HomeMy WebLinkAboutGROLL BLK 2 LT 4&roll Block 2 Lot 4 #050-521-34 UBMrrTA Inspection Report_1-ITd6c Municipality of Anchorage VAUG 2 2 1 1 Community Development Department of 4 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: OSP121216 PID Number: 050-521-34 ❑ New ❑� Upgrade Name: Ronald and Linda Babb ABSORPTION FIELD Q Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 25460 Eagle River Road ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.6GPD/SF 7.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.0 Ft. I Gravel depth beneath pipe 5•OFt. Subdivision Block Lot Groll 2 4 Fill added above original grade 0.5 Ft. Gravel length 80 Ft. Township Range Section Gravel width 3.01FL Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 800 Fe 2 13.OFt. well 115.6 134.9 N/A N/A 109.6 TANK+❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 1000Gal. Surface water 100+ 100+ N/A N/A Material Steel Number of compartments 2 Lot Line 46.8 32.5 N/A N/A NA Foundation 7.1 32.7 N/A N/A LIFT STATION Manufacturer N/A Capacity Gal. Curtain Drain N/A N/A N/A N/A Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank PVC dminfield Tank to PVC Installer Flintstone Enterprises Drainfield PVC CO/MT PVC Inspector Steven R. Pannone BENCHMARK (Assumed elevation) 100.0ft Inspection,r dates: f 8/8/2012 2w 8/8/20112 Location and description 3" 8/9/2012 4'" 8/9/2012 Top of FCO COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp w Conditional Approval: Date" Pteven .. `�'annorae all Aw Approved Date Inspection Report_1-ITd6c M �M WSW W W__�Vd / 2B SEPTIC AREA v /� (E) 4� / WELL (E) / 1000g SEPTIC TANK (E) �y�° HOUSE F9 TO REMAIN (E) DRIVEWAY 134.9 p 3 C2Z DV M q M FS M1 41 - I \w 1A C4 ci \ 4� �W_� \ /TH-1 ss •0 NEW DRAIN FIELD ti+ �o�' (2EA) 40LFx3.0'Wx5.0'EDx7.0'TD' ,•'. \INSTALLED DIVERTER VALVE AND DRAIN FIELD (E)r{43 FLOW SPLITTER` REUSE AS RESERVE --., .� `� a x,`�' yy LIKELY PATH OF EFFLUENT PLUME j FROM END OF FIELD. 257 (HORIZONTALLY) FROM PERPENDICULAR TO FIELD �S• NOTES: ate PANNODNE7 ENG SVC, AK 99L"sL10C .. `�°F Acgst�� 08/,4/,2 RECORD DRAWING PHONE (907) 272-8218 FAX (907) 272-8211 io,•:' y ' P • '•� �`` Scale ....... . .. .:.. P.I.D. NO GROLL, BLOCK 2, LOT 4 .050-521-34 RONALD & LINDA BABB Steven fi. Pannone PERMIT NO. 25460 EAGLE RIVER ROAD �j� �•. CE 8149. moi OSP121216 PLAN EAGLE RIVER, AK 99577 1� AEP•••• .. Sheet 2 OF 3 A B DV 29.0 35.2 FS 31.0 37.8 C1 35.5 50.3 mi 34.6 49.0 C2 46.0 38.3 M2 44.1 37.7 C3 51.1 63.3 M3 51.5 63.4 C4 61.3 56.8 M4 60.4 56.4 WELL (E) / 1000g SEPTIC TANK (E) �y�° HOUSE F9 TO REMAIN (E) DRIVEWAY 134.9 p 3 C2Z DV M q M FS M1 41 - I \w 1A C4 ci \ 4� �W_� \ /TH-1 ss •0 NEW DRAIN FIELD ti+ �o�' (2EA) 40LFx3.0'Wx5.0'EDx7.0'TD' ,•'. \INSTALLED DIVERTER VALVE AND DRAIN FIELD (E)r{43 FLOW SPLITTER` REUSE AS RESERVE --., .� `� a x,`�' yy LIKELY PATH OF EFFLUENT PLUME j FROM END OF FIELD. 257 (HORIZONTALLY) FROM PERPENDICULAR TO FIELD �S• NOTES: ate PANNODNE7 ENG SVC, AK 99L"sL10C .. `�°F Acgst�� 08/,4/,2 RECORD DRAWING PHONE (907) 272-8218 FAX (907) 272-8211 io,•:' y ' P • '•� �`` Scale ....... . .. .:.. P.I.D. NO GROLL, BLOCK 2, LOT 4 .050-521-34 RONALD & LINDA BABB Steven fi. Pannone PERMIT NO. 25460 EAGLE RIVER ROAD �j� �•. CE 8149. moi OSP121216 PLAN EAGLE RIVER, AK 99577 1� AEP•••• .. Sheet 2 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALLED NEW SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS NOT OBSERVED TO A DEPTH OF 13.0' AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 13.0 FEET BELOW EXISTING GRADE. RIGID INSULATION �FILTER FABRIC 4" 0 DRAIN PIPE ORAIN ROCK V ABOVE PIPE INV m_Z 89.0(S) OR 0.6 -Yyik -86.5(5) GM UN ROCK SM -81.5(5) 3.0-1 -13-0 __.. 77.6 SECTION 0 o _ 8 B� _ 5 ? Rlcn o z FIL 1000g SEPTIC TANK (E) DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1000g (E) PERC RATE = 3.8 MPI SOIL RATING: 0.6 GPD/SF AREA ROD: 750 SF SYS. TYPE: DEEP TRENCH 5.0' E.D. MIN LENGTH: 75 LF PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC USED: (2EA) 40LF X 3.0' WIDE, 5.0' E.D., 7.0' TD TOTAL AREA: 800.0 SF TRENCH SEE DESIGN ABBREVIATIONS CU m DIP DUCTILE IRON PIPE INSULATION $ ER FABRIC O z T# TANK CLEAN OUT NO. AIN ROCK 6' ABOVE PIPE INV i ' B DRAIN PIPE In In TRENCH SEE DESIGN ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 � pI ACgi�\\ i .S ( �o� �.... .. ..:.. / ......05Steven0-521-34 Panno a �, CE 8149 % +�"••••� �l\�"=�' Date 8/14/12 RECORD DRAWING scale NTS P.I.D. NO 050-521-34 PERMIT NO. OSP121216 GROLL, BLOCK 2, LOT 4 RONALD RONALD &LINDA BABB 25460 EAGLE RIVER ROADj+gs•,�i EAGLE RIVER, AK 99577 DESIGN DETAILS Sheet 3 OF 4 SITE SECTION SECTION ALONG THE UKELV PATH OF EFFLUENT PLUME FROM END OF FlELO. 