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Home My WebLink AboutWYNTER PARK #1 BLK 1 LT 13 Municipality of Ancilorage Page _ DEPARTMENT OF HFALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: "~ RID Number: _~.~\- ~_{c~ ~m~, ~, ~, ~, Wastewater System: DNew U Upgrade *~ ~ ~ ~. ~¢~ ABSORPTION FIELD Total Depth fr rinal grade:/ Soil Rating: LEGAL DESCRIPTION ~J ~ ~.~S~."h ~,5 ~Lot'~ ~ ~BIock: I ~/~~S bdivision: Dep,h to pipe bott~m original~ ~, ~qr~d~Ft. Grave[ depth b~ipe ~ Eh Township: Range: Section: Fill added above original grade: Gravel length: Number ~ines: lD]stanc~ t eon Hnes' WELL: ~ New ~ Upgrade ar~w,~u~ ~ FL [ .- ~' Fi. Olas)ificagon(Private, A,~O):~L~ ~ TotalDepth: Fi, CasedTo: FL Totalabsorptionarea:~)~ SQ. FL Pipe~ Driller, s[ t ~~ Date Drilled: SlalicWater Level:Ft. Instal[er: U~ D~a led:: ~- Yield:GPM ~,. [o~,,,, H.,g",A~o,~Gro..~:F,. TANK SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. To Sep[~c A~sorption Lift Holding Public/Private Manufacturer: Capacity in gallons: ~ro~ T~nk Field Station Tank Sewer Lines ~ Well ~ ~,~ / / ~,~ Material: ~ NumberofCompar~:: Surface Water ~1~ ~ / / / LIFT STA'rlON Lot I ~ Size in gallons~~ Line ~ ~ ~1~ / / Electrical DraiR ~ / ~ ~ Pump Make & Model Inspections performed by: Rem.rk~ ~~ I~ ~>~ ~ BENCH MARK . ~.. E~GINEE~'~S~6L S & S ENGINEERING ~ /~ ~ 1' H Inspections performed by'. ~ 7034 ,a,le Rive,' c~p Road Ne~s: 1 st ~ ' ~' ~;~'' '~' ~'''' '~~~ Department of Heel H e[vices approval~ ~?~?.. Reviewed and approv Date: 72-013 (1/91) MOA 25 ASBUILT-N0 C0RNEES SET THIS DATE, I HEEEI~y CEETIFY .THAT I HAV£ SUEVEYED THE FOLLOWING DESCRIBED PROPEETY~ Block 1~ W~ter P~'k Subdivision, No, 1 , ~D ~AT NO ~HMENT$ EXIST ~CE~ INDICA~ IT IS THE RES~$1BILI~ OF THE ~ ~ D~EMINE THE ~ISTEN~ OF ANY EA~ENTS~ ~VENANTS~ OR RESTRI~ION~ ~1~ ~ NOT ~E~ ~ THE RE:~ /ISl~ P~T. U~ NO ClRCUM~TANCES~ ~Y DATA H~ ~ US~ F~ C~$~U~ION ~ ~N~ LIN~% OR ~R E~LISH/NG' ~ND- AEY LINES. [ '~ 1" = 30' ' 1 3/15191 N~1361 %-33 December 29, 1978 $:780597 Franklin Reece 4110 De Barr RoaC[ Space tI30D Anchorage, Alaska 99504 Sttbject: Lot 13 .B~oc]~ 1 Wynter Park Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calen~{ar year basis~ as stated on the pe~nit, by authority of Municipal ordinance. ~f you have drilled the well, a well log should be sent to this department 'to document the installation date o ~f there are 0]%y further questions, please contact ~:h.%~, office at 264-~:720o Sinoerely, Les No Buchholz, RoSe Senior Environmental Specialist enc~ copy of permit /, . ~1 PERMIT NO. RPF'I-. I CRNT L. OE:RT I ON L,EGRL FRRI",IKL .'( 1"4 REECE PETERS CRK 1..:1.]~: IF,:1. NYNTER PRRK 4:'L:t~'3 DEE:FIRR SI'"' LO]' SIZE 25867 ];]:7 ]:EISKq SQURRE FEET I"YPE OF SOIl.. RE:SORBTION SYSTEM IS: TRENCH IdRXIMUH NUMBER OF 8EDROOHS = 2-; SEII[.. RRTING (SQ FT/E:R).= ]:00 TFtE RE6~UIF;:E[:' '" ;' -: ,: - :*c" ', ' - ¢:, ,,:" -.~ . aJ,,~.E I..1[ rFl~_,CmIL IflE.,.r.,(.IF,,PIII.,IN ..,,..,JEll I .... o f2c_f" · ,, . ~ .,. ,.., ~J THE LENGTH [:,~MENS~ON ~S THE LENGTH (IN FEET) OF TFIE TRENCH OR I'.:,RFIINFZEI..[:,. THE [:,EPTH OF' R TRENCH OR F'~T ZS THE D~STRNCE: E:ETNEEN THE SURFRC:E OF THE GF'.OUND RN[)THE BOTTOM OF THE EXCRVRT~CmN (IN FEET). THERE ZS NO SET N~D'FH FOR TRENCHE. S. THE GRFIVEL. DEPTH I~S THE I'IZNZI"IUf'I DEPTFI OF' GRRVEI... BETNEEN THE OUTF'RLL PIPE RND THE BOTTOM OF THE EXCRVRTZON (IN FEET). PERM I T FIPPL I CFINT FIRS THE RESPON51IBI L ITY TO INFORM ]'FtlS DEPFIRTMENT DUR);NG THE INSTRIJ...RTIOI"I INSPECTIONS OF'" FINY P.IELLS RDJFtC:ISNT TO TFIIS PROPERTY RNI} THE NU['IBER OF' RESI[:,ENCES THR'r THE klELI.. 