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T15N R1W SEC 18 LT 101A
TISN RIW Section 18 Lot 101A #0§ 1 - 172-47 • • O P •i f r Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 s A ETY Certificate of On-Site Systems Approval Parcel I.D. 051-172-47 Expiration Date: 7 ^J 1 1. GENERAL INFORMATION: Complete legal description T15N, R1W,SECTION 18,LOT 101A Location (site address) 19632 Adrian Avenue*Chugiak,AK 99567 Current Property owner(s) Montt/Seelye Day phone 267-9821 Mailing address 19632 Adrian Avenue*Chugiak,AK 99567 Real Estate Agent Erica Sourivona Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex E Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank 0 Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 2 ' — Waiver Fee $ Date of Payment ) a-& —11rr Date of Payment Receipt Number CEJ 5 G3 ro U Receipt Number COSA# CSC-- t`? In 5- Waiver # 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, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: c / b- -- „.,..,.,,,\„,,In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system aFA in accordance with the guidelines and regulations established by the Municipality of Anchorage and .ss.O.... pQo industry practices. The reported results describe the condition of the system/s on the date/s of the 0 P•,• �,_ ,V�OI1 evaluation. Separation distances were measured to readily identifiable features. Hidden defects or • -�7 Q encroachments may exist that were not identified during the evaluation. The operational life of all wells i * '' Al .•7*00 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, .� ' ' groundwater levels (that may fluctuate during the year), quality of construction (materials and • rill workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and VA are outside the control of GEG. Satisfactory test results do not guarantee future performance of the 0n Je = A. Corn ess;• system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of Un ' , , —7?53 .• .t Q� the well or septic system. GEG makes no representation whether an alternative well or septic system VQ can be installed on the property in the event either of the current systems fail to perform adequately in Dale e. �� ?/I C���0 the future. The content of this report is for the sole benefit of the person/party that retained GEG to �14a pr 0 f e s sion°oQ perform the evaluation. Reliance upon the information provided in this report by any other person or � Oooaa party (including subsequent property purchasers) .is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE K System #1 Approved for 3 bedrooms `G`��,r1T Y 0� v System #2 Approved for bedrooms S Cy .- ON-SIT o Disapproved w F ATTRll m Conditional approval for bedrooms, with the foll'c vin PROP kd f R 20 Rp .RAM \off. .Qr-r-\/1 rCC•'� By: - \ 1A^-te1' -5-7-1 7 Original Certificate Date: aZ-2-&-i/ The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory )C Well Flow Advisory Other COSA blue sheet 10.10.12.doc If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: T15N, R1W, SECTION 18, LOT 101A Parcel ID: 051-172-47 A. WELL DATA Well type Private If A, B. or C provide PWSID# N/A Well Log (YIN) Yes Date completed 1974 Sanitary seal (YIN) Yes Wires properly protected (YIN) Yes Total depth 53 ft. Cased to 53 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 1974 12/29/2016 Static water level 18 ft. 27.1 ft. Well production 12 g.p.m. 4.3+ g.p.m. WATER SAMPLE'•� RESULTS: Coliform v colonies/100 ml. Nitrate°' « mg./L. Collected by: GEG, Ltd, Arsenic: ug./L. Date of sample: 5124/2017 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/31/1999 Tank size 1,000 gal. Number of Compartments 2 Cleanouts (YIN) Yes Foundation cleanout (Y/N) Yes Depression over tank (YIN) No High water alarm (Y/N) N/A Date of pumping 2/1/2017 _ Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA *Crib Depth Below Existing Grade Date installed 6/28/1971 Soil rating (g.p.d./ft'or `Ibdrrr) 150 System type Crib Length 19 ft. Width 18 ft. Gravel below pipe 6 ft. Total depth *9.4+ ft. Eff. absorption area 444 ft Monitoring tube Yes Depression over field No Date of adequacy test **12/30/2016 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test ***0 in. Water added 504 gal. New depth ***17 in. Elapsed Time: 137 min. Final fluid depth ***0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) None Known If yes, give date — **Pre—soaked crib with 2,038 gallons on 12/29/2016. Test was performed on crib only. Viability of 1983 trench was not verified; however, sumps appeared to be dry. Records of 1983 trench are on file with MOA. ***Crib MT only extends approximatley 38" below top of crib. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at •. a er alarm level at in. 111- •• Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *100 + On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line **0' Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS *101.59'from edge of well to edge of ST1 **WR#010084 G. ENGINEER'S CERTIFICATION o ifx - ...1.--'•-57{)°0 I certify that I have determined through field inspections and H •. 0 review of Municipal records that the above systems are in (10,_,/.1) t7 conformance with MOA COSA guidelines in effect on this ..: .4 date. ► •. Ga ess.Engineer's Printed Name JEFFREY A. GARNESS I. -J - I kpi0 Date 14 41 �DOeap 2. o\VII c rofession 4 ' �044000�a #AECC884 (Rev. 11/05) • Municipality of Anchorage S 3 , Development Services Department Building Safety Division S'A F E TJY On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On-Site Systems Approval # OSC 171015 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 101A of T15N R1W Sec.18 Subdivision. This inspection revealed an arsenic concentration of 25.3 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 470(~ B_r, aga~_ S~re~t P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.Org/onsite (907) 343-7904 CERTIF CATE FOR A OF ON-SITE SYSTEMS APPROVAL SINGLE FAMILY DWELLING Parcel I.D. 051-172-47 1. GENERAL INFORMATION COSA# Expiration Date: Complete legal description T15N, RIW, SECTIONI8; LOT 101A Location (site address) 19652 ADRIAN AVENUE * CHUGIAK, AK * 99567 Current Property owner(s) ANDY REMBERT Day phone · 301-6461 Mailing address 19632 ADRIAN AVENUE * CHUGIAK, AK * 99567 Lending agency Day phone Mailing address Real Estate Agent CINDY LINDBLOM W/ GREATLAND REALTYDay phone 694-9125 Mailing address 11411 OLD GLENN HIGHWAY * EAGLE RIVER, AK * 99577 Unless otherwiSe requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: individual Well · individual On-site · individual Water Storage [] Individual Holding tank [] Community Class__Well [] Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 a,~xed here~u ~nu as oft,be · ":~-" ~'~ -" ..... ~' .... I verify As ce~,leo oy my seM =' ' '- ~ ~ investigation, based on procedures outlined in the Cedificate of On-Site Systems Approval Guidelines for this application, shows that the on.site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I fu~her veri~ that based on the information obtained from the Municipality of Anchorage Nes 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 GARNESS ENGINEERING GROUP, Ltd. Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 · Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone Date 557-6179 Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being sen/ed by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE / Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory ~': .....Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report utner /'4L~ '0'¢-~' ~ Original Certificate Date: CERTIFICATE Legal Description: WELL DATA Well type PRIVATE: Date completed 1974 Total depth 5,3 ft. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 OF ON-SITE SYSTEMS ,PPROVAL CHECKLIST T15N, R1W, SECTION 18; LOT 101A Date of test Static water level 18 Well production 12 WATER SAMPLE RESULTS: Coliform ~* colonies/lO0 mi. Arsenic: ~g./L. SEPTIC/HOLDIrNG TANK DATA If A, B, or C provide PWSID# N/A Sanitary seal (Y/N) YES Cased to 5,3 .ft. FROM WELL LOG 1974 g.p.m. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 9/9/2010 28 ft. `3.46 g.p.m. YES YES 12+ in. .IL. Date of sample: 9/9/2010 Other bacterM~~!~olonies/lO0 mi. Collected by: GE(;; Ltd. Foundation cleanout (Y/N) YES Date of pumping '8/25/2010 ABSORPTION FIELD DATA Date installed 9/17/198.3 Length 57 .ft. Tank Type/Material SEPTIC/STEEL Tank size 1000 gal. Number of Compartments 2 Depression over tank (Y/N) NO Pumper. [*BELOW EXISTING GRADEI Soil rating (g.p.d./ft2o~ 155 Width 2.5 ft. Total depth '9.2-8.6ft. Date of adequacy test High water alarm (Y/N) SANITARY PUMPERS Eft. absorption area 556 ft2 Monitoring tube YES 9/9/2010 Results (Pass/Fail) PASS Depression over field NO For `3 bedrooms Fluid depth in absorption field before test 18 in. Water added 540 gal. 'New depth `34 in. .Elapsed Time: 280 min. Final fluid depth ,30 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YiN & type) NONE KNOWN If yes, give date - NOTE: PREVIOUSLY DOCUMENTED 1971 CRIB CONNECTED AS RESERVE SITE. CRIB WAS NOT IN USE AND DRY. System type TRENCH Gravel below pipe 5.25 Date installed 7/,31/1999 Cleanouts (Y/N) YES N/A Parcel ID: ~) .~') -! 7.2. -/'/7 D. LIFT STATION Date installed "Pump on" level at' in. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons Manhole/Access (Y._~N_~ ~ "Pump off" leve_La~. High water alarm level at Cycles tested Meets alarm & circuit requirements? Septic tank/lift station °n lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas. 50'+ .in. On adjacent lots. 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main N/A Wells on adjacent lots 100'+ SEPARATION DIsTANcE FROM ABSORPTION FIELD ON LOT TO: Property line 5'+ Water service line 10'+ Absorption field 5'+ Surface water, 100'-I- 'Property line *0'+ Building foundation. 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ Water main N/A Driveway, parking/vehicle storage 10'+ COMMENTS *PER EXISTING WAIVER #WR010084. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date c~ / 7-~. /l O COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number. ........... SGS Reft# 1104754001 Client Name Garness Engineering Group, Ltd Printed Date/Time 09/24/2010 14:05 Project Name/# T15N~R1W,SEC18,L101A Collected Date/Time 09/09/2010 14:00 Client Sample ID T15N,R1W,SECI 8,LI 0lA Received Date/Time 09/10/2010 11:00 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals'by ICP/MS Arsenic 8.42 5.00 ug/L EP200.8 C (<I0) 09/16/10 09/23/10 NRB Waters Department TotalNitrate/Nitrite-N 0.100 U 0.100 mg/L SM20 4500NO3-F B (<10) 09/14/10 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 09/10/10 DLC Total Coliform Negative 1 100mL SM20 9223B A 09/10/10 DLC p 13 10 12:19p Betty Van Boven I 907688-0993 ~DDRESS SOLD BY CASH C.O.D. C~RGE ~N ACCT. MDS~ RET'D. PAID OUT ':'."-?. :-.~, . .'.--.: ,.:' "'.'. ;., ?.. ::.-;./:'::....",', :....,,;',' '..',..:'..'.:, .' ." ,:.:.,:'.~:..;: ::::::::::::::::::::::::::::::: :,:;.:::~ ':;~:.:::;::'.~;: :~.i~;:: ',?:,;:;;~:~.;' ':.7.::'/::~ ': "~..;?;)-,;; ";.',~--'.~:~,: :'"~; "'.':' ' :;~';':" :': ':=:" ' ....... ':'. ~cE~ ~v · ' ..... TOTAL All cie. ires and returned goods MUST be sccompanied by this bilt. 1! 3 3 0 Thank You! U,(;E ZONE i P By. Da~ All work shall be done plot plan. Approved shall ~:o! be chant withoul first obtaining a zZ n on this specifications :hange order. F{.} ...' 5' ,AS BUILT SEWARD & ASSOCIATES LAND SURVEYING f HEREBY CERTIFY ,THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND ~AT NO ~N~OACH~5NTS EX'SI EXCEPI AS INDICA~D. IT IS THE RESPONSIBILITY OF THE OWN~ TO D~ERMINE THE EXISTENCE OF ANY E~EMENTS~ COVENANTS~ OR RESTRICTIONS WHICH DO NOT ~PEAR ON THE RE~D~ ~BDI- VISION PLAT, UNDER NO CIRCUMSTANCES S~ ~Y DATA H~EON BE USED FOR CONSTRUCTION OF FENCE LINES~ OR FOR EST~LISHING ARY LINES, :SCALE: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 An~orage, AK 99519-6650 v*vw.d.anchorage.ak, us CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-172-47 1. GENERAL INFORMATION Expiration Date: Complete legaldescdption TI§N, RlW. SECTION 18, LOT 101A, Location (s[te address or directions) 19632 ADRIAN AVENUE * EAGLE RIVER, Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address AK 99577 JOHN WOOD Day phone 440-1778 19632 ADRIAN AVENUE * EAGLE RIVER~ AK 99577 Day phone KATHI OLMSTEAD w/ REMAX PROPERTIES Dayphone. 244-8020 16600 CENTERFIELD DRIVE * EAGLE RIVER. AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ~ Individual Water Storage Community Class Well ~, Public Water System TYPE OF WASTE~NATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certiticates 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 g0 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.) Certiticates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note:Alaska Water and Wastewater Consultants, Inc. shall ba paid $1,275.00 at, or prior I to closing for the engineering services provided. I 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 bedreoms and type of structure indicated herein. I further vedfy 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 ALASKA WATER & WASTEWATER CONSULTANTS. lNG. Phone Address 69010EBARR ROAD, SUITE 2B ° ANCHORAGE. AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation, A WWC, Inc. atlempted to provide a thoroflgh, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the perlormance of the system under the conditions encountered at the gme of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may tTuctuate dudng the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWCo Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person er party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE L,'"'"' Approved for -5~ bedrooms. Disapproved. Conditional approval for __ Attachments: HAA Checklist Septic System Advisory Well Flow Adviso~ bedrooms, with the tqlowing stipulations: ~'~ : · ON-SITE WATER AND Manitenance Agreements Supplemental Engineer's Reort Other (Rev. IZ~O) Original Certiticate Date: /0 ' 0 ! Legal Description: A. WELL DATA Well tyl:)a pRIVATI~ Date completed Total depth 5..3 Municipality of Anchorage Development Services Department On.~te Warm' & Wsstew~er I~ P.O. Box lg~850 Anclxx~le, AK 99519-~850 HEALTH AUTHORITY APPROVAL CHECKLIST 1974 T15N, R!Wh SECTION 18~ LOT 101A. Psrcel ID: 051-172-47 If A, B, or C provide I~N$1D~ 8anlte~/seal (Y/N) YES Date of test Stetio water level 18 Well production 12 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Date of ~ample: 9/26/2001 B. SEPTIC/HOLDING TANK DATA Cased to FROM WELL LOG 1974 53 It. lt. .g.p.m. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 9/26/2001 30 It. 4.0+ YES YES 12+ In. Nl'cate 0.5 m0JI.. Other bacteria Collected by: AWWC, iNC. DATA AND TESTING DATA ! FOR 1983 TRENCH ONLYJ Tank Type/Material STEEL Tank size 1000 gal. Number of Compartments 2 Foundation claanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 9/26/2001 Pumper C. ABSORPTION FIELD DATA Date installed e/t 7/83 Soil rating (g.p.d./It~or~) 155 Length 57 It. Width 2.5 .it. 0 colonies/100 mi. Date installed 7/31/99 Cleanouts (Y/N) YES High water alarm (Y/N) N/A JR'S PUMPING System type TRENCH Grovel below pipe 5.25 Toteldepth 9.5-m It. Eff. abaorptionama 556 It= Monltalngtuba YES Date of adequacy test 9/26/2001 R~Ults (Pass/Fall) PASS Fluid depth in absorption field before test47/561n. Water added 443 gal. Bapsed Time: 1260 min. Final fluid deplt~6/551n. Absorption rate >=. Any rejuvenation treatment (past 12 mo.) (Y/N & lybe) NONE KNOWN Depression over field NO For 3 bedrooms New depth62/7qn. 450 + g.p.d. If yes, give date - D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump off' n. Higl~ water alarm level at __ .in. Datum Cyc~ee tasted. Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt station on lot100'+ Absorption field on lot ~ 00'+ Public sewer main N/A Sewer/septic eewtce line 25% On adjacent lots 100'+ On adjacent lots ~ 00'+ Public sewer manhole/cieenout Holding tank N//A N/^ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5' + Properly line 5'+ Water main N/A Water eewlce line. 10'+ Wells on adjacent lots. 100% Absorption field Sur[ace water 5'+ 100'+ SEPARATION DISTANCE FROM ABSORPllON FIELD ON LOT TO: Property line UNKNOWN Water sewice line 10'+ Curtain drain NONE KNOWN Building foundation. 10'+ Sun'ace water ! 00'+ Wells on adjacent lots lOO'+ Water main N/A Driveway, parldng/vehlcle storage 25% F. COMMENTS (~ / G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspect/one and review of Municipal records that the above systems are in conformance with MOA I-IAA guidelines in effect on this date. Engineer's Printed ~ame Date JEFFREY A. GARNESS HAA Fee $ Data of Payment Receipt Number ~. ~} Waiver Fee $ Date of Payment Receipt Number $EP-28-0! 19:00 FI~U-CT&E ENVII~NI~KTAL SRV 9075515301 T-982 P.01/OI CT&E Environmental Services Inc. Laboratory Division 200 W. Potter Ddve Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 CT&E Ref. #: Client Name: Project Name: Client Sample ID: Matrix: PWSlD Sample Remarks: 1016574001 AK Water & Wastewater Cons. n/a T15N RIWSec 18 Lot 101A Ddnking Water Client PO#: n/a Pdnted Date/Time: 09/28/01 18:55 Collected Date/Time; 09/20/01 11:40 Received Date/Time: 09/27/01 10:40 Technical Director. Stephefl Erie Released B~ Results PQL Units Allowable Prep Analysis Method Umits Date Date Init Total Coliform (MF) 0 cot/lOO mi Nitrate 0.5 U 0.5 mg/L SM9222B 09/27/01 KAP EPA 300 10.0 09/27/01 SCL Sep-28-O! ]8:16 CT&E Ancho~age/Htc~o CT&E Environmental Services Inc. Laboratory Division Drinking Water Analysis Report for READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE MUST 13E COMPLETED BY WATER SUPPLIER 0 PUBLIC WATER SYSTEM LO. # IIIIIII ri SengR#$utn C] Stntlln~lct 907 561-5301 P.02: rl Send lnmlce CONSULTANTS. INC. ANCHORAGE. AK 99504 Year acteria Anchorage, AK 99818-1605 Tel: (907) 562-2343 Fax: 1907} 561-5301 TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE lo be: O Satisfactory Unsatisfactory Sample over .10 hours old, results may be unreliable Sample too long in transil; sample should not be over~l~hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date R.elved Time Received I ~ .n.,,,,, \ Anal~kal Melh~: ~Memb~eMM~MuGFilter * Number af rnln~ i,-e / I Ill1 ,-I Analyst 101 B574 0 W~ Date: Time: Date: ,c~ . Time: Fazed Treated Water Untreated Water Collected By Month Day SAMPLE TYPE: n Routine 13 Repeat Sample (for routine sample with lab ref. no. } 13 Special Purpose Time SAMPLE LOCATION Collected BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MUGRe~alt: TetalCollfurm ~ r'll-I ~ rlIL"~Ce/I ti,,.r: Verification: LT" IIGI~ Fecal Cnfiform Confirmation ,{, -. Final Membrane tilter R~snlts Time Cnllform~100 mi ~~ Member of the SOl Gro~;, .t _~c_ jo_t4 G~h~4tnle de Suweillance) ENVIRONMENTAL FACILITIES IN ALASKA, CAUFORNIA, FLORIDA. ILLINOIS, MARYLAND. MICHIGAN. MISSOURI, NEW JERSEY, ONIO. WEST V~RGINIA ALASKA WATER & WASTEwATER CONSULTANTS, INC," October 2, 2001 Municipality of Anchorage Public Works On-Site Water & Wastewater P.O. Box 196650 Anchorage, Alaska 995 ! 9-6650 Ref: Lot Line Waiver for Lot TI5N, RIW, SEC 18, Lot 10lA To whom it may concern: We request that your department issue a 0 foot lot line waiver from the northeast property line to the existing drainfield. I am una~vare of any adverse impacts this waiver would have on adjacent wells or.septic systems. If you have any questions, please contact us at 337-6179. Thank you for your ss,sl 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwxvc.com Munic ~o o e '_--- ~ ipality f Anch rag _ _ George P. I~ uerch, Mayor ---- ------ Dep~rtmen! o~ Building Safety Dix~sion ~ubnc Workq. P.O. Box 1~?.~50" ~?00 $. Bragaw Strcct t'mchon~gc, tMaska 00510.6C~50 · {007) g48-8.~1 http:[[w'.vw.¢l.anchoragc.nk.us 10/4/2001 Jeffrey Gm'ness P.E. Alaska Water & Wastewater Consultants Inc. Subject: Waiver Request forTl5N RIW Section 18 Lot 10lA Waiver Request #WR010084 Parcel ID/t051-172-47 HAA#010528 Dear Engineer: 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 0.0 feet. 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, Jeffrey W. Poet Engineering Technician On-Site Water & Wastewater Program Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewa~er Program 4700 Bragaw Sa'eat P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (9~7) 343-7904 Waiver Review Worksheet WRY: WR010084 Date Received: 10/03/01 Legal Description: Tt6N RIW Section 18 Lot 1~1A Engineer:. ~ Alaska Water & Wastewater Consultarl~ 111~, Anchomos. AK 99504 Applicant: John Wood PID~: 0S1-172-47 I..IA~: HA010528 Pem~it#: Waiver Requested: 0 feet from lot line to dralnfleld Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: Waiver Is Granted: Waiver Is not Granted: List Conditions or Reeso~s for above: Date: By: Name of Reviewer Rec~: 11021 Amount: $1t6.00 Date Paid: 1014/2001 81/81/1999 88:84 68B2259 SULLIV~q PA(~ 81/81 LOG OF DRILLING by A 6' L DRILLING COMPANY DATE--STARTED DATE---ENDED KIND OF }'OI%~ATION= ~-~ '' ' FI~OM ............. _FT. TO .............. F~OM ......... _FT. TO Sent By: REIIJAX OF EAGLE RIVERj INC.; 9076960214; Oct-l-01 11:59PM; Page 111 pERMIf NUMBER: sw99o236 REVISED AS-BUI-LT DRAWING: 10/2/01 PARCEL IO NUMBER: 051-172-,47 \ & / DBL~ 53.5 ~ 79.33 ~ / DB~ 54.33 ~ 79.67 ~ ~ / C01 49,7~ ~ 71.08 ~ [__ I FD 51.08 72.0 ~ I/ CRIB 60,5 78.25 . ~ ~2~ .f ~ _ ~ ~ / / t x ~ ~ ~--'~ ~/ /_~-I / ~ - ~ ~N~ CRI~ ~D ~CH. ~E ~ON OF ~E CRiB C/O SUMP ~E ~Y SH~. S~ON D~CE TI5N, R1W, SEC. 18; LOT 101A ~E OF WORK: ,) AS-BUIlT FOR SEPTIC SYSTEM UPGRADE ~. ~.~ ~ ~.~,,. c~I , ""~JOHNF°R:wooDs P.ON[ .uue~: V0~.~ 1..' kJC~ 7953 ...' (soy) 688-~z~/~-~o~4 ~L~,..~...~. ..... .._:~ K.D.W. 1" = 30' 2 OF 2 ofessto~ FCO 6.25 ST1 4~,~, 71.85 ST2 51.5 77.58 DBL1 55.5 79.55 DBL2 54.55 ! 79.67 C01 49,75 ~ 71.08 C02 51,75 72,17 FD 51 .O8 72.0 CRIB 60,5 78.25 Municipality of Anchorage Page 1 of. 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 Anchoroge, Alasko 99519-6650 Telephone: 545-4-744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW990256 PID Number: 051--172--47 Name:JOHN WOODS WastewaterSystem: [] New · Upgrade Address: 19652 ADRIAN AVENUE ABSORPTION FIELD No. of Bedrooms: MouyrlOther Ph°ne:(907) 688-5266 5 [] Deep Trench [] Shollow Trench [] Bed [] LEGAL DESCRIPTION .o,, .or,.0= ~,D/s..., ,o~o, ~.~.. ~,D.pth~,~ ~., .~.:.~.: .. Lot: Block: Subdivision: Depth to prpe bosom from odgrnal grade:R ~pth b~e~ plp~ 101A - - , WELL: D New ~ Upgrade n. Ft, ~ OPM Pump Set Ab I~li.o H8~ght ~ove Ground: .. .. TANK SEPA~TION DISTANCES · sepfio a .oldl.g a -rom Tank Reid Stet[on Tonk s.~.r Un.~ ANCHORAGE TANK 1000 Well 100'+ '100'+ N/A N/A 25'+ STEEL 2 SurfaCeW~ter 100'+ *~00'+ - LIFT STATION KNOW~ Drain ~emarks; *PER INSPECTION REPORT, BENCH MARK ~(~ ~~/~ BOSOM OF BACK DOOR THRESHOLD J ~sumld Ei.voflon: 100.00 Ft, ,fp?' Inspections pedormed by:. AWWC, INC. Dates: 2nd 8/2/991st 7/31/99 ~ )~ ......'(~"-/.~i ~~....~: .... Oepa~ment of Health and Human Sa.ices approval Reviewed and approved by: ~ ~. ~ D~te: ~- ~- ?~ q~" ........... " PERMIT NUMBER: AS BUILT DILAWING PARCEL ID NUMBER: SW990236 m 051 --172--47 WELL ~ FCO 6,25 : 37,5 x ST2 51,5 77,5B DBL1 55,5 79,33 co2 ~k DBL2 5~,33 79,67 C02 51,75 72.17 FCO~ OIVERTE CRIB 60,5 78,25 S_MP ~ ~ 001 ~ ~ .~ ~ ~/ C~MT ~ ~ISTING DI~INRELDS ' / ~ ST~ ~ x. / [~PROX, LOCATIONS) ~PflC T~K ~AS~ WATER ~ WASTEWATER CONS~T~TS, ~C. LEGAL DESCRIP~ON: T~SN, mW, SEC. ~; LOT ]0]* ~PE OF WORK; AS-BUILT FOR SEPTIC SYSTEM UP6RADE ~ ~ ~;~..;~.../...~ PREPARED FOR: PHONE NUMBER: JOHN WOODS (907) 688-3266/269-3034 %%~ '... ......... .. K.D.W, = 30' 2 OF 2 A B FCO 6,25 37.5 ST1 45.08 71.83 ST2 51.5 77,58 DBL1 5.3,5 79.33 DBL2 54.3.3 79,67 C01 49.75 71.0B C02 51.75 72,17 FD 51.0B 72.0 CRIB 60.5 78.25 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services 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 Date Issued: Jul 29, 1999 Expiration Date: Jul 28, 2000 Permit Number: SW990236 Legal Description: T15N R1W SEC 18 LT 101A Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: John Wood OwnerAddress: PO Box 771186 Eagle River, AK 99577-1186 Parcel ID: 051-172-47 Site Address: 019632 ADRIAN AVE Lot Size: 44764 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 t5.55 and 15,65 and the State of Alaska Wastewater Disposal Regulations ( '~ 8AAC72 ) 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. Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-B ~ Anchorage ~ Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers July 29, 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 Tank Upgrade for T15N, R1W, SECTION 18, LOT 10lA To whom it may concern: The property has a 3 bedroom house on it which is served by a private well & septic system. The septic tank has collapsed and must be replaced immediately. At this time we ate tequesting a permit to replace the septic tank only. Attached is the site plan, which shows the proposed location for the new tank. There are no surface waters or well radii that will be encroached upon by this install4tion. If you have any questions, please contact me at 337-6179. h~d~ylA.'~arfiess, P.E., M.S. P~ :si/l~nt I I ~ I ~ I I I ~t,'.) //8 / ' GENERAL LOCATION / ~, ~ //--~T~ WELL / ~1 / .// / / T~SN, ~W, SEC. 1~ T~SN, mW, SEC. 18 / / J / / ~ aEOROOM HOUSE / // /] / ,_100' W~LL ~DIU~ / ~1 ~EXI~INO SEPTC TANK ~' / / / / ~/ ,;~2~t~ ~, I /,/ /~ // J ,/ ' I // / ~ [ = LOT 125 , T15N, R1W, SEC. 18 ~AS~ WATER ~ WASTEWATER CONS~T~TS, ~C. PHONE: (007) 337-6179/F~: (907) 338-3246 .' ~,~c.,~o,: ~?/ //~" , T15., ,~w, SEC. ~S~ LOT lO~A ~.~/fl ~F~ "~ SITE P~N PREPARED FOR: PHONE NUgBER: ~."~CE-7953 .," 688--3266/269-3034 JOHN WOODS (907) "~_',.,, , ,.. ~ATE:7/29/99 ID~wu ~Y:K,D,W. SCALE: 1 = 100' PAGE: 1 Of 2 COMPL~ION OF THE SEPTIC SY~M UPG~DE, / ~ ~ m~mNo D~NFIELDS LL DBL m ~ I ~AS~ WA~ ~ W~STgWAT~E CO~S~S, ~C. PHONE: (907) 337-8179/F~: (907) 338-3246 " .... LEGAL DESCRIPTION: T15N, R1W, SEC. 18; LOT 101A SITE P~N FOR SEPTIC TAhlK DESIGN '.ePAREO FOR: PHONE NUmBER:688_~266/269_30~4 JOHN WOODS (907) DATE:7/29/99 D~WN BY: SCALE: PAGE: K.D.W. 1 = 30' 2 OF 2 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 PHONE [] NEW MAILING ADDRESS Jweu .~ J~tion area Dwelling PERMIT NO. DISTANCE TO: ~ ~ Manufacturer Material No. of compartments ~ ~ Liq. capacity in gallons iF HO DE: Inside length Width Liquid depth ~_~O ~ Manufacturer ~ ~ / J Material -- Liquid capac~ity in gallons ~ DISTANCE TO: Well ~ u ~ No. of lines Length of each line Total length of lines Trench width Distance between lines ~j Top of tile to finish grade Material b ]e ~ Total ef)ective absorption area Length Width Depth ' PERMIT NO, ~P Type of crib Crib m ter Crib depth Total effective absorption area m W Building foundation Nearest lot line ~ DISTANCE TO: ~ Class DD~th ~ Driller Oistancetolotline ~E'~MITNO, ~ DISTANCE T ildin atlon Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS __ 72-013 (Rev. 3/78) FIPPL. I C:FII'.,FF .]'OHN [?.. HIZIO[.':, i ..OC:I::IT I Oiq I..ECq::IL LOT ::[.O'1 la :E;-::L6~ T:I.51'.,I SI:;'. ::L E;O;:':: ;:%~:7'O C:HLIGIFII<: FIK I'R:I..I-,.I LOT 5; I ZIE 9'.r.'.'~:~%'-)9S~ S(;:!LIFII~:E FEEl" T'¢I:::'E OF' :~i;(:IIL izlE;5;O[;~:P"f'iE~iq SY:T',TEH IS: TRENCI-I HI:::~XZHU['I i",iIJHiE~E:F,: OF:' I~i:E[:'F~:OOI'i:S .... SOIL F:'. FFF t I",IG 'f'HE [~:F:.-.':L?.!I._I ]: F::[~:E:, ~; ]: 2% OF' 'TI-IE' 'SO I I... RBSCtF:F'T I O1'.,I S.i'¢'.STEM 15;: THE I._EI'.,IG"FH E) I IdEl'.,IS I ON I :F., THE: L. EI",IGTH ,:: I N I::'EET ::, OF THE TREI',IC:H OF;: I;::,I~'.FI I NI:' I ELF.:,. 'T'FI[E E:,EPTFI OF FI TRENC:H OF?. F'IT I:E; THE I)t:::';TI'":If.,IF_:[:.' E:ETI4EEI9 THIS SI..I[~:F:'FIC:E ElF' THE GI:;:OLINE:, FIND TFIE E:OTTOPi I.".'IF ']"HF-~ E',,':;C:F:I',,,'I:::ITIOI"~ < I I",l FEEl".':'. THERE Z'.':~; NO :E;ET I.,.IIE.,TH FOR TRENE:HES. THIE (:~I~:FI',,,'EL D, EPTH I:~; THE i'"llf',lll"lLJl'l [:'EF'TFI OF GRR',,,'EL BE'FHEEN THE: OIJTFFI[..L PIPE laND THE E:o'r'TOM OF THE: EXCFI',,,'FITIOI'.,I <ll'.,I FEET). ..............141 I...: ............. FI I I :. [:,EF'I::IRTP1EI",IT [:,IJB: I 1',16i TFIE F'l!ii;l:l"l:["l" PI FI I .~ I~ F TIdE [.E.:,F..i~:,II:,iI-I 1 TCJ INFOI2. H" ':: 1HI_, [F-I EF~I~ FINI":' THE IH':r, TFILLF:ITZ--N .I.[I-[ L._."I I-IL. OF FIl",l"r' I.]I.-I...L-, FII%J'I'":IC:EI",I'T' NI. Ji"IEff'ZF?. OF' F4'.ESIDEI",ICL:::E; T'I'"IFI"[' THE P.IELL. I-,]IL.L. ...................... -I{'" ~..JI I(~ll ":: ;2~.~ .":" % ["",~ "-:"~; Il::::" EE E:F~CKF I L.L.:t: I",IG OF RI",I'¢ S'i"r'S'I"EM 1.41 THOI..IT F I NFIL I NSF'EC:T I OBI FIN[:' F:II::'PI~::OYFIL [)E':F'F:IRTMEI",I"I' I.,.IILI... BE 5~UEL:rEC:T TEl I,'I]:I'.,I]:I','IUI,'I D IS"FFiNE:E E:ETI,.IEEN R HELL I::1['.,1[::, RF,I'T' OI",I-:.:.';i-FIE SEHFIGE I],IE;I:'O"Z, FIL S'¢STEPI IS :LOO I:::EET F'OR FI F'R]:',,,'FITE HEL. L. OF.: ~L50 TO 200 FEET FF:OFI I::1 F'UBL. IC HELL DEF:'EN[:'II",IG LiPON T["II~ "F'¢F'E: OF' F'I_II!!d_IC HELl ..... I'i I ?',i I HUM [:, I :S TFII",IC:E FI:;'.OM f::l F'R I VFITE WELL. "1"O R F'R I 'v'FiTE.' L:';IEI.qER L I hie i S 25 FEET FIND TO Fl COI'IidI.JNI'I"'¢ '.SEI,.IE:.R LINE': IrS 75 FEET. OTI.~[li~R: Iq:E'.(~!UIRI:!]'IEI'.,IT:S HI::I'¢ F:IF'PL"r'. .:,F[:.L. 1F1L. HI ILd'4..., FII",I£:' -:Fff..IS"I"R "TIZd",l £:,IFIGRFIM£"~; FII'TdE F:t',?FI I [.F:fl3L.E TO Z NSLiRE F'F?.OF'E:F?. Z I",ISTFIL. LFIT Z ON. FOF?.TH EA¢ THE HI. JiqICZPFILZT¥ L")F Ir:INCHOI~'.FIC'iE. ;7: Z HII.J... INS-I'F:II...L THE :E;'T'STEM IN FICCI3RDFINCE WITH THE CODES. P.IITH TI-lIE F4tEQIJIP..'EP'IEBFFS FOR' OI'.,I-S:[TE SEHERS FIN[::, IqEL..LS; FI':C, :.SET THE: POIJCII 6-650 ANCIIORAGE. Al {90;) 2(}; 1!]1 January 4, 1982 John Wood SR Box 680 Chugiak, AK 99567 Permit # 810986 Subject: LOT 10lA S 18 T15N Ri~ SM A permit issued by this department for a well and/or sewer system has expired as of December 31, 1981. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an sewer files. engineer inspected the installation of the on-site system, please have them send us the as-builts for our If there are any further questions, please call this office at 264-4720. Sincerely, Sewer and Water Program Enclosure: Copy of Permit I::'[i~FU"! I T IqCI. ~:gPF'L ! E:F~I",F F L. OCRT I ON LE;GFII ]'C)H["J t"1]: % 5 S [~:[[~:CFII,.!OOD L. OOF' LOT ::lJ~d..FI S :LQ T::!..SN [;::L!.,.I :~;1'"1 I...CF/" SZZE ,~h!5~)!:i!llZI S6.]LJI::ff;?.E I:::E;;Ei:'I" 'T'YF'E (::Il::' SOIl_ f:I[.:~SORF"f' ]: ON '6Y:~:;TEM IS: 'FRENCH i"IFIX]:FII...II'i I",!I..IP'IE',EF.-.' CIF' BEDf,;:OOI"IS ,;~ SO]:L., RF('I'II",IG '::S~]:! F"f',.'"Eff;:) .... ::1.55 TI~IE 17E(;!U I F?.ED '.E; :[ ZE Cfi:' 'THE SCI ]: L. REr. i:~;OF4:I::'T :[ Obi S:;YSTEH ]; S: F'HE t...ENG'TH D :[ HE;NS ]; ON :[ S THE L,.EI",IGTH < I N FEET ::' 131::' THE TRENCFt OR DF.'.'FI I NFI EL.I::'. THE [)EF'TH C)F' la -I"I:~:EI",!C:H OR: PIT IS:; THE I~,I'.'i~;"Ff:'Ii",!C:E E=ETI.'.IEEN-rile SLI~:FFII:)E Cfi:' 'Tt,,IIZ 12iI:,:.'.CIUN[:, FIN[:, THE F~OTTCiH OF THE: EX:.:',CFI',,,'FFI':[OI',~ ,(IN FEE'T). 'ITIEI:N'.[C :IS NO SET I,.IZDTH F:'OI7 THE C!iI:;~IFY,,,'[EL. D[EF"/'H :['_5 THE P'I:[NIHI...IH DEF'I'H CIF GF~'FI',,,'EL, E~ETklEE;N TH[':'.' OIJTFFIL.L. F:'ZF'E t::IF,I[) 'I'HI'Z E:C'ITTOi',I OF THE: EXC:FI',,,'F:I'TIOI'.,I (:IN F:EE"f'). F'EF?J',I ]: 'I" FIPPL.]:C:f:II'.,I'T FIi::iS 'I"HE I:;?.E:SIX'I:]NSIEC[L. ITY "I"CI INF'O[;?.I','I 'TH]:E; DEF'F:IRTP'IEI'.,IT [:,[.l[;i:]:i~.,!(:i THE ]:I'.,IE;TFILLF:I'I"]:CiI'.,I ]:I'.,I:!i;I::'IEE:T:[ON'.E; CIF FII'.,!Y HEL. LS I::ID.J'FICEIqT 'l"O 'T'HZS F'F?,EIF'IE[~:'T'Y [::lf..!l::.', THE IqUI'flE:EF?. OF F;'.E:i!!;I[:,EI'.,ICE:ii; THFIT "I'HE I.,.IELL IqZL.L ':Z.;EF.'.',,,'E. I!!~FIC:I<:I::' I L..L.. :1: I'.,!G OF' F]NY SYSTEM 14 [)E:I::'FtR:TH[~:N-F I,,II[..L E~E SLJEL:FEC"F "FO F'F?.OSE;CUT]:OI'.,I. H :[1'.,! !' P1UH [> I S'FI::II'.,IC;E E:ETP.I[EEIq FI I,.IELL. FII",ID Fll'.,l'.r' OI'.,F-S I 'f'E SEI-41::~CiiE: [> :[ SF'OSFIL SYSTEH :[ S ::L~Z,,_TI FEET FOR'. Fi F'RI',,,'FITE: I4[:_'L.L. 017 ::I.~SEI 'TO ;;2EH;~ FEET F:'F.:OH I:::1 I::'UEIL.]:C I.,.IEL.I... [:,EF'Ef'.,!D]:i'.4G I.Jl:::r(]lk! 'f'H[E "f'"r'PL:: OF F'UBL.:[C I'~,ELL,. h'l:[l",!Zh'll..Ih! D.'[S~;'f'F:II",II:::[% F'l:;;%ff'l fa F'RI',,,'I::I-FE I'-IEL.L 'l'O FI PRI","FITE S[ZI.',IEF;: I,,..ZI",IE IS ;?.!Zi I::'EE:T F:!I",!I::' 'T(] FI E:OHHUI",!]:TY '.'~;EI,.IE:I'7 I.,..IINE IS 'TEl FLEET. OTi'I[ZF;i: 1711~QLI ]~ F~'.E;P'!EIqT'z"]; t"II::IY FIPF:'L..Y. SPEC I F I CFIT :[ ONS FII",ID CO[",PE;TRI, JC'I" :[ OF,I D I I:::ICq;?.FII'"IS F~I:;[:E; FI',,,'F:IZI..FIE~L.E TO IF,IE;I...IF".E PROF'[E[[: I!",I',E;TFIL, I.,.FIT:[OI",I. :[ C:EF.:."TIFY THFIT J.: ): FIH I::'I::IF'IIL..:[FII:~: I'.!:[TH TliE RE(~:H..IIt:,~:I'EH[':'.'IqTS FCI[':". ON'"'SZTE SEI.'.IE:I;?.S FIND I,.IEI-LS I':1'-:!; SET F:(.)ITTH E?T' TIdE F1L.II",IZC:]:F'Iql..,:[TY Cfi:' ¢alqC:HOR:FIGE. ;2: ]; I,.!]:LL ]:NS'TFI[_.[.. TFIE' SYSTEM ;iN 2OF;:DFII",IC:E P.II'I"H THE CODES. [~:: Z I. JNDE;f;'.STFIN[) CII",F S"r'STEI'd f'lf:IY f:]:E6!U I RE ENLFIF4'.GEP'IEN'T' I F I"FIE 17ESIDIEN(:::E: ];S t;:l I'"IOf~'.E THFIN 2 'v'4.. Et Gr '~TER ANCHORAGE AREA BORO~'~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-251 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM t?llz , SEPTIC TANK: DISTANCE FROM WELL L/~0 ! LIQUID CAPACITY /~[~ GALLONS. MAILING ADDRESS LEGAL DESCRIPTION MATERIAL '~'":/~=~',/~ NUMBER OF ,~ COMPARTMENTS LIQUID INSIDE LENGTH. .INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: J NUMBER OF PITS / OUTSIDE DIAMETER --- or WIDTH /'Ug' NEAREST LOT LINE'- '/~'~) '/~ '~'~'~/~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , DEPTH , BUILDING FOUNDATION. SQ. FT, TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES / ABSORPTIO~ DEPlH: lOP OF IILE 10 FINISH GRADE TOTAL LENGTH ~:'O~NgA.T~N ., NEAREST LOT LINE , OF LINES DISTANCE BETWEEN ~ TRENCH WIDTH TIN, TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH~- ~ DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPE /~),'4~U/'//~'=,'~ DEPTH ~ LOT LINE ~/'~ NEAREST .-- SEPTIC ., SEWER LINE , TANK DISTANCE FROM /~x-~ / WATER ~. · BUILDING FOUNDATION SAMPLE , NEAREST (¢~/~'~ / SEEPAGE ~/'~ / -~-- OTHER , SYSTEM , CESSPOOl , SOURCES DISTANCES: DIAGRAM OF SYSTEM HEALIH AUI~RI]Y 327 E~~3LC STREET A~CHORA~E. ALAf~LA 99501 Depth This Form Reports Was Ground Water Encountered?_.,_//~/2 I~' ~,es~ At ,i~at Depth Net Drop ...... Drain Field Frcoo:?,a hmtallal~,m S.,c, a:,e .~,~- , - :.+ r-~ Trench j.~,, ::' . · --:r'::'"::"'~2 ~, ~..~ , v* ~'u~_ eZf~[.~.~ - , m....// Test Performed BY~,,~[~2~)~L~ .................. ~7~/~' GREATER ANCHORAGE AREA BON,JUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE. ALASKA 99502 PErmit SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK ~/ DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED ~ FINANCED THROUGH SO,L TEST RES.LTS COMPLETION DATE ANTICIPATED FINAL IN~PEGTION~ 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYETEM WITHOUT FINAL INEFECTION BY THE EEP^GE AREA S'ZE TYPE / FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT ., DRA]N FIELD SEPTIC TANK TO SEEPAGE Pit WALL SEPTIC TANK .,SEEPAGE PIT DRA]N FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD . ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD SEPTIC TANK, SEEPAGE PIT , DRAIN FIELD . TO RIVER, LAKE, STREAM. CASt Iron INTO ANO OUT Of SEPTIC TANK AND INTO CRIB CROSSING GAP Of EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 [NCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE P[T FITteD WITH AIRTight REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM HEALTH AUTHORITY OR LICENSED DESIGNER ] CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DescribED SYSTEM IS IN ACCORDANCE WITh SAID CODe. DATE APPLICANT'S S]GNATURE GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Cony. Date Received Time of Inspection . Date of Inspection May 4, 1976 10~0 0:~ m. 5-7-:~ Friday I. Approval requested by: Mailing Address Property Owner: Mailing Address Legal Description: Location: Alaska National Bank of the North (University Branch) Phone: Phone: 3901 Seward Highway, 99503 Allen R. & B'everly A. Marple 279-4585 688-2207 Post Office Box 698, Chugiak 99567 T15N R1W SE¼ NE¼ Section 18 Lot 10lA, resub Lot 101 NHN Adrian Avenue off of Birchwood Loop Road Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: A. Type Individual B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On-site system. A. Installed B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line t , Absorption area , Other contamination , Sewer Lines __ B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line __ EQ-034 (1/74) Page 1 of two pages ,©o MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C' Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF ANCHORAGI:: DEPT. OF HEALi'H & ENVIRONMENTAL p,'<OTI!CTION RECEIVED Type of Inspection: CMRO VA FHA Property Owner: ALLEN R, HARPLE and BEVERLY ANN HARPLE CONV X Mailing Address: P.O, BOX 698~ Chugiak, Alaska Day Phone 688-2207 3. Name of Buyer: QOHN E. WOOB and CATHERINE B, WOOD Mailing Address: P.O. BOX 8167. Anchoraae. Ak. 99508 Day Phone 688-3266 4. Name of Lending Institution: ALASKA NATIONAL BANK (University ¢.enter Branch) Mailing Address: 3901 Seward Hwy,, Anchorage, Ak. 99503Phone 279-4585 5. Name of Realtor or Agent: NELL 6IBBS or ALMA WERRE (Selective Realt.y) Mailing Address: 1515 E, Tudor Rd,, Anchoraqe, Ak, Phone 279-8624 6. Legal Description: Lot lO1A, a subdivision of Lot lOl~ SE~ NEb $18 T15N R1W S.M. Location: NHN Adrian Avenue off Birchwood Loop Road Type of Facility to be inspected: Sin.qle Family Residence Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served Individual One No. Bdrms. 3 If Individual, depth of well Sewage Disposal System Type of System: If Individual, date of installation Unknow~ Public Utility Unknown Individual (on-site) EO-037 (1/74) Page 2 of two pages - Re( ;t for Approval of Individual ~ Jr & Water Facilities Legal Description T15N R1W SE¼ NE¼ Section 18 Lot 10la, resub of Lot 10,1 Comments m /~/~. /) /L/~ /; Approv~~ .~f Disapproved f>f~f '" Date ¢~ Approval~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) 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 PHONE [] NEW MAILING ADDRESS Box LEGAL DESCRIPTION LOCATION ~ ~1~-'~'~¢'~ ~_~ NO. OF BEDROOMS~.~ PERMIT NO, DISTANCE TO: ] WeJJ LD~E Liq. capacity in gallons Well DISTANCE TO: Manufacturer Material No, of compartments Inside length Liquid depth Well DISTANCE TO: /~''- ''/'' No. of lines of each line Top of tile to finish 9rede q~-~'" T'~ ~L~" Length Width Type of crib Crib mter DISTANCE TO: w6m/ Class D~u >th g~dd DISTANCE T ildin ation Total length of lines Material ben'~eat h~ t~l e Depth Material Nearest lot line I Trench width ~ --~.. inches PERMIT NO. Liquid capacity in gallons PERMIT NO.~9 ~O~ Distance between lines Total effective absorption area PERMIT NO. Crib depth Total effective absorption area Building foundation Nearest lot line Driller Sewer line Distance to ~ot line PA~ sro rMi t~ o~'r e a ( s ) Septic tank OTHER PIPE MATERIALS 72-013 (Rev. 3/78) LEGAL ¢¢ 7-/5-/,/ PERNIT NO. RPPL'ICFINT JOHN E. 1.,.IOOD LOCRTI ON LEGRL. LOT :lEI'.:[ R S-.'L8:1".:1.:51`..i SR :£ BOX 23?0 CHUGIRK RK 688-~266 L. OT SIZE ~9999D SQURRE FEET T'¢PE OF SOIL RBSORPTION SYSTEM IS: TREI'.,ICH I'iFI;:.C[I'IUt'I NUI"I[.:JEI:[: OF BEDROOHS = SOIL RRTING (SQ FT?BR)= ~.55 TFIE RE).'qUIRE[:, SIZE OF 'THE SOIL. RBSORF'TION S'¢STEM IS: E.:, E:_." F' ]'" I-,--i ='~ :J_ ICZ', L_ E I"-,,~ G "T' H = 4 ,=";. ~; C~ F: FI"..." E IL [:,EF"'T H= ~'; THE LENG]"H DIMENSION IS THE LENGTH (IN FEE].') OF I'HE TRENCH OR DRRI1`',II='IELD. TNE [:,EPTH OF R TRENCH OR PI]' IS THE DISTFINCE BET[,.IEE1`4 THE SURP':RCE OF THE GI:~¢.OUND FIND ]''HE BOTTOM OF TNE EXCR',,,'RTION (IN FEE].'). ]"HERE IS I'40 SET NI[:,TH FOR TRENCHES. THE GRR',,"EL DEPTH IS THE MININUM DEPTH OF GRFI',,,'EL BETP.IEEN THE OUTFFILL PIPE FIN[:, THE BOTTOM OF' ].'HE Ei,..','CFI',,,'FITION (IN FEET). ',; '-'" '- ,' ' rFlI_, DEF'RRTMENT [:.,URINL~ THE PEF.:HIT RF'F'LICRNT HI-_ THE RE=,FuN=,IE, ILIT-r' TO INFORM" '~- ' '" INSTFILLFITI]N II I_FE.~.TI.t,I= OF FIN'-r' [,IELLS RE:i..TFICENT TO THI_:.'; PRI]PERT"r' FIND THE NLII'IBER OF RESIDENCES ]"HFIT ]"HE NELL NILL SERVE. BFICKFIL1...ING OF' RN"? .S'¢STEi"I 1.4ITHOUT FINFII... INSPECTION RND FIPPROVFIL E¢'r' TNIS DEPRRTMENT 1.4:[I._1_ BE SUBJECT 'fO PROSECUTION. MINIMLIM DIS"FRNCE E:ETNEEN FI NELl._ RN[-" FIN's" ON-SITE SENFIGE [:'ISPOSRL SYS]"EH IS :.[.88 PEET FOR FI PRIVRTE NELL OR ::L50 TO 288 FEET FROH R PUBLIC NELL DEPENDING UPON ].'FIE; T"r'PE: OF F'USLIC !.4ELL. MIiNII"IUH DISTI'~NC:E FROH F:I PRI',,"RTE P.IELL TO R PRI".CRTE SENER LINE IS 25 PEET RND TO Fl C. OHHUNIT'¢ SENIER LINE IS 75 FE~ET. OTNEF.': REI;!UIREHEI",ITS MR'T' FIPF'L'¢. SPEC:IFICRTIONS FtND CONSTRUCTION DIFIGRRNS FIRE FIVFIILFIE:LE TO INSLIF.'.E PROPER INSTFILLRTION, t CERTIF"r' TNFtT ~'L: I RM FF~HIL. IFIR NITH "rilE REQUIREI',IENTS FOR ON-SITE SEWERS RND I.,.IELLS RS SET PORTH B"r' THE I"IUNIC:IPRLIT'¢ OF' RNC:i40RFIGE. 2: I NILL INSTRLL 'THE S~"STEH IN FICCOR[:'RNCE NITH THE CODES. ]~.: I UNDERSTRN[:' THFr'F THE ON-SITE SENER S't':<TEN l"lR"r' RE6!UIRE ENLFIRGEMENT tF THE RES IE:,ENCE,,,~S REMO[:'EL.E[:' TO INCLI_IDE MORE TNI=IN 2: BEDROOMS. ~., I bi",IEE,. T ..TI]INN E. ANGItORAGI AI A%i',/, (9/),) 261 ,1!11 January 4, 1982 John Wood SR Box 680 Chugiak, AK 99567 Permit ~ 8].0986 Subject;: LOT 10lA S 18 T15N R1W SM A permit issued by this department for a well and/or sewer system has expired as of December 31, 1981. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264--4720. Sincerely, ~oSg~mB~Cahnha~lerZ~~ Sewer and Water Program Enclosure: Copy of Permit PERI'II T F,IO. DEPFIR'T'i"IENT OF HEI::~L.'T'H I::'llq[.'., ENVIRONMENTR/.. PF~!O'T'ECTION :~:25 '"L'" '?TREET., RNC:HORFIGE, FILE. 995EEL FIF'PL. I C:lahlT L. OCFI T I ON !... E GI::~L ,:r OH['.,! HOOE:.., MI .2. 5 S BIRCHI.4OOD LOOP LOT :I.C'd..R S .28 T::L5N SR E~OX 680 CFIUG:t:FIK LOT SIZE 46OOE~ S(;!t]FIRE FEE'r 'T"¢F'E OF:' ?~;OIL F:IB~;ORF:"T' :[ ON S~'2;TEM Z¢5: 'T'RENC:H I',IR',,<IMI...IM NUMBER OF SO:EL RRTING ,::S*:;.:! F"T',..'E:I~::)= .255 THE I~:E[~L.I:I;RE£:, :iE;:[;~.'E OF' THE 5;OIL FE.:.~SORPTION S~r':~;'i"EM IS: "FHE L. ENG'I"H [':' :[ ME:NS I ON IS THE LENGTH (IN FEET::' OF THE TRENCI'..I OR [>RFIII'.,IFIEIJ). THE DEPTH OF' FI TRENCH 01~'. PIT IS, TFIE DI'.E;"FI::Ii'.,ICE BE"I".t,.tEEN THE ~;I_JRFI:::IC::E OF' THE GF.:OUN[> FIND THE BOTTOM OF THE: E:.%',CI::IVRTION ".:IN FEET>. THERE IS NO :F.';ET klI[YT'H FOF.'. TRENCHE:E;. 'THE GRFtVEL [:,EF'TH :[?~ THE MIhlII'qUi'q DEPTH OF [.~iRI:::I',,,'EL. BETI.,.IEEN THE OI...ITF:'I::IL~L. PIF'E FiND THE BO"FT'C~M OF THE EXCFIVF:Fr'ION <IN FEET>. F'ERMIT RPPL. IC:FINT HRS THE RESPON!~;IBILIT'¥' 'TO INFORM THIS [:,EPF:IRTMENT DURINE~ THE IN:.E;TI;:tLLF:ITICiN IN:~;PECTIONS OF FII'.,I'¢ !.4ELLS IRD..)'FICENT TEl THIS PROPERTh.' F:IN['., THE NUPIBER OF RESIDENCES THFIT THE 1.4ELL. I.,.IILL L=;ERME. BFICI<FILLIN(:~ (]F' FIN'¢ S~r'!.E;'I"EM I-4ITHOUT FINFIL INSF'ECTIOi",I FIND, FIF'PRO',,,'RL. Bh" 'I'HI!~; I]:,IEF'F~R]"i'4ENT 1.4IL. L BE SUB.'rECT TO F'ROL=;ECUTION. MIN:[f,IUFI [:,IS"['FINCE [::':ETP~EEIq F:I 1.4ELL ::Le~b F'EET F'OR R PRI'¢Fr'f'E 1.4ELL. OR '258 TO 280 FEET FROM FI F'UBLIC 1.4EL. L DEPENE:,ING LIF'ON THE Th.'PE OF' F'UBLIC 1.4E:LL. MINIMUM [:,IE;TFINCE FROi'4 R F'RIVRTE 1.4ELI... 'TO R PRI',,,'R'TE: SEI.,.IER L. INE IS 25 FEET FINE:, TO FI COi"l["ltJF, IIT*r' SEI.,.IER L:[NE ]ES 75 FEET. OTFtER REf;II.JIF?.Ei"IENTS f'lFl"r' f:IPF'L'¢. SPECIFIC:FITIONE, RND CONS"I"RUC:TION I:>IF:t[:'~F.':FIMS FIRE FIVFIIL. FIE[LE TO INSURE PROPER I C:EI:R~f'IF~'r~ "['I~II::IT :1.: I FIM FFIMILIF:IR Iq ITH THE RE:[;:!UIREMENT..S F'OR ON-SITE SEP.IERS FIND I.,.IEL. LS; I::IS SET F'ORTH E?'r' THE MUNtCZPFI!-..I]"'~" (:IF' RNCI'"IORFIC:iE. 2: I 14ILL INSTFIL. L THE '.~2;'¢STEM IN ~ORDFINCE !.4ITH 'T'HE CODES. ?.: I UI"~DERSTFIND ON' ':_"]~'r'STEM fqf:l"r~ RE6!I..tI[~]:E I:ENLFII~!I3EI"tENT :IF' THE RE::E;]:DEi",ICE tS RI MORE THFIN 3 BE[)ROOi"IS. S I GI'.,IED: Gr '~TER ANCHORAGE AREA BOROI'~,H HEALTH DEPARTMENT ~T°. 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM w / LOCATION xo ? LEGAL SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY /O~ ~) GALLONS. MATERIAL '~:/~J~*-~"~ NUMBER OF COMPARTMENTS LIQUID INSIDE LENGTH. .INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER ~ OR WIDTH LINING MATERIAL ~'~'~/ J~C~,~dI~X~) , DISTANCE FROM WELL /~'~ / , NEAREST LOT LINE 3~/~ /~ ~'~S/ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,LENGTH /9 ,DEPTH BUILDING FOUNDATION. d44 SQ, PT. TILE DRAIN FIELD: TOTAL LENGTH ~u ION NEAREST LOT LINE OF LINES DISTANCE FROM WELL ~ , Ctt~g~lON , -- NUMBER OF LINES / DISTANCEBETWEEN TRENCH WIDTH IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE .DEPTH OF FILTER MATERIAL BENEATH TILE iN. ABOVE TILE ~ DISTANCE FROM /~' / WATER ~ WELL: TYPE /~////~-/~ , DEPTH , BUILDING FOUNDATION SAMPLE , NEAREST LOT LINE c~"~/ NEAREST SEPTIC (~ / SEEPAGE /J~,~ / OTHER , SEWER LINE. -- ,TANK ~ , SYSTEM , CESSPOOL ~ , SOURCES DISTANCES: DIAGRAM OF SYSTEM DATE APPROVED ANC}iO~A{~}5. AI,Af'FA 99591 Date I,oc~tii:n Sketch Depth ,. · - ~ ee!. Soil Ch~t. :ct,~u, stics Was G~ound Waler Encounter'ed? , at Depth , ~' iqme ~4e'~' Time Depth Read lng Pat e ~pc .., ' - ' Net Drop ' ' ' Depth 'to 15~.,ttom Of , Test Performed . ~ GREATER ANCHORAGE AREA BON,JUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCh 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT // DRAIN FIELD SOIL TEST RESULTS , OTHER. NOTE~ THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD DRAIN FIELD . SEEPAGE PIT. ALSO CONSIDER AREA WELLS, SEEPAGE Pit · DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCh DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH Airtight REMOVABLE CAPS GRAVEL }BACKFILL CONFORM TO BOROUGH RegULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM health AUTHORITY OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITh THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND ThAT THE ABOVE DESCRIE~ED SYSTEM IS IN ACCORDANCE WITH SA[]:] CODE. DATE APPLICANT'S SIGNATURE iUO F GREATER ANCHORAGE AREA BOROUGN Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received ~ May 4, 1976 oo/ Time of Inspection lO ~m. Date of Insoection 5-7~ Friday REQUEST FOR APPROVAL 0F Fre~ Se~tty r0R / \ Cony. / 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. Location: NHN Adrian A~enue 5. Type of facility to be i,nspected Alaska National Bank of the North (University Branch) 3901 Seward~Highway,. 99503 Phone: Allen R. & B'everly A. Marple Phone: Post Office Box 698, Chugiak 99567 T, I5N R1W SE¼ NE¼ Section 279-4585 688-2207 18 Lot 10lA, resub Lot 101 off of Birchwood Loop Road Single Family No. of bedrooms 6. Well Data: A. Type Individual Depth C. Construction 7. Sewage Disposal System: D. Bacterial Analysis On-site system. A. Installed B. Installer C. Septic Tank: 1. Size Manufacturer D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines Material 8. Distances: A. Well to: Seotic.tank Absorption area ~ / /~0 ~L , Sewer Lines Nearest lot line , Other contamination B, Foundation to seotic tank ., Absorotion area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 -- 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF A~.cI[ORAGE RECEIVED, Type of Inspection: CMRO VA FHA Property Owner: ALLEN R, MARPLE and BEVERLY ANN HARPLE CONV X Mailing Address: P,O, BOX 698~ Chuqiakt Alaska Day Phone 688-2207 3. Name of Buyer: JOHN E, t~OOD and CATHERINE B, ~/OOD Mailing Address: P.O. BOX 8167, Anchoraoe, Ak. 99508 Day Phone 688-3266 4. Name of Lending Institution: ALASKA NATIONAL BANK (University Center Branch) Mailing Address: 3901 Sewar`d Hw,y, ~ Anchoraget Ak~ 99503Phone 279-4585 5. Name of Realtor or Agent: NELL G]~BBS or' ALHA t~ERRE (Selective Realt.y) Mailing Address: 1515 E, Tudor Rd,~ Anchor`aqe, Ak, Phone 279-8624 6. Legal Description: Lot 101A, a subdivision of Lot 101, SE~ NE~ S18 T15N RI~ S.~. Location: NHN Adr`ian Avenue off Bir`chwood Loop Road 7. Type of Facility to be inspected: Sin.gle Famil.y Residence 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Unknown 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation linl<nnwn No. Bdrms. 3 Individual One Individual (on-site) X EQ-037 (1/74) Page 2 of two pages - Re( ;t for Approval of Individual ~ )r & Water Facilities Legal,Description T15N R1W SE% NE¼ Section 18 Lot 10la, resub of Lot 101 Comments Approv~ ' , ~Y Disapproved~ )~C"~/~, , Date /Approval Valid for one year from/date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74)