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Home My WebLink AboutTRAILS END BLK 7 LT 3 3u..~.~ 98 02:07p JEEEY LERCH [907] 694-850! p.3 ~$KA _~J~AINFI ELD ~RATI ON, INC. To: DHHS Date: Suly 15, 1998 We hereby notify DHHS as required by permit of the intention to terralift the foIlowi~g property. Block: 3 ./ Address: 11481 Browder Ave. A~chorage, Ak. Engineer Consadted: Yes_x_ No.__ RECEIVED JUL 1 6 1998 Municipality of Ancllorage Dept. Health & Human Services Jerry Lea ch Alaska Draiiffield Restoration President NAME LEGAL DESCRIPTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE r-I UPGRADE LOCATION D,STANCETO: J We,, I0(0' JA"s°'Pt'°nar"Io' ~t~ Manufacturer O z < Manufaclurer ~ ~ DISTANCE TO: ~ [ ~ NO* of lin~/ I~Lenq ~ Top of tile to finish grade ~ I__ ~' Material beneath t,le Length W~dth Depth < ~ Ty~ of crib Crib diameter Crib depth ~ Well Building foundation m DISTANCE TO: ~ Class Depth Driller m Building foundation Sewer line ~ DISTANCE TO: NO. OF BEDROOMS Dwelling I PERMIT NO. Width Liquid depth PERMIT NO, Material Liquid capacity in gallons Trench Distance betweeo PERMIT NO. Nearest lot line Distance to lot line Septic tank OTHER PiPE MATERIALS SOIL TEST RATING/ INST~ALLER / APPROVED 724~$3 {Rev. 3/78) DATE LEGAL INSF'ECTION ~UNICIPALIT¥ OF' ANCHORAGE, DUILI>IrH; SAFETY DIVI$ION 5500 [AgT I'UDOF4 I<OAD IN~F'ECTION~ (~07) 563-3464 Al, MINISTRATION (~07) NAME: MOONLIGHT ELEC. CHRG STREET ADDRESS: NHN BROWDER LEGAL: TRAILS END LO~ COMMENT: INSF'ECI'ION~ F([QUESTED: ELECKRICAL 20 ELEC FINAL COMMENTg: I I NO NONCOMPLIANCE OBXERVED ABOVE I I WILL REEXAMINE AF NEXT I I DO NOT C[J~JCEAL UNTIL INSPECTION I~FINAL INSPECTION APF'~OV~D I I AF'F'ROV[D CONDITIONAL FOR ..... FINAL START lINE: STAR'I WORK UNITX: .--__~ TOfAL 78&-0211 F'ERMIF NO: 83-5089 PHONE: '549-00~t DATE: 06/25/84 EXPLAINED REIN~F'EC'IED I'~U~Im3IPFILIT'¢ OF AI~¢HO~:AGE DEPARTMENT OF HEALTH AND ENVIRONI'IENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 9950± 264-4?20 PERMIT DATE ISSUED: m~m~ I TE SEIdER ,~: .8400~3 EHGINEERED DESIGN F"ERt'I T T APPLICANT: ADDRESS: CONTACT PHONE: LEGAL DESCRIP: 'LOT SIZE: FEJES CONSTRUCTION' PO BOX 11-2009 345-5022 SUBDIVISION: TRAILS END · SECTION: 24 TONNSHIP: 22560 (SE FT. OR ACRES> LOT: ~ RRNGE: 3t,I BLOCK: 7 I CERTIFY THAT: i. I AI.1 FAI,1ILIAR ~.IlTH THE REQUIRB'IEHTS FOR Of.I-SITE SEllERS AND i4ELLS RS SET FORTH BY THE f,IUNICIFALITV OF ANCHORAGE (~lOA> AND THE STATE OF ALASKA. 2. I 14ILL INSTALL THE SVSTEM IN ACCORDANCE ~IITH ALL ~IOR CODES AND REGULATIONS, AND IN CO~,IPLIRNCE NITH THE DESIGN CRITERIA OF THIS PEAl'lIT. 3. I NILL ADHERE TO ALL MOA RI.ID STATE OF 8LRSK8 REQUIREI'IEHTS FOR THE SET BRCK DISTANCES FROI,1 RNV EXISTING PIELL, NRSTENRTER DISPOSAL SYSTEM OR PUBLIC SEPERRGE SYSTE~I ON THIS OR ANY ADJACENT OR NEARBY LOT. IF A THEN PIILL ELECTRICAL NORK MUST BE DONE BY A LICENSED ELECTRICIAH. SIGNED ~~ DATE: APPLICANT: FEJES CONSTP~;CT~ON ISSUED BY LIFT STRTIOH IS INSTALLED IN AN AREA COVERED BY I'IOA BUILDING CODES, (i> RN ELECTRICAL PERPIIT AND INSPECTION f'IUST BE OBTAINED,~ (2> AS-BUILTS I-lOT BE APPROVED ~IITHOUT AN ELECTRICAL IHSPECTION REPORT~ AND (3) THE ..J~III~UCIPALITY OF ~NCHORAGE.~.. ("'~ · ~, Department~ ~ ~alth and Env~ronmenta~ ~r~cect~on · -~ · 825 -~ Street, Anchorage, AK. .~501 ~ 264-4720 = Permit WELL AND/~0N-S[TE S~WER PERMIT Location,f ~ ~ Phone N~er: , 4q - gq/ Legal Description:~$ ~ ~ ~ ~ ~P~ Lot Size: ~~ ~ /--' Type of Soil ~sorption System Is: Trench: Dra~field: Seepage Bedt ~Holding Tank: Max~ N~er of Bedrooms: ~ Soil Rating(sq.ft/br) //~ The Required Size of the Soil ~sorption System Is: ' / C NGTH . GRAV C · .X TH The length d~ension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the m~ depth of gravel between the outfall pipe and the bottom of the excavation(in feet). Pe~it applicant has the responsibility to info~ this department during the installation inspections of any wells adjacent to this property and the n~er of residences that the well will serve. Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 $ 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of ~knchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the.residence is remodeled to include more that 3 bedrooms~.-7 S zgne~' ~~ ~~ ' Issued by ../~ ~.~z~/~ SWP/024(1/81) "In the event that a lift station la Installed an electrical permit and inspection must be obtained. A$-builts cannot be approved un- til the electrical Inspection Is received In this office. Tho electrical work must be per- formed by a licensed electrician," · ALASKA ENVIRONM.~.NTA, L, · ' > CONTROL SERVICr 'N' 1200 West 33rd Avenue Suite · , ANCHORAGE, ALASKA 99503 Phone 276-136:1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERPO.MEDPO.= (FEET) I 2 4T · ! 57 6- ell o -~%'~ 11 - ~2- ~D 13- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? DATE P,.FO.MED: SLOPE SITE PLAN S L O P 14- 15- 16- 17- 18- 19- 20- COMMENTS ~0~ ~H-O~4 72-008 (6/79) Reading Date Time 5.t-I.~ ,oroe, I0~ IO'.~ ~o'.~0 PERCOLATION RATE [ ~-~ ~ I / ~.~.'~t~ST R UN BETWE E N Net Depth to Net Time Water Drop 1~ .0~ .Ir~ ~0 ,e<) .o~ .~? CERTIFIED BY: / ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Ancho~ige. Aliska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST 6 7 8' OL. SLOPE 10 11 12- 13- 141II ~ 18- 20- COMMENTS WASGROUNDWATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date Time Time 72-008 (6/79) Depth to Net Water Drop .w- ~'3 · v~5'7 :Z,v, .ss ALASKA ENVIRONMENTAL CONTROL SERVICr'""NC. 1200 West 33rd Avenu'~ ,~Jite B ANCHORAGE, ALASKA 99503 Pho~ 276-1361 . . CALCULATED BY I~, ~'~l~J DATE ~)~)Ul ~)~ SCALe I ', 2 ~ ".' CONTROL SERVIC~ 1200 West 33rd Avenue ~uite ~CHORAGE. ~SKA 99503 ~ 276-1361 . . ! I , . , ~ , , : , ~ ~ , . · SIX iNCl-{ ,,','ATE~R. II_LED AT THE F,?:'-/TE gl-- . ..:-~ ........... FI-:R J"OOr, VuEI. L LOg: 2~---5~~ ~ ~z~ ~,~A 3~.~ ~;'. I~ ~ ILz ~'~=.~ Z~~':..:~<',,'~ ~-'.t~'_~,~.% ~:/J. ~).~ '-, - c~ Z,~d~(.~. ~r~.~ 159 ~ 195 374 ~tet.:e *:~",~.~.z;~.'.z ;:.z..F .~t~uL4 Z z Zn~t:.tZ~ 20 ~,~t ~:~. bc.~,~.~ ~.':-?~:.~ .t~ cosr INCLUD£'$ ~M.L L.~,DOR AND t~;~,'rERIAI. FOR CO~PLr~ION ~,~./1' TH/.~4i~ YOU %'ERY MUC~. ALASKA 6i uIROI]Fn6I TAL CORTROL IRC. ~ncjin¢¢rifl~ ~ ~nuironmcnlol Slu~,¢s SPECIFICATIONS FOR ELEVATED BED ALTERNATIVE WASTEWATER TREATMENT SYSTEM- LOT 3, BLOCK 7, TRAILS END SUBDIVISION 1.0 GENERAL 1.1 THE DRAWINGS, SHEETS 1 THRU 2~ SHALL BE A PART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKHANSHIP SHALL MEET THE REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONHENTAL PROTECTION PERMIT AND REGULATIONS. 1.3 IT IS THE RESPONSIBILITY OF THE OWNER TO OBTAIN ALL NECESSARY PERMITS OR EASEMENTS, 2.0 SEEPAGE BED 2.1 THE GRAVEL FOR THE BED SHALL BE SCREENED TO 0.5 TO 2.5 INCHES PER CODE. 2.2 THE BERM AROUND THE SEEPAGE BED SHALL BE CONSTRUCTED OF IMPERMEABLE MATERIAL, AND ON A SLOPE OF I FOOT VERTICAL PER 3.0 FOOT HORIZONTAL. 2.3 THE BOTTOM OF THE EXCAVATION SHALL BE RAKED NITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. THE BOTTOM ELEVATION SHALL BE PLUS OR MINUS 2". 2,4 THE DISTRIBUTION PIPE SHALL BE 4 INCH RIGID PVC OR POLYETHYLENE. THE PIPES SHALL BE LAID LEVEL. 2,5 AN OBSERVATION PIPE SHALL BE PLACED AS SHOWN IN THE DRAWINGS. IT SHALL BE RIGID PVC, ASTM 3033 D-3034o THE SECTION SHOWN NITH HOLES MAY BE EITHER DRILLED 0.5" HOLES @ 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE OR A REGULAR SECTION OF REGULAR PERFORATED SEWER MAY BE CLAHPED TO THE SOLID SECTION ~ITH A NO HUB COUPLING OR SOLVENT JOINT. A RUBBER RAIN-CAP (JIMCAP OR EQUAL) SHALL BE PLACED ON THE TOP OF THE PIPE. 2.6 THE INSULATION SHALL BE DOW EXTRUDED BLUE STYROFOAH BOARD, ARCO GEOFOAH ENBANKMENT INSULATION BOARD Og ~/ESTERN INSULFOAM II OF THE THICKNESS SHO~N ON THE DRAWINGS. 2.? THE TOP AND SIDES OF THE BED SHALL BE PLANTED ~ITH A ~HITE CLOVER AND RED FESCUE MIX OR BLUEGRASS. MUi~/ICIPALITY OF ANCHORAGE Department of Health & Human Services · DIVISION OF ENV RONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D.# ~/.<r' /~,~ z:~..3' · * .HAA# .1. GENERAL INFORMATION (Must be c~)mpleted prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) (b) Property owner ,~:e"t,///',,/~',~k/,~',~',t,,'-.,..-.~. Telephoge: (home) J'~'~'-q'7'5'7'Business ~,''~ .' j+'~'. "7''* ,. · Mailing Address 2;' "*~'"."~'~:~'~"~'g,: :, ...::. ,. ', (c) 5-?, -: ....... ~..-*~' ~':Telephone .,:,.. ,., ,, ,',,-,.-C~....---,_ .,...:~ .¥ · ".Z "?'* ..... .';' (d) ,~?,,,'E~:[ ~'-- ~-". o' Lending Institution Mailing Address Real Estate Company and Agent Address ' . Telephone (e) Mail the HAA to the following address: (or ch~ck hei'e ~,lf hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family ~" Number of bedrooms 3. WATER SUPPLY Individual Well [~ Community I-I Public 1-1 ~ Note::lf community,well*system, must have written confirmation f, rom the State Department of Environmental ;' 'cd'n~:~;ationattesting':t~){h'legalityan~l'St.~,~? · :./: ..... ~..~ ·., ~..... ~ ~ :, ,-:.. .... 4,.'SEWAGE DISPOSAL , ............... ,; On-siteEr' ~. Publicl-I ~..Communityl-I Holding Tank C] .....-. .... '7 ': -.,.: : "Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and statu§: ......... 72~ (~,.?~) Page I of 2 '~JOM speeu!§ue IgUO!SSejoJd gq1 u! 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Slql lo el~p gq1 uo loelle ul suo!l~lnSaJ pu~ 'saoueu!pJo 'sapoo elelS 'pug led!o!un~ lie ql!