ To Property Line 1~) / 7/,. To Existing or Abandoned System on ; On Adjoining Lots '.'~-'~) To Cutbank (if present) ldo /¢'-- Comments D. LIFT STATION Date Installed Dimensions Size in Gallons /, Ma~hole/Ac~7 (Y/N~J High Water Alarm Level at [~-[,[[I j-~'- Vent (Y/N) Tested for / '/ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Commen~~ ** Check Permitted Bedroom Rating Against HAA Request I certify that I hav~t c,~e. cc~.ed~ied,.~r conformed to all MOA and I~AA guidelines in effect on the date of this inspection, Signed Q.c~/,.,~/'/~.¢(.~ Date / ~ ~/~ Company / /~C~ /~C¢ MOA No, 1o o/ Oo Receipt No. Amount: $ · Page 2 of 2 72-026 (11/84) DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: {907) Address: 274-2533 DATE: December 18, 1986 PWS I.D.# 210605 To Whom it May Concern: According to records on file in this office the VALLI-VUE Water System is in compliance with the State Drinking Water Regulations Sincerely, Steven W~.g, PE District Engineer INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOI~EPT' OF  825 L Street - Anchorage, Alaska 99501 ENV]RONME; ~ ~ .... i £CT ON ( ENVI RONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND !DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1, PROPERTYOWNER I PHONE I MAILING ADDRESS PROPERTY RESIDENT (If different from above) / PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION ~ PHONE MAI ADDRESS 4, REALTOR/AGENT J PHONE ~'T-/~¢~'/~:' £~ //-/,,- .'/~/~' c'.~7_~, ../'"Z. .4 /~ f~ c.¢ C (_ ,.b,4?br'-~:~ MAI LING ADDR ESS ( 5. LEGAL DESCRIPTION ~-~o '7- STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four  SINGLE FAMILY [] Two [] Five MULTIPLE FAMILY ,~ Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* * ATTACH WELL LOG. A well log is required for atl wells drilled ~ COMMUNITY since June 1975. For wells drilled prior to that date, give well ~ [] PUBLIC UTILITY depth (attach log if available.) 8. SEWAGEt~/DISPOSAL SYSTEM - ,/ ~, ,~/~ b_~ -INDIVIDUAL/ON-SITE** / YEA_ ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONL, 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FWE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] I NDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY [ (~) ~ 3 ~ Connection Verified iNSTALLER Size: /r~-0 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER /~c~p.~.~_~ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVEDFOR BEDROOM? [] CONDITIONAL APPROVAL (letter must/accompany certificate) 72-010 {Rev, 6/79) June 13, 1980 Jack White Company 3201C Street Anchorage, Alaska 99503 IR&Fi No. 051001-39 MUNICIPALITy OF ANCHORAOE DEPT. OF I.!EALTH & ENVIRONMENTAL P; Ol ECTION JiJiq 1 9 1980 Attention: Toni Brown Subject: Adequacy Test on Existing Sanitary Sewer System; Lot 68, Block 1, ga~le~y~Ae~ Estates #2 Subdivision Anchorage, Alaska Dear Mrs. Brown: Per your request of June 10, 1980, we conducted a test of the sanitary sewer~ system on the above described property. During this test the liquid level in the septic tank was monitored as water was added to the system. The measurements are sunmmrized in the following table: Time Liquid Level Below Top of Standpipe Total Gallons Added 9:00 5.85' 0 9:15 5.55 50 9:55 5.55 100 11:20 5.55 200 1:25 5.55 350 The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&MConsultants, Inc. aek lte co. 5u~e 13, 1980 Page -2- If the 3 bedroom residence on the property is to house 6 people, the average load on the system can be expected to be 450 gallons per day or 0.31 gallons per minute. During the test, the system accepted 300 gallons in 250 minutes.' This indicates an average effluent acceptance rate of approximately 1.2 gallons per minute at the time of the test. Because the house on the lot is occupied, we assume that the leach field was at its normal degree of saturation. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 3 bedroom resi- dence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours ~ R&H CONSULTANTS, INC. JC/3 h/AT&SI-Q 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTI~OTION April 25', 1980 George W~/A. Virginia Liskow Star Route A Box 35M Anchorage, Alaska 99507 Subject: Lot 68'Block 1 Valli Vue Estates Subdivision #1 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 submited to this office. An adequacy test be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: Alaska Statebank Mortgage Loan Department 310 East Northern Lights Boulevard Larry Clarke % Jack White Company 3201 C Street 99503 99503 #1: Time ~ MUNICIPALITY OF ANCHORAG~ DEPARTM~ ~OF HEALTH AND ENVIRONMEN~'~ 8~5 L street, Anchorage, Ala~ 279-2511, ext. 224 or 225 ~2: Time Date Received: PROTECTION 9950]. May 5, ~977 ~3: Time Date Date Date Insp Insp Insp REQUEST FOR AppRovAL OF INDIVIDUAL SEWER AND WATER FACILITIES t. Lending Institution Request: Alaska Pacific Bank Mailing Address: Post Office Box 420 Phone: 276-3110 2. Property Owner: Francis Mouser Mailing Address: 6806 Round Tree Drive Phone: 3. Legal Description: Lot 68 Block 1 Valli Vue Estates #2 4: Single Family Residence: (x) Number of Bedrooms: Multiple Family Residence: ( ) Nu~er of Bedrooms: 3 Well System: Permit # Construction Individual well ) Community/Public System ( ~ Depth of Well Well Log on File Bacterial Analysis ( ) Sewage Disposal Permit # Septic Tank Size Absorption Area System: On-site System (x~ Public utility ( Installed /O -~-~ Installer /~-D Manufacturer Soils Rate /~' Material Distances: Well to Septic Tank ~-~v~x~ to Sewer Line Nearest Lot line to Nearest Lot Line Absorption Area Absorption Area Page ~wo ~ ~ · ~J ~' ~ Department of Health and Environmental Protection Request for Approval of Individual Sewer and Wa%er Facilities Legal Description: Lot 68 BloCk 1 Valli Vue Estates #2 Comments: Affadavit Attached: Approved: Disapproved Letter Attached: ( ) Date: ~epartment Worksheet: · A4UNICIPA[tTy OF ANCHOrAGe. MUNICIPALITY OF ANCHORAGE DBPT. OF HEALT DEPARTMENT OF REALTH AND ENVIRONMENTAL PROTECTION . AL PROTEc[I©~,~ 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: VA FHA Mailing Address: ~f//J ~~ ~. Day Phone: 3. Name of Buyer: Mailing A 4. Name of Lending Institution: ~,~~~ Ma n g Address: o,,.,tor or 6. Legal Description:~~ ~ ~~~ Mailing Location: 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: CONV ~--~ ~ J No. Bdrms. Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation 72-003(3/76)