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HomeMy WebLinkAboutNORTH WOODS BLK 3 LT 1Northwoods lock Lot I 051 - 731 -39 · MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ,~To-,z- ~'.~/~-.~ ~ SEPTIC ADSORPTION Address ' TANK FIELD WELL Phone(s)~ ~--- ~)--~,~- IPermit NO'~OO '? N°'SBedr°°ms WELL ~/ LEGAL DESCRIPTION LOT LINE ~5- Lot/ [Block ~ I Subdivision ~ ~ ~oo~ FOUNDATION Township, Range, Section AS-BUiLT DIAGRAM (Show location gl well, septic system, properly lines, foundation, r/~'-~ ~ I ~ ~'~ ~ ~ driveway, water bodies, etc.) , N ~ SEPTIC ~/¢,>¢ ~ HOLDING Manufacturer Capacity in gallons - ~ ~ Material No. of Compadments TYPE OF SYSTEM :TRENCH ~ BED ~ W. DRAIN :OTHER Fill added above origina[ grade Gravel depth beneath pipe // I ~ ~ / -- I Gravel length Gravel width 'Tg- FT /~ FT , Total absorption area ~ ~SQFT ~r~2~D ~u~ ~ Installer Z~ ' ~ ~ ~ Date Installed ~ J i WELLS ~ ~ ~ I ~ PRIVATE ~ OTHER (Identifv~ Classification (A,B,C) Total Depth FT C~sed to ~ F~ / '' REMARKS: ~/ ~=,,/~ ~." ~ .... ~i ~o~ ....... , Scale: /r~ , ;~hG~NEER'S ~'EAL~ I~ I ¢ ¢~ cedily thai this inspe~i0n was ped0rmed according to all Municipal and State guidelines in elfect on this date: .. / Health Depa~ment Approval: . . ~/~ ~' ._ Date' 72-013 (31851 EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAC:.~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Phone 694-5195 '~¥ To ~'.~-.~ ~.--,,,-;.-, RECEIVED IVIJ®UL ® LETTER Date Subject ~ ''/'' / EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 Northwoods ~1, Lot 1, ~IocK 3 JOB- SHEET NO, OF CHECKED SY DATE- SCALE ........... i.....6..i..~.~ e~-a-~ s----.~.-rdm---~'---~en~ r ~----- ~a~-f ~-a- =i--.~--ic~M...~-~e~i......~.~ e~.a ~ i ............ i ........ i i .......... i'""'"":i ............ ............ t......~.~.~.~.~.~:~..~:~.~.~.......~1...~..~.:~..~1:....~i~r~~~.~.~..i.....~ ........... i ...... i ............ i ....... i ........... ! i ........... i ........ i ............ i ............. [ ............ ........... i .............. i ........... ~'"'"'~'~'~'~'~;'~'~'~'"'i'~'~"~'"'"~'~"'"~'~t~a] imahi~o~-~. ~ -i i i i i i i i i i i i i L~t~ai ~is~bu~i~n ~-9~esiw~!lib~ 3~1~i.I i(O~fibe~ i i ............ i ............ [ i ............ [ ....... i. ............. [.......J..i ........... ........... i ............ i ................. A~s~m.~.hg..5' p~es~.u~e-...~r~p.~ ~c.~os~..---5~~f.~-c~ ..... i i ......... i ................ 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' ~ ~ ~ .......... i ............ i .............. i .......... i ................... i ..... ! ...... i ...... ~ .......... ~ ........ i ........ i ......... ~. ...................... ! ........... i .......... i ....... ! ........ ~'":o~?f~'"~i ............ i ............ ........................ : .......................................... : .............. ................. : .................................... i .......... -i ............... ?'"'i ............. i ............ i :i !' i ¢/ 1§' Uti"ty Eoement ' ' . 3~ I · I I D~PT. OF HEALTH & L: ! 85' ~ I I I ! ~NVIRONMENTAL pRO~E~iON I '] ~ ~ ~AY2 19~ .... ~ MT n, M~ ~ , ~ - TE~ HOLE ' ~O~,O~' ~ - MONITOR TUBE / 15' Utility Eaement ,, ] ~ ~////x . ~Z Z I Exis~ng ~ E I I Leachmm~ I I ~ . 3~ I,1 I I ] -- Do~ ~back " I ; ::::: - CURTAIN DRAIN ~ Avg Slope = 2~. ::::::::::~- PROPOSED L~ACHFIELD ~S. EM~NT. LEGAL: Lot 1, Block 3, Northwoods #1 ........... , .... · .... -, . ;let,' ~.~. , ,z~. , ~ ;, ~ OWNER: Mr.Ouigley };l ; l~~ ~~ ' l ..... ' .......................... ; 'N/ JOB # 87-3731 DATE: ¢/1 /901 SCALE 1" = 50' ..,.,..:.: c~.:sx:::~. ' ~ ( l. (l~O ~ '' '; 'J ''. A';' -'% 4::',':,' ~'~:: ;&'..'7:'. · P.O. Bo~ 773294 -;..,.' ;, :,-- :¢~,~,,..~ EAGLE RIVER, A~ 9957? Eevbed .it* plon/~o .how addition to house. No other (9Or) 694-5195 ~: (907) 694-3297 chang., from 1988 ,ubmit,,I From Lift Station 1" PVC -- 5' Spacing typ. 6 holes each lateral CAPPED ~ ,-, ~ 5' -~ Mt C PALITY OF ANCHORAC'.'~ 3/16" DPJ~N HOlE/ DEPT. OF HEALTH & ON BOTTOM ENVIRONMENTAL PROTECTION . MAY 2 RECEIVED. In, Ear-bh Cover ~ Il' y 1" Laterals ~ ~ /- Insulation% ~.~' i.'..,,jq~.~' ~ I ... 7.'.%'".~..:'o'i ' ' 6" eewer rockj ~ Sandy fill LAYER C]NN_ (~ROUND SURFACE /aferal Derail --~.'~OFA.~?t%~:. ' LEGAL: Nor~hwoods #1, Lot 11 Block 3 ~ "" ~'" '-':~ ' OWNER: Mr. Quigtey ¢'*/49!~.~ ~*~4~. · CONTRACTOR: N/A '~' .... ° .... ' ........ °'""'~"~" JOB # 87-3¥3I,.DAIE: 05/01/@0I, NOI 10 SCALE ~'~:'"~~,'~o~. to~,A.~.~,o~a .'°:~. · P.O. Boa~ 773294 ,~?~,,,,'2~'&,~.,.,~%, EA~LE RIVER, AK. 99577 (907) a94-5~95 ~.4~: (907) 594-3297 81.17" ¢/ 15' Utility Easment ]] I~~ ~ s~p~c I ]] I. Q Exi~tlng ~ ~ ! '- ~ I ~ ~' I 30' Setback '- , [ MT ~ Cudoln drCn MT J ' , 101.03' o - MONITOR TUBE ....... CURTAIN D~IN ~ Avg Slope = 2~ ::::::HM- PROPOSED EASEMFZqI SEPTIC SITE PLAN ~.,... ~....~,'~, LEGAL: Lot 1 Block 3, Northwoods //1 ";'" OWNER: Mr. Quigley N'A(, CONTRACTOR: JOB # 87-5751DATE: 04/~8/9°1 SCALE 1"= 40' EA~LE RIVER ENGINEERING SERVICES P.O. Box 77329~ EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 ~' SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LOT l, BLOOK 5, ~ORTHWOODS ~l GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 5. All materials and workmanship shall meet the Anchorage Department of Health and State Department Of Environmental Conservation require- ments. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer, 5. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly io the area shown on the site plan, any deviation requires engineer approval. B. It is always recommended that a surveyor locate the 'nearest lot line position and the looatioo of any easements. BED 1. The bed is to follow the natural land contour to maintain uniform · · :total depth of the bed bottom. 