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HomeMy WebLinkAboutGREAT LAND ESTATES #1 BLK 2 LT 4Greatland Estates #1 Block 2 Lot 4 #051-131-08 Municipality of Anchorage Page 1 of 3 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: SW9901 60 PID Number: 051-131-08 NamCh Charles B. Fetters Wastewater System: ❑ New M Upgrade Y P9 Address: 23526 Greatland Drive, . Chugiak, Ax 'ABSORPTION FIELD Phone: rooms; No, of re(eede 3) Th X�(Deep Trench ❑Shallow Trench G Bed G Mound ❑ Oiher LEGAL DESCRIPTION Soil Rating: .6 Total Depth from original grade: GPD/So. Ft. 12.5' Lot: Block: Sub ivision: 4 2 Greatlanc�l Est. #1 Depth to pipe bottom from original grade: Gravel depth beneath pipe 6' Ft. 6.5' Ft. Township: Range: Section: - Fill added above original grade: Gravel length: .5' Ft 73 Ft. WELL: ❑New ❑Upgrade Gravel depth: Number of lines: Distance between lines: 3 FL 1 — FL Classification (Private. A.B.C): Total Depth: Cased To: Total absorption area: Pipe material: Existing Ft. I Ft. 949 . SG.Ft. ASTM D3034 'PVC Driller Date Drilled. Static Water Level: Installer. - Date installed: Ft. MM&M Contracting 8/13,17/99 Yield: Pump Set at: Casing Height Above Ground: TANK - - GPM Ft. Fl . SEPARATION DISTANCES XI septic G Holding G S.T.E.P- To Septic Absormlon Lift Holding PubliHPrivate Manufacturer. Capacity in gallons: From Tank Field station Tank S—Linx Anchorage Tank 1 Well >100' >100' N/A N/A N/A Material:. Steel Number of Compartments: Two SurfacWater >-100' >100' N/A N/A N/A- LIFT STATION - N/A Lot >51 - >10' N/A N/A N/A Size in gallons: Manufacturer: Line Foundation > 51 >10' N /A N/A N/A Pump on" level at: 'Pump off' level at: High water alarm at: Curtain None Noted on Loi Pump Make & ModelElectrical I Inspections performed by: Drain Remarks: Existing Service Line From BENCH MARK House Intercepted Near New Septic Location and Description:Bottom Step Front Tank Location. Entrance to House Zabel Diverter Valve Placed At Locati nAssumed Elevation: 100.0 shown. Existing Absorption Trench Remains in Tact. ERti$A ° t/f; esthole Deepened During Construction to Verifyb�°°°�l Absence of Impervious Layer 6' Below Bottom of Trench. Inspections performed ormed by: A. xarala Dates: 1st 8/l"i/99 2nd 8/17/99 9t11�y Department of Health and Human Services approval Reviewed and approved by: Date: ' / o -q 72-013 (1 Y1) MUA Lb NOTE: M U To Municipality of Anchorage Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744 On -Site Wastewater Disposal System or Well Inspection Report Permit Number SW990160 PID No. 051-131-08 N c 4F a 61 l 6 i Existing Line From House Intercepted Just Prior To Location of New Septic Tank. aMI1111111 M H U 76.0 4.7' 68.3'9,'°se° sd. _— la . PROFILE AS -BUILT=° HORIZONTAL SCALE 1" = 10' 4i= NO VERTICAL SCALE r `( �it" -001 r Municipality of Anchorage Page 3 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744 On -Site Wastewater Disposal System or Well Inspection Report Permit Number SW990160 PID No. 051-131-08 MW DVS2 1 M1. C3 C1 GREAT LAND CIRCLE Three 0% - 1% cJ � Existing Well A B DV Zabel D verter Valve S1 50.5 59.4 C Cleanou S2 53.3 64.6 M Monitor be DV 59.2 72.0 C3 52.6 69.6 M1 56.8 73.0 10''Utility Easement . PLAN AS-BUILT6a . SCALE 1" = 50' 6G�,�iia,�i; MUNICIPALITY OF ANCHORAGE I Department of Health and Human Services S -13 • ON 5-pwi On -Site Services Program .17 , �� 3 i 30 �� 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW990160 Date Issued: Jun 25, 1999 Expiration Date: Jun 24, 2000 Parcel ID: 051-131-08 Legal Description: GREAT LAND ESTATES #1 BLK 2 LT 4 Design Engineer: 0014 Anderson Engineering Site Address: 023526 GREATLAND DR Owner Name: Charles B Felters Lot Size: 90169 SQ. FT. Owner Address: 23526 Grealand Drive Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567-0000 This permit is for the construction of: ❑✓ Disposal Field ✓❑ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. MAXIMUM DEPTH OF THE ABSORPTION TRENCH SHALL NOT EXCEED 10.5 FEET FROM GROUND SURFACE. Received By: Issued By: Date: )%: `T2 �' 'tel Date: y — 25—/ June 17. 