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HomeMy WebLinkAboutPARK HILLS #1 BLK 2 LT 12Perk Hills Block 2 Lot 12 #017-112-58  Municipality of Anchorage .__o__ · Development Services Department ,.-~.: Building Safety Division .,.~.. -..- On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 ~ ~ www. cLanchorage.ak.us (907) 343-7904 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW010348 PID Number:. ' 017--112--58 CINDY LEAKE c/o NElL THOMAS w/ COLDWELL BANKER Wastewater System: [] New aa Upgrade Addresl: 2525 C STREET * ANCHORAGE, AK 99505 ABSORPTION FIELD No. of I~drooml: Ph°ne:(907) 562--7653 4 B D~lp Trench ~ Sh~tlo. Trench · Bed D Uound · Other LEGALDESCRIPTION ~' ~ 2.0 ~,~/s~ r~ **SEE DWG. 2 12 PARK HILLS #1 SEE DWG, r~ 0.32 - - - SEE DWG. r~ 30 WELL: [] New [] Upgrade 12 ,. 5 ,...-- r~ r~ 360 s~. rL D-3034/F-810/SCH.40 PVC r~ A+ HOME SERVICES 2/20-25/2002 ~ ~ ~ TANK SEPARATION DISTANCES ° SePt~ rlHold~ng · $*T.r' P. ri Other Tank F~ld Station Tank ~,.~ U.., ANCHORAGE TANK 1500 Well 100'+ 100'+ 100'+ -- 25'+ ~ STEEL ~ '~ ~ 2 so,oco wot., lOO'+ lOO'+ lOO'. - - LIFT STATION Lot Une 5'+ 10'+ 5'+ - - 1500 ANCHORAGE TANK/ORENCO SYSTEMS FoundoUon 5'+ 10'+ 5'+ - - TIMER TIMER Curtain Droln N(iNE KNOWI t20 M.O.A. Remarks: *THIS IS A BO'I'I'OMLESS INTERMITI'ENT BENCH MARK SAND FILTER (ISF) SYSTEM.. TOP OF BOTrOM STEP FOR DECK STAIRS THE EXISTINC SEPTIC TANK AND DRA~NF3ELD WERE COMPLI-I-I-I-I-I-I-I-I-I~'ELy ABANDONED. ~=,~'==~ t"~..F',~..~ Inspections performed by: AWWC, INC. Dates: 1st 2/20/2002 'ecOi', 4 ) _T!J/~'~ / '"-'~ 5th 2/25/2002 Development Services Department Approval (/~.~¢ '.. :- .'",~ ~""~ ~ AS BUILT DRAWING SW010348 ~ 017-112-58 PR~m FO~ CINDY LE~KE P.Oa[ Nua~: c/o NElL THOMAS w/ CO~WE~ BANKER (907) 562-7653 2 P,,~ ,=L~ su~ws~o, ~= LO~ ~=. ~LOCK ~ ,~{~.". ............. .'~ AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE (BO~OMLESS ISF) A B 5'3'1 9.62 40.9 ST2 16.06 37.29 MH 18.58 36.57 MT1 53.56 29.81 IvlT2 63.32 36.53 kiT3 61.28 53.14 MT4 69.2 57.37 AS BUILT DRAWING SM010348 ~ 017-112-58 FINAL GRADE -, gg.g,'J+ ~ ~P OF ~HO~ ~ ~(~ - g~.go /- ('"~ ' '"~ 5,T.~,P. T~K ~~ o~ ~.o  (0~ - 98.32 *NO~: THE TOT~ DEP~ W~ UMffED TO 4 ~ BELOW ORZGI~ R~G~E AT ~ POZ~. A ~SQU~N ~RIER W~ IN~A~rO ON ~E ENDS ENDS ~D DOWNH~ SIDE OF ~E ~D RLTER. /~MO~ORING ~BE~R~ ~R,O,~ C~ X ' / - / - 92.,6-g3.16 ON ~WNHI~ SlO~ ~ ~ / ~ 0 ~HI~ S~OE-- X ' ~ / ~~ .-s',~'." ~ "~':4 .... :i,~ ~x~;'v .... ,..-'.k.~. ...... , .... ~,~ ,. .... ~:,-..: , ., ....~-~ : ,- ~ . ~ ~. ... .,..... ? ~ ~ .) '~U 'F ~ / ~ -- g1~1 ~.) ON UPHX~ SIOE ~., ................ 2/27/2002 ~.~.~. ~; t ,~'".~ CONSULTANTS. INC. N.T.S. · '"' .R~[~ ~0~: CINDY LE~KE PHo.E .uu.~: P~[ .uN.~: ~..I / ~/~['.~.L.~~ .... rL c/o NElL THOM~ w/ CO~WE~ BANKER (907) 562--7655 5 OF 5 PARK HIL~ SUBDIVISION ~1; LOT 12, BLOCK 2 ~[',:"k ......... "$e~ PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 02/27/2002 11:42 FA! 9078686770 A+ Rose Ser¥1ces Inc. .q~'.~..Fax - DDCF&x1. 2/27/02 6:08 PAOE 10/23 RighkFAX v~ ~ ~ ~a INSPECTION REPORT " · MUNICIPALITY OF ~O~GE - BL~.D~G S~' D~SION · 47~ SOUr~ B~GAW ~.T, ~O~G~ ~ · .. ~rA~q~: TEDS F_.L~C . AflflP&"sS: 14731PARKHILLSCI~CLE /.OD 12 BLOI~.. 