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HomeMy WebLinkAboutSOUTHPARK BLK 4 LT 2AOnsite File Southpark Block 4 Lot 2A #020-491-49 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191064 PID Number: 020-491-49 Dwelling: A Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Heidi Hammond ABSORPTION FIELD ❑ Deep Trench X Wide Trench ❑Bed [:1 Mound Site Address 16210 Chasewood Lane Anchorage AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 223-1736 1 3 1.2 GPD/SF JTotal 8.6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.6 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot Southpark 4 2A Fill added above original grade 0.0 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5.0 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 500 Ft2 1 Ft. Well N/A N/A N/A N/A >25' TANK ❑ Septic X S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Anchorage Tank 1,500 Gal. Surface Water >100' >100' >100' NIA Material Steel Number of compartments 2 Lot Line >5' >10' >5' N/A NA Foundation >10' >10' >10' N/A LIFT STATION Manufacturer Anchorage Tank Capacity 250 Gal. Remarks Septic system is adequately sized for four bedrooms. Alarm location Inside the home near point "A" (see site plan) Electrical installed by Power Lighting & Control PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer Denali Excavating Drainfield D3034 CO/MTD3034 Inspector J. Millette / J. Wiliams BENCH MARK (Assumed elevation) 100 ft Inspection151 8/8/19 nd 8/9/19 Location and description 2 Garage slab. 3`d 41" ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp -trio '� Conditional Approval: Date ®®P�x®OF ®� ,, •••" .° ® 49th = $ . ...... .. . ... ... ...... .......... ®................nuuu................ `. �6 MICHAEL E. ANDERSON ���!f'% No. CE-4381ZO Septic System P=LMk' � Approved Date 102020 g/1 FDp........ P�'®®�` A44�e;®®®�® Note: this approval does not include well permit requirements. (Rev 05/02/18) EXISTING TRENCH ABANDONED IN PLACE. 100500 FEET 1"=50' EXISTING SEPTIC TANK FILLED w/ SOIL & ABANDONED IN PLACE. 3-B D R M H O M E NEW 1,500-GAL S.T.E.P. TANK CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND MT1 PERMIT # OSP191064 PID # 020-491-49 SOUTHPARK, BLOCK 4, LOT 2A A B FCO 20.2 SV1 17.8 SV2 18.7 A B C C MH 19.0 MT1 MT2 46.1 90.3 11.7 20.5 28.7 30.3 CHA S E W O O D L A N E 6/23/20 10'x20' T&E EASEMENT 10'x10' T&E EASEMENTSOUTHPARKBLUFFDRIVE10' T&E EASEMENT 50' LONG x 5' WIDE x 4' EFFECTIVE DEPTH ABSORPTION TRENCH MT2 TH1SV1 MH WATER SERVICE LINE. EXACT LOCATION UNKNOWN. SINCE KEY-BOX IS LOCATED ON NORTH END OF PROPERTY, MINIMUM 10' SEPARATION TO SEPTIC SYSTEM IS ASSUMED. ALTERNATE SITE5-10%5-10%5-10%SV2 FCO INSPECTION PIPE FOR LATERAL DRAIN PIPE DEPTH. ELECTRICAL INSPECTION PIPES. PLAN AS-BUILT NOTE: NO RECORD OF A COMMUNITY WELL CAN BE FOUND SERVING ANY OF THE NEARBY LOTS. THE WELL ON KAROLASKA TR B1 TO THE SOUTH HAS BEEN CLASSIFIED BY THE ADEC AS A RESIDENTIAL WELL. D 87.3 125.0 D PROFILE AS-BUILT (NO SCALE) 90.9 86.8 91.5 95.8 50' DRAINFIELD ROCKMTFCOSV1 SV2MH1500 GAL S.T.E.P. TANK TH#1NO GROUNDWATER 6/13/19 84.3 88.3 MT77.9 84.3 88.3 92.9 ORIGINAL/FINISH GRADE 6/23/20 PERMIT # OSP191064 PID # 020-491-49 SOUTHPARK, BLOCK 4, LOT 2A MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Qox 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191064 Work Type: SepticTank Upgrade Tax Code Number: 02049149000 Site Legal Address: SOUTHPARK BLK 4 LT 2A G:3236 Site Mailing Address: 16210 CHASEWOOD LN, Anchorage Owner: HAMMOND HEIDI Design Engineer: FORGE ENGINEERING This permit is for the construction of: NJ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date Lot Size in Sq Ft Total Bedrooms: o� Deparmlent 4/2/2019 4/1/2020 33555 ❑ 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 Ell cls o, � 1 3D 1� SIS iso, `�P1 � P Received By: Issued By: Date: Date: MUNICIPALITY OF ANCHORAGE 0189 7077 rb A Community Development Department Development Services Division 719 ax: On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT 'LICATIO Parcel I.D. 020-491-49 Property owner(s) Heidi Hammond Day phone Mailinq address 16210 Chasewood Lane Anchorage AK 99516 Site address 16210 Chasewood Lane Legal description (Sub'd., Block & Lot) Southpark Block 4 Lot 2A Legal description (Township, Range & Section) �1 Lot Size 33,555 Sq. Ft. Number of Bedrooms 907-343-7904 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field X❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank FX]Upgrade R Duplex ❑ (D) Holding Tank ❑ Renewal❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / 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: 3 7 Waiver Fees: _ Date of Payment: ;3 122,11 q 424191 Date of Payment: Receipt Number: - 02Z79 ID 08" J Receipt Number: Permit No. 69,0IQ 164 Waiver No. Permit App_'-'- ,�. c June 18, 2019 MOA Development Services Dept, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Southpark, Block 4, Lot 2A —16210 Chasewood Lane Septic System Design Dear On -Site Services Engineer: The existing septic system on the subject lot has failed and a new system must be placed to serve the three-bedroom home. The existing septic tank will be decommissioned in accordance with Municipal Code. We are submitting this permit application to construct the new septic system. The attached site plan identifies the location of the home, the water service line and septic system along with the proposed septic location. No conflicts exist between this proposed system and any other well or septic system on this lot or adjacent lots. The ground surface on the lot in the area of the proposed absorption system slopes to the northwest at 15%. There are no slopes greater than 25% within 50 feet downslope of the primary site. Topographic contours are shown on the site plan indicating the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trenches will be constructed parallel to the slope as much as possible. The new system will be a minimum of 10' from water service lines, 100' from surface water, 200' from existing wells and more than 5' away from the septic tank. Please refer to the attached test hole log, laboratory soils analysis and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, f (} Michael E. Anderson, P.E. SOUTHPARK BLOCK 4 LOT 2A Cygs�w WATER ERVICE LINE. EXACT \ LOCATI N TO BE ETERMINED TO PRIO CO TRUCTION. MINIMU 10' SEP RATION TO SEPT SYSTEM. 10' T&E EASEMENT \\,\� WOOD FENCE LOT 2A Ll - 0 NEW 1,500 -GAL 3B�/�M / ` �a AL F S.T.E.P. TANK u— /REMOVE EXISTING\ CO MT TH1 .._! SEPTIC TANK AND SV / _ \ CD DISPOSE OF PER MH MT _ MOA CODE 0' LONG x 5' WIDE x 4' EFFECTIVE DEPTH 10' W T&E EASEMENT ABSORPTION TRENCH jEXISTING TRENCH LOT 4 0 LOT 1Aco / 10'x10' T&E EASEMENT NOTE: PLACE NEW SEPTIC TANK A MINIMUM OF 10' FROM BUILDING FOUNDATION AND 5' DECK OR STAIRWAY SUPPORT. / SEPTIC TANK MUST BE A MINIMUM OF 10' FROM THE WATER SdRVICE LINE. / t.. 200' WELL RADIUS EXISTING COMMUNITY WELL (CLASS A) ENGINEERING NOTE: I NO SLOPES >25% WITHIN ®®®�E OF q®�� PROPOSED SEPTIC SYSTEM OR SURFACE WATER WITHIN 100` OF THE : LEGEND ..•......... ..........®®® CO - CLEANOUT ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 2CO - DOUBLE CLEANOUT }° R •"e'g th •.m:• •• •�•••• PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS LLS OR SEPTIC FCO -FOUNDATION CLEANOUT �TZK : 0 SYSTEMS. FS - FLOW SPLITTER VALVE ......................................... �.� n MICHAEL E. ANDERSON 0 50 100 MH - MANHOLE sem. No. CE -4381 ..,: f A MT - MONITORING TUBE ®®00 FO snsns. ,,,.��®� FEET SV -SEPTIC VENT ®O�®�ROn®S®�� �� 1"=50' TH -TEST HOLE SOUTHPARK, BLOCK 4, LOT 2A DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW 5' WIDE TRENCH SYSTEM PERK RATE: <1 MIN/IN 1,500 -GAL S.T.E.P. TANK APPLICATION RATE: 1.2 GPD/SF 600 GPD / 1.2 GPD/SF /5' WIDE * 0.50 REDUCTION = 50 LF TRENCH REQUIRED (50 LF SPECIFIED) BOTTOM OF TRENCH: 7'6" BELOW GRADE FLOW LINE ELEVATION: 3'6" BELOW GRADE TOP OF TRENCH: 6" ABOVE GRADE I -I " PVC w/ 30 - -6" HOLES @ T SPACING (HOLES DOWN) JRAINFIELD ROCK E N G I N E E R I N G� TYPICAL TRENCH SECTION OF ®®14 (NO SCALE) Q;,.•••, ... NOTES: _ �`� 49th �. R ..... ...............a.....