HomeMy WebLinkAboutLAKE O THE HILLS EAST BLK 2 LT 6Lake O' the
Hills East
Block 2
Lot 6
#015-333-08
Municipality of Anchorage O
Development Services Department eeI -E 2.
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 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
0 333 8
Permit Number. 5"020327
PID Number. 15— —0
Name:
1KATE SANDBURG
Wastewater System: ❑ New ■ Upgrade
Address:
7151 MOUNTAIN LAKE CIRCLE a ANCH, AK 99516
ABSORPTION FIELD
Phone: No, of Bedrooms:
(907) 346-2631 4
■ Deep Trench a Shollcw Trench o OW oHound 0Other
LEGAL DESCRIPTION
TOW Depth hwn
sw 1.2
apa/sa R 71.03-7.64 rt
Block Lot. Subdivhion:
Depth to ppe batter, ham wlpe,c Vete Creel depth bwooth pips
2 6 LAKE 0' THE HILLS EAST
1.03-1.64 rt 6.0 rt
Township: Range: Section:
ro sewed Wore erlpnd eras: Gael WMrc
— — —
0.65-1.26 rt 44 rt
WELL:
crewel wbu,: Nwd,r of iwe:
DM between iwe:
❑ New ❑ Upgrade
2.5 R 1
— rt
Cknefoutbn (Pnwate. AE.C): TOW De Cwsed Ts
Total obearptla, exec pipe watedwh
rt R
528 so. rL D 3034/ F-810 do SCH 40
Date DrYled: EtsDa YroW eoe.t
swloner. Dote Mweet:
A+ HOME SERVICES 9/24/2002
R
n.�Iw
np seta
lavN.lent,ome Dram,
es
TANK
CPN
R
R
SEPARATION DISTANCES
aseptic 0Holding ■S.T.E.P. 0Other
To Septic Absorption Uft Holding Put"" rhate
rro Tank Field Station Tank swear tk«
tlwwf cba . Capealq H tleeerw
ANCHORAGE TANK 1500
Well 200'+ 200'+ 200'+ — 25'+
wWlek STEEL wwko.r of aaewwbr"nte. 2
Surface Water 100'+ 1001+ 100'+ —
Lot Una
Foundation
Curtain Drain
5'+ 10' 5'+
5'+ 10'+ 5'+
NONE KNOWV
Remarks:
—EXISTING SEPTIC TANK AND DRAINFIELD
COMPLETELY ABANDONED PER UPC.
LIFT STATION
M" a eaewea Yandaahew:
1500 ANCHORAGE TANK/ORENCO SYSTEMS
'Pwap en" keel a: •Pump on" lewd M: wen wwtw elven, a:
42" 42" 1 46"
Vere wee t wee tD.ablow kwveatlarr wtwrM W.
/20 OSI 05 HHF M.O.A.
BENCH MARK
Locatkn ed Deewlpawc
TOP OF MANHOLE
Inspections performed by: AKWWC, INC. Dates: 1st 9/24/2002.
2nd 9/24/2002
3rd 9/24/2002
Development Services Department Approval
Reviewed and approved by: - Date: /a//6/aZ
Re ,eve 1
Iwd EwIww,a 95.11
ENGINEER'S EEK
CF
t•
Jeftoy A. GL-
�� '•. (E-7953
•' �aPa
R
PERMIT NUMBER:
SW020327
`-VACANT
LOT S. BLOCK 2
LAKE V THE HILLS EAST
/
/
/
/
/
AS -BUILT DRAWING P015 ID NMB:
333- 08
/100' SURFACE
WATER SETBACK
If
If
3•
EXISTING FOURA0'+
"• •'•
BEDROOM HOUSFCO
WATER UNE WAS
:'
PROFESSIONALLY
NEW 1500 GALLON '• STAKED BY THE
/ S.T.E.P. TANKMT
oac` ,
X9/30/2002 0!� �F '��� p
T i _.1'r ........��... -._... .... .. DRAWN BY: O `•' �`�Sp0
ALASKA WATER & WASTE WATKR C"'G•
CONSULTANTS, INC. SCALE: _ Y
6001 OFRARR ROAD SUITE tR • ANCNORAOF. AK 00304 • FNONF (00))331fiA0 • FAX (00])338-3m 1 - 30'
PREPARED FOR: PHONE NUMBER: PACE NUMBER: ���JJLLC����Q�
KATE SANDBURG (907) 346-2631 2 OF 3 oa
LEGA. DESCRIPTION:
D
� •'; CONTRACTOR
o.
NEW DRAINFlELO
Mrt
TH�1 •.''
/
/
/
/
/
% ST1
/ ST2
MH 45.19 53.02
39.64 43.13
43.78 50.92
MT1 87.67 109.70
MT2 93.29 101.55
LAKE 0' THE HILLS EAST SUBDIVISION; LOT 6, BLOCK 2,
TYPE OF WORK:
AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
PERMIT NUMBER:
SW020327 AS -BUILT DRAWING
=1
TOP OF TANK
AT INLET 90.08
PARCEL ID NUMBER:
015-333-08
�F1WIL CRADE 94.07+
/ TOP OF MANHOLE 95.11
ST2
TOP OF TANK
AT OUTLET - 90.07
INVERT OF BUNG NEW 1500 GALLON
AT INLET - 89.53 S.T.E.P. TANK
O
FINAL CRADE
99.06 (AVC
RELATIVE ELEVATION OF
GROUNDWATER - 84.41
i
-REUOF ELEVATION OF BOTTOM
OF TESTHOLE - 82.41
O
B ORIGINAL CRA
97.80-98.
eFIlNUUTION
LTER FABRIC
1.25' PVC WTH
0.25' HOLES
SPACED EVERY
2.15' ON CENTER
INVERT OF PIPE -
96.77 (AVG.)
