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Home My WebLink AboutSILVER CREST BLK 2 LT 7Silver Cres Block 2 Lot 7 #015-062-38 Municipality of Anchorage Pag, 1 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 34;3-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Numben SW000483 PID Number;. 015--062--38 Name:JUDY WHITCOMB Wastewater System: [] New · Upgrade 6963 LOVITr CIRCLE ANCHORAGE, AK 99516 ABSORPTION FIELD Ph°n~:(907) 346--1160 13Deep Trench lB ShaIIow Trench 1:3Bed 13Mound LEGAL DESCRIPTION 0.8 ~,o/s~ ~. 11' (e DEEPEST POINT) 7 2 SILVER CREST 7 n 4 - - - 0 ~ 75 WELL: [] New [] Upgrade 5 ~. 1 ~ ~ 750 ~. ~. ASTM 0-3034/ F-810 ~ EAGLE MOUNTAIN EXC. 11/20/00 - 11/21/00 SEPARATION DISTANCES , s.,,c a .old;nO a S.T.C P. Fierl~ Station Tank ~ ~ CREER 1250 we~l 100'+ 100'+ - - 25% STEEL 2 loo', ~oo'+ - - - LIFT STATION Surface Water Une 5'+ 10'+ -- -- -- FoundaUon 5'+ 10'+ -- -- -- '~'~'~ "' ~ ~ ~" rr~ -~ ~ CurtainDmin NC~NE KNOW~I ~P~'~' ~-*,~d: ~ ~ p~.,~ ~. Remarks: BENCH MARK (~,_~) ~ ~ ~ TOP OF HOSE BIB. 100.00 Ins~ons ~ffo~ by: A~C, INC. Dates: 1st ~/2o/~ooo ....... j...FZ.~.~. ........ ~.~' ~ ........... ? .... 4~ ~ 2/6/2000 _7953......~z~ Depa~ment of Health and Human Se~ices ppproval ,~,'"... y~ ~'* ............ R~vlew~ and appmv~ b_ _ ote:~ '~~ P~"~""""~: AS-BUILT DRAWING SW000483 O15-062-38 '""":':'::.~:?" / /'/. ~ ~ ~2 ~., ~ , ~/8/~ooo ~.~:.: ...... ALASIGX WATER & '~X%STEWATER K.D.W. CONSULTANTS. INC. $cJ.~.:,, JUDY WHITCOMB (go7) ~46-1160 2 OF 3 SILVER CREST SUBDIVISION; LOT 7, BLOCK 2, AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE A B ST1 30.2 54.8 ST2 38.1 60.8 DBL1 39.4 62.0 DBL2 40.5 62.7 FD 41.3 63.3 C01 73.1 73.0 MT1 73.2 74.3 CO2 137.5 136.7 MT2 138.0 137.6 PERMIT NUMBER: swooo~ AS-BUILT DRAWING .*"C~'.O,~_OB2_~NUMB~: 5fl 9B.9 / , N~W 12¢0 ~bON A~SI~ ~ATER & ~ASTE~ATER CONSULTANT~, IN~ ............. CE SILVER CREST SUBDIVISION; LOT 7, BLOCK 2 PROFILE AS-BUILT OF SEPTIC SYSTEM UPGRADE ALAS KA WATER & WASTE WA TER CO N SULTANTS, IN C. PHONE (907) 357-6179 * FAX (907) ~58-5246 i · ISOIL LOG - PERCOLATION TESTI , LEGAL DESCRIPTION: SILVER CREST S/D; LOT 7, BLOCK 2, ' ........ ,~. ~'~' ......... DATE PERFORMED: ,1/20/2000 ~,J',.I"IiE--79~'3 ..: CONFIRMATION TEST HOLE - · ~ .=, ~ GW I--===: ORG 11--~[~lJ~lJ DATE READING CLOCK NET TINE WATER LEVEL NET DROP TINE (NINUTES) READING (INCHES) 12 19 PERCOLATION RATE- (HIN./INCH) PERC. HOLE DIA. 6' (INCHES) 2 TEST RUN BETWEEN - FT. AND - FT. · PERFORMED BY ALASKA WATER & WASTEWATER I, ( )r ~ , CERTIFY THAT THIS WAS PERFORM,ED ~1 ACCORDANCE WITH ALL STA-I'~ ~jNj I~ JNIClP~UIDELINES IN EFFECT ON THIS DEPTH TO DATE GROUNDWATER DRY 11/21/00 MUNICIPALITY OF ANCHORAGE Department of Health end Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Nov 16, 2000 Expiration Date: Nov 16, 2001 Permit Number: SW000483 Legal Description: SILVER CREST BLK 2 LT 7 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Judy Whitcomb Owner Address: 6963 Lovitt Cir. Anchorage, AK 99516- Parcel ID: 015-062-38 Site Address: 006963 LOVI'Fr ClR Lot Size: 52551 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under consb'uction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. ALASI(A WATER & WASTEWATER CONSULTANTS, INC. November I, 2000 Municipality of Anchorage Department ofHealth & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Well and Septic Design for Sih'er Crest Subdivision; Lot 7, Block 2 To whom it may concern: The existing four bedroom house is currently served by a private well and septic system. The existing septic system is in a state of failure and in need of an upgrade. One test hole was excavated on the property. The proposed septic system will be designed within the 30 foot radius of this test hole. We are proposing that a 1250 gallon septic tank and a deep trench type drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate ofO.8 gallons/day/ft2 should be used. 2. TRENCll DESIGN: a. Percolation Rate: 6.7 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. Number ofBedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 750 fl2 f. Total Depth: 11 feet (max.) g. Effective Depth: 7 feet h. Width: 2.5 feet i. Reduction Factor: Minimum Length: 55 feet long {~. Effective absorption area = 770 fi2 3. SURFACE WATERS: There are no surface waters within I00 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338°3246 * Website: akxvxve.com 4. TOPOGRAPllY: As can be seen on the attached topography site plan, the average topography of the proposed septic area is a 15 to 16 percent running from approximately north to south; in short, there are no slope concerns. The trench is to be installed parallel to slope contours. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Jeffre [.t Presi~ ~ ness, P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, one soil log, and a 7 page construction speci, fication letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwxvc.com ABBOTi' ROAD ~ REID VTd~lPf THIS WELL ~~'"'"----... /LOCATION PRIOR TO ,NSTALMNO ~. ........................... ~ PROPOSED ~C ~T B. CONSULTANTS, INC. aR~ FOR PHONE NUMgER: a~g NUMBS: ~..~..~ JUDY WHITCOMB (907) 546-1160 I OF 2 ~ ~ wo.~: ~,~o,..,~o~:~ SITE P~N FOR DESIGN OF SEPTIC SYSTEM UPGRADE ABBOIT ROAD /~ ~ ~ PROPOSED DRNNFiI~.D. ~ ~1~_._ __ ~ F~ET DE,T.P MAXI U , BY 2.5 / -- ~ ~' ~ ~ ~ FEET W1DE, BY 55 FEET LONG. NOTE: ~-I£ CONTRACT~ SHALL HAV[ ~H£ "~ ~ ADD 7 FEET OF CLF. a.N, WASHED ,SUER PRIOR TO ~ ~ON. / / . / ' ~ ~ ~ - / / / ~/..t~l~ ~.~ED ~"ED ,~/ ,- / ~ 11/1/2000 A~S~ JUDY WHITCOMB (907) 546-1160 2 OF 2 c SILVER CHREST S/D; LOT 7, BLOCK 2 DESIGN OF SEPTIC SYSTEM UPGRADE ALASKA WATER & WASTEWATER CONSULTANTS, 6901 DEBARR ROAD, SUITE 2B ~' ANCHOR,~GE. AK. 99504 PHONE (907) ~57-6179 · F~ (907) ~58-3248 ISOIk LOG - PERCO~TION TESTI LEGAL DESCRIPTION: SIL~R CR[, S/D; LOT 7. BLOCK 2. PERFORMED FOR: JUDY WHECOMB ' DATE PERFORMED: 10/5/00 j ~ ~..,,..~ ...' I TESTHOLE ~1 '~,,,~ GC OL .~--- SW NH SM OH SC DEPTH TO GROUNDWATER DATE D~ 10/5/00 I0 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MIN~ES) RE, lNG (INCHES) 12 ~0/~/~ 1 1:34 -- 6' 2 2:04 30 1 1/2' 4 1/2' 15 3 2:04 ~ 4 2:54 ~0 1 1/2' 4 1/2' 14 5 2:54 ~ 6' 6 5:04 50 1 ~/2' 4 ~/2' 15 16 17 18 19 PERCO~TION ~TE 6.7 (HIN./INCH)_ ~ / ~ERC. HOLE DIA. 6' (INCHES) COHHENTS: PERC-HOLE W~ PRE-SO~ED FOR 4+ H~RS PERFORMED BY A~ WATER · W~T~ATERm, ~, '(~;~' [ Y . CERTI~ T~T THIS W~DATE. DA~:PERFOR*g IN ACCORD~CE WITH ALL ~ATE fNIt//,/~ r~INICIPAL GUIDEUNES IN EFFE~ ON THIS DEPTH TO GROUNDWATER DATE DRY 10/5/00 DRY 10/12/00 DRY 10/22/00 ON-SITE SEWAGE DISPOSAL ,' ......... 344-7486 1.0.8' 780~76 Applicant: Location: Legal Description: k 17 ~ ~- Type of Soil Absorption System Is: Trench: Drainfield: Maximum Number of Bedrooms: MUNICIPALITY OF ANCHORAGE Department ~ Health and Environmenta-" rotection 825 ,, Street, Anchorage, AK. 99501 264-4720 * * * ~.-~_ HANDWRITTEN PERMIT * * * , WE~__~AND/OR ON-SITE SEWER PERMIT ~q 7,.~. ' ~/~.,~L~ Mailing Address: 9a~ ~, g~ Phone Muter: ~G~-~ ~'2 ~ O ~~ Lot Size: Seepage Bed: Holding Tank: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31j 1 9 8 1 * * * 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 instal], the system in accordance with codes. (3) I understand that the on-site sewer system may requir~enlargement if the residence~is remodeled to include more that 3 bed~o~s. Signe~: /.~ ~C~' ~~-v- ~/~ .. Issued by: Applicant SWP/024 (1/81) PERMIT NO~ FII::'P L. :[ CFINT ~..,OC:F]T I ON ~EGRL TY'f' :r. ON blRM I LTOI',I ,!i'-: SONS C:OI'.4ST l...~ B2 :..?.,.~I...',?I}.:R CREST L:;,,-"[:, 9400 ..,']'LIPZTER [:,R I..OT '!~; ~. ZE /:1:4.:I ?486 SOiL I'gSE;OIRI~:TION E;'¢STEM IE;: TREI'.,ICH vlf:'IX:[MIJM i'.,IUI'"I[:]EF:: OF I:.':E[)ROOFIS ..... :t. THE: REt;!U.IRIED ."L:; :[ ;~:E 01:: THE TIdE LENG'fH D :I:I'"IENE;I ON :[.'_:.; THE LE:NGTH ,:: Z N FEE":T) OF THE "ll'RE~",tI:::H THE [)EPTH OF R 'TF.'.EI',tCH OF.'. PIT .rS THE D~S"R:qi".ICE E~[~:'T't4EE:N THE ~:;UF.'.FF:ICE OF GROUND RF!b 'rile 8OTTOI'4 OF THE 1::;.:',:4CR',,,'FIT :[ ON ,:: :1: N r:EET). THERI:~: :.~.% NO SET !dI[)TH FOR Tf;.:'.ENCHE2;. "['FIE GRI::I'v'EL. I)EPTH I'5 "file t-,1):N~MLIM [:,r!:F, TH OF C:iF..'FIVEI... 8ETHE'EN THF!: 01..ITFFIt.t.. I::IN[) THE E:O]'TI]M CIF THL:': EXCFI',,,'RTION (:l:lq [:'"EET::,. ~]If4 I Ill Rr:*PL I OF~i',l"r FIRf:; THE RESF'Ot'.,IS ]1 E: I L I'["¢ "FO 1: ND'ORFI 'f'H .'[ NSTf:;:II.J..RT ]: ON I 1'4SPE(:Y['): ()[*',1.":-:; (][:' FIN'¢ !