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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 6 LT 5/ ountain Park Estates Lot 5 Block 6 #017-$91-06 Municipality of Anchorage Page 1 of 5 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 54,3-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW000239 PID Number: 017--591--06 Name: BRIAN HOEFLER WastewaterSystem: [] New · Upgrade Address: 1.3100 RIDGE"VIEW DR. ANCHORAGE, AK 9951E ABSORPTION FIELD No. of Bedrooms: Ph°ne:('907) 563--2139 [3Deep Trench DShallow Trench ~lBed [3Mound BOther** LEGAL DESCRIPTION 2.0 cPD/S.. ~.. ***,3.32 - 5.22 rt. 5 6 MOUNTrAN PARK EST.-, 0.09 - 1.99 ~ 0.,.37 ~t. - - - 0 - 1,5 F~ 20 /~"~"" grovel widU~: Number of ,ne.: Iol.to.~ between lines: WELL: [] New [] Upgrade 18 r~ 9I 2 Ft. F~ 360 SO. r~ DbO54/SCH 40 PVC/HDPE ~ DENALI SEWER 7/19-26/2000 ~Yieid: GPM I PumpPump SetSet AhAb Ft. Co,lng H,lgbt ~°v, Cmund:Rt. ****(EXISTING) TANK SEPARATION DISTANCES · Septic [] ~o,dlng [] S.T.E... To Septic Absorption Uft Holding Public/PrivatE Monufacture~. Capacity in gallons: From Tank Reid StoUon Tank S,wor Uno. ANCHORAGE TANK 1 250 Well 100'+ 100'+ 100'+ - 2§% STEEL 2 Sa.ace 100% 100'+ 100% - - LIFT STATION Water Line 5'+ .1'+ 5% - - 500i ANCHORAGE TANK/ORENCO SYSTEMS "Pump on" level et' I'Pump off' laver eL' IHigh wot~r olorm Foundation 5'+ 10'+ 5'+ -- - TIMER[ TIMERr 47" Drain NONE KNOWN ' 20 OSl 05 HHF M.O.A. I Remarks: *REQUEST THE 5' LOT LINE WAIVER BE AMENDED BENCH MARK TO 1 FOOT TO THE NORTH AND EAST PROPERTY LINES. TOP OF GARAGE SLAB · ~HIS IS AN BO~i'OMLESS INTERMITFENT SAND FILTER (ISF). · **2.86 OF MOA APPROVED SAND FILTER ADDED TO TOTAL 102.78 Inspections performed by:_ AWWC, INC. Dates: 2ndlSt 7/20/20007/19/2000 ~!.,'[,~/~., iT~?~..~., .l'~h 3rd 7/26/2000~-t~e'fq) ........ ~,~,' ~]~ ess,..! ....... ~"'":'"'~.~ Department of Health and Human Services, approval , t~ .... ..... .. ~ Reviewed and approved by: ,D.,///~-~,~ /'f-/, ~"~- Date: ~7,*~ ~- Oo [~.~'~""~-' o', ~,,~'~ ,~-o,~ ~,av..~.,~ .o~ ~ ~"-// ~' '~'~'~4:.~.~'~ PER~.UM,ER: AS BUILT DRAWING 5W000259 - 017-591-06 ~ /J ~ ~ / EXIS~Ng D~IN~ELD TO BE~ / MOUNTAIN PARK ESTATES SUBDIVISION ~'; LOT 5, BLOCK 6 ~E OF WORK: AS-BUILT OF SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF) : ~,%'~$~: AS-BUILT DRAWING 7/27/2000 BRIAN HOEFLER (907) 56~-21~9 ~ OF ~ MOUNTAIN PARK ESTATES S/D ¢~ LOT 5 BLOCK 6, AS-BUILT PROFILE OF SEPTIO SYSTE~ UPGRADE FROM : Danali Sewer & Drain Jul. 27 2000 12:50PM Pi PHONE NO. : 907 333 97?6 191UNICIPALITY OF ~CHO~GE -- B~LD~G SAFETY DIVISION' 4700 SO~ ~GAW S~ET, AN~O~G~ ~AS~ I~PE~O~: Vo~e: (90~ 34&~300 ~: ~OD 343~235 I~O~ON: (~OD 34&~211 ALCAN/CHRIS 13100 RIDGEVIEW DATE: 7/27100 PItONE #2: 244-8850 LOT: [~ WiIl~ramin~atn~0~thmp~'~ion. [] Donotconee~tmtilre-in~ected, [] C.O, approved. [] ¢.C.O. av~o~l (~ram~l~ below). RECEIVED JUL 28 2000 Municipality ot Anchorage:.: .>:= ~, .: .- ..:..: .': Dept. Health & Human Service~ ' i " ' '" '" ...... : WHEN CORRECTION~ ARE MADE, PLEASE CALl. FOR INSPECTION 8063 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 Permit Number: SW000239 Legal Description: MOUNTAIN PARK ESTATES 13LK 6 LT 5 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Brian Hoefler Owner Address: 13100 Ridgeview Dr. Anchorage, AK 99516-3108 ParcellD: 017-391-06 Total Bedrooms: 4 Date Issued: Jul 17, 2000 Expiration Date: Jul 17, 2001 G Site Address: 013100 RIDGEVIEW DR Lot Size: 24700 SQ. FT. Permit Bedrooms: 4 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 ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. ALASI WATER & WASTEWATER June 28, 2000 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: Sewer Upgrade for Lot 5, Block 6, Mountain Park Estates Subdivision #1 (Bottomless Intermittent Sand Filter-ISF) To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system consists of a 1250 gallon septic tank and a bed type drainfield. The existing drainfield is surcharged and must be upgraded. We are proposing that the integrity of the existing 1250 gallon septic tank be verified. If of good integrity, a 500 gallon lift station is to be installed. If of poor integrity, a 1500 gallon S.T.E.P. tank will be installed. We are also proposing that a bottomless Intermittent Sand Filter (ISF) system be installed. Comments regarding the proposed upgrade are summarized as follows: 1. GENERAL: Two test holes were excavated west of the existing house to determine an area suitable for a septic system upgrade. Due to impermeable soils south of the existing septic system, only one of the test holes was found to be suitable for an on-site septic system. Given the limited area around the testhole, the setbacks from wells and the existing septic system, and the location of the driveway; it is our opinion that a Bottomless Intermittent Sand Filter (ISF) system is the most viable option. 2. SOILS: Attached are logs which show the soil classifications, groundwater monitoring, and the percolation test results. In TH#l, the soils below the organics are a ML material to a depth of 14 feet (bottom of test hole). In TH#2, the soils below the organics are a SM/GM material to a depth of 8.5 feet followed by a ML material to a depth of 14 feet (bottom of testholes). Groundwater was not encountered in either of the testholes. A percolation test for TH#2 was performed between the depth of 2.5 feet and 3.0 feet which had a percolation rate of 4 6901 Debarr Road,, Suite 2B ~ Anchorage, AK 99504 N (907) 337-6179 ~ Fax (907) 338-3246 ~ akwwc.com minute/inch. A scond percolation test for this was performed between the depth of 4.0 feet to 4.5 feet which had a percolation of 40 minutes/inch. It is our opinion that due to the overall appearance of the soils, a application rate of 2.0 gallons/day/sq, ft. should apply for the proposed bottomless intermittent sand filter system. 3. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (ISF) a. Percolation Rate: 4 & 40 minute/inch b. Allowable Application Rate: 2.0 gallon/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 300 ft2 f. Effective Depth below pressure pipes: 2.5+ g. Effective Depth: 2.5+ inches h. Width: 18 ft. i. Length: 20 ft. k. Effective absorption area-- 360 ft2 j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". k. Air Supply Line: "Wasteflow" emittedine, 1/2 inch I.D, "Anchorage Tank". 1. Sand material: In accordance with M.O.A. latest standards m. Pea Graves: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the #8 sieve. We are prol~osing to excavate down to a depth of 5.0 feet (maximum), place a minimum of 18 inches of sand, install the air supply line, and cover it with 18 inches of sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic upgrade. 