1999 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 4, Block 2, Great Land Estates Subdivision Septic System Design Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption trench on Lot 4, Block 2, Great Land Estates Subdivision has failed and must be replaced. We are therefore requesting a permit be issued to upgrade the system. A flow diverter will be placed in line from the septic tank to allow use of the existing absorption trench at a later date if necessary. The attached site plan and backup documentation describe the proposed system and the location of the new system. The testhole placed on the lot revealed silty gravel with some sand. The percolation rate was measured at 30 minutes per inch. No groundwater was encountered during excavation and none was noted during the monitoring period. We have therefore designed a deep absorption trench with 8' of gravel beneath the distribution pipe. The trench will be 65' long, 3' wide and have a total depth of 11.5' from the original ground surface. The existing septic tank will be pumped, crushed, backfilled and abandoned in place. The ground surface of the lot is basically flat with only a minor slope towards the north and the east. The absorption trench will be constructed in a flat area of the lot and will not be impacted by the slope. The lot is 300' long by 300' wide as are the adjoining lots. No conflicts exist between the septic system on this lot and other wells or systems in the area. Lot 4, Block 2 .tune 17, 1999 Page Two Great Land Estates Subdivision If the system is constructed as designed the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, 701ce'�'9F AA � Michael E. Anderson, P.E. V o 4, Attachments +' '°yif a#.ft; ;.F,AVA,s f Lot 11 GREATLAND CIRCLE (DRIVE Lot 4 This Project Lot 10 r AREA MAR ' SCALE 1" = 100' No wells are located within 100' of new septic system GREAT LAND CIRCLE 65' Long X 3Wi e X 8' Effective De th Absorption Trench i Exis 'n Tren h TH1® 0 ckO r i Zabel Diverter Valve New 1 , 250 Ga' on Septic Tank 0% - 1% III l Four Bedroom Hou e Existing Well 10' Utility Easement NOTE: Existing Septic Tank to be Pumped, Crushed, Backfilled and Abandoned in Place. No Conflicts With Neighboring Wells or Septic Systems. SITE PLAN' SCALE 1" = 50' '49 PA ..oemi aA=oyq �oaoo NF. LOT 4, BLOCK 2, GREATLAND EST. NO. 1 DESIGN FACTORS: Four Bedroom System Pere. Rate: 30 Min./Inch Application Rate: .6 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 1,250 Gal. Septic Tank 8' Drainfield Rock 4 Bedrooms X 150 GPD / .6 GPD/SF = 1,000 SF of Absorption Area 1,000 SF/16 SF/ LF of Trench = 62.5 LF Trench Length Therefore: Construct a Deep Absorption Trench System With One Lateral 65' in Length with 8' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed at 3.5' Below the Original Ground Surface. Total Depth to be 11.5' from Original Ground. TYPICAL DEEP TRENCH SECTION NO SCALE) Q NOTE: Grade Area Over Trench to Drain Away. b o °'��� Minimum 4' From Groundwater. � 'Ti� fiy Maintain 10' Separation From Lot Line. s"°. Natural 31 BaC4Ifill Geotextile Fabric 6" O 4" Perforated PVC (Slots Down) g� Drainfield _ Rock i 3' TYPICAL DEEP TRENCH SECTION NO SCALE) Q NOTE: Grade Area Over Trench to Drain Away. b o °'��� Minimum 4' From Groundwater. � 'Ti� fiy Maintain 10' Separation From Lot Line. s"°. qw 44 Municipality of Anchorage �v° a -,- j� DEPARTMENT Or HEALTH &HUMAN SERVICES � ° 825 "L" Street, Anchorage, Alaska 99502-D6SO 00 SOILS LOG — PERCOLATION TEST �, �......... 7 t ®I =. P.IG E. 0 ' PERFORMED FOR: MM&M Contracting DATE PER LEGAL DESCRIPTION: Lot 4-, Bl ock 7 RrpAtl and F.statps I- "` SLOPE SITE PLAN 1IFE10TI PT/OL /. 2- 3- 4 - GM 3 4GM g ti t 10 Q" i 11 �C •.k ,2- 13- 14- 15- 16- 2 13 14 1s 16 Bottom of U � 17 Hole 18 19 WAS GROUND WATER ENCOUNTERED? 1F YES, AT WHAT DEPTH? No L 0 P E ND4 Mmunup? }hG b'30 �g�j Reading DntI Grua I Net Time Time I DepTh to Net wmc Drop 1641 19:15 1 — I it" I . — *fz I 13!YS I I 238" s I 4f /57- I 1 .53 I " 11 I I _T4s' 1 1 4 31$ I !' I I I I I 1 I I I I I I I I I I I I I I I I I I I 20 �� PERCOLATION RATE 9 ? � at Itrunutevmeh) PERC HOLE DIAMETER • TEST RUN BETWEEN •� F AND FT COMMENTS Perc. Cavity presoaked prior to testing. PERFORMED BY: ""•(t•C'tiC. G MF& 1 `RTIFY THAT THIS TEST WAS PERFORMED IN Michael E. Anderson 1,1 ACCORDANCE WI i H ALL STAT S AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DAT E DATE: ,/7 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 4, BLOCK 2, GREAT LAND ESTATES GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,250 gallon septic tank. It also includes the construction of a new 65' long x 3' wide x 8' effective depth absorption trench at the location shown on the attached Site Plan. The existing septic tank must be pumped, crushed, backfilled and abandoned in place. A Zabel flow diverter valve must be installed to allow use of the existing absorption trench at a later date. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. The 1,250 gallon septic tank must be procured from an approved source and installed at the location shown on the plans. Lot 4, Block 2, Great Land Estates June 17, 1999 Page 2 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. Lot 4, Block 2, Great Land Estates June 17, 1999 Page 3 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. Lot 4, Block 2, Great Land Estates June 17, 1999 Page 4 INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. ,MUNICIPALITY OF ANCHORAGE: Q He. h and Environmental Prote on Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME C�r%) QOlLZ�-e - MAILING ADDRESS e110 Q-"V0dZAo�'D46LI,U&PY Q42610 MONE G88- b" ) LOCATION 6%V' fTF P APA � CatL< bl- LEGAL DESCRIPTION "4 QNV" 2, <q'? -CAT `AND QTR -Its SEPTIC TANK: DISTANCE % NUMBER OF FROM WELL rd -% MANUFACTURER QLpC-� MATERIAL S� L- COMPARTMENTS INSIDE LENGTH 'v INSIDE WIDTH r� LIQUID DEPTH t4ja LIQUID CAPACITYM GALLONS. TILE DRAIN FIELD: k f TOTAL LENGTH 6 DISTANCE FROM WELL _FOUNDATION `ICS —NEAREST LOT LINE 3� OF LINE S8 # of Lines L ©N 1 S��1/DISTANCE BETWEEN LINE—TRENCH WIDTH !-0 IN. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE W DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE _G_—MATERIAL BENEATH TILES -IN. ABOVE TILE IN. SEEPAGE PIT: DIAMETER OR WIDTH LENGTH_, DEPTH Log Crib _Rings_ Crib Size:' DIAMETER_DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LANE ABSORPTION AREA (WALL AREA) SQ. FT. Well 1ND Class:V,t,4 Depth: Well Distance To: Lot Line Bldg: Sewer Line: 1p�z Pipe Materials: # of Bedrooms: Installer: 'FR'Efl laAM%Li-8w %W% Remarks: �C\L. ku e o- A ti *M V�r btl HOLE \ ♦ �`` `, S i I I i 1 a I I I I ►�� 14 r t�T�l R R \ ♦ �`` `, S ^-�� ` ��� � � :1 � ��� /~`\z �� ���� ���� / Y1�` ����'�� /��/[ " TMENT OF HE�LTH HND ENVIRONMENTHL PkUTECTION —�-- r�� �25 /L' '7'�/7/~L�� ST�EET/ ���� HNCHORHGE/ HK 99501 ���� ��� ���� s 2-4_�--����� ID Yl' \ / IVAT K L. L. Fog 141131 11 A A 1- 1 " 11 ' E.'- :,S--'.-'4*-'-.*.: UP IETE IFY, ���9 ,1 1 , 0"' t-�5 � PERMIT NO ( 7801]1 ) � F1PPLICHNT I C/OGEN DELIYERY CHUGI�K 6�8 2141 � LOCHTION GREHT LHND CIRCLE DR � LEGHL L4 B2 GREHT LHND EST LOT S1":!E SQUHRE FEET TYPE OF SOIL HBSORBTION SYSTEM 10 TRENCH MHXIMUM NUMBER OF BEDROOMS = 4 SOIL RHTING 125 ` THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS: ��1- U jr 14 L. �K Ph (of -T- 10-1 ANT A. �9 9_- �� + THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF 8 TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE HND THE BOTTOM OF THE EXCHVHTION (IN FEET). �I Iff IE'.-- 50 M 1=1 -V 1 Cl "T- 101 X1 K'�I A'! � P�*.--�n L --- L- �D�� PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO I1,1100RM THIS DEPHRTMENT DURING THE INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THHT THE WELL WILL SERVE �:,:n 1 1"J'A F,:m� IF�-' C::::' V 31:: !1-:-,H P -A Fog FT" g."HE: P.* -::u ~�~ BHCKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION AND HPPROVHL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL HHD HNY ON-SITE SEWHGE �ISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL/ OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOGS HRE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DAYS OF THE WELL COMPLETION OTHER REQUIREMENTS MHY HPPLY. SPECIFICHTIONS HND CONSTRUCTION DIHGRHMS FIRE HVHILHBLE TO INSURE PROPER INSTHLLHTION 1: -T- 1071 -Wo" I ����HE: VCR low �FT.". ���� fl -MD I CERTIFY THHT 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR SEWERS AND WELLS HS SET FORTH BY THE MUNICIPHLIT9 OF HNCHORHGE 2� I WILL INS"FF LL THE SYSTEM IN HCCORDHNCE WITH THE CODES ]: I UNDERSTHND 1 -HAT' THE ONbSITE SEWER SYSTEM MAY REQUIRE ENLHRGEMENT IF THE RESIDE E I E ODE TO INCLU ORE THHN 4 BEDROOMS SIGNED���������l��' HPPLICHNT PRED COLLEY // ISSUED BY __ VI0 reg �D"-A 1 C,����L �.� �F� �i �A ���������C ^ � DEPHRTMENlOp"IEHLTH HND ENV lHOWMENTHL ECA' 1UN L. TREET, HNCHORHGE, HK. 99�- . ^ v 279�2511 ' 0 �P.A. �L-'. k�� F-4 F-- 14�! M X 0 HPPLICHNT F COL EY 440 N KLEVIN 27472(9 L0CHTIUN GHEHT LAIN[) CIkCLE DRIYE LEGAL�QT4 8L 2 GREHT LI -IND 2��THTES LOT SIFEET lYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH MHXIMUM NUMBER OF 8EDROOMS = SOIL RATING, (SQ FT/BR)z 125 THE REQUIRED SlZE OF THE SOIL H8SORPTlUN SY�T1-41 IS: ~�� THE LENGTH DIMENSION .1.1n THE LENGTH (IN FEET) OF THE TREN0~ OR DRHINFIELD� THE DEPTH OF H TRENCN QR PIT l5 THE DISTHNCE BETWEEN THE SURFACE OF THE UTION N FEETQH [HERE IS NO SET WIDTH FOR TRENCHE�� THE GKHVEL DEPTH lS THE MINlMUM DEPTH OF GRAVEL BETWEEN THE UUTFHLL PIPE HND THE 8OTTQM OF (IN FEET). - - - �ff� --a� ���� cA .0,1.0*..,A�-A H PHCKHGE PLHNT MHY 8E INSTHLLED HT THE PERMITTEE/S OPTI8N SUBJECT TO THE FOLLOWING CONDITIONS: i� EITHE�� H CLHSS I OR II NSF HPPROVED PLHNT MHY BE INSTHLLE[l 2 H CONTINUOUS MHINTENHNCE AGREEMENT IS REQUIRED. IF H MHlNTENHNCE AGREEMENT IS NOT KEPI CURRENT YOU MAY 8E REQUIRED TO ENLHRGE -1111-- YOU HEYOU P11 -:1Y BE SUBJECT TO PRUSECUTIOW. -U-�K� ��� ��������'����� ���� ���LJ���� —�— BHCKFILLING OF. ANY SYSTEM WIfHOUT FlNHL INSPECTION HND HPPROVHL BY THlS DEPHRTMENT WILL BE SUBJECT TO PR8SECUllON. MINIMUM DISTHNCE BETWEEN H WELL HND MY ON-SIlE SEWHGE DISPOSHL SYSTEM IS 1@0 FEET FU� H PRIYHTE WELL OR 200 FEET FQR H PUBLIC WELL WELL LOGS ARE' REQUlRED HN& MUST BE 1-,--'E7URNED TO THE DEPARTMENT WITHIN I0 DHYS UF |HE WELL i�OMPLETIUN OTHEH REQUlREMENTS MAY HPPLYSPECIFICHTIONS HND CONSTRUCT�QN DIHGRHMS HRE HVH11.18LE TO INSURE PRUPER INSTHLLHTION. I CERTIFY THHT FHMILIHR WITH llfE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS AS SET FURTH 8Y THE MUNlCIPHLITY OF HNCHORHGE 2� I WILL INSTHLL THE IN HCCORDHNCE WITH THE {X}DES. ]� I UNDERSlHND THHT THE ON~SITE SEWER SYSTEM MHY REQUlRE ENLHRGEMENT IF THE RESIDENCE N ] BEDROdMS SIGNED�~� F='a'-h and Envi'_"O^.=l-_-nt:a . '� otection - SOILS LOG 77-20 Perfov-.e for Fred Colley Date Performed $/3/77 Legal DescriptiA '- Lot 4, Block 2, Great Land Estates Subdivision 0" Red -broom, sandy silt w/organics (ML) 275 ft.2/bdrm. Brown, well graded sand w/gravel 125 ft. /bdrm. Brown, silty, sandy gravel (GM) 225 ft.?/bdrm. p ,•',: Brown, wellgraded sand w/gravel ..� 125 ft.2/bdrm. u 4-3 d. 14- `o Total Depth - 15 feet 10 No water table encountered 1� 20 AVERAGE ABSORPTION AREA FROM SOILS LOG = 136 ft. 2/bdrm. Date Net Tina l D-Pth �— Net Drop r� t 1 7 DRILLING COMPANY, INC. P.O. Box 8-9113 • 3350 Mountain View Drive Anchorage, Alaska 99508 • Telephone (907) 276-8800 Champion Drilling Company, Inc. is an Alaskan based corporation co-a-litted to serving Alaskans. CHIUMPION offers complete on-s--i.te rats services including water well. drilling, developing and pump installation, and septic tank and drain field construction. Our experienced staff will insure that your complete water system s 4cistalled right the first time. Our water policy guarantees v, -'-,i vour well will produce to Municipality of Anchorage specifications. in addition to water well services, CHAi4PION also perforir:s soils tests and percolation tests for septic systems within the municipality o -f =ar:c:norage. PRICE SCHEDULE ;• :.iter 5,ell Drillin Cost per foot drilled_ - Deaosit iIf 500 feet or more of drilling can be guaranteed - $17.50 per foot drilled.) oils Testing $19.00 per foot $1,500.00 CHAMPION furnishes backhoe - approximately $200.00 to $250.00 CLIENT furnishes backhoe $ 60.00 to $ 90.00 Ask About Our Guarantee . . _ _ _ _ _ .. .. - .. .. . - -_ ..J IA/...... IA/..II.. R.AM AR D , IL1,91%G� WO _` S SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF 927.00 PER FOOT. PROPERTY OWNER rrt. T&e-d Cat tte 274-6511 sm my, ub, R" 997 Teet. LOCATION OF WELL SITE • Btk. 'Lj Su,&. V-w� DRILLER Bei e C ata a� R'arpv t &U.� byO;JA. WELL LOG: 0----23' S.i UL &aua to th 10% ctac, dr-inden. 23---85' �Aavet and 4riea i,L . 0aidelr4. 30% cAal. Uinde ,* 85--113' �&auet and trautde-u. 113-162' Sdtt4 9AaueL tv th 15/ CtO4 triad -en. 162-187' Wet 4 i4 c i.a4. 30% gAaveL with a 4haar a.A iaaxe t at 162 deet. Two 9frQ. lwxjLD4 Atind and q=vet '_du�SJX . 11 oy�h aw4OUoc,,'- n,,Ig P tha ga-ilz t -I.t e -d c.Leaxi_ and .the _rycadaah Marl. d4 atalyd-e at 4.ix �.Piit am that a &e -a. SeLlrtne uity'te, pA=,at 3/4 HO&4e, jhoutd dre t"ta Led f -am P -et 04 bot tam. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 94137.00 THANK YOU VERY MUCH. BE,RNIE CLAUS OF RAMPART DRILLING WORKS DATE uq• 23 -td, 1978- �I' .....-.. ,...... .-.....-...,- _. .- ... ,,. .,.-,-, ..-... . a..ar . or nccccccn nM PAFT r1f IF ACCr)l1NTS_ Parcel I.O. 'Fa-eLe0��( Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street i P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsfe (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 051-131-08 1. GENERAL INFORMATION Complete legal description COSA# Expiration Date: Lot 4, Block 2, Greatland Estates Subdivision No. 1 Location (site address) 23526 Greatland Drive Chuglak, AK 99567 Current Property owner(s) Charles B. and Nancy H. Fetters Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone 688-0776 23526 Greatland Drive Chugiak, AK 99567 Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Throe (3) 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 On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -She Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of OnSfte Systems Approval are varid 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. (Certificates may be reissued for a period of up to one year with 7varid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of Onsite Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-sfte 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 Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 5. DSD SIGNATURE -kz Approved for _ bedrooms. Disapproved. Phone 522-7773 Date =22006 riff e�-+ i 49th /^1 Conditional approval for bedrooms, with the following stipulations: L wmotsav ruwaunencs: COSA Checldist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other BY ��/^L��-✓ f/V Original Certificate Date: as „ft) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 47W Bragew Street P.O. Box 196650 Anchorage, AK 995194;650 www.muni.org/onske (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel ID: 051-131-08 Legal Description: Lot 4, Block 2, Greadand Estates No.'_'f A. WELL DATA Wen type PAvate If A, B, or C provide PWSID 0 Date completed 8/23/78 Sanitary seal (YIN) Y Total depth -19-7ft Cased tD 197 ft. FROM WELL LOG Date of test 8rwa Static water levet 157 ft Well production 8 9— p.m-WATER SAMPLE RESULTS: Wall Log (Y/N) I Y Wires property protected (YM) 1 Y Casing height (above ground) In AT INSPECTION 819/2006 156.7 (L 3.7 g.p.m. CdHorm 0 colonkW100 mL Nitrate 3.26 mglL Other bacteria II Arsenic. NID mg/I Date of sample: 820/08 Cottected by: TXImtaough B. SEPTIC/HOLDING TANK DATA Tank TypelMaterial Ssptk/Stael Date instafled 513/89 Tank size 1.000 gal. Number of Compartrrmft 2 Cieanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping 4/17/2008 C. ABSORPTION FIELD DATA Date installed 8/17199 Sail rating Length 73 fL Total depth 12-13 R Pumper Sanitary Pumpers (g.p.d./tl2 or fl2)bdrm) •8 GPD/SF System type Deep Trench i Width 3 R. Gravel below pipe 6-5: ft. Elf. absorption area 949 fl2 Monitoring tube Y Depression over field N Date of adequacy test WE Results (PasalFail) Pass For 3 bedrooms Fluid depth in absorption field before test 32 in. Water added 863 gal. New depth 37.5 in. Elapsed Time: 88 min. Final fluid depth 32 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 112 mo.) (Y/N & type) If yes, give date D. LIFT STATION Data installed Size in gallons Manhole/Access (V/N) 'Pump are level at _ in. 'Pump air level at _ in. High water alarm level at in. Datum Cycles tested Meet darn & circuit n qusemenb9 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tenkM station on lot :-IW On adjacent lots >1W Absorption field on lot >1W Public sewer main WA Sewer /septic service One >25' Animal containment areas None On adjacent lots >1W Public sewer manhole/deanout WA Holding tank WA Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SE17110HOLDING TANK ON LOT TO: Building foundation >S Property We>S Absorption field >10' Water main >10' Water service ane >10' Surface water >1W Wells on adjacent krit >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One >11r Building foundation >10' Water main >10' Water Servs a One >10' Surface water >1 W Dnveway, perWngNa dde =rape >2S Curtain drain None NOW Wells on adjacent lens >1W F. COMMENTS: O. ENGINEER'S CERTIFICATION 1 codify that I have determkred through rre/d krspecfions and 49th review of Munk *W records that the above systems are in conformance wth MOA COSH guddines in effed an this dateVs64MM p Engkreer's Printed Name Michael E Anderson. P.E. c Q Date a/22nooe s44i COSA Fee E Date of Payment 7 Waterer Fee S IN, Dated Payment Receipt Number Niq Racelpt Number fRev. 11mm SGS RCLM 1064571001 Client Name Anderson Engineering Project Name/q MD632 Client Sample ID Lot 4 Olk 2 Greatland Est. Matrix Drinking Water Sample Remarks: All Datcsrrimes are Alaska Standard Time Printed Dale/rime 08/21/2006 16:56 Collected Date/time 08/092006 10:30 Received Daterrime 08/092006 13:50 Technical Director Stephen C. Ede Allowable Prep Analysis Pa ctcr Results POL Units WOW Container ID Limits Date Date Init Metals by ICP/M$ Arsenic ND 5.00 ug/L EP200.8 A (<10) 08/15/06 08/17/06 Mll SGS RcLM 1063566001 All Dates/Times arc Alaska Standard Time Client Name Anderson Engineering Printed Date/time 08212006 9:58 Project NamcIN 42 Greatlands Collected Date/time 06/302006 11:50 Client Sample ID 42 Grcatlands Received Date/fline 06/302006 13:20 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis pyu,neter Results PQL Units Method Container ID Limits Date Date Init Waters Department Nitratc-N 3.26 0.100 mg/L GPA 353.2 D (<10) Microbiology Laboratory Total Coliform 0 col/100mL SM209222B A (<I) 06/30/06 ALR 06/30/06 TLF 1 § coo §�k§mA � } { E 0, ( \[( \f °§(( -�:*kl .0 ƒ-0 k ~� m n t § § ! 3 ( ~ a » § O ■■ k §§§§j)j))j\49- [ J[ (D\ O OO E EE §§ A Zi �j 00000 E \q 000000000W 2\/n =m#| 2\(g M&cn 1 § coo §�k§mA � } { E 0, ( \[( \f n-0r-raR -�:*kl .0 ƒ-0 k ~� m n t § § 12 ~ a » § O ■■ k §§§§j)j))j\49- [ J[ O OO E EE 1 k \ § / 10 i ■ § / ❑ 2 0 » ❑ / CL f / ❑ ( k E coo §�k§mA C ( \[( \f %(( E@lw�r–=�O §§§§j)j))j\49- 00000 \q 000000000W M&cn ' in ;m§§E§e§�w%E£§ �&� LP 0 ' /\ �m Bkw§wN[(& 000000000» f( =r to 0000%\{9 1>1 t\ §%k{k 21 �AGl�Sokge� &E 2m $§ ® ( () k \ § / 10 i ■ § / ❑ 2 0 » ❑ / CL f / ❑ ( k E _ ... ._ � �-, -., .. ry... .. i 3 A r-. MUNICIPALITY OF ANCHORAGE 05-113109 DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 5-12-87 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 4 Mock 2 Gteattand Est. *% Location (address or directions) Gteat2and Ct. Ee tete-------- ---- (b) Property Owner Telephone: Home Business Mailing Address UK (c) Lending Institution Notthtand Mortgage Telephone UK Mailing Address Eag.Le Rivet, AK. 99577 (d) Real Estate Company and Agent Romax A.ttn AA Address Eagle Rivet, AK. 99577 Telephone 694-4200 (e) Mail the HAA to the following address: or: Check here ®, if hold for pick up. List contact person and day phone number below. 