2.. ' The bottom of the bed shall be level, plus or minus 1.5". · '5. The total depth Of the bed excavation is not to exceed 2.5' at any point. 4. The sewer line is to replace the existing sewer line that leads to the existing leaohfield. . 5. The bed gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 4~ or equivalent is to be placed over the leachfield. 7. Th8 'aFea over the bed is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be olosor than 100' to any existing private well, 150' to any Class "0" well, or 200 feet to any community well. ~EOOMMENDED LEAOHFIELD DIMENSIONS 'OTAL DEPTH =2.5' GRAVEL DEPTH = 1' )oil Rating = 284 ~edroom Capacity= 5 ~eptio Tank SiFe = E~isting BED LENGTH = 75' BED ~¢.I. DTH .= ~**NOTE: LIFT STATION REQUIRED TO BE PREAPPROVED 500 GAL. ANOHORAGE TANK TYPE [NSTALLATION OF WIRING BY LIOENSED ELEOTRIOIAN TO MOA OODES. INVOICE DATE: ApPil 19. !990 TO: hlr,~ Ou ~ gl E;V 7806 Mc~qar;us Or'~ Chuqiak~ At<. 9956'7 INVOICE NO: 90--0064. LEGAL DESCRIPTION= NoPt:h,/,,oods 8:1 ~.o'L I~ !'3qk 3 ?806 ~cD4ai"lus bp'fv.'.e TERMS: !0 OAYS PROFESSIONAL SERVICES .~..E.s,.c,,R..L.E.T.!._0~_ ................................................................................................................................ p_U._A_~ .e.._E ..... ~,,,~:~.~,3 Fd.OT P.../~N & !A!ATER MONITOR FC)R PERMIT .r~ ' = PLEASE PAY THIS BALANCE ................................... $ 200.00 PLEASE PAY FROM THIS INVOICE HO STATEMENT UILL 8E SENT REFERENCE ABOVE ~NVO~CE NUMBER WHEN ~AKZNG PAYMENT THANK YOU ! Invoices ~r,e due Un~F' the '~erms sta'c~d ~bove~ Invoices no~: pa~Td P.O.B.. ??3294 Eag']e ~qven. AK 995?? Phone: (9071694¢5195 Fax: 694-.3297 Fedana3 Z ~D~ :!.!-920119547 JOB :!~ 87 ~373 unicipality of Anchorage Department of Health and Human Services ,' Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 January 9, 1989 Secretary of H.U.D. 701 C Street Box 64 Anchorage, Alaska 99513 Subject: Lot 1 Block 3 Northwoods Subdivision Permit #880001, P.I.D. ~051-731-39 A permit issued by 'thi~ Department for an individual well and/or'-on-·site sewer system has expired as of December 31, 1988. 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) musk.be sent to this Office for review and apprdval', -and for documentation. When applying for a new permit, the fees are: $90.00 for an on-site sewer permit; $50.00 for a well permit; $140.00 for a combined sewer and well permit. If there are any further questions, please call this office at 343~4744. Sincerely, Daniel J. Roth Acting Program Manager On-site Services Section DJR/ljw enc: Copy of Permit This Section for Department of Housing and.~an Development Use Only: BROKER NOTIFIED OF: (~Acceptance ~ · Bac -I~Un No Conditions of Sale ~/~ A. All assessments, including i / /~B' ment'taxes'rent'andgr°u ,,~ .......... //~/ A ..... Purchaser will accept the pi the property, including but make no repairs to the pro! C. Should Purchaser refuse or at Seller'g'sole option, retal~ earaes~ money, or any porti D. Seller ~nay rescind this cont~ 1. Seller has not acqu,ired ti 2. S31~r is u,qable or' unwilli 3. Seller determines that pm Tender of the deposit shall r E. Risk of loss or damage is as; in which case state law shall this contract. Tender of the, F. If this property is being offe: stitutes a commitment to ins~ an acceptable borrower, and G. Purchaser understands that S H. No member of or Delegate t( any benefit that may arise th~ tion for its general benefit. I. Purchaser warrants that no p, or understanding for a comm established commercial agenci Seller shall have the right to ~ the contract price or considen Purchaser and Seller agree th~ assigns but is assignable only ;t or penalty for advance pay- not warrant the condition of / ~ code requirements and will time limitation, Seller may, es the right to apply the ler for rent. - ~nditions: the property prior thereto, erves the right to terminate m this transaction. tance of this contract con- dorsement Underwriter to be ~ time the sale is closed. ~art of this contract or to act if made with a corpora- )ntract upon an agreement >loyees or bona fide · violation of this warranty, ;er to pay, in addition to atingent fee. ministrators, successors or If this property was constructeu prior to ~v/3 {.or between 1973 and 1978 without HUD insurance or assistance), Seller has in- spected for defective paint surfaces. Seller's inspection found no defective paint surfaces, or if defective paint surfaces were found, Seller has removed such defective surfaces. Purchaser understands and agrees that the Seller's inspection and/or removal is not intended to, nor does it guarantee or warrant that all lead-based paint and all potential lead-based paint hazards have been eliminated from this property. Purchaser acknowledges that he has receivd a copy of a brochure which discusses the lead-based paint hazard. L. The effective date of this contract is the date it is signed by the Seller. M. If the amount stated in Item 5 (obverse) exceeds actual alloxvable financing and/or closing costs, according to the list of such allowable expenses provided to the Broker by Seller, such excess shall not be paid by Seller and ma3' not be used by Purchaser to reduce amount(s) owing to Seller. N. Seller's policies and requirements with regard to earnest money (including forfeiture thereof), extensions of time in which to close the sale, back-up offers, and allowable financing and/or closing costs are detailed in instructions issued to selling brokers. O. This contract contains the final and entire agreement between Purchaser and Seller and they shall not be bound by any terms, conditions, statements, or representations, oral or written, not contained in this contract. U.S. Departr~.ent of Housing-~~ and~Jrbm, Development ~ Office of Housing Federal Housing Commissioner Property Disposition Program - ' . (Purchaser(s)) agree to purchase on the terms set forth herein, the following described property in H,~.lCl_p~,I !ty OE ~neh~ra~ounty, State of ~[a~ka The legM description of the propeay is: ~O~ [eB[k. 3 ~O~[h~oo~ ~ab./ ~e address is: 7806 ~n~n~ (Strut N~ber, Street Name, Uni~ Numar, ff Appg~bie, and City) 2. ~e S~creta~ of Housing and Urban Development (S~er) agre~ to se~ the prope~y described above at the price and terms set fo~h here~, ~d to prep~e a deed contai~ng a covenant which w~ants ag~st the acts of the Seller and ~ clog by, t~ough or under h~. Title will be taken in the fo~owing n~e(s) and style: TOK HU~ 0UIGL~Y, a marr~e~ woma~ ~ (OMB. No.2502-0306 (Exp. 9-30-89) HUD Case No. 111-026237-203 3, The agreed purchase p~ice of the prope.rty is .......... >"' '~ ...... -': ..... : .............. v' '.'-' J ...... ~-: 3v $14~:'~00, 00:: ~' Purchaser has paid $ 1 · 000.00 as earnest money to be applied on the purchase price, and agrees to . - pay the balance of the purchase price, plus or minus prorations, at the time of closing, in cash to Seller. The earnest money deposit shall be held by "l'o~ay s ~ Re~.l g~taL~ 4. ( ) Purchaser is applying for HUD/FHA insured fmancing with a down payment of $ in cash due at closing and the balance secured by a mortgage in the amount of $ for iq!A months (does not include HUD/FHA Mortgage Insurance Premium). ) Said mortgage involves a repair escrow amounting to ..................................... ( ) Purchaser is applying for conventional or other f'mancing not invoMng HUD/FHA insured financing. 5. Seller will pay reasonable and customary, but not more than actual, costs of obtaining fmancing and/or closing (not including broker's commission) in an amount not to exceed .............................. ~- 5. $ 300/00 6. Upon sales closing, Seller agrees to pay to the broker identified below a commission of ................ 7. The net amount due Seller is .................................................................. ,. ~urch~e price, Item 3, less Item 4 escrow, if any, less Items 5 and 6) 8,. 'Purch~er ( ~ w~ ( ) wffi not occupy t~s prope~y m the prim~ r~idence. 9; ~ The sfle sh~ close not later th~ 60 fl~l'e ~ff~er a~e~p~a~O~ ~6 ~q~ . Clos~g sh~ be held at ~ 10. If Se~er does not accept t~s offer, Se~er (~) may ( ) may not hold such offer a a back-up to accepted offer. 11. ( ) ~ addendum is attached hereto and made a pa~ of.t~s contract. 12. ~s contract is subject to the Conditions of S~e on the reverse hereof, w~ch ~e inco~orated herein and made a pm of this contraa. Certification of Purchaser--The undersigned certifies that in affixing his/his/its signature to this contract he/she/it understands all the contents thereof (including the Conditions of Sale) and is.in agreement therewith without protest. Purchaser(s) Address Purchaser(s): (Type or print names, Social Security Nos., and sign) Tek Hui Q~igley ~£g~';'£-,3¥,~'~. ~; _Seller: Secretary of Housing and Urban Development I~y:~¥pe Name and T.l.tl_eand-Sign ....~ '~.~<...~.. - _- ~.- ~ ..... ~ .... 17440 Beaujolais Circle Phone No. Date Contract Signed by Pumhaser(s) Date C~ntract Accepted by HUD Certification of Broker--TM undcrsi~hed certifies that: (1) neither he nor anyone authorized to act for him has declined to sell the property described lierein to or to make it available for inspection or consideration by a prospective purchaser because of his race, color, religion, sex, or national origin; (2) he has executed and filed with HUD, Form HUD-9556, Joint HUD-VA Nondiscrimination Certification (Sales Broker); and (3) he is in compliance with HUD's earnest money policy as set forth in Agreement to Abide executed on 19 . Type Name and Address of Broker (include Zip Code) ;Social Security No. or Employer  Identification No. of Broker (include hyphens) TODA¥'S REAL gS~A~ 430-30-4437 P. O. BO X 6 70 7 8 9 Area Code and Telephone No. of Broker CEUGIAK, ALASKA 99567 Att: Betty J.Fields/688-2321 [Sionature of Broker , I ~ ./ ~-... _~ , ~ , -~ 0'/ .,. Pr~jous Editions are Obsolete: ~py 2: To HUD Lo~l Offi~/Retain by H~D Lo~l Offi~ / HUD-9548 (5-87) P.O. BOX 196650 AN,..,mORAGu_, ALASKA 99519-8650 (907) 343-4200 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 5, 1987 Louis Butera, P.E. Eagle River Engineering Services P.O. Box 773294 Eagle River, Alaska 99577 Subject: Waiver Request For Lot 1 Block 3 Northwoods #1 Waiver Number WR87-076 Dear Mr. Butera: Your request for waiver of the required separation distances to a down slope curtain drain, a lot line and an abandoned absorption field have been granted. These distances have been waived from the required 100 feet, 10 feet and 10 feet, to 80 feet, 3 feet and 5 feet respectively for the proposed upgrade. This waiver was approved because the upgrade of the absorption field will create a 4 foot separation to the ground water table making it comply with the municipal code. Since the proposed upgrade will be adjacent to the house located on lot 2, I do not feel a 3 foot separation to the lot line will be detrimental to a potential upgrade by the owner of lot 2. The overall slope of the subject lot is away from the curtain drain extending parallel to the west and south lot lines. This should cause no interference to the proper functioning of the absorption bed. This waiver applies to the upgrade covered under permit number 88Q'001 and any future upgrade to this system will require another approval from this department. Si erel.y, Daniel J. Roth Civil Engineer On-Site Services cc: Gus Andress, P.E. Manager, On-Site Services/Water Quality Programs EAGLE RIVER ENGINEERING SERVICES  Lou Butera, P~ P.O. ]]ox 773294 Eagle River, Alaska 99577 Telephone (907) 694-5195 December 23, 1987 Mr. Dan Roth