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SHERWOOD HEIGHTS LT 8
rI 1 �� �_ 1. �'�` ;� �. � __ L __ � � - Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231080 PID Number: 020-042-29 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name SHAUN J PFEIFFER ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 15601 ELIZABETH STREET, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 3 GPD/SF JTotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot SHERWOOD HEIGHTS 8 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ -- 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Tank & pre -tank service line insulated. Alarm location Electrical installed by Installer DAN BEEK PIPE MATERIAL House to tank SCH40 Tank to 3034 drainfield Drainfield CO/MT Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspdection fisc 5/19/2023 2 n 5/19/23 Location and description 3rd 4`h TOP OF RISER / MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL or—AQ Conditional Approval: Date Q� '•:�,� ° • J:V TM *� .... .....•... �r r • • • • Curtis Huffman... uffman••• • • •� rr� �F�•, CE 128991 .•�`�� s1F - . s/3o/202�. -'�C�,� Septic Syst Approve . Date6 tFO pROFESSIO11 *�A���"r Note: this approval does not include well permit requirem nts N\�"t`�'� trcev uoiuu i ut PID:020-042-29 PERMIT:OSP231080 FIRST WATER CONSULTING SHERWOOD HEIGHTS LOT 8 EO TEAST 156TH AVENUE I � I, \ .\ 0 20' 40' .15' SEPTIC �/t/ rl STANDPIPES 01 SEPTIC lsJ SEPTIC p MANHOLE 20,� C \ 0 7 A- DCn I m o' z l \ o --iI LOT 8 Z I 45,244 sq. ft. E: O v, UTILITY \ W, PEDESTALS M O I FTS \ M W = O G �10 2' JJ I o 15' REBAR - ,-UTILITY W/CAP' I POLE I I EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (68-73) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEYAND IS SUBJECT TO ANY INACCURACIES THAT SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR ISA VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. JOB # 23056 1 NO CORNERS SET THIS DATE I SCALE 1" = 40' AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 8, SHERWOOD HEIGHTS SUBDIVISION ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 25TH DAY OF MAY, 2023, AT ANCHORAGE, ALASKA. FIXED HEIGHT, LLC C.O.A.122554 Land Surveying Services 907.290.8949 225 W 23rd Ave., Anchorage, AK 99503 WWW.FIXEDHEIGHT COM MUNICIPALITY OF ANCHORAGE Dent On -Site Water & Wastewater Program �o sS' PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite Department On -Site Wastewater Disposal System Permit Permit Number: OSP231080 Effective Date: 5/11/2023 Work Type: SepticTank Upgrade Expiration Date: 5/10/2024 Tax Code Number: 02004229000 Site Legal Address: SHERWOOD HEIGHTS LT 8 G:3238 Site Mailing Address: 15601 ELIZABETH ST, Anchorage Owner: PFEIFFER SHAUN J Lot Size in Sq Ft: 45244 Design Engineer: FIRST WATER CONSULTING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Ss��-� %� F�"C Date: V Issued By: Date: 20 -2- MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICMELL PERMIT APPLICATION Parcel I.D. 020-042-29 Property owner(s) SHAUN PFEIFFER Day phone Mailing address 15601 ELIZABETH STREET, ANCHORAGE, AK 99516 Site address 15601 ELIZABETH STREET, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) SHERWOOD HEIGHTS LOT 8 Legal description (Township, Range & Section) Lot Size 45,244 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade Q Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: _t'2 Z S Date of Payment: 2_ Receipt Number: sit 3 Permit No. M 11 ► O S10 Waiver Fees: Date of Payment: Receipt Number: Waiver No. G\Development Services\Building Safety\On Site Water and Wastewater\FormsUient FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! May 1, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: SHERWOOD HEIGHTS LOT 8 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1000-gallon HDPE tank per the attached design to serve the existing 3-bedroom residence. Given the site and area we would recommend a 1500-gallon epoxy steel tank be installed for future consideration or flexibility. Groundwater was noted at 10 in the MOA on-site file and if groundwater is encountered during installation an epoxy coated steel septic tank may be required and/or other action taken. The total depth of the existing septic tank is approximately 6.5 from grade. The lot and area are served by private water or the properties are vacant. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231080, Curtis Townsend, 05/11/23 FIRST WATER CONSULTING VACANT SHERWOOD HEIGHTS LOT 8 DESIGN DETAILS: NO PRIVATE WELLS WITH IN 100'+. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231080, Curtis Townsend, 05/11/23 MUNICIPALITY OF ANCHORAGE MOft ST83 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 �, I ��_ PHONE -� NEW ❑ UPGRADE MAILInAnDRESS LEGAL DESCRIPTION f"'eI' LOCATION / NO. OF BEDROOMS U DISTANCE TO: Well I� Absorption area .� Dwelling j� j- i f) PERMIT N _Y a Q LU F Manufacturer Materia_l-_ No. of compartment V)Liq. ca a 'ty lions IF HOMEMADE: Inside length •---�---- Width Liquid depth ••—._, a Y adz DISTANCE TO: Well Dwelling PERMIT NO. S?< Manufacturer Material Liquid capacity in gallons D w x DISTANCE TO: Well 115 Foundation r�o•1- �� Nearest lot line _ PERMIT NO �? .moi U -3- 2. K, Lm o. Z �Zw No. of lines t-- Len th of each I}ne ,]2.,. (� Total length of lines G� Trench width '(-� inches Distance betweef lines 6 FTop O of tile to finish grade �y Material beneath tile 6 inches Total effective,sorption area "5 q n' w 0 Length Width Depth PERMIT NO. oQ. F -Type wa of crib Crib diameter Crib depth _ Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. w ;I DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS fiJ Cr SOI L TEST RATING INSTALLER liek f t REMARKS I ) a%er- W(ts z Z� A 0 1 WeLl APPROVED y�DATE LEGAL E��+GyAr�"�Lp-ar IZ.0 1,5 lttev. s„6) Items G TITIPE:. C)F' "OlL Is - TR E I,. -I C 1-1 1'E",("A FT/BR' 0:5 I -if-, E:EEllF,CIOI-IS,:. :.-I ;CITE RAT11'-113 TI-lilE f`-U,-.I-AJIkR.ED _EM SUIZE OF THE '-" -IT:'-,T ji.-A FE, II -A 'JL tal L.-, Fl., VA ICH 7, liil =m i"H!:-'-' LE-J,AGTH IS FHE LENGTH tAhl FEET) CIF' THE' THEE E)EF11-i OF- ii „-q h d Ill -A "If.: C 1: F: -.h L... 1: '11- IF::" IF -I It,. -A 11-1 F;:.° F,.:H LGio E'_' OR PIT 1"_:; THE DISTMACE BEETWEEPA TIAE SURF"ACE OF' ']"HE E.- 1:1 F*,ifs: T I I E I%IT HEFLTH AkID ElAVIRCII;AHL 0 T E A TI 1, -.CT .1 10 1 OF THE' E1.11' C.': F1',.-TIT'[0 I'A FEET:. '_;TREE T.I A J'A C 1-1 Cl R A G E:.. FIK 9_,D klID"i"ll FOR TREhIGFIES. "i"HE (ARWe'El 2 64 0 IS THE MINIHI il-1 EIEPTH '-IF GRAVEL BETWEE[A THE OIJTFALL PIPE 0 V-141 _1 E-7 II N 11E. -F 11=1 E. -E, h 0 :1 "IT" E::,,CAVFITION Clhl FEET'.). 3 d4 15�� A P F, L I I"-': F1 I,. -I T TIHOTHY .3'. s*rFicT"_,,,I n c. �l 11 RA L. 1-11."'. FI -1" 1 L )'N —,-1 �l I ECiAl.- LOT _C;FIERWOOD HTS:'-'. L.OT 9995-J-99 SGUAIR,11 FEET TITIPE:. C)F' "OlL Is - TR E I,. -I C 1-1 1'E",("A FT/BR' 0:5 I -if-, E:EEllF,CIOI-IS,:. :.-I ;CITE RAT11'-113 TI-lilE f`-U,-.I-AJIkR.ED _EM SUIZE OF THE '-" -IT:'-,T ji.-A FE, II -A 'JL tal L.-, Fl., VA ICH 7, liil =m i"H!:-'-' LE-J,AGTH IS FHE LENGTH tAhl FEET) CIF' THE' THEE E)EF11-i OF- A OR PIT 1"_:; THE DISTMACE BEETWEEPA TIAE SURF"ACE OF' ']"HE GFROLINE, AND THE' E.,CiTTOH OF THE' E1.11' C.': F1',.-TIT'[0 I'A FEET:. TFIEFJE I"-. kjO klID"i"ll FOR TREhIGFIES. "i"HE (ARWe'El DEFil"H IS THE MINIHI il-1 EIEPTH '-IF GRAVEL BETWEE[A THE OIJTFALL PIPE R -Al) -I'll[ : E..;OTTON OF- THE E::,,CAVFITION Clhl FEET'.). lL _,5j; FE, IF U- --11- 0*--,...* Ti - F,�:u P,li �H� I 6-7. ==_. -a... C_- I I I H H I C-'. I I Cii F�:Il U. L_ Cu V-41 -; F,ETTIIT AFA:-I_JCAhIT HFr THE 1TYT U IhIF'OFd1 THIE' EIEPARTHEhIT DUl.":IhIG OFAf-,h` I. -JELLS FIDJAC.D.-IT "ITI'l THIS FIF.,C)PERT Y AND THE, I kii OF' RESIDEhICES 114-iff!" THE WELL WILL -1---F �. f`,:" -.-'E. E_= 'Y 0.-- ll-'=' C 101 ll,� TH,; IF R FR -.'"N Ull 1: 11 E BACl-,-:FII._LIi,.,IG OF* AN',' SY''.-I-EM 1,111"HOUl" F- I FINE, APPROVAL BY -n E,lEF-IiF.'FI,IFJ-AT WE[ L BTT SI IE;JE'.C.T TO 7, i-ill'-.11HUH F..11STAi,-JC:E BE-i-I-JEEN F1 IdEl L AND Akll,rl OhI:.--.ITE , F"IdFiCiE .:: 'is J.01:: FEET F'OR F"i WEI L OR' J.50 TO 21210 FEET FR011 A PUBLII_: IxIELL DEPENE"11,Aj.-i UP( IN THE J'YPE.' CIF' PLIBI IC. WELL. i'lli'AINUM I`:'ROM A P IR I%.' Fi TE WEL.L. TCI A PRIVATE 3ENEIR LINE IS 05 f -EEA" TO Fi C..OIlMI.JI,-,IITI-vI SEkIET': LJJAE IS 'r5 FE'."ET. ITI.-IER REQUJREI,IEI%ITS:" Nffi` APPL`r'. SPECIFlurricli,is ra-x, i*,.:i,.IY-,]S-FRI-IC:I"J.,.'.'It-,I DIFIGF.FIIfI_E_ ARE A!-lUF'E' PF .-IST A L L FIT I I.".) N. T --:CF'ER 11, 72 -1 : F - � L :-L, IF JEE. F; Ii - IJ 1 'T 1". E -E. L. . IEE R.I... =7 II �# FE.;, E--- F� T. C'ER'TIF"-r: THAT J.: I 1AI"I'l-I THE' FFIR SEWERS AhID WELL,,-, AS SET FORTH M' THE'. MI -11-11 CIPFLI TY Fjf.- ANCI ICIRFIGE. 0 D I WILL ASTALL THE IN FjC.('.:ORDANC.-. 141T[A ]'HE C. I.-' W. THF)"I' THE O?A-_STTE': SE:1-JER MANI RE-CUIRE IF THE" F2E.'-_-,I1.IENCE IS REI*-ICiDE'LED TO INCL.L.IE'E' I'II__'F`E THAhl BEEIRCjOY-1'. SICINECI FIFT'L,�.' �,FINT FIHOITI`r� 'TACEY A CARRING I S'E; I -I . . . . .. �_ .-___.DATF.......171 --"-- SOI LS LOG MUNICIPALITY OF ANCHORAGE V,�,�„'” • +,. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 10j PERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: G �Z? \) <-) a.-,) 1a ��'t DATE PERFORMED:.. LEGAL DESCRIPTION: L O- i `.� \-1 �, t-< V\/ DEPTH _ SLOPE SITE PLAN (FEET) N 1-I C- 1 •moi.-_ \.-.- -� _ _ 2 3 4 5 6 7 =s 9 10 11 12 13 15 16 17 18 19 20 7k s%v ,_N- y �`ar11 COMMENTS PERFORMED BY: 1< - 1.- I l 1• 72-008 (6/79) WAS GROUND WATER S ENCOUNTERED? ��,,,> L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Depth to Time Water Net Drop QF A �r • co s Ler C. Reld, Jr. �+ . ( N 8 pyo s1 ^� 3' •n_t i . �t r " i Reading Date Gross Time Net Depth to Time Water Net Drop QF A • co s Ler C. Reld, Jr. �+ . ( N 8 pyo s1 ^� PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND _, FT CEH rlFIED BY: DA GRED `�R ANCHORAGE AREA 60R"'IGH d Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME— MAILING ADDRESS ir.410 PHONE LOCATION �7� Jam/ C� �a // t All LEGAL DESCRIPTION Q— 4� 7 SEPTIC TANK: DISTANCE 7 % % NUMBER OF FROM WELL (2 ANU�TURER LI�E�. C �7( MATERIAL OMPARTMENTS INSIDE LENGTH vv� IfNSIDE ID`TTHJc LIQUID DEPTH _LIQUID CAPACITYGALLONS. SEEPAGE llG _ NUMBER OF PITS LENGTH DIAMETER OR WIDTH `l _, DEPTH ' LINING MATERIAL CRIB SIZE: DIAMETER DISTANCE FROM: WELL o TOTAL EFFECTIVE BUILDING FOUNDATION__, NEAREST LOT LINE �_ . ABSORPTION AREA (WALL AREA) % _$Q, FT. ADDITIONAL ABSORPTION WELL: TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE—,SEWER LINE—,TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL: V��-dye e - LOT SLOPE: REMARKS: U.M.M'M Form No. EQ -031 o.o/l DEPHR[MENT UF �RLTH HND ENVIRONMENTRL P! �CTION �-��-�/^ 2516 E[U0OR R|), HNCHORRG[, RK99507 276-2221 ~�� CT IV 1 X A n 5" TYA841 TR ����X I PERMIT NO ( 76569 ) HPPLICHNT CHRISTINE 13SS 4125 TERI CE DRIVE I49�2980 / -OCHTION ROBIN LEGHL L8 SHERWOOD HOOD �RIv£ HEIGHTS SUBD LOT Sl�E 44000 SQUHRE FEET TYPE OF SOIL H8SORBTION SYSTEM IS� DR0INFIELD M8XIMUM NUM8ER OF BEDROOMS � ] SOIL RHTING (SQ FT/BR)� 140 THE R2QUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� �� LATHWETRY R-1=0 J. -1� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELv THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE 8ETWEEN THE SURFHCE OF THE GROUND RND THE BOTTOM OF THE EXCRVHTION (IN FEET) THE TRENCH NIDTH FOR DRRINFIELDS IS ] FEET THE GRHVEL DEPTH IS THE MINIMUM DEPTH UF GRHYEL BETWEEN THE OUTFHLL PIPE H�D THE BOTTOM OF THE EXCRVHTIUN (IN FEE[). 'A .. .x.11, 2516 li. I udor lto;ua Anchorage, Alaska 99507 276-2221 R01,1vi, Io Performed for Christine .Bass _----------------- --- --- - Leyal Deccriptiorl: ); to Performo-,j �2�Io_ _._Lot Sherwo_od_Heights Subv_.,-_Anchorage,.-Ak._ This form reports: Soil; log _ -X--- --`-- - _ percolation Dep th Feet_ 1 Topsoil r 2 - cx 3 - CH (350)'--- 4 Ca (350) 5 •- M11 -SP 1 .6 - GW -SP (1"40-) i/©? 7 - GW -SP (14o) S - GW -SP (140 ) 9 - GW -SP (140) _:1 - G - l� 1P 401 -- Flat S/ (1/)o Was ground water encountered? t If yes, at rrilat de;,th? C 1p '------ Rea diny Datc Gross Time ------------- - ---- _ Flet Time _ Deptlr to ivater ticrt Droi) ---------------- �------------ •Proposed iris tallatlon: Sec,payc Pit-- - Depth of Inlet -- ---- Drain Iield Depth to bottom of pit or trencil - --- -- - "-` -- - — --- _ Perforincd li -- ---- - - y ra CcrLific(I Ly: ../M76 'ar71; P.G. - - i --i -.rI E'll 1- - % JI 11, -1 -11 _I 'TI 1 I "T 1 '71 i,7"1 FTJ T m m IT! n I r, M71 , Iff .71 - 7j 2: i -n !I it 7. �I-, -7j, i -i -r 71.1 it 1 1 71 C .19 M i r I F- -1 1-1 71 CI :11 =1 1.1-1 VI H Fill -7.* 2: 1 C.;i 71 7T, 71 r- =1 U'l 13 1:--' F- M C.9 M VI -4 M - -r- T t7l I =1 Vi 1-1 1l izi M i i i --j r- =1 L 7 In F- 7- -C, ITI --i Fq rrl r- T I LI CC, In 7, -ri %I !i11-11 1-[ =I M 71 .71 i I -r, IY! V !--I rri 7 M Iff 171 7 -17 VI V --1 171 m --i U 1 --i M M M =1 T M M .7-9 F- it E77 -7 M 7-1 M Q rri 1 -1 11 t Fri -1 1 IT -C-7 VI G.1 1-.] .7% C, T 1-1-1, -r" i rn T- C -i M 7.1 !-1 !1 Jq 1 p! v T r m T m m, 5-2 m =i I 17 I M M I- LO H T Ul --i -- Ti -I I IT, !7., rri 1'7 IM =1 -C --I F5 1=1 I - - r =I Z, Ul M M::u .71 1---- j: 11:1 AT If -1 -1 171 a, C' ID -:- H iTT —=:-- I VI T 1:71 T -j C, IT --4 1M -2-- r- 0 2:1 -- MH T 2: '77 - r- MZ Z M Ti iTi 171 --1 TI 177 --r I Cj 7t :It 71 Tr m -0 0 -4 m fii z ZI m TI 171 T Z, m m Lj Imr, _7 -n 1=1-,, '-=I M T- P-1 -=r :D r - m '7 -:� !.- I "-1 (71 C -I M I C., 1.11 V M - --1 71 1.0 C (7' C, -9 E L, r- kj:i 71 M T- 17 m 1 n -I TF, 1-11 71 Iji 1171M I--. M :11 7-K I --F, r- (71 Zi Vi Iff m H VI F -I- U-1 I C! T- 1:7 --1 "Q Cl if, I t=1M 1:71 -Al �9 .- III Ti Z' �-- X CO 71 M M --i 0 Fill I m CC] im.-i 71 -,u F- it IZI 0 r- Lri m .:n --j IE 1 rl M — M --I C: M 17-1 VI I ETI o 7- G -i a: m :i. (71'7 I:D F -i C71 V! V, m 71 H i7i m m 2 m I � r cn z v m O co—{ L D v z D r v � m \ _ D > E N — O 3 ° ✓` o>U 0 / CD m X SYN Z to4�- 0 = N� �D Do -4 9 CD m r lD Z m (n m o m Z 3 m z O �p r m { r m r ° r v G) � 7! mi f A I i 1:1 Iii Ul --j 7i 1 = .7f Efj_i _ii --}-ice j_r, In Ti If' If —L., T -2 m M, rl .7 7— wl -r f7i M V Ul cl 2) I'D rrl _ij 7%, U, 70 1 if l.q Ti c - _1 rrl * T, -0 m U-1 l Er if, P-1 im 1 Iij Fln. _71 I— Fl it] X1 71 iia it Iwo MUNICIPALITY OF ANCHORAGE Development Services Department _a Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 020-042-29-000 Expiration Date: Legal description SHERWOOD HEIGHTS LT 8 Site address 15601 ELIZABETH ST Anchorage AK 99516 Current property owner(s) PFEIFFER SHAUN J 9/7/2023 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 6/7/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory X Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaUune 2022 MUNICIPALITY OF ANCHORAGE ® Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 020-042-29 Complete legal description SHERWOOD HEIGHTS LOT 8 Location (site address) 15601 ELIZABETH STREET, ANCHORAGE AK 99516 Current property owner(s) SHAUN J PFEIFFER Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ® Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5130 Waiver Fee $ Date of Payment S/�23'.A-5 Date of Payment COSA # 05C 23 1 -5.5 Waiver # COSA Application 2022.doc COSA Checklist 2022.docx COSA Checklist Legal Description: SHERWOOD HEIGHTS LOT 8 Parcel ID: 020-042-29 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 11/1/1983 Total depth 80 ft Cased to 80 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 4/27/2023 Static water level at beginning of test 31 ft. Well production at time of test 0.7 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative* Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 4/25/23 & 4/28/23 Comments Shallow low-producing well – see MOA Advisory. Coli sample retaken from kitchen sink.* Secondary abandoned well was completely and properly decommissioned – See attached Sullivan letter. B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW HDPE TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 9/9/1983 ALL standpipes present per record drawing Total measured depth from grade 6 ft (max) Measured depth to pipe invert from grade 5.6 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 4/27/23 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 4/28/23 Results Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth <1 in Elapsed time <5 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in Effective depth used 0 in Effective depth remaining 6 in Comments/Deficiencies: Total depth from existing grade. Field probed & was dry. Good material at septic tank installation. Existing record documents are sparse & it appears all standpipes were present. Old encountered standpipe appears to be an old testhole pipe was dry and extended to 6’ similar to field monitoring tube depth. COSA Checklist 2022.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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 Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 5/30/223 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 5/30/23 Well Water Advisory Certificate of On -Site Systems Approval # OSC231155 Subdivision: Sherwood Heights, Block: , Lot: S This well's productivity was determined to be .7 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate and may be insufficient to meet your needs. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Marling Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org '' 2 �_ MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On -Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite 0 Legal AddressWell Decommissioning Lo . �,k Subdivision 5erie°J I' C,4&5 Block "/ Lot T R Section Lot— On-site Water & Wastewater Section certified contractor performing the well decommissioning: Na Company: i UGtiA Signature: IWell decommissioning date _. Method of decommissioning: AMC 15.55.060L1 a. ❑ b. ❑ C. �r I Location: Use the space below to provide a drawing of the property showing the following items: • North arrow • Decommissioned well location • Location of other water wells on the property • Two separate swing -tie distances for each well shown on the drawing Note: The swing -tie distances shall be measured from either permanent structures or the property corners. C Site Water and Wastewater\Forms\Client Forms\Well Decommisioning form.. MUNICIPALITY OF ANCHORAGE �- DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 02004229 1. GENERAL INFORMATION HAA # a IS19 2f-)2 ) Complete legal description Sherwood Heights, Lot 8 Location (site address or directions) 15600 Robin Hood Drive Property owner ZPt-J9A-L(_ %tS Day phone G_&2_- I Sib Mailing address )5-'(900 F -0g (ti k ap Lending agency Day phone Mailing address Agent Robin ward Day phone 345-6955 Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 '\t Individual well x Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. Individual on-site x Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 421 5. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Mountain Engineerin Address 3868 Shanno: Engineer's signature 6. DHHS SIGNATURE M ircle Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Phone 562-1500 Date 10/26/92 bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health 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 engineer's work. 72-025 (Rev. 1/91) Back MOA k21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 8, Sherwood Heights Parcel I.D. 020-042-29 A. WELL DATA Well type Private If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed 11 / 1 /8 3 Driller Jay Total depth 80' /� i Cased to � — F„r Casing height 1 51 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y FROM WELL LOG AT INSPECTION 3 CZ 5Z Date of test 11/1/83 10/25/92 70 6 DM Static water level 2 2 ' 0 - 5 ' rn (o Well flow 3 g.p.m. '�f3 9.p.rrr— �= C v n C) Pump level 80' 70' `Tt N o Ui G) SEPARATION DISTANCES FROM WELL TO: o r" ~ Septic/holding tank on lot 100' ; On adjacent lots 185' Absorption field on lot 115, ; On adjacent lots 105, , Public sewer main None Public sewer manhole/cleanout nrnnP Sewer service line None Petroleum tank None WATER SAMPLE RESULTS: Coliform 0 Nitrate ND Other bacteria 0 Date of sample: 10/13/92 —" Collected by: Mountain Engineering B. SEPTIC/HOLDING TANK DATA Date installed 9/9/83 — Tank size 1 , 250 gal - Compartments 2 Cleanouts (Y/N)y Foundation cleanout (Y/N) Y Depression (Y/N) High water alarm (Y/N) NSA Alarm tested (Y/N) N/A Date of pumping 10/23/92 Pumper Isaacs SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wells) on lot 100' — On adjacent lots 175, To property line 451 Absorption field 401 Surface water/drainage None Foundation 80' Water main/service line None 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed None Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" level at SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Cycles tested Surface water Date installed 9/9/83 Soil rating 85 SF/BR System type Bed Length 2 2 ' — Width 18' Gravel thickness 1 ' /)," Total depth 6 Total absorption area 396 SF- Cleanouts present (Y/N) Y ( installed 10/23/92) Depression over field (Y/N) N Date of adequacy test Results (pass/fail) Passed for 3 —Peroxide treatment (past 12 months) (Y/N) N If yes, give date 10/25/92 SEPARATION DISTANCE FROM ABSORPTION FIELD�T\`,� Well on lot 115' On adjacent lots-,, 1 60' 35' � Property line To building foundation 100' On adjacent lots 1651 Surface water None Curtain drain None E. ENGINEER'S CERTIFICATION To e: Cutbank None or abandoned system on lot Unknown Water main/service line None Driveway, parking/vehicle storage area 100' bedrooms certify that I have checked, verified, or conformed to all MOA and HAA guidelines in efeton the date of this inspection. ,gyp.. I Signature f ` ✓t-,� _� Engineer's Name Mark Pearson Date 10/25/92 MARK WCPS'EAR—SON_4�` �- "�`c?.;°o CE - 7760_Il le 0 HAA Fee $ Waiver Fee: $ 0 % Date of Payment 6� Date of Payment L11 'Lr ZQ Receipt Number -� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 17-- 2-/—S7 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block,subd.vision, section, township, range) l-o� 'y �`ierrv��f 2 r 4& Location (address ordirections) (b) Property Owner,/ �/�?1-r Ate&-- Telephone: Home r Business.��'�" �= Mailing Address (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the following address: or: Check here, if hold for pick up. List contact person and day phon"umber below. \ , 2. TYPE OF RESIDENCE Single -Family( Number of Bedrooms , 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to 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 Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (Rev 8/86) Front (J 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 wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. i Name of Firm �c SS e��' Telephone JJ� Address 1,2I-,> Date i'qltinji's Seal .1� C D� s:� �� �: as�•a r-• x� Cc;z R. hlerr ffc o. 20,55.c �' ,�<��-, •Sar � �C'p `4 ,0,� 6. DHHS APPROVAL';�6 / Approved for �,�/% bedrooms by Date +����®r�21..��� Approved A Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health 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 engineer's work. e Page 2 of 2 72-025 (Rev 8'86) Back MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) OF ANC�°>� j T - FEBRUARY 1984 MUNICIPALI.f r CFS D1VIS1 A�NTAL SES\ i - 264-4744 ENVIP.Oi�R - ,/ 1 Legal Description: A. WELL DATA F Well Classification 7 ' ' IV -4 If A, B, C, D.E.C. Approved (Y/N) Al. Well Log Present (Y/N) >11 Date Completed 1/—/-93 Yield Total Depth Cased to 111 Depth of Grouting Static Water Level ��< Pump Set At %g{ Casing Height Above Ground Sanitary Seal on Casing (Y/N) / Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot !�� < ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot X30 < ; On Adjoining Lots 100 To Nearest Public Sewer Line IV` To Nearest Public Sewer Cleanout/Manhole �' To Nearest Sewer Service Line on Lot Water Sample Collected by 7pp-s� ; Date Water Sample Test Results Comments 7h/.r /s zz_ /r e=Gs � - / c o ,17vP-1 LTZ ,[.,C/S' u? A B. SEPTIC/HOLDING TANK DATA 5 Date Installed 3 Size " No. of Compartments y Standpipes (Y/N) Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) Depression over Tank (Y/N) N Date Last Pumped Ly ��— Pumping/Maintenance Contract on File (Y/N) Al - /1 -- for Holding Tank High -Water Alarm (Y/N) /SJ o "q— Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation To Property Line �� V Tn n,,;nncal RpIri To Water Main/Service Line 9oi Course P i Comments �� DU r�i/. rwrn � .�a�vi�'r �?�•u . ,one '* /'VZ#/" Page 1 of 2 72-026 (Rev 8/86) Front ,7,91- '51 7,9t S' To Stream, Pond, Lake, or Major Drainage MUNICIPALITY OF —. .r e I cr-rv1C PS DIVISION r' 1987 RECEIVED C. ABSORPTION FIELD DATA o' Soils Rating in Absorption Strata Bd,f Type of System Design �e Date Installed S-L-7'7� /y'S3 Length of Field ?--3 Width of Field / R Depth of Field S Gravel Bed Thickness 41 C -r -L CA e-5 y �1 Square Feet of Absorption Area 3 /6 Standpipes Present (Y/N) /` Depression over Field (Y/N) nate of Last Adequacy Test 7 - Results Results of Last Adequacy Test SA�ISyA�TbCGJ Separation Distance from Absorption Field: To Water -Supply Well /lO To Property Line To Building Foundation 6© / _/_ Lot ; On Adjoining Lots -3v /;'- To fi To Existing or Abandoned System on /CT -d> " f To Water Main/Service Line _��® 17- To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course �7�� To Driveway, Parking Area, or Vehicle Storage Area ldy Comments ?mil is at o-/ Ln D. LIFT STATION Date Installed . Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify th have checl ed, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed /% Date 1 -1 --Al rP% CompanyAMOA No. Receipt No. �/��1� —(�� �'�`, ® Date of Payment /Z- _/ _49 7 Amount: $ E '( r' Page 2 of 2 72-026 (Rev 8/86) Back TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907-479-3115 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 907.277-8378 Besse, Epps, & Potts 2220 E. 88th Avenue Anchorage, Alaska 99507 Attn: Dale Merrill Source: L8, Sherwood Hts. Sample ID#: A121887-5 Parameter Unit Nitrate -N mg/L Reported By: Result <0.10 Date Arrived: 12/18/87 Time Arrived: 1700 Date Sampled: 12/18/87 Time Sampled: 1630 Date Completed: 12/23/87 ADEC MCC* 10 MUNICIP40r ENVIRONMENTAL ORvICr pVIGE 1 - �/ON C� 2 1987 t ICE! 1v I. D Date: 12/23/87 Carol J. Garrison, Vice -President ------------ * MCC = Maximum Contaminant Concentration MUNICIPALITY OF ANCHORAGE DEPARTMEi•.. OF HEALTH AND ENVIRONMENTAL PR4 ACTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 54-1 Location (address or directions) l 6©0 c - (b) Applicant Name /�5 Telephone: Home -_4, Z.� Business Applicant Address % 7 t0.1 rte-© I d cZ Vic W )02, (c) Applicant is (check one): Lending Institution El ; Owner/builder; Buyer ; Other E3 (explain); (d) Lending Institution �1O�LLo Address r © 2 (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following add Telephone Z7 T _'` ! i �-15f 2. TYPE OF RESIDENCE Single -Family K Multi -Family O Other Number of Bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to 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 Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11184) 5. ENGINEERING FIRM PROVIDIN 4SPECTIONS, TESTS, FILE SEARCH, DA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm JaVne-sTelephone2- Address T �� f�i�C`J. l;t5 Date at vk =a�Tba ® 30as see :ossygaet teles ° io •+°tees® agy--6(�ff�3/.--�� see •°: as rnZ; James F. 5izemoro woe 0 1517 E ® `C'`'`- •pav e°®se toss'°°°°�.%, AV 6. DHEP APPROVAL Approved for bedrooms by ate Approved �� Disapproved Conditional Terms of Conditionaf 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. Page 2 of 2 72-025 (11/84) J °may y� r va%Qk Ai rp" ;_r.t�.,�'.../ ,r*' F `: ,,..✓., - tea; %. ?��`�..�F� � A ,Z50 Z5 f ,Z50 Z5 � ,.�•� i F Via` r e i 3 � 3 F e GREATER ANCHOA0 G� �:.AEA9 BOaROUGH B '� 414 Y Department of Environmental Quality �A�ffD ,anty '` 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received July 12, 1976 Time of Inspection 1:30 p.m. Date of Inspection 7-13-76 — Pratt REQUEST FOR APPROVAL OF Tuesday INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Securitv Pacific Mortgage Corporation % Bob Fritz Mailing Address: 319 West 5th Avenue Phone: 272-9501 2. Property Owner: Wayne Bass Phone:'�� Mailing Address: % Totem Realty 516 Fireweed Lane 7J �� �'7 3. Legal Description: Lot 8 Sherwood Height Subdivision 4. Location: NHN Robin Hood Drive 5. N Type of facility to be inspected Single Family No. of bedrooms Well Data: Individua V A. Type V B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: A. Installed C. Septic Tank: 1. Size On—site system B. Installer 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines n-8. Distances: A. Well to: Septic tank , Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) ( Page 1 of two pages ]m Page 2 of two pages - Re, st for Approval of Individual r er & Water Facilities Legal Description Comments Approved Lot 8 Sherwood Subdivision ,Disapproved Date Approval,Valid for one year from date signed eater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM (f- V--,- I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date MUNICIPALITY OF ANCHORAGE , DEPT. OF HEALTH & / MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 �� U L 1 �- � u e REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV X 2. Property Owner: _ Wayne Bass Mailing Address: % Totem Realty,516 Fireweed Lane Day Phone 279-0571 3. Name of Buyer: LEON GRIGOROPOULES Mailing Address: 1718 Aleutian, Anchorage, Alaska Day Phone 278-9434 4. Name of Lending Institution: SECURITY PACIFIC MORTGAGE CORPORATION Mailing Address: 319 West 5th Ave., Anchorage Phone 272-9501 5. Name of Realtor or Agent: Totem Realty Mailing Address: 516 Fireweed Lane Phone 279-0571 6. Legal Description: Lot 8, SHERWOOD HEIGHT S/D Location: NHN Robin Hood Drive 7. Type of Facility to be inspected: Singel Family No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility Individual X If Individual, number of dwellings presently served ONE If Individual, depth of well 25 ft. 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) X If Individual, date of installation EQ -037 (1/74) P.T 86e, 7—es 71 -fee -7,.;- � 4.1 :1-lortgavie rritz 5tla &Veavae a lie T,4e-ject acc-crdLay to V�xis test a:t;ust bc ---ea -pro-nos-c- aow yotem a. ie are ,-.ny furtiwr queationazit, ples-se CazxtacL thir,; rvlfficz� at 2 7! 5 - Z 22! Let X4. 2uChholz 4 � I A. Xi;irZ W-41VIjil