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HomeMy WebLinkAboutFLAT TOP VIEW #1 BLK 2 LT 3Onsite File Flat Top View #1 Block 2 Lot 3 #018-391-27 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: PID Number: 018-391-27 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ®Upgrade Name William Carpenter A ORPTION FIELD Existing ❑ De Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 3244 Staysail Dr. Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 /S F Ft. LEGAL DESCRIPTION Depth to pipe invert from original g e Gravel depth beneath pipe Subdivision Block Lot Flat Top View #1 2 3 F . N, Ft. Fill added above original grade GrI length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Dista a between lines SEPARATION DISTANCES To Septic Absorption I Holding Sewer Lift Station Ft. Total absorption area Number of trenches Ft. Dist. between tr ches TField FromTik Tank Line Ft2 Well 90' I + TANK 21 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water I100+ Greer 15000al. Material Number of compartments Lot Line 5+ i NA Plastic 2 Foundation 110+ ttFTATION Manufacturer Capacity Remarks CO installed at 5' from tank. Gal. CO & MT installed in field on 6/29/22. Alarm location Electric i ailed by Installer ERIAL House to tank Tank to D3034 drainfield D3034 JR's Drainfield CO/MT D3034 FBENC:HH Inspector Arcterra Consulting ARK (Assumed elevation) 100ft Inspection 1n 7/29/22 dates: 2nd 7/29/22 Location and description 3id 8/1/22 4'^ SW bottom of siding. ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp +•ate*�aaalK�� COI Conditional Approval: Date `••�P�� 1� Septic S stemf KENNETH M. U 5 s •i�i�rF rov Approved Date - 0'ZZ CE ii rte: Note: this approval does not include well permit requirements. it���raa• •• (Rev 05/02/18) lu 0' 'I AS -BUILT SYSTEM DETAILS/SITE FLAT TOP VIEW 1 BLOCK 2 LOT 3 WELL = i y'Nt kHt •. i HOUSE arse FCO C a F �� D d Pt-nfl A -C=22.1' 98.37 98.04 B -C=44.3' A -D=25,7' W W B -D=40.7 N ¢ted A -E=29.8' _ _ M B -E=48.7' A -F=35,6' R B -F=18.9' A-6=35.8' A 1500 GAL B—G=18.6' o SEPTIC Zr TANK SCALEt NTS AdW Ilk Ilk TH k P, ICENNM s CE- 1� Ilk ss 030, Aw PREPARED FOR: WILLIAM CARPENTER 3244 STAYSAIL DR ANCHORAGE, AK FIELD BOOKS BOUNDARY: N /A STAIONC: N /AA ASBUaT: HOLT DWG. FILE: ACRD FILE: FILE COMPUTED: DRAWN- KSD CHECK' KMD DATE: 8/3 /2 G'D' SW293 '08 No' 22123. PLAN Permit OSP221283 PID# 018-391-27 10 ,0 SCALEt 1' = 30' SCALE: NTS MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221283 Work Type: SepticTank Upgrade Tax Code Number: 01839127000 Site Legal Address: FLAT TOP VIEW #1 BLK 2 LT 3 G:2934 Site Mailing Address: 3244 STAYSAIL DR, Anchorage Owner: CARPENTER WILLIAM J Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: cnt `,. 9-1 I)epaI,trnent 7/27/2022 7/27/2023 14000 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: rd • Locate the field prior to installation to confirm that the 5' separation between the tank and field will be met. Install a cleanout so the field can be located in the future. Received B) Issued By: Date: Date: Municipality ofAnchorage VO. Ikon I!l(4(�it) • Anc)a�ragc, Afaskn 9'1a19•G(,St) • Tcl�7�honr (5107) 3I3 (i i01 • Fax (fXY!) 34 3•fQ(X) \ / 47(X) B agaw Street • Anchorage, Alaska 9'1.5()7 wwmtnuni.org Mayor ttlurk 13egicll T3uilding Safety Dhisloii 10/5/2005 S&S Engineering 17034 North Eagle River Loop, Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Flat Top View No. Waiver Request #WR050086 Parcel ID #018-391-27 HAA# IIA050489 Dear Mr. Shafer, h°` � Way I a�endcd� \e 1 �� � c1. ' ° the, ZQ Subdivision, Block 2, Lot 3 Your request for a waiver of the required 100 feet horizontal separation from the septic tank and absorption field to the private well have been approved. The approved separation distance from the septic tank to the private well is 89.0 feet and the approved separation distance from the absorption field to the private well is 94.0 feet. In addition, your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance from the absorption field to the property line is 8.0 feet. This waiver approval applies to the existing septic tank and absorption field to private well separation, and absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Julie Makcla, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 018-391-27 Property owner(s) William Carpenter Day phone Mailing address 3244 Staysail Dr. Anchorage, AK Site address 3244 Staysail Dr. Anchoraj4e, AK Legal description (Sub'd., Block & Lot) Flat Top View #1 Block 2 Lot 3 Legal description (Township, Range & Section) Lot Size 14,000 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) N (w/wo AD U) Septic Tank NX Upgrade 0 (D) El Holding Tank ❑ RenewalDuplex ❑ 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. Dea Duffus (Signature of property owner or authorized agent) A U5 14 Permit/Rush Fees: A 135 Waiver Fees: Date of Payment: %71a OLR oz 2 71�% Date of Payment: Receipt Number: 0 02 7 76- 07000G Receipt Number: Permit No. OS (,212 1 a& 3 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221283, Deb Wockenfuss, 07/27/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221283, Deb Wockenfuss, 07/27/22 MUNICIPALITY OF ANCHORAGE \I DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~ I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME'v/ PHONE ❑NEW /i e .7yr-0 e1E+ UPGRADE MAILING ADDRESS Pro 4 O—/7 l 9.VVI LEGAL DESCRIPTION �3 !? Z — To ie LOCATION kpoC E 14 O & fli'h+o v NO. OF BEy(200MS 'Y DISTANCE TO: Well Absorption area Dwelling PER IT NO . Oy � 7 0.4 Manufacturer No. of companments Will- e . r e- c, z Liq, capacity in gallons IF HOMEMADE: Inside length Width Liquid depth a Z DISTANCE TO: Well Dwelling PERMIT NO. O _ Manufacturer Material Liquid capacity in9a lIons W = DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. LL Z No. of lines Z Len th of each line Total leng h of lines �� Trench width Distance between lines h? W ! 74 Inches f Top of file to finish gradr� Material beneath file Total effective absorption area 0 3 inches 3 8 4-, W Length Width Depth PERMIT NO. a I— W L Type of crib Crib diameter Crib depth Total effective absorption area to DISTANCE TO: Well Building foundation Nearest lot line j Class Depth Driller Distance to lot line PERMIT NO. W 3 DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) U OTHER aI 1� PIPE MATERIALS SOIL TEST RATING a.? e- 3 �t INSTALLER �2rfs t�'crva�., REMARKS � O 7 r 6 Le L, e . --- NFFFF APPROVEDDATE LEGAL 3t3 Z /of TpVlat ...ev. �„o, tYUte I r I PFiL I TY ID F= Ffr-40"FlF�_* Fi0,E DEPARTMENT Q HEALTH AND ENVIRONMENTAL (i3OTECTION > 25 'L STREET, ANCHORAGE, AK. 99,.31 264-4720 CD r4 I TE SEWED_ PERtY I T PERMIT NO. C 011174 ) APPLICAFJT KEN SPEARIN PO BOX 10-1726 345-0^16 LOCATION ROCKY A DEARMOUN LEGAL L302 FLAT TOP VIEW LOT SIZE/n 22000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH Lon lS V � Al A MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING CSO FTIBR)= 262 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C�EPTH= 11. LEr•aVTH= S*iD Ca- FLF:ik'EL DEPTH= r THE LENGTH DIMENSION IS THE LENGTH CIN FEET> OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). FZEG!lJ I FLED SEPT I C-rn"1-< S I GE— :JL GZZ; E1 C3nL.LQr•-0•S PERMIT APPLICAFJT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TWcD C = > I rJSP•EE: CT I iC3r-1S AFLE RE:0U I FLELN --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTAFJCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTAFJCE FROM A PRIVATE WELL TO Al PRIVATE SEWER, LINE IS 25 FEET AND TO A COMMUNITY SEWER. LINE IS 75 FEET. OTHER•. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PEPhY I T EXP I RE'S ©EGEMEER 2:1- s 1E4u1 I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE rI•S` REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. Syno-_ Olt APPLICANT KEN SPEARIFJ ISSUED % V4. 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG - PERCOLATION TEST M SOILS LOG F ci, PERCOLATION TEST PERFORMED FOR: 'e,QN C -z) r A) DATE PERFORMED: II. I— 10— LEGAL 0—LEGAL DESCRIPTION: L 67— 3 � K a- F-IrT aO ti SCJ 6 oDEP� SLOPE SITE PLAN PERFORMED 72-008 (6/79) D 177 tJ� WAS GROUND WATER 0 S ENCOUNTERED? L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 0 �t to ossa - o 3 7S tos �l ,► to G o '63 106 PERCOLATION RATE /.�r� (minutes/inch) TEST RUN BETWEEN ('. S' . FT AND IFT :n . [dXh1121481 DATE: -IO -JC/ MUNICIPALITY OF ANCHORAGE 0{ 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. 018-391-27 Legal description Flat Top View #1 Block 2 Lot 3 Site address 3244 Staysail Dr. Eagle River Current property owner(s) Carpenter Expiration Date: X The On-site system(s) is/are approved for 4 bedrooms 11-10-22 Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 8-10-22 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) islare 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 Development Services Department On -Site Water & Wastewater Section 905" ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 018-391-27 Complete legal description Flat Top View #1 Block 2 Lot 3 Location (site address) 3244 Staysail Dr. Eagle River, AK Current property owner(s) William Carpenter Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 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 0 - See advisory if steel older than 20 years 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 $ 55D 1330 Waiver Fee $ Date of Payment a0 Date of Payment COSA # 0 S C�.Z 1 `� "� Waiver # COSA Application—June 2022 Ilk ; Legal Description: Flat Top View #1 Block 2 Lot 3 Parcel ID: 018-391-27 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 7/14/05 Total depth 200 ft Cased to 200 ft ✓❑ Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 30 in. Date of flow test for COSA 7/14/22 Static water level at beginning of test 60 ft. Comments B. TANK DATA Measured operating fluid level in septic tank New Date of pumping New install 7/29/22 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 11/16/8.1 ✓❑ ALL standpipes present per record drawing Total measured depth from grade 11.6 ft (max) Measured depth to pipe invert from grade 5.6 ft (min) ❑ N/A —pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 6 ❑✓ 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 7/11/22 date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist—June 2022 Well production at time of test 8.9 gprn Water storage tank volume - gallons Well disinfected for coliform test? F./I Yes ❑ No Z Coliform bacteria is Negative Nitrate 0.299 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L g?] Arsenic less than MRL (ND) Collected by Arcterra Consulting Date 7/14/22 C. LIFT STATION LD-Raired maintenance completed Age of lift station years Lift station material Comments: �� Adequacy test date 7/12/22 Results 0 Pass Fluid depth prior to test 33 in Water added 600 gal New fluid depth 39 in Elapsed time 1200 min Final fluid depth 33 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 76 in Effective depth used 37 in Effective depth remaining 39 in 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' 0 Yes if No ft Field to Property Line > 10' Community Sewer Manhole/Cleanout > 100' ❑Yes if No 90* ft ❑✓ Yes if No Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' ?] Yes if No Absorption Field on Lot > 100' ❑ Yes if No 94* ft Holding Tank > 100' ✓❑ Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F%—/] Yes if No ft 0 Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water ft ft ft ft III From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ./❑ Yes if No ft Tank to Property Line > 5' 0 Yes if No ft Field to Property Line > 10' ❑J Yes if No ft Water Main > 10' Fv� Yes if No ft Water Service Line > 10' P] Yes if No ft F. ENGINEER'S COMMENTS *Waiver #WR050086 Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' ✓❑ Yes if No ft Q Yes if No ft If tank or field is under driveway comment below 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 Areterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date �Z Engineer's Comments. This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra cannot give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. COSA Checklist June 2022 5 T ysA& DR/VE S 89°56'47"E 100.10' C] r CO O O ISI ROOF EA VE 0 1 C S 89°56'47"E 100.10' ALLEY (UN -DEVELOPED) o .�F.q.4.'J' p P , 49 TH pL � o SHANE A. HOLT G �p e LS -6914 �` O 8.1 �I SLOCKRET WALL NOTE.' NO EASEMENTS APPEAR ON THE RECORD PLAT FOR THIS LOT AS-BUILTSURVEY 1 " = 30' q4" 0 es si°na� NO CORNERS SET THIS DATE D�OOoo�� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT3 8LOCK2FLAT TOP VIEW 1 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW dANYANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IVISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENC ELI NES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD,OR ANY LEGAL ENTITY, OTHER THAN THOSE APPEARING ON THE RECORD PLAT EXIST OTHER THAN NOTED. ARE NOT SHOWN HEREON( UNLESS INDICATED) DATED AT ANCHORAGE,ALASKA THIS 3RD DAY OF NOTE: FENCELINES THAT NAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE AUGUST , 2022 PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LAND SURVt YING THESURVEYDATA ON THIS DRAWING ATISPREPAREDFOR THE OWNER OFRECORDOLA 9309GROCER DRIVE ANYCOPYIN� OR UTILIZING 7/lf DATA 11EREON /SPROIlI(i/TED UNDER COPYRIGHT LAW ANCHORAGL-.AK 99507 9730 226-37 718-40 2233615 Municipality of Anchorage -. Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 0IR-�91-aq HAA# Q5)Q � Expiration Date: I ?9M[D 1. GENERAL INFORMATION Complete legal description Lot 3 • Block 2; Flat Ton View No. 1 Location (site address or directions) 3244 Staysail Dr. Anchorage, AK 99516 Current Propertyowner(s) Wanda Weber Day phone 765-5791 Mailing address 9 am Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 7WZ. 2. NUMBER OF BEDROOMS: t 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site R 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 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health 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. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER 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. Name of Firm S b S Engineering Phone _694-2979 Address 17034_ N. Eagl ,�er �oqp Stle./ 20y_'Eagle River, AK, 99577 Engineer's Printed Name 5. DSD SIGNATURE ,/, Approved for —4— bedrooms. Disapproved. Date Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By:Original Certificate Date: (R.v. OV02) Municipality of Anchorage •e, • '� Development Services Department a, Building Safety Division ` On -Site Water &Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L -0-r 3 j tZtDck Z'r f 14 P Vic -to -3/6 Parcel ID:CAP�- 2011 -e?-1 A. WELL DATA Well type Z IVFFTE Date completed 7 t TOS Total depth Zcd ft. If A, B, or C provide PWSID # - Sanitary seat &i) E� Cased to ?Z0r ft. Well Log�14 J) Wires properly protected (DN) ES Casing height (above ground) W_in. FROM WELL LOG AT INSPECTION Date of test 7 1 OS S II O S Static water level fo3 I ft. q0 ft. Well production 2-0 g.p.m. ti"2- g.p.m. WATER SAMPLE RESULTS: Coliform O colonies/100 ml. Nitrates• � mg./I. Other bacteria C] colonies/100 ml. "1TI�MTE Mles Arsenic: mg./l. Date of sample:4u �1 I1111j4;ollected by: -5 a S t 4P -t&-16, B. SEPTIC/HOLDING TANK DATA Tank Type/Malerial• ' r' f-rI c / STEL- Date installed I t L(a l Tank size W70 gal. Number of Compartments 2 Cleanouts (N)r-5 Foundation Foundation cteanouZQ N) J`,• Depression over lank (Y/NY High water alarm (Y16 fir' OS Pum i+ -ke-7eAer Cc�sPtarc ��vKp1n�G Date of pumping � 3p per C. ABSORPTION FIELD DATA Date installed 11 Ile I Soil rating (g.p.d./ft= c ft�/bdr System type -r?Z-V tlz H Length ID o ft. Width 30j1 r"Ht'qL Gravel below pipe 6.3 ft. Total depth 1 � ft. Eff. absorption area 134' I ft2 Monitoring tube jDepression over field 08 Date of adequacy test / 1 OS Result a s/ ail)�J For q bedrooms Fluid depth in absorption field before test S" in. Water added_L31bgal. New depth in. Elapsed Time:bd min. Final fluid depth It' in. Absorption rate >= 6 60 {- g.p.d. Any rejuvenation treatment (past 12 mo.) (Yjg�& type) "C> If yes, give date — D. LIFT STATION Date installed Size in gallons _ "Pump on" level at _ in. 'Pump off" level Datum Cvcles tested E. SEPARATION DISTANCES Manhole/Access water alarm level at Meets alarm & circuit requirements? Ii SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot $q I On adjacent lots I OO (+ Absorption field on lot 9141 * On adjacent lots + 90r(I 'a0zo o ll' Public sewer main IV 14 Public sewer manhole/cleanout N A Sewer /septic service line 29 1+ Holding tank 1.914 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 1 Building foundation 5 k Property line � Absorption field `�I4 Water main Water service line to I.;- Surface water 1001+ Wells on adjacent tots I00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line tS �K Building foundation 10 �-r Water Service line Iv' -t-- Surface water ( yD 14 Curtain drain KAM! f KATkx) Wells Eadjacent lots _(00 F. COMMENTS'�F� KtSTt 14c wPc5 -r>FEPEA---�v' 91 G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records th hove systems10, a��ry in conformance with MOA HAA u' nis l��fdate Engineer's Printed Name G� Date A Water main 0 rt Driveway, parking/vehicle storage Ib 4- A-07&,145 N{PiuE' PMILLI", 7/40c, HAA Fee $ ��).cb Waiver Fee $ Date of Payment qtr%C�aS Date of Payment���A/�i Receipt Number -74 33-7 Receipt Number (Rev. 12x01) ❑ 0 ❑ a 3 ❑ 0 0 0 KI STAYSAIL DRIVE S B9°56'47"E 100.10' I I S 89056'47"E 100.1 ❑ O eELL fO I I L I I _❑ I I I I 0 I J I Z e S N OD I I T I I �J fj I � •• i 0 ?AQ 4 D.H. DICK I s VO VD � s+ z S 89056'47"E 100.1 ALLEY LUN-DEVELOPEDI NOTE: NO EASEMENTS APPEAR ON THIS LOT ON PLAT NO. P - 282 THEINFORMATION HEREON IS FOR THE USE Of IENOIN G INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING 3TRUCTURES AND RATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONNG ADOITDNML STRUCTURES OR F ENCELINES. EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT. APE HOT SHOWN HEREON BINLESS INDICATED) NOTE: ANY FENCELNES SHOWN ARE LOCATED APPROXINATELY AND ARE HOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRUCTURES. ANY PAVING SHONN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS o OF AC �4 P� .............1's, P:*49TH* a . ............................ SHANE A. HOLT: AD !, LS -6914 i OJ' AS -BUILT SURVEY (NO CORNERS SET THIS DATE) 1•"30' 1 HFREBY CERTIFY THAT 1 HAVE PERFORMED A IAORTOAOEE'S INSPECTION OF THE FOLLOYANO DESCRIMD PROPERTY. LOT 3. BLOCK 2. FLAT TOP VIEW NO. 1 ANCHORAGE RECORDING DISTRICT. ALASKA ANO THAT INE VISIME IA VEMENIS SITUATED THEREON ARE WITHIN THEM KRTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN TOTED. DATED AT ANCNORAOE. ALASKA THIS _BTU_ DAYOF MAY ]ODS . HOLT LAND FO -TIS -40 TFL. 345 5513 ❑ ❑ O a ❑ _❑ 0 0 ❑ Z e S N NO EASEMENTS APPEAR ON THIS LOT ON PLAT NO. P - 282 THEINFORMATION HEREON IS FOR THE USE Of IENOIN G INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING 3TRUCTURES AND RATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONNG ADOITDNML STRUCTURES OR F ENCELINES. EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT. APE HOT SHOWN HEREON BINLESS INDICATED) NOTE: ANY FENCELNES SHOWN ARE LOCATED APPROXINATELY AND ARE HOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRUCTURES. ANY PAVING SHONN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS o OF AC �4 P� .............1's, P:*49TH* a . ............................ SHANE A. HOLT: AD !, LS -6914 i OJ' AS -BUILT SURVEY (NO CORNERS SET THIS DATE) 1•"30' 1 HFREBY CERTIFY THAT 1 HAVE PERFORMED A IAORTOAOEE'S INSPECTION OF THE FOLLOYANO DESCRIMD PROPERTY. LOT 3. BLOCK 2. FLAT TOP VIEW NO. 1 ANCHORAGE RECORDING DISTRICT. ALASKA ANO THAT INE VISIME IA VEMENIS SITUATED THEREON ARE WITHIN THEM KRTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN TOTED. DATED AT ANCNORAOE. ALASKA THIS _BTU_ DAYOF MAY ]ODS . HOLT LAND FO -TIS -40 TFL. 345 5513 FROM : ALPINE DRILLING FAX NO. : 907 345 0202 Sep. 16 2005 12:37PM P1 ALPINE DRILLING & ENTERPRISES Permit Number. #SW Date of Issue: Parcel Identification Number. Date Started: 7-14-06 Date Completed: 7-14-05 Is well located at approved permit location? ® Yes ❑ No Y.egal Description: Flat Top View Blk 2 U 3 Property Owner Name & Address: Oscar & Wanda Webber 3244 Staysel Ave. Anchorage. Alaska 99516 Borebole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thiclaim & Water Strata From To Casing type: steel Existing well 0 85 Wall Thickness:. 250 inches water sand & gravel 85 87 Diameter. 5 inches Depth: 200 feet sift gravelly cobbly silt silt sr7ty gravel 87 98 98 146 146 175 175 194 Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 63 feet Pumping level: 200 feet after watersand &.gravel 194 200 2 hours pumping 20 spin Recovery Rate: 2Q gpm Method of Testing:is rliR WellIntake Opening Type: ® Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Startfeet Stopped feet Grout Type: bentonite Volume: 50 gal Depth: Start 85 feet Stopped feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion! ® Yes ❑ No Method of Disinfection: chloine tablets Comments: benronlre grout was installed between the existing 6 inch casing and the S inch casing so as to follow the 5 inch as it was being driven. Well Driller. Alpine Drilling & Enterprises PO box 110496 Anchorage AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property S& WALTH99HOFM APPROVALS September 21, 2005 ROBERT C. COWAN. P.E. ROBERTA. SHAFER PE. CML ENGINEERS (907) 6942979 FAX (907) 6941211 MUNICIPALITY OF ANCHORAGE Development Services Department SEl4ER°WATER P.O. Box 196650 MAINECTENSONS Anchorage, AK 99519 SEWERSWATER REFERENCE: Lot 3; Block 2; Flat Top View Subdivision No. 1 INSPECTION Request you grant a formal waiver for the existing private well to the septic tank on ENGINEERNGSTUDIES the referenced property at 89 feet separation and the well to leachficld at 94 feet We ANDREPOATS also request you grant a waiver on the referenced property for the horizontal separation distance between the leachficld and the cast property line at 8 feet. To assist you in your review of this waiver we have included well logs from 3 other properties NELLNSPECTION in the area. S PLOW TEST The mitigating factors involved which support the issuance of this waiver is as follows: SITE PLAINS 1. The topography of the referenced property slopes away from the well towards the septic tank and system. This would prevent any surfacing effluent from flowing toward the well. ROAD DESIGN 2. The original well had a high nitrate count at testing in June 2005. We believe this aquifer to be naturally high in nitrates. The well was deepened from 85 feet to 200 feet in July 2005, and bentonite grout was applied between the old and SM TEST new casings to seal off the old aquifer. The new nitrate results came back undetectable. 3. There is no original well log for the property, but well logs from nearby wells TEST show hardpan or clay layers at various depths above 85 feet and the deepened well log (attached) shows two silt layers at 87 to 98 feet and 146 to 175 feet, which would form an impermeable layer to any vertically migrating effluent. The static water level for the subject well was measured at 42 feet before the MECHANICAL ° well was deepened and 63 feet in atter drilling in July 2005. INSPECTIONS 4. Water samples taken from the well located on the referenced property on 6/3/2005 indicate no coliform or other bacteria, and nitrate sample taken on ONSITE 8/4/2004 indicate undetectable nitrate levels at 0.100 mg/L. WASTEWATER DCSPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 Page 2 1-9; B2; Flat Top View # 1 9/21/2005 �. Thee adjacent property's well logs are provided. The soils are similar to the referenced property's deepened well log. 6. Many lots in this area have existing well waivers (due to small lot size?) We do not anticipate any adverse effects on the neighboring properties by the granting of this waiver. We therefore recommend an approval for the requested separation distance waiver. Enclosures lease contact us at 694-2979. cu Iu co til co I yC ----- I----------- ---------------- tkl c gt"= aovrid allVH 32Wx� l Q ,09 = «t 'I vna Nrld 31LIS Mayor Mark Begich Municipality of Anchorage P0. Dox l9liM) • Anchomgc, Alaslut 9!1.il9.CCa) • Tck7thonc (1X)7) 34.0,8:i()I • rax exrn M-820-«) 47(X) Bragaw Si reel • Anchorage, Alaska 91LR)7 a„u.munl.org Huilding Safety Dixisiorr 10/5/2005 S&S Engineering 17034 North Eagle River Loop, Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Flat Top View No. 1 Subdivision, Block 2, Lot 3 Waiver Request #WR050086 Parcel ID #018-391-27 HAA# 1 IA050489 Dcar Mr. Shafer, Your request for a waiver of the required 100 feet horizontal separation from the septic tank and absorption field to the private well have been approved. The approved separation distance from the septic tank to the private well is 89.0 feet and the approved separation distance from the absorption field to the private well is 94.0 feet. In addition, your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance from the absorption field to the property line is 8.0 feet. This waiver approval applies to the existing septic tank and absorption field to private well separation, and absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Julie Makcla, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department / - Building Safety Division On -Site Water and Wastewater Program \� J 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#: WRO50086 PID#: 018491-27 HA#: HAO50489 Permit#: Date Received: 9122/2005 t.1o•9- Legal Description: Flat Too View Subdivision Block 2 Lot 3 Engineer: S&S Engineering 17034 North Eaale River Loop Suite 204 Alaska 77 Oi �04.r Applicant: VHanda Weber Waiver Requested: 89 feet well to septic tank 94 feet well to absorption field. 8 feet absorption field to property line Criteria: Geology Points: A. Water Table . B. Soil Sorption �. 1 C. Permeability I .9 D. Water Table Gradient �i r E. Horizontal Separation ,r). LD Total: I-7--1 ............................................................................... Waiver is Granted: X_ Waiver is not Granted: List Conditions or Reasons for above: Date: A By: ame of Reviewer .......................................... 0000....0.686....................... Rec#: 74337 Amount: $1.150 Date Paid: 101512006 Flat Top View No. 1 Subdivision, Block 2, Lot 3 Parcel ID: 018-391-27 Waiver for 89 feet from septic tank to well, 94 feet from absorption field to well, and 8 feet from absorption field to property line Issued October 5, 2005 General 1. The June 2005 water sample had a nitrate concentration exceeding 10 mg/L. The well was deepened in July 2005. Total coliform, other bacteria, and nitrates were not detected for the August and September 2005 water sample collected from the well on the subject lot. 2. The well was deepened from 85 feet to 200 feet in July 2005, and bentonite grout was applied between the old and new casings to seat off the old aquifer. There is no original well log, but nearby wells show hardpan or clay layers at various depths above 85 feet. The deepened well log show two silt layers at 87 to 98 feet and 146 to 175 feet, which would form an Impermeable layer to any vertically migrating effluent. 3. The wastewater disposal system on the subject property was installed In approximately 1981. The septic tank is constructed of steel, with an assumed total depth of approximately 8 feet below grade. The absoprtion field is a deep trench and is located 9 feet below existing grade. 4. Due to lot size and location of septic systems and water wells on surrounding properties, there appears to be limited area on the subject property to meet the current minimum separation requirements for a wastewater disposal system or water well. ADEC Criteria Points Water Table 5.3 Static water level on 7/14/2005 63 feet Assumed total depth of septic tank -8 feet 55 feet x=15/45+5.0 x=5.3 Soil Sorotion 3.4 Soil descriptions from well log for Block 1, Lot 11 Clay w/ sand & gravel 8 -18 feet Hardpan (silt) 18 - 49 feet Silty sandy gravel 49 - 70 feet (10/55 x 4.5) + (31/55 x 3.5) + (14/55 x 2.5) Permeability 1.9 Soil descriptions from well log for Block 1, Lot 11 Clay w/ sand & gravel 8 -18 feet Hardpan (silt) 18 - 49 feet Silty sandy gravel 49 - 70 feet (10/55 x 3.0) + (31/55 x 2.0) + (14/55 x 1.0) Water Table Gradient 4.5 Subject well is upgradient of wastewater disposal system. Assume 5% slope Horizontal Seoaration 2.6 89 feet between septic tank and well x=14/25+2.0 x=2.6 Total Points 17.7 As per ADEC waiver guidelines a point value of 17.7 is almost sure to be free of any form of contamination from household sewage. W1 lkne / Time > as Date Date Date Inspector Inspector Inspector Comments Conditional Approval (4-) Approved Bodrooms ( ) DI���prcvcd ( ) Czin:U!,xicl Approval C�te- Date Sewer Installed Permit No. Septic Tank Size S� I- el Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner y e w k" Phone Mailing Address uX •1 a ci`I S \1 3vs-o&r6 Buyer w r' Address % NRA D. 3 1 L9. �.vt /,ora t' f) le s kR cl`I $D7 r Lending Institution a'" n. .�.. ..i Phone Address P C) �.� CO Realty Co. 3 Agent Phone Address 0 15Z N/, Legal Description v t t I, V r zz w „tU i s i ti Street Location Ro�L {�os pt TypeResidence Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Water$upply L^Indivldual ❑ Community ATTACH WELL LOG. A well tog Is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log If ❑ Public Utllitv available. Sew Disposal C 1q4` r Individual Year Individual Installed: O Public Utility When Connected to Public Utility ❑ Holding Tank NOTE THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 7.0 P - F If -Con, 5. LEGAL DESCRIPTION DEPT. O." 1 _.ALT I & MUNICIPALITY OF ANCHORAGEpp JJ'' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECAI fiRON M£NTAL 11,0T:QION 825 L Street • Anchorage, Aleaks 99801 • JUN 71979 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 R E C E I D _V -E REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Rase allow ten (101 days fw Processing. 1. PROPERTY OWNER PHONE NUMBER OF BEDROOMS / 2 G MAILING A � 5 CLY PROPERTY RESIDE T (lf tlilferent from above) PH NE 2. BUYER 7. WATER SUPPLY /� K. ea P— IS INDIVIDUAL' MAIL GADDR ESS 17 3. LENDING INSTITUTION PHONE f L a Wk & SEWAGE DISPOSAL SYSTEM AICA, I� INDIVIDUAL/ON-SITE" MAILI GADDRESS 4. REALTORIAGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION F"'rt CIZ S R E LOCATI N bC 8. PEO EBIDENCE NUMBER OF BEDROOMS SINGLE FAMILY ❑ One US Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY IS INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled pri r tq that date, give well 1:1 PUBLICUTILITY depth (attach log if available.) �f r & SEWAGE DISPOSAL SYSTEM I� INDIVIDUAL/ON-SITE" **If individual/on-site, give installation date ❑ lf system is over two (2) years old an adequacy test is required PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY _ INSPECTION APPOINTMENTS DATE RECEIVED _ TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE D THREE ❑ FIVE D OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA - MATERIAL - 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS Lc/ / ❑ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) DISAPPROVED DATE BY Title - ZZ LEGAL DE CRIPTION 72-010 (Rev. 3/78) n Rr_unicip fit -y Oy June 11, 1979 r"1 825 "L" STREET ANCHORAGE, ALASKA 09501 { .\ l �'"' I (907) 264-4111 - GFORI,_G M. SULLIVAN. r, MAYOR OE vgR T.'.I, ^, f OP FIC -,LTH A%:'� -PROTECTION Wilma Frary Star Route A Box 255 Anchorage, Alaska 99507 Subject: Lot 3 Block 2 Flat Top View Subdivision i Approval for your individual sewer and water facilities will not be granted until the following items have been completed: I (1) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. (2) A four(4) inch cast iron cleanout be installed to the septic tank and/or leaching area. h'e must re -inspect this and verify the distance requirements from the well to the sewer system. (3) Expose the septic tank for our inspection and verification of its existence. (4) The septic tank is pumped with a receipt submitted to this office. The number of gallons pumped should be on the receipt to verify the tank size. (5) A percolation test be performed on the existing leaching area. This will determine if -the system is adequate according to National Standards. A list of private firms who perform the test isoenclosed. Notify this department for a re -inspection when descrepancies have been corrected. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw