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Home My WebLink AboutSUNSET HILLS BLK B LT 20 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241225 Work Type: SepticTank Upgrade Tax Code Number: 01820157000 Site Legal Address: SUNSET HILLS BLK B LT 20 G:3033 Site Mailing Address: 14011 SUNVIEW DR, Anchorage Owner: LAURION DAVID J Design Engineer: FORGE ENGINEERING This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: I L)cliartmcitt 8/9/2024 8/9/2025 13000 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Clo b. Covered a ed, and heated to prevent fre i pecia' Provisions: • Prior to construction, the end of the trench is to be located in order to ensure that the required separation will be met. "4�Y: �� -10 Date: Issued By: Date: -7 2 `' 3 �!; I '4:7W 2 � 1 11111I M Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 018-201-57 Property owner(s) David Laurion Mailing address 14011 Sunview Drive, Anchorage, AK 99515 Site address 14011 Sunview Drive, Anchorage, AK 99515 Day phone 907-223-0368 Legal description (Sub'd., Block & Lot) Sunset Hills, Block B Lot 20 Legal description (Township, Range & Section) Lot Size 13,000 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (S all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo AD U) Septic Tank ❑X Upgrade ❑X Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. z (Signature of property owner or authorized agent) Permit/Rush Fees: 22� Date of Payment: Receipt Number: /0a19_ Permit No. �2 225 Permit App__-: ,_..:c: Waiver Fees: Date of Payment: Receipt Number: Waiver No. July 23, 2024 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Sunset Hills, Block B, Lot 20 – Sunview Drive Septic Tank Replacement Dear On-Site Services Engineer: The owner of the above lot has a septic tank that has reached its end of useful life, so we are submitting this permit application for its replacement. The attached site plan identifies the location of the home as well as the wells and septic location. No conflicts exist between this proposed system and any other wells or septic system, whether on this lot or adjacent lots. We are replacing the septic tank with the same size designed for 3 bedrooms. The new septic tank will be a minimum of 100’ from all wells and surface water. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241225, Deb Wockenfuss, 08/09/24 x x x x x x x x x x x x x x x Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 1"=30' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND SUNSET HILLS SUBDIVISION, BLOCK B LOT 20 FEET 0 30 60 FCO SUNVIEW DRIVE 3-BDRM HOME SEPTIC PLAN 7/23/24 SUMP VENT EXISTING 56' LONG TRENCH TO REMAIN IN SERVICE HANNAH COURT SHED EXISTING WELL NEIGHBORING CLASS 'B' COMMUNITY WELL WITH 150' WELL RADIUS DECOMMISSION EXISTING 1000 GAL SEPTIC TANK INSTALL NEW 2CO NEW 1000-GAL SEPTIC TANK 5.0 5.0 10.0 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241225, Deb Wockenfuss, 08/09/24 ------------------------------ 0 N HANNAHS COURT -- — N 89'59'00"E 100.00' WELL 10.2' x 15.6' SHED 4 I f' N + CHAIN-LINK FENCE ' \* 3.0' CANT 2.0' CANT 16.2' 25.7' oF�k °'- Z O O O a N Lot 19 C Ut O Lot20 13,000 s.f. (MOA) 48.3' 2 STORY RESIDENCE 48.3' O 16.2' ASPHALT PAVEMENT S 89'59'00"W 1 0.00' SUNVIEW DRIVE O O / o 0 Lot 21 25.8' r1 \� 3.5' CANT P SEPTIC PIPES PLOT PLAN ___ AS BUILT _X_ SCALE _ 1=__ 30__ GRID–SW 3033 ___ Project