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Home My WebLink AboutTIMBERLUX #3 BLK G LT 7 Municipality of AnchoragePage I 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: ,, ,~"~ ~'~-~z~ PID Number: Name.~. J~r. ~-'~° "~o WastewaterSystem:D New ~pgrade ~1 ~~~ ~. ABSORPTION FIELD Total Depth from original grade: LEGAL DESCRIPTION SoilRating. ~'~GPD/Sq Ft Lot. Subdivision: Depth to pi~ bottom from original grads. Gravel depth beneath Township: I Range: I Section: Fill added above original g~/ Gravel length: Number of lines: J Distan~ be~n lines: WELL: D New D Upgrade G~a~,.,~th: ~ ~t ~ ,~ ~' ~t ~c~'~'ca~'°~t ~ ~(~n~te' A.S,C):~ ~'~ Zo~a~ Oept,: ~t.C~e~ ~o: ~. ~ota~ abso~p~io. Dnlter: ~ Date Drilled: StahcWater Level: In, taller: Date installed: Y~eld:GPM Pump Set at Ft ~ Casmg Height Above GroundFt. TANK SEPARATION DISTANCES ~ Septic ~ Ho~i,g ~.T.~.P. From Tank Field Stahon Tank Sewer Lines - Well I1~~ ID~' I1~' ~ ~'~ Ma~~ Number~of Compartments: su~,~C~w~t~ I~ !~ j~ ~ -- LIFT STATION Lot ~ I I I Size in gallons: ~ Manufacturer: Foundation ~1 ~1 el ~ ~ "Pump ~e>t: I "Pu~l~l at: High water alarm at: Remarks~ ~t~ ~~ ~ BENCH MARK Location and De~iption: 17034 Eagle River L~p Rold~N~. Inspections performed by: ~E~, A:G~G ~=~ ~ates: ~sT I~-~ ~ "'*""'" '"' .... * Department of Hea~ and Human Se~ices approval Reviewed and approved by' te- 72-013 (Rev. 9/91) MOA 25 Permit No. ~ I~ ~'~ .~'~) Page ~ o! Municipality of Anchorage 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 Legal Description: "~f~:2~f.. ~ : ~ :::3r PID No.: A 72-013 A (Rev 9~9t) MOA 25 INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 3500 EAST TUDOR ROAD INSPECTIONS (907) 563-3464 INFORMATION (907) 786-8211 FOOTING [] ELEC. TEMP. ~ . [] PLBG. UNDGR. [] FOUNDATION [] ELEC, SERVICE (,,,~ ~.~,. PLBG. ROUGH [] BOND BEAM ~ [] ELEC. ROUGH ::~ J~ GAS TEMP. [] FRAMING [] ELEC. FINAL~ ~] - GAS i-1 INSULATION ~ [] OTHER ,~..r~,¥,t.~{~ MECHANICAL ~ [] SHEETROCK ~ [] MECH. FINAL I-I STRUCT. FINAL [] FIRE FINAL [] PLBG. FINAL ~ [] OTHER [] ZONING [] OTHER [] O NONCOMPLIANCE OBSERVED WILL REEXAMINE AT NEXT INSPECTION CI CORRECTIONS ESSENTIAL AS EXPLAINED BELOW I-I DO NOT CONCEAL UNTIL REINSPECTED COMMENTS WH~E ///, INSPECTOR DATE N CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION 84-002 IR®v. 11/87) DO NOT REMOVE THIS NOTICE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920368 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:FEDERAL NATIONAL OWNER ADDRESS:4601 MANYTELL AVE PAGE 1 OF 1 PARCEL ID:01827161 LEGAL DESCRIPTION: TIMBERLUX #3 BLK G LT 7 LOT SIZE: 50965 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: DATE: October 21, 1992 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & PLOW TEST SITE PLANS ROAD DESIGN SO~L TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER OISPOSAt. SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HOMANSER¥ICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 7; Block "G"; Timberlux Subdivision Request you issue a permit to upgrade the septic system serving the referenced property. The existing leachfield was investigated for Health Authority Approval purposes and found to be encroaching groundwater. The proposed upgrade consists of a mounded type of pressurized distribution absorption bed. Due to the notorious elevated groundwater level history of the area we have assumed a high groundwater level of 5 ft. below the ground surface, although groundwater was found at 8 ft. below the surface at this time. If you have any questions or require additional information for your review, please contact u~. Sincerely, ROGER J. SHAFER, P.E. RJS/tv _ 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 ILEGAL DRAWN IcKD* I DATE1 c:::~.. ,~.1_~1 ~ ISHT' Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PER,ORMED FOR: L~¥~¢-,./ ~..-L-~'~.-- "'~ ~Jg, l.¢c ~. LEGAL DESCRIPTION: ~ 1 2 3 4 5 6 7 8 9- 10 11 12 13 14 15 16 17 18 19- 20- COMMENTS '~--~-~' DATE PERFORMED; Township, Range, Section: WAS GROUND WATER ENCOUNTERED? 1 si DEPTH? p Depth lo Water Aher ~,~..I Monitoring? SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop ~ 4-:~c- .. 4t/~ ~" 4-- ~-: ,~t,, " 4-"-/,~" PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND "~ FT PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85} (L~ 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 LEGAL DESCRIPTION I ~ ~.~ ~ I / -- --/ ~.' '. ~'"_ ' I~'°~" '~ ~"'"~o ~Z ManufacturerS. ~ ~ =~ Materiapl~ --~Z m No. of lines / Length °' 'a~iD' Total leng~e, Trenched '/inches Distance be~e, ~=Q Top of tile to finish grade ~ ~ Materiat beneath tile ~ inches Total effective absorption area ~ ~ ~ : Crib depth Tot a ~ DISTANCE TO: Well ~ ~est lot line ~"" Cla~roF~l Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER SOl L TEST RATING 5~ n, ~o'~ .,,~' ~PP~OVE~ ~ DATE LEGAL 72-013 (Rev. 3/78) DEPARTMEHT OF HEALTH AND ENYIRONMEHTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 9'950i OI'-I--S I TE _~..FI-~FR PER~q I T PERHIT NO. ( 790018 > APPLICANT KRIS DAVIS 555 H. HORTHERH LTS It202 274 4505 LOCATION MANYTELL RD LEGAL L? BLK G TIMBERLUX LOT SI~E 52~ SQUARE FEET TY~E OF SOIL ~BSORBTION SYSTEM I~: DRR~HFIELD ~ MAXIMUM HLIHBER OF BEDROOMS = ~ SOIL RATING (SQ FT/BR> THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= ~ LF~]TH= 49 GRA'..-'EI DFPTH= 2 THE LEHGTH DIMENSION IS THE LENGTH (IH FEET> OF THE TREHCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETHEEH THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IH F~ ..m THF TP.FI",ICH HIDTH IS /"- 5. ~--~-~T-~ ~J~"EET THE GRAVEL DEPTH IS THE MIHIMUH DEPTH OF~THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IH FEET). I:;:FL--~..IJ I RED SEPT I E:: TF:iI'-.II-( $ I 7--_E= I c__.~r-:.~£--~ GRLLOI'-.,,I$ PERMIT APPLICANT HAS THE RESPONSIBILITY TO IHFORM THIS DEPARTMEHT DURING THE IHSTALLRTION INSPECTIONS OF AHY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL NILL SERVE. TI-~IO ( 2 ) I I'-I_C. PECT I L'-~I'-.I$ :=IRE RF ~i'-~ L~ I RED BflCKFILLIHG OF fiNV SYSTEM HITHOUT FINAL IHSPECTION AND APPROVAL BY THIS DEPARTMENT HILL BE SUBJECT TO PROSECUTION. MIHIMUM DISTANCE BETHEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL; OR 150 TO 200 FEET FROM R PUBLIC HELL DEPEHDING UPOri THE TYPE OF PUBLIC HELL. OTHER REQUIREMEHTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER IHSTRLLRTION. PEP.M I T E~<:P I RES [:.F. CFt'IBFP, --~::1.. I 979 I CERTIFY THAT i: I RM FRHILIAR HITH THE REQUIREMENTS FOR ON-SITE SEHERS AND WELLS RS SET %2' FORTH BY THE MUNICIPALITY OF ANCHORAGE. ,_ ~ 2: I WILL IHSTRLL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEHER SYSTEM HAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO IHCLUDE MORE THAN ~ BEDROOHS. ~[ GNED: APPLICANT KRIS DRVI~ Anchorage POUCH ,,.650 ANCHORAGE, ALASKA 99502 (907) 279-2511 GEORGE M. SULLIVAN, MA YOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION {825 "L°' Street) December 29, 1978 #781004 Jim Arnesen 555 West Northern Lights Boulevard #202 Anchorage, Alaska 99503 Subject: Lot 7 Block G Timberlux Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Senior ' EnvironmentalSpec~ist LNB/ljw enc: copy of permit. PERM ! T' tlc PL I C. Fii'lT CFIT ! ON GRL ,-,1'-~--~ I TE ..I-~.! f*,rT'f IFSEf. i MRNYTELL RD L7 B-G T!MBERLUX T ,3 'r Pr-IL Z T"'r' DEPRF;TItEfIT O~'IERLTH RND ENV!F:Of4MENTRL 825 "L' STREET, Rt. ICHORRGE, 264-4720 SEPJE~-: F'E~.:r.1 I T 555 t,l. NORTHERN LTS tt202 LOT SIZE 274-4505 5200£~ SC4URRE FEET PE OF SOIL FIBSORBTION SYSTEI'I IS: DF:RINFIEL[~ :::IMUM NUtIE:EF: OF BEDROOMS SOIL F:RTING (SC! FT,/E:R)= il5 .E REQUIF:E[) SIZE OF THE SOIL RESORPTION SYSTEM IS: E F' -r I-t = 4 L E 1'-4 i] T I-t = 4 '_; ~..3 'F~: R '-..' E L [:, E F' T l-I = 2 THE LENG]tt [:,IMEN_ION IS THE LENGTH <IN FEET> C,F THE TRENCH OR DRRINFIELD. ]fie DEPTH OF Fi TRENCH OR PIT IS THE [:,ISTRNCE E:ETHEEN THE SURFFiCE OF THE GROUND RN[:, THE BOTTOM OF THE EXCFiVRTION (Ill FEET). -I-I-IE 'rF4Er-4121-1 lq I DTH I '5 ' ~_-~ IZ~ CdrZ~ FEET THE GRAVEL DEF'TH IS THE MItlIMUM DEPTH OF GRR',..'EL E:ETI.IEEfl THE OUTFFiLL PIPE RND THE E:OTTOM OF THE EXCFiVRTION (Itl FEET>. E,F-!I_I I F~[E I-.', SEF'T I iS; TI-lb.Il:,' '; I ZE= I I.:_~ ~Z~iZ~ ~3FILLI:,I'-.I$ :I;:MIT FiF'F'LICRtIT HRS THE F..E_,FLN:.IE, ILIT~ TO INFORM THIS DEF'RRTMENT DURING THE ~'5'fRLLRTION Itt_~F'ECTIONS OF RNY HELLS RC, JRCEfIT TO THIS PROF'ERTY RND THE );'lEER OF F:ES~DENCES THRT THE HELL t4ZLL SERVE. I'1' ~'f' Im_:KFILLING .OF tiNY SYSTEM HITHOUT FJIiRL INSPECTIm)N RilE:, RFFF,. sRL THIS iPRRTI1EIIT HILL BE SUBJECT TO PROSECUTION illII'IUM DISTANCE E:ETI.IEEII A HELL AND ANY ON-SITE SEI,IAGE [)ISF'OS~L SYSTEM IS FEET FOR A PRIVATE HELL; OR TO 200 FEET FROH A PUBLIC HELL DEF'EII~ING UPON THE TYPE OF PUBLIC I,IELL IHER RE~UIF~EMEIITS MAY APPLY. SPECIFICATIONS AND COIISTRUCTION DIAGRAHS ARE /AILRBLE TO INSURE PROPER INSTALLATION. F'EF;Id I 1' ETgF' I A:E~q DEIDEf'IE:EE~ ~:l.- CERTIFY THRT .... :'"'l 'RI1 FFII.IILIRR I.IITH'THE RE6~UIREMENTS FOR-.C,N-SITE SEHERS RND HELLS RS.. SET L~R]H BY THE MUNIC~PRLITY OF RNCHORRGE. ] HILL INSTRLL THE SYSTEM ltl RCCORDRNCE HITH THE CODES. : I UNDERSTAND THRT THE OIl-SITE SEI4ER SYSTEM I'IR',' REOLIIF:E ENLRRGEMENT IF THE ESIDENCE IS REMODELED TO INCLUDE MORE THRtl ~ BEDREOrIS. A[~F'~'~ ~fl~lT blM RR/IESEN [:'FITE /3 ,' ¢' / A !0! , DEPARTMENT O, HEALTH AND ENYIRONMENTAL ~-..JTEC'IION ', ...... 825 'L' STREET, ANCHORRGE, AK. 9~50i 2~4-4720 O~--S I TE SEPJER PERM I T PERMIT NO. ( 781004 ) APPLICRNT LOCATION LEGRL JIM RRNESEN MRNYTELL RD L? B-G TIMBERLU~ 555 W. NORTHERN LTS #202 LOT SIZE 2?4-4505 52000 SQURRE FEET TYPE OF SOIL ABSORBTION SYSTEH IS: DRAINFIELD MAXIMUM NUMBER OF BEDROOMS SOIL RRTING THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS; DFPTH -I. I ..Er~GTH= 4~ GRAVEL DEPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFACE OF THE GROUND RND THE BOTTOM OF THE EXCAVATION (IN FEET>. THE TRENCH HIDT-" .' IS 5. ~E10 FEET THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE RND THE BOTTOM OF THE EXCRVATION (IN FEET). REL~.U T RED SEPT I C Tfq~( $ I ~F 1 000 6RLLO~-~$ PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE HUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T~O ( 2 ) I NSPFP~T I 0~$ ARE RE~.U I RED BRCKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL RND RNY ON-S]TE SEHRGE DISPOSAL SYSTEM IS i00 FEET FOR A PRIVRTE WELL; OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MRY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTRLLRTION. PFR~I I T F'XP I RES DECErIBER _?--:[.. :~978 I CERTIFY THAT i: I At1 FRMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS AS SET FORTH BY THE MUNIOIPRLITY OF RNCHORRGE. 2: I WILL INSTALL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTRND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. / ..... AP~ANT ~M ~RNESEH V~. 2 Gc~ober 18, 19U8 ~ 'Mr. Jim Arnesen Real Estate Corner~of Alaska 555 W. Northern Lights Blvd. Anchorage, Alaska' 99503 Subject: Soils investigation for sanitary sewer system on: Lot 7, Block G, Addition No. 3, Timber!ux Subdivision, Anchorage, Alaska. Dear Mr. Arnesen: At your request of September 26, 197~, I conducted a soils investigation at the proposed location of a sanitary sewer'system on the subject lot. This investigation, which"was accomplished on September 28, 1978, consisted of the inspec- tion of soils removed during ~rilling of a 6 inch diameter, 8.5 feet deep test hole, using solid flight augers, powered by a Nodwell mounted Mobile B-50 drill rig. After completion o~.drilling, Test Hole No. 1 was filled with water and a percolation test performed. The results of this test are tabulated on an accompanying sheet. The soils encountered are graphically shown on the accompanying test hole boring log. The soils consisted of a layer of Organics and Organic Silt 0.5 feet thick, overlying an Organic Silt with a trace Sand and Gravel,,and an occasional Cobble 1.5 feet thick, underlain by a Sandy Gravel with some Silt and scattered Cobbles to a total depth of 8.5 feet. The topography of th~ lot consists of a gentle slope in a west - northwest direction of approximately 2 - 3 per cent grade. Vegetation present on the subject lot consists of spruce and birch to 40 feet tall, with scattered groups of alders and willows to 8 feet tall, and grasses and bushes to 3 feet tall, with Some mosses. Existence of many stumps indicates