BOTTOM OF
TRENCH -
90.77 (AVC.)
H2O 0 14.8' B.G.
ON 9-24-02
DATE
9/30/2002
(_ Y .._ ." ..--'♦, _ .. _.. DRAWN BY:
ALASKA WATI✓R & WASTEWATER Ste: C.J.G.
CONSULTANTS, INC. 1 ° = 40'
5001 DFAARR MGD. SUITF 70 • ANOHORACF. AK OOSM. • PHONF (007)3374170 • FAX (O07)37AJ7GO
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
KATE SANDBURG (907) 346-2631 2 OF 3
LEGAL DESCRIPTION:
LAKE 0' THE HILLS EAST SUBDIVISION; LOT 6, BLOCK 2,
TYPE OF WORK:
PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
�... .
1p JB' eV GOT 893.•
ox—
ho.' ..... '• ee4��
09/28/2002 17:02 FAX 9078888770
A+ hove Services. Inc. Q1001
.. YM EDS. ELECTRIC 272 4390 P.01
RithtFAX 8/28/2002 6:13 PAGE 1/1 IliahtPAX
Inspection Report
MunlClPality ofAnChorage, Building Safety Division
4700 South Bragow
IN9PECRON: Voica 3434300 INaP11=10rt: FAX (907)249-7777 tffFO: 343.6211
kanea ens ELECTRIC pwvmt 02-8941
Addnm 7151 14DUUTAIN LAKE CIR Phoo. 272-4591
Lead BK 2 LT 6 3:apsctfon Data 9/26/2002 AM
sut:dlvislon LAKE O THE HILL3 EAST
Comments or Direction,
AM -CALL B4 TO MEET—SEPTIC SYSTEM
1"Spettlon Pubo Elacbiwl Rel:apeetfon K
NO NONCOMPLIANCE OBSERVED
❑ CORRECTIONS ESSENTIAL AS EXPLAINEO BELOW
❑ WILL RE-EXAMINE AT NEXT ❑ 00 NOT CONCEAL UNTIL REINSPECTION
INSPECTION
CON149WM (for kepeda um anly)
d • de,5i ,.
N 89'58'48"W 177,04'
DECK
OF Ae%
SHANE A. HOLT ,
LS -6914
1.'s.............a4
TWO STORY
FRAME HOUSE
3
LIFT
➢STATION
ASPHALT
PARKING
AREA
tii.m
4c
C3
O
CD
N
N
W
is
0
0
ri
89'58'48"W
27.88'
MOUNTAIN LAKE CIRCLE
AS -BUILT SURVEY
NO CORNERS SET THIS DATE T' - 30'
I HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOVING
DESCRIBED PROPERTY.
LOT 6, BLOCK 2, LAKE D' THE MILLS EAST SUB.
ANCHORAGE RECORDING DISTRICT, ALASKA AND TWIT
HIE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
THE MING STRUCTURES
ICN H[R[ON a ATT THE USE Of LENDING ENTITAND 1 SOT TO
TO SHOW ANY I O MNG Ab HIN THE PROPERTY LINES AND NO VISIBLE
EXISTING STRUCTURES AND PLATTED LOT LINES OR CASEMENTS AND 6 NOT i0 BE USED FOR POSITIONING ADDITIONI(NOROACHMENTS EXIST OTHER THAN MITE➢.
STRUCTURES OR iENCEUNE3. pATED /�
EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PUT, ARC NOT SHOWN NEREON.(UHLESSR.OHfpF�AT{p) T MAGE, ALASKA THIS �8T
NOTE: ANY FENCEUNES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY L#[[gT 315-5513
LAND SURVEYING 8319�B101-33
OR LOCATE STRUCTURES.
#L[.5
ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS.
MUNICIPALITY OF ANCHORAGE
Development Services Department
Onsite Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
9/z3'Ioa 3p-7
Date Issued: Sep 05, 2002
Expiration Date: Sep 05, 2003
Permit Number: SW020327 Parcel ID: 015-333-08
Legal Description: LAKE O THE HILLS EAST BLK 2 LT 6
Design Engineer: 0041 AK Water & Wastewater Consultarr Site Address: 007151 MOUNTAIN LAKE CIR
Owner Name: Kate Sandburg Lot Size: 27000 SQ. FT.
Owner Address: 7151 MOUNTAIN LAKE CIR Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99516-1866
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.
LY
Received By: � /#
C9
i
Issued By: CZ 7;�O-�
Date: l/SA)
Date: 97140 i
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.ek.us
(907)343-7904
ON—SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-333-08
Permit Number 5W020527
Property owner(s) KATE SANDBURG
Day phone
346-2631
Mailing address (1) 7151 MOUNTAIN LAKE CIRCLE
Mailing address (2) ANCHORAGE. ALASKA
Zip Code
99516
Legal description (Lot, Block & Sub'd.) LAKE 0' THE
HILLS EAST S/D: LOT 6. BLOCK
2
Legal description (Section, Township & Range) N/A
Lot Size P7VOI7 Acre sl q.Ft.
Number of Bedrooms
4
THIS APPLICATION IS FOR:
Sewer Only ❑
Well Only
❑
Sewer and Well ❑
Water Storage
❑
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub ❑
Jacuzzi
❑
Swimming Pool ❑
Water Softening Unit
❑
Therapy Pool ❑
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 & WASTEWATER CONSULTANTS, INC.
(Signoturc of property owncr or outhorizcd ogcnt)
Permit Fees: $400, Waiver Fees
Date of Payment: 5130102- Date of Payment:
Receipt Number. z4 110 / Receipt Number.
ALASKA WATER WASTEWATER
CONSULTANTS, INC.
August 27, 2002
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic System Upgrade for Lot 6, Block 2, Lake 0' The lulls East Subdivision
To whom it may concern:
The existing 4 -bedroom house is served by a community well and a private septic system. The
septic system consists of a 1250 gallon septic tank and a deep trench type drainfield that is
completely surcharged and must be upgraded. A test hole was excavated south of the existing
septic system. The new septic drainfield will be designed around the 30 -foot radius of this test
hole. We are proposing that a new 1500 gallon S.T.E.P. tank and a deep trench type drainfield be
installed. Comments regarding the design are summarized as follows:
1. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring,
and the percolation test results.
2. TRENCH DESIGN:
a.
Percolation Rate: <1 minutes/inch
b.
Proposed Application Rate: 1.2 gallons/day/fi
c.
Number of Bedrooms: 4
d.
Design Flow: 600 gallons per day
e.
Minimum Absorption Area: 500 ftZ
f.
Total Depth: 8 feet (mar.)
g.
Effective Depth: 6 feet
h.
Width: 2.5 feet
i.
Reduction Factor: N/A
j.
Minimum Length: 43 feet total length
k.
Effective absorption area = 516 fe
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade.
4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average
topography in the area of the proposed drainfield is a 10% to 15% slope running from
6901 Dcbarr Road, Suite 213 • Anchorage, AK 99504
Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com
approximately southeast to northwest. In short, there are no slope concerns.
I am 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. J
M.S.
NOTE. Attached is a site plan drmving, a design drmving, a topography site plan, a soils log,
and a 7 page construction specification letter which are all part of the design package for this
septic system.
6901 Dcbarr Road, Suite 2B • Anchorage, AK 99504
Ph: (907) 337.6179' Fax: (907) 338-3246' Website: akwwc.com
-------r------------- T ----------
\LAKE
---1-"---`_� --- ILOT S, BLOCK 1OCK 1 uKE O' THE HILLS EAST////HILLS EAST 100' SURFACE WATER SETBACK �T l � /
�WROXIMATE LOCATION OF
COMMUNITY WATER UNE , LOT 7, BLOCK 1
-I I CROMWELL HTS
J-
AM LOTS WITHIN 100' OFI
(SUBJECT PROPERTY ARE
III ON A COMMUNITY WELL. i
rvACAfD \5 _
1 Sl�TRACT I 1 2
NCE 0' THE MILLS FAST i Q �(I
PROPOSED SEPTIC I X'
SYSTEM (SEE PACE 2 OF I g
2 FOR DETAILS) 1
I Z -Q LOT 8, BLOCK 1
IH I CROMWELL HTS
I 7'
O,
EXISTING FOUR I
BEDROOM HOUSE h I i \
j� IXISTI M TSE
O BE /'
O amPLETELY
ABANDONED
/f
LOT S. BLOCK 2
LLSOETHE
h ^-
--------------1
LOT 4. BLOCK 2
%. r unls EAST`.
j LOT 3, BLOCK 2
LAKE O' THE HILLS EAST
1
I
l I \
kti 1 / \
It 11 5
1'::' 3 I LOT 9, BLOCK t rf
I? II\ CROMWELL
A10�NTAIN IAKF—gIRC1/LOT to. BLOCK t
/ CROMWELL HTS
1(50• WELL RADIUS,
- a I 115
5 � \
1 {
EPEC I \\
�I
I
LOT 2. BLOCK 2 �,`1'_y 1
LAKE 0' THE HILLS EAST
ALASKA ""TKR & AVASTRNATLR
CONSULTANTS. INC.
5901 DFBAB9 ROAD. "TF 2B • AHOMOPAGF, AN 99501 • P" P (401 NUMBER:
Fe• ro9n55Mgne
PREPARED FOR 346-2631
KATE SANDBURG
LEGAL DESCRIPTION:
LAKE 0' THE HILLS EAST, LOT 6, BLOCK 2
TYPE Of WORK:
SITE PLAN FOR SEPTIC SYSTEM UPGRADE
DATE:
8/27/2002
DRAWN BY:
M.E.W
SCALE:
1" = 100
PAGE NUMBER:
1 OF 2
\
LOT 11 BLOCK 1
CROMWELL HTS
(: ACANT--i
/100' SURFACE
/ WATER SETBACK
r
I
NOTE: SOUTHERN LOT UN�
E, ANDWATER
SERVICE UNE MUST BE FLAGGED BY A I
PROFESSIONAL LAND SURVEYOR PRIOR
TO ANY CONSTRUCTION.
� � Qcwf�siluN4-vu�( LoCn-s� '�a�i
LOT S, BLOCK 2
LAKE 0' THE HILLS EAST
/ INSTALL FOUNOATION
/ CLEANOUT IF ONE IS
NOT PRESENT
/ EXISTING SEPTICE TANK TO
/ BE REPLACED WITH 1500
/ GALLON S.T.E.P. TANK.
/ EXISTING DRAINFIELL
/ BE ABANDONED
/ AROPOSED TRENCH THAT6
PRESSURIZED IS FEET DEEP, BY
/ WIDE, BY 43 FEET LONG. ADD 6 FL
CLEAN. WASHED SEWER ORAINROCK.
PERFORATE DISTRIBUTION LINE TO WITHNT
0.
HOLES EVERY 2.15 FEET ON CEN
TO
INCH
2111
H '� _ �,SMf•� T.H. jl
\ •. APPROXIMATE
• LOCATION OF
WATER UNE
1• ,•• yJ
M
22'/�
DATE:
8/27/02
DRAWN BY:
ALASKA WATER & SNTASTKWATRR M.E.w
CONSULTANTS. INC.
PREPARED FOR: 1 n - 30,
KATE SANDBURG PHONE NUMBER: PACE NUMBER:
(907) 346-2631 2 OF 2
LEGAL DESCRIPTION:
LAKE 0 THE HILLS EAST; LOT 6, BLOCK 2
TYPE OF WORK:
DESIGN OF SEPTIC SYSTEM UPGRADE
LBLOCK
E HILLS
100'
WATER
r
LOT S,B OCK 1
LAKE 0' THE ILLS EAST
a
2
�AYrc E LOCATION F
COMMUNI TER U
/ A \ W\ITNI 00' OF
UBJECT PROP R ARE
rr++O-N A CO MU TY W L.