No. J24-064 Al P.O. Box 210005 Lang & Associates, inc. Anchorage, Alaska 99521-0005 000 0 (907) 522-6476 oa Professional Land Surveyors Jonathan®langsurvey.com o O A �p kenAlangsurvey.com I hereby certify that I have surveyed the following described property: O� .QOO LOT 20, BLOCK B, SUNSET HILLS SUBDIVISION (Plat No. P-288) Anchorage Recording District, Alaska, and that the improvements situated thereon are "" """""(, 9 9 N....: .... within the property lines and do not encroach onto the property adjacent thereto, that Q G no improvements on the property lying adjacent thereto encroach on the surveyed (7""' NA \ o premises and that there are no roadways, transmission lines or other visible QO ATHLANG G easements on said property except as indicated hereon. O �'••�� J ) ZO _.ic L `�Q��I �Q Pio ' .LS -9944.•'' SJ�� Dated this the _ _Y Day of �– Y11 at Anchorage, Alaska o • • • • • o 0 p04a� It is the responsibility of the owner to determine the existence of any easements, OFfSSIONACoOppppo covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 ? MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I~.,~ rl'~. l~l ENVIRONMENTAL ENGINEERING DIVISION ~ ~'~, ~17~ 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION , ~0. OF BEDROOMS ~ ~ Liq. ca ac'tv in gallons ' Inside length Width Liquid depth /~(~ IF HOMEMADE: 0 Z ~ Manufacturer ~ Materia) Liquid capacity in gallons No. of lines Length of eaSh llne Total length of lines~ Trench ~i~th Distance between lines ~ ~~ Top of tiJe to finish grade __1 ~'- Material beneath the ~ ~ Total effective absorption area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller D~stance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(sD ~ DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING RINSTALLEREMARKS 72-013 (Rev. 3/78) IIIYA• r.. 0,.,,. �, )^^,• 1111 s'.•�p.7' .M .. ..• 10..41 ..CSI ' A^t+•r•,., Alf.t• ,tyy tl • IWI N ALAI.A Otnrw(,) Or YfYIIA IIIOOCIS Orllllnf C°gyn. ,.•• Y•I S •=• y (tel , (a ° I u 1 rr , lD[IIIOY 0. Nll %�� J.1 (. 1. , P=•.I.��.1f _� �.�_(•`�.. • M royt, Lotal l..� rf. 7.1111.1 r•ral b. M11.<I ^S.rwl.+.l� •1,.. ly A.O.I. b. rq<t's+ '7. -7f�•G L •• b. �wn.yl 4, go.01101•, 'A. O•111.<e 1^1 O•r•ae•nn 1.e, all (/Y 1. Ow(1 Ol NLL, .. I f . r; Alsn.0 • � 1 • , It'"t 141.01, •N A. %. .•ILL LN. 11•b.1.1 �.r, left ►.IA t.t.f,,, ! WILL Olrrw• I<e.e le 1..11 fMrr I It" I l + i f�. n 1 ybN• feel ❑Iebh ❑011e•, f ❑ ' / ? 1. / • .fr w ["' • D1YHr ❑httN Db1N (3DfiNft L. Y1f1 De'11111t OPNIIt f+Po1/ ❑INHtr/ 13 top It,I IMM, DIKNrp O CwPK 111 ❑htt wen ❑otb.1 J. CAtNt: u T,1Kd°4 JDU!IIN G 1,. y7 f 1 �1►UIt. Iw ro wry. Bert+ t. rlelfM OF 'ILL,/ t.po �r�N f tet/It• 111 111•; �� legtYt fol ►•Iw.M ft. r.1 tt. ♦Illhfll f frATlt Wile tt,ft, ft. ❑Awn 0641,M 11. 7 IpYII1t. typo Of ly211. 11 �x t.1f'I:•lG.l--e. 10. PUMOIWC LIV(L Nle, reN tvryq 1 ICIDAIIiv opt,, rNyt ' It. ^f It. art,, UL E 1111.. ►n. PY.o le t••ll N 11. Vitt MCAD Cewr f 11/1011: I4 Aporoeed III yy OPIIIIt/ Ad•rlb IKNr Go," role 17. flOYf IYC, well fro.t.4, Ur.- Ob . N1u411 Obel Ce.owt U. PIMP, (It 0.61111,14) M L"th of Orae rlpo It. ryM1 01.1'"'O►11 fere ❑AK Irrote t Iwe ❑Jet 0DtN1: 1 16. Iq•A1A7' _ S, M°T111 WILL CO,f4ACt0A•I CC Ii1r ICAT1O°; 'hit welt w•, dIll"d Yn4 1.,,,., !(i' \ti. Jw 4ntt •nw •.. ttt, . 1•'rt I! w� !d!1./Se1ewI edY�-- (' V end ►dl.e1; A/f 1114• fib A ylr� ..al..al Lf.... y..r.. .. I7•WY1 r.