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HomeMy WebLinkAboutVALLEY VIEW TERRACE BLK 1 LT 15Vol y View Terrace lock I Lot I 050- 352 -30 (-}  Municipality of Anchorage 0~;~!7 ~t' '-:'?,i,~- Development Services Department :~ ~: Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW030382 PID Number: 050-352-30 Name: Lynn Klip.~el Wastewater System: [] New [] Upgrade Address: PO Box 775~!91, Eaale River. AK 99577 ABSORPTION FIELD Phone: Number of Bedrooms: 694-2o3 a [] DeepTrench [] ehallowTrench I'! Bed [] Mound [] Other:. Soil Rating: Total Depth f~om original grade: LEGAL DESCRIPTION 1.2 GPe~e 5.5 Ft. Block: Lot: Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe: I 1 5 Valley View Terrace 1.85 Ft. 3.65 Township: Range: Section: Fill added above orfglnal grade: Gravel Length: 0.66 - 1.45 Ft. 41 Gravel width: Numbe* of lines: I Distance between lines: Well: [--I New [] Upgrade 5 Ft. I I NA F, Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 162 Ft. 162 F, 375+ Ft' D3034 & F810 Dallier: Date Drilled: Static Water Level: Installer:. Date Installed: $~lliVen 9/19/0~1 117 Ft. RPC 9/30/2003 1 0 G~'M unknown Ft.I 2 SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:. To Septic Absorption Lift Holding Public/Private Manufacturer; CapaCity: Tank Field Station Tank SewerLIne Existing 1000 Cal. We, 100'+ I 00'+ NA NA 25'+ Ma,,~: ,ummo~Compa~,o,~: 2 S~r~a:eWater 100'+ 100'+ NA NA ~ / LIFT STATION ~ot Ur. 5'+ 1 0'+ NA NAA ~e: M..uta~u~er: Gal, Fo~.da~on 5'+ 1 0'+ NA NA 'Pur~p on' level at: 'Pump off' level at: I High water alarm at; In, In.I In. Cu,~n Dra~, NA *50'+ NA NA Pur~p Make & Model Electrical Inspections performed by:. Remarks: Inte[Irity of exist/nil tank visually BENCH MARK Location and DeSCription: verified and insulation added to tank Bottom of siding Assumed ElevaUon: & field. E~t~,~o- ~;c~c ~[q.b ~,~o~-~. 100 Original well decommissioned, Engineer's Stamp Inspections performed by: KND Enaineerina._ __ Inc. Dates: 1 st.,O.Z.;T0..~Q.0~ ~,'.~'~,~,,..~,.,. , 2"~ ~ Development Services Department Approval '., ~,?,, CE 7~ ~ Reviewed and approved by: /'"~--~_ / ~/- ~4-<.~ Date: / 0 -/..~** O~ '*~ :<''~:'**' .."'c~'"' AS-BUILT SYSTEM DETAILS/SITE PLAN PerM~t~ SW030382 VALLEY VIEW TERRACE SUBD, BLOCK 1, LOT 15 PID# 050-358-30 ~ ~B~r~~ X ~/~, N50'46 20 W 86.07 (R) /, I ....... ~-c= 3~,7' ~ ~ A-D= 46,6' B_D=59.7' ' ~ FINAL GRADE ~ ~L' ~ ......... . ....... .. ,....., ...... . ....... . ~-F=--~ ...... ~('~ ~ ~1:~ I ~~~ ~ 4,, I LYNN KLIPPEL PD BDX 77339 EAGLE RIVER, AK. 99577 (907) 694-7394 FIELD BOOKS coueult, o: ENGINEERING eOUNO~Y: NA ~: S,~NC: NA ~c~=: KMD 20441 PTARMIGAN BLVD. · ~u,Lt: NA oxm 10/9/03 EAGLE RIVER, AK 99577-8736 SW160 L[ ...~..........v.....v...............v...................v.....v...........v.................~.v.........~.........~.......v......... .v... j · c, emO3066.DWG ~.o.: 03066 (907)090-611I/F~ (907)690-8111 by' SULLIVAN WATER WELLS P.O. BOX 6702/2, CHUGIAK, ~ 99587 kTTENTION'. It is the respons~llity of the prope~y owner to submit a copy of the well log to the p~3per authority. Municipality )f Anchorage: Depafiment of Health & Human ServL-e,s and/or Department of Environmental Cone, aeration. MatSu Borough: 3epartment of Environmental Conservation. ;0/I0 Bg~d N~^IqqRS GS~889 [0:00 GGG;/;0/;0 MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Upgrade Date Issued: Sep 17, 2003 Expiration Date: Sep 16, 2004 Permit Number: SW030382 Legal Description: Design Engineer: 0070 KND Engineering Owner Name: Lynn Klippel Owner Address: PO BOX 773391 EAGLE RIVER, AK 99577-3391 Parcel ID: 050-352-30 Site Address: 009011 WALLACE ST Lot Size: 47916 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ~-I Disposal Field r-'] Septic Tank Holding Tank I-"1 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. Received By: ~ Issued By: ~ ° ~ Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci .anchorage .ak.us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-352-30 Permit Number SW ~,/~.~ ~ ~ Property owner(s) Lynn Klippel Mailing address (1) PO Box 773391; Eagle River, AK 99577 Mailing address (2). .Zip Code Legal description (Lot; Block & Sub'd.) · -Valley .View Terrace, Block 1.. Lot 15 Legal description (Section, Township & Range) .~ (3 II ~%,)~'_,~, \ (~ r~ ~ ~..,~3~_, Lot Size ~C( \ (.~ THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Acre~ Number of Bedrooms 3 Day phone 6 9 4- 2 0 3 5 [] 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. (Signatu['e/of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) ¢' s-cb Waiver Fees: Date of Payment: · Receipt Number: (907)696-6111/FAX (907)696-8111 September 10, 2003 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Septic & Well Upgrade Permit - Valley View Terrace, Block 1, Lot 15 Gentlemen: The owner has requested we proceed forward to obtain a septic and well permit on the subject lot. On September 3, 2003 one testhole was performed for the proposed system. 'The results of this test are attached. The general slope of this lot is from north to south at a grade of approximately 15-20%. We have designed our system utilizing the existing testhole that was excavated for the existing 3-bedroom house. The existing well on the lot does not meet MOA well production requirements. Therefore, a new well is to be drilled in close proximity to the existing well. The existing well will be properly decommissioned. We propose to install one 5' wide shallow trench. Water was not encountered during the excavation and was measured at 10.5' during monitoring. The existing absorption field encroaches groundwater and will be abandoned. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, ]I~]]D Engineering,m Inc. Attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test Owner/Contractor Specs /ELL & /ASTE /ATER DISP[]SAL SYSTEM VALLEY VlE~4 TERRACE SUBD. BLrlCK 12 I I 16 ND PUBLIC VELL$ VITHIN 200' I~' PRDI~SED SYSTEM. ~ ~IVATE ~LLS VITHIN eO0' ~ PR~SED SYSTEH EXCEPT AS ~TED. ~ ~EPT[C SYSTEHS VITHIN 2~' OF PR~OSED ~LL EXCEPT AS ~TED, DETAILS/SITE 1, LOT 15 PLAN 14 2A DESIGN DETAILS 3 I)DRM X 150 GPO = 450 GPI) 450 GPO/I,2 GPI) PER SQ, FT. (1,62 MIN/IN.)= 375 SQ. FT (375/5'(W)) X .54(RF) (3,5' GRAVEL) = 40.5 FT. TRENCH USE I TRENCH - 41' (L) X 5' (W) X 3.5'(D) To't~l dep~:h oF sys'tem Is 5.5' £r'om orlgln~t grc~de, To't(~l dep'l:h oF grc~vel betow dis'trlbu~;Ion pipe Is 3.5'. NOTES, 1, VERIFY EXISTING TANK INTEGRITY &/OR REPLACE WITH 1000 GAL SEPTIC TANK, INSULATE IF <4' DF COVER, INSULATE TRENCHES WITH 2" HD I)URIAL FOAM. 3. CONTRACTOR WILL ENSURE MINIMUM 2Y. SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL I)E ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED, 5. CONTRACTOR WILL ENSURE ALL SEPARATIONS 'TO ADJACENT WELLS, SEPTICS, LOT LINES, FOUNDATIONS AND ALL OTHER SETI)ACKS. PREPARED FOR: LYNN KLIPPEL PD BOX 77339 EAGLE RIVER, AK. 99577 (907) 694-7394 ^c~ nm 03066.DWG D^~: 9/9/03 cmo: SW160 ~ "°': 03066 Scare: 1'= 100' PAGE 1 DF 2 ~D ENGINEERING 20441 PTARMIGAN BLVD, EAGLE RIVER, AK 99577-8736 i i ~/ASTE~/ATER DISPOSAL SYSTEM DETAILS VALLEY VIEW TERRACE SUBD, BLBCK 1, LBT 15 s( 4~ 41' TMO3-~ CO 33' PREPARED FOR: LYNN KLIPPEL pn BOX 77339 EAGLE RIVER, AK. 99577 (907) 694-7394 FIELD BOOKS eouaoxm,: N A STAKING: NA ASSUILT: N A OW,T,. fiLE: c~rc~zo: KMD o^m 9/9/03 ~o: SW16 0 Sca[e, 1'= 20' PAGE 2 DF 2 ]-~ ~[~ ENGINEERING 120441 PTARMIGAN BLVD. ^c,m ntt: 03066.DWG ,x)e No.:. 