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Home My WebLink AboutKATIE LT 1Katie Lot 1 #051-144-59 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL JYST AND/OR WELL INSPECTION REPORT Name DISTANCES TYPE OF SYSTEM ❑ TRENCH UV BED ❑ W DRAIN ❑ OTHER Depth to pipe bottom from original grade TO SEPTIC TANK ABSORPTION FIELD 41 WELL #Z Address - '- -- vE [�� (] I o �(Q 11lp��'L iO4 A_ _ mi Q 7 WELL '31-I-� I� / /0,3 %O �d / �z0 / gDP`�I c Phones) Permit No No of Bedrooms LOT LINE %1J 1 3o Number of lines Soil rating L �/�7 � v� Z 5 3 LEGAL DESCRIPTION A-jm l -8fo Installer L� Date Installed CjANt7t.ANO ENTE I$$ Lot I Block — Subdivision IGaTI)_ FOUNDATION(p 1 30 ( Z5' Township Range Section AS -BUILT DIAGRAM (Show location of well septic system property lines foundation 7-15'-J Fe 1 Scdriveway water bodies etc) TANKS [SEPTIC ❑ HOLDING Manufacturer UNIGNC7wN CC%�i�l� Capacity in gallons I)DOO Material No of Compartments S-rt=EL_ Z TYPE OF SYSTEM ❑ TRENCH UV BED ❑ W DRAIN ❑ OTHER Depth to pipe bottom from original grade Total depth from original grade * Zlz FT 5 FT Fill added above original grade Gravel depth beneath pipe YZ O FT FT Gravel length Gravel width L15 FT IS FT Total absorption area Distance between lines 675 SQ FT 5 FT Number of lines Soil rating Pipe material 3 IH7 SQ FT A-jm l -8fo Installer L� Date Installed CjANt7t.ANO ENTE I$$ /O/ZZ/go WELLS PRIVATE '&I/it-Z- ❑ OTHER (Identity) Classification (A,B C) Total Depth Cased to Fk%-4A-t-7_ 567 Soo FT 3'i IZO FT Installer Date Installed M146mwoN SuL.J_%-JP% I 3 -I -t34 7-5, REMARKS. I fwlf Grrmf L_ r� Municipal and State guidelines in effect on Health Department Approval. FF LT:=r_ MIN— a d®aoaoa illilihasu It F1111nsa0o° gam. C6A2 �° Inspections PerfgrmAe�d by zko / Date ®®e certdy ilia Inspection was performed according to all On>o. ` 2 3/ Date/ MIN— a d®aoaoa illilihasu It F1111nsa0o° gam. C6A2 �° Fm ERDMAN & ASSOCIATES CONSULTING ENGINEERS October 30, 1990 Municipality of Anchorage DHHS Onsite Services 825 L Street Anchorage, Alaska 99502 Attention. Robbie Robinson Subject: Lot 1, Katie Subdivision Project 489131 Dear Mr. Robinson: The following is in response to your review of our final inspection report for the wastewater disposal system upgrade at the referenced property. 1) A completed "On -Site Sewage Disposal System and/or Well Inspection Report" is attached. 2) Our previously submitted final inspection report drawing showed swing ties to the "Tank Outlet". The "Tank Outlet" is the septic tank standpipe on the outlet side of the tank. 3) The excavator/installer was Sandland Enterprises. 4) Our design was submitted prior to implementation of the new regulations, and was approved with 1 cleanout between the tank and drainfield. I hope that this satisfies your concerns. Please call if you have any questions Sincerely, Michael R. Erdman, P.E. 151 East Herning Avenue Wasiila, Alaska 99687 907-376-6989 1 ,, m 1, It 0 R A ('j I'l Iq i If C) i i r v L t.) j I cj 3}9 '::10 1 (J III L, i I I C31 F" T "K, Nut Y, r.:) Cj P cl d 4. 1 I t ic:)uv , I V I el rm i I It , c, Oc'I q, It. -Id /4 ("1 W jt ;whd t v I in it -I n (..j o 1,)41`.1 (s I::[ r C I NO, I s I c,rlm III t t fit (;,j a �.a I.. a fit JJ 40 r, MUt t I t 4 (..I tj I I pr, II'lt,tttrtt L I rt nvi �r L r -I 1, - I I LID -1 W11 0X I Ol.."N I I fol' -X 'd 1:.11"'I•'.. I-ifD !%,I('Iy I\K 11 t-il HF* 11`11 I I 'It.) ('21 00-1:1 (-", 01 VoX :31 01 t LJ 0 C) i I 1\1 I i I I1+111 CH 1^'i LC YAN11, 14h3 OL LJWF_D L)NILY 11 LN(J I 1A I hi C1 y M! 11.31 I it I Ir 1"y I I t 311 F 0 LJ F L I 1\1 Gj "S ON I ONI" ('I\li 11hir. I i L OU I V i )1\1 MONI K."M -11'.3 E, I AN11% 1\11' L.DS C1 F (IN(J) .. J I H 110 1 lain 1 t rcrn �) kAj a P ps Oil h (::� r a qj I..- ( 1,411 1"1 Ja. t V...( t v c, f I w I I I I "Y"I c-lyl I I c.) r clia n c, w i t h ..a 1 1 IV! I WI c- c, 4"! CR c." I I CA r Cl Lk 1 ZI 1 0 1 Clal I a rI I. w I f 1-1 1'• p) o r' In I c"i c, I., t I... kj 1 r C., o a. IVICY'l trid t a t in f 0 1 P F5 kJ 1 1, ( I (A I t , t c C." i I" M cA I I >1 FIX L I:D t .] 11 :7 w F-1 I ] , lglcisi F.6'xWa t tk: r d I r.3 C) c." CY, cj r k..t1::7 S( "tl� i j V., -i � ,1 0 C)I I t. ("I I -, 1..31" n y ra It (-111 L C) I" I"I igk I., 'y I ) k I I I In I" U t 41) r (:j 111 At i it I t1 1.,i r, fit I 1 1 t, v,.. -kJ I d f or,a fn,:a.. Ifflum (-A r3 1 t , r I AJ I I CJ Ct I` t t ]"I c 1 11- c y C:)¢ t h, t ( Y 1 c..., 1 ,Yt, c; III d d .1 t I ona I 1..)far in I [,/U ASIAN'. Y' I k F its H. t I . V rczmrl By:! D(1 1 .0 L13 Loj (2M nU q "'i qc�-7q Lf, a �a LA, J 46L, -f --d em (gAq _M_ tflpt� ar g 4>li'T•V 06RBP Mir 00 �•p • Municipality of Anchorage M t DEPARTMENT OF HEALTH & HUMAN SERVICES •• • •'° 925 1" Street, Anchorage, Alaska 99502.0650 ' = Michael R Erdman 00 00 CE -6232 SOILS LOG -- PERCOLATION TEST 0 PERFORMED FOR �SSo�lq I� F -'w '7� ��t--. DATE PERFORMED LEGAL DESCRIPTION I -OIL kq -7LI ��-!