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FLAT TOP VIEW #1 BLK 2 LT 12 W 59'
Onsite File Flat Top View # 1 Block 2 Lot 12 W 59 ' #018 - 391 - 38 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: SW050001 PID Number: 018-391-38 Dwelling: EI Single Family (SF) ❑ Duplex(D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: BOB DUNCAN ABSORPTION FIELD Address El Deep Trench El Shallow Trench 1:1 Bed ❑ Mound ❑� Other _ Phone Number of Bedrooms Soil Rating Total depth from original grade 4 3.0 GPD/SF 12.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 5,5 Ft. 7.0 Ft. FLAT TOP #1 S/D, BLK 2, LOT 12 W59' Fill added above original grade Gravel length Township Range Section 1'+ Ft. 20 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 2.0 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 280 Ft2 Ft. Well 100'+ 100'+ 100'+ 50'+ TANK ❑Septic El S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water 1004' 100'+ 100'+ ANCH TANK 1500 Gal. Material Number of compartments Lot Line 5'+ LA'+ 5'+ NA FIBERGLASS 2.0 Foundation 20'+ 20'+ 20'+ LIFT STATION Manufacturer Capacity Curtain Drain UN UN UN ANCH TANK (ADVANTEX) 1500 Gal. Remarks Pump on level at Pump off level at High water alarm at 30 in. 24 in. 36 in. Pump make and model Electrical Inspections performed by PF-20 MOA PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfield MIKE ANDERSON Drainfield 3034 CO/MT3034 Inspector MIKE N ANDERSON, PE BENCH MARK (Assumed elevation) 100 ft Inspection 1'19/10/05 2°" 9/10/05 Location and description da 3"' 4'h TOP OF ADVANTEX POD COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ,. .% k��� Conditional Approval: Date e, y,. >IJ* .49TH* . .y:* lA % •... . MICHAEL N. ANDERSON : : /4 y -- ld�•• CE-94 9 .•.1'% It1fF9Fo.•(�1� � .• . �,.. Approved UN Date ��‘‘\‘‘\S‘ . '`. Inspection Report_9-1-12.doc 1ermit No. SW050001 Page 2 of 2 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: W 59' OF LOT 12, BLK 2 FLAT TOP VIEW #1 S/D PID No.: 018-391-38 / / MARK A / g GRND. PIPE \ LO/f 1 HAS ADVANTEX// \�11 ELEV. ELEV. \ T}�EREFORE 50' WELL/RADIUS CO1 20 /X15 102.7 97 \� REQUIRED 1 } CO2 30 / 33 100.8 96.7 'SI) TC01 29/ 34 100.2 \ i I 1 CO3 21 40 100.4 95.5 \ I OR OINAL WELL I } C04 20/ 52 100 94.4 NEW WELL a CO5 3/ 48 100.4 94.4 1 DE OMMISSIONED PFR AMC II MT 211 52 99.8 115. 1.060 BY MNA 1 I \ � \ I \ I \ HOUSE \ 1 1 1 \ 1 \ I \ 1 / \ \ f \ \ / \ r\ \\ \\L� �/ \N� r \\ 5--\---- ------..., / N N --. 7 \ i \ -� !N / / --�_- ' \ a / \ / \\ \ w ,\� `` 50' WELL RADS I \ \ Q OLD HOL6JNG TANK / / \ \ = PUMPED AND FILLE) / \ \ \ ��---�\ // \ } \\ l / . 01 \ / \ 1 } / \ / \* I (A @iFENCE CORNEA \ / Ciiii C I / N � \ 1 1 . CRABS, � ELEv. 100.0 -_ / } Tallow./-C01 TEST HOLE RADIUS _ FILTER FABRIC -1...._- \_ _ - - - 4.0"0 PIPE / - \ Q SEWER ROCK / \ CO4MT Coy' ASBUILT 94.5 ,r. / \\ / J / N_ ,' SCALE: 1"=30' ,N J Op \ / ------- I \ 87.5- - -- ` / OCOFBASLIOE82.0 4--- EXISTING CATCH BASIN MANHOLE IN DEARMOUN RD. 2.0' 51: -i O SLOPE CROSS SECTION DEARMOUN ROAD / NTS COt CO2 TC01 L OC ACCESSC01 Co MT CO5 �� O. /14'44!♦♦ Ilinnii 2 loon tQQ^ 1 tQg�_�\pgiGll�Al ^\�• •• •.0�I- ♦. J \ ate- a J ••..v .. O FILL N M • -1.0 OR / " . • . /—F4TER 14800 •• 1 • 1 95.4 .500 CALICO!FILER \_2.4.-5 l.".4_5 / GLASS 1.04( •4"= 815 \ 87.5 SM/CM /.��;MICHAEL N. ANDERSON'; •.. ... � No. CE 9469 •�If �> mat \90 4 /// SEPTIC SECTION �♦♦••• ••1'j f6 N.T.S. -25.0_ 74.a 4, i. Belk. DRY JULY 200. ,1,.,-1`•x• 08/29/2018 02:53 907-345-0202 ALPINE DRILLING PAGE 01/01 ALPINE DRILLING & ENTERPRISES Permit Number:#SW050001 Date of Issue: 1-05-05 Parcel Identification Number: 018-391-38 Date Started: 3-21-05 Date Completed: 3-22-05 Is well located at approved permit location?Ei Yes ❑ No Legal Description: Flat Top View#1 elk 2 Lt 12W59" Property Owner Name&Address: Robert Duncan 3201 De Armours Rd Anchorage, Alaska 99516-3548_ - . _ Borehole Data: Depth (ft) Method of Drilling® air rotary ❑cable tool Soil Type,Thickness&Water Strata From To Casing type: steel stick-up 0 2 Wall Thickness: .250 inches organics silt &wood 2 11 Diameter: 6 inches Depth: 181 feet gravelly silt 11 40 Liner Type: silty sandy H2O 40 43 Diameter: inches Depth: feet Casing stickup above ground: 2 feet silt 43 47 - Static water level (from ground level): 59 feet gravelly silt 47 68 Pumping level: 180 feet after water sand&gravel 68 73 2 hours pumping 20 gprn silt 73 81 Recovery Rate: 20 gpm gravelly silt 81 129 Method of Testing: air lift silty gravel 129 145 Well Intake Opening Type: gravelly silt. 145 162 ®Open End ❑ Open Hole silty sandy H2O 162 178 ElScreened Start feet Stopped feet ❑Perforations Start feet Stopped feet water sand&gravel 178 181 Grout Type: bentonite granules Volume: 3 Depth; Start 0 feet Stopped ?feet Pump: Intake Depth feet Pump size lip Brand Name Well Disinfected Upon Completion? ®Yes ❑No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling&Enterprises PO Box 110496 ?t<�. I_. - Anchorage Alaska 99511 EF '\ Oa ,f❑ JLf / ]C97 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property • MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT907-343-7904 On-Site Water and Wastewater Section `t l t ) Fax: 343-7997 www.muni.org/onsite Well Decommissioning Log Legal Address: Subdivision FLATTOP VIEW#1.B2,L12W59' Block Lot T R Section Lot On-site Water&Wastewater Section certified contractor performing the well decommissioning: Name: MIKE ANDERSON Signature: Company: SAME Well decommissioning date 9110/06 Method of decommissioning: AMC 15.55.060L1 a. ❑ b. ❑ c. ■❑ Location: Use the space below to provide a drawing of the property showing the following items: • North arrow • Decommissioned well location • Location of other water wells on the property • Two separate swing-tie distances for each well shown on the drawing Note:The swing-tie distances shall be measured from either permanent structures or the property corners. 4 T c/ a 4, 4. �H g r� r 400 Pe tPai � Pw , G•\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Well Decommisioning form.doc Municipality of Anchorage S` P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV181101 COSA#: Permit#: SW050001 PID#: 018-391-38 Legal Description: Flat Top View#1 B2 L12 W 59' Engineer: Mike N. Anderson Applicant: Bob Duncan Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 4.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 127�1/(g Approved by: V__ Name of Revi;/er **** VARIANCE/WAIVER REVIEW **** Dec. 21, 2018 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage,Alaska 99519-6650 Fax 249-7847 Re: Lot live waiver Legal: Flattop View#1, Blk 2, Lot12 W59' To Whom it may concern: This is a request for a lot live waiver on the above referenced lot. The waiver will not impact any of the surrounding neighbors due to this design. Please call me if you have any questions. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 MUNICIPALITY OFANCHOR4GE Development Services Department Onsite Water& Wastewater Program \1p 1 4700 South Bragaw Street CAI I 1 P.O. Box 196650, Anchorage, AK 99519-6650 �O (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number. SW050001 Legal Description: FLAT TOP VIEW #1 BLK 2 LT 12 W 59' Design Engineer: 0014 Anderson Engineering Owner Name: ROBERT DUNCAN Owner Address: 3201 DE ARMOUN ROAD ANCHORAGE. AK 99516-3548 Date Issued: Jan 05, 2005 Expiration Date: Jan 05, 2006 Parcel ID: 018-391-38 Site Address: 003021 DE ARMOUN RD Lot Size: 8260 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. -THE LOCATION OF THE ORIGINAL AND REPLACEMENT SUBSURFACE DISPOSAL FIELD MUST BE IN 50 FEET UPHILL FROM ANY MANMADE OR NATURAL BREAK IN THE NATURAL SLOPE OF THE TERRAIN WHERE THE SLOPE CHANGES 25% OR GREATER UNLESS THE TOP OF THE DRAIN FIELD IS LOWER IN ELEVATION THAN THE OW OF THE SLOPE. -THE ORIGINAL WELL NEEDS TO BE PERMANENTLY DECOMMISSIONED IN ACCORDANCE WITH AMC 15.55.060 PRIOR TO INSTALLATION OF NEW WELL. -THE HOLDING TANK NEEDS PROPERLY ABANDONED PRIOR TO INSTALLATION OF THE NEW WELL. Received By. Date: r/5r-/v t5z- Issued By. __f`^ Date: t Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. C9 I e - 72 5 / — 31 iS Permit Number SW Property owner(s) �40 b p') h r e +'I Day phone Mailing address '312,21 nC a I" V'0 .1 12 d. Zip Code _ Site address :302-( SDE ArmnU&n 'R� ky-�i 1&L Zip Code I01g51(o Legal description (Lot, Block & Sub'd.) yrlee7 / 5 t% U P6�0 r *" :�LI Legal description (Section, Township & Range) Lot Size g;zCcO Acreq.Ft. Number of Bedrooms `f THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well 9 Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 1035-00 Date of Payment: 1:2) 2al Dq Waiver Fees: Date of Payment: Receipt Number. topisp- Receipt Number. (Rev. 09104) Michael N. Anderson, P.E. Civil/Structural Engineering 4640 Shoshoni Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 December 28, 2004 Municipality of Anchorage Department of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: West 59' of Lot 12 Block 2 Flat Top View No.l Subd. To Whom it may concern: This is a request for a new well and septic permit on the above referenced lot. The existing well on this lot is only 60 feet deep and has very high nitrate levels. The existing well cannot be deepened due to the location, 2 feet away from the garage door therefore a new one must be drilled. The new location is to the southwest of the existing well along the property line, this will allow some room for the new septic system to be installed. The new septic system will be an Advantex from Anchorage Tank due to the small plan area, see the new proposed plan. A test hole was drilled to 25 feet due to the deep slope to verify the water table and the soils. No water was observed. The perc was 22 to 24 minutes per inch. The test was difficult to do using the plastic V monitoring tube, however it was very typical of the area. The soils consisted of silty sands SM with some GM for the entire depth. This was consistent with the road excavation also. The slope on the south side of the lot is above the 25 percent limit therefore the system will be installed deeper than the normal 2 to 3 feet, see profile. Also a storm drain manhole has been installed in the Dearmoun Road upgrades (summer 2004), near the bluff area. A 25 foot offset will be maintained from the catch basin however no offset distances area required. This new well and septic system upgrade will not impact the neighbors and should correct a high nitrate level problem for all residences in the area. If you have any question please call me at 345-3377 Sincer� Michael N. Anderson, P.E. DESIGN CRITERIA: 4 BDRM X 150 = 600 GPD APPLICATION RATE: 3.0 GPD/SQ. FT. 6.01 DEEP TRENCH 600/3.0 = 200 SO. FT. REQURIED 200/12 = 16.7' REQUIRED TRENCH TRENCH: 16.0' DEEP 6.0' EFFECTIVE 2.0' WIDE (1) 20' LONG I � " PROPOED NEW-\\ WELL OCATION EXISITNCOLDING TANK — — JO E ABANDONED I � " MOUND OVER (THl(1) p GRADE -0.5 FILTER FABRI 4.0'0 PIPE SEWER ROCK SM/GM -10.0 OP -16.0 -25.01 1 2.0' / \ / X I II I \ TING WELL BE (ABANDONED STP TANGALLON . --- D E A R IA'O-U-R R 0 A D / f 1 I ' o SEPTIC \\ --- STORM GRAN MANHOLE Septic Design Prepared For BOB DUNCAN WEST 59' OF LOT 12 BLK 2 FLAT TOP VIEW NO. I S/D Prepared By MICHAEL N. ANDERSON, P.E. 4640 SHOSIIONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE 1"=100' DEC 26, 2004 <...�. ° MICHAEL N. ANDERSON;' No. 941,9 'Witil � ♦ �'' ss�o:•• 4hikalL � Tlii' 'v is •:; / \ \ NEW 1 '){ 8' ADVANTEC \ FILTER BOX MOUND OVER (THl(1) p GRADE -0.5 FILTER FABRI 4.0'0 PIPE SEWER ROCK SM/GM -10.0 OP -16.0 -25.01 1 2.0' / \ / X I II I \ TING WELL BE (ABANDONED STP TANGALLON . --- D E A R IA'O-U-R R 0 A D / f 1 I ' o SEPTIC \\ --- STORM GRAN MANHOLE Septic Design Prepared For BOB DUNCAN WEST 59' OF LOT 12 BLK 2 FLAT TOP VIEW NO. I S/D Prepared By MICHAEL N. ANDERSON, P.E. 4640 SHOSIIONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE 1"=100' DEC 26, 2004 <...�. ° MICHAEL N. ANDERSON;' No. 941,9 'Witil � ♦ �'' ss�o:•• 4hikalL � I _ I PROPOSED NEW —I— —WELL LOCATION I \\ I \ I 1 EXIST Nq HOLI TO BE A \ EXISITNG FI NEW 4�X 8' ADVANTEC -JITTER BOX— — 25% 2 NG / 20. \THII / y y \\\��J 25%1 Q T6k-/i—I— S21 EXISTING PTIC 1 EXISTING WELL TO 1 0 11 I I I I r NEW/1500 GALLON STP TANK / >/ :SEPTIC \ — NEW DEEP TRENCH 1 0.0' 1PPROX. BLUFF LINE STORM DRAIN CATCH BASIN c 1 Septic Design Prepared For BOB DUNCANE.�........ bW� WEST 59' OF LOT 12 BLK 2 mel * FLAT TOP VIEW NO. 1 S/D : �': ' 49 TH ! Prepared By ........... y.... ..... MICHAEL N. ANDERSON, P.E. /./.. m '!f.� 4640 SIi05Ii0NI DRIVE f MICHAEL N. ANDERS........ ON: f 0 345-3377 / FAX (907) 345-1391 No: SCALE 1"=30' DEC 28, 2004 _ FROM TANK TO FILTER 676 1 �aooa0000000•I PLAN o�tfa4�rsQ• � � DISCHARGE FILTRATE AOVANTEX 6' JIM CAP AX20 POD /_30' INSULATED RISER ( 6* ABS PUMP -OUT / / (TYP 2) -- 6' ABS COUPLING CLUED TO TANK m (TYP 2) FROM 1 FIBERGLASS TANK TO FILTERTO DRAINFIELD � I• � ISI 1 'I I � I INSULATION 24* Ir BEYOND TANK MIN. r NO INSULATION BETWEEN TANK I �; AND POD. 1 , �• I i !� I� i �I � I� I"I 166.5' 70' FLEVATIO SECTION NOTE: 1. ADVANTEX AX -20 BY ANCHORAGE TANK. INC. Septic Design Prepared For BOB DUNCAN �.•��E, A���y� WEST 59' OF LOT 12 BLK 2# FLAT TOP VIEW NO. 1 S/D Prepared By .... r...... .. . ..................0 MICHAEL N. ANDERSON, P.E. :.....��%.............: 4640 SHOSHONI DRIVE �I :MICHAEL N. ANOERSON;': (907) 345-3377 / FAX (907) 345-1391 �1' No. V94 %f {i NOT TO SCALE DEC 28, 2004 •♦� , 5sx Municipality of Anchorage Development Services Department Building Safety DivWcn • �.t On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Boz 196650 Anchorage. AK 99519.6650 w ei.anchemce.ak.u5 (907)343.7907 Solis Log - Percolation Test OF * y . Q9TH ; Pc,formed For. pJ%z V.. ti C k __Date Performed. Legal Description: kr54. 59,01. Lyf- Township, Range. Section: �1oR fopvLY1.9 ( I Slope ( I I I I—( I I I -F—I 1 2- 3-I I 1,1141el M L*it r.'i It 5- 6- 7- s- 9- 10- 11- 1 Oil 5y /f .7 bard, 6ve+C� Pr;l�rci 1w/ I'Yt r r rLC1 . WAS GROUND WATER ENCOUNTERED? l� Gross Tune s IF YES. AT WHAT DEPTH? L Depth tohion Water After 0 P Atonitoringl .LY.[p, E Date: J44Y MICHAEL N. ANDERSON; Ca, CE -9469 Il pROtrretnBll�'+ a _.L Reading Date Gross Tune Net Time Depth)oWater Net Drop 7Tj iSO 'f 0wjn 10.E S.Y.i 9 S . i y3 s PERCOLATION RATc Ir.•�w1e&ireq PERC HOLE DW.IETER 17r'/.'r PERFORMED BY: All, f� { 1 !�`�j(� rl 4'4Y1 I CERTIFY THAT THIS TEST p/ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7 0 ADVANCED WASTEWATER TREATMENT SYSTEM I\IAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN I1 UNICIPALI�Y OF ANCHORAGE AND �ohe-r� �n(•rn THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this 3 r 4 - day of ya n Ne i ✓). 20p , by and between �o ��r fi �" n ���, , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as 3? located at PC&Cct , Anchorage, Alaska. w r g }- T'? 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65 B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC Page 1 of 5 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction). An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating). An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all requirements of this agreement, the conditions of the Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65. 3. Fee. Owner shall pay to Municipality an annual fee of V o ($4.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. Page 2 of 5 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the ANVWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of on site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, owner agrees to comply with all applicable ordinances, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: e*M ellac(n� 1'a Page 3 of 5 C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the systems. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way affect the validity of this Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality as this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. Page 4 of 5 B..- For,the, purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: R 6 b cd N 0,4 vt Ca V7, Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: Date: d OS STATS OF ALASKA THIRD JUDICIAL DISTRICT MUNICIPALITY: By: Zoe -(7woona.t, Title: ; . f'&s Date: •/T- C - ss. rd XM57 The foregoing instrument was acknowledged before me this L day of u r ,4i, by I?Aoff Dvhctih , the GtonPf of -;t�'q , on behalf of Municipality of Anchorage. SSo i DcAr. vv^ ad. My Comn6ssion Expires NO P�A June t 3, 2005 UBLIC FOR ALASKA Page 5 of 5 My Commission expires: MyComm!on Expires Jlmet3.2005 RichardlASSIGNMEKMAACode Addendum AAJC 15.65 (Noo-0257plemor2nudm of Understanding Version Vl.doc Page 6 of 5 • Municipality of Anchorage Page 1 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: PlC2PID Number: Oltq i Name:ia*-.1 t.-1 t .-- f'' '‘ Wastewater System: ❑ New ❑ Upgr Address: ABSORPTION FIEL �✓'Lf>I 'G t �tt'12 . G. I Phone. No.of Bdrooms: rJ/ ❑ Deep Trench CI Shallow Trench ❑ Be ❑ Mound 0 Other LEGAL DESCRIPTION Soil Rating: Tot epth from original grade: GPD/Sq.Ft. Lot. I Block: subdivision: _' Depth to pipe bottom from original grade: Gravel depth beneath pipe 2���` —f�/Vr� Ft. • Ft. Ton h LAAI I Range: I Section: Fill added above original grad- Gravel length: Ft. Ft. WELL: ❑ New ❑ Upgrade Gravel width: Number of lines: 1Distancebetweenhines: Ft. Ft. 9ipficatio/n(Privat�A.B.G) l oral Depth: Cased To: Total absorption:rea: Pipe material: "'P"'1--.G LL —1 Ft. Ft. SQ.Ft. Driller: ate Drilled: Static Water Level: Installer: DarteJininstalled: � I Ft. f-.1 -.re- •6)v. 4 ecr` JyVI I �� Yield: f Pump Set at: l Casing Height Above Ground: TANK GPM Ft. I Ft. SEPARATION DISTANCES 0 Septic Molding 0 S.T.E.P. To Septic Absorption Lift Hjinq Public/Private M6aripctur r {ap�acity in gallons: From Tank Field Station k Sewer Lines ,r ��/04>4 Gj [�. ?�� Well l �_ e1 �1/ iiMaateriall: � Number of Compartments: Water CI, , LIFT STATION_.LotLSize in gallons: Manufacturer: Line I 'f �� _r 'Pump on"level at: 'ump off"level at: High water alarm at: Foundation , / Curtain f�(G: t-}( _ _., Pump Make: .del Electrical Inspections performed by: Drain Remarks: BENCH MARK 01(( c %�JfG t'—I 1/1 �• - P— .. Location Description:eLED.rG1-,•-4_.-- .P- I I--'" Assumed Elevation: 1d Ft ENGINEER'S SEAL —:**f., OF •f'lli a S&S ENGINEERING . Nit 1lb sr*;' ;rte- \IP 4 17034 Eagle River Loop Road,No.204 / • 9 , r` • it Inspections performed by: Dates: 1st 8 11 y'•� • •••••••t••• 2nd •• -.... ...r.../� i %••. No. 1457-E •••*€`' Department of Heal . nd Hum Services approva . �e4An• •,.•(`�S . Reviewed and approved by: �I�� �V Date:g/19/93 1%A,.-M��46.4.4117 A 72-013(Rev.9/91)MOA 25 Permit No. SW930255 Page 2 of 2 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 DescriptionYLAT TOP SUBDIVISION, BLOCK 2, LOT 12 PID No.: 01839138 CO 6" CO ALARM��99 6, NEW 2000 GAL c'.1 - HOLDING TANK SCALE 1" = 10' 88.5' A B FCO 15.5' 16' CO 31 ' 24.5' LOT 1 LOT 2 6" CO 33.5' 30' ALARM 35.7' 33.5' 20' ALLEY GRAVEL PARKING w a DECK WELI9 ' .75' WELL RADI S U II EXIST { N 3 BDRM _ [ HOUSE W U I g \-FENCE LOT 11 B A DELA I = FCO EAST NEW HOLDEN PORTION TANK Co ENGINEER'S SEAL LOT 12 ��n�►u� ALARM ��w'q�.••,, •�+o® o°ZL4 C • I � °1# •d GJn..�.�oo of06DN� 4.. SCALE 1" = 40' i • •° ' " • 'e g• a°oboe A. Shalom ,i'� DEARMOUN ROAD • No. 1457-s . 4%t aRoF[SSVN ' 72-013 A(Rev.9/91)MOA 25 08/12/93 11:48 CT&E ENVIRONMENTAL LAB SERVICES :' .:.. NO.237 ''`D02 41- COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES .r'„.;: _: ,,Ib L. n,Num mwi REPORT of ANALYSIS Chemlab Ref.* :93.3963-15633 B STREET ANCHORAGE.AK 99516 Client Sample ID :L12 B2 FLAT TOP SID TEL (907>5V•9143 Matrix :WATER FAX.(9070 561-5301 Client Name :S & S ENGINEERING WORK Order :69352 _ Ordered By :R. SHAFER Report Completed :08/12/93 Project Name Collected :08/09/93 @ 16:35 hr: Project# Received :08/09/93 @ 17:20 hr: PWSID :UA Technical Director:STEPHEN C. EDE Released By : (/;; >444„;7/--- Sample Remarks: ROUTINE SAMPLE COLLECTED BY: S.S. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Ini- Nitrate-N 9.37 mg/L EPA 353.2/300.0 10 08/10 LL! / - ThLs we l pnoduced a n,i tn.ate Level o6 4.2 an June 2, 1993. The high n.itnate Leve.. n.epan.led at this time is pnababLy due to an -,neneased cancenlna.t on as a n.esuLt athe house setting empty son. sevetaL months. � IP/, 1 • S •3 = .. = = -.