25% (HORIZONTALLY) FROM PERPENDICULAR TO FIELD 4:1 INFILTRATION LINE \ SECTION A -A SECTION B -B l� NOTES: PAMONE ING SVC LLC +� Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 r c�oFA�gstl� 6/14/12 PHONE (907) 272-8218 FAX (907) 272-8211 rH �.'7 A Scale �..... .. ..... �// P.I.D. NO GROLL, BLOCK 2, LOT 4 Y 050-521-34 teven fi. Pannone RONALD &LINDA BABB / PERMIT No. 25460 EAGLE RIVER ROAD �+ 4 CE 8149 � OSP121216 SITE SECTION EAGLE RIVER, AK 99577 `�l �o s.... Sheet 4 OF 4 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: OSP121216 Tax Code Number: 05052134000 Work Type: Septic Upgrade Permit Effective Dates: August 03, 2012 to August 03, 2013 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: GROLL Site Legal Address: GROLL BLK 2 LT 4G:0263 Owner/Address: BABB RONALD ANSWORTH & LINDA K REVOCABLE TRUSTS BABB R A & L K 26460 EAGLE RIVER ROAD ANCHORAGE AK 9957796! Site Mailing Address: 25460 EAGLE RIVER RD, Eagle River Lot Size in Sq Ft: 88633 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: A cross section drawing of the drainfields and steepest slope within 50 feet down gradient of the drainfields shall be submitted with the final inspection report. Received E Issued By: Community Development Department I Development Services Division On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D.0 S-0- 92 1— 3L/ Property owner(s) RwALp d C,(,VPA- ZAP,6 Day phone Mailing address ZS --?4(,p 6f}6te KILL C eo/ifl Lr441E Pavc`K �M q �� Site address C61-tt Kt✓EIC W Legal description (Sub'd., Block & Lot) 6-*90Lt- , 0>(—& Z, LoTy Legal description (Township, Range & Section) Lot Size '9%6'33 Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Initial ❑ Absorption Field & Septic Tank ❑ Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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: 45,30- Waiver Fees: Date of Payment: 0//a Receipt Number: Permit No. Date of Payment: Receipt Number: Waiver No. GABuilding\On Site\Forms\Client FormsTermit App310411.doc (Rev. 1/11) Pannone Engineering Services «c Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panenaak.com July 25, 2012 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Groll, Block 2, Lot 4 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgrade septic be issued for this property. The proposed systems will serve an existing three (3) bedroom house. Currently the lot is developed. The existing drain field is in failure and will be re -used as a reserve. The new drain field will be built just uphill from the existing field. The lot is served by a private well that is located over 100' from the new system. The surrounding lots to the north east and south are also served private wells that are located over 100' from the new system. Lot 2B to the northwest is served by a Class 'C' well on lot 2A further to the northwest, greater than 200' from this system. 1. Soils. One test hole was excavated by Pannone Engineering Services in July, 2012, and the ground water was monitored for seven days. Ground water was not found during the monitoring period. Bedrock was not encountered. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.6 gallons/day/square feet should be used for a conventional wastewater system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The drain field will be installed on an area of approximately 20%, downhill from the house. There are steep slopes on the lot, that are further than 50' from the proposed system. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments -Soils Log -Septic System Design Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 M -�M �M w� w W 2B h� �3 L SEPTIC AREA (E) pP WELL (E) / 10008 SEPTIC TANK (E) HODUSE �cC / TO REMAIN (E) DRIVEWAY F�p2 3 F OF / �j 9p 144.6 4 \ TH–W /1 w� w � o DRAIN FIELD (P) (2EA) 40LFx3.0'Wx5.0'EDx7.0'TD > INSTALL DIVERTER VALVE AND FLOW SPLITTER . ;•� °y D" DRAIN FIELD (E) y REUSE AS RESERVE \ NOTE: \ IF OLD DRAIN FIELD OR CRIB IS \ ENCOUNTERED, IT IS TO BE \ REMOVED COMPLETELY. �S -M — 44 FOR CONSTRUCTION PANNONE ENG SVC, LLC .►�'oFa���ll Date P.O. BOX 100217 ANCHORAGE, AK 99510 r �� qt4 1, PHONE (907) 272-8218 FAX (907) 272-8211 �roj�p'y++ Scale j*:49TH 1-=50' _. �:-... .. .... P.I.D. NO GROLL, BLOCK 2, LOT 4 /.,,„ / 050-521-34 RONALD & LINDA BABB teven nn I / PERMIT NO. �.�F;. CE 8149 j OSPXXXXxx 25460 EAGLE RIVER ROAD �+ �s , r PLAN EAGLE RIVER, AK 99577 ,&...• ' � Sheet `l�� OFM 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS NOT OBSERVED TO A DEPTH OF 13.0' AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 13.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 1000g SEPTIC TANK (E) DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 10009 (E) PERC RATE = 3.8 MPI SOIL RATING: 0.6 GPD/SF AREA ROD: 750 SF SYS. TYPE: DEEP TRENCH 5.0' E.D. MIN LENGTH: 75 LF USE: (2EA) 4OLF X 3.0' WIDE, TOTAL AREA: 800.0 SF 3ID INSUTATION TER FABRIC 0 DRAIN PIPE MN ROCK 6" ABOVE PIPE INV z.o T-0.5' 5.0 I.0 DRAIN ROCK I-3.0-1-10.0—}-3.0-1 61 SECTION PROFILE LEGEND —W— WATER LINE/ WELL RADIUS — SS — NEW SEPTIC 5.0' E.D., 7.0' TD TRENCH SEE DESIGN --- . e1,! CU COPPER DIP z INSULATION s ER FABRIC C z T# z AIN ROCK 6"ABOVE PIPE INV 0. M# u • 6 DRAIN PIPE n n TRENCH SEE DESIGN --- . e1,! CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NOTES: PC1L\l\OM ENG SVC, LLA. ,� 1� A \�� Date FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 r �'<<� 8 2/12 PHONE (907) 272-8218 FAX (907) 272-8211 /rg�Qyt� Scale NTS �.... .. ..... P.I.D. NO GROLL, BLOCK 2, LOT 4 / 050-521-34 RONALD & LINDA BABB �` Steven �. f�annone �PERMIT N0. 25460 EAGLE RIVER ROAD r'+��y., CE 8149 �� OSPXXXXXX DESIGN DETAILS EAGLE RIVER, AK 99577 �i,;'�``�`'`= SheetOF 3 TEST HOLE 1 SOILS LOG - PERCOLATION TEST SITE PLAN SLOPE OR ORGANICS 31313 1 HOUSE 2 (E) DRIVEWAY 3 / �Fc 4- 6—SILTY 5 8 GP/ ANDGAX GM/ AND GRAVEL L TH CIO Wim_ lN" 7 SP POORLY /TH-1- GRADED �\ 8- 9— to ,0 12 13 BOH WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 IF YES, AT WHAT TH 16 DEPTH? -DRY-' X 17 DEPTH TO WATER AFTER MONITORING? -DRY'- 18 DATE: 7/25/12 DATE PERFORMED: 7/18/12 PEROLATION RATE 3.8 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Prec hole was presoaked. Test run for at least one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: ���� FOR CONSRUCTION PANNON95 ENG SVC, LLC .