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Home My WebLink AboutTRAILS END BLK 8 LT 5Onsite File Trails End Block 8 Lot 5 #015-191-31 (Rev 03702/18) WHO JAN 2 4:: Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221159 PID Number: 015-191-31 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name ARTHUR E. COPOULOS ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ® Mound Site Address 8681 E KLATT RD ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 2 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. TRAILS END 8 5 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ft z Ft. Well 100'+ __ 25'+ TANK ❑ Septic ® S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1500 Gal. Surface Water 100'+ -- Material EPDXY STEEL Number of compartments 2 Lot Line 10'+ __ NA Foundation 10'+ __ LIFT STATION Manufacturer ANCH TANK / ORENCO Capacity 1500 Gal. Remarks REPLACED EXISTING STEP TANK IN SAME PLACE STEP ANCHORED & BENTONITE ADDED Alarm location FIRST FLOOR Electrical installed by CAPSTONE PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer A+ Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection 15' 10/24/22Location 10/25/22 and description dates: 2nd 3rd 4th GARAGE SLAB ON-SITE WATER AND WASTEWATER SECTION APPROVAL OF A 4 Conditional Approval: Date � .. 4.... .....�.. —17 Curtis Huffman % �� F� • CE 128991 . i�`� Septic Syste Approved - Date 1 /20/2023. #� /�l� • . FFA .... • �, �...,... il` pROFESS10N4.�. Note: this approval does not include well permit require nts. (Rev 03702/18) WHO JAN 2 4:: PID: 015-191-31 PERMIT: OSP221159 30' elf 4 O CA W v W O Q co Q `- fy M O W Lo It N O O O Z S89°59'30"W 189.31' (189.97' R) 8.0' ¢i CANT N EXISTING 2 BED HOUSE 0 WELL EAST KLATT ROAD 19.7' 7.8' '--NN \ m SHED Of DECK CD O INSTALLED MT 10.0' 1500 -GAL EPDXY-COATED MT ® ° STEEL STEP TANK ~ o ANCHORED & BENTONITED G a CONNECTIONS & RISERS. W U7 O F- O FCU O C D N ° LOT 5 a BLK 8 MT ® o U GRAVEL RECONNECTED EXISTING MT W MOUNDED D/W TO EXISTING 0 FIELD FIELDO 100' WELL RADIUS 16.0' O O N HSE O [::I I Z 10' UTILITY ESMT N89°59'20"E 189.41' (119.07' R) BASIS OF BEARING 0 n TRAILS END BLOCK 8, LOT 5 PREPARED FOR: ARTHUR E. COPOULOS 8681 E KLATT RD ANCHORAGE, AK 99507 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK@gmail.com JUrrUK 10 -)1- OFAL ' vA � 9 TII DATE: 1/20/23 SURVEY: JLS tis Huffman DRAWN: FWCS CE 128991 w SCALE: 1" = 30' 1/20/2023e PAGE: 1 OF 1ssiozz�' BM: GARAGE SLAB A—C=39.1' F00 A e MT MH MH 100'86 FINIAL GRADE B—C=30.3' i A— D= 46.2' 95.86 B—D=37.5' 1.500 -GALLON RECONNECTED 95.2 EPDXY-COATED PRESSURIZED LINE STEEL STEP EXISTING MOUNDED FIELD TANK STEP ANCHORED & ADDED BENTONITE TO CONNECTIONS & RISERS SEPTIC SECTION SCALE: NTS TRAILS END BLOCK 8, LOT 5 PREPARED FOR: ARTHUR E. COPOULOS 8681 E KLATT RD ANCHORAGE, AK 99507 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK@gmail.com JUrrUK 10 -)1- OFAL ' vA � 9 TII DATE: 1/20/23 SURVEY: JLS tis Huffman DRAWN: FWCS CE 128991 w SCALE: 1" = 30' 1/20/2023e PAGE: 1 OF 1ssiozz�' 30' W S89°59'30"W LOT 4 BLK 8 189.31' (189.97' R 10' UTILITY ESMT i N89`59'20"E 189.41' (119.07' R) BASIS OF BEARING EAST KLATT ROAD ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: TRAILS END SUBDIVISION LOT 5 BLOCK S PLAT P-604 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a OF physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should* 49`�'H any information on this drawing be used for construction of fences, Al , ... E structures, improvements, or for establishing boundary lines. J EXCLUSION NOTES: It is the owners responsibility to determine ' ' ,1:<}HN L. ' 1 " .. ' ' ' "' SCH' ' ' ' ' ' ULLER: o ' ' ' " ' : ' 'C the existence of any easements, covenants, or restrictions which � do not appear on the recorded subdivision plat. � s� LS -10408 �'D I WORK ORDER NUMBER: DATE: SCALE: E -NAIL• Ro64N Y' cHEEcR5 ey (�YiiD NUNDER:2022 O, SChUIIBD��1 ��ArGE:0f • S -o o, LOQ 22-049-2 �Ls SW2641 220359 ®�tO` 0 LA,4 :\N' O a t, r/] a 0 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax I 7.8' ( N B.0 N rl- � SHED S HED O�tann DECK SEPTIC a VENT ® ~ - u CANT 10.0' BLK 8 32.0' O Lo zo o O 33.9' EXISTING a M H �. HOUSE N a MH ® O 12.3' W r 0 o z ro 19.7' 6 O W O 16.0' _ X GRAVEL �X GRN HSE l D/W 10' UTILITY ESMT i N89`59'20"E 189.41' (119.07' R) BASIS OF BEARING EAST KLATT ROAD ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: TRAILS END SUBDIVISION LOT 5 BLOCK S PLAT P-604 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a OF physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should* 49`�'H any information on this drawing be used for construction of fences, Al , ... E structures, improvements, or for establishing boundary lines. J EXCLUSION NOTES: It is the owners responsibility to determine ' ' ,1:<}HN L. ' 1 " .. ' ' ' "' SCH' ' ' ' ' ' ULLER: o ' ' ' " ' : ' 'C the existence of any easements, covenants, or restrictions which � do not appear on the recorded subdivision plat. � s� LS -10408 �'D I WORK ORDER NUMBER: DATE: SCALE: E -NAIL• Ro64N Y' cHEEcR5 ey (�YiiD NUNDER:2022 O, SChUIIBD��1 ��ArGE:0f • S -o o, LOQ 22-049-2 �Ls SW2641 220359 ®�tO` 0 LA,4 :\N' O a t, r/] a 0 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax I � d7 SEPTIC a VENT ® ~ - LOT 5 (t,D) W Ln BLK 8 O o M H ~ `- a MH ® O W O O 16.0' _ X O O �X GRN HSE l a O Xt Z 10' UTILITY ESMT i N89`59'20"E 189.41' (119.07' R) BASIS OF BEARING EAST KLATT ROAD ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: TRAILS END SUBDIVISION LOT 5 BLOCK S PLAT P-604 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a OF physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should* 49`�'H any information on this drawing be used for construction of fences, Al , ... E structures, improvements, or for establishing boundary lines. J EXCLUSION NOTES: It is the owners responsibility to determine ' ' ,1:<}HN L. ' 1 " .. ' ' ' "' SCH' ' ' ' ' ' ULLER: o ' ' ' " ' : ' 'C the existence of any easements, covenants, or restrictions which � do not appear on the recorded subdivision plat. � s� LS -10408 �'D I WORK ORDER NUMBER: DATE: SCALE: E -NAIL• Ro64N Y' cHEEcR5 ey (�YiiD NUNDER:2022 O, SChUIIBD��1 ��ArGE:0f • S -o o, LOQ 22-049-2 �Ls SW2641 220359 ®�tO` 0 LA,4 :\N' O a t, r/] a 0 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax MUNICIPALITY OF ANCHORAGE On -Site Water & WastLawater Program PO Box 195,550 4709 Frnwe Road Anchorage, Alaska 99519-6650 Ph -one; (907) 3434904 Fax' {947 343-7997 htlpJA rw.muni.arg onsite On -Site Wastewater Disposal System Permit Permit Number: OSP2*21159 Work Type. SepticTank Upgrade Tax Code Number: 015191310.OG Site Legal Address: TRAILS END BLK 8 LT 5 G:2641 Site Mailing Address: 8681 E KLATT FAD, An0-ora0e Owner: OPOIJL08 ARTHUR EMMANtUEI, Design Engineer: FIRST WATER CONSLJLTING This permit is for the construction of: Effective Date: FKpiration Date: Lot Size in Sq Ft: Total Bedrooms: titrnr; Er1812022 61812023 22789 ❑ Di-sposal Field V Septic Tar.k ❑ Holding Tank ❑ Privy ❑ Private Well M Water Storage All construction stall be in acc-ardance with: 1. Tho attar ed approved design, 2. AIJ requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 arkd the $note of Alaska VVastevra.tcr Disposal Regulations (18AAG72) and Drinking Water Regulations (18AA 801 3. Tine wastowater coda rcguirar- incpertiDn^ during the installation. The engineer 3h all notify the Deve lopmont Services Department per AMC15.65. Provide notification by calling (007) 843-7004 (2417). 4. From October 15 to April 15, a subsurface sail absorption sy.5tom under construction during freezing woather shall be -either: a_ Opened and Closed on the sante day, or b, Covered, sealed, and heated to pro -van( freezing G I Special Provisions: "Pl�asa note: The Greer plastic, tanks are only approved for installalion in groundwater uo higher than 1 ft above bottom of tank. Re [ved By: Date: 6i Issued 18y:A /I Date, 2 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-191-31 Property owner(s) ARTHUR EMANNUEL COPOULOS Day phone Mailing address 8681 E KLATT ROAD, ANCHORAGE, AK 99507 Site address 8681 E KLATT ROAD, ANCHORAGE, AK 99507 Legal description (Sub'd., Block & Lot) TRAILS END 138, L5 Legal description (Township, Range & Section) Lot Size 22,789 Sq. Ft. Number of Bedrooms I APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank El Upgrade Q (D) El Holding Tank ElRenewal ElDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 122.5 Waiver Fees: Date of Payment: �/ a 6�� D �� Date of Payment: Receipt Number: (01 L 1 Receipt Number: Permit No. Dsr'2Z 115 Waiver No. G1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com June 1, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK STEP UPGRADE PERMIT LEGAL: TRAILS END B8, L5 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic STEP tank on the above referenced lot. We propose to install a 1250-gallon HDPE STEP tank per the attached design to serve the existing 2-bedroom residence. The lot and area are served by private wells. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221159, Rebecca Carroll, 06/08/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221159, Rebecca Carroll, 06/08/22 I ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: TRAILS END SUBDIVISION LOT 5 BLOCK 8 PLAT P-604 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul4 any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners, responsibility to determine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DAM- SCALE:E-MAIL- MAY 23, 2022 , , =30' schullerOoknet 22-049 DRAM BY: ICHECKED BY: GRID NUMBER: BOCK AGE JLS SW2 4-11 220207 SU RV L A ?V AW 0 F 4 �� 0 41 �►,, Ay 'P 49TH RA ........... .. . ......... •7 HN L SCHULLER. 0 sem' LS -10408 'qj -far 1831 Talkeetna Street �'ry + • ��j- d „� Anchorage, Alaska 99508 (907) 227-1455 office �� ssio'��r• (907) 274-4992 fax LOT 4 BLK 8 S89*59'30"W 189.3 V (189.97) R) 30 �7 'C'4 7.8' 8.0' cv 06 SHED Ntl Ln CANT 10.0, SEPTIC 0• LIjQ� 32.0' 1 VENT LOT 5 (t yp) W< > 0 33.9' EXISTING -1 CL c' BLK 8 0CN <1 0 (D 0 'do. HOUSE < 0 0 12.3' 0 0 00 19.7 10 z 0 MH 0 L.Li Ld GRAVEL D/W 0 0 0 0 P 0 0 o4 ? G 0 z 1 NSE 0 WELL 10' UTILITY ESIM-1 N89*59'20"E 189.41' N89*59'20"E 189.41' (119.07' R) 0 EAST KLATT ROAD I ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: TRAILS END SUBDIVISION LOT 5 BLOCK 8 PLAT P-604 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul4 any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners, responsibility to determine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DAM- SCALE:E-MAIL- MAY 23, 2022 , , =30' schullerOoknet 22-049 DRAM BY: ICHECKED BY: GRID NUMBER: BOCK AGE JLS SW2 4-11 220207 SU RV L A ?V AW 0 F 4 �� 0 41 �►,, Ay 'P 49TH RA ........... .. . ......... •7 HN L SCHULLER. 0 sem' LS -10408 'qj -far 1831 Talkeetna Street �'ry + • ��j- d „� Anchorage, Alaska 99508 (907) 227-1455 office �� ssio'��r• (907) 274-4992 fax Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report "a'"~--[3-~l~. ~_,,. ~ d ~ . Wastewater System: D New ,~pgrade Address: tt~ I ~~ ~ ~ ABSORPTION FIELD Phone: INo. o~ooms: ~DeepTrench ~ShallowTmnch DBed ~ound ~Other Tolal Depth fro originalgrade: LEGAL DESCRIPTION Soil Rating: ~' ~ GPD/Sq Township: I Range: I S~,ion: Fill addedsl~above ,ig,nal grade: Ft Gravel length: WELL: D New ~ Upgrade Gravelwidtb: ] ~1~, Num~lines: Dis,a~li=:~ F, SEPARATION DISTANCES ~ Septic ~ Holding ~S.T.E.P. R~marks: ~ ~¢~ ~ BENCH MARK ENGIN[E~ SEAL Department of Health~ ~man Se~s approval ~,~.... Reviewed and approved by: ,, ate: 72-OI3 {Rev. 9/91) MOA 25 .PermltNo. ~;:)[~----~l~J ~ I Page ~ o! ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description:"~P' {~ ~ ~. ~ LC3"r'~ PID No.: "? RTLRS WIRELINE SERVICE TEL NoJg07-561-4028 Nov 4.92 8:10 No.O02 P.02 m . .,l,¢ ~ ..... -~r~am ur ~UkAO~ BUILDINO ~A ' ~ -~ . ~uu ~7 ~'U~O~ ~OAD /~ ADDRESS{ IISBI COBRA AVE P£RNIY {{ 9'!-8455 · 1,01: $ ~LOCK: 8 ~U~: TRAIL~ £ND PHDN£ t: 3~G-3978 COHM£H~: CALL ~EFO~£ ~0~ A~T DR LYN DA?E: 10/2B/1992 O0 0 0 WILL ~E~XAMINB AY NEXT INS~C%ION 'tXPLAIN~D BE&OU _. ..~-:. COHHEN~G. - ........ .,-' .; RECEIVED· .' ' , ...,.,',. .... ~::.'. ' NOV 2 0 19~2 · · . ~. ~ F' . . .. · ' ' .' . / " '-...v'; ,.'.. ' :..'-.~v ' '.. · . ............ j . ~ ~ · . ..... ~,.: · ,..~. r ~ ,-.~ ;, : · . ~ ......, .... . ~ .?~ .....~ ..,:.. · ~ · i~/',=-: · ' ·., - ".' . ,f I[~ . .. ~ ~ .... ~. , ,. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "LN STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PAGE 1 OF PERMIT 10 '~0-~-~ PERMIT NUMBER:SW920320 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:COPOULOS ARTHUR E OWNER ADDRESS:il581 COBRA AVENUE ANCHORAGE, ALASKA 99516-1266 DATE ISSUED: 9/30/92 EXPIRATION DATE: 9/30/93 PARCEL ID:01519131 LEGAL DESCRIPTION: TRAILS END BLK 8 LT 5 LOT SIZE: 22789 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~' ~/, ISSUED BY:~/~'~ ~ DATE: DATE: SEWER & WATER MAIN EXTENSIONS WELL INSPECTION & FLOW TEST SiTE PLANS ROAO DESIGN SOIL TEST ROSERTSHAFER. PE. RCGERSHAFER.P.E September 17, 1992 CIVIL ENGINEERS (907~ 694.2979 FAX 694.1211 Municipality of Anchorage DEPARTMENT OF MEALTHAND ~UMAN SERVICES 825 L Street ~nchorage, Alaska 99501 REFERENCE: Trails End Subdivision, Block 8, Lot 5 Request you issue a permit to upgrade the septic system serving the referenced property. The existing system is in a state of failure. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. We do not anticipate any adverse effects on the neighboring properties by the installation of the proposed upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, Roger J. Shafe~, P.E. RJS/JPW/lsu 17034 EAGLE RIVER LOOP. SUITE 204, EAGLE RIVER. ALASKA 99577 t~1LEG^L TRAILS END SUBDIVISION, BLOCK 8. LOT 5 D.^W. L. S. ULSTER IcKD' ~.J.S. ID^'E 9/'~/~ ~ 4~0 * 0.5 · 900 ~. fl. REO~ INSTALL 4'~ND FILTER 6" GRAVEL U~ER 8 OVER ~_J DIS~ PIPES 18' X 50' ~ EO. 4 /v c ,r 7 ;TRIBUTION SYSTEJ/b PUMP = 20 051 05HH - 5 STAGE (-30 GPM). 3 LATERALS - 44' LONG EACH = I0 I0 ~,o~s/~r . 30 HOLES TOTAL = I t/,~" DIA. HOLES FACED DOWNWARD. I t/~" DIA. LATERALS. I ~" 50LID ~NIFOLD LOT 5 PR~O3EDPRE~ZED J ~$T~BUTI~ I EXIS~ I000 GAL MO~ ~Y~TEM ~ TO I~E ,48ANOONED 3 BDRM HOUSE EX/ST. CURTAIN ~ PROPOSED DRASV [APPROX. ~ & T.E.P. LOCATIONI · SYSTEM MB,~ON EXIST. LOT '6 SEPTIC AREA NO WATER FLOWING IN ROAD DITCHES AT THIS TIME KLA TT ROAD AlE SUPPLIES 1LEGAL TRAILS END SUBDIVISION, BLOCK 8, LOT 5 ID-W. I ISHT. MT FINAL GR.4DE - 6' TOP.,COIL .,41'ID .SEED , MI' IMPE, RMEA~LE ~ER LS' 0 AlE SUPPLIES I~OZOa Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR= LEGAL DESCRIPTION: '"~'f(,.,S F_..r 1 2 3 4 5 6 7- 8- 9- 10- 11 13- 14- 15- 16- 17- 18- 19- 20- PERFORMED: Township. Range, Section: SLOPE WAS GROUND WATER y~ ENCOUNTERED? IF YES. AT WHAT ~' SI- DEPTH? pO E Depth to Water ~er~. j ~)J::~ 9 _ ,,I e Monitoring7 f ~ f~: ~ SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop :15 Io ¥" PERCOLATION RATE I'~'~ (m,nutes,'mch) PERC HOLE DIAMETER TEST RUN BETWEEN .-.~!.~-- FT AND ~'P,~ ~' FT COMMENTS $ &S ENGINEERING ~/~ PERFORMED BY: : 17334 ~.,,~1,: ~;,~, L~,p A~a~ ;{u. 2~ CERTIFY THAT THiS TEST WAS PERFORMED IN ACCORDANCE WIT~X~['~~L GUIDELINES IN EFFECT ON ?HIS DATE. DATE: ~--~~ 72'008 (Rev. 4/85) ATLAS ~IRELINE SERVICE TEL No.907-561-4028 Sap 24,92 14:00 No.OI6 P.O1 .i Date: September 23, 1992 50: John Smith, DEC From~ Art Copoulos S~bJect: Septic System Installation i ~% I (and Lynn Means) request permission to install a new ~eptic system on Lot 5 Block 8 as designed by Jim Williams of S & S Engineering (design attached). We would like to install the systea. ourselves because we can save $4000-6000. = I (Art Copoulos) am a graduate Civil ~ngineer and a nine resident of Alaska. ! also have completed 7/10 of the requirements for a Masters in Civil ~ngineertng at University of Alaska. If yOU have any concerns about my qualifications or my ability to do a good Job, I would be happy to meet with you to discuss the. pro~ect and my qualifications. I would also be willing to provide' professional or academic references, feel free to contact UAACivII' Engineering professor Dr. Robert Miller. .'i I would like to get on the Municipality approved list for "septic system installers", however, the timing will not allow ~t. The house transaction ~s already underway and I only recently =on£irm~d there was a problem. In addition, I have ~o get the. project complete~ before Winter (in the next two weeks). .. While I understand the need for the regula~ions, considering ~hat you make exceptions to the regulations, I would expect that you could make one for ms considsr~ng my qualifications. I am not a ~ #fly-by-nighter". I am an experienced professional' w~th'a ~roYen record. I have strong ties throughout the community and em not one to do a ~half-ass" Job. I plan to be in Anchorage for years to come and I give you my word of honor that I will do a good Job installing this system. .. I would appreciate if you could get beck to me today ~s I ~uld like to begin installation this weekend. You oan reaoh me at"563-. ~233 (days), 346-~978 (evenings), and 561-4028 (fax). Tha~k. ygu. ~tncerely, Art Copoulos r ~ 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 MAILING ADDRESS LEGAL DESCRIPTION Liq. capacity in gallons Inside length Width Liquid depth ~O ~ Well Dwelling PERMIT NO. DISTANCE TO: ~ ~ ~ Manuf~turer Materiel Liquid capacity Len th o~ ee h line Total length f lines Trench width Length W~dth ~pth PERMIT NO. ~ ~ Ty~ of crib Crib diameter Crib depth Total ef f~ti~ a~orption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ ~ ~ C'as~ ~ DePth Driller D,stance to lot I,n. PERMIT ~O 76 ~ DISTANCE TO: Building foundation Se~r line Septic rank Absorption area(si OTHER PiPE MATERIALS SOIL TEST RR~ 'lNG INSTALLER REMARKS .ll : .............. APPROVE~ DATE LEGAL 72-013 · °;" * ' 825 'L' STREET, RNCHORRGE, RE. _~950i ~,.'-M ' ~'"" ' 264-4 ?20 ~ ~ ~ ~ : 14ELL Rf'ID Of4--S I TE SEI4ER PERf'I I T ~_ ]~.~ PERMIT NO. ( 828875 ) ~[Od~S¢ RPPLICRNT CHRIS FEGES 6917 OLD SEHRRD HIHY ~4B-~911 LOCRT I ON ~ · ~ I I~]~ L~ B8¢TRRILS, END . ' LOT SIZE 280~:0 5~URRE FEE¢ ~ TVPE OF SOIL RB~O~PTION'$V$TEM I~: TRENCH , ~ DEPTH= ~ LEr-IGTH= 105 GRRk~EL DEPTH= 5 THE IZENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETHEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET HIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF 6RRVEL BETHEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). REOLIIRED SEPTIC TRNF< SIZE= IE~OE~ 6RLLOf4S PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF AN'¢ HELLS RDJACENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE HELL HILL SERVE. TI,lO ( 2 > I 1'4SPEOT IONS RRE REC~.IJ I RED BRCKFILLING OF RNY SYSTEM HITHOUT FIHRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT HILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETHEEN R HELL RND RNY ON-SITE SEHRGE DISPOSRL SYSTEM IS 480 FEET FOR R PRIVRTE HELL OR i50 TO 2~ FEET FROM R PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC HELL. MINIMUM DISTRNCE FROM R PRIVRTE HELL TO R PRIVRTE SEHER LINE IS 25 FEET 8ND TO R COMMUNITY SEHER LINE IS 75 FEET. HELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT HITHIN 2~ DRYS OF THE HELL COMPLETION. OTHER REOUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. PEI;:r4 I T EXP I I;;:E$ DECEMBER _~---.-I ~ ::L_C~82 I CERTIFY THRT l: I RM FRMILIRR HITH THE REQUIREMENTS FOR ON-SITE SEHERS RND HELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I HILL INSTRLL THE SYSTEM IN RCCORDRNCE HITH THE CODES. ~: I UNDERSTRND THRT THE ON-SITE SEHER SYSTEM MRY REQUIRE ENLRRGEMEMT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOHS. [.l)[ PERFORMED FOR: , LEGAL DESCRIPTION: 1 4- 5- 6- 7- 8- 9- 13 15~ 16- 17- 18- lg- 20- COMMENTS f~f PERFORMED BY: 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ILS LOG [~'~PERCO LATION TEST SLOPE SITE PLAN / / WAS GROUND WATER ENCOUNTERED? IF YES. ATWHAT DEPTH7 Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE /~ ~" ~* / (n~inute$/inch) TEST .u. EE','WEE. . ',, ~?~1-[ ..'. .- Box 1369, ST,~kR I, OUTE A ANCHORAGE, ALASKA 99502 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF SP..~.00 PER FOOT. PROPERTY OWNER ~rc~'~c.o ~,=~e,~. 349-6692 LOCATION OF' WELL SITF' f2.o ,~ aJJC. o ~'~ Su/~,, 7~'~W-.w' ~__~'~m.~/ ~-,.~.. DRILLER WELL LOG: 0 .... 22' 7,br~ ~e,L a~,Ltk 30;; ~ l~X. rrde~. $22.00 p~ ~oot X 15.2 ~_.t: S3344.oo RECEIVED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF .~4~00 THANK YOU VERY MUCH. DATF BERNIE CLAUS OF RAMPART DRILLING WORKS SERVICE CHARGE O F lY~% PER MONTH WILl. BE ASSESSEDOH PAST DUE 7 MUNICIPALITY OF ANCHORAGE .� Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-191-31 Legal description TRAILS END BLK 8 LT 5 Site address 8681 E KLATT RD Expiration Date: Current property owner(s) COPOULOS ARTHUR EMMANUEL XThe On-site system(s) is/are approved for 2 bedrooms Conditional approval for Comments or advisories: 8/12/23 bedrooms, with the following stipulations: By: Original Certificate Date: 5/12/23 /Z This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-191-31 Complete legal description TRAILS END BLOCK 8, LOT 5 Location (site address) 8681 E KLATT ROAD, ANCHORAGE, AK 99507 Current property owner(s) ARTHUR EMMANUEL COPOULOS Day phone 2. ON-SITE SYSTEMS SIZED FOR 2 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age <1 YREAR - See advisory if steel older than 20 years — NEWER STEP TO MOUNDED BED 6. ABSORPTION FIELD: ❑ AWWTS ® Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ S70. Date of Payment COSA # 0S Z 31 r 1 Waiver Fee $ Date -of Payment Waiver # COSA AppllcaUon.doc COSA Checklist.docx COSA Checklist Legal Description: TRAILS END BLOCK 8, LOT 5 Parcel ID: 015-191-31 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 4/5/1982 Total depth 152 ft Cased to 152 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 4/26/2022 Static water level at beginning of test 27 ft. Well production at time of test 4+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 2.66 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 4/25/2023 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NEW STEP TANK Required maintenance completed, if AWWTS Comments: INSTALLED OCTOBER 2022 C. LIFT STATION Required maintenance completed Age of lift station <1 years Lift station material STEEL Comments: No maintenance required for new STEP. D. ABSORPTION FIELD DATA Which system tested (date installed) 10/20/1992 ALL standpipes present per record drawing Total measured depth from grade 2.8 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective (assumed) Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 4/25/22 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 4/26/2022 Results Pass Fluid depth prior to test 0 in Water added 610 gal New fluid depth 0 in Elapsed time <10 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 0 in Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade on the edge of the mounded bed. Other areas have predominately more cover up to 1’ & owner has had no known frost or freezing issues. See owner letter. Mound checked on 4/25/23 & MTs were dry. ED assumed per visual observations and MOA file. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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 Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 5/11/2023 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 5/11/2023 From:Art acop321@gmail.com Subject:Re: Trails End B8, L5 - MOUND COVER Date:May 11, 2023 at 10:58 AM To :Brent Western ﬁrstwaterak@gmail.com Brent, Thank you. I have never had any frost or freezing issues with the vegetated mound for the past 30 years. I added topsoil, grass, and ﬂower seed to the top of the mound when it was built in 1993. As you note it is heavily vegetated. Art On May 11, 2023, at 2:06 PM, Brent Western <ﬁrstwaterak@gmail.com> wrote: MOA has raised a question about the covering over the mounded, insulated septic ﬁeld. The MOA ﬁle states that you were to add additional cover of topsoil and seed in the spring of 1993. There was only 26”, 33”, 27” and 34” of total depth found at the monitoring tubes on the edge of the mound with approximately 1’+/- in the center of the ﬁeld. Per visual observations the mound appears to be heavily vegetated with grass and lupine. Per previous discussions, please provide an email stating that you have never had any frost or freezing issues for the past 30 years of this vegetated mound and also state if you added any ﬁll or cover (top soil / seed) in the spring of 1993. Once we receive your email per above, we will send it to the MOA and get back to you. Thanks! Brent M. Western First Water Consulting Services Ofﬁce: 907-350-9566 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage. Alaska 99519~o650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING % Parcel I.D. # ('~,~/-~- ~ c~ %- ~t HAA# 1. GENERAL INFORMATION Complete legal description LoZ 5; ~ocJz Ji T~ E~E S~bgJ. v.~.~.~o~ . Location (site address or directions) !lSJ! Cob~t~ Av~. 4~clto,t~o_~. Property owner A,t~t~u[ E. Copou, t.o~ Day phone Mailing address ' Lending agency Mailing address Agent Day phone ': Address ' ' Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site X Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 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 Address s & $ ENGINEERING 17034 Eagle Riva' L~x~p ~.iqle R|ve~, Alaska 99577 Phone Engineer's signature DHHS SIGNATURE _.;;z~.'..._Appr-°ved for .7~'~y)~ ) Disapproved. Conditional approval for bedrooms. Date with the followin~ stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates 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 Municipalify of Anchorage is not responsible for errors or omissions in the professional engineer's work. Legal Description /_O-T' ~. A. WELL DATA ' ['~[~-~ , T~°tlL~- ~OParcel I.D. · . ~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST ADEC water system number Well type ~ If A, B, or C, attach ADEC letter. Log present ~N) Y~-'~ Date completed Totaldepth 1.~2~. Casedto [ ~.~'7-. Casing height /~" Sanitary seal~/~q) Y~, Wires properly protected (~N) I'//E~ FROM WELL LOG AT INSPECTION Static water level 'Pump level · Absorption field on lot . Public sewer I~ain ' ', Sewer service line SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ I ~ r ' ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ('~ Nitrate Date of sample: .. !(~-.~.r.,- cr ~ . B. SEPTIC/HOLDING TANK DATA Date Installed '" Cleanouts (~)N) High water alarm (~.~N) Date of pumping Tank size 1 '~L,=-.~C._% ~ Compartments ,~ " Foundation cleanout ~1) YF-~ Depression (Y/(~ ' ~i~---~ Alarm tested (~N) Y~.~ ~-I,~' 7'A~J/~ Pumper /'~.)/~' SEPARATION DISTANCES FROM SEPTIC/H~I~G TANK TO: Well(s) on lot' I / ~-, ~ On adjacent lots [(-.) ~ ''f' Foundation To propertyline Z~-~ ~ ~ ' Surface water/drainage Absorption field /Oa 't Watermain/service line ~'~ ~ ~'/- 72.026 (Rev. 7~) Front CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Size in gallons Vent (~N) t/ES High water alarm level GP L. "Pump on" level at Meets MOA electrical codes (~,1) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot I )~ ~ ' On adjacent lots ,, D. ABSORPTION FIELD DATA Manufacturer".. I~. Manhole/Access Y~_.~) Y~--~ --- ~,q.~'~ ~-~- ~ ~' "Pump cfi" lea, el at ~2" Cycles tested 1~,//~' --/~/~v' Date installed Length'---' '~,~' Width Total ab. sorption area . . _ Depression over field (Y/~} Results '(pass/fail) ~J//'} ' Surface water Soil rating ~,-~ (~PD/~p. Gravelthicknes~ ' ~'~ }t Cleanouts.pres'ent (Y/~ ~c~o ~, ~"~ ~. Da~e of adequacy test ~ ~ ~1~ ~[ for ~ bedrooms Systemtype ./~///(g(INOEO /~,~ Total depth -- ~" Peroxide treatment (past 12 months) (Y/~.)) mG ' Ifyes, givedate SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot . /~...~1 On adjacent lots /0~ ~' ' Prope~yline . , ~..,, To building foundation ~ I To existing or abandoned system on lot ._ On adjacent lots ~ ~ t+ Cutbank ~/~ Water main/sewice line Surface water Curtain drain ~ONr E. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area "~ ~ ~' I certify that I have checked, verified, or conformed to all MOA and HAA guidelines $ 8. S ENGINEERING t o34 Loop No. Signature ~--, ........ Engineers Name Date ~--~~ "'~' ' HAA Fee $ Date of Payment Receipt Number 7?0 Waiver Fee: $ //~-'"~ - C~c')" _"~, Date of Payment ~ ~ ~ ~ (~ Receipt Number HOV- 2-~J2 t40H ~:4~ P. ~2 .~~ ~ CHEMICAL & GEOLOGICAL ~BORATORY A DIVISION OF COMM£RCIAL ~ £~?1~ & £N~N £RING CO. 5633 ~ S~EET A~CHORAGE, ALAS~ ~518 ~E[~PHONE [93~ 5~2-2343 FAX: (~ 561-~01 Cll*nt lcct :3~$~¢P SpecJll ]ut:~ction~ Above ?kan. GT*Crooter MUNICIPALITY OF ~NCHORAG'E DIVISION OF ENVIRO~,'iMNTA~ HEALTH DEPARTMEN~ OF HEALTH AND ENVIRONMMNTAL PROTECTION A~PLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Legal Description (include lot, block, subdivision, section, township, range) (a) Location (address or directions) (b) Applicants Name ~,,~{~,~- ~1/-C~~ Telephone - Home~X((,~Business (d) Lending Institution. . .~ ~t'.~ Telephone Addre~ (e) Real Es~a~e Co. & Agent ~(a~ Telephoue (f) Hail the HAA to the following ~ddress: 2. Type of Residence Single-Famlly~--~ Number of Bedrooms 3. Water 5uppl7' Individual Well~ Multi-Famlly~ Other (describe} Communi C- Publi CU Note: If co=unity well system, must have vritten confirmation from the S~ate Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Note: If community veil system, must have written confirmation from the State Department of Environmental Conserva~ion attesting to the legality and status. [Page I of 2] En~tneer~n~ Fir~ Providin~ Inspec~ions~ Tes~s~ Pile Search~ Data and Infonna~ien As certified by my seal affixed hereto and 'as of the validation ~te sho~ below, verify that my investigation of this He~th ~thority Approval sho~ that the va~er supply and/or ~s~e~a~er disposal system ts safe, f~c~ion~ aM ~eq~e for ch. ~aber of bedrooas aM ~pe of s~ruc~ure iMica~ herein. I further urify thaC~ based on the iMomtion ob~ain~ fro= the ~nicipall~y of ~chorage files aM lnves~ita~io~ ~ i~s~c~ion, ~he o~si~e ~er supply aM/or ~s~e~acer system Is in c~pliance ~th ~1 ~nici~l aM S~aCe c~es, ordinances, aM reg~a- ~ions in eifec~ on ~he dace of ~his ins~c~ion. Address ~ ~P Approval ,. / / 'tk~r~Or~~ Approved '~ ' Disapproved, ~ · Co~itiou~ ,- \ Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRO~iENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE RE~RESENT- ATION~ GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIO~L ENGINEER REGISTERED IN THIg STATE OF ALASKA. 'TH~ IIIEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. DiPLOYEES OF IIiEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A C~RTXFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OK OMISSIONS IN THE PROFESSIOIIAL ENGINEER'S I~OP.K. (DHEP SEAL) RR4/eJ/D18 [Page 2 of .2] 7-19-84 Ae ~ELL ~TA Well Classifieatic~ I~ICIP~LITY (~ ~If-_~iOg{Gg Hg~t~ ~In~O~TY APPK~L (HAA) CHECKLIST i-~ F~/ARY 1984 " DEPT. OF HEALTH & ENVIE~NMENTAL PROT~'CTIO~ 'JUl_ ~ 0 RE£EI.V. ED Lega,l~ Description: If A, B, c~ C, D.E.C. A~roved(Y/N) ~/~- Well LOg 1~sent ~/N) Date _Ccmpleted q/~-/~_ Yield~_~ Static Water ~e~l ~ nog- Pump Set At Casing Haight Abo~ Ground ~ ~-~ Sanitary Seal on r~ing Electrical Wiring in Conduit ~N) Depression Around Wellhead (Y~ Separation Distances f~cm W~ll: ~L '~]' 16)OJ'/ 7o Septic/.olding ~ on ~ot I~0+ . ~ on ~oi.ing LO~ ~ TO Nearest Edge of Absc=ption Field on Lot Ic04~- ; On Adjoining Lots To Nearest Public Se~= Line ~ ~/~r To Nec=est Public Sewer c:~"~r~le t',~N[~¥ ~ N~st Sewer Se~vio, ".ine on Lot B. SEPTIC/HOLDING TANK DATA" ,. . t Co Soils ~ating in Absorption Strata Width of Field ~ ~! ~ D. LI~T S~tTI(lq Date Installed Si-- in Gallons "Pump On" ~e~l at High Water Alarm fe~l Tested fo=. Electrical Co(~s Ccm.~nts Dim~nsi~s ~evel at Vent (Y/N) Cycles du=ing Adequacy ~st. ** Check Permitted ~edrocm Rating Against MAA ~equest ** I certify that I haw checked, %~rified, c~ o~f~med to all ~ ~ ~i~s in effe~ on ~ ~ of ~is i~i~. C~,~ny - ~ ~ ~. [~ 2 of 2] 2-15-84 ALASKA UIROI]m I]TAL COI]TROL SeRUIC[ S, Iric. J~nclin¢¢rinq ~ J~nuironm~nlol JULY 5 1984 ROB~RT PAN(I~T 11501 (DBaA ANC~OaASE AK 99516 Sk~.?.wR - ROB~T PANOOST BUY]~ - SUBDIVISION - ~ ~ SUE) ~50(~ - 8 LOT - 5 ADEQUACY TEST FOR SEW~{ SYST~4 THE TYPE OF ABSORPTION SYSTEM IS A ~qENC~ WITH AN AREA OF 1040 SQFT. THE SYST~4 IS CAPABLE OF ACCEPTING 480 GALLONS OF T,"IA'J.'I:,v, PR DAY. THE SURGE CAPACITY OF T~E SYST~4 IS 172 GALLONS. BASED UPON THE TEST DA~ THE SYSTEM IS ACCEPTABLE FOR A SEPTIC TANK AD~3ACY THE EKISTING SEPTIC 91~qK %DL[~4E OF 1000 IS AD]DQUATE ~lq THIS 3 ~re/X/4 HOUSE. 1~?00 LUcsl 33r~1 Aucnu¢. Suilc B ,/~ncJ~oroqe. Alesl~ 9~503,[907) 5GI-50~10 Time Time ,re Date Date Inspector Ina~tor Ins~tor / ~m~nts ~ltional Approval Date ~wer Install~ ~~ Pe~lt No. ~ptlc Tank Size ~il8 Rating Well To Ab~rptlon Area Well L~ R~elv~ Well to Tank APPLICANT FILLS OUT LOWER HALFONLY Address ~ ~ ~ ~ Lending Instltutlon~/~ ~/~ / ~ Phone Type of Residence ,, ~ S~ngle Family ~ Multiple Family No. of ~dr~ms Water Supply . ~ ~ ~ Individual ~ A~ACH WELL LOG. A well ~g Is requlr~ for all wells drl~l~ since June ~ ~mmunlty ' TM '~'~- 1975. For wails drlll~ prior to that date, one well depth (attach log If Sewage ~ -~ - ~ Public Utility ~-;" ' ' When ~nn~ted to Public Utility: ~ Holding Tank NOTE: THE INSPE~ION FEE MUST ACCOMPANY ~CH REQUEST BEFORE PReCEdING CAN BE INITIATED.