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HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 5 LT 5Onsite File m ft 1 k f: 77-71L, 7775, Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Re ON-SITE WASTEWATER INSPECTION REPORT �. OSP181212 20 Permit Number: PID Number: 015.-123=52_. '� Dwelling: Single Family (SF) ❑ w'ith ADCJ4❑ Dupl�iCE� ❑ TwaSiile�Famrfy Prplect ❑New D lJp9 rade Name Robert and Donna Lee ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 6601 Crooked Tree Dr. ❑ Other' Phone 907-240-0380 Number of Bedrooms 4 Soil Rating' Total depth fr original grade GPDISF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Subdivision Block Lot Valli Vue Estates #2 5 5 Ft. Fill added above origi nal gr Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic AbsorptionHolding Lift Station ;Sewer Total a rption area Number of trenches Dist. between trenches From Tank Field Tank j Line Ftz Ft. Well 100+ TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1250 Gal. Surface Water 100+ Material Number of compartments Lot Line 5+ NA Steel 2 Foundation 10+ j LIFT STATION Manufacturer Capacity Remarks BioMicrobics RetrOFAST installed Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 'Tank to drainfield 3034 ARM Services Drainfield CO/MT3034 Inspector Crewdson Engineering LLC BENCH MARK (Assumed elevation) 100 ft Inspe tion 15` 8-23-2018 2�� 8-27-2018 Location and description 3m 41h bottom of siding at "A-BM" on plan view ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp AL Conditional l Approval: Date ,f,�� �Q'�. --- %i.4 ........ Septic System James A: Crewdson ., ,4C,_0 Approved f�� Date a8 1 1311527 � 1�1` ,p ' .-ate.1•Cl Note: this approval does not include well permit requirements.its\\ROF\E'S`O_IZ- I.AU (Rev 05/02/18) yF / PLAN SCALE: I"=30' ti / 0 Lot 3 / / a / Lot 5 / / C1 / RetroFAST / BLOWER / 1 / MH / C2 DC / NIT (E) CRIB LEGEND (E) existing BM - bench mark BR - bedroom C# - cleanout DC - double cleanout EG - existing ground ELEV - elevation FG - finish grade INV - invert Lot 4 Lot 6 air✓ �, ��ti 4 BR SFH G A -BM a� s• ti F B Q S1 2 1250 GALLON STEEL SEPTIC TANK W/RetroFAST0.375 O��O BENCH MARK O BOTTOM OF SIDING AT "A ASSUMED ELEV 100' ELEV o`er EG 99.1' FG 99.4' S1 S2 MH RFB DC MH - manhole MT - monitor tube OH - overhang RFB - RetroFAST blower S# - septic tank cleanout SFH - single family home TOT - top of tank SWING TIES (feet) A B FC 16.8 9.2 S1 18.7 23 S2 24.4 27.7 MH 25.9 29.2 DC 33.2 36.6 C1 16.7 38.8 C2 52.8 63.6 MT 53.5 1 63.9 Valli Vue Estates #2, Block 5, Lot 5 Septic Tank Upgrade Record Drawing Plan & Profile Views SEPTIC TANK STEEL, 1250 GALLON W/RetroFAST 0.375 ELEV: TOT 94.88' INLET INV 94.32' OUTLET INV 94.17' PROFILE Civil & Environmental Engineering Prepared for: Robert Lee Date: 3-22-19 Box 671389 ChugiakAK 99567 . celic.l@outlook.com Permit: OSP181212 Page: 1 of 1 Cell/Text:907-280-9493 . Fax:907-688-2295 ALL INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING. LLC AND SHALL NOT BE USED FOR ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING, LLC NOT TO SCALE CO -V I ;W1 . TH :` James A. Crewdson . C1 1527 �¢ �c�`�rF,�•�-ate l y. •�c����. �A,®�p�OFES510NP ..