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SUN VALLEY HEIGHTS BLK 5 LT 3
Sun Valley Heights Block 5 Lot 3 #017-062-42 Municipality of Anchorage Page 1 of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW990285 PID Number: 017-062-42 Name: C/0 FIRST NATIONAL OF ANCHORAGE Wastewater System: ❑ New ■ Upgrade Y Address: 1751 GAMBELL, ANCH. AK, ABSORPTION FIELD Phone: (907) 777-4334 No. of Bedrooms: 3 ■ Deep Trench ❑ Shallow Trench ❑ Bad ❑ Mound ❑ Other LEGAL DESCRIPTION Solt RoVnq: Total Depth from original grade: 11.2 0.7 CPD/Sq. R FL Lot: Block: Subdivision: Depth to pipe bottom from original grade: Grovel depth beneath pipe: 3 5 SUN VALLEY HEIGHTS 3.5 rt. 8.1 Ft. Township: Range: Section: Fill added above original grade: Gravel length: — — — 0 — 0.5 Ft. 37.0 Ft. WELL: Gravel width: Number of lines: Dlelonoe between Ilnes: - ElNew [IUpgrade 3 FL 1 Ft. Closslfiwllon (Private, Ae,C): Tolal Dept • Caeed To: Total absorption area: Pipe material: Ft. R. 599 so. a ASTM D -3034/F-810 <J\ �\tAG Ddllar. `n S Dale Drilled: Stout Water level: Installer. WHITTERS Date Inelalled: 9/9/99 Ft. Yeld: Pump Set Al: Cueing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑septic 13 Holding ■S.T.E.P. TO SepAc Absorption Lift Holding Public/ rivals Manufacturer. ANCHORAGE TANK Capacity In gallone: 1250 From Tank Field station Tank sewer Lines Well 200'+ 200'+ 200'+ - - Material: STEEL Number of compartments: 2 Surface 100'+ 100'+ 100'+ - - LIFT STATION Water Line 5'+ 10'+ 5'+ — — Size In gallons: 1250 Manufacturer. ANCHORAGE TANK/ORENCO SYSTEMS "Pump on level at Pump off, level at, Nigh water alarm at: Foundation 5'+ 10'+ 5'+ — — 42" 42 44" Curtain I Pump Make S Model: Electrical Inspections performed by: Drain NO KNOWN — 20 OSI 05 HHF M.O.A. BENCH MARK Remarks: LINE FROM S.T.E.P. TANK TO TRENCHES WAS NOT Location and Description: INSPECTED BY ENGINEER FOR INSULATION AND TOP OF CONCRETE SLAB AT THE FINAL COVER. EXCAVATED BY WHITTERS CONSTRUCTION. BOTTOM OF THE STAIRS NEAR WEST/NW HOUSE CORNER. Assumed Elevation: 100.00 Fl. ENGINEERS SEA oo6o�p O of q 000���. •. '�5��0 Inspections performed by: AWWC, INC. Dates: 1st 9/9/99 * 2nd 9/9/9s 3rd 9/13/99 f e A. ness- Department of Health and Human Services approval 0o ., E-7653 a e10 aa- r 4a ..... °oo� 4�ODa Reviewed and approved by: Date: Prof 72-013 Rev. 9/91) MDA 25 PERMIT NUMBER: SW99O285 A S —BUILT DRAWING A I B I C I D ST1 31.0 17.7 — — ST2 37.0 21.0 —_ _ MH 38.3 22.4 — — — — 64.5 86.9 _MT1 MT2 — — 51.1 64.9 NEW DRAINFIELD / " A B Ph \ EXISTING CRIB sF TO BE USED AS A A RESERVE SITE. 1 1/4" PVC —��—�� FCO 1 1/9" PVC TIES NEW 1250 GALLON INTO OLD 4" SEWER S.T.E.P. TANK WITH Mf LINE DUAL OUTLETS _ 6 y� INPL CRAU - 1013+ APPROXIMATE LOCATION Ow!NN. am - no.c.. B OF CUTBANK /r PINPL 6m - 97.44 fP.fER PADHL 5P / 512 MH fGF Of fA'�K j 101' OF fPNK Af IN,if - 93.42 Ai WILEf 9337 125IM�Rf � 0,25 _ pin - 96.19 Af 3 I NSW 1250 GALLON I (I INv5u0O Nm \_S,T,�,P, TANK IWERforfA G AT IN,Ef - 92,84 Af MVT - 92,621 DOffOM GP fF.I; a -/ - 90.G6 (AVGJ ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 LEGAL DESCRIPTION: SUN VALLEY SUBDIVISION; LOT 3, BLOCK 5 TYPE OF WORK: AS—BUILT OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: FIRST NATIONAL OF ANCHORAGE (907)777-4334 DATE: DRAWN BY: SCALE: PAGE: 10/20/99 K.D.W. 1 = 40' 2 OF 2 .. .. e frGar ess: C 7953 m.}, �4Fe�o ''•..........•' �c4 ev �Q dorofessloo\ �44000�00 PARCEL ID NUMBER: 017-062-42 GENERAL LOCATION -/ K—I C LA C \ OF WATER LINE \ D \ \ \ \ \ / " A B Ph \ EXISTING CRIB sF TO BE USED AS A A RESERVE SITE. 1 1/4" PVC —��—�� FCO 1 1/9" PVC TIES NEW 1250 GALLON INTO OLD 4" SEWER S.T.E.P. TANK WITH Mf LINE DUAL OUTLETS _ 6 y� INPL CRAU - 1013+ APPROXIMATE LOCATION Ow!NN. am - no.c.. B OF CUTBANK /r PINPL 6m - 97.44 fP.fER PADHL 5P / 512 MH fGF Of fA'�K j 101' OF fPNK Af IN,if - 93.42 Ai WILEf 9337 125IM�Rf � 0,25 _ pin - 96.19 Af 3 I NSW 1250 GALLON I (I INv5u0O Nm \_S,T,�,P, TANK IWERforfA G AT IN,Ef - 92,84 Af MVT - 92,621 DOffOM GP fF.I; a -/ - 90.G6 (AVGJ ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 LEGAL DESCRIPTION: SUN VALLEY SUBDIVISION; LOT 3, BLOCK 5 TYPE OF WORK: AS—BUILT OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: FIRST NATIONAL OF ANCHORAGE (907)777-4334 DATE: DRAWN BY: SCALE: PAGE: 10/20/99 K.D.W. 1 = 40' 2 OF 2 .. .. e frGar ess: C 7953 m.}, �4Fe�o ''•..........•' �c4 ev �Q dorofessloo\ �44000�00 OCT -19-99 TUE 03;54 PM FNBA Special Credits FAX N0, 907 777 4334 P. 02 v: /.J L Faye 12 of 19 INSFEC17ONRE,P" .. , . MUNICIPALITY OF ANCHORAGE -- BUILDING SAFETY .DIVISION 3500 EAST TUDOR ROAD, ANCHORAGE, ALASKA INSPECTIONS: Vase: (904 SM4464 Fax (90 343.8235 1NFORMA770N• (907) 3"211 NAME: SPARROW ELECTRIC PERMITNUMHXIL 99»9273 ADDRESS: 13540 TAHOE CIR DATE: 10/15/99 6:43 AM . '. PRONE MI: 227-9506 PROM N2: LOT, 3 BLOCS: 5 SUBDIVLSION.• 'SUN VALLEY HGIM COMMENTS PM TYPE OF ]+ #L 1MVPF,C770N.- Electrical Rough (� No non-wM ienoe oUsecvod_.... Cauections essential as wmla ncd below. 0 C.O. approved. Q WM rc-examute atna:d hVectjorL Do not conceal Md1 rodnspected C.CA. approved (comments below), COMMENTS: CGrrerTian r R6tapaiion7 'H INSPECi1�R� /` DATPr1 WMBN CORRE&ONS ARE MADE, PLEASE C4LL FOR INSPECTION ia�e DO NOTREMOYE Ti11S NO27CR 01/26/1994 05:43 19076940496 WHITTERS S' EXCAVATING I KNOB HU DWE 'SA AWR,ALASKABB677 PHONE 698 M2 PAGE 02 %`u�o �oaG�-� leu-�:>�irrru otr� MUNICIPALITY OF ANCHORAGE Department 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: Aug 17, 1999 Expiration Date: Aug 16, 2000 Permit Number: SW990286 Parcel ID: 017-062-42 Legal Description: SUN VALLEY HEIGHTS BLK 5 LT 3 Design Engineer: 0041 AK Water & Wastewater Consulta Site Address: 013540 TAHOE CIR Owner Name: First Nat'l Bank of Anchorage Lot Size: 56375 SQ. FT. Owner Address: PO Box 100720 Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99510-0720 This permit is for the construction of: ❑✓ 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 ( 18AACSO ). 