�VnCAN
LAKE 0' THEE HILLS EAST/ 1
PROPOSED SEPTIC
TEM (SEE PACE 2 OF
2 FOR DETAILS)
FOUR
n000C y
h
MOUNTAIN LAKE CIRCLE
HILLS EAST
h�S
VOp �
AIL:
8/27 02
r)wr:
ALASKA WATER & WASTEWATEREW
CONSUI,LL"TANTS.INC. 100'
090 DFBAR9 A 1. $ViTE Hf ANCHO9AGE, A 99504 • PH�NF (901)33)-0AO FAX (90113383746
PREPARED OR If PHONE NUMBE r'AGL NU BLR:
KAT VDBURG 346-2631 1 OF 2
LE DES RIPTUN: /
0'/ THE HILLS EAST, LOT 6, BLOC 2
NTTP F WO
RAPHICAL DRAWING \ /
C
I� J
i
LOT 9, BLOCK 1
CROMWELL HTS
.1)0 WFLLLL RADIUS,
1
LOT 1, LOCK 1
^ CRO HTS /
\/\
i
trey Gne
•, 1p
CE 7953 FFG
Op?•,_ coQv
SITE PLAN
1"=100'
CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
13—
DATE READING
ALASKA �'VATKR 8 VVASTK"ATE R
CONSULTANTS. INC.
8901 DEBAR RPA. SUrM 28 •
ANCHORAGE. N 99504 • N"C (907)337-6179 • FAIL (907)338-3246 • WESS(IE:
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION:
LAKE 0 THE HILLS EAST; LOT 6. BLOCK 2
PERFORMED FOR:
KATE SANDBURG DATE: 8/14/02
DEPTH _—_--
(feet) ORG
(TEST HOLE #1
6. g•
-0o
SOIL CLASSIFICATIONS
.N o
2
uoop000
tl; .• _ _
l
GW _ _== ORG
o•: o•o•�
0000900 SW
GP I
ML
3— 0400°00
IP1 GM
CL
00; 0•o0c
0000000
4 o0°�°n^�
.•.T
//� GC OL
o0
o SW MH
..•••.•�:
5—
; .� SP CH
:.e
SM .' OH
.. �.� ..
.•...•.
s>Y.. Sc
6.5 FT.
20
7—�•�� ��
DEPTH TO DATE
.•; .•.•.
GROUNDWATER
8—;;":� ;:
DRY 8/14/02
14' 8/22/02
trey Gne
•, 1p
CE 7953 FFG
Op?•,_ coQv
SITE PLAN
1"=100'
CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
13—
DATE READING
'::•: ••
8/15/02
.•
trey Gne
•, 1p
CE 7953 FFG
Op?•,_ coQv
SITE PLAN
1"=100'
CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
13—
.•
B.O.11.
�RO�Q
17 —
PQ'
18—
--
PERCOLATION RATE <1 (MIN./INCH)
PERC. HOLE DIA. 6 (INCHES)
19—
TEST RUN BETWEEN 6.0 FT. AND
6.5 FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED:
Cl YES N NO
SOILS LOGGED BY:
SUSAN OSWALT PERCOLATION TEST PERFORMED
BY: ROBERT CAMPBELL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ca(a-7/0,1-
~(1~ ~.~/ , MUNICIPALITY OF ANCHORAGE '~_ /
· 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 PHONE / ~NEW
BouoE/o Co s'T R oc-no/,) 62.-3zogf
LEGAL DESCmPT~ON
LOCATION ~ NO. OF BEDROOMS
O~ ~AKE VIeW oi=~
I We,, ~?*~ ~.~1~o.,~..~.. Dwelling PERMIT NO.
~ ~ Manufacturer Material No. of compartments
~ Liq.~?in gallons IF HOMEMADE: Inside length ~ Width Liquid depth
~ -- ~ ~anufacturer ~aterial Liquid capacity in gallons
Q Well ~,~ ~ ~**~ Foundation Nearest lot lingo ~ ~ PERMIT NO~o~ ~D
~ DISTANCE TO:~ [,'~¢ Total ,e~o~/li~:e~' Zrenc~r~t,~ b~en lines
No. of lines ~ Lenat~ af each lin~ Distance
~ ¢ zo- . ~s
~ Top of tile to finish grade ~O' Material beneathtile - , ~ area
Length Width Depth PERMIT NO,
~ ~ TgOe of crib Crib diameter Crib depth Total effective absorption area
m Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller , ~ ~ "Distancetolotline PE~MITNO.
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTAELER
SC H ~ ~ bT 'BRO'T ~E~5
REMARKS
CHA~GE~ PeRmiT TO
.~~
' ~ ~ DATE
REC V
~6
$CALI~:.
7
FNGTNFERS,
ZNC
I "EREBY cERTiF¥"THAT I HAVE SURVEYEO THE FOLLOWING OESCRIBEO PROPERTY.
7~25 OLD SEWARD HNY. .,
ANCHORAGE. ALASKA g9504
LoT G , i~ BLK ¢_... ',LA~.E'O' 'T~4F_ HILL~ ANCHORAGE RECORDING DISTRICT. AK.,
AN0' ~HA~ THE IMpROvEHENTS sITUATED THEREON ARE WITHIN THE PROPERTY LINES
AND DONOT ENCROA~ ~ THE PROPERTY 'LYING A~AC~T THERETO. THAT NO
IMPROV~TS ON ~ERTY LYING AOdACENT TH~ETO ENCROACH ON THE
IN QUEST[~ A~ THAT' THERE ARE' NO ROAOWAYS, TRANSMISSION LINES OR OTH~
VISIBLE EASEHENTS ON SAID PROPERTY EXCEPT AS I~ICATEO HEREON.