•.r,u .. 1101 -•�� _ .t• 4µt Cr.tl• .. ��.. ..�.._ _fY=•. _[... 0111 ';,ltl,or ~ '~ 2(~ t i / / HIS ~d,*~.: P*O* ,iO× 10606 _ , ~- ~,~ ,.. ~,~. : ~tP~ ~ ._.,~ ~ . ,, , - ..... r ~lE~l~ ~ ' ~ ..... ~., RPF:'L I C:FIN'F LOCRT I ON LEGRL CHFIRLES E. JFICKSON PO BOX ±CI-6¢~-];, 99511 t::,EFIRMOUN & OLD SENFIRD ON SLiNSET L2(~ E:LO(.":K E: '.-]IJN~¢ET HILLS LOT SIZE E:,EF'RR]"MENT r',r;' HEFILTH RND EN'v'~RONMENTFIL '"a,_ ...... lEu] ........... [LEE. F., I:~NCFIOR~GE., RK. 9'i EL ' ..~...., ,~,~, ~t. TEIE~E~ SI~H.JRRE FEE~ I' 'T'¢F'E OF' SOIL RBSORF'TION S"r'STEM IS: TRENC:H MR',:':;IMUH NUMBER OF BEDROOMS SOIL RRTING <S6! FT,,"E:R)= 275 I"HE REQUIRED SIZE OF THE SOIL RE,'SORPTION S'¢STEM TFIE L. ENGTH DIMENSION IS ]"FIE LENCiTH ,::IN PEET) OF THE TRENCH OR DRFIINFIELD. TFIE DEPTH OF F! TRENCH OR PIT ~S THE [:,ISTFINCE E:ETHEEN THE SURFFIE:E OF THE GROIJN[:, FIN£) THE BOTTOM OF 'THE FNCFI',,,'FI'f'ION (IN FEE]"::,. THERE IS NO SET b. IID'¥H FOR TRENCHES. THE GRRVEI... [:,EF'TH IS THE MINIMUM [:,EPTH OF GRRVEL. BETNEEN THE OUTFRLL. PIPE FIN[) THE BOTTOM OF THE EXC:RVFITION (IN FEE'['). PERMIT RF'F:'LIC:RNT FIRS THE RESPONSIE:ILIT'¢ 'l"O INFORM TFIIS [.',EPRR'FMENT DURINIS THE IN'.:STF~LLFKFION INSPECTIONS OF RN'¢ HELLS FI[:,3'RCENT TO THIS PROPERT'¢ RND 'rile NUMBER OF RESIDENCES ]'FIR]' TIqE I.,IELL I.,.IILI.. SEF.'.'v'E. E:f:flZ'.KFII..LING OF fllq¥ SYSTEM F.III"HOUT FINFt[_ INSPECTION RN[:' flPPRO',,,'FtL B'¢ THIS DEF'RI:~:TMENT HILL 8E SLIE:JEC'F TO PROSECUT]:ON. MINIMLIM I}ISTflNCE BETWEEN fl NELL~ RND RN"r' ON-SI'rE SEHRGE DISF'CISFIL S"r'STEM IS ::L~E~ FEET FOR FI F'RI',,,'RTE NELL OR :%5~ TO 28E~ FEET FROM FI PUBLIC: HELL DEPENDING Uf:'ON THE T'¢PE OF PLIBLIC WELL. MINIMLIM [:,ISTFiblC:E FROM FI PRI',,,'RTE NELL TO R PRI',,,'RTE SEHER LINE IS 25 FEET FIND TO FI COMHUNITY E;ENER LINE IS 75 FEET. NELL LOGS FIRE REg!UIRED FIN[) MUST E:E RETt.tl;?.NED TO TFIE DEF'RR'FMENT NITHZN 3:E~ DR'CS OF THE NELL COMPt_ETION. OTHER REE:]UIREMENTS MFI'¢ RPPL'¢. SPECIFICFITIONS RND CONSTRUCTION DIRGF?.RMS RRE RVRILRBLE TO INSURE PROPER INSTI:~LLFITION. I C:ER"FIF'.? TFIRT :1.: I RM FflMIL. IFIR HITH THE REQUIREMENTS FOR ON-si'rE SEI.qERS fiND NELuLS R:S SET FORTH BY THE MUNICIPFILIT"r' OF flNCHORRGE. 2: I HILL INS]'RLL TME SYS'f'EM IN RCE:ORDflNCE HITH ]'FIE CODES. ]:; I UN[:'ERSTflND¥/THRT THE ON-SITE SENER SYSTEM t'lfl~r' REf.:.!UIRE ENLf~RGEMENT IF THE lfESI[:'EI'4~~FO IN~[:'E MORE THFIN ]: BEDROOMS. I':;ql IE[:, B ~ E"FI"FE ",,',:k E1 [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82§ L, Street, Anchorage, A~aska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST LEGAL DESCRIPTION: 1 -- 2 3 8 9- SLOPE SITE PLAN 10- 11 ~13 - 14- 15 16 17 18 19 2O O. Talbot 4069 ENCOUNTERED? O P E IF YES, AT WHAT DEPTH7 Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE '~(~ (minutes/inch) TEST RUN BETWEEN ~O FT AND (~' FT COMMENTS PER.ORMEDBY: 72-008 (6/79) Parcel I.D. # 1.- GENERA~ INFoRMATioN Complete !egal d~ription ', .. 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 "_ APPR~JVAL FOR A SINGLE FAMILY DWELLING ~0t '20, Bi0~! B,~Su~s'et, Hills ,Subdivision Location (site address'bt ;di~ecfi°ns) 1 ~tni 'i .m;r;-b~ ~w :m-~ ~-~ - - ' , .':?~Mai incl address ,~'1401 1 .-sunv~e~ Dr3. ve '.-'A~cboraqe~.A~ 99515 , . · .... ': Lending agency" ,, _,,,,,-_._ , _ _ · '~ Day phone _ · _ . ,. Madmg address ? .......