Loading...
HomeMy WebLinkAboutSUMMIT ESTATES BLK 4 LT 5Lam. NN.� •�i• � kvco15-oll-oS i-�Municipality of Anchorage .••�;�, ,�,;,, 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: D PID Number: — — 0 71 — Q_'5 Nam, • Wastewater System: ❑ New E Upgrade � Address ABSORPTION FIELD Prone Number of edrooms O Deep Trench p Snalbw Trench p Bed O Mound 011"Otner LEGAL DESCRIPTION Soil Rating : Z Total Depth from original grade. P Ee I ( Ft. Block. _Lot. /. Subdivision: _ Lo qt S T t=S� Depth to pipe bottom from original grade: Gravel depth beneath pipe, t u (L t GS Ft. k2 FI Tov,nsrvp Range Section: Fill added above original grade, Gravel Length: Z Ft. n 9 Ft. Well: (:1 New ❑Upgrade Gravel width. 19 Number of Ines: Distance between Imes. FI. Fl Classirca!ion (Pnvale, A. B. C)•. r Total Depth: Cased to: Total absorption area. L T Pipe Material, Ir Ii FI. Ft. 325 Fts 016 Driller 1. Date Dmled: Stahc Water Level: Installer. PeAm Date Installed: Ft. Yield Pump Set at: Casing Height Above Ground: TANK GPM FI. fL SEPARATION DISTANCES ❑ septic ❑ Holding ❑ S.T.E.P. [I Other: To Septic Absorption Lift Holding PublidPrivale Manufacturer. \ capacity. From Tank Field Station Tank Sewer Line Gal Well y � /^) ` Material: Number of Ccmpalmerls D Surface Waver �`t p N10 LIFT STATION Lot Line L4 u 7 Size: Gal Manufacturer. 'Pump on' level at: 'Pum M level at. High water alarm a1 Founds!'on In in in Curtain Oran V �� Pump Make a Model Electrical Inspecuom onnad by Remarks BENCH MARK ' u � L'/C/ /7 D t Location arid Description:Description:4" DOA1.0 C. D bL1% Assumed Elevation N s Ide=Ft q.d �tgGtrf� 1s1 �*i49311 J*�I .» ecce ele aeeN •o e S `"1 t$la Inspections performed by: 1. . Dates: 1S1 2"d767, a3 �I d T tt$ 4e���r Development Services Department Approval Reviewed and approved by: Date: _2 - n GOO) +`��AROFESSt0O�*�� (Rev I I`• 49th l�V`0•�� I 11 _..:.............. ...... ........ ... ..... � I I I ' TUB N SPURKLAND 5 �' No CE -2225 • ••''�•• BLOC 3 �1 •••ir .: • 4 1 FESS1��0� I I 25 0 i ,tQo 1 150 3 SCALE, 1 50 FT. — _ — — — \ ~�_ E99H.AVE. _ 4- -¢ eBell 7 VING TAM 4 I AC 19 FT I :::.:•i ;: BC 17.5 / :•�,,: AD 53 it ,.. A B OCK 4 / I a T aouar CIO. D EXIST. LOG CRIB MUM DRIVEL --------- --_ ARWX.19X19X6FT — 10 \ 9 vacont m 1UHNLN 5FUMANU Y.L. OT 5 BLOCK 4 SUMMIT ESTATES SEPTIC SYSTEM AS BUILT 203 W 157H AVENUE RICHARD SULLIVAN DATE: JUNE 20, 2003 ANCH.(907) 7 9916 5480 E 99TH. AVE SHEET 213 GRID: 2437 907 ?79-3916 PERMIT NSV✓030174 PID # 015-071-05 SUM04052.dwg 1000 gal Septic tank O 00 -- 19, Double Clean Outs 19' 1000 gal. septic tank 6 FT ' * 1 y f I --i 49th 'BEN SPURKLAND No. CE -2225 •. WATER AT 15.5 MAY 30, 2003 u TOBBEN SPURKLAND P.E. LOT 5, BLOCK 4 SUMMIT ESTATE SEPTIC SYSTEM SCHEMATIC W15th Ave An SEPTIC SYSTEM SCHEMATIC DATE, JUNE 20, 2003 Anchorage Ak 99501 SHEETS 3/3 GRID, 2437 PERMIT SWOJ0174 PID 015-071-05 SUM0504J DWG 6-18'03 (�! 2;;36 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 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW030174 Legal Description:98UMMIT. ESTATES BLK ':4 LT'.,5, Design Engineer: 0007 Tobben Spurkland, PE Owner Name: Richard Sullivan Owner Address: 5480 EAST 99TH AVENUE ANCHORAGE. AK 99516-6422 Date Issued: Jun 09, 2003 Expiration Date: Jun 08, 2004 Parcel ID: 015-071-05 Site Address: 005480 99TH AVE E Lot Size: 16250 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of. ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: x/'/63 Date: '6 / 0J CMunicipality of Anchorage $: J.c �- Builclilig Safci�• Dit•isiotl George 1. 11'rrerch. Mayor 6/24/2003 Tobben Spurkland 203 W. 15rh Avenue Suite 203 Anchorage, Alaska 99501 Subject: Waiver Request for Summit Estates Block 5 Lot 4 Waiver Request #WR030046 Parcel ID #015-071-05 SW030174 Dear Engineer: Anchorage All -America City I I I I I'VI 2002 Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is —/% feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, irfirop et Engineering Technician On -Site Water & Wastewater Program P.O. Ilox 196650 • Anchorage, Alaska 99319-GG50 • Telephone: (907) 343-8301 • Tax: (907) 343-8200 =4700 South Ilrag xAv Street • Anchorage, Alaska 99507 1 dtp://������.ci.anchorugc.alc.us Municipality of Anchorage Development Services Department +.r Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#: 030046 PID#:015-071-05 HAM Date Received: 6/24/03 Legal Description: Summit Estates Block d Lot /.r Engineer: Tobben Spurkland 203 W. Ir Avenue #203 Applicant: Richard Sullivan Permit#: Waiver Requested: 3 Foot Waiver between the Septic System and the East lot line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Waiver is Granted: _Ll__� List Conditions or Reasons for above: Total: Waiver is not Granted: Date:<.? i - 3 By: 490y� �w� Wmeflof Reviewer Rec#: 37510 Amount: $150.00 Date Paid: 6/24/2003 ` w 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.enchorage:ak.us (907)343-7904 ON—SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0/5— 0-7/— b t Permit Number SW Property owners) 'p- i c'�a r ct Day phone Mailing address (1) 5, V90 q gal Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) i -n b i3p y u vvi Legal description (Section, Township & Range) Lot Size I U aA- Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only. ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade V THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized ageno Date of Payment: Date of Payment: Receipt Number: ?JG y (7g Receipt Number: (Rev. 12/00) Municipality of Anchorage • Development Services Department Building Safety Division =" ='; • . - _ On -Site Water and Wastewater Program s A F C a 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 _ON-SITE SEWERNVELL PERMIT.APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. of C:; oll — O C:� Permit Number SW 11 - '0�i_V►Oy-14 Property owners) Q' `2 T�I� �\ )1 l i V N Lj Day phone Mailing address (1) t'lLl "6D F. G "l � A -VO Y Mailing address (2) Zip j Code Legal description (Lot, Block & Sub'd.) �1)y%q nn I Eimer— h%l u I Legal description (Section, Township & Range) r Lot Size 1 'PLS 0 Acres q.F THIS APPLICATION IS FOR: Number of Bedrooms Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: ,C4 O Date of Payment: �— 3 Date of Payment: 3 Receipt Number: 10 Receipt Number: (Rev. 12100) T.SFU aLA1\\TD P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 5 BLOCK 2 SUMMIT ESTATE SID RICHARD SULLIVAN Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bmgaw Street Anchorage, Alaska 99519-6650 June 2, 2003 We are submitting an application for the upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. It is assumed that the log crib excavation was not backfilled with clean sewer rock as shown on the As Built from 1972. We suggest to replace the "sewer rock" around the log crib. The amount of rock required is based on the following: Ground Water at 15.5 ft on May 30, 2003. Log Crib is standard 8x8x6 ft i l feet deep. Soil Rating. From Testhole 05/20/03 <1 minlin = 1.2 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 15011.2 = 125 sq.ft. Total area required: 125 x 3 = 375 sqft Crib Depth 6 feet Linear length of wall: 375/6 = 62.5 Rectangular Excavation: 16 x 16 feet. Bottom Rock At 1 I feet Top Rock At 5 feet SEPTIC TANK 1000 GAL CONCRETE CHECK BAFFLES. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99519 Subject: 5 -Waiver Request Lot -r, Estates PID 015-071.05 Gentlemen; June 20, 2003 We are applying for a 3 foot waiver of the separation distance required between the septic system and the east lot line. The drain field serving this lot was installed in 1972. During repair of the drain field performed during the last couple of days it was discovered that the sewer rock around the log crib was 7 feet distant from the lot line. ("A , E* t Yo14a G�C.L k "'t �� N Load o,r wi, V �n ✓2, a..<5 ��t�e a.�i.�-�- °�-. �-[�.� ac(jo; H i •� P ro �+c,rl� T. Spd P.E. 50 0 `• 49th • ,.. ... . ....... ....•• .r ..... ........ .; J TO HEN SPKLAND , 4tCrr G �1cf '• No. CE-2225�� .( Voil I � I �° 10" 112 zs0 ' BLDCK 3 SCALES 1' = 100 FT. I , III 3 — — — �♦ E 9 . AVE._ -- I I� 4 e ^ 6� 11 I I .x --—— — — — — —� — lc = _----- ,r I 10 9 I I vacant 1 III No. • � I III 11 \ � jl III j� I III � `' • III I I I I S - Well MUMN 5PUKKLAND /'.to OT 5 BLOCK 4 SUMMIT ESTATES SEPTIC SYSTEM DESIGN TH. AVENUE ANCH.. AK. RICHARD SULLIVAN DATE: MAY 29, 2003 (NC99501 907 279-3916 I r 5480 E 997H. AVE SHEET • 1/3 GRID: 2437 PERMIT #SV✓030XXX PID # 015-071-05 SUM04051.dwg I �'' 49th � •' � �� I 1/ I .............. ......... .......� I I �••T BEN SPURKLAND.�= NO. CE -2225 ti AV I 0,•• •''�•• BLOC 3 • �sst�: I I 25 0 21 50 7.5 iso 3 �SCALE� \ FT. — — — — — �� E99H.A 4 ` Well Well 6 7 .•y: • , LI1I..I. IMI. LOCK 4 LW Ow Cr Goum X. MUM FT - - - - - - - - - - - - - - - - -0 - - - - - - - - - - - - - - - - 10 \ 9 vacant m l I&M SPUNKL4ND P.L. OT 5 BLOCK 4 SUMMIT ESTATES SEPTIC SYSTEM DESIGN 203 157H AVENUE RICHARD SULL/VAN DATE: MAY 29, 2003 (NCH.. AK. 99501 907 279-3916 1 r 5480 E 99TH. AVE SHEET • 2/3 GRID: 2437 PERMIT #SV030XXX PID # 015-071-05 SUM04052.dwg 16' It 6 FT O 1000 gat Septic tank O O Double Clean Outs 1 -4 16'sw --f— 16 f / —u 1000 gal, septic tank WATER AT 15.5 MAY 30, 2003 BENCHMARK. e0nom samo ASSUMED ELEV. 10000 TOBBEN SPURKLAND P.E. LOT 5, BLOCK 4 SUMMIT ESTATE SEPTIC SYSTEM SCHEMATIC Anchorage orag Ave SEPTIC SYSTEM SCH£1/ATIC DATE, JUN£ 1, 1003 Anchornge Ak 99501 11 11 SHEET, 3/3 GRID+ 2437 PN SW030XX PID 015-071-05 SUI105043.DWG Municipality of Anchorage Development Services Department Building Safety Division on -Site Water and Wastewater Program 47C0 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6680 www ci.anchoraoe ak.us (907) 343.7904 Soils Log - Percolation Test Performed For: J%� L GttCf Q,�t' Ir -j%.44 Dale PE Legal Description: LOT 6, 8V, x S •. w.. t 1 £s4• Township, Range, Section: Depth CO>.C,tENTS WAS CROUN0 YrATER s IF YES. AT WHAT DEPTH? ( (Zo L Depthto Water After iD i v Monitoring? ( 5 r— t: Date: 25530 0?j Reading Dave Gross Time Net Time Depth to Water I Net Drcp I 6•``` r SW e ✓e, �(� Ir / O! r R u4 t. i0 i r• 12- 13- I G.; I }G 15. J 17- // wI �0 *1 0 7Y 2 1�•I CO>.C,tENTS WAS CROUN0 YrATER s IF YES. AT WHAT DEPTH? ( (Zo L Depthto Water After iD i v Monitoring? ( 5 r— t: Date: 25530 0?j Reading Dave Gross Time Net Time Depth to Water I Net Drcp I I e ✓e, �(� Ir / O! r R u4 ,e I � I PE`CCLATION PATE < 1 Iroulnira) FSRC NCLE CIA.METE3 64 TESTRU"tBSTNE:H —SFr AND 7 FT PEnFOR :IED BY, I , S I L S CERTIFY THAT THIS T cS) V!�•S PERFORMED IN ACCORDANCE WITH ALL STATE ANDMUNICIPAL GUIDELINES IN EFFECT ON TH..IS DATE. DATE: GREATER ANCHORAGE AREA BURUL D@partment of Environmental Quality 3500 Tudor Road — Pouch 6-650 ,PAucliorage, Alaska 0059.24 ANCHORAGE AREA BOROI' ,H N° 962 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME-�dG���� �%fl✓✓/.�%Gl"i' ADDRESS PHONE i LOCATION �%%�—zG' LEGAL DESCRIPTION JU/�iy✓/.i �'1T��_...r Ji//� SEPTIC TANK: UMBER OF DISTANCE FROM WELL.