?' ' ~ .O~:.-~.A~T, I~, ANCH~AGE; ALA~A.
~ O~N~ .~:BUZLD~.. PR[~ TO
:' RELATZVE TO F~N~ :gRA~ A~ ~]L~TY:
[ .THE ~-9T~CE: O~ ANY EAs~~8. - cOV~A~S
~ 'THE RECKED S~ZVI8i~ ~AT..::
PERMIT NO. ( 830570 )
FiPPLiCRNT BOI,4EN CONSTRUCTIONS
LOCFIT I ON
[:,EPFtRTHENT %' HEI-~LTH FiNC, EN',,,'I F.:ONMENTflL PF.'OTEC:T I ON
825 '"L'" STREET., FINCH]F.'RGE., FlK. 9950±
264-4720
.~.p_,~....._ PtF.:TIC BLVD ~±571
LOT 6 BLK 2 LFtKE 0 THE HILLS LOT :SIZE
LEGRL
T'"r'F'E OF ~7F~IL FIBSORPTiObl S'-r'STEt"'i iS' TRENCH
i'!FIXIHUM NUHBER OF E:E[:,ROOhiS = 4. 'BOIL RFlTING ':Si.! FT,.-"BF.'.)=
THE RE6!UIF.:E[:, SIZE OF THE Sf]!L F:IBL=OF:'F'Tt]N "--]'-r'STEt"'I IS:
E:, E F~ ]- iH ==
562-E:208
:~'D'.9'_=,.'9'.9 S6!URF-:E FEET
±65
,-- L. Eb~i,_~-f"H= :E:5: .z F: l-fi -.- EL E:,EF"TH= ,,:I-
THE LENGTH DIHENSiON IS THE LENGTH (iN FEET) OF THE TRENCH OR DRFtlNFIEL[:,.
THE DEPTH OF' Fi TRENCH OR Pti' IS THE DISTFlNCE BETI,,IEEN THE SURFRCE OF ]'HE
GROUND FiN[:' THE BOTTOM OF THE E;:.:;CFt',,,'FiTtON (IN FEET).
THERE tS NO SET .[,.iI[:,TH FOR TRENCHES.
THE GRFlVEL DEF'TH IS THE MINiNUM DEPTH OF GRFI',,,'EL 8ETI,,.IEEN THE OUTFFILL PIPE
RND THE BOTTOM OF THE E',=<CFI'v'FITION ,.'.'IN FEET).
F-:EL--:., Ut I: F:E[:, '_~]EF'T :I C: TRtb~K '.b-] Z ZE= :J_":,_..:'-5 ~Z-~
F'EF.:MIT FIF'F'LiCRNT Hi=IS THE RESF'ONSIBtLIT'¢ Tf] !NFOF.:H THIS [:,EPFIRTMENT DURING TFtE
iNSTfiLLFiTIFd',I Ii'.]SF'EE:TIL-d'.,IS f]F FIN'¢ ±,SELLS FIDJFICENT TO THIS PROF'ERT'¢ FIND THE
NUMBER OF F.:ESiDENC'ES THFtT TNE ±.SELL. !.,.IILL SEF. t',,'E.
'T i---~ C, .:: 2 ::. I b,,ll S F' E C: T' i C, t'.,t '::;-. R F-': E F: E i::.~ LIt Z F-: E [:,
BRCKFILLINFi FiF RN'¢ SYSTEM b.I!THOUT FiNRL INSF'ECTiCd'.,I RN[:, RPPRO'v'RL E"¢ THIS
DEF'RF.:TMENT ±,4ILL BE SUE',JECT TO PF.:F~SECUTION.
MINIMUM DISTRNE:E BETWEEN R ±,SELL RND RN"r' ON-SITE SENRGE DI'=;F'OSRL S"r'STEM IS
±¢i0 FEET FOR R PRI'v'RTE I',.IELL OR 't5E'~ TO 200 FEET FROH R PUBLIC WELL [:,EPEND!NG
UPON THE T'¢PE OF PUBLIC WELL
MtNIMUH DISTFINCE FROM R PR I ',,,'RTE 14ELL TO R F'RI',,,'RTE SEWER LINE IS; 25 FEET RND
TO R COHHUNIT"r' SEI-'-IER LINE IS 75 FEET.
OTHER REL.-~UIREMENTS HR"," RPPL"r'. SPECiFICRTIONS RND CONSTRUCTION [."IRGRRMS RRE
RVRiLFiBLE TO iNSURE PROPER INSTRLLRTION.
i _.EF. TtF'r THflT
±' I FlM FRMILIFiR WITH THE RELqUIREMENTS FOF: DN-SITE SE[,IERS RND WELLS RS SET
FOF.:TH B"r' THE MLNIt]IF'FIL!T'-," OF RNCHOF.:RGE.
2: i ±,SILL iNSTFiLL 'f'HE :,T_-TEI IN FICCOF.'[,RNCE I,,.IITH ]'HE CODES.
3:: I UN[:,ERSTFiI",I[:, THFlT THE fiN-SiTE SEWER SYSTEM HR¥ RE6!I_iIRE ENLFiF.':GEHENT iF THE ~'~"b~)
RE_,I[:,ENCE IL=; REMf][:,ELE[:, TF~ INCLUDE MOF.:E THFlN 4 BEDF.:OOHS.
S t GNE[:,: _ - ~ ~0 '""~b = (
FiF'F'L. i C:;.R N T E,'OI.,IENt FJ~NSTF'..LIF:T IONS ,~e., ~ --- ~' ~
SOILS LOG
PERFORMED FOR:
LEGAL DESCmPT~ON:
1
2
3
5~
....~, 6
7
8
9,
11
12
13
14
15
16
17
18
19-
20
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
PERCOLATION
TEST
~LocK 2.
