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Home My WebLink AboutMCMAHON #1 BLK 3 LT 27McMcxhon #1 Block 3 Lot 27 #017-361-07 . MUNICIPALITY OF ANCHORAGE o~,....~..o~.~..~.....u...s~.v,c~s o/7-36/- 07 EnvirOnmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name R ~ c ~ ~ &~r~ E~//e ~ DISTANCES ~d,e~ ~0 SEPTIC ABSORPTION ~ / Do ~ ~ ~ ~ ~ ~ ~ TANK FIELD WELL cE~c ~sc.,.~o. LOT LINE Township, Range, ~ction ~ ~ 7/ ~ / ~ ~ ~ ~ ~ AS-BUILT DIAGRAM (Show Iocat,on of well. septic system, prope~y hnes, foundat,on. driveway, water ~dies. etc.) ~ SEPTIC ~ HOLDING --~ " 'IP ~ "'-~-~. Material NO. Of Compa.men~ Efae Conc~ Iv I ---- ~pth tO p~pe bottom from Total ~epth from original grade Installer Date InsmUe~ WELLS ~ ~J~/~ ~ PRIVATE ~ OTHER fldentifvl Cla.lhcabon (A.B.C, Total Dept,I~...,o , / Installer Date InstallS; I -~---- ~ ---- ~...&.....~ ~ Muniapal and St~e guidelin~ In dl~ e~is date: ~fll/~d r · · ,~ 013 (3185) M U Iq I C I P A L I T Y 0 F A N C H 0 R A G E Department of Health &. Human Services' 825 L Street, Anchorage., Alaska 99501 .'-.4.~-4.7~0 0 N - S I T E S E W E R Permit Number 9L LL~-..~.~ Upgrade Date Issued: 08/¢~6/9¢~ Engineer Designe. d F' E R M I T Owner Name: RICI< &. LAURA BELLER~ Owner Address: :5~8.31 DOROSHIN ANCHORAGF, AK 99516 Day Phone: :545-7440 Parcel Id: 017'.361-07 I_ot Legal: Subdivision: MCMAHON ~1 SUBD. Lot: 2'7 Section: 27 Township: 12)1'4 Range: :SW I_mt Size 22050 (sq. f'L. o~ acr'es) Max Bedrooms: This Permit: 4 ]oral Capacity: 4 Block: SEPTIC TANK: Minimum total septic tank capacity: 1,250 gallons. Each septic tank must have at ].east R compa~tments. Depth to top ol' septic tank(s) <' 4.0 Ce..:~.:t.. reClu~es ~nsulation ove~ tank(s). IhlFORM D.H.H.S. PRIOR TO IhlSPECTIONS BY ENGINEER, IF AFTER OFI::rICE HOURS, CALL 54~;-4681 AND LEAVE A MESSAGE. CONS]I=~UCT F'ER EhlGINEER'S AT'rACHED DESIGN. THIS PERIdI]' EXPIRES 12/.~1/90 AND VALID FOR A SINGLE FAMILY HOME. I CERTIFY TNAT: 1. I am familiar with the.requirements for on-site sewers and wells as set. [orth by the Municipality o£ Anchorage (MOA) and the State o[ Alaska. R. I will install the system in acc~pdance with all MOA c~des and pegulati~ns, and in compliance with the design c~itepia ~' this permit. 3. I will adhepe t~ all MOA and State o~' Alaska pequipements {op the set back dis{antes ~pom any existing well~ wastewate~ disposal syst'~-~m op public sewepage system on 'Lhis Dp any adjacent ~ neapby 1pt. 4. I und~mstand that this permit is valid ~or a maximum ~[ 4 bedrooms. 1 also undepstand that the capacity ~[ the total system is 4 bedpooms and any enlargement will requi~e an additional permit. (Owner) RICK ~, ,= LAURA BELLER ~./.attop Techn~ca! Services 14530<Echo ~stree't,. · .~ifi~horage, Alaska 99518 Lot 27. Block 3. McMahon S/D 383! Doroshin Avenue Septic system Upgrnde Specifications 1. The scope of the project is the construction of a new 25' x 36' soil absorption bed, and connecting it to the existing septic tanks. The bed design is based on a soil rating of 150 square feet per bedroom x 4 bedrooms x 1.5 safety factor - 900 square feet. 2. The system is to be constructed as shown on the site plan and design drawings, except that minor modifications may be allowed or required by the engineer conducting the inspections. 3. All construction practices and material specifications shall be in conformance with Municipal and State requirements. The excavator shall be responsible for obtaining necessary utility locates, and working around any buried utilities. 4. The existing seepage pit is to be properly abandoned by removing the top, pumping the pit and backfilling it with non-organic soil. 5. The soil absorption bed is to be constructed by excavating the loam and silty gravel material down to a sandy stratum at approximately 7 feet. Two feet of medium pit run sand is to be placed in the excavation to bring the elevation back up to achieve a level surface 5 feet below the surrounding ground. A total of 12 inches of approved sewer gravel is to be placed on top of the sand, with the perforated and non-perforated distribution pipe network buried level with the bottom of the,pipes rio less than 6 inches above the top of the sand. Cleanout pipes and monitor tubes'with perforations extending through the sewer gravel zone only shall be installed as shown, and filter fabric placed over the entire top of the sewer gravel before backfill. Unclassified backfill shall be placed over the filter fabric to bring the grade up to six inches above the surrounding soil to allow for settlement. An additional six inches of topsoil shall be spread over all disturbed arefis' to allow the yard to be readily relandscaped. 