2 SUBDIFISION.. PARKI-[K~ :: C03.iM~ ' AM-SEPTIC SYS'f~!M-CALL FOR ~.1'~. .MEET TYPE OF INSPECTION.: Electrical Final : r-i · 0102 Z $~o4y THOSE SHOWN ON THE. R_E_C_O_R.,DED "FMH At. BUILT HO CORNERS SETI'HtS pATE '" ~ ~at I of ~e ~1~1~ ~fl~ ~ / Anchorage Recording pr~l~t. AI~a. In8 liniments s~uat~ ~er~ are ~ln ~ ~ n~ ~ap or e~r~ch on ~e ~a~ ~ ~e preml~ ~ qu~n a~ ~t ~ ~ exert as ~t~ he~. Oal~ at A~hora~. (907) 24e.lG66 day of ~-.~--~~--~-~- FRED WALATKA & ASSOClATE[$1~ Engineers and Surveyors MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (go7) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 29, 2001 Expiration Date: Aug 29, 2002 Permit Number: SW010348 !Legal Description: PARK HILLS #1 BLK 2 LT 12 , Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Cindy Lelake Owner Address: 1511 ELCADORE CIRCLE #33 ANCHORAGE, AK 99507-4510 Parcel ID: 017-112-58 Site Address: 014731 PARK HILLS Lot Size: 50770 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit Is for the construction of: [] Disposal Field [] Septic Tank [] Hofding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. Ail requirements specified in Anchorage Municipal Code Chapters 15,55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ..~,~'"~-.~ Date: Issued By: Date: Municipality of Anchorage Development Services Department Building Safety DMslon On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchomge.ak, us (907) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT ,b, PPLICATION FOR ~, SINGLE FAMILY DWELLING 817-/12- -$~ Permit Number Property owner(s) Mailing address (1) Mailing address (2) CINDY LELAKE Day phone 1,511 ELCADOR CIRCLE ~33. ANCHORAGE. AK 99507 Zip Code 349-3332 Legal description (Lot, Block & Sub'd.) PARK HILLS SUBDIVISION ~1: LOT 12. BLOCK Legal description (Section, Township & Range) Lot Size 51D770 Acres/Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Well Only Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Jac, r~-~l Water Soffenlng Unit I certify that the above Information Is correct. I further certify that this application Is being made for a Single Family Dwelling and Is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS~ INC. Permit Fees: ,-~ '~ Date of Payment: Receipt Number, Waiver Fees; Date of Payment: Receipt Number,. ALASKA WATER & WASTEWA'I"ER CO N SI.J I.'TAN'r S , INC, July 17, 2001 Municipality of Anchorage Development Services Department On-Site Water and Wasterwater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for Lot 12, Block 2, Park llills Subdivision #1 (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system consists ora 1250 gallon septic tank and a bed type drainfield. Tile existing bed is in a state of failure and must be upgraded. \Ve arc proposing Ihat a 1500 gallon S.T.E.P. tank and a Bottomless Intermittent Sand Filter (ISF) system be installed. Comments regarding the p~oposed upgrade are summarized as follows: !. GENEIL, kL: Two test holes were excavated on the east half of the property to determine en area suitable for a septic system upgrade. Due to tile high groundwater in Ihe area, and given the limited area around the test holes and the setbacks from surface water, it is our opinion that a Bottomless ISF system is tile most viable option. 2. SOILS: Attached are logs wbich shows the soil classifications, groundwater monitoring, and the percolation test results. It is o~.~ opinion that due to the overall appearance of the soils, a application rate of 2.0 gallons/day/fi- shoukl be used.. 3. DILMNFIELD DESIGN: Bottomless Intermittent Sand Filter (ISF) a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate for ISF: 2.0 ga on'day/It2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day '~ e. Minimum Absorption Area: 300 fi- ~ ~ f. Effective Deptb below pressure pipes(,~+ inches~¥-"-~ g. Width: 12 feet h. Length: 30 feet. 6901 Dcb:~rr l>,oad, Suite 2B * Anchorage. AK 00504 I'h' ~'o,'~7~ 'I'17-617o * Fax: ¢otz't! 'VIR-3246 * \\'eh,rite: akxxx~c.com i. Effective absorption area = 360 ft2 j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". k. Air Supply Line: "Wastefiow" emitterline, !/2 inch I.D, "Anchorage Tank". 1. Sand Material: In accordance with M.O.A. latest standards m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the #8 sieve. We are proposing to excavate down to a depth of 4 feet (maximum on uphill side), not to exceed 2.5 feet depth below top of natural organic layer, place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. SURFACE WATERS: There is a drainage ditch along the south side of Park tlills Circle that has water running in it from a curtain drain outfall. There is a stream protection and maintenance easement in the northwest end of lot 1. The proposed septic system will be placed greater than i 00' from this surface water. 5. TOPOGRAPHY: As can be seen on the attached topography site plan, the slope of the lot runs approximately from east to west at approximately 15 to 25 percent. The ISF is to be installed on a benched area that is relatively flat. Any slopes greater than 25 percent within 50 feet of the 1SF will be re-graded to less than 25% in order to eliminate slope concerns. 6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with MOA' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (4700 South Bragaw St.). 7. CLOSING: I am open to any suggestions from your department, which would be an improvement to the proposed design. I am unaware of any adverse impacts this' installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179. Thank bu for your assistance. Sincerely,/~'~ NOTE: Attached is a site plan drawing, a design drawing, a profile and detail drawing, a topography site plan, 2 soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com ' "~"~ ~"-~ ~, , / ~ ~-~'-_. '7' / / '-~-.. =.~ / .~ ". I I/ ." / "~'-. ~ /,-' ~ I ~.-t,,~HZ -'-~ .--T---. / / ~ $' ~ ............. I, ~~NG, P~E 2 OF ',I I I I I I I I I I I 7/~0/2001 .... CONSULTANTS, INC ......~f..~ ~ PR~ED FOR PHONE NUMBS: CINDY LE~KE 522-3332 1 OF LOT 12. BLOCK 2 PARK HILLS SUBDIVISION ~1 ~E or WORK: SITE P~N FOR SEPTIC SYSTEM UPGRADE (BO~OMLESS ISF) EXIS~NG TO BE ABAHOONED PER PLUMBING COD[. -~-**?* TO BE OP~ON 42. BOTi'O~L[SS \ ,SAND F'tLTER. FOR DESIGN ~ '~,,Z" "."k ~ ~o~ Isoo~.:" ',\ \ ~,u.o.s.Txl,.L ... '. ', "X ~ ' / 'r.,~K I ,.: .:': .X / /:......::..: .,.. :.. "\../~ ' .' ".'. 7'.,, ·\ ~ \\ ~ / I,FILL W~S NOTED IN ~ * / JTi-I£ ~r JD(~VA11ON SHOULD "4' p.E ~ o,~.,,,~c gAT'r: 7/18/2001 RAWN J~Y: B.S.G. 1" = 40' 20F5 AI~kSIGk WATER & WAS'I'I£V,WI'It-R CONSULTANTS. INC. PHONE NUMBER: PR£PN~£D FOR: (907) 522-3532 CINDY LELAKE t.[GAL DESCRIPTION: PARK HILLS SUBDIVISION #1; LOT 12, BLOCK 2 ~'PE 0£ WORK: DESIGN DRAWING FOR SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF) ! i x~~ 1114 I:~I/~ ~:tt 40 t'1:~ 5~ f~ ~ ~ ~, ( ~b I/4 ~ ~ ~) P~N VIEW ~/4" ~6 ~A¢~¢ ( ~.4 ) ~ J ' ~' PROFI E VIEW B.S.G. ,, CONSULTANTS, INC. - ~EP~ FOR: PHONE NUUB~: CINDY LE~KE (907) 345-2756 PARK HIL~ SUBDIVISION ~1; LOT 12, BLOCK 2 DETAIL Or BO~OMLESS INTERMI~ENT SAND FIL~ER (ISr) "ALASICax hVATER & ' VASTE' VATER CONSULTANTS. INC. .~,~_ ~ ............... ISOIL LOG - PERCO~TION TESI~ ,..,.:.~ ~4.~ .........~ :..,: PERFORMED FOR: CINDY L~E DA~: 6/4/01 95~ ....*'~ ......... ~ ~Pr ~o~ I A N GC OL SW MH CW-OM SP CH . SC ~!~ SP (RN[) GROUNDWATER ~{~.~ ~ -~- . ............. ~-~-/- ~ ~: 8.3' 6/11/01 --~ ~--- ~ .... 10 11 GM DATE RE. lNG CLOCK NET TIME WATER LEVEL NET DROP TIME (HIN~ES) RE. lNG (INCHES) 6/4/2001 1 4:07 - 10- - 12 2 4:17 <10 MIN. O' 10' 13 3 4:17 - 10- - 4 4:27 <10 MIN. O" 10' 14 5 4:27 - 6- - 6 4:31 4 MtN. O" 6' 15 7 4:31 - 6- - 8 4:35 4:30 O" 6" 16 9 4:35 - 6- - 17 10 4:40 4:45 O" 6" 11 4:40 - 6- - 18 12 4:45 4:50 O" 6' 19 PERCO~TION ~TE <1 .(MIN./INCH) PERC. HOLE DIA. 6' (INCHES) TEST R~ BET~EN **2.5 ~. ~D 3.0 FT. 2 COMMENTS: * WEEPS ~ 7' · 14' PERFORMED BY ~ WATER & W~ATER I, JEF~ A. ~N~S, CE~ T~T THIS W~ P~RFORMED IN ACCORD~CE W~ ~L ~A~ AND MUNIClP~ GUlDEUNES IN EF~CT ON ~IS DATE: ALASIC x ' VA'T'ER & %VASTE g ' ATER , CONSULTANTS. INC. , ....................... PERFORMED FOR: CINDY tEaC DA~: 6[4/01 ' 53 ...-' ~EPTB ~ feet) OR~ICS ITEST HOLE ~ GW :~ ORG sP ~ GP ~ HL C~ ~ GH CL -- GC OL SW NH SP (RNE) $p CH SH OH GROUNDWATER BROWN CO~SE ~D ~D G~L ~ ~'". SW/~W ...... q r---: ........................... 10 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIHE (HINGES) RE, lNG (INCHES) 6/4/01 1 4:13 - 10' _ 12 2 4;23 <10 MIN. O' 10" 13 3 4:23 - 6- - 4 4:27 3:30 O' 6" 14 5 4:27 - 6- - 6 4:31 3:35 O' 6' 15 7 4:31 - 8 4:34 5:40 O' 6' 16 9 4:34 - 6- - 17 10 4:38 3:45 O" 6' 11 3:38 - 6- - 18 12 3:42 3:45 O" 1~ PERC~TION ~TE <1 (HIN./INCH) PERC. HOLE DIA. 6' (INCHES) TEST R~ BETWEEN. ~.0 FT. ~D. 2.5 FT. COHHENTS: · WEEPS ~ 5', 7', · 8.5' PERFORMED BY A~ WA~R ~ W~ATER I, JEF~ A. O~NESS, CE~I~ T~T THIS W~l PERFORMED IN ACCORD~CE WITH ~L ~ATE ~D MUNICIP~ GUIDEUNES IN E~CT ON THIS DA~: PROPERTY OWNER MAINTENANCE AGREEMENT ON-SITE WASTEWATER DISPOSAL SYSTEM This a-reement dated /~- Z-~,~, 200 {, is made between the Municipality of b ' ~' '-' '7 Wller s of Anchorage Department of Healfl(and Itulnan, Scrvlcc. s (DHHS) and the property o ( ) This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owner(s) agree to the following: The property owner(s) will have an annual inspection of the system performed by a registered professional engineer, This inspection shall verify that all effluent and air pumps, timers, and alarms are functioning as designed, Any deficiencies shall be corrected and the engineer's statement that the system is functioning as designed shall be filed annually with the DHHS, (Notarize Here) sworn and subscribed before me State of ~ Judicial District ~v(! SS. OnlhigZl) dayof ~LL~-fflA~' .inth¢ ' ~e~ ~ , ~fom ~, ~e ~de~i~ no~ ?i~, ~ly ap~: ex~uted ~e s~ for ~e pu~ ~e~ ~n~ed. In'eSS whe~f, I hereto ~t my h~ ~d o~blic (slg~mre) . (No~'s p~t~ ~e) yy co~ion expkes: ( o t lO · ~,~ . !~ ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE J [-JUPGRADE~NEW MAILING ADD~ESS LEGAL DESCBIPTIO~ LOCATION NQ. OF BEDROOMS Well Absorption area Dwelling L PERMITNO, DISTANCE TO: '~ ;'~ lO~ ~'~ ~ ~ ~ Z Manufacturer ~_¢~ . Material ~4 ~ N°' of compartments ~ P Liq. capacity in gallons Inside length Width Liquid depth [ ¢%~O IF HOME,DE: ~ ~ ~OZ~ ~ DISTANCE TO: Wall ~ Dwelling ~ PERMIT~ NO. O Z ~ Manufacturer Material Liquid capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO. Length of eaCh line ~ Total length of lines , Trench width Distance between lines ~ -- Top of tile to finish grade ~, Material beneath tile Total effective absorption area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ m DISTANCE TO: Well ~ Building fou~ation Nearest lot line ~ Class ~ Depth Driller ~ Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line ~ Septic t~nk Absorption area(s) OTHER PIPE MATERIALS ~ -~,-~ ~e~ ~ ~ ,.~- ~ ~ . INSTALLER REMARKS APPROVED DATE LEGAL ~/72-013 (Rev. 3/781 WATER WELL RECORD ~ J STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Seological 8 Geopl~ysical Surveys'. Drilling Permit No LOCATION OF WELL (P{ease complete either lo, lb or lc.) A.D.L. No. ]o~.lBoroogh Subdivision Lo, Block I-~1.I '/4fl,;,. Secl'ien No. TownshlPNO Re,ge ED Meridian ic.jJ DISTANCE AND DIRECTION F~OM ROAD INTERSECTIONS e 5. OWNER OF WELL: Feet 8elo~ 4. WE~ ~TH: (final) 5. DATE OF COMPLETION/ WELL LOG Surface Mater,al Type Top Bottom ~ ft. ~~F/_ ~ ~/ ~ Auger ~detted OBored ~~~ ~~ ,~ ~ 8. CASING: OThreaded 0 Welded ~' : ~ '~ ~ Set between ft. and ft. ; ) /~ Backfilling Gravel pack "~ ~' '0. STATIC WATER LEVEL: ~'~ ft. ~ ~/~ ~' ~ ~ ~ ~Above or ~ Below Iond surface Date ~- ~' fi. after hrs. pumping ~. g,p.m. ~.Materlel: ~Neat Cement ~Other: ~"~ngth of Drop Pipe ft. capacity g.p.m. 14. REMARKS: WATER WELL CONTRACTOR'S CERT~ATION: 15. Woter Temperature ',-;'o~ ~ F ~ C 'UNICIPALITY OF ANCHORAGE , ' Department \..,/ Health and Environmental~:otection 825 L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * Permit # WELL AND~%,/:,40N-S ITE~.~.~SEW:R PERMIT ApPlicant: ~*L~ ~~ ~ l~aiiing Address: Z :~ ~~f Location: ~: ~X~ ~ /:.J' ~' Phone Nu~er: ~Z7-/~ Legal Description: .~C ~- ~/Z~ r~~ Lot Size: ~ ~ Type of Soil ~sorption System Is: Trench: Drainfield: Seepage Bed: ~ Holding Tank: Maximum Number of Bedrooms: _~ Soil Ratin~/(sq. fi/bt) /~ DEPTH The Required Size of the Soil Absorption System Is: LENGTH 32 / " _ GRAVEL DEPTH ~' WIDTH ,~,Z/, / The length dimension is the length(in feet) of the trench or drainfieldo 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 gra,vel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = I~Z.b'U GALLONS * * Permit applicant 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. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance 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 distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8- F* * * 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 codes. (3) I3n~tand that the on-site sewer system may require enlargement if ~e re:dense ~/m~od~o include more th~3 bedro~ Signe~:~ ~,q ~/~ / ~ ,N~.." Issued by~~~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82§ L, Street, Anchorage, Alaska 99~;01 264-4?20 SOILS LOG - PERCOLATION TEST SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: LOP" //~' ~/~fl, c..~ ~' /~.8....-.-.,i<. [~ ~./,o0 DATE PERFORMED: ~'O]~' SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? NJ ~ SL O P IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading 'Date Time Time Water Drop 1 I I 2 3 4 5 6 8 10 ~2 14 15 MUF CIPALI~ OF ANCHO~OE DEPT, OF HEALTH & 16 EN~ [RONMENTAL PROTECTION JUl J_ !. lO~ RECEIVED 19- 20- · r~ ~ PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND -- FT PERFORMED BY: ~M-~ '~0~ :T ~-~'~'0 b CERTIFIED B:: ~~~' ,~.oo~ ~,,~ ~= x~ ~,~ ~ ~4 ~o7 7 DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 264-4720 SOILS LOG-- PERCOLATION TEST ~_ SOIt. S LOG , [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: SLOPE SITE PLAN MUNI, ENVff 10- 11 12 13 14 kLITY OF ANCHO!~,AI DEPT. OF HEALTH & 'IMENTAL PROTECTIO JUl RECEIVED WAS GROUND WATER ~,~&~ Sk ENCOUNTERED? O IF YES, AT WHAT ~ t E DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop 15 16 17 18 19- 20- COMMENTS -~'~q"t -~'Z,,~ m 1 '"~ PERFORMED BY: ¢~¢~-,y 72-008 (6/79) PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT AND -- FT i.s-o / MUNICIPALITY OF ANCHORAGE DEPARTI~ENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) (b) Legals. Descriptionl~ '~(include~ lot, block,~,.~¢._~ ~ su bdiv~i~ion,~ ~ section,5 ./L)J~ J~t°w'nship't/ range) ,~' J ~- Location (address or directionsl Applicant Name ..l, ~. ~-~. ~,/~--<,~v-~ Telephone: Home ~.. ~ Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other ~; (explain); ~->~,~ ) ~,¢,'~' (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~ Multi-~amily Number of Bedrooms Other attesting to the legality and status. 4.. SEWAGE DISPOSAL Onsite,,[~' Public [] Community [] WATER SUPPLY Individual Well ~]~ Community [] Public [] Note: If community well system, must have written confirmatio~ from the State Department of Environmental Conservation Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspectior~HAWl. HORN~'- Name of Firm 7]77 Old ° .... ,. , Telephone Address Anch., AK 99502 344-471] pate ,~//;~/¢ ~ WATER WELL NOTE: This Health Authority Approval inspection merely certifies that the subject water ~ell produced 150 gallons per bedroom per day and that certified laboratory tests showed no presence of coliform bacteria in a sample of that water. Ho warantee or certification is expressed or implied concerning the long term adequacy or safety of the water supply. ON-SITE SEWAGE DISPOSAL SYSTEM NOTE: This Health Authority Approval inspection merely certifies that the subject on-site sewage disposal system accepted at least 150 gallons of water per bedroom per day as determined by methods approved by the Municipality of Anchorage Department of Health and Human Services. No warantee or certification is expressed or implied concerning the long term adequacy of the on-site sewage disposal system. Construction data reported on buried system components is from MOA files and was not verified during this inspection. Approved for Approved /._..~' DisapprovedV Conditional Terms of Conditional Approval Date CAUTION The Muncipality of Anchorage Department of Healt~h, and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP'does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 DI:P1. Ul' Ill:Al. IH & ~ ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPFIOVAL (HAA) CHECKLIST - F£BNUARY 1984 254-4'/20 Legal Description: WELL DATA Well Classification Well Log Present (Y/N) Total Depth ~/'~'/ Casedto Static Water Level ~/~Z) ~ Casing Height Above Ground ,/,~ '"'* Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot /~_~-~ To Nearest Edge of Absorption Field on Lot , To Nearest Public Sewer Line ..~ Cleanout/Manhole Water Sample Collected by Water Sample Test Results SEPt RECEIVED If A, B, C, D.E.C. Approved (Y/N) Date Completed ~'~-~2 '~¢~'~--~ Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot / ~'~'"/~,'~/ ;Date Comments B, SEPTIC/HOLDING TANK DATA Date installed Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) . ~'/~,~ Separation Distances from Septic/Holding Tank: To Water-Supply Well .~_ '~ To Property Line ,/~'~ To Water Main/Service Line Course ~ ~' Size ,/z:'~,~'~) c~']~_ No. of Compartments /- Air-tight Caps (Y/N) Y~'~ Foundation Cleanout (Y/N) Date Last Pumped ¢~ ~2~ ;for _~/,~ Temporary Holding Tank Permit (Y/N) To Building Foundation ~,~"~ ¢ TO Disposal Field ,,~¢~" To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well .,,~_.~"¢'"" To Building Foundation Lot TO Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots '. ' To 'Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area ~)" ~'' Comments /v]~./-~,,~,.~ ~/~2,;~¢',~¢.~ u'}~Jgr" ~¢w~ ~ ~ys~,~}s ~,~d~ Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at High Water Alarm Level at Tested for "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify tha~H~¢~ c~eckecJ, v~rifiec~ Cf'/conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ,~./~,¢~/ //-4'-'~'-¢~ate ..¢)//* /~ Date of Payment /,~, ~/~/ E~ '¢, ;¢~,~, p .:~ ¢ -~.- Page 4kNCHORAGE, ALASKA 99718 (907)344-8551 LABOr'TORY I.D. d~ BACTERIOLOGICAL I~ATER ANALYSIS TO BE COMPLETED BY MATER SUPPLIER DATE COLLECTED TIME COLLECTED TYPE OF SYSTEM I-1 PUBL!C~NDIVIDUAL -I.D. NO. (PUBLIC'SYSTEMS) CTRCLE CLASS I t ! I I I. I A B C Residential SYSTEH ADDRESS LOCATION WHERE SAMPLE WAS COLLECTED · COLLECTEI ZIP CODE (CHECK ONLY ONE THIS COLUMN) ~RIflKING WATER ·/CHECK TREATME~FF ~I~Aw SOURCE WATER [] NEW CONSTRUCTION OR REPAIRS [] OTHER(Specify) IS THIS SAMPLE A CHECK SAMPLE TO A PREVIOUS NON-CONFORMING SAMPLE? D YES ~ PREVIOUS COLLECTION DATE []]CHLORINATED ~-)FILTERED [~4~I~TREATED OR OTHER ANALYSIS REQUESTED {IF OTHER THAH TOTAL COLIFORM) SEND REPORT TO:(PRINT ))U~L NAME,ADDRESS AND ZIP CODE ADDRESS FOR LAB USE ONLY ri RESUBMIT 5AMPLE Sample rejected because: CHECK ONE OR MORE f'l Sample too long in transit. Sample should not be over 30 hours. [:)Sample received too late in week fl Not in proper container I-1 Leaked out I'~ Insufficient information provided. Please read instructions on form. [-)Other (Specify) RECEIVED FROM RECJ~IVED BY DATE ~-~-~J TIME ANA.~L~AL METHDD: LtFMEMBRANE FILTER []FERMENTATION TUBE Date & Time Started _~/~/~6 ' ~ , . ~, ~ Date & Time Completed 9.~/~ ~.'~ LABORATORY RESULTS I-1 Other Bacteria D Test unsuitable because: [] Confluent Growth [] TNTC ~TISF~ORY ~/UNSATISFACTORY [] BACTERIOLOGICAL MATER ANALYSIS RECORD FOR LAB USE ONLY TOTAL COLIFORMS FECAL COLIFORMS OTHER Membrane Filter: Direct Count Verification: LTB Final Membrane Filter Results Reported By. READ SAMPLE COLLECTION INSTRUCTIONS ON BACK OF FORM BGB Date Coliform/lOOml Coliform/lOOml Time A.M. P,M. DIVISION OF ENVIRONMENTAL HEALTH v'~off~' ~'t~ DEPARTMENT OF ~TH ~ E~O~ ~OTECTION ~ ~ ~PLICATION FOR ~TR A~HORI~ ~PROV~ ~RT~IGA~ (a) Legal Descri~t~o~ (include lo~ block, Subdivision, section,~to~ship, ra~e) - Location (address or directions) (b) Applicants A~dress Telephone -'Home Business (c) *p licant is (check one) Lending Ins ttntion Buyer ~ ; Other ~ (d) Lending ~nseleue~on /~//~ Tel~hone Address (e) Real Estate Co. & Agent Address (f) Telephone 9_7f - /33 ~ Mall the NAA to the following address: T~pe of Residence Single-Family~ Number of Bedrooms Water Supply Individual Well~ Multi-Family .~ Other (describe) Community~ Public~ Note: If community well system, must have wrigten confirmation from the State Department of Environmental Conservation attesting to the legality and status° 4. Sewage Dis osal Onsite~ Public~ Community g-~__~ Holding Tank~__~ i Note: If community well system, must have written coufirmatiou from ~he State Department of'Environmen~al Conservation attesting to the legality and status. [Page 1 of 2] Se e En~ineering Firm Providing Inspections. Tests. File Searah_~_ Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of. this Health Authority Approval shows th'at the on-site water supply and/or wastewa~er disposal system is safe, functional and adequate for the number of bedrooms and ~ype of structure indicated herein.· I further verify that, based on the information ob~ained 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 a~l MUnicipal and State codes, ordinances, and reguia- tions in effect om the date of this inspection. Address ~0~ [.t./. ~ "5 ~/ pHEP Approval Approved for ,.~X] bedrooms Approved Disapproved Conditional Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIROb~dENTAL PROTECTION (DHEP) ISSUES R~ALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONA--------~ ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO !~JRCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTSo EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK° (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ae WELL DEP'£. OF .... '" MUNICIPALITY OF ANCHORAGE (MOM ~:NVI:¥~Ni~,;:~N-~,~ i::~i¥c;ioN HEALTH ADTHORITY APPROVAL (HAA) I.,. i I985 CHECKLIST - FEBRUARY 1984 ~.~q~'l~ ~. f~ . ~c =~ ' Le,al Description: /~©~ t,~, '~/~5~, If A, B, c~ C, D.E.C. Approved(Y/N) Date Completed ~- ~ ZT/ Yield ~ / Depth of Grouting Pump Set At ~' Sanitary Seal on Casing Depression Around Wellhead (Y/~.). ' ~ Adjoining /C~(? /CO ; On Lots ' ~ ; On Adjoining Lots /OC0 To Nearest Public Sewer To Nearest Sewer Service LiP~ on Lot ~(~) /~ Well Classification Well LOg P~esent 0~N) Total Depth ~' Cased to / Static Water Level Casing Height Above Ground Electrical Wiring in Conduit Separation Distances f~cm Well: To Septic/Holding Tank on Lot To Nearest Edge of .absorption Field on Lot /~ To Nearest Public Sewer Line C leancut/Manhole /%/~ Water Sample Collected By Water Sample Test Results SEPTIC/HOLDING TANK DATA Date Installed ~-/~-,~/ ~7 Size l~ ~ ~/ ~> Standpipes (~N) Ai~-tight Caps ~) Depression over Tank (Y~ Date Last Pumped No. of Ccmpart~ents ~ Foundation Cleanout ~,/N) Pumping/Maintenano~ Contract on File (Y/N) ,,{,'/'~ ; for ~ Holding Tank High-Water Ala,,m (Y/N) ~{/A Tempora~z Holding Tank Permit (Y/N) ~//~' Separation Distances frc~ Septic/Holding Tank: / To Building Foundation To Disposal Field To Stream, Pond, Lake, c= Major Drainage To Wate~-SuppIy Well To Property Line '~© To Water Main/Service Line Course J~'~ V Date Paid: ~.~1 ,%~~' Amount: ~..~ [Page 1 of 2] 2-15-84