0'-/,0' OI~GAA/tc SILT OL
L,r~c~ T0 /40 F~N~, Po0~'I.Y
SLiGHTLy ~o~sr G~ 3/4"~ I,~"
~P
~V~ < 1.0"
~C~HTcY ~O~ST
5~5 ~ WAS GROUND WATER
ENCOUNTERED?
SLOPE
SITE PLAN
7-0
A Jo o
E
IF YES, AT WHAT ,
DEPTH?
Gross Net Depth m Net
Reading Date Time Time Water Drop
- Z 'l -4-: o~ ~ ~;~. y~" v~"
3 , 4: o.~ L ~,,. ,~. I,q ..... _'Z; .........
ff ! q.' ~o %~,~ I.~" Yz"
~ d: ~z z ~,~ 2,0' '/z~
~ i ~,, /'~ ~ ~ ~,'~, s. o'. ~.o"
' Z~ ~ ~ '~ ~,0" I, 0"
d; 33 Z ~,~, ~, ~" ~z "
q 4:40 7 *,'~. 5.~7~ ..... ~z "__ _
PERCOLATION RATE ~. ,~ (minums/inch)
TEST RUN BETWEEN 7 .. FT AND ~"' S FT ¢ ~ °
DATE:
72-008 (6/79)
ANCHO?,a,C,! . ,:~[ AS!<,:', tiqS02-0650
(907) 264 ,i! i ~
,',iA YO f,~
DEPARTMENT OF IlEAl. TH AND ENVlHONMENfAL PROTEC'!
<Permit ~: 821151
~January 31, 1983
TO: Permit Applicant
Subject: Lot 6 Biock 2 Lake O' the Hills East Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
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 ar& 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
" 825 ~ Street, Anchorage, AK. ~501
~,. 264-4720
*'* * HANDWRITTEN PERMrT* *
Psrmit ~ ~\\~ \ W~~,ON-SITE SEWER PERMIT
Location: Phone Number:
Type cf..Soil. Absorption'System Is:
.~ Trench': .~ ,.Drainfield: Seepage.Bed: __'Ho:lding Tank:
Maximum~Number of Bedrooms: ~ Soil Ratin.~(sq.ft/br)
The Required Size of the Soil kbsorptiQn 'System Ts:
.DEPTH. ~/ .EENGTH 7'-~ GRAVEL D:EPT~ ? WIDCH
,~The length.dimension is'-the length(in feet) of th~ tr. ench or drainfield. The
.depth of a~trench or.'pit is the.~istance between ~he surface of 'the ground and
~the bottom.of the-excavation(in feet). :There is no'~s~t~.width for trenches.
~The'gra~el deuth is-the~minimum depth of ~gra~el~-~bet~een cthe o~tfall pipe and
the~bot~om of the-sxca~tion(in'feet).
* * REQUIRED' SEPTIC(HOLDING) TANK SIZE = /~--~ GALLONS * *
Permit~applicant has the responsibility to inform this department, during the
installation ~inspections 'of any'~ells adjacent 5o 'this property.and the number
of. residences that.the'well will .ser~e.
· * * * T~0(2)INSPECTIONS ARE R£QU}R'ED
Backfilling of any system without f'inal ,~nspection'and"approval by-this department
will be subject to prosecution.
Minimum distance'betwee~ a well and.~'any-on-si~e sewage disposal system is 100 feet
for a.private~well.'.or 150~'to 200 feet'~rom a public well depending upon the type
of public well. Minimum cdistance.from a-~private well to .a private, sewer line
is 25· feet .and ~to .a. community ~sewer line is ~5 feet. ~ell logs are required
and ~must~.be r~eturned ~to this .de~ar~ment~it'kin 30 days of the well completion,
Other .requirements may :apply. Specifications and construction~diagrams are
available to insure proper-i~st~tlation.
* * * 'PERMIT E×PIRiES~DE~EMB£R.31~ 1 9 8 2 * * *
T-certify that:
(!) I.am 'familiar with the ~eq~irements~for on-site sewers and wells as
set forth by' thecMun~cipality of~Anchorage.
(2) I will.install the system in accordance with codes.
(3) I--under.stand that the on-slte sewer system may require enlargement if
the-~residence is remodeled to' inc'lude~more that~ ~edrooms.
Applicant
SWP/024(1/81)
f~,~N ~ -% ~,PAL t T¥ OF AmJ~O~
%~a of ¢Ot~ AbsOrpt~o~ Syshe~-~
~a !.a~gth d~menaion 1_~ the ke~q(h(kn ~ee~) of the
,~" i ~;~-i_%)~ Ln~tak% the ~ys~e~ in accordanoe *~-' ,~c~e~,~ - .
..... 6/ ~ f ....
