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Home My WebLink AboutWYNTER PARK #1 BLK 2 LT 6Wynter Pork lock 2 Lot 6 051-492 -O7 Permit Number: Tax Code Number: Work Type: On-Site Wastewater Disposal System Permit OSP101268 05149207000 Septic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade Permit Effective Dates: November 19, 2010 to November 19, 2011 Design Engineer: F ROBERT BELL & ASSOCIATES Subdivision: WYNTER PARK #1 Site Legal Address: WYNTER PARK#1 BLK 2 LT 6 G:1361 Owner/Address: MILLER LYNN M & WADE H PO BOX 672511 CHUGIAK AK 995672511 Site Mailing Address: 24436 PARK DR, Chugiak Lot Size in Sq Ft: 22000 Total Bedrooms: 5 This permit is for the construction of: Y Disposal Field Y SepticTank N Holding Tank N Privy N Private Well N Water Storage 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 (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: 1. The entire subsurface disposal field and/or alternate is not within a 30 foot radius of a percolation test. The Engineer needs to do an additional percolation test prior to construction of the septic field. The percolation test procedure is to follow Table 3-8 of the EPA Design Manual. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. AMC 15.65.060.B.3 Received By: ~'~ ,ssued ,: Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www. muni.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-492-07-000 Property owner(s) Miller, Lynn and Wade H. Mailing address P.O. Box 672511, Chugiak, Alaska Site address 24436 Park Drive, Chugiak, Alaska Day phone Zip Code 99567 Zip Code 99567 Legal description (Sub'd., Block & Lot) Wynter Park #1, Block 2, Lot 6 Legal description (Township, Range & Section) T15N, R01W, Section 10 Lot Size 22,000 Sq. Ft. Number of Bedroom~~' ~ THIS APPLICATION IS FOR ([~ all that apply): THIS APPLICATION IS AN: Absorption Field [] Initial [] Septic Tank [] Upgrade [] Holding Tank [] Renewal [] Private Well [] ~-~,~ ¢V'¢.,~'; _ *-¢Z~.- F~,~L,:.:~.~ Water Storage [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: F. Robert Bell and Associates F. Robert Bell and Associates 1365 E. parks Highway, Suite 203 Wasilla, Alaska 99654 December 13, 2010 Municipality of Anchorage Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519-6650 RE: Replacement SAS Design, revised Wynter Park #1, Lot 6, Block 2 ro Whom It May Concern: The address of the property is 24436 Park Drive. This property is served by a public water system. The property topography is generally level with a very slight slope to the northeast corner. There are no slopes greater than 25% on or within 50' of the subject property. The previous submittal has been modified to reflect the following: The existing steel septic tank of approximately 1000-gallons was determined to be in an unsound condition. The owner has at one time remodeled the house and added two additional bedrooms for a total of five bedrooms. This redesign reflects this change in both the adsorption field and all related components. This proposal is to replace the existing crib soil absorption system for the existing 5 bedroom home on the subject property. The existing 1000 gallon steel septic has been replaced with a new 1500-gallon steel tank. Two test holes were dug at the locations shown on the Plan View Drawing. These test holes indicated the soils to be gravelly sand (SP). Due to the uniformity of the soils in the two test holes only a single percolation test was performed at the location of Test Hole No. 1. A percolation rate of 5 minutes per inch was determined. The soils have been rated conservatively at 150 gpd per day per bedroom or 1.0 gal/ sqft/ day. The proposed replacement 5 -Wide soil absorption system (5WSAS) will be installed to the north of the existing crib and 5' south of the 1500 gallon septic tank as shown on the attached drawing. The 5WSAS will be connected to existing line from the septic tank to the existing crib, which will be abandoned in place. WASILLA ANCHORAGE PRUDHOE BAY 1365 E. Parks HWY 801 W. Fireweed LN P.O. Box 340010 Suite #203 Suite #201 Prudhoe Bay, AK Wasilla, AK 99654 Anchorage, AK 99503 99734 PH: (907) 357-5247 PH: (907) 274-5257 FX: (907) 743-3480 PH: (907) 659-5000 December 13th, 2010 The 5WSAS will be constructed per MOA requirements and will utilize 4' effective depth of 3¼,, _ 1- 1/2" sewer aggregate under the 4"diameter pipe which will allow a 50% reduction in the length of 5WSAS. The maximum total depth below existing grade is not to exceed 8'. Below are the computations supporting our proposed design of the 5WSAS. Using an application rate of 1.0 gallon per square foot per day: Required SAS Area = 5 br x 150 ft2/br = 750 ft2 Required Length of 5WSAS w/4' Sewer Aggregate under the Perforated Pipe = (750 ft2+ 5 ft) x 0.5 = 75 ft. There will be at least 4 inches of sewer aggregate placed over the perforated pipe and then a geotextile placed over the entire surface of the sewer aggregate. Then at least 4 ft of soil will be placed over the geotextile with the top surface of the soil cover being slightly mounded to a height of 6 inches to shed precipitation. Back fill over the 5WSAS will not be compacted. The laterals for the 5WSAS will be extended using sweeps and tight line pipe extensions with caps to at least 1 ft above the final grade. Capped monitoring tubes will be placed at each end of the 5WSAS as shown on the plans. The monitoring tubes will be perforated within the sewer aggregate and tight line used from the top of the sewer aggregated to at least 1 ft above final grade. Routine maintenance shall be performed on the system, including pumping of the septic tank, at least every two years. Using garbage disposals and flushing of fat and cooking oils and of non-degradable items (coffee grounds, cigarette butts, tampons, paper towels, etc.) must be avoided. The owner should limit heavy surface loads in the area of the septic system to maintain the structural integrity of the system. Trees, shrubs, and other large plants should be prohibited from growing at an adequate distance from the septic system area to prevent roots from growing into the system and clogging the piping. Sincerely, ...... .... Daniel Simpson, P.E. Engineer Encl: MOA On-Site Permit Application Design Drawings (3) Soils Information (2) CC: Guaranteed Services 2 of 2 LOT 5 1 o o 2 o GRAPHIC SCALE 1'=20~ E ELEV.=-I.O' TYPICAL DRAINAGE / GARAGE ELEV.=O.O' ELEV.:-I.O' 6 ~ / ~G 1500 ¥°"~'~T~°~ucl'~'~u°~'-t5' MIN. GAL. SEPTIC PROPOSED 5' WIDE F~ TANK TO REMAIN 4'EDx75'L TRENCH SAS~ APF)ROX. 100' WELL RADUS -~ lOCATION PLR AS BUILT DRAWNC ~-(}R I_A[ON PARX FUDD. LO'] /-- VERFY ~-~ .~ WOOD CI~IB SAS PRIOR [0 CONSTRUCT ON ~ ~' (ABANDON) ELEV.=+I.O'/ ? / / 30' WIDE / DRAINAGE / EASEMENT ELEV.=+I.O' 20' WIDE U TI LI TY EASEMENT / /...: ................... ~... / %".. c~ a~l~ ..".~ ~ t ~ X ~ P~OFESS ~ O~ S89'59'41"W 110.00' ENGINEERS AND LAND SURVEYORS 801 WEST FIREWEED LANE SUITE 201 ANCHORAGE, ALASKA 9950.3-1801 PHONE (907)-274-b257 WYNTER PARK #1 SUED. LOT 6 BLOCK 2 WASTEWATER SYSTEM PREPARED FOR: GUARANTEED SERVICES DRAWN BY:KdC/RLW DATE: CHECKED BY: KH 12-15-2010 JOB NO.: 10-1707.01 MOA GRID: NWl561 'SCALE: 1'=20' FIELD BOOK: N/A 0 O- 0 · 0 II -- ~ Z >- TEST HOLE 2 Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test Lynn Miller, Soil Log #1 Wynter Subdivision, #1, Lot 6 Block 2 Slope I 0-1' TOPSOIL 1- 2- 3- 4- 5- 6- I 1-14' GRAVELLY SAND 7- J (SP) 8- 10- 11- 12- 13- 14-~ 15- 16- 17- 18- 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? yes s IF YES, AT WHAT DEPTH? 14' L Depth to Water After O P Monitoring? 14' E Date: 10-2-10 ~..%""~",?-' ' ' ': Date Pe~ormed: 8-26-10 Township, Range, Section: T15N. )IW, Section 10 Site Plan I I SEEPS@ 14' I Reading Date Gross Time Net Time Depth to Water Net Drop 1 8-26-10 2:05 0 2" 0" 2 2:11 6 MIn 3 1/2" 1 1/2" 3 2:14 0 2" 0" 4 2:21 7 3 1/2" 1 1/2" PERCOLATION RATE 5 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 5' FT AND 6' FT 40 minute pre-soak, suspected ground water observed at 14', monitoring tube installed 10" PERFORMED BY: KURT MACKENZIE I KURT MACKENZIE CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 8-9-2010 TEST HOLE 2 Performed For: Legal Description: 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14-~ 15- 16- 17- 18- 19- 20- COMMENTS Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www c anchoraqe ak.us (907) 343-7904 Soils Log - Percolation Test LYNN MILLER :~ ~.. WYNTER PARK #1, LOT 6, BLOCK 2 TOP SOIL IGRAVELLY SAND (SP) J Township, Range, Section: T15N, 01W, SECTION 10 Slope Site Plan SEE ATTACHED SITE pEAN WAS GROUND WATER ENCOUNTERED? YES S IF YES, AT WHAT DEPTH? 14.0 L Depth to Water After O Monitoring? N/A P E Date: N/A Date Gross Time Net Time Depth to Water SEEPS @ 14.0' J PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT SOILS LOG ONLY TO CONFIRM CONSISTENCY OF SOILS IN SAS CONSTRUCTION AREA. PERFORMED BY: KURT MACKENZIE ] KURT MACKENZIE CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 8-9-2010 GRE/ : ANCHORAGE AREA BOP Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM :OCAT,ON /Y~-/-e,~ MAILING ADDRESS 2'~O~t~ ~'~"/~'~¢ ~'~ '~'~7~ PHONE LEGAL DESCRIPTION g,'* z wp, SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTN MANUFACTURER '~¢~" 5/~-'e~_ MATERtAL INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS .LIQUID CAPACITY //1¢¢~ GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION ADDITIONAL ABSORPTION DIAMETER ~g~/' OR WIDTH //,~I /¢./,I (¢1 , LENGTH DEPTH CRIB SIZE: DIAMETER__~ DEPTH (~ DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINEM~l'q ABSORPTION AREA (WALL AREA)__~/'~---- SQ. FT. WELL: BUILDING FOUNDATION CONSTRUCTION DEPTH DISTANCE FROM: NEAREST NEAREST SEPTIC SEEPAGE LOT LINE SEWER LINE TANK__ SYSTEM CESSPOOL OTNER SOURCES APPROVED DISAPPROVED REMARKS. DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: PIPE MATERIAL: LOT SLOPE: Form No, EQ-031 6, /' ~G.A.A.B. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. NAME OF APPLICANT INSTALLATION OF: SEPTIC TANK SEEPAGE PIT- / FINANCED THROUGH TO BE ]NSTALLED BY SOIL TEST RESULTS SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NOTE~ THIS PERMIT I$ NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED ~ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAl. INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY Will BE SUBJECT TO PROSECUTION. DIAGRAM OF SYSTEM MINIMUM DISTANCES, REOUlREMENT$ SEPTIC TANK --, SEEPAGE PIT--'"~]/' DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF ?,)~CAVATION 5 FEET INTO UNDISTURBED SOIL. FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACt(FI LL CONFORM TO BOROUG ULATIONS REGARDING iNSTALLATION, ~ LICENSED DESIGNER I CerTIfY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE ; ~ : '" "'~ % '-~ ;~ ':' /'e'"'J'~'~ '?- DEPARTMENT OF HEALTH & HUMAN SERV CES ' ",~ '~ '~"~¢~- '-' :.'~' ~J - '' D V sion of Envlronmenta 8e~ ces-.: ..... - , ,.~ ,~,[~[~r~¢~L~N~¢~¢~:~Jq? P'O Box 196650 , Anchorage,-A aska~gg519~650 - .... d'¢~ ~a'~¢~,f~,u ~ '. ', ,= ;~- ~'~; '~A~¢'.',~,,.*~"~¥~ . - , ..';~'~-, APPROVAL FOR A SINGLE FAMILY' DWELLING Lot 6; ' .' ~Completejlegaldescription ~'1;.o ~ . adi-lre~$ or d roct on~ ' ¢/m~&z~., AK " '"~' : ' : ' "' ''688 '0670 " .' ' "..' Day phone-'-' - SPECTION BY ENGINEER ~ STATEMENT OFIN ~ .~-? ? ~.~*~ ..... As certified by my seal affix0d heret0 and as of tho validation date show9 below; l:veri~that nvesttgatlon of th,s Health~fiihori~ A~pr~va appl~C~tion'~hows thai tile and/or wastewater disposal system is ~fe, functional and adequate for the numar of and ~po of ~tructuro indicated h~min. I fu~hor vori~ that ~a~od on th~ bforma~i~n'~btain the Municipali~ of Anchorage files and from my inves~ation and inspection~ the on'site water supply and/or wasteWat~;di~p6~l s~e~ is In compliance with all Municipal and State codes, ordinances, and regblations in eff~t 0n the date Of this inspection. . -.. :: Nam~ o~ mrm~''' , .-,t ~ 'S&S~INEERING ~' ' : ' : ..... Phone ~'~-~ 17Q~ ~e RIv~ ~ R~ No. ~ Addre~ ' " Eaalel~.~ilkl .,~,...... ;,., .. Municipality o1' Anchorage D EPARTM ENT OF:. HE ,AL,T,H, &i HUMAN SERVICES Environmental ser~i'ce~ Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Dcsdription: A. WELL DATA Well type Health Authority Approval Checklist If A. B, or C, attach ADEC letter. ADEC water system mnnber Log present (Y/N) Total depth Saoitary seal (Y/N) Date of test Static water level Well productim) WATER SAN~LE~LTS: Colifon~/~ Da e~of sample: Date completed Cased to FROM WELL Ct¢~t4~ve grouod) Wir~roperly protected (Y/N) AT INSPECTION Nitrate Collected by: Other bacteria g.p.m. B. SEPTIC/HOLDING TANK DATA Date installed ~ Fou nd,4,t'i0 n cldanont ~N) .Daie of Pumping c.' ABsoR~ION FIELD DATA Date installed L8~gth ~ . Width Tmtk size I,C::z~C> Nnmber of Compartments '.~.~.~.~.~.~.~.~.~.~ Clcaaouts ~;iq'q)~/~ Depression (Y~). ~ High water alarm (Y~ ~ Pan, per ..~__f-~~ J~O,',A,¢ ,,-~¼ Soilrating (g.p.d./ft orft-/bdrm) t~ L,. Systcmtype Gravel thickness below pipe ~ Total depth Effectivd absorption~,'irea. ~.q~4 ~ Monitoring Tube prese,~i~tN) ? Depressioo over field Date of adequacy test ~ -~-~ ~ Result~ail) ~S For ~ bedrooms Fluid depth in absorption field before test (lo.); ~6 ~ hnmediately after~° gal water added (lo.): Fluid depth ~ ~ (ius.) Miuutes later: /~ Absorption rate = ~6~ q g.p.d. Peroxide treatment (past 12 months) (Y~ ~/~o~f yes, give date D. LIFT STATION Date installed Size itl galloos Manhole/Access (Y/N) "Pamp on" level at* ~ off" level at* High water alarm leveI at* .~n E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Pnblic sewer main : On adjacent lots On adjacent lots Public sewer ma]flmlf~t Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ,5' ~ 4, Property line /o t 4- Absorption field Io ' ~ Water main/service line / o / 4- Surface water/drainage /oO t 4- Wells on adjacent lots ~.oo / 4-- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Bnilding foundation la; & Water main/service line /~ / 4- Snrface water ]0o t ~ Driveway, parkin~vebicle storage area ~a / ~ Ctmaio drain ~/~ Wells on adjacent lots ~ ~ t ~ Property line la t ~ F. ENG~EER~S CERTIFICATION I cert~p that I have determined thrufield i,lspectionx and review ofMunicval reco,~~ are Signalnmi"e°I'rmancewithMOAH~guidelineau"effeet°nthisdate'~/~ ~ ~;5;'~~~ - HAA Fee Date of Payment Receipt Ninnber Rev. 8/95 Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE .,~ Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343~4744 Parcel I.D. #_ CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 6; Block 2; Wynter Park Subdivision Location (address or directions) 4625 Park Drive (b) Property owner John Thompson Mailing Address Telephone :'(home) 694-4200 Business (c) Lending Institution .F~*ont4 ~r- Al a.q]c~ ¢~r'~¢]~ i- Un10~¢L_ Telephone Mailing Address (d) RealEstate Company and Agent RE/H~ OF EAGLE RIVER - A1Romaszewski Address 16600 Centerfield Drive, Suite 201, Eaqle River, Alaska 99577 Telephone 694-4200 (e) Mail the HAA to the following address: (or check here7~, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eaqle River Loop Road/ Suite 204 Eaqle River/ Alaska 99577 2. TYPE OF RESIDENCE Single-Family:~ Number of bedrooms 3. WATER SUPPLY Individual Well [] Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site]EX Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FiLE SEARCH, DATA AND 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 & $ ~.NG~HF-ER~NG Address T~u~,*,=~, ...... ~ ,- ..... Nm-284 Date Eagle River~ Alaska 99577 Telephone Approved for .~3 bedrooms by Date Approved _ Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DH HS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev 7/88) Back Page 2 of 2 ~¢.O%~CIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: If A, B, C, D.E.C. Approved CN) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Date Completed Depth of Grouting SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot '7~-,.p~.~ 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 '~.~,~/,~. ~_~-~..d~ 7.--~ Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ;~oc~~'4' ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~:,-~.b-~'~ Size _\¢)z::~ No. of Compartments Standpipes ,~/N) ~ ~- Air-tight Caps~YN) Depression over Tank (Y~ /'~ -~ Pumping/Maintenance Contact on File (Y/N!f/ Holding Tank High-Water Alarm (Y/N) /,l/h.~ Foundation Cleanout d~N) Date Last Pumped~ ~r ~l/A- ; for ~-' Temporary Holding Tank Permit (Y/N) N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well .~.¢:~ To Property Line ~f'3 To'~ater Main/Service Line To. Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field 72-028 (Rev. 7/88) Front Page 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~) Type of System Design Length of Field 14¢~ Depth of Field t.c~ ~ Gravel Bed Thickness L~~ Statndpipes Present (~N) Date of Last Adequacy Test Results of Last Adequacy Test ~,,,¢"F ~'%~"~1 ¢'~¢--- '~ '~'¢'~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well TO Building Foundation Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area \ ~:~ Comments To Property Line To Existing or Abandoned System on ; On Adjoining Lots '~=' \ ~ ~ To Cutback (if present) D, LIFT STATION Uat 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 ping 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 guidelines in effect on the date of this inspection. Signed Company S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River~ Alaska Date MOA No. Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7~88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 ST~VE COWPER~ GOVERNOR DEPT. OF ENVIRONMENTAL CONSEIIVATION ANCHORAGE WESTRRN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 October 10, 1990 563-6775 Attn: Bob. Sharer Aoo0rding to the records on £ile in thin office, the Drinking Wate~ Regulations. D~wn ~ate~ of Alaska Sincmrely, Richard Sundet Environmental MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section township, range) __Lot'6, ?dock 2~ 9Afnter Park ~t Location (address or directions) P 8~4D~iv e (b) Property owner ~]UD !!111-031218 Mailing Address ~605 W. dth~ Anchoragci Ak. (c) Lending Institution Mailing Address Telephone:(home) 99501 Telephone Business (d) Real Estate Company and Agent Realty Store- Dan Huckabay Address 8040 Opal CE., Anchorage, Ak. 99502 Telephone 243-1022 (e) Mail the HAA to the following address: (or check here~, if hold for pick up.) List contact person and day phone number below: S & $ ENGINEERING 17034 Eagle River Loop Road No, 204 Eagle Rivel*, Alaska 99~77 2. TYPE OF RESIDENCE Single-Family [~ Number of bedrooms 3. WATER SUPPLY Individual Well [] Community [3( Public [] P.W.S. ~211~. Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, 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 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 Address Date S & S ENGINEERING 17034 E=~Ie Eh, er Loop Road No. 204 Eagle River, Alaska 99577 Telephone // / 6. DHHS APPROVAL Approved for'/~?:)bedrooms by Approved ,-~ Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of Health and Human Services (DH HS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev 7/88) Back Page 2 of 2 ~ MUNICIPALITY OF ANCHORAGE (MOA) ,~,d~',~,~ Health Authority Approval (HAA) O~< ~'.~1~/~./ CHECKLIST- FEBRUARY 1984 ~-~_~ ,~'~¢,~- ~, '~'" .,%'~ Legal Description: t----o,¢ L.~ A. WELL DATA ~"¥'\ Well Olassification~' h If A, B, C, D,E.C. Approved~.N) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Date Completed Depth of Grouting 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 '~,(.~, ~, \ Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole V ; Date No. of Compartments ~' Foundation Cleanout (~N)~ I'~ ~e Last Pumped; for ~ '~-'~'~-----,.,.) -- Temporary Holding Tank Permit (Y/N) B. SEPTIC/HOLDING TANK DATA Date Installed ~¢~¢"~¢~ Size_l Standpipes~.t~'N) ,7/ Air-tight Caps ~N) Depression over Tank (Y/(¢~ '1'"'~ Pumping/Maintenance Contact on File (Y/N)~, / Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ~ ~Jd' To Building Foundation \,c::?'-~' To Disposal Field To Water-Supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev. 7/88) F¢ont Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~'~" ~///~(~"-~ Type of System Design [~:;~ ~ f~ Date Installed ~ "' ~ -7 '~ Length of Field \'¢~F) Width of Field 1'-'2 ~ Depth of Field ¥~:::~ Gravel Bed Thickness [~ ' Square Feet of Absortion Area ~-~¢'~¢F '~ Statndpipes Present([~/N) f .~/ ..... '------._ . Depression over Field (Y/~[~ b-~ Date of Last Adequacy T s~ Results of Last Adequacy Test ~¢:"'~"~\~-~~ ~ ~'~ ~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well TO Building Foundati (.¢¢~. I~_ Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) Date I ~ed Size in Gallo-"ns. Dimensions "Pump On" Level at~""~ High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Manhole/Access (Y/N) "Pump Off" Level at ~ Vent(Y/N) g Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect..~ date of this inspection. .~ ~,~ Company 17034 Eagle River Loop Road No, 2~ Receipt No.~//~ 7~ 7 Receipt NO, Date of Payment ~ /~ Waiver Fee: $ Amount: $ /~ ¢ ~ . Date of Payment 72-026 (Rev 7/88) Back Page 2 of 2 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 DATE: Apr%l__19, PWSID: 211431 1989 To Whom It May Concern: ~According to the records on file in this office, ~ Water System ~s in compliance with the Drinking Water Regulations. the Dawn W~e_~r State of Alaska Sincerely, Vera E. Craig Environmental Fie Officer VEC: gd MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAl. HEALTN CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~ ¢- GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, t.~_o, wnship, range) Location (address or directions) (b) Applicant Name ¢~3~,.~/'::.~ ~.~}~_~_~_~_~_~_~_~_~p~.~..a _ Telephone: Home Business Applicant Address _ ¢,o~ ~fO~4 ~'~1.~(~'¢".t' ~' ~J/,¢~)~;~/¢~¢...~ ,//g%L--. (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer [~; Other [~"¢--(explain); (d) Lending Institution __tC~;~_q--L_./,>~_~_) ¢-~bCL-l-t_..~_ Telephone Address (e) Real Estate Company and Agent Address Telephone (f) 4~,falTthe HAA to the following address: 2. TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well F_.] 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 [] 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 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, 'rESTS, FILE SEAl:ICH, DATA AND INFORMATION As certified by my seal affixed I~ereto 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, functioaal 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. N~me of Firm ~:~t~t~:~;;~O~ Telephone Address .., ,~: u V~.&E;[~t~ ,: ~'~ ~ ~ Date ..... ~2~ ~ ~ ~ ~ Approved for~ bedrooms by Date Approved __. L.,.~'~- Disapproved Conditional" 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 DJ-JEP 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 (i]/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH_,,~.U.T.I;tORITY APPROVAL (HAA) LITY OFAN MUNICIPA _..,cNEq~KLIST- FEBRUARY 1984 DEPT. Ut' ENVIRONMENTAL pROTECTIO~E64-4720 [~EC '[ 5 '~5 Legal Description:,,._.¥1~-.'r''''¢~--~ (0 [~, .~4.. 'Z.. RECEIVED 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 Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ~'~, ~,.~. Z=., ~ I~'. If A, B, C, D.E.C, Approved(~N) Date Completed Yield Cased to De~)th of Grouting ~.~/.&. Pump Set At -- Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ~ + ; On Adjoining Lots ~['~¢ ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B, SEPTIC/I-~OL--BfNG TANK DATA Date Installed Standpipes ~'~/N) Air-tight Caps ¢~N) Depression over Tank (Y,~ Pumping/Maintenance Contract on File (Y/N) / Holding Tank High-Water Alarm (Y/N} Separation Distances from Septic/l-~LdJn¢ Tank: To Water-Supply Well ~ t ~ To Property Line \ c, t .~. To Water Main/Service Line Course ¢,5 Size ~, ~.-~5~-~ No. of ComparLments ~.- Foundation Cleanout (Y/t~ _/_ Date Last Pumped [ '2... ~ ; for / Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~ q~']/'~/t...-- Date Installed ,¢~ ~ ~ ~ r-? ~ Width of Field ~,~l 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 Foundation Lot Type of System Design Length of Field Depth of Field Gravel Bed Thickness "~j.~,..z..J-. ~ I ~ Standpipes Present ICC)N) 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 To Property Line To Existing or Abandoned System on ; On Adjoining Lots ..~ To Qutbank (if present) 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) 'lCump Off" Level at / ' Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedro'om 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 ,. ,?, ¢'~ ¢~:',~{~I~'~L;'&~[~E'~' Date ( ,. ,, ,. . ,.. Company_. ~ ........ ~..,~L~ - ~ MOA No. , ~ ...... ~j.~ 8~J~"~9~~ Date of Payment Amount: $ (~', ~ Page 2 of 2 72-026 (H/84) DEPT. O~ ENVIilO~IM]ENTAL CONSERVAT~ION ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 to records on file in this office the C~, ~/' Water Regulations Sincerely, Time Time Date Inspector Inspector Inspector Comments Conditional Approval ; Date Sewer Installed Permit No. Septic Tank Size ~ --~ ~ Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~/1~ ..~~' ~ ~ ~ ~ 0/~ ~I~ Phone Mailing Address~/~ ~/~ ~ ~ ~ Buyer /~)/~ ~ Lending Institution ~ . ~¢~ ~ Phone Street Location ~ Type.of~dence ~Ingle Family ~ Multiple Family No. of Bedrooms ~ Other _ W~ter Supply ~miVldual A~ACH WELL LOG. A well log is required for all wells drilled since June munity 1975. For wells drilled prior to that date, give well depth (attach log ~ Public Utilit~ ~vallable.) .... Sew~¢sposal ~lndlvidual Year Individual Installed: B Public Utility When Connected to Public Utility:. ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INrFIATED. p TE~S T;RA Finis Realty, ATT'~7~'P!ON: Nancy stably Mile 20, old G]en Highway Chugiak, Alaska 99567 Dear Ms. stahly. EXCAVATION WORK Hay 1, 1982 ROBERTA. SHAFER CIVIL ENGINEER 694-2979 MUNICIPALITY OF ANCHORAGE D"~T Cc ],- r.r'] r, ENVIg J, ii. :I;,A. '. ~O E' h. '~ RECEIVED Reference: Lot 6: Block 2; Wynterpark Subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank, in accordance with a receipt which you furnished, was pumped on April 21, ]982 by Alaska Northwest Pumping, Incorporated, and was verified to have a capacity of ]000 gallons. The seepage pit was tested over a period of 2~ hours by adding 480 gallons of water at a rate of 8 gallons per minute. At the completion of a 24 hour period the water which had been added to the crib had -~ percolated out. There was no rise in the water level in the septic tank at any time during the charging of the system. It can be concluded from this test that the waste water disposal system serving the two bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. If we may be of further service, cc: Nat ional I~aDk o[ Alaska please do not hesitate to call. Muniaipalitv of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER,ALASKA