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Home My WebLink AboutVALLI VUE ESTATES #2 BLK 3 LT 15 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division ~/~/~/ 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name ~l ~ DISTANCES ~dd,~ G ~g LO~ T~-- ~FROM~ TANK FIELD WELL Ph°ne(s)~ ~__~U ~ L E O ~0~ R,~ Permit "°' ,Z~ N°' °deOr°°ms WELLLoT LINE //~ ~ 1+ ~ t~, ~ driveway.AS'BUILT DIAGRAM {S"°wl°cati°n °' well' sepUc system' pr°pedylines'foundali°n'water bodies, ~ TANKS ~ X ~ SEPTIC ~ HOLDING NX MaRUIaCIUre[ l/z o Material No. o~ Compaflmems TYPE OF SYSTEM N , ~TRENCH ~ BED ~ W. DRAIN ~ OTHER .~ ~ /, odg,nalDepth ,o pipe bottom frOmgrade ~ T°tal depth "°' °dginal g'70 ~ / TOt~IFiI' added above original g,adeabsorption ~ ~T Grave,Gravel depth beneath p~pe .~w,d,, ~ F1 X '0' ~'~/~''~ Gravel te.gth ~ FT ~ FT Distance between Ii.es [ ~ area~/~ ~ 0 SQ FT ~ FI ' Number of lines Soil raUng Pipe material ~ ~'. Installer Dale Installed WELLS - _ i( / ~ PRIVATE ~OTHER fldentifv) '~ X / REMARKS: ~,.~ .; '~f [ -~ '~ ~ U Inspections Pedormed by: ~..~ Municipal and State guideJin~ in effect on ~ate: ~ ..... ..... 72-013 (3/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES PO BOX 196650 ANCHORAGE, ALASKA 99519 343-4744 HAND WRITTEN PERMIT Permit Number: SW90c~2k~ Permit Type:$E~ Date Issued:~-~O-~O Expiration Date:~-~-~D Design Engineer:~N~ Owner Name:~M~&~ ~ F~;~ Owner Address:~4~ AO#~ r~ Lot Legal: Subdivision: V~I~ ~M~ ~$L ~2 Lot:/~ Block: Section: /~ Towns~; Range:3~/ Lot Size: 9~SFm ~ or acres) Max Bedrooms: This Permit: ~ Total Capacity: SEPTIC TANK: Minimum septic tank capacity:/~-~ gallons. Each septic tank must have at least 2 compartments, insulation is required if depth to top of septic tank(s) is less than 4.0' Lift stations require an appropriate electrical inspection. WELL LOG: A copy of the well log must be sent to DHHS within 30 days of the well's completion. Day Phone:~-6~ '7~3 I CERTIFY THAT: 1. I will install the on-site sewer system and/or well in accordance with all codes and regulations of the Municipality of Anchorage (MOA) and State of Alaska , and in compliance with the design criteria of this permit. 2. I will adhere to all MOA and State of Alaska requirements for separation distances from any existing well, septic system, or surface water on this or any adjacent or nearby lot. 3. I understand that this permit is v~lid for a single family dwelling with a maximum of ~bedrooms. I also understand that any enlargement will require an additional permit. . ~. I understand~ this permit is issued for the calendar year and expires on December 31 of the year issued. 5. I wilI notify' DHHS prior to all inspections by the DATE: Y-~/zc~ DATE:~----3O'~ SIGNED: ISSUED engineer or well driller (owru~r/des~gnee) ab/ll5 Kniefel Engineering 8441 Miles Court Anchorage, Alaska 99504 (907) 337-1121 On-Site Services Department of Health and Human Services Municipality of Anchorage 825 L Street Anchorage, Alaska 99502-0650 SUBJECT: LOT 15, BLOCK 3, VALLI VUE Dear Mr. Smith: The approved sewer upgrade permit (attached) for the above lot needs to be modified to reflect conditions requiring the proposed field to be moved. At the time of construction of the bed system, the contractor was notified that before any trees could be removed from the lot, the subdivision covenants require approval from the Homeowners Association co~]]ittee. This review would have provided a major time lag in the completion of the upgrade and therefore we