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HomeMy WebLinkAboutWYNTER PARK #1 BLK 1 LT 2Wynter Park
#1
Block 1
Lot 2
#051-491-51
Municipality of Anchorage Page —1 -of 2�
DEPARTMENT OF HE=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
Permit Number: .oil 9 t 0oo.2 — PID Number: — O5 1 - AA -I 1 - S
Name:
BgVGE'
Wastewater System: ❑ New ❑ Upgrade
>"11J LLLI�
��s
Address:
•
�463N PARK, GIRCLC%_Gr1UGlAK-��K-�IgSff/
ABSORPTION FIELD
--- --
Phone: 3$°1 •- Z'4q O No. of Bedrooms:
�L" 68 _0 Z,(a f s�
O Deep Trench Shallow Trench ❑Bed ❑Mound O Other
—
LEGAL DESCRIPTION
I
Soil Hating: 2 e
GPD/Sq. Ft.
Total Depth from original grade :
L.'a✓•,i -^ 7,0'
Lot: f Block: {{ Subdivision:
dl �A11�IJTE'A. PARK.'�
Depth to pipe bottom from original grade:
4F 1
Gravel depth beneath pipe
�
1
• � �r - O Ft.
.C7 Ft.
Township:
Range: Sectio:
Fill added abVve originill grade:
Gravel length: ` I
A I Ft.
Ft.
--_
WELL'• New ❑Upgrade
Gravel width: 5 1
Number of lines: Distance between lines:
17x15' //d
Classification (Private, A,B,C): Total Depth: Cased To:
etAs "{�" _d FL
Ft.
Total absorption area:
_ 3 F 30. Ft.
I Ft.
Pipe material:
Asan f 810
Driller: rb filled: Static Water Level:
Ft.
Installer:
$ P. EKCgllYrl.1G
led:
Date stalled:
'Z1 �Sq "• 1 Z(v nq
Yield:
Pump Set at I
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
Rseptic ❑ Holding ❑ S.T.E.P.
_
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
Well
"Zaol+
1Material:
Number of Compartments:
SurfaceLIFT
Water
1001.}
led .f
"-
STATION
LotI•}
Line
!fp —Lit_
t
: I
�•
�r
.s
---.
_
Size in ons: Manufacturer.
.'Pump on" level at: "Pur7pref�7wel-a High water alarm at:
Foundation
,�_
,__,.
Curtain
11
L
Pump A Electrical Inspections performed by:
Drain
Remarks:LiI ia'� LINI—IJ1AUCk *0
BENCH MARK
ua�t_E of Pctc t_r. •nom
Location and Description:
'r(3m i`oe e)C rk.wr pori -C14
.� AND L NE5 PRIar7&_To N20
Ctase T pliwr
114 1ArJiL WL-: L,Lra'T80
Assumed Elevation:
100.0
0n
ENGINEER'S SEA
A,,,�.^.^•^
Inspections performed by: _ A •W A, i INC, Dates: 1st I 21
, ••^,.•• .••
2ndJ h
�:. •... ...... ..�
••;
fie, •/; of A. Gornea 1
Department of Heal and Human Services approval
�y`;;°e• E•7933
Reviewed and approved by: Date: � � '3
—
72-013 (Rev. 9/91) MOA 25
PERMIT NUMBER: SW990002 AS -BUILT DRAWING PARCEL IU NUMBER:
051-491-51
A __8 C
FCO 14.9 -
ST1 13.2 23.0 -
ST2 14.2 27.5 - I
QBL1 l5agl 28.6 - 1
DBL2 17.1 28.7 - C04
13R 77.6 28.7 I -'--
001 23.9 22.5 = TH#1
CO2 24.3 23.0
CO3 24.0 14.4
Ml'1 27.Q � 26.1 I 4 d
C04 46.Q 51.3 myp'sA�L OBLi D
NEW GRAINFIELD
APPROXIMATE LOCATION
�)F M.O.A. GROUNDWATER
®9 M.B.A.NG TUBE
PARK
CIRCLE
•01
INSrALLEO B}1L4- 8 "y/���p(g
RUN VALVE BR MT / /%
/ F-MpROXINAiE LI
r OF WATER SERVE
6 PER HOMEOV
NEW 1000 GALLON
SEPTIC TANK
- --
,P' 1 30' DMNA0E EASEVENTJ
MSUNC. ORANFlELD TO 9E .,�D
USED AS A RESERVE SKE }`- 20' UIILRY FISEMENT
(EXACT LOCATION 15 UNNNIWN)
T --
I
ra A° rPhK 971%1+/ R2P Of f9! K
95.91 F I 95.69
1000 6&WN
Dorromod %TIC TANK I�RDorroMor
IN,if�15.17 CAW -94,94
1161 ^ 90.92
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 2B. ANCHORAGE, AK 99504
PHONE: (9D7) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
WYNTER PARK SUBDIVISION #1, LOT 2, BLOCK 1,
TYPE OF WORK:
AS -BUILT OF SEPTIC SYSTEM UPGRADE
PREPARED FOR: PHONE NUMBER:
BRUCE MUL.LER 384--2990/240-2725/688-0284
GATE: ��� DRAWN HY: SCALE: AGE:
1/26/99 �.L_M. 1 = 40' PAGE:
2 OF 2 —
f yess
.A. G'hF .�
CE -7953 t
41wBP_•• 1111. �•'G t`T'��
Municipality of Anchorage
Department of Health and Human Services
825 "L' Street
Rick Mystrom, p.0. Box 196650 Anchorage, Alaska 99519-6650
Mayor http://www.ci.anchorage.ak.us
February 3, 1999
Jeff Garness, PE
Alaska Water & Wastewater Consultants, Inc.
