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Home My WebLink AboutKASILOF HILLS BLK 4 LT 18Kasilof Hills Lot 18 Block 4 #015-131-14 Municipality of Anchorage P.~ _ 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 .e..~tNu.,~eF: ¢;1'd0/~/O-£'~_~' [~UNu,.beF: OI~LI'%i- I~ Na~.: ~¢, ( ~,//(~r Waslewaler System: u New ~Upgrade Address: ' I ' s:~ ~ Deep Trench ~ Shallow Trench BBed BMound BOther Lol: Subdlvb on: Depth Io pipe boltom ¢rom original grade: O~avel deplh beneath pipe WELL: ~ ""W ~ U"'~ ~2 ,,. "umber°'l~: I ~ Ft. ' Driller: ~ Date DHged: Slatic Walm Level:Fl. Installer:.~¢¢.~ A.~ ¢~ f,~~' Date 'nslalled: ¢;7-- e.~ ~L ~, TANK SEPARATION DISTANCES , ~Septic g Holding U S.T.E.P. Flora Tank Fletd S1alJo. Tank Sewer Lines Water ~00~ ~t¢ ~00~¢ ~ LIFT STATION I1' I' 17034 Eagle Eiver Loop Road, N~, 2~ ~ ~ /~h ~ ~ . ~f,,..~,,,.¢ ..... ~,,,. Inspections performed by:Eagle myer. Alaska 99~ Dates: lsl~-~~-~ "~~,,~, .... Deparlmenl of ~ea~ aha Human ~erwces approval ~-~; ......... Reviewed and approved by:._ Date'./D -1~-~_ -t... ~c~;' ....... :.~- PERMIT NO SW990335 PAGE 2 _ OF 3 Municip. alit oF Anchorage DEPARTHENT OF HEA~.TH AND HUNAN SERVICES ENVIRONHENTAL SERVICES DIVISION P.D, Box 196650 OAnchopage, Alaska 99519 6650@Te~ephone: 343 4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 18, BLOCK 4, KA$1LOF HILLS S/D P.LD. NO. 015--151--14 100' ~0 S / EXISTING TRENCHES EXISTING DRIVEWAY ALTERNATE SITE EXISTIN( u HOUSE ~TH#~ FAT ALBERT UNIT WITH LIFT STATION LOT 19 SAND FILTER SCALE: 1" PERMIT NO SW990335 PAGE 3 OF 3 Hunicip. ~[i~ of AnchoraGe DEPARTHENT OF HEALTH AND HUMAN SERVICES ENVIRONP~ENTAL SERVICES DIVISION P.E]. Box 196650 O/~nchorage, A/o. ska 99519-6650 O Tetephone: 343-4744 ON=SITE WASTEWATER DISPOSAL SYSTEN AND/OR WELL [NSPECTION REPORT LEGAL LOT 18, BLOCK 4, KASILOF HILLS S/D P.I.D. NO. 015--131--14 ST FINAL GRADE~'~ S T,~..- 95.2' 'NEW 1000 ~~, GALLON [ x89.1' SEPTIC TANK I MT1 GRADE INSULATION MT2 -ORIGINAL GRADE MTI =99.1 DIST. LINE=lO1.3' A B FCO 20.5' 21.0' ST1 16.5' 29.0' ST2 15.5' 35.0' DBL1 16.0' 38.0' DBL2 16.5' 39.0' DV 17.0' 40.5' MT1 40.0' 35.5' MT2 55.0' 21.5' MH 40.5' 68.5' FVl 55.5' 22.5' FY2 56.5' 24.5' FV3 57.5' 26.5' FV4 59.0' 29.0' FV5 60.0' 30.5' EFFLUENT INLET GROUNDWATER AT 94.1' 91.1' B.O.H. :== :~--- INSULATION OUTLET N.T S ,HtJLIUI /UL:U METER8 · ~ 8O 30O 20O 0 ~ lO t~ 20 25 3O GPM 35 I I I I,, I I I ,I 0 I 2 3 4 5 6 ? m3m CAPACITY I L.~b ((nc~ We,~ (ih, Ordl~ Hamblr -HP Pk~ ~llS W~,~ ~ ~r, LO~,~ W.E. ~ ,, T~ ~[B~,~ ~ ,~" 4 9,6 ,0,6, '~,1g,1 3 t8 21 ~E~7~ ~ I 6 ~1,3 10.7 ,; ~,o 4 ~ 24 _ 20E61~ , 1 I 8 13.0 11.8 ~B16~2 1~ 1, tl 18.5 ~.~ PW.E. :, v~terr~d..dr pgIT~witJ~it motor. D]~CI~fl6E fi4' NPT ' ~. prk~ o n re,~c~l p~lpe r. TOTAL PAGE.004 ~ MUNICIPALITY OF ANCHORAGE Deparfment of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 14, 1999 Expiration Date: Sep 13, 2000 Permit Number: SW990335 Legal Description: KASILOF HILLS BLK 4 LT 18 Design Engineer: 0003 S & S Engineering Owner Name: Eric Walker OwnerAddress: 10701 Rezanof Circle ANCHORAGE, AK 99516-0000 Parcel ID: 015-131-14 Site Address: 010701 REZANOF ClR Lot Size: J~ SQ. FT. Total Bedrooms: ~' Permit Bedrooms: ~' This permit is for the construction of: [] Disposal Field ~' SepticTank [] 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. blDSF - This permit is for a bottomless intermittant dosing sand filter system. Received By: Issued By: Date: ROBERT C. COWAN, P.E, SEWER&WATER SEWER&WATER INSPECTION ROAODESIGN SOIL TEST STRUCTURAL& MECHANICAL INSPECTIONS September 8, 1999 · CIVIL ENGINEERS (907) 694-2979 FAX (g07) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 18, Block 4, KasilofHills S/D It is requested that you issue a permit to install a bottomless intermittant dosing sand filter and lift station to serve the existing four bedroom dwelling on the referenced property. Two test holes were excavated and percolation tests performed. location of the test holes are located on the attached site plan. monitored as shown on the attached soils logs. The approximate Ground water was We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/jhm Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Rick Mystrom, Mayor Municipality of Auchorag¢ Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us September 17, 1999 Robert C. Cowan, PE S&S Engineering 17034 North Eagle River Loop, Suite 204 Eagle River, AK 99577 Subject: Waiver Request for KasilofHills Block 4 Lot 18 Waiver Request #WR990071 Parcel ID #015-131-14 Permit #SW990335 Dear Mr. Cowan: Your request for a waiver of the required I0 feet horizontal separation from the on-site wastewater disposal system to property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the existing on-site wastewater disposal system to property line separation only. Any future upgrade to the on-site wastewater disposal system will require ali separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, Donna C. Mears, E.I.T. Civil Engineer On-Site Water Quality Program WR~ WR990071 PID# 015-131-14 Date Received: Sept 10, 1999 Legal Description: Lot 18 Block 4 Kasilof Hills Engineer: Applicant: MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet HA~ Permit Robert C Cowan, PE.~ S & S Engineering 17034 Easte River Loop Raod~ Suite 204~ EAgle River, Alaska Eric Walker 99577 Waiver Requested: property line lot line waiver ofi:l foot from the leachfield to teh south Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2o Special Conditions: Points: 3. Other: Waiver is Granted: Waiver ms NOT Granted: List Conditions or Reasons for above: Date: Nam~ of Reviewer Rec #: 05258/8219 Amount: $ 115.00 Date Paid: 9-10-99 WELLINSPECTION &FLOWIEST ROADOESIGN SOILTEST q neemnq ROBERT C. COWAN, P.E. September 8, 1999 ' CIVIL ENGINEEP~S (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519 REFERENCE: Lot 18, Block 4, KasilofHills Subdivision Request you grant the following waiver for the existing four bedroom house on the referenced property: a waiver for the separation distance from the proposed bottomless intermittant sand filter bed and the south lot line of the above referenced property at one foot. The mitigating factors involved which support the issuance of the waiver is as follows: 1. The existing drainfield trenches are saturated and an alternate system needs to be installed for the existing four bedroom house. 2. Required 100 foot setback to existing surface water encroaches on the west perimeter of the lot and surrounding well radii to the north limit the area available to install a septic system elsewhere on the lot. 3. A 20 percent slope in the only available area to the north is unsatisfactory for installation of the proposed intermittant sand filter. This leaves only the area near the southern lot line available. We, therefore recommend a waiver for the separation distance between the proposed bottomless intermittant sand filter and the south lot line at one foot. We do not anticipate any adverse effects on the neighboring properties by the granting of this waiver. If you have any questions, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/jhm 17034 NORTH EAGLE RIVER LOOP SUITE 204 · EAGLE RIVER, ALASKA 99577 · I," = 40' SITE PLAN UPORADE SCALE --1 N.T,S. ' SCALE PLAN VIEW BED DETAIL N.T.S. SCALE PROFILE DETAIL 1 PERFORMED FOR: LEGAL DESCRIPTION: LO Municipality of Anchorage. r DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~ ~b ~ ~ DATE PERFORMED: ~ Lo~ ~ Township, Range, Section: 1 2 3 4 5. 6 7 8 9 10 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After ~ y MonDednD? Date: Reading Date Gross Net Depth to Net Time Time Water Drop o - - :~ o :~ o ~,,,,., r~ '~" / ~/~'" ~,-,~,_ ? 0 S"~ ~o / ~ ~/~" / '/~" " " ~ ~' ~ O~ G V~" I ~/~ ' PERCOLATION RATE '~. 0 (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ~ FT AND ~ FT $ & S ENGINEERING ACCORDANCE WI~Y~~AL GUJDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) IN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~j~ ~'~ I. LEGAL D~SCRtPTION: Township, Range, Section: 1 2 3- 4- 6- 7- 8- 9- 10- 11 13- 15- 16- 17 18 19 2O WAS GROUND WATER ENCOUNTERED? 'Yf~ ~ IF YES, AT WHAT t DEPTH? -~ pO E Depth to Water Alter ? Monitoriflo? / o Date: SLOPE SITE PLAN J I Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN FT AND __ FT COMMENTS PERFORMED BY: fi & ~ F.i~iGii4EF.~ii~i~ [ / . ~.,~,-, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITHJ~'~,JJiJMIIII~J~t~JA~I~II'II~I, IJ[I~ IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Eagle River, Alaska RORERT C, COWAN, P,E, W~LLINSPEOTION & FLOWTEST SOILTEST STRUCTURAL& MECHANICAL INSPECTIONS INTERMITTENT SAND FILTER SPECIFICATIONS (Bottomless) Lot 18, Block 4, Kasilof Hills Subdivision September 8, 1999 ' CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 GENERAL STATEMENT OF WORK The work covered by these specifications and the plans consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an intermittent sand filter system as described herein and on the attached drawings. All work under this project shall comply with current Municipality of Anchorage (MOA) Wastewater Regulations. 4 Bedroom House = 600 GPD Use 4.0 GPD/SF for polished effluent 150 S.F. required 18' x 20' sand filter and absorption area Sand filter to be constructed on accepting soil SITE INVESTIGATION The Contractor who proposes to complete this project must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must be satisfied with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered insofar as this information is reasonably ascertainable from an inspection of the site, including all prior exploratory work, as well as from information presented by the plans and specifications made a part of this project. Any failure by the Contractor to become acquainted with the available information will not relieve him/her from responsibility for performing the work as stated in these specifications and drawings. Location of utilities will be the contractor's responsibility. 17034 NORTH EAGLE RIVER LOOP SUITE 204 EAGLE RIVER, ALASKA 99577 Page 2 Lot '[8; Block 4, · Kasilof Hills S/D September 8, '1999 At least twenty-four (24) hours prior to commencing work, the Contractor shall contact all local utility companies to obtain underground utility locates. The Contractor shall exert due care to prevent damage to utilities. Should a utility be damaged, the Contractor shall notify the utility company and shall have repaired at his own expense any damage resulting fi:om failure of the Contractor to request an underground utility locate or to exert due care. If any utility company determines that a utility has to be temporarily raised, lowered, moved, guyed, shored, braced or otherwise protected during construction, it shall be done at the expense of the Contractor to the satisfaction of the utility company. INSPECTIONS Typically, there will be a minimum of eight (8) inspections required during the installation of the waste water disposal system. These inspections will occur as follow: Inspection of work in progress may be made by the Engineer and MOA at any time. The following schedule of required inspections is to be adhered to. Twenty-four (24) hours notice is required prior to each inspec- tion. Inspections can only be arranged during weekdays and during normal working hours. The following inspection schedule is to be strictly adhered to: 1. Septic tank/lift station is in place, but not backfilled. Sewer piping fi:om building to tank is complete, properly bedded and backfilled. 