•- sm to==x z---. * See Special Instructions Above UA = Unavailable • ** See Sample RemarksAbove NA = Not Analyzed U = Undetected,: Reported value is the practical quantification limit. ` LT =' Less Than D =Secondary dilution. • GT Greater Than reN SGSMember of the SGS Group(Societe Generale de Surveillanoe) ENVIRONMENTAL SERVICES IN ALASKA,COLORADO. UTAH, ILLINOIS,OHIO,•MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE Q m DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 )1-9 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930255 DATE ISSUED: 7/27/93 DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE: 7/27/94 OWNER NAME:FEDERAL NATIONAL OWNER ADDRESS: 3021 DEARMOUN RD ANCHORAGE,AK PARCEL ID: 01839138 LEGAL DESCRIPTION: FLAT TOP VIEW #1 BLK 2 LT 1 2 LESS E40 ' LOT SIZE: 8260 (SQ. FT. ) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: HOLDING TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1 . THE ATTACHED APPROVED DESIGN. 2 . ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15 . 55 AND 15 . 65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80) . 3 . THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4 . FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5 . THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY. DATE: ISSUED BY: DATE: 7724 3 - ngr�� ROBERT SHAFER,P.E. ROGER SHAFER•P.E. :,., ' I July 6, 1993 CIVIL ENGINEERS A A / 3i. (907)694-2979 A - FAX 694-1211 E4CtF R�VER,A04'1‘ HEALTH AUTHORITY APPROVALS unicipality of Anchorage 'DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street anchorage, AK 99519-6650 SEWER&WATER MAIN EXTENSIONS • FERENCE: Flat Top Subdivision, Block 2, Lot 12 SEWER&WATER INSPECTION e request you issue a permit to install a 2000 gallon :olding Tank to serve the three bedroom house on the referenced property. ENGINEERING STUDIES 4n adequacy test was performed on the existing system on June AND REPORTS • , 1993. From this test it was concluded that the system is ' n a state of failure. Due to the topography and square rootage of the referenced property, there is not sufficient .rea for a conventional septic upgrade. WELL INSPECTION &FLOW TEST he attached site plan shows the location of the proposed lolding Tank. SITE PLANS e do not anticipate any adverse effects on neighboring .roperties by the installation of the proposed Holding Tank. If you have any questions, or require additional information ROAD DESIGN for your review, please contact us. •incer- SOIL TEST /or A. Shafer, P.E. PERCOLATION TEST • aS/LSU/lsu STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 LEGAL FLAT TOP ITTBDTVTSTON, R .ncu- 2. T. ?T 12_ ..c,. (.i 1� QQ �"ngt�PII DRAWN CKD. DATE '���� °�s� °• �� . 4/ L. 5, ULSHER R.A.S. 7/5/93 i of 1 :e`'. `'E4.pk ° >aa' •cam.a. a saevn•v w1�,, ito�sr� A. sh.ia K.. No. !x.57•!RIVER,AA-c'S�P L LOT 1 LOT 2 _` 20' ALLEY GRAVEL PARKING r W DECK WELDcl .75' WELL RADIOSIF EXIST N — 3 BDRM I HOUSE 1 w 0 I -J \-FENCE LOT 11 LIJa 0 1 = Q �/ EAST cY PROP. HOLDING TANK PORTION ate. (2000 AL) o co LOT 12 s77eP, i \-7,--- XIST. SEPTIC TANN' POMP, CRUSH, AND ABANDON) Cl.,/ 6Gfi1l{ FENC 7(EXIST SEPTI SYSTE i TO BE ABANDONED I LAC _ _ (REMOVE ALL STANDPIPES) O / DEARMOUN ROAD tir NICIPALITY OF ANCHORAGE Heal_ and Environmental Protec n Fourth Floor West • 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME- _S IJL.•�/-iA. _ MAILING ADDRESS _/i 4 'Y' ' A ��- PHONE LOCATION --_ _ -- -- LEGAL DESCRIPTION `7r /'y�e�C 2 �/"/-'Z/-�LL-� __ _____--------- w \la' Lam. \--)-" SEPTIC TANK: DISTANCE 0, f -��,,-/) NUMBER OF 0_.- FROM WELL- V _ MANUFACTURER .I L MATERIAL '��I�'x�C�' COMPARTMENTS INSIDE LENGTH__ INSIDE WIDTH -___.____ LIQUID DEPTH LIQUID CAPACITY/04 ALLONS. TILE DRAIN FIELD: ' TOTAL LENGTzse / DISTANCE FROM WELL /a_o__-FOUNDATION NEAREST LOT LINE_ 2 OF LINE Of Lines. .- .. . 1_...._ DISTANCE BETWEEN LINES _-LL9- IL.�9TRENCH WIDTIN. TOTAL EFFECTIVE ABSORPTION AREA _3_420....___._ SQ. FT. LENGTH OF EACH LINE _ ZZ/ DEPTH OF FILTER / DEPT II: TOP OF TILL TO FINISH GRADE MATERIAL BENEATH TILE 2i OP ABOVE TILE If IN. SEEPAGE PIT: DIAMETER OR WIDTH —, LENGTH_, DEPTH . Log Crib Rings Crib Size: DIAMETER_--DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION , NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) SQ. FT. 311 • - - �..}• ! + - I I .0-- ( --' I -It I lass : Depth: _.;J__.;- --I ; .�. �� • ___I___ all Distance To: Lot Line — -- - j • i lh — ldg: Sewer Line : '-- j ,-ii_-�__ 1,_..11.-11/.11._. ._._ . _-J ipe Materials : - :_._ _ d , -.. --- ---- o f Bedrooms : 3 i--, __-__ zstaller. ,, . .;-1 . - i. . -� - - ?marks : /N5T,94/Ep lax y de I Tn ra" 13 k Ar- pe,Aff'es i I. ._ 1 40 orh,e s.r I !. I i _ I I I -- ---- Dor raj size -i-- . .L_.! I. _ : ' . ; -� -1 l-_ I_l ■ ---- ---- - ._ _ . _� -- - • L. 1. 1- - .._ _ - _ _ ; _ r I : . , ,„ 1 ,,v I.- I ( I i •I 1 i-t I I 1- -I -i-- - DATE;/ag/-7_2Al'l'Rovi.D .- -tee 4.• - -1r I-1 LI NI .JI.. a_: I From 0____ I. ..°r° Cu IF r-°I c:FA c.,„:Q7.IR a i I:E. J•c`lU Q I 1 L DEPARTMENT i I EALTH AND ENVIRONMENTAL FfsmjECTION V - 025 1_.' S,TREET, ANCHORAGE, W. 99501 /6- 19:77 w . 264-'�1 i'20 1 •�!U 0' I Y� i 1"-°I---• I_ --I El: FE 0-.-11 C_.IF! F a:.-..tI�"1--1 I ..I" PERMIT NO. 770957 .' kfi6 APPLICANT L.ING CONST 1605 SAN'r'A CIRCLE f:ih•aCH 737-6-U0 LOCATION OFF DEARMOUN LEGAL L12 E:2 FLAT TOF' VIEW SUB LOT SIZE 12:E:EO SQUARE FEET TYPE OF SOIL AE: ORE:TION SYSTEM IS : TRENCH MAXIMUM IM I''dI.IF'th:ER OF BEDROOMS = 72. SOIL RATING (5•I-! FT/E:R)= 1.00 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS : C.:. F"-1-I--1= -_ E__I_C'-.I Yom,-1-1-1 ::_•-:_! " m::: IF!ifq"-...°ft: :.I._.. I:_="FE F"`I-El ;' THE LENGTH DIMENSION I'S THE LENGTH ( IN FEET) OF THE: TRENCH OR DRA I NF I ELD. THE DEPTH OF Fi TRENCH H i I F'I T IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION ( I N FEET). THERE IS NO SET WIDTH FOR TRENCHES THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION ( I N FEET). : 11::::!I_I T. IF==' 1_:° w:la-1="-i- I C: 1..-I=_i I'-.1 it w= i 'Z1'ELT== :i_Cil a_=i 1117_1 A_rN Fit IL_.IL__CA it-4 f_ —...-------.— .°.1 112::::I.=__I. 11:3 IL_ F I__EI Ni-1- c:a 11- "-T- IID 1° ._----—_...-—_-__ A PACKAGE PLANT MAY E:E INSTALLED AT THE PERM I TTEE''S OPTION SUBJECT TO THE FOLLOWING CONDITIONS : 1. EITHER A CLASS I OR II NSF AF'F'RO'v'ED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT IS REI_!LI I REL::. IF A MA I.N rENANI:E AGREEMENT IS NO`IT.. KEPT CURRENT YOU NAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MA'T' E:E 'SI_Ia:FEI_T TO PROSECUTION. ---- ------ 1-11-4C) i r-4'._.:F.°EEc ._T- i n:_i 1"-.1 I..._I ff-,"1:_ 1::-.E.E u_:LII_I l[- 1="1= ------ BACKFILLING -_-. .._._ EIIL F::F I LL._:[NG OF ANY SYSTEM WITHOUT FINHL INSPECTION ANF' APPROVAL E:'r' THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE E:ETWE:EN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 2011 FEET FOR A PUBLIC WELL. OTHER REQUIREMENTS MA'r' APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F—E: 1"°1 I -1- Ir:ti=:11=' 11' E—_'_:: L.:°1___a__:1:=_1 I L-::I::='.1;=` _=fIL. :.�"_ R.- I CERTIFY THAT 1 : I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH E:''r' THE MUNICIPALITY OF ANCHORAGE. 