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Home My WebLink AboutSUN VALLEY HEIGHTS BLK 2 LT 2 MUNICIPALITY OF ANCHORAGE DF qTMENT OF HEALTH AND HUMAN SER' ES Environmental Health Division 825 'L' Street, Anchorage, Alaska 99502, Telephone 264-4720 I-SITE SIF:WAGE DISPOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT DISTANCES ;~,~t 6/1 '=:~------ TO SEPTIC ABSOflPTION !octn ~m [>[~c~ ~c~o~ ~OM ~_ TANK FIELD WELL ....... jPo.,., no~. ~1 ~ff [~o Ct B~rooms WELL 120' ~ ~ ~C ~' ~S-BUILT DIAGRAM [SHow Iocat,~,, of well. septic system properly hnes, Ioundahon, TANKS ~ HOLDING I TYPE OF SYSTEM ( ] BED ~ W, DRAIN ~ OTHER WELLS Address 13 g Ya Phone(s) 1 ownshlp, Range, SeCllOn SEPTIC [] TRENCH ortgmal grade (~, PRIVATE REMARKS: t,,~E f ( __~c,t,, I..¢oo d.~/ Municipal and State g Health Depadnlenl Approval: 72-013 (3185) I.Jp g r'. ad flih"u:] :L n(~:(:~,P ])L .~ :1. gl I (. .I...:,,~.4.. I¥1E}LINT~'4]iN F I...P,L,E:. F-/l'4 L, H. J:'d-d.:~ I::. ~ t.'d-::i Day F I~one ,, ..... q.,, .L~... ~ I NF:'(:]F;:I¥1 D. H ,, I"1 ,, S ,, F'I':~: :1: [IR 'T'CI ;I.,~j'/' ¢¢4 2N):) :[ NSI::'f:?:CT :[ [INS BY IEN[:) :[ I',II.T. IEF:; ~ r2fl:::'TE:F:~ DFI:::' ]: CE: I"IE)tJF~.S~, C(.:fl..,L, :54,.:',!;--,Zl,~fliill ~1',1]) I.,.IEAVE (:l Cf3NDI"F~UC'I" I::~IZR li!:I'q['.")]:NE::E:~?~.~ (4'13"(.~CHE:D ~'~F'F:'FIEIVET.) 'f'H :1: S F:'lii:t::~H ]: T IE X F' :1: l::d:~:!i!i :l. 2/:5:1./81!) ,, 'f'H :1: S F:'IEI::~Ft :[ T gPd... :1: D F:'C]F.: (.~ S ]: NGL. IE I::',gl¥1 :): L,..Y F(E.S ]: DENI::Ei DIxII.Y ,, Flattop Technica] Services 14530 Echo Street Anchorage, Al~slcc~ 99516 ~ IT~ Pl..,4N NOT Fl~tlop ' · :. I echmcal Services, 14530 Echo Street Anchorage, Alaskc~ 99516 Lot 2, Block 2, Sun Valley Heights 13240 Mountain Place Septic System Upgrade Specifications All materials and construction practices shall conform with current M.O.A. require ments. The layout and configuration shall be as shown on the site plan and design drawing, except that minor changes may be approved to accomodate site conditions Prior to construction, all brush and trees smaller than 6" diameter shall be cleared within 10 feet of the bed. Brush and roots not suitable for firewood re, ay be buried at an agreed upon location uphill from the bed. All peat, surface organics and roots shall be stripped from a 22' by 46' area which is 2' larger than the bed in each direction. The stripped area shall be graded to achieve a level surface with no more than a 1.75' cut below ori§inal ground surface on the uphill side. Careful attention to grade will be necessary in all phases of the work to allow gravity flow from the existing septic tank. A total of 12" of approved sewer gravel shall be placed with top dimensions of 18' by 42', and 6" thickness beneath the 4" diameter perforated pipe. The distribution pipes shall be laid level and connected in the configuration shown on the plans. Cleanouts and monitor tubes extending to the bottom of the gravel shall be installed in the locations shown. The existing line from the septic tank to the seepage pit shall be cut and abandoned in place, and a new line with a 1% slope ( 1/8" per foot) installed with appropriate couplings to carry septic tank effluent to the new soil absorption bed. Two inches of approved rigid burial type insulation shall be placed over the top of the sewer rock with an additional 2 feet of soil covering it. Cover material side slopes shall be no steeper than 3:1, and shall not contain brush or roots. Cover material shall be trucked in from off site, as needed. Inspections will be required at the time of initial layout, immediately prior to placement of sewer rock, a. fter rock and pipes are in place, and after final backfill. PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 13- 14- 15- 16- 17- 18- 19- 20- Township, Range, Section: WAS GROUND WATER ENCOUNTERED? SLOPE tF YES, AT WHAT DEPTH? p E [)epth to Water After Monitoring? ¢~v Date: ACCORDANCE WITH ALL STATE AND MUNiCiPAL GUiDELiNES iN EFFECT ON THiS DA-re. DATE: 72-008 (Rev, 4/85t PERCOLATION RATE -.~ (minutes/inch) PERC HOLE DIAMETER ~o TEST RUN BETWEEN -~'~ FTAND .~,?~ FT Gross Net Depth tO Net Reading Date Time Time ~ ~;~) Water Drop Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PEFICOLATION TEST PERFORMED FOR: 3- 4 5 6 7 8 9 10 11 12 13 14 15 16 17, 18- 19- 20- Township, Range, Section: SLOPE WAS G HOUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Deplh to Watar Allar SITE PLAN Monilorir~g? _ P ~ T' __ Dale: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RA1E ~ {minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN [*~'.- FT AND ~,~7 FT PERFORMED ~'(~ I o~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85) ./ '. '~ STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE ... PUBLIC WATER SYSTEMS APPROVAl. TO CONSTRUCT Plans for'the construction or modification of_ ~"'~ ,~ ,'~ In ., Alaska, submitted In accordance with 18 AAC 80.100 by. have been reviewed and are ~ approved. [] conditionally approved (see attached conditions). 8Y TITLE DATE If construction has not started .'. .. ~ two years of the approval date, this certlflcate is void and new plans and specifications must be submittee t,~,' r¢-~",,:~w and approval before construction. APPROVED CHANGE ORDERS Change (co,t,act order no. or descriptive deference) Approved by Date APPROVAL TO OPERATE The "APPROVAL. TO OPERATE" section must be completed and signed by the Department before any water is made available to the public. The construction of the public water system was completed on granted interim approval to operate for 90 days following the completion date. (date). The system is hereby BY TITLE OATE As-built plans submitted during the interim approval period, or an inspection by the Department, has confirmed the system was constructed according to the approved plans, The system is hereby granted final approval to BY TITLE DATE OISTRISUTION: 1, WHITE · ENGINEER (Comp[ale Section C) 2, YELLOW · WATER SYSTEM FILE (Complete Secllon C) 3. PINK - ENGINEER~MUNI.BOROUGH (Complele Section C) 1P~07 (Rev, 1118.3) 4. GOLOENROD- MUNI,SOROUGH (ComDlele Section A) .,-R ANCHORAGI! AREA BOL Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~-~"/~, ~'~0/'~'~'// MAlt_lNG ADDRESS '~¢-~X /O.~..~.~_ . ,,~./_~,, .~'~,__ PHONE.~g'~'~.~"?~,'~' SEPTIC TANK: DISTANCE FROM WELt_ INSIDE LENGTH MANUFACTURER INSIDE WIDTH · MATERIAL LIQUID DEPTFI NUMBER OF COMPARTMENTS LIQUID CAPACITY.___ GALLONS. TILE DRAIN FIELD: DISTANCE EROM WELL FOUNDATION TOTAL LENGTH NEAREST LOT LINE ..... OF LINES NUMBER DE LINES DISTANCE BETWEEN LINES TRENCH WIDTH__ IN. TOTAL EFFECTIVE ABSORPTION AREA (..~ ko SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTN: TOP DE TILE TO FINISPI GRADE MATERIAL BENEATH TILE IN. ABOVE 'rILE IN. WELL: TYPE BUILDING FOUNDATION __ CESSPOOL APPROVED _ CONSTRUCTION NEAREST NEAREST LOF LINE __, SEWER LINE OTHER SOURCES _ DISAPPROVE[} REMARKS _DEPTH SEPTIC SEEPAGE , TANK ____ SYSI-EM DISTANCE FROM: DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: ...... 'J' SEWER LINE[ DEPTH: PIPE MATERIAL: ~OT SL. OPE: REMARKS: GREi. ,ER ANCHORAGE AREA ROI',JGH~/ 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4~61 SEWAGE DISPOSAL SYS'rEM --. APPLICATION AND PERMIT INSTALLAT[ON LOCATION INSTALLATION Of: SEPTIC TANK ~/~ SEEPAGE Pit · FINANCED THROUGH TO BE INSTALLED BY DRAIN FIELD SOIL TEST RESULTS THIS FERMIT 15 NOT VALID WITHOUT SOIL FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION I~Y THE DEPARTMENT OF ENVIRONM[:;NTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEEPAGe AREA SIZE SEPTIC TANK , SEEPAGE pIT TO NEAREST LOT LINE, WELL TO SEPTIC TANK ~ ~ / DRAIN FrELD __,~ ~ / ., DRAIN FIELD / , SEEPAGE PiT //'~O · ALSO CONSIDE,q AREA WELLS, SEEPAGE PIT SEPTIC TANK, , SEEPAGE PIT TO RIVER, LAKE, STREAM. --, DRAIN FIELD ~ , 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO E]OROUGH ~{EgLILATIONS REGARDINg INSTALLATION. OR -- TYPE I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGh' ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN CCORDANOE WITH SAID CODE, =77; ""' EQ-016(3-75) GRENf I ANCHORAGE AREA BORO Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPFCTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION _ MAILING ADDRESS ~'~O¢/,0 /-,/t/~ Ot/,.S /'2~¢t~/ _ PHONE .:,~/~'/ LEGAL DESCRIPTION/g)7" ,,~ L'x~//..~' ~ ,~(¢z;I ~I/1LZ4.-.u' SFPTIC TANK: DISTANCE lid ~ NUMBER OF FROM WELL. L'/(~//)//~¢/p~, MANUFACTURER.~//I(J/5 ~Q~t;~:E~- ('!g ~ MATERIAL ~c~/'~-~/2, COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /~k$~0 GALLONS. SFEPAGE PIT: NUMBER OF' PITS / DIAMETER _ OR WIDTH 20( , LENGTH LINING MAI'ERIAL'/~)Ddhg~P'/~ILY'~3C, FffB SIZE: DIAMETER <;/ BUll_DING FOUNDATION ~) z NEAREST LOT LINE ~ / TOTAL EFFECTIVE , ABSORPTION AREA (WALL AREA) /¢-~ .SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE~-g¥;t?/)7(,'[~)/[t,/ CONSTRUCTION ~,~ ~/¢5/,U~ //g/~C~_//~yg DEP-rH DISTANCE FROM: / ~ BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION_ ., LOT LINE SEWER LINE TANK SYSTEM OTHER SOURCES DISAPPROVED REMARKS CESSPOOL APPROVED DISTANCES: INSTALLED BY:. PIPE MATERIAL: LOT SLOPE: REMARKS: ~<~(1~(_ )~%~'.~ 7,32 ~ DIAGRAM OF SYSTEM APPROVED ]~'i%~.4.'e.., (7 ~..A~.~./'~I/,-~"- G.A.A.B. Form PW-026 GREATLZR ANCHORAGE AREA BOROUGH SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK SEEPAGE PIT / SOIL TEST RESULTS 2~-~/¢¢ .Se,"/ '~¢'/ NOTE:, THIS PERMIT IS NOT VALID WITHOUT PFRMTT VAI TD 8NE YFAR SEPtiC TANK SIZE {~'"'~'~ TypE~_'~p,F~l 'n'r P~Cr~-tesEsPAGE AREA SIZE TYPE MINIMUM DIIITANCE$, REQUIREMENTS 5 ft. FOUNOATION TO SEEPAGE PIT 20 f~* DRAIN FIELD . ]0 f~. 8EPTIC TANK TO SEEPAGE PIT WALL [5 ~'9 10 ~o.~*.~OT~,.~. E~" ~/,;- e~. ~/. WELL TO SEPTIC TANK - ~0 ? ~ / 2~0 WATER MAle TO SEPTIC TANK [0 f~ ,_, SEEPAGE PIt --~0 f~t , DRAIN FIELD [0 ~e ~EPT~C TANK, 2~ ~e SEEPAGE PIT [00 ~e' DRAIN FIELD ~0 f~ , Q - / ~?- '7 7.~ ^PPL,OAET'S SI~N^TURE / / GR' 'TER ANCHORAGE AREA BOROUGF DEPA, .~ENT OF ENVIRONMENTAL QUAL~I'Y 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE # Performed For 0o.~ E×e~vat±n~ Date Performed Legal Descript~-~-? Lot2 ~iock2 Subdivi~ion Sun Valle,IF-Hts. This Form Reports Soils~g -- x Depth __feet 2~ 2O-.- Soil Characteristics Gray and Brown Sand-Silt ~i× (~L) Gray Sandy Gravel (OW) Gray and Brown Sand-Silt ~ix w/occasional Silty Sand (ML) wi~h (SM) Was Ground Water Encountered? No If Yes, At What Depth? Reading Date Gross Time Net e Depth to H20 Net Dro Proposed Instal' Seepa!le Pit Z Drain Field Depth Of Inlet COMMENTS:.,, ~q~:[~,, o21 dr~i Dep~~-tom Of Pit Date: ..... (¢,~,~ DEPARTM ~NT OF HE!ALTH & HUMAN SERviCES ::: /¢1~ ~/~J Divis on of Environmental services , ~ 0 ~.S t~ services Sect on ' PZ). F3ox 196650 Anchorage, Alaska 99519'6650 Parcel I.D. t~ 1, GENERAl,. INFORMA'I'ION Complete legal description 343;4744 ?,ERTIFICATE OF HEAL'IH AU ~ rlORFr'~ i · AP, REVAL FOR A sINGLE FAMli-,: r.)WELLING//.~f/~/'¢¢ ~ ¢2 ., ,...4,~./.~ : :: ~ HAA ~ Location (site address or directions) /,'~ ~ ~-~_o_ h4-f~"~'!~,uE- Property owner Mailing address Lending agency __ Day phone Day phone Mailing address __ Agent Address gay phone _ Unless od~erwise requested, HAA ~vill be held for pickup. NUI~BE~I OF BEDROONIS: -- TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: NOTE: if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL,: Individual on-site ~ Holding t a ¢.F. Community on-site Public sewer If community wastewater' system, provide written confirmation from State ADEC attesting to the legality a~d status ~f system. STATEMENT OF iNsPECTION By ENGiNEER:,~ As certified by my seal affixed hereto and as of thevalidation 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 Mun'icipalify of Anchorage files and from my investigation and inspection, the on-site water supply and/or Was~eWa(er dispOsal system is in'cOmpliance with all MUniCipal and state c°deS, ordinances, and regUlations in effeCt on the date of this inspection. Address ~c~,~'~nY-z'~'zC~--~ /,~¢I'L ,,~l~ Engineer's signature: ~ - Date Approved for Disapproved. Conditional approval for bedrooms. oedrooms, with the following stipulations: Additional Comments 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 DH HS does this as a cour[esy 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 eng~ neer's work, ~UNICIPAtI[¥ OF ANCHORAr~ I-3,lVlI~DNMENI'AL 6[~RVICE$ DIV}SIOM Municipality of Anchorage APR 15 1997 DEPARTMENT OF HEALTFI & FIUMAN SERVICES Environmental Seivices Division RECEIV£D 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: LT_, 'T~'P_. ~,~ VAI-C~-'r' /¢-~--,.% _ Parcel I.D.: CT/} - o~'-z -,~ -~_ A, WELL DATA Well type A If A, B. or C. attach ADEC letter, ADEC water system number L"~g..p resent (Y/N) Total dept~ Sanitary seal (Y/N)"-. Date of test Static water level Well production Date completed Cased to %'~.FROM WELL LOG Casing height (above grou.~ Wires properly pro~/N) CTION g.p.rr WATER SAMPLE RESU~: Coliform // ~ of sample: Nitrate B. SEPTIC/HOLDINGTANK DATA Date ins[a[le~ '~lto/pj~ _Tank size Foundation cleanom (Y/N) ~) Date of Pumping --. Other bacteria Collected by: '~',. Number of Compartments '~.-- Cleanouts (Y/N) Depression (Y/N) f,,..t High water alarm (Y/N) Pumper "~-S ~ A C, ABSORPTION FIFLD r)ATA _ Soil rating (g.p.d,/ft2 or~..?r~_ / 2_.~- System type '1~ Date installed I~ :~.3~ ~--c~ I Z~ l (~,~' Length ~/~' Width x ~ Gravel thickness below pipe ~ .~ Total depth Effective absorption area ~.s-6 Monitoring Tube present (Y/N) '¢ Depression over field (Y/N) _ ~ Date of adequacy test '-~/,' ] cf '~ Results (Pass/Fall) ~:~'A S.s ~ For ~/ bedrooms Fluid depth in absorption field before test (in.); '1:)~-¢ Immediately after ~;c~ gal, water added (in,): ~? r, Fluid depth 'l:b~¢' (ins) Minutes later: Absorption rate = cot ~I~ ~,o,o g,p.d. Peroxide treatment (past 12 mont~s) (Y/N) I'-<o If yes, give date -- LIFT STATION Date installed ~ Manhole/Access (Y/N) High water alarm level at* Size in gallons / ~%--~ ~ "Pump on" level at* ~'¢z-/;.~ '~ "Pump off" level at* ~ ~ *Datum ~¢', -cv/~ Cycles tested E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/h~tank on lot I'Z%. ~ t Absorption field on lot /~:~o ! ~ On adjacent lots On adjacent lots /.,.,~-o Public sewer main /U/[~ Public sewer manhole/cleanout Sewer/septic service line /¢ ~. (~ ' Lift station /~?,,,¢ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO; Foundation ~. ot Property line ~.~'-~ Absorption field Water main/service line /c~''~ Surface wateddrainage / c~c~'~ Wells on adjacent lots / ¢,,~ ~r- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property lin~~'~ / ~ Building foundation /--(-s-I Surface water Water main/service line /c~ Driveway, parking/vehicle storage area Wells on adjacent lots Z Curtain drain / c~o ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records th~ the:aboye~s,y, stern$,ar,e: in conformance with MOA HAA guidelines in effect on this date. · :: . Signature, -- Engineer's Name S-'~-r,a~.) ~"~.%~'p,.~,/v~,.,,J ~ ~::~.~. Date Waiver Fee $ HAA Fee $ ~¢~r~ ,, ~ Date of Payment Date of Payment Receipt Number 72-026 (Rev. 3/96)* - ! RI:~IIus /-/ ~ abandoned In ptat:e ~'~ ~, k / ~"':~' / / X 1~0~9¢~ / I Ex~, 4 3~ House / Ne~)~ II, line ~ w 3-way bait valve / ,, / ' ~9'-o "o' , -~ ~.,o~/ ~ ! ~, ~ ~yp~ ~ / ~.J soil absorp~lo%, system C,XWoekX2.-2SUNV.dw0 .... ...- '" WASTEWATER ABSDI;tPTIFIN SYSTEM "-,.. LDT 2, BLnCK 2 SUNVALLEY HTS Nr~TEgl 1) ADEC waived 'bhe seapara~lon distance 'For 'i;he subdivision being served by ~hls well ~o 100' 'For septic ~anl<s, and 130 ?ee~ ~o leach ~letds Per ~he ?allowing to~s~ Lo~s 1-10, ~lockl~ Lo~s 1-4, ~tock ~ Lo~s 1, 3, 4, 5 Block 3 oP ~hls 2) Bo~h existing systems are ~pproved by ~he NO~, The c~lb / w~s Inst~lled on 9/~5/7~ $ w~s' ~b~ndoned In place when ~he/~ bed w~s Inst~lled on 8/3/88;' 3) ~n ~dequ~cy 'best p~eso~ked before ~h~ 4) This modl~lc~l~ w~s neccess~y because ~h~,,b~d system ~lled ~n PREPARED FI]RI Mr, g~erLIn§ MILler 13240 M~, ])rive Anchorage, AK 99516 (907) 345-5158 PANNDNE ENG, SVC P, 0, BDX 148085 ANCHORAGE, ALASKA 272-8218 99514 !BATE, 4-4-9,7 DESIGN iSCAL D I°=50 J New ¢ 1/4 LimE; Exls.t, ~ed soil al0sof,p¢16'E% system AS-BUILT \¢AS'FE~/ATER A3SORPTIEIN SYSTEM LOT 2, ;BLF1CK 2 SUNVALLEY HTS / Expt, 4 ouse / / 3-wo.y bo, ti v~tve / Ins.to, lied Inside ~ 6' / / Clo, ss A Welt NOTES. l) ADEC wo, lved .the seo, po, f,o,.tlon dlsto, nce For, 't:he subdivision belnB sef,ved by .this weLL 'to 100' 'For, sep.tlc tm.r~ks, r~nd 130 'Fee.t .to leo, ch ?letds ?or .the ?ollowlng to.ts, ./l Lo.ts l-lO, BlocN1J Lo.ts 1-4, tl(ock 2j/'I & Lo.ts 1, 3, 2> Bo.th exls.tlng o. ppf,oved by .the MBA, The cf'b " w0. s Ins.t~,tLed on 9/25/72 & we.S/ Abtxndoned In pllzce when .the,," bed wo, s Ins.t~Lled on B/3/~8.' 3) Art (~dequo, cy on .the crib on 4/1/97~, 4) This modI'Flco, tle¢(' wc~s neccesso, f,y ~dec~¢~,,-t'Sst ?of, e, pending scale, PANNONE ENG, SVC P, B, BOX 142025 ANCHORAGE, ALASKA 99514 272-82].8 )ATE, 4-20-97 I AS-~UILT ~r~ L E, 1'=50' / PREPARED FOR, Mr, Stertln§ Mitten 13240 Mt, Drive Anchoro, ge, AK 99516 (907) 345-5158 ................ ~) Exist, C,I, Lime w6s Je.tted .to f,emove build-up, 6) Exls.t. bed w~s pumped dry .to pf,even.t b~ck-up In.to .the .trench, 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 tz~¢ q/ /~:~ GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) PropedyOwner %~n ~¢¢bCb~ Telephone:Home ~¢~--/~¢ Business ~'~O8 Mailing Address. 1~8¢O /~'fn~'¢~ ~f~¢~ ~¢¢~ ~ ))-¢(~ (c) Lending Institution ~;~B~ ~¢~6 Telephone ~¢' ~/¢~ Mailing Address ~0( ~, %~ ~ ~,~ ~c~or~ ~ ~ (d) Real Estate Company and Agent ~ ~¢~/¢~ -- V~ ~ Address 3~ ~ .¢¢,~ ~¢ ~ ¢9~ Telephone ~¢ ¢ - F¢~ (e) Mail the HAA to the foilowino address: or: Check here (;~, if hold for pick up, List contact person and day phone number below. TYPE OF RESIDENCE Single-Family Number of Bedrooms' WATER SUPPLY Individual Well [] Community I-] Public [] 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 [] Community [] Holding Tank [] Note: If com munity well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 trey 8/861Fronl 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 aU Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm F/~tJ'."~/~ '~J~/lt'c~/ ~'~'f'"~¢'¢~' Telephone ~-/~ Address /~3~ ~c~o ~ ~C~O~ ~ ~/~ Date DHHS APPROVAL . Approved ~ Disapproved Terms of Conditional Approval Conditional CAUTION The Menicipality 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 DH HS does th is 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. Page 2 of 2 72-025 fRev 8/861 Back Well Classification Well Log Present (Y/N) Total Depth Static Water Level MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEI:]RUARY 1984 264-4744 Legal Description: c51%o ¢.,.'3 If A, B, C, D.E.C. Approved (Y/N) Date Completed _ Yield Cased to Depth of Grouting Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from, Well: To Septic/Holding Tank on Lot Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) I ~O ~ '/- ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results /¥d ' ; On Adjoining Lots ~;~ To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B, SEPTIC/HOLDING TANK DATA Date Installed 8/-.~/~!i'~ Size Standpipes (Y/N) ~' Air-tight Caps (Y/N) Depression over Tank (Y/N) ~ Pumping/Maintenance Contract on File (Y/N) _ I~1,/¢', Holding Tank High-Water Alarm (Y/N) _ ~, ~, Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course __~ (OO' No. of Compartments ~ Foundation Cleanout (Y/N) Date Last Pumped __ ; for N, ~. _ Temporary Holding Tank Permit (Y/N) /~, ~,, To Building Foundation 80 ¢ To Disposal Field -~ ¢ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026 fRev 8/861 Fronl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~;~/..~/8~ Width of Field I~ ¢ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test t/~ocft~ Type of System Design Length of Field Depth of Field _ Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Properly Line ! ~" To Existing or Abandoned System on ; On Adjoining Lots ;~ ~O t To Cutbank (if present) /~,,~. To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments 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 Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Bating Against HAA Request ** certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed '~'"~ ~. ~ Date Company ¢~'7'¢-d~/¢ ~'*~.-.~ ~'~/cJ' MOA No. ReceiptNo. ~ ~ ~ ~ Date of Payment ~ ~ Amount:$ ~- ~/~ Page 2 of 2 ~ O~ 72-026 fray 81861 Back Engineer's Seal 04/25/~7 FRI 05;11 FAS 19075616253 INDL'STRI:%L %-%LYE & FT(; ~ 001 .J 400 WOG "STANDARD BORE" BRASS BALL VALVE KITZ Code No.64/55 8-Way Body Forged Brass Ball Valves can instantly change flow direction. Has L-port ball, blow-out proof stem, PTFE seats, NPT threaded or solder joint ends."'"' For water, oil, and gas m COmmercial and industrial applications, Code No, S4 (~g. Akq'N) Cools No.,,~ (Fig. CTN) Working Pressure Test Pressure 400 p~i, W.OG. '~cn.s,~¢k Snell ......... oeo psL hydc08t(~{~c 100 pm. 300:F Seat .............~0 psi. ~e Materials Parts Material ~ ASTM ~p~, ~ ~Y Fo/ged brass Cra' ~ E' ~ NO. C377~ C~s bronze 2-t~' & 3') ~ No. ~ ~y cap Forge~ Oras~ ~ NO, ~ O.~lng FPM Du~de iron (2~,~' to 3") ~ DhTtei'lsJo tls inch 600 WOG "STANDARD BORE" BRASS BALL VALVE KITZ Coda No,56/57 Brass Ball Valves have forged brass body, threaded cap, cllrome plated ball, ulowout proof stem, PTF."E seats, NPT threaded or solder joint ends.*" PTFE ~ provide bubble-tight seal Quick, quarter-turn, easy oper~,tion. Valve allows uniform flow in either direction. For steam, water, ell. and gas In commercial and industrial appli- cations. Masts Federal Specification WW-V-35B, Type II, Class A, ~ NO, E6 (FI~, AKTH) Coda NO.$7 (.~. C'TH) Materials Shell ........ 900 psi. h y~ro~'tat~c ASTM Spec, So~y & Cap 1~¢~9e¢ i~rass 8283 No,C37700 @all fgrged brass (Chrome plctledJ B283 Ne. 037700 PTFE Bore 031 03~ 039 0~9 079 0,98 126 150 1.97 2,56 3.15 L(iPS1 ~65 L69 20, 2.32 2.80 307 .3.46 3.90 8,00 6.02 L(OxO' ;57 ~89 ~93 ~68 323 362 417 5.00 5.79 6,g7 I 30 130 ~34 146 1 t7 ~ 93 320 2.40 3.58 4,13 4,88 O 3~5 3~5 3.15 SAS 3.94 394 512 5.12 ?.87 11.8115,75 DEPT. OF ENV][RONMENTAL CONS]ERVATHON 4NCHORAGE/t~IESTERN DISTRICT OFFICE 3601 C STREET. SUITE 1334 A~'. CHORAGE. Al_ASEA 99503 STEVE COWPER, GOVERNOR 563-a77s DATE: PUSID ~: To /,Ihom It M@v Concern: Accor'dinq to the records on ¢ile in this o¢¢ice, the .Do~ ~)~k%~I ~%~-~._.~£~V3_ ..... U~[er System is in compliance with the qt~te o¢ Alaska Orinkinq I,later Requlations. Sincere ] y, Ronald S, Klein Environmental Field OF¢icer :<,-~' MIJNI, C][PALITY OF ANCHORAG[: ~,~- ;:~: ,DEPA,R~FMEN'T'~,~,::'HEANTH "AND ENVoi RONMENTAL 1 ROI}£C;?I ON , :~ -: 99501 inspection: TJ_me ' .~ ....... 2nd Inspection: Date ~ Wednesday Inspector Kennedy Inspector March 22, 1977 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lendillg Institution Requesa: Mailing Address: Phone: Property Owner: MailLing Address: J.E. Caldwell/Elaine Caldwell Phone: Box 10332 Klatt Station 349-3575 3. Legal Description: Lot 2 Block 2 Sun Valley Heights Subdivision Single Family Residence: (x) Number of Bedrooms: 4 Multiple F~uni. ly Resm~ffence. ( ) Number of Bedrooms: Well Data: Type Commu.nit~. Depth Well Log Fi].ed ( ) Cons'hruchion Bacterial Analysis Sewage Permi-h Septic Absorption Disposal System: On-site sysr:em {x) Public Utility ( ) Tank Size Manufacturer ~7~_~_F_F' Distances: Well co Septic Tank . //¢3 to Absorption to Sewer Lines _ g~/~____ Nearest Lot Line _ ~ Absorption Area to Nearest Lot Line __~,~. ~Z Area Page Two Department 6f"Heal'th and ,Environmenta.1 Protection ' · Request for Approval' of Individual Sewer and Water Facilities Lega[[ Description: Lot 2 Block 2 Sun Valley Heights Subdivision Corar~ent s: Affadavit Attached: ( ) Disapproved: Letter At%ached: ( ) Date: Department Worksheet: ~'-- ~~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HI-:ALTH AND ENVIRONMENTAL PROTECTIO~I,i,/iRo~,M~' d,~, ~-,,, ~ cf ION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA_ FHA___ 2. Property Owner: ,T. 1~. ,~82.(]we!1 ~znd ~Zai'ne Oa, ldweZ1 ~7'ta'b~ S%a.'bion ~o× 10332 Mailing Address:An cho:tm, F~e CONY. X Day Phone:. '~49"'~:'7: 3. Name of Buyer: 7,!o'b yet ourchased Mailing Address: Day Phone: 4. Name of Lending Institution: Mailing Address: Phone:_ 5, Name of Realtor or Agent: Jon C. ])a.wson ,TACK W?]I'PE COMP_I~Z¥ 3201 "C" S-treat Mailing Address: Anchorage~ Alaska 99503 .Phone:_277~1553 6. legal Description: Lot 2, !~Lock 2, Sun V~.lley Hei~h'ts SubdJ. vJsJ~o~ Location?~orthea. st co:crier of junction of Flora,]. r~ar~.d Mnuni:a'in Place 7. Type of Facility to be lnspected: Si,n[~le family residence No. Bdrms, .. 4 8. Water Supply Commun:i ty Type of Supply: Public tJtility. Well Individual If individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility __Individual (on-site) If Individual, date of installation ~Tn]~:~ own ( A~)T)ro:~in a.'l;e} y 1972 ) . -5-': 72-003(3/76) April 5~ 1977 J.~. Caldwell Box 10332 Klatt Station ~]chorage, Alaska 99502 Subject: Lot 2 Block 2 Sun Valley Heights Subdivisien The recent pere test conducted by this department indicates that the existing pewer system serving the subject property is inadequate for a four (4) bedroom residence and must be upgraded before we can grant final approval. Specifications fo/: the upgrade are as follows: Deep trench fomty-four (44) fe~t long. Total depth of twelve (12) feet. Eight (8) feet of gravel underneath the pipe. A permit to upgrade is r~quired prior to uonstruetion. If there are any further questions, please contact this office at 279-2511, extension 224 or 225. Sincerely, John Kennedy rlncipal Environmental Control Officer JKYljh