Civil Engineer On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 RE: Lot 1, Block 3, Northwoods #1 Dear Mr. Roth: Mr. and Mrs. Joseph Talbott, owners of the property neighboring -the above referenced property, have been uncooperative in providing a statement of nonobjection to install a septic system at the above referenced property with 18' separation distance from their septic system. Please proceed with releasing a waiver of new leachfield to existing neighbor leachfield of 18' separation distance. If there are any questions or concerns, please feel free to contact me at 694-5195. Sincerely, Lo/uis Butera, P.E. LAB:bjr EAGLE RIVER ENGINEERING SERVICES [ Lou Butera, P.Eo P,O, Box 773294 Eagle River, Alaska 99577 Telephone {907} 694-$19~ December 4, 1987 Mr. Dan Bowles On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 RE: Lot 1, Block 3, Northwoods #1 MUNICIPALiTy OF ANCHo;~AG,~ ENVIRONMENTAL SERVICEs DlVlfil©;~ DEC 4 1987 RECEIVED Dear Mr. Bowles: On behalf of my client, information necessary for your separation distance. The waivers required are line - 3', septic leachfield Nova Properties, I am submitting the determination of several waivers of septic replacement leachfield to lot to downslope curtain drain - 80', new leachfield to abandoned leachfield - 5', new leachfield to existing neighbor leachfield - 18' and determination of definition of downslope as applied to this lot. The existing leachfield serving this lot is in violation of the 4' vertical separation distance to level ground water table. We have looked at available options and have determined that this bed design, as shown on the plot pan, is the only alternative besides a holding tank installation. The proposed bed will be 75' x 18' at 2' total depth based on an unadjusted soil rating of 284 S.F. per bedroom. The curtain drains affecting this lot are located on both south and west boundaries of the lot, seriously limiting replacement area under current regulations. As the slope is not excessive, we are asking for a waiver of required distance. The slope from septic system to the curtain drain along the south boundary is towards the curtain drain but overall (corner to corner) slope of the lot is away from the curtain drain. What we have is a matter of definition of slope and actual effect on the curtain drain of leachfield placement. Change in surface grading can be accomplished if this will produce desired effects. The leachfield will be located 7'-8' above local ground water table, as measured in November. Mr. Dan Bowles Page 2 The distance of 6' separation to abandoned leach area allows for twice the installed gravel depth of 2.5~ separation distance. Leachfield to lot line and leachfield to neighbor leachfield effects would be minimal with a bed type system. If there are any questions or concerns, please feel free to contact me at 694-5195. Sincerely, Louis Butera, P.E. LAB:bjr Attachment g, Nv~LU~ N~/clPALI?y OF , ~ '~RWCEs OiVl~~ OLd'(2 I987 RECEIVED ~ ~ ~ SO,LS LoG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~' PERCOLATION TEST 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST PERFORMED FOR: /~,)z~/~. /~-o/~e"¢~, ,/'27~.~,,~,~-~-~¢,-~'/' DATE PERFORMED: LEGAL DESCRIPTION: ~--~' ~' // /~//"~" ~ ~ ;w'-,/~ ~,,,,,'~,~,,,A~..r" "~ 7"/-?'w 10 11 12 13- SLOPE SITE PLAN 14- 15 16 17 18 19. ;GROUND WATER OUNTERED? COMMENTS PERFORMED BY~ IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ff /;/U /~,~ ~ ~ 7~ ~" 20 ~_/Z~ (minutes/inch) PERCOLATION RATE TEST RUN BETWEEN '~/~ FT AND ~ FT 72-008 (6/79) Eaglg River Engineering Services P, u. uox 173294 Eagle River, AK 99577 694-$195 ; · AS-BUILT I hereby certify that I have surveyed the following described property: ::t Anchorage lqecording Precinct, Alaska, and that the improve- ments situated thereon are :~,'ithin the property lines and do not overlap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission line.~ or other visible ea~sernents on said property except as indicated hereon. Dated at Eagle River, Alaska this ROBERT C. JOHNSON SCALE: Registered Land Surveyor No. 880-LS i" ~ '~ ~ Box 456, Eag](~ River, Alaska Phone (997) ~94-2543 EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 -EAGLE RIVER, ALASKA 99577 Phone 694-5195 LETTER [] Please reply [] No reply necessary EAGLE RIVER ENGINEERING SERVIC q3 · Lou But~a, PJL December 15, 1987 MUNICIPALITY OF ANOHORAQE D'Zt'l. UP HEALTH & ENVIRONMENTAL PROTECT/OI~ JAN 1 fl l sq P.O. Box ~Tagg4 Eagle Pdver, AJaska 995~7 Telephone (g07) 694-5195 Mr. and Mrs. Joseph Talbott SR Box 7812 McManus Drive Chugiak, AK 99567 RECEIVED REF: Installation of. Septic System at Northwoods #1:Lot 1, Block 3 7806 McManus Dear Mr. and Mrs. Talbott: On behalf of my client, Nova Properties, I am requesting your statement of nonobjection concerning the installation of a septic system on the above referenced property with 18' separation distance from your septic system. This neighboring septic system will not encroach on your lot and should not affect your septic system in any way. As the Municipality of Anchorage requires a letter of non- objection from the owners of the neighboring lot, we are that you sign, date and return to us the statement below. ~A~lf-~ =ddressecL~ai .... ~ ~n,,~l~ is enclosed for your convenience. ~ Thank you for your prompt assistance in this matter. If there are any questions or concerns~ please feel free to contact me at 694- 5195. Sincerely, I Louis Butera, P.E. / LAB:bjr Enclosure We have no objection to the neighbor at 7806 McManus, Northwoods #1: Lot 1, Block 3, installing a septic system with 18' separation distance from our septic system at 7812 McManus, Northwoods #1: Lot 2, Block 3. Nancy T~lbott~' Date  ~ ,, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MA,L,NGADDRESS( ' OO LEGAL DESCRIPTION ~ -- ~ O DISTANCE TO: I ~ / ~ Liq. cafi~gallons IF HOMEMADE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons ~O DISTANCE TO: Well ~. Foundation/~ [ Nearestlotline/~ ¢;~ PERMITNO.~/O~, Leng eahli . Total length of I~ Tre~i, th Distance No, oflin~ 3~ ~ ~ Matedal beneathti~ inches ~ lopofti,.to,in,sh~ra0e ~ ~ ~ ,riches lot,leff.ct,veabsor~t,onarea ~en~th ~Mth Depth ~[BMIT ~O. ~ ~ T~e of crib Crib diamoter Crib dopth Total effectivo absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: j Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption aFea(s) OTHER PIPE MATERI~LS so~ L TEST RATING ~ N ~ REMARKS/ - S ,~ ! I / A~ DATE~ LEGAL 72-013 I F'ERMIT NO. [:,EPFIR]'MENT OF HEFtETH FIN[:, EN',,,'IRONMENTFIL PROTEC:'I'ION :=._ "L '~TREET., FIN'~H ,' 810504 ) FIF'F'L I C:RNT LOCRT I ON LEGFIL. FJ,.~.::, 601-."I E E,E..,Iz, UN MC rlHN..I.: [:,R LOT i BLK 3: NORTHHOOD, LO'F .=, I ~:E ;20000 SI2~LRRE FEET T'T'F'E OF SOIL HE,-,LF..FTION S'¢STEM IS: TRENCH MH,.,IMUM NIIME;EF.'. OF EEE. Ruufl_, = ~: SOIL RFITTNG ,.'.'Sg! FT,.."BR)= '.~..90 THE RE:4..IRE[, '~ ~F __ ~ ::,I,::_ nF THE SCiIL FIE':-r4'.F'TI-M 'E,'¢STEM IS: THE LENGTH DIMENSION IS THE LENGTH <IN FEET> OF THE TRENCH OR DRFIINFIELD. THE DEF"TH OF FI TRENCH OR PIT IS THE DISTFINCE BETHEEN THE SURFFICE E:F THE GROUND FIN[:, THE BOTTOM OF THE E;,-:;CR',,,'FITION (IN FEET). THERE IS NO SET HI[:,TH FOR TRENCHES. THE GRR',,,'EL DEPTH IS THE MINIMUM DEPTH OF GRFI',,,'EL BETWEEN THE OUTFlaLL PIPE ~; ........ ~_. ............. ,~-_ E,':'.',CFI',,,'RTION (IN FEET). F'ERMI]" FIF'PI_ICFINT ."IH:, TNE RE=,F~N=,IE, ILIT-~ TO INFCF'M THI"g DEF'laR1-MENT [.LIRING THE INSTFILLRTIZN IHSPECTIONS OF laN'¢ .4EL..L:, FIDJRCENT TO THISF' "F..L F"ER'""". ~ cR-,I[' THE NLMEER OF RESI[:,ENCES THFIT 'FHE WELL HILL SERVE. ........... 'l" 11....~ C, ,:: 2-:_" ::, .I t"-;] 27-:; F' £-] i:; T' ].: C, ~'---!. S F-~ F: E F.: E t_:~ UI I F...' ['E [: BF!CKFILL!NG OF laN'¢ S¥S'TEM 1.4I]"HOUT FINRL iI'.,L-:,F,_L. ION FIND RF'F'R",,]FIL B'¢ THIS DEPFIRTMENT HILL EE SUE.:rECT TO F'F.'L'SEEI. T!ZN. MINIMUM DISTFINCE BE:TWEEN FI HELL FIND RN'¢ ON--SITE SEWFIGE DISPOSFIL S"¢STEM IS :L00 FEET FOR R PRIVFITE WELL OR tSei TO 200 FEE'T FROM Ft F'UBI..IC HFLL DEF'ENDtNG UF'ON THE T'¢PE OF PUBLIC W. EL.L MINIMUM DIS'TlaNC:E FF.:OM la F'RIVFITE HELL TO R F'R!VFtTE SEHER LINE. IS 25 FEET FIND TO ta COMHUNIT'¢ SEI.,.tER LIN[:_' IS': '75 FEE]". OTPIER REQUIREMEN'TS MFI"r' RPPL'¢. SF'ECtFICFITIONS laND CONSTF::UCTION DIFIGRFIMS RRE R',,,'FtILFIBLE TO INL'-.;LIRE F'ROPER INSTFILLRTION. I ]ERTIF¥ THFIT !: I laM FI--Ii'IlLIH[~. HITH THE REQUIRE]MENTS FOF.': ON-SITE SEWERS FIND t-,.IELLS F-E:: SE.T FOF~:TH E,'t I'HE MUNICIF'FI!._IT'T' ElF' RN_-HOF.'RI3E 2 ' I w !LJ._ ! Ns'rFIL. L TFIE S'¢STEM Ilq FIE ]:OF-.:[:,FINC:E Ht TH THE' CODES. ]:: I UNDEF. tS"r'FIN[:, ]"NFIT THE ON-.-SITE SEHEF.'. S'¢STEM I',IFIV REQLt. E ENLFIRCiEMENT IF THE r..-:'F'~IE,FNF:F: I':; REM][,EI ED Ti !N]LU[,E MORE THFIN 3: E,'EDROIEIM'/,. ............... . FIF'F'L I CFINT t' '?' PERFORMED FOR: Mum PJ&S ~AT~P~RFOm~: April 23, 1981 Lot l, Block 3, Northwood Subdivision LEGAL DESCRIPTION: Organics and organic silt, dark SLOPE SITE PLAN 1 2 3 4 5, 6 7 8 9 10 11 12 13 14, 15 16 17 18, 19- 2O COMMENTS PERFORMED BY: ~? 008 17~76) ,.xbrown, wet , soft, tree debris.'F "~ .......... (Bt~-QL) ........ Gravel]y-s~ndy-si]t, ~ht brownI stiff, moist, with some F-'(- organics. Silty-gravelly-sand, gray, moist, compact, rounded to sub- rounded particles to cobble size. (GM-SM) o r~ L" MA USjD iVE I : i I ~;0I. T ST WAS GROUND WATER Yes s ENCOUNTERED? L DEPTH? 1 3 ' .I.. J $ i . · Reading Date Gross Net Depth to Net Time Time Water DroD 2 4-23-81 3:30 PM 20 M~n. ]5 1 3/4 3 4-23-8l 3:40 PM 30 Min. 16 1 4 4-23-81 3:50 PM 40 Min. 17 1 5 4-23-81 4:60 PM 50 Min. 17 3/4 3/4 6 4-23-81 4:10 PM 60 Min. 18 1/2 3/4 PERCOLATION RATE 15 ~.~-{mlnutes/inch) ...... Howard Grey & Assoc., Inc. CERTIFIED April 27, 1981 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~ ON SOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DE~CRIFTION: ! 2 3 4 5- 6 ? 8 9- ~0 P,.]& S Lot 1, Block 3, Northwood Subdivision Organics and organic brown, wet , soft, tree debris. Gravelly-sandy-silt, 1 ight brow stiff, moist, with some organics. Si 1 ty-gravel ly-sand, gray, . moist, compact, rounded to sub- rounded particles to cobble size. (GM-S ) ' 11 12. 13- 14 16¸ 16- 17 18 lg. O^~P~"FOR~En: April 23, 1981 si'rE PI. AN I -.il ,i ..... WAS GROUND WATER $ I I ( : ENCOUNTERED? Yes 0 , i IF YES, AT WHAT E: OF-"TH;, 13 ' .... ~ , --~--. i ._: ............ Olin ~ Net ~,nm. ~me Wat~ 4-23-81 3:30 PM 20 Min. 15 1 3/4 4-23-81 3:40 PM 30 Min. 16 1 4-23-81 3:50 PM 40 Min. 17 1 4-23-81 4:60 PM 50 Min. 17 3/4 3/4 4-23-81 4:10 PM 60 Min. 18 1/2 3/4 FERCOI.ATION RATE 1 5 ~OmmDm~: Howard Grey & Assoc,~ Inc. C~R~FmEOe~'~ ~ AZ=: April 27, 1 27, 1981 HOWARD GREY & ASSOCIATES, NC. GEOLOGISTS AND ENGINEERS 715 L STREET, SUITE S ANCHORAGE, ALASKA 99501 TELEPHONE (907) 274-2314 July 6, 1981 Municipality of Anchorage Department of Health and Environmental Protection 825 L Street Anchorage, Alaska Subject: Revision of Soils Log Lot #1, Block #3, Northwood Subdivision Attention: Les Buckholtz Gentlemen: On July 2, 1981 the subject lot was re-examined, by our firm, because of shallow ground water conditions. A new test pit was excavated and water was measured at 9 feet. On the original soils log, submitted 4-27-81, ground water was reported at 13 feet. We would want to re-design the on-site system considering this new development. Would you please issue a new permit utilizing the following data: total depth - 5 feet, depth of gravel - 2 feet, trench width 5 feet. Soil type and percolation data will remain identical to the previous log. Thank you for your consideration. Sincerely, HOWARD GREY & ASSOCIATES, INC. Patrick Stidmon Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY :DWELLING Parcel I.D. 051-7.31-39 COSA# Expiration Date: GENERAL INFORMATION Complete legal description T,ot I, Block .3, Northwoods'. LOcation (site address) 22414 McManus Drive Chugiak, Alaska Current Property owner(s) Mike & Stephanie Workman Day phone(907) 688-5660 Mailing address 22414 McManus Drive Chugiak, Alaska 99567 Lending agency Mailing address Day phone Real Estate Agent Brooke Stiltner @ Re/Max Day phone(907) 244-6742 Mailing Address .. 