made a field ad3ustment in the system location which also necessitated a new soils test hole and percolation test. Attached for your information is a certified copy of the new Soils Log - Percolation Test sheet for the revised hole. AS can be seen, the materials reflected the same conditions as found in the other test hole on this lot along with the new test hole on Lot 14 directly adjacent to the west of this lot. Following the digging of the test hole we also perc tested this new location with the results as shown on the Soils Log. The soils showed a rate of 177 si/bedroom. We have also attached a new site plan showing the location of the new trench. Because of the tree removal problem, we are forced into using a trench system rather than the original absorption bed approach. We are providing this information at this time rather than waiting until the final as-builts in order to reduce the confusion on this system. We appreciate your time and patience with this lot. Please let us know as soon as possible if you have any co~]~ents or questions. Respectfully Submitted, Kniefel Engineering Robert Kniefel, P.E. --i've percolation testing of th~ test hole produced rates at levels in the 177 sf/bed rang~ The nearest adjacent lot syst is greater than 50 feet away. SEPTIC SYSTEM DESIGN Lot 15, Block 3, Valli Vue Subdivision 6443 Lone Tree Circle DATE PREPARED FOR: 5/29/90 Acreage Systems SCALE PREPARED BY: 1. = so, Kniefel Engineering MOA CE 90-030 . 1.'. System Design, 3 bedrooms @ 150 sf/bdrm = 450 sf of area 2. Absorption Bed, 18' x 38' = 684 sf provided \ 450 sf needed x 1.5 = 6?5 sf total needed Community water system for.all lots The existing tank to be inspected at time of ew system installation and replaced if necessary° $. System installation to follow all MOA regulations and guidelines for materials, installation methods and inspections. 7 ~ '~.. 11. The nearest adjacent lot syst~ ~ is greater than 50 feet away. SEPTIC SYSTEM DESIGN Lot 15, Block 3, Valli Vue Subdivision 64q3 Lone Tree Cirele DATE PREPARED FOR: 5/29/90 Acreage Systems SCALE PREPARED BY: l" = so' Kniefel Engineering MOA CE 90-030 b d. is ti~ ,~oTTO~,t, ,,,~.~ OF ? ~ AC ~< 91C.k. %- , 0o p A--(.,-e ~//Z.. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: 'f'~--'/'~ LEGAL DESCRIPTION: 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18- 19- 20- DATE PERFORM[ Township, Range, Section: ~ ( ~r', T \ SITE/PLAN SLOPE WAS GROUND WATER ~ 0 ENCOUNTERED? IF YES, ATWHAT DEPTH? Reading Date Time Time W~ter Drop PERCOLATION RATE __ [m~nuleslmCh) PERC HOLE DIAMETER TEST RUN BETWEEN __ FT AND COMMENTS ~-10. FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev, 4;65) CeRTiFY THAT THIS '[EST WAS PERFORMED IN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 625 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION; § 6 7 8 g 10 11 12 13 15 16 17 18- 19- 20- ''t~'-'v~ ~ DATE PERFORME _Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH7 Oegth to Water After Monitoring? ~' 0/d,~ Dele: Reading Date Gross Net Depth to Net Time Time Water Drop ,~ ?,'x&~ /0 . q? .z ~ COMMENTS PERCOLATION RATE ,/'~ ~ ;minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT ACCORDANCEWITHALLSTATEANDMUNICIPALGUIDELINESINEFFECTONTHISDATE. DATE: ~"~,~ ~'~O 72-008 (Rev. 4/85) ~ MUNICIPALITY OF ANCHORAGE /'~1 ~ o DEPAR;rMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~,~ }~'.. ~)) ~. ENVIRONMENTAL ENGINEERING DIVISION '~j//~ 825 LStreet-Anchorage. Alaska 9950~ Telephone264-4720 ~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT DISTANCE TO: ]Well ~ Absorption area Dwelling PERMIT NO. ~ ~ Manufacturer Material No, of compartments ~ ~ Liq. capacity [n gallons Inside length Width ~> Liquid depth ~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons ~ Nearest lot line PERMIT NO. ~ D'STANCE TO: We,~~ Foundatio+ ~ No. of lines Length of each llne Total length of lines ~ Trench width ~N Top ~tilo to finish grode ~¢ Material beneath tiio ~ :,,.t7 Totaloffoctiveab?go~a 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 llne PERMIT NO. m Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER INSTALLER ~~ 72-013 (R 3/78) PERMIT' NO. DEPFIRTMENT O, 825 "L" ?".'::~ 0458 ) RPPLICRNT LOCRTION LEGAL F'HILLIP JERNS 644S LONE TREE L±5 B3 VB[_L.I VUE S,."D LOT ~IZE 20000 SQURRE FEET TYPE: OF' SOIL RBSORBTION SYSTEM IS: TRENCH MR~IMLIM NUMBER OF BEDROOMS = 3 SOIL RRTING (SD FT/'BR)= 250 TNE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IE;: TNE LENGTH DIMENSION IS THE LENGTH (IN FEE]') OF THE TRENCH OR DRRINFIEL. D. TEIE DEPTN OF Ft TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURF'FICE OF THE GROUND RND THE BOTTOM OF THE ENCR',,,'RTION (IN FEET). THERE IS NO SET WIDTH F'OR TRENCHES. ]'HE GRR'v'EL DEPTM I'5, ]'HE MINIMLIM DEPTN OF GRR'v'EL BETWEEN :'HE OUTFRLL PIPE FiND THE BOTTOM OF ]"HE ENCFI',/RTION (IN FEET). PERMIT RPPLICRNT HRS TNE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DIJRING THE INSTRLLRTION INSPECTIONS OF FIN~' WELLS FIDJFICENT TO THIS PROPERTY FIND THE NUMBER OF RESIDENCES THRT THE WELL WILL SER',/E. BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RN[:, RPPRO',,,'RL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSEBUTION, ['tINIMUM DISTRNCE BETWEEN R WELL RND RN~r' ON-SITE SEWRGE DtSPOSRL SYSTEM IS ~,00 FEET' FOR El PRI'¥'EITE WELL) OR :L50 TO i:-:'F~O FEET FROM FI PUBL. IC WELL DEPENDING UPON 'THE TYPE OF PLIBLIC WELl_ OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS FIND CONSTRLICTION DIRGRRMS FIRE FtVRIL_IRBLE TO INSURE: PROPER INSTFILLRTION. I ±: FORTH B'Y THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL. THE S'YSTEM IN FICCORDRNCE WITH ]'HE CODES. ~:: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE tS REMODELED TO INCLUDE MORE THFIN 3: BEDROOMS. RPPL ICRNT ~~EFINS ~ i:,:,UE[. BY_ ................... [:,RTE ........ '¥'-~.. ":' CERTIFY THRT I RM FRMILIFIR WITH 'FHE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET GRE/' ' R ANCHORAGE AREA BOF '"tGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION SEPTIC TANK: DISTANCE FROM WELl ~Fr~ r~ INSIDE LENGTH MANUFACTURER NUMBER OF ~'7~ ~.~- MATERIAL ~L~ / B~2 ~ COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY ,/~-~0 GALLONS, SEEPAGE PIT: ! · NUMBER OF PITS / DIAMETER __ OR WIDTH '~'~,7 LENGTH'~, DEPTH J~ LINING MATERIAL~CRIB SIZE: DIAMETER DEPTH g~,l DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION ~ /"~', NEAREST LOT LINE__ ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: ~__~'~-1~-'~. TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION __ LOT LINE CESSPOOL_ OTHER SOURCES APPROVED DISAPPROVED NEAREST SEWER LINE REMARKS. DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK __ SYSTEM DISTANCES: INSTALLED BY: ~ P~PE MATERIAL: LOT SLOPE: REMARKS: ~///'~ Form No, EQ-031 DIAGRAM OF SYSTEM DATE C/~/~_ .