� pF ACq\Sly, D8/2/12 P.O. BOX 102954 ANCHORAGE, AK 99510 „�Q• •• •;F � Scale PHONE (907) 272-8218 FAX (907) 272-8211 �* ggTH yt+�/ NTS .... .. :.. P.I.D. NO GROLL, BLOCK 2, LOT 4 050-521-34 Stevenf2. an RONALD &LINDA BABB PERMIT No. �.•. CE 8149 j OSPXXXXXX 25460 EAGLE RIVER ROAD (+ 6A SOILS LOG EAGLE RIVER, AK 99577 �1 ED'"••'•.. Sheet Pi0FFSS1 `.�, 3 OF 3 CLOCK WATER READING DATE TIME NET TIME LEVEL READING NET DROP , 7/18/12 5:10 -- 3.10 -- z 5:20 10 MIN 6.13 3.03 a 5:20 ___ 3.10 --- a 5:30 10 MIN 5.81 2.71 s 5:30 -- 3.10 -- 8 5:40 10 MIN 5.75 2.65 I� Municipality of Anchorage Page —L of !� 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: ��' L� l� �j`� C/ PID Number: _06,�—)45Z- Name: Wastewater stem: ❑ New U rade ABSORPTION FIELD No. of Brooms: �--'j, C57 peep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: e Total Depth from original gradoi C2 • GPD/Sg. Ft. ^! e Lot. Block: Subdivision. Depth to pipe bottom from original grad I:. Gravel depth beneath pipe t1• 21 Ft. , Ft. _ Township. Range: Section: Fill added above original grade:f f— Gravel length. ®® 2 Ft. ..� Ft. WELL: ❑ New O Upgrade Gravel width� 2 Number of lines: tiistance betweer)nes ' ) FL Ft. ,Gla ification (Private A,B,C) 'ALO Total Depth: Cased To. Total absorption areeaa:J Pipe material:!IC7 Fl. Ft. 1 J� SG. Ft. `.�(Y�l —lJ %' kFV Driller. Date Drilled: Static Water Level. Inst--ayyller:__''1 y Date installed: Yield: Pump Set al: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ®a _ septic El Holding ❑S.T.E.P. To Septic Absorption Lin Holding Public/Private M In, acturelC. Capacity in gallons: �..lC�{'1 From Tank Field Station Tank Sewer Lines WellI 1 D f 16'h t4 Material: eGr�^� � Number of Compartments: Surfac Water 1 C?)'k lcvD - — — - LIFT STATION LotLr I fvfi _ Size in gallons: Manufacturer Line Foundation /,�/ "Pump on" level at 77 "Pr off" level High water alarm at Curtain ` Pump Make & M Electrical Inspections performed by: Drain Remarks:>Xt�1� l� G,% BENCH MARK Location and D�escc'r'iptionr � ���,1-�-�j Assumed Elevation: .�, A®� '. '5 sp o ,r F .� U J CP1Gf MERINCr Inspections performed by: iaoaa Cagle River Loop R���tggp,l� I �_ � TS Dp nQ i0a0 • aao1eY�'®dn® sea 0 Lit, 9 V`� Eagle River, Alaska 99577 2nd i �� Ig ' Z p�e0o �A A® ®M °B Zor J. AFER ; �r ®® ip"0 Nc�, 02 b too Department of Health and Human Services approval Fosano�� Reviewed %` i2. V %, and approved by: Date:12' 72-013 72-013 (Rev. 9/911 MOA 25 Permit No. 5Page of Municipality of /anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ®n -Site Wastewater Disposal System and/or Well Inspection Report �q- Legal Description:402���7 —I PID No.: Zy 1�lhu o1.1 Go ri toDo �� ` u�l�n or,l G� I fir-lAi�.4Tzorc�Fi,� 1-� ,, �Nsu�►�-fes —fi- �b N 'ia2 �✓Ya � (p'( = t � �iWl►�a��(r �tTt• Col 9" Gco r,16a.1 IdCbG�- coi q q. o ��•- 0o r'�"rt �" I�Y(2 GD b „afiAt@1 �' ems 9®0 eBe9e90Ye ®ty0 U, �eeoae eo a as % n ozo ��� RO ER d SHAF %r �e ® No. 15 a. � `, 6� H4001) Pe�'Y�CC4 %%'0fr'©FF.Q50N ' ` --- 72-013 A (Rev. 9/91) MOA 25 PAGE 1 OF MUNICIPALITY OF ANCHORAGE paig M' 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:SW920378 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:ST JOHN DONNA J OWNER ADDRESS:PO BOX 773949 EAGLE RIVER, AK 99577 PARCEL ID:05052134 LEGAL DESCRIPTION: GROLL BLK 2 LT 4 LOT SIZE: 93610 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED:11/05/92 EXPIRATION DATE:11/05/93 "5,C -A l f - / c _ --/ 7. - C/a'C/a, / v 1'-;� - li 7_- 1. 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ABANDON OLD CRIB AND TRENCH, IF THESE ARE RETAINED FOR FUTURE USE INSTALL DIVERSION VALVE AND PUMP CRIB. THIS TRENCH PERMITTED IN LUE OF A HOLDING TANK, MAINTAIN MAXIMUM SEPARATION POSSIBLE TO EDGE OF BLUFF. RECEIVED B ISSUED BY: DATE:l DATE:_/ .� Z_ E� ttgtjt to October 23, 1992 ROBERT SHAFER, P ROGER SHAFER. P CIVIL ENGINEERS (907) 6942919 FAX 694. 121 1 HEALTH AUTHORITY Municipality of Anchorage APPROVALS DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 I, Street P.O. Box 196650 SEWER 8 WATER Anchorage, Alaska 99519-6650 MAIN EXTENSIONS REFERENCE: Lot 4; Block 2; Groll Subdivision Request you issue a permit to upgrade the septic system serving the SEWER d WATER referenced property. INSPECTION Inspection of the existing system for Health Authority Approval purposes found liquid levels near the ground surface indicative of a system in failure. ENGINEERING STUDIES AND REPORTS As depicted on the attached site plan the proposed upgrade consists of drainfield trenches terraced down a small ridge -dine. There is a small concern of effluent daylighting out of the steep hillside. However, due to the heavy organic and vegetation cover; the relatively dense WELL INSPECTION subsurface soils; and the fact that the existing system is in an &FLOW TEST obvious state of failure without any apparent signs of day. -Lighting/ we feel the possibility of the new leachfield ever daylighting is very remote. SITE PLANS We also do not anticipate any adverse effects on any neighboring properties by the installation of the proposed upgrade. If you have any questions or require additional information to complete your review, please contact us. ROAD DESIGN, Sincerely, soILTEsr ROGER J. SHAFER, P.E. l� PERCOLATION RJS/tv TEST Attachment STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 /" = 40' UPGRADE \ k -J�, .�t � t ! ƒ 2 # z m| ■ to § � $\% ® !«t ` ` * \ \ /1 E ^a I ame \„K O A y o np” c) rTl „® & A g Grzmo% - � Cl) - y § � § \ $ o \ , \ k -J�, .�t � t ! ƒ 2 # z m| ■ to § � $\% ® !«t ` ` * \ \ /1 E ^a Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �F?f"��P `moi t �G�+-rr+ DATE LEGAL. DESCRIPTION: U Township, Range, Section: DEPTH 1 2 3 d� 4 5 0' 6 C9 7 m 8 9 p b 10 d 1 1 /jo r 12 r O 13 14 15 16 17 18 19- 20 COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? - 1:7 S IF YES, AT WHAT L O DEPTH? p E Depth to Waler A(le 1 ''Z4 Monitoring? Dale: _ SITE PLAN W Reading Date Gross Time Net Time Depth to Water Net Drop __nn 1 I I b /�J �l�, h PERCOLATION RATE �j (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ` FT AND e� FT PERFORMED BY: S & S i NGINEIiRING CERTIFY THAT THIS TEST WAS PERFORMED IN 170341 Eagle iffier Loop Rond No. -2 --- ACCORDANCE WITH L%1I 1j'6VpANUttAWNl!E"VGUIDELI NES IN EFFECT ON THIS DATE. DATE: 79-008(Rav 4/8fi1 UNICIPALITY OF ANCHORAGE He& and Environmental Protek >n Fourth Floor west 825 L Street Anchorage, Alaska 99501 nAe 264-4720►` -- - --- INSPECTION REPORT ON-SITE SEWAGE DISP05AL SYSTUA NAME ___or�___-___ MAILING ADDRESS - Z_r,.20_"�-{----__ PI-IONE LOCATION�_�'�_.._ -� --_— LEGAL. DC:SCRIPTIONU-Ro`'__`' C�' _ SEPTIC TANK: Z-)(15tTlv�c DISTANCE FROM VJLLL_-_________ MANUE"ACI-URER __MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH--___-____ INSIDE WIDTH_.__....__.— LIQUID DEPTH LIQUID CAPACITY GALLONS. TIL` DRAIN FIELD: Ii_FOUJDAo1 -___- . TOTAL LENGTH DISTANCE iROM G:ELL TION _NEARFSI LOT LINE_ -..-OF LINE 3o J ''��LL L-� L� of Lines ---._ _— DISTANCE BETWEEN LINES __�YIlY\__—TRENCII VJIDTI-I `_C'_ IN. TOTAL EFFECTIVE AiiSORFTION AREA __- � �rz__�-_ SQ. FT. LENGLH OF EACH LINE DEPTII OF FILTER DEPTH: TOP OF TILL TO FINISH GRADE S-tv1ATERIAL GENEA1H FILE __�Z---IN. AF30VF TILE SEEPAGE PI f: DIAMETER OR WIDTH_._., LEND "Til__, DEPTH 1N. Log Crib _Rings_ Crib Size: DIAMEIER____DERnJ.___DISTANCL FROM: WELL__ TOTAL. EFFECTIVE BUILDING; 1(JUNDA-1ION__--, NEAREST 1_0T LIME___ . ABSORPTION AREA (WALL- AREA) _SQ. FF. Wel 1 L z L D -V-1 IL ^ Class : �'ept,nh Well Distance To: Lot Line _ Bldg: Sewer Line: Pipe Materials:_h_�—I of Bedrooms: Installer: Remarks: DATE_1U(D/7)7 APPROVED TYPE OF SOIL HBSORBTION SYSTEM IS� TRENCH MHXIMUM NUM8ER OF BEDROOMS = ] SOIL RHTING (SQ FT/BR)� 175 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� ���� :,::If ::E. , �EYE �ill �1-1 — oil low w1i lot fit NO sv� L. 134 K 10" K F H =� IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE GROUND HND THE 8OTTO11 OF THE EXCHYHTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRRYEL BETWEEN THE OUTFHLL PIPE HND THE BOTTOM OF THE EXCHVfill ION (IN FEET). 11 - R"A cu < All J ����RE: ��J.". '(:::fi ��F.�.: IT? RE] oil 1-1 1: ITZ U 134 8HC1:::FILLI11 .1G OF HNY S9STE1, 1 WITHOUT FINHL INSPECTION HND 8Ii, PRUy, HL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTIUN. MINIMUM DISTRNCE BETWEEN H WELL HND RNY ON~SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 200 FEET FOR H PU8LIC WELL UTHER REQUIREMENTS MHY HPPLYJ SPECIFICHTIONS HND CONSTRUCTION DIAGRHMS HRE HYRILHBLE TO INSURE PROPER INLLHTION I CERTIFY THIii T 1 I HM FHMILIHR WITH THE REQUIREMENTS FOR ON ... SITE SEWERS RND WELLS HS SET FORTH BY THE MUNICIPRLITY OF HNCHORHGE 2� I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CODES ]� I UNDERSTHND THF -IT THE ON~SITE SEWER SYSTEM MHY REQUIRE ENLI'M EMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THHN ] BEDROOMS SIGNED...... ~.... ..... .... HPPLICDNT R�YMOND HLLEN �� V]� _~......DRTE,.����,��..����.�~/��.-�� 0 GR-_ (I ANCHORAGE AREA BORA** aH Department of Environmental Quality 0 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL, SYSTEM NAME /� � / ���)�/ MAILING ADDRESSG P( ///),'/) )�X'C< i 0� PHONE 616/4- r,, yC LOCATION"/qwc FCt.a z `�tL('JL c`(� LEGAL DESCRIPTION 16T �F. �_� 2 Ca'42"_ Suri SEPTIC TANK: DISTANCE FROM WELL -MANUFACTURER AlMATERIAL -V ' l" / l(l�l f f _ NUMBER OF COMPARTMENTS INSIDE LENGTH _ INSIDE WIDT/H/ LIQUID DEPTH 1 LIQUID CAPACITY_ ion GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH/� LE:NGTI sIcU DEPTH HU LINING MATERIAL 44 CRIB SIZE: DIAMETER ----DEPTH DISTANCE FROM: WELL 2( / TOTAL E ECTIVE <C BUILDING FOUNDATION�'t'� NEAREST LOT LINE 1)0 ABSORPTION AREA (WALL AREA) °' SQ. FT. ADDITIONAL ABSORPTION WELL: %v iYiun 1 6 6IIIIJ3 TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES: /11 � aaC 'w INSTALLED BY: �ChNI f' jY•�:rc PIPE MATERIAL: (1 P/757- U/' LOT SLOPE:`c.cJ REMARKS: Form No. EQ -037 /^LL��t.bl'i-)"ham iu 1s NEAREST SEWER LINE REMARKS DEPTH SEPTIC TANK_ DIAGRAM OF SYSTEM DISTANCE FROM: SEEPAGE SYSTEM _ =2°prlc later wRe r-eo-,aor icf 4` r < r 30 �i z4- C��L 13 G. ,�. I � -nV- ,✓4 K� ._ ,1�L�; ^�� . , R �� 1._ �K[ 1'�� v 171 M I/1� 1�2 J ,J `oU ---� DATE, APPROVED.' G. A. A. B. 4' GREATER ANCHORAGE AREA BOROUGH o ✓ $ DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO Y 0 3330 "C" STREET ANCHORAGE, ALASKA 99503 5 F TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT /��"/�C `F�� !` �L� MAILING ADDRESS PHONE INSTALLATION LOCATION LEGAL DESCRIPTION //01-ZI '/77/�r ` _3 1)nII ',a <-"��L✓ INSTALLATION OF: SEPTIC TANK i SEEPAGE PIT !-` DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED 7 FINANCED THROUGH / 1 TO BE INSTALLED BY SOIL TEST RESULTS _( �'J�-a NOTE: THIS PERMIT IS NOT Y LID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL 13E SUBJECT TO PROSECUTION. 