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HomeMy WebLinkAboutGRANITE VIEW #1 BLK 5 LT 4Granite View Block 5 Lot 4 #014-301-13 w.t Municipality S Ihynnhni nt(, P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV241046 COSA#: Permit#: P I D#: 014-301-13 Legal Description: GRANITE VIEW #1 BILK 5 LT 4 Engineer: Pannone Engineering Services Your request for a waiver of the required 100 feet horizontal separation from the public sewer trunk to the private well has been approved. The approved separation distance is 24.0 feet. Your request for a waiver of the required 100 feet seperation from the proposed public sewer manhole to the private well has been approved. The approved separation distance is 54' This waiver approval applies to the existing public sewer trunk only. Any future upgrade to the on -site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: - Approved by: _ Nanie ofRetower **** VARIANCE/WAIVER REVIEW **** Pannone Engineering Services uc Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska Subject: Granite View #1 Blk 5 LT 2,3,4 Private Wells to Sewer Main and Manhole Separation Distance Waiver Request Ladies and Gentlemen: I am writing to request a separation distance from the private wells on each of the above -mentioned lots to the proposed 8" DIP sewer main extension and manholes. The soil and groundwater conditions in the area are not conducive to the installation of conventional individual onsite wastewater treatment systems. The property owners have elected to decommission their holding tanks and extend the existing sewer main on North Circle. An application including a plan and profile has been submitted to AWWU for permitting, the design package is attached to this request. A summary of the requested separation distance waivers is in the table below. ALL distances are taken from the closest edge of the sewer component to the outside edge of the well casing. Legal Description Distance (ft) to Proposed 8" DIP Sewer Main Distance (ft) to Proposed Type A Watertight Manhole Granite View #1 B5 L4 24.7 54.2 Granite View #1 B5 L3 33.3 33.4 Granite View #1 B5 L2 58.2 54.2 The proposed sewer main will connect to an existing manhole on North Circle. It will run southeast down North Circle approximately 211 feet and terminate in a manhole. The pipe joints will be positively connected by the use field lock gaskets. Further, each pipe connection will be wrapped to provide a watertight seal using material specified in AWWU Design Criteria Manual. The existing manhole currently has all mechanical joints inside the manhole and is watertight. The proposed manhole will be a watertight manhole with mechanical joints inside. See the attached plan set. These plans have been submitted to AWWU for review and comments. We are also requesting a waiver from the sewer service line for Granite View #1 B5 L2 to the Well. on Granite View #1 B5 L3 to a distance of 14.6' from the outside edge of the well casing to the outside edge of the C900 PVC sewer service line. Due to area constraints on the properties and the location of existing utilities it is not possible to achieve a distance of 25'to the subject well. All proposed sewer service lines will be constructed on 4" C900 DR18 PVC. All joints wilt be wrapped in a heat shrink membrane to provide a redundant watertight seat. Granting these waivers will not pose a risk to public health or the environment. If you have any questions or concerns, please contact me at (907) 745 8200. Sincerely, Steven R. Pannone, P.E. F.ASCE Owner/Civil Engineer 7 August, 2024 f.f.=208.59' f.f.=211.38' f.f.=215.16' 2n d F l r D e c k 2 n d F l r D e c k 2n d F l r O H Inv.=206.69' Inv.=212.00' 220 215 210 205 Inv.=212.00' Pa n n o n e E n g i n e e r i n g Se r v i c e s , L L C C. I . 1 0 8 8 GR A N I T E V I E W # 1 B L K 5 L T 2 , 3 , 4 , 5 SI T E : N O R T H C I R C L E 8/ 1 / 2 0 2 4 SW 2 3 3 4 JR L AC P C1.0 1 OF 1 1 SCALE: 1" = 40' (11x17 PRINT) SEWER EXTENSION PLAN Municipality of Anchorage Page 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: ~L~c~ '?OO~t, PID Number:_ 4g~/.~ -"~OI - I~ N~m~: ~~~ ~O ~O Wastewater System: D New ~ Upgrade~ Address: l~ PL~e~ ¢~. ~P~&~ ~¢~, ¢~ ~602 ABSORPTION FIELD Phone~) ~'~ No. of B~rooms: ~ Deep Trench ~ShaliowTrench ~Bed ~ ~Other LEGAL DESCRIPTION Soil Rating: ~ot¢~om original grade: Subdiv~ion: ~ % from original gr~ Gravel depth beneath pipe Lot: ~ Block: 5 ~*~ ¢~¢ DeCh to pipe bottom / Ft. Ft. Township: ~ Range: Section: ~ Fill added above original ~: Gravel length: WELL: ¢~,N aw ~ Upgrad~ Gravel width: ~ Number of lines: Distance betwee, lines: Ft. Ft. Classification¢~)~(Private, A,B,C): Total ~Dept~Ft' ~ased To: Ft. Tolal ~ion area: SQ. Ft. Pipe material: Driller: ~Drilled: Static Water Leveh In~]er. (Ho~ o,'~c ~.) Yield: ~Set at: Casing Height Above Ground: ~,. ~,. TANK ~EPARATION DISTANCES u Septic ~Holding ~ S.T.E.P. To Septic Absorption Lift Holding >ublic/Private Manufa~arer: ~ Capacity in gal~ From Tank Field Station Tank~ Sewer Lines ~, we,- ~ .... 