6901 De Barr Road, Suite 2B
Anchorage, Alaska 99504
Subject: Waiver Request for Lot 2 Block I Wynter Park Subdivision #1
Waiver Request #WR990005
Parcel ID 4051-491-51
HA990038, SW990002
Dear Mr. Garness:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
4.0 feet. This waiver is between the north property line and the absorption field.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-4744.
/Sincerely,
Daniel J. Roth
Civil Engineer
On -Site Water Quality Program
OR,
MUNICIPALITY OF ANCHORAGE.
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR#�11�gC]L7i2�_ PID# _051--491--51 HA# HA990038— Permit # SW990002_
Date Received: Feb 2, 1999
Legal Description: _Lot 2. Block 1 Wynter Park_#1 _----
Engineer: Jeff Garness, PE, Alaska Water -& -Wastewater Consultants, Inc-. - - -
6901 De Barr Road, Suite 2B, Anchorage, Alaska 99504 —
Applicant: Bruce Muller
Waiver Requested: Lot line waiver of 4 feet from the new absorption field to
the north property line.
Criteria: 1. - Geology:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3 Other:
Points:
Waiver is Granted: _ Waiver is NOT Granted: ----
List Conditions or Reasons for. above:
L. � iT c �e pF• j u 3 7-/ Fi�A T l ��—-----------
Date: 2-3 –92_ —_— ay. OWN --_—
Name of Reviewer
�s o
Rec #:6.4¢66 —Amount: $-9021--- Date Paid: 1 -2 7--
-
Alaska Water & Wastewater Consultants, Inco
6901 Debarr Road, Suite 211 — Anchorage — Alaska 99504
Phone (907) 337-6179 — Fax (907) 338-3246
February 1, 1999
�e
Municipality of Anchorage 10Y " Gip
Department of Health & Human Services °airh�'ryu� /y,99
P.O. Box 196650
Anchorage, AK 99519••6650 S0ree
REFERENCE: Lot 2; Block 1; Wynter Park Subdivision #1
Properly line waiver request
Request you issue a four (4) foot property line waiver from the new absorption field on
the referenced property to the north property line. The property to the north, Lot 3, Bk 1,
Wynter Park, is served by a community water system and the water service line is much
greater than 25 feet away the new septic system. No stand pipes were visible on the septic
system which serves Lot 3, Bk 1, Wynter Park; however, according to the MOA
inspection report, it is 25 feet from the closest lot line. In short, we do not anticipate any
adverse effects associated with the issuance of this waiver. The lot line was surveyed by a
registered land surveyor prior to construction.
If you require additional
P
JAG/jlm
please contact us at 337-6179.
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services (,
On -Site Services Program
��� 825 L Street, Room 502
P.O. Box 19
' \ 6650, Anchorage, AK 99519-6650
'\` (907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jan 14, 1999
Expiration Date: Jan 14, 2000
Permit Number: SW990002 Parcel ID: 051-491-51
Legal Description:
WYNTER PARK #1 BLK 1 LT 2
Design Engineer:
0041 AK Water & Wastewater Consulta
Site Address:
024034 PARK CIR
Owner Name:
Bruce Muller
Lot Size:
33063 SQ. FT.
Owner Address:
24034 Park Circle
Total Bedrooms:
3 Permit Bedrooms: 3
Chugiak , AK 99567 -
This permit is for the
construction of:
[] Disposal Field
E Septic Tank ❑Holding 'Tank
❑Privy
❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify 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 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
/-/-�t-9%
Date: / /`, �y
Alaska Water & Wastewater. Consultants, Inca
6901 Debarr Road, Suite 211 — Anchorage — Alaska 995U4
(907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
January 4, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Upgrade Design for Lot 2, Block 1, Wynter Park Subdivision 41.
To whom it may concern:
The existing 3 bedroom trailer is served by a private septic system and a conununity well. The
existing drainfield does not meet municipal standards and must be upgraded prior to the sale of
the property. A test hole was excavated to the north of the existing septic system Comments
regarding the proposed upgrade design are summarized as follows:
1. SOILS: Attached is a log which shows the soil profile and the percolation test result. The
proposed upgrade is to be designed around a 30 feet radius of test hole 41. No groundwater was
encountered during the excavation of the test hole. One soil percolation test was performed at 5.5
to 6.0 feet which perked out at a rate of <1 minute/inch. During the site visit with your
department.to inspect the existing trench, the need for a sand filter was discussed. We both agreed
(Dan Roth and Jeff Garness) that a sand filter should not be necessary since there is a significant
quantity of sand present. A grab sample has been taken and can be provided if necessary.
2. TRENCH DESIGN:
a. Percolation Rate: <1 minutes/inch
1.2 gallons/day/ft/
b. Allowable Application Rate:
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 375 ft2
f. Effective Depth: 3 feet
h. Width: 5 feet
i. Reduction Factor= 0.58
j. Length: 45 feet
j. Effective absorption area = 388 fi2 (>375 ft2 OK)
k. Maximum depth = 7 feet
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPHY: In the area of the proposed septic upgrade, the grade is mostly flat. In
short, there are no slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have ar;� questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistance. /
P.E., M.S.
r LOT 20, BLOCK 3,
l
EARL. RAY S/D
i CtJ
,
U
/� LOT 21, BLOCK 3, \\ �
EARL RAY S/D
C)
LOT 29, BLOCK 1, LOT 28, BLOCK 1,
BLOCK
WYNTER PARK S/D #1 WYNTER PARK S/D 1 VIYMER2F'ARK S/D 7. iHi
---
PROPOSED SEPTIC UPGRADE
(SEE DESIGN, PAGE 2 OF 2)
EXISTING'//
LOT 22, BLOCK 3, SHSPP--
w EARL RAY S/D
A EXISTING
SEPTIC
SYSTEM
i
Ian°' WE 'i
LOTI 23, BLOCK 3,
EARL RAY S/D
1
U
�J
Maac°�
LOT 4, BLOCK 1,
WYNTER PARK S�D 41
SERVED BY A PRIVA E SEPTIC
AND A COMMUNITY WELL
CIRCLE
1
ySTH
� ES(1S11NG �
�7 3 BEDROOM
:XISTING `—SHED N'Po%IhUTE IOCATION
OF KEY 00%jjSEMACE
GARAGE LINE PER HOO'HNER
Lt1
>1
TRACT 3, WHALEY SUBDIVISION
�I
TRACT 2A, WHALEY SUBDIVISION
ALASKA WATER AND WAS'ITN TER CONSULTANTS, INC.
6901 DEBARR ROAD SURE 28, ANCHORAGE, AK 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
WYNTER PARK S/D #1, LOT 2, BLOCK 1
SITE PLAN
PARED FOR: PHONE NUMBER:
BRUCE MU LLER 384--2990/240-2725/688-0284
DRAWN BY: SCALA PAGE:
-1/4/99 J.L.M T 1 = 100' —1 OF 2
r - ...
J. y . Ga ss,:
m CE 7953 k
m�
011 �e,. • ...... ' • c S�v�
I
i
I
I
I
I
I
I
EXISTING DR
USED AS A
(EXACT LOCAT
II
I
I
I
I
I
�I
I
I
FLOWI
I
IS UNKNOWN)
i
ry 1
w
X
Lo5
L
CO
MONITORING
BY 5 FEET WIOE (MINIMUM) BY
h5 FEET LONG. ADD 3 FEET OF
CLEAN, WASHED SEVIER DRAINROCK.
PARK
MT -" CIRCLE
TH( INSTALL DBL CO
PROPOSED GALLON
TANK SEPTIC TANK
—INSTALL FCO
GIN
Qp�cAtic
SEPTIC TANV
TO BE A13ANDONNED COMPL
APPROXIMATE LOCATION
OF WATER SERVICE UNE
PER HOMEOWNER.
(SEE: NOTES)
.30' DRAINAGE EASEMENT -
20' UTILITY EASEMENT -
NOTES:
1. THE CONTRACTOR SHALL HAVE THE NORTH PROPERTY LINE FLAGGED BY A REGISTERED
IAND SURVEYOR PRIOR TO CONSTRUCTION.
2. THE CONTRACTOR SHALL HAVE THE WATER LINE PROFESSIONALLY LOCATED PRIOR TO
CONSTRUCTION TO VERIFY THAT THE 10' SEPARATION DISTANCE BETWEEN THE WATER LINE
AND THE PROPOSED SEPTIC UPGRADES WILL BE MET.
3. RAISE SEWER LINE: AND NEW TANK AS NECESSARY TO OBTAIN GRADE TO NEW
DRAINFIELD_T— i -----------__--
ALASKA WATER ANI) WASTEWATER CONSULTANTS, INC.
8901 DEBARK ROAD SUITE 2B, ANCHORAGE, AK 99504
PHONE: (907) 337-8179/FAX: (907) 338-3248
WYNTER PARK S/D #1; LOT 2, BLOCK 1, �!
TYPE OF WORK: -- a
DESIGN OF SEPTIC UPGRADE
PREPARED FOR: Q
> R: PHONE NUMBER:
BRUCE MUILLER 384-2990/240-2725/688-0284
2 OF 2
1/4/99 I.L.M. 1 — 30'
B
O
f re
A. nese:
I `f%s '
—7953 m�
•' SFO
0(� f0�.•
......... c OAO�
I
w
7
� !
O
6 I
J
u
FLOWI
I
IS UNKNOWN)
i
ry 1
w
X
Lo5
L
CO
MONITORING
BY 5 FEET WIOE (MINIMUM) BY
h5 FEET LONG. ADD 3 FEET OF
CLEAN, WASHED SEVIER DRAINROCK.
PARK
MT -" CIRCLE
TH( INSTALL DBL CO
PROPOSED GALLON
TANK SEPTIC TANK
—INSTALL FCO
GIN
Qp�cAtic
SEPTIC TANV
TO BE A13ANDONNED COMPL
APPROXIMATE LOCATION
OF WATER SERVICE UNE
PER HOMEOWNER.
(SEE: NOTES)
.30' DRAINAGE EASEMENT -
20' UTILITY EASEMENT -
NOTES:
1. THE CONTRACTOR SHALL HAVE THE NORTH PROPERTY LINE FLAGGED BY A REGISTERED
IAND SURVEYOR PRIOR TO CONSTRUCTION.
2. THE CONTRACTOR SHALL HAVE THE WATER LINE PROFESSIONALLY LOCATED PRIOR TO
CONSTRUCTION TO VERIFY THAT THE 10' SEPARATION DISTANCE BETWEEN THE WATER LINE
AND THE PROPOSED SEPTIC UPGRADES WILL BE MET.
3. RAISE SEWER LINE: AND NEW TANK AS NECESSARY TO OBTAIN GRADE TO NEW
DRAINFIELD_T— i -----------__--
ALASKA WATER ANI) WASTEWATER CONSULTANTS, INC.
8901 DEBARK ROAD SUITE 2B, ANCHORAGE, AK 99504
PHONE: (907) 337-8179/FAX: (907) 338-3248
WYNTER PARK S/D #1; LOT 2, BLOCK 1, �!
TYPE OF WORK: -- a
DESIGN OF SEPTIC UPGRADE
PREPARED FOR: Q
> R: PHONE NUMBER:
BRUCE MUILLER 384-2990/240-2725/688-0284
2 OF 2
1/4/99 I.L.M. 1 — 30'
f re
A. nese:
I `f%s '
—7953 m�
•' SFO
0(� f0�.•
......... c OAO�
ALASKA WATIzR & WASTEWATER CONSULTANTS INC.
7320 E. CHESTER HTS. CIRCLE ANCHORAGE, AK. 99504 G'
PHONE (907) 337-6179 * FAX (907) 338-3246 Q
��..• .S�ppO
SOIL LOG — PERCOLATION
LEGAL DESCRIPTION:
WYNTER PARK SUBDIVISION #1; LOT 2, BLOCK 1, """' ' ' ...•
PERFORMED FOR: BRUCE MU LLER _ .,:77 . •••...
Q e f e A. am ss;
DATE PERFORMED: 12/23/98_ �Q m —7953 o`Q
(f et) it 6"-8" ORGANICS TEST HOLE #1 4��@ofoasio6
1 �
SOIL CLASSIFICATIONS
2
00
GW ORG
3 GP ML
GM CL
n> °o
h- oo ' GC OL
° ° o SW MH
5a SP CH
O° O"fl
SIM OH
UO o �
n b'd'(
s °(,° SC
°o< GW/SW
7 ° °"°°(
V°°
°o
oo°
OU
9 O OHO
JV
UOD
10 •O -O°p(
V(o
12
13--
14—
PER
3 `B.O.H.
14
15
16-
17-
19
61719 PERCOLATION RATE <1 _(MIN./INCH) PERC. HOLE DIA. 6" (INCHES)
20 TEST RUN BETWEEN 5.5 FT. AND 6.0 FT.
COMMENTS: * BOTTOM OF MONITORING TUBE ONLY EXTENDS TO A DEPTH OF 10.5 FEET.
THE INSUTI SAND IN SOILS SHOULD ACT AS A SAND FILTER_
PERFOMED BY ALASKA WATER & WASTEWATER I, __, CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS
DATE. DATE:
DEPTH TO DATE
GROUNDWATER
_
DRY
DATE
rSITE PLANT
CLOCK
TIME
NET TIME
(MINUTES)
12/23/98
DRY*
1/4/99
DATE
rSITE PLANT
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
////�
PROPOSED SEPTIC UPGRADE[
; (SEE DESIGN, !'AGE 2 OF 2)
EXI'.iTING'
sNDP�(
� /
/
—EXISTING
3 DEDRODM
EXL'iTING
TRAILER -
SEPTIC
SYSTEM
SKIED
---
PER[. HOLE AHSORI3ED WATER AS FAST
i
i GARAGE
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
AS IT WAS ADDED.
-------
---
PER[. HOLE AHSORI3ED WATER AS FAST
G.—AGRE1 =R ANCHORAGE AREA BOR" IGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ���✓i j6°'"��-S MAILING ADDRESS'
DDRESPH/ONE ( /
LOCATION- ✓r'/L:Lt-S l{i�tZ, ---LEGAL DESCRIPTION °�- 2-
SEPTIC TANK: `) /
DISTANCE
NUMBER OF
FROM WELL MANUFACTURER.61lC�t ju"SS . MATERIALL°f11SC��(GS COMP//ARTMENTS_
INSIDE LENGTH_ /
INSIDE WIDTH DEPTH__LIQUID CAPACITY G�_GALLONS.
Ti2ei�iH
SEEPAGE FIT:
/ �/
NUMBER OF PITS � DIAMETER (MLOR WIDTH � LENGTH �_, DEPTH �O
i
LINING MATERIAL _ iQ`� CRIB SIZE: DIAMETER__DEPTH_ DISTANCE FROM: WELL _.
TOTAL EFFECTIVE
BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) 421 _SQ. FT.
ADDITIONAL ABSORPTION
WELL.: %
TYPE _6)W1wG6w( CONSTRUCTION
BUILDING NEAREST
FOUNDATION__LOT LINE.—
CESSPOOL
OTHER SOURCES
NEAREST
SEWER LINE
APPROVED DISAPPROVED _.REMAR
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
P0 s� /roe✓
LOT SLOPE:
REMARKS: :p%�L CI`YcZG
Form No. EQ -031
DEPTH --
SEPTIC
TANK_
DIAGRAM OF SYSTEM
DISTANCE FROM:
SEEPAGE
SYSTEM
.y — ✓: �. SCF
zP' _
DATE .:`17/ t ? _ APPROVEO���
G.A.A.B.
I
GREATER ANCHORAGE, AREA BOROUGH
�t IInII� DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT' NO.
�I'I� 3330 "C:" STREET ANCHORAGE, ALASKA 99503
W���/� TEL,EPHONE 274-4581
�°4,rto
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
IE OF APPLICANT .- " v+' MAILING ADDRESS _ PHONE
ASTALLATION LOCATI(O/j,J, ��i is
LEGAL DESCRIPTION ✓/CLICCIGf
INSTALLATION OF: SEPTIC TANK L/ / SEEPAGE PIT/ DRAIN FIELD , OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED l
FINANCED THROUGH p TO BE INSTALLED BY <'�'r�'� �'C-4alIC fix.
ft
SOIL TEST RESULTS �/ S� V (/L NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: Z4 HOUR NOTICE REQUIRED. BACKFILLING OF' ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL. QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE 711 TYPE _ �, /oy (zaJ S SEEPAGE AREA SIZE _ w" n / TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
% r
FOUNDATION TO SEEPAGE PIT ZO DRAIN FIELD _
SEPTIC TANK TO SEEPAGE PIT WALL / ✓
SEPTIC TANK , SEEPAGE PIT DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK _- SEEPAGE PIT
DRAIN FIELD _ ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK _. SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, /ov / SEEPAGE PIT / DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
T4 INCH DIAMETER CAST IR¢N.S P_HON-PfPES-ON-SEPT16_.TANK AND SEEPAGE PIT
.�FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL EIACKFILL
CONFORM TO BOROUGH RESiU ATIONS REGARDING
INSTALLATION.
G,A.A.B.
LICENSED
OR
DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26-66 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
Oz'IDATE _ APPLICANT'S SIGNATURE
FORM NO. EO -016
Municipality of Anchors
On -Site Water and Wastewater Prograt
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS
JG
Parcel I.D. 051-491-51 Expiration Date: -7P 14 .
1. GENERAL INFORMATION
Complete legal description WYNTER PARK #1 BLK 1 LT 2
Location (site address) 24034 Park Circle, Chugiak AK
Current Property owner(s) Byrd Day phone 350-1945
Mailing address
Real Estate Agent Caroline Streano Keller Williams Day phone 350-1945
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑
Individual
Individual Water Storage ❑
Holding Tank
❑
Community Class C Well ❑
Community
❑
Public Water System ®
Public Sewer
❑
Received by ; "d
Date i
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ �oZ//.
Date:
' /
Date of Payment gl�O�l�d
Date Payment
of
Receipt Number CJI �!$
Receipt Number
COSA #
Waiver #
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,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm NorthRim Engineering Phone 694-7028
Address PO Box 770724 Eagle River
Engineer's Printed Name Steve Eng_
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved.
Conditional approval for
3 bedrooms.
bedrooms.
Date 8/1/2614
bedrooms, with the following stipulations:
/� — '
By: �'°� r�l�"> . r� Original Certificate Date: e5
The Municipalky- T'nchorage Devlopment Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
COSA blue sheer 9-1-12. doe
X Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
. COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: /i1JY�✓TF'�Q P�k'�'/ B/ L 2 Parcel ID: OS/
A. WELL DATA /�.$�!C &&,17160
Well type If A, B, or C provide PWSID # Well Log (Y/N)
Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N)
Total depth ft. Cased to ft
FROM WELL LOG
Date of test
Static water level ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate
Arsenic ug/L Date of sample:
mg/L
Casing height (above ground) in.
AT INSPECTION
Collected by:
ft.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material _ 59 f'rlr ISrOeV Date installed /-Zig
Tank size /006. gal. Number of Compartments Z Cleanouts (Y/N)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) Al High water alarm (Y/N) tet/
Date of pumping 71ZSl3 Pumper5-,4,,N / T�S
C. ABSORPTION FIELD DATA
Date installed ZS 9 Soil rating (g.p.d./lf or ft2lbdrm) /.2 System type T/PEBiVC#
Length e -/S ft. Width S ft. Gravel below pipe 3 ft.
Total depth 4? SfL Eff. absorption area 388 fe Monitoring tube Depression over field A/
Date of adequacy test Results (Pass/Fail) /�1ss For 3 bedrooms
Fluid depth in absorption field before test _0 in. Water added ZSOC gal. New depth-/ 2 in.
Elapsed Time: 06'400 min. Final fluid depth d in. Absorption rate >= Y S0 -t- g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION NA
Date installed
"Pump on" level at
Datum
Size in gallons
Manhole/Access (YIN) _
in. "Pump off"level at in. High water alarm level
Cycles tested
E. SEPARATION DISTANCES
WELL ON LOTTO: /R-J&1CWAi C-9
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer /septic service line
Meets alarm & circuit requirements?
