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HomeMy WebLinkAboutTANAINA HILLS LT 25  Municipality of Anchorage :;:~ .,~,, Development Services Depadment .'~_~ Building Safeb/Division '~ .~' On-Site Water and Wastewater Program, 4700 $. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page [ of,~ www. ci. anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number: 5 ~ OIO ~)¢ PIDNumber: 011-- WastewaterSystem: E]New I~]Upgrade Well: ~ New D Upgrade e.~ ~ r,. ~ · ~ r,. SEPARATION DISTANCES ~se~ic DHo~ding DS.T.E.P. DOthe~ To Septic Abso~tior Lift Holding Publ~al~ Tank Field Station Tank S~r ~e f ~ V "~" BENCH MARK S & S ENGINEERING DevelOpment Se~ices DepaHment Approval PERMIT NO SW0J 0226 PAGE 2 OP 3 Municip. olii: oF' .A.n._c h.o..r' g g.e. DEPARTMENT OF HE~.THAND HUIVlAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 ~._Anchop~geo Alosko 99519-6650S Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LOT 25, TANAINA HILLS S/D P.I.D. NO. 011--051--0~ .-" ',, LOT 19 ',,,x',,, .~'~ NDEVELOPE LOT 23 .. c7 / \\ \ \ \ \ \ \ \ \ \ \ \ 24 Ov (DIVERTER LOT \ \ \ \ \ \ \ \ \ \ \ , \ . \ CL£ANOUT P£R~IT NO SW010226 PAG£ 3 OF 3 D ........ M u~i,_c i p, 9 !.i .'J: ¥_o. F .A.n_c h.o.r' a g.e. I-'HAl-~/r"lbN/ UP HI::AL/H AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION p.n. Box 196650 eAncho,'age, Atasko 99519-6650eTelephone, 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 25, TANAINA HILLS S/D P.I.D. NO. 011--051--09 ST1 FINAL GRADE/ ST2/78.9' EXISTING 1000 GALLON SEPTIC TANK CO1 ~~_~_~ AL GRADE I ~J~LdCOt = ?3.4' IC02 = 73.4' ~-MTI = 69.2' · NO WATER FOUND 63.2' B.O.H. A B ST1 97.0' 91.0' ST2 103.0' 97.0' DBL1 107,0' 101.5' DBL2 108,0' 102,5' DV 110,0' 104,5' C01 106,5' 102,5' MT1 102.5' 101.0' 002 73.5' 79.5' 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 Date Issued: Jul 06, 2001 Expiration Date: Jul 06, 2002 Permit Number: SW010226 ~Legal Description: TANAINA HILLS LT 25 Design Engineer: 0003 S & S Engineering Owner Name: Michael Williams Owner Address: 6035 TANAINA DRIVE ANCHORAGE, AK 99502-1832 Parcel ID: 011-051-09 Site Address: Lot Size: 58133 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of' [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All 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: Issued By: Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Sile Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.cl.anchorage,ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel LD. Permit Number Property owner(s)/'~/'~- ~ ~1 ¢ / Mailing address (1) ~ ~ Mailing address (2)~~, ~ ~?~0; Zip Code Legal description (Lot, Block & Sub'd.) Legal description (Seclion, Township & Range) Lot Size Jr ~ ~q. FI. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Day phone Well Only Water Storage Jacuzzi . . Water Softening Unit I certify that the above Information Is correct. I further certify that this application Is being made for a Single Family Dw6111ng and Is In accordance with applicable Municipal Codes. S & S ENGINEERING ,~.d~2' ~_ 17034 £.gl. River L.p R.d No. 204 . - Eagle Rivert Alaska 99577 (Signature of property owner or authorized agent) Permil Fees: Date ol Payment: Receipl Number: (Rev. t2/00) 0 0 Waiver Fees: Date of Payment Receipt Number: June 20, 2001 ROBERT C. COWAN, P.E. CML ENGINEERS (907) 694-2979 FAX (907) 694-"12 I1 ~74. TEST MUNICIPALITY OF ANCHORAGE Development Services Depmtment P.O. Box 196650 Anchomge, AK. 99519 REFERENCE: Lot 25, Tan,aim Hills Subdivision It is requested that you issue a permit to upgrade a septic system to serve the existing three bedroom dwelling on the referenced property. Two test holes were excavated and percolation tests performed on 9/25/92. The approximate locations of the test holes are located on the attached site plan. Ground water was monitored and after seven days the hole was dry as shown on the attached soils logs. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, RCC/N3 Enclosure 17034 NORTH EAGLE RIVER LOOP ', SUITE 204 · EAGLE RIVER. ALASKA 9'3577 1" = 60' 0 DESIGN SITE-PLAN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAl. DESCRIPTION:/~'T 4- 5' 6- 7 8 9 10 11 12 13 15' 16' 17- 18- 19- 20- W/7~4 CtTTLE DATE PERFORMED /~l~..