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. Received By: Issued By: Date: f_[ / '— 22 Date: 9-1799 Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 211— Anchorage — Alaska 99504 (907) 337-6179 — Fax (907) 335-3246 Consulting Engineers August 11, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Design for Lot 3, Block 5, Sun Valley Heights Subdivision To whom it may concern: The existing 3 bedroom house is served by a community well and private septic system. The existing septic system is in a state of failure and in need of replacement prior to gaining a Health Authority Approval for the sale of the house. Comments regarding the proposed design are summarized as follows: 1. SOILS: Test hole #1 was excavated on 8/3/99 to a depth of 19 feet and no groundwater was encountered. From the top of the test hole to a depth of 1 to 2 feet was orgainics and loam followed by a SM/ML material to the bottom of the test hole. The bottom 0.5 to 1 foot was much denser than the soils encountered in the upper layer. One percolation test was performed at a depth of 6.0 to 6.5 feet. The soil absorbed water at a rate of 3 minutes/inch, which corresponds to an application rate of 1.2 gallons/day/ft2. It is our opinion that this perk test is not truly representative of the overall absorption capacity of the soils encountered so a 0.7 application rate will be used in the design. 2. TRENCI3 DESIGN: a. Percolation Rate: 3 minutes/inch b. Application Rate: 0.7 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 642 ft2 f. Total Depth: 11 feet g. Effective Depth: 8 feet h. Width: 3 feet i. Reduction Factor: N/A i. Length: 45 feet j Effective absorption area = 720 ft2 3. SURFACE WATERS: The Rabbit Creek Greenbelt is to the south of the reference property, but the proposed septic system will be well over 100 feet away from Rabbit Creek as well as any other surface water. 4. TOPOGRAPHY: There is a cutbank approximately in the middle of the lot. The proposed trench will be over 50 feet away from this cutbank. In short, 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. E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a detail drawing of the proposed bed, one soil log and a 4 page construction specification letter which are all part of the design package for this septic system. I EXISTING SEPTIC SYSTEM l \ ` EXISTING 3 ` BEDROOM HOUSE \\ l APPROXIMATE LOCATION OF CUTBANK \ \ - DE ARMOUN ROAD ----- --- o' r•t 1 LOT 5, BLOCK 5 t� LOT 1, BLOCK 5 SUN VALLEY HEIGHTS SUN VALLEY HEIGHTS r 1 a PROPOSED SEPTIC SYSTEM LOT 2, BLOCK 5 (SEE DESIGN, PAGE 2 OF 2) F SUN VALLEY HEIGHTS \\ o ( +TH 1 � l a o LOT 4, BLOCK 5 SUN VALLEY HEIGHTS I EXISTING SEPTIC SYSTEM l \ ` EXISTING 3 ` BEDROOM HOUSE \\ l APPROXIMATE LOCATION OF CUTBANK \ \ RABBIT CREEK GREENBELT ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 28. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 LEGAL DESCRIPTION: SUN VALLEY HEIGHTS SUBDIVISION; LOT 3, BLOCK 5 TYPE OF WORK: SITE PLAN FOR SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: FIRST NATIONAL OF ANCHORAGE (907) 777-4334 DATE: DRAWN BY: SCALE: PAGE: 8/11/99 K.D.W. 1 = 100' 1 OF 2 ..... .. ....... r A. a ess:'••• P C —7953 v pp DO afrofessWf%a% ✓SCJ rX TAHOE CIRCLE PROPOSED PRESSURIZED DRAINFIELD — 45' LONG BY 2' WIDE BY 11' DEEP. ADD 8' OF CLEAN, WASHED SEWER DRAINROCK. TRENCH SHALL BE INSTALLED PARALLEL TO SLOPE CONTOURS. 1 1/4" PVC PRESSURE LINE WITH 6 1/4" 0 HOLES DRILLED ® 3' O.C. / M` '/ /6 TH#1 �- 50' CUTBANK SETBACK._ IG CRIB TO BE USED A RESERVE SITE. OLD SEPTIC TANK It TO BE ABANDONED COMPLETELY PROPOSED 1 1 1/4" HDPE PIPE. 3' MINIMUM BURIAL. GALLON S.T. SLOPE SO THAT THE LINE DRAINS BACK TANK WITH [ OUTLETS TO THE PROPOSED S.T.E.P. TANK. NO "BELLIES" IN THE LINE. NOTE: THE CONTRACTOR SHALL HAVE THE 10' SETBACK FROM THE WEST PROPERTY LINE AND THE 50' SETBACK FROM THE CUTBANK FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. KEY BOX GENERAL LOCATION \ OF WATER LINE EXISTING THREE BEDROOM HOUSE c7 x LA " 50 0.T ANK v.,. 1 \ INSTALL FOUNDATION \ CLEANOUT l \ \\ \ APPROXIMATE LOCATION \ OF CUTBANK ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 28. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 SUN VALLEY SUBDIVISION; LOT 3, BLOCK 5 DESIGN DRAWING OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: FIRST NATIONAL OF ANCHORAGE (907) 777-4334 8/11/991K.D.W I I= 40' I 2 OF 2= 40' I 2 OF 2 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B • ANCHORAGE, AK. 99504 0 �QOO PHONE (907) 337-6179 • FAX (907) 338-3246 SOIL LOG - PERCOLATION TEST * ; ` y) LEGAL DESCRIPTION: SUN VALLEY HEIGHTS SUBDIVISION; LOT 3, BLOCK 5 ""' ' ' "' """' """' PERFORMED FOR: FIRST NATIONAL OF ANCHORAGE.. ....... �- J f A. Garness: DATE PERFORMED: 8/3/99 do? 09s E-7953 oG (feet] TEST HOLE #1 '".......... � 1 _ PCO fesSW o ORGANIC/LOAM 2 �$ SOIL CLASSIFICATIONS T "a GW ORG 3 '=M'i`ni*�: GP ( ML GMCL 41Z GC a�I [{_I OL SW MH pUV nV 5 3 ry SP L/ SM OH 6—j ESC 7 10 �l���ll SM/Ml- 12 M/ML 12 13 14 15 16 17 18110 19 SM/M(TIGHT) 20 ' COMMENTS: DEPTH TO DATE GROUNDWATER NET TIME (MINUTES) DRY 8/3/99 DRY 8/11/99 SITE PLAN % l� #TH#1 L 1 l DATE READING CLOCK TIME NET TIME (MINUTES) I WATER LEVEL I READING NET DROP (INCHES) 8/4/99 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 1 2:17 — 6" - - - - -- - - 2 - 2 - . 2:27 - -- - -- - - 10 --- ------- --- - - 19/1 6" ------ 4 7/16" 4 3 2:28 -- 6' — 4 2:38 10 2" 4" 5 239 — 6 — 6 2:49 10 2 1/2" 3 1/2" 7 2:50 — 6' - ----- --_ ..-----`--`--- 8 ------------------ --- 3:00 ------------- 10 ---------------- 2 9/16" --------------- 3 7/16" --- 9 - -- 3.01— — -_ — — s r—- 10 3:11 10 2 11/16" 3 5/16" 11 3:12 — 6" - -- 12 3:22 10 --- -1 ----- 2 1/16" - - PERCOLATION RATE 3.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMEIh IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON AR GUN D---�--.._.._ J C)_ LO 5, BLOC 5 T 1 BLOCK 5 SU VALLEY H IGHTS S,N VA LEY HEIGHTS L11 O x � r % -\a \ M LOT LEY` CK 5 SUN VALLEY EIGHTS oa Ja LOT 4, BLOCK SUN VALLEY GHT 0 i A SKA WA AN TEWATER CONSULTANTS, I C. 69 RR RO , SUIT B ANCHOGE, AK. 99504 PHON • (907) Y.-8179/FAX: (907) 338-3246 LEGAL. DESCRIP ON: SUN-VALL £ GHTS UBDIVISION; T 3, BLOC TYPE-OF`WcK: TOPOGR7CP,,HICA DRAWI PREPARED FOR: ONE NUMBER: ' FIRST NATI NAL F ANCHO GE (907 7 433 D DRAWN BY: SCALE: PAGE: 7/2 99 K.D.W = 100' Il 1 OF 1 FILE / %1415 L o j GRE `—EIRpartment ANCHORAGEnmental AREA�BIOP'UGH 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMMAILING ADDRESS_,kG_,?,�P�z�• PHONE LOCATION LEGAL DESCRIPTION SEPTIC TANK: DISTANCE / NUMBER OF FROM WELL-Oei MANUFACTURER _MATERIAL"_J__ _COMPARTMENTS (LC� INSIDE LENGTH_ INSIDE WIDTH_ _LIQUID DEPTH LIQUID CAPACITY_NI�O_GALLONS. SEEPAGE PIT: NUMBER OF PITS Uj✓!. DIAMEI"ER "�> OR WIDTH=:, LENGTH_, DEPTH-=c>'✓✓'/w!- :i-�-n_:-. �"o:'� LINING MATERIAL G'=l_ CRIB SIZE: DIAMETER _c DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION, NEAREST LOT LINE,I ABSORPTION AREA (WALL AREA) -SQ. _SQ. FT. ADDITIONAL ABSORPTION N ./c.>r_" l L l_.a c=/»r'-;a c>.�/ !c,/-� .i `✓�-i✓� G- .�=1/l S�1Ni✓ i/,/tG�e y//rl WELL: TYPE ��d/.yl%196�/�//y"J_ CONSTRUCTION` BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES DEPTH NEAREST SEPTIC SEWER LINE -_TANK - APPROVED _ DISAPPROVED_ REMA DISTANCES: -: t: w _ DIAGRAM OF SYSTEM INSTALLED BY:el i PIPE MATERIAL: f ✓y: LOT SLOPE: REMARKS: //✓�cU<��:c�Ti//�r% Farm No. EQ -031 DISTANCE FROM: SEEPAGE SYSTEM_ v 0 -fix ,W ` � _�` ,.'` �r,-:rte io>' � /✓a'-. DATE '_-APPROVED G.A.A.B. n I// �� %0 I',ri GREATER ANCHORAGE AREA BOROUGH Y O l PERMIT NO S DEPARTMENT OF ENVIRONMENTAL QUALITY ��j���\(\(g ✓I 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 u SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT � _ NAME OF APPLICANT ////I' -'� MAILING PHONE �ADDRESS INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK SEEPAGE PIT-- DRAIN FIELD OTHER /., /;+�`�l]GI/✓% /L/�" - ��/'�/�� TYPE AND SIZE OF FACILITY TO BE SERVED '�"v''��-������G FINANCED THROUGH -^ - TO BE INSTALLED BY SOIL TEST RESULTS ��/�-` G%'//" /=1 NOTE, THIS PERMIT IEi NOT VALID WI'PHOUT SOIL TEST COMPLETION DATE ANTICIPATED ��� .___- /O�iy�iY FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL_ QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE MINIMUM FOUNDATION TO SEPTIC TANK TYPE-%T��L' SEEPAGE AREA SIZE .-�/`!T_ -- TYPE i FOUNDATION TO SEEPAGE PIT �// DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK '✓ / , SEEPAGE PIT �/, DRAIN FIELD "-0 NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT -. DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK /�� SEEPAGE PIT DRAIN FIELD -. SEPTIC TANK, SEEPAGE SEEPAGE PIT /-�. DRAIN FIELD/j-) TO RIVER. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FI'f TED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM 15 IN ACCORDANCE WITH SAID CODE. DATE -�'S APPLICANT'S SIGNATURE FORM NO. EO -016 DIAGRAM OF SVSTEPA ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE GREATER ANCHORAGE: ARCA BOROU.... Department of Environmental Quality 3330 "C" Street Anchorage, Alaska 99503 SOLS 1,0a - PEMO ,ATION Trar Performed for `�So�ls to - — �/P rcolation L)(te Periorci, ) _. _ ��e cL _ _ _ Leval Ue�cri t' n This form reports. 3--. ------- -� est__ ._....----- --- Depth Feet 3 - 4 7- 7S� SCou4/Cum-J II- 10 - 4 12 - 13 - 14 - Was ground water encountered? if yes, at wiiat depth? Reading Date Gross Time Net Time Depth to Water ---------------- Percolation rate minute. Net Urop -Proposed installation: Seepage Pit Drain Field Depth of Inlet Depth to bottom or pit or trenci, COMMENTS: Performed rtified L(�-040 (6/74) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 / -i__w r e CERTIFICATE OF ON-SITE SYSTEMS APPROVAL l FOR A SINGLE FAMILY DWELLING Parcel I. D. 017-062-42 COSA# 01 a l�6a 1. GENERAL INFORMATION Expiration Date: 7? C� / Complete legal description SUN VALLEY HEIGHTS• BLOCK 5 LOT 3 Location (site address) 13540 TAHOE RIDGE *ANCHORAGE AK 99516 Current Property owner(s) ROBERT KLIEFORTH & ANN LOYD Day phone C/0 AGENT Mailing address 13540 TAHOE RIDGE *ANCHORAGE AK 99516 Lending agency Day phone Mailing address Real Estate Agent TERESA BELL W/ PRUDENTIAL Day phone 240-2248 Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well 0 Community On-site , ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances. and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 9)0/17— 2Engineer's Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, the in ADEC MOA 000` F��p 44 conscientious engineering analysis of system accordance with and DSD Guidelines & Regulations. The results described the of the...... ...... reported performance Op '9S�Qo system unde: the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and Q * 4. T � septic systems depend on the local soils condition, groundwater levels that may . . . . . . .. . .. . . . fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test ... ... ..... ......... •. results do not guarantee future performance of the system, nor do they guarantee that f y A. r ess. 4 P there are no hidden defects or encroachments. GEG, LTD. can therefore not provide future how long the will continue to the - 049 E� 7953 .•' c��G •' any warranty or estimate of system meet 0 +` 12 a operational requirements of the ADEC or MOA DSD. The content of this report is forProf the sole benefit of the owner listed above. Any reliance upon or use of this report by any essio��o� °0040�00o other person or party is not authorized, nor will it confer any legal right whatsoever 5. DSD SIGNATURE v Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipul�t�ph "OF"" ON-SITE uuc)m i,liecnuss Arsenio Advisory Septic System Advisory Well Flow Advisory Maintenance Agreements. Supplemental Engineer's Report Nitrate Advisory Other Jj _% By: r� ,,. ten/ Original Certificate Date: Z (Rev. 11146) Municipality of Anchorage • '� Development Services Department Building Safety Division On—Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ok.us (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SUN VALLEY HEIGHTS; BLOCK 5, LOT 3 Parcel ID: 017-062-42 A. WELL DATA Well type A Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE RE: If A, B, or C provide PWSID# 213962 Well Log (Y/N) Sanitary seal (Y/N) Cased to ft. FROM WELL LOG Coliform _colonies/100 ml. ug./L. B. SEPTIC/HOLDING TANK DATA g.p.m. Nitrate mg./L. Date of sample: Tank Type/Material STEP/STEEL Tank size 1250 gal. Number of Compartments 2 Wires properly protected Casing height AT Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping _(� Pumper l JlN h l Gt C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE 10/14/74 175 Date installed 9/9/99 Soil rating (g.p.d./ftorft1bdrm)0•8+ 20 20 Length 37+ ft. Width 3 ft. *14.16 720 Collected by: Date installed 9/9/99 Cleanouts(Y/N) YES Hig¢ water alarm (Y/N) ieS System type SEEPAGE PIT TRENCH 9 Gravel below pipe 8.1 ft. in. Total depth *11.66 ft. Eff. absorption area 599 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **7/30/12 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 46 in. Water added 685 gal. New depth 62.5 in. Elapsed Time: 620 min. Final fluid depth 50 in. Absorption rate >= 450+ g.p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — **TRENCH TESTED ONLY. SEEPAGE PIT HAD 57" OF LIQUID IN IT AT TIME OF INSPECTION. VALVES IN STEP TANK WERE CONFIGURED SO THAT FLOW WENT TO BOTH 1974 & 1999 SYSTEMS. D. LIFT STATION Date installed 9/9/99 Size in gallons 1250 Manhole/Access (y/N) YES "Pump on" level at 42 in. "Pump off' level at 42 in. High water alarm level at 44 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main Sewer /septic service line areas On adjacent On adjacent lots manhola/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ PVT/ 200' PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parkin g/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PVT/ 200' PUBLIC F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date COSA Fee $ Y�U Date of Payment_9�/p� Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 05/15/07 THU 09:44 PAX 1 907 762 7169 Jack Waite Estate LOT 2 D x 0 71 LOT 3 10' UTILITY EASEMENT N 89.56'10" W 370.25' d�T�r EY STNG HOUSE U U 002 LOT 4 �F \ CP N 5' UTILITY EASEMENT 10392 , EREEREM or: EKOWSION N01E5: It Is the oxner6'r.,.o.ibllty to determine I_c�clvu. CoI rNu C YN p E P A R TC H Ne eKlabnre of any eoaement., Covenants rcmtrictione 5/5'R5 w/uv0 5/B' xe O Which tlo not appear on the leceYtletl aubd,folon plat NOTE: 5,25' ALMON. jFMM1AAZfT 4$ with PRUDENTIAL JACK WHITE under no olroumatonces should any dalo hereon be woad for Rue k TACK L'j aonalruoton or for esteb4hin, property linea. PENCE- —x— x — SURVEY OERTFICAPON: LANTECH hes conducted OVERHANG Physical tY o/ this Property as sM1own an this WOOD EEGKs- � and dtl 11:01 91e ITpravnss an nc there CONCRETE- ECS Oa an .1. 1VI611n the propene Linea and a0 Cn Craa C11- no encroach- ■AS—BUILT onto to ea to aNBt eLM1 Cr than noted. GRASPHALT- VEL- GRAV[L- OF: LEGAL DESCRIPYR)N; SCIIG sTANDPT_ Q wATER oELL- AND & CONSTRUCTION SURVEYORS -PLANNERS -ENGINEERS 440 WEST BENSON BLVD. # 103 (tax) 561-6626 ANCHORAGE, ALASKA 99503 (907) 562-5291 LOT 3, BLOCK 5, WORK ORDER Nl1M9ER: PALE: SCnIL pJ.Y xurs,B; MAY 12, 2003 ,"=5D• 70-233 S U N VALLEY HEIGHTS 2003 -L -145A Crtn a dre m e uo xu aooK A E Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program V 9665 South rage. St. P.O. Box 196650 Anchorago, AK 99519.6650 www.cf.anchorage.ek.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL^� FOR A SINGLE FAMILY DWELLING Parcel I.D. -0J 7 — o % p, — Y2— HAA# 0 J;� O JC" 1. GENERAL INFORMATION Expiration Date: Complete legal description SUN VALLEY HEIGHTS SUBDNISION LOT '3, BLOCK 5 Location (site address or directions) 13540 TAHOE CIRCLE * ANCHORAGE. AK 99516 Current Property owner(s) SAM STEELE Day phone 240-9489 Mailing address 3609 RHONE CIRCLE " ANCHORAGE AK 99508 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site ■ Individual Water Storage ❑ Individual Holding tank ❑ Community Class X Well Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) sate, functional and adequate for the number bf bedrooms and type of structure indicated herein. I further verify that based on the, .L lei informationn dbtained from the Municipality of Anchorage (los and from my investigation and inspection, the on-sitew9fer supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and Otto codes, ordinances, and regulations in elect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUrrE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Engineers Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wolfs and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the wafer usage of the family being served by the system. Those conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE __Z Approved for --3 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Phone 337-6179 Date I u 16 os bedrooms, with the following stipulations: V. WATT ERS AND • m= EWATER : PROGRAM__: (� Maintenance Agreements-/j"kM1L Supplemental Engineer's Report Other By. Original Certificate Date: /0-6-0 (Rw. 17A1) �,.. Municipality of Anchorage Development Services Department J Building Safety Division On-Sks Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.ancharage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST F Legal Description: SUN VALLEY HEIGHTS S/D; LOT 3, BLOCK 5. Parcel ID: 017-0(62,142— A. /7—D(c2,4Z A. WELL DATA Well type •A• Date completed Date of test Static water level Well production COMMUNITY WATER If A. B, or C provide PWSID# 213962 Cased to ft. FROM WELL LOG WATER SAMPLE RESULTS: Coliform oolonies/100 mi. B. SEPTICIHOLDING TANK DATA ft. g.p.m. Nitrate Well Wires properly protected (YIN) Casing height (above ground) in. AT INSPECTION ft. g.p.m. 00 ml. Date of sample: Collected by: Tank Type/Material STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanou epre n over tank (Y/N) NO Date of Duma) 1! oer C. ABSORPTION FIELD DATA Date installed 9/9/1999 Cleanouts (YIN) YES High water alarm (Y/N) YES Date installed 9/9/1999 Soil rating OE?rlbr ft'/bdrrn) 0_7 System type TRENCH Length 37 ft, Width 3 ft. Gravel below pipe 8.1 ft. Total depth •11.60 ft. Eft. absorption area 599 ft' Monitoring tube YES Depression over field NO Date of adequacy test 8/31/2005 Results (Pass/Fail) PASS For 3 bedrooms 32/ 45/ Fluid depth in absorption field before test31 in. 41/ Water added 522 gal. New depth 44 in. Elapsed Time: 120 min. Final fluid depth 40 in. Absorption rate >= 450+ g,p,d. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed 9/9/1999 Size in gallons 1250 Manhols/Access (Y/N) YES "Pump on" level at 42 in. "Pump otP level at 42 In. High water alarm level at 44 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main - line COMMUNITY WATER On adjacent lots On Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water service line Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line 10'+ Buildingfoundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date to HAA Fee $ 1450 t n5 )6t5h Date of Payment Receipt Number (Rev. 12101) Waiver Fee $ Date of Payment Receipt Number /CE --7953 03/13/03 THU 00:01 PAZ 1 007 702 3100 Jack White Estate fQ 002 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-062-42 HAA# [ l 'Q 3 6 19 GENERAL INFORMATION Expiration Date: Complete legal description SUN VALLEY HEIGHTS SUBDIVISION; LOT 3 BLOCK 5 Location (site address or directions) 13540 TAHOE CIRCLE • ANCHORAGE. AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ANDREJ KR07FL Day phone 277-7980 13540 TAHOE CIRCLE • ANCHORAGE, AK 99516 Day phone CYNDIE PARTCH w/ PRUDENTIAL J.W. . Day phone 762-5822 3201 "C" STREET • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class •A• Well Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm AKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 213 s ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identsable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the System. Satisfactory test results, do not guarantee future pedomrance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKW WC, Inc. can therefore not provide any wairantyorfuture'estimate ofhow long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed ab&W'Anyreliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Date 51(o 03 Conditional approval for bedrooms, with the filowing stipulations: Q •• 0� `J�: • ON-SITE G� . m= WASTEWATER Attachments: _ / �,0•, ,•'•�\` HAA Checklisty Manitenance Agreements J���/ZOA.�\� Septic System Advisory Supplemental Engineer'sReort Well Flow Advisory Other By: tel/ Original Certificate Date: S--8-03 (Rev. 12101) MunJelpart-ty. of Amborage Development $ervices Department Building Safety Vivislon Ort-SIte Water & Wastowater,13rogram 4700 South BnigaW St P,O. BOX, 100650 AnChorege, AK 99519.6650 WW&XI.anCh0r4ge.0k.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST WgpI.QQ$Wp 017-X062-42_Von: SUN VALLEY HEIGHTS S/D; LOT 3. BLOCK 5. ParcelID: A. WELL DATA COMMUNITY WATER SYSTEM well typo IfA.8,or0provide PWSID# 213962 Well LOCI (YIN) Date completed Sanitary seat Wires properly proteCted (YIN) Cased to �_ft- Casing height (above.ground) in. FROIVIVELLLOG AT INSPECTION Date of lost static water level Well-produ -ption �90.m. . WATIEROAMPL6RE6ULTS: Collform . colonles/1 00 ml. Nitrate mg''111'' Date of sample: . Collected by: 0. SEPTICIROMNOrTANK IATA Tang,Type/Material STEEL DatOnstalled 9/9/1999 Tanks" 1250 pal. Number of Compartments 2 Cleanouts (YIN) YES Foundallort,cleanout (YM) YES Depression over tank (YIN), NO High water alarm (YIN) YES Bate of pumping 2/4/2003 Pumper CHUGACH PUMPING 1D, ABSO PTION FIELD DATA 11 PF1FrQWrTX19nN?1 mm Data -Installed 11,041999 SOD rating: 0E0rft1`bdrm) 0.7 systemtype TRENCH t.englh 37 ft. WidthA3 8.1 t. .�fL Gravetibelow-pipe f Total depth .*' �-= ft. Eff. absorption area 599 fe Monitoring tube XES' Depression over field NO Date of adequacy test 2/4/2003Results (Pass/Fog) PASS For 3 bedrooms 6-5/ 1 94/ Fluid depth in absorption fieldbefore test 8,5 In. 2/ 9 Water added 1043 at. - New depth 24 in. 1 Elapsed. lime: 1350 rnin. Final fluid depth in. Absorption rate >= 450+ Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN It yes, give date D. LIFT STATION Date installed 9/9/1999 Size in gallons 1250 Manhole7Access (Y/N) YES "Pump on' level at 42 in. "Pump off" level at 42 In. High water alarm level at 44 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WATER SYSTEM Septic tankAlft station on lot On adjacent lots Absorption field on lot On adjacent In Public sewer main Public sewer manhole/deanout S§e orlse ervice line Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 1000+ Driveway, parkingtvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and a Z!' ! ' review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Nme JEFFREY A. GARNESS �p�4 s j•, C 7953......' Date :t l7 �fJ Ne^eq �ofessWn��c4 HAA Fee $ 375-- Waiver Fee $ Date of Payment 5. 