-,IEIZ.S FiDJRCEN]' 'TO TIq ]: S F"ROPERT'.r' Rlql';, THF:: ',IUM[¢ER OF" RESIDENCES "I'HR]' THE H[:::L.L I*I:[LL.. :F:;ER'v'E. OF' I":I['~ITI :5"r':ii;'l"El"l H :[ THOLIT F ]:i',IFIL I I',tSPECT I ()lq FIN[) FtPF)RO"/RI.. E:'¢ TH :( ?iil; I.,.I:[LI. F:~E ~;U:F:L)'ECT ]'0 P[e:'.CI.':.::';[~:CI..IT]:CIi'..I. ',il ['.]): MLJM [:, I :E;TRNC:E [.:;ETI-,.IEEN f:~ I,][~1...l... RNr::, [:ti'.,l~.rI ON.-:-.J_'; :[ TE ~-.:,EHlaGE :L:'aO FEET FOil;'. a PRZ',,,'ITFE t,.IE:I.L~ OR :LSO TCi ;;;:: O (.:ii FI:£ET FF.'.OI'I F'I PUE:LIC: I~.[[:~:L.l.. [)Ef:'EN[:i:[NI.'~ LIF:'ON THE "F~r'F'l:/ 01'::' .'.IELL. LOGS FIR[::: [;'.E(::!IJ):F.'.E[;, FtI"~D I"11J~;'F 13E RETIJF.'.NL::f) 'FO THE E:,EI::'FtRTMI:~]",IT 14ITH:(I",t 3:0 [:,F:I"/'.::; OF THE HELL C:OMF'I...ET]: CrFHER I-;::E)]:!UIF,:EMENT::i; MI::I'¢ F:IF:'F'L'-/. '.'~;F'EC:[F:i'CI::IT:[OIqS¢ FII'.,![:, (::ON:E,;TRI..JC:T):ON [:, ;[ laCq:;:FIM'.:; F:tRE FiVFI:[ LRSI...E 'FO ~( N'E;URE F:'f;:OPEI;~'. ]: NE;TFII...,LFFI' I OIq. I C:ERT):F'T' THFIT :t.: I FliVl I:::'f:IMII.If:]R !-,.IITH 'rH[:.' REQUIREMEN]'S FOR ON,~-SI'FE SE'.'t.,llERS FiN.F.:, ::'()[;;:TH 13'.r' THE f'ltJi'.,I :[ C I PFII. )'. T'¢ OF:' FiNC:HORFIGE. ;:_': ]: H:[L.L. IN'.i!;'f'FiLL THE ~.:,'¢STIEM l'N FIC:COF,:DflNCE H.T. TH THE CO[:,ES. ~:: ).' L.IN[)ERE;TFiIqD TI*IFiT THE ON-:::;Z'FE ':.:.;EHE:F.'. 'ig./'/.:.;"FEM f"IFW r-::E6!UiRE E]qI..I':II:;;:G[.::MI!EI",FF IF '['F'I[: :;?.[!:i:::i;]j[:,l!B'..t[;:l.}: ];::~;.,~IvICI[::,I.~]...E][:,/'T'O,/I.NI]:,...I..I[:,[::-~"//"'¢.,.~ ' -.~~ ~--" I"]I]R[~: THI:II".' 4 '"~ ~'es, At what: Denth? ....... 2ead~nq I Date grr~ss Ti!:-~e [¢et T~,~e Denth to H20 ~et Drop c, rco]at~on Rate ~ nute Pr~,pese4 Instl~]'~at~o'-~{: Seer~a~e P~L Dra~n f~e]d Death of Inlet [:,c~)'Ci~-?o"-:S6[Yon', Of P~t Or Trench RETURN TO: Division of Geological and G tslcal Surveys (DGGS) STATE OF ALASY~ )001 Porcupine Drive (TeJe~ a: 277-6615) DEPARTMENT OF NATURAL RESOURCES Anchorage, Alaska 99501 WATER WELL RECORD U.S.G.S, Local No, Drilling Company Nam~ Drilling Permit No. LOCATIOti OF WELL J Please complete either ia, lb, or lc...: A.D.L. No. la. i~3rough Subdivision Lot Block Ih. Fraction Section No. 'rownshlp Range Meridian / / / N/S E/W lc. Distance and Direction from Road Intersections ). OWNER OF WELL: Address: Street Address and Area of WelJ Location 2, WEt. L LOG Feet Below 4. WELL DEPTH: (completed) Surface Elevation Date of Surface Completion Ma~erial Type ...... ' Top Bottom . . ft. 6. usE: [~]Dom~stlc [~]Publlc Supply [] Industry __~ - ~ . . . [~]lrrlgation [~]Recharge [~Corr~ercial .... []Test Well ~Othor: ~' ~ ~ 7. CASING: ~ Threaded ~Welded .... 8. FINISH OF WELL: Type: ..... 0latter: SIo~/Mesh Size: Length: 9. STATIC WATER LEVEL: ~ ~A~ve ~gelow land surface .... Type of Measur~nt; JO, PUMPING LEVEL below land surface ......... ft, after ~ hfs, pumping g,p.m. ~,~(~i I r f~ . after ~ hrs. pumping ~ g.p.m, ~-r ~xl ¢ ~3 ~. PUMP: (If available) HP -'- Type: ~Sub~rslble ~Recl~rocating ~Jet ~Other: ~q, REHARKS: 15. WATER WELL CONTRACTOR'S DERTIFICATION: Form 02-WR Copy,Olstribu~ion: ~HiTE - 5ta~e DGGS, PINK - Driller, CAHARY - Customer Well Owner_ M-W DRILLING, INC. DRILLING LOG Use of Well Location (address of: Township, Range, Section, if known; or distauce main road Size of casing._ Depth of Hole_ Static water level ft. (above) Screen ( ); Perforated ( Xeet Cased to. .feet (below) land surface. Finish of well (check one) ). Describe screen or perforation_ Well pumping test at ..... gallons per (hour) of drawdown from static level. open end ( (minute) for____ hours with Date of completion_ WI~LL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ); __ft. TO__ ...... TO. _TO~_ ....... TO~ ....... TO ..... TO_ __ 2'0. TO ..... TO. .2`O. .TO TO. ........ _TO___ 3 -- CONTRACTOR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AN[;) ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date /O '- ,/ ~ - ? ~-=~ GENERAL INFORMATION (s) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) 'ApPlicant Name ;)'" E-*¢'.'"' '+¢' Telephone: Home _3'-/~- 2 <'3 F ,'2' Business Applicant Address __~'-, ? ~ ;~' i_.o.,>, 'fi~ ,£~ ,;,-~ /¢_ (c) Applicant is (check one): [.ending Institution iD; Owner/build . ; Buyer []; Other [] (explain): (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address -relephone (f) Mail the HAA to the followina address: TYPE OF RESIDENCE Single-Family 'E~- Multi-Family [] Number of Bedrooms Other 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 [] Holding Tank ['~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 7~-025 n~,m~) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 ~ pr_'. £ Telephone Date /0 '- ,!'¢ '- ~'~' S "~ DHEP APPROVAL Approved :~: Disapprov -Ferms of Conditional Approval Conditio~'l O ..... /~ ..... ,..-~ CAUTION The Muncipality of Anchorage Department of Health and EnviFonmental Protection (DHEP) issues Health Authority Approval CeFdficates based solely upon the repFesentations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALI2% OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A4UNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ,¢IRONMENTAL PROTECTION RECEIVED A. WELL DATA Legal Description: _/~0~' ~ Well Classification ~[ U~L~ If A, B, o~ C, D.E.C. ADp~oved(Y~) ~ Well ~ P~esent~,) Date ~leted /~/~ Yield Total ~pth ~/ Ca~d to ~//~/~ ~pth of Grouting ~/~ Static Water ~1 ~/ ~ ~ ~t At ~/ ~asing ~ight ~ve Ground ._ j. ~ f Sanitary ~al on Casing ~lectrical Wiring in Conduit (Y~ ~¢~/.~ ~pression ~ound ~llhead.(~ ~ Sep~ation Distance f~ ~11: .... .' To ~ptic~olding Tank on ~t ]~ / ~ ; ~ ~joining Lots To ~arest Edge of ~sorption Field on Lot' ';~/~ ; ~ Adjoining Lots To Nearest Public ~ Line ~ (~ ' TO Newest Public a / ' . Clean,t/Manhole ~? To ~est ~ ~rvice,Line on ~t Wate~ Sample Collected By ~~%/ . ; ~:te Jl ~, Wate~ S~le Test ~sults ~,~TI3 SE~IC/HOLDING T~ DATA Standpi~s~) Ai,-tight Caps.) Foundation ~leancut (Y~ P~ing~intenan~ Con~act on File (,Y~) ~ ; for Holding Ta~ High-Wate~ Ala~ (Y~ ..~ Te~ra~y Holding Tank Permit (Y~) Separation Distance f~ ~ptic~olding Tank: To Water-Supply ~11 ]~/'~ To ~ilding F~ndation To ~o~rty LJ.~ ~ To Dis~sal Field To Water Hain/Servi~ Line ~Ob '~ To S~e~, Pond, ~e, ~ Major ~aina~ , _ . Page 1 of 2] Receipt # ~o71~ Date Paid: /?~,/~D Amount: / '~ 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed y/~.~/7- ~ Width of Field ~/ ~ Type of System Design Length of Field ~ Depth of Field /gP Gravel Bed Thickness Square Feet of Absorption Area ,~'~ Standpipes l~esent ~N) Depression over Field (Y/~ __ Date of last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply ~t~ll /~) /~/-- To P~operty Line ~--~ / To Building Foundation ~/J(~ To Existing or Abandoned System on Lot /~7//~ ; On Adjoining Lots 7~ ~ To Water Main/Service Line . j~/~'~ To Cutbank(if present) TO Stream/Pond/Lake/or Majo~ Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ,~i~/-/f~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested fo~ Electrical Co, Lents s /;/-"Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA HAA @aidelines in effect on tP~ date o~ thi~ inspection. Signed ~4~ ~/~ Date Company ~--~ ~_a_~ MOA No. KB1/d5/s [Page 2 of 2] 2-15-84 k_ MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARI/~ENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATF, 1. General Information Application Date. (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address qr directibns) (b) AppliCants Name Appli~'ant s Address Telephone - Home Business Real Estate Co. & Agent Address (f) Telephone %YPe of Residence Single-Family'' Multi-Family~ Number of Bedrooms.~ ML~/~jthe HAA to, the following address: Other (describe) Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status° Sewage Disposal - ,- Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. E~ngineerin8 Firm Providing_In~pgctions~ .Tests, File Sear~h~ Data and Information e As certified by my seal affixed hereto and aa of the validation date shown below, I verify that my .investigation of- this Health Authority Approval shows that the on-site water supply and/or w~stewater disposal system is safe, functional and adequate for the number of bedrooms ~nd 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 complianoe~with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection° CAUTION THE MUNICIPALITY OF ANCHORAGE DEPART~NT OF ~ALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSOES ~ALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-. ATIONS GIVEN IN PARAGI~4PH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERFD IN TEE 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 REQUIRE-. MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. 'i~EE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. RR4/ej/D18 [Page 2 of 2] 7-19-84 PUMP & WELL B837 H.~F~ ! STREET A~OP~GE, ALASKA 995O7 ~7 -- 344-0732 PhoRo: I~.~ption: 1002co,5 Date: Well Depth: P~np Depth: Static Level: Ti.m In: ~ Out: i' // - ' ' Materials ................... $ Labor ....................... $ Total /unount Due ............ $ How Paid: Check # VISA Cash Work Ac.c~.p. ted By: Motor Winding Resistence (okras) Start Winding:. Run Winding:. Idle Amps:. lind Amps:. ALASKA eI1LIIROFImeFITAL COFITROL $ RUIC S, IFIL 11/29/84 JAMES CARTE 6963 LOVITT ANCHORAGE AK 99501 SELLER - JAMES CARTE BUYER - JUDITH WHITCOMB SUBDIVISION - SILVER CREST BLOCK - 2 LOT - 7 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 536 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 767 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON12/1/84 . FLOW TEST ON WELL THE WELL FLOW RATE WAS 7 GPM FOR 2 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. D A T E: 'TO: FROM: SUBJECT: ,}'~.~.iy 6, 1.9811. RJ. sk Managemc',n[: ~[oa].(:h aF~d Ehv]ronmenLa]. Prohect:.ion S:LLves (h:'esl:: SubdivJs'Lon Nnci. o?,ed J.s a par'l:Jai plat map for S~].ve~:' Cuest Subd:Lvision. NoLe ~he !oca-hion of t:he welL1, on Eot: ? and hhe sewer on ]l,o t: 6, The ~,/e!l~ dephhs :[n thah area are: Lok 6 Block 2 ..- 1.20 fleet; '~.~oh 7 I.~i. ock 2 -- 140 feet; igor 8 Block 2 ~, ].80 fee['. The dep(hs I gave yot~ eve~ the phone are ebvAously incocrech. Tha name and add]-ess o{' the owner }{.~sha BLll:'rls }3erden S~a:' Route ;', Box Anchorage, Alaska 9950? i hope {.h:ls '] nfo:n'.~al: ion wi].l, be of some he].p ho you.. Robe rt C. Pt'akt, 2.S., ~ · / bATE RECEIVED INSPECTION APPOINTMENTS TIME TI'ME DATE DATE DATE MUNICIPALITY OF ANCHORAGE PEPT. OF I-IEALTH & D~PARTMENT OF HEALTH & ENVIRONMENTAL PROT~I~MEN~AL 82~ L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION .RECEIVED ~EQUEgT FO~ APPROVAL OF INDIVIDUAL WATE~ AND SE~E~ FACILITIES DI~[CTIO~g: Complete all parts on page 1, I~ompl~te requests will not be pra~ssed, Please allow ten (10) days for proeessinfl. ~ PROPERTY OWNER [ PHONE MAI ~ING ADDRESS PROPERTY RESIDENT (ff different from above) PHONE 2, BUYER PHONE ~AIklNG ADDRESS ~ LENDINGIN~TITU~ION ''' ~ PHONE MAIklNG ADDRESS 4. REALTOR/AGeNT ~ PHONE MAILING ADDRESS 4 o4 5. LEGAL DESCRIPTION STREET LOCATION ~. TYPE OF RESIDENCE E~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [~] Two [] Five E~ Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) ) c/,? ' 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY .YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EAcH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY '-7"-~ ~ Connection Verified ! iNSTALLER []Septic Tank. or F-I Holding Tank Size: / ~3 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS ! [] APPROVED FOR ~ BEDROOMS [~-"~CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev, 6/79) ' (,: :;'?:-; '- /' ,..,: ::: ,:.?// ANCI.I()RAG: /,I.A.dO\.k ~01 (fi07) 264-4111 G::(;RGI~ ~v U~ I\P/~ ', ~iAYOI Hay 2]., 198]. P, obe-_st ];:. Wh.i they Sta~? Rouhe A ]3ox Al!chorage, A]_aska 99507 Sqbjec[:: Lot 7 block 2 Si].ve~:' CA.=. t Subdivision ApprovalL for t:he individual, sewer and wa'her facilities cannot he grar~'ked unkJ], the fol. l. owJ.ng ikems have been complet(~d: J_) Ph:: wai~er ,.m,.tl ........ reporh needs ~o be submi.~.bed to khi. s cfC.ice fr:'om t:l'~; Cnen Lab, 5633 B S~reet, for our (2 ..ti (3 ( 4 The weii.], seal }toads L~o b(; t:[.ghl::ened sc} that it is water tight. '.l'his wi!! ~3eed {3o be reinspected by this off'kce when completed~ 'i'he sept:~(-: i-.ank pumpex't v~J. tha recei_pt: submit:ted ~.o hhJ. s office. The we].], is coaled seventy('/0) Jleeh from the neJ. ghbo]r's sewer sysL~:m.. The Veklui!red protective radius between well and sewer i.s one-hundred(100) feet. The sevenky(70 feet distance was approved by khJ_s deparhmenk khrough an j I'IspechoF~ S (~CI?O]7. {L'hd) well wi. L] need one-..I~undred(t00) feet lfrom any seWeF syshem. may EJ.Le a claim w~th thc Hun.i.cJpa]. Claims re-.zimbu]csement:, of the new well. /11~{ t:.here are any quesi:ior~s, })]_ease; ca].l hi'tis office Robert: C. ]-'~:akt, R.S. Assoc:laLe Spt;c: a] :Jst RcP/:I jw C C: i,cs N. Bnchhollz Roll R. St:r:ick] and C1 a J ms Of:l!:i c:e FvltJJ'qtCiI'/d i ~ ',' ',;): ./\NC', ,()!~/.',(iiL DEPT. Oi: I!~ALTH & .: : Df:PAI:i'I MFN I' [)1. HI:Ai Iit t', I.NV RE f~riEf~i Al iU~OI[EC ~'~RONMENI'AL [%.C:i'ECTION ' ::: ~:' , N0V ~ 0 t978 ~,,..LU .... I F()RAPPI~OVA!.OF iNL-tlV[i)U/Xi,WA-fEI:~ AND?i:V' i I I I iqUl_.-~ IPLE FAMILY COMMUNITY ~rnce June ?/F, [:m v, allsch'Hled ['~h)~ ~otimt da~,., give well , F'UBI_iC UTII IFY chu~ih ~[tad~ioftif ~vxdah'~.) ~ ' INDiViI.)UAI_/ON-Si i%: I,: Wsccn~ i:; r,vm t'¢.,o 12) yeus oki an nd(xiu~x;y t~;:it is f',.i(iLliled i'UBI.tC l.I'1 I I. iTY hV ' [ ,.I (), : PR(ifii,SSiNG CAI'~ ~'' !f~JlI'IATI ['i, INSPEC i'ION FEE MUST ACCQCViPANY Tills SIDE FOF', (): £1At l , [.', LCiICFJS: - ': ' . /'/['1] O[' I~I~$IDEF.~C[~ NUR,11:H-:R OF BEI)H[-)OMS ',~I F!G L.[i FAMILY I ~.J ONE .i~]I.TIPI.E FAMILY i 3 iWO :' FOUR [.] SIX IFU')IVI DU,~kL DEPTII OF WELL COMMUNI ] Y DATE DHtl LED ................................... ['Llt?! lC LITtLITY (;, n.~ecdon V,.~fi M I.OG RECEIVED i .i ,;;:W/VH; I)!SPOSAL SYSTEM PEIIMIT NUMBEll .... MANtJFACTUR[~I~ ~ ~ APPROVEI3 FOR . ~ I~EDI]OOMS '. } C(dxH)ITIONAI.. APPROVAl. (lettm n~ust accumpany certificate) I DISAPPROVED