HomeMy WebLinkAboutPARK HILLS #1 BLK 3 LT 2Park Hills #1
Block 3
Lot 2
#017-142-20
Plai-3' 21 09-59-a Aiiohorage 'Aleil &
S-072430742 0.1
A
MumNICIPALITY OF )ANCHORAGE
Development Services DepartmentPhone: 90'17-343-7904
On -Ste Water & Wastewater -Section Fax: 907-343-7997
Pump Installation Log
Well Drillim, Permit Number: Dsteoflssue: 3
Parcel Identification Number:
Legal Description Block' Let Property Ovviuer Name & Address:
Ca4-k HJ! s #I
I
Pump Installation Date: '30
L
Pump Intake Depth Beiow,rop of well casing: feet - . /� I
M
Pump.anufacmrur's Name:
Pump I'Aodel:.
Pump Size: hp
Pities Adapter Burial Depth. feet
Pitle,s-, Adapter Man alact arer's Name:
Pitless Adapter Installer:
Welt Disinfected Upon Comp"on? 0-/YLs 0 No
Nlethod of Disinfection:
Comments:
Pump Installer Name:. MCHORAGE WELL& PUMP SERVICE
7640 J(j!jg Street
Company: 411c"Or3se, AK 995,19
PP: ,'9D71243-0-740
I Mailing Address -
L21
State:
Mtention: The putn't) instaj'er shall provide a pump installat-ion log -0 Ori-s:te within 30 days of -pump installation.
Municipality of Anchorage Page 1 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska
99519-6650 Telephone: 343-4744
Onsite Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW000385
PID Number. 017-142-20
Name.
Wastewater System: ❑ New ■ Upgrade
STEVE FRANCIS
Ad'""'ABSORPTION
FIELD
14720 PARK HILLS DRIVE
Phone: No. of Bedrooms:
(907) 279-9407 3
a Deep Trenth ■ Shallow Trench O Bed O Mound 13 Other
sw Ratl"9; Told Depth sem ergYal weft
LEGAL DESCRIPTION
1.2 aPan4 R 1.22 - 1.96 AVG. R
Lot: Block: Subdivision:
caps, to pipe eemn tram Oftd Aadk
Gn. eWU O PIOK 1.Z2
3 PARK HILLS #1
0 — 0.37 R
m2
Township:
—
Range: —
Section: —
rm added aeon enyaa aadt
SEE DRAWING
a'ei I Wifk
90 (3 a 30') R
R
WELL: ❑ New ❑ Upgrade
arms .Ian:
5' R
Nwnee. a bwc
3
Ol.tawe saw— sn.e
15' R
cM. dkwuen Pomte A9.0 Tetd CQ"d Ta:
Told a.e tkM ar.o:
517+
Pipe a ofenek
D 3034/F-810/SCH 40 PVC
R R
so. R
I>,w«:t pG Datea NW: stork war `«.I.
tat~ OWNER INSTALL
t. x%2000 — 10/31/2000
R
pump sd AL
ce.lno "ht Ab" &DWI&
TANK
GM
R
R
SEPARATION
DISTANCES
0Septic 0Holding ■S.T.E.P.
To
Septit
Tank
Absorp0on
Heid
UH
Station
Holding
Tank
D1k/Prlvale
sews tkw.
�• .
ANCHORAGE TANK
Dep�b in 9M
1500
From
ya'*dw;
Number el emrparun .
Well
100'+
100'+
100'+
—
25'+
STEEL
2
Surface
100'+
100'+
100'+
-
-
LIFT STATION
Water
Lot
5'+
10'+
5'+
—
—
Slee M eesarc
Nara fwtwen
ANCHORAGE TANK/ORENCO SYSTEMS
Line
1500
M I.wl el:
ump ON le." R
,fpn e o au
46"
Foundation
5'+
10'+
5'+
—
—
42w
42w
Curtain
NONE
KNOW
Pwnv Ita,e a Md.n
/20 OSI OS HHF
f3wtr nrp.clI Parrannad W.
M.O.A.
Drain
BENCH MARK
1. S.T.E.P. WAS INSTALLED BY A+ HOME SERVICES.
teoolbn and pe.vigbn:
2. OLD SEPTIC TANK AND LIFT STATION WERE ABANDONED
TOP OF MANHOLE LID.
PER THE UPC.
FL.wu«.:
w.'"rwe
99.74 R
3. SIZED FOR 4 BEDROOMS.
eMoseeire SEAL
00640
O�
O� ��• SdO�
Inspections performed by AWWC INC. Dates: s/ze/2000
0 y00
0• • •' • •• ••• .......D
2nd 9/29/00-10/31/00
3rd 12/6/2000
I.V f e Carnass.
Department of Health and Human Servi
es approval
9
dp�t,�4•. c 7953
Reviewed and approved by:
Date: I °
7
Q� OdProfession°oma
X4406000
-ots «. 9/91) ua 25
W0 NUMBER: AS—BUILT DRAWING PARCEL NUMBER:
SW00038-
5 017-11 42-20
EXISTING DRAINFIEUD i
TO BE USED AS A
RESERVE SrrE
I
I
STI
9.9
49.0
ST2
17.9
51.8
MH
19.1
52.2
MT1
53.8
45.3
MT2
72.5
66.6
MT3
63.2
43.9
MT4
79.4
65.2
MT5
74.7
47.1
MT6
89.9
69.0
I
WELL TO STI WAS MEASURED
WTIH A TOPCON TOTAL STATION
AND CONCLUDED A SEPARATION
DISTANCE OF 103.9 FEET.
I \\ 3
I \ �
r---� \ NEW DRAINFIELDS
I 8
I I \\
I I I
I I I MT41r MT
I II II II
LJ
I ITM�{ I I I
I I �
NEW 1500 GALLON
ST S.T.E.P. TANK
STI
bI
EXISTING THREE
BEDROOM HOUSE '•!••
I � ,
I / \
1� \
12/13/20
DRAWN BY:
ALASKA `VATKR & WASTENVATKR SCALE K.D.W
.
CONSULTANTS INC. 1" c 40•
.nn. nen.m m.n e�..f w . ♦,Mul1O/.ff 1K ",l • fHfI1F (0071337.A170 • FAX (907)335-3266
STEVE FRANCIS
279-9407 1 2 OF 3
PARK HILLS SUBDIVISION #1; LOT 2, BLOCK
OF WORK:
AS -BUILT OF SEPTIC SYSTEM UPGRADE
I
I I
I
1 I
\\ I
I
�I
I
I \ \
-1984 TEST HOLE.
JOHN IAMBE. P.E.
WATER O 7.6 FEET
(6/28/84.
2 MIN/INCH ERK
I
I
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of
YI
GOTICS3;
7953
..... .*c�q1
PERM- NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
SW000385 017-142-20
FINAL cm
98b - 98.8
511 5f2
fOP OF fA K
Af lWf - 91.29
NSW 1500 GAI.I.ON
lmff or ftm 511"1 , AANK
Af IN.Ef -9037 ; 10 GAIZG MP 6LIPW
WEST TRENCH CENTER TRENCH
TOP OP MANae
LID - 99,99
—fOP OF fA%
Af 011f1.if - 9133
`iM/l;Rf OF M4
Af Nl f - 90.78
fPY1 CXADi ftmaPDE
—
O�lll. CRh'�E
C � 102.5IG52
fm"10
OrGINw' am n�� pq[iQ`1�i. SIDE
• 1051+ � I I r _101.4-101B •102.-102.5
"TOM OF �
1MNO1- 9987 AVG. "TOM of 1nN
100.61 AVG.
.09 OF EFFECTIVE E
f 12/13/2(
Y tf� DRAWN BY:
r_
ALASIU M7ATI:R & AVASTr«TATER SCALE:K.D.W.
CONSULTANTS, ORAINC. N.T.S.
6901 DEBARK ROAD. SUTE 29 • ANOMGE. A6 9950. •,HONE 907)117-0179 • FAX 9071516-3246
REPARED FOR: PHONE NUMBER: PACE NUMBER:
STEVE FRANCIS (907) 279-9407 3 OF 3
:GAL DESCRIPBON:
PARK HILLS SUBDIVISION #2; LOT 2. BLOCK 3
fPE OF WORK:
AS -BUILT PROFILE OF SEPTIC SYSTEM UPGRADE
B0f10M or
1REN01-101.26 AVG.
mmof m I
102.44
:.l..I....V.
A. Gamess.
-7953 `��
0
0r1/02/2013 01:10 FAX
.0 r- /1, r e .,/af
� 3"1
e001
Page Y of 10 ' n'SPF,CT 0,V REPORT '
-MUNICIPALITY OF ANCHORAGE - BUILDWG SAFETY DIVISION
4700 SOUTH BRAGAW STREET. ANI CHORAGE. ALAS"
INSPEC770NS: Yoj (907) 343.8300 Far: (901) 343-8233 INFORMATION.(901) 3*3-8211
NAAM EDS ELECTRIC �^ PgRwTNumBER: 00-9521
ADDRESS: 14720 PARK BILLS DR DATE: 11/1/00
PHONE 01: 272-4591 PHOhTOI:
LOT. 2 DLOGX.• 3 SUDD1i7SI04v. 'PARK BILLS trl
COhfhfEN7S AMUrGCALLB4
7TPE OF W., i —2. 43:
INSPECTION.- Electrical Rough
❑ No non-compliance observed ❑ Conacdons essential as explained below. ❑ GO.Opproved
❑ WM re mmuw at neat inspection ❑ Do not conceal untie -inspected. u C.C.C. approved (comments belaW).
co_tirsrE±vls:
1:
INSPECTOR: �% G -�' t �'^ `G AIA) C—
DA TE:
//- f —0 d
WIZEN CORRECI70NSARE MADE, PLEASE CALL FOR INSPECTION 0459
DO NOTREMOYE TILS NOT7CM
Permit Number: SW000385
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
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Sep 18, 2000
Expiration Date: Sep 18, 2001
Parcel ID: 017-142-20
Legal Description: PARK HILLS #1 BLK 3 LT 2
Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: 014720 PARK HILLS DR
Owner Name: Steve Francis Lot Size: 50204 SO. FT.
Owner Address: 14720 Park Hills Dr. Total Bedrooms: 3 Permit Bedrooms: 3
Anchorage , AK 99516 -
This permit Is for the construction of:
O Disposal Field Q 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 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: / �� cre
Date: 7 —146 M
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
September 8, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Design for Lot 2, Block 3, Park Hills Subdivision.
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The existing septic
system consists of a 1250 gallon septic tank, a 100 gallon dosing tank, and a pressurized bed type
drainfield. The existing drainfield is in a state of failure and is in need of a upgrade. One test hole
was excavated on the property. The proposed septic system will be designed around the 30 foot
radius of this test hole. Per the request of the homeowner, the system will be sized for a 4
bedroom house. We are proposing that a 1500 gallon S.T.E.P. tank and a five foot wide
drainfields be installed. Comments regarding the proposed design are summarized as follows:
1. SOILS: A soil log which shows the soil classifications, groundwater monitoring, and the
percolation test results is attached. It is our opinion that due to the overall appearance of the
soils, an application rate of 1.2 gallons/day/f12 should be used, and the insitu soils should act as a
sand filter.
2. TRENCII DESIGN:
a. Percolation Rate: <1 minutes/inch
b. Allowable Application Rate: 1.2 gallons/day/f12
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 500112
f. Total Depth: 3 feet (max.)
g. Effective Depth: 1.5 feet
h. Width: 5 feet
i. Reduction Factor: 0.78
j. Minimum Length: 78 feet total leng2th (3 @ 30 feet long)
k. Effective absorption area = 577 R
Note: the distribution line is to have 1-1/4 inch Sch. 40 PVC with 1/4 inch diameter holes spaced
every 3 feet on center.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
3. SURFACE WATERS: There is a creek north of the proposed drainfield. The 100 foot
setback will be flagged by a registered land surveyor prior to construction.
