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HomeMy WebLinkAboutTHAYERMOORE HEIGHTS BLK 1 LT 3Thoyerrnoore Heights Block Lot #015-081-04 FNVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION RI=PORT NAME. PHONE BI NEW MAILING ADDRESS LEGAL ~SCRIPTION I LOCAT2Q~ t NO. O~8E BROOMS f ~ Abs~ptio area / Dwelling .~. / PERMIT NO. ~ ~ Manufacturer Material No. of compartments Liq. capa~it in gallons IF HOMEMADE: Inside length~ Width Liquid depth Well Dwelling PERMIT NO. ~ DISTANCE TO: Well '7 ~ / Foundation~' t Nearest lot linle~/ ~ PERMIT NO. ~ ~ Z No. of lines Length of each Ih~e 7oral I~0¢t~ )f li,~es Trenct~}~th Distance~t Nnes ~ T°P °f tile t° finish 9radeg g '~2 ~ ~t, (2~ inches Total effective absorptio[, area Total effective absorption ar ~ ~ Type of crib Crib diam ter Crib ~ Class Depth Driller .... Distance to lot line ~ERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank ~ .~ Absorption area(s} ..... OTHER PIPE MATERIALS REMARKS APPROVED f ' ~ ~ ~ &il~S~)O~¢' ¢'E LEGAL 72-013 (Rev. 3/78) AI:::'I:::'I.. I C AhH :: I'1! i;l-.El',l I=IERGUt.~S[]N · *~I.I.,II.)R-( I., AK //,.]6 f..t::.~',~.t, DI., L I, J,I ,~ll~ D I ¢ I , ~ I I)f h, '1HAYERMORIE I'IE ]:GilTS LEI]:.., BI.,,O[;K~', ]. · :~I:::I,I,t(N:, :1,4 I ]WII,:HII-. 1,,:,N LO I S I ZE: ;,.".q. 6 ')' (SL. F: '1', C}R .,,I d= ) ]: cel'L:i, fy Ll"iat: for"!'h by 'l;hc..: Hu~:i.c;i. pa]:ity c~F Al'lcl'~cH"age (MOA) ali(::l 'Lhe StaLe of' Alaska,, ]: !..!:i].l :Jn!_~;t.a]I 'Ll'it:~ systl..;¢m :i.r"~ aEi;::c:lr'darlc!': ~:J. LIi all IvlE!('~ codl:!s and ,'.¢.1i!::I :irl c:l)ml:)].:L;:'~.l"m:l~.! ~,~:J't'.l'i ti'i,'.? d~;.,s:i, gn cr,:iLer,:i_,a c:!f' th:J.!!; ]: [,:3:L].] adl'm!r'e Lc) ail t't(::JA and S(:a't,.(.:~ (::tf AJ.a~zH.::a i'eql.CLl'(::!menL':~ Fc:)p I:.lm! !ii(:~)t-. b~;.u::l.:: ;:~t(~1 ~t1,I IN~:., A!.I,I:::I I1",1 AI',I AI::;:IF:A CEIVIEF,'.IED !3Y I"IC]A BIJ:U ):)]]',IG II'lIEN (].) AN IEL,I~:CFI::;:ICAL I:::'E]$;H:I: I AND "(:': ' ' W:I:I.I, t"IEYI BE AF'I='FR[]',]I[D I/,I]:TI"II~"¢iN*,EI.~C]'RI(;)Af. ]:NSF'ECYI']:ON RIEI:::'ORI': AND E:t. lEE; [R ICAI. I!](]l::(K I*lt,J~l BE: L)t~NIE BY A' I]%:I:CEI',ISI:~ED !EI..I]:C I]:;'.Ii;; r AN,, ' . ..... / .......... ......... I ql I t I.L,¢.tlI. 11:,1.,t:::1,t Steve Morris Dept. of Health & Human Svcs. Municipality of Anchorage Anchorage, AK. 10/23/1986 Dear Mr. Morris: The following is our proposed septic design for Lot 3 Block 1Thayermore Heights Subd. 11600 CANGE ROAD ' ANCHORAGE, ALASKA ' 99516 ' PH. 345-7008 WHITEWATER ENGINEERING CONSTRUCTOR iZ - ~ ' r' -, ',~ Should there be any questions please contact me at RA~-TnnR / ,Y /'~ / ~ Thom A. Fischer P.E. P.O. B~.)X-196650 ANCt-IORAGE, ALASKA 99519-6650 (907) 264-41 '11 DEPARTMENT OF HEALTH & HUMAN SERVICES Noven~er 17, 1986 Thom Fischer, P.E. Whitewater Engineering Constructor 11600 Cange Road Anchorage, Alaska 99516 Sub)ect. Lot 3 Block 1 Thayermore Heights Subdivision Waiver Request WR86-158 Dear Mr. Fischer: Your request for a waiver of the 100 foot separation required between the septic system and well on the subject property has been granted. This waiver is based on your assessment that soils and hydrogeolegical conditions in the area make contamination of the well very unlikely in this ease. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen So Morris civil Engineer On-Site Services Steve Morris 11/6/1986 Dept. of Health & Human Svcs. Municipality of Anchorage Anchorage, AK. SUBJECT: Lot 3 Block i ThC~y~rmore Heights S/D. NOV & 986 Dear Mr. Morris, We are requesting a waiver from the minimum 100' requirement between a single family well and septic system. The distance between the well and leach field would be 78~ and the distance between the well and septic tank would be 82'. The well is existing, drilled in approximately 1965. Two previousely installed leach fields have failed on this lot, both installed downhill from this latest (the .third) leach field. The lot slopes from East to West at approximately 20%. Underneath the top organic layer, the soils are a gravelly silt (GP) overlaying .silt (ML). As you move West downhill the soils get worse; the GP layer gets thinner and the ML layer gets denser to a point at the extreme West lotline where the ML layer will not perk (perk rate in excess of 60 min/in). Clearly the higher uphill on the lot the better the chances of the septic system lasting. Drawn below is a profile of the different soil types based upon four different soils tests. Also the well is on the East property line uphill from the septic system, with a static water level of 140'. On a four hour test the well produced a minimum of 5.6 gpm with a drawdown oI two feet. ,,/ L_J I ; t Thom A. Fischer P WHITEWATER ENGINEERING CONSTRUCTOR 11600 CANGE ROAD · ANCHORAGE, ALASKA · 99516 ' PH. 345-7008 7¢ REMOVES SOLIDS utilizing over 198 feet of filtering capacity INCREASES EFFICIENCY over 198 feet of settling capacity in a 1 foot wide space PROTECT DRAINAGE FIELDS solid-reduced effluents drain away faster UTILIZES FLOW the Zabel disc dam concept slows internal velocity but increases effectiveness. INCREASES EFFLUENT QUALITY reducing suspended solids in the effluent discharge. EASY INSTALLATION just slides in any 41/2 inch outlet opening the unique, patented, ZABEL DISC DAM FILTER PLATE almost unbreakable (see spec's.) the series of Zabel disc dams am normally set with 1/16" spac- ing to filter out any biological sludges, water works sludges and light flocculent sludges. the Zabel disc dam assembly easily slides in the sturdy case. You can readily see how influent enters thru the open bottom of the case; is filtered as the liquid passes thru the Zabel disc dams; and suspended solids then fall back to the bottom of the septic or collection tank thru the return holes. The clarified liquid flows on to the next stage (or the drainage field) thru the side-wall effluent opening. For Local Distribution Contact: Easy HAND cleaning-simply pull the Zabel disc dam filter out of the case and flush with water. 1-3/16" .~ 4.762cm T 4-1/2" 5" Q.D. 11.43cm 12.700cm Distance between Zabel Disc Dams (Aperture) 1/16" (.1588cm) Shipping Wt. ea: 17V2 lbs. (6.Skg) 30.004cm ~ 1/4 Specifications - Case-Sewage-Acid Resistant Ethyl 7042 like PVC Disc Dam Plates- 16" High Impact White 40.64cm Styrene Bolts- White H.D. Polyethylene  '~ 28,893cm ' Zab¢l Ilncluslll'ics Inc. Box 1484 · New Albany, IN 47150 · (812) 738-1197 I !,500 ¢;AN~;E' RD, ANCHOI?AGE ~ AK, (907) Edg-'TO0~ PERCOLATION 'FEST P~RFORMEO FOR: !~.~,~i.;,.