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NORTH WOODS BLK 3 LT 10
No th Wood Block Lot 10 #051-731-30 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241137 Work Type: Septic Upgrade Tax Code Number: 05173130000 Site Legal Address: NORTH WOODS BLK 3 LT 10 G:1459 Site Mailing Address: 22630 MC MANUS DR, Chugiak Owner: SMITH BENJAMIN L & RACHEL L Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: Delmrrrr�� nt 6/24/2024 6/24/2025 2 Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing r Received By: i -5 4L) 6 S Issued By:`� — - Date: Date: z 2, MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Wafter & Wastewater Program ON -SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 051-731-30 Property owner(s) Benjamin & Rachel Smith Mailing address 22630 McManus Drive Chugiak, AK 99567 Site address same Legal description (Sub'd., Block & Lot) North Woods 133 L10 Day phone Legal description (Township, Range & Section) Lot Size 20,046 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field x❑ Initial ❑ Single Family (SF) ❑x Septic Tank x❑ Upgrade ❑x (w/wa ADU) Holding Tank El Renewal ❑ Renewal (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: 1 certify that the above information is correct. 1 further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: 2 2 Z Date of Payment: Receipt Number: (' `) -) Permit No. (1� ( . 1 `, Receipt Number: Waiver No. Permit App_-'- :- Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com Mailing: P.O.Box 1807, Palmer, AK 99645 Telephone: (907) 745-8200 FAX: (907) 745-8201 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska Subject: North Woods B3 L10 Septic System Upgrade Permit Request This is a design narrative for a permit to install a septic system upgrade on the subject property. The proposed upgrade will serve an existing three (3) bedroom house. This lot and surrounding lots are served by AWWU drinking water. Currently there are no wells within 200 feet of the proposed installation. 1. Soils: Three test holes were performed on this lot, one by S&S Engineering on 10/8/1990, one by Thomas R. Smith 6/5/1981, and another by PES on 5/21/2024. Groundwater was observed during the excavation of the test hole at a depth of 6.0’ BGS, Bedrock was not encountered. Groundwater was observed in the test hole monitor tube after 7-days at a depth of 4.75’ BGS. For the purposes of the design the worst-case percolation rate of the test holes on the lot was used. Based on the results of the percolation test and overall soil appearance. An application rate of 0.4 gpd/SF was used for the design of a conventional wastewater treatment system upgrade. 2. Soil Absorption System Design. See Sheet 1 of the design package. We are requesting approval from the department to construct a 24ft wide bed. Construction equipment will not operate in the bottom of excavation. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. 4. Topography: See attached site plan for area topography. There are no slopes exceeding 25% less than 50ft from the proposed drain field. 5. Drawing Markings: The Drawings are marked “For MOA Review Only”. When written notification that the review is complete and no further comments are received from MoA On-Site Department, the note will be removed and “For Construction” drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at (907) 745-8200. Sincerely, SRP Steven R. Pannone, P.E. F. ASCE Owner/Civil Engineer 11 June 2024 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241137, Curtis Townsend, 06/24/24 PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241137, Curtis Townsend, 06/24/24 PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) A SCALE: 1"=5' DRAIN FIELD SECTION Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241137, Curtis Townsend, 06/24/24 PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) COMMENTS: Test hole excavated by WHITTERS. PERFORMED BY: PANNONE ENGINEERING SERVICES, LLC. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. ·2.7 (min/inch) ·6" ·2 FT AND 3 FT · SOILS LOG & PERCOLATION TEST Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241137, Curtis Townsend, 06/24/24 PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) 2.2. SCOPE OF WORK: INSTALL SYSTEM IN ACCORDANCE WITH THE ATTACHED DESIGN AND SPECIFICATIONS. 4.75 FEET 4.75 FEET Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241137, Curtis Townsend, 06/24/24 22630 McManus Drive Subject: Originator:ACP Checker: SITE PARAMETERS 1. No angle of repose on backfill material Weight of Water 62.4 lb/ft3 Weight of Soil 100.0 lb/ft3 Tank Bury Depth 4 ft TANK DIMENSIONS Diameter 59.0 in Diameter 4.92 ft Length 12 ft Area 18.99 ft2 Volume 227.83 ft3 Weight 0 lbf Manholes Yes Percentage of Tank in Groundwater 100% BOUYANT FORCES (weight of the displaced water) 14217 lbf UP RESISTING FORCES (weight of soil & tank) Is Backfill Material Saturated?NO Volume of Manholes 25 ft3 Volume of Soil 211 ft3 (Volume of Soil over Tank minus Volume of Manholes) Weight of Soil 21087 lb DOWN NET FORCE ON TANK 6870 lb DOWN No Additional Ballast Required Septic Tank Buoyancy Check Job Number:SRP Job Name: Buoyancy Check 1500-gallon STEP Tank ASSUMPTIONS 2. 100 lb/ft3 backfill material 3. Tank is empty 4. Tank is completely submerged. Buoyancy Control: 1.4.0' of unsaturated fill above tank resists buoyant force from groundwater. 1�� SCALE: 1"= 30' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON UNLESS OTHERWISE NOTED. as6-_o S%SN 00 �1 0 4%p OF •• �, . 49th r...r.....,- ... / Elizabeth L. Walatka : �o00 • • • 8036 - LS • �� �Q AW ��•�P�� AMW CIFessIONO- BE AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: LOT 10, BLOCK 3, NORTH WOODS SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 21 st day of MAY , 2024. FRED WALATKA & ASSOCIATES, L.L.C. FB 24-2, pg 18-19 Engineers and Surveyors i 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. · ' Municipality of Anchorage Page \ of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~ I ~='~ ~ PID Number: ~ [ - ~'~ Nam~T~d_~ Wastewater System: D New ~Upgrade A~~. ~ ~~, ~~ ABSORPTION FIELD Phone:~[~ [~ No. of~ooms: ~ Deep Trench ~ShallowTrench~ed ~Mound ~Other LEGAL DESCRIPTION so~ Rating: Total Depth from original grade: t Block: . ~ Subdiv,siqn:~ ~' ~ GPD/Sq. Ft. Depth to pipe botlom from original grade: Gravel depth beneath pipe ~ I ~Ft. T~:~ ~ Rang~¢ S~. ~ Filladded aboveoriginal,grade:~,~ '/,~' Ft. Gravellength: ~ Ft. Numb~f lines: Distance helen fines: WELL: D New B Upgrade G~: ~ Ft. ~ Ft. Classification (Private,A,B,C):~ Total Depth: Cased To: Total absorption area: Pipe materiah Driller: Date Drilled: Static Water Level:Ft. ~~ ~, Date installed: Yield: GPM ~ Pump Set at: Ft. Casing Height Above Ground:Ft. TANK SEPARATION DISTANCES ~eptic ~ Holding U S.T.E.P. To Septic Absorption Lift Holding ~ublic/Private ~nu~ctur~r: ~ ~. Capacityin gallons: From Tank Field Station Tank SewerLines ~1+, ~ ~ ¢~ / ¢ ~* Ma~ Number of Compartments: we" Surface Water ~ ~ / / / ~ LIFT STATION Lot Size in gallo~ Founds~ion ~I ~1 ~ ~ ~ "Pump °n' level ~l~ I "Pump o~~e~ alarm ~ Lo~n ~nd Descdpfiom ENGINEEH'S.SEAL Inspections performed by: s s SENe~N[EmNe Dates: lst~'~ ~ '¢"~'~ Department of Heal, and ~uman Services approval ~~~-~:~ Date: ~'/~-~/, 72-013 (1/91)MOA25 Permit No. -~l,,,J~ I ~0~"~ Page ~- 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: Z.Z~T7- l~ ~LO~2A",~ /Jo,~/~:~2;D~..~ ~'/.Z~ PID No.: 051- · .72-013 A (2/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES PO BOX 196650 ANCHORAGE, ALASKA 99519 343-4744 HAND WRITTEN PERMIT Permit Number: SW9~ Date Issued: Design Engineer: Owner Name: Owner Address:~0 Parcel ID: ~/'~/'~(9 ~/~ Lot Legal: Subdivision:~ Section: ~ Township:/~ Lot Size:~ Permit Type: Expiration Date: Day Phone Lot: /~ Block: Range: /la,' (sq.ft. Max Bedrooms: This Permit: ~ Total Capacity: SEPTIC TANK: Minimum septic tank capacity: gallons. Each septic tank must have at least 2 compartments, insulation is required if depth to top of septic tank(s) is less than 4.0' Lift stations require an appropriate electrical inspection. WELL LOG: A copy of the well log must be sent to DHHS within 30 days of the well's completion. I CERTIFY THAT: 1. I will install the on-site sewer system and/or well in accordance with all codes and regulations of the Municipality of Anchorage (MOA) and State of Alaska , and in compliance with the design criteria of this permit. 2. I will adhere to all MOA and State of Alaska requirements for separation distances from any existing well, septic system, or surface water on this or any adjacent or nearby lot. 3. I understand that this permit is valid for a single family dwelling with a maximum of bedrooms. I also understand that any enlargement will require an additional permit. ~. I understand this permit is issued for the calendar year and expires on ~ -:~ ~'the year~ 5. I will notify DHHS prior to all inspections by the engineer or well driller. SISNED: ~--~& ~k~ff~¢~a DATE: IssoED B D~TE: db/ll5 December 12, 1990 ROBERT SHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & PLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 10; Block 3; North Woods #I Subdivision PER~IT REQUEST NARRATIVE Request you issue a permit to upgrade the septic system on the referenced property. The existing system was installed in June 1981. On October 8, 1990 a groundwater monitoring tube was installed approximately 10' from the absorption trench. On October 15, 1990 the groundwater was measured at 74' below the ground surface. The total depth of the trench is approximately 10' Therefore, the existing system is located 24' in groundwater. We feel the proposed septic upgrade design is the best for this property and will impact adjacent properties the least because of the following reasons: I. The nearest well is a community w~ll and is located far beyond 200' 2. The proposed location of the septic upgrade is over 75' away from the nearest septic system and over 20' from the property 3. The slope of the prpoerty is relatively flat with no cutbacks within 100 '. *NOTE: Septic tank out, et must be exposed for elevation shots to determine if ~ift station is required. If we may be of further service, please contact u~. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9, 10- 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN S IF YES, AT WHAT DEPTH? ~7'~ p E Depth to Water Ait~ Monitoring? t, .,.~ Date: ~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~' ~ (minutes/inch} PERC HOLE DIAMETER TEST RUN BETWEEN ~ FTAND ~ FT PERFORMED BY: I ' ' .... CERTIFY THAT THIS T/EST ACCORDANCE WI~E AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE. DATE: /',~./////~/~0 72-00B (Rev. 4/85) ~ / ' / WAS PERFORMED IN !(k~'~r~'-j)) ENVIRONMENTAL ENGiNEE,RIklG DIVISION ~~ 825 [. Street- Anchorage, Alaska 99501 Telephone 264-4720 ~~ ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WELL INSPECTION REPORT NAME. ~NE ~EW ~AILING AD~ ES~ LEGAL DESCRIPTION 1] Absorption area Dwelling PERMIT ~ ~ Manufacturer ~~'~ MateHal~ No. of compart Liq. ca~tbi,~allon, IF HOMEMADE: Inside length Width Liquid depth '~ ~ DISTANCE TO: Well ~ Dwelling PERMIT NO. ~Z DISTANCE TO: ~90~ '~10 OM 7 ~ ~ ~ Top of tile to finish grade Material beneath tile ~ ~ 0 ~,~ Total effect,ye abs ti~a Length Width Depth PERMIT NO. ~ ~ TV Cfi Cfi ~ C~~ Depth Driller Distance to lot line PERMIT NO. ~ ~uilding foundation Sewer line ~ Septic tank Absorption area(s} ~ DISTANCE TO: APPROVED / DATE LEGAL 3/78) / ) RF'F'LICFINT FRFINK E:ETHF!F.:D Li3F:RT I Oi'.,I F"ETEF.:S ..F..,:EF... LEGRL L:20 E:3: Nf_]RTlal.4OCID SLID [:,EPFiF..:TMENT k _, HEFILTH RN[:, EN',,,'I F'F NPIEN]"FtL ~. ~.~. Fc.L. I I ON ':"-.'~ "L '" STREET., RNCH 264-472,9 SRFIi698F..' 8NC 99507' LOT =, I-" E TYPE OF SOIL RB.'-];ORPTION S":'STEM IS: TRENCH MRXIMUM NLIMBER OF BE[:'ROOMS = 2: SOIL. RFITING THE REL".!UIRED SIZE OF THE SOIL FIBSORP'f'ION S'¢STEM IS: E:" E $' T F4! =, i ,Z~ b E ~'JJ i_.%-~ T' H =-= ,~1.. rZ.l ,3 F: R '-,," E b THE LENGTH DIMENSION tS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTFINCE DETklEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE E;w, CFIVFITION (IN FEET). THERE IS NO SET HIDTH FOR TRENCHES. THE GRFi',,,'EL DEF'TH IS THE MINIMUM DEPTH OF GRR',,,'EL BET.WEEN THE OUTFF1LL. PIPE FIND THE BOTTOM OF THE EECR',,,'RTION (IN FEET.':,. F'ERMIT RPPLICRNT HRS THE ~Em, F_hlz, IE:ILI TO INFOF.:M THIS [:,EPR~?TFIENT [:,UF.:ING THE IN. STF1LLaTION INSPECTIONS OF FINY HELLS FIDJF!F:ENT TO THIS PF.'3PERT'.-? FIN[) THE - F.,'E NUMBER OF F.'.ESIDENCES '¥HRT THE HELL HILL '=,E ...... BRCI<FILLING OF RN"r' S'¢STEM HITHOUT FINRL INSPECTION Rt",!D RPPRO',,,'RL B"r' THIS DEF'FIRTMENT HILL. BE L=;LIDJECT TO F'F.:OSE_-UTIL]N. MINii"IUM [:,ISTFINCE E:ETHEEN R HELL RND FINY ON-SITE SEI.4RGE DISPOSRL SYSTEM IS '1_88 FEET FOR R PRI',,"FITE WELL OR :1.50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE T'¢PE OF PLIE:LIC ~,4ELL. MINIMUi"! DISTFINCE FROM R PRI',/RTE HELL TO R PRI',/FITE SEH. ER LINE IS 25 FEET FIND TO R COMMUNITY SEHER LINE I25 75 FEET. OTHER REL--.!LIIREMEN'f'S MR'¢ RPPL'¢. SPECIFICRTIONS RND CONSTRUCTION DIRGRFIi"IS FIRE R',/FIILFIBLE TO INSURE PROPER INSTFILLFITIOi',t. I CEF.:TIFY THRT !: I I=~J"l FRMILIRR HITH THE REC!LIIREMENTS FOR ii'I-SITE SEI-,IERS AND 1.4EI-L.C; R:]'Z C;ET FEIF.:]-H D"r' THE MUNIEIF'FII_ITY OF FINCHORRGE. 2 I HILL INSTFILL THE .::,,rz, TEi'l IN RCCOR['-'RNCE HITH THE CO[:'ES. -"::: I I_INDERSTRND THWF THE r]N-SITE SEI.4ER S'¢STEM MF!Y RE6,~UIRE ENLFIROEMENT IF THE/ RESI[.ENL-:E IS REMO[:,ELE[:, TI] INCLI_IDE MORE THFIN 7~: EEDR]OMS PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3- 4 5 6 7 8 9 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Ala~ka 99502 276-222~ SOILS LOG-- PERCOLATION TEST · PERCOLATION TEST 10 11 12 17- 18- 20- COMMENTS WAS GROUND WATER .. ENCOUNTERED? ' ' "" :" ' IF YES, AT WHAT: DEPTH? I Gro~ Net Depth to' Net Reading Date Tirn~ Timl Water Drol~ /z,'~s s_%~ 0 ' o 7 ~ /:/~ ,, z~ /o i~Y~ I PERFORMED BY:~ PERCOLATION RATE //~) _(minutes/inch} TEST RUN BE~'2EN ~ - FTAND .~ ~ FT CERTIFIED BY: . DATE~ ALASKA elqUIROFlmeF1TAL COFITROL SeRUICe$, I[1C. ~ngin~:ring ~- ~nuirar~rn~:ntcJl $1u,:Jk's MUNICIPALITY OF Fi"_' ~ 6 Ig82 RI CEIV D January 29,1892 Mr. Les Bucholz Department of Health and Environmental Protection Pouch 6-650 Anchorage, Alaska 99502 Attn: Les Bucholz Dear Les: On the 29th day of January 1982, Alaska Environmental Control Services Inc. inspected the on-site sewage system for 5 homes located at Northwoods Subdivision...Lot 10 Block 3 Lot 25 Block 3 Lot 13 Block 1 Lot 16 Block 4 Lot 12 Block 1 In my inspection I found a cap missing, and final grade, needed for Lot 12 Block 1. All construction of the sewage systems, except for Lot 12 meets Municipality of Anchorage code.,_~ll had dry sump pipes. If you have any qu .ease contact me. Sincerely; C. Reid Jr., PhD, PE ~?resident 1220 ~¢st 25Ih Aucnu¢ · Anchorog¢, Alaska 99503 ° (907) 276-1361 Municipality of Anchorage Development Services Department Building Safety Division On-Site Wa~er & Wastewater Program 4700 South Bragaw SL p.O. Box 196650 A~chorage, AK 99519-6650 www.ct.anchorage.ak.us (907) 343-7904 CERTIFICATE Of HEALTH AUTHORITY AppRovAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-7`31 -`30 1. GENERAL INFORMATION HAA# ~-~ Expiration Date: Completelegaldescription NORTHWOODS SUBBMSION; LOT 10~ BLOCK 3 Location (site address or dire~ons} 226.30 McMANUS DRIVE * CHUCIAK, AK 99567 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MIKE & KRISTNE STRICKLAND Day phone 333-2121 ~;~630 McMANU$ ~)RIV[ * CHUCIAK, AK 99567 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 3 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 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) 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 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 ermre or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ ~ 4.,'""" at, or pdor to dosing for the enginsedng sen,ices provided. 4. STATEMENT OF INSPECTION BY ENGINEER As cergfied 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 Authorfiy Approval Guidelines for this ~lication, shows that the on-site water supp¥ and/or wastawatar disposal system is(are) safe, funcffonal arid adequate for the number of bedrooms and lype of sffucfure Indicated herein. I further verify that based on ~he information obtained from the Municipality of Aschorage files and from my investigation and Inspection, the on-site water supp¥ and/or wastawatar disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. NameofFirm ALASKA WATER &: WASTE'WATER CONSULTANTS. INC. Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE. AK 99.504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In cenducting ~hls evaluation, AWWC, Inc. etfempted to pn:wide a thorough, , consdenffi~us engineering analysis of the system In sc=ordance with ADEC and MOA DSD Guidelines & Regulagons. The repotted results descnT~ed the pedon"r~nce of the system under the condiffons encountemd at ~he ffme of the teat, and separalf~n distances measured to readi~ Identifiable features. The cpecatlonal iife of all wells These cendiffons a~ ou~side the conffol of the evaluator of the ~Tstem. Satisfactoty test resuYcs do not guarentea fulure pedormence of the system, nor do ff~y guarentea that there are no hidden defects or encmachrnents. AWWCo In~ can therefore not previde operational requlrements of the ADEC or MOA DSD. The content of this report Is for the sofe benefit of ff~e owner llsted above. Any rellance upen or uea of this mport by any other persno or patfy ls not author~zed, nor wTl lt confer eny legal rlght wha~/en DSD SIGNATURE Disapproved. Conditional approval for __ Attachments: HAA Checldist Septic System Advisory Well Flow Advisory Phone 537-1;179 bedrooms, with the fllowlng stipulations: Manitenance Agreements Supplemental Engineer's Reort Other Original Cert/ficate Date: .... . ON-SITE WATER AND . WASTEWATER : PROGRAM....' Municipality of Anchorage Development Services Department O~,~ W~r & Wsmw~t~r Program 4700 6ou~ Bmgmv St. P.O, Box 196650 AncO, AK 99519-6650 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescflpUo~ , NORTHWOODS SUBDMSlON; LOT 1Of BLOCK 3 P~'celID: 051-731-30 A, WELL DATA Well typecouumrfY IfA, B, ore provue PW~~ ft. g.p.m. AT INSPECTION WATER SAMPLE RESULTS: e: , Collected by:. , B. SEPTIC/HOLDING TANK DATA TBrt~ l~:~ated81 51'~L Tank stm 1000 gal. Number of Compa~d~ente Foundat~ deanout (Yet) 2 Dapm~slon overtank (Y/N) NO I' C. ABSORPTION FIELD DATA Date Instened 8/1/1091, Ckmnoute (Y~) YES Water ~ (YIN) N/A Dam Installed e/l/lool Soil raUng (~or ft'rodrm) 0.4 Toteldepth 3..~ - ¢.~fL Eff. abs(xpUonarea1152 ~' Monltodnglube YES Dateofadequacytest 8/3/2001 Results(PasM=~l) PASS Fluid depth in at)sor~o~ lleld before test *3.5/0 In. Wateradded 710 gal. System type BED Gravel below pipe . 0.5 fl. C)epmsslon over tleld NO For 3 bedrooms New deplh*9/9.$ In. Elapsed Time: 1308 min. Final auld depth*2/6 ~ ~ rate )= 450 g.p.d. A~ymJuvenaUonlma;,,.~nt(pastt2mo.)(y~&type) YES (Su~I~C CLEAR) Ify~,glveclate 6/6/2001 D. UFT STATION Oate Inst~ed Size In ga~ls ~ 'Pump on' level at in. 'Pump~ High water alarm lewl at In.. .~_I_~ ~es tested Meats elarm & drcult mqulmmen~s'~ E. SEPARATION DISTANCES I SEPARATION DISTANCES FROM WELL ON LOT TO: ~ P.b,c..w.~ n~n ~ Pub,~ ~mr rnenho~wno~ I SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Bulidlng fcmnda~n 5'+ Properly llne 5'+ Water maln 10% Water sen'Ice line. 10% Wells on adjacent lots 200'+ Absot~on field Surface water SEPARATION DISTANCE FROM ABSORPTION fiELD ON LOT TO: Pro~rty line lO'+ Water ~endce line 10'+ Cuflalndmln. NONE KNOWN Bulidlng foundation 10'+ Surface water 100'+ Wells on adjacent lots 200'+ 10, F. COMMENT8 SEE AT[ACHED ELEVATION DATA ON DRNNFIELD Water main 1o'+ 4- '4- O 10'+ G. ENGINEER'8 CERTIFICATION .,~.~.~. #,C,,~'...l, i,L ~ '~..'7-.~.% I CellEy that l have determlned ~ fleld ln~oecUona endE i~ J.'' I~ Y F ~ (/~ I ! ".~* ~, corlformarice wlZh MOA HAA guldellne.1~ effect on thla date. HAA Fee $ ~00 Date ~f Payment Receipt Number Waiver Fee $ I~t~ of P~ment Receipt Number. ~",~ i tli !!1 I t tlil t I I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFI CATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING , , . Parcel I.D. # O~'l--'1751-'~o :~.~:~ HAA,#~.. - 1, '~ GENERAL INFORMATION ........ ,:,,. Complete legal description r, ot 10; B].oc]~ 3; 'North Woods Subdivision Location (site address or directions) 22630 McManus Drive .,:'.Pr0Pehv'~wner.~.~''~__ - ~ scott & Debora Hankinson :-" Mailing address ".'- .. .... Legding agency ,Mailing.address~' Agent '.' Ad~i'ress ' Chugiak, AK Day phone An~h~g~ A~ Day phone Day phone 688-6018 99503 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ~ TYPE OF WATER SUPPLY: Individual well Community well Public water xxx NOTE: 4. TYPE OF WASTEWATER DISPOSAL: NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. Individual on-site xxx ~ Holding tank Community on-site .. Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 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 s(ructure indicate, d herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disPosal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect On the date of this inspection. $ & S ENGINEERING Name of Firm ......... ,- ,~, .................... Eagle River, Alaska 99577 __ Phone ~ ci y_ ~c/'7 ~ Date DHHS SIGNATURE Approved for -~ Disapproved. Conditional approval for bedrooms. ............. ~, ~ ROBERT C. COWAN /~ bedrooms, with the following stipulations: 'Additional Comments __ Date /~- -/7-¢7 The Munici~)ality of Ar~bhOrage Department of Health and Human Services (DHHS) issues Health Authority Approval Ce~lificates.'based only upon the representations given in paragraph 5 above by an independent professional engin~'~ registered in the State of Alaska. The D HHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued, The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, 72-025 (Rev. 1/91) 8sck MOA#21 :/~ONM~NT^L SERVICES D~VlSI~. ~ Municipality of Anchorage "'"C I /~J~IA\ DEPARTMENT OF HEALTH & HUMAN SERVIC~ 0 d ]99~ ~) Environmental Se~ices Division .... ~ __ ~ 825 L Street, Room 502. Anchorage, Alaska 99501-(9~)~GE4~ D Legal Description: A. WELL DATA Health Authority Approval Checklist / -~T'1 If(~ B, or C, attach ADEC letter. ADEC water System number ;~ / Date completed Log present Total depth ~, Cased to Casing height (above ground) Sanitary seal (Y/N) ~ Wires properly protected (Y/N) FROM WELL LOG ~.~ AT INSPECTION Date of test Static water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform , ~ Date of sample: Nitrate SEPTIC/HOLDING TANK DATA Date installed ~-l-cl~ Tanksize IOO(2 Foundation cleanout~'~N) Date of Pumping ABSORPTION FIELD DATA Date installed Length ~L~ / Width ~ g.p.m. Other bacteria Depression Pumper Number of Compartments ~ Cleanouts, (~}N) ,_~ ~ (~ High water alarm (Y/N) ¢ ] ~ Soil rating ~or ft2/bdrm) O, '¢' System type Gravel thickness below pipe L/~, ~ / Total depth Effective absorption area I~ ~ ~i'¢' Monitoring Tube presenO)_[(~ Depression over field (Y/~ pC) Date of adequacy test ,~lzt. lqD( Results ~Fai,)~ For ~, ¢~ bedrooms .,0 Fluid depth in absorDtipn field before test (in.) ~lmmediately after ~¢gal. water added (in.): ~" Fluid depth ~ ~ I (ins) Minutes later: ,~ ,~G Absorption rate = ~)-- g p d Peroxide treatment (past 12 months) (Y/N) ~ 0h~ ~, ~¢~ If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "P-~um~o'~n leveJ~at~....,,~ "Pump off" leve! at* High water alarm level at* *Datum Cycles tested E. '--SE__PARATION DISTANCES SEP~IG-T~CES FROM WELL ON LOT TO: Septic/holding tank on Iot~'"~ ~DO~ 4- On adjacent lots Absorption field on lot ~ On adjacent lots Public sewer main ~le/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation I b Property line I f~ Absorption field Water main/service line Surface water/drainage i¢5 rt' Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Surface water Curtain drain Building foundation I ~;~'-P Water main/service line Driveway, parking/vehicle storage area ~'lx[ Ou,)I~ Wells on adjacent lots "~ ,©©~ ENGINEER'S CERTIFICATION I ce,ify ,hat lhave determined thru field inspections and review of Municipal in conformance with M A AA gu,del~nes ~n effect on th,s date. ,¢ ~ / ~ ' ~ ~'~ Date t ~ / ~/~ 7 ~t,':'-~ ........ ~:', * ~':';.'- ", ,7,',- 72-026 (Fiev. 3/96)* Waiver Fee $ _. Date of Payment Receipt Number " ...... 7: .... attest/ng to the leaahtv_ :_.. ~nd status 72-025(Rev. 1/91) Front MOA#21 ,' '--' :'-:': '~'~A~ f ~ ~?' ~'sea '~ X~r Rs[ut~.-~llu. a~.~,¢.&u~.~,,~ .... .,_ _.. . -.: .:- ~...; : . ..... .' ." · ........' .' ' r vala Ii~tionshowstha[the, on s~tewa,~e~ .... o th s Hea th Authofi~APP ,~ . .P~.. .... ~ ..................... : ........ ** ......... .... .,. :.. Investl atloR. [ ......... ,, _-~- , ~ ..¢ .,.,~ ......... .:, ........ . ........ ;;;'~e of structure i~d ca~ he~e' n; I f~A?~ ~e~i~' {hat based O&,the information the Municipali~ of Anchorage files and from· my. mvest~atlon and ~nsp~t~on, the on;s~e · . - - ':,' SuPp y and/cc W~tewate:~ disp~l;s~ste~ is. in/c°mpliance witha I: Munici pal and State 72-025(Re~. 1/91) 8ac~ MOA~21 Municipality of Anchorage . Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~ ~,~ f~-,~,- -~ ~oF-r~ ~,~o~$ Parcel I.D. A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Cased to Casing height Wires properly protected~-~/ FROM WELL. ~TION Static water level Pump level1 .g.p.m. ; On adjacent lots SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot '7--~ ~ i- Absorption field on lot ~ ~ ~r ; On adjacent lots Public sewer main Public sewer manhole/cleanout .__-~ Sewer service line Petroleum~ WATER SAMPLE RESULTS~ Coliform ~ Nitrate Other bacteria Dat~ Collected by: Date installed Cleanouts~l) High water alarm Date of pumping B. SEPTIC/HOLDING TANK DATA Tank size I c> o ~ Compartments 2.- Foundation cleanouf~N) F Depression ~(Y~) ~t' Alarm tested (Y/N) /"//~ ~ - ( ~ ~- Pumper ,.,~, f'2. fc)~ ?/J ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot -/,4 To property line /0 Surface water/drainage On adjacent lots 2--o,~ ~ v- Foundation /.~ ~ Absorption field ~' ~'' Water main/service line /o / ¢' 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) ~ SEPARATION DIS..T.~NCE~ROM LIFT STATION TO: ~ lot On adjacent lots Manufacturer Manhole/Access (Y/N) ...Cycl'e"~st ed Surface water D. ABSORPTION FIELD DATA Date installed ~ ~ \ ~ ~ ~ Soil rating (GPD/Ft Length 5/,~ ' Width 2. ¥' ' Gravel thickness Total absorption area //5-2. ~/' Cleanout present'N) Date of adequacy test ,~-- ,5 - ?.-~ Result~il) Water level in absorption field before test -~ Peroxide treatment (past 12 months) (Yl~j~ /,/o,JE System type L~,~p .5- Total depth '-/---<- "¢ Depression over field (Y~i) /,-./ S for .~' Bedrooms After test .~ '/z J ~ If yes, give date ¢'~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot "-~J,~ To building foundation On adjacent lots Sudace water adjacent lots z_c~ ,~ / -~ Property line /o / '/- /-/- TO existing or abandoned system on lot Cutbank ~-//,~ Water main/service line Driveway, parking/vehicle storage area ,5'--,g Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in Signature Engineer's Name Date r inspection. .'~ HAA Fee $ ~-'~ Date of Payment Receipt Number 72-026 (3,'93)' Back Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE 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 APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# 1. GENERAL INFORMATION Complete legal description Lot 10; Block '3; North Woods Subdivision Location (site address or directions) 7850 McManus Drive Property owner AHFC ~f119538 Mailing address Day phone Lending agency Mailing address Day phone Agent Lee Scantlin/GREATLAND REALTY Address Unless otherwise requested, HAA will be held for pickup. Day phone 11411 Old Glen Hiqhwa¥, Eaqle River~ Alaska 99577 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water 694-9125 NOTE: If community well s. ystem, provide written confirmation from State ADEC attest- , lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Address ~ ?n'~.~ ~S~- ~,,,- ~ -,-'~p Eagle River, Alaska ~577 Engineer's signature Phone DHHS SIGNATURE /~._ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date zC;'-/¢' - 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. Em ployees 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 engineeCs work. 72-025 (Rev. 1/91) Back MOA ~1 Legal Description: A. WELL DATA Well type A Log present (Y/N) Total depth Sanitary seal (Y/N) Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST [~c:~'~IC~ '~'~---'~, ParcelI.D. C- If A, B, or C, attach ADEC letter. Date completed Cased to FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Public sewer service line ADEC water system number Driller Casing height Wires properly protected (Y/N) AT INSPECTION g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~ I -- ':=1. 1 Cleano utsd¢~;:~,l) y High water alarm (Y/~) , Date of pumping Tank size 1 ~ Compartments 7_..- Foundation cleanout4~/N) y Depression (Y/~' Alarm tested (Y/N) ~ SEPARATION DISTANCES FROM SEPTIC/HOLDiNG TANK TO: Well(s) on lot ~,,.I C) I~ On adjacent lots To property line ~ ~ Absorption field Surface water/drainage ~ c::P~:::~ Foundation Water main/service line 72-0~6 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Length /m~ ~::~ Width Total absorption area Depression over.field (Y/~ Results (pass/fail) Peroxide treatment (past 12 months) (Y~ Soil rating cO,/-~ ~'¢¢4~--"~System type ~ Gravel thickness ~ ~- / ~ /~- Total depth ~ ~ ~} I Clean outs p resent ~i~N)Y/~/A Date of adequacy test -.,~/~'/~_ ¢,V'4~T~ for "~ bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ¢,.(t-~t'.J~ On adjacent lots '~I~L Propertyline To building foundation "~'~? To existing or abandoned system on lot On adjacent lots "22z:;~ f J¢ Cutbank 4~.~1¢ Water main/service line Surface water ~ ~[ ~ Driveway, parking/vehicle storage area Cur tel n d rain t'~ F'~r~L~.~ E. ENGINEER'S CERTIFICATION Signature S 8,-~ENG!NEER!NG 17034 Eagle Ri,vet Loop Road Engineer's Name --~,~ ,., .... .,,--, .... I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. HAA Fee $ / 7¢ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 June 5,1991 WALTER J. HICKEL, GOVERNOR 563-6775 FOR: S & S Engineering Ray PWSID 213001 My review of the records on file in this office reveals that the Chugiak Utilities, Northwood Subdivision Class A Public Water System, is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Sincerely, Keven K. Kleweno Lead Engineer ~;'~.,! Time ~ ne Time ~-~ ~ , . Date Date Date Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner }3et]~ard Colo-s~cructJ. on¢ I~qc, Phone Sra ~_lox 1698-K~ Anchorage, AK 99.50'7 345-1615 Mailing Address Buyer Address Lending Institution Phone Address Realty Co. & Agent Nozle Phone Address Legal Description ~O% 1()~ 1:;took :3 Northwood~ NHN ~c~anus T)rive Street Location Type.gf Residence '~3 Single Family [] Multiple Family No. of Bedrooms. 3 [] Other Water Supply ~ Individual ATTACH WELL LOG. A well Icg is required for ell wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach Icg if [] Public Utility available.) 1981 Sewage Disposal "[~] Individual Year Individual Installed: [] Public Utility When Connected to Public Utility: [] Holdin~ Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. k...~./ I~.~:T E RECEIVED INSPECTION APPOINTMENTS ~ ~ DATE DATE DATE INSPECTOR INSPECTOR '1 ~ - q ~'~ ~'~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~)EPT. OF H~ALiiI & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ?; O'fECTION ENVIRONMENTAL SANITATION DIVISION {}F.:~.~ O ~980. Telephone 264-4720 APPROVAL OF INDIVIDUAL WATER AND SE~ ~&IL~T~ REQUEST FOR DIRECTIONS: Complete all parts on page I. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1, PROPERTY OWNER PHONE JOHN W. DAUGHTERY 694-4051 MAILING ADDRESS PROPERTY RESIDENT Ill different from above) ~3~;~ ~][B :~]~:3]~B ~;B ~]~R ~dG~.3~ PHONE 2, BUYER ANDREW P. MORRIS JR. PHONE MAILING ADDRESS :P.O. :B0× 1_66 ANCHORAG~ AK 9961.0 3, LENDING INSTITUTION I PHONE FIRST NATIONAL BANK OF ANCHOI~GE 265-381~ MAILING ADDRESS 4. REALIOR/AGENI I PHONE JOHN PARKER TOTEM REALTY INC. 169A-qAqA MAILING ADDRESS P.O. BOX 911 EAGLE RIVER AK 99577 5. LEGAL DESCRIPTION LOT 10 BLK 3 BROADWATER HEIGHTS STREET LOCATION NHN SKYLINE DRIVE - EAGLE RIVER 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS E~ SINGLE FAMILY [] One [] Four [] Other ~ Two [] Five [] MULTIPLE FAMILY [~ Three [] Six 7. WATER SUPPLY [~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [~I INDIVIDUAL/ON-SITE** 1.973 YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED . 72-010 (Rev. 6/~9) DAVID A. SLI:N KAMP ROBERTA. SHAFER MECHANICAL ENGINEER 694-9O55 CIVIL ENGINEER 694-2979 De~ember 11, 1980 MUNICIPALITY OF ANCHORAGE . DEPT. OF i ~I - , 'I !IT ~[ ~ ENVIRONMENT,ii. ,: ;~dCTION Totem Realty ATTENTION.~ John Parker P.O. Box 911 Eagle River, Alaska 99577 .... C , 1980 RECEIVED Dear ~ir. Parker, Reference: Lot lO; Block 3; Broadwa~er Heights Subdivision A~sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit ~zas charged with approximately 1000 gallons of water and after a period of 24 hours all the water had percolated out of the crib. It can be concluded from this test that the septic ~ystem is currently functioning adequately for the three bedroom residence located on this property. If we may be of further service, please do not hesitate to call. Sinc~vely, cc: First National Bank Municipality of Anchorag~ Department of Health and Enviornmental Protection SRB 196X EAGLE RIVER, ALASKA 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4'111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 9, 1980 John W. Daughtery Post Office Box 555 Eagle River, Alaska 99577 Subject: Lot 10 Block 3 Broadwater Heights Subdivision Approval f6r your individual sewer and water facilities cannot be granted until the following items have been completed: ( ) A well log submitted to this department for our review. The top of the well casing sealed with a sanitary seal so that it is water tight. The depression or pit around the well casing needs to be filled with impervious ~type soil so that it slopes away from the well casing. The well casing extended twelve(12) inches above ground level. ( Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. The water facilities turned On at the time were not of the s~heduled~ inspection. Please call this office for another appointment. [+-{~_Th~ water analysis report needs to be delivered to this fice from th= Chez Lab, 5633 B Street, for our review. / ( ) Expose the well for our inspection to determine proper '/ construction, also to insure minimum distance requirements are met between the well and sewer system° John. W. 6aughtery December 9, 1980 Page Two ~X~ The septic tank pumped with a receipt submitted to this department. ( ) . The septic tank pumped with a receipt submitted to this department. The total number of gallons pumped needs to be on the receipt and verified by a registered engineer as to the actual numbem of gallons p%~aped. This is to verify the size of the septic tank. ( ) Expose the septic tank manhole to verify its existance. ( ) Locate and expose the standpipe to the seepage pit for our inspection. This is to insure the minimum distance requirements are met between your well and sewer system. A four(4) inch cast iron cleanout needs to be installed to the septic tank and/or leaching area. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. ( ) The permit for the installation of an on-site sewer'system has expired as of December 31, 19 We have not received the as-builts of the installation in this office. If a private engineer inspected the system, please send us the report for our files and r~view. ( ) The application shows the number of the bedrooms exceeds the number the sewer system was originally designed for. An upgrade will be required. Prior to any upgrade, a permit needs to be issued from this department. Please notify this department for a reinspection when the noted descrepancies have been corrected. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt~ R.S. Associate Specialist RCP/ljw SWP/059 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 ,C" Street, Anchorage, Alaska 99503 274-4561 Date Received August 27. 1973 Time of Inspections4:30 p.m. Date of Inspection,~qgust 27: lg7s.' REQUEST FOR APPROVAL OF INDIVIDUAL SEIZER & WATER FACILI%I~S FOR Conventional 1. AoProval Requested By: Edgar Bailey Address~ General De!.ivery, Eaqle River AK 99?77 Phone:~ 2. Prooert¥ Owner: SAME Phone: 3. Legal Description:_ Lot ]O,..Block 3.~ BrOadwatsr H~igh-~:~ ~u~ivisien 4. LocatLon: Up Loop Rd. ~urn right nn skyline d~iv~.; ,,nelpished build.. 5. Type of Facility to be Inspected: ~inglA Family g':~!l!gg Number of Bedrooms: Three (3) 6. Well Data: A. Type Drilled C. Construction 'Z. Sewage Disoosal System: A. Installed JOl~ 73 B. Depth 2(]4m , D. Bacterial Analysis 8. Installer ' Gene Nm~dlm~ .. C, Septic Tank: 1, D. Seepage Pit: 1, E. Disposal Field: Distances: A. ~e!L To: Septic Tank 1Gfi' , Nearest Lot Line Foundation to Septic Tank. Size 1000 Gals 2. Manufacturer Wallace Size 2. Material_ £nnn~mt~. Total Length of Lines _, Absorption Area t63 , Sewer Lines · Other Contamination "~ AbSorption Area C, Absorption Area to Nearest Lot Line Re~uast for Approval Of',xndiviSUal Sewer ~ Wate~ Factlltl~s Page Two 9. Comments: App~ Disapproved Date Approval Valid for One Year From Date Signed ~eater Anchorage Area Borough, Department of Environmental Quality D~AGRAM OF SYSTE~ I certify that the information contained in this request for appreval to be a true and accurate representation of the subject sewer and water fac~!ities located Signed Date ANCHORAGE AREA BOr 'UGH Department of Environmental Quality 2230 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ! ~/~. NUMBER OF / FROM WELL /~'-b MANUFACTURER g MATERIAL (~-~(~F- COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH __.LIQUID CAPACITY /~ GALLONS. SEEPAGE PIT: NUMBER OF PITS / , DIAMETER '~' /OR WIDTH__ LINING MATERIAL ~'t(:~'Z~/"~ CRIB SIZE: DIAMETER BUILDING FOUNDATION__ NEAREST LOT LINE ADDITIONAL ABSORPTION LENGTH DEPTH ~ f DEPTH DISTANCE FROM: WELL /L'~ ~ z' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) '~";~ SQ. FT. WELL: BUILDING FOUNDATION CONSTRUCTION NEAREST NEAREST LOT LINE SEWER LINE DEPTH DISTANCE FROM: SEPTIC /~'~! SEEPAGE /~:~X ' TANK SYSTEM CESSPOOL APPROVED ~AL/ OTHER SOURCES DISAPPROVED DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. LQ-031 REMARKS M 0 F_~YSTE M ....... /o~, -z .~ DAT~/~Z/ APPROVE GREAL"f/ER ANCHORAGE AREA BOA's/UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-86~6 PERMIT NO. /~ NAME OF APPLICANT SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK /~ -- ~ SEEPAGE PI~T/~ ~ ~., DRAIN ]FIELD OTHER TypgAND~IZEOFFACILITYTOBgSgR~E ~ TO B~ INST~LL~D BY g~- ~ NOTE: THIS PERMIT IS NOT VALID WITHOUT BOIL TES1 COMPLETION DAT~ ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY Th-- HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDAT,ON TO SEEPAGe PIT-- ~/~ DRAIN FIELD SEPTiC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE Pit DRAIN FIELD . TO NEAREST LOT LINE. ( oo DRAIN FIELD ALSO CONSIDER AREA WELLS. DIAGRAM OF SYSTEM SEEPAGE PIT WATER MAiN TO SEPTIC TANK DRAIN field SEPTIC TANK, : SEEPAGE Pit DRAIN FIELD TO RIVER, LAKE, STREAM. ~asT Ip~N INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. EALTH TNOR TY LICENSED DESIGNER I CERTiFY/~HAT I AM EAMILIAR WiTH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRI SYSTEM IS iN ACCORDANCE WiTH SAID CODE. ~ .~.~ ~ 2. r'rooertv Owner: ,-' GREATER ANCHORAGE AREA BOROUGH /' Department of Environmental Quality ' 35.00 Tudor Road, Anchorage, Alaska 99B07 279-8686 Date Received~~7 Date R~qu~sT FOR APPROVAt UP I~IVIDUAL SB~R & ~AZ~R ~ACILIZIES Phone ~. Well Data: ?, Sewage D1~os~l System: ' pth C~0 ~ # B. De , D. Bacterial Analysi~ C. Septic Tank: 1. Size~ 2. Manufacture O. Seepage Pit: i. Size 2. Material ~,~/~e=,7~- Disposal Field: Total Length of Lines 8. Distances: A !,%1' To' Septic Tank ~"~'/ , Absorption Area /~ 3', Sewer Lines ,':' , Nearest Lot Line , Other Contamination . FL Feundatton to Septic.Tank "} Absorption Area C. Absorption Area to Nearest Lot Line t' ,e Two 9: Comments Approval Valid for One Year From Date. 5tn.. ' ~ 'it Anchorage Area Borou.qh, Department of Environmental ~ual y DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representat~.on of the subiect sewer and water facilities located at: Signed Date