HomeMy WebLinkAboutSLEEPY ACRES LT 3Sleepy Acres Lot 3 #017-091-80 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .51/V920010 PID Number. Name: y�M � ��`/ Wastewater System: ❑ New ❑ Upgrade Address: ABSORPTION FIELD Phone: N of Bedrooms.2 J ❑Deep Trench ❑Shallow Trench kV Bed ❑Mound ❑Other �Deptl3;m — -- --- LEGAL DESCRIPTION -- Soil Rating: ), GPD/S Ft Tot/al 6;nel grade _ Lot: gg Block: % Sub/c�gvision: 3 lee / / s Depth to pipe bottom from original grade: �Y" JiA Ft. Gravel depth beneath pipe 2r �� Ft. _ Township: Range: Section:— Fill added above original gr do: '%! Gravel length: ? /) FL Ft. --- WELL:❑ New ❑ Upgrade • Gravel width: 1� Number of lines: 3 Distance between lines: 1 Fl FI. Classification (Private, A,B,C): Total De Cased To: Total absorption area: 3 Pipe material: A�9�/] ell Ft. Ft. SD, Ft. 3C_`�'3 Driller: �� Date Drilled: Sialic Water level: Ft. —� Installer � Q \1_ / �YA,Z, � Date installed /' /, ���'� — Yield: Pump Set at: Casing Height Above Ground: —y er�PM Ft. -- Ft. TANK __-- -- SEPARATION DISTANCES septic ❑Holding ❑S.T.E.P. _ To Septic Absorption LIII Holding ublic/Private Manufa turer:: _._- Capacity in gallons: From 'rank Field Station Tank Sewer Lines , /{%/J7a% Ile, Well' / /0 ) Material:/ Number of Compartments� Surface Water /Dv+ //JD 4_ - — LIFT STATION Lot Line lb 4- + Size in gallons: Manufacturer: Foundation / / "Pump on" level at: T Woo "level at: High water alarm at: Curtain,_ A �E 7� I _ Pump Make&M elm Electrical Inspections performed by: Drain - � Remarks:+ 4C) kytptQVI O-U/c�L (�4�rzt_�' —�—o_--- BENCH MARK . Location and Description:: '72A Assumed Elevation: Assumed ENGINEERS SEAL �y1e \�` Of• A ( 11 1� — v �p�E.••.....,,,gs, % a.r ..... ..........p ------- ' ', Dates: ''�.. Inspections performed by: 1 �� .� �1 .... ...: .....0 t 2nd -tr�9= ��rn1� K::.:::r!:I M. Uu y T�/ / �� P .• C 71 �1oy�op�fo;�7NP���-� Department of Health and Human Services approva Reviewed and approved by: _ �/� v - - — Date: ��� 92` _ � O,A �w 0 013 (Rev 9/91) MOA 25 AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SW970070 SLEEPY ACRES SUBDIVSION LOT 3 PID#017 091 80 23 E 140th Ave 22 EL=0.00 10' UTILITY ESMT, EL=0.00 ....... _......... ........... __...... .. ........._ b....: ._..... _. .... ........... ...................... n 6 D l SEPTIC � 0 F G CO 9 1p 0 EX ST. S STEM AB DONED !. c a I> A -C-17,2' COQ COEXIST STAN ANDONED B -C=30,10' 1000 S.T. A -D=23.20' cO C B B -D=30,86' FCO A -E=91.58' A APPROX. WATER LINE LOCATION 3 BD M B -E=89.19' SFR A -F=100.43' B -F=97.07' A -G=92.90' B -G=77.11' A-hi=101.64' B -H=86,10' LUT 4 L T 3 SCALE 1' = 50' 9Inn 95,31 4288,4135 a 89.190RIGINAL GRADE 89.28 'A PILITR IRRRIL VARIES N N 1000 GAL T 4 O1 SEPTIC 83.44 83.43 TANK 83,43 SEWER ROCK 83,42 83,45 83,43 ./ �OF AT \4 91,44 81.17 ......_.......L 4 91,65 —{I WITH = I5' */4 TH* ...,..0 —� SCALES NTS69.69 ami FUS CE -711 wa PREPARED FOR1 KND ENGINEERING w / 20441 PTARMIGAN BLVD ��/ iTOM SPENCER EAGLE RIVER, AK, 99577 pftlTS81OW00 / 7010 E. 140TH AVENUE (907)696-6111/Fax (907)696-8HI ANCHORAGE, ALASKA 99516 DATE: 8/8/97 �RpWING 7t SCALES AS NOTED e7o12—sl d� c OPP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 �sr G PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970070 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:SPENCER L THOMAS & CHRISTIE L OWNER ADDRESS:7010 E 140TH AVE ANCHORAGE, ALASKA 99516 PARCEL ID:01709180 LEGAL DESCRIPTION: SLEEPY ACRES LT 3 LOT SIZE: 49043 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: �, - /S--- 9 7 00/4. <h, DATE ISSUED: 4/24/97 EXPIRATION DATE: 4/24/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE SAND USED IN THE FILTER LAYER MUST BE] A CLEAN COARSE SAND WITH 4% OR LESS PASSING THE #100 SIEVE AND 20 OR LESS PASSING THE *200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE SAND USED OR OBTAINED FROM AN APPROVED SOURCE. / RECEIVED BY:DATE: ��" "" �' S ^ e)'7 ISSUED BY: DATE: 4 - 9/ KN 1) ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AI< 99577-8736 (907)696-6111/PAX (907)696-8111 April 9, 1997 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Sleepy Acres Subdivision Lot 3 - Septic Upgrade Permit Gentlemen: Following a request from the owner, we conducted an adequacy test on the existing septic system for the subject property. The system began backing up into the septic tank after approximately 200 gallons of water was injected into the field. The owner requested we proceed with the upgrade of the septic system. On March 2.2, 1997 we dug a testhole for the proposed upgrade. The results of this test are attached. 