~ eoUe!ldmoo u! si melSXS lesods!p Jale~else~ Jo/pu~ ~lddns Ja~e~ el!s-uo gq1 'uo!loadsu~ pug UO!leS!lSa*ul Am ~oJj pug sal!j e~eJOqOUV JO Al!l~dlolun~ gq1 moji peu!elqo UO~e~JOJU! eqt uo paseq leU1 ~J~JGA JaqpnJ I 'u~eJaq paleo~pu! eJnlO~lS Jo edX1 pug smooJpeq jo Jeq~nu gq1 JoJ elenbepe pu~ I~UO~lounj 'ales si malsXs lesodsip JOi~MOISeM JO/pUg Xlddns Jai~M ellS-UO gq1 leqi SMOUS I~AoJddy ~i!JOqlnV qll~eH s!ql Io uoileSllsaAu! Xm leql XI!JeA I '~oleq UMOqS elep uo!lepJleA aql Jo se pug OlaJaq paxule leas Xm Xq peu!pe3 sv NOIIY~aO~NI aNY v~va 'HOOVES aql~ 's~s;z 'SNOIIO~dSNI ~NlalAO~d ~ld ~NI~NI~N] 'g A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA). CHECKLIST- FEBRUARY 1984 ' · *' 343-4744 Legal Description: ~. Well Classification' ,,~,,,e///.e~' Well Log Present (Y/N) ~' Date Completed Total Depth/~.-~" Cased to ~_~.~l~;~'~'~/f/~r~uting Static Water Level ~-~', Casing Height Above Ground Electrical Wiring in'Conduit (Y/N) ~'/ SEPARATION DISTANCES FROM WELL: ~' - To Septic/Holding Tank on Lot /~ ~- ' ' If A~ I~; C, D.E.c. Approved (Y/N) /P/,,~ Pump Set At Sanitary Seal on Casing (Y/N) J"' ' · Depression Around Wellhead (Y/N) ; On Adjoining Lots T6N'eal;e~t,E~g~0f'Abs~rptJonField'o'nl-ot ~:/~'/ ' ;OnAdjmnlngLots ~ _,'-' To I~e'~ie'st Public ~ewer I~i~e' ,,~./,~, ' "' T6 Ne~'est Public Sewer CleanouVManhole To Nearest Sewer Service Line on Lot ~,~' '"' Water Sample Co.l!e.c!ed ,by., //, ~5~'~,s' ; Date Water Sample Test Results ~,~,,V',,"~''''~ -/tx/ /' ''~ ~.s.. : .: 'L~'t, ' ' Comments ,/~_~"'~'~"~-.~e~//~,e~,~ -~',~.~.s- ~_. ~_~[ Z.~,~'~* ('~ ~'~"~',~,~/',.) ~:¥--,,r~.-' B. SEPTIC/HOLDING TANK DATA Date Installed lz/z~'~' Size /~'~'~:~ NO. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary I~tolding Tank Permit (Y/N). Standpipes (Y/N) y Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance C?tact on File (Y/N), Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FRO.M SEPTIC/HOLDING,TANK: ' ' '~ ;: f : . ;.:f ~e,~,~.a.~r' ~'~#~'] . . . ' ' TO Water-Supply~;Welr ~-,,~'/O~'__ _ ~* :"; ! ~ = .,,/To Building Foundation .... .......... To Property Line ¢-- '~ ~ To Disposal Field To Water Main/Se~tice'L. ine' 0~.~,'h~.~: ~. To Stream. Pond, Lake or Major. D'ra~n~g~ Course Comments Page I of 2 C. ABSORPTION FIELD DATA ' .Soils Rating in Absorption Strata ,"',~'.~ Date Installed · Width bf Field "~.~ ' ' Square Feet of Absortion Area ,~' Depression over Field (Y/N) Type of System Design Length of Field -~ ~ Depth of Field :~ ' '~/- ~ --Gravel Bed Thickness ~' ",~4'Z.~c~.,, ~'/,~,, Statndpipes Present (Y/N) ~" · . Date of Last Adequacy Test Results of LastAdequacy Test ,,~,~$~/.'~ .,,"?~,,.. .~ ,~'~,~.~,~, '~OoX e' ' ' SEPARATION DISTANCE FROM ABSORPTION FIELD: :_3 .. .... To Water-Supply Well ,/~/ ( /~'~ ~oPrope~yLine 'E~ ' ' To Building Foundatio~ ' Z ~ To Existing'dr Abandoned System on Lot ~' ; On Adjoining Lots ") ~ To Water Main/Selma Line ~ ~ 7 To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ~ - - - Comments.~~ ~&~ ~ ~ +~ '~ ~ ~ D. LIFT STATION Date Installed ~ ~,-,.~ e~.~ .,~'_ ~,~'.=~,-~ _ ... .. .... - Sizein Gallons / ~'! '~'~t,~'/[''a,~'v=' ' ' "Pump On" Level at -' -~ ~ ,~-,.~"' .... ' ' "PumpOfr'Le{/elat "~"~-~' ...... · '. · ' H gh Wafer Alarm Level at ' ' ' "f/' ' ' "~- ~;' "' Tested for , ~. ~" '..... (""~-'7 ~ .?...;~ o/~ '~ ~E.g",~/.~-~ . ' · 'Pumping Cycies during Adequacy' Test. Meets MOA Electrical Codes (Y/N) Comments **Check Permitted Bedroom Rating Against HAA Request*,* I certify that I have checked, verified, or conformed to all MOA and inspection.' :, . . . Company ,,~'~,,~, ~ Date ~'//~ ..I'~/ . MOA No. Receipt No. "~ ~744 ~/~ ~ff:)~ )e x Date of Payment ,-~- R~- ~ / Amount: $ /~, ~ Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 effect on the date of this Engineer's Seal ~ t'l'.e e:~t'cF, ce oF any eaSt..T:er~5, COCd~:~lt;, 0;' I'L'- ! !~skln~ bour;d.~iv or f'{-n:e lh~es. The surveyor CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633 B STREET ANCHORAGE. ALASKA 99518 TELEPHONE(907}562-2343 FAX: (907) 561-530! Date {~epoxt T:le~ed: MAY'20 9: t !.8(35/" / Collected MA! lg 91 e 09:42 hze. Recelved ~I! 20 91 I 09:1S hz*. Cltent Aoct :~AERYBA B?O I PO ! NOHE [ECEI;~D Req I 0:de:ed By :I{ARRY BA~E$ L&borato:~ Supervlso: :SYE?HE~ C. EDE 1)HAZY liTES YECH. ~.~.,..~ ~: ..~.,,~-- ~. ~ Che,~ab ~ef I: 912096 Lab Smpl ID: i Matrix: Allowable Pale)etel )e)te~ lesult ~nltm ~ethod Vesta ~e:~ozmed See Special Ir~t~uctlor~ Above UA-O~vailable Mona Data:ted "See Dample Remarke Above Not Analyzed LT-Leee ~han. G~-G~eatm: ~han MUNICIPALITY OF ANCHORAGE ~:) / ~- DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMEI~TAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILIW 2~744 " Application Date ~/~ GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot. block, subdivision, section, {ownship. range) Location (address or directions) (b) Property Owner ~ ~}~'t~.~ Telephone: Home Mailing Address ,c} Lendinglnstitution Ne","~'~-[~'"~ I~"r'~reJ~'~L Telephone Business (d) (e) Mailing Address Real Estate Company and Agent Address Telephone ~[-'7 G - Mail the HAA to the followina address: or, Check here J~ if hold for pick up. List contaot person end day phone number below. ,! TYPE OF RESIDENCE Single-Family'~ Number of Bedrooms WATER SUPPLY Individual Well ]~ Community rq Public r'l Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite/~ Public I'-I Community D Holding Tank f-I Note~f community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or w~stewater 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 tl~e 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 ins~ect~ion.. ~ Name of Firm Address Date ~Telephone AL zL' Engineer's Seal DHHS APPROVAL Approved for 7'~/_~-~,)bedrooms ~y Approved ~ Disapproved Terms of Conditional Approval ~onditional Date CAUTION The Municipalify of Anchorage Department of Health and Human Services (DHHS) issues Healtl~ Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. Page 2 of 2 ~-o?s IRev 8/66i eJck -- O~ I"~C~-~ 0\q~$\C~ HEALTH AUTHoRiTy APPROVAL (HAA) · ~\C\?k.~'~%%~\C~*~ CHECKLIST; FEBRUARy lg~ Well Classification 'J~ ~ ~ If A. B. C, D.F_(~. Approved (Y/N) Well Log Present (Y/N) ~ Date Completed ~'//~'/~-~ ~I/ Yield TotalDepth I~ C~to ~0~ Depth of Grouting ~0~~ 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 To Nearest Public Sewer Line CleanouUManhole N Water Sample Collected by Water Sample Test Results Comments Pump Set At ~'/~ 7 Sanitary Seal on Casing (Y/N) Y' Depression Around Wellhead (Y/N) I%1 ; On Adjoining Lots I 0 ~ ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot B. SEPTIC/HOLDING TANK DATA Date Installed ~/. ~4:~.~ t/ Size I ~ NO. of Compartments 'T'~I/O Standpipes (Y/N) -,r'l~,'o Air-tight Caps (Y/N) ~7/ Foundation Cleanout (Y/N) ~/ Depression over Tank (Y/N) ~'~ Date Last Pumped ~. 7 · ~ ~.~' ~.f,a~ ~ g ~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) 1'~'/~, Separation Distances from Septic/Holding Tank: To Water-Supply Well I O ~, TO Property Line ~ · ~ To Water Main/Service Line .~' 17 Course /~ 0 61 I= ; for Temporary Holding Tank Permit (Y/N) To Building Foundation J *~ To Disposal Field I~ To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026( 11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date nsta,ed 3 U Width of Field ~ ~ Square Feel of Absorplion Area Depression over Field (Y/N) N Results of Lasl Adequacy Test '"'P~, Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To SIream/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 '~ Gravel Bed Thickness Standpipes Present (Y/N) Date of Lest Adequacy Test To Property Line ~,, ~ To Existing or Abandoned System on On Adjoining Lots IO,4~ t~ TO Cutbank (if present) /'~ O P~ D. LIFT STATION Date Installed ~ Size in Gallons "Pump On" Level at High Water Alarm Level Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump oIr' Level at · Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or c,e~nformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company MOA No. Receipt NO. Date of Payment /-/C//~ ,~' Amount: $ Page 2 of 2 Engineer's Seal CONSUL~'ING ENGINEER 203W 151hAVE'*C"SUITE 203 ANCHORAGE. ALASKA g9501 TELEPHONE.(907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LbCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: Lot 3, Block 7 Trails End 11481 Browder Dough Damrow Single Family On Site FROM MUNICIPAL RECORDS: ~; TANK: Greer Steel, 1000 gal. 2 comp. ABSORPTION SYSTEM: Bed ABSORPTION AREA: 828 sq ft SOIL RATING: 183 INSTALLATION DATE: July 1984 DATE OF LAST PUMPING: April 6, 1988. Isaacs Pumping Service DATE OF TEST: April 6, 1988 TEST PROCEDURE: System was inspected and ~easured. Tank was found with 2.5 feet of cover and a liquid level of 48.5 inches. Lift station was 73 inches deep with a high water level of 18 inches. Bed monitor tube was 4 feet deep and dry. 750 gallons of clean water were added to the lift station. Pump on was found to be at a liqui~.dept~ of 18 inches. Pump off was at 8 inches. 25 gallons were Pumoed pet cycle. 1.5 inches of water were meant]red ~n ~h~ ~,,m~ ~4~r a~ng t~e water. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. ' NOTE The operational ·life of all septic systems depends on t'he local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by. the system. These conditions are outside the control of the .evaluator of this septic system..We.can therefore not give. any estimate of how long this system will function satisfactory for current or future occupants. RESIDENTIAL WELL INSPECTION LEGAL: Lot 3, Block 7, L6CATION: 11481 Browder OWNER: Dough Damrow TYPE OF WELL: Single Family W~LL LOG. AVAILABLE~ Yes INSTALLATION REQUIREMENTS MET:Yes WELL YIELD FROM WELL LOG: 4 Trails End PUMP YIELD FROM TEST: 6 gallons per minute DATE OF INSPECTION: Apr$1 6, 1988 TEST PROCEDURE: Well was pumped at a constant rate while the drawdown was monitored with an acoustic probe. At the 'beginning of the test water level was found at 58 feet below top of.casing. At a pumping rate of. 6 gallons per minute the water level dropped to 137'feet after two hours of pumping. A total of 750 gallons were pumped. The well recovery rate was monitored for 15 minutes. The well recover to 90 feet during this period, a 59% recovery. .. .. TEST FOR E.COLI AND TOTAL NITROGEN: Water was and total nitrates on April.8, 1988 E.Coli 0. Total Nitrates 0.95mg/1. . Max. allowable Total TEST ~ESULTS: This well meets the Municipality of Anchorage. THIS WELL WILL PRODUCE MORE THAN 3 GALLONS THAN FOUR HOURS tested for E.Coli Nitrates 10mg/1. requirements of the PER MINUTE FOR MORE The 'Municipal requirement.for well flow is 150 gallons of water per bedroom per day. This well exceed this requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. APPLICATION FOR HEALTH AUTHOP~TY APPROVAL Lza~',FICATE . · in l~ude l_~ot, .b)cx:k~ sub~tv~si~cx~ sectim, t. oe, nship;:.zmnge) :..: [Pacje;l'of 2]: ' ' ' '. - 2-15-84 Engineering Firm Providing ~nspections, T~sts, Data and ~nfc~,~ation I certify that I have Checked, ~rified, c~ conf(x-med to all MDA HAA Guidslines in [Pa~e 2 of 21 . 2-15-84 A o ~ELL I~TA .. J~UNICIPALITY OF ANCHORA(~ MUJ~CTPAL'I'TY OF ,;~'JCHOJ~'%GE [,MOA, J DEPT. OF HEALTH ~ A%J"i'J"]OJ~[T~ A~J:~C)VAL (J'JAA)ENVII~ONM[NTAL PROTECTIO~J CHECKLIST - FEBRUARY 1984 Jill 6 '1984 Legal Description:,~ ETV Well Classificatic~ -xuD · Wen Total ~p~ C~i~ ~i~t ~ ~ ~, W ' E~i~l ~i~ in ~it ~ati~ Dis~s ~ ~11: To ~i~oldi~ Ta~ To ~st To ~st ~blic If A, B, ~ C, D.E.C. i~o~sd(Y/N) Date Completed /o A,~ ~¥ Pump Set At Yie Id Sanitary Seal ~ r~i~ ~ ~essi~ ~ ~l~ad (Y~ ~6 I01 ; On Adjoining Lots ~-T/O. ! ; On Adjoining Lots C~T/oo To Nsa=est Public Sewsr Cleancut/Manhole ~ To Nsa=est Sewsr Service Line on Lot Water Sample Collected By ~ ~0.~)¢~ ; Date ~J Water Sample Test Bssults ~%~ B. SEPTIC/%]OLDING ~ ~I~TA Date Installed ~-%O-~ Size /OdO 7~[ No. cf Cc~a~tmsnts ~-- ~i~in~n~ ~a~ ~ Fi~ (Y~)~ ; f~ ~ ~ldi~ Ta~ Hi~te~ ~ (Y~) ~ ~ ~ldi~ T~R ~t (Y~) ~ ~ati~ Dist~s ~ ~ptic~ldi~ Ta~: TO Building Foundation I~o~' To Disposal Field /O' To St~e~, Pond, Lake, (~ Major D=ainage 2-15-84 Cm Date Installed q-~o~d/~-';o~ I~r~th of Field Width of Field Square Feet of Absc~ption Area De~essi~ over Field ~y~N) Depth of Field B- ~.~ Gravel Bed Thickr~ss (~" Standpipes l~esent ~N) Dete of Last 2~quaey ~st ~A- D. LIFT Date Installed Si~s in Gallons "Pump On" fe~l at High ~ater Alarm Level at Tested foe Electrical ff...o~ ) Km/dS/s [Page 2 of 2] 2-15-84