6. The waste line leading into the soil absorption bed shall be connected to the outlet of the second (concrete} septic tank, with a cleanout pipe being installed within 3 feet of the tank. 7.. A total of 5 inspections will be required during construction: (I) Initial stakeout, at which time holes are to be dug in opposite corners of the proposed bed to confirm the depth to which the bed bottom is to be excavated, (2) after the bed is excavated, but before placement of sand, (3} after the sand is placed, but before placement of the sewer gravel, (4} after the sewer gravel is placed and the pipes are laid and connected up to the septic tank, but before the filter fabric and backfill is place~l,'and (5} after the'final backfill and topsoil is in place and graded to smooth contours. LoT pRoposEr, :25 ~< 3G~ VACANT LOT tH- u'~iL ES~qT K/ELL ELL LOT I,~E Lt. LOT 2.'7 Iq'7' Z" D.ORO SH IN LoT 2G LOT 2 ,L'E pT~C BLK ~ _"".~ X~.,' A ', HEODORE F MOORE LoT 3. BLK G Flattop Technica! Services 14530 Echo Street ~i~choraqe~ Alaska 99516 L 2'7, B,S i~c kAA~tON SEPTIC S~STE~ S/D UPGRADE SITE PLAN SCALE: I,"= 5o' DATE: S/riO DwN BY: CA NOTE: Tills tS NO' A SURVEYEb PLA' ALL LOCATIONS &RE APPRoXt~A~ 71 "b~ToPSolL OVER ERTIRE '<---~' ,,ARE ..& SA'Nb',( S o I L .~EC"F ION "A- A" L27, SOiL PLAN ~attoP Technical Servi'c~ ~.,-X 14530 Echo Street "~fi'choraqe, A]~kcr 995] SCALE: i"--- S/ DATE: 7/~o DRAWN 12" 5£t.VEl[' GR/JI,'EI,. ~55 McMAHoN S/D AI~5o R B,T l0 N BE: b AND CROSS - SECTION PERFORMED FOR:. Flattop Technica! Services 14530 Echo Street Mfichorage, Alaska 99516 Municipalily o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST K BE LLER LEGAL DESCRIPTION:_ L ::~"'7. J~)3 PT 1 $I,4 5ANDY 2 3 5 Township, Range, Section: -~EC 2'7 10 11 12 13 14 15 16 17 18, 19 2O LoAI~ SILTY 6 7 .SW/$P 8 SLIGI~L¥ SILTY 5ANb · 501,4 E COBBLE~ g SLOPE WAS GROUND WATER ENCOUNTERED? YEs IF YES, AT WHAT SILTY SANb DEPTH? Depth Ia Water After~ MonilorinD? . JC) Reading 12" PR~'$o.q J Date COMMENTS_ BO'T"rO~ OF' Hot~ , R'3~/,T 12 N HTE PLAN DOI~OSN IN AvE Gross Time II:g~ 11:55 ~o II:~: 35' 12:oo:3~' ~ 12:OI :10 12 :ok: IO ~ Net -- J Depth to Time (~3 Water I '~, 2 ~(~ Net Drop 2 12:/'7:3o ~' 2., 3/g 2 ' PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER __~// TEST RUN BETWEEN `7.,&"" FT AND _ J~ '_FT PERFORMED BY; _F/,ATTOP "rE(::H. SVC S.-- , ~ ~ ACCORDANCE WITH ALL STATE AND M~JNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 {Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN ...FJattop Technica! Services 14530 Echo Street ~fichorage, Alaska 99516 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PER.ORMED.OR: RICK LEGAL DESCRIPTION:__ L PT 1 2 3 5 6 7 8 SP/5W' 9 10 11 12 13 14 is 16 17 18 lg 20 COMMENTS. TEST HOLE BELLER SlLT~{, SANbY SILTY GRAv£ L DAF~P SILT'~ WET Township. Range. Section: SEC 2'7, E'3h/, TI:2. N LOA~ SLOPE ;ITE PLAN WAS GROUND WATEI/ ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth Io Water After Moniloring? Reading Date O3te:. Gross Time Net Time Depth to Net . Water Drop PERCOLATION RATE . TEST RUN BETWEEN 5L Ou(~ ~/£b 'IN [minutes/inchJ PERC HOLE DIAMETER ~ FT AND _ FT ~ H E. t,I b R I L L BIT tMIT/~DR/~4/N . P~RFORMEDEW: _FLATTOP 'TE¢~. SVCS .... , '~'...~~ ACCORDANCE WITH ALL STATE AND M~JNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ' ' UNICIPALITY OF ANCHORAGE - DEPARTMENT OF HEAl'TH & ENVIRONMENTAL PROTECTION ' 'ENVIRONMENTAL ENGINEERING DIVISION 825 L Street-~Anchor~ge, Alaska 99501 Telephone 264-4720 N SITE SEWAGE~DISp0~AL sySTEM AND/OR WELL INSPECTION REPORT NAME ' ~' ~ ' IPHONE I F-INEW MAILING ADDRESS ~ , LEGAL DESCRIPTION LOCATION : r.~,~ 0~ ~ .~ :, .o.~oo~s Z Manufacturer .... Material: ~ No, of compartments Liq.~apacit~ n ga ons ' ' '. ' Inside length Width Liquid depth ~ IF HOME~D.E: . ~ DISTANCE TO: Well { n ~i; Dwelling t,,'/.. ~ ~ ; PERMITNO. ~ ~ ~ Manufacturer ~/~,.' : . Material Liquid capacity in gallons Q Well , m ~: Foundation Nearest lot line PERMIT NO, =~ ~ = DISTANCE TO: ~ ~ Z ~ No. of lines Lengt~e~c~ line '. Total length of lines Trench width Distance bet~en lines ~ ~ ' J ~ ; ' ' inches ~ ~ Top of tile to finish grade ~ , . ~ ~. ~ Material beneath tile Total effective absorption area ~ ~ ; inches Length Width ~ :~ . Depth ~ PERMIT NO. ~ ~ Type of crib Crib di~ e~ ~.. ~ ." ; Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: '~: '; ': : ~ c,... ~,~ ~!/~ ~,~,,, ~,,,~ ~,.,..c~,o,o,,,n~ P~.~,T.O. Build n~ ~n~tion ~~ Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER .,, PIPE MATERIALS . ;, SOILTEST)~ATI~ ~ NG INSTALLS4 REMARKS : .' I- _ _ ' b:F --' {ev, 3~78) F'ERMIT NCI. LOCFITION FURF.:ON CREEK RI:, : , I i; LEGRL L27 E:_~ MCMRHRN S,"D ""'"' T'¢F'E OF SOIL RE:SOF.:E:TION S'T'STEM IS' DF.i~INFIEL[:, r'll,~ll"-.! IC: I F'i-UiL I TCT' ,3,C i==~I'4L-:HC,~--~::_Fi.~t.~E '"' DEpRF.:TMENT OF HERLTH RND EN:.IRONMENTRE F'ROTEL;TION E'":'=" "L' STREET., RNE:HORRGE, BF.'.. 264-4720 C~r4--5 I TE ~'---%EL--IEF.: I_I F' ,3 F; FI [) E F'EE:I'-I I T LOT SIZE ~44 9227 ~:0000 S6!URRE FEET I'tRXIMUM I'.JUME:EF.: OF E:EC, ROOMS= _.3: SOIL F.:RTING (S~2 FT,--'E:R:¢= 0 THE F.:EC!UIRED SIZE OF THE SOIL RE:SOF.:F'TION S'T'STEf~-.I$: THE LENGTH [:, ] MENS I ON 'rS THE LENGTH (IN FEET) OF'THE-TRENCH OF.: DF.:RINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETHEEN THE SURFRCE OF THE GROUND RN[) THE E:OT'FOI'I OF THE E,-.,_.H,, HTICN"P-','~ I ¢.' I1'.~;. FEET')... .. THE GRRVEL DEPTH IS TFIE MINIMUM DEF'TH nF GF.:RVEE E:ETHEEN THE' OL!TF.FI, LL PIPE RND THE E:OT'f'OM nF THE E,s::CR'v'RTIOI'.4 ,'.:IN FEET). .' F'EF.:MIT RPPLI,::FtNT HRS THE F.:ESF'~-JN$IBILTT'~' TO INFOF:M TH'IS E:,EF'RRTMEr.JT DUF.:ING TFIE INSTRLLRTION II"~SPECTIONS nF RN'~';~"I.4EL~.S FID,TRCEIqT TO THIS PF:_F'EF..TTn ' "RND THE NUMBEF.: OF RESIDENCES THRT THE I4EEL;:'I'4ILL SERVE. .BRCKFILLING OF RI'-,t'¢ SYSTEM 14ITFIOUT FINAL INSPECTION RND RRPROVFIL E:'¢ THIS E:,EF'RRTMEI'.~T HILL BE SUE:¢ECT TO PF.:OSEC:UTION. , .- '" , MINIMUI'I DISTRNCE BETI.,.IEEN R HELL RND FIl'4',r', ,ON-SI'rTE SENRGE .~£:"ISF'OSRL S'T':.:"';TEI"I IS :.t. 50 TO 200 FEET FF.:OM R F'UBLIC: HELL [:'EF'~N~.,~'I':,IG UF'ON)'THE,'"'T'T'F'E OF F'UE:LIC HELl._ OTHER REL'-.!UIREMENTS I"lR"r' RPF'LY. SF'ECIFTCRT,IOI'-.IS"RI'-,ID 'COI':,ISTF.:I'JCTIFd'.4 r':,IRGF.:RMS RF..'E I CERTIF'T' THRT :.1.:I Fit'1 FRMILIRR HITH THE REC!UIREMENTS FOR ON-SITE SElqERS RNB., HELLS RS SET FORTH B'¢ THE MUNICIPRLITY OF RI'-,ICHORRGE. 2: I HILL INSTRLL THE S~r'STE['I II",l RCCORDRNCE HITH THE CODES. ~:: I UNDERSTRN[:, THRT THE ON-SITE SENER S~r'STEM I'IRY REC4UIRE ENLRRGEMENT IF ]'FIE RESIDENCE IS REMODELED TO,INCLUDE MORE THRN ~ BEDROOMS. SIGNEC, · RF'F'L I CRI'.4T SCHRCHLE EXCRVRTING L Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 ,INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH 0 .~ MATERIAL ~/~¢-~'t~f"~ NUMBER OF COMPARTMENTS J INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/~OO 'GALLONS. SEEPAGE PIT: NUMBER OF PITS ! DIAMETER LINING MATERIALdtC'W.C, f}/'I~,,~RIB SIZE: BUILDING FOUNDATION ~ OR WIDTH'~'(, DIAMETER NEAREST LOT LINE ADDITIONAL ABSORPTION LENGTH Z,;~ DEPTH //~'//'-- TOTAL EFFECTIVE ~ ABSORPTION AREA (WALL AREA) " SQ. FT. WELL: TYPE bUILDING FOUNDATION __ CESSPOOL APPROVED CONSTRUCTION NEAREST , LOT LINE , OTHER SOURCES. DISAPPROVED DEPTH NEAREST SEPTIC , SEWER LINE , TANK , REMARKS DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: INSTALLED BY: ~'~'lA.l~k 5)'/3;/']} LOT SLOPE, Form No. EQ-031 DATEi7 -- /- ~ APPROVE ~ '-, V~/ - - ~" ~ - ~ ...... ~.A.A.B. NAME OF" APPLICANT GREATEr ANChOrAgE ArEA Borough DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 :"C'* STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! INSTALLATION LOCATION 'EGAL OESCR,PT,ON C-Z713 INSTALLATION OF: SEPTIC TANK ? ~ ~EEPAGE PIT FINANCED THROUGH PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT SOIL TEST RESULTS DRAIN FIELD OTHER TO BE INSTALLED BY NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /~ TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT I TO RIVER, LAKE. STREAM. DRAIN FIELD _ DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED S01L. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGU~TIONS REGARDING INSTALLATION. LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHO/~AGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE wITH SAiDCODE. FORM NO =O'OI 6 ~r ' ~ '-- ~ : ["~ATER ANCHORAGE AREA BOROUGH ~ ,Dep:~..nent of Environmental Quality, ~, ,3330 "C" ·Street Anchorage, Alaska "99503 P e~O ~ d fo ~ ~~~ J ~~ mDate perfomed ~/S~ ~/)(~ Legal Description. /~ ~ '~ ~ ~ ~?~/7/c~- v~'o_o~ . ~'~Jj~Y/_,' ')his-form r~por.ts: Soils log K ' '. Percolation test . Depth Feet 1 2- 3- '4 -- 5- 6 --. 7 -- 8- ll- 12- Was ground. Water.encoUntered?' ~L~'" If yes, at what depth? ........ Reading · Date Gross Time . 'Net Time Depth to H20 Net Drop Percolation r~ te .minute. ... Proposed installation:-Seepage.Pit:''" .... Drain Field"i~'. ..... Depth of Inlet- . .Depth to bottom of pit,or trench .... . COMMENTS: ..... ..... Perrfomed By: :.Certified By: Date: MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING ~ t"~ - -3-,(J3 \ -- {~)'-~ HAA# 1. GENERAL INFORMATION (M'ust be completed prior to submittal) (a) Legal Description (include Iht, block, subdivision, section, township, range) Lot'z loc i.- Location (address or directions) (b) Property owner ~ck- {~/,,~'~z ~e/le~ Telephone: (home) ~¢~-TqqO Business MailingAddress ?,0. ~o~ ~ 7 ~1~ / ~t//~ ~ ~ (c) Lending Institution ~~/~ ~c~~ Telephone MailingAddress ~0 ~ ~ ~./ ~nCb~& (d) Real Estate Company and Agent ~ RA Pf~~f - Address ~ 70~ ~ be//~ ~nC~O~. ~ ~q~ ..."".' Telephone ~7~ ' ~77~ (e) Mail the HAA to the following address: '(or check here [], if hold for pick up.) " r,, = List contact person and day phone number below: .'