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HomeMy WebLinkAboutPARK HILLS #1 BLK 1 LT 4Park Hills Block Lot 4 #0 ! 7- ! 427-07 Municipality of Anchorage Page / of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTALSERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~b¢~70,~-/~ PIDNumber: ~/~ -/~- ¢-~ Address: LEGAL DESCRIPTION Lot: Block: Subdivision: Township: Range: Section: WELL: [] New [] Upgrade Classification (Private· A,B,C): Total Depth: I Cased To: Date Ft.~ Ft. Driller: Drilled: Static Waler Level: Ft. Yield: ~ Pump Set at: ~ Casing Heighl Above Ground: GPM[ Ft.J Ft. SEPARATION DISTANCES Wastewater System: [] New I~Upgrade ABSORPTION FIELD [] Deep Trench [] Shallow Trench [l~/Bed [] Mound [] Other ~3oil Rating: t ~O C~%~,'Sq. Ft. Depth to pipe bottom from original grade: ITotal Depth from original grade: Gravel depth beneath pipe Gravel length: Fill added abo,~,, original grade: (~ ~, Ft. Gravel width: Total absorption area: //7~~ SO. Ft. Installer: Number of nes: IDistance betweenlines: ¢ I Ft. Date nstalled: TANK I~Septic [3 Holding [] S.T.E.P. To Septic From Tank Surface Water Lot Line OO-O Foundation ~ '~ Curtain Drain J~ Remarks: Holding Public/Private Tank Manufacturer: Capacity in gallons: A,,-,+&- ~-,,-.,.-,.-'q I~ ¢o Material: um erofDompcZents: LIFT STATION Size in gallons: Manufacturer: "Pump on" leve~ at: "Pump off" level at: High water alarm at: Pump Make & Mo~del I Electrical Inspections performed by: BENCH MARK Location and D, scription: Inspections performed by: ~'~". -~ Dates: 1st: 2nd ¢//,!_/¢7 Department of Health and Human Services approval Reviewed and approved by: '.-~-~ 4',-..~ Dat6:,¢/~/¢//~¢- 72-013 (Rev. 9191) MOA 25 ' Assumed Elevation: ¢tCt~./ ~ · E~6~EER'S SEAL / / SWING TIES: AC 67 FT 8C 50 AD 69.5 BD 57 AE 69 88 9O / / ~',.~,_~ , 85 0 ~5 ,50 75 i00 1~5 150 SCALE: I" = 50 FT, £ENCH MARK: BOTTOM SIDING ASSUMED ELEVATION: iO0, O0 F[ TOBBEN SPUNKLAND P.E. 205 W 15TH. AVENUE ANCM. Al(. 99501 (907) 279-59~6 1450! V/OODHA VEN CIRCLE SEPTIC SYSTEM DESIGN DATE: AUG. 27, 1997 SHEET:2/$ GRID:SOS7 PERMIT Ii Sh/970~18 PID Ii 017-~_ 4~-07 PAHOiO4£.Dh/6 © 4-INCH ~ONITOR 4-INCH DISTRIBUTION PIPE 4-INCH MONITOR STANDARD BED 25 X 47 Fl- J FI, of Cover 1250 GAL SEPtiC lANK ANCHORAGE TANK MONITOR /E 90.4 89.7 88. 7-+ , 12" Sewer Rock 4" Distibulion Pipe GW ~ 8 FT SILT z/11/gm 89. 7 88.7-+ LAKE OTIS GRAVEL IE 90.75 / ~1.00 ~ 1250 GAL S.F. BENCH /dARK: BO[. S/D/NG ASSU/dED ELEVATION; 100.00 F[ ITOBBEN SPURKLAND P.E. 203 W 15TH. AVENUE ARCH AK. 99501 (90~)' 279-$916 PERMIT NO: SW970218 I[ LOT 4 BLOCK I PARKS HILL DIANE LAURENCE 14501 WOODHAVEN C/ROLE I[ SEPTIC SYSTEM REPAIR DATE: AUG. 27, 1997 SHEET: 3/3 GRID: 5057 PID NO: 017-142-07 PAHOIO45. DWG PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AiqD HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970218 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:LAURENCE DAVID B & DIANE M OWNER ADDRESS:14501 WOODHAVEN CIR ANCHORAGE, ALASKA DATE ISSUED: 7/28/97 EXPIRATION DATE: PARCEL ID:01714207 1 OF 7/28/98 1 LEGAL DESCRIPTION: PARK HILLS ~1 BLK 1 LT LOT SIZE: 40720 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) ~qD DRINKING WATER REGULATIONS (iSAACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS } (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AMD HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: DATE: T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: Drain Field Repair Lot 4, Block 1 Parks Hill #1 14501 Woodhaven Circle July 11, 1997 Gentlemen; The septic system at this location was inspected by Jeffrey Gamess P.E., M.S. during the week of June 16, 1997. Mr. Garness concluded that the drainfield did not meet the requirements of the DHSS due to the fact that one end of the drainfield was dry while the opposite end had more than 7 inches of liquid in the monitor. This level was above the distribution pipe. The drainfield is a 25 x 47 ft bed installed in December of 1987. On July 1 the drainfield was excavated and it was observed that the distribution pipes were not level, and that the gravel used in the would not distribute the wastewater freely. The distribution pipes sloped from the septic tank to the far end of the bed. One pipe did have a 6-inch "hump", but this hump should not prevent water from flowing through the rocks. Water was observed at different locations in the bed, but the water levels were not identical. We speculate that unwashed gravel was used, and that the silt on the rocks combined with the organic slime produced by the anaerobic bacteria have prevented free flow of water throughout the bed. At present it looks like approximately 50% of the bed has been working. We request a permit to rebuild the bed. Ail contaminated materials will be buried on site. Filter sand will be used to replace any contaminated sub grade material. Washed rock will be used. A minimum of three feet of cover will protect the bed fi.om freezing. The existing tank will be checked for corrosion damage. Yours T£AC T C $0 0 I PC VACANT 50 100 150 £CALE', 1" = 4OO~-T. LI]IT 5 ~ ~ TOBBEN SPURKLAND P.E. 205 lY 15TN. AVENUE ANCN. AK. 99501 ('907) 279-5916 [LOT 4, BLOCIf 1 PARES HILL //1 DIANE LAURENCE 14501 WOODHAVEN CIRCLE SEPtiC SYSTEM REPAIR DATE: JULY 6, 1997 SHEET: I/$ gRID: $057 PERMIT # PIz9 # ?ANOiO4i. D~/G © 4-INCH MONITOR STANDARD BED 25 X 47 FT CLEANOUTS AND ~ON/TOR GW-- ~ 8FT 4-INCH DISTRIBUTION PIPE 4-INCH k~ONITOR 1250 GAL SEPTIC TANK ANCHORAGE TANK J Ff, of Cover -- Topsoil 12" Sewer Rook CPP RoADSAND, AS REOUIRED ~ 4" Disfibufion Pipe 1000 gol fonk I SILT ITOBBEN SPURKLAND P.E. 203 W i5?H. AVENUE · . 279-J916 PERMIT NO: SW970XXX II LOT 4 BLOCK 1 PARKS HILL DIANE LAURENCE i450i WOODHA VEN CIRCLE SEPTIC SYSTEM REPAIR DATE: JULY6, i997 SHEET: 3/3 GRID: 5057 PID NO: PAHOIO45. DWG PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3 4 5 6- 7 ti 12 14 15 16 18 1@ 20 Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Oeplh t0 Water Aller ~ i' Moniloring? ~ Dale: SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ (minutes/inch) pERc HOLE DIAMETER __ TEST RUN BETWEEN FT AND FT .... DISCLAZMFR: Rrnundwater conditions indicated are' for the dates shown only. Past and future presence and/or depth of groundwater can not be predicted PERFORMED'from By:t~ese ooserva~.l~ns. ' I ~r,- '~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE'. DATE: 72-008 (Rev, 4/85} MUNICIPALITY OF ANCHORAGE DE[~_~,.TMENT OF HEALTH AND HUMAN SER% :S ~.) ~'~L'~/'3r ]~ · Environmental Health Division ~'-" 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 d/~ /f't/-' ~ ,d ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Township, Range, Section TANKS SEPTIC [] HOLDING TYPE OF SYSTEM [] TRENCH '~' BED [] W. DRAIN [] OTHER Depth to p~pe bottom from orl§lRe{ grade Fill added above original grade Gravel length Total depth irom original grade FT / ,-.- ~ Gravel depth beneath ppe FT ,, ,,.~..~..~..~..~..~ Gravel w~dth FT Distance between lines P~pe material Date Installed WELLS Total absorption area //?L-~ S0FT Number Ot lines I Soil rating ¥ I Installer [] PRIVATE [] OTHER fldentifv) Classd~cahon (A,8,C) Total Depth,F~- Cased to REMARKS: DISTANCES SEPTIC TANK ABSORPTION FIELD WELL LOT LINE FOUNDATION FT FT FT [1 WELL AS-BUILT DIAGRAM (Show loca el of well, septic system, property hnes, foundation, driveway, water bodies, etc ) RIVERTDN AVENUE $ 89' 47' 24'E 255.~ M.L 67' I250 G~! 56' LOT 4 To~a! Are~ 4~236 ..~g0t FIDHAVEN ~CLE Scale: I'l=so ! Inspections Pedormed by: ,/? . ¢ .~eriily that this inspection was pedormed according lo all - . Municipal and Slate ¢idelincs in effect.,~--°n Ihis oate: t Health Department Approval: ~-~~ LBT 3 Vacan~ 72-013 (3/85) R~-9'ER TEIN AVENUE '"'~ / ~ 89* 47' ~4'E ~55,4~' ~ t~ed TESTHOLE ~e~erve Are~ ~ 10,000 sq,£-'c, ~ 1250 Go[ Tonk ToPoi Areo _,~ I ~ ~'B~BHAVES C~ROLE / L~T Vacan~ ~-... ,~. '.;.~.,~ // NDTES~,. I~, '"-, ...... A~AN~DN ENZ~TZN5 T~ENCH INSTALL ~E~, Bd'X 53' 4' TDTAL ~EPTH 4 RUWS DF 5' PERF PIPE 2-NONiTORO GRAPHIC SCALE 2-CLEANOUTS ~' = 50' T09]~EN SPURKLAND P,E, II LOT 4, 3LDCK 1, PARK HILLS SEPTIC SYSTEM DESIGN 203 ~/. lSTH, &VENUE ANCHDRAGE, ALASKA II SEC, 34, T12N, R3~/ DATE, ]SEC,P, 1987 <907) 279-3916 DECKER ~, O'~RIAN 14501 WOD~HAvE~ cR, I SHEET, 1/1 GR]D, 3037 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 %" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST A~C_ 'EGA' OESCR,PT,ON: ~T H; 1514 Ij PA~ZlC 1 2 3 4 5 6 7 8 lYf/~7 lo 11 12 13 14 15- 16 17 18 19 20 COMMENTS Township, Range, Section: "~ ICN SLOPE WASGROUND WATER ENCOUNTERED? SITE PLAN IF YES, AT WHAT DEPTH? 0eplh (0 Waler After MonitorinD? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER ~ I/ FT AND ~ FT 72-008 (Rev. 4~85)  ~..,. MUNICIPALITY OF ANCHORAGE '-~ r DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME '1~ APPLICANT: ~INE_& LEVINE PHONE r ~EW 'kEGAL DESCRIPTION LOCATION ,~ NO. OF BEDROOMS ] Well I Absorption area DwelHng PERMIT NO. ~ ~ DISTANCETO: I I~ ~ ~' 4~/ ~ / Manufacturer a ' - , Mate~l No. of compartments JLiq. cap,irwin O~l~ns ......... d~h /~ I F ~uM~lv~u:: Inside length~. W~dth ~ Liquid ~ ~ DISTANCE TO: We DwelHn9 PERMIT NO. ~ ~anufacturer /' Material Liquid capaciW in 9aHons ~ Well ~ Foundation ~ Neares~lot line PE~MI~NO. ~ DISTANCE TO: ,,O ~ __~ L~ngth of ~ach line Total le~f No. of ,in.~ /. -- ~, ~ ~es ] Trench w~dt~ . Distance between lines N ~ ~ Top of tile to finish a~ th tile ~ ~ ~/~ches ne Total effective absorption area ~ ~ qgrade ' _ Mated ~7O/t inches ~ Length ~ Width Depth PERMIT NO. ~ ~ Type of crib Crib dia~ ~rib depth Total effective absorption area ~ DISTANCE TO: W~ Building foundation Nearest lot line ~ Class ~epth /~rille~ ~i~ ~ ~tance to lot line PERMITNO. ~ D STANCE TO' Building foundat/ Sewer~ ....... [ ~i~:fDnk Absorption area(s) OTHER ~~-~. ~ PIPE MATERIALS ~ ,~ . ~ INSTALLER ~- ;: ~ ""~o '*. REMARKS ~¢~ -,g // ~'~ - (4' a~ '~*--,~,~ ~FP 9 APPROVED - DAT~~' LEGAL RECEIVED 72-073 (Rev. 3/78) F'ERI"tI T NO. DEPFIRTHENT i_~H/ HERL TI'-i FtN. F.) EN",,'I RONMENTFIL PF:r]TEE:T I ON ',~'::.z5 "'L'" LqTREZET. F-INC:HFtRRGE., RI-:::. 99501 264-4720 Ib41E b L ~-~ [~-~ [:, ,-'- , , ,' 8Z.':070J_ ', FIF'F'L iF:FtNT_ LE',,,'INE .¢ L.E;' II'.EJ E:I_E,G F'O BOX 4-5~'-] L OC:FIT I ON ......... LEGF~L L4FJ± PFtF.:I.::: HILLS ~i LOT :.SIZE T"FF'E ~]F SOIL RE;SORF'TION '-'"-'"'P'~','~ - _-.-r=,._.,~ IS: DRFtINF'iELD 2.:45-3:52t SQURRE FEE]' t'"IFt;:-:;IHt_IH i'.,ILII"IE:ER OF E:EDF.:3Cd-,iS = S: SI:iL RFt'TIi'.~r.':i ,:,:;.': F]-,.-"BR)= THE REQUIRED S.:IZE OF THE SOiL AE:SORPTZFd'.,I S'-r'STEH IS: THE LENGTH D'It'"IENSION IS THE LENGTH ,'IN FEET::, OF THE TRENCH CE' DRBINFIELD. THE DEPTH OF ~ TRENCH OR PIT IS THE DISTANCE BETHEEN THE SURFAC:E OF TFIE GF'D_tND AND THE E:OTTOH OF THE EXCAVATION (IN FEET::,. THE TE:E:~-~E:H I-..~ Z [:.~-H Z 25 5. C~Z~C~ FEET. THE .... -'~ '~' m~n,mL [:'EF'TH IS THE MINIMLIH DEPTH OF GRR'v'EL BETNEEN THE OUTFRLL F'IP~- RND THE BOTTOM OF THE EXCR',,,'RTION (iN FEET::,. - F'EF.:MIT RPF'LIC:FINT HRS THE FE'S;PON'.=sIE:ILIT'-,.' TO INF]RH THIS [:,EF'RRTHEF,tuF DUF.:ING THE iNSTRLLFIT.'[ON iNSPEC:TIONLq OF Ri'.,t'-? ktELLS Ft[:,JRCENT TO THIS F'F.:OPERT'¢ FIN[:, THE i'.,li_ti,'lE:ER OF RESI[:,ENCES 'TI-iRT THE !.,.IELL I.,.iILL :5ERVE. T i---t C~ ,:: ;2: ::, E:FIr:I<FZLLiNG OF FIN'-? '-'"--F' .=,'r.:-,'l_ll NiTHOUT FINFtL tNSPEC:TION RI'.,!D HFFF.:_ ,HL THIS DEF'FIRTHENT P.!ILL BE SUBJEF:T TF~ PROSECUTIK~N. MINIHUH DISTRNCE BETNEEN FI NELL RND RN"r' ON-SITE SENRGE DISPOSRL Sb'STEf'I IS i00 FEET FOR R PRI",,'RTE 1.4ELL OF..' '150 TO 200 FEET FROM F:I PUBLIC I.,-!ELL [."EPEN[:,ING UPON THE T"¢PE OF PUBLIC HELL I'iiNiMUH DISTRNCE FROi-'I FI F'RI",,'FITE I-'.tELL TO R PRI",,'RTE SEklER LiNE IS 25 FEET RND TO R COMHUNIT"r' SEHER LINE I'---; 75 FEET. NELL LOGS FiRE REL.]LIIREL':, RND i"ILtST BE RETURNED TO THE DEPFIRTHENT f-,.IITHIN ~:0 OF THE HELL COF1PLETION. OTHER REC.!UIREPIENTS i'"lR¥ FIPF'L~'. SPECTFiCRTIONS RND CONS, TRLICTiON [:'IRGRRHS RRE RVRILRBLE TO INSURE PROPER .iNSTRLLRTION. t CERTiF'T: THFtT ±: i RH FRMILIFIR I.,.IITH THE REQUIREMENTS FOE'. ON-SITE SEHERS FIN[.., HELLS RS SET FORTH B"r' THE HUNICIPFtLIT'-¢' OF' RNCHORFIGE. 2: I P. IILL INSTFtL. L THE SYSTEM IN RCCOR[.',RNCE .WITH 'THE CODE:F.,. 2:: ! UNDERSTRN[.', THRT 'THE ON--SITE SEI.4ER '--'.;"r'STEH, t-'lFt"r' REQUIRE ENLFtRGEMENT IF THE RE'-qIDENCE IS REMODELED TO INCLUDE MORE THFtN --': BEDROOH:'_;. FIF'F'LICFtNT LE,~INE & LE',,,'II'.,IE BL[:,F~ .... .... I '--,'-~t ED, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264*4720 SOILS LOG - PERCOLATION TEST SOILS LOG [] PERCOLATION TEST PERFORMED FOR: L~--~, ~N ~ LEGAL DESCRIPTION: ['~T q l 1 2 3 5 7 DATE PERFORMED: 'lB I,.oc.K SLOPE SITE PLAN 8 9, 10- 11 12 13 ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop 14 15 19- 20- PERCOLATION RATE TEST RUN BETWEEN FT AND (minutes/inch) __ FT COMMENTS PERFORMED BY: CERTIFIED BY: ~ DATE: 72-008 (6/79) Levin~ & Levine Anchorage~ AK 99502 Lot 4, BlOck 1~ Park Hills The engineer's as-builts, which have been submitted to this office, are not within the parameters of the on-site installa- t:Lon [~ermJ. t issued by this deparhtuent0 The discrepancies will need -izo be corrected be[ore this department cad accept the sub- ,~:lithed engineer as-builts0 Tectonics, I~'~Co~ is not on the a?i)roved list of authorized engineering firms for on-site installations o zurcne~, questions please contact youu engl- if you have any ~: ~ ~' neering firm or this uc.p~a~.nt. Sincerely, cc: Edward Mack 9?ectonics, inco P. O. Box 4-2265 Anchora~je, AK 99509 Cory Willis Program ~'ianau er ENGINEERING }NNOVATION IN TRE FAR NORTH ARCTIC ENGINEERS, INC. ENGINEERING STUDIES ** DESIGN ~ CONSTRUCTION MANAGEMENT . SURVEYING December 19, 1983 AEI# 83-020-03 Levine & Levine P.O. Box 4-566 Anchorage, Alaska 99509 Re: Lot 4, Block 1, Park Hills #1 Dear Mr. Levine: On December 16, 1983 an inspection on the above referenced lot was performed by our firm. The inspection was to verify compliance of the well and septic systems with Municipality of Anchorage requirements. The Municipality of Anchorage requirements for individual wells are: Casing extends 12" above ground. Ground surface sloped away from the well. Well cap is tightly sealed. Wiring is enclosed in conduit. Total Coliform analysis is satisfactory. Adequate clearance from setpic systems is maintained. The Municipality requirements for completed septic systems are: I. Cast iron cleanout - 1' to 4' from foundation. 2. Clean-out at 90 degrees bends in line between house and septic tank. 3. Clean-outs on septic tank. 4. Sump stand pipe in place. 5. Excavation backfilled. 6. All clean-outs and stand pipes extend to ground level and be capped. 7. Adequate clearance from wells is maintained. ARCTIC ENGINEERS INC ~*0~ w. 38-ri-i AVE¢'X]E ¢/m~C~4ORAGE. ALX',t:~<A E;9503 ® 907/277°8593 ~ " 3901 RA,' , R ~¢~'~;~ J~AN'-~,, ~ ~ ANCHORAGE. ALASKA 99504 ~ 907/333-9428 (AcCOUNTiNG} All of the above items were found to be in compliance. Copies of the well log and water quality analysis report are attached. We conclude that all items are satisfactory Municipality of Anchorage requirements. according to If we can be of further assistance, please contact us. 2 attachments ~..~WATER WELL RECORO STATE OF ALASKA OEPAR~TMENTOF NATURAL RESOURES Oivision of Geologicol ~ Geophysicol Surveys Drilling Permit No. LOCATION OF WELL (Pleoee complel~ either Ia, lb or lc.) A.O.L. NO. _tc~. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS OWNER OF WELL: WELL LOG Feet 8elo~ 4. WELL DEPTH: (fl~l) 5. OATE OF COMPLETION Moterl~l Type Top 8offom ~: fl' JO. STATIC WATER LEVEL,: ~. ~ Above or ~ aelo~ land ~urface IZ.GROUTING Well Grouted: ~ Yes ~ No Material; ~ Neat Cement ~ Other: ~ .... 15. Water Temperature ~o ~ F ~ C PO~- ANCHOp ,, ~ ....... , (907) 264 .!~ DEPAR FML'NT OF HE/\LTH AN[) [!N',/IROt~tvlENTAL PRO FEC'i ',()i.., <Permit ~: 820462 ~January 31, 1983 TO: Permit Applicant Subject: Lot 4 Block 1 Park Hill Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982o Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and'to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerel~ Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 PERMIT I",!0. F!PF'L :[ C.ei",F[' L. OC:RT I ON L.EGFIL. RMC i NC ~_~ Ei F:'RRK HILL T'?'F'E OF E !"mi 7 L -- '"' ...... ''""T ~' .-- -- ' I-dl:,.::,U.~. - , .. il I'd S'T'S'TEH T '::; HRHit"!IJM h!IJ.~'tE:EF: OF EEE:,IE:OOM'S .... { SO ! L. RFiT I BIG ,' ?;0 F'T,,"BR 1: .... THE F:EQU I F:E[:, S:I: ;::CE:_' '_'!F:' TFIE: P";O I L F!E:E;OF;!PJ'!ON '.E '.r":S'FErH ! S: ~l::, EC:.i F::" 'T ~-..~ == L.F..-.-£Z P-.~_ ~."2~ 'T %-q == !:Z::~ ,~;i.,~: F..i~ F;.;: Frq ".,P El ~ ...... il:~ FiZ E=> 'T' ~.H.~ THE LENGTH D I !"!Ei'"!S ! 01"".' Z S 'THE !__ENGTFi ';: i i'"! F:EET ::' OF THE 'I'F:Et"!CH OF;: DRFI I NFi FZL..D. THE DEF'TH OF' F! TIRENE:H (.'IR PiT IS THE [:,ISTFINCE E:E:"FHEEH THE SUFtFF:IC:E' OF 'T'HE GF.:OUND FIND THL( BOTTOi'! OF "!'HE: EHC[:!VFiTiCH',! (Zf',! FEET>. 'TH['ZB:E' Z'E. HO :'5lET I.,.IZDTH F'OFR TP:'.ENCHEE;. THE G[~:F!VEL DEPTH .!'S fi'FiE MZN!MUM DEPT'H C!F' GF:F~'-v'EL BETHEEN THE OUTFF!L.L. PZF'E FIND T'HE F'~O'TTOI'! OF' THE: EXCFi',,/F!TION <i'N F'EET). PF:!iF.:M i' !' RPP!.... ! CFINT HFrS THE: F:E:F;F'ONS i D i L I "F'T' "FO T. HF l F'I"I TH l E; DEF'F!RTMENT r-~ '- ~ .~ ". ... _ iHSTFILJ_FITI ON i NSPECT 10!',!E; OF '"~ ' NUME:EF'. OF [:ES Z DENC:ES 'THRT THE !.,.!E:LL 1.,.I Z L.L SE[~:'v'E. ...........FFi.r:,k'F:'ft [ ]'NI~ OF FtN'T' ::,'-"-TFh'_-., ...... '~ !.,.IITHOt.jT F'iMFI ............... INSPFCq"TFP.,i FLNF,.:, RF'F:'P""q! F":, r '!'FILS E,E'PFIP'FmMENT' HILL MINIMUM D tSTRNCE BEiTHEiEN R !4ELL.. FINE:, RNh.' ON-SI'TE SEHRGE E:,ISPOSP, L SVS'TEM iS ici[3 FEET FOR R F'FR!',,,'RTE I.,.IEL. L OF: ::L{iCi TO 2elel FEEET F'F:OM F~ PUBLIC HELL. DEF'E!'m-![::,:[i'qG UF'ON THE TVPE OF F'UE:L.!C HELL. !'diN!MLIM DISTFINCE F:F:OM R F'F:IVRTFZ 14EELL. TO F:! F'RIVRTE i~;~:([,]ER LINE iS ;25 FE:ET FIND TO R COMMUNITY SEHER LINE IS 7'5 F'EET. HELL LOGS RF:E F;E:QUI[~:ED FIND MLIST E:E F~:ETLtF:NED TO THE DEPFffRTMENT Hi'THIN 3e DR?S OF THE HELL. COMF'LETIOI'.L OTHER F:EQIjIREMENTS Mfr.? R!:::'PL'~'. SF'ECiF'!C:RTIONS F:iND COHSTRUCT!OI',~ DIF!GF~:FiMS RP.E F!VF!IL. FIE',LE TO INSLtRE F'ROF'E[~: !NSTF!LLFiTION. .T. CEF:T :[ F'?' THRT l: ! FIM F'FIM. IL!RF.: HLFTH THE REQUIREMENTS !=OF:: ON-SITE SEi,.!ERS RN[:, HEL. L.E; RS SET FOF:"FF! 8'T' THE hlLII'.,!ICIF'FIt_IT'~-' OF:' RNCHI3F~:FiGE. 2; I HILL INSTRLL ']'HE :;~;'='STEH Zt~,! ,RC:COiq:DRI'.,!CE !.,.! :[ '['FI THE i:; I UNDEF;:STRND TPIRT THE ON-SITE SEI-,.!ER Sh-'STEM MR? REQUIP. E ENLRF:GE:HE:NT .'.'..':F THE RE.SZE:,ENC.:E I:":] FIEHODELED 'TO iNCLU[>E IfiOF;'.E TFiRN 4 ::T, .l: Ci.NE~[:,: !~]i L,,~,/ MUNICIPALITY OF ANCHORAG'x~/' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST PERFORMED FOR:.-~ LEGAL DESCRIPTION: -'~'~' [] PERCOLATION TEST 9 10 13 17 18 20 COMMENTS DATE PERFORMED: 3 -23 - ~- ~ ~ Iq~ o~ 155~ ~'ro,,, ~*~,~.E SLOPE SITE PLAN WAS GROUND WATER S ENCOUNTERED.::' ~/E S ~ P E IF YES, AT WHAT DEPTH? I 2. ~ ~-/~ SP_.. Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ ~,- (minutes/inch) ~EST RUN ~E*~EE. ,~ =/4- FT ANO ~--~/¢ ET GS'/Z~ ~'/z" ~.bc, v~ ~c~D PERFORMED BY: CERTIFIED BY: DATE: 27 72-008 (6/79} Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us /907) 343-7904 Parcel I.D. 1. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE 017-1 ~-2-07 GENERAL INFORMATION Complete legal description LOT 4, BLOCK Location (site address or directions) 14501 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address FAi'd ILY DWELLING Expiration Date: ¢ /b /~- / 1; PARK HILLS SUBDIVISION = ,-rt WOODHAVEN CIRCLE * ANCHORAGE. AK KEN AND GAlL JONES Day phone $45-2956 14501 WOODHAVEN CIRCLE * ANCHORAGE, AK 99516 Day phone DONNA ORR w/ REMAX PROPERTIES Day phone 2600 CORDOVA BRIVE '~ ANCHORAGE, AK 9950,3 276-2761 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank 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 atso 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 sampies.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality cf Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ to dosing for the engineering services provided. STATEMENT OF INSPECTION BY ENGINEER at, or prior As certified by my seal affixed hereto and as of the vafidation date shown below, I 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. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with afl appficab/e Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY, A. GARNESS, P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation, AKW1/VC, /nc. attempted to provide a thorough, conscientious engineering analysis of the system/n accordance with ADEC and MOA DSD Guidelines & Regulations. The reported resutts described the performance of the system under the conditions encountered at the time of the feet, and separation distances measured to readily identifiable features. The operational life ef atl wefts 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 controi of the evatuator 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. AKWWC, /nc. can therefore not provide any warranty or future estimate of how tong the system will continue to meet the operetional 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. DSD SIGNATURE Approved for / Disapproved. Conditional approval for bedrooms. bedrooms, with the fllowing stipulat~on~ ~: ', ';~. '~,'~/T qc . 'c%'~,' Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other (Rev. 1210!) / // Original Certificate Date: Eo Date. installed "pump on" level at ..' in. Datum SEPARATION' DISTANCES ' SiA~'iriigallbns~: '.':. ~;; ~,'-.::~:..~.M'~:nhPlelAcc~s (Y/N) ...... ., ~/ ' . .';f -., "Pump off'...lo ~,l.at ..... '... ~ln.: .: '.Highwater alarm level at ........... :.in, Cycles'teSted ......... :.,. Me-ets.a arm & circu t requ rements? SEPARATION DISTANCES' FROM' WELL ON. LOT TO: Septic tank/lift station on' lot 100'+' O'n' adjacent lots 100'+ Absor'piion.field,dn'lot l~OOr~ '. · - ' ..- (~h"Adjacent. lOts t. OO.~+ Public sewer main N/A Public sewer manhole/cleanout N/A: :. Sewe[./septic setviceline - 25"+ ~..:?' Holding .tank N/A · SEPARA'FION: DISTANCES :FROM,SEPTIC/HO:EDI,NG ~TA.N K::ON:,LOT'TO: ' Building foundation'... 5'+ Property line -.5'+ .,- . Absorption field- .5'+ Water main , N/A - - Water Service'line ' .1.0~+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION .D.ISTAN'CE-FROM. ABSORPTION FIELD ON LO;I' TO.; *SEE WAI~ER ~WR.0.10074 Property.line .'2'+ Building foundation --t 0'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway.,: parking/vehicle storage t,:O'+ Curtain:.drain.'" .NONE KNOWN". Wells on adjacent:,t~s,:, t;0~+ F.: .COMMENTS G. E N.G.I~JEEI~'S 'C E RTIFICATI'ON / ce/tifY 'tha~ I ha~e deterrnined through field .insp~Cti°ns 'and' review of Mu~icipal:i'e~ords that the ab~.~e syst~ms, are'ir~ ;:: conformance with MOA HAA guidelines in effect on this date. Engineer's. Printed. Name, · JEFFREY. :A.. GARNESS.: HAA FeeS': :'.:'  iD~t~.:d~.P. ayment. 'R~C~i~;~NUn~ber.<:Rev '12~0i) 2'~'~ Waiver'FeeS ' Date,o[.15aYr~ent *. .Receipt. Nu'rhbet', ,~t~__ CT&E Environmental Services Inc. 200 W. Potter Drive Anchorage, AK 99518-1605 Tel: (907) 562-2343 Fax: (907) 561-5301 Web: http:llwww.cteesi.com JeffGamess AK Water & Wastewater Consult. 