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family 5l Number of Bedrooms _ 3. WATER SUPPLY Individual Well 1� Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-02e (Rev s s6) Front 5. ' ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & 5 ENGINEERING Telephone Address 17034 Eagle River Loop Road No. 204 Date Eagle River, Alaska 9577 6. DHHS APPROVAL Approved for bedrooms by 'Q' �°'"6'''�' Date Approved Disapproved Conditional Terms of Conditional Approval CAUTION .Wiwig♦ f yY•f�iG p :Ti latil .3 � ,f"ti�:S S— 2 -4, -2:7 - The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 rBev 8i86) Back tPP�`C� 01A gICIPA ITY OF ANCHORAGE (MOA) R THORITY APPROVAL (HAA) lnV�p O??'t4tON CHECKLIST - FEBRUARY 1984 `RO n C. 19161 264-4744 J �D Legal Description: L_'Z A. WELL DATA 1z c_ Well Classification S. F If A, B, C, D.E.C. Approved (Y/N) A//_'A Well Log Present &N) Date Completed (5 'Z3 - YeB Yield" Total Depth / 51, Cased to Depth of Grouting �— Static Water Level / Sy- Pump Set At V A, Casing Height Above Ground — Electrical Wiring in Conduit (#/N) Separation Distances from Well: Zr� Sanitary Seal on Casing (y91\1) Depression Around Wellhead (Y& To Septic/Holding Tank on Lot /d ; On Adjoining Lots Dov /f To Nearest Edge of Absorption Field on Lot Z! r ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole � To Nearest Sewer Service Line on Lot S 1 Water Sample Collected by Date Water Sample Test Results S Ai F(-�- T t2 (A7 1` C -O Comments -Y- l,f�_c_L� FLLi o).r S - /S - S y- 'F C1 2 A, F� 4 S B. SEPTIC/HOLDING TANK DATA Date Installed `/ -/ rf - Size / ZSR No. of Compartments Z Standpipes &N) Air -tight Caps(G)N) Foundation Cleanout/N) Depression over Tank (Y& Date Last Pumped Pumping/Maintenance Contract on File (Y/N) N?A_ ;for "JZA Holding Tank High -Water Alarm (Y/N) 1\11A Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well / oL To Building Foundation Sv To Property Line 3 To Disposal Field To Water Main/Service Line f p14 To Stream, Pond, Lake, or Major Drainage Course CommentsaF R S nn PI e� S� gra -oz.Z_ Page 1 of 2 72-026 Mev. 8/86) Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / ZS -0/oiz Date Installed Width of Field 3 01 — Type of System Design Length of Field 68 Depth of Field Gravel Bed Thickness / Com• S, S Square Feet of Absorption Area Standpipes Present/N) Depression over Field (YCNP,,- Date of Last Adequacy Test Results of Last Adequacy Test 514 / -Wf- /1 ae X'_ �� 3 32 - Separation Distance from Absorption Field , - 2 2 -3 q To Water -Supply Well z To Property Line 7�7 To Building Foundation To Existing or Abandoned System on Lot h/( ; On Adjoining Lots �y/_� To Water Main/Service Line /b % To Cutbank (if present) Kt/(4 To Stream/Pond/Lake/or Major Drainage Course 'AZIA To Driveway, Parking Area, or Vehicle Storage Area 35 Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at A "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments " Check Permitted Bedroom Rating Against HAA Request " Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & 5 ENGINEERING �j 2z16-2 Sig 4 Eagle Rtier Loa M, a_.A�1_Ne. 2041 Date CoofflolplFiver, Alaska 99577 MOA No. Receipt No. Date of Payment Amount: $yL'0 0D jrs SLfal Page 2 of 2 72-026 (Rev 8186) Back �'Akw 0 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 LABORATORIES u L I t I 1"n' 'T4 r Ll; 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS I 1 2 / CA C r�nlyd S�sa leS S'�� ,v/siati TIME TIME TIME DATE DATE DATE 17:1 One V Four O Other 1�. INSPECTOR INSPECTOR - INSPECTPIR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. Gi= `•!-! 11 825 L Street - Anchorage, Alaska 99501 ENVIRON,0-L-11;'.'- '. - -CTION • ENVIRONMENTAL SANITATION DIVISION�,jiAYOu 0 3 i� Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWR3kUdIV fiD DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE Mv.r -Creol A - MAI LING ADDRESS 60 Clv IAK 1A IASkA 49SG'7 PROPERTY RESIDENT (If different from above) PHONE 13K. 2 %reA+lnly(A CIrd 0- (ir. 'Pe�ev'vQpeevl. Q �'�tS� 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4.-REALTOR/AGENT - - PHONE MAILING ADDRESS - 5. LEGAL DESCRIPTION • L -d f 14 Q 1 oc-k I 1 2 / CA C r�nlyd S�sa leS S'�� ,v/siati STREET LOCATION CareA+bk�c� CtvleC,e- e4-evs ('ve -eK �• 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS 17:1 One V Four O Other 10/ SINGLE FAMILY 0 Two 0 Five E__1 MULTIPLE FAMILY O Three 0 Six 7. WATER SUPPLY [V INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled O COMMUNITY since June 1975. For wells drilled prior to that date, give well O PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM - INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. O PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/7 9)6 �J A /P/ k_ c_ it „ r THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ ❑ TWO ❑ FOUR ❑ FIVE ❑ OTHER SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED — INSTALLER ❑Septic Tank or ❑ Holding Tank Size: I a S_' If Tank is homemade give dimensions: SOILS RATING �S TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS \at,S ❑ APPROVED FOR BEDROOMS ,1❑_CONDITIONAL APPROVAL (letter must accompany certificate) Lam'DISAPPROVED DATE rY c BY ( P� 2 Andnc "�e May 23, 1980 825 "L" STREET ANCHORAGE, ALASKA 99501 (907)264-4111 GEORGE M. SULLIVAN, MAYOR DEPART HENT OF HEALTH AND ENVIRONMENTAL PROTECTION Manfred A. Colley Post Office Box 608 Chugiak, Alaska 99567 Subject: Lot 4 Block 2 Greatland Estates Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: (1) The water analysis report be delivered to this department from Chem Lab, 5633 B Street, for our review. (2) The top of the well casing sealed with a sanitary seal so that it is air tight. (3) The septic tank pumped with a receipt submitted to this department. Please notify this department for a reinspection of the well when it has been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw -Tu r 5. LEGAL DESCRIPTION f� 1 L �` 9 G I'f'Al LAA MUNICIPALITY OF ANCHORAGE I ` DEPARTMENT OF HEALTH & ENVIRONMENTAL PR6Trt6TI6N 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER HAl'j V— , PHONE MAILING ADDRESS P.C.(4oq� LIQ (jkK AK. q '7 PROPERTY RESIDENT (If different from above) PHONE L' -I aI 6 ,4I LAwA 114tes- S�(�. 7e}ev,s CreekQKt ❑ Two ❑ Five 2. BUYER PHONE {� r�t A P1 t v� e. A. C' D I MAILING ADDRESS A /r 3. LENDING INSTITUTION � T AT r e+ Q v, iv .r A C r o c;,4 17 YU PHONE MAILING ADDRESS ` 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION f� 1 L �` 9 G I'f'Al LAA iT 1 - �+ j I /� , 4Ates LAI CIV (e4err x i. J,V� (`FN� -'Cit .i, \ve STREET LOCATION j j GrP LAvucl e t (� Dr A� 1V 6. TYPE OF RESIDENCE NUMBER OF BEDROO S Vo"SINGLE FAMILY ❑ One Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUP LY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled priort that date, give well E]PUBLIC UTILITY depth (attach log if available.) 17 4 8. SEWAGE DISPOSAL SYSTEM -q `*If individual/on-site, give installation date INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required EJ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) 1<' 4 kl, THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE Eg' SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY LL�' INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM EgtNDIVIDUAL/ON -SITE ❑PUBL-IC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: /(;Sfl If Tank is homemade give dimensions: SOILS RATING 1 -).S TYPE OF TANK MANUFACTURE TOTAL ABSORPTION AREA - MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS t-'_ w ❑ APPROVED FOR BEDROOMS 47`CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 1����'• 0) BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78) January 4, 1978 Fred Colley 440 North Klevin Anchorage, Alaska 99504 Subject: Lot 4 Block 2 Great Land Estates subdivision Permit #77766 A permit issued by this department for well and/or sewer sytem has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of municipal ordinancee if you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264®4720. Sincerely, Health and Environmental Protection sewer and Water Section