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HYLEN CREST #3 BLK 4 LT 11
Ex �j A( S I w7 M WrA INg vvnIIII 1 1 H� SEP 13 2012 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: SW090217 PID Number: 050-474-25 n New P/1 Uoarade Name: Alan and Ellen Izer 10301 Stewart Drive Eagle River, AK 99577 Phone Number of Bedrooms 266-2665 3 LEGAL DESCRIPTION Subdivision Block Lot Hylen Crest No. 3 4 11 Township Range Section SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Well N/A N/A N/A N/A N/A surface water >100' >100' N/A N/A Lot Line >5' >10' N/A N/A NA Foundation >5' >10' N/A N/A Curtain Drain None Noted Remarks Existing Absorption Trench Decommissioned in Accordance with Municipal Code. Absorption Trench Only Replaced Under this Permit. ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound ❑ Other Soil Rating Total depth from original grade •8GPD/SF 4 Ft. Depth to pipe invert from original grade Gravel depth beneath pipe 1 Ft. 3 Ft. Fill added above original grade Gravel length 1.5-3 Ft. 80 Ft. Gravel width Beds: Number of Lines Distance between lines 5 Ft. Ft. Total absorption area Number of trenches Dist. between trenches 552 Ftz One Ft. TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Existing I Gal. Material Number of compartments Steel LIFT STATION Gal.l on level at I Pump off level at I High water alarm at in.1 in.1 in. make and model Electrical Inspections performed by PIPE MATERIAL House to tank Tank to D3034 Installer drainfield PCN, Inc. Drainfield CO/MT Inspector A. Harala BENCHMARK (Assumed elevation) 100.0ft Inspectionsr Location and description dates: 11/6/09 2^d 11/7/09 3rd 4,h Back Deck Northeast Corner. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date �,`Po• . �I•'����� 49Tt1 • ••�sasoryrr�r.y�s+pw�rsu... Approved Inspection Report 1-1- Date 1Z �AucH a S MI ERSON w CE - 4381 �.•`" ?" "ROf 551 R co O N w Z w ca a UJ -� CO UJ QU O ry .>' w n x w . 2EQ- O w w 0 LO N 4 rl- O LO O I. - C) O O Cl) d - ch 7 LO LO m LO O Y Q ai rn m 0 v c Q m O O E LU O O N O O 0 is N .Q E x Z E n I NN,C C 1'- N H � OD 'CJIou as N m o 0 z 0 w J a > 012 O x � N0a �2mm 41, I 1 OJ O 1 � O11 C6 7 Q � w z z V t , z � S . 4� e I O r r 1 cn U f i r�N� zsos O 1 ' Q m m tai Ir 1 I 1 I LO I I cn 1110 F -- --WO r 1 1 ' 1 i i t A w I C\ I � w i i ti I I 1 I 1 r I t 1 I / / 1 1 f / / / I / 1 / / NN,C C 1'- N H � OD 'CJIou as N m o 0 z 0 w J a > 012 O x � N0a �2mm 41, ' Z '. OJ O 07 C6 7 Q � w z CD ro V t 11C W Q c� ri S . 4� e • O r r ;¢ z Q� f r�N� zsos N N NN,C C 1'- N H � OD 'CJIou as N m o 0 z 0 w J a > 012 O x � N0a �2mm 41, ' Z '. w z CD ro my 0� t 11C W -1L-1 U S . 4� e • O ;¢ z Q� Permit Number: SW090217 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report 1,250 Gallon STEP Tank I ST N Page 3 of 3 PID No. 050-474-25 _ 100.0 8-31-99 87.2 No Groundwater 8-31-99 30 - 1-" Diameter Holes @ 2.7' No Scale .3 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW090217 Legal Description: HYLEN CREST #3 BLK 4 LT 11 Design Engineer: 0014 ANDERSON ENGINEERING Owner Name: ALAN AND ELLEN IZER Owner Address: 10301 STEWART DRIVE EAGLE RIVER , AK 99577-9514 ri 0 C Date Issued: Oct 22, 2009 Expiration Date: Oct 22, 2010 Parcel ID: 050-474-25 Site Address: 010301 STEWART DR Lot Size: 52992 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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. II�y�Uw �,P DNu���c�`c�d �ev'ted �N CC)'��. Received By: Date: � Q NO I Issued B : Date: ld Municipality of Anchorage Development Services Department "G ?'.' Building Safety Division _z On -Site Water and Wastewater Program c 4700 Bragaw Street s A £ r Y P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-474-25 Property owner(S) Alan and Ellen Izer Day phone 266-2665 Mailing address 10301 Stewart Drive Eagle River, AK Zip Code 99577 Site address 10301 Stewart Drive Eagle River, AK Zip Code 99577 Legal description (Sub'd., Block &.Lot) Lot 11, Block 4, Hylen Crest Subdivision No. 3 Legal description (Township, Range & Section) Lot Size 52,992 Sq. Ft. Number of Bedrooms Three (3) THIS APPLICATION IS FOR (® all that apply): THIS APPLICATION IS AN: Absorption Field F-1 Initial ❑ Septic Tank ❑ Upgrade El Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ 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: 5—so Waiver Fees: Date of Payment: o Date of Payment: Receipt Number: 0 7 61 Receipt Number: (Rev. 11/05) October 20, 2009 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 11, Block 4, Hylen Crest Subdivision No. 3 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption system on the subject lot has failed and must be upgraded. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing 1,250 Gallon STEP Tank was placed in 1999 and is barely 10 years old. We are confident it is in good condition and suitable for continued use. The lift station will be inspected to insure it is in good operation condition. The existing absorption trench system will be left intact and tied to the new system with a series of b all valves. Also identified on the plans are the locations of the adjacent septic system. The subdivision is served by a Class A Community Water System. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test holes placed on the lot in 1999 indicated silty gravel (GM/SM) with some sand. The percolation rate was determined to be 10.2 minutes per inch in the area of the new absorption system. Groundwater and bedrock were noted at 9' below the surface. We have designed the new trench to be within the 30' radius of the test hole completed in 1999, and to the same application rate of .8 gallons per date per square foot. We are proposing to place 2-50' long trenches with a 1.0' effective depth. The total depth of the system will be 3'. Three ball valves will be placed to tie in both the old and new absorption systems. The old system will be allowed to dry out and regenerate for possible future use. Lot 11, Block 4, Hylen Crest No. 3 October 9, 2009 Page Two The ground surface on the lot slopes steeply from the north. The absorption system will be constructed at the toe of the slope where the ground is flat to 5% in a southerly direction. A steep slope approximately 50' from the edge of the new absorption system then drops to the southern property line. The new absorption system will be constructed parallel with the contours of the ground surface. A minimum of 100' will be maintained between all components of the septic system and the proposed well and from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, 111'i"J E—a'j—' Michael E. Anderson, P.E. Attachments 1i 1J • � A I ii DATE: November 4, 2009 TO: Jay Crewdson, P.E. FROM: Mike Anderson, P. E. SUBJECT: Lot 11, Block 4, Hylen Crest Subdivision No. 3 Septic System Upgrade Test holes placed for the construction of the existing septic system on the subject lot indicate bedrock at depths of 9' and 11'. We have been unable to find a sufficient area around Test Hole No. 2 to allow placement of a system and remain more than 6' above bedrock. We are therefore proposing to replace the existing absorption trench in its current location and extend the trench 14' to the west for a total length of 80'. Test Hole No. 1 utilized to design, permit and construct the existing trench indicates a bedrock level of 11' bellow the surface. We will remove the existing absorption trench in its entirety. Overexcavation will be completed along the sides and bottom of the trench to insure complete removal contamination. Overexcavated areas will be backfilled with sand or similar on site material on the bottom and drainfield rock on the sides. The trench will be extended 14' for a total length of 80' to provide additional absorption area. All material removed from the existing trench will be placed at the area shown on the Site Plan. It will be covered with a minimum of 2' of on site material. Revegetation of the surface will take place in the spring. The attached Site Plan and Trench Profile detail the work to be accomplished to upgrade the septic system. Please modify the permit to allow this work to proceed. , 1 •®®®®®� ar�l�t®`®1 AV E3 w CO z I 1 ®®®� 0, ' r ¢ Z �• ® �epAV41i 9 1 = o Lo my ° S G.r .7 z / ( owa \ QEDo, CO xQ EL w of � mo= U) Cli m LO titn`o m� 10 Q°R 7a m.o p m 2 m / m m (n '"c� x o est` / wo J iD iT 1 1.� E N 1 LO 0 D E c 0 FE z ' W w J 1 ' J � ' z 1 E v in 1 ' It �' ' w r l- � H 1 r , / W1 LOT 11, BLOCK 4, HYLEN CREST SUBDIVISION NO. 3 DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5' Wide Trench System Perc. Rate: 10.2 Min./Inch Existing 1,250 Gallon STEP Tank Application Rate: .8 GPD/SF 2.5' Drainfield Rock 3 Bedrooms * 150 GPD/Bedroom = 450 SF Absorption Area 450 SF/.8 GPD/SF/5 SF (Width) *.58 (Red. Factor) = 65.25 LF Trench Length THEREFORE: Construct a 66' Long x 5' Wide x 3' Effective Depth Absorption Trench. Flow Line Elevation in Trenches to be 1' Below Original Ground Surface. Total Depth to be 4' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tankor 2" of Insulation and 2' of Cover. Place 3 Ball Valves at the Locations Shown. Tie In Existing Absorption Trench for Future Use. 2' Min. Natural Backfill A 2" Insulation and Geotextile Fabric 6" 0 1" Perforated PVC (Holes Down) 3'0" 3/16" Holes @ 2' Spacing Drainfield Rock Coarse Sand (See Specification) 5' TYI-ICAL 5' WIDE TRENCH SECTIO"' (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 10' Separation From Water Service Line on Lot. Minimum 100' Separation From Surface Water or Streams. Cox ONSITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 11, BLOCK 4, HYLEN CREST SUBDIVISON NO.3 GENERAL: 1. The scope of this project includes the construction of 2 new 50' long by 5' wide by 1.0' effective depth absorption trenches at the location shown on the Site Plan. A 1.25" PVC line must be placed between the existing lift station and the new absorption trenches. The distribution pipe for the trench will be placed at 2.0' below the ground surface. The total depth of the trench will be 3'. Three ball valves will be placed at the locations shown and the existing absorption trench will be tied in to the system for future use. A minimum of 3' of cover must be placed atop the trench. Two inches of insulation and 2' of cover may also be placed to insure protection against freezing. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Contractor is also responsible to verify the separation distance from the well on this and adjacent lots. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Development Services Department Building Safety Division On - Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On - Site Water and Wastewater Program before beginning system installation. SEPTIC TANK/LIFT STATION INSTALLATION - EXISTING 1. The existing 1,250 -gallon STEP Tank may be reused for this installation. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Lot 11, Block 4, Hylen Crest Subdivision No. 3 October 9, 2009 Page 2 of 3 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Tanks installed without 4' of cover shall have a minimum of 2 of direct burial insulation. 5. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drain field. 6. Final grading over the tank shall be such that a positive slope exists away from the septic tank. 1. The drain field shall be constructed to the dimensions shown on the design. The bottom of the bed shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drain field rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drain field rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drain field are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drain field rock for a 5' wide trench. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. The lift station must be constructed by a municipally approved septic tank manufacturer. An Orenco 20 OSI 05 HHF-5 pump is recommended. Lot 11, Block 4, Hylen Crest Subdivision No. 3 October 9, 2009 Page 3 of 3 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. FILTER SAND SPECIFICATION: 1. Material for Filter Sand must be classified as a masonry sand and meet the following gradation: 50% or More Passing the No. 4 Sieve 2% or Less Passing the No. 100 Sieve 1 % or Less Passing the No. 200 Sieve INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage Page 1 of 2 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. SW990324 PID Number. 050-474-25 Name: DANA AND DEBBIE HAHN Wastewater System: ❑ New ■ Upgrade Y Address: 10301 STEWART DRIVE EAGLE RIVER, AK 99577 ABSORPTION FIELD Phone: 696-3985 No. of Bedrooms: 3 Deep Trench ■Shallow Trench ❑Bad 13 Mound ❑Other 13(907) LEGAL DESCRIPTION Son Rating: 0.8 Total Depth from original grade: 3.0 — 4.5 wolsq. tt It Lot: Block: Subdivision: Depth to pipe bottom from or%lnol grade: Gravel depth beneath pipe: 11 4 HYLEN CREST #3 0.5 — 2.0 Ft. 2.53 Ft Township: Range: Section: Fill added above original grade: Gravel length: — — — 0.5 — 2.0 Ft. 74 Ft Gravel width: Number of Anew Dletanoe between liner WELL: ❑ New ❑ Upgrade 5.0 Ft 1 1 — PL Claalficatlon Private, A.B.C):Total Cased To: Total absorption area: 578 Pipe material:Ft. ASTM D -3034/F-810 so. Ft Driller: oMMVNDate Drilled: c Static water Level: Installer. EAGLE MOUNTAIN EXC. Date installed: 9/10-15/99 PL Yield: Pump Set At lCang �ht Above end:TANK GPMFtFt SEPARATION DISTANCES 13 Septic ❑ Holding ■ S.T.E.P. To Septic Tank Absorption Field Uft Station Holding Tank Public/Private sewer ernes Manufacturer ANCHORAGE TANK Capadb In gallons: 1250 From Material. Number of compartments: Well 200'+ 200'+ 200'+ — 25'+ STEEL 2 was �e 100'+ 100'+ 100'+ - - LIFT STATION Line 5'+ 10'+ 5'+ — — Size n gak� 1250 Mafacturer. nu ANCHORAGE TANK mss on level at -Pump level at High watx alarm at: Foundation 5'+ 10'+ 5'+ — — 42" 1 42" 44" Curtain Pump Make & Abdel: Electrical Inspocuorn perforrned br. Drain NONE KNOWN 20 OSI 05 HHF I ALCAN ELECTRIC BENCH MARK Remarks: ENTIRE TRENCH INSULATED; WEST SOUTHEAST Location and DeeMptlon: HALF OF TRENCH WAS DOUBLE INSULATED. BOTTOM OF SLIDING DOOR THRESHOLD ON THE NORTH/EAST FACE OF HOUSE. Assumed Elevation: 100.400 Ft, ENGINEER'S SEAL Q06�00� I Ti '•:� OQ AWWC INC.9/10/990'��;' Inspections performed by: Dates: 1 st 0. • • • : • • / ...... •:•••• �..