that trees have been cut and removed. A water table was encountered at 8.0 feet while drilling. Upon returning to the test hole three hours and fifteen minutes later after completion of drilling, the water table was measured to be at 7.5 feet. An accompanying sketch shows the subject lot with the approximate location of the test hole in relation to the property lines. I appreciate the opportunity to be of service to you. Please contact me if you have any questions regarding this soils investigation. Very truly yours, .. Box 191, Star Route A Anchorage, Alaska 99502 ~ (907) 344-9150 Attachments: Drawing of test hole boring log with location sketch, and tabulation of percolation test results. xc: Department of Health and Environmental Protection Lot 7, Block G, Addition No. 3, Timberlux Subdivision, Anchorage, Alaska Percolation test performed on September 30, 1978, by filling the 6 inch diameter, 8.5 feet deep test hole with water and measuring the water level drop periodically for one hour. TABULATION OF PERCOLATION TEST RESULTS TIME LEVEL(inches) 1449 9.5" 1459 35.0" 1509 46.0" 1519 50.75" 1529 53.5" DROP(inches) ET(min) RATE(min per inch) start start start 25.5" 10 0.4 11.0" 10 0.9 4.75" 10 2.1 2.75" 10 3.6 3.0" 10 3.3 1.75" 10' 5.7 ~ ' Average percolation rate for entire hour = 1.2 minutes per inch Average percolation rate for last one half hour = 4.0 minutes per inch Michael B. Bergmann Consulting Geologist .. Box 191, Star Route A · Anchorage, Alaska 99502 (907)344-9150 Due East 170.93' ,~--T.H. NO. Lot 7, Block G, Timberlux Subdivision, Addition No. 3, Anchorage, Alaska Jim Arnesen Property N89°56' 36"E 150.93' Manytell Road NOT TO SCALE Distances are approximate and have not been m~asured by surveying methods as to location of test hole. Michael B. Bergmann Consulting Geologist Box 191, Star Route A Anchorage, Alaska 99502 (907)344-9150 T.H. No. 1 9-28-78 0.0' Organics & Organic Silt, --~loose, sl moist, brn. '~--.-- 0.5' Silt: w/trc sand & gravel, occ cobble, sl moist, loose, dk brn. (OL) \ ~-- 2.0 Gravel: w/some Silt, scattered cobbles, sl moist, med dense, graybrown. (GM) 7.5'AB 1930hrs 9-28-78 8.0'WD 1615hrs 9-28-78 8.5'TD Test Hole Boring Log represents soils e~countered on Lot 7, Block G, Addition No. 3, Timberlux Subdivision. Jim Arnesen Property October 18, 1978 M~. Jim Arnesen Real Estate Corner of Alaska 555 W. Northern Lights Blvd. Anchorage, Alaska 99503 Subject: Soils investigation for sanitary sewer system on: Lot 7, Block G, Addition No. 3, Timberlux Subdivision, Anchorage, Alaska. Dear Mr. Arnesen: At your request of September 26, 1978, I conducted a soils investigation at the proposed location of a sanitary sewer system on the subject lot. This investigation, which was accomplished on September 28, 1978, consisted of the inspec- tion of soils removed during drilling of a 6 inch diameter, 8.5 feet deep test hole, using solid flight augers, powered by a Nodwell mounted Mobile B-50 drill rig. After completion of drilling, Test }Iole No. 1 was filled with water and a percolation test performed. The results of this test are tabulated on an accompanying sheet. The soils encountered are graphically shown on the accompanying test hole boring log. The soils consisted of a layer of Organics and Organic Silt 0.5 feet thick, overlying an Organic Silt with a trace Sand and Gravel, and an occasional Cobble 1.5 feet thick, underlain by a Sandy Gravel with some Silt and scattered Cobbles to a total depth of 8.5 feet. The topography of the lot consists of a gentle slope in a west - northwest direction of approximately 2 - 3 per cent grade. Vegetation present on the subject lot consists of spruce and birch to 40 feet tall, with scattered groups of alders and willows to 8 feet tall, and grasses and bushes to 3 feet tall, with some mosses. Existence of many stumps indicates that trees have been cut and removed. A water table was encountered at 8.0 feet while drilling. Upon returning to the test hole three hours and fifteen minutes later after completion of drilling, the water table was measured to be at 7.5 feet. An accompanying sketch shows the subject lot with the approximate location of the test hole in relation to the property lines. ~ I appreciate the opportunity to be of service to you. Please contact me if you have any questions regarding this soils investigation. Very truly yours, Box 191, Star Route A Anchorage, Alaska 99502 (907)344-9150 Attachments: Drawing of test hole boring log with location sketch, and tabulation of percolation test results. xc: .Department of Health and Environmental PrOtection It' Due East 170.93' N Lot 7, Block G, Timberlux Subdivision, Addition No. 3, Anchorage, Alaska Jim Arnesen Property N89"56'36"E ' 150.93' Manytell Road NOT TO SCALE Distances are approximate and have not been measured, by surveying methods as to.location of test hole. Michael B. Bergmann Consulting Geologist Box 191, Star Route A Anchorage, Alaska 99502 (907)344-9150 T.H. No. 1 9-28-78 0.0t Organics & Organic Silt, -- -~loose, sl moist, brn. ~-- ..... 0.5' Organic Silt: w/rfc sand & gravel, occ cobble, sl moist, loose, dk bm. (oL) ~-- 2.0' Sandy Gravel: w/some Silt, scattered cobbles, sl moist, med dense, graybrown. (GM) 7.5'AB 1930hrs 9-28-78 8.0'WD 1615hrs 9-28-78 8.5'TD Test Hole Boring Log represents soils encountered on Lot 7, Block G, Addition No. 3, Timberlux Subdivision. Jim Arnesen Property f..Owv'~. F£OOfC ff £ ~ V,4TIOAt~ .... ~.2. · ~,hud grade ~l~i u~.l;~y c. cn:%zct!=n~ acd ,,,I I · 4'- _"IL--7.-']._. MAKIYTELL _ A'V E ~U,'E LOT SURVEy CERTIFICATION Lot '--/-'= , Block "-7'1N.C-~ 7'~-t-Lt ¥----~- ?~: i ~ Anchoroge Recording Precinct, Alaska ~,e~re# gy: ~ DiCIONClDN CY;Whl D.WKlCH'I66] ~ ENGINC6.. ~ ~c.o.Act. Ai~S.A LEGEND: ~ Bross Cap Monument 0 Iron Pipe · Steel Pin 13 Survey Hub 8, Took Residence of: _v.~"~_c~:iiq ,," 5~&blPT--: ........ 825 "L" STREET A, r,ICHORAGE, ALASKA 99501 (907) 264-4111 GEOaGE .%',. SULLIVAN. [)EP/FIT) ENT[]F tiEALTIIAND ENVIftONMENTALP~OTECTIO,N December 31, 1979 Kris Davis 1106 West 53 Avenue Anchorage, Alaska 99502 Permit ~ 790067 Subject: Lot 7 Block G Timberlux Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to 'this department to document the installation date. If an enginee~ has inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Speci~i~'ist LNB/ljw enc: Copy of Permit PERMIT HO. I"ILII'-,I I I~--.. 1' F'RL I T"r' I--'IF RI".ICHL, RRI...]E DEPARTMEHT OF HEALTH AND ENVIRONMEHTRL PROTECTION 825 'L~ STREET, ANCHORAGE, AK. 99501 264-4?20 NELl PERI"1 1' T 790067 ) APPLICANT LOCATION LEGAL KRIS DAVIS RABBIT CREEK L? BLK G TIMBERLUX 1106 W. 53RD LOT SIZE 276 08ii 51000 SQUARE FEET MINIMU£'I DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 400 FEET FOR A PRIVATE WELL~ OR i50 TO 200 FEET FROt,1 A PUBLIC NELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSLI~,,E PROPER INSTALLATION. PEF.:I'.I I T E~-.'P I RES DECE[,1E:ER 2:~t... I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL I[ISTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. V3. 2 KEN'S COMPANY WATER WELL DRILLING PUMP SALES & SERVICE (907) 243-7893 KEN JOHNSON 3163 LINDEN DRIVE ANCHORAGE. ALASKA 9950?. WATER WELL LOG Mac Davis Lot ? Blk. G Timborlux Subdivision Anchorage, Ak. 0 ft to 3 ft. 3 ft to l! ft. ll ft to 13 ft. 13 ft to 23 Ft. Brown organic .ilt Compact silt and gravel., some cobbloo trace o~ surface water Water bearinJ co~oe gravel with cobbles Surface wa~or 23 ft to 4~ ft. ~2 .ft to 48 ft 48 ft ~o 52 ft 52 ft to 59 ft 59 ft to 62 ft 62 ft to 76 ft ?6 ft. to 95 ft 95 ft to 9? ft. Course ~r~vel. wlth some clay..drille open but tight. Hardpan with cobbles ( ti~ha ) Same but slight trace of water dry Water bearing sand and Mod. gravel.. 20 ft. h=ad.. Bails down at 3 GPM... Slow recovery Hardpan Clay and Erav~l Water Bearing Med. Sand and Gravel Over night Sdatic 16 ft. Toot bailed 3 hrs. at !2 Drawdown to 56 ft. Nominal recovery Clearing.. Mo fines.. Bottom Stable Set ~,mp at 90 ft. ', '. '.-'"- · K COMPANY WATER WELL DRILLING (907) 243-7893 KEN JOHNSON PUMP SALES.