6901 DeBarr Road, Suite 2B Anchorage, AK 99504 WorkOrder: Client: Report Date: 1028047 Lot 4, Blk 1, Park Hill #1 AK Water & Wastewater Consultants Inc. December 02, 2002 Enclosed are the analytical results associated with the above workorder. As required by the state of Alaska and the USEPA, a formal Quality Assurance/Quality Control Program is maintained by CT&E. A copy of our Quality Control Manual that outlines this program is available at your request. Except as specifically noted, all statements and data in this report are in conformance to the provisions set forth in our Quality Assurance Program Plan. If you have any questions regarding this report or if we can be of any other assistance, please call your CT&E Project Manager at (907) 562-2343. The following descriptors may be found on your report which will serve to further qualify the data. U Indicates the analyte was analyzed for but not detected. F Indicates an estimated value that falls below PQL, but is greater than the MDL. J Indicates an estimated value that falls below PQL, but is greater than the MDL. B Indicates the analyte is found in the blank associated with the sample. * The analyte has exceeded allowable limits. GT Greater Than D Secondary Dilution LT Less Than Surrogate out of range Member of the SGS Group (Soeiete Generate de Surveillance) 04:03P Bonni~ Mehn~r & Associate (907)762-1858 ./ P.O1 4121 -S PrepQred ' 5'y. Robert E. Johns, Jr. & Assoc. Profeeelonol Lond Surveyors ]" = 40 ' AU~US~ ~1.2~1 R~,T ~r,,~ ~T 4, BLOCK '1, P~ ~ILLS SUBDIVI~ION ~x~zoN $1 Municipality of Anchorage Development Services Department Building Safety Dlvlslon On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchomge.alcus CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 017-142-07 1. GENERAL INFORMATION Expiration Date: ~'- Completelegaldescrlption ' ,PARK HILLS SUBDMC.;ION ~1 LOT 4 BLOCK 1 Location (site address ordirectl~ns) 14501 WOODHAVEN CIRCLE *ANCHORAGE, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address BEN LANDRY Day phone 348-8323 14501 WOODHAVEN CIRCLE *ANCHORAGE~ AK 99516 Day phone BONNIE UEHNER W/PRUDENTiAL J.W. Day phone 563-5500 3201 "C" ST. SUITE 200, *ANCHORAGE, AK. 99503 Unless o~heneise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well IndMdual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (FIAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the bansfer of title (except between spouses) for properties served by a single family on-sits wastawatar disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a pedod of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineer's work. Note: Alaska Water a.nd Wastewater Consultants, Inc. shall be paid $1000.00 at, or prior to dosing for ~he engineering sa/~fces provided. 4. STATEMENT OF INSPECTION BY ENGINEER As cer~'fied by my seal affixed hereto and as of ~he validaUon date shown below, I verify that my Investigation, based on procedures outtined ln the Heal~ Authority Approval Guidelines fer this application, shows that the on-site water supply and/or wastewator disposal system is(are) safe, functional end adequate for the number of bedrooms and type of structure indicated herein. I further veda, that based on the information obtained from the Munidpali~y 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. NameofFlrm . ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, surrE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Date 337-6179 Engineer'~ Comments: In conducting this evalua~3~, AIM/i/C, Inc. attempted ~o p~vlde a th<~ough, c~3scl~tlous engineering anal~is of the system in accordance ~ ADEC and MOA DSD Guld~nes & Reguis~s. The reported results described b~e performance of the system under the condigons encountemd at ine ffme of ine test, and separaUo~ fluctuate dudng ~e year, and the water usage of b3e famlly being served by the ~Tstem. These c~cr~tlons are ou~ide the control of ~ evaluator of ~he system. Sa~factoty test msults do not guarantee future pefformance of ~he sy~em, nor do they guaran~e ~at operaUonal requlrements of the ADEC or MOA DSD. The ~oetalt of ~s repo~t is for otha' pers~n or patly Is not au~flodzed, nor v, Yll It c~fe~ any legal right wha 5. DSD SIGNATURE Disapproved. Conditional approval for __ Attachments: HAA Checldist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Englnee?s Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department On.Site Water & Wastewater Program 4700 ~loulh Bragaw St. Oats of test Static water level Well production WElL DATA Welltype PmVA~ ffA, B,~xCIXovldePWSID~ N/A Oatecompeted 10/~7/~ Sanrmw.ea{Y~)YES Total depth ~0 ft, Cased to 66 ft, FROM WELL LOG ~o/~/~3 18 5 HEALTH AUTHORITY APPROVAL CHECKLIST PARK HILLS SUBDIVISION ~1, LOT 4,, BLOCK 1 P~'CelID: It, g.p.m. WATER ~.MPLE RESULTS: Coliform ._~ ¢=lonles/lO0 mL Nllmte ~'~' mgJl.. D~te of ~mple: 8/7/2o01 Collected by:. B. SEPTIC/HOLDING TANK DATA Tmllc Type/~ter~l STEEL Tank size 1250 gal. Number of Compartments 2 Foundalioncleanout(Y/N) YES, Oepresalonovertenk(Y/N) NO Date of pumping · 6/28/2001 Pumper C. AI~Oi~IION RELD DATA ~ Date Installed ~/~/;7 Soil rafing (g.p~Jlt'or~) 190 Length 47 t~ ~ 2,5 lt. wen Lng ~n~) AT INSPECTION 8/1/o~ 23 ft. 2.9 g.p.m. Other becterla . AWWCt INC. 017-142-07 18+ .In, Fluid deplh In abeorpllon field before test 0 In, E~al:~ed Time: 265 mIn. Final fluid deplh o Any rejuvenation lmalTnent (past 12 mo.) (Y/N & (ype) O~)installed 8/6/97 C~ou~Cr~N) A+ HOME SE'RV~CES Systemtype BED Gravelbelow~pe 0,5 Toteldepth 3.,~.-4.1 It. Eff. abeoq~ionama1175 It" Monlteringtube YES Depresslonoverflald NO . .Oate of adequacy test 8/01//01 Resulte(Pas~/Fall) PASS For 4 bedrooms Wateradded 756 gal. Newdepth 0 In. In. Absorption rate >= 600+ g.p.d. NONE KNOWN If y~S, give date - D. UFT 8TATION .~D~_ instalied Size In gallons ~ Pump ~" level at In. "Pump . High water alarm level at In. Datu._.~m Cycles tested Meets alarm & dmult requlmmente? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WI=II ON LOT TO: Se~c lank/lift ~a~on on lot 100'+ Absorption ~ld on lot. 100'+ Public sewer main Sewer/sepUc ~ewlce line 25'+ On adjacent Iote 10o'+ On adjacent lots lOO'+ Public sewer numhole/cleanont N/A Hold]llg tartk N/A Property line 5'+/- Water ~ewlce line 10'+ Cu~n drain NONE KNOWN F. COMMENTS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Buliding foundation 5% Property llne 5'+ Water main N//A Water ~en~ce line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Bulidlng foundatlon 10'+ Surface water, lOO'+ Wells on adjacent Iote 100'+ At3~orpl~on field 5'+ Sun'ace water 100'+ Water main N/A .Oflveway, paddng/vehldestorage 10'+ O. ENGINEER'S CERTIFICATION I cetlffy that I have determined t/~ough field InspecUons end review of Munidpui recolds that the above ~'ern~ em In conformance with MOA HAA guidelines In effect on this date. H Fee$ 00. oo Da ofPayr nt D /GI Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Bttilding Safc~' D~v~s~on P.O. I~)x 196650 * 4700 $. Bragaw Strcct Anchorage, Alaska 99519-6650 · (907) 343-8301 h ttp://www.ct.anchorage.ak.us 9/5/2001 Jeffrey A. Gamess Alaska Water and Wastewater Consultants, Inc. Subject: Waiver Request for Park Hills #1 Block I Lot 4 Waiver Request #WR010074 Parcel ID #017-142-07 HAA#010462 Department of Public Works Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation from the on-site wastewater disposal system to property line has been approved. The approved separation distance is 2.0 feet. This waiver approval applies to the existing on-site wastewaterdisposal system to property line separation only. Any furore 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 Municipollty of Anchorage Development Services Department Building Safc~y Division On-Site Water and Wastewaler Program 4700 Bragaw Stn~ P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WRY: W~010074 PID~: I)'i7-142-07 HA,9:HA010462 Permit/*: Date Received: ~ll4/91 Legal Description: Park Hills ~ Block I Lot4 I~palneer: Jeffrey A. Gamess. P.E. - Alaska Water & Wastewater Consultants. Inc. 6901 E Debarr Rd, ~uite 2B Anchoraae. AK 99504 Applicant: Ben ~nd~ Waiver Requested: 2 Feat from SePtic SYstem to Lot Line Criteria: Geology Points: A. Water Table B. Soil C. Permeability D. Water Table Gradient E. HorizOntal Separation Waiver is Granted: Waiver Is not Granted: LIst Conditions or Reasons for above: Date: By: Name of Reviewer Rec~: 9598 Amount: $1t5.00 Date Paid: 914/2001 ALASKA WATER September 4, 2001 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 4, Block 1, Park Hills #1 To whom it may concern: The septic system on the subject property appears to be approximately five (5) feet from the northern lot line. Because the system is underground and we do not know it's exact location, we request that your department issue a 2 foot lot line waiver from the northeast property line to the existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or.septic sys}ems. If you have any questions, please contact us at 337-6179. Thank you for your ass,sTce~ 0 I'?-I~Z.-o7 L~ P-.. olc)0'Tq 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I,D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 01'7.-1 / -0"1 HAA# GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone ~-7~- 77¢~f Unless otherwise requested, HAA will be held for pickup. I NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Address DHHS SIGNATURE k Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~25(Rev. 1/91) Back MOAff~I Municipality of Anchorage ^r-- ,- '~-'""'"' DEPARTMENT OF HEALTH&HUMAN SERVICES ~cP ~)~? 1,~!)? (~.~.~ Environmental Services Division i:~ ,-~ ~- ICJ! 11 825 L Street, Room 502. Anchorage, Alaska 99501. (907) 3~@'~14¢ l/~:= / ~ Health Authority Approval Checklist LegalDescription: 9A[~ [J~ILL¢'14}, ParcelI.D.: ¢)1'7-I~{,IL-¢ ¢7 A. WELL DATA Well type. ~ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to ~ I Casing height (above ground) ~/._/d Wires properly protected (Y/N) "'/ Date of test Static water level Well production FROM WELL LOG ! g.p.m. AT INSPECTION g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: ,~'/~ Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Foundation cleanout (Y/N) Date of Pumping J~)//-~ Tanksize ir¢~O Number of Compartments ¢,~ Cleanouts (Y/N) . ,,/ Depression (Y/N) ~'*\ High water alarm (Y/N) Pumper C. ABSORPTION FIELD DATA Date installed ~/////~ ~' Soil rating (g.p.d./ft2 or ft~/bdrm) l~E] Length /,//-~ / Width c¢'5 / Gravel thickness below pipe Effective absorption area //~5 )~¢ Z'Monitoring Tube present (Y/N) "/ Date of adequacy test r4//ar Results (Pass/Fail) ~i~ Fluid depth in absorption field before test (in.); t"//xa¥ Immediately after Fluid depth. ~ (ins) Minutes later: ~ Peroxide treatment (past 12 months) (Y/N) ~ System type '~ ~ ¢, ~ Total depth. / · Depression over field (Y/N) For __~ bedrooms C/gal. water added (in.): ~/' Absorption rate = ~ g.p.d. If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) Size in gallons "Pump on" level at* High water alarm level at* *Datum Cycles tested "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Sepbc/ ........ g tank on lot On adjacent lots Absorption field on lot I ¢/.p J On adjacent lots Public sewer main t"V'/A- Public sewer manhole/cleanout Sewer/septic service line ~ ~o / Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDiNG TANK ON LOTTO: Foundation ~.~ I Property line 'L'&d ' ~ Water main/service line ~¢ ' ~ Surface water/drainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ~ i /' - Building foundation ~'. Surface water /"///£2 Curtain drain F. ENGINEER'S CERTIFICATION Absorption field Wells on adjacent lots Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lets · ~ /¢--~ I I certify that I have determined thru field inspections and review of Municipal records that the above ~yst¢ms are in conformance with MOA HAA guidelines in effect on this date. Engineers Name I ¢_. u HAA Fee $ Date of Payment 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE · DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent ~.1 ~J., ~- I..~o..v~,~ ~ L) Add ress Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC ' attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~--'~ ~ Address Engineer's signature ~ ~'~~ I Date DHHS SIGNATURE X Approved for /~o~/~(~) bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: AdditionalComments ~U'~[~.~ /F'~ ~)' ~U~'''~- By: ~ ~'~ Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 1/91] Back MOA #21 L __ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type ~ Log present (WN) Total depth Sanitary seal (Y/N) ~'7~ "'/ / Parcel If A, B, or C, attach ADEC letter. ADEC water system number Date completed I°/IC//~ Driller ~. "" Cased to ~ ~/z~ Casing height Wires properly protected (Y/N) Date of test Static water level Well flow '-~ Pump level1 ~'~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line FROM WELL LOG .g.p.m. AT INSPECTION · , g.p.m. ,,~ ~ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate ,/. ~-- ~.~ Other bacteria Collected by: ~ ~ B. SEPTIC/HOLDING TANK DATA Date installed ~/Z'//'~' ~ Tank size //,~,5-O Compartments Cleanouts (Y/N) %/ Foundation cleanout (Y/N) y Depression (Y/N) High water alarm (Y/N) J'~//,~, Alarm tested (Y/N) Date of pumping C~/~ $ / ~/,~ Pumper /../3,:~_o._c SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Surface water/drainage On adjacent lots Foundation ~C:) Water main/service line Absorption field CONTINUED ON BACK PAGE 72-026 (3/93)* Front C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D, ABSORPTION FIELD DATA Date installed /~/~1/~ ~ Length /'"// 7 Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/Ft2) I ~ O System type /~ Width ,,~ ~ Gravel thickness ~ // Total depth / - .~ / 1/7 ~" Cleanout present (Y/N) ~/ Depression over field (Y/N) q/'~ )~ '2~ Results (pass/fail) /~ for /-'¢/ Bedrooms ~ ' ! After test ~/*1 ~%/ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots ~' Surface water ¢'¢ Curtain drain /'1// On adjacent lots ~ /,,~ 5 Property line To existing or abandoned system on lot Cutbank ~'~ ¢ b'/~ Water main/service line Driveway, parking/vehicle storage area '~ / C~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA gu/defines in effect on the date of this inspection. Signature 7 .._.~~ Engineer's Name J~/~ ~d ,.-.~¢.,,-~L~.~.cJ~ '"~-~- Date ~/l ~/~._~ HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee Date of Payment Receipt Number W. DiMOND BLVD. ANCHORAGE, ALASKA 99502-5904 (907) 279-59i6 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 i Street Anchorage~ Alaska 99501 Subject: HAA for Lot 4~ Block 1 Park Hills ..... p~-m~. 6~ 1993 Gentlemen; During an HAA inspection for subject property we established that the ~eil produces .7 gallons per minute. This is substantially less than the 5 gallons per minute recorded by the well driller. We found the static water level at 24 feet. After pumping ~50 gallons the water level was at the pump intake- The well recov- ered for i35 minutes and was pumped again. A total of i00 gal- tons were delivered before pump intake was reached. The well ~as allowed to recover for i75 minutes and then repumped- This time 130 gallons were delivered before water level reaches the p~,mp intake. The well yield from these two cycles are 100/i35= 0.74 130/i75 = 0.743 in both cases the water level in the casing was at 24 feet ,~e~ore pumping started. ~rkl~d F = MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 0 ! '~ DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION /MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot bio~k, subdivision, section,~nship, range) Location (address or directions) (b) Property Owner .'~.~./-,~.~" t, 0'~'¢'~-~ Telephone:Home ~,~/~t..~.ut.'~ Business Mailing Address (c) Lending Institution A~ ~'~-..~ Telephone Mailing Address (d) Real Estate Company and Agent Address O,~.~ ~ '~' J~/O '~'¢ ~ '~ V' ~ Telephone ¢~"""~' - ] ~'-~ ~ (e) Mail the HAA to the followine address: or: Check here,,.~ if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family ~ Number of Bedrooms WATER SUPPLY Individual Well'~ Community [] Public [] /- Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~/ Public [] Community [] Holding Tank [] / Note:J'f community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72 025 fRev 8/861 Front 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 Name of Firm Address Date Telephone Seal Approved for ¢ bedrooms by ~ Date Approved X Disapproved Conditional Terms of Conditional Approval CAUTION 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 cedificate 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 tRey 8/86) Back .,A©%;~?¢h~/IUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 Legal Description' UOT Cased to ~"~' Depth of Grouting t~O/~J~ ~. ~,,.~ PumpSetAt ' ' ~¢1"'r°1~1 Sanitary Seal on Casing (Y/N) ~ Depression Around Wellhead'(Y/N)' ~'~ If A, B, C, D.E.C. Approved (Y/N) ['d/,~ Date Completed - lO'lq' ~ Yield a,~qDi~'~ II Well Classification' """~----"~ Well Log Present (Y/N) _ Y Total Depth _ ~ Static Water Level Casing Height Above Ground Electrical Wiring in Condu'it (Y/N)._ Separation Distanc(Js from Well: Y To Septic/Holding Tank on Lot ! -~ ~ ' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~; On Adjoining Lots · To Nearest'Public Sewer Cine ~ To Nearest Public Sewer · Cleanout/Manhole I"~J 0 ~J.~, . To Nearest Sewer Service Line on Lot Water Sample Collected by ~ ~ ; Date I~/~,/~ Water Sample Test Results - ~'. CO/...~I ¢.. ""r'. /'~i~"/~.,T. JiE~..~:~.~_~// Comments Date Installed_ At~"~ Standpipes (Y/N) _ Depression over Tank (Y/N) SEPTIC/HOLDING TANK DATA Size J~""~ No. of Compartments Air-tight Caps (Y/N) _ ~' ,-/ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) - ~ Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ ~' '~ Foundation Cleanout (Y/N) Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) "To Building Foundation To Property Line To Water Main/Service Line _ Course To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 ?2-026 fRev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata _ Date Installed I ~'/'~l [~ 7 Width of Field ~,,~ Square Feet of Absorption Area // Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: Type of System Design '"~ ~.~.~.~.~.~.~.~.~.~. ~ Length of Field ~ ~' Depth of Field / '"' ~ Gravel Bed Thickness /~,,~ ~'' Standpipes Present (Y/N) _ ~ Date of Last Adequacy Test To Water-Supply Well To Building Foundation ~,~, Lot ~' / O To Water Main/Service Line . To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments _ J~ ~ ~ ,.~ ~'.~,"~j~, To Property Line _ ?, To Existing or Abandoned System on ; On Adjoining Lots ..~ To Cutbank (if present) LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or-conformed to all MOA and HAA guidelines in effect on the date of this inspection, Signed '"~'~ Date / Company MOA No. Receipt No. ~ Date of Payment Amounts __ Page 2 of 2 72 026 fRev 8861 Back Engineer's Seal ~CONSULTING ENGINEER TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: LOT 4, BLOCK 1, PARK HILLS 14501 WOODHAVEN CIRCLE DECKER & O'BRIAN SINGLE FAMILY YES-' INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 5 GALLONS PER MINUTE PUMP YIELD: 6.5 GALLONS PER MINUTE DATE OF INSPECTION: NOVEMBER 5, 1987 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6.5 GALLONS PER MINUTE WHILE THE' DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE; AT THE BEGINNING OF THE TEST WATER LEVEL WAS FOUND AT LESS THAN 25 FEET BELOW TOP OF CASING. AFTER 27 MINUTES OF PUMPING THE PUMP STARTED TO SUCK AIR. PUMPING WAS STOPPED. RECOVERY WAS MONITORED FOR 35 MINUTES. RECOVERY RATE WAS MEASURED TO BE 2 GALLONS PER MINUTE. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA TOTAL NITRATES ON OCTOBER 28, 1987..E.COLI=0,- TOTAL NITRATES = 0.61mg/1 AND TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requiremen~ for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of.the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. ,CONSULTING ENGINEER TELEPHONE: (907) 279-3916 sEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: LOT 4, BLOCK 1, PARK HILL .,~-. ~. .~'~ 14501 WOODHAVEN CIRCLE ,¢'~? ~,,:~ -.~ DECKER & O'BRIAN ~ ................. SINGLE FAMILY, FOUR BEDROOMS ~.~ ~o. 2225-E PRIVATE, ON SiTE ~. FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1250 GAL. ABSORPTION ~YSTEM: TRENCH ABSORPTION AREA: 532 SQ. FT SOIL RATING: 85/150 INSTALLATION DATE: AUGUST 1983 DATE OF PUMPING: OCT. 28, 1987 ISAACS PUMPING SERVICE DATE OF TEST~: NOVEMBER 9, 1987 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH FOUR FEET OF COVER. THERE WERE NO STANDPIPES TO THE TRENCH. TRENCH WAS EXCAVATED AND STANDPIPES INSTALLED. DURING THIS OPERATION IT WAS DISCOVERED THAT THE TRENCH HAD ONLY ONE FOOT OF COVER AND NO INSULATION. THE 'SYSTEM WAS' TESTED BY ADDING WATER TO THE DRAINFIELD. ON NOVEMBER 9 1000 GALLONS OF CLEAN WATER WAS ADDED TOT HE FIELD. THIS CAUSED THE WATER LEVEL IN THE TRENCH TO RISE 22 INCHES. AFTER 22 HOURS THE LEVEL HAD DROPPED 11 INCHES INDICATING THAT APPROXIMATELY 500 GALLONS HAD BEEN ABSORBED. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE FOR A THREE BEDROOM HOUSE BUT NOT FOR A FOUR BEDROOM. ADDITIONAL FILL MUST BE PLACED OVER THE DRAINFIELD TO PROTECT IT FORM FREEZING. THE MUNICIPAL REQUIREMENT IS AT LEAST THREE FEET OF COVER. The operational life of all septic systems depends on the local soil conditions,, 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 this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. CONSULTI~FF~AL S-~RVICE3 DIVISION RECEIVED. ~.~.~ 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 Municipality of Anchorage Division of'Environmental Health Department of Health and Social Services 820 L Street Anchorage, Alaska 99501 January 6, 1988 Subject: REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR SEPTIC SYSTEM TO LOT LINE Lot 4, Block 1, Parks Hills '~1 Permit # 870312 Gentlemen; We distance lot line are requesting a waiver for the required separation of ten feet between a subsurface disposal field and a as required by AO No. 86-21, 15.65.060.2.B5. As installed the closest point of the field three feet inside the north property line attached As Built. is approximately as shown on the The field was installed this close to the lot line in order to obtain maximum separation between the field and the abandoned drainfield. Yours C,t 47' ~4'E H,L 67' 1250 Go! T~nk 56 ' ~55.4~' WnEIDHAVEN'~ CIRCLE NOTES, EXIS TING TRENCH ABAND. NEW BED ~5' X 47' 5' TOTAL DEPTH 1~' DF SEdER ROCK 4 RUNS OF 6' PERF PIPE 2-MDNITOR$ 2-CLEANOUT$ LOT 3 75 6RAPHIC ~CALE 1' : $0' 100 125 150 TrlBBEN SPURKLANI] P,E, :~03 V/, 15TH. AVENUE ANCHORAG~ ALASKA (907) ~79-3916 LOT 4, BLOCK 1, PARK HILLS SEC, 34, T12N, R3W DECKER & D'BRIAN 14SOl WOOl)HAVEN CR, SEPTIC SYSTEN AS-BUILDT DATE~ JAN.4 1988 SHEET, 1/1 ORID, 3037 MunicSp itYof Anchorage P.O, Bk.../196650 ANCHORAGE, ALASKA 99519-6650 (907) 343-4200 TONY KN. OWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 12, 1988 Tobben Spurkland, P.E. 203 West 15th Avenue "C" Suite 203 Anchorage, Alaska 99501 Subject: Waiver Request-for Lot 4 Block 1 Park Hills #1 Waiver Request Number WR88-003 Dear Mr. Spurkland: Your request for the waiver of the required separation distance between an absorption bed and lot line has been approved. The required 10 foot separation has been waived to 3 feet. Because this encroachment is fronting a public right-of-way, there should not be any impact to a neighboring lot. This waiver applies to this existing bed type absorption field only. Any future upgrade will require all separation distances be met or another approval from this department. ~cerely, Daniel J. Roth Civil Engineer On-Site Services cc: Gus Andress, P.E. -~' Manager, On-Site Services/Water Quality Programs APPLI(...NT FILL,5 Uu I Property Owner ,t~ 1/1/ l ~_' ~'-, ~' -- Buyer Phone Address &ddress Zip Code Zip Code Zip Code Phone Phone Street Locatioe Type of Residence  S ingle Family Multiple Family [] Other Water Supply /Individual Community [] Public Utility No. of Bedroorr~s~ ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available). Sewer Disposal /i~ Individual 'Public Utility [] Holding Tank ~-~¢ Year Individual Installed: ~4-'/ ~- When Connected to Public Utility: -- NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date -- Inspector\ Inspector Inspector ~C~~ MUNtCIPAL/TY OF ~ Field Notes: E~ViRO~M:~'¥AL pp, O~C~IO~ 'CONDITIONS OF APPROVAL Inspector (~)APPROVED BEDROOMS DISAPPROVED , , CO,NDITION~,~-APPR/~.~ Soils Rating 72-O23 (3182) Date Sewer Installed w ell To Absorption Area ell to Tank tWell Log Received Septic Ta~k Size