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Home My WebLink AboutCRESTWOOD LT 17Crestwood Lot 17 #015-061 - 19 Permit Number:. SW020561 Name: JEFF CODBOUT 9700 BRIEN STREET (907) 346-5620 4 LEGAL DESCRIPTION - 17 CRES3WOOD WELL: 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 On-Site Wastewater Disposal System and/or Well Inspection Report PID Number:. 015-061-19 I-I Upgrade~ Wastewater System: [] New O Page 1 of 3 · Upgrade ABSORPTION FIELD Trench E3Shallow Tmnoh 13Bed nMound ~er 1.2 ~ ~ 10 M~ SEE DWG ~ 5.38 SEE DWG ~ 48 3 ~ 1 - 516 ~ D 3034/ F-810 ~ ~ 9/26/02 ~C TANK 1:3 Ho~d;ng 13 S.T.E.P. a Other TFmm"~~ Septic Tank Wall 100'+ Surface Water 100'+ Lot Une Foundation 5'-F Curtain Droin Remorks: Inspections performed by: 100'+ -- -- 25'+ 100'+ -- -- - 10°+ -- - - 10'+ -- -- - NONE KNOWq ANCHORAGE TANK 1250 STEEL LIFT STATION ~ BENCH MARK TOP OF CONCRETE SONA-TUBE UNDER AKWWC, INC. Dates: 1st 2nd 3rd UNDER SW CORNER OF DECK. I*"~ ~ 100.00 9/27/o~ ~... Development Servic.e~ DepartmeE~t Approval . R~viewedandappr°ved bY:~,~//2*~'~/'z//~I~,) //~[~ate: lO-/& ~"' pERMff NUUBER: $W020561 I I / / / / / / NEW DRAINF1ELD. - AS- BUILT D RAWIN G pARCEL ID NUMBER: 01.5-061-19 10' u'nUTY EASUENT ['::ZCZ:3 I ALASic~'WA'I'ER & WAsT'E~i;ER' ~...s.o. JEFF GODBOUT (907) 546-5620 2 OF CRES~OOD SUBDIVISION, LOT 17, ........... .. AS-BUILT DRAWINO OF SEPTIO SYSTEM UPORADE AS BUILT DRAWING SW020361 ~ 015-061-19 TOP OF' TANK AT INLET = 94.6 INVERT OF BUNG AT INL_rT -- g4.0J GRADE ,- 99.8~, NEW 1250 GALLON SEPTIC TANK TOP OF TN, IX AT OUTLEt - 94..6 ~----INV~3Lq' OF BUNG AT OUTLET -- 93.83 fiNAL CRADE ,- 97.51 - 98.05- -OP, JGINAL GRADE - 95.$1 -- 97.61 FABRIC PIPE - 92.99 //-~AT£LA'TIV~ ELEVATION BOITOM OF TH 81.81 NO GROUNDWATER NO BEDROCK ALASIC6~ WATER & WASTEWATER CONSULTANTS, INC. PREPARED FOR: PHONE NUMBER: JEFF GODBOUT (907) .'.'346-;~620 CRESTWOOD SUBDIVISION; LOT 17, AS-BUILT DRAWING OF' SEPTIC SYSTEM UPGRADE OF TR[NCH- 87.61 OATE: 9/50/02 DRAWN BY: B.S.G. N.T.S. P~E NUMBER: $0F$ MUNICIPALITY OF ANCHORAGE Development Serv/ces Department On-Site Water & Wastewater Prograrn 4700 South Bragaw Street P.O, Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 18, 2002 Expiration Date: Sep 18, 2003 Permit Number: SW020361 Legal Description: CRESTWOOD LT 17 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Jeff Godbout Owner Address: 9700 BRIEN STREET Total Bedrooms: 4 ANCHORAGE, AK 99516-6448 Parcel ID: 015-061-19 Site Address: 009700 BRIEN ST Lot Size: 49500 SQ. FT. Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 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.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O15-061-19 Permit Number Property owner(s) Mailing address (1) Mailing address (2) JEFF CODBOUT 9700 BRIEN STREET * ANCHORA(~E. AK Day phone 346-1163 Zip Code 99516 Legal description (Lot, Block & Sub'd.) LOT 17: CRES3WOOD SUBDMSION Legal description (Section, Township & Range) Lot Size /-'~ ~----'~('~ Acres/.t~'~ THIS APPLICATION IS FOR: Sewer Only D~ Sewer and Well Sewer Upgrade · N,/A Number of Bedrooms 4 THIS PROPERTY CONTAINS: Hot Tub ~r~ Swimming Pool Therapy Pool [] Well Only Water Storage Jacuzzi [~] Water Softening Unit I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. (Cignoturc of propcrty owncr or outhorizcd ogcnt) Permit Fees: ~t~'~)0~' I~ "'~ WaiverF~e's: Date of Payment: ~1~"!0~ Date of Payment: Receipt Number:, .~-~"~q ~'~( Receipt Number:. ALASIr 'WATER & WASTEWATER CONSULTANTS, INC. September 16, 2002 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System Upgrade for Lot 17, Crestwood Subdivision To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The septic system is in a state of failure and must be upgraded. One test hole was excavated west of the existing drainfield. The drainfield will be designed around the 30 foot radius of this test hole. We are proposing that a 1250 gallon septic tank and a five foot wide drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classificat!ons, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 1.2 gallons/day/ft2 should be used. 2. TRENCII DESIGN: a. Percolation Rate: <1 minutes/inch b. Proposed Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 500 ft~ f. Total Depth: 10 feet (max.) g. Effective Depth:~ feet h. Width..~e. et ~' i. Reducti~nFactor: 0.50 j. Minimu~h Length: 50 feet long k Effectif/eabsorption area = 500 / 3. SURFAC~g'WATERS: There are no surface waters within' 100 feet of the proposed design. t~' ~a 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwe.com 4. TOPOGRAPIIY: The area for the proposed septic system is a 0%-10% slope running approximately north to south; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely Presi~cm NOTE: Attached is a site plan drawing, a design drawing, one soil log, a topographical drawing, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com l- ........... J L%. LOT 4. BLOCK CRESTWO00 $/0 LOT2~ PROPOSED LOOGI~OLE $/O I ~ LOT ,'~, BLOCK 1 I \ I ~ \ I ~ I I CRESTWOOD $/O I I LOT 16 CRE~TWO00 LOT 21 ......... ~- ....... , ~ /~ *. I.. / " ' " ~% /~, ! ~ -/ " I I -'~--~' ~ I /I ~, ~ ~ I I / ~ ~ I iI I S2, ~4, ~4. ~4 ;~ ...... ~ ............... ~-~1~ -- ,~ .... ~ ................. ~.-~---..__ _ I / ~-~- ~ ---~- I / ...... // ~% camo s~ PRO~ S~C U~E ~ CR~D S~ '~'. [I X _.. ~, ~ ~x I - / //: ",, 9/~6/2002 ~S-~ ~ ~o.~.~.~.,~..~o~.~,~.~,,,,,~.,..~o,,,,,~ ,.~ ,oo. [t,-,t=r· ..~ J[rr OODBOUT (go7) 346 3620 1 OF 2 CRES~OOD SUBDIVISION, LOT 17 ~h,~,._. ~--~"". ..." SITE P~N FOR PROPOSED SEPTIC SYSTEM UPGRADE NOTE.: THE CONTRACTOR SHALl. RAVE THE 10C~ FOOT WELL RADIUS ON THE REFERENCED / PROPERTy' FLAGGED BY A REGISTERED LAND~ I SURVEYOR PRIOR TO CONSTRUCTION. m~ / ! / / REPlaCED ~ N~ INSTNJ. I~UBLE CLEANOUTS ~ I~$TN..L P. OW ~ DRNNFIE[.D TO BE USED AS A RESERVE 10' U~I~q'Y EASMENT Al ASKA WATER & WASTEWATER CONSULTANTS, INC. PREPARED FOR: PHONE NUMBER: JEFF OODBOUT 546-5620 I.[GA/. DE~CRI~ON: CRESTWOOD SUBDIVISION; LOT 17, T/Pi: OF WORK: DESIGN OF PROPOSED SEPTIC SYSTEM UPGRADE 9/16/2002 C.J.G. I" = 40' 20F2 ALASI~ IVATER & WASTEWATER ~?.' ;~ ~'~0~ CONSULTANTS, INC. 49 _ ~ DE$ORI~ON: CR~D $UBD~SION; Lm ~1. ~;;~J" D~ =-==- ~- ' ..........."~ (~e~[ ORGANICS ITEST HOLE ~lJ '~<~ SOIL CLASSIFICATIONS ~ GW ~ ORG ~ GP ~ ML %~, GM CL GC OL SW" NH ~ SP CH SM OH SC DEPTH TO GROUNDWATER DATE SP/SW w/ GRAVEL MIXED DRY 9/4/2002 THROUGHOUT DRY 9/5/2002 MORE SILT AND FINES w/ DEPTH DATE 9/5/2002 READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 2 - <1 O' 6' 4 -- <1 O' 6" ,5 - - 6' - 6 - <I O' 6' 17-- 18-- 19~ 20 SOILS LOGGED BY: PERCOLATION RATE <I (MIN./INCH) PERC. HOLE DIA. TEST RUN BETWEEN 5.5 FT. AND 6.0 FT. A FOUR HOURPRESOAK WAS PERFORMED: r--lYES M NO JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS 6 (INCHES) COMMENTS: THE NATURAL INSITU SANDY SOILS WILL ACT AS A SAND FILTER. PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS/PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE: T 4. BLOCK I LOT 15 LOOGI~OLE $ BLOCK 1 · , CRE~TWOOD . LOT22 2 or 2)- HOUSE 9/~ $/2o02 DRAWN = 100' PAGE NUMBER: 1 OF2 GREk'r R ANCHORAGE AREA BORLn:JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME bt~--~g- A~'~-~D~)~/.~_ MAILING ADDRESS LOCATION ~ ~ _'"'~/~l~r/O ~ T~ LEGAL DESCRIPTION ~>~ ~' PHONE SEPTIC TANK: DISTANCE FROM WELL ~('~ INSIDE LENGTH MANUFACTURER INSIDE WIDTH NUMBER OF COMPARTMENTS LIQUID DEPTH ~ LIQUID CAPACITY/;;2~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL /(~C) ~' FOUNDATION ,~'~ t~ NUMBER OF LINES / DISTANCE BETWEEN LINES ABSORPTION AREA 4'~ SQ. FT. LENGTH OF EACH LINE '~-I DEPTH: TOP OF TILE TO FINISH GRADE.~'- ~-/' DEPTH OF FILTER MATERIAL BENEATH TILE NEAREST LOT LINE ,~(~2 ~oFTOTALLINEsLENGTH "'"-- TRENCH WIDTH_.~._~ TOTAL EFFECTIVE __IN. ABOVE TILE ~:~ IN. WELL: TYPE j/~/~ ' V DEPTH DISTANCE FROM: BUILDING ~ NEAREST / NEAREST SEPTIC FOUNDATION'-'~'~ LOT LINE /~ SEWER LINE """"' TANK CESSPOOL ~ OTHER SOURCES SEEPAGE SYSTEM APPROVED DISAPPROVED DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: Form LQ-032 DIAGRAM OF SYSTEM G.A.A.B. PERMIT NO. MUN I C I ~L I T~' OF 8r~CH~AGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 E TUDOR RD. ~ ANCHORAGE., AK. 9950? 276-2221 ON--S I TE SE~ER PERgq I T 76197 ) APPLICANT LOCATION LEGAL DICK ANTHONY BARRY & BRIA~ STS Li? CR~STWOOD SUBD 2522 BROOK DR LOT SIZE 2?8-3644 49500 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 100 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 8 LENGTH= 41 GRAYEL DEPTH= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND MD THE BOTTOM O~ THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REQU I RED SEPT I C TANK S I ZE= 1250 ORLLO~4$ BACKFILLING OF ~NY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND 8NY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 200 FEET FOR R PUBLIC WELL. SPECIFICATIONS 8ND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PER~I I T ¥8L I D FOR ONE YEAR FROM I$$UE I CERTIFY THAT l-; I 8M FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH B~ THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. S I GNED: ~ -AP~NTHONY' Depti~ Feet 1 - Z- 3- 4- 5- 6 - 7 - 8- cj _ 10- 11 - 12 14 - l? 3330 "(.:" SLreet /\nchoratle, Alaska 99b()3 ,'-;()II,:S I,()(1-. I'E]~.()I,A'I'I()N 'I'I,;S'I' [,;:ga, Descr,pLlOn: ~0 ~Z7 ....... ~~5~~ .... ~ Date Performed This form repor~s:--~-6Tls- i~g .................................. ~ . ~ ...... Percolation tes~ g~ound wato~ un¢ouateru~? If yes, at what depU~? Reading Date Gross Time /~et Time Oepth to Wn~er Net Urop ................ t ............... f .................... I ......................... 4 ..................... ~roposed.i~stalla~]on. .~eul~aUe Pit Urain Field MUN I C I PAL I TY OF ANCHORF~GE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 25i0 E. TUDOR RD., ANCHORAGE.. AK. 99507 276-222i ~ELL ~=~ER~ I ~- PERMIT NO. < ?~334 ) APPLICANT F_OeEMOST_ S~VICES_ LOCATION BRIEN STREET LEGAL Li? CRESTWOOD SUBD 2523 BROOK DRIVE 278-~:644 LOT SIZE 49000 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS t00 FEET FOR A PRIVATE WELL OR 200 FEET FOR R PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPRRTMENT WITHIN 30 DRYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS RRE AVAILABLE TO INSURE PROPER I NSTRLLRT I ON. PER£4 I T VAL I D FOR ONE YEAR FROM I SSIJE I CERTIFY THAT l' I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2' I WILL INSTALL THE SYSTE~IN ACCORDANCE SIGNED' _ , APPLICAN~ EMOST ISSUED BY~~~~---.~-' ...... DATE / WITH THE CODES. 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.a k.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 015-061-19 1. GENERAL INFORMATION HAA~ Expiration Date: Completelegaldescfiption CRES'P~/OOD LOT 17 Location (site address or directions) 9700 BRIEN STREET Current Property owner(s) . Mailing address Lending agency ' Mailing ~ddress Real Estate Agent Mailing address JEFF C0DBOUT 9700 BRIEN STREET ANCH. AK, 99516 Dayphone 346-1163 Day phone TAMMI TAYLOR W/ JACK WHITE Day phone 3201 "C' ST. SUEE 200, ANCH. AK, 99503 563-5500 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. 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 also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A er B wells or a public water system. The Muni!:ipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As cedi[zed by my seal affixed hereto and as of the validation date shown below, I verfly 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 bedreoms and type of atructure indicated herein. I further vedly that based on the information obtained from the Municipality of Anchorage ryes and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in co['nptiance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. NameofFirm ALASKA WATER & WASTE'WATER CONSULTANTS. INC. Phone 3.37-6179 Address 6901 DEBARR ROAD. SUITE 2B "ANCHORAGE. AK 99504 // Engineer's Printed Name JEFFREY A. GARNESS. P.E. Date Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough. conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test. and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condiflon, groundwater levels that may fluctuate during the year. and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactoey test results do not guarantee future performance of the system, nor do they guarantee that there ara no hidden defects or encroachments. AKWWC. Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report ia for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for L'l/" bedrooms. Disapproved. Conditional approval for ~ Attachments: HM Checklist Septic System Advisory Well Flow Advisory bedrooms, with the fllowing stipulations: . ..