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Home My WebLink AboutVALLI VUE ESTATES #2 BLK 4 LT 20 ' Municipality of Anchorage (~ Page ) of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL'SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6350 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Name: ~0,__~~ ~V~ ~ Wastewater System: ~ New ~Upgrade Address: lOq~O LoN~ T~E ABSORPTION FIELD Phone: ~ Nc. of B~rooms: ~Deep Trench D Shallow Trench ~ Bed ~ Mound ~ Other Township: [ Range' ~ Section: Fill added abov:, original grade: Gravel length; WELL: Q New B Upgrade Gravelwidth: ~ FL JI -- Ft Classification (Private; A,8,C): Total Depth: Cased To: Total absorption area: Pipe material: ~ GPM Ft. Ft. SEPARATION DISTANCES ~ Septic ~ Holding a S.T.E,P, From Tank Field S[ation Tank Sewer Lines ~ j~y ~~ ~ ~ ~ ~ Sudace wat.~ Ilo IH~ ilo LIFT STATION Lot Size in gallons: J Manufacturer: "Pump on" levm~lev~lah JHigat; "Pump ofl" lev I ah High water:~z~alar Foundation J Pun Make & M,~d.I Electrical inspections performed by: Remarks: BENCH MARK . Location and Dascription: ~ Assumed Elevation' ~ / ENGINEER'S Inspections performed by: ~,5¢ ~', Dates: ,s~ */'' ' 2nd Department of Health and Human Services approval Reviewed and approved by: ~ ¢~ Dat6:~ -~ 72-013 (Rev 9191) MOA 25 203 W 15TH. AVENUE ANCH. AK. 99501 SWING TIES: I ID 21.5 FT BD 11.5 BE $$.7 CE 24.5 t TOTAL LENGTH 67.5 ET I fRENCH I TOTAL DEPTH 15 FT ,ROCK DEPTH 5 FT EFFECTIVIROCK DEP~ 5 FT BIOCYCLE I197 -"'- I0420 Lonelree DATE: JULY $I, 1997 Sieve Porter SHEET: 2/5 GRID: 2558 PEr?MIT # SW970190 Pig 11 015-$22-25 VVEO42&%Db/G 99.2 8?.4 ~ AIRCO~PRESSOR 4-INCH INSULAHON STANDARD DRAIN FIELD I-II4 PVC WITH 1/8' HOLES Al- $0~ TOTAL LENGTH 40 FT TOTAL DEPTH 8 FT TOTAL ROCK DEPTH 66 INCHES /~, EFFECTIVE ROCK DEPTH 60 INCHES 1~_ TOTAL COVER 5 FT. ~IIl~llt~lll~lll~lll m ,,, .... , ~ ~ <9~ ~ ~ 98. 7 Oo~oOouo u _~ SILT BARRIER ) OoOoOoOoOoOoOo~o~ }°o o o o o o o o o o o o o o o o o o o o o OoOoOow · 93.7 INSULATION NJ7 SCALE 95.7 ~ TESTHOLE !4 FT. DEEP LEGEND: i. PR/WARY TREATMENT, SEPHC TANK 2. AERATION TANK 3. CLARIFICATION TANK 4. DISCHARSE TANK 5. SOIL ABSORPTION TOBBEN SPURKLAND P.E. 205 WlSlh Ave Anchorage Ak 99501 279-,Y91~ FALLI VU£ £STAT£ ~2 BLE 4 LT 20 WASTEWATER SYSTEtd SCHEMAtiC STEVE PORTER SEPTIC SYSTEM AS BUILT I DATE: JULY 31; 1997 SHEET: 3/5 GRID: 2558 VVEO4205. DWG PERMIT ~4 SW970190 PID NO 015-522-25 (FOR II.tSPE~'i OR USE ONLY) 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:SW970190 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:PORTER STEVEN B & OWNER ADDRESS:10420 LONE TREE DR ANCHORAGE, ALASRA 99516 DATE ISSUED: 7/16/97 EXPIRATION DATE: 7/16/98 PARCEL ID:01532223 LEGAL DESCRIPTION: VALLI VUE ESTATES #2 BLK 4 LT 20 LOT SIZE: 21638 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SRECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 kND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) kND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SA~ME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~----~[~ DATE: DATE, 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 20, BLOCK 4 VALLI VUE ESTATE #2 STEVE PORTER Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 July3, 1997 We are submitting an application for a septic system upgrade for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and septic system are subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. This subdivision is served by a community water system. This lot was developed in 1976. A septic system upgrade was performed in 1986 due to performance failure of the original system. A adequacy test performed in April of 1997 revealed that the present system also could not meet adequacy requirements. Due to limited space and the previous short-lived performance of standard septic system, a BioCycle system is suggested. The presence of the creek running along the back lot line forces the location of the drainfield in the front of the residence. The suggested drain field is located between the present drain field and the drain field installed in 1976. The two drain fields were relatively deep, with eight to ten feet of cover. The proposed trench will have a total depth of eight feet, thereby utilizing soil above the level of the old trenches. According to the records from the Health Depar~nent the two old trenches are more than 20 feet apart, installing the suggested trench ten feet distant from the present trench should therefore meet the requirement of the regulations. The design is based on the following assumptions: Soil Rating 13 min/in - 1.2 gal per sq.fl/day with BioCycle No. of Bedrooms 3 Required Area per Bedroom: 150/1.2 -- 125 sq.fi. Total area required: 125 x 3 = 375 sq.fi. Use standard trench. Testhole depth: 14 ft Bottom Rock At 8 feet Top Rock At 3 feet Rock Depth 5 ft Cover 3 R. Required Length 375 / 10 - 37.5 fl, The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. ~\ ~., ,.~ \ Loi. 4,9 100 Fl,, TOBBEN SPURKLAND P.E. 205 W 15TH. AVENUE ANCH. AK. 99501 (907) 279-5916 Vue Estate ~2 BJk 4 L~ 20 10420 Lonetree Sieve Poller SEPT/£ SYSTEM DESIGN DATE: June 20, 1997 SHEET: I~5 GRID: 2558 PERMIT # PIP # 015-522-25 VVEO4201,,Dk/6 \ ~ TOTAL LENGTH 67.5 FT 19~6 TRENCH ~ TOTAL DEPTH ~5 FT INSTALL~TR[N~ ~ / ~ JET AERATION TANK ~ [ ~ ~ ~ ~ ~ ~ EFFECTI~ROCK 5 F[ ~ ~ CHECK T ~.. ~' ~..~ ~. ~F~ ~ TOB£EHSPURKLAHDP. E. 203 W 15TH. AVENUE ANCH. AK. 99501 (907) 279-$916 Vue £stale ~2 Elk ~ £~ 20 i0420 Lonetree Sieve Porter II SEPTIC SYSTEkt DESIGN DATE: June 20, i997 SHEET: 2/3 GRID: 2535 PERMIT # PZD # 0i5-$22-25 VVEO4ZO~.DWG 4-/NCH INSULATIONSTANDARD DRAIN FIELD 1-1/4 PVC W/rH ~/8" HOLES xr so TOTAL LENGTH 40 Fl' TOTAL DEPTH 8 FT ~ TOTAL ROCK DEPTH 66 INCHES EFFECTIVE ROCK DEPTH 60 INCHES ~ AIRCOWPRESSON. TOTAL COVER 5 FT. - I -- t ND SCALE .........~ TESTHOLE BIOCYCLE 6000 +~ INSULATION ~4 FL DEEP LEOEND: 2. AERAHON rANK ............ -- ~. ~ ~ ~ 4. D/SCHAROE ~h¢ ....... ;~0~, 5. SOIL ABSORPTION ~,,,,.~ ..................... ~,a.,.,,~ TOBBEM SPUNKZAND P.E. SEPTIC SYSTEW DES/ON VALLI VUE ESTATE f2 BLK 4 LT 20 205 WlSth Avo DA[E: JUNE 20, 1997 Anchoraae Ak 99501 WAS[EWATER SYSTEM SCHEMAtiC 27,q-,~,~ STEVE PORTER SHEET: 5~5 GRID: 2558 PERMIT ~ PID NO 015-522-2J VVEO4205. DWG Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG --. PERCOLATION TEST 10 11 12 3 c~i l-l- It-IL 4 7 8 13 14 ~4o L~ 15 16- 17- 18- 19- 20- COMMENTS Township, Range, Section: SLOPE WAS GROUND WATER ENQOUNTERED7 IF YEa, AT WHAT DEPTH? Depth to Water Alter ,. MonDoring? SITE PLAN Reading Date Gross Net Depth to Net ~ I L. ~- Time Time Water Drop ~l~ fl7 ~7 ID Io Y~ ': ~'z ~ o q ~ ~1~ : ~ 7 ~ ~ ~7~ ~/~ PERCOLATION RATE ~_'~ (minutes/tach) PERC HOLE DIAMETER TES1 RUN BETWEEN ~ FTAND ~"' ff/)~-- FT PERFORMED BY: ~ '~ I ~ ~'~ CERTIFY THAT THiS TEST WAS PERFORMED iN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~.~ 72-008 (Rev. 4/85) .- MUNICIPALITY OF ANCHORAGE ,. - DE[ 'TMENT OF HEALTH AND HUMAN SERV IS Environmental Heallh Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720' ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ^dd,es, '-F~ E'T'F- ~.. ...~A':~-/5¢''F'~ ... ~ SEPTIC ABSORPTION WELL ~ TANK FIELD Pin'ne(s) -- PeFmit NO. No. of Bedrooms WELL ..,..~['; -I'5¢'~o~ ~0 1 ~ LINE LEGAL DESCRIPTION ~0, -- I V/& ~_1 ~/i~iE FOUNDATION ~/~lq, ~ ¢~ ~C 1 ~ Oriveway, waterbodJes, etc.) T~NKS - m TY~E OF ~Y~T~ ~'TRENCH ~ BED D W. DRAIN mOTHER Fill added above obg,n~l grade gravel deplh benealh pipe ~ ¢ ~1 ;~ "~ -- , I ~ F~ FT Installer '¢~0 WELLS ~ PRIVATE ~ OTHER (Identify) Scale: / t~ ~ 0 ENGINEER'S SEAL ~ ~/~ ~u~ ~ 7.~/ g~,~: '~'~'~'~' · .... '""'"~' ' 7/7/~ Heallh Depa~menl Approval; Date: " 72 013 {3/85) .... E..~i,~E.R E- E=.IE ~.Er fll :[ '"ii .... DATE ! ,.~IJt=D= 06/:1.0/8~ ~'~-,~l~- ¢~'~-~'F" ~ /~>~ ~t. /~ AF'F:'L ~ CANT ~ PE:TER JARR~TT ~-~ '~ "- ADDRESS: 207 E NORTHE:RN LIGHTS/ ANCHORAGE, Al< 99503 ~ CON'I"ACT F:'HONE:: 2'76-' 1333 £ I_0( ,I ....4 cert. i~'y t. hat: £amiliar, w:i,t.h t. he reqoirement, s £or on-site sewer's and wells as set. ¢ort. h by the Municipality of Anchorage '(MOA) and the State o~' Alaska. I will install the system in accopdance with all MOA code~ and regulations, and in compliance wit. h the design (::pit. ep:Ea c][' this pepmit. I will adhef'e to all MOA and State (:)~' Alaska pequipemerlt, s for' t. he set. back distances ¢r. om any exist:i, ng well, wastewaten disposal system or' publ:i.c sewerage system on this or any adjacent of near'by lot.. Il;:: A L..IF'T c ......... ,':' ' ~c*", =' , ,-~IA] ION .d.~ .[II..,tAL. Lt-:O IN AN AF(EA C[)VERED BY MOA BUILDING []ODES,, THEN (1) AN ELE:C'I"F(IChl.. PERMIT AND tNSPIECTION IdU~] BE OBTAINED; (2) A,~'-BU].LT,:~ WIt_L NOT BE A~,-I-d. VEO WITHOU'T AN ELEC'TRICAL INSPECT'ION REPORT~ AND (...~) 'THE EL.ECTF~:ICAL WORK MUS]" BE DONE BY A 2~:CENSED ELECTRICIAN. .... ;~lJbD BY TELEPHONE: (907) 279-3916 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O.BOX 6-6650 ANCHORAGE, ALASKA 99502-0650 JUNE 6, 1986 Subject: Up-Grade permit for Lot 20, Block 4, Vallie Vue Estate Gentlemen; The existing septic system 1986 and found not to requirements. for this lot meet the was tested on March 18, Municipal operatioinat Transmitted herewith is a soil log and percolation test results, and a site drawing showing the location of the proposed trench. Design calculations shows that a 67.5 feet long trench, 13 feet deep and with 5 feet of rock is needed. To place this trench on the property with a minimum interference with the existing trench a waiver from the suggested of set from the lot line is needed. We propose to install the trench 7.5 feet from the lot line and ask for your approval to do so. Yours Tobben/Spurkland P.E. ~ ,~.