7.03 Date of Payment Receipt Number A 919 Receipt Number (Rev. 12(01) a U=D 5,19 POLI rt? •9t iii' '. 02/02 ;W -c • " I L" I s �� r}�/ J �• !:.a' �Z ►tom' s � , t: 7/aOr. 4 i w C lab Seel. er c^ . Z "UILi HO 0000i"S EV THtl W►TI I balbT eatily Unit I ba.a patla'md a � er-sret's 1a• ti•,�� L� tP"CM o: th 19DW149 tleaaAMd pzoy.r T.-.£L_�% 4' 1wSSF t t!5c. . . 0.,taeeraN T.raoro"�a� itadact.hbatta,and t::at t.`.• ),ayra�. � ..{.� :�I'a :''�l �. � fj � mf' manta �a ar ficj"4t ua wIthiG the 'ei*t3' :'ne, and do j•••••,•%, ••�••r• .. / \ ' 0. e•at9t>! o: rnvrat3 rn tba MYv )ing jag*s.�t thara- :;t/;'!j; ...rC_�-••�}f:' -Tir i �L\ o, tLa: se tupr:ramaatt fli yrryatY >>n[ adiac•at tlereto •. aocwrh oa tar yatm)tu in juarneLand • at %Sart rn rw A. !nf w.lario t� m4daays, vanamiWAm Unu or ottwr v 1 aaureaats an * .., nro. 3=yis / saidyroq��aarrq�y .o.e.oe u Inliatad baraou 44- aid at Atuf+era Alba i TltLb WALf►TKA 11s ASSO=TCS �/)r MUNICIPALITY OF ANCHORAGE ° DEPARTMENT OF HEALTH & HUMAN SERVICES a Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 3434744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 017-062-42 HAA # XlrMOI %10 1. GENERAL INFORMATION Complete legal description SUN VALLEY HEIGHTS S/D7 LOT 3 BLOCK 5 Location (site address or directions) 13540 TAHOE CIRCLE Property owner Mailing address C/o BRIAN BRODERICK PRUDENTIAL VISTA Lending agency Mailing address Day phone Day phone Agent BRIAN BRODERICK Day phone _(907) 273-7361 Address C/O PRUDENTIAL VISTA 4241 B STREET ANCHORAGE AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water *00 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC ing to the legality and status of system. 72-025 (Rev. 1191) Front MOA #21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $450.00 at, or prior to, closing for the engineering services provided. 5. 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 Municipa�nfp tate codes, ordinances, and regulations in effect on the date of this inspection. 1 j Name of Firm Engineer's Signature Phone _(907) 337-6179 5—/ /. In conducting this evaluation, AWWC, Inc. att mpf d to prow a thorough, conscientious engineering af�alysis of the system in accordance with ADE C and M�A HFI Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water oo600pp� usage of the family being served by the system. These conditions are outside the control of o 4 the evaluator of the system. Satisfactory test results do not guarantee future performance o . .... 4 of the system, nor do they guarantee that there are no hidden defects or encroachments. p� j•, p AWWC, Inc. can therefore not provide any warranty for future estimate of how long the p� system will continue to meet the operational requirements of the ADEC or MOA DHHS.... .. •7 1. ....:. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or parry is not authorized, ....... ...... nor will it confer any legal right whatsoever.ff ' A. G r essi 6. DHHS SIGNATURE Qa s ' .-7953 •' .ceG 0 0 Approved for 3 bedrooms�04edprofessiendo�� Disapproved Conditional approval for bedrooms, with the following stipulations: Additional Comments 0 Date .S- /2 - 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. 72-025 (Rev. 1/91) Back MOA #21 Computer Version &LCEIM Municipality of Anchorage MAY 1 2 . DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIFALIVY or 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744^ (MENTAL See Health Authority Approval Checklist Legal Description: SUN VALLEY HEIGHTS S/D; LOT 3, BLOCK 5 Parcel I.D.: 017-062-42 A. WELL DATA Well Type CLASS "A" If A, B, or C, attach ADEC letter. ADEC water system number 213962 Log present(Y/N) Date completed Total depth Cased to Casing height (above Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE I Coliform —� FROM WELL LOG Wires properly prod (Y/N) AT INSPECTION Nitrate Other bacteria Collected by: B. SEPTICIHOLDING TANK DATA Date installed 9/9/99 Tank size 1250 Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression (Y/N) NO High water alarm (Y/N) YES Date of Pumping NEW Pumper – C. ABSORPTION FIELD DATA Date installed 9/9/99 Soil rating (g.p.d./112 or ft2/bdrm) 0.7 System type TRENCH Length 37' Width 3' Gravel thickness below pipe 8.1' Total depth 11.2' Effective absorption area 599 SO FT Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Date of adequacy test NEW Results (Pass/Fail) Fluid depth in absorption field before test (in.); I edle after— Fluid depth (ins)jMinute er: Absorption rate = (past 12 months) (Y/N) 72-026 (Rev. 3/98)' Computer Verslon For If yes, give date gal. water added (in.): Bedrooms D. LIFT STATION Date installed 9/9/99 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at* 42" "Pump offlevel at* 42" High water alarm level at* 44" *Datum BOTTOM OF TANK Cycles tested NEW E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WELL Septic/holding tank on lot 200'+ On adjacent Absorption field on Public sewer main Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10, + Water main/service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage area 10'+ Curtain drain NONE KNOWN Wells on F. ENGINEEZ1ave FI 1JUrnu 1 certify thd t� n fi Id inspections and review of Municiprd tft te s stems are In conformance with MOAuidel non this date. Engineer's Nae JEFFREY A. GARNESS n0ro �/ /i nG% HAA Fee R 3 C , 67) Date of Payment �5 Receipt Number 72-026 (Rev. 3/86)• Computer Verslon Waiver Fee Date of Payment Receipt Number 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//��r,p, Parcel l.D.# 017-062-42 HAA# al'Z :l 1 L)4�)QS 1. GENERAL INFORMATION Complete legal description Sun' Valley Heights Subdivision 1,ot 3; Blk 5 Location (site address or directions) 13540 Tahoe Circle Property owner First National Bank Day phone 777-3380 Mailing address 1751 Gambell St. Anchorage, AK 99510 Lending agency Day phone Mailing address Agent Bob Baer/Totem Realty Day phone Address _ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well - Community well Public water XX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xx 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 (Fay. 1/91) Front MOA#21 5. 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 forthe 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 Name of Firm Address Engineer's signature ALASKA WATER 6. DHHS SIGNATURE Approved for THRE E bedrooms. Disapproved. Conditional approval for Additional Comments 0 inspection.. Phone 337-6/79' Date A bedrooms, with the following stipulations: Date U 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 pu rchasers 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-=(Av.1M) Back MOAM21 RECEIVED Municipality of Anchorage OCT 21 1999 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALIIY OF ANCHORA 825 L Street, Room 502 • Anchorage, Alaska 99501 • toyl �3-rtaICES DIVI 0 Health Authority Approval Checklist Legal Description: SUN VALLEY HEIGHTS: LOT 3. BLOCK 5 Parcel I.D.: 017—n62-42 A. WELL DATA Well type CLASS "A" If A. B, or C, attach ADEC letter. ADEC water system number 913989 Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE Coliform sample: Date completed Cased to FROM WELL LOG B. SEPTIC/HOLDING TANK DATA Nitrate _ Casing height (above grour Wires properly pro ed (Y/N) A PECTION 9— p.m- Collected by: Other bacteria g.p.m. Date installed 9/9/99 Tank size 12Sn Number of Compartments 9 Cleanouts (Y/N)YES Foundation cleanout (Y/N) YES Depression (Y/N) No High water alarm (Y/N) YES Date of Pumping NEW Pumper C. ABSORPTION FIELD DATA Date Installed 999 Soil rating (g.p.d./ft2 orft2/bdrm) 0.7 System type TRENCH Length 37' Width 3' Gravel thickness below pipe H.1' Total depth 11.2' Effective absorption area599 SO FT Monitoring Tube present (Y/N)YFS Depression over field (Y/N) NO Date of adequacy test NEW Results (Pass/Fail) For Fluid depth in absorption field before test (in.); Immedi _ gal. water added (in.): _ Fluid depth (ins er: Absorption rate =g.p.d. Perc a treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)" D. LIFT STATION Date installed 9/9/99 Size in gallons Manhole/Access (Y/N) YES "Pump on" level at` 42" "Pump off' level at* 49" High water alarm level at" 44.1 'Datum BOTTOM OF TANK Cycles tested NEW E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 1COMMUNITY WELL Septic/holding tank on lot Absorption field on lot Public sewer main Sewer On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 5'+ Property line 5'+ Absorption field 5'+ Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line 10'+ Building foundation 10' Water main/service line Surface water 100'+ Driveway, parking/vehicle storage area Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. ENGINEER'S CERTIFICATION I certify that 1 ave�7et9ri e/�/hr field inspections and review o1 Municipal in conformal ce with ��H�jl�( au defines in effect on this date. Signature Engineer's Name Date— -UOS QO4P .. VCE -7953 HAA Fee $ 3op r /-)=D Waiver Fee $ Date of Payment )0,/4/&2 > Date of Payment Receipt Number .532P( ' `' / Receipt Number 72-026 (Rev. 3/96)' are MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OP HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL. CERTIFICATE 1. General Information Application Date /0 36 XS (a) Legal Description (include lot,. block, subdivision, secton, township, rang 1-0-7-3 UGa�/� 'Gf ✓/I�� �7�J�7 EC'_ Locat /.3 �- (address or directions) -7�V74_ - UfZeX&_ '6, (b) Applicants Name���1�/�/%� 5�i�� T` Telephone - Home Business Applicants Address /3S� Allyl (c) Applicant is (check one) Lending Institution ; Owner/builderl o Buyer ; Other G---] (explain); (d) Lending Institution ��i�j'Ic'''1-c<t _ Telephone Address (e) Real Estate Co. & Agent Address i„ Telephone (f) Mai]. the HAA to the following address: 2.e Single-Familyla_z� Number of Bedrooms 3. Water Supply Multi --Family F___1 J Other _(describe)_.__,__ Individual Well = Community Public F_ 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 Environmental Conservation attesting to the legality and status. [Page 1 of 21 5. Engineering Firm Providing Inspectionsp 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 regula- tions in effect on the date of this inspection. - Name of Firm%I�• E�✓� �liea�ijh C;i�:'Puff- jib -5 jJc�. �� Telephone " / Address /1.610 C'J ififa%o/ Ae Date (ENGINEER SEAL) 6. DHEP Approval. , Approved for r _ _obedrooms Approved "YDisapproved Terms of Conditional. By CAUTION E3 iOppCt4�G0 0j4 (j!10 0 or a9a� 'Cc%c cca4ma y+ •) i TOY C Reid Jr. i C, No. 2261 -fl/ Da -Lei`:: l Condi 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 21 7-19-84 'UNICIPALITYOF ANCHORAGE: DEPT. OF. HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) - HEALTH AUTHORITY APPROVAL (HAA) IJOV L 5 CHECKLIST - FEBRUARY 1984 264-4720 Legal Description A. WELL DATA Well Classification d �Kw,'r f- If A, B, C, D.E.C. Approve(ION)Well Log Present (Y/N) _�—_ Date Completed _4A --Yield Total Depth A24 Cased to _-AZL_ Depth of Grouting L Static Water Level Pump Set At — 14,14 Casing Height Above Ground —_ N�/ Sanitary Seal on Casing (Y/N)✓U�/ /J Electrical Wiring in Conduit (Y/N) Ni'I Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot — // _ ; On Adjoining Lots � 2114 To Nearest Edge of Absorption Field on Lot _ /�/L� _ On Adjoining Lots "�_ To Nearest Public Sewer Line k1--1 - -- To Nearest Public Sewer Cleanout/Manhole .—SI..