2 : I WILL INSTALL THE SYSTEM IN ACCORDANCE[TINGE WITH THE I_I=II:lE': :: . I UNL'ER_, -IND THAT THE ON-SITE SEWER SYSTEM NAY REQUIRE ENLARGEMENT IF THE RESIDENCE REMODELED TO INCLUDE MORE THAN BEDROOM'_. 1 i lk 1).§+-e A F't_.I DANT LING CONST ISSUED E:'r' .... t_._ �'`-""_-_______C,ATE_-��.�f __?-. 0 • • GARY PLAYER VENTURES CONSULTING GEOLOGIST BOX 476-M, STAR ROUTE A • ANCHORAGE, ALASKA 99507 • PHONE 344-7071 SOILS LOG LPerformed for 1 V1 C- C Date k 0 I I /1 -1 Location JPS+ L+ e2 1�1 ( 2 ) 1 4-De So.kooktuisto,,, Soil Type Water Level Remarks 0 2 - 6w - 1 4 - 0\rao Sorvv`cr3 _ 4k 'tr.) 5( ?-4-- ami 8 r a1 10 — 4J 12 - -' a aJ 14 - - 16 - - 18 - 20 Total Depth of Excavation Material at Total Depth k-4.) Groundwater Bedrock V) Not Reached () Not Reached Depth, if Reached Depth, if Reached Classification Method bQ Visual Sieve Analysis Cj`'1/4O Qiair ( ) Gary F. Player, Consulting Geologist M/ Municipality of Anchorage ' Development Services Department d R: Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.d.enchorage.sk.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-391-38 HAA#_N /9 0 / 02 D 7 1. GENERAL INFORMATION Expiration Date: Complete legal description FLAT TOP VIEW SUBDIVISION #1; LOT 12 BLOCK 2 ❑ Individual Water Storage ❑ Individual Holding tank Location (site address or directions) 3201 DE ARMOUN ROAD • ANCHORAGE, AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address LETA BELARDI Day phone 348-0242 3201 DE ARMOUN ROAD • ANCHORAGE, AK 99516 Day phone RANNA FEKRAT w/ PRUDENTIAL J. W. Day phone 762-5802 3201 "C" ST. SUITE 200 ANCHORAGE. AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 1 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 errors or omissions in the professional engineer's work. Note. Alaska Waterand Wastewater Consultants, inc. shall be paid $800.00 at, or prior to dosing for the engineering services provided. 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 AuthorityApproval Guidelines for this application, shows that the on-site wa ter supply andlor wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and" of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system ls(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of Installation. Name of Finn ALASKA WATER do WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 2B ' ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A CARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to protide a thorough, ' conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test and separation distances measured to readily ktenIffiable tea lures. The operational No of afi wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the familybeing served by the system. Those wnditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do May guarantee that there are no hidden defects orencroachments. AWWC, I= can Moniforo not provfde any warranty or future estimate of how tong the system wfll cenflnue to moat the oporattonal requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner fisted above. Any refiance upon or use of this report by any other person or party is not authorized, nor will R confer any legal tight whalsoover. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Date Conditional approval for bedrooms, wi�the f1joyAn?ep(mlatiq Note iI a well for this property meets existing State an lumcipaf odes. present. It is suggested that periodic testing be performed to Insure the wells `��(1t1111or!(////� Jam:. • ON-SITE WATERAND' WASTEWATER �o PROGRAM erL�}�jiitSates-,,• information on nitrates is available from the On -Site Services Program, at 343-7904. Attachments: HAA Checklist y Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other /U% By: �!/. �erti! Original Certificate Date: (Rw. +mo) Municipality of Anchorage ' Development Services Department Su"W 69* Dlvleion O"Its Water& WWW*TterProgram 4700 South Bragaw SL P.O. Banc 108650 Anchorage, AK 985198650 www.d.andgrege.akus (907)943-7904 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDeaafption: FLAT TOP VIEW S/D M1: LOT 12, BLOCK 2. ParcellD: 018-391-38 A. WELL DATA Wen type SATE Ira B, or C provide PWSID9 N/A Date complated UNKNOWN Santiary seal (Y/N) YES Total depth 40'+ fL Cased to 40'+ fL FROM WELL LOG Date or test Static Water levet fL Well production g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonles/100 mL Nitrate 8.96 mgJL. Wen Log (YIN) NO Wires properly protected (Y/N) YES Casing height (above ground) 20 In. AT INSPECTION 4/26/2001 40 fL 4.45 9 -P.M. Other bacteria 0 cobnies/100 ml. Date of sample: 4/25/01 Collected by: AWWC, INC. e. SEPTIC41OLDING TAN ATA TankType/Material STEEL HOLDING TANK Date Installed 8/11/1993 Tank stye 2000 gat. Number of Compartments I Cleanouts (Y/N) YES Foundation cleanout (YM) YES Depression over tank (Y/N) NO High water alar (Y/N) YES Date of pumping C. ABSORPTION FIELD DATA Date Installed Length f; Pumper MCDONAWS PUMPING — PUMP ONCE A MONTH HOLDING TANK Son rating (g.p dj*r 1emrm)_ System type Width It. _,iVl;fbelow pipe R Total depth R Elf absorption area R'/M0nitar tube Depression over field_ Date of adequacy testu (Pass/Fag) For bedrooms Fluid depth in absorption test_ in. Water added _gal. New depth _in. Elapsed TI _ min. Final fluid depth _ In. Absorption rete lm g.p.d. rejuvenation treatment (past 12 mo.) (YIN 6 type) H yes, glue date D. LIFT STATION Date Installed Size in gallons 'Pump on* level at ---In. E. SEPARATION DISTANCES High water alarm level at Cycles Meets alarm & circult requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanklOft station on lot N/A Absorption field on lot N/A Public sewer main 75'+ Sewer /septic service One 25'+ On adjacent lots 80'+ On adjacent lots 80'+ Public sewer manholatcleanout 100'+ Holding tank 75'+ SEPARATION DISTANCES FROM SEPTICZ@OLDING TAN N LOT TO: Building foundation 5'+ Property One 5'+ Absorption field N/A Water main N/A Water service One 10'+ Surface water 100'+ Wells on adjacent k>ts 75'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One Water service One F. COMMENTS G. ENGINEER'S CERTIFICATION Building Weill on adjacent kft —Driveway, parking/vehlde storage I car* that I have determined through field lnspectlons and reHew of Mun/dpal records that the above systems are In conformance adfh MOA HAAguidepnes In effect on this date. Engineer's Privte/Q N me JEFFREY A. GARNESS Date '� 7. HAA Fee $ 500 - Date of Payment 5 -1 I - O I Receipt Number ya 5O (Ra. 1200) Waiver Fee $ Date of Payment Receipt Number • MUNICIPALITY OF ANCHORAGE 02,-- DEPARTMENT OF HEALTH & HUMAN SERVICES aii!,/fil Division of Environmental Services On-Site Services Section 6.1 P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 016— VA 1 -3F3 HAA # aA fAc1/1 Ci-VcrZ 1. GENERAL INFORMATION Complete legal description Lot 12; btocfz 2; Vat Top Subdi.vL6.Lon Location (site address or directions) 3201 DeAnmoun Anchorage, AK Property owner FANNIE MAE C/0 Jack white Day phone 762-3118 Attn: George McCoy Mailing address 3701 "C" St,io.et Suite 0100 Lending agency Day phone Mailing address Agent Geokge McCoy/ Jack GlhA..te Day phone 762-3118 Address 3201 "C" Street Su,Lte 11100 Anchorage, AK Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater:;stem, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Froot MOA v21 • . 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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. 5 &S ENGiNEERINC� Name of Fir 1 River Loop tto 204 Phone 'f -.z9 7 703 3 ba};'Alas'Ka 99° Address Eagle River, Engineer's signature Date V'2- ct-7 i • •,, :(t: Or -,4."'�„, 417 f! ^ yvJenaoo s»n4»oe n, ti � SNsifor .:471 `'I ' \• Nu. 1457-E kiI 6. DHHS SIGNATURE 'Cv-�''"°°�...0i• ,s�,Y�trn / lk � y �tp\l Y” v Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments NntR • The well for this property meets existing State and Municipal Codes . There are nitrates present. It is sugg st-d that a periodic testing be performed to iirsure Lhe wells conti. 1-d suitabil ty. Nitrate concentration is 9 . 37 mg/l . EPA maxi concentra i4�� ±s 10 . 0 . my/l. l. Alt � Q i By: UJ r Date : c CAUTION 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 DPI-IS 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. -.,,,r,t7« 1,r'. MO\'71 Municipality of Anchorage 1 Department of Health and Human Services �J�;, HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: -f'lX` "1t� ��"(i,c7\Jt BION arcel I.D. Z7 le '7cl k-e) -% 1�'i i V©"t' \'1— A. Well Data Well typlg--\J,---1 If A, B, or C, attach ADEC letter. ADEC water system number 1--) / 7}}- . Log present (Y//Ny _ Date completed h -/ it l- k ' ' Driller L • Total depth (� t > Cased to - r Casing height 1 �'' -4—'Wires properly rotecte Y N Sanitary se I (Y/N) P P Y P ) Xy rrir1,. Z z Q• n ROM WELL LOG AT INSPECTION r tilbiqc. Date of test ��jj,� 'C: A -n Static water level '�l o r-rw rn Z // � c o Well flow g.p.m. L0 g.p.m. $ Pump levell IL- 6;m 2 - 'D. .NI �— -t- / h * Ifi 'moi Z I---v\t--\ --t "" --t r-'I -R. SEPARATION DISTANCES FROM WELL TO: • I d� 1 /holding tank on lot ��/ ; On adjacent lots Absorption field on lot �/.�-• ; On adjacent lots I b Public sewer main 1--1/•I,' Public sewer manhole/cleanout 0/4- • Sewer service line 2 4 Petroleum tank _ N WATER SAMPLE RESULTS: � Coliform (/ Nitrate 0 • �-t" ► /�� Other bacteria [� Date of sample: ,t31' ) 1.q .7 Collected by: + 6 -• B.—;HOLDING TANK DATA Date installed 'Si I I Tank size 2� 20 Compartments Cleanout® ) Foundation cleanout (Y/N) Depression (Y N) • hi High water alar ( / 7Alarm tested 6N) 7io Date of pumping ►i/k- Pumper t �--1-71a4-- SEPARATION DISTANCES FROM /HOLDING TANK TO: / I Well(s) on lot ed On adjacent lots 1 f "' Foundation —` i -f- To property line r% Absorption field 1�/a • Water main/service line ID_ Surface water/drainage I O•eD t CONTINUED ON BACK PAGE 72-026(3/93)'Front C. LIFT STATION - Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent(Y/N) "Pump on" level at "Pump off" Level at High water alarm level \ 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 Date installed Soil rating (G:0/Ft2) System type Length Width Gravel thickness Total depth Total absorption area Clea ut present(Y/N) Depression over field (Y/N) Date of adequacy test Results(pass/fail) for Bedrooms Water level in absorption field before t: t After to Peroxide treatment(past 12 mont ) (Y/N) If yes, give da.- SEPARATION DISTANCE F:OM ABSORPTION FIELD TO: Well on lot On adjacent lots Property line To building foundati. To existing or abandoned system on lot On adjacent lots Cutbank Water main/service line Surface wate Driveway, parking/vehicle storage area Curtain d :in E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date,of this inspection. . C��c. :� Cyt Signature _ •. • ,ice ... /, ass'- • T.: fir — S Engineer's -m- g �g�1�HQ--- ' 3 t�£OLL <: € ;:<:>::.. :;. r.. 17034 Ea�I�Nt�JBboApR>IF�iBVS. 04 ; )6abert A. Shafer t4E Date GaglP River,Alaska 99 ►7��2 �� • # J,'• No. 1457-f. :•��y �' l CFS ',gig" �. HAA Fee$ /7 • LfD Waiver Fee$ Date of Payment 7-/3 -13 Date of Payment Receipt Number Z 37)---S—/ r, 0 Receipt Number 72-026(3/93)*Back • MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date 47- 7-“- (a) - 7“(a) Legal Description (include lot, block, subdivision, section, township, range) W.S- 3e- F4-7r i'iCct' S' 23- 7-12_ Location (addres or directions) d .3L47 (b) Applicants Name /QGA) SP/17•W : Telephone - Home Business Applicants Address 72-c( 7),'44ArlCv'L) ( (c) Applicant is (check one) Lending Institution ' ; Owner/builder- ; Buyer ; Other (explain); ��� (d) Lending Institution _/_/14(2. 2.. /'J' .�=cc2l Telephone Address /sot &JL /', a44. (e) Real Estate Co. & Agent ��4� Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single-Family maa Multi-Family Other (describe) Number of Bedrooms "g 3. Water Supply Individual Well . Community ' Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite f Public Community Holding Tank TT Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal • system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. E XC c/ '9$ A.i 7 )) aA) evv/ZifS4 E� Q St-� ji0A) �tJA/44 2 /2��v��s%. ,/ Name of Firm a_cA,'S % G �(.l(�/��. Z��t.�C Telephone 4 f4 Address y?4,O/ ,c3U/�/�� A /L i2 .--444 f 57, rf Date (ENGINEER SEAL) .® N0. 17.2.2.E Dine zw oe44141"s .. f0.\4w ! 6. DHEP Approval `= t:,: N'AL �"safi• Approved for Ji -raelObedrooms By XL-L--4-4%-4--- (U1-vt/4.7tr`Date Approved X Disapproved Conditional Terms of Conditional Approval • • CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 • MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH $ ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) 1385 CHECKLIST - FEBRUARY 1984 fib 0 7 Legal Description: vR `E4DZ- A. WELL DATA Fti}rj C L' tAi5% Lir —/ I-s.) R 3t-kJ $, Well Classification C RI tiikrC If A, B, cr C, D.E.C. Approved(Y/N) Well Log Present (Y/N) N Date Completed it /1/4J KN Q w I✓ Yield j Pen Total Depth 75 * Cased to iS�* Depth of Grouting ~" Static Water Level 4/ cc I ry Pump Set At (r � f 4C- Casing Height Above Ground -t- Z' Sanitary Seal on Casing (Y/N) Y Electrical Wiring in. Conduit (Y/N) Y Depression Around Wellhead (Y/N) ied Separation Distances from Well: To Septic/Holdirg Tank cn Lot b7 Ti; 5 i/tk On1 PC ; On Adjoining LotS 6 S To Nearest Edge of Absorption Field on Lot 'cc ' ; ,'Qn Adjoining Lots7C' io S:AN0 Tc Nearest Public Sewer Line 111)//1 To Nearest Public Sewer FiEcD f Cleancut/Manhole it.//// Sew '/// To Nearest er Service Line cn Lot 6c1* Water Sample Collected By ; Date Water Sample Test Results 4/ f i i fict-#CD Convents 7r.�OT�S Da 'i, 1T7-6c7 7 5 CcPy of ttisr c1 0/%1 /2Et'o/ei.S T i4CHEiD, B. SEPTIC/HOLDING TANK DATA /(APIA -11-4‘- is( Date Installed PO Size /co C c' No. of Compartments 2- Standpipes (Y/N) / Co/J(9 Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N) /✓ Depression over Tank (Y/N) Al Date Last Pumped 5^ Pumpirg/Maintenance Contract on File (Y/N) '' ; for Holding Tank High-Water Alarm (Y/N) A1/4i Temporary Holding Tank Permit (Y/N) A1/4 Separation Distances from Septic/Holding Tank: To Water-Supply TAbll 7 '± To Building Foundation 2' To Property Line 2W- ' t To Disposal Field ' To Water Main/Service Line Fe' To Stream, Pond, Lake, cr Major Drainage Course 1'1/4)/4 Comments S L c 0'/ c/= ii-'s-/'rci�v 1 7s / r'Ci'E P Receipt 4 A R(4)(- 1 Date Paid: q,-`7-.)S Amount: [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /CO Type of System Design (( '''C/1 Date Installed /O 'T 7 Length of Field `Z Width of Field 3 ' Depth of Field // ' C7.53-irr7.S-TE/� Gravel Bed Thickness 7 ' Square Feet of Absorption Area g41-4 Standpipes Present (Y/N) Depression over Field (Y/N) A) Date of Last Adequacy Test 7- z V'k.S— Results of Last Adequacy 'lest /f 7)Et 'L',4 i E Fc, i/3(- Separation 32Separation Distance from Absorption Field: To Water-Supply Well ,C0 ' To Property Line 4- 'C" To Building Foundation. 4'2C To Existing or Abandoned System cr. Lot Cl/KN1.',4d ; On Adjoining Lots + 3t To Water Main/Service Line 4•/C ' To Cutbank( if present) I L' To Stream/Pond/Lake/cr Major Drainage Course ti`//-1 To Driveway, Parking Area, or Vehicle Storage Area '0' 2-C' Contents D. LIFT STATION r- A/4 Date Installed Dirrtensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles erring Adequacy Test. Meets MCA Electrical Ccdes(Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. 6 Ace K; 45 NO re-D row; _ s-c>Ja�{re0 .L�++vc41 '•'45kd Signed //0 Date Date - lc -a'5- ,r c OF A� e$ Company C2Gs43-f. ii'''cs G MOA No. kr- c,Z.. ERS' .gI 111/ � / .:>. KB1/d5/s /, •ti TK?.i737•E %-/ + PAir,ticbon + e 22.i956 [Page 2 c f 21 a; Sj01YIAL L 2-15-84 Municipality POUCH 6-650 ANCHORAGE, ALASKA 99502-0650 of t tame (907) 264-4111 Anchorage / TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION August 8, 1985 Mr. Hank Wilson Constructing Engineers, Inc. 9601 Buddy Werner Drive Anchorage, Alaska 99516 Subject: W59' Lot 12, Block 2 Flattop View Subdivision The Department hereby waives the following distances: 1) From the well on the subject lot to septic tank and field, 85 feet. 2) From the well on the subject lot to the field on Lot 1, 80 feet. 3) From the well on the subject lot to the tank and field on the East portion Lot 12 and West portion Lot 11 (one parcel) , 65 feet and 90 feet, respectively. 4) From the trench on the subject lot to the well on the East portion Lot 12 and West portion Lot 11 (one parcel) , 98 feet. These waivers are written for a three bedroom, single family dwelling. Any changes to this sewer system and/or well invalidate above waivers. Sincerely, Susan E. Oswalt Acting Program Manager On-site Services Concur, / Robert W. Robinson Division Manager Environmental Health cc: Ron and Judy Sparks SEO/pah t - � PC!!'1; 6-650 iln1cip 1� ANCHORAGE, ALASKA 99502-0650 Of ' (907) 264-4111 � Anchorage jt.( TMAYOR ONY KNOWLF S. TONY K DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION October 29, 1982 National Bank of Alaska `.➢ Mortgage Loan Production q° Corporate Headquarters , V Pouch 7-025 Anchorage, Alaska 99510 Attention: Cindy Smith Subject: Lott"12 Block 2 Flat Top View Subdivision This letter is in reference to the health authority approval issued on October 13, 1982. It has come to this department' s attention that there is 1. 6 mg/1 of a petroleum based product in the water supply serving the subject property. This exceeds the recommended limits of 0 . 2 mg/1. Therefore, this department is withdrawing its health authority approval dated October 13 , 1982. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S . Associate Specialist RCP/ljw APPLIC 'JT FILLS OUT UPPER HAI ONLY Proparty Owner•• Y)4 jof d Car v rN e,, 4I(U kl, Phone f .Mailing Address p • nn Zip Code 9 / , .31/5"-53.a Buyer. Address Zip Code Lending InstitutionPhone Address • Zip Code Realty Co.&Agent Na, P Phone Address Zip Code Legal Description F hal Too S u bait/i5i0)^ £lock 2 L 0 Street Location /4 , ;/e. 6, 4,,.,- e7 Type of Residence pti Single Family ❑ Multiple Family No.of Bedrooms l ❑ Other Water Supply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community For wells drilled prior to that date,give well depth(attach log if available). 0 Public Utility Sewer Disposal Individual Year Individual Installed: Public Utility When Connected to Public Utility: 0 Holding Tank NOTE:THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time ii :OO n1_a I ,;ilX) Date Date ^/� n^ Date 1 r� , ` Date 1e"r-AnJ- Ld In- l:.] d 1 f � !- 1 -1- 1, �n i . Inspector Inspector Inspectors Inspector / J fi)4a k 1 Y ,g N MUNICIPA TY •F ANCHORAGE Field Notes: 1/ 1/j, �A ,-•.- -• ,, am_ ENVI. i. .1. A A. v : d le 4, f /it r 1 6 1982 o- ' � Gidt,;,zr RECEIVED -,,,,___ r.,_ ( 3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED /o � - 8 L --- ( ) CONDITIONAL APPROVAL' DATE —/3 e�/ �� gieb BY: PCr„.cam/ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received 1 0 —1—"\ Well to Tank Septic Tank Size 1000 72.023 PM) 44: Anchorage Well/Pump Service v �:, , clik- N° 1425 Vis. • g,; ,,,=.,, 6901 Tanalna Drive • Anchorage, Alaska 99502 = ` .` —. s - . . .,x .w„ ," JOB P.O. or REF.: r . ,., bt _ 0872 i • Domestic and Industrial Pump Sales and Service • ��'"+AOR-' IN��O�' • Peerless Deep Well Turbines and Pumps • NAME Jerry Al lum DATE 12-14-82 • Hydromatic Waste Water and Sewage Pumps • ADDRESS PHONE 20692-311 BILLING ADDRESS P.O. BOX 4 475 PHONE • Clack & UWS Water Filtration and Treatment Products • BILLING ADDRESS P-• - _ • i is CALL FOR SERVICE (907)243-0740 LEGAL DESCRIPTION i PARTS LABOR & SERVICE I) QUAN. NAME OF PART AMOUNT DESCRIPTION AMOUNT 1 GPllen r)etergent 16 .00 11-11 Pul 1 Pump , Rail Well With Dart T. =lfic., Pental 45 - 00 Ad;i Detergent, Install Pump Reci culate , Excavation ( at Cost ) 500 ,00 Pump Off At Wellhead, Reconnect itless Flush System. 2 1/2 P. 60 • 11 -13 Test Water 1/2 @ 60 11-16 Pull Pump , Bail Well With Dart , Add Detergent , Install Pump Recirculate, Pump Off At Wellhead, Reconnect 'Pitless Flush System. 2 1/2 @ 60 11-27 Pull p,lmp, 3ai-1 Ide1 l With rar1t • • Add Detergent , Install Pump,• Rec- rc4lat = , Pune Off At Wellhead, Reconnect Pitless ` Flush System. 2 1/2 A 60 0 SF7 P A GF. #1 2 • TOTAL PARTS5Fii nn I TOTAL LABOR TOTAL PARTS WORK AUTHORIZED BY SEE PAGE # 2 TOTAL Due and Payable on Receipt of This Invoice — interest charges begin to accrue 10 days from FORM OF PAYMENT invoice date at the rate of 1'/:%per month. CASH ICHECK CHARGE 4 ".x: EPSt N0 14 2 6 • Anchorage Well/Pump Service 4 • 6901 Tanalna Drive • Anchorage, Alaska 99502 �VC' :1;• y ~' • " .: � JOB P.O.or REF.: PAGE # 2 • Domestic and Industrial Pump Sales and Service • *A/y D IYE • Peerless Deep Well Turbines and Pumps • NAME ,Terry A11um DATE 12-14-82 • • Hydromatic Waste Water and Sewage Pumps • ADDRESS PHONE BILLING ADDRESS __ PHONE • Clack & UWS Water Filtration and Treatment Products • BILLING ADDRESS CALL FOR SERVICE (907)243.0740 LEGAL DESCRIPTION _ PARTS LABOR & SERVICE QUAN. NAME OF PART AMOUNT DESCRIPTION AMOUNT 1 2-1 3 Fxr•avate Pi tl ess and Water. Tine, Remove Pitless Adapter, Casing Was Tack Welded Only , Break Tacks , Straio.hten and Weld Casing, Properly_ Install Pumn, Add Detergent , Rec4rculate Conner't Pitless , Flush Systen 7 @ 60 Total Hours 15 @ 60 900. ]0 • • J TOTAL PARTS TOTAL LABOR 900. 00 TOTAL PARTS 561. 00 TOTAL 1461. 00 WORK AUTHORIZED BY Due and Payable on Receipt of This Invoice — interest charges begin to accrue 10 days from FORM OF PAYMENT invoice date at the rate of 1Y2% per month. CASH ICHECK CHARGE • '4111111111111111. .. . , ____C7- ___________________ 0.. .......... ............. ................................. ._..... • ALASKA NORTHWEST PUMPING, INC. k.- 4601 GARFIELD ANCHORAGE, ALASKA 99503 _..... -,-._-- ( 278-4068 (....._ .. NAME Al) / -- _......_..._...._...... ADDRESS / i'Ipez ice, i F,/ t-:- - .._. ._. .. PHONE DATE }rt �- CASH C CHARGE DA E TIME - - DESCRI E IOR CAPACITY AMOUNT ------ -- . - _ --**-- SEPTIC TANK7- to �� - CESSPOOL . . "' N HOURLY RATE i ���•T�--�-�-•����-� _.._ t 1 l' i ) . . ................ I jj - TOTALS I --_..._.._ -- 297 • x E CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. • _. P.O. BOX 4-1276 TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER ••-o�'���* Anchorage,Alaska 99509 274-3364 5633 B Street ANALYTICAL REPORT From Jerzy Allum Product Water Address Federal Way, Washington Date December 14, 1982 Other Pertinent Data Analyzed by SH Date December 20, 1982 Lab No. 1229 REPORT OF ANALYSIS WA'1'h R SAMPLE ANCHORAGE, ALASKA Sample received December 14, 1982 SAMPLE OIL & GREASE, mg/1 Water 0.33 (-74401 Prix H/ea. SE4Cd/cE Com, ertii 4,•C4 CHEMICAL GEOLOGICAL LABORA 1 DRIES OF ALASKA, INC. P.O. BOX 4-1276 TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER „eoW*oA,ES , Anchorage,Alaska 99509 274-3364 5633 B Street ANALYTICAL REPORT From Jerry Alltum Product Water Address Anchorage, Alaska Date December 6. 1982 Other Pertinent Data Analyzed by JI Date December 8, 1982 Lab No. 1161 REPORT OF ANALYSIS WATER SAMPLE ANCHORAGE, ALASKA Sample received December 6, 1982 SAMPLE OIL & GREASE, mg/1 Water 7.6 Note: Maximum recommended total Oil and Grease is 0.7 mg/1 • W III� A!0 "'ACKOi✓ `rtL CbEsote ��ldeg6E �c sER A t. CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. P.O. BOX 4-1276 TELEPHONE 1907)-279-4014 ANCHORAGE INDUSTRIAL CENTER rpw�e! Anchorage,Alaska 99509 274.3364 5633 B Street ANALYTICAL REPORT From Municipality of Anchorage Product Water Address Anchorage, Alaska Date October 20, 1982 Other Pertinent Data Analyzed by DB/JT Date October 25, 1982 Lab No. 804 REPORT OF ANALYSIS WATER SAMPLE ANCHORAGE, ALASKA Sample Received October 20, 1982 III DATELOT BUCK LOCATION OIL & GREASE, mg/1 10-20-82 12 2 Flat Zbp View 1.6 0 6 69, • p,,- p-` 0 11�� 203 W. 15th U o ° ° n�pUJ �oIL AN HORAGE,AVE ALASKASUITE 99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 September 27, 1982 Geratd T. Allum Box 7076 Federal Way, WA 98003 SEWER ADEQUACY TEST LEGAL Lot 12, Block 2 , Flattop View LOCATION Mile DeArmoun RESIDENCE Three-bedroom, single-family OWNER G.T. Allum WATER On-site well SEWER From Municipal Records: Tank - 1000 gallon, Greer Steel, two compartments Absorption System: trench, 22 feet long, 7 feet of rock Absorption Area - 308 square feet Soil Rating - 100 Installation date - October 1977 DATE OF TEST September 24 - 25, 1982 TEST PROCEDURE System was inspected on September 23. C.O. was 4' 2" deep and dry. Sump was 94" deep and dry. Tank was 96" deep with 48" of clean liquid. On September 24, water was added to the drainfill in 200 gallon increments. Tobben Spurkland P.E. The liquid depth in the trench was monitored at the sump. The following readings were made: Water Volume (gal) Water Depth (inches) 0 0 200 1 400 9 600 19 800 29 1000 33 Time - 1 :30 p.m. September 25 at 8:30 a.m. 17 TEST RESULT This system absorbed 400 gallons in 19 hours, or 505 gallons per 24 hours. The municipal requirement is 150 gallons per bedroom per 24 hours, or 450 gallons for a three-bedroom house. This system meets this require- ment. Pa-c.c.s. .�.�.� r• -?5 .fes ' •9 ref 1142f * 49TH .* ) to ode iv. JUNE 25,2225-E 1971 - 2 - �\ '� MUNICIPALITY OF ANCHORAGE DEPARTMENT HEALTH AND ENVIRONMENTAL r'ROTECTION (4:1-;:;A \ 825 L Street, Anchora e, Alaska g 99501 . 279-2511, ext. 224, 225 1:1,1(? Date Received: April 11, 1977 1st Inspection: Time Q() ) A m 2nd Inspection: Time Date ./_ 'do_ /7 �. Date Inspector aey a Inspector REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Teamster ' s Federal Credit Union Mailing Address: 1200 Airport Heights Road Phone: 2. Property Owner: Ronny Hablutzel Phone : Mailing Address; 2/cP �i,�n _ �,�/�l-�C��1 3. Legal Description: Lot 12 Block 2 Flat Top Subdivision 4 . Single Family Residence: (x) Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms : 5. Well Data: Type Unknown Depth Well Log Filed ( ) Construction Bacterial Analysis 6. Sewage Disposal System: On-site system AXE Public Utility ( ) Permit i# Installed 1968 (?) Installer Septic Tank Size Manufacturer Absorption Area. Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Lines Nearest Lot Line Absorption Area to Nearest Lot Line s MUNICIPALITY OF ANCHORAGE T �� Department of Health and Environmental Protection /7T - , '`�\�i� • _ 825 L Street, Anchorage, Alaska 99$000gr+"•• - c. r << , � 279-2511 , ext. 224 , 225 u•.. ,. or t; t. ENVIr� r , -CTION t �—Request for Approval of Individual Sewer and Water Facilities q A" 111977 1. Property Owner: 1/9QAJA/,Y fke<u ZFL RE-EE1V{�!/ Mailing Address: // Phone : 2. Name of Buyer: 6enenco 77 /Led m Mailing Address: Pd. &sic jo Thj Phone: 0/3 3r74S 3. Lending Institution: 2-40/ S /rel Gee- 'i7 ON/0A/ Mailing Address : io ! . , 4 '&40 Phone: 4 . Realtor/Agent: ,elle x/7764,�/C f� Tti �nehFi ie ' Mailing Address: m; 7 OCD $ /►9w• . AX77d"/ Phone: JYV 803/ 5. Legal Description: #2197" /a/° Su/° 4000K 2 G 'r /2. . Street. Location : AeWoglAlAJ /4; 64T7 Of ,#4 4/ y5 u. /// 64thJ/ 6. Single Family Residence: Dc Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms : 7. Water Supply: * Individual Well Public/Community System ( ) If Individual Well, well depth If Community System, name of system 8 . Sewage Disposal System: On-site System fj') Public System ( ) If On-site System, date of installation: in, 6p'," *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 ' Page Twq Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 12 Block 2 Flat Top Subdivision Comments: • Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date : Disapproved: Date: 6. - ?- -)- -) ) Department Worksheet: