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HomeMy WebLinkAboutOLSON HEIGHTS BLK 2 LT 1Olson H i hts Lot 1 Block 2 #018-231-17 Municipality of Anchorage Page J of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SEF:IVlCES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: '-"-~'t-'O~¢o ~c¢-/' PID Number: OI ~ -- 2.A~ - ~'7 Address: /-/200 e. I~;'t-~ /~u. A~c~,.~ i~,~. Phone: ~f15 '-- ~'~ ~ NO. of ~drooms: LEGAL DESCRIPTION Lot: ~ Block: Subd[v~ion: Township: .~ Range: ~, Section: ._ WELL: ~l~.r~New O Upgrade Classification (Private, A,B,C): Total Depth: Driller: Yield: From Well- Wastewater System: [] New ~jil:'Upgrade ABSORPTION FIELD [] Deep Trench 'J2C, Shallow Trench [] Bed [] Mound [] Other ~oil Rating: (~). G GPD/Sq. Ft Depth to pipe bottom from original grade: I'~O~' ~' Et Surface Water Lot Line Foundation Cultain Drain Remarks: Fill added above original grade: Gravel width: Static Water Level: installer: Ft. Total absorptio~¢~ ~/ SQ. Pump Set at: Casing Height Above Ground: GPM Ft. Ft. SEPARATION DISTANCES To Total Depth from original grade: Gravel length: ~ ~ Ft. Number of lines: Distance between lines: ~k~OfbZg- Sewer Lines Pipe material: Date installed: 8/~.,~ TANK ~i~Septic •Holding Capacity in gallons: Material: Number of Compartments: LIFT STATION Size in gallons: Manufacturer: "Pump on" level at: "Pump off" level at: High water alarm at: Pump ~a~e & ~odsl Electrical Inspections perJormad by: BENCH MARK Location and Description: /~,~.~, ~d^'r.~L $ u2a~-Acc,-re~ Inspections performed by: ~o,.~;.uur,~,,rr~, ,oc.Dates: 1st 2nd ? Department of Health and Human Services approval Reviewed and approved by', (~-/-~/--q.'-,--.¢~ ~./, ~~Date: . 7~-0~3 (Rev. 9/91) MOA 25 Assumed Elevation: Ioo. o ..~a~.. ~ '° .'.~ ~ -,,~7..., ~. ........... ~/% JAMES R ~LUAMS /,~ ~ 'u~ ~,~ ,'~_r,~.SW980`304N..~,F:r~: AS ' BUILT DRAWING 5fl 9[2 ~V~,tl - MT2 /CPERC. TESI I"EI,FORMED DURING QNS FRUCTION ALASKA WATER AND WASTEWATER COI~ SULTANTS, INC. 7320 E. CHEm'ER HBOHTS CIRCLE, ANCHORAGE, AK 9950¢ PHONE: (907) 337-6179/FAX: (907) 338-3246 LEGAl_ I)ESCRIP'ilON: OLSON HEIGHTS SUBDIVISION, LOT 1, BLOCK 2 PAP, I:': 20F2 \ \ TYPE OF WORK: AS-BUILT OF SEPTIC SYSTEM UPGRADE ~REPARED FOR: Pl IONE NUMBER: CHRIS AND MAUREEN WlLLIAM~ ,345-9271 ALASKA WATER I~ WASTEWATER CONSULTANTS, INC. ~ OF- ~ Z. [SOIL LOG - PERCOLATION TEST] i~.c [."49_TU//~I[ PERFORMED FOR: CHRIS AND MAUREEN WILLIAMSk / %o*,~¢"/~"";";ES P. WILLIAMS." DATE PERFORMED: 8/24/98 ~LLc¢ ',. NO. 9608 ." · DEPTH ...... TEST HOL_£ #~ ..... ' .......... (feet) OR(; .~, -,e~ 1--~ 2--~;~'~: ~' ~ SOIL CLASSIFICATIONS SW/SM ~ GW i:~:::;'''-' OR6 ...... ~ ~~ GC OL HH 5--~o~ BOSOM OF :,- ¢o ~-. SP ~ CH TRENCH ~ ~ ~ ~' ,:~ SM OH SEE AS--BUILT DRAWING, 6 SC ~ PAGE 2 OF 2 7- DEPTH TO DATE GROUNDWATER 8-- DRY ~//~ 8/24/98 10-- 11 --, DATE READING CLOCK NET TIME WATER LEVEL NET DROP TI~E (MINUTES) READING (INCHES) ~ 2 -~ 8/25/98 1 4:33 6" 2 4:46 1 ~ DRY 6 1 ~ -~ 3 4:47 6" 4 4:57 10 DRY 6 14 .~ 5 4:58 6" 6 5:03 5 ~" 5 15 ~ 7 5:05 6" B 5:10 5 1" 5 ~6~ 9 S: 12 6" ~7~ 10 5:17 S 1' 5 18~ 19-- PERCO~TION RATE 1 (HIN,/INCH) PERC. HOLE DIA. 6" (INCHES) 20-- TEST RUN BETWEEn. ~.~ FT.~AND ~.~ FT. PERFOMED BY A~SKA WATER A WASTEWATER I, X ~ ~ ~'k~ CERTI~ THAT THIS WAS PERFOAM~D IN ACCORDANCE WITH ALL S~¢ t~ AND MUNI~IPAL~GUIOEI-INES IN EFFECT ON THIS DATE. DATE: ~g ,, DEPTH TO DATE GROUNDWATER DRY ~/f~ 8/24/98 LO~. FAX562-$2~6 COMM£NT~' $45-8235 INFORMATION: 007) 343-8211 DA2~: 9/~9~ 04:~ PM PtlO~I: 563-3787 SUBDIVISION: OLSON 8TOP TIIvlE: llV~P~CTOR: ~F[£N C, ORRI~CTIONS AI~ MADE, PLB~,B GALL FOR$.A'$PEC'riON DO NOT ItEM@VE ~ NOTICE. FAX TRAN$1VlI$$10N ALCAN ELECTRICAL & ENGI~iEEltiNG INC. 6670 ARCTIC SP&~R ROAD 99518 P.O. BOX 91499 99509 ANCHOI~GE, ALASKA TELEPItONE # (907) 563.-3787 FAX # (907) 562-6286 SUBJECT: MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box '196650, Anchorage, AK 995'i9-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 13, 1998 Expiration Date: Aug 13, 1999 Permit Number: SW980304 Legal Description: OLSON HEIGHTS BLK 2 LT 1 Design Engineer: 41 Owner Name: Maureen Williams Owner Address: 4200 E 135TH Ave Anchorage , AK 99516-3601 Parcel ID: 018-231-17 Site Address: 004200 135TH AVE E Lot Size: 39223 SCL FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: I~ Disposal Field [] Septic Tank [] Holding Tank [] Privy Private Well [] 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. An additional percolation test shall be performed at the bottom of the trench at time of construction and results submitted with the As-Built package. Received By; ~ Date: Issued By: ""~t~/~"/~d.. C ~'-~1~ Date: Alaska Water & Wastewater 7320 East Chester Heights Circle ~ Anchorage N Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers July 29, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ret~ Septic Upgrade Design for Lot 1, Block 2, Olson Heights Subdivision. To whom it may concern: The existing 3 bedroom house is served by a private septic system and well. The existing trench will not pass an adequacy test and must be upgraded prior to the sale of the house. Two test holes were excavated to the east of the existing septic system. Comments regarding the proposed upgrade design are summarized as follows: 1. SOILS: Attached are the soil logs which shows the soil profiles, and the percolation tests results. No groundwater was encountered during the excavation of the test holes. Two percolation tests were performed, one at 8.0 feet to 8.5 feet in test hole #1 which perked out at a rate of 40 minutes/inch and one at 5.5 feet to 6.0 feet in test hole #2 which, perked out at a rate of 12 minute/inch. 2. TRENCH DESIGN: a. Percolation Rate: 12 and 40 minutes/inch b. Allowable Application Rate: 0.6 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 Ct2 f. Effective Depth: 3.5 feet g. Reduction Factor = 0.54 h. Width: 5 feet i. Minimum Length: 81 feet long j. Effective absorption area = 750 ft2 k. Maximum depth = 5 feet 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As you can see from the attached topography site plan, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. lincerellI V~; SEPn .g~/ni~l~ram s, P.E. DEARMOUN S/O , // / P ~ X ;A~~WA~R AND WAS~WA~ E~ ~ ~o~F ~E~. / CHRIS AND AUJ~EN WlLLIAA~S ~45-9~-/1~ ~ ~ '.... .... ...'~ I RAC, I U, IUIRNAGAIN VtFiW LA:gl I) E/",,I,~MO U N i_0i I0, BI.OCK 1 DRARMOUN II)RAWN FlY: 0i' !, ['I!.OOK i ~0r 2, [~ .... ,, / / / t \ \ c- ()LaON li[il(.]!lTSN \ / · SON I h:.!(~lJ I o /\V., l t J t! ALASKA WATER AND WASTEWATER 7~20 E, CHES'~ER HEIGHTS CIRCLE, ANCHORAGE, AK 99504 .ECA! DESCRff'TION: PHONE: (907) 337-6179/F,~/~ (907) 33B-~246 OLSON HEIGHTS SUBDIVISION, LOT 1, BLOCK 2 ~'PE OF' WORK: SITE PLAN · , ~Re~I~I~°~XND MAUREEN WILLIAMS Pc: I SCALE: 7/29/98 A.C.6. I 1 = 100' LO1 19, BIOCI< O! SON IiE1(;i4,,IS LO/ ;5, [JLOCK 2 SON h/[:!C!llS OIS()N !,LI(,ll],~ ,/ Iii /- TANK i0 BE AR^N[]ONED COMPLFYEHF IDRAWN FlY: . _ - ~ H<ffgIING DRAINFIEJLI~ TO BE ABANDONED COMP!EIE[Y PRUPUS~ D P[,:I% 5UI,]I Z] ii DI-EP Hy fi' WIDE] BY 81' I.ONG (SEE D~;IAIi, PAGE 5 OF 5) ALASKA WA"IT.,R AND WASTEWATER 7320 E,"CHESTER HEIOHT$ CIRCLE, ANOHOR/M~E, AK gg504 PHONE: (907) 337-617g/FAX: (907) 338-3246 OLSON HEIGHTS SUBDIVISION, LOT 1, BLOCK 2 7~~ DESIGN OF SEPTIC SYSTEM UPGRADE '~REPARED FOR: PHOHE NUMB[ER: CHRIS AND MAUREEN WILLIAMS o 545-9271 iOl 2, i31 OCK ! / I D~TAIL PRO~'ItB Dg~ING ALAS~ WATER ~ WASTEWATE~ DERAIL AND PROFILE OF PRESUURIZED TRENCH "' '~'."~iLLiZ~" MAUREEN WILLIAMS ~4.5-927~ ~ '.. u.~. ,.' .~ CHRIS AND ALASKA WATER & WASTEWATER 7320 E. CHESTER HTS. CIRCLE * ANCHORAGE, AK. 99504 PHONE (907) ,357-6179 * FAX (907) 338-3246 ]SOIL LOG - PERCOLATION TEST] LEGAL DESCRIPTION: OLSON HEIGHTS SUBDIVISION, LOT 1, BLOCK PERFORMED FOR: Gl-IRIS AND MAUREEN WILLIAMS DATE PERFORMED: 7/22/98 ORG I TEST HOLE ;JAMES P. WILLIAMS: ',. NO. 9608 ," c.,. SM/ML SW W/ SOME GRAVEL ML/SM SOIL CLASSIFICATIONS ~GW ~ ORG GP HL GM gL GC OL SW MH SP CH SM OH SC DEPTH TO DATE GROUNDWATER DRY 7/22/98 10' 7/29/98 DATE READING DENSE SILT TO SILTY SAND B.O.H. 7/22/98 7/25/98 CLOCK TIME BEGIN Pi IESOAK NET TIME! (HINUTES) PRESOAK 1 2 3 4 --D OVER 24 HOURS 4:30 5:00 30 5:00 5:30 30 NATER LEVEL READING 5 1/4" 6" 5 1/4" NET DROP (INCHES) 21,* 3/4 COHHENTS: PERCOLATION RATE TEST RUN BETWEEN PERFOMED BY ALASKA WATER & WASTEWATER I, THIS WAS PERFORMEfD I~ ACCORDANCE WITH ALL S' DATE. DATE: 40 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 8.0 FT. AND B.5 FT. ~4~ I ~~ , CERTIFY THAT AND MUNICIPAL GUIDELINES IN EFFECT ON THIS ALASKA WATER WASTEWATER PHONE (907) 357-6179 * FAX (907) 338-3246 I SOIL LOG - PERCOLATION TEST I LEGAL DESCRIPTION: OLSON H.~EIGHTS S~UBBIVISION, LO~T 1, BLOC.__K 2~_ PERF'ORMED FOR: CHRIS AND MAUREEN WILLIAMS DATE PERFORMED: __7/22/98 ORG TEST HOLE #2 SW ML/SM W/ SOME SM LENSES. LITTLE TO NO GRAVEL B.O.H. SOIL CLASSIFICATIONS GW GP GM GC SW SP SH SC :.:::; ORG ~CL~ ' ' "'*~ MLoL ,J cH ~ OH DEPTH TO DATE GROUNDWATER DRY 7/22/98 11' 7/29/98 DATE 7/22/98 7/23/98 1 READING BEGIN PI RESTARTI 1 2 3 4. CLOCK TIME IESOAK PRESOAK 4:30 5:00 5:01 5:31 NET TIME:- (MINUTES) AT 12:00 30 30 WATER LEVEL READING 1/4" 3/4" ~/2" NET DROP (INCHES) 2 1/2" 2 1/2" PERCOLATION RATE 12 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN~ FT. AND _6.0 FT. c PERFOMED BY ALASKA WATER & WASTEWATER l, / ~,~/~'1~. / ~/U~,-.v' ,CERTIFY THAT THIS WAS PERFOR~E[~ IN ACCORDANCE WITH ALL ~T~I~E AND MUNICIPAL GUIDELINES IN EFFECT ON THIS · DATE. DATE'~ ~/~1[~ [/ 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 MAILING ADDRESS ~ , EGAL DESCRIPTION LOCATION ,~/ ~ ~ ~ I Manufacturer ~ ~ I Manufacturer / ..... ~-- ~ ~ ~ I No. of linesl I Length ~e~h I~e ~ Total lel~t~of~nes ~ ~ I Top of tile to finish grade ~ Material beneath tile -~ I Length Widtl~ DePth ~ p I~i~ ~ Crib diamete~ Crib depth- S[ ~-- -- Wel~ ~- Building foandat~b,~ I DISTANCE TO: ~ 5 I~ss Depth Drille~ ~ [ ~C~TO B ulldln~ foundatlo~ Sewer hn~ Material N"'~a r e s.~.~o~i '~1~ Trench widt I]~ ,-~..~. ~.., -inches NO. OF B~ROOMS PERM'T NO?/0 ,.'S 7 No. of compacts Liquid depth PERMIT NO. Liquid capacity in gallons '5'7 £ Total effective absorption area PERMIT NO. Total effective absorption area Nearest lot tine OTHER PIPE MAT E PcI~ LS SOIL ']-EST RATI N~, .~) (/~ REMARKS Distance to lot line Septic tank PERMITNO. Absorption area(s) DATE LEGAL Z 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 © 0 0 0 Hz. l~d < Z ? FtPPL :1: r'_':FtFI" HEf;;:L[.5 EEETE. F,i! L 017.1:::1 f' I OP.,I I..iLIF: F N:II'.,I FIREF:t LE!OI::L Ll-:'.'.l. F:,'LI-:::20L. SD.,I HT'_::; E:,B-:'F:IE;{iI"HENT (.. HEI::ILTH Flit.,IE:, El'A,' I ROI'.,ME!:hlt'FtI_ 825 '" L. '" 5"FI?.E:EI"., FtI'C:HORFI(.iE., FIk:. 5050:1. Ot F,,li ..... 5:;; t '"'If"' E: 5':; EE 5 F::F.t E:;,.:: L_OT 5 1 ]"'¢F'E OF SO]iL FIE::!?iF:'.F:'TZOI"~ :E;'t'STE:t'I IS: TF.'.EI'.,E:H HFIXt?IUP1 i'.&MBD;i: OF' [~E[)[;~:Ol:::~l"l'_""!; ='. ~: SOTL F.:FITIN6 ,::'_E;(;! F'T,.'"ES:) .... ±08 'FiE [;:[i~:~;!I...l I FEE:, 5 :[ ;..7. E OF THE 9:) I L FIE,'SOF:F'T 101'.,t 5't".E;TEH :[ 5: ![> EE F" ql'" F.li ....... ::.~ L. EE ~'..,1~ ,2~ T' F..~ ..... :~: ~;'E~ r:3~ F: IF:~ ",,/E: ~ ..... E::,, E:.. F' -F t]4 ...... THE LEI'-~GTH E:,:[i"IEt'.,E;IOI'.4 I5 THE LE~,ISI"H ,::IN FEET) OF 'T'HE TF.:EI'.,IE:H TFIE [:,EF'TH OF FI T'F.'.'F:~:NE:H OF?. F']:T Z5 THE .F..',ISTRI'.,lCE E~E:T!.,.E[::.['i'4 THE SUF4:F'FICE 01:' 'fie GF.'.'OUI'.,I[:, FIN[:, THE: ESTTL-M OF THE E;='::Cf:I'v'FITIO[q ,:: 7[[.,I FEET). THERE lis I'-,t0 5;E1" P.lI[:,'f'H FOF,;': 'I"FEI'.,E:HES;. THE tBRFIVEL E:,EF'TH Z5 THE I',tZI',IIi"II...IH [::,EF:"I"FI OF' 6RFI',,,'EL Ei',ETI.,E:[EI'.,t THE OLITI::'FILL. PIPE FI[',E:, THE ECI'f'TOH OF 'I'HE E;:.OZ:FI',,,'RTIO[.,! ,:.' IN FEET). F'EF..:I',! I '1" FIF'PL I L"::FINI" F.IFI'_--.: TFIE.: F;;~E'.q:::'O[.4S I I NS'ITIL. LRT I ON t t'.,tSF'ECl" I t>,l:~'; OF Rl',t'-r' klELL. 5 FI[:,..:rF:tCE:NT 'TEl TI-f :[ 5 PROF'EF~:T"¢ FIN[) THE I'.,IUI'4!E~EI:~'. OF' F, ESI I)EI'.,tE:E5 THFIT THE: t.,.IE:[_L.. E:f::IE:KF]: LL I [.,IG OF RN"r' :E;'T'%TEi:I'"I I.,.I I THOUT F:'I NFIL. I 1",ISF'EC"I"Z Ol'.,f I:::'F,I[:, RI:'F'FEIVFIL E:"," TH 1 5 [:,EF'FIFI"r"IEI'.~T klI[...L E:E '.51_IE:..!ECT TO PF;;'.O'.SEE:I_tl"];ON. I'"111'.41 t"IUH I) 15;"Ff:II'C:E E:ETNEEN F:I klELL. FIN[:, FII'.,I'¢ Ol'.b-'.'~; I 'T'E SEI.,.IFIGE [::, ]: :E;F:'OSF:I!.... :..'7,'¢:ii;Tliii:f'l :1:5 ::1..00 F'EET [:'0~;i: I:::I F'?.IVFtTE I.,.IELL. OR: :1.50 "FO 208 FE[i:T ~:~::01'"1 i::~ F:'I.JECIC I.,.IELL !)EF:'EI'.,I[::,II'.,tl::) IJPOI'.,! THE T'.,.'F'E OF F'I..IB..IC I.,.IEL. I ..... i'iIl'.,lIhll..tl'i [:, :I: STFINCE F:'f;:~Z~I'I FI PF;:I',,,'FtTE I.,.tELL TO I::1 F'F4:IVFITE :5;EklEF?. L. II'.,!E I'::"; 25 !:::IE:E'T' !::I I'.,I E:, TO FI COHi',IUNIT'¢ SB,tE[;;: LINE IS 75 FE:ET. I.qEL. L LOG5 FIRE F4:E~;!I.JIF:EED, FINE:, HUST BI.:: I~:ETI..IF'.NE[:, TO THE [)EF'FII~:I"FIEI'.,IT I.,.IlTFIIf.,I 5:::0 [)FI'.,.'5 ~'.')!::' TH[F: I.,.IELL COP1F'LET ]: FIt'.,t. Cd"HER REQLI ! RF-':t"'I[EI'-,!T5 !"'II::IY F:IPI::'L'-r'. SPEC ]: F I CFtT I Ol'tS F:It'.,![::, COt'.,ISTI;;:UE:T I ON C, l FI(]RF~I"I':':'; F:II?E FA,'FI I L. FIE~LI.}: TO ~ t'.,I::T,I..I[~:[~: F'F.:OF'ER t NSTi::ILI...FITI ON. ! CEI?T I F:"r' "I'HFIT :1_: I FM F'FMILIRR I.,.II"FH THE I:E%iLI ].' F, EHEEF5 FOR I::IN--'SITE :'i:;EI,.IE[~:5.; F~N[:' I.,.IELI....S FI5 5ET [:'Ct[~:'['I'"I B'¢ THE ["ll..If',l ! C I F'FIL I 'f"¢ OF FINIZ:HI]F~:FII]E. 2: I kt.l'!J_ ZN".E:;TFE. L THE L:.,'¢%I'EH If',l FE:COI~'.[:'FIf',tCE I.,.tI"I"H THE (:::l][:,[i?"_:;. 3: I I.JI'.,IDEF.:STFII'.,t[:, THFIT THE: 13i'.b..5ITE .SENEF;[: 5'T'STEP'I ~"IF:I'T' F:Ef..':!I. J IRE E::NLFI[;.'.GEP1ENT I[::' "f'HE RE511)ENI:::E 1:5 F::EI"ll]E:,ELE[:, 1"0 I I',E:LU[)E I"IOF,".E I"HFII'.~, 2: EC[:,RO0~"t'..:.;. FtF'I::'L. I CFII',ff I'iEf4:LE ECETEI? ?- ....... :: ......... z.... :.'. ............................... [ h T E ....... ,~ ....... .../._....::_......L ........ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTALPROTFCTION 825 L. Streot, Anchorage, Ataska 99501 264-4720 SOILS LOG - PERCOLATION 3'EST PERCOLATION TEST ~, lt¥.~ SLOPE SITE PLAN 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER . IF YES, AT WHAT /~ / E DEPTH? -¢,,,'""' ,'~"~-'"~z~'Gross Net Depth to Net ~'~ ~. }.TM Time Water Drop N ~¢" "' ' ' '4~7 PERCOLATION RATE ~ (V/~ ~'~ 4 ~""'5 (minutes/inch) TEST RUN BETWEEN -~ FT AND ~ FT ,ERFORMEDBY:~, ~*~'~ "CERTIFIEDBY: ~_ ~~. DATE: 72-008 (6/79) : ~:.: MUNICIPALITY OFANCHORAGE :: , :: ' Individual on-site' ,.. ~.-...,.I.~.= ,.,....~., .-,:~ , ,-,, _, " : C:r '~' :'~ i: ~'-n: 'ire'''~'':' 'ommun tyo -s '- XXX 72-025 (Rev, l/gl] Front MOA fl21 Computer Vemlon - - Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1;~.00 at, ' l or prior to, closing for. the engineering services p~ovided. ' ~, , ' ~ 5. ST~,TEMENT OF INSPECTION BY ENGINEER , , /,"*,,d ./~.~v~/ ~S certified bymy ~a, affixed hei:e[0 and.as of':he vaiidation date Sho~n below., verify that myff'lr'~ Investigation of this.'Health Authority Approval application shows that the on,site water supply and/or wastewater disposAl'system iS safe functional and adequate'fo~;thenumber of bedrooms and type of based o~the information obtained from the Municipality of ~.tructure.indicated heteln.~l..further verify that b~sE n'chorage tiles'and.~0m.m~))~e~fl~atioh"ai'id mspe.c, tion..the on;site water supply and/or wastewater disposa s2stem'.is n.~omp ah~ Witia Muh c pa arid State code~ 0rd nances and regulations in effect Name Of F:~:mr A~SK~ w~r~ ~rI~A/J~I~RC°NsuLTANTs, l'NC.. Pi/one: (997)337-6179' in c~n~duc~ng~th~`,~va~u~t~1;~A~?~nc;~:~n~t~c~t~ pr~e` a;~hbraugh; conscie~t~u~b~h`~~n~ ;ana~is of the system' /n' accord!anco With ADEC and i MO~(~i~H~l~,Gqlde/inas : & Regulations, . Th~ /repe ~ed m ~u/ts desc#bbd the performance of the system;under the'co'nditio~s enCOuntered at 'the time of the t~st, and separation d/stances, measured to read/ly identifi~b/e fea~u"r~!.Tfie °Pe'~atib~Ta/ /ifa'of ai~ wei/S a'nd's'epti~ systems dePend =':" on the.-ioc~l soils condition; g~'ound water:le~ls that m~y fluctuate during the year, a'nd the Water,' ~%.~,~ ,~ : / ~. p! y ~; : . . ~::'.b/~tm~',~.~/' '...-~'~, system ~11 continue to meet 'the.OPerbilonal requirements, of the ADEC o~ MOA DHHS. ' ,~.~.-~. ;,-,, ', J ..... : ,,. Thbcententofthlsrepert/s~r'thesole'ben, efitofth~wner~/stedabove. Any ~ :L~ ',' JJ//~",~, ~ ': :, re/iance Upen or use of t is repo a'"Y other persoi 'or' is ,ot a,therl ed. . ' ' mess, nor will it confer any legal rightwhatscever, , ' - ~,.).7¢f-,q,~'~'~YA; '~:~rnes'% ,-J,"~ ApprOvedfor :-,~" ". bedJ'ooms. " ' ' '~o~'~'~'o~x<=~,=~~ DisapprOved.' ,., Conditional=approval for bedrooms, w th the following,stipulations: Note: The'weJZ1 for th:ES property:meets e×ist±ng State and.Hun±c/pal Codes, ;' ' There are nitrates present. It is- suggested,that perfodi~',testing be conc'entration is 5.13'mg/h ,EPAmaximum concentration .is 10~G mg/1. More ,informationr on nitrates,is available ',from the On-'s~t'e: Services Program, bate - o The Munlcipality of Anchorage Department of Health and Human Services (DHHS) ssues Health Authority Approval Certificates based only upon the representations given ~n 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 cedificate Is Issued. rThe Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, 72,.025 (Rev, 1/9'1) Back MOA#2'1 Computer Vemlon RECEIVED Municipality of Anchorage _ _ DEPARTMENT OF HEALTH & HUMAN SERVICE~CT 2 ~1 4uu~/~i~ ....Environmental Services Division 825 L Street, Rm 502 Anchorage, Alaska 99501 (907) 34~ii3~i~ALiTY OF ANC~ ENVIRONMENTAL SERVICEs BIVI5IUN Health Authority Approval Checklist Legal Description: OLSON HEIGHTS S/D; LOT 1, BLOCK 2 Parcel I.D.: 018-251-17 A. WELL DATA Well Type PRIVATE Log present (Y/N) YES Date COmpleted Total depth 59' Cased to 59' Sanitary seal (Y/N) Ifa, B, or C, attach ADEC letter. ADEC water system number 6/`3o/81 Casing height (above ground) YES Wires propedy protected (Y/N) N/A .31.5" YES Date of test FROM WELL LOG 6/5o/81 AT INSPECTION 9/25/2000 Static water level 2`3' 2`3' Well production 8 g.p.m. 4.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 Nitrate Date of sample: 9/25/2000 B. SEPTIC/HOLDING TANK DATA Date installed 8/24/98-8/27,'~'Tank size * 1250 5.15 mg/L Other bacteria. 0 Collected by: A.W.W.C., INC. ~S.T.E.P. TANKI Numberof Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) Date of Pumping 9/25/2000 Pumper NORTHLAND C. ABSORPTION FIELD DATA ~**BELOW FINAL GRADESI Date installed 8/24/98-8/27/~ Soil rating (g.p.d./ft2 or ff2/bdrm) 0.6 YES Depression (Y/N) NO High water alarm (Y/N) YES Length 81' Effective absorption area Date of adequacy test Fluid depth in absorption field before test (in.); Fluid depth 0"/1" (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Computer Vemion [NORTH MT/SOUTH MT] System type TRENCH Width 5' Gravel thickness below pipe `3.67 Total depth **6' 778 SQ FT Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO 9/25/2000 Results (Pass/Fail). PASS For 5 Bedrooms 0" Immediately after 1155 gal. water added (in.): 3"/l .5" 602 Absorption rate = >450 NONE KNOWN ' If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at*. Cycles tested ' ~ qE /24/~-8/27/~ Size in gallons YES ."Pump on" level at* 41" 125O "Pump off" level at* *Datum BOTFOM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service Ilne 100'+ 100'+ 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cIeanout N/A Lift station 10O% SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation_ 5'+ Property line 5'+ Absorption field 5'+ Water main/sarvice line 10'+ Surface water/drainage 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line_ 10% Building foundation Surface water' 10o% Curtain drain NONE KNOWN F. ENGINEER'S CERTIFIC.~TI(:~/ I certify that lha. y~de~r~i¢~J~ru field inspections and review of Municipal re~,or~s tfJa,~ t~e~bo~/e systems are in conformance Signature__ ~-~-//~/]- \.._~7 -- Engineer's Namd r ~,, JEFFREY A. OARNESS Date /-~ Wells on adjacent lets 100'+ , 10'+ Water main/service line 10% Driveway, parking/vehicle storage area 1 o'+ Wells on adjacent lots 100'+ HAAFee$ '~ ~' Date of Payment Receipt Number ' 72-028 (Rev. 3/96)* Computer Version Waiver Fee $ Date of Payment Receipt Number CT&E Environmental Services Inc. Laboratory Division Laboratory Analysis Report 1005771001 AK Water & Wastewater Consultants Inc. Olson Hts Lot 1 Blk 2 Olson Hts Lot 1 Blk 2 Drinking Water CT&E Ref.# Client PO# Client Name Printed Date/Time 10/02/2000 17:49 Project Name/# Collected Date/Time 09/25/2000 16:30 Client Sample ID Received Date/Time 09/26/2000 8:50 Matrix TechnicalDirector~ ~ Stephen C. Erie Ordered By y~~.~ ~ PWSID 0 Released B Sample Remarks: Allowable Prep Analysis Parameter Results PQL Units Method Li~rdts Date Date Init Waters Department Nitrate-N 5.13 0.500 mg/L EPA 300.0 10 nmx 09/26/00 SCL Microbiology Laboratory Total Colifom~ 0 col/100mL SM18 9222B 09/26/00 JDT 200 W. Potter Drive, Anchorage, AK 99518-1605 --Tel: (907) 562-2343 Fax: (907) 561-5301 3180 Peger Road, Fairbanks, AK 99709-5471 --Tel: (907) 474-8656 Fax: (907) 474-9685 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1, GENERAL INFORMATION Complete legal description HAA# ~¢ Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WAI'ER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site NOTE: Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system, 72-025 (Rev, 1/gl) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER o 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 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 I--~ ~b<'-~ ~ ~ u ¢-I~[~.~,¢¢ Address ~o~ u¢ ~ ~ ;z. o3 Engineer's signature "(~- r¢--~-~ ~ Date ~/'~' ~//~' ~' / Phone DHHS SIGNATURE ./~' Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date 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 (Re~, 1/91) B~ck MOA ~1 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number "-/ Date completed Cased to Date of test FROM WELL LOG Static water level Well flow /? Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line Driller Casing height Wires properly protected (Y/N) AT INSPECTION g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout h-/,/~,~, Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate I/¢ ~' Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~ /'*¢/~-~ ? Tank size Cleanouts (Y/N) "~ ? Foundation cleanout (Y/N) / - High water alarm (Y/N) Date of pumping /?%/r~ Compartments · ~.~' Depression (Y/N) Alarm tested (Y/N) N//A, Pumper /E~ "k SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I,r,~ ~,~ TO property line Surface water/drainage On adjacent lots Absorption field l© Foundation_ "~ Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed (~ /~// Length ~'~, ~,. Width Total absorption area ,?~* -~ ¢~ Date of adequacy test ~//1 7/":;~ Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Soil rating (GPD/Ft Gravel thickness Cleanout present (Y/N) Results (pass/fail) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~ To building foundation On adjacent lots Surface water Curtain drain Surface water System type Total depth Depression over field (Y/N) for After test If yes, give date On adjacent lots \,:-~? '~ Properly line To existing or abandoned system on lot Cutbank /"t/ o ~-'1 ~ Water main/service line Driveway, parking/vehicle storage area ~'~ E. ENGINEER'S CERTIFICATION / certify that I have checked, verified, er conformed to all ~OA and HAA guidelines in e ~0'~' th'e date O~ this/ns~ection. Bedrooms Engineer's ,-~,~u,u [ ~'~ r-,~-"~ , f ' [ ...... HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number CT&E Ref.# Client Sample ID Matrix Commercial Testing & Engineering Co. Environmental Laboratory Services ~~7~,~/~~J~~~ LABORATORY ANALYSIS REPORT 94.3007- i LOT 1 BLK 20LSEN HGHTS WATER Client Name TOBBEN SPbrlUG,AND, P.E. WORK Order 79578 Ordered By TOBBEN SPURKLAND Printed Date 06/22/94 ~ 12:23 hrs. Project Name Collected Date 06/17/94 ~ 13:30 hrs. Prt~iect# Received Date 06/17/94 ~ 14:00 lu's. PWSID UA Technical Director STEPHEN C. EDE Sample Remarks: SAMPLE COLLECTED BY: TOBBEN SPURKLAND. QC Allowable Ext. Anal Parameter Results Qual Units Method IJmits Date Date luff Nitratc-N 4.7 mg/L liPA 353.2/300.0 10 06/20/94 CMR * See Special Instructions Above ** See Sample Return'ks Ab ore U = Undetected, Repodcd value is the practical quantification limil. D = Secondary dilution. UA = Unavailable NA = Not Analyzcd LT = Less 'Ihan Gl' = Ch'eater 'limn 5633 B Street, Anchorage, AK 9951 8-1 600 -- Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA MUNICIPALITY OF ANCHORAG% DIVZSION OF ENVIRONMEN'I'AL IlEAl,TH DEPARO~4BNT OF HEALTH AND F,~¥VIRONMI~NTAL PROTECTION A]~PLICATION FOR HEALTH AUTHORITY A~PPROVAL CERTIFICATE ~-~ ~ ~_-- Locagion (address or directions) (e) Applicane is (chec. k one) Landing Inst~.curion l Bc-?-~ ~.mer/bul!der [ ~[ ; (e) Real garage Co. & Agent ~..~/'/,'~;', Address 'g ~? 'V- t~' ..~/" ~'~'~ Telephone ~ ..P-"/'c2 (f) Mail the HAA to the followino~ address: T~e of Residence Single-Family ~ Number of Bedrooms Mull:i-Family Other (describe) Wa t e r. __S u~p~l~y_ %~dividual Well ~ Community Il:: Public Fl: Note: If comm. umi~y well sys~em~ must have +~i~ten co~i~ation from the State Department of Enviroumental Conse~ation attesting to the legality and status~ ~ e__~{a=~e~osal / /~,Note: I.f community well system, mus~ have ~.~itten confirmation from the Stat:e Department of Environmeni:al Conservation attesting to the legality and status~ [Page 1 of 2] 5~ En~.ineeriu~ Firm Providinj~s~ e~.~i~ns, Te~ts Fi~l_e Se~r~cl~ Data and information As certified by my ses% affixed hereto and as of the validation date sho,m below, I verify that my lnvestigatiou of this Health Authority Approval shows that the on-site water supply and/or was~ewate)2 disposal ~ystem Is safe, f~ction~, and ~equate for the number of bedrooms and type of structure indical:ad herein~. I further verify based on ~he lufo~a~ion obtained from ghe Muntcipaligy of Anchorage files and fro~ invesgigation and inspecEion, the o~siBe ~ger supply and/or ~mstewater disposal system is in compliance ~.~.th ~ll ~nicipal and State codes, ordinancas~ a%%d regina~ tions in effect on the dai:e of Bhis lnspecgiou. Da~e (ENGINEER SEAL) DHEP A~p~r ov al Approved for ~.--~ bedrooms Approved / --~- Dl,~approved Te~nns of Condiciona& Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMEWf OF ~ALTH AND E~IRONM]ZNTAL PROTECTION (DHEP) ISSUES E~TH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE, REPRESENT-~ ATIONS GIVEN IN PARAGB2kPtt 5 ABOVE BY AN INDEPENDEb~ PROFESSIONAL ENGIneER RJZGISTERED IN THE STATE OF ALASKA° ~,~, DttEP DOES THIS AS A COURTESY TO PLrRCHASERS OF I{OMES AND THEIR LENDING INSTITUTIONS IN 0PODER TO SATISFY CERTJklN FEDERAL AND STATE REQUIRE- MENTSo EMPLOYEES 01~ DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICA'i~E IS ISSUED° TIJE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK° (DHEP SEAL) RR4/eJ/D18 [Page 2 of 2] 7 =1 9~84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description Well Classification P~'/¢.4~-¢~ Well Log P~esent~) Total Depth ~-~ / Cased to Static Water Level /~ / ~ Casing Height Above Grcund ElectriCal Wiring ~n Conduit.~/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot MUNICIPALITY OF AN(:!! t:i,,<~;- DJ!PT. Ol: HEALi~i ,~ F:NVIRONMRN'[AL PiRC F£CI'ION 1985 ' Ec. RIVE[). If A, B, or C, D.E.C. App=oved(Y/N) ,~ff/ Depth of Grouting. Pump Set At Sanitary Seal on CasingS__ Depression A~ound Wellhead ; On Adjoining Lots To Nearest Edge of AbsorPtion Field on Lot.. /~ ~; On Adjoining Lots To Nearest Pub] ic F~we~ Line ¢d/~ To Nearest Public Sewe~ Cleancut/Manhole /M~Q~ To Nearest Sewer Service Li. ne on Lot ' ' / f/"- ~/ / j t ' Water Sample Collected By ~~e~¢~ ; Date ~ ~tO/~ ~Wate= Sample Test l~sults ~ /~%~1-~¢~ ~ -- ~ ~ , · // /~ J {/' [ / / Be¸ .S.EPTIC/HOLDING TANK DATA Date Installed . ~/~ ~ Si?~ /¢P~ No. of C~a~tments Standpipes ~) /.l Air-tight Caps,) Foundatio~ Cleanout~N) Depression ove~:r Tank (Y~ Date Last Pumped ~/./(,/~_~ Pumping/Maintenance Contract on File (Y/N)~/~L~, for / Holding Tank High-Water Alarm (Y/N) ~//~-~/'~mporary Holding. T.]a~nk Permit (Y/N).~I~-~-- Separation Distances ~om Septic/l~olding Tank: To Wate=-Supply We 11 I ! To Property Line To Water Main/Se=vice Line / To Building Foundation To Disposal Field..f ~/ To Stream, Pond, Lake, or Major Drainage cou=se 41 7e- [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Stmata Type of System Design Date Installed ~(~ (fl Length of Field ~/ Width of Field ~/ Depth of Field ~ ~)/~l Gravel Bed Thickness ~t(~ Square Feet of Absorptio~ A~ea ~ Standpipes P~esent ~) Depression over Field (YO Date of Last Ad~qua~z Test_ /, /9/%~ Results of Last Adequacy Test _~P~-~o~I) ~o~ ~ Separation Distance f~cm Absorption Field: To Water-Supply Well }~'~ To P~operty Line ~ To Building Foundation . .~i_~ To Existing or Abandoned System cn To Water Main/Se=vice Line ~O~, To Cutbank(if present) To Stream/Pond/Lake/c~ Major Drainage Course t[6v0 To Driveway, Pa~kir~ Area, or Vehicle Storage Area LIFT STATION Date Installed Size in Gallons ~ a .igh Water Alarm Le~l~at //- .~..--"'-- Vent (Y/N) Eleetuical Codes (Y/~ ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect Company ec% Kml/d5/s [Page 2 of 2] 2-15-84 ALASKA IEIIUIROFImIEFIT,qL COFITROL :RUICIE$, IBC. ~nclineerinq 8- ~nuironrnenM $1udie~ JOHN HARTZ 4200 E 135 STREET ANCHORAGE ALASKA SELLER-HERITAGE HOMES MAY 15 1985 WILL PICK UP FROM OUR OFFICE 85136 LEGAL:OLSON HEIGHTS SUBD/BLOCK 2/LOT 1 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-NOV 9 1984 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 320 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 665 ~G~L~O_N~NS. ~TEST DATA THE SYSTEM IS~F~ SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IlS ~)EQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON NOV 11 1984 . FLOW TEST ON WELL WELL FLOW DATE-NOV 9 1984 A FLOW TEST WAS PERFORMED ON THE WELL. 665 GALLONS OF WATER WAS PUMPED AT A RATE OF 5.1 GPM OVER A DURATION OF 2 HOURS. THE DRAWDOWN WAS 33 ' WITH A RECOVERY TIME OF 90 MINUTES AND THE STATIC WATER LEVEL WAS 15.5 FEET. THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME. 1200 [~¢sl 33rd Aucnue. Suile [~eAnchoroi)e glosko 99503,(907) 561 50L!O MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIROI~MENTAL HEALTH DEPARTMENT OF KEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE General Information Application Date _ (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name ~[~, Applicants Address (c) Applicant is (check one) Lending Institution ~..~---~zO~Ib:'~r~ider ot er (explain); Telephone - Itome Business (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address (f) Telephone Mail the HAA to the following address: ~ of Residence Single-Family ~/~ Number of Bed#ooms Multi-.Family Other describe) Water Supply' Individual Well ~.- Community ~ Public ~ Note: If community well system, must have v~itten confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Di?,posa. Onsite I~' Public Note: IY community well system, must have written confirmation from the State  Department of Environmental Conservation attesting to the' legality and status. [Page 1 of 2] 5. Engineerin$ Firm Providin$ Inspections~ Tes.ts~ File~Sear~,__Data and. Informatio_~n. DHEP Approval Approved for ~'~ bedrooms Approved ,~ Disapproved As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm /~ ~'_<~ ~;~c-~ Tel. ephone_~Z~b~)_~_~__ Date Conditional Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19--84 A® WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 We'i1 Classification Well Log P~esent~/N) Total Depth ~;~ Cased to Static Water Level ~ Casing Height Above Ground Electrical Wiring in Conduit~. ) Separation Distances from We~.' To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line MUNICiPALIT,' OF ;' "'"'~' ..... ~ DEPL 0[: = ' I, ov J, 5 I984 Legal Description: l'"'~ B~ ~'X Date Co~leted ~ I~/~ *ie( e ~l/ ~pth'of~routing Sanitary ~al on CasingS) ~p~ession ~ound ~llhead (.Y~ ; On Adjoining Lots ~lO0/~t ;';'~O! 'ye- ; On Adjoining Lots ~/~O ~ ~(~ TO Newest Public Clean, t/Manhole ~[~ To ~a~est ~r ~rvige Lib'on ~t Water Sample Collected By ~}'~ ; ~te Water S~le Test ~sults ~ ~~' Be SEPTIC/HOLDING TANK DATA Date Installed ~/~{'1~1 Size xJOo-~'~ NO. of Compartments Z~- Standpipes ~);'~ Air-tight Caps ~JN) Foundation CleanoutC~/lq'i Depression over Tank (Y~ Date Last Pumped .~//(/~ Pumping/Maintenance ContJact on File (Y/N),~//~-~'for Holding Tank High-Wate~ Alarm (Y/N) ~/~emporary Holding Tank Permit (Y/N)/~ Separation Distances from Septic/Holding Tank: To Water-Supply Well //,~t To Property Line To Water Main/Service Line ~_~/~ Course ~f'l ~0 ~ Corar~nts Receipt # Date Paid: Aanount: To Building Foundation ~ ¢//~ To Disposal Field"~'~'~'- ~; ~,L/'~[~)f~ ~~ To S~e~, Pond, ~e, ~ Major ~aina~ [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils P~ting in Absorption Strata Date Installed Width of Field , j~ / Square Feet of Absorption A~ea Depression over Field (.Y~.)) Results of Last Adequacy Test /~) .~' Type of System Design _ Length of Field. ~,~_ ~pth of Field , ~,~ Gravel ~d Thickness ~ Stan~i~s ~esent~) [~te of ~st A~qua~ Test Separation Distance from Absorption Field: To Water-Supply Well /~)/'~'~ To l~operty Line., z//~" To Building Foundation ,~9/~ To Existing or A~ndoned System on Lot ~&~/~ ; On Adjoining Lots ~ ~/~ / ~ To Water Main/Service Line .~-~) /~ To Cutba~<(if ]present) To Stream/Pond/Lake/or Major Drainage Course. ,/~/Z2D/~- To Driveway, Parking Area, or Vehlule Storage Area ~ LIFT STATION Date Installed Dimansions Tested for / ~/ Pumping Cycles during Adequacy Test. Electrical Code~/. ~I~ . . Comments // - Meets Y~'A ** Check Permitted Bedrcom Rating Against HAA l~equest ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect KB1/d5/s Date MOA No. [Page 2 of 2] 2-15-84 ALASKA lldllqOIqmeF1TAL COI TIqOL S BdlC S, IF1C. ~§i~¢¢Hn~ 8 ~nuironm¢~Id Sludi~ NU)V 10 1980 TRANS~.I CA RELOCATION FOST OFFICE BOX 8026 WALixlJT O~IED< CA 90596 SELLER - 3OHN HARTZ BUYER - SUBDIVISION - OLSON HEICJTFS BLCO~ - 2 LOF - I ADE~JACYTEST FUR SEWER SYSTEM THE TYPE OF ABSCRPTION SYSTEM IS A TRENCH WITH ~q AREA OF 320 S~. THE SYSTEM IS CAPABLE OF /~Z)CEPTING 050 GALLC~NS OF WAT~ PD~ DAY. THE, SURGE CAPACITY OF THE SYSTEM IS 665 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS /gUCEPTABLE FlER A 3 BEDRCCMA3ViE. THE SEPTIC TANK WAS I~JM°-'ED ON 3ULY ii 1984 . A FLOW TEST WAS PP, EFCR/~',D ON THE V~ELL. 665 GALLONS OF WAFER WAS PUNPED ,5F A RATE OF 5.1 GPM OVER A DURATION CF 2 FEIJRS. THE DRAV~ WAS 33' WITH A RECDVERY ThVE. OF 90 MINUTES AND THE STATIC WATER LEVEL WAS 15.5 FEET. THE ~gELL I S ADEQJATE FCR TH I S 3 BEDRCCM HCA'E. SEPTIC TAF~ ADEQUACY THE ID(ISTING SEPTIC TAN< VOLU~/E OF 1000 IS ADEQUATE:, b-UR TItlS 3 BEDRCCM HCUSE. 1200 [IJesl 33rd Auenue. $ui1¢ B.Anchore¥. Alaska 99503e(907) 561-50/40 Time Date Inspector Time Date Inspector Date Inspector Comments Soils Rating Conditional Approva Permit No. Well To Absorption Area Welt to Tank Septic Tank Size Holding Tank Size Well Log Received APPLICANT FILLS OUT LOWER HALF ONLY Property Owner Buyer Phone Lending Institution ~- ~_: ~ ¢ °ne, g:l Type Cesidence ~ ~3 Single Family [~ Multiple Family No. of Bedrooms i~ Other Water~S~ipply /Q Individual ,~/" ;/ ATTACH WELL LOG. A well Icg is required for all Wells drilled since June r Id Community (~/// / 1975. For wells drilled prior to that date~ give well depth (attach Icg if iD Public Utility available.) f Sew~ Disposal /t'J Individual Year Individual Installed: iN Public Utility When Connected to Public Utility:_ · _FJ Holdin_g ~iank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATE[).