~ -"~ ......... SLOPE SITE PLAN 2 7 10 11 THOM A. FISCHER CE-6793 13 14 15 16 17 18 19 20 COMMENTS PERFORMEO B Y: .~_. ~ .... ~ ,-..;_~r.~ -- WAS GROJND WATER ENCOUNTERED? IF YES, AT WH/~,T Gross Net Readin!; Date Time Time PERCOLATION RATE TEST RUN BE'FWEEN FT AND ~ SOH_S LOG 6 7 8 9- 10- 11 13 14 15 16 17 18 19 20- SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Date SITE PLAN Reading Time Net ! Depth to Time ! Water , ~,,' ~9TH~-~ --"~,,?," '.'. ~'M.....--:~:..:..,,. ~...~ ~~ PERCOLATION RATE ~ ~__ ~lminuto~/inch) TEST RUN BE'~EEN ...... FT AND ~ FT PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 / I~00 ¢,a.A/EE (~07) SOILS LOG PEIc.'CO LATION __DATEPERFORMED: SI.OPE , ¢SITE PLAN I0 11 13- 14- 15~ 10- 17- 19 20 THOM ^. FISCHER CE - 6793 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Time Net Time PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN ........ FT AND FT COMMEN'rS. ')~ t~.'(f~_LL._~_~J~j~;.~[, ?~'~_~ ~['"~'~' ~_~._~_~_____~' _ 'T'O GREt:, R ANCHORAGE AREA BOR GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INS~.PECTION REPC~R,~T/gN-SITE SEWAGE DISPOSAL SYSTEM, -. J,") -_ ./~ SEPTIC TANK: ~/~r'l)~ / ~ ~ INSIDE LENGTH INSIDE WIDTH_ LIQUID DEPTH LIQUID CAPACITY_/,/='~>GALLONS. / / / TOTAL LENGTH __FOUNDATION //C7 4 ._NEAREST LOT LINE /~. OF LINES / DISTANCE BETWEEN LINES _ TRENCH WlDTII~ TOTAL EFFECTIVE ~/ DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE IN. TILE DRAIN FIELD: DISTANCE FROM WELt_ _/~) / NUMBER OF LINES ABSORPTION AREA DEPTI4: TOP OF 'rILE TO FINISH GRADE TWyEpLEL: _ ~-'~.-~ ) ,,~¢ ~' '~_----~ CONSTRUCTION BUILDING / FOUN BATiON/~ "~_, CESSPOOL _ APPROVED --- NEAREST'~ /, /./ NEAREST LOT LINE_~;/--w ,, SEWER LINE OTHER SOURCES DISAPPROVED ______REMARKS SEPTIC TANK <~'{, SEEPAGE SYSTEM FROM: DISTANCES: SEWER LINE DEPTH: PIPE MATERIAL: Form ED-032 DIAGRAM OF SYSTEM /¢1'd GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY  PERMIT NO. SI;WAGE DISPOSAL SYS'I"EM~-- APPp/CAT~ION AND PERMIT / ~ ~SEEPAGE PIT ~ / . DR~ P~ ,] OTHER COMPI.[TION DATE ANTICIPATED FOUNDATION TO SEEPAGE P]T SEPTIC TANK TO S~E.~..AC~P]T WALL f SEPTIC TANK '~-- ' --, SEEPAGE PIT TO NEAREST LOT LINE, DRAIN FIELD WELL TO SEPTIC TANK. /'/~-~"~ DRAIN FIELD_ /,~ '~'~_ / SeEPAge PIT / .~¢~ ~.,//2 · Al. SO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD- SEPTIC TANK, --. SEEPAGE Pit TO RIVER. LAKE, STREAM· -, SEEPAGE PIT · ., DRAIN 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAge PIT FITTED With AIRTIGHT REMOVABLE CAPS, CONFORM TO BOROUGH REG LATIONS REGARDING INSTALLATION. I CERTIFY THAT ( AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH C~iBDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS ]N ACCORDANCE WITH SAID CODE, ~,"~¢,~,, '~ ~ z-~ ' / ........... ',. fill The sediments were loose with a high water I content. ~here was .54s~_oi1 high cobble and boulder ~ 10 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak,us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-0814)4 1. GENERAL INFORMATION Complete legal descdptic~n Location (site address Or directions) Expiration Date: THAYERMOORE HEIGHTS, LOT 3. BLOCK 9740 Hillside Drive. An~hora(~e, AK 99507 Current Property ~wn~r(s) Toni Sparrows Day phone 346-3236 Mailing address same as above Lending agency Dayphone Mailing address Real Es~te Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3, 3. TYPE OF WATER SUPPLY: IndMdual Well Individual Water Storage Community Class Public Water System Well TYPE OF WAS I EWATER 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 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. (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, 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 vedfy that based on the information obtained from the Munidpality 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, ordi.nances, and regulations in effect at the time of installation. Name of Firm KND ENGINEERING, INC Address 20441 Ptarmigan Blvd., Eagle River, AK 99577 Engineer s Pdnted Name Kenneth M. Duffus Phone (907) 696-6111 Date 08/29/02 DSD SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with Additional Comments By: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer s Report Other Odginal Certificate Date: ¢/~'/'; ~ 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.ua (907) 343-79O4 HEALTH .AUTHORITY APPROVAL CHECKLIST Legal Description: Thavemoore Hts.. 1.3. BI A. WELL DATA Parcel ID: 015-081.04 Well type I~vate If A, B, or C provide PWSID # Date completed 1965 AnBrox. Sanitary seal (Y/N)_y_ Well Log (Y/N) H Total depth I+T+ ft. Wires pmpady protected (Y/N) y Cased to 4<P ft. Casing height (above ground) FROM WELL LOG AT INSPECTION Date of test Unavailable 08t23R2 Static water level ft. t41 ft. Well production " g.p.m 4.53 g.p.m. WATER SAMPLE RESULTS: Coliform Q coloniss/lO0 mi. Arsenic: gA mgJl. B. SEPTIC/HOLDING TANK DATA Nitrate 3.71 mgJI. Other bacteria _IL colonies/lO0 mi. Date of sample: 8/23/02 Collected by: KND Engineering. Inc. Tank Typa/Matarial seoflc I concrete Date installed tl/06/86 Tank size 1250 gal. Number of Compartments L Clesnouts (Y/N) ~ Foundation cteanout (Y/N) y._Depression over tank (Y/N) gHigh water alarm (Y/N)B Date of pumping 68/23/02 Pumper McDonald's C. ABSORPTION FIELD DATA ' Date installed 1t/06/06 ' "Soil' rating (g.p.d./f~ or ft2/bdrm) :~1!1 System type Trench Length [~ ft, Width ~ fl. Gravel below pipe 5.5 fl. Total depth ~ ft, Eft. absorption area 979 ft2 Monitoring tube Y Depression over field N Date of adequacy test 0~23/02 Results (Pass/Fail) Pass For :} bedrooms Fluid depth in absorption field before test 39in. Water added 453 gal. New depth 44 in. Elapsed Time: 1435 min. Final fluid depth ~1~1 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed HA Pump on level at in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 82' * Absorption field on lot 77' * Public sewer main ?5'+ Properly line 10.+ Water Service line Curtain drain §0.+ COMMENTS Size in gallons Manhole/Access (Y/N) Pump off level at __ in. High water alarm level at Cycles tested Meets alarm & circuit requirements? Go On adjacent lets t00'* On adjacent lets t00'* Public sewer manhole/cleanout t00.* Sewer/septic service line 25* Holding tank t00'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5,~ Property line ~'+ Absorption field 5' Water main t0'+ Water sewice line t0'e Sudace water t00'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation lQ'* Water main t0",' 10'~' Surface water t00'~ Walls on adjacent lets t00.+ Driveway, paddngNehicie storage 25'+ * MOA separation wai~er for septic I~eld &weti issued 11/17/86. Al~*~on field is operating in the too 40% of elfective. ENGINEER $ CERTIFICATION I certify that I heve determined through field inspections end review of Municipal records that the above systems ere in conformance with MOA HAA guidelines in effect on this date. Engineer s Printed Name Kenneth M. Duffu$ Date 08/2912002 HAA Fee $375.00 Date of Payment 8/~;V02 (Rev.Receipt 12/O1) Number Waiver Fee $ Date of Payment Receipt Number in. AU{~-28-02 og:lgAU FROU-CT&E E~VIRON~NTAL SRV ~lkK CT&E Environmental Services Inc. 9075615301 T-147 P.02/O~ F-?04 CT&E Ret# Client Name Project Name/// Client Sample ID Match Ordered By PWSID Sample Remarks: 1025451001 KND Engineering Thayermoor= ills I.,3, BI Thayermoote Hts L3, B1 Drinking Water 0 All DaterdTlmes are Alaska Standard Time Printed Datefflme 08/27/2002 11:20 Collected Date/Time 08/23/2002 15:45 Received Date/Time 08/23/2002 16:30 Technical Director Releast~l By ~~ PQI. Units Me~he, d Allowable hep Analysis Lka|ts Date Date Init Wa~era Deparl:men~ Niuatc-N 3.71 0.200 mg/L EPA 300.0 (<-I0) 0g/23/02 J'DT MicrobioloeJy Laborat:ox"y Total Coliform eoVI OOmL SMI 8 92.22B {<-1) 08/23/02 KAP VI4, ~ 0 oO'A/ ...... ~ ~ MUNICIPALITY OF ANCHORAGE . ~ ;, ', *,',...I '~l~t~ I.." DEF ARTMENT OF HEAl.TH & HUMAN SERV CES ,: ..... ~ ~.'~/J _' ' DIv sion of Environmental Services ; "" P.O. Box 196650 Anchorage, Alaska 99519-6650 . , ~..:. · '-,~: · '. -':.~ ,:; :' CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMII2Y DWELLING Parcel I.D.'# '~ O 1~--O81-O~ HAA# 1. ".! GENERA[:'IN FORMATION . '.Complete legal,description _ ~3 nl ~'ha'fermore Heiqht~ S/D 9740 'Hillside Drive'- ; ,,~,gocatlon'(slte address or directions) '- "" '- -, ' · ' ' Helen Property owner '- '<'Ma. ng address 9740 Hillside Drive "~,.v. Lending agency ,,. ~,.?. ~. ,, ?,,:;,~/.. . ';:, ';'.Mailin 'address' ': "1' Da h ne 34622]9 ypo ~ ' Anchorage, AK 99516 Day phone _ Da3 3. :.!*TYPE OF WATER StJPPt[~(: '~ ........... STATEMENT OF INSPECTION BY ENGINEER As certifled'.'b~, my se~,l a~i'xe'd h~ret0*~nd as~0f thevalldation date sh0wn.below, I .verify, tha. t my investigatloh"'of' this Health~'~uth0ri'~ A~3P~'&{'ai 'aPPJ¥Cati0n 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 inves.ti, gation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection, ~/ S&S Engineering Phone - 694-2979 Name of Addres~ 17034 North Ea~lg J~ver ~oop Suite 204 Eag].e RivervAK 99577 Engineer's signature Date ~'///'3-~'/,~ 7' .... Approved for *'""~=>'~* .... *-*~.bedrooms~ .......... . ~ ............. ,.. ~nndt~na aoDrova 'for '?'.'~ "~ ~ "~. '~ b~rooms ~wth the.fl o' The Munlclpa ty of Anchorage Department of Health a6d H[iman',$~,,i~e~iD'~) Approval 'ce~i~icates based only upo6 '{he [epresentations given in raph5 abo{;e ~by an Independent istered In the stat~ bf Alaska, The DHHS do6S ~ ,rnes is not Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal DescrJptJon:~.~T "~r' I'~L~ I/ '~¢Pl!/Z~,C~'arcC~e/~ll.l::). A. Well Data Well type ~U~T~__ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y,~ d~rqU,,~l L Date completed ~--=:F'o~,~- ~/':~ Driller Total depth / ~(~ ~ '~ Cased to Z'/'O ' '/- Casing height Sanitary seal ~/N) Wires properly proteoted (~N) /~'"~¢' FROM WELL LOG Date of test C.,¢l~J~f/,,~! C Static water level ~, Well flow Pump level1 AT INSPECTION g.p.m. ~,~ ' On adjacent lots ; On adjacent lots Public sewer manhole/cleanout t .k SEPARATION DISTANCES FROM WFLL 'f'O: ?~Septic/ll~tank on lot ~ ~' ~ct ~'~bsorption field on lot ,~'~¢' -~-o Public sewer main ~J//~ Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate ~, ~t ). -,~,,~. ~d Other bacteria Collected by: ~% '~ B. SEPTIC/H~[c~IG TANK DATA Date installed ~!/4;/~f~ Tanksize /~X~)~¢/_ C¢r~,~Compartments Cleanouts ~) ~5 ~O~)Foundation cleanout (Y/N) _ /~ Depression (Y~ High water alarm (Y~ ~)/~ Alarm tested (Y/~ ¢/~ Date of pumping SEPARATION DIoTANCES FROM SEPTIC/~ TANK TO: Well(s) onlot ~¢%:O~'{-° .~.f., Onadjacentlots To property line ¢-/~-~/"P Absorption field Surface water/drainage Foundation c~0 Water main/service line 72-026 {3/93)* Front CONTINUED ON BACK PAGE Manufacturer Size in gallons ~ Manhole/A~ Vent (Y/N)_ __"Pum~~ ~ "PL/mp Off" Level at High water alarm level ~ % Cycles tested __ Meets MOA electrical c~ ~ SEP~CE FROM LIFT STATION TO: ~ ~li~n lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length '~' Total absorption area Date of adequacy test Width Water level in absorption field before test Peroxide treatment (past 12 months) fY/l~ Soil rating (GPD/FF) .~ ~ Gravel thickness Cleanout present cN) Results (pass/fail) System type Total depth .Y Depression over field (Y/(~) P/::F~ ~ for After test ~, ~ ~4~r.~-~ ~ If yes, give date /o/~ Jh'f Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ¢/6 '-~ ~ To building foundation On adjacent lots Surface water ~/0~) ~ Curtain drain /"~0,~ ~- E. ENGINEER'S CERTIFICATION ¢ On adjacent lots / 0-~ L~ Property line ?-~(~ ~ To existing or abandoned system on lot ¢:~© '-~ Cutbank /'-///¢~ Water main/service line Driveway, parking/vehicle storage area ~0~ lO 'e I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date // HAA Fee $ Date of Payment Receipt Number 72~026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number CF_ - 880,}, COMMERCIAL TESTING ~ 9076941211 N0.058 Q02 Commercial Testing & Engineering Co. Environmental L~boratory Services ~i~m-,e-~a~mm~w~'~il~4~e,~'~m~m~:;~ LABORATORY ANALYSIS REPORT ' 94,5901-3 WORK Order 12018 Technical Director STEPHEN C. ~I.~ Secondary d~lut~.o~. GT Greater Tha,~ [~{ 5633 B Streel, Anchorugo, AK 89B18-1600 -- Tel; (907) 56~-2343 FaK: (907} 561-5301 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAl.. HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL"~ (~'?~D- OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~'~ ~~elephone: Home t tG- I '1 Business Applicant Address ~-l~Z~~l I~ ~l~' / ~"~-~ ¢ ~ (c) Applicant is (ch¢:k one): Lending Institution ~; Owner/builde~; Buyer ~; Other ~ (explain); (d) Lending Institution Address 1-elephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: . TYPE OF RESIDENCE ,, Single-Family.,~ Multi-Family [] Number of Bedrooms ~'~ Other WATER SUPPLY, '~ rndividual Well,~ Community [] Public [] Note: If corn munity well system, musl have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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 I of 2 72-025 (11~84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AN[) 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 ('~:~ ¥~' ~TL'~"~ ,Pf~'~'~.