~Z APPROVED G.A.A.B, GREATER ANCHOrAgE AREA Borough DEPARTMENT OF ENVIRONMENTAL QUALITY SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT ~ ., DRAIN FIELD , OTHER FINANCED THROUGH TO SOIL TEST RESULTS COMPLET,ON DATE ANT,C]PATED 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. FOUNDATION TO SEEPAGE Pit , DRAIN FIELD WEll TO sePtiC TANK ~~ seePAge Pit WATer MAIN TO SEPTIC TANK ~ , SEEPAGE Pit SEPTIC TANK,/~E . SEEPAGE PIT DRAIN Field CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE DATE APPLICANTS SIGNATURE .... ~. Department of Health & Human Services ~ r DIVISION OF ENVIRONMENTAL SERVICES ;, ~ ' ~h¢ :~ CERTIFICATE OF INSBECTION EOR HEALTH,AUTHORItY APPROVAL ' - :~ ON-SITE SEWER AND WATER [AClLIT~ FOR S.INGLE. F~MILY~DWELLING :~Id;'~3~t~}:~} Parcel I.D.~ ~- ~L~,- ~ ~:'- -, ,~-~ .._~,.,:HAA~ h~'~~.~:~:, 1. GENERAL INFORMATION (Must be completed pno[ ~9 submdta (a) ke~al Description (include 10t, block, subdivision, section, ~ownship, mn~o) Location (address or directions) ~ ~.., -,~ - .~ .-~- ~,' R¢[=d~o~ .... Telephone: (home) · - - Bus~ness. (c) Lending Institution ~n~ T~P/¢ = ~=~ ~1~ Telephone Mailing Address ~ ~t ~" ~ - ~chor~ (d) Real Estate Company and Agent ~qf~ Address ~qO0 ~r~ll R~. ~ (e)Mad the HAA to the {~"~ -~.~..~wh,~' address'. ~,or cheCk here ~ fhodforpckup):':;":~:? List contact person and day phone number below: · _;; . ~,;::: Single-Family ~ Number of bedrooms. ~ 3, WATER SUPPLY Individual Well [] Community J~ Public [] ·¥.. stem. must have wr tten conf rmat on from-the State Department-of En¥ironm, ental - Note' If communlt we I sy ......... Conservat~on.a~t~Stih(j ~'o tnlegan;~y ~r:/8'~t~tO~; :, ' ....... "" ~- ..... ~: '~ ':"~ . ....;""~"' :: ~ - 4 SEWAGE DISPOSAL ........ ~ .......... ~ ......-,,-.,o,~ ...... ¢ ,,.: -.-,,. , ¢:~'_ .~.~..~', · On-s~te ~ :.(,- Pub cD :, .CommumtyD ...~.Hold~ng TankB? N~t~ f C0m~u~ t'~e ¢~tem must'h~ ~itt~n cb~firmafibn.fr6m th~:State Depa~ment C6nsemation' attesting to the legadty and status. 72-025 :Rev. 7/88) Page 1 of 2 ~ j.o ~ eOed MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: 1'..¢/3 Well Classification (~ (¢.-~--¢ Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ~ '~ 6"*~,r~ me4~,/-,tv If A, B, C, D.E.C. ApproVed (Y/N) Date Completed Yield Depth of Grouting 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 To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments .0~.. (.~.~/-¢r' ~ ¢z/~/~/ ; Date B. SEPTIC/HOLDING TANK DATA Date Installed 5-/.$O/¢'~' Size Standpipes (Y/N) ~' Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) No. of Compartments t' Foundation Cleanout (Y/NC Date Last Pumped ; for N,/~. Temporary Holding Tank Permit (Y/N) ,N, ~,-. To Building Foundation To Disposal Field ~ 5" SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ~ &c,o To Property Line ~' i~r' od- bdo, If To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course ~ ioo ' C. ABSORPTION FIEL~D DATA Soils Rating m/~b'sorpbon Strata Date Installed 5'/ ~O / Width of Fi~td ;e,,c:~¢%' ~- ~,~f~uare (.,~-of~rtion Area Depression~f~C'ield (Y/N) Results of La'st Adequacy Test /~'¢_.Zr',,~ Type of System Design Length of Field 9'5' Depth of Field Gravel Bed Thickness 7 Statndpipes Present (Y/N) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ~ ~oO ' To Property Line I~' ' To Building Foundation ¢~' To Existing or Abandoned System on Lot ~' tS"' ; On Adjoining Lots ~' .~2 ' To Water Main/Service Line '~ ~,¢-' To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course '~ ~c~o' To Driveway, Parking Area, or Vehicle Storage Area ~ Comments !..occ~o,~ o~ ~'l~a~i¢~.~/' .nc,/ ~ ~'~oc.