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Home My WebLink AboutELMORE #2 BLK 8 LT 10 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: OSP251103 Work Type: Septic Upgrade Tax Code Number: 01817243000 Site Legal Address: ELMORE #2 BLK 8 LT 10 G:3036 Site Mailing Address: 4701 E 145TH AVE, Anchorage Owner: GROVE ADAM F & Design Engineer: FORGE ENGINEERING This permit is for the construction of: 0 Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 4/15/2025 4/15/2026 40280 ❑ 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 P(LD 71� C_--r 41/2- Y/ 20 Z. �- I G r� i--rL -I Received By: KJ-') 74� F-0 C- C-L" Issued By: E (Z.-I yr I.. & Date: Date 4 MUNICIPALITY OF 4 Development Services Department On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 018-172-43 Property owner(s) Adam Grove Mailing address 4701 E 145th Ave, Anchorage, AK 99516 Site address 4701 E 145th Ave, Anchorage, AK 99516 Legal description Elmore #2, Block 8 Lot 10 Number of Bedrooms 4 Engineering Firm Forge Engineering Building Permit Number Phone: 907-343-7904 Day phone (907) 227-6661 Not Applicable RN APPLICATION IS FOR: APPLICATION IS AN: (N all that apply) Absorption Field FX1 Initial D Septic Tank El Upgrade El Holding Tank EJ Renewal 0 Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: S_ Waiver Fees: Date of Payment: YZ 2-0 2 5 Date of Payment: Permit No. C, C S C Waiver No. April 15, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Elmore #2 B8 L10 - 4701 E 145th Ave Septic system design Dear On-Site Services Engineer: The owner of the above lot would like to replace his aging STEP tank, and is concerned about how much life is left in his existing absorption bed, so we are submitting this permit application for the construction of a new septic system. The attached site plan identifies the location of the home as well as the existing well and new septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot moderately toward the west. In the area where the septic is planned the lot is very flat. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole log, plan and section pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251103, Curtis Townsend, 04/15/25 ELMORE #2, BLOCK 8 LOT 10 ILOT MONITORING TUBES WITHIN VOF ENDS AND SIDES OF BED 10' UTILITY EASEIVIENT -- -------- - DECOMMISSION EX. STEP IVIT TANK PER UPC MT NEW 1500 GAL TH#1 STEP TANK MT SHAF R TH#1 4-BDRM HOME X, DECOMMISSbf� EXISTING BED EXCAVATE SOILS WITHIN 6'OF 60'LONG, 15'WIDE, 0.5' NEW BED LOCATION AND REPLACE EFFECTIVE DEPTH BED W/ 2'SAND WITH UNCLASSIFIED FILL FILTER. EXCAVATE ALL DISPOSE OF ALL CONTAMINATED CONTAMINATED SOILS TO 2' SOIL AS HAZARDOUS WASTE BELOW EXISTING SAND FILTER. REPLACE WITH TYPE 11 SOIL TO BOTTOM OF NEW SAND FILTER EXISTING WELL LOT 10 145th AVENUE -i A LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT SEPTIC PLAN 49..TH FCO - FOUNDATION CLEANOUT 1�-, % FS - FLOW SPLITTER VALVE .... .......... Benja i Schiller . . % 11 0 30 60 & CE 2592 MT -MONITORING TUBE 4122125 FEET =5 ..,,o AW 4P SV -SEPTIC VENT kv� 1"=30' TH -TEST HOLE WZ� DESIGN FACTORS: 600 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 0.7 GPD/SF (BED) SYSTEM REQUIREMENTS: SHALLOW BED SYSTEM 1500-GAL STEP TANK 600 GPD / 0.7 GPD/SF / 15'WIDE = 867 SF, 57.1 LF BED REQUIRED (60 LF SPECIFIED) BOTTOM OF TRENCH: 25BELOW GRADE C'o FLOW LINE ELEVATION: 2.0'BELOW GRADE TOP OF MOUND: MIN 6" ABOVE GRADE. ADD ADDITIONAL FILL TO ACCOUNT FOR SETTLEMENT rlrnP%% 11mr- f-%Il it Alk I A mml_rlr%h I Al r-11 I 15' TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3'OF COVER OVER TRENCHES AND 4'OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY FEXTILE FABRIC INSULATION (C w/ -1" ORIFICES 8 ILY SPACED @ 6' OC NFIELD ROCK APPROVED SAND ENGiNEERING G. '*-."49 7H ;;njZchill*er* CE 12592 4/2W5 4p PROF LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING DEPTH TO WATER AFTER MONITORING <1 3/18/25 1 2 3 4 5 6GW (GRAVEL SILT SAND) Professional Engineers Stamp: ELMORE #2 BLOCK 8 LOT 10 3/18/25 018-172-43 A+ 159 8 16 ORGANICS 1 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: J. EARLS 8'10" 3/25 COMMENTS: SITE PLAN 6" USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 4/8/25 MOISTURE NOTED AT TIME OF DIGGING?YES 159 8 16 159 8 16 159 8 16 159 8 16 159 8 16 165 8 16 165 8 16 165 8 16 165 8 16 165 8 16 6" 6" 6" 6" 6"1 1 1 1 1 165 8 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251103, Curtis Townsend, 04/15/25 145TH AVENUE ELMO R E S U B D I V I S I O N BLOC K 8 Taylor L. Dosch No. 189892 R E GISTEREDPROFESSIO N A L L A N D S U RVEYOR : Municipality of Anchorage Page I of-z-- " 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 Permit Number: "~V'-~"~&::~C~""~'~ PID Number: "~~ ~. ~1 ~ ~ Wastewater System: D New ~Upgrade Address: .~o.~:~ ~S-~ I"°l°~"'°°m: DDeep Trench DShallow Trench Township: I Range: I:~,'o,: ,ill added above original grad~: fl Gravel length; WELL: D New D Upgrade G~.~m~: ~t F~ ~ F~ SEPARATION DISTANCES ~ Septic ~ Holding ~.T.E.P. S.~::ce ~ LIFT STATION Cu~ain Remarks: B[NOH ~ARK . . ~,~ ~, Department of Health~~ Se.i~qs approval ~ ~. ~eviewed and approved by: ate: / Per'tit No. ~ Page = of ~, 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 LegalDescription: EL~O~E ~IJ~D!V!~!O~ ~. n~n~ ~ tnT In PIDNo.: t31RtT~4~, 1500 G,U., S.T.E.P. SYSTEM 4 BDP, M HOUSE A B I C ID FCO 35,5' CO/ 51.5' 28' coz I I 54.5' I 35.5' u~ I I 55' I -~7-5'1 I mil 64.2'1 .... I ..... 149' I_ ~31 9~' oe'~l I I MT4 '/7.2' 74.4' D 31.9 19.2 Z ~'~'~-10' UT]/,. ESUT. - I I I I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930043 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WIRSHING RODNEY W & OWNER ADDRESS:4701 E 145TH AVE ANCHORAGE, ALASKA 99516 DATE ISSUED: 3/31/93 EXPIRATION DATE: 3/31/94 PARCEL ID:01817243 LEGAL DESCRIPTION: ELMORE #2 BLK 8 LT 10 1 LOT SIZE: 40280 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: LING SAND FILTER. .MUST DISCHARGE RECEIVED BY: ISSUED~BY: ~ BACKFILL AND COMPACT TESTHOLE #1 IN MIDDLE OF PROPOSED BED PRIOR TO BED INSTALLATION. REMOVE ORGANICS AND SM MATERIAL TO -2.0' BEFORE INSTAL- INTO PER'D SOIL. DATE: DATE: SEWER&WATER INSPECTION S~TE PLANS March 22, 1993 ROBERT SHAFER. P E ROGER SHAFER. P.E. CIVIL ENGINEERS (907) 694.2979 FAX 694.1211 Municipality of Anchorage DEPARTMENT OF MEALTHAND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Elmore Subdivision, Block 8, Lot 10 Request you issue a per. it to upgrade the septic system 9et~ring the referenced property. An adequacy test was performed on the existing system and the absorption capacity of the system was found to be inadequate for a four bedroom house. Three test holes were excavated and percolation tests ~erformed. The approximate location of the test holes are .ocated on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information foryour~,~iew, please contact us. ~S/JPW/LSU/lsu ON S;TE WASTE WATER D~SPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 .'1"=40' UPGRADE -I SCALE DETAIL / PRO~'IL£ PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 7 8 9. 10- 11 DATE PE~R~ 14- 15- 16 17 18 19 Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ~ni~ing? SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop 20 PERCOLATION RATE ~' ( (m,nutra~mch) PERC HOLE DIAMETER /~ ¢.~-~ 1~4"~--~) TEST RUN BETWEEN "~ ~"'~'""t-~ND ,'~ FT PERFORME~e RIv~. Al..b. ~e~ __ _ _.1/~ ( / CERTIFY T~T T~IS TEST. WAS PERFORMED IN :~7~,~TtT H ALL STATE ANO M MNICIPAL ~ ~IOEL, S. T ON THIS OATE. DAT~ ~/~ ~/~ Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: · EGA' DESCR,FT,ON: ~_ ~: ~ 8, ?,~r IO 7- 8 9 10 15 10- 20- DATE PERF/ Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? OEPT.?'F YES'A~W"AT I1' E Iloni~"ing? ~ r Bil~ SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop ! ~-m-'t~ ~:o~ -- --- PERCOLATION RATE / ~ (m,nutes/mcl~) PERC HOLE DIAMETER TESTRUN ~ETWEE. ~~/~.~C. FT ~.. ~ ~ I~ / - PERFORMED BY: ...... I ~// ~ ~ CERTIFY~HA~ ACCORDANCE ~m~~~N~T ON tHIS DALE. DATE Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERPORMED POR:~ ~ E~'~ ~/~S~/~, LEGAL DESCRIPTION:~--.~/~'V//~.g~'. /,~/ ~/_E'~. (~?/O Township, Range, Section: 2- 3 4 5 6 7 8 9 10 11 13- 14- 15- 16- 17- 18- 19 20 WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN S L IF YES, AT WHAT DEPTH? II p E 0epth lo Waer Aller Gross Net Depth to Net Reading Date Time Time Water Drop ~ (mmuteshnch) PERC HOLE DIAMETER PERCOLATION RATE TEST.~RUN BETWEEN ~AND FT COMMENTS hO P~ PO'~- ~ 'to ,,~, ~,~,d~3 PERFORMED OY~0~ ~1, DI~ t~ - i~ / ~ ~ CERTIFY T~T THIS TEST WAS PERFORMED IN 72~ (R~. 4/~) ~// / ,~ f ~ MUNICIPALITY OF ANCHORAGE ( DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet-Anchorage, Alaska 99501 Telephone264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE i--'1 UPGRADE LEGAL~DESCRIPTION NO. OF BEDROOMS LOCAT,ON IAbso,pt,o.,eaT,. D..,ng Liq. ~l~atlons IF HOME.DE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O z < Manufacturer Material Liquid capacity in ~llons Lan o each I' No. of ,in.~ Total ,e~l~es Trench ~g~nche, Distance Total ell~t' Length W,~ Depth PERMIT NO. .' < k Ty~ of crib Crib diameter Crib depth Total ef f~ti~ absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller D~stance to lot llne PERMIT NO. ~ DISTANCE TO: Building foundation Se~r line Septic tank Absorption area(si OTHER ~ SOILTESTRATING ~ ' , BOX 1~69, ~T.A~II. ]~OUTE ~ ,~I[."~CHORAGF_,~ ALASKA 99~02 ~,,:1~-1-??14 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF $10-q'.00 PER FOOT. PROPERTY OWNER LOCATION OF WELL SITF DRILLER B e.~u'u~ C./n,~a WELL LOG: -- 110 7,_~.. C,~,a~ o~ ~)~: $2090.00 C~,~t o~ I~J.. Sex,L: $21o00 COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLE'"rlON OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF $2111.00 THANK YOU VERY MUCH. DATE ~ P..5,U~, 1979 SERVICE: CHARGE: O F' I~% PER MONTH WILL BE: ASSE:S~.ED ON PAST DUE: ACCOUNTS. BERN%L~PART. ~DRILLING WORKS .,," DEPRRTMENT OF HERLTH RND EN~IRONMENTRL PROTECTION ~" ",: , ... 264-4720 ' .,. ,, ' I~ELL RinD' .Or~--5 Z TE: 5EIdER PERHZT PERMIT ,,0. ( 7900~ > ", :"; -' ~' RPPLICRNT DRNNV 5TRNFIELD 78~0 DE~RRR RD. ~2~9 ~-<7 ~._.