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Home My WebLink AboutWILDWOOD BLK 1 LT 2 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: ~"~q~'o~o f,, PID Number: Name:~_~.~,~ ~ ~,~r/~ ~ Wastewater System: ~ New ~ Upgrade Address: ABSORPTION FIELD Oh3~c: [ No. of B~drooms: ~o~ ~ ~¢~O~ ~ Deep Trench B Shallow Trench BBed ~Mound ~Other LEGAL DESCRIPTION SoilRating: ~,~ GPD/Sq. Ft. Total Depth from original grade: Lot: Block: Subdivision: Depth to p~pe bottom from original grade: Gravel depth beneath pipe Township: I,a~ge: ISection: Fgl added above original grade: Gravel length: WELL: B New ~ Upgrade Gravelwidth: Numberofbnes: IDist~e~lines: Ft Ft. ~7 q SQ. Ft. ~ ~Fr¢ Ddger: Date Drilled: Static Water Level: Installer: Date installed: Yield: GPM IPump set at: Ft. Icasing HoiohtAb°ve Ground:Ft. TANK SEPARATION DISTANCES ~Septic U Holding U S.T.E.P. TO Septic Absorption Lift HoIdin~ Public/Private Manufacturer: Capacity in gallons: Sur[~o~ ,¢ ~ LIFT STATION Water /¢0 /00 ~ ~ Line j~ ~ /O t ~ Foundation *' /%{ -- -- "Pump on" level at: ' ~ i "Pump off" level a~alarm at: CurtainDrain ' ~¢ ~ ~ ~ O ~ Pump Make & Model I Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: I Assumed /~ '~ ~h Elevation: E NGI~ER~ SEAL Inspections performed by: EagleRlver, Alaska 99577 Dates: 1st z-~o -~ ; Department ot Heal~ ~ Human Services approval . ~. ~, ..... ..~ Reviewed and approved by:. ~* · Date 72-0t3 (Rev 9/91 } MOA 25 · Per~it No. SW930506 Page 2 of 2 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 and/or Well Inspection Report Description:WILDWOOD SUBDIVISION BLOCK 1, LOT 2 PID No.: 01223513 Legal CO1i C08 r 99.1' "N~ ............. 1000 GAL SEPTIC TA~K 96.6: MT COi 84,4~ ~ ........................................ t ...................................................................... ~. 7 g'2I '" NO""W'ATER" I~I,rND A Bi C FC0 12.0 6.0i -- CO1 18.5 10.~ -- C02"2~0 1~':~ C03 -- 42.~ 54.5 C04 -- 43.& 13.0 MT -- 37.4 31.5 NO WELL RA0 ENCRO~,CH T ~PO."PR'OF~T¥ ! ............................. ~i ........................................ ~ ............... i WOOD FENCE :~ NEW 1000 3 BDRM. HOUSE I" = 40'i :02 DBL 10' UTIL. ESM~ ENGINEER's SEAL PAGE 1 OF i 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:SW930506 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:EARL CHRISTINA HANSEN OWNER ADDRESS:2910 STRAWBERRY RD ANCHORAGE, AK 99502-3106 DATE ISSUED:12/29/93 EXPIRATION DATE:12/29/94 PARCEL ID:01223513 LEGAL DESCRIPTION: WILDWOOD BLK 1 LT 2 LOT SIZE: 11050 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 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 (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: ROBERTSHAFER, P.E. ROGER SHAFER, P.E. December 22, 1993 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER &WATER INSPECT[ON ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL ~IECHANICAL INSPECTIONS Municipality of Anchorage DEPARTMENT OF HEAL TH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99519-6650 REFERENCE: Wildwood Subdivision, Block 1, Lot 2 We request you issue a permit to upgrade the septic system serving the three bedroom house on the referenced property. An adequacy test performed on the existing system for Health Authority Approval purposes found the absorption capacity of the existing system to be inadequate. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. Attached it the proposed upgrade design. This property is served by a Community Water System. There are no protective well radii which encroach upon the property. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. =.rt A. Shafer, P.E. ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 r N¥'ld 311 ,0~ PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~ HILi$7-/~ ~ ~[~hJZEN LEGAL DESCRIPTION: Lc,"~ ~- ~(-~"~ ! ~[~00~ 5/P Township, Range, Section: OL 2 .,~//v'J 3 4 SLOPE 5 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT ~ DEPTH? geplh 10 Wale ~ Gross Net ' Depth to Reading Date Time Time Water (IN) Drop ~0'~ /hgl:oo 31 ~ ~,o ~,o 0 I I ;3~ :oo 0 11:5o:oo /z: o~; OD 0 I~:Z~;oo __lg'/ l~37~o I~1~ I,~ I1.~ {minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~-F~ AND /~/-'/~..-~ ~ PERFORM ---~lA m.'...-- , ------ "~-----" --.- ~** CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDA~XL~UNICIPAL GUIDE~~ ~ T~ D~ 72'008 {Rev. 4/85) ON-SITE WASTEWA TER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MA TERIAL SPECIFICATIONS REFERENCE: Wildwood Subdivision, Block 1, Lot 2 GENERAL: 1. The scope of this project includes the installation of a leachfield trench to serve the three bedroom residence located on the referenced property and excavation of the existing 1000 gal septic tank to verify its integrity. If the integrity of the existing septic tank is poor the existing septic tank is to be excavated, pumped, crushed, and abandoned in place and a new 1000 gal septic tank installed. Construction shaft be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and aft applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shaft include two 4" cleanouts for pumping access. 2. The septic tank shall be suff/ciently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Page Two Wildwood Subdivision, Block 1, Lot 2 December22, 1993 Septic tanks installed with less than 4 ft. of cover shaft be insulated. A foundation cleanout shaft be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shaft be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shaft be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shaft be to clean toward the leachfield. The second cleanout shaft be to clean toward the septic tank, Final grading over the septic tank shaft be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soft backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shaft be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shaft be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be instaJled when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Wildwood Subdivision, Block 1, Lot 2 December 22, 1993 MINIMUM MA TERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: 3. Type of Pipe Perforated Solid Cast Iron Yes ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shaft be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, it's gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Wildwood Subdivision, Block 1, Lot 2 December 22, 1993 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction, ff necessary, a pre-construction meeting will take place on-site. Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME./'~/J/~?/~A-~' .~'~/ MAILING ADDRESS ~;~'J~ ~' ~-~"~J/t'//:2 PHONE SEPTIC TANK: DISTANCE ~.' NUMBER OF FROM WEL~/~/2J~'~MANUFACTURER -~'~-C:~/~ ~f~fTERIAL ~// COMPARTMENTS ~ INSIDE LENGTH ' - INSIDE WlDTH~ .LIQUID DePth ~ _LIQUID CAPACITY /~Y~ GALLONS. SEEPAGE PIT: NUMBER OF PITS // DIAMETER /~/' OR WIDTH /~,' LENGTH DEPTH ? /~// / LINING MATERIAL42.~/''~'/~ 'L~:///~C/Rf~ ~/I/Z"'~'. ~ DISTANCE F~O~: WELL /, ///. TOTAL EFFECTIVE BUILDING FOUNDAT'ON/~ NEAREST LOT LINE ABSORPTION AREA (WALL AREA) /~ SQ. FT. ADDITIONAL ABSORPTION WELL: FOUNDATION~-~ CESSPOOL APPROVED CONSTRUCTION DEPTH DISTANCE FROM: NEAREST NEAREST ~~~F~PA G E DISAPPROVED REMARKS DISTANCES: ~/2~ Z~,~) INSTALLED BY: //J~'~ / PIPE MATERIAL: LOT SLOPE: 5, ~-~ ~- REMARKS: ~ ~'./~[d~: ~C~/~/~ Form No. EO-031 DIAGRAM Of SYSTEM DATE ~ ,// ~-~ APPROVED G.A.A.B. GREATER ANCHORAGe AREA BOROUGH · '~ DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 'C' STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 l ~o 0:J ~)~j~S,~AGE DISPOSAL SYSTEM -- APPLICATION AND P£RMIT NAME O r '~ FINANCED THROUGH PERMIT NO. OTHER NOTE: THIS pEFZMIT IS HOT VALID WITHOUT SOIl. TEST FINAL INSPECTION: 2/[ HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENT:5 FOUNDATION TO SEPTIC TANK SEPTIC TaNK TO SEEPAge Pit WALL TO NEAREST LOT LINE. WELL TO SEPTIC TANK ~l ~0~ , SEEPAGE PIT ALSO CONSIDER AREA WELLS, WATER MAIN TO SEPT]C TANK DRAI~ FIELD · SEEPAGE PIT SEPTIC TANK, ., SEEPAGE PIT DRAIN FIELD TO R]VER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SO~L. 4 ]NCH D]AMETER CAST IRON S~PHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED W~TH Airtight REMOVABLE CAPS. ~OROUGH ~EGULATI~NS REGARDI STALLATION. I CERTIFY THAT ] am FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORD{NANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEm IS IN ACCORDANCE WITH SAID CODE, ~ ~ ~ T.H.I 5- 16-7:5 ORGANIC MATERIAL W/SOME SiLT SAND W/ SOME SILT ' 0. O' 1.0' SAND (SP) Medium Groin Brown No Water Table Test Hole extended witiq auger type drilling rig. 15' T.D. V Engineering ~ Geological Consultants Al Casqueira Property LOG OF TEST BORING Anchora g e Alaska DATE 5-17-75 ISCALE I% .~' IDWN nY O.A.S. nY W.E.D. No. 36612 DW<S NO. A-OI 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 Parcel I.D.# l, GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL; FOR A SINGLE FAMILY DWELLING NAA# ~ (~c~ ~\ ~?~ Lot 2; Block I; Wll~0b'~ Sub'division Location (site address'ordirections)' 2910 S~aw6~ry Road e Property owner C~s~ Ha~¢n Mailing address 2910 Str~wb~rr~ Road Anchorage, Day phone AK 99502 243-0596 Lending agency Mailing address Day phone Agent Address - · Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: .3 TYPEOFWATER SUPPLY: Individual well NOTE: Community well Public water ×XX 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 tho legality and status of system. STATEMENT OF INSPECTION BY ENGINEER ..;,' ., ' As certified by my seal affixed hereto andas of the validation date sh6wn below, I verify th£,t,,my investigation of this Health Authority Approval application shows that the on-site water,supply, and/or wastewater disposal system is safe, functional an d 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 investigatiori and inspection, the on-.site water supply and/or wastewater disposal system is in compliance with all Munici pal and State codes, ordinances, and regulations in effect on the date of thi~$-insr~ection Name of Firm ·/ /// Phone ~ S & S ENGINEERING / / / Date ~--'~/~ ~ .~' Address ......... / / · ,vo. Loop .old / Engineer's signaturF¢¢e R,ver, Alaslca 99577/~</ ~"~ DHHS SIGNATURE . ~_~ ~ Approved for -~ bedrooms.' Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments ' he'Municipatity of ,A, ndhorage Department of Health and Human Services (DHHS) issues Health Authority A~p¢~/al ,Oertific~te'~ 5ased only upon the representations given in paragraph 5 above by an independent , '; prof~§sional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes ' i"~ and their lendin'g institutions in order to satisfy certain federal and state requirements Employeesof DHHS do not i conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not respunsible for errors or omissions in the professional engineer's work. 72-025 (Rev+ 1/91) Back MOA ~1 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Description: ~..OT ~;'~.~ /~--~ I,! ~/Ll)l/V'dd¢~ 'S/Z:) Parcel I.D. A. Well Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow ~,, B, or C, attach ADEC letter. ADEC water system Casing height Wires protected (Y/N) FROM WELL Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding t~ Absorption field on lot ~-,~ ~--~ Public sewer main Sewer service line g.p.m. .g.p.m. ; On adjacent~ ,....-P~ubr[c~eanout Petroleum tank WATER sAMPLE RESULTS: c o,,orm Date of sample: B. SEPTIC/~ Date installed ~ ~ [ 1 - ~' ~ Cleanouts (~q) y High water alarm (Y,~ Date of pumping ~//~ - Tank size p~O Compartments Foundation cleanout ~/N) ,~/~5' Depression (Y/~) ~J//~ Alarm tested (Y/N) ~/~- /~,/'~2J 7/:~ /~ Pumper ~/~'/~ SEPARATION DISTANCES FROM SEPTIC/~ TANKTO: · Well(s) on lot ft'/,//~ To property line [~ Surlace water/drainage 72.026 (3~3)* Front On adjacent lots ~) Foundation Absorption field I~ ~' Water main/service line CONTINUED ON BACK PAGE C~ LIFT ~TAT~'~0N'--~I ~ Date installed ¢~J/~ '"'~~ ~::~:;:r~eress(Y/NAccess Size in gallons ~ _ Vent (Y/N)~ __"Pump on" level at"~'~---~ _ .~'"¢~Pump'"off" Level at High water alarm level ..~"'~es tested Meets MOA electrical codes (Y/N) ~ ~ SEPARATIO~STATION TO: ~ _ On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Soil rating (GPD/FF) Length /~/' Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/I~/ Width ~ ~ Gravel thickness C eanout present d /NI _ ,/~/~' ~,/~:¢2 ~. Resutts (pas~fail) System type ~ / Total depth Depression over field (Y/~¢)~. for ~ Bedr~ms After test /~ _ yes. give date ~/~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /~//D To building foundation On adjacent lots Surface water /~g)// Curtain drain On adjacent lots ~'V~'~ Property line 10 ',~ To existing or abandoned system on lot Cutbank ~d.~ Water main/service line Driveway, parking/vehicle storage area ~ ~// 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 -~i Enginser's Name Date 17034~a~i;-~iver Loo~ Road No. ~ J ~ ? ~ Eagle River, Alaska 99577 HA,& Fee $ ~:~ '~) Date of Payment Receipt Number 72-026 (3~93)' Back Waiver Fee $ Date of Payment Rece pt 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 10t, block, subdivision, section, township, range) Lot 2; B~ock I; Wildwood Subdivision Location (address or directions) 2910 Strawberry Road (b) Property owner Mailing Address Telephone: (home) Busines~ (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent MARSTON PROPERTIES~INC. ATTN: John Huber Address 4105 Turnaqain Anchoraqe, A~aska 99503 Telephone 248-1717 (e) Mail the HAA to the following address: (or check here I~Xif hold for pick up.) List contbct person and day phone number below: $ & S ENGINEERIN~ 17034 Eagle RiYer Loop Road No. 2(}4 Eagle River, Alaska 2 TYPE OF RESIDENCE Single-Family [~ Number of bedrooms ..~ 'w 3, WATER SUPPLY Individual Well [] Community [] Public'~ Note: If community well system, must have written confirmation from the State Department Conservation attesting to th legality and status. of Environmental 4. SEWAGE DISPOSAL On-site ~ Public [] Community [] Holding Tank [] Note: If community wetl system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. r/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 Telephone ANEERING Date _.....,ver~ Alaska S & S ENGINEERING '17034 Eagle River Loop Road No, 204 Eagle River, Alaska 99577. 6, DHHS APPROVAL Approved for ~F Approved bedrooms~~" Disapproved Conditional Terms of Conditional Approval Date 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 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 'N~UNICIPALITY OF ANCHO~I= J)EPT. OF HEALTH & ENVIRONMENTAL PROT~ SEP 2 4 MUNICIPALITY OF ANCHORAGE (MOA) '.(~ Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 RECEIVED A. WELL DATA Well Classification __ Legal Description: Well Log Present (Y/N) Total Depth Cased Static Water Level Casing Height Above G round Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FRO M 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 Date Corn pleted Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead [Y/N) If A, B. C, D.E.C. Approved (Y/N) Yield : On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~'2-/--~-~Size ! OOO Standpipes (Y/N) C~ Air-tight Caps (Y/N) Depression over Tank (Y/N) J~ pumping/Maintenance Contact on File (Y/N) / Holding Tank High-Water Alarm (Y/N) f0/l~ No. of Compartments ~" Foundation Cleanout (Y/N) ~ Date Last Pumped ~ - ! ~6~ - ~ O ./LJ//¢I ;for A//~ Temporary Holding Tank Permit (Y/N) /~/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments ,=.~ ~..¢"h r-_ ~2~o~v~,r~c~ ~ TO Building Foundation TO Disposal Field 72-026 (Rev. 7/88) F,ont Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area /---/ ~- O-- zcTC4ravel Depression over Field (Y/N) ~? Type of System Design Depth of Field Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test 5¢-~ "~ L5 'TgCl-c~.-f-o ¢ ~ 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 / L.O "~ To Existing or Abandoned System on ; On Adjoining Lots ~,~ '+ To Cutback (if present) / 120 D, LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I h~,e$~[~f.~l~i~'~.ied, or conformed to all MOA and HAA guidelines in 17034 Eag,e River Loop Road No. 204 . i:l :) %1 inspection. Signed Company 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 f this MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE Application Date 1. General Information (a) Legal Description (include lot, block, subdivision, section~ township, range) Location (addres~s or dSrections) (b) Applicants Namer'S' Telephone - Applicants Add~ss.'~ '~'/D ~ -~-.'~ .'- ~-' ' tton ~ er b~ld~r (c) Applicant ls ('check",one) Landing I~s~itu m,v~r ~]"' Other~ ~ (~p~ai~); Address ~'" ~ ~ '~ ' " (e) Real Estate Co~ Eusiness Address Telephone (f) Mail the HAA to the following address: Type of Residence Single-Family~ Multi-Family~-~ Other (describe) Number of Bedrooms ~ Note: If community well system, must have writ~ten confirmation from the State Department of Environmental Conservation attesting to the legality and status° Sewage Disposal. Onsite~ Public~ Community~--~ Holding Tank~ Note: ~ community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page i of 2] DHEP Approval Approved for~drooms Approved ~ Disapproved Terms of Conditional Approval 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 f~rther 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 reguIa- tiGriS in effect on the date of this inspection. Name of Firm Address /~ ~ ~ ~ ~ ~~ ~ ~--~--- Conditional CAUTION THE bILrNICIPALITY OF ANCHORAGE DEPARtTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPElfOENT PROFES%IONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES ~ND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MIHqICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN %~tE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/Ol8 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST ' FEBRUARY 1984 264-4720 Legal Description: MUNICIPALITY Ot: ANCHOP'AGE DEFT. OF HEALTH & ENVIRONMENTAL PROTECTION NOV ! $ Well Classification Well Lpg Present (Y/N) Total Depth Static Water Level Casing Height Abov~ Ground Electrical Wiring in Conduit Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Abso~'ption Field on Lot. To Nearest' Pubtic Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments If A, B, C, D.E.C. Approved (Y/N) Date Completed Yield Cased to Depth 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/HOLDING TANK DATA Standpipes~N) - Air-tight Capl~"l) - Foundation Cleanout~(Y N~/ . ~' Date Last Pumped ,~,~' Depress,on over Tan k (~ .~. Pumping/Maintenance Contract on File (Y/N) ~ ;for Holding Tank High-Water Alarm (Y/N) ~emporary Holding Tank Permit (Y/N) . ~ -- Separation Distances from Septic/Holding Tank: To Water-Supply Well _ To Property Line To Water Main/Service Linb Course JF ['~ Comments To Building Foundation ~/' ~' ')~ To Disposal Field /~, ~/ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 /,,.~L.~/ /.~,..ccL~oooct' C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~/~l/'~.~z. Width of 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 ~~' 7 ~l~Square Feet of Absorption Area Depression over Field (Y/~) Results of Last Adequacy~'"'""Test Separation Distance from Absorption Field: Depth of Field Gravel Bed Thickness Standpipes Present~N) _ Date of Last Adequacy Test Type of System Design Length of Field To Property Line /5'/'')~'- To Existing or Abandoned System on ; On Adjoining Lots _ ¥- ~ To Cutbank (if present) _ D. LIFT STATION Date Installed Dimensions Size in Gallons - ump on" Level at High Water Alarm Level at /..~ - Tested for Electrical Codes (Y/N) Comments Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request **. I certify that I ha~, checked, ~ed, or conformed to all M O/A and/MAA._~g uidelines in effect on the date of this inspection. Signed ],//~?~-'¢*---,~--~'/~. --z-~-/.~-"'~a t e _ ¢/~/~¢ Company ,/~ ~ _ MOA No ~~-~ ~~ / ...... Receipt No. ~(O ~b ~ ~ ~., .., ~"%,~: Dateof Payment I/' ) ~-~b ~ ..... ~ ~ Amount: $ ~ ~er's Seal Page 2 of 2 72 026 (11/84) ALASKA CIidlROr/meFITAL COFITROL I[1C. ~Ll§ineel'in§ ~ ~uiPonmcntcJ SILl(lies R SANDLER 2910 STRAWBERRY ANCHORAGE ALASKA 99502 SELLER-SAME SEPT 23 1985 WILL PICK UP FROM OUR OFFICE 50616 LEGAL:WILDWOOD SUBD/BLOCK 1/LOT 2 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-SEPT 19 1985 THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 420 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 383 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON SEPT 20 1985 . 1200 Wcsl 33r([ Aucnt~¢, SLlil¢ [~. AnchorLl§¢, J\[Ll$[Ll 99503. (907) 561-5040 R&M ENG qlEERING & GEOLOGIC L CONSULTANTS 229 EAST 51st. AVE. - P.O. BOX 6087 - ANCHORAGE, ALASKA 99503 TELEPHONE 907-279-0483 TELEX 090-35419 Civil Engineers Geologists Land Surveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P.E., L,S. JAMES H. WELLMAN, P.E. RALPH R. MIGLIACCIO Engineering Geologist May I7, 1973 R & ]VI No. 36612 Mr. A1 Casqueira 6820 Cranberry, Apt #2 Anchorage, Alaska Re: Test Hole and Soil Log Report for Sanitary System Lot 2, Block 1, Wildwood Subdivision Dea~ Mr. Casqueira: We are submittLu~ herewith the test borir~ results.and our comments regard- lng soil conditions encountered at the subject site. This investigation was per- formed Lu accordance with your request of May 14, 1973 and those procedures outlined in a letter dated September 13, 1971 by A~r. Roll Stfickland of the Greater Anchorage Area Borough, Department Of Environmental Quality. A single test hole was put down within the Lot 2 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger .type drilling rig and the test hole was extended to a total depth of 15 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M ENGINEERING & GEOLOGICAL CONSULTANTS James W. Rooney Partner JWR:wb Enclosure xc: GAAB ANCHORAGE ~ FAIRBANKS JUNEAU ~ D~ RECEIVED , INSPECTION APPOINTMENTS DATE INSPECTOR NSPECTOR 1~3LIT DEPT. OF H~ALTH MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PaOIECHON DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 AUG 6 198 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED ~EOUE~T FO~ APPROVAL OF I~DIVIDUAL ~ATE8 AND SEWE~ FAGILITIES 2. BUYEB PHONE MAI'LING ADDR~ MAILING ADDR'ESS ' 5, LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RE~-DENCE / 'J~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS ~ One ~ Four ~ Two ~ Five ~ Three ~ Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM .J~ INDIVIDUAL/ON'SITE*~ [] PUBLIC UTI LITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION 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 [~ ONE [] THREE [] FIVE [~ OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~'~ ~- '~;~ Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: /(~0d If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS E~"~PPROVED FOR -~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev. 6/79) ALASKA E IqUIROIql]qerlTAL COFITROL SI RUICeS, ~nclin¢¢rin§ ~ ~nuironmenld ~I~(~J¢$ 9/1/81 InC. MUNICIPALITY OF ANCHORAGE I]NVIRONMENTAL P2OT~CTION SEP :] 1981 RECEIVED CAROL BLACK/C21 209 W. DIAMOND BLVD. ANCHORAGE AK 99502 SELLER - FRANK PETTJOHN SUBDIVISION-WILDWOOD BLOCK-1 LOT-2 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 480 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 75 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 9/1/81 SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3 BEDROOM HOUSE. 1000 IS ADEQUATE FOR A che a e 825 "L' STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 DEPARTMENT OF HEALTH AND ENVI[~ONM[!NI'ALPR[)qECTIO/~I September 1, 1981 Helen Pettyjohn 2910 Strawberry Anchorage, Alaska 99502 Subject: Lot 2 Block 1 Wildwood Su~ivisiOn Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The septic tank pumped with a receipt submitted to this office. (2) R1 adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review° If there are any further questions, please call this office at 264-4720. Sincerely, Robert Co Pratt, ReS. Associate Specialist RCP/ljw CC: Security Pacific Mortgage 2550 Denali Street 99503 Carol Black or Betty IIaycox % Century 21 Shennum Realty Dimond Boulevard 99502 209 West