~,T~'o~wnship. Range. Section: WAS GROUND WATER ENCOUNTERED? /~-~ S IF YES, AT WHAT DEPTH? p E O~p~ to Wzlu SLOPE SITE PLAN Gross Net De~3th to Net Reading Date Time Time Water Drop ;10 ~ 5 ~,~ ?" I ~/~" ~1~ 5~' ~a" / ~/~,. :~ ~ ~ ~,/~', :~ ~ ~'/y' (~" PERCOLATION RATE (:~f'l~' (m,nutes,,mcn) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND (;~ FT COMMENTS PERFORMED BY: S 3. $ ~.HGh~IEER lNG I F~/~EcT ON/HIS CERTIFY THAT THIS TEST WAS PERFORMED IN t ;'." ' Y'~,3le River Loop Road No. 204 ~.~__ ~ ~ ~ ACCORDANCE WITH ALL ~T~ E AN~UIDELINE~ IN EF DATE. DATE; 72~ (R~. 4~) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN S~:RVICES 825 "L" Street. Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAl. DESCRIPTION:/J~T 1 4 6- 7 8 I0 Wt?H ,T~o~E. DAtE PERFORMED: }~ICL5 ~oZwnship' Range, Section: WAS GROUND WATER ENCOUNTERED? SLOPE SITE P/AN 11 13- 14- 15- 16- 17- 18 19 2O IF YES, AT WHAT DEPTH? Depth Io Water After ~ Moniloring7 .l~l~/ Oa~ I0!ZL/ctL' Gross Net Depth to Net Reading Date Time Time Water Drop ~',,o lo ~'/~" I~ ~o ~o 6~'' I ~" PERCOLATION RATE 6.2- Im,nules~,nch) PERC HOLE DIAMETER TEST RUN BETWEEN ~rT~ FT AND ~_.CO FT COMMENTS $ & $ £HGINEERING I ~-'-~ ~'J CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED 17034 E;.gie River Lcop Road No. 204 / ~. o - ~ ~----~ ~ ACCORDANCE WITH E~B~"P~'~I~t~..-~t~I~j~t~UIDELINES IN EFFECT ON THIS DATE. DATE. 72-(~8 (Re~. 4/85) ~041. TEST TEST ROBERT C. COWAN, P.E. CML ENGINEERS (907) 694-2979 FAX (907) 694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 25, Tanaina Hills Subdivision June 20, 2001 GENERAL: The scope of this project includes the verification of the 1000 gallon septic tank, replacement with a 1000 gallon minimum septic tank if required, and a new trench to serve the existing three bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shiffing of the tank. 17034 NORTH EAGLE RNER LOOP * SUffE 204 · EAGLE RIVER, N.A..~ KA 99577 Page 2 Lot 25, Tenelne Hills Subdivision June 20, 2001 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield them shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 fi. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (rafted-up) before gravel (sewer rock) placement. Once the gravel is installed, thc distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert ofthe distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 25, Tenalna Hills Subdivision June 20, 2001 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must 10c constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM FSI0 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafl 140N, or equal) must be installed between the final leachfleld gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the//200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wast,water disposal system. These inspections will occur as follows: Page 4 Lot 25, Teneina Hllle aubdlvlslon June 20, 2001 The first inspection must be conducted after the excavation of ditches, pits, ~'enches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be hackfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER Municipality of Anchorage Page l ot~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report ~ ~ .~. ~ ~ ~ . Wastewater System: ~ New ~Upgrade ~ ~ Deep Trench hallow Trench D Bed ~ Mound FJOther LEGAl_ DESCRIPTION S°ilRating: ~,~-GPD/Sq. Ft. TotalDopthfromoriginai~a~e: ~ Block: . Subdivision: Peplh to pipe bottom from original grade Grave depth beneath pipe ~' ~Ft Township: [ Range: ~ Section: Fill added above original grade: Gravel lenglh: Number of lines: Distance et eenlines: eEL, L: B New D Upgrade Gravelwidth: ~/ Ft. SEPARATION DISTANCES Cs.pt~ ~ Ho~di.g ~ S.T.E.~. TO Seplic Absorption Litl Holding )ublic/Private Manufacturer: Capacity i~ gallons: Material: Numb~ Compartments: Surface O~ Water 1~`+ I¢% -- ~ ~ LIFT STATI Curtain ~ ~ ~ ~ PumpM~de~ B~tr,~l InspecUons performed by: Location and Description: Inspections performed by!Tea4 ~,1o Rive~ Loop Ro,,, No.