~ LOCRTION ~45TH ST : ,', '~,~ '. LOT ~IZE 4~2~0 SQUARE FEET LEOAL L~O ~ ELI'IO~E S/D . TYPE OF SOIL A~SO~TION SYSTEM I~: D~AIHFIEL~' ', MAXIMUM NUMBER OF ~ED~OOilS = ~ SO~L ~ATIMG (S~ FT/~): THE PE~UI~ED SIZE OF THE SOIL ABSORPTION SYSTEH DEPTH= ~-; LEt-JGTH= THE LENGTH DIMENSION THE DEPTH Of R TRENCH OR PIT IS THE DISTRNCE BE%IEEN THE SURFACE Of THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THE TREI'4~--H IJIDTH I5 5. C~OO FEET THE GRRVEL DEPTH ID THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). REQLm I RED IS THE LENGTH (IH FEET) OF THE TRENCH OR DRRINFIELD.. SEPT I C TRr-JF. $ I -~"E=. 'l 251:i'_-~ BRLLE~t-~ PERMIT APPLICANT HRS THE RESPOHSIBILITY TO INFORM THIS DEPRR'IMENT DURING THE IHSTRLLRTION INSPECTIONS OF ANY HELLS ADJACENT TO-THIS P~PER. TY AND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. : TI40 ( 2 ) I r~SPECT I 0t45 RRE REQL: I RED BRCKFILLIHG OF ANY Sg$TEM WITHOUT FINAL INSPECTION AND APPROVAL DY THIS DEPARTMENT WILL BE SUBJECT TO PROSEC~ION. MIHIMUM DISTRNCE BETWEEH 8 WELL AND ANY ON-SITE SEWRGE DISPOSRL SYSTEM IS ~.00 FEET FOR R PRIVRTE HELL~ OR ~.50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC HELL. WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONSfRND CONSTRUCTION DIRGRRMS RRE AVAILABLE TO INSURE PROPER INSTALLATION. - PERt-11 T ' EXP I RES CERTIFV THRT I RM FRMILIRR WITH THE REQUIREblENTS FOR ON-SITE SEWERS AND HELLS RS SET I FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTRLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMEHT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. ISSUED BY~~CRTE__ V~. 2 ~ r'~. ~ SO~LS LOG MUNICIPALITY OF ANCHORAOE [] PEROOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEOTION TEST Pouch 6,650, Ancho~Ne, AlaM(a 99602 27~-2221 SOILS LOG - PERCOLATION TEST SLOPE SITE PLAN 11 ENCOUNTERED? 12 IF YES, AT WHAT DEPTH? 13 Oro$i Net Depth to Net Reading Date Time Time Water Drop 14 15. 16. 17- ~ 18- 19- . 20- ~, PERCOLATION RATE ,{minutes/inch TEST RUN BETWEEN , FT AND FT PERFORMED BY: c.-, ~ ~ ~-~.c e~.~. CE.T.F,EO.~: ~ ~-~ OATE: ~ O,/~.,/~ ~' 72-00~ (7/76) . .;; !':i: !: :,": ':' '" ~::' " MUNICIP-A~/TYOFANCH0RAGE'~: ~ ' :~ :~=:*": ..... · . ' ' · . ~'~f~'- ~ .... ~'c - "Dlvisl n f Environmental Services ~'<,'.~R~~-.''~ -'=,Y~ ,:~:~-' ~ =".'~ ~c' P.O; Box 196650 :'Anchomge;'Alaska~; 99519-6650"~,s~=,'J ,-* .~!,'~- ' -'~: -- ,'- ;' -: :~,~:?~ ~,~,.~.~ ~ :.~,:,-:~., :j.~r~ ,~':~ :=..CERTIFICATE OF HEALTH AUTHORITYA3..,C-.~ ~,~ ~-~ ~,,..,~:,...~: ?.-:,]:,~ :.~: ~ ,' : ;: .~'.'. ~ '"' '"..~. '-~" ~'~' ~ ''. wTM -.~..-~, Lo~ ~O?~c~'~=;E~o~e S~5~o~.~ .'....'~.. ::' ~.~ 4 ~.~.,~.': r~;,~s ~'.~ ~ ~ro~ owner,. ............... ~ax ~,~,~ :.,...-~ _ ~,; .. ...* .... OF. WAT~ SUPPLY ...... . .__...: -- , ..... ~ .......... ~;. ~ ,...., ........ ,, r. ~:.::~;:~'~.; NOT~;tlf comm~nl~,wel( s~tem, p[ovlde wd~en confi~atlon from State ADEC a~t- .- - ..... .... ~:'-7,.,"-.'.'- ?.~,,,'. .......... ~ ....... ~ In~ to the.~ali~ and smtus ofs~tem"'":~ · ..... . -~ '~-':'~' ~"-~' "~'~ ' ~'"~',-"-': ~ · - '-. 4, . ~PE OF W~A~R DISPOSA~ -=.~:' ~:~?.~:'.... ::'..'-~.:-"~'-' -.,.:'~..~, .- ~'~ ... ,.. ~ .: ...... --,..?..: .. :....:-;c: .;~-.~.-..;--.--.:;-~'..,..::?.~..~::.-.~.. .-..-.: .'~.'......:.;".:':. -'. :..,: :. .... ;;:.'.;.:: · '- ~". ': NOT~ If communi~ ~tewater s~tem, provld~ wn~en confi~ation from Stat~ ADEC ,,....: ...... - . a,,~,.n._ .~ua...x status ~.~..,,,., ... .... . .... ,. .. , * ~'--~ STATEMENT OF INSPECTION BY ENGINEER..*..,~. · .... : .... * .~ .... _ :-: , ,:'. · ":~;, ~'*';*' As'cert f ed by my seal affixed hereto and as of the vahdat~on date shown below, I verify that my *~ :'-+7.+*.-~:'-~-~::_~--.~.-----' n~,'~stig~ti~'~'of th's Health.A._u~,_.o..ri~ ,ty...At~.p.r.o~.a.I app!!cation sho~.w?~h~, t the on-site .water sup~/5 -.: "~ .... *~ ~=:-***** .................. * ..... ' for h ms" ?:~:~.;~:~..?~and/~r~astewater`d~s~sa~syst~m`~f`.e~.f..un..~..~na.~-a.n~d~a~[~`~u~[~~::~ .- · '";';::'~ %:~!~::~i"'and type of structure Indicated herein. I further verif7 that ~ on the information obtained from. -:"; ':' :~.::~: the Municipality of Anchorage files and from my invest~ation and !nspectlon, the on-s~te wa~r~W~.~,~ -,~'~ :~::~:~;-'~i'i~,~ ,~'and/or wastewater disposal svstem is In compliance w~th ~il ~unictpal and State ~:~les,; :~:,,:*.. '~"*7'7:~.'::.~-.~:~*ordlnances ' and regulations in effect on the date of this ]nspecflorl.;~..,-~ :,:? ~:--::.-.~.-.--~ ~. :~, ,:,,:.,, ~ -,~-~.~,:~:. .::.,-~_~.; '.::~.:..*~.~;::.Name of Firm .......... $ & s ENG Phone /"~ .7 '~' ~ .... ~ '.?- · :.-~ The Municipality of Anchorage Department of Health and muman ~erv~ce~ {U.HH~} .~ssues Heroin./~umo ~y ' ,*:':*.-:'.; *";. Ap'~:o~I certificate~' based only· up~3n the representations given In pamg~ph. 5. r .. · .ab°ve.. by an independent '.'-"' :' ,: ' m'ofsss 0na e~a neerrea steredlntheStateofAlaska. TheDHHSdoesthisasacourt~ytopurchasersof hornes '~4:~'=:.'i; · ;;,=': and their I~r~d ing institutions I~ o~erio satisfy ce ,r~.in federal a~Kt stat? requ i~.?nts: ~m plOyens Of DH Hs do not -~?:;'.~':-.;:~?-~6nd~ct:i~l~tion'$'~'r:'~,; ~ze '~J~a bef°r~ 'a certifiCate Is Issued.;.~The ~unicipality.of An,c~horage is not · ' ':'-~' "' """ :'" '::" ' "! i::~.:' "' ';' " ';':= ":' "': ": ~" Department of H6a!th'add H~man Services 'HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~7' /0, J~ 8/ ~:;:~v/~E % ~-~ Parcel I.D. A. Well Data Well type Log present ON) Total depth Sanitary seal ~I~N) Absorption field on lot Public sewer main Sewer service line If A, B, or C, attach ADEC letter, ADEC water system number Date completed "~/~. 5/?'~ Driller Cased to //O' Casing height Wires properly protected (~N) FROM WELL LOG AT INSPECTION Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ; On adjacent lots ; On adjacent lots .Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Date of sample: .~,!~, Nitrate B. SEPTIC/HOLDING TANK DATA Date Installed ,.~/~,/'~-.~ Cleanouts {~N) ~E_~ High water alarm ~.p'~) Collected by: Date of pumping Other bacteria $ & S ENGIN,~ERING 17034 Earl1'3 River I,.o~p Eagle River, Alaska 99577 Tank size /,~:C~3 (~ c Compartments Foundation cleanout ~q~l) /I/~5 Depression (Y/~ . ,,f/~:~ Alarm tested ~;:../N) ~'z~' SEPARATION DISTANCES FROM SEPTIC/i'I~L=I~I~ TANK TO: Well(s) on lot I(~' On adjacent lots lO0 e Foundation To property line .~ ~ Absorption field ~/0 ' Water main/service line Surface water/drainage ~)(~ ';~: ~ /'' ~'' ''~ '-L'.* .... 72-028 (3~93)' Front coNTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons VentOliN) ,,I/.~::~.~ High water alarm level Meets MOA electrical codes (~/N) sl~lt~ Manufacturer ~/U~-/~ ¢,~--- "Pump on" level at ~ ~t "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot' /0(~ .On adjacent lots /OO ~ Sudace water D. ABSORPTION FIELD DATA Date installed Length ~ ~ .Width Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/~ Soil rating (GPD/Ft~) L~/'~' .System type Gravel thickness ~),~ Total depth ~ ' Cleanout present (Y/~ z//1~.'T~'_ 'q Depression over field (Y,~ Results (pass/fail) .for ~- Bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Sudace water Curtain ~)r~C~in~'~ .On adjacent lots ! C~O '~ Property line .To existing or abandoned system on lot .Cutbank /...J/A .Water main/service line Driveway. parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certi~/that I have checked, verified, or confon'nedto-'dThMOA and HAA guidelines in effect on the d.,a, te o~ thi~ inspection. /. / "'~"'~ '* " ~ '~,i - , '.' , . -/ ' '/? x ..,.,, Engineer's Name,. 0~..~aglot~/ - /- No. 204 · =ag,e t(~¥er, Alaska 9?577 /~/ Date ,~.,/ ',.~ ~//~' '~',.-("- t'"~-'~~.~'~.~~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number. 72-~26 (3/93)° Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lo:t. 10; Bt. ock'8= E,bno~. S~zbdZu.~6~.on #2 Location (site address or directions) ¢OIV'r~ACT #252050166 Property owner Mailing address Lending agency Mailing address 4701 E 145:t.J~. . An~flto,'tccge, A/(~' 995~6 Rod: E~e.n (fl~6/~n~ Day phone 4701 E 145.t.h Ancho~aq¢t AK; 995~6 PHH/~OMEQUITV (K~uth~ 545-7863 Day phone I~1#1 400 E~6~ b:z.6 Co.~.y~6 B~v~. Su~e 500 Iru~J~g, T~6 75059 Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Individual well XJ(X Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, p~ovide written confirmation from State ADEC attesting to the legality and status of system. # 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 heroin. 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 Adc] .... 17034 Eagl. RIY~'~L~/~p Rgt/d N~. 204 Engineers s~gnature DHHS SIGNATURE Approved for __ Disapproved. ~ Conditional approval for bedrooms. bedrooms, with the following 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 Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. · . · Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~"('/(~ ! ~'*~)/ ~'/'J~--/D Parcel I.D. A. WELL DATA Well type '~tk,~7~_-- If A. B, or C, attach ADEC letter. ADEC water, system numbe~ Log present(~l) ~/~:::~ Datecompleted -~~~.~ ~.c.j Driller Total depth I [ C) Cased to ~ I 0 Casing height Sanitary seal {~/N) Y~--~ Wires properly protected (Y/N) FROM WELL LOG Date of test ~ _~.~_.~o ,.-~c~ Static water level ~ j~ Well flow ~ Pump level ~ J~ g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot I 0 ~ Absorption field on lot (0 [ Public sewer main ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout, Sewer service line I0o "/ I0o '4 t.fo'f- Petroleum tank ~6'~J~ ~U~.p WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate O, ~,"~ ~'~-/~ Other bacteria 0 ~-oq-%-c~ '~ Collected by: ~__~ B. SEPTIC/HOLDING TANK DATA Date installed ~'~:'~--0"c~ ~ Tank size J~O0 (~o,t.. Compartments Cleanouts ~1) ~ Foundation cleanout ~N) Y Depression (Y/~ High water alarm ON) ~/~;~ ""- Alarm tested (Y/J~ I,'d//3-' '-'/UeCJ .~. Date of pumping P//~r- -- /~f~/ '7'.4/d/~. t,~,: p6~n'per' ~, ~//i~! ~"~" ~'j{,)~ SEPARATION DISTANCES FROM SEPTIC/HOL'DtNG TANK TO: Well(s) un lot [C)~ ' On adjacent lots J{~(~ ~J' Foundation ~,~,~ I To propert, line ' ~-~' Absorption field JJ(~ Water main/service line ~3,,~~ Surface water/drainage I(~(~ 'Jr 72-026 (Rev. 7/91) Fronl CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) Y High water alarm level IC'- 30 "Pump on" level at Meets MOA electrical codes ((~VN) Y SEPARATION DISTANCE FROM LIFT STATION TO: ¢ Well on lot ' "'1°c~ On adjacent lots D. ABSORPTION FIELD DATA Date installed.,*' "- Length~. * ~3 width ~.,c.{ Total absorption a~a, Depression over field (Y/~ ~o Results (pass/fail) Manufacturer ~~ ' ~ Manhole/Access {~rN) ;'Pump off" level at cyc . t.t d - Surface wa~er 100 ~ Soil rating 0 0"~' Gi'P//SF 'System type Gravel thickness ~ ~ ~ ' Total depth Cleanouts present (Y~ ~ ~T' Cate of adequacy test ~/~ -~E~ for ~ bedrooms Peroxide treatment (past 12 months) (Y/I~) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot [(.~ t . On adjacent lots I00 To building foundation On adjacent lots Surface water Curtain drain E. ENGINEER'S CERTIFICATION If yes, give date Property line ~,~, r To existing or abandoned system on lot Cutbank ~J//~ Water main/service line Driveway, parking/vehicle storage area '+ I certify that I have check/ee~rified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ~gnature / ~ ¢ ' ' ' , ~'~' 4?? '*~, Engineers Name ~ ....... ,_., .................. ~. ~ ~2;.~.~C'. ......~-' ~ / HAA Fee $ //~'O 0 o" Waiver Fee: $ Date of Payment ~'. -/-/- ~-~ Date of Payment Receipt Number c--3c/7--q'~ l~ '~/~) Receipt Number' DAlE RECEIVED ' ~" INSPECTION APPOINTMI~NTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street · Anchora~, Al~ka 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts o~, page 1. lnconyplete reque~t~ will not be pro~e~ed. Please allow ten (t 0) days for processing. t. PROPERTY OWNER I PHONE Danny and Mickey Stanfield ~ (work)I 344-7782 MAILING ADDRESS (home) 345-2356 SPA Box 334-F,Anchora~e, Alaska 99507' PROPERTY RESIDENT (if different from above) PHONE same as above 2. I~UYER PHONE Donna Hurdle and John Sagan 277-4282 MAILING ADDRESS P.O. Box 3113 Anchorage, Alaska 99510 3. LENDING INSTITUTION ] PHONE First National Bank'I 276-6300 MAILING ADDRESS 36th and C Street. (realtor will ~ick UO aoorovalT 4. REALTOR/AGENT ~ PHONE Connie YoshimuraI 279-7~11 MAILING ADDRESS 501 W. Northern Lights Blvd., Anchorage, Alaska 99501 5. LEGAL DESCRIPTION Lot' ~ ~ Blk ~Elmore Subdivision STREET LOCATION NHN 145th Avenue 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [~ Four ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY IK'l INDIVIDUAL* ~J~L.~ . * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY ----- since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth {attach log if available.) 8, SEWAGE DISPOSAL SYSTEM ~-I .INDIVIDUAL/ON'SITE** 1-C)~0 YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED I--IPUBLIC UTILITY Connection Verified INSTALLER i--ISeptic Tank or I-'1 Holding Tank Size: ~_~'O If Tank is homemade SOILS RATING give dimensions: 4. DISTANCES WELL TO: Septic/H°lding Tank IAb$°rpt'°n Acea Isewer Line Nearest L°t Line 5. COMMENTS.. [~.~A'PPR OV E D FOR Z~J BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79) )'" 3036 ',. DE* SHO 13Znd AVE IR~th \ A~lr TR e AVE I~ith AVE /4..5 /,~ 7 7'/( A v£ & ~-.e 2,%,.® e 1-,: ~ :e e e e e e August 6, 1982 Danny and Hickey Stanfield c/o-Connie Yoshimura 501%~. Northern Lights Blvd. Anchorage, AK 99501 Subject: Lot 10 Block 8 Elmore Subdivision Approval for the individual sewer and water facilities cannot e granted until the following items have been completedz The top of the well casing ~ealed with a sanitary seal so that it is water tight. The water analysis report needs to be submitted to this office from the ~lem Lab, 5633 B Street, for our review. · The septic tank pumped with a receipt submitted to ~%is department. · A four (4) inch cast iron cleanout needs to be installed to the septic tank and/or leaching area. Please notify thi~ Department for a reinspection when the noted di~crepancie$ have been corrected. If there are any further question~, please call this office at 264-4720. Sincerely, (, ,Robert C. Pratt Associate Environmental Speciali~t RPlS0/p/EH [&unicipalitT o,o 6-6 0 ANCHORAGE, ALASKA 99502-0650 O~ (907) 264-4111 A chora e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION . t ~ ~ 501 W. Northern Lights Blvd. ~ ~' ~ Anchorage, ~ 99501 . . ~ ~ ~Q Subject: Lot 10 Block 8 Elmore Subdivision ~ Approval for the individual sewer and.water facilities cannot be granted until the following items have been completed: The top of the well casing sealed with a sanitary seal so that it is water 'O The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. The septic tank pumped with a receipt submitted to this department~ AJ, , ~ A four (4) inc~c~s~ iron cleanout needs to be installed to the septic tank and/or leaching area. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, ~o~Robert C. Pratt Associate Environmental Specialist RP180/p/~H " · - " ~DATE RECEIVED TIME TIME TIME DATE ,~ . DATE DATE INSPECI~,.j ~ INSPECTOR INSPECIOR MUNICIPALITY OF ANCHORAGE DEPT. OF H~ALTH & /,'~-~l i~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~I~'RONMENTAL PROT~CCTION 825 L Street · Anchorage, Alaska 99501 OCT 2 9 1979 I ENVIRONMENTAL SANITATION DIVISION RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts OIt page 1. Incomplete requests will not be proce~,sed. Please allow ten (10) days for processing. el. PROPERTY OWNER MAILING A~)~R ESS PROPERTY RESIDENT (If different from above) · PHONE 2, BUYER PHONE MAILING Aj~DR ESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT I PHONE I MAILING ADDRESS J STREET LOCATION 6. TYP'E OF RESIDENCE ~ SINGLE FAMILY I-'1 MULTIPLE FAMILY NUMBER OF~BEDROOMS i--I One [] Four I'--I Two [] Five ~ Three [] Six [] Other 7. WATER SUPPLY ~ INDIVIDU/~L* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTI LITY * ATTACH WELL LOG. A well log is required for all wells drilled ' since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ,/ ~7 ~ YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-OLO (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS I--I SINGLE FAMILY I--} ONE [] THREE [] FIVE [] OTHER I--] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY r--I INDIVIDUAL · DEPTH OF WELL [] 'COMMUNITY'' ]ATE DRILLED [] PUBLIC UTI LITY~ ~ Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified ~NSTALLER [~]SepticTank or F'qHoldingTank Size: /~ If Tank is homemade SOLES RATING give dimensions: TYPE OF TANK MANUFACTURER ~ _ ,...~ TOTAL ABSORPTION AREA MATERIAL 5. COMMENTS , ~! u ~PP.OVED FO. BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [~' DISAPPROVED ~.~' /'~ . ' DATE ~o I~"~O BY '~ 72-010 (Rev. 6/79) · ': / /iunicipality Anchorage POUCtt G ,550 ANCHORAGE, ALASKA 99502 (907) 2?9 2511 October 29, 1979 First National Bank of Anchorage Post Office Box 4-2090 Anchorage, Alaska 99509 Subject: Lot 10 Block 8 Elmore Subdivision (Buyer: Danny Stanfield) Approval for the sewer and water facilities can not be granted until the following items have been completed: (1) The well log submitted to this office. (2) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw