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HomeMy WebLinkAboutPAYNE LT 2Payne Lot 02 #015-163-61 GRE TER ANCHORAGE AREA BOP UGH kN_, Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSIDE LENGTH SEEPAGE PIT: NUMBER OF PITS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /460 GALLONS. DIAMETER OR WIDTH_, LENGTH—, DEPTH n LINING MATERIA �•`'U Y6,t)6-f CRIB SIZE: DIAMETER DEPTH _i /DISTANCE FROM: WELL CCCVVVI// H- /1 TOTAL EFFECTIVE BUILDING FOUNDATION Zl' , NEAREST LOT LINE 20 ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION WELL:? / TYPE CONSTRUCTION- (y ��i��t DEPTH BUILDING REPORT ON-SITE DISPOSAL SYSTEM U //INSPECTION NAME D9Z-E / �A�E /SEWAGE MAILING ADDRESS /�L 4Ox ';y-'3vf glj-V PHONEy 7"?�al�(� LOCATION �nJyu/L�KJE �� LEGAL DESCRIPTION Z07- 3[�tulzl /�- S/,a SEPTIC TANK: 'l �' 5szz '. ._ DISTANCE 6/2'C-_E2'e- � NUMBER OF FROM WELL MANUFACTURER MATERIAL �� COMPARTMENTS INSIDE LENGTH SEEPAGE PIT: NUMBER OF PITS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /460 GALLONS. DIAMETER OR WIDTH_, LENGTH—, DEPTH n LINING MATERIA �•`'U Y6,t)6-f CRIB SIZE: DIAMETER DEPTH _i /DISTANCE FROM: WELL CCCVVVI// H- /1 TOTAL EFFECTIVE BUILDING FOUNDATION Zl' , NEAREST LOT LINE 20 ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION WELL:? / TYPE CONSTRUCTION- (y ��i��t DEPTH BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES APPROVED y DISAPPROVED DISTANCES: INSTALLED BY: ���L>�O 46kC a - PIPE MATERIAL: C,IS'7- ZOA) 2�-zzu i.2En .i5_%lSi LOT SLOPE: 10 . . Ezea). REMARKS: VIL 6 - P4-141711LP4-141711L I-A)sl'. tea i✓E S / q /73 Form No. EQ -031 NEAREST SEPTIC/�Z,�Ie- SEEPAGE SEWER LINE TANK /0a / , SYSTEM REMARKS DIAGRAM OF SYSTEM SQ. FT. DISTANCE FROM: G.A.A.B. 0 �P' GREATF.ri ANCHORAGE ARF'. -A En ROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. POA(_) (,50 (,;!I ALASKA 99502 - c),, r. 77 9,13 1 li 1; 00 W Cc -l_ SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT -IONE NAME OF APPLICANT MAILING PI INSTALLATION LOCATION LEGAL DESCRIPTION z INSTALLATION OF, SEPTIC TANK SEEPAGE DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED TO BE INSTALLED BY Z��-e /z I RMIT 15 NOT VALID WITHOUT SOIL 'MST ,,e NOTES THIS PF SOIL TEST RESULTS COMPLETION DATE ANTICIPATED P_ER1U1_YAL1D_QXE_1EAR_ ITINAL IN_PECTIONt 24 HOUR NOTICE REQUIRED- BACKFILLING OF ANY SYSTE.F.1 WITHOUT FINAL INSPECTION MY THE'' HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. r TYPE TYPE ___C.0Rr__r SEPTIC TANK SIZE -P.teSEFPAGE AREA SIZE MINIMUM DISTANCES, WMQUIREMENTS DIAGRAM OF ZYSTEM 5 ft.?-.- FC )ATION TO SEPTIC TANK Y FOUNDATION TO SEEPAGE PIT 20 ft.DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL. SEPTIC TANK 5 ft2,_ SEEPAGE PIT -2-1-ft, _. DRAIN FIELD TO NEAREST LOT LINE. 1�7 4� WELL TO SEPTIC TANK 5SEEPAGE PI DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANKt_t_____ SEEPAGE PIT DRAIN FIELDXQ —ftt-­ SEPTIC TANK, 25 ft -. SEEPAGE PIT DRAIN FIELD ­5LQ_f_t_-. I'D RIVER, LAKE. STREAM, CAST IRON INTO AND OUT OF SEPTIC 'TANK AND INTO CHID CROSSING GAP OF EXCAVATION 5 FEE'r INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GrAVEL DACKFILL CONFORM TO 130ROUGH REGULATIONS REGARDING INSTALLATION P'CASTIRON SIPHON s!'1-Ic PIPKITH IRT GMT CRIB I ACh C r, p S 4 CAST I CASI IRON ONDISTLTBI'D SOIL (F;S. C I rc.qAr(d %ihnnever Lino cro5ses (CRIB hINIVIum ApO%'F NATER 1.n,J,r Jri,:­ TARIJ) I1� i 1. " 1 0 M tiIil P I 11PI IC I 4 10( 11 S 1!1i: R : i IJ . LON, I I;!r, " kC P. I:ELI, S. .',[[PCC[ Pil FXCAktTIOII BASED ON 5011 7 , ST . MORSE CAST `PONS SEPTIC T 0 Of ' , T v P CF 0) 01'_ Grade: 2%,per10' I or IIA" p fQ,1, except 10' procrcAing tank 1, thh. should not exceed ?:. 6' Per 10.0 on flat terrains. 4INCII CAST IRON SIPHON PIPE -_-Sr.EPACF PIT CRI R GRAVEL IJA49l't-l' HEALTH AUTHORITY OR 2o ^1 ml'i . )i1mutt-i LICENSED DESIGNER t:Fpp(ST LOT —LI PI F I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO 2(3-68 AND THAT THE AE30VE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 00w) CASE. 1-07- Z 10A-VM'F Sb Performed For -oc.J C R'VVV a Date Performed Legal Descripta.on: Lot Block Subdivision This Form Reports a: Soi s Logercolati este Depth .� �� '47— r'—Pt Soil Characteristics Was Ground Water Encountered?-.- °o if Yes, At What Depth y Location Sketch �rw� ■ i JUNmmm i Reading Date Gross Time Net Time Depth To HIO Net Drop Percolation tate Mute " FrGpcsed Snst,al.l'tion: Seepage Pit Drain field Depth` cif�� rlet --� th To Bottom Of Pit Or TrencT— COMMENTS : /3t�...�rH�.,.�% L� '���., �..i �.d,..,. Testi Performed F3I; J— Datta. Certified By:,� Dater ,,.,1 7� / �a'1rwR (��t fee N,\,, r, At p `'Novr�► G �Y Oak 150 0A. —0 all aor`y S 4V slow n�� t Aw Was Ground Water Encountered?-.- °o if Yes, At What Depth y Location Sketch �rw� ■ i JUNmmm i Reading Date Gross Time Net Time Depth To HIO Net Drop Percolation tate Mute " FrGpcsed Snst,al.l'tion: Seepage Pit Drain field Depth` cif�� rlet --� th To Bottom Of Pit Or TrencT— COMMENTS : /3t�...�rH�.,.�% L� '���., �..i �.d,..,. Testi Performed F3I; J— Datta. Certified By:,� Dater ,,.,1 7� / LP pNOHORgDE ARF �R�vl 9FOPo 0 ORGAN/ZED JAN GREATER ANCHORAGE AREA BOROUGH 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 December 4, 1972 Dale Payne P.O. Box 3-308 Anchorage, Alaska 99501 DEPARTMENT OF ENVIRONMENTAL QUALITY Subject: Permit to install sewer system Dear Sir: c o -r 2 (:�-^-yo C- s JC:' A permit was issued to you by this Department for the installation of an on-site sewer system and at this time we have no record of this system having been installed. Please complete this form and return it to this Department at your earliest convenience. yes no 1. The system has been installed. [� 2. The system will be installed later this year. 3. Void my permit; the system will not be installed. 4. The system will be constructed during the next construction season. Your cooperation is requested as we have a great number of outstanding permits for 1972 and we would like to clear our permit files out as much as possible. hank you, ohn R. Lee, R.S. Environmental Services Supervisor Municipality of Anchorage Development Services Department Building Safety. Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951M650 rl I G www.ci.anchorage.ak.us V &,rl,7e'5-_5 (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY -APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 015-163-61 Og Q4� HAA# 1. GENERAL INFORMATION Expiration Date: Complete legal description _PAYNE SURDivieinu• I nT Location (site address or directions) L1 21511 SNOWLINE DRIVE * ANCHORAGE AK Current Property owner(s) SUSAN BALL Day phone 346-1893 Mailing address —.11261 SNOWLINE DRIVE * ANCHORAGE AK Lending agency Day phone Mailing address Real Estate Agent NEIL THOMAS w/ COLDWELL BANKER Day phone 562-7653 Mailing address 2525 "C" STREET * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 01 Individual Water Storage 11 Individual On-site Community Class Well Individual Holding tank [] Public Water System 0 Community On-site 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 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that s application, investigation, based on procedures outlined in the Health Authority Approval Guidelines for this shows that the on of -site water,bedrooms and �ype ofly /structuor treW ndicated hereineater disposal tem 1 furtherrverify tt that) unctional based on the and adequate informationfor the numbe rom my investigation an supplywastewater lity of disposal system s(are) n files ( on on-site water and/or compliance with all applicable Mutl n cipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, engineering analysis of the system in accordance with ADEC and MOA conscientious The reported results described the performance of the DSD Guidelines Regulations. system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system Will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the ance upon or use of this port sole benefit of the owner or party is not aluthorized,vnor will it confer any legal right whatsoever. 5. any oever other 5. DSD SIGNATURE -- --- Approved for bedrooms. Phone 337-6179 Date ia2 it ht Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: ttt(lt(tfttfffffij���� 4a : WATER AND . P • ROGRAM ; Attachments: ✓ Manitenance Agreements HAA Checklist Supplemental Engineer's Reort .-------- Septic System Advisory Other Well Flow Advisory In Qu„ By:Original Certificate Date: � (Rev. 12101) � o yr � provide PWSID# N A eted PR�I�-24%73', Sanitaryseai (Y/N) YES , � ,,„�„ �� �, Wires prope7ly protected (Y/N) �Y�S X67+ > � .Cased to *67 ft � Y���„ � �, Casing height (above ground) 12+ �n 8/20/2004" rel®vel 26 coon � 6,7 y.p.m. k� " Otherbaetena 0 colonies/100 ml A- mg./L. Date of sample 6 2004 Collected by.'ARROdV"l�l)I�fff Menai STEEL Date irsstaUed 9�24�79i3 gal Number of Compartments 1 �* ClCleanouts (Y/N) YES 3anout (Y111 -1.IN) YES ( ) Depression Duet tank (Y/N) NO H� h water>alarm (Y/N) N/A � 8 6� 2004 _.���„�����,. g Pumr P� MCDONALDS -p �9 24 1973 Soil tmg p.d ( r ft�/bdrm 150 ft• „ ..Width 14 19 ft Gravel below� .� ..�---9�ft .�.� ft. Eff absorpYionarea'66'7 ft7 Mon�toriri` Aube YES` �' s 9 __� Depression aver field NO Results (Pass)ai PS For 4 bedrooms bsorption field before test 54 � -- � - .- �2 (Past 12 m(o) (Y `'type) NONE IEN01�5""'""� If ves: Dive a r �� �� VCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5 + , ., .w< 5'+ Absorption field _PropertyIme• _ - -- . 100'+ Surface water Water s'derviceline__— 20M ABSORPTIi'CN FIELD ON LOTTO: N/A Building foundation' ` 10'+ Water main storage 10'+ Surface water 100,+ _Driveway, parking/vehicle N Wells on adjacent lots *WAIVER #WR020072 letermined frough field inspection`s and records that the above systems are in IDA HAA guidelines in effect'on this date. Jef ._ wp4t jog Date of Payment �j ' ' Receipt Number . F°qsQ� 4 *000, ...........:.... Ga: essl ,E 7 �¢�O S¢e in Manhole/Ac gahons- - , High wateralarm level at _-- —m._,..,. 9 —m. Meets alarm & circuit requirements? Cycles tested__-.. --- . ,_.. _ . ._..... ... 1 TANC"ES. _ - _ _ _. _ .. TANCES FROM WELL ON LOT 70: j 100'+ 100+ 'On 'Onadlacentlots on on lot ----- 100'+ - " 100 + On adjacent lots lot N/A Naw 'KI/a' `' ^°' "'"�Publicsewermanhole/cleanouf VCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5 + , ., .w< 5'+ Absorption field _PropertyIme• _ - -- . 100'+ Surface water Water s'derviceline__— 20M ABSORPTIi'CN FIELD ON LOTTO: N/A Building foundation' ` 10'+ Water main storage 10'+ Surface water 100,+ _Driveway, parking/vehicle N Wells on adjacent lots *WAIVER #WR020072 letermined frough field inspection`s and records that the above systems are in IDA HAA guidelines in effect'on this date. Jef ._ wp4t jog Date of Payment �j ' ' Receipt Number . F°qsQ� 4 *000, ...........:.... Ga: essl ,E 7 �¢�O N.T. S. i U" i'g i;c Ve')f pia-k Rei. W11 l .12s Z i Sf Fr� %� w Ir �. N� Pe.ime4r ° e � !U E 3 ° 3 No cK 3. , r0 aC t N ,\ Sha a •t 2° N 3 � \ _ t `b- O .