~.o o~ c~,'-/a~//, Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HA,~.:gu de is~s n effect on the date of this inspection. Company F(o~ ~ ~ ~,.'I ~ .................. , ....... ¢ Engineer's Seal MOA No. ¢~ - ol9 ¢ .. Receipt Uo.~)~.%~ ~ ~ Receipt No. Date of Payment ~-/-~ / Waiver Fee: $ / Amount: $ '/O Date of Payment 72 o26 (Rev. 7/88) Back Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION ~- ~n ,~m ,_,U~.~..~ 322 WALTER J. HICKEL, GOVERNOR 563-6775 January 29, i991 FOR: Ted .... ~.,* 0 0 ~. ~ P~JSiD i-"9.!0605 Val!i Vue S/D :.~y review of the records on ~11= in ~nlo office reveals .~hat the Valii Vue S/D Class A_Dubi~c_ 7later System ~o'- in compliance with the ;~:covision$ of 18 AAC 80.060, . o~a~= of Alaska Drinking ,~,~et. P, egulat ions. Sincerely, Timo"chy ~. ~<arnowski ~.nv ir onman ~ ~ ~ u~ Engineer 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) Location (address or di~ctions) (b) Applicant Name '--~O~,~---- $~'J~/'~-/X,/Telephone:Home Applicant Address ~.~ ~E ~ (c) Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain); Business (d) Lending Institution ' , Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well [] Community [~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite,~ 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. Page 1 of 2 72-025(11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto afld as o~ the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water sappJy 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. Name of Firm ~ ~,~ C~ Telephone ~/-~0 YO Address IZO0 ~~ ~1~ ~ ~, ~ ~ a,e DHEP APPROVAL Approved for ~l"h'-~oed rOd ms ~ Approved ,~ Disapproved Conditional 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) ~IUNICIPALITY OF ANCHORAGE HEALTH AND ENVIRONMENTAL PROTECTION ION OF ENVIRONMENTAL HEALTH :~F,~I~P~cTION FOR HEALTH AUTHORITY APPROVAL WATER FACILITY Application Date township range) Business TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well [] Community~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 SEWAGE DISPOSAL 0nsite~ 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 (I 1/84) Name of Firm Address Date ENGINEERING FIRM PROVIDI~IG INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION AS certified by my seal affixed hereto a nd as of the validation date shown below, I verify th at my investigation of this Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adeqi for the number of bedrooms and type of structure indicated herein. I further verify that based on the information 0bb from the Municipality of Anchorage files and from my invest gat on and inspection the on-s te water Wastewater disposal system is in compliance with all Municipal and State codes, ordinances and regu ations n effec[ the date of this inspection. Telephone ,~/"~-----~'~ D.;;APPR ~ Disapproved Conditional 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) "~ MUNICIPALITY OF ANCHORAG'~ MUNICIPALITY OF ANCHORAGE (MO~i~ DEPT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) FNVIRONMENTAL PROTECTION CHECKLIST - FEBRUARY 1984 ,.- 264-4720 [-~.B 1 8 1986 WELL DATA Well Classification ~'~'~E/~? ~/ I, A, B, C, D.E.C. Approved(~N) We,, Log Prese.t lYlN, Z~I/~ Date Complete' Tote, Depth .'h+ casedto, Static Water Level~J/~- , Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ,~.~TJ .-~- ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~ t~/_ ; On Adjoining Lots To Nearest Public Sewer Line . i/'~--'~/'~ To Nearest Public Sewer Cleanout/Manhole ~'//~/"//'/ To Nearest Sewer Service Line on Lo/~/.~ Water Sample Collected by ; Date Water Sample Test Results Comments SEPTiC/HOLDING TANK ~ATA Date Installed Standpipes{~N) d~7' ,~'F~ -¢,~'/!,~,~ir-tight CapsrN) Depression over Tank~N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~//~ Separation Distances from Septic/Holding Tank: To water-Supply Well ,~ //--~ (?/~ NO. of Compartments Foundation Cleanout (YO' Date Last Pumped ~' ~ ;for Temporary Holding Tank Permit (Y/N) To Property Line "~ To Water Main/Service Line Course To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field&N) Results of Last Adequacy Test Type of System Design Depth of Field Gravel Bed Thickness Standpipes Present(~)N) Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation .-~ / To Water Main/Service Line Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ,~,O ~ To Cutbank (if present) ,~//¢ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~'~ ~'~¢'~/~'~'4/'/)~'~ ~"~ .~'¢'¢' ~20'/~¢;~/~4/5 LIFT STATION f Date Installed-'~'~"~ Dimensions Size in Gal,l, ons '"'"~'~'~~ Manhole/Access (Y/N) "Pump On Level at "'-.~._ "Pump Off" Level at High Water Alarm Level at ~ Vent (Y/N) Tested for Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I hav~¢hec.~ed, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~//~-~/'~ ///'~'¢'~ Date Company /¢"~'~ -~ MOA NO. Receipt No. ?'~'~ ,~.)ICl Date of Payment ~' I~ Amount: $ L,~ Page 2 of 2 72-026 (11/84) ALASKA ENVIRONmeNTAL CONTROL $1:RVI~ ~ INC. 1200 west 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 CHECKED BY DATF SCALE ! ~.~0 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 ,? BILL SHEFFIELD, GOVERNOR Telephone: Address: 274-2533 PWS I.D.# ~ / U ~O~/4- /V[UNICIPALI'D( OF ANCHORAQ~ DEp~, OF HEALTH & ENVIRONMENTAL PROTECTION F ~B 1 8 1986 RECEIVED To Whom it May Concern: According to records on file in this office the / Water System is in compliance with the State Drinking Water Regulations Sincerely, MUNICIPALITY OF ANCHORAGE DMSION OF ENVIRONMENTAL HEALTH DEPARTMEN'U OF ?~EALTH AND ENVIRfkNMENTAL ~OTECTION APPLICATIC~N FOR HEALTH AUTHOP~TY AP[~ROVAL'CEKTIFICATE 1. General Information Application Date 5/21/__~8_4_ ~_ (a) Legal Dgscription (include 10t, block, subdivisicn, section, township, range) Lot 15, Blk 3 Valli Vue Subdivision Location (add, ess or directions 6443 Lone Tree Circle Applicants Narre Gene Brauer Te].ephp~_~__~346-3422 (b) Applicants Add~,ess 6443 Lone Tree Circle Anchorage, Alaska (c) Applicant is (check one) ~nding Institution ~-~; ~¢ner/builder~ !'; Buyer~--~; Other~ (explain); Seller - Agent (d) Lending Institution Teleh~ Ad,tess (e) Real Estate Co. & Agent Marston Properties Management Dean Pefanis Address 4105 Turnagain Blvd. Telephcne 2. ~ of Fesidence Single-Fami!y.~.. Number of ~drocms 3. Water SuDp~ ® 248-1717 Multi-Family~--~ 3 Other, (~scribe) Note: If cc~ar~nity ~11 system, must harm written confirmation ~ ~e State ~par~nt of ~viro~ntal Con~rvation attesting to t~ legality ~d status. Is ~e ~tl a~ate fo~ the n~r of ~ s~cified in this ~ (Yt~) Y ~w~ge Dismal Onsite~ x ~ ~blic~ ~nity~ HoldingTa~ Is t~ wastewater dismal system adequate f~ ~e ~r of h~ (Y/N) Y [Page 1 of 2] 5o Engir~ering Fi,tm Pro_vi__di~_qg Ins_pect~o_n~ Tests, Data and Information I certify that I have checked, verified, or ~onforred to all MOA HAA ' : = · effect on the date of this insDecticn. Name of Firm Signed by ( F~GINEER SEAL) 6. DHEP ADDroval Appro~d for ...... kedrooms By ~'~- Appromd L ! Disap[~oved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Envirorm~ntal