7~'> 25'~ U~r~a~:5 T~ .umber of Comp/~ent,: Surface w~t~r .... I~0'~ ~ LIFT STATION Lot Size in gallons: Manufacturer: Line '~ ~ ~ JOI ~ Foundation ~ ~ ~ jot ~, ~ "Pump on" level at: ~ level at: High water alarm at: Remarks: F)/~¢,)L 0¢~¢,~c ~ ~ BENCH MARK Location and Description: J Assumed Bevation: ~C"~?/~l~ / ) ~ .'..'~k~'', ....... " ~.~,~ Inspections performed by: s.~ S ~G[NEE~mG Dates: 1st ~-~o-~'? cq// ~ y/,/ 17034 EagleRiver LoopRoad, N~,~ q.H-~'7 ';',% ~ ~o~ c, Cow*N Department of H Ith and CrL~e~ices approval ,~,,q~;,. ............ ?gnMn~ ~o. SW970052 p~s~ 2 oF 2 Munlclpe~ti±y of' Anchoro. ge DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DWISION P,D, Box 196650® Anchorct9e, Ataska 99519-6650 ®Telephone', 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~.~.cAt, LOT 4, BLOCK 5, GRANITE VIEW ADD. //1 S/D p.I.~). No. 014-501-15 A B FCO 24.0' 18.0~- C01 40.0' 46.0' HT1 4.5.5' 51.5' HT2 50.0' 57.0- HT3 54.0' 60.0' HT4 4.7.0' 58.0~- N.T.S. NEW 2000 GAL HOLDING TAN "-- EXISTING N£W 2000 GAL HOLDING TANK 1000 GAL. HOLDING TANK PAGE 1 OF 1 MUNICIPALITY OF AJNCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970052 DESIGN ENGINEER:S & S ENGINEERING OWNER NANE:PANONCILLO GEORGE T OWNER ADDRESS:2836 NORTH CIRCLE WAY ANCHOKAGE, ALASKA 99516 DATE ISSUED: 4/07/97 EXPIRATION DATE: 4/07/98 PARCEL ID:01430113 LEGAL DESCRIPTION: GP~qNITE VIEW ADD #1 BLK 5 LT LOT SIZE: 14500 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: HOLDING TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. 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 (18AACS0). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SPUME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: '-~J~. I S SUED BY: ,A._//~!/O~/ DATE: ~ ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL [EST PERCOLATION TEST STRUCTURAL& MECNANICAL INSPECTIONS WASTEWATER DISPOSAL SYSTEM DESIGN May 27, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 4, Block 5, Granite View Subdivision Reqnest you expedite issuance of a permit to replace one of two holding tanks serving the four bedroom house on the referenced property (upgrading from 3 to 4 bedrooms). The existing 1500 gall. on concrete holding tank (former septic tank) is leaking effluent into ground water when full and is to be replaced with a 2000 gallon steel holding tank, while the existing 1000 gallon steel holding tank was verified to have good integrity on 03-24-97. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. The proposed 2000 gallon holding tank is to be placed outside the 75' well protective radius. Attached is a site plan which depicts the location of the proposed tank. If you require additional information, please contact us. Sincerely, ~obert C-.' -- Cowan, P.E. RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 " EAGLE RIVER, ALASKA 99577 1" =50' SITE-PLAN SCALE \~ o- :,::© I oc~O o ~ o c~> o°~ ~z~~o ~ o mmz~ 0 0 o5s ~~~>~o _~o --z~m ~ ~ 0 ~ ~D ~ ~Z© DESIGN / 0 0 0 ? ~o~ 0 100' WELL RADIUS 0 1" = 4.0' SCAL~ © z© DESIGN PROFILE ~0 OOC --mOo~ 0 ~0 / _'=' o _x_ I zo~ © ED 0 ::;U --00 ZOq~ © 0 db(/') Z' 0 1% f ROBERTC. COWAN,RE. ROBERT A. SHAFER, RE. IVi~m!oipaiity of A~.chora(;~e ON-SITE WASTEWATER [~'S~, ~r¢ices CIVILENGINEERS (907) 694-2979 CONSTRUCTION P~CTICES F~(907) 694-1211 and ~TERI~ SPECIFICATIONS HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANO REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN REFERENCE: Lot 4, Block 5, Granite View Subdivision March 27, 1997 GENERAL: 1. The scope of this project includes the installation of a 2000 gallon Holding Tank to serve the four bedroom house located on the referenced property. The existing 1000 gallon holding tank will be left connected. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from 'the Municipal Health Department. HOLDING TANK INSTALLATION: A holding tank is to be constructed by a certified wastewater holding 'tank manufacturer. Construction shall include a 6" cleanout for pumping access and watertight manholes. The holding tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the holding tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 . EAGLE RIVER, ALASKA99577 Page Two Lot 4, Block 5, Granite View Subdivision March 27, 1997 Holding tanks installed with less than 4 ft. of cover shall be insulated. The holding tank shall be equipped with a high water alarm which registers both visually and audibly J. nside the dwelling. The alarm shall be positioned 'to allow at least 150 