�' ALLC #112279 Chain link fence (typl_ " Wood fence (typ) / 00, c 09 Lot 3 / a3 ;. ZJ 0� j o � �y� Lot 5 - // h f a�+ 3 / e° 0 260 / Septic tank",- ank ° / / g / Septic vent (typy\ ti % 99 00 Lot 4 H SCALE: V= 30' r D� gyp` EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLATARE NOT SHOWN HEREON FB 18-6, pg 57 UNLESS OTHERWISE NOTED. FB 74-10, pg 38 BE wall 6650 Lot 6 ,7 .00 00 4f ®► 0 � Ab A4 pz 49th W* *00 Elizobeth L. Walatka : F0, $� ATF • 8036 - LS • •�e� P d ofess�ont+L V, o /AS-BUILT ECERTIFIED 9-19 18 ' � •' v NO CORER ST THIS DATE I hereby certify that I have performed a Mortgagee's inspection IDI the foiiowing described PTope,1Y: LQT 5 5=K 5 VALLI VUE ESTATES UNIT No 2 Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements an said property except as indicated hereon. Dated at Anchorage, Alaska this 16th day of October 1974. FRED WALATKA & ASSOCIATES, L.L.C. 907-248-1666 Engineers and Surveyors MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,-. http://www.muni.org/onsite Dcpartmc nt 4:C;_;;Gtt On-Site Wastewater Disposal System Permit Permit Number: OSP181212 Effective Date: 7/23/2018 Work Type: SepticTank Upgrade Expiration Date: 7/23/2019 Tax Code Number: 01512352000 Site Legal Address: VALLI VUE ESTATES#2 BLK 5 LT 5 G:2539 Site Mailing Address: 6601 CROOKED TREE DR, Anchorage Owner: LEE ROBERT A & DONNA R Lot Size in Sq Ft: 20488 Design Engineer: CREWDSON ENGINEERING, LLC Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: NI Date: _C)? / ‘/C Issued By: ��''R 1 � , Date: ®I' MUNICIPALITY OF ANCHORAGE 7)Development Services Department \ Phone: 907-343-7904 On-Site Water & Wastewater Section - Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-123-52 Property owner(s) Robert & Donna Lee Day phone Mailing address PO Box 111338 Site address 6601 Crooked Tree Dr. Legal description (Sub'd., Block & Lot) Valli Vue Estates #2, Block 5, Lot 5 Legal description (Township, Range & Section) Lot Size 20,488 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field I Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank X Upgrade n Duplex (D) Holding Tank Renewal n Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that t•e above information is correct. I further certify that this is in accordance with applicable :unicipal Codes. -(7 LI (Si 2 na re of property owner or authorized agent) Permit/Rush Fees: 2-15 Waiver Fees: Date of Payment: 7-2-0-18 Date of Payment: Receipt Number: MSS 16) Receipt Number: Permit No. 05f(.g 12.12_ Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Crewdson Engineering0, C , :, e,.,, *General Contactor James"Jay" Crewdson, P.E. V' F Email: CELLC.1@outlook.com 44 ties. Cell/Text: (907)280-9493 Fax: (907)688-2295 CMI&Environmental Engineering July 17,2018 Plan Reviewer On-site Water&Wastewater Program Municipality of Anchorage 4700 Elmore Road Anchorage, AK 99519-6650 Reference: Valli Vue Estates#2, Block 5, Lot 5 Septic Tank Upgrade Crewdson Engineering LLC is requesting a septic tank upgrade permit for the four bedroom home. The scope of work for the project is: 1. Decommission the existing septic tank in accordance with the code. 2. Install a new Infiltrator IM-1530 two chamber septic tank and post tank double cleanouts. 3. Install BioMicrobics RetroFAST septic treatment system. 4. Repair or replace the damaged sump located at the southwest end of the existing drainfield. There are no probable adverse impacts to adjacent properties if installed in accordance with the design. Please feel free to contact me if you have any questions. / Thanks, , / ......%.,..N.NAN‘t J "Jay" Crewdson, P.E. /"*.** �, '1911 +,'•� . Crewdson, •j ���o' C11527 ,•' j/ \‘\\FE'S`pN= ALLC { I21 PO Box 671389 • 18368 Amonson Road • Chugiak,Alaska 99567 vRLLZ Vu E ESTATES 4- 2 bLl< 5 LT 5 0 'E r,RAM 48how kJ ° APROX.SCALE: 1"=20' 3r t t.tout>(�. o� eiy.water Waive..% .) mimosin111,14i m I ,,i 1. Decommission existing septic 1 tank in :cord:once with ,�,,,,,111111e. uIaV4r1uIiUNFAuuI 2 InnfistItarlaltnoerwIM- 111111111,151111111111111wwill11111101 1530 two chamber septic 111111 lrillNUJIIIIIIIIIIIIMnmmpr tank double M _I fAmpoom 3. Install uts. ansuin .ilibritrifemzei, air BioMi AST septic BioMicrobics arsunsa treatm * _ systement 51E� 0 NPR 4. Repair or replace lir the damaged P�mr *, �A� sump located at VIIII=I4115E307"!tahhigi'l-11111111111111111111 '! the southwest end of the � existing awiimarinw w� � a■ ' drainfield. 111111P11111111202111kEtilM iiilaiiiiiiilifilltibmill11111111E111 111111111111111111164 11111111111111111111111 lifillirill INIIPE "1EW 11112:2111P1 ' . 01111111! NNW"! 1111111132111 �.�_ ">� 'IMI . ...._. /I,•Imes A Crew,son, ' / t . 1‘00FE`SO `L- MUNICIPALITY OF ANCHORAGE ' DEPARTMENT OF HEALTH AND HUMAN SERVICES Flattop Techn]ca! Services Environmental Health Division '14530 Echo Street 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720~;dc~orc[ge, Al~sk~ 995~6 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~ .... DISTANCES ~/~- / Address~( ~ Tre~ Dr;~ ~c~ ~¢~1~ ~~ SEPTICTANK ABSORPT[ONFiELD WELL Phone{s)~¢ --~ Per mlt~oNo I~ NO. of Bed~ ...... WELL L~*~ m~.,.~,o~ LOT LINE r ~ F0~N~ATION I Township, Range, Section ~ E ( ~ ¢ ¢ /~ ~/ ¢ ~ ~/ ~' ~* drlveway,AS-BUILTwaterDIA6bodies.RAMetc{Sh°w) location of w¢l, septic system, property lines, Ioundahon, TANKS ~ SEPTIC ~ HOLDING M~nulactufer Capacity m gallons , / ~TRENCH ~ BED ~ W. DRAIN ~ OTHER Depth to p~pe bottom from Total depth from original grade Total absorpt,on area 18,mhD. betwee, hnes SOF, FT / C~tFI~ ~c~ WELLS~/~/~ ~ PRIVATE ~ OTHER fldenlifv) co~el,~~ o/~ ~*~ erm~e~ ~.~ ~,~m J/Y/aY ~:'4ov~ "L~ 72 013 (3/85) Depar'Lmen'L of' Healt:.h & Human Set'vices 825 L Stree'L, Anchc)rage, A:l. aska 99501 :;:.;43.....4'720 P E R f"l ]: "1" Owner Name: GEF~ALD & JANICE SMITH ,Owner. Address: 66():1. CF~OOI<ED "f'REE DI:?.IVE AIxlC)HC~RAGE~. AK 995 16 Day F:'h clr"~e: 269-5638 I::'a r ¢: e ]. ][ d: 015- :[ ;i'.3-'5;=]: I.o'L Legal: ,'.3ubdivi~;:i. on: VALLI VUE ESTATES t~2 Lot: 5 S~.%:t,:Lon~ 14 Township: ].~N Range: 3W Lot Size) 2'.0.q-8l~1 (SCl, f'L,, or acpc)s) Bedr'oc)ms: Tl'~i.s Perm~.'L: 5 'Fora]. Capacil. y~ 5 ]81ock: 5 SIEF"T:i.C "FANK~ I"hi.r'~imum tota:!, sep'Lic: 't'.ank c:apac:Lty= 1,5C~() 1'.arik must have at ]r.~as'[:. ,'.?, coml:)aPtm,~.:,rl'kf,~. D~pth to top of ~eptic f'(ae'(', requ:i.r*(?.)s :J.r~su].a'L:L(::)n over tar'lk (s) . Eac:h septic tarik(s) < 4..() INF:[)RM D,H..H,,S,, PRIOR TO );NSPIEC]"]:ON BY ENGINIEIER~. ]:Fr AI::TER OFF:!:CE liOtJF~S;, CC)Iq'TACT 34;~;.-..468]. AND !,..lEAVE A MIZSSAGE.. CONST'RUCT F'ER ENGINEERS ATTACHED APPROVIED DESIGN,, 'fl-{IS F:'ERMIT EXF'IRES :1.;?./31/89 AND VALID F:'OR A SZIqGLE F:'AMILY HOHE. SOII...S L.OG/WATER M[]NITOR MUST BE SLJBMITTED WITH AS-.-BLJ:[L.T, :[ CI!:RI'Ii::rY THAT: :[,. :i: afr. fam:i~lial', w:Eth 'Lhe i".(.~)qLt:i, reml¢:~.!r]'L,s Fop on.-..sil:.e sew(ars al'id we].Js as set for'U] by the I%~n:Lcipality of Anchorage (MI]A) and the State of Alaska. :7.,, :[ ~,i:i.] ]. :i. nsta].l the system in ac;cordanc:e with a].l MOA codes and regH].a'L:EcH'~s, and J.n 'comp].is.n(::e t*~ith the cle2sJ, gfl cpJ. tepia :.:S,, ][ ~.~J.]l][ adhE,)p(,~.) tel all MOA al'id Sl'.ate oF Alaska requir'em(:)nts for the ~et. back dis'Lances from any existing well~ wastewateP disposal, system or publ%c s~a)~wc:,rag~,,) s'ysi'.em on 'Lhis cJP ar't}/ ad.ja(::er'lt op Fi(~eal"by IE!'[:., ][ Lu'ii:lepstaFld tha'L '[.his pel"m:['[:. J.~:5 valid for' a max:i, mum of' aiscl understand 'Lhat'. 'Lhc,e capaci'Ly c:H' the 't:.otal system :i.s 5 bedrcx:)ms and any en].~u"gemer'd:, will require an a(:ldit, iona! permit~ ~:h,~ner > (.,1~.,1..[ ....... IAI I.t ...,L ,.~l II tll / / I~07- 6- ~lattop TechnlcaI Services 14530 Echo Street Anchorage, Alaska 99516 /..07 ¥ ! S l T~ p~41V NOT6: TtH.~ u NoT APF~OKt UtAT~. i~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl.. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 254-4720 ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELl- INSPECTION REPORT ~,~.~.~,.o: IW~'' I ~o~,,io.~ro. Dwelling P E R B I~'S~ ~ ~'ST~"~*°: ~°"¢~muni,[~ 14'1~' ~n' ~:~¢~ I L~n,~h Of each I'~ ' Total length of~ Trench wi~ '.~ho~ NO. Ot lines Distanc~ between ~-- Topoftiletofinishgrade ~ /Z Materialbeneathtile 7~ inches Totaleffectiveabsorptionarea OTHEB Pvc, 0~ ~E~A~KS I0 ~ ~r~ ~ 72-013 (Rev. 3/78) PERMI'I" NCL DEF'RF;:'TMENT HEFiLTH RNL':, EN',.,*IRONMENTF!L X:OTECTION E!:;2L-', -"L"' :~TREE:T., FINCHC~RRGE., RI-:::. ;264-4720 ,:: 8206]:4 ) FIPF'L I L7 FiN T L 0 C ['-:I T Z 0 N L. EGFlL P.'E R Fd... [:, P .....!f~ ~?],.~ ',,,'FtLLI ',.,'liE. _ E.=,F? I ~ F [.. OP ....... '~q'rl HE,_,df4.1: I' .[I..[i',! , ~ _,.._.,, TRENC:H MFlXIMUM i",!Uf'IE:ER OF EE£:,tq'OOhlL:; = 4- '_--O'I.~L RRTING ,::LqL::! ! ],.,..,[ ..... :LOE~ THE F~'F"::LIF.':ED SZ;ZE OF 'THE Eh]IL REC-;ORP-FION ._,,_,TE I .. THE LENGTH D!MEN'E. ION IE:: THE LENGTH (iN FEET) OF' THE TRENCH OR [:,RRiNFIELD. THE [:,EPTH OF Fl TRENCH OR PIT IS THE [:,i5:TFINCE E[ETi4EEN THE 5;URFRCE OF THE GROi. JN[:, RND THE E:O"FTOM OF THE E;:.:',CR',/RTtON (tN FEET). THE:RE IE; NO SET tq!E:,Tl.-I FOR TRENCHES. THE GRR',/EL [:,EF'TFI IS THE MIN:[MUM DEPTH OF GRFIVEZL 8ETI.4EEN "FHE OUTFRLL PIPE BND TFlE BOTTOM OF THE E::.::CFI'¢WTtON ,::IN FEE'1'). ~-!h_-, "'- "- ' '" ._ FriZz .......... PERHZ'T FIPF'LIE:FIN] ...... FHE RE..:,F_NcJ. E, ILI¥~ TPI ZNFORf'i '' '"" [:,EPRR"H'"!EN-F f",IIRTi'.JR .u,!::,]!',L;.?Ff Z E f,. IhL':,FE... '[ _,C., OF RN"r' 14ELLE; FiI':,.TFIF:EN'r TO TH'i':; PR--PERT"/ RND THE F,iUMBER O? RESIDENCE'.2, THFlT TFlE k!ELL HILL ~;ER',,,'E. 8F!CKF'iLLIN(:~ if RF,IL¢ ,.-.~.¢c-r~:- klI]"HOLIT FINI::IL. II"i'~;PEf'-:TZON P.i'tr'* h.-Ff ....... LL :, THT':; [:,EPFIR]"i','!ENT I.,i i L.L E~E E; JBJEC:T TO F'ROSECUT 10.N. MINIMLIf,i E:,I:~,TFINC:E BETI4EEN FI NELL..FIN[;, R,N'?' ON-SITE SE!.4FIGE DISPO.SRL SYSTEM IS 100 FEET FOR Fl F'RI',/FI"FE 1.4EL.L OR ::LSE~ TO 20G FEE]" FROId fa PUBLIC I-,.!EL..L DEPENDING UPON THE T"¢PE OF PUBLIC WELL. MINIMUM D!STF!NE:E PROM R PRZ',/FfTE 1.4ELL 'TO R PRIVF. ITE SEI4ER LINE IS 2.5 FEE]" FiND -FO R COMi'ILINIT'?' E;EI.qER LINE l:5 75 FEET. OTHER RE:.C!I.JiREi'iENT:~ !"'IF!'T' RF'PL'¢. :E;PECIP!CRTIONS FINE) CONE;TRUCTION DZ6!ORRMS RP.E FI',,,'RILFIBLE TO Zi',i'_-T.,URE F'ROPER IN:E;TFILLFITION. i 7 E',B.':T Z F"T' THFlT F'ORTFI F" . ......... '2: I F]IL..L iN:E;TRLL. THE E;?E;TF]'"I IN 8Z:CORE:,FiI',!CE HZTH THE icE,Fic ZE:: ] IJN£:,E:,?.E:T,CFF,E:, THRT THE ON-'-GITE :SEklER E,"r'STEPi Mfl'¢ RE:C!JZRE EblL,:Lf;..GEf!EI,FF if 'THE '_5: I GNED : ................................................. .,/ GRE ER ANCHORAGE AREA BOP UGH Department ;~3E;~irs~rnen~ntal Quality Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURE~'~-~ MATERIAL ~--~ NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH __.LIQUID CAPACITY. //~ GALLONS. SEEPAGE PIT: NUMBER OF PItS / DIAMETER OR WIDTH LENGTH DEPTH // / LINING MATERIAL' ~- lb SIZE: DIAMETER__DEPTH ~ ! DISTANCE FROM: WELL BUILDING FOUNDATION ~ /f NEAREST LOT LINE 2-~ I'~- TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WE-,: TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES APPROVED / DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK , SYSTEM REMARKS DISTANCES: INSTALLED BY: ~ PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM APPROVED ~ ~'~ G.A.A.B. - / G~R ANCHOPf~GE AREA BOROUGH Depart, ,it of Environmental Quality 3330 "C" Street Anchorage, Alaska 99503 ;epth eet torm reports: Soils log ./ , Percolation test ground water encountered? If yes, at what depth? ' ' ' ~eadin9 Date -colation r~ te ,posed installation: ,th of Inlet i:[!itTS: Gross Time m~nute Seepage Pit ' Net Time Depth to H20 .Drain Field ' Depth to bottom of pit or trench Net Drop f'ormed By: Certified ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 563-6775 DATE: Auqust 31, 1989 PWSID: 210605 Requested By: Flattop Technical Services According to the records on file in this office, the Valli Vue Water System is in compliance with State of Alaska Drinking Water Regulations. the Sincerely, Cindy Thomas Environmental Engineer ' ~-~UNICIPALITY OF ANCHORAGE 'DEPARTMEN] J~F HEALTH AND. ENVIRONMENTA~L ,~ROTECTION 825 L Street, Anchorage. Alaska~ 99501 264-4720 Date R~ceived: October 27, 1977 #1: Time #2: Time Date !