4. TOPOGRAPHY: The area for the proposed septic system is generally flat; in short, there
are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179, or 244-9612. Thank you for
your assistance. _
.S.
NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, two soils logs,
and a 7 page construction specification letter which are all part of the design package for this
septic system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
G
1
I
I
1
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1
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-- U
I �
I �♦ TRACT A-1
BIRCH TREE ESTATES S/D
LOT 19, BK 1,
I �
�\
BIRCH TREE ESTATES S/D
LOT 20, BK 1,
FIELD VERIFY
EXISTING �RAINFIEID
1 \ 1 I �\\
\ I 11111
I
I I I
BIRCH TREE ESTATES S/D/ 1 I
LOT 21, BK 1, I I
I
'c;k
-EXIST`NG SEFrnC TANK I I
I I
1 1
S S/D��---
• I
IY \\
j\ 4� PARK ILLS S/D
�pIUS1 LOT I.
(BLOCK 3,
I � 1
WOOD -HAVEN
PARK HILLS S/D
LOT 1 S. BLOCK 2,
y
-- — DATE:
(J/,) 9/8/2000
DRAWN BY: '`�•O •.`��l y'1
ALASKA VATKR & WASTKWATKR
C.J.G. •`r ''�1s
SCALE
CONSULTANTS, INC. .. .....
1 " = 1007 ,
6901 DEBARR ROAD. SUTE 29 • ANfHORAGF. AX 9950.' MONS (907)337-6179 FAX 907)336-3246
PREPARED FOR PHONE NUMBER: PAGE NUMBER: G ••
STEVE FRANCIS (907) 279-9407 1 OF 2 �`%,. ' re A. Or ss. <;
LEGAL DESCR1PnON: I'(1r y '• • —79 F'.
PARK HILLS X11; LOT 2, BLOCK 3,
TYPE OF WORK: y��V�dProfe6slo��:'�
SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE
--PARK HILLS S/D
LOT 16, BLOC; 2,
I 1 I
RApIL II I
1 �
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V
I I
I
PARK HILLS S/D I I 1
�\
LOT 15, BLOC 2, i 1
`\
(: ERFEAC
I I I
ROPOSED SEPTIC UPC E I
, SEE DESIGN, (PACE 2 OF 2) 1
PARK HILLS S/D
LOT 1 S. BLOCK 2,
y
-- — DATE:
(J/,) 9/8/2000
DRAWN BY: '`�•O •.`��l y'1
ALASKA VATKR & WASTKWATKR
C.J.G. •`r ''�1s
SCALE
CONSULTANTS, INC. .. .....
1 " = 1007 ,
6901 DEBARR ROAD. SUTE 29 • ANfHORAGF. AX 9950.' MONS (907)337-6179 FAX 907)336-3246
PREPARED FOR PHONE NUMBER: PAGE NUMBER: G ••
STEVE FRANCIS (907) 279-9407 1 OF 2 �`%,. ' re A. Or ss. <;
LEGAL DESCR1PnON: I'(1r y '• • —79 F'.
PARK HILLS X11; LOT 2, BLOCK 3,
TYPE OF WORK: y��V�dProfe6slo��:'�
SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE
PROPOSED DRAINFIELD. EXCAVATE \ \
3 TRENCHES THAT ARE 3 FEET DEEP
MAXIMUM BY S FEET WIDE AND 30 \
FEET LONG EACH (94.5 FEET TOTAL
LENGTH). ADD 1.5 FEET OF CLEAN.
WASHED SEWER DRAINROCK. THE
' DISH SCH40 NNPVC WITH 1/4 INCE IS TO HAVE 1 H4
DIAMETER HOLES SPACED EVERY 3 FEET.
I \
iris i 7wr i (Mr
EXISTING DRAINFIELD
TO BE USED AS A
RESERVE SITE I I
I I
I I
EXISTING TANK TO BES
ABANDONED COMPLETELl
I I
I I
I I
I �
4,411
/
EXISTING
3 BEDROOM
�.,. HOUSE F
PONDER WATER W I '
THIS AREA SHALL BE U
FILLED WITH 8' TO 12'
RIVER ROCK AND GRAVEL
AS REJUIRED TO EUMINATE
lI
I
ALASKA NVATER & WASTE NVATER
CONSULTANTS, INC.
A, ♦wun0e0. eR aaSM • MW (00717]7-6170 • FAX (007).770-0M
STEVE FRANCIS
PARK HILLS SUBDIVISION 01
OF WORK:
DESIGN FOR SEPTIC SYSTEM
(907) 279-9407
LOT 2, BLOCK 3.
UPGRADE
9/8/2000
0
AWN BY:
C.J.G.
Op
ALE:
000
�0•.:.
�E NUMBER:
2OF2
_
I I
I1 I
\ I
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-1984 TESTI HOLE.
JOHN LAM E. P.E.
WATER O 7 6 FEET
(8/28/q4).
2 MIN/INC ERK
L\L-� I
(7)I
JI
JI
I
�1
A.� GdrrtCss�
WATER & WASTEWATER
NTS. INC.
SOIL LOG
- PERCOLATION TESTI
0 ;
LEGAL DESCRIPTION: PARK
HILLS SUBDIVISION A1; LOT 2, BLOCK 3
a
CLASSIFICATIONS
PERFORMED FOR: STEVE FRANCIS
DATE PERFORMED: 6/26/2000
�'
�QOo
••.. •
ossa,
., 7953
DE ___
(feel) yoy� ORGANICS
TEST HOLE # 1
00 ewe '•.........• \ioc
00 dProfesslo^ooc
��40000�a
1zz=
•.
7
6
9
10
11
12
13
14
15
16
17
DEPTH TO DATE
GROUNDWATER
11.0' 8/28/00
7.4' 9/5/00
e
DATE I READING I CLOCK I NET TIME I WATER LEVEL NET DROP
TIME (MINUTES) I READING I (INCHES)
19� PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6. (INCHES)
20 TEST RUN BETWEEN 4.5 5.0 FT.
COMMENTS:
PERFORMED BY ALASKA WATER & WASTEWATER I, CERTIFY THAT
THIS WAS PERF M D IN ACCORDANCE WITH ALL STATyrjjUAZVPl GUIDELINES IN EFFECT ON THIS
DATE: 11, ZQ
r
SOIL
CLASSIFICATIONS
1zz=
•.
1GPIIIIIIIIIML
II�III!11GM
CL
GC
•
1SWIIIIIIIIIMH
!tet
CH
GM/SM�ztl�isl
•
�.�SC
7
6
9
10
11
12
13
14
15
16
17
DEPTH TO DATE
GROUNDWATER
11.0' 8/28/00
7.4' 9/5/00
e
DATE I READING I CLOCK I NET TIME I WATER LEVEL NET DROP
TIME (MINUTES) I READING I (INCHES)
19� PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6. (INCHES)
20 TEST RUN BETWEEN 4.5 5.0 FT.
COMMENTS:
PERFORMED BY ALASKA WATER & WASTEWATER I, CERTIFY THAT
THIS WAS PERF M D IN ACCORDANCE WITH ALL STATyrjjUAZVPl GUIDELINES IN EFFECT ON THIS
DATE: 11, ZQ
72-013
72-013 Rev. 3/78)
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
'13.
EW
Seal
❑UPGRADE
MAI LING ADDR(E'S�S T/ rZ- V&EAL-r 441
e-1® c�//
/�
l ,�`i'tL pYf.,, N�.N t� -✓iy �_
-
LEGAL DESCRIPTION
l-el)-rl M-cue-I41l
LOCATION
77
LGL47gr 1VIYz�� 06
IL�3gt
NO. OF BED OMS
O
! \ CeIZi���
o
_Y
DISTANCE TO:
Well /
���
AbsorpZtio�area
Dwellings
1
PE�IT�NOO.�bQ
93 UC7
F- z
Manufacturer ,/
Material
No. of copyBartments
LU
V)
Liq. csap�ci�in gallons
IF HOMEMADE: -
Inside length
Width
Liquid depth
_QZ
DISTANCE TO: Well 11-�' Dwellingzbi_!_
rr
PERMIT NO.
S4oSS
yyxx
F
Manufacturer
���� Material
`7"W
Liquid capacity in gallons
w l:__
9 C30�
J
DISTANCE TO:
Well
�,3�
Foundation
®�
Nearest lot line
o
PERMIT NO.
Lu
3 s'
J LL
No. of linesLength
of ea h line
o '
Total length of lines
Trench width
Distance between I f!es
z
3 2
4����s ��
46 inches
/C7
Top of the to Finish grades
Material beneath the
Total effective abs rption area
2185 10'/- ,3L
inches
r1
W
Length Width '
apt h
PERMIT NO.
(9
a F
W °.
Type of crib
Crib d
ete
C b depth
Total effective absorption area
W
y
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE TO:
Buildin�oundation
Sewer line
Septic ta
Absorption area(s)
OTHER
%GI 6 AC
PIPE MATERIALS
u/
ASG, I. P, Z 4U IZ/f 3034
—.a
, _"X4iZD
4
-
SOILTESTRATING
ec"i
ss
s
� �
cgs
p ���
1+r s
-- f.
4H c
INSTAL ER+ rim
{,r r
�L 6, { \ it
-6
t
_(Oil
REMARKS �t%G (il1-=�7Jf v`i2
W �
ryas ruE�
i '1
12s ei (-
C �y
6w Te-
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a
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h
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\ c� r2_ 1 `+ h Yn Y �'LL/Sj— `o, VT,ZPC s :r
::-
IN APP N 77o FL7t e-TlZ1LAL, LNS P, �k`rl§0G
+ice
APPROVED O; L.tP1�--1 DATE
72-013
72-013 Rev. 3/78)
����I C� I F=-"flc� 9 1 -11- V C3 F=- �A LhJ U-:� H --j CIT FR 44 C-3 E: -.-
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825L STREET, ANCHQRAGE� AK 99501
264-4720
����Ir. -T1=— �S IE� 1W E-7- F:;� Z-!: W E-..-. L-� 11-- F-- E:-7. F�-e,- P011 I�
PERMIT NO: 840588 ENGINEERED DESIGNvn
DATE ISSUED: 07/18/84
APPLICANT: HELEN PARKER
ADDRESS: 401 E. 41TH
ANCHORAGE, AK 99503
CONTACT PHONE: 561~1333
LEGAL DESCRIP: SUBDIVISION: PARK HILLS #1 LOT: 2 BLOCK: 3
SECTION: 34 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 1.15A (SQ.FT. OR ACRES)
I certify that:
1. I am familiar with the -requirements for on-site sewers and wells`asset
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install, thesystem in accordance with all MOA codes and regulations
and in compliance with the design criteria o{ this permit.
3. I will adhere to all MOA and State of Alaska'requirements for the set back-
distances
ackdistances from any existing well, wastewater disposal system or, public
sewerage system on this or any adjacent or nearby lot.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1)C ION MUST BE OBTAINED; (2) AS~BUILTS
WILL N8T ELECTRICAL INSPECTION 3) THE
ELECTRICALB SED ELECTRICIAN
SIGNED DATE
--7--------e
APPLICANT: HELENJr
ISSUED BY DATE:
~~-r~~-
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�
GEOTECHNICAL
i M LAMBE AND ASSOCIATES INC. ANDITESING
ETING
John M. Lambe, P.E. 7127 Old Seward Highway ® Anchorage, Alaska 99502 907-349-6531
July 17, 1984
Radine Williams
Helen Parker
c/o Star Realty
401 E. 45th Avenue
Anchorage, AK 99503
REF: Lot 2, Block 3
Park Hills Subdivision Addition #1
In response to your request, we have designed a sewage
disposal system for Lot 2, Block 3, Park Hills Subdivision. The
original plans for the system are attached. On July 13, 1984
copies were submitted to the Department of Health and
Environmental Protection (DHEP) for review. Mr. Keith Bandt of
DHEP called our office on July 17, 1984 and indicated the plans
were approved. Upon submittal of the original plans you should
obtain your permit, you should ask specifically for Mr. Bandt.
We should inspect the installation of the system.
Ground water was observed to exist approximately 7 feet
below the ground surface in our test location. We believe
shallow ground water may also affect your house. We recommend
provisions to intercept ground water prior to intruding into the
basement. These measures will include, but are not limited to:
1) Waterproofing of Basement Walls.
2) Installation of Footing Drains. The drain should be
carried to daylight. The outfall should be protected from
freezing.
3) Placing at least 1 foot of NFS Sandy Gravel below all
footings.
4) Placing 20 inches of NFS Gravel below the slab.
5) Installing a drain tile in the Gravel beneath the slab
terminating at a sump equipped with float controlled pump and
high water alarm.
6) Installing an impermeable membrane between the slab and
the Gravel.
7) Lining the building excavation with Typar 3401.
A sketch of these precautions is attached.
Sincerely,
'5m
O I7:�<
John M. mb, P.E.
Civil Engineer 4254-E
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ANCHORAGE, AIS 99502
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�,,/IUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
❑ PERCOLATION
825 L Street, Anchorage, Alaska 99501 264.4720 TEST
SOILS LOG — PERCOLATION TEST I
PERFORMED FOR-_ /D
DATE PERFORMED: 3 -?S -,L
LEGAL DESCRIPTION:
DEPTH SLOPE
tor' k",rns.rS
1 0�gf 1 4Q Si Lr r 3,0wNr I-rOLC AJ
2 F'roZEAJ To 20
5�Sv� cjrAvE.. $A.,Jd w,-ra Sl6.r
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SITE PLAN
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\a `Pea m� GUI. Y/,�=i25 5'S ,.JauTN �v
,,Date`Drilleds 7-2,6--81-
Static dater Level 46 feet
Draw Down
r)/ ^ feet
a Material Drilledt
9 feet
to 8 Sandy �rnVP1
Park Mi. 11 Sllh(i o
Gallons Per Minute 20
Total Feet of Casing 1.08
8 feet to 70 0rey ha.rdnan, �xwP1
MUNICIPALITY OF ANCHOP%-Ge
HEALTH
&
20 feet to 55 S,)tld, nravP
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ENVIDEPT. OF
RON
80 Brown r_ 1",
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55 feet to
RECEOV ED
P� feet_ to 1.00 Rocks, hould ers
1.00 feet to 108 Boulders, nravPl a/•rater
Hefty Drilling ,� iZ tPo�zC7
S.R.A. Box 1553 H
Anchorage,Alaska
�a til V � IZSl��o ►J L.y/ NA 2
99507
3�S v5�3
Municipality of Anchorage
'• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw, Street
P.O. Box 196650
Anchorage, -7904 6650
www.muni.org/onsite
(907) 34 3-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
�1 FOR A SINGLE FAMILY DWELLING
Parcel I.D. OIC- - I - �y COSA# OX96
1. GENERAL INFORMATION Expiration Date: -7-9-10
'� 1 �
Complete legal description PARK HILLS f16 BLOCK 3. LOT 2
Location (site address) 14720 PARK HILLS DRIVE *ANCHORAGE, AK 99516
Current Property owner(s) STEVE FRANCIS Day phone 229-0106
Mailing address 14720 PARK HILLS DRIVE *ANCHORAGE, AK 99516
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing address
Unless otherwise requested, COSA will be heldby DSD /or pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well
N
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Individual On-site
0
Individual Holding tank
❑
Community On-site
❑
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
S.
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 riles 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 Finn GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 rt
Engineers Printed Name JEFFREY A. GARNESS. P.E. Date
Engineers Comments:
In conducting this evaluation, GEG, LID. 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 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. 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.
Conditional approval for
bedrooms, with the fllowing stipulations:
Attachments:
COSA Checklist t/ Arsenic Advisory
Septic System Advisory Maintenance Agreements
cy
ONSITE e.
WATER AND
WASTEWATER
PPr1COA1.
Well Flow Advisory Supplemental Engineers Report
Nitrate Adviso Other
By Original Certificate Date: tJ
(Rev 11,15)
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
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: PARK HILLS #1; BLOCK 3, LOT 2 Parcel ID: 0/7 - % HZ �. n
A. WELL DATA
Well type PRwATE If A. B, or C provide PWSID# N/A Well Log (YIN) YES
Date completed 7/26/1984 Sanitary seal (YIN) YES Wires properly protected (YIN) YES
Total depth 108 ft. Cased to 108 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of lest 7/26/1984 7/1/09 '
Static water level 46 ft. 56 ft.
Well production 20 g.p.m. 4.54 g.p.m.
WATER SAM(P' E RESULTS:
Coliform t colonies/100 ml. Nitrate (mg./L. Other bacteria l colonies/100 ml.
Arsenic:' 5 ug./L. Date of sample" 1 y L O Collected by GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEP/STEEL Date installed 9/28-12/6/2000
Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (1Y/^N) YES Depression over tank (YIN) NO High water alarm (YIN) YES
Date of pumping L���1 0 Pumper 6A- 1-j b IYl e "Sr i t
C. ABSORPTION FIELD DATA row EXISTING GRADE
Date installed 9/28-12/6/2000 Soil rating (g.p.(1./ft b /bd 1_2 System type TRENCH
Length ;3030=90 ft. Width 5 ft. Gravel below pipe 1.09-1.22 ft.
1
Total depth 3.08-3.49ft. Eff. absorption area5151 �+ ft2 Monitoring tube YES Depression over field NO
Date of adequacy test **7/l/2009 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 2 in. Water added 450 gal. New depth 3 in.
Elapsed Time: 495 min. Final fluid depth 2 in. Absorption rate >= 450 g.p.d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
"NOTE: !ADEQUACY TEST PERFORMED ON MIDDLE TRENCH ONLY. EAST TRENCH WAS DRY AND WEST
TRENCH HAD 2" OF LIQUID IN R. ALTERNATE SITE WAS NOT IN USE AND DRY.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at in. "Pump off leve High water alarm level at
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 1000+
Public sewer main N/A
Sewer /septic service line 25'+
Public sewer manhole/cleanout N/A
Holding tank N/A
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 N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
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 NN/me JEFFREY A. GARNESS
Date t{ I s0
u -CD
COSA Fee S q t 0
Date of Payment y� (s i f /O
Receipt Number. D G "7
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
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NO CORNERS SET THIS DATE SCALE.T' P 40'
I HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOMNG
DESCRIBED PROPERTY
LOT 2. BLOCK 5. PARK HILLS SUB NO 1
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN I ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL THE IMPROVEMENTS SITUATED THEREON ARE WTHIN THE
STRUCTURES OR FENCELINES PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST
OTHER THAN NOTED
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PIAT, ARE NOT SHOWN HEREON. DATEDAT ANCHORAGE, ALASKA THIS_xTH_
DAY OF _MARCH 2010_
NOTE. ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINE HOLT LAID SURVEYING
OR LOCATE STRUCTURES. I
TEL 515-M13 11255. FB 14M120
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NO CORNERS SET THIS DATE SCALE.T' P 40'
I HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOMNG
DESCRIBED PROPERTY
LOT 2. BLOCK 5. PARK HILLS SUB NO 1
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN I ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL THE IMPROVEMENTS SITUATED THEREON ARE WTHIN THE
STRUCTURES OR FENCELINES PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST
OTHER THAN NOTED
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PIAT, ARE NOT SHOWN HEREON. DATEDAT ANCHORAGE, ALASKA THIS_xTH_
DAY OF _MARCH 2010_
NOTE. ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINE HOLT LAID SURVEYING
OR LOCATE STRUCTURES. I
TEL 515-M13 11255. FB 14M120
_ _.Property owner
Individual well ✓
Day phone
319 -76'5 i
Community well _. 77 `
Mailing address
-.;
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'"thl!r Dr��
Ancharagp
/}� `t9Sl�
NOTE:
`!f community well system; provide written confirmation
--
from State ADEC
Lending agency
6' I`y A C -'
:Ifa►ro / Nes b', ft
^' Day phone
J -d 2. - 23 8 i
Mailing address
�/60Gr1 Tucla�='
Ol�iacl , i4achoragP
/1-�c '99503
Agent Teaneki u/a/ki i
Pour RQc►//y
Day phone
3 y9 - 76761
72-025 (Rev. 1191) Front MOA #21
Individual well ✓
Community well _. 77 `
Public water
NOTE:
`!f community well system; provide written confirmation
--
from State ADEC
attest-
-
ing to the legality and status of system.
4. TYPE OF
WASTEWATER DISPOSAL:41
Individual on site ✓
f
Holding tank
Community on site
- (Public sewer
UL
.'NOTE: `
If community wastewater system; provide written confirmation from
State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1191) Front MOA #21
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 of this Health Authority Approval application 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 verifythat 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 FRh4.o 7RC62-I ca/ SPrv;eew- Phone kyr— 13SS
Address 116-30 oGel7o -rf.. AAr-4 27 a At< 99116"
Engineer's signature Date 'y �Z y 94
•,r Yxy••1Y 11 .tw p 4.
> a
}. 6-41"eODO�E F. MOORS � �. z42 .., ...- 3
+The MQriicij ality of Apth6rage Department of Health and Human Services (DHHS) issues Health Authority
Aj)p roval dertificatesL�ased only upon the representations given in paragraph 5 above by an independent
protassional,engtr ;sf registered in State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their)ending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conducf "inspections or analyze data before a certificate is issued. -The Municipality. of Ancho_ rage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Sack MOA #21
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: �va 20 t3/k3- Park JfIjls S'(p Parcel I.D.
A. Well Data
Well type Pry v u FG If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) Yes Date completed -71Z6_1611 Driller Heff�
Total depth 10 6 ' Cased to 1060 Casing height / ? fi
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump levell
Y Wires properly protected (Y/N) _
FROM WELL LOG AT INSPECTION
-/ 26/6yg /16/
N6' y6'
O g.p.m. E.3 -v g.p.m
9'/'
SEPARATION DISTANCES FROM WELL TO:
6I'
Septic/holding tank on lot 105, ; On adjacent lots > 100'
Absorption field on lot 13S'
; On adjacent lots > 100 '
Y
Public sewer main N. A. Public sewer manhole/cleanout N. A.
Sewer service line > 2s' Petroleum tank None Seen
WATER SAMPLE RESULTS:
Coliform O cot
/ , as M Q Nitrate
z
Other bacteria
IVone Regar /eW
Date of sample:
H / 18 / 9S
Collected by:
7v CZ
Z
SVC.
l
m v
K
M
'
r
m Cn
®
C) Z
R c
<�S
o 'T
Z
Public sewer main N. A. Public sewer manhole/cleanout N. A.
Sewer service line > 2s' Petroleum tank None Seen
WATER SAMPLE RESULTS:
Coliform O cot
/ , as M Q Nitrate
< o.
Other bacteria
IVone Regar /eW
Date of sample:
H / 18 / 9S
Collected by:
1=10b4e Tech
SVC.
B. SEPTIC/HOLDING TANK DATA
Date installed 9 /6Y Tank size 1 Zsy.) qa/ Compartments Z
Cleanouts (Y/N) y Foundation cleanout (Y/N) Y Depression (Y/N) N
High water alarm (Y/N) N.A. Alarm tested (Y/N)
Date of pumping 3 / J3 / 9S Pumper ,rscwac
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 10S' On adjacent lots -> 100' Foundation
To property line — GO ' Absorption field = ZS. Water main/service line > 25''
Surface water/drainage l ao'
72-026(3/B3)•Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed 9 / 6 Y Manufacturer un k
Size in gallons 100
Vent (Y/N) Y "Pump on" level at
High water alarm level > r 7 "
Manhole/Access (Y/N)
17
e
"Pump off" Level at 5
Cycles tested
Meets MOA electrical codes (Y/N) O tTu y (J t M e o fI ns AT4 v h
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot I t On adjacent lots > t as Surface water > «o
D. ABSORPTION FIELD DATA
Date installed 9 / 8 % Soil rating (GPD/Ft2) 85 t]'/ Lad,„, Systemtype `i'' w, De-awflaro/
Length I bs-' Width y' Gravel thickness 6 Total depth I -S' - 3
Total absorption area 587 o Cleanout present (Y/N) Y Depression over field (Y/N) N _
Date of adequacy test Y / rb/ 9S Results (pass/fail) Post for 3 Bedrooms
Water level in absorption field before test D
After test 2 1/1 `/ J/y
Peroxide treatment (past 12 months) (Y/N) None 1<noc�un of If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
13S
On adjacent lots > 100
Al.
Property line .33-1
To building foundation y a' To existing or abandoned system on lot N, 4.
On adjacent lots > 3 0' Cutbank N- A, Water main/service line
Surface water i 1(6" Driveway, parking/vehicle storage area
Curtain drain None 5 ee,)
E. ENGINEER'S CERTIFICATION
1 certify that I have checked, verified, or conformed to all MOA and NAA guidelines in effect op he date of this inspection.
Signature J.� 64 `i' ,
Engineer's Name% h ea o<are >� �o VA
Date Apr;) 2 Al /9 9,5-
HAA
S
HAA Fee $ 3 as GG
Date of Payment 1Z Z/ - % S_
Receipt Number�/� l ��_'� `f
Waiver Fee $
Date of Payment
Receipt Number
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
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 2 Block 3 Park Hills Subdivision #1
Location (address or directions)
14730 Park Hills Drive
(b) Applicant Name Randolph/Radine Will' 345-6022
lffthone: Home _ Business
Applicant Address Pouch 6577 , Box 623 Anchorage, Alaska 99502
(c) Applicant is (check one): Lending Institution ® ; Owner/builder EP�, Buyer ® ; Other ❑ (explain);
(d) Lending Institution Security Pacific Mortagage Telephone 276-1933
Address 2550 Denali Street, (1601 Anchorage
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
Randolph/Radine Williams
Pouch 6577 Box 623
Anchorage, Alaska 99502-
2. TYPE OF RESIDENCE
Single -Family Multi -Family ❑ Other
Number of Bedrooms three (3)
3. WATER SUPPLY
Individual Well (ice Community 11 Public El
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 0 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 72-025(11/84
5. ENGINEERING FIRM PROVIDIAIG�>rSPECTIOMS, TESTS, FILE SEARCH, DAI�__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 wastewater disposal system is safe, functional and adequate
forfhe 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.
Nameof Firm
Address
Date
Telephone
This Department has received written confirmation from the engineer, JPfLambe
and Associates, Inc., and the descrepances have been corrected. This property
now meets with this Department's approval.
Engineer's Seal
S. DHEP APPROVAL
Approved for three(3) bedrooms b?)
Date September 6, 1985
Approved y=xx Disapproved Conditional
Teres of Conditional Approval
CAUTION
The LAuncipalisty 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
+2-LCc5 l�±;sj
GEOTECHNICAL
MLAMBE AND ASSOCIATENGINEERING
JS, I N C INC.• AND TESTING
John M. Lambe, P.E. 7127 Old Seward Highway • Anchorage, Alaska 99502 907-349-6531
September 4, 1985
Radine Williams
14720 Park Hills Drive
Anchorage, Alaska 99516
RE: Lot 2 Block 3
Park Hills Subdivision Addn # 1
Dear Ms. Williams,
This letter is to certify that the conditions of your
"Conditional Health Authority Approval" dated in January 1985
appear to have been met and all stated deficiencies appeared to
have been corrected, based on my site visit early this summer.
Sincerely,
/00!
John M. Lab P.E.
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
L. General Information Application Date _ j lIra V,
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(T)9.
u9 l ii t el -inns 3
(b) Applicants Name�i�E� y rye \�[ �� �� Telephone — Home &y2,�Business51
Applicants Address '1 UttC� lQ_Z
(c) Applicant is (check one) Lending Institution�--p
Buyer ; Other {. T Owner/builder ;
(explain);
(d) Lending
Ads s
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
!120 19d az 2C >r) f' /1 //, / �'✓� S
2. jZpe of Residence
Single—Family Multi—Family
Number of Bedrooms _�gw
3. Water Supply
Individual Well Community
Other (describe)
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 r77-, Public 7-7 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]
g. Engineerin Firm Providin 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 App shows
ite
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 onsite water supply and/or wastewater disposal
system is in compliance with all Municipal and State ed@� z ordinances,Sa�nKpg,��f�-
tions in effect on the date of this inspection. �,,.T3� �,„ r, , �, wocz ��" �F�
Q7✓r 15 5'✓2, W,fi 78Ct;sFr 1�26�swA-1 'D VJ%Z4lah F'¢AT
wL� '2E.4U,1Z� i�U 21'+9 i- 15 /
3
wits Cid 1h,�Ct,>t,z �(i Ti^T sPR� r..tiy tv
Name of Firm J I✓1 1 ��*nss*� �"'ss�L "` c
Telephone ��%—��
Address 71'Z7 Ot- v
Date /��'`>� �rA
(ENGINEER SEAL)
6. DHEP Approval
Approved for PP bedrooms By Lf•1�� ae
Approved Disapproved Conditional
Terms of Conditional Approvals ji'�tit Lc" ���-
-..4 moo,.:. T Yt_PC
CAUTION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
THE MUNICIPALITY OF ANCHORAGE
(DHEA) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT
ATIONS GIVEN IN PARAGRAPH 5 ABOVE EY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DEEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE
—
DATA
EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZEDATA 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 21
7-19-84
~MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Le al Description:
A. WELL DATA /I... > <-, s „
CI NL ONMEN AL Pr: i s CPGPJ
J A N 10 1985
.CES
Well Classification If A, B. cr C. D.E.C. Approved(Y/N)
Well Log Present (Y/N) ytsS Date Completed 7/Z4/¢, 4 Yield Z,.�
Total Depth _lop Cased to I OP Depth of Grouting --
Static Water Level QG crEa-r Pump Set At
Casing Height Above Ground Sanitary Seal on Casing (&—)
)
Electrical Wiring in Conduit Y N)(% Depression Around Wellhead (&!)(Z
Separation Distances from Well:
To Septic/Holding Tank on Lot /O. ' ; On Adjoining Lots too �4
To Nearest Edge of Absorption Field on Lot /35_1 ; On Adjoining Lots ioo'4
To Nearest Public Sewer Line t`tl% To Nearest Public Sewer
Cleanout/Manhole _%n To Nearest Sewer Service Lire on Lot
Water Sample Collected By )t L- Date�/ S S
Water Sample Test Results 6vzgAjjt,
Coe nts
B. SEPTIC/HOLDING TANK DATA
Date Installed 7/0 Size l Z2 No. of Ccmparrments
(
Standpipes N) Air -tight Caps N) Foundation. Cleanou ( /N)
Depression over Tank (Y ) 3 Date Last Pumped
Purrping/Maintenance Contract on File (Y/N) ; for
Holding Tank High -Water Alarm (Y/N) �� Temporary Holding Tank Permit (Y/N) ►�
Separation Distances from Septic/Holdlng Tank:
To Water -Supply Well /aS ' To Building Foundation /11
To Property Line 0'01-&6 ' To Disposal Field IZS'l
To Water Main/Service, Lire To Stream, Pond, Lake, or Major Drainage
Ccurse
Comment I l�arscsw� uy war r/rt yn,.i. GP^i -ruby►-tA AWoL.Ez 17epg slow
G�8c� 1Rt�. 6lQi�D1►.l
Receipt # 3 L J13 QL
Date Paid:
Amount: _j QL:�_
[Page 1 of 21
2-15-£34
C. ABSORP'T'ION FIELD DATA
Soils Rating in Absorption Strata i 2N Type of System Design
Date Installed 42/9; 4- Length of Field / �5
Width of Field 41 Depth of Field 11$5 z
Gravel Bed Thickness 144w -r
Square Feet of Absorption Area Standpipes Present (Y/N) `4f:�2
Depression over Field (YM) N Date of Last Adequacy Test N�
Results of Last Adequacy 'Test A
Separation Distance from Absorption Field:
To Water -Supply Well /3 To Property Line �`-
To Building Foundation 4c.,'/ To Existing or Abandoned System cn
i
Lot WA, On Adjoining Lots to%- 6115�
To Water Main/Service Line t4lb To Cutbank(if resent) W&
To Stream/Pond/Lake/cr Major Drainage Course e�-//G
To Driveway, Parking Area, cr Vehicle Storage Area
Ccaments wl;_vx�
D. LIFT STATION
Date Installed %f8 4--- Dimensions J&o6
Size in Gallons job Manhole/Access ((YAN)
f
"Pump On" Level at "Pump Off" Level at/
High Water Alarm Level at 3Z / Vent (Y/N)lWaouuw M.%-A%oc,r.,
Tested for & Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes /N) TeVVU%zW�'Te) liwq gygg. l►-wre-iwy>/ G'�b'z'Z N3LPIs:eiZX'MAW I fb
f r
Comments Z -G e i is %off or- 7m "tc
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA HAA Guideli]N.§,in effect
on the date o this i sect' rcrfyr ns �mr7 ` "
--t--�' 9
f�� 5
Signed �,✓ � Date / I Ole, '
Compan ,� l� 13�c sSsc-_ (Ke MOA No. t
KBl/d5/sj
r.
r , 1 L
(Page 2 of 21
2-15-84
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC:
�f TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER
5633 B Street'
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER II TO BE COMPLETED BY LABORATORY
WATER SYSTEM: (•) See h on back
I.D. NO.
Water System Namet
Phone No.
y J M C� ✓v6 Q A SSoG
Mailing Address
City
SAMPLE DATE: LYS`
Mo.
State
Zip code
SAMPLE TYPE: -
❑ Routine
❑ Check Sample (for routine sample1 ❑ Treated Water
with lab ret. no. ❑ Untreated Water
❑ Special Purpose
SAMPLE Time Collected
NO. LOCATION Collected By
fo
2
3 I '
4
5
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Analysis shows this Water SAMPLE to be:
Satisfactory
❑ Unsatisfactory
❑ Sample too long in transit; sample should
not be over 30 hours old at e)iamination to
indicate reliable results. Please send new _
sample via specialdelivery mail.
Date Received _Li
Time Received ��O
Analytical Method:
❑ Fermentation Tube
Membrane Filter
Lab Ref. No.
Result' Analyst
l I
Q]
L I m
FT -1
I I m
•Noof colonies/ 100 nil or No. of Posnrve portions
06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 1983 -
Membrane Filter. Direct Count
Verification: L
BGB
Coliformlt00ml
Final Membrane Filter Results Collform1100ml
Reported ByDate fir—`7 — S S
v Time: l ��a a.m.
P.M.
TNTC = Too Numerous To Count
Y
WELL SEPTIC &�TEMSYS
LOCATION PLAN:
ND
PARK -HILLS SUBDIVISION
_
T ADDITION NO. 1
ES HOLE LOCATION 'J
PROTECTIVE RADIUS j
NTN ,,EACHFIELD LOCATIONS i
NLASKA ENVIRO-NMENTAL_CONTROL SERVICES INC._TEST HOLE- - - -----
M F. RCEDES
--- -------- - ---- __ _ __ __ __ ..-- -- --- _ ___. _ - ----_ ._.. _ _-� --MSRCEDES STREET
OHN M. LAMBE & ASSOtIAlfES TEST HOLE
J;
®O
D 5D 100 SOCA
V