Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
SPRING HILLS ESTATES BLK 2 LT 2
Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .5W'c~ffo2,~_8 PIDNumber: ©IS-OS'IG9 Name: ~o~ALb HUFFM~N Wastewater System: D New ~ Upgrade Address: Phone: ~_ 7~ ~No.o,~drooms: ~DeepTrench ~ Shallow Trench QBed ~Mound UOther LEGAL DESCRIPTION so, Rating: Tolal Depth from original grade: J' 2 GPD/Sq. Ft. J Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe ~ ~ SPRING ~tLLS G,~ Ft. ~'~ Ft. Township: [ Range: Section: Fill added above original grade: Gravel length: 12 NI 3 ~ J~ 0,~ Ft. 7~ Ft. Number of lines: Distance between lines: WELL:EX~ST U New ~ Upgrade eravelwidth: 2.~ Ft. 2 ~'~' Ft. Classification (Private. A,B,C): Total Deplh: Cased To: Total absorption area; Pipe material: Ft. Ft. EFF~CTIvE ~00 SQ. Ft. ~'S10 ~"PERF Driller: Date Drilled: Static Wa~er Level:Ft. Installer:c~$ EXCAVATING Date installed:~ Yield: Pump Set at: Casing Height Above Ground: GPM Ft. Ft. TANK SEPARATION DISTANCE8 ~s~pt~c ~ Holding ~ S.T,E.P. ~O Septio Absorpl~on LifJ He,ding ~ublic/Private Manufaclurer: CapacJly in gallons: Frbm Tank Field Slalion Tank Sewer Lines [ ~ wen- I1o Joe -- ~ jo~ ~TEEL Surface ~ ~ Water >~OO >/oo - - >/co LIFT STATION I ~ .High water alarm at: Foundation ~ ~ O¢ ~ ~ O "Pump on" level at: "Pump off" level ~t: Curtain ~ ~ ~ Pump Make & Model Elec~(i~a! I~specti0ns performed by: ' Drain ~ ¢~c ~¢ ~Grur~o~ ~¢¢~ Fn '~e ~4~ J Assumed Elevation: Inspections performed by: . 7L47%OP mECH S/JS Dates:lst Department of Health and Human Services approval -~ %~,,~ogo~ Reviewed and approved by: 72-018 (Rev. 9/91) MOA 25 ~."~i~"r'*~,''~'~" Permit No. 5W 95o2z~ Page 2 of 3 Municipality of Anchorage D£PARTM£NT OF HI=ALTH AND HUMAN SERVICES ENVIRONMENTAL SI=RVlCES DIVISION P.©. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription: Lo'r2_, 8~2 5?R~ ~I~.L~ PIDNo.: OI5o.g1~9 5~PTI~. ~ou$~ ~ m.,%...C., To: ~VER$~ot,.t VALVE 1o' 'fi:z' TReNcH M.T. "C" 52' 25.5 ' Flattop TechniCal Services , 14530 Echd Street .. Afichorage, Al&sk~ 99516 72-013 A (1/93) bt~.¢ R SION VALV~ ABS. i,L£ N GT H ~>(o SPR~NG HILL CIRCLE- ENGINEER'S sEAL Permit No. Sw 9Uro2z~ Page 3 of ~ Municipality of Anchorage 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 Legal Description: LoT -2, ~LK 2~ 5PRtNG HI£L5 PID No.: 015'05'//ocl ! No Ho&~;2ONTA£ S~J~ALE ........................................................................................................................................................ i ......................................... Flat!op Technical Services i14530 Echo Street Anchorage, 2-das~a 99516 ENGINEER'S SEAL ...~ ..... · ~'~.~ THEODORfi F. MOO~E 72-013 A (1t93) · PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940228 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:HUFFMAN RONALD E & KAREN G OWN'ER ADDRESS:9210 SPRING HILL DR ANCHORAGE, ALASKA 99516 DATE ISSUED: 7/08/94 EXPIRATION DATE: 7/08/95 PARCEL ID:01505169 LEGAL DESCRIPTION: SPRING HILLS ESTATES BLK T 2 2 L LOT SIZE: 43120 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM AL1, 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 (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVEDBY: ~~'~'-- DATE: DATE: Department of Health and Human Services 825 "L" Street :~:~'~ P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 8, 1994 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 2 Block 2 Spring Hills Estates S/D Waiver Request ~WR940039, PID #015-051-69, SW940228 Dear Mr. Moore: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 0 feet from the lot line-.abutting Spring Hill Circle and 0 feet of the common lot line with Lot 3. This approval applies to the existing septic system lot line separation only. Any future upgrade to the sep'tic system will require all separations be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services ljw#7 MUNICIPALITY OF ANCHORA~ Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR940039 PID# 015-051--69 HA# Date Received: June 29, 1994 Legal Description: Lot 2 Block 2 Spring Hills Estates Engineer: Ted Moore, P.E., Flattop Technical Services 14530 Echo Street, Anchcraqe, Alaska 99516 Permit # Applicant: Ron Huffman Waiver Requested: Lot line waiver of 0 feet from the lot line abuttinq Spring Hill Circle and ~ of the common lot line with Lot 3 Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: o 3. Other: Waiver is Granted: X _ Waiver is NOT Granted: List Conditions or Reasons for above: ~ f~&/~f~ Date: N~.me of Reviewer Rec #: 00058/5329 Amount: $ 115.00 Date Paid: 6-29-94 CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS TIIEODORE F. MOORE, P.E. June 28, 1994 PH: (907) 345-1355 14530 ECHO ST. M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 ANCHORAGE, ALASKA 99516 Dem' Sirs: The purpose of this letter is to provide the required design nan'ative in support of our application for a pe~rnit to consta'uct wastewater disposal facilities on Lot 2, Block 2, Spring Hills Estates, located at 9210 Spring Hill Ch'cle. The existing soil absorption trench is no longer able to accept the effluent load originating in the residence. Soils logs, perc test results, a site plan, design ch'awings and specifications are enclosed for yom' review. A lot line waiver is also requested allowing the system to be constructed 0' fi'om the lot line abutting Spring Hill Cimle, and,~of the common lot line with Lot 3. Since space for furore upgrades is at a premium, the waiver will allow the proposed trench to maximize the available area on the lot. Granting of the requested waiver to 0' from Spring Hill Circle will have no impact on the ability to develop futura wastewater disposal systems and the waiver to 5' from Lot 3 would still allow a similar trench to be consmtcted on Lot 3 at the same distance from the lot line. The proposed system will be constructed in the vicinity of test hole # 2. As can be seen from the soil log, the native material between 8'and 17' is a fine sand with a measured perc rate of less than 1 minute per inch. Subsequent to excavating the test hole a perforated steel pipe was pushed down through the bottom of the monitor robe to a total depth of 19 feet to verify absence of groundwater or bech'ock to that depth. Using the soil application rate of 1.2 gpd/sq, ft. specified in the wastewater ordinance for soils with percolation rates faster than 5 minutes per inch, this existing 4 bech'oom residence requh'es a total absorption area of (4 x 150)/1.2 = 500 square feet. The proposed 50 foot long soil absorption trench with 5 feet of sewer gravel beneath the horizontal disn'ibution pipe has a total absorption area of 500 square feet. This design provides the trench size required by the wastewater ordinance. Depending on space and financial considerations, the owner may elect to install a longer trench. The topography of the lot in the m'ea of the proposed construction slopes down towards the northwest at approximately- 5%. Except as discussed above, the proposed project will have no impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space/surface and subsurface, or on di'ainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. ABBOT RoA~ I0' UTIL. I T'"/ E~MT, £0'~ 2 BL~ 2. L o'T PRO?O~Eb ~o~ Lo'I ~ BLK 2. O0 "% SEPTIC IE /° VALVE Flcdtop Technicc~l Services 14530 Echo Street Anchorc~ge, Alc~ska 9951 LOT 2, 5LK2, 57R~16 HILLS SEPTIC SYS-'rEIVt tJP6~AbE ~CALE : 1"=S0/ NOTE', TH~% I~ NoT' A CugV,E"/'Eb PL.A-'F ALL LocATION S A~E A PPRoXI PLAN V EW CLEAN~u'r 3 FIt. TER F~BRI¢~ T ,5.5 ' G ~,AV.~ L DISTR, I~UTIOIq PIP~') l SECT ~o N MoNITOP, TUBE ------ Mou,'4b I A~oVE ORIG. ~AbE' ToTAL EX¢~VATIO~ Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99518 LOT 2, BLK 2, SPRING HILLS SOIL ABSOR PT~oN TRENCH PLAN A~b SSCTION £CAL~ : AS SHOUJN DA'TE '. Fo/qq D~N Bq: ~ Flattop Technical Services 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 2, Block 2, Spring Hills Estates 9210 Spring Hill Circle Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installing a diversion valve downstream of an existing 1250 gallon septic tank and constructing a 50' long soil absorption trench containing a total of 5.5 feet of sewer gravel. 1.2 Consu'uction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedm'es and material specifications shall confmrn with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that propel' drainage is achieved after settlement and that them are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, tile homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the consu'uction. 1.6 Prior to the start of construction the owner shah arrange fora land surveyor to locate the southeast lot corner and also place a stake on the south property line approximately 50 feet fi'om the southeast lot corner and another stake at the intersection of the driveway with the property line abutting Spring Hill Circle. 2.0 Septic Tank: 2.1 The existing septic tank may be retained in selwice so long as it appears to still be in good condition at the time of hook-up to the new system. 2.2 A "Bull Run" diversion valve is to be installed in the waste line downsn'eam of the existing septic tank allowing septic tank effluent to be directed either to the new trench or to the original trench. 2.3 The existing soil absorption trench is to be left in serviceable condition with all standpipes in place. 2.4 The portion of the waste line which passes under the paved driveway shall be insulated with 4 inches of rigid insulation. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 50 foot long trench to a total depth of 13 feet below ground level in the vicinity of test hole #2. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 5.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated disu'ibution pipes laid level such that the pipe inverts are no less than 5 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved ~ter fabric shall be placed over the entire top sm'face of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shail be raised a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for m~'anging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the consu'uction. 4.0 Inspections: 4.1 A total of 4 engineering inspections will be required dm'ing the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and consU'uction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensm'e that it is level and at the right elevation, and conforrns with the soil test information, (3)after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. 4.2 The inst.aller shall coordinate the timing of the inspections with the engineer sufficiently fro' in advance to ensm'e the availability of the engineer. FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: LO"/" 2, BLK'2~ SPRING HH-L ESTATE5 DATE PERFORMED: PERFORMED FOR: DEPTH (feet) -- 2-- 3-- 4- 5- 6- 9- 10- 12- 20-- RoN HUFF~_AN T,H. 2 oF' TRfi~SI ",'ION TO .SP 13ELok/' Z^"fER% oF FINER "(-4~4 5AHb SLOPE Sp F~E Ct. EhN Depth to Groundwater Date Clack Net Time Percometer Net Drop Time (minutes) Reading (inches) .~$', o~ o:::N ~1 ~/~ I'. o~:oo PERCOLATION RATE --/ [ (minutes/inch) PERC HOLE DIAMETER '7" TEST RUN BETWEEN_ 7~._~. FTAND ........ ~ ...... FT COMMENTS: PERc t~, ~,~KEI~ S/IND C_..HARI~cTE..~ISTIC oF' ~'OTTON, t,/z oF' HOLE PERPORMED BY FLATTOP TECHNICAL SERVICES. I °7-'~{~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE: . ~' ,/~' /9~/ LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) 1 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST RoN H~JFF'M A N SLOPE 4--'~ND~sT~HCT TRANSIT'ION J-J:~ 0 COMMENTS: Depth to Groundwater Date Date Reading Clock Net Time Percometer Net Drop Time (minutes) Reading (inches) PERCOLATION RATE ............ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY FLATTOP TECHNICAL SERVICES. r___..~_~~.._~.,~%.~__~.____ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ /...'~,:~ / ¢ ~ MLJNICIPALITY OF ANCHORAGE E ~,RTMENT OF HEALTH AND HUMAN SE~ CES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT 'rANKS [~'~EPTIC ~ HOLDING TYPE OF SYSTEM DISTANCES SEPTIC ABSORPTION FROM ~ 'rANK FIELD WELL WELL LOT LINE FOUNBATION AS-BUILT DIAGRAM tShow Iocahon OI well, septic system, property hnes, IoundaholL driveway, water bodies, etc) ~2~'"~RENCH [] BED [] W. DRAIN [] OTHER ~111 a~)ve o~gmal grade J Gravel depth benealh p~pe 0 Number ol hnes, ~ Sod rating ~ ~P~pe mater.u WELLS ~ PRIVATE Classlhcabon IA,B.C~ REMARKS: "~J/('¢ ~(? ~ ~ -- ~1~ ~ ~ InspoclionsPerformedby: Health Department Approval: ....... ,' '-~ ~ Dbt~'. ~,~ ¢~-- ENGINEER'S SEAL 72-013 (3~85) Dlii]:::'ARTMENT OF' I..Ilif. AI..T'H AND Eh. IVIRONMENT'AI.. F='RO]"I~ii:C'T'ION i!]~::!5 L.. S'['F:;:li:]:i:[', At",l[',l"ffJJ::d.~Gli!!:, ~.'~1'::'. i:7950 :L 2. 64-. Zl, '7 ~:~ 0 J::'}~i}:~ J'/J ]i '[ I",l C} '.', [)A ]'J!!~ ]: SSLII!i]): OJiiJ/2, 1/8',::~ AI:::'PI_ ]: CAIq'I" ~ CONI'AC]' I='HI]N}i~:~: D:.'.'.,.!3 LINI... I M ]: TED 78l}0 DI::BAF:q:;~ RD~' ANC;HC}RAGE~, Al< 99504 :337- & 763 I...0"1 S I ZE MAX BEDF:~C.Z}OF'iS~ SLIB).:) :[ V I S ]: ON: SF::'I::~: I big H :1: LJ_S SECT I C)N JJ 15 TOWNSH I F;:': 43120 (SG}. F::'T,, OR AC)RES) 4. DIi:P'I'H "I'CI [:::' :1: F::'I!E BO'I'T(3F'I (F:'T' Ir ) GRAVI~i].... DEF'i"H (F:'T") '10TAI,., DIEF::''I:'H (F''f ,' ) (':)l::d:~glii:l., IAIDTH (F::''T'.) GRAVEl. I,..IZNG"Ill (1::;'1" ) Gl::d')Jgli!],,., g{:iL..lff"lE (12U. YDS" ) TANK !ii;I: ZE (i:;AL, S) SO :l: I.., RA'I' I: i"lG ( S(:;! ,, F:'T" /BR ) J 2. 5 ~?.9 0 .... ' 63 ,, 2 6() ,, 2 101.5 · ~+'~+ CD~hVEI.. LENGTH > 75 F='[,, I::~I::E&JIRES I"tLJL. TIPLI~: IRLJNS (NOT EXC[~::EDING · ~"~' TANI< MLIS'T HAVE hT LE[AS'I" "IWO (:X)I"tF":'AF'(T'MEN'T'S cer"L:L[y t. liat.: 1. ! am fami].:i, ar w:i.t.['l 'Ll'm~ r'(}~!Clu:i.r¢~!mervLs '['(::,r cm....s:i, te sew(.:~r's and ~or't.h I::)y the Mull:i.c:ipality oF Ar~c:hmr'age (MOA) anti t. he St. at.e c)f Alasl.::a. 2.,, I will inst. a].]. 'l.l"l~;:.) sysi:.er~l in ac:ccH".darlce wi'Lb all MOA ccldes arid r~:,gula'L:i.(::~ns, ar'~(::i :i.n cc~mj:)].iance ~,~J.t.h t, he c),esigl'i c:ri'Ler'ia (::)F t.l"lis p~:]r'm:i.t,, 3. ]: wi].l a(::lh(.::H"e t.o all M[]A ancl State of Alasl.::a I"<.:;,)[:jl..l:Ll"[(~ili(:~l'~'[.f~[~ for' t.l':m:, ~iet. back d:Ls'Lar'ic:J.'.~s fr'.(::)m a~jriy ex:i.s'L:i.r'~g w¢~].].~, wast. e?~,~a'l:.er' dislJ)osa], sysl'.(~m oi' public f.[H):)J/4E~Pa(~B.::.:, syst~?~)~li or'l i:.h:i.s or any a'd:l,.j,'~c:~?)r'rL c:)r' l"~eal"l:)y 4,, :[ urH:Ji:.~,l"si:.ancl i:.hai:, t.J]J.~ per'm:i.t is va].J.d [[)1". ~ I'lia~xi~ilLlrlJ c:~J' 4 any er]lar'ge~m(.::.)Frt, v~i].l r'equir'(.::~ al'J adclit.:L(::H"ia], i::)er'.m:i.t.. I1=' A I...IF'"I' STA'TIO[',I IS INSTAL..I...ED Ii"-I AN AREA COVEF:([:UD BY H[]A BLJII_DING 'l"l'tl!ilxl (1) AN EI. Ji'::C]"F:~ICAI.... F::'I:[F:U"tlT Al'ID INSF'E!:CTIOI',I MUST [.:]Hiii: OB'I"AINliii:D; (2) W]:I..I.. NOT F:d: AF'I:::'I::~:OVED WITHOLJT AI".I Ei]...E~C'I"R:[[]AL. IIq,'::3F::'I:::CTION F:~IZF:'C3RT; AND (3) I::I_..Ii!:CT'F;:]:CAL WORK MUST :(.'.qiii: DE)NI: BY A I..ICEIxlSED ~: .L L.4 q I:, ), D A T E: F:'ERH I '1" I',10 DA]'E ISSL.JED:: ~ 8 /2. 1 /135 AF:'I:::'L I C, ANT: ADDRESS CONTAC~T PI'~OI~IE: 9 9 5 () 4 I,.EGAL, ].)l ,c Cl~ll ,, MA X BI:::I'.)ROOM(,:i: I_OT.::,:..'".' E L t}(~l ...... ,= :L2. N RANGE: 3W I..i!~,'Led I::~e'].ow ar'e: the C)F~'L:i. on~.~i availalale 'Lc:~ you in de~BJ, glqJ. i]g yC]LU" septic sy~;>tem,, []]c:)[)~;e 'l:.he:, c)p'l:.:i.c)r'i tha'l:, be~:. f':i.'l:.~ yOLH~ site,, I)I~F"H-'I "['0 I:::' I PE BOT'T'[)Id (F:"I' ,, ) 4 ,, () 4 ,, 0 4 ,, 0 Gf-~AVEI.... DEF"]"I~t (F:"T' ,, ) 7 ,. 0 () ,, 5 3.5 TcFr'AL. DEP'TH (FT.) 11.0 4. ~5 7,, 5 E ::~AV[~J,.. W I DTH (F'I".) 2,, f5 ................. ~u) 5,, () GIRAVEL. I.,,.EIqGTH (F"I'.) 69~./]" 49~0 1()3.0 .~..~. Gr.:~AVEL VOI..UI"II~ (CLJ ,, YDS.) zt.~t~ Zl. 5.4 76 ,, 3 SOIl.... ,::~AT]NG (SD,I='I",, /BR) /;~2/~ ::267 :];18 EAC;H) · ,~-.,~. ",'ANK ,qUS"r' HAVE A"f' I.EAST "fW(~F, ~ ...]:..~ ...... al]d :il'i i::c,~tr~jt:),l~.al'~i:::(e~ ~i'~.Jl ~:,J]E, de~;:i, clr't cpitB[ ia oJ' this p~plil:L'l:,,, '~A :Z~:,, I wi 1 1 adh(.~.H~e 'Lo al 1 M[]a ar'~ct St~'[~'Le cji' Alaska pequir'~ments {'c)P th(.z,~ ~:~ d ~ ~'J:.~?~t"~(:::E~E~ {' I" c]fi~ ,~l']y (.:~ i S'IL ~ IICi I,gl.~:~]. '.J. ,, k~'A~S'L~W,W~ lap d s~.m~er'age syst. elli tin tl-i~.s (]P any adjacent any ~Fi].~:':'d"gE'HilI'~I"Yt;. HJ.].]. I"<.:.~ql.lir'~:~) an additiorial i::~er'm:i.'L,, ]:1::' A I...~F::'T STAT]ON IS INSTAL. LED IN AN AREA DOVIZRED BY MOA BUII...DIIxlG CODES, THEIq (1) AN EI....I~]:CTF~ICAL I:::'ERI'fl]:T ~ND INSF:'IECT'ION MUST BE E)BI"~ZNED; (2) AS.-...BLJ]:L, TS HILl.... NOT BE AF:'I::'IROVED NITHDLJT ~Jkl EL.E['/I"RIC~L. INSI::'EC;TION REF:'[)R'[']I AND (:]~;) THE IEI_EC]"I::~ I C AL WOI::~I'::: MLIEFT' BE DONE BY A L. I CENSI~I} I]]~]_.I~]C]"I:~ I C I AN. :1: ,~3,~{I..IIED B ~ ~.. L~ ~ - DATE P,O. aOX 6650 ANCHORAGE, ALAS;<A~"95u2-~o9'"' n,'-r (907) 264-,~ 1 '11 T ?,? '.' ~NC .',,,_ES DEPARTMENT OF HEALTH & HUMAN SERVICES January 10, 1986 TO: Permit Applicant Subject: Permit # 850523 Lot 2 Block 2 Spring Hills Estates Sbudivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance° A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: (ENGINEER'S SEAL) LEGAL DESCRiPTiON: ,/-2' ~Z ~'//~/'~'//~,¢~ ,/1//~5 Township, Range, Section: 5 6 7 8 9 10 11 .' 12 13 14- 15- 16 17- 18 19 2O SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? s IF YES, AT WHAT /V/,~ DEPTH? p E Del]Ih to Waler Alter ~,//~ Moniloring? ' '~ Date: _. Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (m~nutes/inch) PERC ROLE DIAMETER TEST RUN BETWEEN __ FTAND FT COMMENTS PERFORMED BY: .~'X '',~'.~ ' /~;/~¢~,T ~ DA~T~:TIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES INEFFEC ON TH . DA : 72-008 (Rev. 4~85) POo .,16 650 /\NGHORA(}['. At /\SI(/\ 99502-0650 (907) 2(Pl 41 I DEPAWI'MENT OF HEALTH AND ENVIFIONMENTAI_ PROTECTION Permit ~: 840211 January 31, 1985 TO: Permit Applicant SUBJECT: Lot 2 Block 2 Spring Hills Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of Decen~er 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as-built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264--4720. Sincerely, Keith E. Bandt, Supe]fvisor Environmental Engineering Program KEB/ljw enc: Copy of Permit SWP/057 ]: I::' I:::1 L :[ F'I" :!::;]"FIT :!: I::lh! :1: :::; ]: I'.,t;::;"l"l::lL...I...l:]i:l::., :!: i'.,t I:::IN I:::1[;::[:::[::1 C:O',,,'EF:::E!:I::, E::'.F I'tl.-.II::l [:i',t..t :1.' LD I ~.~1] C: CI [::, E ::i; ., 'i'l-IIi!i:l'.,I ,;: ::L ::, I::ll",J ::::::::::::::::::::::::::: :l: C:F::IL.. F:'li:Rff'1:1: T I::ff',l[:;, :1: I'.,iSI::'I:i:C:T :[ ON I"IlJ'.:;T l::31F.: O[i::"['l::l ]~ 1'.4El::,.; ,;: ;?. ::, l::l'.:i;-..,li::t..I ]: L.."t'::i I.,.1]: M... HOT I!::l:i: t:::IF'F:'R:I:)VI::D i.'.! :1: '/'l.l(:)i...IT I:::11'.,t EM.:i:C'T'I:: :[ C. FiI... :[ IW'.~:;F:'I:CT ]] Ot'.,I I:;:'.EF'OI;::T.~ FIND ,:::];::, THE t!:i:LI:E(:::TF;:: :1: OF:IL. t.,.l(:)i:~:l.( i"IUST li:::[]: t:::,(::ff.,ll:: B'.F I:::t I... :i: Cl~i:l'.,ISlii:l:::, E::I....E::C:TI:'. ]: ~::: 7 F:II',I. ::: :':'"::' ...~..~.:...~ ................. ,L ......... J:::'~::',::: ........... FIPF'L. :1: ~::;I:::INT; [~:'; LII",~. :1: H :1: 'T'i::t:) SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 b C~V~('.~ .~ ~Jv~ \;',,~; ~,,(-l DATE PERFORMED: 4--~"]'-~ /--o ~- '7_. i~ i~(_k z. 5'p,';,',r~ /-I;ll.~ SLOPE SITE PLAN WAS GROUND WATER '~ ~ S ENCOUNTERED? ~--~ L O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop .'F 14zo I ,,$-i].-r~¢ ~,.)'.OL~IIc,'.~L, ~10 o,S~,/'o,,'j"b 0,08 PERCOLATION RATE TEST RUN BETWEEN 72-008 (6/79) 86-186 Well Owner ,."":"M'W DRILLING, Inc, BoJ< 110378 · 10330 Old Seward Highway (907) 349-8535 ANCHORAGE,. ALASKA 99511 ~'~. DRILLING LOG Designs in Wood , .UseofWe]l Domestic Location (address of: Township, Range, Section, if known; or distance main road Lot 2 Bluck 2 s0rin~'Ilills Subd S~ze of casing 6" Static water level 216 Screen ( ); Perforated ( Describe screen or perforation, ~ --4 Wen pumping test at 2.0 gali6hs p~ ~ (minute) for ] hours with 100% . o~ drawdown from static l~el,;- Date of completto~ 6l'il/a[-; : :.~:. ~[.~. Depth in feet from -:~;; :' ?j,. ..,:[ ":~.':~i, .." . gro~d surface Give derails of formations penetrate~t~e of ~9~olo~nd hardness _ 0 TO 2 2 .TO. 3 3 .TO. 4 4 .TO. 30 3O .TO. 9O 90 .TO. lllTo. 180 180.TO. 220 .220TO 262 __.TO .TO .TO .TO Depth of Hole 2~2 feet Cased to 26 ~. 6 . feet , , ,~ ,.'~ rt. ~v~: (below) land surface. Finish of Well (cheek one) open end i X ); Certiflcat~ No's. 814 & ~7~ .TO¸ TO 3 -- CONTRACTOR DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519:6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPR©VAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# _~\,~ ~\ GENERAL INFORMATION Complete legal description Lol 2; Block 2; Sp~ng Hills Est~ Subdivision Location (site address or directions) 9210 Sprin.q Hi~s Circle Anchorag ~., Alaska Property owner Mailing aSdress Lending agency Mailing address Agent Ad dress Ron Huf fman 1501 West Nortke~n Li~ts CITY MORTGAGE ATTENTION, Wa~¢, ¢n~¢~ Day phone 274-7674 work 546-1151 &om& Bo~le. vard, Anchora~&, Alaska 99517 Day phone Day phone = Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~¢~ ~ TYPE OF WATER SUPPLY: NOTE: XXX Individual well Community welt Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) F¢on( MOA ~21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, lfurtherverifythatbasedontheinformationobtainedfrom 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 Address Engineer's signature D~//HS SIGNATURE Approved for Disapproved. S & S ENGINEERING 17034 Eagle R~ver Loop Road Ne. 304 Eagle River, Alaska 99527 Phone bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments Note: Total absorption in error on inspection report but soil average also in error. Total absorption is 858, soil average is 1'78. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineeds work. 72-025 (Rev, 1/91) 8ack MOA ~1 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type~~lf A, B, or C, attach ADEC letter. Date completed Log present (Y/N) c./¢=~. :~ Total depth ~ (¢~- ' Sanitary seal (Y/N) Date of test Static water level Well flow Pump level ADEC water system number (~-1[-~ Driller Cased to _ ;Z. (¢,~ I , ';;~ Casing heigllt ~ Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION ~0 _ g.p.m. ~. ~ ~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ____/OdD Absorption field on lot Public sewer main k3/~ Public sewer service line ~,3l IA ; On adjacent lots ; On adjacent lots _ Public sewer manhole/cleanout __ Petroleum tank /~o -/- ., ) WATER SAMPLE RESULTS: Date of sample: ~5~ ~ I -' B. SEPTIC/HOLDING TANK DATA Date installed [ -- J '~- ~ Cleanouts (Y/N) t1 High water alarm (Y/N) Date of pumping Nitrate ~--~1~ ."?.5~.~o¢,¢ (tO.'~_~'~ O,I, er bacteria Collected by: ~<~ _~ ~--~ Tank size /~ ~O ~/ Compartments Foundation cleanout (Y/N) !d Depression (Y/N) Alarm tested (Y/N) . SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I (.20 f- On adjacent lots To property line ~ Absorption field _ Surface water/drainage 14[r20 '/- Foundation ~ Water main/service line 72-026 (Rev, 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump o~" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION T~ Well on lot On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA date installed Length ~ (C~ ' Width Total absorpti(~n area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating ~--~ "~ ~/~, ~'~ System type Gravel thickness /~. ~ Total depth ~r C eanouts present (Y/N) Date of adequacy test for If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO; / Well on lot / ~¢ ~ To building foundation On adjacent lots . On adjacent lots ! LeO 'f' Property line Cutbank To existing or abandoned system on lot ~,--~ 'f' Water main/service line Surface water . Curtain drain bedrooms /oo -/' Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on Signature ENGINEERING 17034 Eagle R~¥er Loop Road No. 2g4 Engineer's Name Eagle River, Alasl~ ~0~;77 ~;!,. Date ~ "-'/~ ~ ¢~ ~'~ '" this inspection. HAA Fee $ / ~0, ~0 Date of Payment '¢, //'P', Receipt Number ~ .~ ~:~.. r~/ Waiver Fee: $ Date of Payment Receipt Number 72-026 [Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL I BORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS REPORT BY SAMPLE £o~ ~ORKerdor~ 36788 Date Report Printed: AUG 5 91 ~ 12:20 FAX: (907) 561-5301 Client Sample ID:L2 E2 SPRINg HILLS ESTATES $/D PWSID :UA Collected AUG 1 91 ~ 16:30 hrs. Received AUG i 91 ~ 17:10 hrs. P~eserved with :AS REQUIRED Client Name ;S & S ENGINEERING Client Acct :SNSENGP BPO ~ PO { NONE RECEIVED Req J Ordered By : Analysis Completed :AUG 2 91 Send Reports to: Laboratory Supervisor :STEPHE~EDE / 1)S & Chemlab Ref $: 913841 Lab Smpl ID: I ~atrix: WATE~ Allowable Paxamter Tested Result U~ts Nethod Li~t~ ................................................................................................................... NITRATE-N 0.43 ~/1 EPA 35~.2 Sample ROUTINE SAI~PLE COLLECTED BY: R.D.J, Remarks: I Tests Performed ' See Special Instructions Above UA-Unavailable ND- ~one Detected "See Sample Remarks Above NA- Not Analyzed LT-Less Than, GT-Greate~ Then ~,~ SSS Member Of the SGS Group (SociOt~ G6n~rale de Surveillance) A CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562,2343 5633 B Street Drinking Water An Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PRIVATE WATER SYSTEM Name Mailing Address Phone No. S & S ENGINEERING 17e3~4-E~le River Loop Road i~i_ ~_~ Ea~le River, Alaska City State Mo, Day Year SAMPLE TYPE: ~ Routine Check Sample (for routine sample with lab ref. no. ~ Special Purpose Zip Code .) [3 Treated Water E3 Untreated Water SAMPLE Time NO. LOCATION Collected I Collected TO BE COMPLETED BY LABORATORY SatiS shows this Water SAMPLE to be: is factory [] Unsatisfactory E~] Sampletoo long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS! BEFORE OOLLEOTING SAMPLEi' . Reported By TNTC = Too Numberous OB = Other Bacteria Membrane Filter:. Direct Count Verification: LTB. Final Membrane Filter Results To Count BGB Collformtl00 mi Coliform/100 mi pART ONE OF RE:nAmOE. R TO,. rOt. LO'V,' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF iNSPECTiON FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL fNFOR, M'A~'ION Application Date (a) Legal Desciiption (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ,/~'~_;/_~?,.~s _.L,,4 ~-'o-4L,.. 'Telephone: Home Applicant Address Business (c) Applicant is (check ()ne): Lending Institution E]; Owner/builder~, Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [~/ Multi-Family [] Number of Bedrooms _ Other WATER SUPPLY Individual Well¢ Community [] Public ~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsit¢ Public [] Community [] Holding Tank ~ f Note: tf community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) J-'NGINEERING FIRM PROVIDIh,~ 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 arid State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm A~>(5:~('~l ~,'~ ~t- ~)'~7% Telephone Address :-~-~ ~> /-. Date Engineer's Seal ', Dale ~. t~errell ,,', ~ DHEP APPROV~ -" ~,~[,.." ,:~,~ ,-- - Approved ~"' Disapproved ,: Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ~_~,.~'/-- Well Classification _~¢7)~ Well Log Present (Y/N) 61~ Date Completed Total Depth ~'~'- sed to Static Water Level Casing Height Above Ground / /::~' Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot . B, C, D.E.C. Approved (Y/N) /J/¢4 If A, Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) _ Depression Around Wellhead (Y/N) ; On Adjoining Lots To Neares"t Edge ~f Absorption Field on Lot /~'2DP.~- ; On Adjoining Lots To Nearest Public S~wer Line .___~//,a, To Nearest Public Sewer Cleanout/~'anhole ,,u/,4/ ~ T~ Nearest Sewer Service Line on Lot Water Sample Test Results __ SE?TIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) · _ Air-tight Caps (Y/N) _ Depression over Tank'"J(Y/N) Pumping/Maintenance Contract on File (Y/N) ~-,3/.~ Holding Tank High-Water Alarm (Y/N) / Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line / TO Water Main/Service Line Course ~ /OO Comrnedi~' Size /~"--~ O No. of Compartments ~ Foundation Cleanout/kj~) ,¢'~_.._-. ~ -.b~ V,.,-,(Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) _ To Building Foundation ~, S~ F--~- To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-02'6(11Y84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ,// Width of Field ,/~, ,%~ ,~')'- Square Feet of Absorption Area Depression over Field (Y/N) /V'/' Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ./0(~'/-,~ To Building Foundation /// Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area '~¢'/-// ~--'^- Type of System Length of Field ~z~ /3'7- Gravel Bed Thickness ~.¢ · Standpipes Present (Y/N) Date of Last Adequacy Test /tJE~J To Property Line _ To Existing or Abandoned System on ; On Adjoining Lots ,.'(~¢- To Cutbank (if present) ~/?/~ Comments D. LIFT STATION Date Installed 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 ~ .~'"'~umping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have cheC/~eq, ,/eCf~.d, ¢'~ conformed to all MOA. and HAA guidelines in effect on the date of this inspection. Signed /~'~.,;~/'"/¢//'~ /~'~.~("~/~---I~e ¢///c ¢.,/~¢-~¢) C 0 m p a n y ~:::~"~¢~,-~ '~'-~ ~'~ ~/'~'~ MOA No. Receipt No. Dateof Payment Amount:$ ~ , ~ Page 2 of 2 72-026 (11/84) }.IEL;.SE, I~C£'J & 2220 I~%L;I.' 8~3 AVaqUC ANCIIiX~AGI'~, Al( 99507 (907) 349-6451 WATER ~I!iLL TF2Y£ Client'S Add~:ess Znitia]. Reading ca Mat:er: .... ~L~3-Q.2-~. .__ CALLON.'~ ~, VOL;JMM CJ~L LO~L~ fl~/£AL VOLUHa 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALAS~O& 99709 6957 OLD SEWARD HIGHWAY, SUITE 101 , ANCHORAGE, ALASKA 99518 TO BE COMPLETED BY Ct. lENT I~ PUBLICWATERSYSTEMI,D.#~---[ II PRIVATE WATER SYSTEM ,,,..- , 907-479-3115 907-349-8623 Drinking Water Anaivsis Repo,rt for Total Coliform Bacteria TO BE COMPLETED BY LABORATORY Received at: '~= A~ch. [] Fbks. Mailing Address City Slate Zip Coda Mo. Day Year Purchase Order No. [] Treated Water: [] Untreated Water Collected by SAMPLE TYPE: . ,p' .Routine [] Special Purpose [] Check Sample (for original contaminated .. sample with lab reference no. Sampl~ Time 2 ,? - - 4 5 ,' / t / ./,/ ~ ///.~' ?/:',-,. ,l ,f.. ,/ / ..P.,~¢,_.:.,, Signature of Representative , . , : . ~R ~BO~TORY USE oNlY :':' ' ¥ ' Date Received _ ¢~,~;.~ '~///~:'~ __ Time Received Next Sample Due COMMENTS: SATISFACTORY UNSATISFACTORY U RESAMPLE R OTHER BACTERIA OB TOO NUMEROUS TNTC TO COUNT Direct Final Count Result Verification LSB BGB *Nq,'qf Total Coliform Colonies per 100 mis. ~el)drted by/ Time ring Hill Estates Block 2 Lot 2 #015-051-69 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak, us (9O7) 343-79O4 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING _o Parcel I.D. 015-051-69 1. GENERAL INFORMATION Complete legal description Lot 2 Block 2 SpHn.q Hills Estates Location (site address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address HAA# W'~ ozo~t3 ExpirationDate: I I],~ I0 ~- 2. NUMBER OF BEDROOMS: 9210 SI3Hn~ Hills I~,~; Anchora.qe, AK 99516 Ronald & Karen Huffman Day phone 346-1131 9210 Sl~rincl Hills Drive, Anchoracle, AK 99516 Day phone Jan Penninqton Day phone 244-3099 Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [~] Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties sen/ed by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties sen/ed by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties sen/ed by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my Investigation based on procedures outlined in the Health Authority Approval Guidelines for this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms 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 Pannone Enq. Svc. Phone 272-8218 Address P.O. Box 102954, Anch, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date engincering analysis of the sTstcm in accordanc~ ~ith MOA DSD Guidclin~ & Regulations. Thc ..~' ~ ........ reported results describe the performance o f the system under thc conditions e~l~ at ~e ~c o f ~,~,~ .~,.; ........... the test, and separation distancea measured to readily identifiable f~turea. The operational life o f all ~ ~'9...** we~sandsepticsystemsdcpend~nth¢~a~s~i~c~nditi~n~gr~undv~ater~eve~sthat~yfl~t~ ~ '~'.'" ~.c~ '~-'~ #....i.. x ....... results do not guarante~ futur~ pe~'ormance o f the system, nor do they guarantee timt th~ ~¢ no -~~,.~C.~A,.~ ............ ?.~.~..~ hidden defects or encroachments. PES can Iherefore not provide any ~xranty for future performance ~ ~ ~.Steve n ~. Fo n no ...... ~C~; i~orgtwe~yestmlateofhowlongthesystemwillcontLnuetomectlheoperattonal~of~e ~ '..~. % No. CF' ADEC or MOA DSD. Thc cont=t of this report is for the s~l¢ benefit of thc owner listed a~v¢. ~y }e~-~'_..,..~. ZC~c~....."~-¢~/~ reliance upon or usc of this report by any o~er person or lXm7 is not authorized nor will it co~ ~y ~*~ .~) ',~* ·.,., .;-,,, .'_'~bX...~ 6. DSD SIGNATURE Approved for Z/f Disapproved. Conditional approval for __ Additional Comments bedrooms. bedrooms, with the following stipulations: Y-9"" ~-~.' ...~.. ON-SITE !-i WATERAND :m: ~ WAST~:W~,TER · PROGRAM i' '.; · ...... Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other (Rev Odginal Certificate Date: Reissue Date: Municipality of Anchorage Development Services Department , Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Desc~ption: Lot 2 Block 2 SDrina Hills Estates Parcel I.D.: 015051-69 A. WELL DATA Well type _P If A, B, or C provide PWSID # Well Log Y Date completed 611111986 Sanitary seal y_ Total deplh ~6;~ fl Cesedto 261.5 FROM WELL LOG Wires properly protected Y Casing height (above ground) 31 in. AT INSPECTION Date of test 6/ttlt 986 7123/2002 Static water level 216 tt 202 fl Well production 20 g.p.m WATER SAMPLE RESULTS: Coliform 9 colonies/100 mi Nitrate ,~ Date ~f sample: 7/23/2002 Collected by: B. SEPTIC/HOLDING TANK DATA Laura Pannone 6+ g.p.m Other bacteria 0 colonies/100 mi Tank Typa/Matedat t250 Gal Steel Datelnstalled 111711986 Tankstze 1~,~0 gal Number of Compartments Cleanouts 2 Foundation cleanoul Y Depression over tank N High water alarm NIA Date of pumping 7124/2002 Pumper Northland Pum~ina C. ABSORPTION fiELD DATA .. ~ ~ . Dateinsta,ed11,71,,,/~l ~ratieg (g.p.d.m orfl ~rm)m//0;? ~ s~emtype /_ Length I~, fl/iS '* WKflh 2.6 fl/~,~ -. Gravel balow pipe I~., ~',~ · ~ I_, To~al depth :t,/y/_~,~ Elective ~ ama ~S8 f~/q ~.) Monitoring tube y/V Depression ove~ field J~L~,~ Date of adequacy test 7123/20021 t/"Resuits (Pass/Fail) Pas~ For_4 bedrooms Fluid depth in absoq~ion field ba;ore lest ~[Eia ~/~(~ Water added600 gal/*~r--) - New depth1 in//.*/~/' Elape~T'me ~Omin/qqo,~;aFlnat fluid delX, 0 In/~ G' Absorption rate Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date (Rev. D. LIFT STATION Date installed 'Pump on' level at Datum in'Pu{~ E. SEPARATION DISTANCES In Manhole/Access High water alan~ level at ~ in Mee~s alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanUift station on lot iO0+ Absorption field on lot 100+ / Public sewer main '100+ On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout t00+ Sewer/sel~ic service line t00+ Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5" Property line 7''~ Absorption field Water main 25+ Water se~,ice line 25+ Surface water 105+ Drainage 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ./:~, t,~.,~ex- Property line 7 ~ ~;~ Buildi~ four.ion 'A~ ~ ~OA ~ o~inal in~all I · . G. ENOINEER S CERTIFICATION - ~ c~ ~ MOA H~ ~s ~ven E~in~Fs Pd~ Name I-IAA Fee $ ~'~ Date o, Pa,ment Receipt Number (R~. Waiver Fee $ Date of Payment Receipl Number gOT§SIS301 T-ZgZ P.OZ/O~ F-St2 L'ni'm M~ ~e ~, Ini~ Ni~m-N 0.200 ~g/l. EPA 300.0 (<10) 07/2~,'02 ToM CoTifonn (<l) 09,'23~2 SBH CT&E Environmental Services Inc~ 2C0 W. Potm~ Drinking Water Analysis R~ort for Total Coliform Bacteria ~.~..,.. ^, saass.~sos Te~ {e~07) 562-2343 SeMI la~ :3 Rout[ne ct Trnnt~d Water Ct RepeatSampl.(for ~ufln. [amp~ ~ Unt~Water ~ sF-,., ~.,~.,. Ir~/~1 ~ ~ . ~ t [ J-' ~lm. C~IscI~ ~AMPLK bOCA~ON Cell~td lh, ( TO BE COM. PLET~D BY LAIIOR.ATORY n ~ · S~le ov~ 30 hour/o~,~l~ ~ ~ S~le ~ Io~i in ~:; s~ple should Time ~ /,~ AMlytftal~e~od; ~Me~Fil~r · N~ ofcoloni~l O0 mL L~ R*f. h'o. Result* Analyst ~leflg aoflfltd Of untltlif~ mulU: BAC~£~ZOLOG~CAL WAT]ER ANALYSIS EECOR~ Membrane filter: D~t C~nt V.~cntlon: LTB FerMI Coliform Confirmation f~al Membrane ~er R.s~lu .E. Ce/i Cnlonlts/100 mi Collfarmll OI mi ~1~ I~m'~ #,,-,,kM.~, t,la ~l Grouo ISac[~t Genirele de Sutveig .~lnct.} , HOUSE DETAIL · ~'~~":~ZZ~'~ /.--~"°~ "' ~' ~c~ // ~ ~ I .