gallons of storage per bedroom or a minimum of 300 gallons after the alarm has been activated. Final grading over the holding tank shall be such 'that a positive slope exists away from the holding tank. MINIMUM MATERIAL SPECIFICATIONS: Any holding tank proposed for installation must be constructed by a Municipally approved holding tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM FS10 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemicai Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Page Three Lot 4, Block 5, Granite View Subdivision March 27, 1997 INSPECTIONS: Typically there will be a minimum of two (2) inspections required during the installation of the wastewater disposal system. These inspections will occuz as follows: The first inspection must be conducted after the tank has been set; lines, cleanouts, standpipes, and insulation are in place; and prior to backfilling. The final inspection is 'to occur upon final grading of the property. The inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-~ construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with 'the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER IVlUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPQSAI. SYSTEM AND/OR WELl- INSPECTIQN REPORT NAME ~IAI LING ADQRESS / LOCA~ON ' DISTANCE TO: __jAbsorption area gallons IF HOMEMADE: DISTANCE TO: Inside length DISTANCE TO: Well No. of lines grade Length Width Type of crib Crib diameter Well DISTANCE TO: Class Depth :oundation line Material Depth Crib depth of lines Dwelling Width tMaterial('2. / Nearest lot line ITrench width L~(~a p~- gal Ions Distance between Total effective absorption ar e~,,..~ PERMIT NO. Total effective absorption area Builcling foundation Nearest lot line Driller Distance to tot line PERMIT NO. Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS SOl L TEST -INSTALLER" ,~~/~ . DATE LEGAL .... / APPROVED P[.?F4:t"]'I;T 1`',10. ,:: E:E~¢..E:'~6::I. 4. RPF'L :Il CFINT N1::INC'-r' .~I'RI.-'..'FIBCI'.::]I-,:i'¢ t... OE:F3T ]: Ct1`-,I E;RI'"IE L. EGFIL. 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E;PEE: ]: F :[ CRT .I: O1`'t:5 FIND COF,12;TP..UCT]:Ed",I E:' ]: FtGRFII'"I:5 RI:~:E.'". FI',,,'FI:[ LRBLE': TO .'[ N:E;UF.':E I::'F.:OF'ER :[ NE;'I'RLL. flT :1: O1`4. :[ CERT :[,::'"l" THR'I" ::[.: I RFI F'R["IIL]:FII"4: I-,.I :.I: TH ]''HE REQUIREMENT~ F'OR OI",1"-:::.;ITE E;EI.,.IEI;.'.f5 1::11`'4['.' P.IELI..E; RE; :SET F'O[~'.]''H B"¢ TFIE 1`']UN ]: C l PRE. I T'¢ (:iF FINCHOF'.:RGE. ;2:: ]: .b,1ll....l'.. :[IqE;TFIL. L '['PIE '.".:;"r'.'E;TEI"I I1`',1 FICCOF.:E:'F:INCE': !-,.IITFI' THE CO[)E:5. ::~:: :1:. UN[.':'ER:L:;TFIN[:' THFIT THE OI",I-E, ITE :':¢EI,4ER 'E;"r'E;TEP1 i"tFI'T' RE6.!UIF.:E". ENL. FIRGEt'IENT IF' :,'HE F:::E'E;IDIEI",IC.E '.r.E; REI"IO[;,ELE[:, 'FEi :[NE:I.JJDE klOF..'.E THFIN 3: -~ GRE, LR ANCHORAGE AREA BO~ '~',', ,',5' Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE 51:WAGE DISPOSAL SYSTEM SFPTIC TANK: FROM WELL_/_.~._~ '~ MANUFACTURER .- MATERIAL ~'Y]r'~4L- COMPARTMENTS INSIDE LENGTH / INSIDE WIDTH / LIQUID DEPTH j LIQUID CAPACITY/,~)~'-'~_ GAL_LONS. TILE DRAIN FIELD: DISTANCE FROM WELL//(~~) I-fx' FOUNDATION NUMBER OF LINES / ___ DISTANCE BETWEEN LINES ,~// :' TOTAL LENGTH ' NEAREST LOT LINE OF LINES J i~-'/~TRENCH WIDTH ~ IN. TOTAL EFFECTIVE / ABSORP]-ION AREA ¢ 6 ~ SQ. FT. LENGTH OF EACH LINE A--L-~-~ = 5,~ Z, 5' DEPTH OF FILTER ~ ! ¢~-"' DEPTH: TOP OF 'FILE TO FINISN GRADE MATERIAL BENEATH TILE ~. ABOVE TILE ~ IN. TYPE~ CONSTRUCTION DEPTH BUILDING NEARESF NEAREST SEPTIC SEEPAGE FOUNDATION__ LOT LINE SEWER LINE____ TANK__ SYSTEM_. DISTANCE FROM: CESSPOOL OTIqER SOURCES APPROVED DISAPPROVE[) __REMARKS DISTANCES: '~' DIAGRAM OF SYSTEM ..... INSTALLED BY: ~'~--{'`2~ /''''/' ' ~ ~ ~ <, ~C~7 ' l ,I '~.-0"~ '~ SEWER LINE DEPTH:_~ ..... , ¢ 1'1t_t1 J I e_ I F'r t!_ I T'T �_iF= F t-.11::- 1Ci1 't=t!_�E _ DEPARTMENTQ"- HEALTH AND ENVIRONFENTAk-"NOTECTIONI W Ant • 251E F. bDOR RD. , ANCHORAGE. AK _.tet! 'v/pon , , `xjwNmaww4 A71-as.t 1_4ELL F=It•JC• IDt•J—= I T1= :E7EI--IEF: F'E=f:'*1.1 I TJ -9,L/-7% 1� PERMIT NO. ( 7705 ) APPLICANT JIM MC:COY P 0 PON 3-4024 53501 LOCATION N171H CIRCLE LEGHL L4 P5 GRANIT VIEW SUED LOT SIZE %•��` �35�77 1.2401_1 SQUARE TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = _ SOIL RATING CSO FT%BR)- 150 THE REQUIRED SIZE OF THE SOIL ABSOOPTION SYSTEM IS: C•E-t='TH= 1J._ 1_F_tJ��TH= - = t �F'tik'EL C •EF"TH = THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCA'•iATION (IH FEET). F: E c_! 1J I F=: F= C:• =• A' F' T I r!