5. TOPOGRAPHY: As can be seen on the attached topography site plan, we are proposing to install the bottomless ISF on a bench that is generally flat; in short there are no slope concerns. 6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (5th floor, 9th & L St.) 7. LOT LINE WAIVER: Due to the limited area for construction, we are requesting a five (5) foot lot line waiver from the north property line to the proposed bottomless ISF. 6901 Debarr Road,, Suite 2B N Anchorage, AK 99504 ~ (907) 337-6179 ~ Fax(907) 338-3246 N akwwc.com 8. CLOSING: I am open to any suggestions £rom your department, which would be an improvement to the proposed design. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 'qY M.S. Presi, NOTE: Attached is a site plan drawing, a design drawing, a detail drawing, two soil logs (4 pages) and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr PPad~ Suite 2B N Anchorage, AK 99504 ~ (907) 337-6179 ~ Fax(907) 338-3246 ~ akwwc.com ~..... · \ \ ~ LOT 2 BLOCK 6 ./ ~ ~ ~ tm / ~ I_ 100 WE~ ~-'-~-. ~ ./',. ~ ~ ~ ~'F (~ox,~) - ~,~ ,,~--~>~ ....... ~ CONSULTANTS, INC>; ........................... ~ sm.~, ,, - PREPPED FOR PHONE NUMBER: PAgE NUMBER: ~ ~"t ~ BRIAN HOEFLER (907) 563-2139 1 OF ~ :"' ~L DESORIPqON: i~ ~-. g Cl ~' '7953 ,,' MOUNTAIN PARK ESTATES SUBDIVISION ~1; LOT 5, BLOCK 6 %~,~ .......... .~ff~ SITE P~N FOR SEPTIC SYSTEM UPGRADE ~ 18 FEET WIDe BY 20 FEET \ I '~ DETAILS AND REQUIREME~,ON~ ~ PS) PRESSURE ~AU~E AT A LO~ON / ~ ~ ~R LINE ~ w~ N ~E HOUSE NOD A 30 PSI ~U~ / ~SEE NOTE) F ~E ~I~NG S~C T~K IS FOUND / ~ O~S (SEE NOTES). -- ' ' NOTE- ~E CO~CTOR MUST .A~ THE o A ~ ~ I ~ocK ~ o~. ~K ~, ~. / ~ ~ / 3. ~E 100 WE~ ~lUS ~OM LOT 5, 6/28/2000 AI,AS~ WATER & WASTEWATER J.W.~. ~ BRIAN HOEFLER (907) 565-2159 2 OF 5 ~ ~ "'~ LEGAL DESCRIP~ON: /Oh~ MOUNTAIN PARK ESTATES SUBDIVISION ~1; LOT 5, BLOCK 6 q~e.".~ ........ ! -, 20' LONO ~ ' --2-- :40 PVC LATERALS W/ 1/8 DI~ i .__.~- © © ._~_~ T~K~ = MONITORING TUBE~ 2 FE~ MINIMUM OF M.O.~ APPRO~D BRAIN HOEFLER (907) 565-2129 5 OF 5 DETAIL DRAWING OF BOTTOMLESS ISF SEPTIC SYSTEM DESIGN. ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEI~RR ROAD, SUITE 28 * ANCHORAGE, AK, 99504 LEGAL DESCRIPTION: MOUNTAIN PARK EST. ~1 S/D; LOT 5, BLOCK 6 ..z PERFORMED FOR: BRIAN HOEFLER DA~ ~E~O~D: ~/~/~ooo ~".. {:-7,s3 ....'A~ I TEST HOLE ....... DEPTH ~ ORGANICS (PAGE 1 OF 2) SOIL C~SSIFICATIONS ~/ GP ~ML i / ~GMGc oLCL ~ L. ~ on CH ~S~ ,sc DEPTH TO DAT~ , ~ GROUNDWATER ~ '. ~ ~ ~J~J~IBL (BONDED SILT) -->-~ ' - IlllllIIlIFINER AND DENSER DRY 6/13/00 '"~ F 11 DATE READING__..,_ I (MINUTES) READING (INCHES) 12 6/15/0C 1~ --~ - 1 2:27 --- ~ ~ ~ 2 2:57~ ~' ~0 MIN. 6" O" ~ ~ ~ - 2:s~ ~ -- -~- 5:27 ~0 MIN. 6" 0" 15 16 17 18 19 PERCOLATION RATE >240 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) 20 TEST RUN BETWEEN 2.5 ,FT. AND,/,, ~.0 FT. PERFORMED BY A~SKA WATER & WASTEWATER I, ~ Jj ~ ~/~ [ , CERTI~ THAT DATE. DATE: ~ [ ~ ~/o 0 DEPTH TO GROUNDWATER DATE DRY 6/1~/00 DRY 6/15/00 ALASKA WATER & WASTEWATER CONSULTANTS, INC. -~'~m~ PHONE (907) 337-6179 * FAX (907) 33B-3246 LEGAL DESCRIPTION: MOUNTAIN PARK EST. S/D #1; LOT 5, BLOCK 6 ~ ................. [ ".JJ ;f 're ,1( A. Gar~ess: DATE PERFORMED: 6/13/2000 (/Oh~,o.,:.~/-. !Cg-7953 ...".~ (foet) TFST HOL£ #] u~l '"' ....... 1-- (PAGE 2 0~ 2) 2-- SOIL CLASSIFICATIONS GM CE 4-- GC OL ~ ,, SW ~..UJ_L HH %~_%72 SP~ CH SEE PAGE 1 OF 2 FOR 5-- m m SM OH LOCATION OF TEST HOLE. B-- 7-- _:, DEPTH TO DATE GROUNDWATER 0 Fo SEE PAGE 1 OF 2 0 0 ~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 TIHE (MINUTES) READING (INCHES) ~ 2 2:58 30 MIN. 5 15/16" 1/16" 14-- z ~ 3 2:58 6" 4 3:28 30 MIN. 6" 0" 19-- PERCOLATION RATE >240 (HIN./INCH) PERC. HOLE DIA. 6" (INCHES) 20._J__ TEST RUN BETWEEN 6.5 ,FT. AND ///7,0 FT. COMMENTS: PERCOLATION DATA ON THIS PAGE FOR UP~¢;;/~ ~FE~. IiOLE ONLY. PERFORMED BY ALASKA WATER & WASTEWATER I, ~- , CERTIFY THAT THIS WAS PERFORMED IN[ ACCORDANCE WITH ALL ST~T~ /~N~ ~ lUNI~ GUIDELINES IN EFFECT ON THIS DATE. DATE: ¢0/2-~/Dc) / /j ( ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUffE 2B * ANCHORAGE, AK. 99504 PHONE (907) 337-6179 * FAX (907) 338-3246 I SOIL LOG - PERCOLATION TEST I LEGAL DESCRIPTION: MOUNTAIN PARK EST. S/D #1; LOT 5, BLOCK 6 PERFORMED FOR: BRIAN HOEFLER DATE PERFORMED: 6/21/2000 SM/GM ITEST HOLE #21 (PAGE 1 OF 2) SOIL CLASSIFICATIONS ML eL OL CN OH SC ML (BONDED SILT) DEPTH TO GROUNDWATER DATE DRY 6/21/00 DRY 6/23/00 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 6/25/0( SOIL WAS PRESOAKED FOR 4 HOURS PRIOR TO PERCOLATION TEST. 1 3:24 6" 2 3:49 25 MIN 0" 6" 3 3:50 6' 4 4:10 20 MIN 0" 6" 5 4:12 6" 6 4:36 24 MIN O" 6" PERCOLATION RATE 4 (HIN,/INCH TEST RUN BETWEEN 2.5 FT. Ah COMMENTS: THE ABOVE PERK TESTS ARE CONSERVATIVE/~S'[ /,~ WITH 10 MINUTE READINGS. PERCOLATION DATA ON TI~'S P/~3~/' ' ' ''f~R.FP' L_Jd, PERFORMED BY ALASKA WATER &: WASTEWATER I, THIS WAS PERFORMED I~ ACCORDANCE WITH ALL STATE//~ DATE. DATE: PERC. HOLE DIA. 6" (INCHES) ~3.0 FT. TES COULD HAVE BEEN ACHIEVED BENCH PERCo HOLE ONLY, , CERTIFY THAT GUIDELINES IN EFFECT ON THIS 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 PHONE (907) 557-6179 * FAX (907) 358--:3246 LEGAL DESCRIPTION: MOUNTAIN PARK EST. S/D ~1; LOT 5, BLOCK 6 I PERFORMED FOR: BRIAN HOEFLER ............... : ness: DATE PERFORMED: 6/21/2000 ~(~fl'~.-~ I/~..~ 0i1~-7955 .'"' ~ (feet) TEST HOLE #2 1-- (PAGE 2 OF 2) SOIL CLASSIFICATIONS 2-- Grvl CL 4-- GC OL !o 0~ SW MH 5-- m SP CH SEE PAGE 1 OF 2 FOR m SH OH LOCATION OF TEST HOLE. 6-- > SC rq 7-- _~ DEPTH TO DATE GROUNDWATER 0 ro SEE PAGE 1 OF 2 0 10-- r-- CLOCK NET TIME WATER LEVEL NET DROP 1 1 DATE READING TIME (MINUTES) READING (INCHES) [~ 6/23/00 1 3:51 6" 12-- r- 2 4-:21 50 MIN. 5 1/4" 5/4" 13-- ~ ___3 ~?:22 6" 5 ,* ,*:52 ~0 UlN. ~--~/~ 6" 1~/16" 14-- 7 ....... 6" u) 5 ,*:55 -- --~ 5:23 30 MI----N. 5-'1/4" 5/4" 15-- - -- 16-- _--- -- 17-- 18-- 19--I PERCOLATION RATE 40 (HIN./INCH)~ PERC. HOLE DIA. 6" (INCHES) :~ TEST RUN BETWEEN ,*.0 FT. AN~DJ~ ,*.5 FT. 20 PERFORMED BY ALASKA WATER & WASTEWATER I, ~,, , CERTIFY THAT THIS WAS PERFORM~:D ~ ACCORDANCE WITH ALL STATE//Ai~D/ /IUNIC"IP-A GUIDELINES IN EFFECT ON THIS DATE. DATE: /I// LOT 1 , BLOCK i LOT 15 BL( K 8 PR~AR~ FOR: ~ J / ~ONE NUMBER ~ )ATE: / ~ I ID~WM BY: / t ~C~ I PA~E~ X ~ ~ F~/~ooo~I X~.