Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
JEWEL LAKE HEIGHTS #1 LT 36B
; Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION' - '~ P~O, Box 196650 · Anc,horage, Alaska 99519-6650 · Telephone: 343-4744 on'Site Wastewater D,sposal System and/or Well Inspection Report Permit Number: '~"t"] cl ~" C) C) ~1 D PID Number: ~/I Name: '~F_ ~ ~ ~~ Wastewater System: ~ New ~ Upgrade ~-~ ABSORPTION FIELD Phone: ~ -- ~ Nc. of B~ooms: ~ DeepTrench ~ Shallow Trench ~Bed D Mound ~ Other Soil Rating: ~ Total Depth [rom original grade: LEGAL DESCRIPTION .~--~ ~/sq. ~. Lot: ~ ~ ~ BIock:~/~' ~Subdiv~ion:~ ~' Depth to pipe~o~bot~om from original~grads: Ft. Gravel depth I,beneatho pipe Ft~ Township: ~/~ ~Range: ~1~ Section: ~/~ Fill added above origind grade: Gravellength: ~: g~ Gravel width: Number of lines', Oislance between lines; D New ~ Up Z5 ~ Z~ ,~/ Fl. ~ ~-~ Ft. ----~ Classifi~atlon (P~ ~ Cased To: Total absorption area~ Pipe maleriah ' ~ Ft. FL 1~4~ * SO. FL ~, Driller: . ~ Date Drilled: SlaticWaler Level: Installer:. ~ Ft. ~ GO~ Date i~st,lled: ~ . ~,u.. ,,. ~ %~.~.~ TANK 'SEPARATION DISTANCES ~ Septic a Holding ~S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From ~ Tank Field Station Tank SewerLines ~' ' ~ ~/~ I ~ / Material: .:.: Number of Co~rtments: Water ~ _ ~0 ~ I - ~ ~,¢- : ' ' Lot I+ / ~ ~ Line J~ -- ~ [~ I~ ~/~ ;;P~'mp on" level at: "Pump off' level al: High water a~rm at: . ~" CurtainDrain ~]~ ~./~ .~ ~J~ ~/~ Pump Make &Modelo~ ~ J Electrical Inspections performed ~,.0, Remarks: ~ Two ~~o~ ~s BENCH MARK ~ ~ Location and Description: ~,~n~rformedbv' ~~~ Dates'1st ~ ~g~ Department of Health and Human Services approval - · Reviewed and approved by: ~~/~ ~Date: 7-/¢- 7~ Permit No. . Legal Description: '%'~cf~'O°cl'¢') Page_ '~-. of .~ 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 W~II Inspection Report 'ID No.: ! / / / ¢0,,¢.-M4~.- ~F / · 'd CE-7953 / / / / / ~ ~ q...' .'~ ; .. ~ * ., .. ..,. - 0 o o~ 0 ~- F' m F~ /,' 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 PERMIT NUMBER:SW950090 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NAME:CATHCART WALLACE III & OWNER ADDRESS:8739 EMERALD ST ANCHORAGE, ALASKA 99502 PAGE 1 OF (UPGRADE) PERMIT ~t~ DATE ISSUED: 5/25/95/ EXPIRATION DATE: 5/25/96 PARCEL ID:01115224 LEGAL DESCRIPTION: JEWEL LAKE HEIGHTS #1 LT 36B LOT SIZE: 22751 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHOP~AGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM A SOILS TEST AND PERC. TEST OF THE PROPOSED RECEIVING SOIL. DATE: Alaska Water & Wastewater Services "Preserving The Last Frontier" May 22, 1995 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Attn: Dan Roth Ref: Resubmittal of Septic System Design for Lot 36 8, Jewel Lake Hts. Dear Dan: Attached is the application, site plan, and modified design drawings for the subject upgrade. Modifications were in response to your "pink sheet" remarks, dated 4/6/95. GENERAL: The existing system was designed for 4 bedrooms, and installed in November of 1981. It is now 15.5 years old and at the end of its useful life. The homeowners noted problems in the summer of 1994 with sponginess and light puddling on the grass over the top of the mound. If it were not for the fact that pressure distribution is being utilized~ it probably would have backed up into the house. Regardless, the intent is to replace it this spring. The limited width of the lot, the house location, and setback requirements from the well and Jewel Lake leaves virtually no room for a septic upgrade, consequently, we are proposing to reconstruct over the existing site. The intent is to remove the old steel septic tank (Greet) and lift station (Greer) and replace them with a 1500 gallon STEP tank from Anchorage Tank. The old drainrock and all "fouled" sand will be chlorinated, removed, and disposed on site. "Lake Otis'" gravel (sand filter material) will then be placed, so as to bring the sand mound to an elevation 4 foot above the groundwater level (monitored 5/22/95). Twelve inches of drainrock ~ill be installed below the pipe. Filter fabric will be placed over the top of the drainrock~ and insulation will be provided as necessary to ensure the ~ foot equivalent soil cover. BED DESIGN: As can be seen from reviewing the 1981 percolation test results, the soil "perked" at 20 minutes/inch. For a bed, this corresponds to an application rate of .4 gpd/ft2. Since the existing home has 4 bedrooms, the total design flow is 600 gpd. eased upon Telephone: (907)337-6179 · Fax: (907)338-3246 · 8471 Brookridge Drive · Anchorage, Alaska 99504 current design standards, 1500 rtz of absorption area would be required. The existing system has a drainrock area 500 ft2, and basal area gcc the sand mound of 1~75 ft2 The intent is to increase the bed area to the same dimensions as the basal area of the mound per your comments dated 4/8/95. This design will not be as conservative as M.O.A guidelines dictate, however, based upon the fact that the existing bed worked adequately for approximately 1S years, it is reasonable to assume that reconstructing to 275~ of its original size will provide an adequate system. I am open to any alternatives your department might suggest. DISINFECTION AND DISPOSAL OF CONTAMINATED ORAINROCK & SAND: The contractor will be instructed as follows: Expose the top of the existing bed. b. Pump the liquid out of the bed. Spread approximately 10 pounds of calcium hypochlorite (powdered chlorine - NTH) over the drainrock. Hose down the HTH so that it is absorbed into the drainrock/sand. Allow chlorinated drainrook to sit overnight~ Pump the remaining liquid from the bed the following day. Dig a hole at the toe of the existing mound~ Remove the disinfected sand and drainrock, placing it in the excavated hole. Put soil cover over the disinfected drainrock/sand. Contractor shall ensure that no contaminated water flows over the ground surface and into Jewel Lake. I am unaware of impose on adjacent wells, or septic systems. any question, ~lease call me a 357-6179~ Sincerely, ~/'/ Jef ., M.S. Owner/Consultant any impacts that this installation would If you have Kathcrt4.wps ,4UNICIPAL!TY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-850, Anchora~, Al~ka 9950:2 :~76-2221 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST LEGAL DESCRIPTION: 3 · '-' :~' L'..', : ',~ 8~ DATE PERFORMED: ~ //~) '~: /~ ~/~-~,/~ ~ SLOPE SITE PLAN ..... ~ ~-q--~. ~ ........ ~- ~ . u.,~ : ~ T - ~-- ' : -- ~.-~-- , J L WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross J.i Net II Depth tO Drop Net Reading Date T;me / Time Water N',~o,~_ ~c~' ~s~ F,~]) - .~.r,~-;.~o. ....... .:% *~ Z,L4 ~, ~: -( I ,.~ t .? I~- [ ~> / . ..~;. ',~ PERCO~TION RATE ~/(~ (minules/inch) TEST RUN BETWEEN FT AND PERFORMED 79-008 (7/76) CE-7953 Rick Mystrom, Mayor Muni pality of Anch6 age Department of Health and Human Services 825 %" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 July 20, 1995 Jeff Garness, P.E. Alaska Water and Wastewater Services 8471 Brookridge Drive Anchorage, Alaska 99504 Subject: Waiver Request for Lot 36B Jewel Lake Heights Subdivision Waiver Request ~WR950032, PID ~011-152-24, SW950090 Dear Mr. Garness: Your request for a waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 3 feet from the leachfield to the north property line. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljm WR~ ~~ PID# 011-152-24 Date Received: July 6, 1995 ~ MUNICIPALITY OF ANCHORAG~-/ Department of Health and Human Services On-site Services Section Waiver Review Worksheet HA# Permit # SW950090 Legal Description: Lot 36B Jewel Lake Heiqhts Subdivision #1 Engineer: Jeff Garness, P.E., Alaska Water & Wastewater Services 8471 Brookridqe DRive, Anchoraqe, Alaska 99504 Applicant: Wallace Cathcart III Waiver Requested: Lot line waiver of leachfield 3 feet from the north property line Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: X Waiver is NOT Granted: List Conditions or Reasons for above: Date: 7-- / ~-- ~-- Name of Reviewer Rec #: #01064/1261 Amount: $ 115.00 Date Paid: July 6. 1995 Alaska Water & Wastewater Services "Preserving The Last Frontier" July 5~ 1995 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic system as-builts for Lot 36 8~ Jewel Lake Hts., and lot line waiver. To whom it may concern: Attached is the as-built package for the subject upgrade. Comments regarding the need for a lot line waiver are as follows: Per the direction of DHHS the system was upgraded to a 25' X 55' bed system. Because of the existing mound configuration, the location of the stairs coming down from the deck, ect. it was necessary to place the bed only about 5 feet from the north property lire, and very close (see photographs) to the edge of the mound cutbank (50~ or greater slope). This slope was necessary so that the mound would not extend onto the neighbor's yard. In order to minimize the potential for wastewater to daylight out the cutbank, the vertical walls of the excavation was lined with visqueen in this area, add partially along the east side of the bed. Pictures are attached. I believe that the potential for wastewater to daylight is minimal. /he need for a lot line waiver was discussed with Dan Roth during construction, and verbally approved. /he only concern is the potential for daylighting. I believe those concerns have been adequately addressed. Increasing the bed dimensions from 10' X 50' to 25' X 55' also moved the bed closer to the edge of the mound cutbank along the east. In order to minimize the potential for wastewater to daylight from the new bed, excavated soil from the old bed site was placed at the toe of the old mound, creating a tiered earth barrier, which is greater than what existed with the old system. Daylighting out the side of Telephone: (907) 337-6179 · Fax: (907) 338-3246 · 8471 Brookridge Drive · Anchorage, Alaska 99504 the old mound Nas not a problem before, according to the homeoNners (waste~ater surfaced on top of the mound), consequently, it is reasonable to assume that the new bed Nill not daylight either. Again, see the enclosed photographs. If you have any question, please call me a 337-6179. Sincerely ,~ O~ne~rF{ onsultant KathcrtT.~ps Alaska Water & Wastewater Services "Preserving The Last Frontier" April 1, 1995 Munlclpa Y _ . ' ' lit of Anchorage .- xxOepartment of Health and Human.uervices cE. Te53 _, 'vision of Environmental Services On Site Services Section ~Box 196650 A~h~ge, Alaska 99519-6650 ReT: Se~O System Upgrade for Lot 56 B ~el Lake To ~,h~ it~a~ concern: Attached is ~e application, site ~lan and design drawings for th~ub~upgrade- Commen~¢are as follows: GENERAL: The ex'sting system ~as designed for 4 . . end of 'ts usef~ life. The homeowners noted %o~ fo~ the fact th pressure d~strzbut~on ~s be~_ng utilized, it probably ~ have backed uP into the house. Regardless, the intent replace ig this sprin¢. The limited midth of the he house location, and setback requirements from gh v~el! 7e~el Lake leaves virtually no room .for a sepgi( )grade, )nsequengly, ee are proposing go reconstruct the <istin9 The intent is ~ remove the old eel septic tank (Greet) and lift stat: (6reef?) and lace them with a 1500 gallon STEP ga from ~nchorage Tank The old drainrock and ail "fouled'] nd will be chlorinaged,~removed, and disposed on site- / _ake Otis" gravel (sand f~lter material) will then be pl~ ~d, so as to bring the sand ~und back up to its original ~r~ ~ and 12 inches of drai2q%o insta d (below the pip,~ per the original design (ll/81,~oopy attaohed)~ Filter abric will be placed over the top o~the ~rainrook, and i lation will bm provided as necessary t~enourm the foot uivalent soil cover- OE~VON = As can be seen from rmviewin~thm 1981 ~-= ' ~ - ~ , ~ ' " ~ ed' at 20 -colagzon test ~esults, che ~o~! p_~rk ad'~ lutes/inch- for a bed, this cot responds ~ to an 4 bedrooms, the total design rio ...... current design standards~ !500 ft~ of absorpt]~on ~-ea ~ld be required. ~ ' ~ ' ' ' ock area of ~00 ft The existing sysgem nas a oraznr' . basal area for the sand mound of 1S75 ftz~ It appears that Telephone: (907) 337-6179 · Fax: (907) 338-3246 · 8471 Brookridge Drive · Anchorage, Alaska 99504 the sand was treated as the accepting soil stra and assigned an application rate of 1.2 gpd/ftz. The )rich that the sand mound acts as the accepting seems reasonable based upon the sand depth, and the area t the base of the mound. Furthermore, the a ~n rate consistent with ADEC practice which the same rate beds and trenches (1.2 gpd/ft2 for SP In short, design is not as conservative dict~ however, based upon the fact adequately for approximatel, .e to assume that reconstruo ade~ system. I am open to departmeni might suggest. M.O.A guidelines the existing bed 13 years, it is it will provide an alternatives your DISINFE( The contr, AND DISPOSAL OF will be instr, D DRAINROCK & SAND: as follows: a. Ex he top of tl existing bed. b. Pump the iquid of the bed. Spread a hypochlorite drainrock. 10 pounds of calcium chlorine - HTH) over the d. Hose down ~o that it is absorbed into the d ra i n too k e. Allow~l,~ ed dr~ock to sit overnight. f.Pump ~he r~maining liqui~ from the bed the following day. R. dye. the disinfected sand nd drainrock, placing' ensure ~ha~ no con~a~na~e~a~ek flows over ~he / ground surface and into Jewel Lak% unaware of any ~mpaots that th~s inst~l!abion would e on adjacen~ wells, or septic systems. ~If you have ~/ question, please call me a ~61~. erely, Kathcrtl wps ,35 FOR SEPTIC US£~G£ ./ / / ./ ~(~I(' T~ fMAN 8'HA¥1ES I °vi 2525 I / / L£G£ttD ~ t~ropa~d/'Fbi/Lamt/bn: \ 'x \ / LO"r~ ~ u-OT '7 %6~ ~0'~' LoT ,'~y A. Garn~ £ /~ // l: / - ' ~N IVIUI~II..II'ALI I Y Ul- A~UHUH/~bl: ·~ DEPART~NT OF HEALTH & ENVIRONMENTAL PR~CTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~AILIN~ ILEGAL DESCRIPTION LOCATION - NO. OF BEDROOMS ~. Manu,acturer ~~ Mat~~ No. of compa.ments ~ ~Liq. capacity in gallons ........... Inside length Width Liquid depth ~ ~ DISTANCET~:~ t~eA Dwelling PERMITNO. OZ< Manufacturer {~//~ Material Liquld capacity in gallons Well/ ~ ~ Foundation~ I Nearest ~l°' ~e PERMIT NO. ~ DISTANCE TO~ ~~ ~ Top of tile to finish ~rade M~te[i~l beneath ~il~ Total ~ Lenglh :. ~h Depth PERMIT NO. ~<~ Typeofcri~/~ri~eter Cribdepth Total effective absorption area ~ ~ISTANCE TO~ W~I ~ Building foundation Nearest lot line ." CI~ I~ Dept~ Driller ~~ Dista~ot line_ PERMIT NO. ~ DISTANCE TO: Build~dation PIPE MATERIALS OTHER SOIL TEST RATING [:,EPF~RTMENT OF HEF~LTH F~N[.', EN',,,'IRONMENTF~L PROTECTION 825 '"L'" STREET, F~NCHORAGE., FIK. 9~]5F'~ F~ COP'T' MUST BE OBTF]INE[.', FROM THE FILES - DFITF] NOT F~',,,'FtILFtBLE IN THE COMPUTER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: ~. i.C%.~i~ ~c~, 4'_:/%. t:->~' ' ~ ~ 4 ~('f' ~:: V ~ , , -~ t- t , ---~-- DATE PEt:~FORMED: LfiGAL DESCRIPI-ION: :: t~'x-. .C>(,,:' ~:', . ,~ '..., ,'::'~, ~_ ~ .,::,b:.::. .~ (. : ';-] &~'f'~... PERCOLATION TEST / 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ENCOUNTERED? IE YES, AT WHAT DEPTH? Reading Date PE~COEATION ~ATE SLOPE SITE PLAN Gross Time Net ] Net Depth to Time Water (minutes/inch} 'TEST RUN BETWEEN FT AND c, -~ FY . . i, " . .... '~' mr &¢_.,c'f'/ ~, ,/', COMMENTS ';~ /4 .. ~ ~ . . t_ ~ , ~__:_ -. ~% Or>~-~. t .e.?r.¢>~_~~';,~', ( 6;v }~;5 ] -~ " ' x i ~ ' ~ ~ 5)c-'~ ' ' ~/~ .,-,. ,/'>/ k.~?IUNIC~PALITY OF ANCHORAGE '~.~) DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECi"tON [] PERCOLATION TEST Pouch ~-§50, Anc~ors~]~, Atsske 99502 :Z7G-2221 SOILS LOG - PERCOLATION TEST -::~:~ ~-- 1 2 3 5 6 SLOPE SITE PLAN Reading Date i I WASENCOUNTERED?GROUND WATER ~"-~ ~ L P ....... ~ "1-1-~ E! I i ~ I ! i DEPTH? Gross Net { Depthto Time Time ~ Water Drop I ~,--~ ~, ~ ,,.~ i ~ / / * ......... ,., ~.,~ PERCOLATION RATE [~L~ (minute~/inch) TEST RUN BETWEEN FT AND FT 72-008 (7/76) *3600 EA '~'~ ILDING SAFE'Fy ST TUDOR ROAD DIVI$10~i FOOTING ~ ELEo. TEMp. FOUNDATi~ [~ ELEc. SERV, CE ~ ~ ~L,G. UNDG~ ~ ~ ELEc. ROUGH NSULA TiO~ ~ ELEc. FINAL ~ --" GAS TEMp SHEETRoo, ~ ~ OTHER ~ MECH. FINAL )THER EXPLA 84-002 (Rev. 2/83) PLEASE CA-- / DO ~,~.~ _ ~'~.2.~~ FOR INSp / .J 0 / / C ITl © Z 0 E I i,q~ F- j -dU) rN, CZ jm o mo ~ q "ri Jl-'- tFq C -< ~'0 ~o~ y- -~>"0~oo...- .. ? -iE-z mo m ~m;0~mlm~_ ' 2, ~ d~o . . < "-~ '-I r'- --~ ~- ~>~-- ' ©0 OC ::5 :::a r- ~< ,-t,. ~ ~mr- .~-~ mm o~mmon' ~ z~ ~ ~ q~ o Frl _<. 0 MUNICIPALITY OF ~.NCHORAGE DEPT. OF ~.E~,LT'~ & ENViRONMENT,~,L pT~G'fECTION Ootten Drilling sou....A..o. ,20,, Jo..,..oAo WELL LO([ For: Wallace Cathcart III Location: Lot ~6B, Jewel Lake Hgts, Date completed: August, ]981 ~pth of well: 442' Static level: 71' from ground Pr~duction: 6 GPM from t15' Sandy silt Dark brown sandy sSlt, fluid Gray sandy silt, fluid Gray sandy clay Gray silty sand Gray clay Gray till Gray silty clay Gray till, fine grained Gray clay Fine grained gray till Gray till with water sand & gravel; weak Water sand; very weak & dirty Gray clay Water sand 0 ]6 76 95 1.36 t/+4 566 58? ~+09 16 76 95 156 14-4 258 529 555 366 587 ~+09 427 GEOLOGIC SOIL INVESTIGATION OF JEWEL LAKE HEIGHTS Report to: Mr. Ed O'Neil August, 1971 Prepared by: Hewitt V. Lounsbury & Associates 723 West Sixth Avenue Anchorage, Alaska 99501 INTRODUCTION This report is the result of our field soil investigation conducted August 18,.1971, on Jewel Lake Heights, Anchorage; Legal description: Lots 41 & 42 less W 132' of Lot 42, NW 1/4, SW 1/4, SE 1/4 and NE 1/4, SE 1/4 SW 1/4, Sec, 10, T12N, R4W, S.M., Alaska. Jewel Lake Heights is a newly proposed residential area being planned exclusive of public water or sewer utilities. Development of adequate san- itary facilities wi!! be the responsibility of the individual property owners. The sewage disposal will consist of conventional septic tanks draining into a seepage pit and/or drain field. The water source will be from individually drilled and cased wells. The purpose of the investigation was to define in detail the'soils con- ditions within the property and determine area requirements for proper sewer -seepage in the particular soil found. INVESTIGATION Our investigation was conducted at a l0 foot deep hole dug by backhoe at the location indicated on the enclosed plat. L~'-~ _~ Page 1 Investigation of road cuts in the area also'revealed the area soils to be consistant with the data found at the test hole. SUBSURFACE SOILS & CONDITIONS Specific types and depths of soils are shown on the enclosed test hole report. The soils were found to be basically sand and gravel strata with a cover 6f sand, clay and silt to a depth of about two feet. Below two. feet the soils are alternating layers of sand and sand-gravel mixed with a trace of silt. The last layer of sand and gravel was very damp but no ground water table was present. CONCLUSION From the information gathered'during our investigation we conclude that the soil conditions are well suited for the proposed residential development. On-site sewage disposal systems should consist of septic tanks with seepage pits or drain fields. The minimum seepage area requirements for individual systems based on 10 foot depth of pits will be 123 square feet per bedroom. If placing o.fthe sanitary system is done as indicated on the en- closed plat, and normal precautions are followed, the lot sizes proposed in the Jewel Lake Heights Subdivision are ample for the type of develop- ment'proposed. Page 2 Such data as: (1) (2) Septic tanks design requirements for Sub-surface disposal fields and seepage pits; Locations for disposal systems may be found in Ordinance No. 28-68; Section l, Chapter 9, Article VI, Sewage Disposal Practice, Greater Anchorage Area Borough, Alaska. Such data as: (1) Water wells, location, design and regulation (2) Pollution of ground water prohibited (3) Development of public (commercial) water supplies may be found in Chapter 2 (Sanitation Engineering) S~b-chaoter 1 (Water Supply) Regulations and Guide of the Alaska Department of Health and Welfare, Branch of Environmental Health. Respectfully submitted, HEWITT V. LOUNSBURY & ASSOCIATES Chas. W. Wainwright, ~e/chnician Page 3 ~ote Completed ~.'{(.;/~ /,~_~ 1~?.?/ Hewitt ~ Lounsbury ~' ssociates " -- ... s~ _ ~ N~ ~n~ineer~ ~ S~eyor~ ~otal Depth ~ject N~ An~horag% . Alaska' S~mp Iln~ DESCB IP TI ON Localz~n Notes 6 D~gramz SoIl ~o, colo~ texture, Vogol~tl'o n : Unless otl~?fwi'se noted dl ~e.Tw,'e. ~ u,'e token ~./'[.G'?~ Sy~ndgrd ,o?~otr,~,,~ c .... ~ ...... ...... . ...... ¥ · ,e $o DEPT. OF ENVIRONMENTAL CONSERVATION / SOUTHCENTRAL REGIONAL OFF/CE /33B DENALI STREET .]~l.lgl2st 21, 1973. / MACKAYBUILDING ROOM850 ANCHORAGE 9550! Mr. Roll Strickland Dept. of Environmental Quality Greater Anchorage Area Borough 3330 C Street Anchorage, Alaska 99503 SUBJECT: Water & Sewer Service Layout -Jewel Lake Heights Dear Rolf: This is being written with reference to a letter from James K. Dowling, Hewitt V. Lounsbury & Associates, which was writtmx to you on August 16, 1973 and carbon copied to this office. One pertinent comment that we would have with regard to his paragraph no. 3, is that of course there is no longer any such thing as a semi-public well. Any well drilled to serve more than one connection or to serve the public would be a public well and it would be required to meet the protective radii set out by the AlaskaAdministrative Code, Title 18, Ch. 72 -Wastewater Disposal. As I see it we would not be in any position to allow any waiver in this regard as requested by Mr. Dowling in the next to last paragraph of the August 16th letter. Yours truly, in g eer H E'WITT V. ~ ENG NEERS LOUNSBURY & PLANNERS ASSOCIATES SURVEYORS 723 W. 6th. Avenue, Anchorage, Ak. 99501 Tel. (907) 272.545'1 August 16, 1973 Rolf Strickland, R.S. Greater Anchorage Area Borough Dept. of Environmental Quality 3300 "C" Street Anchorage, Alaska 99503 Subject: Sewer and Water Service Layout Jewel Lake Heights Dear Rolf: As a follow-up to our previous conversations and verbal agreement made, the following stipulations have been agreed to by the developer: 1. If the developer sells Lot 5, Jewel Lake Heights, there will be a stipulation in the deed that no greater than a three bedroom house will be constructed. If the lot is sold. after the developer receives easement for seepage pit on Government L~t 36 (to the North of Lot 5), then a building will be allowed to be constructed. 2. If the developer does not acquire easement of Lot 36 stated in No. 1 above, no seepage pit will be allowed on Lot 5 and no building will be allowed. 3. That the developer reserves the right to drill a semi-public well in Emerald Circle to serve all the remaining lots. The ownership and maintenance of this well shall be by the owner of Lot 6. If option no. 3 is used, the developer agrees that the existing seepage pit located on Lot 8 will be moved to the most Southerly Southwest corner of the lot (100' from the shoreline of Jewel Lake) and that the house shall be connected to the semi-public well. On behalf of the developer, I wish to apply for waivers and/or approvals as needed per our conversations. Thank you for all the help you have been in the completion of these re- quirements. Very truly yours, owling, P.E. JKD/erq cc: Kyle Cherry, D.E.C. Ed O'Neill, Brown Jug • • *pt 8, •-__1!c_. Municipality of Anchorage ° On-Site Water and Wastewater Program <_ (907)343-7904 SAF ETY Certificate of On-Site Systems Approval Parcel I.D. 011-152-24 Expiration Date: q - ! -1 7 1. GENERAL INFORMATION Complete legal description Jewel Lake Heights #1 , Lot 36B Location (site address) 8739 Emerald Street Anchorage, AK 99502 Current Property owner(s) Mark and Renee Houle Day phone Mailing address 8739 Emerald Street Anchorage, AK 99502 Real Estate Agent Mary Stephens Day phone 748-5579 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well E Individual 0 Individual Water Storage ❑ Holding Tank Cl Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: -1 '7 .1,2._L c`.- ---n Date: 4e - 1-17 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 52-11..,- Waiver Fee $ Date of Payment (0-17-1co Date of Payment Receipt Number ©1(7 .S5- Receipt Number COSA# OSC- (Cot'I g7 Waiver# 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, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation_ Name of Firm Anderson Engineering Phone 522-7773 Address PO Box 240773, Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 5/30/2017 2 •"C OF,AC 4 6. DSD SIGNATURE System #1 Approved for Lf bedroomst A10 t J• OFA System #2 Approved for bedrooms yin ICH E�I� DERSOt:•nc� ' Disapproved ���•c� aff :- rU..i • �`� Conditional approval for bedrooms, with the following stipul47,dffori rES�S a�-'w \���X441 .1 Or ,`+rrG ON SITE ; WATER AND 'I"' WASTEWATER c PROCRAivI <•` 31 -1 Original Certificate Date: tCJ"'� The Municipality of Anchorage Development Services Division(DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r '. c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Jewel Lake Heights #1 , Lot 36B Parcel ID: 011-152-24 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 8/81 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 442 ft. Cased to >40 ft. Casing height(above ground) >12 in. FROM WELL LOG AT INSPECTION Date of test 8/81 9/19/16 Static water level 71 ft59.6 ft. Well production 6 g.p.m. 5.1 g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate ND mg/L Arsenic ND D ug/L Date of sample: 5/1/17 Collected by: Anderson Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/Steel Date installed 6/95 Tank size 1 '500 gal. Number of Compartments 3 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping 6/17/16 Pumper A Plus Home Services C. ABSORPTION FIELD DATA Date installed 6/95 Soil rating (g.p.d./ft2 orft2/bdrm) .3-.5 GPD/SF System type Bed Length 55 ft. Width 25-28.5 ft. Gravel below pipe 1 ft. Total depth 4 ft. Eff. absorption area 1,429ft? Monitoring tube Y Depression over field N Date of adequacy test 9/1 9/16 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 2/0 in. Water added 615 gal. New depth 510 in. Elapsed Time: 1,440 min. Final fluid depth 2/0 in. Absorption rate >= 600 g p d N Any rejuvenation treatment(past 12 mo.)(Y/N &type) If yes, give date D. LIFT STATION Date installed 6/95 Size in gallons 250 Manhole/Access (YIN) Y "Pump on"level at 44 in. "Pump off'level at 40 in. High water alarm level at 46 in. Datum Bottom of Tank Cycles tested 3 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main 776 Public sewer manhole/cleanout >10 Sewer/septic service line >25 Holding tank >75 Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: >5' >5' >5' Building foundation Property line Absorption field >10' 710 >100' Water main Water service line Surface water Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: ** >10' Property line 3 Building foundation >10 Water main Water Service line 71 Surface water 7100 Driveway, parking/vehicle storage >10' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS **See Waiver No. 950032. G. ENGINEER'S CERTIFICATION ,,��,a.�'+°� `6`� � 4L.,F'gC,9 c'8r I certify that 1 have determined through field inspections and ,p, �. f� �j. review of Municipal records that the above systems are in ow A. •• .�`'.�.;�'•:. , conformance with MOA COSA guidelines in effect on this date. a x :7t: - '�, *f;. Engineer's Printed Name Michael E. Anderson, P.E. ==', •"° '" Date 5/30/17 10. .• ;;;;o.'E MSCith,El E. a,j!'ERSOP!��' ra' • c 0 J,•. CE-4361 h S ,. COSA brown sheet 10-10-12.doc Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.a nchorage.ak.us (907) 343-7904 Parcel I.D. 011-152-24 1. GENERAL INFORMATION CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Expiraiion Date: <~ - ,/.~'-- Completelegaldescription JEWEL LAKE HEI~S SUBD~SION; LOT 36B ~ [ Lo~tion (site address or directions) 8759 EME~LD ~RE~ * ANCHO~GE, AK 99502 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address WALLY & KAY CATHCART Day phone 258-6240 8739 EMERALD STREET * ANCHORA(~E, AK 99502 Day phone Day phone Unles$otherw~erequested, HAA w~beheldbyDSD ~rp~k~. 2, NUMBER OFBEDROOMS: 4 3. TYPE OF W~,TER SUPPLY: Individual Well ' ' Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certi[icates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,175.00 at, or pdor to dosing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authodty Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I fur~her vedfy that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name ot Firm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD. sUFrE 2B * ANCHORAGE. AK 99504. Engineer's Printed Name JEI-I-I~EY A. GAYNESS, P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation. AWWC, Inc. attempted to provide a thorough. conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may tTuctuate dudng the year, and the water usage of the family being se~ed by the ayatem. These conditions are outside the control of the e valuator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report ia for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the fllowing stipulations: ~.U~' .' '. 'OiB ~: ON-SITE · - ,- . ~VA~-R~ND - m- : · WASTEWATER . . Attachments: HAA Checklist Septic System Advisory Well Flow Advisory ~'-. .. ~..~ Manitena~ce Agreements ~ u~t ..... ~,~ Supplemental Eng,neer's Reo~ ~'yj)~;;; ,~)~9' Other Original Certificate Date: ~- /_~--- 0 ~. Municipality of Anchorage Development Services Department BulldtnO Safety Division On-Site Water & Wastewater Program 470o South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (g07) 343-?~04 Legal Description: A. WELL DATA Well type ~IVAI[ IfA, B, or C provide PWSID# N/A Date completed 8//1981 Sanitary seal (Y/N) YES Total depth 4-42 ft. Cased to 40+ ft. FROM WELL LOG Date of test 8//1981 Static water level 71 .ft. Well production 6 g.p.m. WATER SAMPLE RESULTS: HEALTH AUTHORITY APPROVAL CHECKLIST JEWEL LAKE HEIGHTS S/Di LOT 36B -~ J Parcel ID: 011-152-24 Colifon~ ~ colonies/100 mi. Arsenic: ~ll,~ mg.~.. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL//$.T.E.P. Tank size 1500 gal. Number of Compartments 2 Foundation ctoanout (Y/N) ~ Depression over tank (Y/N) NO Date of pumping ~ Pumper. Well Log (Y/N) Wires pmperiy protected (Y/N). Casing height (above ground) AT INSPECTION 4//26//2002 56 ft. 6,9 g.p.m. C. ABSORPTION FIELD DATA Date installed Length 5,5 Total depth 4 Nitrate O, 'Z mgJL. Date of sample: 4//26/2002 Collected by: YES YES 12+ in. Other bacteria )'-' colonies/100 mi. AKWWC. INC. Date installed 6/1995 Claanouts (Y/N) YES High water alarm (Y/N) N/A ISAAC'S PUMPING BEL(~ ~3(ISTING ~ s/~e.5 Soil rating (~,p~,d,~oir ft~rodlTn).3--.S fl. W~ 25-28.5 .fl. fl. Eft. a~o~on ama 1429 ~= M~dng ~ ~ Date of adequacy test 4//26/2002 Fluid depth in absorption field before test 0 in. Elapsed Time: 0 min. Final fluid depth 0 Any rejuvenation treatment (past 12 mo.) (Y/N & type) Results (Pass/Fall) PASS Water added 1459gal. in. Absorption rate >= NONE KNOWN BED System type Grovel below pipe 1 ft. Depression over field, NO For 4 bedrooms New depth 0 in, 600+ g.p.d, If yes, give date. - D. LIFT STATION Date installed 6/1995 'Pump on' level at 42 in. Datum BOTI'OM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons 1500 "Pump off' level at 42 in. Cycles tested. 3 Manhole/Access (Y/N) YES High water alarm level at 46 in. Meets alarm & circuit requirements?. YES Septic tank/lift station on lot100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout Holding tank N/A · SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line Water main N//A Water service line N,/A Wells on adjacent lots . 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field 5'+ Surface water. 100'+ *SEE WNVER ~9500.~2 Water main N//A .Driveway, parking/vehicle storage Property line *5' Water service line N,/A Curtain drain NONE KNOWN F. COMMENTS Building foundation. 10'+ Surface water 100'+ Wells on adjacent lots 100'+ 25'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. C. ARNE:SS Date HAA Fee $ Date of Payment Re~ipt Number (Rev. 1~01) Waiver Fee $ Date of Payment Receipt Number cb. u~,dt ~ S 8t'51'38' [ 3.$'---c-.I ' ~'1~"1TM UI~ 4123 II l~ C~rl II 4.~'~ I x PARCEL CONTAINS: 22,751 -+ SO. FT. £ASE~£NTS OF R~'CORO, OIH[R THAN THOSE: ,~-IOWN ON RECORDED PLAT No. 78-l$ , ~E NOT SHOWN HEREON. 292.34' LEGEND IX~ CHNN UNK FENCE 40' AS BUILT NO CORNERS SET THIS DATE hereby certify thor I ho~ per(o,'med o Mortg(xjce'$ ~:~pectlo~ of the Ic~lowlng described property: LOT 368 JEWEL LAKE HEIGHTS ADD. NO.1 N~choro~e Recording Oisb'lct. Noska, and thai ~e im- ~ov~ls slluoted ~ereon ~e with~ the pr~uly I~ ~d do not overlap or ~ch ~ the w~rty I~ng ad~c~t thereto, ~ot ~ ~ov~ents ~ ~op- ~ty yn9 od~l ~ere[o ~crooch on the pr~es ~estl~ ~d ~al there ore no ~ss~ I~es ~ oth~ ~le easem~ts ~y e~c~t os ~coted hereon. ~ted ut ~age. ~o~a LO~NS~URY A-ASSOCIATES. INC. ~rve~s, [nglne~s, ~ Plonners 725 W. 6Ih Aw. AN~A~ A~A 272-~51 &SSL~LT 8@-1002. 01-26-89 GRID 2325 FIELD BOOK No. O2-1006 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) (b) Location (address or directions) Applicant Name Cc-,. ¢-~ c ~- Applicant Address f~) /oov'¢* Telephone: Home Applicant is (check one): Lending Institution []; Owner/builderj~; Buyer []; Other [] (explain); (c) (d) Lending Institution { % ./~/¢- ~ / Telephone Address (e) Real Estate Company and Agent /%///~ Address Telephone (f) Mail the HAA to the followTy~,~s: TYPE OF RESIDENCE Single-Family'S' Multi-Family [] Number of Bedrooms z~L Other WATER SUPPLY Individual Well ~ Community [] Public Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4, SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) E~NG NEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INF~ORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspeqtion. NameofFirm /~1-°/-7~'°'/'K1~' ~_.'-"-~_~ v- Telephone- ~-'~-~- ~-~-~ /I Address '~ ~' ~' --~ ~'~ ~' Date ~ WATER WELL NOTE: Thfs Health Authority Approval inspection merely certifies that the subject water well produced 150 gallons per bedroom or more on the date of testing and that certified laboratory tests showed no presence of. coliform bacteria in a sample of that water, No warantee or certification is expressed or implied concerning the long term adequacy or safety of the water supply. ON-SITE SEWAGE DISPOSAL SYSTEM NOTE: This Health Authority Approval inspection merely certifies that the subject on-site sewage disposal system accepted at least 150 gallons of water per bedroom on the date of testing as determined by methods approved by the Municipality of Anchorage Department of Health and Human Services. No warantee or certification is expressed or implied concerning the long term adequacy of the on-si]te sewage disposal system, Construction data reported on buried system components is from MOA files and was not verified during this inspection, Approved for /z~c~'r~ bedrooms by -~,~z_.~.. Approved -- ~X, Disappr°ve"8~- .. Condibona 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 order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: DI'PT. OF HEALTH & - ENVIRONMENTAL PROTECTION APR 2 WELL DATA Well Classification ~¢.~:,],~,, "/L, Kt/ -- f Frl/,r,~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) y D~.t,e. Completed/ .,L)~ ~-- ~ Yield Total Depth AC' d~- ,~' Cased to -~ ~, ~¢'~-V/Depth; Grouting ./~/~ Static Water Level ~ I {'L~¢_~ casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Pump Set At U/~ k,,,~ ~, Sanitary Seal on Casing (Y/N) Y Depression Around Wellhead (Y/N) ! i~O4 On Adjoining Lots To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results. Comments.'~i~ /OO/+ ; On Adjoining Lots /R¢., 4- To Nearest Public Sewer / To Nearest Sewer Service Line on Lot /¢¢ ;Date ?' /~ / //~J~-.';' SEPTIC/HOLDING TANK DATA Date Installed tl /~l Size Standpipes (Y/N) ~ Air-tight Caps (Y/N) Depression over Tank (Y/N) ~5/ Pu,mping/Maintenance Contract on File (Y/N) fV//~ ~Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ! To Property Line .'~O ~ To Water Main/Service Line ,5-0 Course i ~ O ~ No. of Compartments ¥ Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) ~//~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 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 Lot /g)/.4 To Water Main/Service Line Type of System Design Length of Field Depth of Field Gravel Bed Thickness / .~ '7 .~"~ (~['~¢,--S¢.~) Standpipes Present (Y/N) /V Date of Last Adequacy Test To Stream/Pond/Lake/or Major Drainage Course / To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) /U/.//~ To Driveway, Parking Area, or Vehicle Storage Area LIFT STATION / Date Installed _ /t /g~ Size in Gallons "Pump On" Level at High Water Alarm Level Tested for ~ Electrical Codes (Y/N) Comments Dimensions C"~ ,¢"~-'~ ~" Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that~..e/eqk~,~e.r~r conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~./'~/,~,//~,~~ate '"~/,2../,~ -~' .~'~' .~' .'F_.,~ $ ~, J~ ~'e~- ~-', ~. ¢'~ Company /UJ'~C~,¢c-.*TL~¢/~ MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 APPLIC.~ IT FILLS OUT UPPER HAL' ONLY Buyer · ~%~.~ Address Zip Code Lending Institution F I ¢ ~>+ ~ ~'%q ~ i-_%f'k~ ~,-J'~b ¢~ C% ( ~. i%~O ~'% Phone -' ~ Phone Realty Co. & Agent Address Zip Code Legal Description L~ street Locati~ ~-- Type of Resi~nce ~fngle Family ~ Multiple Family No. of Bedroo~ ~ Other Water Supply ~ndividual r'c' ~ A~ACH WELL LOG. A w¢l log is required for all wells drilled since June 1975. ~ ~¢)o~ For wells drilled prior to that date, give well depth (attach log if available). Community Sewer Disposal ~ividual - ~1~ ~ Public Utility When Connected to Public Utility: O Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date ~/ Inspector Inspector Inspector Inspector Field Notes: MUNICIPALITY OF ANCHORAGE DSPT. OF HEALTH ENVIRONMENTAL pROTECTION .~'~ {lie ~ o 1983 ~ "CONDITIONS OF APPROVAL PPROVED BEDROOMS ( ) DISAP~OVED ~ //~o Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ~ 72-023 MEMORANDUM DATE: June 22, 1983 TO: F'ROM: Buchholz, Pratt, Kennedy, Lindquist, Oswalt, J. Lynn, Willis, Roberts Environmental Engineering Manager SUBJECT: Electrical Permits/Inspections - Ail Lift Stations During. a recent inspection(by a private sector engineer) of an elevated mound system with a lift station, the inspecting engineer found what he thought to be numerous deviations from the electrical code. Mr. Joe Jameson, the MOA Electrical Inspector, was contacted regarding this specific case, and he advised that an electrical permit and subsequent electrical inspection should be obtained on every lift station located within that portion of the Municipality included under the MOA Building Codes. It will therefore be DHEP policy, from this date hence, that the final inspection or any system utilizing a lift station must ~ include evidence that an electrical inspection has been made and approved. The private sector engineer must also, when they are involved in health authority approval inspections/testing, inspect the lift station to assure that it is in proper working condition and the wiring thereof is in accordance with the applicable electrical code. Robert W. Robinson Environmental Engineering Manager ~qR/ljw 91-010 (4/76) L.._~ ! L~,~'~ RECEIVED INSPECTION APPOINTMENTS TI,ME TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF I!~:ALTi! & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~I~Vh~ONMENT;\L P2OTECTI©N S2E L Street- Anchorage, Alaska 99§01 OCT 2 ENVI RONN]ENTAL SANITATION DIVISION Telephone 264-4720 RFCJ J¥ D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FAClLITI DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. I PHONE 1, PROPERTY OWNER MAILING ADDRESS " PHONE PROPERTY RESIDENT (If different from above) '~'"'-~ PHONE 2, BUYER MAILING ADDRESS 3, LENDING INSTITUTION I PHONE MAILING ADDRESS I PHONE 4, REALTOR/AGENT MAI LIN G'"A D DR ESS 5. LEGAL DESCRIPTION STREET LOCATION 6; TYPE OF RESIDENCE / [~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OFtBEDROO~8 [] One ~ Four [] Two [] Five [] Three [] Six [] Other 7. WATER S~I~PLY [~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach log if available.) , 8. SEWAGE DISPOSAL SYSTEM ~ INDIVI DUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTIONi~=EE MUST ACCOMPANY E,~FL-~EST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SiX [] OTHER 2, WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM E] I NDIVl DUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or []Holding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line 5. COMMENTS DATE [~APPROVEDFOR ¢ BEDROOMS [] CONDITlONALAPPROVAL(lettermustaccompanycertificate [] DISAPPROVED 72-010 (Rev. 6/79)