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HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 1 LT 50Valli Vue Estates #2 Lot 50 Block I #015-123-05 Municipality of Anchorage Page I 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 Name: ~I~'~[ f2. LAv/./~,~ r. tC.~ Wastewater System: [] New ~Upgrade Address: ABSORPTION FIELD Phone: I NO, of B_.~rooms: ~ Deep Trench [] Shallow Trench E~ Bed [] Mound E3 Other Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION e ~.} !D CPD/Sq. Ft. Lot: Block: Subdivision: ^L/~'~' ' Depthtopipebottomfromoriginalgrade: Gravel depth beneath pipe Township: I aang~ Section: ~'~ Fill added above original grade: Gravel length: WELL: [] New [] Upgrade Gravelwidth: Numberoflines: JDistancebetweenlines: Ft. Ft. Classilication (Private. A,B,C}: Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. SQ. Ft. Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. Yield: GPM J Pump Set at: Ft. JCasing Height Above GroundFt. TANK SEPARATION DISTANCES ~.,Septic E] Holding [] S.T.E.P. TO Septic Absorption Lifl Holding Public/Privet( Manufacturer: Capacity in gallons: From Tank Field Station TaNk Sewer Lines Well i~//~ Matoria~.l~,~__/ Number of C~..partments: Surface Water r~L~ ~. LIFT STATION Lot Size in gallons: J Manufacturer: I Line Foundation j~I "Pump °n"level at: J "Pump °fl" level at: I High water alarm at: Curtain Pump Make & Model I Electrical Inspections performed by: Drain Remarks: BENCH MARK Location and Description: J Assumed Elevation: Inspections performed by: '~,-~ Department of Heal,th'and Hu/m~/~r~vices appro, va). 72-013 (Rev 9/9~) MOA 25 ooo i 0 £0 $0 SCALE: 1' = £0 FT. 40 50 dO 98.8 1250 GAL, SEPTIC TANK BENCH MARK: DDTTDM OF SIDING ASSUMED ELEV. 100, O0 TO,BEN SPURKLAND P.E. 803 ~ 15TH. AVENUE ANCH. AK. 99501 LOT 50 ~LI1CK 1 VALLI VUE #8 66~0 R~UN~ TREE ~RIVE LAWRENCE FRAIR SEPTIC SYSTEM DESIGN DATE, FEi3, t?[', 1994 SHEET, ~2~ GRID, ['539 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920398 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:FRAIR LAWRENCE W OWNER ADDRESS:6620 ROUND TREE DR ANCHORAGE, AK 99516 DATE ISSUED:il/30/92 EXPIRATION DATE:il/30/93 PARCEL ID:01512305 LEGAL DESCRIPTION: VALLI VUE EST #2 BLK 1 LT 50 ~ LOT SIZE: 20208 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: /~/~ ISSUED BY: ~ - v DATE: ANCHORAB£~ ALASKA (9071 Munic:ipality c~: Ant:borage Divis~,ien o~ E£nviror~mental Health Department a'F Health and Sc~cial Services 820 I St.r'eet Anchora~je~ Alaska 99501 Sub j eot: Nc~vember 3C)~ :[992 Gentlemen; -['his merning I got a call ~:r'om Mr. L..arry F:rer'e~ 6620 Roundtree. H:i.s septic tank had col lapsed and he needed permi ssiol'~ t.c~ i'"epl ace it.. He had tal<er~ contac:t with K.[2. Alaska Inc. ~ ~-~l",o ie on site with a backhoe and a dozer. Please issue a permit ¥or septic: tank replacement. An As Built will be transmitted at the completi¢~n o'~ the work.  ~,,~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [] NEW LEGAL DESCRIPTION LOCATION ~0 g ~F~~2 ~ ~ Manufacturor M~toriol ~o. of compartments m ~ Liq. capacity in gallons ~ ~ Inside length Width ~ Liquid depth JF HOME,DE: . ~ Well Dwelling PERMIT NO, ~ ~ ~ DISTANCE TO: O ~ ~ Manufacturer Material Liquid capacity in 9aliGns ~ Foundati~ Nearestlot~elo PERMITNO.~)~ ~ ~ DISTANCE TO: Well~ (~ I Distanc~e/w~n lines ~= No, o~e~ ~ Length of e~ne Total length o~n~ Trench width ~ ~ ;&ches Total effectiv~s~ n ar ea ~ Top of tile to finish 9r~e~ ~ , Material beneath tile ~O inches Length Width Depth. PERMIT NO. ~ ~ype of crib Crib diameter Crib depth Total effective absorpBon area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ ~~~~la ~ Deoth Driller Distance to lot llne PERMIT NO, m Buildin~ foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS 72-013 (Rev. 3~ ~] 825 ~L~ ~TREET, O~-~--SITE B000~9 ) [ SRA BOX ~2-F 8NCH LOT SIZE PERMIT NO. APPLICANT LAWRENCE FRBIR LOCATION ROUND TREE LEGRL :LO~, 50~iBLK i.LVALLI VUE SOB ~ TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH DEPARTMENT ,_.,, HEALTH AND ENVIRONMENTAL , ROTECTION ANCHORAGE, AK. 99501 ._,_ _ ~4 4Z~O 5E~EE F'EF:r~ IT MR>(IMLIM NLIMBER OF BEDROEIMS = ~ SOIL RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION S~.TEM IS: PEPTH= -1 ~-I LE~qGTH= ~_~RA"v'EL DEF'TH= ~ THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE 80TTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE 80TTOM OF THE EXCAVATION (IN FEET). REL:~.LI I RE[:, SEPT I C TRNa-( S I 2E= 1~---i00 GRLLC~f-]S PERMIT RF'F'LICRNT HAS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. T~I~D ( 2 > I ~,~SPECT I O~,~S ARE REF~!I_I I RE~~ BflCKFILLING OF tiNY SYSTEM WITHOUT FINRL INSPECTION fiND fiPPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND RNY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS 8RE AVAILABLE TO INSURE PROPER INSTALLATION. PEI;~:I~I I T E:~:P I RES t~.~ECEt"~BER -~i.- i980 I CERTIFY THAT l: I RM FRMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: t WILL INSTRLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTRND THAT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRROEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. ( SIGNED: .... .... .~..ER ANCHORAGE AREA BQr 1JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ( '~)/~/t/ .,~.~:~'/'/'S"~/,~,~/~.~f" MAILING ADDRESS /~.~ -'~ ~,~ //"--o2,:~f~'% PHONE · OCAT,ON -~'-~ .'~-~ ,~.~///~ LEGAL DESCR,PT,ON ~/~ ~× ~'//.Qb'//~ SEPTIC TANK: DISTANCE , NUMBER OF FROM WELL~/z~/2~/ MANUFACTURER , f2~/]<'~-/~/ ~/~ZL/~'~zi~ MATERiAL~/'~/..' COMPARTMENTS ~ INSIDE LENGTH INSIDE WIDTH ~ LIQUID DEPTH ~ LIQUID CAPACITY /.'~' GALLONS. SEEPAGE PIt: NUMBER OF PITS / DIAMETER -- OR WIDTH //4~ LENGTH /~, DEPTH /~,'~' ~/9/~/' LINING MATERIAL ~/~CRIB SIZE: DIAMETER~DEPTH DISTANCE FROM: WELL [~, . ~% ~/~/ TOTAL EFFECTIVE BUILDING FOUNDATION~/~ NEAREST LOT LINE ~ . ABSORPTION AREA (WALL AREA)~ SQ. FT, ADDITIONAL ABSORPTION WELL: TYPE ~P)~/~//U/~/// CONSTRUCTION BUILDING ~ NEAREST FOUNDATION __ LOT LINE DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK SYSTEM CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED D I STA N C ES; S-//'~g¢/-,~ REMARKS DIAGRAM OF INSTALLED BY: ~O~/u) PIPE MATERIAL: ~////~.C~ .~:~/'~/ LOT SLOPe: REMARKS: ~-~Z/~/.~/Jg~ DATE APPROVED / - G.A.A.B. Form NO, EQ-031 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO, INSTALLATION OF: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD , OTHER FINANCED TH ROUGH TO BE iNSTALLED BY ~ SOIL TEST RESULTS ~ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST C O M p LET [ O N DATE A N t l C, pAT ED//<:~/--/~/~ ~.?-~./~// /~/ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SiZE /~ / TYPE SEEPAGE AREA SIZE TYPE DIAGRAM OF :SYSTEM MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK S / FOUNDATION TO SEEPAGE Pit ~/~) / SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK - TO NEAREST LOT LINE. ., SEEPAGE PIT DRAIN FIELD WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK /~) / SEPTIC TANK, /~ / SEEPAGE PIT ., SEEPAGE PIT ALSO CONS[DER AREA WELLS. / SEEPAGE PIt. /~-~/ /,~ / · DRAIN FIELD 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, OR LICENSED DESIGNER ] CERTIFY THAT I AM fAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SA[~3 CODE. ~/<b,,.~cK ANCHORAGE AREA BOROUGH ,. Department of Environmental Quality ~ 3330 "C" Street ,. AnChorage, Alaska 99~u3 er,o~med for ~x~, /~ ~]~ ' performed This form reports: ~oiis log ~ - [ ~ ~]~'t~6iT test Depth Feet 1 2- 9- lO- ll.- 12- 13- Was ground water encountered? ~;~ If yes, at what depth? -'Reading Da te Gross Time Net Time Depth to H20 Net Drop minute, Seepage Pit Percolation r~ te Proposed installation: Dcpti~ of Inlet CO~,I~qI3~TS: D a,n F~e~d Depth to bottom of pit nr tren,..n C ..... ~-~ By: ................... MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services _: On-Sita Services SecUon ~: · P.O. Box 196650 Anchorage, Alaska 99519-6650 (9071 343-4744: :- .... '. - · ~'-'~.. CERTIFICATE OF HEALTH AUTHORITY ' ' APPROVA~ FOR A SINGLE ?AMILLY DWELLING : "~ ';"- ~ ' ':'" Parc~l I.D. # 015-123-05 : c~m~l~6 'i~g~l d~H~fi~h' 9AL~'"vuE ESTATES' ~2~ ' .Lp~ ~' B~OCK ~: '~ Ig agency Mailing address Agent" Day phone. Address .::: :: ':'Unless otherwise requested, HAA will be he!~.fo~: piCk~P: :;,:: .2.~: N~BER'oF BEDROOMS.-'.~' '. :- "3'" -:,. 3: TYpE OFWATERSUPPLY: ' ...- ..... ' '- , ' '. ' -._'..':. - .. -'. ' ~ , ' :': ~-:' ' ::::": >: :, ndvidualwell":>~:"'. ' .. · ~ ' ' ''- . ':,:/'~,,,~,'h,~ll' ' ' XXX ' · · ' , -. -. ' ' Pub 'c water- , '- ; ::. :-N 0TE: ilf commb~ity'~vell -s~,s~e'~n;~revide Written-confirmation-from State , .: :" . :''ingto'thelegalityandstatusofsys · --" ..... "' 4 TYPE OF WASTEWATER DISPOSAL: Individual on-site . ... comm.,.,nil~:~A:si{-~? :.' .. - - - Public sewer, ' ' NOTE: If communtty wastewater system, prevtde wntten confirmatiOn fr°m State ADEC ing to the legality and status of system. 72-025 (Rev, 1191)Front MOA g21 Computer Version - 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of ihe validation date shown below, I vedfy that my investigation of this Health Authority Approval application shows that the on-sita water supply and/or wastawatar disposal system is safe, functional and adequate for the number of bedrooms add 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 dispo, sal system Is in compliance with all Munici on the date 0f thts inspe~on. Name of Firm Address 6901 DEBARR Eng 1./n conducing ~ the on-sita water supply and/or wastewater State codes, ordinances, and regulations in effect CONSULTANTS, INC. Phone'· (907) 337-6179 ALASKA 99504 consdon#oue eng/nearlng anat,/sis'Of the system In aceerdance with/{DEC and MOA DHHS Gu/del[nee & Regu~a#cos. ' The reported results deecrlbed the performance of the system unde? the CdndltlOna encountered at the time Of the the test, 'and separation dlstencea measured to readily Identifiable feeture~,. The eg~attona! llfe of all walls r and eep#C ,5'.~tema depend~n the local soils co~dfiton, ground water te~l$ that reay fluctuate during the .t~ar, and the water usage of the farnliy bblng ee~ved by the system. These conditions are outelda the conkbl ~f the eva~uater ~f the s~stere~ Al~ systeres~ ever~ua~iy fa~ and eet~tect!:~y teet resu~s d~ n~t ' guarantee futor~ performance of the system, nor do they guarantee that there are no hidden defects encreachments, AWWC, ~nc. can therefore not provfde eny wan,anty for future pe/f~mance nor glve any ee~mate of how long the system w/ll con#hue to meet the °Pera#on~l regu[rereente of the ADEC or MOA DHHS. The content of this report I$ for the sole benefit of the oWner Ilsteci above. ;~ly rollance upen or use of this report by any other person or par~ is not authorized, ~or wfll It center ariy legal right wt~a t~ever. 2. Alaska Water and Wastewater Conaultent8, the. ~hall be paid $400.00 at, or prior to, closing ~or the engineering eerv~ces pro~ded, 6. DHHS SIGNATURE ~ Approved for Disapproved Conditional approval for ' · bedr~0oms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority App,'oval 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. 1/911 Sack MOA ~Y21 Computer Version Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES D~vls[on Environmental Sewi~s ' ' ' , 825 "L" Street, Rm 502 ~chorage, Naska 99501 (907) 343~744 Health Authority APproval Checklist Legal Description: VALLI VUE EST. #2; LOT 50, BLOCK 1 Parcel I.D.: 015-123-05 A. WELL DATA Well Type CLASS "A" Log present(Y/N) Total depth If A, B, or C, attach ADEC letter. ADEC water system number. 210605 Date completed ~ Cased to ~round) ~ Wires propedy protected (Y/N) AT INSPECTION g.p.m. ,,/'J g.p.m. Sanitary seal (Y/N) FROM WELL LOG Date of test / Static water level ,,~..,~ ~/~ Well production WATER SAMPLE RESULTS: Coliform Nitrate Date of sample.' ~ B. SEPTIC/HOLDING TANK DATA Date installed 11/,30/92 Tank size Foundation cleanout (Y/N) YES Date of Pumping 3/15/2000 C. ABSORPTION FIELD DATA Date installed 5/74 & 3/80 Collected by: 1250 Number of Compartments Depression (Y/N) NO Pumper A+ HOME SERVICES [CRIB/TRENCH] Soil rating (.q.e.d./ft2 or ft2/bdrm). 2 Cleanouts (Y/N) YES High water alarm (Y/N) N/A 85 Length 14'/29' Width 14'/3' Gravel thickness below pipe Effective absorption area 336/290 sQ ET Monitoring Tube present (Y/N) YES Depression overfield (Y/N) Date of adequacy test 3/17/2000 Results (Pass/Fail) PASS For. ,3 49" Immediately after 776 122 Absorption rate = NONE KNOWN If yes, give date ITESTED TRENCH ONLYI System type CRIB/TRENCH 6'/5' Total depth 12.5'/14' NO Bedrooms gal. wateradded (in.): 61.5 450+ Fluid depth in absorption field before test (in.); Fluid depth 52.75 (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-028 (Rev. 3/96)' Compater Version D. LIFT STATION ~/ Date installed ~o Manhole/Access (Y/N) ~evel at* _ ."Pump off" level at* High wat~ *Datum ~CyrJesTested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 200'+ Absorption field on lot 200'+ Public sewer main N/A Sewer/septic service line 25'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5' + Property line 5' + Water main/service line 10'+ Surface water/drainage 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: 10% Building foundation. 10% Property line Surface water Curtain drain On adjacent lots 200'+ On adjacent lots 200'+ Public sewer manhole/cleanout N/A Lift station 100'+ Absorption field Wells on adjacent lots 100% Driveway. parking/vehicle storage area, NONE KNOWN F. ENGINEER'S CERTIFI~TI/Q.,~,//~ I certify that I ha~ ~/~t~i~l~e~J~hrulfield inspections and review of Municipal re~o~ :~/ t~f/he~)~ovelsystems are in conformance with MOA HA~ g[ i~/~/d~his date. Signature ~ ~wj,,~vy ,~. j- Engineer's Name~ JEFFREY A. GARNESS Date ,~/~-/Oa 5'+ 200'+ __ Water main/service line_. 10'+ 10'+ Wells on adjacent lots 200'+ HAA Fee $ Date of Payment --~ Receipt Number 72-028 (Rev. 3/98)* Computer Version Waiver Fee $ Date of Payment Receipt Number Parcel I.D, # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmenta~ Services On-Site Se~ices Section P.O. BOX 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Completelegaldescription LoF' 507 ~,~¢_.t ~/ALL1 V~E E:S'FA.¥~----~_~. Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent DA LP_. ~ U ~_-~ H-~--/ Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well 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 ~' 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 (Rev. 1/91) Fronl MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage flies 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. NameofFirm '~=,~6_~ ~U'¢~-~.~-~¢-~ ~"'~--'- Phone ~?9-gRl&, Address .¢0~o~::, ~ I ~4-t,1 t:~ ,¢Zo'-~ Engineer's signature DHHS SIGNATURE Approved for -~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Huma" arvices (DHHS) issues Health Authority Approval Certificates based only upon the representations giver paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS dc,J° 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. Health Aulthority Apprlval Checklist Legal Description: A. ~LL DATA Well type Log present (Y/N) Total depth SanitatT ~eal (Y/N) Parcell. D.: Olg- ~L~- DS If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (Y/N) Date completed Cased to AT INSPECTION g.p.m, g.p.m. Nitrate Other bacteria FROM WELL LOG Collected by: Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: ~ Cleanouts (Y/N) Depression (Y/N) ~ High water alarm (Y/N) ¥'"~ B. SEPTIC/ItOLDING TANK DATA Date installed 111'3Ol q'L~ Tank size ¥2-,~ r9 Number of Compartments__ Foundation cleanout (Y/N) Date of Pumping ti>lC lq~ C. ABSORPTION ~'mLD DATA Date installed IqTq t I q ~ System type ~,-~',-~- ~ Length v~q t Width ~' ~ I Total depth I q Effective absorption area o~C~) Depression over field (Y/N) Date of adequacy test ~/~q/:v For .~ bedrooms Fluid depth i~ absorption field before test (in.);q'rve~v~t t'z~Inunediatelyafter[°O gal. wateradded (in.): Fluid depth ~2~" (ins.) ~ ater: I/:> Absarption rate = ~ /r/D-/~ g.p.d. Peroxide treatment (past 12 months) (YflXl) k-4 If yes, give date Pumper '~4o q~oe~4e~¢-~ Soil rating (g.p.d./fi2 or fi2~d~) ~ Gravel t~c~ess below pipe Moffitofing Tube presentff~ ~/ Resets ~ass~ail) ~ D. LIFT STATION ~.~/ Date installcd Size itl gallons Manhole/Access (Y/N) "Pump oil" level at* "Pump off" level at* High water alarm level at* *Datuln Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ; Ou adjacent lots Absorptiou field on lot ; On adjacenl lots Public sewer main Public sewer manholc/clcanont Sewer/septic service line Lift statiou SEPARATION DISTANCES FROM SEPTIC/~ ON LOT TO: Buildiug fouudation [ ~ Property liue ~ ! ~D Absorption field Water ma n/serv ce line '7' I O Surface water/drainage ~'~/,Z'k_ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation --fl,-O! Water main/service line ~ I Snfface water Curtaiu drain __ Driveway, parking/vehicle storage area ~ O Wells on adjacent lets ~'~/,~ Property line F. ENGINEER'S CERTIFICATION 1 certify that I have determined thrufield inspections and review of Municipal re¢ords tltat the above systems are in coqformance with MOA H'AA guidelines in effect on this date. ,. - - ';7: Signatnre ~, ~ -~ ' ~, En itl ' g HAA Fee $ , ~ Waiver Fcc $ Date of Payment _~,//r//~/~.~::~ Date of Payment Receipt Nnmber ./ ~,~ ,~/Y~:?t~O"~). ~ ~ _ Receipt Nnmber Rev. 8/95 OSS: haa,wk.doc I I I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIO~ DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACIL'TY264-4720 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) 66z0 p ODNO TI EE Op , (b) Applicant Name L/ Rt ¢ FF, filF~ Telephone:Home Oqg-27(Z Business 3V~Z%~'7 ApplicantAddress ~6 2~') ~[~INI') '~'ii~EE ~ DR, Cl Cl %'~ (c) Applicant is (check one): Lending Institution []; Owner/builder [~'; Buyer []; Other [] (explain); Cd) Lending Institution / ~'~ Address ~D ,.b ¢~ (e) Real Estate Company and Agent Address Telephone Telephone (f) Mail the HAA to the following address: 'FYPE OF RESIDENCE Single-Family ~i~l Multi-Family[] ~umber of Bedrooms Other WATER SUPPLY .... Individual Well~i~ Communiw/~,~ Public [] Note: I[ cum munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite J~° Public [] Community [] Holding Tank [] Note: If cum munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the le~: a[ity and status. 72-025 (11/84) Page 1 of 2 I i I L yALL I pOI 6S'Frg-Tz. ~NGiNEERING FIRM PROVtDI~ ~INSPECTIONS, TESTS, FILE SEARCH, O ,~ AND INFORMATION As ce~ified by my seal affixed hereto and as of the validation date shown below, ~ verify that my i~vest[gation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based o~ the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the omsite 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 ~EC~ / ~C- Telephone ~/ ~ ~ Address /~0~ ~, ~ ~ ~[T~ ~ ~, ~ ~ DHEP APPROVAL Approved for//"~-~-) bedrooms by ~e~' ~ Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority App.'oval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MO,-,/ HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ANCHORAGE DEPT. OF HEAL'~[I'[EcKrlsT ' FEBRUARY 1984 ENVJRONMENT^L PROTECTION 264-4720 MAY ~ © Legal Description: ~ / ~-~'~) RE_6EIVED ¢_.¢')/t~ ~ (.//~/'/'7'-~/ I~) B, C, D.E.C. Approved l~N) 2/~ ~0~ Well Log Present (Y/N) Date Completed Yield / Total Depth Cased to Depth of Grouting Static Water Level / PumpSetAt / Casing Height Above Ground /I/~ Sanitary Seal on C.¢~ing (Y/N) Electrical Wiring in Conduit (Y/N)~//f.~ Depression Ar~ Wellhead (Y/N) Separation Distances from Well: J ~ / ! ~/ To Septic/Holding Tank on Lot / /; On Adjoining Lots To Nearest Edge of Absorption Field on Lot-- ; On Adjoining LwO~ TO Nearest Public Sewer Line /~i~i~nSgtw°~ Cleanout/Manhole ~To Nearest Sewer Service Line on Lot Water Sample Collected by ~ ; Date Water Sample Test Results Comments / ,.SEc, B. SEPTIC/HOLDING TANK DATA Date Installed *-~,/~O~/ Standpipes ON) Air-tight Caps Depression over Tank Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /~//~ Separation Distances from Septic/Holding Tank: To Water-Supply Well ~)~ TO Property Line ~'~0 To Water Main/Service Line Course [0~/../L Comments Size /00 0 No. of Compartments Foundation Cleanout ~.N) Date Last Pumped /~//'¢- ;for /~//Z~ Temporary Holding Tank Permit (Y/N) /V//~ To Building Foundation JO / To Disposal Field /' ~ / To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72~026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~ ~ Type of System Design ~-'"/~/'/'~ Date Installed C~l/~ ,5~/2~/?¢ ~/~,EWd¢ ~/2c{,/¢O Length of Field ~,~/~ -/¢/ ~,,~¢'E,A/¢./¢' ~_~___ Width of Field (~ ~1,¢ Ir( / '~'~E/V'CH .~ f Depth of Field _~1~11'~ -~2,.~ Gravel Bed Thickness C/~/I~-~ Square Feet of Absorption Area ~l~J~ 2¢¢O Standpipes Present (~N) Depression over Field (Y/e Date of Last Adequacy Test Results of Last Adequacy Test ..~c.~ ~4; ~:~¢2~ ('~ Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation ,~ /' Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line ~.O To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) __ ./~///~ Ioo ¢0 Comments D. LIFT STATION Date Installed __ Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions _ . Manho, . .~,uCnp Off Level at Vent (Y/N) Pumping Cycles during:,.r~fAd~q~aGy,~t.~ 0~O~ Meets MOA RE-£-EWED ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I havcfche~cke~,verified, er conformed to all MOA and HAA guidelines in effecl on the date of this inspection. Signed Q. ,~//) ~C,~-~.~ Date , _~'--/'/?/~'~ ~" '~' r'' Receipt No.. Date of Payment Amount: $ ~, Page 2 of 2 ALASKA B NOIROIqmeF1TAL COIqTROL SelN t'C6S, IRC. ~n§ineerin§ $ ~ironmcnta] $1udies LARRY ERAIR 6620 ROUNDTREE DRIVE ANCHORAGE ALASKA 99517 SELLER-SAME 5/19/86 LARRY FRAIR 6620 ROUNDTREE DRIVE ANCHORAGE ALASKA 99517 60202 LEGAL:VALLI VUE ESTATES #2 BLOCK 1 LOT 50 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-5/8/86 THE TYPE OF ABSORPTION SYSTEM IS A CRIB/TRENCH WITH AN AREA 0~1466 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DA~'~.~L~ ...... J THE SURGE CAPACITY OF THE SYSTEM IS 701 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OEi~iOOOj.__ IS ADEQUATE FOR THIS S BEDROOM HOUSE./' THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 11/8/85 · THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. 1200 ~JesI 33rd Au6nu¢, Suile [~,.Anchero§¢, Al~s~<o 99503.(907) 561-5040 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-5533 DATE: May 12, 1986 PWS I.D.# 210605 To Whom it May Concern: According to records on file in this office the SUBDIVISION Water Regulations VALLIE VIEW Water System is in compliance with the State Drinking Sincerely, Michael P. Lewis Environmental Engineer ALASKA ENVIRONI~TAL CONTROL SERVIC; ,'INC. '1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO. OF CHECKED BY. DATE I I ~o.~.~Z~L~ ~ Uu~ ~.STm'~-.S '*2 ALASKA ENVIRON~Y~TAL CONTROL SERVlC , INC. , SHEET NO.. OF [200 West 33rd Avenue, Suite B ANCHORAGE, A~SKA 99503 CALCULATED BY ~ ~ (son ssz-s~o CHECKED BY ~O~E I '/'" 20 ~ DATE i t"IOUS~ : ~(~' DP?~"~{ EC El V E D INSPECTION APPOINTMENTS TIME TIME ~ ~) T-fig1 E INSPECTOR INSPECTOR ~'/ INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTEI & ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~vIRONM/NTAL PROTECTION  825 L Street - Anchorage, Alaska 99501 ENVIRONMENTALSANITATION DIVISION AU6 2 1981 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MAI LING ADDR ESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING AODRESS 3. LENDING INSTITUTION .,,~ PHONE tv[Al LING ADDRESS 4, REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE 'NUMBER OF BEDROOMS ~ One ~ Four ~INGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six [] Other 7, WATER SUPPLY [] INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled II--COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach Io§ [f available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** /~' ~'~' YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or []Holding Tank Size: If Tank is homemade give dimensions: NUMBER OFBEDROOMS [] ONE [] THREE [] FiVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOl LS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORFTION AREA MATERIAL Septic/Holding Tank 4. DISTANCES WELLTO: [] OTHER Absorption Area ISewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS L~'"~APPROVEDFOR . ~ .BEDROOMS CONDITIONAL APPROVAL (letter must accompany certificate) DISAPPROVED DATE Rev, 6/79) ANCHORAGE, ALASKA 99502 March 27, 1980 ADC NO. 80009 Mr. Larry Frair SRA, Box 32-F Anchorage, AK 99507 Re: Inspection of Septic System Drain Field, Valli View Subdivision, Addition No. 2. Lot 50, Block l, Dear Mr. Frair: At your request I inspected the drain field around the seepage pit of your septic system on Monday, March 24, 1980. Present were Mr. Kennedy from the Municipality's Department of Health and Environmental Protection, the excavator - Chuok's Backhoe Services, and yourself. When I arrived, I found that 15-foot deep trench, approximately ~O-feet in length, had been excavated. The trench began at the concrete rings in the seepage pit and extended in a westerly di- rection. No ties or horizontal measurements were made to the trench. The depth was measured in the vicinity of the concrete rings. Material in the trench was observed to be a moist, brown, gravelly sand. The material within one to two feet of the concrete rings was gray in color, had a septic odor, and was slightly more moist. ' I collected three samples of the drain field material from the 12- foot depth of the trench. The first sample was taken from adjacent to the concrete rings, approximately two feet below the top of the rings. Sample two was collected five feet from the rings on the south side of the trench. Sample three was collected at a point ten feet from the concrete rings on the north side of the trench. The samples were obtained from undistrubed material in the trench walls. The samples were returned to our office for visual examination and classification. The samples were then submitted to our soils testing laboratory for particle size analysis for final classifi- cation. Particle size analysis was performed in accordance with American Society for Testing and Materials (ASTM) Method D-422 for the mechanical sieve analysis. Ail three samples were determined to be a clean gravelly sand with a Unified Soils Classification of SP. Inspection of Harch 27, 1980 Page -2- Septic System Drain Field Based on Table 1~ Anchorage Municipal Code Chapter 15.65 Waste Mater Dlsposal Regulations, a Unified Soils Classification of SP indicates a required seepage area of 150 square feet per bedroom. For your three bedroom residence, this would require 450 square feet of absorption area. For a seepage pit of 6 feet effective depth this would require a 9'x 9' square pit or a 10 foot diameter pit. The clean, uniform gravelly sand sampled from your drain fiield can be expected to have a goad percolation rate. In my opinion, the material sampled would not have caused your seepage pit to fail. Two possibilities are that the holes in the concrete rings have become plugged, or that holes were never made in the concrete rings. No holes were noticed in the concrete ring daring my inspection, however, only a couple of feet of concrete ring was exposed. I am enclosing for your information a copy of the Municipal Waste Water Regulations and a portion of the Manual of Septic-Tank Practice concerning seepage pits. Also, enclosed are color prints of pictures taken during my inspection. If you have any questions, please contact me. Very truly yours, ALASKA DEVELOPMENT CONSULTANTS phen D. Shrader, P.E. Project Maeager:. Enclosures: as stated SS:bd , :mr/.  , 22~855 20,914 44 20,494 " 43 24,542 ,/ 42 21,881 41 21,084 20,622 39 20, 72 8 38 20,171 37 20~518 36 20,738 202.98 35 20~828 : .. 20, 149 4 20,037 45 21,298 53 20,073 54 20,479 ' 55 20,073 54 21,970 / / 5 20,488 46 22,147 51 eo' 20~526 20,748 57 20,659 20,321 58 20,206 47 24,859 49 20,349 21,( / / / / / / 48 / 20,093 20~557 23,303 0.00 4 2:3,573 5 26,562 . 23,981 29 29~37 8 22,405 9 21,224