& SERVICE 3163 LINDEN DRIVE ANCHORAGr~, ALASKA 99502 N~c D&vie Ttmberl~x SubdivLsion·. Anohera~e, AX, ~ ft to 11 ft. $1 ft $~)' 13 ft, 13 ft ~o 23 Ft. 23 ft tO 4~ ft. ft to ~8 ft' ft to ~2 ft ft $o 59 ft ft to 62 ft Compact silt and gravel,, some cobbles trace of surface wate'r. Water bearing counss ,~ravel with cobbles Surface wa~er Course gravel with some clay..drills opeu but t i~ht. Hardpan with~ cobbles (' ti~h~ ) B~e but slight ~r~co of w~ter S~e. ~ · dry Water ·bearing s~nd ~d He'd. gravel.. 20 ft~ ~ils do~ at 3 GPM... Slow recovery 62 ft to 76 ft Hardpan ?6 ft, ~o 95 ft Clay and ,~ravel 9~ ft to 97 ft. Water Bearing Med. S~nd and Gravel Over night S~%~ic 16 ft. ~ Test bailed 3 hru, at 12 GPM · Drawdown %o .56 ft. Nominal recovery · ' Clearing,. No fines.. Bottom Stable Set Pump at 90'ft. - ..-1. ..,,..."' 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 7; B~ocE "G" T,~b~'~.cuc $~bd. iuZ6~.on ~'~,~ Location (site address or directions) 4601 Manyt~&~ Avcn~e Property owner Mailing address FANNIE MAE #R-92-0222 Day phone e e Lending agency Mailing address Agent Address 5201 C S:t.~.~ #100 Anchoraq~, A~zs~a 99505 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: Day phone Day phone 56_~-55~_n If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Fronl MOAI~2! Se Name of Firm Address Engineer's signature STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify {h'at 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. S & S ENGINEERING Phone m ~u,.<4 Eaglo River Loop Road No. 204 Ea~le River, Alaska ~577 6." DHHS SIGNATURE Date Approved for bedrooms. Disapproved. Conditional approval for .7~..,.~,.,,,,J"~,~) bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered In the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is Issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.. 72-025 (Rev. lYgl) Back MOAml2! Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoT r~ /~,//4 ~ "/'//~ ~'~_~_(J.~ Parcel I.D. A. WELL DATA Well type P~I Log present (~N) Totaldepth Sanitary seal, N)~'~'~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed /O//~/~'? Driller Cased to ~"~ ' Casing height Wires properly protected (~N) Date of test Static water level Well flow Pump level FROM WELL LOG /~--- g.p.m. SEPARATION DISTANCES FROM WELL TO: AT INSPECTION Iq o ! Septic/hc~dlng. tank on lot /~ Absorption fie!d on lot /O~' ~ Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank /Oo ;' ~'0. [/~,~,,/.,~ Other bacteria , Collected by: ~'~---~' ~'/"/&~ B. SEPTIC/N~'~N~ TANK DATA Date installed. ] ~' / ~' / ~ ?--, Tank size ~ 2...C0 Compartments ~.. Cleanouts~_.~) 'T'E;~ Foundation cleanout(~;N) ~'~".~' Depression (Y~.~ High water alarm (~N) ~/{~"~ ~' Alarm tested (~N) Date of pump!.ng..,~/f~ .4~'~ .C~'J~'~'/~t Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ...'/fJ~' ~' On adja.cent lots To property line ~ ~ ~ Absorption field' ' 4 Surface water/drainage /(~,3.UE' Foundation. ~ ' ' Water main/service line ~'~'~'" ~' 72-026 (Rev. 7/9~) Fmnl CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (~N) ~'~'~' '"Pump on" level at High water alarm level '~ 5'" Meets MOA electrical codes (~) ~-~' ' Manufacturer A Manhole/Access (~N) ~'~' I! * ";'P~mp off" Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot !/,r r On adjacent lots · /Oc'ry'- Surface water ,uo~c'- /o~ D. ABSORPTION FIELD DATA D'ate installed /'~. / ~'/~7_._ Length ~ .~'~ ~''' ' ..... Width ~.~'o · Total absorption area Depress!on ov~'r field (Y~-b~ Results (pass/fail) ,<~ Y'$ ~'E/~ /~'5/~,~E'~ Peroxide treatment (past 12 months) (Y~I~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot /o~-( On adjacent lots Soil rating 3~,.C' ¢Zr~.-.~,2o~,~4 System type Gravelthickness ~:~.5' · Totaldepth ,-~ Cleanouts prese,nt([~/N) ~"~'~ Date of adequacy test for ' -,~ - If yes, give date bedrooms Propertyline To building foundation On adjacent lots Cutbank Surface water Curtain drain Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION To existing or abandoned system on lot ff--~ ~' ~u~.~ t~.rO.~Watermain/service line ."-~0 I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect On the date of this i~spection. $ & S EHGINEERING 17034 Eagle River Loop Road No. 204 Signature -%~1= R;vur, alaska ';'y3// , Engineer's Name HAA Fees / .-~ 00L'~' Date of Payment /-I/" '"'C:~ -~.--~) ~ Receipt Number c~ (('..-%--'-~' I "7-.~-.- / (~ Waiver Fee: $ Date of Paymen: Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET Chemlab Ref.! :93.1245-! Client Sample ID :L7 B "G" Matrix : #ATER ANCHORAGE. ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Client Name :S & S ENClEERI~C Ordered ~y :R, SHIER Project Na~e : Project! : PW$ID :UA Collected :03/25/93 e 18:35 hxe. Received :01/26/91 i 14:40 mE[ Order :64367 Report Completed :03/29/93 Tecl~'~tcal Director :ST~?H£~ C. Sample R0~IE S~LE COLLECTED BI= S.S. ~ Allovahle Extract Analysis Pa[ameter Results ~ual. Units Method Limits Date Date Init HIBIB-~ 0.10 U m~/1 EPA 353.2/300.0 I0 03/29/93 LLH · See Special Irmtructions Above UA - Unavailable '" See ~mple Remarks Above ~A - Hot Analyzed U - Undetected, Reported value is the practical quantification limit. LT = Less Than ~_e~l~ u.<~ o, t~ SCS Group (Soc~t~ G~.~a~ ~ Su~e,,a.ce) ~. DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE ,NSPEOTOR ,NSPECTOR MUNICIPALITY OF ANCHORAGE DEPT. OF I,. ~LTrl DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~ ) ~5 L Str~ - An~oram, Al~a 99~1 ENVIRONMENTAL SANITATION DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all pa~s o~t page 1. I~plete ~u~ will not ~ pr~. Please allow ten (10) days for processing. 1. PROPERTY OWNER I PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from abo~) PHONE 2. eUYER rj~Z~ PHONE MAI LING ADDRESS 3, LENDING INSTITUTION ~ PHONE MAILING ~DDRESS 4. REALTOR/AGENT I PHONE I MAILING ADDRESS NUMBER OF~BEDROOMS r"] One [] Four [] Other~ [] SINGLE FAMILY [] Two I-'l Five [] MULTIPLE FAMILY D~I Three [] Six 7. WATER SUPPLY ~ INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled r--I COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM I~ INDIVIDUAL/ON*SITE" /¢7'7~' YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) ("~(~11 ~.~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROONIS [] 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 Connection Verified INSTALLER •Septic Tank or []HoldingTank ~,~ '~D /~')~' Size: /~_~O If Tank is homemade SOILS RATING TYPE OF TANK MANUFACTURER ~~ TOTAL ABSORPTION AREA MATERIAL Absorption Area to nearest Lot Line 5. COMMENTS [~ APPROVED FOR ~ BEDROOMS . [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVEDI / " : 72-010 (Rev. 6/79) !: - . ___~..~ Architecture · Engine?~.g ° Land Surveying ° Planning ~-~ ~--- -=== = ~ ~- Anchorage Fairbanks ~ ~/~ : ' A~u~'~w,:~u~ ~ .... .. .. ~t~ .... ~~' ~ : .......... . ~ ~. ............. .. ~. - .... ~ ...... {.~I ....... I ..... : .... ~ .... ~ ...... H~ : .......... ....... .................... I ' : [" , ~ , , ~ I , ~, . ~ .... , , , ~~ '' ~ ..... .................. : ........ ~ ............. ~ .......... :-~ ..... : ...................... ~ ................................................ ~ ..... : ] .... ; :~'1 '," ' : ; : , ' ' ] ' : ......................................................... ~ ............... ~ ..................... ~ ..... [ ...................... :'7 ......:r ~ · I ........ , , I ' ' ' t ..... ~;...: : " ~ ' ~ *:Z, : ~ ...... ~ ........ Project Title ~~ ~D. ~bO~,~, ~ Page Title W~&~ F~ ~ W.O.~ Date W-I~ By , Page I off MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date /~'"'/B "'~.~' GENERAL INFORMATION (al (b) (c) Legal Description (include lot, block, subdivision, section, township, range) Location (addre~ or directions) Applicant Name ~]~Y' ~fi ~/STelephone: Home ~'~ Applicant Address ~/ ~YTE~C R~. Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain); (d) Lending Institution .-,~?/~27'Z,~''' ~"--~ (e) Real Estate Company and Agent Address (fl Telephone Mail the HAA to the following address: TO ~ ?I~,~C~ ~IP FSY t:YppI..I~Atv~. TYPE OF RESIDENCE Single-Family~ 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 o! Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~ Publicl-I Community [] Holding Tank [] Note: I! community well system, must have written confirmation from the State Department o! Environmental Conservation attesting to the legahty and status. 72-025 Ill, 84) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certifie~J 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. 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 ~, .~, .~, J"~, . J,~, Telephone _,~ 7,~ '~ ~,~¢,.~ Engineer's Seal ~::r:;::Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Healtl3 Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers ot 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 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 APR I8 1985, 264-4720 Legal Description.' WELL DATA Well Classification //VZ~IVI ~:3~1~... If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Y Date Completed ~¢~ /~ 1~7~ Yield Total Depth ~ ~, Ca~d to ~7 ~. Depth of Grouting Static Water Level J~ ~, ' ' Pump ~t At ~ ~. Casing Height Above Gm~ ]~~// ' ~nita~ ~al on Casing (Y/N) Sl~trical Wiring in Con~t (Y/N) ~~: Depr~sion Around Wellhead (Y/N) ~paration Distances fromm;;. To ~ptic/Holding Tank on Lot ] ]~ ~.' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot / ~ ~, ; On Adjoining ~ots TO Nearest Public Sewer Line N/A TO Ned;est Public ~we, CleanouVManhole N/~ ' T~ ~earest ~wer ~i~~. Water Sample Collected by DAV~ ~O~Y ~.~']~i Date Water Sample Test Results ~J ~T~ ~' B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (WN) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course Size No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72.026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Puml~ On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MoA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~3/~ .~. /_,~l,~/I/~ Date Company (~. ~,~,~, /~, MOANo. Receipt No. '~ ~ ~ ~ ~ ~ Page 2 of 2 '~?. NO. 1958-E ..~ /Vt uni cipa ty ANCHORAGE. ALASKA 99502-0650 O5 (907) 264-4111 Anchorage MA YOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION May 14, 1985 State Federal Mortgage 10300 S.W. Greenburg Road, Suite 125 Portland, Oregon 97223 Subject: Lot 7 Block G Timberlux Subdivision Gentlemen: This office recently signed a Health Authority Approval Certificate on the above property in Anchorage. We have now found that this approval was issued in error and wish to notify you that we are invalidating it immediately. It is our policy to write Health Authority Certificates for a combination of sewer and water components, and not for single components. In this case, the engineer performed a well flow test only. The deficiencies for a full approval include pumping the septic tank, adequacy testing the absorption system, sealing the well where wires exit the wellhead, and obtaining a current water sample(taken by the engineer). Please correct your record to reflec~ our withdrawal of approval. If you have any questions, please call this office at 264-4720, area code 907. Sincerely, Susan E. Oswalt Acting Manager~ On-site Services SEO/lJw cc: Billy Mac Davis John Lynn RETURN RECEIPT REQUESTED ~ ~o wh~, da~ ~d a~r~ of~..--~ ~ to ~ ~d date ~ ............ ~ ~ ~ERY. ~ ~ ~ ~, ~ ~e~ of ~.$~ SEO/~]w Env~ronmenC~ He~Ch (~LT ~g FOR F~ 4601 ~nytell Avenue ~chorage, Alas~ 99515 RtO~D~. I CEflTW~ED~ ~ ~ PG65-6892~16 P 665 689 615 ?' RECEIPT FOR CERTIFIED MAIL ' NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) sen'~%ate F~deral Mortgage Stre~0~' S...W. GREENBURG ReA P.O.,~.~M_.~ ~'~ d ~ode Post2~ttland~ Oregon ~7223 Certified Fee Special Delivery Fee ~ Restricted Delivery Fee .....~ Return Receipt Showing to whom and Date Delivered Return receipt showing to whom, Date, amd Address of Delivery TOTAL Postage and Fees $ Postmark or Date RETURN RECEIPT REQUESTED · SENDF-J~ ~ ~ 1. 2. and 3. 1. ~f~o~g ~ ~ ~es~d (~e~k ~.) ' ~S~ to ~. da~ ~ ~ of ~ ~-~ ~ ~RY ~ ~C~ ~Y. SEO/lJw Environmental He~Ith~Dix (~T ~ I~R FOR FFgm) 10300 S.~. Greenburg Road~ Sufee Poreland Oregon 9722B " P665 689 6~5 665 689 614 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) Sent :o Billy MacDavis Stre~t~0tN~anytell Avenue '-" P.O., State and ZIP Code Anchorage. Aln~lc~ qqql9 Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to whom and Date Delivered Return receipt showing to whom, Date, and Address 'of Delivery TOTAL Postage and Fees $ Postmark or Date