-- �_ t:' 1_t e=1 Tt-•1 co •_: _ '> IF:F F:E�_!U I F:EC EHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION! AND APPROVAL BY THIS DEPARTMENT MILL EE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 1.1.0 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 0 DAYS OF THE WELL COMPLETION. SPECIFICATIONIS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F' E F=: t 1 I T ti:' Fi L I C• F i:) F." C1 t -J F= '-r' E n F: F" F_,_11'1 I c'711_1 E I CF_RTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I HILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCOS REMODELFD TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED F'LICANT - JIM ISSUED B' _ 000p' ----BATE -al - f ;40_77 I - ds. 67 sY ��a�7 ,12 Lot 6 88th Street Lot 2 Lot 4 Lot 1 TEST HOLE LOCATIONS J~4ES McCOY - GRANITE VIEW SUBDIVISION, ANCHORAGE, AK GRID: /l oo. o GSa303 T.N. 3 9-21-76 O[~GANIC MATERIAL W/SOME SAND SILT w/SOME SAND AND TRACE GRAVEL 0.0' 2.0T 7.5~ SAND W/SOME SILT, TRACE GRAVEL 9.5' SILTY SAND W/SOME GRAVEL --11.0' SAND W/SOP~ SILT, TRACE GARVEL 12.0' SILT W/SOME SAND SILT W/SOME SAND, TRACE GRAVEL 14.5' NO WATER TABLE ~ 19.0' T.D. T.}I. 4 9-21-76 ORGANIC MATERIAL' SILT W/SOME SAND SILT W/SOME GRAVEL, SOME SAND GRAVEL W/SOME SAND AND SOME SILT GRADING INTO GRAVEL W/SOME SAND AND TRACE SILT , 0.0" --IO.5, 2.0I 4.0I 7.5' SANDY GRAVEL W/SOME SILT 9.5~ GPJtVELI~ SAND W/SOME SILT t0.5' SANDY GRAVEL W/SOME SILT Boulder at 12.0' 11.5' SILT W/SOME SAND AND TRACE GRAVEL sI~T W2~ME' SAND AND SOME GRAVEL SILT W/SOME SAND NO WATER TABLE 16.0' 17.0' 18.0' T.D. LOG OF 'PEST HOLES JAMES McCOY - GRANITE VIEW SUBDIVISION, ANCNORAGE, AK PERCOLATION TEST GRANITE VIEW SUBDIVISION BLOCK 5, LOT 4 T.H. 3 656303 ELAPSED TIME TIME INCHES 12:14 9.0 12:15 1 9.25 12:16 2 9.5 12:17 3 9.75 12:18 4 10.5 12:19 5 10.75 12:20 6 11.0 12:21 7 11.0 12:22 8 11.25 12:23 9 11.5 12:24 10 11.75 12:29 15 13.0 12:34 20 14.0 12:39 25 14.5 12:44 30 15.25 12:54 40 16.25 1:04 50 17.0 1:14 60 17.5 DROP IN INCHES 0.25 0.25 0.25 0.75 0.25 0.25 0 0~25 0.25 0.25 1.25 1.0 0.5 0.75 1.0 0.75 0.5 8..5" Total Drop 7.06 minutes/inch February 23, 1978 Jim Mc Coy Post Offtc.~ Box 3-4024 Anohora~je ~ Alaska 99509 Subject: Lot 4 )3lock 5 Granite View S~divis:ton Due to ground water intrusion, apparsntly floodin9 the ~×isting on-siSe sewe:~ system~ this departm~ has no obj~Ct~ons to the installation ~6 a 2,000 ~ailon s~wage boll(lng ta~ as an approved facility on the subject lot ~ Access to th~ tank (~nhole, standpipes) must be made water ti%~ht to prevent any surfaco ~Bt~r ent~rint~ the tank ~ there are ~lny further questions, pleas~ contact this office at 264~4720o I.~s N. ~uchholz, sanitarian LN~/1 j h September 9, 1977 Jaguars Mc Coy Post Office Box 3-4024 ~nchor a~.3e, Alaska 99510 C~ LC Ck C~ Lot 4 Block 5 Grani'be View Su)~l~vzsion %'.b.e above subject lot nov; has overflowing s~wage mi×od with a high water table° A check of our records and revla%~ of -~d~e R & ~-I Consultants, Inc. s~ils investigation showed no water present in the area of the se[t~r system. 9?his is not The condition of the sanitary sewa~.$¢: disposal system iS not satisfactory at this ti~e and correc~tive measure~e~ed '~o be taken. The water table may indicmte that a new soils test a~d s~itary sewage system may be n~eded to r~pl~[co ~ ~urrently existing system. This d~pa~'tment's concern is '~hat ov~rflowing sewage not be allowed to flow on the gro~ld and the matter of t'.he water table in th~ area is between you~ tho builder, R & 5~ ~onsultants an0, the owners o~ Lot 4 Block 5, Mr. and Mrs. Jaka~sky. Zf t:here are a~!y cf~testions~ please contact this offi. cc~ at 8 anitar i an (X /ljh Mr. and Mrs° Jakabosky 2800 North (,irc, lo A~,chora9~ ~ Alaska 99507 1111 n VUL CORSIRUCT1O:l Wr txpernmentai rom \ Drilling Co. �pC 1` , �111�71 1_USrs No. Griller _\ks_mti� 1_, r, 1 t,C' `7 Dale well comoleted Well Owner�(_h1 (11��Gta Nearest CNeiunity r 1]f)l.el fre Well location: (address d legal deseriptioni j OY-_LV , IP'. 7 location sketch or Pe^eres i Depth of well �/u It. Casing: depth I3_ " / ft. diam. G tn. Static water -level t-1 5 ft. (Oheve. below) land surface. Date l -7a' Finish of well.ooen-end screen, perforated, open -hole, other) Describe intervals and size: \ ,, Well yield tested by (pumping, ailing; air) at i) gal/min. for Y1_ hours with _Z— ft. of dra»do.m from static ltvel. DRIIIC.^.S t1ATER( is LOG Depth below land Give descriptionof strata penetrated (size of material. color, hardness of surface in feet drilling, and water content) t:y to I t E� �1 / to for � to ! 11 / to it JO to �_MtJ ?C1 Cl C tl 11 F 1 ( 1 - to to to to to to —_ to _ to _ rw °"'r C,- ,,_:a11 •-,. to c to Utz tor. to = — JtL)— _ to to _ to .Lvid"WAId ez Municipality of Anchorage • —� Development Services Department Building Safety Division Onsite Water and Wastewater Program ` 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 014.301.13 HAA #_Q fJO ) Expiration Date: �- — G, - O 1. GENERAL INFORMATION Complete legal description Lot 4. Block 5, Granite View Subdivision Addition No 1 Location (site address or directions) 2800 North Circle;. - Current Property owners) Georae 8 Cassandra Sika Day phone 746.9002 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 2800 North Circle Way Anchorage AK 99507 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Four 4 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ❑ ❑ Individual Holding tank ❑ Community On-site ❑ ❑ • 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 5 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 sample results less than 30 days old. (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, 1 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. l 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 Anderson Enaineerina Phone 522.7773 Address _ P.O. Box 240773 Anchoraae. AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 12/30/2005 b. DSD SIGNATURE ff 49th MCHMEL r. Approved for __ LL_ -� Disapproved. rooms. Conditional approval for bedrooms, with the following stipulations: (qtr Additional Comments WATER AND PROGRAM Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By . 04404! Original Certificate Date: ffl i IZW) Municipality of Anchorage u ' Development Services Department Building Safety Division Onsite Water & Wastewater Program • r 4700 South Bragaw, SL P.O. Box 198850 Anchorage, AK 99519850 www.d.anchomge.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 4. Block 5.0ranfle New 8ulxthhlon No 1 Parcel ID: 014!M-13 A. WELL DATA Wel type I'm If A, B, or C provide PWSID t _ Wen Log (YM), Ij Date completed Y22M Sanitary seal (YIN) Y Wires property protected (Y/N) Y Total depth ]4_R Cased to jj—fL Casing height (above ground) M2 in. FROM WELL LOG AT INSPECTION Date of test 3r22 W 120=15 Static water level 45 R. 24 R Wel production 8 g.p.m. 5 g.p.m. WATER SAMPLE RESULTS: Coliform ...2—colonies/100 ml. Nitrate .kali m9A1. Other bacteria _L colonkWi o0 mi. Date of sample: _1715 MS Collected by: _Brian WIRe B. SEPTICIHOLDING TANK DATA Tank Type/Material HoklnaTsnklSteel Date installed 10124HOSO Tank size 20MOOO gal. Number of Compartments 1 Cleanotds (YM) Y Foundation cleanout (YIN) Y Depression over tank (YIN) fl High water alarm (YM) Y at Data of pumping - 12 - 22'?�05 Pumper ArkW the Gam Rrat.pr� V' C. ABSORPTION FIELD DATA Date installed Son rating (g.p.dA a or fe/bdrm) _ System type Length fL Width R Gravel below pipe It Total depth _ R Eff. absorption area fta Monitoring tube _ Depression over field Date of adequacy test Results (Pasa/Fal) For _ bedrooms Fluid depth In absorption field before test _ In. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate k g.p.d. Any rejuvenation treab. ant (past 12 mo.) (YIN & type) If yes, give date D. UFT STATION Date installed 'Pump on' level at _ In. Datum Size in gallons 'Pump off level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic: tankilift station on lot NIA Absorption field on lot NIA Public sewer main 931 Manhole/Access (YIN) High water alarm level at in. Meets alarm a dreuk requirements? On adjacent kris ),JW On adjacent lots _ ,1W PubOc sewer manhole/cleanout MOT Sewer /septic service One >251 Holding tank >75' SEPARATION DISTANCES FROM SEPTICMOLDING TANK ON LOT TO: Building foundation >S Property One >' Water main Mir Water service One Mir Surface water Aff Wells on adjacent lots >IT SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One Building foundation Water main water Service One Surface water Curtain drain Wells on adjacent kris F. COMMENTS G. ENGINEER'S CERTIFICATION I cerfiiy that I have determined through field inspecBons and review of MunkW records that the above systems are in conformance with MOA NAA guldefines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. HAA Fee $ qfo r Date of Payment / Z –30 – 05" Receipt Number :7!5 1-4% !1—&4 m Mm. 120M Driveway. patkin0veNde storage Waiver Fee S Date of Payment Receipt Number. ACLA o\ , oa�w• •cP a'� ,�' n 5 � CJi o a%s Sy J i El a O v v �•/' Ti �^ O � 1 ?a •4l y ro° 41 3)• !. 16 2 fy J � � a c•4 FCj t• • � 'a.6o' / s. •s • � � 44• / oar /l 3o^� m o •.+000v z u DO Ap nn ou 00 \ �nv< A D Vn o �_ n q• v ;�; -1 10 n m V w -1 2 m 0 o v �=• M o� D O z A .�mU •o. �oo.m �o� %�p M D Fn C 'A • (n a o su nwoj' ID_ •"�p/� ••��♦� C o Nw no• aMo Io•(0 ��♦ V 7 C N' •� ' M€ I y • G• j p 0 y N e(n n3 c��—cam o N• I o• o o D N N116� • N o. N y m i r> >cm�p�oed /. fo �W �3 ��s000c� �•• �` I 1 u� M V_ N H 1• 1144 9 •• : � 2 is i \N o u o" .Z o o • i* �� (D qN oce yon • ,1tTA V W G7 � �O � n O � p • M A p � o, � oM rt• �� /•' W G • -J V � • Q� C-21-2014 12:11A FROM: %M TO:677T766 P: Va WATERWELL -TEST PUMP REPORT Conducted by ice Owner. ' t Address: Well Location: _,a Tf00 or r'Yrc le Well Information: Total Depth: _% o� Depth of Casing: -7;) , Screen From;_ —To - Casing To -Casing Size: �'— Screen Diem: Screen Slot - Remarks: �_ o Prr.foro �IOAS o b e ut Y_T' Pump information Intake Depth: Pum Size efd i' . A, Air Line Depth: Static Water i evet:- ' Av. Dischargr. - S GPM; his: Drawdwa:Ya' Pump On Time: /a:09AkDate: 114'-0 Pump Off. Time: Date:/3s tiw Municipality of Anchorage Development Services Department • +.e Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Mike Anderson Legal description: Granite View No. 1 Block 5 Lot 4 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. _ ❑ Topographic information missing or Inadequate. ® Incomplete; missing Pumper and date of pumping, ® Incomplete; missing Well log is in file. ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. Survey scales less than 75 feet well to holding tank 1Vel;V SvVt/e S �ow5 O Q /71. I Name of reviewer: Je Date: 1-5-06 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage • "` Development Services Department`: Building Safety Division , Onsite Water & Wastewater Program 4700 South Bragaw SL 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 Parcell.D. 014-301-13 HAA4 4�L3 1. GENERAL INFORMATION Expiration Date: to — Complete legal description GRANITE VIEW SUBDIVISION $1: LOT 4. BLOCK 5. Location (site address or directions) 2800 NORTH CIRCLE • ANCHORAGE AK, 99507 Current Property owner(s) RODELL RAY Day phone 336-1977 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 2800 NORTH CIRCLE • ANCHORAGE. AK 99507 Day phone PEGGY YOUNG W/ DYNAMIC PROPERTIES Day phone 3111 'C* STREET • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 242-3825 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank Community Class 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 affixedhereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined in the Health Authority Approval Guidelines forthis 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 onsite 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 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's 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 6 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 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 orMOA 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 Approved for 2 bedrooms. Disapproved. Conditional approval for 337-6179 Date 3 bedrooms, with the flowing stipulations: Attachments: HAA Checklist L11-11 Manitenance Agreements jl Septic System Advisory Supplemental Engineer's Reort 69) Itlt1 Well Flow Advisory Other QLL By: / Original Certificate Date: 3 — ` (RM.1Mn Municipality of Anchorage e • Development Services Department Building Safety Division . OnSft Water b Wastewater Program 4700 South Bragew St. P.O. Box 1966W Anchorage. AK 995195650 www.d.anehorage.ak.us (907)343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: GRANI AIIEW SUBDIVISION 1111: LOT 4. BLOCK 5 Parcel ID: 014-301-13 A. WELL DATA Well type PRIME If A, B, or C provide PWSIDN N A Date completed 3/22/1977 Sanitary seal (Y/N) YES Total depth 74 ft. Cased to 74 ft. FROM WELL LOG Date of test 3/22/1977 Static water level 45 ft. Well productlon 8.0 9.p -m. WATER SAMPLE RESULTS Coliform _.(N colonies/100 ml. Nitrate &LLffIngJL. Well Log (Y/N) YES Wires property protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 3/1/2004 29 ft. Other bacteria �_ colonies/100 ml. Arsenic: N/A mg./L. Date of sample: 3/1/2004 Collected by: GEG. Ltd. S. SEPTICIHOLDING TANK DATA 4/11/1997 & Tank TypelMat/rfall HOLDING TANK/STEEL Date installed 10/24/1980 Tank size 1006 gal, Number of Compartments 1 Cleanout (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YM) NO High water alarm (Y/N) YES Date of pumping 2/23/2004 Pumper AROUND THE CLOCK PUMPING C. ABSORPTION FIELD DATA HOLDING TANK Date installed Soil rating (g.p.d./ft'or ft°lbdrm)_ System type Length ft. Width ft. Greve) below ft. Total depth ft. Eff. absorption area— ft' Monitoring tube Depression over field Date of adequacy test Results, al) For bedrooms Fluid depth in absorption field _ in. Water added _gal. New depth _in. Elapsed Time: Final fluid depth _ in. Absorption rate x g.p.d. uvenation treatment (past 12 mo.) (Y/N 8 type) If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at _in. "Pump of rjm4a4 E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A Absorption field on lot N/A Public sewer main 75'+ Sewer /septlo service line 25'+ On adjacent lots 1000+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 75'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field N/A Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 75'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water Water service line Surface Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION IxG v,.•. I certlly that I have determined through field inspections and +! 4 review of Munkloal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. j Engineer's PrintName JEFFREY A. GARNESS • 9 Date 319!04 �p�,'• HAA Fee $ ! 13V Waiver Fee $ Date of Payment r1 C6 10� Date of Payment Receipt Number It `1'U [ `J Receipt Number (Rev. 12101) storage 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,~-30! - 1.3 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA ,, /4 Lot 4; Block 5; ¢ra~te V&e~ Subdivision Location (site address or directions 2800 North Circle Anchorage, AK Property owner George Panonciiio Mailing address 131 Plainfield Drive Day phone (757) 877-0689 Newport News, Virginia 63602 Lending agency Mailing address Day phone Agent Kevin Elfrink/ Key Properties Address Day phone 345-4535 Unless otherwise requested, HAA will be held for pickup. 3 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATE"R DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72425 (Rev, 1/91) Front MOA #21 5. STATEMENT OF IN~P..~.C[ION BY ENGINEER. As certified by my sea! 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 an: ty~.}e of strL:ctu re in:'/:'--ated herein. I ft'~her verify th,'.~t based on the inform~.tion obtained from the t, tiunicipality of Ar',r: )rr:'.ge files and from my investiga:ion and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S ENGINEERING Eagle River, Alaska 99577 Engineer's signature }~-!.-1.~// -, Date Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: Additional Comments 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 certifico, t~. is issued. The Municipality of Anchorage is not responsi~: ia for eTrors or omissions in the professional e¢: ;-iesr~s work. 72-'325 (Rev, 1191) Back MOA MUNICIPALITY OF ANCHORAGI~ ENVIRONMENTAl. SERVICES Municipality of Anchorage APR 14 1997/ j , DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division t1~ E C E i V E 825 L Street, Room 502 · Anchorage, Alaska 99501 · (g07) $43-4744 Health Authority Approval Checklist LegalDescription:/_~T-~t/ a~-oc~< 5' C/~/~,,,,~ V,~w '~/,,) ParcelI.D.: O~*/-30/-~-~ A. WELL DATA Log present Total depth Sanitary seal If A, B, or C, attach ADEC letter. ADEC water system number ? Date completed Cased to -7 ;J, 3~ Casing height (above ground) properly protected ~N) Wires Date of test Static water level Well production FROM WELL LOG g.p.m. AT INSPECTION 3/?-o I q 7 g.p.m. WATER SAMPLE RESULTS: Coliform (2 Date of sample: © '~ / ~ Nitrate O. 3 cl 7 Collected by: Other bacteria $ & $ ENGINEERING B. ~.SEPTIC~TANK DATA Eagle River, Alaska ~577 Date installed ~/,,/~'7 "Tanksize ~000 ~ Number of Compa~ments ;)' CleanoutsC~)N)__ Foundation cleanout (~N) Y ¢ ~ Depression (Y~. N Pumper Date of pumping V/'/o/cf 7 C. ABsoRPTION FIELD DATA Date installed Soil rating (g.p.d./fF or fF/bdrm) System type Length,: _Width _ Gravel thickness below pipe To_tal~tt~pth __ · . ~ Effective absorption area __ ~ __ Monitoring Tube present (Y/N) .,J~pression over field (Y/N) __ Date of adeqUacy test ..... Results (Pass/F_~~-'' For ..... Fluid depth in absorption field before te~ Immediately after__ gal. water added (in.): Fluid depth __~L~tes later: Absorption rate =_ g.p.d. Pe~ent (past 12 months) (Y/N) If yes, give date Y~ 3' bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm E. SEPARATION DISTANCES Size in gallons .__..-. *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic~tank on lot '? 5' / "/- Absorption field on lot /v //~ Public sewer main '"? ~- / 'f' Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC H~-~D~G~TANK ON LOT TO: / Foundation /9 -¢~ Property line -~;- -/- Absorption field Water main/service line Surface water/drainage )oo ¢ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water ma~n"~ Surface water ...--- J:).rJve~age area Curtain drain..~.------'-'-- Wells on adjacent lots ENGINEER'S CERTIFICATION I certify that l have determined thru field inspections and review of Municipal record~c~ e"'~tems are in conformance with MOA HAA guiCe#nes in effect on this date. ~c?,¢~,. ...... .,~_ ~. ~ Si~naturo HAA Fee $ ._~ (~ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number PropertY, Owner MaiIMg Address APPLI¢" NT FILLS OUT UPPER HAl ONLY Zip Code 99507 Phone 3q~,-5559 Robert E. Reynolds 2800 North Circle Anchorage, Alaska 99507 Buyer Raymond E, Pearse Address 9Z199 Brayton Drive IH31 Anchorage, Alaska Zip Code 99507 Lending InstitutionFirst National Bank o'1~ Anchorage Phone Address PO['~o Box 720 Anchorage, Alaska Zip Code 99510 276-6300 ~_.,~ -Phone Realty Co. & AgentTotem Realty, Inc, (Nola Cedergreen) C.c ~._~/,~--~ ~-- ~Pk!: cxcL.,. Address 72O, East 15th Anchorage, Alaska z~p Code 99501 2"~,'-0571 Legal Description L~)t zt Block S Granite View Subdivision Street Location ~800 North Circle Drive Type of Residence ~ Single Family [] Multiple Family No. of Bedrooms. Three [] 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 {altach log if available). [] Public Utility Sewer Disposal I~ Individual [] Public Utility [] Holding Tank Year individual Installed: ~1977 /.~'~ 0 ~.~ ~ ' When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. I\ 'rime Time l'irr'~ Time Date Date Date Date Inspeclor Inspector Inspector Inspector MUNIcff ALII Y Oh ANCi JORAGE Field Noles: D~~T E .... /./ '~. ,~ ENVI~ ~,~; :~, ,~ ..... ~LTIGN ( ~ ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED Soils Rating Date ~wer lnslalled Well To Absorption Area Well Log Received J Well to Tank Septic Tank Size 72.023 (3102) DA'rE RECEIVED INSPECTION APPOINTMENTS ¢~ ~--~L- ,-'. ~_~.. ~ ~..~, -~ME TIME TIME DATE DATE DA'rE T~SPECTOR INSPECTOR I NBPECTOR(~)  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION ENVIRONMENTAL SANITATION DIVISIONSEP 2 5 1980 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER ~E:I~dEVE DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. ~-. PROPERTY OWNER/~,, /] / /] pHONE MAILING ADDRESS '..~./ {~ - PROPERTY RESIDENT (If different,from ~3bove) PHONE _ 2. BUYER PHONE ~'AI LING ADDRESS 3. LENDING INSTITUTION I PHONE I MAILING ADDRESS ~, REALTOR/AGENT MAILING AD DF{~SS 5, LEGAL DESCRIPTION STREET LOCATION 6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One E~] Four ¢'-""/L~ ' SINGLE FAMILY [] Two EZ] Five [] MULTIPLE FAMILY ~fJ Three E~ Six [] Other 7, WATER SUPPLY ~ INDIVIDUAL~ *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 Io§ if available.) B. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** ' q-1 ~) YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE 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 [~] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER E~SepticTank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [~APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264 4111 GEORGE M. SULLIVAN, ()FP/',RIk,iEN] OF IlEAL_TH AND ENVIRQNMEIN]AL PROTECTION October 6, 1980 Mr./Mrs. Jakabosky % Mary Tudor Century 21 - Metropolitan 523 West 8th Avenue Anchorage, Alaska 99501 Subject: Lot 4 Block 5 Granite View Subdivision The sewer system located on the above property has had problems with overflowing sewage due to a rising water table. Therefore, before we may approve the request for approval on the sewer and water facilities, a holding tank will need to be installed. ~ ~©O(P/+ ~ 10/~__/~2d Prior to the upgrade a permit will need to be issued. A 1,000 gallon holding tank can be connected to the existing septic tank. The drainfield will need to be disconntected. The water analysis report be delivered to this department .il: f~/from Chem Lab, 5633 B Street, for our review. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw 825 L Street, Anchorage, Alaska 279-2Sll, e×t. 2nd Inspection: MUNICIPALITY OF ANCHORAGF DEPARTMENT ,,: HEALTH AND ENVIRONMENTAL ~ROTECTION March 11, 1977 1st Inspection: Time C~/.:.,~,S~ Time Date (o- ~:>.._Z."77 ~ , I)ate Inspector ~~[~ Inspector =QUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Lomas & Nettleton Company Mailing Address: 4449 Business Park Boulevard Phone: 274-7661 Property Owner: James Mc Coy Mailing Address;, 4619 Spenard Road 3. Legal Description: Lot 4 Block 5 Granite View 4. Single Family Residence: (x~x Multiple Family Residence: ( ) Number of Bedrooms: Number of Bedrooms: 5. Well Data: Type Individual Construction Depth Well Log Filed ( ) Bacterial Analysis Sewage Disposal System: On-site system ( 9x Public Utility Permit % ~ _Instailed ' 1~77 Installer ' Septic Tank Size _/~,~0 ~m~/~'~q .... Manufacturer Absorption Area _//~ ~fO, ~ Soils Rate /~.) p~/R~j~.Material ( ) Distances: Well to Septic Tank to Sewer Lines Nearest Lot LJ. ne Absorption Area to Nearest Lot Line to Absorption Area GREATER ANCHORAGE · . DepartmenL of EIl~lrOrlIl,~(l~:al Qual Ity ~ 3330 "C" St., Anchorage, Alaska 99503- 274-~q9 REQUEST FOR APPROVAL OF 1. Type of Inspection: CMRO VA FHA 2. Property Owner: ._~ /Lv,;..~)-~ 3. Name of Buyer: (]A(i Hailing Address: -~) ~- 4. Name of Lending Institution: Mailin9 Address: L/~ 5 Name of Realtor or Agent: __ Mailing Address: . ,~.~._. (}'~OL;};"~ Phone 7. Type of Facility to be inspected: 8. ~ater Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal' System Type .of S~stem: Public Utility Individual If Individual, date of installation No. Bdrms. (on..site Page Two Department of Heal'th and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 4 Block 5 Granite View Comments: Affadavit At%ached: ( ) Letter Attached: ( ) Approved: Date: Disapproved: Date: Deparhment Worksheet: