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BARNHILL TR A LT 2
I mod Md AM' Lot Tract A De--,, 16 2`105.58p A n ch o: a y e %A! s 111 & Pump S ti;: - III 111�11:"Iql�I 91072 0742 p.1 904 Developmen., Services Department Phone: 901' -343, �_7- On -Site Water & Wastewater Section Fax: 907-2.43-799F %A'ell Drilruig Perwit Number: Date of Issue,-_--_ Parcel Identification Numner, S 2 Legal Description 4;,OCr I 1,ot Pr,jpertv 01% tier Name & 'Lddress: Tr- A Pump Installation Date:/'t- _- /I .- 'ZO Pump Inlike Depth Below rop of 'Wesj Casing: feet 2 Pump ?Vlanufacturer's Narne:At`` PkimpModeh Damp Size: --hp P4 Ll(,Ss, Adapter 'Surial Depth: feet Pidess AdapterNianufacturer's Name- Pidess Adapter .In staller: vi-,pil Disin.fecled Upon Covnjj�tiun? &i"A es C No of Disiifuctlan: Comments,: Pump InstaRcr Naune: Company. Mai.lin Address: State --------ire: & LIMP- Services. 330 EaSt Mfth Avaw 400fage, AK qr,4bj8 PhO110, 907-243-0740 POY; 907-243-0742 .A iteiition: The purnp installer shni I provmc. a -rump instailalion ior to 011 -silk 30 days of pump Municipality of Anchorage Page I of 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: PID Number: O ll i ' 462-37— 62-3ZName: Name: Wastewater System: ❑ New VUpgrade Address: ' ABSORPTION FIELD 67-3i &—t ay Phone: No. of Bedrooms: Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other /� c/+ p� L R P LEGALDESCRIPTION Soil Rating: Y h;2- Total Depth from original grade: H's GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe �o -L 1J gA j I L L Ft _ Ft. Township: Range: Section: Fill added above original grade: Gravel length: Ft. 34 5 Ft. WELL: El New ❑Upgrade Gravel width: Number o®®f lines: Distance between lines: Ft. 9 Ft. Classification (Private, A,B,C): ¢¢ Total Depth: I Cased To: Total absorption area: Pipe material: Lit FL Ft. d%7.8_' SC. Ft. 30 3 °j f V' 611 Driller: ® Date Drilled: Static Water Level: Installer: Date installed - 0y Ft. V Yield: 7/' Pump Set at: Casing Height Above Ground: TANK ®tl GPM Ft. Ft. SEPARATION DISTANCES Ijseptic ❑ Holding ❑ s.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines J AN L 14 _ / A )14IZ Joe a3 Welh _ _ Material: // Number of Compartments: Urfa e ��; --- LIFT STATION WatLot 1'7-°�'-� 3 Size in gallons: Manufacturer: Line 2.- Foundation.� _ r "Pump on" level at: "Pumpoff' I el at: High water alarm at: 3 9 6 Curtain §.� --11 1�, yy Pump Make&Model Electrical Inspections performed by: Drain Remarks: BENCH MARK Location and Description: , pt— AC ailvenreizl Pj ddz40"' Ll s to.. Assumed Elevation: Ft ENGINEER'S SEAL C Inspections performed by: 5 Dates: lst 7�/�//" /e 2nd a Department of Health and Human Services approval Reviewed and approved by: -.i 66� P*Jr Date: - 2 8.Oa 72-013 (Rev. 9/91) MOA 25 a P5 0 25 - 50 75 100 'P5 150 SCAL E/ 1 " = 50 ET ** O1 a�'♦♦ S 00 CAL SEPT . CC 7 � a DEE TJTAL /1,5 FT 49tH "; TOTAL LENGTH 30 FT FF ECTP/E ROCK 75 FT • . l/ m C ✓ER FT T�7 En S UO�, 77 tri CRVCH AA'B BURY c" !S'rING T/NK Nc. CE -2225 o /C—'LIUIVJ TATF9i� CL FAN OU% ®®^••P •...... \, u'G Ph' NIC l SN✓lNC TIES: BB -A 9.5 PP PP -A 25.5 BB -9 40.5 PP -B 34 BB -C 35 PP -C 36.5 BB -D 25 PP -D 29.5 /Uvazry 3tUKI\ ,vvu r.t. 203 W 15TH. A , "' " SEPTI SYSTEM AS BUILT VENUE ' ANCH. AK. 99501 EDWARD REASOR DAT : JULY 27, 2000 _(907) 279-3916 6731 W. DIMOND BLVD. SHE T: 2/3 GRID: 2322 PERMIT A SA1000252 PID 4 011—F63 -3P B4NOR022,DWG 0 b Standard Trench' 0_ 2' Wide 31,5' Long 11.5' Deep 75' Sewer rock 4' Cover NO SCALE INV 96.3 Silt Bo rrh 88.5 L 7„ 5 f`C o7 Sep tic Rocl, Effective Mon; for Oeonouis - 4' Cover NO SCALE 1000 gal Septic to INSULATED V 98.5 88.5 rA _9 � rt - Or 49tH , IEN SPJRKLAND No CE 2225 'Ok FESS l� mks INSULATION Y`— INV 96.7 1000 gal Septic tank unlzuv L: -U <nLeN_j r' c T7C SYSTEM SCHEMgTIC SE 203 203 W15th Ave BARNHILL TRACT A LOT 2 Anchorage Ak 99501 EDWARD REASOR DIA 1;- JULY 27, 1998 279-3915 11 6731 V✓ DIMOND BLVD. SHEET: 3/3 GRID: 2322 PERMIT ?t SW000252 PARCEL ID f 011-262-32 BAHOA 023.DWG MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW000252 Legal Description: BARNHILL TR A LT 2 C Date Issued: Jul 24, 2000 Expiration Date: Jul 24, 2001 Parcel ID: 011-262-32 Design Engineer: 0007 Tobben Spurkland, PE Site Address: 006731 DIMOND BLVD W Owner Name: Edvard Reasor Lot Size: 23300 SQ. FT. Owner Address: 6731 W. Dimond Blvd. Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99502-3904 This permit is for the construction of: Disposal Field _�] Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL PERCOLATION TEST IN ACCORDANCE WITH AMC 15.65 AND SUBMIT IT WITH THE AS -BUILT INSPECTION REPORT OF THE WASTEWATER SYSTEM. J Received By: Issued By: �,V/,l '1'Date: n-' Date: ��(// 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM UPGRADE DESIGN LOT 2 TRACT A BARNHILL S/D S/D EDWARD J. REASOR Municipality of Anchorage Department of Health and Social Services 825 L Street Anchorage, Alaska 99501 June 28, 2000 We are submitting an application for the upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following : No Ground Water or Impervious Layer to 17.5 ft. Use Standard Trench Soil Rating. From Testhole June 22, 2000 <1 min/in = 1.2 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 15011.2 = 125 sq.ft. Total area required: 125 x 3 = 375 sqft Testhole depth 17 .5 feet Bottom Rock At 11.5 feet Top Rock At 4 feet Rock Depth 7.5 feet Total Trench Length 375/ 15 =25 ft USE 30 LF SYSTEM CONFIGURATION STANDARD TRENCH TOTALLENGTH 30 FT TOTAL WIDTH 2 FT TOTAL DEPTH 11.5 FT ROCK DEPTH 7.5 FT COVER 4 FT SEPTIC TANK 1000 GAL The installation of this septic systen will not prevent development of adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. 9 FC'2 Sc4V/FW HEIGHIS TFS NG'i F �yI k"- mmmemmmmm 5061 50 i00 150 200 250 300 SCALE- I" = 100 FL IUCHLN SYUKKLANU P'.t.BA NIIL.� S�� T�l��'1' A� LOT SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE ANCH. AK. 99501 EDWARD REASOR DATE: JUNE 30, 2000 _(907) 279-3916 11 6731 W. DIMOND BLVD, SHEET: 1/3 GRID: 2322 EIS0xxx PID BAHOA02LDWGA/ 2b 0 25 50 75 100 125 150 SCALA" = 50 FT, os�� OF.. STANDARD SEPTICS �EM e7- qsJ♦.� GALT SEPTIC TANK J � l KE JC, TO0 T 49tn TE74L LENGTH 30 FT EF FEC VE ROCK 75 FT �...... .:... ..... n? CO ✓ER 4 FT TOB- N SPURKL AND•••�:�e z -Q. r%% ChUCH AND BLIP, V EXISTING TANK No. cE-222.. ti T: ,.,�.; -;r-00%?*.u��L EAI T UG PHONE & Al TRENCH W TANK 203 IV �rurrKtaNU E.tE BARNHILL SID TRACT A LOT��SEP�/c SrSTEM DESIGN TRACT A LDT��SEP�IC SYSTEM DESIGN 203 W 15TH. AVENUE EDWARD REASOR DAT : JUNE 30, 2000 ANCH. AK. 99501 6731 W. DIMOND BLVD. SHE T: 2 3 GRID: 2322 (907) 279-3916 PERMIT # S',✓DUXXX PL # 011-26p 34 24HO 0122, DV; PRIMARY ATNAH Standard Trench 2' '✓ice 30' long 115' Deea 75' Sewer rock 4' Cc ver Silt Barr 75 Ft of Sept Effective - ----- O O O 000 goEcptic tan 0 ICY NO SCALE F.L�•'4�tn A ; TCHN SPURKLAN7 UA A CE -2225 UU LL I UBbLN lKUKN'LHNll Y L.i 203 �.I15th Ave BARNHILL TRACT A LOT 2 SEPTIC srs-sM Sc:.E,wnTic Anchorage AA 99501 EDWARD REASOR DP TE JUNE $ 1993 a79-39'_6 6731 VL DIMOND BLVD. S EEVi ,y/,3 GRID, 2322 PERMIT �y SWOODOXX PARCEL ID / 011-262-32 5AH0A023.D WG e Municipality of Anchorage „ DEPARTMENT OF nEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Emj�,Ae3> 7 t\ -c. en 12 DATE PERFORMED LEGAL DESCRIPTION: LL i I I 1 1 A - C t A Township, Range, Section: P SLOPE SITE PLAN Ir I 2 t o� 3 4 6 7 U -a Vu, r'ca v -e V 8 9 L, 1 Net Time 10 ` i- 11 �� 12 C ✓f 6 v'�i w /6 13 y — 14<<� Cleo Sa: z' c 'ch 16 �` 17 18 1?� L 7—, br- WAS GROUND WATER ENCOUNTERED? r S IF YES, AT WHAT L O DEPTH? P E DepthMonet to Water After!1 Moniloringt t>r� Date. Feeding Date Gross Time Net Time Depth to Net Water Drop ` i- St . -f,'2"— ✓f 6 v'�i w /6 I wr l v 20 it It_ J PERCOLATION RATE 13(minutesimch) PERG HOLE DIAMETER i TEST RUN BETWEEN '5/2- FT AND ' �- FT DISCLAIMER- Groundwater ronditinns indicated are for the dates shown only. Past and future presence and/or depth of groundwater can not be predicted rom these Do SQrSya ions. PERFORMED BY: 1 ®- S CERTIFY THAT THIS//y EST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIC ELI NES IN EFFECT ON THIS DATE. DATE �/ /'� 7` 72-008 (Rev. 4/85) GREI"ER ANCHORAGE AREA BOP^1JGH Department of Environmental Quality �,•(- - r �J;�N�r, 3330 C Street /y,, c.� �� �,;�nr'� Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME 40 A-tHSCl/C MAILING ADDRESS ? �: -�f9/8-=/1 PHONE LOCATION LEGAL DESCRIPTION h"� 69A mll _yo SEPTIC TANK: DISTANCE FROM WELL — INSIDE LENGTH SEEPAGE PIT: MANUFACTURER AL NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS. NUMBER OF PITS .1 DIAMETER OR WIDTHLZ., LENGTH, DEPTH "/ LINING MATERIAL//Y4 S CRIB SIZE: DIAMETER'S _DEPTHL DISTANCE FROM: WELL X00 �, , TOTAL EFFECTIVE BUILDING FOUNDATION NEAREST LOT LINES ABSORPTION AREA (WALL AREA) 14�._' SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE QRIIIE D CONSTRUCTION �' DEPTH ,< �� DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE—,TANK—,SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM U INSTALLED BY: �i4�OLk'S��V E.YG '�P�nS F• ! ev .za PIPE MATERIAL: C19$ iTgol' d� �r= l6 LOT SLOPE: L�284e12 )n j°� REMARKS: AX % 1,1w,i, oly (+VERY S7eef) Difyk so ek':6 To 4111iGE DATE /G'%/rc%.3 APPROVED - ,�v� zE%�sts c-6�irc r? / [>itf �c�rYG- �l(loEw% G.A.A.B. Form No. EQ -031 9� �J O F �A NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS / COMPLETION DATE ANTICIPATED -_�.E MAILING ADDRESS- ��' '--' SEEPAGE PIT. DRAIN FIELD TO BE INSTALLED BY PERMIT NO. PHO- / moi/ OTHER NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE �_ TYPE SEEPAGE AREA SIZE __ _ — TYPE - MINIMUM DIS A GES, REQUIREMENTS DIAGRAM OF SYSTEM J FOUNDATION TO SEPTIC TANK i 0 i FOUNDATION TO SEEPAGE PIT `� %� DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL -- SEPTIC SEPTIC TANK _—_i1---. SEEPAGE PIT v ' DRAIN FIELD TO NEAREST LOT LINE. /`�� ' WELL TO SEPTIC TANK SEEPAGE PIT —' DRAIN FIELD _ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK �� / SEEPAGE PIT lU ` DRAIN FIELD SEPTIC TANK, �, SEEPAGE PIT ` (1C% / DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FI'T'TED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER ; I CERTIFY THAT I AM FAMILIAR WITH THE REANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE Z DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. -'APPLICANT'S SIGNATU DATE! RIRE FORM NO. EQ -016 GARB -Ho -I r"CATER ANCHORAGE AREA BOR" '' �H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME �MAILING ADDRESS —PHONE Z� LOCATION SEPTIC TANK: LEGAL DESCRIPTION 1 �j / ! DISTANCE FROM WELL / MATERIAL NUMBER OF �` COMPARTMENTS 'Z-2' C J�CZ-L ��A (ze) LIQUID LIQUID CAPACITY - GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS rz OUTSIDE DIAMETER OR WIDTH, LENGTH, DEPTH I , LINING MATERIAL 44Q<V---V . DISTANCE FROM WELL /62" , BUILDING FOUNDATION�� NEAREST LOT LINE 2e? �`e . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 1090 SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF/lIN ABSORPTION AREA , FOUNDATION , NEAREST LOT LIN ISTANCE-KIMEEN LINES SQ. FT. LENGTH OF EACH LINE TRENC"IDTH TOTAL LENGTH OF LINES EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE W ELL: 12A-0 <' DISTANCE FROM WATER TYPE DEPTH .,BUILDING FOUNDATION. ® SAMPLE, NEAREST NEAREST SEPTIC r SEEPAGE A OTHER �-- LOT LINE SEWER LINE TANK—79 SYSTEM ©2_ , CESSPOOL !_— , SOURCES DIAGRAM OF SYSTEM DATE APPROVED _ ---&e-- s,L HEALTH AU September 27, 1973 Edward J. Reasor 525 West 3rd Avenue Anchorage, Alaska 99501 Subject: V.A. Health Approval Dear Mr. Reasor: Our inspection on September 26, 1973, on Lot 2, Tract A, Barnhill Subdivision, revealed a discrepancy. The distance from the well casing to the edge of the seepage pit excavation is 71 feet. According to State and Borough Cortes, this distance should be 100 feet. After a permit for upgrade is issued, upgrading your system to meet our require- ments may be done as follows: a) cave in the old system (seepage pit) b) continue the sewer line from the existing seepage pit another 30 feet beyond the existing seepage pit standpipe, and C) construct another seepage pit If,' x 15' with a 9' crib and use three (3) concrete rings with gravel backfill. (Concrete rings are recommended as you stated intentions of a future tennis court in this area.) The nearest edge of the new seepage pit excavation must be 100 feet fron your well casing. If you have any questions concerning this matter, please do not hesitate to call us. Sincerely, Les Buchholz, R.S. Environmental Control Officer mld iA }.7Dr "T7[OIj.^3IlI}Stii6ti1U46 �a IL�3 Puz� TTn}ate P 17M3 'TV:]T' oTjnT!j�1Q xrns ITrPTZrAA-Y/1 r --- - INSPECTION REPORT ON-SITE S(_`�%UL ...-..... . p, r ►Anr,i s, ,'' ►► C' 0. �� PHONE a :� ATION PTIC TANK: 4 CJ e MATERIAL DISTANCE FROM WELL - � %>� �1� I / f'rf% %r� DEPliH (f t UEPTr tJQUID CAPACITY / 5 C' GALLONS. INSIDE LENGTH -- �.: SEEPAGE SYSTEM: SEEPAGE PIT: / c7 NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH._ Y! - - --- - DISTANCE FROM BUILDINGFGUivDi+TlOf:�.�, LINING MATERIALSO, FT. 7 d TOTAL EFFECTIVE ABSORPTION AREA (WALL NEAREST LOT LINE TILE DRAIN FIELD: TOTAL LENGTH -- , OF LINES ----- FOUNDATION .-.�_-----. NEAREST LUT IINE�,�- DISTANCE FROM WELL {C7T9 EFFECTIVE TRENCNi'W IDT NUMBER OF INE D TT�/EEN LINES -"C------ -��/ ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH Of FILTER MATERIAL BENEATH 111E _ _IN. ABOVE TILE.-..------ DEPTH: TOP OF TILE TO FINISH GRADE WATER NEAREST =�j w DISTANCE FROM /d 4 SAMPLE---�-' DEPTH BUILDING FOUNDATION /�/, 2f- .-- OTHER TYPE / SEEPAGE le 7°" -- SOURCES NEAREST SEPTIC S' SYSTEM = CESSPOOL __ LOT LINE SEWER LINE --,TANK--"'— DIAGRAM OF SYSTEM DISTANCES: I =7b =79 i -7 f3 �7 I DATE I- JL P APPROVED GAAB-HD-2 GREATL ANCHORAGE AREA 9ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM — APPLICATION & PERMIT A'3a Case No. NAME OF APPLICANT E(J !CP a 100— MAILING ADDRESS PHONE NO. RESIDENCE ADDRESS "' ` � LOCATION OF INSTALLATIONA MieLjy,04� 'S aVb 4e-ld LEGAL DESCRIPTION— 2— Ile, A4• 1q1L-t,.. IS 0z` - APPLICATION TO INSTALL: SEPTIC TANK, SEEPAGE PIT , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY _ 3 FINANCED THROUGH�-�-- TO BE INSTALLED BY`� S PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETIONi;) `� r— A)Q M4 BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT /MA 4a. S -el — PERMIT TO INSTALL A THIS IS TO SERVE AS � —.--�- AS DESCRIBED BELOW. SIZE ObUNIT TO 5F SERVED00 AA Al I SEPTIC TANK SIZE A)00 TYPE C1 SEEPAGE AREA TYPE DIAGRAM OF SYSTEM ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■ ■■NNEN ■■Il i1l■■■■■Yi■■■ I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordin nce No. 28-68 and that the above described system is in accordance with said code. N (j 'f" },�' � 4 / J> A D a�► , �� - 1 DATE APPLICANTS SIGNATU RE �_J 3R£ATER ANCHORAGE AREA BOROUt HEALTH DEPARTMENT CASE 0 927 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For Date Performed / Legal Description: Lot Block Subdivi"s"ion This Form Reports a: Souls Loi ercolationTest Depth Feet Soil Characteristics The SeAfirenf5 were T6,3 tc'fr� loose (.".fh r._ low YVIOM(.i a Go. -14e0+. $ SP rl Was Ground Water Encountered? 0 If Yes, At.What Depth Location Sketch Reading Date Gross Time Net Time Depth To H2O Net Drop erca a ion ate xnu e Proposed Installattion: Seepage Pit v� Drain Field Depth Of Inlet f� Depth ToBottom Of pit or Trench COMMENTS: ► jzi- r i V_ . 14 . Test Performed B� Data Certified By:-- Date: y:--Date: v� _ .....r.. 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G't(-b2-3,_ HAA# Expiration Date: 1. GENERAL INFORMATION Complete legal description Alz M 1� I L_ A Le i Location (site address or directions) b 73 is Current Property owner(s) %pvl;,k,ZD 2e t�,,Soe Day phone Mailing address & 7 3 1 I'& b I I—t a N a Lending agency Mailing address Day phone Real Estate Agent ;a rDay phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: ►#ltEli►rF��: � : r': � � a t 3. TYPE OF WATER SUPPLY Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL Individual On-site t/ Individual Holding Tank Community On-site ❑ J Public Sewer The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer or title (except between spouses) on properties served by a single family on-site wastewater disposal and, or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Auther,ty Approval are valid for 90 days from the date of issue for properties served by a private or Class C wail anc may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or 3 wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional enoineers work. a 925 •.,_•: o. car 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 Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S � h c vi �a J rl�LotA rJ7 t� Phone 97Y - d to Address o S /t , 4 A 9/ 9v 5-01 Engineer's Printed Name q"u �,V_ice Date "/z7/,'n 5. DHHS SIGNATURE % Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments 3 ENGINE bedrooms, with the following stipulations. Attachments: HAA Checklist Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other i By: %� - CL— Original Certificate Date: r Expiration Date: Reissue Date: -s -c_s„ , ", Municipality of Anchorage • Department of Health and Human Services ;',Lc E I Division of Environmental Services On -Site Services Section 825 "L" Street Room 502 JUL. 27 200G P.O. Box 196650 Anchorage, AK 99519-6650 WWW.CI,anChorage.ak,US ,M1jNICJVXL Y OF ANCHORAGE (907) 343-4744 ^DTIV SFR', -P° """ HEALTH AUTHORITY APPROVAL CHECKLIST 0i+ - Legal Description: BA1? Pt H ILL 'T 2ACT A 1-11 T ;2- Parcel l.D.: aecz- 3Z A. VVELL DATA Well type .Z If A, B, or C provide PWSID # t\/A Well Log N1 Date completed 1473 Sanitary seal Y Wires properly protected X__ Total depth ze? ft Cased to 2k 5 ft Casing height (above ground) e E3 in. FROM WELL LOG AT INSPECTION Date of test1��%D Static water level ft2 ft Well production g.p.m G-5 g.p.m WATER SAMPLE RESULTS: Coliform _colonies/100 ml Nitrate /. 2-tu mg/I Other bacteria int iZ_colonies/100 ml Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA We Ie:;V"P Tank Type/Material _ella e - Date installed 7�Tank size gal Number of Compartments m2. Cleanouts -_Foundation cleanout __7Y__ Depression over tank Iii High water alarm r-% Date of pumping Pumper 1� C. ABSORPTION FIELD DATA Date installed ', s%vc� Soil rating (g.p.d./ft2 or ft2/bdrm) L System type %4'e44 & 4 Length 3/ s ft Width _�ft Gravel below pipe ft Total depth Yf. ft Effective absorption area 1%7,2 ft2 Monitoring tube Depression over field N Date of adequacy testes Results (Pass/Fail) ✓ For _� bedrooms Fluid depth in absorption field before test in Elapsed Time: r/ min Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type) 72-026 (Rev. 01100)' Water added --*" gal. New depth '--� in. in Absorption rate >= '% g.p.d. If yes, give date _ D. LIFT STATION Date installed Size in gallons "Pump on" level at in "Pump off" leve Datum Cycles tepZ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Manhole/Access in High water alarm level at in Meets alarm & circuit requirements. Septic tank/lift station on lot 10-3 On adjacent lots > 10--C) Absorption field on lot 1 1 D On adjacent lots > d &-V Public sewer main Public sewer manhole/cleanout Sewer /septic service line _,:;p V Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 05 Property line Absorption field Water main Water service line 7 .25 v Surface water Drainage N10 Wells on adjacent lots > i&y SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: C,4iv Property line U Building foundation h a Water main Gu /A Water Service line _> Surface water N<ts Driveway, parking/vehicle storage Curtain drain N 10 Wells on adjacent lots _> i ox� F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and ENGIN R'S review of Municipal records that the above systems are in T .~ conformance with MOA HAA guidelines in effect on this date. P ZZ) , ,d Engineer's Printed Name i o b.beti Date 7!x7le"-y HAA Fee $ � c oU Waiver Fee $ Date of Payment —7-a7 o c) Receipt Number 0&,S� 1na`'I 72-026 (Rev. 01/00)* Date of Payment Receipt Number CT&E Environmental Services Inc. CT&E Ref.# 1004071001 Client Name Tobben Spurkland P.E. Project Name/# Barnhill TR A Lot 2 Client Sample ID Barnhill TR A Lot 2 Matrix Drinking Water Ordered By / , PWSID 0 Client PO# Pre -Paid Colis/NO3 Printed Date/Time 07/27/2000 19:52 Collected Date/Time 07/26/2000 8:45 Received Date/Time 07/26/2000 8:45 Technical Director Stephen C. Ede Released By JdU / , Sample Remarks: Parameter Results PQL Units Method Waters l2epartment Nitrate -N 1.24 0.500 mg/L EPA 300.0 -- ob+oroav Laboratory Total Coliform 0 col/100mL SM18 9222B Allowable Prep Analysis Limits Date Date Init 10 max 07/26/00 SCL 07/26/00 KAP CUE Environmental Services Inc. CT&E Ref.# 1002970001 Client PO# Pre -Paid Colis/NO3 Client Name Tobben Spurkland P.E. Printed Date/Time 06/19/2000 8:27 Project Name/# Barnhill S/D L2 T.A Collected Date/Time 06/14/2000 14:45 Client Sample ID Barnhill S/D Lot 2 T.A Received Date/Time 06/14/2000 16:45 Matrix Drinking Water Technical Direct Stephen C. Ede Ordered By Released /J n PWSID 0 Sample Remarks Parameter Waters Department Nitrate -N Microbiology Laboratory Total Coliform Results PDL Units Method 1.26 0.500 mg/L EPA 300.0 0 coL/100mL SM18 92228 ALLowable Prep AnaLy:is Limits Date Date Init 10 max 06/14/00 SCL 06/14/00 KAP 1. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received A 1 7 Time of Inspection// .`3c /-) %I% Date of Inspection y a G //73 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES � FOR / A 11) Aoproval Requested By: Address; 2. Pronerty Owner: 3. Legal Description; Phone: oZ 7.:z - y.5--' / P'' /none : �- 7 9- ;k- -/ 3 -1 -/- SL - -;4Z G K-- 5. Type of Facility to be Inspected: Number of Bedrooms: 6. Well Data: A. Type p B. Depth ✓J C. Construction 60 !C- D. Bacterial Analysis, t\; ,5 7. Sewage Disposal System: A. Installed B. Ivote44er eLQnSA.Zr /qz&/z4. C. Septic Tank: 1. Size 2. Manufacturer L-&111119-61141 D. Seepage Pit: I. Size/$)/S-Xg? 2. Material_ 8. Distances:�aco 1 Ifflell. Absorption Area e e ines A. To: Septic Tank �, Nearest Lot Line 9j21f-- , Other Contamination 3. Foundation to Septic Tank Absorption Area � !go � C. f Absorption Area to Nearest Lot Line Requast for Approval. of -Page Two idividual Sewer & Water r`aoilit' Approved Approval %4.Yd for One Year Greater Anchorage Area Borough, Department of DTAGRAM OF SYSTEM Date Signed ronmental Quality I certify that the information contained in this request for approval to be a true and accurate representation of the subiect sewer and water facilities located at: Signed Date GREATER ANCHORAGE ARIA b(...iUG1,? 104 West Northern Lights boulevard Anchorage, Alaska 99503 Plat Status: Final Date: BOROUGH: Engineer Upa 1 th i)Qp-g rtmant Public Works Department -Send bee4e•-Fire Department School District Street Names Tax Assessor Alaska Department of Highways Alaska Railroad Anchorage Natural Gas Corp. Central Alaska Utilities Chugach Electric Association S-2523 September 21, 1971 CITY OF AilMORAGE: Fire Marshal Hunicip al Light & Powe;: Deparl. ar --nt= Property Management Officer Public Works Department Telephone Utility Traffic Engineer Water Utility GAB Telecommunications, Inc. Matanuska Electric Association Aatanuska Telephone Association Assistant Superintendent of Mails Re: Subdivision / XXXX�€7�taX Description of Property: Lots 1 & 2, Tr. B. Barnhill Subdivision Owner. Harvey W. Barnhill Gentlemen: Petition has been received by the Greater Anchorage Area Borough Plannti a.. and Zoning Commission for the proposed Subdivision of subject prop& t-;, Attached is a copy of fie proposed plat. Will you please submit your comments in writ.in's, Specifying any easem:nt6 or other requirementn that your department cr igercy ;iay need, If we do not hear frcm you by Oct. 6, 1971 _, we will assume that you do not wish to sub -aft a:ay comments. If you have no further use for the attached print, please return it with your comments. Planning Department Enclosure