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HomeMy WebLinkAboutHERITAGE HEIGHTS LT 23Heritage H ights Lo1' 23 #015-361-37 Municipality of Anchorage Page : DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: '.'V~ 143 '~/__,~ PID Number: Name~,.~___~,~ .~ ~ ~~ H' ~~Wastewater System: 0 New 0 Upgrade Address: j~ ' /~,, ~ ~~~~ ABSORPTION FIELD ~ - .... ' (j~ No. of Bedrooms: Phone: ~- Q~' I~'~ ~ OOeepTrench~OShallowTrench OBed OMound OOther so,'.~ ~o~, ~ep~h ~ro~ o~,~n~, ~d~: LEGAL DESCRIPTION GPD/S~. Ft. ILot: Block: Subdivision: Depth to pipe boffom from ~ade: Gravel depth beneath p,pe I .Township:.~,.~ . Sectiom ~. Fill added above original grade: Ft. ~ Ft. Gravel depth: Number of line~nce ~tween lines: WELL: New Upgrade Ft. I ~ Ft. Classification (Private A B C): Total Depth: Cased To: Total absorption area: Pipe material: ! ~'~1 .~ ~ ~,. ~. so. Driller: Date Drilled: Static Water Level:Ft. In~er:[~ ~ ~~ Date installed: Yield: Pump Set at: Casing Height Above Ground: TAN K GPM Ft. Ft. SEPARATION DISTANCES ~ptic ~ Ho~di~g ~ S.T.E.P. TO Septic Absorption Lift Holding Public/Private~~---,~~ ~ ~ Capacity in gallons: Matg~¢ ~ Number of Compadments: Well ..... _ : Surface w.t~, ~ I~ .... LIFT STATION LineL°t ~t [~ ~ ~ ~ Size in gallon~: Manufacturer:~ Cu.ainDrain ~ )~¢ ~DJ ~ ---- Pump Make & Model~ Electricallnspectionspedormedby: Remarks: ~~ ~ BENCH MARK ~~ ~ ~ ~ ~J ~ Location and Description~ ~ E ~~L by:~-~_~ ~,~ '~ IA~ kl'~i ~ ~ates: 1st--~--,~-/~1 - ~~;~~~' --' .... Inspections performed Department of Health and Human Services approval ~... Reviewed and approved by:~~ ~ ~ Date'. ~-2~-~/ '~OFESS~ 72~013 (1/91) MOA 25 ~-Permit.No. Page ~' of ~" Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well 'Inspection Report Legal Description: PID No.: N PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910265 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:GURR GEORGE R & LOREN M OWNER ADDRESS:196 E. ANDERSON RD. SQUIM, WA 98382 DATE ISSUED: 9/03/91 EXPIRATION DATE: 9/03/92 PARCEL ID:01536137 LEGAL DESCRIPTION: HERITAGE HEIGHTS LT 23 SEC 22, T12N, R3W, SM LOT SIZE: 9213 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVIS IONS~-~ DATE: DATE: i l Municipality of Anchorage Development'Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL · P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak, ua CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Pan:el I.D. 015-361-:57 1. GENERAL INFORMATION ExplraflonDate: ',7- ~ -'0 I Complete legal description HERITADE HEIGHTS SUBDMS10N; LOT 2:5 Location (slteaddrees or directions) 5949 YUKON ROAD * ANCHORAGE ALASKA 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real E'stete Agent Mailing address JEFF GROSS Dayphone ' 346-4207 5949 YUKON ROAD * ANCHORAGE AK. 99516 Dayphone CAROL BUTLER w/ REUAX-PROPER~ES Dayphone 2600 CORDOVA * ANCHORAGE AK. 99503 257-0161 Un~o~etwf~requeded, HAA~llbeheMbyDSDfor~ckup. 2. NUMBER OFBEDRoOMS: 4 3. TYPEOFWAI~RSUPPLY: Individual Well ' * ' Individual Water Storage Community Class Well Public Water System TYPE OF WASi~-WATER DISPOSAL: Individual On-site ~ Individual Holding tank Community On-site []~ Public Sewer ' The Municipality of Anchorage Development Services Depe;~ment (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In pomgraph 5 by an Independent pmfaeslonal civil engineer registered In the State of AJaska. Certificates of Health Authority Approval am required for the transfer of ti'de (except between spouses) for pmperUes sewed by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. CortJficetes of Health Authority Approval are valid for 90 days from the date of Issue for properties sewed 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 fora podod of up to one year with valid water samples.) Certiflcetes 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 omlsslons In the professional engineer's work. Note: Alaska Water and Westewater Consultants, Inc~ shall be paid $1601,25 a~ or prior to dosing for the engineering sangces provfded. 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 Heel~ Authodly 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 lypa of structure indicated herein. I further verify that based on the Information obtained from ~e Municipality of Anchorage files and from my Investigation and Inspection, the on-site water supply and/or wastewator disposal system Is(are) In compSance with all applicable Municipal. and State codes, ordinances, and regulations In effect at the time of Installation. NameofFirm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's PHnted Name JEFFREY A. GARNESS. P.E. Date En lnee[' Comme.ts: DSD Guidelines & Regula~ns. The repori~d resulls described ~e pen'ormance of anywa/ran~yo~'futureeslfmateofhowlonge~esystemv,471¢onUnue~omeetgle '~'~;.' rotess~ ~._.~, 5. DSD SIGNATURE Approved for IqL bedrooms. Disapproved. Condi~one! approval for __ be~' ' ' ' ' rooms, with the fllowlng supumaon~ - --& .... · - . Attachments: HAA Checklist SePtiC System Advisory · Well Flow Advisory · Manitenance Agreements Supplemente! Engineers Reort Other .... original Certificate Date: Municipality of Anchorage Development Services Department BuMing ~b' ~ Of~ Water & Wamvmtm' Program 4700 Sou~h 8mgaw St. P.O. 6ox 196850 Anchorage, AK 99519-6650 HEALTH AUTHORITY APPROVAL CHECKLIST Legal DescdptiOll: HERITAGE HEIGHTS SUBDNISION; LOT 23 Parcel ID: 015-561-37 A. INEU. DATA Wall type Ftmuc IfA. B, otc provide PWSII:W WeD Log (Y/N) Date completed ~ardtmy ~ (Y/N) Wires p~ Total depth ft. Cased to ~'lt. ~,..,..,,..~a~gT~alght (above ground) Date of test FROM WIEI.Ly AT INSPECTION WATER SAMPLE RESULTS: In. ,g.pJ~. .g.pJ~. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date Installed 9/6/91 Tank$1ze 1250 gal. Number of Comparlments 2 Cleanouta(Y/N) YES Foundation aleanout (Y/N) YES Depression over tank (Y/N) NO High water ~ (Y/N) N/A Data of PUmping · 3/6/01 Pumpef~ ISAAC'S PUMPING SERVICE AB$ORPTIONRELDDATA I*TF. STED SEEPAGE PIT ONLY. SEE ATTACHED LE'~if:.R. I 1) o/et Soil rating (g.p.dJfl'o,~)) leosystem type 1)~m:. Langlh ~tt. Width ~-) =,/~s lt. Gravel below pipe 2) ~'9 ft. 1) 11.6' 1~ ~27~2 Tc)~depth 2) 12' ft. Eff. absoq~ionama ~t~ Monlt~lngtube YES Depresalonoverlield NO Oate of adequacy teat 4/12/01 Resalts(Pass/ICall) *PASS For 4 bedrooms Flulddeplhinabsofl)tionfleldbefomtast 0 In. WatareddedlOa7gal. Newdepth 4,7 In. EtepseclTIme: 1421min. Flnalflulddepth 0 In. AJ~onmte>= 600+ g.p,d. Any mJuvanation Imalment (past 12 mo.) (Y/N & type) NONE KNOWN If yes. give clate - 5LL~'AGE PIT WAS PRE-SOAKED ON 4/11/2001 WITH 2000 GALLONS OF WATER D. h~',' ~I'ATION Date Installed Size In gallons 'Pump on' level at In.~ E. SEPARATION DlSl'ANCF.~ SEPARATION DISTANCE~ FROM ~ I ON LOT TO: Sep~c tenMlff ~teton on Ab~ field on Mot. Public sewer main Hlgh water alam~ level at Pmperty line. ,1' Water eewlce line 10'+ Curtaln drain NONE KNOWN F. COMMENTS Meets alarm & ctrcult requirements? PUBLIC WATER On adjacent lots Building foundaton 8°+ Surface water 100'+ Wells on adjacent lots 200'+ 5'+ Surface water. 100'+ ~'SEE LOT UNE WAIVER REQUESTI Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foondatten 4' Property I~e 5'+ Absorption field. Water main 10'+ Water eendce fine, 10'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM AB~ORFTION FIELD ON LOT TO: Water main. 10'+ Driveway, paddng/vehlcle ~orage G. ENGINEER'8 CERTIFICATION I cerSfy that I have determined tlvough field InspecSor~ and revfew of Munldpal records Inat Ine above ~]~terr~ are In conformance with MOA HAA guldeflnes in effect on Inls date. Engtneel'S ~ N~lnle JEFFEEY A. C, ARNESS Date .~_~o t 50'+ HN~ Fee $ '~oO Date of Payment (Rev. Date of Payment /-//--~ 5-0~ RecelptNumper .-'~c! ~7~' AI- ASIu WATER & wASTEwA ER CONSULTANTS, INC. April 17, 2001 Municipality of Anchorage Public Works On-Site Water & Wastewater P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver for Lot 23, tleritage Heights Subdivision To whom it may concern: We request that your department issue a I foot lot line ~vaiver from the northwest property line to the existing seepage pit. I am unaware 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 assistance. Je P.E., M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com Municipally, ,of Anchorage George P. 1I uerclt. Ma!lor Burring Safety Division P.O. I~x I!)GC~O · 4700 $. Bragaw Street Anchon~g¢, Alaska !ff)S19-i'W~O * t~)7) 343-8:~OI h t t p://~,~'w.ci.nnchoragc.ak.lls Department o~ Public Works AK Water & Wastewater Consultants, Inc. ATTN: Jeffrey Garness, PE 6901 De Ban: Road, Suite 2B Anchorage, AK 99504- April 30, 2001 Subject: Waiver Request forHERITAGE HEIGHTS LT 23 Waiver # WR010019 Lot Line Request for Parcel ID 015-361-37 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 1 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation d/stances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 3434744. Engineering Technician III On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Services Waiver Review Workshe~t WRS: 010019 PID~: 015-3~1-~? HA~: 010066 Perrnit~: Date Received: 042501 Legal Description: Herltaoe Helahts Subdivision: Lot 23 Engineer. Alaska Water & Wastewater Consultants. Inc. 6901 Debarr Road. Suite 2B. Anchoraee, Applicant: Jeff Gross Waiver Requested: Absomtlon Field to Lot Une Criteria: 1. Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 2. Special Conditions: 3. O~ec Points: Total: Waiver is Granted: List Conditions or Reasons for above: Waiver Is not Granted: Date: By: Name of Reviewer Rec~: Amount: 1t ~,~1) Date Paid: 04-2501 I I I OF OUTSIOC OIAML'TER Or [XISTING CRIB I I I I I I ........ , --I I I YUKON EOAD 4/17/2001 ........... DRAWN ~Y: CONSULTANTS, INC.. HERITAGE HEIGHTS SUBDIVISION; LOT 25, ~[ oF WORK: DRAWING FOR LOT LINE WAIVER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 23 Heritage Heights Location (site address or directions) 5949 yukon Rd. Property owner Mailing address Lending agency Mailing address Agent Address Chris Roach Day phone 346:2204 c/o Seattle Mortgage 4300 "B" St. Ste 107 Anchorage, AK Day phone Day phone 99503 Unless otherwise requested, HAA will be held for pickup. 4 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water xxx If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: XXX Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 JUL, 03 199~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES R ~ (~ [ l_V~ ~ Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist LegalDescription:J.