11525 Old Glenn Hwy Eagle River~ AK 99577 Unless otherwise requested," COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] 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 On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family' on-site wastewater disposal and/or water ' supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to. one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in' the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my. investigation, based on procedures outlined in the Certificate of 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 Pinard Engineering Phone (907) Address PO Box 871347 Wasiiia, Alaska 99687 Engineer's Printed Name Pau~ E. Pinard, P.E. . . Date bedrooms. DSD SIGNATURE 't/''''/ Approved for Disapproved. 357-3647 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater'Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343~7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot, 1, Block 3, lqorthwoods ~ Parcel ID: 051-731-39 A. WELL DATA Well type ~ If A, B, or C provide PWSID # ~ Well Log (Y/N) Date completed ~ Sanitary seal (Y/N)~ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m, g.p.m. Nitrate ~ mg/L Collected by: WATER SAMPLE RESULTS: Coliform colonies/100 mL Arsenic: ug/L date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tanksize 1250 gal. Number of Compartments . Depression over tank (Y/N) 1~ Pumper ,.TEe l~um_o-i zt_~ Foundation cleanout (Y/N) ¥ Date of pumping 1 0 / 1 2 / 1 1 C, ABSORPTION FIELD DATA Date installed Cleanouts (Y/N) High water alarm (Y/N) Date installed Length ?,5 Total depth 1 Date of adequacy test 10/8/11 Fluid depth in absorption field before test 0 9/20/90 Soil rating ~[~.Z)r ~/bdrm) ~ f. Width 18 ff. ~ ft. Eft. absorption areal 35Oft2 Monitoring tube~ Results (Pass/Fail) ;Pa:ss ~ in. Water added ~)00 gal. System typeSee~e Gravel below pipe 0 ¥ Depression over field Elapsed Time:00 min. Final fluid depth 0 in. Absorption rate >= Any rejuvenation treatment (past 12 mo.)(Y/N & type) For .3 bedrooms New depth 0 in. /+50+ g.p.d. If yes, give date LIFT STATION Date installed 9/20/90 "Pump on" level at 38 in. Datum Bottom Tan_E E. SEPARATION DISTANCES Size in gallons 12~0 STEP "Pump off" level at /+1 in. Cycles tested ;3 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot , Public sewer main Sewer/septic service line Animal containment areas Manhole/Access (Y/N) Y High water alarm level at /+5 Meets alarm & circuit requirements? Y NA On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ;5 ' Property line 1 O+ ' Water main 10 ' + Water service line 1 0 ' + Wells on adjacent lots }iA SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field 10' Surface water 100 ' + Water main 10' + Driveway, parking/vehicle storage 10 ' Property line '~ ' Building foundation 12 Water Service line 10 ' + Surface water 1 O0 ' + Curtain drain /+1 ' Wells on adjacent lots in. (Rev. 4/10) COSA Fee $ ~'~© -"' Waiver Fee $ Date of Payment [ O \ t ~' l ~.~ f~.~C=J~/--{-(~ ~[ ~ ;'C~ ~ t~ J~n;~JDate of Payment Receipt Number i,~'") L3~ Receipt'Number F. COMMENTS System was approved in 1990 with above letter ,of 1/5/87. G. ENGINEER S CERTIFICATION I cedi~ that I have determined through field inspections and of r. a ow i. N A~-BUI~T hereby ~ that I have surveyed the following IJo ,-'//.~ ' '. '' '7'-I ..~A2 ~ ~ Anchorage l~ec~rding l~ec/nct, Alaska, and that the improvements situated thereon are within the property Lines and do not overlap or encroach on the property lying adjacent ',hereto, that no improvements on pro.p- erty lying adjacent thereto encroach on the pre~i.~ m question and that there are no roadways, tra~m~nission lines or other visible e~_ments on said prop~ty except as inclieated hereon. Dated at Eagle l~iver, Alaska t~i~ 1o r-~-- day of SC~T,~-: Reg~ered Lancl Surveyor No. 8~0-L~ 1" = ~ C2 ! Box a.56, Eagle l~/ver, Alsska Phone 694-2543 PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 1, Block 3, Northwoods Subdivision APPLICANT: Mike & Stephanie Workman 22414 McManus Drive Chugiak, Alaska 99567 SEPTIC TANK TYPE/SIZE: Steel11250 Gallons, per MOA Records ABSORPTION SYSTEM: Seepage Bed, per MOA Records DAILY FLOW: 3 BEDROOMS x 150 GAL/BR = 450 Gallons JOB NUMBER: 11-333 DATE OF TEST: 10/8/11 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 3 SCUM: 0.2' SLUDGE: 0.2' NEEDS TO BE PUMPED: Yes XX CURRENTLY IN USE: Yes XX No TEST DATA Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments Rate Volume Tank AM (GPM) (GALs) (GALs) Liquid Level A Level Monitor A SAS Monitor A SAS * Tube 1' Level Tube 2* Level l 1:30 6.7 4.5'** 0.0' 0.0' Start Flow - Meter 234400 11:45 6.7 100 100 5.4'** 0.9' 0.0' 0.0' 0.0' 0.0' 234500 12:00 6.7 100 200 4.1' - 1.3' 0.0' 0.0' 0.0' 0.0' 234600 12:15 6.7 100 300 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 234700 12:30 6.7 100 400 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 234800 12:45 6.7 100 500 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 234900 1:00 100 600 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' Stop Test 235000 RECOVERY Date Time SAS MT1 SAS MT2 *ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: Testing on this WWl)S found it to be operating satisfactorily. There was no measurable liquid in the SAS MTs prior to or at any time during the test. ** Level in ST was found to be high at beginning of test. Found that an electrician had been working on the breaker panel and had left the breaker for the lift station turned off. As soon as it was turned back on, the liquid level in the tank quickly returned to normal. Reviewed by: Paul Pinard ~d Date: 10/10/11 Billing Information 22414 f'AcMa'~, s Chua ak AK 99567 , u u,: 68,3-5550 Job Site Information Ste2~an=e 224 ~4 McLla- LIS Drr,'e :.';hr;; .