HomeMy WebLinkAboutDEER PARK BLK 2 LT 3ADeer Park
Block 2
Lot 3A
#051-042-50
MUNICIPALITY OF ANCHORAGE
�\
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
P I ENVIRONMENTAL ENGINEERING DIVISION
825 L Street • Anchorage, Alaska 99501 Telephone 264-4720
�— ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAM
PHONE
NEW
I111 I _-Fa
aYL�
JJ��
_ 7-93e-
UPGRADE
MAILING ADDRESS
i473
LEGAL DESCRIPTION
-- esr—p-A .bdty Low •81o�1s�-
LOCATION �Drr NO. OF BEDROOMS
i
s `7
tAjfl G
Well IAhmmnnn
DISTANCE TO: / S '
Dwelling
'�'
PERMIT NO.
�1 Cis
Uy
�s•
_
62
a
Manufacturer
MateriI
No. of mpartments
o. ~
L
4q. capacity in gal Ions
00
IF HOMEMADE:
Inside length
Width
Liquid depth
N
O se
J02
DISTANCE TO:
Well
Dwelling
PERMIT NO.
Manufacturer
Material
Liquid capacity in gallons
X-4
o
w=
Well
DISTANCE TO:
Founda on Nearest Int line
--`
PERMIT Niq
at a 2
No. of line length of a/pch line
Total liength of h es Trenc nt
3a inches
Distance tartween lines
Material bene S
Total elf«ylveyabs r unn area
Z
2
MP
Top of tole to finish g•ad
th rile
O
S
inches
J (�
Length
Width
Depth
PERMIT NO.
W
0
Qn 1-
Type of crib
Crib diameter
Cribdepth
Total of fecove absorption area
WE:
w
Well
Building foundation
Nearest lot line
DISTANCE TO:
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
�+
DISTANCE TO:
Budding foundation
Sewer line
Septic tank
Absorption areas)
OTHER
PIPE MATERIALS
i
S
SOIL TEST fykT
INSTALLER
M Za. G�13f�o oto
REMARKS
J
i
01
APPHOVED DATE LEGAL
f 3 Ql� Z �7e-e.r A7 r-
--v//o
7-14 .
72-017 (Rev. 3/7811
MUN I C; I F�AI_ I -T Y C3 -- /:,SD
+' DEPARTMENT -Ir HEALTH AND ENVIRONMENTA'r ROTECTION .� 5 R�
825' _' STREET, ANCHORAGE, AK. ...�Ol Lr)1�I
264-4720
WELL_ AN[D ON—SITE SEWE1=d PERM I T
PERMIT NO. ( 810555 )
APPLICANT BILL TAYLOR 1473 W 25TH AVE ##30A ANCH AK 277-9387
LOCATION PETERS CREEK
LEGAL L3 82 DEERPARK LOT SIZE 40000 SQUARE FEET
Type of soil absorption system is: TRENCH
Maximum number of bedrooms = 3 Soil rating (SO FT/BR)= 85
The required size of the soil absorption system is:
01t-�ptt-.= C, L_#--Ts0tt-.= 43 1C;ravL--I [DIL- ptl-1= :3
The length dimension is the length (in feet) of the trench or drainfieid.
The depth of a trench or pit is the distance between the surface of the
ground and the bottom of the excavation (in 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 excavation (in feet).
Requi red Septi c TaT-ti4c Si = e= 1flC}O {aa1 I aT•rs
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the
number of residences that the well will serve.
--- TWO CZ S INSPE{OTI C]NS ARF RE4UIRES ---
Backfilling of any system without final inspection and approval by this
department will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is
100 feet for a private well or 150 to 200 feet from a public well depending
upon the type of public well.
Minimum distance from a private well to a private sewer line is 25 feet and
to a community sewer line is 75 feet.
Well logs are required and must be returned to the department within 30 days
of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
Permit expirress. (December- 331. 1'3H1
I certify that
1: I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage.
2: I will install the system in accordance with the codes.
3: I understand that the on-site sewer system may require enlargement if the
residence is remodeled to include more than 3 bedrooms.
SIGNED:_
APPLICANT BILL TAYLOR — —
ISSUED BY_____—DATEL_J 2 - 9 1 ____ V4.0
!'NICIPALITY OF ANCHORAGE
Department u, Health and Environmental _rotection
r' 825 L Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT
WELL AND/OR ON-SITE SEWER PERMIT
Applicant: Mailing Address: /L/,•f3 Gc1 • sir 'F 3a�1
Location: �- � -�`� Phone Number: 1 -7
Legal Description: 3� �n ��`'��- Lot Size:
Type of Soil Absorption System Is:
Trench: �i _ Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH LENGTH. GRAVEL DEPTH WIDTH
The length dimension is the length(in 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(in 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 excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE _ %� a b GALLONS
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee-
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) 1 will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the ri ce modeled to include more that 3 bedrooms.
Signed: Issued by: 24
o'
Applicant
Date: 6 Z/��'�
SWP/024(1/81)
• O & E ENC. AEERING & DEVELO MV WT CO.
Box 90. Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russett Oyster Earl Ellis
694-2774 SOIL LOG 688-2280
-77
Performed for: Name: <- y�' �� Tel. No.
Mailing Address: I'M W. e?Srl I #F.0/� 4/V61161*9crE,
Legal Description: La7- 3 , /SGUCK Z , ESTATES
Depth (feet) Soil Characteristics
0
1
2 ML - 5147- /or Se/Z
3
4
e -7-p-
5—
p — S9/V/�: taCQ //,EG, �PfSC6 S
5 �! ee 0,1_0 70
7
6 �M 5/c rY GQ.9c��L
s/.e.: �.E/vs�
P./LOT PLAN
10 _ o� jCgLE
11 Ec+TrOlt/ D F / o u / T
12 —
13 — PERC. TEST
14
15
16
-= OF qt hk.
Ground Water Encountered: Yes No If yes, what depth r x f491�
00.••i••xrymuau•( • R.•.
Proposed Installation: Seepage Pit_ Drain Field ♦ '/L �F� ���
Elllr :45,
'L
7
'RETURM 70: Olvlslon o/ Geological ai/ S^yvlcel survey, OF ALASKA
y. (OGGSI 1 DEPARTMENT OF NATURAL RESOURCES
7001 Polavpine Drive (T ane 277.1-615)
Anchorage. AlaskA 99501
"1 Co.pany Na.e W A T E R W E L L R E C 0 A 0
ling
' DrilMarnuson Drilline
Pr.... cepolete eitivtr I.. Ib. or Is.
U.S.G.S. Local Ho.
Or111In9 Per.lt No.
A.D.L. Ib.
1• brougn �_--
Anch
Subdivision
Deer Park
lot
3
Rlock
2
Ib. Fractlon
/ / /
Section No.
Township
x/s
Range
E/V
Mer idlan
Ic. Distance and Direction froM Road Intersections
Street Address and Are, of Well Location
3. OWNER OF WELL: 2t^ Till Taylor
Address:
NcTay Const,
Anchorare Ak
2. WELL LOG Feet 9alav
Surl,ce
Material TYoe tooztto.
4. WELL DEPTH: (co.pleted)
62 It.
Surface Elevation
-
Date of
Completion
7-81
Gravel
S. ❑Cable tool XoA.tery ❑Driven ❑Duq
❑Auger ❑Jetted ❑llured ❑Other:
8n
Ay, grave
6. USE: YoDomrst is (3 Public Supply ❑Industry.
❑ Irrlg,tlon []Recharge ❑ Coesrcl,l
❑ Test Well ❑ Other:
Waters gravel
7. CASING: ❑ Threaded X)�qW.Ided
6 in. to Ju—ft. Depth Weight 17 bsirt.
In. to _ft. Depth
0. FINISH OF WELL:
Ty.,Open Hole ola.eter: 11
Slot/Mesh Size: Length:
Set bet.en ft. and ft.
Fittings:
9. STATIC WATER LEVEL: ft.
❑Above ❑llelor land surface
Type of Measurement:
10. PUMPING, LEVEL beloN land surface
ft. after hrs. Dump Ing g.p.m.
ft. after hrs. pupping g.p.m.
11. WELL MEAD COMPLETION: ❑ In Approved Pit
❑ Pltless Adapter Inches Above 911de
(
12. GROUTING: Wall Grouted: ❑ Yes ❑ x.
Mterlal: ❑ Neat Cement ❑ Other:
13. PUMP: (If available) HP 1
Length of Drop Pipe 52 ft. Capacity g.p.
TYPO: X® Submertlble ❑ Reciprocating
11 Jet ❑Other:
14. REMARKS:
Pail tested at 10 GPM/
IS. WATER WELL CONTRACTOR'S CERTIFICATION: -H in.S[5 d
This cell ws drilled under my jur lsdict inn and this report is true to the belt of .y krxa 1049e and bel [of:
Magnuson Drilling AA 5385
.9Oyu rrd u. n." N.Me ..tract L•,.n.a humoer
Addr.,sP C 504 Laae River. Ak.
figneJ: f{a�',�a—���►��' • e �Z Date: J111ys 19 1
Aulnurxa Rrpre unutry _ .
•
• Municipality of Anchorage ..,",J �=°•
��
•
c ,..°`'i--On-Site Water&Wastewater Program .. < Q i , 1-
(907)343-7904 u c) ' 7 s, `r.
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r
'� ice!'r
CERTIFICATE OF ON-SITE SYSTEMS \ ROVAL
Q
Ni 6
Parcel I.D. 051-042-50 Expiration DatUt.1----.-.c� �i. it
1. GENERAL INFORMATION
Complete legal description DEER PARK SID; BLOCK 2, LOT 3A
Location (site address) 22306 DEER PARK DRIVE, CHUGIAK,AK 99567
Current Property owner(s) CAROL MARCHANT Day phone 907-355-5866
Mailing address P.O. BOX 773603, EAGLE RIVER,AK 99567
Real Estate Agent DENNY WOOD W/KELLER WILLIAMS Day phone 907-337-9663
2. TYPE OF DWELLING:
111 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well I Individual On-site III
Individual Water Storage n Individual Holding tank ❑
Community Class Well n Community On-site C
Public Water System n Public Sewer n
WaiverNariancerequest for.. DRAINFIELD TO FOUNDATION Distance: 7.5 FEET
Received by: _ IV Date: 34/0
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee$
5 Waiver Fee$ 2..15-
Date of Payment 3l V-/- 7 Date of Payment 3122/1 /
Receipt Number et 040s311 -) Receipt Number Q1/04G)
COSA# 050.71 !O2 Waiver# 63VI2l60
•
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On-Site 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-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 GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD,SUITE 101 *ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A. GARNESS,P.E. Date 3/ 24)/(a,
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septi:system in accordance with the .,.��11X%ail,1
guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the 4 \.j` ( 4�♦
condition of the systern/s on the dates of the evaluation.Separation distances were measured to readily identifiable features. �
Hidden defects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septic 41•, ;.' .•••'�'•. ♦�•
systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during �••• .•
the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the systems.These = 4. ' I\ *•�0
conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the ■ 49
systems;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. ■( 0
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the 0. , .1„ •
current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the #, e r-y A. - ess .4�r
information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not ♦ C3 :, 4v i
i
authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. #. 11 ... E-7 53 .;'ZI
6. DSD SIGNATURE ...Fp r—•••' . 44.
14ROFESS\� �4
LICENSE ,i1li"".4
#AECC884
A System#1 Approved for bedrooms. �� y� OF A/
System#2 Approved for bedrooms. AQP 60,10
`9
Disapproved. := ONWATER-SITE Gam.
4 AND z
Conditional approval for bedrooms,with the following stipulatib...r.: WASTEWATER O.
OGRAM _'
.qr—TifteA
M� I I u S �/ c . I'S 2 ,•1e �i' F:9\I`G5
By: vim.- Original Certificate Date:
The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS: •
COSA Checklist• .. Nitrate Advisory
Septic System Advisory Arsenic Advisory . .
Well FIow.Advigor i. Other -
• 'r�..
• •1. • .. • .. jr i,
(Rev.10112/12)
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: DEER PARK S/D; BLOCK 2, LOT 3A Parcel ID: 051-042-50
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 7/1981 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 62 ft. Cased to 62 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 7/1981 3/19/2018
Static water level NOT GIVEN ft. 38 ft
Well production 10 g.p.m. 5.8 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 ml. Nitrate 3.92 mg./L. Collected by: GEG, Ltd.
Arsenic: ND ug./L. Date of sample: 3/15/2018
B. SEPTIC/HOLDING TANK DATA *DUE TO AGE OF TANK,THE STEEL SEPTIC TANK MAY BE REACHING ITS LIFE EXPECTANCY.
/**CLEANOUTS IN CRAWLSPACE.SHOULD ACT AS A FOUNDATION CLEANOUT (SEE ATTACHED PHOTOS)
Tank Type/Material Se L% *STEEL Date installed *7/16/1981
Tank size 1000 gal. / Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout(Y/N) **NO Depression over tank(Y/N) NO High water alarm (Y/N) N/A
Date of pumping 3/19/2018 Pumper ARM SERVICES, LLC --
C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE (SEE NOTE*')I
Date installed 7/16/1981 Soil rating (g.p.d./ft2or t/bdrl� 85 System type SHALLOW TRENCH
Length 43 ft. Width 4 ft. Gravel below pipe 3 ft.
Total depth */**6.58 ft. Eff. absorption area 258 ft2 Monitoring tube **YES Depression over field NO
Date of adequacy test 3/19/2018 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added*1240 gal. New depth ***5 in.
Elapsed Time: 14 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date -
**NOTE:THE SUMP AT THE END OF THE DRAINFIELD DOES NOT EXTEND TO BOTTOM OF DRAINFIELD.-15 INCHES OF EFFECTIVE IN SUMP
(INVERT OF DIST.LINE TO BOTTOM OF SUMP) . INVERT-64"BELOW GRADE.ADDED ADDITIONAL WATER TO DRAINFIELD TO INSURE
PASSING SEPTIC ADEQUACY TEST.PRIOR TO TEST,HAD PUMPER SUCK DEBRIS/LOOSE DIRT FROM SUMP.SUMP WAS DRY PRIOR TO TEST.
***THE LAST 607 GALLONS INTRODUCED ONLY CAUSED 1.5 INCHES OF RISE.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at '• wa er alarm level at in.
_ _•• Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation *7.5+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
`WAIVER REQUESTED-SEE ATTACHED LETTER AND DRAWING.
•
G. ENGINEER'S CERTIFICATION
i*, .*.1
I certify that I have determined through field inspections andg
I
review of Municipal records that the above systems are in • i
•
conformance with MOA COSA guidelines in effect on this ••� : l •1�e ; tt•
date. •�r J ff `c. Garness::kki=
JEFFREY A. GARNESS •• ",% E-795 'a
Engineer's Printed Name .♦4, , /Z, (§D*.
'zi
Date 2 i'I LICENSE ,.-4•.
\ - w
RAECC884
(Rev.10/12/12)
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G •"Y .:. 4gt. :7
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'o Duane Mark Sewer
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- ----"e--;111----1- ?%r'4°- -?%/ 25'
��-�c/Q rfr As..BUILT No corners set this date
I hereby certify that I have performed a Mortagee's in-
EASEI4 NTS OF RECORD, OTHER THAN THOSE SHOiNN ON THE
RECORDED PLAT ARE NOT SHOWN HEREON. spection of the following described property:
Deer
Park Subd., Lot 3A, Elk. 2 '
The information hereon is for the use of lending Anchorage Recording Precinct,Alaska, and that the improve-
institutions showing the 'relationshi of existingments situated thereon are within the property lines and do
P "not-overlap or-encroach on the property lying adjacent there,
structures and platted easements and lot lines. to, that no improvements on property lying adjacent thereto
It is not to be used for positioningencroach on the premises in question and that there are no
additional roadways, transmission lines or other visible easements on
structures or fencelines. said property except as indicated hereon.
Dated at Anchorage,Alaska
.,4/TE' this 18 day of Sept. 88
'_ / . 19
,'• 9/8-6aE
.i.=fJL // F.c9' Circe/�,'
1-170 -?"? 4'./'/SS6' SEWARD & ASSOCIATES LAND SURVEYING
•
141
GARNESS ENGINEERING GROUP, Ltd
ENGINEERING SALES CONSULTING
March 21 , 2018
Municipality of Anchorage
On-Site Water and Wastewater
4700 Elmore Road
Anchorage, Alaska 99501
Attn: To who it may concern
Re: Waiver from Drainfield to Foundation for Deer Park S/D; Block 2, Lot 3A
While performing an adequacy test on the septic system for the referenced property, we
measured from the center of the sump standpipe to the edge of the foundation to be 9'-
10". The standpipe is leaning toward the foundation; however, the separation distance
between the sidewall of the drainfield and the foundation appears to be less than 10 feet
and will require a waiver. Attached is a profile drawing which shows a cross-section of
the drainfield with the approximate relation to the foundation. We shot elevations of the
invert of the distribution line in relation of the top of the footer in order to confirm if there
was any concern with the wastewater from the drainfield influencing the foundation.
Based upon these elevations, it appears that there is no to little risk with the wastewater
influencing the foundation. Based upon our calculated measurements, it is estimated
that there is 8.25 foot separation between the sidewall of the drainfield and the edge of
the footer below grade. In order to be conservative, we are requesting a 7.5 foot
separation distance waiver from the drainfield to any portion of the foundation. It is our
opinion that there is minimal risk with the granting of this waiver.
Please do not hesitate to call us at 337-6179 if you require further information. Thank
you for your time and consideration.
Sincerely,
Q . Garnes,, s, .E., M.S.
Pres1i�e
U
3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179'Fax: (907)338-3246'Website: www.garnessengineering.com
iiiii_
Municipality of Anchorage
\.. ./ I) partln ;it
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http://www.muni.orq/Onsite
Development Services Department
On-Site Water and Wastewater Section
**** VARIANCE/WAIVER REVIEW
Waiver#: OSV181010 COSA#: OSC181102 Permit#:
PID#: 051-042-50
Legal Description: Deer Park Block 2 Lot 3A
Engineer: Garness Engineering Group
Applicant: Carol Marchant
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the foundation has been approved. The approved separation distance is 7.5 feet. See
engineer's letter and profile drawing for justification.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
r
Waiver is Granted: X Waiver is not Granted: •
_Ai a ji,"
Date: *28,7/8 8 Approved by: ✓`eitt,C'A
•
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
TOP OF FOUNDATION WALL=100.00
9'-10"(EDGE OF FOOTER TO CENTER OF SUMP PIPE)
TOP OF PIPE FOR SUMP=98.36
LANDSCAPING TIMBER
EXISTING GRADE
;a.
8.25(REQUESTING A 7.5 FOOT WAIVER) SUMP STANDPIPE LEANING
'.' � APPROXIMATELY 1 FOOT
y;; TOWARDS FOUNDATION
\-
BOTTOM OF FOOTER=96.00
(NOTE:ASSUMED 48"BELOW
TOP OF FOUNDATION WALL)
r!:yTr� �y7 .yry7v w p
ji1g1z1:1:1a1 '.,;I:I. 1�1.;1.;'-q
j e-..-.-1_ :1F:1:1:1�11.
1.1�1�1:1.1:1 :`!.101.1 40
p1.1,= 1:11 °Ij1j1a1;1��
•
Ii1:1:1j1�1:1; -.j1.1:1�1f.
.�-.•. .� � •�-..= . �._.�-�._.•'• 36"PER
INVERT OF DISTRIBUTION LINE ti1i1�4!_j• ! 1�f•1�1;1�1.1yl INSPECTION
=93.03(APPROXIMATE) I�1�1�1�1je1jiAA1A1A-fes. REPORT
ty1.1.1.1.1.1:1.1.1..1.1.1:e
0110:70:710:10:710i#:710:10:71014
►_1_1:1_1jO
•sIT
•j . 1li.1.11.1► 1.1,.ft1:o
BOTTOM OF SUMP PIPE
ON 3/19/2018=91.78
ASSUMED BOTTOM
OF DRAINFIELD=90.03
SCALE:lil f--48"PER INSPECTION REPORT
1"=2'
..\\\\\\,I
4•7 oF
44.
VA
\ •* ..
GARNESS ENGINEERING GROUP, Ltd •r ' 9I �: ••
:saNiir CIVIL&ENVIRONMENTAL ENGINEERS /A� 0
3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE,AK 99507•PHONE(907)337-6179•FAX(907)338-3246•WEBSITE.www.gam essenginooring.com • -- V
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 ;ffr: •A.-Gam •
ess• ,
CAROL MARCHANT 355-5866 1 OF 1 II
•4.�J,�: FE-79r
PROJECT/LEGAL DESCRIPTION: DRAWN BY: ..< ••.• �I• 3. c•4,
DEER PARK S/D; BLOCK 2, LOT 3A J.L.M. •I pR•'�'•••• 1�P�-�.
TYPE OF WORK: 1 ESS ••
PROFILE FOR DRAINFIELD TO FOUNDATION WAIVER DAT 3/21/018 #AECC884 11���\\\��
O MUNICIPALITY OF ANCHORAGE
• Department of Health t4 Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. q r,, % \ -K_�LV l�U HAA b 1 I
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
LOT 3J)13LOCK 2• DEER PARK SUBDIVISION
Location (address or directions)
DEER PARK DRIVE
(b) Property owner A.H.F.C. Telephone: (home) Business
Mailing Address 520 Ea6t 34th Avenue Anchokage A. 99504
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent RE/AIAX OF EACLE RIVER ATTN• Eva Laken
Address 46600-Cewte46ieYt!-D4ive—X203—€agte-Rive4y-AK-99
Telephone 694-4900
(e) Mail the HAA to the following address: (or check hereZK9f hold for pick up.)
List contact person and day phone number below:
S S S ENGINEERING
17034 East* River loop Roaij1Ie,204
Eagle River, Alaska 79577
2. TYPE OF RESIDENCE
Single-FamllyXX Number of bedrooms ___3-
3. WATER SUPPLY
Individual Well J( Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to in legality and status.
4. SEWAGE DISPOSAL
On-site Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-02Sjne..7i8e1 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/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 Telephone r2 UZ_;7 l7
Address 17034 Eagle River Loop Road No. 204
Eagle River, Alaska YY377
Date
,........ _.r.
�., & Wv*
/rp�s5t�� e
6. DHHS APPROVAL �_�ezx
Approved for�._bedrooms by ZtDate J�Oe
OL
Approved OL Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Municipalityof Anchorage Departmentof Health and Human Services (DHHS) Issues Health Authority Approval
cerificated based onlyupon the representations given in paragraph Sabove byan 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
oranalyze data before a certificate is Issued. The Municipality of Anchorage is not responsible forerrors or omissions
In the professional engineer's work.
72 025 (R.+.?/U) BaCk Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
•�./ Health Authority Approval (HAA)
,..;CHECKLIST - FEBRUARY 19E
r.,.......,.,. ;vicsc'1;1cN343-4744
Legal Description: _Lot'3 ISIL4— -Z—
]-"9 1-9
A. WELL DATA RE CEI VE D`¢ Yom- VV ../L
Well Classification OtU 1 P3 pct _ If A, B, C, D.E.C. Approved (Y/N) t1
Well Log Present (§%N) Date Completed -7 f3 ( Yield
t
Total Depth bZ Cased to bZ Depth of Grouting
Static Water Level Pump Set At I�1L
y
Casing Height Above GrouSanitary Seal on CasingQY7N)
Electrical Wiring in Conduit (ON) Depression Around Wellhead (Yip r'
SEPARATION DISTANCES FROM WELL:
t
To Septic/Holding Tank on Lot \ \S ; On Adjoining Lots t
t (
To Nearest Edge of Absorption Fier1 lr} q�,n Lot \ ! ; On Adjoining Lots
To Nearest Public Sewer Line r" To Nearest Public Sewer Cleanout/Manhole N
To Nearest Sewer Service Line on Lot
Water Sample Collected by S't S Date — f::kk _ Vzj _ v ,
Water Sample Test Results :�— S --
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed — 'gt Size L and No. of Compartments Z
Standpipes (WN) —Air -tight CapsgY7N) _Foundation Cleanout (Y/IG)
Depression over Tank (YQ Date Last Pumped 9 14 "
Pumping/Maintenance Contact on File (Y/N) a ; for
Holding -Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
t
To Water -Supply Well is To Building Foundation 23
i
To Property Line o tA_ To Disposal Field 5
To Water, Main/Service Line t d
To Stream, Pond, Lake or Major Drainage Course
t
Comments
72-026 )Ray. T/N) F,wn Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Type of System Design 071
Date Installed Length of Field
Width of Field Depth of Field 1,2,S
Gravel Bed Thickness
Square Feet of Absortion Area $
q Statndpipes Present (tYN) - V
Depression over Field (Y/,V) Date of Last Adequacy Test
Results of Last Adequacy Test S�"n S ra—�f-J—
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well X k S* To Property Line V �
To Building Foundation/ 22 To Existing or Abandoned System on
Lot o ; On Adjoining Lots .3--b 1.4 -
To Water Main/Service Line l o t,r To Cutback (if present) a
To Stream, Pond, Lake, or Major Drainage Course ( oo I'4"
To Driveway, Parking Area, or Vehicle Storage Area "� S
Comments
D. LIFT STATION
DatoIns`talled —
Size in Galiona�
"Pump On" Level at
IN
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Check Permitted Bedroom Rating Against HAA Request"
"Pump Off" Level at
Vent(Y/N)
Pumping Cycles during Adequacy Test.
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect
Inspection.
Signed S & S ENGINEERING r
Company F,nje River,Alaska 99577 r
G r
9 O /� 7 ~
Date r
� 3
MOA No.
RJ
Receipt No. 1ny17/8�2 9
Date of Payment
Amount: $
72-048 )R". 7/88) Beck
Receipt No. _
Waiver Fee: $
Date of Payment
Page 2 of 2
of this
h.
b.q 0. 866,
td%4
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services a
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # 651=472-��
HAA # 069, — L59 'IJ
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Deek Pakk S r6 ;v Aicn
Cer�Crrs( lr < iG D3 jl,i7�
Locatltn (address or directions)
(b) Property owner A_ N_ F_ C_ Telephone: (home) Business
MailingAddress590 F_ ;4th'Anrhn)n7ge_ APr7Abn 99-W.
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent RF A1Av Fun I Oka"
Telephone
Address 16600 Centex6iefd Drive 0201 Eaqte Riven 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:
5 & $ ENGINEERING
17034 Eagle River Loop Road No. 204
Fanle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family Q
3. WATER SUPPLY
Individual Well EX
Number of bedrooms 3
Community ❑ Public ❑
_Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site IN Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 JRw. 7M) 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/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
Telephone
5 & 5 ENGINEERING
Address 170.14 F.niw River—Ip R—d Pic g
Date
Eagle River, Alaska 99577 / [,
6. DHHS APPROVAL
Approved for 3 bedrooms 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
cranalyze data beforea certificate is issued. The Municipality of Anchorage is not responsible forerrors oromissions
in the professional engineer's work.
72-025 (Rat. 7/88) Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA) SEP 14 1988
CHECKLIST - FEBRUARY 1984
284-4744 E C E I V E D
Legal Description: ",r'
' ��t�oc
A. WELL DATA Cdi�'�'� t77-AfF;)
Well Classification ��ad1DyA�� If A. B. C. O.E.C. Approved (Y/N)
Well Log Present 19N) _-)— Date Completed 7- 81 Yield 3 •Z C Pel ')
Total Depth tol�' Cased to
Depth of Grouting
Static Water Level 36r
Pump Set At (�1L
Casing Height Above Ground 'L
Sanitary Seal on Casing(VAN)
Electrical Wiring in Conduit&N) !
Depression Around Wellhead (YA15P ►-i
Separation Distances from Well:
I
To Septic/field ng Tank on Lot
On Adjoining Lots
1
To Nearest Edge of Absorption Field o� Lot 1 15 ; On Adjoining Lots cnl� ( 4
To Nearest Public Sewer Line a
To Nearest Public Sewer
I}
Cleanout/Man6le
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Date 8' ?A - PSB
Water Sample Test Results �"FiSFGr�r[
-y '�'Jtx� 4 r-1
Comments
B. SEPTIC/901:1)MQ TANK DATA
Date Installed J'1'P-H Size ,Ct70 No. of Compartments Z
Stand pipes 6l) `� Air -tight CapsgPN) ~r Foundation Cleanout (Yds a
Depression over Tank (YiW Date Last Pumped e
Pumping/Maintenance Contract on File (Y/N) ; for
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/H`0kW;g,_Tank:
I
To Water -Supply Well
To Property Line
To Building Foundation
23 r
,- r
To Disposal Field �
t
To Water Main/Service Line •~ To Stream, Pond, Lake, or Major Drainage
Course
Comments �S cj�FOO
L- �Jr-0P IrJFn.
Page 1 of 2
72-026 IPry 0 MI PoM
"0]11;•1.144112iP1IIiff4Ro1ZiZl
Soils Rating in Absorption Strata ES�ta— Type of System Design
Date Installed 1 110 — 61 Length of Field
1
Width of Field Q t Depth of Field r✓
Gravel Bed Thickness 3
Square Feet of Absorption Area Standpipes PresentfP/N)
Depression over Field (YO Date of Last Adequacy Test ' ' 1-43 — $
Results of, Last Adequacy TestRte--
Separation Distance from Absorption Field:
r
To Water -Supply Well 115 To Property Line 1 0 ',
To Building Foundation To Existing or Abandoned System on
Lot ; On Adjoining Lots 30 14'
1�
To Water Main/Service Line To Cutbank (if present) .-• LN
To Stream/Pond/Lake/or Major Drainage Course (-F'
To Driveway, Parking Area, or Vehicle Storage Area 5 r
Comments
D. LIFT STATION lv
Size in Gallons
"Pump On" Level at —
High Water Alarm Level at
Tested for
Electrical Codes (Y/N) _
Comments -
— Dimensions
Manhole/Access (Y/N) —
_ "Pump Off' Level at
Vent(Y/N)
Check Permitted Bedroom Rating Against HAA Request ••
Cycles during Adequacy Test. Meets MOA
Icertify that Ihave checked, verified. orconformed toall MOA a dHA,A guidelines in effect on the date olthis inspection.
Signed Date /Z
ENGINEYK
Companr7o34EagtaRlvsr_Lr"PRoad okb 4 No. 00 3
ia as 9 , 77 ���.�♦
ReceiptRiver
f: OF -
Receipt
f3 CQ•(• ...,,• S �l
Date of Payment y .; • ••..A •�'fi'S7�
or
Amount: $ 1-70 - 02 / x e1 t
Page 2 of 2
.1
72 PPG IR. 8 861 RACk
JL ib&'Fer
No. 1457: J
� Sal L)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL r J4 %,2i
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date
1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdiv�Sl'on, section, t nship, range)
1& -IDA Or— ' 'ti 'lz_
Location (address or directions) \
(b) Property Owner &4-,A 1 A'IAIIi Telephone: Home
Mailing Address
(c) Lending Institution
Mailing Address _
(d) Real Estal
Address
Telephone
Business Z ?tP - S59S
Telephone l'5N--iZoO
(e) Mail the HAA to the following address: or: Check here hold for pickup.
List contact person and day phone number below.
S a e ENGINEERI
17034 Eagle River Loop Road Id -
Eagle 9�
Iver, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family Ga",
Number of Bedrooms 3
3. WATER SUPPLY —/
Individual Well O Community O Public 4i
Note: If community well system, must havewritten confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DIS P SAL
Onsite Public O Community13 Holding Tank O
Note: It community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 n-o?S IRP. 8 861 F.om
rove (98,0 ••ep Selo-& ' , Z 10 Z a6ed
'Niom S,jaau16ua
teuolssalad ayl w suolsslwo jo siaia jol alglsuodsai lou sl a6ejoyouV to Alledlopnpy ayl •ponssl sl aleoilluao a ajolaq
elep az(leue jo suolloadsul lonpuo0 lou op SHHO to saaAoldw3 'sluawailnbai alels pue lejapal u!epao A sues of japio
ul suollnl!lsm 6ulpual jlayi pue sawoy to siaseyojnd of AsaUnoo a se slylsaop SHHO ayl'eMsely to ale1S a4l ul paialsl6ai
iaaul6ua leuolssalad luapuadapu! ue (q anoge S ydeAeied w uaAlb suolleluasaidai a41 uodn Aluo paseq saleollNao
lenaddV AluoylnV 4lleal-1 sanssl (SHHO) saolAlaS uewnH pue y11eaH to luawpeda0 abejoyouV to AUledlolunyy a41
ee
B•1541 *ON
jWgS •V 1+•9x%
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leuo l!puo0
IenaddV leuoll!puo0 to swial
panaddeslO—�x- panaddV
ale0 tq sw000paq (2)VV iol panaddy
i
IVAOHddV SHHO '9
G i o LLS66 m]jS@IVJ0AIjf 91883 ele0
tnr •n.. nnniicool MAIy.41SR3 not SsaippV
VNIH33NION3 S I S
suo4dola.L wnd to aweN
•uo!loadsu!slyllo atep a41
uo papa ul suogeln6ei pue'saoueulpio'sapoo ale1S pue ledlolunlry Ile yl!m eouelldwoo ul sl walsAs lesodslp jalemalsem
Lo/pue (lddns jalem al!s-uo a41 'uolloadsw pue u01le61lS3nul tw woil pue sale a6eio4ouV to Atledlownyl a41 wwl
paulelgo uogewolul 041 uo paseq leyl AuaA layvnJ 1'ulajay paleolpui ainlonils to adA pue swowpaq to lagwnu ayl iol
alenbape pue leuollounl ales sl wals (s lesodslp ialemalsem io/pue (lddns ialem al!s-uo ayl leyl smogs Ienadd V A1uo41nV
y11eaH slyl to u01le61lSanul .(w 1e41 A 18A I'molaq UM04S alep uollep!leA 04110 se pue olaiay paxlll , leas Aw ,(q palllyao sV
NOI1VWtlOjNI CNV V1V0'H:)UV3S 3IId'SIS31'SNOI103dSNl ONtOIAOUd Wtll3 JNIH33NION3 'S
n
M,NiG?hUi-r CMUNICIPALIT,y OF ANCHORAGE (MOA)
ENvI -HEALYH %WTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
( 2 1987 2644744
D Legal Description:
R�Ce1VE
A. WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth —
Static Water Level
If A. B, C. D.E.C. Approved (ON) Y ` S
Date Completed
Yield
Cased to Depth of Grouting
Casing Height Above Ground _
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
r
To Septic/H=M Tank on Lot ,// -� ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot y / $ / ; On Adjoining Lots —
To Nearest Public Sewer Line
Cleanout/Manhole _
— To Nearest Public Sewer
To Nearest Sewer Service Line on Lot $ r /-
Water Sample Collected by Sa"C' Date
Water Sample Test RS
1esults AT r S/-/tc_?i92✓
Comments V,� 1JAry,-rz- %-V Pic—LE LO (i -I
c >r 5. Ed l/r4. if C'
B. SEPTIC/HOLDING TANK DATA
Date Installed jk -,re -61 Size /cOO No. of Compartments Z
Standpipes L9N) Air -tight Caps &N) Foundation Cleanout (Y/17j)
Depression over Tank (Y/P Date Last Pumped
Pumping/Maintenance Contract on File (Y/N)—� AN ; for
Holding Tank High -Water Alarm (Y/N) J r ' Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Well
To Property Line _
To Building Foundation-;/
To Disposal Field S r
To Water Main/Service Line /Ort To Stream, Pond, Lake, or Major Drainage
Course —
Comments
Page 1 of 2
77-0-6 fRr F W1 From
Zt
C. ABSORPTION FIELD DATA
g58.9
N
*0,0,
a
Soils Rating in Absorption Strata 5S/W911• Type of System Design %3z1
Date Installed 8 f Length of Field y3r
Width of Fieldy q' r
� Depth of Field � •3
ravel Bed Thickness 3 r
Square Feet of Absorption Area Standpipes Present (P/N)
Depression over Field (Y/ Date of Last Adequacy Test `! - L 6 -8:j
Results of Last Adequacy Test S a T +s r- n c. i»2 i F-02 3 Rp_ �l
Separation Distance from Absorption Field:
To Water -Supply Well _
To Building Foundation
Lot
To Water Main/Service Line
To Property Line 401.1
To Existing or Abandoned System on
On Adjoining Lots 3J�-/
— To Cutbank (if present) 'YEa
To Stream/Pond/Lake/or Major Drainage Course ' I ps
To Driveway, Parking Area, or Vehicle Storage Asea
D. LIFT STATION
Date Installed Dimensions
Size in Gallons Manhole/Access (Y/N)
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N) _
Comments
'Pump Off' Level at
Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
•• Check Permitted Bedroom Rating Against HAA Request •'
I certify that I have checked, verified, or conformed to all MOA and HAA guideli nes in effect on the date of this inspection.
SigneS 8 5 ENGINEERING Date 40
-/ B 7
17034 Eagle River Loop Road No. 204
Compga�la"Rivar,Alaske-99577 MOA No.
Receipt No. .2- - D O / .Q O.)- f
Date of Payment /,0/1"/�
Amount: $
Page 2 of 2
72.026 (R. P'PAI pAck
_y7 003
E
OF
nSTEVE COWPEI� GOVERNOR
DEPT. 0 F ENVIRONMENTALCON5ERVATI ON
ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775
3601 "C" STREET. SUITE 1334
ANCHORAGE, ALASKA 99503
DATE: _QCiII1zEC_2�_14$Z__
PWSID #: __C1a55_C___------
To Whom It May Concern:
According to the records on file in this office, the _Lai_S�_@lath
2..--0EE8__26RK-5UBQ1YISIQd____ Water System is in compliance with
the State of Alaska Drinking Water Regulations.
Sincerely. C—
1
Ronald S. Klein
Environmental Field Officer
O,1t c c� I '}-
5. LEGAL DESCRIPTION
DATE RECEIVED
I . 11 INSPECTION APPOINTMENTS
DcGr�e.rk s,,b. /JL
TIME.
TIME
TIME
NUMBER OF,BEDHOOMS
C '\TCL P•
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE
DEPT. OF i -' 2.
�\ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI N a
1 4,.�IecN ,L 1: :..iLcrcN
625 L Street •Anchorage, Alaska 89501
I •
ENVIRONMENTAL SANITATION DIVISION SEP2.; , �r
j Telephone 2644720
RFC F
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER NUN' Y6 D
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
PHONE
v-)Alg-. for
-277-738
MAILING ADDRESS
1473 W >S41^ -1fr 30M• o.I.o 14>_'. Q95"03
PROPERTY RESIDENT (If different from above)
PHONE
2. BUYER
PHONE
LOII I Imo.., k '% a-Iil
MAILING ADDRESS
6e'ller o3' No.we' -t•4n: N�eL�cle-• C�vte.il�i-
3. LENDING NSTITUTIONPHONE
MAILING ADDRESS
(J�e
4. REALTORIAGENT
PHONE
27G �n
MAI LING ADORESS
o Ar_
O,1t c c� I '}-
5. LEGAL DESCRIPTION
/
I o t 3 B1K- 02—
DcGr�e.rk s,,b. /JL
STREET LOCATION
6. TYPE OF RESIDENCE
NUMBER OF,BEDHOOMS
❑ One ❑ Four ❑ Other
SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
Pd 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 UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE"
/9g i YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72.010(Rev. 6/791 s ���
M
72010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLEFAMILY
O MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE O THREE ❑ FIVE ❑ OTHER
O TWO ❑ FOUR O SIX
2. WATER SUPPLY
❑ INDIVIDUAL
O COMMUNITY
O PUBLICUTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
0INDIVIDUAUON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
INSTALLER
❑SepticTankor OHoldingTank
Size: . If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
JrAPPROVED FOR BEDROOMS
O CONDITIONAL APPROVAL (letter must accompany certificate)
O DISAPPROVED
DATE17�. /Dr/1-�%
M
72010 (Rev. 6/79)
APPLIC"IT FILLS OUT UPPER HAI" -'ONLY
Time
Properly O �.er C<� 1 1 (� p,/�w.+r 1-+ k Yl Phone
Mailing Address
Zip Code
}.y. �A
Buyer q r, i'�-�2_ \ t �. 1 "� VA r,j' y
•
Address 10 It V fX O Y' ti (,1, 43
f�
- Y Zip Code / '7 S -Z)
Lending Institution !� S KR /-1 ,,_rL, dt-I
•�
Oate. r�
s
Inspector
Address ^
r zip Code
/Phhone
�7 �7
61 q-
Really Co. d AA ntPhone
S,
1 r c r 0 L,_-�ca l%
Field Notes: V
Address '
Zip Code
563-365
Legal Description L 3 A 6 -D— DSC Y
Pyr LL t_$T�.f�.S 612(67 SIA"
MAY 2 01983
�.-� S C Q_
Street Location
\ v'
Type of Residence
1�6ingie Family '?
�.1 Multiple Family No. of Bedroom
Ci Other
Water Supply
APPROVED BEDROOMS 3
>�Ondlvidual
jFtIs
H WELL LOG. A well log Is required for all wells drilled since June 1975.
L Community
dllled prior to that tlete, give well depth (attach log if available).
Ci Public Utility
DATE
Sewer Disposal
1; J dividual
Year IndivNual Installed: ��/
f 1 _Public Utility
When Connected to Public Utility:
0 Holding Tank
Soils Rating
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Date
Date
Date
•�
Oate. r�
s
Inspector
Inspector
Inspector
Inspector
Field Notes: V
Nr�l �OW(r D1UU U IL7 D
M
MAY 2 01983
"Municipality of Anth9*a�a"
•'Dept. of Health E
En*Ct"Incnlal ••
APPROVED BEDROOMS 3
'CONDITIONS OF APPROVAL
DISAPPROVED
CONDIT L APPROVAL'
�� � p�
DATE
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area ISS—
Well Log Received LAILD
Septic Tank Size 10v
$S
, _ %, _(i
Well to Tank
i]a1)rren
Municipality
Of
Anchorarse
n ))L.. tv-Ji-81
325-1-:1L-
:1tFT Pr l•
ANO t, )RAGE , ALASKA X19';01
(501; ; 64 41 1
nrPAfcrmfr.EofII: .vcI'%i Er,vi^Ur^.!NfAIPHOTPMON
September 23, 1981
William F. Taylor III
1473 West 25th Avenue #304
Anchorage, Alaska 99503
Subject: Lot 3 Block 2 Deer Park Estates Subdivision
Approval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1) The water analysis report needs to be submitted
to this office from the Chem Lab, 5633 B Street,
/ for our review.
(2) Exposed electrical wires to the well head are in
violation of the Municipality of Anchorage codes and
must be encased in conduit.
t).\/L�
(3) The standpipe on the septic tank is in need of repair.
(4) The area over the septic tank needs to be filled in
with dirt.
\'lease notify this office for a reinspection when the noted
/�\ descrepancies have been corrected. If there are any further
V questions, please call this office at 264-4720.
Sincerely,
James S. Roberts
Associate Environmental Specialist
JSR/lw
cc: Alaska National Bank of the North
3301 C Street, Calais II
8 Debbie Tuomi
Marcia Outcalt
8 Gallery of homes