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HomeMy WebLinkAboutWYNTER PARK #1 BLK 1 LT 24 Municipality of Anchorage Page DEPARTMENT OF HEALTH 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:_ ~O,*J ~O~r$~ PlDNumber: Name: (~2"~'1 ~ ~u~¢ Wastewater System: ~ New ~ Upgrade Address: %4~ ~%~%~ ~ ~ rk~( ABSORPTION FIELD LEGAL DESCRIPTION so, Rating: Total Depth from origina~ grade: O, % GPD/Sq. Ft ~,0 ~ WELL: El New~ ~U pg radeBde~ Gravel width:¢7~l Ft. Number of fines:j IDistance between lines:~ ~ Ft. Classification (Private, A,B~):~ ~ ~H~~Cased To: Total absorption area: Pipe material: Driller ~(;~ ¢~ %~led Ft StalicWaterLe:ll' (~*~¢¢ SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. Mater : Well ~ ~L~S¢ Number of Compartments: Su,'f~ce *t~ +~o0' ~-' ~ LIFT STATION Water - Lot Size in gallons: Manufacturer:-- 'Pump on" level at: vol ah High wster alarm 81: Foundation ~1 ~ I Curtain )ump Mske~ ~ Electrical Inspections performed by: Department of He~lt d Hum~ Reviewed and approved by'~ ~ Date' /%. ~ 72-013 (Rev 9/91) MOA 25 Permit No, 5'L,~ 3~ ~z~ Page ~' of '~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System a,ld/or Well Inspection Report Legal Description: PID No'OSI '~cJ~7-cJ 72-013 A (2/91} MOA 25 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: L 13 14 15 16 17 18 19 20- DA~E PERFORMED: Township, Range, Section: SLOPE WAS GROUND WATER ~j~..~ ENCOUNTERED? L IF YES, AT WHAT ~ O DEPTH? P E SITE PLAN Dale: Gross Net Depth to Net Readi~lg Date Time Time Water Crop - , / PERCOLATION RATE -- TEST RUN BETWEEN ~ FT AND ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE tm~nute$/inch) PERD HOLE DIAMETER '7 FT CERTIFY THAT T:'IS TE~; WAS PERFORMED IN DATE: ~O '~1 ~ 72-008 (Rev 4/85) HENRY WILSON 9601 BUDDY WERNER DR.: ANCHORAGE, AK 99516 (907) 346-2000 October 28, 1993 ConstrL cting Engineers Engineers, Surveyors CHARLES A. LANDERS HC83 0OX 192-A, MYRTLE DR. EAGLE RIVER, AK 99577 19071 694-909[~ Mr. John Smith, PE Manager, On-Site Services, DHHS 801 L Street Anchorage, AK, 99501 re: Lot 24 Block 1 Wynter Park Sub Request for change in design/Permit SW930438 Dear Mr. S~.' A replacement absorption system was designed for the existing owner of the subject property as a condition of the sale of the house; this replacement system was for a 3-bedroom system. The new buyer is requesting the system be upgradecl to a four bedroom system. Consequently, we are requesting to modify our approved design (SW930438) to accommodate his request. A four bedroom system will require a trench of similiar design to be 75' long, an increase in length of 18.5' from the original 56.5'. The system design will still be a wide trench. Since the owner has hired a contractor to install his system starting today, it is critical the permit be changed as requested. The new trench length of 75' will extend out of the test hole radius, and a replacement site will also extend out of the site by a similiar amount (10' - 15'). We propose to provide one additional test hole located to provide the neccessary coverage area during the construction phase. Please co]mnent as soon as possible. Thank you for your prompt consideration. Sincerely, Chuck Landers 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:SW930438 DESIGN ENGINEER:CONSTRUCTING ENGINEERS, OWNER NAME:HUGHES WAYNE & OWNER ADDRESS:24220 HEARTHSTONE DR INC. DATE ISSUED:10/19/93 EXPIRATION DATE:10/19/94 PARCEL ID:05149129 ]LEGAL DESCRIPTION: WYNTER PARK #1 BLK 1 LT 24 LOT SIZE: 22503 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST 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 (iSAAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 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 SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAl, PROVISIONS: THIS PERMIT WAS ORIGINALLY DESIGNED AND ISSUED FOR A THREE BEDROOM RESIDENCE. THIS HAS BEEN REVISED AND APPROVED FOR A FOUR BEDROOM RESIDENCE. RECEIVED BY: DATE: F~om ; C A Landers;Cons~ru¢~ln9 En9in PHONE N~. : 907 694 9098 0o~,28 1993 8:3?AH P02 October 20, 1993 Mr, John Smith, PE Manager, On-Sit.