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HomeMy WebLinkAboutGARRETSON LT 5Onsite File Garretson Lot 5 #017-432-42 The 2004 absorption field can only be tested for up to a 4-bedroom COSA approval. Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211293 PID Number: 017-432-42 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New n Upgrade Name Tom & Toshiko Rueter / Lea Rueter ABSORPTION FIELD 0 Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 7201 North Park Dr, Anchorage, AK 99516 ❑ Other Phone (907) 223-2907 Number of Bedrooms 6 Soil Rating Total depth from original grade 0.45 GPD/SF 12.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 7.0 Ft. Gravel depth beneath pipe 5.0 Ft. Subdivision Block Lot Garretson 5 Fill added above original grade -0.2/-1.7 Gravel length 100 Township Range Section Ft. Ft. Gravel width 3.0 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 *1,000 Ftz Ft. Well >100' >100' >100' N/A >25 TANK ❑p Septic 9 S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1500 Gal. Surface water >100' >100' > 100' N/A Material Plastic Number of compartments 1 Lot Line >5' >10' >5' N/A NA Foundation. > 10, >10, > 1 0' NIA LIFT STATION Manufacturer Greer Capacity 1250 Gal. Remarks *The existing 1981 drain field is being utilized for the additional absorption area required for 6 bedrooms. Alarm location Inside garage Electrical installed by Capstone Electrical Installer PIPE MATERIAL House to tank D3034 Tank to D1785 drainfield A+ Home Services Drainfield D3034 Co/MTD3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspdection 15` 10/20/21 1/24/22 Location and description 2nd Yd 4m Bottom of siding @ point A ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date P�•^°"'°' "�gSoo�0, ®mss 49th ®. ............... ... ..4.....JO ® ................................................ 0 %MICHAEL E. ANDERSON l � a0 ♦ %° No. CE -4381 ;' Z� Septic System ��r� /�/J00. ��n ,f/ Approved Y't�lSc Date v /10,, �Fi;°•.,FO ,,?/1 /22•°,,..••'���' Note: this approval does not include well permit requirements. ��o OFESS\��®®®� (Rev 05102/18) S+aACI p 0J SOq c XX1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP211293 PID # 017-432-42 GARRETSON SUBDIVISION, LOT 5 A B CO1 50.2 2CO1 47.8 MH1 50.2 A B SV1 54.9 2CO2 56.9 SV2 58.3 MH2 63.0 20.4 69.2 70.7 74.5 76.1 77.5 81.4 FEET 0 50 100 NORTHPARK DRIVE 4- B D R M H O M E 2/16/2022 9 5 5 950945SHED SHED EXISTING WELL EXISTING WELL 100' WELL RADII TH#2 100' LONG x 3' WIDE, 5' EFFECTIVE DEPTH ABSORPTION TRENCH ALTERNATE SITE: CAT III SYSTEM w/ A 20' LONG x 3' WIDE, 5' EFFECTIVE DEPTH ABSORPTION TRENCH APP RATE 5.0 NEW 1,500-GALLON SEPTIC TANK w/ 20" MANWAY FOLLOWED BY A 1,250-GALLON STEP TANK EXISTING TANK DECOMMISSIONED PER UPC EXISTING TRENCH TIED INTO NEW SYSTEM NEW MT INSTALLED 10' UTILITY EASEMENT EXISTING TRENCHES TO REMAIN INTACT FOR POSSIBLE FUTURE USE& DISCONNECTED FROM SYSTEM CO1 CO3MT3 PROPOSED ADU(GENERALLOCATION)2 C O 1 DECK2 C O 2 S V 1 M H 1 S V 2 M H 2 MT1 CO2 MT2 MT4 TH#1 PLAN AS-BUILT CO2 62.9 MT1 62.7 MT2 108.8 CO3 138.0 MT3 137.6 MT4 102.2 66.1 65.7 126.5 161.3 161.1 126.7 STUB-OUT FOR FUTURE TIE-IN TO PROPOSED ADU PROFILE AS-BUILT (NO SCALE) 92.6 86.7 93.1 98.7 MHSV1500-GAL SEPTIC TANK 101.0-102.5 FINISH GRADE 100' DRAINFIELD ROCKMT TH#1GROUNDWATER @ 84.7 ON 7/7/21 90.7 95.7 COCO83.7 90.7 95.7 102.7 ORIGINAL GRADE MT2CO92.4 2/16/2022 PERMIT # OSP211293 PID # 017-432-42 GARRETSON SUBDIVISION, LOT 5 2CO93.0 1250-GAL STEP TANKSV MH92.3 87.1 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 1966504700 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: OSP211293 Work Type: Septic Upgrade Tax Code Number: 01743242000 Site Legal Address: GARRETSON LT 5 G:2839 Site Mailing Address: 7201 NORTHPARK DR, Anchorage Owner: RUETER TOM W & TOSHIKO 50% & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date G G � llchartrneni Lot Size in Sq Ft: Total Bedrooms: 7/30/2021 7/30/2022 49420 ❑ 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 Veronica Pope GE 2021.07.30 Received By: 08:50:42 -08'00' Issued By: Date: Date: 7 I. U 9M PALITY OF Community Development Department -= Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-432-42 Property owner(s) Tom & Toshiko Rueter / Lea Rueter Day phone 907-223-2907 Mailinq address 7201 North Park Dr, Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Garretson Subdivision, Lot 5 Legal description (Township, Range & Section) Lot Size 49,420 Sq. Ft. Number of Bedrooms 6 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 ❑X Upgrade ❑X Duplex (D) El Holding Tank ElRenewal ❑ 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: 5c/5 Waiver Fees: Date of Payment: 7 *11112,0-21 Date of Payment: Receipt Number: 0 0 `i Receipt Number: Permit No. /�2I I2 q Waiver No. Permit App__- : ._..:c July 16, 2021 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 7/16/21 Subject: Garretson Sub, Lot 5 – 7201 Northpark Drive Septic system design Dear On-Site Services Engineer: The owner of the above lot intends to build a 2-bedroom ADU on the property in the near future. We are submitting this permit application for the construction of a new septic system to serve a total of six bedrooms. The attached site plan identifies the location of the home and the existing well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot is mostly flat. We are proposing to connect the existing 3-bedroom trench constructed in 1981 and abandoned in 2004 with a flow splitter valve and installing a new trench designed for the soils encountered in test holes parallel to the east property line and capable of absorbing 450 gallons of water per day. The existing trench will be brought up to code with all pipes present and an adequacy test performed to ensure the trench will absorb a minimum of 450 gallons of water per day. The new system will then have sufficient capacity to absorb 900 gallons of water per day. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Contour lines and elevations are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. The alternate site is located more than 10’ away. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211293, Rebecca Carroll, 07/30/21 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH#1 GARRETSON SUBDIVISION, LOT 5 FEET 0 50 100 NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. NORTHPARK DRIVE 4-BDRM HOME July 28, 2021 9 5 5 950945SHED SHED EXISTING WELL EXISTING WELL 100' WELL RADII TH#2 100' LONG x 3' WIDE, 5' EFFECTIVE DEPTH ABSORPTION TRENCH ALTERNATE SITE: CAT III SYSTEM w/ A 20' LONG x 3' WIDE, 5' EFFECTIVE DEPTH ABSORPTION TRENCH APP RATE 5.0 NEW 1,250-GALLON SEPTIC TANK w/ 20" MANWAY FOLLOWED BY A 1,000 GALLON SEPTIC TANK WITH SEPTIC VENTS MAINTAIN 5' FROM EXISTING TRENCH DECOMMISSION EXISTING TANK PER UPC COMPLETE ADEQUACY TEST TO VERIFY TRENCH CAN ABSORB 450 GPD. ADJUST OR INSTALL MTs AND COs TO MEET CODE. 10' UTILITY EASEMENT EXISTING TRENCHES BY REMOVING PIPES & DISCONNECT FROM PROPOSED SYSTEM FS MT CO CO MT FUTURE ADU(GENERALLOCATION)CO FCO 2C O DV Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211293, Rebecca Carroll, 07/30/21 GARRETSON SUBDIVISION, LOT 5 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 3' 6" 6" 6' 6" 5' DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW (ADDL. REQUIRED) PERK RATE: 42.9 MIN/IN APPLICATION RATE: 0.45 GPD/SF 5' DEEP TRENCH SYSTEM 2,000-GAL EPOXY COATED SEPTIC TANK w/ 20" MANWAY BOTTOM OF TRENCH: 12' BELOW GRADE FLOW LINE ELEVATION: 7' BELOW GRADE TOP OF TRENCH: 6" ABOVE GRADE 450 GPD / 0.45 GPD/SF /5' DEEP / 2 SIDES = 100 LF TRENCH REQUIRED (100 LF SPECIFIED) July 15, 2021 NOTE: EXISTING TRENCH TO BE TESTED TO VERIFY IT CAN ABSORB 450 GPD. TRENCH TO BE CONNECTED TO NEW SYSTEM WITH SPLITTER VALVE. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211293, Rebecca Carroll, 07/30/21 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) J. MILLETTE DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? 13 6 3 4 1 2 3 4 5 6 GM (SILTY SANDY GRAVEL w/ LOTS OF FINES) Professional Engineers Stamp: NO 18' 7/7/21 GARRETSON SUB, LOT 5 6/29/21 017-432-42 TOM RUETER 11:141 2 3 4 5 6 5 0 16 11:44 11:45 12:15 12:16 12:46 1' OB July 9, 2021 GM (SILTY SANDY GRAVEL w/ LOTS OF FINES) SP/SW (PURE WELL GRADED SAND) 30 30 30 7 6 16 5 0 16 5 0 16 7 6 16 7 5 16 2 6 16 2 6 16 2 5 16 7/1/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211293, Rebecca Carroll, 07/30/21 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 2 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) J. MILLETTE DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? 42.9 6 3 4 7/1/21 1 2 3 4 5 6 GM (SILTY SANDY GRAVEL w/ LOTS OF FINES) Professional Engineers Stamp: NO NONE 7/7/21 GARRETSON SUB, LOT 5 6/29/21 017-432-42 TOM RUETER 9:301 2 3 4 5 6 5 0 16 10:00 10:01 10:31 10:32 11:02 1' OB July 9, 2021 30 30 30 5 14 16 5 0 16 5 0 16 14 16 5 12 16 12 16 5 11 16 11 16 PERC HOLE WAS PRESOAKED PRIOR TO TEST Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211293, Rebecca Carroll, 07/30/21 Cli 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.cl.anchorage.ak.us (907) 343.79D4 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5 Lk.) Q l0 01 PID Number:�— Nam. -rc) VA 'eU —R_ Wastewater System: ❑ New [lq Upgrade Address iZ01 Na R1 -U. De-iV6 ABSORPTION FIELD Plwnr ^ r Numberdeaboama - JC 0(Daep Trench❑Sh.1awTrani❑e ❑Mount ❑ONar LEGAL DESCRIPTION r Sod RaM9 O (c Taal Deghhom ongZa" a GP xFt° 1 L t0 I Ft. Stick LM OT [ _ Subdwax,n'. LOTS_I Depth b pqa bonom hom ng,naI grade Grovel depth bonealh plpo V 1 ai K 5PQ � 0 FI. 15 Ft 7o shp'. RangeSewn Fl added abma aybal grade O Fl. Gjr}},weI L"h't IL ,e "Tt ji604Z+5Jr FI. Well: ❑New ❑ UpgraGnm el Wdth. Number a hose. 2 Dnbnce betvean ane,' 2 Ft. O Ft O.W.I. (Prwala. A. S. C): Taal Q CaseO to r Taal abserpoon area. n ter- O S Q Flip* Matenal. PV` - FL Ft FII Deer Data Dahra. •• Stat. Warr Laval. Ft Installer: IlLwke"WM Dab InstaMd CCn1MCaC0 ` 0rYoLf Pump Sal at CaurpHaghlAboveGrouts TANK GPM FL F[ SEPARATION DISTANCES [J Septic []Holding ❑S.T.E.P. ❑Other: To From Septic Tank Absorption Field Lilt Station Holding Tank ublic/Pmale Sewl,r Line an eau1.1 & tZ e L (Z a P ly JZSQ Gal, oval BOO 112— NI4 NIS NIk' Meterul ST ,3L Numoer a Con ponir en% sadacawaler "lk ^'IA- O(4 N(A- LIFT STATION La Los 2 j N14 "IA- Gal fouMallon s4 N Purtp on Wel a1 P ., twat a1 Mph wla alarm at Y1 w st Cumin Dan ^ 1 nl�� !!!! N IA- �/A /� N��1 �/Y' Purry M+ ..tidal Ebchlcal lnfpaclMa grlametl by Remarks: -rMar. Iv�ri. ,J b �i`t aT BENCH MARK Louuan and Gesulplon. CONvEGIen to oc-a FAC-Lva TeeeX0CS Luau COAC9,3-t A -o Rt Srrt(ttn G lL1 'tAtl� o).l Is to 11 ocrosc�_zoo umrwd Iwatam. S-reT-s ,-o oeu,, 00 Ft s LIT r h'Q-�i� L•ZTCi�� AAS�f3VLlT DRhU01L.](7j$ Engineer's Stamp kc, 0 'fy * g 1xT- CL Inspections performed by: _(__'3ZZ Pdid"WASO',) Dates: I" Ib 9T Olt 0 49 h S2"d Developnnnt Services Department Approval t song. [. vntw Reviewed and approved by: Date: UIIIg2C CE yj` s��„"533 -' J__ '���fRpROFESS10Na`�. 10/27/2004 17:43 9072358639 AS—BUILT NEW SEPTIC SYSTEM LOT 5. GARRETSON SUBDIVISION PUT 79-82 ANCHORAGE RECORDING DISTRICT 4" DN. pvc PIPE TYP It pffcp. Loc C. e4 .� t00' WELL PROTECTION RADIUS Eric P. Fugleetod No.7218—S .0 , , SCALE: 1" = 20' HOUSE rtwt ni FOU15 * MATCHED EW ((TYP) " NORTH PARK DRI.£ ERIC P. FUOLE$TAD Yc/o LANDSURVEYOR k , mm m 2M-19rr !AY 2J5- m zr / Ii I Ofd Ia Ia NEW 1.250 Gof. I SEPPC TANK DETAIL :fl %SCALE: 1" — `�M 5' mor wt o O I 7 °c/° I ,�,,, ( ° / Z I SEPTIC I TANK I I I NORTH PARK DRI.£ ERIC P. FUOLE$TAD LANDSURVEYOR k , mm m 2M-19rr !AY 2J5- m P.O. Box 210306 Anchorage, AK 99521-0306 (907) 332-9550 / Fax: 332-9555 28 October, 2004 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 (907) 343-7904 RE: As -Built Information -Lot 5 Garretson Subdivision/ Parcel ID 01743242 /Permit Number SW040401 Dear Sirs: am submitting this letter to describe as -built conditions of the new system installed at Lot 5 Garretson Subdivision. Attached to this letter is a as -built drawing done by Eric Fugelstad, RLS. This drawing was done after completion of the installation. I was on-site during all inspections and measured the burial elevations of the pipes. Eric conducted the horizontal as -built survey after construction. The old system is still available for use to allow the new system to rest in the future. This was accomplished with a Bull-RunTm valve which allows the homeowner to alternate the fields. It was also done for ease of construction. The tank was set on the 8'" of October and connected to the old field on the 9'" of October. The tank was backfilled to allow more room to work and use of the old system during construction. The cleanouts on the old field were installed during this process. A table at the end of this letter will document the invert elevations of the various pipes. The old field was shortened by 5 feet to allow easier placement of the septic tank. Drain rock and tile was removed and backfilled with in-situ soils to seal the old field from leaking into the area around the tank. There is a cleanout for the old system as shown on the as -built detail and a double cleanout between the bull-runTM valve and the old system. The distance from the tank outlet to the old field drain tile is 6'7". The new system was installed as shown on the as -built drawing. A 4 foot wide bucket was used therefore there is approximately twice as much drain rock as the design called for. Both trenches are 4 feet wide. The first trench is 50 feet long as designed, the second trench is 55 feet long. The reason for the extra length on the second trench Is that the trench was over -excavated due to caving during excavation. We had enough rock and drain tile and extended it to 55 feet. The as -built shows this as 58 feet because the cleanouts are set back 1.5 feet from the ends with a street 90 pointing into the field. The line connecting the two trenches has a cleanout pointing to the east located at the western end of the line, just before the western trench starts. There is a double cleanout between the bull-runTM valve and the connecting line as shown on the detail. As mentioned above both trenches are 4 feet wide and 5 feet deep filled with approved sewer rock. The gravel is level on the bottom of the trench and the invert of the perforated drain tile is level. The drain tile pipe is covered with geotextile and 6 inches of sewer rock. There is 2 inches of blue board insulation over the entire western trench. There is also insulation over the tee connection to the new field and from the forward cleanout back to the bull -run"" valve. The depth in all locations is greater than 7 feet except for portions (about %) of the western trench which is between 6.4 and 7 feet deep. Pipe invert information is as follows: FEATURE INVERT ELEVATION FEET Tank Inlet Invert 93.54 Tank Outlet Invert 93.38 Bull-RunTM Valve Outlet— Field #2 Old Field 93.36 Old Field — Reverse Cleanout Invert 93.36 Old Field — Forward Cleanout Invert 93.36 Old Field Cleanout Invert 93.37 Old Field Pipe Invert 93.35 Bull-RunTM Valve Outlet — Field #1 New Field 93.31 New Field Reverse Cleanout 93.10 New Field Forward Cleanout 93.10 Junction Between Tank and New Field 92.32 New Field Top of Sewer Rock 92.82 New Field Pipe Invert 92.32 Bottom of Drain Rock Elevation 87.31 BM - All Elevations Relative To 100' Assumed Elevation Located On The Concrete Pad At The Bottom Of The Deck Steps 100.00 If you have any questions regarding this submittal please feel free to contact me. Than ou, Ge age R. Wilson, P.E. L 49th 2GE R. WILSON CE -7553 MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW040401 Legal Description: GARRETSON LT 5 Design Engineer: 0082 CE Services Owner Name: TOM RUETER Owner Address: 7201 NORTHPARK DRIVE ANCHORAGE. AK 99516-3244 Date Issued: Sep 23, 2004 Expiration Date: Sep 23, 2005 Parcel ID: 017-432-42 Site Address: 007201 NORTHPARK DR Lot Size: 49420 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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 specked 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 Date: d r 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.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 11 +3 Z L�Z— Permit Number SW a"a Propertyowner(s) -rO.V-1 Rvur-rt'7'- Dayphone ZZ-3-Zg0-7 Mailing address (1) -1 Zp ( tJOei-A PAE-.(L C)C_%U Mailing address (2) lzrinc.(AtCS. ,..r_., A -k, Zip Code Ci15((o Legal description (Lot, Block & Sub'd.) LOT S e'-, --T-coni 5 Cp,Vi �a Legal description (Section, Township & Range) Lot Size LINN� Acre /Sq.FL THIS APPLICATION IS FOR: Sewer Only ❑ Sewer and Well ❑ Sewer Upgrade B THIS PROPERTY CONTAINS: Number of Bedrooms 3 -ty 4 - Well Only Water Storage Hot Tub ❑ Jacuzzi Swimming Pool ❑ Water Softening Unit Therapy Pool ❑ e certify that the above information is correct. I further certify that this application is beina made for (Signature of property owner or authorized agent) Date of Payment: Receipt Number: 6X (M /4j Receipt Number. (Rev. 12/00) 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 (907) 343-7904 RE: Lot 5 Garretson Subdivision / Parcel ID 01743242 Dear Sirs: P.O. Box 210306 Anchorage, AK 99521-0306 (907) 332-9550 The owner of the referenced property would like to upgrade his on-site disposal system to accommodate a 4 bedroom house. Currently the home is a 3 bedroom home and there is no indication of failure of the existing system. In order to upgrade the system two percolation tests were performed adjacent to the existing field (see attached sketches and test results). Based on the new test information one hole was rated at 8.3 minutes per inch and the other at 26.7 minutes per inch. The existing system was designed using 10 min/inch with the original data collected in 1981. Approximately 90% of the proposed new field is located within the boundaries of the higher percolation rate test of 8.3 min/inch. The two 35' zones around the holes do overlap and some of the proposed system is in the area overlapping by both tests (see attached sketch). The design calculations are based on the slower test rate of 26.7 minutes per inch to be conservative. A application rate of 0.6 gpd/sf was used for the calculations. Assuming a loading of 150 gpd/bedroom a 4 bedroom house would require 1,000 sf of percolation area. Using a deep trench design with 5 feet of gravel in the bottom the length of leach field required is 100 ft. The new design proposes two 50' trenches be used (see attached figures). These trenches will run parallel to the existing 55' trench and be located 16 feet off center of the existing trench. The two new 50' trenches will be located 16 feet on center from each other. The minimum requirements would dictate the trenches be 12' on centers from each other, 16' was used to be conservative. In addition to the 100 lineal feet of infiltration trench the septic tank will be replaced with a 1,250 gallon tank. The existing tank will be cleaned and disposed of. To prolong the life of the system the owner wishes to install a Bull Run ValveT" to have the capability of alternating the fields. Again, there is no indication of failure of the existing field. Upon approval of the permit application the system will be constructed by the homeowner and inspected by myself during construction. Proper notification will be given to the municipality prior to the inspections. During an adequacy test in 1995 a ground water monitoring well was installed on the property to a depth of 20 feet below ground surface. The well encountered a damp layer at 20 feet and has never produced any water. The bottom of the hole continues to be damp, but, there is no accumulation of water in the hole. The hole was monitored from November 1995 to June 1997 and no water was ever encountered. This hole is located within 20 feet of the proposed system (see attached sketches). Please notify me if you require any additional information regarding this system. R. Wilson, P.E. 11 5LQ oY- S. G"o IL VOI. CE -7553 pROF�N�' P.O. Box 210306 Anchorage, AK 99521-0306 (907) 332-9550 21 September, 2004 Julie Makela, P.E. 