~es: lst_[l~ Department of Health and Human Services approval Reviewed and approved by: ~v~-~' Date: 72-O13 (Rev 9/91 ) MOA 25 Permit No. ~,~[~-~:~z~_ Page of Municipality of Anchorage DEPARTMENT OF HI-'ALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343--4744 On-Site Wastewater Disposal System and/or Well Inspection Report PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW920363 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DUNCAN RONALD A 50% & OWNER ADDRESS:6034 TANAINA DR ANCHORAGE, ALASKA 99516 (UPGRADE) PERMIT DATE ISSUED: 10/21/92 EXPIRATION DATE:10/21/93 PARCEL ID:01105109 LEGAL DESCRIPTION: TANAINA HILLS LT 25 LOT SIZE: 58133 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ! ROBERT SHAFER, P E ROGER SHAFER. P E CIVIL ENGINEERS October 12, 1992 (907)694.2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL iNSPECrlON & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, AK 99519-6650 REFERENCE: Tanaina Hills Subdivision, Lot 25 We request you issue a permit to upgrade the septic system serving the referenced property. Two test holes were performed on the property. The approximate location of the test holes are located on the attached ~ite plan. The monitoring tubes within the holes have been checked and found to be dry. This property has enough area for a future septic upgrade, which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. Sincerely, Roger J. Sharer, P.E. RJS/LSU/lsu b/tanaina 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 I"=50' SCALE UPGRADE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502~0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: '-EDAL DESCR'PT'oN:Lo A, ~:-~ { ,[/~ C/"~,/~J DATE PERFORMED: fllu_~,Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 13- 14 15 16 ~:~ 0, I~,, 17 18 19 20 SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? o P E Gross Net Depth to Net Reading Cate Time Time Water Drop ~ ~o : z~e~ -' ~" :~ ~ ~v~' : ~ ~ ~ 5 ~ ' , ~ ,/~ ,, PERCOLATION RATE ~1~-__ (m~nutes/mch) PERC HOLE DIAMETER _ TEST RUN BETWEEN _ ~ FTAND . (~ __FT COMMENTS PERFORMED BY: S a S ~[NGINF'.ERING i ~/~ . CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ~E~;~3~,~aD~UIDELINES IN EFFEC~ ON THIS DATE, DATE: 72-008 (Rev, 4/85) Municipality of Anchorage DEPARTMFNT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCR PT ON:.~ r'~,(~j ~--,'~-/'-J DATE PERFORMED: ~' ~9 Section: H{tj~5 ~o~wnship, Range, o rec.- 1 2 3 4 5- 6- 7- 8- 9- 10- 11 12 13 14 15 16 17 18 19 20 SLOPE SITE PLAN ~>O, H WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~--- ~} DEPTH? p E Depth Io Water/~Der ~'~ Gross Net Depth to Net Reading Date Time Time Water Drop ~-~c A',~ ~ ~'/v/' PERCOLATION RATE ()' ~ (m~nutesMnch) PERC HOLE DIAMETER TEST RUN BETWEEN ~1~ FT AND 5, ~ FT COMMENTS S & S ENGINEERING I ~--2./~ PERFORMED BY: 17034 Eagle River Loop Road No. 204 ACCORDANCE WITH ~[~i~TI~i'T~i~,h~I~I~/GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED'IN DATE; ~''~ ~ \'~--~ ~"~' GRF "ER ANCHORAGE AREA Bg Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 'JGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTfiM LOCATION ~'~'~(~ '~A/~'~, 'L~ ~ LEGAL DESCRIPTION ~-'~(- :~' ~-' MAILING ADDRESS ~C)~,~- T~¢~'-~', ~O/U~, PHONE SEPTIC TANK: DISTANCE FROM WELL ~7$- INSIDI-- LENGTH -- MANUFACTURER . INSIDE WIDTH____ MATERIAL LIQUID DEPTH NUMBER OF / COMPARTMENTS' .LIQUID CAPACITY /'~-~ GALLONS. SEEPAGE PIT: NUMBER OF PITS j . DIAMETER __ L,N,NG CR,B S,ZE: BUILDING FOUNDATION___ . OR WIDTH__., LE NGI'H~_, DEPTH DIAMETER ~ DEPTH (,.¢' DISTANCE FROM: WELL / -FOTAL EFFECTIVE / NEAREST LOT LINE __ ABSORPTION AREA (WALL AREA) ~¢/cr'/C SQ. FT. ADDITIONAL ABSORPTION WELL: BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION (D NEAREST NEAREST LOT LINE '¢~)-'~ SEWER LINE'~ DEPTH_ DISTANCE FROM: SEPTIC __l SEEPAGE TANK "~ S SYSTEM /~)-0 ¢' OTHER SOURCES _ DISAPPROVED REMARKS DISTANCES: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No, EQ-031 DIAGRAM OF SYSTEM GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL C~UALITY :3330 "C" ST]~EET ANCHORAGE~ ALASKA 99503 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND P£RMIT SOIL TEST RESULTS --~~/~ NOTE~ THIS PERMIT IS NOT V~LID WiTHou'r SOIL TANK SIZE ~ ~) '~'' / '~"~'~' SEPTIC E/~ ~d,~ TYPE / SEPTIC TANK,/%9~ _~, SEEPAGE PIT /~__, DRAIN FIELD GRAVEI~ BACKFILL. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. LICENSED DESI(;NE~ "One test is worth a lhousand opinions" renal Qescrin'iion: ~ ,lock Subdivision_ This ;orm Re~orts Soils Lo~~-~.- Percolation Test. .neath Feet Soil Characteristics I~'- .... :--:----.. ~ .... --.~ Was Ground Water Encountered?__/~ I~ Yes, At what De~th? Readino Date Gross Time Net Time Depth to H.O Net Dron Percolation Rate ~{inute Pronosed Installation: Seeoa¢le Pit ~.I -.~> Drain Field Den. th of Inlet , Denth To Bottom Of Pi~ Or Trench. Cn"!~E.NTS: I*0 0 .~-.4'~)~'~ ,,'~Z?'7 ,: ;'~ r~~ u/red Test Performed By ~~.~. .. Data Certified By: Performed For Hoyman Local ~lescristion: Lot 2~5 Block l'his Form Resorts Soils Loq ~es PeDth I¢ YeS, /1, t whdt !ir, fi') j Readinq !~ate I qr'n!:;s lime i Net lime J Denth to I!,~0 Net Pron Percolation Rate Hinute ......... Proposed Installation: Seeoaae Pit 2es Drain Field De,)th of Inlet Depth To Bottom Of Pit Co~ENTS: 27.~ aq:~--~'~'~1~a ~eq~re& pot bo~oom Test s e e~p aide pit ', Performed By ,r~m Mack Data Certif' ~'d B~:~Ool~sti'~oti~m q}~!&~,'..::::,~! Municipality of Anchorage Development Services Department , ,. ~ ,.. .... ..~ .... . .. Building Safety Division ~ ,, , :, . , On-Sit9 Water a6d Wastewater Pro'gram . ~., .: Anchorage. AK 99519-6650'. " .-' -:,~ ~ .....: : : . :www.cl.anchorage.ak.us : ,' ... (907) 343-7904' ' CERTIFICATE OF HEALTH AUTHORITY APPROVAL ........ " FOR A SINGLE FAMILY DWELLING · ',011-05-109 Parcel I.D... . ;I; 'GENERAL. INFORMATION {'-;c ;'C°mplete ega descriptionLot 25, Tanaina Rills Subdivision '~ _ Locatlon (site address or directions) 6035 Tanaina Drive ..... ,, Michael Williams · : ,..',.CurrentPrope,rtyowner(s) Dayphone 248-3849 "~...-"·'Mailing' .... address' ?' 6035 Tanaina- Drive, Anchorage, A~ 99502 Lending agencY. Mailing address Real Estate Agent Mailing A~dress Day phone. Unless otherwis~ requested, HAA will be held by DSD for pickup. 2.: NUMBER 'OF BEDRooMs: 3 · 3, .TYPE OF WATER SUPPLY: Individual Well [] individual Water Storage [] Community Class Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for propedies served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. Day phone. Expiration Date:. /O - .~,.o - o I 4. STATEMENT OF INSPECTION BY ENGINEER , As certified by my seal affixed hereto and as of t~&'~,ali~atio/~ d~ie shown' below. I veH~ ~at my Investigati6n. 'based on proceeures outlined tn ~e Heal~ 'AuthoH~ ~prs~al Guidelines for ~is appli~fion, shows ~at ~e on-site ~ater supply and/or wastewater disp0~al ~y~te~ Is(a~e) ~afe. functional and ad--bate fdr ~e number of bedrooms end ~pe of s~cture Indicted herein~ I ~er veH~ ~t b~s~d on ~e Info~ation obtained from ~e Municipali~ of ~chorage files and from'my I~vestlgation and inspection. ~e on-site water supply and/or wastewater disposal s~tem is(are) In compliance'~ith all appli~ble Municipal and State codes, ordinances, and regulations In effect at ~e time of installation. S & S [NGINEERING ' ' .- --. Phon'e ' ~ -~7~ . .... · . .?.. '. , .{'.~.'.~- ~ .~GINEE~ .. .. : x%.;~.~.).~. . ~ .. ,_ . . :: .- *1,~,2-;.. ",,,.,'~%~ --, Disapproved. Conditional approval fo~ ' '.- ' -b~d}Oo~,'~it~ th~'f~llowing stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~-.,~. 0 - 0 ( Municipality of Anchorage Development Services Department Bulldlng Safety Division On-SEe Water & Wastewatar Program 4700 South Bmgaw St. P.O. Box 196650 Anchorage, AK 99519-6G50 w~w~.d.anchorage.ak.us (~07) ~-?~4 HEALTH AUTHORITY APPROVAL CHECKLIST LogalOescripfion: J..O'T- ~,~' T pa,H. ParcellD: 01) - A. WELL DATA Data completed u ] K Total depth 16 .+ ft. if A, B, ar C provide PWSID # -- · San~ s~ 0~) Y ~ J' Cased to ~0 "/' ff. FROM WELL LOG Date of test / Static water level Jl~///' fl. Well production / g.p.m. Well Log (Y/~). Wires properly protected ~1) Casing height (above ground) AT INSPECTION I~"~ in. WATER SAMPLE RESULTS: Coliform O colonies/100 mi. Data of sample: ~ ] I ~ / 0 I Ni~'ata . O. S'" mgJI. Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material ~XPTIC / Tanksize ~000 gal." Number of Compartmen~,__ Foundation cleanout ~_.~) co.~ Depression over tank (Y,tl~ ~O High watar alarm (Y/~ C, } l '~ / o l Pumper Re 7o C. ABSORPTION FIELD DATA Other bacteria 0 colonies/100 mi. S & S ENGINEERING 17g~4 Emgle River Leop Read Ne. 204 Eagle River, Ala~ra ~577 "2-. Cleanouts (~N) ¥ · J Date instal'led "?/I"a,/I~ f Soil rating~or ~/bdrm) O- ~' Length S ~ ft. Wioth &"" ft. System type Gravel below pipe Total depth } O ft. Eft. absorption area ~ ~0 ~ Monitoring tube Date of adequacy test N/,~ -' ~.~ ~., ~,~ Results (Pass/Fa~.,~ Fluid depth in absorption field betom test In~er added gal. Elapsed Time: min. ~th in. Absorption rate >= Any rejuvenafi~~3a~-12 mo.) {Y/N & type) If yes, give date Depression over field ~' 0 For ~ bedrooms New depth in. g.p.d. LIFT STATION Date installed 'Pump on' level at in. Datum .~'~Cy~es tasted E. SEPARATION DISTANCES Size in gallons ~ ~' High water alarm level at Meets alarm & drcult requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank)lift station on lot Absorption field on lot Public sewer main ~/"~ Sewer/septic service line On adjacent lots On adjacent lots ]oo + Public sewer manhole/deanout Hol,,ng k · .,v SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~ 0 '-J' Property line /"/'-""' Water main ,k// Wells on adjacent lots / SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / Property line ~ ~' Building foundation ~'O t~/.- Water Service line / 0 ~ Surface water / o o -~ Curtain drain I~o,,~ ~. J~,v,~ Wells on adjacent lots / 0 O ~ COMMENTS' . Absorption field Surface water /oo '-I- wa= main Driveway, parking/vehicle storage /o0 G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal mco~ls that the above systems are in conformance wfth MOA HAA guidelines ~n effect on this date. Engineer's Printed Name ~"*~-~-C. ~:~g~/J,J /o Date "TJJ ~ I HAA Fee $ Date of Payment Receipt Number (Rev. 12/00) '? //I,/e / Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99619-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # -J(~'~\\-- (~;;~,\- (~";©) HAA# /~/'~q ~.L~'¢~ GENERAL INFORMATION Complete legal description Lot 25; Tanaina Hills Sub.vision Location (site address or directions) 6035 Tan~ana DJ~ve Property owner Mailing address Ronald A. Duncan Day phone 4150 W~St 88th Avenue Anchorage, Alaska 99502 I_ending agency Mailing address Day phone Agent Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: ×X Individual on-site Ho[ding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature '17034 Ea.q~e Eiver Loop P, oad No, 204 Phone Date SIGNATURE Approved for Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAl. CHECKLIST Legal I:::)escription.'~C~cl'~t'~'(~b. ¢:%' I~, L~ '~-~LX-¢".~. Parcel I.D. A, WELL DATA Well typ~ ¢~ If A, B, or C, attach ADEC letter. Log present (Y~ h~ Total depth ~~ Sanita,'y sea~/N)~ ADEC water sy§tem number Date completed ~ Driller Cased to ~LO '4- Casing height Wires properly protected(~d~N) . y Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot l~?~~) ~ Absorption field on lot t~t~ I Public sewer main Sewer service line LOG g.p.m. AT .SPECnO. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATEFI SAMPLE RESULTS: Coliform ¢ Date of sample: I J ~ ~'¢--1 ~- Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed t l Cleanout ) High water alarm (YN~. Date of pumping Tank size J &)(DO ~ 4~ L~_ Compartments Foundation cleanou, (Y/~.:"~ I"--~/ Depression (Y~ Alarm tested (Y~ Pumper ~ ~ SEPARATION DISTANCES FROM SFPTIC/HOLDING TANK TO: Well(s) on lot 1~'~)/ On adjacent lots To property line_ ~_j¢~__~ I Absorption field Surface water/drainage ~ 4:~ d~ _Foundation Water main/service line 72 026 (Rev 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed ~ Size in gallons , .............~V~hole/Access (Y/N) __ Vent (Y/N) · "Pump ~t "Pump off" level at High water alarm level ~..-'" Cycles tested Meets MOA electric~.cte's (Y/N) __ SEPARATI~I~fSTANCE FROM LIFT STATION TO: We~,kYt On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ii - ~ Length ,;~7~ / Width '~' Total absorption area ¢:~)~ 4::) Depression over field (YO Results (pass/fail) f.-4 ~-~ .o,.~ Peroxide treatment (past 12 months) (Y~) Soil rating I .'¢-, Cd'"~'C/C'.--.i'--Z-- System type Gravel thickness Total depth Cleanouts present (~N) Date of adequacy test for if yes, give date t~)/'~''' bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot i~.~ ~, To building foundation On adjacent lots Surface water Curtain drain On adjacent lots Property line To existing or abandoned system on lot Cutbank l'd,~ h.-~ ~/ Water main/service line Driveway, parking/vehicle storage area tO cd-- E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA ~ Signature Engineer's Name Dste S 8, S £NGINEF. RING 17034 Eagle River Loop Road No. ~04 ~,~ -.,,~,, ,.,,,~.~.. ;;577 HAA Fee $ Dste of Payment \ '~L - ")~ -¢~ '?--- Receipt Number ~-'"~. k~ ~(~LI ~.. COO ~, q*~ 72 026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX:(907)561-5301 ANALYSIS NESULTS ioz INVOICE t 60446 Chemlab Nef.$ 92.6203 Sample $ 7 Matzix: WATEH Client Sample ID Colleoted Received P[ese~ved with L25 TANAINA HILLS S/D Client Name :S & S ENGINEERING UA Client Acct HOV 6 92 0 11:35 l~s. BPO~ : NOV 6 92 @ 14:40 hze. Req# AS REQUIRED Ordered By :R. SllAEEH PO~ :DODE RECEIVED Analysis Completed ; NOV 9 92 Send Hepozts to: Labozato~y Supervioor : STEPHEN C. EDE 1)S ~ S ENGINEERING Paxarnoto~ ResultB Umts M,thee Allowable Limits HITBATE-N ND(O.IO) m~/1 EPA 353.2/300.0 Sample SANPLE COLLECTED BY: 1 TeBte Performed ' See Special Inst~uctlon~ Above UA-Unavailable NDe None D~tocted "See Sample Rema~ke Above NA- Not Analyzed LT-Less Than, GT-Groate: Than ~.,,~-~$~S ~ember of ,he SG8 Group (SOCiO'O GOn(~rale de Surveillance) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CER"I IFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applio~nt ~ame ~~ ~ d~ Telephone: Home Applicant Address ~, ~,~~ Applicant is (check one): Lending Institution Business ; Owner/..~builde_r~; Buyer E]; Other [] (explain); (d) Lending Institution Address Telephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: -- Number of Bedrooms WATER SUPPLY Individual Well)]./'_...Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, SEWAGE DISPOSAL Onsite.,~ Public [] Community E] Holding Tank [] Not~: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 z2-o25 nt,84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of tile 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 tile number of bedrooms and type of structure indicated herein, I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm~ ~'~/~__~,,~/~'/~.~ .,.,~ Telephone __~ 6~/~/~,~_ Approved for Approved _ Terms of Conditional Approval CAUTION The Muncipality of Aachorage [)epartment of Health 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. 'rhe Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 ¢1/84) MUNICIPALITY OF DEPh O;: HFAL[!I & ENVIRONMENT/C PRO li~Ci ION AU(, 2, 5 1988 w ECT[ IV [! D MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Well Classification T__ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ~ Date Completed * ~ l¢0,[~,,1~. (/~)I,%¢' Yield Total Depth --L~ O ¢' Case~ to I~.O '*¢ "~ ) Depth of Grouting ~10~,.~ I~ Static Water Level ~ '~ 8 - ' Pump Set At ~rOO T Casing Height Above Ground . Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) _ '~ Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot "~'~ / .t- ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot _~,,.-~_; On Adjoining Lots ( To Nearest Public Cewer Line V~ ,/,~ To Nearest Public Sewer Cleanout/Manhole. Water Sample Collected by Water Sample Test Results _ To Nearest Sewer Service Line on Lot /J~ 0/'4, Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~/"~.~_ Size ~_O__ ~ ~ NO. of Compartments ____% Standpipes (Y/N) ~ Air-tight Caps (Y/N) L-~ Foundation Cleanout (Y/N) Depression over Tank (Y/N) ___~::~(. Date Last Pumped ~? Pumping/Maintenance Contract on File (Y/N) I~..~,,~ _; for Holding Tank High-Water Alarm (Y/N) __ ¢,~./.,,~. Temporary Holding Tank Permit (Y/N) ~/_~_ Separation Distances frorn Sep..iic~Holding Tank: To Water-Supply Well ~1~ To Property Line ~ To Water Main/Service Line ___.~bO Course Comments · To Building Foundation ~" ( .-~ ! To Disposal Field ~ "~ / To Stream, Pond, Lake, or Ma or Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ ~ '~ Width of Field '~ O / !oo ¢ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test f'~ Separation Distance from Absorption Field: To Water-Supply Well 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 ~ L~ To Building Foundation Lot ~ 0 To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Existing or Abandoned System on ; On Adjoining Lots ~ O '~"~ To Cutbank (if present) ~.~//~ Comments L, T ST^T O. Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that~ h. a~v,,cche~ifie, C'~r conformed to all MOA and HAA guidelines in effect on the date of this inspection. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal OEPARTMEN 825 Time Date Insp MUN lC I PAL I-FY HE!AL'Flfl AND EN ~RONMEiiT, RO1-ECTION b Street, Anchora~e. Alaska 99501 264-4720 Daue Received: Sop'member 29, 1977 Time REQUEST FOR APPROVAL OF INDIVIDUAL oEWLR AND WATER FACILITIES 1. Lending Institution Request: Alaska Mutual Savings Bank 274-3561/244 Mal_.lng Address: Post Office Box 1120 Phone: 2. Property Owner: Duane/Carol Heyman Phone: 243-5585/h Mailing Address: 6035 Tanaina Drive 99502 277-1553/w 3. Legal Description: Lot 25 Tanaina Hills Subdivision 4: Single Fami].y Residence: (x~ Number of Bedrooms: Four Multiple Family Residenee: ( ) Number of Bedrooms: Well System: Individual well (x) Community/Public Sysnem ( Permih# Dephh o.{ We].]. Well Log on I3_le Construction Bacterial Analyszs ( ) 6. Sewage Disposal System: On-site System (x) Public Uti].ity ( ) Permit # Septic Tank Size Absorption Area Installed 7. Distances: Installer Manufacturer Soils Rate /~ ~ Material Well to Sepuic Tank to Absorption Area to Sewer Lille Nearest Lot line Absorption Area to Nearest Lot Line Page ' TWO Depar~men~ of Healkh and Lnv_ronmenkal Profeckion Reguea'c f. or Approval of Individual. Sewer and Water Facilities Legal Description: Lot 25 Tanalna Hills Subdivision Affadavi% Aktached: Letter Attached: ( ) DJ_sapproved: ................................. Date: ....................... Department Worksheet: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 Fast Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL. SEWER and WATER FACILITIES Type of Inspection: MUNICIPALITY OF ANCHORAO~ D~PT, OF HI~ALTH & ENVJRONMI~NTAL pp, OT ECTJON SEP g 9 1977 RECEIVED CMRO_ VA FHA __CONY ~ 5. Name of Realtor or Agent: 6. Legal Description:. Location: 7. Type of Facility to be Inspected: No. Bdrms. ¢ Water Supply Type of Supply: Public LJtility ,Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) X If individual, date of installation 72-003(3/76) October 19, 1977 Duane 6035 '9anaina Drive Auchorage, Alaska 9950:~ Subject~ Lot 25 Tanaina I-Iills Subdivision BefOre this department ~ approve your request for and .war,mr approval, we will require a percolation t~st run on your existing system. See handout atta(=hed, para'~- graph B should be use~[~ Mak~ sure thesstandpip~s to septic 'kank are exposed so that the p~[~%pur will have no 'If %her percolation t~st fails '~o meet the ad(~gu~.cy test we ~ill require an upgrade of your system. A permit must be issued prior to any construction. ~if ther~ are any further qusstions, ]?lease contact ~khis office at 264~-4720. Sincerely, Robert Co Prat:t, [~an itar~an RCP/IJh Alaska Mutual Savings Bank Mortgage Lo~u Sec'tion Post Office Box 112.0 99510 GREATER ANOHO~G~ AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Rece~veO~. REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACII. ITI~S FOR "' ' 1. Approval Reqoested By:__ ,,~~,. Address ~ .......... 3. Legal Desc~zp~on: ~~.) ~ )~~ ,~_~~. 4. Locat~on.~ ~ , 5. Type of ~acJlity to be Inspected: Number of Bedrooms: A. Type g. Depth ........ C, Construgtion D. Bacterial Analysis' Sewage Disease]. System: 0~~ A. Installed B. Installer C. Septic Tank: 1o Size 2. Manufactorer D. Seepage Pit~ l. Size 2, Material E. Disposal Field: Tetel Length of Lines Distances: A, Well To: Septic Tank AbsorPtion Area , Sewer Lines , Nearest Lot Line , Other Contamination . ~3o Foundation to Septic Tank ",, AbSorption Area Absorption Ares to Nearest Lot Line ........ · · ltequest for Approval ( r. ndividual Sewer & Water Faeili Page Two 9. Comments~ Approved Disapproved Date Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, geFartment of Environmental quality DIAGRAM OF SYSTEM 'i corti'l'v that the information contained in this request for appraval to be a true arid accurate represe~tation of %he subjec~ se%qer an(] wa%er facilities located Signed Date July 19, 1973 Mr. Duane Heyman 6035 Tanaina [)rive Anchorage, Alaska 99502 SUBJECT: Lot 25, Tanatna tlllls Subdivision Dear Mr. Heyman: On July 18, 1973, a requegt for inspection was made on your sewage system . The sewage syst(~ was noted to be overflowing and not functioning properly. Th(,refore, this system should be pumped on a re.qular bas~s to be sure that sewage is not running on'lo the ground. Before the sewage systen (:an be approved on the subject property, the following will need to be taken care of: 1. A soils test must be obtained. 2. A permit must he obtained from this office when the soils results are available. 3. There needs t:o be a lO0 foot distance between the well and the seepage pit. 4. A 1250 ~allon septic tank wtllr, need to be instal3~ed. 5. The existing seepage pit will need to be caved in and filled with dirt so that it can no longer he used. If ,you should have any further questions on this matter, please contact this office at 274-4~61, extension 137. Sincerely, Robert C. Pratt Envtromnental Control Offtc lb RECEIPT FOR CERTIFIED ~/IAIL---30~~ (plus postage) STATE AND ZIP DOPE POSTMARK OR DATE -- ~PT OttAt'~E~VICE~ ~O~AODIT¥ONAL F~S~-- - I1El~lltl ~ Slow to~h~m ad(I d~io clbJiV~e~ i .......... -~5~ ECE 'T ~ With delivery to addressee only ........... 0Sd SERVICES ~ V i h delivery to addressee onmy~: .......... 85~ ' ' 2. Show o whom date amid wh(,~e doliverod ,, 35d T6 ADDAm~SSEE ONEY ......................................... :,..,,.,,.. ~Qd_. :~PEdmA~ m~EUik~ ~J~g ~o;ro,{.);o~),.,: ........................... (Fill out in Triplicate) -~. ~lame of person requesting approval,, 2. ' ~[ame of property~ owner '. Number off, be&rooms in house ~ b, Detergent Well data: a. Type ~ b. Depth----~ / c. Casing Size d. Distance from well to closest existing or proposed: 1, Sewer line 2, Septic tank 3 Seepage Area_ 5, Property Line 6. Other sources of possible contamination~ i.e,~ creeks, lakes, houses, barn~ drainage ditch, etc. Sewage disposal system. a. Age of system /' b, Septic 'tank ' ' ~¢~ capaczty in gallons '7~'O __, c. ~lame of septic tank manufac'tu~r.__._.__~_~~~_~. 1. If "home made" show diagram on reverse side of this form. d.' Disposal field or seepage pit size and type__ . Distance to property line /~)~9! to hOUSe foundation Percolation Temt Vesul'tS f. Percolation Test performed by Use the reverse.aide of this form to show diagram, Diagram should include '"~'[he foJ].owlng information: ~popemty lJ. nes~,well loeation, house location, ~-~t~c tank location, disposal area location~ location of percolation tsst~ ~ direction of ground slope, 9. The i~£ox.,~tlon on this form is true end correct to the best of my knowledge, TO_. BE FILLED OUT BY HEALTH DEPARTI.~ENT' PERSONNEL [-~T~e above ascribed uanitary facilities are hereby approved, subject to the d ' ~6~llowing con~]i'~ions: ' -~ Conditions: The above described sanitary facilities are disapproved for the following re aeons: Signature of ....... .:. ~--rF 6..!, :,~ ..~ ~ ~f~l¢~'atv ' ' '"'-~ ...... Approval is valid for one year following the date of approval, CPJ: cw GREATER ANCHORAGE AREA BOROHGH 1228 EAST SEVENTH AVENUE ANCHORAGE, ALASKA PLAT STATUS DATE_ A1Rska Department of Highways City of Anchorage Municipal Light and Power Department Cit~ of Anchorage Public Works Department City of Anchorage Telephone Utility Assi§tant Superintendent of Mails Anchorage Natural Gas Corporation Chugach Electric Association, Inc. Federal Housing Administration Charles Harvard Spenard District Health District Gentlemen: Petition has been received by the Greater Anchorage Area Borough Planning and Zonin§ dommission for the proposed~34,~ i~,j;3/},~. ......... of subject property, Attached is a copy of the propo'sed plat. Will you please submit your comments in writing, specifying any easements or other requirements that your department or system may need. If we do not hear from you by. ~¢3~,//_~~- we will assume that you do not wish to submit any comments~ Our next scheduled meeting after above date will Ver~ truly yours, Gordon E. Harmon Platting Officer GEH:ms Attachment MAY :1.3 1961 ~REATElt ANCI [O}IAGE IIEALTH DiSTI~ICT