2. Sand filter pit is excavated and prepared for filter construction. Prior to placement of filter liner material. Engineer to be notified with Contractor's schedule during actual construction of the sand filter to allow spot inspection during construction. Any deviation fi:om reported schedule is to be reported to the Engineer. Final inspection of the sand filter with all pressure piping in place, but prior to placement of cover material. Flow testing of pressure piping at this time will require completion of lift station wiring prior to this inspection. 5. Inspection of final grading. The Owner shall contract with the Contractor to perform the work outlined in these specifications, plans and in accordance with the attached MOA permit. There will be no contractual arrangement existing between the Contractor and S&S Engineering. S&S Engineering shall be the Owner's representative and will inspect the work as stated above to document the Contractor's activities. Final acceptance of the Contractor's work rests with the Owner. Page 3 Lot '[8; Block 4, Kasilof Hills S/D September 8, '1999 S&S Engineering shall have no liability to the Owner or to others for acts or omissions of the Contractor or any other persons performing work on this project or the failure of the Contractor to carry out the work in accordance with these construction documents. S&S Engineering's inspecting Engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. All landscaping, fences, sidewalks, paving, driveways, utility markers and other improvements, removed to facilitate the Contractor's operations shall be fully restored to their original condition and location by the Contractor unless otherwise directed by the Engineer. Items damaged by the Contractor during removal, storage, or restoration, shall be repaired or replaced in kind by the Contractor. This work shall be considered incidental to the project. MINIMUM MATERIAL SPECIFICATIONS 1. Any septic tank proposed for installation must be constructed by an MOA approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes ASTM D2241 Yes Yes ASTM D2239-74 Yes Yes Use of a tyPe of pipe other than listed here must be approved by the inspecting Engineer. 1. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 2. Septic tank inlets and outlets shall be fitted with water tight couplings (Cauldcr, Femco, or equal). 3. When sand is being used as a filter material, its gradation specifications must confomr to current MOA or ADEC requirements. Page 4 Lot '(8; Block 4, Kasilof Hills S/D September 8, '1999 SEPTIC TANK/LIFT STATION A. General The work under this section consists of the perfom~ance of all operations pertaining to furnishing and installing the septic tank/lift station and piping to the sand filter. B. Materials 1. Tank for Lift Systems Septic tank shall be a two compartment steel tank specifically for the use of Orenco Systems, Inc. patented lift station assembly Orenco No. 4200, or approved equal. The tanks shall be designed for soil loading conditions as required by the MOA and State regulations. The design or analysis shall be in accor- dance with accepted engineering practice and local regulatory agencies. c. All welding shall be in accordance with applicable codes and standards. 2. Risers a. First compartment shall have a separate 4" pump out riser. The second compartment shall have a separate 4" pump out riser. An additional second compartment manhole riser shall be 12 gauge sheet steel and shall extend 12" (minimum), above surface grade, shall have a minimum nominal diameter of 24" and shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the riser. c. UL listed electrical cord grips, installed in the J-box. d. A lid - shall be furnished with the riser. It shall be constructed of fiberglass or equivalent aggregate finish, meet H-10 loading requirements and have a latching mechanism. Page 5 Lot '18; Block 4, Kasilof Hills S/D September 8, 1999 Riser installation - each riser shall be sealed or welded to the top of the tank in such a manner as to prevent infiltration of ground water. f. Lid insulation - 4" rigid extruded polystyrene shall be placed in the riser directly below and attached to the lid. g. Riser insulation - 2" sprayed shop applied urethane on circumference of riser with 46465 Tnemec coating. 3. Effluent Pumping Assembly a. Effluent pumping assembly shall be Orenco systems (TM) Model 20-OSI-05-HHF series, or approved equal, consisting of the following: 1. 1/2 H.P. 110 volt or equal U.L. Listed effluent pump. Screened pump vault (U.S. patent No. 4439323) 59" deep, 3/16" thick high-density PVC cylinder houses the pump, level controls and screen and serves as a baffle to prevent the screen tkom clogging. Fifteen 1 1/2" diameter holes are drilled in thc vault at a level that places them at about the midway point in the depth of the septic. Flap check: Allows the vault to dram when removing the tank. Screen: 15" diameter cylinder of high-density polyethylene 1/8" mesh. 3. All piping shall be PVC or other non-corroding material. b. Pump controls and alarm system shall be Orenco systems SICTETMRO 110 volt with the following options consisfmg of: 1. Event counter 2. Elapsed tune meter 3. Program timer Page 6 Lot 18, Block 4, Kasilof Hills S/D September 8, 1999 4. 10wattheater Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the. home. 6. Oil-tight visual alarm with push-to-silence feature. Automatic audio-alarm reset. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (H.O.A.). 8 Nema 4x-rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. Piping fi.om the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the septic tank. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. CONSTRUCTION SEQUENCE In order to insure proper inspection procedure, the system is to be installed in the following order: I. Sewer line from house to tank I1. Septic tank/lift station III. Sand filter iV. Final grading Page 7 Lot '18, Block 4, Kasilof Hills SID September 8, '1999 CONSTRUCTION 1. Pipe Grade and Alignment Variance of individual p~pe sections from established line and grade shall not be greater than 0.02 feet, providing that such variance does not result in a level or reverse sloping invert. During the progress of the work, the Contractor shall provide instruments such as transits, or levels, for transferring grades from offset hubs or other construction guides from the control points and bench marks provided to the Contractor by the Engineer. The Contractor shall provide qualified personnel to use such instruments and who shall have the duty and responsibility for placing and maintaining such construction guides. 2. Pipe Laying All pipe shall be laid with Class C bedding, free of large stones and orgamc matter. Each section of pipe shall be handled carefully and placed accurately, the spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water fight seal. Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be securely and satisfactorily closed so that no undesirable substance will entel the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines The pipe should be bedded with Class C bedding materials, compacted to 95%. Native materials may be used as back fill material above the pipe, provided it is free of large stones and organic matter to a point one (1) foot above the top of the pipe. All pumping services shall be installed in accordance with the manufacturer's recommendations and standards. Electrical installation is to be to code by a licensed electrical contractor, with Municipality inspection where required. If an MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. Page 8 Lot 'i8; Block 4, Kasilof Hills S/D September 8, ~1999 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted to 95% classified sand fill material. Line excavated tank pit walls with 2" +35 PSI burial foam full depth of tank. Back fill between tank and foam with sand material and compact in a manner to prevent damage to tank surface coating. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank location to a depth of 2' above finished grade to allow positive drainage away from tank and cotmteract buoyancy. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. A sample of the proposed filter sand must be submitted to the Engineer for testing one (1) week prior to construction. A sample will be taken f~om the sand bed during construction for purposes of quality control. If the sample does not meet specifications, all sand will be removed and replaced. b. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no f'mes (0% passing the #100 sieve) and a maximum size of 1/4" diameter. c. The Contractor shall provide the manifold assembly. The manifold assembly shall be the Orenco Model SFM 1036 or equivalent with orifice shields and flushing Page 9 Lot '~8~ Block 4, Kasilof Hills S/D September 8, 1999 assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. d. Side walls and top of the filter box to be insulated with 2" direct burial polystyrene insulation and be inside the plywood box. e. The Contractor shall be responsible for providing filter fabric. f. The linear air difuser line and compressor is available from Orenco, no model number available. The feed line from the house to the filter is HDPE arctic insulated pipe 3/4"-2" SDR-11 Maskell-Robbins or equivalent. The compressor will have a gauge (0-10 psi) and be installed in a heated area, crawl space, or garage. 2. Construction of Sand Filter The sand filter construction is to follow procedures as outlined in the Orenco Installation Manual as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.02 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. Work on the sand filter may be suspended at the Engineer's discretion due to inclement weather conditions, such as rainfall. The sand filter and material stockpiles will be completely covered by a tarp over night during construction until finished. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water mn off. Side slopes shall not exceed 3:1. Six inches of top soil and seed are required over the entire sand filter when the side slopes approach 3:1, or at the discretion of the MOA. The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material. CONTRACTOR / INSTALLER , ~ L~/ MUNICIPALITY OF ANC}tORAGE · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street* Anchorage, Alaska 99501 Telephone 264-4720 ~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ~W MAILING AD ES LEGAL DESCRIPTION ~ Well / J A~orption area D~eHing I/ PERMIT NO. ~ ~ Manufacturer~ ~ / ~ ~ / NO. of comoartment~ , ~ Well Dwelling ,/ / . PERMITNO, ~OZ DISTANCE TO: O z ~ Manufacturer~/~ Material Liquid capacity in galJons ~ N°' of lines ~ Len~th each ine g Total length~of~lines Trench wld~ inches ~ Top oftiletofinish grade /~ ~ tile / ~ '( inches Material beneath Total ption area Length Width ~ Depth PERMIT NO~ ~ ~ Type of crib Crib diameter Crib dept] / Total effective absorption area / ~ ~ DISTANCE TO: Well BuildiCg fe~]d~tien Nearest lot line Class Dept~O / ~/ ~ Driller Distance to lot line PERMIT NO, ~ DISTANCE TO: / Buil~in9 foundation Sewer line Septic tank Absorption area(s) ,/ OTHER__~__~ ~' (- PIPE MATERIALS '~~ .... INSTALLER REMARKS I~; ' ........ ¢* ,.~h~~ 72-013 (Rev. 3/78) DED'AF(TMEIq"I' OF HEAI._TH AND EIqV]].~OIxlMENTAL PROTECI-IOIq 8,'.25 L STREE-I, ANCHORAGE. Al< 9950:i 264--4720 F'IERM I "I qO ~ DATE ISSUED: AF:'PLICANT: PARVIZ H. AZARIOON ADDRESSi: 8850 P]]OIqEER DF,'. AI\ICHORAGE ~ Ak:, 995~5 CONTAC] PHONE: 338-0505 LEGAL DESCRII:::': EilIBDIVISION: KASILOF HILLS LOT: 18 SECTION: 24. I'[]WI\ISHIP: 12N RANGE: 3W LO-I- SIZE: :];0000 (S(2,FT, OR ACRES) qAX BEDROOMS: BLOCK OEPTH TO F:'IF'E B[3"I-'l'OI~ (ET. ? 4.0 4.0 E.iRAVEI_ DEPTH (FI I"O'FAL DEP'I"H iF'T,, ) 4.5 U. 0 GRAVEL WID]"I-~ (F:"I.) 19,, 0 5.0 GRAVEl. LIENGTH (FT.) .56.0 79.0 '~"~<- GRAVEL VOLUME (CLI. YDS. ) 2~5,, 4. 22~ 0 TANK SIZE (GAL. S) 1, ()00,,0 .~..~ I,C' ']. ] '~-~ SOIL RATING CSI;!.ET. /BR) 11.50 150 -~'-~ GRAVEL_ L..ENG'I"H > 7L. I::'T. REQUIRES IqtJI._.TIPLE RI,JNS (NOT EXCEEDING 75 Fl'. EACH) ~"-"~-TANK PILl,~] HAVE AT LIEAST ]'WO COMF'ARTMEN]-S ce~i"'t:.i fy that." fop1'.h by :.he I'%unicit:)a].ity of Anchor'ag6-~ (MOA) and tine State of A].asl<a. ~. 1 t4i].], :instal]. t.h(~ system ~n acc:cmdaric:e wi'Lb a].l MOA codes arid eguJ.'at:ions, and in comp].iarl(:t~.) with the des:i, gr~ epithet'ia of this per, rn:it. 3. I will aclhepe t.o al.]. IflOA ~al"Id Sta'Le ot Alasl.::a l"(~qt.tiPE, mentr5 fclp t. hIB se't, back ,,any en].aPgemen'L will r'equipe an addit:i, onal pepmit,, I:F; q ._t::T STATIOIi IS IIqSTAI.._I._.ED I1\1 AN AREA COVE:RED BY MOA BUIL_I)iNG CODES. I'HEN (1) qN EI..EL-TTI::tlCAI_. ::'EI.;;PtI'I' AND INSF'IECTION MUST 'L:'4E[ OBTAZNIED~ (2) AS-BUIL. TS W]:LL NOT BE APPROVED WITHOU'T qN EL. ECTF~ICA[ INS!::'IE[]TION REPORT; AND (:~) THE ELEC-IRICAL. WI.]l::d':; MLIST 81E D[II',IE BY ¢.t [._ICEN,"i~ED [:]_..EC;TR]:CIAN. E'i~?.',5 Z '. L...Z. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) LEGAL. DESCRIPTION: ~------'//O~2 ~C~ ¢ ,/¢~.~C/Z,¢.¢.////~. Township, Range, Section: ,_~ 2 3 6 7 8 9 t0 12 13 14 15 16 17 18 19 20- WAS GROUND WATER ENCOUNTERED? SLOPE SITE IF YES, AT WHAT // ~ DEPTH? ? 0 E Del]Ih l0 Water Alter¢ / :~,~///~. Menil0rin§? · Date Reading Date Gross Net Depth to Net Time Time Water Drop / 7- t 7- P-~ &,Il5'~TM .... 4-11z" PERCOLATION RATE '''~' ~7 (~,nutes/inch/ PERC HOLE DIAMETER TEST RUNSETWEEN__~'~ #~AND 7{~- _FT COMMENTS '"~,E~ ,~/"7-~'~,""~ /,~'~¢:: ,,¢-¢-~5'¢' ~ ~¢~ ~ PERFORMED BY: S~ 196~ .... I~/~~/ OppT,¢V T~T ~ ~ . , ~f~ ........ THIS TEST WAS PERFORMED IN ACCORDANCE ~ TH AL~~_~ICIPAL GUIDELI~EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 826 L, Street, Anchorage, Alaska 99601 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST PERFORMED FOR: Robert Hammond DATE PERFORMED: 7/16/82 LEGAL DESCRiPTiON: Lot 18. Block 4. Kasilof Hills Subdivision SLOPE SITE PLAk' FIBROUS PEAT w/ORGANIC SILT Brown GRAVELLY SILT, W/trace FIBROUS ORGANICS, ML, wet Brown SILTY SANDY GRAVEL, GM moist Brown SILTY SANDY GRAVEL, GM moist lO~ ~WHAT 13.5 Gross Net Depth to Net 'm~Reading Date Time Time Water Drop I 7/16/82 11:14 0 65-1/4" 0 2 7/16/82 11:44 30 min 68-3/4" 3~1/2" 3 7/16/82 12:14 30 min 71" 2-1/4" 4 7/16/82 12:44 30 min 73" 2" 5 7/16/82 1:14 30 min 75" 2" 6 7/16/82 _--1:44 30 min 76-3/4'~ 1-_3/~{_4'~ 7 7/16/82 2:14 30 min 78-1/2" 1-3/4" 8 7/16/82 2:44 30 min 79-318" 7/8" 9 7/16/82 3:14 30 min 80-1/2" 1-1/8" 14 - Brown-rust 15 SANDY GRAVEL, GM wet 16- Decomposed BEDROCK 17 TOTAL DEPTH OF BORING - 17.0' 18 19 20 PERCOLATION RATE 30 (minutes/inch) TEST RUN BETWEEN 5,0 FT AND 6.0 FT COUMENlS Revised 11-2-84t water level 13.4'. / 72~-008 (6/79) 5 ~ 7 ~ 'i:,H, ? w LOT 14 W LOT 15 E ~H; D LoT Ko T.H. ~ ~CALE: W LAMBE AND ASSOCIATES, INC. Soils Laboratory and Geotechnical Engineering Job no. Appr, Dole _ SITE PLAN PLATE 1201 Bix INCH WATER WELL DRILLED .......... OUT TO THE DEPTH OF 20~ DRILLED AT THE RATE OF .... PER POOT. f/~. & ~. (t~ & /~t~) ~J~o~ 338-0503 PROPERTY OWNER LOCATION Of WELL SITE ~:. 18 B~L. 4 :7~v~J~f ~ $~bo DRILLEr WELL LOG: 38.'-$1 ' 146-152~ Th,L* a,~ha~ ~oadpo,f, en,,fAa. L fo~ ma,~J,~. 152-203~ Th, i~ of woAe~~a~ow~ l~.,l,~a~, Iww~.,% ~ WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS For THE SUM OF THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS SERVICE CHARGE O~ IYa% PER MONTH WILL BE ASSE$$E~ON PAST DUE AC~OUNT$. RECEIVED ;.lAN 2 1992 u '' ed' 99~1 ~ ANCHORA~:~ ~,A~KA 120i Ramona St. SlX INCH WATER WELL DRILLED .......... oUT TO THE DEPTH OF_ DRILLED AT THE RATE OF ........... PER FOOT. ~. ~ Mimi) Azarioon PROPERTY oWNER '.',Ir. ~, ,..frs. (~enry . LOCATION OF WELL SITE~t. l~Blk~ 4 Kasilof Hills Sub. DRILLER Bernie Claus of ~am-part prillirlg Works Feet. WELL LOG: Initial Well deepened from 203 feet to 43i feet. 20~ - 43]' A sedimentary bedrock. Water production at several depths from 28> - 285' (]/2gpm) 1/2~gpm in a porous area from 345 - 546'- From 415 4]8' showed a porous area of fissured rock oroduc~ing 2~?m of water [ield. The potential in this location should pro're to increase with water use. Total water production is presently_at 180 gallons per hour. 4~320 of water · er~_~a~otentisl. Due to the arid time of the ~ear~ this Well is at its minimal water yield. Spring Z, fall water yield should show upward to at least 240gph. The quality of water in this Well is very good. Medium-hardness only. Water recovery is back up to within 5~ feet of surface. All work paid for in full (7-29-90) by Mr. Azarioori] Bernie Claus of ~ampart Drilling Works Parcel I.D. # 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 CER~flFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 015-131-14 GENERAL INFORMATION Complete legal description Lot 18, Block 4, Kasilof Hills S/D Location (site address or directions 10701 Rezano£ Circle, Anchorage, AK ;Property owner Er!c Walker ,Lending agency ...... ~ :~Mailing address Agent First Choice Realty/George Address' PO B~w ~l~Ag; An~hnrag¢;AW qq5]]-]648 ~leSS Otherwise requested, ~AA will be Deld for pickup. NoMMMR OF BEDROOMS: Day phone 346-1710 Anchorage, AK 995/~ Day phone Stanicky' Dayphone 345-2322 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. 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 (Rev. 1/91) Front 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 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. __ Phone_ ~ ~/- -~¢-~ '7 ¢/ Name of Firm s & s ENGINEERING Address EagJe P, iver, Alasl(a 99577 Engineer's signature Date__/ DHHS SIGNATURE X Approved for 4 Disapproved. __ Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date ~-- -~ - ~O 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-O25 (Rev. 1/91) B~ck MOA~21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 343-4744 Health Authority Approval Checklist LegalDescription: LO~-i~ /~.~ /c,~$,~t.oF /~cc$ 'Y~)ParcelI.D.: WELL DATA Well type Log present ~/N) Total depth H ~ ~ Sanitary seal {~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed C~ FROM WELL LOG AT INSPECTION .~' ~- ~1 Cased to ~ <~ Casing height (above ground) I /''j'- Wires properly protected(~/N) ~/~5 Date of test Static water level Well production ),/ '~ g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 Date of sample: .:;:'__.' ,~?/¢2,,/'/o O SEPTIC/HOLDING TANK DATA Date installed '~ / ~,0 i ~ $- Tank size Foundation cle.a,~0Ut ~'N) Y Date of Pu~pi~g -7 [; et ~l ABSORPTION FIELD DATA Date installed q / ~' -~/~ ~ Length :~ ~ Width" Effectiveabsorption area J ~ Date of adequacy test '~//~ - Nitrate <9.5" Other bacteria Collected by: S & S ENGINEERING ',7C=4 -"~,~:~ ~;'~r Loop ~oad No. Z~ Eagle River, Alaska ~577 J00 0 Number of Compartments ~ Cleanouts~/N) ¥,~ J~ Depression (Y/t~ /" ~ High water alarm (Y/j.~ ~ 0 Pumper Soil rating~rfF/bdrm) ~_. 0 System type ~',~..,,o Gravel thickness below pipe 0, ~ ' To~al depth '~- Monitoring Tube present (~N) YeJ Depression over field (Y,~ '"-' Results (Pass/Fail) For L/ bedrooms Fluid depth in absorption field before test (in.); Fluid depth ~ Pero~as 2 months) (Y/N) 72-026 (Rev. 3/96)* ~er Absorption rate = If yes, give date gal. water added (in.): g.p.d. LIFT STATION Date installed Manhole/Access High water alarm level at* Size in gallons __ "Pump on" level at* *Datum Cycles tested $ T'4u 7~ro ,~, "Pump off" level at* '~ ~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 1 o 0 ' -~c On adjacent lots Absorption field on lot /00 4- On adjacant lots /0 Public sewer main )'¢ / '~ Public sewer manhole/cleanout ,¢/,4 Sewer/septic service line ~oc &- ~- Lift station / o o SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ] (~ Property line ~ I Absorption field Water main/service line ?0 ~c Sudace water/drainage.)O0 ~' Wells on adjacent lets ]0 0 "~ Property line Surface water Curtain drain SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: I / (~ cJcloo'll) Building foundation ) ~ )oo F. ENGINEER'S CERTIFICATION Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots ) 0 b -/- I c ify that I have determined thru field inspection and review of Municipal recorCf~f~!~lz~,~J~,~,,¢}~&ems are in conformance wit~ M~A ~A guidelines in effect on this date. ~.~'" A'"'.'.~ Signature Date ) HAA Fee $ Date of Payment ~ / '~ "~-',~ Receipt Number °L'~/"2-/¢" ( 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number ~01-27-00 I~:ZO FEOM-CTE ENVIRONMENTAL 5615301 T-450 P.O2/03 F-gTZ CT&E Environmental Services Inc, Laboratory Division v~`~j~f~a~a~j~j~`a~a~`~ar~a~a~ja~a~`~`~j~a~`a~jJ~j~ Laboratory Analysis Report CT&E Re~.a Clien! Name Projec!~ Nam¢/~ Client Sample ID Matrix Ordered By PWSID 1000276001 Lo[ 18 Block 4 ~asilof Hills Lot 18 Block 4 Kasilof Hills Drinking Water 0 Client PO# Printed Date/Time 01/27/2000 7'56 Collected Date/Time 01/21/2000 9:30 Received Date/Time 01/21/2000 13 O0 Sample Remarks: VATERS DEPT p~L un{~6 ~erhod 0.~00 O G.S00 II~/L EPA 300.0 01/21/00 01/21/00 SCL HICRO LAB TO~aL CoLiform 01/21/D0 JOT 200WFPo~er Drive, Anchorage, AK 99518-1605 --Tel: (907~ 562-2343 Fax: (807) 561-5301 3180 Peger Roao, 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 Parcel I.D. Cf CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING -\~\ -ILl HAACf GENERAL INFORMATION Complete legal description Lot 18; Block 4; Kasilof Hills Subdivision Location (site add'ress or directions) 10701 Rezanof Circle, Anchorage, Alaska Property owner Mailing address Lending .¢gency Mailing address Agent Address Eric ~d Charlotte Walker Day phone 10701R~zanof Circle, Anchorage, Alaska HOMEQUITY ATTENTION: Mike Lewis Barbara Parker/JACK WHITE COMPANY 3201 C Street, Anchorage,-Alaska 99503 346-1710 (hm) 564-4557 .Day phone .... Day phone 563-5500 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: '~ 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. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 sluewwoo leUOp4ppv :suo!~elnd!~s 6uV~OllOJ eq~, q~,!~ 'suJooJpeq 'suJooJpeq JoJ leAoJdde leUO!l!puoo 'peAoJddeslQ Joj peAoJddv ~ =It:I~J.¥NIDIS SHHO eJn~euS!s s,~eeu!Su3 sseJppv ~uJ!H jo eUJeN 'uop, oedsu! s!q~ ,to elep eq~, uo ),oejCe u! suoj~eln6e~ pue 'seoueu!pJo 'sepoo ele~,S pue led!o!unbl lie q~!/~ eoue!ldLuoo u! si LUm, SXS lesods!p ~e~eMe~set~ ~o/pue Xlddns Je~et~ e~!s-uo eq~ 'uoRoedsu! pue uo!~eSp, se^u! XLU LUOJ,t pue Sel!¢ eSeJoqouv ,to ,~!led!o!un!,N eLl~ LUOJJ peu!e~qo UOReLUJOJU! eq), uo peseq ~eq~/~jHe^ ~eq~Jnj I 'u!eJeq pm, eo!pu! e]n~on4s jo edX~ pue su~ooJpeq jo JeqLunu eql ~oj e~enbepe pue leuo!~oun¢ 'ejes s! LUe~S,~S lesods!p ~m,e~e~se~ Jo/pue ,~fddns Je~,e~ e~!s-uo ?q), ~eq), st~oqs uo!~eo!ldde le^oJd'd¥ X~,poq~,n¥ q~,leeH s!q~, jo uo!~eGp, se^u! XLU ~,eq~, ,~pe^ I 'Moleq u~oqs e~ep uo!~ep!le^ eq), jo se pue o~,eJeq pex!jCe leas XLU Xq pe!j!ueo sV '9 I=Ii]~NIgN;] A8 NOIJ. O~dSNI ..-I0 J.N~ilN~i/'g'.I.S Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type'/~! Log present.N) Totaldepth Sanitary seal ~N) Parcel I.D tf A, B, or C, attach ADEC letter. ADEC water system numl~er '"-'-- Date completed ~\ ~'~'~:~) Driller ,~--'''/'~I'-A ~;~''~'"~'~'r ' Casedto ~1 ~~Casing height Wires properly protected~;)N) g.p.m. FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot i~c:> Jr-- Absorption field on lot Public sewer main Sewer service line AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: I'~- ~ C>-''~ I ~'~9 Other bacteria Collected by: ~'~'~ '~ B. SEPTIC/HOLDING T~/~ DATA Cleanoutsd~N) "-f' FOundation cleanout~N) High water alarm (Y/N) ~ Alarm tested (Y/N) Date of 'P,urfipin'g I'~' I'~- "~ SEPARATjON~ STANCES FRO, MSEPTIC/HOLDING TANK TO: Well(s) on lot [ , . On adjacent lots To property line ] ~ I'Jr' Absorption field Surface water/drainage ~ ~ ~ ~ Compartments Depression (Y~ Foundation Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date i~ Manufacturer Size in gallons -"'""- ,, Manhole/Access (Y/N) Vent (Y/N) ~ "Pump off" level at High water alarm level ~~ Meets MOA electrical codes (Y/N) ~ ~ SEPARATION DISTANCE FROM LIFT STATION TO' ~~, Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ~ ~ Width Total absorption area ' Depression over field Results~ail) Peroxide treatment (past 12 months) Soil rating { ~'~'"'-/~/¢~¢-~ System type Gravel thickness ~ t Total depth Cleanouts present d~::~N) Date of adequacy test (-o~" I ~1, -- ~ O for "~ bedrooms If yes, give date ~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot / To building foundation On adjacent lots Surface water Curtain drain '7 On adjacent lots 1 ~ I ,;~ Property line I To existing or abandoned system on lot Cutbank ,~b ~- Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in eff. e._c~_*~l~tlT~.. ~,l~,.of this inspection. "E G ~ -~" '~ ~ Signature 17n24 Ea~de Ri,vet Loop RoadNo. 2O4 ~W. &OTH ~ ' W~, Eagle Eiv~l', Alaska ~5~ ........ HAA Fee $ } '7~ ' &~ Waiver Fee: $ Date of Payment /~- )~--~/ Date of Payment Receipt Number ~ ~ ~ ~ ~~ ~ocelpt ~umger MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 18; Block 4; Kc~ilof Hills Subdivision; Location (address or directions) 10701 R~anof Circle (b) Property owner Henrq & Mimi Aza~ioon Telephone : (home) 346-2083 Mailing Address P.0.Bo~ 112723 Anchorage, Alaska 99511 (c) Lending Institution Telephone Business Mailing Address (d) (e) RealEstate Company and Agent Address 3201 C S~eet Telephone 563-5500 JACK WHITE COMPANY ATTN: Dale Murphy Anche~ag~ Al~ 99503 Mail the HAA to the following address: (or check here,;!E~, if hold for pick up.) List contact person and day phone number below: 5 & $ ENGINEERING Eagla [~iver; Alaska 99577 2. TYPE OF RESIDENCE Single-Family [~x. Number of bedrooms 3 3. WATER SUPPLY Individual Well,~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-siteX~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72 025 (Rev. 7/881 Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S ENGINEERING Name of Firm 17034 ~ag~ iL~4,~r Loop 1~ o~ ,'~,~. 204 Telephone Address Eagte R~ver, Alaska 99577 Date 6. DHHS APPROVAL Approved for ,~ bedrooms by Approved :/'¢~-- Disapproved ate _ Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72 025 (Rev 7/88) Back Page 2 of 2 A. WELL DATA Well Classification Well Log Present d NI Date Completed Total Depth'~5''~ Cased to ~_~_Depth of Grouting Static Water Level ~'~L~ t...-, )---. Pump Set At ~ MUNICIPALITY OF ANCHORAGE (MOA) ~ [*'-'~zz.~.~'~ A~c~O~'~r~.~l.t~ Authority Approval (HAA) ~(~.V~,C~.s O~',/~I-~c~CKLIST - FEBRUARY 1984 · ' 0~~- 343-4744 ~ ~ 7 t~0 Legal Description:· ~ ~ g~,~~ ,fA, B,C,D.E.C. Approved<Y/N) Yield Casing Height Above Ground Sanitary Seal on Casing(~.~ZN) Electrical Wiring ir~ Conduit ~i~N) ~r SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot \ ~ Depression Around Wellhead (Y~i) ~ ; On Adjoining Lots I ~! ~L- To Nearest Edge of Absorption Field~\o~ Lot To Nearest Public Sewer Line /~ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Comments B SEPTIC/HOLD "G '~ANK~D/~,,~ Date Installed '~/~) Size ~ ~ Stand pipesc.~C~/N) "'f Air-tight Caps Depression over Tank (Y/;J~- r~ Pumping/Maintenance Contact on File (Y/N) _/ Holding Tank High-water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well /00/I¢' To Building Foundation To Property Line (~d::;' I"t~ To Disposal Field To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments ~ 1~ ~f¢~' No. of Compartments /,4/~.~Date Foundation Last Pumped ; for ~/,/~ Temporary Holding Tank Permit (Y/N) 72-026 (Rev. 7/88) Front Page 1 of 2 C, ABSORPTION FIELD DATA Soils Rating Jn Absorption Strata Date Installed -?~ :~ '~/~ Width of Field ~'- / ?/'~2-- Type of System Design .~"~,, .~./~_ Length of Field /~P4P / Depth of Field ~;~ Gravel Bed Thickness _ Square Feet of Absortion Area '~"- .~'~' ':~ Statndpipes PresentdJ~N) Depression over Field (Y~, /~J Date of Last Adequacy Test Results of Last Adequacy Test ~/~ ~F"~,4~ ,.~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well / O'7 / To Building Foundation "7 / Lot ~ To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line To Existing or Abandoned System ; On Adjoining Lots '~ To Cutback (if present) D, LIFT STATION Date In~ Dimensions ,S, ize in Gallons'~'----.. Manhole/Access (Y/N) Pump On" Level at ~'-..--~~ "Pump Off" Level at High Water Alarm Level at ~_ Vent (Y/N) _ Tested for -'~"~"~_...~umping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~ Comments **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date MOA No. $ 8, ~, FNGINEERING 17034 Eagle River Loop Road No. 204 Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) Rack Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 al ':'--? MUNICIPALITY OF ANCHORAGE ~'~' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Lega[ Description (include lot, block, subdivision, section, township, range) ~zJ~_LS_BO~k 4 Kasilof Hills Subdivision Location (address or directions) 2-3-86 (b) Applicant Name A ?.~rl ont~ Telephone: Home 338-0503 Business Applicant Address BRS¢I Pqon~r ~rqvm. Anchorage AK 99.504 (c) Applicant is (check one): Lending Institution []; Owner/builder [](; Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 9q577 TYPE OF RESIDENCE Single-Family[~ Multi-Family[] Other Number of Bedrooms r~,~,~,~ ~'-~ WATER SUPPLY Individual Well~[ Community [] Public [] Note; If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status, Page 1 of 2 72-025 ($1/84) As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S Engineering Telephone Address SRB ]96X Ea~le River AK 99577 Date 2/].0/86 We have received written confirmation from the engineer (S & $ Engineering) that the conditions of the conditional approval have been met and that full approval is given by this Department. Engineer's Seal DHEP APPROVAL Approved for Thr~ Approved XX ------'~'~-~'/ te~ bedrooms b~ Disapproved Conditional Terms of Conditional Appi~oval 1986 CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval 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) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~'~ -- GENERAL INFORMATION (a) Legal Description (include Iot~ block, subdivision, section, township, range) Location (address or directions) , (b) Applicant Name /~--/'~/0/...o/k~J Telephone: Home .~-~-- 05-0-~ Business Applicant Address ,¢~,__~f~_ /g)kJ~/ ~_/)~ ~¢-~ ¢/ ~'Di.~ (c) Applicant is (check one): Lending Institution []; Owner/builder,,~; Buyer []; Other [] (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone %el,ephone (,) -/~t ~eJ~AA to the following address: SRB 196x Eagle ~,Jver, Alaska TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms '~ Other WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system, mu~t have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL OnsiteJ~ Public [] Community [] -~olding Tank [] Note: If community well system, must haue Wdtten confirmation from ~he State Department of Environmental Consewat[on attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below I verdy that my investigation of this Health Authority Approval shows that the on-site water st. pply 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 ~nspection. the on-site water supply and/or wastewater disposal system is in corn pliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm __~;_E~m~! Telephone Address ~;~r; 17~× Date k~;oL- ~h.:-~. 41a~F,a ~r2L~2,~,*,.. ~. ~ /'O - ~ ~ CAUTION The Muncipa~lty of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates oaseo solely upon the re presentations given m paragraph 5 above by an independent professione 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 requwements. Employees of DHEP do not conduct ins pections or analyze data before a certificate is ~ssued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work Page 2 of 2 WELL DATA Well Classification~p Well Log Present ~Y/)N) _ Total Depth ~.. E:) ~ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (~N) Separation Distances from Well: To Septic/Hulding'Tank on Lot MUNICIPALITY OF ANCHORAGE (MOAT" HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal D~escription: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION E6 0 u 1986 ~'~, 1 U~-- If A, B, C, D.E.C. Approved (Y/N) Date C~ompleted /~¢'~--'- ~:)' ~.~c~' Yield Cased to ~-~ .~,'~' Depth of Grouting ~-)/~ Z~:) ! Pump Set At /-"¢ ~/-/' /~ Sanitary Seal on CasingCN) Depression Around Wellhead (Y/~ /~::~ /'/ ;On Adjoining Lots To Nearest Edge of Absorption Field on Lot /'~) ~ / ; On Adjoining Lots To Nearest Public Sewer Line ~-/'-)/~,/~ To Nearest Public Sewer Cleanout/Manhole //J~ To Nearest Sewer Service Line on Water Sample Collected by .~',' -~' ~'""/'¢//¢~'/'/z~'/¢' ; Date ~ ~. Water S~mple Test Results ' ~'~/~) (~",~_,¢ ,~,~ ~: 2'",::~ ~, B. SEPTIC/HOLDING TANK DATA Datelnstalled *'~J,'~/¢-;,~ Size /OOO No. of Compartments Standpipes (~)/ / Air-tight Caps (Y~) Fou ndation Cleanout/(t~N) Depression over Tank (Y(~) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) "/J'/f~' ; for Holding Tank High-Water Alarm (Y/N) /'~ / ~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~¢~;) To Property Line /~:~ / To Water Main/Service Line -/6 ' Course'- Comments To Building Foundation 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 ,'¢"-.~ Date ,nsta,ed Width of Field Square Feet of Absorption Area Depression over Field (YO Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /O 7 To Building Foundation ~? / Lot To Water Main/Service Line /zP ,-~ Type of System Design Length of Field Depth of Fielcl Gravel Bed Thickness Standpipes Present ~.~)'4) Date of Last Adequacy Test To PropertyLJne /0 ~'.F To Existing or Abandoned System on ; On Adjoining Lots /~.f' O/.J' ~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Co m m e n t s ~/' ;~-~;~/,¢-'3 /~,/' To ~utbank (if present) r D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions Manhole/Access (Y/N) / "P/~mp OfF' Level at //(1 /],/~/ent (Y/N) . / ~/~umping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ & 4 ~ngmeernl~ Date ~' --/-~ -- ¢¢¢ ~ Company Ea~l.~ ~r Receipt No. '-~ ' - ~ ~'""""""""~ Date of Payment ~// Amount: $ MOA No. ~,.~--4_.N.~ .~ Page 2 of 2 72-026 (t 1/84)