~ Services, 801 L Street ~chora(le~ AK~ 99501 re: LOt 24 Bleak I Wynte~ Park Sub Reqnost for change in design/Permit SW930438 Dear Mr. S~~.~ ~ replacement absorption system was designed for the e~isting owner of the subject property as a condition of the sale of the house; thi~ replacement system was ~or a 3-bedroom ~ystem. The new buyer is requesting the system be upgraded to a four bedroom system. Consequently, we are requesting to modify our approved design (SW930438) to acco~modate his request. A four bedroom system will require a trench of similiar design to be 75' long, an increase in length of 18.5' from the original 56.5'. The system design will still be a wide trench. Since the owner has hired a ~ontractor to instal], his syote~ starting today, it is eritical the permit be changed as requested. The new trench length of 75' will extend out of the test hole radS. ue~ and a replacement site will al~o exte~;d out of the site by a similiar amount (~0' - la'). ws propose to provide one additional test hole located to provide the noecessary coverage area during the construction phase. Thank you for your prompt consideration. Sincerely, Chuck Landers From : C A Landere;Cons~ruc~in9 En9in PHONE No, : 987 694 9098 0ct, 28 i993 8:3TAM P02 SCOP~ OF PRO~EO~!: Proposed replacement absorption field is designed for t.b~e~ bedroom sys=em. Lot lu served by ~ communiby wa=or ~ystem. ABSORPTIONS' ~ Minimum ~egutred~'~edreoms x 150~d/bed~oom -~O~d eapaoity 8oils ra~n~, p~osed addition, 0.8 ~in~um s~zzng:~d -~ 0.8 ~pd/u~ =~ ~f absorption area Due to depth o~ useable soil, U~e w~d~ trench design: ~5' min~um %ren~h 1~n9~1~, 5'Wlde x 4' XM~ACT ON ~JAC~NT ~TGs There ar~ no private wells wi%hin 100' 9roposed absorption system. ~paot 5o adjaoent lo5~. this This proposed absorption sy0tem ha0 no adverse 2& DLOOK X WYNTER ~K flU~D~VXBXON FOR: ~. WAYN~ HUGH~B 24220 H~AKT~STONE DR CHUGIAK, AK~ 9~569 NOT TO 8CALI~ ~CHOBA~, ~K, 99516 10-12-93 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 PERMIT NUMBER:SW930438 DESIGN ENGINEER:CONSTRUCTING ENGINEERS, OWNER NAME:HUGHES WAYNE & OWNER ADDRESS:24220 HEARTHSTONE DR EAGLE RIVER, AK 99567 INC. PAGE 1 OF 1 (UPGRADE) PERMIT DATE ISSUED: 10/19/93 EXPIRATION DATE:10/19/94 ]PARCEL ID:05149129 LEGAL DESCRIPTION: WYNTER PARK #1 BLK 1 LT 24 LOT SIZE: 22503 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. AL1, 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 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 SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAl. PROVISIONS RECEIVED BY: ISSUED BY DATE: DATE: SITE PLAN-WASTEWATER ABSORPTION SYSTEM ENGINEER SITE PLAN DETAILS PROPOSED REPLACEMENT WASTEWATER ABSORPTION SYSTEI LOT 26 BLOCK 1 WYNTER PARK SUBDIVISION PREPARED FOR: MR. WAYNE HUGHES 24220 HEARTHSTONE DR CHUGIAK, AK, 99567 SCALE: 1" = 100' DRAWN BY CAL CONSTRUCTING ENGINEERS 366-2000 9601 BUDDer WERNER DR 694-9098 ANCHORAGE, AK, 99516 10-12-93 DRAWINS II 93-$1--I0-2 ABSORPTION SYSTEM DESIGN DETAILS-~WIDE TRENCH ! SCOPE OF PROJECT: Proposed replacement absorption field J.s designed for a three (3) bedroom system. Lot is served by a community water system. ABSORPTION AREA CALCULATIONS: Minimum Required: 3 Bedrooms x 150gpd/bedroom = 450 gpd capacity Soils rating, proposed addition, 0.8 gpd/sf Minimum sizing: 450 ~)d e 0.8 gpd/sf = 563 sf absorption area Due to depth of l]seable soil, Use wide trench design: 563 sf % 5' W = 112.5 sf x Correction factor [(W+2)+(W+i+2D)] = 112.5 sfx [(5+2) % (5+1+(2)(4))] = 56.5' minimum trench length, 5'wide x 4' deep IMPACT ON ADJACENT LOTS= There are no private wells within 100' of this proposed absorption system. This proposed absorption system has no adverse impact to adjacent lots. EN~ ~ITE P~&N D~TAIL~ PROPOSED REPLACEMENT WASTEWATERAB$ORPTION SYSTE! LOT 26 BLOCK 1 WYNTER PARK SUBDIVISION PREPARED FOR: MR. WAYNE HUGHES 24220 HEARTHSTONE DR CHUGIAK, AK, 99567 NOT 1'0 SCALE DRAWN BY CAL CONSTRUCTING ENGINEERS3~6~2000 9601 BUDDY WE~ER DR 69~-9098 ~CHORAG~, l~K~ 99516 10--12-93 ORA~JlNG ~ 93~S2-~0-2 Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES `525 "L' Street, Anchorage, Alaska 99,502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: L'AJ~Ng~'"~)~/~ DATE PERFOR,~, LEGAL DESORIP'r~ON: L. Z4' [~l /-AJ.L~.y')-~' ~.~ ~'~ Township, Range, Section: N 6 I/'1- 5 )~ ~' SLOPE S~TE PLAN 3 4 5 6 7 8 9 10 WAS GROUND WATER ENCOUNTERED? 11 12 13- IF YES, AT WHAT DEPTH? Depth 10 Water Allot f~on[lorJng? 14- 15- 16- 17~ 18 19 Gross Net Depth to Net Reading Date Time Time Water Drop 20 PERCOLATION RATE TEST RUN BETWEEN COMMENTS-~ ~)5"~__._._ 1~,..~1~)~ '~iOC~¥~ ~t~IJ {~ {minutes/inch) PERC HOLE DIAMETER _ FT AND 5-~- FT . C PERFORMED BY: (~,¢~"~-"~¥k~2 ~'~q'~.L')(.r- Cn,~CB r-,t~L~,'~-.~l ~k.'.,~-(~,-w,.~)gt~L-'~ CERTIFY 'IHAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EEFECT ON THIS DATE. DATE: 72-008 (Roy. 4/8.5) NAME LOCATION _ GREta,ER ANCHORAGE AREA BOR,.JGH Department of Environmental 0_uality 3330 C Street Anchorage, Alaska 99503 RE~R~ 0N-SITE SEWAGE DISPOSAL SYST~ , MAILING ADDRESS /~ (N'~ F-~:TM L __ PI-IdNF SEPTIC TANK: FROM WELL ..... MANUFAC]URER ~ L~N-~_~ _ MATERIAL ~ COMPARTMENTS INSIDE LENGTH ..... INSIDE WIDTH LIQUID DEPTH . _ _ LIQUID CAPACITY/~)_ GALLONS, TILE DRAIN FIELD~.'~/L-~ NUMBER O~ L,~ES ~_ ~ D,srA~c~ u~'rWEEN LINES ..... I~ENBN WIDTH__. IN TOTAL EFFECTIVE Ausa~FnON A~EA ~ Sa, Fr, LENaTII OE EACI'I LINE DEPTH OF FILTER DEPTH: TOP OF TILE 'FO FINISN GRADE MATERIAL_ BENEATH TILE ~ _ __IN. ABOVE TILE WELL: TYPE CONS] RUCTION _ DEP FI-I _DISTANCE FROM: BUILDING NEAREST NEAREST FOUNDATION LOT LINE SEWER LINE SEPT lC SEEPAGE , TANK __, SYSTEM ...... CESSPOOl __, DTHER SOURCES APPROVED .. __DISAPPROVED REMARKS DISTANCES: . DIAGRAM OF SYSTEM INSTAt_LED BY: SEWER LINE DEPTH: PIPE MATERIAL: . - LOT SLOPE: REMARKS: F'Ei]r;~ff"l]iT NIZL .f RI::'F::'L. 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Ii",I:::~;'I'I:::IL.L THE: :E;Y'JE;TL::]'q %i",1 FIC:C:(31~:[:,FIi",IC:IiE I.'.I]:TH 'TIqF_: C:O[>I~E'.F_';. 2:: I I..II'.,II)IiZR'.:~;TFIN[:, THFII' 'I"HE ON"*L:;XT[{ SEI.,.IIEI:::: :i':iY'.'_:~;'I"I~]"I I"1RY I:~:I~Xi:[I..IIF':'.E I:!]",II~FIF,~:(3EHIEEIq'I' ]:1:: 'I'HI_{ Fd::i::~';ID[.:]IqC:E I::~i; F~:EI'"IO[::,E:LEE) TO :[I'.,I[;L.I...I[:,[~: I"'iOI::;:E: I'FIFIIr',I }J: I:::IF I:::'1 T f':l':ll'.,IT I-':f"lNl'.,I '[ [: I':,ON ........ :" '", I."Y I" FiTI ,/c) MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection SOILS LOG PERCOLATION TEST Performed for Connie ~n Date Perfozm~ed Legal Description lot ~f, 2I}~ 1 "v!~ter ]~r~ Eub 0 2 4 6 8 10 12 14 16 18 2O Date Net Time Depth Percolation Rate minute MUNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems. Approval Parcel I.D. 051-491-29 Expiration Date: 1. GENERAL INFORMATION Complete legal description Wynter Park #1, Block 1, Lot 24 Location (site address) 24220 Hearthstone Dr., Chugiak, AK 99567 Current property owner(s) Ryan Griffith Day phone 907-830-8627 Mailing address 1389 S Shelby Dr., Wasilla, AK 99654 Real estate agent Stephanie Olendorff Day phone 907-229-6099 2. TYPE OF DWELLING: E] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic" 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System 0 Public Sewer' ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: i COSA Fee $ S� `� Waiver Fee $ I Date of Payment d'LL(o �� Date of Payment Receipt Number rj to (.0 Receipt Number COSA # I clC4 I Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date on procedures outlined in the Certificate of On -Site Systems Appr( on-site water supply and/or wastewater disposal system is (are) bedrooms and type of structure indicated herein: (..further verify Municipality of Anchorage files and from my. InvQtlgat;dn arad,�r�s)a disposal system is (are) In "cgpyarjoe Wtf3�dle effect at the time of installation. I acknoviri'cftss -Si own below, I verify that my investigation, based it -Guidelines for this application, dhows that the Fe functional and adequate for he number of it based on the" information obt fined from the ?1 fhe �n sit water supply and or wastewater a�4laences, and regulations in WG" site to•verify the informati n submitted. Name of Firm Crewdson Engineering LLC Phone 907-280-9493 Address PO Box 671389, Chugiak, AK 99567 Engineer's Printed Name James Crewdson Date '2(4(2020' 6. DSD SIGNATURE System #1 Approved for bedrooms Jam A. Crewdso System #2 Approved for� bedrooms '• C11527�� Disapproved �' ° �.•`1-aG� •''o PP , ROFESV�N�� �. Conditional approval for bedrooms, with the following stipule `llll(ld��ff((f��i. , �A(z) d -moi 1 By: - Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) bs representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipal not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet i ed only upon the of Anchorage is Legal Description: Wynter Park #1, Block 1, Lot 24 Parcel ID: 051-491-29 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) 43+ years Tank type/material fiberglass Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 2/4/2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 0/30/93 0 ALL standpipes present per record drawing Total measured depth from grade 7 ft (max) Measured depth to pipe invert from grade 3 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: * flushing a toilet produces flow at the double cleanout, indicating the fluid operating level is correct Adequacy test date 2/4/20 Results ❑Pass For 4 bedrooms Fluid depth prior to test 12 in Water added 600+ gal New depth 20 in Elapsed time 60 min Final fluid depth 12 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) NO If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/, ift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' Cj Yes if No ft C] Yes if No ft NeighboringTank Feld > 100' F-1 Yes Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption on Lot > 100' ❑ Yes if No ft Holding> Tank _ 100 ❑Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community ewer Main > 75' ❑ Yes if No ft❑Yes if No ft From Septic(Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 5+** ft Surface Water > 100'[]✓ Yes if No ft Property Line > 5' Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main J 10' 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Servic:� Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foutidation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10'✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Servica Line > 10' ❑✓ Yes if No ft Community Wells > 200' ✓ Yes if No ft Surface Watf �r > 100' _ ✓❑ Yes if No ft F. ENGINEER'S COMMENTS ** separation was approved 11/12/93 G. ENGINEER'S CERTIFICATION I certify th t I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COCA guidelines in effect on this date. COSA Checklistl yellow sheet TN •�q roi E .ffi..... v� a► e Crewdson ,c 527 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ParcelI.D.# OF'!,-Hcl! '- ~.r~ 1. GENERAL INFORMATION Complete legal description Lot 24; Block 1; Wy~er ?ark Subdiuision Location (site address or directions) Property owner Mailing address Lending agency Mailing address 24220 Hearthstone Drive Chugiak, AK Virgil & Jac~e Fiske Ea,qle River~ P,O.,Box 771089 Day phone 688-3920 AK 99577 Day phone Agent Cindy Wilson/ .]ack White Co. Address 11823 Old Glenn //wy. Eagle River, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well Community well XXX Public water Day phone 694-5500 NOTE: 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. 