HomeMy WebLinkAboutTIMBERLUX #2 BLK H LT 13./ Timb rlux Block H Lot 13 #018-271-42  Municipality of Anchorage ,. Development Services Department..: Building Safety Division On-Site Water & Was~water Program, 4700 South Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 ~ :.~ www.d.anchorage.ak.us (907) 343-7904 Page I of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW010008 PID Number;. 018--271--42 N°me:TERRY ROWRER Wastewater System: [] New · Upgrade P.O. BOX 414 WHrrE SALMON. WA 98672 ABSORPTION FIELD Phone: No. of B~drooml: * (:509) 49,3-2052 ,3 n Deep Trench · Shotlow Tr, nch [] Bed [] Mound · Other LEGAL DESCRIPTION ~' ~ *2.0 ~/~. 1,3 H TiMBE:RLUX #2 **3.02 MAX DEPTH - - - SEE DWG. WELL: [3 New [] Upgrade 6+ r~ r~ 225+ rL EAGLE MOUNTAIN EXC. 2/14-16/01 SEPARATION DISTANCES []s. puc [] Holdlng · $.T. Ep. []Other ~'o s~puc Ab~qe°~dU°n St~onl'~t ~o~d~,g~.an~ ~,~ ANCHORAOE TANK 1250 From Tank Well 100'+ 100'+ 100'+ -- 25'+ STEEL 2 s.,ooo ~Voto. 10o'+ loo'+ loo'+ - - LIFT STATION Lot Une 5'+ *"1'+ 5'+ -- - 1250 ANCHORAGE TANK Foundation 5'+ 10'+ 5'+ -- -- TIMER T MER 45" Curtain Omen N(~NE KNOW ' 20 051 05 HHF M.O,A. .e~a~=: *TH~S ~S AN ~N.OVAT~ ~OWOML~SS BENCH MARK INTERM~TrENT SAND FILTER. BOTrOM OF SIDING ~ FCO · ,2.13' OF M.O.~. APPROVED SAND FILTER TOP OF MH UD == 92.28 ADDED TO TOTAL DEPTH. 89.94 · W.OlOOO OLD SEPTIC TANK ABANDONED PER EAGLE MOUNTAIN EXCAVATION 2nd 2/15/2001 SW010008 - 018-271-42 10' UTILrrY EASMENT / c --~., I EXISTING DRNNnELD ~ I ,',B~ONa) N PL,~C£ ~ i I'~(' -(J ml~ I ~ I ~AJR LINE ~ / U I / ,,,--OLD DRAJNF'ID. , (?) i / / PIPE. i \ r----... I '/ STXnO, WAS /B / / COMPLETELY NOTE: WHAT WAS ORIGINALLY NOTED / ~ / ~"i ~DO.Eo m AS A CURTAIN DRAIN PIPE ON THE L.~ ~ ,, ~EXI~N¢ SEFI~C ~ WAS COMPLETE Y 11/23/83 INSPECTION REPORT WAS / EXPOSED AS PART OF' THIS j .//,/ ABANDONED UPGRADE. IT APPEARED TO BE A /~'t~/,'t" ..... BOOTLEG TRENCH, SEVERAL FEET /.o/"// / ....... WIDE. WITH ABOUT 18 INCHES OF ~ -- ~ "' /I DRAINROCK. THE SOIL AROUND IT ~ ~ ~ j k / WAS DISCOLORED. GIVEN ITS -- ~1 ~ / I,~ CONSTRUCTION AND LOCATION IT ~ ~ ~ J~ I WOULD NOT HAVE BEEN FUNCTIONAL r ' ~' ~ ~ ' AS A CURTAIN DRAIN. ALL PiPE AND J ~ (/30 DRAINROCK WITHIN 30 FEET OF THE ~ ~ ~j NEW ISF WAS REMOVED AND ~ EX~nNO -- 0 BACmLL~D W,H NAT~ SO~ ~ ~ ~%~o..~. X A B C ~::'~::1111111 ~ ~co ..1~ 1~,o~ - :~~111111 ALASKA WATER & WASTEWATER ~ !t-": .... ~'i I(fl~ ........... CONSULTANTS, INC. 1 # = 50~ ~RE. PARED FOR: PHONE NUMBER: PAGE NUMBER: TERRY ROWRER (509) 495-2052 2 OF ~ r,, ~,/~f~rev A. TIMBERLUX SUBOIVISION 1~2; LOT 1~, BLOCK H, ~h e. ......... AS-BUILT DRAWING OF' SEPTIC SYSTEM UPGRADE (BOTTOMLESS I.S.F.) "_~ W 12¢,0 ~L. bOl,,I ~ a, m,~ 5,'r,l~,P, TANK - .~.~3 ~.) ~/~o/~oo~ ~ O~..A~'~ ~ C.J.g, , CONSULTANTS, INC. TERRY ROWRER (509) 493-2052 TI~BERLUX SU~DIVISION ~2; LOT 13, ~LOCK H, ~K OF WORK: PROFILE AS-BUILT OF SEPTIC SYSTEM UPGRADE (BO~OMLESS I.S.F.) · MUNICIPALITY OF ANCHORAGE - BIIrI,DING SAFETY DMSION 4700 SOL'TH BRA,CAW STREET, ANCIIORAGE, AI.,ASI~ INSP£CTIOSt~: V,,~ee: fgO?) ~,~-~3~ Fax~. fg{;F; 343.4235 IA"FORI~4TIOA'.. (907) ~D~: 4935 ~~ A~ DA~: ~l/Oi PHO~ LOR 13 BLOCg: H --- m...,--'U:ri' STA~6N ..... COM;WENT~ IA~P2?C~OA.': EtecrH~I Rough COMMEz .xT~: z'~PECTOR: {F'HE,;¥ COPJ, LECI31ON$ ~IRA' MADE, PLF..4~E CALl. FOR INSPF. C';7 0N 353~ TO AWOX3 NIVANfl0~ '~5903 6L~SP69 gg:Lg MUNICIPALITY OF ANCHORAGE Depa~lment of Health end Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTE~NATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jan 11, 2001 Expiration Date: Jan 11, 2002 Permit Number: SW010008 Legal Description: TIMBERLUX#2 BLK H LT 13 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: TERRY ROWER OwnerAddress: PO BOX 112369 ANCHORAGE, AK 99511-2369 Parcel ID: 018-271-42 Site Address: 004935 HILLANDALE AVE Lot Size: 33242 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] D sposa Fie d [] Septic Tank [] Ho dingTank [] 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 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. Date: Date: / Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Waslewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#: WR010003 PID~: .01827142 HA#: Permitg: SW010008 Date Received: 01111/01 Legal Description: TIMBERLUX Ir2 SUBDIVISION LOT 13 BLOCK H Engineer:. ALASKA WATER & WASTEWATER CONSULTANTS~ INC. 6901 DEBARR ROAD~ SUITE 2Br ANCHORAGE~ ALASKA~ 99504 Applicant: TERRY ROWRER Waiver Requested: LOT ENE SEPARATION OF 1 FOOT FROM BOTTOMLESS I.D.S.F, TO EAST LOT LINE FROHTING BUFFALO STREET Cdteda: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: ~ Waiver is not Granted: List Conditions or Reasons for above: ~.~_ [AJf_~IJU~.F_.R ~ Date: / - //"~0 By: Nam~ of Revi~er Rec~: 0818 Amount: 11~5 Date Paid: 1111101 ipality ,o ---- Munic f Anchorage o ¢'1~. lluerch, t r ~ ~ Public Works Ihfildmg Safety Dxxas~on P.O. Ik>x 1.0C'C~50 · ,-'t700 $. Bra#aw Street Anchorage, Alaska 00519-GG-50 * {007) B2t3-8301 h t tl~://w~xav.el.m~chomgc.ak.us 01/12/01 Jeffrey A. Gamess, PE Alaska Water & Wastexvater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Timberlux #2 Subdivision Lot 13 Block H Waiver Request #WR010003 Parcel ID #018-271-42 Permit Number SW010008 Dear Mr. Gamess: Your request for a waiver of the required 10 feet horizontal separation from the on-site wastewater disposal system to property line has been approved. The approved separation distance is 1.0 foot. The 1.0 foot separation is from the lot line that fronts Buffalo Street. This waiver approval applies to the existing on-sitewastewaterdisposal system to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer On-Site Water & Wastewater Program NOTE: Application must be §lied out completely Property Owner Name '"~'('V / Mailing Address . ~).0. [~.y. Legal Description ~ MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Sewer/Well Permit Application ('~ SINGLE FAMILY DWELLING Day Phone Zip Code Lot Size ,..~,24:~ Acre~.~..Ft. Number of Bedrooms ,"~ will be conducted by: J~'Approved Engineering Firm r-] Municipality (permit fee included Inspections Does your house contain any of the following: [] Hot Tub [] Swimming Pool [] Therapy Pool [] Jacuzzi This application is for: [] Water Softener Unit [] Sewer Only [] Sewer and Well [~Sewer Upgrade [] Well Only [] 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 in accordance with applicable Municipal Codes. AbJkJC [ Waiver Fees: '-~/] ~ · '~')¢) Receipt# 72-012 (Rev. 4~J8)° ALASIG WATER & WASTEWATER CONSULTANTS, INC. November 27, 2000 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 System Upgrade for Lot 13, Block H, Timberlux Subdivision #2 (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: The existing 3 bedroom house is served by private well and a private septic system. The existing septic system consists of a I000 gallon septic tank, a lift station, and a bed type drainfield. The existing drainfield is state of failure and must be upgraded for the sale of the house. We are proposing that a 1250 gallon S.T.E.P. tank and a innovative Bottomless Intermittent Sand Filter (ISF) system be installed. Comments regarding the proposed upgrade are summarized as follows: 1. GENERAL: A test hole was excavated east of the existing septic system in order to determine an area suitable for a septic system upgrade. Given the location of the documented curtain drains, the setback from surface water, and the presence of groundwater; it is our opinion that a Bottomless ISF system is the most viable option. 2. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, a application rate of 2.0 gallons/day/ft2 should be used.. 3. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (ISF) a. Percolation Rate: 60 minutes/inch b. Allowable Application Rate for ISF: 2.0 gallons/day/ft2 c. NumberofBedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 225 ft2 f. Effective Depth below pressure pipes: 3.0+ inches g. Width: 6 feet h. Length: 37.5 feet. i. Effective absorption area = 225 ft2 j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com k. Air Supply Line: "Wasteflow" emittefline, 1/2 inch I.D, "Anchorage Tank". 1. Sand Material: In accordance with M.O.A. latest standards m. Pea Gravel: 100% passing 3/8' sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the #8 sieve. We are proposing to excavate do~vn to a depth of 6.0 feet (maximum - on uphill side), place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand. On top of the sand, we will place 6 inches (minimum) of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. SURFACE WATERS: There are several areas with some surface water within 100 feet of the proposed septic upgrade. All such areas will be filled with fiver rock, covered with filter fabric, and than covered with native material. 5. TOPOGRAPHY: As can be seen on the design dra~ving, the drainfield is to be installed on a 25 percent slope that runs from east to west approximately. In short, we do not anticipate any slope concerns. 6. LOT LINE WAIVER REQUEST: We request a I foot lot line waiver from the proposed ISF drainfield to the east property line. We are unaware of any adverse effects on the neighboring property with the granting of this waiver. 7. ABANDON OLD CURTAIN DRAIN: There is a clean-out near the south end of the proposed trench that was identified on the 11/23/83 MOA inspection report as a "curtain drain observation pipe". Based upon our site assessment, it is uncertain where the curtain drain originates or ends, and what purpose it serves. Given that the area looks "undisturbed", it is almost certain that this curtain drain does not extend into the proposed ISF site. Our design calls for excavating out any portion of the curtain drain that lies within 20 feet of the propbsed ISF and filling it with sand or insitu soil. The curtain drain outleta,vill be located (with a transn~itter) and plugged. ~,~. qn.~..ttf~ ,~ ~,~-"~ ¢ 8. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (5th floor, 9th & L St.). 9. CLOSING: I am open to any suggestions from your department, which would be an improvement to the proposed design. I am unaware of any adverse impacts this installation would have on at acent wells or septic systems. If you have any questions, please contact us at 337-6179. Thgn)tf ~ou for your assistance. JefCq aar ess, P.E., M.s. Pre§ide/~ 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akxvxvc.com tOT 2. ~ H. -- ~ ~: I ~', r - ~- -- ~ wI I I I I ~ ' I ~T ~. B~K H, % ~MB~ S/O '2 J [ I ~T .... _ I I ~HO~IN~ "-- ~ ~ l~1~ I : t T~K~ Illllll ~'~ I t I -- - IIIIIIl~ ~ ;, ,' ~ ~ ~J ID~IGN P~[ 2 OF 3 /'/~ t ./ ~UB~R~ S/D ~2 ~ ~ r ~ / ~ FOR OD~ .,~?~-~ ~ ~-~_ ~ ~ / , ,' 1 1/27/2000 A~S~ WATER & ~STE~'I'ER ~ '" CONSULIANI$, lNG. TERRY ROWRER (509) 49~-2052 1 or z TIMBERLUX SUBDIVISION ~2; LOT 15, BLOCK H, .." _ SITE P~N FOR DESIGN OF SEPTIC SYSTEM UPGRADE ..... SEE PROfiLE AND PI.,~., PONDL*D [' V1EW ON PAGE 3 OF AREA (F~..L 2O00) I I . . , , ~',\'~', /-,* CEN1T~R OF A 2 BY1 I I ~ // OEEP DRNNAGE DITCH. I I . ~t1 ~ / / INSTALL A 1' CULVERT AND ; i ..~ ~ ~ ~ 1' LOT ~V .// BURY WITHNATNi~RIV[RsoiLROCK AND ; ; IIUI" I tl[~ 't/ / W~V[R ~' O[]S[3~/AT~ON PIPE. s; [XC*VA~O our. ~ ~ I I ,, I I !~ sE; COVER I.["r~R. - ' ..... 7 / i' ' X ~0. TO B£ COMPL.-rl~LY / i GNJ.ON S.T.F-P. TANK ,,,, O~,U 2' f DEEP PONDFr. D AREA.~ I ,..--AJR UNE 1. SEE COVER Lf. llER REOARDING THE / --AIR COMPRESSOR :UR'rAiN D,~N. ~.o SE~C TANK J ~0~.. C/ (S~ .0~) TO BE COMPLY I ~ 2. ALL SURFACE WATER WITHIN 100 FEET OF AaANOCNED'~ ',f PROPOSED SEPTIC UPGRADE SHALL BE FILLED ! WITH RIVER ROCK AND COVERED WITH FILTER FABRIC AND NATIVE SOIL ~ D(IST1NC THREE: ,3. THE CONTRACTOR SHALL HAVE THE ':,,"?: !'~" ".'".'?" ::"]llllll \ NORTH AND FAST LOT LINES F'I_AGOED BY A ~-' ~':. "~!,':' ~'"1111111 REGISTERED LAND SURVEYOR PRIOR TO ANY ~.~:.'-. ~,'..*..~,'.:'-:lllllll ~ CON~UC~ON. ': ': ':.' :,'-".~BIIII , / \ / I ~ ~ r: ',:'~ ,.'-..'.,;/ ~ / j I P~q[~URC ~ AT A LOCJ~TK~N WHICH ~ READILy ACCE:~gBI..~ './ ~*~.,~ OF' A 3' -d------, ,'/ 1 /;~":'/  11/27/2000 ~ ~F ~,w. ~,: AI.~iSIr~ WATER & ~,~STEWATER **,~.. I ~:.~ TERRY ROWRER (509) 493-2052 2 .OF 3 I,, ;.t.'f 'e)~.. Garness: TIMBERLUX SUBDIVISION #21 LOT 13, BLOCK H ~[... C]:7953 .o.." DESIGN OF SEPTIC SYSTEM UPGRADE INTE~~ SAND FILTER %% ~ ~ ~-- DIS~RIBt~]ON UN~. PiPE SIZE ~- ~ OR[NCO ~S, INC. ~o c~ P~N VIEW ORIGI~ R~ G~E DI~IB~ON UNES MOA ~PRO~D '~%~ .. I 4 + FE~ TO ~D RLTER ~' -- GROUNDWA~R NRUN~ IN~ ~s ~.c.~s ~LOW PROFILE VIEW TOP OF ~D. , CONSULTANTS, INC. TERRY ROWRER (907) 495-2052 5 OF 5 ~ ~ ~ ~f~ey~A. Gerness2 TIMBERLUX SUBDIVISION ~21 LOT 1~, BLOCK H ..'"' DETAIL DRAWING OF PROPOSED ISF DRAINFIELD ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DIFBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 PHONE (907) 337-6179 ' FAX (907) 338-3246 I SOIL LOG - PERCOLATION TESTI LEDAL DESCRIPTION: T~UBERLUX S/D ~2; LOT 13, BLOCK "H" PERFORMED FOR: TERRY ROWRER DATE PERFORMED: 10,/9/00 ORGANICS I TEST HOLE SM/ML CV/ML I I I GP ML GM CL GC OL SW MH SP CH SM OH SC DEPTH TO DATE 3ROUNDWATER DRY lO/9/oo 10' 10/12/00 9.5' 10/22/00 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 10/12/0o I 2:38 6' __ 2 3:08 30 5 1/2" 1/2' 3 3:08 ~ 6' ~ 4 3:38 30 5 1/2' 1/2' 5 3:38 -- 6' __ 6 4:08 30 5 1/2" 1/2' PERCOLATION RATE. 6._~.0 .(HiN./iNC, vl/i~ PERC. HOLE DIA. 6.~" (INCHES) TEST RUN BETWEEN 6.0. ~FT. ~ I 6.5 FT. PERFORMED BY A~ ,WATER A W~ATER I, ~ ~ ~ [ ) , CER~ T~T ~IS W~ PERFOR~D I~ ACCORD~CE WITH ALL S~E~A~D MUNI~ GUIDEUNES IN EFFECT ON DATE. DATE: 1115~1oo I J Sent By: A~aska Water and Wastewater Con; 907 335 3246; Dec-30oO0 12:19; Page 1/1 PROPERTY OWNER MAINTENANCE AGI~:MENT ON-SITE WASTEWA'I'EK DISPOSAL SYSTEM This agreement, dated. ,200_, b made between the Municipality of Anch,..~p, ge~ .I~_ .)r? .c~, of Health and_ .Human Services (D.HHS) aM the p~'op~y owner(s) of This a~'eement is made ~or thc purl~se of maintnln[ng an on-sim wastewater disposal system on the subject property. The property owner(s) agree to the following: The property owner(s) will have an nnmlnl inspection of the system performed by a registered professional engineer. This inspection shall veri~ that all effluent and air pumps, timers, and alarms are functioning as designed. Any deficiencies shall be corrected and the ~ngineer's statement that the system is functioning a.s designed shall be filed annually with the DHHS. In witness whcrco~ [ hereunto sci my hand and ~'i'f~;ials~l. '~ (/,.- -,..,~ ' flo~. Pub.lie (~ig~a_ ture) __ . ,_.,, (Nogary's primed na~e) My cc~nn~slon e~p~,,es: MUNICIPALITY OF ANCHORAGE · DEPAR-~MENT 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 PHONE ~NEi/V MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS ]Well I Absorption area Dwellin9 PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons Q DISTANCE TO: Well Foundation Nearest lot Hne PERMIT NO, ~ m Z No, of lines Length of each line Total length of lines Trench width Distance between lines ~ ~ Total effective absorption area OTHER PiPE MATERIALS REMARKS ? ~ '~ 72-013 IRev. 3/78) 'x../ WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological 8, Geophysical Surveys OriJ[ins Permit No, LOCATION OF WELL (Please complele either la~ lb or lc.) A.D,L, No, Io-o~..I8orough~ Subdivision Lot Block [b~.I, I/4qtrs. Section NO. Township Nr~ Range E[~ Meridian 2. WELL LO~ Surfece / 0 ~ ft -- .... "~ ~ ~ ~ ~ ~:; D'~: ~<? ~ ~" :,~ ? ~ Auger O~etted ~Bored ,f'~,=~ '~ .~:;tC'"?~,.~' ~ ,~ j ~/ (~ 7. USE: ~'D°mestlc ~ Public Supply ~ Industry ' ~ * ..... ~ F d~em. ~ in, to /. ~*~ft. Depth Weight I0. STATIC WATER LEVEL: :~/ /;[' ft. 0 Subm. 0 Jet 0 Centrlfic~l 0 Other Permit , // , _ ~ ~./ ~ MUNICIPALITY OF ANCHORAGE( > ~ ~) ~/Department~r,~f Health and Environmental~'rotection ~/ 825 L Street, Anchorage, AK. 99501 \~ / 264-4720 ~.~ * * * HANDWRITTEN PERMIT * * * ~ ~~ WELL AND~-ON-SITE SEWER PERMIT Applicant: ,ocation: Legal Description: Mailing Address Phone Nur0ber: ~ Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed; ~ Holding Tank: C~f>) Maximum Number of Bedrooms: Soil Rating (sq. ft/br) The Required Size of the Soil Absorption System Is: DEPTH ~Q L~H GRAVEL DEPTH ~ '~ The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in 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(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SiZE = /OC) C~ GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 8 2 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I undar~tand that~the on-site sewer system may require enlargement if the~s~denc~remodf~o, include more that 3~ ~bedr°°ms' Applicant SWP/024 (i/81) ALASKA eI1UIROIlm6nTA COI TROL SeRUICe$, Inc. June 5, 1981 Judy Lamb Remax Properties 2702 Gambell Street, Suite Anchorage~ Alaska 99503 201 Dear Judy: Here are the soils tests for lot i3, block H, Timberlux Subdivision. Three holes were drilled on the north portion of the lots. It appears possible to place a house on the lot and have an on-site system in this location. The silty sand (SM) encountered here appears to be the same as on the front of the lot. We therefore reco~nend a design of 257 sqft per bedroom. As in our letter of April 22, 1981 to Dianne Lund, I can not over emphasize ~e importance of the diversion of water off the lot by reestablishing the drainage along the south side Hillandale Avenue. Another option to improve the drainage would be to install a curtain drain along the lot lines at the NE corner of the lots. This would probable lower the water table very significantly. Here also is the consolidated bill for the original work (Carol Black) and the last work. If i can be of further service please let me know. Sincerely, l'.eroy (2. Reid ,Jr. ~ PhD~ President PE 1220 UJcst 25t~ Auenue · Anchorage, Alosko 99503 · [907) 276-1361 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ~/'SOrLS LOG PERCOLATION TEST 1 2 9 15 16- 17- 18- 19- 20 SLOPE SITE PLAN WAS GROUND WATER S ENCOUNTERED? ~--~ L O Reading Date Gross Net Depth to Net Time ,Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT 72-008 (6/79) LOT DEPTH 2 3 4 5 7 d 14 1~- 20. Subdivision A,E,C,S,, INC, 1220 W, 25-~1, AVENUE ANC~DRAGE, AK, 99501 SupplernenLal Soils InFormation. ~m ~/-~ Block ~ -~--~&~,(V~ ~ ' LO1 2 3 4 7 8 10 13 14 17 18- 20- LOI TH 1 2 3 4 ? 8- 10 12 14. 20- LOT TH OEPTH 2 3 7- 8- 10 13. 14 - 15 - ~? 20 Municipality of Anchorage Development Sentices Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196850 Anchorage, AK 99519-6850 www.ct.anchorage.ak.us (9O7) 343-79O4 RELEASE OF CONDITIONAl.' HA010055 CERTIFICATE OF HEALTH ,&,UTHORITY .&,PPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 018-271-42 1. GENERAL INFORMATION H.Z~t~. HA010055 Expiration Date: Compfetelegaldescription TIMOERLUX.SUBOM$10N ~2; LOT 15, BLOCK H, Location (site address or directions) 4955 HILLANDALE DRIVE ANCHORAGE, AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address TERRY ROWRER P.O. BOX 414 Day phone WHITE SALMONt WA 98672 Day phone. (509) 495-2052 NEILTHOMAS w/ COLDWELL BANKER Day phone 2525 "C" STREET ANCHORAGEI AK 99503 265-9106 Unless otherwise requested, HAA will be held by DSD forplckup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Indivi,~ual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Ce~ficates of Health Authority Approval (HAA) based only upon the representaUons 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 propertJes served by a single family on-site wastawatar 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 data 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.) Cer'dficates 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 enginem's work. Note: Alaska Water and Wastewaler Consultants, Inc. shall be paid $256.25 a~ or prfor -. to closing for the engineering san, ices provided. " 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the valida#on dale shown below, I ve#~y that my investigation, based on procedures ou#ined ln the Health Authorify Approval Guidelines for this application° shows that the on-site water supply and/or wastewatsr disposal system Is(are) safe, funcfional end adequate for the number of bedronms and ~e of structure lndicated berein. I further verify that besed on the information obtained frem the Munidpalib/ of Anchorege f~les and fmrn my investigation end inspection, the on-sits water supply and/or wastewatsr disposal system is(ere) in compliance with all applicable Municipal and State codes, ordinances, and mgulalions In effecf at the time of lnstallation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS. INC. Address 6901 D£BARR ROAD. SUITE 2B * ANCHORAGE. AK 99504 Engineer's Printed Name. JEFFREY A, GARNESS. P.E. Engineer's Comments: In conduc~g thie evatue~on, AWWCo Inc, attempted to provide · thomngh, ¢~nsctentious engineering enalyale of the sysfem/n accordence ~ ADEC end MOA DSD Guidelines & Regulatlcm& The reposed msulte desctfbed the perto~rnenca of the ~ under the condi~one encountered et the ~me of the ~ end ~eperatton distances measured to mad~Ty Identifiable features. The operational life of all wells end =epEc systems depend on the Iocal soils condlffon, gmundwater lewl$ that may #ucfuale du#ng the year, and the wator usage of the family being served by the system. These cond/ffons ~ outalde the conbo/of the evalualor of the sy~em. Sa#sfac~ test msulte do not guarantee futura performance of ~he system, nor do they guarantee that them am no hidden dofec~ or encroachment. A WWC, Inc. can therefore not provfde eny warranty or futura e~Jmate of how long the system wiff c~n#nue to meet the operaff~lat mqulramente of the ADEC or MOA DSD. The content of thl~ report la for the sole benefit of the ownor ll~nd ebove. Any mSence upon or uca of thi~ mpoct by eny other peraon or parly Is not euthoHzed, nor v~71 It c(mter eny legal dght whatsoever. DSD SIGNATURE ~ Approved for "~ bedrooms. Phone 357-6179 Disapproved. Conditional approval for __ bedrooms, with the fllowlng stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other Origlnal Certificate Date: Municipality of Anchorage Development Sewices Department 8uaclTng Safety o~.81te water & wa~valer Program 4700 S~ulh aragaw ~ P.O. Box 196650 Anchorage, AK 99519-6650 www. cl.anc~mage.alcu~ A. WEU. DATA We~ type ~aVA~ HEALTH AUTHORITY APPROVAL CHECKLIST TIIdBERLUX S'/D ~2; LOT 13, BLOCK H, Parcel ID: 018-271-42 If A. B, or C proqdde PWSID~ Da~ gx~mpleted 10/30/82 TotaldepUt 106 It. Date of test b"taUc water level Welt producUon WATER 6AMPLE RESULTS: ~tO 106 ft. FROM WELL LOG lo/`3o/82 46 fL 40 g.pj~. Wires propedy pn:~ec:md (Y/~) Casing height (above ground) AT INSPECTION 2/~5/Ol 50 fL 5.8 g.p.m. YES 12+ Collfmm 0 colonles/lOOml. Nllmte 0.5 mg./L. Date of ~ample: 2,/14,/01 Collected by:. B. $EPTIC/HOLDING TANK DATA Tank~ze 1250 gal. NumberofCompm'm~nts 2 Found~de~noutCflN) Y~S Depmsslonovermnk(Y/N) NO Date of pumping NEW C. AB~ORPllON RELD DATA Otherbacte~, ,o colonies/lO0 mi. AWWC, INC. Date Insbdled ~ 2,/16,/01 Ckmnout~ (Y/N) Y~s Hlghwaterelarm(Y/N), ,, N,/A Pumper - *BELOW FINAL GRADE, 2.13' OF M.O.A. APPROVED SAND FILi~J< ADDED BE/OW TOTAL DEPTH. Date Imtalled ~ 6olt mUng (i~r tt'/txlrm) 2.0 Length 37.5 fL Width 6 fL Toted depthe5' +,/- fL Eft. absmpUon area 225 fi' MolII~ tube YES Date of adequacy test NEW Results (Pass/Fall) - Fluid depth In al:~orpfion field before test -% In. Water added - gal. Ehal:~ed~: - ~m Rna] fiuld deplh - In. Absoq~on rate Any reluvenaUon treatment (past 12 mo.) Cr/N & type) Symmtype eOTTOMUmS LS.F. Grovel below pipe 0.,35 fL DepresMon over fiekJ NO For 3, bedrooms Newdepth - In. - g.p.d. - ffy~, give d~te ., , - , D. UFT 8TATIOH Oate blM~ed 2/16/01 'Pump on' level atTIMER In. OatuIll BOTTOM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size In gallons 1250 'Pump off' level etTIMERIn. Cy~e~ tested NEW High water alarm level at 45 Meets alarm & circuit requirements? YES $epfi¢ tank/lift station on lot 100'+ AbsorpUon field on lot 1 (30'+ Public 6~wor main N/A ~ewer Isept~ sewlce Eno 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cteanout Hok g tank N/^ Bulldlng foundafion 5'+ Pmpertyl[no , 5'+ Water main 10'+ Water ~en'lce Ilno lO'+ Wells on adjacent Iota 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: AbsofpUon field 5'+ Sur[ace water 100'+ Property Erie Water ~ervlce llne Curtain draln F. COMMENTS SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: · 1'+ Building foundaUon lO'+ ~JYNVER ~WR01000~ Water main 10'+ 10'+ 50'+ Surface water lOO'+ Driveway, paddng/vehlde atomge 50'+ Wells on adjacent lots 10o'+ O. ENGINEER'~ CERTIFICATION I cerU~ ~hat I have determined through field Inspecffons and review of Municipal recoils ~het ~he above eysfems are In cor~rmance wlth MOA HAA guidelines In effect on ~hls date. HN~Fee$ Date of Payment Receipt Numtmr pz.v. ~oo) Waiver Fee $ Date of Payment Receipt Number ztK CT&E Environmental Sea, Ices Inc. CT&E Ref. S 10 ! 0?39001 Client Name AK Water & Wastewater C0nsul~ Inc. Project Nam~ T~berl~ Client Snmp~ ID Lot 13 Bl~k H Ma~ix ~klng Water Ordete~ By PWSlD 0 Sample Remake: Client PO# Printed Date/Time 02/21/2001 16:19 Collected Date/Time 02/14/2001 14:30 Received DntuTime 02/I 5/2001 11:05 Technical Director Stephen C. Rele.sed By 'lqilrat e-N Results ~L Units Method 0.500 U 0.500 mr,/L EPA 300.0 Allovabta Prep Analysis Limits Date Date Init 10max 02/15/01 SCL lticrobioloov Labor& ~ox~ Total Coliform 0 col/lOOmL SMI8 9222B 02/15/01 SKW l~-J £O/ZO'd riO-! IOt~19~ ]¥1N3MNO~IAN3 313~0~J ZZ:91 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Febmary23,2001 Municipality of Anchorage Department of Development Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: CONDITIONAL HEALTH CERTIFICATE: Lot 13, Block H, Timberlux Subdivision #2 (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: We have completed the subject septic system installation, however, because of the snow conditions it is not possible for us to be certain that all of the surface water issues are resolved. The ponded area noted on the original design submittal as 5' diameter by 2' deep, and the ditch that flowed from it towards the northwest, have both been filled with bone rock, covered with filter fabric, and buffed. The ponded area in at the northwest lot comer was not addressed because its boundary could not be identified at this time. After break-up the contractor (Eagle Mountain Excavating) will do final grading and deal with (cover with bone rock and gravel) any other ponded areas identified. In short, we are requesting that you issue a conditional health certificate at this time. All work will be completed prior to June 1, 2001. If you have Sincerely,. Presi~ an~lons, please contact us at 337-6179. Thank you for your assistance. rnek~F.E., M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwxvc.com F£B-22-200! 11.1U 02:33 PM I~TECE/SL'J~R F~ NO, 5616828 P. OI LOT 2 LOT S 86'55'04# £ 137,71' 35.0 ~'~r I LOT 12 ~...' ~'~. ~"~9~ '~ / E.~;!.~ ............. ~':C~'~,~ ~,' / · ~;'.. "'..: .... :...":~ /: :// d  -'-~o'oo. ~ , ~,c.o,,c~. ,~,s~, .~o~ (~o~) ~,~-~, LOT 15, BLOCK H, ~'~"'~"m ~,.~o, m~ ~',o~t, ADDN. NO. 2 ~MBEELUX SUBD. MdniCipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 A~chorage, AK 99519-6650 ~vww.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-271-42 '1. GENERAL INFORMATION Expiration Date: Completalegaldescdption TIMBERLUX SUBDMSION #2; LOT 13, BLOCK H, Location (site address or directions) 4935 HILLANDALE DRIVE ANCHORAGE, AK 99516 TERRY ROWRER P.O. BOX 414 Day phone (509) 493-2052 WH~E SALMON,'V~ 98672 Day phone Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address NElL THOMAS w/ COLDWELL BANKER Dayphone 2525 'C' STREET ANCHORAGE~ AK 99503 Unless 'otherwise requested, HAA will be held by DSD forplckup. 2. NUMBEi~ OF BEDROOMS: 5 3. TYPE OF WA~TER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: 265-9106 Indivldual On-s.}te Indivldua! Holding tank The Municipality of Anchorage Development Services Depadment (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 Naska. Certificatas of Health Authority Approval are required for the transfer of title (except between spouses) for preperties 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 Authoflty Approval are valid for 90 days from the date of issue for propedJes 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 pedod of up to one year with valid water samples.) Certificates are valid for one year for properties sewed 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 Water and Wastewater Coosultants, Inc. shall be paid $2,768.20 at, or prior to closing for the engineering seMces 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 Authodty Approval Guidelines for this application, shows that the on-site water supp~/ and/or 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 files and from my investigation and inspection, the on-site water suppO/ 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 ALASKA WATER & WASTE-WATER CONSULTANTS, INC. Phone Address 6901 D~BARR 'ROA[~. SUITE 2B * ANCHORAGE, AK 99504. Engineer's Printed Name JEFFREY A. CARNESS, P.E. Date 357-6179 Engineer's Comments: In conducting ~hts evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysts of the system In accordance with ADEC and MOA DSD GuldeNnes & Regulations. The reported results described the pefforroance of ~he system under the conditions encountered at the Erne of the tes~ and separation distances measured to readi¥1dentiEable features. The operational fife of all wells and septic systems depend on the local soils cond~on, groundwater levels that may flucfuate during the year, and the water usage of the family being ca/red by the system. These condigons are outside the conb'ol of the evaluater of the system. Satisfactoi7 test results do not guarantee future performance of the system, nor do they guarantse that thora are no hidden doffs'ts or encreach,'nents. AWWC, Inc. can therefore not provide any warranty or futura estimate of how long the ~3,storo will continue to moot the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of tho owner #stsd abew. Any reliance upon or use of this report by any othor peraon or perty ls not aut]~orlzed, nor wiII It confer any legal right whatsoever. DSD SIGNATURE . . ON-SITE '. · · WATER , , : - ___ Approved for bedrooms, ' ~ : WAST~-~/~p ~rn= . . = : ~ *. .* .~ ~ "Condi~onal approval for ,~ bedims, w[~ ~e fllowing s~pula~onsY~'' ;~5~" $2000 shall be p~:c~ esc~o~ ~o comple:e ~o~k o~ su~ace ~a~e~ ts~~tl ~' Honey in esc=ow shall not be released until this o££1ce has ~iven final approval. Work shall be completed no later than 6-15-01 Attachments: · .- HAA Checklist Septic Sys!em AdvlsoO' Well Flow Advisory Manltenance Agreements ' Supplemental E~glneefs Reort Other Odglnal Certificate Date::' ~ - ~ '~' '~ O/ Municipality of Anchorage Development Se ices Department BulMlng Sa;ely Division On-Site Water & Wastewater Program 4700 ~OUlh Bragaw SL P.O. Box 196850 Anchorage, AK 99519*6650 www.d.anch~'age.ak.us Legal Descrl~on: A. WELL DATA BI. HEALTH AUTHORITY ,PPROVAL CHECKLIST TIMBERLUX $/D 1~2; LOT 15, BLOCK H, ParcallD:. 018-271-4.2 Well type ~VATE ff A, B, or C provide P1NSID# N/A Data completed 10/50/82 Sanitary ~ (YIN) YES Totaldepth 106 ft. Casedfo 106 ft. FROM WFI I LOG Date of tsst 10/30/82 Static water level 46 .ft. Well pmduc~on 40 WATER SAMPLE RESULTS: Coliform 0 colonla~J100 mi. Data of sample: 2/14/01 SEPTIC/HOLDING TANK DATA .g.p.m. Nllmta 0.5 mgJg Tank Typa/Matarlal ' Tank size 1250 gal. Fouedafion cleanout (YIN) YES Data of pumping NEW C. ABSORPllON FIELD DATA Data Installed 2/~4-~s/o~ Length 37.5 It. S.T.E.P./STEEL Number of Compartments 2 Depression over tank (YIN) NO Pumper well Log (YIN) Wlres pmpa y protected (YIN) Casing height (above ground) AT INSPECTION 2/15/01 50 ft. 5.8 .g.p.m. YES YES 12+ In. Other bects~ 0 colonlas/lO0 mi. AWWC~ INC. Date Installed C~eanouts (YIN) High watar alarm (YIN) *BELOW FINAL GRADE. 2.15' OF M.O.A. APPROVED SAND FILTER ADDED BELOW TOTAL DEPTH. 2/16/01 YES Soil rating (i~rlt'/txlrm) 2.0 System type BOTrOMLESS LS.F. Width 6 ft. Grovel below pipe 0.35 .ft. Depression over field NO For 3 bedrooms New depth - In. Absorption rate >= - g.p.d. If)ms, give data - y£~ ~ Total depth *,~' +/-fL Eff. ebscxpfionema 225 It= Monltaringtube YES Data of adequacy test NEW Results (Pass/Fall) - Fluid depth In ebeorplJon field before test - In. Water added - gal. Elapsed Time: - min. FL, mi fluid depth - In. Any mJuvenafion lmatment (past 12 mo.) (YIN & type) - D. UFT STATION Data Installed 2/16/01 'Pump on' level atTIME:R In. Datum Bo'FroM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WTM ~ ON LOT TO: Size In gallons 1250 'Pump ofl' level atTIMERIn. Septic tank/lilt station on lot 100'+ Absoq~on field on lot. 100'+ Publle sewer main N/A Sewer/sepU(~ eewJce line Manhole/Access (Y/N). YES High water alarm level at 45 .in. Meets alarm & drcult requirements? YES On adjacent lots 100'+ On adjacent lots. 100'+ Public sewer manhole/deanout Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: At~ori~on field Surface water Building foundation 5'+ Water main 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 5'+ 5'+ Water ~en4ce line 10'+ ** Property line ,1 '+ Water eewlce line 10'+ Cudaln drain 50'+ F. COMMENT8 *WAIVER ~WR010005 Building foundation. 10'+ Water main 10'+ Surface water ** OflVeWay, paddng/vehlcle storage Wells on edjacent lots 100'+ **SEE CONDmONAL WAIVER REQUEST G. ENGINEER'8 CERTIFICATION I cergfy that I have de~ermlned through field Inspec~on$ and rm4ewofMunlclpe/mcordsthattheabove,ystemsemin ~~....( ~..:...~ conformance with MOA HAA guidelines in efi~ct on this date. Englnee;'s Pdntud.Name _ JEFFREY A. C.A~NESS Date of Payment Receipt Number O~v. t2mo) Walver Fee $ Date of Payment Receipt Number ~'~ MUNICIPALITY OF ANCHORAGE L"~41 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 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, t, ownship, range) Location (address or directions) (b) Applicant Name ~ ¢'~/P---~¢'¢~---~--~ Telephone: Home ,¢/-//,-~'- ~,~--¢? Business ,.~¢,~ ApplicantAddress ~¢- ~ //~J~ .. ~~' ~ (c) Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain); (d) Lending Institution ~--~'~ ~,~ ~'~¢'-a-~Telephone Address (e) Real Estate Company and Agent Address (f) ~ffi~t~-~ HAA to the following a~dress: ?¢,s- ?? TYPE OF RESIDENCE Single-Family~ Multi-Family Number of Bedrooms ,~ Other WATER SUPPLY Individual Well ~1' 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 I of 2 72-025 (11/84) ~ ' SEARCH, DATA AND iNF¢.~.~tATION ENGiNEERiNG ~IRM PROViDiNG INSPECTIf'~41'~' TESTS, FiLE Authority Approval shoWS ma~ L. ' ' w I verify the! my investigation of this Health . ,,' ~,4 h~retO and as of the vai,dat,on date s.h~,n^,b,~el~s°n~saI system ,s safe, funcbonal and adequate As certified by my seal amX.~,.;~,~ on site water supply and/or wastew,* ...... for the number of bedrooms and type of structure indicated herein. ~ further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supplY and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S ENGINEERING _ Telephone Name of Firm ~96X Address E RIVER, AK 99577 Date DHEP APPROVAL Approved rot *"~-~- conditional - "~ __ Disapproved ~ Approved ~ Terms of Conditional Approval Date 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 of DHEP do not conduct inspections or 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 in the Municipality of Anchorage is not responsible for errors or omissions analyze data before a certificate is issued. The .-. professional engineer's work. Page 2 of 2 72-025 (11/84) A. · WELL DATA MUNICIPALITY OF ANCHORAGE ~ ~ DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MO~ENVIRONMENTAL pROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Descri_~ion: Well Classification Well Log Present~)/N) Total Depth ~ ~ ' Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (~/N) Separation Distances from Well: To Septic/14z;C,d~.Tank on Lot Cased to If A, B, C, D.E.C. Approved (Y/N) Date Completed J.~)_ ~ ~'7..~- Yield ~ ~t~,* Depth of Grouting Pump Set At I.) ~. '"¢"~c:~ ~ Sanitary Seal on Casing (~Y~'N) Depression Around Wellhead t. ~,~, I Jo' ; On Adjoining Lots To Nearest Edge of Absorption Field oJ~ Lot ~,,~> t..~ ; On Adjoining Lots To Nearest Public Sewer Line t~ .1~ To Nearest Public Sewer Cleanout/Manhole ~ To Nearest Sewer Service Line on Water Sample Collected by ~--~ "~::~t.~,.,'~=~t~3¢. ;Date Water Sample Test Results Comments .t~. ~:¢~..~..~ ,,,.J J ~:~..-~ ~ ~1~ ,~,. ~-~ B. SEPTI'C/H~ TANK DATA Date Installed Standpipes (~/N) Depression over Tank (Y/~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/J;J~;ldi~j-Tank: Air-tight Caps ['o To Water-Supply Well To Property Line to To Water Main/Service Line Course No. of Compartments Foundation Cleanout ~ Date Last Pumped ; for ¢3 ,~ Temporary Holding Tank Permit (Y/N) To Building Foundation [ ~ ~ To Disposal Field t'J¢b To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026(11/84} C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed I~ "'~ Width of Field "Z"¢I Square Feet of Absorption Area Depression over Field (Y~...~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water:Supply Well To Buildir~g Foundati~ol Lot ~ To Water Main/Service Line Type of System Design Length of Field Depth of Field ~ Gravel Bed Thickness [¢, t ~ '~"~"'~ =P Standpipes Present4~'N) Date of Last Adequacy Test ~ (c'~ To Property Line ~' t To Existing or Abandoned System on ; On Adjoining Lots ~ f~ ~,~ ~ To Cut[~a~lk (if present) To Stream/Pond/Lake/or Major Drainage Course To Drivewa~/;'Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes Dimensions ~k'~,-O I,.A, Manhole/Access ~)N) "Pump Off" Level at Pumpin~g Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify t~a~l ~a~j~d~e~d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection, Signed ~[ ~ i~6X Date Compar~t.~Ll~~~77 MOA NO. Receipt No, -~(~ ~l'/~ ~ Date of Payment ~ ~ ~" ~ ~ Amount: $ 4~ ,~ ~ Page 2 of 2 72-028 (11/84) JtCLl tt~ou . APPLI~.~NT FILLS OUT UPPER HAI.~ONLY P;opJrty O~wner D O ~? ~ z'~- /(-~£//~- Phone Address Zip Code Realty Co. & ACnl Phone Address Zip Code Legal Description ~ Type of Resi~nce Single Family ~ Multiple Family . No. of Bedroo~ Water Supply ~ Individual A~ACH WELL LOG. A w~l Icg Is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give wail depth (attach Icg if available}. Sewer Disposal . ~ Individual Year Individual In,tailed:_ // ~ ' ~ Public Utility . When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time "~' [;,h.t 2 0 1982 ( ) APPROVED BEDROOM8 *OONDITION8 OF APPROVAL 72-023 (3/~2) December 27, 1982 Don Van Ells 210 E. Potter Anchorage, AK 99502 Subject: Lot 13 Block H Timberlux Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: o The depression or pit around the well easing needs to be filled with impervious type soil so that it slopes away from the well casing. o The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerer, Robert C. Pratt Associate Environmental Specialist RP256/p/EH