~. //~/,= oo' I X~,( ALASI WATER & WASTEWATER ~~~ CONSULTANTS, INC. ~;'~; 6901 Debarr Road, Suite 2B Anchorage Alaska 99504 Phone: (907) 33%6179 Fax: (907) 338-3246 Invoice DATE INVOICE # 6/28/2000 2000-293 BILL TO: Brian Hoefler 13100 Ridgeview Drive Anchorage, Alaska 99516 P.O. NO. TERMS PROJECT: Due on receipt MTN PARK EST, LS, B6 DESCRIPTION HRS/QTY RATE AMOUNT Site & soils evaluation, percolation tests, 400.00 400.00 groundwater monitoring, and preparation of the soils logs. 2 test holes. Excavation of test holes. You will be separately 0.00 0.00 for this service by A+ Home Services. Intermittent Sand Filter Design 900.00 900.00 Reimbursement to AWW for payment of the 320.00 320.00 M.O.A sewer permit fee. The following engineering services have yet to be performed: 1. Inspection and documentation of the ISF installation: $1000.00 2. Water sampling/analysis: $100.00 If you have any questions, pl~e contact us at 337-6179. ~ Vie appreci ~te yotlr 1~ t~n~s. TOtal i ',A~/ ~/'~ $1,620.00 ~,.. .~,.;a~J..],l~! ,,~ as~esse~finance charoes of I 5% per month beginn ng from the date the invoice was issued. A Property hen will b'q~ine~i;:~i~;~:~e~; i u'~p?~ ;;~d'~;s (froWn the d~te of issmmce). There is aS150.00 charge for the filing and releasing of thc Yen. PROPERTY OWNER MAINTENANCE AGREEMENT ON-SITE WASTEWATER DISPOSAL SYSTEM Anchorage Department~of ~.ealth and Human Services (DHHS) and the property owner(s) of This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owner(s) agree to the following: The property owner(s) will have an annual inspection of the system performed by a registered professional engineer. This inspection shall verify that all effluent and air pumps, timers, and alarms are functioning as designed. Any deficiencies shall be corrected and the engineer's statement that the system is functioning as designed shall be fried annually with the DHHS. Owner Name ~ Property Owner Name (Notarize Here) Judicial District ~ ~-~' SS. On this ~ day of ~c~ in ~c ye~ ~0~, befor~ ~dersi~ no~ public, p~rso~ ap~. ~e person(s) whose nme(s) ~/~e subsc~ to ~e wi~ ~ant ~d ac~owledg~ ~at executed ~e sm~ for ~e p~oses ~ere~ con~d. In witness whereof, I hereunto set my hand and ~/blic (signat~e) ~, (Notar~ printed name) My commission expires: / DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ~~---' ~ SEPTIC ABSORPTION Address ~ ~ ~ ~ ~ ~~ ~ LOT LINE Township, Range, Se tion ~¢~ , ~G i ~ [¢ driveway,AS'BUiLT DIAGRAM (Show location of well. septic system, prope~y lines, foundatiOn,water bodies, etc.) ~ TANKS ~SEPTIC ~ HOLDING M~~' ~~ Capacity in gaffons TYPE OF SYSTEM ~ TRENCH ~D ~ W. DRAIN ~ OTHER Depth to pipe bottom from Total depth lrom original grade original grade 'Z, ~ FT ~, ~ FT~ Fill added above original grade Gravel depth beneath pipe ~ FT ~ FTI ~ ~ 8QFT~'~ F1 Number of line~ ~ ~oO r~tin~ ~i~ m~t~ri~l ~ ~ ~I ~ SQ FT ~ ~'~ ~ IVATE ~ {ldentifv) OTHER Classification (A,B.C} Total Depth ~ Cased to Installer I Date Installed: REMARKS: I , . cedify that this~spe~ion ~as pedormed according to all 17034 ~a~ze River Loop Koa~ No. 204 . ~_ /~ ~ /~ ~ Health Dep~me~l Approval' 72-073 (3/85} SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 3 4 5 6 7 8 9 10~ 11 12 13 14 15 16 17 18 19 DATE PERFOF Township, Range, Section: ENCOUNTERED? SLOPE SITE PLAN IF YES, AT WHAT DEPTH? Deplh to Water Alter Monitoring? CO~N,S /~ ~ /~ ~~ '~ ~ PERFORM ED B~O~:2~.~:~ ~''~ '~0 ~. CERTIFY THA: THISEST W/~P:FORMED IN ACCORDANCE ~,~~~IPAL GUIDELINES ~T ON THIS DATE. DATE: ~ ~ ~ ~/ / Gross Net Depth to Net Reading Date Time Time Water Drop ~,J¢ LL ELL .~ 5 Bdrm House 275 sq ft / Bdrm soil 2onstruct Bed Type Absorption System 2,063 sq ft total area. Install 1500 gallon Septic tank w/Lift Station Insulate Bed if is less than 3' ~ ~ Install clean-outs ~ ~ -~ I~ ~ / and monitor pipes ~ 0~~ \ ~ ~-~ J Ma~nSt2ih2w~ ' separ at: , ~ ~ \ . /-' from exist, trench / -- ~L I 1! \ \ .~ Abandone exist, cyst, · I~/ per M.O.A. Specs. //~' ~- /[~ .~ ~ .--- All construction to / ' ~ :~ /./ \ - / meet M.O.A. Specs. / ~ ~ ~ y / / There is approx. / ' ~ ~ _~/~ / /_2_,100 sq. ft. available to ,/ - - \ ~ / install a new system. The new ~/ ~// ' . /--~ system requires 2,063 sq. ft. All ~ / /--'~ required separation.distances ~must be ~ / ~ontr~ct°r Prio, r to construction. 2 111441 -"- L~,".~-~ 14' ~111~ . CONTRACTOR: CHECK ALL SEPARATION DISTANCES PRIOR TO START OF CONSTRUCTION. NOTE: ~11 Dimensions And Locations Must Be Field Verified Prior To Construction .SEWER SYSTEM LOCATION PLAN NORTH F_STAT ~cTlqN/'~owNsmP/RA~e~ .. . ?PCcX.: r'= DRAWN BY* JEEE'¢ :KEF_SS . : : ' Municipality of Anchorage 825 "L" $l~eeL Anchorage. Alaska SOILS LO~ -- PERCOLATION SU-.L} pEfl~ORN~O ~OR: A.C ~-- Ag F_ L~CAL O~SC~,P'r~ON:/-,07' ~ 1 2 4 8 10 12- t3- 14 18- Township. Range. Section: SLOPE ENOOUNTEREO? _ YES. AT WHAT OEPTH? SITE PLAN ~i~.COLATION pAT£~-]o 7~ (mi~ul~,'~d~l PER¢ HOLE OIABE1-ER ,.~ ./ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING A D ~J3.F~S S LOCATION (~. ~ . / ~ ,~. NO. OF BEDROOMS [~ ] Well~ ,~ . I Absorption PER~T~Q.' ~ ~ Manufacturor ~ Liq.~y~ gallons IF HOMEMADE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons Well _ I Foundation Nearest lot line PERMIT NO. S~ DISTANCE TO:/ ~ ~ ~ T,'e~ ¢~dth Distance ~ ~ ~ line~ Length ~ eac~ ,i~e Total le th ~, li~es ~ No, of e ~--_ ~( ~S inches ~)/~lines ~ ~ Top of tile ~o finish grade ' Material ~eneath tile Total effective aSsorption area ~ inches 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 Distance to lot line PERMIT NO. ; Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS ~ ~~ RE~R~ ~ ~ ~ ~ :. 72-013 {Rev. 3/78) ..... DEPRRTMENT '~' HERLTH RND ENVIRONMENTRL ' '"'~ION LOC:RTION RI[:,GEVIEW DR ...." 7 .... ~,.I S LEGRL .LOT 5 BLK: ~; "T. ::PRRK EST. LOT S ~ZE OZ~Z~RE FEET MR,:slMUM NUMBER OF BEDROOM=, = 4 SOIL RRTINb THE REQUIRE[:, SIZE OF THE ~]IL HE,:,U /_T_,TEbl IS: [':,EF"T~"~-- t-1 LE~4C~TH== ¢~1L'~. ~]F-:R'-.-'EL [:,ES'TI.4= 7 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETHEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. TNE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN TNE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). F-:EL--'~.L, 'ir F-:E[:. SEF'T I C: TRI'-.~.:: S I ZE= -1 5P:"~-'~ GRLII PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RNY HELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE HELL HILL SERVE. Tl.4C, (2) ~ ~-~2;F'E,;TI C,~-~S Fi~:E RE,;~L~I ~:E[:, BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R HELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS ~00 FEET FOR R PRIVRTE WELL OR ±50 TO 200 FEET FROM R PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTRNCE FROM R PRIVRTE HELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE'TO INSURE PROPER INSTRLLRTION. F'EF-:M T T F::-=:P ][ F..:E$ [:,E,3EI"IE:ER ---=:::L.. I CERTIFY THRT :L: I RM FRMILIRR HITH THE REQUIREMENTS FOR ON-SITE SEWERS RND HELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE GREATER ANCHORAGE AREA BoRb-dGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAM E ',,.~ ~ 1,~'\ LOCATION MAILING ADDRESS ~)~ z~-~'-~ LEGAL DESCRIPTION SEPTIC TANK: ~ /o~ DISTANCE.~)vt~*¥~z.{r' ~ ~ FROM WELL ~ -, MANUFACTURER INSIDE LENGTH INSIDE WIDTH MATERIAL LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY ('~'~ GALLONS. SEEPAGE PiT: NUMBER OF PITS LINING MATERIAL. BUILDING FOUNDATION ADDITIONAL ABSORPTION DIAMETER -- OR WIDTH LENGTH DEPTH CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) "~')")*~- NEAREST LOT LINE .SQ. FT. TYPE ~1//g ~'j~ BUILDING FOUNDATION -- CONSTRUCTION DEPTH DISTANCE FROM: NEAREST NEAREST SEPTIC t SEEPAGE J '0'tf¢i LOT LINE SEWER LINE TANK I~O SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES:, INSTALLED BY: PiPE MATERIAL: LOT SLOPE: REMARKS: Form No, EO-O31 DIAGRAM OF SYSTEM APPROVED g(~,_,,,C' ~)/4. ¢ G.A.A.B. Z Z 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SEWAGE Gte/ r ANCHORAGE ARea BOf lgh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 l DISPOSAL SYSTEM m APPLICATION AND PERMIT INSTALlaTION LOCATION INSTALLATION OF: SEPTIC TANK ~ ~EEPAGE P~T . DRAIN FIELD PHONE NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST 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. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK '~ FOUNDATION TO SEEPAGE.~I' , DRAIN FIELD ~4. -7/ SEPTIC TANK TO SEEPAGE P'~ WALL . , SEEPAGE TO NEAREST LOT LINE. WELL TO SEPTIC TANK ~/ DRAIN FIELD WATER MAIN TO SEPTIC TANK DIAGRAM OF SYSTEM DRAIN FIELD S E EPAG E'-P+~ ALSO CONSIDER AREA WELLS. · SEEPAGE P-J.T DRAIN FIELD SEPTIC TANK,'/~/~/(JT~// SEEPAGE'Prr , DRAin FIELD ¢ , 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 FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH ~:~EGULATIONS REGARDING INSTALLATION. I CERTIFY THAT ~ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28°68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. (~) bed~oo~. ~ ~de~t~nd ~ u~d.e ~ou~d be ~e~e~ ~ho~d ~o~e he~oo~ he ~dded. DATE..:.' -- ~ ' ' ..... /.: ,~¢,~ ' APPLICANT'S SIgNATU. /' GrEATeR ANCHORAGE ArEA BorOUGh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 27/[-456 I SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT ~ , DRAIN FIELD , OTHER FINANCED THROUGH .... tO BE INSTALLED bY V~ f IN P TION 4 HOUR NOTICE R UIR D A ~FI INAL SEC : 2 EQ E . B C~ LL~OF ANY ~STEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTH~RITY~WIL~ BE SUBJECT ~ PROSECUTION, $~PTiC TANK SiZE /~ ~"// TYP~ ~ I I ~ S'EPAg~,~}SIZ, '1~/~/~ TYPE CAST lEON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF SEPTIC TANK TO NEAREST LOT LINE. WELL tO SEPTIC TaNK /~ ( SEEPAGE Pit DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK //// SEEPAGE PIT DRAIN FIELD £ FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR GEE ANC ORAGE AREA BOR GH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTE IS I ACCORDANCE WITH SAID CODE. DAtE :~"~/~/ aPPLICaNT'S $1GNATURE · ' G1'r ;ER ANCHORAGE AREA BOROUGH ',~_~ ' ,, DeparYment of Environmental Quality ,~ ,~ 3330 "C" Street Anchorage~ Alaska 99503 Performed for >Ir. ~a~aes B,~o~, Date performed Legal Description: I~o&_~_~,o, pk_6 ~Io~u~!ain Park 3sCares ~ i Subdivisio~ fi 'This form reports: Soils log ~ , ~ Percolation test -. Depth Feet i- 2 " 3- 5- 6- 7- 8- 12- 13- ~s ~ound water encountered? If yes, at what depth? ..... 'Reading Percolation rate Date I Gross Time mi nute, Net Time Depth to Hp. 0 Net Drop Proposed installation: Seepage Pit "x. ' Drain Field Pe. pth ef i~qlgt , . ~epti~ ~, bottbm of, pi~t or trench Performed Dc?.h Soil Char,~ct r...rJ :;tics .,.. %~ - ~;as Ground Water Encoun[ered?~~ Yes, A~.Wha~ Dop~h Reaaing Date Gross Time Location Sketch CPC~J~.~L~©:~ ~,ale 'i'"?}' ,', ~;'~e FroTescd Inst'ali'iYf~',~"S.a, cpage Pi~ .... ~ · Drain Field Depth Of 1 ,.c,. Depth To Bontom Of Pi~ Op Trench COHV,}]iiTS: · , , . .~ - ParcetI.D.# MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 995'19-6650 (9O7) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 1. GENERAL INFORMATION Complete legal description MOUNTAIN PARK ESTATEgSUBDIVISION . ; LOT 5. BLOCK 6, Location (site address or directions) 13100 RIDGEVIEW DRIVE ANCHORAGE . AK Property owner Mailing address Lending agency Mailing address Agent Address BRIAN HOEFLER 15100 RIDGEVIEW DRIVE Day phone ANCHORAGE. AK 99516 Day phone (907) 565-2139 Day phone Un/ess otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community weft system, provide written confirmation from State ADEC attest- lng 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 lng to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #2I Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shaft be paid $1400. O0 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 vedfy 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 Municip~a~tand State codes, ordinances, and regulations in effect on the date of this inspection. ///¢,, 7~ ~, NameofFirm ALASKAwA~TE~'C~&/~As~EWATERcONSULTANTS, INC. Phone ,907} 337..6179 Address 6901 DEBARR ROAD~SrlLIITE2B,/ANCHORAGE, ALASKA 99504 / ,/ bngineers ~ignature t~f//7 · '-- Date · . t .~.il,, ~ '..~ ' . In conducting this evaluation, AWWC, Ina. atte/~pted to provide a thorough, conscientious engineering analysi',, of the system in accordance with ADEC and M/DA~Dt~S Guidelines & Regulations. The reported results described the performance of the system under the conditionstbncountered at the time of the test, and separation d/stances measured to readily identifiable features. The operational life of afl welle and septic systems depend on the local soils condition, ground water 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 there are no hidden defects or encroachments. ~;'/..~'~ "' · Inc. can tharefore not provide any warrant, for future estimate of how long the ' %~.~ ~,~ ' ... system will continue to meet the operational requirements of the ADEC or MOA DHHS. ~. ?.. :'. .... ,..?.~ ............ The content of this report is for the sola benefit of the owner listed above. Any ~ reliance upon or use of this raport by any other person or parly ie not authorized, ~.:-/.. ~'~. ,'. . . nor will it ¢onfer any legal right whatsoever. ~w~, 6. DHHSSIGNATURE 'L/h.~''t!. , / ~, ~'"~'q'~(~, '. ............. .' o~,~ ~ Approved for '¢' bedrooms D~sapproved Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ~./~, ~ .,/ /4z/ ~¢'~t- Date 2" .2., ~ -0 0 The Munidpality 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 Municipality of Anchorage JUL DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division '~ MUNICIPALITY 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744 ~"t'?qqTAL'~ Health Authority Approval Checklist Legal Description: U0UNTAIN PARK EST. S/D #1; LOT 5, BLOCK 6, parCel I.D.: 017-591-06 A. WELL DATA Well Type PRIVATE Log present (Y/N) Total depth 284' Sanitary seal (Y/N) . If A, B, or C, attach ADEC letter. ADEC water system number · YES Date completed Cased to 284' YES N/A 10/30/1975 Casing height (above ground) 14" Wires properly protected (Y/N) YES Date of test Static water level Well production FROM WELL LOG 10/30/1975 NOT GIVEN 4,0 g.p.m. AT INSPECTION 5/15/2000 197' 2.1 g.p.m. WATER SAMPLE RESULTS: Coliform 0 Nitrate Date of sample: 7/21/2000 1.64 mg/L Other bacteria 2 Collected by: A.W.W.C., INC. SEPTIC/HOLDING TANK DATA Date installed 12/3/1990 Tank size Foundation cleanout (Y/N) YES Date of Pumping 3/50/2000 ABSORPTION FIELD DATA Date installed 7/19-26/2000 Length 20' Effective absorpfion area · 250 Number of Compartments 2 Cleanouts (Y/N) YES Depression (Y/N) NO High water alarm (Y/N) N/A Pumper SAAC'S PUMPING *2.86' OF MOA APPROVED SAND C, ~?-~ FILTER IS BELOW TOTAL DEPTH. Soil rating (g.p.d./ft2 or ft2/bdrm). 2.0 System type BOTrOMLESS ISF Width 18' Gravel thickness below pipe 0.37' Total depth *2.7' 360 SQ.FT. Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Date of adequacy test NEW Results (Pass/Fail) For Fluid depth in absorption field before test (in.)~dded (in.): __ Fluid depth (ins ' er: Absorption rate -- ~ent (past 12 months) (y/N) If yes, give date 72-026 (Rev. 3196)® Computer Version D, LIFT STATION Date installed Manhole/Access (Y/N). YES High water alarm level at* 47" Cycles tested NEW 7/20/2000 Size in gallons "Pump on" level at* TIMER *Datum BO~q'OM OF TANK 5OO "Pump off" level at* __ TIMER E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line 100% 100'+ N/A 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Lift station 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5% Property line 5'+ Water main/service line 10'+ Surface water/drainage 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: '1'+ Building foundation 100'+ Absorption field 5'+ Wells on adjacent lots 100'+ *WAIVER REQUESTED TO ~-~-'-] NORTH & EAST PROPERTY LINESJ 1 O'+ Water main/service line 10% Driveway, parking/vehicle storage area__.1 '+ Wells on adjacent lots 100% __ NONE KNOWN Property line Surface water Curtain drain F. .G NEER'S CERTteCAp of Municipal~coSd¢~het ¢~ above systems are in confo~ance with MOA ~ g~~ect on this date. Signature ~ _ ~ ~~~~ ~ ~{ ~'~/*~ ...... :' '~ '.~ Engineers' ' "Na~e~ JEFFR~ A. GARNESS HAA Fee $ Date of Payment Receipt Number 72-021t (ROY. 310~)' Computor 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 Parcel I.D. # 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 0,/"7'- ~o/,/-~ (2~ HAA# ~,~c~ ~(-,~\~ Location (site address or directions ].31oo Ridgev±eu Drive, Anchorage, Alaska Property owner ~Pc 557753 Mailing address Day phone Lending agency Mailing address Day phone Agent Carolyn Abney/FORTUNE PROPERTIES Address 300o A Street, Anchorage, Alaska Day phone 562-7653 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: individual well ×xx Community well Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: individual on-site Holding tank Commu. nity on-site Public sewer NOTE: xxx If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 S & S ENGINEERING Eagle River, Alaska 99577 Address Engineer's signature DHHS SIG NATU R~o r ~_~_ ~/~.. (/-¢ ~ Approved = Disapproved. Conditional approval for Phone bedrooms. bedrooms, with the following stipulations: Additional Comments ~ ~_.~-/' Date //f / ~ 9/ By: 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 isnot responsible for errors or omissions in the professional engineer's work, 72-o25(Rev. 1/gl) Back MOA#21 (~ Municipality of Anchorage ~ Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~ ~('"~' }~'~"/~" ~"~-~ ~'' Parcel I.D; O/ '~ ~ ~'~ ~/- ~ ~ A. WELL DATA Well type /~'~/~' If A, B, or C, attach ADEC letter. Log present~Y~N) ~ Total depth ~ ! Sanitary seal ~q) ~'~ ADEC water system number '"--'- Date completed /' C~ .~ ~c~r '~' Driller Cased to Casing height Wires properly protected4~N) Y FROM WELL LOG Static water level L) ~---', Well flow ~ g.p.m. Pump level Absorption field on lot public sewer main Sewer Service line SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot \ f WATER SAMPLE RESULTS: Coliform ~ ~/.~,~o Nitrate Date of sample: [~- AT INSPECTION ! \~/ ' ~UNICIPALITY OF ANCHORAGE ~ ~ D¢,'h".o,HMENTAL SF..RVICES DIVISION ~t ~ ~'0 1991 RECEIVED ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed I~-'''''~- '~ C:~ Tank size / '"7..-'~-~ Cleanouts~_~/N) ~/' Foundation cleanout ~;~N) y High water alarm (Y/N) [ / Date of pumping Compartments ~ Depression (Y/gr):~ ~ Alarm tested (Y/N) -- pumper ~7~ U/k~ U .~ ~----~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line' Surface water/drainage On adjacent lots Absorption field '~ c-"'"'"'"'"'"~I'A?' Foundation Water main/serviCe line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons ~ Manhole/Access (Y/N) Vent (Y/N) ~"Pump "Pump off" level at High water alarm level ~cles tested Meets MOA electrical codes (Y/N) ~ SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~"~- ~ '~ Length '~'~'~ ~ Width Total absorption area Depression over field Results (pass/fail) ,~"-/~¢"f"l..-~ Peroxide treatment (past 12 months) Soil rating ~ .~-'C::~¢:~'//~System-- / type Gravel thickness 4:2', ~ Total depth Cleanouts present ¢~1) Date of adequacy test for ~ ' ~ ""--' If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1 ¢5("~ ~ On adjacent lots ~, ~:~::::'~ J¢ Propertyline To building foundation '~'~' To existing or abandoned system on lot On adjacent lots '~c~l ''P' Cutbank N-~b, ~ Water main/service line Surface water / ~ t~ Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect or Signature Engineer's Name Date $ & S ENGINEERING 7034 Eagle River Loop Road ¢~agle River, Alaska 99577 HAA Fee $ ,/~¢ Date of Payment //~-.:~o ~/ Receipt Number ¢-~-~/~¢~- /~z) 72-026 (Rev. 3/91) Sack MOA 21 oAt.be date of this inspection. ~,~..'~'~.~ . Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA99518 TELEPHONE (907) 562-2343 A~ALISIS REPORT BY SAMPLE for WORKerder~ 39641 Date Report Printed: OCT 28 91 @ 14:32 FAX: (907) 561-5301 Client Sample ID:L5 E6 MOI~AIN PARK EST. PWSID :UA Collected OCT 25 91 @ 14:00 h~.. Received OCT 25 P~eserved with :AS R~OUIRED Client Name :S & S ENGI~ERING Client loot :SNSENGP BPO t PO 8 NONE RECEIVED Req 8 Ordered By :R. SHAFER Analysis Completed :O~T 28 91 Send Reports to: EDE I)S & S ENGINEERING laboratory Supe%v~spr }S~P~EN C. Released ~y : ~~.~~ 2) Chemlab Ref $: 915756 Lab Smpl ID: ? Matrix: WATER Allowable Pazametez Tested Result Units Method Liaits NITRATE-N ND(0.10) ,,,,' ~/l EPA 353.2 10 ~a~pte ROUTI~ SAMPLE COLLBCTED Renazks: Tests Performed * See Special Instructions Above Ut-Unavailable None Detected ** See Sample Remarks Above Not Analyzsd LT-Less Than, GT-Greater Then S-~ Member of the SGS Group (Soci6te G6n~rale de Surveillance) MUNICIPALITY OF ANCHORAGE ~, Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # ~)~.'"~- ~c-~\- ~LZ) HAA# ~-'~c"~ \ (~"~c~'-~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Lot 5~ Block 6~ Mountain Park Estates Location (address or directions) 13100 Ridgeview Drive (b) Property owner ~HFq# 5.v75_~ MBS # 86104431 Mailing Address (c) Lending Institution Mailing Address Telephone: (home) Telephone Business (d) Real Estate Company and Agent FO2~/INE PR..OPERTIES ATTN: Ks'~t.~. LLn~ey Address $000 A Str¢_~t: Suite I01 Anchorage. Ak. 99503 Telephone 562-7653 (e) Mail the HAA to the following address: (or check here ~if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eagle R~ver Loop Road Eagle River, Alaska 99577. 2. TYPE OF RESIDENCE Single-Familyl:2~X Number of bedrooms 4 3. WATER SUPPLY Individual Well)l~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4, SEWAGE DISPOSAL On-site [~x. Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page I of 2 5. ENGINEERING FIRM PROVIDING ,NSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, Iverifythat myir~vestigation 0ft~is Health Authority Approval shows that the on-site water supply and/or wastewater disposat 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 Address 7034 }~.acjIo p.i¥~r Loop Road No. 204 Telephone Date 6. DHHS APPROVAL Approved for ' y bedrooms by Approved //~. Disapproved Terms of Conditional Approval ,~//~/~Date Conditional '4'JIIt'Jt The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data beforeacertificateisissued. TheMunicipalityofAnchorageis not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 A. WELL DATA Well Classification Well Log Present (Y/N) ENViR~.,NMFN[AL S~R ,rt~J3 LAV ~ Date Completed Total ~epth 2~ tCased to ~o t~ Dopth of Groutin~ Static Water Level ! ~:~ ~ MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: /--,.6)~ If A, B, C, D.E.C. Approved (Y/N) ~ JO- .~0-~.. ~' Yield ~,.~. "~ ~p~' ~.5%~¢/,~,~ Pump Set At ::;2 ~¢ J Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL:' To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Sanitary Seal on Casing (Y/N) ~ Depression Around Wellhead (Y/N) k.) ; On Adjoining Lots /~ ~ ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Comments B. SEPTIC/HOLDING TANK DATA Date Installed ,/~--~-?0 Size Standpipes (Y/N) ~1 Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) / Holding Tank High-Water Alarm (Y/N) /,-)/A- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ! ~ %--O,~(- No. of Compartments Air-tight Caps (Y/N) To Water,Supply Well To Property Line To Water Main/Service Line Foundation Cleanout (Y/N) Date Last Pumped ! ,for Temporary Holding Tank Permit (Y/N) /,,'/IA To Stream, Pond, Lake or Major Drainage Course Comments /~/r~<~ e . b)C,C~4~J-~ ~f~¢-~ To Building Foundation To Disposal Field 72-028 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed I ~ - ~ Width of Field / ~-O ~:¢/~' Typeof System Design -~ 1~ Length of Field ~ O ~,C~ / Depth of Field x/ / Gravel Bed Thickness /' 2. Square Feet of Absortion Area / (OOE>~ Statndpipes Present (Y/N) Depression over Field (Y/N) /~) Date of Last Adequacy Test / Results of Last Adequacy Test /t,_) ~ SEPARATION DISTANCE FROM ABSORPTION FIELD: /Z-/~ To Property Line / '"~ ,~- To Existing or Abandoned System on ; On Adjoining Lots ~'~ © l © ~L TO Cutback (if present) ~--'O /'lc (' CO To Water-Supply Well To Building Foundation / Lot ( 0 To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course 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 ~ Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the. date, ~,f. this inspection. ,',." ....... Signed Company MOA No. Receipt No. ~=-~,~-'-% Date of Payment ,.~ Amount: $ /"')O,~ 72-026 (Rev. 7/88) Back ReceiF Waiver Fee: $ Date of Payment Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 DIALYSIS REPORT BY SAMPLE for ?tORKordez~ 32762 Date Report Printed: k%R 23 9i ~ i2:21 P~SI3 :UA Collected ]~R 20 91 ~ i~:30 h~. Received ]~ 21 91 ~ 3.4:30 hrs. Preserved with :AS REQUIRED Client !]~e :$ Client ]~cet ~PO t~ PO ~ };O}I~ RECEIVED Ordered ~y Analysis Cot.plated :~iAR 22 91 Send Reports Laboratory Super¥isor :STEPHEN C. EDE iJS & S ENGP~EERIt~G / Chel~ab Ref ~: 9J. 10~2 Lab Smpl ID: I ]~atrix: WATER Allowable Parameter Tested ~eeu].t Units I~ethod [,il~it~ NITRkTE-N 0.84 mR/1 EPA 353,2 ,,Sample ROUTINE ,q, A14P[,E uO.J,F, CZED BY: _~DJ Remarks: ~est.'.~ Perfezi,ed See SpecJ. ai Yn.~truct~o~s Above UA-'Un.~va:~J. able ]lone Detected 't See Sa~ov].e Remarks Aboye Not AnaJyzed Z~3~Less Than, GT-Greater Than ACHEMICA"L & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 56fi-2343 5633 B Street ~ Anchorage, Alaska 99~18 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PRIVATE WATER SYSTEM Name Mailing Address Phone No. $ & $ ENGINEERING 17034 Eagle River Loop Road_N_O~ ~ Eagle River, Alaska 99577. City State Mo. Day , Year SAMPLE TYPE: .Routine Check Sample (for routine sample with lab ref. no. [] Special Purpose SAMPLE NO. LOCATION I Zip Code ) [] Treated Water [] Untreated Water Time Collected Collectedl .4/._~ (~ Date Received Time Received Analytical Method: TO BE COMPLETED BY LABORATORY shows this Water SAMPLE to be: factory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* Analyst I I-FI I I-i-I I I-FI A.D.E.C. READ INSTRUCTIONS BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filtec Direct Count ~ ColiformYl00 mi Verification: LTB BGB. Final Membrane Filter Results .Coliform/100 mi Reported By S~ ~ ~. ~__~%.,~-------Da te k-~--¢:~- ~~' / Time: ~7_~-7' '~ a.m. p.m. TNTC = Too Numerous To Count OB = Other Bacteria PART ONE OF TWO REMAINDER TO FOLLOW: APPLI( NT FILLS OUT UPPER HAl .ONLY . ~ Phone Mailing Address ~/1~-~---/~/~'~/TbT~''~'/~ ' Zip Code. ~'~ Address Zip Code Lending Institution/~/~', L,)lS/~, F,~)~_.~_L_ ,~.._A~f~-T¢~]~' U/'L-//~')/4.,/ Phone z Address A' T'/'/~jO2h O/ti ? fi~'~J./5,~L flLJL/,~Z~ L,..- Zip Code Address ~ ~ r ~, /d':'., Z,p Code ¢ ? Y'Z2 ? LegaIDescription /_..~' ~ ~-0~..-~:> ,A'IOO[~A~}J~} J°t~-lt~ ~'~'~i~'7-~5 Street Locatiof~ / ~ 1,~/3 /~ tfi//~/~¢/..~ ~)~l Type of Residence ,~Single Family ~ El Multiple Family NO. of Bedroorss ~ .~ /~-[J~/~'l/k/ ¢ F~A ~ BE~i2~ao~ [] Other Water Supply  Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility Sewer Disposal ..~,nd~v,dee, Year,nd~v,dua, ~nsta,,ed: Z-L~- 80 ' U Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Date Date Date 1' ~ ,//~/ * Date Insp~lor Insp~tor Insp~tor Insp~tor Field Notes: ~ ~ ~UNICIPAdTY O~ ~8 ~NVlRONMENTAL . *CONDITIONS OF APPROVAL Soils Rating ~ Date ~wer Installed Well To Absorption Area Well Log Received ] % ~ Well to Tank Septic T~k Size 72-023 (3182) Dece~ber 5, 19~3 David E and Vicky L. [.~eeman SRA Box 1600-]{ Anc]]orage, Alaska 995(J7 ;.~ubject: Lot 5, }istock 6, ~-lountain Park Estates Approval for the individual sewer and water ~acilities cannot be granted until the following iten~s have been com~!eted: The depression over the sewer systenl will need to be filled so that surface water drains away from t[%e sewer system. Please notify ti~is Department for a reinsDection when the noted discrepancies have been corrected. If uhero are any further questions, please call this office at 264-472Uo Sincerely, Roberts Assistant Environmental Specialist GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 " D L~ /l ~ Date Received March 3, 1976 · : · ........ _ ~ ~ ~ .~ ~ ~ Time of Inspection d~/~~ Date of Inspection 1. gpproval requested by: ~laska ~at~onal Bank ~a~l~n~ ~ddress: ~ouch 7-010 99510 Phone: 277-5511 x 2. Property Owner: Giro Brown Phone: 344-Z320 Mailing Address: Box 4-207, Anchorage 3. Legal Description: Lot 5 5look 6 Mountain Park Estates 91 4. Location: NHN Ridgeview 5. Type of facility to be inspected Single Family 6. Well Data: Tndividual No. of bedrooms A. Type C. Construction Sewage Disposal System: A. Installed 2-76 B. Depth 283' D. Bacterial Analysis On-site system. B, Instal ]er C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank 2. Manufacturer 2. Material , Absorption area , Other contamination , Absorption area , Sewer Lines C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - ReL~.?t for Approval of Individual ~_~r & Water Facilities ' Le~'a 1 Description Lot 5 Block 6 Mountain Park Estates Comments Approved~m~~/~6~ Disapproved Date ~ Approval ~Valid for one year from date signed %~Greater Anchorage Ar~a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I c'ertify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ,034 (1/74) 1. Type of Inspection: 2. Property Owner: Mailing Address: 3. Name of Buyer: Mailing' Address: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES PAl TY f')F ANCHORAGE DEPT, r)F HE/,J. Tt-[ & II, ON v~ENTAI. PF, OTt:Ci'ION 3-1-76 MAR 13 CMRO VA FHA .T~m Br~wn R~-z /,-907; AnPh(~r2gp; AW Day Phone $031 Wisconsin Avenue~ Anchorage~AJ(Day Phone 4. Name of Lending Institution: Alaska National Bank CONV x 344-1320 Mailing Address: Name of Realtor or Agent: Mailing Address: Pouch 7-010. Anchorage, AK Allen Realty Phone 274-2671 2509 Fmlrbanksr St. Anchorage,A~qone 277-5511 Ext.31 279-2451 6. Legal Description: Location: Lot 5, Block 6~ Mountain Park Estates #1 NHN Ridgeview 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well ?83' 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation ?-76 PLEASE CONTACT JIM BROWN AT ABOVE NUMBER FOR INSPECTION. No. Bdrms. 2 Individual 1 Individual (on-site) X EQ-037 (1/74) GREATER ANCHORAGE AREA BOROUGH Department bf'Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection /~)~ January 13, 1976 /L6~J~ Date of Inspection~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR //"/~ ~ Conv. /~ Approval 'requested by: Alaska National Bank Mailing Address: Pouch 7-010, 99510 Property Owner: Jim Brown Mailing Address: Box 4~207 Legal Description: Lot 5 Block 6 Mountain Park Location: NHN Ridgeview Phone: 277-5511 Phone: 344-1320 Type 6f facility to be inspected Single Family No. of bedrooms Well Data: Individual A. Type .283 ' C. Construction B. Depth D. BaCterial Analysis Sewage Disposal System: A. Installed 1/76 C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank On-site system B. Installer 2. Manufacturer 2. Material , Absorption area , Other contamination C. Ab,sorption area to nearest lot line , Absorption area , Sewer Lines EQ-034 (1/74) Page 1 of two pages .P~ge 2 of two pages - Rt~ ~.st for Approval. of Igdividual, ler & Water Facilities Legal Description T,ot 5 Comments Approved Disapproved Date Approval...Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) 3330 1-13-76 L,,~.,~,, "~..~_./' MUNiCIPALiTY OF ANCHORAGE GREATER ANCHORAGE AREA BOROUGH DEPA~TA4E-NT OF HEALTH & ,ENVJRONM~N]'AL PROTECTION Department of Environmental quality "C" St,, Anchorage, Alaska 99503 - REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES RECEIVED 1. Type of Inspection: 2. Property Owner: Mailing Address: 3. Name of Buyer: CMRO Jim Brown Box 4-207 David E. Beeman VA FHA CONV xx ,, Day Phone 344-1320 Mailing Address: 3031 Wisconsin Avenue ,, Day Phone 274-2671 Name of Lending Institution: Alaska National Bank Mailing Address: Pouch 7-010 Anchorage Name of Realtor or Agent: Allen Realty Mailing Address: Phone 277-5511 2509 Fairbanks St, Anchorage Phone 279-2451 Lot 5, Block 6, Mountain Park NHN Ridgeview 6. Legal Description: Location: 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility 2 No. Bdrms. Individual x If Individual, number of dwellings presently served 1 If Individual, depth of well 283' Sewage Disposal System Type of sYstem: Public Utility If Individual, date of installati,~n 1-76 EQ-037 (1/74) Individual (on-site) x SCO'l-r WETZEL SERVICES, INC. SPEED MEMO ........ D~.~.~ o~. ~. .~. .~. . . ~. .: ~,. ~. [1.7 ...... .~. . : ,. . .~. z . . .,. : ..... ,. .~. : ~:~.~. ...... ~.~. ~ .... ,..-. .......................... EN'~IROi~'ENTAL p,,OTECTIO -- ......................... ~...:/~:.....~~.: ............... , ................... ,. I ... .......... ~.?..:...!!.~.!..:.. ........................... ~~.:...:.~..:.. ~.~.~ : .............. RECEIVED Because we wish to serve you more By. quickly, we use this speed memo. ADM- 107 ~' MUNICIP '.ITY OF ANCHORAGE ?. _. . MUNICIPAL USE ONLY · OF CLAIM[] School District~ AGAINST: .-~...unicipality of Anchorage Anchorage . NOTE: This form should be filled out in as much detail as possible to assist the Municipality in evaluating your claim, and upon completion it should be filed with the Municipal Clerk, Municipal Annex, 630 W. 5th Avenue, Anchorage, Alaska within two years after the date of the occurrence 0f injury or damage. I, the undersigned, do hereby submit, under oath to the Municipality of Anchorage, Alaska, this Notice of Claim for damages to my person or property. I do hereby intend to hold the Municipality liable for such damages claimed herein. I. PERSON OR PERSONS MAKING CLAIM I1~ DATE, TIME, PLACE OF INJURY OR DAMAGE Date (Mo., Day, Year) J,Ti~ (am or pm) Place/Location III. PROPERTY INVOLVED Description ' I If Vehicle (Year, Make, Model and License No.) IV. MUNICIPAL DEPARTMENT INVOLVED (If known) Department ~ Municipal Employee - V~ INJURED PERSON/PERSONS (Use attachment if additional space is necessary) 1) Name Age 2) Name ' Age Address Telephone Address Telephone Occupation Employed By Occupation Employed By Person's location when injuced Person's location when injured Person's activiw.when injured Person's activity when injured How did injury occur? How did ibjury occur? VI. AMOUNTCLAIMED(Pleaseattachanestimateoritemizationofthedamagesc'imed)~,~l~, * ~~0~ ~'~ y~'~l' VII. DESCRIPTION (Nature and extent of injury or damages. Please describe in detail.) VIII. MANNER OF OCCURRENCE OF INJURY OR DAMAGES (Please explain in detail what happened and why the Municipality is liable. Use attachment if additional space is necessary) IX. ~IT~SSES: '~lnol~de~utomobil~ passen~m, Police, Do~tors and all °xhers havin~ in~°rmati°n ~°n~emm] the claim} Name of Witness Address Telephone ~) 2) 3) STATE OF ALASKA ) J SUBSGRIBED AND SWORN to before me this .~ day 0f THIRD JUDICIAL DISTRICT ) I; being first duly sworn upon oath, depose and say: That I am the claimant in the above NOTICE OF CLAIM for damages, that I ha~ read the foregoing NOTICE OF CLAIM and that the information and NOTARY PUBLIC IN AND FOR ALASKA statements therein are true as I verily believe. My Commission Expires: SIGNATURE Soott Wetzel Servioes Inoorporated An Alfiliale 01 The Home Group, Inc. 255 East Fireweed Lane · Suite 101 · Anchorage, Alaska 99503 Phone: (907') 27§-2~ 11 February 19, 1981 Mr. David Bemian S.R:A. 1600 R Anchorage, Alaska 99507 Re: Beemanvs. ~Lnicipality ofAnchorage Date of Loss: 10/1/7.5 Claim Number: 6350 Dear Mr. Beeman: This is to acknowledge receipt of your claim dated 2/13/81 against the ~unici")ality of Anchorage for losses arising from the incident of 10/1/75. We represent the b~nicipality of Anchorage in claims of this nature and your file has been assigned to me. The proper evaluation of your claim will require the gathering of information and data not readily available to us. We are in the process of doing that, however, it may take several weeks before a determination can be made regarding your clafin. Your patience is gratefully appreciated and I'll be in touch with you as soon as .our investigation is completed. Sincerely, SCOT~WBTZEL SERVICES, INC. E. T. Walsh Claims Representative ETW/pb :.".~"~""?~rJ'~i!i!i![ii?~i!~i:"GP, E/."~-R ANCHORAGE AREA B0, '~JGH ":' .' .... ~' ,,.,' ,. '!~] ~: !~ii~ h,~., ~/' I,,'.". ¢~' ;,: ' '~':l~(. I~ · ; ~ .'i~' " %',~Jlli~,~ Department of Environmental Quality '..'~/ ' ~[~ 3330 c IN$.PECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING ADDRESS I~',.',_~ LEGAL DESCRIPTION '/ '/- ~' ~ /~"(~' sEPTIC TANK: DISTANCE ,, INSIDE WIDTH INSIDE LENGTH PHONE ~ Y'"/- )( ',., MA-rERIALj: ' :'' NUMBER OF COMPARTMEN.TS LIQUID DEPTH ...... LIQUID CAPACITY (C'~ - GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION__ ADDITIONAL ABSORPTION · DIAMETER · OR WIDTH LE NG'FH DEPTH CRIB SIZE: DIAMETER__DEPTH_ DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE ....... ABSORPTION AREA (WALL AREA) '"~')'~z'-- __ SQ. FT, BUILDING ~ FOUNDATION CONSTRUCTION ........................ DEPTH ..... DISTANCE FROM; NEAREST NEAREST SEPTIC : SEEPAGE . I LOT LINE SEWER LINE ............... TANK /0__~., SYSTEM /I/~ CESSPOOL OTHER SOURCES APPROVED ~ ..... DISAPPROVED REMARKS_ DISTANCES: INSTALLED BY:-- PIPE MA'f ERIAL: 3.iAGRAM OF SYSTEM LO'[ St.OPE: REMARKS: SOI. D TO Hr. D~i~ SRA Bo~ Anchorage, Alaska 99507 ,:. MILL S EXCAVATING, 8].0 lq,~l: 'Tg~ Ave,. Ane. borage, AJ~.~lxa g9,502 2767 Net 10th 8-11-80 Pick-up ~ delivery septic tank 1 hr. 8-tl-80 m~cktillin~ & ~radin~ 2 hrs. ~gO, (4~o-L) ~100.~ 8-1~-80 F~cnv.tine lencbin~ field 1 hr, 8-13-80 ~bor (2) mn 2 bm. ea. ~;26. 8-13-60 (2) losds WAS~,~ ~ SORE~D R~K fl-3,3-80 24' perfer~ted pi~ ~: fittings 8-13-80 Car~rirW rock. bagkfi].lin~ ~ ~adi~ 2 '~ S-OL~--~ CASH C.O.D. CHARGE ON ACC[. MDSE. REID, PAID OU! 5 6 15 16 17 3uslomer's Rec'd Drder No. By KEEP THIS SLIP FOR REFERENCE Redif~rm BOX 6708 · 2g~21 INTERNATIONAL AIRPORT ROAD · ANCHORAGE, ALASKA IB9~O2 - TELEPHONE 243-2455 r-" . ' iustomer's '~.,. )rder No. ' .... uaTe ....... - ...... : ................... : ~ddress ......... ~_. !i~'! :~"-'(~' ' h..': ~..~'..~..z QUAN,: ,' DESCRIPTION PRICE AMOUNT ALL Claims and returned goods MUST beaccom PAST DUE ACCOUNTS SUBJECT TO 1 ~/~% SEEVICE OIAI~E PER MONTH. A 14 7 5 2 .,_~'_~?_. ...................... l ........................... 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-41 'i t GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONME~',ITAL F'ROTECTION File ~6350 March 9, 1981 Ed Walsh % Scott Wetzel Services, inc. 255 East Fireweed Lane - Suite 101 Anchorage, Alaska 99503 Subject: Lot 5 Block 6 Mountain Park Estates Subdivision David E. Beeman Property This department reviewed the blueprints for the Sunset Plastic septic tank. The plans were approved, however, the manufacturer may have had defects in some of the tanks~ Obviously, this department could not detect defects during installation. Also, handling of the tank during insta:Lla{:ion could be critical. The manufacturer should be responsible for poor workmanship. The sewer installation was installed to a soils test conducted by a registered engineer and to National Standards° I see no error by the Municipality of Anchorage in this case. If there are any further questions, please call this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Spedialist LNB/ljw