617 /I �% /J `/ SEPTIC TANK SIZE �--��(�<�--� /� TYPE � ' -`� AI�I SEEPAGE ARCA SIZEµ��F��t�X �yp� TYPE 0 �C._ / MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK} ' FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL �- SEPTIC TANK -''-� SEEPAGE PIT i. _���DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK /C--��,J SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT , DRAIN FIELD % , SEPTIC TANK, /`--��� / SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL, CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. ^�K_/L%�-�- t_'. is -`l �✓°�/�'i/(J� G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS. IIN/ACCORDANCE WITH SAID CODE. DATE /;��/�/EJ APPLICANT'S SIGNATURE �l_.1 //•' `�r', L'-' /� `-j�-`� I 0 & E EivuINEERING & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333-5240 RusseN Oyster 694-2774 Civil Engineering Soils Et Foundations Earl Ellis 333-5240 Surveying Land Development SOIL LOG Performed for: Name:�L_ `�ab°6'�CZc�U.i�� ��c.�TeI. No. lvrlA'`ZjA(N-` Mailing Address: Legal Description:,)--�; 1�i�c �'n �1,��\�(5i Depth (feet) Soil Characteristics 0 _ 2 3 4� d r Grp- (,� �7� 6 8 9 10 i �5\ Ao . c -N-- -� :=-i KCI -y vJ f.L-L _ Q_6 N�.' *' o\c-v ``c S> . 1] 12 Ground Water Encountered: Yes— No If yes, what depth Proposed Installation: Seepage Pit_ Drain Field Comments:.—. �:� U � CL�C�y Q�•' �,czc5v�•�:*-r C'i� X17_ � c� ` �-) Performed by:, 4�„�� �� ,-� Date: C Municipality of AncWraj • Development Services �[YYepartn Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196660 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-521-34 COSA# 05C (alyo� Expiration Date: 0,-1-7— 13, 1. GENERAL INFORMATION Complete legal description Groll. Block z Lot 4 Location (site address) 21;46o Eagle River Road Current Property owner(s) Ronald & Linda Babb Day phone Mailing address 2546o Eagle River Road Eagle River AK c)g577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services LLC Phone 272-8218 Address P.O. Boxsooa3.7 Anchorage, AK ggSio Engineer's Printed Name Steven R. Pannone, P.E. Date lam_ Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. .��"i��, The operational life of all wells and septic systems depend on the local soil condition, ground water ••W OF / ++++ levels that may fluctuate during the year, and the water usage of the family being served by the system. ............ 1+ These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future •••••...... •• ...... ••••• j performance nor give any estimate of how long the system will continue to meet the operational 0 i requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed ♦ Steven• R. Pannoneg above. Any reliance upon or use of this report by any other person or party is not authorized nor will it �1� No. cE 8149 a �: confer any legal right whatsoever. +j .• 5. DSD SIG ATURE ++++++ss;�a�:••• Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By:0, IZ, / � Z, Original Certificate Date: (Rev.'11I0� Municipality of Anchorage ez ' Development Services Department ° Building Safety Division < On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Groll Blk 2 Lt a Parcel ID: 0W-522-14 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 20t31197fi Sanitary seal (Y/N) Y_ Wires properly protected (Y/N) Y Total depth 402 ft. Cased to zap ft. Casing height (above ground) 3.2 in. FROM WELL LOG AT INSPECTION Date of test 20W'974 8126/203.2 Static water level 235 ft. tag ft. Well production 2 9-p.m. 4,9 g,p,m. WATER SAMPLE RESULTS: Coliform Egg—colonies/100 mL Nitrate ND mg/L Arsenic: ND ug/I Date of sample: 8126/2022 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel Date installed 22h811o92 Tank size 2000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N/A Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed 8/g/203.2 Length 8o ft. Total depth 7 ft. Soil rating (g.p.d./ft2 or ft2/bdrm) o.6 System type Deep Trench Width 3 ft. Gravel below pipe c ft. Eff. absorption area Boo ft2 Monitoring tube Y Depression over field N Date of adequacy test N/A Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: —min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at_ in. Datum Size in gallons "Pump off"level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot zoo+ Absorption field on lot zoo+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas moo+ Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots moo+ On adjacent lots loo+ Public sewer manhole/cleanout moo+ Holding tank zoo+ Manure/animal excrete storage areas moo+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation c+ Property line r+ Absorption field 5+ Water main mo+ Water service line mo+ Surface water moo+ Wells on adjacent lots moo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line mo+ Building foundation mo+ Water main mo+ Water Service line mo+ Surface water moo+ Driveway, parking/vehicle storage mo+ Curtain drain 50+ Wells on adjacent lots moo+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and `�� ' review of Municipal records that the above systems are in�.n 9�" conformance with MOA COSA guidelines to effect on this date. .. .•..... ........ Engineer's Printed Name Steven R. Pannone P.E. ♦�0 %Steven R. Pannone: '• No. 0E 8 14 9 o c� ♦ • Date /'2633-�/ ♦i♦�.�.._..;�.vN-.�• COSA Fee $ a 1Y0.0� Date of Payment U Receipt Number aJ'�bSG (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage o me 11 ts 4 i ' P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 llepartmeot hftp:liwww.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: osp121298 COSA#: osc121406 Permit#: PID#:050-521-34 Legal Description: Groll B-2 L-4 Engineer: PES Applicant: Ron & Linda Babb Your request for a waiver of the required 50 feet horizontal separation from the absorption field to a slope greater than 25% has been approved. The approved separation distance is 10 feet. This waiver approval applies to the existing 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. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: �� % Date: 2 I Approved by: " Revj� er ............................................. .. e ..................................... Rec#: 09658G Amount: $200.00 Date Paid: 9113112 **** VARIANCEIWAIVER REVIEW **** Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(@paneneak.com August 14, 2012 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: OSP121216 Groll, Block 2, Lot 4 Field Orientation Waiver Request Ladies and Gentlemen: a 1i31(a. I am writing to request a waiver for the distance to a slope greater than 4:1. There is a slope on the subject lot of approximately 50% that is located 10' from the end of the field. This slope is located off the end of the field along the contour of the slope. It is likely that the effluent plume will travel downhill and with an angle of approximately 4:1 from perpendicular to the contour of the slope. An infiltration line that travels out from the end of the field at 4:1, and down at 4:1 does not daylight for 50 feet. See section on sheet 4 of 4. The existing field located just downhill from the new system has been operating in failure and has not daylighted out of this slope. Granting this waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. If you have any questions or concerns, please contact me at 272-8218. Sincerely, 49 TM Steven R. Pannone Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Bax 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AIC 99501 Telephone: (907) 272-8218 FAX: (9077) 272-8211 MUNICIPALITY OF ANCHORAGE • �`� DEPARTMENT OF HEALTH & HUMAN SERVICES Ak Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # Y HAA #� 1. GENERAL INFORMATION Complete legal description Lot 4; Block 27 Groll Subdivision Location (site address or directions) Mile 6.3 Eagle River Road, Eagle River, Alaska Property owner _ Donna ohn Day phone (50..3) Mailing address _ Lending agency Mailing address Day phone Agent Jean Locke Day phone 694-9035 Address 13135 Old Glen Highway, Suite 100, Eagle Riverf Alaska 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: "i _\ 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Re, 1/91, Front MOA P21 5. M STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 5 Z : ENGINEERING Phone 17034 Eagle River Loop Road No. 204 Address Engineer's signature DHHS SIGNATURE 7X Approved for bedrooms. Disapproved. Conditional approval for Additional Comments 11 ITIr,, Date �1-2�' ` f__- OF AC W% ••MN••••�' �pp 4a��9d %t °u.u��uwri•° ROGER J. QfiAFEK a No. 8215 r �4 F °°'• '064 •4 H••••• bedrooms, with the following stipulations: Date 12 - 7— 1'72 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-.>< A �� %mow ��� Parcel I.D. A. WELL DATA 04) Well type QR -kJ rrs� It A, B, or C, attach ADEC letter. ADEC water system number Log present &N) — Date completed �� - 3 - 4 _ Driller A�L Total depth "�O-- Cased to 2� Casing height 12 - Sanitary seal(Y/N) —14 Wires properly protected O/N) _ Date of test Static water level Well flow Pump level FROM WELL LOG Z,D J Y_ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot \10 Absorption field on lot l Public sewer main —' Sewer service line 2' WATER SAMPLE RESULTS: (,u 1.1 100mA Coliform 0 Date of sample: —J \ - Ik AT INSPECTIONrn v D 2e>o _ n `; Z +' —; On adjacent lots On adjacent lots \ e 1� \ 4, Public sewer manhole/cleanout— Petroleum anhole/cleanout Petroleum tank 2S k Nitrate Other bacteria _ N0 L Collected b S & 5 ENGINEERING y'--T7U34-EayteRiverkoon-ReOd-NO-904-- Eagle River, Alaska 99577 B. SEPTIC/HOLDING TANK DATA Date installed \\ \ 3�_c1v Tank size l DO Q Compartments - Cleanouts ON _ Foundation cleanout (_bN) _ _ Depression (YO High water alarm, (Y t. _ t_� — Alarm tested (Y/N) Date of pumping IA! Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (s) on lot. o ' On adjacent lots \C00- _ Foundation To property line__ �� `� Absorption field I_�`� Water main/service line Surface water/drainage \pct \ �- 72-026 (Rev. 7/91) From CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) — High water alarm level "Pump on" level at Meets MOA electrical codes (Y Manufacturer Manhole/Access (Y/N) mp off" level at Cycles tested SEPARATION-DFSTANCE FROM LIFT STATION TO: n lot D. ABSORPTION FIELD DATA Date installed 1�– t 8 Length -7s Width Total absorption area Depression over field (Y& Results (pass/fail) On adjacent lots Peroxide treatment (Past tz months) (YCN)_) Surface water �t9DISoil rating b' \° sMF:r.System type T �� Gravel thickness S Total depth S S s rti Cleanouts present ON) � Date of adequacy test for � bedrooms If yes, give date a SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot \ C> C> `�_ On adjacent lots � L--,) ° v�- Property line �a To building foundation \ �To existing or abandoned system on lot t r' On adjacent lots ��\ Cutbank s o tl--Water main/service line \ol Surface water \ o o ` � Driveway, parking/vehicle storage area Curtain drain A 1 A * SF_Cv SF PTtc_ Da_- — \ L"� E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA gui 5 &, S ENGINEERING 17034 Fagle River Loop Road No. 204 Signature Engineer's Name Date \ \ - -Z-45 - -1 -Z__ HAA Fee $ 10,'x_- Waiver Fee: $ Date of Payment c� �j Date of Payment Receipt Number ���Z (0 �r f Cr Receipt Number pection. O �- l n -fl- r_��I:QD chlf�_�L�r STREET LOCATION , IA11-E TIME TIME 6. TYPE OF RESIDENCE 5. LEGAL DESCRIPTION D 'E CEIVED INSPECTION APP oTMENTS �V STREET LOCATION , IA11-E TIME TIME 6. TYPE OF RESIDENCE TIME I SINGLE FAMILY C,: ❑ Two ❑ Five DATE ATE 7. WATER SUPPLY DATE " * 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.) INSPECTOR INSPECTO V4 INDIVIDUAL/ON-SITE** INSPECTOR MUNICIPALITY OF ANCHORAGE MUN IPALITY OF ANCPI RAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE(M� (EPT. OF HEALTH & ONMENTAL PROTECTION " 825 L Street - Anchorage, Alaska 99501 • NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ENVIRONMENTAL SANITATION DIVISION J L 14 1981 Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW@!f4WIVU DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. M Awo 12!74. x. /yJi�L� HONE MAILING ADDRESS `�/"c /SOX PROPERTY RESIDENT (If different from above) PHONE" A//GE 616- (!-f _6zE 2/ V61-0 Ire D. 2. BUYER PHONE MAILING ADDRESS &SS00 LA 10 CAIC,(a , (7F • znsA XiZA . Ar, 3. LENDING INSTITUTION^ - - __FP HONE AILING ADDRESS " 7_0 -1 a, (UoA_7f-%-e52A,) L(� ENs tiL-Up 4. REALTOR/AGENT IMA-U-.-Tt� ��e�al�f �J PPHONE `7T� G`($^7�p MAILINGADDRESS _ZSrJc( l JO &7tW.C.d UG Ofn . jcj401 5. LEGAL DESCRIPTION L-07- i fK COCK —2— STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS I SINGLE FAMILY ❑ One ❑ Four ❑ Other___ ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY 9k 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. SEWAGE DISPOSAL SYSTEM V4 INDIVIDUAL/ON-SITE** YEAR ON(( -SITE SYSTEM WAS INSTALLED. E]PUBLICUTILITY !� !tl- L,�PLVCtr�Y i NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 11A72-010 (Rev 61 /79) :t om1Aom wl u.� THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ 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 V1 /I Jay DATE INSTALLED y INSTALLER eptic Tank or ❑ Holding Tank Size: NO U If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS L� APPROVED FOR - 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) [DISAPPROVED _ \. n BY P-C� u.� ,Oi M , MAVOW ! - PA iT`7PN-"`;. IL -.01 .'JigF NVI .,,.,bt -FAL 1.1 )i'r'"!(ifl JUly 1.6; 1981 Chart es J. Sevc fl. /R. _t:r+ Madol e SLar Route Box 0130 liagl-e River, 1a1.._iska 95 17 S.ki-)ject: .ot g r].ock 2. (',roll. Subdiv_is.i.on Appr.Ova_t f.o t:h.e r.rlc(rvt-dz:kal. Y-,crwGr and :..iter. raci.J_:).tros Cannot bc: grarit ed Until the to.f..towinq ).tt^1S have beem l7 UIRI3, e 11: Cod rpI (2' 4cR%e;-- ana1yf31.S a:epO i: -c- nec'.ds 't".O 1)e Submit t. ed L.0 this of ricks from t.nr Chem Lab 5633 13 St:r.ect, for our rc,.vicaw. (2) InInc septic tank puyipeel with a rCiCE-i-pt: SUbmitt.e t.0 this office, (3) An a.C1C9C{11acy -est need..S t0 be per:'f.oriacd on the existing leaching area. `I.'his test will. ( etermine if the system is ad .quite- ;a,,.tc:o) .ingf t0 NaL+_Orial, Standards. i\ of p.r.ivate :E.i.rms oerf'ormi.nq they test iS CUICJ_Osed. This report needs to he su.bmi lct:ed to Lhis office for our rev:i_Fva. If therC'. ;--Ire any f1j.3 t.hc c C_iuest:Jons, please call this off tc t aL 264-4720, 1a7-rl ('fes --e `t`r I' . N. Buc1-11101Z, T'.S. 11 i.c;: : zl v i rozllr.ez. tc, l 'Spc-c:i.a ). i.St (Oct .,i L._1.. !`: i. a9.::>tS C=. V--OrtLCI("; 207 twist _ a thhrn. L:igllt_ 30Ull.:VFt.LC1 9950 mai tv Plunkett iii !°Ia- iLon Real I State I Rita Mada ica SRB .1.750 F,agl-e River, EXCAVATION WORK Da, ROBERT A. SHAFER CIVIL ENGINEE=R 694-2979 September 22, 198] - MUNICIPALITY OF ANCHORAGE DEPT. OF I'.4 ENVIROWENT. '[CII0N Alaska 99577 RECEIVED Dear Mr. and mr's. Madale, Reference: Lot , Plock 2; Grol]- Subdivision A sewer systern adequacy test was performed on the system located on the reie.r.enced property as you requested. The septic tank was pumped an! verified to have a capacity of 1000 gallons. The absorption trench wcr; tested by a continuous flow of water over a period of 72 hours. The a'%)erage flow for a 24 hour period was 512 gallons without any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the three bedroom .residence located on this property is currently funcL-.ioning adequately. However, the system cannot be guaranteed against subsequent failures. If we may be of further service, please do not hesitate to call. Sincer�ly, r �R BRT A. ;;IIA AS�ss Marston Realty ATT E11TICA\! : Marty Plunkett Alaska Uousing Finance Corporation Municipal 'iLy of- ;'�ncllorage Departme,-:. of TTc<: L:h <<nd P;nv:i.ronmental Protection SRB 196X EAGLE RIVER, ALASKA 11)VEE i PF/ cQ(- r MUNICIPALITY OF ANCHORAGE MUNICIPALITY Ui ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. Or 825 L Street - Anchorage, Alaska 99501 IVIRONi, SNI/1 ; , .,.Y -TION • ENVIRONMENTAL ENGINEERING DIVISION MAY� ! r'J Telephone 264-4720 rr ``ee REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWAEk'C � MEh DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow tan (10)days for processing. 1. PROPERTYOWNER 1;!f ell— ew. SINGLE FAMILY MAILING ADDRESS 'F'6 --4,4E7 X/YZ�f pelf 42 €,q� � • � �' ee', �y jG G PROPERTY RESIDENT (If different from above) - - PHONE - 2. BUYER 065y JAS PHONE MAILING ADDRESS 3. LENDING INSTITUTION— )4L— PHONE .��� MAI LI NGADDRESS 4. REALTOR/AGENT — PH NES--- 5'��sr92� C�R���s;>•r�� ;�'�F. �- lr�� c�ll�r�_ �y-j�'���,— MAILINGADDRESS - 5. LEGAL DESCRIPTION ,cE�7- --/ iso 7& 1.8 STREET LOCATION y— I�. �f /� 4W6-/— � /(p llKG /I 6l,4Y 101 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS — SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY J Three ❑ Six 7. WATER SUPPLY 15INDIVIDUAL* * 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. SEWAGE DISPOSAL SYSTEM -- INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date ❑ If system is over two (2) years old an adequacy test is required PUBLIC U fILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. /L•V IV IJI /i51 � _ KOAP Ri�rl p THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED - TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO Cl 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 INSTALLER m_-fV- ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER - 0 TOTAL ABSORPTION AREA MATERIAL � 7''7 4. DISTANCES WELL T0: Septic/Holding Tbsorption ank AArea Ij labwer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS t2— APPROVED FOR , Y� BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompan certificate) ❑ DISAPPROVED DATE 3 %P BY (Title) C " V-,M& LEGAL DESCRIPTION 72-010 (Rev. 3/78) REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Lomas and Nettleton Mailing Address: 3380 C Street 99503 Phone: 2. Property Owner: Raymond/Linda Allen Mailing Address: Star Route Box 211-K 99577 274-7661 Phone: 694-2291 3. Legal Description: Lot 4 Block 2 Groll Subdivision 4: Single Family Residence: (x;j Number of Bedrooms: Three o -14 -- Multiple Family Residence: ( ) Number of Bedrooms: S. Well System: Individual Well (x$ Corununity/Public System ( ) Permit ## Depth of Well 400' Well Log on File ( ) Construction Bacterial Analysis 6. Sewage Disposal System: On-site System (x:4 Public Utility ( ) Permit ## Installed 1974 v Installer t Septic Tank Size �(�/f)(} Manufacturer ' L_e)-k r Absorption AreaSoils Rate —< �5 / Material_ A moi"_ 7. ]distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line "MUNICIPALITY OF ANCHORAGF j 3iQ DEPARTMEi. 825 JF HEALTH AND ENVIRONMENI PROTECTION L Street, Anchorage, Alaska 99501 264-4720 xz Daae Received: September 6, lb 7 t ``'y'"�� #l: Time 10:00 a.m. $2: Time �L•, .�, ##3: Time LL,�,L) Date 9-W7 7 Thurs Date ,. j jl ,'� , i� Date Insp JK edy Insp ��1 A",.� Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Lomas and Nettleton Mailing Address: 3380 C Street 99503 Phone: 2. Property Owner: Raymond/Linda Allen Mailing Address: Star Route Box 211-K 99577 274-7661 Phone: 694-2291 3. Legal Description: Lot 4 Block 2 Groll Subdivision 4: Single Family Residence: (x;j Number of Bedrooms: Three o -14 -- Multiple Family Residence: ( ) Number of Bedrooms: S. Well System: Individual Well (x$ Corununity/Public System ( ) Permit ## Depth of Well 400' Well Log on File ( ) Construction Bacterial Analysis 6. Sewage Disposal System: On-site System (x:4 Public Utility ( ) Permit ## Installed 1974 v Installer t Septic Tank Size �(�/f)(} Manufacturer ' L_e)-k r Absorption AreaSoils Rate —< �5 / Material_ A moi"_ 7. ]distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line ul REALTOR"' I REQUEST FOR APPROVAL OF I�'v INDIVIDUAL SEWER & WATER FACILITIES µFa r rr-`- 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner: � lwal/e7_1 Cwo% /9/11&moi Mailing Address: A -Re X- 4? Day Phone =�J �� /clri t' -tea � ✓%� 3. Name of Buyer:!rpm. r'se7 ?/ Mailing Address: Day Phone 4. Name of Lending Institution:. ���>� � �/� 17/1 e'2 Mailing Address: �,y© � /�����>l, Phone -Z 7 Z_ 5. Name of Realtor or Agent: Y���i��� /, . "-6X— Mailing Address: L. -a_ czS e(ce-0hone /�/-y 6. Legal Description: z2l e C � � L Location: 7. Type of Facility to be inspected: No. Bdrms. : a Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served ___z If Individual, depth of well V o r Sewage Disposal System Type of System: Public Utility Individual (on-site) Y, If Individual, date of installation: ��� /��v AREA, INC. REALTORS Anchorage "C" St. Office 3300 C Street mn7i ')7A.9r, )r East Anchorage Eagle River Eastgate Office Parkgate Office 5437 E. Northern Lights P.O. Box 249 Page Two Department- of I3ealth and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 4 Block 2 Groll Subdivision Comments: _ Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date: 10/ll /7 Disapproved: Date: Departm-nt Worksheet:CY 1 O c---) c�� — \ Ci V (.*ptOrNber 15, 1977 t/` Tso)y[,,�tafs / and NettletonJ.,7 V i� 4 Street Anchorage, Alaska 99503 ,3ulaj Nc t . :t oto 4 Block 2 c,roM Stibliv+ sion Rayr,.tond/Li ncla .hers Property Please be advised that the p€rxc test perforrsstec7 _b this department on tho Esula Jec.t Property' a sne),- (je pit -failed to rite€at t ho mi.ni.rtturt required absorption .nate, tlhuxoforo, axt uvgrade of the existing Syrjtem it necomiary before approval. Of guur: recruost can be granted. Sped ifricatA,orjfj :Frit- tlt€ upgrade are a.t3 fc)ljows. s' mel r �nclh lE�ncjt;l� � tee sty-fo f'e d f `fatal clean th F3 . on (: et Gravel cyti gravel under Pipe � F� rjew ar permit: Is urke Ears, Ujis ).6rior to Construction. ':rox:tporar�y approva:1, will bre grante(A if functs aro escrowed forl. th-o uiAir tcdo, with a completion cdnto of October ly, 1.977. 1f there are any further gaustionss,, at 264--•47205 Taira, ex« ly John Xonne dyt / Principal Code T;,n orcement officor ,TKA 111 pleaoe Contact tihi;� oLfie \N Cc a Ztavr1t0at,lj:r,.i TIdEc Allen Virginia L. XoMbalo, :star ?loutc, BOX 2,11, �; 99577 Arpa Realtors Post: €fftce: Bm- 219 99577