~-~-~Q ~. Date Insp ~ ~ Insp Time Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Lomas and Nettleton Company Mailing Address: 4449 Busines~ Park Boulevard Phone: 274-7661 2. Property Owner: Employees Transfer Company Mailing Address: Phone: Legal Description: Lot 5 Block.5 Valli Vue Estates Subdivision 6601 Crooked Tree Drive Single Family Residence: ~ Multiple'Family Residence: ( Number of Bedrooms: / Number of Bedrooms: Three 5. Individual well Depth of Well 6. Sewage Disposal System: On-site System Permit # ~/~ Installed ~/7 ~ Well System: Permit ~ Construction Septic Tank Size Absorption Area ( ) Community/Public System ~) Well Log on File Bacterial Analysis ~ Public Utility ( ) Installer ~~ * Manufacturer ~~, Soils Rate ~/~ ~ Material ~ Distances: Well to Septic Tank ~_ to Absorption Area~_~__~ to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line e 3 MUNIcIPALITy OF ANCHOP, AG~ DEPT. OF HEALTH '~'~IUN I C ! PAL ! TY oF ANCHORAGE i~-~ Depar~:ment of Health and Environmental Protection 825 L Street, Anchorage, Alaska 99501 . 279-2511, ex~. 224, 225 Property Owner: Mailing Address: Employees Transfer Company Unknown Phone Name of Buyer: Mailing Address: Teddy R. Story 2204 Cleveland St,, Anchorage Phone: 277~0231 The Lomas and Nettleton Company Lending Institution: Mailing Address: 4449 Business Park Blvd, Phone: 274-76'61 5° Realtor/Agent: Kenneth Boggs Mailing Address: Colonial Realty 1709 Bragaw Phone :Bus, 276-2766 Hm. 69C-9 / b~/ Legal Description: Lot 5 Block 5 Valli View s/d c,- 6601 Crooked Tree Dr. otreet Location: ' Single Family Residence: Multiple Family Residence: (x) Number of Bedrooms: ( ) Number of Bedrooms: 3 o Water Supply: * Individual Well ( ) If Individual Well, we].l depth If Co~mnunity System, name of system Public/Community System (x Sewage Disposal System: On-site System (x) Public System If On-site Si'stem, date of installation: Unknown ( ) *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 P%ge ~w,o ~" Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 5 Block 5 Valli Vue Estates Subdivision Comments: Af fadavit Attached Approved :~/~~ Disapproved: Letter Attached: ) Date: Date: Department Worksheet: ~ovember 1, 1977 Kenneth Boggs Colonial Realty 1709 Bragaw Anchorage, Alaska 99504 Lot 5 Block 5 Valli Vue Estates Subdivision The On-site sewer system on the subject property must have an adequacy test conducted. Enclosed is an instruetion sheet. The responsibility of the test dates, correlati°nwith the pub%per and this department is yours. If there are any further questions, please contact ~is office at 264-4720. Sincerely, Los N. Buchho~zr Sanitarian cc: Lomas and Nettleton Company 4449 Business Park Boulevard 99503 ....... :, -'r-,.:5-T-r ...... certify that Anchorage Recording Precinct, Alaska. and that the improvements situated thereon are within the propert'y lines and do not overlap or encroach on the property acent thereto, that no improvements on prop- g adjacent thereto encroac}~ on the premises m and that there are no roadways, transmission other visible easements on said property except as indicaled hereon. ~' Dated at Anchorage, Alaska this '/~_~ day of ~'f-~)~'~:) , 19 FRED WALATNA & ASSOCIATES Engineers and Surveyors. 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 ~&(~C~ 264-4744 Application Date ..~ 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 ~'ec'a(~4- ,~,,~)~h Telephone:Home ~/~¥7 Business Mailing Address ~'~'¢:71 ~foo[~ ~Cdd ~d., ~c/~. ~ ~1~ (c) Lending Institution ~ Mailing Address ~ ~. (d) Real Estate Company and Agent Address ~( ~, ~¢~¢~cr~ ~¢'~ Telephone ~ 77 ~ (e) Mail the HAA to the followino address: or: Check here ~, if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family [] Number of Bedrooms ,/ WATER SUPPLY Individual Well [] Community [] Public [] Note: If com m unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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 fRev 8/861 Front ')JJOM S,Je@u!6ue j~uojsse~oJd Gq), u! 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X~ ~o4 pub selU e6eJoqouv jo Xl!ledfo!unR eql pau!ejqo uo]lemJOCU~ eql uo peseq leql ~JpeA Jaqpnj I 'uleJeq peleoipu~ eJnlom~s ~o adXl pub smooJpaq jo Jeq~nu eql Joj elenbepe pub leUOilOun~ 'eJes s! ~als~s lesods!p Je~eMelSeM Jo/puB Xlddns Ja~eM el!s-uo eql leql SMOqS leAmddv ~lpoqlnv qlleaH Bfq1 Io uo!leS!lseAu! ~ ~eql XJpeA I 'MOlaq UMOq9 e~ep uo!lep!leA eql ~o se pub oleJeq pex!j~e lees X~ ~q Pe!/!peo sv NOILV~BOJNI aN~ viva 'HO~S ~ql~ 'S~S~ 'SNOI~O3dSNI 9NIOIAOBd ~Ml~ .g A. WELL D~C'¥A'~'~' Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit(Y/N) MUNICIPALITY Health Autl CHECKLI.~ Date Complete( Depth of OF ANCHORAGE (MOA) .(~'~' ~orily Approval (HAA) T - FEBRUARY 1984 343-4744 Legal Description: /..~,{- ~ /~t'c~C A' ~ Grouting 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) 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 DE~.~ [.~/-~¢r' Of B. SEPTIC/HOLDING TANK DATA Date Installed ~/'-¢'/'~'9 size 12-,.¢~v9'~( Nc Standpipes (Y/N) ["' Air-tight Caps Depression over Tank (Y/N) Pumping/Maintenance Contact an File (Y/N) Holding Tank High-Water Alarm (y/N) SEPARATION DISTANCES FROM SEPTIC/HOL To Water-Supply Well ~ TOo' To Property [.ine To Water Main/Service line ~ ~ ' To Stream, Pond, Lake or Major Drainage Cours ; On Adjoining Lots ; On Adjoining Lots To Nearest Public SeWer Cleanout/Manhole ; Date of Compartments '~ 'Y/N) )" Foundation Cleanout (Y/N) Date Last Pumped ~, ~t. ~r~..o) h/,/~, ; for N.,~. Temporary Holding Tank Permit (Y/N) DING TANK: To Building Foundation t ~ ~ To Disposal Field i5' ~ ~ ~00' Comments 72-026 (Rev. 7/88) Front 'age 1 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 ~, 'Eoo ' To Building Foundation /8 Lot 8¢' ¢-0 ~f¢.-~ To Water Main/Service Line ~' To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments 63' /~¢(¢-/r, Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~', Stat'ndpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~" ,7~' ' To Cutback (if present) ~ fO0 ' 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 gu...L~C~i,f~e,~e, ffect on the date of this inspection. 4.~'.'~ OF..~ ~1~,,. Signed ~~ ¢ ~ ~ ~ ...... "~ Company Date ~¢f~ ~ MOA No, Receipt No. Date of Payment ~-- ~" ~ Waiver Fee: $ Amount: $ / ~' ~ Date of Payment ~2~026 (Rev. 7/88) Back Page 2 of 2