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TRAILS END BLK 5 LT 6
Trails End Block 5 Lot 6 #015-192-35 K4ay 29 19 12:26p Anchci-age Ale!! & Pump Ser 9072430742 p.1 beve!opment Services hepar tment Budding ScIfety bivision On -Site WOtler 4 WGstewater Prograin R.r 4700 Elmore Road P.O. box 295650 tv�rr egch Anchorage,, AK 99507 f;faycr W-K1M[:ni.aM/Msite (907)343-7904 Pump Installation Log Wen Drilling Ptrmit NiII3 her: SW areei Identification umber: 015-192-39 Legal Deseriptiars `-"--�- %Tra i S 0 o/ 6 5 L (o Pomp lit stall atinn Pate: '� 1 1'uml� Intake Deptk; ticical�•'.Tor of feii Casing: Piar"p _;4;(auuitcturer's iL7arue: Pulup Model: "331 pump'size - c"bp Pidess Adapter Burial tDepti): feet Pidess Adapter Manufacturer's Narne: Pitless ,adapter installer: Well Disinfected Upon Cojnpletitrta.? ct.,'es !11 No Method ofDisinfestion: Comments! A Qvi/� eip ' Pulup Installer Name: Date of issue: 1Prap rry O'Mlar 1 -am & Address: c. (W'� Attention: Ti7epur?�p irsta'!ler s!?i peon ide a pump irs�a;ia~icn ic+g to the DD wit'7in.3L� dzY; afpu;rp i tstallatic.n. Municipality of Anchorage Department of Health and Human Services Building Safety Division On -Site Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 4 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWSW030038 PID Number: 015-192-35 Name: Wastewater System: ❑ New ® Upgrade Address: 11380 Stroqenof Drive, 99516 ABSORPTION FIELD Phone: Number of Bedrooms: ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound ❑ Other: LEGAL DESCRIPTION Soil Rating: Total Depth from o ginal grade: Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: Township: Range: Section: Fill added above original grade: Gravel Length: Well: El New El Upgrade Gravel width: Number of lines: Distance between lines: Classification (Private, A, B, C): Total Depth: Cased to: I Total absorption area: Pipe Material: Existing Ft. Ft. 225 Ft= F81013034 PVC Driller: Date Drilled: Static Water Level: Installer: Date Installed: Ft +Home Se[Xices 1 41512003 Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. ® Other: AdvanteX To Septic Absorption Lift Holding ublic/Private Manufacturer: Capacity: From Tank Field Station Tank Sewer Line Anch Tank 1500 Gel. Well 112.4 145 75 Material: Fiber lass Number of Compartments: 2 Surface Water 100+ 100+ LIFT STATION Lot Line 23.2 20.4 Size: 250 Manufacturer: Orenco Gel. 37 75 "Pump on" level at: "Pump off" level at: High water alarm at: Foundation 44 in. 41 in. 46 in. AA 1 0+ 100+ Z Pump Make & Model Electrical Inspections performed by: Curtain Drain V Curt H. Remarks: BENCH MARK Location and Description: South Side Door at Basement Assumed Elevation: 100.0 Ft. Engineer's Stamp Inspections performed by: Pannone Eng. Svc Dates: 15`4/4/2003 AJV : ? 4 9 1-H, �.....::.. ...... ............ .....� 2nd04105/2003 Department of Health an H man Services approval p pp ........ ve ' """' �M'` ':Steven R. Pannone' 5 r 'jWV :�f ��j B Reviewed and approved by: Date: 8 a NO. CE sT� .,• �749 #, �6.... 1 (Rev. 71/99) • ♦��r�D�� ESS\� W Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax June 28, 2003 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Dear Sirs: RE: Lot 6 Block 5 Trails End S/D Review of As -Built Drawing I performed a review of the as -built drawing of the septic system servingthis lot on June 28, 2003. As part of the review, I checked all the measurements from the reference corners to verify their accuracy. The measurements were found to be within 0.1 feet of the measurements we originally measured. I returned to my office and checked to make sure the locations of the readily identifiable features (clean-out pipes, lift station manholes, etc.) that we measured were drawn correctly. They are. The one issue that needed modification was the west end of the original trench. This trench does not have a clean-out that can be located. The original location drawing on the asbuilt drawing was based on record information. I measured the approximate location of the west end of the original trench (based on disturbed ground) and found it to be 10 feet from the new tench. I modified the as -built drawing to reflect this change. I have attached the modified drawing to this letter. If you have any questions or concerns, please contact me at 2273522 or 272-8218. Sincerely Steven R. Pann ne, P.E. Civil Engineer Attachments: C:\Work\Letters\6-5Trails End.003.doc PERMIT NO: SW030038 AS -BUILT DRAWING WASTEWATER DISPOSAL SYSTEM LOT 6, BLOCK 5 TRAILS END S/D aS3 _� ° ICCURES S3 TO DEPTH CAUTI❑N! NUMEROUS TD i { rri ul P.I.D. N0: 015-192-35 ! I I III III III ! y III : - ,VIVI�1\VECUIJiV.I� � L/�1J � ..! vvi ---L1T_I4=ITIE------- 4 -TRE.NCW-TZ- PROPOSED UPGRAD 45LFx5'x2' EFT' /TH1 III ! III ! o III INSTALL BALL 0'4 TYPE DIVERTE VALVE. CDV);1 NO WELLS OR I I III SEPTiC'S W/IN I C2 I 100' OF PROPOS 5'X35"! ° E1 EXIST'G TRENC G ABANDON IN P ACE 3 B HOUSE P IC UPC ADE TO. lil B HOUSE T'G 100 g E IST`G IC IIII I A DI7jV I PLACE ELL L 1 ; r � 1 T (� z �E70 l E:1 ' TI �� �I ren , SWING TIES CD A B Cl 37.1 40.2 LS 47,0 50.0 DV 51.7 545 J NEW ADVANI L.XJ . SEPTIC SYSTEM W/ 'AX 20 POD TRAIL Street ------"" C:\Work\DRAW ING\6-�l� AILSEND.DWGAV ,..e... .r.. .............h.....� REVISED 6/28/03 .............................:�...;.. PREPARED FOR: Steven R. Pannone: � Steve Klowienwski CE 6149 � jr 11380 Stragenof Drive ��'• �• Anchorage, AK 99516 ;. •••••••. •�•wl._��� 786-3523 Wk ,14 S❑UTH TRENCH' 43LF ! I 5'x1,5 EFTV, 4' PANN❑NE ENG, SVC, LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax qTE: 5 Li,! UPGRADE, I I ! H 5'X35"! ° E1 EXIST'G TRENC G ABANDON IN P ACE 3 B HOUSE P IC UPC ADE TO. lil B HOUSE T'G 100 g E IST`G IC IIII I A DI7jV I PLACE ELL L 1 ; r � 1 T (� z �E70 l E:1 ' TI �� �I ren , SWING TIES CD A B Cl 37.1 40.2 LS 47,0 50.0 DV 51.7 545 J NEW ADVANI L.XJ . SEPTIC SYSTEM W/ 'AX 20 POD TRAIL Street ------"" C:\Work\DRAW ING\6-�l� AILSEND.DWGAV ,..e... .r.. .............h.....� REVISED 6/28/03 .............................:�...;.. PREPARED FOR: Steven R. Pannone: � Steve Klowienwski CE 6149 � jr 11380 Stragenof Drive ��'• �• Anchorage, AK 99516 ;. •••••••. •�•wl._��� 786-3523 Wk ,14 S❑UTH TRENCH' 43LF ! I 5'x1,5 EFTV, 4' PANN❑NE ENG, SVC, LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax qTE: 5 C2 75,0 78,0 Ml 73.9 72.9 C3 85,5 81.2 El 92.0 83.7 -2-03 AS -BUILT PERMIT NOi SW030038 AS -BUILT DRAWING WASTEWATER DISPOSAL SYSTEM LOT 6, BLOCK 5 TRAILS END S/D ll'I I I P.I.D. NO, 015-192-35 CAUTIONI UMEROUS -'t1NIIERGRDt7NIl L -------EXIST' x5'x-3:5'I 0 -+---UTILI-TIE&. ----- -TRENCH- TO -RE -R -E -USED. PROPOSED UPGRAD� 45LFx5'x2' EFT INSTALL I I INSTALL BALL TYPE DIVERTE VALVE. (DVY NO WELLS OR I I SEPTIC'S W/IN I 100' OF PROPOS 2 UPGRADE. I I I [1l it.*r •i AenU kEIET'G TRE �IDON IN XI T'G 1P IC TA DONA PLACE NEW ADVANTEX SEPTIC SYSTEM W/ 'AX 20 POD TRAIL Street -- R. Ponnone f,55 Steve Klowienwskl CE 8149 d 11380 Strogenof Drive A�2•..••+'� Anchorage, AK 99516 "•••••".';.�D1� 786-3523 Wk HOUSE DE TO HOUSE III � III 6b ' mQy Z I 'IM III "- I ul ur d �7 m 0 Ci N H m, SWING TIES CO A B P.I.D. NO, 015-192-35 CAUTIONI UMEROUS -'t1NIIERGRDt7NIl L -------EXIST' x5'x-3:5'I 0 -+---UTILI-TIE&. ----- -TRENCH- TO -RE -R -E -USED. PROPOSED UPGRAD� 45LFx5'x2' EFT INSTALL I I INSTALL BALL TYPE DIVERTE VALVE. (DVY NO WELLS OR I I SEPTIC'S W/IN I 100' OF PROPOS 2 UPGRADE. I I I [1l it.*r •i AenU kEIET'G TRE �IDON IN XI T'G 1P IC TA DONA PLACE NEW ADVANTEX SEPTIC SYSTEM W/ 'AX 20 POD TRAIL Street -- R. Ponnone f,55 Steve Klowienwskl CE 8149 d 11380 Strogenof Drive A�2•..••+'� Anchorage, AK 99516 "•••••".';.�D1� 786-3523 Wk HOUSE DE TO HOUSE PANNONE ENG. SVC, LLC P. ❑. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P. 272-8218 Fax AS -BUILT . c<z; Z<m n 6b mQy Z O 'IM A'm "- o'o d �7 m 0 Ci N H m, SWING TIES CO A B C1 371 402 LS 47.0 50.0 DV 51.7 54.5 C2 75.0 78.0 MI 73.9 72.9 C3 85.5 81.2 El 92.0 83.7 PANNONE ENG. SVC, LLC P. ❑. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P. 272-8218 Fax AS -BUILT PERMIT NOi SW030038 AS -BUILT DETAILS P.I.D. NO, 015-192-35 WASTEWATER ABSORPTION SYSTEM NOTEi LOT 6, BLOCK 5 TRAILS END S/D 1) ALLWORK SHALL BE PERFORMED IN ACCORDANCE WITH, & ALL METERIALS SHALL CONFORM TO AMC15.65. 2) SEE GENERAL NOTES ON SHEET 1. 3) ADD A MINIMUM OF 1' OF FILL OVER ENTIRE TRENCH. tno NY= 4) B.O.T. STANDS FOR BOTTOM OF TRENCH i/ �i i/ 7/ i w • ik�Ni�y�jpl �// � i�i�i•i�i� Drawing Ci\Work\2-2SBV.DWG ms TWiN, . �P..••••• i Al Air At 49TH %..... i.... .............;.....,; �....;............... ................. ..� PREPARED FORT Steven R. Pannone: a ♦�'' CE 8149 ,o°�AV Steve Klowienwskl �j•.��'�� 11380 Strogenof Drive 786-3523eWkK 99516 3VU MUO IM NV31 Li J Lt - C3 m (L 1110 NV3M~ 1110 NV313 Niffl MIVQ m W Pannone Eng, Svc., LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218P PHONE & FAX DATEo 5-1-03 1 AS - BUILT APR -7-2003 03:32P FROM:A+ HOME SERVICES IN 907-868-6770 70:2728218 P:1�1 RightFax 4/3/200 5:33 PACE 1/1 RightFax a Page I of I Inspection Report Munlclpallty of Anehorage, Building Safety Dh/lelon 4700 South bragaw 2NSPECMN- Vous 341-2200 IMPICT201011: PAX p07)2"-7"7 _ : 2NP0: 343-7062 Name EDS Nes:trlt Permit 03.7588 Addrem 11360 5Trt03AN0r DR Phone 772.4591 Legal BK a LTG Snapeetlon Date 4/4/2003 P subdlvlebn TRAILS END Commedtn or Directions septic ilk ststbn,call to meet at site inapesatlon Final electrical Rainspaotlon �© NO NONCOMPLIANCE OBSERVED ❑ COARECRONSt ESSENTIALAS EXPLAINED BELOW 13 WILL RE•EXAMiNf AT NEXT INSPECTION C)DO NOT CONCEAL UNTIL REINSPECTION COMMENIM (for Inspector use only) 7 J i ]utepaatw �' 278!82 ItY. APR -4-2203 FRI 04:59.=11 ID:A+ HOrIE SERVICES. PKIE:I MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW030038 Irtegal Description: TRAILS END BLK • 5 LT Design Engineer: 0062 Pannone Engineering Services Owner Name: Steve Klowienski Owner Address: 11380 STROGANOF DR ANCHORAGE. AK 99516-1255 This permit is for the construction of: ✓] Disposal Field ❑✓ Septic Tank Date Issued: Mar 06, 2003 Expiration Date: Mar 05, 2004 Parcel ID: 015-192-35 Site Address: 011380 STROGANOF DR Lot Size: 22800 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 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 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: Issued By: nct"" Date:3 14 03 A wG , , Date: � �� la 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 15.192.35 Permit Number SW0300313 L 0S1 EWSkl Property phone 786.3523 STAO &AVVP Mailing address (1)11380Drive 07 Mailing address (2) Anchorage, AK Zip Code 995r Legal description (Lot, Block & Sub'd.) Lot 6, Block 5 Trails End SID Legal description (Section, Township & Range) Lot Size -22�3T ZZ, EDO Acres q.Ft THIS APPLICATION IS FOR: Number of Bedrooms 4 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. (Signature of property owner or authorized agent) Permit Fees: CV Waiver Fees: Date of Payment: a lgC7 163 Date of Payment: Receipt Number: �I v ^ Receipt Number: ' (Rev. 12/00) In Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax February 17, 2003 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 6, Block 5 Trails End S/D Septic System Replacement Permit Request Failed Septic System — PLEASE RUSH Gentlemen: My firm was asked to investigate a failed septic system serving this lot. The existing trenchwas inundated with liquid when I arrived. The system is in failure. Tvo test holes were excavated on January 25, 2003 on the lot. The soils report and a percolation test result is dttached. No bedrock was encountered in the test hole. Ground water was encountered while digging the test holes at a depth of 10 to 12 feet. The ground water stabilized at a depth of 12 feet after seven days of monitoring. This is consistent with ground water depths in this subdivision. Also, the ground water was monitored through an extremely wet fall. We received an unusually high amount of rainfall in October, November and early December. Freezing temperatures came late to the Anchorage hillside. Higher than normal ground water levels were monitored throughout the hillside late into December. An eight foot depth to ground water will be used for the ground water design depth based on the historical data and extremely wet fall Anchorage experienced. Two trenches will be installed to obtain the required length. A two foot step may need to occur between the east and west trenches to maintainthe four foot separation to ground water. The Contractor is required to stake the well radiuses to ensure separation distances. The neighboring lot area developed and will not be adversely affected. The lot is approximately 22,253 square feet in size. lot 6 slopes to the west at approximately 8% to 13% percent in the area of the test holes. The existing septic tank will be abandoned in place A new Advantex fiberglass tank/septic system will be installed on the property The proposed installation will be located on thewestern portion of the lot. The lot is served by a private well. The proposed location is greater than 100 feet away from existing & neighboring wells and 25 feet from the water service lines. The surrounding wells are located greater than 100 feet from the proposed installation. The proposed instalation will not affect the future development of the surrounding or existing lots. See the attached Design and Specifications. If you have any questions or concerns, please contact me at 2273522 or 272-8218. Sincerely, Steven R. Pannone, P.E. Civil Engineer Attachments: C:\Work\Letters\6-5 Trails End.001.doc PERMIT N01 SW03 DESIGN DRAWING P.I.D. NOi 015-192-35 WASTEWATER DISPOSAL SYSTEM LOT 6, BLOCK 5 TRAILS END S/D II I II , O --- I III I III I cf-� Ill CAUTIONI NUMEROUS I - ,UNDERGROUND L-------EXIST"G-6b xSx-35'I -.---UT-ILI4'IES, ----- -TRENCH-TI3-BE-REUS D. PROPOSED UPGRAD� I / 'G 45LFx5'x2' EFT TH Ir EXIST G TRENC 3 B HOUSE Y I III FABA�. IN P ACE UPG ADE TO I III ' 9• III li � \� B HOUSE INSTALL BALL -1 I III III III E IST'G TYPE DIVERTE III 10%111 III ESI T'G 10 Og ELL VALVEJ III I SEP IC - TA K i III ! NO WELLS OR I 18• SEPTIC'S W/IN I 100' OF PROPOSE I I IPrPAn�. I I ICn 49Mi W �? AB ND 1 r- 6. 6. - 13% 3 /-107 NEW ADVANTEX SEPTIC SYSTEM W/ `AX 20 POD TRAIL Street - - - - - R. Pcnnonedir IN86-3523 eve Klowlenwskl E 8149 �Jl 80 Strogenof Drive chorage, AK 99516 Wk PANNONE ENG, SVC, LLC P. ❑. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax NTE, 2-17-03 DESIGN 1 11=50, 1 I I I 1 1 1 �♦ I 1 � ♦. cgz; [] z 3 mm ,r M rq m ' I ' A !/1 au ID �7 m r' 90 H m ; PANNONE ENG, SVC, LLC P. ❑. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax NTE, 2-17-03 DESIGN 1 11=50, PERMIT NOo SW03 DESIGN DETAILS WASTEWATER ABSORPTION SYSTEM r i ORS7p,.1v P, Pa, To Am''VW"-rA'17-- LOT 6, BLOCK 5 TRAILS END S/D DESIGN CALCULATIONS Number of Bedrooms - 4 Total Bedrooms - 4 INSTALL 4' RIGID INSULATION OVER TANK & DRAINFIELD. EXTEND R.I 2' BEYOND SIDE OF TANK. INSTALL R.I. AROUND AX -20 FILTER. ADVANTEX TANK DETAIL Design flow - 150 gal/br/day, Total flow - 600 g/day 4 ren R. P4 No. CE 8 P.I.D. NO, 015-192-35 TANK SIZEi 1500 gallon Advantex tank SOIL ABSORPTION SIZE, Advantex Sewer System AX20 Pod - Class III System Perc Rate= 30-60 min/Inch Application Rate= 2 GPD/SF Size Required= 600 GPD/2 GPD/SF = 300 SF Use 5 -WIDE Trench, 2.0' effective Red. Factor = 0.7, 20 if Req'd L= (300)/5))K0.7 = 42 if Single Trench, 45 If. Steve Klowlenwskl 11380 Strogenof Drive Anchorage, AK 99516 786-3523 Wk PANN❑NE ENG. SVC. P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 PHONE & FAX DESIGN PERMIT NO, SW03 DESIGN DETAILS WASTEWATER ABSORPTION SYSTEM NOTE, LOT 6, BLOCK 5 TRAILS END S/D 1) ALLWORK SHALL BE PERFORMED IN ACCORDANCE WITH, & ALL METERIALS SHALL CONFORM TO AMC15.65. 2) SEE GENERAL NOTES ON SHEET 1. 3) ADD A MINIMUM OF 1' OF FILL OVER ENTIRE TRENCH. 1W NV= 4) B.O.T. STANDS FOR BOTTOM OF TRENCH 2.0' o N I Drawing Ct\Work\2-2SBV.DWG I : 4L Cu I :� Cu O O o CU 1 I Co %D I 3eru 21MV0 un NVn im NV= � m P.I.D. NO, 015-192-35 P a Pannone Eng, Svc., LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 PHONE & FAX E-17-03 DESIGN 0-2= LOG - FMMDWAT= 7= PANNONE SERVICES P.O. BOOL 102954 ANCHORAGE;. AS 99510 MM 272-8218 MAT. DEscRUIYON' la 6. Block 318PH= l Orrolo- 5 Y1,r a 1-25-03 19#36 OR RM* ll" ---- 1 30 I3cI mW 5/8' ew W' aA5CP&44mA — 8 am F 18nanb aw 5/8' 20,36 ---- to b em* ELT 4 30 NA2,-b6w- 5/8' PtQQ Wcr 6 6 7 i e 9 OY awaft 10 11 17 13 14 l6 16 17 16 19 90 DAYS MWOMED: -09 1-25'414,,r1� ---- � L End S/D on OMPLAX % I TH I I III � I I III 0%III III ! 6I T'G 10 Og II I SEPI ICS TA K III AB ND[lN` I , PLACE I I I ' I I �'THc'13% `` f10% WAS GROUND WATER ENOOUWTZR= Ya IF YES, AT WHAT DEPTH? 8eeo m A -8.0- e0H DEPM TO WATER AFTER MONMRINGT -10A DATE: 2-1600 03 TlO Te : M L LAY'a.L--F-eZc5 LP- ss T[IAAI 6o MWjrvcIt. XWAa1030 CMis am= mm mer imm to= 0r WAM 3Wr n wr 1-25-03 19#36 6' ---- 2006 30 5 Mr 5/8' ew --- 6 3/8' — 2d36 30 5 3/4' 5/8' 20,36 ---- 6 1/4'— 21x6 30 5 5/8' 5/8' PEROIATION RATE 48 tmla/le*l PERO HOLE DIMWMR 61 TEST RUN BZWT=N 4 FT and 5 FT COTr'llEPT1'8: Test hole emmvabed by A+ Hoare Svc. Teat Hole Was Taecsoaloed befim re= test. DO= ]LOS - 73MOMAIMM 7P= PANNONE ENGINEERING SERVICES P.O. BOX 101954 ANCHORAGE, AK 99510 )907) 971-8918 PERFORM® FOR: Stan 10owleadd DATE PSRFORIIS.D: 1-43.09 LEGAL DEBORip7TON: Lot 6. Block a Traffs End aro 9m"T"W4 oqpsdo- NAM i �' Ia1VRII aa.T8 3- 4- 5- 6- 7— a- 9— 4a67e9 am 10 11 12- 13- 14— is- 16- 17— is- 19- 20-4 J13141a16171a1940 PARS F3 R. P, M 8 a2 *vt l- I sme aaii Manor WA33M TRT DaOP r----------- j------- I TH' 3 B 20,10 30 UPB A I o Irl �" I III III � 61/8' --- I 0%III E 1III 6I T%G 10 0 i I EL I III SEPI IC,.TA M40 --- AB NDOM I , PLACE ---- I I I j r 3/ � f10% 3 3/8' 1 ` WAS GROUND WATER ENCOUNTERED? Yes TF YSB. AT WHAT 1]EPTH? -30A DEPTH TO WATER AFTER 1[ONITORIITG? -14 DATE: 2-16.03 ti M L r;AYt�L'��pcS Le-sSTila.v 6c) mtN�XiVC:i, TW HMZ MMAEM DAM c a TM 3w TM Manor WA33M TRT DaOP 1-23-03 1940 6• -_ 20,10 30 3 3/8' 3/8' 2410 ---- 61/8' --- 2140 30 3 1/2' 3/e' M40 --- 61/4' ---- Milo 30 3 3/8' 3/8' FMW'ATTON RATE 48 (m!n/fachl FEW HOLE DTAMWM 6 Inches TEST RUN BEWIEEN a FP and 6 FT DOM11112m: Test bale ezoavated by A+ Haeme Svc. Test Hale Was =esoalmd befte 14ac best, Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax RECERCULATING SEPTIC TANK AND TRICKLE FILTER SPECIFICATIONS Lot 6, Block 5 Trails End Subdivision 1. GENERAL STATEMENT OF WORK 1.1 The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an recalculating septic tank with trickle filter system as described herein and on the attached Contract Drawing. All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations and shall conform to the following: • Four (4) Bedroom Private House 1.2 The Contractor shall carefully examine the project documents, have full knowledge thereof, have investigated the site and be satisfied with all conditions affecting the work. The Contractor shall notify the Engineer IMEDIATELY if conditions are encountered during the site investigations that affect the work. Any failure of the Contractor to become acquainted with the available information will not relieve the Contractor from the responsibility of performing the work as stated in these specifications. 1.3 The Contractor shall call for locates of utilities. Damage to utilities by the Contractor if locates are not called for is the responsibility of the Contractor. 2. MATERIAL 2_1 Tank: Septic: Tank shall be a two (2) compartment tank of at least the minimum size indicated on the drawings and shall be MOA approved. The compartments shall have a separate 4" clean-out riser. 2_2 Manhole Riser or Lift Station Tank: An additional second compartment manhole riser shall be capable of being equipped with the following: a. A junction box (Nema 4x) or equal, bonded or attached to the pump basin. b. UL listed electrical cord grips, installed in the J -box. C. An additional tank (MOA Approved) may be provided for the effluent pumping assembly and the items above. 2_3 Effluent Pumping Assembly, Controls, Alarm & Piping: a. Effluent pumping assembly shall be of approved materials, including: A 110 volt or equal UL listed effluent pump; High-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging; All piping shall be PVC or other non corroding material approved (`•\IUn.Y\Cnarifnoh:nno\ AA..onfevFilfa♦ Rnnr Ann Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax by the MOA. b. Pump controls and alarm system shall be an approved system with the following options: - Event Counter - Elapsed Time Meter - Program Timer 10 Watt Heater Remote alarm panel option with a minimum of 80 dB sound pressure at 24 inches, operating temperature 30 AC to 65 AC, and continuous sound to be located in the house. Oil tight visual alarm with push -to -silence feature. Automatic audio alarm reset. 15 amp motor rated toggle switch, double pole, double throw with three positions; Manual (man), Automatic (auto), and off. Nema 4x rated fiberglass enclosure with hinged cover, or equal. - All controls to be installed per manufactures instructions. - Control panel to be installed on outside wall of home within sight of septic/lift station. c. Piping from septic tank to the trickle filter is to be 1 '/4" PVC schedule 40 solvent weld piping properly bedded and sloped to drain back to the lift station. Insulation board shall be placed over the line where the cover is less than four feet. d. The Air Compressor shall be a Thomas Linear Series model No. 5060-A or 5070V -A or MOA Approved equal. 2.4 Trickle Filter a. Trickle Filter Pod shall be AX20 manufactured by Orenco Systems Inc. and distributed by Anchorage Tank & Welding. b. Install all materials according to manufacturers instructions and in accordance with MOA regulations. 2.5 Soil Absorption System a) The drain field shall be constructed as shown on the drawings and in accordance with all applicable regulations described in Municipality of Anchorage AMC Title 15.65, "Wastewater Disposal Regulations" (MOA). b) Gravel to be used in the soil absorption system shall be well graded rocks and cobbles with size ranging from '/2" to 2 '/2" and approved for use in soil absorption systems by MOA. c) Perforated pipes shall be F810 LDPE or PVC 3034pipe, with two rows of perforations and shall be approved for use in soil absorption systems by MOA. d) Clean-out pipes and monitor tubes shall be 3034 PVC solid pipe. !`•\U/..�L\ Cnn.•:froti....o1 A. "Q"t.VV;1t.. Cnnr rlM Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 )907) 272-8218 Fax e) Clean-out caps shall be rubber "Jim Caps" securable with adjustable metal bands. Friction fit caps will not be accepted. PART 3 EXECUTION 3.1 LOCATION AND GRADE a) The septic tank shall be placed at the locations and elevations as shown on the Drawings. b) The drain field shall be placed in the location shown on the Drawing, with minor adjustments allowed to minimize excavation and accommodate the existing terrain. The drain field piping shall remain level over the length of the drain field. c) Dewatering may be required for all excavations that penetrate the groundwater surface. Dewatering costs shall be incidental to the excavation. If ground water is encountered during the excavation for the septic system, notify the engineer immediately. 3.2 EXCAVATION a) General: The Contractor shall accomplish all excavation required by the drawings through whatever substances encountered, to the depth as shown on the plans. All excavation shall be accomplished in accordance with the State of Alaska safety code and other applicable safety requirements. b) Water Removal: Water is expected in the limits of excavation as evidenced by the soil test pit information. If an apparent water table is observed in any of the excavations less than 5 feet below existing grade, notify the engineer immediately. 3.3 INSTALLATION A. Septic Tank 1. After excavation the tank shall be placed on undisturbed soil on a level grade at a depth as indicated on Drawings. Backfill around the tank with structural fill. Fill shall be installed in 12 inch lifts, compacted to 95% maximum density. Any damage to the protective coating during installation shall be repaired as recommended by the manufacturer. 2. The tank inlet shall be set at the elevation shown on the drawings. Care shall be taken during installation to ensure the proper elevation drop between the inlet and the outlet. -Install flexible "furnco" rubber fittings at connection from tank to inlet and outlet pipes as indicated on Drawings. !`•\1f/n�4lCnnnifirohinne\ AA.ronf.vFiltn. Cnnn AM Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax B. Joining Pipe Sections 1. Pipes shall be joined to one another, to the polyethylene fittings, cleanouts, and electrofusion couplings. 2. Cleanouts: (1) All earthwork and fill necessary to install the cleanouts shall be considered incidental. 3. Jointing: a. Fit the heat channel in place, ensuring that ends are deburred and square to allow easy passage of electrocal or glycol heat trace. b. Fit the insulation half -shells snugly in place. Band with strapping to hold tightly in place. c. Heat Shrink Coupling: Cover entire exposed joint plus an overlap of four inches on pipe coated on either end. Heat in accordance with manufacturer's instructions. 4. Installation: a. Install insulation half -shells and heat -shrink wrap at pipe connections. Maximum gap in half -shells shall be '/4 inch. b. Lower assembled insulated pipe carefully into trench. Do not allow joints to deflect greater than the elastic capacity of the heat shrink sleeves. If sleeves are found to be damaged, reduce the deflection and repair the damages sleeves. c. Tolerances: (1) Lay mains to indicated line and grade. Perform earthwork in accordance with the Drawings. (2) Minor Changes in Direction: Pipe deflection will be allowed for small changes in direction, provided that the pipe bending radius is less than 30 times the diameter of the outer jacket of the insulated pipe system. C. Drain Field a) The drain field area shall be excavated to the elevation and dimensions as shown on Drawing. Remove all organic and silt material to the top of the well -graded sand layer. After excavation, the open bed shall be protected from surface runoff to prevent the entrance of silt and debris. Under no circumstances shall the use of heavy equipment be permitted on the drain field surface. All smeared or compacted surfaces shall be raked to a depth of 1 inch, and loose material removed, before any of the drain rock is placed. b) After all organic and silt material is removed, sand bedding shall be placed to an elevation shown on the drawings. Sand shall not be compacted. c) The bottom of the bed should be as level as practical. !`•\\17n.Y\ CnPr:fire Nnt.a� 0A..en1..vFilrn.• Qnne Ann Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax d) The gravel -less system and distribution piping shall be installed as shown on the drawings. e) The drain field shall then be backfilled with sand bedding to a depth of 1.0 above gravel -less system. Filter fabric and insulation shall be placed over the sand bedding. Backfill above insulation with material excavated from the building pad to the elevation shown. The material shall be mounded over the drain field as shown on Drawings. Backfill of drain field shall not be compacted. D. Close -Out A. Contractor shall submit unqualified as -built drawings and certificates on MOA approved forms to the Engineer, and MOA for approval to Operate. f`•\llln.L\ Cn.n:fro Nnno\ AAvanf.vA:11o� Qron Anr 10 Idlbibi[O pp y.- 14 P p C 1A 7MP -T Zvi alf L AM_ Jjr �G -:Ii f I fl !—k4�wr.• Ajr'-).V:W :N—limiucslirf** lo (..f A toprw[Y#va TMW J'j4/"jj-r A . 0 AtD"'_[3- M1 r—no LO T ILS rND 5(118p,, 13 to 4(k L o ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND STEVES JL'L OS /6 WSlrf THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this day of S 20 6 ) by and between STt Vt, /'LOS/�WS%fr herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described asA,�IvAi7leLAkd�tocated at //380 S7`roge2,,o70 A , Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65 B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC Page 1 of 5 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system consfruction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction). An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating). An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all requirements of this agreement, the conditions of the Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65. I Fee. Owner shall pay to Municipality an annual fee of =0 —� (S --O–.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. Page 2 of 5 4. Term. The term of this Memorandum of Understanding shall,be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of on site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, owner agrees to comply with all applicable ordinances, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's ANVWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: Page 3 of 5 C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the systems. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwalver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way affect the validity of this Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality as this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. Page 4 of 5 B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: 57-6V15- K'LOsIEwSk/ Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. ONVNER: By: Date: 3 —Q -r - 0.3 STATE OF ALASKA THIRD JUDICIAL DISTRICT The regoin ' strument wa: it the Municip�,I! e. TA --- :� •_ PUB00 MUNICIPALITY: ss. 0 /J y of , 2003, by n hPh�lfnf Page 5 of 5 a My Commission expires: Richard\ASSIGNNIENTNAAACode Addendum ANIC 15.65 [N00-0257MIemoranudm of Understanding Version Vl.doc ;•.w+.•.�•�w�.����'n.'q.w.. �riw.•I.1�M�yrV't.`'.y�Mw�rP�lt��I��.M,r. ... R+ wra irb Drilling ifing by 00c Co. aor SULLIVAN WATER WELLS P.O. BOX 670272. CHUGIAK. ALASKA 99547 • TELEPHONE 886-2759 OWNER OF LAND l ES Ul �) N / E DEPTH OF WELL a a ADDRESS // 3$'a STA O G4^]n F 479S/6 STATIC LEVEL OF WATER FT. S4 LEGAL DESCRIPTION Lel 6 /?[ t I_Zed'41 Citl 13 DRAW DOWN FT. DATE -Started Ended GALS. PER HR �4 PERMIT NUMBER KIND OF CASING C KIND OF FORMATION: From IJ Ft. to_L T Ft. EK /Si/AA U!=LC From4L�__Ft.to-LLEFt._134&4,.e,3G./_' From Ft. to Ft. From Ft. to Ft. Fromh%';� FL tO�e¢_Ft. &EAQbG/c 0Arfc i- 'QJ:VFrom Fl. to Ft. From Ft. to Ft. /'G jP/71 From/42 _Fl. to ,e f Ft. G.' 6114 o C- K From Ft. to Ft From Ft. to FromA b -l -Ft. to� I / Ft. 636 - JAL C e A&CZJQrCkrom Ft. Ft. to Ft. From. Ft. to Ft.n jl/n From Ft. to Ft. Frort►I /! Ft. to J J n, Ft. L �OQJ C K SA C, O From Ft. to Ft. From Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. DRILLER'S NAME ,N,��JICIPAIIT� CP ANAlTCHORAGE Ci 1",.1 FA rCT10N na AY 21979 n n WATER WELL LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 SIZE OF CASING_(2/JDEPTH OF HOLE�4FT. CASED TO f _ FT. STATIC WATER LEVEL_g4 PTO YIELD.cl-GAL.PER.MIN. WITH FEET OF DRAWDOWN. - REMARKS ,,'' DATE COMPLETEDT��_ !?-.--.PUMP TO BE SET AT _at o-7- ^^.�_t ocw c�1Lto� 7t°�/ _t°_ V) Municipality of Anchorage: Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 Well Drilling Permit Number: SW Parcel Identification Number: Legal Description Trails End blk 5 lot 6 Pump Installation Date: 11/4/13 Pump Installation Log 131253 1519145000 Pump Intake Depth Below Top of Well Casing: Pump manufacturer's Name: Goulds Pump Model: 7SB074712CL Pump Size: 3/4 Pitless Adapter Burial Depth: 10 Date of Issue 8/23/13 Property Owner Name & Address Foster's Fine Finishes PO Box 3511 Palmer, AK 99645 212 feet hp feet Pitless Adapter Installer: Sullivan Water Wells— Cole Sullivan — Chad Cross Well Disinfected Upon Completion? Method of Disinfection: Comments: Pump Installers Name: Sullivan Water ® Yes ❑ No — Cole Sullivan — Chad Cross Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION _ 825 L Street • Anchorage, Alaska 99501 Telephone 204.4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME C CtAj "A� PHONE La1GEW UPGRADE MAILING ADDRESS LEGAL DESCRIPTION �, n 10 I & LOCATION NO.OF BEDROOMS U Y DISTANCE TO: Well t Absorption area Dwelling PERMIT NO. 2 W H Manufacturer Material No. of compartments Z w Liq, capacity in gallons OQa IF HOMEMADE: Inside length Witlth Liquid depth b O Z DISTANCE TO: Well Dwelling PERMIT NO. SZ < Manufacturer Material Liquid capacity in gallons DISTANCE TO: Well Sr Foundat cm Nearest lot line. PERMIT NO. nUaO I '++ No. of line Length of each line Total length of lines Trench yy++din, &oO inches Distance besween ling .S-' /p'� Top of tile to finish grade Material beneath oe r � inches Total effective absorption area p W f7 Length VY Depth PERMIT NO. Q F W� Type of crib Crib diameter Crib depth Total affective absorption area a DISTANCE TO: Well Building foundation Nearest lot line —1 Class Depth Driller Distance to lot line PERMIT NO. ' DISTANCE TO: Building foundation Sewer line Septic tank Absorption area (s) OTHER PIPE MATERIALS /•� s SOIL TEST RATING 4_lJ-.Y�_- Q I el INSTALLER REMARKS r C, r 0 3' Got APP HOVED �Q— DATE G LEGAL /tIu�/ —( -1 I 72-013 (Rev. 3/78) r P1 L -I t+i I C I F?c. :1 -r Ce F H r-1 C t-4 n 9--i E DEPARTMENT OH_ _ALTH AND ENVIRONMENTAL Pl._.fECTIOFI 825 'L' STREET, ANCHORAGE, AK. 95001 Jid 264-4720 I-JEL-L- Rt -.IC• Orr -E I TE _ Et•JEF F•EH: Rr1 I T /1 PERMIT NO. ( 790219 ) n lFuo15.�'s�ai'i% APPLICANT CARL E. LUCHSINGER BOX 94 SRA 264 66-41Y Ll� 'LOCATION TRAILS ST LEGAL L6 65 TRAILS END S/D LOT SIZE 22500 SQUARE FEE TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING (SO FT/BR)= 240 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: OEPTH= 1^ L-EtJrTH= 1,D7: GRFikrEL DEPTH= - . tl- THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR, DP.AINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IFI 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 (IN FEET). F-"l—=Q I I REO SEPTIC Tt=ir-JK -]C=F-== 1 y�y�-t GRL_l_Ord '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. --- TW Cl C 2� ? I rJSPECT I Or+IS FIRE F:->FEEI REO --- 'BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT !•JILL 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. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER. REOUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERrlJ I T EXP I RE- C•ECEME-ER =-1 : 1I+:- c. I CERTIFY T 1: I AM FAM FORTH BYT 2: I WILL 3: I UtJDE PESIDENCE I E SIGNED: ---_ APPL ISSUED BAO �= IRF. WITH THE P.EOUIREMENTS FOP. ON-SITE SEWERS AFID !•JELLS RS SET '9UJ9 CIPALITY OF ANCHORAGE. TAL THE SYSTEM IN ACCORDANCE WITH THE CODES. (llD HAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLAP.OEMENT IF THE 3'EMJ DELED TO INCLUDE MORE THAN 3 BEDROOMS. CARL E. LUCHSINGER V3. 2 PERMIT NO. r-1 Ll I C I F? I T Y CA F t -J HQK; H 1:3 I=— DEPARTMENT DEPARTMENT OF .�ALTH AND ENVIRONMENTAL PK_ ECTION 825 'L' STREET, ANCHORAGE, AY.. 99501 264-4720 LJELL F r-4 C> 0r-4 I TE = EWER F'ERth I T ( 790220 ) APPLICANT CARL E. LUCHSINGEP. LOCATION TRAILS ST LEGAL L6 65 TRAILS END BOY, 94 SRA 264 6641 LOT SIZE 22500 SQUARE FEET TYPE OF SOIL ASSOP.BTION SYSTEM IS: DRAINFIELD 'MAXIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: CoEF'TILEH: MC3TH= 7':2: inF:>-R%EL THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TR. THE DEPTH OF A TRENCH OR, PIT IS THE DISTANCE BETWEEN T GROUND AND THE EOTTOM OF THE EXCAVATION CIN FEET). THE TREtJCHW I c�-fH I'S 15.r -+921i THE GRAVEL DEPTH IS THE MINIMUP DEPTH OF GRAVEL BET WEE AND THE BOTTOM OF THE EXCAVATIO CIN FEET!,— , FQEnCALJ I REE? 'oEF?T I co 17Ar4K 14 I ato_ = v r DR:A I NF I ELD. CE OF THE _ET OUTFALL PIPE CA CA GRL_LOt-AS PERMIT APPLICANT HAS THE P,ESPONSIBILI Y TO Alf THIS DEPARTMENT DUPING THE INSTALLATION INSPECTIONS OF ANY WELLS DJAC PJT TO THIS PROPERTY APL? THE 'NUMBER OF RESIDENCES THAT THE WELL WIL SERI:. / --- TWO C G ] I tJ5}F'ECT I DrJ A :E REL -71U I RELY --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL JSFE ' AtJC� APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE SETWZEN A WELL AND ANY ON --ITE 100 FEET FOR: A PRIVATA ELL: OF. 150 TO 200 FEET FROM FL C WELL DEPENDING .JP WELL LOGS ARE REQUIRED AND M - BE RETURNED T OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPEC ICATIONS AVAILABLE TO INSURE PROPER INSTALLATI, F'EF?M I T E14F" I F1 ES DECEM DISPOSAL SYSTEM IS ON TRE TYPE OF PUBLIC WELL. THE DEPARTMENT WITHIN 30 DRYS CONSTRUCTION DIAGRAMS ARE :1"1 1 Z. S? r o '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 R:EQUIR:E ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: ---------------------------------------- APPLICANT CARL E. LUCHSINGER ISSUED BY ------------------------------DATE--------------- V3.2 M.D.G. ENGINEERING SOILS LOG - PERC. TEST A performed for: �.) legal desc: _/ter � .oi-CS -i,�,�slope i i..'i de th M.. \\��� / .c.•. lf��ni �. I31 4 3 5 . °iii �Yn��sJoN 0 M T� .r 6 •: i �, . . tdl — Drt ar,4A1ee 74AS1- 7 Sr�u�- �czi�74r/ s 8 \\� l�iV/<'O.P.tf _/__/1 V4 - y _ro II sM ') ground ,water Cez 9 x-12. z/7 13 depth 14- 15- 16- 17- 18 4•15 161718 N 19- D soils "log ® percolation test date: IIIII1I111111 MMIIIII,VIII1IIIIII1111I1IIIIIII1IIIIII, =='MMMMMMIMM .. o . . °iii T� . ► .. �, . . I perc. rate 77 -i::.°* .,min✓ in. i between B.S.fi:��•.:..:,%�+�#.i; comments performed by:ins! certified by;""• "`date: Z SU,�FAI� !✓'9TcL� f,�GYL>-Ti%E UPPP EA.Si ,4.t//J ND.2Tr1 j,/,gtLS LUPff/GG Sio�'� ��vrC.P/NG TEST HOGS. -2W• T�/E ^/ ©F 7�E 5ue.� � .�GOk/ .9.�OuND i/1�' .QB�•E'i'TX�J�c/ T.�NG�fir T�/.E�OUGrSr TriE L/SC OF AN Ur�f,J/GG /p� ._ ,S"ur �'.�e�� rv�rri• ..,d�d1a �nr�r'�. / 4 lee !err lia�, �rddao� �v�TPr E'aroc�rrr,/�a� �•� OF Al i MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES p Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D.N 1. GENERAL INFORMATION 2. 3. 4. HAA # VA nct 1r.GGi� Complete legal description Lot 6; Stock 5; 74a.lts End Subdlv"ion Location (site address or directions) 11380 Stkogano6 122fve Property owner l eAlio ► K lnnnno t1 ynanJQ DayM Mailing address 11380 St2ogano6 D4ive, Anchouage, Ak 99 Lending agency Mailing address Day phone Agent Day phone Address Unless otherwise requested, HAA will be held for pickup NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well XX Community well Public water 3e S-�n a,� i64-2743 NOTE: 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 XX NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-0251Pw.1/91) From MOAM21 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 —S&S ENGiNEGRING Phone 17034 Eagle River Loop Road No. 204 Address G Engineer's signature Date 6. DHHS SIGNATURE Approved for �- bedrooms. M Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Q �) �� Date 9 / S — 9'2— The '2 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 _�condutf inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. +/91) SwA MOA 821 Municipality of Anchorage ARL Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT C / SCK S4 TAres En+o SIO Parcel I.D. A. WELL DATA Well type _HbORIE If A. B, or C, attach ADEC letter. ADEC w ter system number N Log present �N) TIAt� Date completed y �% Z Driller Ne t uua+v. Total depth O , Cased to - �/� Casing height '' - 1,1.'t Sanitary seal &N) IltS Wires properly protected &N) YFS W n FROM WELL LOG AT INSPECTION o o Q Date of test -9� ig-6-`j2 b LU k Z Static water level Sy �f Q r < ix 4 LUWell flow M g.p.m. /0C / 9.p.m� = W Pump level UK l�I IL SEPARATION DISTANCES FROM WELL TO: Septic/hoWW44ank on lot C ; On adjacent lots /� f r Absorption field on lot On adjacent lots m Public sewer main - OJA Public sewer manhole/cleanout Sewer service line 3-S,+ Petroleum tank NONE knp(I#J WATER SAMPLE RESULTS: Coliform Nitrate — 3 ma-lt Other bacteria - n Date of sample: S -y`9 �- Collected by: S & S ENGINEERING 7034 Eagle River Loop Road No. 704 B. SEPTIC/10I000ING TANK DATA Eagle River, Alaska 99577 Date Installed 8- -�� Tank size 1!006 Gat Compartments Cleanouts(N). 063E-^ Foundationcleanout©'N) Depression(Y)G) NO �...�, d High water alarm (Y/& N�A Alarm tested tY)( I�N/A r��' Date of pumping 'S—� Pumper Aly(W-/ ! UAAP//Vc— SEPARATION DISTANCES FROM SEPTIC/HGUDWG TANK TO: Well(s)onlot .�5 ,'' - On adjacent lots. l�0 kf Foundation o2() I To property line �k Absorption field /0 �4- Wate?main/servicelirie %s Surface 'f water/drainage iW 14- 72.026 (Rev. 7)91) FOM - CONTINUED ON BACK PAGE LIFT STATION Date in led Size in gallons Vent (Y/N) !RP�on' Manufacturer Manole/Access(Y/N)el at "Pump off" level at. High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface D. ABSORPTION FIELD DATA t -Date installed soil rating`�o SF�Rlt system type T2 u `Length �03 Width" 60 Gravel 3•� f Total depth 1-LTotal absorption area ;?U '&F Cleanouts present (!ON) VES -D epression over field (Y/& Nd Date of adequacy test 8- 6-9 Z Results( as /fait) ?Ass for 3 bedrooms Peroxide treatment (past 12 months) (Y, fJ --rk)67 KNOww If yes, give date A'14 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot (OQ f On adjacent lots Property line 5 f To building foundation 35 To existing or abandoned system on lot u�a Onadjacentlots oZrJ r Cutbank "/,4 Water main/service line L10 f Surface water 11 �4o rA Driveway, parking/vehicle storage area �5 Curtain drain �1lvh ki.tSWn/ E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines In effect on the date of this inspection. OF AL S R S ENGINEERING i�P•••• ••sf �+ Signature res •. '•ti9 l� Eagle Rtvor, Alaska 99577 Engineer's Name •�•• •"" '•' Date ,1�, �.•ROG •SHAFER t W( No. 15 t �� V ,tll1`gOFESSta�� HAA Fee $ ��-Waiver Fee: S' Date of Payment 3 (q Z ' Date of Payment / 3( Receipt Number �c���g t'�7A 3 Receipt Number _ ZJ Z 72-028 (Rm. W91) Beck MOA 21 xC4UGACH S?A-?Fz PAA'c>�I Cs7RO6,q41O1- .ORIVZ. - �c$ EL.30 %%%%%%1 OF . %-%I :R SHAFER S too. 215 O TH711 �f'ELG I � I 237 M 2 STORY j r '`414/1-Y FRRME � n° oEck - 1000 cy SEPT TM+C EXSIST�NG Sc. 1K �yS. !P LoT �[i2A1l.S awn SufSQ. /�•b S�'TiCs PlITM A) 160,+ I WEcc. t i� � .s1b "REB�9R 0 NoTt Ecru. counnFtis N6'cCS 11071 Eagle River loop Road RODERT A. SIIAr E E sole rover. A1809 99511 CIVIL E.NOINE E e' TILL FLV I TEST DATA SHEET "' t94 291 I ROJECT: /Lai IF= ic SOA"(v M VA(4HI E DATE OE TEST: towioN Of WEtt (Lepel Description) �srr �r R[ e TR/+'r c f,D &,S.D WELL DEPTH. rr r . CASIN9 ��a 11, sbCk,EE�N�:,,� DATE DRPL ILtINO COMETED: 1 L I92 DRILLER. f r,r�� dv—,— STATIC WATER LEVEt(TopolCsslnp) - '%Us rt. DATE:_ CLOCK TIME ELAPSED TIME SINCE PUMOPP E,JAIN. I pEFTNiO DRAWDOWN/ PUMPING STOPPED, LAIN. WATrkm RECOVERY RATE,OFM REMARKS 0 (sv.0 1 66 ' no 10' J[i!/7ff FLn4J (Lv >=LILL is 2025 '20 ` s ao `, _ /P St 4 Pcunvse as 43 � Is � = y :40 so Se to(rrour) I `-- SI'Ll �g O 90 110 ).►.ours) ISO 5: 0 16017 tours) 106 6:30 ?to to4 :So 210 (l tours) Cycl.[N(r H+1pUGN-O -T TEs). RECOVERY 1 0 0 5 t0 t5 ?0 25 ao 1 no uar te^, e4ts0 aeM�.t as Comments: WELL-- p A MINiwuAA DF 6•S Gqucr: ^gin Occur. 'PBI- MINCA,y% OUC(L Fl FOWL- HdcAfl_ PrFiuk"D c4ti6i Municipality of Anchorage Department of Health and Human Services Tom Fink. 825 "L" Street Mayor. P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 September 15, 1992 Roger Shafer, P. E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 6 Block 5 Trails End Subdivision Waiver Request #WR920049, PID #015-192-35, RA920550 Dear Mr. Shafer; Your request for waiver(s) of the required 100 foot horizontal separation --of a septic system to a private well has been approved. The approved separation distance(s) are: a septic tank to the private well of 93 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely Daniel J. Roth Civil Engineer On-site Services ljm:#6 am Manager to Services MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR920049 PID# 015-192-35 HA# IIA920550 Permit # Date Received: August 31, 1992 Legal Description: Lot 6 Block 5 Trails End Subdivision Engineer: Roger Shafer, P. E., S & S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River 99577 Applicant: Leslie 1?Joanne M. Younie 9.7 Waiver Requested: Well to septic tank - -4.5-feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: x Waiver is NOT Granted: List Conditions or Reasons for above: S Ff 1 TT)9 CNT•6 Date: 9-- /,; - 9z By: Rec #: 23999 Amount: $ 410.00 r Date Paid: Aug 31, 1992 �I R/41 VEA RCgt LST fdT 107' 6 Eck S TRp/Lt ENO SaBO. WRIVER REQLcjesr .VkMQEIQ wR92Om49 ]bv/¢1vER REQLc E s r FOR 0A" -SITE w fLC TO 5ERT/C rr/,v f ox 9S,' SLPTU .O4r.9..- rkF SE-PT/C 7-l4NK /,v Qu F-Sr/oti /S A (,REEK -STEEL- i2 CaMPi4R7-K,ENT- MOO 6,09dl cti SEPT/C T/4Nh e VA'f r/da iTEt iJN /979 THE 7ANK{f o9r.TH/S T/HE 4,ERE ro.er7.,eA rrrt %-/ n-/ . �NI/fITr TO DC 14s4n _ 1./71-t L"rER;rItHr COupL/�vGI. rT.G.1�f N Ptu.vi<iP�ciTY 9�fPErrED �s�SIF/q. /ti U-N/C// TSF_ 1ASAFerve LOdJ Ti -CE._ i SEG/3RAr/vti AIS7, IV C E TAt E Tfi.Vk 70 t E( C :70 0E y3 %//L` SrPrIC WAS` ihrrAR THE Lv ELL Iti/g-1 IN. Tkc SEPT/t 7'19,vK /S LOC.vdTED DOwAl 6R4P1fN7- fRo,• 7-&e wE6L /N Vuefr/ov ON N O - /3 ;THE SfPTlC TfiNk Is guflucn iN So/LS rKAr 41eE ifiriorlov ;SILTY (2 90 ft�BfO>. w,�cc DRT — %kE WELL Op TN/S t oT k-AS IP79 7 �r0 (% ;!ILvELI 0/?/LLFR RS AILifV/f}L zyfirF_/?//tL. _ �ROr�_ 67 pro / ¢ FfCr /S ArPROC/C t,,1.7-H L•-/t 7-CR- I v _ fAY /992- nvE j;lwE1,L OED/?OCk TO /NCREi}SE I ;!!rkF Gr/9rrfl P/?or4 C no,vl re 22 0. FEET. A r&lrvey .'lof TkE _t�Ett cO6S /N T/-/E Su RRou,vp/,vG lJNalenrES r/rE 0F,017oCk /,v r/-I/f flR.rf/ /a/�S // rE.IiDE.oCy Ii T O E /'%KFK r-01101- r1YE S UR rfiCE T 6P0G,?fiA/{Y . OR . /.vCRfAs, Ii ,:;/N PfPTH A$ /T rOuT/a,uES DOiA Pfz OPE r0a./9RD TkE t !T/11 kEIC /N_Ccit6srlOti /� Gt/SLVOE f/�d•k T/rte s�Prlc T/3w/c ow A -/7 % st oFE. �'.,tv/�T'GR sR/'tir'LES Itit�/C/�-rE AB/gCk�Rou�vo.tiirR/4r£ FvFt. of /• My /f O cot /.r0?n . i, S 0f A. 0• E. C •. S. 0. lv. G, fur s . 1. R.' O. �;� POIe�Ts i ,.i 1 v6TER 7-138t 6 . i S4 �- l D Thug D£PTN = 44' i i" SO l L SO/q D T l Qd/ i 44 or f Sar �. S ii9ERrtE,9 ILDTY _� SlcT 3 ��'6vATFR TgDtE (,P.aDIFNT fl�Turt� lvORSr crrsE d e� ?. �i i.t l7ouT-!4L_tEyaR_ i9_ r/vav x=.7+ 2 2.7 is 6 /? D To ire E 17. 2 (�ODVC Z (�L S/ati i] G R&,v-r w/iive p% �i NEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ANDREPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PEPCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN August 28, 1992 Muni,cipatity o6 Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Boz 196650 Anchorage, Ataska 99519-6650 REFERENCE: Lot 6; Block 5; Traita End Subdivision; ROBERT SHAFER, P.E ROGER SHAFER. P.E. CIVIL ENGINEERS (907) 694 FAX 694 1211 o15- Iola -36 Lt -)Qq QbkoxA`i This tetter is to request a waiver boa the separation distance between the weft and the septic tank aerving the se6erenced property at 95 it.. The weft on the 4e6ehenced property was initiatfy d4ifted to a depth o6 114 6t. in Aptit 1979 by Foss Dtifti.ng. In May 1992, the wet wits deepened to a depth o6 220 it., by Suttivan water wetfa. The septic system was inatafted and .inspected in August 1979 at which time the septic tank was insta ted teas than the sequined separation distance o6 100 6t., to the weft.. For the 6ottowing seasons we beet the separation distance paescnibed in 18AAC.72 may be waived to 95 6t. in this case: 1) The encAoachment is upon the septic tank onty. Generafty speaking, a septic tank does not aerve as a continuous bounce o6 contamination as wound a teach6iefd.l 2) Due to the drainage patterns o6 the se6erenced .Tot (see attached) aur6ac.i.ng e66tuent 6rom the septic tank woutd not travel towards the weft, rather it woutd travel away 6rom the weft (to the west)., 3) The tog 6or the re6erenced weft shows bedrock at the 60 to 70 6t., depth. Topography o6 the area suggests that bedrock. probabty 6ottows the contour o6 the tand (atoping to the west) suggesting that subsur6ace migration o6 e66tuent would be directed away 6rom the weft lather than towards it., 4) Sohl tests on the se6esenced property show that ao.i.£s are mainly tight silty sands which woutd 6urther detour migration o6 e66tuent towards the aqui.6m. 16 you have any Gunther questions pteaae contact ua., S.ierety, 61fffP..WILLIAMS Civit Engineer ROGER J. SHAFER, P.E. RJS/gm 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 INSPECTION APPOINTMENTS�C,'' DA CEIVED STREET LOCATION` t6e TIME TIME TIME C 1O,FF lam SINGLE FAMILY ❑ One ❑ Four ❑ Other DATE - DATE DATE INSPECT INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE �sxA�1t,B0CIpWTYOFANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTTOItr OF HEALTH & OEC. 825 L Street •Anchorage, Alaska 89501 PROTECTION • EWIRCNMENTAL ENVIRONMENTAL SANITATION DIVISION OCT171979 Telephone 2644720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWRSE45NA-ED DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPE TY OWNER PHONE 1 MAILING ADDRESS Zk-A IJox 9 A k • 94 0 PROPERTY RESIDENT (lf different from above) PHONE 2. BUYERy� H NE _ e1 e I s�• MAILING ADDRESS �R R .1-ag 24a'2 3. LEN ING INSTITUTI N `� PHONE d 1n rT: LALtr►�r MAILING DORESS 94 (D 0. REALTOR/AGENT � PHONE MAILING ADDRESS 6. LEGAL DESCRIPTION Lo 6 S f �hd �tLb . STREET LOCATION` o I. (go 6 UIRM E1.'Fnet,ee,- �urr� Mme u.c ,>,rK 6. TYPE RESIDENCE NUMBER OFs6EDR0 MS pyo M 1O,FF lam SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY CRT Three ❑ Six 7. WATER SUPPLY P INDIVIDUAL- *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.) S. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE" _1()_I9 YEAR ON-SITE SYSTEM WAS INSTALLED. /❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEDL 72-010 (Rw. 6/79) Aloj4 t'4-pK-S.r� t'4- r,.(J. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ 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 91-19 INSTALLER ❑Sepjy'�Tank�or ❑Holding Tank Size: zi If Tank is homemade give dimensions: /CDD SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sewer Line - Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS Cf —APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE lobc 1'Y 72010 (Rev. 6/79)