=,k AK ~~~ Se rvice Ag re eme n t Se.",i:e :)ate ¢'~ 0 T:r.-c: NC: ~C Lt.I, 234?43 1C-Oc:-2g: ' 12-Oc:-28'. ' · 3COq /',.'1C tl2r. a; J ta:,-at:2" Comor h2mc. on C;ive ~e s on ligq: blue T :Jbcrt~ Se;;h$ cn ~253 P,_mp S.¢51em ¢ / Exlcnsiofi Actual ,$2'203.: !~". (' NonTaxable To~al Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Municipality of'Anchorage , ' ._.Q_ Development ServJce$"l~'a ~r~;( ~ Budding Safety Division j. ~ - On-S~te Water and Wastewater Program .... , " P.O..Box 196650 Anchbrage,'AK 99519-6650.? ' '"':" www.cl.anchorage.ak.us - ,~ ... (907) 343-7904 . , . - ........... " CERTIFICATE OF HEALTH AUTHORITY APPRO~/AL -~',.,..:~' . : ...... '...~-I ..~ :~,1, FORA,Si~,G. EEF,~MiLY. DWEL[iNG?~i: ..... ;-.. . GENERAL INFORMATION Complete lega(d~s?dption Location (site address or directions) Current Property owner(s)~Oe 0o. Expiration Date: /, G~,~ le,~ Day phone Un/ess othenMse requested, HAA will be held by DSD for plckup. 2. NUMBER OF BEDROOMS: ,,'~) 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 o~ 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 AJaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one yesr with valid water samples,) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. .: 4. STATEMENT OF INSPECTION BY ENGINEER , As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation. based on procedures outlined in the Health Authority 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 ]~ag].e ~J.¥er ]~ngL,'zeer']~¢' ~ez'~ces Phone ~C~q_ Y.O. Box 22~29~, Ea~b River, AK 99577-~29& Address Engineer's Printed'Nerve ((")H ;5 r~, ""~(,,,J-t"r~: ,,~rT. Date 5. DSD SIGNATURE .... Conditional approval for _ bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory _ Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchoraga.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST WELL DATA Well Log (Y/N) wires property protected (Y/N) Casing heigM (above ground) AT INSPECTION g.p.m. Well typ~.~ If A, B, or C provide PWSID # Dar, sea, (Y/N) Total dep~'" ~ Cased t~.._._.~fl. '%~OM 1NELL LOG Date of test '~ Static water level '~ ft. Well production ',~ g.p.m. WATER SAMPLE RESULTS: ~ ColEorm colonies/l~ mi. Nitrate ~ mg./l. Date of sample: Collected by.'~'"'~ SEPTIC/HOLDING TANK DATA Other bacteria colonies/100 mi. Tank Type/Material Tank size /.z f'e gal. Foundation cteanout (Y/N) Date of pumping Numbe~ of Compartments Depression over tank (Y/N) Date inst~led Cleanouts (Y/N) High water alarm (Y/N) ,~Y ABSORPTION FIELD DATA Date installed //~ Soil rating (g.13.d.h'[' ,,,' It2/bdrm) e~~/-/ System type ~6",e,~/ Length '75" ft. W~th /.,f fl. Gravel below pipe &" ~''' ff. Total depth / ft. Eft. absorption ama /.[/-4p ft2 Monitoring tube ~' Depression over field /~/ Date of adequacy test 5'///~//¢'/ Results (Pass/Fail) ~w.f For ~ bedrooms Fluid depth in absorption field before test ~) in. Water added ~ gal. New depth :z in. Elapsed Time:/oJ'v min. Final fluid depth D in. Absorption rate >= /- ~'~-o g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/lq & type), f~ If yes, give date LIFT ~FATION Date installed 'Pump on" level at 3y in. Datum /~/~.,--, Size in gallons /.24'2~ *Pump off" level at /,"/in. Cyctes tested /~' Manhole/Access (Y/N) Y High water almm leval at ~,"S"/' Meets alan~ & circuit requirements? /I,/ E. SEPARATION DISTANCES SEPARATION D~ANCES FROM WELL ON LOT TO: Septic tank/lift staflon'~.~t Absorption field on lot Public sewer main Sewer/septic service Hne On adjacent lots On adjacent lots Public sewer manhole/deanout Holding tank Surface water SEPARATION DISTANCES FROM SEPTIC/HOLDiNG TANK ON LOTTO: Building foundation -~-- / Property line. -/'/~ ' Absorption field Water main '/-/~ · Water service line z-/,, / Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: P[operty line ..--~/ Building foundation /.-~ / Water main '"/'.~ ' Water Service Dine ~'/,) · Surface water ~-/,, · · D~veway, pa~ng/eehicle storage Curtain drain ~,/· Wells on adjacent lots .F. COMMENTS S. yr~,..-,. ,.~,r,,,,~.,/ ,-'. /'~'-' ~'"')=' ,~-~...~ ~.~./'~,J.~ ,~./¥-o,.,~..~-. z,.,,,~,- G. ENGINEER'S CERTIFICATION review of Muni~l m~s th~ the a~ sy~ms am in con~an~ ~ MOA H~ gu~eli~s in effe~ ~ ~ date. HAA Fee $ Date of Payment Receipt Number (R~. 1~) Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DIVISION OF EI~YIRONMENTAL ~FJULTH (a) Legal Description (include loC, block, subdivision~ section, township,,, ra ~g~ Location (address or directions) (b) Applicants Name ~. Business (c) Applicant is (check one) Lending Znstitution Buyer ~ ; Other ~ (explain); (d) Lending Institution ~ ~ ~ . ,.~_ ~ .__-- Tel_e~ho__ne Address o (e) Real Estate Coo & Agent__ k~/.~- ~~ Address Telephone (.f) Mail the HAA to the following address: ..... , 7/ zif-:z- Single-Family~ Multi-Fmnily~ Number of Bedrooms__~_~ Other (describe) Water Supply Individual Woll~ Community ~ Public ~--~ Note: If community well system, must have ~itten cor~irmation from the State Department of Environmental Conservation attesting to the legality and status° 4o Sewage Disoosal Onsite~ Public ~ Community ~ Holding Tank ~ Note: If community well system, must have writteu confirmation from the State /Department of Environmental Conservation attesting to the legality and ,s_tatus. " ' ,rd..P ' : ~Ftrm Providin~ Inspections, Tests~ File Search?