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HomeMy WebLinkAboutTERRACE HEIGHTS BLK 1 LT 12 Municipality of Anchorage ~..'~ Department of Health and Human Services Building Safety Division '~ ,~ On.Site Water and Wastewater ProD'am, 4700 Soufll Bragaw Street P.O. Box 196~50 Anchorage, AK 99519-6650 Page 1 of 2 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAl. SYSTEM ANDIOR WELL INSPECTION REPORT Permit Numbe~ SWSW010186 PID Number: 0t7-073.42 Name: Rnh R, .Inn~,f.lnhn~nn Wastewater System: [] New [] Upgrade 7940 Llnner D~Armnnd_ 9§~1R ABSORPTION FIELD ~ Dc~,t,.,~ nS~,T,.,,~ na.~ nuo..~ ~o~-Molding Tank LEGAL DESCRIPTION ~' I 12 Ttrr~¢e Hts .. Well: [] New [] Upgrade c.,~,~,~: n. ~,,~,~: [t~,~.,~,t~,~: n. . n~ 3034 PVC ~ Dan Beeks 6122/2001 ¥~: c.~l ""~'~": n.I c'~ "'~'°"'~' c"~:,~ TANK SEPARATION DISTANCES iD septic [] Holding r-I S.T.E.P. [] Other: ~ SepUc AbsorpUon Lift Holding PulNic~dvat~~ Tank Field StaUon Tank s~,~ u.o Greer 2000 w,~ 106 76 Steel 1 c~.~u~="~'w'"' 12800+~ s~: ~ ~,~.,,:LIFT STATION FOU~'~¢~ 19.7 '~'~ ""'~": '~'~ ~' "'~': I 100+ n,,~,~ a ~.,~. "'"'"': BENCH MARK SW Comer of house on Drive way 100.0 Engineer's Stamp Inspections performed by: Pannone Enq. Svc Dates: 1~6122/2001 ~ '~.~ 4Cl~ }r~ o7 o7 2ool Department of Health and H[jnpan Services approval ~ ~_~Steven R. Ponnone#/~,  P~-R.~T Nn, sv0mm~ AS-3UILT ~,,~,~. No, m7-073-42 ~*/ASTE~,/ATER A~gORPTION SYSTEM ~ LOT 12 ~LDCK I T~RRACE HT~ ~,~ / EXIST G ~ELE EXIST 6 ~ELL . ~ ~. R DVAE i HDL~ING TANK,~ ~ ~ , TREN( H - IN FAILUREr~ #~ r . ~ IN PLACE, -TH1 ct eo.4 Ti E9.7 ELK TE 30.7  ~ ~ T3 31.1 30.; Esm~ 73 P9 GO1 9~.7 PERC RAT~m <60 MIN/IN~ ~ NEV ~r~/ 49~ ~ ~ ~O00g HOL~IN~ TANK ~.~~ ~ VITH ALARM C,LLC Mr. ~ob ~ J~net Johnson P.O. ~OX 102954 -~O~u~~/G~~CE~]~ ~ 7940 Upper ~eArond ANCHORAGE, ALASKA 99510 ~~,.~-,, ~ E7E-S218 Phone ~ Fox MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-0650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 13, 2001 Expiration Date: Jun 13, 2002 Permit Number: SW010186 Legal Description: TERRACE HEIGHTS BLK 1 LT 12 Design Engineer: 0062 Pannone Engineering Services Owner Name: RODGER C. DAVIS Owner Address: 8000 UPPER DE ARMOUN RD ANCHORAGE , AK 99516-3807 Parcel ID: 017-073-42 Site Address: 007950 HILLSIDE WAY Lot Size: 20700 SQ, FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 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.ci.anchorage.ak~us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW Mr. Bob a Janet Johnson / ~.,J~, & .~xJ~.4 ~.. Property owner(s) Mailing address (1) 7~0 Up~r D~ond Mailing address (2) Anch~oe, AK ~ ~'l/~i~ ~ Legal descH~ion (L~, BIo~ & Sub'd.) L~ t2, Bl~k t Te~ce Hfs Dayphone Zip Code 99516 Legal description (Section, Township & Range) Lot Size ~ 2C)l~(p Acres/Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Well Only [] Water Storage [] THIS PROPERTY CONTAINS: Hot Tub [] Jacuzzi [] Swimming Pool [] Water Softening Unit [] Therapy Pool [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: ~_~C~,~.