~ l=1 l- I" I r~..J I~-
.... SOILS
PROJECT Lake 0' The Hills TEST HOLE NO. 7
CLIENT H,T. Newton ELEV. TOP OF HOLE 830
W.O. '0716 DATE February 7, 1981
0
1 Organic Material
3 Moist, Brown Sand)/ Gravel, GW
4
$
6 Moist, Brown, Silty Gravelly Sand, SM
7
10--
11
T7 Water Table
13 Saturated, Brown, Silty Sand, Gravel, GM
14
15
16 Bottom of Hole
Water Table at 12.0
17
18 Perculation Rate 8.6 min/inch
19
'Time Depth to Water
20 --
12': 29 6' 9"
21 12:39
12:49 7'0"
22 __ 12:59 7'1-3/4"
__ 1:09 7'3" --
23 1:19 7'4"
1:29 7' 5¼"
24--
25-- --
n ~ ~ n UNWIN · SCHEBEN · KORYNTA · HUET'rL
II
i i, ,,.-.~ ,...~ ,,,~ i ,---.--,I
ANCHORAGE, AK. 99503 276-4245
.. PROJECT___[~ The H~11s
CLIENT H,T, Newton
TEST HOL',.~,NO. 7 '- __
W.O. 0716
ELEV. TOP OF HOLE 830
DATE February 7~ 1981
organic Material
· Moist, Brown Sand)/ Gravel, GW
Moist, Brown, Silty Gravelly Sand, SM
Water Table
Saturated, Brown, Silty Sand, Gravel, GM
BOttom of Hole
Water Table at 12.0
Perculation Rate 8.6 mih/inch
"Time .... D_9_egth to Water
12:29
12:39
12:49
12:59
1:09
1:19
1:29
1011
711-3/4"
7'3"
7'4"
7' 5¼"
UNWIN J SCHEBEN ~ KORYNTA B HUETTL'
r
Municipality of Anchorage 0
• Development Services Department
Building Safety Division ,n
On -Site Water & Wastewater Program C
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. 015-333-08 HAA# 144cpo5-qy
1. GENERAL INFORMATION
Expiration Date: /67/1C. /VS
Complete legal description LAKE O' THE HILLS EAST SUBDIVISION; LOT 6, BLOCK 2,
Location (site address or directions) 7151 MOUNTAIN LAKE CIRCLE ' ANCHORAGE, AK 99516
Current Property owner(s) KATE SANDBURG Day phone 346-2631
Mailing address 7151 MOUNTAIN LAKE CIRCLE • ANCHORAGE, AK 99516
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
O
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, orprior
to closing for the engineering services provided.
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 verify,that based on the
information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Finn ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179
Address 6901 DEBARR ROAD, SUITE 28 ' ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date
Engineer's Comments:
In conducting this evaluation, AKW WC, 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 condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. 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 Is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
By:
tR«. loon Cr
bedrooms, with the fllowing
�%'1? Y OF r cam'
WA S/TE ••,�=
W4 STEN�1 D . m
Jom: PROGRAM R
�' •�
Manitenance Agreements
Supplemental Engineer's Reort
Other
Original Certificate Date: )D A. /0 Z'
I
Municipality of Anchorage 0
' Development Services Department
Sullding Safety Division <
On.Ske Water R Wastewater Program °
4700 South Brag" SL
P.O. Box IN= Anchorage, AK 9951941550
www .cLandwrage ek us
(907)343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: LAKE 0' THE HILLS EAST S/D; LOT 6. BLOCK 2, Parcel ID: 015-333-08
A. WELL DATA COMMUNITY WELL
Well type cuss i1. If A. B, or C provide PWSID# xI� Well Log (YM),
Date completed Sanitary seal (Y/N) Wires property protected (YM)
Total dpptO n. Cased to ft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Data of test
Static water level
Well production ��/ g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform cclonies/100 ml. Nitrate mgJL. r)rh9r bae eria colonies/100 ml.
Arsenio. mgdL. Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL/S•T•E.P• Date Installed 9/24/2002
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation deanout (YM) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping NEW Pumper —
C. ABSORPTION FIELD DATA reELOW FINAL CRADEI
Date installed 9/24/2002 Soll rating 11.p.d ft1bdrm) 1.22 System type TRENCH
Length 44 ft. Width 2.5 ft. Gravel below pipe 6 ft.
Total depth <e.a ft. Eft. absorption area 528 fe Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) — For=bedrooms
Fluid depth in absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: min. Final fluid depth = in. Absorption rate >a — g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) — If yes, give date —
i
D. LIFT STATION
Date Installed 9/24/2002
Size in gallons 1500 Manhole/Access (YIN)
YES .
"Pump on' level at 42 in.
'Pump ofr level at 42 jn. High water alar level at
46 in.
Datum BOTTOM OF TANK
Cycles tested NEW Meets alar & circuit requirements?—)%§.—
equirements?YESE.
E.SEPARATION DISTANCES
11I t' I1�1 TY
C O M M U f V I' I
WELL
YY L �L
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankflift station on lot
On adjacent lots
Absorption field on lot
On adjacent IMe
Public sewer main
Public sewer manhole/cleanout
So -gr /aoyuc service line
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+
Property One 5'+ Absorption field
5'+
Water main 10'+
Water service line 10'+ Surface water
100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'
Building foundation 10'+ Water main
10'+
Water service line 10'+
Surface water 100'+ Driveway, paridng/vehide storage 5'+
Curtain drain NONE KNOWN Wells on adjacent lots 2001+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I cef* that I have determined through field inspections and
review of Munidpal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printedme JEFFREY A. GARNESS
Date `)/3o�t�,L
HAA Fee E 3 i 5 -
Date of Payment 1/0/10/0`7
X
Receipt Number (ori O y
(Rev. 12J01) .
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Applicant Name ~"o~4n (.~e~.~',~,~ Telephone: Home ~ ~O"'" ~(70 Business
Applicant Address "1~,.5'1 I~/'~ l~l'c~' C~'~c(~., //~c/~o/'o~~ ¢¢,.~Wd~
(c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Cor~pany 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
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.
4. SEWAGE DISPOSAL
Onsite [] Public [] Community [] Holding Tank []
Note: If 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 (11/84)
Er~IGINEERING 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 nvestigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequat~
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.
Engineer's Seal
Approved for ~ bedrooms by
Approved ~/' Disapprove~/ '
Terms of Gondit~nal Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
D~r~ 9 ~f 9
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
Well Classification
Well Log Present (Y/N)
Total Depth Cased to _
Static Water Level
Casing Height Above Ground
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
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments ('~,'~
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
If A, B, C, D.E.C. Approved (Y/N) ENVIRONMENTAL PROTECTION
Date Completed Yield , r~r~ ~ '~f'lOR
Depth of Grouting
Pump Set At ~__
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N) ~' Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) N,A.
Separation Distances from Septic/Holding Tank:
Size l ~_~'o ~,¢~' No. of Compartments
Foundation Cleanout (Y/N) ~"
Date Last Pumped ~/
; for
Temporary Holding Tank Permit (Y/N)
To Water-Supply Well ~,/~.
To Property Line '~
To Water Main/Service Line
Course ~
To Building Foundation (~ /
To Disposal Field 7 ~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11184)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed '7 {¢¢ ,/ 83
Width of Field ~ ~ O ~'
To Water-Supply Well
To Building Foundation
Lot
Square Feet of Absorption Area ~/' ~7
Depression over Field (Y/N) ~
Results of Last Adequacy Test /~c4~'~/-~
Separation Distance from Absorption Field:
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
'
'/¢~¢'~'~ Type of System Design
Length of Field ,$~'~ ~
Depth of Field ~L O
Gravel Bed Thickness ~'r''O
Standpipes Present (Y/N)
Date of Last Adequacy Test
Y
To Property Line ~ {~'
To Existing or Abandoned System on
; On Adjoining Lots '.,,~' ,~ ¢
To Cutbank (if present) ~',,4
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (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 T~-.~-"~/-~'~--Date ¢/'.-~/~''~'6'~'
MOA No.
Company F{c¢"/L~
Receipt
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Engineer's Seal
,, APPLI(:, ~T FILLS OUT UPPER HA[~ ONLY
Phone
Buyer
Address Zip Code
Lending Institution Phone
Address Zip Code
Realty Co. & Agent Phone
Address Zip G~de
.?Type of Residence
[~" i~ngle Family i
[] Multiple Family No. of Bedrooms
[] Other
Water Supply
';~ E;}'lnd v dua ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
[] Community For wells drilled prior to that date, give well depth (attach Icg if available).
[] Public Utility
Sewer Disposal
~-'l'ndividual Year Individual Installed:
[] Public Utility When Connected to Public Utility:
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Er'
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
. ~ ~ ~! v~ ~ ~'~c '~ ~
Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received
Well to Tank Septic T~k Size
72-023 (3182)
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
RILL ~HEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
To Whom it May Concern:
According to records on file in this office the ~
~f~/~ ~ Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH & '
ENVIRONMENTAL PROTECTION
APR
RECEIVED
APPLIC, FILLS OUT UPPER HAL .... ONLY
Property Owner ,'~ .,' (. .~'[ /.? ~.'~- :/~ ? Phone
i',,:'~.~ ~ ~ ~-~
Buyer ~ [~ ~.~ I'~' b~ c~
Address Zip Code
Lending institution ~ ~ ~;;: ~ '/ '~; Phone
Address Zip Code
Realty Co. & Agent ;")~ ~ C_ Phone
Address Zip Code
Type of Resi~nce
~-'Single Family
~ Multiple Family No. of Bedroo~ ~/
~ Other
Water Supply
~ Individual A~ACH WELL LOG. A w~ Icg is required for alt wails drilled since June 1975.
~/Community For wells drilled prior to that date, give well depth (attach Icg if available).
~ Public Utility
Sewer Disposal
~- Individual Year Individual Installed:
~ Public Utility When Connected to Public Utility:
~,~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector ~ ( ~nspector
· - ~ *CONDITIONS OF APPROVAL
( ) DISAPPROVED " ~
(
) CONDITIONAL
APPROVAL*
DATE
BY:
Soils Ratin~ ~ate ~wer Inst~ll~d WeJl To Absorption Area W~II Log Received
W~II to T~nk S~plJc T~k Size
& ENGINEERS, INC.
7125 OLD SEWARB HIGHWAY · ANCHORAGE, ALASKA 99502
February 29, 198#
Department of Health and Environmental Protection
825 "L" Street
Anchorage, AK
Attn: Laura Ward
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTIOI"J
RECEIVED
Re: Lake O'The Hillls East Subdivision
Block 2~ Lot 6
Dear Ms. Ward:
This letter is to clarify the confusion regarding the recent
work done by us for Lake O'The Hills East Subdivision. The word
East was inadvertantly left off the name.
Should you have any questions regarding this matter~ please
do not hesitate to contact us at 3#9-6561.
Very truly yours,
David A. Stanley
Geotechnical Manager
DAS:wel 8A
3ob 365#
WASILLA ANCHORAGE SOLDOTNA
(907) 376-3770 (907) 349.6561 (907) 262-9534
& ENGINEERS, INC.
S W
7125 OLD SEWARD HIGHWAY * ANCHORAGE, ALASKA 99502
3anuary 26, 198#
Bowen Construction
3605 Arctic Blvd., No. 1571
Anchorage, Ak
Re: Lake O' The Hills Subdivision, Lot 6, Block 2
Dear Sirs:
Per your request, S & S Engineers, Inc. has collected a water
sample and had it analyzed by Chemical and Geological
Laboratories of Alaska, Inc. for Health Department approval.
This letter certifies the septic system design as-built is
sufficient for the four bedroom house built on the subject property.
Standpipes on the septic tank and at the end of the absorption area
are as required by the Municipality.
The water sample, taken from an outside faucet on the north
side of the house is satisfactory as tested by Chemical and
Geological Laboratories of Alaska, Inc. on 3anuary 25, 198#. The
water is supplied to the house by a community well.
You now need to take the water sample results to the
Department of Health and Environmental Protection on 825 "L"
Street, and fill out an application for Health approval of this
residential property.
Should you have any further questions regarding this matter,
please do not hesitate to call us at 3#9-6561.
William Evans
Engineering Geologist
WE:wi 5A
Job 365#
WASILLA ANCHORAGE SOLDOTNA
(907) 376-3770 (907) 349.6561 (907) 262-9534
" ,,1_ ,/