'The lot is served by a class "C" well previously approved by ADEC. The proposed upgrade system will be placed approximately 12' north of the existing system. As indicated on the site plan there is sufficient grade to maintain a gravity system. The 1000 gallon tank is damaged and will be replaced. Due to concerns with ground water we are installing 4' sand layer to provide separation from the accepting soils. As indicated by the site plan drainage arrows, natural drainage is away from this site and will be maintained after construction. There is no surface water within 100' of the proposed installation. There are no known curtain drains within 50' of the proposed installation. No wells exist within 100' of the proposed installation and the community well is over 200' away from the proposed site. This upgrade should have no adverse effect on development of adjacent lots. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, 1_KJFTD Engineering Kenneth M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test 75 a 0 Y N N i U 4 4 C5 rvl 0 WASTEWATER DISPOSAL SYSTEM/SITE PLAN SLEEPY ACRES SUBDIVSION LOT 3 ` EL=0.00 10' WILIIY CUR. EL -OAU SEPTIC SEPTIC o; PROPOSED NEW SYSi M 9 i1 C 4 ( E .•S ICM IX wa sa. r � APPRO (. WATER LINE LOCATION 150' APPROX. CLASS 'C' WELL LOCATION LOT 4 LCT 3 LOT 2 LOT 1 comm, Ity Water Community Water bmmunity W 24 21 NO PRIVATE OR PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED, 410 N AV OF ALS �KENNETII!CE S / CC 77' S 116 A; w t'ROFI;SSION Nti s LL=u.Vn LL=nau DESIGN CRITERIA 1. 3 BEDROOMS X 150 GAL./DAY/BEDROOM = 450 GPD 2, SOILS RATING: 0.89 MIN✓INCH = APPL. RATE 0.7 GPD/SF 3. 450 GPD/0.7 GPD/SF = 643 SF 4. 643 SF /15'(W) = 42.87'(L) 5, MIN. DESIGN SIZE = BED - 43' LONG x IS' WIDE x 0.5' DEEP 6. DEPTH OF GRAVEL BELOW PIPE IS 0.5'. 7. TOTAL DEPTH OF SYSTEM IS 7,0' FROM ORIGINAL GRADE. .ter Nf7TES: I. TIE INTO BED AT MIDPOINT. 2. USE 1000 GALLON SEPTIC TANK, INSULATE TANK IF <4' COVER. 3. INSULATE BED WITH 2' ED BURIAL FOAM IF <3' COVER. 4. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK, 5. INSTALL MINIMUM OF 4' OF SAND FOR SEPARATION 6. EXIST. TANK & SYSTEM '10 BE ABANDONED IN PLACE. 7. INSTALL FABRIC OVER FIELD. TOM SPENCER 7010 E. 140TH AVENUE ANCHORAGE, ALASKA 99516 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 4ni9i Municipality of Anchorage (T DEPARTMENT OF HEALTH & HUMAN SERVICES ,® 491H ,,,,,, ,,,.. 825 " L" Street, Anchorage, Alaska 99502-0650"am ti ..... SOILS LOG — PERCOLATION TEST �,�% Kenneth M. Duf' v �1 0,-'. • CE 7116 s Vii' PERFORMED FOR: O t� S2I")LI.sR_, DATE PERFOR LEGAL DESCRIPTION: S L�C'-'G-1Ll.j L J Township, Range, Section: Fr7l SLOPE SITE PLAN 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 I)e6aNl�� m� r*1Br> oWsS' koso(�. SPISW COurS`L _terzc .Leyho-a lza'�n Lao St', YA L rneo-o�c. ,o u WAS GROUND WATER 1 ENCOUNTERED? NO IF YES, AT WHAT DEPTH? — Depth to Water After Monitoring? _ "I t\ Dale: 't s19i Reading Date Gross Time Net Time Depth to Water Net Drop I aaz (0— z I 3 II q 3 2 y If t? to A - I S7o II _NKwZ)17WrwIG14_ � "� /I II PERCOLATION RATE "81_ (mmulevinch) PERC HOLE DIAMETER _'a TEST RUN BETWEEN _ 11 FT AND 12- _FT COMMENTS I T PERFORMED C'B�Y��La� CER"rIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 72-008 (Rev. 4785) MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION \\\\\\ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT --' PHONE NAME'"�'z /� > t, , / -rte- CL� Pte, U N\ R, F_ A— ., K y, t�1 T(2.iJ e I �'ir70 -J� Z U UPGRADE MAILING ADDRESS 1315 14 OP ii AmC(J__/ [,e_ 295o'6 LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS Uy. h- Z W I Well DIS7 bsorpwelling TANCE TO: I�OT �.t � ti on area Dwelling I Manufacturer ��Material R = S rj= L_ PERMIT NO. —-- �t,{�� //1_ No. of compartme iis Y l Liq. capacity in gallons Inside IEHOMEMADE: length Width Liquid depth ❑j DISTANCE TO: Well — Dwelling -- -- PERMIT NO. C7Z 02 FQ- Manufacturer Material Liquid capacity in gallons ❑ wU -- DISTANCE TO: Well ^I I ^' IN Foundation �B -r-- '� Nearest lot line — .�0 PERMIT NO. —®— g 0 //45 wa u.;2 F z w No. of lin s Length of Vch line '—J �'� Total length of lines Trench width ij (J inches Distance between lines --�—• Q O — Top of tile to finish grade n t �_ � �` Material beneath tile inches Total effective absor tion �7 f j h LengtWidth — Depth PERMIT NO. w U Q F a- Type of crib Crib diameter Crib depth Total effective absorption area ui LU ui DISTANCE TO: _ Well Building foundation Nearest lot line w Class TO: DISTANCE Depth Building foundation — Driller Sewer line — Distance to lot line PERMIT NO. Septic tank Absorption area(s) ---- ----- OTHER PIPE MATERIALS As7M- D -_z, L/ SOIL TEST RATING INSTALLER — REMARKS LL�`OGq{E.L�X� l•4.C- C.uO-F�VLu-z V-�. -- (/�✓flJ ^7I�— 10 �•• ••w•• • •• •'.d -,1_ r- P•• i••- •••••.w6••• c• P A - _ _ '0. oi, 2225-HInklir 19 10711 APPROVED DATE LEGAL --- 'LCL y /, 0 _: E Pv Ac n e 72-013 (Rev. 3/78) ' ` H -H Kj lyl 1: K0 1: FO" ril L..`1: "1- "FA CA FF ���F 4 CA FZ Fl C_ -i EE ` DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, HK 99501 264~472(--,1 K.Di V -4~ I 'T'EE ���E!il 0:-,-! 9 - il l: -T PERMIT NO: 840115 HAND WRITTEN DATE ISSUED: 04/02/84 APPLICANT: BOB RUNKLE R & || CONSTRUCTION ADDRESS: 481l BISHOP WRY ANCHORAGE, HK 99508 CONTACT PHONE: ]]8-1674 LEGAL DESCRIP: SUBDIVISION: SLEEPY ACRES LOT: �.: BLOCK: NH SECTION: 35 TOWNSHIP: 12N RANGE: ]W LOT SIZE: 49043 (SQ.FT. OR ACRES.') I CERTIFY THAT: 1. I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOH) AND THE STATE OF ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOH CODES AND REGULATIONS, AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. I I WILL ADHERE TO ALL NOR AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY EXISTING WELL/ WASTEWATER DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT. IF 8 LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOH BUILDING CODES. THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED/ (2) HS~BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT/ AND (]) THE ELECTRICAL WORK MUST BE DONE BY H LICENSED ELECTRICIAN. SIGNED____DATE: APPLICANT: BOB RUNKLE R & H CONSTRUCTION ISSUED BY ' DHTE Department 825 Pt 4 5'-/- o / /'r MUNICIPALITY OF ANCHORAGE: of Health and Environmental Drotection Street, Anchorage, AK. )501 264-4720 " # HANDWRITTEN PERMIT erma nWELL AND/OR ON-SITE SEWER PERMIT Applicant: Mailing Address: AOf3 /ic LL 1 _ -- � Location: Phone Number: -3- f/1�7`/ Legal Description: l__oT' -3, SL_C=E-til fief: -s Type of Soil Absorption System Is: T Trench: Drainfield: A _ Seepage Bed: Lot Size: `/-9 C, P31 Holding Tank: Maximum Number of Bedrooms: 3 Soil Rating(sq.ft/br) / 6--d X1 g�90 The Required Size of the Soil Absorption System Is: DEPTH 6 LENGTH S3� GRAVEL DEPTH WIDTHZ)C�r r74 76 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(Z) INSPECTIONS ARE REQUIRED * # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement the residence is remodeled to include more that 3 bedrooms. Signed:.__ Issued by: Applicant Date: "L-1/I"y SWP/024(1/81) if PERFORMED FOR I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 2044720 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: .> ICC 1�1 tre S DEP COL) (F4E 1 Pews. ana 1 I 1 2 I 3 I I 4- 5- 6 7- 8- 9- 10, Loi" 3 (tAL) i", <i If w) ;um< ,'.J.A [ "U'Irl (1hL) -}PIS 5:111- w.tl. no r. Ll;lr� SLOPE �+t < L1u<V S�•,� -••�cl ' ®'• \ W> C<��WAS GROUND WATER 11- ENCOUNTERED? IF YES, AT WHAT DEPTH? _ (I" aL, lx<' < D v0 / c— 21'-- SOILS LOG' �. r PERCOLATION��, TENT DATE PERFORMED: •> 1 �' + !J SITE PLAN S t. 0 P 4 s </, Reading Date 1 1 MEN mom Depth to Water M. 3,2657,( 00 r o cl o n Ak IN. • ' G9 e,o�'�9tJr f> • v -,.< Wei.. rai s 60.. i 0® S t. 0 P 4 s </, Reading Date Gross Time Net Time Depth to Water Net Drop 3,2657,( 00 r o cl o n Ak IN. • ' G9 e,o�'�9tJr f> • v -,.< Wei.. rai s 60.. i 0® c, •Reid, Lo y C. tA. 1r. ;7 — • PERCOLATI NT, ' ,roe•. �-(minutes/inch) TEST RUN BETWEh"S_- FT AND FT COMMENTS �Li / '/;, nl_�U�=1 /• <�i ,'(t � pP.< -A-r i" i/1eic '/,'r ar S IC.. CY<n S/I C_ f. Nr �n:.rN rFr YY� PERFORMED BY: Lir`"°� CERTIFIED BY: --DATE: e 07J /3�y 72.008 (%i/79) ALASKA RUIR01111611TAL COnTROL SRICCS, Inc. Engincerinq G 6ironmentol Studies PERCOLATION TEST DATA SHEET CLIENT ,JAIL C �rrCUn S� DATE ADDRESS ZIP CODE LEGAL LOCATION L it 9 TOTAL DEPTH OF HOLE %� ft. ZONE TESTED T _ft TO �.,� ft f -c I READING # ' CLOCK TIME NET TIME DEPTH TO NET DROP DATUM RATE (min/in) i-1--(2- r o 7 - y --- ----- - -- - -- - I __X7. 47 FINAL PERCOLATION RATE PERFORMED BY J��-d�n Ca �ro2 47%8i� J m lq e .• P : •'1. 1 ow co min/im �qp•p v �j °ee�' bJ CfJ4o �*t�i>� •°o� C. Paid, Jr. �y ALASKA RUIROnn MAL COnTROL SRRUICCS, Engineering & Enuironrnenlal Sludies PERCOLATION TEST DATA SHEET nc. CLIENT_JILL DATE~ ADDRESS ZIP CODER__ LEGAL LOCATION Lpr TOTAL DEPTH OF HOLE ZONE TESTED -_—..--_ft TO T _ Q____, -^-_-•-ft READING CLOCK TIME NET TIME DEPTH TO NET DROP DATUM 1, 07 -e- ' .37- - -- -- °- -- -�7 to TE (min/in) FINAL PERCOLATION RATE �_ (min/in) PERFORMED BY 01 / 149:04 `� ����" � 4° n° •ave• . A. �` �Qrl 4orcr C. Roll, .•. «�' �A r °e Ar.. � 3 i � s I I Ian 122.0 bsl 251h Auenue ° Anchorage, Alaska 99503 ° (901) 276-1361 tX SOILS LOG MUNICIPALITY (,F ANCHORAGE DEPARTMENT OF I4EALT14 AND ENVIRONMENTAL PROTECTION PERCOLArION TEST J 025 L. Street, Anchorage, Alaska 09501 2644720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: j_- �f �IYI A�V� DATE PERFORMED: -7 LEGAL DESCRIPTION:J^ Ot 3 1 Date Gross oRGAN7c moss Jwrk 61no1DN F .a�a va 3 Al 2 15 Wdtr`i Drop /0 n 7/30/91 1 o:ob ArA 4 s 0.. 8 ) NO+ hrOWVI'Sk_�resll c4lej-s1*H&4) 10 { 11 \ 1 2 END l"l10C� 13 Date Gross 14 Dep dt m .a�a va 3 Al 15 Wdtr`i Drop /0 n 7/30/91 1 o:ob ArA O 121 I O 17 l 0id/ Q -4.,01 1 CE19 6omliv pirf ,V'Voa e-i5 SLOPE SITE PLAN —_ S / WAS GHOUND WATER A/ S ENCOUNTERED? _L° 0 • L —�~— O P IF YES, AT WHAT E DEPEH? —_— —_ Reading Date Gross Net Dep dt m Net Time Time Wdtr`i Drop /0 n 7/30/91 1 o:ob ArA O 121 I O l 0id/ f7 //: v6A 6omliv PERCOLATION RAT[ / � � � (mmures/inch) / � -: :/r, �,%/ �^ TEST RUN BETWEEN Ff AND FT COMMENTS Spvr12 %L�11�S--Q SLl('-0..GE Lo r c�v PERFORMED BY: �/V. A.✓� Illers CAI CERTIFIED BY: _ DATE: 72008 (6/79) ,IUNICIPALITY CIF ANCHORAGE DEPARTMENT OF HEALTH AND L NVIRONMEN rAL I'll OTECTI ON 825 L. Streit, Anrho,.,go. Ahmka 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMEDF LEGAL DESCRIPTION: ILO 3/GSLUI'fi S b F I bark ro,a,,, f"ZA-+ � p � � 1 j _ — 2 3 7 / J - 8 9 O ly so( OG ❑ PEIICOLA T ION TEST DATE PERFORMED. 6 VTF ✓1 AfJ 10 Dale Gr,,%s Tim,! NotDepth '1'Nno Wa Ncl Drop 16 COD 7v 16 11 / 17 WAS GROUND WA FR S L ENCOUNIERED? / Q,®4.v�wva® O 12 P It YES, AT WHAT E DEPTH? 13 14 Dale Gr,,%s Tim,! NotDepth '1'Nno Wa Ncl Drop 16 COD 7v 16 A 4` ........... // :. 17 ••••. 8 V' INE C:10"q JON CE -4488 '••,:, Q,®4.v�wva® 10 20 PERCOLATION RATE TEST HUN UETWFFN -- F AND Reading Dale Gr,,%s Tim,! NotDepth '1'Nno Wa Ncl Drop I I - COMMENTS 5 nchl ©' 7 PERFORMEOSY: (•K). fj-P, ry CEPTIFIEU UY:DATE: 7 2.00 0 (6/7n) /�� - s' 1 I�IIInInI�pNf"tlY!'Alipt`nRNN140gAa�ullllnl illr�li{I�ugrru�Ilh;�yr�gllly�N�h4tlNAl6l'JN�'�h'@�tl,%V�nnlnlnlnlllllllnnnlulllllll��u�llllinnlln 0T {� STATE OF ALASKA t / DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE ^L for PUBLIC WATER SYSTEMS A. APPROVAL TO CONSTRUCT ��) U I F 4 d:) P�lens for the construction or modification of. i:AM1'I L :i, I, L,'..,_1I I r (. T d f:�, y- - r f7 - e_ r✓ publicwater system coated In _ 14fo( No> t+1E_ —_ , Alaeks, submitted In accordance with 18 AAC 80.100 by Aodj �Wr_ L—_ have been reviewed and are LV approved Q conditionally approved (see attached condltlona). BY TITLE DATE If construction has not started within two years of the approval date, this certificate Is void and new pi he and speclflostlons must be submitted for review and approval before conatructlon. B. APPROVED CHANGE ORDERS Change (MINROI oma no. or diNII III Nf$WO$l Approved by Date C. APPROVAL TO OPERATE I The "APPROVAL. TO OPERATE" section must be completed and aligned by the Department before on. water Is made available to the public, The conatructlon of the WS -i /��_S ae re Spublic water system was completed on — )_C,i�-X (date). The system Is hereby granted Interim approv I to operate for 00 days following the completion date, 9Y� TITLE DATE As•bullt plans submit d during the Interim approval period, or an Inspection by the Department, has oo firmed the system was constructed according to the approved plana, The system Is hereby granted final app vel to o ernte.� 10-1 -� ! !/`�� DATE 8Y j-�(prof, Tit S_LM ���-'4 fI C{ ,L 'f� r. 11 Y �Y u Ihd k 5 7,Y �.� 1 �w i. S DIBTRIDUTION: 1. WHITE • ENOINEEn (OOMN611 eNeM 1 rte ^ 7. YELLOW - WAUR 9Y97EFILE (eempldf U n 0) 1 WWW I z, o3. PINK • ENUINEEWMUNFe0R00011 (0011`014111Nlldn 0) 1ON0/ IRev. bIB'� M 4. UOLDENROD • MUNI.00R000H (OOMPIM 54010f, AI I STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION C C CONSTRUCTION AND OPERATION CERTIFICATE A. APPROVAL TO CONSTRUCT for PUBLIC WATER SYSTEMS �4a.1 - (7A- )J- n`SI�P�lans for the construction or modification of�c_940 rig S h I� 4� rr,?n,y� \ rr / �� / 3 jc� T1j -0-4- 2- �-3 public water system located In k)c oQ4P_ ---,Alaska, submitted In accordance with 18 AAC 80.100 by_&r' J have been reviewed and are L approved. ❑ conditionally approved (see attached conditions). _ s = _Fid �� 68 By TITLE DATE - If construction has not started within two years of the approval date, this ce)tificate Is void and now plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract ordor no. or deecrlpeee reference) C. APPROVAL TO OPERATE Approved by Date The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water Is made available to the public. The construction of the "TS ) . z ,'- 3 public water system was completed on__L - 2=�Q -- � � l —(date). The system Is hereby granted Interim approv I to operate for 90 days following the completion date. 4r L BA_ TITL DATE As•bullt plans submllt d during the Interim approval period, or an Inspection by the Department, has confirmed the system was constructed according to the approved plans. The system Is hereby granted final approval to Bery — By TITLE DATE Stora'Tc (�o„e's�— � t o..—t'rT-a �p T" S 7y'O Y- rl C t I a_' �,�' DISTRIBUTION: t WHITE - ENGINEER (CompleteY fl Cr 1 1 fCLLOW %NG Y 0 aAtERS9TEMFEIGomIletLfton G) ctlon C) - - 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 017.091-80 1. GENERAL INFORMATION Complete legal description Sleepy Acres Lot 3 HAA# hi �d �C7 Aq Expiration Date: 9— 2 S= U l Location (site address or directions) 7010 E. 1401^ Ave., Anchorage, AK 99516 Current Property owner(s) Bill & Patricia Bieber Day phone 345.5560 Mailing address Lending agency Mailing address Real Estate Agent Same as above Day phone Jerry Duhurst (ReMax) Day phone244.7237 Mailing Address 2600 Cordova St:, Anchorage.AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site" Individual Water Storage ❑ Individual Holding tank ❑ Community Class ; Well ® Community On-site Public Water System - ❑ 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 properties 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. (00/u Baa) aleoy!iao leul6uo� :A8 jeglO tioslnpy nnol8 IIaM }ioda�l s�aau!6u3 le;uawalddnS luos!npy wa;s (S ol;daS s;uawaaj6y aoueuepeW X lsiNoayO yyH :sluawyoe;;y :suo!;elndgs 6ulnnopo; ay; ql!m 'swoapaq ao; lenoadde leuoa;lpuoC 1dNo1SS3joyeo 8@ •panaddeslo •swoapaq — Jo; panaddy --,;7- 381"I Mus dSa '9 FI LOOZ E6 aunr algia sn;;np •W y;auuaH aweN pa;uud s,Jaaw6u3 LLS66 NV Tf3 'PAIS ue Iwje;d 6t Z ssajppy 6669 969 auoyd ul�aaul u3 aNX wa!d;o aweN voge0elsui10 awl; ay} le }oa}}a ul suol}eln6ai pue 'saoueulpio 'sapoo ale}S pue IedlolunW algeopdde Ile yi!nn aouelldwoo ul (aje)sl wa;s Cs lesodslp ja;enna}Senn jolpue liddns ja}eM a}ls-uo ay} `uol}oadsul PUL uolle6l}sanul Cw wa; pue Salg a6eloyouy;o Al!ledloluniq ay; wa; paulelgo uollewjo;ul ayi uo paseq ;e o �}uan ales (d I 'ulajay paleolpul ain}onils ;o adAl pue swoapaq ;o jegwnu ay; Jo; alenbape pue leuol;oun; 'ales (a�e)sl wa;s�Cs lesodslp Ja;ennalsenn Jo/pue llddns ia}enn a}ls-uo ayl 1e43 sMoys `uol;eolldde slyi Jo; sau!laP!nJ lenaddy lluoy}ny y}leaH ay; ul paulgno sainpaooad uo paseq uol;e6lisanul (w }ey; C;uan ! rnolaq uMoys alep uol}ep!len ayi ;o se pue olaaay paxWe leas Cw Aq pa' Up'Go sy U33NIJN3 AG NOLLo3dSNl dO 1N3W31`d1S 'ti Municipality of Anchorage . • Development Services Department Building Safety Division On -Site Water & Wastewater Program •" 4700 South Bregaw St. P.O. Box 196650 Anchorage. AK 99519.6650 www.ci.anchomge.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Descroon: sleeov acres Lot 3 Parcel ID: 017-91.80 A. WELL DATA Well type rt-.- If A, B. or C provide PWSID # 8421-FA•273 Well Log (YIN) Date completed _ Total depth _ft. Date of test Static water level Sanitary seal (Y/N) _ Wires properly protected (Y/N) Cased to _ft. Casing height (above ground) FROM WELL LOG AT INSPECTION ft. Well production 9 -p.m WATER SAMPLE RESULTS: ft. Coliform 0 colonies/100 ml. Nitrate 0 mgA. Other bacterlajL colonies/100m1 Date of sample: 0811312001 Collected by: KND Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel Date installed 08M411997 Tank size 1000 gal. Number of Compartments 2 Cleanouts )L Foundation cleanout Y_Depression over tank (-High water alarm N6 Date of pumping 4125101 Pumper A+ C. ABSORPTION FIELD DATA Date installed OB115M997 Soil rating (g.p.dJW or ft=/bdrrn) QZ System type jhd Length 4_ fL Width 15 ft. Gravel below pipe 2.28 ft. Total depth 6.3.8.1 ft. Eft. absorption area 141jMonitoring tube Y Depression over field y Date of adequacy test 04RS101 Results (Pasa/FaiQ Pass For I bedrooms Fluid depth in absorption field before test L in. Water added JU gal. New depth IL in. Elapsed Time: Q_ min. Final fluid depth L In. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN 3 type) no If yes, give date 00'00£$ swalss, �IaaaS/iTaN f£0 wvtl E:S0 i0/6c/ jegwnN 10909M /UeWAed 10 8380 s eed jeAmm 1WZ1*A816 jegwnN idIODGM lueuu(ed 10 9180 6ej VVH 'g. NOLLVDIdLLM30 S.M33NION3 V S1N3WWO0 A +—UF slot lugOe(pe uo speM +, uIpiP ulaunO +,If 9BwMs 9R4en/8uPVgd 'A9MenY0 +, velem eoeynS —+ F eu8 eoWgS jeleM +, ulew JeleM uogepun0l BulPling gull dyedad :01 101 NO 01314 NOI1dMOSSV WOMB 30NV1SIO NOLLVlMd3S +,O;F Slol iueoe(ps uo slleM +,cor ie1em soel+ns gull eolnies jolum +,Or ulew velem +.S Pleg uopdio$W +.J� gull AUedOJd ' uogepunol BulPling :01 101 NO NNVI duSNIOIOH/J�LLd3SS W_OW SS330NV1SIO NOI1VWd3S YN el BulPIOH � gull eolnies opdes/ jameS inoueelo/elo4uew jemes Olignd ulew iemes olignd 9301 lugoe(pe UO Rol lueOe(pe UO YN MUD pleg uopCJOSW ----VW 101 uo Mom IAIPIum OgdeS :Ol 101 NO ll3M WOMB S33NV1S10 NOI1VWd3S S33NVJLSIO NOLLVHVd3S '3 6quewepnbei Ilnwp g uuele g9eyy pg3Sel SelOAO wn4e0 'ul le level uuele JeleM Offul — le IBAGI .10 dwnd, •ul — le level ,uo dwnd, (N/A) SSODW/e104uep1 suolleB ul ezlS 6Fr Pellelsul eleO NOLLVIS kill '0 •%'p, �e0 !� : ;,. a : Y SAI ew8N PelulJd Sleaulllu3 • •. ••••• ,•.. 'eneP 9141 uO laege ul seu/lePlnfl VM VOW 4WM s0u9uuolu03 ul eve swelsAS enoge 941 /947 sprwer led un !O! W W Melnev �i bi Pue suolpedsul plel1 48nav41 POWWOW ene4 AjWeo •._ r _.�S I Join I 'g. NOLLVDIdLLM30 S.M33NION3 V S1N3WWO0 A +—UF slot lugOe(pe uo speM +, uIpiP ulaunO +,If 9BwMs 9R4en/8uPVgd 'A9MenY0 +, velem eoeynS —+ F eu8 eoWgS jeleM +, ulew JeleM uogepun0l BulPling gull dyedad :01 101 NO 01314 NOI1dMOSSV WOMB 30NV1SIO NOLLVlMd3S +,O;F Slol iueoe(ps uo slleM +,cor ie1em soel+ns gull eolnies jolum +,Or ulew velem +.S Pleg uopdio$W +.J� gull AUedOJd ' uogepunol BulPling :01 101 NO NNVI duSNIOIOH/J�LLd3SS W_OW SS330NV1SIO NOI1VWd3S YN el BulPIOH � gull eolnies opdes/ jameS inoueelo/elo4uew jemes Olignd ulew iemes olignd 9301 lugoe(pe UO Rol lueOe(pe UO YN MUD pleg uopCJOSW ----VW 101 uo Mom IAIPIum OgdeS :Ol 101 NO ll3M WOMB S33NV1S10 NOI1VWd3S S33NVJLSIO NOLLVHVd3S '3 6quewepnbei Ilnwp g uuele g9eyy pg3Sel SelOAO wn4e0 'ul le level uuele JeleM Offul — le IBAGI .10 dwnd, •ul — le level ,uo dwnd, (N/A) SSODW/e104uep1 suolleB ul ezlS 6Fr Pellelsul eleO NOLLVIS kill '0 JUN -20-01 08:27 FROtI-CT&E ENVIROMOTAL SRV G CTBE Environmental Services Inc. `e irrr rrrri rrrrr� CF&E Ref.N 1013368001 Client Name KNM Engineering Project NawW# Sleepy Acres, Lot 3 Client Sample ID Sleepy Acres, Lot 3 Malls Drinking Water Ordered BY PWSID 0 Sample Remarks Penn Resahs PQL 8075615301 T-008 P.02/03 F-853 Client PON Printed Date/flme 06/1912001 17:38 Collected Date/rime 06/1412001 13:20 Received Date/time 06/1412001 113:40 Technics) Direc hen `i7 Released 'H Allowable PMP Aaabllis Init Units Method limits Date Date Natere Department NitmtrN 0.5000 0.500 mg/L EPA300.0 (<10) 06/14/Ul SCL Microbiology Laboratory p coV100rnL SM189222B (<1) 06/14/01 SKW Total Coliform 0 MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # L7-19 / —9�5` 1. GENERAL INFORMATION Complete legal description ICIPA�"' OF ANCHORAGE ENTAL SERVICES DIVISION UG 13 1997 RECEIVED HAA # � mac \ Location (site address or directions) '!�7 �6 Property owner Mailing address Lending agency Mailing address. Agent Address Day phone / Ili //l /�� to //� J111 /; 11 p—//J /1 p � Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 2 i Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site �\ Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-02000 l/91) Front MOA N21 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 KNI) €ngineering Phone 41�9 Address 2044Pl _1jrniganBlvd. Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments M- _ Date o�o��e`01 (E OF A4 ®1 :�P .•••......,••9S, Y� p' •... t. x J.S r , Kenne;n M. ��� n4` '90.; •SSIaNP� bedrooms. ,e%�,..�®� 4UTIC bedrooms, with the following stipulations: Date / Z / 92 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. 72-025 (Rev.1AJ1) Back MOAN21 ORA Municipality of Anchorage MUNICIPALIT YOF NCE$ DIV E C*D' N DEPARTMENT" OF HEALTH & HUMAN.06�k Environmental Services Division 11997 825 L Street, Room 502 • Anchorage, Alaska 99501 • (&LW 34.3-`4,7144 Health Authority Approval Checklist R E C E I v I" Legal Description: LoT , .5 /['Pj9.e.z__ Parcel I.D.: JYC� A. WELL DATA / Well type _ �� If A, B, or C, attach ADEC letter. ADEC water system number. Lo g resent Y/N p ( ) _—A/ ---Date completed_ Total depth Cased to _-_ Casing height (above ground) Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. �g.p.m. WATER SAMPLE RESULTS: Coliform —�Z—— Nitrate _ ® - Z I -j Other bacteria Date of sample:Collected by:�/�� B. SEPTIC/HOLDING TANK DATA Date installed 6' -1V' -1Z Tank size _Z92ML Number oAf/Compartments --,?� Cleanouts,(/Y,//N)� Foundation cleanout (Y/N) _� Depression (Y/N) �_ High water alarm (Y/N) /yA Date of Pumping NA —Pumper C. ABSORPTION FIELD DATA Date installed/5�/ % Soil rating (g.p.d./ft2 or ftz/bdrm) :ASystem typec�C� Length 'Widthf/ Gravel thickness below pipe 12"-26 _Total depth Effective absorption area _ Monitoring Tube present (Y/N)_ Depression over field (Y/N) Date of adequacy test_ Fluid depth in Fluid depth Peroxide tri 72-026 (Rev. 3/96)* /Results field before test (in.); (ins) Minutes later:__ (past 12 months) (Y/N) For l imediately after gal water ad�c�d (in.): r _ Absorption rate = _ If yes, give date Z D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: / Z Septic/holding tank on lot��r l On adjacent lots Absorption field on lot %V1 On adjacent lots /y Public sewer main 4114 Public sewer manhole/cleanout ! Sewer /septic service line �� "� Lift station // SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line Absorption field /D Water main/service line ✓�Q ''f Surface water/drainage //J Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: ! / I Property line Building foundation Water main/service line Surface water M i4 Driveway, parking/vehicle storage area r U[J f' jjll � ! Curtain drain �/f Wells on adjacent lots �.17f F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records in conformance with MOA HAA guidelines in effect on this date. Signature M Engineer's Name c? /S, Date HAA Fee $ vV Date of Payment O /� Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number area �\ MUNICIPALITY OF ANCHORAGE �}fi \\\("`\!\\�^,,,///��) Department of Health &Human Services DIVISION OF ENVIRONMENTAL SERVICES &logy 343-4744 ZINTS CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # c') 1 —h - t� X 8 0 HAA # t '02'_\ L:L,( 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) 7060 E: I Vo /,A (b) Property owner D14. ��laL ___ Telephone: (home).3 Business Mailing Address %010 E 1 140i-1 w (c) Lending Institution �u4 LA� L.,&, o,-tk Telephone Mailing Address K -'— (d) Real Estate Company and Agent Address Telephone — nCo� - S (e) Mail the HAA to the following address: (or check here', if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family Number of bedrooms —3 3. WATER SUPPLY Individual Well Community Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community CI Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/8B) Page 1 of 2 Z 10 Z abed hDeg (88/E 'sae) 9ZO-ZL laom s,Aaambue leuolssaloid ay; ul Suolss!woao saoaaajola!gpsuodsw lou Si abeaogouyloAli led to!unvN agl'panssl sl aleo!lpaao a aaolaq slepaz (!sueao suolloodsu!Ion puoolouopSHHOlosaaloldw3'sluawaimbaaalslspueleaapaluleliao (;s!leso;aapioulsuollnlllsul bulpual i!ag1 pue sawog to siasegoand of Asalinoo a se slgl S90p SHHO aql 'e�!se!y to ale1S eql ul paaa;S!Baa jaau!Bua leuolssaloid luapuadapul ue lq anoge 9 gdeiBeaed ul uanlb suol;eluasaidaa aq; uodn (luo paseq paleollpeo !enoaddyAluoglnb' glleaH sanss! (SHHO) saolAJaS uewnH Pug g11eaH lo;uawlaeda(] abeaogouylo l!ledlolunw aql lenoaddy leuo!llpuoO to swaal Ieuoll!PuoO panoiddesl(] 7� panoaddy ale�����?%{ t7-�—d /q swooapaq /v y aol panoaddy -IVAOdddV SHHO '9 CJ �O — �11V- 1 ale(] sseippy 11 �- auogda!al �d a S H _ Wald to a(ueN •uo!loadsui s!ql to alep aq; uo loalle ui suol;elnbai pue'saoueulpio'sapoo alelS pue ledlo!unW Ile gl!m aoue!ldwoo ui si walsls lesods!p aejema;sem ao/pue /lddns aalem al!s-uo agl'uol;oodsu! PUL uol;sbllSanu! Aw woal pue sa!!1 abejogouy to /xl!led!olunw ag; woal paulelgo uollewjolul aql uo paseq leql /�luaA aagljnl I-u!aaaq poleo!pui ain;onj;s to ad (; pus swooapaq to aagwnu aq; aol a;enbape pus lsuol;ounl 'ales sl walsAs lesodslp aalemalsem ao/pue A!ddns jalem ells-uo aq; legl smogs !enoaddy /llaoglny glleaH S!q; to uol;eb!lsanul (w;egl AIIJaA I 'mo!aq umogs alep uol;eplleA aq; to SVPUB olaaag pax!lle leas lw Aq palllliao sy N0lIVWH0dNI ONY V1V4 'HOHV3S 31Id 'S1S31'SN0II03dSNl ONIOIAOFid Wdld JNId33NION3 '9 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) MUNI*, F ANCHOR/QQ HECKLIST - FEBRUARY 1984 t ENVIRONMENTAL SERVICES DIVISION 343-4744 a i 1989 Legal Description: Lo- 3 -R1"p/ Ac 12ES MARSRC_ 35Q I, —6LVJ A. WELL DATA RIS C L- I V S D Well Classification C 0-_21-,<✓&-�7 3 _ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Date Completed Electrical Wiring in Conduit (Y/N) Depth of Grouting SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Date r� Water Sample Test Results — E' tel__ NP Mn.l7 � /Y03 Comments B. SEPTIC/F69MO Pa TANK DATA Date Installed 1.11$'1 _Size __LCrt�No. of Compartments 'ty'/0 Standpipes (Y/N) TIAL O Air -tight Caps (Y/N) _ Foundation Cleanout (Y/N) Depression over Tank (Y/N) rsi Date Last Pumped - HA' C,l& I181 IActmerS Pumping/Maintenance Contact on File (Y/N) NlAr ; for --N-14 Holding Tank High -Water Alarm (Y/N) — NIA Temporary Holding Tank Permit (Y/N) N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 130 -F To Building Foundation To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments To Disposal Field — 1 y ( 72-626 (Rev. 7188) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 10o Type of System Design lt110L i2srtL14 Date Installed NZBy Length of Field 53 Width of Field �' Depth of Field 10-/2 ' Gravel Bed Thickness I/ Square Feet of Absortion Area 376 Statndpipes Present (Y/N) Depression over Field (Y/N) r( Date of Last Adequacy Test S 113 q Results of Last Adequacy Test -P0.ss F., 1 In r -,e- .D�cY rom w-9 SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well To Building Foundation Lot N/� To Water Main/Service Line 50 + To Property Line 3 0 F To Existing or Abandoned System on On Adjoining Lots 1 &.0 + To Stream, Pond, Lake, or Major Drainage Course - To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFTSTATION /yONe Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments To Cutback (if present) N/a Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection Signed Company lobiotN �aurltlaK� �� Date �'{� l3, l 4 Engineer's Seal MOA No. Receipt No. 03 Date of Payment Amount:$ /70-6D Receipt No. Waiver Fee: $ — Date of Payment 72-026 (Rev. 7/66) Back Page 2 of 2 ' i I STEVE COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL. CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322. ANCHORAGE, AK 99503 FOR: TOLBERT STRICKLAND DATE: March 20, 1989 PWSID: "Class C" To Whom It May Concern: According to the records on file in this office, the Sleepy Acres SID Water. System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, 21A1, Q-, /, C. -L. Vera E. Craig Environmental Field Officer VEC:kk MUNICIPALITY (V ANCHORAGE DIVISION OF rtWTRO'4XEUAL, HEALTH ULPAR'SNENIT OF llEjJ.J:H AND I NVIROtt.91_f11AL PROTECTION APPLICATION F'OR UAL:tH AUEHORITY APPROVAL CERTIFICATE rsnarai Information Applicatlon Date (a) Legal Descripti.on,(includo lot, block, oubdivision, section, township, range) i Location (addzes or directions) ` (b) Applicants Name./..f5Tel.ephono Home � Business i � Applicants Address�f /�� 'u;� it%�, j�...,�l�'`4�:a.��•�.' f: �� rl '...��..;f<'-: (c) Applicant is (check one) Lending Institution Owner/builder `F ; Buyer ; Other. [:�� (explain); i (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. jUe of Residence Single --Family IIJ Multi -Family F__1 Other (describe)���� Number of Bedrooms '3 3. Water SHU-L-7- Individual Well M Community M:1 Public E-1 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite 7-1 Public Community E.4 Holding .lank E:. 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 21 5. Eneering Firm Providing Inspections, TestsbFile 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 shown 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 regula- tions in effect on the date of this inspection. Name of Date (ENGIINEER SEAL)a� F99 on oewA 9�Q7 0Q®°acoq<' 6. DHEP Approval I roy c. acid, Jr. 2251— Approved Approved for ff•eG bedrooms By1 eo g" Approved �- Disapprovecl� Condi,tionai. Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE; A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE; PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNIMPALITY OF ANCHORAGE - OrPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) APE' 1986 CHECKLIST — FEBRUARY 1984 R E C E.1 V p A. WELL. DATA Description: ��(J 2; c�_S_c 3=5'_ Well Classification �ornmc If A, B, cc D.E.C. Approve Y ) �� Well Log Present_o�--^_ Date Completed _�11245J�, !T Yield L5*/,2__ Total Depth Z�' _ Cased to„� p f__ Depth of GrcutingA2VcG 1a.Q l Static Water Level �60 Pump Set A3,Ao lel _ Casing Height Above Ground c w c 2P �/az�¢�_ sanitary Seal on Casing OL/N)_ Electrical Wiring in Conduit (Y/N) C� _ Depression Around S"kl.lhead (YM)( Separation Distances from Well: To Septic/Holding Tank on Lot (1?0 X/ ” /" _—_; On Adjoining Lots_>/,S•o 11 To Nearest Edge of Absorption Field on Lo P) Vit__ ; On Adjoining Lots >16u '.Po Nearest Public Sewer Line +yj�t' To Nearest Public Sewer Cleanout/Manhole_--To Nearest Sewer Service Line on Lot AJI Water Sample Collected By (tom'4ct2ne4 _ Date Water, Sample •'Test Results'_� "s 2 ^� B. SEPTIC/HOLDING TANK DATA Date Installed �i�/S�8'l Size lonr), J� No. of CaTartments Standpipes ) Air -tight Caps) —_ Foundation Cleanout dY/N) Depression over Tank (Y�I —_ Date Last Pumped _�%_ ("< a Pumping/Maintenance Contract on File (YM) Wtk ; for T Holding Tank High -Water Alarm (YM) A) A- Temporary Holding Tank Permit (Y V/) �L_ Separation Distances from Septic/Holding Tank: To Water -Supply Wall 2L?o,' To Building Foundation.���� _ To Property Lire _—_ ��To Disposal Field A)ol. s lu g T8�`.�iylac To Water Main/Service Line _!j Stream, Pond, Lake, cc Major Drainage Course } z� ��k3aa1cJ2 (Page 1 of ?.j Receipt # < `� Date Paid: — Amount: L� _ 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /ppt.. Type of System Design Date Installed ��/S �f,"F' Length of Field 151.3 Width of Field S _ Depth of Field /�?i40 Gravel Bed Thickness c? "' (() _ Square Feet of Absorption Area 2,7,6 StandYpipes Present ) Depression over Field (Y/,LQ,) Date of Last Adequacy Test Results of Last Adequacy Test N�+4 Separation Distance from Absorption Field: i To Water -Supply Wall (;?,o g/ / h To Property Line 30 To Building Foundation 3-�16/0 To Existing or Abandoned System on Lot 0/14 ; On Adjoining Lots &0 t® To Water Main/Service Line ol7 To Cutbank(if resent) YUI, - To Stream/Pond/Lake/or Major Drainage Course /00 F To Driveway, Parking Area, or Vehicle Storage Area /D tU e Comments Cipey o�,rz�t �.a.�n rse%ldu�ci -lw�,K az�(21n4-f "8- am 8- QM eG dun ct� �1 e)x �S�w dG�?ad la/ii/8 "f D. LIFT STATION DD Date Installed N (A- Dimensions rV(% Size in Gallons A)/A- Manhole/Access (YM) ��4 "Pump On" Level at "J(q- "Pump Off" Level at 'VIA v� High Water Alarm Level at A)(A Vent (YM) Wl,F Tested for n')0p- Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(YM) 0(.A - Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. „ OF Signed✓✓11 si�Q���.......;i Company 1-/r�g MOA No. S'S =02 /1 '�' e. -V C--' MOW..._ KB1/d5/s (Page 2 of 21 I C. Reid, J, a 0.2251•E •`a F>14IIi1