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Home My WebLink AboutVALLI VUE ESTATES #2 BLK 3 LT 48 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 Nam~ DISTANCES ~ SEPTIC ABSORPTION WELL A~ TANK FIELD Phone(s)~__/~q~-- Permit9~OO8~NO NO of Be~ooms WELL LEGAL DESCRIPTION LOT LINE ~& ~ FOUNDAtiON AS-BUILT DIAGRAM (Show Iocahon Of well septic system, property hnes, Ioundahon, TANKS /' ' % ~ SEPTIC ~ HOLDING TYPE OF SYSTEM ~'~ ' Gal added above original grade GraveJ depth be,zeal, pipe Distance beJwee~ lines Tolal absorpt,on area ¢ ~ SQ FT ~ Fl~ Number oH .... Soil rat,nD Pipe material ~.a~ Installer ~ ~ ~¢~ Date Installed ~ PRIVATE ~ OTHER fldentifv) / _ Inspections Pedormed by: Municipal and SJate Buidelines in ellecl 0n Ibis dale: ~ / ~ 72-013 (3/85) (ilJE FXl' ]i {3 l ' ' I l I l ~ [' ' fyi :~!;4:::~l-4744 {:}t::;'. :~;47;--"46~ :L ,, THEODORE F. MOORE, P.E. PH: (907) 345-1355 g TTOP TECHt ICA SER¥!· CIVIL & ENVIRONM[ENTAdL ENGINEERING · ENERGY CONSERVATION & ANALYSIS 14530 ECHO ST. ANCHORAGE, ALASKA 99516 February23,1990 Susan Oswalt M.O.A. Dep't of Health and Human Services P,O. Box 196650 Anchorage, AK 99519 MUNICIPALITY OF ANCHORAGE DEPT. OP HEALTH & ENVIRONMENTAL PROTECTION F U O 2 3 1990 RECEIVED Dear Ms. Oswalt: On February 7 you issued a permit for a sewer upgrade on L48, B3, Valli Vue Est #2. A couple of contractors who are bidding on the job have suggested that the configuration be revised as shown on the enclosed revised site plan and specifications. The major reason for this is to avoid the necessity for the waste line to pass under the driveway, with the attendent freezing considerations. It will also allow retention of a portion of the existing trench and the existing septic tank, if an inspection proves it to still be in good condition. Because the existing trench slopes down hill, I propose to remove the sewer gravel from a 10 foot section beyond the intersection with the new waste line and plug that gap with tight soil. I believe this alternate configuration will be equally functional, and should result in some cost savings, as well as avoiding possible problems with the driveway crossing. Please advise me if you have any problems with this alternative approach, cc: Robert and Mary Anne Urquhart Sincerely, oore, .< l.o7- q7 F T~ \ ,. \ F~atlOp Technic*~ Services 14,520 Echo Street ~~cje,.Al~ Dt.~/~{. wy: TF~t ~ AS:t..L ,.Af4'~- ,4-PflRO i~ ii,~ AFL h 5EC¥10N :Flattop Technical Servi, 14530 Echo Street Anchorage, Alaska 99~ PERFORMED FOR: Pla{top Technical Serv.~ces '*'"' 14530 Echo Street DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST l LEGAL DESCRIPTION; /~ ~::~/ /~.~ ~/~[// ~' ~]~'i~a Township, Range, Section: 2- SITE PLAN ~..~ - 7 8 9 11 12 ~-~ve/~, 5';/F WAS GROUND WATER ENCOUNTERED? SLOPE 15 - 17- 18 lg hi IF YES, AT WHAT DEPTH? Deplh to Waler ADer Maniloring? 1~1,1~, O~'y Dale: Reading Date Gross ~et Depth to Net Time Time (~.) Water Pr~.,eo~ I/~$ 11:27 ~e~d( It: q~ 27 ~ PERCOLATION RATE -~ (minutes/inch) PERC HOLE DIAMETER 7 ~ ~ ~J~ ~ TEST RUN BETWEEN 3. 0 FT AND 3,~'- FT PERFORMED BY: F/a/~p ~C4~iC~[~ I. ~ ~ CERTWY THAT THIS TEST WAS PERFORMED iN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELJNES IN EFFECT ON THIS DATE. DATE: _, 72-008 (Rev. l~la~to~ Technical Services "'"" 14530 Echo Street DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: L~ 2 5 6 P-iL ? 9 ~.H. 12 20 COMMENTS Township, Range, Section: SITE PLAN SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth Io Waler After Monitoring? /~t,~, ,O~,,y Date: Reading Date Gross ~et Depth to Net Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PEBC HOLE DIAMETER __ TEST RUN BETWEEN FT AND FT ¢-~b~ '/.x/~/(~.~ , 7-~J;4 bott'_ ~f.~. PERFORMED BY: Fl~f~ ~M~,c.f~ve~ ~" ~ ~ .CERTIFYTHATTHISTESTWASPERFORMEO'iN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72~8 (Rev. Lot 48, Block 3, Yalli Vue estates #2 10621 Lone Tree Drive Septic System Upgrnde Specifications nnd Design Notes 1. The measured perc rate is 3 minutes per inch, however the design of the system is based on a soil rating of 150 square feet per bedroom, which for this three bedroom system requires a total area of (150)x(1.5)x{3) = 675 square feet of bottom area. This is achieved by means of a 34' by 20' soil absorption bed. No sand filter is needed because the perc rate of the absorption stratum is slower than that of imported pit run sand, and this stratum is underlain by tighter material. 2. The configuration of the system shall be as shown on the site plan and design drawings, except that minor deviations may be allowed or required by the engine'er conducting the inspections. 3. All construction practices and material specifications shall conform with M.O.A. requirements. 4. The owner or contractor shall arrange for all necessary utility locates, and the contractor shall work around these utilities as appropriate. 5. The existing septic tank shall be thoroughly pumped and exposed to allow the engineer to verify it's integrity. If it remains in good condition, it may be retained~ providing "Ramnek" seals are installed on the manhole covers, a cleanout is installed in the second compartment, and '(Calder" couplings are used on all connections. If the tank is not in acceptable condition, it shall be replaced with a new approved 1000 gallon, two compartment septic tank. 6. The first half of the existing soil absorption trench shall be retained, to the approximate location shown on the site plan, providing adequate slope remains for a new, 4" diameter ASTM D-3034 gravity waste line to be installed from that point on to the proposed soil absorption bed. The sewer gravel in the existing soil absorption trench shall be removed for a distance of 10 feet beyond the point of divergence of the new waste line, and the original trench backfilled with tight native soil 9. The soil a~)sorption bed shall be constructed by first removing all peat and loam material from the site. Then the underlying gravel shall be excavated to create a level surface which is 3 feet below the original ground level at the uphill side of the bed. A total of 12" of approved sewer gravel shall be placed in this excavation as shown on the plans, with ~he perforated distribution pipes and non perforated manifolds laid level with their inverts 6~' above the bottom of the excavation. 10. Cleanouts and monitor tubes shall be ~nstalled at the locations shown, and the entire surface of the sewer gravel covered wi~.h 2" of approved burial type insulation prior to backfill with 2' of unclassified soil. The finished surface shall be mounded 6" above the natural grade, and shall be contoured to promote ready surface drainage off of and away from the bed. 11. If construction takes place during tl~e winter, the buyer and seller shall make arrangements to have a final regrading done after breakup, at which time any desired topsoil or landscaping work can be accomplished. 12. A total of 4 inspections will be required during construction: (1) initial stakeout, (2) after the bed is excavated, but prior to placement of the sewer gravel, (3) after the gravel is placed, the septic tank is installed and all pipes are connected, but prior to final backfill, and (4) after the backfill work is completed. ,~- -.~ ,~;, ~)~ ,IUNICIPALITY 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 ~ PHONE LEGAL DESCRIPTION J Well I Absorption area Dw~ng~ PERMIT NO. DISTANCE TO: ~ / Liq. capacity in gallons Inside length Width Liquid depth IF HOME.DE: ~ ~ DISTANCE TO: Well Dweging PERMIT NO. OZ~ I Manufacturer Material Liquid capaclty in gallons ~ Well Fooundation Nearest lot line PERMIT NO. _ STANCE TO: / O --~ ~ mZ No. of lines / Length /~°f each li~ e Total length.;~./~of ines Trenc~h~.~ inches Distance between lines ~ a~t Total effective absorption are . ~ Top , .~, gr~e/ ile~ ~ inches of 'l~to fi ish Material bene /¢ ~ ~ Length Width Depth PERMIT NO. ~ P 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 llne Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS INSTALLER REMARKS 72-013 (Rev. 3/78) [:,EF'I::!F;-'"ME'-4"" O::'( _TF RI'.,[':, Eq',,'ZI~'OF4MFI'.~TFI[ F:'F~ '--I"T-I'.~ · ¢, , ,::k~:..:, · L' ~:, FRf=.E I'., HNL:HUI:4. MGE., I-]K. S':.S'.SC~ ....... "'- -- /Z-~ ~l~. ;';';"dl'T" ..... '"F ' "~ " ' ............... /¢ ~j' la LOCF:IT I lin O" MRLL. E'¢. RE:, LEGF:IL. 1_48 Bi: '¢I=ILLI ',/UE SOB LOT SIZE 28EI~S(; S6:!URRE FEET TYI::'E Of::' SOIl.. FtE~SORI3TIOI",I S'¢STEM IS: TI:RENCH I',tF:IF,:IMLIM BILIME~EF4: i)F E:EDROCIMS = THE RE6!UIRED :5IZE OF' THE '-"':;OIL. SOIL RRTING ,::SQ I::~B~!;ORPT!Or.~ S'.¢STEM IS: F:]",.."BR :: .... :L25 THE LENG'FH [)IMENS;!ON IS THE LENGTH <IN F'EEET) CII::' ]"HE ]"RENCFI OR DRFIINF'IEL. D,. 'THE I}EF'TH OF R TI:~:ENI:::I:4 OR PIT IS -rile I::,ISTRNCI:E BETP.IEEN THE SIJRFF:ICE OF' TI-IE Cii:~:OI_II'.,ID KIND THE BOTTOi-,1 OF THE EF:,'CFI',,,'F:iTZON ,:Ii'.4 F:EE]"). THERE I:E; NO :SET I.,.lI[)-f'H FOR TRENCHE:S. THE C~RF:i',,,'EL DEPTH IS THE MINZP1UM DEPTH OF GRIg,,,'EL E~E]'P]E:EN THE: CHJTI::'FiL. L PIPE RI'-,1D THE BOTTOM OF' THE E:,~:CR',,,'IaTION (IN FEET>. PIERP'!]:]" F:IPPL I CRIqT HFF.:~; "FHE RESPONS I B I L I T'¢ 'T'O INFORM TH I:S DEF'RF4:TMENT DUR! NG THE :[P,ES]"F-'IL. LFI]"IO[q INSPECTIONS:] OF FiN'.r' P.IELLS FiB, JRCEI'.,FF TO TEllS F'ROPEI:;]:T'T' FIND THE I'.,!Ui-,iBE];:'. O1::' RESIDE]'.,ICE:':'~ 'TFIFIT THE !.,.IEL. L WILL E:F:ICKI::'ILL.I'NG OF FIN? S'T'STEM I.,.IITHOUT FINFtL INSI::'ECTIO[",I RND RPF:'RO',,"FIL B"r' THIS [:,EF'IqRTMEi",I'T' P.I!LL BE '}.'!;LIBJECT TO F'ROSECUTIC)N. MINIMLIM [:'ISTF'INCE 8ET!.qEEN FI P.IEL.L FIND RN"r' OI"~-SiTE :SEI.qF!GE DiSPOSRL.. S"¢S;'FEi"I IS d..EIel FEET F:'OR F! F:'I:~:IVRTE I,-IELL.~ OR ::l..Se~ TO 2E~E~ FEET FROM R PUBLIC P.IELL DEI::'ENDING LIF'ON THE ]"'¢F'E OF I::'UE',LIC: 14EL±... CFI"HI:_'::F4: REL.-.!LIII'4:EMENTE; i'"il=l'T'FIF'F'L'T'. SF'ECIFICI::I'I"IONS RND CONSTRUC'f'ION DIRGI:RI::IP'IS RRE R","R!L.F:IBLE TO INSURE PROPER INSTF]LI..I::ITZON. I C:ER'TIF'T' -i:'Hi:rtT ±: I F:IM KFtI'dILIF~II:R I.'.IITH THE RELT.!LIIREMENTS F'OR ON"-SITE SF.'JI.'.IERS i::IND I.'.IELL. S RS SET FOI::~-FI:-I E~'T' 'T'HE MUI",IIC.:II::'FIL. I]""r' OF Fii'qC:HORRGE. 2: I I.,.I!l....i:_ INSTF"ILL. THE S?:STEM II",l FICC:OR[:q~fNCE I-,.!ITI:-I THE CO[:'ES. Z'-':: I L.!N[>ERSTFZIND -FI:"II::IT 'FHE ON-.SITI:..:.: SEI-4ER S"r'STEM I"IFI'T' REL::!UIRE IEIqLF'IRGEMI:.:JqT IF:' THE RIZSIE:,EI'-,ICE iS REMOE:,ELE[:, 'FO INC:LIJ[:,IE MORE 'I'HF:IN 2~: E:E[:,I:.i'.I]~Oi','IS~;. ~ F'I::'L I C:F]i'-,IT CI}~rli'dLIN ~ T '~> I~,LDC:i MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6~650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST LEGALOESOR,PT,O.= d /;% DATE PERFORMED: [] SOILS LOG [] PERCOLATION TEST 1 2 - 3 4 5 6 7 8 9 10 11 12 13 14. 15- 16- 17- 18- 19- 20- SLOPE /- >j. y'- .~ , ,. ~'~ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) ! I' , ~ ~ TEST RUN BE'I~V. EEN FT AND -- FT COMMENTS [' '~; '~' Ii [JL 'i'L-, -( ,'L. ,"') Z' ~ 'J'C ,~'' ~: '(:~. ,'-' ,,~ ~)~¢i ~'~/~ 72-008 (7/76) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section ----~1~..~llz?-- ~,~-o5~ P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING OI..~- ~. ~ I~' NAA# GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address. Agent Address Day phone Day phone 7¢~- ~7/- Day phone = Unless otherwise requested, HAA will be held for pickup. N~.U_MBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status Qf system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-D25 (Rev, 1/91) Front MOA#21 S~UeLUWOO I~UOi~!pp¥ eq~, q~,!A~ 'Sl,,OOJpeq 'suJooJpeq Joj le^oJdde leUO!~!puoo · pe^oJddes!Q -- Jo~ peAoJddv =II:IrI.LYN~IS SHHO '9 · uop, oedsu! s!q~ jo e~ep eq~ uo ~oejje u! suogelnDeJ pue 'seou~u!pJo lo]UnlA1118 q~'!t~ eoU~ildLUo0 u! S! LUe~S~S leSOds!p jm, e~e~seA~ Jo/pue/~lddns JOii~edsu! pue uo!~elB!~se^u! ,%u LUOJ~ pu8 Sel!J e6eJoqouv ~o ,~Jled!ojUnlAJ eq~ uo peseq ~,~q~, ,~J!Je^ Jeq~nj I 'u!eJeq pe~eo!pu! eJn~onJ~s ~o ed~l pue eq~ Joj e~,~nbep~ pue I~UO!~ounj 'ej~s s! LUe~,S~S lUsods!p Je~et~e~,seA~ Jo/pu~ ~q~ SAAOqS uo!~eo!ldd~ I~AoJddv/~liJoq~nv q~l~eH siq~ ~o UOI~Di~SeAU! IS m, ep uog~p!le^ eq~ Jo se pu~ ole~eq pex!JJ~ I~eS ~uJ ~q pegIl~eO sv I::Ia=INIDN=1 AB NOIJ.O=IdSNI dO J.N~IN~J. VJ.S '~ ( Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LLi/~//'~ L/'~/~- ~/u''¢' ~'~ Parcel I.D. A. WELL DATA Well type /~ Log present (Y/N) Total depth Sanitary seat (Y/N) If A, B, or C, attach ADEC letter. Date completed Cased to ADEC water system number ~'¢'51~ ~] O(.oO¢ Driller Casing height Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cteanout Petroleum tank r,;, O WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~//~//?O Tank size It.,,-~.~ Compartments Cleanouts (Y/N) 7 Foundation cleanout (Y/N) ~"~ Depression (Y/N) High water alarm (Y/N) hCJ, z~ Alarm tested (Y/N) Date of pumping ~"/'~ 7/9 ~ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot J~//,,~ On adjacent lots ~A Foundation To property ~ine ~'~ Absorption field ~) Water main/service line Surface water/drainage ~O~r~ > ~' 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION //-~'~'"~ _ Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacentlots Surface water D, ABSORPTION FIELD DATA Date installed Length ~ t¢ Width 'Z. Total absorption area ~¢ ~:~ Depression over field (Y/N) /'~ Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating System type Gravel thickness ,- ~,~ Total depth Cleanouts present (Y/N) Date of adequacy test for If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain On adjacent lots /"/'//,/-~ Property line J O To existing or abandoned system on lot Cutbank ~i/ ¢,, ~4 -~. Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe~ct on the date of this inspection. Engineer's Name ~ ~P~ ~/ ~---~0 ¢ I.& Date p~9 t~-/[ I c:~ ~-~ HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Department o! 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 ~-~} ~ ~/-~ _ .~.%.~..Q.. - \~-~ HAA# L'=\ ~'~ °~(~f'''~ I ~ O/~ 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 Re6'¢ ~' ~¢~ ~ ~¢¢e4~¢~Telephone: (home) ,~¢d-/d~ Business Mailing Address /~ ~ / ~o~ Tf~ ~Ztce ~ ~ . (c) Lending Institution N,~, Telephone Mailing Address (d) Real Estate Company and Agent ~'or ]'~n ~: ~>ro,/¢ ~' ~'~ - ~A~ ~ Address ~00~ '~', ~/~ ~c~p~ ~ ~0~ Telephone ~ 8 - 7 (e) 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 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATIOI~ As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of tl~is Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm ]='[¢z:/-./'~f ?-ec~/~'c~/ _~4'/-~/t'c.,e' Telephone ~/--""'-/-"~'~J"' Address Date 6. DHHS APPROVAL Approved for ,."~ __bedrooms by Approved ~. Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of Health and Human 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 Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 . ~ MUNICIPALITY OF ANCHORAGE (MOA) ~UNiC,~EA~A~"AO~ ~c~alth Authority Approval (HAA) ~i~,t,~ DIVISION HECKLIST - FEBRUARY 1984 ENVIItONM 343-4744 MAR 28 ]990 Legal Description: A.w ,,DA ARECEIVED Well Classification ,~4^ 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 To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments D ~;~-. /~ ~LJ-er o.¢2 Date Completed . Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) If A, B, C, D.E.C. Approved (Y/N) Y' Yield ; On Adjoining Lots ; On Adjoining Lots TO Nearest Public Sewer Cleanout/Manhole B. SEPTIC/HOLDING TANK DATA Date Installed ~/E.g'/P/2 Size Standpipes (Y/N) ,I,,' Air-tight Caps (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: ~ ~0o~ TO water-supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments No. of Compartments ¥' Foundation Cleanout (Y/N) Date Last Pumped ; for /V,~. Temporary Holding Tank Permit (Y/N) A/,/~.. To Building Foundation To Disposal Field 72-026 (Rev. 7/88) Front Page I of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well '~ To Building Foundation Lot / 6" ¢r/~¢-'(r','~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness h Statndpipes Present (Y/N) Date of Last Adequacy Test N,4. To Property Line ; On Adjoining Lots To Existing or Abandoned System on To Water Main/Service Line ;> ~-5-' To Stream, Pond, Lake, or Major Drainage Course To Drivewg, y, Parking Area, or Vehicle Storage Area Comments To Cutback (if present) /q, 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 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 inspection. Signed ~'~-~ ~, ~ Company F [c¢~/¢,,~ .7-~(..~..*1.; c~.[ .~¢'r/ ~c 'cv' Date ~ ~, /~0 MOA No. ~ -~/~ on the date of this ineer's Seal Receipt No. Date of Payment Amount: $ 72 026 (Rev. 7188) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 January 10, 1990 STEVE COWPER, GOVERNOR 563-6775 FOR: Mr. Ted Moore PWSID: #210605 According to the records on file in this office, the Valli Vue Subdivision Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, VEC:bas ~,'lbNl~r MUNICIPALITY OF ANCHORAGE DEPT. OF t-IZALTFI & DEP)~RTMENT OF HEALTH & ENVIRONMENTAL PROTECT~[¥IRONMENTAL '~, 825 L Street - Anchorage, Alaska 99503 DEC 8 1978 ENVIRONMENTAL ENGINEERING DIVISION e,e.,o.a R E C E I ¥ E D ' REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. PROPERTY OWNER I PHONE uRQUHART, Robert H. & Hary Ann I 344-1463 MAILING ADDRESS SRA Box 27Q Anchorage, Alaska 99507 PROPERTY RESIDENT (If different from above) 10621 Lon-e Tree Drive Anch0rage~:Alaska 99507 BUYER n/a PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE Alaska USA Federal Credit Union (H~ Diane Gibson) 277-5602 x 209 MAILING ADDRESS 777 Juneau Street 4. REALTOR/AGENT n/a Anchorage, Alaska ~9501 MAILING ADDRESS PHONE LEGAL DESCRIPTION Lot 48, Block 3, Valli Vue Estates #2 ;TREET LOCATION 10621 Lone Tree Dr±ye TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [~ Four [~0 SINGLE FAMILY I'-I Two [] Five [] MULTIPLE FAMILY [~ Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL~' "ATTACH WELL LOG. A well log is required for all wells drilled ~ COMMUNITY since June 1975. For wells drilled prior to that date, give well [] , PUBLIC UTI LITY depth (attach log if available.) 8, SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY l~- **If individual/on-site, give installation date ne¥I O If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010{3/78) THIS SIDE FOR OFFICIAL USE ONLY DA3 E I~{ECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIR£CTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER EZ] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER ~.. , A~E~ ~Urr ~Y ~ INDIVIDUAL DEPTH OF WELL ~ COMMUNITY DATE DRILLED [.~ PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~ INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER ~Septic Tank o~' ~Holding Tank Size:~, If Tank is homemade SOILS RATING give dimensions: TYPE QF TANK ~ANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absocpdon Area to nearest Lot Line 5. COMMENTS ~ APPROVED FOR ~ BEDROOMS ~] CONDITIONAL APPROVAL (letter must accompany certificate) ~ DISAPPROVED ~ DATE ~Y (Title) 72.010 (Rev, 3/78)