� 0 2nd 9/11-15/99 OQQ 3rd 9/16/99 • • efr y A. arne IC Department of Health and Human Services approval 0� s '•.,. —7953�J: �cOQO D�ppoapr •'s• Reviewed and approved by: / �• Date: �� - ofessi oVX0\ ��0�000� 72-013 Rev. 9/91) MOA 25 PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW990324 050-474-25 fop OF fANK- Af INLET - 6836 INVERT OF PUN6- Af IM& - 87.76 FINAL cm - 9432 5� 5T2 MH n f NSW 1250 6& ON 5,f.ff, WANK fG? OF MAM aO -95'.10 —for OF TANK Af OIALEf - 8836 HNVEpf of DUNG AT OUTLET - 67,61 FINAL cim 96,65 - 97.42 r 0061% 6m / -953-96.6 Ri 09�� "-(5/ - 4 f OF pl L (35// h" p�55LM plpE) - 94,83 Pmom OF TMNCN i - 9230 ( AVG.) �5, UTIIl7yNOTE:OF T EASEMENT ELEVAT ONTTOM85.30.EST HOLE i 2� NEW DRAINFIELD C �. �, TOE OF EXISTING DRIVEWAY SLOPE S R060 lT \ \ yO�SF B FCO H#1 MT1 H#2 \ A `�° i A B C FCO 17.4 11.2 - \ ST1 21.4 15.2 - S NEW 1250 GALLON ST2 24.5 21.3 — ��� S.T.E.P. TANK G MH 25.8 22.3 — TS OF MT1 50.3 35.8 — — 33.8 33.8 ALASKA WATER AND WASTEWATER CONSULTANTS, INC. oo��oDO p 6901 DEBARR ROAD, SUITE 26. ANCHORAGE, AK. 99504 0 . v G ., PHONE: (907) 337-6179/FAX: (907) 338-3246 p v U LEGAL DESCRIPTION: HYLEN CREST SUBDIVISION #3; LOT 11, BLOCK 4 * '„ 4 , H , ....... ,* or7o TYPE OF WORK: AS -BUILT OF SEPTIC SYSTEM UPGRADE 0••_•1. �•�-••••• ••••• •••••••Q Q fry A. Gar ess: Q PREPARED FOR: PHONE NUMBER: oOpco'•—7953 DANA AND DEBBIE HAHN (907) 696-3985 �9.s ,•.�,) •• .`�0p DATE: DRAWN BY: SCALE: PAGE: 44�e~loo& 9/22/99 K.D.W. 1 = 40 edprofess 2 OF 2 ��00000�o Alcan Electricai Engineering, Inc. 6670 Arctic Spur M. Anchorage, Alaska 99518 Fax Cover Sheet DATE: September 23, 1999 TIME:, 11:37 AM TO: AVVWC HONE: Jenny FAX: 338-32A6 FROM: Alcan Electric PHONE: 563-3787 i Sklpp Bringmann FAX: 5626286 RE: Highland Crest Sub #3, Lot -11 , Block -4 ! �-Iy inn Cresf Jenny - In regards to the sewage lift station that Alcan connected at the above mentioned location. All electrical work performed by Alcan was done to 1996 National Electrical Cod6, (NEC) standards. i If you have any questions please contact me. Thank you! Number of pages including cover sheet:1 I •i Anfiti 1041 1i?I 11a1a NH11H wvHS .:11 6661 'U 'bac MUNICIPALITY OF ANCHORAGE Department of Health and Human Services �/(/l� 1` 10 - 9 j 1 .,3( On -Site Services Program 825 L Street, Room 502��� P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW990324 Legal Description: HYLEN CREST UNIT #3 BLK 4 LT 11 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Dana & Debbie Hahn Owner Address: 10301 STEWART DRIVE EAGLE RIVER , AK 99577-9514 Date Issued: Sep 08, 1999 Expiration Date: Sep 07, 2000 Parcel ID: 050-474-25 Site Address: 010301 STEWART DR Lot Size: 52992 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: 0 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: F__1 Date: 17— G%" Alaska Water r Wastewater 6901 Debarr Road, Suite 2B — Anchorage — Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers August 31, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade Design for Lot 11, Block 4, Hylen Crest Subdivision #3 To whom it may concern: The existing 3 bedroom house is served by a community well and a private septic system. The existing septic system consist of a 1000 gallon septic tank and a deep trench type drainfield. The drainfield is completely surcharged and must be upgraded prior to the sale of the house. Two test holes were excavated to the north of the existing septic system. The proposed septic system will be designed around the 30 foot radius of test hole 91. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil profile, and the percolation test results. In TH#1, the soils below the organic layers are a GM material to a depth of 11.25 feet where bedrock/impermeable soils were encountered (bottom of test hole #1). In TH#2, the soils below the organics are a GM/SM material to a depth of 7.5 to 9.25 feet where then factured bedrock was encountered (bottom of test hole #2). Groundwater was encountered during the excavation of the test holes at 11 feet in TH#1 and at 9 feet in TH#2. A percolation test for TH#1 was performed between the depth of 5.5 feet to 6.0 feet which had a percolation rate of 10.2 minute/inch. A percolation test for TH#2 was performed between the depth of 4.0 feet to 4.5 feet which had a percolation rate of 6.7 minute/inch. Due to the better soil conditions in TH#1, we are proposing that the new drainfield be installed around the 30 foot radius of this test hole. 2. TRENCH DESIGN: a. Percolation Rate: 10.2 & 6.7 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 563 ft2 f. Total Depth: 4 feet (max.) f. Total Depth: 4 feet (max.) g. Effective Depth: 3 feet h. Width: 5 feet i. Reduction Factor: 0.58 i. Minimum Length: 66 feet long j Effective absorption area = 569 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the design, we are proposing to install the drainfield upgrade at the toe of a slope that is greater 25 percent. There is a retaining wall at the toe of this slope that will most likely will have to be removed. The area behind the house and north of TH#1 was graded off during the construction of the house and pushed to the downhill side of the house. Given the fact that the original grade prior to the installation of the house cannot be established, we are proposing that the drainfield maximum depth be based off the bottom of TH#1 elevation. We are proposing to maintain a 7 foot elevation difference between the bottom of TH#1 and the bottom of the proposed drainfield elevation. Also, there is a cutbank to the south of the proposed drainfield which will be greater than 35 feet away. We request that a 35 foot waiver be granted. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you M.S. NOTE. Attached is a site plan drawing, a design drawing, two soils logs and a 4 page construction specification letter which are all part of the design package for this septic system. I! NOTE: ALL PROPERTIES SHOWN IN HYLEN CREST SUBDIVISION, ARE SERVED BY A COMMUNITY WATER SYSTEM AND PRIVATE SEPTIC SYSTEMS. I I I TRACT L NO ENCROACHMENTS I I I _ I VENUE - PROPOSED SEPTIC UPGRADE \\ EXISTING _ — (SEE DESIGN, PAGE 2 OF 2) 3 BEDROOM 1 - HOUSE— , — �s%� #TH#2 \ \\ EXISTING \ \O \ SEPTIC SYSTEM v LOT 4A, BLOCK 5 \ 2 HYLEN CREST #3 \ I I I I I I LOT 10, BLOCK 4 HYLEN CREST #3 I \ � I I STEWART _DRIVE \� _ �� I -----------------[HYLEN --- — -__-_ - / LOT 5, BLOCK 4 -� / I HYLEN CREST #3 LOT 7, BLOCK 4 ��. LOT 4, BLOCK 4 OT 6, BLOCK 4 HYLEN CREST #3 LOT 9, BLOCK 4 HYLEN CREST #3 CREST #3 LOT 8, BLOCK 4 HYLEN CREST #3 HYLEN CREST #3 I ALASKA WATER AND WASTEWATER CONSULTANTS INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 �v•• s� f� :GAL DESCRIPTION: HYLEN CREST SUBDIVISION #3; LOT 11, BLOCK 4 �,,, .......... .. ........... TYPE OF WORK: SITE PLAN FOR SEPTIC UPGRADE PREPARED FOR: PHONE NUMBER: DANA AND DEBBIE HAHN (907) 696-3985 DATE: DRAWN BY: SCALE: PAGE: 8/31/99 1 K.D.W./J.L.M. 1 = 100' 1 1 OF 2 rf�.G6ness, E .. ,N'a pyofess�o"G\�� EXISTING DRIVEWAY HI AVENUE-- UTILITY jl:�SfMENT TOE OF SLOPE (APPROX. LOCATION) H2 FCO TH#1 MT`��-uT� +H#2 EXISTING DRAINFIELD C AND SEPTIC TANK TO BE COMPLETELY ABANDONED � M C;F AT±� PROPOSEDGALLON LIFT STATION TOP OF SLOPE (APPROX. LOCATION) O,p � ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 LEGAL DESCRIPTION: HYLEN CREST SUBIDVISION #3; LOT 11, BLOCK 4, TYPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: DANA AND DEBBIE HAHN (907) 696-3985 DATE: DRAWN BY: SCALE: PAGE: 8/31/99 1 J.L.M. 1 = 40' 1 2 OF 2 -PROPOSED PRESSURIZED DRAINFIELD UPGRADE. ~EXCAVATE 4 DEEP MAXIMUM BY 5 FEET WIDE BY 66 FEET LONG. ADD 3 FEET OF CLEAN, WASHED SEWER DRAINROCK. THE DISRIBUTION LINE IS TO BE 1.25 INCH SCH. 40 PVC PIPE WITH 1/4 INCH DIAMETER HOLES SPACED EVERY_ 26 INCHES APART ON CENTER. THE TRENCH IS TO BE INSTALLED PARALLEL TO SLOPE CONTOURS. J ff A. amess: 0 E-7953 44���pt'o f ess1ondoo� ALASKA WATER & WASTEWATER CONSULTANTS, INC. 690PHONEARR ( 07) 337-6179 *UITE FAX (907)3 38 9504 3246 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: HYLEN CREST SUBDIVISION #3; LOT 11, BLOCK 4, PERFORMED FOR: DEBBIE HAHN DATE PERFORMED: 8/23/99 (feetI ORGANICS TEST HOLE # 1 �`-1 1 2 SOIL CLASSIFICATIONS 3 4 111111111 7 8 9 10 11I�LIII`lI e___ (REFUSAL) 12 B.O.H. 13 14 15 16 17 18 DEPTH TO GROUNDWATER GWE ORG GP Ii�l I I ML r .�. 8/22/99 GM//// CL 77/,71 GC OL PERC HOLE SW I I I I I I I I MH SP//// CH fftj OH gMOWSM 7-&- SC DEPTH TO GROUNDWATER DATE 11' 8/22/99 10' 8/31/99 8/23/99 — PRESOAKED PERC HOLE FOR 4+ HOURS PRIOR TO TEST. PROPOSED - SEPTIC EXISTING UPGRADE 3 BEDROOM - HOUSE - +TH#2 EXISTING SEPTIC ` 9 SYSTEM \17--\ iL SITE PLAN I" = 100' DATE READING CLOCK I TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/23/99 — PRESOAKED PERC HOLE FOR 4+ HOURS PRIOR TO TEST. 1 4:19 6" — 2 4:49 30 MIN. 3 1/16" 2 15/16- 3 4:49 6" — 4 5:19 30 MIN. 3 1/8" 2 7/8- 5 5:19 6- 6 5:49 30 MIN. 3 1/16" 2 15/16" 19 PERCOLATION RATE 10.2 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) 20 TEST RUN BETWEEN 5.5 FT. AND 6.0 FT. COMMENTS: LARGE BOULDER AT 7.5' BELOW GRADE ON EAST SIDE OF HOLE PERFORMED BY ALASKA WATER & WASTEWATER I, , CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 PHONE (907) 337-6179 * FAX (907) 338-3246 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: HYLEN CREST SUBDIVISION #3; LOT 11, BLOCK 4 PERFORMED FOR: DEBBIE HAHN DATE PERFORMED: 8/22/99 DEPT OLE #2 (feet TEST H 1 - ORGANICS/LOAM 2 i �- SOIL CLASSIFICATIONS 3 4 =1111111 6 7 8 9 ,; ,)<,� FRACTURED B.O.H. BEDROCK 10 11 12 13 14- 15 16 17 18 19 20 COMMENTS: DEPTH TO GROUNDWATER GW ��� ORG GP ~ML GM CL =- 8/22/99 9' GC OL FA, ^ion°n°no c SWMH Bo®0o e`"SP %��CH UPGRADE SM '� ,��' OH SC 9!sys DEPTH TO GROUNDWATER DATE WEEPING AT 7.25' 8/22/99 9' 8/22/99 DRY 8/31/99 EXISTING MILE --_AV�IJE_ --- READING CLOCK I TIME NET TIME (MINUTES) PROPOSED_ '- 8/23/99 — PRESOAKED SEPTIC EXISTING UPGRADE 3 BEDROOM HOUSE 4:21 6" — ♦TH#2 ` EXISTING SEPTIC SYSTEM 4:51 30 MIN. 1 1/4- 4 3/4- 3 iL 6" — SITE POLO N 4 5:21 30 MIN. DATE PERCOLATION READING CLOCK I TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/23/99 — PRESOAKED PERC HOLE FOR 4+ HOURS PRIOR TO TEST. 1 4:21 6" — _ 2 4:51 30 MIN. 1 1/4- 4 3/4- 3 4:51 6" — 4 5:21 30 MIN. 1 1/2- 4 1 /2" 5 5:21 6" — _ 6 5:51 30 MIN. 1 1/2- 4 1/2 - /2" PERCOLATION RATE 6.7 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. PERFORMED BY ALASKA WATER & WASTEWATER I, , CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME S Yzc PHONE W 1 "c . y j� G 6��j' c� F ❑ UPGRADE MAILING ADDRESS LEGAL DESCRIPTION 'eli �e•, Cres LOCATION & NO. OF BEDROOMS )G��5 oet 44 //e V DISTANCE TO: WellAbsorption G'ov+>mK^ LdC/ area /a Dwelling PERMIT NO. f Q j O _Y wManufacturer Glc Material / No. of compartments ti Liq. capacity in gallons GQL� IF HOMEMADE: Inside length Width Liquid depth D DISTANCE TO: Well Dwelling PERMIT NO. � Q 2—F_ Manufacturer Material Liquid capacity in gallons 0 w DISTANCE TO: Well /O crr,rn�», Foundation Nearest lot line PERMIT NO.9_q `T lJS' = %G J LL z No. of lines Length of each line Total length of lines Trench width, Distance between lines ~ 3o inches Top of the to finish gradeso 1 Material beneath tile 1 Total effective ab rption aret- O '7 % — �� inches ysp T' Length Width Depth PERMIT NO. W C7 a F- wa Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J W Z' DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SO10L TEST RATING INSTALLER REMARKS li.,, a rlt Ae- f ei !c - . 41t �G pO v T /a7`si'2 ,E ly SX ;a n a� t.�qi;. r;.coe Jm G 0. 2225-F- Q)�o° JUNE 25, 1971. APPROVED�w�.a+•° ° o ° ,., e ° °� DATE LEGAL %/ li ��r-er7� ,J 72-013 (Rev. 3/78) ���Z 1D. I Er" tP�, L_ :1 T- "�r' C-11 F-- �,E-3-iEE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: 840520 06/28/84 STRATA INC. ST ROUTE BOX EAGLE RIVER, 688-4949 18 AK 99577 NOTE: THIS SUBDIVISION IS SERVICED BY COMMUNITY WATER , LEGAL DESCRIP: SUBDIVISION: HYLEN CREST LOT: 11 BLOCK: 4 SECTION: 8 TOWNSHIP: 15N RANGE: 1W LOT SIZE: 52992 (SQ.FT. OR ACRES) MAX BEDROOMS: 3 Listed below are the options available to you in designing your septic system. Choose the option that best {its your site. -F 11'4 Jlf� E-11 �-6. 1 L-:- D' 114~ IF!, F�:P"! T'J DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0 GRAVEL DEPTH (FT.) 7.0 0.5 3.5 TOTAL DEPTH (FT.) 11.0 4.5 7.5 GRAVEL WIDTH (FT.) 2.5 19.0 5.0 GRAVEL LENGTH (FT.) 33.0 ' 36.0 49.0 GRAVEL VOLUME (CU.YDS.) 22.9 25.3 36.2 TANK SIZE (GALS) 1,000.0 ** 1,000.0 ** 1,000.0 ** SOIL RATING (SQ.FT./BR) 150 150 150 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS ________________________________________ I certify -that. 1. I am familiar with the requirements for on-site sewers and wells asset forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum{ 3 b ~ - o eorooms gnd'~' any enlargement will require an additional permit.; IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINEDI (2) AS-BUILTS WILL NOT BE APPI-.*ZOU -SIE-J) WITHOUT AN ELECTRICAL ION REPO E ~^~.,ED DATE: APPLICANT: STRATA INC710'~-^ ' ISSUED BY DATE: ^^ '` SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION El PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: 1 "' �h L DATE PERFORMED:_/� LEGAL DESCRIPTION: Z5) 74 DEPTH / / / SLOPE SITE PLAN (FEET) 1 P:P� 2 ( ) a � C` ,, 3 eJ 4- 5 [. 7 8 9 10 11 12 13 14 15 Date ON F TFq�N/ /y AD-. /y ■-■■■■■■■■■ 16 ■MIMME ® F Ala��q 17 NEW ■_■_■ °•� �i? ■-mq1' m ■NES-' _MWA■ ■■NIMMEMIMEE T el ■■■■',N■■ ■■■■■■M■■■ 18 ■MINE■■■■■■ 19 f�i �ef • o. 2 2 2 5 - UNE 25..1971 ■■A■ ■■r�■ ■NE■ MINES ■■I■■ 10.111■ ■IAM■ ■�-400 EIS■■ MOON ■■■■■■■■■■ Date ON F TFq�N/ /y AD-. /y ■-■■■■■■■■■ DW ■MIMME ■■■■ irMIa■. NEW ■_■_■ ■►`Smmmmom 006 HIM■,■■E■E■ ■-mq1' m ■NES-' _MWA■ ■■NIMMEMIMEE T el ■■■■',N■■ ■■■■■■M■■■ ■MINE■■■■■■ WAS GROUND WATERS ENCOUNTERED? L O P _ IF YES, AT WHAT E DEPTH? �%�/N� Reading Date ON F TFq�N/ /y AD-. /y Net `� DW Net Drop T el 20 ° ATE �// /',TEST RUN BETWEEN —y- FT AND / FT COMMENTS ti�,77. //,��7>-r^ 0 Slee !-z'S�.��C I PERFORMED BY: 72-008 (6/79) CERTIFIED BY: Ms DATE:_ WALTER J. NICKEL, GOVERNOR DEPT.F ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 "C" STREET, SUITE 322 ANCHORAGE, ALASKA 99503 Ms. Lynn Eiander 10301 Stewart Drive Eagle River, Alaska 99577 SUBJECT: Lot 11, Block 4, Hylen Crest #3 Eagle River, Alaska ADEC Project Numbers 9121-DWW-065 and 9121 -DW 055; Review Dear Ms. Elander: 563-6775 July 1, 1991 RECEIVED Municipafi y of Anchorage Dept. Health & H urnan Services This is in response to your submittal, received in this office on June 10, 1991, in which you requested approval for the on-site water and wastewater disposal systems located on the above -referenced lot dues to the proposed change from a single family residence to a Bed and Breakfast. I have completed my review of the submitted information and have the following comments. WASTEWATER DISPOSAL SYSTEMS: The submitted information it appears that the wastewater disposal system was installed substantially in accordance with State regulations and guidelines at the time. The results of the adequacy test also verifies that on the day the adequacy test was performed the wastewater disposal system was accepting the necessary flows. In addition, there will not be an increase in the volume of wastewater being treated and disposal by the existing wastewater disposal system due to the change from a single family residence to a bed and breakfast. Therefore, the wastewater disposal system is approved for the concerns of this Department. The enclosed signed Approval of On -Site Residential Water and Sewer Systems, constituting this approval, is enclosed for the existing wastewater disposal system. Ms. Lynn Elander July 1, 1991 Page 2 DRINKING WATER SUPPLY SYSTEM: From the information that has been submitted, the proposed facility will that the water system was received water from Hylen Crest Class A Public Water System (PWSID #213289). My review at this Departments file reveals that this system is currently in compliance with 18 AAC 80.060 at the State Drinking Water Regulations. Thank you for your cooperation with this Department. if you have any questions, please do not hesitate to call me at 563-6775. Sincerely, 4ev�- 4 daa-e� Keven K. Kleweno Environmental Engineer Enclosures: As Stated cc: John Smith, DHHS, without Enclosures i � E: r c I r D€�L'-Li KKK/pf 11 U 2 1 Go MIU19icipa-h-iy of Anchorage Dept. Health a Hu. -Ln Services Municipality of Anchorage 4TG£ 8Gi • �-� Development Services Department s . Building Safety Division r. Z On -Site Water and Wastewater Program 4700 South Bragaw St. s n E T Y P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us 411& (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 050-474-25 HAA# t�-i'/�-c���Z-�q Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 11; Block 4; Hylen Crest. Subdivision #3 Location (site address or directions) 10301 Stewart Dr. Eagle River Current Property owner(s) Tim Lindquist Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone Lynn Swanson Day phone 689.=1803 Prudential Vista 16635 Centerfield Dr. Eagle River Unless otherwise requested, HAA will be held by DSD for pickup.��`/ 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System Individual On-site U 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 errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this applA allon, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adegt'e,:,for the number of bedrooms and types "-structure indicated herein. I further verify that based on the inform 'o- o- Wained from the Municipality, of%``` ge files and from my investigation and inspection, the on-site wPfer. supply and/or wastew ter;� a `system is(are) in compliance with all applicable Municipal and State cocf s, ordinances, and rpgl4tiops in effect at the time of installation. Naningineering Phone 694-2979` mb of Firm S & S Engineering _ Address 17034 N Eagle River Loo12 Ste 2.04 Eagle River, AK 99577 Engineer's Printed Name Robert C. Cowan Date s-/ a- r10_3 5. DSD SIGNATURE Approved for bedrooms. Disapproved. 0 01 � INEE• • :r• �.rj 'I� tf lY1NN ♦1ft'tN1i1.11.t�'•• ROBERT C. COWAN�� Ie��o•,•1 CE - 8801 Conditional approval for bedrooms, with the following stipulations: • • ON-SITE • : �; Additional Comments WATER AN9 WASTEWATER DO GGRAM �JJJir0, hT S ,r Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rev. 12100) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program S A E T Y 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:' c," d 9L4C-K Parcel ID: bS-0- 21 -7 3' A. WELL DATA c_ Wr37-e-'. Well type Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE RES If A, B, or C provide PWSID # Sanitary seal (Y/N) Cased to ft. FROM WELL LOG Coliform /colonies/100 ml. Nitrate mg./I. Arse ' mg./I. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S °; , c S: a L Tank size / gal. Number of Compartments 2 - Foundation Foundation cleanout ON) CLQ-) Depression over tank (Y/19 rL Date of pumping 7 / 11 Pumper C. ABSORPTION FIELD DATA n Well Log (Y/N) Wires properly ected (Y/N) Casi eight (above ground) in. AT INSPECTION Other bacteria Collected by: ft. g.p.m. colonies/100 ml. Date installed of / 1 y / - Cleanouts &N) Y't J High water alarm 6N) `/ !& J SHA zi� z c✓ Date installed I /IV /`t j Soil rating (g.p.d./ftZ or ft2/bdrm) C" System type j'I�� `'N Length -7 H ft. Width ft. Gravel below pipe ft. Total depth s ft. Eff. absorption area s 7, ftZ Monitoring tube y'�f Depression over field N c Date of adequacy test c �i' C 1 Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test 0 in. Water addedd)L°CO gal. New depth AA in. Elapsed Time: 70 min. Final fluid depth /H in. Absorption rate >= `�S_� g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) 4 L S 0 0" 1 N 1-7- CI'd tiJ}a/c j K NC Cep/ If yes, give date — D. LIFT STATION Date installed 01 !1 SV/C1 --7 "Pump on" level at I 1 in. Size in gallons I a 5- C' "Pump off"level at Lt IV in Datum Go I %d -n T4 -K Cycles tested Z Manhole/Access(CYC N) Ye 1 High water alarm level at Y / in. Meets alarm & circuit requirements? -Y!� J E. SEPARATION DISTANCES P, 0 r L l C w A i n` SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septi�rvice line On adjacent lots adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S t Property line dL �4- Absorption field S- , ` ! 7 Water main / 0 4- Water service line /0 4 Surface water Oct Wells on adjacent lots N SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ! 0 f Building foundation / 0 Water main %0 f Water Service line /0 -�- Surface water 1 00 --f Driveway, parking/vehicle storage Curtain drain N�'••/c ��' F. COMMENTS Wells on adjacent lots N / 1) 1 G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and , .....c c ,4 review o unicipa recor s t at t e above systems are in ✓ �. c �r `_ ;: d..!% ......., v conformance with MOA HAA guidelines in effect on this date. ROBERT C. COWAN f Q Engineer's Printed Name "� L' C C,�h% q�`� `ti CE - 8801 r1�5a'� Date" HAA Fee $ 3 i S-• J 15-0 C n"' fiWaiver Fee $ Date of Payment S—/ X -s 3 Date of Payment Receipt Number 0 3 I� 0 Receipt Number (Rev. 12101) Municipality of Anchorage Development Services Department'` ram_ Building Safety Division On -Site Water and Wastewater Program 5 A E T Y 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ©S� '"�%tel 02� HAA. # �Jlkd Expiration Date: 1.' � GENERAL INFORMATION Complete legal description Lot 11; Block 4 ; fay l e n Crest #3 Location (site add ressordirections) 10301 Stewart Dr. Eagle River AK 99577 Current Property owner(s) Dana & Debbie Mahn Day phone 646-1985 Mailing address Lending agency Mailing address Real Estate Agent 10301 Stewart Dr. Eagle River AK 99577 Day phone C-r,li€, RPnnPt-f/Priirlentj,gj Dayphone 689-6472 Mailing Address 16635 Centerfield Dr. Eagle River, AK 99577/ Unless otherwise requested, HAA will be held by DSD for pickup. -r Lig✓'— Ef r �`��0 1 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System Q 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 errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S ENGINEERING Phone -7 9 1;1834 Eagle River -Loop Road Na. 204 Address Eagle River, Alaska 99577 Engineer's Printed Name ����• % C- Co WA /%,' Date f p 5. DSD SIGNATUREROBERT C. COWAN r �rFCS• CE -8801 Approved for _bedrooms.��t,F~•�• •0. Disapproved. Conditional approval for bedrooms, with the following stipulations: J ON-SITE •' _ � rnrnrrR nr,m _ rn— c Additional Comments _ = WASTEWATER o �• T�DU�iG� Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: 6&�, Original Certificate Date: O % (Rev. 12100) Municipality of Anchorage *�__ . Development Services Department / Building Safety Division On -Site Water & Wastewater Program s A F E T Y 4700 South Lragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 34.3-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT- _IParcel ID:_�, A. WELL DATA �aLfL Well type If A, B, or C provid . SID # Well Log (Y/N) Date completed Sanit ry seal (Y/Pl) ___ Wires properly protected (YIN) Total depth . ft. /Cased to ft. Casing height (above ground) _in. F M/WELL LOG AT INSPECTION Date of test Static water levy W/edion _ g.p.m. ��_ g.p.rn. WAPLE RESULTS: Cocolonies/100 ml. Nitrate mg./I. Other bacteria colonies/100 ml. Dale: _ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Materials L Date installed ld m— Tank size gal. Number of Compartments �- Cleanouts (Y/N) Foundation cleanout (Y/N) // Depression over tank (Y/N) N/ High water alarm (Y/N) Date of pumping —57- 2e ® Pumper . �fQ r S #07'-'2s �C' /t a,*1-, C. ABSORPTION FIELD DATA Q �" Date installed '�urg7 Soil rating (g.p.d./ft2 or ft2/bdrrn) ��v System type Length ft. Width ft. Gravel below pipe _� • S ft. Total depth,3�sft. Effabs7�1 rtion area ft2 Monitoring tube Y_ Depression over field _^_ Date of adequacy test Results (Pass/Fail) PASS For .J bedrooms Fluid depth in absorption field before test _ in. Water added716100 gal. New depth,;�i�in. Elapsed Time: 77) min. Final fluid depth !�G5'n. Absorption rate >_ 6 v g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) f fb If yes, give date 7_4 G f4 � (V 5U LA-�-_42� ;�?� rinz�'� D. LIFT STATION Date installed 9 �� "Pump on" level at4;�?- in. Datum&mm E. SEPARATION DISTANCES Size in gallons / 05 U "Pump off"level at 4-6 in. Cycles tested __ ;�?- SEPARATION DISTANCES FROM WELL Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Manhole/Access (Y/N) High water alarm level at _ ly'l't in. Meets alarm & circuit requirements? YL�5— TO: /�/ILhri On adjacent !ots _ On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/Hpl a G TANK ON LOT TO: Building foundation 1514- Property line S Absorption field '~ Water main / C / Water service line %� /� Surface water /00 Wells on adjacent lots N A SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 Building foundation IO Water main l� Water ServiceZ; in A Surface water /� O f Driveway, parking/vehicle storage Curtain drain 0 /�N Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name C Date Gi /xs-) r; HAA Fee $ 300. Date of Payment G1 / 3,- J A) / Receipt Number 0 / v S- 7 % Z,�I- (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number h9Ei 4 Roi TTTAMPOWAN ti CE -8801 04/22/03 TUE 10:58 FAX 6896499 VISTA REAL ESTATE ER X1001 i AS-BU1LT i hereby certify that i have surveyed the following, described property: AM, 3 Anchorage Recording Predr.L<t, Alaska, and that tkre improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent. thereto, that no improvements on property lying adl'acent thereto encroach on the premises in question and that there are no roadways, transmission lines or other vysible easements or, said property except as indicated hereon. Dated at Eagle River, -Alaska ROBJERT C. JOHNSON r?-�,� . SCALE:" Regi-tered Land Surveyor..40; 880 LS xBox 717-0456, Eagle Rive: A taska 99577 Phorate (90i� 694-2543 AS-BU1LT i hereby certify that i have surveyed the following, described property: AM, 3 Anchorage Recording Predr.L<t, Alaska, and that tkre improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent. thereto, that no improvements on property lying adl'acent thereto encroach on the premises in question and that there are no roadways, transmission lines or other vysible easements or, said property except as indicated hereon. Dated at Eagle River, -Alaska ROBJERT C. JOHNSON r?-�,� . SCALE:" Regi-tered Land Surveyor..40; 880 LS xBox 717-0456, Eagle Rive: A taska 99577 Phorate (90i� 694-2543 Tf 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.# Oc;0_474-25 .HAA# 1. GENERAL INFORMATION Complete legal description yrnt R1 '�r-k a • RV en CrPGt R/n #3 Location (site address or directions) 10301 Stewart Drive Eagle,River, AK 99577 Property owner Dana and Debbie Hahn Day phone 696-398-9 Mailing address 10301 Stewart Drive Eagle River, AK 99577 Lending agency Day phone .Mailing address Agent ` Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well XX 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 I'm 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 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 furtherverify 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. ALASKA !NATER & WASTEWATER �3 7-6� 7`j Name of FirmeONPhone Address 6901 DEBARR ROAD, S ITE ZB Engineer's signature Date Alaska Water & = Wastewater Consulta9ts, kM Shall be PAID $ ! DOD or prior to, closing for the grIgineipring ;01rVidua Proyl 6. DHHS SIGNATURE Approved for T.RF bedrooms. Disapproved. M Conditional approval for bedrooms, with the following stipulations: Additional Comments _Date �';2�-9� 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 orderto 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-M (Rev.1/91) Back MOA 821 RECEIVED 23 Municipality of Anchorage SEP 19 DEPARTMENT OF HEALTH & HUMAN SERVICESILIVALITY 0FANCH0 Environmental Services Division ENV IRONMENTAL SERVICES DI 825 L Street, Room 502 - Anchorage, Alaska 99501 - (907) 343-4744 Health Authority Approval Checklist Legal Description: HYLEN CREST /D #3: LOT 11. BLOCK 4. Parcel I.D.: 050-474-25 A. WELL DATA Well type CLAS "A" If A, B, or C, attach ADEC letter. ADEC water system number 91398A Log present (Y/N) – Date completed Total depth – Sanitary seal (Y/N) Cased to – Casing height (above ground) FROM WELL LOG Wires properly protected (Y/N) AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate B. SEPTIC/HOLDING TANK DATA `_S_1_GLP Collected by: Other bacteria Date installed qq /1 n-1,/qg Tank size 1,)c;p Number of Compartments 9— Cleanouts (Y/N)YES Foundation cleanout (Y/N) YES Depression (Y/N) Nn High water alarm (Y/N) YES Date of Pumping NEW Pumper – �a- t�l C. ABSORPTION FIELD DATA C Date installedg/1 n-15 fgg Soil rating (g.p.d./ft2 or ft2/bdrm) n s System type SHALLOW TRENCH Length 74' Width 5' Gravel thickness below pipe 2 .9.V Total depttO.75 – 5.0' � Effective absorption area 578 �c�_Fr_ Monitoring Tube present (Y/N) YFC Depression over field (Y/N) NO Date of adequacy test NEW Results (Pass/Fail) – For .3 bedrooms Fluid depth in absorption field before test (in.); – Immediately after– gal. water added (in.): – Fluid depth – (ins) Minutes later: – Absorption rate = – g.p.d. Peroxide treatment (past 12 months) (Y/N) – If yes, give date 72-026 (Rev. 3/96)' D. LIFT STATION Date installed 9/10-15/99 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at* 42., "Pump off" level at* —42" High water alarm level at* 44" *Datum RaTrom nF TANK Cycles tested NEW E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 2nn'+ On adjacent lots Absorption field on lot 200'+ O eft lots Public sewer main Sewer Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 5'+ Property line 5'+ Absorption field 5'+ Water main/service line 1 o'+ Surface water/drainage 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line 1 n'+ Building foundation 10' Water main/service line 10'+ Surface water 1 on' =I= Driveway, parking/vehicle storage area 20'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. ENGINEER'S CERTIFICATION /� I certify that 1 h?6eef', i ed"hrq field inspections and review of Municipal in conformance with M, H, quldelines in effect on this date. Signature Engineer's N Date HAA Fee $ Date of Payment Receipt Numberl- 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number _ cir' ass —7953 are 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. # f% � '- ^ Z'" HAA # � �Lk 03a -S;- 1. GENERAL INFORMATION Complete legal description Lot 11; Btock 4; Hyten Cneat #3 Location (site address or directions) 10301 Stewart A ive Eagle Riven, AK Property owner Lynn Et nden Day phone 696-0390 Mailing address 10301 Stewart Dni.ve Eag.2e Riven, AK 99577 Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 / XXX Day phone Day phone 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 system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev.1/91) Front MOA #21 5. STATEMENt OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 & 5 ENGINEERING Address Eagle River, A�IAS Engineer's signature 6. DHHS SIGNATURE LIM Lf' -Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Phone r rMT:0 3 i3 . it i L 0 4;p, bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approyal Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (Rev.1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L -.,-r ll (`7U— 4 d'i L-rz l ➢sr arce1 I.D. A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number. Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N1 Wires properly protected (Y/N) 9•P- Z S FROM WELL LOG Date of test Static water level Well flow Pump lev_P-u� p.m. AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 7ioo t 4 ; On adjacent lots Absorption field on lot 2n 0 L4- ; On adjacent lots _ Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Nitrate Date of B. SEPTIC/HOLDING TANK DATA Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria 9 Date installed 2'10 Tank size /000 Compartments Z Cleanouts (9/N) Foundation cleanout (&/N) Depression (YA c High water alarm (Y& /J Alarm tested (Y/N) ~ A Date of pumping Pumper TI-, �ssPdo v SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot Zvd �� On adjacent lots IdA Foundation To property line 'LD - Absorption field Surface water/drainage t o o L 72-026 (3/93)' Front Z1 Water main/service line LLJ; kzj; f CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION on lot D. ABSORPTION FIELD DATA LIFT STATION TO: On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off�.L� at Surface water Date installed % -1 -$ A' Soil rating (GPD/Ft2) 1 �� am System type T72-6,� Length Width 2. S Gravel thickness -71 Total depth I 1 Total absorption area `J D Cleanout present &_N) / Depression over field (Y/,* 14 Date of adequacy test -7,19-921 Results as ail) for 3 Bedrooms Water level in absorption field before test �S" After test 47 H Peroxide treatment (past 12 months) (Y& J/Z- A" a"I If yes, give date -tlA- SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot -7,-z:, o ` k On adjacent lots '" v, Property line 1 a k To building foundation 3 1 ` To existing or abandoned system on lot ~ �M On adjacent lots 3 Cutbank ',1 , Water main/service line Surface water o D Driveway, parking/vehicle storage area 3o�k Curtain drain E. ENGINEER'S CERTIFICATION 1 certify that l have checked, verified, or conforme to a/ MOA and HAA guidelines in effect ori th datehis!inspection. ;C' Signature S & 5 ENGINEERIN <::> >•,: 1703 • Eagle Itiver ® No. 204 Engineer's Name Date _ HAA Fee $ a Waiver Fee $ Date of Payment / Date of Payment Receipt Number �`� (/� Receipt Number 72-026 (3/93)' Back 7/t 7 MUNICIPALITY OF ANCHORAGE 0 5 0 7-7 Lj ;�-s' DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVALlg��-% OF ON-SITE SEWER AND WATER FACILITY 264-4744 / Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, towns ( range) L©r //, /3r y. 17'e)II-A ! CAF_si �'E_G Location (address or directions) la 3o t s7ELY,AP_ D t2 - (b) (b) Property Owner 01P'49Dy V• a. Telephone: Home Business Mailing Address /050/ ''S.. 7��/���4 (c) Lending Institution A «r "-'ti i±° nY Telephone Mailing Address ,'!2+ -- (d) Real Estate Company and Agent Address CGU eo rQ® eJ0. Telephone 2 7 G a"74, (e) Mail the HAA to the following address: or: Check here, if hold for pick up. List contact person and day phone number below. S ti ,.. 2. TYPE OF RESIDENCE Single -Family ` Number of Bedrooms 3 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 Public ❑ Community ❑ Holding Tank ❑ 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 72-025 (Rev 8/86) Front 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 regulations in effect on the date of this inspection. Name of Firm Telephone 7f " 391,6, Address Date , l FAt • 4 � rr is �: ''€� Engineer's Seal • t r.2222.5-E� S - JUNE 25. 1971 .�;V , `. ^�, . s . • •Ghia .as 6. DHHS APPROVAL _ Approved for bedrooms by Date �,2 Approved Disapproved Conditional Terms of Conditional Approval 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 DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-02e (Rev 8/86) Back l STEVE COWPER, GOVERNOR d ou o dsmo I)EPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775 3601 "C" STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 DATE: September-3,-1987- PWSID #: 213289 ------------------ To Whom It May Concern: According to the records on file in this office, the------------- HYLEN CREST_____ Water System is in compliance with the State of Alaska Drinking Water Regulations. SincereIY. Ronald S. Klein d Environmental Field Officer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 'z7 A 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) . Applicant Name �'-C��P?r Telephone: Homce� Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder [`; Buyer ❑ ; Other 0 (explain); (d) , Lending Institution Address (e) Real Estate Company and Agent Address one Wv (f) Mail -the HAA to the following address: `_SFS I 2. TYPE OF RESIDENCE Single -Family 14 Multi -Family ❑ Other Number of Bedrooms .2/ Telephone 3. WATER SUPPLY V it Individual Well ❑ CommunityAr Public CSS A 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 Public ❑ Community ❑ Holding Tank ❑ 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 72-02e (11/64) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION M! 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 regulations in effect on the date of this inspection. Name of Firm - Telephone rtgir+e®ritsg Address -SRB 1967 Eagle INTer, Kaska Date A f- + -nwa�e yR9 D a,P a Pi x G s3. a '• Q v r r. 76 v3 V.- DHEP APPROVALC Approved fore bedrooms by ArA_. ate Approved Disapprov f Conditional Terms of Conditional Approval.lIICLC°� ��Cf�tJ✓/J.gT/J/� C: C CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) i C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata (�� Type of System Design Date Installed 7_7,,ey Length of Field 3 S N I Width of Field 06 Depth of Field J ! Gravel Bed Thickness Square Feet of Absorption Area ��� Standpipes Present©/Ar Depression over Field Results of Last Adequacy Test Separation Distance from Absorption Field: Date of Last Adequacy Test Mir N/_ To Water -Supply Well if pi "7 -(G To Property Line Za � r To Building Foundation 3i To Existing or Abandoned System on Lot �/� ; On Adjoining Lots 'ry ►; To Water Main/Se+priee Line S`Df11- To Stream/Pond/Lake/or Major Drainage Course To Cutbank (if present)G+ To Driveway, Parking Area, or Vehicle Storage Area 36 y Comments - CL our13QFo C Ttfrr-A d -t -t -65 _JS rr- D. LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at i "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S Engineering Signed DateSIZE 196x Company Eagle Sliver, Alaska 9957Z MOA No9--5__— 0 �� Receipt No. �� 151 q.0 Date of Payment — t�2 —":6b Amount: $ Page 2 of 2 72-026 (11/84) BILL MIEFFiELD, GOVERNOR Lf DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 DATE: PWS i.r,).# 2 / � Zgq To Whom it May Concern: According to records on file in this office the 64�' ater System is in compliance with the State Drinking Water Regulations Sincerely, MNICIPALITY OF ANCHOR -AGE DIVISION OF ENIVIRONTHENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIROWHENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Descriptioinclude lot block, ubdAvision sect on, township, range) fl�39 1-7z' IV �-ee 1 -7 Location (address or direction 3 76- (b) Applicants Name rr-j L K -j Telephone - Home Business Applicants Address .2 It (c) Applicant is (check one) Lending Institution Owner/builders7-" Buyer E:::l ; Other E::] (explain); (d) Lending Institution Aj 0 /--) r= Address (e) Real Estate Co. & Agent A) C9 ,,-J Address Telephone X f the HAA to the following address: 2. Type of Residence Single -Family Number of Bedrooms 3. Water Supply Individual Well Multi -Family 2 Community Other (describe I Public j t t i Telephone 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 Public Community Holding Tank 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 21 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. Name of Firm Telephone Address Date (ENGINEER SEAL) t Z. No. 6. DHEP Approval ' bedrooms A e,� ;'11111 AIX Approved for By Approved 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 REGIS TEIIED 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/DI8 [Page 2 of 2] 7-19-84 ,,1Ui�1CIPALJTY OF ANCHORAGE C FT. OF J iE LTH & MUNICIPALITY OF ANCHORAGE (MOA) ENV IRONI%AMENTAL F' OTLCTIOM HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 r r U' �c� L` .xPiJ A. WELL DATA 14\1 Well Classification If A, B, or• C, D.E.C. Approve (Y ) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Static Water Level Pump Set At Depth of Grouting Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) ,Separation Distances from Well: To Sept ic%eld-i-ng-Tank on Lot 200 4 On Adjoining Lots To Nearest Edge of Absorption Field on Lot ZOO On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected By Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size DDZ_ No. of Ccirpartments Z Standpipes ryM Air -tight Caps (Y Foundation Cleanout (YM -1) Depression over Tank (X ,y Date Last Pumped tiJ Pumping/Maintenance Contract on File (Y/N).'AJj& ; for eyl r'�- Holding Tank High -Water Alarm (YIN)� Temporary Holding`Tank Permit (Y/N) P/4 -- Separation Distances from Septic/Holding Tank: q To Water -Supply 4+b ll ` -/ To Building Foundation / To Property Lire /o 7 To Disposal Field / 2 / To Water Ma W- Service Line ,SU To Stream, Pond, Lake, or Major Drainage Course / p Comments A,) -t) N [Page 1 of 21 2-15-84 I BILL SHEFFIELD, GOVERNOR L LJ -j DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 DATE: PWS I . D. To Whom It May Concern: 274-2533 Accord i ng to records on f ide i n this off ice the Water System is in comp liance'with the State Drinking Water Regulations. Sincerely,