+ 1. GRADE AREA OVER TRENCH TO DRAIN AWAY • „� i �.....y................................. e 2. PROVIDE 3 OF COVER OVER TRENCHES AND 4 OVER SEPTIC TANK, OR 2 0 ;MICHAEL E. ANDERSON ffi WITH 2" OF INSULATION �%® ,A.,. NO. CE -4381 ••,:��- 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER &17119 6"719 ®�� ® ® THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY ®411mial pROFESS\cJ��� SOILS LOG AND PERCOLATION TEST ENGINEERING LEGAL DESCRIPTION: SOUTHPARK B4 L2A PERFORMED FOR: HEIDI HAMMOND DATE: 5/30/19 PROJECT No.: PARCELID#: 020-491-49 TECHNICIAN: J. MILLETTE DEPTH TEST HOLE 1 (feet) 1 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 V OB GM (SANDY SILTY GRAVEL) •. i ' • WAS GROUND WATER ENCOUNTERED? IF YES a WH DEPTH OF WATER AFTER MO DATE OF MO COMMENTS: SLOPE NO Sl I E PLAN SEE SITE PLAN AT DEPTH? NITORING: NONE NITORING: 6/13/19 P E DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 6/3/19 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 10:24/10:28 4:32 60x/12 g 616 2 10:43/10:48 4:54 13ax/12a 616 3 10:49 / 10:55 5:26 60 /12-9- - 616 16 4 10:56 / 11:02 5:40 6a/ 12 6 6 0 5 11:03 / 11:08 5:44 6106/12-L 6 �0 6 11:09/11:15 5:16 6-1/12-s 6 0 PERCOLATION RATE: 0.9 (MIN/INCH) PERC. HOLE DIA._�INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. NORTHERN GEOTECHNICAL ENGINEERING, INC_/ TERRA FIRMA TESTING PROJECT CLIENT: Forge Engineering PROJECI'NAME: South Par'liSuhdivision PROJECT NO.: 5248-19 SAMPLE LOC.: Lot 2A/ Block 4 NUMBER/ DEPTH: 16210 Chasewood DESCRIPTION: Poorly -graded sand w/ silt and gravel DATE' RECEIVED: 6!3/2019 TESTED BY: EA REVIEWED BY: RJPC 100 90 80 a 70 ,c') 60 50 m 40 30 20 10 0 145 140 3 135 Z 130 125 120 11 % GRAVEL 41.8 % SAND 51.0 % SILT/CLAY 7.2 % MOIST. CONTENT 4.5 USCS USACOE FC % PASS. 0.02 mm % PASS. 0.002 mm SP -SM N/A NIA N/A UNIFORMITY COEFFICIENT (CI,) DEGRADATION 51.6 152.40 COEFFICIENT OF GRADAToN, (Ce) PLASTICITY INDEX 0.3 3" ASTM D1557 (uncorrected) 38.10 N/A, 100 ASTM D4718 (corrected) 3/4" N/A 12.70 OPTIMUM NIOIST. CONTENT. (corrected) N/A 9.50 PARTICLE SIZE ANALYSIS ASTM D422 / C136 U.S. SIEVE OIEVINGIN MOIL' I U.S.SIEVENMUIERS I WMRONIETER 100 10 1 0.1 0.01 GRAIN SIZE (Sam} GRAVEL SAND COBBLES Coarse Fina Coarse i�4edium Fine SILT or CLAY MOISTURE -DENSITY RELATIONSHIP ASTM D1557 0.001 'MIN M ==MMMM !!! ! !! 551 MEMO== 5=C��CC���� !!iceMW !ter 555_ WE WEEM woniM MUMMMMEMMEi !EM �� MOISTURE SIEVE ANALYSIS RESULT SIEVE SIZE (nun) SIEVE SIZE (U.S.) TO'rAL% SPECIFICATION PASSING (% PASSING) NIA DEGRADATION 152.40 6" PLASTICITY INDEX 76.20 3" N/A 38.10 1.5" 100 19.00 3/4" 93 12.70 1/2" 81 9.50 3/8" 75 4.75 #t4 58 2.00 910 47 0.85 #20 40 0.43 #40 33 0.25 #60 24 0.15 #100 15 0A75 4200 7.2 HYDROMETER RESULT ELAPSED DIA4tETER TOTAL% Thb1E (MTN) (mm) PASSING 0 0.5 1 2 4 s 15 30 60 250 1440 HYDRAULIC COND. (ASTM D2434) NIA DEGRADATION (ATM T-313) N/A PLASTICITY INDEX ASTM 4318 N/A The testing services reported herein have been performed to recognized industry standards, uuless otherwise noted. No other warranty is made. Should engineering interpretation or opinion be required, NGE-TFT will provide upon written request. 11301 Olive Lane • Anchorage, Alaska 99515 • Phone: 907-344-5934 - Fax: 907-344-5993 • invmnge-tfr.com 1103-03B Grid 3236 EN19018 020-491-49-000 This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Heidi Hammond (herein "Permittee"), whose address is 16210 Chasewood Land, Anchorage, Alaska 99516. 1. Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Described in these certain written instruments recorded on the 10th day of June 1959, at Book Ease 5, Page 152, recorded on the 11th day of May 1981, at Book 595, Page 578, and recorded on the 17th day of June 1988, at Book 1748, Page 739, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, Dedicated by the plat of the subdivision known as Southpark Subdivision, according to Plat Number 87-112, recorded on the 181h day of November 1987, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The northeasterly heading Ten Foot (10') T&E Easement crossing the central portion of Lot Two A (2A), Block Four (4), Southpark Subdivision, according to Plat Number 87- 112, recorded on the 18th day of November 1987, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Encroachment Permit - Page 1 of 4 Lot Two A (2A), Block Four (4), Southpark Subdivision, according to Plat Number 87- 112, recorded on the 18th day of November 1987, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein "Parcel"). 2. Encroachment. Permittee has proposed to construct the following improvements on or within the real property subject to said Easement: A private underground septic line with an approximate buried depth 3 feet that encroaches entirely across said Easement, for a width of approximately One Foot (1'), (herein "Encroachment") 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its existing location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the Encroachment. 5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. 8. Covenants Running with the Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. Encroachment Permit - Page 2 of 4 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if. a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Agreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC Shelly Schmitt, Senior Manager Distribution Engineering Date: PERMITTEE By: :m Heidi Hammond Date: -1 3 0 - () / Encroachment Permit - Page 3 of 4 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of 2019, by Heidi Hammond. STATE OF ALASKA NOTARY PUBLIC '� Allen P. Martin My Commission Expires: March 2, 2021 STATE OF ALASKA THIRD JUDICIAL DISTRICT ) ss: /�� - X., I Notary Public in and for the S to of Alaska My commission expires; ;�67-1 The foregoing instrument was acknowledged before me thi day of 2019,by Senior Manager, Distribution Engineering of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. Notary Public in and for the State of Alaska My commission expires: AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. P.O. Box 196300 Anchorage, Alaska 99519-6300 Encroachment Permit - Page 4 of 4 j gLaska dl,la.k If f;rr,fni)n14",NIfill 4 tnrn July 2nd, 2019 Heidi Hammond 16210 Chasewood Lane Anchorage, Alaska 99516 Alaska Communications has no objections to the proposed septic system encroaching into the 10' Telecommunications & Electrical Easement located in the middle, from the southern boundary to the northern boundary, of block 4, lot 2A, Southpark Subdivision, otherwise known as 16210 Chasewood Lane, Anchorage, Alaska as depicted on the drawing provided by Benjamin Schiller, Forge Engineering. Alaska Communications currently utilizes a portion of this easement and has no objection to the encroachment. Alaska Communications hereby issues this letter with stipulations to allow the encroachments of the above mentioned into the easement. Acceptance, (your signature below), and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. Alaska Communications will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. 2. Any Alaska Communications facility damaged or destroyed as a result of this encroachment will be repaired at no cost to Alaska Communications. 3, Any costs incurred by Alaska Communications for special construction necessitated by this encroachment will be borne by the property owner. 4. All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way preclude Alaska Communications from full use and enjoyment of its rights within any portion of this easement 6. Alaska Communications is under no obligation to restore any structure damaged as a result of Alaska Communications full use and enjoyment of its rights within any portion of easements or right-of-ways. Please sign both copies, retain one copy for your use and return the other to Alaska Communications. S9cerel Austin K)ng, Network Engineer, Outside Plant Alaska Communications Outside Plant Engineering, MS#14 600 Telephone Ave. Anchorage, AK 99503 ACCEPTANCE SIGNATURE: Grid SW3236 RCWC DATE: 7-50_ ai June 25, 2019 Heidi Hammond 16210 Chasewood Lane Anchorage, AK 99516 Re: Letter of Non-obj ection Dear Heidi Hammond, 6C1 Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the new septic system encroaching into the utility easement of Southpark Block 4 L2A, also known as 16210 Chasewood Lane City grid #3236, GCI WO# 19-0001-28. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also any additional and extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to me at the address below. Sincerely, MarIn1S Kofoid Manager Outside Plant Design & Data Management GCI Communication Corp 5151 Fairbanks St. Anchorage, AK 99503 907-868-6168 Office 907-868-8580 Fax CT" Acceptance 7 Date MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION ENVIRONMENTAl. ENGINEERING DIVISION 82.5 [. Street- Anchorage, Alaska 99,501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELL INSPECTION REPORT PHONE NAME /¢ 11,'., [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION NO. OF BEDROOMS Well ----.' DISTANCE TO, I ~5)t/¢ z ~ /OP~-.IAb'°r,t'°naroa Owe.,ng PERM,Tg__,2_O¢,r/NO, ~O.<Z Manufacturer ~.~ ¢~'1¢-~ Materia~2~.~ z~_.f / No, of compartments ~ I- Liq. ca )a¢ity in gallons I Inside length Width Liquid depth / O ~) O IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons O Well Foundation Nearest lot line PERMIT NO, ~ ~: DISTANCE TO: No. of lines . Length of ea~ i e Total length of lines Trench width Distance between lines -,." = ~ 74 , 'r~,,.ohe; ~-~ Top of tile t~o finish grade/.~/ / Material benTaeat~tOe -- Total effective absorption area Length Width Depth PERMIT NO, ~ ~-- Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: .~ Class Depth Driller Distanqe to lot line PERMIT NO, ~ Building foundation Sewer line Septic tank Absorption arealsl ~ DISTANCE TO: OTHER SOl L TEST RATING /~ ~,-rt {~.~. L/~, INSTALLER \ REMARKS "" 'T4,~. ~¢~., ~ /¢,~,1t ,~ 1o¢- /,o~. 5;e_.,..,-e~ oCys]~_ z..,'/I i,e. ¢*a APPROVED (.,] DATE LEGAL 72-013 (Rev. 3/78) PERH I'T NO. DEF'FIRTME'NT HEFILTH FIN.l) ENVIROF,i!"!ENTI.:![ ..... <O'TECTtON 825 '!~'" '_:i;TI,;.IEE]'., F'b'qCHORFIGE., Rk:. 9:.-350i 26¢-4720 ( 820E;q.:J..':, F!PF'L. i C:RNT !...OCFI T I ON LEGF~L FILLEN ROSEN'THF!L X:908 LOiS CHF!SEF.!OOP L..2 84 SOUTH F'FtRK [~;~[E:~~L-O-i" :SIZE 27'4-8258 22000 SL:.ILIFtRE FEET TYF'E 01':' SOIL. I,:IBSORF'TiON S'¢STEH iS: TF}.ENCH I,,.IFr,,<ZMLIH !qUI',1BER OF' BEDF;'.OOMS = 3 SOIl... I,:~:FI-FING (SQ FT,..'BR)= ±94 THE I,;~'.E):;!UIF.IED SIZE: OF THE SOIL RBSORF'TION SYSTEM iS: TFiE L. ENGTH DiHENSION iS ]"HE: LENGTH (IN F,ISE]") OF THE ]"RENCH OR DRtaINFIELD. THE DEPTH 01,: FI TRE:NE:H OR Pi:" ZS THE DIS-]TRNC:E 8E'TF!EEN THE: SLiI"~:F'FICE 01,: TI-YE GROUND Bf'.tD THE BOTTOH. OF THE E:XCFI'v'I,:ITION (IN FEET). THERE IS i'.,!O SET F.!IDTI,4 FOR TRE:NCHES. ']"HE GRR',/EL E)EF']"H IS THE HINIMUM DEPTH 01,:' GF.lRVEL BET'HEEN THE OUTI,:!:,ILL PiPE FIND THE BOTTOH OF' TF!E EXC:FIYRTION ,.':IN FEET::,. PERP.IZT FIPPL. iCFItqT HFLS TI,.,IE RE'_z;PONSIBILITY TO it",IFORH THIS DEF'F~RTMEN]' DURING :"FIE lhlS'T'FILL. FiTION IF!.I~:;PE-'CT:[ONE; OF: ,':II',!Y HELLS RDJFICENT TO THIS PR,I]PERTY FIND THE hRJHE:EF: OF REE;I[)ENCES TI,aRT THE 1.4ELL I.qZL. L SER',,,'E:. ................ r_ ~. ! ~.,.I±]F~,.JUq ~:'i!",IFIL !NSF'EE:TiON RND PIFFF.- H_ ~:,~ THIS DEF'FIRTMENT N!LL BE SUE:JEC"F TO PROSECUTION. I'd!N!HUH DIS]"Rb!CE: BETI,.tEEF,I R HELL. R.I',!D RNY ON-SITE SEHFIGE [>iSF'OSFIL SY::.';TE'I"I IS :~..00 FEET FOE: R PRZ',,"F.ITE FIELL OR :1.50 TO 200 FEET FROP.I R F'UE:L. IC .k!ELL I}EPENDING UF'ON TFIE TYF'E OF F'UEd_.,IC: NELL P'.::F.iM...H Dt:E';TFiF,IC:E I,:ROM Ft [-F..i ,H,E. t,.iELI. Tr' FI, Ft:::~I'v'I::~TE E;EI.4ER LINE l:, ':'~= F::'F:T FINE:, T'O [::~ CO!','I!',!UIqITY SE!-,.IER LINE IS ]:'5 FEET. ,:,-, .,' ~' .......... ,:.- .... ~,.,i'=;T¢,I.Ii]:TZE!N F:,T~RGRRMS FF--:'E' ]THEI:;:' RE!::!UZI,;:EME.I,ITS i,'.lF:!Y FIPPLY. .... PE.L..~F.~L.I-~ .[..r.L Fli'.,!E:, ~ EI',/EIILRE:LEE TO iF~SI...IRE F'F'.OPER iN'_:JTFiLLFITZON. I CERTIFY TFfRT ::t.: ! Ri','! FEli,,IZLZ~R !.4!TH THE REC¢..IIREHENTS FOR OIq-.SITE SEI,.!ERS RI,'4D P.IELLS RS, SET F'ORTi-..I E:Y TI-..tE HUN i C iPF!L iTY OF FII,qE:HORRGE. '":': :[ I,.IZLL ii'.,IE, TRLL THE =,.:,TEl IN PUL...I-.,_..HN.L.b. WiTH THE "-"::' . ]:: I UNE:,ERSTI,:IhE:, TFII";I'I' TI.YE C)N--.Si'I',IE E;ENER ..... FE,! I'"!EIY RE(:¢JiRE ENL. I::]F:;tGEI,,'IE:r-,I]" IF :"FIE RESIDENCE ZS REHODEL. EE:, TO ~TNCL. LIDE i'"IORE THI.:IN ]': BE[:,ROOHS. .:~.. z ~E.£ R'F'. CP L I CFIi'.,! T FtL. LEN ROSEN"FF.IIaL ~ y~_ .~ .......................... ... ................................... "-, 4. 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL OESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS DATEPERFORMED= lox ;2.?_ ~,~,(~ / z SLOPE SITE PLAN ENCOUNTERED? O E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop //¢ ¢ i(/'/ Io I,~'J'- ~ , PERCOLATION RATE TEST RUN BETWEEN ~--. FT AND ~.,~",j~ FT (minutes/inch) DATE: 72-008 (6/79) POUCH 6-650 ANCtlORAGE, ALASI<A (907) 264 411 I DEPAtq~ F. iEN1 OF tlEALTH AN[) ENVIF/ONMEN'FAL PRO] ECIION January 4, 1982 Allen Rosenthal 3908 Lois Drive Anchorage, AK 99503 Permit ~ 810681 Subject: Lot 2 Blk 4 South Park Terrace Estates A permit issued by this department for a well and/or sewer system has expired as of December 31, 1981. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. further questions, please call this office If there are any at 264-4720. Sincerely, Sewer and Water Program Enclosure: Copy of Permit F'ERMIT NO, ,:: o:.tuc,,..::L RF'PL I cRr.,FF RI_.LEN RCISENTHRL [:,EF'FIF~:TMENT' HEFILTH RN[:, EN',/IRONHENTFIL OTECTZON ,=,.-:,.,= ,= , r ...... "' '~'..=-'50i _,,=o '"L'" =,TF. EET., HNL. HORHGE., BK. 264-472'0 .F_..~..[E-'F." F" E F.:' ~'"1 Z T' ._,_-~L4,_, L~]Iq DRI"/E LOC61T ! ON L. EGRL L-:HFISEWOOD ,= 9 E, Lk, 4 .=,uUTH PRRK _-~¢~~.LOT _,I~.E LOT 2 ..... "" ._ _ , TREN-.H T"/PE OF SOIL RBqCIF'F'TI:IN S~'STEM !'S: ' 2;:z000 S.F,.!URRE FEET , " E E [.,F..0LIM .... MR,'-4IMUM NLII'IE, EF,. OF "'' ' - '= ,- ,- F' (E;Q ' ' '"- _-,OIL RHTIN= F ¥,.. BR. - THE REEqUIRED ..I,~E OF THE =,JIL F4BSORPTIE~N [:~ b=._. F" T' H .... ,'E=: L_ E [-~ F:i T ~-t = 97 t3 F: R'..-' E L DEPTH .... 4 ']'HE LENGTH DIMENSION IS THE LENGTH ,.'.'IN FEET.'.', OF THE TRENCH OR DRRINFIEL. D. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCR',/RTION ,.'.IN FEET.'.,. THERE IS NO SET WIDTH FOR TRENCHES. THE GRR',,,'EL [:,EPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE E',,.,:CR',/RTION ,.-;IN FEET). PERMIT HFF_IL. HNT HRS THE RESPONSIBILtT'¢ TO INFORf'I THIS DEPRRTMENT DUR. iNG THE INSTRLLRTION IN_,FEuTILI',L OF FIN'-r' WELL=, R[:,:fR_-ENT TO THIS r ._rF-.r..~' FIND THE NIJMBER OF RESIDENCES THFIT THE WELL WILL ..,ER E. E, Mu, kFILLIN.~ OF RN'-r' =~=TEH WITHOUT FINRL INSPECTION RND HFFRE~¢NL E,~ THI.., DEF'RRTMEN-F WILL BE SUBJECT TI:I pR:EEZLITIFIN. MINIMUM DISTFINC:E BETWEEN R NELL RND RN'¢ ON-SITE SEWRGE DISPOSRL. SVSTEM IS ±00 FEET FOR 8 PRI'¢R]'E NELL OR 450 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE T'¢PE OF PUBLIC NELL MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PR. IVRTE SEWER LINE IS 25 FEET BND TO R COMMUNITY' SEWER LINE IS 75 FEET. OTHER RE~UIREMENT~, MR'¢ RPPL'¢. SPECIFICRTIONS BND CONSTRUCTION DIRGRRNS RRE FtVRILRBLE TO INSURE PROPER INSTRLLRTION. F'E~R~"I ][ T E.--.F ]C F.E_. [-.EL.E[1E. EF- ].].~!.. I CERTIF'¢ THRT :&: IRM FRMILIRR WITH THE REC!UIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH B'¢ THE MUNICIPRLIT~' OF RNCHOR8GE. 2: I WILL INSTRLL THE SVSTEM IN RCCORDRNCE WITH THE CODES. 2:: I UNDERSTRN[:, THRT THE ON-SITE SEWER S'¢STEM M8'¢ REC!UIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. ~ MUNICIPALITY OF ANCHORAGE /~'%' ~' MUNIcIP.4" · ~ eNViRoN DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION M£NI'Ai' ,,~ .... DIVISION oF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY "'~ug App/icationDate- J/~?*' Legal Description (include lot, block, subdivision section, townsh p, range), ~ ~ ~ ~ '~ t . Location (address or directions) ~. 1. GENERAL INFORMATION (a) (b) ,~_~pplic~nt Na~.e _ . '5~'1,-- ""%c'zl%',¢:~'-Telephone: Home Applicant Address ~ · ~ ~A~h/ t,,,*~"~ I . . ..... ~ I ~1~ (c) Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family,~ Multi-Family [] Number of Bedrooms _ .:~ Other WATER SUPPLY [] Communit.~..~'; Public [] Individual Well Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsitei~;]y 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(1~,84) ')~JOM s,JaeU!OUa leUOlSSeJoJd mil u! suo!ssFuo Jo sJOJJa JoJ alq!suodseJ lou s! abeJoqouv lo ,~l!ledlo!un[~N eqJ. 'panes! si ajeo!J!peo e aJoJaq elep eZ/,leUe ~o suol~oadsu! lonpuoo lou op CIE]H(] lo see~oldLuE] 'elUaLUeqnbaJ aisle pus le~apaJ ule]Jeo ,~Js!lee oh Jap JO u! suo!in~!lsu! 8u!puaI J!eqi pub seuJoq Jo sJeseqoJnd ol ,~eelJnoo e se s!ql seop cIE]HQ eq± 'e)lSelV Jo ele19 Sql u! paJalS!aeJ Jeeu!6ue leUO!SSeJoJd luepuedepu! ue ,~q e^oqe ~ Llde~§eJed u! ua^!8 sUO!lelUeseJdaJ sql uodn/[lelOS peseq seleo!l!peo le^oJddv ,~lpOqlnV qlleeH sense! (dE]H(]] uo!IOalOJd lelUeLUuoJ!^uE] pub qlleaH jo ~ueLupedac] aOeJoqouv jo ,~l!led!ounv~ eqJ_ NOIJ. FIVO le^oJddv leUO!l!puoc) jo suJJaj_ leUO!l!puoo pe^oJddesiC] /x( PeA°Jddv a]e(~, . /~q SLUooJpaq ~ JOJ paAoJddv '9 C..~- '~' euoqdeleJ_ 'uo!]oodsu! s!q] jo uo ioajja ul suo!jelnaeJ pub 'seoueu!pJo 'sepoo elelS pus led!o!unR lie ql!M eoue!ldmoo u! s! Jo/puB ~lddns ~eleM a]!s-uo pou!elqo UolJemJOjUl aql uo peseq JetJ~ ~J!JOA Joqpnj I 'UIOJOLt paleo!PUl oJnJonJjs Jo adXi pub smooJpeq Jo JOqLUnU roll JOJ alenbape pub leUO!iounj 'ales s! ~ejsXs lesods!p Je]eMalSe~ Jo/pus Xlddns JaleM ells-uo aq] leql SMOLIS leAoJddv Xlpoqlnv qlleaH s!ql jo uo!lea!lse~u! Xm 1Bql XI!JaA I 'MOleq UMOqS ejep UO!1~p!IRA eqi 10 Se pUB OleJaq paxllJe lees Xm Xq pa!l!Peo sv .g MUNICIPALfTY OF ANC:HOI~GE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOJ%J ^. WEJ C EIV ED MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 Legal Description: L-~.~ - Well Classification if A, B, C, D.E.C. Approved (Y/N) Y~'-~ Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by ,"" Water Sample Test Results Date Completed Yield Depth of Grouting , Pump Set At /~- Sanitary Seal on Casin..g (q/N) Depression Around Wellhead (Y/N) ~/; On Adioining Lots /' ; On Adjoining Lots ./ To Nearest Public Sewer / To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date installed ~_)/~/~-,~__%ize ~ O(D(;~ ~ ~ . . (a~C'l--No. of Compartments ~ Standpipes (Y/N) k(L-~'~ Air-tight Caps (Y/N) '.~'1;~, Foundation Cleanout (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well Z~)o' To Property Line ~ / To Water Main/Service Line Course ~ O~ J~- Date Last Pumped ~ ;for N5 Temporary Holding Tank Permit / - To Building Foundation To Disposal Field ~' To Stream, Pond, Lake, or Major Drainage Page 1 of 2 ~'-~_ D. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field-- ~'///~¢'¢¢~ Type of System Design Length of Field '"7 ~-/ Depth of Field Gravel Bed Thickness /-~t''t Square Feet of Absorption Area ~¢~'~.. Depression over Field (Y/N) ~%'~ Q~ Results of Last Adequacy Test _. %¢VT1SF-'~'I~,'~I Separation Distance from Absorption Field: To Water-Supply Well .~.(~(~ i ~ To Building Foundation Lot ~/¢'"~f Standpipes Present (Y/N) Date of Last Adequacy Test To Water Main/Service Line ~--.) ¢ -i¢ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~f' '~'~.,:~'¢~ -j~ ifH~ ~% LIFT STATION To Property Line ~, -Cf-4 To Existing or Abandoned System on ; On Adjoining Lots ~:~O" To Cutbank (if present) Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) ~ Comments /.~/' Manhole/Access (,.~N)''''/'~ --~ "Pu m p?,Jf~'f.~evel at /' .............. ,._.--'// Vent (Y/N) __ J'""'"~umpi~, Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, ~;i, o~nformed to all MOA and HAA guidelines in effect on the date of this inspection. Company ~'" ~<=;~,~.,~-.-~ ~ ~.;,,~¢~; MOA No. Date of Payment / - Amount: $ / 7 ¢ '~"~'~' EngJneer's Seal Page 2 of 2 72-026 fRev 8/861 Back Municipalityof Anchorage P.O. ,_.OX 196650 ANCHORAGE, ALASKA 99519-6650 (907) 343-4200 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 11, 1988 Thom A. Fischer, P.E. Corwin & Associates 12001 Industry Way Building B, Suite 11 Anchorage, Alaska 99515 Subject: Lot Line Waiver For Lot 2 Block 4 Southpark Estates #1 Waiver Number WR88-002 Dear Mr. Fischer: This letter is to approve a lot line to absorption trench separation for the subject lot. The required separation distance is 10 feet and is waived to 2 feet. A formal waiver was not granted at the time the trench was installed in 1982. After talking to Lee Reid, P. E., and you, I have concluded that there should not be an impact on the neighboring lot as a result of the 8 foot encroachment to the lot line. Because of the location of the house on the neighboring lot and the direction of slope, the existing septic system and any future upgrades will not conflict with the septic system on the subject 10t. This waiver will apply to the existing absorption trench only, Any upgrade in the future will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth civil Engineer On-Site Services cc: Gus Andress, P.E. Manager, On-Site Services/Water Quality Programs DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: (907) 274-2533 DATE: June 30, 1986 PWS I.D.# 213475 To Whom it May Concern: According to records on file in this office the TERP~CE Water Regulations SOUTHPARK Water System is in compliance with the State Drinking Si ncerely, Michael P. Lewis Environmental Engineer GENERAL INFORMATION (b) Applicant Name/,0. ~-feve_A ~ o~S Telephone[Home ~9~ ~[~ ~ ~Bu~,ness ~& c) A p cant s (check one)' Lending Institution ~ Owner/bu der ~ Buyer ~ ;Other ~ (explain) -[ (d) ;., Lend ng nsttuto¢:~-t~~ ~ - '~2 ~!~p~0~er~ "'"~¢~ ", ~ r" ' :~;' Address ........ " ':,'? r''~ ...... ~ : ~',~', ' (e) Real Estate Company and Agent ~V~ Address Telephone Mail the HAA to me following address: ~ 3' w~TER sUPPLY'! n the State De 5. ENGINEERING FIRM PROVIDIJ,*~ INSPECTIONS, TESTS, FILE SEARCH, D~ J A 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 Abthority 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 nd cated herein: I further verify that based on the information obtained -,, '.~ '.-~; ' d r , ' , ~:!~:: from theCMunlcipality:of Anr~:horage'files and fr~m':'mY investigation and inspe~tion; the 0n-~lte water' supply an /o' wastewater disposal system is in compliance with all Municipal and State codes ordinances, and regulations in effect on the date of this ins~ction. Name of Firm C'Or~ ~ ~~ Telepnone Approved for . bedrooms by App~'og~d r ,/~'! -"': '~: Disapproved Conditional The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragrapl~ 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 ic_ertificate is issued. The Municipality oI Anchorage is not respo,n, sible for er~:ors or omissions in the u'~, , ,,.;',p~ofessional engineers work: -. '.,',;, , ,., ,+:? ~'~;;:~':;~' :.~: · ',."; ':ii-'. ,'"~'x MUNICIPALITY OF ANCHORAG~ I DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA/ ' ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKUST- PEBRUA.Y 1964 Jill, 0:5/986 Legal Description: ~-~ WELL DATA Well Classification ~ ['Y)~"lh IA.~ i ~ I~ A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date ~ompleted Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot TO Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date SEPTIC/HOLDING TANK DATA Date installed ~-' Size /~00 ~. ~ No. of Compartments Standpipes (Y/N) (¢ ~ Air-tight Caps (Y/N) y£,5 Foundation Cleanout Depression over Tank (Y/N) /~ 0 Date Last Pumped Pumping/Maintenance Contract on File (Y/N) /~/,/~- ; for Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit Separation Distances from Septic/Holding Tank: Te Water-Supply Well ~.~.~(~ I To Property Line '~© f To Water Main/Service Line ~Of t' 100' Course To Building Foundation / ~' ~ ¢, To Disposal Field To Stream, Pond. Lake, or Major Drainage Comments Page 1 of 2 72-026{11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date installed 8_4~ _[;~, Cf-. Width of Field ,~ ~ '"'¢" Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well -~- ~)~ To Building Foundation ~ 4// Lot /NJ/A TO Water Main/Service Line ~o O ¢ To Stream/Pond/Lake/or Major Drainage Course eZT'/¢~2,///.~)Jf~ ¢¢Type of System Design Length of Field ~74/ Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Driveway, Parking Area, or Vehicle Storage Area Comments 4e- ~'~r*O r~ b ~;-~ ~,; L65 u To Property Line ,~. To Existing or Abandoned System on ; On Adjoining Lots ~1;~O To Cutbank (if present) '~/OO t D. LIFT STATION Date Installed f Size in Gallons ~ "Pump On" Level at~.. ~ie~iedW~r Alarm Lev¢~....~ Electrical Codes (Y/N) ~ Comments ~ ~ Dimensions Manhole/Access (Y/N) j,WSnt (Y/N) '~ Adequacy Test, Meets MOA ~_..--'"'~Pumping Cycles during ** Chec itted B m Rating Against HAA Request ** I certify t h~t~/b/a~g'g.hegf~e..Cf/verified, or conformed to aJ~ MOA and HAA guidelines in effect on the date of this inspection. Signed Date CompOrt MOA ~o. Date of Payment Amount: $ Page 2 of 2 72-026 (1ua4) Engineer's Seal DEPT. O!~ i~NVIRONMENTAL CON~ERYATION ANCHORAGE/~ESTERN DISTRICT 0~C~ 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR 7'elephone: (907) Address: 274-2533 DATE: June 30, 1986 PWS I.D.# 213475 To Whom it May Concern: According to records on file in this office the TERRACE Water Regulations SOUTHPARK Water System is in compliance with the State Drinking Sincerely, Michael P. Lewis Environmental Engineer J 7 - APPLIf'-XNT FILLS OUT UPPER HAr -,'ONLY Mailing Address ~-~ ~/0 ~ ~---(.~i-.~ , Lending Institution ~; ¢~. ~c~(O~{ ~c.~[&~ ~:( ~[ ~. Phone Address ~1 ~'~ ~. ~ q ~C~ ~ ZipC°do ~/O Address Zip Code Legal Descripsen ~ '~ ~' ~ ~ ~ ~ ~O~ ~e~ '[ ~[~k~C '~ Type o Resi~nce ~ingle Family ~ MulBpl~ Famdg ~o. of Bodroo~ ~ Othor Water Supply / ~ ~ndividual .~,- A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~ Community ~2 '~ ~/ For wells drilled prior to that date, give web depth (attach ~og if available). ~ Public Utility Sewe Disposal ~lndividual Year Individual Installed: ~ Public Utility When Connected to Pubbc Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: i'~ ~_,.~ J ~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH ENVIRONMENTAL PROTECTION APR ? 3983 RECEIVED (--">) APPROVED SEDROOMS 'CONDmONS OP APPROVAL ( ) DISAPPROVED ( ) CONDITIONA~A~- A~EROVAL* DATE ,L/ ~ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received {~-- ~,"' WeJl lo Tank Septic Tank Size 72-023 (3/82)