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO
Building foundation 5 �* Property line Id �- Absorption field .J® f4 -
Water main /4 11+ Water service line Surface water �OO �f-
Wells on adjacent lots Zod r
ABSORPTION FIELD ON LOT TO-
Property line' Building foundation D t Water main �D
i
Water Service line /D '1 Surface water Driveway, parking/vehicle storage 2�
Curtain drain 1160 /A Wells on adjacent lots 00"-
F. COMMENTS
G. ENGINEER'S CERTIFICATION
i certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name _C;nr FNC
Date ?Z/ZIW
COSA brown sheet_10-10-12.doc
t r SioyccnyNV. r".9 '-
in.
FROM AURORA PROPERTIES
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Municipality of Anchorage
�S
Development Services Department
/i Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ek.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING "
Parcel I.D. 051-49i-51 HAA# H R 0 100 R G
1. GENERAL INFORMATION Expiration Date: 3 - f 3 - O -7-
Complete
Complete legal description WYNTER PARK SUBDMSION fl: LOT 2. BLOCK 1.
Location (site address or directions) 24034 PARK CIRCLE CHUGIAK. AK 99567
Current Property owners)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
DALE TURNER Day phone 696-8110
12415 EAST PRINCE OF PEACE DRIVE EAGLE RIVER, AK 99577
Day phone
CAROLINE STREANO w/ COUNTRY REALTY Day phone 688-8500
P.O. BOX 671923 CHUGIAK, AK 99567
Unless otherwise requested, HAA will be held by DSD for p/ckup.
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 "A" 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 tille (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.
Note: Alaska Water and Wastewater Consultants; Inc shall be paid $610.00 at, or prior., :
to closing for the engineering seivlces provided
i
4.. STATEMENT OF INSPECTION BY ENGINEER ,; r
As certified
by myseal affixed hereto and as of the validation dat:e shown below, I Verily that my,
Investigation, based on procedures outlined In the Health.At;Vw lyApproval Guidelines for this application,' ,
shows that the on-site water supply and/or wastewater disposal system Is(aie) safe; functional and adequate
for the number of bedrooms and type of structure indicated hereln. 'I further verily that based on the
Information obtained from the Municipality ofAwhorege Abs and from my in vestige and Inspection, the
on-site water supply and/or wastewater disposal system ls(eie) In compile nco with all applicable MunldpaI
and State codes, ordinances, and regulations in effect at the time ofinstaliafton.
.,
Name of Finn ALASKA WATER do WASTEWATER . CONSULTANTS, . INC.,, Phone 337-6179
Address 6901 DEBARR ROAD, SUITE2B-' ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY, A. GARNESS; .P E Date % 0�
Engineer's Comments:
in conducting this evaluation, AWWC Inc. attempted to provide i thonwgh, 00o6o�4pp4 ;
conscientious engineering analysts of the system in accordance wiM ADEC and MCA o
DSD Guidelines a Regulations. The reported results described the performance of the
system under the conditions encountered at the time of ft testi and separation
distances measured to readily Mentfiable features. The operetional ftle of all wells and
septic systems depend on the local soils condition, grourdwaterlevsis that may: ......... :........ t....
fluctuate during the year, and the water usage of the familybeing served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory pest.
results do not guarantee future performance ofthesystem, nor dodwguarantseMet OO ' Je re A. Garnessr i
Moro are no hidden defects or encroachments. AWKV, Inc. can Marefore not provide Q ° —7953
any warranty or future estimate of how long the system will continue to meet the OQ
cparagonal requirements of the ADEC or MOA DSD. The content of this report Is for �0°dProfee.lo�
the sole benefit of the ownergsted above. AnyraUence upon or use of this report by any OpOpp000fo
other person orparty is not authorized, nor will it conforanylegal right whatsoever.
5. DSD SIGNATURE YtOFfr/'%//_�
Approved for 7 bedrooms.`���C+��P , .. • . , Cy0
`J • • ON-SITE •• •'�
Disapproved. WATER AND r
Conditional approval for bedrooms, with the filowing stipulations WASTEWATER
o^•,• PROGRAM
A�S0l
Attachments:
HAA Checklist Manitenance Agreements
Septic System Advisory Supplemental Engineer's Reort
Well Flow Advisory Other
By: le�K✓ irl • t— Z Original Certificate Date: 3 ' / 3 ' 0 1
QW.IZU)
Oil
Municipality of Anchorage
Development Services Department
Building Safety Division
O"Its water a wastewater Program
4700 South Bragew SL
P.O. Box 198850 Andiorage, AK 99819-8650
vrWNtLandhorage.akus
(907)943-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDeaaiptloM WYNTER PARK SUBDIVISION ri1: LOT 2. BLOCK 1. Parcel ID: 051-491-51
A. WELL DATA
Well type A• KA, B, or C provide PWSIDN 2,1431
Date completed Sanitary east
Total d Cased to fL
FROM WELL LOG
Date of test
Static wafer level R
uc tion g.p.m.
WATER SAMPLE RESULTS:
Conform colon"MOOad. Nitrate mgJL.
by,
B. SEPTICMOLDING TANK DATA
Tank Type/Materlal STEEL
Tank size 1000 gal. Number of Compartments 2
Foundation deanout (YIN) NS Depression over tank (Y" NO
Wen Log
properly protected (YIN)
Casing heW (above ground) in.
AT INSPECTION
R
g.pm.
Date trnstaned 1/21-26/99
Clearwuts (YIN) YES
High water atamh (YIN) N/A
Data of pumping 3/8/2001 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA
ml.
Date installed 1/21-26/99 Solt rating G.p.d A'/bdrm) 1_2 System type TRENCH
Legh 45 R Width 5 fL Gravel below pipe 3 fL
Total depth •a.4 fL EH absorption area 388 R' Monitoring tube YES Depression over Held NO
Data of adequacy test 3/2/2001 Results (Pass/FaIQ PASS For 3 bodrooms
Fluid depth In absorption field before teat 2 in. Water added 676 gal. New depth 7 in.
Elapsed Time: 15 min. Final Auld depth 0 in. Absorption rate >• 450+ g.p d.
Any rejuvenation treatment (peat 12 mo.) (YM & Mn) NONE KNOWN K yes, give date —
D. LIFT STATION
Date Installed Size in gallons
'Pump on• level at n.
E. SEPARATION DISTANCES
High water aterm levet at in.
Cycles tested Meets alar S circuit requirements?-
SEPARATION
equirements
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanknifi station on lot
Absorption field on lot
COMMUNITY WELL
On a*cent
0
Public sewer main Public sewer manhole/cleanout
S e ce pne Holding tank
SEPARATION DISTANCES FROM SEPTICIHOLO1NG TANK ON LOT TO:
Building foundation 5'+ Property One 5'+ Absorption field 5'+
Water main 10'+ Water service One 1 O'+ Surface water 100'+
Weds on acUacent kft 100'+ �s
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: *WAIVER WR990005
Property One *4 . Building foundation 10'+ Water main 10'+
Water service One 10'+ Surface water 100'+ Driveway. parldripehlge storage 50'+
2.
Curtain drain NONE KNOWN Wells on ecQscent lots 900'+.a•5
limdielTlTF4111-1
0. ENGINEER'S CERTIFICATION
I car* that I have determined through field krspecllons and ♦'7w
review ofMun/dpal records that the above systems are M ......... .... ... .....
conformance with MOA HAAgu/dellnes M ed'ed on Nmis date.
' e .Gamess;'
Engineers Pri Name JEFFREY A GARNESS �A 7953
Date 3 4 0/ •.•d' ••.......••
�•/a•w�d
ww Fee $ 300 .
Date of Payment 3 - 9 -o r
Receipt Number
Mo. 12w)
Waiver Fee $
Date of Payment
Receipt Number
Ml1NICIhALITY OF ANCHORAGE ^?
Parcell D;# 051-491=51 4 ' hIAA# E 0, CXILL
.3
1. . GENERAL INFORMATION
is n;
Complete legal description;_wyntor Park' Subdivi cion #1 .
7
Lot2; 'Block 1 ;
Location (site address or directions) -034 Park Circle
Property owner iirilrP M111 1 er _ --� Day phone -384-2990
•'Mailing address _24'034 Park Circle Chuaiak AK 99567 —
Lending agency Day phone
Mailing address---
Agent Caroline Streano w/ Aurora Prop.Day phone 688-4939
Peters Creek Business Park Chugiak, AK- 99567
Address _— —
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: _ 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well ^xx
Public water
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 _xx
Bolding 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.'
72-025(Rov.1/91) From MOAR21
5. STATEMENT OF,r INSP
TION BX:tENGINEER
VDVl 1 Ll try .
Address S`2B
Engineer's signature 01VDate 2
Alaska Water & Wastewater:Consultants;.Inc.
shall be paid $2255.00 at closing for; the q�A
engineering services provided. The invoice .+"''OF �©
was submitted to Aurora Properties on 1/26/99.4, 9S
IV
!a YA. Gamma •j ��
DHHS SIGNATURE _ Pa+ rT� CEJ939
1 rF •y,.......•° ��s
_ Approved for _ bedrooms. ®. R F. SO
Disapproved.
Conditional approval for
Additional Comments
a
bedrooms, with the following stipulations:
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 orderto 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-O26(Rw.1i91) Beck MOAR21 -
D. LIFT STATION N /j
Date install@d Size in
Manhole/Access (Y/N)
High water alarm
*Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot __ 7_00` fi
at* _ ".Pump off' level at*
On adjacent lots
Absorption field on lot _ Zoof•i-_ On
Public sewer main
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/SWM TANK ON LOTTO:
I
Foundation S Property line 40 I: Absorption field O� f-
1 1
Water main/service line 10 1 4 _Surface water/drainage _ 100 -1- _ Wells on adjacent lots _ 1150
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
I1:
Property line _4 _ Building foundation _ 1 I —Water main/service line _ In 1 -i -
Surface water _ 001'1- _ Driveway, parking/vehicle storage area 30
Curtain drain N0d6 IC_
,* WAIVE C9RRN-TL--0 Fg`f
F. ENGINEER'S CERTIFICATION
1 certify that I
in conforman
Signature
Engineer's
- Wells on adjacent lots
01 R RAUT
inspections and review of Municipal
.s in effect on this date.
Date
----- ane.,. Ewa.
HAA Fee $ ;,75_ ( Waiver Fee $/
_ /
q
Date of Payment L� it /Z I c7 / l Date of Payment
Receipt Number! �b Z L� Receipt Number._ 'Z
72-026 (Rev. 3/96)*
RECEIVED
Municipality of Anchorage JAN 2 7 0*1999
DEPARTMENT OF HEALTH & HUMAN SERVICEANICIPALITYOFANCH
Environmental Services Division ENVIRONMENTAL SERVICES
825 L Street, Room 502 • Anchorage, Alaska 99501 (907) 343-4744
Health// Authority Approval Checklist
Legal Description: W'/O*EK PA2K S[pI Lo f__ Parcel LD.: o5l — q q I S' I
/ Bwu< I i
A. WELL DATA 60P%r+lvrj''rY WATcrc SYS'rc�t
Well type Loris n A" If A, 8, or C, attach ADEG letter. ADEC water system number Z 11 49
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date completed
Cased to
FROM WELL LOG
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
Date of test
Static water level
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Nitrate
Date of sample:
B. SEPTIC/"k*%4j&TANK DATA
Collected by:
Other bacteria
Date installed I Z 1 z6 f 1 Tank size 1000 Number •ofII Compartments Z- Cleanouts (!)N) `�rr S
Foundation cleanout �1) i(Yo'vS Depression (Yb High water alarm (Y I� /L0
Date of Pumping N lav, Pumper
C. ABSORPTION FIELD DATA
Date installed ►/zI -'iSoil rating p.d./ft ori) ) 2 System type ''rRenle 4 m
Length `i51 Width C Gravel thickness below pipe .R i Total depth i1 %• S t d-1
Effective absorption area '' `91680 Monitoring Tube present ON)yt� j < Depression over field (YI Mo
Date of adequacy test N e"s Results (Pass/Fail) For 3 bedrooms
Fluid depth in absorption field before test (in.); Immediately after= gal. water added (in.):
Fluid depth (ins) Minutes later: Absorption rate = g.p.d.
Peroxide treatment (past 12 months) (Y/N) If yes, give date
72-026 (Rev. 3/96)*
<%ice ✓I PrI �'C. 0 V LL (,elCyt �� �'e/i✓C,)-> Pw i
APPLIC ST FILLS OUT UPPER HA ®l NLY
f,roperty Owner K_J l.J� T I Phone � /y'/LI /=�� ery
Mailing Address /" �. -� `=:. ri'/(•� 4�Z P de ! c� r., 4- 7
l5f`t
Buyer 1 L' e L Lt --vest L._. t,61-ev L Y'. %�rz77C k
Address 2 Ci / Lt ��J�r�� !'/).rLt4 ZIP/Code
Lending Institution-� Y),, •t_ I Yom.--� �V ���f-1'�lN C_ �"� C ♦�- C"� rv� 1,t-�Y�{^ � Phone
ff I1
Address, 1 w l;,i�,. �(�F•F• 1- r�e� , t-c2X 4 -U-'`l b�1"tiC`zl Code <7r j�
Realty Co. &Agent q/ 1 IrU! �%-L-r t� lOr�,�/it'`.=°) Phoned%i�
Address% J / int=t/.VV~1 1%�Y �GC-C�,RrJ�'Zip Code
Legal Description
Street Location
Type of Residence'{
IX,Single Family
❑ Multiple Family No. of Bedrooms
Cl Other
Water Supply
❑ Individual
,K Community pn wrU W A'tf y— C J
ATTACH WELL LOG. A well log is required for all drilled since June 1975.
For wells drilled prior to that date, give woll depth (attach log It available).
❑ Public Utility
Sewer Disposal
Individual ., <- p P,L- Year Individual Installed _ --
❑ Public Utility When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Date
Date
Date
DateW@dQ
Inspector
Inspector
Inspector
Inspector
Field Notes: � r � ?
<
i `ij)
It. I ILJ' Gl 4�
II
AUG 3 1983'
"Municipality of Nnc!,'': ."
"Dept. of
milonment;
('-4APPR ED BEDROO
'CONDITIONS OF APPROVAL
( I DISAPPROVED
( 1 CONDITIONAL APPROVAL'
5
DATE -2_/G--�
BY: C /'- CD
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received ._. ..
Well to Tank
Septic Tank Size
72 023 Imazl
it
9
EXCAVATION
WORK
Perkins Realty
ATTENTION: Georg�e Perkin
Dear Mr. Perkins,
August 8, 1983
Reference: Lot 2; Block 1; Wynterpark Subdivision #1
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
A sewer system adequacy test was performed on the system located
on the referenced property as you requested. The septic
tank was_pumoed and verified to have a capacity of 1000 gallons.
The drainf:ield was tested by a continuous flow o-E'waf–er over —
a period of 48 hours without any adverse effect on the system.
It can be concluded from this test that the waste water disposal
system serving the three bedroom trailer located on7this property
is currently functioning adequately, However-, the system cannot:
be TuaranL•eec1-against--su'5seque'nf-£-ailure.
If we may be of further service, please do not hesitate to
call.
ere
. SHAPER, P.E.
ss
cc: Municipality of Anchorage
Department: of Health and Environmental Protection
SRB 196X EAGLE RIVER, ALASKA