14ILL SERVE. BRCKFIL. LING OF FINY SYSTEM kIITHOUT FINFIL INSF'ECT!OI,,I RNB, RPPRCe[Rt. 8Y TFIZS DEPRRTf,IENT 14ILL. BE SUBJECT TO F'ROSECUTION. f,lINIf"lt..IM DISTFINCE BETNEEN R NELL FIN[:, RNY ON-SITE SE:NFll.':~E I)IS.;F'CISRL. S"r'STEH IS FEET FOR FI PRIVRTE 1.4ELL..~ OR TO 20EI EEET FROM R PUBLIC PlELI_ DEPEN[:'ING LIPON THE TYPE OF F:'I...IE:L. IC NEI..! .... O'THEF. I RE(;~UIREMEN'f'S hlRY RF'PLY. SPECIEICRTIONS RND CONSTRUC]'ION DIRGRRb'IS FIRE F:I',/RILRBLE TO INSURE PROPER INSTFII_.LFITION. I C:ERTIFY THRT i: I RM FI~M.'(LIRR WITH ]"File REQUIREMENTS F'OR ON-SITE SENERS RN[) klEI.[..S Fr.S SIET FORTH 8Y THE MUNICIPRLI]'Y OF RNCHORRGE. 2: I 14ILl.. INS'rRLL. THE SYSTEM ~[',1 RCCOR[:,RNCE I,.IITH THE CODES. S~: I LINDERSTRND 'rHRT THE ON-SITE SEI.4ER SYSTEM MRY I~'.E6'.IL.IIRIE ENLRRGEHENT IF RESI[:,ENCE IS REMODEl. ED TO INCLUDE HORE Tt4AN ]: E:EDROOMS. "-' '-' "".. ' ........................... A~L.: I C:IEIN~ FRB~. 0 Er E GEC 694-2774 Soils It Foundations · 2CFINICAL Er DEVEL_.?MENT Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 CO. Ear/Ellis SOIL LOG. ~88-228o Land Development Perfomed for: Name: / ,-:,,/~,//<,. /<¥/' £ ~'.x: , Tel. No. ~ _Depth (feet) 0 /~/~' 1 2__ 3 __ < 6 / zX'~'. /,': lO~ Sotl Char~cterts~:tF~ -[I Ground Water Encountered: Yes.~ No >:~ If yes, what dllpth.~_~ Proposed Installation: Seepage Pit._____ Drain Field___._ MUNICIPALITY OF ANCHORAGE DFPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE-' OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 13; Block I; Wy.ntz. r Park Subdivision;¢I Location (site address or directions) 24331 Park Drive Property owner Mailing address Lending agency Mailing address A.H.F.C. #102505 W.A.#96896 Day phone 520 ~ast 34th Avenue, Anckoraq¢¢ Ar. 99503 Day phone_ Agent ~r~n. MJ~A~ RE/MAX OF EAGLE RIVER _ Day phone Address !5¢¢0 q~n~..*-~Leed D,,_ive ¢I70! Fc. gZ_~ RJ,¢~. ~b gq~77 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: ×X 694-4~00 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of 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. 72-025 (Rev. 1/91) Front MOA :suo!lelndRs 6u!MOllOJ eql LIW~ 'suJooJpeq ~o~ leAo~dde leUO!~lpuoo 'SLUompeq 'peAo,lddes!(] ,ot peAo,ddv ~ ~rlJ.~N~DIS SliNG euoqd 'uo!~oadsu! s!q~ jo e~ep aq~ uo ~,oejce u! suoRelnSa~ pue 'seoueu!p~o 'sapoo e~e~$ pue led!o!un~l lie qW~ eoue!ldUJoo u! s! Lue~sAS lesods{p ~e~eMe~se~ Jo/pue X. lddns Je~e/~ e~fs-uo aM1 'uo!~oedsu! pue uo!~eSp, se^u! Au~ LUOJJ pue sel!J elSeJoqouv jo X~!led!o!unF~ eq~, LuoJ~ peu!a~qo uo!~eu~Jo~u! eql uo paseq ~eq~ ~pe^ Jaq~Jnj I 'u!eJeq p@),eo!pu! e~n~on~s jo ed~ pue sLuooJpeq JO JeqLunu eql ~o~ e~enb@pe pue leUO!~oun~ 'e~es s! LUe~SXS lesOds!p ~e~e~elset~ ]o/pue Alddns Ca~a/~ a~!s-uo eq~ ~eq~, s~oqs uo!~ao!ldde la^o]ddv/qpoq~nv qlleeH s!q~ Jo uo!~eSl~se^u! ALU ~aq~ XjFla^ I '~oleq u~oqs e~,ep uo!~ep!le^ eq~ jo se pue o~eJeq pex!j~e leas ALU Aq pe!JCJeo s¥ U::I~NI~)N::I ),8 NOIJ. O::IdSNI 40 J.N':IIN':I£V.LS '~ '9 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~::::~\~'¢'~ '~-~--' \ ~_.~rcel Well type ~ If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) Date of test Static water level Well flow FROM WELL LOG g.p.m. AT INSPECfI~)~J:IPAL~TY OF ANCHOI~GE ENVIRONMENTAL SERVICES DIVISION ? 1991 RE_GI .WED Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot ; On adjacent lots ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate _ Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~;;~ ' I~t"7~ _Tank size Cleenouts ~2N) High water alarm (Y/N) Date of pumping ,c~ ..-- ..~ Compartments t,..~/_~ Fou d tion cleanout~,?N) "?/ Depression (Y~.~D ~'~ Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ (~, To property line ~J~ Surface water/drainage On adjacent lots · Absorption field _Foundation. .Water main/service line_ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date i n sta~'~'e~ Manufacturer Size in gallons % Manhole/Access (Y/N) Vent (Y/N) ~at "Pump off" level at High water alarm level ~~:~e~ tested Meets MOA electrical codes (Y/N) ~ SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~ · l~'"/~ Soil rating Length k~ ~ Width ~) ~E.~ Gravel thickness Total absorption area ~) ,~-~ Depression over field (Y~ Results (pass/fail) '~ Peroxide treatment (past 12 months) (Y/(~[~) Cleanouts present ~:~N) Date of adequacy test for ~ System type"~ Total depth bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 4~' h-~ On adjacent lots ~ Iq. Property line To building foundation ~ ,¢~1,~ To existing or abandoned system on lot On adjacent lots ~'~f ~P Cutbank NJ C;),,'--~ Water main/service line Surface water Curtain drain Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines ~ of this inspection. · ,¢. 5 ?LNGINEEEING Signature .;'u~,4 Ea~ie River Loop koad NO_, ~. Engineer's Name ' a~.jle River, Alaska ~577 HAA Fee $ //¢~) Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 ~ .... ~EP'OB ~i'10:i2 RE/MA× OF EA~LE RIVR Munic~pa~ity of Anchorage Depa=~ent O~ Health and Envirom~en~al Division of ~nvi~onment~l ~chorag~ Alamha 99501 Wynte~ ~a=k Sub~£vlsio~ ~1 hereby acknowledges disclosure Of the £ollowing information: The exis~in~ system, was i~%alle~ somet:im~ between JuZy 11, by a representative of the Municipality of Anchorage at the test in November 1982 with =he followang results: t) The septic lank was verified to have a Capacity of 1000 2) The absorption trench was subjected to a oontin~ous ~low hours and accep%Bd all ~he wa~er which was added acting th~ tent period without an~ adverse e~feot. that ~he wast~ water disposal system ].o¢$~e~ on ~his lot 4) Th~ Municipality of Anchormge issued ~ Certificate of on November 2, 1982 for th~ above referenced system. ~he system w~ sub~ec~ed :o another adequacy tez: in October ~98~ and again on Mar~h 16-18, 1991. It again passed the ~o absorb a minimum of 4~0 ~allons of water over a 24 hour period. This req~i:~emen~ is based a formula of ~Wo ps,sons ~he Municipality of Anchorage and SaS Engineering have no know.. lo~, They cannot guarantee ~he system auainst failure a~ any rims in the future for any reason whatsoever. As such, ~hey ~e~uire that ~he purchaser provide them with a waiver of liability for any failure of %he above syste:~. T~e ~n{ersipned purchaser, Thoma~ J. Lanier, he,roSy acknow- system an~ that he is awa~e ~ha~ the Muni~lpalil:y of Anchorage and sas Enginee~ing a~e unable t~ make any r~p~e~entati~ns regarding th~ system o~her than the results of the ~o$~ rec~nt SEP 06 '91 10:13 RE/MAX OF EAGLE RIYR~ Page 2 (¢~on~) Anoho~age and S&B Engine~ring from any linbility what~omver oonnected with the pe~forman~ o£ the'septi~ ~tem f~om WALTER J. HIOKEL, GOVERNOR DEPT. OF ENVlRONMENT~kL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 July 2, 1991 563-6775 FOR: S & S Engineering PWSID 211431 My review of the records on file in this office reveals that the Dawn Water Company Class A Public Water System, is in cornpliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Sincerely, Keven K. Kleweno Lead Engineer ROBERT SHAFER, P.E. ROGER SHAFER March 19, 1991 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUOIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SiTE WASTEWATER DISPOSAL SYSTEM OESIGN Ms. Sharon Minsch RE/MAX OF EAGLE RIVER 16600 Centerfield Drive Suite 201 Eagle River, A£~ska 99577 REFERENCE: Lot 15; Block I~ Wynter Parh Subdivision; 24331 Park Drive AHFC # 102565 W.A.