~-,- (--'--~'f~-- ~--~O~"~_~1 i:~eere p h o n e _ ~ ~-- '--7 Engineer's Seal DHEP APPROVAL Approved for -/~-'C¢ bedrooms by Approved Disappreved '~¢-~'~'~"~ Date //~/¢- 2 ~ Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEiP 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) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ~NVIRONMENTAL PROTECTION 6 1988 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 28...72o RECEIVED Legal Description: (~ ~- ~ ~-,..~k.¢ WELL DATA Well Classification '~-~ ¢5¢~----_- If A. B, C, D.E,C. Approved (Y/N) . We Log Present fY/N). ~'~%;~ _ Date Completed ~u~_~_ i/'lrP~°,~ Yield Total DeDtr J 7 ~)' ~¢' [b4Cased to ~1;~' ~-J- Static Water Level ~ '1~/ Casing rie~ght Above Ground '~4 Electrical Wiring n Conduit (Y/N) _ Separauon Distances from Well: To Septic/Fielding Tank on Lo~ To Nearest Edge of AbsorDuon Field on Lot _ TO Nearest Public Sewer Line Cleanout/Manhole _.~ Water Sample Collected by Water Sample Test Results Depth of Grouting Pume Set At Sanitary Seal on Casing (Y/N) _~' -'~"~"~ Depression Around Wellhead (Y/N) ~E2) £ : OI1 Ad,olnlng LOtS / : On Adjoining Lots To Nearest Public Sewer I o o (4--- To Nearest Sewer Service Line on~ot . ~'~/¢'~f Oommems 3 SEPTIC~HOLDING TANK DATA Date Installed ~ ~ ~-'~("~" Size I'~''(~ No. of Comoartmems _ J_ Standp. Pes (Y/N) __t~,~-.;L¢, Air-tig ~t CaDs (Y/N) _~ Foundation Cleanout (Y/N) Depress,on over Tank fY/N) ~ Date Last Pumped Pure.lng/Maintenance Contract on File (Y/N) ~ -k~- for Holding Tank Hign.-Wate, Alarm (Y/N) ~_ Temporary Holding Tank Permit (Y/N) . [%l R . Separabon Distances from Septic/Holding Tank To Water-Supply We ~-/ TO Building Foundation 'Z. J To Property Line . /J-~ ~ "J'' To Disposa Field _ '~ To Water Main 'Service une _ ~J /~' To Stream, Pond. LaKe. or Malor Drainage Course ~ ~ Comments Page 1 of 2 72-026 11/841 C. ABSORPTION FIELD DATA Soils Rating in Absorptior) Strat~ ~.~ Date Installed I I /~'~"'/~-% ~-~ Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well _ "7 ~ · To Building Foundation Lot To Water Main/Service Line Type of System Design ~T""~ Length of Field ~% i .~ ~r-.)--*.~,-~ _: ~ ~'/ · Depth of Field c~ ! Gravel Bed Thickness ,~' i"-- ~ tt Standpipes Present (Y/N) Date of Last Adequacy Test N / To Stream/Pond/Lake/or Major Drainage Course To Driveway; Parking Acea, or Vehicle Storage Area Comments To Property Line r To Existing or Abandoned System on , On Adjoining Eots -:~(- ~ ~ '~ To Cutbank (if present) D. LIFT STATION Date Installed Dimensions ~ ~-~ Size in Gallons ./-~ Manhole/Ac sc~(Y/N) / J "Pump On" Level at/'/~ / ~f" Le;el ~, / ~ High Water ~,~ff Level at / / Vent(Y/N)/ ~ Tested f~ / ~ P~pi~ Cy~ d~ng Adeq~e~. M~t~ MOA Electr~l Codes (Y/N) / / / / ' ** Check Permitted Bedr~.~t_ing Against HAA Request ** Icertifythatlh' vecheck ,verif ,' rconformedtoa OAa dHAAguidelinesineffectonthedateofthisinspection ........ ~ d ~~~A g~d~i~si . Company ~MOA No. ~ _ ~;~ Amount' $ ~ ~) ~ ~"""~.~.. ~ ~Engineer's Seal WHITEYVATER ENGINEERING CONSTRUCTOR HOME SERVICES 15[)OO Francesca l)rivc Anchorage, Alaska 99516 907-345 18.90 NoYember 7, 1986 I, Helen Ferguson, agree to have A+ Home Services pump my septic system on an annual basis. I understand that at that time the Zabel Filter will be cleaned and the housing that it is in will also be vacuumed, The above mentioned services will be done on the anniversary of the Eilter's installation. Helen Ferguson J ing~rd A+ HOME SERVICES Your .'-4c1)I1(, Ces.%)oo[ and I)rOilqfiekl Profcssiolqal '~ v'" . Date [;)ate Date Inspector Inspector Inspector Comrnents Conditional Approval I /7 Date Sewer Installed Permit No, Septic TankSIze / - ,~ (.~_ ~j ~ Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~ ~ ~O ~ ~ Phone Buyer Addres~ Address ~ o I~ ~, ~' ( ~x ~-S Realty Co, & Agent Phone Address Street Location (~ ~-~.O U C ~ ~ f~ ~ ~ 2 ~ ~ 4~ Type~Residenoe ~3 Single Family I~ Multiple PamIly No. of Bedrooms. Q Other Watff~pply M Individual L~C.;(~ ~ ~c: r~E~x ~,, ~¢ A~AOH WELL LOG, A well Icg Is required for all wells drilled since June [~ Community%~ _~ "- ' 1975. For wells drilled prior to Ihst date, give well depth (attach Icg If lO Public Utlllty available.} Sewa¢ D posa ~O Individual Year Individual Installed: ~ t ~ Public Utility When Connected to Public Utility; ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Alaska SUBJECT: Lut 3, tl',loot~ l, Thayormoove Subdivtat,~n An in,npceli(m of the ~ul~Ieet lot wa~ made Marel~ 3, 19~5. Tb;~ on,-~ito so;you ~ys'~oro la ton (10) yaa~s old and t~ l~to~nning to Fall. Tim top of tho well oa~in~ will, nell to bo {nsk~llod, A aoil~ tos;t will elao he r~lulred bnfora a p~rmlt te do I:tm repaI,v work (:an be isaued. app~ov<;d. be completed boa)re dun~) 15, 1975. you.have any questlo{ta ~egarding thte, mailer, pleaae ¢.ontaet' ' "~,~' ~;~ ~t R'I4~4501, e~ctensien 133. Lynn S. Coed Sa~ltarl~:n L.qC~/lw GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection //.'m o ~/x)? Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAl. SEWER & WATER FACILITIES FOR ~ \ Mailing Address~~~--~Phone:~ 2. roper y Owner: Phone: X:-:.::/ Mailing Address: .T'. :m. ~, ~, ~: ~ '.',' - /f~c 7 5. Type of facility to be inspected No. of bedrooms Well Data: A. Type C. Construction Sewage Disposal System: A, Installed C. Septic Tank: 1. B. Depth ~_/~/~:~i-l~ D. Bacterial Analysis B. Installer Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank' _ , Absorption area ., Sewer Lines __ Nearest lot 'line B. Foundation to septic tank , Other contamination Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages GREATER ANCttORAGE AREA BOROUGH. Department of Environmental Duality 3330 "C" St., Anchorage, Alaska 99503 274-.456'1 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER I:ACILITIES Type of Inspection: CMRO ] VA FHA 3. Name Mailing Address: =_ _Da__y_ Phone Mailing ~ddress: .~.~l~.~ .~{~.~/ Phone 5. Name of Realtor or Agent: Mailing Address: Phone 7. Type 8. Water Supply Type of Supply: If Individual, Lega~ ~escri,tion: ¢/o~/'< I ,.°cation: ---F/" /-/~ "¢/ ~:-- · of Facility to be inspected: Public Utility number of dwellings If Individual, depth of well ~_~i2_F Sewage Disposal System Type of System: Public Utility If ~ndividual, date of installation Individual presently served EQ-037 (!/74) Page 2 of two pages - Re( for Approval 'of Individual c ~ Water Facilities Legal Description Comments Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in 'this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74)