. "7"~ c'r'oor& TYPE OF RESIDENCE Single-Family I~ Number of bedrooms 3. WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system, must have written .confirmation from the State Department of Environmental Conservation attesting t° th legality and status. 4. SEWAGE DISPOSAL On-site [] Public [] Community [] Holding Tan'l~ [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 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. NameofFirm ..~'/~o~ Tcr.~'~c~zl' ..~r'v~c~.[ Telephone ~'~..5-- I ~'~.~'" Address Date Approved,f0, r ~ b~drooms by Date_.~'" Approved ~ Disapproved Conditional Terms of Conditional Approval ,, - The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 A; WELL DATA Well Classification Well Log Present (Y/N) Total Depth.l~$' Cased to ~ ¥O° Depth of Grouting Static Water Level. Casing Height Above Ground ., Electrical Wiring in Conduit {Y/N) .SEPARATION DISTANCES FROM WELL: "- ·; '--: To Septic/Holding Tank on Lot .lO,'? ' "'~,'~ ¢. O. To Nearest Edge of Absorption Field on Lot To Nearest Public SeWer Line To Nearest Sewer Service Line on Lot Water Sample Collected by FIo~o~ 7'oo5 MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF Heallh Authority Approval (HAA) ~NVIP. ONMENT.AL SERVICE_~ DIVI§I(~N : "CHECKLIST-:FEBRUARY 1984 ' AUG1 :~ ]990 : ! ~ ', ,' 343-4744 "'. ', ~ Legal Description: .. ~0 ~: P. 7/, If A, B, C, D.E.C. Approved (y/N) /V,,~. ~' i . Yie dl~, /~q'/om Pump Set At' ' ,64.~ ~ Sanitary-SeaJ on'Casing (Y/N). -- Depression Aro'un'd Wellhead (Y/N) N. Air-tight Caps (Y/N) i0~/~ TO Nearest Public Sewer Cleanout/Manhole ; Oh Adjoining Lots . ~. too" ; On Adjoining Lots ~ ICC, Water Sample Test Results ..G~u':~C/tOt',y'. - O Comments P~r;n~ well ~(oco ~/ :o~ ~u~ SEPTIC/HOLDING TANK DATA . - :' Date InstalledT/7~, ~/70 Size I~; ~ No. of Compa~ments t~ 1 Standpipes (Y/N} ~ ~ c° "Foundation Cleanout (Y/N) Depression over Tank (Y/N)' ' N Date Last Pumped '~/~/90 ~,/, Pumping/Maintenance Contact on,File (Y/N) N,b. · for N,~. Holding Tank High-water Alarm (y/N) N,/g. Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ......... "''~' '.- To Property. Line '," -- To Water Mainr/ser~iCe Line ,.~..,,z'... To Stream, Pond, Lake or Major Drainage Course Comments ' To Building Foundation Disposal Field 72-026 (Rev. 7/88) Front Page :1 of ,2 C."ABSORPTION FIELD'DATA S,.0!!,s,~R~ating in AbsorPtion Strata Date Installed Square Feet of Absortion Area .. ,D, epression,., over Field (Y/N) _ .-.: Length of Field ~ ~'/'' ¢) ~ Sta.tlndpipes Present (Y/N) t'/ Date of Last Adequacy.,Test Results of Last Adequacy. Test N./f.' (_lYCu.~ COn$/'r'~c'~O~~ SEPARATION DISTANCE'FROM ABSORPTION FIELD: To Building Foundation To Water M~in/Service'Line '7~ ' To Stream, Pond, Lake, or Major Drainage Course To Driveway,;Parking Area, or Vehic!e storage Area .,,'r'~ Property I~ine ' /'3' · - - To Ex~shng or Abandoned System on ';'On Adjoining Lots -'''' ~ ,R'~ ' To Cutb~k (if present) Comments D. LIFT STATION ./~t,/~. Date Installed Sizein Gallons '"'"Pump On'! I~evei a{' ,,' '. ' High W~te? Alarm . !., :. Level at Tested for ' '- ": ':'.' ' .... Dimensions · - Marihole/Access (Y/N)'" ' "" '"'"' : '"'PrimP' Off" Eev~I at' "- "" "'Veht (Y/N)- Meets MOA Electrical Codes (Y/N) · 'Pumi~ing Cycles'during Adequacy,Test. Comments - - " **Ch'eck Permitted Bedroom Rating Against HAA Request~* J,.,~'~ .. ~,' ' : i, · ,~.; . I certify'{i~'~t I have checked, Verified, or conformed to all MOA and HAA inspection,'. .I .'.. Company F(c~/~-c,t~. ~"~/~,~'~c~[ ~erv,~ Date- ~~/ lC .l~ . MOA NO. ~' ~g~ Receipt No. Receipt No. Date of Payment . Waiver Fee: $ Amount: $ .. Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 ~ cj_~4~)~,zn effect on the date of this , ~... , . ~ . .~ : ~eeeeeeleeeeeeeeeee'eee eeeee Q ~H~IH~/ ~ Seal .~ '._ .- _~'~ . ~L ~. -.. .... . .~ " ':' Parcel I.D. # ,,:-~ MUNIcIP.~LI'~Y OF ANCHORAGE' .~ Department of Health & Human Services · DIVISION OF ENVIRONMENTAL SERVICES . · ~ : .343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) :3831 n (b) Property owner Mailing Address ~-~ I DOrox~'~o:. 1~,¢..~. Lending Institution .~'¢~-('t~/e Mailing Address ~0 E ~ Real Estate Company and Agent .. Address ~70 ~. ~b~ll ~ ...... ~' ""~ ..... ~ ..: ............. Mail the HAA to the following address: (or check here ~, if hold for pick up.) List contact person and day phone number beloW: (c) (d) (e) o' t o Telephone: (home) 'Z"L4"-7¥,/~ Business ~ 7~- I:~_~1 Telbphone ~' ~ - ~"~' ~ ~' TYPE OF RESIDENCE si.ng!e-Eam.jlyID ...., Number of.bedrooms WATER SUPPLY Individual Well I~ Community [] Public [] ote:;Ifcommunity well ~system, .must have written confirmation,from the State Department of Environmental (~ns~rvatid'hYJtteSting tO th"J~g~litY arid statdS. ' ..... " .... -': :':':' ':' ' '.:" ~:': ........ ' SEWAGE DISPosAL " On-site [] Public [] Community [] Holding Tank [] .. Note: If Community well system, must have written confi~:mation from the' State Department of Environmental Conservation attesting to the'legailty and status. ' 72-025 (Rev. 7/88) Page 1 'of 2 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/ot'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. NameofFirm F l~'~o,p '7-~chn i¢~(./ .C¢~'~,'~c~J' Telephone ~'~'.5"-1.3'5.5" Address Date Engineer's Seal APPROVAL ' , , " 6. DHHS for '~' bedr ' '' -- te 7-/7- Approved Approved .~-.,_ Disapprove Conditional Terms of Conditional Approval /1/ O T ~: ; · 'I':i"IE' SEEP,,96E ,o/7' u.,,HIc'I.y' THIS 7:'OR THIS £Ou'~ BERRoo/-/ HO/YE 6KO e~_,~.lJl II lei ~ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Appioval cerificated based only upon the representations given in paragraph 5 above by an independent prOfessional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections 6r analyze da{a before a certificat~ is'issued. The MuniCipality of Anch0'rage is not resPonsible for e~'rors or omissions in the professional engineer's work. 72-025 (Rev. 7/88)Back Page 2 of 2 'A. WELL DATA- ' '~ Well Classification' MUNICIPALITY OF ANCHORAGE (MOA) Health Authority,Approval (HAA) ~ CHECKLIST -'FEBRUARY 1984 ' i :,I' ;~ .I. 343-4744 Legal Description:./.- ~- 7,,. " If A, B, C, D.E.C. Approved (Y/N) ~ t,l.,4, TotalDepth I?S' Casedto ~.Ym' Depth of Grouting N,~. "' Static,Water Level Pump Set At ~ ~ Casing Height Above .Ground -1~" Sanitary Seal on Casing (Y/N) Electrical Wiringin Conduit(Y/N) . ' ~ Depression ArOund Wellhead (Y/N)' SEPARATION DISTANCES FROM WELL: .'." - - '. ~ :. ' · . . :.. . ToSeptic/Holding Tank on Lot . 1~7~ .".-' "'- "' ; On Adj6iningEots :' '~ 'To Nearest Edge of Absorption Field on Lot ~' I EO' ; On Adjoining Lots To Nearest PUblic Sewer Line ~ IoO~ To NeareSt Public Sewer Cleanou~Manhole' To Nearest Sewer'Se~ice Line on Lot ~' 7~' : :'Well io~Present ( ) IV Datec°mpleted Water Sample Collected by Water Sample Test Results · Comments B. SEPTIC/HOLDING TANK DATA Date Installed 7{-[q.. 9/7,~ Size toa~. 3o0 Standpipes (Y/N) Y ' Air-tight Caps (Y/N) No. of Compartments · ' I ~-I ': :~"' · · ~' . Foundation Cleanout (Y/N) Date Last Pu*mped 7/1~/ Depression o~ei: Tank"(Y/N) ' N Pumping/Maintenance Contact on File (Y/N) N, ~. "for . ':, : ~ . :' : ,'::' ': :! ..,: ',: ... ,.: ,,. ... :. Holding Tank High-'WaterA!arm (Y/N). bI, A Temporary Holding Tank Permit (Y/N) SEPARATION DIS,TANCES FROM SEPTIC/HOLDING-TANK: ..... To.Water-Supply Well l~'7' To Buildin~ Foundatior{'" '~5' ""'" To Property Line: '" ~ 5"O~ ...... To Disposal Field ~ 2." ' To Water Main/Service Line ~ To Stream, Pond,-Lake 6r. M~j0r Drainage Course Comments ..... . 72-026 (Rev. 7/88) Front Page 1 of 2~ C. ABSORPTION FIELD DATA :': ' ' .........." ' ...... : " ' : "'" ~ Soils Rating in Absorl~ti0n Strata "~ ~5' f ta-o n {l~r~. Type of System De~'ign" Date Installed '7 [ .'7.?' ;~'. Length of Field ~'~ ' ':'/-:'. · ' ..... . - ~.:Width of'Field · '"~ I' ~,- ~' '. ..... . Depth of Field t o ' -: ..'~ ... Gravel Bed Thickness ~" ' Square Feet of Absortion Area t~,f ,_~e¢. ct, et.r- ~x~.df Statndpipes Present (Y/N) D,e. pression over Field (Y/N) /~/ Date of Last Adequa, cy. Test · '~.'-" . .'~'i ' '::',.."". ;I .L .~ ,;~ . - ResultSof Last Adequacy Test .A~,aa~-t :~r ~/' ~,~r,,~' (/I/,.¢or?~~ ~/c'~-;¢-~' ........ '~ :: · : '""' ""~ ~;~:PxI~,~;I'I'0~'61~"3~X~I(~E':~RoM ABSORPTION" "' FIELD: .. ToWater. SupplyWell~ - ~. ~o' .r, .,..', 'ToP~OpertyLih~' ~. To Building Foundation - ~'~"~q¢' :" ~"' ' To Existing orAband°nbd's~;s'tem on Lot N,/t,"' ":.'~":'~ ~ ." :::": ": ~'- 'i:': "'; On Adjoining Lots ~:'' ;';> .?o ' ' To Water. Ma'in/ServiCe~Line'' . ~ 7J'L' ' ' :-' '. ': To Cutb~ck (if present) · , ~,4..~: To Stream, Pond, Lake, or Major Drainage Course ~. too' To Driveway, Parking Area,~or Vehicle Storage Area ~ &'~'" " Comments ,. ~,;', -~,. : ,n '' '" ' ..' ~ 'L" .:,~ ~ , I ! · , ' ~ ' . :," , i:. · ~, , ~ . ,: ,. : D. LIFT STATION I'q.A. .. Date Installed "' ~'TSi~;~i~G~.llo~s'~ .... ..'i- ". · .,,. ?~m'p O~" Le~elat :" '''" ~ ', <"~'Hi' "', gn Wate~Alarm L~vel.at '.~ Tested for "' ".-' ' Meets MOA Electrical Codes (Y/N) ' (Y/N) ~ ~:,'" ', .'. Vent :~ -' ~ "' ':" "'"' ' ' " " """ ,-'. .... Pumping Cycles during'Adequacy Test. Comments ' '- '~ '. , ]:;'.' .:':' i ;'.:"';.' ::. ', '. · ) . . i,- ' , . ,. ~ ' : I.~ ',:, . : , **CheCk' P'erh~it{ed Bedroom Rating Against'HAA Request** ' ' I certify thai i"i~ave checked, ~erified, or conformed to ali!M~A arid'HAA g~i~"~[feci' on t~'e'dat~ '~f this . -' , ,-, inspecuon.-"~ ~' ,' " ' .: ' :: .' ' ' ......... _ ..... Company F(~A~' ~c~,t~l ~r,[c~, ~' ~9~ ...... ~ · ~ "- .... ' ....... .......... ~"z ............. ~ ....... ~Engineer's Seal Date ,/,ly I ~,, I~0 ~~~ ~.~..~ ,. .. . . A..', ~ ~/~ ~ . THEODORE F ~OORE .............. ~ ~.... ~- - .... 'u _~ ~ ..... ,. ...... Receipt No. ~ , [] . Receipt No. ~ · Date of Payment ~/I >/Tn . Waiver Fee: $ __ Amount: $ ~ ~ ~~ Date of Payment 09 mo CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. '~633BSTREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 A~ALISIS I~E?0RT ~I SD~LE ~o~ Work Order t 25224 Date l~eport Printed: 3UL 12 93 ~ 11:2! Client Sample ID:L27 B3 KCYAHON P~$ID :UA Collected JUL 6 90 ~ 15:00 Received JOL 6 90 ~ 15:15 Pre=erved ~lth :AS REQUIRED Client Na~e : [LATTOP TEC~qlCAL SRV Client Acct : P.O.t ltOh~ RECEIVED Req ! Analysis Co=pleted :3UL 9 90 Laboratory Supezvlsor :STEPHEN C. EDE Released ~y : ~ ~". ~ Special Ir~truct: I)~LATTOP TEC~ICAL SRV 2) Chemlab Ref I: 902285 Lab Smpl ID: I ¥~tzlx: ~ATER Allewable Parameter ~ested Result Unlte gethod LI~Lt~ NITRkT£-N 3,3 ~g/1 EPA 353.2 lg Sanple ROUTINE S~LE. Remarks: SAM2LE COLLECTED ~T T. MOORE. 1 ~est= Performed ' See Special Irmt~uctlcns Above UA-Unavailable ND- None Detected "See Sample Remarka Above NA- Not Analyzed LT-£e=e Th~n, GT-Greatez Than MUNICIPALITY OF' ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTALPROTECTION ~i'~ DIVISION OF ENVIRONMENTAL HEALTH ~::.* ~, " CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAl OF ON-SITE SEWER AND WATER FACILITY' 264-4720 " · ' , Application Date. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) , (b) Applicant Name Applicant Address (c) Applicant'is (check one): Lending Institution []; Owner/builder I~ Buyer []; Other [] Telephone: Home .~zl.~-_ ?z/z/.o Business E(ol- I(~'1 (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCES. Single-Family~ ~ulti~Fa~yLI .,,,~ther Number of Bedroom' s ~,~,,,,..// WATER SUPPLY Individual Well I~ Community [] Public [] ...... Note: If community well system, must have written c. onfir~nation from the State Department of Environmental Conservation attesting to the legality and status. '" ' 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 I of 2 72-025 (11/84) · ' 5. ENGINEERING FIRM PROVIDIN~ INSPECTIONS,.TESTS, FILE SEARCH,' DA~A AND INFORMATION :'.~...i'- · '.. .... . : : ' ~* ~ ~' ' .~ ,' 'i,:~ ~ ~' ' " ''*:. . ' ~ '¥ '~: ' . ' L t~ ;*%'* :,!,~' *:~'.'. ~' "' As certified by my seal affixed heret° and as of the validation date shown bel°~V, I Verify that my inveStig~ti0r; 0~ this 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 fu~her 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~~ ~P~ ~ ~ Telephone ~- ~1 Address ~ ~ Date o Approved for ~_,C~.~----,~edrooms b Approved .~ Disapproved Terms of Conditional Approval ', Engineer's Seal , ~-~~~ ~'~ate Conditional CAUTION The Muncipality of Anchorage Department of Health.and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representati0,ns given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) Ao WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) 4~IB~I~H AUTHORITY APPROVAL (HAA) 264-4744 Legal Description: ,Z~ ~-~7 Well Classification _~...~l~tV~r-~~ ;:' If A, B, C, D.E:C:Approved (Y/N) Well Log Present (Y/N) .... i~L~' Date Completed':,;. ~./?~X.~.. ' ' Yield Total Depth ~~'~'~]!'= Cased to ~---~' Static Water Level l~,.~ F'7'- 1o 8eptic/HolOin~.Tank on Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Nearest Edge of Absorption Field on Lot Depth of GrOUting` ,,,, Pump Set At C )~J.~.,.~,_) Sanitary Seal on Casing(Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line ~_/_~,,.,~' To Nearest Public Sewer , o+c.r . · ' CleanbuVManh~le "' ~J-,~-J~ -' To Nearest.Sewer Se~ice'Lihe'on Lot Water Sample Collected by '~ Y~,~/~-~' P~; ~ate: /~/~Z>::o Water Sample Test Results ~~;~~f' SEPTIC/HOLDING TANK DATA Date Installed ~Q::~..=-~C~.E- Size Standpipes (Y/N) ..~"" Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~J//C- Separation Distances from Septic/Holding Tank: To Water-Supply Well ~k~''/'; ~- To Property Line ,-~;'(:~ ~ To Water Main/Service Line 7---~-~]C'~ Course /,,J~/~. No. of Compartments Foundation Cleanout (Y/N) .~ .~' Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026 {Rev 8/861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed · Width of Field Z,,I Square Feet of Absorption Area Depression over Field (Y/N) /~' .... Date of Last Adequacy Test Results of Last Adequacy Test · . ~. ._~~' ~ , Separation D~stance from Absorption F~ld.~-: ,- ~ ,;.~.,' To Water-Supply Well, /~ ~ · ' To Properly Line ' ' Type of System Design - Length of Field-- .~..z..-- .... / ," Depth of Fi~i~''/O ;" "/'. Gravel Bed Thi~kne .. Standpipes Pr.~?~(w~) To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, Or'Vehicle Storage Area To Existing or Abandoned System on ; On Adjoining Lots ' ' To Cutbank (if present) Com men,~ts. D. LIFT STATION ?. Date Installed Dimensions .~-. Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at '. ."V Tested for ' : ~ ~..;..~ng Cycles during Ad~q~a~:~,"l:~'st. Meets MOA: .) Electrical Codes (Y/Ni ' ''= ~':' ' : ' ~ I certify that I have check_ed, v. erjfie~, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date of Payment Amount: $ Page 2 of 2 72-026 CRev 8/86) Back 22?.0 ANCiI'.;NA:Td-:, AK 9D507 ('307) 3~-~::Sl Su 'b. lJ. vision: Lot: Block: _.. _~' Cliea ~' s Nam: __~__~. ~ a ct~_,'e s s: ____~31 Zkz, z___o.~,,O Initial P.e-ading cw~ Production Rate_: _~.3_~ GP.~ 24-1{our C~acity3q/~ Gallcx-~. INVOICE # I 2 7 5) CUSTOMER Block DATE 10-,~0-86 8;00 HOME SERVICES 15900 Francesca Drive Anchorage. Alasha 99516 345-1890 or 345*2444 Richard Belier 3831 Doroshin R45-7440 Lot DESCRIPTION cheek will be by foont door if no one home Besse;. Epps & Ports · (refinance)" TOTAL AMOUNT 60't0 ,4 REMARKS:ii _ ~"-d::~ c:~ Gallons Septic Cesspool r-I PROBLEM AREA--CALL FOR MORE INFORMATION [] NEEDS TO BE DONE AGAIN IN/6MONTHS [] Good Shape I~ Sludge buildup on bottom [] Jim cap missing or needs replacing 3 [] Cut standpipe to 1' above ground Standpipes ~ ~'90Time [] Floater on top [] Needs Septictrine --PLEASE PAY FROM THIS INVOICE-- Time .? -- Date. Inspector Comments Date Sewer Installed Soils Rating UNlaP^U Y OF DEPT. OF HE/',LTH ENVIRONMr'NTAL PROTECT APR 2 RECE Time Date'. Inspector Conditional Approval Date Inspector Permit No. Septic Tank Size Holding Tank Size :;::: Well To Absorption Area ~W., ell Log Received Well to Tank :,LI APPLICANT FILLS OUT LOWER HALF~~''I ....... . . ,,ONLY ill /moo ./. Buyer. :% ~,...7~Michael' C.'L.,& T,"~nda E. Pa~de'h .......' ...... f," iAddress 8420 Golden %CiliI Anchor~9 /..-..t/~..~..~./~...~.,:?_~...~ ,.,~ ,....~.._ .. ? Phone;i I;. ::': ~! 345~,3~77 I: .Le?l.ngl.nstitutlon l'st Nationa',I"Bankof Anchorage · A(~(~ress soUth'6~nter Br~nch /~ . ' , /,~.,. ~. , - RealtyC0-&Age. nt ,.' Totem Real:~y, Inc. viole~ G. H~lce 'Address ~' ' ' 724 E. 15th Avenue ' '" Lega! Description .'.,',13~t. 271 =Bloc~i 3 :. P[CMahOn Sub,i.:~ 1'. i; 'lSh°nei J i': i !' .272m057l:' !' Street LoCation3831 ' D°r°snln ' ~venue Typepf Residence Slngle Family Multiple Family N0. of Bedrooms__~ _ J'. ~ ' .~'~ J!']. ~:: J COmmunity ~A ~_: I~.~.~ 1~5. For wells drilled prior to that date, give well depth (attaCh log' if~J Public Utility ' L',~ ..... avallable.) ~[rl~ Sewage Disposal ~ : !ii!!' ,1:11 ;Ii , 1 k" ~ Individual ii Year Individual Installed: -UDctrac]ed --see attached.~: ~ PUblic Utility ' : ." ~:~ When Connected to Public UtJll{~: ~ ~ ~' ' ~ Holding Tank ,.': ./' [iii i ~; ~ r.~:. ~ MUST CCOMPANY EACH REQUEST BEFORE:PROCESSING CAN BE INITIATED.' NOTE: THE INSPECTION FEE A ..", / ii;Il ;.i A'LASKA nUIROnmenTAL cor/TRoL $ UlCe$, i~nqin¢¢rinq 6 I~nuironmenlal $1udies IllC. MAY 6 1983 IST NATIONAL BANK/SOUTH CENTER/ATTN MARION YOUNG 201 W 36TH AVENUE ANCHORAGE AK 99503 SELLER - DR. WILLIAM THEOBALD SUBDIVISION-MCMANN BLOCK-3 BUYER-MICHALE pADDEN LOT'27 MUNICIPALITY OF ANCHORA(~E DEPT. OF H~AtTH ENVlRO,~M.':NTAL PROTECTION ~AY g .RECEIVED ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A ESPINOZA-PIT WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER'PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 4 BEDROOM HOUSE. 1500 IS ADEQUATE FOR 1200 lUcsl 33rcl Aucnu¢, $uii¢ B · jl~nchoracl¢. ^lasko 99503 · (907) 276-1361 . ' : : ,i : ~ MUNICIPALITY OF ANCHORAGE =' ' f** T ! 825 L street- Anch0~'ageo Alaska 99501 : ; ~ · : '. iENVIRONMENTAL ENGINEERING DIVISION L ' ; · . .. ' Telephone 264-4720 [ i'.~ ;..REQUEST FOR APPROVAL oF,INDIVIDuAL' WATER AND SEWER~FACILITIES ~ DIRECTIONS:, Co~mp et~e 'ails. par~$, on page 1. Incomplete requests will n'ot' :be proc~essed.~ Please allow ten (10) days'~; ' f(~r processing. 1. PROPERTY OWNER'; ~., { ~ ~ I PHONE I MAILING ADDRESS ' ~ PROPERTY RESIDENT {If diff~ent from above) , ~ : :. ' ; j PHONE Willi~ ; . I &' ~sie' O. ~eobald '' ~''. ' ;.,;: :':~,~,: ' ' " ~. ,' 3~-7400 MAILING ADDRESS ~i~ =.- ~ 5 1 r ', ~ , ~ 1 c/o~S~ Hospital; ~:~x 9 12, :E~end0~f;~, Alas~'' ' : ~ 3. LENDING INSTITUTIONr ' ,~ , , t~, ' :' ,', i~ ~'1 : ' · I PHONE ~oas~:z,~~ Od ~ ~ . ' , ~ 279-0665 I MAILING ADDRESS ~$'?![ ~ ~ ' :' i. :,;, P.0J.Boxl20 ~ho , Alas~. I t'~,~' ,,,,' ,.' ~: '. · . 4, REALTOR/AGENT ;:!~ i ... ' ~' ; ~ " ~ ' ' ~ PHONE 5. LEGAL DESCRIPTION ~ , : : Lo% 127, STREET LOCATI ON NHN Doroshzn. 6. -TYPE OF RESIDENCE l, r r3q SINGLLE FAMILY '?-1 -MULTIPLE FAMILY:! iNUMBER OF BEDROOMS O,e i.'ir . Four Two ! I--I Five Th'ree i~ :II--I Six i [] Other i[Z] INDIVIDUAL. · iI--] COMMUNITY, iF-1 puB LI'~ UTI LITY ~ ~.~.'ACH ~ELL~I"OG. A w~[I Ic~g is requ]~ed fbi',al we s dri ed · 'slnce June 1975. For wells dril ed prior to that date, give wel ' ]depth (attach log ~f~available.,) 8. SEWAGE DISPOSAtJ~SYSTEM · i '-I: r[!:l,:' : ~ ],'::- ;I~--I INDIVIDUAL/ON-SITE** .,I--1 PUBLIC UTILITY ;~ ' iI In, dlvldual/on-s~te, g ve nsta at on date , ; t. :If system ,s over two (2) years old an adequacy test is required :i;'l t.'.,;.~' I ~ II ;:1". 1~ ' , ,. ; Dy Ibis Department. t ' ' , NOTE~ THE ,N~rpE~IO~:fEE '~M~ 0iT ACC, O~IP~ ~A~Ch ;tIR~;e~ U;~m BEFO~E ~ROCESSI~Gi~;N BE INITIATED. 72-01 o 13/78) THIS SIDE FOR OFFICIAL USE ONL TIME DATE INSPEC~ INSPECTION APPOINTMENTS TIME DATE INSPECTOR DATE RECEIVED TIME DATE INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE [~SlNGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [~INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified vGE DISPOSAL SYSTEM IDUAL/ON -SITE []PUBLIC UTILITY Connection Verified ~eptic Tank or [] Holding Tank Size:/__~c)(~ ~) If Tank is homemade give dimensions: TOTAL ABSO R PTI ON,AR EA 4, DISTANCES WELL TO: Absorption Area to nearest Lot Line NUMBER OF BEDROOMS [] ONE [~THREE [] FIVE -'- [] 'OTHER [] TWO [] FOUR [] SlX =ERMITNUMBER ' ' ' DEPTH OF WELL DATE DRILLED LOG RECEIVED ...... PERMIT NUMBER DATE I NSTALL~/7 ¢ SOl LS RATING MANUFACTUF~_ R MATERIAL Septic/Holding Tank .~Absorptii~n-Area I00' I Ioo' Sewer Line INearest Lot Line 5. COMMENTS [] CONDITIONAL APPROVAL (letter must acc~[~fipany%'~rt~ticatel ~t [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev. 3/78) R&M CONSULTANTS, INC. 5024 CORDOVA · BOX 6087 · ANCHORAGE:, ALASKA 99502 · PH. 907-279-0483 · TLX. 090-25360 ENGINEERB June 6, 19'78 R&M No. 851529 Coast Mortgage 4797 Business Park, Suite 4 Anchorage, Alaska 995~0 Attention': Hodges property Subject: Adequacy Test on Existing Sanitary Sewer System; Lot 27, Block 3, McMahon Subdivision, Anchorage, Alaska Dear Sirs: At your request of May. 30, 1978, we conducted a test of the septic system on the above described property. During the .test the liquid level in the septic tank wa§ monitored as water was added to the system. The measurements are summarized in the following table: -Liquid Level Below Top Total Gallons Time of Standpipe. Added 10:00 5.9' 0 10:05 5.9' 25 10:15 5.9' 75 10:22 5.9' 125 10:30 5.9' 175 The meter used during the test was a RocRwell 5/8" standard Water meter which had previously been calibrated by R~! Consultants, Inc. If the 4 bedroom residence on the property is to house 8 people, the average load on the system, can be expected to be 600 gallons per day or .41 gallons _per minute. During the test, the system accepted 175 gallons in 30 .minutes. This indicates an average'effluent acceptance rate of approximately 5.8 gallons per minute at the time of the test. Because-the house on the lot is occupied, we assume that the leach field was at its normal degree of saturation. We can therefore conclude that the system is disposing of effluent at 'an adequate rate for a 4 bedroom resi- dence. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA June'6, 1978 Coast:Mortgage Page~-2- A water sample was taken'from the existing ,well 'aCcOrding to Municipality specifications'. The sample has been delivered to the lab for analysis fnd the results will be' delivered directly to you. We appreciate this opportunity to be of service 'to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours, R&M CONSULTANTS, INC. Lynne KOsikowski Staff GeOlogist 'Gary'. 'Smith Project Manager JMB/kah ~R~q'T_ER At;CHORAGE AREA BOROUGH ...i).epartm. ent of .]Environ.~ental Quality ..2]3.39 '~"':S. tr._ee.t, An. chorage, Alaska 99503 274-4561 ]Date :Received -~ime .of Inspection 'Date 'of Inspection ~.E.QUEST :FOR APPROVAL OF - iI~.I,V.I_D.UA_L :S.E~.I_ER & ~.:AT. ER FACILITIES :~,.~..i.l-lin:g A_d.dr._e_s.s.:__ (.~. ~ 3'~-/ :2: P:rgp_er~y pwn.er:: Phone: _~¢- 'Phone: .B, Depth /~ / 'D, Bacterial Analysis E. Disposal' Field: Total length of lines 8. · Distances; · · . '&: t:(e.!l t.~_:. S.e_~t.i~ t.a_nk //~ , Absorption area ~ ~-~-',' Sewer'Lines /~,m.~, ~.!e_a_r.e.s.t. !'9~ tine '/J / Othe~ contamination' BJ ~u~dation t_o. s. ept. ic.. t..ank _~/.'Y' Absorption areaI ~. $t.b~o. rpt. ion a.t~e_a., to..~qa_re_s.t !Qt line Page 1 of two. pages F.Q-_Q3.4 (1/74) ..am: ._'..,o=~_ -Z~,-r,,r.h rue~,.~.rt~ent oF Environmental Quality DiA,S?.A!.! OF SYSTEM I . Department of [nvironmental Quality 3330 "C" St., AnChorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: M.~¢~~. ~V~FHA CONV 2. Property Owner: · Mai-lin.g Address: .~Z / Day Phone. 3. Name. of Buyer: ~~ ~ Mailing Address: Day Phone 4~ Name of Lending Institution: ~/~,~/,_ .-~ Ma'iling Address: Phone Name of Realtor or.Agent: Mailing Address: Phone Legal Description: ~-- ~.-] - Location: /~_~ /L~.~ .h,,~/v,. 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: public Utility e No. Bdrms. Indivi.dual ~ If Individual, number of. dwellings presently served . / If Individual, dePth of well Sewage Disposal System · Type of SyStem: .Public Utility If Individual, date of installation Individual (on-site) EQ-037 (~/74)