#91914 Dea~ Sharon~ We have completed an i~itial assessment of the referenced property for Heath Authority Approv~ purposes. ~ The property is s~rved by the Dawn Water System which is curre~y in compliance with O.E.C. regu~x~Lions. An adequacy t~st was performed on the septic system s~rving the referenced property on March 16-18, 1991. Water was added to the system wh~e water level m~asur~ment~ were taken from the monitoring tube located within the l~achfield. From this test we have concluded the system is currently functioning adequately for a three (3) bedroom residence. However, the system cannot be guaranteed against subseque~ failure. The septic system servin~ th~ property was installed som~5~me b~tween July 11, 1978 and October 27, 1982. The system was apparently not inspected at the time of installation. Usually, the Municipally would require e~cavation of the system a~ this time for docume~on. However, in 1985 a H~alth Certificate was issued without documentation because the purchasers signed an agreement r~asing the M.O.A. and S & S ENGINEERING from lia§il~y. (A copy of th~ A~reeme~ is at~¢hed). In discussing this property with the M.O.A., they have a~reed to issue another H~z~th Certificate if the n~w purchasers si~n a slmi~r agreem¢~. If you have any contaet/~ or if we may be of further service, please 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HFALTH AND ENVIRONMENTAL. PRO~(?I'iON DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SFWER AN[) WATER FACILITY 264-4720 1. GENERAL INFORMATION section, township, (a) Legal,Description (include lot, block, subdivision, range) 7 · - . Location (address (b) Applicant Name ,/.--¢_~"~4-J..-/~,4~-~'f~¢- Telephone: Home¢~5~ Business Applicant AddreSs ~ ~ ~ ¢¢ ~ / ~~ ¢¢~¢ ~ (c) Applicant is (check one): Lending institution ~; Owner/builder~; Buyer ~; Other (explain); (d) (e) Address Real Estate Company and Agent Telephone (f) Mail the HAA to the following address: 'TYPE OF RESIDENCE Single-Family,J~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well ~.'1 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 E"I Holding Tank [] Note: If corn munity well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72~025(11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ,/' ' - ~ As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposa~ system is in compliance with aH Municipal and State codes, ordinances, and regulations in effect on the date of this [r~spection. Address ,, ,~,I,~8~Z~ _/ Approved f~-r L~''~ ~ ms by Date Conditional Approved Disapproved 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) WELL DATA Well Classification Well Log ~resent IY/N) Total Depth Cased to Static Water Leve~ Casing Height Above Ground Electrical Wiring ~n Conduit (Y/N) Separation Distances from Well: MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 "/985 Legal Description' _ f A. B. C. D.E.C. Approved~l) Date Completed Yield depth of Grouting Purr p Set At Sanitary Sea on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/~ Tank on LOt ____,,,~,¢:~::.,.,.,~ t,.j¢, ¢-- : On Aajoining Lots To Nearest Edge of Absorption Field on Lot ~""~'~::~ "; On Aaloining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected oy ; Date Water Sample Test Results Comments B. SEPTIC/HOL-~)INI~ TANK DATA Date Installed /A~C'-¢z..~ V~.r/~Size Standpipes ~2~'4) _ Air-tight Caps ~9~N) Depression over Tank (Y/~ Pumping/Maintenance Contract on File (Y/N) / Holding Tank High-Water Alarm (Y/N) Separation Distances from Seotic/l-~hJing Tank: To Water-Supply Wel _ ,..~,.~:::~¢;~t To Property Line }LC TO Water Main/Service Line. Course Comments _ ~,.1~ No. of Compartments ~_~ ~4,.. Foundation Cleanout Date Last Pumpea I~ I,,..1/~,~ :for Temporary Holding Tank Permit (Y/N) To Building Foundation _ To Disposal Fielc _ L~, TO Stream Pond. Lake. or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foun~d~tl~n _ (.~ Lot ~J'.\(, Type of System ~ ~'~ Length of Field Depth of Field ~'l/~ ' Gravel Bed Thickness ~ ~, ~' Standpipes Present~) Date of Last Adequacy Test To Water Main/Service Line \ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments f,,,.~ C~ To Property Line '~ ~ ~ ~'- ";5~ ' To Existing or Abandoned System on ; On Adjoining Lots ~'.,.~-~ '~' '1o Cutbank (if present) ~ ~ -/. t D. LIFT STATION Date Installed Size in Gallons "Primp On" Level at ~/ High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~u~_o ? ~,,lntglF~RiN(~. Date Comp~n~ ~A~ ~vSl! Amount: $ ¢~¢ Page 2 of 2 72 026 01/84J / DE]~C~T. OIF ~NVI~RONM~NT/~L ANCHORAGE/WESTERN OISTRICT DFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephon~: (,q07} Addross: 274-2533 To Whom it May Concern: According to records on file in this office the . wA //Po/e/ / ,~m}L¢~Y__ ....... Nater System is in compliance with the State Drinking Water Regulations Sincerely, October 30, 1985 Municipality of Anchorage Department of }~alth and Enviromnental Protection Division of Environmental Health 825 L Street Anchorage, Alaska 99501 Partin, Dewey Jr. and Barbara 0., Purchasers Reference: Septic System presently in use on Lot 13, Block 1 Wynter Park Subdivision The undersigned purchasers of the above referenced rea]. property hereby acknowledge disclosure of the following information: The existing system was installed sometime between July 11, 1978 and October 27, 1982. This system apparently was not inspected by a representative of the MuDic~pality of Anchorage at time of installation. The system was subjected to.snalec~y~v test in Nove,~er 1982 with the following results: 1) The septic tank was verified to have a capacity of 1,000 gallons. 2) '~he abso)!ption trench was subjected to a continuous flow of water through %he septic system for a period of 72 hours and accepted all thewater which was added during the testing period without any adverse effect. 3) lit was concluded by S & S Engineering, the testing firm, 'that the waste water disposal system located on this lot was adequate to serve a t]~ree bedroom residence. 4) The Municipality of Anchorage issued a Certificate of Inspection On-Site Sewer and Water Facility Approval on November 2, 1982 for the above referenced system. The system was subjected to another adequacy test in October 1985 and again passed this test for a three bedroom residence. The system was required to absorb a minimum of 450 gallons of water over a 24 hour period. This require- ment is based upon a fomnula of two persons per bedroom and 75 gallons of usage per person per day. The Municipality of Anchorage and S & S Engineering has no knowledge of exactly what type of system was installed upon this lot. They cam]or guarantee the system against failure at any time in the future for any reason whatsoever. As such they require that the purchasers provide them with a waiver of liability for any failure of the above system. The undersigned purchasers, Dewey Parhin,Jr.and Barbara O. Partin, hereby acknowledge that they understand the history of the existing septic syst~n and that they are aware that the Municipality of Anchorage and S & S Engineering are unable to make any representations~ regarding 'that system other than the results of the most recent adequacy test. They hereby agree to hold the Municipality of Anchorage and S & S Engineering completely ha~].e~s f~ any failure of this system at any time in the future for any reason whatsoever. They further agree to release the Municipality of A~chorage and S & S Engineering from any liability whatsoover connected with the performance of this system from this date forward, as is attested to Dy th~rsignatures below. Dewey Partin, Jr. ~ Barbara O. Partin Date Date State of Alaska On this day personally appeared before me Dewey Partin, Jr. and Barbara O. Partin to me known to be the individuals described in and who executed the within and foregoing instr~nent, and acknowledged that they signed the same as their free and voluntary act and deed, for the uses and purposes therein mentioned. Given under my hand and official seal this Notary Public in and for the State of Alaska My Cormlission expires: APPI. F '.NT FILLS OUT UPPER HA ' ONLY Propedy~wger' t"~'='~'~?y-r.\j, j~,.'~ -t ~'_~,'c/~(?7/ ,J~ ~x~o~-~'~. Phone . ~V¢~(,/~3/~ Mailing Addre~ C~,, ~.~ I. ~q~.l al ("] K (~ 7 ' Address ~ ~v. C Zip Code . . . Phone A~dress Iq,., C , ~v ~)C D ' ' Phone Realty Co. & Agent Address /.~ ~ ',. (_. Zip Code ~ Multiple Family NO. ol Bedroom_ .,~ ~ ~ Individual ATTACH WELL LOG. A w~l Icg Is required for all wells drilled since June 1975. ~ Commungy For wells ddlled prior to that date, give well deptb (attach Icg g available). Public Utility Sewer Disposal Year Indiv~ual Installed: ~ ~ Public Utility When Connected to Public uIIgty: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INIT~ATEQ Time TIn~ Date Date Inspector Field Notes: Time Date inspector APPROVED BEDROOMS DISAP~OVED CONDITIONAL APP OVAL' Inspector 'CONDITIONS OF APPROVAL ~Ub!!C!PAIITY (3F ANCHORAGE RECEIVED Date Sewer Installed Well Log Received Septic Tank Size Soils Rating Well To Absorption Area Well to Tank EXCAVATION ROBERTA. SHAFER WORK CIVIL ENGINEER 694-2979 November 20, 1982 ~UNICIPALITY OF ANCHORAGE ENVR;;i,, v Terry Kincaied SR 2 Box 462]. Parch Drive ChQgiak, Alaska 99567 R[C 'IVI D Dear Hr. I<incaied, Reference: Lot 131 Block 1: W,¥nter Park Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of water through the septic system for a period of 72 hours. The system accepted all the water which was added during the testing period without any adverse effect. It can be concluded from this test that the waste water disposal system located on this lot is adequate to serve a three bedroom residence. However, the system cannot be guaranteed against subsequent failures. If we may be of further service, please do not hesitate to call. Sincerely, ROBERT ,Afl. cc aska State B~k MuniCipality of Anchorage Department of Health and Environmental Protection SR8 196X EAGLE RIVER, ALASKA