~ (Rev. Waiver Fees: Date of Payment: Receipt Number:. Pannone Engineering Services, LLC Consulting Engineer (907~ 272.8218 May 24, 2001 P.O. Box 102954 Anchorage, Alaska, 99510 (907)272-8218 Fax Municipality of Anchomge Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519 Subj~:t; Lot 12, Block I Terrace }Its. Subdivision, Emergency Septic System Upgrade Permit Request Gentlemen: My firm was contacted to design and install a replacement septic system for thc referenced lot. The existing drainfield is in failure and backing up into the house. ! conducted a field investigation to locate existing wells and septic syst~n as well as a record search before designing the proposed system. ! discovered that there are two systems on this lot. The crib was installed in the late 60's, and the trench system was installed sometimes in the last 15 years without MOA approval. We conducted a soils investigation in the most likely location for a replacement system. The soils were fight silts, with a percolation rote ofgreater than 60 minutes per inch (see the attached soils log and percolation test). 1 propose installing a 2000-gallon holding tank on the referenced lot. The holding tank will have an alarm system. The lot is approximately 21,000 square feet in size. Lot 12 slopes to the south at a rate ofapproximately 3 to 5 percent. The proposed holding tank installation will be located in the central portion ofthe lot on a relatively flat area south of the existing house. There will be easy access to the tank for pumping tracks. The proposed location is greater than 75 feet away from any wells. The proposed system will be greater than 10 feet from the water service lines. The proposed tank will connect to the effluent side ofthe existing septic tank. The existing septic tank will be inspected and reused if found competent. The proposed installation will not affect the future development ofthe surrounding or existing lots. See the attached design. Please contact me at 272-8218 or 227-3522 ifyou have any questions about thc proposed installation. Sincerely, Steven R. Pannone, P.E. Attachments: PER.~T NO, SVO~ DESIGN P.~. WASTEWATER AI4SDRPTION SYSTEM LOT 12 t~LDCK 1 TERRACE HTS S,~ , / / ~ELLS ~R SEP~ICS~ ~ / ~ ~ ~ ~'~ ~oooo HDLDING TANK. ~ ~ v~?,I, z,,,~u~, ........ ' ~ ~ C--~ ~AILURE. AgAN~DN TREN('H - IN FAILURE~ ~ ~' . At ~NDDN ~IN-~LACE, ~ ~ I IN PLACE, 601 PERC RATEm <60 MIN/INm ~ NEW ~ ~~ GROUND WATER V/IN 2000 OAL ~ ~000g HDLDINO TANK ~-~~&.--~ WITH ALARM SYSTEM ~ M~. Dob & J~De~ Johnso~ P. O, No. CE S~4p ~ ~g40 Upped DeA?oDN ANCHORAGE, ALASKA '~-~~ ~ATE~ 5-84-o~ ~ DESIGN e~- ~ALE, 1'=50' PERFORMED~ ~.~b&J~Johnnon DATE PERFORMED: 4-2-01 : ~ DESCRIPIION; Lot li Block 1 Terrace Hts. : TEST HOII W~ GROUNI) WATL~ F. NCOUNTERED? No IY Yin, AT WHAT DEFII~ DEPTH TO WATER AFTER MONITORING? -$ DATEI: 5-15-01 TEST HOLE PEROLATION RATE ~60 (mtn/inch} PERC HOLE DIAY~rr_.,R 6 Inche TEST RUN BEWTEEN 7 P'I' smi 8 FI' COMMENTS: Te~t hole excavated by Dan Beck. Soils no md,,~ ~t~ for ~ll absorption ~!~tem. No perc test performed. PERFORMED BY: Stevcn R. Pannone, P.E. I CEKI-WI' THAT THIS ~ WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EI~-,'.;CT ON THE DATE OF THIS TF-.~T. i..~.~UNI~IPALITY OF ANCHORAGE..~ Department~ : Health and Environmentar~rotection ' 825 '~' Street, Anchorage, AK. ~9501 · .: ..... 