~'~ '~ ' - . - Agent y ph .... ', .' Da one Address ~';' ~!::: ,-~" :'" ' ' ' Unless otherwise ~equested HAA will be held for pickup... ', NUMBER OF BEDROOMS: Three (3) ? ' 'TYPE OF WATER SUPPLY: ' · Individual well ×xx Community well Public 'water' NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. ' ' 4, TYPE OF WASTEWATER DISPOSAL; Individual on-site Holding tank Community on-site Public sewer xxx NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72,~25(Rev. l/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 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 :' ~n~-.~,~ ~,~g±,~eer±ng ' Phone~ ~reSSn~ ignat,~P'O' ~Box:.~,240773 ~horac~e .~iAK 99524 "~D~"~' ' ~ i r'ss r " R/16!~c~ 6,'. DHHS SIGNATURE' "-. ' . ' ' ~ Approved k)r '~'~//'~'~'~' bedrooms. DisaPproved. " '- ~Conditional approval for bedrooms,' With'th'e~ollowing stipulations: The Municipality of Anchorage Department of'Health and Human Servic~s'(DHHS) issues Health Authority Approval Certificates based only upon the representations given in p~ragraph 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 Munic!pality of Anchorage is not responsible for errors or omissions in the professional engineer's work. . · , Municipality of Anchorage DEPARTMENT ~F. HEALTH& HUMAN SER~I,.._(:~ Enviror~'~en:[ai'Services Division 825 L Street, Room 502. Anchorage, Alaska 99501. Health Authority Approval Checklist Legal Description: A. WELL DATA Well typo Private Log present (Y/N) Total depth 1 47 ' Sanitary seal (WN) Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 Date of sample: 8/9/99 B. SEPTIC/HOLDING TANK DATA Date installed 5/81 Foundation cleanout (Y/N) Date of Pumping 4 / 9 / 99 C. ABSORPTION FIELD DATA Date installed 5 / 81 Length 56 ' Width Lot 20, Block B, Sunset Hills Parcel i.D.: 01 8-201 -57 If A, B, or C, attach ADEC letter. ADEC water system number Y Date completed 5 / 7 / 81 Cased to 1 47 ' Casing height (above ground) ¥ Wires properly protected (Y/N) ¥ FROM WELL LOG 5/7/81 AT INSPECTION 8/4/99 95' 93.6' 10 5.2 g.p.m, g.p.m. Nitrate 1 . 78 mq/L Other bacteria 0 Collected by: A, Harala Tank size 1 , 000 Number of Compartments 2 Cleonouts (Y/N).__ Y Depression (Y/N) N High water alarm (Y/N) N Pumper Old McDonald ' s Soil rating (g,p,d./fF or fF/bdrm) 2 ?~5 3 ' Gravel thickness below pipe Effective absorption area I; Or).q ~P Monitoring Tube present (Y/N) ¥ Depression over field (Y/N) _. Date of adequacy test 8/9/99 ResuIts (Pass/Fail) Pass For Three Fluid depth in absorption field before test (in.); 78,75" Immediately after 573gal. water added (in.): Fluid depth 82" (ins) Minutes later: 24 Hrs, Absorption rate = > 450 g.p.d. Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Y SF System type ~ 9 ' Total depth 1 0,5 ' N bedrooms 89.75" N If yes, give date N/A D. LIFT STATION - N/A Date installed: Manhole/Access (Y/N) High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot > 1 00 ' Absorption field on lot > 1 00 ' Public sewer main N/A Sewer/septic service line > 2 5 ' Size in gallons "Pump on" level at* "Pump off" level at* On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation > 5 ' Property line > 5 ' Absorption field Water main/service line > 1 0 ' Surface water/drainage > 1 ~ (1 ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line > 1 0 ' Building foundation > 1 0 ' Sudace water > 1 0 0 ' Curtain drain None Noted. on Lot' F, ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of ~ in conformance with MOA HAA guidelines in effect on this date. Sign at u re (~'~/~,~, Engineer's Name Hi r, hR~,l R An,'~c,~scm, P.E. Date 8/16/99 ~5' Wells on adjacent lots > 1 0 0 ' Water main/service line Driveway, parking/vehicle storage area > 1 Wells on adjacent lots > 1 0 0 ' HAA Fee $ Date of Payment ? I "'l ~' C/F~/ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number August16,1999 Prudential Vista Real Estate 4241 B Street Anchorage, AK 99503 Attention: Cheryl Ponder Subject: Lot 20, Block B, Sunset Hills Subdivision Septic System Adequacy Test Certificate of Health Authority Approval Dear Cheryl: On August 9, 1'999, we inspected and tested the septic system located on Lot 20, Block B, Sunset Hills Subdivision. This system was originally constructed in May of 1981 and consists of a 1,000 gallon septic tank and a deep absorption trench approximately 56' long with 9' of gravel beneath the distribution pipe. The standing water level in the monitor tube was measured at 78.75" out of a maximum possible of 108". We then injected 573 gallons of water into the system and the water level rose to 89.75" indicating the system holds approximately 52 gallons of water per inch of' rise. The water level in the monitor tube was measured at 82" approximately 24 hours later indicating 403.7 gallods of water had been absorbed. During this same period, however, the sewer facilities in the house remained in service. It is feasible to assume at least 50 gallons of water was disposed into the septic system during that period. The absorption trench is therefore capable of absorbing at least 450 gallons of water per day and meets the Municipal minimum requirements for certification. It must be noted again that the system is over 18 years old and well past the average life expectancy of a normal drainfield. It is impossible to project the future life of the field as it is dependent on many variables. We can say, however, the system at this time is capable of absorbing the required minimum of 450 gallons per day. Sincerely, Michael E. Anderson, P.E. 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 Parcel I.D. # 0/~'~';2z~['-5~':~ HAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner '~OdL, '~'-..Tub)/ S"T'OL:'r'~' Dayphone ,-~/~"~ -~5~4 Mailingaddress ~..0, _~ ~10~4~, i~"f,, AIL.. 9(15"~t Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA wF~Lbe held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: NOTE: Individual well X~Y.Y~w Community well Public water 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: 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 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ,~7'z..50~J -~--~J c,~J ~' c~/~ O Phone ._~ ~J- '-/~5>-5- ( Address J~ (~), ~- Z-c/O 77~ ~d (tjX. ~ A~'- q ~'-~c'z, q Engineer's signature ~ ~--'~ ~,t/,¢,~__ Date __ P~/~'l /,¢¢ DHHS SIGNATURE Approved for -~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: /(~'~, ~ Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS 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. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~.vr" Z~)j J~>co (p-- ~ .~)~J~.'~l-' /L/,u..{Parcel I.D. A. Well Data Well type . Log present (Y/N) Total depth Sanitary seal (Y/N) '~>~ ,J/~r'/~-' If A, B, or C, attach ADEC letter. ADEC water system number "~" Date completed ~'/~1/~'~/ Driller '~<;5 -~/L~Lttqb, /"~'7 / Cased to /5z'7 Casing height '~' Wires properly protected (Y/N) ~'~ Date of test Static water level Well flow Pump level1 FROM WELL LOG AT INSPECTION i /0 g.p.m. ~7 ~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~tDD I Absorption field on lot ~, tz~O ~ Public sewer main ~ ~-'~o O ' Sewer service line ; On adjacent lots ~/00 ; On adjacent lots ~/O0 Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: ~c~/,'t / c~ ~ Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed ~/~ / Cleanouts (Y/N) '¥" High water alarm (Y/N) Date of pumping DO Tank size /,, Foundation cleanout (Y/N) 7/zo/4 9 ~,~ .4~.~, Compartments ~ Depression (Y/.N) /~ Alarm tested (Y/N) /",/'/~ Pumper A'7' /-~-~/vtc ,~'~ffZ-k/l~Le-.~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~>i O 0 ~ On adjacent lots ~. t O ~' To property line / Z~/ Absorption field :~' / Sudace water/drainage ~ / .SO / Foundation Water main/service line 72-026 (3/93)' Frent CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (WN) "Pump of[" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Weft on lot On adjacent Pots Surface water D. ABSORPTION FIELD DATA Date installed Length 5JL~ J Total absorption area Date of adequacy test Width Soil rating (GPD/FF) ~'~ ~- r~ , ~t. System type b E/?,~ '~//~/4 ~-~ Gravelthi~ness ~ '~ Total depth /D ~. ' Cleanout present (Y/N) ~ .Depress~n over field (Y/N) ~ Resu~s (pas~fail) ~A ~'.~ for .~ Bedr~ms Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) After test 7 ~ ' If yes, give date /'-///~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~ / D~' To building foundation On adjacent lots Surface water Curtain drain On adjacent lots Cutbank ~ / D O~ Properly line To existing or abandoned system on lot .,~ o,'~/~;:~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I cerb'fy that l have checked, verified, or conformed to all MOA and HAA guidelines in effe¢~t:'o.~.'ti~e~d~t~.e[~this~::'~"~ ~' inspection. Eno Reefs Name /v / ~z~//) L, ~- ~: /~/-~ u ~/L~[~,'. ~ ,.~", - - . z .'~ .~ 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number DATE RECEIVED INSPECTION APPOINTMENTS ~rlME TIME TIME DATE DATE INSPECTOR INSPECTORZ ~/ , ~/ ( ENVIRONMENTAL SANITATION DIVISION /APR 2 9 1981 Telephone 264-4720 DE EI /E o. DIRECTIONS: Co~lete all parts on page 1. Incomplete requests wirl not be processed. Please allow ten {10) days for processing. PROPER~Y'RESIDENT~If ~ifferen~ from above) ' ' ' PHONE 2, BUYER PHONE MAILING ADDRESS 3. LE.,ING ,.~UT)O~ PHONE MAILING AD~S ' 4. REALTOR/AGENT PHONE MAILING ADDRESS STREET LOCATION 6. TYPE OF RESIDENCE [~SING LE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Other [] ...T.w o [] Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER SUPP ¥ ~DIVIDUAL* *ATTACH WELL LOG, A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ ~/y [~;~'~DIVIDUAL/ON-SITE** / EAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN RE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER (~]IN DIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY -~' ~c~ ~-' (~-( Connection Verified INSTALLER []Septic Tan~ o~,J~] Holding Tank Size: ] ~('~'('~f Tank is homemade SOl LS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO; Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS I~"~PAPPROVED FOR . ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72 O10 (Rev. 6/79)