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TONJESS ESTATES BLK 2 LT 3
Ton jess Estates Block 2 Lot 3 #051-832-26 UBMITTA Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 V SEP 21101 of 16 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141245 PID Number: 051-832-26 Dwelling: ■ Single Family (SF) ■ Duplex (D) ■ Multiple (SF and/or D) Project: ❑ New • Upgrade Name: FRED THIBODEAU ABSORPTION ■ FIELD Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other Address 25115 PRINCE CIR., CHUGIAK, AK 99567 Phone Number of Bedrooms 4 Soil Rating GPD/SF Total depth from original grade Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot TONJESS ESTATES 2 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area Ftp Number of trenches Dist. between trenches Ft. Well >100' >25, TANK ■ Septic • S.T.E.P. ■ Holding ■ Other Manufacturer ANCHORAGE TANK Capacity 1250 Gal. Surface Water >100' NA Material STEEL Number of compartments 2 Lot Line >5' LIFT STATION Foundation >5, Manufacturer Capacity Gal. Curtain Drain NA Remarks EXISTING SEPTIC TANK DECOMMISIONED Pump on level at in. Pump off level at in. High water alarm at in. PER UPC REQUIREMENTS. Pump make and model Electrical Inspections performed by Installer DEAN CONSTRUCTION PIPE MATERIAL House to tank 3034 Tank to 3034 drainfleld Drainfield 3034 CO/MT3034 BENCH MARK (Assumed elevation) 100 ft Inspector LARS SPURKLAND Location and description BOTTOM SIDING SE HOUSE CORNER Inspection " 1 7/29/14 dates: ed 3rd 4th COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date Engin s Stamp �,"'\ =` QFq i P,E'. ....0 111 . 49T SPURKLAN I'l�� li4il10,: I1�Fb•.ic,/31'*- fir 11 D Z toi / � Approved `/ / 47 ate fZ/ 7 / Inspection Report 9-1-12.d TA ' NEW 1250 GALLON STEEL SEPTIC TANK CONNECTED TO DRAINFIELD. / LOT 3 ABANDONED EXISTING / SEPTIC TANK PER MOA CODE REQUIREMENTS /.0 / SWING DES A B S.T. C.O. C 30' S.T. CO. D 35' OBL C.O. E 38' 42' 38' 36' roc coot 20, . < /' Parr " 25 0 25 50 75 100 SCALE 1' = 50 FT. NOTE: THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. DOUBLE CLEANUUTS NOTE: 4' CONTOUR LINES TAKEN FROM MOA RECORDS ARE APPROXIMATE AND ARE NOT SURVEYED. 125 150 TONJESS ESTATES SAO BLOCK 2 CONNECTED TO EXISTING DRAINFI£LD BENCH MARK BOTTOM SIDING SE HOUSE CORONER ASSUMED ELEVATION 100 FEET SPURKLAND ENGINEERING 203 W 15TH. AVENUE NCH. AK. 99501 (907) 279-3916 TONJESS ESTATES B2 L3 FRED THIBODEAU 25115 PRINCE CIR CHUGIAK AK SEPTIC SYSTEM ASBUILT DATE, JULY 31 2014 SHEET' 1/1 GRID NW1462 PERMIT # OSP 141245 PID # 051-832-26 TONJESSESTATESBRLIDWG On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141245 Tax Code Number: 05183226000 Work Type: SepticTank Upgrade Permit Effective Dates: July 22, 2014 to July 22, 2015 Design Engineer: SPURKLAND ENGINEERING Subdivision: TONJESS ESTATES Site Legal Address: TONJESS ESTATES BLK 2 LT 3 G:1462 Owner/Address: THIBODEAU FREDERICK J & PATRICIA B PO BOX 671133 CHUGIAK AK 995671133 Site Mailing Address. 25115 PRINCE CIR, Chugiak Lot Size in Sq Ft: 48690 Total Bedrooms: 4 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: '277,7//4 Issued By: (�t/�,�/%— Date: 7 40r MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-832-26 Property owner(s) FRED THIBODEAU Mailing address 25115 PRINCE CIR CHUGIAK AK 99567 Day phone Site address SAME Legal description (Sub'd., Block & Lot) TONJESS ESTATES B2 L3 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage APPLICATION IS AN: Initial Upgrade Renewal TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings (SF and/or D) SUBMITTAL THIS APPLICATION INCLUDES A VARIANCE /laUEST FOR: Distance: x❑ 11 I certify that the above information is correct. I further certify that this is in accordance with appjicable Municipal Codes. of property owner or authorized agent) Permit/Rush Fees: c2 t 5 Date of Payment: 1144 Receipt Number: n 5 G Gt Permit No. OS'PM4 OAS - Permit M 5 Permit App_9-1-12.doc Waiver Fees: Date of Payment: Receipt Number: Waiver No. Spurklland Engineering Environmental Consulting and Design i t July 11, 2014 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Elmore Rd. Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION Tonjess Estates Block 2 Lot 3 Ladies and Gentlemen: We are submitting an application to upgrade the septic tank for this lot. The current septic tank has been compromised and needs to be replaced. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Si ce ly Jia s urkland, P.E. 203 West 15th Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net / `NSTALL NEW 1250 GALLON STEEL SEPTIC TANK ;ONNECT TO DRAINFI£LD OT MANN EXISTING SEPTIC TANK PER MOA CODE REQUIREMENTS 25 0 25 50 75 100 SCALD 1'=50FT, NOTE: THIS 15 NOT A SURVEYED PLAT WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. DOUBLE CLEANLUTS NOTE: 4' CONTOUR LINES TAKEN FROM A104 RECORDS ARE APPROXIMATE AND ARE NOT SURVEYED. 125 150 TONJESS ES TA TES S/D BLOCK 2 4 FEET COVER CONNECT TO EXISTING DRAINFIELD 1250 GALLON SEPTIC TANK N FOUNDATION CLEANOUT •i i •vv,��.No, CE -11500 ��iS1I Sso;,. # SPURKLAND ENGINEERING 203 V 15TH AVENUE ANCH. AK 99501 (907) 279-3916 TONJESS ESTATES B2 13 FRED THIBt1DEAU 25115 PRINCE CIR CHUGIAK AK SEPTIC SYSTEM DESIGN DATE' JULY 11 2014 SHEET' 1/1 GRID, NV1462 PERMIT # OSP 141XXX PID # 051-832-26 TDNJESSESTATESB2L3.DVG 0 MUNICIPALITY OF ANCHORAGE 0 1 r DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION rill ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAMET SI/ PHONE EW MS& CO s1•biz f:0t. T1 -•C ■UPGRADE MAILING ADDRESS ‘7/0 e/Gst, Atte - AKcLoraye AK 'f 4504 LEGAL DESCRIPTION Lai 3 b'/OC't Z Ta3.4...) e3t5 is/4fts LOCATION lcrrs C kee k - AK NO.OF BEDROOMS O DISTANCE TO: Well / 'JZ Absorption area /1' Dwelling 4Jone. PERM NO. Y3 /00 I- Z uJ 4 Manufacturer /% rl "-Gilfir %� }� aye -Mt.,. i� Material SYIC. I No. of CO[np m nts G Liq. capacity in gal IF HOMEMADE: Inside length Width Liquid depth. 6DISTANNCE TO: Well D g P IT NO. 0 Z F Manufacturer "4/714 / T Material Liquid capacity in gallons 0 w= DISTANCE TO: Well , /zri Foundation �j�DOl' Nearest lot line IL' PERMIT NO. <P�, 00 al u Z —Zw No. of lines Length of each line 32 Total Ie_ngth of lines Trench with Distance between lines CC 3Z1 3 inches 2N. f 0 Top of tile to finish grade ,j r Material beneath tile 2- 3 ..SG re...� Gh,,,. 9 > q 6 inches Total effective absorption area 'f - S/ b 0 ts Length Width epth PERMIT Co ad f GLE.1- aI- w a Type of crib Crib diameter Crib depth Total effective absorpti area C CoMp cs_, • ssyst-t JT;:' ta as DISTANCE TO: Well Building f n ti n Nearest lot line Class Depth Drill �'�` Distance to t line PERMIT NO. J Iii .. DISTANCE TO: B ding foundation Sewer line Septi ank Absorption area(s) OTHER SFNG PIPE MATERIALS ID f-- 224%2 ZPAiU can- ci ' N R8s 4'' � 32 'Peri, Rl/.C,9' f v (uP A S /2' tt. SOIL TIESTT.dA2 G 1 aSsq. ''t/Stirs. v„ 17' 0 4 f"Cir, %� 11;, _ el/ �_ INSTALLER ,,..11 tat' 0 e- z rOAM Ai D G. B.0.-`t:Cnat k4 8"rr / V !Z $U CGALix/! REMARKS a A c oP Fn,a nt Alb P0,.....141:o.. ar kids, ' I .senc Moot of 9D -07-i; Serine TG.,k T.,sc.L-tnt - - I As-Drt el -al I st 6.4.400.6 L../ 2 r`rTest.../4rt:i PL.= 4., wiL I Visit, ew. oust- e•al:rr _.&o 44-; 4, ./ M j i �OO�FNAL��; 2 11 a ir P,.••...... d� t Or 1. 9th 'vi ii 11ToR 6Lk a `U JOHN E SWANSON : e, N.� 8E . ,� * '•. 1`SI�34-E . ,,? •(cc/0/1'4-01/ t�Teta*••.ii�••„eta. 0 t ,#// Ca W4 5,11k �JiP®®�'1A`J ESSI01►P / DATE LEGAL 22'411 UIS IHev. i•yi,f1�1 i CL: I LIT`- 'DF Ht 1i_ F-• 1F'HUE — DEPARTMENT In HEALTH AND ENVIRONMENTAL rROTECTION• AiO /:70.1g 825 'L' STREET, ANCHORAGE, AK 99501Q+ • w 254-4720 : ANCHORAGE 694-2131 : EAGLE RIVER ON—=.ITE : EL•JEF: F'EF:M I T PERMIT NO: 831000 - APPLICANT: SHASTA CONST. INC PHONE: ADDRESS: 6710 E 168 L AV:. ANC, AK 99504 LEGAL DESCRIPTION — SUBDIVISION: TONJESS EST. BLOCK: 2 LOT: LOT SIZE 48690. SQ. FT. TOWNSHIP: 15N RANGE: 1W SECTION: 2 MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING = 125 125 125 (SQ.FT.lBR) LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS•YOUR SITE. TF:E.t-J H G.E= I (31-1 WIDTH = 2. 5 FT. LENGTH = 32. 0 FT. TOTAL DEPTH = 12. 0 FT. e" GRAVEL DEPTH = 8. 0 FT: GRAVEL VOLUME = 25. 1 CU. YDS. TANK SIZE = 1, 250. 0 GALLONS <TWO COMPARTMENT TANK) BEC. C. I Cat -4 WIDTH = 20. 0 FT. LENGTH = 40. 0 FT. TOTAL DEPTH = 5. 0 FT. GRAVEL DEPTH = 0. 5 FT. GRAVEL VOLUME = 29. 6 CU. YDS., TANK SIZE = 1,250.0 GALLONS (TWO COMPARTMENT TANK) • JAI E. E Er■ F: F IIA F I EL. C'1101--.1 WIDTH = LENGTH = TOTAL DEPTH = GRAVEL DEPTH = GRAVEL VOLUME = TANK SIZE = 5. 0 FT. 5<",1.1,71 FT. 7. 0 FT. • 0 FT. 38. 2 CU. YDS. 1,250.0 GALLONS (TWO COMPARTMENT TANK) I CERTIFY THAT: 1. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET . FORTH BY THE MUNICIPALITY OF ANCHORAGE AND THE STATE OF ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES AND HAVE RECEIVED A COPY OF THE CODE SUMMARY AND DIAGRAM ATTACHMENTS WHICH IS PART OF'THIS PERMIT. <:. I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO. INCLUDE MORE THAN 4 BEDROOMS. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM PERSONNEL DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. IF A LIFT STATION IS INSTALLED, AN ELECTRICAL F'ERIIIT AND INSPECTION [IUST BE OBTAINED. AS—BU I LTS CANNOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT. THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. APPLICANT: SWf? T rCONST. INC ISSUED 64. � o DATE: '10/05/83 PERI (MIMED f ON 0 & ENGINEERS, INC. S FIRST FEDERAL SAVINGS AND LOAN BUILDING P.O. BOX 15000.93 WASILLA, ALASKA 99687 SOILS LOG PERCOLATION rES1 r,A-A5'12. Co+,.541- Eieti LEGAL. DESCRIPTION mss ("Co tPr:-Tw 3 - 4 - 6- 7 - 8- 11 — arts 12 - 40 �.0140 'q o. o A si 44.• b tor Op b .. 16 < 17 18- 19 - 20 - T D• L0+ 3 B//l Z or 9 ;``c`` /1414,144:t0p e- .5.0-Jj N►'+rw-wI,si!t(NL OrJ4„;e3 sM�rt' cc,14,43 I oe3,!� �a u`Coci7 ts�oi5�� t "°'�.9r41.'1 , 1 4,e sil1t. i -Lb/ fo 8•. Gr4.02 SQ.w,( •SH/ ice'>ti •' boa > + k fir, _ *Ilk COMMENTS JOHN E. SWANSON :� S k '<`',9 %•, • 1834-E •••, • 4'44 -®•sem ®�i _. PERFORMED BY 17.00! (4/791 DATE PEW'OItMEU 13an EL S...$ C 5i4iE`{c5 SLOPE. WAS GROUND WATER ENCOUNTERED, IF YES. AT WHAT DEPTH' L t sore' zoo Ija 1'I II(.O1 AT INN rY� 1 1 SI O -4-P3 /�ci.terS SIT Z�7'C-A J4 3 R.Lk 1 1S LUT ) a Ye - vv i'adi' !9 Reading Date Gross Time Net Time Depth to Water Net Drop lr iP-4-�3 3r.0, 4 :0? stater zo �,.;,. d� 6 c, " / z qt )P 1U;. O •, 2.'/zn 2- Z) 3 4.22 / per 0 /,a 5 N z " S y 4.4 ? !oma_- ) -� 4>-;i510-<.- Z.3.4" 3.4,., PERCOLATION RATE TEST RUN BETWEEN /oee i�ea� 01N. 51+-.-+./(/ c")13 -e__ i i c,L , tt).c. C p r &.;1,e of lY. �Ow r/lr WASILLA (907) 376.3770 ANCHORAGE (907) 349-6561 4minutes/inch) FT its,4,T tiM'G. CEslilf LED DY 37 El EAGLE RIVER (907) 694-9846 DATE: /D' S 83 HOMER (907) 235-8179 October 24, 1953 John Swanson 6 & S Engineers, Inc. 7125 Old Seward 1lighwy Anchorage, A.::: 99502 SUBJECT?, Lot 0A, Another Subdivision On-site As -built and Lot 3, Block 2, Tonjess Estates site As -built SOear Mr. Swanson: This department cannot accept the submitted as-bailt tor Lot 3-A, Another Subdivision, until the drawing shows the stand pipes locations. Also, please recheck the absoTption area for Lot 3, Block. 2; you will find it should be 512 square feet (2 x 6. feet x 32 feet) and not 760 square feet. Please have your inspectors check tnis computation. If you have any further quest ',171s please call me. at 264-4720. Sincerely, Cory 'Allis, Acting Sewer a ter Program Manager Cli'83/j P' LOCATION OF WELL (Please complete either lo, Ib or lc.) . WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological 8 Geophysicol Surveys Drilling Permit No. A.D.L. No. tot Borough Anch Subdivision Tonjees Lot 3 Block 2 Ib. 1/4 qtrs. —of—of—of — Section No. Township No a❑ Range E ❑ w❑ Meridian Ice DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS Street Address and Area of Well Location 3. OWNER OF WELL,. Ray Pelletier Address: 6710 E. 16th Ave. Anchorage, Ak. 99504 2. WELL LOG Feet Below Surface 4. WELL DEPTH: ( final) 140 5. DATE OF COMPLETION 10 5 83 ft. — O M aterlol Type Top Bottom Sand, gravel, silt t 0 40 6, ❑ Cable tool )N Rotary ❑ Driven ❑ Dug Greenstone 40 85 U Auger ❑Jetted ❑Bored ❑ Other : Gray rock 85 89 7. USE:Domestic 0 Public Supply 0 Industry Greenstone 89Z 0 irrigation ❑ Recharge 0 Commerical Greenstone with gayly 125 C140 0 Test Wellr• 0 Other; ravers, crevices, water —J\ B. CA ING: Tare d y Welded diam. b in to t. Depth Weight 17 lbs./ ft. diom. In. ft. Depth Stickup It. 9. FINISH OF WELL: Type: Diameter: Slot/Mesh Sin: Length: Set between ft. and ft. Back filling Gravel pock / 10. STATIC NATER LEVEL' ft. / - Date ❑ 0 Above or Below land surface Equipment used: 11 . PUMPING LEVEL below land surface and YIELD tt after hrs. pumping g.p.m. ft. after hrs, pumping. g.p.m. 12.GROUTING Well Grouted: 0 Yes ❑ -No Material: ❑ Neat Cement ❑ Other: 13. PUMP: (if available) HP Length of Drop Pipe ft. capacity g.p.m. ❑ Subm. ❑ 4.t ❑ Centrifical ❑ Other 14. REMARKS: Production of 10 GPM 16. WATER WELL CONTRACTORS CERTIFICATION: 15. Water Temperature ❑ F ❑ C —a This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; Magnuson Drilling AA 5385 Registered Business Name Contract License Number Address: D O. ox 770504 Ea le River Ak. Signed: r�/ GfI e6„11y----- Dote: Oct. 10, 1983 Authorized Representative / Form 02- WWR (II/SI) Copy Distribution: WHITE -Stole DGGS,. PINK 'Drifter,. CANARY' Customer ON 10301 SOHO O 3 LIt' L /ce 6 Ji •'6 :5 /eV so /0' -3a //•'6o //-•c e2 10 0 / OC7 /5� Gam;. -)r /3 rVfje,e, "eD 4c T & tn.) rie L) rM rc 4c) y� ./ 5 -cel _pad/ /Y d i c� rec;Tez dye_i?A)/ / //1 71/Pa 'e,,y/i//J,`e�+ e!- J r " rez IA) �'AT e wc° /Q/,' /) e-v,)s <„Qtt) vim - `ZLp r1. 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 //) 20/w 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 4n74 .? 4'/4 z f Tom% F<< Es"f1�S sine Location (address or directions) (b) Applicant Name /6/6 Ds71/ 4 Telephone: Home '?Y- 23&'`x' BusinesssZ.f Applicant Address "e?. 77 VS 2.7 L f/ ,�ii/t�� f7.5-7 (c) Applicant is (check one): Lending Institution 0 ; Owner/builder Cl ; Buyer 0 ; Other Et -I -explain); e %71dr- (d) Lending Institution Telephone Address (e) Real Estate Company and Agent /� Address Al 4'z' 7 7 /.6." Z7 Telephone 6.-.r ' 2 / /i�•:. 1"?' y 2. Pi' 2 (f) Mail the HAA to the following address: cel/7 7? "9; 4:-.,V r-3g'f". 6N- 7;7e Zea,7 s�, Tie Q5,2, 2. TYPE OF RESIDENCE Single -Family Multi -Family 0 Other Number of Bedrooms 3. WATER SUPPLY Individual Well Community 0 Public 0 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,( Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health' Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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.`r/' Name of Firm !l �-Z ��t Su. /r,c� -nis Telephone 6' .f J^ y` 3 74` Address i�% 4x 7 7 6/4 9 `/ � .�Gzyl' -& j ,%/a!t / 9 5— 7 -) Date //A O/ S''� 6. DHEP APPROVALC 0u2� Approved for bedrooms b Approved Disapprov ._ fi�t O Y eA�A�9 r.[ ° e°°®®°s°Ga .r' I‘. " 'osa , 011 N C2°° °...; :,r sa®® ,may b •e fr: 1676;117' 0 ?r, Vernon L. Roelfs f # �°o® No. CE 5107 . _. ate Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health .Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) Aga oR A. WELT MUNICIPALITY OF ANCHORAGE (MOs,) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 4// t7 Legal Description: Z4,71 3 2, e3-75'4: deck 514a iCais-/nab Well Classification %i`i�/�7e If A, 8, C, DEC Approved (Y/N) Well Log Present (Y/N) S Date Completed 42//5/1? 3 Y'l d /G /A A/41s1 Total Depth /9U Y` tr ' Cased to ' 2 4' Static Water Level t G 47•/ / Casing Height Above Ground 2 S ie Depth of Grouting ycyne ��SfC3c>!" Pump Set At /fief L?Ved Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N)` !/61 Depression Around Wellhead (Y/N) rU� Separation Distances from Well: To Septic/Holding Tank on Lot // - ; On Adjoining Lots `' fit To Nearest Edge of Absorption Field on Lot /33 ft On Adjoining Lots / To Nearest Public Sewer Line �lA To Nearest Public Sewer Cleanout/Manhole /r// To Nearest Sewer Service Line on Lot Water Sample Collected by /��ei-n ".f.�cc?l7' ; Date /l r/9Ji 0 Water Sample Test Results 4�UO /1 C / Comments B. SEPTIC/HOLDING TANK DATA Date Installed fO 7/2 �2 5 'a- ( No of Compartments Standpipes (Y/N) )//s ' Air -tight Caps (YIN) 7 8' C Foundation Cleanout (Y/N) i/e•S Depression over Tank (Y/N) /(1/, Date Last Pumped //Z v ?' .re Pumping/Maintenance Contract on File (Y/N) /1%/iQ , for Holding Tank High -Water Alarm (Y/1\1)+ Temporary Holding Tank Permit (Y/N) 11//f Separation Distances from Septic/Holding Tank: To Water -Supply Well //'Z, 2F To Property Line 2 `C� To Water Main/Service Line A//iQ Course/j�l Comments To Building Foundation 77' To Disposal Field ,/ {f To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(1;1/84):x: C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata// �2 S % Type of System Design Date Installed /4197")./ 3 Length of Field Width of Field /h ,Oce 3 2 ff Depth of Field Gravel Bed Thickness , 7t7 1 Square Feet of Absorption Area 5- / Z Standpipes Present (Y/N) ye $ Depression over Field (Y/N) /la /� 1Date of Last Adequacy Test /11/0'6' i -'f Results of Last Adequacy Test S'is 7` --Zorn Separation Distance from Absorption Field: To Water -Supply Well To Property Line /2 -it' To Building Foundation / 8'44 To Existing or Abandoned System on Lot d/4 . On Adjoining Lots To Water Main/Service Line O. To+C/utbank (if present) /44['` N% To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage, Area Com ments D. LIFT STATION Date Installed 4/0 Size in Gallons "Pump On" Level at Dimensions Manhole/Access (Y/N) "Pump Off Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** • d, or ,. - ormed to all'M�O and AA guidelines in effect on the date of this inspection: Date // 67‘ l/�� lana MOA No. 5 S�� /O (p /2-- I certify that 1 h e checked, veri Signed Company Receipt No. Date of Payment Amount $ Page 2 of 2 72-026 (11/84) rd'.* m swy OF 411141 orisr* 9114 e "9 9 es . Oes rasa.. ease* ••• B n ...... . .. ®cans, Vernon. 1. Roelfs �i s e% No. CE 5107104 .ere. ee CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM I.D.# 2"TiIVATE WATER SYSTEM s 79 Name .ef is 7 7116 y L Mailing Address l=�G //:" City / State Phone No. ,,A 7 _7 7 SAMPLE DATE' Mo. Day SAMPLE TYPE: utine O Check Sample (for routine sample with lab ref. no ) ❑ Special Purpose SAMPLE NO. LOCATION Ito/ ,8A 2 Ton - es< E U 5a4(1 1 2 3 4 5 Year Zip Code O Treated Water O Untreated Water Time Collected /.'30 "fit Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: E Satisfactory Unsatisfactory Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received / / -. Time Received /4'381 Analytical Method: Membrane Filter * No. of colonies/100 ml. Lab Ref. No. 1 it%l 1 I 1 I Result* 6 Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD i Membrane Filter: Direct Count Coilform/100mI Verification: LTB BGB Final Membrane Fifte Re.ults C Coilforml100m1 I j Reported By Date l�/g//,�'E 1 TNTC = Too Numberous To Count OB = Other Bacteria Time: /510 a.m. p.m. L_ C) VEI Engineering, Architectural and Surveying Consultants Serving All of Alaska November 20, 1986 Municipality of Anchorage Department of Health & Environmental Protection 825 "L" Street Anchorage, AK 99501 Re: Health Authority Approval (HAA) Application, Lot 3, Block 2, Tonjess Estates Subdivision Gentlemen, P.O. Box 774649 Eagle River, Alaska 99577 (907) 694-3574 On November 19, 1986, we performed research, investigations and testing pursuant to Health Authority Approval on the above referenced lot. We performed a flow test on the well and found the output to be adequate for a 4 -bedroom house. Well production was found to be in excess of 5 gallons per minute (gpm); for a 4 -bedroom house well production of 0.416 gpm is required. We took a water sample for bacteriological analysis and results were negative (Refer to Chemical & Geological Laboratory Analytical Report, attached). We performed an adequacy test on the septic system and found that it absorbed at a rate in excess of 2000 gallons per day (gpd). This is more than the 600 gpd required for a 4 -bedroom house and the system is therefore adequate. The septic tank was pumped and the volume was verified to be 1,250 gallons. To our knowledge, we have assembled all available information on the HAA Checklist and Application Form. We offer this information for your review. Please call if you have any questions. Sincerely, VEI 20NSULTANTS L Vernon L. 'oelfsPE Vice President Attachments: HAA Application HAA Checklist Sewer As -Built Well Log Total Coliform Analysis (Chem Lab) cc Pete Ostdiek o„°o°o.00 .00°e.e oo; (F�1 Vernon L. R:170: elfs w,O �� e No. CE 107 f �® ���, ror-�ssl© .�® W MT. EKLUTIJA. DRIVE M Kt 89°49'' E 85.55' 3/2 CoN6 PAD vow 5T 3.0 ALIT) - 2 � lv Scale "=4O" L N I HERMY CERTIFY THAT 1 HAVE SURVEYED THE FOLLOWING D& RI BED PROPERTY : LOT 2, L K 2, To JJESS ESTATES;. y4 $TIOU Z T lel, Rlti,M 1-77 4 •:1114s •*s RORFoi 0 FOER •. .. i 1; LS -3105 /47.; /411/44):„., 414�Ai+4. (D AS- e›U)LT LUT 3, BLOCK 2 TULIJE55 EsTATE5 VE l CONSULAI.IT5 P.O. BOX -174(.49 EAGLE RIVER, AK II -l6-840 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3 Block__? TonjPss Estates Subdivision Location (address or directions) (b) Applicants Name Shasta Construction Telephone - Home Applicants Address 6710 East 168th Avenue 99504 (c) Applicant is (check one) Lending Institution Buyer ; Other (explain); (d) Lending Institution Bank of the North Business ; Owner/builder xx Telephone Address Pouch 6608 Anchorage, Alaska 99502 (e) Real Estate Co. & Agent Bob Martin, Commonwealth Area Realty Address Post Office Box 770249 Eagle River, Alaska 99577 Telephone 694-9555 (f) Mail the HAA to the following address: 2. Type of Residence Single -Family xx Multi -Family L1 Other (describe) Number of Bedrooms Four 3. Water Supply Individual Well xx Community Public 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 xx Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 Firm Telephone Address Date This office has received written confirmation from the engineer regarding the conditional approval. It has been repaired and inspect therefore, this property now 6. DHEP Approval , meets with MOA standards and is appy. ed. Approved for four .bedrooms By jjte August 2, 1984 (ENGINEER SEAL) Approved xx Disapproved Conditional 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 TECH ENGINEERS, INC. CIVIL • SANITARY July 31, 1984 Municipality of Anchorage Department of Health & Environmental Protection 825 "L" Street Anchorage, AK 99501 Re: Reinspection, Shasta Construction, Health Authority Approval (HAA) Application; Lot 3, Blk 2, Tonjess Estates Gentlemen: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION AUG 11984 RECEIVED During March of this year we performed research, investigations and testing pursuant to Health Authority Approval on the above referenced lot. Everything was acceptable with the exception of the inspection pipe for the absorption trench. It was buckled and not serviceable. Due to frozen ground conditions, this deficiency was not corrected at that time. As we understand it, a conditional Health Authority Approval was granted. This letter is written to inform you that we recently reinspected this system and we found that the defective pipe had been repaired according to Municipality Standards. call. If you have any questions, please do not hesitate to Sincerely, 1 Vernon L. Roelf%, PE a'c't.° F •ffirk.'s is cc Shasta Construction Bob Martin, Commonwealth Realtors O i South Fork Construction L� v t Vernon L. Roelfs : �// �' rp. % No. CE 51.07 . r itVF we.ww.wwNwww'+r(r� ‘1`ROFESSO®�� 13 LE DOUX LANE • EAGLE RIVER, ALASKA 99577 • TELEPHONES -3574 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECri0N " APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date March 16, 1984 (a) Legal Description (include lot, block, subdivision, section, township, range) T,nt 3, Rik 2, Tnnjss Es_t_atas Location (address or directions) NHN Prince Circle, Pet_er's Creek, AK 99567 (b) Applicants Name Shasta Construction Telephone 337-0892 Applicants Address 6710 East 168th Ave., Anchorage. AK 99504 (c) Applicant is (check ore) Lending Institution Buyer I I ; Other (explain) ; (d) Lending Institution Bank of the North Address Pouch 6608, Anchorage, AK 99502 ; Owner/builder XX Telephone 278-4581 (e) Real Estate Co. & Agent Commonwealth Area Realty; Bob Martin Address P.O. Box 770249, Eagle River, AK 99577 Telephone 694-9555 2. Type of Residence Single -Family x. Number of Bedrooms 3. Water Supply Individual Well Multi -Family( 4 XX Community Other (describe) Public r---1 Note: If community well system, must have written confirmation frau the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA (Y/N) Yes 4. Sewage Disposal Onsiter7 Public Conuunityl Holding Tank Is the wastewater disposal system adequate for the ;umber of bedrooms (Y/N) yes (Page 1 of 2] 2-15-84 5. Engineering Firm Providing Inspections, Tests, Data and Information I certify that I have checked, verified, or conformed to all MSA HAA Guidelines in effect on the date of this inspecti Signed Name of Firm Entech Engin•ers, Inc. Date Telephone 94-3574 Address 13 LeDoux, EaE1e River, AK Signed by Vernon L. Roelfs. PE Date March 16, 1984 (ENGINEER SEAL) 99577 ,..,^7; O .. F Pg,..... r * s 9H ..•. * , 'WI,Vernon L. Roelfs ♦ c : CE 5107 Zj \ elatofR0FESS0®P�•e 6. DHEP Approval ®o®'��.� Approved for e bedrocns By -- ru' Date %)/;;L Approved Disapproved Conditional Terms of Conditional Approval ,rr-/'U- -c-G -,/ Stlyz The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedroom and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. WELL DATA Well Classification Private Well Log Present (Y/N) Yes Total Depth ' 140 ft Cased to Static Water Level (Roe an -hp 1) Q e`13D3 t .dVVJ N0i1D3J O Jd lv.INEvoladma 'S HIld3H 4 0 d If Al B, or C D.E.C. �(d DQ11'ldvd Date Completed 10-5-83 Yield 10 GPM 42 ft . Depth, of Grouting(See Note 1) Pump Set At (SPP Nnto 1) Casing; Height Above Ground 2.7 ft Sanitary Seal on Casing (Y/N) Yes Electrical Wiring in Conduit (Y/N) Yes Depression Around Wellhead (Y/t') No Separation Distances frau Well: To Septic/Holding Tank on Lot 112 ft • On Adjoining Lots 132 ft To Nearest Edge of Absorption Field on Lot 133 ft ; On Adjoining Lots 150 ft To Nearest Public sewer Line N/A To Nearest Public Sewer Cleanout/Manhole N/A To Nearest er Service Line on Lot N/A Sew Water Sample Collected By mikP�Hagan , Date (March 6 Water Sample Test Pesults Comments Note 1: Information not available from Well Log 19R4 SEPTIC/HOLDING TANK DATA Date Installed 10-7-83 Size 1250 gal No. of Caartments 2 Standpipes (Y/N) Yes Air -tight Caps (Y/N) Yes Foundation Cleanout (Y/N) Yes Depression over Tank (Y/N) No Date Last Pumped N/A Pumping/Maintenance Contract on File (Y/N) N/A ; for N/A Holding Tank High -Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y/N) N/A Separation Distances frau Septic/Holding Tank: . To Water Supply Weil 112 ft To Building Foundation 12 ft To Property Line 12 ft To Disposal Field 11 ft To Water Main/Service Line N/A To Stream, Pond, Lake, cr Major Drainage Course NiA Comments [Page 1 of 21 2-15-84 . ABSORPTIONFIELD DATA Soils Rating in Absorption Strata 125 sq ft/bdrnlrype of System Design _ Tile trench Date Installed 10-7-83 Length of Field 32 ft Width of Field 36 in Depth of Field 12 ft Gravel Bed Thickness 8 ft Square Feet of Absorption Area 512 sq ft Standpipes Present (Y/N) Yes** Depression;, over ;Field (Y/N) No Date of fast Acbquacy Test N/A Results of ,Last Adequacy Test N/A Separation Distance from Absorption Field: To Water -Supply cob11 133 f t To Property Line 12 ft To Building Foundation 18 ft Lot N/A ; :an Adjoining Lots N/A To Water Main/Service Line N/A To Cutbank( if present) N/A To Existing or Abandoned System cn To Stream/Pond/Lake/or Major Drainage Course N/A To Driveway, Parking Area, or Vehicle Storage Area 15 ft Coci¢aents_ **Monitoring tube at end of trench is badly buckled and not usable. LIFT ST'ATION Date' Installed Size in Gallons "Pump On" Level at Dimensions Manhole/Access (Y/N) "Pump Off" Level at High.Water Alarm Level at Tested for Electrical Codes(Y/s1) Comments vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to on the date of this inspection. Signed Company KBI/d5/s Enteeb 1 nginPars [Page 2of2] Ire Date 3 /-6 MOA No. `STF3=OZ-0 all MOA HAA Guidelines in effect ��.Q •."_„,.�° •� • q� R5 w Oleos° Weeew a ..•.ww.e ® �• Vernon L. Roelfs•_ e No. CE 514Z�® t 7 .° \ se<. • .•s° < .i, 2-15-84' TECH ENGINEERS, INC. CIVIL • SANITARY Municipality of Anchorage Department of Health & Environmental Protection 825 "L" Street Anchorage, AK 99501 March 16, 1983 'J 611A NCI10310d Td1N 'T;NO1AN3 H.Th3H dO 1d3❑ 30`daOHDNV dO 1J.11VdJDiNfl Re: Shasta Construction, Health Authority Approval Application; Lot 3, Bik 2, Tonjess Estates Gentlemen: (HAA) During the period from March 4 to March 5, 1984, we performed research, investigations and testing persuant to Health Authority Approval on the above referenced lot. We performed a flow test on the well and found the output to be adequate for a four bedroom house. (Refer to Water Yield Test, attached). We also took a water sample for bacteriological analysis and results were negative (Refer to Chemical & Geological Laboratory Analytical Report, attached). In the course of the test and inspection, we identified two deficiencies: 1) The foundation cleanout was not covered. 2) The absorption trench monitoring tube was buckled and not serviceable. A sealed cap was provided for the cleanout and the first deficiency was corrected and reinspected. However, the second deficiency was not corrected due to frozen ground. Shasta Construction is aware that money may have to be escrowed to correct this problem. 13 LE DOUX LANE • EAGLE RIVER, ALASKA 99577 • TELEPHONE (907) 694-3574 To our knowledge, we have assembled all available information on the HAA Checklist and Application Form. We offer this information for your review. Please call if you have any questions. Vernon L. Roelfs PE cc Shasta Construction Attachments HAA Application HAA Checklist Water Yield Test Sewer As -Built Well Log Chemical & Geological Testing Lab, Total Coliform Analysis itr9L • :.! r�• •. N•Nb••tl•••)NM•• ./1 CCPr 1 rit, ; Vernon L. Roe fs i g% V 1:0••• No. CE 5707 ,•• ?,r V t�4% ''9PROFESS700%ter