264-4720 ' * * * HANDWRITTEN PERMIT * # * Permit ~ ~O~ ~ ON-SITE SEWER PERMIT Location: ~~hone N~er: ~ ¢¢-- e'~ 5egal Description: ~/ ~ ~ ( ~~c e. ~,~ Lgt Size: ~ Type of Soil ~so~tion System Is: ' ~~~~d~ Trench: Dra~field: Seepage Bedt lng Tank: Max~ N~er of Bedrooms: ~ Soil Rating(sq.ft/br) ~9/  The Re~ired Size of the Soil ~sorption System Is: ' DEPTH ~ .LENGTH~ ~AO GRAVEL DEPTH ~" WIDTH 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 ~e bottom of the excavation(in feet). There is no set width for trenches. , The gravel depth is ~e m~ depth of gravel between the outfall pipe and ~e bottom of the excavation(in feet). ~ ' REQUIRED SEPTIC(HO~[NG) TANK SIZE = /~O GALLONS Pe~it applicant has the responsibility to info~ this department during the ~stallation inspections of any wells adjacent to this property and the n~er of r.esidences that the well will serve. "' "TWO(2) INSPECTIONS ARE REQUIRED ~ ~ ' Backfill~g of any system without f~al inspection .and approval by this depar~en' will be subject to prosecution. ~n~ distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Min~ distance from a private well to a private sewer line is 25 feet and to a co~ity sewer line is 75 feet. Well logs are re~ired and must be returned to this department within 30 days of the well completion. Othe= requirements may apply. Specifications and construction diagr~s are available to insure proper installation. ' ' ' PERMIT EXPIRES DECRIER 51, 1 9 2 ' ' ' I certify that: (1) I ~ f~iliar with'the requ'irements for on-site sewers and wells as set forth by the M~icipality of ~chorage. (2) I will install the system ~ accordance with codes. / (3) I under~tand t~at the on-site ~ewer system may require enlargement~if / the residence is remodeled to ~nclude more thatf~.bedrooms. . Signea: Issued by: ~, Applic~t Date: %~/~' ~ ANCHORAGE. AkASKA ~cl9502-0650 {~07) 264-4111 .January 31, 1983 ~Permit #: 820926 TO: Permit Applicant Subject: Lot 12 Block 1 Terrace lleights Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. 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 needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerel~ Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 . ,- DEFBRTf,IEf,]T r(~IHEFILTH FII~ID EHV!ROI'.IblEi',ITFIL (' OTECTIOi',I · . ' E, 25 'L STREET, A~ICHORAGE, A~,. 99bE~l / ," 264-4720 / IWELL RI"-,IB, Ed"4--S I TE SEI4ER PERM I T PEP?fIT ~0. ( e.202_~ ) · RPPLICRf-IT STEVE ~1 STEFRf'I SPA E.O,, -?.81-P 345-6 LOCRT I Of't UF'PER DERRMOUf'I LEGRL L12 Bi TERRRCE HTS LOT SIZE 20416 TYPE OF SOIL RB_O~.FTIOfI SYSTEM M;.q,?,IMUr,1 HUf'IE:ER OF E:EDROOM$ = 4 SOIL RRTIr. IG <SO FT?BR)= 29i THE REQUIRED SIZE OF THE SOIL RBSORPTIOfl SYSTEM IS: ' DEPTH= LEr4GTH= ,---,,-~' ~] R R",,.-' E b DEPTH= THE LEHGTH DIMB]SIOH IS THE LEHGTH (IH FEET> OF THE TREHCH OR DRRI~IFIELD. THE DEPTH OF ~ TREf'~CH OR PIT IS THE DISTAl'ICE BETPlEEH THE SURF8CE OF THE GROUf'ID R~'ID THE BOTTOM OF THE EXCRVRTIOH <If't FEET>. THERE IS ~'~0 SET I.IIDTH FOR TREHCHES. THE GRRVEL DEPTH IS THE ~II,IIMLIbl DEPTH OF QRRVEL BETI.IEB-~ THE OUTFRLL PIPE Pr'lO THE B. OTTOM OF THE EXCRV8TIO~-I (If'I FEET). REr~.L~ I RED SEPT I C TI:Ir-IF( S I ZE= :1.25'-3 GFtLLOI'-,IS PERMIT RPF'LICRfE HRS THE RESPOf. ISIBILITY TO If.~FORM THIS DEPFIRTMEHT DURING THE If.iSTRLLRTIOH I~SPECTIOHS OF 8HY ;4ELLS RC, JRCEF~T TO THIS PROPERTY Rf.~D THE f.iUMBER OF RESIDE[.iCES THRT THE I{LL ~,IILL SERVE. TI40 < 2 ) I I'-,ISPECT I Of-IS PRE RE f2. L~ I RED BRCh'FILLIf-IG OF Pr'lC SYSTEM I,IITHOUT FIHRL II'ISPECTIOf. I FtHD RPPRO'¢FIL BY THIS DEPRRTMEf'IT I,IILL BE SUB,:rECT TO PROSECUTIOf'I. Pllf. IIMUM DISTRf. ICE BETI,IEEI~I Ft I,IEL~ Pr. ID Rf. IY OH-SITE SEI,IRGE DISF'OSRL SYSTEM IS 100 FEET FOR Ft PRIVRTE I,IELL OR 150 TO 200 FEET FROM R F'UE',LIC WELL DEPE~IDIH6 UF'Of.I THE TYPE OF PUBLIC I,ELL MINIMUM DISTRf. ICE FROr,1 R PRIVRTE I,IELL TO A PRIVRTE SEI,IER LI~E IS 25 FEET Rr.~D TO R COMf,IUf.~ITY SE,ER LIFE IS 75 FEET. fELL LOGS PRE REQUIRED Pr-ID 1,1UST E:E RETURtED TO THE DEPRRTr,IB~T I,IITHItI 28 DRYS OF THE I,IELL COMPLETIOf.I. OTHER REQUIREMEf.4TS MRY RPPL~. SPECIFICRTIO~.~S Rf.4D COf.4STRUOTIOf. I DIRGRRMS PRE RVRILRBLE TO INSURE PROPER It~STRLLRTIOf. J. ] PE~:H I T EXP I F:ES DiCEr.lEER 2:2, 29S=2 I: I RM FRMILIRR filTH THE REOUIREblEHTS FOR Ot.I-~ITE SEI,IERS RHD PlELL5 RS CE FORTH BY THE ~IU[.IICIPRLITY OF R~.~CHORRGE. '2: I I,IILL IHSTRLL THE SYSTEM I~ RCCORDRf. ICE I,IITH THE CODES. ~: I Uf. IDERSTR~.~D THRT THE Or-I-SITE SB,IER SYSTEM f,iRY REQUIRE Ef.~LRRGEblEf. IT IF THE RESIDEHCE IS REblODELED TO I~.~CLUDE f,IORE THRf.~ 4 BEDROOMS. ~ 18ED: ~ POUCH 6-650 ANCHORAGE, ALASKA 99502-065,') (907) 264-4111 D~ ;'ARTMENT or ILEAL1 H ,','.'t ENVli~ONMENTAL PHOTECTION ~Permit #: 820291 .January 31, 1983 L lf~-~q TO: Permit Applicant Subject: Lot 12 Block 1 Terrace Heights Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of blunicipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerel~ Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 ,PERFORMED FOR: ;LEGAL DESCRIPTION: .2 7- ~ 10- 15- 16- 17- 18- 19- 20- MUNICIPALITY OF ANCHORAGI:: ' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PE. RCOLATION TEST SOILS LOG '* · TEST SLOPE DATE PE.FO"=EO: I (". "-~- 5, ~ / IF YES, AT WHAT oEP,.? ! 1/ % ~//,.<<. 72-008 (6/79) Reading Date /! // Time //.v/? 11'57 ,2:~ 7 . /2;27 Net Time /~ /.~ Depth to Net Water D;op / 75~ /.fi7 ,06 PERCOLATION RATE .... ,' (minutes/inch) TEST.~..~-~WEE. --~.0 ....:N~:'">'.S '.--' '-" · ,-/, . , /,'. ¢,,,t.~' ¢;,.-, .. 4.<"....'.~ // y/-~ ,u., ¢~,o .,/ ' '. · :.,,,"~_.;....,, .... .~, ' "'~,'~'-~.'~'- /'K/. '. - - ".':. t":" :' .' ~' .' ... ,:~..-:,. 1-:' .." ',,. ':.,.. ..... t.":'~, ;~ .os-'I )qPP. L,96 0~A1~19~8 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) ]~o1: 12 ]~lock I Tet't'ace tle'~hl-~ ~t~h~v~nn Location (address or directions) (b) Applicant Name. Steve Stefan Applicant Address Telephone: Home 522-3959 Business (c) Applicant is (check one): Lending Institution I'1; Owner/builder ~; Buyer D; Other I-I (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family I-,','~× Multi-Family I-I Number of Bedrooms ~'ou]c(/~) Other WATER SUPPLY Individual Well~x Com. munity171 Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ~x Public [] Community [] Holding Tank [] Note: II community well system, must have written confirmation trom the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 ?=.ess {~,B4~ DA/~AND ENGINEERING FIRM PROVIDINg. ',ISPECTIONS, TESTS, FILE SEARCH, INFORMATION As ce~ified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality.of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone Address Date Engineer~ Seal This department has received written confirmation regardin~ the Conditional Approval of December 31, 1985. The conditions have been met and the property is now fully approved. DHEPAPPROVAL Approved for [our(4~ Approved xxxxxxxx bedroomsby ~'"''/J' '~/'"-~Date June 3, 1986 Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Departr~ent of Health and .EnviroNmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) . .... BESSE, E'*'PS & POTTS January 13, 1986 Municipality of Anchorage Department of Health and Environmental Protection Anchorage, AK 99501 Attention: Susan Os~ld Re: Private Residence Water Well Variance of Lot 12, Block 1 Terrace Heights subdivision, Anchorage, Alaska Gentlemen: On December 18, 1985, Besse, Epps &Potts performed an adequacy test on this system. The system met, without any problem, the criteria for a four-bedroom home. However, the 100-foot separation requirement is not fulfilled. Therefore, we are requesting a variance to the requirement that the private well be greater than 100 feet from the existing septic tank. The well is 76 feet from the existing septic tank. (Installation of the system was based on Table A of the Wastewater Disposal Regulations 18 AAC 72 Booklet.) The septic system was installed in August, 1982 and is physically sound and working properly. The leachfield has a separation distance from the well of over 150 feet and a vertical difference of 7 feet, the leachfield being the lower elevation of the two. The well is 118 feet deep and cased to that depth. The well casing is 6 inches in diameter and 3.5 feet above the ground surface with a sanitary seal. All cleanouts of the septic system have airtight caps and are physically sound. Public sewer is not available or present. Lot 11 to the east is vacant and Lot 13 to the west has a similar layout of well and septic system, the well being between the home and upper DeArmoun Road and the septic system to the south or rear of Lot 13. The water sample taken for coliform results tested satisfactory, and several families have lived in the residence ENGINEERING, PLANNING, SURVEYING ~0 E. 88th Ave./Anchorage, Alaska 99507/Telephone 907-3496451/344.1352 "ProWdino a ~3ualih/ Dersonalized se~lce to those bulldino Alaska's future" Municipality of Anchorage - DHEP Page 2 January 13, 1986 served by the w~ll with no adverse effects. Please find attached: " As-built of Lot 13 showing septic system and well ~ locat.ton Copy of bacterial report (satisfactory) Affidavit confirraing installation of steel banded flexible couplings in septic lines ° Well log In my professional opinion, the lesser separation distance is justifiable and reasonable. Please review and issue a variance. Thank you. Your attention is appreciated. Dale R. Merrell, PE Partner smh Attachments NORTHERN TESTING LABORATORIES, INC. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CUENT r-i PUBUC WATER SYSTEM I.D. # '~[~ PRIVATE WATER SYSTEM SAMPLE DATE:/~ MO. Doy yom* tPurchase Order No. SAMPLE TYPE: r-I Routine 1-1 Treated Water ' I-I Untreated W..ater r-i special Purpose .,,,, F'] Check Sample (for original contaminated sample with lab reference no. ) 3 4 5 6 7 8 9 10 Signature of Representative Date Received Time Received Next Sample Due COMMENTS: .............. - SATISFACTORY UNSATIS,CACTORY U RESAMPLE R · OTHER BACTERIA OB TOO NUMEROUS TNTC TO COUNT Coum /., ,~ /'~ C..--","., . / 1~o. of Total Cohform Colomes per 100 mis. ~ ~ ~, _! / ,*,_ . Reported by *'/ ' ~ ~ ~ ~.2'-.¢J: .Y S- BESSE, E-*PS & POTTS January 3, 1986 ~861 9 ~ IV I, Mike Gerharz, do hereby o~rtify that I assisted in the installation of the septic system on Lot 12, Block 1, Terrace Heights Subdivision and that steel banded flexible couplings w~re used as pipe connectors. Mike Gerharz 13630 Venus Way Anchorage, AK 99515 STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT) The foregoing instrument was acknowledged before me this Notary public for the State of Alaska ENGINEERING, PLANNING, SURVEYING 2220 E. 88th Ave./Anchorage, Alaska 99507/Telephone 907~49-6451/ 344.1352 "Providing a quality personalized sen/ice to those building Alaska's future" Mr. Steve Stefan 8000 Upper DeArmoun Road Anchorage, AK 99516 December 30, 1985 Municipality of Anchorage Department of Health and Environmental Protectio~ 825 "L# Street Anchorage, AK 99501 Attention: Ms. Susan Oswalt Subject: Statement for Conditional Approval of On-Site Sewer and Water Facility on Lot 12, Block 1, Terrace Heights subdivision Gentlemen: I, Steve Stefan, do hereby agree to move, on or before June 15, 1986, the septic tank on subject property to a distance of 100 feet or more from the existing well on subject prot~erty and that I will place in escrow $2,500 to insure that this will be accomplished. yours truly, STATE OF ALASKA ) )SS. THIRD JUDICIAL DISTRICT) The foregoing instrument was acknowledged before me this . .'~O~'~day of ~'/C~ ~f~/k_3 , 1985, by .~(~. -~/-~9 Y% - Notary Public for the State of Alaska' -. My Commission Expires: BE$$E. EPP$, E, POUFS QUANT. P.~GJECT Lt g'81 Engineering. Plmnnlng & Surveying 2220 E. 88th Avenue, Anchormge Alaska 99507 Telephone {g07} 3~4.1352, 34g-8451 DAILY INSPECTION REPORT WORK IN PROGRESS THIS DATE DESCRIPTION LOCATION DATE ,'v');,;, WEATHER CONTRACTORS WORK FORCE AS OF NO. INSPECTOR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION · (a) Legal D~scription (include lot/block, subdivision,~..;tion, township, range) Location (address or directionsi ' (b) Applicant Name---~',;,~'~'~' ~-~2'/t"/~"4'4// Telephone: Home ...,-".Z-'- .--~.~' Business Applicant Address (c) (d) Applicant is (check one): Lending Institution I'1; Owner/builder/~; Buyer []; Other ri (explain); Len, ding !?stitution Address Telephone (e) Real Estate C~mpany and Agent Telephone '~ (t) Mail Ihe HAA to the Iollowing address: TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms ~ Other MUNICIPALITy OF ANO'{ORAGE IFNVlRONMENTAL P,~OTECTION BEC 3 0 l°.85 WATER SUPPLY IndividualWell~ Community[] PuDlicI''1' ' RECEIVED Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page I of 2 SEWAGE DISPOSAL Onsite~ P~blic D Community 1-1 Holding Tank [] ' · Not~ If community well system; must have written confirmation from the State Department of Environmental Conservat;on attesting to the legality and status. - · , . I~NGINEERING FIRM PROVIDIN~ iNSPECTIONS, TESTS, FILE SEARCH, DA,,4 AND INFORMATION '.As ce~tlfied by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site wafer supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula!ions in effect on the date o~ i~.~i°n- Name of Firm ,/~ ~ ~- ~_c~--' Date f"~-~,~",'- Approved for .~q:::::~-~"~ bedrooms by~l/~Y~'~'-~w~w-w~w~ *-~'""~'Date Approved Disapproved Conditio~ , Termsof~nditionalApprova, ~~ ~~ ~' ~ ~ ~ ' CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 NORTHERN TESTING LABORATORIES, INC. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CUENT (-I PUBUC WATER SYSTEM I.D. ·; PRIVATE WATER Mo. D~W Yw Purchase Order No. SAMPLE TYPE: n Routine I-I Treated Water I-I .Special Purpose n Untreated Water n Check Sample (for original contaminated sample with lab reference no. ) TO BE COMPLETED BY LABORATORY Received at: ~ch. ) %Fbks. O.,e.ece,ved Time Received Next Sample Due COMMENTS: SATISFACTORY ~) UNSATISFACTORY U RESAMPLE R OTHER BACTERIA OB TOO NUMEROUS TNTC TO COUNT 2 3 4 5 6 7 10 Signature of Representative Time L,cx:at~on: Br~SS~-~ EPPS & POTT$ 2220 EAST 88 AV~:rdR ANOI(lrUtGE~, Al( 9~507 (~07) S49-64SZ Client's Name: Address: Initial Reading c~et~r: ~'-. Prcxlnctlon Ratn: .~,~ GP~ 24-ltour Capacity MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal D~scription: WELL DATA Well Classification ,~- /"~'//-Y If A, B, C, D.E.C. Approved (Y/N) Well Log Present {y~il Date Completed ~"-~)~'='-~'~_ /~'~ Yield / Total Depth ~'"'~'~' Cased to '~ ~ Depth of Grouting '"'--" Static Water Level ,/~/7 '/ Pump Set At ,..~.~..5"- / Casing Height Above Ground .~..5," / Sanitary Seal on Casingl~4) Electrical Wiring in Conduil{~) Depression Around Wellhead ('~. Separation Distances from Well: ("~'"~ To Septic/Holding Tan~( on Lot ~/'~'7~2 ' ~-~/-/ ; On Adjoining Lots /'~<:~ "~'" ' /.._~------ TO Nearest Edge of Abso'rption Field onLo~~.~ ~ ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole ~"" To Nearest Sewer Service Line on Lot - Water Sample Col!ected by ~'~~P~,4/~'/ ;Date Water Sample Test Results Comments ~' ~"~-'- ."4-/,~-/~/-' B. SEPTIC/HOLDING TANK DATA StandpipeS) , Air-tight Cap~l) Depression over Tank (Y~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ To Property Line .5~ To Water Main/Service Line Date Installed ~'~>~- /~'.~--Size '~,,/,.~"'o No. of Compartments ~ Foundation Cleanout (Y~ Date Last Pumped ,/~" -- ~'~ · "'"'-- ; for ~ Temporary Holding Tank Permit (Y/N) Course Comments To Building Foundation ~' To Disposal Field ~'"~ / To Stream, Pond, Lake, or Major Drainage -' ' °P~g~ 1 of 2 '72-026{11/84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed · / Width of Field Type of System Design Length of Field ~ Depth of Field Gravel ~ Thickness ~ Date of Last Ad~uacy Test Square Feet of Absorption Area Depression over Field ,(~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot .4/~-, ~r/.~' To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION __ ------- To Property Line To Existing o,~,Abandoned System on ; On Adjoining Lots · ,'/~c'~' To Cutbank (if present) .~,,'~' Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (WN) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~'ing Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request I certify that I have chec k*~d. verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed .~?/.~x'~ .~'."t' ' Date ,/~" Compeny-'"~--~-~"~ -'~--/'/~"~ ~ ~-'-'-'-'-'-'-'-'--b",'~,~lOA No. Receipt I/ Date of Payment ! '""~-~"~-~-,~'* Amount: $ (~ ~ Page 2 of 2