~_~?~and Information ~ As certified by my seal affixed hereto and as of the validation date shown below, : ve=ify that my invesCigation of ~his He~th Authority Approval sho~ th'a~ ~he o~site -,aCer sunnly ~/or ~stewater disposal system is safe, f~ction~ and ~eouate for ~7~:~:~.; baaed on the infomatiOn obCain~ from the ~nicipality of ~chorage files and from ~ ": investigation ~d inspection~ the on-si~e ~er supply and/or ~stewa~er dispos~ ~;:,' system is in compliance ~th ~1 ~ntctpal ~ State codes, ordinances, and regula~ ~:, ~to~ in effect on the da~e of Chis inspection. ~ENGI~ER S~% Approved ~/ Disapproved -- Co~iCion~ __ Te~s of Condition~ Approval ~, CA~ION [ T~ ~CIPALITY 0F ~CHO~ DEP~ OF ~TH ~ E~qiRO~NT~ PROTECTION (D~P) ISS~S ~TH Ab~HORITY ~PROV~ ~RT~ICA~S B~ SO~LY UPON ~ ~RESE~- ATIONS GI~N ~ P~A~H 5 ABO~ BY ~ ~EPE~E~ ~OFESSI0I~L ENGI~ER ~GISTE~ IN ~ S~TE OF ~S~. ~ DEEP ~ES ~IS AS A CO~SY T0 P~C~SERS 0F E0}~S ~D T~IR ~ING INSTI~IONS IN O~ER T0 SATISFY ~R~IN ~DE~ ~D S~TE ~S. ~PL0~ES 0F DEEP DO NOT C0~UCT INSPECTIONS 0R ~YZE DATA BEFORE A CERTIFICATE IS ISS~D. ~ ~ICIP~I~ 0F ~CH0~ IS NOT ~SPONSIB~ FOR ~ORS OR OMISSIONS ~N ~ PROFESSIONAL ENGI~ER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ae Well Classification Well Log P~esent (Y/N) ~t~ j Total D~pth ~ Cased to Static Water Level ~l~ Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distanoes ~rom Well: / To Septic/Holding Tank on Lot ~7OO MUNICIPALITY OF ANCHORAGE (MOA~ [i~i,:;~: .,,:; , HE~LT~ mmO~T~ ~P~OV~L (~) I: :.i-~ 5 '~985 CHECICLIST - FEBRUARY 1984 Legal Description: ~J~T/~o~D~ If A, B, C= C, D.E.C. Approve~/~) Date %7~eted ~/~ Yield ~_~__ Depth of Grouti-ng Sanitary Seal on Casing Depression ~nd ~l~ead (Y~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~jOo/ ; On Adjoining Lots To Nearest Public Sewer Line C leanout/Manhole Water Sample Collected By Water SamDle Test Results ~1~ To Nearest Public Sewer ~ I~ To Nearest Sewer Service Line on Lot B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes ~'~'~q ) Air-tight Caps .~) No. of Cc~ga~tments ~ Foundation Cleanout ~N ) Depression over Tank (Y Date Last PumPed Pumping/Maintenance Contract on File (Y/N)~/~--; for ~//~ Holding Tank High-Water Alarm (Y/N) ~/~ Temporary Holding Tank Permit (Y~) .~ ~p~ation Distan~s ~ ~ptic~olding Ta~: To Water-Supply ~11 > ~O f TO ~o~rty Li~ To ~ter Mai~Servi~ Li~ +~O/~ ¢-[ 0 b/ . / Yf To Building Foundation To Disposal Field To Stream, Pond, Lake, c= Major Drainage [Page 1 of 2] Receipt % Date Paid: Arno un t: d.~o 2-15-84 Soils P~ting in Absorption Strata Date .Installed Width of Field Square Feet of Absorption A~ea Depression over Field (Y~ Results of last Adequacy Test To Wate~-Supply Well To Building Foundation Lot ~,, To Wate~ Main/Service Line Length of Field Gravel Bed Thickness ~ Standpipes Present ~/N)0 Date of ~st ~a~ Test ~/~7/~ Type of System~Design q]~lJCtt Separation Distance f~om A~sorption Field: ~ ~ To lh~operty Line ~ To Existing or ~ndo~d System ; ~ ~joining ~ts ~ ~/~ ~/~/~ To ~t~(if pre~nt) To St~e~ond~ke/~ ~jo~ ~aina~ C~se ~/D~/~ TO ~iveway, Pa~ki~ ~ea, o~ Vehicle St~a~ ~ea .~z ~ , .,. , , I.,~' ~ . . .~ , , Date Ir~talled Size in Gallons Tested fo~ J ~ing Cycles ~ing Adequa~ ~st. Elec~ical Co~s (Y~) Msets MOA _/ Check l~.rmitted Bedroom Rating A~ainst HAA Request ** certify that I have checked, verified, or conforn~d to all MOA HAA Guidelines in effect on the date o~%this inspection. Signed KB1/dS/s MOA No./ ,~-~-~ [Page 2 of 2] 2-15-84 ALASKA e,'ndlROFlm[ llTAL COI1TROL S1 I -o1'C1 $, Inc. I~nqineerinq $ ~nuironmcntal $1udies JANUARY 17 1985 TIM HEILY 7806 MCMANU8 CHUGIAK AK SELLER - TIM HEILY BUYER - SUBDIVISION - NORTHWOODS #1 BLOCK - 3 ADEQUACY TEST FOR SEWER SYSTEM LOT - 1 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 600 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 701 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 4/17/84 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEJ)J~I~£ £ HOUSE. qb ~/, t'~ ..... 1200 [LJcsl 33rcJ Auenu¢, Suile B * Anchoraq,, Alaska 99503 *(907) 561-5040 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 To Whom it May Concern: According to records on file in this office the GLj~bik]l'Sia/~. Water System is in compliance-with the State Drinking Water Regulations Sincerely, ',~ r D~. ~ RECEIVED INSPECTION APPOINTMENTS TIME TIME .xj~,,~./~¢ ~.~ TIME ~). · ~ ('. DATE DATE DATE iNSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUN~CIPAU~ OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ~NVJ~ONM~NTAL ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 .... DI~E~TIO~8: Complete all parts on pa~e 1. Ineomplet~ r0quosts will not Bo procass*d. ~ease allo~ ten {~0) da~s [or processing. 1, PROPERTY OWNER PHONE MAILING ADDRESS P~OPE~TY ~ESIDENT ~differen~ from abo~e)-' PHONE PHONE 2. BUYE~ MAILING ADD~ESS 3, L~DI~INSTITUTION I PHONE MAILING ADD~ESS 4, ~EALTO~/AGENT I PHONE MAILING ADD,ES8 5. LEGAL DESCRIPTION STREET LOCATION TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four [] Two [] Five ,~ Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 9, SEWAGE DISPOSAL SYSTEM ,~ iNDIVIDUAL/ON-SITE** ~>,/ YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTI LITY 21 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY . - 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS E~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVID[JAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANU'FACTURER TOTAL ABSORPTION AREA MAI'ERIAL 4. DISTAN-C~ Septic/Holding Tan~ IAbsorption Ar~a Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. C(~MMENTS - [~"/\PP Rev ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ../ DATE BY ,, ,?/ /~