� 2 Cot Lit 299,61 I RECeRT f STAKE NOKTH p,QoPERTY GNE �/-/,�.OZ��/ '. AS-BUILT fib► CORNERS SET THIS DATE gro't•o'®C� . �OY��{Ig I hereby certify that I have performed aMor 'W r' `'1, : ° Y• u spection of the s m 3 ..,ls,I '°° 7" �,� following described Property: oo t-----Z s e Y°� y® vee '5'4'r b d L Scale: l "=4o, £;.�j ".c)/8f7��1`t�a ; A; rI ••ilq.. ..I ,IY/•..YY ys Anchorage RecordingPrecinct, ?°, .,• ., Alaska, and that the improve- t44 situated thereon are within the pro�rarty lines and do c. Fred walarka a d} not overlap or encroach on the property IYmg adjacent there. 34555 ,%��� "to, that no improvements on property lying ° °Jt• go encroach on the remises in dadjacent thereto oa •••...•.+° o' m roadways, tr p question and that there are no tf }k ROPE. : `pr '"' said property erty except gas indicated hereon.on lines or other viaible easements on ti'k\';10+34 m+a� Datedd at Anchorage chorage, Alaska ASEMENTS OF RECORD, OTHER THAN this _ aayOf -50dp_'r7 6 er HOSE SHOWN ON THE RECORDED LAT ARE NOT SHOWN HEREON. F� FRED WALATKA & ASSOCIATES FW Engineers and Surveyors ° il Municipality of Anchorage ° Development Services Department ...: � Building Safely Division On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www,ci.anchorage.ak.us / (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL l �, FOR A SINGLE FAMILY DWELLING q Parcel I.D. 015-163-61 HAA# 1. GENERAL INFORMATION Expiration Date: Complete legal description PAYNE SUBDIVISION: LOT 2 Location (site address or directions) 11261 SNOWLINE DRIVE " ANCHORAGE. AK Current Property owner(s) SUSAN BALL Day phone 346-1893 Mailing address 11261 SNOWLINE DRIVE " ANCHORAGE, AK Lending agency Day phone Mailing address Real Estate Agent CORA CARLESON w/ COLDWELL BANKER Day phone Mailing address 2525 "C" STREET • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well E Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class —Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Health Authority 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. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS. INC. Phone 337-6179 Address 6901 DESARR ROAD. SUITE 28 • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Date Cl- Engineer's Engineers Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readilyldentifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluatorof the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKW WC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 4 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory By: (R". 7701( 0r A ....... .. .. .. .Cess. -'- r ... .moi p ' • � y .Gar 7953oeG 4rotesslof° ooo bedrooms, with the tllowing stipulations: Manitenance Agreements OFON-Sfflf"VrG' IT ANS •: �' WASTEWATER PROGRAM Supplemental Engineers Reort Other �� Original Certificate Date: 10- 49 _ 40 -12, Legal Descriptio Municipality of Anchorage Development Services Department Building Safety Division OnSke Water & Wastewater Program 4700 South Sragsw St P.O. Box 108850 Anchorage, AK 995196650 www.cLanchorege.ak.ua (907)543.7904 HEALTH AUTHORITY APPROVAL CHECKLIST PAYNE S/D; LOT 2 •O Parcel ID: 015-163-61 A. WELL DATA 'ASSUMED BASED ON PAYNE. LOT 1 WELL LOG Wen type PRIVATE If A, B, or C provide PWSID# N/A Wen Log (YM) NO Date completedPRIOR 9/24/73 Sanitary seal (Yr Wires properly protected (Y/N) YES Total depth 60+ ft. Cased to�ft- Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 6/19/85 8/9/02 Static water level 26 ft. Well production 6.7 g.p.m. . WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 4.98 mg./L. Arsenio N/A mgJL. Date of sample: 8/12/02 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Tank size 1500 gal. Number of Compartments Foundation cleanout (YM) .__L Depression over tank (YM) NO Date of pumping 8/9/02 Pumper 30 ft. 3.5+ 9— p.m- Other bacteria 0 colonies/100 ml. Collected by: AWWC. INC. Date Installed 9/24/73 CleenoUtg (YM) NO — 2 STANDPIPES High water alarm (YM) N/A ISAACS C. ABSORPTION FIELD DATA Daft ku toned 9/24/73 Soil rating ft.p.d ftibdrm) 150 System We CRIB Length 19-21 ft. Width 14-19 ft. Gravel below pipe 9 ft. Total depth 11.5 fL Eff. absorption area 657 fV Monitoring tube YES Depression over field NO Date of adequacy test 8/9/02 Results (Paw/Fad) PASS For 4 bedrooms Fluid depth in absorption field before test 83.5 in. Water added 876 gal. New depth 10 � • Sin. Elapsed Time: 1211 min. Final fluid depth85 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date — i I D. LIFT STATION Date Installed "Pump on" level at _in. Datum E. SEPARATION DISTANCES Size in gallons Manhole/Ar"aQ (Y/N) "Pump oIr IPvol at =1n. High water alar level at in. Cycles tested Meets alar & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots On adjacent lots Public sewer manhole/deenout Sewer /septic service Une 25'+ Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Water main N/A Water service line 10'+ Surface water Wells on adjacent lots 100'+ 100'+ 100'+ N/A N/A 5'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '0' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots "87' F. COMMENTS 'WAIVER ON FILF. LOT 1 PAYNE 'WAIVER REQUEST FOR 0' LOT LINE WAIVER ATTACHED 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 HAA guidelines in effect on this date. Engineer's Printed lame JEFFREY A. GARNESS Date $�� 0 9/24"/001 HAA Fee $ 3'15 - Date of Payment 't/? -L4 //1002 Receipt Number Z b 059 j , (Rev. 12IO1) Waiver Fee S 150• Date of Payment 112-1A 1102 Receipt Number Ito 0919 61 we-oa0o7a ALASKA WATER & WASTEWATER CONSULTANTS, INC. August 27, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver for Lot 2, Payne Subdivision. To whom it may concern: We request that your department issue a 0 foot lot line waiver from the north property line to the existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistanc . m ere, / e f r} eso, P.E., M.S. Pr id . 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com Municipality of Anchorage Development Services Department � Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorageak.us (907)343-7904 Waiver Review Worksheet WR#: WR020072 PIEW 015-16361 Date Received: 9124/02 Legal Description: Pavne Subdivision Lot 2 Engineer. Jeffrev A. Garness. PE HA#: HA020492 Permitil: Alaska Water & Wastewater Consultants. Inc. Applicant: Susan Ball Waiver Requested: 0 Feet from north urooerty line to existino drainfleld Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: Date: — 3 O 7 By: t�c-t Reviewer Red#: 26036 Amount: $160.00 Date Paid: 9/2412002 � o_ AZtuiicipaliiAnchorage 3T of Anchorage k - - All -America City Building S,tfct-* Di-visloyl I I Georgiµ• !'. 11"uerch. ;Mayor 2002 9/24/2002 Jeffrey A. Gamess, PE Alaska Water & Wastewater Consultants, Inc. 6901 DeBarr Road, Suite 2B Anchorage, AK 99504 Subject: Waiver Request for Payne Lot 2 Waiver Request #WR020072 Parcel ID #015-163-61 IIAA# IIA020492 Dear Mr. Gayness: 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 0.0 feet. 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 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program P.O. floe 196650 • Anchorage, Alaska W519-6.56.50 • Telephone: (5X)7) 343.8301 • P:Lr: (5X)7) 343-82(X) 4700 South Brafi tw Street • Anchorge, Alaska W.507 h tip://e�t�c.ci.nnchornl;r.nk.us MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner X77° yS�✓' Mailing Address 11-26,1 C Telephone: Home = 'r'' `LZ3 Business = 4�7 '4�4 446 (c) Lending Institution Telephone 3�5' ` 41 Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followina address: or: Check here ❑, if hold for pick up. List contact person and day phone number below. 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms 3. WATER SUPPLY Individual Welix 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 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 72-025 (Rev 8/861 Front 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. Name of Firm Telephone Address '2-2-5-2 rA5 five Date /'✓/��/ l I r x' mos �s /-r Cif 1P_fi?/_ et '461 �`7 / trite / ohs�es �?✓' Y� ��6�� ✓ �x c�p-f ��z �'Cr s �srn�b /e w<zo �rz /r^z.-r Engineer's Seal AV Ar AW .•Itmerr ° t Dv �t •,� No. 2055-E 6. DHHS APPROVAL Approved for C` bedrooms by �p''�•' �"'"� Date Approved I/* Disapproved Conditional Terms of Conditional Approval CAUTION S-ZO-$-7- 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. Page 2 of 2 72-025 rRev 8/86) Back MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST - FEBRUARY 1984 264-4744 91987 LO� Legal Description: RECEIVED A. WELL DATA Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present (19 Date Completed Yield' Total Depth Cased tom' Depth of Grouting Static Water Level ,t'` Pump Set At Z- I-y-7/_A/amu Casing Height Above Ground Electrical Wiring in Conduit/N) Separation Distances from Well: To Septic/Holding Tank on Lot e2, F // Z_ 0 Sanitary Seal on Casing ©N) Depression Around Wellhead (Y/ ; On Adjoining Lots 4- /Dt1 / To Nearest Edge of Absorption Field on Lot �¢b ; On Adjoining Lots t /QVC To Nearest Public Sewer Line N/1 To Nearest Public Sewer Cleanout/Manhole e lJ ,� To Nearest Sewer Service Line on Lot Water Sample Collected by /)b //-S ; Date Water Sample Test Results CommentsF B. SEPTIC/HOLDING TANK DATA Date Installed j `' Size Gg "'"� No. of Compartments Stand pipes (?Y�N) Air -tight Caps N) Foundation Cleanout (YIN Depression over Tank (Y/O)i Date Last Pumped" Pumping/Maintenance Contract on File (Y/I�l Holding Tank High -Water Alarm (Y/N) ;for Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation j To Property Line 5� To Disposal Field Pter' To Water Main/Service Line ftp To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026 fRev 8/86) Front C. ABSORPTION FIELD DATA CI Soils Rating in Absorption Strata d /1��/� Type of System Design = r Date Installed f - Length of Field Width of Field Depth of Field ` Gravel Bed Thickness Square Feet of Absorption Area Depression over Field (YEN) — Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well 1" To Building Foundation Lot — Standpipes Present,(Y/N) Date of Last Adequ cy Test To Property Line 4 - ; On Adjoining Lots To Water Main/Service Line `��' ` To Cutbank (if present) To Existing or Abandoned System on To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments x -,/,-AFc D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) _ "Pump Off' Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. / Receipt No. l o ` Date of Payment .511 Amount: $ —/ Page 2 of 2 72-026 (Rev B/Ml Back Alt G OF AttA cow �trq oa„m • ° gm,eq°fr/1„ Dale R. Merrell No. 2055-E �� �(� o . , e ®®�°pROFESSIO�Aw4r BESSE, E' PS & POTTS May 19, 1987 Department of Health and Human Service 840 L Street Anchorage, AK 99501 Re: Recertification Health Authority Approval - Payne Subdivision - Lot 2 Gentlemen: I am submitting the Health Authority Approval done in August, 1985 by Alaska Environmental Control Services, Inc. for Lot 2, Payne Subdivision. I am also submitting results from new water samples taken May 13 and May 14 1987. Also a pumping receipt is attached. Sincerely, 4al"!R'. Me�`rell, PE jmm ENGINEERING, PLANNING, SURVEYING 2220 E. 88th Ave. l Anchorage, Alaska 99507/ Telephone 907349-64511344-1352 "Providing a quality personalized service to those building Alaska's future" NORTHERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907-4793115 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 907-2778378 Besse, Epps, & Potts 2220 E. 88Th Avenue Anchorage, Alaska 99507 Source: Lot 2, Payne Subdivision Sample ID#: A051487-10 Parameter Unit Nitrate -N mg/L Result 3.0 Date Arrived: 5/14/87 Time Arrived: 1500 Date Sampled: 5/14/87 Time Sampled: 1400 Date Completed: 5/15/87 ADEC MCC 10 Reported By: Date: 5/15/87 Carol J. Garrison, Vice -President --------------------------------------------------------------------------------- * MCC = Maximum Contaminant Concentration NORTHERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 9074793115 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 907-2778378 Quality Control Report Client: Besse, Epps, & Potts ID#: A051487-10 Listed below are quality control assurance reference samples with a known concentration prior to analysis. The acceptable limits represent a 951 confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring the accuracy of your results. Sample# Parameter Unit Result Acceptable Limit EPA WS378-6 Nitrate -N mg/L 0.97 0.84 - 1.02 Reported By Garrison, Vice -President Date: -__5/15/87=-= NORTt�ERN TESTING LABUdATORIES,INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907-479-3115 6957 OLD SEWARD HIGHWAY, SUITE 101 ANCHORAGE, ALASKA 99518 907-349-8623 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT TO BE COMP ETED BY LABORATORY F] PUBLIC WATER SYSTEM I.D. # Received at: Anch. O Fbks. PRIVATE WATER SYSTEM Date Received �h % Time Received _ NAME _ Mailing Address State SAMPLE DATE: -,�- -3 S % Phone J y L L %J / Mo. Day Year Purchase Order No. SAMPLE TYPE: Routine ❑ Special Purpose ❑ Check Sample (for original contaminated sample with lab reference no. ❑ Treated Water ❑ Untreated Water Zip Code Sample Time No. Location Collected Collected by /,-'taboratory Ref. No. Al c 3: v o Pry _4_ 2 3 4 5 6 s 9 10 Signature of Representative FOR LABORATORY USE, ONLY CASH CHARGE PREPAID TRANSMITTAL SPECIAL INSTRUCTIONS MAIL HOLD FOO PICKUP Next Sample Due COMMENTS: SATISFACTORY O-S UNSATISFACTORY U RESAMPLE R OTHER BACTERIA OB TOO NUMEROUS TNTC TO COUNT Direct Verification Final Count LSB BGB Result* Comments *No. of Totail Coliform Colonies per 100 mis. Rep S eI/bS A� Date I Ime 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 ____ a (\ --.-� 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) �,st Location (address or directions) , A_5 .-4�d' CX..k_a(r 1 i te-:' (b) Applicant Name '� `y_ -JJTelephone: Home BusinessLL_ Applicant Address�-- (c) Applicant is (check one): Lending Institution ❑ Ct:w uilderK ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution „'Y�i �'_= _ Tri- TelephoneAddress (e) Real Estate Company and Agent Address -------- -------------------- -- ___ __ _. Telephone ----- - - --- -- -- --_- ---- - - (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Xl Multi -Family ❑ Other Number of Bedrooms _-_- `_4_-. 3. WATER SUPPLY, Individual Wei; l7 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 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 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 Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and a~ee�.ate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information ct`anti' from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply arc or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effec, on the date of this inspection. (? Name of Firmi2_f Address _..... Date G. DHEP APPROVAL bedrooms by Approved for �r}.� .r` �— Approved 1` _ Disapproved Terms of Conditional Approval Seal 'l(f f , ,(- , f a . 4,-, : Date Conditional 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 professionaf 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) M -W DRILLING INC. P.O. BOX 110378 ANCHORAGE, ALASKA 99511 PHONE 349-8535 NAME ADDRE S -Lee I SInDw 1 i CITY LEGAL DESCRIPTION LEGAL OWNERS BANK OR LENDING INSTITUTIONS CURRENTLY HOLDING DEED OF TRUST HOME PHONE WORK PHONE B 93 TOTAL MATERIALS WELL NUMBER DIAMETER DEPTH STATIC LEVEL GPM DRAWDOWN PUMP MAKE HP SETTING VOLTS PHASE AMP RATE SERIAL NUMBER MODEL SCREEN LENGTH SLOT SIZE LINER/SCREEN DESCRIPTION OF WORK DATES -'M ll t„� �r - s �i I( r to C f— .0 tj ) I etj)i INVOICE N2 2899 DATE DATE OUT H LABOR RATE© UNIT O OTY. MATERIALS PRICE AMOUNT LEGAL OWNERS BANK OR LENDING INSTITUTIONS CURRENTLY HOLDING DEED OF TRUST HOME PHONE WORK PHONE B 93 TOTAL MATERIALS WELL NUMBER DIAMETER DEPTH STATIC LEVEL GPM DRAWDOWN PUMP MAKE HP SETTING VOLTS PHASE AMP RATE SERIAL NUMBER MODEL SCREEN LENGTH SLOT SIZE LINER/SCREEN DESCRIPTION OF WORK DATES -'M ll t„� �r - s �i I( r to C f— .0 tj ) I etj)i WORKMAN DATE IN OUT H LABOR RATE© 84 O A# charges shall be paid in full within ten days unless other arrangements are made prior to drilling. The customer shall pay in- 3 (je'Q 030 MATERIALS (FROM ABOVEI OTHER CHARGES terest at the rate of 1!12 % per month on any amount not paid within ten days. Failure to pay may result in a lien against the property. CUSTOMER SIGNATURE PAY THIS AMOUNT —� 4 �1 MUNI. .LITY OF ANCHORAGE DEPARTMENT OF HEAL o H AND ENVIRONMENTAL PROTECTION DIVISION OF ctv'VIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FUDR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER ANO WATER FACILITY 264-4720 AH plication Date 1. GENERAL INFORMATION (a) Legajpescription (inc!yde_lot, bl on (address or directions) subdivision, section, township, range) (b) Applicant Name _ 'G4 / � f_-�"—_ Telephone: H��me �.�—�.— —__-. Business - Applicant Address _ Q�--kms �,-_ -- --- (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer ❑ ; Other ❑ (explain),- (d) explain); (d) Lending Institution - _A/h A Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: a elephone 2. TYPE OF RESIDENCE Single -Family Call( Multi -Family Other Number of Bedrooms 3. WATER SUPPLY ./ Individual Well j�7 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.X1 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 2 724-J25 111 84) r ,A 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE S6_'ARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify treat my investigation of this Heath Authority Approval shows that the on-site water supply and/or'avastewater disposal system= s safe, furclic^a! and adeq; a'.e for the number of bedrooms and type of structure indicated herein. I further verify that t a.F:•er on the <r1fcrmat:on obta r from the Municipality of Anchorage files and from my investigation and inspection, t e on,-s:te water supply and,. a' wastewater disposal system is in compliance with a,i'i Municipal and State codes, orerr.ances, ar:d reg%,,lations in effect on the date of this inspection. Name of Firm Address Date �, •oA•ooAaoo4^�-: CyVt':i 00 oosoewoa eosw:co� eF •�• wwe :Y�r•y ca.@ •4`r-� oy C. Reid, Jr. q• ,-'�� �',, ' • No. 2251E • ' Eng,, gee s Seal 6. DHEP APPROVAL *pproved for `�>Lf`4-tom bedrooms by �:- � ,� — Date —. Approved Disapproved rConditional Terms of Conditional Approval-- t�i. Q.e.z,�A�.- can �• � + e -_ . . _ I C ' i CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Autty 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 (11184) ANCH"-'G, MUNI DEPT. OF HEALTH t ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) 1 HEALTH AUTHORITY APPROVAL (HAA) GA � � "� � y CHECKLIST - FEBRUARY 1984 I 1 ./ V 264-4720 n j, £ inc, Le gal Description: yt,7 `Q- R T I a N t>J pec ioa WJLN3 NOVI M IT to lvm do id30 A. WELL DATA 30VWK NV d0 A"WdgIMM yU Well Classification ( If A, B, C, D.E.C. Approved (Y/N) 4 Well Log Present (Y V Rate Completed Yield �7Q I. Total Depth '> to Cased to ZZ-7Depthof Grouting 1 Static Water Level L)'& / Pump Set At Casing Height Above Ground 0.16l Sanitary Seal on Casin C(Y)N) Electrical Wiring in Condu'(Y ) (z ti n Distances from Well: Depression Around Wellhead epara o / To Septic/Holding Tank on Lot �rZ ; On Adjoining Lots t�Op To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots To Nearest Public Sewer Line !` _ To Nearest Public Sewer , Cleanout/Manhole �To Nearest Sewer Service Line on Water Sample Collected by ; Date Water Samp Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size 1-'`-' E?p 0 No. of Compartments Standpipe (Y N) Air -tight Ca (Y N) Foundation Cleanout ( N) Depression over Tank ( Date Last Pumped / ) Pumping/Maintenance Contract on File (Y/N)�_ ; for Holding Tank High -Water Alarm (Y/N) �I`Temporary Holding Tank Permit (Y/N) *4 Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation To Property Line To Disposal Field�'� I -s GLd 6 To Water Main/Service Line t /O To Stream, Pond, Lake, or Major Drainage 49 Page 1 of 2 72-026(11/84) Z-0 r :�-_ 1_1 NV -- C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 456L Type of System Design Date Installed gzy/73 Length of FieldP�+-� Width of Field Depth of Field .. �z�o Grave Bed hickness 1f Square Feet of Absorption Area Standpipes Present49N) Depression over Field (Y410 Date of Last Adequacy Test �$ Results of Last Adequacy Test � � � _/ Separation Distance from Absorption Field To Water -Supply Well N To Building Foundation I _qZ!*- To Property Line i -X-- To Existing or Abandoned System on Lot AJ On Adjoining Lots t 56 To Water Main/Service Line + qZ To Cutbank (if present) l/6 To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area comments 9_7 � �` � % �` t 2 7 - V.17//}1 / D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) — Comments —� Dimensions Mantole/Access (Y/N) "Pump_4Y''Cevel at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that ave the c q v iced, or conformed to all MO and AA guidelines in effect on the date of this inspection. Signed Date Company 1(�_� __MOA No. Receipt No. AL1 _t,7�%I��1 Date of Payment bC7 Amount: $ Page 2 of 2 72-026 (11/84) OF A4.4 �,� .• „y�� Engineer's Seal ,A•4 l 0�� so 064120 V*.Oak 0 •� • Y C. Reid, Jr..g 0 J'j • No. 2251-E ,• ALASKA CIiffiOI1MenTAL COnTROL SRUS, IN. 6ngineerinq & enuironmental Studies ALBERT AND SUSAN BALL SELLER—SAME 11261 SNOWLINE DRIVE ANCHORAGE ALASKA 99507 50333 LEGAL:PAYNE BLOCK 0 LOT 2 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE—JUNE 19 1985 JULY 17 1985 ALBERT AND SUSAN BALL 11261 SNOWLINE DRIVE ANCHORAGE ALASKA 99507 THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 615 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1500 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON JUNE 20 1985 . FLOW TEST ON WELL WELL FLOW DATE—JUNE 19 1985 A FLOW TEST WAS PERFORMED ON THE WELL. 615 GALLONS OF WATER WAS PUMPED AT A RATE OF 6.7 GPM OVER A DURATION OF 2 HOURS. THE DRAWDOWN WAS 39 ' WITH A RECOVERY TIME OF 300 MINUTES AND THE STATIC WATER LEVEL WAS 26 FEET. THE WELL IS ADEQUATE FOR THIS 4 BEDROOM HOME. OF A4 e 3 aooaoeoo aPamy ao_n°/roRo "p O Leroy Ae9ci, Jr. ri 42"51 E :7 1200 West 33rd Auenue, Suite B • Anc6roge, Alaska 99503-(907) 561-5040 M -W DRILLING INC. P.O. BOX 110378 ANCHORAGE. ALASKA 99511 PHONE 349-8535 NAME ADDRESS � ll CITY LEGAL DESCRIPTION LEGAL OWNERS BANK OR LENDING INSTITUTIONS CURRE1,7-1 HOLDING DEED OF TRUST HOME PHONE WORK --ONE INVOICE No 2 7 9 3 DATE UNIT QTY. MATERIALS _ _. PRICE AMOUNT I WORKMAN DATE All charges shall be paid in full with- ten days unless other arrangements are made i prior to drilling. The cust0rr)er shall pay :!� I terest at the rate of 1 "'o per month on a,'v --- arnount not paid within ten days. Failure 'o pay may result it 3 her against the prope't. CUSTOMER S'GNATURE I IN OUT H S RATE LABOR MATERIALS IFROM ABOVE) ----------- ---- OTHER CHARGES clC. PAY THIS AMOUNT -I I C" TOTAL MATERIALS WELL NUMBER DIAMETER DEP H STATIC LEVEL GPM DRAWDOWN el Of -;.(l ' PUMP MAKE HP SETTING VOLTS PHASE AMP RATE SERIAL NUMBER MODEL SCREEN LENGTH SLOT SIZE LINER/SCREEN OF WORK _DESCRIPTION DATES + "L )�(2 I WORKMAN DATE All charges shall be paid in full with- ten days unless other arrangements are made i prior to drilling. The cust0rr)er shall pay :!� I terest at the rate of 1 "'o per month on a,'v --- arnount not paid within ten days. Failure 'o pay may result it 3 her against the prope't. CUSTOMER S'GNATURE I IN OUT H S RATE LABOR MATERIALS IFROM ABOVE) ----------- ---- OTHER CHARGES clC. PAY THIS AMOUNT -I I C" R&M CONSULTANTS, 11MC. 5024 CORDOVA ■ BOX 6087 0 ANCHORAGE:, ALASKA 99501 B Pli. 907-279-0483 R TLX. 070-7:1360 FIIG-ru- C; E"k-O G I STS VI_ANNEHS ,UHVEYOHS August 22, 1980 R l i(NALITQ5dF00 (!fi 6RAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION S E P 8 1980 Mr. Dale Payne 2525 271st Avenue S.E. RECEIVED Isaquah, Washington 98027 f-100 t,DT -7— Re: Re: Adequacy Test on Existing Sanitary Sewer System; Consisting of G septic tank with a seepage pit, N.W. %j N.E. q; S.E. ; N.E. 14; Sec. 24; T12N; R3W; Parcel 1-48. Dear Mr. Payne: Per your realtors request of August 11, 1980, Philip Baldner of R&M Consultants conducted a test of the sanitary sewer system on the above described property. The test indicates acceptance rates determined under conditions at the time tested. Actual system performance over long periods of time depend on factors which cannot be evaluated by this test thus our office cannot warrant the suitability or fitness of the system for either an extended period of time or for user demand in excess of the expected flow noted herein. Factors affecting system performance include: ° Actual use demand on the system; • Fluctuations in groundwater levels; ° Physical conditions of the septic tank, leach field, trench or seepage pit and soil. It should be noted that while a septic tank and leach field disposal system is one of the most reliable methods of sewage treatment and disposal it is nearly certain that the leach field or seepage pit will fail sometime during the useful life of the structure. Studies indicate leach fields, trenchs and pits have a life expectancy of ten to twelve years under optimum conditions. All septic systems have a finite hydraulic loading capacity which can be expected to decrease with time. Because the house on the lot is occupied, we assume that the seepage pit was at its normal degree of saturation. During this test the liquid levels in the septic tank and seepage pit were monitored as water was added to the system. The measurements are summarized in the following table: ANCEIOFIAGU F'AIRPANK-; 1l)N',AU \/AL0E:7 WASII_I..A If the four bedroom residence on the property is to house eight people, the average load on the system can be expected to be six hundred gallons per day. During the test, the system accepted six hundred and fifty gallons in twenty-four hours on two consectutive days with 800 of that value or five hundred -twenty gallons entered at the maximum output rate of the existing well. We can therefore conclude that the system is disposing of effluent at an adequate rate for a four bedroom residence. We have appreciated this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of addi- tional service. Very truly yours, R&M CONSULTANTS, INC. /fit" 'd Richard S. Giessel Staff Engineer JC: RG/jg k1 9 r r a� i �� t��, R �i�� ��,'} �?;r"� ti= DATA & CALCULATIONS FOR SEEPAGE PIT TEST SUBJECT: Four Bedroom = 600 GPD Required Flow PROJECT NO. 051001-66 DATE: August 18, 1980 1. TIME OF PUMPER ARRIVAL: 9:20 a.m. SEPTIC TIME SEEPAGE TIME GALLONS GALLONS GALLONS TIME TANK PIT REMOVED REMOVED ADDED LEVEL LEVEL FROM TANK FROM PIT TO PIT 2. 5.85' 9:09 5.0' 9:10 3. 4. 5. 6. 7. 7.80' 9:37 5.0' 9:34 DATE: August 19, 1980 8. 7.70' 9:07 5.35' 9:05 9. 7.70' 9:28 5.0' 9:27 Calculate measured effluent acceptance rate = 100 100 Gallons From: 9:34 a.m. August 18, 1980 TO: 9:05a.m. August 19, 1980 Time = 23 hrs. 29 min. = 1409 min. 100 gal. X 1440 min/day = 102 GPD 1409 min. SEPTIC TANK LEVEL TIME SEEPAGE PIT LEVEL TIME CUMULATIVE GALLONS ADDED TO SEEPAGE PIT TIME METER READING 10. 7.70' 9:32 5.0' 9:32 0 9:32 7.70' 9:43 5.0' 9:42 50 9:42 4.25' 10:26 650 10:26 4.95' 9:49 100 9:49 7.70' 10:00 4.90' 9:58 150 9:58 4.80' 10:07 200 10:07 7.70' 10:16 4.75' 10:14 250 10:14 4.70' 10:25 300 10:25 7.70' 10:35 4.65' 10:34 350 10:39 4.55' 10:44 400 10:44 7.70' 10:54 4.50' 10:53 450 10:53 4.45' 11:02 400 11:02 11:12 4.40 11:11 550 11:11 4.35' 11:22 600 11:12 7.70' 11:35 4.30' 11:34 650 11:34 11. DATE: August 20, 1980 7.40' 8:48 5.0' 8:47 0 8:47 12. 7.40' 9:40 4.55' 9:38 325 9:38 7.40' 10:27 4.25' 10:26 650 10:26 13. DATE: August 21, 1980 7.50' 9:04 4.90; 9:03 C _ 5 -'Hod tjPVL . - . \.... _. _ . n3 N bee - .. � r I LONGV11-w SUBi7. iPViNr_ SURD NI 2 1 1 FOUND REBAR C -E -NW 1/64 BASIS OF BEARING( 1B) PLAT 32 OOT 3299TR N89°45'45"E 329988 ,,ID,S"AEX BOLT 299.88 C3'BELOW GRAVEL S R0. W/v 6N TOP HER PLAT 73-163) m LOT 1 6 49,489 B. F a I _ LONGJIE `N SUED. _ 589°48'20 W 29974 YT o LOT 2 ^ 0 49,461 5. F. 298.61 5 89-50'54-W 32961 i3 m \6-N -SE NW I/256 Oo U N S L' B D 1 1/ 1 D E D Im I B -NW 1/64 O,NO �— 5/8'REBARR NOTES SOUTHEAST CORNER OF LOT 2 SET ON THE MIDPOINT OF THE LINE BETWEEN THE COMPUTED MIDPOINTS OF THE EAST AND WEST BOUNDARIES OF THE NE 1/4 SE 1/4 NW 1/4 SECTION 24, T,12 N., R. 3'N., S.M. 09 F'O 'Al /2REBAR I BOTH) - to N 89.50L, E i t +H Yk S 71 sl ,- 4p , z HI w zv� I _ URMAN q0 t ]E t5 30 ac N I TI zm 92-9 I W 2I 2 1 ED END ,2 BC. IN SIDE 21/2 975 OO ALUM. PIPE 02ABOVE ` So 3 GROUND. 1, N89°5545"F 300.041R)(TT) 5° _I N—Al35'£ 329.i8M FOUND I PLUG6EDPIPE 0.5 BELOW ROAD WITH C -E -E NW 1/256 C -N 1/16 I TAW FLASHER W/I/t QHC,' REAILVY OYNA�M IC REAL] Y,INCr BY ANN BOUDREAUX i;NSJBDIVIUE^ j ALASKA NATIONAL BANK 4 TH 6 'E ANCHORAGE, ALASKA O �m o mp 1D p S CRAIG JONES .WE 9E NW /266 m 43h3 LLUAEL 9T C -N -9 N 1/256 '\ ANCHORAGE,ALASKA,99504 _ ( COmwtea ) 1 S BE. 50 54" W 32961 HOBART MET 1344 W.I BN AVE !° ANCHORAGE, ALASKA,99501 iHVL AYNE P SUB -�+ I� 3745-S o MICHAEL A. JONES 1 97T i0 4325 LAUREL ST. I� ANCHORAGE, ALASKA,99504 I T R Is " 1 �I N 39'60'32"E o3B.76 M EAST 660 00 LEGEND ® FOUND BC MONUMENT e SET 3' BC ON 2"x30° GALVANIZED IRON PIPE FLUSH FOUND REBA • BET 5/8". 30" REBAR REC O a'1 IRVINE. SUB. ( PIPt P 75-093 ) PEC ITT) TIFFANY TERRACE (Plot P 71- 178) R,M RECORD, MEASURED REC(LV8) LONGVIEW SUB. ( Plat P 73-163) NOTARY'S ACKNOWLEDGEMENT FOR ANNBOUDRIAUx SUBSCRIBED AND SWORN TO BEFORE ME THS,Z'X 2UAY OF #1981 OT.RlSAFOR ALASKA MY COLI MISS( ONI EXPIRES C -S -N 1/64 (FOUND F'O 'Al /2REBAR I BOTH) - to N 89.50L, E i t 30-06 S ,- 4p , ACCEPTANCE OF DEDICATION 9Y THE MUNICIPALITY OF ANCHORAGE THE MUN CPLLTY QF ANCHORAGE HEREBY ACCEPTS FOR PUBLIC USES AND FOR PUBLIC PURPOSES THE REAL PROPERTY DEDICATED ON THIS PLAT INCLUDING. BUT NOT LIMITED TO THE EASEMENTS. RIGHTS -OF -WRY, ALLEYS. ROADWAYS. THOROUGHFARES, AND PARRS SHOWN HEREON. GATED AT ANCHORAGE, ALASKA. THIS yx� DAY OF 1981 67 ATTEST o` u - aM4 u to z HI w PLA I _ URMAN q0 ]E t5 30 ac N I TI Nl l: HA = I MILE CERTIFICATE OF OWNERSHIP AND DEDICATION WE HEREBY CERTIFY TART ME ARE THE OWNERS OF THE PROPERTY SHOWN AND DESCRIBED HEREON. WE HEREBY REQUEST RPPROVRL OF THIS PLAT. SHOWING SUCH EASEMENTS FOR PUBLIC UTILITIES. ROROWAYS AND ALLEYS DEOICRTEO BY US FOR PUBLIC USE. THERE SHALL BE RESERVED ADJACENT TO THE DEDICATED RIGHTS -OF -WRY SHOWN HEREON. R SLOPE RESERVATION SUFFICIENT TO CONTAIN CUT AND FILL SLOPES OF 1 1/2 FEET HORIZONTALLY FOR EACH FOOT VERTICALLY 11 1/2 TO 11 OF CUT OR FILL. FOR THE PURPOSE OF PROVIDING AND MAINTAINING LATERAL SUPPORT OF THE CONSTRUCTED STREET, AND THERE IS RESERVED TO THE GRANTORS. THEIR HEIRS. SUCCESSORS AND ASSIGNS. THE RIGHT TO REMOVE SAID SLOPES AT ANY TIME UPON PROVIDING AND MAINTAINING OTHER RDEOURTE LRTERRL SUPPORT. AS APPROVED BY THE MUNICIPALITYOFANCHORAGE. DATE BK549 PG123 DALE PAYNE SANDRAPAYNE BOX 3-305 BOX 3-308 99501 ANCHORAGE, ALASKA 99501 ANCHORAGE, ALASKA 99501 LORAI,yVN PAYNE FOR NOTARY'S RCHNOWLEDGEMENTW,ALT.,, IEA SALE VAYNE SANDRA PAYNE HOBART WATT 5 CRAIG JONES MICHAELA JONES SUBSCRIBED AND SWORN TO BEFORE HE THIS on, OF _ -- 1981 NOTARY f9k ALASKA - nr [Onn35510N EXPI REb PLAT APPROVAL q PLAT RPPROVEO BY THE MUNICIPALITY PLATTING AUTHORITY THIS ZCrd DRY OF MAY — ]981 I n .%: A THO 1ZE0 DEFT lAt SURVEYOR'S CERTIFICATE PAUL E. FOX PROFESSIONAL LANE SURVEYOR. EO HEREBY CERTIFY THAT THIS PLAT IS A TRUE AUG CORRECT REPRESENTATION OF LANDS ACTUALLY SURVEYED AND THAT ALL THE DISTANCES AND BEARINGS ARE SHOWN CORRECTLY AND THAT ALL PERMANENT EXTERIOR CONTROL MONUMENTS. ALL OTHER MONUMENTS, AND LOT CORNERS HAVE BEEN SET AND STAKED. OR IF FINAL COMPLETION IS ASSURED BY SUBDIVISION AGREEMENT. THEY WILL BE SET AS SPECIFIED IN SAID SUBDIVISION AGREEMENT. DT1001283SI GNATURE OF (ANE SURVEYOR PLAT OF LOT 181 LOT 2 PAYNE SUBDIVISION A SUBDIVISION OF THE NW I/4 NE 1/4 SE 1/4 NW 1/4, SECTION 24, ^L\ T 12 N, R 3 W,S.M., ALASKA n _ CONTAINING 2.272 ACRES O n61 LJ. own CLEAN 14:—.Yw HENITT Y- LOUNSBURY C RSSOCIFITES KN INELP5 - PLNxXfRS - SJVVL VA44 /^/��` RNCHORAGE AI ASHR V• Oq-E: JANUARY 1981 SCAt L: 1' = 100' O CRAFN: RLC SHOE': 1 CF ' �4��PR�� CIILCRLC: P, C. FD. 8K.:!'-021 GRIL: 2640 OD v