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 ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm __s 8, s ENGINEERING Phone ~ 't ~70-'J~Eagle River Loop Road No. 204 Address Eagle River, Alasl~a. 99577 J Engineer's signature ~g~'-6"'//~/_(~', ~l,.":"--..~ Date DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: .... ~~ !'"~ ~/~1 ~.--!- '~IV~, Date Tile 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 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. Legu[ Description: A. WELL DATA Well type Log preseut (Y/N) Total depth Sanitary seal/Y/N) Munlclpahty of AnchoragE; DEPARTMENT OF HEALTH & HUMAN SERVIOE'Sz ,-, Environmental Services Division 825"L" Street, oom 502 · Anohor ge, Alaska gini,. Healt~ Authority Approval Checklist If A. B. or C. uttach ADEC letter. ADEC wuter system ntunber ~/[ ~4 ? Date completed Cased to FROM WELL LOG Date of test Static water level / Well production ~.,./' g.p.m WATER S AMPL,~-"~TS Coli£o r~'"' Nitrate Dute of salnple: Collected by:. Casing height (ubovc groun, m.m.m.m.m.m.m.m~_ Wires properly ~Y/N/ ~A5 INSPECTION g.p.m Other bucteri*: II. SEPTIC/HOLDING 'rANK DATA Date installed \D ~ 1 9~-I¢ Tauk size 1 ooo Nomber of Compartments 7-,- CleanoutsJS~N) Foundation clcunout ~) ~/ . Depression (Y~__ ~ _ ltigh water ularm ~Y/N) C. ABSORFI'ION FIELD DATA Dute mstulled L'~ - 2..q - q g Soil mtmg tg,p.d./ft~ or fl/bdrm) O, q . System type T,'* ¢- c t-/ Length "~S": ,.~ Width ,5"-, 4~ ~ Gravel thickness below pipe t../r Total depth ~ o~ ~ Effective absorption area '7.5"g- ~/' Monitoring Tube prcsentL~2~N) ,~_ Depressioa over field ~YP~ip ~ __ Dale ofudequacy test [ ~,25'---0/b Results (~Fail) .t"A'~,~ _ For J bedroolns Fluid depth in absorptiotL field before Lest fin.): O Immediutely ariel' q'?~' gal. w tcr Ldded (ill.): t9 Fhdd depth t5 (ms.) Minutes later: ~ Absorption rate = '/,5-3 '"' g.p,d, Peroxide tremment {past 12 months) (Y~ ~ if yes, g~ve 0ate ~ D. tIFF STATION Date installed Size in gallons Maoholc/Access (Y/N) "Pmnp n" level at* ~t* High walcr alarm level at* ~~~ Cy~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Scl)tic/holding tank on lot Absorption field on lot Public sewer umin Sewer/septic sep,,ice line SEPARAT~NCES FROM SEPTIC/HOLDING TANK ON LOT TO: Buildiug fouudation fi-" Propmly linc / o ~ ~ Absorption field r~ , Water mafiffsen,ice line {~ Surface ~ater/drafimge /~o Wells on adjacent lots : On adjacent lots : On adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundatiou 9 2- Sur£acc ;rater / o o Curtain drain ~/~ ~4- Water mai~ffservice line Driveway parking/vehicle storage area Wells on adjacent lots z-,., ,~ t ~ Property line F. ENGINEER'S CERTIFICATION . .. . , , . , . . ,' . ., co,go,,,,(,,,ce ,,,a, MOA IL [1 X,,,deli~,e~ ,n effect o,, this date. Engincer'sName ffoOe,.,r C. (o~,~ / ~a ]o/ Dale . , ~-,t t ~ HAA Foe $ · -~ Waiver FeeS Date of Pay,nent //~/f~ Rev, ~/~$ OSS: haa.wk,doc Date of Payment Receipt Number MUNICIPALITY OF ANCFIORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. I,~ CERTIFICATE Of: INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 0~"1 z~gl 7_.c~ HAA # 1. GENERAL INI-'ORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) (b) Location (address or directions) Property owner ~.U.~I~ r.,~ F~,,~'~ Telephone: (home) Mailing Address 'Z-z[ 'b'Z~ ~'~ -~Y~'~.~"~' '~)""/ ~'~ O~ I ~T Business (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address (e) Telephone Mail the HAA to the following address: (or check here iD, if hold for pick up.) List contact person and clay phone number below: / I ' TYPE OF RESIDENCE Single-Family,~ Number of bedrooms WA'rER SUPPLY ~ '~-~z~-r 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, SEWAGE[ DISPOSAL On-site,S" Public [] Corn, rnunity [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the IF~fi~ and status. 72-025 (Rev. 7/88) Page 1 of 2 5, 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 thfs 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. Name of Firm ~"c~-~ Address ~v~ Date ] o ¢-7~-~ Approved Approved for ~ be~drooms by 4'/~'/~ Date Disapproved ~ Conditional Terms of Conditional Approval 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 Mu nicipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, 72-025 (RoY 7186) Back Page 2 of 2 Municipality of Anchorage Department of Health and Human Services HEAt. TH AUTHORITY APPROVAL CHECKLIST Legal Description: Parcel I.D. d'2¢Iz)~ t'Z9 A. Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height Wires properly protected FROM WI=LL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FRC Septic/holding tank on lot Absorption field on lot Public sewer main ' On adjacent lots · On adjacent lots Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 1,9-7 Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size IO0© Compartments ~-- .Foundation cleanout (Y/N) ~ Depression (Y/N) Alarm tested (Y/N) hJ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line .4- Sudace water/drainage On adjacent lots 4- [d':'x'p~ Foundation Absorption field I .9' Water main/service line 72-026 (3/93)° From CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM ~LI~TION TO: Well on lot J~--' On adjacent lots D, ABSORPTION FIELD DATA Manufacturer Manhole/Access (Y/N) "Pump~i at -/ Sudace water Date installed Length Width Soil rating (GPD/Ft2) o, % System type ~ ~De -T~c~4 ~'- '~' Gravel thickness 4-,o' Total depth 8 ,o' Cleanout present (Y/N) ¥ Depression over field (Y/N) ~ Bedrooms Total absorption area Date of adequacy test N~ Water level in absorption field before test Peroxide treatment (past 12 m/onths) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Results (pass/tail) -- for ~ After test If yes, give date Well on lot ~ ~ On adjacent lots Property line Driveway, parking/vehicle storage area To building foundation On adjacent lots 4- 50' Cutbank To existing or abandoned system on lot + lop Water main/service line Surface water Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMFNTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL oF ON-S TE SEWER AND WATER FACiLiTY 264-4744 Application Date GENERAL INFORMATION fMUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, tow~, range) (b) Propelly Owner Mailing Address Telephone: Home Business (c) Lend ng net tut on ~--¢'?J("'-~ -~--~'-;"~¢'~ '~'~"~c'C~2-¢2~¢/_z_ Telephone Mailing Address ~/~ ~'~.~/. ~ (d) Real Estate Company and Agent ~¢-/~/~ ~~ /~/~ ~4~ Address _ /~¢ ~ /~ ~~ (e) Mail the HAA to the followine address: or: Check here~ if hold for pick up. List contact person and day phone number below. '~ 17034 Eagle River Loop Road No. 204 Eagle River~ Alaska 99577 TYPE OF RI-'SIDENCE Single-FamilYr~ Number of Bedrooms WATER SUPPLY individual Well I-] Community [] 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 Onsite'J~ 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 8/861Fronl 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 disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm --~S~NEEEiNG Address '11034 Eagle Rib/er Loop Ro;Ld No. 204 Eagle Rlver~ Ala,,ka 99577 Date _ Telephone DHHS APPROVAL Approved for ~z/'"~c'~""~',,~bedrooms by Approved ~ Disapproved Conditional _ Terms of Conditional Approval CAUTION 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 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 72.025 fRcv 8/861 Back , WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Well Classification Well Log Present (Y/N) Total Depth 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 L~ne Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments _ ~'~ '¢,," ~"~ If A. B, C, I).E.C. Approved ~N) __ Date Comeleted Yield Cased to Decth of Grouting Puree Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ~- ¢"¢~" "/ ; On Adjoining Lots ~.¢_.2~ ~Y' : On Adjoining Lots TO Nearest Public Sewer To Nearest Sewer Service Line on Lo~ B. SEPTIC/HOLDING TANK DATA Date Installed /f~ '/~ ~ ~'~'_ Size ~',o~¢ No. of Co~ oartments Standpipes/~/N) Air-tight Caps ~)N) Foundation Cleanout V Depression over Tank (Y_~ Pumping/Maintenance Contract on File (Y/N) Holding 'rank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ To Property Line To Water Main/Service Line _ Course Date Last Pumped f~r~ ~ ~ : for /'~//4 Temporary Holding Tank Permit (Y/N) "~//,/~ To Building Foundation To Disposal Field To Stream. Pond. Lake. or Major Drainage Commen!s Page 1 of 2 72-026(H/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /C.~ ~/,.¢~ ~ Width of Field Square Feet of Absorption Area Depression over Field (Y/I~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~ ~/''~ To Building Foundation ~:~ Lot To Water Main/Service Line /3 r-/- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field '~! Depth of Field /I Gravel Bed Thickness Standpipes Present (~N) Date of Last Adequacy Test TO Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Comments D. LIFT STATION 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 thai I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. $ & $ ENGINEERING /I/~ /~,"~ Signed ...... Date I~ZO3~RLYer ~.oep ~oaa I~'u. ~u~ Compile River, Alaska 99577 MOA No. ~ 7''~';~'~--~ Receipt No. ~/¢cO Z' 0 ~' Date of Payment ~F/~ ~' Amount: $ Page 2 of 2 72-026 (11/84) OATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME TNSPECTOR - INSPECTOR MUNICIPALITY OE ANCHORAGE DEVL OF HEAUrH &  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~VIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaske g9501 ~ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R [ C E 1 V [ 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) deys for processing. 1. ~OPERTYOWNER J PHONEE MAILING ADDRESS P~OPE~TY ~ESI DENT (If diiferent from ~bove) ~ BUYER PHONE MAILING ADDRESS ~ LENDING INSTITUTION PHONE MAILING ADDRESS MAILING ADDRESS ~'. 'LEGAL DESCRIPTION STREET LO ~.ITI ON ~-~ 6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One FI Four ~ SINGLE FAMILY [] Two [] Five ~ MULTIPLE FAMILY ~] Three [] Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL- *ATTACH WELL LOG. A well log is required for all wells drillea ,~ COMMUNITY since June 1975. For wells drilled prior to that date, gwe wel E PUBLIC UTI LITY aepth {attach o~ if available. I ~. SEWAGE DISPOSAL SYSTEM ,[~ INDIVIDUAL/ON'SITE** \C~-'H . YEAR ON-SITE SYSTEM WAS INBTALLED. ~ PUBLIC UTILITY NOTE: THE INSPECTIOi~ FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY .~- 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ SINGLE FAMILY [~1 ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX ~ERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Con~lection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBUC UTILITY / Connection Verified INSTALLER []SepticJ~k~r []Holding Tank Size: /~ If Tank is homemade SOILB RATING give dimensions: TYPE OF TANK MAN U FACTUR E R ~W,~.J~_ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: I Absorption Area to nearest Lot Line 5. COM~iENTS [~"~PP ROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED /,~ 72 010 (Rev. 6/79) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE D~PT 0'~ ?'-AL1; & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTR3N 'IR * ~ ' - 826 L Street - Anchorage, Alaska 99501 E~vV ON~.,,,.NT %L ~ :CT[ON ENVIROF, MENTAL ENGINEERING [)IVISION MAR 2 cD Telephone 264.4720 DI RECTIDNS= Commete all parts on page 1, I ncorrlplete requests will not be processed. Please allow ten (10} deys for processing. PHONE PHONE PFIONE 1. PROPERTY OWNER ~'J"~MAI LIN G AD[~SS ~ PRDPER~'Y RESIDEN If different from above', V~A[ LING ADDRESS ~-, LENDING INSTITUTION ' PHONE 4. ~REAL'rOR/AGENT :HONE MAILING ADDRESS ~', LEGAL DESCRIPTION ' ST CATIO~ ~ ~ One ~ Four :] Other SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7, WATER SUPPLY [] INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY 8, SEWAGE DISPOSAL SYSTEM '¢'~' INDIVIDUAL/ON-SITE** [] ~UBLIC UTILITM * ATTACH WI---LL LOG. A well Icg is required for all wells drilled since June 1975 ;or wells drilled ddor to that date, give wel depth (attach Icg if available.) ........ If ~ndlwdual/on-s~te, gwe instal at o ~ date NOTE: THE INSPECTION FEE IV LIST ACCOMPANY EACH REQUEST BEFO RE PROCESSING CAN BE INITIA'rED. ~ 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [~] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL ~ COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER E3 INDIVIDUAL/ON -SITE DATE INSTALLED [~] PUBLIC UTI LITY Connection Verified INSTALLER []Septic T~k or []Holding Tank Size: ]0~ If Tank is homemade SOILS RATING give dimensions: L TYPE OF TANK MANUFACTURER jr j . .~ .....~..~ TOTAL A RSOR PT I ON AR EA MATER IA 4. DISTANCESwELL TO: Septic/Holding Tank Absorption. Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS I~--'~APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev, 3/78) DEPT. OF ENVIRONiMENT&L ~ON§~RVAT]ION / ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA gg501 STEVE COWPERt GOVERNOR Telephone: (907) Address: 274-2533 DATE: April ]. ,_1987 PWS 1.0./~ 211431 To Whom it May Concern: According to records on file in this office the DAWN WATER COMPANY Water System is in compliance with the State Drinking Water Regulations Sincerely, ~/J/ames~- C. Allen, RS ~egional Sanitarian Supervisor L al Ri:I: I 52~5 .... ~ ANCHOltAG[:., AI..ASI(A 99601 (907) 2644111 April 21, 1981 Rick/Connie Vann % Peter Dart'att Ileritage Homes 207 East Norl~hern LighEs Bo~llevard Anchorage, Alaska 99503 Subject: Lot 24 Block I Wynter Park Subdivision Approval for the ind:[vidual sewer and water facilities cannot be granted nnti], the followLng items have been completed: (1) 1he septic tank pumped with a ffeceipt submitted ~o thi. s department. (2) Aa~ adequacy test needs to be performed on the existing leaching area. This '[:est will determine if the sysnem is adequane according to NatJ.onal Standards. A listing of private firms performing the tesL is enclosed. This report needs to be submitted to this office for our roviow. If there are any further questions, please ca]./[ '[dlis office at 264-4720. Sincerely, Robe]:'~ C. Pratt, RoS. Assoc ate Specialist RCP/ljw , CC: First Alaska Mortgage 207 East Northern Lights Boulevard 99503 DAVID ,~, SLENKAMP ROBERTA. SHACER MECHANICAL ENGINEER 694-9055 May 12, 1981 MUNICIPALITY OF ANCHORAGE DEPT. OF I tEALfH & ENVIRONMENTAL p,,,OTECT~ON Rick Vann 5024 llearthstone Drive Chugiak, Alaska 99567 RECEIVED Dear Mr. Vsnn, Reference: Lot 24; Block 1; ¥~nter Perk Subdivision A sewer system ~dequacy test ~s performed on the system located on the referenced property as you requested. The septic tank vms pumped end verified 'to have a capacity of lO00 gallons. The seepage trench ~ms 'tested by s continuous flow of approxi~ote]~ 760 gallons of ¥~ter over a period of 24 hours with no adverse effect on the system. It can be concluded from this test that the on-site waste water disposal system is currently functioning adequately for the three bedroom residence located on this property. The system cannot be guaranteed, however, against subsequent fail,ares. If we may be of further assistsnce, please do not hesitate to call. Sincerely, A. , P.s. ¢ AS/ss /' cc: Century 21, Heritage Homes ATTENTION: Peter Jaret Teamsters Credit Union l,~nicipa].tty of Anchorage Department of Health and Environmental Protection CIVIL ENGINEER 694-2979 SRB 196X EAGLE RIVER, ALASKA