&��eZ Z5 MATERIAL�� '�,�T��J/� COMPARTMENTS LIQUID CAPACITY -GALLONS. INSIDE LENGTH INSIDE WIDTH-DEPTH— NEAREST IDTHDEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER Z ----OR WIIIDTH_�//_, LENGTH / 2 , DEPTH 6>_ LINING MATERIAL Gl✓� ���X DISTANCE FROM WELL /�121,j > , BUILDING FOUNDATION��x NEAREST LOT TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF L ABS PTION AREA DEPTH: TOP OF TILE TO FINISH GRADE_ WELL: TYPE NEAREST LOT LINE 4�/����.I'�i SEWER LI DISTANCES: TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ��SQ. FT. TOTAL LENGTH NEAREST LOT LINE , OF LINES , E BETWEEN LINES -TRENCH WIDTH FT. LENGTH OF EACH LINE OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROM- WATER EPTH 414IX ,BUILDING FOUNDATION. r SAMPLE —/i�!>/�/�r, NEAREST SEPTIC SEEPAGE OTHER TANK SYSTEM "'LJ, ` CESSPOOL��U�f_ , SOURCEFr DIAGRAM OF SYSTEM DATE APPROVE B �- ucAl L All—DIry __ GREATER ANCHORAGE AREA BOROUGH SppHu�oeacE"nyFy 3500 TUDOR ROAD gym° Ir li \°o` POUCH 6-650 ANCHORAGE. ALASKA 99502 DEPARTMENT OF ENVIRONMENTAL. QUALITY ry69N�2EO JPN\.\96 January 10, 1972 Mr. Edward Shumway Box 33992 Anchorage, Alaska Subject: On-site Sewer Installation, Lot 5, Block 4, Summit Estates Subdivision. Dear Sir: In reviewing our files through 1971, we have discovered that you received a Sewage Disposal System permit but did not re- quest and/or receive a final inspection on said system prior to backfill. If this system has been installed, you are in violation of the provision of Borough Ordinance 28-68, Section 9-71, paragraph A, subparagraph 4, which states: "No septic tank, drain field, seepage pit or cesspool shall be backfilled without the permission of the health authority. All persons shall contact the Health Department giving as much notice as possible prior to covering (backfilling) any septic tank, drain field, seepage pit or cesspool." In an effort to alleviate this situation, this office requests that you send or bring to our office, within 15 days from the receipt of this letter, data concerning the sewer system. This data should be in the form of receipts for backfill, septic tank, crib, percolation test, excavation work, etc., along with a de- tailed drawing of the system. If such receipts have been mislaid it would benefit you to make an appointment with this office to have an inspector observe what he can of your system and discuss it with you. If, however, this situation remains unchanged and you make no effort to comply with Borough regulations, this office will be forced to treat your sewage system as an illegal system and start court proceedings. If you have any questions concerning the above, please feel free to call this office for assistance. Sincerely, Sue McKechnie Environmental Control Officer s January 18, 1971 "r. Edward Shumway Box 33992 Anchorage, Alaska 99501 SUBJECT; Permit'Ladt Application for Sewage Disposal System , Block 4 Summit Estates Dear "Ar. Shumway, June 1S, 1970) you obtained a for the installation Permit from this date, ermitoisa Jewa' System.Asthe p £o disposal y still outstanding. A of — Please advise this Department if you have still intend to install, a sewer s pro ert installed, or Y and wish your C Ystem on the subjoct P rmit kept penclinf; in our files, Sincerely, Lynn S. Coad Sanitarian rn GAA>rnD_2 GREATEJ ANCHORAGE AREA, TROUGH Case No. HEALTH DEPARTMENT 1 I 7 Eagle fi Anchorage, Alaska 99501 279.2511 7 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME L ANT A�LING ADDRESS—&X 3,3 9f.2 PHONE N0. RESIDEN D LOCATION OF INSTALLATION- %' -/ 6v� L L SCRIPTION LQ -T-5- 81-1-e 4 A5,CT3�C APPLICA 0CTO SERVE T FFINANCED THROTO BE INSTALLED BY__ ,iC' LF __ PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION` -.'2 r AIB5"Is F (� BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT R THIS IS TO SERVE AS �LI IM I PERMIT TO INSTALL A J e AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED _ be,M SEPTIC TANK SIZE o TYPE da!e0E PE AGE AREA TYPE LQ DIAGRAM OF SYSTEM % ,/) ?., c DISTANCES: �f WexX LO 2) &It o � MMM.MMMMMMO EEMEMMINMEN II EENNEENEOII ---mu REEK ==ME== ��iMANNNONOMON� II■III�III/II■IIEINIII WE ONES f HEV OO RUTHORITY L I I I I I I I I, I I I I I I I I I I II LICENSED DESIGNER �--L I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordin ce No, 28-68 and that the above described system is in accordance with said code. 0 ©`t' U a L l I> �( 0, 07 5a J L 7� DATE L,:�61D APPLICANTS SIGNATURE a y REATER ANCHORAGE AREA BOROUGH r HEALTH DEPARTMENT CASE N 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For a,,. _r� („ Date Performed p j _ (O _ C) Legal Description: Lot _�Block division ��,� 4a fic.«f�� This Form Reports a: Soils Log �c erg solation Test Depth Feet Soil Characteristics Location Sketch l 'The zed�menfs corrfotn '10 Vnuch Ch 4 YIL %0 6e dcjssed es Gw. The scJi, care loose ,,,,th c, wodeee'(ee �Ric) 16re- are Sone pe -661e E Sw lenses, s� Was Ground Water Encountered? °eo If Yes, At What Depth Reading Date Gross Time Net Time Depth To H2O Net Drop erco aionEtevif inu e rroposed Installation: Seepage Pit ,/ Drain Field Depth Of Inlet __ Depth To Bottom Of Pit Or Trench COMMENTS: C+nz-<- ii5-V� IA'I-�,,.: —_ .a. Test Performed Bg.; Arc n Data Certified By; Date ; \./{, •- /.� •- � �-- WELL CONSTRUCTION LOC Drilling ca. Vern's Drilling & Ent crm,# *26008'b Driller Vern Type of rig Rotary Date well completed 8-20-86 Well owner Wilhelm Hinrichs Nearest community Ancbnrage Well location: (address & legal description) 5480 E. 99th Ave. Location sketch or remarks L 5. B 4 Summit Estates Muk" Depth of well 312 ft. Casing: depth 306 ft. diam, tr in static water level 2761 ft. (*Is***, below) land surface. Date Finish of well: (open-end, sa.cean, pelfntaJLd, open -hole, other) Describe intervals and size: Well yield tested by (pumping, hailing, air) at gpm gal/min. for 1 hours with 10 t it. of drawdown from static level. DRILLER'S MATERIAL LOG CIPALIIY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAY 5 198 % RECEIVED Depth he low land surface in feet Give description of strata penetrated (size of material, color, hardness or drilling, and water content) 0 to 10 silty sand with cobbles 10 to 40 silty till 40 to 50 gray brn silty clay 50 to 60 gray brn silt 60 to 68 gray brn silty till 68 to 140 gray silty gravel with H20 -cemented lenses of gravel & silt 140 to 1§5 g ay clay and gravel -cemented 155t°175 gray black clay 175 to 198 silty gravel 198 235 brn gravel & sandy silt with seepage 235—'a to 298 cemented gravel & silt with boulders 298t0502 gravel -cemented, lenses of gravel & seepage-bould.ers brn. to to 312 brn cemented gravel -H20 c@ 3061 to 312f 6 ain to to to to to la to to to F' Er -!h L I -1 9-1.11 F-7 9�7�j N i13�� ~ DEPARTME OF HEALTH AND ENVIRONMEN`� /PROTECTlON 825 L STREET, ANCHORAGE, AK 99501 (~-� 264-4720 PFRMTT NO: DATE ISSUED: APPLICANT: ADDRESS: CDNTACT PHnNE: LEGAL DESCRIP: LOT SIZE - 860081D 04/14/R6 WILHERM HINRICHS 5480 E. 99TH AVE ANCHORAGE/ AK 99516 243-1566 ���Pw 0 1: , 0, SUBDIVISIQN: SUMMIT FRSTATES LOT: 5 SECTION. 15 TOWNSHIP: 121\1 RANGE: 3W 16000 (SQ -FT. OR ACRES} � BLOCK: 4 I certifythat-, a: 1` I an, familiar with the requirements [or on-site sewers and wel)s as set forth by the Municipality of Anchorage (MOA) and the State of Alaska 2^ I willinstall the system in accordance with all MOA codes and regul~^ijons and in compliance with the design criteria o[ this permit. ` 3" I will adhere to all MOA and State of' Alaska requirements for the set |~ack distances From From any existing well, wastewater, disposal system or duhlir sewerage s t this any adjacent or nearby lot" S7GNED DATE: APPLICANT: W���ERM��INRICHS 11,3911ED BY DATE: �xz___. Municipality of Anchorage O • Development Services Department^" Building Safety Division On -Site Water and Wastewater Program : T 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 c/ Parcel I.D. Urs- oil—ori HAA #_ (7ZJ(72-1 b Expiration Date:___7 - �L -S 6 3 1. GENERAL INFORMATION Complete legal description L -0"r S "bv_ �I. S U..w.wt i k P --S Q Location (site address or directions) 5,49-C) E 99" A V-0, Current Property owner(s) Qtr Let eeJ� l l i v Day phone U q — 6111 Mailing address YJ' 4Ro t= gq Lending agency Day phone Mailing address Real Estate Agent -'r IFti,a Zakep C'a Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: ' TYPE OF WASTEWATER DISPOSAL: Individual Well 031*� Individual On-site 9 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 o aloe ti !S�a V r1 -t AVUI�2 1�- G Phone _ P -14-3°r I b Address Ac L4, / — M 203 Engineer's Printed Name 1 Date 64'a /0-S 5. DSD SIGNATURE _jZ Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: WATER AND WAST Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: C "C2,5 = 0 3 (Rev. 018)2) 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. anchorag e. ek. u s (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo`I r> SVti 4 ZSWC-15 Parcel ID: O15- 011- o-5 A. WELL DATA Well type IZ If A, B, or C provide PWSID # _Lf'% Well Log (Y/N) Date completed 13 Ao-S b Sanitary seal (Y/N) -�/- Wires properly protected (Y/N) Total depth _3i&- ft. Cased to FROM WELL LOG Date of test 9- L o - srb Static water level JT1 b ft. Well production g.p.m. WATER SAMPLE RESULTS: r Coliform41Ionies/100 ml. Nitrate 1 �mg-11. 1470 Arsenic. mg.A. Date of sample: t6d'03 B. SEPTIC/HOLDING TANK DATA Casing height (above ground) 3Qin. AT INSPECTION . 6 -Lo -o 3 td$ ft. 7.J g.p.m. Other bacteria L.. colonies/100 min Collected by: T S D✓✓ H) 6 K 4� Tank Type/Material e �C�rtc r �� Date installed. I47 Tank size 1"y gal. Number of Compartments 1 Cleanouts (Y/N) Foundation cleanout (YM) ! S .Depression over tank (YM) High water alarm (YM) l� _ Date of pumping, b Ija d : Pumper c. L7ov�4-1 C. ABSORPTION FIELD DATA Date installed (0/0/0> /0 Sop rating (g.p.d.e or feurm) System type 1.0seri k Length _ 19 ft. Width, jq ft. Gravel below pipe _16, ft. Total depth 11. ft. Eff. absorption area 1Z Lft? Monitoring tube Depression over field Date of adequacy test tVA! Results (Pass/Fail) T' For -3- bedrooms Fluid depth in absorption field before test �in. jMater added �ai. New de th ✓ in. Elapsed Time: ! min. Final fluid depth ^P/in. Abso tion rate >= A. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off level at _ in. Cycles tested E. SEPARATION DISTANCES i oielAccess (Y/N) igh water alarm level at in. Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: 1C>< Septic tank/lift station on lot 4X On adjacent lots q'J Absorption field on lot 14-0 On adjacent lots �z 14-17 Public sewer main N/A Public sewer manhole/cleanout Sewer /septic service line iSp Holding tank _ N/A, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line t'ti' 0 Absorption field iZ0 Water main N�A Water service line �_ Surfacewater N O Wells on adjacent lots mtD U SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: �' Property line 7 ' X Building foundation 4_ Water main N/A Water Service line Surface water _ N o Driveway, parkinglvehide storage 15 Curtain drain N I o_ Wells on adjacent lots F. COMMENTS I/ ^ Ul/ ezt U'V- t i' & G Q 4 G. ENGINEER'S CERTIFICATION bA9lt 4�eA ' i 1 certify that I have determined through field inspections and a. y nr . review of Municipal records that the above systems are in _ conformance with MOA HAA guidelines in effect on this date. 9 c- Engineer's Printed Name n . Date HAA Fee $ Date of Payment Receipt Number 3 7 Y -% (Rev. 12/01) d Y Waiver Fee $ i0 Date of Payment Receipt Number J'(1N-06-20C3 FRI 03:27 PM LAHTECH/SLANA FAX f;0. 9075618628 POsfdt' Fax We 7°71 ► � / Frear CCJEX;r. ,S/lFir!CL / Cq NolaI pftV f AVENUE i Orerr••� •, -1OJ91 ,-� Cf I, u W 67.50 4].a EXISTING HOUSE P. 01 Q _ N EAISTIAG N GARAGE So 6 LOT 5 10.1 ...... _.___......_....._. � �. 10' U11LITY EASEMENT N89'57'00eE 140.00 rra�a0t�rx -- - ae.•u�,. a.. (1 I L K SL; L_L_l VAN CX0.'1LOGI NO91 ts, ry.pa.y lny tr dlens a 11 er nwtctlw •Ifdr m GINC• a my WPM M the re_*W �C6En0� �k r 'o o LrrIM a/cxrG erb• •D O U Ynfw he *-watwrtw Nowa I R ,Nix yl al. MOTL; n Oe wed for ]!a' KYOII H uawu:w• 4% ewrarraelba M Iw f101►M1n•p M'aV.'(7 tiri•e, MG • IMX E! C �Fl Ur17["M tN a WE- —X—. X al.7 •RXWeI K WI MW.r1y as she" an It, � y aha 1ti .,entre anlwtwl llwn 'A la ,el 'ram vccxa: ,L. , th frr, en M the y •nee MM no anerevdr- awta �IIrE Olnr note& nlnw.r.. A'J A3. qy.. �'�:•-1 Y] ,�. cr+^�n•Nuc AZ;—SUIL,T UF: IfC/L°EMXX nWr pAla- StPef STAv0A.2y. ST MW;0N BLVD. 1 103 (AGC, ALASKA 99565 - .�N. 107 62 ��� ��-3291 LOT 5v BLOCK 4 -tea, SUMMIT O,�. I t 2437 161 „ y, ESTATE S tyv. 5�r loo 3�6� MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D.# �\,2Q-Q1\ `�� HAA If �iQq \ 22 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 5• Stock 4• Summit Eztates Subdivision,• Location (address or directions) 5480 Eaht 99 (b) Property owner GI,LQhe2m & Manganet Htinn4chsfelephone: (home)346-3523 Business 1-474-8144 Mailing Address (c) Lending Institution 5480 Etat 99th Avenue Ak. 99516 Telephone Mailing Address (d) Real Estate Company and Agent Re/Max Pnapeatjea Attn; Ken McCain Address Telephone (e) Mail the HAA to the following address: (or check here Gxif hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 E Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family Exx Number of bedrooms 3 V 3. WATER SUPPLY Individual Well t�c Community ❑ Public ❑ Note: If.community well system, must have.written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site%% 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. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or 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 FirnI ( Telephone Address 17034 Eagle River Loop Road No. 204 Date G— Za i ' il�ai eersSeat' ,;'. r_' V 6. DHHS APPROVAL Approved for, bedrooms by aLv —'-- Date Approved v Disapproved Conditional Terms of Conditional Approval 8,' CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7188) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • Health Authority Approval (HAA) T I IECKLIST - FEBRUARY 1984 1 FEB 2 U 1991 Legal Description: ,-)UAA M Municipality of Anchorage A. WELL DATA Dept. Health & Human Services Well Classification '` N� �e f 44th— If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield/ t Total Depth -3 1 Z Cased to -10b-Depth of Grouting Static Water Level Z ls� (a Pump Set At a 1< li Casing Height Above Ground t. Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding an on Lot To Nearest Edge of Absorption Field on Lot -�qI Depression Around Wellhead (Y/N) t7 On Adjoining Lots On Adjoining Lots (o l d To Nearest Public Sewer Line 2 S To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by 64 `d�� t—�- e� d i tJ - I Date 2 Water Sample Test Resultsi71�L7.L+1iC+7Y•��!:l�,Ts�Jr�ra�a�a�iar�.�sa«.r Comments•V r tr— � B. SEPTIC/HOLDING TANK DATA Date Installed 2 -'F- 72 Size ( O©O No. of Compartments j Standpipes (Y/N) Air -tight Caps (Y/N) ._ Foundation Cleanout (Y/N) —1 � Depression over Tank (Y/N) Il) Date Last Pumped / A - Cl a Pumping/Maintenance Contact on File (Y/N) A)/(A • for e) //A Holding Tank High -Water Alarm (.Y/N) — 6)/A Temporary Holding Tank Permit (Y/N) A) 16 SEPARATIONDISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 7b( To Building Foundation To Property Line ( C) :t To Disposal Field To Water Main/Service Line (D f To Stream, Pond, Lake or Major Drainage Course Comments 6Pc_-J%�ntiUAA ,.P�,r S Ln6 72-026 (Rev. nes) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata F}ssvr r_ / !90 �& ype of System Design L -!a re'( Date Installed 7 77" 2 Length of Field;_ Width of Field 9 Depth of Field to Gravel Bed Thickness Square Feet of Absortion Area 4.5 6 Statndpipes Present (Y/N)' Depression over Field (Y/N) AJ Date of Last Adequacy Test Z Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well qngmso`� 2 To Property Line — ( h 4 To Building Foundation 30 t To Existing or Abandoned System on c Lot AVi On Adjoining Lots 7allp f To Water Main/Service Line ( n % To Cutback (if present)G4 To Stream, Pond, Lake, or Major Drainage Course (t2n To Driveway, Parking Area, or Vehicle Storage Area 71 O Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) 'Pump Off' Level at Vent (Y/N) Pumping Cycles during Adequacy Test. "Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in inspection. Signed :i A S ENLiN: ERING 1.031-1`.c.aglu Rivcr Loop"ad No. 204 Company Eagle River, Alaska 99577 Date I om he date of this MOA No. t C Receipt No. ����(� Jr ��7 Receipt No. Date of Payment �" %✓I - Waiver Fee: $ Z -)°to ��C7 Amount: $ 1'lU, OU �Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 Municipality of Anchorage Department of Health and Human Services dl"1r15 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 February 26, 1991 Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 5 Block 4 Summit--Estatesr Subdivision Waiver Request #WR910007, PID #015-071-05, HA910055 Dear Mr. Shafer: Your request for waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance is well to septic tank 76 feet; and well to leachfield 92 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Since , Robert W. Robinson Civil Engineer On-site Services Concur: usan Oswalt, Acting Program Manager On-site Services Z6r 741 0 i rie-1 4Iii f1 Ale &44- led/ e-Xrn, 76 Le11h,e,'-- 4 8 0 ME (4z 0 ROBERT SHAFER, P.E. ROGERSHAFER CIVIL ENGINEERS (907) 694-2979 Feb4ua4y 18, 1991 FAX 694-1211 RECEIVED HEALTH AUTHORITY APPROVALS Muvu,ci. pa.P i -.t y o6 Anehoxa ge FEB 2 0 1991 DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L St9Det Helth Municipality Human Serrviices of Anchorage P.U. Box 19665665 0 p SEWER &WATER Ancho4a e Ataska 99519-6650 MAIN EXTENSIONS g f LL) REFERENCE: Lot 5; Btock 4; Summit Estatea Request you i66ue .the attached Heatth Autho,% ty App4ovat and g)tant a INSPECTIONTER wa,ive4 boo .the sepa4at2on distanee6 between .the weft and septic tank and teaehb.ietd Located on the 4e4e4eneed p4opetty at 76 it. and 92 it. ne6pecti-vety. ENGINEERING STUDIES The weft a4.Cg.inatty .instatted on the 4e4e4eneed ptopeAty p4odueed a AND REPORTS m.cn-unat amount ob wate4. In August, 1986 the paope4ty owne4 had VeAn's D4itting dniU a new well on the p4ope4ty. This new welt .is toeated nea4 the o.%ig.inat wet2 and e6bo4t6 we4e taken to maintain a 100 it. sepa4ation distance to the 2each6ietd standpipe. Un6o4tunatety, the WELLINSPECTION wet is app4ox.imatety 76 it. to the septic tank and app4ox.imatety 92 &FLOW TEST it. to that po4tion ob the teach4ietd unde4 the ground 6wc4ace. The septic tank is also tocated tess than the 100 it. Lequ.i)ted to the neighbo4.ing welt on Lot 4; Btoek 4. Howeve4, this tesse4 6epa4ation SITEPLANS distance was 4ev.iewed and approved .in 1986. It shoutd be noted that the weft on Lot 4 .is onty 78 it. deep whe4eas the wett on the %e6e)tenced p4ope4ty is 312 it. deep. ROAD DESIGN A )tisk anatys.is was pe46o4med boo the waiveA u62ng the ADEC, "Sepa4ation Distance (Va,iveh Guitde2,ines". OUA anatysiis bound in excess ob the 16 pts. 4equ,i4ed boo .issuance ab the wa,ive4. SOILTEST Attached boo you4 nev.iew ane the bottowing documents: 1. A weft 9 septic site plan showing the tetative sepa4ati-on distances. PERCOLATION 2. A topog4aphy map boo the axea. TEST 3. Sati-64acto4y bacten.iatogicat 9 n-it4ate sample %ezutt6. 4. (Vett toga bon area weet6. STRUCTURAL& ENWR4NNENI AL MECHANICAL INSPECTIONS €Fs:.i 1991 ONSITE "' 1 WASTE WATER DISPOSALSYSTEM -- - DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 5; Btock 4; Summit ]:states Febkuaky 18, 1991 It .i6 auk opinion the hokizontat sepakation di6tanee6 pkesekibed by 18AAC72.021 ase not kequiked .in this case. Ig you k.equite additi.onat ingowation {oh you, kev.iew, pteaae contact u,6. an 71 77 _n 9 1 ,a a r aJ t't) an 71 77 _n 9 1 ,a ' J i --I' �{ t� o /a5 El v iI I (b)Applicant Name Wilhelm Hinrichs Telephone: Home 346-3523 Business 243-1566 -Applicant`Ad&ess,� 5480 East'' 99th Avenue, Anchorage, AK, 99516 (c) Applicant is (check one): Lending Institution GAF; Owner/builder ❑ ;Buyer ❑ ;Other ❑ (explain) Re -Financing (d) Lending Institution Alaska Pacific Mobt-gage Telephone 564-0208 Address 101 west Benson Blvd. Anchorage, AK 99510-0420 (e) Real Estate Company and Agent -_/VSA I Address Telephone (f) Mail the HAA to the following address: c1' S &-S ENGINEERING EA LE RIVER, AK 99577 i i I 2. TYPE OF RESIDENCE I Single -Family ED Multl-Family ❑ Other Number of Bedrooms 3 3 WATER SUPPLY Individual Well [2 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 i Onsite Public ❑ `Community ❑ Holding Tank ❑ Note; If community well system, must have written confirmation from the State Department of Environmental Conservation r44 attesting to the' legality and,'status s, 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 S & S ENGINEERING Telephone, r( 29 7f Address SR B 196X Date EAGLE RIVER, AK 99577 7 Approved X Disapproved ri s.0 Date' 7-y —6 —Conditional Page 2 of 2 -� 72-025 (11180) MUNICIPALITY OF ANCHORAGE ^ DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) I 2 3 9986 CHECKLIST - FEBRUARY 1984 W 264-4720 RECEIVE D Legal Description:'C3L'k'`i' S J MA A. WELL DATA a �p Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present (YfQ Date Completed 1'Fy-toA tai IZ Yieldd Total Depth Zg''r Cased to� k Depth of Grouting Static Water Level ''S( Pump Set At 253 Casing Height Above Ground Electrical Wiring in Conduit ON) Separation Distances from Well 30' Sanitary Seal on Casing SYN) Depression Around Wellhead (Y)R To Septic/Hehdhtg Tank on Lot 15 (lfa5gD^-'r pPz X02 On Adjoining Lots To OvC, tf�3 To Nearest Edge of Absorption Field on Lot too' On Adjoining Lots t To Nearest Public Sewer Line i 1P To Nearest Public Sewer Cleanout/Manhole a'p To Nearest Sewer Service Line on Lot 2S I -t Water Sample Collected by l S�Yt �aG Date %-Z-$I° Water Sample Test Results Comments 'fo SJGc1,y5,s\JY_- P0P4p1Jlw An1p ?+EcdJHAn T*r5� R�sU�sS B. SEPTIcA40t:DMG TANK DATA Date Installed 2l9' 1-2— Size I Oo0 fNo. of Compartments Standpipes64/N) Air -tight Capso/N) Foundation Cleanout (Y�Q Depression over Tank (Y/Q Date Last Pumped 6"� 9. - Pumping/Maintenance Contract on File (Y/N) a for a Holding Tank High -Water Alarm (Y/N) A Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/I leldiRg Tank: -1 To Water -Supply Well /� To Property Line J0 14 - To Water Main/Service Line i A Course Comments Page 1 of 2 72-026(71/84) To Building Foundation FA To Disposal Field To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata MSJwtEED ),5-2) tj,0 4 Type of System Design L&,G GQ 7a Date Installed 2-- 9 - '7 2 Length of Field 19 Width of Field /g r Depth of Field /,0 Gavel Bed Thickness Square Feet of Absorption Area Standpipes Present<9?N) Depression over Field (Y/tQ _ Results of Last Adequacy Test Separation Distance from Absorption Field: I To Water -Supply Well k oto To Building Foundation Lot S To Water Main/Service Line I To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments — D. LIFT STATION Date of Last Adequacy Test LZS� �2Tr52�./ f To Property Line 1 0 '4- To Existing or Abandoned System on On Adjoining Lots '%d1-(" To CutF, pk (if present) I+ Date Installed Dimensions Size in Gallons _ Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at _ High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify" ShfiNGINEERM(Red, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. SignedSR B 196X Date CompS#GLE RIVER, A ?9577 MOA No. Receipt No. .' y �p�•n� `{(�s�g Date of Payment _ (A �%`� i4 Sc9 V* Amount: $ :� e ��� r° •� Y x+ba+•A. ahs. I Page 2 of 2 �+ 9Fq �': •.....•' ��+� 72-026 (11/84) �J Vezmt d O eeiog & c5jttezpzided STAR ROUTE A - BOX 1560 - ANCHORAGE, ALASKA 99507 - (907) 345-4417 June 23, 1986 Report of well located at Wilhelm Hinrichs resid.enee, 5480 Last 99th, Anchorage, Alaska. Six inch cased well. Total depth 283'. Pump intake at 2531. Ten inch plug in bottom to hold water static level of 35'. Well producing 1 gprn. 6-21-86 12:00 noon pumping at 221 gprn. Pumped down to intake at 3:30 P.M. Total pumped 525 gallons. 9:30 p.m. pumping 9 gpm. 10:08 pumped to intake 342 gallons in 38 minutes. 6-22-86 6:10 a.m. pumping 9 plus gpm. 6:55 pumped to intake 405 gallons in 45 minutes. 2:20 p.m. pumping 9 plus gpm. 3:08 pumped to intake 432 gallons in 48 minutes. 8:43 p.m. pumping 9 plus gpm. 9:21 pumped to intake 342 gallons in 38 minutes. 6-23-86 6:40 a.m, pumping 9 plus gpm. 7:29 pumped to intake 441 gallons in 49 minutes. APPLK \IT FILLS OUT UPPER HAI ONLY Time Property Owner �. �1{{'j �� "r! c>rJ Phone Mailing Address - Zip Code Date Buyer Date I a- 3Q'Vi_t1A5 Address Zip Code Lending Institution;_ T Phone Address hle g•rlrPr` /_Ii.. r`."�-�, a, C. -'— .] 1.0 i>L �.r<. Zip Code �- Realty Co. & Agent Phone Address,:�9 !i --R t i..{ .�-I\ r� t Zip Code Cc7 _. �, 3 ;Z 76 i; Legal Description 1 T t r % •' k TFQStreet DEPT. OF HEALTH Location - .r. ;[�, 5./ .. •_ Type of esidence r Ingle Family y� AUG 181983 ❑ Multiple Family No. of Bedrooms --� ❑ Other Water Supply (3) APPROVED BEDROOMS ,Individual 4`:^ ( ) DISAPPROVED ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community 15 ( ) CONDITIONAL APPROVAL' For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility DATE �1� _S 3 Sewer isposal Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank Soils Rating NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Dale Date Date I a- 3Q'Vi_t1A5 Inspector Inspector Inspector Inspectorn I Ca vivo S . Field Notes: ISL © MUNICIPALITY OF ANCHORAGE e< DEPT. OF HEALTH ENVIRONMENTAL PROTECTION AUG 181983 RECEIVED. (3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE �1� _S 3 Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received SS' �•- (yns— 7 Well to Tankr Septic Tank Size 72 023 APPLK 'NT FILLS OUT UPPER HA( ', ONLY Property Owner �'16,ei «L ynicb . Rc> o C 21n 71 Phore Mailing Address 21p Code - Buyer - _..... Address < Zip Code - Lending Institution Phone ' t Address _ .' Zip Code Realty Co &Agent CCro?Oay 7�1 hi �21'T"'k3�E �}ojyi�s -.GrGlz JAIz P.A Phone Address �,o �, (�IGe`zN ERr� ..%1 ^b}q-$,'-Aµc Zip'Code Qcj qrs �.i4-1333 Legal Deseriptbn dors'���te+Sec fn �tT CSc�p�S r _ � 9 Street Location :5 gp Type of Residence &Single Family --❑ MultipleFamily No. of Bedrooms ❑ Other Water Supply -individual-.:ts_rs i L I ATTACH WELL LOG. A well log is require( ❑ Community For wells drilled prior to that date, give well 11o Public Utility .7. • er .b� �, .y.: r, r o _ k Sewer Disposal u r ; J.t ...... Individual Year Indi vidual Installed ❑Public Utility ? 5 -t, ,'' _r }jos +^+-, When Connected to Public Utillty. wells drilled sinceJune1975. ttach log if available). NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. - - u umer 'CONDITIONS OF APPROVA ❑ Holding Tank L - APPROVAL FOR - BEDROOMS ❑ CONDITIONAL ❑ DISAPPROVAL 0 APPROVED ❑ Community (shared) DATE: BY: -. NOT APPLI(`,NT FILLS OUT UPPER HAS ' ONLY ProPertY Owner `4612-P 1-- �"-y(JC k:1 tai-: 1-o. \" Cc�;v�vnr�U / Phone Mailing Address - Zip Code Date Buyer Date - Address Zip Code Lending Institution - - , - Phone Address `� Zip Code Inspector n�J �SYQ� Realty Co. &Agent Crr ta,j JQ.) x IAC #2rTi''-1 C, t�- t�c>jri i-"� Vii:%GP - <AF P, Ax Phone Address �-f t l�<'� 1'(L tJ -1 "t- s-' Zip Code `56 0276 - 13 3 3 Legal Description - i-bY r - - -5Ss k GOT 1 3 9982 Street Location Type of Residence _ - K Single Family- r ❑ Multiple Family No. of Bedrooms - ❑ Other Water Supply R. Individual - ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community - For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal 1 �� P Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time chi '% Date Date Date - Date Inspector Inspector Inspector Inspector n�J �SYQ� Field N es �Wt� 3 £. til �MILP� IC3�.U'tl'O1� MUNICIPALITY OF A' DEPT. C`' NC " I t) (� 4a� ^� f _ �,` rte, W (✓del IRONPJeP: A_ ..J,- (ION - ( GOT 1 3 9982 RECEIVE® ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( 1-) DISAPPROVED ( )CONDITIONAL APPROVAL' /'� _ -]- — �' \ - n a ,!` // n� DATE � BY: C /X//v.X-/Qv�/_j( Soils Rating Date Sewer installed Well To Absorption Area Well Log Received 3'--1 qV Well to Tank --2S- Septic Tank Size I06c) 72 023 October 18, 1982 ___G'texx''1.�:--I;ynFlr°k2e'i.Zs� C�SFn�sany c/o Peter .7arratt C-21 Heritage domes 207 E. Northern Lights Anchorage, AR 99503 Subject: Lot 5 Block 4 summit Estates Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: ° Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. ° The water analysis report needs to he submitted to this office from the Chem Lab, 5633 P, Street, for our review. ° The septic tank pumped with a receipt submitted to this department. An adequacy test needs to be performed on the existing UNv leaching area. This test will determine if the system is adequate according to National. Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. if there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt Associate Environmental specialist RP201./p/EH Enclosure i 1`/ DA E RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTORt/_ 't'Y0'1. - MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF ;i_,.!.r! u DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOf,JIRONMENTAL rl.� TECiION 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION OCT2 9 Telephone 264-4720 FF ((�� �// INDIVIDUAL WATER AND SEWER FQTVEE D REQUEST FOR APPROVAL OF DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten 00) days for processing. PHONE PROPER FMAILING ADD}RRESS /� (fn � � - - AwX 27 +� - PHONE PROPERTY RESIDENT (tit dif erent(f�rom above) NOTE: THE INSPECTION FEE MUST ACCOMPANY PHONE 2. BUYER /!MES MAILING ADDRESS ,.t Atc 12,4 �v PHONE 3. LENDING INSTITUTION MAILING ADDRESS PHONE ) 4. REALT R/AGENT - PH / ✓'!b / ) MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATIO q' 6. TYPE OF RESIDENCE NUMBER OF�BEDROOMS ❑ One ❑ Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ;1�9_ Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled 10, ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) , B. SEWAGE DISPOSAL SYSTEM 11-72, YEAR ON-SITE SYSTEM WAS INSTALLED. S� INDIVIDUAL/ON-SITE** ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE 79� THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY FA INDIVIDUAL ❑ COMMUNITY LJPUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 4 -----APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79) ALASKA BUIR0110 nTAL COnTROL SCR US, InC. 6ngineerinq & 6nuironmental Studies 11/2/81 MUNICIPALITY Or ANCHOP.AGE U=2T. GF ii_j iil c ENVIRONMENTAL I'AOIECT(ON i:ViiJ tJ�i]! LINDA DUFFIN RECEIVE) SRA BOX 87 ANCHORAGE AK 99507 SELLER — LINDA DUFFIN BUYER— SUBDIVISION—SUMMIT ESTATES BLOCK -4 LOT -5 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 456 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 500 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 10/28/81 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. l" t 1k R®W. No. 2231.0 1220 West 25th Auenue o Anchorage, Alaska 99503 a (901) 216-1361 #1: Time Date Insp 1 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES'. r if r^TM��r r7 --? Al -anm Lending Institution Request: c ^ � Mailing Address: 712 West 4th Avenue9'501Phone: 2. Property Owner: Edward/Beverly Shymway Phone: 243-1141 Mailing Address: Box 10024 South Station 99502 3. Legal Description: Lot 5. Block 4 Summit Estates Subdivision 4: Single Family Residence: (x)c Multiple Family Residence: ( ) 5. Well System: individual Well (x) Permit # Number of Bedrooms: Depth of Well Construction 6. Sew '"e Disposal System: Number of Bedrooms: Three I Community/Public System ( ) 278' Well Log on File ( ) Bacterial Analysis on-site System (x) Permit # Installed Public Utility ( ) Installer Septic Tank Size 106)(5 Manufacturer (\mac . S»ten cQ Gi wzc Absorption Area Z.{S(a Soils Rate /Es- Material 7. Distances: Well to Septic Tank -7-S-' to Absorption Area /©d' to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHORAGF DEPARTME( OF HEALTH , AND ENVIRONMENT PROTECTION 825 L Street, AnchoraaR. Alaska 99501 264-4720 Date Received: February 21 1978 :1 .m. #2: Time : pm #3: Time 'q 78 Date �/��g �j�ps Date �/�%'$/.LL-) � at Insp _ f h ,� o " Insp _Q do REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES'. r if r^TM��r r7 --? Al -anm Lending Institution Request: c ^ � Mailing Address: 712 West 4th Avenue9'501Phone: 2. Property Owner: Edward/Beverly Shymway Phone: 243-1141 Mailing Address: Box 10024 South Station 99502 3. Legal Description: Lot 5. Block 4 Summit Estates Subdivision 4: Single Family Residence: (x)c Multiple Family Residence: ( ) 5. Well System: individual Well (x) Permit # Number of Bedrooms: Depth of Well Construction 6. Sew '"e Disposal System: Number of Bedrooms: Three I Community/Public System ( ) 278' Well Log on File ( ) Bacterial Analysis on-site System (x) Permit # Installed Public Utility ( ) Installer Septic Tank Size 106)(5 Manufacturer (\mac . S»ten cQ Gi wzc Absorption Area Z.{S(a Soils Rate /Es- Material 7. Distances: Well to Septic Tank -7-S-' to Absorption Area /©d' to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line fage, -Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 5 Block 4 Summit Estates Subdivision Comments: S 6ALS &S = Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date: Disapproved: Date: Department Worksheet: r MUNICIPALITY � PARTMENT OFENV ENVIRONMENTAL I�', l$ J � __2 -2 7� R`0={,=Straei, Anchorage, Alaska 99503 — 2� 271-OrN REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: t VA FHA CONV 2. Property Owner: Mailing Address: a Z 995Dy Day Phone �X3 — /A// 3. Name of Buyer: gaL4&e/ �u h 90/ Mailing Address: / �'� N/J�G (/rc% �esofe! Ui Day Phone a92 / 4. Name of Lending Institution: tplr' c' ��h 6t (�1mrr cvGP Mailing Address: _7/a a2 Ale Phone d7e? ''5-611 ,— 5. Name of Realtor or Agent: / iv,d S /%/ ZP V Mailing Address: 1q�a2 Phone 31fg �f4�7(o 6. Legal Description: '/_e Al ///I/ 6?qZh e 14,66,9 d /rd Ii� Location:Z igk I on &ecfl J"O g� ty. /� l ��i� /lig , C/ilsr/( Qt EWZJ2a c `a A ' �.�' Gey'/l d --it le�fA4,4 ,Si�t'�; � 7. Type of Facility to be inspected: 40 No. Bdrms. 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served D� If Individual, depth of well B. Sewage Disposal System • r i Type of System: Public Utility Individual (on-site).__• If Individual, date of installation I lease Glrl'a�C c� �f. �jr� re-a.ffe)r fo r I EQ '` J© (1/74) � / on -037