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 (907) 343-7904 RE: Lot 5 Garretson Subdivision / Parcel ID 01743242 Dear Ms. Makela: As you requested in your comment sheet dated 21 September, 2004 1 have addressed the issues of concern. COMMENT #1: The measured distance to the well located on Lot 4 Garretson Subdivision is 123 feet from the septic tank on Lot 5 Garretson. With respect to other wastewater systems, Lot 4's disposal trench is 65' from lot 5's original trench. Lot 6's disposal trench is approximately ISO feet from the proposed new trench and 200 feet from the existing tank. There is also a surface drainage swale on Lot 6 that is within 160 feet of the system. Lot 2's disposal trenches are located approximately 140 feet from the proposed new trench. Included are additional drawings by others for Lots 2, 3, 4, and 6 that clarify these measurements. COMMENT #2: As we discussed in your office, the percolation tests were not used to determine the total depth below the system. The monitoring well that was drilled in November of 1995 was used. This well is 20 feet below ground surface which allows the lateral to be no deeper than 9 feet. This should be no problem if existing subsurface elevations on previous work by others are correct. If we need to go deeper than 9 feet for the lateral we will excavate below the 20 foot level and verify that there is no bedrock. COMMENT #3. There are no obvious probable impacts to adjacent properties. Surface drainage from this property flows in the general direction of North Park Drive and toward Lot 6. Lot 6 has installed a surface drainage swale to divert water away from his disposal system toward the road. Any drainage that may reach lot 6 would be intercepted by this swale and carried to the roadway. Lot 2 has its disposal system in the back of the property adjacent to the back of Lot 5. As noted above the disposal systems will be approximately 140 feet apart after construction of the new field. With respect to Lot 4, the wastewater systems are within 65 feet of each other, however, this does not seem to pose any future conflicts with property use for lot 4 or lot 5. Lot 4 has a well approximately 123 feet from Lot 5's septic tank. The only impact that this could cause is if for some reason Lot 4 needed to become a public water system, then a 200 foot separation distance would be required. Due to the disposal system on Lot 4 having the disposal system on Lot 5 within 200 feet does not seem to present any conflicts. Soils in the area are not classified as gravel or sand, therefore there is no apparent danger from wastewater reaching any of the adjacent property wells. In summary, there does not appear to be any negative impact to adjacent property owners by approval of this system upgrade. COMMENT #4: The eastern most trench has been moved 6 feet to keep it away from the existing 20 foot deep groundwater monitoring well. COMMENT #5: The detail for the cover of sewer rock over the perforated pipe has been corrected. COMMENT #6: The Owner Installation Request is included. COMMENT #7: The radius around the percolation tests has been changed from 35 feet to 30 feet. COMMENT #8: The note on the septic tank on the plan view detail sheet has been changed to insure proper placement in the field. The piping configuration will be fitted in the field to meet the 100' separation distance from the well and the 5' separation from the drain field. The tank will be angled and plumbed as necessary to accommodate this requirement. Please notify me if you require any additional information regarding this system. F ........ ,}� R. Wilson, P.E. 4.7553 7201 North Park Drive Anchorage, AK 99516 (907) 223-2907 22 September, 2004 Julie Makela, P.E. 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 (907) 343-7904 RE: Owner Installation Request - Lot 5 Garretson Subdivision / Parcel ID 01743242 Dear Ms. Makela: am writing this letter in response to your comment sheet on my septic system permit application. have lived in this home since 1996 and intend to upgrade the home to 4 bedrooms. Prior to this upgrade 1 am upgrading the septic system to accommodate the additional loading. It is my intent to occupy the residence for 3 to 5 years prior to selling the property. My past experience excavating is basically that I grew up on a farm and am familiar with a multitude of heavy equipment. I have extensive experience in operating a Case 560 backhoe and some smaller track -hoe machines. I am very familiar with various tractors, bulldozers, ditching machines, hay bailing equipment, and many other types of heavy equipment. 1 have also worked in the shipping industry for many years and am familiar with several fork lifts and cranes for loading ships and barges. believe that my experience is sufficient to install this system and intend to have my engineer inspect the system at the proper times. I am also familiar with the material requirements for sewer rock, septic tanks, piping, and notification of inspections. If there is any additional information you require, please feel free to contact me Thank you, om Rueter u MORT" E .« r -W E N I c O u I 8 O C I � Of I o <� de .-: WW c 1 .............. o�r'E ei c 0 1 sdov� m v l e :_ d d cm I N,c� �'r- N f Z fri o � p Ql-�p d O I sY tCil I. 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Box 196650 Anchorage, AK 99519-6650 www.muni.ag/onsite (907) 343-7904 Soils Log - Percolation Test I" Performed For. rQ X1'1 RULre?� Date Performed: Legal Description: Lp'r rj C_-nl3-,P,PA? S�l�/ Township, Range, Section: Depth 2- 3- 4- 5- 6- 7- 8- 10- 11- 12- 13- 14- 15-1 .3-4- 5- 6- 7.6- 10-11-12- 13-14- 15- 16- 17- 18- 19- 20- 16- 17- 1s- 19- 20- fz Corr ROor .-4/a cc SLL.r - yL 0M(.A3&!, -GI L -C W1 t... wlit-t4 &"JZL ClzA-1�3 LL'rMO-S 01= SA -^TO A -N0 � Tt;Sf •ktlrJLr B D rToav O F %01-a: WAS GROUND WATER 1 N O ENCOUNTERED? Net Time Depth to Water s IF YES, AT WHAT DEPTH? L Depth to Water After U P Monitoring? E Date: Ss4a(' Site Plan N 't -S Reading Date Gross Time Net Time Depth to Water Net Drop l�:ly SxVcri (D p.00 -Z ^a • S 0:30 p.7O�r, 2 3� 2" -1'.tkS t : 30 a,.'