%¢ Manitenan~ Agreements ~ ,~ ~,~ Supplemental Engineers Reo~ Other Original Certificate Date: /O -/fo- oP- Municipality of Anchorage Development Services Department ~ Wa~r & W~r ~ 41~ ~ 8~ ~ P.O, ~ 1~ ~e. ~ ~1~ Legal Description: A. WELL DATA Well type Date completed 6/24/76 TotaJ depth 73 ff. .:: Date of test Static water level Well pnxluctldn WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi, Arsenic: N/A mg./L. e. SEPTIC/HOLDING TANK DATA HEALTH AUTHORITY APPROVAL CHECKLIST CRESTWOOD S/D: LOT 17 Parcel ID: If A, B, or C provide PWSID~ Sanitary seal (Y/N) YES Cased to 40'+ ft. FROM WELL LOG 6/24/76 50 fi. 10 g.p.m. Tank Type/Material Tank size 1250 gal. Foundation ctaanout (Y/N) YES Date of pumping NEW C. ABSORPTION FIELD DATA Date installed g/26/o2 Length 48 ft. 015-061-19 well ~ (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 8/20/02 46 ft. 7.5 g.p.m. Y YES 12+ in. Nitrate 3.87 mgJL. Other bacteria 2 cofonies/100 mi. Data of sample: 8/22/02 Collected by:. NONWC STEEL Number of Compartments 2 Depression over tank (Y/N) NO Pumper PBELOW FINAL Soil rating ~ .~or ft~rx:lrm) 1.2 Width 3 fl, Date installed 9/26/02 Cleanouta (Y/N) YES High water alarm (Y/N)N/A N/A System type TRENCH Gravel below pipe 5.38 Depression over field__ Totaldepth to.~ ft. Eff. absorpUonarea 516 fi= Monltodngtube YES Data of adequacy test NEW Results (Pass/Fall) Fluid depth in absmpfion field before test - in. Water added - gal. Elapsed Time: - min. Final fluid depth - Any rejuvenation treatment (past 12 mo.) (Y/N & t~3e) in. Absorption rate >= NONE KNOWN If yes, give data NO For 4 bedrooms New depth - in. - g.p,d. 0. LIFT STATION Date installed "Pump on' level at in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size In gallons "Pump off' lev;I ct Cyclee tested Septic tank/lift station on lot100'+ ,ad~orption field on lot 100'+ Public sewer main N/A Sewer/septic sewice line 25'+ In. Manhole/Ac~<o (Y/ri) High water alarm level at Meets alarm & circuit requirements?. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cieanout Hol~fing tank N/A N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Water main N//A Water service line 10'+ Surface water Wells on adjacent lots 100'+ 5'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Pmperb/line 10'+ Water service line 10'+ Curtain drain NONE KNOWN Building foundation 10'+ Surface water 100'+ Wells on adjacentlota I00'+ Water main N/A Drflmway, paddngNehide storage, 10'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municfpal records that the above systems am in conformance with MOA I-fAA guidelines in effect on this date. Engineer's Printed Nan2e JEFFREY A. GARNES$ Data of P. e.t (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number ,0~=,, l / .00'00~ 3.00.6~.6~ S .00'00~ 3.00,6~.6B S 'J'S OOG'6~, / l I09 NOISIAIC]fns C]009153S:3 G~g-d Z AUG-29-OZ 10:4?AU FROI,t-CT&E ENVIRONt, ENTAL SRV ZfK CT&E Environmental Service, Inc. 90?5515361 T-184 P.O2/O3 F-rTZ CZ&E Ref.# Client Name Pro,~ect Name/# Client Sample ID Matrix Ordered By PWSID Sarrq~lc Remark: 1025409001 AK. Water & Wastewatet Consuhants Inc. Crestwood LI'/ Crestwood LIT Drinking Water 0 Uni~ Mcthe8 All Date-./Time~ are Alaska Standard Time Printed Date/Time 08/28/2002 10:15 Collected Date/Time 08/22/2002 11:25 Received Date/Time 0R/22/2002 12:15 Stephe~l Technical Director £de Released By ~~ Allowable Prep Analyr~s Limiu Date Date Init Nitrate-N 3.87 0.200 mg/L EPA 300.0 (<-10) 0~22/02 IDT M:Lc~-ob:l. ol ogy 'r. abor&t:ory Total Coliform 2 OB. No Coti col/100mL SMI8 9222B 08/22/02 KAP MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) LoT 1'7 C_.P E Txico Location (address or directions) (b) Property owner A ~ F(" Mailing Address (c) Lending Institution. Mailing Address AK A k!(.H A K'_ Telephone · (home) Telephone ~1 //-~ _ Business (d) Real Estate Company and Agent /. Address _~/./~ Telephone ~J/~ (e) Mail the HAA to the following address: (or check here ~.if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family,J~ Number of bedrooms & 3. WATER SUPPLY Individual Well ~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site/J~' 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. 72-025 (Rev. 7/88) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Address P(") ~0~' 7~0~0~ Telephone ! ~'~gineer's Seal 6. DHHS APPROVAL Approved for 4 Approved X Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7/88) Back Page 2 of 2 , ,~. F;~" MUNICIPALITY OF ANCHORAGE (MOA) A. WELL DATA Well Classification ~L)~. I L/,~7-1--- Well Log Present (Y/N) ¥ Total Depth ~7,~ Cased to Static Water Level ~'O ~ Casing Height Above Ground ~ t Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results .~ Comments Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: Date Completed 7~'~-~ Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) 7 Depression Around Wellhead (Y/N) ~.~ If A, B, C, D.E.C. Approved (Y/N) Yield '7 ; On Adjoining Lots ~ ~(-~) ) lO ~ ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) Y Depression over Tank (Y/N) .~ Pumping/Maintenance,Contact on File (~i/~Jl~_ Holding Tank High-Water Alarm (Y/N) . . SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: /,,Z S'-O Air-tight Caps (Y/N) To Water-Supply Well ~(~ ' To Property Line ~ ~-~,.~ ~ To Water Main/Service Line ~' '~--~- < To Stream, Pond, Lake or Major Drainage Course No. of Compartments ? Comments Foundation Cleanout (Y~N) Date Last Pumped ~///?~ ;for Temporary Holding Tank Permit (Y/N) To Building Foundation Zo ' To Disposal Field I ~ ' ~--~- 72-025 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata j%.~ ~'/,~/r,-,, Type of System Design Date Installed '-~ Length of Field '~*Z ~ Width of Field ,_:~' Depth of Field ~' -~"~---' Gravel Bed Thickness ,C~ J,.,'~) ~'~ ~/' Square Feet of Absortion Area '~20..v/,~f- ~- Statndpipes Present (Y/N) Depression over Field (Y/N) ~ // Date of Last Adequacy Test Z Results of Last Adequacy Test (~'~TJ-~J~-~7'~,~v/ - SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well I jO ~ To Property Line Z.O ~ + To Building Foundation _,~__ ~- ( To Existing or Abandoned System on Lot ~J /~ ;On Adjoining Lots 7.,~"' To Water Main/Service Line ~'~ ' To Cutback (if present) [,[/,~ To Stream, Pond, Lake, or Major Drainage Course To Driveway, ~Darking Area, or Vehicle Storage Area ~" ~C_.) ~ Comments ~,~w-, ~ ~ ~ ~~ ~~ D. LIFT STATEN Date Installe~ Size in Gallon~ "Pump On' Level~ High Water Alarm L'~el at Tested for MOA Electrical Meets Col~s (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check P d Bedr lng Against HAA Request** I certify the/t I/~.~e/che~q~d,~erified, or conformed to all MOA and inspection///////~// Sioned ~ iii/~././c~ / ~ --..----~ Date No. Receipt No. Date of Payment Amount: $ H~C~ ~1~1 l~.in effect on the date of this Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 LEG_AL /k_ ~':'? / / CORWIN & ASSOCIATES, INC. 1000 E. Dimond Blvd. Suite 205 /Z / ANCHORAGE, ALASKA 99518 DATE (907) 522-1311 / CHECKED BY DATE iADEQUACy TEST i ~TER iTHiS ~ iTOTAI~ i TANK FIEND FIELD TIME READING RERIOD GALLONS GPM DEPTH DEPTH DEPTH ~, ....... i ............ ~ ............. ~.'..-...i.::~,:~ ........ :':...~.,..~ -~.....i ........ -LOCATIO;I OF ~IELI] (Legal Description)- ~/ELL DEPYH' -/3 ~ FT. CASING- DATE DRILLIIIG CO:iIPLETEO: .-STATIC t-lATER LEVEL (Top of Casing)- FT SCREE;I' D~LLER: ~r~+,c Dr','II,'~ FT ' Iock Tine ~ :00 Elapsed Iime Since ?umping'Star~d/ S~pped, 0 10 2O 25 _ab 35 40 5O S5 · 60 (l hour,) r~-~.~-- ~ -~- .... 180 (3 hours I 210 2~;0 (4 hours RECOYER¥ 0 $ lO IS 25 30 3'5' 40 ,IS SO SS hour) Depth to ,Nat.er, D.~a v~d own / Recovery Pumping Ra ce, GP!4 0 Start. Renacks INC. ~ Drinking Water Analysis Report for Total Coliform Bacteria ~ TO BE COMPLETED BY WATER SUPPLIER .PRIVATE WATER SYSTEM Name Phone No. Mailing Address City State Zip Code Mo. Day Year SAMPLE TYPE: Routine Check Sample (for routine sample with lab ref. no. [] Special Purpose .) [] Treated water [] Untreated Water SAM PLE NO. LOCATION I t,--¢,..'-7-- /-7 ,I I 5I I Time Collected Collected By. I % I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [Z;~Satisfactory [] Unsatisfactory [] Sampletoo long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received - Time Received Analytical Method: Membrane Filter * No. of colonies/100 mi. Result* [-7] Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD q0 Membrane Filter:. Direct Count O Coliform/100ml TNTC = Too Numberous To Count OB - Other Bacteria Collform/lOOml PART ONE OF TWO REMAINDER TO FOLLOW CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ANALYSIS REPORT BY SAMPLE for Work Order It 19951 Date Report Printed: FEB 27 90 ~ 12:06 Client Sample ID:L17 CRESTWOOD PWSID :UA Collected FEB 20 90 ~ 15:00 hrs. Received FEB 21 90 ~ 14:00 hrs. Preserved with :AS REQUIRED Client Name : CORWIN & ASSOC Client Acct: CORWINP P.O.t NOWE RECEIVED Req t Ordered By : BRUCE CORWIN Analysis Completed :FEB 23 90 Send Reports to: Laboratory Superviso~_~_~PHEN C. EDE lJCORWlN & ASSOC Special HOLD POR PICK-UP Instruct: Chemlab he£ t: 900171 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Units Method Llmts NITRATE-N 4.5 mE/1 EPA 353.2 10 Sample ROIFIINE SAWPLE Remarks: SAWPLE COLLECTED BY J. KRESS. I Test8 Performed * See Special Instructions Above UA-Unavailable ND- None Detected *' See Sample Remarks Above NA- Not Analyzed LT-Less Than, GT-Greater Than APPLI( NT FILLS OUT UPPER HA[ ONLY Pr6Perty O;~er ,~.~_.~.~/,~ /~ ~(- ~O ~ Phone Phone Lendin~ Instilulion Phone Realty Co. & A~nt Address ~~ Zip Code Legal Descript~n ~ ~ / ~ ~5 ~~ ~ ~, ~ StreetLocat,~ ?7o-D 8r,~ Ye ?TY~ Type 9f Resi~nce ~ ~Single Family ~ Multiple Family No. of B~roo~ ~ Other Water Supply lndividual A~ACH ~LL LOG. A w~l log is r~uir~ for all wells drilled since June 1975. Community For wells drilled prior to th~ date, give well depth (attach log if available). ~ Pub.cUti,ty ~t~) ~ ~ Sewer Disposal /~7~ ndividual Year Indiv~ual Installed: ~ Public ~ility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Ti~e Date Date Date Date~-O-- Inspector Inspector I nsp~tor I nsp~tor Fiel~Not~: ~ I) t -- MUNIClP~LIW OF A~HOBGE ENVIRONMENTAL PROTECTION J U N RECEIVED ( ~P~ovED BED~O0~8 ~ 'GONDITION8 OF APPROVAL ( )DISAP~OVED I. /~ ' ' Soils Rating Date ~wer Installed Well To ~sorption Area [~O Well Log Received 7-- ~ WelltoTank / ~ Septic T~k Size 72-023 (3/82) ALASKA EI1UIItO[lm I1TAL COIqTI OL $ r01C $, II1C. I~nqineerincl g- I~nuironmenlal Studies JUNE 9 1983 PETER ELSON SRA BOX 2363 ANCHORAGE AK 99507 SELLER - PETER ELSON BUYER-THOMAS FAULKENBERRY SUBDIVISION-CRESTWOOD BLOCK-0 LOT-17 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 420 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 6/9/83 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 4 BEDROOM HOUSE. 1250 IS ADEQUATE FOR 1200 Lgest 33rd Aucnu¢, Suite ~ · Anchoracle, Alosl~o 99503 · {907) 276-1361 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received December 1, 1976 Time Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR of Inspection Conv. l. Approval requested by: Alaska Bank of .Commerce Mailing Address: 712 west 4th Avenue 2. Property 0wner: Foremost Services Phone: 272-0571 Phone: 278-3644 Mailing Address: 2523 Brooke Drive 3. Legal Description: Lot 17 Crestwood 4. Location: Barry, * Brian 5. Type of facility to be inspected Single Family 6. Well Data: No. of bedrooms ~ ~ ~ .'" ' L2,,_--~-~ · -,~;; · A. Type Individual B. Depth C. Construction ~ D. Bacterial Analysis Sewage Disposal Sy~em-: A. Installed C. Septic Tank: D. Seepage Pit: 72' On-site system, Permit 976197 1976 B. Installer ~ ~ 1. Size _~__ 2. Manufacturer ~m~ 1. Absorption Area L/~]).~O. ' 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank __a2l~___, Absorption area __L~, Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. AbsorptioQ area to nearest lot line EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA ~ FHA CONV 2. Property Owner: -~l~~,~J ~z,~ - ~_,~_~ .~~d_) Mailing Address'~'_~'~ .~_ ~:)_,~/~' ~ Day Phone: ~'~-- _~ 3. Name of Buyer:.'~". J~_ ~/ ~. LQ. ~ Mailing Address: Day Phone: 4. Name of Lending Institution: ~..~G.~_. ~' ~/ ~ Mailing Address: 7/~ (~ ~ /'~ ~ o Name of Realtor or Agent: %~FYl -- Mailing Address: Legal Description: Location: ~ 7. Type of Facility to be Inspected~ 8. Water Supply No. Bdrms. ~r~_~ Type of Supply: Public Utility. If Individual, number of dwellings presently served If Individual, depth of well ~~~.Z~ Individual Sewage Disposal System Type of System: Public Utility If Individual, date of installation ~ '- ('~-- Individual (on-site) 72-003(3/76) Page 2 of .two pages - Re ~st for Approval of Individual Legal ~escripti0n Lot 17 Crestwood ~er & Water Facilities Comments pprove~ A Disapproved Date Valid for one year from date signed Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I 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)