~.~..~ \ APPREIX. CREEK ~%'~'.o..~. ~ ~', SETBACK SEPTIC SYSTEN UPGRADE LBT ~0, BLBCK 4 VALLZE VUE ESTATE ~ARRELL ~BRRELL JUNE 3, t986 50 100 GRAPHIC SCALE, 1'= 50' 150 TDBBEN SPURKLAND P.E, 203 WEST 15TH. AVENUE ANCHDRAGE, ALASKA, 99501 SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST PERCOLATION TEST PERFORMED FO R:~ ~' ~t~'f~ LEGAL DESCR,PT,O~: L~"T" ~O. t~ q. 1 2 SLDPE SITE PLAN 5 7 10 11 12 13 14 15 16 17 18 19 2O COMMENTS WASGROUNDWATER ~ S ENCOUNTERED? ~ ~ P E IF YES, AT WHAT Gross Net Depth to Net Reading Date Time Time Water Drop _o.._ -o-.-. PERCOLATION RATE ~ ~ (minutes/inch) PERFORMED BY: 72-008 (6/79} GRE~ ER ANCHORAGE AREA BOR Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: FROM WELL 0/~////)~~¢~! MANUFACTURER ,,~)uC~J NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY'------~- GALLONS. ~) , '~ TOTAL LENG TH/~'_ DISTANCE FROM WELL~*0I"~t~/~'~DATION ,// /' NEAREST LOT LINE OF L NES r¢~ 7/ NUMBER OF LINES--'Y DISTANCE BETWEEN LI"~~ ~ ~ TRE'C' WIDTH ~*~IN. TOTAL EFFECTIVE ABSORPTION AREA 7¢--¢¢ SQ. FT. LENCTH OF EACH LINE /0 ~ I 0 +' 9 7 DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE ~ATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPE_ ~ I;'.~ ¢~.~ d~)¢ ~ CONSTRUCTION. DEPTH BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE __ SEWER LINE__ TANK,__ SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANgES: DIAGRAM OF SYSTEM INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: Form EQ-032 [:,EF'RRTMENT 2516 E. ,UDOR RE:,. RPPLIE:BNT HRRVELLE HRRRISON 2281 C _,T ~ ~ '~ y'- ~}'x,-.:,...,,,z LOCRTION L~ D,K ~ LEGRL L~k~ B4 VRLLI VUE EST ~2 LOT _,I~E ~1~ ......SQURRE FEET T"r'PE OF SOIL FtBSORBTION .=?_TEM IS: TREHL. H MRXIMUM I'IUMBER OF E, EDROuM_, = SOIL EH] IN.~ <SD FT, E,R.'- '~'-- ,- ~- c', ,--'" IS: THE REQIJIRED .=,I~.E OF THE SOIL RBSORPTION _,'¢_,FEM [:.EF"TH= 12 LE~-.~GTH= ¢=--. -.~:-: b~ E~. U-~ ... EL_ [:.EPTU4= ¢=--. THE LENGTH DIMENSIO[--~ IS THE LENGTH (IN FEET;, OF THE TI~EM_.H OR DRFIINFIEL[:,. THE DEPTH OF FI TRENCH. OR F'IT IS THE DISTFllqCE BETWEEN THE SLIR. FFICE OF THE GROUND FIND THE BOTTOM OF THE E,W,E:FIVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRFlVEL DEF'TH T'- -.~ TFIE MINIMLIM DEPTH OF GR. RVEL E:ETWEEN THE OUTFFlLL PIPE FIND THE '- - ~ 6UTTLffl OF THE EXCFI',?FITION ,:lIN FEE]']:'. EITHER Fl CLFlSS I OR II NSF FlPPROVED F'LFtNT MFl¥ E:E INSTFILLED. FI C. uNFINLIuLI_-, MFlIWTENFlNCE H=REEMENT I.=, REQUIRED. IF Fl MRINTENFINC:E FlGREEMENT IS NOT KEPT L. URF..ENF '-¢OU MR'-F BE REQUIRED TO ENLHR_~E THE SOIL B_,OF..PTIuN _,9=,TEM FIND/OR 'T'OU MFl¥ BE SUBJECT TO FRu..,ECJTION. IF R F,E~,'R, SE,~.,I... S'¢STEM IS LI~E[:, THE LENGTH IS 45. 0 FEET. IF ~ 'g:LFISS I~",~5~',S'FEf,1 IS OSED THE LENGTH IS 57. E~ FEET. ]-~4Cff .-" 2 > ][ ~'-.~'~.PEC:T I Oi'-.~S RE:E E4:Ei_%.~I.J I RE[:' BHCKFILLINU OF FlNY _,'r_,TEIt WITHOUT FINRL INSPECTION FIND HPFR_~HI_ THI_, DEPRRTMENT WILL BE =,UBJE_.T TO PROSEC_TION. MINIMUM DISTFlNCE BETWEEN Fl WELL FIND RNb' ON-SITE SEWRGE DISPOSFIL SYSTEM IS 200 FEET FOR R PRIVFITE WELL, OR 200 FEET FOR R PUBLIC WELL, SPECIFICFlTIONS FIND CONSTRUCTION DIRGRFIMS FIRE Fl~FlILFlBLE TO INSURE PROPER INSTFILLRTION. .... LE I 1: FORTH BY THE MUNICIPRLIT'¢ OF RNCHORFIGE. 2: I WILL INSTRLL THE SYSTEM IN FICCORDRNCE WITH THE CODES. -~ I UNDERSTFlND THFlT THE ON-SITE SEWER S~¢STEM MFl¥ REQUIRE ENLBRGEMENT RESI[:,ENCE IS REMODELED TO INCLI~MORE THFlN Z BEDROOMS. 8PPLICBNT H~RVELLE HBRR ISON .... ~EF..I IFC THRT I FlM FFlMILIFlR WITH THE REQUIREMENTS FF~F,' uN _,ITE _,EHER_, RN[:, WELLS -'- SET IF THE Performed For Leoal ~escrintion: This Form Renort$ "Ohm t~st is ~orth m ~ho~sand oBinions" 2204 CleVeland Anchorage, Alaska 99503' Harvelle - Harrison Date ;erf0rmed 9-11-76 Soils Lo~ Percolation Test_ yem ~enth Feet Soil Characteristics ~__ 12" of Topsoil 4 Sandy Silty Gravsls 6-- GM-Mois ~t Sandy Silt, SM-ML Moist 12-- 14--, 16-- 18-- 20-- Gravelly Sandy Silt ML Bottom of Test Hole3 moist Was Ground Water Encountered? No I~ Yes, At what Denth? NO BEDROCK ENCOUNTERED I Readinq Date Gross Time Net Time Depth to H20 Net Dron hours inches inchs $ 9-10"76 ~ hours 29" O I 9-11-76 24 Hour Sattrate Period 9-11-76 0 Pg~" ~ " 3.0 hours 3~ ~,~ ' ~.~ hours %6' 1 h.O hours %7 I Percolation Rate 1"/ 30 ~linute s Prnnosed Installation: Seenaoe Pit Drain Field Deoth of Inlet Depth To Bottom Of Pit Or Trench CAMbiENTS: 2~0 Squa~. Feet of Drainage Area Required Per Bedroom Perc Test performed between minus 29" to 10 ft. Test Performed By Data Certified B~: Date: 9-11-?6 Jim Mack 19 TOP OF FOONOATION WALL ELEVATION, 5/~/.O IT SHALL BE THE REBPONBrBILtTY OF THE BUILDER ELEVATIONB 8A~ED ON ~.~¥'~r~' ~/P'.y[ '~ DATUM OR OWNER TO VERIFY THAT BUILDING LOCATION SHOWN MEETS ALL ~UBDIWSION COVENANTS AND ~EPARED FOR* PLOT PLAN ~s,~ o~,~ ~iiqi~ LOT Z~ , BLOCK ¢ ' Parcel I.D. # Division of Environmental Services ~¢k/4'0 On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-66~/.. 343-4744 r~uo' 0~ ~,~_ ~'/~/0~/ ? CERTIFICATE OF HEALT" AUTHORIT~DC~"/. APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description i-CT Location (site address or directions) ~,O OI 2--0 Lo i,~ E TP-~-~ ~l°-Iv/E. Property owner ~O~-TP- ~ Mailing address Lending agency Mailing address Agent b,~ c~ Address Day phone Unless otherwise requested,' HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: NOTE: Day phone Day phone Individual well Community well Public water 724)25 (Rev. 1/91) Front MOA #21 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. If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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. NameofFirm ~)~-4~ .~,r~"-.[~.'.~P' ~-~- Phone Address ~'~ ~ J~ ~"~ /~c~, ~ ~.~OI EngineeCs signature ~-~~~ Date 7~//~. 7 DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 OH HS does this as a courtesy to purchasers of homes and their lending institutions in orderto 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. Legal Description: ,~/ A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seaF (Y/N) Date of test Static water tevel Well production WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed '~'7//~ Foundation cieanout (Y/N) Date of Pumping I'v'A C. ABSORPTION FIELD DATA Date installed ~? Municipality of Anchorage mUN/c DEPARTMENT OF HEALTH & HUMAN SERVlC~/~z~,'~'o~,~N~_ Environmentalo Services' Division1 · 7 --- 825 L Street, Room 502 Anchorage, Alaska 9950 (90) ~ Z /°N Health Authority Approval Checklist ~//[ ~ ~.~ Parcel I.D.: '~/~ If A, B, or C, attach ADEC letter. ADEc water system number Date completed Cased to Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION FROM WELL LOG g.p.m. g.p.m. Nitrate Other bacteria Collected by: Tank size /~>~-~ Number of Compartments Depression (Y/N) ~ High water alarm (Y/N) Pumper Length ~7.5 ~ ~ Width ¢~' Effective absorption area '~7,-~/~ Date of adequacy test W'/A Fluid depth in absorption field before test (in.); Fluid depth ~ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Soil rating (g.p.d./fF Gravel thickness below pipe Monitoring Tube present (y/N) Results (Pass/Fail) '"-'- System type 'T/c¢..¢~c.~/ ~ ! Total depth ~ t Depression over field (Y/N) ~.~ For ~ '""' Immediately after ~ gal. water added (in.): Absorption rate = ~'- g.p.d. ~ If yes, give date -' bedrooms D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons "Pump on" level at* (-~-~" "Pump off" level at* *Datum '~/,~ ~¢~'~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDINGTANK ON LOTTO: Foundation -~'-~ Property line ¢,¢-. ~ Absorption field ¢,~'7 l / t.///A Water main/service line ~ Surface water/drainage 1/P I Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line I ~ Building foundation ¢~ I Surface water ~ ~0I Curtain drain ~/62 Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots F. ENGINEER'S CERTIFICATION .... ,, '~"':'-, I cart fy that I have determined thru field Inspections and review of Municipal records Jhat the, abqlce.$yaterOs~ are in conformance w~th MOA HAA gu de#nes in effect, on this date Signature Engineers Name ob~ -~ ~l~ / Date of Payment 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number ' (d) :~ MUNICIPALITY OF ANCHORAGE '~,~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~//~/Y//~ ~:~ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name ~~ Telephone: Home ~ Business Applicant Address Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other/~] (explain); Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Famil~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well [] Communit/~ 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 Onsitey 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 ENGINEERING FIRM PROVIDIN..~NSPECTIONS, TESTS, FILE SEARCH, 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 adeq u ate 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 inv(~stigafion 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 inspecti n~ ~ Name of Firm ~.. T...elephone ~' 7 ~ --~ ~ Address / , ~ ~ ~/~ ~ DHEP APPROVAL Approved for 2¢'~/¢'///':) )bedrooms by Approved ,~ Disapproved Terms of Conditional Approval Condition .~ (/¢2 ' ' 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 Well Classification Well Log Present (Y/N) Total Depth Static Water Level MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAl.. PROTECTION u L 'i 4/986 264-4720 Legal Description- ~' Jf A, B, C, D.E.C. Approved (Y/N) Dote Completed Yield Cased to Depth of Grouting 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 Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Pump Set At Sanitary~Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date B. SEPTIC/HOLDING TANK DATA Datelnstalled~Size ~ ¢' No. of Compartments "~ (7~-*~'4~v~'~"'~) Standpipes (Y/N) '~ 1,~f..3 Air-tight Caps (Y/N) y To Water-Supply Well To Property Line To Water Main/Service Line Course Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: Foundation Clea~n2~t (Y/N) Y Date Last Pumped f~r.~.~.~l~. :for t,' Temporary Holding Tank Permit (Y/N) To Building Foundation J~ To Disposal Field ~t ~ To Stream, Pond, Lake, or Major Drainage Comments Page 1. of 2 72-026(11/84) C, ABSORPTION FIELD DATA Date Installed . Width of Field ~;~2~ '! Type of System Design Length of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: TO Water-Supply Well TO Building Foundation Lot / ~'~ TO Water Main/Service Line ~' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line '"~ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Comments D. UFT STAT O. Date Installed Size in Gallons "Pump On" 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 during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify tha. U have checked, verified, or c.~nformed to all ~OA end HAA guidelines in effect on the date of this inspection. Sgned ~~ Date / Company MOA No. Date of Payment A~o~t: ~ G ~¢~' ~*~.4~[~ ]~ t~ Sncne~r'~ S~ Page 2 of 2 ~,~,,',, ,'" ," !~U~JICIPALh r u-, ANCHORAGE MUNICIPALITY OF ANCHORAGE - DEPT. O/ , ' ',i & ~' ';/d~OJ'~'WE,~]AL ?EOfECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 RECEIVED 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. 1, PROPERTY OWNER MAI LING ADDR ESS ~]~ Duna,~i~;~-~+.u, .5OI P~OPERT~RESJDENT (If differen~ }rom above) PHONE PRONE PHONE 2. BUYER MAI LING A DDR ESS 3. LENDING INSTITUTION MAILING ADDRESS PHONE 4. REALTOR/AGENT PHONE MAILING ADbRESS ' " 5. LEGAL DESCRIPTION STREET LOCATION /oq~.G Lone Trs~. 6. TYPE OF RESIDENCE 1~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One ~, Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* COMMUNITY [] PUBLIC UTI LITY 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY * 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.) **if individual/omsite, give installation date 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' . DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR NSPECTOR NSPECTOR ' DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OFBEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FiVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] IND~VI DUAL 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 or [] Holding Tank Size: I(~ O~ If Tank is homemade SOILS RATING give dimensions; TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwE LL TO: Septic/Holding Tank Absorption Area Sewer Line[i Nearest Lot Line Absorption Area to i~earest Lot Line 5. COMMENTS ~,,,~PPROV ED FOR .~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (TF~/ LEGAL DESCRIPTION 72-010 (Rev. 3/78) October 1, 1979 Terri Huffman % ..Dynamic Realty 501 West Northern Lights Boulevard Anchorage, Alaska 99503 Sl~ject: Lot 20 Block 4 valli Vue Estates ~2 Approval for your individual sewer and water facilities can not be granted until the following items have be~n oorapleted~ (1) The septic tank pumped with a receipt s%~mitted to this office. If there are any further questions~ office at 264-4720. Sincerely, please contact this Robert C. Pratt, R.S. Associate Specialist I~cP/ljw 3330 "C' GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality Street, Anchorage, Alaska 99503 274-4561 Date Received February 9, 1977 Time of Inspection 9ate of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Spokane Mortgage Company Mailing Address: 3201 C street, Suite 250 Phone: 277-0543 2. Property Owner: Roger H. Bates/Richard H. Matthew~h0ne: 276-5551 Mailing Address: 3201 C street, Suite 201 3. Legal Description: Lot 20 Block 4 Valli Vue Estates ~4 4. Location: NHN Lone Tree Drive 5. Type of facility to be inspected 6, Well Data: A. Type Community C. Construction Single Family No, of bedrooms 3 B. Depth D, Bacterial Analysis Sewage Disposal System: On-site system ~7~7d~7 A. Installed ~7~ B. Installer · C. Septic Tank: 1. Size~ ~c2. Manufacturer D. Seepage Pit: 1. AbsorptiOn Area ~d~mn, ~ 2. Material E. Disposal Field: Total length of lines ,~ ,~7. Distances: A. Well to: Septic tank , Sewer Lines , Absorption area Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two ~ag~s - Re~/-~'st for Approval of Individual .~/-~er & Water Facilities Legal Des'cription r,ot 20 Block 4 Vall~J- Vue I~states Comments · ApProve cL~-~bx~-~2~ty~ Disapproved , approval~Va/id for one yea from date signed Greater Anchorage Area Borough, Department of Environmental Quality Date~-//-77 DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAOE DEPT. ~)F HEALTH & EN~'IRONMENTAL ~ROTECTION · EB 8 1977 RECEIVED MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY- Sewer and Water Section 825 "L" Street, Fourth Floor, Anchorage, Ak. 99503 279-2511 Ext. 229 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV ~× 2. Property Owner: Roger H. Bates and Richard H. Matthews Mailing Address: 3201 "C"~Suite 201~ Anch. Day Phone 276-5551 3. Name of Buyer: C. William Simms o Mailing Address: 4454 Business Park Blvd. Name of Lending Institution: Spokane Mortgage Co. Mailing Address: 3201 "C" Street, Suite 250 · 5. Name of Realtor or Agent: Area Inc. Realtors Day Phone '276-6811 Mailing Address: Phone ( Joe Ravanell) 277-0543 5375 E, Northern Lights Phone 337-9424 Legal Description: Location: Lot 20~ Block 4, VALLI VUE ESTATES. UNIT #2. NHN Lone Tree Drive Type of Facility to be inspected: Water Supply' Type of Supply: sinsle f~mily I,,~ v dua Community Well unknown If Individual, number of dwellings presently served Public Utility No. Bdrms. 3 ENVIRONMENTAL .PROTECTION If Individual, depth of well unknown Sewage Disposal System Type of System: If Individual, date of installationunkn°wn FEB 9 197 - E0-O37 (1/74)