HomeMy WebLinkAboutGREENLAND BLK 6 LT 4Greenland Block 6 Lot A #015-171-21 Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP101248 PID Number: 015-171-21 ❑ New ❑✓ Upgrade Name: Brian J. Putzel ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench El Bed El Mound Address 4640 E. 113th Avenue Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 •8GPD/SF 6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2 Ft. Gravel depth beneath pipe 4Ft. Subdivision Block Lot Greenland 6 4 Fill added above original grade 1-276 Fl. Gravel length Ft. Township Range Section Gravel width 5Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Stalion Tank Line 760 FP 2 > 10 Ft. well >100' >100' N/A NIA >25' TANK ❑ Septic ❑ S.T.E.P. []Holding ❑ Other Manufacturer Existing Capacit Gal. Surface Water >100' >100' NIA N/A Material Number of compartments Lot Line >5' 3'** N/A N/A Steel Two NA Foundation >5' >10' NIA NIA LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks-Existing STEP Tank Inspected and Verified Pump on level at in. Pump off level at n. High water alarm at in. Suitable for Continued Use. Owner Installed New Trenches. **See Lot Line Waiver. Pump make and model Electrical Inspections performed by PIPE MATERIAL Housetotank D3034 Tankto D3034 drainfield Installer Owner - See Letter on File Drainfield HDPE COIMT D3034 Inspector A. Harala BENCHMARK (Assumed elevation) 100.Oft Inspdate n 1" 11/14/10 11/15/10 Location and description 2nd Garage Slab. 3" a" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date ��Q.'`� • ;Std • *; 49TH • /_ y) •.. •ti e.• s.• vies �••............«. �° • AAIrI9AEt E ANDERSON • c ' 4381 . ? /'Z/1 �Date7-/�/3 �fF•pkOF�t$5{Owa�'��''r Approved Inspection Report_1-1pt2.doc,.1V Permit No.: OSP101248 NOTE Existing STEP Tank Inspected and Found Suitable for Continued Use. Absorption Trenches Only Placed Under This Permit. System Installed by Owner. Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report 0 0 0 ao 0 z z 113th AVENUE LOT 4, BLOCK 6, GREENLAND SUBDIVISION 45,865 S.F. Drawing Not Completed Existing LEGEND: Well 49th Built. Locations are Not Exact. CO — Cleanout ..:`. .....,.. .. .... j� Four Bedroom \ Home \\ FCO — Foundation Cleanout 9,'; MICHAEL E. AN➢ERSON �jj SITE •�:;,:yq;4, BV V PLAN TH — Test Hole f••. NO. CE -4361 'tip; Ab n ned Crib M7 E c Location known i 4i ti THA M2 Mi — — _ -- 10 CEA Ease_ment 1 Abandoned Absorption Trench BV — Ball Valve EAST 100.00' 0 0 0 as Page 2 of 3 PID No. 015-171-21 A B M 1 54.7' 28.7' M2 60.0' 48.9' NOTE: `• � 0, 0, •i Drawing Not Completed From Surveyor As LEGEND: 49th Built. Locations are Not Exact. CO — Cleanout ..:`. .....,.. .. .... j� SV —Septic Vent ,,,``,;`„`„�F,,,,,,,,,,,•,,,,,,,,, FCO — Foundation Cleanout 9,'; MICHAEL E. AN➢ERSON �jj SITE PLAN TH — Test Hole f••. NO. CE -4361 'tip; Mi — Monitor Tube 1 BV — Ball Valve SCALE 1" = 30' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP101248 NOTE: Existing STEP Tank Verified Suitable for Continued Use. x H 102.2 5 Drainfield Rock Page 3 of 3 PID No. 015-171-21 Groundwater @ 91.8 � 90.8 98.2 10-15-2010 38' (Trench Length) 15 -16" Holes @ 2.5' Each Lateral 102.9 1"019 2" Insulation and Geotextile Fabric Drainfield Rock ,�-- 90.8 38' (Trench Length) nnnF— TI F— <` T)l ITI T No Scale 102.2 102.9 y� 49th W ? ...�G-.�S .................................... } { MICHAEL E. ANDERSON �C No. CE -4381 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 4, BLOCK 6, GREENLAND SUB. - PERFORMED FOR: POOR Boy CONSTRUCTION DATE: 10/7/2010 PROJECT No.: PARCEL ID#: TECHNICIAN: A. HARALA DEPTH TEST HOLE A (Feet) 10 14- 15-- 16- 17- 18- 19---1 41516171819 BOH @ 15' SLOPE SITE PLAN SEE SITE PLAN WAS GROUND WATER ENCOUNTERED? No IF YES (n} WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: 14 0% DATE OF MONITORING: lo/15m DATE READING NET TIME (MINUTES) DEPTH To WATER (INCHES) OB/OG 1 Am TEST HOLE PRESOAKED PRIOR TO TESTING: 10/12 1 1:14 2 2 3 a .. 4.50" 2.37" d 3 4 2.25" 5 ° 4 2:16 d 4.38" 6 4 5 7 a 2.13" $ GRAVEL WITH SILT 2:47 1 30 AND SAND 9 d GM/SM d 10 14- 15-- 16- 17- 18- 19---1 41516171819 BOH @ 15' SLOPE SITE PLAN SEE SITE PLAN WAS GROUND WATER ENCOUNTERED? No IF YES (n} WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: 14 0% DATE OF MONITORING: lo/15m DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 10/12 1 1:14 2.1311 2 1:44 30 4.50" 2.37" 3 1:46 2.25" 4 2:16 30 4.38" 2.13" 5 2:17 2.13" 6 2:47 1 30 1 4.25"j 2.12" PERCOLATION RATE: 14.1(MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4.5 FT. and 5.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 4/15/2010 11/17/2010 09:42 9075625691 Brian Putzel 4640 E. 113th Avenue Anchorage AK 99516 GREENLAND ALK 6 LT 4 G:2636 November 16, 2010 MUNICIPALITY OF ANCHORAGE On Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage AK 99519-6650 Regarding: OSPI01248, Septic Upgrade Dear On Site Services Engineer: ADVANTAGE BASS SALES I am the homeowner of the properly above. I have experience with septic systems and the equipment to install the systems. I will be on site during the installation of the new drain field. I will also have two good friends helping me with this project. Earl Carmichael from Poor boy Construction and Steve Dickman from Constructing AK who between them have over 50 years of experience installing septic systems. I am renting a Takeuchi TL 140 from United Rentals and Earl is bringing his Hitachi EX 90 Excavator. These friends of mine have generously offered their services for .free. I will not be compensating them for their services. Sincerely, Brian Putzel; Homeowner 907.350.1600 PAGE 01/01 On -Site Wastewater Disposal System Permit 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 Permit Number: OSP101248 Tax Code Number: 01517121000 Work Type: Septic Upgrade Permit Effective Dates: November 10, 2010 to November 10, 2011 1f�S�ia /�M Design Engineer: ANDERSON ENGINEERING Subdivision: GREENLAND Site Legal Address: GREENLAND BLK 6 LT 4 G:2636 Owner/Address: PUTZEL BRIAN J & JULIE A 4640 E 113TH AVENUE ANCHORAGE AK 995161619 Site Mailing Address: 4640 E 113TH AVE, Anchorage Lot Size in Sq Ft: 18000 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage .4ois 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. eated to prevenxf�@e4ng. .... Special Provisions: The entire subsurface disposal field and/or alternate is not within a 30 foot 3 radius of a percolation test. The Engineer needs to do an additional percolation test prior to the construction septic fiel _Rleas senit m e stad and sin results with the As -built Ins ectio Report. If there -suits require a design chan nstructio ofth system will stop ¢finding On -Site review and app oval. AMC 1�65.060.6 3 11 l >.( 0. TiiS CdtnSTi n _Ndl QGl +rt4A � 1ve4 41%2 S'e vveld oxelA o, Received Issued By: Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Program ment 'S, C� epartment **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP101267 COSA#: Permit#:OSP101248 PID#: 015-171-21 Legal Description: Greenland Block 6 Lot 4 Engineer: Anderson Engineering Applicant: Brian Putzel Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3.0 feet. In addition, the field will be an unknown distance from an old abandoned crib. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Reviewer Rec#: 085152 Amount: $200.00 Date Paid: 11/4/10 **** VARIAN C E/WAIVER REVIEW **** ON-SITE SEWER/WELL PERMIT APPLICATION var,Axe_ 05?lviz67 FOR A SINGLE FAMILY DWELLING ')5r 16)12 yCO Parcel I.D. 015-171-21 Property owner(s) Brian J. Putzel Day phone Mailing address 4640 E. 113th Avenue Anchorage, AK Zip Code 99516 Site address 4640 E. 113th Avenue Anchorage, AK Zip Code 99516 Legal description (Sub'd., Block & Lot) Greenland Subdivision, Block 6, Lot 4 Legal description (Township, Range & Section) Lot Size 18,000 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field Municipality of Anchorage •�, Development Services Department Holding Tank Building Safety Division r On -Site Water and Wastewater Program Private Well 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION var,Axe_ 05?lviz67 FOR A SINGLE FAMILY DWELLING ')5r 16)12 yCO Parcel I.D. 015-171-21 Property owner(s) Brian J. Putzel Day phone Mailing address 4640 E. 113th Avenue Anchorage, AK Zip Code 99516 Site address 4640 E. 113th Avenue Anchorage, AK Zip Code 99516 Legal description (Sub'd., Block & Lot) Greenland Subdivision, Block 6, Lot 4 Legal description (Township, Range & Section) Lot Size 18,000 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage LE Number of Bedrooms Four (4) a � A F G T THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ 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 �� 3 Waiver Fees: ^' i Date of Payment: % L'4 _ 0 Date of Payment: i l Ll l G Receipt Number: Receipt Number: (Rev. 11/05) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) October 22, 2010 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 4, Block 6, Greenland Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption system on the subject lot has failed and must be upgraded. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the four-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing 1,500 Gallon STEP Tank will be uncovered, inspected and tested and verified sound for continued use. If it is found defective it will be replaced with a new 1,500 Gallon STEP Tank. The existing absorption bed will be left intact and tied to the new system with a ball valve valve. Also identified on the plans are the locations of the existing well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Protective radii are shown to the adjacent wells. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole recently placed on the lot indicated Gravel with Silt and Sand (GM/SM). The percolation rate was determined to be 14 minutes per inch. We have designed the new trench to be within the 30' radius of the current test with an application rate of .8 gallons per date per square foot. We are proposing to place 2 — 38' long trenches by 5' wide with a 4' effective depth. The total depth of the system will be 7' with the distribution line at 3' below the existing surface. The test hole was placed to a depth of 15' with water monitoring over the past two weeks. Groundwater has stabilized at 14' below the surface. A recent drainage project in the area has improved the surface runoff efficiency and lowered the groundwater table in the area. Lot 4, Block 6, Greenland October 22, 2010 Page Two The ground surface on the lot slopes slightly to the south in the area of the absorption trenches. The trenches will be placed parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the proposed well and from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments ANDERSON ENGINEERING P.O BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) November 3, 2010 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 4, Block 6, Greenland Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: Three complete septic systems have been placed on Lot 4, Block 6, Greenland Subdivision in the past. Little undisturbed area remains for a new system. We are proposing to place the new absorption trench type system within 3' of the east property line to avoid the assumed locations of the abandoned absorption areas. Placement of the absorption trenches within 3' of the eastern lot line will not adversely affect the neighboring lot. The septic system on lot to the east is more than 10' from the end of the new absorption trenches. We hereby recommend a lot line waiver be issued allowing placement of the absorption system within 3' of the eastern lot line. Sincerely, Michael E. Anderson, P.E. OF •49th �.....iL ...... ......... ...........x.L... /.....• ................. :...........�::� MICHAEL E. ANDERSON �1.��jo�.• No. CE -4381 •��? 40 44.- FESS10NP��•i ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) November 3, 2010 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 4, Block 6, Greenland Subdivision Separation Distance Waiver Absorption Trench to Abandoned Absorption System Dear On Site Services Engineer: Three complete septic systems have been placed on Lot 4, Block 6, Greenland Subdivision in the past. Little undisturbed area remains for a new system. We are proposing to place the new absorption trench type system within 1' of the east property line to avoid the assumed locations of the abandoned absorption areas. This location, however, may be less than 10' from the abandoned systems. The systems have been out of service for many years and placement of the new absorption trenches at the location shown will not adversely impact either the new system or the abandoned systems. Sincerely, mr'� Ea_e��� Michael E. Anderson, P.E. OF '•• 49th ................... �... •MICHAEL E. ANDERSON NO. CE -4381 ,•����� A-.41 ROFE. 0��: i I O \I 7 8 9 10 11 12 We • I I I /I i \\\� 6 i �p 4 3 2 1 Existing II Existing j EA�F 113th AVENUE Well ie lin• Existing II Westing 6 i oI �I i m � O i J i i O i I 6A • 1 T 115th AVENUE i I\ j 6B Al '. If ....... ......49..... th - AREA MAP ................... ........._ ., MICHAEL E. ANDERSON ;' 4�i j SCALE 1' = 100' NO. CE -4381 ����F,p'• �4� ply-��0,,.•' I I O \I 7 8 9 10 11 12 I I III II \I �EWisting i I I Exist g. I We • I I Wieing /I \\\� 6 5 4 3 2 1 Existing II Existing j Existin � Well g Well Existing II Existing j Existin � Well g Well ie lin• Existing II Westing LOT 4, BLOCK 6, GREENLAND SUBDIVISION 45,865 S.F. O O O 00 Verify Integrity of Existing 1,500 Gallon Of STEP Tank. o z Place 2 — 38' Long x 5' Wide x 4' Effective Depth Absorption Trenches. Place 2 Ball Valves in Lift Station and Tie In Existing 19' Wide x 43' Long Absorption Bed. OF .............. I... N-71#4 4, •'• ♦♦1 49th ........�..,{.....�....�......................... • •, MICHAEL E. ANDERSON ;' - A, AIP No. CE -4381 ♦�1.pR�FESSI4N�i•• 113th AVENUE EAST 100.00' SITE PLAN SCALE 1' = 30' O O O co NOTE: No Areas of Excessive Slope or Surface Water are Within 100' of Any Part of the New Septic System. LEGEND: CO — Existing SV — Well FCO — Foundation Cleanout TH — Test Hole MT — Monitor Tube Four Bedroom Ball Valve \ Home \ FCO BV Ab n ned Crib M E c Location U known • �" ~ —___ ® Trees & Brush THA MT — — ----------- 1 � CEA Easement Abandoned Absorption Trench EAST 100.00' SITE PLAN SCALE 1' = 30' O O O co NOTE: No Areas of Excessive Slope or Surface Water are Within 100' of Any Part of the New Septic System. LEGEND: CO — Cleanout SV — Septic Vent FCO — Foundation Cleanout TH — Test Hole MT — Monitor Tube BV — Ball Valve LOT 4, BLOCK 6, GREENLAND SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rate: 15 Min./Inch Existing 1,500 Gallon STEP Tank Application Rate: .8 GPD/SF 4' Drainfield Rock 4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area 750 SF/5 SF/LF-.5 (Red. Factor) = 75 LF Trench Length THEREFORE: Construct 2 - 38' Long x 5' Wide x 4' Effective Depth Absorption Trenches at the Location Shown. Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be 7' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Natural Backfill 2'6" Geotextile Fabric 611 O 1" Perforated PVC (Holes Down) 3/16" Diameter Holes 15 Per Lateral @ 2.5' 4'0" 5' Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. •:. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. 0. Minimum 100' Separation From Surface Water or Streams. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2- 3 4 5 6 7 8 9 10 11 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 4, BLOCK 6, GREENLAND SUB. PERFORMED FOR: POOR Boy CONSTRUCTION DATE: 101712010 PROJECT No.: PARCEL ID#: TECHNICIAN: A. HARALA TEST HOLE A OB/OG d V -d d a. GRAVEL WITH SILT AND SAND a GM/SM a 14 15 16 17 18 19 a BOH @ 15' SLOPE SITE PLAN SEE SITE PLAN WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH? DEPTH OF WATER AFTER MONITORING:14' 0% DATE OF MONITORING:70/15/10 O 0 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 10/12 1 1:14 2.13" 2 1:44 30 4.50" 2.37" 3 1:46 2.25" 4 2:16 30 4.38" 2.13" 5 2:17 2.13" 6 2:47 30 4.25" 2.12" PERCOLATION RATE: 14.1 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 4.5 FT. and 5.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 4/15/2010 MUNICIPALITY OF ANCHORAGE (DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Namr yT c 6ichccl Ilu J)ies /O /`(emit( 1-'A l) DISTANCES rJ /s, •., r ��—../ TO FROM SEPTIC TANK ABSORPTION FIELD WELL Address F/ - -- /o /�en/a�e gcal i s/A - PeFer J'arratl C" s�, /4nchaar�e J9 -h 99.5 03 J QJ - Phonels) Permit No No. No of Bedrooms Sur2-(222 8,90203 IV LOT LINE LEGAL DESCRIPTION Lot Block Subdivision __� I en �M - FOUNDATION - 9' -- Township, Range. Section ____ AS -BUILT DIAGRAM IShow location of well septic system grope y es. foundation, r� e 2 2r J /2 All / 3 �r i /. _S'e driveway, water bodies, etc) TANKS --- — SEPTIC ❑ HOLDING 4n Manuipcturer Capacity in gallons /1n cAor"gre %rn h =10 - I �: Material No. of Compartments SI-ee( - - -- -- -- - TYPE OF SYSTEM ❑ TRENCH BED D W. DRAIN El OTHER Depth to pipe bottom from Total depth bole engine) grade original grade 018 FT Ird FT — FIII added above original grade Gravel depth beneath pipe 2B fnsu(a{7o4 -I- 2. O FT 21 Sa/r't + OJ. FT Gravel Ieng;h (,ravel width —— — — - — --- y3 FT 19 FT _ (_ Total absorption area _ I Distance between Imes 7�/ SQ FT .S fT Pipe matena, _C)30 3 y -- �5iyy _ _ —� + Number of Hors Sod ratmg Sppe.e 8 I 128 SQ FT I SC.I) eet r/CJ Pu — - -- - — - Installer!- :���. I Date Installed S'vncz r•# C -n cct ��fTrr / I /!(, � (/ 2 2 / 89 - _ i - _e. WELLS y 4-4144 _ _ ol/ t� — - --- - CA PRIVATE n OTHER (Iderfifvl Classdcabon�lA.B.CI--�— l ota. Depth Cased to f'vl 711,,9_ FTJ 7(,S FT — � — OA — — — — - --- Instauri Date Installed- /{(U/If/c59 / 2 cta _ aArcri '+c.r -- - REMARKS:�s/em Inr<ct!(e� per cz�!//�ove� i9 10 — — - - - _ r �r4ccra�on �P1 Jq+n w rpt fh rno rY' [on l� 4r✓aro( Vse — -- __ __ - _ _ _- �(d aye //J�.�Lcw _Uj/ )e_line /retia//e�( l)pu.r {eenlr - — - - Scale: /it 2i. / - ENGINEERS SEAL ip,o) IS710 al toq r Sfeef Se/J/-'rc V / L fal)6 (({p�_ CLTr'%r of2 �1 Uren cc, lr.>�f -flat-ri Inspections Performed by. /�%'f %CCh .if/ fl_ r, r f `r' 't f rt t Ea (7 _1 1 r1S ((� /rJ 2rlGi COJY1 0'I' I h.0/Icl 6n b 6 fi Llec�+c under M,O.A. ptis/l /4 (armDate _/1 , rhounFrcC r�J c"o Ter s4�/I/ie rYCommendu ^ill, O(� s /ic fr+nls OLSe-t��,� eW�f hn�Yc t pon e y crr-cr�n ano! �r71r� , - Jy F;t certify that this inspection was pedarme it according to all { � Municipal and State guidelines in effect on this date: �� 27 /,9rj �e �� ( J J ;• /9 '�'1.�C...r IX�J Trh... ��Y..{r� --Health)=)eparlmentApproval: �0��,,. �_Date.��_— - n, - - ! - - .- / / _J-- nr.r uir _ -- -. - j �,-/s_ � De!�artmentof Health & Human Services 825 L Street, A:chorage, Alaska 99501 343�4720 � Permit Number: 890203 Upgrade Date {ssued: 09/12/89 Engineer 0es1gned Dwner Name: R[CHARD & VIRGINIA HUGHES Day Phone: Ownep Address: P.O. 8OX 110 C/O VALDEZ CR. MNG" CO 562�1222 CANTWELL, AK 99729 Parced: 015 -171 1 Lot Legal: Subdivision: GREENLAND SUBD^ Lot: 4 Block: 6 Section: 22 Township: 1211 Range: 3W Lot Size 18180 (sq.It. or acrno. s> Max Bedrooms: This Permit: 4 Total Capacity: 4 SEPTIC TANK: Minimum total septic tank capacity: 1,250 gallons. Eac1 septic tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.0 7eet requires insulation over tank(s), WELL: Log must be submitted to Municipality of Anchorage Department of Health and Human Services within 30 days ot well completion. INFORM D,H.H.S. PRIOR TO I10PECTI(ANS BY ENGINEER, IF AFTER OFFICE HOURS, CALL 343`4681 AND LEAVE A MESSAGE. CONSTRUCT PER ENGINEERS ATTACHED APPRUVED DESlGIt! . 11-1I5 PERMIT EXPlRES 12/31/89 AND VALID FOR A S1NIB! E FAMILY HUME. [ CER|IFY |HAT: �amziiar wzth the requiremenLs for nil ~siLe sewers and wells as sei iorth by the M1-tnicipa1ity o{ Anchorage (MO)) and the State of Aiask a. 2. I wi1l install the system in accordance with all MOA codes and regulations, and in compliance wioil the design criterza o[ this permit. 3. l V4 1. adhere t all MOA and StaLe o[ Alaska requirements For tin, set back distances f,oIli any existing we1l, wastewater disposal system or plit) iic sewerage system on Lhis or any adjacent or nearby lot. 4. I undersLand thai this permiL is valid for a maximum of 4 bedrooms. [ a1so understand that the capacity of the total system is 4 bedrooms and M& enlargement will require an additional permit. �» �,m`��4/�/���O L-�-JL�.�2.�'�. L1LJ|( 0 | ^-,��.�u0 Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 19, 1989 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 4 Block 6 Greenland Subdivision Waiver Request #WR890058, PID #015-171--21, SW890203 Dear Mr. Moore: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 4 foot of the west property line abutting Lot 5 Block 6 Greenland. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, 9—a O Daniel J. Roth Civil Engineer On-site Services DJR/ljw#7 W:" PRC' P0.56 wiF ti 1- cXrs TrN6- U'.C-A Tr> 00 '* a 4.N DON op x Ex(ST iN6Z / \ y 6,0131-T H "C T, µ. 4-YC3\, C., 1 o , L3 7 pRapoSED \ /�-- ZS'X33r V Sorg. A41 23 rtouND NEw IS -00 6,44 S,% w l rFrsTN M UtiD -C, j. � SCEP/}cam PrP H 1'0 (3C^ /�6gHlbNEu 10 �# tt 3' Enrs riry6i T'r3_sncM Tb ae Aa+Ncwnc d8t'9 L,to S EP7"rC s rs r -c -n Flattop Technical Services I4530 Echo Street Anchorage, Alaska 99510 13 " 14V r yOaf r q OF AOk 4 9 �......... ..`i........`.'t a THEODORE f. MOORE 3. CE - 3589 S E P r C L. h'/ 661 �rRC-CNG.AIV D S /D wE� t S cP7-1(f CX P6 -R,4 P C= PrEvest=D S rTE P1fIN D�rc pcuN. 6 r�rr NUTS: Tfilr IS Nor fi•Sr-i (fit=YC-r� P�v4T� /�l,G. G.UCATIONJ ARE f1PPFto X, Flattop Technical Services 14530 Echo Slroot Anchorage, Alaska 99518 Lot 4, Block 6, Greenland S/D 4640 East 113th Avenue Well and Septic System Upgrade Specifications Amendment #1 (10/6/89) WELL: A new well is to be drilled in the approximate location shown on the revised site plan, and plumbed into the existing pressure tank located in the crawl space under the house. The existing well located in the garage is to be abandoned in accordance with Municipal requirements. The casing shall be cut off below grade with a steel plate welded on top and the concrete floor of the garage repaired. SEPTIC SYSTEM: The septic tank and the soil absorption mound shall be constructed in the locations shown on the revised site plan, with the expectation of minor field modifications to avoid areas disturbed by the existing septic tanks and seepage pit. The edge of the sewer gravel of the soil absorption mound shall be no closer than 4 feet from the west property line and 10 feet from the south property line. tnuNlclv�uly of /"RC1-10`/\cr Flattop Technical vices SERVIl..5 DIVISION 14530 Echo Street Anchorage, Alaska 99516 i`j 69 Lot 4, Block 6, Greenland S/D CV��`,� 4640 East 113th Avenue Septic System Upgrade Specifications 1. Since the underlying gravel has a perc rate faster than that of the sand to be used in the mound construction, the,size of the soil absorption mound is based on the perc rate of the sand, which is 125 square feet per bedroom. Thus, for this 4 bedroom residence (4) x (125) x (1,5) = 750 square feet of basal area is required, which is accomplished by a 23 foot wide by 33 foot long soil absorption bed. 2. The septic system shall be constructed as shown on the plans, except that minor modifications may be allowed or required by the engineer doing the inspections. All construction practices and material specifications shall conform with Municipal and State requirements. 3. Due to the presence of an old seepage pit in the area, the final configuration of the soil absorption mound may have to be changed slightly from that shown on the plans, but this can only be determined once the overburden is stripped and the extentof the undisturbed gravel stratum can be seen. For this reason it is recommended that the pressure distribution laterals be cut to length and the holes drilled only after the final configuration is determined. 4. The existing septic tanks and seepage pit are to be pumped and properly abandoned by being filled with clean soil or by being crushed and buried on site. The soil absorption trench in the alley is to be abandoned in place and the standpipes removed. 5. Due to the limited area of suitable soils available on the lot for the septic upgrade outside of the 100 foot radius from the well, a lot line waiver is needed allowing construction up to 0 feet from the south property line abutting the 20 foot wide alley, and up to within 4 feet of the west property line abutting Lot 5. This will not have any significant impact on the ability to develop future septic upgrades on Lot 5. 6. The contractor shall install a foundation cleanout within 5 feet of the point where the existing waste line exits the building, and shall thoroughly clean the line from there to the new septic tank. The 4" dia. waste line leading to the new septic tank shall be tied in to the existing line at a point prior to the existing septic tank, and shall proceed at a 2% slope to a suitable location in undisturbed soil outside the 100 foot radius from the well. 9-1 C�? 11JC� 7. The new septic tank shall be an approved 2 compartment 1 500 gallon tank fabricated of 10 gage steel. The tank shall be equipped with a 6 foot manhole riser giving access to the second compartment, and shall have an "Orenco" package lift station installed in the second compartment. The lift station pump shall be a 1/2 hp submersible pump capable of pumping 34 gallons per minute at 20 feet of head. The excavator shall verify that the 6 foot manhole riser is long enough to extend above ground from the appropriate septic tank burial depth, and shall adjust the riser length, if' necessary. 8. The soil absorption bed shall be constructed by excavating the surface soils down to the top of a gravel stratum located approximately 2.75 feet below ground surface. Approximately 2 feet of medium sand shall then placed in the excavation and compacted to achieve a level surface 0.75 feet below the original ground surface. 9. A total of 9 inches of approved sewer gravel shall then be placed on top of the sand, with the bottom of the manifold and .lateral pipes located 6 inches, above the top of the sand. 10. The pressurized line running from the lift station to the mound and the central manifold shall be 2" dia. sched 40 PVC or high density polyethylene, The pressure distribution laterals shall be 1.25" dia. sched. 40 PVC with 3/16" dia. holes drilled in the bottom on a 30" spacing. All piping in the mound itself shall be laid level. Special care shall be taken to compact the soil beneath and around the 2" pipe at the point where it exits the lift station and to provide suitable protection from subsequent ground settlement. 11. The ends of all laterals shall be capped, and all pipe connections in the pressurized distribution system shall be glued. 12. 4" dia. monitor tubes which include perforated pipe extending through the depth of the sewer gravel shall be installed at the locations shown on the plans. Two inches of rigid, burial type insulation shall be placed over the top surface of the sewer gravel before covering the entire field with 2 feet of unclassified soil cover. The side slopes shall be 3:1, except that 2:1 is acceptable where necessary to prevent encroachment onto Lot 5. 13. The contractor shall be responsible for obtaining the necessary utility locates and electrical permit and inspection. The lift station on, off and alarm float settings shall be as specified by the lift station supplier. 14. Four inspections will be required during construction: ( I ) Initial stakeout, (2) After the excavation is complete, but before placement of sand, (3) Flattop Technical Services 14530 Echo Street Anchorage, Alaska 9951.5 After the sand is placed, but before placement of gravel, and (4) After the gravel is placed, the pipes are laid, the lift station is installed and all piping is connected, but before final backfill. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 LOT 5- WLOLL HOUSE S E' PrI S YST. , r H. # H 7: H. #1 a PROPOSec) 23'x37` So/L Amr, tyouND- E,gsi / 13 -rh AVE. r_ C X(sr t Nor u LOT I sinc- HSE CxIsr/N 6 - rt apRM Hous F_ Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99510 NEW IW GAt, s.r. carry 4x. dt-D �S',T.t % 5Fj5 vnud r1 r 70 CE AG4,vDon a -T. M. # 2 QE IiQqNPdN ICO. L•OT 8 S YST KoT 6 : 'rN95 C-Ro u N D IN THE vtC rN (rY OF OF A4 `0 -rNE PROPOSED MOUNP,• ..••••.. •� , S1�0P45S To Tµ95 Nu/ Al(y�: TWE. -� •, � A7 3S7 n* •. THEODORE F. MOORE /Q d • . CE - 3589 stPto� BAofmw�a� 1,07- 9 S67Prir 'S rsrFm t-oT tO L y, 06J GREENLAND 510 SEPTIC 5S�ST. c.FP6�iPADE SITE Pt -AN .SCAG.E.' �i� �Di NOTE: THIS is NOT A 0.4re., S4Ruf'51rP Pk -Ar. ,4At. tocArloNs Ar?6r DwN,UY. 7 -Ft -1 ,gPPRoxrm4r95 3' !S' h'je q. S. ` NSf ..r^MONf7'o(t r(4ar I 33' J %�,v SC060 KO PVC d.AM?M.l W. 3116"D14 /Fol.Lu 01m i eD ON 00770M auc-liY 30" ?" SHOD Yo PVC MAMFof.D OUTSfD45 OC)C-e Or 6*RA0e4.-r 2" SCUM(> to PLC P'060 AMC PRO1 Ile c,fiwr srty, iN s.r. J '- / LAN VIEW 2'Trr�ci< soi� mvEr7 2' VC ellgfGAr iv TNSurarfon� 7y1"0-4 o.7S .• Sffiw el SAND lrll i� 4+--Y.S ryP —p{ OA aN41 P?OwvD NAT f v E G 19hvF4 SFcTDrV A -A'' 9 C") . 49 •`S • y •. THEODORE E. MOORE �016% CE -3589 wc� 1.y, Q6, �I�E�NG.AIVIJ S/P 501L AGS; MouND P4AN >C -SECT ION SCA6.fc: DATE 9/89 Flattop Technical Services 14530 Echo Street Anrhnrrrrfa Alnalrr WIMP I ,uN �I icon werglass Ud ri/ 2' Yoo-M uid re'bamung Med-L&NsM EM 4X ,junction box PVC UNION 24' x 4' 6' Culver -t Manhole 1' Flexible Pre_ssure Hose 1' P V C Pipe Typ 2' Wr haoe Poor (shop oppUed. stth Tnemec top coat AcQustvble Float Switch Asseribly Seal etth FtAM-NEK or Equal PM_Z1M'rdr.W.r* ii1 1 1/4' welded steel coup&Q 4"pvc Plow inducer 1 3/f3' holed 6' OC 1!8' mesh polyebhylene srr-een IT duck x 39' Wgh 1/2 hp, U,L, Listed EFFIuecrb Subgrwrsjble Pump Re-twnmg ongleg Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99510 OR CNCO �-iFT STAT1aN PACk�G� D1J��1f WI FRFSSURF SYSTFM Pl-"-( (3` i4NCW01?AXG Ti4NM' 1aqn 19nn Pnnn Reserve Capacity 12 GAUGE 121 1/2' 81' above Alar -m 161 GAL 192 GAL 257 GAL Capacity Between 97' 48 1/2' (4 BEDRODW Pump on & Pump off 109 GAL 131 GAL_ 175 GAL Float Level CENTER FLOAT CDRD AT Settvlgs Above Vault Alox-m 47' 48' 45' On /Off 41' 42' 39' Bo-ttom no zo Iva 140 -P nn s no m0 � so io w 00 40 80 EA m' LIFT STATIEN DATA Oall.o s per mroute TYPICAL PUMP PERFORMANCE- CURVE SIZE SHELL A B C 1250 12 GAUGE 121 1/2' 81' 40 1/2' G9 BEDROOM) 15710 12 GAUGE 145 1/2' 97' 48 1/2' (4 BEDRODW 2D00 10 GAUGE 194' 129 3/8' 64 5/8' G5 & 6 B£DROOhll SIZE CHART NOTE — LIFT STATION TANKS MUST BE 250 GALLONS LARGER THAN STANDARD TANKS FOR SAME APPLrCATION NOTE— SEE ATTACHED SPEC=ATMNS FDR EQUIPMENT SHOWN HERE Flattop Technical Services 14530 Echo Street Anchorage, Alaska 9A51R 91 tfq 1ss'ume 2' h ervae toss dcee!F,, 3�(6 ri ofccc Ac7(Q/ d rsclia.rge q�m � 2` f7,e7' Aet7,� fy�Ccc(�(Of hr`f 60 h✓✓iR,Vo,�z� Flow GcSSurne 5-o' of 2" P6 -G From l,s. 1�o `nonrdo0f ,6 2s- f'prf On munc�vl� �rcc�r Ston la.rJ' Co 30 c7r y,� = 2 .�f l/rcc-Pon � In �GtCrACfVCd .3 17 ^} X /so � ( .T"^ 1e- head (O.fY J�rvm /�umrl / /Fret/ T 7 / hee"c / (O..r� 7'rom taul�7// Cuvzc_ fin '/Z- {1P ,S"t"'er.Rkl" rJur,� = 35 yOn,(LV l�,r �lur/y it m/,w Ue o/ �u��(virr�/ Flvc� a'nr�( bo(ej- er-Ve/ d4lc/ta��i,) / P(c cc,, ink ire<o/ ! Per ceyolle.—'4 in�o,m/.�a4o� /"0�7f la'" -' a' f-' ,54-4n a(aed V�I2rvC p2�uc�/�� G+�G U�xlar., 19 P Flattop Technical Services 14530 Echo Street Anchorage, Alaska 995IF; 0 A4 Ar Ar . LJ .• •, * ,(J.9TH 0. •. THEODORE F, MOORE Af �, �CE - 3589 � � Syr f-ein - C)0,r7n Pgramel-rU d elrgr ✓nunc�a( , 2 7i3 - 2!9G F ? r, (Ao7 7on-hPXARhoo .Sre 1ss'ume 2' h ervae toss dcee!F,, 3�(6 ri ofccc Ac7(Q/ d rsclia.rge q�m � 2` f7,e7' Aet7,� fy�Ccc(�(Of hr`f 60 h✓✓iR,Vo,�z� Flow GcSSurne 5-o' of 2" P6 -G From l,s. 1�o `nonrdo0f ,6 2s- f'prf On munc�vl� �rcc�r Ston la.rJ' Co 30 c7r y,� = 2 .�f l/rcc-Pon � In �GtCrACfVCd .3 17 ^} X /so � ( .T"^ 1e- head (O.fY J�rvm /�umrl / /Fret/ T 7 / hee"c / (O..r� 7'rom taul�7// Cuvzc_ fin '/Z- {1P ,S"t"'er.Rkl" rJur,� = 35 yOn,(LV l�,r �lur/y it m/,w Ue o/ �u��(virr�/ Flvc� a'nr�( bo(ej- er-Ve/ d4lc/ta��i,) / P(c cc,, ink ire<o/ ! Per ceyolle.—'4 in�o,m/.�a4o� /"0�7f la'" -' a' f-' ,54-4n a(aed V�I2rvC p2�uc�/�� G+�G U�xlar., 19 P Flattop Technical Services 14530 Echo Street Anchorage, Alaska 995IF; 0 A4 Ar Ar . LJ .• •, * ,(J.9TH 0. •. THEODORE F, MOORE Af �, �CE - 3589 � � b �V,vF 11 A(� N� F1Crttop Technical Services �� 11GINEER ••L)?. 0 14530 Echo Street �.*?f•L�,gTH•"..•,••':p*1 Anchorfoei? yAtt Bka 'ge"-" , Munici . II o nchora e +T DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650CE-389 THEODORE F•"' MOORE ; 1 ., ; 0I CE - 3589 ttti a SOILS LOG — PERCOLATION TEST OQ���P,�••,,,,,. ..••o�a�`G 1�1 � PERFORMED FOR:. ,Mef_ mrd f ' yYn Ch CIO Her) loge PI M/ i—�('/n k DATE PERFORMED:_ BI3O I99 V LEGAL DESCRIPTION: L [�]�r30. Gr -eel? ('ar1CC SID Township, Range, Section: T Sec 221 -rl zlyy, t? 36v S,? DEPTH SLOPE SITE PLAN 1 2 3• 4 5 6 7 8• 9• 10- 11 - 12 - 13- 14- 15- 16- 17- 18- 19- 20 - Pt SP'1 $I(A'y Sandy 1_0 am 0-9 .N• GP clecro sandy C'"&,el ti r i is a'iaccr m Ngo a h►. 6:-/y Sandy S((A GratiL I — Pochekr 07S cv Pocke{j of M H. WAS GROUND WATER Y y ENCOUNTERED? Z> IF YES, AT WHATL r O DEPTH? 5 P E Depth to Water Alter Monilorint17 68" Date: 2/6/89 21 2 Reading Date Gross Time Net Time Depth to Water Net Drop III PERCOLATION RATE (mmules/inch) PERC HOLE DIAMETER r H. ^ / 1 TEST RUN BETWEEN FT AND FT COMMENTS ..J. li6nrr•vn lcc�e i�s7l rffe Q (.ytl( r-crat(v'G mocrnbt e.V, 2r SC2ne� PERFORMED BY: _Eta6Lcr %.rrnrC*e Ser'Y,ecet- ICERTIFYgTHAT �THIS OTEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) .01 �attop Technical Services s y IINNEE, L) . 14530 Echo Street : TH ; Anchora�q� AtlCtska g�SrG"••: ••••...•••.•••...: �. u ,� Munici a ify o Anchorage 00. !�j/J- r $4 ..... ..............s 2f DEPARTMENT OF HEALTH & HUMAN SERVICES Tlae000ae f. MooRE 825 "L" Street, Anchorage, Alaska 99507_-0650 d4 : '•. CE - 3 , M k� a SOILS LOG — PERCOLATION TEST P4a ze�••.,••' o�`''Q�".� PERFORMED FOR: rreff Lyn eh clo 6Gh1t'tCje 8egl rflgk DATE PERFORMED: BI.?D I99 LEGAL DESCRIPTION: C.�/. %$' 6rreeAjejoa SID Township Range,Section: DEPTH I SLOPE (FEET) I Pt t--�—�—T—I 2 d 1 S 0 St (� , S'Ctne(Y (,GRM 3 - Net Time Hao Sevlor 4 M � Silf 5- 6— S� 7 M1. 8- B.H. 9- 10 - WAS GROUND WATER ENCOUNTERED? G IF YES, AT WHAT L 12 1 DEPTH? 0 E 13 14 15 16 17 18 19 20 Depth to Water After Monitoring? Date: Reading Date Gross Time Net Time Depth to Water Net Drop L ---J PERCOLATION RATE _ (minutes/inch) PERC HOLE DIAMETER T N. 1*2 TEST RUN BETWEEN _ FT AND - FT COMMENTS - 610 mO1111P 1445 in,CAftl(�-ct G-,-auG( SyCM,/U ., „Oi �unoC PERFORMED BY: F(a6Lcp 7tirAlJr m( Serr/rcer I �%<-- CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) , 4W 01. iq qqI Flattop Technical Services �4GINEE S L) •.'�^ 14530 Echo Street s 0) ggTH '•'S�' Anchora @@ A aska JIfi Ey•..• r •...•••.•....e ;r• n ..� Municip lily o�Anchora9goOr DEPARTMENT OF HEALTH & HUMAN SERVICES �•'•" "" "'•"+ • TH[OpORE f. MOORE +' 825 "L" Street, Anchorage, Alaska 99502-0650 .a CE • 35D9 n` 4 SOILS LOG a PERCOLATION TEST OQ ��,'••.,,,,,,,.• o�`�4r T. N. #' 3 �� PgproP Im�a1 V%,.& PERFORMED FOR:. Merr-rif J I v n Ch 01O Her) &Ire Req/ JE�f%u f-- DATE PERFORMED:_. EI3O 169 LEGAL DESCRIPTION: 36 (l►'eeR JCrrICC SID Township Range Section: SQG 22, 7-1?-A/,R 3!v_S t DEPTH SLOPE SITE PLAN (FEET) f—� 1 2 �3 4 5 6 7' 8• 9• r SM S1 f Fy 504d y 40CIA-1 6r P Coa lue Sandy C-mwl IIS tit la'>(rm (rM/M k' 5ilfy �rl7ive/ 6, H. 10 WAS GROUND WATER ENCOUNTERED? 11 S IF YES, AT WHAT L 12 DEPTH? r O E Depth to Water Alter 13 Monitoring? 7.7 n Date: 14 15 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop l�llII PERCOLATION RATE _ (minutes/inch) PERC HOLE DIAMETER 7 N. #3 TEST RUN BETWEEN FT AND FT COMMENTS Man i6e 1!t,6e 'tA A/lezt PERFORMED BY: f"itR.t&X TG{%jgr (( Scrvrcar I '��.Q. Il?CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: _.—L�r</0 72-008 (Rev. 4/85) n !�attop Technical SE3- rvices 14530 Echo Street Anchoraee A ska °516 Municipality JJ nchorageg DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 7. A # V �F. vr° M< `A A -°. 1� 4GINEER� L)'. 0 49TH •'7�t �. . ..............e 1.1• . THEODORE f, MOORE PERFORMED FOR: Merrf+t_ �,yYT Ch C� HC2 11"Cle ROn/ E—:fl*k DATE PERFORMED: 8130 V LEGAL DESCRIPTION: 8t! 67f -eel? �Qr10C SID Township Range, Section: sec 22� i �ZN� R 3W s N DEPTH I SLOPE 1 t.5 2 3 4 5 --- - 6 7 8 g_ 10- 11 - 12 - 13 14- 15- 16- 17 - 18 415161718 19- 20 Pt 0 r -w Mat rl. SN (� P H io Se e1v 1"1 L, WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Aller Monitoring? Dale: 71 S r L S 0 P E Reading Date Gross Time Net Time Depth to Water Net Drop I PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER 71117 H��� JJJ� TEST RUN BETWEEN _ FT AND _ FT COMMENTS �iT r"e o rfX eA Af- SQ7 COAct eAtaAr �a .S• �/TO/ C9T %r,(f f�o%. %r i-gvG/ S'fL?x��'+_-�I in�tiP.f _ occ� _76_-- 6rr fh•tc� ccs �,e /�o�fi+ �n�C ®�Y�e . lD' /o..�_�^-y_ ha(_p PERFORMED BY: EIA6�W /rVr/r/ cre( SC/'f/KRr ICERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) LOCATION OF WELL (Please complete either to, Ib or Ic.) WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological R Geophysical Surveys Drilling Permit No. _ A.D.L. No. I 6a rough Subdivision Lot BI00, Section No. 1 Township N ❑ Range E '00,Merldlon WE ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL: // 3 x/f Lj rscv/fif Address: 19il Ch Street Address and Area of Well Location 2. WELL LUG Feet Below Surface R. WELL DEPTH: (11na1) 21 �' 5. DATE OF COMPLETION,,/ — �'� Material Type Top Bottom ft.�A -,(LJC !—. .:Ls! — 7 s Q 6. D Cable tool ER'Rolory 0 Driven E] Dug 13 Auger Q Jetted ❑ Bored 0 Other: w tg 7. UBE:)Q Domestic E) Public Supply 0 Industry Irrigation O Recharge O Commerical (P r Test Well Other: _ S. CASING: E) Threaded_ Welded diam. d_In, to-2j�tt. Depth Weight /7 tbs./ it. dlom,__In. to_ ft. Depth Stickup ft. 9. FINISH OF WELL tp fir Type _ Diameter: slot/Mesh Size: _ Length: Set between ft. and ft. Backfllling Gravel pack MUNICIPALI OF ANCH RAAGE DEPT. 5F HEAtTill k ENVIRONMENTAL PROT TION 10. STATIC WATER LEVEL: -f-1'/7avft. %0 /U — Above or RBalow/land surface FQC— Date Equipment used: — (p' I I . PUMPING LEVEL below land surface and YIELD �py 11, offer� hn. _ Pumping q.p.m. ft. after hrs. pumping g.p.m. 12.GROUTING Well Groulsd: Yee X No Material: ❑ Neat Cement C] Other: 13, PUMP: (If available) HP Length of Drop Pipe ft. capacity g.P. M. Q Subm. O Jet O Centrifical ❑ Other 14. REMARKS: 16. WATER WELL CONTRACTORS CERTIFICATION: — 15. Wafer Temperature ._._a F C Thishis well was untltr jefisdIclion end this report Is True to the Ab s1 of �y knowledge and belief; Re istered Business frorn, Contract Llc nee Number Address: / s r Signed: ,OF Dole: Authorized Repyrsentallve � 0 MUNICIPALITY OF ANCHORAGE ® �\ DEPARTMENT OF I IEAI_TH & ENV] RONMEN'rA!- PROTECTION ENVIRONMENTAL ENGINEE13ING DIVISION 825 L. Street - Anchorage, Alaska 99501 Telephone 264-4720 \` ON-SITE SEWAGE DISPOSAL SYSTEM ANI;/OR WEI_.I_ INSPECTION REPORT NAME - _ PFIOf�,C �_^ TODNEW UPG AR D� _ .G�l.S---�L�„�------. _ ------ ----- -- MAILING ADDRESS 3 enc 7:z LEGAL DESCRIPTION LOCATION / NO. OF BEDROOMS Well I Absorption area Dwelling cf DISTANCE TO: �0 _�©—� �� _ Y _ — _._ PERMIT NO. ©/ s� (77 I I_ 2 Manufacturer Material No. of compartments N~ Liq. cap city-i3gal ons l 79' �IF HOMEMADE: Inside len th g — Width Liquid depth Y' mQ DISTANCE TO: Well Dwelling Manufacturer - Material PERMIT NO. Liquid capacity m gallons O WS J u. z DISTANCE TO: Well U� f Foundation r Nearest lot line No. of lines Length Itf ea h 1"r}e Total length of lines/ Trench PERMIT NO. [ Distance between lines ♦• cc �� Inches �� F LWr __- ___2� _ Top of file to finish grade t Material beneath file Total effective /absorpti�o'�are W Length Width Depth PERMIT NO. Q H aFL Type of crib Crib diameter Crib depth Total effective absorption area N LU DISTANCE TO: Well Building foundation Nearest lot line UjJ Class I — DISTANCE TO: Depth Building foundation Driller Sewer line Distance to lot line PERMIT NO, Septic tank Absorption area(s) OTHER PIPE MATERIALS / r I SOIL TEST RATING ? e i? ! �✓L�i� I ` e _ INSTALLER, 7 REMARKS __4p�mr_ PA ° &`? 3 d ae -- -- •� ° - — TO /q G I _ I l_ APPROVED ATE i.L I %l P. -H 6'4 1 C-`: 1 0 '--1 L_ 1 -11'" %-" F:" Fr "i 11%,q F -1 f-1 IF n C'n E:*-'.' !TVI E r D E PA R -,IT i HIEALTH AND P. -Il...' I FPOr,INEkI'fFiL I- I ON :TREET.. ANCI-IORAGFE., FIK 99501 CE, "_E_ E--'-': P-4 E7E Fp`. U FN­:-m F"! F:1 U." ff R`::*,,, 1-Z F"'.111 1 PERMIT NCI. A )e:e,, -21 A t A P P L I C A NT DEr.-Ill S HEBERT 01P SRA 1'�; L0 C": FIT' I 0 N Cj M F"I L. L E Y AREA LEGAL L.T. -4 BLF-l". 6' GREUILAND LOT SIZ.E 2C1000 '�'.',C!UARE f: E . TYPE CiF ABSuRPTIC"r.-I -.-;Y,.TEtl I,--;: TRENC>1 h - MLI M I`IUMBE-R OF' BEDF,Cif"IMS 4 S01 RAT IV -46 FT,-'BR':l= , "I"HE REOLUREE) SIZE OF THE SOIL AB,.:7,OF,PTl0r--1 c-:YSTf­.,M IS: C -n k -E. I. -I _IL.. ­::� I_.. F.=: I%g Tr -1—'d E-3 Cj F='s No Er-N_._CH -I- F -I --7. - 'THE L.EhIl.-I'TH DIMEtISION .15 THE LENGTH C.Irl f"F.YF? OF 'THE TRENCH OR 1:1RAINFIE'Ll.). THE DEPTH OF A TRENC'M OR PIT is THE DISTANCIZ BETWEEN THE Sl-.Ir-.,FAI.-.:E OF THE GROLIhID AND THE BOTTOF1 OF THE EXCW,-'AT11*_lr-4 (IN FEET'). 'I HERl-,*: IS NO 'SE'T WIDTH FOR TRENCHES. THE GR.AV EL. [.'.,jEPTF.l 15 THE' MINIMUM DEPTH OF GRA' -.-'Et_ BETHEU-1 THE OLITFALL. PIPE AND THE BC)TTOM OF THE EXCAwATION CIN FEET). ME.FlITT F-PPLICAY-4T FIR ', THE RESPCjNS1F.;ILITY TO INFORM THI' I.)EPARTMENT E.A.)RNE IG TH INSPECTIC.INS OF At -Vi -I WELU.�..: ACIJACENT TO THIS PROF'ERP-r' AND - rFIE NUMBER CIF THAT THE WELL. WILL. '_-;ER'yE. F:AC:l­l'F I Ll ... INi"i OF' ANY S',r'STEVJ WITHOUT FINAL. INSPEC-l"101'.1 AND F_IPPRO%-AL. B`r' THIS DEPARTMENT WILL BE St.,IBJEC:T TO PFTISECUTICIN. PlIkIll"MI'l DISTAr.IF:E BETWEEN A kIELL, AND ANY Or,i­sim E;BIAGE 'E"'T'S."'TE-11 IS lM*,'.i FEET FOR FI PPIII,JATE WELL OR 1r -5(l TO 20CI FEET F.'ROM F) PUBLIC: WELL UPCIN TFIE TYPE OF PUBLIC WELL. P-11.1`11.1"ILIM DISTAI`-IC:E F-RCill A F'RIVATE WELL TO A PRIVATE "E'A"EVIEF, L.lr,IE 15 ;-25 FEET AND TO FI COMMU!'41TY SEI,.IER LINE IS FEE'T. C.ITHER REC!(.l:[ REHE-1`11"S MAY FIPPLY. AND MISTRUC:71ON W.JAILABLE: "I"Cl PROPEF" INSTALLATION. C -n EE #:::�- L`E. Pl 9E."FE.Fi?L. I CEF: TIP,,' THAT 'L: FT -T I AM FAIIILIAR IdUld THE RIEC.0-11REMENTS FTR Or..] -.SITE SEWERS AND IdELLS SE.. FY THE I'll-INIFIPALIT'iF' -I i-ANCFICiRFji3F-. THE IN FICCCRDFINCE WITH THE CODES. [.j Ij.. I r.,J S 1' 171 L L 3 I THAT THE OP -1-S. I TE EU.-IIER YSTEM M19Y REQUIRE ErILARGEMP-4-l" -IF THE RES IDEENC'E. 1'-.; REMODELED TO IrICLUDE IlORE TF -IAN 4 BEDRC)OMS,, ,,,,g 76 67 7NAlk 1-; 1 G N E ', itv'7414�1 alvt� of 13' _DJU'D Bi . . ..... GP"-*ATER ANCHORAGE AREA BORO"aH HEALTH DEPARTMENT N? 431 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM f� f%MAILING57,,0 NAME_ CRL7 x// ?� ADDRESS >" PHONE- LOCATION,'/ HONE I1 �j 1 LOCATION � �✓IhCI?!�i `J �� �'"� , LEGAL DESCRIPTION / �� C1, }•,/iTpe , w SEPTIC TANK: / DISTANCE FROM WELL=(_l MATERIAL `UaiC d / NUMBER OF C? �q<L l —COMPARTMENTS LIQUID LIQUID CAPACITY / C'C_�« GALLONS. INSIDE LENGTH ���e ��INSIDEZ�fDTH LIQUID SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF L S ABSORP ON AREA _OUTSIDE DIAMETER OR WIDTH Z / LENGTH / DEPTH--, . DISTANCE FROM WELL__, BUILDING FOUNDATION r q c �Q TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)_ L7 SQ. FT. FOUNDAT BETWEEN LINES SO. FT. LENGTH OF EACH LINE NEAREST LOT LI WIDTH TOTAL LENGTH OF LINES AL EFFEC DEPTH: TOP OF TILE TO FINISH GRADE /// DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPE It,'f QG c/,, I//DH �4� DISTANCE FROM WATER BUILDING FOUNDATION. SAMPLE_ , NEAREST / NEAREST SEPTIC/ SEEPAGE OTHER LOT LINE _ SEWER LINE—, TANKG> SYSTEM , CESSPOOL SOURCE._ DIAGRAM OF SYSTEM DISTANCES: // �J� `10' C4 _'/co 11 _5t /'/"o I� I/qe- DATE �/! CG t_, / C 'l /( / A HEALTH w I p cAAB-nn G[�EA.TE1 ANCHORAGE AREA (ROUGH Case No.��`ia 1IEALTII DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 �( SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT G`� – �_�L�— MAILING ADDRESS& ! �`I PHONE NO.--- RESIDENCE ADDRESS se LOCATION OF INSTALLATION �' kltnC 0' _ /��`��i%�� LEGAL DESCRIPTION- d / ��(%/���� ���� 1� (t' SSI 6 e APPLICATION TO INSTALL: SEPTIC TANK SEEPAGE PIT__/, DRAIN FIELD / _, OTHER_ TO SERVE THE FOLLOWING FACILITY ���d��'-Dv✓i �� �: �� /�/cS C' FINANCED THROUGH TO BE INSTALLED Cr _ PERCOLATION TEST RESULTS SC%/��S ANTICIPATED DATE OF COMPLETIO 2 BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT 4c? .-,'P i�r� I / Y> f�� o>1 THIS IS TO SERVE AS ✓ )v'j�"L S PERMIT- TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED °���✓ �1 `Io SEPTIC TANK SIZE / 2 IYPESEEPAGE AREA v TYPE �/ / DIAGRAM OF SYSTEM ( r r t t%/�YGi 1T /�C� /_TT 6- 1STANCES: 0/ T6 Cr' 7`v 6 C' EL HEALTH AUTHORITY OR LICENSED DESIGNER I certify that I am familiar with the requirements of Greater �jecho age Al 'I Bor ugh O dinance o.S28-68 an that he above described system is in accordance with said code. �j,��C�" %JG>l/ / � APPLICANTS SIGNATURE ���i l•T �. /ti.i :.'1 ilii(`, /. �. t... [� .ii'.` �'erYcrn;F;j For Donald Dahl rmed� 5/4/71 's ... Greenland i1e,:rb ,.�•• •b,T._ ...�_„�._. �,.. erc-;i.: t � o. Tes • .. ,....,,.,��_.�..�., 2 brown gravelly silt (Mq)' 4 } gray sandy sil q) 1! w/few scattered gravel ! 6 3' to 9' w/silty sand seam 6' to 7' 10 12 14 no 0 Cin r,T �. :.re Depthiet Drop .. 4::.fAtlCtun !<cIt!` Tff �...�..�.a.. "."'�vr•..�._�...<...,,-..�-... _�._,. -.. .r-„��:�--,m a�z._.. -.r�.. 1M x et-,--�y:,�Y _ rt 27-�..��... 0 ua e fe t >... ,. n �3hfi+ _�,....�.�, .,�,.. of drainage,area is re uired `�""•�"".��,.�.a�- - z.=bedroom Test Performed x?wTeSlz4g.Sv2c� Thes I recommendations are computed ` from C`T 3,r: visual observations R. E. Carlisle n„ ,•1, �,r, and baec>_d MUNICIPALITY OF ANCHORAGE • -- Department of Health & Human Services M DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel l.D.# �t1�-�1�-c� HAA #..—�is'�C)�41L�� 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) i. 0 f `[� 13 (c c (- -, Gee e17 (a no{ S /-p Location (address or directions) O C 113 1" (b) Property owner /-{ug'J O1 '7�y[r�il/ l y c% Telephone : (home) — Business 5 62 -I2 2 Mailing Address cQ 14Cr',� e Rea/ c—slok' 3230 C "S ion c% /4 h 995'03 (c) Lending Institution OMP70n Cx-ea(�1-torTelephone 2-76 Mailing Address 33 33 !J e',Rl r f}i,c/jorvl AP- 9'5s`o3 (d) Real Estate Company and Agent k4er/3Qzl F__s%le — /�e�er Jarraff Address 3 �O C Sf A-7 cha�cr�/P Telephone _5-62 — f222 (e) Mail the HAA to the following address: (or check here 9, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family rZ Number of bedrooms 3. WATER SUPPLY Individual Well L$ 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 0 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 Z to Z abed NOVO (99/L nab) SZo-&L '�jom s,aaaui6ua leuolssaload alj ui suolssiwo ao saoaja Aol alglsuodsai jou si abeaogouy to Aj!ledlolunw all •panssi si aleoilllaao a eAolaq elep ozAleue ao suoiloodsui jonpuoo lou op SHHO to saa (oldw3 •sluawaiinbei alels pue leaapol uieliao Alsiles olaapao ui suollnl!psu! 6ulpuol Alagl pue sawol to sieseloand of Asalanoo a se Slll saop SHHO aql Te SUIy to alelS all ul paaalsibei jeoui6ue leuolssajoid luepuedepui ue Aq anoge 9 ydeibuied ul uanlb suoileluesaidaa agj uodn Aluo paseq paleolluao lenoaddV A;!joglny gjleaH sonssi (SHHO) saolAaaS uewnH pue glleaH to luawlaeda4 abeaogouylo Al!ledlolunw all . NoijLnv0 lenoiddy leuoll!puo0 jo swaal leuoljlpuo0 panoaddesiQ panoaddy i algia � v(q swooapaq �>h-n-/aol panoaddy lVAOHddV SHHO '9 •� �¢.��e�ssa,o�d� � �► Moovi .i 3a0ao3Hi'• tl leag s,aaau16u3 �................. ,����p ..ri......yd �� • �y^.. ° �Q ®®© >v �fl 8 61 G 2 n ON ale(] 1566 �I{z' d r��oy�uy f� oy�� O Shl ssaappb' auoldalal Jo>>n d3S / 4.2 u y )�1 off bl wild to aweN -uoiloodsui slgl to alep aqj uo loalle ui suoljelnbei pue 'seoueuipao 'sopoo ajejS pue ledlolunW lle yl!M eouelldwoo ui si wags (s lesodslp aalemolsem ao/pue Alddns aalem alis-uo all 'uoiloodsui pue uolle611sanul Aw woal pue sold o6eaogouy to !l!ledlolunV� all woal poulelgo uollewaolui aql uo paseq jell Allaan aaljanl ! •ulaaal paleolpul einjonjjs to ad/j pue swooapaq to aagwnu all aol olenbope pue leuollounl 'ales sl wajsAs lesodslp aalumalsern ao/pue Alddns aalum alts-uo agj jegj smogs lenoaddy Allaoglny glleaH slgj to uollebllsanul AW jell Aj!aaA ! 'Molaq unnogs alep uolleplleA all to se pue ojaaal poxllle leas (w (q paipliao sy NOIIVWHOdNI ONV V1V0 `HOHV3S 3-113 `S1S31 `SNO1103dSNl JNIOIAOHd Wald ONIH33NION3 '9 MUNICIPALITY OF ANCHORAGE (MOA) •,, Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 �4 343-4744 Legal Description: —Jno /o C /T f ` ' ld k f ' 6:rec2nlcxno( /D A. WELL DATA Well Classification ('� vcpcf-2 If A, B, C, D.E.C. Approved (Y/N) A1,4, Well Log Present (Y/N) Y —Date Completed L_4 /I/ / 69'5'V_Yielpor;, Total Depth'71,,;- Cased to /-SS Depth of Grouting N,4, Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) aort r SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot /Os' Pump Set At _G[n G Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots i (00 ' To Nearest Edge of Absorption Field on Lot / 20 ; On Adjoining Lots _5 roe To Nearest Public Sewer Line Nr A. To Nearest Public Sewer Cleanout/Manhole Nr A. To Nearest Sewer Service Line on Lot 2s r Water Sample Collected by e On/fino ; Date /I S"/'q9 Water Sample Test Results Z(00'r'e 0•5'6-7/-Q Comments Pilyvracc, welL a6an�on�oC 6, err/��� _ wry ro/9ere1-e erRe;'e ru�¢r„6 0JCf h,elmw L?arCzrxe__ A210r- 1-e�e/ B. SEPTIC/HOLDING TANK DATA Date Installed /i / 2�Size (--00,%q( No. of Compartments ? Standpipes (Y/N) Y —Air -tight Caps (Y/N) r Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) N Date Last Pumped — N, /9 - ( nec-0 Pumping/Maintenance Contact on File (Y/N) Allh. ;for Holding Tank High -Water Alarm (Y/N) Al, 4. Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well /DS' To Building Foundation To Property Line / `/� To Disposal Field To Water Main/Service Line > 2S To Stream, Pond, Lake or Major Drainage Course '7_> e ' Comments _ 72-026 (Rev. 7/88) Front Page 1 of 2 N 4. All d. C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / ZS i3'A60rn r4/t Type of System Design 6e� Date Installed I f / 2 2 / 89 Length of Field y3 Width of Field !y Depth of Field !, d Gravel Bed Thickness O•s Square Feet of Absortion Area i9 / Statndpipes Present (Y/N) Y (2 mon1/or Aube_, Depression over Field (Y/N) N Date of Last Adequacy Test P1 1A, (/IewJ Results of Last Adequacy Test N. 4 (n�W� SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well 120, To Property Line 1 To Building Foundation '211 To Existing or Abandoned System on c! 0-koe, 0-e-( �> Lot �c�C(a�enf f,�f� On Adjoining Lots — 3G ' To Water Main/Service Line ? ZS ' To Cutback (if present) 1%A . To Stream, Pond, Lake, or Major Drainage Course >. roQ ' To Driveway, Parking Area, or Vehicle Storage Area 6'6 Comments D. LIFT STATION Date Installed !I / -2 ®9 Dimensions 2/10'( Co.nWf 01 iS�Dgai ST. Size in Gallons -5-0b a( Manhole/Access (Y/N) Y "Pump On" Level at Co moor (off W Z" "Pump Off' Level at cc F'e (2 W Z " High Water Alarm Level at Coma @ 1Y& If Vent (Y/N) Tested for N A. ( A eW ) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) r Comments Alec IAs1a// ahoy 6y G. � H elcl-r c **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guid igreffect on the date of this inspection. ov IT A Signed Company f=(ccf/b %chncnc/ Serv.0 alb ! Ts-�; •°e'' r 'J — C oEngineer's Seal Date !!/ 2 7/ �y °r®°tt.°.°°°..°..°.°......� MOA No. ®9 - 0.5" 2 4� , THEODORE F. WO ; y r� c,: -j-589 ,•' 0 e3 a N 0,professi. Receipt No. Receipt No. Receipt Date of Payment Waiver Fee: $ Amount: $ f Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE Department of Health &Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # 0/3—/7/ 2 1/ HAA # t�22 — C) L_� i 1 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) t4to 4 © EF, 11� (b) Property owner � iL e- S Telephone : (home) - s' ,Business _ Mailing Address 4: (c) Lending Institution L.T,AeIA Telephone Mailing Address (d) Real Estate Company and Agent Address "7 A_.- N* V " Telephone (e) Mail the HAA to the following address: (or check here Xif hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family 3. WATER SUPPLY Number of bedrooms erg 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 Public ❑ Community ❑ Holding Tank ❑ Note: f 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 Z }o z aged H0e9 (89/L'nay) SZO ZL -NioM s,jeauibue Ieuolssa}oad agj ul suoissiwo ao saoaaa ao} alq!suodsaa jou si abeaogouy }o Aj!ledlolunVd ag j'panssl si aleol}ljaao e aao}aq elep azAleue ao suoijoadsui jonpuoo jou op SHHa }o saaAoldw3 'sluawaalnbaa ajejs pue Ieaapa} ulejaao A}s!jes of aapao ul suollnjljsul 6ulpual alagl pue sawog }o saasegoand of Asajanoo e se slgl saop SHHa egl 'eiIsely }o ajejS agl ul paaajslgaa aaaulbue Ieuolssa}oad luepuadepul ue Aq anoge g ydea6eaed ui uanlg suoijejuasaidaa ayj uodn Aluo paseq pajeoi}laao Ienoaddy Allaogjny gjleaH sanssi (SHHa) saalnaaS uewnH pue glleaH jo juawlieda4 ageaogouy joA;!IedlolunVj ag1 - .�NAl1fJf/O Ienoaddy IeuoIl!PuoO }o swial Ieuoll!puo0 panoaddeslQpanoaddy ale Aq swooapeq--T—AO} panoaddy ( } IVAOadd'd SHHa '9 IeaS s,aaaul6u3 r' % ssaippy J _ C auogdalal (ua!d }o awaN •uoljoodsul slgj }o ajep agj�ape ul suoljelnEw pue 'saoueulpio'sapoo ajejS pue ledlolunw Ile gjIm aouelldwoo ul si wejsAs Iesodslp aajeMalseM Jo/pue Alddns aajeM al!s-uo agj 'uoljoadsul PUL, uo!jeg!lsanul Aw woe} pue sej!} ageaogouy }o Aj!IedlolunVj agj woe} paulelgo uoljumo}ul agj uo paseq jegj A}laan aaiI I -ulajag pajeolpul ainjonajs }o adAj pue swooapoq }o aagwnu agj ao} alenbape pue Ieuoljoun} 'ejus sl welsAs Iesodslp aaleMajseM jo/pue Alddns aalum ells-uo agj jegj sMogs Ienoiddy Al!aogln`d glIeaH slgl }o uoIjegljsanul Ata jegj A}laan I 'mo Iaq uMogs ajep uo!JIB p!IBA agj }o se pue ojaaag pail}}e Ieas Aw Aq pal}ljaao sy NOIIVYY80dNI (INV `dlda `HOUV3S 3"11d `S1S31'SN0003dSN1 JNIaIAOHd UY81J ON1833NION3 '9 MUNICIPF4e, "qNCHORAGE (MOA) H altff 17,otAority Approval (MAA) • +� \�PX��o LKLIST - FEBRUARY 1984 043 -4744 Legal �CDescri�pt�io'n: 1 I � t V. � ���� GA�1�11� A. WELL DATA, Well Classification 1 If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) �L_ Date Completed I q I + _ Yield� � A Wt Total Depth�Cased to7S7 Depth of Grouting hi g- Static Water Level 7' 6 Pump Set At G Tro Casing Height Above Ground Sanitary Seal on Casing (Y/N) — Electrical Wiring in Conduit (Y/N) S/ Depression Around Wellhead (Y/N) t�_ SEPARATION DISTANCES FROM WELL: To Septic/14&� Tank on Lot '-?b i I 10 ; On Adjoining Lots '> /0'0 To Nearest Edge of Absorption Field on Lot — _ _I ; On Adjoining Lots _ _ >/ 0-0 To Nearest Public Sewer Line . N& To Nearest Public Sewer Cleanout/Manhole ty/A To Nearest Sewer Service Line on Lot > I D Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/ TANK DATA Date — q x.7.9, M( Date Installed -1-9-V A,6 9U -Size io00k$'VVNo. of Compartments —/ --k / Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cle/anZee, (Y/N) 10 Depression over Tank (Y/N) �7 Date Last Pumped _ 7/ !y L AOLCte. Pumping/Maintenance Contact on File (Y/N) Y�A ; for bVA Holding Tank High -Water Alarm (Y/N) WA Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HTANK: To Water -Supply Well To Building Foundation _ To Property Line h To Disposal Field © To Water Main/Service Line �7 1 To Stream, Pond, Lake or Major Drainage Course. Comments 72-026 (Rev. 7/881 Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorpt'on Strata 76 Type of System Design Date Installed %�� �e Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absortion Area i % (o Statndpipes Present (Y/N) Depression over Field (Y/N) Date of Last Adequacy Test 9h Yhor Results of Last Adequacy Test OtJLh Fw e rco ✓ ✓ 79,,e®, e&a+M.A SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well ! P. To Property Line 4; To Building Foundation To Existing or Abandoned System on Lot iO - ; On Adjoining Lots 9 6; 0 / To Water Main/Service Line �✓ To Cutback (if present) N/A - To Stream, Pond, Lake, or Major Drainage Course - To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed . Size in Gallons N0PIC—: "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments °- Dimensions Manhole/Access (Y/N) '"Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. 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 �e�iG�, ��� Engineer's Seal °. Date ° ° ; `^ MOA No. ? 5 [:: =,.'' 2_ Receipt No. 6 Receipt No. y Date of Payment Waiver Fee: $ Amount: $ Z-7 ©✓ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 GOAo �0nA C) (j 4(�nQ _ V 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS 1. TIME TIME TIME SINGLE FAMILY ❑ One Four ❑ Other _ C1 fY\ DATE DATE - DATE 7. WATEJt SUPPLY tt I INSPECTOR INSPECTOR - -�� INSPECTOR - P ❑ PUBLIC UTILITY MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE _ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH .-& - 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL P11O TLCTION • ENVIRONMENTAL SANITATION DIVISION MAY 2 11,98) Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW E��tGE! i " D DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. P ERTY OWNER j ,,1 PHON c. k `� 4 LSI r1�. .1� 7 _ _Rf MAILD/�KESS v � f`r h PROPERTY RESIDENT (If dferent from abo ) _ —� PHONE 2. BUYER PHONE MAILING ADDRESS - - - 3. LEN G �IMSTITUTIO ONE GADDRE� MAIL (/ C owl 4. RE ALT R/AG N PHONE GOAo �0nA C) (j 4(�nQ _ V 5. LEGAL DESCRIPTION STR' ETLOCATION C� - - - 6. TYPE OF RESIDENCE NUMBER OF,BEDRO MS SINGLE FAMILY ❑ One Four ❑ Other _ ._ ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATEJt SUPPLY !k{� INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAZDISPOSAL SYSTEM INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) C470 THIO SRIF Fr)R r)PrirnAi Imp nNl V 70-nin IRn.• R/701 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED z _ INSTALLER ❑Septic Tank or ❑Holding Tank Size: / C70 « If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL (` C I , 0o 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS d4 ---APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 70-nin IRn.• R/701 MUNICIPALITY OF ANCHORAGE DEPARTME` OF HEALTH AND ENVIRONMEN PROTECTION 825 L Street; Anchorage, Ala ...a 99501 �. 279--2511, ext. 7.24 or 225 Daae Received: May 2, 1977 #1.: Time #2: Time #3 Time - Date 5-2-77 Monday Date Date Insp Pratt Insp Insp �- REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: First Federal Savings and Loan Mailing Address: Box 4-2200 99509-----.— u_ Phone: _274-6561 2. Property Owner: Dennis L./Carol D. Hebert Phone: 344-5827 Mailing Address: Star Route A Box 1721 -99507 3. Legal Description: Lot 4 Block 6 Greenland Subdivision 4: Single Family Residence: (x) Number of Bedrooms: "3��_ Multiple Family Residence: ( ) Number. of Bedrooms: _ 5. Well System: Individual Well (x) Cormunity/Public System ( ) Permit # Depth of Well 75' Well Log on File ( ) Construction Bacterial Analysis 6. Sewage Disposal System: On-site System ( Public Utility ( ) Permit # Installed 1971 Installer Septic Tank Size _ Manufacturer Absorption Area Soils Rate Material- 7. aterial 7. Dist.ances: Well to Septic Tank to Sewer Line Nearest Lot line to Nearest Lot Line to Absorption Area Absorption Area A/aT R 541E !IJHIrl PAurr t. MUNICIPALITY Of: ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 I REQUEST FOR APPROVAL OF i g f1J y� INDIVIDUAL SEWER and VVATER FACILITIES 'I. Type of Inspection: CMRO VA FHA CONV XX� 2. Property Owner: Dennis L. and Carol D. Hebert Mailing Address: SRA Box 1721, Anchorage, Alaska Day Phone 344-5827 S. Name of Buyer: ,__ Same as above Mailing Address: Day Phone 4. Name of Lending Institution: First Federal Savings and Loans _� Mailing Address: v_ — Box 4-2200,_ Anchorage 99509 Phone 274-6561 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: Location: Greenland Sub. Blk. 6 Lt 4 116th Street Anchorage, Alaska Phone 7. Type of Facility to be inspected: Single Family _ No. Bdrms. 3 3. Water Supply Type of Supply: Public Utility Individual 75 foot well If Individual, number of dwellings presently served one If Individual, depth of well 75 feet _ 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) XX If Individual, date of installation _ May 1971 We would like a purification test and a measurement of distance from the well to the septic tank. Any comments on the seepage, if any, will be app ec. ted. We are not requiring an adequacy test. EQ -037 (1/74) ohn Ekemo Mortgage L oan Dept. First Federal Saying & Loans Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: _ Lot 4 Block 6 Greenland Subdivision Comments: Affadavit Attached: (') Letter Attached: Approved: Date: Disapproved: Date: Department Worksheet: First National .'aaak of nciiurti<le Mortgago Yaoiii sect-kon POSt t)ffiCe 330,c A--2200 Anchoragoe ,ii,:laa ka 93509 Smb jact. T40t 4 Block G Griaon3.and Smbdiviuiwx The tviater analysis for f;lie� rtuh f eet: axc�c��w��ty � �Eat� r�J'ac:tr�ry. The protcaction radius betweeki well wid s awe:: system meet the d apartment° N approval. r.�iae: vl 1, Ccinstruction 1k;satisfactbbry. rJOblefoe isn't ally evidence of surface sewage ovorf7ow. Th i g is not a Idull c`:cimp reaho n s ivea a,pprov_il, of tlk _ nubs e ct Property. If Lucre: aremuly further (iutistions, ploaae. c:caaita.c-t tlii. office at 279-251.1, extejiirion 224 or 225, Sincerely, .icil;aert C. Pratt, T,.S. Sanitarian ACV/1J11 Star Route A 'Dox 1723 Axxchorage, AlasWt t 99507