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Home My WebLink AboutLAKEWOOD HILLS LT 10L( kewood Hill Lot #015-312-05 Mt,nicipality or Anchorage .':,~ :-,'. Development Services Depadment '~'~}' [~1.~: Bu ding Safety Divfs~n On-Site Waler and Wasle~er Pr~ram. 4700 S. Bragaw P.O. Box 196650 Anchorage, ~ 99519-6650 Page ~ cl.an~o~age.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: ~ O ~O Z~ PID Number: ~O~ KO~AL~E Wastewater System: ~ New ~ Upgrade ~o%o~ ~t~ ~ ~.~ ABSORPTION FIELD LEGAL DESCRIPTION ~"~ ~. ~ ~. ~t TAN~ S~PARATION DISTANOES ~Septic ~Hold~ng DS.T.E.P. ~Other: ~o Septic Abso~pUoe Lift floldingPubn~lbateM~: s~w., NJA ~1 A ~ J A ~ ~/ LIFT STATION [~,Jr~C ~7,~ ~ BENCHMARK ~ngineer's Slamp . Develdpme~t Services Department Approval .~v~ewedand app~o~eaby:~~ D~te: I0'~01 ,,-,,-, ...... P£RM~T NO. SWOlO~g P~c£ 2 OF 3 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ENVIRONMENTAL SERVICES DMSION P.O. Box 196650~ Anchoroge, Alosko 99519-6650 eTelephone: 543-4744 On-Site Wostewoter Disposol System ond/or Well InspecUon Report L£C,~. LOT 10, LAKEWOOD HILLS S/D P.LD. NO. 015--312--05 i'~ I C02 T .r. :--'-'- ~ co~ ! ~T,, NEW TRENCH'-~ co, ~~~1%":'" PERMIT NO. SW010219 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650~ Anchorage, Alaska 99519-6650 eTelephone: 343-4744 On-Site Wostewater Disposal System and/or Well Inspection Report LOT 10, I.AK-EWOOD Hlll~ S/D P.I.D. NO. 015-312-05 2" INSULATION f'lr3. CO1 = 102.1' -C02 = 101.1' y FINAL GRADE .[_C01 =99.0' S~ ~C02=99.0' A 8 C .-CO 22.0' 7,0' --- ST1 6.5' 29.0' --- ~T2 17.5' 35.5' --- ~H 23,0' ~3,5' --- 301 18.0' 19.5' --- ~¢T1 18.0' 18.0' --- C02 --- 52.0' 13.0' ~IT2 --- 41.0' 15.0' C05 --- 41.5' 16.5' C04 --- 12.0' 52.0' MT2 = 97.8' -/ · -MT1 = 97.8' NO WATER FOU.,ND , B.O.H. = 80.8 [ 100.7 ---FINAL GRADE - sT1 / OUTLET _ :. SEPTIC TANK ': 5' s~[: ,.,.s. - 94.1' I%'%X c~.~o, ./~ B1/27/1~% 21:30 ~B?27255B~ HUNTER ELECTRIC PAG~ 1/27/19cj~, 13:50 =JO72725§8~J HUN~r.~: ELECTRIC PAGE 81 01 ~^'m I ':',- {'<.9 -o/ WHEN CO;~J~E~. ~.[.ON ~E It~AbE PL~ CaLL FOR REINSPECT'ZON I:)O NOT I~lov~ 'I*'~:~. NC,:i-~ MUNICIPALITY OF ANCHORAGE Development Sen/ices Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 02, 2001 Expiration Date: Jul 02, 2002 Permit Number: SW010219 llLegal Description: LAKEWOOD HILLS LT 10 Design Engineer: 0003 S & S Engineering Owner Name: Robert Kowalke Owner Address: 10720 HILLSIDE DR ANCHORAGE, AK 99516-1105 Parcel ID: 015-312-05 Total Bedrooms: 4 Site Address: 007351 OMALLEY RD Lot Size: 20910 SQ. FT. Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspect[on. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: 7-?_,--O/ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number Property owner(s) ~,, o~ ff.. ~"~' ~o b3 ~,~ ~'/~-f~-- Day phone Mailing address (1) ~mP---~ (~,.~'~"~'~ ~"~'~'-'~ % 5~.t3[, ~/-,,~,~,.?_ Mailing address (2) P O ~c,'z' ~.¢[0[,~, ~.t3c~rt~. ~ ZipCode Legaldescription(Lot, Block&Sub'd.) L,-,~ '~LO L~.~.~.~',-~- ~--.~\~( ~-~ Legal description (Section, Township & Range) Lot Size c,~_..o0~ .~[~ ~ Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool [~ Well Only ~r~ Water Storage , Jacuzzi . ~]~ ~] Water Softening Unit I certify that the above information Is correct, i further certify that this application Is being made for a Single Family Dwelling and Is in accordance with applicable Municipal Codes. S & S ENGINEERING r~,_~la R~ver. Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. t2/00) Waiver Fees: Date of Payment: Receipt Number: SO~LTEST ROBERT C. COWAN, P.E. ClWL ENGINEERS (907) 694-2979 FAX (907) 694-1 June 13, 2001 MUNICIPALITY OF ANCHORAGE Development Services Department , P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 10, Lakewood Hills Subdivision It is requested that you issue a permit to upgrade a septic system with a 1500 gallon septic tank with lift station & pressurized trench to serve the existing four bedroom dwelling on the referenced property. A test hole was excavated on 6/9/01 and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. Ground water was monitored as shown on the attached soils logs, and after seven days of ground water monitoring the test hole was found to be dry. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowun, P.E. CC hm Enclosure 17034 NORTH EAGLE RIVER LOOP · SUffE 204 · EAGLE RIVER. ALASKA 99577 "~ LOT 10, LAKEWOOD HILLS .~>~r~ or a, ROBERT g. JOHNS. JR. & ASSOCIATES~} ~,~ UO~iut C COW~ ~, flO0/l.2 = 500 SQ.~. REq'D. ~T Is THE R~NSIBIL~ OF ~g CON~OR CO ~o~. TRENCH~ T~ ~mm~/~ NEW 1500 , I/ CRUSHED & ABANDONED)~~M~ , ~ , ,, , ~ LOT 10, LAKEWOOD HILLS S/D J.H.M. R.C.C. 6-~5-0~ 2 OF DESIGN CRITERIA: ~u~. ~. o~ ssc~o~c~ ~ 4 BD~M = 600 GPD ~HO~N ON THIS SITE P~N ~E ~ SHO~N SOI~ - I.~ ~PD~Sq.~. ~ ~-~UILT SURVEY D~N BY; 600/1.2 = 500 SQ.~. REQ'D. ROBERT E. JOHNS, JR. & ASSOCIATES ~,% ,'~*~ ~ IS THE R~PONSIBIL~ OF THE CONT~OR TRENCH CRITERIA: ~ v~. ~.~.~s. ~U~EU S~P~,O. ~' DEEP CON~RU~ON. ~{ ~ m~m t~p ~o 1' EFFE~IVE X ~ I ~ ~ I~7 t)..~,., ............. .,~ 91' ~NG (5~ ~DED FOR 'L' SH ~ L { COMT~OR ~ REQUIRED ~0 I~ [ OmA~ ~moa ~ ~ =ctwno~ ~OR~ ~o' ~N. MIN. 10'-- ] ~f Om~ , NEW TRENCH~ ~ ~[__ I I X T~ ~1 ~m~ NEW 1500 I SHED (TO BE RELOCATED ~ ~ ~,~ :.,.-"C. ~GALLON I IF NECESSARY)~ ~ ~ ~o ':..'~ SEPTIC TANK I , ~[~ .~' ~/ I OLD SEPTIC TANK ~ (. ,:, [ CRUSHED &~~ED)~V ~ 8 / ,, I I I ALL PORT{ONS OF SYSTEM J WiTH LESS THAN a.5' OF Nn'~,,~v~nAn COV[R R[QUiR[ iNSU~IiON. Municipality of Anchorage. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG .-- PERCOLATION TEST PERFO.MED FO.= J~O6 LEGAL DESCRIPTION?'0~' )O ~E~.~ _,,.'/.~"., .... · :. ,'~,~ DATE ,ERFORME&* '.. ~/l£ L J"1'ownship. Range. Section: 1 2 3- 5- 6- 7- 8 9 10 1! 12 14, 15- 17- 18- 19- 20- COMMENTS s O*/~A,~ ~ L WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN IF YES, AT WHAT - DEPTH? ~ pO E Mor, iteri~g? Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE $,~-~ (m,nute~'mch) PERC HOLE DIAMETER TEST RUN BETWEEN I ~/~. FT AND ~' FT ACCORDANCE WITL~;~ ]~e'l~ Ahi]ildL,'~L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-(~08 (Rev. 4/85) ROBERT C. COWAN, P.E. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CML ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 10, Lakewood Hills Subdivision June 13, 2001 GENERAL: 1. The scope of this project includes the ins~allation of a pressurized five foot wide drainfield and a 1500 gallo~ S.T.E.P. tank to serve the existing four bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A Beptic tank is to be constructed by a certified septic tank manufacturer. Conswuction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent sealing or shifting of the tank. 3. All s~andpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. ofcover shall be insulated. 17034 NORrH EAGLE RIVER LOOP · SUffE 204 * EAGLE RIVER. ALASKA 99577 Page 2 Lot t0, Lakewood Hills S~ June 13, 2001 5. A foundation cleanout shall be installed one to four feet from the building foundation. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH]DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the holes faced downward. The distribution piping is to be ofPVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth ofthe gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page '~ Lot 10, Lakewood Hille S/D June 13, 2001 MINIMUM MATERIAL SPECIFICATIONS: I. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated .Solid Cast Iron ASTM D3034 (PVC) ASTM FSI0 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the//200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever specifications applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. Page 4 Lot 10, Lakewood Hills June 13, 2001 2. The second inspection must be conducted after the placement ofthe silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading ofthe property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pm-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The ovaaer shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER Ref. #10720 10720 Hillside Drive Lakewoodhills Sub. #10 Dear Sirs, / This is a letter to advise you that I, (Kurt Rentfro) i/nstalled the septic at my home at 10702Hillside drive ~ (Lakewood hills subdivision # 10) system 1. I have installed or helped install 15 septic systems. 2. I have also installed 3 septic systems on my own. If you have any Questions Please feel free to call me at 727-8453 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 MAI LING ADDRESS p. o, Bo.x. 37?; LEGAL DESCRIPTION LOCATION We[ 0 J Absorptio~ar~a ~ ~ Manufacturer ~ O/<c E ~ lLiq./~capa~ gallons IF HOME.DE; Inside length ~ I DiSTANCETO: Well Dwe, ng ~ I Manufacturer ~ ~ I Top oJ tile to finjs~ade - Crib diameter ~ ] DISTANCE TO: Well ~ ICla~ . ~ _ Depth ~ I ~[/~ . .~ ~°. Material FoundatL~o , Near~t~e! Total le~_9~_h~fllines Trench v~i_clt~ ~ I ~ (z~ inches Material-beneath tile ~ f.. ~ ~ inches Depth Crib depth Building foundation Sewer lineO 0 I OTHER PIPE MATERIALS SOIL TEST RATING 1o-'o INSTALLER REMARKS PHON~ /~NEW NO, OF B[~R?OMS -/ PERMIT No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons Distance~ lines Total e f fe~'~t,i ve/a bs o r p rio n.~r ea.~.~ PERMIT ~0, Total effective absorption area Nearest lot line Septic tank + I0O PERMIT NO, Absorption area(s) .+-ioo APPROVED DATE LEGAL L~ ~ F"FtLiT~~ £~F F~-I~3HCIR~-3~3E DEPRRTMENT OF HERLTH RND ENVIRONMENTRL PROTECTION 825 L STREET, RNCHORRGE, RK 99501 264-4?20 0~-~--'__--] T TE SEI-~EF-: F'ER~'I I T PERMIT NO: [:,BTE ISSUE[:,: 840.~ -'.':B 05,..'±4,.,'84 RPF'L I CRNT: RDE:,RESS :' b~NTRL. T PHONE: RNDERSON BRCS CONSTR P 0 BOX 3?? ERGLE RIVER.. RK 995?? b_.4 ~_.,, LEGRL DESCRIP: LOT SIZE: LOT LOCRTION: MRX BEDROOMS: SUBDIVISION: LRKEWOOD HILL~ SECTION: f4 TOWNSHIP: t2N 249~0 (SQ. FT. OR RCRES) O~MRLLEY RORD 4 LOT: ~0 RRNGE:-~W BLOr:K: NR ::LISTED BELOW RRE THE OPTIONS RVRILRBLE TO YOU IN [Ez, I~NINu YOLIR SEPTIC_: --,r_,TEM. CHUJ_-,E THE OPTtON THRT BE:,T FITS YOUR SITE. · T~:E~I~]H DEPTH TO PIPE BOTTOM (FT.) 4.0 GRRVEL DEPTH (FT.) 4.0 TOTRL DEPTH (FT.) 8.0 GRRVEL WIDTH (FT.) 2.5 GRRVEL LENGTH (FT.) 48.0 GRRVEL VOLUME (CU. YDS. ) 20.0 TRNK SIZE (GRLS) 1,250.0 SOIL RRTING (SQ. FT./BR) 9~ i:::ED I--.t.DRF-t I 4.0 4.0 0.5 3.0 4.5 7.0 t?.0 5.0 _~4. 0 45. 0 -. 21. 4 29. t, 250. 0 : **' TRNK MUST HRVE RT LERST TWO C'OMPRRTMENTS , I CERTIFY THRT: ±: IRM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE (MOM) RND THE STRTE OF RLRSKR. ' 2. I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH RLL MOR CODES RND-REGULRTIONS, · RND IN COMPLIRNCE WITH THE DESIGN CRITERIR OF THIS PERMIT. ~. I WILL RDHERE TO RLL MOR RND STRTE OF RLRSKR REQUIREMENTS FOR THE SE~ BRCK DISTRNCES. FROM RNY EXISTING WELL, WRSTEWRTER DISPOSRL SYSTEM OR PUBLIC SEWERRGE SYSTEM ON THIS OR RNY RDJRCENT OR NERRBY LOT. : 41 I UNDERSTRND THRT THIS PERMIT IS VRLID FOR R MRXIMUM OF 4 BEDROOMS RND RNY ENLRRGEMENT WILL REQUIRE RN RDDITIONRL PERMIT. IF R LIFT STRTION IS INSTRLLED IN RN RRER C:OVERED BY MOR BUILDING L:ODE_... THEN (±) RN ELECTRICRL PERMIT RND INSPECTION MUST BE OBTRINED.~ ~. R~-BLILT~ WILL NOT BE RPPROVED WITHOUT RN ELECTRICRL INSPECTION REPORT.~ RND (2~) THE ELECTRtCRL WORK MUST BE DONE BY R LICENSED ELECTRICIRN. RppLICRNT:' RNDERSON E, ROS C:ONSTR ..... ,2__ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST '[~- SOl LS LOG (7/ . [] PERCOJ-ATION TEST LEGAL DESCRIPTION: 9 I0 11 12 13 2 SLOPE WAS GROUND WATER ENCOUNTERED? /JO IF YES, AT WHAT DEPTH? SITE PLAN 14 15 16 17, 18- 19- 20- Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch} COMMENTS PERFORMED BY: TEST RUN BE.TWI~EN -- FT AND FT ~ SR BOXi668, BOG~RD RD. . PALMER, ALASKA 99645 I ,, ~ , - m'-~_~ ; Ik Sub 0 I L L ' SAU~MA. ~ i~ Sm FORMATION / /C~A SIN FORMATIO2q DEPTH ~A DE~H D~ CAS~ FOrMAtION ~FT.