-30 A-fl0 ia- Z r r 2:00 0:3o SS/" PERCOLATION RATE 6,2, (mnow.ch) PERO HOLE DIAMETER (o r r �n�c- ��,,, .r TESTRUNSETWEEN I -L FT AND �9 _FT COMMENTS r C �Z AYL-IL- J ' I }iOI.P - ty AAlcnyA F.FL 2}L- F UL.I Loi2 Ra[ - to rc 7 - PERFORMED PERFORMED BY: 6gi?oe-&a A. ty,%j I ' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUI LINES IN EFFECT ON THIS DATE. DATE: S 5C�P Ol�- Municipality of Anchorage Development services Department Building Safety Division y2 On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951 M650 www.muni.org/onsite (907) 343.7904 Soils Log - Percolation Test Performed For. _ `r('jm (Z. Vi,�r tJR _ Date Performed: S SOJpQ pa�. Legal Description: (_Dr S 5(j Township, Range, Section: 0 1 1 Depth �t�� U'/o2�atnres S % LIT 1'`.t V OF SANn ik 6a" L-tix�LlrtTL-�11��b �'. a / TeST COMMENTS WAS GROUNDWATER _ 1 T ENCOUNTERED? 'v V s IFYES,ATV"TDEPTH? L �ONC Depth to Water After D P Monttoring? E Date:.? � t'p Oy- $oTTOak O 14 O Vti Reading Date Gross Time Net Time Depth to Water Net Drop lSt'7o 75LVO 0:W 0:00 d_ 110:30 \ . SO 0130 1 I/ 'r /�-OD uJAcL�� Z4 11 T:Ga 2:00 0:3o 5� rr 1 r/8 t• 11,30 2:3a PERCOLATION RATE '7&,-f-(mnute•/nch) PERC HOLE DIAMETER (e b TESTRUN BETWEEN Ito FT AND r L FT -2- — Nott? &C4Lc42_n n-ip_ 2c- y4mms (wy- to tteir PERFORMED BY: _. �9130Q�i� e. L%h1 U3r'j I /L_-71_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GU ELINES IN EFFECT ON THIS DATE. DATE: S 5th 0`�- - Municipality of Anchorage Page I of 3 ' DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650" • Anchorage, Alaska 99519-6650, 0 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report. Permit Number: SW 920141 PID Number: 01-71432.42 EL12A8ETH + SIMON KAY Wastewater System: ❑ New 0Upgrade Address: ABSORPTION FIELD Exlsrwc, 7201 NORTH PARK DRIVE Phone 34S- 3S35 No. of Bedrooms. rooms. ❑ Deep Trench ❑ Shallow Trench ❑.Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: GPD/. Ft. Lot: Block: Subdivision: S Depth to pipe bottom from original grade: Gravel depth beneath pipe — GARRETSON Ft. FL Township:1 N Range: W 1 Section: 26 Fill added above original grade: Gravel length:_ 3 Ft. FL WELL: Ex1S7114G❑ New ❑ Upgrade Gravel width: Numberoflines: DistancetieMem Mr[ 1, Ft. Classification (Private, A,B,C): otal Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. SQ. Ft. " Driller. Drilled: Static Water Level: [ED)@Ie Installer: Date installed: CARL'S Ej�XMMrIKG `7 1192 Ft. Yield: Pump Set at: Casing Height Above Ground: I "�� TANK GPM Fl. Fl. SEPARATION DISTANCES WSeptic ❑ Holding ❑ S.T.E.P. To - Septic Absorption Lift Holding Pubficiprivate Manufacturer: Capacity in gallons: 1000 GAL From Tank Field Station Tank SawerLines ANC14. TANk Well 1 Of 1 120' _ _ 5 t Material: L ts: Number of Compartments: Number >/oc >100• — — >��' LIFT STATION N. er WatSurfacer Lot Sol 2S — _ , ^ • Strum gallons. Manufacturer Line bV Foundation Jr7 r 7S r- — • "Piemp on" level at: "Pump off" level at: High water alarm at: 0 Curtain Pump Make d Model Electrical Inspections performed by: Drain — — — - BENCH MARK Remarks: Aigcv S he Ik f "Itt Location and Description: r m l- 0l COIJCRETE :5LAR 130TTOM OF STEPS jejervvirivt ion Ir um bl4 ance bar.%d. _ Assumed E16vallibn: JDO.O F,k{}on TAChIIICQl ervims ENfi1111GEER'S SEAL w go,,.... r� ice: •. ' —�•% ftho Street Anchors a STa Inspections performed by: FLATTOP TECH SI/CS. Dates: 1st 7 1119 2 : 060 2nd__ - - - -- _*A Aaw Department of Health S fV' approval P PP �' %TH,OCE - F. AkOORE ; t a CE - 3589 Reviewed and approved by: Date: �' 4(�, ..Aai♦♦ t 72-013 (Rev. 991) MOA 25 t f permitIOo. S W 92 014•'7 page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Weill Inspection Report Legal Description: LOT S 6ARRETSON PID No.: 01'743242- EXISTING 1743242 EXISTING SOIL - ASS. TRE14CN � M.T. SCAL9 : l „= 40. NEW 1000)6. NEW TANK DougLE C.D. u \g- 71 ` hllfzl � CONCRETE 3 BDRM siAs %ov5E B01"M O StM Flattop Technical 14530 Echo St ee Anchorage, A1=k 9%1. NELI - - -- - -- 3� 0 NORTN PARK DR%vE 72-M3 A (RW. 991) MOA 25 a Permit No. SW '120 142 Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report . __ r � .�Ti. l I _.. .._ _ n1-7 L19242- 72-013 i92u2 72-013 A (Rw. WM) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920147 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:KAY ELIZABETH A & SIMON T OWNER ADDRESS:7201 NORTH PARK DR ANCHORAGE, ALASKA 99516 PARCEL ID:01743242 LEGAL DESCRIPTION: GARRETSON LT 5 LOT SIZE: 49420 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 DATE ISSUED: 6/23/92 EXPIRATION DATE: 6/23/93 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: V / Zy /4 Z •itL � DATE - 23 - �z WELL '3 SRM NOvSE A NORTH PARK DRIVE _ Fkdl* Technical Services 14530 Echo Street Anchorage, Alaska 99516 r, : •5 �; 9TH t'f..0 0 of ... •....:.4 THEODORE F. AROORE CE - 3589 . 4, WELL LOT 5 GARRETSoN !D SEPTIC TARK REPLACEriE„r SITE PLAN SCALE : 1 '�-L(O' NOTE : TVIS IS Nor DATE: U17. A SutvlUb DwM By" RAT ALL LoCATIOXf eor e�.e..urlu eTl� LoT 2 SGS UTILITY ESKT. L OT (o L OT S 1 LOT 4 I� 1 I � E%/1 TI NirM - rn - SOI F Isir. x T/{6NGH (;i W EXISTING loon 8 SEPTIC TAgk To 6F REPLACED New 6Le v. %Ew 0 TANk� SAME LetAT/oH I • vERrFr ��. g mien rvewA. I MCK i o WELL '3 SRM NOvSE A NORTH PARK DRIVE _ Fkdl* Technical Services 14530 Echo Street Anchorage, Alaska 99516 r, : •5 �; 9TH t'f..0 0 of ... •....:.4 THEODORE F. AROORE CE - 3589 . 4, WELL LOT 5 GARRETSoN !D SEPTIC TARK REPLACEriE„r SITE PLAN SCALE : 1 '�-L(O' NOTE : TVIS IS Nor DATE: U17. A SutvlUb DwM By" RAT ALL LoCATIOXf eor e�.e..urlu eTl� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Ttlapi n 1 2644720 ONSITE SEWAGE DISPOSAL SYSTEM ANDW WELL INSPECTION REPORT NAME�� L. I �. Cohsir%.Aor n� PHONE 333-$'1562 Ew ❑UPGRADE MAILING ADDRESS D 9-�i .mak Oso LEGAL DESCRIPTION LOT .S GCC r M4%o v, LOCATION Norte. �k�r1�� j� NO. OF BEDROOMS t7 DISTANCE TO: WellAbsorption (7S area Dwelling PERMIT NO. ??� —Y E Z u Manufacturer reef al c No. of compartments Liq. capacity in gallons /O D Inside length Width Liquid depth C Y JOZ DISTAN Well PERMIT NO. =Z FMorwffacturer Liquitrcapacity in gallons O m= DISTANCE TO: Well Foundation /7� Nearest lotjine PERMIT NO. p- _ -i a Z H Z W No. of lines Length each me S Total length of li Trench widtW Iz— inches Distance between lines Q F O Top of tile to finish grade Material file r J—inalrer Total effective absorption Length Depth PERMIT NO. Type of ai Crib diameter SOrlepth Total := on area DISTANCE TO: Well Building foundationJ. lot line J J pass Depth Driller Distance to lot line PERMIT NO. 023 Us Building foundation DISTANCE TO: Sewer line Septic tank Ilk Absorption ares(s) / OTHER PIPE MATERIALS C"+ -trvn in and oA of 4ctnk SOILTESTRATING g 5 INSTALLER he . l,• Cows%�ci:ot, The- REMARKS RpEM-�ARK,S ��eCorhd 6 Age rr s r 4 V 01 42 Q, IV D APPROVEDDATE LEGAL .10 l,f�/6/ KA r _ Dox 13009 STAN IL;tO'J-rz A SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF 821.00 PER FOOT. L &K. Coa4t ucc.- a PROPERTY OWNER Lt. � B k... Sub. &" /� LOCATION OF WELL SIT Belri►. C.tWL4 o� l aapan t j)&zUZW Gioak d. y, LOG: lAlELL 1 o S. 4 19-321 21 R cued 2-180' Bedtock. R 4 1 .ehoore a klateA 180 Tee t. _ gat th 140 I-eet 4 w teA duw AA cam na C.,,.".,.:lyd� Puma. 41watd be ine,tal l ed .ten. P 014 bo t ta+a. Coat q- Dq i,V ing: 821.00 PRA Pot X 180 Aa: 53780.00 Ro Change X02 OeU SeaA. T°WL COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 13780.00 THANK YOU VERY MUCH. BERNIE CLADT RAMPART DRILLING WORKS fiiat� 27 th, 1981 DATE -9� SERVICE CHARGE O F i y.% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNTS. r•1 1-1 r'; 1!_ T F' i'-3 TE':TION DEPAF:TMENT — HEALTH AND EN'.'IF:i!f-JMENTIAL �STREET: ANCHORAGE: AK- i?c 264-4720 20 ELL Hr-i c- �_,r-a I --• TE-.EL4F-= F'EF* 1.J:r•7 �� ter, =sE>..MIT FJO. = > _ '9_1504 _. � 4� _'47-1 E�� it -J I FACE PARKWAY FL I CRNT L. H. CONSTRUCTION, INC- _ -i iAF•.E FEET CATION NORTH PARK DRIVE LOT SIZE 4_?57_+c_� rAL LOT 5 GARF,ETSON Sr'G 'PE OF SOIL ABSORPTION SYSTEM I_ TRENCH I 1 SOIL EATING :_,� FTr'ER?= 3xIMUM NUMBER OF BEDROOMS S SYSTEM I_ : j otiz —. ;�,(r SOIL AB_OF•.F'TU7FJ ,� �E REQUIRED SIZE OF THE i^G , a.21 1:3EF=1%.'EL F• _r l= tiEF'TH= �� TRENCH DR OF THE THE LENGTH D I MENS I' BJH I SPTPIT L IS ��THE DISTANCE BET WEEN THE OR CE OFF I HE THE DEPTH OF A TRE O. GROUND AND THE BOTTOM OF THE EXCAVATION ( I N FEET) . OUTFALL PIPE THERE IS NO SET WIDTH FOR TRENCHES. GRAVEL BETWEEN THE THEE GRA EL DEPTH IS THE ETHE :SCAMINIMUM DEITHFEET H _ r c• I^E_ �V14=i f=1 EHLL�t�1� =:E�=!�_� I F:EC_ =•EF'T I �- TAr-dK — =ERMIT APPLICANT HAS THE RESPONSIBILITAGJRY ToCENTINFOTM THIS THI PDEPARTMEF,OFEF•.TYtJAND'JTHE', THE INSTALLATION I NSPEGT I HUMBER OF RESIDENCES THAT THE WELL WILL SERVE. I E E 0% — -- _ .? 22> I N cF'E�1T I nt-J: SEE EEU — TLJ BL INSFECTIOFJ AND APPROVAL BY THI_ ACKFILLING OF ANY SYSTEM WITHOUT FINA DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE EETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS MIN FEET FOR R E BETWE WELL OP•. 1547 TO 200 FEET FROM A PUBLIC WELL DEPENDING JOOUPON THE TYPE OF PUBLIC WELL. 25 FEET AND MINIMUM DISTANCE FROM A PRIMATE WELL TO A PRIVATE SEWER. LINE _ TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED ANC*MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION.SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE OTHER REGUIREMENTS'MAY APPLY. AVAILABLE TO INSURE PROPER INSTALLATION. F•EErl I T E>4F=o IEE=. C?E1- EMElFEE E I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SE FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCETEMTMAY'HREQUIRE ENLARGEMENT IF THE : I UNDERSTAND THAT THE ON—SITE =EWER RESIDENCE IS REMODELED TO INCLUDE MORE THAN = BEDROOMS. SIGNED:---------------------- APPLICANT L. H. CONSTRUCTION, I ON, INC. ISSUED BY 4'4. 0 .l'( SOILS LOG MUNICIPALITY OF ANCHORAGE • �.. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L Street, Anchorage, Alaska 99501 264.4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 1—. 16 , I (2ON J I R U T I ON( I /INC:.. DATE PERFORMED: LEGAL DESCRIPTION: f© f Gf�l'2.2 ETSL�N Sle�l DEPTH SLOPE SITE PLAN 4FEET1 OILEwAMC' 5, NO 7ANN60 1 SILTI OpTiffZdNC 2 3 .- p �% 4 S f L lM L LoLA ' 4 6 8 f �OGkti� o�-Y u�cLH �K 15 r " r Net Time 9- Net Drop f. oo 7723-6 c 0 12 0- 4. 30 30 10- 1011 16. 7 5 Jo:e:7 Lo 30 11'- 7.5 . 12 12 r 1A 2.0 13- 3 1 ;, vo0 10 14-- 14 15 16- 17- r P��• OP Al NJ is to": �:•' *; 49TH• .....,,, .•••• • e 191 N 225 E COMMENTS WAS GROUND WATERO L ENCOUNTERED? 0 P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop f. oo 7723-6 c 0 12 0- 4. 30 30 3 0 16. 7 5 Jo:e:7 Lo 30 t/ 7.5 . • 50 1A 2.0 1 ;, vo0 10 :u J D l6 q.. O 1• O. t`.i;•• JUNE 25s 1911 '. ,;�: f'00 2y0 30 .25 ,•'��ACOLATION RATE 1 0 (minutes/inch) >%\ "ONAL ��� TEST RUN BETWEEN .�L_ FT ANO _S FT \ ., t,' PERFORMED BY: 1 • aiall.(1,UAAL( CERTIFIED BY: ! • DATE: MUNIGPAUTY OF ANCHORAGE • DEPARTMENT OF HEALTHAI ALAN 3EIMCES Division of Environmental Services On -Site services Sac"" P.O. Box 196650 Anc horege, Alaska 99519-6650 349-4744 CERTIFICATE OF HEALTH AUTHORLTY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 11 df 1--q32-`f2 HAA. 49 1,500441 1. GENUM INFORMATION Complete legal description Z,10 r 5 �t�,ere! &�% bol U�%(,'�►� Location (site address or directions) 21 O I 4041-PPOIAt, Dff- I VE Property owner eU? 4a01k- k 4y Da pone 3 '33 -g 3$ I Mailing address C/O 6torge- W; /.Send 694 of&-earCT. Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2 NUMBEd OF BEDROOMfft !sr(3�IZls•L' [Ji IsurJ lo�iio'� p9e r Cr. 3. TYPE OF WATER SUPPLY: rA,t' cfgs04—" Individual well Community well Public water NATE: If community well system, provide written confirmation from State ADEC attest- Ing ttestIng to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site J-loldinsi Community on-site Public sewer NOTE If cornmuni y wastewater system, provide written confirmaUbn from State ADEC attesting to the legality and status of system. 5. 6. By: STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm rib 7a,� lirC Phone �3 Address Engineer 4j�P( , s .41 Ohet �`MH... •..•• • l+I. r rJ-P �� 49►�h .,, i •.. . ,1_ % UGsorgs R. Wilwn r; 1�`GiJ • CE - 7553 DHHS SIGNATURE �')O l` �� %% Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 111TIC, The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (Rev. 1/81) Back MOA 021 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l D # 4 -7- }i�4A # 7 7/ 1. GENERAL INFORMATION 1 Complete legal description _l _ Q7_ Location (site address or directions) 7001 1V6P_'r*PkP_H D21�r2. Property owner :►+ronl �I i3,t►rrG. �C.1Day phone s6 Z-3*52— Mailing address %201 IUG(?-T* �A-�yP�j1e- ��L q�j�o Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. L 72-025 (Rev. 191) From MOA 621 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm C L Se ty"s Phone Address !Nl 1"`w C T . 691heees signature 6. DHHS SIGNATURE Approved for _ bete ')oms. Date 33 3-8 391 dq1 � C•I• � \�` "WA ............. i� r rr , e forge R. Wilson, CE -75531 ,.' PpCfESS���Pt Disapproved. j V1• � conditional approval for -I ' bedrooms, with the following stipulations: Alit) NIi;S MUST !� PLACF/O //u IFN' F50Z(Jw f{F'CauM To CWE(L ii1_ (1US7 OF IN&7,' (•C.IIU(r /4 RaP ACEMEsy W145TE fit/r9�EiL Sy�f7L�yl lay- �Uo / R7Fit TNPrN 1r,,EJJ976 Additional Comments ffrc�_sizrl -- OF 1�t�i* 21t✓ 50211'f6 r.-i"E�LMINr� of MQru1TC'1?1"G l TNKu ���- tY4C 1 %tvG=�/,`cTFivt G/�Gcq[CNtS fftbH [v� Date a9 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rat. 1/91) Back MOA a21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Lcgal Dcscription:l--0'r 5, 4Alt-2ETSc1.1 '*310, Parcel 1. A. WELL DATA Well type Prat V ATE 117A, B. or C, attach ADEC letter. ADEC water system number N id Log present (Y/N) Date completed Z 7 MAY, ) q $ Total depth - ) QUO IC'r. Cased to 150 �. Casing height (above ground) Sanitary seal (Y/N) Wires property protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Z-7 9 S Static water level y' O l7T 2 (C?', Well production - g.p.m. 413 g.p.m. , „ ' WATER SAMPLE RESULTS: Coliform Q Nitrate/ 8 Other bacteria ) Date of sample: q I Z 9�2 7 / Collected by: �e e • `5 v >< B. SEPTIC/HOLDING TANK DATA . Date installed13 ULI 92 Tank size0U�o- Number of Compartments 2- Cleanouts (Y/M •, Foundation cleanout (Y"y Depression (YIN) t j I-ligh water alarm (Y/N) Date of Pumping ? O Sem Pumper Q O'er izooT !�� C. ABSORPTION FIELD DATA Date installed 1 Soil rating (g*p 71f or ft-/bdrm) 1 L S System type Q K49'" 11 Length' Sr 5 Width 1Z r.o-ssumuGravel thickness below pipe �5 Total depth 1 O r Effective absorption area -T0 *r11Monitoring Tube present(Y/1)- '�_ Depression over field (Y/N) Date of adequacy test ZZ Sent 9S Results (Pass/Fail) PRSS For bedrooms Fluid depth in absorption field before test (in.)-. 35 • Immediately afteR s^0al. water added (in.): Q Z Fluid depth 44 s g ins.) Minutes later: Absorption rate = > I 'o 0 O a p d Peroxide treatment (past 12 months) (Y/1) If yes, give date �i$ D. LIFT STATION W/ Date installed Manhole/Access (Y/N) High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump ori" level at* "Pump off' level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 1 d l On adjacent lots > 1 Dot Absorption field on lot 12 o' : On adjacent lots Public sewer main N 1Ae Public sewer manhole/cleanout �1 / Sewer /septic service line "f J� Lift station N/* SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S 7 Property line so-' Absorption field S t Water main/service line 1 /0' Surface water/drainage (�JJA Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation -7 5 t Water main/service line 1\J 1A Surface water *7 2 oot Driveway, parking/vehicle storage area 1 I Curtain drain N Wells on adjacent lots 7 2 d Property line F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review ofMunicip ,records "I stems are in conformance wi OA HAA guidelines in effect on this date. .(% F A �� �P too. g3,�11 Signature * ~'•,�yti�� 9k }1 / Engineer's Name 6q, 00 K-6010- UJ i �Se1�3 ..% Date ' �� J t or9. a. wnwn� CE - 7553 J,�44' HAA Fee $ �_ l �I /� Waiver Fee $ _ Date of Payment ly�•y5 Date of Payment Receipt Number Receipt Number Rev. 8/95 OSS: haa.wk.doc MUNICIPALITY OF ANCHORAGE Auk • Department of Health & Human Services MuMil 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 1. D. # C-) " i-1 - i1 Q HAA # "(:YC 1 QC�Q L - 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) 1. o f 5� 6CZ j1 Q Location (address or directions) (b) Property owner C�. d u Telephone: (home) 3 a_S Business Mailing Address (c) Lending Institution T0L XC etli tv4 - ---Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family`$ Number of bedrooms 3. WATER SUPPLY Individual Well 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 legailty and status. 72-025 (Rev- 7/88) Page 1 of 2 Z to Z abed MOVe (88/L way) SZO-Z[ �jom s,joeuibuo leuolssaload ayl ui suoissiwo ao sjaja aol alglsuodsai lou sl a6eaoyouV 10 Allledlolunyy a41 •panss! si aleoll1liao a ajolaq elep azAleue ao suoiloadsui lonpuoo lou op SHH(] to sa@Aoidw3 •sluawajinbei alels pue leaapal ulel.iao Alslles of japio ui suoilnlllsui 6ulpual j19y1 pue sawoy 10 siaseyo.(nd of Asalinoo a se siyl saop SHH(] 941 TNselV 10 91e1S ayl ul paaalsi69J jaeulbua leuoissaloid luapuadapui ue Aq anoge S ydoiBeied ui uaAIb suoileluesaidej 9y1 uodn Aluo paseq paleollliao lenojddV AluoylnV 4lleaH sanssi (SHH(]) saoiAJaS uewnH pue ylleaH 10 luawlieda(] ebejoyouV 10 (1!jedioiuny4 ayl NOI1f1V0 'T/bw O'OT sz uoz4pzqu9ouo3 wnwixpw vdg •T/bw g•S sT uOT4vaquaou0a 94PJgTN •AgzTTgpqTns panuiquoo sTTam aqq a.znsuT oq pawzojaad aq buTgsaq oTpoTaad gpgq pagsabbns sz -4I • quasaad sagpzgzu aap a.zauy • sapo(] TpdzoiunW pup agpgS bulgszxa sgaaw Agaadozd stuq aoj Tram aqs 6/' i :a-4oN leno.(dd)V leuoll!puo0 10 swja1 leuoll!puoO panoiddesla panoaddy ale(] /,q swoojpeq Jo; panojddV IVAOtlddV SHHO 9 I^ =i� n• °ro inn �� • •.s ns�w..• leaS s,Ja9ul6u3 .. .,-..e`: C' ! Z 1^62)'" 'Q %Yr 1.57 ale(] ssajppy auodalal owa13 to aweN-� ��5 -uolloedsul siyl to alep 9y1 uo loal;a ui suoileln6aj pue 'seoueulpio 'sapoo alelS pue lediownVI !le yllm aouelldwoo ut s! wags (s lesodslp jalemalsem jo/pue Alddns jalem al!s-uo ayl 'uoiloodsul pue uo!1e611s8nul (w woal pue sa111 a6ejoyouV 10 Al!ledlolunyy ay1 wa1 paulelgo uollewlolul ayl uo paseq leyl A1!J9A aaylinl ! •ulajay paleolpul ainlonils 10 adAl pue swooapaq 10 aagwnu 941 aol alenbape pue leuollounl 'ales si wals(s lesodslp jalemalsem jo/pue Alddns jalem al!s-uo 9y1 1241 smogs leno.iddV A11joy1nV 029H s1141 10 1(ol1e6l1sanul f.w legl Aj!JGA ! 'molaq umo14s alep uolleplleA a41 10 se pue olalay pax111e leas Aw Aq pa!1Raao sV NOI1VWUOANI aNV V1Va'HOliV3S 3-113'S1S31'SNO1103dSNl 0NIaIAOdd WHId ONId33NION3 "S MUNICIPALITY OF ANCHORAGE (MOA) • '� Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: 1-O7 5 &AR __E i SoN A. WELL DATA Well Classification 71j;,� ES If A, B, C, D.E.C. Approved (Y/N) WR Well Log Present (Y/N) Date Completed -! /;L7/BI Yield Total DepthIAO Cased to 30 Depth of Grouting No Nt= Static Water Level Pump Set At /70 t Casing Height Above Ground /02 `r Sanitary Seal on Casing (Y/N) 'y Electrical Wiring in Conduit (Y/N) Z Depression Around Wellhead (Y/N) N SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot /05 + ; On Adjoining Lots > I &CD To Nearest Edge of Absorption Field on Lot 120 + ; On Adjoining Lots > r To Nearest Public Sewer Line N/� To Nearest Public Sewer Cleanout/Manhole "A To Nearest Sewer Service Line on Lot i a5 Water Sample Collected by JS ;Date Water Sample Test Results E tel% 5•% PU /y�tra�e5 Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size I °'VV No. of Compartments Standpipes (Y/N) Q k¢ Air -tight Caps (Y/N)Foundation Cleanout (Y/N) Y— Depression over Tank (Y/N) Date Last Pumped 111-151`11 ALA idrqL Pumping/Maintenance Contact on File (Y/N) WA ;for N � Holding Tank High -Water Alarm (Y/N) Nle. Temporary Holding Tank Permit (Y/N) fq/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well IO S t To Building Foundation �% r To Property Line To Disposal Field To Water Main/Service Line > 30 ii To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev. 7/68) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata IL-5 Type of System Design L am+ Date Installed Ql/ Length of Field 5 Width of Field Depth of Field y� t Gravel Bed Thickness Square Feet of Absortion Area 5 Z O Statndpipes Present (Y/N) PLO Depression over Field (Y/N) N Date of Last Adequacy Test [B/4 I Results of Last Adequacy Test ass Fe r- —11y� SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well / .9-C) f To Property Line ! To Building Foundation Lot t_1 To Existing or Abandoned System on ; On Adjoining Lots > 3D To Water Main/Service Line > SO To Cutback (if present) K/74�� To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area > 05 6Le__1 Comments � `� 511 - P. 1 . I k4 to -Ile c� 1 D , dt--e-P c_1 16:"kN i o-(. �. <.0 r t%i 7/p 11 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) ""Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA-gujdp6 e� in effect on the date of this inspection. Signed S Company Date fl l8�a/ � Engineer's Seal MOA No. Receipt No. OS PY/ Date of Payment �� 70 Amount: $ Receipt No. - Waiver Fee: $ Date of Payment 72-026 (Rev 7i8e) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTi-KATE CF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date /!U r♦ - ty ( �- 1. GENERAL INFORMATION (a) Legal Description ; nciude lot, block, subd v sion, section. township, range) Location (address or directions) (b) Applicant Name-0.�,46� /:L t: C��)��elephone: Home Business Applicant Address _,' f if2,z (c) Applicant is ;check cnei: Lenc,ng institution ❑ : Owner: builder ❑ ; Buyer a. Other ❑ (explain); L'lV� (d) Lending Inst tut. cn �__ V ` ' � b �' r Telephone n Address (e) Real Es L:e Co ­ pan; and Arent IL Address Telephone (f) 1:°&i he HAA to t',e fc.low:ng address: f 2. TYPE OF RESIDENCE Single -Family 9 Mu!ti-Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well ® Community ❑ Public ❑ Note. If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite 29 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. M^^^ , -4 72-025 h1:841 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as ofthe 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 Fla He Techn(cal 5eYV'tcq Telephone 3 ys" /35 Address l �S��C Allclio,-may,' /P -s ?'?S_/ 15 Date 7e-, l y 3 D /QS 6. DHEP Approved for /�L-Pedroom Approved Disapp Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in oder to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Engineers Seal ,:0OF A4 qS e� �.P�E .'....., .Vr '*':'49rH..��''� e E ..................... ..........e....... . iH_CD^^_ F. ,'.CORE; CE- 504,: ¢,�AF / Date Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in oder to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. MUNICIPALITY OF ANCHORAGE DEFT. OF HEALTH $ MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION CTIO HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 / RECEIVEDLegal Description: L.4T S G-urrefsa Sob A. WELL DATA Well Classification Prwoc1-e If A, B, C, D.E.C. Approved (Y/N) N,/¢- Well Log Present (Y/N) i^ Date Completed S�2 !&J Yield Total Depth /B0 Cased to 35 Depth of Grouting N,,+ - Static Water Level 2S If Pump Set At ' 170' Casing Height Above Ground 17 Sanitary Seal on Casing (Y/N) r Electrical Wiring in Conduit (YiN) Separation Distances from Well: Y I Depression Around Wellhead (Y/N) To Septic Holding Tank on Lot 100 , On Adjoining Lots fOG' To Nearest Edge of Absorption Field on Lot 113' ✓ On Adjoining Lots 7 [OG To Nearest Public Sewer Line N, A. To Nearest Public Sewer CleanouVManhole N44 To Nearest Sewer Service Line on Lot N,A - Water Sample Collected by •`F/9 Date 7/ t9 /&S Water Sample Test Results Sct f-mdo! sZ ho coltfoep" Comments B. SEPTIC/HOLDING TANK DATA Date Installed 9 / 1*40 ( SizeOC-10 No. of Compartments Z Standpipes (Y/N) Y Air -tight Caps (Y/ N) Foundation Cleanout (Y/N) Depression over Tank (YiN) N Datelast Last PumpedQ`,;Z�;g-4° Pumping Maintenance Contract on File (YiN) Nelt• ;tor nt n Holding Tank High -Water Alarm (Y N) Nth. Temporary Holding Tank Permit (Y/N) N �• Separation Distances from Septic/Holding Tank: To Water -Supply Well 100 To Property Line > 50 To Water Main; Service Line N.R. Course Comments Page 1 of 2 To Building Foundation c To Disposal Field — To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata I65 L7 ' /B D R P7 Type of System Design /tin c- h Date Installed 9 / 19/.Q i '-� Length of Field Vs -1 _� Width of Field Depth of Field .-.0 Gravel Bed Thickness Square Feet of Absorption Area S O a ' Standpipes Present (Y/N) Depression over Field (Y/N) N Date of Last Adequacy Test Noel Ar tyca+r� !� 7/23l85� Results of Last Adequacy Test _7/23 /&S frsf C. &_r Saiuf-ac4r.4 ✓ Separation Distance from Absorption Field: To Water -Supply Well 03' To Building Foundation 7e- Lot ZLot N.A. To Water Main/Service Line N.e4. To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION N4. Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments To Property Line 30 ' To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) N,.4 - Dimensions Manhole/Access (Y/N) "Pump Off" Level at " Check Permitted Bedroom Rating Against HAA Request " Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that'' I havechecked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. s Signed ,!Y:, %!4-rK Date 7/30 /&,5 Company f(a�* %chri,ca( S;cc MOA No. 8S'052 Receipt No. 5? \� Date of Payment ,� Amount: $ `"vim .V Page 2 of 2 72-026 (11/84 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME c t, n 6. TYPE OF RESIDENCE NUMBER OF\BEDROOMS 14" DATE DATE DATE ` l/ ❑ MULTIPLE FAMILY Three ❑ Six `�•\ - I- 11 l \ 1� E l V INSPECTOR INSPECTOR INSPECTOR ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well \ MUNICIPALITY OF ANCHORAGE EN°✓ ._ _, . "- ;� \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 C. 1 i ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PR ERTYOWNER PHONE L MAILING ADDRESS �-' �-f PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTIO PHONE Arl C71 MA LING ADDRESS 4. REALTOR/AGENT PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION oto- ,�. STREET LOCATION c t, n 6. TYPE OF RESIDENCE NUMBER OF\BEDROOMS ❑ One ❑ Four ❑ Other [fid SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY ,tel INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM P: INDIVIDUAL/ON-SITE**YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ 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 El/ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE Ell- THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY Cd INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC 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 INSTALLER ❑Septic Tank or ❑I Holding Tank Size: /G1 rJ 0 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA s'S MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank ! 6 Absorption Area J O Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS D4 APPROVED FOR c BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accom any certificate) ❑ DISAPPROVED DATE BY