— To Nearest Sewer Service Line on Lot ,qw Water Sample Collected by __ —_ ; Date Water Sample Test Results Comments - — B. SEPTIC/MOLDING TANK DATA Date Installed/ Size —��� �� No. of Compartments _ Standpipes 6�IN) — Air -tight Caps (�/N) _ Foundation Cleanout ) Depression over Tank (Y/PI Date Last Pumped Pumping/Maintenance Contract on File (Y/N) AA - ; for Holding Tank High -Water Alarm (Y/N) /(A - Temporary Holding Tank Permit (Y/N) _ A/ Separation Distances from Septic/Holding Tank: To Water -Supply Well _ 1to " To Building Foundation To Property Line ------ To Disposal Field' To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course __62r__ 1460_ Comments Page 1 of 2 72-026(11/84) t 3 6 S }tial✓,tau; /fin C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /76- w Type of System Design < ! r Date Installed /FJ`(`' -71 Length of Field X9_0_ + Width of Field Depth of Field / 2' �Gravel Bed Thickness Square Feet of Absorption Area 720 Standpipes Presen (f '1�1) Depression over Field (Y/ )I— Results of Last Adequacy Test Date of Last Adequacy Test ✓n `��'-�'� /%3JEl�UAicr - S[ /sT/llzl�G� �[YStIGT Separation Distance from Absorption Field: i To Water -Supply Well z ['a t To Property Line To Building Foundation - P 5 To Existing or Abandoned System on i Lot ; On Adjoining Lots �r �xJ r To Water Main/Service Line �. (- /O To Cutbank (if present) 164To Stream/Pond/Lake/or Major Drainage Course 1 X00 /_ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (VN1 (Y/N) "Pump Off" Level at ** Check permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that/�3v{ h he ed, ve fied, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. a Signed r""` � Date , j Company A'eF-, 'S MOA No. Receipt No. 30) (� Date of Payment ((' ) 5' 7 �, �F .. _ dv�a••4 '1 9 Amount: $ (,p �� erC� n Page 2 of 2 9 R . ®c , ( roy C. Reid, C ©pJ' •,• No. 2251-E , 72-026 (11/84) Oe�F,*•e,,°;�. �41h �QfESSiQt�P, 50650 ALASKA CnUIROWnTAL COnTROL SCR US, InC. engineerinq 6 Enuironmental Studies 11/14/85 PATRICIA E STARRATT SELLER—PATRICIA E STARRATT PATRICIA E STARRATT 1350 TAHOE CIRCLE 1350 TAHOE CIRCLE ANCHORAGE ALASKA 99501 ANCHORAGE ALASKA 99501 LEGAL:SUN VALLEY HEIGHTS BLOCK 5 LOT 3 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE -10/23/85 THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 720 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM i�.__ 7-9� GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS for y C. Raid, Jr. 140. 2251-h a 1000 IS ADEQUATE FOR PUMPED ON 9/5/85 . F PNpNp2. PpE MUN\Gp�QjjM�N P�P Qorj,�pt�pN 1200 West 33rd Auenue, Suite 3 • Anchorage, Alaska 99503 • (907) 561-5040 6 1 I C BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 DATE: 1-a PWS 1.0.# Z/3 96Z To Whom it May Concern: According to records on file in this office the S'4 1�eizvr �0 I R, Water System is in compliance with the State Drinking Water Regulations Sincerely, �/- 5. LEGAL DESCRIPTION MUNICIPALITY OF ANCHORAGE n DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 826 L Street - Anchorage, Alaska 99501 - 0* ENVIRONMENTAL ENGINEERING DIVISION �y Telephone 264-4720. 1 REQUEST FOR J� APPROVAL OF INDIVIDUAL WATER AND SEWE FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPE��RT�Y��OWNER - - PHONE MAILING ADDRESS 74 - / (fi/'r/ C2 G .. dt-� PROPERTY RESIDENT (If different from above) PHONE 2. BUYER nn V'c� cos — c�zl 3 c -Z) PHONE . MAILING. ADDRESS - - •—� 3. LENDING INSTITUTION /-,- - - - **If individual/on-site, give installation date42-14,l,' PHONE c - !J $ PUBLIC UTILITY by this Department. MAILING ADDRESS 2-3 - - c � 4. REALTOR/AGENT - PHONE MAILING ADD SS Z06 5. LEGAL DESCRIPTION - STREET LOCATION - - - 5. TYPE OF RESIDENCE NUMBER OF BEDROOMS (� SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY - - ED INDIVIDUAL* INDIVIDUAL* * ATTACH WELL. LOG. A well log is required for all wells drilled 5L COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** - - - **If individual/on-site, give installation date42-14,l,' ❑ If system is over. two (2) years old an adequacy test is required PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) sY— cLJ>7.'' THIS SIDE FOR OFFICIAL USE ONLY - INSPECTION APPOINTMENTS DATE RECEIVED -- TIME TIME TIME DATE - DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS; - 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER of BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY - - ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. -SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: 1600 If Tank is homemade give dimensions: SOILS RATING % S� TYPE OF TANK MANUFACTUF4R TOTAL ABSORPTION AREA MATERIAL I 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area. Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 6---APPROVED FOR _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompaertificate) ❑ DISAPPROVED DATE BY (T't/lef� LEGAL DESCRIPTION 72-010 (Rev. 3/78) APPLIC INT FILLS OUT UPPER MAL ` ONLY Property Owner � �.) A J �_� /11 no Mailing Address I,1 �I ��!' X J-'// 7 % / ` J ; �� / I (.'1 r ` / Zip Code /�L /n Buyer rU / . ?j ) Address Zip Code Lending Institution ,h /! Al- if--%� l'if �/ g t / P Phone C' -f/' i r F(zlfY Address Zip Code Date b Realty Co. d Agent Phone Address Zip Code Legal Description Inspector Street Location i t � d;rir;� i irr rr �� 5r/ � C-- � [- ( � ({ (�� �', 1 ��1��� (i ( / � �1-t_-( � Type o Rosldence —MUKgC TTY-8r—A-Metf9RAeE Pr Single Family ❑ Multiple Family No. of Bedrooms_ ❑ Other Water Supply ❑ �119gdlvidual [FYCommumty ATTACH WELL LOG. A well log Is required.for all wells drilled since June 1975. For wells drilled prior to that date, give well Joplh (attach log If available). ❑ Public Utility Sewer Dispdsal 10,<nndlvidual . Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time rel �t _Ac nNP Date Date Date Date b Inspector Inspector Inspector Insprr —MUKgC TTY-8r—A-Metf9RAeE Field Notes: DF°T .., RECEIVE - D APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE �Z ` BY: Soils Rating Date Sewer Installed Well To Absorption Area d Well to To Septic Tank Size / /4' d �T 720x3 WEQ)