03066 ~D ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST Performed for: Lynn Klippel Date Performed: 9/3/03 Project: Valley View Terrace, Block 1, Lot 15 TEST HOLE # 03-1 11- 14- Depth (Feet) 16- 17- 18- 0RG/OL GP-SP mod. density'w/'ttades of silt & cobbles to 2' Silt & moisture increasing w/ depth SM - B.O.H. SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO What depth? NA Depth to water after monitoring? 10.5' Date? 9/10/03 Reading Date Gross Net Depth to Net Time Time Water Drop 1 9/10/03 1:00 7" . 2 1:10 10 min 9/16" 6 7/16" 3 * 1:11 7" . 4 1:21 10 min 12/16" 6 4/16" 5 * 1:22 7" . 6 1:32 10 min 12/16" 6 4/16" 7 * 1:33 7" . 8 1:43 10 min 14/16" 6 2/16" 9 * 1:44 7" _ 10 1:54 10 min 13/16" 6 3/16" 11 * 1:55 7" . 12 2:05 10 min 13/16" 6 3/16" · Water Added 19- 20- HOLE PRESOAKED PRIOR TO TEST Percolation Rate 1.62 Test Run Between (min/in) Perc Hole Diameter. 6" feet and _ 6 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. ' � _ GREA»d ANCHORAGE AREA BORU�jGH Department ofEnvironmental Quality 3330 C5treet Anchorage, Alaska S9S03 LOCATION INAPE�TION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LEGAL DESCRIPTION SEPTIC TANK: DISTANCE NUMBER OF FROM WELL MANUFACTURER MATERIAL COMPARTMENTS INSIDE LEwu/HINSIDE WIDTH -LIQUID ospT*_____uQu|oC*PAC|Tv_-���_'? GALLONS. SEEPAGE P%: NUMBER OFPITS DIAMETER -OR WIDTH ��. +r LENGTH ~' DEPTH L|m|N8 MATERIAL _�=����_-_ CRIB SIZE: D|AxxETEn___oEpTn_� DISTANCE FROM: TOTAL EFFECTIVE ' �4- BUILDING FOUNDATION_ NEAREST LOT LINE--. *oSOmpT|Ow AREA (WALL *RE*) SQ. FT. ADDITIONAL ABSORPTION V WELL: TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION _____. LOT UNs____-- cs3spoOL_______-. OTHER souncES_ APPnOVED_______D|5apPROVED INSTALLED BY: PIPE MATERIAL: LOT SLOPE: NEAREST . SEWER LINE DATE.. DIAGRAM DFSYSTEM -DISTANCE FROM: SEEPAGE SYSTEM dtfing lfl[xg Tau trb 3 t t by A & L DRILLING COMPANY 13OX 97, EAGLE RIVER, ALASKA 99577 o TELEPHONE 694-2588 ©� OWNER OF LAND a DEPTH OF WELL ADDRESS STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION L2 7" L t#_ _ gym= .` `tg °—"'DRAW DOWN FT. DATE - Started {`{ Ended "' Z ( GALS. PER HR _ ` PERMIT NUMBER m KIND OF CASING KIND OF FORMATION: From Ft. to ,�- Ft. From Ft. to Ft. From Ft. to Ft. ¢ a1 rt From Ft. to Ft. From Ft. to Ft. 5�' Ze Yea. "' From Ft. to Ft. _ From Ft. to it Ft. From Ft. to Ft From -Ft.to Ft. x _`E From Ft. to Ft From -Ft. to r Ft. dip ; t .=w ,� � � � � � � " '`.� �.- From Ft. to Ft. From_ 4, Ft. to Ft. �� F'•n � � d � ,� From Ft. to Ft. From Ft. to Ft.'Orr 6',<' ' n f' From Ft. to Ft. From Ft. to Ft. n` % '1'4" vT,4 From Ft, �o Ft. From Ft. to Ft. From �"�:%ft to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. Froin Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: DRILLER'S NAME Municipality of Anchorage Development Services Department Building Safety Division ~ On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A.SINGLE FAMILY DWELLING Parcel I.D. ~050-352-30 1-13-o_ HAA # Expiration Date: GENERAL INFORMATION Complete legal description Valley View Terrace: Block 1.. Lot 1 5 Location (site address or directions) 901 1 Wallace St... Eagle River: AK 99577 Current Property Owner(s) Lynn Klippel Dayphone 694-2035 Mailing address PO Box 773391, Eagle River, AK 99,577 Lending agency Day phone Mailing address .RealEstate Agent Day phone Mailing Address Un/ess otherwise requested, HAA will be held by DSD for pickup. NUMBER OF, BEDROOMS: 3 3. TypE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: ".Individuai Well [] Individual On-site [~ '.~ "Individual Water Storage [] Individual Holding tank [--1 :,';."'Community. Class Well [] Community On-site r~ : Public W~iter System [] Public Sewer [] Th6 i~Unicipality 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 propedies served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm KND ENGINEERING: Inc. ' Phone_(907) 696-6111 Address Z0441 Ptarmigan Blvd., Eagle River, AK 99577 Engineer's Printed Name._ Kenneth M. Duff'us Date 10/10/2003 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in. land use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. DSD SIGNATURE ~ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: :... ,~r.. -..~ ,~.C,~ * ~ ~ ~ 0N-S TE ~: W~ERAND : m~ ~ [ WASTEWATER : : Attachments: HAA Checklist Septic System Advisory Well Flow Advisory ..... :,,, <r'~ · .~ ~ 'Maintenance Agreements ~~ ~9~' Supplemental Engineer's Repod '.H))))))))ip,' Other Original Certificate Date: / ~) - / ~ - 0...~ 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 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description; A, WELL DATA Well type_gY.[Y..a.te If A, B, or C provide PWSID # Date completed_~ Sanitary seal (Y/N) Y Total depth 16Z ft. Cased to _..l_~,__.ft. Date of test Static water level VALLEY ViEW TERRACE, B1. L15 FROM WELL LOG 9/19/03 117 10, g.p.m Well production WATER SAMPLE RESULTS: Coliform Arsenic: B. SEPTIC/HOLDING TANK DATA Parcel ID:_ 050-352-30 Well Log (Y/N) y wires propedy protected (Y/N) Casing height (above ground) AT INSPECTION _,.0._colonlesll00 mI.Nitrate _0~g./I.Other bacteria NA mg./I. Date of sample:_t_0_~ Collected by: KND g.p.m. ~, colonlesll00 mi. Engineerin_~ Tank Type/Materlal~ate installed ? / 1 4/1 9 7 6 Tank size Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping' 1 0/08/2.003 Pumper SANITARY 1000 gal. (g.p.d.lft= or ft=/bdrm) 1.Z System type TRENCH fi. Gravel below pipe 3,65 ff. 375+ ft= Monitoring tube Y Depression over field N Results (Pass/Fail) PASS For :~ bedrooms Water added.~gal. New depth in. Absorption rate >= If yes, give date C. ABSORPTION FIELD DATA Date installed 9/30/2003 Soil rating Length . 41 ft. Width ~ Total depth $,5 ft. Eft. absorption area Date of adequacy test N,~ - NEW System Fluid depth in absorption field before test in. Elapsed Time: i~in. Final fluid depth Any rejuvenation treatment (past 12 mo.) (YIN & type) in. g.p.d. LIFT STATION Date installed "Pump on' level at~ Datum Size in gallons Manhole/Access (Y/N). in. "Pump off" level at.~ in. High water alarm level at. in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1,00'+ Absorption field on lot 1 00'-l- Public sewer main 75'+ Sewer/septic service line On adjacent lots 1 0 0' + On adjacent lots 1 00'+ _ Public sewer manhole/cleanout, 1 0 0' -!-, Holding tank 1 00'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~;'-1- Property line 5' + Absorption field $ ' + Water main 1 0'+ Water service line 1 0' -t- Surface water '1 0 0'-I- Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1 0'+ Building foundation 1 O' -!- , Water main 1 0' + water Service line 10'+ Surface water 1 0 0 '-!- Driveway, parking/vehicle storage 1 0 ' '1' Curtain drain 50'-I- Wells on adjacent lots 1 0 0 ' + F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Kenneth I~t. Duffus Date 10/10/2003 HAA Fee $375.00 Date of Payment Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: El- F", k ­i= -1 411 1012 K71FT:101104=71.. RYE,- THE LENGTH DIMEMSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H 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 MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET) wQ!E17viK-u I KkEiEO 1 1'-7- K=7 I��� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL HND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOGS FIRE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 38 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ��wt..xK-N d-)bJF=n "w"EEFIK �F;1Cpr.*1 1 L -j E -E I CERTIFY THAT 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: Z WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. Z: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. —4-1 SlQMED�_�� �/ � � � ~/^ ����� � V� 16 lot L-- I -T- kcl) IF=' r -A 91-: 1--, F:,1 E--,�, 7� ^ / DEPARTMENT HEALTH AND ENVIRONMENTAL OTECTION 2510 E. 'UDOR RD. RNCHORHGE, AK 95d07 ' 276-2221 ID / L4 EE L- L_ FA r4 E-.- C, PAR _2i 1 5- EE! �E E 1, 1 IEEE F, L---'�,-%, 1 1 1_ / PERMIT ' NO. ( 76]6] ) iPPLICHN 260 MHN -Q -WAR RD ER� 694-9022 &OCATION WALLACE RD LEGHL L15 81 VALLEY VIEW TERRACE LOT SIZE 58000 SQUARE FEET TYPE OF SOIL HB5ORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: El- F", k ­i= -1 411 1012 K71FT:101104=71.. RYE,- THE LENGTH DIMEMSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H 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 MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET) wQ!E17viK-u I KkEiEO 1 1'-7- K=7 I��� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL HND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOGS FIRE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 38 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ��wt..xK-N d-)bJF=n "w"EEFIK �F;1Cpr.*1 1 L -j E -E I CERTIFY THAT 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: Z WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. Z: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. —4-1 SlQMED�_�� �/ � Coniftuction E7zst -fab "Opts test is worth a thousand opinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For -)v Date Performed 6h 76 Lenal Oescrintion: Lot f5 Block Subdivision tev UteLv This Form Renorts Soils Loq— 14, _Percolation Test tenth Feet Soil Characteristics 2 8- 10- 12- 14 04 16— Was Ground Water Encountered? If Yes, At what Denth? —(til MMOMPRM Percolation Rate Plinute Prnposed Installation: Seenane Pit Drain Field Depth of Inlet Depth To Bottom OfjPit Or Trench -7- Test Performed By Data Certified BY: Date. MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HE CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-472© Application Date Novem t Er (a) Legal Description (include lot, block, subdivision, section, township, range) /_dam r3 (oC (: 1 i/u((e C/rrcu i er�c�c Location (address or directions) [. a((ace 6cad o rnf ��S! L=crcfe Rive' Rce1 Gx (b) Applicant Name Chen c- t2e(ucQ -Telephone: Home It Business K(, Applicant Address S_c5Cc, (r Zorn (a (31vr,4f&,? �zcnc4cc, (c) Applicant is (check one): Lending Institution El ; Owner/builder E7 ; Buyer ED ; Other 0 (explain); (d) Lending Institution t\l, Telephone Address (e) Real Estate Company and Agent R(��� Cin %'' 1-/? C Address Y 062 Ha ¢-7- e fl Ali C1j()r czcf^-e `'? 6-0 `7 Telephone -5' `� ' ��'7 f (f) Mail the HAA to the following address: / 2. TYPE OF RESIDENCE Single-Famil �Multi F# _Other Number of Bedrooms 3. WATER SUPPLY`,;:: -.,.'t Individual Well 0 Community D Public E] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Onsite 0 Public 0 Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 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. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm _C /rt Llr�e '1 eecIn 'c e,_ / ser occur Telephone 3 1/6-- Address i's—Address _ PLOO h CAC7,1Tc1e /} /-c 9- 6'1 C/, Date _h( u veru 15. , - t IY t �Ff1 c; VLr Ate i 6tl Y i ®................. t�.aH toxone F. nno�re : •Y. Engineer's Seal CE - 3589 •'; 6. DHEP APPROVA Approved for bedrooms by Date Approved Disapproved Conditional Terms of Conditional Approval 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. Page 2 of 2 MUNICIPALITY OF ANCHC DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) NOV 14 HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST -.FEBRUARY 1984 264-4720 RECEIVED Legal Description:l 5 A;WELL DATA Well Classification Pr, if If A, B, C, D.E.C. Approved (Y/N) iVx}j Well Log Present (Y/N) Date Completed 7 13 / 76<� Yi�� Total Depth i Cased to Depth of 'Grouting No• Static Water Level I i' Pump Set At I : rr - Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) !� Depression Around Wellhead (Y/N) ry Separation Distances from Well: To Septic/Holding Tank on Lot ; On Adjoining Lots ( ` _..,,. ,. To Nearest Edge of Absorption Field on Lot I t `r ; On Adjoining Lots To Nearest Public Sewer Line N, A• To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot r.• Water Sample Collected by i"/ -i ; Date Water Sample Test Results 5;n( 'q - Comments B. SEPTIC/HOLDING TANK DATA ti Date Installed SEEM Siz"960 No. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) ` Foundation Cleanout (Y/N) Depression over Tank (Y/N) N Date Last Pumped Pumping/Maintenance Contract on File (Y/N) Ni ;for 8,f4 Holding Tank High -Water Alarm (Y/N)I�I/4, Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: �r To Water -Supply Well To Building Foundation To Property line as; To Disposal Field 7 r To Water Main/Service Line N, A To Stream, Pond, Lake, or Major Drainage Course '^ , Comments Page 1 of 2 72-026(11/84) 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 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION ►A ►112 4-1977 Elm 1. Type of Inspection: CMRO VA FHA CONV XX 2. Property Owner: Van Dussen, Robert J. and Herma Mailing Address: Day Phone: 3. Name of Buyer: Powell, Ole A. & Betty J. Mailing Address: 1419 Columbine, Anch. Ak. Day Phone: 278-2146 4. Name of Lending Institution: Peoples Bank & Trust Mailing Address: Pouch 7007 Anch Ak 99510 Phone: 279-7511 5. Name of Realtor or Agent: Smiley's Realty - Rick May,Agent Mailing Address: Box 1086, Eagle River, Ak. Phone: 694-2114 6. Legal Description: Lot 15, Blk. 1, Valley View Terrace Subdivision Location: Eagle River, Alaska 7. Type of Facility to be Inspected: SFR No. Bdrms. 2 finished 8. Water Supply Type of Supply: Public Utility Individual XX If Individual, number of dwellings presently served 1 If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) XX If Individual, date of installation 72-003(3/76)