-eT ¢l'J #¢-~/~'4~-¢_ t/£t(~ ParcelI.D.: 01,,6'--~1-~7 A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test IfA, B, or C, a~taatC~c~Dm%lCei:~er. ADEC water system_.~~.--'~ ---- Case------d to __ __~a.~i?es pro po rig p roteb~:; ;;;;;d) FROM WELL LO~~'~ AT INSPECTION Static water level ~ Well production ~ WATER SAMPL,~SULTS: Co~ Nitrate .pEte of sample: g.p.m, g.p.m. Collected by: Other bacteria Foundation cleanout ~f.)N) ¥ f~ ¢' Depression (Y/g. /u 0 High water alarm (Y/~) /~' © Date of Pumping ~-/'~ 7 Pumper b~¢,4~-~ ?~,~J,~(,- C. ABSORPTION FIELD DATA Date installed ~/ ;~' ¢) ~/ Soilrating (g.p.d./ft2o~ /~'(~} Systemtype Length ~'~ "7 Width Z/~ "-k Gravel thickness below pipe ~' Total depth // Effective absorption area ~ 70 '¢~ Monitoring Tube present(~/N) ~'¢ $ ~ Depression over field (Y~) ~ ~,L,~ ,',4 ~- ~.-,~,~u~.~,¢ ¢/I /~1 7 Date of adequacy test 6/~/¢17 Results(Pass/Fail) P*JJ' For Fluid depth in absorption field before test (in.); 3//o ~' Fluid depth L/ / '7 V;" (ins) Minutes later: ~ '~ bedrooms Immediately afte~gal, water added (in.): '/~" Absorption rate = ~' 0 ~) ~t g.p.d. Peroxide treatmentCpast 12 months) (Y/N) · 72-026 (Rev. 3/96)* If yes, give date B. SEPTIC/HOLDING TANK DATA Date installed <¢/(' /~'1' ~ Tanksize /0%'~0 Number of Compartments ~-- Cleanouts~_.~N) ?J~.:~;x' ~ GRE/-!R ANCHORAGE AREA BOP"'IGH  ~ Department of Environmental Quality -' · 3330 CStreet Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM SEPTIC TANK:I ~,, f~"~"~' ~2~2 ' ~,/~.'~/'~''2~''~0~ FROM WELL ~ U~'', ~ANUFACTURER~I~ ~ '~' ._ MATERIAL _ ~ COMPARTMENTS / ~LIQUID OEPTH ~ _LIQUID CAPACITY /~ GALLONS. INSIDE I.ENGTH INSIDE WIDTH NUMBER OF PITS / . DIAMETER OR WIDTH , LENGTH , DEPTH , .... LiNiNG MATERiALV~.p/VJ~'tBeht~s,z~= o,~[~.~ DEPTH ~/OISTANCEFROB= WELL~/,'z/ ,. , TOTAL EFFECTIVE BUILDING FOUNDATION~, NEAREST LOT LINE /~ / ABSORPTION AREA (WALL AREA) .- .SQ. FT. ADDITIONAL ABSORPTION TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION ., LOT LINE -- CESSPOOL OTHER SOURCES APPROVED % =DISAPPROVED DEPTH .~ ~-.-- DISTANCE I~ROM: NEAREST SEPTIC SEEPAGE SEWER LINE .... TANK .~, SYSTEM REMARKS PIPE MATERIAL: LOT SLOPEI REMAR KS,/~" ~:~ ~',.'X... / . DIAGRAM OF SYSTEM ~ 5,~Or1 I~ .~UNI¢IPALI%Y O~ ANCNORAGE ' Department ~ea~th and ~nvironmental ~otect£on $25 ~ Street~ Anchorage, A~- 99501 ,, 264-4720 * * * HANDWRITTEN PERMIT * * * ~£[L AI|D'/OR ON-SITE SEWER PERMIT L Applicant: JOLt'% }~/~ Mailing Address: ~ ~ ./~ pi Type of soil Absorption System Is: Trench: ~<. . Drainfield: .-- Seepage Bed: , Holding Tank: Maxim~ N~ber of Bedrooms: ~ soil Rating(sq.ft/br) . ~O ~ . . The Required Siz~ of the Soil ~sorption System Is: The length d~ension 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 m~im~ dep~ of gravel between the outfall~ipe and the bcttom of the excavation(in feet). . GALLONS * * REQUIRE9 SEPT~C(HOLg[NG) TANK SIZE = Permit applicant has the responsibi~-ity to inform this department during the installation inspections of any wells adjaceut to this property and the n~er of residences that the well will serve. * "* TWO(2) INSPECTIONS ARE REQU[RED Backfilling of any system without ~inal inspection and approval by this department will be subject to prosecution. Min~ 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. Minim~ distance from a private well to a private sewer line is 25 feet and to a co.unity sewer line is 75 feet. Well logs are re~ired and must be returned to this department within 30 days ot the well completion. other requirements may apply. Specifications and construction diagr~s are available %o insure proper installation. * * ' PERMIT EXPIRES DECEMBER I certify that: (l) I ~ f~iliar with the requirements for on-site sewers and wells as set forth by the M~icipality of ~chorage. he s s~em in accordance with codes. I will install t Y ......... ~m may re~ re enlar amen% if (2) I understand that the on-smte ~e'~7~ml:2~:~ (3, the residence is remodeled to ~n .~u SigneB, A~lic~n~ '-'-/" '' ~ Date' SWP/024 MUNIC!PALITY OF ANCHORAGE DEPARTMENT OF rlEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING O V SION 825 L Street. Anchora§e. Ata'.ka 99501 Telephone 264.4720 ON.SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT .. :~ -: _ <~ F'ER~'I ~. T I.EI]RI_ L 2g HEPITRGE HEIGHTS S/'D LOT 'SIZE TYPE OF SOIL A~S. ORPT[OH f'lA:' ~ f'!L~r'! hlI.It4~?E;P: l'913,3C~ SC..~URRE FEET THE LE~-JG~'N P[f.~Fr. JS1,]~.J l'5 Tt'~E L?.!,}:H ' ~'.'J ¢'-EEi ' L.F THE TRENCH OF' DRRZNFIELD. THE C, EC'TH QF ~-~ ~F'E'~C~ 0~' F,[~ IS r~4E r'.ISrR*-!CE E'Erl,!FEH tHE SURFRCE OF THE THEF'E I? ~'} EfiT ;.~_r,TN F,}P T~'EHC'HE2: THE Gc'~',,,'EL DE~:'r~4 iS !HE ¢.IT~.~[HLIH DE~'T~' OF ,3F'~r*VEL 5:ETHEEH THE OUTFR.. P~PE Afro THC E'O~ rOr'~ ,:,P THE E.:,:R'./RT[O~.~ , f~J FEET' INS~F~LL.~I'ION [D':SP(CT[Cm~':- C'~: ~H'¢ HELL'5 fl[',.IRC'E~.4T TO TH[~: F'ROPEFrT'¢ Rf'/D THE .......... *f'l-!'T'~ ," ::? TM [ f-4:_:-:F'E..']' ! !, C:'f ~-: F!F:E F:EC-!~J J[ I"IIH[hlUH r_,]'...::TFtH(?E E~ETI,!EEfl FI HELL prat_) ¢.j,., ON-SirE ?EI, Ha,~E DI':]POSRL S'¢$.TEM IS /CH~ FEE]' ¢O~' ~ c'F'IVRTE HELL O~' 15C~ rE! ~:'CHD cEEm ~'PCml P PURLIC 14ELL [:,EPENDING UPOfJ rH[[ T'¢,:'E OF r JE:L[C' I,IEI_I. r.lIF~[f.lljf,1 [',ISTflNCE t:~OH F! F'p[~ RTE t4ELt. TO ~ F'~'i'...'RTE '~cI,mE~' LINE IS 25 FEET RN[', TO R C'C~Mr'q. JN~T'Y' SEI,IEP LINE ~'5 F5 FEET OTI4ER REI]LI[REHEHT5 t'IR'T' qF'F'L'T' ¢['E': [FIC~T[C~f-~S Rt.J[', CC, N~TRI_ICTION DIRGRRf4S RRE RVRILRBLE TO iNE;I.IF'E PRE'PEP If'i31¢~l._;..'DT?:If'j PEI4:f.! I 'T E.:=-.:F" I F:E'_-5 1:7. _F: ,t:: E Pl E: C:C F: ~"1.. I PERT~F"¢ THRT J.. I RI,I FRMILIRR HITH THE FCEC."JIREHEHT$ ~,_',¢: O~'.~-EITE '~EHEF'S RNC, HELLS RS _'5ET FORTH DY THE HUHIC!F'RLIT'¢ OF RNCHnP~,3E ,?.: I I.)][LL '[r.,tSTR[_L THE ?r":',TEI,1 [f.} ¢~CC:C,F'C'F!HC'E H[F~4 THE C,JC'E$ 2. I Ui'.,IE:,ERLSTRi'-,I[', THRT THE F~H-'SITE 'SEt,!ER: '?.,'?.:TEf.t r4p'.' ~q'E(!UIRE Eh!LRRGEf'IEI'.,!T IF THE RESI['E. NCE .($ REMO[,ELED TI]I f.t. Jl]_l.l['lE F,'II]I?E FHAN 4 SIGNED: ......................................... RF'F'L I CR~T 'C'HN H ]E,_ LE'¢ I$SUE£' B"_ ............................. r-'~- 4') '~ ;'' './4. 0 .. (:~REAT~CR ANCHORAGE AREA BOROUGH SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT ft. ft. WOOD¥1AFID- LU;DG,':I.':~t & ASSOCIATES. I~IC. June 20, 1973 Job A12109-5 Mr. David Kincaid 780 Kodphur Street Anchorage. Alaska 99502 Dear Mr. Kinca[d: Subject: Lot 2.3 Heritage Heights Please refer to our letter dated ,tune 13. 1973 regarding our test pit inspection at the subject site. Since the referenced inspection, the undersigned inspected _A new_pi.I; .14 ft deep, located about 15 ft north of the structure, and about 12. to 15 ft east of the previous pit. The soils encountered in the new pit vary with respect to absorption due to both vertical variations of the same soil type and to new soils encountered. The avera~,e~bso~_p~ion value at the new pit location from 3 to 14 ft below the existing grad6 is lB0 sq~?re feet per bedroom. For a residence of four bedrooms, this wiI~,,.Eequ[.E~e~'bg0 ft of absorption area betwee~t 3 and 14 ft below present grade (equivalent to 65.5 lineal ft of pit periphery). The crib or concrete ring should be 11 it. Any changes in crib or ring depth will change the averaged absorption value and is not recomended without consulting this office. Rodney Einney, P. ~. ,KLAND ~AN JOSE SAN FRANCISCO ! · . r; e~r~?.~ i I '- , ,' ,~ ,, ~: / 5'/~:'"..~" ,F'~ · d .:? 7' ? 5 /-/6,~',~'/?A ,',6' l-/~',,~ z; WOODWARD-LUNDOREN & ASSOCIATES Consul g Soil Engineers SAMPL£S SAMPLE DESCRIPTION color, moisture, particle size, consistency ~ ~bbUb 11~ ; EO and '~logists casing~ cJsi~ blows, fluid Ioss~ bil condi- tion~ crowd~ rpm, efc,) ¢, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 1. GENERAL INFORMATION Complete legal description Lot 23; H~itag~ H~ights Subdivision Location (site address or directions) 5949 Y~kon Road Property owner Mailing address Lending agency · Mailing address G~org~ R & Lor~na M G~rr Day phone Squim, washington Day phone Cam~a Bashman Agent Address $000 A S~Jt6c. Jc Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well FORTUNE PROPERTIES~INC., Anchorag~, Alaska 99503 NOTE: Day phone 346-2323 Public water XX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site XX Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72-025 (Rev. 1/91) Front MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L~:~F'Z'""~ ~g'~ Parcel I.D. A, WELL DATA Well type ~ ' O, ~'-. If A, B, or C, attach ADEC letter. Log present (Y/N) ADEC water system number Date completed Driller Cased to Casing height Total depth Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Wires properly protected (Y/N) AT INSPECTION g.p.m. Septic/holding tank onlot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: SEPTIC/HOLDING TANK DATA Date installed ~;~ - L~- ~ t Cleanouts~N) "~ High water alarm (Y/N) Date of pumping ~:~ ~' Nitrate Other bacteria Collected by: Tank size ~'~ ~ Compartments Foundation cleanout:~) V ' .Depression (Y~I~ " Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: / Well(s) on lot To property line Surface water/drainage On adjacent lots Absorption field "~:~ ..,t. Foundation Z3¢' t 'Water main/service line 72-026 (Rev. 7/91) Front - CONTINUED ON BACK PAGE GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "¢" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAl. OF INDIVIDUAL SEWER & WATER FACILITIES Mailing Address: Phone: -~'~- ~'~' 2. Property Owner: ~,,~,,~c.~.- ,~.,~-~J Phone: Mailing Address: 7~01 ._~. ~,/~, ~..l~ , ,, · 5. Type of facility to be inspected/~Vm~ r~. of bedro~s 6, Well Data: C. Construction D. Bac.ter~l Analysis A. Installed >Z~</ '7.9 B. Installer Q(e/d C. Septic Tank: l(/ Size /Z~0 2. Manufacturer Pit: 1. Absorption Area ~ ~m' 2. Material .F~ D, Seepage E. Disposal Field: Total length of lines A. Well to: Septic tank , Absorption area , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank C. Absorption area to nearest lot line EQ-034 (1/74) , Absorption area Page 1 of two pages ._ I~ag~'2 of two pages - Request for Approval of Individual S...Jr & Water Facilities 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)