~ ~FT. ~ ~ I~FT. ~ ~08 ~8 . ' ~10 · 11 ~ i 111 I / ' / ~ ' ~1~ ~ , 111t · Iii 213 i18 ~ ; 113 ' { 114 I ~ 14 ~ { 115 216 18 t ~ 116 ~ { 216 -,, ' .... , ; '" , ' ' "' ' _~8 ~ ~ 1~ . :, ,'; ~ ~ /y ~/~. /330 ~ ~ ~ 124 t ~ 2~ /IN ~ ~. ~ ~ , T36 ;:,-~: --, i 126 } I ' 2~ - ~7 ,- , t2~ I ~ 227 ~8 t 128 t{ 29 ~ ~ 129 % ~ 229 ~30 I ; 130 t ~ ~0 ~81 { 131 i I fll , __~l ' Iii { ( 281 ~36 ) ; 135 i t ~5 __36 I 136 i } --89[ t 139 { I ~9 --48 , ~ 143 ~ ~ ~8 ~ ~ ,~, .... ~46 I ~, 146 ~ /~/ x_? ~ 1') ~ ~46 ] 146 i , / ~ ~ ,;~ ~49 f 149 [ ~ / ~ , · 249 ~54 154 ~ ~ ~ ~ ~ 156 i 2~ ~ · ~tO ,, 160 ~ 160 ~61 161 261 ~61 162 ~ 262 ~68 163 ~ 263 ~64 . . 164 ~ 264 --85 165 ~66 166 ' 266 68 t68 i i 71 ; ( 171 { : 271 ~72 172 ~ 272 ~3 : ~ 173 ~ ~ 273 ~4 ~ 174 f ~ 274 ~6 I 176 ~ ~ 276 ~77 = 177 : 277 ~78 178 , ~ 27e ~79 i 179 j I 279 ~81 181 , ~ 281 ' ~82 ~ 182 i ~ ~82' ~88 ISa j ~ 2ea 84 ~ ~ 184 i 284 ~85 t 185 I 285 ~.12, 112 .... .,,1~ i i13" j 14 ~ ! · t '~ 114 ~ 114 --15' ~ , '" '--16 ~ 11§ ' 116 ~ ~ 216 ~17 t ; 11~' i ) 217 JO. I ~ .... 12o ._31, · I ' : ' 121 't i / 221 _.32, ' ' 122 __36, 125 .,.~7 , ~27 .... i [ 22? ._22 ~ 128' ~ I 228 ~2 ! ~2~ ~ ~ 220' ~9o., * ; 1~o i ~ 200 __32 [ 152 r 282' ~33 · ~ ~ 133 i ~ 293 ~34 I 134 ~ i 294 ~35 I 135 ~39 ,, I - 136' t I 286 m~37 / 137 ~ [ 23? ~38 :' ~ 138' ( * 238 39 ; 139 I I 2~9 ~40 I 140 ' ~ 240 ~42' ~ ~ 143 i ~ 242 44 ; 144 [ i /~//.~ 244 '"45 ' I ~ 145 ! ~ ~i /~/-I 24~ ~46' ~ 146 I . · / ,//~ 248 4? t ; 147 ~48 ; 148 ~ ~ ,\, ~/ 248 ~60 ~ 160" ' 260 ~64 , i 263 06 ' : 'i - , 164 [ 264" ~88" ~68 ?! f ( ~7! ~72 ~' 172 --*73 ~ i 173' ~74 : ) 174 ( i 274 ~78 = i ~ ~ 178 ~ I 278~ :9°- I ' ~,o. ~ 182 J I282' __88, ~ 183' 84 384 ~ 284 ~85" i I 185 I I295 I 188 f 988 ~89 i 199 ~ 289 '-so: , , 19o' · · ~--91 ,! ! 191 ! 990 991' ~92 ! ' ~ 192 9~ ! ~ ! 193' i I 293I m94' ~ 194' --96 i 195 m96 - , :. ; 196, '~el :~, i: 198- ~99 ', :/ / 199"' , J ~ 298 10~1 ~, '[' 200 '¥/ PLEASE PAY FROM THIS INVOICE :7' -,~/ WE~L C.~RTIF1CATION A,,.~ump test was conducted 2'0r Constructing'~ng!ne-e~S-, -alt Lot 1,0, Lakewo~d Hills Subdivision in. A, nchorage~, ~'l~sk~, or A~ril;l~', 1~984. ~ ' The results are as f~liows:r Casing diame't~'~.: Well Depth: 218' ...... tatlc. Level: 1,37' Pump set at': 201' Pu'm-A test was started at 9:15 a.m. and the time zncrements. and resulting static levels are listed 2n order. Time (in minutes) 2 1,43' at 7'.5 G~M 5 1,55' ~t 7.5 G~M 1'0 1~80' at 7.5 GPM 20 1~87~' at 30 1~97' ~t 7.5 GPM 60 1.99'.at 6 GPM .. · 120 1:99' at 6 ~PM 1,80 199' at 6 GPM 240 $99' at 6 GPM ].)avid L. Har_t er ' P .0. Box A~cnuraf;e, A,'~ 99511-0496 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) z~/o ~_~/<~u.~ooo /-/:/~ ~ ~ / ~/., 7-/~/o,, /7 ~ CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution / Business Mailing Address (d) Real Estate Company and Agent Address Telephone ~-~ ¢~, - 2- ¢' ¢ ¢ (e) Mail the HAA to the following address: (or check her if hold for pick up.) List contact person and day phone number below: ~ L A J V $ /,'w z. s o,,t/ ' Cr 9' ~ - / 2. TYPE OF RESIDENCE Single-Family.~ / Number of bedrooms WATER SUPPLY / Individual Wellfl~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. SEWAGE DISPOSAL On-site;~ 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. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of thevalidation date shown below, Iverifythatmyinvestigation of th is ' Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or westewater disposal system is in compliance with ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. ~__. O,/O ...3~, L~ ¢'J ~ (~._% .T_ ¢0 ~ Telephone Name of Firm Address 6. DHHS APPROVAL , ,~~ Approved for ~ bedrooms by Approved ~'~--- Disapproved Conditional Terms of Conditional Approval //~/¢~- The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph S above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHSdo not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 , ' , ~ MUNICIPALITY OF ANCHORAGE (MOA) MyNiCIPALIT ( (~.~'~RAGE Health Authority Approval (HAA) ENVh~ONMRN]AL ~_~IVISION CHECKLIST- FEBRUARY 1984 RECEIVED A. WELL DATA Well Classification ,,,'""~?~ / Well Log Present (Y/.N) / Date Completed Total Depth Z/~" Cased to ~-/ $ Depth of Grouting /-'~/'-~' Static Water Level / ~ ~ / /' Casing Height Above Ground ~- f Electrical Wiring in Conduit (Y/N) Y SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot "7~ / ~ To Nearest Edge of Absorption Field on Lot ~/' / To Nearest Public Sewer Line ''f' / ~ 343-4744 Legal Description: To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments If A, B, C, D.E.C. Approved (Y/N) __ Yield ~ ~/°/'~3 Pump Set At 2_4:9/' Sanitary Seal on casing (Y/N) Depressi°n ArOund Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots '¢ / o--o To Nearest Public Sewer Cleanout/Manhole ~-/' /' ~ ;Date c~ ~ ~ ~--~/" " B. SEPTIC/HOLDIN~./~I~ DATA ~1' .I/ Oate Installed -~;-"¢ Size Standpipes (Y/N) DepressiOn over Tank (Y/N) P u m pi n g/M ai nt e n a n ce~o.n.t~A'C'¢; ?? E!I~- :;.\ -.~ ....~... / (Y/N) __ ;for Holding Tank High~WO~r~l¢.rm~'iY~.~i~i¢",../t~/'/~ Temporary Holding Tank Permit (Y/N) SEPARATION DIST~CE~,~OM¢-S~?~ICTHOLDING TANK: To Water-Supply Wb'Ii''~*~¢~' - To Building Foundation TO Property Line. To Water Ma~n/SerwCe Ume To Stream, Pond, kaRe or'Major Drainage Gourse Comments /'~-'O No. of Compartments ~ Air-tight Caps (Y/N) Y Foundation ,/_,2 Date Last Pumped 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~K~ -- o~ F ~"/%~/¢~ Width of Field ~ ~" ~'' Square Feet of Absortion Area Depression over Field (Y/N) Type of System Design Length of Field ._.~"-'O / Depth of Field Gravel Bed Thickness /--/ /t.2 Date of Last Adequacy Test Results of Last Adequacy Test //-/~ ~-~:~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well -/- /¢ O ~ To Property Line To Existing or Abandoned System on To Building Foundation Lot /L~ O,'~ ~ /.¢ A.~ o ~,o,cJ ; On Adjoining Lots To Water Main/Service Line -¢- ~_cb ' To Cutback ~-present) To Stream, Pond, Lake, or Major Drainage Course '¢' /~ ' To Driveway, Parking Area, or Vehicle Storage Area -/- ~--~ ~- Comments /~--~/~/')'2 / 7'- ocr~' ¢ ~ O .2~ 3 ~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and inspection..~. Signed Company Date MOA No. Receipt No. Date of Payment Amount: $ /-20 ,.CO I-j~!~_g ~ lij~j~ ~¢f f e~t Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 NOBTHEBN TESTING LABOBATOB~E 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 $, INC, 907-479-3115 907-277-8378 Constructing Engineers, Inc. 9601 Buddy Werner Drive Anchorage, AK. 99516 Attn: H. Wilson Date Arrived: Time Arrived: Date Sampled: Time Sampled: Date Completed: 08/25/89 1143 08/24/89 0800 08/29/89 Source: Lakewood S~ple ID#: A082689-27 Parmneter Unit Result ADEC MCC* Nitrate-N mg/1 3.9/3.7 10 Reported By: Date: 09/01/89 Francois Rodigari, Anchorage Operations Manager NOI THEI N TESTS G LASOI ATORIES, 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 INC. 907-479-3115 907-277-8378 Quality Control Report Client: ID#: Constructin~ Engineers A082589-27 Listed below are quality control assure]ce reference samples with a known concentration prior to analysis. The acceptable limits represent a 95% confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference s~,ple. The reference smnples indicated below were analyzed at the smne time as your sample~ ensuring the accuracy of your results. Sample # Parem~eter Unit Result Acceptable Limit EPA WS378--12 Nitrate-N mg/1 7.82 7.17 - 8.01 Francois Rodigari, Anchorage Operation Manafer MUNICIPALITY OF ANCHORAGE DIVISION OF EN~IRON~NTAL h~EALTH DEPARTMENT OF HEALTH AND ENVIRON~IENTAL PROTECTION APPLICATION FOR HEALTH AUTHORI%~f APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block~subdivision, sectiou~ ~ownship, range) Location (address or directions) z ///z~,~ 3/2~ ~f~/C /~;~? ~2/~;~2o~/?~T~' u' P/>~/~. ~ ~'~ .... c ~ ~ ~, (b) Applicants Name bl~[7~,~ ,~t~, Telephone - Home Business (c) Applicant,s (check one) Lending %nstigution ,~ ~ ~er/b~lder ~ · Buyer ~ ~ Other ~ (explain)~ (d) Lending Institution t~~lf~ ~f Telephone A~ss Real Estate Co. & Agent (e) Address <f) Telephone Mail the HAL to the folloWing address: 2o T~e of Residence Single-Family~ Number of Bedrooms Multi-Family~ Other (describe) Individual Well.~ Community ~ Public ~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. S~e_wa g, e Disposal Onsite ~. Public ~ Community ~ Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] En~gtneering Firm Providi~$ Inspections~ Tests~ File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of- this Health Authority Approval shows that the on=site water supply and/or wsstewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein°- I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspec~ton~ the on-site ~ater supply and/or ~stewater disposal system is in compliance with all Mnnicipal and State codes, ordinances, and regula- tions in effect on the date of ~his inspection° (ENGINEER DHEP Aj~R~_ov al Approved for ~D~' bedrooms By Approved ~ .~k~ Disapproved Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT= ATIONS GIVEN IN PARAGRAPH 5ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA° THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE~ MENTSo EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK° (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ao MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AIII~ORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification ~r iu~ Well Log Present (Y/N) y Total Depth ~/- I' ~ ' Cased to Static Water Level I .~ ~ ' Casing Height Above Ground ~' Electrical Wiring in Conduit (Y/N) Sepa=ation Distances f~om Well: To Septic/Holding Tank on Lot ENVIRONMENTAL PROTECTION RECEIVED Legal Description: If A, B, ~ C, D.E.C. ~p~o~d(Y~) ~te ~leted ~3~ l~ Yield Pump Set At Y Depth of G~outing ~mz~ Sanitary Seal on Casing (Y/N) %/ Depression Around Wellhead (Y/N) AJ +-[00 ' ; On Adjoining Lots 4- / OO To Nearest Edge of Absorption Field on Lot 4-/O O' ; On Adjoining Lots ~- / 6PO~ To Nearest Public Sewer Line /JpxJ ~ /~7/~/~dJZ~To Nearest Public Sewer Cleancut/Manhole A/~/~ //J /~/~/% To Nearest Sewer Service Line on Lot Water Sample Collected Water Sample Test Pesults B. SEPTIC/HOLDING TANK DATA Date Installed ~.c?/'_~' Size I7...~0 No. of C~,¥artm~nts ~- Standpipes (Y/N) y Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) Depression Over Tank (Y/N) /I~) Date Last Pumped A)C&<3 $ ~ ~z~% Pumping/Maintenance Contract on File (Y/N) ~/ ; for Holding Tank High-water Alarm (Y/N) /J/~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well +W~D ~ To Building Foundation ~ ~ To Property Line ~ ~3- ( To Disposal Field ~ ' TO Water Maip~Service Lir~ ~ /~-r Course /t7 ~/jg3 ~ -~/~0 ' Y TO Stream, Pond, Lake, c= Major Drainage [Page 1 of 2] Receipt ~ Date Paid: Amount: 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date .Installed Width of Field Square Feet of Abscrption A~ea Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance frcm Abscrption Field: To Water-Supply Well ~-/OO ' To P~operty Line Type of System Design Length of Field Depth of Field ~ ~ O Gravel Bed Thickness c/ Standpipes P~esent (Y/N) Date of Last Adequacy Test To Building Foundation +Z O' To Existing or Abandoned System cn ! Lot /J~ ; On Adjoining Lots ~ /~ To Water Main/Service Line ~-/~ To Cutbank(if present) To Stream/Pond/Lake/or Major D~ainage Course /t3o/3Cc //-3 /~P ' To Driveway, Parking Area, or Vehicle Storage Area ~/~' Con, rents ~/d~-~ ~J~///7. /~ 3" ~/C~ Date Installed Size in Gallons "Pump On" Level at High Water Alarum Level at Tested for Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Co~=¥ents ** Check Permitted Bedroom Rating A~ainst HAA Request I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspecticn. S igne d Date KB1/d5/s [Page 2 of 2] 2-15-84