�• Township, Range, Section !,5d I DEPTH SLOPE SITE PLAN 1 2 Cri�C�M B�owh 3- 4 4 5 ! O 6 / 7 s 9- 10- 11 10 11 12 (� 13- 14- 15- 16- 17 314151617 18- 19- 20- COMMENTS 81920 COMMENTS WAS GROUND WATER l�� ENCOUNTERED IF YES AT WHAT . I A DEPTH? t4A- Depth to Water Alter _ Monitoring? Date = now nNORN NNEINNEEN MENEENEEN tl PERCOLATION RAT 2• ) (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 2 FT AND FT PERFORMED BY A CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE 72 008 (Rev 4/85) Mucipatd" Oy of Anchorage *•« '4vjp %* «.o�...�..,..a,..., ,p DEPARTMENT OF HEALTH &HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 # fsaarchc f Iz Erdmg• W SOILS LOG -- PERCOLATION TEST lftl`� cE6252 % PERFORMED FOR Assoe—�g4Loi �Q F—N j� 1ENL.. DATE PERFORMED 1 %g *A ` _ LEGAL DESCRIPTION L07' � S� ~�- Township, Range, Section 77 ,$N (L I W DEPTH SLOPE SITE PLAN 1 2 �/ I��GTM 13�owh 3 T 4 J 5 / 0 8 / 7 8- 9- 10 910 11 12- 13- 14- 15- 16- 17 21314151617 18- 19- 20- COMMENTS 81920 COMMENTS WAS GROUND WATER �O ENCOUNTERED IF YES AT WHAT . 1 A DEPTH? ITT Depth to Water Alter Monitoring? Date MINE MENNEN ■■■.■■■■■■ Reading Date Gross Time Net Time Depth to Water Net Drop DD 5 br o S. hr" 05 Mi ro,o 15, 10M. ZS M, l n 4111 2Jr f4l�A��14-0 vte td 3D �K�.�z5 61 PERCOLATION RATE 1-5 (minutes/in//c--h) P --ERC HOLE DIAMETER TEST RUN BETWEEN � �—FT AND FT PERFORMED BY A ogj�� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE 15.17 /90 70 nnG ID— n,aci m �m -4 i e� Z � OD L4 z ° z U N IMM ERDMAN & ASSOCIATES CONSULTING ENGINEERS MUNICIPALrfY OF ANCHORA3E DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION September 10, 1990 Municipality of Anchorage Dept. of Health and Human Services Environmental Services Division 825 "L" Street, Room 502 Anchorage, Alaska 99501 Attention: Susan Oswalt Subject: Lot 1 Katie Subdivision Project# 89131 Dear Susan: SEP IIfflo RECEIVED This is in response to your "Onsite Services Transmittal Sheet" dated 8/22/90. Attached is a revised plan which incorporates your review comments. The following are our responses to your specific review comments: �/l) The test hole monitor tubes were re -inspected on 9/10/90 and found to be dry. f2) The Perc Test location is within 10 Feet of the proposed soil absorption. Our revised soil absorption system design is less than 50 Feet in overall length, therefore a single perc test is sufficient. /4) Cleanouts and monitor tubes have been shown on the revised plan. 5) A profile/section of the proposed soil absorption system has been shown on the revised plan. 6) System design has been modified to a bed with sand filter. Please call if you have any questions. Sincerely, Michael R. Erdman, P E. 454 East Hernina Avenue Wasllla, Alaska 99687 907-376-6989 P, ERDMAN & ASSOCIATES CONSULTING ENGINEERS September 11, 1990 Municipality of Anchorage Dept, of Health and Human Services Environmental Services Division 825 L Street, Room 502 Anchorage, Alaska 99501 Attention: Susan Oswalt Subject: Lot 1 Katie Subdivision Project #89131 Dear Susan: MUNICIPALITY OF ANCHORAGE DEPT OF HEALTH & ENVIRONMENTAL PROTECTION SPP 1119M RECEIVED Attached is a copy of the Driller's Log for the new well on this property. This well was installed in accordance with permit X6900074, dated 4/19/90. Due to their limited yields, we plan to leave both wells in service. The two wells together should be able to produce the minimum 150 Gal/Day/Bed. Please call if you have any questions. Sincerely, Michael R. Erdman, P.E. 151 East Herning Avenue Wasilla, Alaska 99687 907-376-6989 III I'll ONIi |I'/I/ | )Y i/||p,A!ih & ri . 0I )uruqr, A|aska 99�0J 4 ITOMI ON WI. | | Pk PM[ I t�,a, �� ^�� N��mh�`r: |�,+u(`d: |9/9`� ()wn(`r Na : |A.U,D" D?ay|'ho`n�: Uwnn/ 0rld/�/6 69/4 0NCH(U(001 , Ak 995 Parcp] ]d: 05]-144 59 |oi |rqa|: Su|x||vis1on: K0||i |ut: SPr{�nn: 9 |own�h/|>; i�N Ran4r: I | n| 1_33ze 45U49 \',q"IF| " nr aCrr�) Ma: U('droomh|s Prror, /i|oia{ LaparI Iy: � W8| ;, |ng mu�0- hr itod to Mu|m, |pa|/Ly of An�horage Do pnrimv,nI //f H(`ctith and HumvA/) 6ervIcc-5 w/ih�l|I \U dv4ys c)f wp|| romp|p^txon" }NS|0i| IR |N6[NFLR�i DJFEC||ON AND ]N A<2U|ZINNCT" WI/H 0|lD �| [} 1 11 AN" T||}G |^i Idyll !S |SS@FD FOR D|[ [X161[NO BDHM, 6|N(UI_ |AM|iY DW|||.|N() ONIY 0 N D LX|`]H- 1 ') ON ]2/`'|/90" ABHND()NM| N! U[ Fit D W| | | |S |O L.A. (,DM"| [ |FD A| [|MF N[W W[| i lS DK}|i|D. I C| K| ]| Y |iiA| : 1" | '\m falot ||I.ur w|(h Ip recyuroil I-- *xan6 we1.|'' k `i r, 1-1 by ihr Mun|r |pa|/}y of Ao/c|)nragr (MOA) and ht` 6taie of Aias14'\, 2. | w|!] .111sLa|| tp sy+i(`m In a'(ork|u|ura w -L th ^\/i M(}A cndM |ai/on�^ �nd l|/ (om!>Jlanc(` w|Lh Ihr dr -sign rrtp/rLa of Ii/|n porm2|" w/|l 'x|hrre io a|| MOA aod ��\a(` u� Aiaka rpqu/ro/nrni s �or ih�` spt ba/� d|+t�n/P4* frum vny {xI c.)ttng weji, wuC;\pw pr d|-,posa] sem 0r pub|J( ,rm �d>ar�nt nr oea/b/ und�r+ia/x| \|,aini( .1+ v.\]xd for a mVAxImufri of } bf�,d/orm. | a/+o /Indrrstand \I \ i|at(j </f \hr Lortnf m)y`xId +nv pn]m|()rm0n| w|i} rpqu|r�n Arld-I\ |n|ta[ pprIli /t" q/Ird: DAT[� � |�sued Uy: DAO : mss' x¢; �< �qs E�.l�ivf b o C FtZ.oC�JF.� W Eu. � ITE A R EA A P2,oR-,rr fir. 1 ILAQLC foR NBP/ WELL Skis riwG 7 0 11004167- 0X 100«' Z� CANT, 111�1La1111 u o�,yc�C1S�.c'-e N � ,- pCNNT • s.�.�rrc- srs�.✓v •moi 0X ley a I . yn 0/00 f41 L6'�'N a , a v b�',q�awFN.r►ttq�� ' ,�� a A4,14 d A' 0 to ad N „(fr'.`"D'��/ � \ � • ` pool: 0.� 11 t. r. ♦N..... .. .1•. e.. ..N•,p ^,• c '. thorn. M rk ewMd / QL �Y ; 6��:� .•'' .�Y: 'r f ` ' �� t �•do l -S-6918 •o ; r w- r Q` Z OTE �O I�EI�F\ . e•e. a t..t.,•.. sena. •-o. ..14�i.. Oo' OF Fok ^Vora - '' iso. 08 ` " `' _ • � -= -- N89�S,f'.'13 E A,9»BUILT No aornere set this date EASEMENTS OF REC.ORDr Or1IGR THAN THOSE SIIOWN ON THE I hereby ccrWY that I have pariormed a MortaXec's In - RECORDED PWT ARE NOT SHOWN HEREON. $pectton of the 1oAowtn¢ described property: - Katie Subd. Jot 1 i lutchora`e Jtecording Precinct, Alluka, and that the improve - 'rhe information hereon is for the use of lending trent, ,Muated thereon are within the property lane, and do institutions showing the relationship of existing not overlap or enexoach on the property lying ad)acent there• to, that no hnprovernents on property lying adjacent thereto structures and pkat ted easements and lot lines. encroach on the proirwe% in quer;t,on and that there are no It is not to be used for positioning additional roadways, tronsntwsion lines or other uubla awontcnta on structures or f encelines. mud property except aA Indicakd humi, Dotrd at Artthorag.a, AlVS>ta U116 .29 day o. August 1489 nATF' nn inn o_rcc 1 ti U b O yn 0/00 f41 L6'�'N a , a v b�',q�awFN.r►ttq�� ' ,�� a A4,14 d A' 0 to ad N „(fr'.`"D'��/ � \ � • ` pool: 0.� 11 t. r. ♦N..... .. .1•. e.. ..N•,p ^,• c '. thorn. M rk ewMd / QL �Y ; 6��:� .•'' .�Y: 'r f ` ' �� t �•do l -S-6918 •o ; r w- r Q` Z OTE �O I�EI�F\ . e•e. a t..t.,•.. sena. •-o. ..14�i.. Oo' OF Fok ^Vora - '' iso. 08 ` " `' _ • � -= -- N89�S,f'.'13 E A,9»BUILT No aornere set this date EASEMENTS OF REC.ORDr Or1IGR THAN THOSE SIIOWN ON THE I hereby ccrWY that I have pariormed a MortaXec's In - RECORDED PWT ARE NOT SHOWN HEREON. $pectton of the 1oAowtn¢ described property: - Katie Subd. Jot 1 i lutchora`e Jtecording Precinct, Alluka, and that the improve - 'rhe information hereon is for the use of lending trent, ,Muated thereon are within the property lane, and do institutions showing the relationship of existing not overlap or enexoach on the property lying ad)acent there• to, that no hnprovernents on property lying adjacent thereto structures and pkat ted easements and lot lines. encroach on the proirwe% in quer;t,on and that there are no It is not to be used for positioning additional roadways, tronsntwsion lines or other uubla awontcnta on structures or f encelines. mud property except aA Indicakd humi, Dotrd at Artthorag.a, AlVS>ta U116 .29 day o. August 1489 nATF' nn inn o_rcc '11r ilt IV, aftfirb b, t»c co acl SULLIVAN WATER WELLS P.0 OOX870272, CHUG IAK, ALASKA 99567 • TELEPHONE 685 2759 OWNER OF LAND DEPTH OF SELL - ADDRESS STATIC LElv EL OF WATER Fr LEGAL DESCRIPTIO DRAM' DOWN FT DATE -Started Ended ._7/ 7 GALS PER HR !� PERMIT NUMBER KIND OF CASING a 4) �Sl�flJ�� 411 KIND OF FORMATION, From _1)Ff,to.2 Ft SAS?AdC 6*rl 51K110 From—Ft to Ft, From en2 Ft. to !!I Ft. X( r ld*JQ QrFrom Ft to Ft From Ft.to Ft t C',,iuc,-.r From Ft to Ft From !I Ft, to _Ft// - ��0 +0-K �� m FroFt to --Fl From Ft to Ft. '""et;g i From _.-Ft to Ft From Ft, to � Ft. 1344t adl(4- From Ft, to Ft From, Ft, to Ft. �G*J 0>14 F� _ Ft to Ft ,Ft. to„ -?2 --Ft ofd O c e. (�� C r o m Ft I Ft From � FromlEZ—Ft, to -L51', i D�'a S 5- CA EC AlFrom Ft to Ft From Ft. to Ft.�'�� Z .SEs1M From Ft to Ft a'gl�/' From Ft. to- -Ft From Ft. to Ft. - i Frorre---r—Ft to lIC Ft JC de&S! 4 K From Ft to Ft From Ft to—Ff.s�l~ -- - _� From Ft to Ft, From Ft, to Ft. From Ft, to Ft. From Ft, to Ft — _ - _ From Ft to.Ft. From Ft to Ft From Ft to Ft { s From Ft. to Ft. From Ft. to Ft MISCL INFORMATION O DRILLER'S NAME I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH 8c ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NE NAME A e_ �� / PHOE:1UP RADE MAILING ADDRESS ginx 3 9 / �`1�hk w� LEG DESCRIPTION EG/� / �(��,� �(�, LOCATIONbFf <,/ ha ` C / /� P,bsorp on area Dwell / DISTANCE TO V y CL ZQ Manufacturer LU rn Liq city Irypallons IF HOMEMADE Inside length Width CJ 4 y DISTANCE TO Well Dwelling Jaz O Z H Manufacturer w= DISTANCE TO Well ®o 1 Foun Total effective absorption area Nearest lot line Distance to lot line PEI I No of lines Length of a irk Total lenb J LL Z Fzw he to fine h e Top of t�/ad Material F D Length Width Depth W a F- Type of crib Crib diameter Cnb de f uj W Well Building f DISTANCE TO J CI s f�� Depth Driller J W Building foundation Sewer line DANCE TO IST OTHER PIPE MATERIALS SOI L TEST RATIjNG 1NSl Q� r rY� A wT ��Y•• OQYOR++•�1 rY YV" !L 1 R O 19 + Y• •• Yd • Robert R Shafer No 1467-E it e / • ,. ®s�'AOFLSS��w -ALASKA CUT 79 012 (Rev 3/7E NO OFTEDROOMS �3 PEF3p(IIT4M g s—f No of comp �c G ants Liquid dep(,4,_, PERMIT NO Liquid capacity in gallons dearest tune/ PEI '4r Trenchto th Q inches Dis �^ L� Q /iToi orches PEI Total effective absorption area Nearest lot line Distance to lot line PEI I iept!jp,[aytk C I Ab T U LOCATION Of WELL (pbeee cemplota elther to, Ib or le ) la Scroug�ubdleltlen Lel Sloek Pal— loll I/e airs An et_ot DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS Street Address end Argo of Wall Lecatlae STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geologlcol a Geophysical Surveys Dr.liing Permit No A D L No Section No Townshir. NO Range EQ Meridian ,1❑ v W❑ - S OWNER OF WELL, Mr. Vince Johnson Atldr.ss feet Below 2 WELL LOS Surfaco Malarial Type Top Bottom 4 WELL DEPTH (final) 507 _ n S DATE Of COMPLETION 2 - 19 - £34 S 0 Coble tool X�qxolory 0 Driven 0 Dug []Auger Q Jetted C] Barad Q Other .7 —G- eens one (vire cesit some 7 us(XV40meetic Q Publle Sappiy O Industry C frigotlen O Recharge O Commericill O Test Well Q Other �— .w T B CASING 0 Threode4 u1slded dlow_,In 10_34 it Daplh weight—_IlIbs//t dlam ---In to,— If Depth Stickup It 9 riNISH OF WELL Type __........ Diameter — Slat/Mesh Slse !, Length _ Set between It and It Soektilling gravel pock— —.—•.wd, y - .0 � a p 10 STATIC WATER LEVEL _ 80 it 2 /19r Date 0 Pbove or O Below IoM turtoee Equipment used _ ya _ All, "' It PUMPING LEVEL below land eurtaN sod YIELD It atter hre pomPMg d p m __-�---- It after hes pumping g p m 12 GROUTING Well Grouted C] Yee n No -----^}�� `— --- Material E] Neat Cement n Olher 13 PUMP (r+ ovaliable) HP ----_T, / — Length of Drop Plps It eapacitY g P m -- --- O Sub n LJ Jet 0 Centrifloal j C] Other 14 REMARKS 20 GPH oduCtY 811 hole from 0-34 with Ell casinP cemented 16 WATER WELL CONTRACTOR'S CERTIFICATION !S Water lempe rat ur• -a C) F 0 C This 14 �lmaA(I1W r 1413 yfiltilon and this report Is true to the beer of my knowledge one b000f, 1�letg[TU13UI1 1!l iJ.11lEj An 5385 P It"! 041 l31�A OEagle River, Ak . fJpp(rps LICense Number -- Address „g �d Date _March 1, 1984 Form 02-WWR (II/SI) CMT Distribution WHITE Slots DWI$', PINK Dnl p, CANARY-Cuslomor t , r ^ ~ ��I�� 1� � ^ �J� �� ` D[PARlMINT OF HEAL [H AND LNVlRDNMENTAL �ROTFCT|ON ~ � ^ , 8 i S 25 TH[�| ANC|1ORAOL, Al,., 99501 � - 76It] ~4720 / 1E."ll Ir"A ~ � r -117" E�- EM. F- IL-4 IE L- U F` F;p P1 T "IF PERMll NO: 84095| DATE l3511ED: ii/|9/84 APPLlCANT: ViNCE JOHNSON ADDR1--SO^ DOX r91 I'll RX) lAk, 01-1* 99567 ^ CONTACl PHONE: 688`2/95 LEGAL DESCRiF: SUBD]VIS|ON: MA LOl: 1<9 BLUCk: N0 SEX'TION: 9 TOWNSH]E":]5N RANGF: |W ^ LOT SIZF: 2"5A (SQ"FT" OR ACRES) ^ MAX BEDROOMS:, � L3sLed below are ihe opiionta ava:lab|e tn you zn de,|gnjng you' |c system" Chonse ihe npt:on 1.1-ia0 besL fits your site. DEPTH TU �lPE BU7TOM (FT"> 4^0 40 4.0 GRAVEL DEPTH (FT.) 5.0 0.5 T.5 lOTAL DE"PTH (Fl") 9.0 4"5 7"5 GFAVEL WIDTH (FT") ` 2"5 i9.0 5"0 GRAVEL LEN117|1 (Fl.) 45 C) 6.9 49,0 GRAVFL VOLUME (CU"YDS") ~23.� �5"4 �6"3 TANk SIZE (GALS) ]"000"0 ** 1,000,0 SOIL RAlING (SQ"r,T"/BFk) 150 150 150 ** TANk MUSl HAVE AI L[8ST TW(}`COMF0RlME1N1"S ] cerLIfy at: 1" I �0 fami]jar w i L h Lhe rpqu|/nmenC) 1, C )r'' /tP 1�eWJr�� inrd wP]ls cei forLh by Lho MunI Llpa1Ity of Anc.horago (MO0) and ihe S\a\/` of 0|I,�. it 4.1 LI �y+Lem �� u�cnrdan�� w�Lh pi] MOA rudp� u\`d rrg�]a{ /ons/ and jn c.omp]i anc(I w]th thP des|gn tr1 1.erla of h/s pv�rm|<, adherr Lo u1] MOA and S{ate of 0la�I,a re4u/r-m�nor e a-� dAst.1nLes rDin any stI/)g vv]l, w ewa1er d �,�pu�al qym or 1::)ub|1/ seweraq� syc-Acm on Lhi-, or or O�arby ](0- 4., I under�Land ihaL this ma,znum and any enlargemenl: wll] requ/rr n aadd|txonal pprm1t" ' IFALIFT SlN THFN (1) 01\11rL[ WILL NOT BE A OV�D ELECTR]CAL RK MUS[ SlGNED ALiED IN AN ARU) COVERED BY MOA PU|LD]NO COD[3, rFRM]T AND ]NSPEC\]ON MUSl B[ OBlAlNFD; (2) AS'DU[L|S ITHOUl AN CAL TNJP�CTlON R[FORT; ANID l||E" �efl)[N\[ BY A L]C[NSED ELECTR]C]AN, APPLICAN I I JOHNSON ]SSUED BY � DATE: ^��r~ ��- ` ° � ,- ^ DATL: .. ~ et, v n ^ 2� SOILS LOG MUNICIPALITY OF ANCHORAGE M DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L Street, Anchorage, Alaska 99501 2644720 SOILS LOG -PERCOLATION TEST �t r PERFORMED FOR D / /vC Ir -<✓0 /-//j '5 0 k/ DATE PERFORMED LEGAL DESCRIPTION ` DEPTH SLOPE SITE PLAN ISE P�{ – a d% / C 1 OL T– Lip 3 4- 5 5 t/ Clef7 4 / /ooe 9 G 10- 11- 12 0 11 12 13 090 14 Date Gross Time w i► 15- 51617 Net Drop 1 16- 17 8 18- 19- 1920 20 -L_] COMMENTS PERFORMED&;4'''0Lf , 72-008 (6/79) S WAS GROUND WATERS /'y L ENCOUNTERED? �l�" v O P IF YES, AT WHAT E jv /DEPTH? A4aa1. Robert A. Sheior No. 1457-E Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN FT '8057T CERTIFI (minutes/inch) — FT DATE 't SOILS LOG ' MUNICIPALITY OF ANCHORAGE ❑ PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L Street, Anchorage, Alaska 99501 264-0720 SOILS LOG — PERCOLATION TEST PERFORMED FOR 1 Z1 L C' (� �' Li DATE PERFOF LEGAL DESCRIPTION < <T Cl �J �1 1 , C, Ti d '� SLOPE SI DEPTH 7 (FEET)1CSS 1 2 3 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 L't ,11 G oadC I ", "ll - 5, �t, sl I r, M L /T , I j:-5, -FI n Fag t'1' , L L Co * : sots 9jals L Thode s W %CE 5035 •.• 1 lctq ••••••ee•'•• �+FO pA0FESS101/0 WAS GROUND WA ENCOUNTERED? IF YES, AT WHAT DEPTH? PLAN ■■■■■■■■N■ ■■■■■.■.U. Date Gross Time Net Time Depth to Water Net Drop .■®EE©EM■■ ■ ■ ■■■■.IN■ MO■NAM'■■ ■■ ■ ■.EMMU■ ■■ OMEN MENEM NNMMMEMMM ONMEMOMMEN ■ ■■■.■■■ ■■ MIMEMMEENME ENEEMEMMME Reading Date Gross Time Net Time Depth to Water Net Drop 20 IL_ _JI PERCOLATION RATE (minutes/inch) 1 9-"41 - TEST RUN BETWEEN FT AND FT COMMENTS 9011 R 4 1-{ 1 11 C1 � Lt ��ii , — PERFORMED BY tJq 1Yl E5 4, l h CG Q CERTIFIED BY DATE 169- 1. llft� 69— 0 A I To cvAom ;T N+a6 cON.ceNN feb, /l, /9 % s Jr' akjeJ Soil te5T TO h Lo -t Mw w T /5-1V,, A) W,, S ee-T104 7 The water level aT Ithe 3ub�jec7- /07' was mvplj"�cre,d -'or two weeks cx7" 'rhe 7''l✓ me o -P 1-14e tesY'. The sfia bi j leed wa7'er leve( was /Q 4OF Ja me5 Tf7od e. P, E-, ter' llt *.!,%•�9JLT �v�g�'v►eerf� a 4 Thode CE 5035 Le► ••�990FESSt1 O0 W .• ,6 " o MUMCIPA iryFkNNOF A9RpMETLEENVfA ori JUN 1 n 1985 RECEI VED, Municipality of Anchorage I��\\ 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. GSA - q *04 NAA# Expiration Date: 212 6V02 1. GENERAL INFORMATION Complete legal description Lot 1; Katie Subdivision Location (site address or d irections) 21818 Tarika Ave. Eagle River, AK 99577 Current Property owner(s)Michael & Diane Thomas Day phone 622-6208 Mailing address Lending agency Pacific Alaska 110E 4•19e — Dayphoneg5s-7534 Mailing address 2600 Denali St. #2G7 Anchorage, AK Real Estate Agent Rolf ?-r i' * c Day phone > > 4 a a 4 Mailing Address 11940 Business Blvd, Eagle River, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. ,,� 2. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 3. TYPE OF WATER SUPPLY: Ea Individual Well Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Heaitn Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for ene 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 As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. V—AddName of Firm S & S ENGINEERING Phone 6 /V— Address ress 37034 Eagla,"r Loop Road No. 204 Engineer's Printed Name 6�i� f� ��/ Date Z O �f��g' t GtEER 5 * 0z 5. DSD SIGNATURE r rT:' A. 1457-E X_ Approved for 3 bedrooms.``n Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By'L 7,9,Original Certificate Date: Z 260 01 (Rev. 12/0C) Municipality of Anchorage y ,.•� • Development Services Department = Building Safety Division : On -Site Water & Wastewater Program 4700 South Bragaw Sl. P.O. Box 196650 Anchorage, AK 99519650 www.ci.enctwrage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 1- 0 1 K A 71 # Parcel ID: D S / - /Y N - S -`j A. WELLDATA C /Ouo C-A"ONS OF wA7,sA iSTditAHC G•AAAC- -' Well type �'YaT t- If A, B, or C provide PWSID 9 = Well Log (Y N) Y -t J a/, /atY YES Date completed0 Sanitary seal (OM) Wires properly protected _ &N)XOT- 3q YE f Total depth 300 ft. Cased to zo ft.1 TO B k Casing height (above ground) ! 1 f in. FROM ELL LOG AT INSPECTION Date of test S/' �S 4 7/9 o Static water level �0 S ft. 3 H ft. . 6P K bet, Well production a0 WATER SAMPLE RESULTS: / l 3 It TOTAL iaoOOyTNN FROM a w"a.S = 15-76 444:1DRY Coliform _> _colonies/100 ml. Nitrate . S mgJl. Other bacteria O colonies/100 ml. Date of sample: LL -1C ---0J— Collected by: i ams � 1 MING Loop (Boo No. 204 B. SEPTIC/HOLDING TANK DATA Eaple RWw, Alaska "577 Tank TypelMaterial ,jEp7 f L/ C 7 E it L Tank size / 0 10 getNumber of Compartments -2- Foundation cleanouf�/ M 601 ) � Depression over tank (YO ^� 0 Date of pumping 11 / / pumper T /LI / C. ABSORPTION FIELD DATA Date installed BOJ /� 3AV, Soil rating (g.p.dJfF o�1 y 7 Length )Is - ft. Width /S ft. Date installed _ Cleanouts::64N) >/�6 /F.5 Yh t High water alarm (Y& P o System type Jt3 E. D Gravel below pipe O. S- ft. Total depth .3 ft. Eff. absorption area (0 73 ft' Monitoring lube y* I Depression over field N O Date of adequacy test 'r // 6 /O 1 Results,64en) 64 S J For 3 bedrooms Fluid depth in absorption field before test a in. Water added gal. New depth 3 Yj in. Elapsed Time: min. Final fluid depth in. Absorption rate >= 'ys o g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) " �c.✓C w .� lfyes, give date - D. LIFT STATION Date installed Size in gallons "Pumpon" level at _ in. evel at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: MardZr&TAaess (YM) - High water alarm level at Meets alarm b circuit requirements? i Septic tankAtft station on lot �/O 3 On adjacent lots Absorption field on lot / O O 'Y- On adjacent lots / 0 J .{ Public sewer main N 1,4 Public sewer manhole/cleanout a r Sewer /septic service line X -k Holding tank A" 1A ,V /A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S fi Property line S 10- Absorption field .- -,0-- r Water main P Water service line 10 Surface water /00 -1- in. Weiss on adjacent lots X00 -f- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /t) Building foundation /0 "'� Water main vl f Water Service line 10 f Surface water i 0 O r-1- Ddvmay, parld gi eNde storage Curtain drain `m^ 4 Kd0. w/ Wells on adjacent lots /J J F. COMMENTS G. ENGINEER'S CERTIFICATION = 1F OF 4 1 certify that I have determined through field inspections and p,`•• �7� review of Municipal records that the above systems are in + conformance with MOA Hqq ��deh�es in effect on this date. + �....} S 6 S ENGINEERING t v �• \—� Engineer's PrintdyOtbh6a�ObRir+rLooPRoadNo.204 0P""•••:a•,�' Its%• Eagle Rlwr, Alaska 99577 Date •``b� •• •- •'•✓•ct HAA Fee $ 300 so Date of Payment Receipt Number -12i97-0 (Rev. 12100) Waiver Fee $ Date of Payment Receipt Number NOV-20-01 01:30PM FROM -CRE ENVIROMENTAL SRV LCUE Environmental Services Inc. 4 ��rrirrsrrrrrrrrrsr� 9075615301 T-341 P.02/03 F-117 CUE Rer.A 1017958001 Client PO# Client Name S & S Engineering Printed Datelrime 11/19/2001 15:41 Project Name/e Lot I Kate SID Collected DatelTime 11/16/2001 12:00 Client Sample ID Lot 1 Kate S/D Received Date/Time 11/16/2001 171100 Q Matrix Drinking Water Technical Directow Stephen �yW Ordered By PWSID0 Rdeaud Sample Remarks: Allowable Prep Analysis pax=eter ResultsPQL Units Method omits Date Date lnit haters Department Nitrate -N 0.500 U 0.500 mgrL EPA 300.0 (<10) 11/16/01 SCL Microbiology Laboratory Total Coliform 0 col/100mL SM189222H (<I) 11/16/01 KAP MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel ID # 051-144-59 HAA# Fd�11�11L11j� 1 GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) 1. Katie Subdivision Location (address or directions) Section 99 T15N, R1W p (b� Property owner HUD c/o Associated Brokers Telephone (home) Business 563-3333 Mailing Address 640 W. 36th, Suite #1 Anchorage, AK 99503 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Sandi Hielmstad - Associated Brokers, Inc. Address 640 W 36th, Suite 100 Anchorage, AK 99503 Telephone 563-3333 (e) Mail the HAA to the following address (or check here ®, if hold for pick up ) List contact person and day phone number below Mike Erdman 376-6989 Sandi Hielmstad 563-3333 2 TYPE OF RESIDENCE Single -Family M Number of bedrooms 3v 3 WATER SUPPLY Individual Well IN Community ❑ Public ❑ Note, If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status 4 SEWAGE DISPOSAL On-site 0 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status 72 025 (Rev 7iee) 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 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 ERDMAN 6 ASSOCIATES Telephone 376-6989 Address 151 East Herning Avenue Wasilla, AR 99687 Date 'OF UT Engineer's Mkh"f Q 1 t 6 DHHS APPROVAL ( Approved for �1 _.bedrooms by / -eL�' Date Approved -4Disapproved Conditional Terms of Conditional Approval NOTE: It is strongly recommended that additional water storage be provided due to the low production of the well serving this parcel. This well produces 0.359 GPM. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 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 DHHS 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 72 025 (Rev 7iee) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • He1%tbarity Approval (HAA) FEBRUARY 1984 343-4744 L In t Lot 1, Katie Subdivision � OP"_ Q,,/,0%3p ego escnp ion A WELL DATA Note: Thsidb e ty is served by two wells. Well Classification Private If A, B, C, D E C Approved (Y/N) Well Log Present (Y/N) Y Date Completed 3-84 / 7Z90 Yield 0.192 / 0.167 (gpm) Total Depth507/300Cased to 34/20 Depth of Grouting Static Water Level 57/15 Pump Set At 496/290 Casing Height Above Ground 18"/18" Sanitary Seal on Casing (Y/N) Y/Y Electrical Wiring in Conduit (Y/N) Y/Y Depression Around Wellhead (Y/N) N/N SEPARATION DISTANCES FROM WELL To Septic/Holding Tank on Lot 103 / 170 , On Adjoining Lots 200+ / 200+ To Nearest Edge of Absorption Field on Lot 120 / 190 , On Adjoining Lots 200+/200+ To Nearest Public Sewer Line NA To Nearest Sewer Service Line on Lot Water Sample Collected by M. Erdman To Nearest Public Sewer Cleanout/Manhole NA , Date 10/31/90 Water Sample Test Results Satisfactory Comments Combined yield of the two wells is 517 gpd (172 gpd/BR) B SEPTIC/HOLDING/ATA Date Installed 10 Size Size 19000 No of Compartments 2 Standpipes (Y/N) Y Depression over Tank (Y/N) Air -tight Caps (Y/N) N Y NA Foundation Cleanout (Y/N) Y Date Last Pumped 7/89 7-/S/ d� Pumping/Maintenance Contact on File (Y/N) NA for NA Holding Tank High -Water Alarm (Y/N) NA Temporary Holding Tank Permit (Y/N) NA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK To Water -Supply Well 103 / 170 To Building Foundation To Property Line 75 To Water Main/Service Line 60 to water line To Stream, Pond, Lake or Major Drainage Course Comments 72 026 (Rev 7/88) Front To Disposal Field Page 1 of 2 10 C ABSORPTION FIELD DATA Soils Rating in Abc,orption Strata 147 sq ft/BR Type of System Design Date Installed 10/90 �'>� _ Length of Field 45 Width of Field __ 15 _ _ - _. _ Depth of Field _ 5 (To bottom of sand)_( Gravel Bed Thickness 1 --_ Square Feet of Absortion Area — 675 Statndpipes Present (Y/N) Y Depression over Field (Y/N) N Date of Last Adequacy Test NA(New _stem) Results of Last Adequacy Test NA SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well 120/ 190 To Property Line 30 To Building Foundation _ 30 _ To Existing or Abandoned System on Lot 20 On Adjoining Lots __. 60 To Water Main/Service Line 60 To Cutback (if present) NA To Stream, Pond, I ake, or Major Drainage Course NA To Driveway, Parking Area, or Vehicle Storage Area _ 65 Comments D LIFT STATION NA Date Installed Size in Gallons _ "Pump On" Level at __— High Water Alarm I evel 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 HAA guidelines in inspection , Signed Company_ERDMAN & ASSOCIATES Consulting Engineers Date MOA No Receipt No J_ Date of Payment i (" _ % Lf Amount $ 72 026 (Rev 7/88) Rack of this Receipt No _ Waiver Fee $ __ Date of Payment Page 2 of 2 COFFEY LABORATORIES, INC. 12423 N.E. WHITAKER WAY PORTLAND, OR 97230 PHONE: (503) 234.1794 ,,, FAk (503) 254.1432 FACSIMILE TRANSMITTAL LOG TO: COMPANY ATTENTION PHONE PHONE # DATE # OF PAGES (INCLUDING COVER MET)' -_ TELECOPIER PHONE #: (503) 254-1452 CONFIRMATION PHONE #: (503) 254-1794 21 Z Lot 1, Katie Subdivision / PLEASE LET US KNOW IF THE TELECOPY IS UNSATISFACTORY CLOM\FORM\HELPjFAX FRM------------------�---4 REV March 8, -1990 -T ----- T [l d aV11 15.33300 * I'll 3L'D' T n 0 6 9 0 T T MUNICIPALITY OF ANCHORAGE DEPARTM�T OF HEALTH AND ENVIRONMENTAL P ECTION z `, AN DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVA oe%Aieo Akin %AIA FA(.11 ITV LA K r.'. ...". �� 5 5� "\ ,�dr 'r �Ntj'yt1/J yr 'Rx�tr��.�F �fi,�� ;�rvry �.., e` ��?a,,�.-�� 'wr�4n<r�'YP `g4�cea.>»7r�'$°'S;s�P��•g, �� e��`„�W �` 'r7t trry 5 ENGINEERING FIRM PROVIDIt 04NSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION s As certified by my seal affixed hereto and as of the validation date shown below, I venfy that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein I further verify that based on the information obtained ;. from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection Name of Firm Telephone !2! ,irsr S & S ENGINEERING Address s. + F Rr Date Eagle River, Alaska 94577 /Ap, 8 % tk4a J Y .Ew l L c �. xP�� fA �' 3 � '�✓ i "B ! � 1Jcc � � l x t �,ft x i h r x� P'� I -,4 • � �tv 7a, 144 f � ui Yf �i rt n..- r � a +++ ' � �� _, '� /a � _ :,:/ *` � . � s• �a•.. a �' t ° x *{",�5. r ", �- S�.§,d"�fa'as t i . `� ✓ a , a ,1.�. z: �� C hY,..,1+: � �+`�TYF�y�dt3 • a v k t P� � �3 5."` °�s s� .a " � �� i1�'f0< <ii F Sz xY k ✓ 'r ai 0 t' t. k �� t w i � /moi .i Ha ilwVi� ' Apo =+ ; Op �. fi {,.,., �UFEN `, ;7l *'�� a.6'ix T 4 F x +s tij+S A. .�1s'A y�k� )4 a � '4 , r "' v:.- t ��`r�`+ it Mitt. sw ;,; � � }'�''• S Z'd�.�, t 1x1 1 .. �'� �, .i � •:Slx'k :° i -a". e n.> F "5of yx r rx o{ r r i� �'-1 i ,i MS, gA;9.si 'X?FM'�sti �'-�i"gi4&�f i i; y 'r r �'M�.S r r� t. •n y pp��4,, .1,�' pt'*1� y�,�,� f 1y � � � g �YQ �' �j'b?fl°.rs Y,i xv'Y c s't3 S Rai". r".at"'r'z 5.�c-.,,+•!,L €,ve ';;;{, dr�`yi'-° at�Y �� 4 w ppr ed fo bedrooms b%/ Date °Ilk r'$` !!§mmyy�.vf" „r .k{yx �i �.0 '� A=SP� lJ��Sn-{''+5 } '' °,�,y�, Disapproved Conditional cAl fi ryw fill .R "q Y:. D raJ L FylYt ,a'^�� y„ .�^a'^+4v.'r""�k.{c•`�'� }'Lt y'�Yr.�.r;i ��5 t u'� +' 3 �,4�arR'� �`,yi6f§r ��r �'n A k n k^•• + -'oi i �� i, � � 0. ��fY"`:l k1�.. - • 1 .� � t � � �*Fe MA The4Munc pal(ty of„Anchorage Department of Health and `Environmental Protectioh (DHEt?) issues �Iealth Authority' f j pk¢4 �ApprovaI certrficafes based solely upon the `representations given m paragraph 5 above by an jndependent professional J engineer registered inthe State of Alaska "The DHEP does this as a courtesy to purchasers of homes and their lending a, Ninst)tuiions in order to satisfy certainfederal and state requirements Employees of DHEP do not conduct inspections or "analyie data before a certificate is issued The Municipality of Anchorage is not responsible for errors or omissions in the 1 yr�� Ser``#xY professional engineers work x Page 2 of 2 72.025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALOT #LAT#"TdPRITY APPROVAL (HAA) DEPT OF HEQIFKeKLIST - FEBRUARY 1984 ENVIRONMENTAL PROTECTION264-4720 i A N 7 1987 Legal Description A WELL DATA RECEIVED B Well Classification 44:` If A, B, C, D E C Approved (Y/N) 13 / A Well Log Present PN) Date Completed 2 --►4"%.-15+ Yield Z-04nP14 Total Depth f;b*l t Cased to 14 1 Depth of Grouting Static Water Level 80+ Pump Set At /mss �—• Casing Height Above Ground SON Sanitary Seal on Casing (S?N) Electrical Wiring in ConduitON) Depression Around Wellhead (Yo Separation Distances from Well To Septic/Holding Tank on Lot 1 OS On Adjoining Lots To Nearest Edge of Absorption Field on of 122 r On Adjoining Lots ( C>cp To Nearest Public Sewer LineY P To Nearest Public Sewer f Cleanout/Manhole To Nearest Sewer Service Line on Lot 2S + Water Sample Collected by S S '�A=Calt-St�2tt`( Date S*,5 Water Sample Test ResultsAT�s�l� Comments Tr( ' SL4v��9 --r'tk t�f�t.�. To FffQ204'& za 6,PN 12- 6-85 SEPTIC/HOLDING TANK DATA Date Installed )'2JO' 1131 Size I O'00 No of Compartments Standpipes ON) Air -tight Caps C7N) Foundation CleanoutON) Depression over Tank (Y,tV Date Last Pumped Pumping/Maintenance Contract on File (Y/N) , for Holding Tank High -Water Alarm (Y/N) a P Temporary Holding Tank Permit (Y/N) sJ p Separation Distances from Septic/I Wd... Tank To Water -Supply Well To Building Foundation )Z � t To Property Line 10 -. To Disposal Field To Water Main/Service Line _ Course Comments Page 1 of 2 72-026(11/84) To Stream, Pond, Lake, or Major Drainage C ABSORPTION FIELD DATA Soils Rating in Absorption Strata — �� Type of System Design r Date Installed_ _��P� 8`l_ _ Length of Field _ N 1 Width of Field _ 3rd Depth of Field �r Gravel Bed Thickness Square Feet of Absorption Area i t Sty'' T-OT10111 Standpipes Present 62N) Depression over Field (Y/6 _ Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field I o Water -Supply Well r — ------ To Property Line" — --- _ To Building Foundation —fes __ _ To Existing or Abandoned System on Lot _ __ _- !A On Adjoining Lots To Water Main/Service Line _ To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course — To Driveway, Parking Area, or Vehicle Storage Area _—___—�5br Comments D LIFT STATION Date Installed — __ Dimensions —_ Size in Gallons — Manhole/Access (Y/N)__— Pump On' Level at ____—___—__-- _ - _— Pump Off Level at _____ High Water Alarm I evel at ___ — --� Vent (Y/N) Tested for — — ___ _ Pumping Cycles during Adequacy Test Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have c hecked, verified, or conformed to all MOA nd HAA guidelines in effect on the date of this inspection Signed g1_5 ENfNk-EWNG Date �! __- 17034 Eagle haver Loos Road Nn ComparPagla No od River,,Alaska 993y7 �' Receipt No x �c, Date of Payment Amount $ I L>c ' y[ �r - -_ — __— a; er s S le`VfDI f'J 1 AiJ1'Js;<w r"f f 4i� t�wA'�' �� ♦r t, <1J boa e,�kaa �y 9i f.G Page 2 of 21 ..iW y, '140 12 oas �i ven> 0 .J 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 tz-�,S 1 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L-ar 1ec 9 0--A Location (address or directions) (b) Applicant Name \h n36F Telephone Home Business Applicant Address T' o t3 OX to "nsa t - GI�G1 (^-u, ls_ L4, Gil S L -f7 (c) Applicant is (check one) Lending Institution ❑ , Owner/builders Buyer ❑ , Other ❑ (explain), (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address _ Telephone (f) �n Matt+the HAA to the following address 2 TYPE OF RESIDENCE Single -Family e Multi -Family ❑ Other Number of Bedrooms �3 3 WATER SUPPLY Individual Well'9 Community ❑ 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 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 PROVIDING 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 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 5 & S Engineering Address _ SRB 19 7- Date -Eagle River, Plias@<a 9957' J e"®s000a as �af��®� �r0 ��6000 w • • y ,49 % f6be t A Shafer No. 1457-H DHEP APPROVC��. -- bedrooms for bedrooms b _ f "e-�✓il-a � ZL&. Approved Disapproved Conditional Terms of Conditional Approval 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 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF ANCHOjALTH AUTHORITY APPROVAL (HAA) DEPT OF HEALTH & CHECKLIST - FEBRUARY 1984 ENVIRONMENTAL PROTECTION 264-4720 DEC 171985 Legal Description L.•e-_re VIA `\ � '1'Lsn-I, (L-1 A WELL DATA RECEIVED Well Classification S IF If A, B, C, D E C Approved (Y/N) tom" Well Log Present &N) Date Completed Z" 1 °1 — 84� Yield ZP GAPN Total Depth `r01 Cased to Depth of Grouting Static Water Level or;) Pump Set At V • 14 Casing Height Above Ground — Electrical Wiring in Condudo>/N) u Sanitary Seal on Casing V?I) Depression Around Wellhead (YAW Separation Distances from Well To Septic%klelctrrg Tank on Lot On Adjoining Lots 1cn'o To Nearest Edge of Absorption Field on/ Lot 12-?- { On Adjoining Lots" l iso �x To Nearest Public Sewer Line IS a To Nearest Public Sewer Cleanout/Manhole To To Nearest Sewer Service Line on Lot 2 S 1'•1" Water Sample Collected by S 5 !E"titDate (2--i —g5 Water Sample Test Results Comments ^J&g.Li Ga.o�J T ��10 ''� `i�L� �'SE^"1- Ta C ly,p ca.S < e Z.p 6, 1? !-i Gh 5th v SrrbtJ. B SEPTIC/HCtD114G TANK DATA Date Installed I—ZAO" 0 Sizet iaz No of Compartments �— Standpipes (ON) Air -tight Caps (55N) Foundation Cleanout%!PN) Depression over Tank (Y,V Date Last Pumped Pumping/Maintenance Contract on File (Y/N) d for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/He}ckf*Tank To Water -Supply Well 1 To Budding Foundation (y r To Property Line 1 0 7 � To Disposal Field a To Water Main/Service Lin 1 To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C ABSORPTION FIFLD DATA Comments D LIFT STATION Date Installed Size in Gallons Pump On I evel at High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Dimensions Manhole/Access (Y/N) Pump Off Level at - --- - Vent (Y/N) - - — — Pumping Cycles during Adequacy Test Meets MOA Check Permitted Bedroom Rating Against HAA Request'" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection Signed _�,__� Date Company MOA No Receipt No . Flo Date of Payment 4 Amount 40f L V. 1 C ' 6uY Pae 9 Al 92 UA (11 on) Sods Rating in Absorption Strata t_ I`3a- Type of System Design Date Installed i Length of Field U Width of Field Depth of Field Gravel Bed Thickness N 1 Square Feet of Absorption Area 6�'� — Standpipes PresentON) Depression over Field (Y,CLP Results I Date of Last Adequacy Test of Last Adequacy l est Separation Distance from Absorption Field 9 To Water -Supply Well Z2_ _ _ To Property Line r r to Building I oundanorl - 7 C� 1 _ To Existing or Abandoned System on Lot '4- r On Adjoining Lots I o Water Main/Service Line __ t5 ToCutbank (if present) to Stream/Pond/Lake/or Major Drainage Course ___ L to Driveway, Parking Aiea, or Vehicle Storage Area Comments D LIFT STATION Date Installed Size in Gallons Pump On I evel at High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Dimensions Manhole/Access (Y/N) Pump Off Level at - --- - Vent (Y/N) - - — — Pumping Cycles during Adequacy Test Meets MOA Check Permitted Bedroom Rating Against HAA Request'" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection Signed _�,__� Date Company MOA No Receipt No . Flo Date of Payment 4 Amount 40f L V. 1 C ' 6uY Pae 9 Al 92 UA (11 on)