Protection does not guarantee the continued satisfactory performance of the water supply and/or tbs wastew-ate~ disposal system. Tais approval indicates that, as of the validation date shc~.m abow, based on the data and information furnished by an engine, er registered in the State of Alaska, the water supply and wastewater disposal system is safe and funo tional for the rnmbez of bedrocms and type of structure indicated. (DHEP SEAL) 7. Mmil the HAA to the follcwing address: KB2/'d5./s [Page 2 of 2] MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 WELL DATA LEGAL: /"'"~MUNICIPA~$1'Y OF ANCHORAGE D~FT. OF HEALTH & ~NVJRONM~NTAI- PROTECTION 2 5 1984 Lot 15, Blk 3, Valli Vue Subd. Well Classification community I~ A,/JB, C~ C, D.E.C. Approved(Y/N) Y Well Log P~esent (Y/N) N Datekg~'~'Completed unknown Yiel~ Total Depth unknown Cased~ to/ unkn ~ ~Depq~h of G~outing unknown Static Water Level l~nknown I / ~P?~) ~e~t At unknown Casing Height Above Grcund 12" ~' -' Sanitary Seal on Casing iY/N) Y Electrical Wiring in Conduit (Y/N) Y Separation Distanaes f~om Well: To Septic/Holding Tank on Lot .150' + TO Nearest Edge of Absorption Field on Lot 150' + To Nearest Public Sewer Line N/A C leancut/Manhole N/A Water Sample Collected By Water Sample Test Results DeL~2ession A~ound Wellhead (Y/N) N ; On Adjoini~gLots 150' + ; On Adjoining Lots 150'+ To Nea~estPublic Sewer To Nearest Sewer Service Line on Lot N/A D. Maney ; Date 5/18/84 Satisfactory f6rJTotal Coliform Cc~LaL~nts SEPTIC/HOLDING TANK DATA Date Installed '~"~ ~ ~ Size / Standpipes (Y/N) Y Ai~-tight Caps (Y/N) Y Depression ove~ Tank (Y/N) N Date Last Pumped No. of CG~gart~nts 2 Foundation Cleanout (Y/N) N 5/ 18/84 Pumping/Maintenance Contract on File (Y/N) -- ; for -- Holding Tank High-Water Alazan (Y/N) -- Temporary Holding Tank Permit (Y/N) Separation Distances f~om Septic/Holding Tank: To Water-Supply Well 150' + To bJilding Foundation 6' To Property Line 5' + To Disposal Field 49' To Water Main/Service Line I0,:-+ To Sbleam, Pond~ Lake, c~ Major D~ainage Course None Noted Comments [Page 1 of 2] 2-15-84 C. ABSORPTIC~N FIELD DATA Soils Pating in Absorption Stmata Date Installed 9/79 Width of Field 3' Square Feet of Absorption A~ea Depression over Field (Y/N) Results of Last Adequacy Test 250 . Type of System Design . Trench Length of Field 52' Depth of Field 12' Gravel Bed Thickness 9' 936 Standpipes P~esent (Y/N) Y, Y Date of Last Adequacy Test 5/18/84 Satisfactory Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot none noted TO Water Main/Service Line 150' + To P~operty Line 10' + 33' To Existing or Abandoned System cn ; On Adjoining Lots 30' + 10' + To Cutbank(if present) None Noted To Stream/Pond/Lake/or Major D~ainage Course Nons Noted To D~iveway, Parking Area, or Vehicle Storage A~ea 10' + Large'dep~ssiou~=er__entire length of disposal field. Co, rents ...... ~. D. LIFT-STATION-- N--/~ Date Installed Size in Gallons "Pump O~" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Comn~nts ** Check Permitted Bedroom Rating Against HAA Request I certify that' I have checked, verified, or conform~=d to all MOA HAA Guidelines in effect on the date o~ this inspection. Signed _ ~ -~,/ Date Company KB1/d5/s [Page 2 of 2] 2-15-84 3-5-84 To whom it may concern: Vaiil-Vue #2 L9, PWS ID# 210605 B6 The Valli-vue Drinking Water System (Class A) is currently in compliance with State of Alaska Drinking Water Standards. Environmental Field officer Anch Western District MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHOFIAGE DEPT. O~ W'%T~ & DEPARTMENT OF HEALTH & ENV RONMENTAL PROTE~ ~ON,,',ENL~L;; ;. ~CTION 825 L Street - Anchorage. Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten {10) days for processing. 1, PROPERTY OWNER Phjllip & Chrystal Jeans MAI ti NG A DDR ESS SR Bo× 33-J, Anchorage, Alaska 99507 PROPERTY RESIDENT (If different from above} PHONE 6443 Lone Tree Circle 2, BUYER PHONE MAILING ADDRESS 3, LENDING INSTITUTION PHONE MAILING ADDRESS PHONE 344-4412 4. REALTOR/AGENT AREA, Inc Real~ors / Rita Rosenberg PHONE 278-2525 MAILING ADDRESS 3300 "C" St.~ Anchorage~ Alaska 99503 5. LEGAL DESCRIPTION Lot 15, Block 3, Valli Vue Sub. #2 STREET LOCATION 6443 Lone Tree Circle 6. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY NUMBER OF BEDROOMS [] One ~ Four [] Other__ [] Two [] Five ,~' T~, [] Six * 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.) 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE** [i] PUBLIC UTILITY **If individual/on-site, give installation date 19 7~- . If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUE'ST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED ' ' INSPECTION APPQINTMENTS TIME TIME TIME DATE DATE DATE I NSP ECTO R INSPECTOR INSPECTOR DIRECTIONS: 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WA'rER SUPPLY [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED E~]PUBLIC UTILITY ~)~,~. ~"~ (L/ Connection Verified INSTALLER []Septic Tank or []Holding Tank r"'~d~,l [~-~.0 Size: (/d_J~)O If Tank is homemade SOILS RATING give direensions; ~_ .~'-~ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL (~ f ~ 4, DISTANCESwELL TO: Septic/Holding Tank Absor[ rea Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line [] APPROVED FOR ~ BEDROOMS I ~ t~)_ (/O'~C [;~-CON DITIONAL APPROVAL (letter must accompany certificate) ~ DISAFPBOVED LEGAL DESCRIPTION ~w 72-010 (Rev. 3/78) MATERIALS TESTING ° QUALITY CONTROL SOILS ENGINEERING 2204 Cleveland Ave. / P.O. Box 10-1126 / Anchorage, AK 99510 / 277-0231 710 3rd Ave. / P.O. Box 60547 / Fairbanks, AK 99706 / 452-1267 · 456-5155 August 6, 1979 Mr. and Mrs. Jeans SRA 33J Anchorage, Alaska 99507 Re: Adequacy Test, Lot 15 Blk. 3 Valley View Subdivision Dear Mr. and Mrs. Jeans: The Septic System located on the above referenced project tested as follows: 120 gallons of water in 24 hours. If you have any questions concerning this test, please contact our office. Sincerely, CONSTRUCTION TEST LAB Managing Engineer cc: Rita Rosenberg Area Realty RJP/gk "Professio~als working to design and build a l~'ll~'t', t las'ka" May 16, 1979 Phillip/Chrystal Jeans Star Route Box 33-J Anchorage, Alaska 99507 Subject: Lot 15 Block 3 Valli Vue Estates Subdivision #2 Approval for your individual sewer and water facilities will not be granted until the following items have been completed: (1) The septic tank is pumped with a receipt submitted to this office. (2) A percolation test be performed on the existing leaching area. This will determine if the system is adequate according to National Standards. A list of private firms who perform the test is enclosed. (3) Your application shows the number of bedrooms exceeds the number the sewer system was originally approved for, therefore, an upgrade will be required. An additional 500 gallon septic tank would be needed to qualify for a four(4) bedroom single family residence. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: Rita Rosenberg % Area, Inc. Realtors 3300 C Street 99503